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Hasdeu S, Beliera A, Alvarez J, Sanchez-Viamonte J. [Asymmetries between national articulation and the autonomy of state governments in implementing health technologies to fight COVID-19 in Argentina]. CAD SAUDE PUBLICA 2024; 40:e00117923. [PMID: 38695457 PMCID: PMC11057482 DOI: 10.1590/0102-311xes117923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 01/26/2024] [Accepted: 02/21/2024] [Indexed: 05/06/2024] Open
Abstract
Argentina, as other countries, showed several public policies related to the health technologies implemented to fight and treat the COVID-19 pandemic. This study sought to analyze how articulation vs. cooperation and autonomy vs. division of powers between entities occurred in Argentina, exploring asymmetries between several entities in implementing public policies related to health technologies during the pandemic and the influences of other actors. For this, a documentary research was carried out related to 2020-2021 (technical reports published by the World Health Organization, national agencies and scientific societies, laws, court decisions, press, and research and in-depth interviews with members of the Argentine Ministries of Health). The processes and results of decision-making in the Ministries of Health were analyzed, outlining the coverage and orientations of each technology and the political party in power in the province. This study found heterogeneous results and processes between Ministries and disputes within them. It also observed the poor adherence to official guidelines due to technical-political criteria (power relations, social, media, academic, judiciary, and legislative pressure). Some cases showed a strong tension between the government and its opposition over the discussion of technologies. Each province in Argentina has autonomously defined its policies on health technologies for COVID-19, and decision-making in public administration was disorderly, complex, and non-linear during the pandemic.
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Affiliation(s)
- Santiago Hasdeu
- Universidad Nacional del Comahue, Neuquén, Argentina
- RedARETS, Neuquén, Argentina
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2
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Ferreira RM. Our Patients Deserve More. Arq Bras Cardiol 2023; 120:e20230626. [PMID: 37878897 PMCID: PMC10547431 DOI: 10.36660/abc.20230626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/06/2023] [Accepted: 09/06/2023] [Indexed: 10/27/2023] Open
Affiliation(s)
- Roberto Muniz Ferreira
- Universidade Federal do Rio de JaneiroInstituto do Coração Edson SaadRio de JaneiroRJBrasilUniversidade Federal do Rio de Janeiro, Instituto do Coração Edson Saad, Rio de Janeiro, RJ – Brasil
- Hospital SamaritanoBotafogoRJBrasilHospital Samaritano, Botafogo, RJ – Brasil
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Ribeiro Junior MAF, Costa CTK, Néder PR, Aveiro IDEA, Elias YGB, Augusto SDES. Impact of COVID-19 on the number of transplants performed in Brazil during the pandemic. Current situation. Rev Col Bras Cir 2021; 48:e20213042. [PMID: 34586206 PMCID: PMC10683411 DOI: 10.1590/0100-6991e-20213042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 06/24/2021] [Indexed: 12/24/2022] Open
Abstract
The intense use of resources to combat COVID-19 causes concern in the entire transplant community because, in addition to physical limitations such as ICU beds, lack of homogeneous treatment protocols and uncertainties about the effects of immunosuppression on viral progression have significant impact on transplant surgeries. The aim of the present study is to comparatively assess the number of solid organ transplants performed in 2019 and 2020, as well as the impact of the COVID-19 pandemic on organ donation and transplant surgeries in Brazil. The last 10 years have shown increasing trend in the number of solid organ transplants, which have significantly decreased in 2020. Lung transplantations were mostly affected by the pandemic; these surgeries have been carried out only in Rio Grande do Sul and São Paulo states. Liver transplantations were the least affected ones, since the number of surgeries have only decreased by 10.8% in the first three quarters of 2020, in comparison to 2019. The number of active patients on the waiting list for heart and kidney transplantation has increased in 2020. Therefore, it is necessary developing strategies to keep the structure necessary for organ transplantation processes active and, consequently, to reduce the impacts of the pandemic on these patients.
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Affiliation(s)
- Marcelo Augusto Fontenelle Ribeiro Junior
- - Pontifícia Universidade Católica de São Paulo - PUCSP-Sorocaba, Disciplina de Cirurgia Geral e Trauma - Sorocaba - SP - Brasil
- - Faculdade de Ciências Médicas de São José dos Campos - Humanitas - São José dos Campos - SP - Brasil
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Faria BCD, Sacramento LGG, Filipin CSA, da Cruz AF, Nagata SN, Silva ACSE. An analysis of chronic kidney disease as a prognostic factor in pediatric cases of COVID-19. J Bras Nefrol 2021; 43:400-409. [PMID: 33704348 PMCID: PMC8428649 DOI: 10.1590/2175-8239-jbn-2020-0208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 12/17/2020] [Indexed: 11/24/2022] Open
Abstract
Advanced age is a risk factor for severe infection by acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Children, however, often present with milder manifestations of Coronavirus Disease 2019 (COVID-19). Associations have been found between COVID-19 and multisystem inflammatory syndrome in children (MIS-C). Patients with the latter condition present more severe involvement. Adults with comorbidities such as chronic kidney disease (CKD) are more severely affected. This narrative review aimed to look into whether CKD contributed to more severe involvement in pediatric patients with COVID-19. The studies included in this review did not report severe cases or deaths, and indicated that pediatric patients with CKD and previously healthy children recovered quickly from infection. However, some patients with MIS-C required hospitalization in intensive care units and a few died, although it was not possible to correlate MIS-C and CKD. Conversely, adults with CKD reportedly had increased risk of severe infection by SARS-CoV-2 and higher death rates. The discrepancies seen between age groups may be due to immune system and renin-angiotensin system differences, with more pronounced expression of ACE2 in children. Immunosuppressant therapy has not been related with positive or negative effects in individuals with COVID-19, although current recommendations establish decreases in the dosage of some medications. To sum up with, CKD was not associated with more severe involvement in children diagnosed with COVID-19. Studies enrolling larger populations are still required.
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Affiliation(s)
| | | | | | - Aniel Feitosa da Cruz
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Belo
Horizonte, MG, Brasil
| | - Sarah Naomi Nagata
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Belo
Horizonte, MG, Brasil
| | - Ana Cristina Simões e Silva
- Universidade Federal de Minas Gerais, Faculdade de Medicina,
Departamento de Pediatria, Belo Horizonte, MG, Brasil
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Silva DR, Mello FCDQ, D’Ambrosio L, Centis R, Dalcolmo MP, Migliori GB. Tuberculosis and COVID-19, the new cursed duet: what differs between Brazil and Europe? J Bras Pneumol 2021; 47:e20210044. [PMID: 33950095 PMCID: PMC8332832 DOI: 10.36416/1806-3756/e20210044] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 02/03/2021] [Indexed: 11/17/2022] Open
Abstract
On April 1st, 2020, COVID-19 surpassed tuberculosis regarding the number of deaths per day worldwide. The combination of tuberculosis and COVID-19 has great potential for morbidity and mortality. In addition, the COVID-19 pandemic has had a significant impact on the diagnosis and treatment of tuberculosis. In this review article, we address concurrent tuberculosis and COVID-19, with particular regard to the differences between Brazil and Europe. In addition, we discuss priorities in clinical care, public health, and research.
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Affiliation(s)
- Denise Rossato Silva
- . Faculdade de Medicina, Universidade Federal do Rio Grande do Sul - UFRGS - Porto Alegre (RS) Brasil
| | | | - Lia D’Ambrosio
- . Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italia
| | - Rosella Centis
- . Blizard Institute, Queen Mary University of London, London, United Kingdom
| | | | - Giovanni Battista Migliori
- . Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italia
- . Blizard Institute, Queen Mary University of London, London, United Kingdom
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Geremia DS, Vendruscolo C, Celuppi IC, Adamy EK, Toso BRGDO, de Souza JB. 200 Years of Florence and the challenges of nursing practices management in the COVID-19 pandemic. Rev Lat Am Enfermagem 2020; 28:e3358. [PMID: 32901771 PMCID: PMC7478888 DOI: 10.1590/1518-8345.4576.3358] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 06/15/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE to analyze the main challenges of nursing in facing Coronavirus Disease-19 under the perspective of nurse managers in the west macro-region of Santa Catarina. METHOD it consists of a qualitative study, whose data collection was done through interviews with nurses who represent the management of health care network in the region. The analysis technique used was the Discourse of the Collective Subject (DCS). RESULTS the legacy of Florence Nightingale to contemporary nursing practice; the weaknesses and the technical operational capacity with which nursing faces in the Unified Health System (Sistema Único de Saúde - SUS); the strategies for strengthening the Unified Health System and qualification of nursing practices; and the potentialities identified in the pandemic scenario were the main ideas that emerged. In the bicentennial year of Florence Nightingale, nurses recognize her legacy to public health practice and management. Several variables interfere in professional practice, such as epidemiological aspects, working conditions, and care management in a pandemic. CONCLUSION the pandemic scenario has taken nursing to a position of practical and scientific protagonism as a result of its proactivity and leadership in the search for knowledge based on scientific evidence.
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Affiliation(s)
| | - Carine Vendruscolo
- Universidade do Estado de Santa Catarina, Curso de Enfermagem,
Chapecó, SC, Brazil
| | - Ianka Cristina Celuppi
- Universidade Federal de Santa Catarina, Florianópolis, SC,
Brazil
- Scholarship holder at the Conselho Nacional de Desenvolvimento
Científico e Tecnológico (CNPq), Brazil
| | - Edlamar Kátia Adamy
- Universidade do Estado de Santa Catarina, Curso de Enfermagem,
Chapecó, SC, Brazil
| | | | - Jeane Barros de Souza
- Universidade Federal da Fronteira Sul, Curso de Enfermagem, Chapecó,
SC, Brazil
- Bolsista da Scholarship holder at the Coordenação de Aperfeiçoamento
de Pessoal de Nível Superior (CAPES), Brazil
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Suassuna JHR, de Lima EQ, Rocha E, Castro A, Burdmann EDA, do Carmo LPDF, Yu L, Ibrahim MY, Betônico GN, Cuvello AL, Ávila MON, Gonçalves ARR, Costa CBS, Bresolin NL, de Abreu AP, Lobo SMA, do Nascimento MM. Technical note and clinical instructions for Acute Kidney Injury (AKI) in patients with Covid-19: Brazilian Society of Nephrology and Brazilian Association of Intensive Care Medicine. J Bras Nefrol 2020; 42:22-31. [PMID: 32877495 PMCID: PMC7479984 DOI: 10.1590/2175-8239-jbn-2020-s107] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
We produced this document to bring pertinent information to the practice of nephrology, as regards to the renal involvement with COVID-19, the management of acute kidney injury cases, and practical guidance on the provision of dialysis support.As information on COVID-19 evolves at a pace never before seen in medical science, these recommendations, although based on recent scientific evidence, refer to the present moment. The guidelines may be updated when published data and other relevant information become available.
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Affiliation(s)
| | | | - Eduardo Rocha
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Alan Castro
- Complexo Hospitalar de Niterói, Niterói, RJ, Brasil
| | | | | | - Luis Yu
- Universidade de São Paulo, São Paulo, SP, Brasil
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Abstract
Given the high transmissibility of SARS-CoV-2, COVID-19 pandemic has a huge impact on our health system. Even in developed countries, strategic resources soon become insufficient. Although people over 60 and with comorbidities are at greater risk of developing severe forms, younger people may also require precious and scarce care. Hence, the World Health Organization recommend tests - PCR and serological tests - for detecting infected people on a large scale. The most common symptoms are fever, fatigue, dry cough, anorexia, myalgia, and dyspnea, with tomographic pulmonary findings being frequent even in asymptomatic cases. The Brazilian Society of Nephrology has published guidelines for the management of hypertensive, diabetic, dialysis, and transplant patients. In its alerts, care and precautions in dialysis units are also being detailed, both for the health team and for the patients. Although important renal manifestations are not yet evident in the admission of positive cases, recent studies with renal patients and performed in nephrology services are listed here. This pandemic lead us to learn from its progress in order to face new challenges in dialysis clinics, transplant services, and intensive care services.
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Affiliation(s)
- Carmen Tzanno-Martins
- Grupo CHR, São Paulo, SP, Brasil
- Sociedade Brasileira de Nefrologia, São Paulo, SP, Brasil
- Sociedad Latinoamericana de Nefrología e Hipertensión, Departamento de Economía, Ciudad de Panamá, Panamá
- International Society of Nephrology, Clinical Research Committee, Cranford, United States
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Sousa GJB, Garces TS, Cestari VRF, Moreira TMM, Florêncio RS, Pereira MLD. Estimation and prediction of COVID-19 cases in Brazilian metropolises. Rev Lat Am Enfermagem 2020; 28:e3345. [PMID: 32609282 PMCID: PMC7319758 DOI: 10.1590/1518-8345.4501.3345] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 05/06/2020] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE to estimate the transmission rate, the epidemiological peak, and the number of deaths by the new coronavirus. METHOD a mathematical and epidemiological model of susceptible, infected, and recovered cases was applied to the nine Brazilian capitals with the highest number of cases of the infection. The number of cases for the 80 days following the first case was estimated by solving the differential equations. The results were logarithmized and compared with the actual values to observe the model fit. In all scenarios, it was considered that no preventive measures had been taken. RESULTS the nine metropolises studied showed an upward curve of confirmed cases of COVID-19. The prediction data point to the peak of the infection between late April and early May. Fortaleza and Manaus had the highest transmission rates (≥2·0 and ≥1·8, respectively). Rio de Janeiro may have the largest number of infected people (692,957) and Florianópolis the smallest (24,750). CONCLUSION the estimates of the transmission rate, epidemiological peak, and number of deaths from coronavirus in Brazilian metropolises presented expressive and important numbers the Brazilian Ministry of Health needs to consider. The results confirm the rapid spread of the virus and its high mortality in the country.
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Affiliation(s)
- George Jó Bezerra Sousa
- Universidade Estadual do Ceará, Fortaleza, CE, Brazil
- Scholarship holder at the Fundação Cearense de Apoio ao
Desenvolvimento Científico e Tecnológico (FUNCAP), Brazil
| | - Thiago Santos Garces
- Universidade Estadual do Ceará, Fortaleza, CE, Brazil
- Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal
de Nível Superior (CAPES), Brazil
| | - Virna Ribeiro Feitosa Cestari
- Universidade Estadual do Ceará, Fortaleza, CE, Brazil
- Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal
de Nível Superior (CAPES), Brazil
| | - Thereza Maria Magalhães Moreira
- Universidade Estadual do Ceará, Fortaleza, CE, Brazil
- Scholarship holder at the Conselho Nacional de Desenvolvimento
Científico e Tecnológico (CNPq), Brazil
| | - Raquel Sampaio Florêncio
- Universidade Estadual do Ceará, Fortaleza, CE, Brazil
- Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal
de Nível Superior (CAPES), Brazil
| | - Maria Lúcia Duarte Pereira
- Universidade Estadual do Ceará, Fortaleza, CE, Brazil
- Scholarship holder at the Conselho Nacional de Desenvolvimento
Científico e Tecnológico (CNPq), Brazil
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Nascimento JHP, Gomes BFDO, do Carmo PR, Petriz JLF, Rizk SI, Costa IBSDS, Lacerda MVG, Bacal F, Hajjar LA, de Oliveira GMM. COVID-19 and Hypercoagulable State: A New Therapeutic Perspective. Arq Bras Cardiol 2020; 114:829-833. [PMID: 32491074 PMCID: PMC8386998 DOI: 10.36660/abc.20200308] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 04/15/2020] [Accepted: 04/15/2020] [Indexed: 01/08/2023] Open
Affiliation(s)
- Jorge Henrique Paiter Nascimento
- Universidade Federal do Rio de JaneiroRio de JaneiroRJBrasilUniversidade Federal do Rio de Janeiro – Cardiologia,Rio de Janeiro, RJ - Brasil
| | - Bruno Ferraz de Oliveira Gomes
- Universidade Federal do Rio de JaneiroRio de JaneiroRJBrasilUniversidade Federal do Rio de Janeiro – Cardiologia,Rio de Janeiro, RJ - Brasil
- Rede D’Or São LuizRio de JaneiroRJBrasilRede D’Or São Luiz – CardiologiaRio de Janeiro, RJ - Brasil
| | - Plínio Resende do Carmo
- Universidade Federal do Rio de JaneiroRio de JaneiroRJBrasilUniversidade Federal do Rio de Janeiro – Cardiologia,Rio de Janeiro, RJ - Brasil
| | - João Luiz Fernandes Petriz
- Rede D’Or São LuizRio de JaneiroRJBrasilRede D’Or São Luiz – CardiologiaRio de Janeiro, RJ - Brasil
- Hospital Barra D’OrRio de JaneiroRJBrasilHospital Barra D’Or – Cardiologia,Rio de Janeiro, RJ - Brasil
| | - Stephanie Itala Rizk
- Universidade de São PauloInstituto do Câncer do Estado de São PauloSão PauloSPBrasilUniversidade de São Paulo Instituto do Câncer do Estado de São Paulo,São Paulo, SP - Brasil
- Universidade de São PauloInstituto do CoraçãoSão PauloSPBrasilUniversidade de São Paulo Instituto do Coração,São Paulo, SP - Brasil
| | - Isabela Bispo Santos da Silva Costa
- Hospital Sírio-LibanêsInstituto Sírio Libanês de Ensino e PesquisaSão PauloSPBrasilHospital Sírio-Libanês - Instituto Sírio Libanês de Ensino e Pesquisa,São Paulo, SP - Brasil
| | - Marcus Vinicius Guimarães Lacerda
- Fundação de Medicina Tropical Dr Heitor Vieira DouradoManausAMBrasilFundação de Medicina Tropical Dr Heitor Vieira Dourado,Manaus, AM - Brasil
| | - Fernando Bacal
- Universidade de São PauloFaculdade de MedicinaHospital das Clínicas Instituto do CoraçãoSão PauloSPBrasilUniversidade de São Paulo Faculdade de Medicina Hospital das Clínicas Instituto do Coração,São Paulo, SP - Brasil
| | - Ludhmila Abrahão Hajjar
- Intituto de CoraçãoSão PauloSPBrasilIntituto de Coração – Cardiopneumologia,São Paulo, SP – Brasil
| | - Gláucia Maria Moraes de Oliveira
- Universidade Federal do Rio de JaneiroRio de JaneiroRJBrasilUniversidade Federal do Rio de Janeiro – Cardiologia,Rio de Janeiro, RJ - Brasil
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