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1.
Orthop Clin North Am ; 52(1): 69-76, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33222986

RESUMEN

This article explores the current state of the residency match in 2020 with a focus on orthopedic surgery, analyzing the utility of current applicant screening methods in producing future generations of competent surgeons. Discussed are anticipated changes to the residency application process considering the COVID-19 pandemic and Step 1 becoming pass/fail in January 2022. Also explored are potential changes to improve the process for applicants and residency programs, such as identifying and using predictive factors of resident success in the applicant screening process, finding better ways to match applicants with programs, and increasing female and underrepresented minorities within orthopedics.


Asunto(s)
Infecciones por Coronavirus , Internado y Residencia/métodos , Procedimientos Ortopédicos/educación , Cirujanos Ortopédicos/educación , Pandemias , Selección de Personal/métodos , Neumonía Viral , Betacoronavirus , Competencia Clínica , Femenino , Humanos , Masculino , Criterios de Admisión Escolar , Estados Unidos
2.
Ann Lab Med ; 41(2): 129-138, 2021 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-33063674

RESUMEN

Since its first report in December 2019, coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly emerged as a pandemic affecting nearly all countries worldwide. As the COVID-19 pandemic progresses, the need to identify genetic risk factors for susceptibility to this serious illness has emerged. Host genetic factors, along with other risk factors may help determine susceptibility to respiratory tract infections. It is hypothesized that the ACE2 gene, encoding angiotensin-converting enzyme 2 (ACE2), is a genetic risk factor for SARS-CoV-2 infection and is required by the virus to enter cells. Together with ACE2, transmembrane protease serine 2 (TMPRSS2) and dipeptidyl peptidase-4 (DPP4) also play an important role in disease severity. Evaluating the role of genetic variants in determining the direction of respiratory infections will help identify potential drug target candidates for further study in COVID-19 patients. We have summarized the latest reports demonstrating that ACE2 variants, their expression, and epigenetic factors may influence an individual's susceptibility to SARS-CoV-2 infection and disease outcome.


Asunto(s)
Betacoronavirus/genética , Infecciones por Coronavirus/patología , Variación Genética , Neumonía Viral/patología , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/virología , Dipeptidil Peptidasa 4/genética , Dipeptidil Peptidasa 4/metabolismo , Susceptibilidad a Enfermedades , Expresión Génica , Humanos , Pandemias , Peptidil-Dipeptidasa A/química , Peptidil-Dipeptidasa A/genética , Peptidil-Dipeptidasa A/metabolismo , Neumonía Viral/virología , Serina Endopeptidasas/genética , Serina Endopeptidasas/metabolismo , Índice de Severidad de la Enfermedad
3.
Ann Lab Med ; 41(2): 225-229, 2021 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-33063685

RESUMEN

In response to the ongoing coronavirus disease 2019 (COVID-19) pandemic, an online laboratory surveillance system was established to monitor severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) real-time reverse transcription-PCR (rRT-PCR) testing capacities and results. SARS-CoV-2 rRT-PCR testing data were collected from 97 clinical laboratories, including 84 medical institutions and 13 independent clinical laboratories in Korea. We assessed the testing capacities to utilize SARS-CoV-2 rRT-PCR based on surveillance data obtained from February 7th to June 4th, 2020 and evaluated positive result characteristics according to the reagents used and sample types. A total of 1,890,319 SARS-CoV-2 rRT-PCR testing were performed, 2.3% of which were positive. Strong correlations were observed between the envelope (E) gene and RNA-dependent RNA polymerase (RdRp)/nucleocapsid (N) genes threshold cycle (Ct) values for each reagent. No statistically significant differences in gene Ct values were observed between the paired upper and lower respiratory tract samples, except in the N gene for nasopharyngeal swab and sputum samples. Our study showed that clinical laboratories in Korea have rapidly expanded their testing capacities in response to the COVID-19 outbreak, with a peak daily capacity of 34,193 tests. Rapid expansion in testing capacity is a critical component of the national response to the ongoing pandemic.


Asunto(s)
Betacoronavirus/genética , Servicios de Laboratorio Clínico/estadística & datos numéricos , Infecciones por Coronavirus/diagnóstico , Neumonía Viral/diagnóstico , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/virología , Humanos , Laboratorios de Hospital , Pandemias , Neumonía Viral/virología , ARN Replicasa/genética , ARN Viral/genética , ARN Viral/metabolismo , Reacción en Cadena en Tiempo Real de la Polimerasa , República de Corea , Proteínas del Envoltorio Viral/genética , Proteínas Virales/genética
5.
Front Biosci (Elite Ed) ; 13: 117-139, 2021 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-33048778

RESUMEN

Coronavirus disease (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a member of the human coronavirus (HCoV) family that targets the lower part of the respiratory tract and causes severe acute respiratory syndrome (SARS). In a short span of time, this infection has led to a global pandemic and has become a significant threat to the existence of present human society. Currently, there are no treatments for this infection and the measures established across various countries such as social distancing, usage of mask to prevent entry of the virus into the respiratory tract, quarantine, and containment together have reduced the prevalence of this disease and mortality in highly susceptible individuals. Here, we examine the structure, replication cycle, phylogeny and genomic organization of this virus and discuss the role of spike (S) protein of the virus, an important structure that interacts with the host ACE2 receptor facilitating viral entry. Further, we explore the epidemiology, symptoms of the disease, describe the reverse transcriptase-polymerase chain reaction (RT-PCR) that establishes the diagnosis of the disease and also review its unique diagnostic features in the chest CT-Scan. Finally, we review the current approaches to develop therapies and vaccines as a measure for disease prevention and control.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/epidemiología , Pandemias , Neumonía Viral/epidemiología , Técnicas de Laboratorio Clínico/métodos , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/terapia , Infecciones por Coronavirus/virología , Humanos , Neumonía Viral/diagnóstico , Neumonía Viral/terapia , Neumonía Viral/virología
6.
Sci Total Environ ; 751: 142317, 2021 Jan 10.
Artículo en Inglés | MEDLINE | ID: mdl-33182011

RESUMEN

Nowadays, there is an important controversy about coronavirus air transmission. The aim of this study was to determine aerosol transmission from patients with coronavirus infection using "COVID-19 traps" that included different untouched surfaces within them. 42 swab samples of 6 different surfaces placed in the rooms of 6 patients with a positive diagnostic of COVID-19 were analyzed with RT-PCR technique to evaluate the presence of the virus and its stability. Samples were collected at 24, 48 and 72 h. Patients were in an intensive care unit (ICU) and in a COVID-19 ward unit (CWU) at a Spanish referral hospital. None of the samples placed in the ICU unit were positive for COVID-19. However, two surfaces, placed in a CWU room with a patient that required the use of respiratory assistance were positive for coronavirus at 72 h. Surfaces could not be touched by patients or health workers, so viral spreading was unequivocally produced by air transmission. Thus, fomites should be considered as a possible mode of transmission of coronavirus and frequent disinfection of surfaces should be taken into account. Our results, although preliminary, point the importance of SARS-CoV-2 virus air transmission indoors and may shed some light in this debate.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus , Pandemias , Neumonía Viral , Aire , Infecciones por Coronavirus/transmisión , Contaminación de Equipos , Fómites , Humanos , Proyectos Piloto , Neumonía Viral/transmisión
7.
Sci Total Environ ; 750: 142323, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-33182196

RESUMEN

Controlling anthropogenic mercury emissions is an ongoing effort and the effect of atmospheric mercury mitigation is expected to be impacted by accelerating climate change. The lockdown measures to restrict the spread of Coronavirus Disease 2019 (COVID-19) and the following unfavorable meteorology in Beijing provided a natural experiment to examine how air mercury responds to strict control measures when the climate becomes humid and warm. Based on a high-time resolution emission inventory and generalized additive model, we found that air mercury concentration responded almost linearly to the changes in mercury emissions when excluding the impact of other factors. Existing pollution control and additional lockdown measures reduced mercury emissions by 16.7 and 12.5 kg/d during lockdown, respectively, which correspondingly reduced the concentrations of atmospheric mercury by 0.10 and 0.07 ng/m3. Emission reductions from cement clinker production contributed to the largest decrease in atmospheric mercury, implying potential mitigation effects in this sector since it is currently the number one emitter in China. However, changes in meteorology raised atmospheric mercury by 0.41 ng/m3. The increases in relative humidity (9.5%) and temperature (1.2 °C) significantly offset the effect of emission reduction by 0.17 and 0.09 ng/m3, respectively, which highlights the challenge of air mercury control in humid and warm weather and the significance of understanding mercury behavior in the atmosphere and at atmospheric interfaces, especially the impact from relative humidity.


Asunto(s)
Contaminantes Atmosféricos , Contaminación del Aire , Infecciones por Coronavirus , Coronavirus , Mercurio , Pandemias , Neumonía Viral , Contaminantes Atmosféricos/análisis , Contaminación del Aire/análisis , Beijing , Betacoronavirus , China , Monitoreo del Ambiente , Humanos , Mercurio/análisis , Meteorología
8.
Talanta ; 222: 121534, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-33167242

RESUMEN

As COVID-19 has reached pandemic status and the number of cases continues to grow, widespread availability of diagnostic testing is critical in helping identify and control the emergence of this rapidly spreading and serious illness. However, a lacking in making a quick reaction to the threat and starting early development of diagnostic sensing tools has had an important impact globally. In this regard, here we will review critically the current developed diagnostic tools in response to the COVID-19 pandemic and compare the different types through the discussion of their pros and cons such as nucleic acid detection tests (including PCR and CRISPR), antibody and protein-based diagnosis tests. In addition, potential technologies that are under development such as on-site diagnosis platforms, lateral flow, and portable PCR units are discussed. Data collection and epidemiological analysis could also be an interesting factor to incorporate with the emerging technologies especially with the wide access to smartphones. Lastly, a SWOT analysis and perspectives on how the development of novel sensory platforms should be treated by the different decision-makers are analyzed.


Asunto(s)
Técnicas de Laboratorio Clínico/métodos , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Pandemias , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Técnicas de Laboratorio Clínico/instrumentación , Humanos , Pruebas en el Punto de Atención , Juego de Reactivos para Diagnóstico
9.
J Infect Chemother ; 27(1): 62-64, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32896479

RESUMEN

BACKGROUND: As countermeasures against the COVID-19 outbreak, sports and entertainment events were canceled (VEC) in Japan for two weeks from 26 February through 13 March. Moreover, most schools were closed (SC). OBJECTIVE: For this study, we estimated the basic reproduction number (R0) and SC and VEC effects. METHOD: After constructing a susceptible-infected-recovered model with three age classes, we used data of symptomatic patients in Japan for 14 January through 24 March. The SC and VEC effects were incorporated into the model through changes in contact patterns and contact frequencies among age classes. RESULTS: Results suggest R0 as 2.56, with 95% CI of [2.51, 2.96] before SC and VEC. The respective effects of SC and VEC were estimated as 0.4 (95% CI [0.3, 0.5]) and 0.5 (95% CI [0.3, 0.7]). CONCLUSION: The estimated R0 is similar to those found from other studies of China and Japan. Significant reduction of contact frequency has been achieved by SC and VEC. Nevertheless, its magnitude was insufficient to contain the outbreak.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Brotes de Enfermedades/prevención & control , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Instituciones Académicas/organización & administración , Adulto , Anciano , Número Básico de Reproducción , Betacoronavirus , Niño , Brotes de Enfermedades/estadística & datos numéricos , Humanos , Japón/epidemiología , Modelos Estadísticos
10.
J Infect Chemother ; 27(1): 70-75, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32950393

RESUMEN

OBJECTIVES: The symptoms of Coronavirus disease 2019 (COVID-19) vary among patients. The aim of this study was to investigate the clinical manifestation and disease duration in young versus elderly patients. METHODS: We retrospectively analyzed 187 patients (87 elderly and 100 young patients) with confirmed COVID-19. The clinical characteristics and chest computed tomography (CT) extent as defined by a score were compared between the two groups. RESULTS: The numbers of asymptomatic cases and severe cases were significantly higher in the elderly group (elderly group vs. young group; asymptomatic cases, 31 [35.6%] vs. 10 [10%], p < 0.0001; severe cases, 25 [28.7%] vs. 8 [8.0%], p = 0.0002). The proportion of asymptomatic patients and severe patients increased across the 10-year age groups. There was no significant difference in the total CT score and number of abnormal cases. A significant positive correlation between the disease duration and patient age was observed in asymptomatic patients (ρ = 0.4570, 95% CI 0.1198-0.6491, p = 0.0034). CONCLUSIONS: Although the extent of lung involvement did not have a significant difference between the young and elderly patients, elderly patients were more likely to have severe clinical manifestations. Elderly patients were also more likely to be asymptomatic and a source of COVID-19 viral shedding.


Asunto(s)
Infecciones Asintomáticas/epidemiología , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Esparcimiento de Virus , Adulto , Factores de Edad , Anciano , Betacoronavirus , Infecciones por Coronavirus/diagnóstico por imagen , Infecciones por Coronavirus/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/diagnóstico por imagen , Neumonía Viral/patología , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Tomografía Computarizada por Rayos X
11.
J Infect Chemother ; 27(1): 94-98, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32988730

RESUMEN

The effect of systemic corticosteroids on clinical outcomes in patients with coronavirus disease 2019 (COVID-19) remains controversial. While the use of corticosteroids raises concerns regarding delayed viral clearance, secondary infections, and long-term complications that can lead to increased mortality, corticosteroids have the potential to reduce mortality if used appropriately. Herein, we report good outcomes in two patients with COVID-19 who received systemic corticosteroids as adjunctive therapy. An 83-year-old man with hypertension and smoking history and a 62-year-old man with a drinking habit were transferred to our hospital with a diagnosis of COVID-19. The patients developed general malaise and loss of appetite with persistent high fever. Despite the prescription of antiviral drugs, their hypoxemia progressed rapidly. However, after the introduction of systemic corticosteroids, their symptoms improved as the fever decreased, and their hypoxemia gradually improved. These results suggest that some patients with COVID-19 may benefit from the appropriate use of systemic corticosteroids as adjunctive therapy.


Asunto(s)
Corticoesteroides/uso terapéutico , Infecciones por Coronavirus/tratamiento farmacológico , Metilprednisolona/uso terapéutico , Neumonía Viral/tratamiento farmacológico , Anciano de 80 o más Años , Consumo de Bebidas Alcohólicas/epidemiología , Antivirales/uso terapéutico , Betacoronavirus , Terapia Combinada , Infecciones por Coronavirus/epidemiología , Humanos , Hipertensión/epidemiología , Pulmón/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/epidemiología , Fumar/epidemiología , Neoplasias Gástricas/epidemiología , Tomografía Computarizada por Rayos X , Resultado del Tratamiento
12.
J Infect Chemother ; 27(1): 120-122, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32988731

RESUMEN

INTRODUCTION: Information on the effectiveness of personal protective equipment (PPE) for preventing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among healthcare workers (HCWs), especially among HCWs with frequent contact with patients with SARS-CoV-2, is limited. METHODS: We conducted a prospective cohort study on 49 HCWs who worked in close contact with patients with SARS-CoV-2 infection. HCWs had blood samples taken every 2 weeks to test for SARS-CoV-2 antibodies using two different types of assay. RESULTS: Forty-nine participants (31 nurses, 15 doctors, 3 other workers) were enrolled. In total, 112 blood samples are obtained from participants. The median work days in 2 weeks was 9 (interquartile range (IQR): 5-10) days. In a single work day, 30 of the 49 participants (61.5%) had contact with patients with suspected or conformed SARS-CoV-2 at least 8 times, and approximately 60% of participants had more than 10 min of contact with a single patient. The median self-reported compliance to PPE was 90% (IQR: 80-100%). Seven participants tested positive for SARS-CoV-2 antibody using enzyme-linked immunosorbent assay (ELISA); however, none were seropositive for SARS-CoV-2 neutralizing antibody, so the positive ELISA results were assumed to be false-positive. CONCLUSIONS: The study provides evidence that appropriate PPE is sufficient to prevent infection amongHCWs. It is necessary to establish a system that provides a stable supply of PPE for HCWs to perform their duties.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Personal de Salud , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Pandemias/prevención & control , Equipo de Protección Personal , Neumonía Viral/prevención & control , Neumonía Viral/transmisión , Adulto , Anciano , Anticuerpos Antivirales/sangre , Betacoronavirus/inmunología , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/diagnóstico , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neumonía Viral/diagnóstico , Estudios Prospectivos , Adulto Joven
13.
J Infect Chemother ; 27(1): 110-112, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33039267

RESUMEN

Coronavirus disease (COVID-19) is often characterized by abnormal olfactory and gustatory symptoms in adults; however, detailed studies on pediatric patients with COVID-19 are extremely limited. A 13-year-old Japanese girl presented with fever and cough, and after 2 days, her olfactory and taste sensations suddenly disappeared. A real-time reverse transcriptase-polymerase chain reaction (RT-PCR) test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was performed using a nasopharyngeal swab. Because a positive result was seen, she was admitted on the 7th day of illness. On admission, the visual analogue scale (VAS) score for smell and taste was 0 of 100%. An intravenous olfaction test using prosultiamine (Alinamin test) was performed on the 15th day of illness to evaluate olfaction, and an increase in latency (33 seconds) and a decrease in duration (55 seconds) were observed. In the odor identification test using 12 different odor cards, only 7 odors were correctly identified. On the 18th day of illness, SARS-CoV-2 tested negative in the RT-PCR test; simultaneously, the VAS score for smell and taste fully improved to 100 of 100%. On the 77th day of illness, full recovery was confirmed in the Alinamin test (latency, 7 seconds; duration, 82 seconds). In this present case, an improvement in olfactory and gustatory dysfunctions was observed with negative results in RT-PCR test for SARS-CoV-2.


Asunto(s)
Infecciones por Coronavirus/diagnóstico , Trastornos del Olfato/etiología , Neumonía Viral/diagnóstico , Trastornos del Gusto/etiología , Adolescente , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/complicaciones , Femenino , Humanos , Japón , Trastornos del Olfato/diagnóstico , Pandemias , Neumonía Viral/complicaciones , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Olfato , Gusto , Trastornos del Gusto/diagnóstico
14.
J Infect Chemother ; 27(1): 76-82, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33051144

RESUMEN

INTRODUCTION: The severity of coronavirus disease (COVID-19) in Japanese patients is unreported. We retrospectively examined significant factors associated with disease severity in symptomatic COVID-19 patients (COVID-Pts) admitted to our institution between February 20 and April 30, 2020. METHODS: All patients were diagnosed based on the genetic detection of severe acute respiratory syndrome coronavirus 2. Information on the initial symptoms, laboratory data, and computed tomography (CT) images at hospitalization were collected from the patients' records. COVID-Pts were categorized as those with critical or severe illness (Pts-CSI) or those with moderate or mild illness (Pt-MMI). All statistical analyses were performed using R software. RESULTS: Data from 61 patients (16 Pt-CSI, 45 Pt-MMI), including 58 Japanese and three East Asians, were analyzed. Pt-CSI were significantly older and had hypertension or diabetes than Pt-MMI (P < 0.001, 0.014 and < 0.001, respectively). Serum albumin levels were significantly lower in Pt-CSI than in Pt-MMI (P < 0.001), whereas the neutrophil-to-lymphocyte ratio and C-reactive protein level were significantly higher in Pt-CSI than in Pt-MMI (P < 0.001 and P < 0.001, respectively). In the CT images of 60 patients, bilateral lung lesions were more frequently observed in Pt-CSI than in Pt-MMI (P = 0.013). Among the 16 Pt-CSI, 15 received antiviral therapy, 12 received tocilizumab, five underwent methylprednisolone treatment, six received mechanical ventilation, and one died. CONCLUSIONS: The illness severity of Japanese COVID-Pts was associated with older age, hypertension and/or diabetes, low serum albumin, high neutrophil-to-lymphocyte ratio, and C-reactive protein.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Índice de Severidad de la Enfermedad , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Anticuerpos Monoclonales Humanizados/uso terapéutico , Antivirales/uso terapéutico , Betacoronavirus , Proteína C-Reactiva/análisis , Infecciones por Coronavirus/terapia , Femenino , Humanos , Japón/epidemiología , Pulmón/diagnóstico por imagen , Pulmón/patología , Masculino , Metilprednisolona/uso terapéutico , Persona de Mediana Edad , Neutrófilos , Pandemias , Neumonía Viral/terapia , Respiración Artificial , Estudios Retrospectivos , Factores de Riesgo , Albúmina Sérica/análisis , Tomografía Computarizada por Rayos X , Adulto Joven
15.
J Infect Chemother ; 27(1): 126-129, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33060046

RESUMEN

Considering the issues of shortage of medical resources and the invasiveness and infection risk involved in the collection of nasopharyngeal swab specimens, there is a need for an effective alternative test specimen for SARS-CoV-2 RNA detection. Here, we investigated suitability of saliva as a non-invasively obtained specimen for molecular detection of SARS-CoV-2 RNA in Japanese patients with COVID-19. In total, 28 paired clinical specimens of saliva and nasopharyngeal swabs were collected from 12 patients at various time points after symptom onset. Each specimen was assayed using reverse transcription real-time polymerase chain reaction (rRT-PCR) on the BD MAX open system using primers and probes targeting the N-gene. The saliva and nasopharyngeal swab specimens showed 19 and 15 positive results, respectively. No invalid (PCR inhibition) result was observed for any specimen. The qualitative results of each specimen obtained in the period immediately after symptom onset were similar. Three convalescent patients presented saliva-positive results, whereas their nasopharyngeal swabs were negative at four different time points, suggesting that saliva may be superior to nasopharyngeal swabs in terms of obtaining stable assay result of SARS-CoV-2. In conclusion, our results suggest that saliva can potentially serve as an alternative to nasopharyngeal swabs as a specimen for SARS-CoV-2 rRT-PCR. As saliva can be collected by patients themselves, it may be an effective way to overcome the shortage of personal protective equipment and specimen sampling tools.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/diagnóstico , Nasofaringe/virología , Neumonía Viral/diagnóstico , ARN Viral/aislamiento & purificación , Saliva/virología , Técnicas de Laboratorio Clínico , Humanos , Japón , Pandemias , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Manejo de Especímenes/métodos
16.
Med Educ Online ; 26(1): 1842661, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33108248

RESUMEN

Methods of anatomical education have, as with many facets of normal life, been forced to evolve rapidly due to the Covid-19 pandemic. Whilst some authors claim that cadaver dissection is now under threat, we believe the centuries-old practice can and must be upheld.


Asunto(s)
Anatomía/educación , Infecciones por Coronavirus/epidemiología , Disección/educación , Educación de Pregrado en Medicina , Neumonía Viral/epidemiología , Betacoronavirus , Cadáver , Humanos , Pandemias , Estudiantes de Medicina
17.
Clin Sports Med ; 40(1): 213-220, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33187611

RESUMEN

As the COVID-19 (Coronavirus disease 2019) pandemic continues, the paradigm of treatment continues to rapidly evolve, especially for sports medicine surgeons, because treatment before the pandemic was considered predominantly elective. This article provides subjective and objective data on the changes implicated by the COVID-19 pandemic with regard to the interactions and practices of sports medicine surgeons. This perspective also considers the potential impact on the patients and athletes treated by sports medicine surgeons. This article discusses the impact of the COVID-19 pandemic on sports medicine and provides thoughts on how the landscape of the field may continue to change.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Procedimientos Ortopédicos/estadística & datos numéricos , Pandemias , Neumonía Viral/epidemiología , Medicina Deportiva/métodos , Cirujanos/estadística & datos numéricos , Humanos
18.
Crit Care Clin ; 37(1): 175-190, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33190768

RESUMEN

Older adults are particularly vulnerable during the Coronavirus disease 2019 (COVID-19) pandemic, because higher age increases risk for both delirium and COVID-19-related death. Despite the health care system limitations and the clinical challenges of the pandemic, delirium screening and management remains an evidence-based cornerstone of critical care. This article discusses practical recommendations for delirium screening in the COVID-19 pandemic era, tips for training health care workers in delirium screening, validated tools for detecting delirium in critically ill older adults, and approaches to special populations of older adults (eg, sensory impairment, dementia, acute neurologic injury).


Asunto(s)
Infecciones por Coronavirus/complicaciones , Delirio/complicaciones , Delirio/diagnóstico , Demencia/complicaciones , Neumonía Viral/complicaciones , Anciano , Anciano de 80 o más Años , Betacoronavirus , Delirio/prevención & control , Pérdida Auditiva/complicaciones , Humanos , Unidades de Cuidados Intensivos , Pandemias , Grupo de Atención al Paciente , Trastornos de la Visión/complicaciones
19.
Sci Total Environ ; 751: 141816, 2021 Jan 10.
Artículo en Inglés | MEDLINE | ID: mdl-32861186

RESUMEN

Human coronaviruses are RNA viruses that are sensitive to ultraviolet (UV) radiation. Sunlight contains UVA (320-400 nm), UVB (260-320 nm) and UVC (200-260 nm) action spectra. UVC can inactivate coronaviruses, including severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). The incidence and mortality of coronavirus disease 2019 (COVID-19) are considered to be correlated with vitamin D levels. Vitamin D synthesis in human skin is closely related to exposure to UVB radiation. Therefore, the incidence and mortality of COVID-19 are also considered to be correlated with Vitamin D levels. In this study, Spearman and Kendall rank correlation analysis tests were used to analyze the correlation between the average percent positive of five human coronaviruses (SARS-CoV-2, CoVHKU1, CoVNL63, CoVOC43, and CoV229E) in the U.S. and the corresponding sunlight UV radiation dose The results indicated that the monthly average percent positive of four common coronaviruses was significantly negatively correlated with the sunlight UV radiation dose. The weekly percent positive of SARS-CoV-2 during April 17, 2020 to July 10, 2020 showed a significant negative correlation with the sunlight UV radiation dose in census regions 1 and 2 of the U.S. while no statistical significance in the other regions. Additionally, sunlight UV radiation also showed some negative effects with respect to the early SARS-CoV-2 transmission.


Asunto(s)
Infecciones por Coronavirus , Coronavirus , Pandemias , Neumonía Viral , Rayos Ultravioleta , Betacoronavirus , Humanos , Luz Solar
20.
Sci Total Environ ; 751: 141750, 2021 Jan 10.
Artículo en Inglés | MEDLINE | ID: mdl-32861187

RESUMEN

Wastewater-based monitoring of the spread of the new SARS-CoV-2 virus, also referred to as wastewater-based epidemiology (WBE), has been suggested as a tool to support epidemiology. An extensive sampling campaign, including nine municipal wastewater treatment plants, has been conducted in different cities of the Federal State of North Rhine-Westphalia (Germany) on the same day in April 2020, close to the first peak of the corona crisis. Samples were processed and analysed for a set of SARS-CoV-2-specific genes, as well as pan-genotypic gene sequences also covering other coronavirus types, using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Additionally, a comprehensive set of chemical reference parameters and bioindicators was analysed to characterize the wastewater quality and composition. Results of the RT-qPCR based gene analysis indicate the presence of SARS-CoV-2 genetic traces in different raw wastewaters. Furthermore, selected samples have been sequenced using Sanger technology to confirm the specificity of the RT-qPCR and the origin of the coronavirus. A comparison of the particle-bound and the dissolved portion of SARS-CoV-2 virus genes shows that quantifications must not neglect the solid-phase reservoir. The infectivity of the raw wastewater has also been assessed by viral outgrowth assay with a potential SARS-CoV-2 host cell line in vitro, which were not infected when exposed to the samples. This first evidence suggests that wastewater might be no major route for transmission to humans. Our findings draw attention to the need for further methodological and molecular assay validation for enveloped viruses in wastewater.


Asunto(s)
Infecciones por Coronavirus , Pandemias , Neumonía Viral , Aguas Residuales , Betacoronavirus , Ciudades , Alemania/epidemiología , Humanos
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