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1.
Front Public Health ; 9: 623521, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33796495

RESUMO

Over the last months, mathematical models have been extensively used to help control the COVID-19 pandemic worldwide. Although extremely useful in many tasks, most models have performed poorly in forecasting the pandemic peaks. We investigate this common pitfall by forecasting four countries' pandemic peak: Austria, Germany, Italy, and South Korea. Far from the peaks, our models can forecast the pandemic dynamics 20 days ahead. Nevertheless, when calibrating our models close to the day of the pandemic peak, all forecasts fail. Uncertainty quantification and sensitivity analysis revealed the main obstacle: the misestimation of the transmission rate. Inverse uncertainty quantification has shown that significant changes in transmission rate commonly precede a peak. These changes are a key factor in forecasting the pandemic peak. Long forecasts of the pandemic peak are therefore undermined by the lack of models that can forecast changes in the transmission rate, i.e., how a particular society behaves, changes of mitigation policies, or how society chooses to respond to them. In addition, our studies revealed that even short forecasts of the pandemic peak are challenging. Backward projections have shown us that the correct estimation of any temporal change in the transmission rate is only possible many days ahead. Our results suggest that the distance between a change in the transmission rate and its correct identification in the curve of active infected cases can be as long as 15 days. This is intrinsic to the phenomenon and how it affects epidemic data: a new case is usually only reported after an incubation period followed by a delay associated with the test. In summary, our results suggest the phenomenon itself challenges the task of forecasting the peak of the COVID-19 pandemic when only epidemic data is available. Nevertheless, we show that exciting results can be obtained when using the same models to project different scenarios of reduced transmission rates. Therefore, our results highlight that mathematical modeling can help control COVID-19 pandemic by backward projections that characterize the phenomena' essential features and forward projections when different scenarios and strategies can be tested and used for decision-making.


Assuntos
/epidemiologia , Previsões , Modelos Teóricos , Áustria/epidemiologia , Alemanha/epidemiologia , Humanos , Itália/epidemiologia , Pandemias , República da Coreia/epidemiologia
2.
Bone Joint J ; 103-B(3): 553-561, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33641415

RESUMO

AIMS: The aims of the study were to analyze differences in surgical and oncological outcomes, as well as quality of life (QoL) and function in patients with ankle sarcomas undergoing three forms of surgical treatment, minor or major limb salvage surgery (LSS), or amputation. METHODS: A total of 69 patients with ankle sarcomas, treated between 1981 and 2017 at two tumour centres, were retrospectively reviewed (mean age at surgery: 46.3 years (SD 22.0); 31 females (45%)). Among these 69 patients 25 were analyzed prospectively (mean age at latest follow-up: 61.2 years (SD 20.7); 11 females (44%)), and assessed for mobility using the Prosthetic Limb Users Survey of Mobility (PLUS-M; for amputees only), the Toronto Extremity Salvage Score (TESS), and the University of California, Los Angeles (UCLA) Activity Score. Individual QoL was evaluated in these 25 patients using the five-level EuroQol five-dimension (EQ-5D-5L) and Fragebogen zur Lebenszufriedenheit/Questions on Life Satisfaction (FLZ). RESULTS: Of the total number of patients in the study, 22 (32%) underwent minor LSS and 22 (32%) underwent major LSS; 25 underwent primary amputation (36%). Complications developed in 26 (38%) patients, and were more common in those with major or minor LSS in comparison to amputation (59% vs 36% vs 20%; p = 0.022). A time-dependent trend towards higher complication risk following any LSS was present (relative risk: 0.204; 95% confidence interval (CI) 0.026 to 1.614; p = 0.095). In the prospective cohort, mean TESS was higher following minor LSS in comparison to amputation (91.0 vs 67.3; p = 0.006), while there was no statistically significant difference between major LSS and amputation (81.6 vs 67.3; p = 0.099). There was no difference in mean UCLA (p = 0.334) between the three groups (p = 0.334). None of the items in FLZ or EQ-5D-5L were different between the three groups (all p > 0.05), except for FLZ item "self-relation", being lower in amputees. CONCLUSION: Complications are common following LSS for ankle sarcomas. QoL is comparable between patients with LSS or amputation, despite better mobility scores for patients following minor LSS. We conclude that these results allow a decision for amputation to be made more easily in patients particularly where the principles of oncological surgery would otherwise be at risk. Cite this article: Bone Joint J 2021;103-B(3):553-561.


Assuntos
Amputação , Tornozelo , Salvamento de Membro/métodos , Qualidade de Vida , Sarcoma/cirurgia , Neoplasias de Tecidos Moles/cirurgia , Áustria/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Sarcoma/patologia , Neoplasias de Tecidos Moles/patologia
3.
Artigo em Inglês | MEDLINE | ID: mdl-33668235

RESUMO

Telephone emergency services play an important role in providing low-threshold, anonymous crisis intervention free of cost. The current study aims to examine the mental well-being and perceived stress level of counselors as well as the main topics of helpline callers during the COVID-19 pandemic in Austria. In the current study, 374 counselors were recruited within the Austrian nationwide organization TelefonSeelsorge during the second wave of COVID-19 infection in Austria. The mental well-being (WHO-5) and perceived stress-level (PSS-10) were assessed and counselors were asked about the frequency of different topics thematized by callers and changes compared to pre-pandemic times. Compared to a reference group of the Austrian general population, counselors experienced less stress (13.22 vs. 16.42) and higher mental well-being (66.26 vs. 57.36; p < 0.001). The most frequent topics during the second wave of the COVID-19 pandemic in Austria were loneliness and mental health. More calls were registered in 2020 compared to 2019 and especially the topics loneliness, mental health, professional activities and relationships were reported to be thematized more often during the COVID-19 pandemic compared to the time before (p < 0.001). The results contribute to an understanding of the impact of the COVID-19 pandemic on telephone crisis intervention.


Assuntos
Conselheiros , Linhas Diretas , Áustria/epidemiologia , Estudos Transversais , Humanos , Solidão , Saúde Mental , Pandemias , Estresse Psicológico , Telefone
4.
Eur J Clin Invest ; 51(4): e13520, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33583018

RESUMO

BACKGROUND: A key question concerning coronavirus disease 2019 (COVID-19) is how effective and long lasting immunity against this disease is in individuals who were previously infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to evaluate the risk of SARS-CoV-2 re-infections in the general population in Austria. METHODS: This is a retrospective observational study using national SARS-CoV-2 infection data from the Austrian epidemiological reporting system. As the primary outcome, we aim to compare the odds of SARS-CoV-2 re-infections of COVID-19 survivors of the first wave (February to April 30, 2020) versus the odds of first infections in the remainder general population by tracking polymerase chain reaction (PCR)-confirmed infections of both groups during the second wave from September 1 to November 30, 2020. Re-infection counts are tentative, since it cannot be excluded that the positive PCR in the first and/or second wave might have been a false positive. RESULTS: We recorded 40 tentative re-infections in 14 840 COVID-19 survivors of the first wave (0.27%) and 253 581 infections in 8 885 640 individuals of the remaining general population (2.85%) translating into an odds ratio (95% confidence interval) of 0.09 (0.07 to 0.13). CONCLUSIONS: We observed a relatively low re-infection rate of SARS-CoV-2 in Austria. Protection against SARS-CoV-2 after natural infection is comparable with the highest available estimates on vaccine efficacies. Further well-designed research on this issue is urgently needed for improving evidence-based decisions on public health measures and vaccination strategies.


Assuntos
/epidemiologia , /epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Áustria/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
5.
Schweiz Arch Tierheilkd ; 163(2): 123-138, 2021 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-33528363

RESUMO

INTRODUCTION: Introduction The impact of lameness on milk yield in dairy cows has been investigated already in many countries by several authors, taking into consideration almost exclusively locomotion scores ≥ 3. The aim of this study was to evaluate the impact of lameness and of the various lameness scores (2-5) on milk yield and milk solids in cows of the three most important dairy cattle breeds (Fleckvieh, Braunvieh, Holstein-Friesian) in Austria within one lactation period. Material and methods Locomotion scoring of dairy cows was performed by trained personnel every 30-40 days in 2014 during the course of routine performance testing. From the recorded locomotion scores (1-5) and the number of lameness episodes, the cows were classified into five lactation-locomotion-score-groups (LLS-G1-5). In total, data sets of 4005 cows from 144 dairy farms across Austria could be evaluated. Using two statistical models the fixed effects on LLS group, breed (evaluation across all breeds in model 1), farm, year and season of calving, parity and the «continuous effect¼ number of milking days were included in the analyses of milk, fat and protein yield. Results The mean, cumulative lameness prevalence during the observation period was 51.0%, and 8.1% were cows from the LLS-G5 group showing repeated and severe locomotion scores. During the first 100 days in milk 34.7% of all cows were lame. In model 1, all effects considered had a significant impact (P .


Assuntos
Bovinos/fisiologia , Lactação , Coxeadura Animal/fisiopatologia , Animais , Áustria/epidemiologia , Indústria de Laticínios , Feminino , Lactação/fisiologia , Coxeadura Animal/epidemiologia , Leite/química , Prevalência
6.
Nutr Metab Cardiovasc Dis ; 31(4): 1286-1292, 2021 04 09.
Artigo em Inglês | MEDLINE | ID: mdl-33558093

RESUMO

BACKGROUND AND AIMS: Ideal cardiovascular health (CVH) behaviors in adolescents are defined by body mass index (BMI), diet, physical activity and smoking, and are directly associated with better health in later life. To further improve health prevention programs we investigated the prevalence of these behaviors in a cohort of healthy adolescents and focused on the associations with sex, age, and education. METHODS AND RESULTS: The Early Vascular Aging Tyrol study is a cross-sectional study assessing 14- to 19-year-old pupils and apprentices in Western Austria and South Tyrol. Between May 2015 and July 2018 2047 adolescents (43.6% males, mean age 16.4 years) with complete data for all 4 health behaviors were included. The prevalence of ideal body mass index (BMI) was 78.3%, of ideal physical activity 42.5%, of non-smoking 70.4% and of ideal diet 8.1%. Females showed a higher smoking prevalence and a lower physical activity, but better dietary habits than males. Older adolescents of both sexes had lower prevalence of ideal smoking and diet. Apprentices and pupils of vocational schools had a higher BMI and a less favorable diet compared to secondary academic school students. Smoking prevalence was highest in apprentices. Non-ideal BMI was independently associated with smoking. CONCLUSION: In our cohort, only a minority showed ideal CVH behaviors which were best in adolescents younger than 16 years. We observed significant differences between males and females and a clear impact of school education with apprentices being at risk for non-ideal CVH behaviors. CLINICAL TRIAL REGISTRATION NUMBER: NCT03929692, clinicaltrials.gov.


Assuntos
Comportamento do Adolescente , Doenças Cardiovasculares/prevenção & controle , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Estilo de Vida Saudável , Comportamento de Redução do Risco , Adolescente , Fatores Etários , Áustria/epidemiologia , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Estudos Transversais , Dieta Saudável , Escolaridade , Exercício Físico , Comportamento Alimentar , Feminino , Nível de Saúde , Humanos , Masculino , não Fumantes , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Comportamento Sedentário , Fatores Sexuais , Fumar/efeitos adversos , Fumar/epidemiologia , Adulto Jovem
7.
J Perinat Med ; 49(2): 138-140, 2021 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-33544532

RESUMO

OBJECTIVES: To report clinical data on maternal outcome, mode of delivery and immediate neonatal outcome in women infected with COVID-19. METHODS: Retrospective data collection. RESULTS: A total of 8.6% of the total population of hospitalised SARS-CoV-2 positive pregnant women were admitted to a critical care unit. The premature birth rate for births before 34+0 weeks of gestation among pregnant women who tested positive for SARS-CoV-2 was 7.1%. One newborn (3.6%) tested positive for SARS-CoV-2 two days after birth and showed symptoms. CONCLUSIONS: Pregnant women with COVID-19 seem to be at higher risk of invasive ventilation, admission to a critical care unit and preterm birth, and should therefore be considered a high-risk-population.


Assuntos
/complicações , Complicações Infecciosas na Gravidez/virologia , Resultado da Gravidez/epidemiologia , Adulto , Áustria/epidemiologia , Feminino , Humanos , Recém-Nascido , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Nascimento Prematuro/virologia , Estudos Retrospectivos , Adulto Jovem
8.
BMC Public Health ; 21(1): 314, 2021 02 08.
Artigo em Inglês | MEDLINE | ID: mdl-33557816

RESUMO

BACKGROUND: Impacts of the Covid-19 pandemic and its public health measures go beyond physical and mental health and incorporate wider well-being impacts in terms of what people are free to do or be. We explored the impacts of the Covid-19 lockdown and relevant vulnerabilities on capability well-being, mental health and social support in Austria. METHODS: Adult Austrian residents (n = 560) provided responses to a cross-sectional online survey about their experiences during Covid-19 lockdown (15 March-15 April 2020). Instruments measuring capabilities (OxCAP-MH), depression and anxiety (HADS), social support (MSPSS) and mental well-being (WHO-5) were used in association with six pre-defined vulnerabilities using multivariable linear regression. RESULTS: 31% of the participants reported low mental well-being and only 30% of those with a history of mental health treatment received treatment during lockdown. Past mental health treatment had a significant negative effect across all outcome measures with an associated capability well-being score reduction of - 6.54 (95%CI, - 9.26, - 3.82). Direct Covid-19 experience and being 'at risk' due to age and/or physical health conditions were also associated with significant capability deprivations. When adjusted for vulnerabilities, significant capability reductions were observed in association with increased levels of depression (- 1.77) and anxiety (- 1.50), and significantly higher capability levels (+ 3.75) were associated with higher levels of social support. Compared to the cohort average, individual capability impacts varied between - 9% for those reporting past mental health treatment and + 5% for those reporting one score higher on the social support scale. CONCLUSIONS: Our study is the first to assess the capability limiting aspects of lockdown and relevant vulnerabilities alongside their impacts on mental health and social support. The negative capability well-being, mental health and social support impacts of the Covid-19 lockdown were strongest for people with a history of mental health treatment. Future public health policies concerning lockdowns should pay special attention to improve social support levels in order to increase public resilience.


Assuntos
Ansiedade/epidemiologia , Depressão/epidemiologia , Quarentena/psicologia , Apoio Social , Populações Vulneráveis/psicologia , Adolescente , Adulto , Idoso , Áustria/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco , Inquéritos e Questionários , Populações Vulneráveis/estatística & dados numéricos , Adulto Jovem
9.
Epidemiol Infect ; 149: e52, 2021 02 18.
Artigo em Inglês | MEDLINE | ID: mdl-33597049

RESUMO

We report the development of a regression model to predict the prevalence of severe acute respiratory syndrome coronavirus (SARS-CoV-2) antibodies on a population level based on self-reported symptoms. We assessed participant-reported symptoms in the past 12 weeks, as well as the presence of SARS-CoV-2 antibodies during a study conducted in April 2020 in Ischgl, Austria. We conducted multivariate binary logistic regression to predict seroprevalence in the sample. Participants (n = 451) were on average 47.4 years old (s.d. 16.8) and 52.5% female. SARS-CoV-2 antibodies were found in n = 197 (43.7%) participants. In the multivariate analysis, three significant predictors were included and the odds ratios (OR) for the most predictive categories were cough (OR 3.34, CI 1.70-6.58), gustatory/olfactory alterations (OR 13.78, CI 5.90-32.17) and limb pain (OR 2.55, CI 1.20-6.50). The area under the receiver operating characteristic curve was 0.773 (95% CI 0.727-0.820). Our regression model may be used to estimate the seroprevalence on a population level and a web application is being developed to facilitate the use of the model.


Assuntos
/epidemiologia , /fisiologia , Adulto , Anticorpos Antivirais/sangue , Áustria/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Autorrelato , Estudos Soroepidemiológicos
10.
Clin Transl Gastroenterol ; 12(1): e00293, 2021 01 12.
Artigo em Inglês | MEDLINE | ID: mdl-33438988

RESUMO

INTRODUCTION: Coronavirus disease (COVID-19) has spread from Wuhan, China, and become a worldwide pandemic. Most patients display respiratory symptoms but up to 50% report gastrointestinal symptoms. Neopterin is a surrogate marker for viral inflammation, and its production by macrophages is driven by interferon-γ. METHODS: We measured fecal neopterin in 37 hospitalized COVID-19 patients not requiring intensive care measures and 22 healthy controls. RESULTS: Fecal neopterin was elevated in stool samples from COVID-19 patients compared with that in samples from healthy controls. Especially, patients reporting gastrointestinal symptoms exhibited increased fecal neopterin values. DISCUSSION: COVID-19 is associated with an inflammatory immune response in the gastrointestinal tract.


Assuntos
/complicações , Fezes/química , Gastroenteropatias/metabolismo , Gastroenteropatias/virologia , Neopterina/análise , Adulto , Idoso , Áustria/epidemiologia , /epidemiologia , Estudos de Casos e Controles , Feminino , Gastroenteropatias/diagnóstico , Trato Gastrointestinal/imunologia , Trato Gastrointestinal/patologia , Trato Gastrointestinal/virologia , Humanos , Inflamação/imunologia , Inflamação/virologia , Pacientes Internados , Interferon gama/metabolismo , Macrófagos/metabolismo , Masculino , Pessoa de Meia-Idade , /genética
11.
Ann Hematol ; 100(3): 809-816, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33496839

RESUMO

Adult acute lymphoblastic leukemia/lymphoma (ALL/LBL) is a rare and heterogeneous malignancy characterized by uncontrolled proliferation of B or T cell precursor cells. Here, we retrospectively analyzed the outcome of early autologous stem cell transplantation in standard-risk patients in first complete remission (n=24) and of allogeneic transplantation in high and highest risk, and relapsed/refractory patients (n=35). The 10-year overall survival after autologous transplantation was 45%. The 10-year overall survival after allogeneic transplantation was 58%. The cumulative incidence of relapse was 29% after allogeneic and 67% after autologous transplantation. The cumulative incidence of non-relapse mortality was 0% after autologous and 12% after allogeneic transplantation. This retrospective single center analysis in a limited number of standard-risk patients clearly demonstrates that early autologous transplantation in first complete remission leads to an acceptable long-term outcome with a short overall treatment duration of less than 6 months compared with more than 2 years with conventional chemotherapy. More sensitive and standardized methods to detect minimal residual disease (MRD) will further help to identify those patients more accurately who are most likely to benefit from such a short and intensive treatment strategy (i.e., MRD negative standard-risk patients) or those who require early targeted therapy (e.g., blinatumomab) in case of MRD positivity. Early allogeneic transplantation results in long-term survival/cure in nearly two-thirds of all high and highest risk, and relapsed/refractory patients.


Assuntos
Intervenção Médica Precoce , Transplante de Células-Tronco de Sangue Periférico/métodos , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Adolescente , Adulto , Idoso , Áustria/epidemiologia , Intervenção Médica Precoce/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasia Residual , Transplante de Células-Tronco de Sangue Periférico/efeitos adversos , Transplante de Células-Tronco de Sangue Periférico/estatística & dados numéricos , Leucemia-Linfoma Linfoblástico de Células Precursoras/epidemiologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/patologia , Recidiva , Indução de Remissão , Estudos Retrospectivos , Fatores de Tempo , Tempo para o Tratamento , Transplante Autólogo , Transplante Homólogo , Resultado do Tratamento , Adulto Jovem
12.
BMC Infect Dis ; 21(1): 70, 2021 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-33441091

RESUMO

BACKGROUND: Knowing the number of undetected cases of COVID-19 is important for a better understanding of the spread of the disease. This study analyses the temporal dynamic of detected vs. undetected cases to provide guidance for the interpretation of prevalence studies performed with PCR or antibody tests to estimate the detection rate. METHODS: We used an agent-based model to evaluate assumptions on the detection probability ranging from 0.1 to 0.9. For each general detection probability, we derived age-dependent detection probabilities and calibrated the model to reproduce the epidemic wave of COVID-19 in Austria from March 2020 to June 2020. We categorized infected individuals into presymptomatic, symptomatic unconfirmed, confirmed and never detected to observe the simulated dynamic of the detected and undetected cases. RESULTS: The calculation of the age-dependent detection probability ruled values lower than 0.4 as most likely. Furthermore, the proportion of undetected cases depends strongly on the dynamic of the epidemic wave: during the initial upswing, the undetected cases account for a major part of all infected individuals, whereas their share decreases around the peak of the confirmed cases. CONCLUSIONS: The results of prevalence studies performed to determine the detection rate of COVID-19 patients should always be interpreted with regard to the current dynamic of the epidemic wave. Applying the method proposed in our analysis, the prevalence study performed in Austria in April 2020 could indicate a detection rate of 0.13, instead of the prevalent ratio of 0.29 between detected and estimated undetected cases at that time.


Assuntos
/diagnóstico , /epidemiologia , Áustria/epidemiologia , Epidemias , Humanos , Modelos Estatísticos , Probabilidade , /isolamento & purificação , Adulto Jovem
13.
Clin Med (Lond) ; 21(1): e9-e13, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33479077

RESUMO

A cohort of the first 50 COVID-19 patients in East Tyrol, a region in the southwest of Austria, were monitored in home quarantine. Specific viral ribonucleic acid was detected in throat swabs and stool samples. Analysis indicated a median virus shedding duration of 13 days; however, statistical outliers highlight the importance of consequent testing. This underlines the need of negative throat swabs prior to removing quarantine. We monitored the disease's characteristics via an in-house score called Corona Severity Index, in order to predict an aggravation of the disease. Special attention was paid to early symptoms, such as headache, which appeared to be significantly more common in younger patients (p=0.019). Anosmia and ageusia showed a predominance in female patients (p=0.028). Investigation revealed seven relapses and viral shedding fluctuation in four cases. A follow-up examination shed light on seroconversion which could be observed in 35 of 40 participants. This further clarifies the necessity of establishing discharge standards and follow-up management for COVID-19 patients.


Assuntos
/epidemiologia , Controle de Infecções/métodos , Quarentena/estatística & dados numéricos , Adolescente , Adulto , Áustria/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Retrospectivos , Adulto Jovem
14.
Eur J Public Health ; 31(1): 44-49, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33338225

RESUMO

BACKGROUND: To halt the spread of COVID-19, Austria implemented a 7-week 'lockdown' in March/April 2020. We assess whether the ensuing reduction in social contacts led to increased loneliness among older adults (60+). METHODS: Three analyses were conducted: (i) a comparison between pre-pandemic (SHARE: 2013-17) and pandemic (May 2020) levels of loneliness (UCLA-3 scale), (ii) an assessment of the cross-sectional correlation between being affected by COVID-19 restriction measures and loneliness (May 2020) and (iii) a longitudinal analysis of weekly changes (March-June 2020) in loneliness (Corona panel). RESULTS: We found (i) increased loneliness in 2020 compared with previous years, (ii) a moderate positive association between the number of restriction measures older adults were affected from and their loneliness and (iii) that loneliness was higher during 'lockdown' compared to the subsequent re-opening phase, particularly among those who live alone. CONCLUSIONS: We found evidence that COVID-19 restriction measures in Austria have indeed resulted in increased levels of loneliness among older adults. However, these effects seem to be short-lived, and thus no strong negative consequences for older adults' mental health are expected. Nonetheless, the effects on loneliness, and subsequent mental health issues, could be both more long-lasting and severe if future restriction measures are enacted repeatedly and/or over longer time periods.


Assuntos
/prevenção & controle , Solidão/psicologia , Pandemias/prevenção & controle , Quarentena/psicologia , Isolamento Social/psicologia , Idoso , Idoso de 80 Anos ou mais , Áustria/epidemiologia , Estudos Transversais , Feminino , Humanos , Vida Independente , Masculino , Saúde Mental , Pessoa de Meia-Idade
15.
Artigo em Inglês | MEDLINE | ID: mdl-33322456

RESUMO

We determined the impact of air pollution on COVID-19-related mortality and reported-case incidence, analyzing the correlation of infection case numbers and outcomes with previous-year air pollution data from the populations of 23 Viennese districts. Time at risk started in a district when the first COVID-19 case was diagnosed. High exposure levels were defined as living in a district with an average (year 2019) concentration of nitrogen dioxide (NO2) and/or particulate matter (PM10) higher than the upper quartile (30 and 20 µg/m3, respectively) of all districts. The total population of the individual districts was followed until diagnosis of or death from COVID-19, or until 21 April 2020, whichever came first. Cox proportional hazard regression was performed after controlling for percentage of population aged 65 and more, percentage of foreigners and of persons with a university degree, unemployment rate, and population density. PM10 and NO2 were significantly and positively associated with the risk of a COVID-19 diagnosis (hazard ratio (HR) = 1.44 and 1.16, respectively). NO2 was also significantly associated with death from COVID-19 (HR = 1.72). Even within a single city, higher levels of air pollution are associated with an adverse impact on COVID-19 risk.


Assuntos
Poluição do Ar/efeitos adversos , Exposição Ambiental/efeitos adversos , Poluição do Ar/análise , Áustria/epidemiologia , Exposição Ambiental/análise , Humanos , Incidência , Dióxido de Nitrogênio/análise , Material Particulado/análise , Fatores de Tempo
16.
Artigo em Inglês | MEDLINE | ID: mdl-33333819

RESUMO

On 21 January 2019, public health authorities of two neighboring Austrian provinces reported an increase in measles cases. We investigated this occurrence to identify clusters of epidemiologically linked cases and the associated vaccination status in order to generate hypotheses on those factors explaining the size of the measles clusters. Probable cases were residents of the provinces of Styria or Salzburg with clinical presentation of measles after 1 January 2019 who were linked to a confirmed case using RNA virus detection. We collected data on age, rash onset, certificate-based vaccination status and reasons for being unvaccinated. Contact history was used to identify chains of transmission. By 11 March, we identified 47 cases, with 40 (85.1%) in unvaccinated patients. A cluster of 35 cases with a median age of seven years (IQR: 1-11) occurred between 9 January and 20 February in the province of Styria due to one transmission chain with four case generations. Of 31 vaccine-eligible cases, 25 (80.6%) were unvaccinated, of which 13 refused vaccination. Between 10 January and 1 March, we identified 12 cases as part of five unlinked clusters in the province of Salzburg. Each of these five clusters consisted of two generations: the primary case and the successive cases (median age: 22 years, IQR: 11-35). Eleven of 12 cases occurred in unvaccinated patients, with none of the 11 having a vaccination-refusing attitude. An extended measles cluster in a vaccination-refusing community, compared to five short-lived clusters concurrently occurring in the neighboring province, illustrates how vaccine refusal may hamper control of transmission.


Assuntos
Surtos de Doenças , Sarampo , Adolescente , Adulto , Áustria/epidemiologia , Criança , Humanos , Sarampo/epidemiologia , Sarampo/prevenção & controle , Saúde Pública , Vacinação , Adulto Jovem
17.
BMC Infect Dis ; 20(1): 859, 2020 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-33213360

RESUMO

BACKGROUND: Efficient control and management in the ongoing COVID-19 pandemic needs to carefully balance economical and realizable interventions. Simulation models can play a cardinal role in forecasting possible scenarios to sustain decision support. METHODS: We present a sophisticated extension of a classical SEIR model. The simulation tool CovidSIM Version 1.0 is an openly accessible web interface to interactively conduct simulations of this model. The simulation tool is used to assess the effects of various interventions, assuming parameters that reflect the situation in Austria as an example. RESULTS: Strict contact reduction including isolation of infected persons in quarantine wards and at home can substantially delay the peak of the epidemic. Home isolation of infected individuals effectively reduces the height of the peak. Contact reduction by social distancing, e.g., by curfews, sanitary behavior, etc. are also effective in delaying the epidemic peak. CONCLUSIONS: Contact-reducing mechanisms are efficient to delay the peak of the epidemic. They might also be effective in decreasing the peak number of infections depending on seasonal fluctuations in the transmissibility of the disease.


Assuntos
Infecções por Coronavirus/patologia , Pneumonia Viral/patologia , Interface Usuário-Computador , Áustria/epidemiologia , Betacoronavirus/isolamento & purificação , Simulação por Computador , Busca de Comunicante , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Humanos , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Quarentena
18.
Int J Gynecol Cancer ; 30(11): 1667-1671, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33033166

RESUMO

BACKGROUND: On March 16, 2020, the federal government of Austria declared a nationwide lockdown due to the COVID-19 pandemic. Since the lockdown, screening examinations and routine checkups have been restricted to prevent the spread of the virus and to increase the hospitals' bed capacity across the country. This resulted in a severe decline of patient referrals to the hospitals. OBJECTIVE: To assess the impact of the COVID-19 pandemic on the rate of newly diagnosed gynecological and breast cancers in Austria. METHODS: Data of 2077 patients from 18 centers in Austria with newly diagnosed gynecological or breast cancer between January and May 2019 and January and May 2020 were collected. Clinical parameters, including symptoms, performance status, co-morbidities, and referral status, were compared between the time before and after the COVID-19 outbreak. RESULTS: Our results showed a slight increase of newly diagnosed cancers in January and February 2020 as compared with 2019 (+2 and +35%, respectively) and a strong decline in newly diagnosed tumors since the lockdown: -24% in March 2020 versus March 2019, -49% in April 2020 versus April 2019, -49% in May 2020 versus May 2019. Two-thirds of patients diagnosed during the pandemic presented with tumor-specific symptoms compared with less than 50% before the pandemic (p<0.001). Moreover, almost 50% of patients in 2020 had no co-morbidities compared with 35% in 2019 (p<0.001). Patients, who already had a malignant disease, were rarely diagnosed with a new cancer in 2020 as compared with 2019 (11% vs 6%; p<0.001). CONCLUSIONS: The lockdown led to a decreased number of newly diagnosed gynecological and breast cancers. The decreased accessibility of the medical services and postponed diagnosis of potentially curable cancers during the COVID-19 pandemic may be a step backwards in our healthcare system and might impair cancer treatment outcomes. Therefore, new strategies to manage early cancer detection are needed to optimize cancer care in a time of pandemic in the future.


Assuntos
Neoplasias da Mama/epidemiologia , Infecções por Coronavirus , Neoplasias dos Genitais Femininos/epidemiologia , Pandemias , Pneumonia Viral , Adulto , Idoso , Idoso de 80 Anos ou mais , Áustria/epidemiologia , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/terapia , Feminino , Neoplasias dos Genitais Femininos/diagnóstico , Neoplasias dos Genitais Femininos/terapia , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
19.
Medicine (Baltimore) ; 99(40): e22623, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019485

RESUMO

PURPOSE: To identify the 100 most cited research articles on cervical cancer radiotherapy. METHODS: The Web of Science and Scopus databases were searched to identify the 100 most cited articles on cervical cancer radiotherapy as of September 29, 2019. Articles were ranked based on the total citations received from 2 databases. One hundred articles about radiotherapy for cervical cancer were identified. The following important information was extracted: author, journal, year and month of publication, country or region, and radiotherapy technologies. RESULTS: The 100 most cited articles on cervical cancer radiotherapy were published between 1964 and 2016, and the total citations from 2 databases ranged from 3478 to 211, including a total of 49,262 citations as of September 29, 2019. The index of citations per year ranged from 170.4 to 13.1. These articles were from 16 countries or regions, with most publications being from the United States (n = 38), followed by Austria (n = 15), Canada (n = 8), France (n = 8) and the United Kingdom (n = 7). The International Journal of Radiation Oncology, Biology, Physics produced the most articles (n = 42), followed by Radiotherapy and Oncology (n = 13), Cancer (n = 8) and Journal of Clinical Oncology (n = 7). These articles were categorized as original studies (n = 86), recommendations (n = 5), guidelines (n = 5) and reviews (n = 4). Of the 100 most cited articles, intracavitary brachytherapy (n = 50) and 3-dimensional conformal radiotherapy (n = 34) were the most commonly used treatment techniques. CONCLUSION: To the best of our knowledge, this is the first report and analysis of the most cited articles on cervical cancer radiotherapy. This bibliographic study presents the history of technological development in external radiation therapy and brachytherapy. Brachytherapy is an indispensable part of radiotherapy for cervical cancer. The International Journal of Radiation Oncology Biology Physics is the journal with the most publications related to cervical cancer radiotherapy.


Assuntos
Braquiterapia/métodos , Publicações/estatística & dados numéricos , Neoplasias do Colo do Útero/radioterapia , Áustria/epidemiologia , Bibliometria , Biologia/estatística & dados numéricos , Canadá/epidemiologia , Bases de Dados Factuais , Feminino , França/epidemiologia , Humanos , Oncologia/estatística & dados numéricos , Pessoa de Meia-Idade , Física/estatística & dados numéricos , Publicações/tendências , Radioterapia (Especialidade)/estatística & dados numéricos , Reino Unido/epidemiologia , Estados Unidos/epidemiologia
20.
Gesundheitswesen ; 82(11): 885-889, 2020 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-32977345

RESUMO

BACKGROUND: Despite considerable progress in the fight against tuberculosis, it is still the most deadly bacterial infectious disease worldwide. Every year, up to 10 million people worldwide still die of tuberculosis. The World Health Assembly has set itself the goal of reducing the number of tuberculosis deaths by 90% and the number of new infections by 80% by 2030. Prevention and infection control measures in public health facilities and wherever the risk of transmission of the tuberculosis bacterium "Mycobacterium tuberculosis" is high are especially important. OBJECTIVE: The aim of the guideline is to provide updated and evidence-based recommendations for public health measures to prevent the spread of the tuberculosis bacterium in clinical settings and in tuberculosis management. METHODOLOGY: The World Health Organization (WHO) developed these recommendations according to the methods outlined in the WHO handbook for guideline development. This publication is a summary of the most important aspects of this guideline translated into German by members of the WHO Collaborating Centre at the Danube University Krems (Austria). RESULTS: This guideline takes into account the current evidence base and provides recommendations and comments on the implementation of tuberculosis prevention and control measures at the level of health care institutions and at the national level.


Assuntos
Tuberculose , Áustria/epidemiologia , Alemanha/epidemiologia , Humanos , Controle de Infecções , Tuberculose/epidemiologia , Tuberculose/prevenção & controle , Organização Mundial da Saúde
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