Face-to-face or teleconsultation?: Good clinical practices in psychology students during Covid-19

Covid-19 as a health problem has generated a health and care crisis for the population, especially leading psychologists to examine new forms of care for people. The objective of this research was to compare the results of the clinical practice process in person, by telepsychology and alternately, developed by psychology students from higher education institutions in the Colombian Caribbean in the context of Covid-19;through a mixed study, including quantitative and qualitative data collection through online forms, applied to a sample of 105 students and 6 internship tutors from two Higher Education Institutions located in Barranquilla and Sincelejo. The results show that both telepsychology and face-to-face and alternation allow the development of clinical skills in students such as interviews, observations, evaluations, psychoeducation and intervention, and that practice tutors are satisfactorily valued as facilitators of these knowledge and skills, using different strategies and technological resources for it. It is concluded that the three modalities allow to carry out the training practices in health in a satisfactory manner, especially if accompanied by tutors with a high degree of commitment, empathy and adequate instruction © 2023, Revista de Ciencias Sociales.All Rights Reserved.

Effectiveness and Safety of Nirmatrelvir/ Ritonavir in Real Life Setting

Background and Importance On March 28th 2022, nirmatrelvir/ ritonavir was marketed in Spain. The Spanish Agency for Medicines and Medical Devices (AEMPS) established criteria to prioritise its administration in patients at high risk of progression to severe COVID. Data regarding the effectiveness and safety of nirmatrelvir in preventing severe coronavirus disease outcomes are limited. Aim and Objectives To assess the effectiveness and safety of nirmatrelvir/ritonavir in patients at high risk for severe COVID-19. Material and Methods Prospective descriptive study from April to August 2022 of patients treated with nirmatrelvir/ritonavir. Sociodemographic variables, vaccination status, hospital admission, high risk factors for progression and concomitant treatment were recorded. Readmissions were recorded within 30 days of the end of antiviral treatment. Results 53 patients were included with a mean age of 64 years, 51% women and 49% men. 57% were vaccinated with 3 doses, 17% with 2 doses, 9% with 4 doses, 6% with 1 dose and 11% were not vaccinated. 34% (18/53) were hospitalised at the time of initiation of treatment. The most prevalent high-risk criteria were: 24% active treatment with myelotoxic chemotherapy, 21% treatment in the previous 6 months with anti-CD20 drugs, 14% over 80 years vaccinated with some risk factor for progression, 7% patients with onco-haematological treatment and 7% in treatment in the previous 3 months with inhibitors of the proteinkinase. 3 treatments were performed off-label for persistent covid. The mean number of days from the onset of symptoms to the start of treatment was 1.6 days. 23% of patients required dose adjustment due to renal impairment. 53% required adjustment of chronic treatment for interactions, mainly with metamizole, statins, fentanyl and diazepam. 2 patients received remdesivir and sotrovimab, 2 remdesivir and another two sotrovimab. 4 (7%) patients were readmitted within 30 days after the end of treatment with nirmatrelvir ritonavir, 1 of them with persistent covid. One patient stopped treatment for hives. Conclusion and Relevance Nirmatrelvir ritonavir has been shown to be a safe and effective drug in high-risk patients of progression to severe covid.

Enhancement and Adoption of Sovereign Debt Management Practices in the Advent of the Covid-19 Pandemic

This paper discusses the evolution of sovereign debt management over the past two decades, highlights the need for its further evolution in light of the continuous efforts to build sustainable debt and growth policies, and outlines some views on its future following the ensuing challenges from the Covid-19 pandemic. The paper also outlines some key lessons and considerations for sovereign debt restructurings that might emerge as a result of Covid-19-related sovereign debt distresses and concludes by stressing the need of integrating sovereign debt management with fiscal and monetary policies. © Multinational Finance Society, a nonprofit corporation. All rights reserved.

The role of believing fake news on compliance of anti-COVID-19 measures in Mexico

During the COVID-19 pandemic, fake news proliferated along with the concern that they would affect behavior regarding the disease. With a semi-representative survey in Mexico (N = 1211), this study analyzes a mediational process to determine the impact of the use of traditional and social media on compliance with contagion prevention measures, through the perception of veracity of fake news about COVID-19. As anticipated, results indicate that believing fake news leads to less compliance of preventive measures. Likewise, the analysis indicates that, consistent with our hypothesis, using social media leads to more belief in fake news, but contrary to our expectations, consuming traditional media also leads to a greater belief in fake news. In particular, the study explored the mediating role of belief in fake news on the effect that using traditional and social media has on compliance with preventive measures. We found evidence for this indirect effect: use of traditional and social media is a predictor of believing fake news about COVID-19, which then results in lower compliance with measures. In contrast, the direct effect of using traditional and social media on compliance with measures has a positive direction. Thus, this work evinces that fake news can hinder the resolution of the health crisis, by discouraging compliance with preventive strategies.

Triosephosphate isomerase from mycobacterium tuberculosis as potential target to develop a new anti-TB drug

Tuberculosis (TB) is possibly the most prevalent infectious disease in the world, reports from the World Health Organization (WHO) indicate that TB is one of the top 10 causes of death and an estimated 10 million people worldwide, in addition, there are increasing the TB resistant to conventional antibiotics, multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB). Lastly, TB has become more important and requires more attention since it has been proposed as a risk factor for the severity of COVID-19. Therefore, the need to develop new anti-TB drugs. In this study, we propose to use the glycolytic enzyme triosephosphate isomerase from Mycobacterium tuberculosis (MtTIM) as a therapeutic target against TB. The triosephosphate isomerase (TIM) is a target used in different proposals to develop new drugs against different organisms. The MtTIM is an extremely attractive drug target due to the characteristics of its amino acids sequence. In addition, it has been determined that this enzyme (MtTIM) is necessary for the viability of in vitro and in vivo cultures of Mycobacterium tuberculosis. In this way, using the MtTIM as a therapeutic target, we propose potential compounds against MtTIM by molecular docking. © 2021 by the authors.

A historical-geographical view of pandemics: to understand COVID-19 in a complex way

The outbreak/pandemic investigation approach is a challenging, necessary and challenging activity for health professionals and epidemiologists. This approach allows epidemiology and surveillance services to deepen their knowledge of the disease, collect historical data on pandemic episodes, characterize vulnerabilities, develop hypotheses and intervene risk factors in a given environmental and sociocultural context with local action and a global perspective. A syndemic approach is considered, in such such a way that it combines aspects of interconnected social determinants and deepening in the pandemic.

A multicenter analysis of the outcome of cancer patients with neutropenia and COVID-19 infection optionally treated with granulocyte colony-stimulating factor (G-CSF)

Background: Infection by SARS-CoV-2 can turn into an acute respiratory infection. Approximately 15% of patients will develop a distress syndrome responsible in most cases of mortality. A host hyperinflammatory response induced by a cytokine storm, is the main cause of this severe complication. Chemotherapy myelosuppression is associated with higher risk of infections and mortality in cancer patients. There have been no previous reports about the clinical management of patients with neutropenia and concomitant COVID- 19. Herein, we present a multicenter experience in several hospitals during COVID-19 outbreak in neutropenic cancer patients infected by SARSCov- 2. Methods: Retrospective clinical data were collected from clinical reports. Protocol was approved by a Clinical Research Ethics Committee (HULP: PI-4194). Inclusion criteria were cancer patients with neutropenia (<1500 cells/mm3) and concomitant COVID-19 infection. Comorbidities, tumor type and stage, treatment, neutropenia severity, filgrastim (G-CSF), COVID-19 parameters and mortality were analyzed. Exploratory analysis included a description of all data collected and bivariate analyses among different pairs of variables, including their impact in mortality in this cohort. In addition, multivariable logistic regression was used to predict respiratory failure and death as a function of multiple variables. Results: Among 943 patients with cancer screened in 14 hospitals in Spain, eighty-three patients (8%) had a febrile neutropenia and COVID-19 infection. Lung (26%), breast (22%), colorectal (13%) and digestive noncolorectal (17%) cancers were the main locations and most patients had advanced disease (67%). Fifty-three (63%) of patients included died because respiratory failure. Neumonia was presented in 76% of patients, bilateral in 47% and 12% of all patients had thrombotic events. The median of neutrophils was 650cls/mm3 and 49% received GCSF with a median of days on treatment around 4,5 days. Among all variables related with mortality in neutropenic cancer patients with COVID-19 infection, we found that the number of days with GCSF showed a significant trend toward worse outcome and higher mortality. In particular, a logistic regression model was developed to predict respiratory failure, as a function of the number of days of G-CSF treatment. As adjusting covariates, sex, age, treatment purpose (palliative vs curative, to adjust for patient status), tumor type, and the lowest level of neutrophils in the patient (to adjust for neutropenic status) were used. A significant effect was obtained for the days of G-CSF treatment (OR = 1.4, 95% CI [1.03, 1.92], p-value = 0.01). Conclusions: Our findings suggest that a prolonged G-CSF treatment could be disadvantageous for these cancer patients with COVID-19, with a higher probability of worse outcome.

Screening test for COVID-19 in dental practice: Best options

PURPOSE: To review diverse tests that could serve as a screening tool for the dental community to identify patients with potential COVID-19. METHODS: Detailed automated searches of Medline, PubMed and EBM Review, including ACP Journal Club, the Cochrane Controlled Trials Register, and the Cochrane Database of Systematic Reviews of Effectiveness from 2019 to 2020 were conducted. Real-time polymerase chain reaction (RT-PCR) or quantitative (q) RT-PCR and Western blot assays were excluded. RESULTS: Real time loop-mediated isothermal amplification (RT-LAMP) and Real time recombinase polymerase amplification (RT-RAP) are the most promising methodologies developed as screening tools, and could be a screening test option in dental practice to identify patients potentially carrying SARS-CoV-2 and to prevent cross-infection between patients and dental personnel. CLINICAL SIGNIFICANCE: Biological risk management in the dental clinic is primarily focused on the wearing of protective equipment by dental personnel and disinfection/sterilization procedures for surfaces. With the absence of suitable antiviral drugs or vaccines, simple, rapid, and reliable detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) could be critical for preventing the spread of infection in dental practices.

Treatment guidelines for COVID-19 infected patients

BACKGROUND: New information for potential treatments against SARS-CoV-2 is rapidly increasing. As a result, countries and organizations have begun to release therapeutic guidelines. OBJECTIVE: To provide a synopsis of the recommendations supported in evidence-based guidelines for therapeutic options with potential activity against SARS-CoV-2. METHOD: Rapid systematic review of guidelines and/or protocols that provide interim clinical guidance for COVID-19 disease were extracted from PubMed/Medline, Web of Science, Scopus, Scielo, Google Scholar, and a general Google search. Duplicates were removed and a summary of the proposed interventions was included. A benefit risk analysis was then conducted. RESULTS: Twenty guidelines and/or protocols were selected;the majority of which came from Europe and Latin America. Seventeen interventions were identified and classified into 6 pharmacological groups. Antimalarials, lopinavir/ritonavir and remdesivir were the only agents recommended and supported by clinical trials. The remaining interventions were recommended based on indirect evidence, observational studies, or in vitro studies. CONCLUSIONS: Antimalarials have shown results against COVID-19 with surrogate outcomes and the presence of serious adverse events. We recommend active monitoring of agents with potential efficacy against SARS-CoV-2 and incorporating the results in national guidelines and protocols. Clinical trials should be conducted to show direct benefit with clinically relevant outcomes in various populations. © 2020 Comunicaciones Cientificas Mexicanas S.A. de C.V.. All rights reserved.

Recommendations for the management of urologic patients during the COVID-19 pandemic in Mexico

The COVID-19 pandemic has forced the modification of medical attention around the world, to reserve the greatest amount of resources for the treatment of patients with SARS-CoV-2 infection. Urology departments, just like the rest of the surgical services, have had to adapt to this situation, reducing the medical attention given to different illnesses and only selecting and attending to emergency consultations, procedures, and surgeries, or to oncologic maladies that cannot be postponed. The aim of the present review was to make recommendations regarding outpatient consultation anagement and the correct selection of surgeries and procedures. The postponement of the majority of non-urgent procedures should continue until the COVID-19 pandemic is controlled in Mexico.

Scenario of Elective Colorectal Oncology Surgeries during the COVID-19 Pandemic

The COVID-19 pandemic has changed the world health scenario, causing numerous problems related to the overload of services. In this scenario, the approach to oncological diseases becomes a challenge, considering the risk of progression of cancer disease and death due to delay in diagnosis and treatment. Faced with this exceptional situation, coloproctology services have been forced to change their routine to adapt to the new reality, considering risks and benefits in the conduct of these patients. Thus, the experience of the coloproctology service at the Santa Casa de Saõ Paulo, Saõ Paulo, state of Saõ Paulo, Brazil, during the beginning of the COVID-19 pandemic is described, evaluating the possibility of maintaining elective oncological surgeries through selection by directed anamnesis. Method ?Retrospective cohort study with prospective collection comparing colorectal surgery for cancer before and during the pandemic from December 2019 to July 2020. Results ?In total, 81 patients were included. During the pandemic, 41 patients were operated on with 2 perioperative contaminations by COVID-19. Both length of stay and complications were not different between groups. Conclusion ?Since there was no increase in COVID-19 morbidity and mortality in elective oncology surgeries with patients screened for guided anamnesis, it is worth considering this method for maintaining surgical procedures even in the event of a pandemic. © 2021 SPIE. All rights reserved.