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1.
Viruses ; 13(9)2021 09 12.
Artigo em Inglês | MEDLINE | ID: mdl-34578394

RESUMO

Approximately 67% of U.S. households have pets. Limited data are available on SARS-CoV-2 in pets. We assessed SARS-CoV-2 infection in pets during a COVID-19 household transmission investigation. Pets from households with ≥1 person with laboratory-confirmed COVID-19 were eligible for inclusion from April-May 2020. We enrolled 37 dogs and 19 cats from 34 households. All oropharyngeal, nasal, and rectal swabs tested negative by rRT-PCR; one dog's fur swabs (2%) tested positive by rRT-PCR at the first sampling. Among 47 pets with serological results, eight (17%) pets (four dogs, four cats) from 6/30 (20%) households had detectable SARS-CoV-2 neutralizing antibodies. In households with a seropositive pet, the proportion of people with laboratory-confirmed COVID-19 was greater (median 79%; range: 40-100%) compared to households with no seropositive pet (median 37%; range: 13-100%) (p = 0.01). Thirty-three pets with serologic results had frequent daily contact (≥1 h) with the index patient before the person's COVID-19 diagnosis. Of these 33 pets, 14 (42%) had decreased contact with the index patient after diagnosis and none were seropositive; of the 19 (58%) pets with continued contact, four (21%) were seropositive. Seropositive pets likely acquired infection after contact with people with COVID-19. People with COVID-19 should restrict contact with pets and other animals.


Assuntos
COVID-19/epidemiologia , COVID-19/virologia , Animais de Estimação/virologia , SARS-CoV-2 , Animais , COVID-19/história , COVID-19/transmissão , Gatos , Cães , Características da Família , História do Século XXI , Humanos , Animais de Estimação/história , Filogenia , Vigilância da População , RNA Viral , SARS-CoV-2/classificação , SARS-CoV-2/genética , SARS-CoV-2/isolamento & purificação , Estudos Soroepidemiológicos , Utah/epidemiologia , Zoonoses Virais/epidemiologia , Wisconsin/epidemiologia
2.
J Dent Hyg ; 95(4): 51-58, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34376544

RESUMO

Purpose: Oral cancer risks have been shown to be modified by improving public awareness and reducing barriers to preventive care. The purpose for this study was to assess oral cancer knowledge and awareness and provide oral cancer screenings and education to a population of rural farmers in Wisconsin.Methods: Attendees 18 years of age and older at a rural farming exposition in Wisconsin were invited to complete a 12-item oral cancer awareness paper survey and to receive a visual and tactile head and neck examination/ oral cancer screening. Completing both the survey and the screening were optional. Participants also received educational materials on oral cancer. Individuals with abnormal lesions were provided with dental referrals.Results: A total of 236 attendees consented to participate either the survey or oral cancer screening (n=236). Most (72%) reported seeing a dentist in the past six months regardless of insurance status. In spite of having had recent dental encounters, only 28% of women and 46% of men were able to identify at least one risk factor associated with oral cancer. Among participants consenting to the oral cancer screening (n=194), 17% (n=33) presented with oral lesions requiring additional assessment and were recommended for follow-up care.Conclusions: Knowledge and awareness of oral cancer risk factors, signs and symptoms was low among the participants in this rural population despite high rates of dental care access. Oral cancer screenings and education provided in varied settings could improve oral cancer knowledge and awareness and early detection of malignant oral lesions in rural communities.


Assuntos
Neoplasias Bucais , População Rural , Adolescente , Adulto , Detecção Precoce de Câncer , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/epidemiologia , Inquéritos e Questionários , Wisconsin/epidemiologia
3.
Math Biosci Eng ; 18(4): 3733-3754, 2021 04 29.
Artigo em Inglês | MEDLINE | ID: mdl-34198410

RESUMO

In this study, we design and use a mathematical model to primarily address the question of who are the main drivers of COVID-19 - the symptomatic infectious or the pre-symptomatic and asymptomatic infectious in the state of Wisconsin and the entire United States. To set the stage, we first briefly simulate and illustrate the benefit of lockdown. With these lockdown scenarios, and in general, the more dominant influence of the the pre-symptomatic and asymptomatic infectious over the symptomatic infectious, is shown in various ways. Numerical simulations for the U.S. show that an increase in testing and isolating for the pre-symptomatic and asymptomatic infectious group has up to 4 times more impact than an increase in testing for the symptomatic infectious in terms of cumulative deaths. An increase in testing for the pre-symptomatic and asymptomatic infectious group also has significantly more impact (on the order of twice as much) on reducing the control reproduction number than testing for symptomatic infectious. Lastly, we use our model to simulate an implementation of a natural herd immunity strategy for the entire U.S. and for the state of Wisconsin (once an epicenter for COVID-19). These simulations provide specific examples confirming that such a strategy requires a significant number of deaths before immunity is achieved, and as such, this strategy is certainly questionable in terms of success.


Assuntos
COVID-19 , Infecções Assintomáticas , Controle de Doenças Transmissíveis , Humanos , SARS-CoV-2 , Estados Unidos , Wisconsin/epidemiologia
4.
WMJ ; 120(2): 94-99, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34255947

RESUMO

OBJECTIVE: To assess the clinical epidemiology and outcomes of patients hospitalized with COVID-19 who did not experience fever and cough during the early pandemic. METHODS: Retrospective cohort of all patients admitted during March 13, 2020 through May 13, 2020 with laboratory-confirmed COVID-19 to 3 tertiary-care hospitals. Patient-level data (demographic, clinical manifestations, comorbid illnesses, inpatient treatment) were analyzed. The main outcome variable was atypical presentation, defined as any hospitalized patient with COVID-19 infection who did not experience both fever and cough. We identified risk factors for atypical presentation on univariate and multivariate analyses and assessed 30-day mortality differences via survival analysis. RESULTS: Of 163 patients in the study, 39 (24%) were atypical. On univariate analysis, atypical cases were significantly more likely to be older, reside in a long-term-care facility (LTCF), and have underlying diabetes mellitus, stroke, or cardiac disease; present without dyspnea or myalgia, have lower C-reactive proteins (CRP) and higher beta-natriuretic peptides. They were less likely to receive intensive care unit care or specific COVID-19 treatments (P < .05). The incidence of acute respiratory failure was not significantly different between the groups. On logistic regression, atypical cases were significantly more likely to be LTCF residents (P = 0.003) and have a lower average CRP (P = 0.01). Atypical cases had significantly higher 30-day mortality (hazard ratio 3.4 [95% CI, 1.6 - 7.2], P = 0.002). CONCLUSION: During the first pandemic surge, COVID-19 patients without inflammatory signs and symptoms were more likely to be LTCF residents and had higher mortality. Timely recognition of these atypical presentations may have prevented spread and improved clinical outcomes.


Assuntos
COVID-19/mortalidade , Hospitalização , Pneumonia Viral/mortalidade , Idoso , Idoso de 80 Anos ou mais , COVID-19/terapia , Comorbidade , Tosse/epidemiologia , Feminino , Febre/epidemiologia , Mortalidade Hospitalar , Humanos , Assistência de Longa Duração , Masculino , Pandemias , Pneumonia Viral/terapia , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2 , Análise de Sobrevida , Wisconsin/epidemiologia
5.
WMJ ; 120(2): 100-105, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34255948

RESUMO

INTRODUCTION: Testing and mitigation strategies for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection often focus on high-prevalence, urban communities, leaving low-prevalence rural areas without specific strategies to maintain the health and safety of their populations. We evaluated a cost-effective strategy for SARS-CoV-2 testing to determine point prevalence in a rural community with a generally low prevalence of infection. METHODS: We voluntarily tested asymptomatic clinic employees and conducted 2 community SARS-CoV-2 testing events in Cashton, Wisconsin, that included testing for asymptomatic persons. We also partnered with local clinics and public health departments to conduct weekly drive-up clinics for asymptomatic, high-risk persons identified through enhanced contact tracing. This was possible as testing capacity in Wisconsin never reached its maximum, and we continued symptomatic testing through our clinic. RESULTS: We tested 61 employees, 268 individuals at 2 community events, 36 high-risk asymptomatic people at drive-up clinic events, and 128 symptomatic people within our clinic. We observed 1 positive result in asymptomatic people and 5 positive results in symptomatic patients, confirming the low prevalence in our area. CONCLUSIONS: Our testing events confirmed a low prevalence of SARS-CoV-2 infection, providing prevalence information to local businesses and schools. We reinforced our partnership with local public health departments to facilitate enhanced contact tracing and test asymptomatic persons, and we provided a service to asymptomatic persons requiring testing for travel, school, or work. Local businesses and community members appreciated the services and expressed relief for point-in-time testing results during a period of stress and uncertainty.


Assuntos
Teste para COVID-19 , COVID-19/diagnóstico , COVID-19/epidemiologia , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Adulto , Idoso , Documentação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/virologia , Prevalência , População Rural , SARS-CoV-2 , Wisconsin/epidemiologia
6.
WMJ ; 120(2): 137-141, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34255954

RESUMO

INTRODUCTION: The COVID-19 pandemic presented health care organizations with a unique challenge in determining effective management of a large-scale incident across an extended time period. CASE PRESENTATION: This report describes the response of a multisite integrated system to the COVID-19 pandemic through activation of the Hospital Incident Command System. DISCUSSION: A robust emergency response plan with multidisciplinary involvement can help to ensure clear lines of accountability and expedite decision-making. Consistent physician input across affected specialties allows for a robust understanding of impacted areas, peer-to-peer communication, and a sense of ownership across the medical staff. The necessity of effective communication with staff and patients during times of crisis cannot be understated. The potential for information overload in a pandemic is significant but can be overcome through consistent and transparent communication from leadership. CONCLUSION: Health systems should have a well-organized emergency response system prepared to launch in small-scale or large-scale situations. The threshold to implement the response system and accountability to make that decision must be a clearly defined organizational policy.


Assuntos
COVID-19/epidemiologia , Sistemas de Apoio a Decisões Administrativas , Planejamento em Desastres , Planejamento Hospitalar , Comunicação , Humanos , Estudos de Casos Organizacionais , Política Organizacional , Pandemias , SARS-CoV-2 , Capacidade de Resposta ante Emergências , Wisconsin/epidemiologia
7.
WMJ ; 120(2): 152-155, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34255958

RESUMO

BACKGROUND: The objective of this study was to determine the associations between heart disease, obesity, and demographic factors and increased COVID-19 mortality. METHODS: We extracted deidentified patient-level data from the Froedtert Health System and Children's Hospital of Wisconsin and used descriptive statistics and multivariable logistic regression to characterize relationships between heart disease, obesity, age group, sex, race and ethnicity and mortality following COVID-19 diagnosis. RESULTS: We found heart disease (adjusted odds ratio [AOR] 2.85; 95% CI, 2.11-8.83) and other demographic factors are significant predictors of increased mortality in COVID-19 patients. However, obesity was not a significant predictor of mortality (AOR 1.04; 95% CI, 0.53- 3.10). DISCUSSION: These unique results indicate some comorbid conditions and patient demographics contribute more strongly to mortality in COVID-19 patients.


Assuntos
COVID-19/etnologia , COVID-19/mortalidade , Cardiopatias/complicações , Hispano-Americanos/estatística & dados numéricos , Obesidade/complicações , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Cardiopatias/etnologia , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/etnologia , Pandemias , SARS-CoV-2 , Fatores Sexuais , Wisconsin/epidemiologia
8.
J Alzheimers Dis ; 82(3): 1171-1182, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34151799

RESUMO

BACKGROUND: There is a robust consensus, most recently articulated in the 2020 Lancet Commission, that the roots of dementia can be traced to early life, and that the path to prevention may start there as well. Indeed, a growing body of research demonstrates that early life disadvantage may influence the risk for later life dementia and cognitive decline. A still understudied risk, however, is early life rural residence, a plausible pathway given related economic and educational disadvantages, as well as associations between later life rural living and lower levels of cognitive functioning. OBJECTIVE: We aim to examine whether living in rural environments during early life has long term implications for cognitive health in later life. METHODS: We employed the Wisconsin Longitudinal Study, which tracked 1 in every 3 high school graduates from the class of 1957, from infancy to ∼age 72. The data include a rich array of prospectively collected early life data, unique among existing studies, as well as later life measures of cognitive functioning. RESULTS: We found a robust relationship between early life rural residence, especially living on a farm, and long-term risk for reduced cognitive performance on recall and fluency tasks. Controls for adolescent cognitive functioning, APOEɛ2 and APOEɛ4, as well as childhood and adult factors, ranging from early life socioeconomic conditions to later life health and rural and farm residency, did not alter the findings. CONCLUSION: Rural living in early life is an independent risk for lower levels of cognitive functioning in later life.


Assuntos
Experiências Adversas da Infância/psicologia , Experiências Adversas da Infância/tendências , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/psicologia , Escolaridade , População Rural/tendências , Adolescente , Adulto , Experiências Adversas da Infância/economia , Idoso , Disfunção Cognitiva/economia , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Classe Social , Meio Social , Fatores Socioeconômicos , Wisconsin/epidemiologia , Adulto Jovem
9.
Stud Health Technol Inform ; 280: 235-240, 2021 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-34190093

RESUMO

Recent attention within pediatric orthopedics focuses on the prevalence and prevention of post-operative complications, including surgical site infections (SSIs). While poor nutrition status has been noted as a risk factor, various definitions have been utilized. The aim of this retrospective chart review was to utilize the Academy of Nutrition and Dietetics (AND) and the American Society for Parenteral and Enteral Nutrition (ASPEN) diagnostic criteria to determine both the prevalence of malnutrition in pediatric patients undergoing spine deformity surgery and its influence on the prevalence of post-operative complications. A total of 2603 patients had a spine procedure between 2012 and 2018. Patients were excluded if they were less than 2 years of age or greater than 18 years of age and/or did not have their spine procedure completed at Children's Wisconsin. Patients who met inclusion criteria and had an irrigation and debridement (I&D) were selected for an I&D group. From the remaining charts, 127 patients were randomly selected for the non-I&D group. Patients in both groups were further divided into well-nourished and malnourished groups. T-tests and chi square tests were used to determine statistical significance. We found that 50% of patients who had an I&D had malnutrition during their clinical course. This is compared with 17% of patients who didn't require an I&D. Additionally, patients requiring multiple surgical interventions, had an increased prevalence of malnutrition. With the recent focus on reducing the prevalence of post-operative complications, the identification and treatment of malnutrition may be helpful in reducing post-operative complications.


Assuntos
Desnutrição , Escoliose , Fusão Vertebral , Adolescente , Criança , Pré-Escolar , Humanos , Desnutrição/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Prevalência , Estudos Retrospectivos , Escoliose/epidemiologia , Escoliose/cirurgia , Coluna Vertebral , Wisconsin/epidemiologia
10.
Child Abuse Negl ; 118: 105136, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34098378

RESUMO

BACKGROUND: COVID-19 has had a major impact on child abuse and neglect (CAN) in the U.S. leading to a change in the number of reported screened-in CAN investigations, missed prevention cases, and missed CAN cases. OBJECTIVES: To estimate the deficit number of CAN investigations and resultant estimated number of missed prevention and CAN cases due to the COVID-19 pandemic in the U.S. from March 2020 to December 2020. METHODS: Secondary data analyses of administrative child welfare data from January 2013 to December 2020 from New York City, Florida, New Jersey and Wisconsin were conducted. Spline regression modeling controlling for autocorrelation was utilized to explore any significant changes once the pandemic began in March 2020 in the number of screened-in CAN investigations. The seven-year monthly average of screen-in CAN investigations for March through December from 2013 to 2019 was calculated and compared to the numbers of CAN investigations for March 2020 to December 2020. The resultant number of missed prevention cases and CAN cases was estimated for the four jurisdictions and used to approximate the number of missed prevention cases and CAN cases in the U.S., as well as the projected estimation of national lifetime economic costs. RESULTS: Prior to the pandemic, there were insignificant monthly increases of 0.7 CAN investigations in NYC and 6.2 CAN investigations in Florida, a significant monthly increase 4.2 CAN investigations in New Jersey and an insignificant monthly decrease in 0.6 CAN investigations in Wisconsin. Once the pandemic began, there were significant monthly decreases (p < .001) in each of the four jurisdictions, including 1425.6 fewer CAN investigations in NYC, 3548.0 fewer CAN investigations in Florida, 963.0 fewer CAN investigations in New Jersey and 529.1 fewer CAN investigations in Wisconsin. There were an estimated 60,791 fewer CAN investigations in these four jurisdictions from March 2020 to December 2020 of which there were approximately 18,540 missed prevention and CAN cases suggesting up to $4.2 billion in lifetime economic costs. It was estimated that were 623,137 children not investigated for CAN in the U.S. during the same 10-month period. This suggests that there were an estimated 85,993 children were missed for prevention services and about 104,040 children were missed for CAN with a potential lifetime economic impact of up to $48.1 billion in the U.S. CONCLUSIONS: The COVID-19 pandemic has led to a precipitous drop in CAN investigations where almost 200,000 children are estimated to have been missed for prevention services and CAN in a 10-month period. There are opportunities for the child welfare jurisdictions to work with partner education, public health, social service and other providers to strategically approach this very grave issue in order to mitigate its impact on this very vulnerable population.


Assuntos
COVID-19/epidemiologia , COVID-19/psicologia , Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/tendências , Proteção da Criança/psicologia , Proteção da Criança/tendências , Criança , Família/psicologia , Florida/epidemiologia , Humanos , Masculino , New Jersey/epidemiologia , Cidade de Nova Iorque/epidemiologia , Pandemias/prevenção & controle , Saúde Pública/tendências , SARS-CoV-2 , Estados Unidos/epidemiologia , Wisconsin/epidemiologia
11.
Transpl Infect Dis ; 23(4): e13671, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34146378

RESUMO

Blastomycosis is a fungal infection caused primarily by Blastomyces dermatitis. The fungus is endemic to the Ohio, Mississippi, and St. Lawrence River areas of the United States. Organ transplant recipients are at risk of blastomycosis due to pharmacologic immunosuppression. Over a 20-year period, 30 cases of blastomycosis post-solid organ transplantation were identified at our center. The cumulative incidence of blastomycosis among SOT recipients was 0.99%. There was a male predominance (70% male) and a median age of 59 at the time of diagnosis. Regarding transplant type, 23 patients received kidney transplants, 4 received liver transplants, 2 received pancreas transplants and 1 received a heart transplant. Median time to blastomycosis identification post-transplant was 67.8 months (range: 1-188 months). Amphotericin B was used as initiation therapy in most cases, followed by itraconazole, voriconazole, or in select cases fluconazole or posaconazole maintenance therapy. Regarding comorbid conditions, 87% of patients had diabetes, 50% had congestive heart failure, and 20% had chronic pulmonary disease. Nine patients (30%) developed blastomycosis-related acute respiratory distress syndrome, 33% of these died with a median time to death of 22 days (range 20 days to 2 months); these were the only deaths attributable to blastomycosis.


Assuntos
Blastomicose , Transplante de Órgãos , Antifúngicos/uso terapêutico , Blastomicose/tratamento farmacológico , Blastomicose/epidemiologia , Feminino , Humanos , Masculino , Transplante de Órgãos/efeitos adversos , Estudos Retrospectivos , Estados Unidos , Wisconsin/epidemiologia
12.
J Surg Res ; 265: 245-251, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33962102

RESUMO

BACKGROUND: Lower socioeconomic status (SES) is linked to poorer outcomes for a variety of health conditions in children, potentially through delay in accessing care. The objective of this study was to measure the association between SES and delay in surgical care as marked by presentation with complicated appendicitis (CA). METHODS: Children treated for acute appendicitis between 2015-2019 at a large academic children's hospital were reviewed. Patient home addresses were used to calculate travel time to the children's hospital and to determine Area Deprivation Index (ADI), a neighborhood-level SES marker. Multivariable logistic regression models were used to compare the likelihood of CA across ADI while adjusting for confounders. RESULTS: Of 1,697 children with acute appendicitis, 38.8% had CA. Compared to those with uncomplicated disease, children with CA were younger, lived farther from the children's hospital, and were more likely to have Medicaid insurance and have ED visits in the 30 days preceding diagnosis. Children with CA disproportionately came from disadvantaged neighborhoods (P < 0.007), with 32% from the two most disadvantaged ADI deciles. The odds of CA rose 5% per ADI decile-increase (adjusted odds ratio [aOR] 1.05, 95%CI 1.01-1.09, P = 0.02). Younger age and >60-min travel time were also associated with CA. Association between ADI and CA remained among younger (<10 y) children (aOR 1.07, 95%CI 1.00-1.15, P = 0.048) and those living closer (<30 min) to the hospital (aOR 1.06, 95%CI 1.01-1.11, p=0.02). CONCLUSIONS: ADI is associated with CA among children, suggesting ADI may be a valuable marker of difficulty accessing surgical care among disadvantaged children.


Assuntos
Apendicite/epidemiologia , Populações Vulneráveis/estatística & dados numéricos , Adolescente , Apendicite/complicações , Criança , Feminino , Humanos , Masculino , Características de Residência , Estudos Retrospectivos , Fatores Socioeconômicos , Wisconsin/epidemiologia
14.
Proc Natl Acad Sci U S A ; 118(24)2021 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-34049993

RESUMO

The COVID-19 pandemic is a global threat presenting health, economic, and social challenges that continue to escalate. Metapopulation epidemic modeling studies in the susceptible-exposed-infectious-removed (SEIR) style have played important roles in informing public health policy making to mitigate the spread of COVID-19. These models typically rely on a key assumption on the homogeneity of the population. This assumption certainly cannot be expected to hold true in real situations; various geographic, socioeconomic, and cultural environments affect the behaviors that drive the spread of COVID-19 in different communities. What's more, variation of intracounty environments creates spatial heterogeneity of transmission in different regions. To address this issue, we develop a human mobility flow-augmented stochastic SEIR-style epidemic modeling framework with the ability to distinguish different regions and their corresponding behaviors. This modeling framework is then combined with data assimilation and machine learning techniques to reconstruct the historical growth trajectories of COVID-19 confirmed cases in two counties in Wisconsin. The associations between the spread of COVID-19 and business foot traffic, race and ethnicity, and age structure are then investigated. The results reveal that, in a college town (Dane County), the most important heterogeneity is age structure, while, in a large city area (Milwaukee County), racial and ethnic heterogeneity becomes more apparent. Scenario studies further indicate a strong response of the spread rate to various reopening policies, which suggests that policy makers may need to take these heterogeneities into account very carefully when designing policies for mitigating the ongoing spread of COVID-19 and reopening.


Assuntos
COVID-19/epidemiologia , COVID-19/transmissão , Migração Humana , Modelos Biológicos , Pandemias , SARS-CoV-2 , Cidades/epidemiologia , Humanos , Wisconsin/epidemiologia
15.
Transfusion ; 61(7): 2090-2098, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33913181

RESUMO

BACKGROUND: Pica is characterized as repeatedly eating or chewing a non-nutritious substance including, but not limited to ice, clay and dirt, starch, raw pasta, chalk, coal, paint, or paper. Pica symptoms can be intense and addiction-like and disrupt quality of life. It is strongly linked to iron deficiency. Since substantial iron loss occurs during blood donation, blood donors may be susceptible to development of pica behaviors. METHODS: We investigated demographic, clinical, hematological, and biochemical factors associated with pica using univariable and multivariable logistic regression analysis in a cohort of 11,418 racially diverse blood donors. Pica was defined by questionnaire responses as consuming at least 8 oz of ice daily and/or consumption of non-ice substances regardless of the amount and frequency. RESULTS: Pica was present in 2.2% of the donors. The sensitivity and specificity of pica in iron-deficient donors were 36% and 82%, respectively. Lower ferritin (p = .001), non-Asian race (p < .001), higher red cell distribution width (p < .001), younger age, and restless legs syndrome (p = .008) were independently associated with pica. Female sex is associated with iron deficiency but was not an independent predictor of pica suggesting that iron deficient males and females were equally susceptible to the development of pica behaviors. Donors with normal ferritin levels also reported pica, reinforcing the role of non-iron related factors in its presentation. CONCLUSIONS: We have identified demographic, clinical, and biochemical predictors of pica that help identify those most at risk for developing pica behaviors, and thereby assist in its clinical diagnosis and treatment.


Assuntos
Doadores de Sangue , Ferro/deficiência , Pica/epidemiologia , Adolescente , Adulto , Biomarcadores , Contagem de Células Sanguíneas , Índice de Massa Corporal , Connecticut/epidemiologia , Grupos de Populações Continentais/estatística & dados numéricos , Suscetibilidade a Doenças , Índices de Eritrócitos , Grupos Étnicos/estatística & dados numéricos , Comportamento Alimentar , Feminino , Ferritinas/análise , Humanos , Gelo , Masculino , Pessoa de Meia-Idade , Pennsylvania/epidemiologia , Pica/etiologia , Sensibilidade e Especificidade , Inquéritos e Questionários , Wisconsin/epidemiologia , Adulto Jovem
17.
J Wildl Dis ; 57(2): 453-456, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33822164

RESUMO

Eastern equine encephalitis virus (EEEV) infects many avian species but has rarely been described in Ruffed Grouse (Bonasa umbellus). Between September and December 2019, 40 Ruffed Grouse, most in poor physical condition, were submitted to the Michigan, Wisconsin, and Minnesota (US) Departments of Natural Resources; eight were positive for EEEV.


Assuntos
Doenças das Aves/virologia , Vírus da Encefalite Equina do Leste/isolamento & purificação , Encefalomielite Equina/veterinária , Galliformes/virologia , Animais , Doenças das Aves/epidemiologia , Encefalomielite Equina/epidemiologia , Feminino , Masculino , Michigan/epidemiologia , Minnesota/epidemiologia , Wisconsin/epidemiologia
18.
J Aquat Anim Health ; 33(1): 53-65, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33825241

RESUMO

Serological assays were conducted for anti-viral hemorrhagic septicemia virus (VHSV) antibodies in four species of fish in Wisconsin (Bluegill Lepomis macrochirus, Brown Trout Salmo trutta, Northern Pike Esox lucius, and Walleye Sander vitreus) to examine spatial and temporal distributions of exposure. Sera were tested for non-neutralizing anti-nucleocapsid antibodies to VHSV by blocking enzyme-linked immunosorbent assay (ELISA). Results (percent inhibition [%I]) were analyzed for differences among species, across geographic distance, and among water management units. Positive fish occurred in 37 of 46 inland water bodies tested, including in water bodies far from reported outbreak events. Using highly conservative species-specific thresholds (mean %I of presumptive uninfected fish + 2 SDs), 4.3% of Bluegill, 13.4% of Brown Trout, 19.3% of Northern Pike, and 18.3% of Walleye tested positive for VHSV antibodies by ELISA. Spatial patterns of seropositivity and changes in %I between sampling years were also analyzed. These analyses explore how serology might be used to understand VHSV distribution and dynamics and ultimately to inform fisheries management.


Assuntos
Esocidae , Doenças dos Peixes/epidemiologia , Septicemia Hemorrágica Viral/epidemiologia , Novirhabdovirus/isolamento & purificação , Percas , Perciformes , Animais , Doenças dos Peixes/virologia , Septicemia Hemorrágica Viral/virologia , Estudos Soroepidemiológicos , Truta , Wisconsin/epidemiologia
20.
WMJ ; 120(S1): S70-S73, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33819408

RESUMO

BACKGROUND: Motivated by racial injustice and COVID-19 disparities, health care and medical education are accelerating efforts to address racism and eliminate health disparities. METHODS: In consultation with a community partner, an interprofessional physician-led team prioritized and completed an 8-hour anti-racism training adapted for online delivery during a pandemic. RESULTS: Sixty-four percent of enrollees (25/36) completed the survey, 98% rated the training as valuable, 92% would recommend it to a colleague, 88% reported it would improve their clinical care, and 68% thought their ability to create an inclusive environment increased. DISCUSSION: Virtual anti-racism training is a valuable learning experience. Tools for adapting trainings on high-risk or emotionally charged topics to a virtual format are offered by participants and session leaders.


Assuntos
COVID-19/epidemiologia , Educação Médica , Medicina de Família e Comunidade/educação , Pessoal de Saúde/educação , Racismo , Adulto , Relações Comunidade-Instituição , Educação à Distância , Feminino , Disparidades em Assistência à Saúde , Humanos , Masculino , Pandemias , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , SARS-CoV-2 , Inquéritos e Questionários , Wisconsin/epidemiologia
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