Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 20.534
Filtrar
1.
Artigo em Inglês | MEDLINE | ID: mdl-34205809

RESUMO

(1) Background: to describe the dynamic of the pandemic across 35 European countries over a period of 9 months. (2) Methods: a three-phase time series model was fitted for 35 European countries, predicting deaths based on SARS-CoV-2 incidences. Hierarchical clustering resulted in three clusters of countries. A multiple regression model was developed predicting thresholds for COVID-19 incidences, coupled to death numbers. (3) Results: The model showed strongly connected deaths and incidences during the waves in spring and fall. The corrected case-fatality rates ranged from 2% to 20.7% in the first wave, and from 0.5% to 4.2% in the second wave. If the incidences stay below a threshold, predicted by the regression model (R2=85.0%), COVID-19 related deaths and incidences were not necessarily coupled. The clusters represented different regions in Europe, and the corrected case-fatality rates in each cluster flipped from high to low or vice versa. Severely and less severely affected countries flipped between the first and second wave. (4) Conclusions: COVID-19 incidences and related deaths were uncoupled during the summer but coupled during two waves. Once a country-specific threshold of infections is reached, death numbers will start to rise, allowing health care systems and countries to prepare.


Assuntos
COVID-19 , Pandemias , Europa (Continente)/epidemiologia , Humanos , Incidência , SARS-CoV-2
2.
Artigo em Inglês | MEDLINE | ID: mdl-34206293

RESUMO

An international online patient community, Carenity, conducted a patient study in two independent waves among adults affected by non-communicable diseases (NCDs) in Europe and in the United States of America (USA). The study aimed to assess the real time impact of the coronavirus disease 2019 (COVID-19) on the medical conditions of patients with NCDs, their access to health care, and their adaptation to daily life as well as to describe their sources of information on COVID-19 and their needs for specific information and support. During the pandemic, 50% of the patients reported a worsening of their medical condition, and 17% developed a new disease. Additionally, 26% of the respondents reported an impact of the pandemic on regular/long-term treatment intake. 54% of the patients felt very or completely socially isolated and reported a strong impact of the COVID-19 pandemic on their stress level and state of mind, with higher levels observed in the USA compared to Europe. 59% of the respondents wished to have received additional information regarding the risks associated to their medical condition during the pandemic. Television was the most used source of information, whereas physicians were the most trusted one. This study describes the substantial impact of the COVID-19 pandemic on NCD patients.


Assuntos
COVID-19 , Doenças não Transmissíveis , Adulto , Europa (Continente)/epidemiologia , Humanos , Doenças não Transmissíveis/epidemiologia , Pandemias , SARS-CoV-2 , Estados Unidos/epidemiologia
3.
Hematology ; 26(1): 497-502, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34238136

RESUMO

OBJECTIVES: The objective of this analysis was to assess the effectiveness and safety of romiplostim in the real-world by duration of primary immune thrombocytopenia (ITP): <3 ('newly diagnosed'), 3-12 ('persistent'), and >12 ('chronic') months. METHODS: This was a post-hoc analysis of the PLATON single-arm, observational cohort study of adults from five Central and Eastern European countries receiving ≥1 romiplostim dose as second-line therapy, or where surgery was contraindicated. Durable (≥75% of measurements with ≥50 × 109 platelets/L during weeks 14-24) and overall platelet response (≥30 or ≥50 × 109 platelets/L at least once), rescue therapy, bleeding, discontinuation of other ITP medications, and adverse drug reactions (ADRs) were assessed. RESULTS: Of 100 participants, 22.0% had newly diagnosed, 17.0% had persistent, and 61.0% had chronic ITP. Prior splenectomy was most frequently reported in chronic ITP (32.8%), prior bleeding was predominant in newly diagnosed patients (68.2%). Durable platelet response was achieved in 50.0% (95% confidence interval [CI]: 28.2-71.8%) of newly diagnosed, 35.3% (95% CI: 14.2-61.7%) of persistent, and 31.1% (95% CI: 19.9-44.3%) of chronic ITP patients. Overall platelet response was achieved in >80% across all strata. Safety was comparable across groups, with a low incidence of thrombotic ADRs and no bone marrow ADRs. DISCUSSION: In this real-world study, platelet response to romiplostim was consistent across all strata of ITP duration. ADRs were infrequent and similar across ITP settings. CONCLUSION: These findings support the utilization of romiplostim in patients with newly diagnosed and persistent ITP in accordance with recent guidelines and the recent romiplostim label extension.


Assuntos
Púrpura Trombocitopênica Idiopática/tratamento farmacológico , Receptores Fc/uso terapêutico , Proteínas Recombinantes de Fusão/uso terapêutico , Trombopoetina/uso terapêutico , Plaquetas/efeitos dos fármacos , Europa (Continente)/epidemiologia , Europa Oriental/epidemiologia , Humanos , Púrpura Trombocitopênica Idiopática/diagnóstico , Púrpura Trombocitopênica Idiopática/epidemiologia , Receptores de Trombopoetina/agonistas , Proteínas Recombinantes de Fusão/efeitos adversos , Trombopoetina/efeitos adversos , Resultado do Tratamento
4.
Emerg Infect Dis ; 27(8): 2017-2024, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34286689

RESUMO

Lyme disease, or Lyme borreliosis, is the most common tickborne disease in the United States and Europe. In both locations, Ixodes species ticks transmit the Borrelia burgdorferi sensu lato bacteria species responsible for causing the infection. The diversity of Borrelia species that cause human infection is greater in Europe; the 2 B. burgdorferi s.l. species collectively responsible for most infections in Europe, B. afzelii and B. garinii, are not found in the United States, where most infections are caused by B. burgdorferi sensu stricto. Strain differences seem to explain some of the variation in the clinical manifestations of Lyme disease, which are both minor and substantive, between the United States and Europe. Future studies should attempt to delineate the specific virulence factors of the different species of B. burgdorferi s.l. responsible for these variations in clinical features.


Assuntos
Grupo Borrelia Burgdorferi , Borrelia , Ixodes , Doença de Lyme , Animais , Europa (Continente)/epidemiologia , Humanos , Doença de Lyme/diagnóstico , Doença de Lyme/epidemiologia , Estados Unidos/epidemiologia
5.
J Environ Public Health ; 2021: 5582589, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34194512

RESUMO

FluMOMO is a universal formula to forecast mortality in 27 European countries and was developed on EuroMOMO context, http://www.euromomo.eu. The model has a trigonometric baseline and considers any upwards deviation from that to come from flu or extreme temperatures. To measure it, the model considers two variables: influenza activity and extreme temperatures. With the former, the model gives the number of deaths because of flu and with the latter the number of deaths because of extreme temperatures. In this article, we show that FluMOMO lacks important variables to be an accurate measure of all-cause mortality and flu mortality. Indeed, we found, as expected, that population ageing and exposure to the risk of death cannot be excluded from the linear predictor. We model weekly deaths as an autoregressive process (lag of one together with a lead of one week). This step allowed us to avoid FluMOMO trigonometric baseline and have a fit to weekly deaths through demographic variables. Our model uses data from Portugal between 2009 and 2020, on ISO-week basis. We use negative binomial-generalized linear models to estimate the weekly number of deaths as an alternative to traditional overdispersion Poisson. As explanatory variables were found to be statistically significant, we registered the number of deaths from the previous week, the influenza activity index, the population average age, the heat waves, the flu season, the number of deaths with COVID-19, and the population exposed to the risk of dying. Considering as excess mortality the number of deaths above the best estimate of deaths from our model, we conclude that excess mortality in 2020 (net of COVID-19 deaths, heat wave of July, and ageing) is low or inexistent. The model also allows us to have the number of deaths arising from flu and we conclude that FluMOMO is overestimating deaths from flu by 78%. Averages from the probability of dying are obtained as well as the probability of dying from flu. The latter is shown to be decreasing over time, probably due to the increase of flu vaccination. Higher mortality detected with the start of COVID-19, in March-April 2020, was probably due to COVID-19 deaths not recognized as COVID-19 deaths.


Assuntos
Influenza Humana/epidemiologia , Mortalidade/tendências , População , COVID-19 , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , Modelos Estatísticos , Portugal , SARS-CoV-2 , Estações do Ano , Vacinação
6.
Hum Resour Health ; 19(1): 80, 2021 07 10.
Artigo em Inglês | MEDLINE | ID: mdl-34246288

RESUMO

In the European free movement zone, various mechanisms aim to harmonize how the competence of physicians and nurses is developed and maintained to facilitate the cross-country movement of professionals. This commentary addresses these mechanisms and discusses their implications during the COVID-19 pandemic, drawing lessons for future policy. It argues that EU-wide regulatory mechanisms should be reviewed to ensure that they provide an adequate foundation for determining competence and enabling health workforce flexibility during health system shocks. Currently, EU regulation focuses on the automatic recognition of the primary education of physicians and nurses. New, flexible mechanisms should be developed for specializations, such as intensive or emergency care. Documenting new skills, such as the ones acquired during rapid training in the pandemic, in a manner that is comparable across countries should be explored, both for usual practice and in light of outbreak preparedness. Initiatives to strengthen continuing education and professional development should be supported further. Funding under the EU4Health programme should be dedicated to this endeavour, along with revisiting the scope of necessary skills following the experience of COVID-19. Mechanisms for cross-country sharing of information on violations of good practice standards should be maintained and strengthened to enable agile reactions when the need for professional mobility becomes urgent.


Assuntos
COVID-19/epidemiologia , Educação Continuada/normas , Mão de Obra em Saúde/normas , Cooperação Internacional , Competência Profissional/normas , Europa (Continente)/epidemiologia , Fidelidade a Diretrizes/normas , Humanos , Disseminação de Informação , Pandemias , SARS-CoV-2
7.
Cien Saude Colet ; 26(7): 2863-2872, 2021 Jul.
Artigo em Português, Inglês | MEDLINE | ID: mdl-34231699

RESUMO

This essay proposes a reflection on the social phenomenon that involves communication and construction of facts and narratives around science and the pandemic. We divide the text into four parts. It begins with a rapid overview on the disinformation over health in the context of the global digital integration: in the sequence, we argue about how this phenomenon is characteristic of the post-factual era in which we live, and then critically situate the denial of science in the pandemic context. Finally, the text discusses some propositions on the legal and institutional field commenting on recent advances in the United States and Europe. Our intention is to contribute to an initial reflection that can reposition science in health governance.


Assuntos
COVID-19 , Mídias Sociais , Europa (Continente)/epidemiologia , Humanos , Pandemias , SARS-CoV-2
8.
Ann Ig ; 33(5): 521-523, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34223866

RESUMO

Abstract: The differences of the epidemiology (incidence, case-to-death rate, mortality, etc) of COVID-19 between USA and Italy are analyzed taking into account the social, economic and sanitary characteristics of the two countries, both severely hit be the pandemic; and the causes of the so many different behaviors of the disease in each of them are discussed and explained.


Assuntos
COVID-19/mortalidade , Pandemias/estatística & dados numéricos , SARS-CoV-2 , COVID-19/prevenção & controle , COVID-19/terapia , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Comorbidade , Europa (Continente)/epidemiologia , Política de Saúde , Recursos em Saúde/provisão & distribuição , Humanos , Imunização Passiva , Itália/epidemiologia , Determinantes Sociais da Saúde , Estados Unidos/epidemiologia
9.
BMC Neurol ; 21(1): 276, 2021 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-34253183

RESUMO

BACKGROUND: Spasticity is present in more than 80% of the population with cerebral palsy (CP). The aim of this study was to describe and compare the use of three spasticity reducing methods; Botulinum toxin-A therapy (BTX-A), Selective dorsal rhizotomy (SDR) and Intrathecal baclofen therapy (ITB) among children and adolescents with CP in six northern European countries. METHODS: This registry-based study included population-based data in children and adolescents with CP born 2002 to 2017 and recorded in the follow-up programs for CP in Sweden, Norway, Denmark, Iceland and Scotland, and a defined cohort in Finland. RESULTS: A total of 8,817 individuals were included. The proportion of individuals treated with SDR and ITB was significantly different between the countries. SDR treatment ranged from 0% ( Finland and Iceland) to 3.4% (Scotland) and ITB treatment from 2.2% (Sweden) to 3.7% (Denmark and Scotland). BTX-A treatment in the lower extremities reported 2017-2018 ranged from 8.6% in Denmark to 20% in Norway (p < 0.01). Mean age for undergoing SDR ranged from 4.5 years in Norway to 7.3 years in Denmark (p < 0.01). Mean age at ITB surgery ranged from 6.3 years in Norway to 10.1 years in Finland (p < 0.01). Mean age for BTX-A treatment ranged from 7.1 years in Denmark to 10.3 years in Iceland (p < 0.01). Treatment with SDR was most common in Gross Motor Function Classification System (GMFCS) level III, ITB in level V, and BTX-A in level I. The most common muscle treated with BTX-A was the calf muscle, with the highest proportion in GMFCS level I. BTX-A treatment of hamstring and hip muscles was most common in GMFCS levels IV-V in all countries. CONCLUSION: There were statistically significant differences between countries regarding the proportion of children and adolescents with CP treated with the three spasticity reducing methods, mean age for treatment and treatment related to GMFCS level. This is likely due to differences in the availability of these treatment methods and/or differences in preferences of treatment methods among professionals and possibly patients across countries.


Assuntos
Baclofeno/administração & dosagem , Toxinas Botulínicas Tipo A/administração & dosagem , Paralisia Cerebral/terapia , Espasticidade Muscular/terapia , Sistema de Registros , Rizotomia/métodos , Adolescente , Paralisia Cerebral/diagnóstico , Paralisia Cerebral/epidemiologia , Criança , Pré-Escolar , Estudos de Coortes , Europa (Continente)/epidemiologia , Humanos , Injeções Espinhais/métodos , Masculino , Relaxantes Musculares Centrais/administração & dosagem , Espasticidade Muscular/diagnóstico , Espasticidade Muscular/epidemiologia , Músculo Esquelético/efeitos dos fármacos , Músculo Esquelético/patologia
10.
MMWR Morb Mortal Wkly Rep ; 70(30): 1029-1035, 2021 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-34324482

RESUMO

In 2019, an estimated 14 million persons in the World Health Organization (WHO) European Region* (EUR) were chronically infected with hepatitis B virus (HBV), and approximately 43,000 of these persons died from complications of chronic HBV infection (1). In 2016, the WHO Regional Office for Europe set hepatitis B control program targets for 2020, including 1) ≥90% coverage with 3 doses of hepatitis B vaccine (HepB3), 2) ≥90% coverage with interventions to prevent mother-to-child transmission (MTCT) of HBV,† and 3) ≤0.5% prevalence of HBV surface antigen (HBsAg)§ in age groups eligible for vaccination with hepatitis B vaccine (HepB) (2-4). This report describes the progress made toward hepatitis B control in EUR during 2016-2019. By December 2019, 50 (94%) of 53 countries in EUR provided routine vaccination with HepB to all infants or children aged 1-12 years (universal HepB), including 23 (43%) countries that offered hepatitis B birth dose (HepB-BD) to all newborns. In addition, 35 (73%) of the 48 countries with universal infant HepB vaccination reached ≥90% HepB3 coverage annually during 2017-2019, and 19 (83%) of the 23 countries with universal birth dose administration achieved ≥90% timely HepB-BD coverage¶ annually during that period. Antenatal hepatitis B screening coverage was ≥90% in 17 (57%) of 30 countries that selectively provided HepB-BD to infants born to mothers with positive HBsAg test results. In January 2020, Italy and the Netherlands became the first counties in EUR to be validated to have achieved the regional hepatitis B control targets. Countries can accelerate progress toward hepatitis B control by improving coverage with HepB and interventions to prevent MTCT and documenting achievement of the HBsAg seroprevalence target through representative serosurveys or, in low-endemicity countries, antenatal screening.


Assuntos
Hepatite B/epidemiologia , Hepatite B/prevenção & controle , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Europa (Continente)/epidemiologia , Feminino , Antígenos de Superfície da Hepatite B/sangue , Vacinas contra Hepatite B/administração & dosagem , Humanos , Esquemas de Imunização , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Profilaxia Pós-Exposição , Gravidez , Diagnóstico Pré-Natal/estatística & dados numéricos , Estudos Soroepidemiológicos , Organização Mundial da Saúde , Adulto Jovem
11.
Euro Surveill ; 26(29)2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34296672

RESUMO

Since the introduction of non-pharmacological interventions to control COVID-19, respiratory syncytial virus (RSV) activity in Europe has been limited. Surveillance data for 17 countries showed delayed RSV epidemics in France (≥ 12 w) and Iceland (≥ 4 w) during the 2020/21 season. RSV cases (predominantly small children) in France and Iceland were older compared with previous seasons. We hypothesise that future RSV epidemic(s) could start outside the usual autumn/winter season and be larger than expected. Year-round surveillance of RSV is of critical importance.


Assuntos
COVID-19 , Infecções por Vírus Respiratório Sincicial , Vírus Sincicial Respiratório Humano , Criança , Europa (Continente)/epidemiologia , França/epidemiologia , Humanos , Islândia/epidemiologia , Lactente , Infecções por Vírus Respiratório Sincicial/epidemiologia , Infecções por Vírus Respiratório Sincicial/prevenção & controle , SARS-CoV-2 , Estações do Ano
12.
BMC Public Health ; 21(1): 1207, 2021 06 24.
Artigo em Inglês | MEDLINE | ID: mdl-34162351

RESUMO

INTRODUCTION: Europe has been experiencing a flow of refugees and asylum seekers driven by conflicts or poverty. Their oral health is often neglected despite its clear impact on quality of life. OBJECTIVE: To explore the status of oral health among refugees and asylum seekers groups by examining the available literature and to determine which evidence exists regarding the problems they face in terms of oral health. METHODS: The current paper followed PRISMA guidelines. A scoping review methodology was followed to retrieve 2911 records from five databases and grey literature. Twelve articles met the following inclusion criteria: experimental research concentrated on the oral and dental health of refugees and/or asylum seekers between 1995 and 2020 in English. Analysis was both descriptive and thematic, whilst a critical appraisal was applied using the Critical Appraisal Skills Program (CASP). RESULTS: Seven studies (58,3%) were quantitative, while five studies (41,6%) were qualitative. In general, the quality of most of the studies (83.3%) was good. Limited access to oral health care services was shown with a higher prevalence of oral diseases compared to the native populations of the host countries. Approaches to improve oral health have been implemented in some studies and have shown positive outcomes. CONCLUSIONS: Oral health care strategies should consider the oral health problems facing refugees in Europe, and oral health promotion campaigns are essential to give adequate guidance on how to access oral health care in the host countries.


Assuntos
Refugiados , Europa (Continente)/epidemiologia , Acesso aos Serviços de Saúde , Humanos , Saúde Bucal , Qualidade de Vida
13.
Sci Rep ; 11(1): 13069, 2021 06 22.
Artigo em Inglês | MEDLINE | ID: mdl-34158531

RESUMO

Mobility restrictions have been identified as key non-pharmaceutical interventions to limit the spread of the SARS-COV-2 epidemics. However, these interventions present significant drawbacks to the social fabric and negative outcomes for the real economy. In this paper we propose a real-time monitoring framework for tracking the economic consequences of various forms of mobility reductions involving European countries. We adopt a granular representation of mobility patterns during both the first and second waves of SARS-COV-2 in Italy, Germany, France and Spain to provide an analytical characterization of the rate of losses of industrial production by means of a nowcasting methodology. Our approach exploits the information encoded in massive datasets of human mobility provided by Facebook and Google, which are published at higher frequencies than the target economic variables, in order to obtain an early estimate before the official data becomes available. Our results show, in first place, the ability of mobility-related policies to induce a contraction of mobility patterns across jurisdictions. Besides this contraction, we observe a substitution effect which increases mobility within jurisdictions. Secondly, we show how industrial production strictly follows the dynamics of population commuting patterns and of human mobility trends, which thus provide information on the day-by-day variations in countries' economic activities. Our work, besides shedding light on how policy interventions targeted to induce a mobility contraction impact the real economy, constitutes a practical toolbox for helping governments to design appropriate and balanced policy actions aimed at containing the SARS-COV-2 spread, while mitigating the detrimental effect on the economy. Our study reveals how complex mobility patterns can have unequal consequences to economic losses across countries and call for a more tailored implementation of restrictions to balance the containment of contagion with the need to sustain economic activities.


Assuntos
COVID-19/epidemiologia , Status Econômico , Viagem , COVID-19/patologia , COVID-19/virologia , Europa (Continente)/epidemiologia , Humanos , Pandemias , Quarentena , SARS-CoV-2/isolamento & purificação , Mídias Sociais
14.
Eur J Endocrinol ; 185(2): C1-C7, 2021 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-34132200

RESUMO

Changes that COVID-19 induced in endocrine daily practice as well as the role of endocrine and metabolic comorbidities in COVID-19 outcomes were among the striking features of this last year. The aim of this statement is to illustrate the major characteristics of the response of European endocrinologists to the pandemic including the disclosure of the endocrine phenotype of COVID-19 with diabetes, obesity and hypovitaminosis D playing a key role in this clinical setting with its huge implication for the prevention and management of the disease. The role of the European Society of Endocrinology (ESE) as a reference point of the endocrine community during the pandemic will also be highlighted, including the refocusing of its educational and advocacy activities.


Assuntos
COVID-19/epidemiologia , COVID-19/terapia , Endocrinologistas/organização & administração , Endocrinologia/organização & administração , COVID-19/complicações , COVID-19/prevenção & controle , Redes Comunitárias/organização & administração , Redes Comunitárias/tendências , Atenção à Saúde/história , Atenção à Saúde/organização & administração , Atenção à Saúde/tendências , Doenças do Sistema Endócrino/diagnóstico , Doenças do Sistema Endócrino/epidemiologia , Doenças do Sistema Endócrino/etiologia , Doenças do Sistema Endócrino/terapia , Endocrinologistas/história , Endocrinologistas/tendências , Endocrinologia/história , Endocrinologia/tendências , Europa (Continente)/epidemiologia , História do Século XXI , Humanos , Pandemias , Fenótipo , Papel do Médico , Padrões de Prática Médica/história , Padrões de Prática Médica/organização & administração , Padrões de Prática Médica/tendências , Sociedades Médicas/história , Sociedades Médicas/organização & administração , Sociedades Médicas/tendências , Telemedicina/história , Telemedicina/organização & administração , Telemedicina/tendências
15.
Eur Psychiatry ; 64(1): e41, 2021 06 09.
Artigo em Inglês | MEDLINE | ID: mdl-34103102

RESUMO

BACKGROUND: The COVID-19 pandemic caused an unprecedented worldwide crisis affecting several sectors, including health, social care, economy and society at large. The World Health Organisation has emphasized that mental health care should be considered as one of the core sectors within the overall COVID-19 health response. By March 2020, recommendations for the organization of mental health services across Europe have been developed by several national and international mental health professional associations. METHODS: The European Psychiatric Association (EPA) surveyed a large European sample of psychiatrists, namely the "EPA Ambassadors", on their clinical experience of the impact of COVID-19 pandemic on the treatment of psychiatric patients during the month of April 2020 in order to: a) identify and report the views and experiences of European psychiatrists; and b) represent and share these results with mental health policy makers at European level. Based on the recommendations issued by national psychiatric associations and on the results of our survey, we identified important organisational aspects of mental health care during the peak of the first wave of the COVID-19. RESULTS: While most of the recommendations followed the same principles, significant differences between countries emerged in service delivery, mainly relating to referrals to outpatients and for inpatient admission, assessments and treatment for people with mental disorders. Compared to previous months, the mean number of patients treated by psychiatrists in outpatient settings halved in April 2020. In the same period, the number of mentally ill patients tested for, or developing, COVID-19 was low. In most of countries, traditional face-to-face visits were replaced by online remote consultations. CONCLUSIONS: Based on our findings we recommend: 1) to implement professional guidelines into practice and harmonize psychiatric clinical practice across Europe; 2) to monitor the treatment outcomes of patients with COVID-19 and pre-existing mental disorders; 3) to keep psychiatric services active by using all available options (for example telepsychiatry); 4) to increase communication and cooperation between different health care providers.


Assuntos
COVID-19/psicologia , Transtornos Mentais/terapia , Serviços de Saúde Mental/organização & administração , Pandemias , Adulto , COVID-19/epidemiologia , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psiquiatria/estatística & dados numéricos , Sociedades Médicas , Inquéritos e Questionários
16.
Air Med J ; 40(4): 211-215, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34172226

RESUMO

OBJECTIVE: As part of the humanitarian response to the coronavirus disease 2019 (COVID-19) pandemic, the German and French Armed Forces provided air transport for patients from overwhelmed regional hospitals in Italy and France. The objective of this study was to analyze the characteristics of the missions and the medical conditions of COVID-19 patients transported during an air medical evacuation on fixed wing aircraft in March and April 2020. METHOD: This was a retrospective analysis of transport records as well as other documents for 58 COVID-19 patients requiring artificial ventilation. RESULTS: The median age of the transported patients was 61.5 years, and 61% of them had preexisting medical conditions. They had been ventilated for a median of 5 days and experienced the first symptoms 18 days before transport. The patients flown out of France had less days of ventilation before flight, a lower end-tidal carbon dioxide level at the beginning of the flight, and a lower Charlson Comorbidity Index. There were also some differences between the ventilation and the flight level flown by the 2 air forces. CONCLUSION: The intensive care transport of ventilated COVID-19 patients requires highly qualified personnel and appropriate equipment and should be planned appropriately.


Assuntos
Resgate Aéreo , COVID-19/diagnóstico , COVID-19/terapia , Cuidados Críticos , Transferência de Pacientes , Idoso , Resgate Aéreo/organização & administração , Resgate Aéreo/estatística & dados numéricos , COVID-19/epidemiologia , Comorbidade , Cuidados Críticos/métodos , Cuidados Críticos/organização & administração , Cuidados Críticos/estatística & dados numéricos , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Transferência de Pacientes/métodos , Transferência de Pacientes/organização & administração , Transferência de Pacientes/estatística & dados numéricos , Estudos Retrospectivos , Índice de Gravidade de Doença
17.
PLoS One ; 16(6): e0253071, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34191818

RESUMO

BACKGROUND: Social distancing have been widely used to mitigate community spread of SARS-CoV-2. We sought to quantify the impact of COVID-19 social distancing policies across 27 European counties in spring 2020 on population mobility and the subsequent trajectory of disease. METHODS: We obtained data on national social distancing policies from the Oxford COVID-19 Government Response Tracker and aggregated and anonymized mobility data from Google. We used a pre-post comparison and two linear mixed-effects models to first assess the relationship between implementation of national policies and observed changes in mobility, and then to assess the relationship between changes in mobility and rates of COVID-19 infections in subsequent weeks. RESULTS: Compared to a pre-COVID baseline, Spain saw the largest decrease in aggregate population mobility (~70%), as measured by the time spent away from residence, while Sweden saw the smallest decrease (~20%). The largest declines in mobility were associated with mandatory stay-at-home orders, followed by mandatory workplace closures, school closures, and non-mandatory workplace closures. While mandatory shelter-in-place orders were associated with 16.7% less mobility (95% CI: -23.7% to -9.7%), non-mandatory orders were only associated with an 8.4% decrease (95% CI: -14.9% to -1.8%). Large-gathering bans were associated with the smallest change in mobility compared with other policy types. Changes in mobility were in turn associated with changes in COVID-19 case growth. For example, a 10% decrease in time spent away from places of residence was associated with 11.8% (95% CI: 3.8%, 19.1%) fewer new COVID-19 cases. DISCUSSION: This comprehensive evaluation across Europe suggests that mandatory stay-at-home orders and workplace closures had the largest impacts on population mobility and subsequent COVID-19 cases at the onset of the pandemic. With a better understanding of policies' relative performance, countries can more effectively invest in, and target, early nonpharmacological interventions.


Assuntos
COVID-19/epidemiologia , COVID-19/transmissão , Distanciamento Físico , COVID-19/prevenção & controle , Europa (Continente)/epidemiologia , Política de Saúde , Humanos , Modelos Lineares , Pandemias , Quarentena/estatística & dados numéricos
18.
Int J Chron Obstruct Pulmon Dis ; 16: 1461-1475, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34103906

RESUMO

Background: The long-acting anticholinergic (LAMA) aclidinium was approved in Europe in 2012 to relieve symptoms in adults with chronic obstructive pulmonary disease (COPD). A Post-Authorisation Safety Study (PASS) was initiated to assess potential cardiovascular safety concerns for aclidinium. Objective: To estimate the adjusted incidence rate ratio (IRR) for hospitalisation for heart failure in patients with COPD who were new users of aclidinium, tiotropium, other LAMA, long-acting beta-agonists/inhaled corticosteroids (LABA/ICS), and LAMA/LABA were compared with initiators of LABA. Methods: This population-based cohort study included patients with COPD aged ≥40 years initiating COPD medications in the Clinical Practice Research Datalink (CPRD) GOLD in the United Kingdom from 2012 to 2017. Medications were identified via general practice prescriptions. The first-ever hospitalisations for heart failure were identified in the Hospital Episode Statistics, and general practitioner records from the CPRD. Poisson regression models were used to estimate the IRR for hospitalisation for heart failure in users of COPD medications versus LABA, adjusting for clinically relevant covariates. Results: The study included 4350 new users of aclidinium, 23,405 of tiotropium, 6977 of other LAMAs, 3122 of LAMA/LABA, 26,093 of LABA/ICS, and 5678 of LABA. Mean age was 69-70 years across medication groups. Aclidinium users had the highest proportion of severe COPD, and LABA users had the lowest (35% vs 19%, respectively). Crude incidence rates per 1000 person-years for the first-ever hospitalisation for heart failure ranged from 6.9 in LABA to 9.5 in aclidinium. Using LABA as reference, adjusted IRRs (95% confidence interval) for first-ever hospitalisation for heart failure were 0.90 (0.53-1.53) for aclidinium, 1.02 (0.69-1.51) for tiotropium, 0.86 (0.50-1.47) for other LAMAs, 1.09 (0.41-2.92) for LAMA/LABA, and 1.01 (0.69, 1.48) for LABA/ICS. Conclusion: The study did not find increased risks of hospitalisations for heart failure in new users of aclidinium, tiotropium, other LAMAs, LAMA/LABA, and LABA/ICS compared with LABA.


Assuntos
Insuficiência Cardíaca , Doença Pulmonar Obstrutiva Crônica , Administração por Inalação , Corticosteroides/uso terapêutico , Agonistas de Receptores Adrenérgicos beta 2/efeitos adversos , Adulto , Idoso , Broncodilatadores/efeitos adversos , Estudos de Coortes , Quimioterapia Combinada , Europa (Continente)/epidemiologia , Insuficiência Cardíaca/induzido quimicamente , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/tratamento farmacológico , Hospitalização , Humanos , Antagonistas Muscarínicos/efeitos adversos , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Reino Unido/epidemiologia
19.
J Safety Res ; 77: 1-12, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34092299

RESUMO

INTRODUCTION: The European Union (EU) has developed different strategies to internalize the costs of excessive motor traffic in the road freight transport sector. One of these is a relaxation of restrictions on the size and load capacity of trucks that circulate between member States and a proposal has been made for Longer and Heavier Vehicles (LHVs) to be allowed to circulate across borders. LHVs are the so-called "megatrucks" (i.e., trucks with a length of 25 meters and a weight of 60 tonnes). Megatrucks have allowed to circulate for decades in some European countries such as Norway, Finland, and Sweden, world leaders in traffic accident prevention, although the impact that cross-border traffic would have on road safety is still unknown. METHODS: This article provides an econometric analysis of the potential impact on road safety of allowing the circulation of "megatrucks" throughout the EU. RESULTS: The findings show that countries that currently allow megatrucks to circulate present lower traffic accident and fatality levels, on average. CONCLUSIONS: The circulation of this type of vehicle is only advisable in countries where there is a certain degree of maturity and demonstrated achievements in the field of road safety. Practical applications: European countries that have allowed megatruck circulation obtaining better road safety outcomes in terms of accidents, although the accident lethality rate seems to be higher. Consequently, introducing megatruck circulation requires a prior proper preparation and examination.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Veículos Automotores/estatística & dados numéricos , Acidentes de Trânsito/mortalidade , Acidentes de Trânsito/prevenção & controle , Europa (Continente)/epidemiologia , Humanos , Segurança
20.
BMJ Open ; 11(6): e046359, 2021 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-34130960

RESUMO

OBJECTIVE: To investigate reported extreme temperature-related catastrophic events and associated mortality on the European continent including the Russian Federation. DESIGN: Cross-sectional respecting Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) criteria. SETTINGS: Data source: Emergency Events Database (EM-DAT). PARTICIPANTS: Search criteria: location-European continent including Russian Federation, time-years 1988 until 2019 (close of database 12 July 2019), catastrophic events-extreme temperatures. PRIMARY OUTCOME MEASURES: Numbers of heat waves, cold waves, severe winter conditions and associated number of deaths, overall, and per country and year, respecting STROBE criteria. RESULTS: The most frequent type of the 243 events recorded in EM-DAT were cold waves (54.7%). However, cold waves and severe winter conditions only accounted for 6460 deaths (4.5%), while heat waves were associated with 137 533 deaths (95.5%). The five most severe heat waves in 2003, 2006, 2010, 2013 and 2015 were associated with a total of 135 089 deaths. The most severe heat waves were geographically distributed over the Russian Federation (2010), as well as France, Italy, Spain and Germany, each in 2003. CONCLUSION: Although cold waves are more frequently reported in EM-DAT, heat waves are the major cause for temperature-related deaths. In order to better protect the public, it is important to address resiliency and vulnerability of populations at risk and age groups.


Assuntos
Temperatura Baixa , Temperatura Alta , Estudos Transversais , Europa (Continente)/epidemiologia , França , Alemanha , Humanos , Itália , Mortalidade , Federação Russa , Espanha , Temperatura
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...