Alcohol risk consumption during the COVID-19 pandemic quarantine time in Paraguay, 2020: a virtual survey

Introduction: The impact of the outbreak of pandemic proportions of COVID-19 has initiated several health and social measures worldwide. Thus, there is growing concern about the consequences of preventive social confinement associated with the pandemic due to the potential increase in the consumption of alcohol and other harmful substances. Between 2010-2014, in Paraguay approximately 5% of deaths over 15 years of age are attributable to alcohol consumption and are associated with external cause injuries, cancers, liver disease, cardiovascular diseases, addictions and domestic violence. Early detection and treatment are recommended intervention strategies to prevent these consequences. Objective: To determine the demographic characteristics of alcohol risk consumption during the covid-19 pandemic quarantine period. Methods: Analytical cross-sectional, exploratory observational study. It consisted of 16,538 virtual surveys carried out on persons of legal age throughout the national territory between June and September 2020. A total of 219 respondents were excluded for not meeting the inclusion criteria or for incorrectly filled out data. Risk consumption was determined using a test that rated consumption by scores. More than 5 points for men, more than 4 for women. Results: 12224 adult participants (18-65 years old) with a mean age of 31.9 years (±9.2), were part of the analysis, with a predominance of male participation 64.5% (n=10531). The 74.9% (n=12224) came from the Metropolitan Axis. According to gender, the OR was 1.15 CI95 (1.08-1.23), pv=0.001. When comparing educational level, high school complete/incomplete, the OR was 1.56 CI95 (1.19-2.06), pv=0.001. And when comparing by axes of residence, the OR was 0.83 CI95 (0.77-0.89), pv=0.001. Discussion: It was observed that, during the quarantine period, alcohol consumption increased as the educational level of the population increased. Males presented a higher risk consumption than males. Knowing this behavior would help to propose actions to help prevent alcohol consumption in the most atrisk group. © 2022, Faculty of Medical Sciences, Santa Rosa del Aguaray Branch, National University of Asuncion. All rights reserved.

Smart green supply chain management: a configurational approach for reaching sustainable performance goals and decreasing COVID-19 impact

Smart Supply Chain has been evolving with the use of base technologies and front-end technologies, allowing the development of digital solutions for companies. Besides these technological aspects, companies should create a digital transformation strategy to boost the development of their Smart Supply Chain. Even though creating a Smart Supply Chain is vital for companies enabling their competitiveness in the market, some companies are also applying green supply chain internal and external practices to recover from the COVID-19 outbreak. These green practices are essential for companies to guide their supply chain activities to ensure competitive advantage. We discuss when companies develop Smart Supply Chain to meet Green Supply Chain Management (GSCM), a Smart GSCM is configured to reach sustainable performance goals and to decrease COVID-19 impacts. © 2023 Elsevier Inc. All rights reserved.

A Pilot Trial of Thymalfasin (Thymosin-alpha-1) to Treat Hospitalized Patients With Hypoxemia and Lymphocytopenia Due to Coronavirus Disease 2019 Infection

Background. Thymosin-alpha-1 (T alpha 1) may be a treatment option for coronavirus disease 2019 (COVID-19), but efficacy and safety data remain limited. Methods. Prospective, open-label, randomized trial assessing preliminary efficacy and safety of thymalfasin (synthetic form of T alpha 1), compared with the standard of care, among hospitalized patients with hypoxemia and lymphocytopenia due to COVID-19. Results. A total of 49 patients were included in this analysis. Compared with control patients, the incidence of clinical recovery was higher for treated patients with either baseline low-flow oxygen (subdistribution hazard ratio, 1.48 [95% confidence interval, .68-3.25] ) or baseline high-flow oxygen (1.28 [.35-4.63]), although neither difference was significant. Among patients with baseline low-flow oxygen, treated patients, compared with control patients, had an average difference of 3.84 times more CD4(+) T cells on day 5 than on day 1 (P = .01). Nine serious adverse events among treated patients were deemed not related to T alpha 1. Conclusions. T alpha 1 increases CD4(+) T-cell count among patients with baseline low-flow oxygen support faster than the standard of care and may have a role in the management of hospitalized patients with hypoxemia and lymphocytopenia due to COVID-19.

A Pilot Trial of Thymalfasin (Thymosin-alpha-1) to Treat Hospitalized Patients With Hypoxemia and Lymphocytopenia Due to Coronavirus Disease 2019 Infection

Background. Thymosin-alpha-1 (T alpha 1) may be a treatment option for coronavirus disease 2019 (COVID-19), but efficacy and safety data remain limited. Methods. Prospective, open-label, randomized trial assessing preliminary efficacy and safety of thymalfasin (synthetic form of T alpha 1), compared with the standard of care, among hospitalized patients with hypoxemia and lymphocytopenia due to COVID-19. Results. A total of 49 patients were included in this analysis. Compared with control patients, the incidence of clinical recovery was higher for treated patients with either baseline low-flow oxygen (subdistribution hazard ratio, 1.48 [95% confidence interval, .68-3.25] ) or baseline high-flow oxygen (1.28 [.35-4.63]), although neither difference was significant. Among patients with baseline low-flow oxygen, treated patients, compared with control patients, had an average difference of 3.84 times more CD4(+) T cells on day 5 than on day 1 (P = .01). Nine serious adverse events among treated patients were deemed not related to T alpha 1. Conclusions. T alpha 1 increases CD4(+) T-cell count among patients with baseline low-flow oxygen support faster than the standard of care and may have a role in the management of hospitalized patients with hypoxemia and lymphocytopenia due to COVID-19.

First outbreak of COVID-19 in Cuban pediatric patients

Introduction: Until June 11, 2020, 10.4% of the total positive cases of SARS-CoV-2 in Cuba corresponded to patients under 18 years of age. Clinical manifestations in children affected by SARS-CoV-2 are usually mild and few deaths occur compared to other age groups. Objective: Characterize from the clinical, epidemiological and immunological point of view the Cuban pediatric patients infected by SARS-CoV-2 until June 11, 2020. Methods: Observational, cross-sectional study in 137 pediatric patients infected with COVID-19, who were epidemiologically discharged. Results: 56.9 % of the patients presented asymptomatic form of the disease. Havana was the most affected province and the average age was 11.3 years. The most frequent symptoms were: fever, cough and diarrhea and occurred more frequently in patients with black skin (Odd Ratio = 3.40). Antibody concentrations for tetanus and Haemophilus influenzae type b provided protection in 92.7% to 100% of children, while for diphtheria 24.8% had no reliable protection. Of the symptomatic patients, 62.5% developed specific total antibodies against SARS-CoV-2. Conclusions: Patients in pediatric ages can contribute significantly to the transmission dynamics. Reliable protection for specific vaccines, the development of total antibodies to SAR-Cov-2, and general favorable prognosis without complications require continued research to identify biological and immunological differences between children and other age groups. © 2021, Editorial Ciencias Medicas. All rights reserved.

Three-years real-world evidence of adjuvant dabrafenib plus trametinib (DT) in patients with resected melanoma in Spain (GEM 1901 - DESCRIBE-AD)

Background: DT combination has shown efficacy in the adjuvant setting for BRAF-mutated melanoma (BMM) patients (pts) in clinical trials. Previous reports from DESCRIBE-AD resulted in promising overall survival (OS) rates at 12 months. Methods: An observational retrospective study was carried out in 25 GEM sites in Spain. Histologically confirmed and resected BMM pts previously treated with DT according to standard clinical practice in the adjuvant setting were included. Only surgical resection was allowed as a prior treatment to DT. DT discontinuation rate and time to treatment discontinuation were the primary objective. Secondary objectives included safety and efficacy of the combination. Here, we report 3-year results for OS. Results: From 10/2020 to 03/2021, 65 pts were included. Median age was 58 years, 55% were male and 60%, 25%, and 14% had an ECOG PS 0/1/Uk respectively, one patient presented ECOG 3. Allocation of stage IIIA, IIIB and IIIC according to TNM AJCC 7th edition was 29%, 26% and 32%, respectively. There were 3 pts diagnosed at stage I/II but considered of risk, and 2 pts with stage IV but completely resected, all considered for adjuvant DT. Ulceration was present in 40%, Breslow ≥2 mm in 71%, and nodes were microscopically and macroscopically affected in 39% and 22% of pts, respectively. Only 9.2% of pts discontinued DT prematurely due to toxicity and 21.2% had dose reductions to manage toxicity. After a median follow-up of 36.2 m (range: 13-51.1), the overall OS rate at 3-years was 83.5% (95% CI: 74.5-93.5). According to AJCC 7 stage at diagnosis, the 3-years OS rate was 95.2% (95% CI: 86.6-100), 75% (56-100), and 76.8% (60.7-97.2) for stage I-II-IIIA, IIIB, and IIIC-IV respectively. Throughout the study period 11 (16.9%) pts died, of which 10 died due to disease progression and one due to COVID-19 infection. Conclusions: Adjuvant treatment with DT for melanoma achieved good treatment compliance and has proven efficacy in the real world. Adjuvant DT has a clinical impact in survival in line with previous clinical trial COMBI-AD. Editorial acknowledgement: We acknowledge Mfar Clinical Research staff for their assistance in the development of this . Legal entity responsible for the study: Grupo Español Multidisciplinar en Melanoma (GEM). Funding: Grupo Español Multidisciplinar en Melanoma (GEM) as Sponsor with Industry partner NOVARTIS. Disclosure: P. Cerezuela-Fuentes: Financial Interests, Personal, Other, Consultancy, conference,congress attendance/infrastructure: BMS, MSD, Pierre Fabre, Roche, Sanofi, SunPharma. J. Martín-Liberal: Financial Interests, Personal, Other, Lecture fees: Astellas, MSD;Financial Interests, Personal, Other, Lecture fees, advisory fees: Bristol Myers Squibb, Novartis, Pierre Fabre, Pfizer, Roche, Sanofi;Non-Financial Interests, Personal, Member, membership or affiliation: ASCO, ESMO, SEOM, GEM, EORTC, SOGUG, GEIS. L.A. Fernández-Morales: Financial Interests, Personal, Invited Speaker, Speak at sponsored meetings: BMS, MSD, Pierre-Fabre, Roche;Financial Interests, Personal, Other, Speak at sponsored meetings and advisory role: Novartis. J. Medina Martinez: Financial Interests, Personal, Other, Speaker, consultancy or advisory role or similar activity: Novartis, Roche, Pierre Fabre, BMS, MSD, Sanofi. M. Quindós: Financial Interests, Personal, Other, speaker, consultancy and advisory: AstraZeneca, GSK, Merck Sharp & Dohme, Novartis, PharmaMar, Roche, Bristol Myers Squibb, Pierre Fabre;Financial Interests, Institutional, Other, Clinical trials: Merck Sharp & Dohme, Roche, Bristol Myers Squibb. A. García Castaño: Non-Financial Interests, Advisory Role: Bristol, MSD, Novartis. T. Puértolas: Financial Interests, Personal, Invited Speaker, Speaker and advisory role: BMS, Novartis;Financial Interests, Personal, Invited Speaker: Roche, MSD, Sun-Pharma;Financial Interests, Personal, Other, Speaker and advisory role: Pierre-Fabre;Financial Interests, Personal, Advisory Role: Sanofi;Financial Interests, Institutional, Other, Clinical trial: Roche, BMS, Apexi en Inc, Aduro Biotech, Alkermes Inc;Non-Financial Interests, Institutional, Other, congresses inscriptions: Lilly, Sun-Pharma, Novartis, Roche, MSD;Non-Financial Interests, Institutional, Leadership Role, Vocal: GEM (Grupo Español Multidisciplinar de Melanoma);Non-Financial Interests, Institutional, Affiliate: SEOM (Sociedad Española de Oncología Médica), GEM (Grupo Español Multidisciplinar de Melanoma). P. Ayala de Miguel: Financial Interests, Personal, Invited Speaker, Public speaking: Novartis, Merck Sharp & Dohme, Sanofi, Pierre-Fabré. B. Campos: Financial Interests, Personal, Other, Speaker or advisory role: Roche, BMS, Sanofi, Novartis, Pierre-Fabre, Sun Pharma;Financial Interests, Personal, Other, Speaker role: AstraZeneca, Merck, ROVI, Leo Pharma. E. Espinosa: Financial Interests, Personal, Advisory Role, Advisory: BMS, MSD;Financial Interests, Personal, Other, Advisory, educational activities: Novartis;Financial Interests, Personal, Invited Speaker, Advisory, educational activities: Pierre Fabre;Financial Interests, Personal, Funding, Funding for translational investigation: Roche;Non-Financial Interests, Personal, Member, Vicepresident: Grupo Español Multidisciplinario de Melanoma. A. Rodríguez-Lescure: Financial Interests, Personal, Advisory Role: Pfizer, Novartis, ROCHE, AstraZeneca, Daiichi Sankyo, Seagen;Financial Interests, Personal, Invited Speaker, Public speaking: Pierre-Fabre;Financial Interests, Institutional, Research Grant, Grant for Clinical Trials: BMS, Lilly, Roche, Novartis, Amgen, Pzifer, Zimeworks, AstraZeneca, G1 Therapeutics, Bayer. L. Espasa Font: Financial Interests, Personal, Full or part-time Employment: Novartis. G. Belaustegui Ferrández: Financial Interests, Personal, Full or part-time Employment: Novartis. All other authors have declared no conflicts of interest.

Associations Between Joint Attention and Home Stimulation in the Context of COVID-19

The objective of this research was to describe the type of stimulation at home and the joint attention of infants during the context of the COVID-19 pandemic, as well as to evaluate the possible association between these variables. The sample consisted of 55 primary caregivers of Argentine infants aged 9 months to 3 years (M = 1.63, SD = 0.8, male n = 24). An ad hoc sociodemographic questionnaire, an ad hoc Home Stimulation Questionnaire and the Joint Attention Scale of Wetherby and Prizant (2002) were administered, for which all variables were collected by self-report. It was found that the TV was the device most used by infants, and that TV, cell phone, and Internet use were actively shared with caregivers. In turn, the levels of joint attention behaviors were high for this sample. A positive association was also found between shared reading, joint attention and contact with relatives. On the contrary, the more reading, the less daily TV use by the child. In turn, it was found that high number of months out of work, were associated to high levels of joint attention, and the only factor that positively predicted joint attention was unemployment. Finally, it was found that a greater number of books in the home was positively associated with recreational activities with the child and negatively associated with cell phone use. In this sense, a higher level of cell phone use by the child was associated with a greater consumption of news associated with COVID-19 by the caregiver. It is concluded that it is necessary to work on the amount of time that infants are exposed to technological devices and promote joint attention spaces, such as shared reading in the early years of development.

Characterization of SARS-CoV-2 infection in older adults in Cuba, March-June 2020

Introduction: COVID-19 has the potential to impact any population group, however, older adults have a worse prognosis and a higher mortality rate. Objective: Characterize the clinical-epidemiological variables of older adults with SARS-CoV-2 in the first three months of the epidemic in Cuba. Methods: An observational cross-sectional study was conducted in Cuban patients aged 60 years and older, with epidemiological discharge of SARS-CoV-2 infection, between March 11 and June 11, 2020. A questionnaire with clinical and sociodemographic variables was applied. Statistical analyses were performed using the SPSS 22.0 statistical package. Results: 241 patients were studied, 52.3 % presented mild or moderate symptoms. There was an increase in average age from asymptomatic to severe. Blood group O (46.1%) was the most frequent;however, those in group A showed an increased risk of developing symptoms. The most common associated diseases were high blood pressure, cardiovascular disease and diabetes mellitus. Fever, dry cough and shortness of breath were the most frequent symptoms. Conclusions: Patients with blood group A, hypertensive patients and associated cardiovascular diseases presented an increased risk of suffering from symptomatic forms. The vulnerability of older adults comes not only from their age, but also from associated chronic diseases, which is why the protection of this population group is essential.

Clinical-epidemiological characteristics of patients affected by COVID-19 residing in Havana

Introduction: Havana city was the most complex territory at the national level facingthe first outbreak of COVID-19. Its condition of capital, the population density, the limited geographical delimitation between its municipalities, the high inter-municipal and inter-provincial flow of people, added to the fact that it is the province that receives the largest number of travelers from abroad, conferred particularities on this territory. Objective: To determine the main clinical-epidemiological characteristics of patients affected by COVID-19 living in Havana. Methods: An observational, analytical, cross-sectional study was carried out. The sample contained 431 patients, older than one year, with epidemiological discharge from the SARS-CoV-2 infection. To collect information, a questionnaire was applied through an interview. Results: The average age of the sample was 45 years. More than half of the cases evolved in a symptomatic way (not serious or serious). Fever was the most frequent clinical manifestation. The individuals included in the sample, with blood group O or with a background of asthma, showed less risk of presenting symptomatic forms of the disease. Conclusions: The results suggest that age is the main risk factor for developing symptomatic forms (not severe or severe) of COVID-19. On the contrary, blood group O and a history of asthma are protective factors for these forms of clinical evolution. © 2021, Editorial Ciencias Medicas. All rights reserved.

The role of tumor necrosis factor alpha − 308A > G polymorphism on the clinical states of SARS-CoV-2 infection

Background: Tumor necrosis factor-alpha (TNFɑ) is a cytokine that manages the host defense mechanism, which may play a role in the pathogenesis of COVID-19 patients. Several single-nucleotide polymorphisms, described in the promoter region of the TNFα gene, have a significant role on its transcriptional activity. These include the − 308A > G polymorphism which increases the TNFα levels with the expression of the A allele. The aim of this study was to explore whether the TNFα.− 308A > G polymorphism affects the clinical state of COVID-19 patients. The study included a total of 1028 individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which were distributed in 3 groups: asymptomatic, mild symptomatic and severe symptomatic patients. The amplification-refractory mutation system was used to determine the genotype of the TNFα.− 308A > G polymorphism. Results: Results show a higher tendency of being asymptomatic in individuals carrying the GG genotype (336 of 411;OR 1.24, 95% CI 0.91–1.70). The development of a severe form of SARS-CoV-2 infection was not found in subjects with the A allele compared to those with the G allele (OR 0.96, 95% CI 0.51–1.79), except in the eastern region of the country where the risk increased (OR 4.41, 95% CI 1.14–17.05). However, the subjects carrying the A allele had a higher chance of developing symptoms (OR 1.24, 95% CI 0.91–1.70) compared to those with the G allele. Conclusion: The TNFα.− 308A allele has an influence on developing symptoms of COVID-19 in Cuban patients, and that it particularly increases the risk of presenting severe forms of the disease in the eastern region of the country. © 2022, The Author(s).