Comportamentos de proteção contra a infecção por SARS-CoV-2: um estudo de coorte

INTRODUÇÃO: Nós elaboramos um estudo prospectivo com o objetivo de avaliar fatores (adesão ao distanciamento social, uso de EPI’s, etc.) que poderiam ser determinantes no desenvolvimento da COVID-19 que poderá subsidiar o desenvolvimento de estratégias de saúde eficazes no combate da infecção no município de Passos - Minas Gerais, Brasil, seja em ambientes hospitalar ou não-hospitalar. MÉTODOS: Trata-se de um estudo coorte longitudinal onde foram incluídos 343 indivíduos da população que foram selecionados aleatoriamente por conglomerado. Os indivíduos selecionados responderam a um questionário relacionado às características clínicas, medidas preventivas, comorbidades e uso de medicamentos. Na ocasião foi realizado teste rápido nos indivíduos para detecção de anticorpos IgG e IgM. O tempo médio de acompanhamento foi de seis meses e, durante o acompanhamento, manteve-se contato telefônico a cada duas semanas. Ao final do seguimento, novo teste sorológico foi realizado e calculado o risco associado à presença de fatores de risco e à incidência da doença. RESULTADOS: Verificamos que 27,3% dos participantes que se infectaram no seguimento faziam uso ivermectina e hidroxicloroquina como forma de prevenção, enquanto nós não infectados, 11,3% usavam esses medicamentos. Para os indivíduos que apresentaram a doença durante o seguimento 21,2% relataram respeitar o isolamento social, 27,3% relataram que saíram para trabalhar e 42,14% relataram que frequentaram ambientes hospitalares. Entre os participantes que tiveram a infecção, 12,1% relataram contato apenas com familiares, 9,1% com familiares e colegas de trabalho e 75,8% com profissionais de saúde. CONCLUSÕES: Este estudo forneceu dados epidemiológicos de indivíduos infectados pelo COVID-19, que podem contribuir com o sistema de saúde no estabelecimento de medidas preventivas.INTRODUCTION: We designed a prospective study aiming to assess factors (adherence to social distancing, use of PPE, etc.) that could be determinants in the development of COVID-19 that may subsidize the development of effective health strategies to combat the infection in the municipality of Passos - Minas Gerais, Brazil, whether in the hospital or non-hospital settings. METHODS: This is a longitudinal cohort study where 343 individuals from the population were included and randomly selected by clusters. The selected individuals answered a questionnaire related to clinical characteristics, preventive measures, comorbidities, and medication use. A rapid test was performed on the individuals to detect IgG and IgM antibodies. The average follow-up period was six months, and during the follow-up, telephone contact was maintained every two weeks. At the end of the follow-up, a new serological test was performed, and the risk associated with risk factors and disease incidence was calculated. RESULTS: We found that 27.3% of patients who became infected during follow-up were using ivermectin and hydroxychloroquine as a means of prevention, while in non-infected patients, 11.3% used these drugs. (p = 0.024). For patients who had the disease during follow-up, 21.2% reported respecting social isolation, 27.3% reported leaving for work, and 42.14% reported having attended hospital environments (p = 0.004). Among the participants who had the infection, 12.1% reported contact only with family members, 9.1% with family members and co-workers, and 75.8% with health professionals (p = 0.001). CONCLUSIONS: This study provided epidemiological data on patients infected with COVID-19, which can contribute to the health system's establishment of preventive measures

NEOTROPICAL CARNIVORES: a data set on carnivore distribution in the Neotropics

Mammalian carnivores are considered a key group in maintaining ecological health and can indicate potential ecological integrity in landscapes where they occur. Carnivores also hold high conservation value and their habitat requirements can guide management and conservation plans. The order Carnivora has 84 species from 8 families in the Neotropical region: Canidae; Felidae; Mephitidae; Mustelidae; Otariidae; Phocidae; Procyonidae; and Ursidae. Herein, we include published and unpublished data on native terrestrial Neotropical carnivores (Canidae; Felidae; Mephitidae; Mustelidae; Procyonidae; and Ursidae). NEOTROPICAL CARNIVORES is a publicly available data set that includes 99,605 data entries from 35,511 unique georeferenced coordinates. Detection/non-detection and quantitative data were obtained from 1818 to 2018 by researchers, governmental agencies, non-governmental organizations, and private consultants. Data were collected using several methods including camera trapping, museum collections, roadkill, line transect, and opportunistic records. Literature (peer-reviewed and grey literature) from Portuguese, Spanish and English were incorporated in this compilation. Most of the data set consists of detection data entries (n = 79,343; 79.7%) but also includes non-detection data (n = 20,262; 20.3%). Of those, 43.3% also include count data (n = 43,151). The information available in NEOTROPICAL CARNIVORES will contribute to macroecological, ecological, and conservation questions in multiple spatio-temporal perspectives. As carnivores play key roles in trophic interactions, a better understanding of their distribution and habitat requirements are essential to establish conservation management plans and safeguard the future ecological health of Neotropical ecosystems. Our data paper, combined with other large-scale data sets, has great potential to clarify species distribution and related ecological processes within the Neotropics. There are no copyright restrictions and no restriction for using data from this data paper, as long as the data paper is cited as the source of the information used. We also request that users inform us of how they intend to use the data

Effect of Intraoperative High Positive End-Expiratory Pressure (PEEP) With Recruitment Maneuvers vs Low PEEP on Postoperative Pulmonary Complications in Obese Patients: A Randomized Clinical Trial (vol 321, pg 2292, 2019)

status: publishe

Effect of Intraoperative High Positive End-Expiratory Pressure (PEEP) With Recruitment Maneuvers vs Low PEEP on Postoperative Pulmonary Complications in Obese Patients: A Randomized Clinical Trial.

IMPORTANCE An intraoperative higher level of positive end-expiratory positive pressure (PEEP) with alveolar recruitment maneuvers improves respiratory function in obese patients undergoing surgery, but the effect on clinical outcomes is uncertain

Effect of intraoperative high Positive End-Expiratory Pressure (PEEP) with recruitment maneuvers vs low PEEP on postoperative pulmonary complications in obese patients : a randomized clinical trial

IMPORTANCE An intraoperative higher level of positive end-expiratory positive pressure (PEEP) with alveolar recruitment maneuvers improves respiratory function in obese patients undergoing surgery, but the effect on clinical outcomes is uncertain. OBJECTIVE To determine whether a higher level of PEEP with alveolar recruitment maneuvers decreases postoperative pulmonary complications in obese patients undergoing surgery compared with a lower level of PEEP. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial of 2013 adults with body mass indices of 35 or greater and substantial risk for postoperative pulmonary complications who were undergoing noncardiac, nonneurological surgery under general anesthesia. The trial was conducted at 77 sites in 23 countries from July 2014-February 2018; final follow-up: May 2018. INTERVENTIONS Patients were randomized to the high level of PEEP group (n = 989), consisting of a PEEP level of 12 cm H2O with alveolar recruitment maneuvers (a stepwise increase of tidal volume and eventually PEEP) or to the low level of PEEP group (n = 987), consisting of a PEEP level of 4 cm H2O. All patients received volume-controlled ventilation with a tidal volume of 7 mL/kg of predicted body weight. MAIN OUTCOMES AND MEASURES The primary outcomewas a composite of pulmonary complications within the first 5 postoperative days, including respiratory failure, acute respiratory distress syndrome, bronchospasm, new pulmonary infiltrates, pulmonary infection, aspiration pneumonitis, pleural effusion, atelectasis, cardiopulmonary edema, and pneumothorax. Among the 9 prespecified secondary outcomes, 3 were intraoperative complications, including hypoxemia (oxygen desaturation with SpO(2) 1 minute). RESULTS Among 2013 adults who were randomized, 1976 (98.2%) completed the trial (mean age, 48.8 years; 1381 [69.9%] women; 1778 [90.1%] underwent abdominal operations). In the intention-to-treat analysis, the primary outcome occurred in 211 of 989 patients (21.3%) in the high level of PEEP group compared with 233 of 987 patients (23.6%) in the low level of PEEP group (difference, -2.3%[95% CI, -5.9% to 1.4%]; risk ratio, 0.93 [95% CI, 0.83 to 1.04]; P =.23). Among the 9 prespecified secondary outcomes, 6 were not significantly different between the high and low level of PEEP groups, and 3 were significantly different, including fewer patients with hypoxemia (5.0% in the high level of PEEP group vs 13.6% in the low level of PEEP group; difference, -8.6%[95% CI, -11.1% to 6.1%]; P <.001). CONCLUSIONS AND RELEVANCE Among obese patients undergoing surgery under general anesthesia, an intraoperative mechanical ventilation strategy with a higher level of PEEP and alveolar recruitment maneuvers, compared with a strategy with a lower level of PEEP, did not reduce postoperative pulmonary complications

NEOTROPICAL ALIEN MAMMALS: a data set of occurrence and abundance of alien mammals in the Neotropics

Biological invasion is one of the main threats to native biodiversity. For a species to become invasive, it must be voluntarily or involuntarily introduced by humans into a nonnative habitat. Mammals were among first taxa to be introduced worldwide for game, meat, and labor, yet the number of species introduced in the Neotropics remains unknown. In this data set, we make available occurrence and abundance data on mammal species that (1) transposed a geographical barrier and (2) were voluntarily or involuntarily introduced by humans into the Neotropics. Our data set is composed of 73,738 historical and current georeferenced records on alien mammal species of which around 96% correspond to occurrence data on 77 species belonging to eight orders and 26 families. Data cover 26 continental countries in the Neotropics, ranging from Mexico and its frontier regions (southern Florida and coastal-central Florida in the southeast United States) to Argentina, Paraguay, Chile, and Uruguay, and the 13 countries of Caribbean islands. Our data set also includes neotropical species (e.g., Callithrix sp., Myocastor coypus, Nasua nasua) considered alien in particular areas of Neotropics. The most numerous species in terms of records are from Bos sp. (n = 37,782), Sus scrofa (n = 6,730), and Canis familiaris (n = 10,084); 17 species were represented by only one record (e.g., Syncerus caffer, Cervus timorensis, Cervus unicolor, Canis latrans). Primates have the highest number of species in the data set (n = 20 species), partly because of uncertainties regarding taxonomic identification of the genera Callithrix, which includes the species Callithrix aurita, Callithrix flaviceps, Callithrix geoffroyi, Callithrix jacchus, Callithrix kuhlii, Callithrix penicillata, and their hybrids. This unique data set will be a valuable source of information on invasion risk assessments, biodiversity redistribution and conservation-related research. There are no copyright restrictions. Please cite this data paper when using the data in publications. We also request that researchers and teachers inform us on how they are using the data