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1.
J Trauma Nurs ; 28(5): 298-303, 2021.
Article in English | MEDLINE | ID: covidwho-1455396

ABSTRACT

BACKGROUND: The high mortality rate of comatose patients with traumatic brain injury is a prominent public health issue that negatively impacts patients and their families. Objective, reliable tools are needed to guide treatment decisions and prioritize resources. OBJECTIVE: This study aimed to evaluate the prognostic value of the bispectral index (BIS) in comatose patients with severe brain injury. METHODS: This was a retrospective cohort study of 84 patients with severe brain injury and Glasgow Coma Scale (GCS) scores of 8 and less treated from January 2015 to June 2017. Sedatives were withheld at least 24 hr before BIS scoring. The BIS value, GCS scores, and Full Outline of UnResponsiveness (FOUR) were monitored hourly for 48 hr. Based on the Glasgow Outcome Scale (GOS) score, the patients were divided into poor (GOS score: 1-2) and good prognosis groups (GOS score: 3-5). The correlation between BIS and prognosis was analyzed by logistic regression, and the receiver operating characteristic curves were plotted. RESULTS: The mean (SD) of the BIS value: 54.63 (11.76), p = .000; and GCS score: 5.76 (1.87), p = .000, were higher in the good prognosis group than in the poor prognosis group. Lower BIS values and GCS scores were correlated with poorer prognosis. Based on the area under the curve of receiver operating characteristic curves, the optimal diagnostic cutoff value of the BIS was 43.6, and the associated sensitivity and specificity were 85.4% and 74.4%, respectively. CONCLUSION: Taken together, our study indicates that BIS had good predictive value on prognosis. These findings suggested that BIS could be used to evaluate the severity and prognosis of severe brain injury.


Subject(s)
Brain Injuries , Coma , Coma/diagnosis , Electroencephalography , Glasgow Coma Scale , Humans , Prognosis , Retrospective Studies
2.
Int J Nanomedicine ; 16: 4959-4984, 2021.
Article in English | MEDLINE | ID: covidwho-1334842

ABSTRACT

Antiviral drugs (AvDs) are the primary resource in the global battle against viruses, including the recent fight against corona virus disease 2019 (COVID-19). Most AvDs require multiple medications, and their use frequently leads to drug resistance, since they have poor oral bioavailability and low efficacy due to their low solubility/low permeability. Characterizing the in vivo metabolism and pharmacokinetic characteristics of AvDs may help to solve the problems associated with AvDs and enhance their efficacy. In this review of AvDs, we systematically investigated their structure-based metabolic reactions and related enzymes, their cellular pharmacology, and the effects of metabolism on AvD pharmacodynamics and pharmacokinetics. We further assessed how delivery systems achieve better metabolism and pharmacology of AvDs. This review suggests that suitable nanosystems may help to achieve better pharmacological activity and pharmacokinetic behavior of AvDs by altering drug metabolism through the utilization of advanced nanotechnology and appropriate administration routes. Notably, such AvDs as ribavirin, remdesivir, favipiravir, chloroquine, lopinavir and ritonavir have been confirmed to bind to the severe acute respiratory syndrome-like coronavirus (SARS-CoV-2) receptor and thus may represent anti-COVID-19 treatments. Elucidating the metabolic and pharmacokinetic characteristics of AvDs may help pharmacologists to identify new formulations with high bioavailability and efficacy and help physicians to better treat virus-related diseases, including COVID-19.


Subject(s)
Antiviral Agents/administration & dosage , Antiviral Agents/pharmacokinetics , COVID-19/metabolism , Drug Delivery Systems , SARS-CoV-2/drug effects , Antiviral Agents/metabolism , Antiviral Agents/pharmacology , COVID-19/drug therapy , Humans
4.
Braz J Anesthesiol ; 2021 Apr 28.
Article in English | MEDLINE | ID: covidwho-1208925
5.
J Int AIDS Soc ; 24(4): e25697, 2021 04.
Article in English | MEDLINE | ID: covidwho-1168893

ABSTRACT

INTRODUCTION: The COVID-19 pandemic is impacting HIV care globally, with gaps in HIV treatment expected to increase HIV transmission and HIV-related mortality. We estimated how COVID-19-related disruptions could impact HIV transmission and mortality among men who have sex with men (MSM) in four cities in China, over a one- and five-year time horizon. METHODS: Regional data from China indicated that the number of MSM undergoing facility-based HIV testing reduced by 59% during the COVID-19 pandemic, alongside reductions in ART initiation (34%), numbers of all sexual partners (62%) and consistency of condom use (25%), but initial data indicated no change in viral suppression. A mathematical model of HIV transmission/treatment among MSM was used to estimate the impact of disruptions on HIV infections/HIV-related deaths. Disruption scenarios were assessed for their individual and combined impact over one and five years for 3/4/6-month disruption periods, starting from 1 January 2020. RESULTS: Our model predicted new HIV infections and HIV-related deaths would be increased most by disruptions to viral suppression, with 25% reductions (25% virally suppressed MSM stop taking ART) for a three-month period increasing HIV infections by 5% to 14% over one year and deaths by 7% to 12%. Observed reductions in condom use increased HIV infections by 5% to 14% but had minimal impact (<1%) on deaths. Smaller impacts on infections and deaths (<3%) were seen for disruptions to facility HIV testing and ART initiation, but reduced partner numbers resulted in 11% to 23% fewer infections and 0.4% to 1.0% fewer deaths. Longer disruption periods (4/6 months) amplified the impact of disruption scenarios. When realistic disruptions were modelled simultaneously, an overall decrease in new HIV infections occurred over one year (3% to 17%), but not for five years (1% increase to 4% decrease), whereas deaths mostly increased over one year (1% to 2%) and five years (1.2 increase to 0.3 decrease). CONCLUSIONS: The overall impact of COVID-19 on new HIV infections and HIV-related deaths is dependent on the nature, scale and length of the various disruptions. Resources should be directed to ensuring levels of viral suppression and condom use are maintained to mitigate any adverse effects of COVID-19-related disruption on HIV transmission and control among MSM in China.


Subject(s)
COVID-19/epidemiology , HIV Infections/prevention & control , Homosexuality, Male , SARS-CoV-2 , China/epidemiology , HIV Infections/transmission , Humans , Male , Safe Sex
7.
China Tropical Medicine ; 20(12):1193-1196, 2020.
Article in Chinese | GIM | ID: covidwho-1106544

ABSTRACT

Objective: To understand the results and influencing factors of SARS-CoV-2 nucleic acid detection among specimens in different types and stages of coronavirus disease 2019 (COVID-19) progression.

8.
Preprint | SSRN | ID: ppcovidwho-4100

ABSTRACT

Based on the evidence after the outbreak of SARS in 2003, which is caused by the same family of viruses as COVID-19, we show that due to the “probability weighting” phenomenon, i.e., decision makers tend to overweight the probability of extreme tail events, the epidemic experience induces entrepreneurs to undervalue profitable investment projects. In particular, we show that firms with board chairs experienced the outbreak of SARS during their tenure of high executives invest less in subsequent periods. Among those firms, this effect matter more for board chairs that actually experienced operating distress during the outbreak of SARS. In addition, those firms have lower investment-Q sensitivities and worse performances, implying that the reduction in corporate investment is inefficient. Our paper reveals a specific channel through which epidemic disease can distort the real economy, which has useful implications for assessing the long-run economic impacts of COVID-19.

9.
Infect Dis Model ; 5: 848-854, 2020.
Article in English | MEDLINE | ID: covidwho-813617

ABSTRACT

The pandemic of the coronavirus disease (COVID-19) poses a huge challenge all countries, since no one is well prepared for it. To be better prepared for future pandemics, we evaluated association between the internet search data with reported COVID-19 cases to verify whether it could become an early indicator for emerging epidemic. After the keyword filtering and Index composition, we found that there were close correlations between Composite Index and suspected cases for COVID-19 (r = 0.921, P < 0.05). The Search Index was applied for the Autoregressive Integrated Moving Average with Exogenous Variables (ARIMAX) model to quantify the relationship. Compared with the model based on surveillance data only, the ARIMAX model had smaller Akaike Information Criterion (AIC = 403.51) and the most accurate predictive values. Overall, the Internet search data could serve as a convenient indicator for predicting the epidemic and to monitor its trends.

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