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1.
Osteoporosis International ; 32(SUPPL 1):S100, 2022.
Article in English | EMBASE | ID: covidwho-1748523

ABSTRACT

While it is increasingly evident that preventing secondary fractures can be a feasible and cost-effective task through active steps taken on those identified at higher risk, after suffering a fragility fracture;the burden in morbidity, mortality, and resources needed for acute and chronic care, still will be significant. Patients with fragility fractures requiring attention in a hospital, may not be overwhelming in terms of space and resources needed-as the COVID-19 pandemic-but, as the population ages and the prevalence of osteoporosis grows, the tendency is clearly upwards. Are there realistic interventions to decrease the number or first fragility fracture (FFF) at the population level? Since the early days of the COVID-19 pandemic, proposals to control its burden included ideas on accelerating preparedness on testing, personal protection, and tools to help in medical decisions;on mitigation of the burden of social distancing;on the use of digital technologies, like Tele-Health and artificial intelligence to notify those at risk;on adaptations of legal, regulatory, and support framework;on the need to invest and support innovators and on the need to improve communications on these topics1. In the case of osteoporosis, some of these thoughts may help. We can improve preparedness by broadening the involvement of primary care physicians on detection with simple tools and, if possible, access to DXA. Well informed health professionals may increase awareness among general population on the disease and how to help it. Involvement of the community in identifying those at higher risk, through a broader use of digital technologies and artificial intelligence seems feasible, now that the community sees as normal, a number of intrusive activities. If the world wide web allows a number of entities to identify potential customers, it can certainly provide clues on identification of candidates to be tested. This will require reviews of the legal basis for some of the required actions. There is a need to create sources of funding to support innovators on the design of new approaches-beyond pharmacological developments-for the prevention of osteoporotic fractures and their burden. All of these ideas require a massive distribution through strong communication efforts. The SCOOP study demonstrated that a systematic, community-based screening program of fracture risk in older women brought a significant improvement in terms of prevention of fractures2. A number of lifestyle changes may also have a positive impact in the community, with low cost3. These are only 2 of the many concepts that may find a way in our communication developments to decrease the burden of fragility fractures.

2.
Osteoporosis International ; 32(SUPPL 1):S100-S100, 2021.
Article in English | Web of Science | ID: covidwho-1710845
3.
MEDLINE;
Preprint in English | MEDLINE | ID: ppcovidwho-326687

ABSTRACT

The emergence of current SARS-CoV-2 variants of concern (VOCs) and potential future spillovers of SARS-like coronaviruses into humans pose a major threat to human health and the global economy 1-7 . Development of broadly effective coronavirus vaccines that can mitigate these threats is needed 8, 9 . Notably, several recent studies have revealed that vaccination of recovered COVID-19 donors results in enhanced nAb responses compared to SARS-CoV-2 infection or vaccination alone 10-13 . Here, we utilized a targeted donor selection strategy to isolate a large panel of broadly neutralizing antibodies (bnAbs) to sarbecoviruses from two such donors. Many of the bnAbs are remarkably effective in neutralization against sarbecoviruses that use ACE2 for viral entry and a substantial fraction also show notable binding to non-ACE2-using sarbecoviruses. The bnAbs are equally effective against most SARS-CoV-2 VOCs and many neutralize the Omicron variant. Neutralization breadth is achieved by bnAb binding to epitopes on a relatively conserved face of the receptor binding domain (RBD) as opposed to strain-specific nAbs to the receptor binding site that are commonly elicited in SARS-CoV-2 infection and vaccination 14-18 . Consistent with targeting of conserved sites, select RBD bnAbs exhibited in vivo protective efficacy against diverse SARS-like coronaviruses in a prophylaxis challenge model. The generation of a large panel of potent bnAbs provides new opportunities and choices for next-generation antibody prophylactic and therapeutic applications and, importantly, provides a molecular basis for effective design of pan-sarbecovirus vaccines.

4.
Salud Mental ; 44(4):185-192, 2021.
Article in English | Web of Science | ID: covidwho-1513293

ABSTRACT

Introduction. Preventive social isolation due to coronavirus disease (COVID-19) has represented one of the greatest health challenges of the last decades worldwide. As a result of social isolation, the consumption of information in digital media, such as the use of online sexual material, has increased, leading to risky sexual behavior in young people. Objective. To quantify the impact on the use and type of online sexual material and to determine the predictors of online sexual activity in people in preventive social isolation due to COVID-19. Method. Multivariate cross-sectional study;385 participants were studied and contacted through an online survey. Results. Internet pages and social networks are the main platforms for the use of online sexual material, and its consumption was more frequent in those who had more days of preventive social isolation. Predictors of sexual activity were cybersex (beta = .38), excitation (beta = .36), masturbation (beta = .34), and adventure (beta = .33), which were found to be statistically significant (p < .001). Discussion and conclusion. Privacy plays an important role in the use of online sexual material and activities, and greater consumption can be found in intimacy. It is important to be alert to the effects of the pandemic on sexual risk behavior and further research is needed.

7.
Stroke ; 52(SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1234365

ABSTRACT

Introduction: While the thrombotic complications of COVID-19 have been described, there are limited data on its implications in hemorrhagic stroke. The clinical characteristics, underlying stroke mechanism, and outcomes in this group of patients are especially salient as empiric therapeutic anticoagulation becomes increasingly common in the treatment and prevention of thrombotic complications of COVID-19. Methods: We conducted a retrospective cohort study of patients with hemorrhagic stroke (both nontraumatic intracerebral hemorrhage and spontaneous non-aneurysmal subarachnoid hemorrhage) who were hospitalized between 3/1/20-5/15/20 at a NYC hospital system, during the coronavirus pandemic. We compared the demographic and clinical characteristics of patients with hemorrhagic stroke and COVID-19 to those without COVID-19 admitted to our hospital between 3/1/20-5/15/20 (contemporary controls) and 3/1/19-5/15/19 (historical controls), using Fischer's exact test and nonparametric testing. We adjusted for multiple comparisons using the Bonferroni method. Results: During the study period, 19 out of 4071 (0.5%) patients who were hospitalized with COVID-19 had hemorrhagic stroke on imaging. Of all COVID-19 with hemorrhagic stroke, only 3 had non-aneurysmal SAH without intraparenchymal hemorrhage. Among hemorrhagic stroke and COVID-19 patients, coagulopathy was the most common etiology (73.7%);empiric anticoagulation was started in 89.5% vs 4.2% of contemporary and 10.0% of historical controls (both with p = <0.001). Compared to contemporary and historical controls, COVID-19 patients had higher initial NIHSS scores, INR, PTT and fibrinogen levels. These patients also had higher rates of in-hospital mortality [84.6% vs. 4.6%, p =<0.001]. Sensitivity analyses excluding patients with strictly subarachnoid hemorrhage yielded similar results. Conclusion: We observed an overall low rate of imaging-confirmed hemorrhagic stroke among patients hospitalized with COVID-19. Most hemorrhages in COVID-19 patients occurred in the setting of therapeutic anticoagulation and were associated with increased mortality. Further studies are needed to evaluate the safety and efficacy of therapeutic anticoagulation in COVID-19 patients.

8.
Stroke ; 52(SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1234356

ABSTRACT

Introduction: While coronavirus disease 2019 (COVID-19) has been associated with acute ischemic stroke (AIS), the causal relationship has yet to be elucidated. Factors that likely confer increased stroke risk are COVID-19-associated coagulopathy and hyperinflammatory response. Studying clinical features of patients with otherwise undetermined cause of AIS could help better define COVID-19-associated stroke. Methods: We performed a multicenter cross-sectional study of consecutive patients presenting with AIS and COVID-19 to one of two large healthcare systems in New York City during the local COVID- 19 surge from March 1, 2020 to May 31, 2020. In-hospital stroke cases were excluded. We compared demographic and clinical features of patients with COVID-19 and a cryptogenic AIS subtype to patients with COVID-19 and a determined subtype. Baseline characteristics and clinical variables were compared using chi-squared and Fisher exact tests. Results: A total of 62 patients with AIS and COVID-19 at the time of hospital arrival were identified. Of these, 30 were classified as having a cryptogenic subtype (80% after complete diagnotics evaluation), and 32 had an identifiable stroke mechanism. Patients with cryptogenic AIS were significantly younger (p=0.011) and less likely to have co-morbid hypertension (p=0.019), coronary artery disease (p=0.024), heart failure (p=0.039), atrial fibrillation (<0.0001), and prior stroke or TIA (p=0.033) compared to those with defined mechanisms. Further, d-dimer, but not C-reactive protein, was significantly higher in patients with cryptogenic stroke compared to those with defined causes (p=0.009). Conclusion: Patients with AIS in the setting of COVID-19 and no other determined stroke mechanism were younger, less likely to have classic risk factors, and had higher d-dimer levels when compared to those with a determined mechanism. Further study of COVID-19-associated hypercoagulability as a mechanism of stroke is warranted.

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