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1.
Eur Respir Rev ; 29(157)2020 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-33020069

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome-coronavirus-2. Consensus suggestions can standardise care, thereby improving outcomes and facilitating future research. METHODS: An International Task Force was composed and agreement regarding courses of action was measured using the Convergence of Opinion on Recommendations and Evidence (CORE) process. 70% agreement was necessary to make a consensus suggestion. RESULTS: The Task Force made consensus suggestions to treat patients with acute COVID-19 pneumonia with remdesivir and dexamethasone but suggested against hydroxychloroquine except in the context of a clinical trial; these are revisions of prior suggestions resulting from the interim publication of several randomised trials. It also suggested that COVID-19 patients with a venous thromboembolic event be treated with therapeutic anticoagulant therapy for 3 months. The Task Force was unable to reach sufficient agreement to yield consensus suggestions for the post-hospital care of COVID-19 survivors. The Task Force fell one vote shy of suggesting routine screening for depression, anxiety and post-traumatic stress disorder. CONCLUSIONS: The Task Force addressed questions related to pharmacotherapy in patients with COVID-19 and the post-hospital care of survivors, yielding several consensus suggestions. Management options for which there is insufficient agreement to formulate a suggestion represent research priorities.


Assuntos
Comitês Consultivos/organização & administração , Betacoronavirus , Consenso , Infecções por Coronavirus/epidemiologia , Cooperação Internacional , Pneumonia Viral/epidemiologia , Pneumologia/normas , Sociedades Médicas , Europa (Continente) , Humanos , Pandemias , Estados Unidos
2.
Drugs Today (Barc) ; 56(9): 609-614, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33025954

RESUMO

The Drug Information Association (DIA) Europe 2020 brought together multiple stakeholders from around the world including regulatory agencies, industry, patients and academia, to discuss the most innovative topics in healthcare. Main subjects covered were regulatory science, data and data standards, clinical safety and pharmacovigilance, translational medicines and science, patient engagement in clinical development, value and access, medical affairs and scientific communication, health policy, and public affairs and legal issues. The meeting, which was initially intended to take place in Brussels, was finally held virtually due to the COVID-19 situation. This report covers some of the sessions held on these 5 days of state-of-the-art topic discussions.


Assuntos
Participação do Paciente , Farmacovigilância , Pesquisa Médica Translacional , Congressos como Assunto , Infecções por Coronavirus , Europa (Continente) , Humanos , Pandemias , Segurança do Paciente , Pneumonia Viral
3.
Artigo em Inglês | MEDLINE | ID: mdl-33007942

RESUMO

Human consumption and activity are damaging the global ecosystem and the resources on which we rely for health, well-being and survival. The COVID-19 crisis is yet another manifestation of the urgent need to transition to more sustainable societies, further exposing the weaknesses in health systems and the injustice in our societies. It also underlines that many of the factors leading to environmental degradation, ill health and social and health inequities are interlinked. The current situation provides an unprecedented opportunity to invest in initiatives that address these common factors and encourage people to live more healthily and sustainably. Such initiatives can generate the positive feedback loops needed to change the systems and structures that shape our lives. INHERIT (January 2016-December 2019), an ambitious, multisectoral and transnational research project that involved 18 organisations across Europe, funded by the European Commission, explored such solutions. It identified, defined and analysed promising inter-sectoral policies, practices and approaches to simultaneously promote environmental sustainability, protect and promote health and contribute to health equity (the INHERIT "triple-win") and that can encourage and enable people to live, move and consume more healthfully and sustainably. It also explored the facilitators and barriers to working across sectors and in public private cooperation. The insights were brought together in guidelines setting out how policy makers can help instigate and support local "triple-win" initiatives that influence behaviours as an approach to contributing to the change that is so urgently needed to stem environmental degradation and the interlinked threats to health and wellbeing. This article sets out this guidance, providing timely insights on how to "build back better" in the post pandemic era.


Assuntos
Conservação dos Recursos Naturais , Estilo de Vida , Desenvolvimento Sustentável , Infecções por Coronavirus , Europa (Continente) , Humanos , Pandemias , Pneumonia Viral
4.
Curr Atheroscler Rep ; 22(12): 72, 2020 10 03.
Artigo em Inglês | MEDLINE | ID: mdl-33009957

RESUMO

PURPOSE OF REVIEW: The review highlights selected studies related to cardiovascular disease (CVD) prevention that were presented at the 2020 European Society of Cardiology (ESC) Congress-The Digital Experience. RECENT FINDINGS: The studies reviewed include clinical trials on novel RNA interference-based lipid-lowering therapies AKCEA-APOCIII-LRx and vupanorsen (AKCEA-ANGPTL3-LRx); the EVAPORATE trial assessing the effects of icosapent ethyl on coronary plaque volume progression; the LoDoCo2 trial evaluating the efficacy of low-dose colchicine in cardiovascular disease risk reduction among patients with chronic coronary artery disease; as well as the EMPEROR-Reduced trial evaluating cardiovascular and renal outcomes with empagliflozin in patients with heart failure and reduced ejection fraction. In addition, we review the BPLTTC analysis on blood pressure treatment across blood pressure levels and CVD status and discuss findings from the BRACE CORONA study that examined continuing versus suspending angiotensin-converting enzyme inhibitor or angiotensin receptor blockers in patients on these antihypertensive medications who were hospitalized with COVID-19 infection. The studies presented at the 2020 digital ESC Congress highlight the continuing advancements in the field of CVD prevention.


Assuntos
Betacoronavirus/fisiologia , Cardiologia , Fármacos Cardiovasculares/farmacologia , Doenças Cardiovasculares , Infecções por Coronavirus , Reguladores do Metabolismo de Lipídeos/farmacologia , Pandemias , Pneumonia Viral , Compostos Benzidrílicos/farmacologia , Cardiologia/métodos , Cardiologia/tendências , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/prevenção & controle , Ensaios Clínicos como Assunto , Congressos como Assunto , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Ácido Eicosapentaenoico/análogos & derivados , Ácido Eicosapentaenoico/farmacologia , Europa (Continente) , Glucosídeos/farmacologia , Humanos , Oligonucleotídeos/farmacologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Sociedades Médicas , Telecomunicações
5.
Oecologia ; 194(1-2): 75-86, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33025265

RESUMO

Behavioural plasticity during habitat selection plays a key role in determining whether organisms may thrive under human-induced rapid environmental changes. As organisms rely on environmental cues to make decisions, these behavioural responses may be maladaptive. We studied the European stonechat Saxicola torquatus as a model open-habitat bird species breeding in three structurally different land-use types generated by agriculture and forestry activities. In this mosaic landscape, we compared the relative attractiveness and the breeding habitat quality of intensive grassland, Christmas tree plantations and clear-cut patches in plantation forests to test whether habitat selection was adaptive. We examined the settlement pattern of territorial males to evaluate habitat preference. We recorded key parameters reflecting reproductive performances, adult and first-year survival to estimate the individual fitness of the birds and assess the quality of the different land-use types for breeding. Stonechats preferentially settled in clear-cut patches, but their fitness was not found to be markedly different in comparison with the other occupied habitats. Although they produced slightly lower-quality offspring in clear-cut patches, we did not find a negative consequence on first-year survival probabilities or any among-habitat differences in adult survival. With our analysis integrating multiple components of individual fitness, we show that all occupied land-use types are similarly rewarding for the breeding stonechats. Our study shows that some species can benefit from novel land-use types emerging in the landscape as a result of human activities. Flexible habitat selection in the stonechat has most probably contributed to its recent population increase in Western Europe.


Assuntos
Passeriformes , Aves Canoras , Animais , Ecossistema , Europa (Continente) , Humanos , Masculino , Reprodução
6.
JAMA Netw Open ; 3(10): e2024191, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33026453

RESUMO

Importance: In late December 2019, an outbreak of a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China. Data on the routes of transmission to Los Angeles, California, the US West Coast epicenter for coronavirus disease 2019 (COVID-19), and subsequent community spread are limited. Objective: To determine the transmission routes of SARS-CoV-2 to Southern California and elucidate local community spread within the Los Angeles metropolitan area. Design, Setting, and Participants: This case series included 192 consecutive patients with reverse transcription-polymerase chain reaction (RT-PCR) test results positive for SARS-CoV-2 who were evaluated at Cedars-Sinai Medical Center in Los Angeles, California, from March 22 to April 15, 2020. Data analysis was performed from April to May 2020. Main Outcomes and Measures: SARS-CoV-2 viral genomes were sequenced. Los Angeles isolates were compared with genomes from global subsampling and from New York, New York; Washington state; and China to determine potential sources of viral dissemination. Demographic data and outcomes were collected. Results: The cohort included 192 patients (median [interquartile range] age, 59.5 [43-75] years; 110 [57.3%] men). The genetic characterization of SARS-CoV-2 isolates in the Los Angeles population pinpointed community transmission of 13 patients within a 3.81 km2 radius. Variation landscapes of this case series also revealed a cluster of 10 patients that contained 5 residents at a skilled nursing facility, 1 resident of a nearby skilled nursing facility, 3 health care workers, and a family member of a resident of one of the skilled nursing facilities. Person-to-person transmission was detected in a cluster of 5 patients who shared the same single-nucleotide variation in their SARS-CoV-2 genomes. High viral genomic diversity was identified: 20 Los Angeles isolates (15.0%) resembled SARS-CoV-2 genomes from Asia, while 109 Los Angeles isolates (82.0%) were similar to isolates originating from Europe. Analysis of other common respiratory viral pathogens did not reveal coinfection in the cohort. Conclusions and Relevance: These findings highlight the precision of detecting person-to-person transmission and accurate contact tracing directly through SARS-CoV-2 genome isolation and sequencing. Development and application of phylogenetic analyses from the Los Angeles population established connections between COVID-19 clusters locally and throughout the US.


Assuntos
Betacoronavirus/genética , Infecções por Coronavirus/transmissão , Genoma Viral/genética , Pneumonia Viral/transmissão , Adulto , Idoso , Ásia , California/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Europa (Continente) , Feminino , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Los Angeles/epidemiologia , Masculino , Pessoa de Meia-Idade , Cidade de Nova Iorque , Pandemias , Filogenia , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Análise de Sequência de RNA , Proteínas não Estruturais Virais/genética , Washington
7.
BMC Infect Dis ; 20(1): 728, 2020 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-33028235

RESUMO

BACKGROUND: Late presentation (LP), defined as a CD4 count < 350/mm3 or an AIDS-event at HIV-diagnosis, remains a significant problem across Europe. Linking cohort and surveillance data, we assessed the country-specific burden of LP during 2010-2016 and the occurrence of new AIDS events or deaths within 12 months of HIV-diagnosis believed to be attributable to LP. METHODS: Country-specific percentages of LP and AIDS-events/death rates (assessed with Poisson regression) observed in The Collaboration of Observational HIV Epidemiological Research Europe (COHERE) and EuroSIDA cohorts, were applied to new HIV-diagnoses reported to the European Centre for Disease Prevention and Control. The estimated number of LP in the whole population was then calculated, as was the number of excess AIDS-events/deaths in the first 12 months following HIV-diagnosis assumed to be attributable to LP (difference in estimated events between LP and non-LP). RESULTS: Thirty-nine thousand two hundred four persons were included from the COHERE and EuroSIDA cohorts, of whom 18,967 (48.4%; 95% Confidence Interval [CI] 47.9-48.9) were classified as LP, ranging from 36.9% in Estonia (95%CI 25.2-48.7) and Ukraine (95%CI 30.0-43.8) to 64.2% in Poland (95%CI 57.2-71.3). We estimated a total of > 320,000 LP and 12,050 new AIDS-events/deaths attributable to LP during 2010-2016, with the highest estimated numbers of LP and excess AIDS-events/deaths in Eastern Europe. Country-level estimates of excess events ranged from 17 AIDS-events/deaths (95%CI 0-533) in Denmark to 10,357 (95%CI 7768-147,448) in Russia. CONCLUSIONS: Across countries in Europe, the burden of LP was high, with the highest estimated number of LP and excess AIDS-events/deaths being in Eastern Europe. Effective strategies are needed to reduce LP and the attributable morbidity and mortality that could be potentially avoided.


Assuntos
Infecções por HIV/diagnóstico , Adulto , Contagem de Linfócito CD4 , Estudos de Coortes , Diagnóstico Tardio , Europa (Continente)/epidemiologia , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/mortalidade , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Morbidade , Análise de Sobrevida
8.
Psychiatr Danub ; 32(Suppl 3): 386-395, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33030459

RESUMO

The use of violence and aggression on civilians during the war has become one of the most prominent military events of the 20th and 21st centuries, resulting in an increasing number of refugees and displaced persons in the midst of regional and tribal conflicts. We are witnessing a daily increase in the number of migrants when people are fleeing from their homes because of human rights violations, persecution, poverty, and conflict. When found in "host" countries, they often encounter bad conditions, with uncertainty and instability. Many come to Europe in search of economic and personal opportunities for progress, where they face different types of process of acculturation. 'Place loss', acute and chronic trauma, family disorders, and family reunification issues became more and more important issues. Refugees, asylum seekers and irregular migrants have a higher risk for certain mental health disorders, including posttraumatic stress, depression and psychosis. In addition to being exposed to various risk factors for mental disorders, migrants often face barriers to access to adequate health care to address these issues. Some of the biggest challenges for migrant populations within "host" countries include: lack of knowledge of health care rights and health systems; poor knowledge of the language; different belief systems and cultural expectations of health care; and the general lack of trust in experts and in government. The rates of depressive and anxiety disorders usually increase over time, and poor mental health is associated with poor socioeconomic conditions - particularly with social isolation and unemployment. Acculturative stress often implies a high discrepancy in the acculturation between parents and their children. This dislocation of families in new conditions has been caused by the different degrees of acceptance of "new culture" by children and parents, which causes serious difficulties, especially in bilingual terms.


Assuntos
Aculturação , Saúde Mental/estatística & dados numéricos , Refugiados , Migrantes , Transtornos de Ansiedade/epidemiologia , Transtorno Depressivo/epidemiologia , Europa (Continente) , Humanos , Refugiados/psicologia , Refugiados/estatística & dados numéricos , Migrantes/psicologia , Migrantes/estatística & dados numéricos
10.
Epidemiol Infect ; 148: e209, 2020 09 11.
Artigo em Inglês | MEDLINE | ID: mdl-32912363

RESUMO

Ecologic studies investigating COVID-19 mortality determinants, used to make predictions and design public health control measures, generally focused on population-based variable counterparts of individual-based risk factors. Influenza is not causally associated with COVID-19, but shares population-based determinants, such as similar incidence/mortality trends, transmission patterns, efficacy of non-pharmaceutical interventions, comorbidities and underdiagnosis. We investigated the ecologic association between influenza mortality rates and COVID-19 mortality rates in the European context. We considered the 3-year average influenza (2014-2016) and COVID-19 (31 May 2020) crude mortality rates in 34 countries using EUROSTAT and ECDC databases and performed correlation and regression analyses. The two variables - log transformed, showed significant Spearman's correlation ρ = 0.439 (P = 0.01), and regression coefficients, b = 0.743 (95% confidence interval, 0.272-1.214; R2 = 0.244; P = 0.003), b = 0.472 (95% confidence interval, 0.067-0.878; R2 = 0.549; P = 0.02), unadjusted and adjusted for confounders (population size and cardiovascular disease mortality), respectively. Common significant determinants of both COVID-19 and influenza mortality rates were life expectancy, influenza vaccination in the elderly (direct associations), number of hospital beds per population unit and crude cardiovascular disease mortality rate (inverse associations). This analysis suggests that influenza mortality rates were independently associated with COVID-19 mortality rates in Europe, with implications for public health preparedness, and implies preliminary undetected SARS-CoV-2 spread in Europe.


Assuntos
Betacoronavirus , Infecções por Coronavirus/mortalidade , Influenza Humana/mortalidade , Pneumonia Viral/mortalidade , Ecologia , Europa (Continente)/epidemiologia , Humanos , Pandemias
11.
Scand J Trauma Resusc Emerg Med ; 28(1): 94, 2020 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-32962739

RESUMO

BACKGROUND: COVID-19, the pandemic caused by the severe acute respiratory syndrome coronavirus-2, is challenging healthcare systems worldwide. Little is known about problems faced by emergency medical services-particularly helicopter services-caring for suspected or confirmed COVID-19 patients. We aimed to describe the issues faced by air ambulance services in Europe as they transport potential COVID-19 patients. METHODS: Nine different HEMS providers in seven different countries across Europe were invited to share their experiences and to report their data regarding the care, transport, and safety measures in suspected or confirmed COVID-19 missions. Six air ambulance providers in six countries agreed and reported their data regarding development of special procedures and safety instructions in preparation for the COVID-19 pandemic. Four providers agreed to provide mission related data. Three hundred eighty-five COVID-19-related missions were analysed, including 119 primary transport missions and 266 interfacility transport missions. RESULTS: All providers had developed special procedures and safety instructions in preparation for COVID-19. Ground transport was the preferred mode of transport in primary missions, whereas air transport was preferred for interfacility transport. In some countries the transport of COVID-19 patients by regular air ambulance services was avoided. Patients in interfacility transport missions had a significantly higher median (range) NACA Score 4 (2-5) compared with 3 (1-7), needed significantly more medical interventions, were significantly younger (59.6 ± 16 vs 65 ± 21 years), and were significantly more often male (73% vs 60.5%). CONCLUSIONS: All participating air ambulance providers were prepared for COVID-19. Safe care and transport of suspected or confirmed COVID-19 patients is achievable. Most patients on primary missions were transported by ground. These patients were less sick than interfacility transport patients, for whom air transport was the preferred method.


Assuntos
Resgate Aéreo/organização & administração , Betacoronavirus , Infecções por Coronavirus/terapia , Serviço Hospitalar de Emergência/organização & administração , Pandemias , Pneumonia Viral/terapia , Transporte de Pacientes/métodos , Infecções por Coronavirus/epidemiologia , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Estudos Retrospectivos
12.
Eur Rev Med Pharmacol Sci ; 24(17): 9216-9225, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32965017

RESUMO

OBJECTIVE: The weather allied conditions have an impact on air, water, soil, food, ecosystem, feelings, behaviors, and pattern of health and disease. The present study aims to investigate the impact of heat and humidity on the daily basis incidence and mortality due to COVID-19 pandemic in European countries. MATERIALS AND METHODS: We selected 10 European countries, Russia, United Kingdom, Spain, Italy, Germany, Turkey, France, Belgium, Netherlands and Belarus. This region has a relatively low temperature and high humidity, and has homogenous European ethnicity with almost similar socioeconomic culture and health care system. The data on COVID-19 pandemic including daily new cases and new deaths were recorded from World Health Organization (WHO). The information on daily temperature and humidity was obtained from world climate web "Time and Date". The daily cases, deaths, temperature and humidity were recorded from the date of appearance of first case of "Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)" in the European region, from Jan 27, 2020 to July 17, 2020. RESULTS: In 10 European countries, (Russia, United Kingdom, Spain, Italy, Germany, Turkey, France, Belgium, Netherlands and Belarus), the daily basis mean temperature from Jan 27, 2020 to July 17, 2020 was 17.07±0.18°C, and humidity was 54.78±0.47%. The overall results revealed a significant inverse correlation between humidity and the number of cases (r= -0.134, p<0.001) and deaths (r= -0.126, p<0.001). Moreover, an increase in temperature was linked with an increase in the number of cases (r=0.062, p=0.013) and deaths (r=0.118, p<0.001). The regression analysis results further revealed that with an increase of 1% humidity the number of cases (ß = -15.90, p<0.001) and deaths (ß=-1.56, p<0.001) reduced significantly. Whereas, with an increase of 1°C in temperature the number of cases (ß = 20.65, p<0.001) and deaths (ß = 3.71, p<0.001) increased significantly. CONCLUSIONS: Increase in relative humidity was associated with a decrease in the number of daily cases and deaths, however, a rise in temperature was allied with an upsurge in the number of daily cases and daily deaths due to COVID-19 pandemic in European countries. The study findings on weather events and COVID-19 pandemic have an impact at European regional levels to project the incidence and mortality trends with regional weather events to enhance public health readiness and assist in planning to fight against this pandemic situation.


Assuntos
Infecções por Coronavirus/mortalidade , Pneumonia Viral/mortalidade , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Europa (Continente)/epidemiologia , Humanos , Umidade , Incidência , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Análise de Regressão , Taxa de Sobrevida , Temperatura
13.
Tumour Biol ; 42(9): 1010428320958603, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32964798

RESUMO

This study aimed to investigate whether changes in progastrin-releasing peptide (ProGRP) levels correlate with treatment response and can be used to optimize clinical management of patients with small-cell lung cancer. Patients with small-cell lung cancer (any stage) receiving chemotherapy were eligible. ProGRP was measured in serum/plasma at baseline and after each chemotherapy cycle using the Elecsys® ProGRP assay (Roche Diagnostics). Treatment response was assessed by computed tomography scan. The primary objective was to examine whether changes in ProGRP levels correlated with computed tomography scan results after two cycles of chemotherapy. The prognostic value of ProGRP among patients receiving first-line chemotherapy was also assessed. Overall, 261 patients from six centers were eligible. Among patients with elevated baseline ProGRP (>100 pg/mL), a ProGRP decline after Cycle 2 was associated with nonprogression (area under the curve: 84%; 95% confidence interval: 72.8-95.1; n = 141). ProGRP changes from baseline to end of Cycle 1 were predictive of response, as determined by computed tomography scan 3 weeks later (area under the curve: 87%; 95% confidence interval: 74.1-99.2; n = 137). This was enhanced by repeat measurements, with a 92% area under the curve (95% confidence interval: 85.3-97.8) among patients with ProGRP data after both Cycles 1 and 2 (n = 123); if a patient experienced a ≥25% decline in ProGRP after Cycle 1, and ProGRP remained stable or decreased after Cycle 2, the probability of finding progression on the interim computed tomography scan at the end of Cycle 2 was almost zero (sensitivity: 100%, specificity: 71%). Both ProGRP levels at baseline and at the end of first-line chemotherapy were prognostic; the latter provided a moderately improved hazard ratio of 2.43 (95% confidence interval: 1.33-4.46; n = 110) versus 1.87 (95% confidence interval: 1.04-3.37; n = 216). In summary, for patients with small-cell lung cancer and elevated baseline ProGRP levels, ProGRP may be a simple, reliable, and repeatable tool for monitoring response to chemotherapy and provide valuable prognostic information.


Assuntos
Neoplasias Pulmonares/sangue , Fragmentos de Peptídeos/sangue , Carcinoma de Pequenas Células do Pulmão/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Biomarcadores Tumorais/sangue , China , Europa (Continente) , Feminino , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Prognóstico , Proteínas Recombinantes/sangue , Sensibilidade e Especificidade , Carcinoma de Pequenas Células do Pulmão/diagnóstico por imagem , Carcinoma de Pequenas Células do Pulmão/tratamento farmacológico , Tomografia Computadorizada por Raios X
15.
Environ Monit Assess ; 192(9): 615, 2020 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-32876774

RESUMO

Pesticides are not only used on food but also on non-food crops, such as tobacco, to control a range of unwanted animal, plant, and microbial, fungal pests. The residue levels in tobacco leaves are expected to decline up to harvest, during drying, and when the leaves are further processed. Additional pesticides may also be applied to the finished product and residue levels may remain present even when the tobacco is burned. Human exposure to pesticide residues on tobacco occurs when residues remaining in cigarette smoke are inhaled. Based on this assumption, the objectives of this research were (i) to determine the level of pesticides residues in harvested tobacco leaves and (ii) to assess the risk of human exposure to these residues in tobacco smoke. Pesticide residues were detected in all analysed tobacco samples. These detected residues represent ten different active ingredients (AI), three of these AIs (thiodicarb, alachlor, and endosulfan) are no longer allowed in Europe. A 54.7% of these residues were quantifiable. Furthermore, it was found that with the use of solid-phase extraction sorbent (SPE) as adsorbent and n-hexane as solvent, higher recoveries of the pesticide residues in the tobacco smoke from the amount spiked can be obtained. It was also found that cigarette filters help to reduce the intake of residues of pesticides that may be present in cigarettes. Finally, the study concluded that both active smoking and passive smoking populations are exposed to pesticide residues in the tobacco smoke.


Assuntos
Resíduos de Praguicidas/análise , Praguicidas/análise , Poluição por Fumaça de Tabaco , Monitoramento Ambiental , Europa (Continente) , Humanos , Medição de Risco , Fumaça/análise , Tabaco
16.
Eur J Paediatr Dent ; 21(3): 172, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32893645

RESUMO

The European Journal of Paediatric Dentistry (EJPD) has reached the extraordinary Impact Factor of 1.5 (Journal Citation Reports 2020 Release), passing in few years from 0.421 in 2015, when Luigi Paglia became Editor in Chief, taking over the Journal after Giuliano Falcolini. EJPD is the official journal of the Italian Society of Paediatric Dentistry (SIOI), but its scientific value and diffusion made it an authoritative reference source not only in Europe, but also worldwide. This is the result of the great work and commitment of the Editorial Board, composed by national and international experts, with the collaboration of the Managing Director Giuseppe Marzo and of the editorial staff. The prominent position that EJPD has gained in the international ranking of dental journals, where the top tier is dominated by those that mainly focus on adult patients, rewards its constant pursue of excellence of the scientific approach, giving at the same time great importance to articles dealing with everyday practice. This is the reason why the papers published in the EJPD are so rich in images. Communication through images is paramount for the current generation and generations to come. Digital diagnostic instruments and advanced treatments, 3D technologies, the current concepts of aerosol and no aerosol technique, together with the progress in the field of new dental materials, like bioactive cements for paediatric restorations or new biocompatible technopolymers (milled or 3D printed) for dentofacial orthopaedics and orthodontics are areas of great interest. We believe that our Journal should pay special attention to papers that take into account the overall health and wellness of the child using safe and efficient preventive, therapeutic or comfort techniques (laser, ozone, relative analgesia, caries diagnosis with transillumination, etc), also considering the importance of environmental conditions and promoting the collaboration with other specialists, with a focus on special need patients. EJPD also aims at guiding young paediatric dentists-graduating from postgraduate schools and residency programmes in paediatric dentistry-with a more comprehensive approach to the practical aspects of the profession, while striving to become the global scientific reference point of maternal and child oral care, defending them from the attractive flatteries of the predatory journals.


Assuntos
Fator de Impacto de Revistas , Odontopediatria , Criança , Europa (Continente) , Humanos , Itália
17.
Adv Exp Med Biol ; 1268: 123-139, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32918216

RESUMO

Melanoma and keratinocyte skin cancer (KSC) are the most common types of cancer in White-skinned populations. Both tumor entities showed increasing incidence rates worldwide but stable or decreasing mortality rates. Rising incidence rates of cutaneous melanoma (CM) and KSC are largely attributed to increasing exposure to ultraviolet (UV) radiation, the main causal risk factor for skin cancer.Incidence rates of KSC, comprising of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), are much higher than that of melanoma. BCC development is mainly the cause of an intensive UV exposure in childhood and adolescence, while SCC development is related to chronic, cumulative UV exposure over decades. Although mortality is relatively low, KSC is an increasing problem for health care services causing significant morbidity.Cutaneous melanoma is rapidly increasing in White populations, with an estimated annual increase of around 3-7% over the past decades. In contrast to SCC, melanoma risk is associated with intermittent and chronic exposure to sunlight. The frequency of its occurrence is closely associated with the constitutive color of the skin and the geographical zone. Changes in outdoor activities and exposure to sunlight during the past 70 years are an important factor for the increasing incidence of melanoma. Mortality rates of melanoma show stabilization in the USA, Australia, and in European countries. In the USA even dropping numbers of death cases were recently reported, probably reflecting efficacy of the new systemic treatments.Among younger cohorts in some populations (e.g., Australia and New Zealand,), stabilizing or declining incidence rates of CM are observed, potentially caused by primary prevention campaigns aimed at reducing UV exposure. In contrast, incidence rates of CM are still rising in most European countries and in the USA. Ongoing trends towards thinner melanoma are largely ascribed to earlier detection.


Assuntos
Neoplasias Cutâneas/epidemiologia , Austrália/epidemiologia , Europa (Continente)/epidemiologia , Humanos , Incidência , Melanoma/epidemiologia , Neoplasias Induzidas por Radiação/epidemiologia , Nova Zelândia/epidemiologia , Estados Unidos/epidemiologia
18.
Clin Imaging ; 67: 219-225, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32871426

RESUMO

Since first report of a novel coronavirus in December of 2019, the Coronavirus Disease 2019 (COVID-19) pandemic has crippled healthcare systems around the world. While many initial screening protocols centered around laboratory detection of the virus, early testing assays were thought to be poorly sensitive in comparison to chest computed tomography, especially in asymptomatic disease. Coupled with shortages of reverse transcription polymerase chain reaction (RT-PCR) testing kits in many parts of the world, these regions instead turned to the use of advanced imaging as a first-line screening modality. However, in contrast to previous Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome coronavirus epidemics, chest X-ray has not demonstrated optimal sensitivity to be of much utility in first-line screening protocols. Though current national and international guidelines recommend for the use of RT-PCR as the primary screening tool for suspected cases of COVID-19, institutional and regional protocols must consider local availability of resources when issuing universal recommendations. Successful containment and social mitigation strategies worldwide have been thus far predicated on unified governmental responses, though the underlying ideologies of these practices may not be widely applicable in many Western nations. As the strain on the radiology workforce continues to mount, early results indicate a promising role for the use of machine-learning algorithms as risk stratification schema in the months to come.


Assuntos
Técnicas de Laboratório Clínico/métodos , Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/diagnóstico , Saúde Global , Programas de Rastreamento/métodos , Pandemias , Pneumonia Viral/diagnóstico , Ásia , Betacoronavirus , Coronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/virologia , Europa (Continente) , Humanos , América do Norte , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/virologia , Reação em Cadeia da Polimerase/métodos , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos
19.
Nat Commun ; 11(1): 4663, 2020 09 16.
Artigo em Inglês | MEDLINE | ID: mdl-32938914

RESUMO

Scientific understanding of biodiversity dynamics, resulting from past climate oscillations and projections of future changes in biodiversity, has advanced over the past decade. Little is known about how these responses, past or future, are spatially connected. Analyzing the spatial variability in biodiversity provides insight into how climate change affects the accumulation of diversity across space. Here, we evaluate the spatial variation of phylogenetic diversity of European seed plants among neighboring sites and assess the effects of past rapid climate changes during the Quaternary on these patterns. Our work shows a marked homogenization in phylogenetic diversity across Central and Northern Europe linked to high climate change velocity and large distances to refugia. Our results suggest that the future projected loss in evolutionary heritage may be even more dramatic, as homogenization in response to rapid climate change has occurred among sites across large landscapes, leaving a legacy that has lasted for millennia.


Assuntos
Filogenia , Fenômenos Fisiológicos Vegetais , Biodiversidade , Mudança Climática , Europa (Continente) , Plantas/genética , Refúgio de Vida Selvagem , Sementes
20.
Nat Commun ; 11(1): 4661, 2020 09 16.
Artigo em Inglês | MEDLINE | ID: mdl-32938925

RESUMO

The recent years have seen a growing number of studies investigating evolutionary questions using ancient DNA. To address these questions, one of the most frequently-used method is principal component analysis (PCA). When PCA is applied to temporal samples, the sample dates are, however, ignored during analysis, leading to imperfect representations of samples in PC plots. Here, we present a factor analysis (FA) method in which individual scores are corrected for the effect of allele frequency drift over time. We obtained exact solutions for the estimates of corrected factors, and we provided a fast algorithm for their computation. Using computer simulations and ancient European samples, we compared geometric representations obtained from FA with PCA and with ancestry estimation programs. In admixture analyses, FA estimates agreed with tree-based statistics, and they were more accurate than those obtained from PCA projections and from ancestry estimation programs. A great advantage of FA over existing approaches is to improve descriptive analyses of ancient DNA samples without requiring inclusion of outgroup or present-day samples.


Assuntos
DNA Antigo/análise , Análise Fatorial , Genoma Humano , Metagenômica/estatística & dados numéricos , Algoritmos , Inglaterra , Europa (Continente) , Frequência do Gene , Deriva Genética , Genética Populacional/estatística & dados numéricos , Humanos , Modelos Genéticos , Análise de Componente Principal
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