Definitions and symptoms of the post-COVID syndrome: an updated systematic umbrella review.

Post-COVID syndrome (PCS) describes a persistent complex of symptoms following a COVID-19 episode, lasting at least 4 to 12 weeks, depending on the specific criteria used for its definition. It is often associated with moderate to severe impairments of daily life and represents a major burden for many people worldwide. However, especially during the first two years of the COVID-19 pandemic, therapeutic and diagnostic uncertainties were prominent due to the novelty of the disease and non-specific definitions that overlooked functional deficits and lacked objective assessment. The present work comprehensively examines the status of PCS definitions as depicted in recent reviews and meta-analyses, alongside exploring associated symptoms and functional impairments. We searched the database Pubmed for reviews and meta-analysis evaluating PCS in the period between May 31, 2022, to December 31, 2023. Out of 95 studies, 33 were selected for inclusion in our analyses. Furthermore, we extended upon prior research by systematically recording the symptoms linked with PCS as identified in the studies. We found that fatigue, neurological complaints, and exercise intolerance were the most frequently reported symptoms. In conclusion, over the past eighteen months, there has been a notable increase in quantity and quality of research studies on PCS. However, there still remains a clear need for improvement, particularly with regard to the definition of the symptoms necessary for diagnosing this syndrome. Enhancing this aspect will render future research more comparable and precise, thereby advancing and understanding PCS.

[Recurrent SARS-CoV-2 infections in immunodeficiency]. / Rezidivierende SARS-CoV-2-Infektionen bei Immundefizienz.

A patient with immunodeficiency due to a B-cell lymphoma has repeatedly been tested positive for SARS-CoV­2 during the ongoing SARS-CoV­2 pandemic and has twice received in-hospital treatment. Chronic and recurrent SARS-CoV­2 infections are a threat to the individual health of immunodeficient patients. Only few therapeutic options are available especially due to emerging virus variants with immune escape mechanisms. The medical care of immunodeficient patients with SARS-CoV­2 infections is a great challenge to the treating physician in the ongoing pandemic.

Twenty years of family counselling in Austria: time for a celebration?

PIP: In Austria, approximately 270 Family Counseling Centers have been organized by various interest groups with government support since 1974 when abortion was legalized. In recent years, however, the political situation in Austria has led to a reduction in available funds and to bureaucratic delays in processing applications for support. The Austrian consumers must pay relatively high costs for contraception, abortion, and sexual sterilization, and the counseling centers have gathered information which indicates that women are finding it impossible to meet the costs of abortion or sterilization. The Social Welfare Office only covers the costs of low-income, migrant, or refugee women in certain circumstances. Working through counseling centers, the Austrian Family Planning (FP) Association provides IUDs or diaphragms and information on all methods of contraception. Oral contraceptives and condoms are distributed for free when they are available. Because FP is a necessity and should not become a luxury, it is suggested that the counseling centers become linked to a health sector network to increase access of clients to the support available in state institutions.^ieng

Systemwide effects of Medicaid retrospective drug utilization review programs.

Aggregate pooled cross-sectional and time-series annual state data for 1985 to 1992 were used to estimate the systemwide effects of retrospective drug utilization review programs (Retro-DUR) on Medicaid drug and nondrug outcomes. The results provide evidence that these programs produce significant cost savings in the drug budget without spillover effects (positive or negative) in other nondrug budgets within the Medicaid system. We also examine the influence of restricted formularies in this post-Retro-DUR era on drug and nondrug budgets in the Medicaid system; we find significant cost savings in the former but positive spillover effects in the latter.

Imaging lung function using rapid dynamic acquisition of T1-maps during oxygen enhancement.

This paper describes imaging of lung function with oxygen-enhanced MRI using dynamically acquired T1 parameter maps, which allows an accurate, quantitative assessment of time constants of T1-enhancement and therefore lung function. Eight healthy volunteers were examined on a 1.5-T whole-body scanner. Lung T1-maps based on an IR Snapshot FLASH technique (TE = 1.4 ms, TR = 3.5 ms, FA = 7 (composite function )) were dynamically acquired from each subject. Without waiting for full relaxation between subsequent acquisition of T1-maps, one T1-map was acquired every 6.7 s. For comparison, all subjects underwent a standard pulmonary function test (PFT). Oxygen wash-in and wash-out time course curves of T1 relaxation rate (R1)-enhancement were obtained and time constants of oxygen wash-in (w(in)) and wash-out (w(out)) were calculated. Averaged over the whole right lung, the mean w(out) was 43.90 +/- 10.47 s and the mean (w(in)) was 51.20 +/- 15.53 s, thus about 17% higher in magnitude. Wash-in time constants correlated strongly with forced expired volume in one second in percentage of the vital capacity (FEV1 % VC) and with maximum expiratory flow at 25% vital capacity (MEF25), whereas wash-out time constants showed only weak correlation. Using oxygen-enhanced rapid dynamic acquisition of T1-maps, time course curves of R1-enhancement can be obtained. With w(in) and w(out) two new parameters for assessing lung function are available. Therefore, the proposed method has the potential to provide regional information of pulmonary function in various lung diseases.