Possession of exotic animals and zoonotic diseases: an approach from the Mexican context

The possession of exotic animals as pets is a social practice that has become more visible in Mexico in recent years, so it is interesting to understand its environmental and social implications and those related to human health. The present study aims to identify the main species of exotic animals kept as pets and the zoonotic diseases reported in these species. We analyzed official figures of seizures of exotic fauna in Mexico and reviewed specialized literature on zoonotic diseases documented in Mexico in these species. We identified zoonoses in species of fauna that can be acquired legally and illegally in the country, reported in environments in which animals coexist with other species and are in direct contact with people, which represents an important factor in the spread and propensity of this type of disease. We conclude that the sanitary regulation of wildlife markets, the monitoring and studying microorganisms associated with wildlife are valuable strategies to prevent the emergence of zoonoses.

Impact of the COVID-19 Pandemic on a Cancer Fast-Track Programme.

INTRODUCTION: The COVID-19 pandemic has disrupted many aspects of clinical practice in oncology, particularly regarding early cancer diagnosis, sparking public health concerns that possible delays could increase the proportion of patients diagnosed at advanced stages. In 2009, a cancer fast-track program (CFP) was implemented at the Clinico-Malvarrosa Health Department in Valencia, Spain with the aim of shortening waiting times between suspected cancer symptoms, diagnosis and therapy initiation. OBJECTIVES: The study aimed to explore the effects of the COVID-19 pandemic on our cancer diagnosis fast-track program. METHODS: The program workflow (patients included and time periods) was analysed from the beginning of the state of alarm on March 16th, 2020 until March 15th, 2021. Data was compared with data from the same period of time from the year before (2019). RESULTS: During the pandemic year, 975 suspected cancer cases were submitted to the CFP. The number of submissions only decreased during times of highest COVID-19 incidence and stricter lockdown, and overall, referrals were slightly higher than in the previous 2 years. Cancer diagnosis was confirmed in 197 (24.1%) cases, among which 33% were urological, 23% breast, 16% gastrointestinal and 9% lung cancer. The median time from referral to specialist appointment was 13 days and diagnosis was reached at a median of 18 days. In confirmed cancer cases, treatment was started at around 30 days from time of diagnosis. In total, 61% of cancer disease was detected at early stage, 20% at locally advanced stage, and 19% at advanced stage, displaying time frames and case proportions similar to pre-pandemic years. CONCLUSIONS: Our program has been able to maintain normal flow and efficacy despite the challenges of the current pandemic, and has proven a reliable tool to help primary care physicians referring suspected cancer patients.

Use of hydroxychloroquine in outpatient COVID-19 patients: evaluation of interactions and cardiac risk

Purpose: Hydroxychloroquine was widely used at the beginning of the COVID-19 pandemic with little evidence and off-label use. The objective of our work was to identify in non-hospitalized patients diagnosed with COVID-19 interactions of hydroxy-chloroquine and other drugs with known risk of prolonging the QT interval, as well as risk factors associated with the onset of Torsade de Pointes. Methods: The studied population included patients at home and in nursing homes centers in two health areas. All medications prescribed were considered. The MedSafety Scan (R) tool was used to analyze interactions. A survey was conducted to all the doctors. Statistical analysis was performed with the IBM (R) SPSS (R) statistics version 20 program. Results: The average number of drugs with the capacity to prolong the QT interval in each patient including hydroxychloroquine was 2.8. We found interactions in 93.2% of the patients. Most were affected by, at least, 2 interactions although in institutionalized patients a high percentage had up to 4. The most repeated was hydroxycholoroquine-antibiotics interaction (in 85% of them) mainly due to use of azithromycin with hydroxychloroquine, hydroxychloroquine-antiacids (38%) and hydroxychloroquine-antidepressants (23%). The survey shows that 15.3% of the patients had some adverse effect associated with hydroxychloroquine. Conclusions: Non-hospitalized patients were exposed to a high percentage of interactions between hydroxychloroquine and other drugs with the ability to prolong the QT interval. Faced with a possible efficacy not clearly demonstrated for hydroxychloroquine, patients were exposed to a possible unnecessary risk.

Impact of the COVID-19 pandemic in the cancer fast-track programme

Background: The COVID-19 pandemic has disrupted many aspects of clinical practice in oncology, particularly in making timely cancer diagnosis. Our public health system has been concerned about potential delays leading to a higher proportion of patients with advanced stages. Our cancer diagnosis fast-track program (CFP) in the Clinic-Malvarrosa Health department in Valencia (Spain) is connecting primary care (PC) with different specialists to speed cancer diagnosis and treatment upon well founded suspicion. A 10-year evaluation of our CFP has recently been published. The aim of this analysis was to investigate the impact of the COVID-19 pandemic on the CFP. Methods: We analysed the programme flow during the state of emergency starting on March 16, 2020 for one year. Results: During that year, 975 suspected cancer cases were submitted to the CFP. The submissions only decreased during the times of highest COVID-19 incidence and stricter lockdown (March, April and October 2020). However, referrals were slightly higher than in the two previous years (average 877). Of those 975 patients, 817 were seen by the corresponding specialist. A cancer diagnosis was confirmed in 197 (24.1%) with 33% urological, 23% breast, 16% gastrointestinal and 9% lung cancer. Median time from referral to the specialist visit was 13 (interquartile range, 8 to 22 days) days and a diagnosis was reached in a median of 18 days (interquartile range, 10 to 30 days). In cancer patients, treatment was started in around 30 days (interquartile range, 13.5 to 51 days) from the time of diagnosis. Sixty-one percent of cancers were found in an early stage, 20% in a locally advanced stage, and 19% in an advanced stage. These intervals and proportions were similar to the previous years. Conclusions: Our programme has proven to be a reliable tool to help PC physicians referring patients with cancer suspicion cancer, maintaining its normal flow and efficacy despite the current pandemic. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.

The ghg emissions generating capacity by productive sectors in the EU: A sam analysis

In this paper, we evaluate the generating capacity of Greenhouse Gases (GHG) emissions that all productive sectors have in the EU-27 of 2010. The analysis is performed using the social accounting matrices (SAMs) of each Member State (MS) and evaluating the interactions among industries, productive factors, and households with respect to the aggregated SAM for the EU-27. The main advantages and contributions of this study with respect to the existing literature are two. First, the availability of the whole income distribution detailed in the SAMs and second, their comparability across countries. The aim of this research is to better understand how productive sectors may damage the environment depending on their productive structure and final demand, particularly in a period of economic recession, which is very relevant in the context of COVID-19 and the near future. The results show that intersectoral connections are very diverse by MS and consequently, there are more differences in the generation capacity of GHG emission by country than by sector. Our results reinforce the idea of involving regional and national governments in the design and implementation of EU abatement strategies, taking into account the peculiarities of each region. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.