Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.168
Filtrar
1.
Ann Acad Med Singap ; 50(5): 425-430, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-34100519

RESUMEN

Coronavirus disease 2019 (COVID-19) is associated with an increased risk of thromboembolic events in the acute setting. However, the abnormal thrombotic diathesis is not known to persist into the recovery phase of COVID-19 infection. We described 3 cases of ST-segment elevation myocardial infarction in healthy male patients who recovered from COVID-19 with no prior cardiovascular risk factors. They shared features of elevated von Willebrand factor antigen, factor VIII and D-dimer level. One patient had a borderline positive lupus anticoagulant. Intravascular ultrasound of culprit vessels revealed predominantly fibrotic plaque with minimal necrotic core. Clot waveform analysis showed parameters of hypercoagulability. They were treated with dual antiplatelet therapy, angiotensin-converting-enzyme inhibitor, beta blocker and statin. These cases highlight the strong thrombogenic nature of COVID-19 that persisted among patients who recovered from infection. Several suspected mechanisms could explain the association between vascular thrombosis in the convalescent period (endothelial dysfunction, hypercoagulability, systemic inflammatory response and vasculopathy). Additional studies on "long COVID" are essential for identifying endotheliopathy and thrombotic sequalae.

3.
Eur J Ophthalmol ; : 11206721211021296, 2021 Jun 04.
Artículo en Inglés | MEDLINE | ID: mdl-34088221

RESUMEN

PURPOSE: To report a case of multiple superior quadrant intraretinal haemorrhages in post-COVID-19 patient. CASE DESCRIPTION: A 58-year-old male with a history of coronary artery disease and hypertension, presented with multiple superior quadrant intraretinal haemorrhages in the superonasal quadrant of the left eye 1 month after hospitalization for COVID-19. The right eye was normal. During his 10-day stay, he was treated with hydroxychloroquine, lopinavir + ritonavir, ceftriaxone, and his pre-existing antiplatelet therapy. During hospitalization, a complete medical work up showed an anomalous increase in D-dimer. He did not require intensive care support. CONCLUSIONS: In this report, we focused on the origin of retinal bleeding in a post COVID-19 patient, likely due to a focal occlusion of a vessel. Considering the nature of SARS-CoV-2 infection, we hypothesize that retinal haemorrhages were caused by a combination of factors including the patient's antiplatelet therapy and the thrombotic microvascular injury caused by the virus.

4.
Medicine (Baltimore) ; 100(24): e26366, 2021 Jun 18.
Artículo en Inglés | MEDLINE | ID: mdl-34128892

RESUMEN

BACKGROUND: The study aims to evaluate the effectiveness and safety of Baduanjin exercise for rehabilitation after COVID-19. METHODS: The following electronic databases will be searched from establishment to Jan 2021: Cochrane Library, MEDLINE, EMBASE, Web of Science, Springer, World Health Organization International Clinical Trials Registry Platform, China National Knowledge Infrastructure, Wan-fang database, Chinese Scientific Journal Database, Chinese Biomedical Literature Databases, and other databases, All published randomized controlled trials about this topic will be included. Two independent researchers will operate article retrieval, duplication removing, screening, quality evaluation, and data analyses by Review Manager (V.5.3.5). Meta-analyses, subgroup analysis, and/or descriptive analysis will be performed based on the included data conditions. RESULTS: The results of this study will provide a combination of high-quality evidence for researchers in the current field of COVID-19 treatment and rehabilitation. CONCLUSION: The conclusion of this study will provide the evidence of whether Baduanjin is an effective and safe intervention for rehabilitation after COVID-19. PROSPERO REGISTRATION NUMBER: CRD42020181078.

5.
J Athl Train ; 2021 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-34129674

RESUMEN

COVID-19 has drastically changed everyday life across the world and has dramatically impacted how athletics operate. Since the return of high school sports, high school athletic trainers are now responsible for ensuring the safe return of athletes previously diagnosed with COVID-19 to sports. Due to the relatively recent identification of this novel virus, very little is understood about the long-term effects of COVID-19 infection on the cardiac and respiratory systems. Due to the rapid return of athletics, there is unfortunately limited research available regarding how athletes respond to COVID-19 and how it may affect their ability to return to play. Therefore, it is recommended that high school athletes previously diagnosed with COVID-19 undergo a comprehensive medical evaluation with their physician and complete a graduated medically supervised return to play protocol.

6.
J Am Med Dir Assoc ; 2021 Jun 12.
Artículo en Inglés | MEDLINE | ID: mdl-34129831

RESUMEN

OBJECTIVE: COVID-19 disproportionately impacts residents in long-term care facilities. Our objective was to quantify the presence and magnitude of antibody response in vaccinated, older adult residents at assisted living, personal care, and independent living communities. DESIGN: A cross-sectional quality improvement study was conducted March 15 - April 1, 2021 in the greater Pittsburgh region. SETTING: and Population: Participants were older adult residents at assisted living, personal care, and independent living communities, who received mRNA-based COVID-19 vaccine. Conditions that impair immune responses were exclusionary criteria. METHODS: Sera were collected to measure IgG anti-SARS-CoV-2 antibody level with reflex to total anti-SARS-CoV-2 immunoglobulin levels, and blinded evaluation of SARS-CoV-2 pseudovirus neutralization titers. Descriptive statistics, Pearson correlation coefficients, and multiple linear regression analysis evaluated relationships between factors potentially associated with antibody levels. Spearman correlations were calculated between antibody levels and neutralization titers. RESULTS: All participants (N = 70) had received two rounds of vaccination and were found to have antibodies with wide variation in relative levels. Antibody levels trended lower in males, advanced age, current use of steroids, and longer length of time from vaccination. Pseudovirus neutralization titer levels were strongly correlated (P < .001) with Beckman Coulter antibody levels (D614 G NT50, rs = 0.91; B.1.1.7 [UK] NT50, rs = 0.91). CONCLUSIONS AND IMPLICATIONS: Higher functioning, healthier, residential older adults mounted detectable antibody responses when vaccinated with mRNA-based COVID-19 vaccines. Data suggests some degree of immunity is present during the immediate period following vaccination. However, protective effects remain to be determined in larger studies as clinical protection is afforded by ongoing adaptive immunity, which is known to be decreased in older adults. This study provides important preliminary results on level of population risk in older adult residents at assisted living, personal care, and independent living communities to inform reopening strategies, but are not likely to be translatable for residents in nursing homes.

8.
Public Health ; 195: 158-160, 2021 Jun 12.
Artículo en Inglés | MEDLINE | ID: mdl-34130002

RESUMEN

OBJECTIVES: Schools in the Republic of Ireland reopened to students and staff in late August 2020. We sought to determine the test positivity rate of close contacts of cases of coronavirus disease 2019 (COVID-19) in schools during the first half-term of the 2020/2021 academic year. METHODS: National-level data from the schools' testing pathway were interrogated to determine the positivity rate of close contacts of cases of COVID-19 in Irish primary, postprimary and special schools during the first half-term of 2020/2021 academic year. The positivity rates among adult and child close contacts were compared and the proportion of national cases of COVID-19 who were aged 4-18 years during the observation period was calculated to assess whether this proportion increased after schools reopened. RESULTS: Of all, 15,533 adult and child close contacts were tested for COVID-19 through the schools' testing pathway during the first half-term of the 2020/2021 academic year. Three hundred and ninety-nine close contacts tested positive, indicating a positivity rate of 2.6% (95% confidence interval: 2.3-2.8%). The positivity rates of child and adult close contacts were similarly low (2.6% vs 2.7%, P = 0.7). The proportion of all national cases of COVID-19 who were aged 4-18 years did not increase during the first half-term of the 2020/2021 school year. CONCLUSIONS: The low positivity rate of close contacts of cases of COVID-19 in schools indicate that transmission of COVID-19 in Irish schools during the first half-term of the 2020/2021 academic year was low. These findings support policies to keep schools open during the pandemic.

10.
Nat Med ; 27(6): 930-932, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-34059823
12.
Artículo en Inglés | MEDLINE | ID: mdl-34080005
14.
Artículo en Inglés | MEDLINE | ID: mdl-34090785

RESUMEN

Antiphospholipid antibodies (aPLs), present in 1-5 % of healthy individuals, are associated with the risk of antiphospholipid syndrome (APS), which is the most common form of acquired thrombophilia. APLs may appear following infections or vaccinations and have been reported in patients with COronaVIrus Disease-2019 (COVID-19). However, their association with COVID-19 vaccination is unclear. Notably, a few cases of thrombocytopenia and thrombotic events resembling APS have been reported to develop in recipients of either adenoviral vector- or mRNA-based COVID-19 vaccines. The aim of this review is therefore to speculate on the plausible role of aPLs in the pathogenesis of these rare adverse events. Adenoviral vector-based vaccines can bind platelets and induce their destruction in the reticuloendothelial organs. Liposomal mRNA-based vaccines may instead favour activation of coagulation factors and confer a pro-thrombotic phenotype to endothelial cells and platelets. Furthermore, both formulations may trigger a type I interferon response associated with the generation of aPLs. In turn, aPLs may lead to aberrant activation of the immune response with participation of innate immune cells, cytokines and the complement cascade. NETosis, monocyte recruitment and cytokine release may further support endothelial dysfunction and promote platelet aggregation. These considerations suggest that aPLs may represent a risk factor for thrombotic events following COVID-19 vaccination, and deserve further investigations.

15.
Med Sci Monit ; 27: e933446, 2021 Jun 07.
Artículo en Inglés | MEDLINE | ID: mdl-34092779

RESUMEN

During 2020, increasing numbers of case reports, case series, and small observational studies reported long-term complications of coronavirus disease 2019 (COVID-19) in patients who had recovered from acute infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Long COVID has a prevalence of between 10-30% in patients with a recent history of SARS-CoV-2 infection. Pulmonary, hematologic, cardiovascular, neuropsychiatric, renal, endocrine, gastrointestinal and hepatobiliary, and dermatologic involvement, and chronic multisystem inflammatory syndrome in children (MIS-C) highlights the requirement for a multidisciplinary approach to the management of patients with long COVID. This Editorial aims to present the current status of long COVID, or post-COVID syndrome, and its global impact on health and the provision of health care.


Asunto(s)
COVID-19/complicaciones , COVID-19/epidemiología , COVID-19/economía , COVID-19/metabolismo , COVID-19/terapia , Convalecencia , Atención a la Salud , Humanos , Pandemias , Recuperación de la Función , SARS-CoV-2/aislamiento & purificación
16.
Ann Intern Med ; 2021 Jun 08.
Artículo en Inglés | MEDLINE | ID: mdl-34097433

RESUMEN

BACKGROUND: The COVID-19 pandemic has induced historic educational disruptions. In April 2021, about 40% of U.S. public school students were not offered full-time in-person education. OBJECTIVE: To assess the risk for SARS-CoV-2 transmission in schools. DESIGN: An agent-based network model was developed to simulate transmission in elementary and high school communities, including home, school, and interhousehold interactions. SETTING: School structure was parametrized to reflect average U.S. classrooms, with elementary schools of 638 students and high schools of 1451 students. Daily local incidence was varied from 1 to 100 cases per 100 000 persons. PARTICIPANTS: Students, faculty, staff, and adult household members. INTERVENTION: Isolation of symptomatic individuals, quarantine of an infected individual's contacts, reduced class sizes, alternative schedules, staff vaccination, and weekly asymptomatic screening. MEASUREMENTS: Transmission was projected among students, staff, and families after a single infection in school and over an 8-week quarter, contingent on local incidence. RESULTS: School transmission varies according to student age and local incidence and is substantially reduced with mitigation measures. Nevertheless, when transmission occurs, it may be difficult to detect without regular testing because of the subclinical nature of most children's infections. Teacher vaccination can reduce transmission to staff, and asymptomatic screening improves understanding of local circumstances and reduces transmission. LIMITATION: Uncertainty exists about the susceptibility and infectiousness of children, and precision is low regarding the effectiveness of specific countermeasures, particularly with new variants. CONCLUSION: With controlled community transmission and moderate mitigation, elementary schools can open safety, but high schools require more intensive mitigation. Asymptomatic screening can facilitate reopening at higher local incidence while minimizing transmission risk. PRIMARY FUNDING SOURCE: Centers for Disease Control and Prevention through the Council of State and Territorial Epidemiologists, National Institute of Allergy and Infectious Diseases, National Institute on Drug Abuse, and Facebook.

17.
Psychiatr Serv ; : appips202000903, 2021 Jun 09.
Artículo en Inglés | MEDLINE | ID: mdl-34106738

RESUMEN

Individuals with serious medical illnesses experience high rates of comorbid behavioral health conditions. Behavioral health comorbidity affects outcomes in serious illness care. Despite this consequence, behavioral health remains siloed from serious illness care. Prior to the COVID-19 pandemic, the authors presented a conceptual model of behavioral health integration into serious illness care. In this column, the authors reflect on this model in the context of the challenges and opportunities posed by COVID-19.

19.
Educ Inf Technol (Dordr) ; : 1-19, 2021 Jun 09.
Artículo en Inglés | MEDLINE | ID: mdl-34121909

RESUMEN

COVID-19 pandemic has brought uncertainty in educational response, skilling methods, and training practices among teachers and institutions. Even before the pandemic shutdowns, the incorporation of virtual laboratories within classroom education had brought transformations in teaching laboratory courses. Virtual laboratories were integrated as training platforms for complementing learning objectives in laboratory education especially during this pandemic imposed shutdown. In context of suspended face-to-face teaching, this study explores the role of virtual laboratories as Massive Open Online Courses (MOOCs) in ensuring the continuity of teaching-learning, providing alternative ways for skill training from home. As an innovative approach, the study presents push-pull mooring theory to analyze switching intention of users from offline conventional education to online education. The study explores the complements of physical experiments brought in with animations, simulations, and remote laboratory set-ups for providing skill trainings to learners. To test whether virtualization techniques have global impact in education sector, the study included a comparative analysis of student users during the academic year 2019 (before-COVID) who had a blended approach of learning and those of the year 2020 (post-COVID), with remote learning. Initial before-COVID behavioral analysis on university students (n = 1059) indicated the substantial popularity of virtual laboratories in education for skill training and instructor dependency. Usage adoption of virtual laboratories increased during the pandemic-imposed lockdowns and learners were being less instructor dependent. 24% of students accessed more 10 times a week without the instructor being present and overall, 90% contributed to a minimum of 5 usages a week. In terms of Kolb's learning styles, most of the virtual laboratory learners were assimilators. The results suggest virtual laboratories may have a prominent role in inquiry based and self-guided education with minimum instructor dependency, which may be crucial for complementing practice skills and planning online tools to add to this post-COVID-19 teaching and learning scenarios.

SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...