RESUMEN
Twenty-five B-cell-depleted patients (24 following anti-CD19/20 therapy) diagnosed with coronavirus disease 2019 had been symptomatic for a median of 26 days but remained antibody negative. All were treated with convalescent plasma with high neutralizing antibody titers. Twenty-one (84%) recovered, indicating the potential therapeutic effects of this therapy in this particular population.
Asunto(s)
COVID-19 , Anticuerpos Neutralizantes/uso terapéutico , Anticuerpos Antivirales , COVID-19/terapia , Humanos , Inmunización Pasiva , SARS-CoV-2 , Sueroterapia para COVID-19RESUMEN
OBJECTIVE: The aim of this study was to review musculoskeletal disorder (MSD) prevalence among surgeons performing minimally invasive surgery. BACKGROUND: Advancements in laparoscopic surgery have primarily focused on enhancing patient benefits. However, compared with open surgery, laparoscopic surgery imposes greater ergonomic constraints on surgeons. Recent reports indicate a 73% to 88% prevalence of physical complaints among laparoscopic surgeons, which is greater than in the general working population, supporting the need to address the surgeons' physical health. METHODS: To summarize the prevalence of MSDs among surgeons performing laparoscopic surgery, we performed a systematic review of studies addressing physical ergonomics as a determinant, and reporting MSD prevalence. On April 15 2016, we searched Pubmed, EMBASE, the Cochrane Library, Web of Science, CINAHL, and PsychINFO. Meta-analyses were performed using the Hartung-Knapp-Sidik-Jonkman method. RESULTS: We identified 35 articles, including 7112 respondents. The weighted average prevalence of complaints was 74% [95% confidence interval (95% CI) 65-83]. We found high inconsistency across study results (I = 98.3%) and the overall response rate was low. If all nonresponders were without complaints, the prevalence would be 22% (95% CI 16-30). CONCLUSIONS: From the available literature, we found a 74% prevalence of physical complaints among laparoscopic surgeons. However, the low response rates and the high inconsistency across studies leave some uncertainty, suggesting an actual prevalence of between 22% and 74%. Fatigue and MSDs impact psychomotor performance; therefore, these results warrant further investigation. Continuous changes are enacted to increase patient safety and surgical care quality, and should also include efforts to improve surgeons' well-being.
Asunto(s)
Laparoscopía , Enfermedades Musculoesqueléticas/epidemiología , Enfermedades Profesionales/epidemiología , Cirujanos , Ergonomía , Humanos , PrevalenciaRESUMEN
The number of pediatric and young adult cancer survivors is increasing globally due to earlier diagnostics and expansion of targeted chemo- and biological-based therapeutics. As a consequence, cancer-related infertility and reproductive hormone loss is of increasing concern for both male and female survivors. We attempted to estimate the reproductive loss in oncofertility-practicing countries and to develop a global oncofertility index (OFI). This would allow an accounting of the level of urgency of the issue and would provide national comparisons of fertility loss, which differ based on the prevalence and/or diagnosis frequency and treatment variables by countries or region. While the goal is laudable, an index such as this is unachievable due to the lack of the kind of information that would be necessary to calculate such a meaningful index. Without this metric, we will be unable to assess how oncofertility concerns are being addressed and what lessons can be learned from countries that improve such an index over time.
Asunto(s)
Antineoplásicos/efectos adversos , Factores Biológicos/efectos adversos , Infertilidad/inducido químicamente , Neoplasias/tratamiento farmacológico , Adolescente , Adulto , Antineoplásicos/uso terapéutico , Factores Biológicos/uso terapéutico , Femenino , Humanos , Masculino , Adulto JovenRESUMEN
As cancer survival rates continue to increase, so does the relevance of starting or expanding a family after cancer, impacting quality of life. However, the option of fertility preservation is not always addressed by physicians before treatment. In the meanwhile, many patients look for health information online. Although potentially helpful in the decision-making process, the Internet could also have adverse effects for this vulnerable patient group when information is incorrect. We aimed to assess the availability and quality of information on female oncofertility on websites of (inter)national oncology, fertility and oncofertility organizations. Availability was identified using an original checklist. Quality was measured by reliability (DISCERN and LIDA instruments), usability (LIDA instrument), and readability (Flesch Kincaid Grade Level test). Of all investigated websites, 52% contained information on oncofertility, with 32% containing a stand-alone page. Of those sites, the amount of treatment options covered were equivalent between specialty sites and general fertility and oncology sites (p = 0.07). The quality of information on treatment choices was the highest for oncofertility websites. Reliability and usability did not differ significantly between websites. No websites evaluated were at the recommended 7th-8th grade reading level. Availability and quality should be improved, and high-quality resources are recommended by physicians.