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1.
J Am Med Dir Assoc ; 21(7): 905-908, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32674817

RESUMO

OBJECTIVES: During the Coronavirus disease 2019 (COVID-19) outbreak in the United States, nursing homes became the hotbed for the spread of COVID-19. States developed different policies to mitigate the COVID-19 risks at nursing homes, including limiting nursing home visitation and mandating staff screening. The purpose of this study is to examine whether COVID-19 cases and deaths are related to the nursing home reported quality. DESIGN: We combined the COVID-19 data reported by the California Department of Public Health, quality ratings provided by Nursing Home Compare, and patient racial information from Long-Term Care Focus to examine the association between nursing home reported quality and COVID-19 cases and deaths. SETTINGS AND PARTICIPANTS: Cross-sectional data from 1223 California skilled nursing facilities with reported quality and longitudinal data of COVID-19 cases were used. METHODS: The dependent variable is COVID-19 residents' cases and deaths. The main independent variable is nursing home reported quality. Nursing home ownership, size, years of operation, and patient race composition are also included. RESULTS: Nursing home star ratings and greater percentage of residents from different racial and ethnicity groups were significantly (P < .01) related to increased probability of having a COVID-19 residents' case or death. CONCLUSIONS AND IMPLICATIONS: Nursing homes with 5-star ratings were less likely to have COVID-19 cases and deaths after adjusting for nursing home size and patient race proportion.


Assuntos
Causas de Morte , Infecções por Coronavirus/epidemiologia , Controle de Infecções/organização & administração , Casas de Saúde/organização & administração , Pneumonia Viral/epidemiologia , Instituições de Cuidados Especializados de Enfermagem/organização & administração , Idoso , Idoso de 80 Anos ou mais , California , Infecções por Coronavirus/prevenção & controle , Estudos Transversais , Surtos de Doenças/prevenção & controle , Surtos de Doenças/estatística & dados numéricos , Feminino , Humanos , Incidência , Assistência de Longa Duração , Masculino , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Qualidade da Assistência à Saúde , Medição de Risco , Análise de Sobrevida
3.
N Engl J Med ; 382(23): 2220-2229, 2020 06 04.
Artigo em Inglês | MEDLINE | ID: mdl-32492303

RESUMO

BACKGROUND: Research has consistently identified firearm availability as a risk factor for suicide. However, existing studies are relatively small in scale, estimates vary widely, and no study appears to have tracked risks from commencement of firearm ownership. METHODS: We identified handgun acquisitions and deaths in a cohort of 26.3 million male and female residents of California, 21 years old or older, who had not previously acquired handguns. Cohort members were followed for up to 12 years 2 months (from October 18, 2004, to December 31, 2016). We used survival analysis to estimate the relationship between handgun ownership and both all-cause mortality and suicide (by firearm and by other methods) among men and women. The analysis allowed the baseline hazard to vary according to neighborhood and was adjusted for age, race and ethnic group, and ownership of long guns (i.e., rifles or shotguns). RESULTS: A total of 676,425 cohort members acquired one or more handguns, and 1,457,981 died; 17,894 died by suicide, of which 6691 were suicides by firearm. Rates of suicide by any method were higher among handgun owners, with an adjusted hazard ratio of 3.34 for all male owners as compared with male nonowners (95% confidence interval [CI], 3.13 to 3.56) and 7.16 for female owners as compared with female nonowners (95% CI, 6.22 to 8.24). These rates were driven by much higher rates of suicide by firearm among both male and female handgun owners, with a hazard ratio of 7.82 for men (95% CI, 7.26 to 8.43) and 35.15 for women (95% CI, 29.56 to 41.79). Handgun owners did not have higher rates of suicide by other methods or higher all-cause mortality. The risk of suicide by firearm among handgun owners peaked immediately after the first acquisition, but 52% of all suicides by firearm among handgun owners occurred more than 1 year after acquisition. CONCLUSIONS: Handgun ownership is associated with a greatly elevated and enduring risk of suicide by firearm. (Funded by the Fund for a Safer Future and others.).


Assuntos
Armas de Fogo , Violência com Arma de Fogo/estatística & dados numéricos , Suicídio/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , California/epidemiologia , Causas de Morte , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Propriedade , Fatores de Risco , Suicídio/prevenção & controle , Análise de Sobrevida , Adulto Jovem
5.
MMWR Morb Mortal Wkly Rep ; 69(25): 781-783, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32584799

RESUMO

Outbreaks associated with fresh or marine (i.e., untreated) recreational water can be caused by pathogens or chemicals, including toxins. Voluntary reporting of these outbreaks to CDC's National Outbreak Reporting System (NORS) began in 2009. NORS data for 2009-2017 are finalized, and data for 2018-2019 are provisional. During 2009-2019 (as of May 13, 2020), public health officials from 31 states voluntarily reported 119 untreated recreational water-associated outbreaks, resulting at least 5,240 cases; 103 of the outbreaks (87%) started during June-August. Among the 119 outbreaks, 88 (74%) had confirmed etiologies. The leading etiologies were enteric pathogens: norovirus (19 [22%] outbreaks; 1,858 cases); Shiga toxin-producing Escherichia coli (STEC) (19 [22%]; 240), Cryptosporidium (17 [19%]; 237), and Shigella (14 [16%]; 713). This report highlights three examples of outbreaks that occurred during 2018-2019, were caused by leading etiologies (Shigella, norovirus, or STEC), and demonstrate the wide geographic distribution of such outbreaks across the United States. Detection and investigation of untreated recreational water-associated outbreaks are challenging, and the sources of these outbreaks often are not identified. Tools for controlling and preventing transmission of enteric pathogens through untreated recreational water include epidemiologic investigations, regular monitoring of water quality (i.e., testing for fecal indicator bacteria), microbial source tracking, and health policy and communications (e.g., observing beach closure signs and not swimming while ill with diarrhea).


Assuntos
Doenças Transmissíveis/epidemiologia , Surtos de Doenças , Recreação , Microbiologia da Água , Adolescente , Adulto , Idoso , California/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Maine/epidemiologia , Masculino , Pessoa de Meia-Idade , Minnesota/epidemiologia , Purificação da Água , Adulto Jovem
6.
J Investig Med High Impact Case Rep ; 8: 2324709620930540, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32493147

RESUMO

In the middle of a pandemic, patients with cough and fever are thought to have SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2). It should be remembered that in the desert southwest of the United States, we have an ongoing epidemic of coccidioidomycosis (CM). There are additionally many other respiratory illnesses that could be confused with CoV-2 or overlooked. This is a case report of CoV-2 engrafted on chronic cavitary pulmonary CM. In a time where the coronavirus pandemic is becoming rampant, we demonstrate the case of a coinfection with cavitary pulmonary CM. In this case, the importance of detection of the coronavirus and treatment of the coinfection is explored.


Assuntos
Coccidioidomicose/complicações , Coinfecção , Infecções por Coronavirus/complicações , Pneumopatias Fúngicas/complicações , Pneumonia Viral/complicações , Betacoronavirus , California/epidemiologia , Doença Crônica , Coccidioidomicose/epidemiologia , Infecções por Coronavirus/epidemiologia , Epidemias , Humanos , Pneumopatias Fúngicas/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Tomografia Computadorizada por Raios X
8.
Psychol Trauma ; 12(5): 457-460, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32551751

RESUMO

There is growing concern about the mental health and social impact of COVID-19 on underresourced children, youth, and families given widespread social disruption, school closures, economic impact, and loss of lives. In this commentary we describe how an existing public-public partnership between a large county mental health department and a state university responded to COVID-19. This partnership, originally designed to address workforce needs, rapidly pivoted to support providers through a trauma- and resilience-informed approach to mitigating adverse mental health effects among youth and families in Los Angeles County. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Informação de Saúde ao Consumidor , Infecções por Coronavirus , Educação a Distância , Colaboração Intersetorial , Pandemias , Pneumonia Viral , Trauma Psicológico , Resiliência Psicológica , Populações Vulneráveis , Adolescente , Adulto , California , Criança , Humanos , Governo Local , Los Angeles , Serviços de Saúde Mental , Desenvolvimento de Programas , Trauma Psicológico/prevenção & controle , Universidades , Adulto Jovem
9.
Int J Syst Evol Microbiol ; 70(6): 3912-3920, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32511088

RESUMO

Strain MC02T, a Gram-stain-negative, rod-shaped bacterium, was isolated from field soil collected from California, USA. To examine if MC02T represents a novel species, we compared its colony morphology, 16S rRNA gene and whole genome sequence, and its metabolic phenotype using Biolog GenIII and MALDI-TOF analyses compared to reference strains. Based on 16S rRNA gene and whole genome sequencing, MC02T belongs to the genus Massilia and Massilia agri K-3-1T is the most similar strain with 96.97 % 16S rRNA gene sequence identity. MALDI-TOF analysis revealed that Massilia aerilata DSM19289T is the closest match, but the similarity score was much lower than the ≥1.7 threshold for a reliable identification at the genus level. The predominant fatty acids were summed feature 3 (C16 : 1⍵7c and/or C16 : 1⍵6c; 49.07 %) and C16 : 0 (30.01 %). The genome is 5.02 Mbp and the G+C content is 66.2 mol%. Whole genome comparisons to the closest related strains revealed an average amino acid identity value of 67.4 %, an OrthoANI similarity of 77.1 %, and a DNA-DNA-hybridization probability ≥70 %, confirming that MC02T represents a novel species. Strain MC02T can grow at pH 6 but not at pH 5, and a salt concentration of ≥1 % inhibits its growth. In contrast to other Massilia strains, MC02T can utilize turanose, inosine and l-serine. The genome of MC02T shows putative endophyte genes such as a nitrate reductase, several phosphatases, and biotin biosynthesis genes, 26 flagellar motility genes and 14 invasion and intracellular resistance genes. Based on its metabolic, physiological and genomic characteristics, we propose that strain MC02T (NRRL B-65554T=ATCC TSD-200T=LMG 31737T) represents a novel species of the genus Massilia with the name Massilia arenosa sp. nov.


Assuntos
Oxalobacteraceae/classificação , Filogenia , Microbiologia do Solo , Zea mays , Técnicas de Tipagem Bacteriana , Composição de Bases , California , DNA Bacteriano/genética , Ácidos Graxos/química , Hibridização de Ácido Nucleico , Oxalobacteraceae/isolamento & purificação , RNA Ribossômico 16S/genética , Análise de Sequência de DNA
11.
J Med Case Rep ; 14(1): 66, 2020 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-32527327

RESUMO

BACKGROUND: Coronavirus disease 2019, caused by severe acute respiratory syndrome coronavirus 2, was declared a global pandemic by the World Health Organization in March 2020. CASE PRESENTATION: We report a case of a 51-year-old Chinese woman who was evacuated from Wuhan, China and diagnosed with coronavirus disease 2019 infection at a Southern California quarantine facility. Her clinical course was notable for high fevers, night sweats, productive cough, transient leukopenia, lymphopenia, thrombocytopenia, and transaminitis. Evolving hypoxia and infiltrates on chest imaging warranted the trial of an investigational antiviral drug - remdesivir. Our patient recovered and was discharged after 2 weeks of hospitalization. CONCLUSIONS: This case highlights our patient's clinical course, including diagnostic work-up, medical management, and challenges in defining non-infectivity in a relatively unknown disease.


Assuntos
Monofosfato de Adenosina/análogos & derivados , Alanina/análogos & derivados , Contagem de Células Sanguíneas/métodos , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Radiografia Torácica/métodos , Monofosfato de Adenosina/administração & dosagem , Alanina/administração & dosagem , Antivirais/administração & dosagem , Betacoronavirus/isolamento & purificação , California/epidemiologia , China/epidemiologia , Infecções por Coronavirus/sangue , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/terapia , Transmissão de Doença Infecciosa/prevenção & controle , Feminino , Humanos , Testes de Função Hepática/métodos , Pessoa de Meia-Idade , Pneumonia Viral/sangue , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/fisiopatologia , Pneumonia Viral/terapia , Quarentena/métodos , Resultado do Tratamento
12.
J Emerg Manag ; 18(3): 247-260, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32441041

RESUMO

INTRODUCTION: Thirty-three separate local emergency medical services (EMS) authority agencies serve the 58 counties in California. Each local emergency medical services agency dictates widely different treatment and trans-port protocols for its paramedics. Although previous research has established the problem of geographic EMS dis-parities, nothing definitively explains their cause. METHODS: We analyze California's most recently available EMS performance-measure data to determine if there is still disparity in EMS patient care and patient outcomes in California. If there is a disparity, we determine whether the differences are accounted for by socioeconomic factors, geographical differences, or population size, by combin-ing California EMS data with other state and county level data. If none of these factors are significantly correlated, this supports the hypothesis that something different, such as system structure, could be a potential cause of Califor-nia's EMS disparities. As a secondary analysis, we attempt to replicate these types of analyses at national and inter-national levels, which could potentially permit a structural comparison as well. RESULTS: There is still disparity in EMS patient care and patient outcomes in California. Regression analyses did not identify a single factor to explain the disparity in performance measures. Most notably, the regression found that basic socioeconomic factors and geographical differences frequently speculated as common drivers for disparity of services, including median income, population density, and availability of specialty care facilities, did not account for the disparity in services. CONCLUSIONS: Unfortunately, the striking lack of performance-measure data-a data desert-for EMS throughout the United States meant that the secondary analyses were inconclusive. Based on these results, we propose three recommendations:(1) most importantly, the lack of data must be addressed. Data collection should be standardized and mandatory for all EMS providers. (2) Treatment protocols for the state should be standardized and based on the latest evidence-based research. Providers should be required to offer the same level of care, to all geographic re-gions. (3) It may be beneficial to consider restructuring the California EMS system. While the research is limited due to imperfect information, consolidated systems seem to perform better. An existing framework for this already exists.


Assuntos
Serviços Médicos de Emergência/organização & administração , Disparidades em Assistência à Saúde , Características de Residência , California , Coleta de Dados , Sistemas de Informação Geográfica , Humanos , Estados Unidos
13.
BMJ ; 369: m1923, 2020 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-32444358

RESUMO

OBJECTIVE: To understand the epidemiology and burden of severe coronavirus disease 2019 (covid-19) during the first epidemic wave on the west coast of the United States. DESIGN: Prospective cohort study. SETTING: Kaiser Permanente integrated healthcare delivery systems serving populations in northern California, southern California, and Washington state. PARTICIPANTS: 1840 people with a first acute hospital admission for confirmed covid-19 by 22 April 2020, among 9 596 321 healthcare plan enrollees. Analyses of hospital length of stay and clinical outcomes included 1328 people admitted by 9 April 2020 (534 in northern California, 711 in southern California, and 83 in Washington). MAIN OUTCOME MEASURES: Cumulative incidence of first acute hospital admission for confirmed covid-19, and subsequent probabilities of admission to an intensive care unit (ICU) and mortality, as well as duration of hospital stay and ICU stay. The effective reproduction number (RE ) describing transmission dynamics was estimated for each region. RESULTS: As of 22 April 2020, cumulative incidences of a first acute hospital admission for covid-19 were 15.6 per 100 000 cohort members in northern California, 23.3 per 100 000 in southern California, and 14.7 per 100 000 in Washington. Accounting for censoring of incomplete hospital stays among those admitted by 9 April 2020, the estimated median duration of stay among survivors was 9.3 days (with 95% staying 0.8 to 32.9 days) and among non-survivors was 12.7 days (1.6 to 37.7 days). The censoring adjusted probability of ICU admission for male patients was 48.5% (95% confidence interval 41.8% to 56.3%) and for female patients was 32.0% (26.6% to 38.4%). For patients requiring critical care, the median duration of ICU stay was 10.6 days (with 95% staying 1.3 to 30.8 days). The censoring adjusted case fatality ratio was 23.5% (95% confidence interval 19.6% to 28.2%) among male inpatients and 14.9% (11.8% to 18.6%) among female inpatients; mortality risk increased with age for both male and female patients. Reductions in RE were identified over the study period within each region. CONCLUSIONS: Among residents of California and Washington state enrolled in Kaiser Permanente healthcare plans who were admitted to hospital with covid-19, the probabilities of ICU admission, of long hospital stay, and of mortality were identified to be high. Incidence rates of new hospital admissions have stabilized or declined in conjunction with implementation of social distancing interventions.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , California/epidemiologia , Infecções por Coronavirus/transmissão , Cuidados Críticos , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Unidades de Terapia Intensiva , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/transmissão , Estudos Prospectivos , Washington/epidemiologia , Adulto Jovem
14.
Plant Dis ; 104(6): 1685-1693, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32357121

RESUMO

Bacterial spot caused by Xanthomonas arboricola pv. pruni was first detected on almond in California in 2013, and it is reported herein as a new disease in California based on fulfilling Koch's postulates and identification of the pathogen using species-specific PCR primers. Infected mummified fruit from the previous growing season and their peduncles were identified as primary overwintering sites of the bacterium on the tree. Twig cankers were not observed, and the pathogen was not recovered from dormant buds. Isolation from flowers and emerging leaves was only successful when they were collected within 20 cm of an infected, mummified fruit on the tree. Inoculation of flowers and immature fruit as well as immature and mature leaves resulted in disease development, indicating a long period of host susceptibility in the spring, but disease incidence was highest in fruit inoculations. In split-plot trials over 3 years, dormant applications in December or January with copper or copper-mancozeb significantly reduced the disease compared with untreated controls in seasons with high rainfall, but they had no effect in seasons with low rainfall. In-season applications of copper-mancozeb at petal fall or at full bloom and petal fall were also effective in reducing the disease. Phytotoxicity was observed after repeated applications of copper bactericides, especially in low-rainfall seasons. Dormant and in-season treatments of copper-mancozeb mixtures integrated with removal of mummified fruit are currently the best management strategies for bacterial spot of almond in California.


Assuntos
Prunus dulcis , Xanthomonas , California , Doenças das Plantas
15.
Diabetes Technol Ther ; 22(6): 449-453, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32383989

RESUMO

Background: The Stay at Home order in Colorado and The Stay Safe at Home order in California during COVID-19 pandemic have forced a majority of the endocrinologists/diabetologists to adapt to providing diabetes care remotely through telehealth. This may provide increased access to diabetes health care in certain settings. However, health care disparities continue to challenge availability of diabetes technologies for underprivileged communities. We report our experience with two patients providing diabetes care effectively and preventing hospital admissions by using telehealth. Methods: Two adult patients with type 1 diabetes (T1D): one new onset and the other one with established T1D are presented where telehealth facilitated by Clarity Software and the "Share" feature with the use of Dexcom G6 continuous glucose monitoring (CGM) for management of diabetic ketosis and hyperglycemia. Results: Both patients were managed effectively virtually despite higher risk of diabetic ketoacidosis (DKA). Shared glucose data through CGM facilitated frequent insulin dose adjustments, increased fluid and carbohydrate intake, and prevented hospital admissions in both cases. In the case of new onset patient with T1D, most of the education was done remotely by certified diabetes care and education specialists. Conclusion: Acute diabetes complication like DKA increases morbidity and mortality in addition to adding cost to the health care system. The current pandemic of COVID-19 has allowed newer ways (with the help of newer technologies) to manage high-risk patients with T1D and DKA through telehealth and may result in lasting benefits to people with T1D.


Assuntos
Automonitorização da Glicemia/métodos , Infecções por Coronavirus/prevenção & controle , Diabetes Mellitus Tipo 1/complicações , Cetoacidose Diabética/terapia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Telemedicina/métodos , Adulto , Betacoronavirus , California/epidemiologia , Colorado/epidemiologia , Infecções por Coronavirus/complicações , Cetoacidose Diabética/prevenção & controle , Feminino , Hospitalização , Humanos , Hipoglicemiantes/administração & dosagem , Masculino , Pneumonia Viral/complicações , Adulto Jovem
16.
Chemosphere ; 255: 126941, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32388259

RESUMO

With the aim of evaluating health risk to hake consumers, mercury and selenium were measured in muscle, liver, gonads, kidney, and gills of 62 specimens of Merluccius productus from northern Gulf of California. Means ± confidence interval (95% confidence level) concentrations (mg kg-1 wet weight) of Hg in tissues were: gonads (1.01 ± 0.25) > muscle (0.44 ± 0.06) > gills (0.29 ± 0.04) > kidneys (0.20 ± 0.07) > liver (0.02 ± 0.004). No significant differences between sexes were found for Hg. The distribution of mean concentrations of Se (mg kg-1 wet weight) were: kidneys (4.61 ± 1.27) > liver (1.66 ± 0.22) > gonads (1.66 ± 0.75) > gills (0.86 ± 0.04) > muscle (0.40 ± 0.09). Se in gonads showed a significant difference between sex (females > males). Positive significant correlations with total length (p < 0.05) and total weight (p < 0.05) were found in the same tissue for both morphological variables: Hg in muscle, Se in muscle and Se in liver. An excess of Se over Hg (molar ratio Se:Hg > 1) was found in all tissues. The Hazard Quotient health risk index was evaluated for humans that consume muscle and gonads. The recommended Hg safe intake for adults and children were 110.0 and 33.0 g week-1, respectively for muscle; for gonads weekly consumption portions of 35.0 and 14.0 g for adults and children represent no Hg risk. There was no risk of exposure to Se.


Assuntos
Monitoramento Ambiental , Gadiformes/metabolismo , Mercúrio/metabolismo , Selênio/metabolismo , Poluentes Químicos da Água/metabolismo , Animais , Bioacumulação , California , Criança , Exposição Dietética/estatística & dados numéricos , Feminino , Peixes , Gônadas , Humanos , Masculino , Mercúrio/análise , Músculos/metabolismo , Perciformes , Medição de Risco , Selênio/análise , Poluentes Químicos da Água/análise
17.
Gynecol Oncol ; 158(1): 37-43, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32425268

RESUMO

OBJECTIVE: A global pandemic caused by a novel coronavirus (Covid-19) has created unique challenges to providing timely care for cancer patients. In early-stage cervical cancer, postponing hysterectomy for 6-8 weeks is suggested as a possible option in the Covid-19 burdened hospitals. Yet, literature examining the impact of surgery wait-time on survival in early-stage cervical cancer remains scarce. This study examined the association between surgery wait-time of 8 weeks and oncologic outcome in women with early-stage cervical cancer. METHODS: This is a single institution retrospective observational study at a tertiary referral medical center examining women who underwent primary hysterectomy or trachelectomy for clinical stage IA-IIA invasive cervical cancer between 2000 and 2017 (N = 217). Wait-time from the diagnosis of invasive cervical cancer via biopsy to definitive surgery was categorized as: short wait-time (<8 weeks; n = 110) versus long wait-time (≥8 weeks; n = 107). Propensity score inverse probability of treatment weighting was used to balance the measured demographics between the two groups, and disease-free survival (DFS) and overall survival (OS) were assessed. A systematic literature review with meta-analysis was additionally performed. RESULTS: In a weighted model (median follow-up, 4.6 years), women in the long wait-time group had DFS (4.5-year rates, 91.2% versus 90.7%, hazard ratio [HR] 1.11, 95% confidence interval [CI] 0.47-2.59, P = 0.818) and OS (95.0% versus 97.4%, HR 1.47, 95%CI 0.50-4.31, P = 0.487) similar to those in the short wait-time group. Three studies were examined for meta-analysis, and a pooled HR for surgery wait-time of ≥8 weeks on DFS was 0.96 (95%CI 0.59-1.55). CONCLUSION: Our study suggests that wait-time of 8 weeks for hysterectomy may not be associated with short-term disease recurrence in women with early-stage cervical cancer.


Assuntos
Infecções por Coronavirus/epidemiologia , Histerectomia/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Tempo para o Tratamento/estatística & dados numéricos , Neoplasias do Colo do Útero/cirurgia , Adulto , Idoso , Betacoronavirus/isolamento & purificação , California/epidemiologia , Feminino , Humanos , Histerectomia/métodos , Pessoa de Meia-Idade , Pandemias , Pontuação de Propensão , Estudos Retrospectivos , Centros de Atenção Terciária/estatística & dados numéricos , Neoplasias do Colo do Útero/mortalidade
18.
Plant Dis ; 104(7): 1925-1931, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32396051

RESUMO

In California, citrus tristeza virus (CTV) is regulated by a State Interior Quarantine. In CTV abatement districts in central California, trees with CTV that react to MCA13 (MCA13-positive [MCA13+]), a strain-discriminating monoclonal antibody, are rogued to prevent virus spread. The Tulare County Pest Control District, however, does not participate in this abatement program except for a 1.6-km2 zone around the Lindcove Research and Extension Center, Exeter, CA. To quantify CTV spread under these two disparate management programs, CTV surveys were conducted in abatement plots with mandatory aphid control and nonabatement plots. Abatement plot surveys used hierarchical sampling of 25% of trees with samples pooled from four adjacent trees. Detection of MCA13+ CTV in a sample prompted resampling and testing of individual trees. From 2008 to 2018, incidence of CTV increased by an average of 3.9%, with only two MCA13+ samples detected. In contrast, in nonabatement plots, incidence of CTV increased by an average of 4.6% between 2015 and 2018. Increase in MCA13-negative (MCA-) isolates was 11 times greater than that of MCA13+ isolates, with the number of MCA13+ trees increasing by 19 trees between 2015 and 2018. MCA13- isolates were more randomly distributed, suggesting primary spread, whereas MCA13+ CTV isolates were more aggregated, suggesting some secondary spread. These results suggest that spread of MCA13+ isolates was limited by a combination of tree removal and aphid vector suppression. MCA13+ samples were VT isolates with some mixtures with T30 isolates. Despite the presence of VT isolates, all CTV-infected trees were asymptomatic.


Assuntos
Citrus/virologia , Closterovirus , Animais , California , Doenças das Plantas
19.
Eval Health Prof ; 43(2): 135-137, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32383409

RESUMO

The novel 2019 Coronavirus Disease (COVID-19) pandemic has led to the closing of all but essential businesses in California. However, several nonessential businesses have remained open in Southern California despite the mandated "stay at home" order issued by the governor. As part of an ongoing vape shop project involving 88 participating shops, this study investigated the number of vape shops that remained open amidst the coronavirus outbreak and related mandates. Examination of shop social media websites and telephone calls to shops revealed that 61.4% (n = 54) have remained open, particularly within Korean/Asian and Hispanic/Latino ethnic locations (32 of the 54 shops). Importantly, walk-in service was much higher within Hispanic/Latino locations compared to African American, Korean/Asian, or non-Hispanic White neighborhoods (p = 0.03). It is not known if shops that stayed open were in direct violation of the order, didn't know all the details of the order, or found a loophole in the order and believed that they were an essential business. Better communication between the vape shop industry and public health officials during this pandemic is needed.


Assuntos
Comércio , Coronavirus , Características de Residência , Políticas de Controle Social , Vaping , Betacoronavirus , California , Comunicação , Comportamento Cooperativo , Infecções por Coronavirus/epidemiologia , Sistemas Eletrônicos de Liberação de Nicotina , Grupos Étnicos , Humanos , Pandemias , Pneumonia Viral/epidemiologia
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