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1.
Sci Total Environ ; : 159351, 2022.
Article in English | ScienceDirect | ID: covidwho-2069672

ABSTRACT

Z-drugs, benzodiazepines and ketamine are classes of psychotropic drugs prescribed for treating anxiety, sleep disorders and depression with known side effects including an elevated risk of addiction and substance misuse. Both groups of these drugs have a strong potential for misuse, which has escalated over the years and was hypothesized here to have been exacerbated during the COVID-19 pandemic. Wastewater-based epidemiology (WBE) constitutes a fast, easy, and relatively inexpensive approach to epidemiological surveys for understanding the incidence and frequency of uses of these drugs. In this study, we analyzed wastewater (n=376) from 50 cities across the United States and Mexico from July to October 2020 to estimate drug use rates during a pandemic event. Both time and flow proportional composite and grab samples of untreated municipal wastewater were analyzed using solid-phase extraction followed by liquid chromatography-tandem mass spectrometry to determine loadings of alprazolam, clonazepam, diazepam, ketamine, lorazepam, nordiazepam, temazepam, zolpidem, and zaleplon in raw wastewater. Simultaneously, prescription data of the aforementioned drugs were extracted from the Medicaid database from 2019 to 2021. Results showed high detection frequencies of ketamine (90%), lorazepam (87%), clonazepam (76%) and temazepam (73%) across both Mexico and United States and comparatively lower detection frequencies for zaleplon (22%), zolpidem (9%), nordiazepam (<1%), diazepam (<1%), and alprazolam (<1%) during the pandemic. Average mass consumption rates, estimated using WBE and reported in units of mg/day/1000 persons, ranged between 62 (temazepam) and 1100 (clonazepam) in the United States. Results obtained from the Medicaid database also showed a significant change (p<0.05) in the prescription volume between the first quarter of 2019 (before the pandemic) and the first quarter of 2021 (pandemic event) for alprazolam, clonazepam and lorazepam. Study results include the first detections of zaleplon and zolpidem in wastewater from North America.

2.
International Journal of Pharmaceutical and Clinical Research ; 14(9):899-906, 2022.
Article in English | EMBASE | ID: covidwho-2057965

ABSTRACT

Introduction: COVID-19 pandemic has severe consequences for the whole world. Each age group has been affected. Both the pediatric and geriatric populations have been worst affected by COVID-19. Even pregnant females were affected much and especially the neonates of pregnant women with COVID-19. The vulnerability increases in neonates of mothers with COVID-19. There is less literature and guidelines available which discussed the outcomes of neonates of mothers who had COVID-19 during gestation. Aims and Objectives: To find out the effect on the fetus of mothers, who were infected with COVID-19 during gestation. Method(s): This is a retrospective study which considered 120 pregnant women, comprising 60 pregnant females with COVID-19 (study group) and another 60 pregnant females without COVID-19 (control group). The baseline characteristics were obtained from the hospital in both groups and the outcomes were evaluated and analyzed. Result(s): The study found that there are significant differences between the two groups in gestational age at the time of delivery, premature delivery occurred and neonatal death (p<0.05). Conclusion(s): The study has concluded that the presence of COVID-19 in pregnant females caused placental infection affecting the fetus significantly, as evidenced by premature birth and neonatal deaths among the COVID-19 group. Copyright © 2022, Dr Yashwant Research Labs Pvt Ltd. All rights reserved.

3.
International Journal of Radiation Oncology, Biology, Physics ; 114(3):e345-e345, 2022.
Article in English | Academic Search Complete | ID: covidwho-2036106

ABSTRACT

The COVID-19 pandemic disrupted medical care and reduced access to elective procedures. While prior claims-based research has shown that patients received more conservative care, little is known about how radiation therapy (RT) ordering behavior changed during the pandemic. This study examines whether the rate at which orders for lumpectomy were followed by orders for RT changed from 2019 to 2020, and whether there were changes in the percentage of RT orders that were for hypofractionated (HF) RT, rather than conventional (CF) RT. Prior authorization order data pertaining to patients from one national organization's commercial and Medicare Advantage health plans were used to perform the analysis. Included patients were females, aged 18 to 89, who had an order for a lumpectomy in 2019 or 2020. Patients were excluded if they were not continuously enrolled in their health plan for 90 days following lumpectomy. Orders were reviewed to determine whether patients had an order for RT in the 90 days following lumpectomy. Orders were classified as HF if they were for 5 to 21 fractions, CF if they were for 28 or more fractions, and as neither if they were for other numbers of fractions. Univariate analyses were conducted using Chi-square tests, and adjusted analyses were conducted using multivariate logistic regression, controlling for patient age, urbanicity, local median income (<$40,000, $40,000-$80,000, or >$80,000), region (top four CMS regions by enrollment versus all other regions), if the designated lumpectomy facility's name implied an academic affiliation, and if the designated lumpectomy facility was a hospital. There were 4,689 patients meeting inclusion criteria in 2019 and 4,383 in 2020, for a total of 9,072. In 2019, 47.1% (2,208/4,689) of patients had an RT order following lumpectomy, versus 44.6% (1,953/4,383) in 2020, a significant difference (P=0.02). Of the patients receiving RT orders meeting the definition of HF or CF, 76.3% (1,475/1,933) of orders in 2019 were for HF, and 80.5% (1,383/1,719) of orders in 2020 were for HF, a significant difference (P<0.01). Adjusted analysis found that patients in 2020 were at significantly reduced odds (OR: 0.91;95% CI: 0.83-0.99) of receiving an order for RT following lumpectomy, and among orders meeting the definition of HF or CF, there were significantly increased odds that the order was for HF (OR: 1.29;95% CI: 1.10-1.52). Patient age, region, and receipt of an order for treatment at an academic facility were significantly associated with receipt of an order for RT. Patient age, local median income, and region were all significantly associated with whether CF versus HF RT was ordered. In the population examined, physicians were less likely to order RT following lumpectomy in 2020 than in 2019, and if they did, were more likely to order HF in 2020 than in 2019. This suggests that physician ordering became more conservative in response to the pandemic. [ FROM AUTHOR] Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

4.
Journal of Thoracic Oncology ; 17(9):S24, 2022.
Article in English | EMBASE | ID: covidwho-2031502

ABSTRACT

Introduction: Unintentional weight loss is common in lung cancer, with 40-60% of patients presenting with this at diagnosis. Weight loss and depleted nutritional status have been identified as negative prognostic variables for survival and directly impact the effectiveness of cancer treatments. The Lung Oncology team at the University Hospital Southampton (UHS) received external funding from Bionical Solutions and AstraZeneca for a part time oncology Dietitian to join the team in treating this patient group. The aim was to determine if specialist Dietitian input improves patients’ nutritional outcomes in those diagnosed with Stage III Non-Small Cell Lung Carcinomas (NSCLC) undergoing radical treatment. Methods: Over 12 months (February 2021-February 2022) all patients with stage III NSCLC received specialist Dietitian input during their radiotherapy treatment. Non-patient identifiable data was collected, which included;whether patients were enterally fed, admission rates and reason, and their weights at the start, middle, end and 2 weeks post radiotherapy. This data was compared to previously collected data in 2018 with the same patient group. No ethical approval was required. Results: A total of 50 patient data sets and 11 feedback questionnaires were collected over 11 months. Between the start and end of radiotherapy, patients experienced;2.1% overall average weight loss, 64% experienced <3.0% unintentional weight loss and 0% experienced >9.6% unintentional weight loss. In 2021 patients reached their lowest weight earlier at 70% of their way through radiotherapy compared with 86% in 2018. Patients maximum unintentional weight loss was 3.2% in 2021 compared with 4.4% in 2018. This is likely due to closer monitoring and dietitian input in 2021. Admission rates were higher in 2021 (n=13, 26%) compared to 2018 (n=5, 18.5%). However, this may be due to changes to patients’ radiotherapy treatment plans in 2021 due to the covid pandemic, resulting in more intense treatments. Patients requiring nasogastric (NGT) feeding increased from 0 in 2018 to 6 in 2021. This is likely due to increased awareness of the importance of nutritional support attributable to dietetic involvement in the multidisciplinary team. All patients who completed the feedback questionnaire found dietetic consultations useful and were able to follow most, or all dietary advice. 91% felt well supported during their treatment with dietetic input. Final Outcomes: Patients experienced reduced weight loss during treatment with Dietitian input compared to 2018 data where there was minimal dietetic input. Increased number of patients required NGTs compared to 2018, therefore Dietitian input is required in this area of oncology. Most patients felt well supported receiving dietetic input during treatment. Increased admission rates compared to 2018, however more nutrition support related admissions in 2021. Conclusions: Overall, patients lost less weight during treatment with Dietitian involvement in their care which is a positive factor in the prognostic outcomes. In addition, most patients felt seeing a Dietitian during treatment improved their experience and felt well supported. The final outcomes support the British Dietetic Associations’ recommendation that there is a dedicated dietetic service for lung cancer patients’, and they are seen by a Dietitian during their treatment. Keywords: Dietitian involvement, Reduced weight loss, Improved patient outcomes

5.
Journal of Content, Community and Communication ; 15(8):53-68, 2022.
Article in English | Scopus | ID: covidwho-1965072

ABSTRACT

This study tries to determine if social media argument quality, social media source credibility and perceived usefulness can predict information adoption by the user shared through social media platforms. Data was collected from 376 social media users through online surveys that helped gauge user behavior. The results of the study revealed that perceived usefulness is not a predictor of information adoption. The results of the study revealed that perceived usefulness is not a predictor of information adoption but there is a significant relationship between information adoption and participatory behavior especially when the information is shared through social media networks. The study would help its stakeholders understand the predictors of information adoption. It reveals the importance of credibility of the source Moreover, the central point at issue is still argument quality. Acceptance of the information would lead to the participatory behavior by the user. In this study information exchange and user-generated content have both benefited from social networking. © 2022. Journal of Content, Community and Communication. All Rights Reserved.

6.
Embase; 2022.
Preprint in English | EMBASE | ID: ppcovidwho-335579

ABSTRACT

Background: The impact of chronic health conditions (CHC) on serostatus post-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination is unknown. Methods: We assessed serostatus post-SARS-CoV-2 vaccination among fully vaccinated participants recruited between April 2021 through August 2021 in 18 years and older residents of Jefferson County, Kentucky, USA. Serostatus was determined by measuring SARS-CoV-2 Spike protein specific immunoglobulin (Ig) G (Spike IgG) antibodies via enzyme-linked immunoassay (ELISA) in peripheral blood samples. Results: Of the 5,178 fully vaccinated participants, 51 were seronegative and 5,127 were seropositive. Chronic kidney disease (CKD) (OR=13.49;95% CI: 4.88–37.3;P<0.0001) and autoimmune disease (OR=11.34;95% CI: 5.21–24.69;P<0.0001) showed highest association with negative serostatus in fully vaccinated participants. The absence of any CHC was strongly associated with positive serostatus (OR=0.37;95% CI: 0.19–0.73;P=0.003). The risk of negative serostatus increased in the presence of two CHCs (OR=2.82;95% CI: 1.14–7) to three or more CHCs (OR=4.52;95% CI: 1.68–12.14). Similarly, use of 2 or more CHC related medications was significantly associated with seronegative status (OR=6.08;95%: 2.01–18.35). Conclusions: Presence of any CHC, especially CKD or autoimmune disease, increased the likelihood of seronegative status among individuals who were fully vaccinated to SAR-CoV-2. This risk increased with a concurrent increase in number of comorbidities, especially with multiple medications. Absence of any CHC was protective and increased the likelihood of a positive serological response post-vaccination. These results will help develop appropriate guidelines for booster doses and targeted vaccination programs.

7.
Environmental Science-Water Research & Technology ; : 13, 2022.
Article in English | Web of Science | ID: covidwho-1740488

ABSTRACT

During the COVID-19 pandemic, wastewater-based epidemiology has emerged as a promising approach for monitoring SARS-CoV-2 prevalence on a community-level. Despite much being known about the utility of making these measurements in large wastewater treatment plants, little is known about the correlation with finer geographic resolution, such as those obtained through sewershed sub-area catchments. This study aims to identify community wastewater surveillance characteristics between sewershed areas that affect the strength of the association of SARS-CoV-2 RNA detection in a metropolitan area. For this, wastewater from 17 sewershed areas were sampled in Louisville/Jefferson County, Kentucky (USA), from August 2020 to April 2021 (N = 727), which covered approximately 97% of the county's households. Solids were collected from the treatment plants from November 2020 to December 2020 (N = 42). Our results indicate that the sewersheds differ in SARS-CoV-2 trends;however, high pairwise correlation spatial trends were not observed, and the mean SARS-CoV-2 RNA concentrations of smaller upstream community sewershed areas did not differ from their respective treatment centers. Solid samples could only be collected at treatment plants, therefore not allowing us to evaluate SARS-CoV-2 abundance as a function of the sewershed scale. The population size sensitivity of SARS-CoV-2 concentration detection is non-linear: at low population levels the measures are either too sensitive and generate a high level of variability, or at high population levels the estimates are dampened making small changes in community infection levels more difficult to discern. Our results suggest selecting sampling sites that include a wide population range. This study and its findings may inform other system-wide strategies for sampling wastewater for estimating non-SARS-CoV-2 targets.

8.
PLoS ONE ; 16(2), 2021.
Article in English | CAB Abstracts | ID: covidwho-1410635

ABSTRACT

Importance: Intensity and duration of the COVID-19 pandemic, and planning required to balance concerns of saving lives and avoiding economic collapse, could depend significantly on whether SARS-CoV-2 transmission is sensitive to seasonal changes.

9.
Br J Dermatol ; 185(4): 859-861, 2021 10.
Article in English | MEDLINE | ID: covidwho-1304081

Subject(s)
COVID-19 , Adult , Humans , SARS-CoV-2 , Syndrome
10.
International Journal of Research in Pharmaceutical Sciences ; 12(3):1833-1839, 2021.
Article in English | EMBASE | ID: covidwho-1302878

ABSTRACT

Amid rise in Covid-19 cases throughout the world including India. So study was initiated to find out the impact on different domains of health. A self-administered questionnaire was prepared, which consist of questions per-taining to the change in physical and mental health along with the quality of life during the lockdown period and was distributed through Google forms. During the survey, a total of 663 responses were collected, of which 604 responses were analyzed. Out of responses that were calculated, the physical health of 370 participants (61.30%) was improved, physical health of 111 (-18.40%) participants has deteriorated and the remaining 123 (20.30%) participants barely changed. The mental health of 274 (-45.30%) participants was declined, 201 (33.20 %) respondents tried to maintain a healthy mental state while 129 (29.30%) members maintained a peaceful state of mind. The quality of life of 290(48%) was adversely affected, 218 (36%) participants were able to maintain a healthier lifestyle, and their quality of life increased, while 96 (15.8%) remained unchanged. Quality of life is most negatively ham-pered whereas there is improved physical health status in the adult popula-tion. All the 3 components are Physical and Mental health along with Quality of life was affected due to Covid-19 related lockdown but out of these, physical health was 61.3% positively affected while mental health and QOL were deteriorated by 45% and 48% respectively.

11.
World Journal of Dentistry ; 12(2):121-125, 2021.
Article in English | Scopus | ID: covidwho-1271028

ABSTRACT

Aim and objective: This study aims to find out the frequency for touching the various surfaces including mucosal and non-mucosal as well as the use of preventive measures from coronavirus disease-2019 (COVID-19) among individuals visiting the dental hospital in Gurugram, Haryana. Materials and methods: A total of 34 individuals were observed over a period of 21 days for 60 minutes and the frequencies of their hand touching the various surfaces were recorded. Results: The result showed a higher frequency of touching the surfaces in females. Mucosal and non-living surfaces were more touched than non-mucosal surfaces. Conclusion: This study indicates that citizens must grab better concepts of infection spread to minimize the pandemic effect. Clinical significance: Checking self-inoculation behavior can be a method of prevention of disease spread in dental hospitals. © Jaypee Brothers Medical Publishers.

12.
Geohealth ; 5(7): e2021GH000420, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1269373

ABSTRACT

Wastewater monitoring for virus infections within communities can complement conventional clinical surveillance. Currently, most SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) clinical testing is voluntary and inconsistently available, except for a few occupational and educational settings, and therefore likely underrepresents actual population prevalence. Randomized testing on a regular basis to estimate accurate population-level infection rates is prohibitively costly and is hampered by a range of limitations and barriers associated with participation in clinical research. In comparison, community-level fecal monitoring can be performed through wastewater surveillance to effectively surveil communities. However, epidemiologically defined protocols for wastewater sample site selection are lacking. Herein, we describe methods for developing a geographically resolved population-level wastewater sampling approach in Jefferson County, Kentucky, and present preliminary results. Utilizing this site selection protocol, samples (n = 237) were collected from 17 wastewater catchment areas, September 8 to October 30, 2020 from one to four times per week in each area and compared to concurrent clinical data aggregated to wastewater catchment areas and county level. SARS-CoV-2 RNA was consistently present in wastewater during the studied period, and varied by area. Data obtained using the site selection protocol showed variation in geographically resolved wastewater SARS-CoV-2 RNA concentration compared to clinical rates. These findings highlight the importance of neighborhood-equivalent spatial scales and provide a promising approach for viral epidemic surveillance, thus better guiding spatially targeted public health mitigation strategies.

14.
Acta Medica International ; 7(2):143-147, 2020.
Article in English | EMBASE | ID: covidwho-1024705

ABSTRACT

Introduction: In this paper, we consider a fundamental problem of testing faced by the health staff on testing COVID 19 patients. In general, the number of testing kits or testing capabilities is limited, and the number of COVID 19 patients is much larger than that. This paper tries to answer this fundamental question that how to perform COVID 19 testing to reduce the death rate. Materials and Methods: We consider that the survival rate of patients is dependent over two parameters: their age and severity of symptoms at a time. Based on these observations, we propose a survival rate function. Using the survival rates, the death rate for an individual is obtained. MATLAB was used for plotting the graphs. Results: It is shown by numerical results that by using the proposed mechanism, the average death rate can be significantly reduced. Conclusion: It is proposed to conduct the testing for those patients who lie in the high death rate regimen.

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