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BACKGROUND: COVID-19 survivors may experience persistent neuropsychological disruptions such as lower satisfaction with life (SWLS), depression, and anxiety. While student-athletes are at low risk for severe COVID complications, the effect of COVID on mental health remains to be elucidated. OBJECTIVE: Compare patient-reported mental health outcomes for incoming collegiate athletes who did (COVID+) and did not (COVID-) have COVID-19. METHODS: 79 COVID+ (79/178, 44.4%, 18.90±0.16 years) and 99 COVID- (99/178, 55.6%,18.95±0.16 years) completed SWLS, anxiety (HADS anxiety, STAI), depression (HADS depression). Unadjusted One-way ANOVAs were conducted across all patient-reported outcomes. ANCOVAs were conducted to determine the interaction of COVID history, sex, and race/ethnicity on outcomes. Post-hoc Bonferroni testing was performed to determine specific differences between groups. Chi-square analyses were used to compare the number of athletes who met the standard of clinical cut points for both groups. RESULTS: We observed a significant difference between groups for HADS depression (p=0.047), whereby athletes in the COVID+ group had significantly higher depression ratings (2.9±0.3). There was a significant group difference for SWLS (p=0.019), HADS anxiety (p=0.003), and STAI state anxiety (p=0.014) such that SWLS, HADS anxiety, and trait anxiety was higher for the COVID+ group in the adjusted model. Post-hoc testing revealed that COVID+ females had significantly worse HADS anxiety (p=0.011) and STAI trait anxiety (p=0.002). There were no significant differences in the percentage of responses below established diagnostic thresholds between groups. CONCLUSIONS: Incoming collegiate student-athletes who reported prior COVID diagnosis reported significantly higher depression scores suggesting clinicians may need to be aware of the potential need to intervene with appropriate mental health identification and referral. However, it was encouraging that most participants, regardless of prior COVID diagnosis, had mental health scores that did not exceed established diagnostic threshold values.
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This paper focuses the attention on a real-life case study represented by the design, the development and the practice of OLAP tools over big COVID-19 data in Canada. The OLAP tools developed in this context are further enriched by machine learning procedures that magnify the mining effect. The contribution presented in this paper also embeds an implicit methodology for OLAP over big COVID-19 data. Experimental analysis on the target case study is also provided.
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This paper focuses the attention on a real-life case study represented by the design, the development and the practice of OLAP tools over big COVID-19 data in Canada. The OLAP tools developed in this context are further enriched by machine learning procedures that magnify the mining effect. The contribution presented in this paper also embeds an implicit methodology for OLAP over big COVID-19 data. Experimental analysis on the target case study is also provided. © 2022 IEEE.
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Inflammation is an essential protective response against harmful stimuli, such as invading pathogens, damaged cells, or irritants. Physiological inflammation eliminates pathogens and promotes tissue repair and healing. Effective immune response in humans depends on a tightly regulated balance among inflammatory and antiinflammatory mechanisms involving both innate and adaptive arms of the immune system. Excessive inflammation can become pathological and induce detrimental effects. If this process is not self-limited, an inappropriate remodeling of the tissues and organs can occur and lead to the onset of chronic degenerative diseases. A wide spectrum of infectious and non-infectious agents may activate the inflammation, via the release of mediators and cytokines by distinct subtypes of lymphocytes and macrophages. Several molecular mechanisms regulate the onset, progression, and resolution of inflammation. All these steps, even the termination of this process, are active and not passive events. In particular, a complex interplay exists between mediators (belonging to the group of Eicosanoids), which induce the beginning of inflammation, such as Prostaglandins (PGE2), Leukotrienes (LT), and thromboxane A2 (TXA2), and molecules which display a key role in counteracting this process and in promoting its proper resolution. The latter group of mediators includes: o)-6 arachidonic acid (AA)-derived metabolites, such as Lipoxins (LXs), o) -3 eicosapentaenoic acid (EPA)-derived mediators, such as Eseries Resolvins (RvEs), and o) -3 docosahexaenoic (DHA)-derived mediators, such as D-series Resolvins (RvDs), Protectins (PDs) and Maresins (MaRs). Overall, these mediators are defined as specialized pro-resolving mediators (SPMs). Reduced synthesis of these molecules may lead to uncontrolled inflammation with possible harmful effects. o)-3 fatty acids are widely used in clinical practice as rather inexpensive, safe, readily available supplemental therapy. Taking advantage of this evidence, several researchers are suggesting that SPMs may have beneficial effects in the complementary treatment of patients with severe forms of SARS-CoV-2 related infection, to counteract the "cytokine storm" observed in these individuals. Well-designed and sized trials in patients suffering from COVID-19 with different degrees of severity are needed to investigate the real impact in the clinical practice of this promising therapeutic approach.
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INTRODUCTION AND OBJECTIVE: While subject to frequent speculation, the actual impact of the COVID-19 pandemic on urologic operative practice is unknown. Understanding the consequences of the pandemic will teach invaluable lessons for future preparedness and provide useful context for individual practices attempting to understand changes in operative volume. We analyzed populationlevel changes in operative practice since the onset of the COVID-19 pandemic to contextualize observations made by individual practices and optimize future responses. METHODS: We used Premier Perspectives Database to investigate changes in operative volume through March 2020. Baseline operative volume for urologic surgery was calculated using data from the preceding 12 months and compared on a total and by procedure basis. Multivariable linear regression was used to identify hospital-level predictors of change in response to the pandemic. Our primary outcome of interest was the change in operative volume in March 2020 relative to baseline. Total operative volume, and volume by procedure and procedure-based groupings were investigated. RESULTS: At baseline, we captured 23,788 urologic procedural encounters per month as compared with 19,071 during March 2020e a 19.9% decrease. Urologic oncology-related cases were relatively preserved as compared to others (average change in March 2020: =1.1% versus -32.2%). Northeastern (b=-5.66, 95% confidence interval [CI]: -10.2 to -1.18, p=.013) and Midwestern hospitals (b=-4.17, 95% CI: -7.89 to -0.45, p=.027;both with South as reference region), and those with an increasing percentage of patients insured by Medicaid (b= -.17 per percentage point, 95% CI: -.33 to -.01, p=.04) experienced a significantly larger decrease in volume. CONCLUSIONS: There was a 20% decline in urologic operative volume in March 2020, compared with baseline, that preferentially affected hospitals serving Medicaid patients, and those in the Northeast and Midwest. In the face of varying mandates on elective surgery, widespread declines in operative volume may also represent hesitancy on behalf of patients to interface with healthcare during the pandemic. Long-term follow-up will be necessary to determine COVID-19's final toll on urology.
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Background and aims: SARS-CoV-2 is a single-strained RNA virus belonging to Corona viridae's family. In paediatric age the majority of patients are asymptomatic, however several neurological manifestations associated with SARS-CoV-2 infection have been detected in a percentage of cases ranging from 17.3% to 36.4%. Acute Disseminated Encephalomyelitis (ADEM) has been recently included among the potential complications of SARS-CoV-2 infection. The available data regarding paediatric patient show only one case. Methods: Case report: We present a case regarding a six-year-old child suffering from Fisher Evans Syndrome treated with Sirolimus and Thalidomide therapy and affected by SARS-CoV-2 infection. Results: Case report: We present a case regarding a six-year-old patient suffering from Fisher Evans Syndrome who was given Sirolimus and Thalidomide therapy. After ten days since the first positive nasopharyngeal swab for Sars-CoV-2, in which he had no symptoms, he presented an episode of generalized tonic-clonic seizure with spontaneous resolution. The patient underwent MRI which showed the typical picture of Acute Disseminated Encephalomyelitis. His clinical course was favourable, with a good response to cortisone therapy and a progressive improvement of the neuroradiological and electroencephalographic picture. Conclusions: According to our knowledge, this is the second case of an Acute Disseminated Encephalomyelitis following SARS-CoV-2 infection in a paediatric patient, characterized by monosymptomatic onset, in which the immunosuppressive therapy practiced for the Fisher Evans Syndrome has probably contributed to a favourable evolution of ADEM, in contrast to other case described in the literature.
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The impact of the pandemic caused by COVID-19 may deepen the situations of malnutrition, where it will be necessary to adapt food programs to this new context. The objective of this work was to present the methodology and the main results of the process of formulating a federal guide based on scientific evidence and adapted to the reality of the child and adolescent population that attend school canteens in the 24 jurisdictions of Argentina. It was observed that the modalities for the implementation of SC during the pandemic were: food modules (the most frequent);food modules delivered at school with regular SC support and, food and/or snacks delivered daily. There was little evidence at the global and regional level on specific recommendations applied to the implementation of SC, although recommendations on hygiene and food handling were found. Based on a participatory process among key actors, specific recommendations were obtained according to the dimensions of food and nutrition security (FNS). It is concluded that it is necessary to increase participatory experiences in the design of recommendations based on evidence, adapted to the territory and that assume a comprehensive approach from the dimensions of FNS. Arch Latinoam Nutr 2020;70(3): 215-234. © 2020 Archivos Latinoamericanos Nutricion. All rights reserved.
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Background: In 2020, Med Learning Group (MLG) launched an interactive, multi-faceted educational initiative focusing on COVID-19. The innovative education & tools developed for FRONTLINE are publicly available for the entire healthcare community to use. Learners range from a variety of specialties, including infectious disease specialists, pulmonary medicine specialists, emergency room practitioners, advanced practitioners, nurses, & other healthcare professionals to help support them in their effort to optimize care of patients with COVID-19. MLG partnered with Health Resources & Services Administration, Project ECHO, Public Health Foundation & community, VA & academic centers to create a collaborative network with shared goals for education. Methods: This initiative seeks to reach over 25,000 learners with innovative educational programs & tools to enhance the learning experience, facilitate continuous learning & support the translation of education into practice, & encourage HCPpatient dialogue: • COVID Community of Care Website/Application • COVID Frontline Update Podcast Series • Virtual/Live ECHO Series with 3D animations of pathophysiology • Enduring ECHO Module with Case Discussions • Quality Improvement Personalized Posters Results: By September 2020, we will have the results from pre/posttests, intra-activity Q&A, evaluations, & 60- to 90-day follow-on assessments. We will evaluate learners' changes in knowledge & competence, & reported practice changes. In addition, MLG will have feedback collected via surveys & interviews on the various point-ofcare tools. Based off previous MLG educational initiatives, it is expected that learners will find value in the various tools available in this programming. Conclusion: Advanced tools like virtual live learning platforms, mobile websites/ apps, 3D animations & podcasts will prove to be an asset to the continuing education of HCPs treating patients with COVID-19. The outcomes are expected to demonstrate the extent to which HCPs have enhanced their ability to identify clinical predictors of disease severity of COVID-19 & apply current treatment guidelines, clinical trial data, & patient-specific factors to the management of patients with COVID-19. These results will be available in time to share via a poster at IDWeek 2020.
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In March 2020, the Contra Costa Public Defenders Association (CCPDA) established a task force to counter the injustices and dangers experienced by clients in custody during the Covid-19 pandemic. The purpose of this commentary is to describe the background and work of the task force, discuss the lessons learned and finally, to identify opportunities for reshaping the criminal justice landscape. In response to the humanitarian crisis in jail, the task force fought for systematic reform, including decarceration. However, while faced with increasingly divergent challenges arising from the pandemic, the task force became overextended, reverting its focus onto membership. The task force's main lesson is that alliances with other organizations are essential to propel political and legislative change. The Covid-19 task force provided a platform for CCPDA to publicly protest the treatment of incarcerated people, while also providing an opportunity to rethink its role as a political organization. Moving forward, public defenders can, in collaboration with other organizations, play an essential role in criminal justice reform. To prevent future deaths of people in custody during this and future pandemics, we must find alternatives to the current correctional system.
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BACKGROUND: The presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in saliva has alerted health professionals to the possibility of contamination by aerosols generated in a number of procedures. The indication of preoperative mouthwash containing 1% hydrogen peroxide for reducing the viral load of SARS-CoV-2 in saliva prior to oral procedures has been significantly disseminated through several citations and influenced various dental associations in the elaboration of dental care protocols during this pandemic period, including patients admitted to hospital wards and intensive care units. AIM: To Our aim was to perform a systematic review to answer the following question: does hydrogen peroxide mouthwash (at any concentration) have a virucidal effect? METHODS: The Cochrane, LILACS, PubMed, Scopus, and Embase databases were searched by using the following key-words: 'hydrogen peroxide', 'mouthwash', 'mouth rinse', 'rinse', 'oral rinse', 'mouth bath', 'mouth wash', and 'mouth washes'. Reviews, letters to the editor, personal opinions, book chapters, case reports, congress abstracts, studies with animals and studies on mouthwash containing other compounds other than hydrogen peroxide were excluded. FINDINGS: During the initial search 1342 articles were identified on the five electronic databases. After excluding some duplicates, 976 articles remained. Only studies assessing the virucidal effect of hydrogen peroxide mouthwash were selected, regardless of publication date. CONCLUSION: After reading titles and abstracts, no article met the eligibility criteria. In conclusion, there is no scientific evidence supporting the indication of hydrogen peroxide mouthwash for control of the viral load regarding SARS-CoV-2 or any other viruses in saliva.
Subject(s)
Anti-Infective Agents, Local/pharmacology , COVID-19/virology , Hydrogen Peroxide/pharmacology , SARS-CoV-2/drug effects , Aerosols/adverse effects , COVID-19/diagnosis , COVID-19/epidemiology , Health Personnel/education , Humans , Infection Control/methods , Mouthwashes/pharmacology , Mouthwashes/supply & distribution , SARS-CoV-2/genetics , Saliva/virology , Viral Load/drug effectsABSTRACT
Background: Bullous fixed pigmented erythema is a potentially serious form of toxicoderma. It is characterized by the appearance of cutaneous and / or mucosal lesions, single or multiple, which can appear in any area, after the administration of a drug or other substance. A 73-year-old man is presented with a diagnosis of bullous fixed pigmented erythema secondary to the ingestion of ivermectin. It is necessary for the physician to recognize the adverse effects of self-medication with ivermectin against SARS CoV-2, to make an early diagnosis and initiate timely treatment.
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Introduction: The aim of this study was to analyze the perceived stress, coping strategies, emotional regulation, impact of the event, and psychological distress during quarantine due to COVID-19 pandemic in the Colombian population. Method: Non-probabilistic sample made up of 356 adults who answered an online questionnaire. Results: It was found medium and high scores in active coping strategies and emotional regulation, and low scores in stress, psychological distress and impact of quarantine. The 38.76 % presented scores that indicate risk of post-traumatic stress disorder. Women, people under 35 years of age, high school graduates, students, and living alone during the quarantine showed higher affectation. Statistically significant correlations of stress with all variables except with social support and cohabitants during quarantine were found. Finally, it was found a positive association of stress with venting, expressive suppression, the impact of quarantine, and psychological distress, and negative association with planning, acceptance, cognitive reappraisal, and age over 25 years. Conclusions: These results contribute to understanding responses to quarantine and to identify vulnerability factors to design prevention and intervention programs. © 2022 Fundación Universitaria Konrad Lorenz.