Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Conta hospitalar : análise crítica das definições de diária e taxa de sala cirúrgica

Trata do problema da imprecisão nas definições de diária hospitalar e de taxa de sala cirúrgica praticadas pelos hospitais no Brasil. Aponta a necessidade de se definir, uniforme e interinstitucionalmente, tais termos, em razão de aspectos administrativos, econômicos e jurídicos. Infere a possibilidade de melhoria da competitividade e da eficiência no setor saúd

The potential effects of untreated sleep-related breathing disorders on neuropathic pain, spasticity, and cardiovascular dysfunction following spinal cord injury: A cross-sectional prospective study protocol.

IntroductionSleep-related breathing disorders (SRBDs), neuropathic pain, spasticity and cardiovascular autonomic dysfunction are common after spinal cord injury (SCI). Prior studies suggest that systemic inflammation following SCI may be implicated in the development of neuropathic pain, spasticity and cardiovascular dysfunction. Given that SRBDs also cause a systemic inflammatory response, we hypothesized that individuals with SCI who develop more severe SRBDs would experience more intense neuropathic pain, more severe spasticity and more significant cardiovascular autonomic dysfunction.MethodsThis cross-sectional prospective study will explore the previously understudied hypothesis that SRBDs are associated with increased neuropathic pain, spasticity, and cardiovascular autonomic dysfunction in adult individuals with low-cervical/high-thoracic (injury level at C5 to T6), complete/incomplete (ASIA Impairment Scale A, B, C or D) SCI.DiscussionTo our knowledge, no prior study has addressed this clinically relevant question on whether the degree of SRBDs affects the intensity of neuropathic pain, spasticity, and cardiovascular autonomic dysfunction in individuals with SCI. We anticipate that the results of this original study will provide key information for a future clinical trial on the use of continuous positive airway pressure (CPAP) therapy for moderate-to-severe SRBDs, which may better control neuropathic pain, spasticity, and cardiovascular autonomic dysfunction among individuals with SCI.Trial registrationThe research protocol for this study was registered in the ClinicalTrials.gov website (NCT05687097). https://clinicaltrials.gov/ct2/show/NCT05687097

Substâncias húmicas de turfa: estudo dos parâmetros que influenciam no processo de extração alcalina Humic substances of peat: study of the parameters that influence on the process of alkaline e extraction

<abstract language="eng">This study reports the parameters which influence on extraction of humic substances (HS) from peat. The yield, organic and inorganic contend, E4/E6 ratio and elemental composition (C,H,N) of the extracted HS have been determined. The functional groups were identified by Fourier-transform infrared espectroscopy. The results showed influence of the extractor type, concentration, time, temperature and granular texture of the sample in the extraction. This work contributes to better understanding of the extraction process showing the necessity of the standard method to extract humic substances from soi

An alternative methodology for the extraction of humic substances from organic soils

The present study reports on an alternative methodology for the extraction of Humic Substances (HS) from the soil. The extractions were carried out with 0.5 M KOH for 3 h, at a ratio of 1:20 (m/v) under a nitrogen atmosphere. The HS were separated by centrifugation based on their solubility in alcaline solution. This methodology was compared with the usual procedure in three different soil samples and in one sample from vermicompost. The yield, E4/E6 ratio, ash content, and the elemental composition (C, H, O, N) of the extracted HS have been determined. The functional groups were identified by Fourier-transform infrared spectroscopy. This novel procedure adds a new perspective to the extraction of humic substances due to the short time and high performance of the extraction in relation to the usual procedure