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

Collagen, fibrinogen and thrombin biological addesive is effective in treating experimental liver injuries

ABSTRACT Objective : to evaluate the effectiveness of a collagen-based adhesive associated with fibrinogen and thrombin in experimental liver injury in rats. Methods : the study included 30 Wistar rats randomly divided into three groups: A, B and C. All underwent standard liver traumatic injury. In group A the lesion was treated with the adhesive; in group B, with conventional absorbable suture; and in group C, there was no treatment. We analyzed the time of hemostasis, mortality, occurrence of adhesions and any histological changes. Results : there was no statistical difference in relation to mortality (p = 0.5820). The group treated with the adhesive showed the lowest hemostasis times (p = 0.0573, odds ratio 13.5) and lower incidence of adhesions (p = 0.0119). Microscopic histological alterations of Groups A and B were similar, with foreign body granuloma formation separating the adhesive material or the suture from the hepatic stroma. Conclusion : the adhesive of collagen associated with fibrinogen and thrombin was effective in the treatment of experimental hepatic injury, providing a lower incidence of adhesions between the liver and surrounding structures

Veredas do triângulo mineiro: solos, água e uso Veredas of Minas Gerais Triangle: soils, water and use

Sendo as veredas importantes reguladores do equilíbrio dos cursos d'água da região dos cerrados, objetivou-se caracterizar e comparar solo, água e tipo de uso destes ambientes nas superfícies geomórficas Chapadas e Arenito Bauru. Foram coletadas amostras dos solos e da água, das veredas. O uso foi analisado por observações de campo e entrevistas com proprietários rurais. As veredas apresentam solos hidromórficos em toda a sua extensão, havendo maior homogeneidade no Bauru. Do terço superior em direção ao terço inferior, a drenagem piora, e são maiores os teores de argila, matéria orgânica e fertilidade natural. As veredas do Bauru apresentam melhor drenagem, maior fertilidade, menores teores de matéria orgânica de argila. A água enquadrou-se na classe 4, principalmente em função da cor, acompanhando variações do teor de matéria orgânica do solo. Nas veredas da Chapada, o uso da água na agricultura gera risco de contaminação ambiental, enquanto no Bauru, é comum seu represamento para dessedentação do gado. Os solos das veredas do Bauru são utilizados com freqüência para pastagem nativa, os da Chapada, são mantidos sem uso. A cor preta ou cinzenta dos solos é um atributo de fácil identificação no campo para delimitar tais ambientes.<br>Being the veredas (swampy plains between hills and rivers) important regulators of water courses equilibrium at the cerrado region, we aimed to characterize and to compare soils, water and use type of these environments in Chapada and Arenito Bauru geomorphic surfaces. Soil and water samples were collected from the veredas. The use was analysed through field observations and interviews with farmers. The veredas present hydromorphic soils in all their extension, occurring higher homogeneity in Bauru. From the superior to the inferior part, the drainage gets worse, and the clay contents, organic matter and natural fertility increase. The Bauru veredas present better drainage, higher natural fertility, smaller amounts of organic matter and clay.The water was classified as class 4, mainly as a function of color, following variations in the soil organic matter content. At Chapada veredas, the water use in agriculture generates environmental contamination risk, while at the Bauru ones, it is common the water damming up for cattle supplying. The soils of Bauru veredas are frequently used for native pasture, while the Chapada ones are maintained without use. The black or grayish color of the veredas soils is an easily-identifiable field attribute for delimitation of such environments