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Heart transplant (HT) patients have a higher risk of severity after SARS-CoV-2 (COVID-19) infection than general population. Serological response to the initial vaccination regimen is lower. The clinical impact of the booster vaccination regimen in HT patients is unknown. The INMU_TC study analyze the immunogenicity after the COVID19 vaccination schedule and the clinical impact in patients with HT in Galicia. : To analyze the clinical events related to COVID-19 infection after receiving the booster dose in a population of patients with CT. Prospective observational study. HT recipients followed in the Galician Health System who had received a booster dose of COVID-19 vaccine according to the regional protocol were consecutively included. Serum anti-SARS-COV2 IgG concentration was determined between 14-30 days after the last vaccination dose. A value ≥33 BAU/ml was considered positive. COVID-19 clinical events were recorded. : We included 275 HT recipients, median age 64.5 years (IQR:55.1-70.7), and 21.8% female. Median time since HT was 7.4 years (IQR:2.5-14.9). Of these, 41 patients (14.9%) had COVID-19 after the booster dose, with an incidence rate of 300.6 per 1000 patient-year. Fourteen patients (34.2% of those infected) required hospital admission, and 4 died from the infection (9.8%). No significant differences were found between infected and non-infected patients after the third dose, except for renal function, more deteriorated in infected patients (creatinine 1.8±1.6 vs 1.4±0.8;p=0.008) and treatment with RAASi (12(29.3%) vs 123(52.6%);p=0.005). There were no significant differences in immunosuppression. A higher percentage of patients with infection, admission, and death had a negative serologic test. Serum concentration of antiSARSCoV2 IgG was lower in infected patients (735.8±895.0 vs 1318.1±847.9;p<0.001) and in patients requiring admission (266.9±581.8 vs 1282±862.2;p<0.001). Patients admitted to ICU and those who died had undetectable titers (<4.81 BAU/ml). HT patients with COVID-19 after the booster vaccine dose had lower serum concentration of anti-SARS-COV2 IgG, being even lower in those who presented a more unfavorable evolution. These data could suggest the importance of monitoring the response to vaccination in these patients in order to evaluate other therapeutic options. [ FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
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The COVID-19 outbreak and subsequent public health interventions have depressed demand and disrupted supply chains for many fishing businesses. This paper provides an analysis of the COVID-19 impacts on the profitability of the EU fishing fleets. Nowcasting techniques were used to estimate the impact of the COVID-19 pandemic on the economic performance for the EU fishing fleet in 2020 and 2021. Our results show that the economic impact of COVID-19 on this sector was smaller than initially expected and overall profits remained positive. This was in part due to low fuel prices that reduced operating costs of fishing, and the early response from governments to support the sector. The results vary by fishing fleet, revealing that small-scale fleets and the fleets in the Mediterranean and Black seas have been more impacted than large-scale fleets and the fleets in the Northeast Atlantic. © G. Carpenter et al., Published by EDP Sciences 2023.
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During the COVID-19 pandemic, teaching of Physics at the high school level in the city of Guayaquil was carried out virtually. Consequently, the study that is presented below aims to explore the status and condition of teaching Experimental Physics in Guayaquil at the high school level during the two school years in which the education was carried out virtually (2020-2022) due to the COVID-19 pandemic. The main results aim at the 'rejection' of teachers to carry out virtual laboratory practices and teacher training. © 2022 IEEE.
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COVID-19 is a disease caused by the SARS-CoV-2 virus which has killed thousands of people worldwide. Its high transmissibility is a factor that considerably hinders its containment. The analysis of contagion chains could provide elements of interest for both virological and epidemiological studies. On the other hand, ontologies have become a widely accepted technology for knowledge representation and its corresponding analysis. The purpose of the study was to present an ontological model for the representation and analysis of COVID-19 contagion chains. The model was developed in OWL (Web Ontology Language), a formal language based on descriptive logics. The proposal could therefore be useful to infer knowledge about contagion chains, thus contributing to the struggle of the scientific community against COVID-19. Adoption of this proposal will help speed up the analysis of contagion chains, as well as gain insight into the search for features which could go unnoticed if other approaches are used. © 2021, Centro Nacional de Informacion de Ciencias Medicas. All rights reserved.
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INTRODUCTION: Initiation of ketogenic diet therapies (KDT) for pediatric epilepsy is usually done on an inpatient basis and the diet is managed during clinical appointments following a protocol of visits and routine tests. Because of the 2019 coronavirus disease (COVID-19) pandemic and the associated lock-down measures, we switched from outpatient to telemedicine-based KDT initiation. OBJECTIVE: To explore the feasibility, effectiveness, and safety of online KDT initiation and follow-up by comparing a group of children with drug-resistant epilepsy that was managed by telemedicine compared to a group that was treated on an outpatient basis. MATERIALS AND METHODS: An observational study was conducted in two groups of patients with drug-resistant epilepsy who initiated KDT and were followed up with an online versus an outpatient modality by the interdisciplinary KDT team of Hospital Pediatria JP Garrahan in Buenos Aires, Argentina. Dietary compliance, ketosis, retention rate, adverse effects, number of contacts, and clinical outcome were evaluated at 1, 3, and 6 months on the diet. RESULTS: Overall, 37 patients were included, of whom 18 started the KD by telemedicine and 19 on an outpatient basis. Minimum follow-up of the patients was 6 months. All patients received the classic ketogenic diet. No statistical differences between the two groups regarding efficacy and safety of the diet were found. CONCLUSIONS: Our results support the feasibility and safety of initiating and management of KDT by telemedicine. Patients and their families should be carefully selected in order to guarantee a good outcome.
Subject(s)
COVID-19 , Diet, Ketogenic , Drug Resistant Epilepsy , Epilepsy , Telemedicine , Child , Communicable Disease Control , Diet, Ketogenic/methods , Humans , Outpatients , Pandemics , Treatment OutcomeABSTRACT
Iatrogenic tracheal rupture (ITR) is a serious complication secondary to procedures such as emergent orotracheal intubation or tracheostomy, among others. The management of ITR depends on the size, extension and location of the injury, along with the patient's respiratory status and comorbidities. The priority of treatment is to keep the airway permeable to ensure adequate ventilation. We present the case of a tracheal rupture after performing a percutaneous tracheostomy, in a patient diagnosed with severe acute respiratory distress syndrome secondary to bilateral interstitial pneumonia due to SARS-Cov-2. The issues are discussed, such as the management (conservative vs. surgical) depending on the features of the injury and the patient, in the extraordinary context that the COVID-19 pandemic has entailed.
Subject(s)
COVID-19 , Respiratory Distress Syndrome , Humans , Iatrogenic Disease , Pandemics , Respiratory Distress Syndrome/etiology , Rupture , SARS-CoV-2 , Trachea/diagnostic imagingABSTRACT
Background and importance The pharmacy service (PS) is a cornerstone of the nutritional support of patients, especially those with special needs. For this reason, it is necessary to create individualised nutrition following recommendations from scientific organisations, such as the European Society for Clinical Nutrition and Metabolism (ESPEN). Aim and objectives To analyse prescriptions of parental nutrition (PN) during the pandemic and compare them with those from the same time period in 2019. Material and methods This was a retrospective descriptive observational analysis of data from a secondary care hospital during March and April, both in 2019 and 2020. Demographic (age and sex) and clinical (length of PN and diagnosis) data were collected from medical records. Results There were 157 patients with PN during the period of study in 2020, 106 (67.5%) men with a median age of 67 years (IQR 14.5 years). In 2019, 64 patients received PN, 38 (59.4%) were men with a median age of 70 years (IQR 17). In 2020, 48.8% of patients with PN were under the critical care service (CCS), 30.6% internal medicine service (IMS) and 18.5% surgical service (SS);108 (68.8%) were diagnosed with COVID-19. In 2019, 15.6% of patients were under CCS, 25% IMS and 56.4% SS. In 2020, 85 patients (54.1%) terminated PN due to health improvement and 60 (38.2%) died;in 2019, 54 (84.4%) improved and 9 (14.1%) died. In 2020, the median age of deceased patients was 67 years (IQR 12.5 years) and in 2019 it was 77 years (IQR 9.5 years). The total number of PN prescribed during the periods of the study was 2121 in 2020 and 876 in 2019. Conclusion and relevance In the context of the SARS-CoV-2 pandemic, nearly half of all PN were prepared for CCS patients. This increase in CCS patients in 2020 seems to explain the 10 year reduction in the median age of death and the increase in mortality. In 2020, the number of PN prepared by the PS nearly tripled in comparison with the same period in 2019. They were individually adapted to each patient's requirements, which led to a substantial increase in the care load and the preparation of the PN.
ABSTRACT
Iatrogenic tracheal rupture is a serious complication secondary to procedures such as emergent orotracheal intubation or tracheostomy, among others. The management of iatrogenic tracheal rupture depends on the size, extension and location of the injury, along with the patient's respiratory status and comorbidities. The priority of treatment is to keep the airway permeable to ensure adequate ventilation. We present the case of a tracheal rupture after performing a percutaneous tracheostomy, in a patient diagnosed with severe acute respiratory distress syndrome secondary to bilateral interstitial pneumonia due to SARS-CoV-2. The issues are discussed, such as the management (conservative vs. surgical) depending on the features of the injury and the patient, in the extraordinary context that the COVID-19 pandemic has entailed.
ABSTRACT
Background and importanceThe pharmacy service (PS) is a cornerstone of the nutritional support of patients, especially those with special needs. For this reason, it is necessary to create individualised nutrition following recommendations from scientific organisations, such as the European Society for Clinical Nutrition and Metabolism (ESPEN).Aim and objectivesTo analyse prescriptions of parental nutrition (PN) during the pandemic and compare them with those from the same time period in 2019.Material and methodsThis was a retrospective descriptive observational analysis of data from a secondary care hospital during March and April, both in 2019 and 2020. Demographic (age and sex) and clinical (length of PN and diagnosis) data were collected from medical records.ResultsThere were 157 patients with PN during the period of study in 2020, 106 (67.5%) men with a median age of 67 years (IQR 14.5 years). In 2019, 64 patients received PN, 38 (59.4%) were men with a median age of 70 years (IQR 17). In 2020, 48.8% of patients with PN were under the critical care service (CCS), 30.6% internal medicine service (IMS) and 18.5% surgical service (SS);108 (68.8%) were diagnosed with COVID-19. In 2019, 15.6% of patients were under CCS, 25% IMS and 56.4% SS. In 2020, 85 patients (54.1%) terminated PN due to health improvement and 60 (38.2%) died;in 2019, 54 (84.4%) improved and 9 (14.1%) died. In 2020, the median age of deceased patients was 67 years (IQR 12.5 years) and in 2019 it was 77 years (IQR 9.5 years). The total number of PN prescribed during the periods of the study was 2121 in 2020 and 876 in 2019.Conclusion and relevanceIn the context of the SARS-CoV-2 pandemic, nearly half of all PN were prepared for CCS patients. This increase in CCS patients in 2020 seems to explain the 10 year reduction in the median age of death and the increase in mortality. In 2020, the number of PN prepared by the PS nearly tripled in comparison with the same period in 2019. They were individually adapted to each patient’s requirements, which led to a substantial increase in the care load and the preparation of the PN.References and/or acknowledgementsConflict of interestNo conflict of interest
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The present paper presents a proposal for a didactic material that can be used as an instrument for classes in face-to-face as well as online. This type of material is necessary in this era in which the online modality has taken on the main role in a large part of the educational systems worldwide because of the measures adopted by the COVID-19 pandemic. Available materials are used, as well as a free mobile phone app. With this, it is expected to continue contributing to the teaching of Experimental Physics, which has been affected by the online teaching modality. © 2021, Associacao Iberica de Sistemas e Tecnologias de Informacao. All rights reserved.
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Introduction: recent studies have reported the occurrence of thrombotic phenomena or coagulopathy in patients with COVID-19. There are divergent positions regarding the prevention, diagnosis, and treatment of these phenomena, and current clinical practice is based solely on deductions by extension from retrospective studies, case series, observational studies, and international guidelines developed prior to the pandemic. Objective: to generate a group of recommendations on the prevention, diagnosis and management of thrombotic complications associated with COVID-19. Methods: a rapid guidance was carried out applying the GRADE Evidence to Decision (EtD) frameworks and an iterative participation system, with statistical and qualitative analysis. Results: 31 clinical recommendations were generated focused on: a) Coagulation tests in symptomatic adults with suspected infection or confirmed SARS CoV-2 infection;b) Thromboprophylaxis in adults diagnosed with COVID-19 (Risk scales, thromboprophylaxis for outpatient, in-hospital management, and duration of thromboprophylaxis after discharge from hospitalization), c) Diagnosis and treatment of thrombotic complications, and d) Management of people with previous indication of anticoagulant agents. Conclusions: recommendations of this consensus guide clinical decision-making regarding the prevention, diagnosis, and treatment of thrombotic phenomena in patients with COVID-19, and represent an agreement that will help decrease the dispersion in clinical practices according to the challenge imposed by the pandemic.