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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
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Background: Breats cancer is a major health problem in elderly ( >= 70 years) women. Increase incidence with age and the progressive increase in life expectancy mean that the numbers in elderly breast cancer diagnosis are increasing. These patients do not always receive the proper treatment and despite this the survival of this population is not always depends on cancer, there are other competing causes of death typical of the aging population. Method(s): A retrospective observational analysis of women >= age 70 diagnosed with breast carcinoma in HUPHM between 2014 and 2020 was made. Clinical, pathological data and stages at diagnosis were analyzed. We checked our patients with the national death center (official national registry) thus obtaining an exact date of death and the cause of death. Data updated in January 2023 , ensuring a minimum follow-up of 24 months. We excluded deaths from Covid or of unknown cause to avoid bias. Result(s): A total of 421 patients were analyzed, mean age of 78.6 years and median follow-up of 48 months. 28% of patients had died at the time of analysis, 11% due to cancer and 17% from other causes. If we analyze the population deceased by cancer, no deaths are detected in patients diagnosed with carcinoma in situ (4% of the population), in stage I (30% of the population) the cumulative incidence of cancer death at 5 years is 3%, 7% In stage II (30% of the population), 15% in stage III (16%) and 70% in stage IV (12%). Death by other causes are more frequent in early breast cancer, the cumulative incidence at 5 years are 10% in stage I, 22% in stage II, 44% in satge III and just 10% in stage IV. The most frequent causes of death in this population were caridovascular events and infections. There are no differences in 5-year mortality according to histological subtypes 20%, 12%, 25% and 12% for triple negative, Rh+/HER2-, RH+/her2+ and RH-/HER2+ respectively. Conclusion(s): Although elderly patients do not receive optical treatments, mortality from cancer in early stages is incidental at 5 years, a different scenario is seen in metastatic disease in which the patient's prognosis depends mainly on the oncological disease, Therefore, an effort should be made in the treatment of these patients with metastatic breast cancer since adequate treatments can have a clearly positive impact on the survival of patients. Legal entity responsible for the study: The authors. Funding(s): Has not received any funding. Disclosure: All authors have declared no conflicts of interest.Copyright © 2023
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Coronavirus 2 (SARS-CoV-2) infection has spread rapidly. In pediatrics, a condition similar to shock is described named multisystem inflammatory syndrome in children (MIS-C) or pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS). The mechanisms of cardiological involvement are not clear. Objective: To describe cardiological in-volvement and inflammatory markers in hospitalized patients with MIS-C in a tertiary hospital. Patients and Method: Observational, retrospective study in children under 15 years of age with MIS-C. Demographic, clinical, and laboratory variables were collected from an electronic plat-form, including troponin, B-type natriuretic peptide (proBNP), ultrasound, and electrocardio-gram. Patients with / without cardiological involvement (CCC / SCC) were compared. GraphPad QuickCalcs (c) 2018 Software was used for statistical analysis, considering p < 0.05. Results: Thir-teen patients diagnosed with MIS-C, 9 males, median age 9.5 years. All presented with fever and abdominal pain, adding one or more of the following symptoms: vomiting, exanthema, diarrhea, altered mucous membranes and/or edema. Five patients had hemodynamic compromise, 9/13 were categorized as CCC. Troponins were elevated 4.1 times in CCC (p < 0.05), median ProBNP CCC 6940 pg/ml vs 921 pg/ml in SCC (p < 0.05), median Ferritin CCC 482 vs 154 ng/ml in SCC (p < 0.01), platelets CCC 106,000 vs SCC 207,000/mm3 (p < 0.05). Echocardiogram showed pe-ricardial effusion (N = 6), mild systolic dysfunction (N = 4), moderate dysfunction (N = 1) and coronary alterations (N = 3). In the ECG, 3 patients presented transient repolarization disturbance and 1 first-degree atrioventricular block. None required support with extracorporeal membrane oxygenation, with no deaths. Conclusion: cardiological involvement in hospitalized children with MIS-C is frequent. Our series showed nonspecific and transitory symptoms, and hemodynamic compromise which responded early to medical treatment, with a favorable evolution. The markers in CCC patients were troponin, ProBNP, ferritin, and thrombocytopenia. The most frequent ul-trasound finding was pericardial effusion. The importance of both clinical and laboratory cardio-logical evaluation in these patients is evident.
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Introduction: The health workers are one of the most prone to becoming infected with COVID-19, due to their exposure during their relationship with patients. Background: To determine the clinical and epidemiological characteristics of COVID-19 in workers of the Pediatric Hospital of Camaguey in the period from January to December 2021. Methods: A descriptive and cross-sectional study was carried out in a universe of 238 workers with a polymerase chain reaction-confirmed diagnosis during the aforementioned period;registered in a database. The variables studied included age group, sex, occupational category, service of origin, clinical manifestations, quarter of the year, and possible source of infection. The data were processed using the statistical program SPSS (Statistical Package for Social Sciences), version 25.0, on a Pentium IV computer. Informed consent and the bioethical principles of confidentiality of information were taken into account in the research. Results: The female sex predominated (54.7%) at ages 50-59 years. They were mostly nursing staff (29.4%), infected during the third trimester (39.9%) in the community (59.3%), presenting symptoms such as nasal discharge (32.8%) and fever (17.6%), working in the pediatric medicine wards (28.2%). Conclusions: Despite the difficult epidemiological situation, the main source of infection was the community. There were no institutional transmission events and there were no deaths.
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Background: Guillain-Barré syndrome is a polyradiculoneuropathy that has been associated with infectious diseases as triggers. There is currently little medical evidence exploring the relationship between the development of Guillain-Barré syndrome caused by SARS-CoV-2 infection and long Covid. Objective: To synthesize the medical evidence that describes the relationship between post Covid syndrome and Guillain-Barré syndrome in the paediatric population. Methodology: A scoping review was developed using Scopus and PubMed databases, including analytical and/or descriptive experimental and observational studies. Results: The main clinical manifestations presented by paediatric patients were distal and ascending weakness in the lower limbs and myalgia. The diagnostic approach was based on clinical findings, imaging findings on spinal magnetic resonance and electromyography. The therapeutic strategy is based on the use of intravenous human immunoglobulins. Conclusion: Guillain-Barré syndrome is a frequent disease in the paediatric population with active SARS-CoV-2 infection or in survivors, however, it is necessary to encourage further clinical studies that increase the medical literature that describes this association.
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Coronavirus 2 (SARS-CoV-2) infection has spread rapidly. In pediatrics, a condition similar to shock is described named multisystem inflammatory syndrome in children (MIS-C) or pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS). The mechanisms of cardiological involvement are not clear. Objective(s): To describe cardiological involvement and inflammatory markers in hospitalized patients with MIS-C in a tertiary hospital. Patients and Method: Observational, retrospective study in children under 15 years of age with MIS-C. Demographic, clinical, and laboratory variables were collected from an electronic plat-form, including troponin, B-type natriuretic peptide (proBNP), ultrasound, and electrocardio-gram. Patients with / without cardiological involvement (CCC / SCC) were compared. GraphPad QuickCalcs© 2018 Software was used for statistical analysis, considering p < 0.05. Result(s): Thir-teen patients diagnosed with MIS-C, 9 males, median age 9.5 years. All presented with fever and abdominal pain, adding one or more of the following symptoms: vomiting, exanthema, diarrhea, altered mucous membranes and/or edema. Five patients had hemodynamic compromise, 9/13 were categorized as CCC. Troponins were elevated 4.1 times in CCC (p < 0.05), median ProBNP CCC 6940 pg/ml vs 921 pg/ml in SCC (p < 0.05), median Ferritin CCC 482 vs 154 ng/ml in SCC (p < 0.01), platelets CCC 106,000 vs SCC 207,000/mm3 (p < 0.05). Echocardiogram showed pe-ricardial effusion (N = 6), mild systolic dysfunction (N = 4), moderate dysfunction (N = 1) and coronary alterations (N = 3). In the ECG, 3 patients presented transient repolarization disturbance and 1 first-degree atrioventricular block. None required support with extracorporeal membrane oxygenation, with no deaths. Conclusion(s): cardiological involvement in hospitalized children with MIS-C is frequent. Our series showed nonspecific and transitory symptoms, and hemodynamic compromise which responded early to medical treatment, with a favorable evolution. The markers in CCC patients were troponin, ProBNP, ferritin, and thrombocytopenia. The most frequent ultrasound finding was pericardial effusion. The importance of both clinical and laboratory cardio-logical evaluation in these patients is evident. Copyright © 2022, Sociedad Chilena de Pediatria. All rights reserved.
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Introduction: Acute respiratory distress syndrome (ARDS) is currently the main diagnosis in intensive care units (ICU) and is related to the SARS-CoV-2 pandemic. This syndrome increases hospital stay and costs, and has high mortality. Chest radiography is essential in these patients for diagnosis and clinical follow-up, as it is inexpensive and routinely used in the ICU. The RALE score (Radiographic assessment of lung edema) allows the estimation of the extension and density of alveolar opacities in chest radiography and has been associated with different clinical outcomes such as oxygenation, mortality at 28 days, ventilator-free days, hospital stay, and severity of ARDS. The objective of this work is to establish the association of RALE with clinical outcomes in patients with ARDS in our institution. Materials and methods: Ambispective, monocentric cohort study. Adults older than 18 years with a diagnosis of ARDS hospitalized in the ICUs of Hospital Santa Clara, Bogotá, Colombia, from January to December 2020, were included. Results: The study included 100 patients, 93% with a diagnosis of SARS-CoV-2, an association with RALE on the first day was found with oxygenation on the first day of admission, but without finding a statistically significant relationship between RALE and the other outcomes. Conclusion: The RALE score was not associated with relevant clinical outcomes in patients with ARDS. This can be explained by the different mechanisms of hypoxaemia in these patients. Further studies are suggested to confirm these findings. © 2021 Asociación Colombiana de Medicina Crítica y Cuidado lntensivo
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Background: Guillain-Barre syndrome is a polyradiculoneuropathy that has been associated with infectious diseases as triggers. There is currently little medical evidence exploring the relationship between the development of Guillain-Barre syndrome caused by SARS-CoV-2 infection and long Covid. Objective(s): To synthesize the medical evidence that describes the relationship between post Covid syndrome and Guillain-Barre syndrome in the paediatric population. Methodology: A scoping review was developed using Scopus and PubMed databases, including analytical and/or descriptive experimental and observational studies. Result(s): The main clinical manifestations presented by paediatric patients were distal and ascending weakness in the lower limbs and myalgia. The diagnostic approach was based on clinical findings, imaging findings on spinal magnetic resonance and electromyography. The therapeutic strategy is based on the use of intravenous human immunoglobulins. Conclusion(s): Guillain-Barre syndrome is a frequent disease in the paediatric population with active SARS-CoV-2 infection or in survivors, however, it is necessary to encourage further clinical studies that increase the medical literature that describes this association. Copyright © 2022 Asociacion Colombiana de Reumatologia
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Introduction: Since the first report in Wuhan (China) in 2019, the SARS-CoV 2 virus has spread throughout the world, with a significant impact in public health. To contain the spread of SARS-CoV-2, the WHO has encouraged the development of rapid, simple, sensitive and specific tests that complement the gold standard RT-qPCR. Loop-mediated isothermal amplification (LAMP) has shown a good yield to detect SARS-CoV2 in different fluids. Objective: To validate the colorimetric RT-LAMP technique using two sets of oligonucleotides aimed at identifying the N gene of SARS-CoV-2 in 117 nasopharyngeal swab samples, previously confirmed by RT-qPCR using the Charite/Berlin protocol. Material and methods: 153 nasopharyngeal swab samples from individuals with suspected Covid-19 were subjected to qRT-PCR and RT-LAMP using a commercial colorimetric kit (NEB, Germany). RT-LAMP was run using both extracted RNA samples and raw samples without prior RNA extraction, and the result was assessed by a simple color change in the reaction. Results: RT-LAMP sensibility and specificity for gen N SARS-CoV-2 detection using one primers set previosly reported got values 0.97 (0.85, 1.00) and 0.81 (0.65, 0.92) respectively, for CI 95%. The other set primer used in this paper also reported previosly had 0.96 (0.78,1.00) sensibility and 0.77 (0.55,0.92) specificity to RT-LAMP. Without RNA extraction we found sensibility value of 0.95 (0.74, 1.00) and specificity 0.88 (0.64, 0.99). Conclusion: Taking together, the obtained results show RT-LAMP technique could be considered a rapid diagnostic test, easy to perform, free of sophisticated equipment, sensitive and specific to diagnose SARS-CoV-2 in nasopharyngeal swabs with and without prior RNA extraction, which that allows scaling its portability to places with scarce sources of resources.
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Introduction: Cancer healthcare has been affected by Coronavirus disease 2019 (COVID-19) pandemic, interfering the normal function of oncology units and increasing diagnostic delay. Nevertheless, the rising incidence of respiratory infections led to an increase in medical consultations and chest imaging explorations. The aim of the study was to assess whether the increase in medical evaluations in the context of the pandemic led to an increase in the detection of early-stage thoracic tumours. Methods: We performed a retrospective single-institution study, collecting data from patients diagnosed with thoracic tumours between March, 1, 2020 and December, 31, 2021. We analysed their demographic and clinical data, symptoms at diagnosis and those who were diagnosed due to SARS-CoV-2 infection. Results: A total of 378 patients were analysed. Main results are shown in Table-1. Only 5.3% of newly diagnosed thoracic tumours were related to a suspected or confirmed SARS-CoV-2 infection. However, these patients were not diagnosed at earlier stages (p = 0.414). When we evaluated symptoms at diagnosis, we found that asymptomatic patients presented in earlier stages (p <0.000, Figure-1), being the majority incidental findings during the follow-up of oncological and non-oncological pathologies. Regarding symptomatic patients, most presented as locally advanced or metastatic diseases and no changes have been observed in the pattern of presentation compared to studies prior to the pandemic. [Formula presented] Conclusions: COVID-19 pandemic did not seem to increase thoracic tumours diagnosis in our study. Lung cancer diagnosed in patients due to SARS-CoV-2 infection was not detected in earlier stages. Clinical presentation was similar to previous reported outside COVID-19 pandemic. Nevertheless, we find that asymptomatic patients diagnosed incidentally presented more frequently in localized stages in comparison with symptomatic patients. [Formula presented] Keywords: COVID19, Lung Cancer, Diagnosis
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Background: The impact of some antiretrovirals against SARS-CoV-2 infection and disease severity is conflicting. We evaluated the effect of tenofovir alafenamide/emtricitabine (TAF/FTC) and tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) against SARS-CoV-2 infection and associated clinical outcomes among people living with (PLWH). Methods: We conducted a propensity score-matched analysis leveraging data from the PISCIS cohort of PLWH in Catalonia (Spain). We matched for TAF/FTC versus ABC/3TC in a ratio of 1:1, and 1:3 for TDF/FTC versus ABC/3TC, and TDF/FTC versus TAF/FTC. We used logistic regression to assess the association between tenofovir-based ART and SARS-CoV-2 diagnosis and associated hospitalisation. Results: In our entire cohort [median age: 46.1 years, 82.3% males], 7550 PLWH were being treated with TAF/FTC, 1020 receiving TDF/FTC, and 4135 receiving ABC/3TC. After propensity score-matching, SARS-CoV-2 diagnosis rates were the same in TAF/FTC versus ABC/3TC recipients (12.2% vs 12.2%, P=1.00);lower among TDF/FTC versus ABC/3TC recipients (9.7% vs 12.4%, P=0.05) with borderline significance;and lower among TDF/FTC versus TAF/FTC recipients (9.7% vs 12.6%, P=0.03). In well-adjusted logistic regression models, TAF/FTC was not associated with reduced SARS-CoV-2 diagnosis (adjusted odds ratio [aOR] 0.97;95% confidence interval [CI], 0.83-1.12) or associated hospitalisation (aOR 0.95;95% CI, 0.62-1.45). TDF/FTC compared to ABC/3TC, was not associated with reduced SARS-CoV-2 diagnosis (aOR 0.81;95% CI, 0.61-1.07) or hospitalisation (aOR 0.49;95% CI, 0.14-1.27). TDF/FTC was not associated with reduced SARS-CoV-2 diagnosis (aOR 0.81;95% CI, 0.61-1.07) or associated hospitalisation (aOR 0.47;95% CI, 0.14-1.22) compared to TAF/FTC. Conclusion: TAF/FTC or TDF/FTC were not associated with reduced SARS-CoV-2 diagnosis rates or associated hospitalisations among PLWH. TDF/FTC users had baseline characteristics intrinsically associated with more benign SARS-CoV-2 infection outcomes. Tenofovir exposure or not should not modify the preventive or therapeutic SARS-CoV-2 infection management.
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Given the current COVID-19 pandemic, most people wear a mask to effectively prevent the spread of the contagious disease. This sanitary measure has caused a significant drop in the effectiveness of current face recognition methods when handling masked faces on practical applications such as face access control, face attendance, and face authentication-based mobile payment. Under this situation, recent efforts have been focused on boosting the performance of the existing face recognition technology on masked faces. Some solutions trying to tackle this issue fine-tune the existing deep learning face recognition models on synthetic masked images, while others use the periocular region as a naive manner to eliminate the adverse effect of COVID-19 masks. Although the accuracy of masked face recognition remains an important issue, in the last few years, the development of efficient and lightweight face recognition methods has received an increased attention in the research community. In this paper, we study the effectiveness of three state-of-the-art lightweight face recognition models for addressing accurate and efficient masked face recognition, considering both fine-tuning on masked faces and periocular images. For the experimental evaluation, we create both real and simulated masked face databases as well as periocular datasets. Extensive experiments are conducted to determine the most effective solution and state further steps for the research community. The obtained results disclose that fine-tuning exiting state-of-the-art face models on masked images achieves better performance than using periocular-based models. Besides, we evaluate and analyze the effectiveness of the trained masked-based models on well-established unmasked benchmarks for face recognition and asses the efficiency of the used lightweight architectures in comparison with state-of-the-art face models. Author
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Objective: The CoVIDA project is a public-private collaboration led by Universidad de los Andes that contributed to the SARS-CoV-2 epidemiological surveillance in Bogotá and nearby municipalities. We aimed to describe the development and performance of the Drive/Walk-through free RT- PCR for SARS-CoV-2 testing strategy implemented by CoVIDA. Material and method: We performed a descriptive analysis of the characteristics and performance of the CoVIDA Drive/Walk-through testing centers. The model and the process indicators to assess the model’s performance were based on international experiences and scientific literature. Two screening centers were implemented in shopping centers in the north and south of Bogotá. We reported the number of tests taken, the number of positive tests, and the number of participants that used the model by the type of occupations. Results: In total, 36,689 nasopharyngeal RT-PCR tests for SARS-CoV-2 were performed with a 5.75% cumulative positivity. Process indicators showed an excellent performance and an important contribution in reducing barriers to access to testing. Conclusions: the CoVIDA Drive/Walk-through testing centers supported the epidemiological surveillance in asymptomatic or mild-symptomatic population in Bogotá. Low and middle-income countries can use this model as a cost-effective and innovative solution strategy to intensify testing and help mitigate the pandemic.