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BACKGROUND: Enhanced health and safety measures, such as symptom screening, physical distancing, cohorting, masking, and asymptomatic testing for children have been introduced into schools to prevent SARSCoV- 2 transmission. Although asymptomatic testing has been considered a measure to reduce in-school transmission, it has not been broadly implemented or evaluated. To address this, a pilot project with public health, school boards, and hospital-based testing partners was established to assess the feasibility of offering on-site and low barrier SARS-CoV-2 polymerase chain reaction (PCR) testing across schools in the Toronto region. OBJECTIVE(S): The primary objective of this study was to assess the feasibility of offering on-site and low barrier PCR asymptomatic testing across schools in the Toronto region. DESIGN/METHODS: A six-week testing pilot across the Greater Toronto Area took place. Schools were selected to participate in expanded testing to determine case prevalence in high-risk settings of school-based SARSCoV- 2. Students and staff were excluded if they had tested positive for COVID-19 in the last 3 months. Different testing opportunities were offered based on the testing partner and school preference including location and modality. Descriptive methods were used to assess the uptake of testing and case positivity by individuals recommended to be tested. RESULT(S): Eighteen schools participated in the pilot testing. All students and staff were invited to participate in asymptomatic testing. Testing was offered to 9282 students and 1000 staff, and testing uptake was 29% (2729 students) and 54% (544 staff), respectively. Forty-eight percent of tests (1645) were oral nasal tests, 18% (622) were NP swab tests and 33% (1120) were saliva tests. Of the saliva tests, 52% (590) were on-site saliva tests and 48% (530) were take-home saliva kits. The staff and student positivity rate for on-site testing was 1.9% and 4.9% for tests completed at the COVID-19 Assessment Center at SickKids. CONCLUSION(S): Results from this pilot project demonstrate that on-site PCR testing uptake remained low despite offering in-school testing, specialized support, and reduced barriers by using non-invasive testing with the use of saliva/ oral nasal/PCR testing kits. Results highlight the challenges of asymptomatic testing and the balance of resource utilization for low case counts. Future studies should examine alternate means of symptomatic testing.
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Introduction: Development of vaccines against SARS-COV-2 has resulted in considerable reduction in severe complications and mortality. Several cases of glomerular disease have been recently reported such as Minimal Change disease and Focal Segmental Glomerulosclerosis. We describe a patient with autosomal dominant polycystic kidney disease (ADPKD) who developed nephrotic syndrome, soon after receiving COVID-19 vaccine. Case Description: 40-year-old male with history of chronic kidney disease stage-3 due to ADPKD diagnosed 20 years ago. Baseline serum creatinine 2 - 2.5 mg/dl and minimal proteinuria. Other comorbidities include well-controlled type 2 diabetes mellitus and hypertension. Received two doses of Covid-19 vaccine on February 25 and March 24, 2021. He had malaise, myalgia, and fatigue after vaccination. On April 2021, was noted to have 3+ protein on dipstick, no quantification done. In May of 2021 patient presented to hospital with heart failure and ejection fraction of 39% in association with acute coronary syndrome due to ST elevation myocardial infarction, underwent placement of a drug-eluting stent and placement on dual antiplatelet therapy (DAPT). He had 3+ protein on dipstick. In June 2021 developed abdominal pain with hematuria which was attributed to cyst-hemorrhage, underwent decortication of left renal cyst. However, the patient continued having gross hematuria requiring multiple blood transfusions and cessation of DAPT. Patient was admitted to UTSW in September 2021 and was noted to have nephrotic syndrome with proteinuria of 3925 mg, low serum albumin of 2.0 g/ dL and pedal edema concerning for podocytopathy associated with COVID-19 vaccine. Kidney biopsy was deferred due to active bleeding. Patient was empirically started on Prednisone 60mg with rapid taper. At discharge 12 days later, proteinuria was down to 0.6 g/g of creatinine, serum albumin 3.2 g/dL and hematuria resolved. On his last follow up, proteinuria was 0.3 g/g, serum albumin 3.6 g/dL and serum creatinine 2.67 mg/dl. Discussion(s): Millions of mRNA vaccines have been administered since the developement of the COVID-19 vaccine. Proposed mechanisms when mounting a response to the vaccine are toll-like receptors promoting podocyte damage in the glomeuruli. These glomerulpathies once noted have been treated with immunosupression and there has been remission reported.
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Background: Due to the SARS-CoV-2 pandemic, an increase in stress, anxiety, and depression has been seen, as well as greater use of substances and a decrease in prenatal care in pregnant women. (1) Women of childbearing age with autoimmune rheumatic diseases (ARDs) experience greater psychological stress, which can negatively influence behavior. (2) Objectives: This study aims to compare changes in prenatal laboratory and ultrasound tests by trimester, as well as the detection of anxiety and depression in pregnant women with ARDs due to the SARS CoV-2 pandemic. Methods: This study was carried out on pregnant patients with ARDs from the Pregnancy and Rheumatic Diseases clinic of the rheumatology department of the University Hospital 'Dr. José Eleuterio González' during the period from February 2018 to August 2021. Two standardized evaluations of anxiety and depression were carried out using the Inventory of Trait and State Anxiety (IDARE) and the Edinburgh Postpartum Depression Scale (EPDS) respectively in the third trimester of pregnancy. Maternal report of alcohol consumption during any trimester of pregnancy, as well as adherence to routine laboratory studies such as structural ultrasound and gesta-tional diabetes screening, was addressed. Positive COVID-19 nasopharynx PCR results were evaluated during pregnancy beginning in the pandemic period (March 2020). The pre-pandemic recruited group was compared with the pandemic group. The comparison of the groups was carried out using the Chi-Square and Fisher tests. A significant value of p < 0.05 was considered. Statistical analysis was performed using the IBM SPSS v.25 program. Results: 50 pregnant patients with ARDs were recruited, of which 24 were included in the pre-pandemic group and 26 in the pandemic group. Compared with the pre-pandemic group, pregnant women recruited during the pandemic had a statistically signifcant higher positivity for state anxiety (p=0.023), likewise trait anxiety, depression, and suicidal ideation were detected more frequently, but the difference was not statistically signifcant, a higher rate of adherence to laboratory and cabinet studies was found, being signifcant for laboratories performed in the 1st and 2nd trimesters (0.005 and 0.025 respectively). See Table 1. Conclusion: A higher frequency of positivity for state anxiety was demonstrated in pregnant women with ARDs recruited during the pandemic, as well as higher trait anxiety, depression, and suicidal ideation, although this increase was not statistically signifcant. On the other hand, concern about the pandemic and health status could positively influence better adherence to screening and routine studies during pregnancy.
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Agricultural robots are called to help in many tasks in emerging clean and sustainable agriculture. These complex electro-mechanical systems can actually integrate artificial intelligence (AI), the Internet of Things (IoT), sensors, actuators, and advanced control methods to accomplish functions in autonomous or in collaborative ways. Before the deployment of such techniques in the field, it is convenient to carry out laboratory validations. These last could be at the sub-system, e.g., sensors or servos operation, or the whole system level. This paper proposes the development of the hardware and software parts of a platform of agricultural robot. The proposed system, highly motivated by the restrictions imposed by COVID-19 context, enables laboratory tests virtualization while keeping real-time functionalities
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Background: While cardiovascular complications, including arrhythmias are now a recognized manifestation of Multisystem inflammatory syndrome in children (MIS-C), there are no reports of primary bradycardia preceding the clinical presentation. We sought to describe a case series of sinus bradycardia as an initial manifestation of MIS-C. Methods: We included a series of 10 consecutive patients with confirmed COVID-19 who met WHO and CDC criteria for MIS-C, who developed sinus bradycardia with a heart rate measured in the awake state that was below the normal range for age for children, as an initial manifestation of the disease, in a prospective observational multicenter study. Patients underwent clinical, laboratory evaluation, ECG, Holter, telemetry, echocardiogram, chest X Ray, and a chest CT scan. Results: Of the 10 patients included, 6 were male, with a mean age of 6.52±5.35 years, range 4 months to 14 years. All cases were Hispanic. Bradycardia was transient and did not merit treatment. Coronary abnormalities were noted in 6 cases;4 patients had mild coronary ectasia;9 patients had pericardial effusion with no evidence of tamponade. All patients had a mild clinical course;none had shock, heart failure, the need for mechanical ventilation, or died. All blood markers (Troponin, BNP, Platelet count, C-reactive protein, D-dimer, Ferritin) returned to normal levels by discharge/follow-up with a favorable outcome including resolution of coronary dilatation in all but 2 in which aneurysm persisted. Treatment: All patients received steroids and low-weight-molecular heparin 10 patients, 8 aspirin and 8 intravenous immunoglobulins. Conclusion: Sinus bradycardia may be the initial manifestation of MIS-C, usually transient and mild. Physicians should be aware of this presentation. (Figure Presented).
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Background: COVID-19 is an infectious disease caused by the SARS-CoV2 coronavirus, which affects people, detected in December 2019, in Hubei province, China. It is a pandemic that affects many countries around the world and especially the most vulnerable people. Clinical case: 86-year-old male patient with a history of hypertension, type II diabetes mellitus, grade II obesity, COPD, went to the emergency room due to arthralgia 24 hours before admission, dyspnea on small efforts, hyperthermia, severe hypoxemia, improving saturation with 6 to 8 liters of oxygen. On admission physical examination, poor ventilatory mechanics, with respiratory thoracoabdominal dissociation, pafi: 104, for which we proceed to rapid intubation and admission to the intensive care unit, taking a sample for rapid COVID TEST, giving IgG and IgM positive. He remains intubated for 9 days, is discharged to hospitalization, where he is maintained with oxygen support for 12 days, plus pharmacological treatment, receives medical discharge with isolation measures, drugs, oxygen therapy and self-care education. Conclusion: it is a case of survival to covid-19 of an elderly, vulnerable patient, who was treated in the intensive care unit, with mechanical ventilation, after hospitalization and then at home, receives education on the management of isolation, protection measures, epidemiological monitoring and self-control of diabetes, hypertension and dietary hygiene measures. The case is followed up and the patient is in better condition.
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Background: Pregnant women represent a high-risk population during the COVID-19 pandemic. The main cause of maternal deaths in Mexico during 2020 was COVID-19 with 191 (21.2%) deaths registered until December 2020. The age group most affected was 30 to 34 years. Women during their third trimester and during puerperium were the most affected. Information regarding pregnant and postpartum women with autoimmune rheumatic diseases remains scarce. Objectives: The aim of this study was to describe a COVID-19 case series from a clinic of pregnancy and rheumatic diseases. Methods: We conducted a descriptive, retrospective study in patients from the clinic of pregnancy and rheumatic diseases of the University Hospital “Dr. Jose Eleuterio Gonzalez” in Monterrey, Mexico. Pregnant patients with RD and documented COVID-19 between March and November 2020 were included. Demographic and clinical features were obtained. Results are shown in descriptive statistics. Results: From the 18 women with autoimmune rheumatic disease in follow-up during this period, 2 (11.1%) pregnant women, 2 (11.1%) postpartum women, and 1(5.5%) post-miscarriage woman developed COVID-19. The mean age was 28 ± 6.3 years, 3 (60%) had systemic lupus erythematosus, 1 (20%) had rheumatoid arthritis, and 1 (20%) had the antiphospholipid syndrome. Clinical features and treatments are shown in Graphic 1 and Table 1. The most frequent symptoms were fever (80%), cough (60%) and anosmia (60%). Four (80%) had mild symptoms, and 1 (20%) had severe symptoms requiring intensive care unit admission and mechanical ventilation. Three (60%) referred history of contact with a person who had COVID-19. All the patients were using hydroxychloroquine and prednisone. No patient in our study died. Conclusion: From our population, a total of 27.8% presented COVID-19. Most of our patients had a mild course of SARS-CoV-2 infection consistent with data from the general population. Additionally, none of our patients had risk factors such as hypertension, diabetes, chronic kidney disease or lung disease. Nonetheless, pregnant women remain a vulnerable population. Prevention measures must continue worldwide to avoid additional COVID-19 morbidity and mortality.
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Background: In Mexico, the SARS-CoV-2 pandemic has totaled almost two million cases and exceeded 150,000 deaths (29/01/2021). Currently, COVID-19 has become the leading cause of death in pregnant women in Mexico. COVID-19 has additionally impacted the psychological health of individuals including women with rheumatic diseases. Objectives: The aim of this study is to compare the Fear of COVID-19 Scale (FCV-19S) in postpartum women with and without autoimmune rheumatic diseases. Methods: A cross-sectional, descriptive, and comparative study was conducted. The Spanish FCV-19S version was applied by telephone or e-mail. The instrument consists of seven items, each with a five-point Likert scale of options. The participant must choose the options that best represent their perception about the statements presented. The maximum possible total is 35 points. Sociodemographic information was collected from the clinical charts. The Kolmogorov-Smirnov test was used to determine normality of the data. Statistical analysis was done using the Mann-Whitney U test. Results: Forty-four postpartum women were included (22 from the Pregnancy and Rheumatic Diseases Clinic and 22 from the Obstetrics Department, both groups from the University Hospital Dr. José E. González in Monterrey, México). The mean level of fear found in women with rheumatic disease was 16 (6.6) points versus 14 (4.6) points in the non-rheumatic patients group. No significant difference was found between groups (p=0.65). Regarding the rheumatic diseases group, women in the category of other diagnoses (that included Sjögren's Syndrome, antiphospholipid syndrome, and dermatomyositis) had a greater mean FCV-19S score (20.2), than patients with systemic lupus erythematosus (17.3) and rheumatoid arthritis (15.4). Conclusion: Women with postpartum rheumatic disease had a higher FCV-19S score than postpartum women without rheumatic diseases, although this difference was not statistically significant.
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Background: The SARS-CoV-2 pandemic has directly impacted the psychological and physical health of individuals worldwide, as well as the global economy. Food insecurity rates have risen especially in vulnerable countries like Mexico. Furthermore, social isolation and economic uncertainty have multiplied depression and anxiety disorders. Pregnant and postpartum women are particularly vulnerable to food insecurity, increased stress, depression, and anxiety. Objectives: The aim of this study is to determine the perception of food insecurity (FI) and perceived stress in pregnant and postpartum women with rheumatic disease during the SARS-CoV-2 pandemic. Methods: An observational, cross-sectional and descriptive study was conducted. Patients from to the pregnancy and rheumatic diseases clinic of the University Hospital Dr. José E. González in Northeast Mexico evaluated between August to October 2020 were included. The Spanish validated versions of the Household Food Security Access Scale (HFIAS) and the Perceived Stress Scale (PSS-10) were applied by telephonic interview. The WHO recommendations were employed to determine the appropriate intake for each food group in a week. The Kolmogorov-Smirnov test was used to determine normality of the data. The Spearman correlation coefficient and the Kruskal-Wallis test were used for statistical analysis. Results: A total of 29 women were included. Six (20.6%) women were found to have moderate or severe degrees of food insecurity. In addition, 12 (40.30%) perceived moderate and severe levels of stress in the PSS-10. No relationship was found between food insecurity and perceived stress (p= 0.059). The food groups that exceeded the recommended weekly frequency were oils and sugars exceeded 3.9 and 2.9 frequencies, respectively. Conclusion: We found that 20.6% women suffered household food insecurity and 40.3% suffered moderate and severe levels of stress. No relationship was found between food insecurity with the HIFAS scale and perceived stress measures with the PSS-10. We found that oils and sugars exceeded more by the double of the recommended frequency per week.
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The current COVID-19 pandemic has generated a series of changes in the daily routines of people, including children and teenagers, in an unprecedented way, which constitutes a global challenge in public health. Social isolation has been a prophylactic measure to prevent the spread of the virus, however, it has generated negative impacts on the physical and emotional health of parents, caregivers, children, and teenagers around the world. Our objective was to evaluate the effects of confinement caused by the COVID19 pandemic at the level of nutritional status, dietary and behavioral patterns of elementary school children and teenagers in a small town of Colombia. Anthropometric parameters such as BMI Z score, waist circumference and waist / height ratio were evaluated in 266 school children and teenagers. A questionnaire with sociodemographic, clinical and lifestyle characteristics and the KIDMED were applied to learn about nutritional aspects. A total of 102 students (38.3%) were classified as having altered nutritional status, being 39 (14.7%) classified with overweight, and 36 (13.5%) with obesity. The prevalence of high adherence to the Mediterranean diet was 12%, 95% CI (0.08-0.16). Overweight was more prevalent in women (26/39, 66.7%) (p = 0.0439), and obesity was discreetly more frequent in men (19/36, 52.7%) (p = 0.7193). We observed a worrying nutritional, dietary and behavioral situation in the children and teenagers studied during the confinement associated with the covid 19 pandemic. This unveils the need to establish strategies and / or public policies in our town that help to promote an adequate biopsychosocial development of the pediatric patient and their family group.
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Background: Voluntary confinement, and subsequently compulsory quarantine, is a government strategy for containing and mitigating the effects of COVID-19 contagion. The objective was to characterize food security in Colombian families, perception of weight change and lifestyles during social isolation by COVID-19. Methods: cross-sectional study with a descriptive quantitative approach in a non-probabilistic sample, voluntary participant in an electronic access survey. The information was obtained through a structured survey with the Google Forms Drive tool, with three components, sociodemographic, food consumption and level of food safety. The link of the digital survey was socialized in all Colombian regions, during weeks 15, 16 and 17 of the month of April corresponding to the Colombian epidemiological calendar 2020. Univariate and bivariate analysis associated with the axis of food consumption and access was carried out, in the statistical program SPSS v25 and organizing databases in Microsoft Excel. Results: Of the 1,470 surveys applied in 97% of the Colombian territory (31 departments), 76% were completed by women. The average age of the convenience sample was 39 +13 years, the family composition of 48% was more than three members and 60% considered that their weight is normal. 62% considered the purchase of meat a high priority. Generally. It is observed that foods such as dairy products, cereals, fruits-vegetables had a high purchase priority;they did not buy sugary drinks, alcoholic beverages and processed foods;64% do not buy bottled water;35% of the families reported having a lack of money to buy food, while 15.3% reported eating less with their main meals. Conclusions: there was food insecurity due to lack of money and the purchase of food;a change in weight due to weight gain and modifications in lifestyles in terms of the purchase, consumption, hygiene and waste of food and physical activity. © 2020 Sociedad Espanola de Nutricion Comunitaria. All rights reserved.
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Mexico is a seismically active country. Earthquakes with magnitudes larger than 7.0 happen, on average, every other year. This fact requires a rapid and consistent response from the national monitoring agency, the Servicio Sismológico Nacional, SSN (Mexican National Seismological Service). For this purpose, in 2014, the SSN created a set of procedures for the daily operations and rapid response called “Protocolo de Respuesta Inmediata ante Sismos Amenazantes” (PRISA, protocol of immediate response to threatening earthquakes). This protocol has been triggered for 292 events with a magnitude larger than or equal to 5.0 that occurred between April 2014 and July 2020. Here we present the response of the SSN, based on this protocol, to three significant earthquakes: the 8 and 19 September 2017 events (Mw 8.2 and 7.1, respectively) and the 23 June 2020 (Mw 7.4). The first two quakes caused severe damage in southern and central Mexico, whereas the third occurred during the coronavirus disease 2019 pandemic and confinement in Mexico. Having PRISA in place contributed to the efficient SSN response in the three events, even though some activities for the 2020 earthquake were performed remotely. © Seismological Society of America