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Background: Diet quality is associated with psychobiological, psychological, biological, and physiological factors of individuals, and in the context of prolonged stress, such as the COVID-19 pandemic, it can lead to a worsening of the quality of food for undergraduates. This study aimed to analyze diet quality and associated factors in Brazilian undergraduates. Methods: Data were collected from 4,799 undergraduate students from all Brazilian regions, from August 2020 to February 2021. The online questionnaire contained socioeconomic variables, the ESQUADA scale to assess diet quality, self-referred changes in weight, the Brazilian food insecurity scale (EBIA), sleep assessment and the perceived stress scale. Unconditional multiple logistic regression analysis was performed to study variables associated with poor and very poor diet quality. Results: Most of participants presented a good diet quality (51.7%), while 9.8% had a poor or very poor diet quality and only 1.1% had an excellent diet quality. 58.2% of undergraduates reported to have an increase in weight during the pandemic and 74.3% of the students presented elevated stress during the pandemic. Logistic regressions showed students who gained weight during the pandemic presented the highest AOR = 1.56 (95% CI = 1.12-2.20) for poor or very poor diet quality. The elevated perceived stress was also associated with a higher AOR = 2.85 (95% CI = 1.71-4.74) for poor or very poor diet quality. Conclusion: Most of the studied undergraduates presented a good diet quality. Nevertheless, poor/very poor diet quality was associated with higher perceived stress and weight gain. Our study indicated that policies should beaimed at the socioeconomically most vulnerable undergraduates, those in a situation of food and nutritional insecurity, high perceived stress, and who gained weight during the pandemic.
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BACKGROUND: SARS-CoV-19 infection is associated with an increased risk of thrombotic events. We present a case of acute middle cerebral artery ischemic stroke in a patient with SARS-CoV-19 infection despite being on warfarin with supratherapeutic INR (International Normalized Ratio). CASE PRESENTATION: A 68-year-old Caucasian female with multiple comorbidities was admitted to the hospital with symptoms of upper respiratory tract infection. A rapid antigen test confirmed the diagnosis of COVID-19 pneumonia, and intravenous remdesivir was initiated. On the fifth day of admission, the patient experienced sudden onset confusion, slurred speech, left-sided hemiplegia, right-sided eye deviation, and left-sided facial droop. Imaging studies revealed an occlusion of the distal anterior M2 segment of the right middle cerebral artery, and an MRI of the brain confirmed an acute right MCA infarction. Notably, the patient was receiving warfarin therapy with a supratherapeutic INR of 3.2. CONCLUSIONS: This case report highlights the potential for thromboembolic events, including stroke, in patients with COVID-19 infection, even when receiving therapeutic anticoagulation therapy. Healthcare providers should be vigilant for signs of thrombosis in COVID-19 patients, particularly those with pre-existing risk factors. Further research is necessary to understand the pathophysiology and optimal management of thrombotic complications in COVID-19 patients.
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COVID-19 , Ischemic Stroke , Stroke , Humans , Female , Aged , Warfarin/therapeutic use , International Normalized Ratio/adverse effects , COVID-19/complications , Stroke/diagnostic imaging , Stroke/etiology , Anticoagulants/therapeutic use , Infarction, Middle Cerebral Artery/diagnostic imaging , Infarction, Middle Cerebral Artery/drug therapy , Infarction, Middle Cerebral Artery/complicationsABSTRACT
RESUMEN Introducción . El COVID-19 y la gestación es una nueva intercurrencia en la valoración de riesgos para la atención de la gestante. Desde el inicio de la pandemia en el país, los casos han ido en aumento. El primer caso atendido en el Hospital San Bartolomé fue el 12 de abril. Desde los primeros reportes de gestantes COVID+ en China, a la fecha, se tiene cada vez mayor información, siendo importante para fines del manejo de la gestante COVID+ que se conozca su epidemiología y los resultados perinatales. Objetivo . Determinar la epidemiología y resultados materno perinatales de COVID-19 en las gestantes del Hospital Nacional Docente Madre Niño San Bartolomé, Lima, Perú. Método . Estudio observacional de corte transversal, en los meses de abril a julio 2020. Se incluyó a todas las gestantes que llegaron a la emergencia obstétrica del Hospital San Bartolomé, a las cuales se les realizó una prueba de inmunocromatografía para IgM/IgG, para determinar la seroprevalencia de COVID-19. Las variables obstétricas y perinatales fueron recolectadas en una ficha de datos al ingreso a la emergencia. Resultados . Se realizó prueba rápida para SARS-CoV-19 a 345 gestantes que se hospitalizaron para atención de parto. La edad promedio fue 27 años, con 10% de adolescentes y 16% de mayores de 35 años; 60% tenía 2 a 4 embarazos, 38% de los partos fue vaginal, 15% de ellos pretérmino; 1,2% de las gestantes fue sintomática y 0,2% ingresó a la unidad de cuidados intensivos. El 61% de los recién nacidos pesó entre 2 500 y 3 500 g, 53% fue sexo masculino, 94% tuvo Apgar mayor de 7 al minuto, 3,3% con hisopado positivo dentro de las primeras 24 horas. Se presentaron 3% de óbitos. El 48% de las gestantes provino del Cono Norte de la ciudad de Lima. Conclusiones . Casi 100% de las gestantes fue asintomática y solo 0,2% tuvo complicaciones respiratorias. La culminación del parto por vía cesárea fue baja en relación a otras publicaciones; el motivo de cesárea fue por indicación obstétrica. Escaso número de neonatos tuvo hisopado positivo. Hubo mayor incidencia de óbitos en julio 2020. El mayor porcentaje de pacientes provino del Cono Norte de Lima. Palabras clave. Embarazo, Infecciones por coronavirus, SARS-CoV-19, COVID-19, óbito fetal, Lima, Perú.
ABSTRACT Introduction: COVID-19 and pregnancy is a new intercurrence in risk assessment for the care of the pregnant woman. Since the beginning of the pandemic in the country, cases have been increasing. The first case attended at the San Bartolomé Hospital was on April 12. Since the first reports of COVID+ pregnant women in China, to date, there is more important information on epidemiology and perinatal results for the management of the COVID+ pregnant woman. Objective: To determine the epidemiology and maternal perinatal outcomes of COVID-19 in pregnant women at the Hospital Nacional Docente Madre Niño San Bartolomé, Lima, Peru. Methods: Observational cross-sectional study, from April to July 2020. All the pregnant women who arrived at the obstetric emergency at Hospital San Bartolomé were included, and they underwent an immunochromatography test for IgM / IgG, to determine the seroprevalence of COVID-19. Obstetric and perinatal variables were collected in a data sheet upon admission to the emergency room. Results: Rapid test for SARS-CoV-19 was performed in 345 pregnant women who were hospitalized for delivery care. The average age was 27 years, with 10% adolescents and 16% over 35 years; 60% had 2 to 4 pregnancies, 38% of deliveries were vaginal, 15% of them preterm; 1.2% of the pregnant women were symptomatic and 0.2% were admitted to the intensive care unit. 61% of the newborns weighed between 2 500 and 3 500 g, 53% were male, 94% had an Apgar score greater than 7 at one minute, 3.3% with a positive swab within the first 24 hours. There were 3% fetal deaths. 48% of the pregnant women came from the Northern Cone of the city of Lima. Conclusions: Almost 100% of the pregnant women were asymptomatic and only 0.2% had respiratory complications. The mode of delivery by cesarean section was low in relation to other publications, all had obstetric indication. A small number of neonates had a positive swab. There was a higher incidence of fetal deaths in July 2020. The highest percentage of patients came from the Northern Cone of Lima.
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Resumen Cuando apareció la enfermedad por el coronavirus SARS-CoV-2, no esperábamos su rápida expansión en el mundo y las graves consecuencias que traería. Se ha ido conociendo al virus morfológicamente y su accionar en el ambiente y en el organismo del ser humano, su mayor predisposición de enfermar a poblaciones vulnerables, como el adulto mayor, poblaciones con comorbilidad como obesidad, diabetes, hipertensión e inmunodepresión, predilección por el sexo masculino, mayor prevalencia en países con mayor pobreza, promiscuidad, zonas deprimidas económicamente, entre otros. Se ha tenido que improvisar y descartar diversos tratamientos en aquellos pacientes con enfermedad COVID-19 moderada y severa. Eventualmente se está disminuyendo la frecuencia de muertes con medidas de protección personal, distanciamiento social, cuarentena de emergencia, y combinación de medicamentos y administración de oxígeno. Pero aún no hay cura, y se está a la expectativa en la aparición de la vacuna. Con relación a la mujer, ella es comprometida en menor proporción y severidad por la enfermedad COVID-19, pero debe cumplir las medidas de prevención, especialmente si es frágil y tiene comorbilidades. Se ha postergado temporalmente su evaluación preventiva y las intervenciones quirúrgicas si no son de emergencia. En la gestante se está encontrando aumento de prematuridad, gestaciones frustras, lesiones placentarias y presencia del virus en anexos placentarios, con casos de morbilidad severa y muerte maternas. En este artículo se hace una puesta al día resumida sobre la situación de la enfermedad COVID-19 en el mundo y el Perú, enfatizando el cuidado de la mujer y de la gestante.
Abstract When COVID-19 appeared, we did not expect its rapid expansion throughout the world nor the serious consequences it would bring. We currently understand more about the virus' morphology and its activity in the environment and within the human body, as well as its greater predisposition to affect vulnerable populations, such as the elderly and persons with comorbidities like obesity, diabetes, hypertension and immunosuppression. This virus shows a predilection for men, and a higher prevalence in countries with greater poverty, promiscuity and economically depressed areas, among others. Various treatments have been tested and discarded in patients with moderate and severe disease. The frequency of deaths is decreasing due to personal protection measures, social distancing, emergency quarantine, and combination of medications and supplemental oxygen. However, there is still no cure, and we are waiting for the appearance of the vaccine. Women are less frequently and less severely affected; however, they should follow preventive measures, especially if frail with comorbidities. Preventive medical consultations and non-emergency surgical procedures have been temporarily postponed. Pregnant women are experiencing an increase in prematurity, fetal deaths, placental lesions and presence of the virus in placental adnexa, with cases of severe morbidity and maternal death. This article is an update on the situation of COVID-19 in the world and in Peru, emphasizing the care of women and pregnant women.
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Introduction: The current Covid-19 pandemic has urged the international scientific community to find solutions in regards to therapeutics and vaccine developments. Around 70 vaccines were being developed at the time of the survey. Any vaccine that is reliable, effective, permanent and accessible to a large population is a good candidate. The aim of this study is to determine the knowledge and attitude towards the challenges and limitations in Covid vaccine development in various countries among the dental population. Materials And Method: A self structured online questionnaire was distributed among dental students through the platform Surveyplanet. The survey was distributed to 100 participants who were selected using Simple random sampling. The questionnaire consisted of 16 questions pertaining to Covid Vaccine development and its challenges and limitations. The results were tabulated and analyzed using SPSS software by IBM. Pie charts and bar graphs were used to graphically represent the data obtained. Results: 47% of the participants were aware of the severity of Covid in our country, while 78% were aware that Covid vaccination programs had begun across the country at the time. 51% of the participants thought that Covishield was the most effective vaccine, in comparison to Pfizer, Moderna, Novovax and Covaxin. 36% of the participants believed that India was the frontrunner in vaccine development at the time, followed by the USA (25%). 47% believe that the safety and the testing of the developed vaccines might be hindered due to the time constraints and 69% believe that vaccination and immunisation will be effective against the spread of the coronavirus. Overall, more than 80% of the participants believe that there is a need to be vaccinated against the novel Covid-19. Conclusion: It can be concluded that the dentists are knowledgeable and aware of the challenges and limitations of Covid vaccine development. This is imperative in guiding the general public and sharing knowledge and providing scientific facts so that the public can take an informed decision with regards to vaccination and immunization against the Sars-CoV-19.
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This research work is devoted to undertaking a dynamical system representing SARS-CoV-19 disease under the concept of piecewise fractional-order derivative using the Caputo concept since long-memory and short-memory terms are not well explained by ordinary fractional differential equations. It has been found that for such disruption, piecewise operators of fractional derivatives have been found useful in many cases. Therefore, we study a compartmental model of susceptible and infected individuals under the concept of piecewise derivative. We establish the existence theory of the considered model by using some Banach and Schauder fixed-point theorems. Keeping the importance of stability, a pertinent result related to the said area is also developed. The said concept of stability is based on the concept given by Ulam and Hyers. Further, to derive the numerical results, we use the Euler method to develop a numerical scheme for the considered model. Using real available data, we have presented various graphical presentations of two compartments against different fractional orders and various values of isolation parameters. The crossover behaviors in the dynamics can be clearly observed, which is explained by the piecewise operators, not the usual fractional-order derivative. © 2023 by the authors.
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Coronavirus disease (COVID-19) is caused by severe acute respiratory syndrome virus 2 (SARS-CoV-2), it is a virus belonging to the family Coronaviridae which includes zoonotic viruses infecting mammals and birds. This disease emerged in December 2019 in Wuhan, China, and quickly developed into a global pandemic with high mortality rates. The magnitude of the pandemic has involved a global collaborative scientific response to develop effective preventive and therapeutic means using both traditional and advanced techniques. However, to date specific therapies for COVID-19 are not well established and only a few vaccines are approved for emergency use. Herbal remedies, especially essential oils (EOs) can boost immunity which plays a decisive role in the initiation and progression of the disease in the preliminary stage of a COVID-19 infection. The low cost and availability of medicinal plants as well as the almost non-existent side effects encourages their widespread use during the pandemic, hence a great need to identify plant extracts for anti-COVID 19 use. Although the majority of studies are done in silico, with little in vivo or in vitro study, we can have an idea for further later experiments. © 2022 Authors. All rights reserved.
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Background: Evidence on performance of Rapid Antigen Detection Tests to recognize SARS-CoV-2 symptomatic patients in our context is limited. This study was aimed to evaluate Panbio™ COVID-19 Ag Rapid Test Device (Abbott Diagnostics, Jena, Germany) in identifying SARS-CoV-2 infection in comparison with RT-PCR test. Methods: This cross-sectional validation study was carried out at Margalla Hospital, Taxila from October, 2020 to March, 2021. Three hundred and eighty-two participants of both gender and all ages, symptomatic for 3-4 days were included in this study. For each participant, two nasopharyngeal swabs were collected by trained lab technicians according to SOPs, one for Rapid Antigen Test and other for RT-PCR.Covid-19 antibodies were checked 4-6 weeks after symptoms among 77 randomly selected participants to further evaluate the performance of Rapid Antigen Test. Data was analyzed using SPSS-26. Results: The mean age of the participants was 43.1 years (SD=15.9). More than half of participants were males (n=213%=55.8) and 169 (44.2%) were females. Sensitivity of Rapid Antigen Test was calculated to be 94.3%, whereas the specificity was 39.7%. Out of 34 RT-PCR negatives that were initially detected positive on Rapid Antigen Test, 33 demonstrated presence of COVID-19 antibodies. Conclusion: Panbio™ COVID-19 Ag Rapid Test was found to have 93.4% overall sensitivity and relatively low overall specificity (37.9%). Rapid antigen testing using Panbio™ COVID-19 Ag Rapid Test Device can be effectively used to scale up mass testing to interrupt transmissibility of COVID-19 infection by generating quick result.
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COVID-19 , SARS-CoV-2 , Female , Male , Humans , Adult , Infant, Newborn , COVID-19/diagnosis , Cross-Sectional Studies , Reverse Transcriptase Polymerase Chain Reaction , Hospitals , Sensitivity and SpecificityABSTRACT
The emergency department (ED) is the initial point of contact between hospital staff and patients potentially infected with SARS-CoV-2, thus, prevention of inadvertent exposure to other patients is a top priority. We aimed to assess whether the introduction of antigen-detecting rapid diagnostic tests (Ag-RDTs) to the ED affected the likelihood of unwanted SARS-CoV-2 exposures. In this retrospective single-center study, we compared the rate of unwarranted exposure of uninfected adult ED patients to SARS-CoV-2 during two separate research periods; one before Ag-RDTs were introduced, and one with Ag-RDT used as a decision-support tool. The introduction of Ag-RDTs to the ED significantly decreased the relative risk of SARS-CoV-2-negative patients being incorrectly assigned to the COVID-19 designated site ("red ED"), by 97%. There was no increase in the risk of SARS-CoV-2-positive patients incorrectly assigned to the COVID-19-free site ("green ED"). In addition, duration of ED admission was reduced in both the red and the green ED. Therefore, implementing the Ag-RDT-based triage protocol proved beneficial in preventing potential COVID-19 nosocomial transmission.
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INTRODUCTION: The COVID-19 pandemic situation has brought a considerable growth on the amount of patients requiring ICU admissions and long-term hospitalization. The present study is aimed at determining whether Rehabilitation Services has been able to reach a sufficient adaptation level, regarding the exponential increase on the demand of Rehab-related services from intensive care patients and inpatients. MATERIAL AND METHODS: Through this cross-sectional research, an online survey was implemented in various Rehabilitation Departments across Spain from December the 22nd, 2020 to February the 12th, 2021. SORECAR (The Spanish Cardiopulmonary Rehabilitation Society) was the responsible entity for the design of the survey (ICU Rehabilitation Services Identification). Descriptive statistical analysis was conducted using SPSS. OBJECTIVE: To address the specific needs and changes arising from the new COVID-19 pandemic situation within Spanish Rehabilitation Departments. RESULTS: 38 hospitals from 18 cities (From a total of 49) participated in the study. The ICUs weekly demand scored 7.84 ± 6,8 Medical Consultation (MC) on average (range: 2-45). The hospitalization average was displayed as 9, 63 ± 6,2 MC/week (range: 2-55). The total worktime dedicated by physicians was 10.38 h/week, from which physiotherapists stood with 25.95 h/week. Only 7 hospitals (16.7%) counted with occupational therapists (OT) (average dedication of 5 h/week). Each Rehab-session lasted 30 min on average. 59.1% (n = 23) of the included hospitals had already implemented a specific post-covid follow-up rehab-consultation, whereas 9.1% (n = 4) of them were planning on implementing it. 64.3% (n = 24) of the surveyed centers implemented specific protocols for COVID-19 patients, while another 7.1% (n = 3) were in development progress. 48.5% (n = 18) of the surveyed centers did not owe its own specific training program within its ICUs and respiratory rehab-areas for the internal medical residents. CONCLUSIONS: The pandemic situation has resulted in a substantial increase on the workload in the Spanish Rehabilitation Services. Most of the hospitals included in the present study had already implemented outpatient follow-up consultations. Rehabilitation in critical patients is an exponentially recurrent topic for this medical specialty that needs to be furtherly addressed in the nearby future.
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OBJECTIVE: Coronavirus disease 2019 (COVID-19) is a respiratory infection known as severe respiratory acute syndrome coronavirus 2 (SARS-CoV-2). The purpose of this manuscript is to review information leading to the Food and Drug Administration (FDA) approval of the Pfizer-BioNTech COVID-19 Vaccine. DATA SOURCES: A literature search was conducted of PubMed and clinicaltrials.gov (August 2018-October 2021) to identify trials related to the FDA approval of Pfizer-BioNTech COVID-19 Vaccine. STUDY SELECTION AND DATA EXTRACTION: Trials included are those the FDA deemed significant and accurate enough to be included in the FDA approval process. Information not recognized by the Centers of Disease Control and Prevention (CDC) nor FDA is omitted to not add to further confusion and misinformation. DATA SYNTHESIS: In persons 16 years or older without evidence of prior SARS-CoV-2 infection, a total of 77 COVID-19 cases (0.39%) in the vaccine group from 7 days onward after the second dose vs 833 (4.1%) in the placebo group (Vaccine efficacy 91.1%; 95% confidence interval [CI]: 88.8-93.1). According the CDC definition of severe infection, there were no severe infections in the vaccine group 7 days and onward after the second dose, compared to 31 (0.15%) in the placebo group (Vaccine efficacy 100%; 95% CI: 87.6-100.0). Relevance to Patient Care and Clinical Practice: Reduction of infection by SARS-COV-2 is a top priority in protecting the health of all people and the official approval of the Pfizer-BioNTech vaccination may improve this goal. CONCLUSIONS: Data available show a high efficacy rate of preventing SARS -CoV-2 with relatively low rates of ADE after full vaccination with Pfizer-BioNTech COVID-19 vaccine.
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COVID-19 , Vaccines , BNT162 Vaccine , COVID-19/prevention & control , COVID-19 Vaccines/therapeutic use , Humans , Immunization , SARS-CoV-2 , United States/epidemiology , United States Food and Drug Administration , VaccinationABSTRACT
Introduction: Coronavirus is a family of viruses that can cause illnesses such as the common cold, Severe Acute Respiratory Distress Syndrome & Middle East Respiratory Syndrome. In 2019 new coronavirus was identified, originating in China. The emergence of COVID-19 disease has led to high demand for intensive care services worldwide. Materials And Methods: It is a cross-sectional hospital-based observational study of the clinical profile and outcome of laboratory-confirmed COVID-19 cases admitted in the intensive care unit (ICU) at C.U. Shah Medical College and hospital between October 2020 to March 2021. We have taken a detailed clinical history of patients regarding symptoms of COVID-19 according to the predefined COVID-19 questionaries. Allied history from the patient's relatives was taken regarding contact with COVID-19-positive patients and recent travel history. Emphasis was also made on comorbidities, past medications, and past medical events like ischemic heart disease (IHD), stroke, diabetes mellitus, thyroid disorders, and hypertension. Result(s): In the present study, the most common symptom of COVID-19 disease is breathlessness, followed by fever and cough. Peak incidence was noted in the older age group. Diabetes and hypertension are associated with a more severe form of COVID-19 disease. Most patients have been admitted due to severe acute hypoxemia and tachypnoea. Most patients required mechanical ventilation, although most died due to severe acute respiratory syndrome. Conclusion(s): In a hospital-based cross-sectional study of laboratory-confirmed COVID-19 patients, males and females are at equal risk of COVID-19 infection, and there was no significant difference in severity among them. Hypertension and diabetes, and old age are the most common risk factors for severity and ICU admission in covid-19 patients. Proper strategies regarding covid-19 management and practical training of healthcare personnel with adequate health resources can dramatically reduce mortality in COVID-19 patients. Copyright © 2022 Ubiquity Press. All rights reserved.
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This study assessed the associations between psychosocial factors (social isolation, social support, financial support and emotional distress) and memory complaints during the COVID-19 pandemic. This was a secondary analysis of data extracted from the dataset of participants recruited from 151 countries for a COVID-19 related mental health and wellness study between June and December 2020. The dependent variable was memory complaint, measured using the Memory Complaint Questionnaire. The independent variables were perception of social isolation, social support, financial support, emotional distress and history of SARS-CoV-19 infection. Confounding variables were age, sex at birth, level of education, employment status, HIV status and country-income level. Multivariable logistic regression was used to determine the associations between the dependent and independent variables after adjusting for the confounders. Of the 14825 participants whose data was extracted, 2460 (16.6%) had memory complaints. Participants who felt socially isolated (AOR: 1.422; 95% CI: 1.286-1.571), emotionally distressed (AOR: 2.042; 95% CI: 1.850-2.253) and with history of SARS-CoV-19 infection (AOR: 1.369; 95% CI: 1.139-1.646) had significantly higher odds of memory complaints. Participants who perceived they had social and financial support had significantly lower odds of memory complaints (AOR: 0.655; 95% CI: 0.571-0.751). Future management of pandemics like the COVID-19 should promote access to social and financial support and reduce the risk of social isolation and emotional distress.
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Phloroglucinol and derived compounds comprise a huge class of secondary metabolites widely distributed in plants and brown algae. A vast array of biological activities, including antioxidant, anti-inflammatory, antimicrobial, and anticancer has been associated to this class of compounds. In this review, the available data on the antiviral and antibacterial capacity of phloroglucinols have been analyzed. Some of these compounds and derivatives show important antimicrobial properties in vitro. Phloroglucinols have been shown to be effective against viruses, such as human immunodeficiency virus (HIV), herpes or enterovirus, and preliminary data through docking analysis suggest that they can be effective against SARS-CoV-19. Also, some phloroglucinols derivatives have shown antibacterial effects against diverse bacteria strains, including Bacillus subtilis and Staphylococcus aureus, and (semi)synthetic development of novel compounds have led to phloroglucinols with a significantly increased biological activity. However, therapeutic use of these compounds is hindered by the absence of in vivo studies and scarcity of information on their mechanisms of action, and hence further research efforts are required. On the basis of this consideration, our work aims to gather data regarding the efficacy of natural-occurring and synthetic phloroglucinol derivatives as antiviral and antibacterial agents against human pathogens, which have been published during the last three decades. The recollection of results reported in this review represents a valuable source of updated information that will potentially help researchers in the development of novel antimicrobial agents.
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BACKGROUND: This prospective controlled clinical trial aimed to compare the efficacy of methylprednisolone, dexamethasone, and hydrocortisone at equivalent doses in patients with severe COVID-19. METHODS: In total, 106 patients with mild to moderate COVID-19-related acute respiratory distress syndrome (ARDS) were randomized to receive either dexamethasone (6â¯mg once a day), methylprednisolone (16â¯mg twice a day), or hydrocortisone (50â¯mg thrice a day) for up to 10 days. All participants received a standard of care for COVID-19. The primary and secondary efficacy outcomes included all-cause 28-day mortality, clinical status on day 28 assessed using the World Health Organization (WHO) eight-category ordinal clinical scale, number of patients requiring mechanical ventilation and intensive care unit (ICU) care, number of ventilator-free days, length of hospital and ICU stay, change in PaO2:FiO2 ratios during the first 5 days after treatment, and incidence of serious adverse events. P-values below 0.008 based on Bonferroni's multiple-testing correction method were considered statistically significant. RESULTS: According to the obtained results, there was a trend toward more favorable clinical outcomes in terms of needing mechanical ventilation and ICU care, number of ventilator-free days, change in PaO2:FiO2 ratios during the first 5 days after treatment, clinical status score at day 28, length of ICU and hospital stay, and overall 28-day mortality in patients receiving dexamethasone compared to those receiving methylprednisolone or hydrocortisone; however, likely due to the study's small sample size, the difference between groups reached a significant level only in the case of clinical status score on day 28 (p-valueâ¯= 0.003). There was no significant difference in the incidence of serious adverse events between the study groups. CONCLUSION: Based on the results, severe cases of COVID-19 treated with dexamethasone might have a better clinical status at 28-day follow-up compared to methylprednisolone and hydrocortisone at an equivalent dose. Larger multicenter trials are required to confirm our findings.
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COVID-19 , Respiratory Distress Syndrome , Humans , COVID-19/complications , Methylprednisolone/adverse effects , SARS-CoV-2 , Hydrocortisone/therapeutic use , Prospective Studies , COVID-19 Drug Treatment , Respiratory Distress Syndrome/drug therapy , Respiratory Distress Syndrome/chemically induced , Dexamethasone/adverse effects , Treatment OutcomeABSTRACT
INTRODUCTION: Chatbots have emerged as a first link to care in recent years. The COVID-19 pandemic, and consequent health system disruptions, expanded their use. Socios En Salud (SES) introduced chatbots in Peru, which experienced one of the highest excess COVID mortalities in the world. METHODS: SES and the government identified unmet population health needs, which could be amenable to virtual interventions. Chatbots were developed to screen individuals for these conditions; we describe the period of deployment, number of screenings, and number of people who received services. RESULTS: Between April 2020 and May 2021, SES deployed nine ChatBots: four for mental health, two for maternal and child health, and three for chronic diseases: breast cancer, hypertension, diabetes mellitus, and obesity. Mental health services were provided to 42,932 people, 99.99% of those offered services. The other ChatBots reached fewer people. Overall, more than 50% of eligible people accepted chatbot-based services. DISCUSSION: ChatBot use was highest for mental health. Chatbots may increase connections between a vulnerable population and health services; this is likely dependent on several factors, including condition, population, and penetration of smart phones. Future research will be critical to understand user experience and preferences and to ensure that chatbots link vulnerable populations to appropriate, high-quality care.
INTRODUCTION: Les chatbots se sont imposés comme un premier lien aux soins ces dernières années. La pandémie de COVID-19, et les perturbations du système de santé qui en ont résultées, ont élargi leur champ d'application. Socios En Salud (SES) a introduit les chatbots au Pérou, qui a connu l'une des surmortalités dues au COVID les plus élevées au monde. MÉTHODES: SES et le gouvernement ont identifié des besoins non satisfaits en matière de santé de la population, qui pourraient faire l'objet d'interventions virtuelles. Des chatbots ont été développés pour dépister des individus pour ces conditions ; nous décrivons la période de leur déploiement, le nombre de dépistages et le nombre de personnes qui ont reçu ces services. RÉSULTATS: Entre avril 2020 et mai 2021, SES a déployé neuf ChatBots : quatre pour la santé mentale, deux pour la santé maternelle et infantile et trois pour les maladies chroniques, comme le cancer du sein, l'hypertension, le diabète et l'obésité. Des services de santé mentale ont été fournis à 42 932 personnes, soit 99,99% des personnes proposées. Les autres ChatBots ont touché moins de personnes. Dans l'ensemble, plus de 50% des personnes éligibles ont accepté les services proposés par les chatbots. DISCUSSION: L'utilisation des ChatBots était la plus élevée pour la santé mentale. Les chatbots peuvent augmenter les connexions entre une population vulnérable et les services de santé, mais cela dépende de plusieurs facteurs, dont la condition, la type de population et la pénétration des smartphones. Les recherches futures seront essentielles pour comprendre l'expérience et les préférences des utilisateurs et pour s'assurer que les chatbots relient les populations vulnérables vulnérables aux soins appropriés et de qualité.
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This is the advent of RNA medicine. The successful development of effective mRNA vaccines in record time has opened the door for greater productivity. In the case of SARS-CoV-19, the mRNAs encode the virus spike protein which elicits a strong immune response. Other RNA successes include RNA biobanking, trans-splicing (RNA repair), and RNA reprogramming. The protocols and accompanying discussion in the preceding chapters of this text illustrate various methods for the expedient isolation of RNA from a variety of biological sources and its subsequent analysis. The judicious application of various combinations of these techniques constitutes a systematic method for understanding the role of the products of transcription in the regulation of gene expression. Any experimental model can be well-characterized by assaying specific mRNAs as one parameter of gene expression, although having protein expression data from the Western analysis, immunochemical, or other proteomics techniques generally provides a more complete understanding of gene regulation under a specific set of conditions. Real-time PCR, miRNA cataloging, and innovations in sequencing, particular RNA-seq, have facilitated profiling the depths of cellular biochemistry at levels inconceivable 10 years ago and these methods continue to offer great potential. Bioinformatics, email, social media, and all types of online tools provide a platform for literature search or a great deal of background reading without leaving one’s desk. There are a number of different Internet-based bulletin boards where scientists with difficulties can post specific questions and hope for an answer from the readership.
ABSTRACT
Background: SARS-CoV-19 or popularly known as COVID-19 is recognized as a global public health emergency and a pandemic necessitating readiness of the health system and its operational work force to address the unprecedent challenge. Objective: To assess perceived stress and coping methods using novel brief COPE-4 factor structure and narrate thematic testimonials among health care professionals involved in COVID care in India. Settings and Designs: Health care settings and multi-state cross-sectional study. Methods and Material: A cross sectional mixed-methods study, with multi-modal aids was undertaken during April-May, 2020 using a novel brief COPE-4 Factor structure. Oral informed consent was obtained to document narrative testimonials verbatim from interviews among doctors, nurse practitioners. Statistical Analysis Used: The web-survey data from Google forms analyzed using STATA (Ver 12.0) statistical package. The interview content was subjected to manual inductive thematic coding, grouped into piles to identify broad themes as main categories. Results: Among total 218 respondents, 75 (34.4%) were female and 143 (65.6%) male, mean age of 34.71 (SD = 8.9) years. Majority of the respondents were medical post-graduates on duty (38%) followed by nurses (25%) and public health professionals (14%). Slightly higher levels of stress seen among respondents involved in COVID-19 duty, compared to those not involved (p < 0.001) and positive thinking is the major coping method adopted. Conclusions: Appraising the coping mechanisms of health care professionals reveals positive outlook amidst medium levels of perceived stress while providing COVID-19 pandemic related health care services.
ABSTRACT
Unlike many industries, healthcare was simultaneously affected by the COVID-19 pandemic in two opposite ways. On the one hand, the industry faced shortages and overload of many medical representatives such as nurses and infectious disease professionals, but on the other, many medical professionals such as dentists were left with considerably reduced demand. The objective of this paper is to study the efficiency of medical staff allocation and the performance of small and medium sized outpatient clinics in Poland during the COVID-19 pandemic. Owing to the contemporaneity of this problem, we have employed a multiple case study approach. Our sample comprises 5 small and medium-sized outpatient clinics located in Poland in the 3-year period 2019-2021. The results indicate a considerable percentage of medical staff employed in small and medium-sized outpatient clinics remained outside the pandemic, despite their potential provision of healthcare services. Four of the five clinics studied remained passive towards the pandemic. In view of future pandemics, the indications we provide have practical implications for outpatient clinics executives and public health policymakers.