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Gastroenterology ; 162(7):S-487, 2022.
Article in English | EMBASE | ID: covidwho-1967318

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) has affected more than 249 million people worldwide as of November 2021. Patients with chronic immune-mediated inflammatory diseases are at risk of viral infections either related to their underlying immune dysfunction or the immunosuppressive therapy, but little is known about the impact of COVID19 on outcomes and management of pancreatobiliary IgG4 related disease (IgG4 RD) patients. Methods: This was a multicenter retrospective cohort study aiming to investigate the impact of COVID-19 on the clinical outcomes and management of pancreatobiliary IgG4 RD patients in different geographic areas with COVID-19 outbreak. Pancreatobiliary IgG4 RD patients aged 18 years or older from 7 referral centers in Hong Kong, Japan, Thailand, Singapore, the United States and Italy were included. Case definition of IgG4 RD: elevated serum IgG4 serology with typical features of pancreatobiliary involvement on imaging, EUS, ERCP and/ or typical histopathologic features of IgG4 RD. Medical records were reviewed for IgG4 RD status (organ involvement, disease activity, treatment status), COVID-19 infection and outcome. Outcome measures were incidence and severity of COVID-19 in pancreatobiliary IgG4 RD patients, medical treatment for the IgG4 disease during COVID-19 and incidence of postponement or discontinuation of indicated medical treatment for IgG4 RD during COVID-19. Results: 101 pancreatobiliary IgG4 RD patients (mean age 66.4 +/- 12.1 years, male 74.3%) from 7 referral centers were included from January 2020 to November 2020. Major comorbidities of patients: none in 21.8%, diabetes in 45.5%, hypertension in 49.5%, ischemic heart disease in 8.9%, chronic liver disease in 8.9%, chronic kidney disease in 9.9% and cancer in 5.0% of patients. IgG4 RD organ involvement: pancreas only in 36.6%, pancreas and bile duct in 16.8%, bile duct only in 14.9%, pancreatobiliary and other organs in 26.7% of patients. The mean serum IgG4 serology level was 4.72+/-7.31 g/L. In 2020, 27.7% of patients had active IgG4 disease while 72.3% of patients were in remission. In 2020, 65.3% of patients received treatment (steroid in 48.5%, thiopurines in 22.7%, steroid and thiopurines in 25.8%, rituximab in 1.5%), while 30.7% of patients were not on treatment. 2 patients (2.0%) had COVID-19 infection, with 1 patient requiring ICU admission. All infected patients recovered from COVID-19 without flare up of IgG4 RD. In 2020, 6.9% of patients had postponement or discontinuation of indicated medical treatment for IgG4 RD during COVID-19 outbreak due to concern of COVID-19 infection while on immunosuppressive therapy. Conclusion: In this study, low incidence of COVID-19 infection and low rates of postponement or discontinuation of indicated medical treatment were observed in pancreatobiliary IgG4 RD patients during COVID-19 outbreak in 2020. (Table Presented)

2.
Nurse Educ Today ; 112: 105330, 2022 May.
Article in English | MEDLINE | ID: covidwho-1740061

ABSTRACT

BACKGROUND: Smoking is an important modifiable risk factor of morbidities and mortality. Although healthcare professionals play an important role in smoking cessation, their adoption of such practices is relatively low because of inadequate training. To address this issue, we incorporated a service-learning model to operate the Youth Quitline. Undergraduate nursing students were trained and received supervision while delivering smoking cessation counseling through the Youth Quitline as their clinical placement. OBJECTIVES: We evaluated the effectiveness of the placement by assessing students' knowledge, attitudes and practices regarding smoking cessation and tobacco control. DESIGN: One-group pretest-posttest design. SETTING: Youth Quitline. PARTICIPANTS: A total of 61 third-year students in a mental health nursing program. METHODS: Students were required to complete 80 h at the Youth Quitline. The 80 h were divided into 20 sessions; students used four sessions to approach and recruit youth smokers in the community, then provided them with telephone counseling for the rest of the time. Prior to the placement, students attended a 2-day workshop. The outcomes were changes in students' knowledge, attitudes and practices regarding smoking cessation and tobacco control 3 months after the placement compared with baseline. RESULTS: From January-June 2021, students conducted 105 outreach activities to identify 3142 smokers in the community, and provided telephone counseling for 336 smokers via Youth Quitline. Compared with baseline, significant improvements were observed in students' knowledge, attitudes and practices regarding smoking cessation and tobacco control at 3-month follow-up. CONCLUSIONS: The clinical placement improved students' knowledge, attitudes and practices regarding smoking cessation and tobacco control, enhancing their competency in providing support to assist smokers to quit in their future practice. Incorporating the service-learning model in existing community-based services can provide additional venues for nursing students to practice. This is particularly important because many venues have restricted access during the COVID-19 pandemic.


Subject(s)
COVID-19 , Education, Nursing, Baccalaureate , Smoking Cessation , Students, Nursing , Adolescent , Counseling , Delivery of Health Care , Humans , Pandemics , Smoking Cessation/psychology
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