Corticosteroids in ARDS.

Acute respiratory distress syndrome (ARDS) is frequently associated with sepsis. ARDS and sepsis exhibit a common pathobiology, namely excessive inflammation. Corticosteroids are powerful anti-inflammatory agents that are routinely used in septic shock and in oxygen-dependent SARS-CoV-2 related acute respiratory failure. Recently, corticosteroids were found to reduce mortality in severe community-acquired pneumonia. Corticosteroids may therefore also have a role to play in the treatment of ARDS. This narrative review was undertaken following a PubMed search for English language reports published before January 2023 using the terms acute respiratory distress syndrome, sepsis and steroids. Additional reports were identified by examining the reference lists of selected articles and based on personnel knowledge of the authors of the field. High-quality research is needed to fully understand the role of corticosteroids in the treatment of ARDS and to determine the optimal timing, dosing and duration of treatment.

Citizen Science in the Promotion of Sustainability: The Importance of Smart Education for Smart Societies

Digital society is already a reality and is increasingly shaping many aspects of social, economic and political life, among other aspects. The concept of Society 5.0 is a proposed form of a possible political nature to fulfil this digital society through a super-smart society. Based on document analysis of articles and books on this topic, this conceptual paper aims to critically discuss some aspects of Society 5.0, such as the dimensions of digitalization and sustainability. It is concluded that Society 5.0 is not an inevitability, and that the transformations it entails, as well as its advantages, also have challenges and limitations that should be considered, such as the risk of reproducing old forms of micro, meso and macrosocial inequalities within each country and between countries and regions, and, at the same time, creating new forms of social, cultural, economic and political inequalities, among others. A critical spirit seems to be necessary in the follow-up of this Society 5.0 and for which citizen-science logic, in an interdisciplinary way, can potentially provide tools for previous and prospective analysis of its implementation. We justify the need for smart education in these smart societies as a way of contributing to responding to the pressing problem of sustainability. It is smart education in and for a super smart society.

Challenges of Post-COVID-19 for a Sustainably Developed Society

The COVID-19 pandemic has prompted both preventive and reactive disease control measures, such as lockdown, physical distancing, and mask use, among others [...]

Increment Antimicrobial Resistance During the COVID-19 Pandemic: Results from the Invifar Network.

Aim: This study aims to assess the changes in antimicrobial resistance among some critical and high-priority microorganisms collected previously and during the coronavirus disease 2019 (COVID-19) pandemic in Mexico. Methods: We collected antimicrobial susceptibility data for critical and high-priority microorganisms from blood, urine, respiratory samples, and from all specimens, in which the pathogen may be considered a causative agent. Data were stratified and compared for two periods: 2019 versus 2020 and second semester 2019 (prepandemic) versus the second semester 2020 (pandemic). Results: In the analysis of second semester 2019 versus the second semester 2020, in blood samples, increased resistance to oxacillin (15.2% vs. 36.9%), erythromycin (25.7% vs. 42.8%), and clindamycin (24.8% vs. 43.3%) (p ≤ 0.01) was detected for Staphylococcus aureus, to imipenem (13% vs. 23.4%) and meropenem (11.2% vs. 21.4) (p ≤ 0.01), for Klebsiella pneumoniae. In all specimens, increased ampicillin and tetracycline resistance was detected for Enterococcus faecium (p ≤ 0.01). In cefepime, meropenem, levofloxacin, and gentamicin (p ≤ 0.01), resistance was detected for Escherichia coli; and in piperacillin-tazobactam, cefepime, imipenem, meropenem, ciprofloxacin, levofloxacin, and gentamicin (p ≤ 0.01), resistance was detected for Pseudomonas aeruginosa. Conclusion: Antimicrobial resistance increased in Mexico during the COVID-19 pandemic. The increase in oxacillin resistance for S. aureus and carbapenem resistance for K. pneumoniae recovered from blood specimens deserves special attention. In addition, an increase in erythromycin resistance in S. aureus was detected, which may be associated with high azithromycin use. In general, for Acinetobacter baumannii and P. aeruginosa, increasing resistance rates were detected.

Multimodal analysis of advertising discourse during the lockdown due to COVID-19: Comparison of the communication strategies of financial services and automotive products in Spain

The goal of the following text is to analyze the changes in television advertising in the banking and automobile sectors, according to the social context. The hypothesis is that communication is significantly influenced by the situational context, causing differences between the advertising of the two sectors. A multimodal discourse analysis is used, comparing twenty commercials from the banking and automobile sectors in 2019 and 2020, the period during which the lockdown due to COVID-19 took place. Based on a qualitative and quantitative analysis tables were developed with which to analyze general data such as the value proposition or target audience of the advert, or other special data like the text (verb tenses, rhetorical figures...), the image and the sound used. The fact that context is decisive in communication is made evident, and since this is different in every sector, the communication strategy is clearly different as well. However, the points that the two sectors have in common are remarkable: these range from talking about brands and products, to speaking for and about people. [ FROM AUTHOR] Copyright of Communication & Society is the property of Servicio de Publicaciones de la Universidad de Navarra, S.A. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

COVID-19 Pandemic and its Impact on the Management of Head and Neck Cancer in the Spanish Healthcare System.

Introduction Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has represented a major challenge for healthcare systems worldwide, changing the habits of physicians. A reorganization of healthcare activity has been necessary, limiting surgical activity to essential cases (emergencies and oncology), and improving the distribution of health resources. Objective To analyze the impact of the COVID-19 pandemic on head and neck cancer surgery management in Spain. Methods A cross-sectional study, through an anonymous and voluntary online survey distributed to 76 Spanish otorhinolaryngology departments. Results A total of 44 centers completed the survey, 65.9% of which were high-volume. A total of 45.5% of them had to stop high-priority surgery and 54.5% of head and neck surgeons were relocated outside their scope of practice. Surgeons reported not feeling safe during their usual practice, with a decrease to a 25% of airway procedures. A total of 29.5% were "forced" to deviate from the "standard of care" due to the epidemiological situation. Conclusions Approximately half of the departments decreased their activity, not treating their patients on a regular basis, and surgeons were reassigned to other tasks. It seems necessary that the head and neck surgeons balance infection risk with patient care. The consequences of the reported delays and changes in daily practice should be evaluated in the future in order to understand the real impact of the pandemic on the survival of head and neck cancer patients.

A Review of Prolonged Post-COVID-19 Symptoms and Their Implications on Dental Management.

The available data regarding the short and long-term consequences of COVID-19 is still insufficient. This narrative review aims to provide information on the prolonged COVID-19 symptoms in recovered patients and their implications during dental management. Additionally, this manuscript highlights the oral manifestations of COVID-19 and its management. A systematic search was conducted in PubMed, Embase, Cochrane Library and Web of Science databases, WHO and CDC websites, and grey literature was searched through Google Scholar. Clinical articles (clinical trials, case-reports, cohort, and cross-sectional studies) were included, reporting prolonged post-COVID-19 symptoms. Although COVID-19 is an infectious disease primarily affecting the lungs, its multi-organ involvement is responsible for several prolonged symptoms, including oral implications. In recovered patients with prolonged COVID-19 symptoms, considerations for providing dental treatment has to be made as they can present with assortment of symptoms. These prolonged post-COVID-19 symptoms can affect the delivery of the required dental treatment. Hence, the recommendations proposed in this narrative review can be a useful starting point to aid dental teams providing adequate care for such recovered patients.

Knowledge, Attitudes, and Practices towards COVID-19 in Paraguayans During the Outbreak Period: A Quick Online Survey / Conocimientos, actitudes y prácticas hacia COVID-19 en paraguayos el periodo de brote: una encuesta rápida en línea

Introducción: La rápida expansión del COVID-19 hizo que la OMS la declarara una emergencia sanitaria de preocupación internacional, basándose en el impacto que el virus podría tener en países subdesarrollados con menos infraestructuras sanitarias, y Paraguay no ha sido la excepción, puesto que, para prevenir la expansión del virus, los gobiernos han impuesto restricciones de viajes, cuarentenas, confinamientos, aislamiento social, cancelación de eventos, y cierre de establecimientos. Objetivo: Determinar los conocimientos, actitudes y prácticas de los paraguayos en el período del brote de COVID-19 Métodos: Se realizó un estudio transversal a partir del 20 de marzo de 2020, la semana inmediatamente posterior al cierre de Paraguay. La encuesta se realizó en línea utilizando un formulario de Google Forms (c) distribuido a través de grupos de "WhatsApp". A los nacionales paraguayos, mayores de 18 años, se les explicó los objetivos y propósito del estudio, a quienes aceptaron participar en el estudio, se les solicitó completar el cuestionario haciendo clic en el enlace (https://forms.gle/P6X81SYRMYs1G2Gw6). Resultados: Un total de 3141 participantes completaron el cuestionario de la encuesta. La edad media fue de 29,55 años (DE: 10,7), 2139 (68,10%) eran mujeres y 2073 (66) eran del Interior. La puntuación media de conocimientos de COVID-19 fue de 7,45 (DE: 1,51), lo que sugiere una tasa general correcta del 62% (7,45 / 12 * 100) en esta prueba de conocimientos. La mayoría de los encuestados coincidió en que COVID-19 finalmente se controlará con éxito (66,28%), la gran mayoría de los participantes no había visitado ningún lugar concurrido (88,35%) y llevaba máscaras al salir (74,31%) en los últimos días. Conclusión: El conocimiento sobre COVID-19 en la población paraguaya durante el brote fue aceptable, las actitudes han sido en su mayoría favorables y las prácticas en su mayoría adecuadas, sin embargo, es necesario implementar campañas masivas de educación, para incrementar la proporción de conocimiento sobre COVID- 19, para detener su propagación.

Introduction: The rapid expansion of COVID-19 caused the WHO to declare it a health emergency of international concern, based on the impact that the virus could have in underdeveloped countries with less health infrastructure, and Paraguay has not been the exception, since, To prevent the spread of the virus, governments have imposed travel restrictions, quarantines, lockdowns, social isolation, cancellation of events, and closure of establishments. Objective: To determine the knowledge, attitudes and practices of Paraguayans in the period of the COVID-19 outbreak Methods: A cross-sectional study was carried out from March 20, 2020, the week immediately after the closure of Paraguay. The survey was online using a Google Forms (c) form distributed through "WhatsApp" groups. Paraguayan nationals, over 18 years of age, who were explained the objectives and purpose of the study, who agreed to participate in the study, were asked to complete the questionnaire by clicking on the link (https://forms.gle/P6X81SYRMYs1G2Gw6).. Results: A total of 3141 participants completed the survey questionnaire. The mean age was 29.55 years (SD: 10.7), 2139 (68.10%) were women, and 2073 (66) were Interior. The mean COVID-19 knowledge score was 7.45 (SD: 1.51), suggesting an overall 62% (7.45/12*100) correct rate on this knowledge test. The majority of the respondents agreed that COVID-19 will finally be successfully controlled (66.28%), the vast majority of the participants had not visited any crowded place (88.35%) and wore masks when going out (74.31%) in recent days Conclusion: The knowledge about COVID-19 in the Paraguayan population during the outbreak was acceptable, attitudes have been mostly favorable and the practices are mostly adequate, however, it is necessary to implement massive education campaigns, to increase the proportion of knowledge about COVID-19, to stop its spread.

CONSENSO ECMO COLOMBIANO PARA PACIENTE CON FALLA RESPIRATORIA GRAVE ASOCIADA A COVID-19

Resumen Antecedentes y objetivos: la epidemia de COVID-19 ha creado un desafío sin precedentes en el sistema de salud, generando una demanda creciente. Alrededor del 5% de los pacientes diagnosticados con esta infección requieren ingreso a cuidados intensivos principalmente para soporte ventilatorio con ventilación mecánica por un síndrome de dificultad respiratoria aguda de moderado a grave. Las mortalidades reportadas pueden ser muy altas. Los dos principales Las causas de muerte en esta infección son la hipoxemia refractaria asociada al SDRA y el shock con insuficiencia orgánica múltiple. La oxigenación con membrana extracorpórea (ECMO) se ha utilizado en pacientes con hipoxemia refractaria sin respuesta a manejo con ventilación mecánica protectora, ventilación en posición prono y relajación muscular⁠⁠. La Organización Mundial de la Salud recomienda considerar ECMO en pacientes adultos y pediátricos con COVID-19 y Síndrome de Dificultad respiratoria aguda (SDRA) refractaria, si hay un equipo de expertos disponible. Métodos: se utilizó la metodología de consenso formal para generar el Consenso ECMO en la infección SARS CoV-2 con la mejor evidencia disponible. El desarrollo del consenso combina las técnicas de selección, síntesis, evaluación y gradación de la evidencia: formulación de la pregunta PICO, Estrategias de búsqueda sistemática y técnicas de síntesis (metaanálisis). La evaluación de la calidad de la evidencia y la graduación de la fuerza de las recomendaciones se realizó con la estrategia GRADE, generando al final recomendaciones a los tópicos más relevantes del manejo del paciente con COVID-19 candidato a ECMO y por técnica de consenso formal (Delphi). Resultados: EL CONSENSO COLOMBIANO PARA UN PACIENTE CON FALLA RESPIRATORIA GRAVE ASOCIADO a COVID-19 proporciona un resumen de la evidencia sobre el uso de membranas de oxigenación extracorpórea en insuficiencia respiratoria hipoxémica aguda grave asociada con la infección SARS CoV-2, dando recomendaciones sobre sus indicaciones, Contraindicaciones, consideraciones y la implementación del grupo ECMOred Colombia. Conclusiones: el consenso colombiano de ECMO es un documento de guía y consulta para el manejo de pacientes con insuficiencia respiratoria aguda grave refractaria y disfunción cardiovascular asociada con COVID-19 candidatos para ECMO. Background and objectives: The COVID-19 epidemic has created an unprecedented challenge in the health system, generating increasing demand. About 5% of diagnosed patients require intensive care admissions primarily for support with mechanical ventilation for a moderate to severe Acute Respiratory Distress Syndrome. The reported mortalities can be very high. The two main causes of death in this type of infection are refractory hypoxemia associated to ARD and, shock with multiple organ failure. Extracorporeal Membrane Oxygenation (ECMO) has been used in patients with refractory hypoxemia and no response to management with protective ventilation, prone ventilation, and muscle relaxation⁠⁠. The World Health Organization recommends considering ECMO in adult and pediatric patients with COVID-19 and severe refractory acute respiratory distress syndrome (ARDS), if an expert team is available. Methods: The formal consensus methodology was used to generate the ECMO Consensus in the SARS CoV-2 infection with the best available evidence. The development of the consensus combined the techniques of selection, synthesis, evaluation and gradation of the evidence: formulation of the PICO question, systematic search strategies, synthesis techniques (meta-analysis). The evaluation of the quality of the evidence and the grading of the strength of the recommendations was carried out with the GRADE strategy. Results: The COLOMBIAN ECMO CONSENSUS FOR A PATIENT WITH SERIOUS RESPIRATORY FAILURE ASSOCIATED WITH COVID-19 provides a summary of the evidence of the use of extracorporeal oxygenation membranes in severe hypoxemic respiratory failure associated with this SARS CoV-2 infection, giving recommendations on its indications. Contraindications, considerations and the implementation of the ECMOred Colombia group. Conclusions: The Colombian ECMO Consensus is a consultation and guide document for the management of patients with refractory severe acute respiratory failure and cardiovascular dysfunction associated with COVID-19 candidates for ECMO.

The COVID-19 Contagion–Pandemic Dyad: A View from Social Sciences

The objective of this concept paper focuses on the relevance of the analytical potential of Social Sciences for understanding the multiple implications and challenges posed by the COVID-19 contagion–pandemic dyad. This pandemic is generating a global threat with a high number of deaths and infected individuals, triggering enormous pressure on health systems. Most countries have put in place a set of procedures based on social distancing, as well as (preventive) isolation from possible infected and transmitters of the disease. This crisis has profound implications and raises issues for which the contribution of Social Sciences does not seem to be sufficiently mobilised. The contribution of Social Sciences is paramount, in terms of their knowledge and skills, to the knowledge of these problematic realities and to act in an informed way on these crises. Social Sciences are a scientific project focused on interdisciplinarity, theoretical and methodological plurality. This discussion is developed from the systems of relationships between social phenomena in the coordinates of time and place, and in the socio-historical contexts in which they are integrated. A pandemic is a complex phenomenon as it is always a point of articulation between natural and social determinations. The space of the discourse on the COVID-19 pandemic can be understood as the expression of a coalition of discourses, i.e., the interaction of various discourses, combined in re-interpretative modalities of certain realities and social phenomena. The circumstantial coalitions of interests, which shape the different discursive records and actions produced by different agents of distinct social spaces, enable the acknowledgement and legitimation of this pandemic threat and danger, and the promotion of its public management.

Comparison Between Lung Ultrasound and Computed Tomographic Findings in Patients With COVID-19 Pneumonia.

OBJECTIVES: The aim of this study was to describe findings from lung ultrasound (LUS) and computed tomography (CT) in health professionals with coronavirus disease 2019 pneumonia and to evaluate the associations of the findings of both tests. METHODS: This cross-sectional observational study evaluated 45 health professionals who were initially seen in screening tents and had a diagnosis of coronavirus disease 2019 as confirmed by a reverse transcription polymerase chain reaction and lung involvement diagnosed by LUS. Subsequently, these individuals were admitted to the hospital, where chest CT was performed. Aeration scores were obtained for the LUS examinations based on the following findings: more than 2 B-lines, coalescent B-lines, and subpleural consolidations. A subjective assessment of the extent of lung disease on CT was performed on the basis of the percentage of lung parenchyma involvement as follows: 25% or less, 25% to 50%, and greater than 50%. RESULTS: Regarding LUS signs, more than 2 B-lines, coalescent B-lines, and subpleural consolidations were present in 73.3%, 68.2%, and 24.4% of cases, respectively. The main findings on CT were ground glass opacities, a crazy-paving pattern, and consolidations (66.7%, 20%, and 20% of cases); 17.8% of cases had examinations without abnormalities. Patients with more than 2 B-lines on LUS had more ground glass opacity areas on CT (P = .0007), whereas patients with subpleural consolidations on LUS had more consolidations on CT (P < .0001). In addition, patients with higher LUS aeration scores had more extensive disease on CT (P < .0001). CONCLUSIONS: Lung ultrasound can detect lung injury even in the presence of normal CT results. There are associations between the abnormalities detected by both methods, and a relationship also exists between LUS aeration scores and the disease extent on CT.