Medical System for Tests Analysis and Symptom Checker

The covid-19 pandemic brought the need to reduce human interaction so in order to facilitate the interaction with the doctors but reduce unnecessary trips to a medical specialty, and have a better understanding of the investigation result, we present our approach of a medical test interpreter, integrated with a symptom checker. Our system aims to provide a temporary solution for diagnostic a condition until the patient reaches a doctor, so a proper diagnose can be made. This system can also be used in low-income countries were access to healthcare is limited and people discover diseases too late. © 2022 IEEE.

Respiratory dispositive with intelligent shape-memory alloy wires to help artificial ventilation during sleep for SARS-CoV patients

This chapter discusses in detail the relationship between obstructive sleep apnea (OSA) and COVID-19 complications, the causative mechanisms, the effect of COVID-19 on the diagnosis of OSA, and the effect on the management and treatment of OSA during this pandemic. The restrictions imposed due to the pandemic have led to higher levels of mental stress, depression, and stress, increasing the burden of mental health and affecting sleep patterns, disrupting daily life, and having a significant effect on sleep health. The use of shape-memory alloys in devices to support breathing contributes to increasing the quality of service provided by this equipment primarily by reducing the noise produced by drive motors, but also by lowering the price. © 2022 Elsevier Inc. All rights reserved.

BURNOUT EFFECT IMPACT OVER MEDICAL STAFF DURING ACTUAL COVID-19 PANDEMIC CONTEXT

Stress and burnout are considered modern epidemics and their importance for physical health and work capacity was recognized worldwide. Working environment has a very well-known impact, either positive, or negative, over employees’ health. Adverse working conditions may lead to professional burnout, a syndrome generated from chronical stress at the working place, which is characterized by overwhelming exhaustion, negative attitude or lack of commitment. This process can lead to undesirable consequences for the employees, their families, but also in the working environment and organizations. © 2021 Romanian Society of Legal Medicine.

Implications of the Migration Phenomenon in Romania

The migration of the population is a phenomenon related to the change of a person’s place of living. The numerous existing forms of mobility have imposed a classification according to certain criteria, among which: the duration of the trip, its purpose, the distance traveled, or the degree of freedom of the person making the trip. Migrations involve a lasting or permanent change of residence and most of the time of the activity involves important changes in the lives of the engaged persons. These trips often require a change in the way of life of the people involved, are long-lasting or permanent, and almost always express an imbalance between the living conditions offered at the place of departure and those that exist or are expected to exist at the place of arrival. In order to highlight the current and future trends of migration, this paper will analyze its economic and social effects and the impact of COVID-19 on the migration phenomenon. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Deficiency of Vitamin D, a Major Risk Factor for SARS-CoV-2 Severity.

BACKGROUND: The SARS-CoV-2 outbreak started in March 2020 with more than 120,552,261 cases at present and having caused over 2,667,248 deaths worldwide at the time this paper was written. The clinical signs of SARS-CoV-2 infection are especially evident in the respiratory and cardiovascular systems. Patients can be asymptomatic or present mild respiratory symptoms to severe acute lung injury leading to multiorgan failure and death. The study aims to assess the levels of serum 25-hydroxyvitamin D (25-(OH)-D) in 20 hospitalized patients infected with SARS-CoV-2 and 20 deceased people and to analyze the influence of vitamin D status on the severity of their disease. METHODS: The present study was conducted on 40 patients who tested positive for SARS-CoV-2 infection. They were divided into two groups: 20 patients admitted to the "Victor Babes" Hospital of Infectious Diseases and 20 postmortem cases autopsied at the Institute of Legal Medicine Timisoara, Romania. During the autopsy, blood and bronchial fluid samples were collected for the laboratory. Automate Viral RNA extraction was performed on the Maxwell 48 RSC Extraction System (Promega, USA) using the Maxwell RSC Viral Total Nucleic Acid Purification kit (Promega, USA). After RNA extraction, the samples were amplified on a 7500 real-time PCR (Applied Biosystems, USA) using the genesig® Real-Time PCR Assay 2G (Primer Design, UK). RESULTS: The living and deceased patients selected for the research presented decreased vitamin D levels, which are associated with increased levels of D-dimers, C reactive protein (CRP), and interleukin-6 (IL-6). These patients had a severe form of the SARS-CoV-2 disease, which led to death. CONCLUSIONS: We conclude that deficiency of vitamin D in patients infected with SARS-CoV-2 presents a major risk factor related to the evolution and severity of the disease.

Remdesivir (RDV) pharmacokinetics in the PICU

INTRODUCTION: Remdesivir (RDV) is an antiviral agent with in-vitro activity against SARS-CoV-2 that has been used during the COVID-19 pandemic. Dosing strategies for pediatric and adolescent patients have primarily been extrapolated from adult dosing recommendations and, to date, there is a lack of pharmacokinetic (PK) data of RDV in this patient population. METHODS: Electronic medical record review of patients receiving RDV with concurrent therapeutic drug monitoring (TDM). RDV and GS-441524 concentrations were determined by LC-MS/MS methodology. RESULTS: 3 patients (2 female:1 male) met inclusion criteria and contributed 74 samples for determination of RDV and the active GS-441524 metabolite. The median age was 16 yrs (IQR 15.5-16 yrs) with a median weight of 76.4 kg (IQR 74.9-94.3kg). Patient #1 received ECMO support for the duration of RDV therapy. Patients #1 and 2 received RDV for 10 days with levels obtained daily. Patient #3 received RDV for 5 days with levels obtained daily. For all patients, mean RDV exposures, range 272-893 ng/mL were below the mean exposures reported in the RDV investigators brochure, 2900-7800 ng/mL. Patient #1 received ECMO and RDV exposures did not appear impacted by ECMO when compared with patients #2 and #3 that did not receive ECMO. For all patients, mean GS-441524 exposures, range 109-258 ng/mL, were similar to the mean exposures reported in the RDV investigators brochure, range 69-184 ng/mL. Similarly, the GS-441524 exposure did not appear to be affected by ECMO. Patients #1 and #2 did not appear to have any observable adverse events as a result of receiving RDV. Patient #3 experienced and increase in ALT >5x ULN which resulted in having RDV discontinued. All 3 patients experienced clinical resolution. CONCLUSIONS: These are the first PK data of RDV in critically ill adolescent patients. These preliminary data suggest using adult dosing recommendations in adolescent patients result in RDV exposures below mean values demonstrated in adults with similar exposures of GS-441524 which could be a result of rapid conversion of RDV to GS- 441524 with delayed elimination in the setting of critical illness. Additional PK data of RDV in the critically ill pediatric population is warranted.