Residência Multiprofissional: a saúde mental de quem atua no combate à COVID-19

Multiprofessional residents are instrumental components of the Brazilian Unified Health System (SUS) when facing COVID-19, since they are integrated into treatment teams for many patients. The purpose of this study was to understand the self-perception of mental health in these professionals from a city in the interior of Minas Gerais, Brazil, who were active during the pandemic. The study was qualitative, with data collection performed via Google Forms and analyzed via Content Analysis. It was observed that most professionals showed declining mental health, but developed coping strategies. These professionals also understood the influence of this mental health decline on their lives and actions.Los residentes multiprofesionales son uno de los mayores instrumentos del SUS en el abordaje del COVID-19, ya que forman parte de los equipos que realizan gran parte de la atención brindada. El objetivo, por tanto, era conocer la autopercepción de la salud mental de estos profesionales, de una ciudad del interior de Minas Gerais, que estuvieron activos durante la pandemia. El estudio tuvo un carácter cualitativo, con recolección de datos realizada a través de Google Forms y análisis a través de Análisis de Contenido. Se observó que la mayoría de los profesionales presentan deterioro de la salud mental, pero alcanzan estrategias de afrontamiento. Los profesionales también comprenden la influencia de este declive en sus vidas y acciones.Residentes multiprofissionais são um dos maiores instrumentos do Sistema Único deSaúde no enfretamento à COVID-19, pois integram equipes realizando muito dosatendimentos prestados. O objetivo, portanto, foi compreender a autopercepção da saúdemental desses profissionais, de uma cidade do interior de Minas Gerais, atuantes durante apandemia. O estudo teve caráter qualitativo, sendo a coleta de dados realizada via GoogleForms e a análise através da Análise de Conteúdo. Observou-se que a maioria dosprofissionais apresentaram danos na saúde mental, porém alcançaram estratégias deenfrentamento. Os profissionais demonstraram, compreender a influência desses prejuízossobre suas vidas e atuaçõe

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Risk Categorization Using New American College of Cardiology/American Heart Association Guidelines for Cholesterol Management and Its Relation to Alirocumab Treatment Following Acute Coronary Syndromes

10.1161/CIRCULATIONAHA.119.042551CIRCULATION140191578-158

Effect of Alirocumab on Mortality After Acute Coronary Syndromes An Analysis of the ODYSSEY OUTCOMES Randomized Clinical Trial

10.1161/CIRCULATIONAHA.118.038840CIRCULATION1402103-11

Alirocumab and cardiovascular outcomes after acute coronary syndrome

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