Risk-based management of international sporting events during the COVID-19 pandemic.

Mass gatherings include a diverse range of events such as sporting competitions, religious ceremonies, entertainment activities, political rallies and cultural celebrations, which have important implications for population well-being. However, if not managed properly, these events can amplify health risks including those related to communicable diseases, and place undue strain on health systems in host countries and potentially in attendees' home countries, upon their return. The coronavirus disease 2019 (COVID-19) pandemic has provided a unique opportunity to evaluate the risk factors associated with mass gatherings and the effectiveness of applying mitigation measures during infectious disease emergencies. The pandemic has also allowed event organizers and health officials to identify best practices for mass gathering planning in host countries. To guide decisions about whether to hold, postpone, modify or cancel a mass gathering during the COVID-19 pandemic, the World Health Organization and its partners developed normative guidance and derivative tools promoting a risk-based approach to mass gathering planning. This approach involves three steps to guide decision-making around mass gatherings: risk evaluation, risk mitigation and risk communication. The approach was applied in the planning and execution of several mass gathering events, including the Tokyo 2020 and Beijing 2022 Olympic and Paralympic Games. Lessons identified from these large-scale international events offer insights into the planning and implementation of mass gathering events during a pandemic, and the broader impacts of such events on society. These lessons may also further inform and refine planning for future mass gatherings.

Les rassemblements de masse désignent un large éventail d'événements tels que des compétitions sportives, cérémonies religieuses, activités de divertissement, manifestations politiques et fêtes culturelles. Tous ont un impact considérable sur le bien-être de la population. Toutefois, s'ils ne sont pas gérés correctement, ils peuvent augmenter les risques sanitaires, notamment concernant les maladies transmissibles, et exercer une pression excessive sur les systèmes de santé des pays hôtes, voire sur ceux des pays d'origine des participants après leur retour. La pandémie de maladie à coronavirus 2019 (COVID-19) a offert une occasion unique d'évaluer les facteurs de risque associés aux rassemblements de masse, ainsi que l'efficacité des mesures visant à limiter la propagation dans des situations d'urgence liées à des maladies infectieuses. Cette pandémie a également permis aux organisateurs d'événements et responsables de santé d'identifier les bonnes pratiques à appliquer dans les pays hôtes pendant les rassemblements de masse. Afin de guider les décisions relatives au maintien, au report, à la modification ou à l'annulation d'un rassemblement de masse durant la pandémie de COVID-19, l'Organisation mondiale de la Santé et ses partenaires ont mis au point des orientations normatives et des outils dérivés favorisant une approche tenant compte des risques au moment de la planification. Cette approche comprend trois étapes contribuant à la prise de décision: l'évaluation, la réduction et la communication des risques. Elle a été déployée lors de la planification et de l'exécution de nombreux rassemblements de masse, comme les Jeux olympiques et paralympiques de Tokyo 2020 et Beijing 2022. Les leçons tirées de ces événements internationaux à grande échelle fournissent des informations sur leur organisation et leur mise en œuvre en cas de pandémie, ainsi que les impacts de tels événements sur la société. Elles sont en outre susceptibles de faciliter et d'améliorer la planification des futurs rassemblements de masse.

Las concentraciones masivas incluyen una gran variedad de eventos, como competiciones deportivas, ceremonias religiosas, actividades de entretenimiento, mítines políticos y celebraciones culturales, que tienen importantes implicaciones para el bienestar de la población. Sin embargo, si no se gestionan adecuadamente, estos eventos pueden amplificar los riesgos para la salud, incluidos los relacionados con las enfermedades transmisibles, y suponer una carga excesiva para los sistemas sanitarios de los países anfitriones y, potencialmente, de los países de origen de los participantes a su regreso. La pandemia de la enfermedad por coronavirus de 2019 (COVID-19) ha brindado una oportunidad única para evaluar los factores de riesgo asociados a las concentraciones masivas y la eficacia de aplicar medidas de mitigación durante las emergencias por enfermedades infecciosas. La pandemia también ha permitido a los organizadores de eventos y a las autoridades sanitarias identificar las mejores prácticas para la planificación de concentraciones masivas en los países anfitriones. Para orientar las decisiones sobre la celebración, el aplazamiento, la modificación o la cancelación de una concentración masiva durante la pandemia de la COVID-19, la Organización Mundial de la Salud y sus asociados elaboraron orientaciones normativas y herramientas derivadas que promueven un enfoque de la planificación de concentraciones masivas basado en los riesgos. Este enfoque consta de tres pasos para orientar la toma de decisiones en torno a las concentraciones masivas: la evaluación, la mitigación y la comunicación de riesgos. El enfoque se aplicó en la planificación y ejecución de varias concentraciones masivas, incluidos los Juegos Olímpicos y Paralímpicos de Tokio 2020 y Pekín 2022. Las conclusiones extraídas de estos eventos internacionales a gran escala permiten comprender mejor la planificación y ejecución de concentraciones masivas durante una pandemia, así como las repercusiones más generales de estos eventos en la sociedad. Estas lecciones también pueden informar y perfeccionar la planificación de futuras concentraciones masivas.

A systematic review of cytoreductive prostatectomy outcomes and complications in oligometastatic disease.

Objective: To analyze outcomes and complications of cytoreductive prostatectomy (CRP) for oligometastatic prostate cancer (PCa) in order to elucidate its role in this space. Methods: We performed a systematic literature search using three databases (Medline, Scopus, and Web of Science). The primary endpoints were oncologic outcomes. The secondary endpoints were complication rates and functional results. Results: In all studies, overall survival was better or at least comparable variable in the groups with CRP compared to no local treatment. The greatest benefit from CRP in 5-year overall survival in one study was 67.4% for CRP versus 22.5% for no local treatment. Cancer-specific survival (CSS) showed the same trend. Several authors found significant benefits from CSS in the CRP group: from 79% vs. 46% to 100% vs. 61%. CRP was a predictor of better CSS (hazard ratio 0.264, p=0.004). Positive surgical margin rates differed widely from 28.6% to 100.0%. Urinary continence in CRP versus RP for localized PCa was significantly lower (57.4% vs. 90.8%, p<0.0001). Severe incontinence occurred seldom (2.5%-18.6%). Total complication rates after CRP differed widely, from 7.0% to 43.6%. Rates of grades 1 and 2 events prevailed. Patients on ADT alone also showed a considerable number of complications varying from 5.9% to 57.7%. Conclusion: CRP improves medium-term cancer control in patients with oligometastatic PCa. The morbidity and complication rates of this surgery are comparable with other approaches, but postoperative incontinence rate is higher compared with RP for localized disease.

Electronic APPS in assessing risk and monitoring of patients with arterial hypertension

The medical social significance of the arterial hypertension (AH) in the world is determined by its high prevalence, which allows to call it a non-infectious pandemic of today. The AH still remains the most common chronic disease that triggers the cardiovascular continuum, significantly reduces the body's adaptive capacity, worsens the living standards for people of socially minded age, and represents the leading global risk of increased cardiovascular mortality. The purpose of the study was comparison of informative value of various methods for measuring the arterial blood pressure (ABP) (office-based, home-based using electronic apps, and daily) in order to improve the risk assessment of the condition and monitoring the treatment efficiency for the AH patients. The method of qualitative and quantitative analysis of scientific literature and public online sources was used in the study. It has been established that the ABP analysis is an important tool to prevent the negative consequences of the AH. The results of the experimental study have revealed that hourly home-based ABP monitoring using a mobile electronic app is more informative than monitoring at long intervals, and provides information which is close to the average daily indicators obtained in the daily ABP monitoring.

Patient-reported outcomes: A 5-year long study reveals previously unreported therapeutic, demographic, socio-economic, and other correlations in vitiligo.

Vitiligo is a non-lethal, non-communicable, immune-mediated, and generally progressive skin disease, with poorly understood etiopathogenesis and weak evidence base. The aim of the study is to contribute to the scant research on the patient-reported outcomes in vitiligo, and to examine the presence of associations between various inputs for possible use in clinical practice. The study was designed as a web-based questionnaire with 40 inputs across seven dimensions. The questions include demographics, skin type, eye and natural hair color, age of respondent and age of onset, possible triggers, disease extent, localization, progression and activity, the efficacy of most common treatment modalities, medication side-effects, heredity and diseases among parents, and out-of-pocket expenses for treatments to date. The analysis presented with this work contributes to the discussion about the relation between therapies, socio-economic factors, and treatment outcomes in vitiligo. All physicians should adequately manage patient expectations in terms of overall treatment duration and expected out-of-pocket expenses, and actively evaluate patients at shorter intervals. A more aggressive therapeutic approach using telehealth devices should be considered to supplement therapy, monitor treatment progress, and protocol compliance.