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BackgroundIgA vasculitis (IgAV) is a rare autoimmune disease affecting small vessels. It is well established that the incidence is higher in children (3 to 26 per 100,000 children/year,) [1] than in adults (0.1 to 1.8 per 100,000 individuals/year) [1]. However others epidemiological data and impact of the COVID-19 on IgAV remain overlooked [2].ObjectivesTo collect and analyze epidemiological data on IgAV in both adults and children in France.MethodsWe conducted an observational study using a national database called "BNDMR” [3] (Banque Nationale de Données Maladies Rares) on IgA vasculitis (code ORPHA761), which gathered patients managed in the French rare disease expert network. The incidence was estimated from the date of diagnosis, and we calculated the median annual incidence over the period 2010-2022. We specifically assessed the north/south gradient (latitude of the residence higher/lower than the median of the latitudes), the seasonality, and the impact of the COVID-19 pandemic compared to other patients reported within the same period and addressed in the same expert centers used as controls.ResultsDuring this 12-year period, 1988 patients with IgAV were reported (1498 children;490 adults). The male to female ratio was 1.57 for adults and 1.05 for children. The median IgAV annual incidence was 15 cases/year [IQR 9-30] and 82 cases/year [IQR 72-86] for adult and children cases respectively. Time to diagnosis was less than 1 month for both. Compared with other patients reported in the same expert centers, IgAV was more frequently reported in the southern part of France than in the north (OR 4.88 [95% confidence intervals: 4.17 - 5.74] in adults and OR 1.51 [1.35 - 1.68] in children). IgAV was also more frequently observed in winter than during the rest of the year in both adults (OR 1.60 [1.39 - 1.82]) and children (OR 1.22 [1.01 - 1.48]). The incidence of IgAV decreased during the COVID-19 pandemic period (from March 2020 to September 2022) in children (OR 0.62 [0.47 - 0.81]) but not in the adult population (OR 0.90 [0.76 - 1.06]).ConclusionOur study confirms the winter seasonality and sex ratio in IgAV [4,5], but suggests that the incidence or the reporting of IgAV decreased in children during the COVID19 pandemia, possibly due to barrier measures [6]. The observed north/south gradient need confirmation. The main limitation of this study is a possible IgAV under-reporting as this study rely only on cases addressed in expert centers.References[1]Audemard-Verger A, Pillebout E, Guillevin L, Thervet E, Terrier B. IgA vasculitis (Henoch-Shönlein purpura) in adults: Diagnostic and therapeutic aspects. Autoimmun Rev. 2015;14(7):579-585. doi:10.1016/j.autrev.2015.02.003[2]Deshayes S, Moulis G, Pillebout E, Aouba A, Audemard-Verger A. Positive predictive value of hospital discharge diagnosis code to identify immunoglobulin A vasculitis in France: A validation study. Eur J Intern Med. 2017;43:e18-e19. doi:10.1016/j.ejim.2017.05.025[3]Jannot AS, Messiaen C, Khatim A, Pichon T, Sandrin A, BNDMR infrastructure team. The ongoing French BaMaRa-BNDMR cohort: implementation and deployment of a nationwide information system on rare disease. J Am Med Inform Assoc. 2022;29(3):553-558. doi:10.1093/jamia/ocab237[4]Piram M, Maldini C, Biscardi S, et al. Incidence of IgA vasculitis in children estimated by four-source capture-recapture analysis: a population-based study. Rheumatology (Oxford). 2017;56(8):1358-1366. doi:10.1093/rheumatology/kex158[5]Gardner-Medwin JMM, Dolezalova P, Cummins C, Southwood TR. Incidence of Henoch-Schönlein purpura, Kawasaki disease, and rare vasculitides in children of different ethnic origins. Lancet. 2002;360(9341):1197-1202. doi:10.1016/S0140-6736(02)11279-7[6]Kaya Akca U, Atalay E, Cuceoglu MK, et al. Impact of the COVID-19 pandemic on the frequency of the pediatric rheumatic diseases. Rheumatol Int. 2022;42(1):51-57. doi:10.1007/s00296-021-05027-7Figure.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
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According to literature reports, the injury rate of the athletes in Olympic Winter Games recent years was as high as 10%-14%. Combined with the background of corona virus disease 2019 (COVID-19), the medical insurance work of the 24th Olympic Winter Games held in Beijing had put forward more complicated requirements and more severe challenges. In order to better optimize anesthesia management, this article summarized the perioperative treatment of athletes in Olympic Winter Games, the safety protection strategy of medical staff under general anesthesia, and the potential impact of peri-operative drugs on athletes. Anesthesiologists, as the core members of the rescue team, should be familiar with the particularity of operative anesthesia of athletes, sum up relevant experience to ensure the safety of perioperative patients. So all kinds of technical measures should be taken in the process of operation to minimize the indoor pollution caused by the patient's cough. For example, all the patients should wear N95 masks from the ward to the operating room, and after the operation, wear the N95 masks back to the ward. Although the International Olympic Committee had banned more than 200 drugs for participants and athletes who had to strictly follow International Olympic Committee requirements during anesthesia, the athletes were no longer participating in this Olympic Winter Games, so opioids (sufentanil and remifentanil) and glucocorticoid (dexamethasone) could be used according to the actual needs of surgery and anesthesia. Five athletes in Yanqing competition area underwent surgical anesthesia in Peking University Third Hospital Yanqing Hospital. All the five patients received general anesthesia, of whom four underwent orthopaedic surgery and one underwent laparoscopic cholecystectomy. General anesthesia with laryngeal mask airway was the first choice in the five patients. And the pain after orthopaedic surgery was severe and nerve block technique could effectively relieve the pain after surgery. Three patients received ultrasound-guided nerve block analgesia, the postoperative analgesia lasted 36 h. After the operation, non-steroidal anti-inflammatory drug (NSAID) was infused intravenously in the ward and all the patients recovered uneventfully. As the core member of the trauma rescue team, anesthesiologists should be familiar with the particularity of the athletes' surgical anesthesia, do a good job in medical security, and summarize relevant experience to ensure the life safety of the perioperative patients.
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The additional impact of emission-reduction measures in North China (NC) during autumn and winter on the air quality of downwind regions is an interesting but less addressed topic. The mass concentrations of routine air pollutants, the chemical compositions, and sources of fine particles (PM2.5) for January 2018, 2019, and 2020 at a megacity of Central China were identified, and meteorology-isolated by a machine-learning technique. Their variations were classified according to air mass direction. An unexpectedly sharp increase in emission-related PM2.5 by 22.7% (18.0 mug m-3) and 25.7% (19.4 mug m-3) for air masses from local and NC in 2019 was observed compared to those of 2018. Organic materials exhibited the highest increase in PM2.5 compositions by 6.90 mug m-3 and 6.23 mug m-3 for the air masses from local and NC. PM2.5 source contributions related to emission showed an upsurge from 1.39 mug m-3 (biomass burning) to 24.9 mug m-3 (secondary inorganic aerosol) in 2019 except for industrial processes, while all reduced in 2020. From 2018 to 2020, the emission-related contribution of coal combustion to PM2.5 increased from 10.0% to 19.0% for air masses from the local area. To support the priority natural gas quotas in northern China, additional coal in cities of southern China was consumed, raising related emissions from transportation activities and road dust in urban regions, as well as additional biofuel consumption in suburban or rural regions. All these activities could explain the increased primary PM2.5 and related precursor NO2. This study gave substantial evidence of air pollution control measures impacting the downwind regions and promote the necessity of air pollution joint control across the administration.Copyright © 2023 Elsevier Ltd
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Amid concerns over airflow-induced transmission of the COVID-19 virus in buildings frequented by large numbers of people, such as offices, the necessity for radiant ceiling heating panels has increased. This is due to the concern that the airflows emitted from the convection heating systems installed near the ceiling or windows for winter heating may be a major cause of COVID-19 transmission. In this study, we aim to evaluate thermal comfort under various indoor and outdoor environmental conditions of a building and present the thermal output conditions of the radiant ceiling heating panel that can replace the convection heating system while ensuring comfort in the perimeter zone and handling the heating load. As a result, we were able to present, in a chart format, the thermal output conditions that can secure thermal comfort by analyzing the indoor airflow distribution depending on the surface temperature of the radiant ceiling heating panel, the interior surface temperature of the window, and the influence of internal heat generation. Moreover, through derived empirical formulas, we were able to determine the heating conditions of the panel that can secure the necessary heat dissipation while minimizing discomfort, such as downdrafts, even for indoor and outdoor conditions that were not evaluated in this study.
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Aims: (1) To describe how occupational possibilities of young adults experiencing a first episode of psychosis changed during the pandemic;(2) to describe how mental health practitioners, working in two first episode clinics, strived to assist their clients in maintaining a meaningful daily life during the COVID-19 pandemic. Method(s): This exploratory study used an interpretative descriptive design. Young adults (n = 6), attending a specialized clinic, participated in two semi-directed interviews: they explored how their daily lives changed during the pandemic, their (re)actions in light of the changes and which occupations were (im)possible to pursue. A focus group discussion with the practitioners will allow to explore the adjustments made to clinical practices to enrich young adults' daily lives. The interviews and focus groups were transcribed and analysed independently by two members of the research team, using a thematic analysis approach. Result(s): Preliminary results suggest that if some occupational possibilities were lost, many were transformed or newly envisioned by young adults. They engaged in occupations within existing niches. The presentation will also include the perspective of mental health practitioners, as focus groups will be concluded in early Winter 2023. Conclusion(s): This presentation offers a novel perspective on the daily lives of young adults during the pandemic, focusing on the nature of their occupational engagement, whilst considering how the context shaped their occupational possibilities. Likewise, it will document the innovative practices and challenges experienced by practitioners, as they strived to expand possibilities for their clients and to support their transition into adulthood.
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Background: Students worldwide belong to a vulnerable group with an above-average tendency towards depressive disorders. Empirical studies also show that depressive moods among students have increased significantly during the coronavirus disease 2019 (COVID-19) pandemic. Objectives: The aim of the article is to examine whether the stress experiences caused by the pandemic are related to the depressed mood of the students. In addition, it is analyzed whether resilience, coping and social support as resources are associated with the depressive moods of students. The aim is to clarify which resources can explain the connection between the stress experiences caused by the pandemic and the depressive mood of students as mediators. Methods: The study is based on an online survey of students at Magdeburg-Stendal University of Applied Sciences for the 2020/21 winter semester. The data of 621 students were evaluated. A mediation analysis was carried out. Results: Pandemic-related stress experiences are significantly related to the depressive moods of students. Resilience is also a significant factor influencing depressive moods and partially mediates the influence of pandemic-related stressful experiences on the depressed mood of the students. Coping and social support show no significant association with the depressed mood of the students. Conclusion: Starting points for reducing the depressive mood lie in reducing the stress caused by the pandemic and in strengthening the resilience of the students.
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Objectives: Brazil's annual vaccination coverage rate (AVCR) for Polio has risen to alarming levels in recent years. Given the imminent possibility of the return of the disease eradicated 32 years ago in Brazil, the objective was to assess the historical data of AVCR and foresee the Brazilian performance in the next five years. Method(s): We apply a classic linear forecasting model Holt Winter (HW), composed of a forecasting equation and three corresponding smoothing equations alpha, beta, and gamma. The Polio AVCR between 1994 and 2022 was collected from the National Immunization Program and was evaluated in two stages using the R software involving (i) analysis of data, (ii) application of the HW using least squares adjustment. Result(s): The AVCR showed a growing trend between 1994 (38%) and 1999 (86%). From 2000 to 2015, the average AVCR was 78.72%, with the best coverage in 2015 (95.07%). Between 2016 and 2022, the AVCR was 66.75%, with a tendency to reduce over time. Between 2020 and 2022, AVCR had its lower result (64.44%), which can be explained by the postponement of Polio vaccination due to the COVID-19 pandemic. The best adjustment of smoothing alpha, beta and gamma was achieved (0.67, 0, 0) by HW. The forecast showed positive results in the average AVCR, with a growth of 16.71% in the next five years and with an AVCR projection of just 75.89%, in the case of no public health action is endowed by the country. To reach the best AVCR achieved in 2015, it is necessary to expand it by 48.5%. Conclusion(s): Forecasts using HW are recommended for public health monitoring, helping managers make decisions with limited resources. The results indicate that it is necessary to develop a strategic plan to expand AVCR to keep Polio eradicated from Brazil, mainly due to both disease gravity and treatment unavailability.Copyright © 2023
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Introduction Due to the increasing ease and availability of molecular assays, viral culture is rarely employed for the diagnosis of respiratory illnesses. Despite lower sensitivity than molecular techniques, viral culture may detect a wider array of viral pathogens at a lower cost relative to multiplex molecular panels. In this study, we examined the effects of the SARS-CoV-2 pandemic on viral respiratory culture ordering and trends in the rates of pathogen detection. Methods Viral respiratory culture results from Jan 1st, 2017 to February 28th, 2022 were analyzed for changes in the number of monthly orders, positivity rate, and incidence of individual pathogens. To determine changes in seasonal incidence and viral etiology, a comparison was made between winter (Dec-Feb) and summer (June-Aug) months as well as acute (Influenza A/B, RSV) and chronic (HSV, CMV) infections. Given SARS-CoV-2's classification as a BSL-3 pathogen, our viral culture assay was not designed to detect this virus. As a surrogate method to measure rates of SARS-CoV-2 in viral culture specimens, we performed NAAT testing with the ThermoFisher TaqPath COVID-19, Flu A/B, RSV assay on negative specimens. Results Following the pandemic, testing volume decreased by 46.7% with the overall positivity rate decreasing from 6.67% to 4.85%. Among the 46 states for which more than ten orders were placed, monthly testing decreased in 38 states. Of the eight states with increased average monthly testing, the greatest increases were seen in Rhode Island, Nevada, and Montana. During the pre-pandemic timeframe, acute respiratory pathogens demonstrated a typical winter peak with low summer detection. Post-pandemic, there was an atypical increase of acute respiratory pathogens, driven primarily by RSV. The positivity rate for chronic viral infections increased from 3.43% pre-pandemic to 4.09% post-pandemic. Following the pandemic, HSV has replaced influenza as the most commonly detected pathogen during winter months. Molecular studies of 229 negative viral culture specimens identified 36 (15.7%) samples positive for SARS-CoV-2, 9 (3.9%) for RSV, and none for influenza A or B. Median cycle threshold values for SARS-CoV-2 samples were 21.3 (range: 9.1-36.5). Conclusions Following the SARS-CoV-2 pandemic, the number of respiratory virus cultures ordered significantly decreased. There has also been a statistically significant decrease in the positivity rate driven by the absence of acute viral respiratory pathogens, including influenza A/B and RSV. We also observed an offseason increase of RSV during the summer months of 2021. Detection rates of chronic viral pathogens including CMV and HSV have remained relative stable. The presence of SARS-CoV-2 in negative specimens raises concerns for inappropriate test utilization. While less sensitive than molecular methods, viral culture has the potential to offer a lower cost alternative for monitoring a broad range of viral pathogens.
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Intro: It is hypothesized that metagenomics could contribute to the effective sentinel surveillance of emerging infections to identify plausible cause of respiratory symptoms in the population. Method(s): This study forms part of a longitudinal household cohort study involving the collection of respiratory symptoms and vaccination history in Hong Kong. As a pilot, selected households were provided with swab collection kit for collecting nasopharyngeal and throat samples when there was an influenza-like illness (ILI) during a 4-month presumptive period of the year's winter influenza season. Sequence-Independent Single Primer Amplification (SISPA) and nanopore metagenomic sequencing were performed. After basecalling, demultiplexing, and quality filtering, taxonomic classification was done. Unclassified and host reads were removed and only taxon with over 0.1% abundance were included in the analysis. Finding(s): Between December 2021 and April 2022, of 101 collection kits delivered, 36 (36%) participants returned the samples. Two (6%) had previous COVID-19 diagnosis and almost all (97%) received at least one dose of COVID-19 vaccination. Metagenomics sequencing was performed on 13 samples collected from participants when ILI was present. Of the 1,592,219 reads obtained, 5308 taxa were identified and 136 had over 0.1% abundance, including 128 bacteria, 6 fungi, and 1 virus, which was a bacteriophage. The five most abundant genera of bacteria included Neisseria (19%), Streptococcus (10%), Haemophilus (9%), Veillonella (3%), and Rothia (3%). Haemophilus parainfluenzae was the most abundant species with 97,542 (6%) reads, followed by Neisseria meningitides (5%). Other bacteria identified included Rothia mucilaginosa, Acinetobacter baumannii, Lautropia mirabilis, Veillonella atypica, Streptococcus salivarius, and Streptococcus pneumonia. Inter-participant abundance profile was significantly different (p<0.001). Conclusion(s): The absence of viral infections identified echoed the extremely low proportion (3/21986, or 0.01%) of respiratory specimens testing positive for influenza virus by the government laboratory during the same period. The metagenomic profile could be useful for identifying the likely ILI-causing pathogen.Copyright © 2023
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Aim of the study was to evaluate the impact of anti-epidemic measures (CAM) complex on the dynamics of the epidemic process of COVID-19 in a controlled cohort of patients. Material and methods. Patients from 30 social long-term care institutions of the city were included in the study, including neuropsychiatric boarding schools, boarding houses for labor veterans, gerontological centers, and houses for stage veterans. A total of 8303 patients participated in the study, of which 4237 were men (mean age 53.6 years) and 4066 were women (mean age 62.0 years). Vaccination was carried out with Gam-Covid-Vac. Results and discussion. For the entire observation period from March 2020 to August 2021, 1619, cases of COVID-19 or 19.5% of the total number of patients were registered among patients. At the initial epidemic stage (spring-summer 2020), the incidence of COVID-19 among patients was explosive. At the same time, in the autumn-winter period of 2020, an increase in the incidence of COVID-19 was also observed. However, much less pronounced than in April 2020. Despite the progress, it was decided to strengthen the sanitary and anti-epidemic regime in institutions with the introduction of additional preventive measures. One of the most effective long-term algorithms for reducing the infectious disease incidence was vaccination. In this regard, the Moscow Department of Healthcare suggested the need for voluntary vaccination of 100% of patients in all institutions at the beginning of 2021. In the spring of 2021, the number of cases began to increase in the city. The increase in the incidence of COVID-19 was insignificant among the patients of institutions: the maximum number of cases detected in one month during this period was 13 people (in April), or 60.5 times less than in April 2020, and 2.5 times less than in October 2020. The incidence of COVID-19 has become sporadic rather than epidemic. Conclusion. The introduction of CAM in long-term care social institutions in the early stages of the epidemic contributed to a decrease in the incidence of COVID 19. 100% vaccination of patients in combination with other prevention measures reduced the incidence of COVID-19 by more than 28 times. At the same time, it was found that there is a trend of increasing incidence depending on the increase in the level of independent activity of patients.Copyright © 2023 The authors.
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When the pandemic was at its peak, it was a quite difficult task for the government to schedule vaccine supply in various districts of a state. This task became further difficult when vaccines were required to be supplied to various Covid Vaccination Centers (CVCs) at a granular level. This is because there was no data regarding the trend being acquired at each CVC and the population distribution is non-uniform across the district. This led to the arousal of an ambiguous situation for a certain period and hence mismanagement. Now that we have sufficient data across each CVC, we can work on a time series analysis of vaccine requirements in which we can essentially forecast the number of administered doses and optimize the wastage at all atomic CVC levels. © 2023 IEEE.
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Background/Aims We report the features of chronic chilblain-like digital lesions newly presenting since the start of the covid-19 pandemic. Comparison with primary perniosis and acrocyanosis, reveals a unique phenotype which appears to be a long-covid phenomenon. Methods The case records of 26 patients with new onset persistent chilblain-like lesions presenting to the Rheumatology service of St George's University Hospital, London between Autumn 2020 and Spring 2022 were reviewed. Demographic and clinical features, serology, imaging, treatment response and outcome up to Summer 2022 were collated retrospectively. Results Chilblain-like lesions first occurred between September and March;2019/ 2020 6 cases, 2020/2021 18 cases and 2021/2022 2 cases. Mean age 35.4 (17-60) years, 88% female, 85% white, all non-smokers. Median body mass index (BMI) 20.2, range 17.0 - 33.2. BMI underweight (<18.5) in 27%. All cases reported new red-purple-blue colour changes of the fingers, some with pain, swelling and pruritis, affecting both hands in 12, one hand in 6, and both hands and feet in 8 cases. There was a past history of cold sensitivity or primary Raynaud's in 54%. Covid was confirmed in 3 cases, 2 - 8 months prior to onset of chilblain-like symptoms. Possible covid, unconfirmed, was suspected in 5 cases, 1 - 11 months earlier. Affected digits appeared diffusely erythro-cyanotic in 81%, with blotchy discrete maculo-papular erythematous lesions in 42%, some with both features. Involvement was asymmetric in 54%, thumbs spared in 69%. Complement was low in 50% (8/16), ANA positive in 26% (6/23). MRI of hands showed phalangeal bone marrow oedema in keeping with osteitis in 4 of 7 cases. More severe signs and symptoms were associated with low BMI, low C3/4 and a past history of cold sensitivity or Raynauds. Cold avoidance strategies were sufficient for 58%. Pain prompted a trial of NSAIDs, aspirin, nitrates, calcium channel blockers, hydroxychloroquine, oral or topical corticosteroid or topical tacrolimus in 42%. In general, these were minimally effective or not tolerated. 4 severe cases received sildenafil or tadalafil, effective in 2. In 27% complete remission occurred during the first summer season after symptoms commenced, median duration 6 (range 2 - 10) months. In the remaining 19 cases, chilblain-like symptoms returned or worsened in the subsequent second winter period, with 6 of 19 entering remission the following summer. For the remaining 13 persistent cases the total duration of symptoms spans more than a year, and in four cases more than 2 years. Conclusion This series illustrates a distinct chronic chilblain-like condition. Features similar to primary perniosis include female predominance, middle age, pruritic painful blotchy lesions, asymmetry and low BMI. Features in keeping with acrocyanosis include chronicity, extensive diffuse erythro-cyanotic discoloration, relative improvement in warm weather and lack of association with smoking.
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Aim: The global COVID-19 pandemic and new variants continue to seriously threaten society. In this study;It was aimed to investigate surveillance of SARS CoV-2 and other respiratory viruses in respiratory tract samples in the winter season of 2020-2021 in Sakarya province. Material and Method: The study was carried out at Sakarya Training and Research Hospital between 2020-2021. e study was carried out with respiratory tract samples (Nasopharyngeal swab) stored in the laboratory. Clinical samples included in study were stored in a Bio-SpeedyRvNATRtransfer tube (Bioeksen,Turkey) and no extraction was performed in accordance with manufacturer's instructions. All analyzes were recorded on BIO-RAD CFX-96C1000 Touch Real-time system device using Diagnovital influenza A/B, SARS CoV-2, RSV multiplex Real Time PCR amplification kit. Results: Of the 200 patients diagnosed with URTI/LRTI, 54.5% were male and 45.5% female. e most common clinical symptoms;sore throat 74%, cough 73.5%, fatigue 71%, fever 57%, runny nose 56%, headache 48.5%, sneezing 41.5%, loss of smell / taste 39.5%, diarrhea 36%, dyspnea was 31.5% and myalgia was 23.5%. PCR positivity rates of samples were analyzed as 28.5% for SARS COV-2 and 1.5% for RSV, respectively. PCR positivity for influenza A/B was not defined in the study. Considering the statistical significance between PCR results and COVID-19 symptoms in patients;symptoms of dyspnea (n=63), fever(n= 62) and sneezing(n=56), respectively, were statistically significant(p<0.05). Conclusion: Due to the circumstances, only three main viral agents could be investigated in the study. RSV was frequently identified as an important factor in pediatric patients, whereas influenza-which may be related to social and individual measures (mask,distance,hygiene)- was not detected in any sample. More comprehensive scientific studies are needed to support the data.
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INTRODUCTION AND OBJECTIVE: Nutrition therapy for stone prevention is indicated if risks are diet-related. Dietary recommendations (DRs) include higher fluid intake, lower salt intake, lower dietary acid load, and normal calcium (neither excessive nor insufficient). Adherence is challenging to assess and optimally includes multiple measures including patient-reported outcomes. We assessed adherence to individualized targeted DRs issued in our multidisciplinary stone prevention clinic. METHOD(S): From 1/2020-1/2021 we invited patients to complete a questionnaire 1 month after their appointment. They were to estimate the number of days within the last week they followed specific DRs prescribed them and number of days they followed all DRs. Questionnaires were sent by mail with postage-paid return envelopes. This was a quality improvement project;patients were offered to respond anonymously. RESULT(S): Respondents (n=132) represented 29% of patients who were sent questionnaires and were 50% female (61+/-13 y). Of those providing clinical details, 77% were recurrent stone formers;46% were on stone medication(s). There were no adherence differences for men vs. women, recurrent vs. one-time stone formers, nor for those on stone-related medications vs. not. Overall, adherence to eating more F/ V was lower (4.7 vs. 5.5 d/week for all other DRs, p<0.004). We separated responses by receipt: summer/fall (April to mid-November) and winter/spring (mid-November to April), and by pre- vs. post- COVID (before/after March 2020). F/V intake was significantly lower during winter/spring than summer/fall (4.4 vs. 5.5 d/week, p=0.009). Related to the COVID pandemic, patients reported lower adherence to all DRs after the pandemic start (5.0 vs. 5.9 d/week, P=0.009 for difference from before). CONCLUSION(S): Overall, adherence to eating more F/V was significantly lower than for other DRs and was lower yet during winter/ spring. The COVID pandemic did not affect F/V intake specifically but did reduce adherence to all DRs. F/V are important in stone prevention because they provide HCO3 precursors that increase urine citrate and pH. F/V also provide other stone inhibitors, including phytate (which in urine inhibits calcium stone formation) and prebiotics, some of which enhance oxalate-degrading gut bacteria. Moreover, F/V intake can account for up to 30% of urine output and thus may help meet fluid recommendations. Barriers to F/V intake, which may include seasonal variations in cost and availability, should be addressed .
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Home accidents can cause serious injuries, disabilities, and deaths. Approximately 40 million people were treated in hospitals annually because of injuries occurring in homes, and these injuries were responsible for approximately 76% of preventable deaths. The aims of this study are to compare the home accidents in the one-year period during the pandemic and the home accidents in the one-year period before the pandemic, and to reveal how the home accidents are affected in which part of the home and in which types of injuries. A retrospective study was made of the records of patients injured in home accidents between pre-pandemic and pandemic one-year periods. The patients were classified according to age groups, gender, season, day and time of the home accident, accident type, part of the home, trauma localization and type, and severity of injuries. While 46.5% of the 581 injured patients were before the pandemic, 53.5% were in the pandemic period. The injuries increased as the number of households staying at home increased compared to the pre-pandemic period. Likewise, there was a significant increase in the number of falls from balconies and windows during the pandemic period. It is still not possible to make a definite prediction about the course of the pandemic. In this context, it is of great importance to provide information on prevention from home accidents, especially in television programs and distance education activities.Copyright © 2023, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
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Aim of the study was to evaluate the impact of anti-epidemic measures (CAM) complex on the dynamics of the epidemic process of COVID-19 in a controlled cohort of patients. Material and methods. Patients from 30 social long-term care institutions of the city were included in the study, including neuropsychiatric boarding schools, boarding houses for labor veterans, gerontological centers, and houses for stage veterans. A total of 8303 patients participated in the study, of which 4237 were men (mean age 53.6 years) and 4066 were women (mean age 62.0 years). Vaccination was carried out with Gam-Covid-Vac. Results and discussion. For the entire observation period from March 2020 to August 2021, 1619, cases of COVID-19 or 19.5% of the total number of patients were registered among patients. At the initial epidemic stage (spring-summer 2020), the incidence of COVID-19 among patients was explosive. At the same time, in the autumn-winter period of 2020, an increase in the incidence of COVID-19 was also observed. However, much less pronounced than in April 2020. Despite the progress, it was decided to strengthen the sanitary and anti-epidemic regime in institutions with the introduction of additional preventive measures. One of the most effective long-term algorithms for reducing the infectious disease incidence was vaccination. In this regard, the Moscow Department of Healthcare suggested the need for voluntary vaccination of 100% of patients in all institutions at the beginning of 2021. In the spring of 2021, the number of cases began to increase in the city. The increase in the incidence of COVID-19 was insignificant among the patients of institutions: the maximum number of cases detected in one month during this period was 13 people (in April), or 60.5 times less than in April 2020, and 2.5 times less than in October 2020. The incidence of COVID-19 has become sporadic rather than epidemic. Conclusion. The introduction of CAM in long-term care social institutions in the early stages of the epidemic contributed to a decrease in the incidence of COVID 19. 100% vaccination of patients in combination with other prevention measures reduced the incidence of COVID-19 by more than 28 times. At the same time, it was found that there is a trend of increasing incidence depending on the increase in the level of independent activity of patients.Copyright © 2023 The authors.
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ObjectiveTo analyze the influenza surveillance data in Ezhou City, Hubei Province from 2016 to 2021, determine the epidemiological characteristics and etiological trend of influenza like illness (ILI), and to provide scientific evidence for influenza prevention and control. MethodsThe ILI surveillance data were reported by Ezhou influenza sentinel hospitals and etiological examination results were collected by network laboratory. Influenza surveillance data from 2016 to 2021 were analyzed. ResultsFrom 2016 to 2021, the percentage of ILI visits (ILI%) in Ezhou city was 2.81% and increased over years. Majority (55.55%) of ILI cases were 0-4 years. A total of 7 716 ILI samples were examined from 2016 to 2021, of which 1 467 tested positive with a positive rate of 19.01%. Influenza A H1N1 was mainly concentrated in January-April, A H3N2 mainly in August-December, B Victoria mainly in April-July and December-March, and B Yamagata mainly in December-February. Influenza network laboratory isolated influenza virus from the 1 467 positive samples by using MDCK cells and SPF chicken embryos. The overall isolation rate was 32.78%, which was 26.93% by MDCK cells and 5.86% by SPF chicken embryos. From 2016 to 2021, a total of 13 ILI outbreaks were reported in Ezhou City. Temporally, the outbreaks mainly occurred in winter and spring. Spatially, they were mainly in primary schools, middle schools and kindergartens. ConclusionThe winter and spring are the key time period of influenza prevention and control in Ezhou City, as they are susceptible to influenza outbreaks. Children aged 0-14 are the key population of prevention and control. Diverse subtypes of influenza virus alternate by years, which warrants continually strengthening monitoring. Additionally, certain countermeasures against COVID-19 may be recommended in the prevention and control of influenza.
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Introduction: A service impact assessment was undertaken to understand the influence of winter pressures and omicron on stroke rehabilitation service delivery in November and December 2021. This followed concerns regarding rehabilitation provision raised by clinicians and stroke service managers including acute providers, community in patient teams and early supported discharge (ESD) teams across the East of England. Method(s): Questionnaires were distributed to all acute, community and ESD stroke services within the North and South Integrated Stroke Delivery Networks (ISDN), covering physiotherapy, occupational therapy, speech and language therapy and psychology disciplines. Ratings were made against the key themes that had been raised anecdotally as concerns to service delivery. (0=no impact, 1=some impact 2=significant impact) Follow up meetings were arranged for each Integrated Care System (ICS) to provide narrative around the rated themes. Allied Health Professional (AHP) representatives from each stroke service within the ICS were invited to these meetings. Finally, the ratings and narrative were taken back to the Rehabilitation Clinical Advisory Group (CAG) for solutionbased discussions to formulate a potential action plan to report to the Clinical Reference Group (CRG). In total 61 responses were received from professional leads across the four disciplines. Result(s): Issues, themes and recommendations have been established relating to: * Workforce. * Increased referral rates and caseloads. * Rehabilitation Intensity. * Access to care packages and equipment. * Visiting arrangements and the direct impact on discharge planning. * Perceived patient and family experience. Conclusion(s): Analysis is ongoing;however, ten recommendations are being prepared to enable increased robustness of service delivery in preparation for next winter.
ABSTRACT
The Covid-19 pandemic led to a restriction in the practice of winter sports for two years. The Grenoble-Alpes University Hospital is a level 1 trauma center, a reference center for the management of traumatology, in particular for pelvic fractures. This comparative epidemiological study, conducted before and after the pandemic, shows an increase in the number and a change in the profile of patients with pelvic trauma secondary to the practice of winter sports. A reflection on the specific management of this new population is necessary. © 2023 La pandémie de Covid-19 a entraîné une restriction de la pratique de sports d'hiver durant deux années. Le centre hospitalier universitaire Grenoble-Alpes est un trauma center de niveau 1, centre de référence pour la prise en charge de la traumatologie, en particulier pour les fractures du bassin. Une étude épidémiologique comparative, menée avant et après la pandémie, montre une augmentation du nombre et une modification du profil des patients traumatisés du bassin secondairement à la pratique des sports d'hiver. Une réflexion sur la prise en charge spécifique de cette nouvelle population s'impose. © 2023
ABSTRACT
In the time of regular COVID-19 prevention and control, it has been a medical priority to standardize the management of other diseases (like seasonal influenza) and relevant vaccination, especially to prevent the epidemic of both seasonal influenza and COVID-19 in winter and spring. In the influenza season of winter and spring, children are among those most vulnerable to influenza, making primary schools, secondary schools and nursing centers an influenza epicenter. To reduce the chance of infection among children, Global Pediatric Pulmonology Alliance (GPPA )has organized an expert team to make a proposal. This proposal introduces the epidemiologic features of child influenza, the status quo of the COVID-19 pandemic, and the necessity of child influenza shots during the COVID-19 pandemic. Besides, vaccination strategies based on national and international guidelines/consensuses are elaborated for the reference of relevant people from all walks of life.Copyright © 2020 by the Chinese Medical Association.