Risk factors for healthcare-associated infections and their relationship with waves of the COVID-19 pandemic in an intensive care unit: a nested case-control study.

Objective: To evaluate the risk factors for healthcare-related infections during the COVID-19 pandemic in intensive care units, to investigate the impact of COVID-19 on Central Line-Associated Bloodstream Infection, Catheter-Associated Urinary Tract Infection, and ventilator-associated pneumonia, and to describe healthcare-associated infections in the waves of the COVID-19 pandemic.

Methods: This nested case-control study was conducted in a 137-bed adult medical/surgical intensive care unit at a private hospital in São Paulo, Brazil, between January 11, 2019, and May 21, 2022. Case patients were identified using the Nosocomial Infection Control Committee database and control patients were identified using the intensive care unit's EPIMED system.

Cost analysis of endovascular treatment for unruptured intracranial aneurysms at a private hospital in Brazil.

Background: Intracranial aneurysms have a prevalence of 1-6% and significant rupture risks, leading to high morbidity and mortality. Endovascular therapy demands an understanding of its economic impacts. This study evaluates the costs and complications of unruptured intracranial aneurysm treatment in a private Latin American hospital.

Patient-level cost analysis of intensive care unit acquired infections: A prospective cohort study.

Introduction: Hospital-associated infections (HAIs) are associated with increased mortality and prolonged hospital length-of-stay (LOS). Although some studies have shown that HAIs are associated with increased costs, these studies only used cost estimates, were carried out in a small number of centres, or only in high-income countries.

Methods: We carried out a prospective cohort study in ten Brazilian intensive care units (ICUs) selected from a collaborative platform study (IMPACTO MR).

Is it possible to estimate the number of patients with COVID-19 admitted to intensive care units and general wards using clinical and telemedicine data?

Background: Gabaldi et al. utilized telemedicine data, web search trends, hospitalized patient characteristics, and resource usage data to estimate bed occupancy during the COVID-19 pandemic. The results showcase the potential of data-driven strategies to enhance resource allocation decisions for an effective pandemic response.

Impact of a quality programme on overindication of surgeries for endometriosis and cholecystectomies.

Approximately 45% of patients receive medical services with minimal or no benefit (low-value care). In addition to the increasing costs to the health system, performing invasive procedures without an indication poses a potentially preventable risk to patient safety. This study aimed to determine whether a managed quality improvement programme could prevent cholecystectomy and surgery for endometriosis treatment with minimal or no benefit to patients.

Longer-term effectiveness of a heterologous coronavirus disease 2019 (COVID-19) vaccine booster in healthcare workers in Brazil.

Objective: To compare the long-term vaccine effectiveness between those receiving viral vector [Oxford-AstraZeneca (ChAdOx1)] or inactivated viral (CoronaVac) primary series (2 doses) and those who received an mRNA booster (Pfizer/BioNTech) (the third dose) among healthcare workers (HCWs).

Methods: We conducted a retrospective cohort study among HCWs (aged ≥18 years) in Brazil from January 2021 to July 2022. To assess the variation in the effectiveness of booster dose over time, we estimated the effectiveness rate by taking the log risk ratio as a function of time.

Risk factors for long coronavirus disease 2019 (long COVID) among healthcare personnel, Brazil, 2020-2022.

Objective: To determine risk factors for the development of long coronavirus disease 2019 (COVID-19) in healthcare personnel (HCP).

Methods: We conducted a case-control study among HCP who had confirmed symptomatic COVID-19 working in a Brazilian healthcare system between March 1, 2020, and July 15, 2022. Cases were defined as those having long COVID according to the Centers for Disease Control and Prevention definition.

Quality improvement project to reduce unplanned extubations in a paediatric intensive care unit.

Background: Unplanned extubations are recurrent adverse events in mechanically ventilated children and have been the focus of quality and safety improvement in paediatric intensive care units (ICUs).

Local Problem: To reduce the rate of unplanned extubation in the paediatric ICU by 66% (from 2.02 to 0.

IMPACTO-MR: a Brazilian nationwide platform study to assess infections and multidrug resistance in intensive care units.

Objective: To describe the IMPACTO-MR, a Brazilian nationwide intensive care unit platform study focused on the impact of health care-associated infections due to multidrug-resistant bacteria.

Methods: We described the IMPACTO-MR platform, its development, criteria for intensive care unit selection, characterization of core data collection, objectives, and future research projects to be held within the platform.

Results: The core data were collected using the Epimed Monitor System® and consisted of demographic data, comorbidity data, functional status, clinical scores, admission diagnosis and secondary diagnoses, laboratory, clinical, and microbiological data, and organ support during intensive care unit stay, among others.

Value-based healthcare in Latin America: a survey of 70 healthcare provider organisations from Argentina, Brazil, Chile, Colombia and Mexico.

Objectives: Value-based healthcare (VBHC) is a health system reform gradually being implemented in health systems worldwide. A previous national-level survey has shown that Latin American countries were in the early stages of alignment with VBHC. Data at the healthcare provider organisations (HPOs) level are lacking.

Antiviral activity of bacterial TIR domains via immune signalling molecules.

The Toll/interleukin-1 receptor (TIR) domain is a canonical component of animal and plant immune systems. In plants, intracellular pathogen sensing by immune receptors triggers their TIR domains to generate a molecule that is a variant of cyclic ADP-ribose. This molecule is hypothesized to mediate plant cell death through a pathway that has yet to be resolved.

Impact of the COVID-19 pandemic on emergency department visits: experience of a Brazilian reference center.

Objective: To analyze the impact of COVID-19 on emergency department metrics at a large tertiary reference hospital in Brazil.

Methods: A retrospective analysis of consecutive emergency department visits, from January 1, 2020, to November 21, 2020, was performed and compared to the corresponding time frame in 2018 and 2019. The volume of visits and patients' demographic and clinic characteristics were compared.

Impact of COVID-19 pandemic on care of oncological patients: experience of a cancer center in a Latin American pandemic epicenter.

Objective: Since the rising of coronavirus disease 2019 (COVID-19) pandemic, there is uncertainty regarding the impact of transmission to cancer patients. Evidence on increased severity for patients undergoing antineoplastic treatment is posed against deferring oncologic treatment. We aimed to evaluate the impact of COVID-19 pandemic on patient volumes in a cancer center in an epicenter of the pandemic.

What Do Doctors Think About Value-Based Healthcare? A Survey of Practicing Physicians in a Private Healthcare Provider in Brazil.

Objectives: As health systems start to discuss alternative payment models for fostering value in healthcare, there is increased interest in understanding how physicians will cope with different remuneration schemes. We conducted a survey of physicians practicing at Hospital Israelita Albert Einstein, a nonprofit private healthcare provider in Brazil, aimed at capturing their awareness of value-based healthcare (VBHC).

Methods: Our study uses data from a survey administered to doctors practicing at Einstein between September and November 2018.

Probing Protein Denaturation during Size-Exclusion Chromatography Using Native Mass Spectrometry.

Size-exclusion chromatography employing aqueous mobile phases with volatile salts at neutral pH combined with electrospray-ionization mass spectrometry (SEC-ESI-MS) is a useful tool to study proteins in their native state. However, whether the applied eluent conditions actually prevent protein-stationary phase interactions, and/or protein denaturation, often is not assessed. In this study, the effects of volatile mobile phase additives on SEC retention and ESI of proteins were thoroughly investigated.

Endovascular Repair of Infrarenal Abdominal Aortic Aneurysm Results in Higher Hospital Expenses than Open Surgical Repair: Evidence from a Tertiary Hospital in Brazil.

Background: Endovascular aneurysm repair (EVAR) has become the preferred approach for the treatment of infrarenal abdominal aortic aneurysm (IRAAA) in detriment of open surgical repair (OSR). EVAR results in lower mortality rates within 30 days, but rates tend to be the same after longer periods. Moreover, reduced use of hospital resources with EVAR does not necessarily offset the costs of the endoprosthesis.