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2.
J Cardiovasc Med (Hagerstown) ; 23(8): 546-550, 2022 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-35905001

RESUMEN

BACKGROUND: The 2020 severe acute respiratory syndrome coronavirus 2 outbreak entailed reduced availability of traditional (in-office) cardiology consultations. Remote monitoring is an alternative way of caring that may potentially mitigate the negative effects of the epidemic to the care of cardiovascular diseases. We evaluated the outcome of implantable cardioverter defibrillator (ICD) carriers followed up remotely in 2020 (epidemic period) versus 2019 (control). METHODS: We included all patients with an ICD who remained remotely monitored from the beginning to the end of each year. The combined end point included: new-onset atrial fibrillation; sustained ventricular tachycardia >170 bpm without ICD intervention; appropriate ICD intervention (either shock or antitachycardia pacing); any-cause death. Multiple events in the same patients were counted separately if occurring ≥48 h apart. RESULTS: In 2020, 52 end points occurred in 37 of 366 (10%) ICD carriers [0.14/patient (95% confidence interval [CI] = 0.11-0.19)] versus 43 end points in 32 of 325 (10%) ICD carriers in 2019 [0.13/patient (95% CI = 0.10-0.18) P  = 0.75]. There was no difference between the distribution of any individual end point in 2020 versus 2019 although a nonsignificant mortality increase was observed (from 2.8% to 4.6%, P  = 0.19). The lowest weekly event rate occurred during the national lock down in spring 2020 but a similar trend occurred also in 2019 suggesting that the effect may not be linked to social distancing measures. CONCLUSIONS: We did not observe an increase in a combined end point including arrhythmic events and mortality in ICD carriers who were remotely monitored in 2020, compared to 2019, despite the negative impact of the coronavirus disease 2019 outbreak on the healthcare system.


Asunto(s)
Cuidados Posteriores/métodos , COVID-19/epidemiología , Desfibriladores Implantables , Consulta Remota , SARS-CoV-2 , Cuidados Posteriores/normas , Arritmias Cardíacas/epidemiología , Arritmias Cardíacas/prevención & control , COVID-19/complicaciones , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/normas , Brotes de Enfermedades , Humanos , Consulta Remota/normas , Taquicardia Ventricular/epidemiología , Taquicardia Ventricular/prevención & control
5.
Lancet ; 399(10325): 678-690, 2022 02 12.
Artículo en Inglés | MEDLINE | ID: mdl-35093206

RESUMEN

Measles is a highly contagious, potentially fatal, but vaccine-preventable disease caused by measles virus. Symptoms include fever, maculopapular rash, and at least one of cough, coryza, or conjunctivitis, although vaccinated individuals can have milder or even no symptoms. Laboratory diagnosis relies largely on the detection of specific IgM antibodies in serum, dried blood spots, or oral fluid, or the detection of viral RNA in throat or nasopharyngeal swabs, urine, or oral fluid. Complications can affect many organs and often include otitis media, laryngotracheobronchitis, pneumonia, stomatitis, and diarrhoea. Neurological complications are uncommon but serious, and can occur during or soon after the acute disease (eg, acute disseminated encephalomyelitis) or months or even years later (eg, measles inclusion body encephalitis and subacute sclerosing panencephalitis). Patient management mainly involves supportive therapy, such as vitamin A supplementation, monitoring for and treatment of secondary bacterial infections with antibiotics, and rehydration in the case of severe diarrhoea. There is no specific antiviral therapy for the treatment of measles, and disease control largely depends on prevention. However, despite the availability of a safe and effective vaccine, measles is still endemic in many countries and causes considerable morbidity and mortality, especially among children in resource-poor settings. The low case numbers reported in 2020, after a worldwide resurgence of measles between 2017 and 2019, have to be interpreted cautiously, owing to the effect of the COVID-19 pandemic on disease surveillance. Disrupted vaccination activities during the pandemic increase the potential for another resurgence of measles in the near future, and effective, timely catch-up vaccination campaigns, strong commitment and leadership, and sufficient resources will be required to mitigate this threat.


Asunto(s)
COVID-19/epidemiología , Enfermedades Endémicas/prevención & control , Vacunación Masiva/organización & administración , Vacuna Antisarampión/administración & dosificación , Sarampión/prevención & control , COVID-19/prevención & control , Control de Enfermedades Transmisibles/organización & administración , Control de Enfermedades Transmisibles/normas , Enfermedades Endémicas/estadística & datos numéricos , Humanos , Vacunación Masiva/normas , Vacunación Masiva/estadística & datos numéricos , Sarampión/epidemiología , Sarampión/inmunología , Sarampión/virología , Virus del Sarampión/inmunología , Virus del Sarampión/patogenicidad , Pandemias/prevención & control
7.
Arch Dis Child ; 107(2): 180-185, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34045208

RESUMEN

BACKGROUND: Viral infections may trigger type 1 diabetes (T1D), and recent reports suggest an increased incidence of paediatric T1D and/or diabetic ketoacidosis (DKA) during the COVID-19 pandemic. OBJECTIVE: To study whether the number of children admitted to the paediatric intensive care unit (PICU) for DKA due to new-onset T1D increased during the COVID-19 pandemic, and whether SARS-CoV-2 infection plays a role. METHODS: This retrospective cohort study comprises two datasets: (1) children admitted to PICU due to new-onset T1D and (2) children diagnosed with new-onset T1D and registered to the Finnish Pediatric Diabetes Registry in the Helsinki University Hospital from 1 April to 31 October in 2016-2020. We compared the incidence, number and characteristics of children with newly diagnosed T1D between the prepandemic and pandemic periods. RESULTS: The number of children admitted to PICU due to new-onset T1D increased from an average of 6.25 admissions in 2016-2019 to 20 admissions in 2020 (incidence rate ratio [IRR] 3.24 [95% CI 1.80 to 5.83]; p=0.0001). On average, 57.75 children were registered to the FPDR in 2016-2019, as compared with 84 in 2020 (IRR 1.45; 95% CI 1.13 to 1.86; p=0.004). 33 of the children diagnosed in 2020 were analysed for SARS-CoV-2 antibodies, and all were negative. CONCLUSIONS: More children with T1D had severe DKA at diagnosis during the pandemic. This was not a consequence of SARS-CoV-2 infection. Instead, it probably stems from delays in diagnosis following changes in parental behaviour and healthcare accessibility.


Asunto(s)
COVID-19/epidemiología , Diabetes Mellitus Tipo 1/epidemiología , Cetoacidosis Diabética/epidemiología , Adolescente , COVID-19/complicaciones , COVID-19/inmunología , COVID-19/virología , Niño , Preescolar , Control de Enfermedades Transmisibles/normas , Diagnóstico Tardío/estadística & datos numéricos , Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 1/inmunología , Diabetes Mellitus Tipo 1/terapia , Cetoacidosis Diabética/diagnóstico , Cetoacidosis Diabética/inmunología , Cetoacidosis Diabética/terapia , Femenino , Finlandia/epidemiología , Accesibilidad a los Servicios de Salud/normas , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Incidencia , Unidades de Cuidado Intensivo Pediátrico/estadística & datos numéricos , Masculino , Pandemias/prevención & control , Pandemias/estadística & datos numéricos , Admisión del Paciente/estadística & datos numéricos , Sistema de Registros/estadística & datos numéricos , Estudios Retrospectivos , SARS-CoV-2/inmunología , Índice de Severidad de la Enfermedad
8.
Cancer Rep (Hoboken) ; 5(2): e1426, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34021716

RESUMEN

BACKGROUND: Cancer care during the Covid-19 pandemic has been challenging especially in a developing country such as the Philippines. Oncologists were advised to prioritize chemotherapy based on the absolute benefit that the patient may receive, which outbalances the risks of Covid-19 infection. The results of this study will allow re-examination of how to approach cancer care during the pandemic and ultimately, help optimize treatment recommendations during this crisis. AIM: This study described the factors contributing to treatment delays during the pandemic and their impact on disease progression. MATERIALS AND RESULTS: This retrospective cohort study was done in St. Luke's Medical Center, a private tertiary healthcare institution based in Metro Manila, Philippines, composed of two facilities in Quezon City and Global City. Patients with solid malignancy with ongoing systemic cancer treatment prior to the peak of the pandemic were identified. Clinical characteristics and treatment data were compared between those with delayed and continued treatments. Multivariate analysis was done to determine factors for treatment delays and association of delays with disease progression and Covid-19 infection. Of the 111 patients, 33% experienced treatment delays and 67% continued treatment during the pandemic. There was a higher percentage of patients on palliative intent who underwent treatment delay, and 64% of delays were due to logistic difficulties. Treatment delays were significantly associated with disease progression (p < .0001). There was no evidence of association between delay or continuation of treatment and risk of Covid-19 infection. CONCLUSIONS: There was no difference in Covid-19 infection between those who delayed and continued treatment during the pandemic; however, treatment delays were associated with a higher incidence of disease progression. Our findings suggest that the risks of cancer progression due to treatment delays exceed the risks of Covid-19 infection in cancer patients implying that beneficial treatment should not be delayed as much as possible. Logistic hindrances were also identified as the most common cause of treatment delay among Filipino patients, suggesting that efforts should be focused into assistance programs that will mitigate these barriers to ensure continuity of cancer care services during the pandemic.


Asunto(s)
Antineoplásicos/uso terapéutico , COVID-19/epidemiología , Neoplasias/tratamiento farmacológico , Tiempo de Tratamiento/estadística & datos numéricos , Adulto , Anciano , COVID-19/inmunología , COVID-19/prevención & control , COVID-19/transmisión , Instituciones Oncológicas/organización & administración , Instituciones Oncológicas/normas , Instituciones Oncológicas/estadística & datos numéricos , Control de Enfermedades Transmisibles/organización & administración , Control de Enfermedades Transmisibles/normas , Progresión de la Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Neoplasias/complicaciones , Neoplasias/diagnóstico , Neoplasias/inmunología , Pandemias/prevención & control , Filipinas/epidemiología , Estudios Retrospectivos , Factores de Riesgo , Resultado del Tratamiento , Adulto Joven
10.
Am J Surg ; 223(2): 395-403, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34272062

RESUMEN

BACKGROUND: The time course and longitudinal impact of the COVID -19 pandemic on surgical education(SE) and learner well-being (LWB)is unknown. MATERIAL AND METHODS: Check-in surveys were distributed to Surgery Program Directors and Department Chairs, including general surgery and surgical specialties, in the summer and winter of 2020 and compared to a survey from spring 2020. Statistical associations for items with self-reported ACGME Stage and the survey period were assessed using categorical analysis. RESULTS: Stage 3 institutions were reported in spring (30%), summer (4%) [p < 0.0001] and increased in the winter (18%). Severe disruption (SD) was stage dependent (Stage 3; 45% (83/184) vs. Stages 1 and 2; 26% (206/801)[p < 0.0001]). This lessened in the winter (23%) vs. spring (32%) p = 0.02. LWB severe disruption was similar in spring 27%, summer 22%, winter 25% and was associated with Stage 3. CONCLUSIONS: Steps taken during the pandemic reduced SD but did not improve LWB. Systemic efforts are needed to protect learners and combat isolation pervasive in a pandemic.


Asunto(s)
COVID-19/epidemiología , Control de Enfermedades Transmisibles/normas , Educación Médica/estadística & datos numéricos , Pandemias/prevención & control , Especialidades Quirúrgicas/educación , COVID-19/prevención & control , COVID-19/psicología , COVID-19/transmisión , Educación Médica/organización & administración , Educación Médica/normas , Humanos , Aprendizaje , Especialidades Quirúrgicas/estadística & datos numéricos , Encuestas y Cuestionarios/estadística & datos numéricos , Estados Unidos/epidemiología
13.
Pediatr Infect Dis J ; 40(12): e455-e458, 2021 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-34740997

RESUMEN

BACKGROUND: Early Years' Settings (EYSs) provide childcare and education for children 0-5 years old. They remained fully open in England during the third National lockdown when other educational settings were only open for selected children. EYSs are generally considered to be low-risk settings for transmission of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2). METHODS: An observational study describing a large outbreak of SARS CoV-2 within an EYS in Cambridgeshire, United Kingdom. RESULTS: Overall 45 cases of SARS-CoV-2 were identified; 24 adults (71% of staff members) and 21 children (25% of nursery attendees). One case was identified as the alpha variant (B.1.1.7 [VOC-20-DEC-01]). One staff member became critically unwell. CONCLUSIONS: Transmission of SARS-CoV-2 occurred quickly, with a high attack rate; likely a consequence of a variant with enhanced transmissibility and an inability of the setting to adhere to infection control measures.


Asunto(s)
COVID-19/epidemiología , COVID-19/patología , Guarderías Infantiles , Brotes de Enfermedades , SARS-CoV-2 , Niño , Preescolar , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/normas , Femenino , Humanos , Lactante , Masculino
16.
Sci Rep ; 11(1): 20124, 2021 10 11.
Artículo en Inglés | MEDLINE | ID: mdl-34635703

RESUMEN

The Novel Coronavirus which emerged in India on January/30/2020 has become a catastrophe to the country on the basis of health and economy. Due to rapid variations in the transmission of COVID-19, an accurate prediction to determine the long term effects is infeasible. This paper has introduced a nonlinear mathematical model to interpret the transmission dynamics of COVID-19 infection along with providing vaccination in the precedence. To minimize the level of infection and treatment burden, the optimal control strategies are carried out by using the Pontryagin's Maximum Principle. The data validation has been done by correlating the estimated number of infectives with the real data of India for the month of March/2021. Corresponding to the model, the basic reproduction number [Formula: see text] is introduced to understand the transmission dynamics of COVID-19. To justify the significance of parameters we determined the sensitivity analysis of [Formula: see text] using the parameters value. In the numerical simulations, we concluded that reducing [Formula: see text] below unity is not sufficient enough to eradicate the COVID-19 disease and thus, it is required to increase the vaccination rate and its efficacy by motivating individuals to take precautionary measures.


Asunto(s)
Vacunas contra la COVID-19/administración & dosificación , COVID-19/epidemiología , Control de Enfermedades Transmisibles/organización & administración , Modelos Biológicos , Pandemias/prevención & control , Número Básico de Reproducción , COVID-19/prevención & control , COVID-19/transmisión , COVID-19/virología , Control de Enfermedades Transmisibles/normas , Simulación por Computador , Humanos , India/epidemiología , Dinámicas no Lineales , Pandemias/estadística & datos numéricos , SARS-CoV-2/patogenicidad , Vacunación/estadística & datos numéricos
17.
Sci Rep ; 11(1): 20140, 2021 10 11.
Artículo en Inglés | MEDLINE | ID: mdl-34635728

RESUMEN

The global economic activities were completely stopped during COVID-19 lockdown and continuous lockdown partially brought some positive effects for the health of the total environment. The multiple industries, cities, towns and rural people are completely depending on large tropical river Damodar (India) but in the last few decades the quality of the river water is being significantly deteriorated. The present study attempts to investigate the river water quality (RWQ) particularly for pre- lockdown, lockdown and unlock period. We considered 20 variables per sample of RWQ data and it was analyzed using novel Modified Water Quality Index (MWQI), Trophic State Index (TSI), Heavy Metal Index (HMI) and Potential Ecological Risk Index (RI). Principal component analysis (PCA) and Pearson's correlation (r) analysis are applied to determine the influencing variables and relationship among the river pollutants. The results show that during lockdown 54.54% samples were brought significantly positive changes applying MWQI. During lockdown, HMI ranged from 33.96 to 117.33 with 27.27% good water quality which shows the low ecological risk of aquatic ecosystem due to low mixing of toxic metals in the river water. Lockdown effects brought river water to oligotrophic/meso-eutrophic condition from eutrophic/hyper-eutrophic stage. Rejuvenation of river health during lockdown offers ample scope to policymakers, administrators and environmentalists for restoration of river health from huge anthropogenic stress.


Asunto(s)
COVID-19/prevención & control , Control de Enfermedades Transmisibles/normas , Ríos/química , Contaminantes Químicos del Agua/análisis , Calidad del Agua , COVID-19/epidemiología , COVID-19/transmisión , Monitoreo del Ambiente/estadística & datos numéricos , Restauración y Remediación Ambiental/estadística & datos numéricos , Humanos , Metales Pesados/análisis
18.
Ann Med ; 53(1): 1924-1934, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-34714186

RESUMEN

INTRODUCTION: The SARS-CoV-2 pandemic has forced healthcare providers to reorganize their activities to protect the population from infection, postponing or suspending many medical procedures. Patients affected by chronic conditions were among the most affected. In the case of catastrophes, women have a higher lifetime prevalence of post-traumatic stress disorder (PTSD), and those with endometriosis have higher anxiety levels, making them fragile in such circumstances. MATERIALS AND METHODS: In this cross-sectional study, conducted in May 2020, we considered all women aged ≥18 years, followed up at our referral centre for endometriosis. Patients were sent an anonymous 6-section questionnaire via email, containing different validated tools for the evaluation of anxiety levels and the risk of PTSD. A multivariable linear regression was performed to assess the impact of patients' characteristics on the distress caused by the SARS-COV-2 pandemic. RESULTS: Among the 468 women recruited, 68.8% were quite-to-extremely worried about not being able to access gynaecologic care, with almost one-third of them scoring ≥33 on the IES-R. Older age and increased levels of anxiety were associated with higher risks of PTSD (age: b = 0.28, 95% CI = 0.12 - 0.44; GAD-7: b = 1.71, 95% CI = 1.38 - 2.05), with up to 71.8% of patients with severe anxiety (GAD-7 > 15) having an IES-R score ≥33 suggestive for PTSD. Women who could leave home to work showed lower levels of PTSD (b = -4.79, 95% CI = -8.44 to - 1.15, ref. unemployed women). The implementation of telemedicine in routine clinical practice was favourably viewed by 75.6% of women. DISCUSSION: Women with endometriosis are particularly exposed to the risk of PTSD during the SARS-CoV-2 pandemic, especially if they are older or have higher levels of anxiety. Gynaecologists should resort to additional strategies, and telemedicine could represent a feasible tool to help patients cope with this situation.KEY MESSAGESThe COVID-19 pandemic significantly impacted the lives of women with endometriosis, who appeared to have a considerable risk of PTSD.Older age, higher anxiety levels and unemployment were independently associated with the risk of developing PTSD.Clinicians should develop successful alternative strategies to help patients cope with this situation, and telemedicine might represent an applicable and acceptable solution.


Asunto(s)
Ansiedad/epidemiología , COVID-19/prevención & control , Endometriosis/terapia , Accesibilidad a los Servicios de Salud/normas , Trastornos por Estrés Postraumático/epidemiología , Adulto , Factores de Edad , Ansiedad/diagnóstico , Ansiedad/etiología , Ansiedad/psicología , COVID-19/epidemiología , COVID-19/transmisión , Control de Enfermedades Transmisibles/normas , Estudios Transversales , Endometriosis/psicología , Femenino , Accesibilidad a los Servicios de Salud/organización & administración , Humanos , Internet/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Pandemias/prevención & control , Prevalencia , Gestión de Riesgos , SARS-CoV-2/patogenicidad , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/etiología , Trastornos por Estrés Postraumático/psicología , Encuestas y Cuestionarios/estadística & datos numéricos , Telemedicina/organización & administración , Telemedicina/normas , Adulto Joven
20.
Medicine (Baltimore) ; 100(39): e27360, 2021 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-34596146

RESUMEN

ABSTRACT: Coronavirus disease-2019 (COVID-19) is a global pandemic affecting numerous countries around the world. This study elaborates Taiwan's epidemiological characteristics from the 2020 to 2021 COVID-19 pandemic from human, temporal, and geographical dimensions. Big data for cases were obtained from a public database from the Taiwan Centers for Disease Control (CDC) in April 2021. The data were analyzed and used to compare differences, correlations, and trends for human, temporal, and geographical characteristics for imported and domestic COVID-19 cases. During the study period, 1030 cases were confirmed and the mortality rate of 1.0%. The epidemiological features indicated that most cases (953/1030, 92.5%) were imported. A comparison of the domestic confirmed and imported cases revealed the following findings: No significant difference of COVID-19 between males and females for sex was observed; For age, the risk of domestic transmission was significantly lower for 20 to 29 years old, higher for 50 to 59 years old, and >60 years old with odds ratios (ORs) (P value < .05) of 0.36, 3.37, and 2.50, respectively; For the month of infection, the ORs (P value < .05) of domestic confirmed cases during January and February 2020 were 22.428; and in terms of area of residence, the ORs (P value < .05) for domestic confirmed cases in northern and southern Taiwan were 4.473 and 0.033, respectively. Thus, the increase in domestic cases may have been caused by international travelers transmitting the virus in March 2020 and December 2020, respectively. Taiwan has been implementing effective screening and quarantine measures at airports. Moreover, Taiwan has implemented and maintained stringent interventions such as large-scale epidemiological investigation, rapid diagnosis, wearing masks, washing hands frequently, safe social distancing, and prompt clinical classifications for severe patients who were given appropriate medical measures. This is the first report comparing imported and domestic cases of COVID-19 from surveillance data from the Taiwan Centers for Disease Control during January 2020 and March 2021. It illustrates that individuals infected during overseas travel are the main risk factors for the spread of COVID-19 in Taiwan. The study also highlights the importance of longitudinal and geographically extended studies in understanding the implications of COVID-19 transmission for Taiwan's population.


Asunto(s)
COVID-19/epidemiología , COVID-19/prevención & control , Control de Enfermedades Transmisibles/organización & administración , Adulto , Factores de Edad , Anciano , Control de Enfermedades Transmisibles/normas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Características de la Residencia , SARS-CoV-2 , Factores Sexuales , Taiwán/epidemiología , Adulto Joven
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