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1.
BMC Health Serv Res ; 21(1): 624, 2021 Jun 30.
Artículo en Inglés | MEDLINE | ID: mdl-34193134

RESUMEN

BACKGROUND: The COVID-19 pandemic and lockdown evoked great worries among professionals in the field of domestic violence and abuse (DVA) as they expected a rise of the phenomenon. While many countries reported increased DVA, the Netherlands did not. To understand this discrepancy and the overall impact of the lockdown on DVA support services, we interviewed DVA professionals about their experiences with DVA during the rise of COVID-19, the impact of the lockdown on clients and working conditions, and views on eHealth and online tools. METHODS: Semi-structured interviews were conducted among 16 DVA professionals with various specializations. This data was analyzed using open thematic coding and content analysis. RESULTS: Most professionals did not see an increase in DVA reports but they did notice more severe violence. They experienced less opportunities to detect DVA and worried about their clients' wellbeing and the quality of (online) care. Furthermore, their working conditions rapidly changed, with working from home and online, and they expressed frustration, insecurity and loneliness. Professionals feel eHealth and online tools are not always suitable but they do see them as an opportunity to increase reach and maintain services when physical contact is not possible. CONCLUSION: This study suggests DVA was probably under-detected during the lockdown rather than not having increased. The Dutch system heavily relies on professionals to detect and report DVA, suggesting a need for critical evaluation of the accessibility of professional help. Professionals experienced significant challenges and should themselves be supported psychologically and in their changed work practices to maintain their ability to aid survivors.


Asunto(s)
COVID-19 , Violencia Doméstica , Control de Enfermedades Transmisibles , Humanos , Países Bajos , Pandemias , SARS-CoV-2
2.
Nihon Yakurigaku Zasshi ; 156(4): 208-213, 2021.
Artículo en Japonés | MEDLINE | ID: mdl-34193697

RESUMEN

The mission of regulatory science is to promote human longevity by providing safer and more effective drugs and ensuring human health. At present, various in vitro and in vivo evaluation methods are used for drug development, and no major problems have been observed. However, there is still room for improvement in terms of risk prediction in humans. Thus, new approaches and methodologies (NAMs) have recently been developed to predict adverse events in humans more accurately. Based on the animal alternative methods and the current COVID-19 pandemic, in vitro methods, such as human iPS cells, and computational approach are accelerated to improve the efficiency of drug development, ensure the patients' safety and speed up the review process. In this review, we would like to summarize the current status and future perspectives of pharmacological assay system using NAM in drug development.


Asunto(s)
COVID-19 , Pandemias , Alternativas a las Pruebas en Animales , Animales , Desarrollo de Medicamentos , Humanos , SARS-CoV-2
3.
BMJ Open ; 11(7): e045441, 2021 07 09.
Artículo en Inglés | MEDLINE | ID: mdl-34244254

RESUMEN

INTRODUCTION: People living in slums face several challenges to access healthcare. Scarce and low-quality public health facilities are common problems in these communities. Costs and prevalence of catastrophic health expenditures (CHE) have also been reported as high in studies conducted in slums in developing countries and those suffering from chronic conditions and the poorest households seem to be more vulnerable to financial hardship. The COVID-19 pandemic may be aggravating the economic impact on the extremely vulnerable population living in slums due to the long-term consequences of the disease. The objective of this review is to report the economic impact of seeking healthcare on slum-dwellers in terms of costs and CHE. We will compare the economic impact on slum-dwellers with other city residents. METHODS AND ANALYSIS: This scoping review adopts the framework suggested by Arksey and O'Malley. The review is part of the accountability and responsiveness of slum-dwellers (ARISE) research consortium, which aims to enhance accountability to improve the health and well-being of marginalised populations living in slums in India, Bangladesh, Sierra Leone and Kenya. Costs of accessing healthcare will be updated to 2020 prices using the inflation rates reported by the International Monetary Fund. Costs will be presented in International Dollars by using purchase power parity. The prevalence of CHE will also be reported. ETHICS AND DISSEMINATION: Ethical approval is not required for scoping reviews. We will disseminate our results alongside the events organised by the ARISE consortium and international conferences. The final manuscript will be submitted to an open-access international journal. Registration number at the Research Registry: reviewregistry947.


Asunto(s)
COVID-19 , Accesibilidad a los Servicios de Salud/economía , Áreas de Pobreza , Bangladesh , Países en Desarrollo , Femenino , Instituciones de Salud , Humanos , India , Kenia , Masculino , Pandemias , Literatura de Revisión como Asunto , SARS-CoV-2 , Sierra Leona
5.
JAMA Netw Open ; 4(7): e2116901, 2021 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-34255046

RESUMEN

Importance: The National COVID Cohort Collaborative (N3C) is a centralized, harmonized, high-granularity electronic health record repository that is the largest, most representative COVID-19 cohort to date. This multicenter data set can support robust evidence-based development of predictive and diagnostic tools and inform clinical care and policy. Objectives: To evaluate COVID-19 severity and risk factors over time and assess the use of machine learning to predict clinical severity. Design, Setting, and Participants: In a retrospective cohort study of 1 926 526 US adults with SARS-CoV-2 infection (polymerase chain reaction >99% or antigen <1%) and adult patients without SARS-CoV-2 infection who served as controls from 34 medical centers nationwide between January 1, 2020, and December 7, 2020, patients were stratified using a World Health Organization COVID-19 severity scale and demographic characteristics. Differences between groups over time were evaluated using multivariable logistic regression. Random forest and XGBoost models were used to predict severe clinical course (death, discharge to hospice, invasive ventilatory support, or extracorporeal membrane oxygenation). Main Outcomes and Measures: Patient demographic characteristics and COVID-19 severity using the World Health Organization COVID-19 severity scale and differences between groups over time using multivariable logistic regression. Results: The cohort included 174 568 adults who tested positive for SARS-CoV-2 (mean [SD] age, 44.4 [18.6] years; 53.2% female) and 1 133 848 adult controls who tested negative for SARS-CoV-2 (mean [SD] age, 49.5 [19.2] years; 57.1% female). Of the 174 568 adults with SARS-CoV-2, 32 472 (18.6%) were hospitalized, and 6565 (20.2%) of those had a severe clinical course (invasive ventilatory support, extracorporeal membrane oxygenation, death, or discharge to hospice). Of the hospitalized patients, mortality was 11.6% overall and decreased from 16.4% in March to April 2020 to 8.6% in September to October 2020 (P = .002 for monthly trend). Using 64 inputs available on the first hospital day, this study predicted a severe clinical course using random forest and XGBoost models (area under the receiver operating curve = 0.87 for both) that were stable over time. The factor most strongly associated with clinical severity was pH; this result was consistent across machine learning methods. In a separate multivariable logistic regression model built for inference, age (odds ratio [OR], 1.03 per year; 95% CI, 1.03-1.04), male sex (OR, 1.60; 95% CI, 1.51-1.69), liver disease (OR, 1.20; 95% CI, 1.08-1.34), dementia (OR, 1.26; 95% CI, 1.13-1.41), African American (OR, 1.12; 95% CI, 1.05-1.20) and Asian (OR, 1.33; 95% CI, 1.12-1.57) race, and obesity (OR, 1.36; 95% CI, 1.27-1.46) were independently associated with higher clinical severity. Conclusions and Relevance: This cohort study found that COVID-19 mortality decreased over time during 2020 and that patient demographic characteristics and comorbidities were associated with higher clinical severity. The machine learning models accurately predicted ultimate clinical severity using commonly collected clinical data from the first 24 hours of a hospital admission.


Asunto(s)
COVID-19 , Bases de Datos Factuales , Predicción , Hospitalización , Modelos Biológicos , Índice de Severidad de la Enfermedad , Adulto , Anciano , Anciano de 80 o más Años , COVID-19/etnología , COVID-19/mortalidad , Comorbilidad , Grupos Étnicos , Oxigenación por Membrana Extracorpórea , Femenino , Humanos , Concentración de Iones de Hidrógeno , Masculino , Persona de Mediana Edad , Pandemias , Respiración Artificial , Estudios Retrospectivos , Factores de Riesgo , SARS-CoV-2 , Estados Unidos , Adulto Joven
6.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 33(6): 744-747, 2021 Jun.
Artículo en Chino | MEDLINE | ID: mdl-34296698

RESUMEN

OBJECTIVE: To investigate the clinical practice of Chinese respiratory therapists (RTs) participating in the treatment of coronavirus disease 2019 (COVID-19) patients and summarize the experience and role of RTs in the treatment of pandemic infectious diseases. METHODS: A self-designed questionnaire was used to investigate the RTs who treated COVID-19 patients in 31 provinces, cities and autonomous regions in China. The survey questionnaire included the basic work of RTs, the specific work of the treatment for COVID-19 patients and problems encountered at work. RESULTS: A total of 126 questionnaires were issued and 40 valid questionnaires were collected from RTs who treated COVID-19 patients at 22 COVID-19 designated hospitals in 8 provinces and municipalities. This included 7 hospitals in Wuhan, the epicenter of the epidemic. In their medical team, RTs accounted for 2.9% (1.5%, 6.7%) of medical staff, the working experience of the RTs was about (6.2±5.4) years, the ratio of RTs to beds was about 1:11 (1:5, 1:26), and 85.0% (34/40) of RTs were transferred from other hospitals. 97.5% (39/40) of RTs were involved in formulating individual respiratory care strategies in their medical teams, and they were all involved in the evaluation of respiratory care and decision-making as well as the early identification of deterioration of respiratory function. All RTs [100% (40/40)] indicated that they would actively monitor patients' respiratory status, increase the means and frequency of the monitoring, implement standardized oxygen therapy, prevent ventilator-associated lung injury (VALI), and standardize the management of artificial airway. However, less than 50% of RTs had carried out stress and strain, transpulmonary pressure, partial pressure of end-tidal carbon dioxide (PetCO2), end-expiratory lung volume, electrical impedance tomography (EIT) and other respiratory function monitoring. 85% of RTs conducted training and education related to respiratory care and formulated relevant standard operating procedures for their medical teams. More than 90% of RTs led the implementation of high-flow nasal cannula oxygen therapy (HFNC), pulmonary protective mechanical ventilation, prone ventilation, pulmonary rehabilitation, airway management, transfer of critical patients, and other respiratory treatment. CONCLUSIONS: RTs performed their professional role fully in the assessment, decision-making, and clinical practice in the treatment of COVID-19 patients. However, the manpower shortage of RTs is extremely prominent, the practical experience has provided the basis for the future treatment of infectious respiratory diseases and effectively promoted the development of respiratory care in China.


Asunto(s)
COVID-19 , China , Humanos , Pandemias , Respiración Artificial , SARS-CoV-2
7.
PLoS Comput Biol ; 17(7): e1009120, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-34237051

RESUMEN

Widespread school closures occurred during the COVID-19 pandemic. Because closures are costly and damaging, many jurisdictions have since reopened schools with control measures in place. Early evidence indicated that schools were low risk and children were unlikely to be very infectious, but it is becoming clear that children and youth can acquire and transmit COVID-19 in school settings and that transmission clusters and outbreaks can be large. We describe the contrasting literature on school transmission, and argue that the apparent discrepancy can be reconciled by heterogeneity, or "overdispersion" in transmission, with many exposures yielding little to no risk of onward transmission, but some unfortunate exposures causing sizeable onward transmission. In addition, respiratory viral loads are as high in children and youth as in adults, pre- and asymptomatic transmission occur, and the possibility of aerosol transmission has been established. We use a stochastic individual-based model to find the implications of these combined observations for cluster sizes and control measures. We consider both individual and environment/activity contributions to the transmission rate, as both are known to contribute to variability in transmission. We find that even small heterogeneities in these contributions result in highly variable transmission cluster sizes in the classroom setting, with clusters ranging from 1 to 20 individuals in a class of 25. None of the mitigation protocols we modeled, initiated by a positive test in a symptomatic individual, are able to prevent large transmission clusters unless the transmission rate is low (in which case large clusters do not occur in any case). Among the measures we modeled, only rapid universal monitoring (for example by regular, onsite, pooled testing) accomplished this prevention. We suggest approaches and the rationale for mitigating these larger clusters, even if they are expected to be rare.


Asunto(s)
COVID-19/prevención & control , COVID-19/transmisión , Instituciones Académicas , Adolescente , COVID-19/epidemiología , COVID-19/virología , Niño , Análisis por Conglomerados , Brotes de Enfermedades , Humanos , Máscaras , Pandemias , Distanciamiento Físico , SARS-CoV-2/aislamiento & purificación
8.
Respirology ; 26(8): 745-767, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-34240518

RESUMEN

The coronavirus disease 2019 (COVID-19) pandemic is ongoing and many drugs have been studied in clinical trials. From a pathophysiological perspective, anti-viral drugs may be more effective in the early stage while immunomodulators may be more effective in severe patients in later stages of infection. While drugs such as lopinavir-ritonavir, hydroxychloroquine and azithromycin have proved to be ineffective in randomized controlled trials, corticosteroids, neutralizing monoclonal antibodies, remdesivir, tocilizumab and baricitinib have been reported to benefit certain groups of patients with COVID-19. In this review, we will present the key clinical evidence and progress in promising COVID-19 therapeutics, as well as summarize the experience and lessons learned from the development of the current therapeutics.


Asunto(s)
Antivirales/uso terapéutico , COVID-19/tratamiento farmacológico , Pandemias , SARS-CoV-2 , COVID-19/epidemiología , Humanos
9.
Am J Phys Med Rehabil ; 100(8): 725-729, 2021 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-34257184

RESUMEN

ABSTRACT: The coronavirus disease 2019 has been reported to cause various serious neurological sequelae. However, there is little information available about the impact of the disease and its complications on patients' functional status and their postacute needs. Hence, this study was performed to address the current gap in knowledge about the function and postacute needs of those with neurological complications of coronavirus disease 2019. A prospective chart review was completed for 319 patients admitted with coronavirus disease 2019 between March 4 and May 1, 2020. Primary outcomes included rate of new functional decline, discharge location, need for outpatient physical/occupational/speech therapy, need for durable medical equipment at discharge, and presence of dysphagia at discharge. Patients with neurological complications were compared with patients without neurological complications. Two hundred ninety-six cases were included in the final analysis, and 81 (27.4%) of these patients experienced neurological complications. Results indicated that hospitalized coronavirus disease 2019 patients with neurological complications exhibit a significantly longer length of stay, higher frequency of functional decline, higher mortality rate, and more frequent discharge to a subacute rehabilitation facility (all P < 0.0001). The findings of this study are expected to better prepare patients, providers, and health systems for the postacute needs of those with coronavirus disease 2019 and neurological complications.


Asunto(s)
COVID-19/complicaciones , Enfermedades del Sistema Nervioso/rehabilitación , Enfermedades del Sistema Nervioso/virología , Adulto , Anciano , Femenino , Hospitalización , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Alta del Paciente , Estudios Prospectivos , Recuperación de la Función , SARS-CoV-2 , Atención Subaguda
10.
Sci Rep ; 11(1): 14421, 2021 07 13.
Artículo en Inglés | MEDLINE | ID: mdl-34257350

RESUMEN

A plethora of measures are being combined in the attempt to reduce SARS-CoV-2 spread. Due to its sustainability, contact tracing is one of the most frequently applied interventions worldwide, albeit with mixed results. We evaluate the performance of digital contact tracing for different infection detection rates and response time delays. We also introduce and analyze a novel strategy we call contact prevention, which emits high exposure warnings to smartphone users according to Bluetooth-based contact counting. We model the effect of both strategies on transmission dynamics in SERIA, an agent-based simulation platform that implements population-dependent statistical distributions. Results show that contact prevention remains effective in scenarios with high diagnostic/response time delays and low infection detection rates, which greatly impair the effect of traditional contact tracing strategies. Contact prevention could play a significant role in pandemic mitigation, especially in developing countries where diagnostic and tracing capabilities are inadequate. Contact prevention could thus sustainably reduce the propagation of respiratory viruses while relying on available technology, respecting data privacy, and most importantly, promoting community-based awareness and social responsibility. Depending on infection detection and app adoption rates, applying a combination of digital contact tracing and contact prevention could reduce pandemic-related mortality by 20-56%.


Asunto(s)
COVID-19/prevención & control , Trazado de Contacto/métodos , Teléfono Inteligente , Humanos , Pandemias/prevención & control , SARS-CoV-2/patogenicidad
11.
Sci Rep ; 11(1): 14488, 2021 07 14.
Artículo en Inglés | MEDLINE | ID: mdl-34262069

RESUMEN

Since its emergence, the phenomenon of SARS-CoV-2 transmission by seemingly healthy individuals has become a major challenge in the effort to achieve control of the pandemic. Identifying the modes of transmission that drive this phenomenon is a perquisite in devising effective control measures, but to date it is still under debate. To address this problem, we have formulated a detailed mathematical model of discrete human actions (such as coughs, sneezes, and touching) and the continuous decay of the virus in the environment. To take into account those discrete and continuous events we have extended the common modelling approach and employed a hybrid stochastic mathematical framework. This allowed us to calculate higher order statistics which are crucial for the reconstruction of the observed distributions. We focused on transmission within a household, the venue with the highest risk of infection and validated the model results against the observed secondary attack rate and the serial interval distribution. Detailed analysis of the model results identified the dominant driver of pre-symptomatic transmission as the contact route via hand-face transfer and showed that wearing masks and avoiding physical contact are an effective prevention strategy. These results provide a sound scientific basis to the present recommendations of the WHO and the CDC.


Asunto(s)
COVID-19/prevención & control , COVID-19/transmisión , Portador Sano/prevención & control , Portador Sano/transmisión , Trazado de Contacto , Composición Familiar , Humanos , Higiene , Incidencia , Máscaras , Modelos Teóricos , Pandemias/prevención & control , Cuarentena , Factores de Riesgo , SARS-CoV-2
12.
J Sports Sci Med ; 20(3): 421-430, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34267581

RESUMEN

The aim of the study was to identify coherence, hope for success and coping strategies as predictors of mood among this year's Olympians in the context of coronavirus events. The relationships between the above variables and the mood of athletes were analysed. The study group consisted of 57 athletes - women (29) and men (28) between 18 and 39 years of age - representing various sports disciplines who were preparing for the Tokyo Olympics. The research was conducted in the period of April 7-28, 2020 during the first threat of COVID-19 pandemic, following the decision to move the Summer Olympics to the year 2021. It was time of the greatest national restrictions and information about the postponement of the games had been received. As a result of the step regression analysis, three predictors of vigour were established: sense of meaningfulness, coping with stress through positive reframing, and not using the self-blaming strategy. A positive predictor of anger was the use of substances. Confusion was predicted based on the frequency of behavioral disengagement. Behavioral disengagement predicted the severity of depression. Predictors of fatigue were the sense of meaningfulness, and the strategies of positive reframing and self-blaming. The results obtained emphasize the importance of positive reframing as a factor contributing to maintaining a positive mood state. In contrast, behavioral disengagement and self-blaming were strategies that lowered the mood of elite athletes. The results confirm the importance of factors included in the salutogenic model (sense of coherence, coping strategies) as predictors of athletes' mood during a pandemic.


Asunto(s)
Adaptación Psicológica , Atletas/psicología , COVID-19/psicología , Sentido de Coherencia , Adulto , Afecto , Estudios Transversales , Femenino , Humanos , Masculino , Pandemias , Polonia , SARS-CoV-2 , Estrés Psicológico/diagnóstico , Encuestas y Cuestionarios , Tokio , Adulto Joven
13.
Proc Biol Sci ; 288(1955): 20210834, 2021 07 28.
Artículo en Inglés | MEDLINE | ID: mdl-34284634

RESUMEN

Capturing the coupled dynamics between individual behavioural decisions that affect disease transmission and the epidemiology of outbreaks is critical to pandemic mitigation strategy. We develop a multiplex network approach to model how adherence to health-protective behaviours that impact COVID-19 spread are shaped by perceived risks and resulting community norms. We focus on three synergistic dynamics governing individual behavioural choices: (i) social construction of concern, (ii) awareness of disease incidence, and (iii) reassurance by lack of disease. We show why policies enacted early or broadly can cause communities to become reassured and therefore unwilling to maintain or adopt actions. Public health policies for which success relies on collective action should therefore exploit the behaviourally receptive phase; the period between the generation of sufficient concern to foster adoption of novel actions and the relaxation of adherence driven by reassurance fostered by avoidance of negative outcomes over time.


Asunto(s)
COVID-19 , Pandemias , Humanos , Pandemias/prevención & control , Percepción , Políticas , SARS-CoV-2
14.
Biochemistry (Mosc) ; 86(7): 800-817, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34284707

RESUMEN

COVID-19, a new human respiratory disease that has killed nearly 3 million people in a year since the start of the pandemic, is a global public health challenge. Its infectious agent, SARS-CoV-2, differs from other coronaviruses in a number of structural features that make this virus more pathogenic and transmissible. In this review, we discuss some important characteristics of the main SARS-CoV-2 surface antigen, the spike (S) protein, such as (i) ability of the receptor-binding domain (RBD) to switch between the "standing-up" position (open pre-fusion conformation) for receptor binding and the "lying-down" position (closed pre-fusion conformation) for immune system evasion; (ii) advantage of a high binding affinity of the RBD open conformation to the human angiotensin-converting enzyme 2 (ACE2) receptor for efficient cell entry; and (iii) S protein preliminary activation by the intracellular furin-like proteases for facilitation of the virus spreading across different cell types. We describe interactions between the S protein and cellular receptors, co-receptors, and antagonists, as well as a hypothetical mechanism of the homotrimeric spike structure destabilization that triggers the fusion of the viral envelope with the cell membrane at physiological pH and mediates the viral nucleocapsid entry into the cytoplasm. The transition of the S protein pre-fusion conformation to the post-fusion one on the surface of virions after their treatment with some reagents, such as ß-propiolactone, is essential, especially in relation to the vaccine production. We also compare the COVID-19 pathogenesis with that of severe outbreaks of "avian" influenza caused by the A/H5 and A/H7 highly pathogenic viruses and discuss the structural similarities between the SARS-CoV-2 S protein and hemagglutinins of those highly pathogenic strains. Finally, we touch on the prospective and currently used COVID-19 antiviral and anti-pathogenetic therapeutics, as well as recently approved conventional and innovative COVID-19 vaccines and their molecular and immunological features.


Asunto(s)
Enzima Convertidora de Angiotensina 2 , COVID-19 , Pandemias , SARS-CoV-2 , Glicoproteína de la Espiga del Coronavirus , Enzima Convertidora de Angiotensina 2/química , Enzima Convertidora de Angiotensina 2/genética , Enzima Convertidora de Angiotensina 2/metabolismo , COVID-19/epidemiología , COVID-19/genética , COVID-19/metabolismo , Humanos , Virus de la Influenza A/química , Virus de la Influenza A/genética , Virus de la Influenza A/metabolismo , Gripe Humana/epidemiología , Gripe Humana/genética , Gripe Humana/metabolismo , SARS-CoV-2/química , SARS-CoV-2/genética , SARS-CoV-2/metabolismo , Glicoproteína de la Espiga del Coronavirus/química , Glicoproteína de la Espiga del Coronavirus/genética , Glicoproteína de la Espiga del Coronavirus/metabolismo
16.
Clin Ter ; 172(4): 271-272, 2021 Jul 05.
Artículo en Inglés | MEDLINE | ID: mdl-34247209

RESUMEN

Abstract: Currently, the world is facing an unprecedent change of everyday life, due to the Covid-19 pandemic that has been affecting all the nations for more than one year. The public health systems were restructured in all the countries as a response to the constant emergency status, ne-glecting some services like toxicological analyses. In this scenario, the current spread of the New Psychoactive Substances is less controlled than before and the data on its expected mutation come from seizures analyses. Where the global distribution of drugs of abuse was affected by the restriction, fentanyl seizures did not drop during the pandemic. Moreover, new synthesis of fentanyl analogues resulted in new toxic adulterants as by products. Furthermore, diversion of benzodiazepines and new designer benzodiazepines were reported during the pandemic period. In this scenario, the scientific community and the international agencies should tighten their collaboration in order to monitor the emerging of new unknown substances.


Asunto(s)
Benzodiazepinas/efectos adversos , COVID-19/epidemiología , Contaminación de Medicamentos/estadística & datos numéricos , Fentanilo/efectos adversos , Psicotrópicos/efectos adversos , Salud Pública/estadística & datos numéricos , Trastornos Relacionados con Sustancias/epidemiología , Humanos , Pandemias , SARS-CoV-2
17.
Clin Ter ; 172(4): 284-304, 2021 Jul 05.
Artículo en Inglés | MEDLINE | ID: mdl-34247212

RESUMEN

Abstract: Many Italian universities during the COVID-19 pandemic had numerous students attending hospital wards. The training of health care students was necessary to prepare for good practices in implementing knowledge about COVID-19 and minimizing contagion among students who carried out the internship. In February 2020, a course aiming to guide health personnel so that they can appropriately address the health emergency posed by the new coronavirus was created, making use of the scientific evidence currently available as well as official sources of information and updates. The aim of this study was the development and validation of a useful tool to evaluate the progress in knowledge regarding COVID-19 of students in degree courses for the health care professions. The reliability of the test was assessed using Cronbach's alpha (α) coefficient, while the responsiveness of the test between T0 and T1 was measured with a student t test. The standard error of measurement was used to calculate the minimal detectable change of the tool. The test is made up of 31 items with four multiple-choice answers, one of which is correct. Fifteen bachelor's degree courses at the Sapienza University of Rome were enrolled, for a total population of 1,017 students from different course years. The test showed good internal consistency, with Cronbach's α values of 0.82. The item-total analysis also showed good results, with homogeneous α values from 0.80 to 0.82 for each item. The student t test showed a difference of 3.59 between T0 and T1 (p < 0.001). The minimal detectable change was 0.47. The test is a useful tool for assessing progress in skills regarding COVID-19 for students from bachelor's degree courses in the health professions. It allows the improvement and acquisition of skills as well as a qualitative analysis of the organization of internship degree courses.


Asunto(s)
COVID-19/diagnóstico , COVID-19/terapia , Educación a Distancia/estadística & datos numéricos , Evaluación Educacional/métodos , Evaluación Educacional/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud , Personal de Salud/estadística & datos numéricos , Adulto , Estudios Transversales , Femenino , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Pandemias , Reproducibilidad de los Resultados , SARS-CoV-2 , Estudiantes/estadística & datos numéricos , Encuestas y Cuestionarios , Adulto Joven
18.
Taiwan J Obstet Gynecol ; 60(4): 674-678, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34247805

RESUMEN

OBJECTIVES: The aim of this study is to assess the impact of life change and social distancing measures, during the Covid-19 outbreak, on the OAB symptoms and quality of life in women underwent different types of treatment. MATERIALS AND METHODS: Observational survey analysis in OAB treated patients was performed. The women showed a greater than 50% improvement during specific therapy for OAB. Population had previously completed bladder diary, OAB-Q symptom, OAB HRQL scale, SF-36 and PGI-I questionnaires. Four weeks after the introduction of the restrictive measures, these women were invited to complete the same questionnaires by e-mail for new evaluation during Covid-19 outbreak. Primary endpoint was changes in number of voids/24h, urgent micturitions/24h, urinary incontinence events/24h, nocturia events. Secondary endpoints were the assessment of the change in the OAB-SF, SF-36 questionnaires and PGI-I satisfaction. RESULTS: Six hundred seventy-three patients were considered. The mean age was 63.21 ± 10.24 years. Four weeks after the start of the social distancing measures, the increase in mean number of voids/24h (7.13 ± 1.08 vs 9.76 ± 2.12, p < 0.0001), urgent micturition episodes/24h (2.65 ± 1.11 vs 4.57 ± 1.28, p < 0.0001), nocturia episodes (1.19 ± 1.21 vs 2.83 ± 0.94, p < 0.0001) was observed. The OAB symptom scores (32.67 ± 12.88 vs 51.23 ± 12.11, p < 0.0001), OAB-HRQL (75.45 ± 12.76 vs 48.23 ± 10.34, p < 0.0001), and SF-36 (82.15 ± 11.78 vs 69.39 ± 10.85, p < 0.0001) changed significantly. The satisfaction decreased significantly at the PGI-I during the Covid-19 period 79.8% vs 45% (p < 0.0001). CONCLUSIONS: The Covid-19 outbreak and the restrictive social distancing measures have negatively influenced the OAB symptoms and quality of life in women underwent different types of treatment.


Asunto(s)
Calidad de Vida , Aislamiento Social/psicología , Vejiga Urinaria Hiperactiva/psicología , Anciano , COVID-19/epidemiología , COVID-19/psicología , Femenino , Humanos , Italia , Persona de Mediana Edad , Pandemias , SARS-CoV-2 , Encuestas y Cuestionarios
19.
Rev Neurol ; 73(2): 57-65, 2021 07 16.
Artículo en Inglés, Español | MEDLINE | ID: mdl-34254661

RESUMEN

INTRODUCTION: The COVID-19 pandemic caused a state of alarm in Spain in March 2020. The necessary approach to the care of patients with Dravet syndrome (DS) makes them and their caregivers a vulnerable group in emergency situations. OBJECTIVES: To explore the impact of the COVID-19 pandemic on the management and condition of Spanish patients with DS and their caregivers and families. MATERIALS AND METHODS: Analysis of data belonging to Spanish families taken from a European online survey (14 April-17 May 2020). It included data on DS patients, on the disease and on caregivers before and after lockdown during the state of alarm. RESULTS: Sixty-nine Spanish families participated; average age of patients: 12.6 years. Except in 19% of the cases that were isolated, protective/isolation measures for patients were followed without increasing. Epilepsy remained stable, with no medication or resource/personnel availability issues. Sleep-wake pattern (61%) and behavior (41%) of patients changed. Behavior change was associated with seizures during lockdown and with caregiver emotional state (changes in 76%). Psychological support was offered to only 9% of caregivers. Thirty-eight per cent of patients did not receive remote care. CONCLUSIONS: The experience gathered during the lockdown has allowed the detection of points of improvement to ensure the proper management of DS and to keep the situation of patients and caregivers stable. All of this with a prominent role of telemedicine.


Asunto(s)
COVID-19 , Epilepsias Mioclónicas , Cuidadores , Niño , Control de Enfermedades Transmisibles , Humanos , Pandemias , SARS-CoV-2 , España/epidemiología
20.
Tuberk Toraks ; 69(2): 177-186, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-34256508

RESUMEN

Introduction: COVID-19 pneumonia typically presents with high fever, cough, and shortness of breath and on thorax computed tomography (CT) peripheral ground glass opacities help the diagnosis. Although typical imaging findings for COVID-19 pneumonia are specified in thorax CT, these findings can be confused with other diseases. The aim of this study is to investigate the roles of radiological imaging and laboratory findings in the differential diagnosis of COVID-19 pneumonia and acute heart failure (AHF). Materials and Methods: In the present study, 74 patients who admitted to the emergency department with respiratory distress during the pandemic period and received a diagnosis of COVID-19 pneumonia and AHF were included. Laboratory data and radiological findings of the patients, at the time of admission, were evaluated. Result: On admission, there was no difference in age, gender between two groups. However, COVID-19 exposure history was found significantly higher in COVID-19 pneumonia patients group (p<0.001). Fever, cough, and fatigue were found significantly higher in the COVID-19 pneumonia patients group (p<0.001). There was difference of lesions distribution between the two groups, centrally distributed lesions were found significantly higher in acute heart failure patients (p<0.001). Pleural effusion and cardiomegaly were found significantly higher in AHF patients (p<0.001, p<0.001). Counts of the white blood cells and lymphocytes were found significantly lower in COVID-19 pneumonia patients (p= 0.003, p= 0.009). COVID-19 pneumonia patients had significantly higher levels of CRP, ferritin, LDH and CK compared with AHF patients (p<0.001, p<0.001, p= 0.002, p= 0.013). However the level of NT-proBNP was found significantly higher in the AHF patients group (p<0.001). Conclusions: We believe that laboratory data and thorax CT findings can provide beneficial clinical information in differentiating COVID-19 pneumonia from AHF during the pandemic.


Asunto(s)
COVID-19/diagnóstico , Insuficiencia Cardíaca/diagnóstico , Pulmón/diagnóstico por imagen , Pandemias , SARS-CoV-2 , Tomografía Computarizada por Rayos X/métodos , Enfermedad Aguda , Anciano , COVID-19/epidemiología , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Estudios Retrospectivos
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