SPANISH NATIONAL REGISTRY OF BELIMUMAB IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

BackgroundBelimumab (BLM) is a monoclonal antibody that inhibits B-lymphocyte stimulating factor (BlyS) approved as a specific treatment for systemic lupus erythematosus (SLE) in 2011. We present the experience with BLM in a Spanish cohort with more than 460 patients.ObjectivesTo describe demographic characteristics, efficacy and safety of BLM in patients with SLE in Spanish population since its approval.MethodsDescriptive, retrospective, multicenter study in patients diagnosed with SLE according to EULAR/ACR 2019, SLICC and/or ACR 1997 diagnostic criteria. Data regarding SLE patients treated with BLM were collected from medical records (2011-2022). Demographic features, efficacy, laboratory variables, SLEDAI, renal involvement, steroid dose, administration routes and safety were assessed. To see whether a trend in BLM prescription had changed or not over time, two periods of time were analyzed: 2011-2016 (period1) and 2017-2022 (period2).ResultsBaseline characteristics of patients are summarized in Table 1.A total of 462 patients (36 hospitals) were included, 50.9% were on intravenous (IV), 34% on subcutaneous (SC) and 15.1% switched from IV to SC route. The median number of pre-BLM csDMARD use was 2.0 (2.0-3.0), being hydroxychloroquine (HCQ) the most frequently used (94.5%). Fifty-two patients were treated with IV cyclophosphamide with a median of 6 bolus received. At the time of BLM start, 443 patients were on prednisone with a median dose of 6.2 mg (5.0-10.0). Significant decreases in prednisone dose, SLEDAI and anti-DNA antibodies were observed from baseline until the last visit, whereas complement C3 and C4 values raised (Figure 1). A total of 118 patients (27.4%) had renal involvement with a median proteinuria of 1.0 g/day (0.5-2.4). Renal biopsy was done in 102 out of 118 patients, being class IV (33%), class III (21%) and class V (16%) the most frequently reported. After BLM, 73.3% of these patients improved (median proteinuria of 0.2 g/day (0.1-0.7).In period1, 100 patients started BLM compared to 362 in period2. The median time from SLE diagnosis to BLM begin was 7.1 (4.0-13.7) and 6.2 (2.1 -14.4) years in period1 and period2, respectively (p=0.454). We found a trend to use more csDMARD before BLM treatment in period1: 2.5 (2-3) vs. 2 (2-3) (p=0.088).A total of 143 (30.5%) patients discontinued treatment mostly due to inefficacy (55.9%) and infections (11.9%). In fact, 116 patients developed infections, mostly mild;2 patients died, 16 had COVID-19 and 4 patients developed tumors requiring discontinuation of the drug.ConclusionIn our cohort of SLE patients in a real-world setting, BLM has been effective, safe and seems to be a good choice to treat renal involvement.References[1]Navarra SV, Guzmán RM, Gallacher AE, et al. Lancet. 2011;377(9767):721-31.[2]Stohl W, Hiepe;rt al. Arthritis Rheum. 2012;64(7):2328-37.[3]Furie R, Rovin BH, Houssiau F, et al. N Engl J Med. 2020;383(12):1117-1128.Acknowledgements:NIL.Disclosure of InterestsNone Declared.

Clinical-epidemiological aspects of mental health in children during confinement by COVID-19

Introduction: Confinement during COVID-19 and associated stress can affect children's well-being. Objective: To determine the clinical-epidemiological aspects of mental health in children during COVID-19 confinement. Method: Cross-sectional, descriptive observational study carried out at Dr. Eduardo Agramonte Piña Provincial Teaching Pediatric Hospital in Camaguey, from January 1, 2021 to December 31, 2021 The universe and the sample consisted of 144 (women) with their children (144) who were admitted to Maceo, Adolescent, and Cardiology services, selected at random. The variables studied included: age group, sex, emotional disorders, risk factors (home geographic location, diet, practice of physical exercise, socioeconomic situation, social relationships and sleep disorders), and specialized care. Data were expressed in absolute values and percentages. Results: 57.6 % of mothers reported that during confinement, their children suffered from negative emotional reactions, 78.5 % had inadequate nutrition, 90.3 % had sleep disorders, and 70.1 % did not practice physical exercise. Children from rural areas presented less emotional disorders (22.9 %) than those from urban areas (74.0 %), being those who had average and high socioeconomic status the ones who presented less emotional disorders, 43.7 % and 13.3 % respectively. Those who socialized more reported fewer harmful emotional reactions (38.8 %). Conclusions: Data suggest that adequate nutrition, good social relationships, and physical exercise benefit children's mental health in isolation situations © Este material es publicado según los términos de la Licencia Creative Commons Atribución–NoComercial 4.0. Se permite el uso, distribución y reproducción no comerciales y sin restricciones en cualquier medio, siempre que sea debidamente citada la fuente primaria de publicación

Dengue fever after the covid-19 pandemic: a statistical software analysis of its current situation in Ecuador

Dengue is an acute viral disease that is transmitted by the bite of mosquitoes. Today, dengue infection is the most notable arbovirus infection worldwide in terms of mortality and morbidity. The first case of dengue fever was reported in China in 992 and in 1975 this disease covered much of the world and caused many deaths, especially among children, later in the 1980s it became a common epidemic, at the beginning of the 2000s dengue became the second most common vector-borne disease, it is composed of four distinguishable viral serotypes 1,2,3 and 4 any of them is capable of producing severe forms of the disease, however serotype 2.3 are associated with a greater number of serious cases and deaths, dengue disease has 3 stages, initial phase that occurs from the moment of contagion until the first symptoms occur, Clinical phase of the disease begins to show characteristic symptoms, when the disease exceeds the barrier of six months it becomes chronic and an appropriate treatment must be applied to ensure a prompt recovery without sequelae, then we have the resolution phase in this phase there are several aspects it may be that the disease ends or passes be chronic or even become terminal, according to reports in the last 50 years its incidence has increased annually, an assumption of 50 million infected occur, in America in 2018 560,586 cases were reported with an incidence of 57.3 per 100,000 inhabitants of which 3,535 were classified as severe dengue. Dengue in Ecuador represents a priority problem in public health, this is due to the fact that each year there are a large number of cases, in 2018 Ecuador reported 3,094 cases, of which 2,965 were dengue without an alarm sign and 123 cases were reported with alarm sign, in the last six years Ecuador has reported a greater number of cases in 2018 and 2020. © 2022, Associacao Iberica de Sistemas e Tecnologias de Informacao. All rights reserved.

Pharmacocinétique de population de l'isavuconazole en réanimation chez les patients atteints d'aspergillose pulmonaire associées à la COVID-19 (CAPA) et simulation Monte Carlo de doses élevées

Introduction L'isavuconazole est un agent antifongique triazole de développement récent recommandé comme traitement de première ligne pour l'aspergillose pulmonaire invasive. Avec l'avènement de la pandémie de COVID-19, des cas d'aspergillose pulmonaire associée à la COVID-19 (CAPA) ont été décrits avec une prévalence allant de 5 à 30%. Nous avons développé et validé un modèle pharmacocinétique de population (PKpop) des concentrations plasmatiques d'isavuconazole chez les patients hospitalisés en unités de soins intensifs et réanimation atteints de CAPA Matériels et méthodes La modélisation non linéaire à effets mixtes à l'aide du logiciel Monolix a été utilisé pour l'analyse pharmacocinétique de 65 concentrations plasmatiques minimales provenant de 18 patients. Les paramètres pharmacocinétiques ont été estimés au mieux avec un modèle à un compartiment. A partir du modèle validé des simulations de hautes posologies ont été évaluées par des simulations de Monte carlo. Résultats La moyenne des concentrations plasmatiques d'isavuconazole était de 1,87 [1,29-2,25] mg/L malgré une dose d'attaque prolongée (72 h pour un tiers des patients) et une dose d'entretien moyenne de 300 mg par jour. La modélisation pharmacocinétique a montré que le traitement d'épuration extra-rénal (EER) était significativement associé à une sous exposition, expliquant une partie de la variabilité de la clairance. Les simulations de Monte Carlo ont suggéré que le schéma posologique recommandé ne permettait pas d'atteindre la valeur minimale cible de 2 mg/L en temps voulu (72 h). Conclusion Il s'agit du premier modèle pharmacocinétique populationnel sur l'isavuconazole développé pour les patients en soins intensifs atteints de CAPA, qui souligne la nécessité d'une surveillance thérapeutique de l'isavuconazole, notamment pour les patients sous EER. Aucun lien d'intérêt

Developing Contemporary Survivorship Clinic for Recipients of Hematopoietic Cell Transplantation: A Single Center Experience

Introduction: Survival after hematopoietic cell transplantation (HCT) has improved tremendously over the last few decades. HCT survivors are at increased risk of long-term complications and secondary cancers. This poses unique challenges to the HCT-related healthcare system given the growing need for survivorship care. Developing a HCT survivorship program with a dedicated clinic to survivors ensures equitable access to care and ongoing patient education. Herein, we describe our program survivorship model and our initial experience. Method(s): The Moffitt Cancer Center (MCC) survivorship clinic (SC) planning committee was initiated in September 2019. The SC was launched in January 2021 with the mission to provide high-quality, comprehensive, and personalized survivorship care and to empower patients and community health care providers with education and a roadmap for screening for late effects. The SC initially focused on allogeneic (allo) HCT patients and later opened to autologous (auto) HCT recipients in February 2022. HCT patients are referred by primary HCT team after HCT with an emphasis on preferred timeframe of initial SC visit no earlier than 3 months but less than 12 months from HCT. SC is located at 2 physical locations: main campus and satellite, with virtual visit options to account for the distance from MCC and COVID considerations. SC applies a consultative model. SC is staffed by dedicated advanced practice professional (APP), supervised by SC faculty. The scope of SC care includes but is not limited to prevention of infections (education, vaccinations), surveillance of late effects (endocrine, pulmonary function, cardiac, bone health), and general cancer screenings (breast, colon, skin cancer). Patients' clinical data from SC inception to August 2022 were reviewed. Result(s): From January 2021 to August 2022, a total of 138 patients were seen in SC. The majority were seen in person (62% in clinic, 38% by virtual visit). Median age was 58 years (range, 19-82). Median time to first SC visit was 21 months (range, 3-1464) after HCT. Allo HCT was the most common type of HCT seen in clinic (87%, n=120). Most common diagnoses were acute myeloid leukemia (43%, n=59), myelodysplastic syndrome (17%, n=23), and acute lymphoblastic leukemia (10%, n=14). Only 17 patients (12%) were seen in 2021 but the volume increased significantly in 2022. Currently there are more than 10 patients seen in SC per month. Conclusion(s): We report successful experience in launching a contemporary HCT SC despite the challenges of an ongoing COVID pandemic. As a stand-alone cancer center, we serve a wide geographical location with subspecialty and primary care providers dispersed throughout the community. Our consultative model and experience could provide a useful guide for other programs. In 2023, we plan to expand our SC to a broader population of patients receiving other cellular immunotherapies.Copyright © 2023 American Society for Transplantation and Cellular Therapy

Neurological manifestations in patients with COVID-19

Introduction: COVID-19 pandemic represents a challenge for healthcare systems, due to the impact on different systems, such as respiratory, cardiovascular and nervous systems. Background: to describe the neurological manifestations in patients with COVID-19. Methods: a search for information was carried out in the PubMed/Medline, SciELO, EBSCO, Lilacs and Scopus databases. A search strategy was applied by combining terms and using Boolean operators. Thirty references were chosen. Results: olfactory nerves and invasion of peripheral nerve terminals are suggested as routes of entry;the presence of severe neural symptoms associated with lesions of other organs and cytokine storm is also described. Headache was the most common neurological manifestation in patients with COVID-19, and rhabdomyolysis, acute hemorrhagic necrotizing encephalopathy, Guillain Barre syndrome, meningitis and encephalitis are rare neurological entities. In Guillain Barre syndrome, the literature suggests both a post infectious and para-infectious pattern. Conclusions: COVID-19 is associated with different neurological manifestations, including headache, dizziness, vertigo, vomiting, and alterations of consciousness, stroke and others not so frequent. These symptoms as a whole should be evaluated by healthcare personnel, with a view to their rapid detection and management, in order to guarantee the disappearance of sequelae that reduce the quality of life of patients, as well as to reduce the associated mortality records.

COVID-19 and the Impact on Sports Betting Markets and Sports Bettors' Mental Health

This chapter investigates the impact of COVID-19 on sport betting markets and the mental health of those involved in sports betting. Given the wider discussion about the impact of the pandemic on mental health and the negative consequences of lockdowns and social distancing on people's mental well-being, the chapter focuses on a complex but critical issue for the global sporting community. The chapter also scrutinises the available sports betting data from the start of the pandemic and looks at the impact on bookmaker revenue. © 2023 selection and editorial matter, Stephen Frawley and Nico Schulenkorf;individual chapters, the contributors.

Comparative in silico design and validation of GPS™ CoVID-19 dtec-RT-qPCR test.

AIMS: Providing a ready-to-use reverse transcriptase qPCR (RT-qPCR) method fully validated to detect the SARS-CoV-2 with a higher exclusivity than this shown by early published RT-qPCR designs. METHODS AND RESULTS: The specificity of the GPS™ CoVID-19 dtec-RT-qPCR test by analysis of sequence alignments was approached and compared with other RT-qPCR designs. The GPS™ CoVID-19 dtec-RT-qPCR test was validated following criteria of UNE/EN ISO 17025:2005 and ISO/IEC 15189:2012. Diagnostic validation was achieved by two independent reference laboratories, the Instituto de Salud Carlos III, (Madrid, Spain), the Public Health England (Colindale, London, UK), and received the label CE-IVD. The GPS design showed the highest exclusivity and passed all parameters of validation with strict acceptance criteria. Results from reference laboratories 100% correlated with these obtained by using reference methods and showed 100% of diagnostic sensitivity and specificity. CONCLUSIONS: The CE-IVD GPS™ CoVID-19 dtec-RT-qPCR test, available worldwide with full analytical and diagnostic validation, is the more exclusive for SARS-CoV-2 by far. SIGNIFICANCE AND IMPACT OF THE STUDY: Considering the CoVID-19 pandemic status, the exclusivity of RT-qPCR tests is crucial to avoid false positives due to related coronaviruses. This work provides of a highly specific and validated RT-qPCR method for detection of SARS-CoV-2, which represents a case of efficient transfer of technology successfully used since the pandemic was declared.

A guide for the implementation of network resources

Introduction: Changes in higher medical education, caused by the SARS-CoV-2 virus pandemic, prompted the integration of information and communication technologies to teaching in Cuba and the world. The virtual university of health became an important means to support the teaching-educational processes;therefore, professors had to face the challenge of virtualizing their training activities. Objective: To validate a guide for designing and assembling virtual teaching-learning environments in undergraduate and postgraduate medical education. Methods: A technological innovation research was carried out in three stages: design of the guide, implementation and validation. A survey was conducted to the participants of the virtual training in virtual teaching-learning environments. Results: Six steps were proposed for the design and implementation of training processes through the virtual modality: analysis of resources and feasibility;course design or adaptation of an existing program;content production;resource uploading and activity configuration;training action;and course assessment, improvement and redesign. Conclusions: The integration of technology to higher education teaching is a reality driven by the epidemiological situation, which will continue to develop until it becomes part of the professor's regular work. This guide systematizes and simplifies actions to facilitate the initial virtualization process. A flexible and scalable model is proposed to improve continuously the quality of the educational teaching process in virtual teaching-learning environments. © 2023, Editorial Ciencias Medicas. All rights reserved.

A Questionnaire Survey of Personal and Occupational Variables Associated With SARS-COV-2 Infection in Health Care Personnel of the Spanish Central Military Hospital.

INTRODUCTION: Spain is the country with the highest number of health care workers affected by coronavirus disease 2019 (COVID-19) in the world. The aim of this study was to describe the epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection in health care worker (HCW) at the Gómez Ulla Military Hospital (HCDGU). MATERIALS AND METHODS: A case-control study was conducted during the first outbreak of COVID 19 at GUMH. The study was extended to the total number of HCW in the hospital who met the inclusion criteria. Health care worker of the HCDGU were civilian and military personnel that included nursing and medicine students of Spanish Military Academy, medicine specialty residents, and nursing residents of Medical Surgical Specialty in Operations (EMQO). A questionnaire of 33 items was prepared. The questionnaire was sent by e-mail to the entire population of study. With this questionnaire personnel were classified into sick (cases) or healthy. RESULTS AND CONCLUSIONS: One hundred fifty professionals answered the questionnaire. Cases were defined as those who tested positive in the diagnostic tests (n = 28, 20.7%) and no cases were those who tested negative (n = 107, 79.3%). Therefore, the percentage of SARS-CoV-2 in the GUMH was 20.7%. Of the total number of cases, 64.3% were men (P < .05), with a mean age of 47.1 years (SD 13.3), a mean BMI of 25.3 (SD 3.8), and 48.2% being overweight. Of the total cases, 59.3% had "A" blood group type and 69.2% were Rh positive. 50% were physicians, 32.1% were nurses, and 17.9% were auxiliary nurses (P < .05). Cases and controls with vitamin D deficiency and who took supplements had a lower risk of suffering COVID-19, with significant differences. Fever, cough, and diarrhea were found in at least 50% of the samples with significant differences.

Rare case of post-COVID transverse myelitis

Case Report: Acute transverse myelitis (TM) is a rare inflammatory disease that typically presents asweakness, sensory alterations, and bowel or bladder dysfunction. Among the causes of TM are infections, paraneoplastic syndromes, or autoimmune conditions of CNS. Postinfectious TM can develop secondary to a viral or bacterial infection. SARS-CoV-2 is a recently discovered viral illness, and sequelae due to COVID-19 infection are still being studied. There is scarce literature relating the two conditions, and it is imperative to raise awareness. A 72-year-old man with hypertension and GERD, completely independent in ADL, was brought to the ED with sudden onset of bilateral lower extremity weakness. He reported symptoms started with difficulty climbing stairs that rapidly progressed to inability to ambulate independently and were associated with bilateral thigh soreness. Nine days prior, he developed fever and generalized malaise, and two days later, SARS-CoV-2 PCR and Ag tests were positive. He received azithromycin, Paxlovid, and dexamethasone as treatment. Upon evaluation, the patient was afebrile and hemodynamically stable. Neurological examination was remarkable for spasticity and hyperreflexia at bilateral lower limbs, clonus, preserved motor strength with adequate sensation to soft touch, and intact vibration and proprioception in all extremities. Cranial nerves were intact. These findings were consistent with an upper motor neuron lesion. On imaging, the Head CT scan was unremarkable. Thoracic/Lumbar Spine MRI was significant for distal thoracic and conus areas with central homogeneous brightness compatible with nonspecific myelitis. Laboratories showed leukocytosis without neutrophilia or bandemia, thrombocytosis, and elevated CRP. HIV and RPR tests were negative. A lumbar puncture for CSF analysiswas remarkable for mild monocytic pleocytosis (7 cell/muL), an increased level of total proteins (56 mg/dL), and normal glucose (57 mg/dL). CSF culture and gram stain were negative. CSF cytology yielded few lymphocytes and few monocytes and was negative for malignant cells. The meningoencephalitis panel was negative. Based on these findings, a clinical diagnosis of postinfectious myelitis secondary to COVID-19was made. The patient was treated with intravenous Methylprednisolone 1 g daily for five days. On follow-up, lower extremity weakness resolved completely, and he resumed his daily physical activities. Patients with COVID-19 infection can present with neurologic manifestations such as headache, myalgias, dizziness, dysgeusia, and anosmia. This case hopes to raise awareness of less commonly known neurological manifestations of SARS-CoV-2 infection and how the early recognition of symptoms can help expedite the diagnosis and treatment of the condition to avoid long-term sequelae. [Figure presented] Copyright © 2023 Southern Society for Clinical Investigation.

SARS-CoV-2 seroprevalence in workers from a Colombian University Hospital.

BACKGROUND: Antibody (Ab) tests for SARS-CoV-2 virus allows for the estimation of incidence, level of exposure and duration of immunity acquired by a previous infection. In health workers, the hospital setting might convey a greater risk of infection. AIMS: To describe the frequency of immunoglobulin G (IgG) Abs (IgG-Abs) to the SARS-CoV-2 virus among workers at a third-level university hospital in Colombia. METHODS: In this cross-sectional study, we included medical and non-medical personnel with at least one real-time polymerase chain reaction (RT-PCR)/antigen test between March 2020 and March 2021. In April 2021, an IgG-Ab test against SARS-CoV-2 was conducted for all participants and replicated 2 weeks later in a random sample (10%). The frequency of IgG-Abs is presented based on status (positive/negative) and time elapsed since RT-PCR/antigen test (<3 months, 3-6 months, >6 months). RESULTS: We included 1021 workers (80% women, median age 34 years (interquartile range 28-42), 73% medical personnel, 23% with previous positive RT-PCR/antigen). The overall seroprevalence was 35% (95% CI 31.6-37.4, 35% in medical and 33% in non-medical personnel). For those with a previous positive RT-PCR/antigen test, the seroprevalence was 90% (<3 months), 82% (3-6 months) and 48% (>6 months). In participants with a previous negative RT-PCR/antigen test, the seroprevalence was 17% (<3 months), 21% (3-6 months) and 29% (>6 months). CONCLUSIONS: High IgG-Ab positivity was found in hospital personnel, regardless of work activities. The prevalence of detectable Abs differed by previous RT-PCR/antigen status and time elapsed since the diagnostic test.

Digital Education before Covid 19 in the administrative economic area

The aim of this work is to analyze the impact of adaptive learning forced by Covid-19 at the Faculty of Administrative Economic Sciences of the Autonomous University of Carmen. For this study, we approach the theoretical concepts with a documentary review, subsequently a descriptive analysis of a sample of 291 students was made. The results show that most of the students developed a satisfactory performance, preferably using the Teams platform, although platforms were also used as support. This concludes that the university community quickly adapted to the virtual environment imposed by the pandemic. © GKA Ediciones, authors.

Implementation of a telerehabilitation program for children with neurodevelopmental disorders during the lockdown caused by COVID-19

Introduction: Telerehabilitation is a tool for patients who, for different reasons, cannot participate in person with their physical presence. We aimed to identify the factors associated with satisfaction with telerehabilitation in families with children with neurodevelopmental disorders through a program that included physiotherapy, occupational therapy, and speech therapy. Methods: The program was developed during the COVID-19 lockdown period. Outcome measures: Child's age, the school stage to which they belonged, the person of reference in their daily care at home. The resources provided to the families, as well as the frequency of activities and difficulties detected, were evaluated through a survey. Findings: One hundred thirteen families responded to the survey. The general assessment resources were classified as very good. The average frequency of carrying out the activities was two times a week, with an average of 30 minutes per session. The ability to understand the information in the manual was not affected by the academic status of the caregivers (p = 0.286). Conclusions: This is the first study to quantify the multidisciplinary approach to children with neurodevelopmental disorders using telerehabilitation. The results show high levels of participation and satisfaction. The resources could be shared for their applicability in other countries whose families have similar needs conditioned by COVID-19.

Primary and Secondary Data Collection to Conduct Researches, Write Thesis and Dissertation Amidst COVID-19 Pandemic: A Guidepost

Research has always been regarded by many as tedious because of the difficulties and challenges associated with doing research such as having to forego certain habits like social life. Doing research became even more difficult, especially with regard to limitation on collecting applicable primary and secondary data due to the COVID-19 pandemic lockdowns. It is to be noted that substantive, thorough, sophisticated literature review and intensive pertinent primary data availability are ncessary for doing quality research relevant to the status quo. Various novel approaches have been adopted by scholars through their diverse academic spheres in conducting internationally acceptable research amidst the COVID-19 pandemic. This research aims to come up with a guidepost to facilitate researchers and other stakeholders with fundamental knowledge and skills in conducting substantive, thorough, sophisticated researches that are of international standards. A comparative and diagnostic analysis method is used for analyzing existing literature and policies developed by higher education institutions and schools for doing research in the advent of the COVID-19 pandemic. The output allowed authors to develop a guidepost with rules on using limited primary and extensive secondary data in doing research. The guidepost consists of various sections explaining on how to do research and write theses and dissertations. These sections include among others research title, statement of the problem, research objectives, theoretical and conceptual frameworks, review of related literature, research methodology, analysis and interpretation of data, and conclusion and recommendations. The guidepost is very significant in doing researches and aids researchers in conducting internationally accepted researches with limited primary data and extensive secondary data in the advent of the COVID-19 Pandemic. The guidepost is flexible and can easily be used by local and international institutions’ researchers through little modification in context of their research fields. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Woman and Migrant in Covid-19 Times: The Situation of Venezuelan Women in Peru

This article analyses the work experiences of Venezuelan migrant women in the Peruvian labour market in the context of the Covid-19 pandemic, beginning in March 2020, and the Peruvian state's ensuing public health measures. We argue that the Venezuelan case in Peru presents another example of how migration places women in labour positions that are segmented by gender and migrant status. Likewise, we find that a by-product of the economic crisis caused by the pandemic, is that women are further marginalized from the labour market because of their gender.

Impact of the COVID-19 Pandemic on the Follow-up and Treatment of Patients with Diabetes

Introduction: During the coronavirus disease (COVID-19) pandemic a state of emergency was declared where people were instructed to stay at home to prevent disease transmission, which exerted severe disruptions in the routine care of patients. The aim of this study was to evaluate the impact of the COVID-19 pandemic in the treatment and follow-up of patients with diabetes. Methodology: We conducted an observational, descriptive, cross-sectional study in 39 diabetic patients followed by the Endocrinology department at the Hospital de Clínicas during July-September 2021. We compared anthropometric data, blood pressure (BP), HbA1C, lipid profile, changes in eating habits, physical activity, medication access and number of medical care visits before and during the pandemic. Results: Mean age was 61.3 ± 13 years, mostly females (56.4%). Type 2 was the most common diabetes form (82.1%). Mean diabetes duration was 12.5 years (range: 5-20). Eighty-four percent had microangiopathic complications;the most frequent was diabetic retinopathy (61.5%). Forty-eight percent had macroangiopathic complications. Most frequent comorbidities were high blood pressure (82.1%) and dyslipidemia (69.2%). Twenty eight percent reported smoking. Eighteen percent had changes in medication access during the pandemic, the main reason was the lack of a medical prescription (12.8%), followed by drug unavailability (10.2%). Thirty-three percent reported changes in eating habits, 30% increased the amount of food consumption, 61.5% decreased fruits and vegetables intake, and 2% increased alcohol drinking. There was a significant decrease in physical exercise (43.6%), medical appointments (4.4 vs. 2.9, p=0.006) and LDL (142±63,6 vs.136,7±96,9, p=0.01) during the pandemic. Forty-one percent and 23% lacked hbA1C testing before and during the pandemic, respectively. Most patients presented with hbA1C values more than 7% before and after the pandemic (65.2% and 70%, respectively). There was a non-significant increase in BMI (31,6±6,3 vs. 32,4±11,7, p=0,668), blood pressure (systolic BP: 132,5±20,2 vs. 136,7±23,5, p=0,32;diastolic BP: 76,7±13,3 vs. 80,5±14,3, p=0,089) and HbA1c (8,1±1,6 vs. 8,2±1,8, p=0,662). Conclusion: We found a high percentage of micro and microangiopathic complications in diabetic patients. In addition, many patients had poor metabolic control without HbA1c monitoring. Given the increased risks of COVID-19 complications and death amid patients with uncontrolled diabetes changes in metabolic control may be of great significance. We found a decrease in medical visits, dietary changes, disruption in medication access and a decrease in physical activities during the pandemic. More studies are warranted to understand the indirect effects of the pandemic in patients with diabetes and its long-term effects on micro- and macroangiopathic complications and mortality.Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.