scholarly journals TAMING COVID-19 EPIDEMIC IN SÃO PAULO WITH A LOGISTIC MODEL AND NON-PHARMACEUTICAL MEASURES

Author(s):  
Marcelo Marchesin

Abstract.In this paper I use the simple logistic mathematical model to represent the development of COVID-19 epidemic in São Paulo city under quarantine regime and I estimate the total amount of time it is necessary to decrease the number of seriously ill patients in order to reduce the demand for hospital beds of Intensive Care Units (ICU) to tolerable levels. Clearly the same reasoning and mathematical methods used in here can be used for any other city in similar conditions of social isolation.

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Marcos Amaku ◽  
Dimas Tadeu Covas ◽  
Francisco Antonio Bezerra Coutinho ◽  
Raymundo Soares Azevedo ◽  
Eduardo Massad

Abstract Background At the moment we have more than 177 million cases and 3.8 million deaths (as of June 2021) around the world and vaccination represents the only hope to control the pandemic. Imperfections in planning vaccine acquisition and difficulties in implementing distribution among the population, however, have hampered the control of the virus so far. Methods We propose a new mathematical model to estimate the impact of vaccination delay against the 2019 coronavirus disease (COVID-19) on the number of cases and deaths due to the disease in Brazil. We apply the model to Brazil as a whole and to the State of Sao Paulo, the most affected by COVID-19 in Brazil. We simulated the model for the populations of the State of Sao Paulo and Brazil as a whole, varying the scenarios related to vaccine efficacy and compliance from the populations. Results The model projects that, in the absence of vaccination, almost 170 thousand deaths and more than 350 thousand deaths will occur by the end of 2021 for Sao Paulo and Brazil, respectively. If in contrast, Sao Paulo and Brazil had enough vaccine supply and so started a vaccination campaign in January with the maximum vaccination rate, compliance and efficacy, they could have averted more than 112 thousand deaths and 127 thousand deaths, respectively. In addition, for each month of delay the number of deaths increases monotonically in a logarithmic fashion, for both the State of Sao Paulo and Brazil as a whole. Conclusions Our model shows that the current delay in the vaccination schedules that is observed in many countries has serious consequences in terms of mortality by the disease and should serve as an alert to health authorities to speed the process up such that the highest number of people to be immunized is reached in the shortest period of time.


2009 ◽  
Vol 72 (1) ◽  
pp. 37-42 ◽  
Author(s):  
GABRIELA PALCICH ◽  
CINTIA de MORAES GILLIO ◽  
LINA CASALE ARAGON-ALEGRO ◽  
FRANCO J. PAGOTTO ◽  
JEFFREY M. FARBER ◽  
...  

This study was the first conducted in Brazil to evaluate the presence of Enterobacter sakazakii in milk-based powdered infant formula manufactured for infants 0 to 6 months of age and to examine the conditions of formula preparation and service in three hospitals in São Paulo State, Brazil. Samples of dried and rehydrated infant formula, environments of milk kitchens, water, bottles and nipples, utensils, and hands of personnel were analyzed, and E. sakazakii and Enterobacteriaceae populations were determined. All samples of powdered infant formula purchased at retail contained E. sakazakii at <0.03 most probable number (MPN)/100 g. In hospital samples, E. sakazakii was found in one unopened formula can (0.3 MPN/100 g) and in the residue from one nursing bottle from hospital A. All other cans of formula from the same lot bought at a retail store contained E. sakazakii at <0.03 MPN/100 g. The pathogen also was found in one cleaning sponge from hospital B. Enterobacteriaceae populations ranged from 101 to 105 CFU/g in cleaning aids and <5 CFU/g in all formula types (dry or rehydrated), except for the sample that contained E. sakazakii, which also was contaminated with Enterobacteriaceae at 5 CFU/g. E. sakazakii isolates were not genetically related. In an experiment in which rehydrated formula was used as the growth medium, the temperature was that of the neonatal intensive care unit (25°C), and the incubation time was the average time that formula is left at room temperature while feeding the babies (up to 4 h), a 2-log increase in levels of E. sakazakii was found in the formula. Visual inspection of the facilities revealed that the hygienic conditions in the milk kitchens needed improvement. The length of time that formula is left at room temperature in the different hospitals while the babies in the neonatal intensive care unit are being fed (up to 4 h) may allow for the multiplication of E. sakazakii and thus may lead to an increased health risk for infants.


2011 ◽  
Vol 31 (5) ◽  
pp. 1015-1026
Author(s):  
Julio C. Molina ◽  
Carlito Calil Júnior ◽  
Roberto R. de Freitas

In São Paulo State, mainly in rural areas, the utilization of wooden poles is observed for different purposes. In this context, wood in contact with the ground presents faster deterioration, which is generally associated to environmental factors and, especially to the presence of fungi and insects. With the use of mathematical models, the useful life of wooden structures can be predicted by obtaining "climatic indexes" to indicate, comparatively among the areas studied, which have more or less tendency to fungi and insects attacks. In this work, by using climatological data of several cities at São Paulo State, a simplified mathematical model was obtained to measure the aggressiveness of the wood in contact with the soil.


PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0261958
Author(s):  
Farid Samaan ◽  
Elisa Carneiro de Paula ◽  
Fabrizzio Batista Guimarães de Lima Souza ◽  
Luiz Fernando Cardoso Mendes ◽  
Paula Regina Gan Rossi ◽  
...  

Introduction Multicenter studies involving patients with acute kidney injury (AKI) associated with the disease caused by the new coronavirus (COVID-19) and treated with renal replacement therapy (RRT) in developing countries are scarce. The objectives of this study were to evaluate the demographic profile, clinical picture, risk factors for mortality, and outcomes of critically ill patients with AKI requiring dialysis (AKI-RRT) and with COVID-19 in the megalopolis of São Paulo, Brazil. Methods This multicenter, retrospective, observational study was conducted in the intensive care units of 13 public and private hospitals in the metropolitan region of the municipality of São Paulo. Patients hospitalized in an intensive care unit, aged ≥ 18 years, and treated with RRT due to COVID-19-associated AKI were included. Results The study group consisted of 375 patients (age 64.1 years, 68.8% male). Most (62.1%) had two or more comorbidities: 68.8%, arterial hypertension; 45.3%, diabetes; 36.3%, anemia; 30.9%, obesity; 18.7%, chronic kidney disease; 15.7%, coronary artery disease; 10.4%, heart failure; and 8.5%, chronic obstructive pulmonary disease. Death occurred in 72.5% of the study population (272 patients). Among the 103 survivors, 22.3% (23 patients) were discharged on RRT. In a multiple regression analysis, the independent factors associated with death were the number of organ dysfunctions at admission and RRT efficiency. Conclusion AKI-RRT associated with COVID-19 occurred in patients with an elevated burden of comorbidities and was associated with high mortality (72.5%). The number of organ dysfunctions during hospitalization and RRT efficiency were independent factors associated with mortality. A meaningful portion of survivors was discharged while dependent on RRT (22.3%).


2018 ◽  
Vol 34 (S1) ◽  
pp. 125-126
Author(s):  
Deyvid Silva ◽  
Letícia Lazarini ◽  
Araujo Aline ◽  
Evelinda Trindade ◽  
Otavio Becker ◽  
...  

Introduction:Prostate neoplasia affects more than one million people worldwide. Surgical treatments have evolved from open or video prostatectomy, up to the High Intensity Focused Ultrasound (HIFU) technique. HIFU studies cite less costs and better quality of life during the first year of follow-up. The objective of this study is to describe a consecutive series of eligible patients, with Gleason score 6 and 7, and compare resources used along those three treatment techniques.Methods:A comparative and retrospective study was conducted during the first 2017 semester, at Hospital de Transplantes de São Paulo, São Paulo city, Brazil. Consecutive eligible patients were matched by age, disease stage and profile and Gleason score 6 or 7. Resources used were assessed through medical records review and in- and out-patient visit interviews.Results:A total of 152 patients were followed: 50 underwent open surgery prostatectomy, 50 underwent video prostatectomy and 52 underwent HIFU. Mean age did not differ between groups (66.6, 64.1 and 65.6 years, respectively). All patients were followed for at least three months. The average operating room time was 4.7, 4.1 and 2.3 hours, and the average anesthetic recovery time was 2.0, 1.9 and 2.0 hours, respectively. Average inpatient length of stay was 2.5, 2.7 and 1.5 days, respectively. Postoperatively, nine (18 percent) open surgery patients, and 14 (28 percent) video-prostatectomy patients required an average of one full day of intensive care, compared to only one (2 percent) HIFU patient. During follow-up, the same effectiveness was observed between the groups, none required re-intervention. Thus, considering the 50 percent economy in hours of operating room and of days of hospital stay, as well as 10 times less use of intensive care unit days when the HIFU technique was compared to conventional surgeries, it is estimated the HIFU program allowed 30 percent cost savings.Conclusions:The HIFU program presented effectiveness and savings. The hospital can increase access to care for prostate neoplasia patients.


2011 ◽  
Vol 19 (5) ◽  
pp. 1114-1121 ◽  
Author(s):  
Divane de Vargas ◽  
Ana Paula Vieira Dias

This study aimed to estimate the prevalence of depression in nursing staff working in Intensive Care Units of hospitals from a city in Northwestern São Paulo State - Brazil, examining its association with participants' socio-demographic characteristics. The Beck Depression Inventory was applied to a sample of 67 nursing workers from three general hospitals, showing an 28.4% prevalence of depression. The analysis based on the multiple model showed a significant association between depression and marital status (OR=1.52), night work (OR=1.46) and double shifts (OR=2.11). Also, there were significant percentages of workers who reported discouragement, sadness and hopelessness. In conclusion, the prevalence of depression is significant and more attention should be paid to this problem workers at these units face. Further studies are needed in the attempt to broaden knowledge on the subject, which can support strategies to guarantee attention to ICU nursing workers' physical and mental health needs.


Author(s):  
Silvia Mayumi Okuma ◽  
Ana Flávia Marostegan De Paula ◽  
Gabriela Pereira Do Carmo ◽  
Marcela Maria Pandolfi

A internação na UTI (Unidade de Terapia Intensiva),  e o processo de adoecimento podem gerar implicações negativas ao sujeito como alterações motoras, cognitivas e na participação nas atividades de vida diária. Muitos pacientes compartilham más experiências vivenciadas durante a internação em UTI (as quais desorganizam o sujeito, identificar as necessidades pode contribuir na elaboração do plano de tratamento adequado às demandas do paciente. Dessa forma,o objetivo do trabalho foi de  caracterizar o perfil desses pacientes atendidos pela Terapia Ocupacional na UTI Adulto. Realizou-se uma pesquisa transversal observacional da qual participaram 37 sujeitos internados na UTI adulto de um hospital público da Zona Leste do município de São Paulo no período de junho a agosto de 2016. Verificou-se que as características mais presentes entre os participantes dos grupos conforme gênero, idade e dias de internação foram:  fraqueza, dor, mobilidade reduzida, limitação no autocuidado, banho e higiene foram os mais presentes entre os participantes. Déficit cognitivo e queixa de memória foram os mais elencados no grupo dos idosos. A internação na UTI e o processo de adoecimento podem gerar implicações negativas ao sujeito como alterações motoras, cognitivas e na participação nas atividades de vida diária. Com base nos resultados identificou-se que os pacientes internados apresentaram fatores que interferem na participação nas atividades de vida diária (autocuidado, banho, higiene, arrumar-se no leito, alimentação e controle de esfíncter), e a atuação da Terapia Ocupacional pode contribuir de forma a minimizar os efeitos deletérios decorrentes da hospitalizaçãoAbstractMany patients live bad experiences during their stay in ICU, that disrupt the subject. Identifying the needs of the person can contribute to the elaboration of the treatment plan. Thus, is importante to identify the profile of the patients treated by Occupational Therapy in an Adult Intensive Care Unit. The study consisted of an observational cross-sectional study in which 37 subjects were hospitalized in the adult ICU of a public hospital in the East of the city of São Paulo from June to August 2016. The presence of weakness, pain, reduced mobility, self-care limitation, bathing and hygiene were the most frequent among the participants according to gender, age and days of hospitalization. Cognitive deficit and memory complaints were the most prominent in the elderly group. ICU hospitalization and the process of illness may cause negative implications for the subject, such as motor and cognitive impairment and difficulties in activities of daily living. The data made it possible to identify the profile of the patients treated by Occupational Therapy in the adult ICU, which makes it possible to guide the practice itself.Keywords: Occupational Therapy, Intensive Care Unit, Adult. ResumenMuchos pacientes comparten de las malas experiencias vivenciadas durante la internação en UCI, las cuales desorganizan el sujeto. Identificar las necesidades del sujeto puede contribuir en la elaboración del plan de tratamiento adecuado a las demandas del paciente. De esa forma, se resalta la importancia de identificar el perfil de los pacientes atendidos por la Terapia Ocupacional en la Unidad de Cuidados Intensivos de Adultos. Se realizó una investigación transversal observacional en que fueron evaluados 37 sujetos ingresados en la UCI de adultos de un hospital público de la Zona Este del municipio de São Paulo en el periodo de junio a agosto de 2016. Se verificó que presencia de flaqueza, dolor, movilidad reducida, limitación en el autocuidado, baño e higiene fueron los más presentes entre los participantes de los grupos según género, edad y días de internação. Déficit cognitivo y queja de memoria fueron los más elencados en el grupo de los ancianos. La internação en la UCI y el proceso de adoecimento pueden generar implicaciones negativas al sujeto como alteraciones motoras, cognitivas y en la participación en las actividades de vida diaria. Los datos posibilitaron identificar el perfil de los pacientes atendidos por la Terapia Ocupacional en la UCI de adultos, lo que posibilita a orientar la práctica.Palabras clave: Terapia Ocupacional, Unidad de Cuidados Intensivos, Adulto.


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