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

Características de carcaça e da carne de suínos machos castrados e imunocastrados alimentados com diferentes níveis nutricionais Carcass characteristics and meat of surgically castrated and immunocastrated pigs fed different nutritional levels

O trabalho foi realizado para avaliar as características de carcaça e carne de suínos machos castrados e imunocastrados alimentados com dietas contendo diferentes níveis nutricionais. O delineamento experimental foi inteiramente casualizado com quatro tratamentos principais (T1-suínos machos castrados alimentados com dieta basal; T2-machos imunocastrados alimentados com dieta basal; T3-machos imunocastrados alimentados com dieta basal+3% aminoácidos e energia; T4-machos imunocastrados alimentados com dieta basal+5% aminoácidos e energia) e dois tratamentos secundários com ou sem ractopamina dentro de cada tratamento principal. Os suínos machos castrados apresentaram peso de abate 3,3% inferior (P<0,05), peso de carcaça fria 1,4% superior (P<0,05) e peso de carré 13% superior (P<0,05) em relação aos machos imunocastrados. Suínos machos imunocastrados suplementados com 5% a mais de aminoácidos e energia apresentaram costela 19% mais (P<0,05) pesada e valores superiores (P<0,05) na coloração b* (amarelo-azul) na carne aos 45min e às 24h pós-abate em relação aos machos castrados alimentados com a dieta basal. A suplementação com 5% de aminoácidos e energia aumenta o peso e rendimento de costela e altera o valor da coloração b* (amarelo-azul) na carne aos 45min e às 24h pós-abate de suínos machos imunocastrados.<br>The study was carried out to evaluate the carcass characteristics and meat of surgically castrated and immunocastrated pigs fed with different nutritional levels. The animals were distribuited in a completely randomized experimental design with four main treatments (T1-surgically castrated pigs fed with basal diet; T2-immunocastrated pigs fed with basal diet; T3-immunocastrated pigs fed with basal diet+3% amino acids and energy; T4-immunocastrated pigs fed with basal diet+5% amino acids and energy) and two secondary treatments with or without ractopamine within each main treatment. The surgically castrated pigs had slaughter weight 3.3% lower (P<0.05), cold carcass weight 1.4% higher (P<0.05) and loin chop weight 13% higher (P<0.05) compared to immunocastred pigs. The immunocastrated pigs supplemented with 5% more amino acids and energy had rib 19% more heavier (P<0.05) and higher values (P<0.05) in the color b* (yellow-blue) in the meat to 45min and 24h post-slaughter compared with surgically castrated pigs fed with basal diet. Supplementation with 5% amino acids and energy increases weight and yield of rib and changes the value of color b* (yellow-blue) in the meat to 45min and 24h post-slaughter male pigs immunocastrated