ABSTRACT
Invasive fungal infections (IFIs) represent a severe complication of COVID-19, yet they are under-estimated. We conducted a retrospective analysis including all the COVID-19 patients admitted to the Infectious Diseases Unit of the Federico II University Hospital of Naples until the 1 July 2021. Among 409 patients, we reported seven cases of IFIs by Candida spp., seven of Pneumocystis jirovecii pneumonia, three of invasive pulmonary aspergillosis, and one of Trichosporon asahii. None of the cases presented underlying predisposing conditions, excluding one oncohematological patient treated with rituximab. Ten cases showed lymphopenia with high rates of CD4+ < 200/µL. All cases received high-dose steroid therapy (mean duration 33 days, mean cumulative dosage 1015 mg of prednisone equivalent), and seven cases had severe COVID-19 disease (OSCI ≥ 5) prior to IFI diagnosis. The cases showed a higher overall duration of hospitalization (63 vs 24 days) and higher mortality rate (23% vs. 7%) compared with the COVID-19 patients who did not developed IFIs. Cases showed a higher prevalence of high-dose steroid therapy and lymphopenia with CD4+ < 200/µL, primarily due to SARS-CoV-2 infection and not related to underlying comorbidities. IFIs strongly impact the overall length of hospitalization and mortality. Therefore, clinicians should maintain a high degree of suspicion of IFIs, especially in severe COVID-19 patients.
ABSTRACT
BACKGROUND: Physical activity and physical fitness play an important role in adolescence. Both are considered to be indicators of the current and future health status of young adults. The main objective of this article was to report the normative values of the Physical Activity Questionnaire for Adolescents (PAQ-A) and the International Fitness Scale (IFIS) instruments in Peruvian school adolescents. METHODS: A sample of 1229 participants (622 girls and 607 boys) aged between 12 and 17 years was used. The type of study was descriptive-comparative. All measures used were obtained by means of self-administered instruments. The PAQ-A was used to assess the level of physical activity and the IFIS to assess the self-perceived physical fitness level of the adolescents. RESULTS: It was observed that the PAQ-A questionnaire results obtained from the total sample was 2.34; significantly higher for boys (2.41) compared with girls (2.27). For the IFIS, the total score was 3.07, with boys obtaining 3.13 and girls 2.97. CONCLUSIONS: It was concluded that there was a direct relationship between the level of PA and self-perceived PF in Peruvian adolescents. Furthermore, adolescent boys were more physically active than girls and they had a better self-perceived PF with the exception of flexibility. Finally, there was a higher weight category involved at the lower level of PA.
Subject(s)
Exercise , Physical Fitness , Adolescent , Child , Female , Humans , Male , Overweight , Peru , Schools , Surveys and QuestionnairesABSTRACT
This reflection considers recent United Nations' normative developments in international human rights law and their potential to assess, with a gender perspective, retrogressive economic policies being promoted by International Financial Institutions (IFIs) in the context of the COVID-19 pandemic. Orthodox and androcentric economic policies, such as structural adjustment, austerity, privatisation and deregulation of labour and financial markets, normally have devastating effects on women's rights. Yet, the financial responses with which IFIs are trying to help states manage the effects of the pandemic seem to continue promoting those androcentric economic policies. This piece concludes that ex ante human rights and gender impact assessments of multilateral loans' conditionalities should be conducted and that women's participation in this process as well as access to adequate quantitative and qualitative data to understand the differentiated effects of those economic policies on gender equality, are crucial. These reflections were born out of the authors' own family and country challenges.