Experience Report: A Community Approach During The Covid-19 Pandemic

Introduction

The slum areas present precariousness in terms of habitation, high populational concentration, lack of sanitary infrastructure, violence, and lack of water supply. This scenario makes it difficult the caring to prevent COVID-19 contamination. Belo Horizonte, like other Brazilian capital cities, presents this scenario, which calls society's attention.

Objective

Experience report made by Nursing academics who took basic food baskets to a slum during the COVID-19 pandemic.

Methods

Social action by three Nursing students who collected and delivered basic food baskets to a community in Belo Horizonte. It became an opportunity to social assistance and to the understanding of how these slum dwellers face COVID-19. A local leader prepared a list of families facing vulnerable situation. These families received the baskets. At the time of the deliveries, there was an opportunity to answer some doubts about COVID-19 and health.

Results

The dwellers moved around on the streets without masks, maybe because of lack of resources. The dwellings did not favor social distancing and hygiene care. There were small rooms, excess of people, little ventilation, and deficient sanitation conditions. The people who were infected with the virus suffered retaliation because the other people were afraid of COVID-19 transmission. The infected people became cloistered at home to avoid the community retaliation. Everyone thanked the delivery of basic food baskets saying that this delivery would be a relief during the pandemic.

Conclusions

By observation and contact with the dwellers, it was possible to notice the scarcity of resources and the need of financial and informational help about COVID-19 and other health topics. The basic food basket donation was relevant to the families, but the number of donations did not supply the local necessity. Other social and governmental actions are needed to promote local health.

Key messages

Financial aid from the government must be implemented so that people on the street can have the basics to survive.

Government support and an example model is important for the population to follow as a reference. Our current government has not been a good example, leading to chaos in public and private health.

Candidemia in a Portuguese tertiary care hospital: Analysis of a 2-year period

BACKGROUND

Candidemia is a nosocomial infection of increasing importance, associated with high morbidity and mortality. The aim of this study is to describe the species distribution, risk factors, management and outcomes of patients with candidemia.

METHODS

We conducted a retrospective study at Centro Hospitalar Universitário de São João, Portugal, between January 2016 and December 2017.

RESULTS

A total of 117 candidemia episodes (n=114 patients) were included. Median age was 65 years, with an increased prevalence of older ages. Candida albicans (51.3%) was the most prevalent species, followed by C. glabrata (22.2%), C. parapsilosis (15.4%), C. tropicalis (4.3%) and C. lusitaniae (2.6%). Forty-two patients (35.9%) did not receive antifungal drugs after diagnosis of candidemia. Echinocandins were used as first-line drug therapy in half of the treated patients (50.7%). The median EQUAL Candida Score was 6/17 (IQR 6-9) for patients without central venous catheter (CVC) and 11/20 (IQR 6-14) for patients with CVC. The 30 days-mortality was 31,6% and was not significantly associated with the timing of antifungal therapy and the EQUAL Candida Score.

CONCLUSION

The distribution of Candida species has changed in recent years, with an increase in the proportion of C. albicans and C. glabrata. Rapid diagnostic tests, empiric antifungal therapy and source control are essential to improve the prognosis of patients with candidemia. More multicentric prospective studies are needed to evaluate the association of mortality with the timing of antifungal therapy or the EQUAL Candida Score.

Metal complexes for multimodal imaging of misfolded protein-related diseases

Aggregation of misfolded proteins and progressive polymerization of otherwise soluble proteins is a common hallmark of several highly debilitating and increasingly prevalent diseases, including amyotrophic lateral sclerosis, cerebral amyloid angiopathy, type II diabetes and Parkinson's, Huntington's and Alzheimer's diseases.

Radiolanthanide complexes with tetraazamacrocycles bearing methylphosphonate pendant arms as bone seeking agents

AIM

Radiolanthanide complexes with ligands bearing phosphonate groups have demonstrated their usefulness as bone seeking agents. Herein, we report on the synthesis of 153Sm and 166Ho complexes with 12- to 14-membered macrocycles containing different number of methylphosphonate pendant arms and their in vitro and in vivo evaluation in order to assess the effect of the cavity size and type of appended arms on their biological behavior.

METHODS

Radioactive macrocycle complexes were prepared by reaction of (153)Sm/(166)Ho nitrates with four different tetraazamacrocycles bearing methylphosphonate groups. Radiochemical behavior, in vitro stability and charge of complexes were studied by chromatography and electrophoresis. The lipophilicity, plasmatic protein binding and adsorption onto hydroxyapatite (HA) were evaluated by in vitro assays. Biodistribution was assessed in CD-1 mice. Radiolabeling efficiency depends both on radionuclide and ligand structure. All the complexes are hydrophilic with an overall negative charge and relatively low protein binding. High in vitro stability in human serum and adsorption onto HA was found for all the complexes.

RESULTS

Biodistribution and in vivo stability studies have demonstrated promising biological profile for targeted radiotherapy, namely a rapid tissue clearance from most organs and rapid total excretion. Additionally, 166Ho-tritp has a high bone uptake, which led to high bone/ blood and bone/muscle ratios.

CONCLUSIONS

Our results clearly demonstrate that 12- and 13-membered macrocyclic ligands led to stable complexes with biological profile adequate to radionuclide therapy. The favorable in vivo behavior highlights the interest to further investigate these or closely related complexes to be used as bone seeking agents.