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Background: We still do not have information regarding the impact of the COVID-19 pandemic on medical care activity in Brazil., Objective: To describe the repercussions of the COVID-19 pandemic on the care routine of a tertiary hospital, which is a regional reference in cardiology and oncology., Methods: Cross-sectional cohort study. We conducted a survey of medical visits from March 23, 2020 (when local commerce was closed) to April 23, 2020 (P20), in comparison with the same period in 2019 (P19)., Results: We found decreases in the number of cardiology consultations, exercise tests, Holter, ambulatory blood pressure monitoring, electrocardiogram, and echocardiogram (90%, 84%, 94%, 92%, 94%, and 81%, respectively). In relation to cardiac surgery and cardiac catheterization, there were 48% and 60% decreases, respectively. There was an increase in the number of percutaneous transluminal coronary angioplasties (33%) and definitive pacemaker implantations (29%). There were 97 admissions to the ICU during P19, in contrast with 78 during P20, a 20% decrease. Visits to the cardiac emergency room (45%) and admissions to the cardiology ward (36%) also decreased. The decrease in oncology consultations was 30%. Chemotherapy sessions decreased from 1,944 to 1,066 (45%), and radiotherapy sessions decreased by 19%., Conclusion: COVID-19 has led to a considerable decrease in the number of consultations in outpatient clinics for cardiology, oncology, and other specialties. There was a concerning decrease in the number of cardiac surgeries, chemotherapy sessions, and radiotherapy sessions during the initial weeks of the pandemic. The number of people seeking care in the cardiac emergency room and the number of admissions to the cardiology ward and ICU also decreased, generating concern regarding the evolution and prognosis of these patients with pathologies other than COVID-19 during this pandemic time. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0).

Objective: To evaluate the use of mesenchymal stem cells (MSCs) in the attenuation of canine atopic dermatitis (AD)., Materials and Methods: Sixteen dogs were selected and divided into three groups, mild, moderate, and severe, according to the Canine Atopic Dermatitis Extent and Severity Index (CADESI-4). They were evaluated for 82 days. The protocol recommended in this experiment was to inject 2 × 10 6 /kg bodyweight of MSC's in all groups by the intravenous route with intervals of applications of 21 days. The degree of pruritus was evaluated by examining the visual analog scale, the CADESI-4, the histopathology of the skin, hematological and biochemical parameters, the pyogenic effect of MSCs, and the thickness of the epidermis., Results: There was a significant difference in the reduction of epidermal thickness in the moderate and severe groups. Hematological, biochemical, and body temperature parameters remained within normal limits for the species with no side effects., Conclusion: MSCs attenuated the clinical signs of AD., Competing Interests: The authors declare that there is no conflict of interest., (Copyright: © Journal of Advanced Veterinary and Animal Research.)

The aim of this study was to analyse morphological and molecular (ITS region) characteristics for eight species of mites in the family Macrochelidae that are present in cattle manure in Brazil. Six of these species were already known in Brazil and, for five of these, both tools (morphology and phylogeny) were concordant regarding all the trees used. The species G. saprophila and M. scutatus were reported in the present study for the first time in Brazil. The data obtained in this study suggest that the molecular analysis corroborated the morphological identification in most species of macrochelids. The results also demonstrate the need to correlate identifications through dichotomous keys, by using phylogenetic studies to better distinguish cryptic species.

Ticks of the Amblyomma cajennense complex present high infestation rates. These ticks transmit the bacterium Rickettsia rickettsii, which causes Brazilian Spotted Fever. For this reason, an integrated tick control system was adopted on a farm in the municipality of Itu, state of São Paulo. On this farm, which borders the Tietê river, domestic animals are in contact with populations of capybaras. Six locations were monitored and evaluated between the years of 2015 and 2017. During this work 1271 nymphs and adult ticks were caught, all of them from the Amblyomma sculptum species, except for a single individual from the Amblyomma dubitatum species. The integrated tick management reduced the overall infestation levels to zero. Adult tick population dropped in the first year of the study, while larvae population dropped in the second year. Nymph population dropped in both years, decreasing in higher numbers in the first year. The estimated mean infestation levels for all of the tick's life cycle forms in the six monitored spots did not reach one individual in the end of the study. Estimated mean infestation levels for nymphs in these places equaled zero.

Importance: The effects of intensive care unit (ICU) visiting hours remain uncertain., Objective: To determine whether a flexible family visitation policy in the ICU reduces the incidence of delirium., Design, Setting and Participants: Cluster-crossover randomized clinical trial involving patients, family members, and clinicians from 36 adult ICUs with restricted visiting hours (<4.5 hours per day) in Brazil. Participants were recruited from April 2017 to June 2018, with follow-up until July 2018., Interventions: Flexible visitation (up to 12 hours per day) supported by family education (n = 837 patients, 652 family members, and 435 clinicians) or usual restricted visitation (median, 1.5 hours per day; n = 848 patients, 643 family members, and 391 clinicians). Nineteen ICUs started with flexible visitation, and 17 started with restricted visitation., Main Outcomes and Measures: Primary outcome was incidence of delirium during ICU stay, assessed using the CAM-ICU. Secondary outcomes included ICU-acquired infections for patients; symptoms of anxiety and depression assessed using the HADS (range, 0 [best] to 21 [worst]) for family members; and burnout for ICU staff (Maslach Burnout Inventory)., Results: Among 1685 patients, 1295 family members, and 826 clinicians enrolled, 1685 patients (100%) (mean age, 58.5 years; 47.2% women), 1060 family members (81.8%) (mean age, 45.2 years; 70.3% women), and 737 clinicians (89.2%) (mean age, 35.5 years; 72.9% women) completed the trial. The mean daily duration of visits was significantly higher with flexible visitation (4.8 vs 1.4 hours; adjusted difference, 3.4 hours [95% CI, 2.8 to 3.9]; P < .001). The incidence of delirium during ICU stay was not significantly different between flexible and restricted visitation (18.9% vs 20.1%; adjusted difference, -1.7% [95% CI, -6.1% to 2.7%]; P = .44). Among 9 prespecified secondary outcomes, 6 did not differ significantly between flexible and restricted visitation, including ICU-acquired infections (3.7% vs 4.5%; adjusted difference, -0.8% [95% CI, -2.1% to 1.0%]; P = .38) and staff burnout (22.0% vs 24.8%; adjusted difference, -3.8% [95% CI, -4.8% to 12.5%]; P = .36). For family members, median anxiety (6.0 vs 7.0; adjusted difference, -1.6 [95% CI, -2.3 to -0.9]; P < .001) and depression scores (4.0 vs 5.0; adjusted difference, -1.2 [95% CI, -2.0 to -0.4]; P = .003) were significantly better with flexible visitation., Conclusions and Relevance: Among patients in the ICU, a flexible family visitation policy, vs standard restricted visiting hours, did not significantly reduce the incidence of delirium., Trial Registration: ClinicalTrials.gov Identifier: NCT02932358.