ABSTRACT
BACKGROUND: SARS-COV 2 turned in a global epidemic since January 2020. It is able to directly stimulate the release of proinflammatory cytokines (cytokine storm) and, affecting enterocytis, dysregulates intestinal permeability likewise Inflammatory Bowel Diseases. According to Guidelines, nutritional support in COVID-19 patients is relevant in a perspective of a fast recovery. Aim of this study is to propose in SARS-COV2 patients an early nutritional support using a polymeric-TGF-beta2 containing formula, with immunoregulatory properties specific for bowel disease, evaluating its effects on systemic inflammation and protein energy malnutrition. METHOD(S): COVID-19 patients hospitalized in Santa Maria Hospital of Terni and in Madonna delle Grazie Hospital of Matera (March-December 2020) were enrolled. The protocol consists in supplying 150 gr of nutritional formula powder (750 kcal/day). Values of serum prealbumin, transferrin, C-reactive protein and Lymphocyte count were collected at baseline and every week. Data were compared to a untreated sample of inpatients. RESULT(S): TGF-beta2 containing formula use seems to be associated to a lower needing and longer time free from steroid therapy, increasing of prealbumin and transferrin values and overall with a better outcome in exposed patients;higher values of serum prealbumin seemed to be associated with lower CRP. It does not induce gastrointestinal discomfort or worsen gastrointestinal symptoms. CONCLUSION(S): TGF-beta2 containing formula represents a valid nutritional support in COVID-19, preventing sarcopenia associated to hypercatabolic status and modulating inflammatory response probably thanks to specific properties of its nutritional components. This is only a preliminary observation: further investigations are on-going, involving several Italian Centers. Copyright © 2022-IOS Press. All rights reserved.
ABSTRACT
Background: The COVID-19 pandemic modified the way of practicing medicine, causing a changes in medical actions in the health professional and in their habits in relation to daily practices. Accelerated changes have taken place, which have led to the development and implementation of telemedicine as a very useful tool that allows professional contact with their patients, and on the other hand, access to up-to-date scientific training. Objetive: Evaluate the impact of the COVID-19 pandemic on the activity of the allergist in Argentina during phase 1 of preventive and mandatory social isolation (april and may 2020). Determine the impact of the pandemic on allergic diseases. Analyze the use of telemedicine in daily practice. Method: It is a prospective, observational and cross-sectional study. A questionnaire was made to specialist doctors in Allergy and Immunology during april and may 2020 of preventive and compulsory social isolation, for subsequent statistical study. Results: 113 surveys were carried out, 72.9% showed a decrease in work practice by 50%, 20.7% between 25-50% and 6.3% less than 25%. The most frequent consultations were request for prescriptions in 67%, medical history certificates in 48%, rhinitis and urticaria in 46%, atopic dermatitis and asthma attack in 23%, and contact dermatitis in 5.3%. 94% implemented telemedicine, the most used tools were whatsapp/webcam (61%) followed by telephone assistance (38%). Conclusion: The COVID-19 pandemic affected the practice of the specialty in terms of the decrease in medical consultation, the way of working, interacting with patients, the need for protective equipment, with an emotional and economic cost. On the other hand, it gave the possibility of having other care alternatives such as telemedicine.
ABSTRACT
Background and importance Intraocular lenses (IOLs) are prosthetic medical devices (PMDs) used for the treatment of cataracts. The pharmacist is often the professional person able to guarantee the success of the PMD management path during all phases: acquisition, stock management and correct use. Active vigilance of the PMDs, digitalisation and collaboration with the different professionals (ophthalmologist, operating room nurse, administrative assistant) can improve the logistic path. Aim and objectives The purpose of the project conducted by the pharmacist was to improve the digitalisation of the path for PMDs to increase traceability and safety through active medical device vigilance. Material and methods Since the second half of 2019, evaluation of the efficiency of the PMD supply chain has been underway. Management has been entrusted to pharmacy, which deals with their coding and uploading to the management programme using barcodes with storage of serial numbers (SNs) and expiration dates. This new PMD management downloads to patients and to user cost centres the specification of the IOLs (dioptre and SN) with a concomitant computerised reorder to restore the deposit account (DA). If it is necessary to return the IOL to the company for any reason, it must be downloaded from the warehouse, passing through the pharmacy. Results In 2019, 3094 IOLs of 18 different models were implanted. In 95% of patients (2918 implants), we used only two models. Between October and November 2019, 98.5% of the IOLs in the hospital on the DA were encoded and uploaded to the management programme (eight models with 332 different codes). This allowed an acceleration of DA recovery, more traceability of the implants and easier report data. Between January and November 2019, 2879 IOLs were implanted with no incident report received. Between December 2019 and February 2020, 772 IOLs were implanted;of these, six defective IOLs were returned to the pharmacist who provided a report of the incident to the Ministry of Health. The problems concerned defects of the pre-loaded IOL injectors. Conclusion and relevance The IOL project managed by the hospital pharmacy, in addition to a logistic improvement, has allowed further investigation into the causes of their return and has encouraged the ophthalmologist to point out non-compliances. The project slowed down during the COVID emergency but will be extended to other types of PMDs.