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1.
Enfermedades infecciosas y microbiologia clinica (English ed.) ; 2022.
Artigo em Inglês | ScienceDirect | ID: covidwho-2165253

RESUMO

Introduction Consumption of antibiotics is high in Spain, primarily in children. Excessive use of then contributes to the development of antimicrobial resistance. The aim of our study is to analyse the evolution of antibiotic consumption at the Primary Health Care in the paediatric population of Asturias, Spain, from 2014 to 2021, and to evaluate the impact of COVID-19 pandemic on it. Methods Retrospective and observational study using data about antibacterial agents for systemic use dispensed for official prescriptions to children under 14 years in Primary Care. Antibiotic consumption is expressed as defined daily dose (DDD) per 1000 inhabitants per day (DID). Results The antibiotic consumption rate dropped from 13.9 DID in 2014 to 4.0 in 2021 (β = -1,42, p = 0,002), with and inflection point in 2019. From 2019 to 2020 antibiotic use dropped by 47.1%. Antibiotic consumption remained very low from April 2020 to September 2021, and then moderately increased from October 2021. Prevalence of antibiotic use dropped from 39.9% in 2014 to 17.5% in 2021 (β = -3,64, p = 0,006). Relative consumption of amoxicillin/clavulanic acid decreased, while those of amoxiciline and third-generation cephalosporins increased. Conclusions Paediatric antibiotic consumption collapsed in Asturias in 2020, coinciding with COVID-19 pandemic. Monitoring of antimicrobial usage indicators will allow to check if these changes are sustained over time. Resumen Introducción En España existe un alto consumo de antibióticos, especialmente en los primeros años de vida. Un uso excesivo de antimicrobianos contribuye a la aparición de resistencias. El objetivo de este estudio es analizar la evolución del consumo de antibióticos en población pediátrica entre 2014 y 2021 en la Atención Primaria del Principado de Asturias y estudiar el impacto de la pandemia por COVID-19 sobre el mismo. Métodos Estudio observacional y retrospectivo que recoge las prescripciones de antibacterianos para uso sistémico dispensadas a partir de recetas oficiales emitidas para pacientes menores de 14 años en Atención Primaria. Se mide el consumo en dosis diarias definidas (DDD) por 1.000 habitantes y día (DHD). Resultados La tasa de consumo de antibióticos descendió desde 13,9 DHD en 2014 a 4,0 en 2021 (β = -1,42, p = 0,002) con un punto de inflexión en el año 2019. Entre 2019 y 2020 el descenso fue del 47,1%. El consumo se mantuvo en niveles muy bajos entre abril de 2020 y septiembre de 2021, con un repunte contenido desde octubre de 2021. La prevalencia de uso de antibióticos cayó desde 39,9% en 2014 a 17,5% en 2021 (β = -3,64, p = 0,006). Disminuyó el consumo relativo de amoxicilina-clavulánico y aumentó el de amoxicilina y cefalosporinas de tercera generación. Conclusión En Asturias, el consumo pediátrico de antibióticos en Atención Primaria se desplomó a partir de 2020, coincidiendo con la COVID-19. La monitorización de estos indicadores permitirá comprobar en qué medida se mantienen los cambios en el tiempo.

2.
Bulletin de l'Académie Nationale de Médecine ; 2022.
Artigo em Francês | ScienceDirect | ID: covidwho-2165097

RESUMO

Résumé L'image sacro-sainte que le prescripteur et le public se faisaient de l'Autorisation de mise sur le marché (AMM) il y a trois ou quatre décennies a notablement évolué depuis quelques années, suite à la prise en compte – parfois polémique – de certaines de ses insuffisances ou de ses faiblesses. Le texte de cet article évoque quelques-uns des facteurs pouvant expliquer cette évolution des mentalités, délétère pour la sécurité des patients. Parmi ces facteurs, on mentionnera le retard bien compréhensible de certaines AMM sur les données acquises de la science, un formalisme parfois excessif et contre-productif ou encore de possibles discordances d'avis entre Agences responsables de l'enregistrement des médicaments. Mais il faut surtout retenir certaines AMM fragiles, d'image dégradée, prématurément octroyées sur des niveaux de preuve non optimaux dans le but d'accélérer l'accès des malades aux nouveaux médicaments dits « prometteurs ». Enfin, l'intervention des patients, désormais très importante dans le domaine, est un phénomène de société à ne pas méconnaître, soit qu'ils se méfient du médicament et de son évaluation ou qu'ils fassent pression sur le prescripteur pour obtenir une prescription hors AMM vantée dans les réseaux sociaux. Il n'en demeure pas moins que l'AMM reste la référence et le repère à respecter pour une prescription médicamenteuse optimale, sécurisée et responsable. Un point positif est que la pandémie due au COVID-19 aura permis aux journalistes de mieux maîtriser les notions de niveau de preuve et de balance bénéfices/risques. Par la même occasion, elle aura permis au public, dans sa très grande majorité, de comprendre ce qu'est une AMM et d'en admettre la nécessité, malgré l'érosion de sa confiance dans l'expertise scientifique et sa suspicion vis-à-vis des institutions de santé. S'il n'y a pas lieu de regretter que davantage de transparence et de démocratie sanitaire permettent au citoyen de s'approprier la signification et les déterminants de l'AMM, il y a lieu, pour les spécialistes de l'évaluation, d'appeler au maintien de sa rigueur dans l'intérêt même des patients et pour les autorités de santé de la maintenir. Summary The sacrosanct image that prescribers and the public had of Drug Marketing Authorization (AMM) three or four decades ago has changed significantly over the past few years, following the recognition, – sometimes controversial – of some of its shortcomings or weaknesses. The text of this article discusses some of the factors that may explain this change in mentality, which is harmful to patient safety. Among these factors, we can mention the understandable delay of some AMMs on the data acquired from science, a sometimes excessive and counterproductive formalism, or even possible disagreements between the Agencies responsible for the registration of medicinal products. But above all, it is necessary to retain that some AMMs are fragile, with a degraded image, prematurely granted on sub-optimal levels of evidence with the aim of accelerating patients' access to new, so-called "promising” drugs. Finally, the intervention of patients, now very important in this field, is a social phenomenon that should not be overlooked, either because they are wary of the drug and its evaluation or because they put pressure on the prescriber to obtain an off-label prescription touted in social networks. The fact remains that the AMM remains the reference and the benchmark to be respected for an optimal, secure and responsible drug prescription. A positive point is that the pandemic due to COVID-19 has enabled journalists to better master the notions of level of proof and benefit/risk balance. At the same time, it will have enabled the vast majority of the public to understand what AMM is and to accept, for the most part, the need for it, despite the erosion of their confidence in scientific expertise and their suspicion towards the health institutions. If there is no reason to regret that more transparenc and health democracy allow the citizen to appropriate the meaning and the determinants of AMM, there is reason, for the evaluation specialists to call for maintaining its rigor in the very interest of patients and for health authorities to maintain it.

3.
Front Pharmacol ; 13: 1027808, 2022.
Artigo em Inglês | MEDLINE | ID: covidwho-2154782

RESUMO

Background: Recently, internet hospitals have been emerging in China, saving patients time and money during the COVID-19 pandemic. In addition, pharmacy services that link doctors and patients are becoming essential in improving patient satisfaction. However, the existing internet hospital pharmacy service mode relies primarily on manual operations, making it cumbersome, inefficient, and high-risk. Objective: To establish an internet hospital pharmacy service mode based on artificial intelligence (AI) and provide new insights into pharmacy services in internet hospitals during the COVID-19 pandemic. Methods: An AI-based internet hospital pharmacy service mode was established. Initially, prescription rules were formulated and embedded into the internet hospital system to review the prescriptions using AI. Then, the "medicine pick-up code," which is a Quick Response (QR) code that represents a specific offline self-pick-up order, was created. Patients or volunteers could pick up medications at an offline hospital or drugstore by scanning the QR code through the window and wait for the dispensing machine or pharmacist to dispense the drugs. Moreover, the medication consultation function was also operational. Results: The established internet pharmacy service mode had four major functional segments: online drug catalog search, prescription preview by AI, drug dispensing and distribution, and AI-based medication consultation response. The qualified rate of AI preview was 83.65%. Among the 16.35% inappropriate prescriptions, 49% were accepted and modified by physicians proactively and 51.00% were passed after pharmacists intervened. The "offline self-pick-up" mode was preferred by 86% of the patients for collecting their medication in the internet hospital, which made the QR code to be fully applied. A total of 426 medication consultants were served, and 48.83% of them consulted outside working hours. The most frequently asked questions during consultations were about the internet hospital dispensing process, followed by disease diagnosis, and patient education. Therefore, an AI-based medication consultation was proposed to respond immediately when pharmacists were unavailable. Conclusion: The established AI-based internet hospital pharmacy service mode could provide references for pharmacy departments during the COVID-19 pandemic. The significance of this study lies in ensuring safe/rational use of medicines and raising pharmacists' working efficiency.

4.
Chinese Pharmacological Bulletin ; 38(11):1730-1738, 2022.
Artigo em Chinês | EMBASE | ID: covidwho-2164245

RESUMO

To analyze the mechanism of novel coronavirus prevention prescription in Hunan province by using network pharmacology method. Methods TCMSP, Batman-TCM and ETCM were used to retrieve drug composition and target information, and GeneCards, OMIM, DrugBank, TTD and PharmGkb were used to screen disease targets. The visualization network diagram of "drug-active component-target" was constructed by Cytoscape, the protein interaction network was drawn by STRING, the core targets of PPI network were analyzed by CytoNCA, GO function and KEGG pathway were analyzed, and the mechanism of action was predicted. Results A total of 418 active ingredients, 1 715 drug targets, 1 289 disease targets and 266 intersection targets were screened out. Quercetin, luteolin, kaempferol, baicalein, ursolic acid and naringin were identified as the key components, and 6 core targets were obtained: RELA, AKT1, STAT3, JUN, MAPK1 and MAPK3. The results of molecular docking showed that the binding potential and activity of the key active ingredients to the core target were good. Conclusions "Child prevention formula" has the characteristics of multi-target, multi-approach and multi-faceted prevention and treatment, which plays a role in prevention and treatment of COVID-19 among children. Copyright © 2022 Publication Centre of Anhui Medical University. All rights reserved.

5.
National Journal of Physiology, Pharmacy and Pharmacology ; 12(11):1854-1859, 2022.
Artigo em Inglês | EMBASE | ID: covidwho-2164100

RESUMO

Background: Resistance to antibiotics is rising markedly. Factor which contributes to resistance is the rampant irrational use of antibiotics. The trend of prescribing antibiotics in intensive care units (ICUs) of eastern India is less explored. Aims and Objectives: The aim of the study was to describe and analyze the utilization of antibiotics as per the WHO/INRUD prescribing core indicators in an intensive and critical care unit (CCU) of a tertiary center in eastern India. Material(s) and Method(s): A prospective observational study was carried out on prescription pattern of antibiotics. Case records of patients with restricted antibiotic therapy were reviewed and evaluated using descriptive statistics. A total of 353 prescriptions were evaluated and analyzed. Result(s): Among the total 353 patients most common age group admitted was 41-60 years. Males were more in numbers. Myocardial infarction and post-operative complications were the most common cause of admission in ICU and CCU, respectively. Ceftriaxone (44%) and meropenem (37%) were the drugs used rampantly in ICU and CCU. More than 90% of prescriptions had injections and drugs were written in generic names. Almost 90% of patients in CCU had antibiotics in their prescription. Adverse events occurred in 14.7% of patients and thrombophlebitis was the most common adverse event occurred. Conclusion(s): The study has given us an overall impression of the antibiotics usage pattern in ICU and CCU of this teaching institution. The study has shown that antibiotics should be used judiciously in ICU and CCU. Policy can be made on the basis of the result of this study. Copyright © 2022 Pratap Chatterjee, et al.

6.
BMC Health Serv Res ; 22(1):1506, 2022.
Artigo em Inglês | PubMed | ID: covidwho-2162361

RESUMO

BACKGROUND: The COVID-19 pandemic, and its associated social distancing measures, gave profound changes to the everyday and academic life of students in higher education. The current study is the first to use nation-wide data to evaluate the long-term effect of the pandemic and its countermeasures on university students' mental health care use. METHODS: Using nation-wide individual-level data, we studied mental health consultations in primary care (data available from January 2017 to February 2022) and dispensed prescription drugs used to treat anxiety, depression, and sleep disturbances (data available from October 2018 to February 2021) for first-year undergraduate university students. We compared changes over time in mental health care use in a pandemic cohort (12,501 first-year students enrolled in 2019) to the same change in a pre-pandemic cohort (25,990 first-year students enrolled in 2017 and 2018). Event study and difference-in-difference models allowed us to separate the impact of the pandemic, experienced by the pandemic cohort only, from secular and seasonal changes experienced by all cohorts. RESULTS: The percentage of students with a mental health consultation temporarily decreased during the first period of strict social distancing measures in March 2020. At the end of the second round with strict measures in April 2021, the level of mental health consultations increased by 73% (95% CI 40-106.3). There was also a 42% (95% CI 5.7-79.5) increase in mental health consultations in November 2021. No similar increases were observed for dispensed prescription drugs between March 2020 and February 2021. CONCLUSIONS: The COVID-19 pandemic was associated with increases in mental health consultations in primary care among students, especially during/after longer periods of strict social distancing measures. The benefits of social distancing measures in future pandemic preparedness should be weighed against the cost of potentially worsening mental health in vulnerable groups.

7.
Appl Physiol Nutr Metab ; 2022.
Artigo em Inglês | Web of Science | ID: covidwho-2161980

RESUMO

Physical activity has declined further during the coronavirus disease 2019 (COVID-19) pandemic. Physicians are at the front lines of proactively educating and promoting physical activity to patients;however, physicians do not feel confident and face numerous barriers in prescribing exercise to patients. Exercise referral schemes, comprising collaborations with qualified exercise professionals, represent a fruitful option for supporting physicians hoping to promote physical activity to more patients. Herein, we provide practical suggestions for establishing and creating a successful referral scheme. Ultimately, exercise referral schemes offer an alternative to help physician burnout and mitigate patient physical inactivity during and beyond the COVID-19 pandemic.

8.
European Psychiatry ; 65(Supplement 1):S124, 2022.
Artigo em Inglês | EMBASE | ID: covidwho-2153817

RESUMO

Introduction: Depression and suicidal behaviour are major public health problems everywhere but particularly in Hungary where until 2000 the suicide rate was among the highest in the world. Objective(s): To analyse the possible causes of declining national suicide rate of Hungary. Method(s): Review of the scientific literature on Hungarian suicide scene published in the last 40 years. Result(s): The peak of Hungarian national suicide rate was in 1985 (46/100.000) but due to a steady and continuous, year by year decline, in 2019 it was only 16/100.000, which represents a more than 65% decrease. Rate of unrecognised/untreated mood disorders, availability of health/psychiatric care, antidepressant and lithium prescription, unemployment, smoking and alcohol consumption as well as lithium and arsenic contents of drinking water were the most investigated possible determinants of suicide mortality of the country. More widespread and effective treatment of psychiatric/mood disorder patients, decreased rate of unemployment and smoking as well as the continuously improving living standards were the most important contributors to the great decline of the national suicide rate. However, in 2020 - the first year of the COVID-19 pandemic - the national suicide rate rose by 16%, which was almost totally accounted for by the increase of suicides among males. Conclusion(s): Suicidal behaviour is preventable in many cases, but as it is a complex, multicausal phenomenon, its prevention should involve several medical/psychiatric, psychosocial and community interventions.

9.
European Psychiatry ; 65(Supplement 1):S25, 2022.
Artigo em Inglês | EMBASE | ID: covidwho-2153778

RESUMO

Alcohol, psychoactive substance abuse, and burnout are areas of significant problems within health care professionals and medical doctors. In 2011 we did a survey (n = 1601) in Belgium among the medical specialists. Beginning of 2021, exactly 10 years after the first survey, we repeated the survey this time among both medical specialists, general practitioners, and pharmacists. The results of this survey (N = 4361) will be presented and tendencies compared with international findings. We discuss the findings from both the longitudinal perspective using our 2011 data and also from the perspective of the impact of the Covid19 pandemic on health professionals.

10.
Journal of Poetry Therapy ; 2022.
Artigo em Inglês | Scopus | ID: covidwho-2151391

RESUMO

Unexpectedly taking place in the midst of a pandemic, this research examined historical and contemporary assumptions about the relationship between storytelling and wellbeing and asked how a shared reading group might be used to help repair individuals and communities as they emerge into the post-Covid world. It asked how storytelling can help us to come to terms with the collective trauma we have experienced by developing empathy and enlarging identity, and considered the role of digital technology in creating safe spaces for connection and reflection. The research aimed to provide a nuanced and in-depth account of the experience of shared reading for wellbeing, and to make practical recommendations for the future of such initiatives in community settings. It identified significant risks in shared reading and asked how these can be minimised, whilst being wary of stifling the many benefits of creativity by becoming too risk averse. © 2022 National Association for Poetry Therapy.

11.
Annales Pharmaceutiques Françaises ; 2022.
Artigo em Inglês | ScienceDirect | ID: covidwho-2150409

RESUMO

Introduction: The use of electronic systems in prescription is considered as the final solution to overcome the many problems of the paper transcription process, especially with the outbreak of Coronavirus needs more attention than before. But despite the many advantages, its implementation faces many challenges and obstacles. Therefore, the present study was conducted to review the effectiveness of computerized physician order entry systems (CPOE) on relative risk reduction on medication error and adverse drug events (ADE). Method: This study is one of the systematic review studies that was conducted in 2021. In this study, searching for keywords such as E-Electronic Prescription, Patient safety, Medication Errors prescription, Drug Interactions, orginal articles from 2000 to October-2020 in the valid databases such as ISI web of Science PubMed Embase, Scopus and search engines like google was done. The included studies were based on the main objectives of the study and based on the inclusion criteria after several stages of review and quality evaluation. In fact, the main criteria for selecting articles were studies that compared the rate of medication errors with or without assessing the associated harms (real or potential) before and after the implementation of EMS. Results: Out of 110 selected studies after initial screening, only 16 articles were selected due to their relevance. Among the final studies, there was a significant heterogeneity. Only 6 studies were of good quality. Of the 10 studies prescribing error rates, 9 reported reductions, but variable denominators prevented meta-analysis. Twelve studies provided specific examples of systemic drug errors. 5 cases reported their occurrence slightly. Out of 9 cases that analyzed the effects on drug error rate, 7 cases showed a significant relative reduction between 13 and 99%. Four of the six studies that analyzed the effects on potential ADEs showed a significant relative reduction of between 35 and 98%. Two of the four studies that analyzed the effect of ADEs showed a relative reduction of between 30 and 84%. Conclusion: Finally, e-prescribing seems to reduce the risk of medication errors and ADE. However, the studies differed significantly in terms of setting, design, quality and results. More randomized controlled trials (RCTs) are needed to further improve the evidence of health informatics information.

12.
Neuropsychiatrie de l'Enfance et de l'Adolescence ; 2022.
Artigo em Inglês, Francês | EMBASE | ID: covidwho-2150347

RESUMO

Objectives: The aim of this retrospective study was to question the psychological consequences of the health crisis in a pediatric population, through an analysis of the variations in the activity data of a pedopsychiatric emergency consultation service. Material(s) and Method(s): The present study is a retrospective and comparative epidemiological study based on an analysis of activity data from a pedopsychiatric emergency consultation at the Lille University Hospital center collected over the period contemporary of the social restriction measures of March 17th, 2020 to May 19th, 2021 as well as those collected after the lifting of these measures from May 19th, 2021 to May 31st, 2022 by comparing them to the activity on this same service over the equivalent periods between January 1st, 2017 and March 17th, 2020. Comparisons centered around the three confinement periods were also carried out. Any patient between 0 and 18 years old taken care of in this emergency consultation was included in this study. Result(s): A significant increase in drug prescriptions and consultations for suicidal ideations was observed during, but also at a distance from social restriction measures. The first confinement was marked by a significant drop in the number of consultations and a significant increase in the drafting of child protection documents. Discussion(s): These results were therefore in favor of an increase in suicidality in the pediatric population during and after the lifting of social restriction measures, as well as an increase in situations relating to child protection during the first confinement. The significant increase in discordant discharge drug prescriptions with the more modest increase in hospitalizations foreshadowed a mismatch between needs and hospitalization capacity. Conclusion(s): An impact of the health crisis could therefore be observed on the activity of a pedopsychiatric emergency consultation during, but also after the lifting of social restriction measures. This raises the importance of not limiting research to periods of confinement, as well as the question of the reversibility of the variations observed for the generation considered. Copyright © 2022 Elsevier Masson SAS

13.
Missouri Medicine ; 117(4):362-369, 2020.
Artigo em Inglês | ProQuest Central | ID: covidwho-2147710

RESUMO

Recently, Missouri has followed an overall upward trend in opioid overdose deaths. In 2018, Missouri was the state with the largest absolute and percentage increase in opioidrelated overdose fatality rates per capita over the previous year (18.3% and 3.1/100,000). This increase occurred despite an overall decrease in U.S. opioid-related death rates in the same period. This report identifies illicitly manufactured fentanyl (IMF) (and analogues) as the drug most responsible for this rise in opioid deaths in Missouri, with stimulant overdoses (primarily from methamphetamine) in second place. Within Missouri, we find the areas where opioid deaths are highest: St. Louis and the citys fringe areas, following the national trend for high rates in fringe areas. Based on reports from CDC Wonder data, county medical examiners, law enforcement agencies, and drug addiction prevention agencies, we conclude that IMF and related synthetic opioids arriving from China are primarily responsible for fatal narcotic overdoses in Missouri. Despite the COVID-19 disruption of fentanyl manufacturing and distribution centers in and around Wuhan, China early in the pandemic, preliminary 2020 data from medical examiners offices show an upswing in opioid deaths, an indicator that Chinese fentanyl producers have restored the supply chain.

14.
Missouri Medicine ; 117(5):421-425, 2020.
Artigo em Inglês | ProQuest Central | ID: covidwho-2147115

RESUMO

Though the definitions vary between studies, it is often defined as "emotional exhaustion," feeling "used up" at the end of the workday, and a sense of reduced personal accomplishment.17 Physician burnout has many implications, including financial, and costs exceed $213.1 million.18 Burnout is particularly relevant as it can lead to people leaving the profession, which, as the data from the Severe Acute Respiratory Syndrome (SARS) pandemic in Toronto suggests is only worsened during a pandemic.19 Given these high numbers, some policy changes were previously put into effect in medical education and training, like duty hours restrictions in 2003.20 In 2017, additional changes were made by the Accreditation Council for Graduate Medical Education (ACGME) including the creation of policies and programs that support faculty members and residents to attend appointments for personal care, even during work hours. [...]one study found that not a single female physician who died by suicide disclosed suicidal intent to a doctor prior to her death.23 While there are many reasons why physicians do not disclose information about their mental health, one study found that 60% were concerned it could affect their medical licenses.24 This causes some to get care outside of the system-receiving prescriptions from friends who are not formally treating them- and can lead others to delay treatment until a crisis occurs, if treatment is sought at all.24 As we know that approximately 300-400 physicians die by suicide in the United States, this is not just an urgent issue, it is a critical one.25 During COVID-19 On top of an already strained emotional baseline, healthcare workers faced the sudden onslaught of a pandemic. Interestingly, 61% of participants also expressed an increased sense of meaning and purpose since the outbreak, which is worth more analysis.27 At Washington University in St. Louis, a study was completed that compared trainees exposed to COVID-19 vs those that were non-exposed.28 Compared to the non-exposed group, the exposed group had a higher prevalence of stress (29.4% vs 18.9%) and burnout (46.3% vs 22.7%).28 Meaning and purpose can be further explored in Victor Frankl's book, Man's Search for Meaning, a memoir of surviving a concentration camp. 29 This book reflects that for a meaningful life, you must pursue meaningful work.29 One study of academic physicians showcased that value-aligned work protected from burnout.30 Therefore, including and thinking about these concepts might be protective factors in mental health of healthcare workers or at least important foundations for treatment. To help combat the emotional needs of healthcare workers during the pandemic, the World Health Organization provided recommendations to give psychological support including information about community-based health care, clinical management guidelines, strengthening health systems, and mental health.31 While comprehensive, this can be challenging if an organized structure of support was not in existence before COVID-19, as was the case in many hospitals.

15.
Front Public Health ; 10: 1034450, 2022.
Artigo em Inglês | MEDLINE | ID: covidwho-2142361

RESUMO

Background: Online health care services have been encouraged by the Chinese government in recent years, and the COVID-19 pandemic catalyzed the rapid growing of internet hospitals. As an integral part of online health care services, little is known about the economic value and characteristics of cloud pharmacy especially for children. This study aimed to reveal the economic value and comprehensive characteristics of pediatric cloud pharmacy during the COVID-19 pandemic in a tertiary children's hospital in western China. Methods: A total of 33,254 online prescriptions over the course of February 2020 through December 2021 were analyzed with respect to the user profiles, diseases, consulting behaviors, distribution of departments, delivery region and distance, drug information and degree of satisfaction. The cost savings for patients calculated lost wages and the high-speed railway fees for transport to and from hospital. Results: A total of 33,254 prescriptions, including 56,216 drugs were delivered to 27 provinces and municipalities of China. The internet cloud pharmacy saved a total of more than RMB 11.17 million in financial costs for patients. Of the 33,254 delivered prescriptions, 50.40% were sent to Chongqing Province, the top 5 provinces for out-of-province prescription deliveries were Sichuan (37.77%), Guizhou (8.00%), Yunnan (1.18%), Hubei (0.66%) and Guangdong (0.42%). In terms of department distribution, neurology (31.7%), respiratory (15.0%) and endocrinology (14.6%) were the top three departments. Epilepsy (16.2%), precocious puberty (10.3%) and asthma (8.7%) were the top three frequently consulted diseases. The peak times of day for online prescriptions occurred at 9 AM and 8 PM. 99.67% of users gave full marks for their internet counseling. Conclusion: The pediatric cloud pharmacy is efficient, cost-saving and convenient for children with chronic disease or mild symptoms during the COVID-19 pandemic. The widespread use of this pediatric cloud pharmacy can help alleviating pressure on offline hospitals and facilitated people's lives beyond geographical and time-related limitations. Further efforts are needed to be made to improve the quality and acceptance of pediatric cloud pharmacy, as well as to regulate and standardize the management of this novel online health care service.


Assuntos
COVID-19 , Farmácia , Humanos , Criança , Estudos Transversais , COVID-19/epidemiologia , Pandemias , China/epidemiologia , Hospitais , Internet
16.
Journal of the American Society of Nephrology ; 33:129-130, 2022.
Artigo em Inglês | EMBASE | ID: covidwho-2124650

RESUMO

Background: The Covid-19 pandemic has introduced a number of challenges in managing populations with both acute kidney failure and those dependent on chronic dialysis. Due to a shortage of outpatient dialysis supplies, on February 14, 2022, the Dpt. of Veteran's Affairs issued a memorandum to dialysis units requiring a contingency standard of care. This required a universal reduction of dialysate flow rate to 500 cc/min. Prior to this change, the standard prescription at the Lexington, KY VA unit was 750 cc/min. We evaluated the effect of this change on the adequacy of our dialysis population. Method(s): Data was collected for sp Kt/V urea and urea reduction ratio for 17 chronic hemodialysis patients for the two months prior and three months following the reduction of dialysate flow rate to 500 cc/min from the previous standard of 750 cc/min. There was no change of blood flow rate or dialysis time during this 5 month period for all the patients included. Result(s): A trend towards lower clearance values as measured by single-pool Kt/V and urea reduction ratio was noted between January and April of 2022. Table 1 shows the average spKt/V and URR for each month. The majority of patients maintained adequate spKt/V of >1.2 and urea reduction ratio of >65%. However, 4 patients (23.5% of the population) failed to reach Kt/V and URR goal in April 2022. Conclusion(s): Though this represents only 17 patients from one dialysis unit, the data suggests a significant decline in adequacy due to this reduction in dialysis flow rate to 500 cc/min. Until the current dialysis supply shortage has been addressed, adaptive measures such as utilizing higher efficiency dialyzers or increasing blood flow rates may be necessary.

17.
Medical News of North Caucasus ; 17(3):335-341, 2022.
Artigo em Russo | EMBASE | ID: covidwho-2145419

RESUMO

The review is devoted to the peculiarities of the course of a new coronavirus infection (COVID-19) in elderly and senile patients. Data on the epidemiology, pathogenetic mechanisms of development, clinical manifestations, course and prognosis of the disease among geriatric patients are presented. The role of comorbid pathology in the course and prognosis of a new coronavirus infection in the elderly is shown. Recommendations for the treatment of patients with an emphasis on the need to comply with strict indications for prescribing antibacterial drugs in this category of patients are discussed. Copyright © 2022 Stavropol State Medical University. All rights reserved.

18.
Journal of Chinese medicinal materials ; 44(4):1031-1038, 2021.
Artigo em Chinês | EMBASE | ID: covidwho-2145401

RESUMO

Objective: To analyze the action mechanism of anti-Corona Virus Disease 2019(COVID-19)by Chinese herbal compound and propose a combination of Chinese medicine through network pharmacology and molecular docking. Method(s): Based on the Chinese medicine and Chinese medicine prescription for prevention and treatment of COVID-19, ADME properties(OB>=30%;DL>=0.18)was used for virtual screening;Potentially active molecules in protease Mpro and receptor ACE2 were screened by molecular docking(Binding Scores>4);Through the overlap ratio of active components and key targets, the suggestions on optimizing formula combination were provided. Result(s): 127 Chinese medicinal materials and 885 active components were obtained. The active components close to Lopinavie scores included squalene, shikonin, stigmasterol, etc. The traditional chinese medicinal materials with overlap rate of active molecules>=15% included Ephedrae Herba, Lonicerae Japonicae Flos, Scutellariae Radix, etc. The key Chinese herbal medicines with overlapping rate of key targets>=15% included Glycyrrhizae Radix et Rhizoma, Pinelliae Rhizoma, Curcumae Radix, etc. Conclusion(s): The combinations of Chinese herbal are proposed:(1)Ephedrae Herba, Armeniacae Semen Amarum, Glycyrrhizae Radix et Rhizoma, Curcumae Longae Rhizoma;(2)Lonicerae Japonicae Flos, Scutellariae Radix, Arnebiae Radix, Verbenae Herba;(3)Ephedrae Herba, Pinelliae Rhizoma, Curcumae Radix, Pseudostellariae Radix. Copyright © 2021, Central Station of Chinese Medicinal Materials Information, National Medical Products Administration. All right reserved.

19.
Journal of Chinese medicinal materials ; 44(3):756-766, 2021.
Artigo em Chinês | EMBASE | ID: covidwho-2145398

RESUMO

Objective: To explore the material basis of potential effect and possible molecular mechanisms of Qingre huashi kangdu prescription proposed by Chinese medicine master Wu Bing-cai on the treatment of Corona Virus Disease 2019(COVID-19), and to provide reference for the treatment and scientific research of COVID-19 in traditional Chinese medicine. Method(s): TCMSP, Batman and other databases were used to search chemical components and action targets in traditional Chinese medicines of Qingre huashi kangdu prescription.The disease targets of COVID-19 were screened out by GeneCards, OMIM, GEO databases.Cytoscape software was used to construct the "drugs-components-targets-diseases" network and the interaction relationship between potential targets.Metascape enrichment analysis was used to predict the core modules and mechanism of action, and ACE2 was docking with the main components. Result(s): 202 kinds of chemical components and 301 drug targets in the Qingre huashi kangdu prescription were excavated, there were 360 COVID-19 related disease targets, and 64 intersections of the two.Nine main chemical components were found in the formula, and the key targets involved PTGS2, NOS2, PPARG, MAPK14, NOS3, RELA, etc.Three core modules were predicted, and the core terms mainly included infectious diseases, immune diseases and pathways, immune and inflammatory pathways.A total of 196 items were obtained by GO enrichment analysis, which mainly involved cytokine-mediated signaling pathway, response to oxidative stress, apoptosis signaling pathway, regulation of protein localization establishment, reactive oxygen metabolism, 147 signaling pathways were screened out by KEGG pathway enrichment, including AGE-RAGE signaling pathway in diabetes complications, toxoplasmosis, apoptosis, MAPK signaling pathway, amoebiasis, HIF-1 signaling pathway and RIG-I-like signaling pathway.Molecular docking showed that luteolin, quercetin, baicalein, kaempferol, robinin, wogonin and naringenin had good binding abilities with ACE2, and the combination of quercetin, baicalein and kaempferol with ACE2 was more stable. Conclusion(s): Qingre huashi kangdu prescription treats COVID-19 through multi-components, multi-targets and multi-pathways. Copyright © 2021, Central Station of Chinese Medicinal Materials Information, National Medical Products Administration. All right reserved.

20.
Injury Prevention ; 28(Suppl 2):A85-A86, 2022.
Artigo em Inglês | ProQuest Central | ID: covidwho-2137913

RESUMO

BackgroundWest Virginia(WV) drug poisoning rates were low before 2000 but now are the nation’s highest. We explore the role of excessive opioid prescribing in imitating this epidemic.MethodsWV age-adjusted overdose fatality trends 1979 to 2020 were examined along with toxicology data from our medical examiner(ME) containing drug levels on all drug-involved deaths in WV. Percapita opioid prescribing rates was available 1997–2017.ResultsFatal drug overdose rates increased from 3.3/100,000 in 2000 to 83.6 in 2000. WV percapita morphine milligram equivalent (MME) opioid prescription rates increased from 137 in 1997 to 1,171 in 2011 (850% increase) but decreased to 554 in 2017. Corresponding with 2012 decline in prescribed opioids, prescription drug involvement deaths declined steadily while 2011–2013 overall overdose rates flattened. However, in 2012 heroin deaths began rising. In 2014 introduction of fentanyl began an unprecedented increase in overall fatality rates peaking in 2017. In 2018–19 rates declined but began to rise again corresponding with COVID-19 pandemic. More detailed time series analyses of temporal correlations of opioid prescription and overdose rates, including multivariate trends will be presented.DiscussionUnlike urban drug problems, the WV epidemic origins are largely iatrogenic, starting with extremely high opioid prescription rates. As predicted by the Iron Law of Prohibition, sudden decreases in the availability of prescription opioids were associated with an increased use of illicit, more potent opioids. This presentation will outline the progression of the rural drug problem in WV including harm-reduction efforts.Learning OutcomesDiscuss global implications of findings and lessons learned.

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