Risk factors for death and illness severity in vaccinated versus unvaccinated COVID-2019 inpatients: a retrospective cohort study

ABSTRACT Objective: To determine the clinical profile of COVID-19 inpatients who were vaccinated prior to hospitalization and to compare the risk factors for death and the 28-day survival rate of between those inpatients vaccinated with one, two, or three doses and unvaccinated COVID-19 inpatients. Methods: This was a retrospective observational cohort study involving COVID-19 patients admitted to a referral hospital in the city of Recife, Brazil, between July of 2020 and June of 2022. Results: The sample comprised 1,921 inpatients, 996 of whom (50.8%) were vaccinated prior to hospitalization. After adjusting the mortality risk for vaccinated patients, those undergoing invasive mechanical ventilation (IMV) had the highest mortality risk (adjusted OR [aOR] = 7.4; 95% CI, 3.8-14.1; p 80 years of age (aOR = 7.3; 95% CI, 3.4-15.4; p < 0.001), and those needing vasopressors (aOR = 5.6; 95% CI, 2.9-10.9; p < 0.001). After adjusting the mortality risk for all patients, having received three vaccine doses (aOR = 0.06; 95% CI, 0.03-0.11; p < 0.001) was the most important protective factor against death. There were progressive benefits of vaccination, reducing the frequency of ICU admissions, use for IMV, and death (respectively, from 44.9%, 39.0% and 39.9% after the first dose to 16.7%, 6.2% and 4.4% after the third dose), as well as significant improvements in survival after each subsequent dose (p < 0.001). Conclusions: Vaccines were effective in reducing illness severity and death in this cohort of COVID-19 inpatients, and the administration of additional doses conferred them with accumulative vaccine protection

GREEN FORAGE FIBROUS FRACTIONS AND THREE PEARL MILLET GENOTYPES SILAGE [Pennisetum glaucum (L). R. BR.] IN DIFFERENT FERMENTATION PERIODS

It was determined the fibrous fraction (NDF, ADF, cellulose, hemicellulose and lignin) in green forage and pearl millet silages (CMS-1, BRS-1501 and BN-2). The genotypes were planted at Embrapa Milho e Sorgo, ensiled in PVC laboratory silos and evaluated after one, three, five, seven, 14, 28 and 56 days. NDF values ranged from 46.96 to 62.43% and ADF from 27.86 to 34.56%. Hemicellulose contents in green forage were significantly lower than in silages after 56 days ensiling. The NDF, ADF, cellulose, hemicellulose and lignin mean values in green forages and silages after 56 days of fermentation were 60.76 and 51.8%, 33.58 and 31.54%, 29.25 and 27.66%, 27.18 and 20.26%; 4.33 and 3.89%, respectively. The NDF and ADF average values found in this work were lower than those reported in other studies. The hemicellulose fraction contributed as an additional subtract source to the fermentation process. BRS-1501 genotype showed the lower NDF and ADF contents

Geriatric oncology: concepts, trends and challenges

In Brazil, the elderly population presents the fastest growing segment in proportional terms and according to World Health Organization, the global impact of cancer more than doubled in 30 years. National estimates of 2010, which will be also valid for 2011, show the occurrence of 489,270 new cases. Although the link between cancer and senectude be complex and fundamental questions remain unanswered, it is expected that these indicators will increase even more with the progressive aging of the population. In this context, it is necessary to develop an interaction between oncology and geriatrics, in order to promote the evaluation of elderly patients with cancer individually, in its multiple dimensions, focusing on their comorbidities, functional status, level of dependence and the physiological factors related to senescence that limit treatment to develop the best therapeutic regimen for each patient in an interdisciplinary way, ensuring equal access to quality care.</p

Metabolismo de cálcio e fósforo em ovinos

Realizou-se com essa revisão descrever o metabolismo de cálcio e fósforo em ovinos assim como discutir os fatores inerentes a absorção desses minerais. A importância desse estudo se deve ao aumento crescente das necessidades desses minerais na dieta devido ao melhoramento genético dos animais, à reprodução de animais jovens, às deficiências de fósforo, a crescente incidência de partos duplos, ao aumento do uso de dietas com alta densidade energética e à incidência de hipocalcemia recorrente no rebanho ovino nacional. A taxa de absorção de cálcio a partir do intestino aumenta de forma constante durante toda a gestação, entretanto é insuficiente para atender aos requisitos da ovelha no final da gestação e início de lactação. Pesquisas relacionadas ao aproveitamento de P por ruminantes bem como as fontes dietéticas desse elemento ainda devem ser elaboradas devido ao elevado custo desse mineral na mistura mineral

QUALITY AND NUTRITIONAL VALUE OF SILAGES OF THREE SORGHUM (Sorghum bicolor L.) HYBRIDS HARVESTED IN DIFFERENT MATURATION STAGES

Two dry stem intermediate height sorghum hybrids and a moist stem high height hybrid were ensiled in eight growing stages after bloom. Twenty four treatments were made with three repetitions each, being the three hybrids (AG2006 and BR700 – dry stem, and BR601 moist stem) ensiled in eight growing stages. Silages were evaluated for dry matter (DM), crude protein (CP), DM losses, silage density, pH, ammoniacal nitrogen (N-NH3), neutral detergent fiber (NDF), hemicellulose, cellulose and lignin, IVDMD and total phenols percentages. SNK test was used with a 3 x 8 random factorial design. DM production increased until fifth stage. DM values increased with growth and the best level occurred between 21st and 28th days after bloom. CP and fibrous fractions were reduced with growth. pH, N-NH3 and DM losses were low for all silages. Hybrids lignin and IVDMD varied in erratic ways. Silages were evaluated by Prussian blue assay to total phenols and tannins were detected in all of them. There were no negative correlations between tannins and IVDMD. AG2006 was better than the others two hybrids for some features, and IVDM of BR601, a forage sorghum, was better than BR700, an intermediate height sorghum

CHEMICAL COMPOSITION AND PROFILE OF FERMENTATION OF THE SILAGES OF FIVE SORGHUM HYBRIDS (Sorghum bicolor x Sorghum sudanense)

Five hybrids of Sorghum bicolor x Sorghum sudanense were analyzed asgreen forage (P0) and silage with 7 (P1), 14 (P2), 28 (P3) and 56 (P4) days after ensiling. The hybrids were cultivated at CNPMS/EMBRAPA and ensiled 60 days after planting, in PVC silos, with four repetitions per period. There were determinations of dry matter (DM), pH values and contents of alcohol soluble carbohydrates (CHO’s), crude protein (CP), amoniacal nitrogen (N-NH3/NT), coefficients of IVDMD and cell wall components. A randomized sample design was used in a 5 x 5 factorial arrangement. The analyzed materials showed low DM and CP contents and IVDDM coefficients. All hybrids had similar values for fiber ration. An increase of total phenol contents with ensiling was observed, and those showed negative correlation with IVDDM. It was concluded that DM contents of the studied ensilages were unsatisfactory but, despite the high humidity, the ensilages presented good fermentative standards. As for the quality of the voluminous one, the ensilages were considered of average quality due to the low CP content

Cancer patients, emergencies service and provision of palliative care

SUMMARY Objective: To describe the clinical and sociodemographic profile of cancer patients admitted to the Emergency Center for High Complexity Oncologic Assistance, observing the coverage of palliative and home care. Method: Cross sectional study including adult cancer patients admitted to the emergency service (September-December/2011) with a minimum length of hospital stay of two hours. Student&#8217;s t-test and Pearson chi-square test were used to compare the means. Results: 191 patients were enrolled, 47.6% elderly, 64.4% women, 75.4% from the city of Recife and greater area. The symptom prevalent at admission was pain (46.6%). 4.2% of patients were linked to palliative care and 2.1% to home care. The most prevalent cancers: cervix (18.3%), breast (13.6%) and prostate (10.5%); 70.7% were in advanced stages (IV, 47.1%); 39.4% without any cancer therapy. Conclusion: Patients sought the emergency service on account of pain, probably due to the incipient coverage of palliative and home care. These actions should be included to oncologic therapy as soon as possible to minimize the suffering of the patient/family and integrate the skills of oncologists and emergency professionals