Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.197
Filtrar
1.
Sci Rep ; 11(1): 21812, 2021 11 08.
Artigo em Inglês | MEDLINE | ID: mdl-34750498

RESUMO

An estimation of the impact of climatic conditions-measured with an index that combines temperature and humidity, the IPTCC-on the hospitalizations and deaths attributed to SARS-CoV-2 is proposed. The present paper uses weekly data from 54 French administrative regions between March 23, 2020 and January 10, 2021. Firstly, a Granger causal analysis is developed and reveals that past values of the IPTCC contain information that allow for a better prediction of hospitalizations or deaths than that obtained without the IPTCC. Finally, a vector autoregressive model is estimated to evaluate the dynamic response of hospitalizations and deaths after an increase in the IPTCC. It is estimated that a 10-point increase in the IPTCC causes hospitalizations to rise by 2.9% (90% CI 0.7-5.0) one week after the increase, and by 4.1% (90% CI 2.1-6.4) and 4.4% (90% CI 2.5-6.3) in the two following weeks. Over ten weeks, the cumulative effect is estimated to reach 20.1%. Two weeks after the increase in the IPTCC, deaths are estimated to rise by 3.7% (90% CI 1.6-5.8). The cumulative effect from the second to the tenth weeks reaches 15.8%. The results are robust to the inclusion of air pollution indicators.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , COVID-19/epidemiologia , COVID-19/mortalidade , Clima , Hospitalização/estatística & dados numéricos , SARS-CoV-2 , Algoritmos , Teorema de Bayes , Tomada de Decisões , França/epidemiologia , Hospitais , Humanos , Umidade , Infectologia , Reprodutibilidade dos Testes , Transtornos Respiratórios , Estações do Ano , Temperatura
2.
PLoS One ; 16(11): e0259257, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34739498

RESUMO

Protective behaviors such as mask wearing and physical distancing are critical to slow the spread of COVID-19, even in the context of vaccine scale-up. Understanding the variation in self-reported COVID-19 protective behaviors is critical to developing public health messaging. The purpose of the study is to provide nationally representative estimates of five self-reported COVID-19 protective behaviors and correlates of such behaviors. In this cross-sectional survey study of US adults, surveys were administered via internet and telephone. Adults were surveyed from April 30-May 4, 2020, a time of peaking COVID-19 incidence within the US. Participants were recruited from the probability-based AmeriSpeak® national panel. Brief surveys were completed by 994 adults, with 73.0% of respondents reported mask wearing, 82.7% reported physical distancing, 75.1% reported crowd avoidance, 89.8% reported increased hand-washing, and 7.7% reported having prior COVID-19 testing. Multivariate analysis (p critical value .05) indicates that women were more likely to report protective behaviors than men, as were those over age 60. Respondents who self-identified as having low incomes, histories of criminal justice involvement, and Republican Party affiliation, were less likely to report four protective behaviors, though Republicans and individuals with criminal justice histories were more likely to report having received COVID-19 testing. The majority of Americans engaged in COVID-19 protective behaviors, with low-income Americans, those with histories of criminal justice involvement, and self-identified Republicans less likely to engage in these preventive behaviors. Culturally competent public health messaging and interventions might focus on these latter groups to prevent future infections. These findings will remain highly relevant even with vaccines widely available, given the complementarities between vaccines and protective behaviors, as well as the many challenges in delivering vaccines.


Assuntos
Teste para COVID-19 , Vacinas contra COVID-19 , COVID-19/epidemiologia , COVID-19/prevenção & controle , Desinfecção das Mãos , Máscaras , Adolescente , Adulto , Idoso , Controle de Doenças Transmissíveis , Estudos Transversais , Feminino , Geografia , Comportamentos Relacionados com a Saúde , Humanos , Infectologia/métodos , Internet , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Pobreza , Probabilidade , SARS-CoV-2 , Inquéritos e Questionários , Estados Unidos/epidemiologia , Adulto Jovem
3.
Eur J Nucl Med Mol Imaging ; 48(13): 4272-4292, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34633509

RESUMO

PURPOSE: The aim of this review is to give an overview of the current status of targeted optical fluorescence imaging in the field of oncology, cardiovascular, infectious and inflammatory diseases to further promote clinical translation. METHODS: A meta-narrative approach was taken to systematically describe the relevant literature. Consecutively, each field was assigned a developmental stage regarding the clinical implementation of optical fluorescence imaging. RESULTS: Optical fluorescence imaging is leaning towards clinical implementation in gastrointestinal and head and neck cancers, closely followed by pulmonary, neuro, breast and gynaecological oncology. In cardiovascular and infectious disease, optical imaging is in a less advanced/proof of concept stage. CONCLUSION: Targeted optical fluorescence imaging is rapidly evolving and expanding into the clinic, especially in the field of oncology. However, the imaging modality still has to overcome some major challenges before it can be part of the standard of care in the clinic, such as the provision of pivotal trial data. Intensive multidisciplinary (pre-)clinical joined forces are essential to overcome the delivery of such compelling phase III registration trial data and subsequent regulatory approval and reimbursement hurdles to advance clinical implementation of targeted optical fluorescence imaging as part of standard practice.


Assuntos
Fluorescência , Imagem Óptica , Cardiologia , Previsões , Humanos , Infectologia , Inflamação , Oncologia
6.
J Pediatric Infect Dis Soc ; 10(8): 801-844, 2021 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-34350458

RESUMO

This clinical practice guideline for the diagnosis and treatment of acute hematogenous osteomyelitis (AHO) in children was developed by a multidisciplinary panel representing Pediatric Infectious Diseases Society (PIDS) and the Infectious Diseases Society of America (IDSA). This guideline is intended for use by healthcare professionals who care for children with AHO, including specialists in pediatric infectious diseases, orthopedics, emergency care physicians, hospitalists, and any clinicians and healthcare providers caring for these patients. The panel's recommendations for the diagnosis and treatment of AHO are based upon evidence derived from topic-specific systematic literature reviews. Summarized below are the recommendations for the diagnosis and treatment of AHO in children. The panel followed a systematic process used in the development of other IDSA and PIDS clinical practice guidelines, which included a standardized methodology for rating the certainty of the evidence and strength of recommendation using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. A detailed description of background, methods, evidence summary and rationale that support each recommendation, and knowledge gaps can be found online in the full text.


Assuntos
Doenças Transmissíveis , Osteomielite , Pediatria , Doença Aguda , Criança , Doenças Transmissíveis/diagnóstico , Doenças Transmissíveis/terapia , Humanos , Infectologia , Osteomielite/diagnóstico , Osteomielite/terapia
8.
Dtsch Med Wochenschr ; 146(13-14): 904-907, 2021 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-34256405

RESUMO

From an infectious disease perspective, there have been outstanding findings since January 2020 far beyond the knowledge gained about SARS-CoV, which hopefully will help us to manage future pandemics. Positive highlights include the increased public awareness of infectious disease epidemiology, the increase in immunological knowledge, and the successful use of existing vaccine development platforms and technologies. This article presents a personal selection of interesting developments in recent months.


Assuntos
Anticorpos Antivirais/sangue , COVID-19/imunologia , Infectologia , SARS-CoV-2/imunologia , COVID-19/complicações , COVID-19/prevenção & controle , Humanos , Interferon Tipo I/sangue
9.
Annu Rev Biomed Eng ; 23: 547-577, 2021 07 13.
Artigo em Inglês | MEDLINE | ID: mdl-34255991

RESUMO

The host-to-host transmission of respiratory infectious diseases is fundamentally enabled by the interaction of pathogens with a variety of fluids (gas or liquid) that shape pathogen encapsulation and emission, transport and persistence in the environment, and new host invasion and infection. Deciphering the mechanisms and fluid properties that govern and promote these steps of pathogen transmission will enable better risk assessment and infection control strategies, and may reveal previously underappreciated ways in which the pathogens might actually adapt to or manipulate the physical and chemical characteristics of these carrier fluids to benefit their own transmission. In this article, I review our current understanding of the mechanisms shaping the fluid dynamics of respiratory infectious diseases.


Assuntos
Doenças Transmissíveis/fisiopatologia , Doenças Transmissíveis/transmissão , Hidrodinâmica , Transtornos Respiratórios/fisiopatologia , Aerossóis , COVID-19/transmissão , História do Século XIX , História do Século XX , História do Século XXI , Humanos , Infectologia/história , Distanciamento Físico , Sistema Respiratório/fisiopatologia , Sistema Respiratório/virologia , Reologia , SARS-CoV-2 , Saliva , Ventilação
10.
J Hosp Med ; 16(6): 353-356, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34129487

RESUMO

The COVID-19 pandemic has dramatically disrupted the educational experience of medical trainees. However, a detailed characterization of exactly how trainees' clinical experiences have been affected is lacking. Here, we profile residents' inpatient clinical experiences across the four training hospitals of NYU's Internal Medicine Residency Program during the pandemic's first wave. We mined ICD-10 principal diagnosis codes attributed to residents from February 1, 2020, to May 31, 2020. We translated these codes into discrete medical content areas using a newly developed "crosswalk tool." Residents' clinical exposure was enriched in infectious diseases (ID) and cardiovascular disease content at baseline. During the pandemic's surge, ID became the dominant content area. Exposure to other content was dramatically reduced, with clinical diversity repopulating only toward the end of the study period. Such characterization can be leveraged to provide effective practice habits feedback, guide didactic and self-directed learning, and potentially predict competency-based outcomes for trainees in the COVID era.


Assuntos
COVID-19 , Cardiologia/educação , Infectologia/educação , Internato e Residência , Pandemias , Humanos , Classificação Internacional de Doenças , Cidade de Nova Iorque
11.
Molecules ; 26(11)2021 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-34072765

RESUMO

Dendrimers comprise a specific group of macromolecules, which combine structural properties of both single molecules and long expanded polymers. The three-dimensional form of dendrimers and the extensive possibilities for use of additional substrates for their construction creates a multivalent potential and a wide possibility for medical, diagnostic and environmental purposes. Depending on their composition and structure, dendrimers have been of interest in many fields of science, ranging from chemistry, biotechnology to biochemical applications. These compounds have found wide application from the production of catalysts for their use as antibacterial, antifungal and antiviral agents. Of particular interest are peptide dendrimers as a medium for transport of therapeutic substances: synthetic vaccines against parasites, bacteria and viruses, contrast agents used in MRI, antibodies and genetic material. This review focuses on the description of the current classes of dendrimers, the methodology for their synthesis and briefly drawbacks of their properties and their use as potential therapies against infectious diseases.


Assuntos
Anti-Infecciosos/farmacologia , Doenças Transmissíveis/tratamento farmacológico , Dendrímeros/química , Peptídeos/química , Polímeros/química , Animais , Fármacos Anti-HIV/farmacologia , Infecções Bacterianas/tratamento farmacológico , Biotecnologia , COVID-19/tratamento farmacológico , Catálise , Meios de Contraste , Sistemas de Liberação de Medicamentos , Desenho de Fármacos , Infecções por HIV/tratamento farmacológico , Humanos , Infectologia/tendências , Imageamento por Ressonância Magnética , Camundongos , Nanotecnologia , Polipropilenos/química , SARS-CoV-2 , Estereoisomerismo , Tomografia Computadorizada por Raios X/tendências , Viroses/tratamento farmacológico
12.
Acad Med ; 96(7S): S22-S28, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34183598

RESUMO

PURPOSE: Entrustable professional activities (EPAs) are one approach to competency-based medical education (CBME), and 7 EPAs have been developed that address content relevant for all pediatric subspecialties. However, it is not known what level of supervision fellowship program directors (FPDs) deem necessary for graduation. The Subspecialty Pediatrics Investigator Network (SPIN) investigated FPD perceptions of the minimum level of supervision required for a trainee to successfully graduate. METHOD: In 2017, SPIN surveyed all FPDs of accredited fellowships for 14 subspecialties. For each EPA, the minimum supervision level for graduation (ranging from observation only to unsupervised practice) was set such that no more than 20% of FPDs would accept a lower level. RESULTS: The survey response rate was 82% (660/802). The minimum supervision level for graduation varied across the 7 EPAs from 2 (direct) to 4 (indirect for complex cases), with significant differences between EPAs. The percentage of FPDs desiring a lower minimum supervision level ranged from 3% to 17%. Compared with the 4 nonclinical EPAs (quality improvement, management, lead within the profession, scholarship), the 3 clinical EPAs (consultation, handover, lead a team) had higher minimum supervision graduation levels (P < .001), with less likelihood that an FPD would graduate a learner below their minimum level (P < .001). CONCLUSIONS: Consensus among FPDs across all pediatric subspecialties demonstrates the potential need for ongoing supervision for graduates in all 7 common pediatric subspecialty EPAs after fellowship. As CBME programs are implemented, processes and infrastructure to support new graduates are important considerations for leaders.


Assuntos
Educação Baseada em Competências , Educação de Pós-Graduação em Medicina , Bolsas de Estudo , Medicina do Adolescente/educação , Endocrinologia/educação , Gastroenterologia/educação , Hematologia/educação , Humanos , Infectologia/educação , Oncologia/educação , Medicina , Neonatologia/educação , Medicina de Emergência Pediátrica/educação , Pediatria/educação , Pneumologia/educação , Inquéritos e Questionários
14.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-48215

RESUMO

O primeiro caso de reinfecção do SARS-CoV-2 foi cientificamente comprovada em agosto de 2020. Em dezembro, o Ministério da Saúde confirmou o primeiro caso do tipo no Brasil, quando uma médica de 37 anos voltou a ter diagnóstico positivo de Covid-19 mais de três meses depois de contrair a doença pela primeira vez. Desde então, pesquisadores e profissionais de saúde em todo o mundo confirmaram o risco de infecção repetida pelo coronavírus, especialmente mediante a existência de variantes do vírus.


Assuntos
Infecções por Coronavirus/transmissão , Pneumonia Viral/transmissão , Infectologia , Infecções por Coronavirus/imunologia
16.
Eur J Cancer ; 147: 154-160, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33676266

RESUMO

The worldwide spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the associated infectious coronavirus disease (COVID-19) has posed a unique challenge to medical staff, patients and their families. Patients with cancer, particularly those with haematologic malignancies, have been identified to be at high risk to develop severe COVID-19. Since publication of our previous guideline on evidence-based management of COVID-19 in patients with cancer, research efforts have continued and new relevant data has come to light, maybe most importantly in the field of vaccination studies. Therefore, an update of our guideline on several clinically important topics is warranted. Here, we provide a concise update of evidence-based recommendations for rapid diagnostics, viral shedding, vaccination and therapy of COVID-19 in patients with cancer. This guideline update was prepared by the Infectious Diseases Working Party (AGIHO) of the German Society for Haematology and Medical Oncology by critically reviewing the currently available data on these topics applying evidence-based medicine criteria.


Assuntos
Teste para COVID-19/normas , Vacinas contra COVID-19/uso terapêutico , COVID-19 , Neoplasias , SARS-CoV-2/fisiologia , Eliminação de Partículas Virais/fisiologia , Antivirais/uso terapêutico , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/terapia , COVID-19/virologia , Teste para COVID-19/métodos , Medicina Baseada em Evidências/normas , Medicina Baseada em Evidências/estatística & dados numéricos , Alemanha/epidemiologia , Neoplasias Hematológicas/diagnóstico , Neoplasias Hematológicas/epidemiologia , Neoplasias Hematológicas/terapia , Neoplasias Hematológicas/virologia , Hematologia/organização & administração , Hematologia/normas , Humanos , Imunização Passiva/métodos , Imunização Passiva/normas , Infectologia/organização & administração , Infectologia/normas , Oncologia/organização & administração , Oncologia/normas , Neoplasias/diagnóstico , Neoplasias/epidemiologia , Neoplasias/terapia , Neoplasias/virologia , SARS-CoV-2/imunologia , Sociedades Médicas/normas , Vacinação/métodos , Vacinação/normas
18.
J Prev Med Public Health ; 54(1): 1-7, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33618493

RESUMO

The Korean government's strategy to combat coronavirus disease 2019 (COVID-19) has focused on non-pharmaceutical interventions, such as social distancing and wearing masks, along with testing, tracing, and treatment; overall, its performance has been relatively good compared to that of many other countries heavily affected by COVID-19. However, little attention has been paid to health equity in measures to control the COVID-19 pandemic. The study aimed to examine the unequal impacts of COVID-19 across socioeconomic groups and to suggest potential solutions to tackle these inequalities. The pathways linking social determinants and health could be entry points to tackle the unequal consequences of this public health emergency. It is crucial for infectious disease policy to consider social determinants of health including poor housing, precarious working conditions, disrupted healthcare services, and suspension of social services. Moreover, the high levels of uncertainty and complexity inherent in this public health emergency, as well as the health and socioeconomic inequalities caused by the pandemic, underscore the need for good governance other than top-down measures by the government. We emphasize that a people-centered perspective is a key approach during the pandemic era. Mutual trust between the state and civil society, strong accountability of the government, and civic participation are essential components of cooperative disaster governance.


Assuntos
COVID-19/prevenção & controle , Equidade em Saúde/normas , Política de Saúde , Infectologia/legislação & jurisprudência , COVID-19/fisiopatologia , Programas Governamentais/legislação & jurisprudência , Programas Governamentais/métodos , Equidade em Saúde/estatística & dados numéricos , Humanos , Infectologia/métodos , Infectologia/tendências , Pandemias/prevenção & controle , Pandemias/estatística & dados numéricos , Saúde Pública/legislação & jurisprudência , Saúde Pública/métodos , Saúde Pública/tendências , República da Coreia
19.
BMC Med Res Methodol ; 21(1): 30, 2021 02 10.
Artigo em Inglês | MEDLINE | ID: mdl-33568100

RESUMO

BACKGROUND: In infectious disease transmission dynamics, the high heterogeneity in individual infectiousness indicates that few index cases generate large numbers of secondary cases, which is commonly known as superspreading events. The heterogeneity in transmission can be measured by describing the distribution of the number of secondary cases as a negative binomial (NB) distribution with dispersion parameter, k. However, such inference framework usually neglects the under-ascertainment of sporadic cases, which are those without known epidemiological link and considered as independent clusters of size one, and this may potentially bias the estimates. METHODS: In this study, we adopt a zero-truncated likelihood-based framework to estimate k. We evaluate the estimation performance by using stochastic simulations, and compare it with the baseline non-truncated version. We exemplify the analytical framework with three contact tracing datasets of COVID-19. RESULTS: We demonstrate that the estimation bias exists when the under-ascertainment of index cases with 0 secondary case occurs, and the zero-truncated inference overcomes this problem and yields a less biased estimator of k. We find that the k of COVID-19 is inferred at 0.32 (95%CI: 0.15, 0.64), which appears slightly smaller than many previous estimates. We provide the simulation codes applying the inference framework in this study. CONCLUSIONS: The zero-truncated framework is recommended for less biased transmission heterogeneity estimates. These findings highlight the importance of individual-specific case management strategies to mitigate COVID-19 pandemic by lowering the transmission risks of potential super-spreaders with priority.


Assuntos
Distribuição Binomial , COVID-19/transmissão , Simulação por Computador , Transmissão de Doença Infecciosa/estatística & dados numéricos , Humanos , Infectologia/estatística & dados numéricos , Funções Verossimilhança , Pandemias , Vigilância da População , SARS-CoV-2 , Viés de Seleção
20.
Rev Med Suisse ; 17(720-1): 42-49, 2021 Jan 13.
Artigo em Francês | MEDLINE | ID: mdl-33443830

RESUMO

What's new in infectious diseases in 2020 ? This year has been marked by the COVID-19 pandemic, prompting a review of the current knowledge on SARS-CoV-2 and its management in this article. The results of the Swiss project «â€…PIRATE ¼ indicate non-inferiority between CRP-guided antibiotic durations or fixed 7-day durations and 14-day durations for Gram-negative bacteremia. A Mongolian study did not show any benefit of vitamin D substitution in protecting children from tuberculosis. Baloxavir, a new antiviral against the flu, has been approved by Swissmedic. Finally, new American recommendations for therapeutic monitoring of vancomycin and universal screening for hepatitis C virus have been published.


Assuntos
Infectologia/tendências , Antibacterianos/administração & dosagem , Antivirais/uso terapêutico , Proteína C-Reativa/análise , COVID-19 , Criança , Doenças Transmissíveis/tratamento farmacológico , Humanos , Influenza Humana/tratamento farmacológico , Pandemias , Tuberculose/prevenção & controle , Vitamina D/administração & dosagem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...