Safety and Efficacy of a MEURI Program for the Use of High Dose Ivermectin in COVID-19 Patients.

Background: In the absence of antiviral alternatives, interventions under research for COVID-19 might be offered following guidelines from WHO for monitored emergency use of unregistered and experimental interventions (MEURI). Ivermectin is among several drugs explored for its role against SARS-CoV-2, with a well-known safety profile but conflicting data regarding clinical utility for COVID-19. The aim of this report is to inform on the results of a MEURI Program of high-dose ivermectin in COVID-19 carried out by the Ministry of Health of the Province of La Pampa, Argentina. Methods: COVID-19 subjects, within 5 days of symptoms onset were invited to participate in the program, which consisted in the administration of ivermectin 0.6 mg/kg/day for 5 days plus standard of care. Active pharmacosurveillance was performed for 21 days, and hepatic laboratory assessments were performed in a subset of patients. Frequency of Intensive Care Unit (ICU) admission and COVID-19-related mortality of subjects in the ivermectin intention to treat group were compared with that observed in inhabitants of the same province during the same period not participating in the program. Results: From 21,232 subjects with COVID-19, 3,266 were offered and agreed to participate in the ivermectin program and 17,966 did not and were considered as controls. A total of 567 participants reported 819 adverse events (AEs); 3.13% discontinued ivermectin due to adverse events. ICU admission was significantly lower in the ivermectin group compared to controls among participants ≥40 year-old (1.2 vs. 2.0%, odds ratio 0.608; p = 0.024). Similarly, mortality was lower in the ivermectin group in the full group analysis (1.5 vs. 2.1%, odds ratio 0.720; p = 0.029), as well as in subjects ≥ 40 year- old (2.7 vs. 4.1%, odds ratio 0.655; p = 0.005). Conclusions: This report highlights the safety and possible efficacy of high dose ivermectin as a potentially useful intervention deserving public health-based consideration for COVID-19 patients.

[Body weight increase and quality of semen: a controversial association]. / Aumento del peso corporal y calidad seminal: una asociación controvertida.

BACKGROUND: Infertility is a public health disorder affecting 10% of the population worldwide. Research on the impact of body mass index (BMI) on male fertility is very limited as compared to the multiple studies evaluating the impact of overweight in women's fertility. Although 25%-30% of the cases of couples consulting for infertility are attributable to male factors, studies evaluating the association between semen parameters and BMI are controversial. OBJECTIVE: To assess the impact of BMI on semen parameters in a selected group of men with unexplained infertility. METHOD: A retrospective analysis of 168 patients during the 2008-2010 period. They all had at least one semen analysis and related studies to rule out known causes of infertility. Median age of patients was 35 years (22-55), and they were divided into three groups: normal weight (BMI: 20-24.9kg/m(2)), overweight (BMI 25-29.9kg/m(2)), and obese (BMI ≥30kg/m(2)). RESULTS: There were no significant differences in semen parameters evaluated between the three groups, and no significant correlation was found between the same parameters and BMI. CONCLUSIONS: There was no significant association between BMI and conventional semen parameters, but we cannot exclude an impairment in other semen parameters that are not routinely assessed, which could result in a lower potential fertility in these individuals.

Assistência primária em saúde: atuaçäo do enfermeiro frente as necessidades do portador de malformaçäo congênita de lábio e/ou palato / Nursing care of the cleft lip or palate

Neste relato, destacamos a experiência e a evoluçäo da assistência de enfermagem no serviço ambulatorial do Hospital de Pesquisa e Reabilitaçäo de Lesöes Lábio Palatais da Universidade de Säo Paulo, em Bauru-SP, que visa obter os resultados mais adequados possíveis a níveis estético, funcional e psico-social na reabilitaçäo do portador de fissura de lábio e/ou palato. Ressaltamos também a importância da participaçäo ativa do cliente e família no conhecimento de seus problemas de saúde para uma completa reabilitaçäo.