Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 10.354
Filtrar
1.
Pest Manag Sci ; 77(1): 159-167, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33411365

RESUMO

BACKGROUND: The European earwig, Forficula auricularia is an invasive insect pest found in many temperate regions of the world. Despite being well known predators, earwigs are considered pests in sweet cherry though this has never been empirically tested. Our aim was to quantify the relationship between damaged cherry fruit and earwig population size, cherry bunch size and earwig distribution in cherry tree canopies in the cherry varieties Ron's Seedling, Lewis, Sweet Georgia, and Lapin. RESULTS: Significant differences in earwig damage type and frequency were observed between varieties with earwig exclusion significantly reducing damage by 21% in Lapin and 34% in Ron's Seedling. Earwigs were strongly aggregated within cherry bunches, with greater numbers and damage observed in larger bunch sizes in all varieties except Ron's Seedling where stem damage was independent of bunch size. In Ron's Seedling, cherry stems were 40× more likely to be damaged than Lewis stems and Lewis fruit two times more likely to be damaged than Ron's Seedling fruit. Sweet Georgia fruit were 4.5 times and stems five times more likely to be damaged than in Lapin. No predictive relationship between cherry damage levels and earwig numbers either within the tree canopies or within monitoring traps could be determined. CONCLUSION: European earwigs may have a significant economic impact to sweet cherry production. The nature of this impact differs between cherry varieties and severity is strongly influenced by factors including bunch size. However, why damage differs between varieties remains unknown and warrants further investigation if the impact of earwigs to sweet cherry production is to be minimized.


Assuntos
Prunus avium , Animais , Frutas , Georgia , Insetos
4.
J Spec Oper Med ; 20(4): 100-103, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33320321

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic has demonstrated that new and devastating respiratory pathogens can emerge without warning. It is therefore imperative that Special Operations medical personnel be aware of the presence of emerging pathogens within their area of operation. Human bocavirus (HBoV) is a newly described member of a family of viruses known as the Parvovirinae that are often associated with acute respiratory illness. The presence of HBoV in the country of Georgia has not been previously reported. Nasal and throat swabs were collected from 95 symptomatic members of the Georgian military. HBoV was detected in 11 of them (12%). To our knowledge, this is the first report of HBoV infection in the country of Georgia. This finding may have a significant impact on members of the Special Operations community who train in Georgia as more data concerning the transmission, pathogenesis, and treatment of HBoV are accumulated and the role of HBoV in human disease is more clearly defined.


Assuntos
Militares , Georgia , Bocavirus Humano , Humanos , Pandemias
5.
Georgian Med News ; (306): 76-81, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33130651

RESUMO

HCV infection and its complications, especially hepatocellular carcinoma, is a substantial public health burden. In 2015 "Nationwide hepatitis C elimination program" was launched in Georgia. According to the protocol, patients with HCC also receive DAA antiviral treatment. We study the effect of the different DAA therapy regiments on the incidence or recurrence of HCC and its prognosis. Overall, 408 patients were recruited in Georgian-French Joint Hepatology Clinic HEPA between April 2015-March 2016. The selection criteria were as follows: 1 - age 50-65 years; 2. Liver fibrosis level F3-F4 or cirrhosis at least 15 years of disease history; 3. HCV positive diagnosed by PCR method, whatever the level of viral load and genotype; 4. absence of previous complications of cirrhosis (ascites, gastrointestinal bleeding or HCC; 5. Child-Pugh class A or B; and 6. absence of severe extrahepatic disease. Essential clinical and biological parameters were recorded. Clinical monitoring and management of adverse events were performed on a regular base. HCV All patients included in the study received anti-HCV treatment with direct-acting antivirals (DAAs) within the national hepatitis C elimination program in accordance with national protocols. During April 2015-March 2016 treatment was provided with sofosbuvir (SOF) in combination with ribavirin (RBV), with or without pegylated interferon (IFN). Since March 2016, ledipasvir/sofosbuvir (LDV/SOF) was prescribed to all patients with or without RBV depending on the HCV genotype, level of fibrosis, and previous treatment experience. In conclusion, we find that neither different DAA regimens nor different treatment duration affects HCC risk after antiviral treatment. Moreover, there are no significant changes in mortality rate due to HCC in these groups. Therefore, it can be concluded, that HCC status is not a contraindication for DAA treatment, especially at the early stages of cancer, when a tumor is curative.


Assuntos
Antivirais , Carcinoma Hepatocelular , Hepatite C Crônica , Hepatite C , Neoplasias Hepáticas , Antivirais/uso terapêutico , Carcinoma Hepatocelular/tratamento farmacológico , Carcinoma Hepatocelular/epidemiologia , Carcinoma Hepatocelular/etiologia , Criança , Quimioterapia Combinada , Genótipo , Georgia , República da Geórgia , Hepacivirus/genética , Hepatite C/complicações , Hepatite C/tratamento farmacológico , Hepatite C Crônica/tratamento farmacológico , Humanos , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/epidemiologia , Recidiva Local de Neoplasia/tratamento farmacológico , Resultado do Tratamento
6.
Artigo em Inglês | MEDLINE | ID: mdl-33142755

RESUMO

Systemic inequity concerning the social determinants of health has been known to affect morbidity and mortality for decades. Significant attention has focused on the individual-level demographic and co-morbid factors associated with rates and mortality of COVID-19. However, less attention has been given to the county-level social determinants of health that are the main drivers of health inequities. To identify the degree to which social determinants of health predict COVID-19 cumulative case rates at the county-level in Georgia, we performed a sequential, cross-sectional ecologic analysis using a diverse set of socioeconomic and demographic variables. Lasso regression was used to identify variables from collinear groups. Twelve variables correlated to cumulative case rates (for cases reported by 1 August 2020) with an adjusted r squared of 0.4525. As time progressed in the pandemic, correlation of demographic and socioeconomic factors to cumulative case rates increased, as did number of variables selected. Findings indicate the social determinants of health and demographic factors continue to predict case rates of COVID-19 at the county-level as the pandemic evolves. This research contributes to the growing body of evidence that health disparities continue to widen, disproportionality affecting vulnerable populations.


Assuntos
Infecções por Coronavirus/epidemiologia , Disparidades nos Níveis de Saúde , Pandemias , Pneumonia Viral/epidemiologia , Saúde da População/estatística & dados numéricos , Determinantes Sociais da Saúde , Betacoronavirus , Infecções por Coronavirus/diagnóstico , Estudos Transversais , Demografia , Georgia/epidemiologia , Humanos , Governo Local , Pneumonia Viral/diagnóstico , Pobreza , Qualidade de Vida , Fatores Socioeconômicos
8.
PLoS One ; 15(10): e0239798, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33045008

RESUMO

As the spread of COVID19 in the US continues to grow, local and state officials face difficult decisions about when and how to transition to a "new normal." The goal of this study is to project the number of COVID19 infections and resulting severe outcomes, and the need for hospital capacity under social distancing, particularly, shelter-in-place and voluntary quarantine for the State of Georgia. We developed an agent-based simulation model to project the infection spread. The model utilizes COVID19-specific parameters and data from Georgia on population interactions and demographics. The simulation study covered a seven and a half-month period, testing different social distancing scenarios, including baselines (no-intervention or school closure only) and combinations of shelter-in-place and voluntary quarantine with different timelines and compliance levels. The following outcomes are compared at the state and community levels: the number and percentage of cumulative and daily new symptomatic and asymptomatic infections, hospitalizations, and deaths; COVID19-related demand for hospital beds, ICU beds, and ventilators. The results suggest that shelter-in-place followed by voluntary quarantine reduced peak infections from approximately 180K under no intervention and 113K under school closure, respectively, to below 53K, and delayed the peak from April to July or later. Increasing shelter-in-place duration from four to five weeks yielded 2-9% and 3-11% decrease in cumulative infection and deaths, respectively. Regardless of the shelter-in-place duration, increasing voluntary quarantine compliance decreased daily new infections from almost 53K to 25K, and decreased cumulative infections by about 50%. The cumulative number of deaths ranged from 6,660 to 19,430 under different scenarios. Peak infection date varied across scenarios and counties; on average, increasing shelter-in-place duration delayed the peak day by 6 days. Overall, shelter-in-place followed by voluntary quarantine substantially reduced COVID19 infections, healthcare resource needs, and severe outcomes.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Quarentena , Isolamento Social , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Georgia , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Modelos Teóricos , Adulto Jovem
9.
Emerg Infect Dis ; 26(11): 2787-2789, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33050982

RESUMO

We conducted a cohort study to determine sociodemographic risk factors for severe acute respiratory syndrome coronavirus 2 infection among obstetric patients in 2 urban hospitals in Atlanta, Georgia, USA. Prevalence of infection was highest among women who were Hispanic, were uninsured, or lived in high-density neighborhoods.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Fatores Socioeconômicos , Adulto , Estudos de Coortes , Infecções por Coronavirus/virologia , Feminino , Georgia/epidemiologia , Hispano-Americanos/estatística & dados numéricos , Humanos , Pandemias , Pneumonia Viral/virologia , Gravidez , Complicações Infecciosas na Gravidez/virologia , Prevalência , População Urbana/estatística & dados numéricos , Adulto Jovem
10.
Zootaxa ; 4860(1): zootaxa.4860.1.1, 2020 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-33056170

RESUMO

Ten new species of the feather mite genus Trouessartia Canestrini, 1899 (Analgoidea: Trouessartiidae) are described from various passerines of the superfamily Passeroidea in Georgia: Trouessartia americana sp. n. from Setophaga americana (Linnaeus), T. helmitheros sp. n. from Helmitheros vermivorum (Gmelin, JF), T. mniotilta sp. n. from Mniotilta varia (Linnaeus), T. pensylvanica sp. n. from Setophaga pensylvanica (Linnaeus) (type host) and S. palmarum (Gmelin, JF), T. ruticilla sp. n. from S. ruticilla (Linnaeus), T. seiurus sp. n. from Seiurus aurocapilla (Linnaeus), T. tigrina sp. n. from Setophaga tigrina (Gmelin, JF) (Parulidae), T. passerinae sp. n. from Passerina caerulea (Linnaeus) (type host) and P. cyanea (Linnaeus), T. ciris sp. n. from P. ciris (Linnaeus) (Cardinalidae), and T. spizellae sp. n. from Spizella passerina (Bechstein) (Passerellidae). Based on a specific combination of morphological characters, all new species and six previously known species are arranged into a new species group capensis in the genus Trouessartia. The most important diagnostic characters of this species group include: in both sexes, the dorsal hysterosomal apertures are absent; in males, the postgenital plaque is well developed and genital setae g have cylindrical articulation rings; in females, the external copulatory tube is straight, stylet- or finger-like, and situated on the margin of the interlobar membrane, and the head of spermatheca has a semi-ovate extension without indentations. A key to all species referred to the capensis group is provided and host associations of this group with passerines are summarized and briefly discussed. It is hypothesized that this species group originated on the ancestors of New World nine-primaried oscines (Emberizoidea) and diverged in close relation with this group of hosts.


Assuntos
Doenças das Aves , Ácaros , Passeriformes , Aves Canoras , Animais , Feminino , Georgia , Masculino
11.
Zootaxa ; 4767(3): zootaxa.4767.3.9, 2020 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-33056561

RESUMO

The rove beetles (Coleoptera: Staphylinidae) are one of the most diverse families of beetles comprising more than 63650 species worldwide (Irmler et al. 2018). It is the best studied coleopteran family in Georgia (Herman, 2001; Schülke Smetana, 2015), with more than 750 species recorded (Tarkhnishvili Chaladze, 2019). The first records of Staphylinidae from Lagodekhi were reported by Zhizhilashvili (1941), who recorded 12 species of rove beetles from the reserve: Anotylus hybridus Eppelsheim, 1878 as Oxytelus; Anotylus gibbulus Eppelsheim, 1878 as Oxytelus; Xantholinus variabilis Hochhuth, 1851; Cordalia obscura Gravenhorst; Philonthus parvicornis Gravenhorst, 1802 as P. agilis Gravenhorst; Stenus circularis Gravenhorst, 1802 as S. clavulus Hochhuth; S. cribratus Kiesenwetter, 1850; Tachyporus hypnorum (Fabricius, 1775); Ocypus nitens (Schrank, 1781) as Staphylinus similis Fabricius; Quedius minor Hochhuth, 1849 as Q. distincticolor Roubal; Aleochara intricata Mannerheim; Olophrum caucasicum Fauvel, 1875. The record of Medon bicolor (Olivier, 1795) (as Sunius) in the same paper is erroneous because the species is absent from Georgia. Coiffait (1969) described Quedius grouziacus as a new species from Lagodekhi, however the species was later synonymized with Q. suramensis Epelsheim, 1880 by Solodovnikov (2002). Ushakov (1988) recorded Gauropterus sanguinipes Reitter, 1889, Gyrohypnus angustatus Stephens,1832 and Atrecus affinis (Paykull, 1789) as Baptolinus affinis caucasius Roubal, 1933. Gusarov and Koval (2002) registered Korgella caucasica (Gusarov Koval, 2002; Özdikmen, 2005), as Heinzia. Later Shavrin Khachikov (2019) added Acrolocha amabilis (Heer, 1841) which was new to the staphylinid fauna of Georgia. There have been no other focused studies on the Staphylinidae of Lagodekhi Protected Areas (LPA), though we recognize that there are likely further records in the literature.


Assuntos
Besouros , Distribuição Animal , Animais , Georgia , República da Geórgia
13.
PLoS Negl Trop Dis ; 14(9): e0008614, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32956355

RESUMO

The emergence of mosquito-transmitted viruses poses a global threat to human health. Combining mechanistic epidemiological models based on temperature-trait relationships with climatological data is a powerful technique for environmental risk assessment. However, a limitation of this approach is that the local microclimates experienced by mosquitoes can differ substantially from macroclimate measurements, particularly in heterogeneous urban environments. To address this scaling mismatch, we modeled spatial variation in microclimate temperatures and the thermal potential for dengue transmission by Aedes albopictus across an urban-to-rural gradient in Athens-Clarke County GA. Microclimate data were collected across gradients of tree cover and impervious surface cover. We developed statistical models to predict daily minimum and maximum microclimate temperatures using coarse-resolution gridded macroclimate data (4000 m) and high-resolution land cover data (30 m). The resulting high-resolution microclimate maps were integrated with temperature-dependent mosquito abundance and vectorial capacity models to generate monthly predictions for the summer and early fall of 2018. The highest vectorial capacities were predicted for patches of trees in urban areas with high cover of impervious surfaces. Vectorial capacity was most sensitive to tree cover during the summer and became more sensitive to impervious surfaces in the early fall. Predictions from the same models using temperature data from a local meteorological station consistently over-predicted vectorial capacity compared to the microclimate-based estimates. This work demonstrates that it is feasible to model variation in mosquito microenvironments across an urban-to-rural gradient using satellite Earth observations. Epidemiological models applied to the microclimate maps revealed localized patterns of temperature suitability for disease transmission that would not be detectable using macroclimate data. Incorporating microclimate data into disease transmission models has the potential to yield more spatially precise and ecologically interpretable metrics of mosquito-borne disease transmission risk in urban landscapes.


Assuntos
Aedes/virologia , Dengue/epidemiologia , Dengue/transmissão , Mosquitos Vetores/virologia , Animais , Arbovirus/patogenicidade , Vírus da Dengue/patogenicidade , Ecossistema , Georgia/epidemiologia , Humanos , Microclima , Modelos Biológicos , Árvores
14.
Environ Res ; 191: 110189, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32919963

RESUMO

This study draws the link between COVID-19 and air pollution (ground ozone O3) from February 29, 2020 to July 10, 2020 in the top 10 affected States of the US. Utilizing quantile-on-quantile (QQ) estimation technique, we examine in what manner the quantiles of COVID-19 affect the quantiles of air pollution and vice versa. The primary findings confirm overall dependence between COVID-19 and air pollution. Empirical results exhibit a strong negative effect of COVID-19 on air pollution in New York, Texas, Illinois, Massachusetts, and Pennsylvania; especially at medium to higher quantiles, while New Jersey, Illinois, Arizona, and Georgia show strong negative effect mainly at lower quantiles. Contrarily, COVID-19 positively affects air pollution in Pennsylvania at extreme lower quantiles. On the other side, air pollution predominantly caused to increase in the intensity of COVID-19 cases across all states except lower quantiles of Massachusetts, and extreme higher quantiles of Arizona and New Jersey, where this effect becomes less pronounced or negative. Concludingly, a rare positive fallout of COVID-19 is reducing environmental pressure, while higher environmental pollution causes to increase the vulnerability of COVID-19 cases. These findings imply that air pollution is at the heart of chronic diseases, therefore the state government should consider these asymmetric channels and introduce appropriate policy measures to reset and control atmospheric emissions.


Assuntos
Poluição do Ar , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Poluição do Ar/efeitos adversos , Arizona , Betacoronavirus , Poluição Ambiental , Georgia , Humanos , Illinois , Massachusetts , New Jersey , New York , Pennsylvania , Texas
15.
MMWR Morb Mortal Wkly Rep ; 69(37): 1296-1299, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32941413

RESUMO

Long-term care facility (LTCF) residents are at particularly high risk for morbidity and mortality associated with infection with SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), given their age and high prevalence of chronic medical conditions, combined with functional impairment that often requires frequent, close contact with health care providers, who might inadvertently spread the virus to residents (1,2). During March-May 2020 in Fulton County, Georgia, >50% of COVID-19-associated deaths occurred among LTCF residents, although these persons represented <1% of the population (3,4). Mass testing for SARS-CoV-2 has been an effective strategy for identifying asymptomatic and presymptomatic infections in LTCFs (5). This analysis sought to evaluate the timing at which mass testing took place in relation to the known presence of a COVID-19 infection and the resulting number of infections that occurred. In 15 LTCFs that performed facility-wide testing in response to an identified case, high prevalences of additional cases in residents and staff members were found at initial testing (28.0% and 7.4%, respectively), suggesting spread of infection had already occurred by the time the first case was identified. Prevalence was also high during follow-up, with a total of 42.4% of residents and 11.8% of staff members infected overall in the response facilities. In comparison, 13 LTCFs conducted testing as a preventive strategy before a case was identified. Although the majority of these LTCFs identified at least one COVID-19 case, the prevalence was significantly lower at initial testing in both residents and staff members (0.5% and 1.0%, respectively) and overall after follow-up (1.5% and 1.7%, respectively). These findings indicate that early awareness of infections might help facilities prevent potential outbreaks by prioritizing and adhering more strictly to infection prevention and control (IPC) recommendations, resulting in fewer infections than would occur when relying on symptom-based screening (6,7).


Assuntos
Técnicas de Laboratório Clínico , Infecções por Coronavirus/prevenção & controle , Surtos de Doenças/prevenção & controle , Programas de Rastreamento/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Instituições Residenciais/organização & administração , Idoso , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Georgia/epidemiologia , Humanos , Pneumonia Viral/epidemiologia
16.
Dis Aquat Organ ; 141: 25-38, 2020 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-32940248

RESUMO

Between 2007 and 2013, before the 2013 cetacean morbillivirus outbreak, 26 fresh bottlenose dolphin carcasses were necropsied on the coast of Georgia, USA. Here, we present the pathological and microbiological findings associated with their most likely causes of death. The primary cause of death was determined in 25 individuals and included systemic bacterial infection (n = 7), verminous and bacterial bronchopneumonia (n = 5), drowning/entanglement (n = 5), disseminated histoplasmosis (n = 1), intestinal intussusception (n = 1), vegetative endocarditis (n = 1), meningitis (n = 1), necrotizing dermatitis (n = 1), disseminated angiomatosis (n = 1), emaciation (n = 1) and stingray spine trauma (n = 1). Histiocytic and eosinophilic bronchopneumonia associated with Halocerchus sp. infection was observed in 69% of the animals (18/26) and eosinophilic gastritis due to Anisakidae nematodes was found in 36% of the examined stomachs (8/22). Moderate to severe eosinophilic pancreatitis with fibrosis was observed in 4 animals infected with Brachycladiidae trematodes. Proliferative and ulcerative lymphoplasmacytic dermatitis was found in 5 animals and was considered to contribute to deteriorated health status in 2 calves. Pulmonary and lymph node angiomatosis were observed in 15 and 10 animals, respectively. In at least 2 animals, the concentration of polychlorinated biphenyls (PCBs) in the blubber exceeded 1500 µg g-1 of lipid. Bottlenose dolphins stranded on the Georgia coast have a wide range of inflammatory lesions associated with a variety of helminth, bacterial, and fungal pathogens. Some resident animals have also been exposed to high levels of PCB contamination, which could reduce host immunocompetence. Higher exposure to these or other pathogens could result in further decline in the health of resident and migrant dolphin populations in this region.


Assuntos
Golfinho Nariz-de-Garrafa , Tecido Adiposo , Animais , Causas de Morte , Georgia , Bifenilos Policlorados
17.
MMWR Morb Mortal Wkly Rep ; 69(31): 1023-1025, 2020 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-32759921

RESUMO

Limited data are available about transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), among youths. During June 17-20, an overnight camp in Georgia (camp A) held orientation for 138 trainees and 120 staff members; staff members remained for the first camp session, scheduled during June 21-27, and were joined by 363 campers and three senior staff members on June 21. Camp A adhered to the measures in Georgia's Executive Order* that allowed overnight camps to operate beginning on May 31, including requiring all trainees, staff members, and campers to provide documentation of a negative viral SARS-CoV-2 test ≤12 days before arriving. Camp A adopted most† components of CDC's Suggestions for Youth and Summer Camps§ to minimize the risk for SARS-CoV-2 introduction and transmission. Measures not implemented were cloth masks for campers and opening windows and doors for increased ventilation in buildings. Cloth masks were required for staff members. Camp attendees were cohorted by cabin and engaged in a variety of indoor and outdoor activities, including daily vigorous singing and cheering. On June 23, a teenage staff member left camp A after developing chills the previous evening. The staff member was tested and reported a positive test result for SARS-CoV-2 the following day (June 24). Camp A officials began sending campers home on June 24 and closed the camp on June 27. On June 25, the Georgia Department of Public Health (DPH) was notified and initiated an investigation. DPH recommended that all attendees be tested and self-quarantine, and isolate if they had a positive test result.


Assuntos
Acampamento , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Surtos de Doenças , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Adolescente , Adulto , Criança , Feminino , Georgia/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Adulto Jovem
18.
J Bus Contin Emer Plan ; 14(1): 55-64, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-32847654

RESUMO

Climate change is posing a significant threat to the coastal counties of Georgia. The Georgia Department of Natural Resources and Hagerty Consulting have recognised this threat and are facilitating a nine-year project aimed at developing a disaster recovery and redevelopment plan for the state's coastal communities, and providing state-wide technical assistance. This paper provides an overview of this planning initiative and summarises the many insights into the pre-disaster recovery and resilience planning process gained from this project.


Assuntos
Planejamento em Desastres , Inundações , Cidades , Mudança Climática , Georgia , Oceanos e Mares
19.
Am J Cardiol ; 135: 150-153, 2020 11 15.
Artigo em Inglês | MEDLINE | ID: mdl-32861733

RESUMO

This study aimed to determine if cardiac troponin I (cTnI) is an independent predictor of clinical outcomes and whether higher values are associated with worse clinical outcomes in Covid-19 patients. This case-series study was conducted at Phoebe Putney Health System. Participants were confirmed Covid-19 patients admitted to our health system between March 2, 2020 and June 7, 2020. Data were collected from electronic medical records. Patients were divided into 2 groups: with and without elevated cTnI. The cTnI were further divided in 4 tertiles. Multivariable logistic regression analysis was performed to adjust for demographics, baseline comorbidities, and laboratory parameters including D-dimer, ferritin, lactate dehydrogenase, procalcitonin and C-reactive protein. Out of 309 patients, 116 (37.5%) had elevated cTnI. Those with elevated cTnI were older (59.9 vs. 68.2 years, p <0.001), and more likely to be males (53.5% vs. 36.3%, p = 0.003). Elevated cTnI group had higher baseline comorbidities. After multivariable adjustment, overall mortality was significantly higher in elevated cTnI group (37.9% vs. 11.4%, odds ratio:4.45; confidence interval:1.78 to 11.14, p <0.001). Need for intubation, dialysis, and intensive care unit (ICU) transfer was higher in elevated cTnI group. Among those with elevated cTnI, mortality was 23.2% for 50th percentile, 48.4% for 75th percentile, and 55.2% for 100th percentile. Similarly, further increase in cTnI was associated with a higher need for intubation, dialysis, and ICU transfer. In conclusion, myocardial injury occurs in significant proportion of hospitalized Covid-19 patients and is an independent predictor of clinical outcomes, with higher values associated with worse outcomes.


Assuntos
Doenças Cardiovasculares/mortalidade , Causas de Morte , Infecções por Coronavirus/mortalidade , Hospitalização/estatística & dados numéricos , Pneumonia Viral/mortalidade , Síndrome Respiratória Aguda Grave/mortalidade , Troponina I/sangue , Adulto , Idoso , Biomarcadores/sangue , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/terapia , Estudos de Coortes , Comorbidade , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Bases de Dados Factuais , Feminino , Georgia/epidemiologia , Mortalidade Hospitalar/tendências , Humanos , Unidades de Terapia Intensiva/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Prognóstico , Estudos Retrospectivos , Síndrome Respiratória Aguda Grave/diagnóstico , Síndrome Respiratória Aguda Grave/terapia , Análise de Sobrevida
20.
Public Health ; 185: 341-347, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32738575

RESUMO

OBJECTIVES: The burden of hepatitis B virus (HBV) and hepatitis D virus (HDV) infections is unknown in Georgia. This analysis describes the prevalence of hepatitis B and coinfection with HDV and the demographic characteristics and risk factors for persons with HBV infection in Georgia. STUDY DESIGN: This is a cross-sectional seroprevalence study. METHODS: A cross-sectional, nationwide survey to assess hepatitis B prevalence among the general adult Georgian population (age ≥18 years) was conducted in 2015. Demographic and risk behavior data were collected. Blood specimens were screened for anti-hepatitis B core total antibody (anti-HBc). Anti-HBc-positive specimens were tested for hepatitis B surface antigen (HBsAg). HBsAg-positive specimens were tested for HBV and HDV nucleic acid. Nationally weighted prevalence estimates and adjusted odds ratios (aORs) for potential risk factors were determined for anti-HBc and HBsAg positivity. RESULTS: The national prevalence of anti-HBc and HBsAg positivity among adults were 25.9% and 2.9%, respectively. Persons aged ≥70 years had the highest anti-HBc positivity (32.7%), but the lowest HBsAg positivity prevalence (1.3%). Anti-HBc positivity was associated with injection drug use (aOR = 2.34; 95% confidence interval [CI] = 1.46-3.74), receipt of a blood transfusion (aOR = 1.68; 95% CI = 1.32-2.15), and sex with a commercial sex worker (aOR = 1.46; 95% CI = 1.06-2.01). HBsAg positivity was associated with receipt of a blood transfusion (aOR = 2.72; 95% CI = 1.54-4.80) and past incarceration (aOR = 2.72; 95% CI = 1.25-5.93). Among HBsAg-positive persons, 0.9% (95% CI = 0.0-2.0) were HDV coinfected. CONCLUSIONS: Georgia has an intermediate to high burden of hepatitis B, and the prevalence of HDV coinfection among HBV-infected persons is low. Existing infrastructure for hepatitis C elimination could be leveraged to promote hepatitis B elimination.


Assuntos
Coinfecção/epidemiologia , Hepatite B/epidemiologia , Hepatite D/epidemiologia , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Georgia/epidemiologia , Anticorpos Anti-Hepatite B/sangue , Antígenos de Superfície da Hepatite B/sangue , Vírus da Hepatite B/isolamento & purificação , Vírus Delta da Hepatite/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Estudos Soroepidemiológicos , Profissionais do Sexo/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA