To asses if telemedicine with telemonitoring is a clinically useful and secure tool in the tracking of patients with COVID-19.
A prospective observational study of patients with COVID-19 diagnosis by ...positive PCR considered high-risk tracked with telemedicine and telemonitoring was conducted in the sanitary area of Lugo between March 17th and April 17th, 2020. Two groups of patients were included: Outpatient Tracing from the beginning and after discharge. Every patient sent a daily clinical questionnaire with temperature and oxygen saturation 3 times a day. Proactive monitoring was done by getting in touch with every patient at least 11a day.
313 patients (52.4% female) with a total average age of 60.9 (DE 15.9) years were included. Additionally, 2 patients refused to join the program. Since the beginning, 224 were traced outpatient and 89 after being discharged. Among the first category, 38 (16.90%) were referred to Emergency department on 43 occasions; 18 were hospitalized (8.03%), and 2 deceased. Neither deaths nor a matter of vital emergency occurred at home. When including patients after admissions monitoring was done in 304 cases. One patient re-entered (0.32%) to the hospital, and another one left the program (0.32%). The average time of monitoring was 11.64 (SD 3.58) days, and 224 (73.68%) patients were discharged during the 30 days of study.
Our study suggests that telemedicine with home telemonitoring, used proactively, allows for monitoring high-risk patients with COVID-19 in a clinically useful and secure way.
•A method of correcting the current distortion in air gapped CTs is presented.•The ratio and phase errors due the gap insertion are also corrected by the method.•The proposed correction method avoids ...the CT oversizing.•The secondary circuit impedances values is not necessary, unlike other techniques.
A platform implemented with digital signal controllers (DSCs) developed for real time studies of the dynamic behavior of the air-gapped current transformers (CTs) used in power grid protection and measurement systems is presented. The implemented algorithms simulate the fault current in an electric power system as well as the transient response of the current transformer. A method for correcting the CT secondary current distortion is presented in the case of gapped core where residual flux is negligible. To estimate the flux, a tertiary winding must be available. The ratio and phase errors, as well as the distortions in secondary current due the core saturation in fault situations are properly corrected by the method. Several cases were tested and the results indicate that the proposed method is very effective in improving the performance of protection schemes based on the current measurement.
Worldwide rotaviruses A (RVA) are responsible for approximately 215,000 deaths annually among children aged <5 years. RVA G1P8 remains associated with >50% of gastroenteritis cases in this age group. ...The aim of this study was to assess the genetic variability of G1P8 strains detected in children with severe diarrhea in Belém, Pará, Brazil, during the post-rotavirus vaccine introduction era. Phylogenetic analysis clustered the VP4 and VP7 genes of 40 samples selected between 2009 and 2011 into lineages found to be different from the Rotarix® vaccine strain. A detailed investigation of their complete genotype constellations identified 2 reassortant viruses (5%), resulting from reassortments between the genogroups Wa-like and DS-1-like (G1-P8-I1-R2-C1-M1-A1-N1-T2-E1-H1) and Wa-like and AU-1-like (G1-P8-I1-R3-C1-M1-A1-N1-T1-E1-H1) genotype constellations. A comparison of the amino acid residues presents in the antigenic epitopes of VP7 and VP4, showed differences in the electrostatic charges distribution, between wild type Brazilian strains and the Rotarix® and RotaTeq® vaccine strains. These findings reflect the structural analyses of the antigenic regions of VP7 and VP4 of the RVA G1P8 in children with gastroenteritis in Northern Brazil raising the hypothesis that structural modifications at these sites over time may account for the emergence of new strains that could possibly pose a challenge to current vaccines.
•Detection of reassortment in the VP1 genes (G1-P8-I1-R2-C1-M1-A1-N1-T2-E1-H1) and NSP3 (G1-P8-I1-R3-C1-M1-A1-N1-T1-E1-H1)•Presence of reassortment within the same genotype•Proteins VP7 and VP4 with alterations in the antigenic sites demonstrate important aminoacid changes•Continuous monitoring of rotavirus genotypes is required for a broader genomic characterization of the prevalent strains
To perform a molecular analysis of rotavirus A (RVA) G3P6 strains detected in 2012 and 2017 in the Amazon region of Brazil.
Eighteen RVA G3P6 strains were collected from children aged under 10 years ...hospitalized with acute gastroenteritis, and partial sequencing of each segment genome was performed using Sanger sequencing.
Phylogenetic analysis showed that all G3P6 strains had a DS-1-like genotype constellation. Two strains had the highest nucleotide identities with equine-like G3P6/G3P8 genotypes. Several amino acid alterations in VP4 and VP7 neutralizing epitopes of equine-like RVA G3P6 strains were observed in comparison with vaccine strains.
These findings suggest that equine-like RVA G3P6 strains have been circulating in the Amazon region of Brazil as a result of direct importation, and support natural RVA evolutionary mechanisms.
To investigate the effects of intensive blood pressure (BP) lowering according to baseline BP levels and optimal achieved BP levels in patients with acute intracerebral hemorrhage (ICH).
INTERACT2 ...was an open, blinded endpoint, randomized controlled trial in 2,839 patients with ICH within 6 hours of onset and elevated systolic BP (SBP) (150-220 mm Hg) who were allocated to receive intensive (target SBP <140 mm Hg within 1 hour, with lower limit of 130 mm Hg for treatment cessation) or guideline-recommended (target SBP <180 mm Hg) BP-lowering treatment. Outcome was physical function across all 7 levels of the modified Rankin Scale at 90 days.
Analysis of the randomized comparisons showed that intensive BP lowering produced comparable benefits on physical function at 90 days in 5 subgroups defined by baseline SBP of <160, 160-169, 170-179, 180-189, and ≥190 mm Hg (p homogeneity = 0.790). Analyses of achieved BP showed linear increases in the risk of physical dysfunction for achieved SBP above 130 mm Hg for both hyperacute (1-24 hours) and acute (2-7 days) phases while modest increases were also observed for achieved SBP below 130 mm Hg.
Intensive BP lowering appears beneficial across a wide range of baseline SBP levels, and target SBP level of 130-139 mm Hg is likely to provide maximum benefit in acute ICH.
This study provides Class I evidence that the effect of intensive BP lowering on physical function is not influenced by baseline BP.
The aim of this study was to evaluate in vitro the modifications in the profile of erythrocyte membrane protein band 3 (monomer, aggregates and fragments) imposed by cellular aging, by activated ...neutrophils (AN) and by neutrophilic elastase. The modifications imposed by cellular aging were evaluated in fractions of less dense and dense red blood cells (RBCs). To evaluate the changes imposed by AN, suspensions of RBCs and AN were used, in a ratio similar to or higher than that described elsewhere for individuals post-myocardial infarction (Santos-Silva A et al. Atherosclerosis 1995; 116:199–209). Neutrophilic elastase was used at increased concentrations. We found that the modifications imposed upon band 3 profile by AN and neutrophilic elastase were significantly correlated with AN and elastase concentration, and were similar to those presented by cellular aging. We propose band 3 profile as a useful cumulative marker of oxidative and/or proteolytic stress conditions, namely those arising from normal RBC aging or from an accelerated aging process imposed by stressful situations, such as inflammatory diseases.
Aeromonas were isolated from 27 (6.6%) of 408 patients admitted with acute gastroenteritis in two hospitals at Rio Grande do Sul, Brazil. Isolates were classified as A. hydrophila (51.8%), A. caviae ...(40.8%), and A. veronii biotype sobria (7.4%). The highest prevalence of Aeromonas associated infections occurred in lactants and children. Virulence genes (aerA -aerolysin/hemolysin, ahpA -serine-protease, satA - glycerophospholipid-cholesterol acyltransferase, lipA -lipase, and ahyB -elastase) and virulence factors (hemolytic, proteolitic, lipolitic activities, and biofilm formation) were identified in most A. hydrophila and A. veronii biotype sobria isolates, with lower frequencies on A. caviae. All Aeromonas isolates were resistant to ampicillin, ticarcillin/clavulanic acid, cephalotin, and cephazolin, and most of them (>70%) exhibited resistance to imipenem, carbenicillin, amoxillin/sulbactan, and piperacillin. Multiple-resistance, more than four antibiotics, was evidenced in 29.6% of the isolates. The most efficient antibiotics were the quinolones (ciprofloxacin and norfloxacin), and the aminoglycosides (amikacin and netilmicin).
Aeromonas foram isoladas de 27 (6.6%) dos 408 pacientes admitidos com gastroenterite aguda em dois hospitais do Rio Grande do Sul, Brasil. Os isolados foram classificados com A. hydrophila (51.8%), A. caviae (40.8%), e A. veronii biotype sobria (7.4%). A maior prevalência de Aeromonas ocorreu em lactantes e crianças. Genes (aerA -aerolisina/hemolisina, ahpA -serina-protease, satA - glicerofosfolipidio-colesterol aciltransferase, lipA -lipase, e ahyB -elastase) e factores (atividade hemolítica, proteolítica, lipolítica, e formação de biofilme) de virulência foram identificados na maioria dos isolados de A. hydrophila e A. veronii biotype sobria, com freqüências menores em A. caviae. Todos os isolados de Aeromonas apresentaram resistência a ampicilina, ticarcilina/ácido clavulânico, cefalotina e cefazolina, e a maior parte (>70%) exibiram resistência a imipenem, carbenicilina, amoxacilina/sulbactam e piperacilina. Resistência múltipla foi evidenciada em 29,6% dos isolados. Os antibióticos mais eficientes foram as quinolonas (ciprofloxacina e norfloxacina) e os aminoglicosídicos (amicacina e netilmicina).
The aim of this study is to evaluate the correlation between a rise in blood neutrophil concentration and cellular and molecular changes of erythrocytes, among populations presenting an increased ...risk of cardiovascular disease (CVD). A population of men aged 20–65 years was used which included 22 post-myocardial infarction individuals (< 48 h), 24 survivors of myocardial infarction (> 3 months), 12 hypertensive individuals and 29 individuals presenting normal heamatological values and normal lipid profile. The lipid profile parameters used to ascertain increased risk of CVD included triglycerides (TG), total cholesterol (Chol), high-density lipoprotein cholesterol (HDLc), low-density lipoproteins cholesterol (LDLc) and apolipoproteins A1 (Apo A1) and B (Apo B). The hematological parameters measured were concentration of total white blood cells (WBC) and of the several leukocyte types; concentration of red blood cells (RBC); hematocrit (Ht); hemoglobin concentration (Hb); mean cell volume (MCV); activity of erythrocyte glucose-6-phosphate dehydrogenase (G6PD); band 3, its aggregates and fragments in erythrocyte membranes, the percentage of membrane-bound hemoglobin (MBH), and the linkage of immunoglobulin G (IgG) to erythrocyte membrane. We found that the MBH and the band 3 profile is different in control as compared to pathological groups and that, as expected, the aggregation of band 3 promotes the linkage of IgG to the erythrocyte membrane. A negative correlation was shown between total neutrophils and both total RBCs and erythrocyte G6PD activity. We suggest that the erythrocyte, a cell that undergoes and accumulates oxidative and proteolytic damage along its life span, may provide a useful model of oxidative and proteolytic stress in CVD and that band 3 may represent a useful marker of that stress.
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![G1P[8] Rotavirus in childre...](http://api.summon.serialssolutions.com/2.0.0/image/issn/XR4PS5YY4K/1567-1348_1567-7257/small "G1P[8] Rotavirus in children with severe diarrhea in the post-vaccine introduction era in Brazil: Evidence of reassortments and structural modifications of the antigenic VP7 and VP4 regions")
