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1.
European Stroke Journal ; 7(1 SUPPL):241, 2022.
Article in English | EMBASE | ID: covidwho-1928087

ABSTRACT

Background and aims: The pandemic caused by SARS-COV2 is responsible for a considerable impact on stroke care. During this time many other non-COVID diseases have been neglected. Primary health care centers collapsed in some regions and the control and monitoring of vascular risk factors has been difficult. On the other hand, it is also known that covid infection leads to a certain prothrombotic state that could result in subsequent strokes. Our objective is to evaluate the effect of the SARS-CoV-2 pandemic on stroke unit admission rates. Methods: Temporal admission rates in the stroke unit of a regional hospital were analyzed from 2019, 2020 and 2021. The type of stroke, baseline characteristics and treatments received were recorded. Results: Stroke unit admission rates were similar between 2019 and 2020: 397 and 408 patients respectively. However, in 2021 the number of stroke admission, Ischemic or hemorrhagic, has incremented by more than 30% (p-value 0,005), with 589 attended patients. Hemorrhagic stroke rates were 15.62%, 10.70% and 16.98% in the three years respectively. Conclusions: During the first year of SARS-CoV-2 pandemic the use of health services for neurological emergencies was reduced, included the number of admissions at the stroke unit. However, we are experiencing a significant increase in the number of strokes, which now far exceeds prepandemic levels. It remains to be determined whether the cause of this huge increase in stroke cases is related to suboptimal vascular risks factor control, to COVID-related factors or to optimal population response following stroke campaigns in the region.

2.
Universidad Medica Pinarena ; 18(1), 2022.
Article in Spanish | CAB Abstracts | ID: covidwho-1898101

ABSTRACT

Introduction: in a short period of time, the pandemic caused by COVID-19 has caused a global health problem of great magnitude. Therefore, it was necessary to enable new medical consultations to limit contact between sick and healthy patients.

3.
Reumatologia Clinica ; 18(4):231-235, 2022.
Article in English | English Web of Science | ID: covidwho-1880820

ABSTRACT

Objective: The COVID-19 pandemic has brought major changes to the model of patient care in Rheumatology. Our aim was to compare the change in the care delivered in a rheumatology nursing consultation before and during the pandemic.& nbsp;Material and methods: Descriptive and observational study. Patient care was registered before and during the COVID-19 outbreak. The variables collected were age, sex, prevalent rheumatic disease, type of visit and reason for consultation.& nbsp;Results: 254 consecutive patients were included before the COVID-19 pandemic for 20 days and 251 patients during COVID-19 for 10 working days. The mean age was 61 years before and 57 during the pandemic. Of both groups, 74% were women. The most frequently attended pathologies before and during COVID-19 were rheumatoid arthritis and spondyloarthropathies. Scheduled face-to-face visits decreased during COVID-19 (46.5% versus 1.6%), with an increased number of phone scheduled visits (2.8% versus 52.2%) and spontaneous consultations either by phone or e-mail (28.3% versus 45%). The type of scheduled visits during COVID-19 were for stable diseases (20% versus 37%) and monitoring (12% versus 38%). The reason for spontaneous consultation increased during COVID-19 and were mainly doubts regarding prevention measures and treatment optimization (13.8% versus 31.1%).& nbsp;Conclusions: The first wave of COVID-19 brought to rheumatology nursing consultation a global increase in all activities in the number of visits per day, in the number of stable patient controls, in monitoring and answering patient concerns. (C)& nbsp;2021 Published by Elsevier Espa?a, S.L.U.

4.
Handbook of Research on Developing a Post-Pandemic Paradigm for Virtual Technologies in Higher Education ; : 188-216, 2021.
Article in English | Scopus | ID: covidwho-1810461

ABSTRACT

This chapter examines an innovative learning project in which undergraduate marketing students manage and generate content on an official Instagram profile. The project is designed to provide students with a more active role in the learning process through the application of new virtual technology tools. During the pandemic (course 2020-21), students shared their knowledge about marketing and related topics through storytelling, transmedia, gamification, and virtual/augmented reality via Instagram. The students' perception of the learning outcomes, and their satisfaction, were compared with those of students from three previous courses (2017-20). The findings revealed that students assessed the Instagram activity more highly in the context of the pandemic than in previous years. Interestingly, the students also reported better learning outcomes and improvement in their soft skills and consequently were highly satisfied with the project, which suggests the activity should continue in the future. © 2021 by IGI Global. All rights reserved.

5.
Educational Practices during the COVID-19 Viral Outbreak: International Perspectives ; : 81-106, 2020.
Article in English | Scopus | ID: covidwho-1755472
6.
Emergencias ; 34(2):111-118, 2022.
Article in English, Spanish | MEDLINE | ID: covidwho-1749413

ABSTRACT

OBJECTIVES: The maintenance of sinus rhythm by means of antiarrhythmic drugs and/or upstream therapy to counter cardiac remodeling is fundamental to the management of atrial fibrillation (AF). This study aimed to analyze this approach and its appropriateness in the setting of hospital emergency departments. MATERIAL AND METHODS: Secondary analysis of data from the multicenter observational cross-sectional HERMES-AF study carried out in 124 hospitals representative of the Spanish national health service in 2011. Included were consecutive patients with AF restored to sinus rhythm who were discharged home from emergency care. RESULTS: A total of 449 patients were included;204 (45.4%) were already on sinus rhythm maintenance therapy. Of ,the 245 remaining patients, 107 (43.67%) were prescribed maintenance treatment in the emergency department, as follows: 41, an antiarrhythmic drug;19, upstream therapy;and 49, both treatments. The selection of an antiarrhythmic drug did not follow guideline recommendations in 10 patients (11.8%). Antiarrhythmic drug prescription was associated with having had a prior episode of AF (odds ratio [OR], 2.024;95% CI, 1.196-3.424;P = .009);a heart rate of more than 110 beats/min (OR, 2.147;95% CI, 1.034-4.456, P = 0.40);and prescription of anticoagulation on discharge (OR, 1.862;95% CI, 1.094-3.170;P = .022). Upstream therapy prescription was associated only with a heart rate over 110 beats/min (OR, 2.187;95% CI, 1.005-4.757;P = .018). In total, 311 patients (69.23%) were discharged from the emergency department with sinus rhythm maintenance therapy: 87 with an antiarrhythmic drug, 117 with an upstream therapy, and 107 with both. CONCLUSION: Treatment to prevent the recurrence of AF is underprescribed in emergency departments. Increasing such prescription and ensuring the appropriateness of antiarrhythmic therapy prescribed are points emergency departments can improve in the interest of better sinus rhythm maintenance.

7.
8th Colombian Congress and International Conference on Air Quality and Public Health, CASAP 2021 ; 2021.
Article in Spanish | Scopus | ID: covidwho-1746117

ABSTRACT

Introduction. With the national guidelines of the Sustainable Selective Test-Tracking-Isolation program (PRASS in spanish) and the districts strategy of Detect-Isolation-Report (DAR in spanish) from the Public Health Plan of Collective Interventions (PSPIC in spanish), during 2020 were implemented activities of active search for positive cases of SARS-CoV-2, in order to identify risk areas and implement mitigation and containment strategies for the COVID-19 pandemic in Bogota. The objective of this work is to describe the strategy of active case-finding for COVID-19 in Bogota city, 2020-2021. Materials y methods. Using descriptive statistics, we described the search sessions carried out in the city. Thus, the integrated health services subnets with their home environment public health teams, integrated by professionals and trained technicians, carried out swab sampling in the following clusters: Select groups with greater vulnerability or high exposure to the virus given their daily activities, or specific areas of the city with a high rate of virus transmissibility or apparently silent. Samples were sent to the district public health laboratory for processing using the Charite protocol RT-PCR, Berlin. They also carry out communication and education activities for health and notification of cases to the Public Health Surveillance System-SIVIGILA. Results. Between June 2020 and June 2021, were performed 9997 journeys of active search, where 1000.225 samples were taken along the 20 localities of Bogota city, with a higher concentration of samples in Ciudad Bolivar (11%), Kennedy (9%), Tunjuelito (7%), Suba (6%), Usme (6%), Puente Aranda (6%) and Bosa (6%). Acumulative positivity ratio of 20% was observed for the observed period, in the three moments with the highest frequency of positive cases for the SARS-CoV-2 virus in the city, positivity ratios of 14% were reached in the months of July and August 2020, 19% between December 2020 and January 2021 and 39% in the third peak of infections between May and June 2021, finding for the latter period time, days with positivity proportions that exceeded 45%. Conclusion. In the city, epidemiological surveillance actions are continued, such as Field Epidemiological Investigations (IEC in spanish), as well as the increasing of collective interventions in the different environments of daily life, wich are focused on the areas with the higher positivity, developing actions aimed at empowering the community in relation to care and biosecurity guidelines to reduce the COVID-19 contagion risk. © 2021 IEEE.

8.
Emergencias ; 34(2):111-118, 2022.
Article in Spanish, English | MEDLINE | ID: covidwho-1738131

ABSTRACT

OBJECTIVES: The maintenance of sinus rhythm by means of antiarrhythmic drugs and/or upstream therapy to counter cardiac remodeling is fundamental to the management of atrial fibrillation (AF). This study aimed to analyze this approach and its appropriateness in the setting of hospital emergency departments. MATERIAL AND METHODS: Secondary analysis of data from the multicenter observational cross-sectional HERMES-AF study carried out in 124 hospitals representative of the Spanish national health service in 2011. Included were consecutive patients with AF restored to sinus rhythm who were discharged home from emergency care. RESULTS: A total of 449 patients were included;204 (45.4%) were already on sinus rhythm maintenance therapy. Of ,the 245 remaining patients, 107 (43.67%) were prescribed maintenance treatment in the emergency department, as follows: 41, an antiarrhythmic drug;19, upstream therapy;and 49, both treatments. The selection of an antiarrhythmic drug did not follow guideline recommendations in 10 patients (11.8%). Antiarrhythmic drug prescription was associated with having had a prior episode of AF (odds ratio [OR], 2.024;95% CI, 1.196-3.424;P = .009);a heart rate of more than 110 beats/min (OR, 2.147;95% CI, 1.034-4.456, P = 0.40);and prescription of anticoagulation on discharge (OR, 1.862;95% CI, 1.094-3.170;P = .022). Upstream therapy prescription was associated only with a heart rate over 110 beats/min (OR, 2.187;95% CI, 1.005-4.757;P = .018). In total, 311 patients (69.23%) were discharged from the emergency department with sinus rhythm maintenance therapy: 87 with an antiarrhythmic drug, 117 with an upstream therapy, and 107 with both. CONCLUSION: Treatment to prevent the recurrence of AF is underprescribed in emergency departments. Increasing such prescription and ensuring the appropriateness of antiarrhythmic therapy prescribed are points emergency departments can improve in the interest of better sinus rhythm maintenance.

9.
Rev Esp Quimioter ; 35(1): 260-264, 2022 Apr.
Article in Spanish | MEDLINE | ID: covidwho-1732682

ABSTRACT

OBJECTIVE: Rituximab-induced immunosuppression could be a risk factor for mortality from COVID-19. The aim of the study was to describe the prevalence of SARS-CoV-2 infection in patients who have received rituximab and its association with a persistent viral infection. METHODS: Retrospective observational study of patients who received rituximab in the 6 months before to the onset of the pandemic. We analyzed the presence of infection and associated them with demographic variables, pathological history related to an increased risk of developing severe COVID-19, the doses of rituximab received, the type of ventilatory support, thromboembolic events, and the treatment received. A descriptive analysis of all the variables was carried out and infected and uninfected patients were compared. RESULTS: We screened a total of 68 patients who had received rituximab (median cumulative dose: 4,161mg (2,611-8,187.5)). 54.4% men, mean age 60.8 years (15.7; 25-87)). C + was confirmed for 22 patients. Of these, 45.5% had high blood pressure, 36.4% Diabetes Mellitus, 31.8% smokers/ex-smoker, 22.7% lung disease, 13.6% heart disease and 4.5% obesity. There were no statistically significant differences between C+ and C-. Only 2 patients developed immunity. For 10 patients (45.5%) did not have a negative CRP until the end of the follow-up. There was no association with cumulative dose of rituximab. The mortality rate was 22.7% in the C+. CONCLUSIONS: We observe that the persistence of the infection leads to a worse evolution of COVID-19. The use of alternatives should be considered during the pandemic, because of patients with decreased B-cell function may have high risk of fatal progression from COVID-19.


Subject(s)
COVID-19 , COVID-19/drug therapy , Female , Humans , Male , Middle Aged , Pandemics , Retrospective Studies , Rituximab/adverse effects , SARS-CoV-2
10.
International Journal of Infectious Diseases ; 116:S28, 2022.
Article in English | ScienceDirect | ID: covidwho-1712672

ABSTRACT

Purpose Epidemiological surveillance of novel Coronavirus SARS CoV-2 in the Constitutional Province of Callao in Perú. Methods & Materials We used the data collection about the notifications of cases of COVID-19. The database was uploaded from the application of the national notification system (Notiweb). We analyzed the information from 13th March in 2020 to 27th June in 2021. Concerning deaths, the names and dates also corroborated by the death notification system (Sinadef). Results The first notified confirmed case in the region was a female patient on 13th March in 2020. We have 154 977 notifications cases as accumulated total;97 381 confirmed cases (with laboratory analyzes that confirm infection), 43 970 suspected cases (compatible symptoms of COVID-19), 12 646 discarded cases and 984 compatible cases (suspected case more epidemiological criteria or suspected case more radiological criteria). The districts with more cases are Callao and Ventanilla. The group of age more affected was an adult (30-59 years old) with 43 702 cases (54.60%). The primary care is provided by three “Redes de Salud”, the Red de Salud Ventanilla report 17 421 confirmed cases of COVID-19, Red de Bonilla 13 706 confirmed cases and Red de Salud BEPECA 10 786 confirmed cases. The hospitals, private clinics and others notification centres report the rest of the cases. From 9290 deaths as confirmed cases, the majority occur at the big hospitals;6948 deaths occur at Essalud Hospitals, 1175 deaths at National Hospitals, 977 deaths at the Navy Army hospital, 45 deaths at private clinics. The rest outside third-level establishments;92 deaths on their residence place, 45 on temporary isolation services, 06 on public roads and 02 on primary care's centres. Conclusion The province of Callao is a remarkable region in Peru because it has two points of entry to the country, the International Airport “Jorge Chavez” and the international seaport “Terminal Portuario del Callao”, and also have 01 prisons. The curve of the total number of reported cases of COVID-19 shows two waves;this second wave is currently decreasing, with 9290 deaths over 97 381 confirmed cases, we have a Lethality rate of 9.54%

11.
Multiple Sclerosis Journal ; 27(3 SUPPL):17, 2021.
Article in English | EMBASE | ID: covidwho-1582622

ABSTRACT

Background: Since the Covid-19 pandemic started, it has been necessary to adapt our clinical practice to limit physical contact. We have established a virtual/presential rehabilitation program (VPR) in patients with EDSS ≤6.5. Methods: Our aim was to compare the effectiveness of the VPR with the previous face-to-face rehabilitation program (PR). Retrospective data were obtained from all patients with an EDSS≤6.5 who were admitted between September and December of 2019 and 2020. All patients were attended 3 times per week for 4 months. In the 2019 group the sessions were PR based, whereas in the 2020 group patients received a VPR, with one face-to-face session plus 2 virtual sessions. Outcomes (obtained pre and post rehabilitation programs) compared between VPR and PR groups were: 10MWT, Tinnetti Test (TT) and Berg Balance Scale (BBS). A minimally clinical significant difference was established for each test: 20% for 10MWT, 3 points for BBS and 1 point for TT. Results: One hundred and forty people were included in the groups VPR (n=80) / PR (N=60). For VPR and PR groups, mean age was 51.45y (SD10.71) / 54.65y (SD11.19) and mean EDSS 4.62 (SD1.45) / 4.64 (SD1.46). All clinical outcomes demonstrated statistically significant improvements pre-post intervention in both groups. Comparing VPR vs PR scores, test didn't show differences using a U of Mann-Whitney for independent samples: BBS 54.2%/44.1% (p =0.27);10MWT 36.7%/22.0% (p =0.13) and TT 40.7%/37.3% (p =0.72). Conclusions: No differences were observed in the effectiveness of VPR versus PR in any of the tests. The VPR program could be a useful tool for patients with an EDSS≤6.5, as the VPR provides a series of subjective benefits (ease of occupational and family life, reduction of fatigue caused by long journeys) while maintaining effectiveness. Further studies with improved designs are warranted to confirm these findings.

12.
Blood ; 138:2520, 2021.
Article in English | EMBASE | ID: covidwho-1582169

ABSTRACT

Updated analysis confirms sustained poor prognosis of COVID-19 in patients with lymphoma in Latin America: A cohort of 160 patients from GELL. Introduction: Ongoing SARS-COV-2 pandemic has impacted the management of cancer patients worldwide. Several reports have demonstrated inferior outcomes of patients with hematological malignancies, including higher rates of intensive care unit admission, need for mechanical ventilation and death. The impact of COVID-19 is profound in resource-restricted countries, including Latin America. Most cohorts reported have not included patients from Latin America, and there is paucity of data of the outcome of cancer patients with COVID-19 in low- and middle-income countries. Grupo de Estudio De Linfoproliferativos En Latino-America (GELL )is a collaborative network of hematological centers in 13 countries in Latin America. We report updated outcomes of lymphoma patients diagnosed with COVID-19 in Latin America. Methods: We conducted a retrospective study including patients with a diagnosis of lymphoma and COVID-19 infection. Patients with chronic lymphocytic leukemia/small lymphocytic lymphoma were excluded from the analysis We defined active disease as follow: (1) patients with detectable disease either prior to initiating therapy or upon relapse, and/or (2) patients undergoing active cancer treatment. The primary outcome was overall survival at 100 days. Survival curves were estimated using the Kaplan Meier method. Uni and multivariable analysis were carried out with Cox model. Results: A total of 160 patients were available for analysis. Median age was 60 years old. Hypertension was the most common comorbidity (33%). Most patients had aggressive lymphomas (62%), including 43% of patients with diffuse large B-Cell lymphoma (DLBCL). Follicular lymphomas were observed in 13% of patients and Hodgkin lymphoma in 12.5% of patients. With a median follow-up of 37 days, the 100-day OS was 64% (95CI 56-74%, fig. 1). In univariate analysis, age (HR 1.03, p=0.0025), hypertension (HR 2.01, p=0.017), >1 number of prior lines (HR 2.78, p=0.011), patients currently on treatment (HR 1.83, p=0.043), ferritin >2000 ng/mL (HR 4.74 p=0.00047) were associated with inferior OS. In multivariate analysis, age (HR 1.03, p=0.0026) and patients currently on treatment (HR 1.82, p=0.04) had inferior OS. There was a trend towards inferior outcomes in patients receiving monoclonal antibodies in univariate analysis (HR 1.82, p=0.081) but not in multivariable analysis (HR=1.29, p=0.48). Use of steroids was not statistically related to mortality (HR 1.79, p=0.074). Finally, contrary to other cohorts, no improvement in OS was observed in patients diagnosed later on the pandemic (fig. 2). Conclusion: In this large cohort of Latin American patients with lymphoma malignancies, our updated analysis showed a maintained dismal prognosis with COVID-19 infection. With a median follow up of 37 days, the 100-day OS was 64%. Older age and ongoing active cancer treatment were significantly associated with mortality. The use of monoclonal antibodies and systemic corticosteroids were not statistically associated to poor survival. Current efforts are focused on improving immunization in the Latin American population. There is an unmet need for improving survival in patients with hematologic malignancies and COVID-19 infection. [Formula presented] Disclosures: Perini: Janssen: Honoraria, Speakers Bureau;Takeda: Honoraria, Speakers Bureau;Astra Zeneca: Honoraria, Speakers Bureau;MSD: Honoraria, Speakers Bureau. Otero: ASTRA ZENECA: Current Employment. Abello: Dr Reddy's: Research Funding;Amgen: Honoraria;Janssen: Honoraria. Castillo: Abbvie: Consultancy, Research Funding;BeiGene: Consultancy, Research Funding;Pharmacyclics: Consultancy, Research Funding;Janssen: Consultancy;Roche: Consultancy;TG Therapeutics: Research Funding.

13.
J Healthc Qual Res ; 37(4): 216-224, 2022.
Article in English | MEDLINE | ID: covidwho-1587261

ABSTRACT

INTRODUCTION AND AIM OF THE STUDY: A notable proportion of COVID outbreaks are generated by "super-spreading events", where a few subjects transmit the pathogen to many secondary cases, increasing contact networks and the spread of the pathogen. We conducted a description of a COVID-19 superspreading event in Córdoba during July 2020, linked to a nightlife establishment. MATERIAL AND METHODS: Retrospective observational study describing characteristics of person, time, PCR result and contact network of confirmed cases. PCR results in Córdoba during July and August and information collected in surveillance systems were analyzed. RESULTS: 935 individuals associated with the outbreak were included; 120 (12.83%) became confirmed cases. July 17 was the day with the highest incidence, with 27 new cases (22.5% of the total). People under 25 years old represented 69.2% of the cases. The average number of close contacts per person was 10.7, with a decrease as age raised. During the outbreak, incidence increased at the provincial level compared to previous weeks; at the end, incidence did not return to initial values but remained high with a relevant percentage of cases having unknown epidemiological association. CONCLUSIONS: A greater transmission capacity of SARS-CoV-2 was observed in a closed, crowded space, and among young people that tended to report a greater number of social contacts and may present little or no symptoms. Developing preventive measures in scenarios that combine these factors and early detection of cases are essential to avoid an increase in the spread of the virus.


Subject(s)
COVID-19 , Adolescent , Adult , COVID-19/epidemiology , Disease Outbreaks/prevention & control , Humans , Retrospective Studies , SARS-CoV-2 , Spain/epidemiology
14.
Estudios de Economia Aplicada ; 39(12), 2021.
Article in English | Scopus | ID: covidwho-1566957

ABSTRACT

The family economy of women underwent a transit, which generated the closure of companies;the above-mentioned had an impact on the conversion of economic activities that women carried out in their localities to contribute to the family income. Therefore, the objective of this document is to analyze the women’s transition and economic contribution to family income throughout the Covid-19 pandemic for the establishment of economic activities that support the family economy. The results indicate that women who engaged in tourism activities, the major source of revenue for the town, went to businesses that were seeing a boom due to the use of social media or online sales;in addition, it was possible to identify the strong impact of the woman's role in the family economy, contributing with more than 50% of the income. The foregoing will allow the generation of action proposals aimed at women to strengthen the virtual commercial scenario used in the pandemic for the constant and growing circulation of businesses, as well as the sale of their products and services. © 2021 Galenos Publishing House. All rights reserved.

15.
Journal of Immunology ; 206:2, 2021.
Article in English | Web of Science | ID: covidwho-1548607
16.
Journal of Immunology ; 206:2, 2021.
Article in English | Web of Science | ID: covidwho-1548032
17.
An Sist Sanit Navar ; 45(1)2022 Apr 28.
Article in Spanish | MEDLINE | ID: covidwho-1505992

ABSTRACT

The appearance of COVID-19 has been a problem for public health on a global scale, putting pressure on health care systems. The after-effects of this illness have highlighted the importance of rehabilitation in long COVID patients involv-ing different health professionals. The treatment of the respiratory after-effects of this disease in an outpatient setting is a specialized field. It is appropriate to offer a series of practical recommendations of cardio-respiratory rehabilitation that are helpful to the professionals involved in the after-effects when ending hospitalisation. This review of the literature includes ten key aspects of respiratory physiotherapy that range from assessment, parameters to monitor, signs of alarm and respiratory rehabilitation techniques and other exercises for this population.


Subject(s)
COVID-19 , COVID-19/complications , Humans , Outpatients , Physical Therapy Modalities , SARS-CoV-2
18.
American Journal of Transplantation ; 21(SUPPL 4):861, 2021.
Article in English | EMBASE | ID: covidwho-1494510

ABSTRACT

Purpose: Immunocompromised patients are considered to be at high-risk for infection with SARS-CoV-2 (COVID-19). There have been observations within the transplant community that patients infected with COVID-19 have increased tacrolimus trough levels. A common presenting symptom of COVID-19 is diarrhea, which is a risk factor for increased tacrolimus levels. COVID-19 treatment often includes remdesivir, a weak CYP3A4 inhibitor that may also lead to increased tacrolimus levels. The study purpose was to determine the effect of COVID-19 infection and associated treatments on tacrolimus levels. Methods: This retrospective chart review evaluated all solid organ transplant recipients admitted inpatient to the study institution within 14 days of a positive COVID-19 PCR test. Patients were excluded if they were treated outpatient, were not on tacrolimus, or were initially treated at an outside hospital. Patients were considered to have a clinically significant increased tacrolimus trough level if their admission level was 20% or greater than their baseline. Baseline levels were defined as the most recent trough level on a consistent dose per pharmacist clinical judgement. A logistic regression was performed to evaluate potential risk factors for elevated levels. Results: A total of 55 patients met inclusion criteria from March 1, 2020 to December 26, 2020. Baseline characteristics are listed in Table 1. The majority of patients were male (67.3%), kidney transplant recipients (63.6%), and Hispanic ethnicity (41.8%). A clinically significant increase from baseline was observed in 47.3% of patients on admission. When comparing baseline level to peak trough level, 72.7% of patients had a clinically significant increase (Table 2). Transplant type, tacrolimus formulation, presence of diarrhea, and treatment with remdesivir were not associated with increased tacrolimus trough levels. Conclusions: In transplant patients admitted with COVID-19, 43.7% of patients and 72.7% had increased trough levels on admission and peak trough levels greater than 20% of baseline, respectively. Potential risk factors for elevated levels, including presence of diarrhea and treatment with remdesivir, did not significantly increase the risk of elevated tacrolimus levels. These findings suggest that infection with COVID-19 may be an independent risk factor for increased tacrolimus levels, but will require further investigation to determine the full effect. Increased tacrolimus trough level monitoring should be considered in solid organ transplant recipients infected with COVID-19 to avoid toxicities associated with supratherapeutic levels. (Table Presented).

19.
Palliative Medicine ; 35(1 SUPPL):80, 2021.
Article in English | EMBASE | ID: covidwho-1477048

ABSTRACT

Background: Prognostic scales exist to estimate patient survival in advanced cancer. There are no studies evaluating their use and practical utility. Aim: To evaluate the proportion of respondents who had knowledge of these prognostic scales. Methods: A descriptive national cross-sectional study was conducted between September 2019 and September 2020. An online questionnaire was prepared using international literature and sent to French oncologists and palliative care physicians. Results: Participation rate was 9.6% (325 responses for 3 408 respondents), with 38% (175 responses for 454 respondents) for palliative care specialists and 4% (119 responses for 2 954 respondents) for oncologists. After sorting the respondents out of the inclusion criteria, 294 questionnaires were analysed. 63.6% (n= 187) had no or partial knowledge of prognostic scales. Palliative care specialists had better knowledge of those scales than oncologists (42.3% (n= 74) vs 27.8% (n= 33), p = 0.015). The Palliative Performance Status (PPS) and the Pronopall Scale were the best-known (respectively 51.4% (n= 55) and 65.4% (n= 70)) and the most widely used (35% (n=28) and 60% (n= 48)). Improving training on those scales was requested by 85.4% (n= 251) of participants. 72.8% (n= 214) did not use them. The lack of formation and consensus about the scale to use are the principal brakes for using. Conclusion: This is the first national study on this topic. Due to the COVID-19 epidemic and a lack of research network between oncology and palliative care in France, the participation rate is a major limitation. To our respondents, there is a need for more information and teaching about prognostic scales in advanced cancer. So improvement concerning research network and teaching are requested. Furthermore, identifying circumstances in which prognostic scales should be used in real practice and clear international guidelines are needed.

20.
Sustainable Development of Mountain Territories ; 14(2), 2021.
Article in English | Scopus | ID: covidwho-1399812

ABSTRACT

Flipped learning and augmented reality have become two emerging didactic proposals today in the field of education. This study analyzes the effectiveness of flipped learning and augmented reality in various dimensions related to the learning process. A quasi-experimental design has been carried out in a sample of 116 students from Spain, of the third level of Secondary Education. A questionnaire has been used to collect the research data. The results show that there is a high appreciation by students of both educational experiences, although differences in various dimensions are present. Those who have received teaching based on flipped learning show significance in the dimensions teacher-student, autonomy, deepening and classtime. On the other hand, those who have developed the experience with augmented reality show significance in the dimensions of motivation, interrelation with content and students, and resolution. In conclusion, both the application of an emerging methodology based on flipped learning and the use of educational technology with augmented reality contributes positively to the optimization of learning processes in the Mathematics classroom. © 2021 North Caucasian Institute of Mining and Metallurgy, State Technological University. All rights reserved.

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