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1.
Tidsskr Nor Laegeforen ; 140(13)2020 09 29.
Artigo em Inglês, Norueguês | MEDLINE | ID: mdl-32998491

RESUMO

BACKGROUND: Cardiovascular diseases, cancer, type-2 diabetes and chronic obstructive pulmonary disease (COPD) were initially noted as the most common diseases among individuals who were hospitalised for COVID-19. However, the evidence base is weak. The objective of this study is to describe how selected diseases were distributed among adults with confirmed COVID-19 (COVID-19 positive tests) and among those hospitalised for COVID-19 compared to the general population. MATERIAL AND METHOD: We used data from the Norwegian Patient Registry, the Norwegian Registry for Primary Health Care and the Norwegian Surveillance System for Communicable Diseases for adults from the age of 20 and older for the period 1 March 2020-13 May 2020. RESULTS: Of all those who tested positive for COVID-19, 7 632 (94 %) were aged 20 years or older, and 1 025 (13.4 %) of these had been hospitalised. Among those hospitalised with COVID-19, there was a higher proportion of individuals with cardiovascular diseases (18.3 % versus 15.6 %), cancer (6.9 % versus 5.4 %), type-2 diabetes (8.6 % versus 5.2 %) and COPD (3.8 % versus 2.7 %) than in the general population as a whole after adjusting for age. The proportion of hospitalised patients with asthma, other chronic respiratory disease, cardiovascular disease, ongoing cancer treatment, complications related to hypertension, obesity and overweight, neurological disorders and cardiac and renal failure was also higher than in the general population. There were few differences between persons who had tested positive for COVID-19 and the general population in terms of underlying conditions. INTERPRETATION: Among those hospitalised for COVID-19, there was a higher proportion of patients with underlying illnesses than in the general population. This may indicate that these patients tend to have a more severe course of disease or that they are more likely to be hospitalised compared to healthy individuals. The results must be interpreted with caution, since the sample of COVID-19 individuals is non-random.


Assuntos
Comorbidade , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Adulto , Asma , Betacoronavirus , Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Hospitalização , Humanos , Neoplasias , Noruega/epidemiologia , Pandemias , Doença Pulmonar Obstrutiva Crônica , Adulto Jovem
2.
PLoS Med ; 17(9): e1003207, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32960896

RESUMO

INTRODUCTION: The complex etiology of autism spectrum disorder (ASD) is still unresolved. Preterm birth (<37 weeks of gestation) and its complications are the leading cause of death of babies in the world, and those who survive often have long-term health problems. Length of gestation, including preterm birth, has been linked to ASD risk, but robust estimates for the whole range of gestational ages (GAs) are lacking. The primary objective of this study was to provide a detailed and robust description of ASD risk across the entire range of GAs while adjusting for sex and size for GA. METHODS AND FINDINGS: Our study had a multinational cohort design, using population-based data from medical registries in three Nordic countries: Sweden, Finland, and Norway. GA was estimated in whole weeks based on ultrasound. Children were prospectively followed from birth for clinical diagnosis of ASD. Relative risk (RR) of ASD was estimated using log-binomial regression. Analyses were also stratified by sex and by size for GA. The study included 3,526,174 singletons born 1995 to 2015, including 50,816 (1.44%) individuals with ASD. In the whole cohort, 165,845 (4.7%) were born preterm. RR of ASD increased by GA, from 40 to 24 weeks and from 40 to 44 weeks of gestation. The RR of ASD in children born in weeks 22-31, 32-36, and 43-44 compared to weeks 37-42 were estimated at 2.31 (95% confidence interval [CI] 2.15-2.48; 1.67% vs 0.83%; p-value < 0.001), 1.35 (95% CI 1.30-1.40; 1.08% vs 0.83%; p-value < 0.001), and 1.37 (95% CI 1.21-1.54; 1.74% vs 0.83%; p-value < 0.001), respectively. The main limitation of this study is the lack of data on potential causes of pre- or postterm birth. Also, the possibility of residual confounding should be considered. CONCLUSION: In the current study, we observed that the RR of ASD increased weekly as the date of delivery diverged from 40 weeks, both pre- and postterm, independently of sex and size for GA. Given the unknown etiology of ASD and the lifelong consequences of the disorder, identifying groups of increased risk associated with a potentially modifiable risk factor is important.


Assuntos
Transtorno do Espectro Autista/etiologia , Idade Gestacional , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/metabolismo , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Finlândia/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Noruega/epidemiologia , Fatores de Risco , Suécia/epidemiologia
4.
Artigo em Inglês | MEDLINE | ID: mdl-32899971

RESUMO

In a given country, the cumulative death toll of the first wave of the COVID-19 epidemic follows a sigmoid curve as a function of time. In most cases, the curve is well described by the Gompertz function, which is characterized by two essential parameters, the initial growth rate and the decay rate as the first epidemic wave subsides. These parameters are determined by socioeconomic factors and the countermeasures to halt the epidemic. The Gompertz model implies that the total death toll depends exponentially, and hence very sensitively, on the ratio between these rates. The remarkably different epidemic curves for the first epidemic wave in Sweden and Norway and many other countries are classified and discussed in this framework, and their usefulness for the planning of mitigation strategies is discussed.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/mortalidade , Pneumonia Viral/epidemiologia , Pneumonia Viral/mortalidade , Betacoronavirus , Humanos , Noruega/epidemiologia , Pandemias , Fatores Socioeconômicos , Suécia/epidemiologia
5.
Artigo em Inglês | MEDLINE | ID: mdl-32806769

RESUMO

We aimed to investigate the management of urgent dental care, the perception of risk and workplace preparedness among dental staff in Norway during the COVID-19 pandemic. An electronic questionnaire regarding the strictest confinement period in Norway (13 March-17 April 2020) was distributed to dental staff. Among the 1237 respondents, 727 (59%) treated patients, of whom 170 (14%) worked in clinics designated to treat patients suspected or confirmed to have COVID-19. Out of them 88% (143) received training and 64% (103) simulation in additional infection prevention procedures, while 27 (24%) respondents reported deviation. In total, 1051 (85%) respondents perceived that dental staff had a high risk of being infected, 1039 (84%) that their workplace handled the current situation well, 767 (62%) that their workplace had adequate infection control equipment and 507 (41%) agreed that their workplace is well equipped to handle an escalation. Before an appointment, 1182 (96%) respondents always/often inquired per phone information if a patient experienced symptoms of COVID-19, and 1104 (89%) asked about a history of travel to affected areas. Twice as many patients on average per week were treated by phone than in a clinic. A lower proportion of dental staff in high incidence counties applied additional infection prevention measures compared to low and medium incidence counties. To conclude, urgent dental health care was managed relatively well in Norway. Additional training of the dental staff in adequate infection prevention and step-by-step procedures may be needed. These results may be used to improve the dental health service's response to future outbreaks.


Assuntos
Infecções por Coronavirus/epidemiologia , Serviços de Saúde Bucal/organização & administração , Controle de Infecções/organização & administração , Pneumonia Viral/epidemiologia , Adulto , Betacoronavirus , Estudos Transversais , Serviços de Saúde Bucal/normas , Feminino , Humanos , Controle de Infecções/normas , Capacitação em Serviço/organização & administração , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Pandemias , Medição de Risco , Inquéritos e Questionários , Telemedicina/organização & administração , Telefone , Local de Trabalho/organização & administração
6.
PLoS One ; 15(8): e0232305, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32785271

RESUMO

Shiga toxin-producing Escherichia coli (STEC) that cause severe disease predominantly carry the toxin gene variant stx2a. However, the role of Shiga toxin in the ruminant reservoirs of this zoonotic pathogen is poorly understood and strains that cause severe disease in humans (HUSEC) likely constitute a small and atypical subset of the overall STEC flora. The aim of this study was to investigate the presence of stx2a in samples from cattle and to isolate and characterize stx2a-positive E. coli. In nationwide surveys in Sweden and Norway samples were collected from individual cattle or from cattle herds, respectively. Samples were tested for Shiga toxin genes by real-time PCR and amplicon sequencing and stx2a-positive isolates were whole genome sequenced. Among faecal samples from Sweden, stx1 was detected in 37%, stx2 in 53% and stx2a in 5% and in skin (ear) samples in 64%, 79% and 2% respectively. In Norway, 79% of the herds were positive for stx1, 93% for stx2 and 17% for stx2a. Based on amplicon sequencing the most common stx2 types in samples from Swedish cattle were stx2a and stx2d. Multilocus sequence typing (MLST) of 39 stx2a-positive isolates collected from both countries revealed substantial diversity with 19 different sequence types. Only a few classical LEE-positive strains similar to HUSEC were found among the stx2a-positive isolates, notably a single O121:H19 and an O26:H11. Lineages known to include LEE-negative HUSEC were also recovered including, such as O113:H21 (sequence type ST-223), O130:H11 (ST-297), and O101:H33 (ST-330). We conclude that E. coli encoding stx2a in cattle are ranging from strains similar to HUSEC to unknown STEC variants. Comparison of isolates from human HUS cases to related STEC from the ruminant reservoirs can help identify combinations of virulence attributes necessary to cause HUS, as well as provide a better understanding of the routes of infection for rare and emerging pathogenic STEC.


Assuntos
Bovinos/microbiologia , Toxina Shiga II/genética , Escherichia coli Shiga Toxigênica/genética , Animais , Reservatórios de Doenças/microbiologia , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Variação Genética , Genoma Bacteriano , Síndrome Hemolítico-Urêmica/epidemiologia , Síndrome Hemolítico-Urêmica/microbiologia , Humanos , Tipagem de Sequências Multilocus , Noruega/epidemiologia , Prevalência , Reação em Cadeia da Polimerase em Tempo Real , Escherichia coli Shiga Toxigênica/citologia , Escherichia coli Shiga Toxigênica/isolamento & purificação , Suécia/epidemiologia , Virulência/genética , Zoonoses/epidemiologia , Zoonoses/microbiologia
7.
Tidsskr Nor Laegeforen ; 140(11)2020 08 18.
Artigo em Inglês, Norueguês | MEDLINE | ID: mdl-32815335

RESUMO

BACKGROUND: We wished to investigate how the flow of patients to the Psychiatric Casualty Clinic in Oslo was affected during the acute phase of the COVID-19 pandemic. MATERIAL AND METHOD: All patient records from the Psychiatric Casualty Clinic in Oslo from and including 13 March 2020 up to and including 1 April 2020 were compared with the patient records from the same period in 2019. Patient visits were registered as COVID-19-related when the patient came to the clinic for an issue linked to the pandemic. RESULTS: The Psychiatric Casualty Clinic in Oslo had 105 patient visits in the period 13 March 2019-1 April 2019 and 63 in the same period for 2020 (-40 %). The number of admissions amounted to 16 in 2019 and 7 in 2020 (-56 %). The number of COVID-19-related consultations was 14/63 (22 %). There was a reduction in the number of patient visits for crisis reactions, from 28 in 2019 to 8 in 2020. INTERPRETATION: The background for the decline in the flow of patients in the acute phase of the COVID-19 pandemic is most likely a complex one. We believe that patients primarily chose not to visit the clinic due to the risk of infection and the wish to avoid burdening the health services. With the reservation that our data are limited, it does not appear that increased access to psychiatric health services requiring physical attendance is indicated in the acute phase of a pandemic.


Assuntos
Infecções por Coronavirus/epidemiologia , Serviços de Emergência Psiquiátrica/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Betacoronavirus , Infecções por Coronavirus/psicologia , Humanos , Noruega/epidemiologia , Pandemias , Pneumonia Viral/psicologia
8.
Tidsskr Nor Laegeforen ; 140(11)2020 08 18.
Artigo em Inglês, Norueguês | MEDLINE | ID: mdl-32815353

RESUMO

BACKGROUND: Children and adolescents are at lower risk of disease caused by SARS-CoV-2. We describe the incidence of confirmed infection and hospitalisation of children and adolescents under the age of 20 in Norway, and specifically among those with underlying conditions. MATERIAL AND METHOD: The Norwegian Directorate of Health has collaborated with the Norwegian Institute of Public Health on the establishment of a data extraction system to monitor the coronavirus outbreak. Data from the specialist health service (Norwegian Patient Registry, NPR), and the primary health service (Norwegian Registry for Primary Health Care, NRPHC) are linked to data on positive SARS-CoV-2 tests from the Surveillance System for Communicable Diseases (MSIS). This covers all persons living in Norway as of 1 March 2020, with data on confirmed infection up to and including 13 May 2020 and on hospitalisations up to and including 30 April 2020. RESULTS: Of 8 125 persons with confirmed SARS-CoV-2 in the whole population, 493 (6.1 %) were under 20 years old. The median age of the under-20s was 15 years, and 252 (51 %) were girls. 3 % were hospitalised. No deaths were registered among patients aged under 20 in Norway. We found a somewhat larger share with confirmed SARS-CoV-2 in the group with diseases of the neuromuscular system. INTERPRETATION: Few children and adolescents have had SARS-CoV-2 confirmed, and only a very few have been hospitalised. Underlying conditions may result in a lower threshold for testing, and hence a higher incidence of confirmed infection in this group, although higher risk cannot be excluded.


Assuntos
Infecções por Coronavirus/epidemiologia , Hospitalização/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Adolescente , Betacoronavirus , Criança , Infecções por Coronavirus/diagnóstico , Feminino , Humanos , Masculino , Noruega/epidemiologia , Pandemias , Pneumonia Viral/diagnóstico , Adulto Jovem
9.
Tidsskr Nor Laegeforen ; 140(11)2020 08 18.
Artigo em Norueguês | MEDLINE | ID: mdl-32815354

RESUMO

BACKGROUND: The course of disease, complications and hospital mortality among patients with COVID-19 admitted to Norwegian hospitals has not been widely described. The purpose of this study was to survey patients with COVID-19 admitted to a local hospital. MATERIAL AND METHOD: The data were retrieved from a prospective observational study of all patients admitted with COVID-19 to Bærum Hospital since the start of the coronavirus outbreak. RESULTS: A total of 73 patients with COVID-19 admitted in the period 9 March 2020-7 May 2020 were included. The mean age was 67.9 years, and 43 patients (59 %) were men. The average number of days hospitalised was 10.1. Altogether 19 patients (26 %) had a very severe course of disease, and 14 (19 %) died during their stay in hospital. The mean age among the patients who died was 79.5 years. A total of 49 patients (67 %) had hypoxaemia and required oxygen therapy for an average of 10.1 days. Of these, 9 patients were given invasive respiratory support for a median 18 days. Symptoms of delirium occurred in 26 patients (36 %) and was the most frequent non-respiratory complication. INTERPRETATION: The majority of the patients hospitalised with COVID-19 needed prolonged oxygen therapy, and there was a high incidence of severe complications.


Assuntos
Infecções por Coronavirus/complicações , Infecções por Coronavirus/mortalidade , Pneumonia Viral/complicações , Pneumonia Viral/mortalidade , Idoso , Betacoronavirus , Feminino , Humanos , Masculino , Noruega/epidemiologia , Pandemias , Estudos Prospectivos
10.
Tidsskr Nor Laegeforen ; 140(11)2020 08 18.
Artigo em Inglês, Norueguês | MEDLINE | ID: mdl-32815356

RESUMO

BACKGROUND: Nursing home residents are generally old and frail, and at high risk that COVID-19 will take a serious course. Outbreaks of COVID-19 have not previously been described in Norway, and it is important to identify mechanisms for spread of the infection and course of disease for nursing home residents with this pandemic disease. MATERIAL AND METHOD: We included residents from three nursing homes with outbreaks of COVID-19 in a retrospective observational study, and we retrieved information on the number of staff for whom SARS-CoV-2 was confirmed or who were placed in quarantine. We present resident characteristics, course of disease and mortality associated with COVID-19 in the nursing homes, as well as providing a brief description of the outbreaks. RESULTS: Forty residents were included, 26 of whom were women. The average age was 86.2 years. Thirty-seven of the residents had atypical symptoms, nine of them were asymptomatic at the time of diagnosis, and 21 died during the coronavirus infection. Contact tracing indicated that the outbreaks may have originated from staff in the pre-symptomatic or early and mild phase of the disease. SARS-CoV-2 was detected in forty-two staff members, and a further 115 were placed in quarantine. INTERPRETATION: Many residents had atypical disease presentation, and the mortality from COVID-19 was high. Spread of infection may have originated from staff, also before they displayed obvious symptoms, and contributed to extensive spread of SARS-CoV-2 in the three nursing homes.


Assuntos
Infecções por Coronavirus/epidemiologia , Instituição de Longa Permanência para Idosos/estatística & dados numéricos , Casas de Saúde/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Idoso de 80 Anos ou mais , Betacoronavirus , Surtos de Doenças , Feminino , Humanos , Masculino , Noruega/epidemiologia , Pandemias , Estudos Retrospectivos
11.
Eur Rev Med Pharmacol Sci ; 24(15): 8232-8238, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32767355

RESUMO

OBJECTIVE: The COVID-19 pandemic has caused a global public health crisis with social, psychological and long-lasting economical damages. Weather-related dynamics have an impact on the pattern of human health and disease. The present study aimed to investigate the impact of heat and humidity on daily basis incidence and mortality due to COVID-19 pandemic in ten of the world's hottest countries compared to ten of the coldest ones. MATERIALS AND METHODS: Worldwide, we selected 20 countries; 10 hottest countries with the highest temperatures and 10 coldest countries with the lowest temperature. The selection of the countries was based on the daily basis mean temperature from the date of appearance of the initial cases of COVID-19, Dec 29, 2019 to May 12, 2020. In the world's 10 hottest countries, the mean temperature was (26.31±1.51) and humidity (44.67±4.97). However, in the world's 10 coldest countries the mean temperature was (6.19±1.61) and humidity (57.26±2.35). The data on the global outbreak of COVID-19, daily new cases and deaths were recorded from World Health Organization, and daily information on temperature and humidity was obtained from metrological web "Time and Date". RESULTS: In countries with high temperatures and low humidity, the mean daily cases incidence were (407.12±24.33); cumulative cases (9094.34±708.29); and cumulative deaths (452.84±43.30) were significantly low compared to countries with low temperatures and high humidity: daily cases (1876.72±207.37); cumulative cases (44232.38±5875.11); and cumulative deaths (2008.29±310.13). Moreover, COVID-19 cases and deaths per million population were significantly low in countries with high temperatures (cases 711.23, and deaths 16.27) compared to countries with low temperatures (cases 1685.99; and deaths 86.40). Furthermore, in hottest countries, a 1% increase in humidity reduced number of cases and deaths by (ß = -5.40, p<0.001) and (ß = -0.187, p=0.004) respectively. A similar trend was seen with a 1°C increase in temperature, reducing the number of deaths by (ß = -1.35. p<0.001). CONCLUSIONS: The results revealed a significant decrease in incidence of daily cases and deaths in countries with high temperatures and low humidity (warmest countries), compared to those countries with low temperatures and high humidity (coldest countries). The findings could be of interest to the policymakers and the health officials on the epidemiological trends of COVID-19 pandemic and weather changes.


Assuntos
Clima , Infecções por Coronavirus/epidemiologia , Temperatura Alta , Umidade , Pneumonia Viral/epidemiologia , Argélia/epidemiologia , Áustria/epidemiologia , Betacoronavirus , Canadá/epidemiologia , Infecções por Coronavirus/mortalidade , Estônia/epidemiologia , Finlândia/epidemiologia , Gana/epidemiologia , Humanos , Incidência , Índia/epidemiologia , Irã (Geográfico)/epidemiologia , Cazaquistão/epidemiologia , Kuweit/epidemiologia , México/epidemiologia , Mortalidade , Noruega/epidemiologia , Omã/epidemiologia , Paquistão/epidemiologia , Pandemias , Pneumonia Viral/mortalidade , Análise de Regressão , República de Belarus/epidemiologia , Federação Russa/epidemiologia , Arábia Saudita/epidemiologia , Suécia/epidemiologia , Emirados Árabes Unidos/epidemiologia , Estados Unidos/epidemiologia
12.
Scand J Trauma Resusc Emerg Med ; 28(1): 66, 2020 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-32660623

RESUMO

BACKGROUND: There is a need for validated clinical risk scores to identify patients at risk of severe disease and to guide decision-making during the covid-19 pandemic. The National Early Warning Score 2 (NEWS2) is widely used in emergency medicine, but so far, no studies have evaluated its use in patients with covid-19. We aimed to study the performance of NEWS2 and compare commonly used clinical risk stratification tools at admission to predict risk of severe disease and in-hospital mortality in patients with covid-19. METHODS: This was a prospective cohort study in a public non-university general hospital in the Oslo area, Norway, including a cohort of all 66 patients hospitalised with confirmed SARS-CoV-2 infection from the start of the pandemic; 13 who died during hospital stay and 53 who were discharged alive. Data were collected consecutively from March 9th to April 27th 2020. The main outcome was the ability of the NEWS2 score and other clinical risk scores at emergency department admission to predict severe disease and in-hospital mortality in covid-19 patients. We calculated sensitivity and specificity with 95% confidence intervals (CIs) for NEWS2 scores ≥5 and ≥ 6, quick Sequential Organ Failure Assessment (qSOFA) score ≥ 2, ≥2 Systemic Inflammatory Response Syndrome (SIRS) criteria, and CRB-65 score ≥ 2. Areas under the curve (AUCs) for the clinical risk scores were compared using DeLong's test. RESULTS: In total, 66 patients (mean age 67.9 years) were included. Of these, 23% developed severe disease. In-hospital mortality was 20%. Tachypnoea, hypoxemia and confusion at admission were more common in patients developing severe disease. A NEWS2 score ≥ 6 at admission predicted severe disease with 80.0% sensitivity and 84.3% specificity (Area Under the Curve (AUC) 0.822, 95% CI 0.690-0.953). NEWS2 was superior to qSOFA score ≥ 2 (AUC 0.624, 95% CI 0.446-0.810, p < 0.05) and other clinical risk scores for this purpose. CONCLUSION: NEWS2 score at hospital admission predicted severe disease and in-hospital mortality, and was superior to other widely used clinical risk scores in patients with covid-19.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Escore de Alerta Precoce , Mortalidade Hospitalar , Admissão do Paciente , Pneumonia Viral/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Pandemias , Medição de Risco , Sensibilidade e Especificidade , Índice de Gravidade de Doença
13.
BMC Infect Dis ; 20(1): 515, 2020 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-32677903

RESUMO

BACKGROUND: Procalcitonin is an inflammatory biomarker that is sensitive for bacterial infections and a promising clinical decision aid in antimicrobial stewardship programs. However, there are few studies of physicians' experiences concerning the use of PCT. The objective of this study was to investigate whether hospital physicians' experience with procalcitonin after 18 months of use can inform the PCT implementation in antimicrobial stewardship programs. MATERIALS/METHODS: We deployed a qualitative approach using semi-structured interviews with 14 hospital physicians who had experience with procalcitonin in clinical practice. Interviews were audio-taped, transcribed verbatim and analysed using thematic analysis. RESULTS: Physicians reported a knowledge gap, which made them uncertain about the appropriate procalcitonin use, interpretation, and trustworthiness. Simultaneously, the physicians experienced procalcitonin as a useful clinical decision aid but emphasised that their clinical evaluation of the patient was the most important factor when deciding on antibiotic treatment. CONCLUSIONS: Procalcitonin was regarded a helpful clinical tool, but the physicians called for more knowledge about its appropriate uses. Active implementation of unambiguous procalcitonin algorithms and physician education may enhance the utility of the test as an antimicrobial stewardship adjunct.


Assuntos
Gestão de Antimicrobianos , Infecções Bacterianas/diagnóstico , Biomarcadores/sangue , Hospitais/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Pró-Calcitonina/sangue , Adulto , Idoso , Algoritmos , Antibacterianos/uso terapêutico , Gestão de Antimicrobianos/organização & administração , Gestão de Antimicrobianos/normas , Infecções Bacterianas/sangue , Infecções Bacterianas/tratamento farmacológico , Bioensaio/estatística & dados numéricos , Feminino , Fidelidade a Diretrizes/estatística & dados numéricos , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Médicos/normas , Médicos/estatística & dados numéricos , Padrões de Prática Médica/normas , Pró-Calcitonina/análise , Pesquisa Qualitativa , Inquéritos e Questionários
14.
Tidsskr Nor Laegeforen ; 140(10)2020 06 30.
Artigo em Inglês, Norueguês | MEDLINE | ID: mdl-32602316

RESUMO

BACKGROUND: The COVID-19 pandemic in the spring of 2020 involved closure of schools and strict limitations on social contact. The study examines whether this had an effect on the life satisfaction and subjective well-being among adolescents. MATERIAL AND METHOD: An online survey among students in lower secondary schools in Oslo (N = 8 116, 46 % response rate) was conducted during the period with closed schools and strict infection control measures. The results were compared to equivalent surveys conducted in Oslo in 2018 (N = 13 790, 83 % response rate) and several other counties in 2020 before the COVID-19 restrictions were introduced (N = 19 799, 49 % response rate). Identical measurements were used for life satisfaction, subjective well-being and background factors. We used logistic regression analysis and corrected for sociodemographic differences. RESULTS: Among boys, the proportion reporting high life satisfaction (a score of 6 or higher on a scale from 0 to 10) declined markedly, from 88 % in 2018 and 92 % in 2020 before the COVID-19 restrictions to 71 % during the period of restrictions (p < 0.001). The equivalent figures for girls were 78 %, 81 % and 62 % (p < 0.001). The social inequality in life satisfaction was smaller during the restrictions than in other periods. Concerns about illness and infection were associated with lower life satisfaction. INTERPRETATION: The reduction in life satisfaction and subjective well-being can most likely be explained by the heavy restrictions placed on activities that promote well-being and by concerns about infection. The results also indicate that resourceful adolescents experienced an especially strong reduction in their life satisfaction.


Assuntos
Infecções por Coronavirus/psicologia , Satisfação Pessoal , Pneumonia Viral/psicologia , Sucesso Acadêmico , Adolescente , Betacoronavirus , Emigrantes e Imigrantes , Feminino , Humanos , Modelos Logísticos , Masculino , Saúde Mental , Noruega/epidemiologia , Pandemias , Instituições Acadêmicas , Classe Social , Inquéritos e Questionários
16.
BMC Infect Dis ; 20(1): 479, 2020 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-32631331

RESUMO

BACKGROUND: The study aimed to assess whether gastrointestinal (GI) symptoms at admission are associated with increased short-term mortality in patients with invasive pneumococcal disease (IPD). METHODS: We included all patients with IPD at Aker University Hospital in Oslo, Norway, from 1993 to 2008. Clinical data were registered. Survival data were retrieved from official registries. We used Cox regression and Kaplan-Meier curve to compare mortality within 28 days of admission in patients with and without GI symptoms. RESULTS: Four hundred sixteen patients were included. Of these, 108 patients (26%) presented with GI symptoms, and 47 patients (11%) with GI symptoms only. Patients with GI symptoms were younger (p < 0.001) and had less cardiovascular disease (p < 0.001), pulmonary disease (p = 0.048), and cancer (p = 0.035) and received appropriate antibiotic treatment later. After adjusting for risk factors, we found an increased hazard ratio of 2.28 (95% CI 1.31-3.97) in patients presenting with GI symptoms. In patients with GI symptoms only there was an increased hazard ratio of 2.24 (95% CI 1.20-4.19) in univariate analysis, which increased to 4.20 (95% CI 2.11-8.39) after multivariate adjustment. Fewer patients with GI symptoms only received antibiotics upon admission. CONCLUSIONS: A large proportion of IPD patients present with GI symptoms only or in combination with other symptoms. GI symptoms in IPD are associated with increased short-term mortality.


Assuntos
Gastroenteropatias/epidemiologia , Gastroenteropatias/microbiologia , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/mortalidade , Streptococcus pneumoniae/imunologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Comorbidade , Feminino , Gastroenteropatias/tratamento farmacológico , Hospitalização , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Infecções Pneumocócicas/tratamento farmacológico , Modelos de Riscos Proporcionais , Estudos Prospectivos , Estudos Retrospectivos , Fatores de Risco , Streptococcus pneumoniae/isolamento & purificação , Resultado do Tratamento , Adulto Jovem
17.
Euro Surveill ; 25(22)2020 Jun.
Artigo em Inglês | MEDLINE | ID: covidwho-525934

RESUMO

In response to the coronavirus disease (COVID-19) pandemic, most countries implemented school closures. In Norway, schools closed on 13 March 2020. The evidence of effect on disease transmission was limited, while negative consequences were evident. Before reopening, risk-assessment for paediatric risk groups was performed, concluding that most children can attend school with few conditions requiring preventative homeschooling. We here present infection prevention and control guidelines for primary schools and recommendations for paediatric risk groups.


Assuntos
Infecções por Coronavirus/prevenção & controle , Coronavirus , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Instituições Acadêmicas/organização & administração , Betacoronavirus , Criança , Infecções por Coronavirus/epidemiologia , Guias como Assunto , Humanos , Noruega/epidemiologia , Pneumonia Viral/epidemiologia , Medição de Risco , Fatores de Risco
18.
Tidsskr Nor Laegeforen ; 140(9)2020 06 16.
Artigo em Inglês, Norueguês | MEDLINE | ID: covidwho-608544

RESUMO

BACKGROUND: The Norwegian Surveillance System for Communicable Diseases (MSIS) is based on reporting of cases of 72 mandatory notifiable diseases by clinical microbiological laboratories and diagnosing physicians. The aim of our study was to investigate a potential temporal association between measures against COVID-19 in February-April 2020 and incidence of other infectious diseases reported to MSIS. MATERIAL AND METHOD: We compared the number of disease cases reported to MSIS during weeks 6-14 in 2020 with the median of cases reported in corresponding weeks during three previous years (2017-2019). RESULTS: Compared to the median of cases reported during corresponding weeks in three previous years, physicians and laboratories reported 47 % fewer cases (159 vs. 301) in week 12, 50 % fewer cases (131 vs. 261) in week 13, and 69 % fewer cases (77 vs. 252) in week 14. There was a reduction in the number of notifications of all included disease groups. INTERPRETATION: The observed decline in reporting of diseases other than COVID-19 may indicate a reduced risk of communicable diseases due to comprehensive advice and the requirement for social distancing. However, it is also possible that the sensitivity of the surveillance system was affected by increased resource use on COVID-19 cases management.


Assuntos
Doenças Transmissíveis , Infecções por Coronavirus , Notificação de Doenças , Pandemias , Pneumonia Viral , Betacoronavirus , Doenças Transmissíveis/epidemiologia , Infecções por Coronavirus/epidemiologia , Humanos , Notificação de Abuso , Noruega/epidemiologia , Pneumonia Viral/epidemiologia , Vigilância da População , Quarentena
19.
Tidsskr Nor Laegeforen ; 140(9)2020 06 16.
Artigo em Inglês, Norueguês | MEDLINE | ID: covidwho-604434

RESUMO

BACKGROUND: The Norwegian Surveillance System for Communicable Diseases (MSIS) is based on reporting of cases of 72 mandatory notifiable diseases by clinical microbiological laboratories and diagnosing physicians. The aim of our study was to investigate a potential temporal association between measures against COVID-19 in February-April 2020 and incidence of other infectious diseases reported to MSIS. MATERIAL AND METHOD: We compared the number of disease cases reported to MSIS during weeks 6-14 in 2020 with the median of cases reported in corresponding weeks during three previous years (2017-2019). RESULTS: Compared to the median of cases reported during corresponding weeks in three previous years, physicians and laboratories reported 47 % fewer cases (159 vs. 301) in week 12, 50 % fewer cases (131 vs. 261) in week 13, and 69 % fewer cases (77 vs. 252) in week 14. There was a reduction in the number of notifications of all included disease groups. INTERPRETATION: The observed decline in reporting of diseases other than COVID-19 may indicate a reduced risk of communicable diseases due to comprehensive advice and the requirement for social distancing. However, it is also possible that the sensitivity of the surveillance system was affected by increased resource use on COVID-19 cases management.


Assuntos
Doenças Transmissíveis , Infecções por Coronavirus , Notificação de Doenças , Pandemias , Pneumonia Viral , Betacoronavirus , Doenças Transmissíveis/epidemiologia , Infecções por Coronavirus/epidemiologia , Humanos , Notificação de Abuso , Noruega/epidemiologia , Pneumonia Viral/epidemiologia , Vigilância da População , Quarentena
20.
PLoS One ; 15(6): e0234561, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32555596

RESUMO

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) has been associated with an increased risk of tobacco smoking, and more difficulties with smoking cessation compared to non-ADHD individuals. Women with ADHD may therefore show elevated rates of smoking during pregnancy. AIMS: To examine the association between ADHD and smoking habits among pregnant women in Sweden and Norway. METHODS: Women pregnant for the first time were identified in Sweden (n = 622,037), and Norway (n = 293,383), of which 1.2% (n = 7,444), and 1.7% (n = 4,951) were defined as having ADHD, respectively. Data on smoking habits were collected early and late in pregnancy. RESULTS: In Sweden, ADHD was associated with an increased risk of smoking early in pregnancy, adjusted risk ratio (adjRR) 2.69 (95% confidence interval, 2.58-2.81), and late in pregnancy, adjRR 2.95 (2.80-3.10). Similar findings were observed in the Norwegian data, early in pregnancy, adjRR 2.31 (2.21-2.40), and late in pregnancy, adjRR 2.56 (2.42-2.70). Women with ADHD were more likely to continue smoking during pregnancy, compared to women without ADHD, both in Sweden adjRR 1.13 (1.10-1.17), and in Norway, adjRR 1.16 (1.12-1.20). Having a sibling diagnosed with ADHD was associated with an increased risk of smoking early and late in pregnancy, in both Sweden and Norway. CONCLUSIONS: Women with ADHD are considerably more likely to smoke early and late in (their first) pregnancy and are less likely to stop smoking between the two time points. Smoking, early and late in pregnancy, co-aggregates in families with ADHD. Smoking prevention and intervention programs should be targeted towards women with ADHD, specifically during their childbearing years, to ensure better mother and child outcomes.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Fumar Tabaco/epidemiologia , Estudos de Coortes , Feminino , Humanos , Noruega/epidemiologia , Gravidez , Primeiro Trimestre da Gravidez , Terceiro Trimestre da Gravidez , Fatores de Risco , Irmãos , Abandono do Hábito de Fumar , Suécia/epidemiologia
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