111. Adaptation and Delivery of a Partially Virtual Curriculum for Pre-Exposure Prophylaxis Peer Mentors in Kenya: Lessons Learned

Purpose: While Pre-Exposure Prophylaxis (PrEP) is highly effective at preventing HIV, uptake is low among adolescents. In low- and middle-income countries (LMIC), peer mentors (PMs) are considered best practice to increase PrEP acceptability and uptake. Globally, COVID19 has shifted much education and training to virtual formats. Most young people in LMIC have cell phones. Our objective is to describe our experiences developing and delivering a mixed virtual/physical curriculum for training PrEP PMs. Methods: IRB and local research ethics committee approval was obtained. A literature search (PubMed, EBSCO, USAID website, and MedEd Portal) yielded one published curriculum for PrEP PMs. This curriculum was combined with locally developed HIV PM education modules to create a new curriculum, with planned virtual and physical sessions. Curriculum materials were reviewed and agreed upon by all authors. All sessions were delivered by authors, with the majority delivered by Americans. The first 4 hours were done virtually via Zoom, covering the basics of HIV, detailed information on PrEP, adolescent development, and confidentiality. The remaining sessions were held in person and covered expectations of PMs, basic family planning, research ethics, action planning, role playing, and a review of virtual topics. Feedback was solicited from the PMs after virtual training. A debriefing session was held with the five facilitators involved in training: 1 research staff and 1 physician investigator from Kenya, 1 research staff and 2 physician investigators from the US - all female. Results: All five PMs (aged 21 – 27) participated. One identified as female, and one as LGBTQ. Feedback was solicited via anonymous survey (n=3) after the virtual sessions and debriefing with Kenyan research staff. Respondents strongly agreed that the virtual training was worth their time. Although PMs felt they were able to learn in the virtual format, facilitators noted more engagement during in-person sessions. Facilitators noted the importance of introductions and challenges of building cohesiveness for virtual sessions, particularly with sensitive content and internet limitations restricting video use (eg. low bandwidth, use of cell phones). Kenyan investigators noted that the Kenyan educational system is hierarchical, with students largely learning passively. They felt that this, combined with the newness of virtual learning and minimal dedicated time for introductions, may have hampered active virtual participation. While no PMs pointed to race or accent as limitations, facilitators noted differences between American and Kenyan English idioms, cadence, speed, and pronunciation that may have caused difficulty. Given Kenya's history of colonialism, all raised concerns that PMs may have been more deferential to light-skinned, foreign facilitators. Facilitators who observed both virtual and in-person sessions felt it was easier to break barriers of colonialism and assess for differences in spoken English in person. Facilitators felt that if virtual training were to be used in the future, it would be beneficial to have physical sessions first to set an interactive, educational tone and allow participants to build rapport. Conclusions: Virtual delivery of PM educator training in a LMIC setting is difficult and requires careful consideration or technological limitations and culture. Sources of Support: Indiana CTSI;Grant Number UL1RR025761-01.

IMPACT OF SARS-COV-2 INFECTION TO RISK AND SEVERITY OF HYPERTENSION IN PREGNANCY AND ITS OUTCOME TO THE NEW BORN

Objective: To determine relationship of SARS-CoV-2 infection to the risk and severity of preeclampsia, as well as its impact on newborns. Design and method: We performed a systematic search in databases (PubMed, ScienceDirect, ProQuest, and Cochrane Library) for studies examining impact of SARS-CoV-2 infection on pregnancy. Included studies were evaluated for risk of bias based on the Newcastle Ottawa Score. A meta-analysis was conducted using the data extracted from each study. Review Manager (RevMan) 5.4 was utilized to compute the summary of odds ratios (OR), mean differences (MD), and 95% confidence intervals (CI) for the outcomes. Our outcomes of interest are preeclampsia, preeclampsia with severe features, eclampsia, fetal distress and still birth. The other outcomes are preterm birth (< 37 week), instrumental labor, sectio caesaria and birth defect. Results: We identified twenty two observational studies involving 1,025,048 pregnancy patients. Based on the analysis, SARS-CoV-2 infection in pregnancy significantly increased the risk of preeclampsia [OR 2.01(95% CI 1.59-2.53;p < 0.00001;I2 = 82%)], and the severity was based on the high prevalence of preeclampsia with severe features [OR 3.04(95% CI 1.19-7.78;p = 0.02;I2 = 91%)] and eclampsia [OR 17.73(95% CI 13.83-22.72;p < 0.00001;I2 = 0%)]. Poor outcome in newborns in terms of incidence of preterm birth [OR 1.65(95% CI 1.54- 1.76;p < 0.00001;I2 = 86%)], fetal distress [OR 19.18(95% CI 17.14-21.45;p < 0.00001;I2 = 99%)] and still birth [OR 2.12(95% CI 1.74-2.59;p < 0.00001;I2 = 0%)], were also significantly associated with SARS-CoV-2 infection. Conclusions: SARS-CoV-2 infection during pregnancy increases the risk and severity of preeclampsia and gives a poor outcome in newborn.

Coronaviruses Pathogens in Human in Third Millennium (SARS-CoV, MERS, COVID-19): A Review Article

This study aimed to investigate the most common Coronavirus pathogens in humans in the third millennium. In this study, all documents in English on pathogenic coronaviruses were examined from the beginning of 2002 to March 27, 2020. Articles were searched through reliable databases such as PubMed, Web of Science, Scopus, Google scholar, Science Direct, Cochrane library, and BioRxiv using the keywords "COVID-19", "Coronavirus 2019", "SARS-CoV," and" MERS-CoV." In addition, reliable health websites, such as WHO and the Centers for Disease Control and Prevention (CDC), were used to obtain new figures and information on these diseases. A total of 1563 articles and documents were extracted, and after reviewing the full texts of these articles, 100 papers and documents with necessary eligibility were finally selected in the present review study. The outbreak of pathogenic viruses, especially the latest one, i.e., COVID-19, as a severe threat can affect the entire global community, in particular medical staff who are at the forefront of fighting against the virus. It can generally be concluded that coronaviruses have high pathogenesis, with very rapid person-to-person transmission. Since human knowledge is not yet complete about the new type of this virus, i.e., COVID-19, there are no definitive treatments for the virus. Thus, the best and only way to prevent affection from this virus is currently fully implementing health protocols and preventing self-infection and the virus outbreak.

New coronavirus disease 2019 (COVID-19): Is there an impact on male reproductive health?

The male reproductive health depends on several factors that can be divided into two main groups: the first group, genetic or hereditary (in particular, klinefelter syndrome, etc.), the second acquired factors that depend on the person's lifestyle (bad habits, diet), stress, infectious diseases of the genitourinary system, etc. The presence of infectious and inflammatory diseases of the male reproductive system leads to impaired reproductive and endocrine function, significantly reducing the reproductive potential. In the last three years of our time around the world, including Russia, the number of people who have become ill with a new viral infection (cOVID-19) caused by the new coronavirus (SARS-coV-2), which causes dysfunction and has a negative effect on many organs and organs, body systems. The overview of recent publications is devoted to the study of the effect of SARS-coV-2 on the reproductive health of men. The search was performed using the Medline, PubMed, and EMBASE databases.

Scientific Production And Dissemination Forecast Related With Covid-19

The new coronavirus SARS-CoV-2 cuases the known disease as COVID -19 extended around the world, increasing the infected and deceased cases. It was declared pandemic by OMS in March of this year. It is reason to actívate the scientific community in the production and dissemination of scientific articles. This paper analyzes and predicts scientific publications related with COVID 19, monthly and for country, proceeded and registered daily by CTS Observatory based on PubMed. USA highlights as the main country who publishes with 7,974 (27.73 %) results, followed by China with 4,202 (14.61 %). In Iberoamerican level, Spain and Brazil highlight with 4.26% y 2.37%, respectively. An increase of publications related with COVID-19 of 2,236 monthly publications is predicted in the mentioned database.

Drug repurposing against SARS-CoV-2: A review based on principal reports

Despite the measures taken and the molecular advances for the development of new agents for the control of SARS-CoV-2 infection, there is still insufficient development of an effective treatment. The objective of the review was to de-scribe the clinical studies and reported articles on drugs used as possible therapeutic agents for COVID-19 and the main conclusions on their reuse. A non-systematic review through PubMed, ScienceDirect, and clinical trials at ClinicalTrials. gov on original articles and case report in English and Span-ish that will report information on COVID-19 treatment and its main conclusions. Articles that were not relevant or that did not mention updated information to that reported in other articles were excluded. A total of 99 bibliographic references were included. COVID-19 appears as a multisystemic disease with variable clinical symptoms. Since no specific treatment is yet known, multiple drugs have been proposed that attack the different pathways of SARS-CoV-2. For severe disease in patients who require hospitalization and oxygen support, the use of remdesivir, dexamethasone, or tocilizumab is recommended if there are patient conditions that apply to use them. The use of ivermectin, colchicine, lopinavir/ritonavir, hydroxy-chloroquine, and chloroquine have not reported benefits that surpass adverse effects.

FUNDOSCOPIC EXAMINATION USING A SMARTPHONE CAMERA: A REVIEW OF EFFECTIVENESS AND FEASIBILITY IN DETECTING HYPERTENSIVE RETINOPATHY IN HYPERTENSIVE CRISIS PATIENTS

Introduction: In patients presented with hypertensive crises, a fundoscopic assessment is necessary because once hypertensive retinopathy is discovered, a hypertensive emergency is diagnosed, and intravenous antihypertensive medication is recommended. However, direct ophthalmoscopy is relatively underutilized, especially under the social distance regulation, which may result in delayed diagnosis and treatment. The novel method, namely, smartphone-based fundoscopy offers longer working distance and shorter doctor-patient contact time, however, there is limited data regarding its feasibility and effectiveness. Objective: We aimed to gather scientific evidence on the smartphone-based fundoscopy in terms of its effectiveness, accessibility, and trainability in detecting hypertensive retinopathy among hypertensive crisis patients in emergency room settings. Methods: A literature search was conducted on PubMed, Google Scholar, and the Cochrane Library for papers published from January 2010 to November 2021. Keywords including hypertensive crisis, hypertensive retinopathy, target organ damage, fundoscopic optic examination, direct ophthalmoscope, fundus images, smartphone fundoscopy, digital fundus camera, and COVID-19 were used. Full papers published in English and s of non-English publications were all reviewed. Results: Eight studies out of 34 fulfilled our search criteria. Five observational studies confirmed the effectiveness of smartphone-based fundoscopy in obtaining fundus images adequate for interpretation compared with those from commercially available fundus cameras. Also, smartphone-based fundoscopy offers time-saving properties as it allows fundus examination to be effectively completed within 74 seconds compared to 130 seconds with a traditional direct ophthalmoscope. Two studies investigated the accessibility of smartphonebased fundoscopy and discovered that fundus images can be obtained by using 20 diopter condensing lenses with the video mode of the smartphone camera, which can be easily provided even at a primary level hospital due to their low cost. Another study reviewed the trainability of the smartphone-based fundoscopy in 137 undergraduate medical students which concluded that 75% of these students can identify the optic nerve within 20-25 minutes of face-to-face demonstration. Conclusion: With a greater diagnostic capability, accessibility, and trainability of smartphone-based fundoscopy makes it a potentially game-changing technique for detecting hypertensive retinopathy in hypertensive emergency patients, especially during the current COVID-19 pandemic, in which longer working distance and shorter doctor-patient contact time are both required.

Estimating the extent of asymptomatic covid-19 and its potential for community transmission: Systematic review and meta-analysis

Background: Knowing the prevalence of true asymptomatic coronavirus disease 2019 (COVID-19) cases is critical for designing mitigation measures against the pandemic. We aimed to synthesize all available research on asymptomatic cases and transmission rates. Methods: We searched PubMed, Embase, Cochrane COVID-19 trials, and Europe PMC for primary studies on asymptomatic prevalence in which (1) the sample frame includes at-risk populations, and;(2) follow-up was sufficient to identify pre-symptomatic cases. Meta-analysis used fixed-effects and random-effects models. We assessed risk of bias by combination of questions adapted from risk of bias tools for prevalence and diagnostic accuracy studies. Results: We screened 2,454 articles and included 13 low risk-of-bias studies from seven countries that tested 21,708 at-risk people, of which 663 were positive and 111 asymptomatic. Diagnosis in all studies was confirmed using a real-time reverse transcriptase–polymerase chain reaction test. The asymptomatic proportion ranged from 4% to 41%. Meta-analysis (fixed effects) found that the proportion of asymptomatic cases was 17% (95% CI 14% to 20%) overall and higher in aged care (20%;95% CI 14% to 27%) than in non-aged care (16%;95% CI 13% to 20%). The relative risk (RR) of asymptomatic transmission was 42% lower than that for symptomatic transmission (combined RR 0.58;95% CI 0.34 to 0.99, p = 0.047). Conclusions: Our one-in-six estimate of the prevalence of asymptomatic COVID-19 cases and asymptomatic transmission rates is lower than those of many highly publicized studies but still sufficient to warrant policy attention. Further robust epidemiological evidence is urgently needed, including in subpopulations such as children, to better understand how asymptomatic cases contribute to the pandemic.

Role of vitamin D in modulating the immune response to SARS-CoV-2 and other coronavirus infections

In recent years, new data have been obtained on the significant prevalence of vitamin D (VD) deficiency in the population, and knowledge about the role of vitamin D in the regulation of many physiological processes in the body, including the functioning of the immune system, has increased. The SARS-CoV-2 pandemic has further highlighted the issue of an adequate immune response in vitamin D deficiency. Objective of the review. To present and summarize the evidence on the role of VD in different parts of the immune response in COVID-19, to analyze available studies of the VD status effect on the course and outcome of COVID-19 in patients from different population groups. Material and methods. A search of domestic and foreign literature on the role of VD in the immune response in respiratory viral infections and SARS-CoV-2, as well as practical measures of VD-status correction in COVID-19, was performed. We used Scopus, Web of Science, PubMed, Google Scholar, eLibrary, and Cyberleninka databases. Results. Numerous clinical and observational studies have found an association between 25-hydroxyvitamin D levels, COVID-19 severity, and mortality. This association can be explained by the multifaceted role of vitamin D in the physiology of the human immune and endocrine systems. On the immunological side, the active form of VD promotes the secretion of antimicrobial peptides responsible for inhibiting viral replication and stimulates autophagy by increasing the level of Beclin1 protein and decreasing the level of mTOR protein regulating cellular homeostasis. It leads to the presentation of antigens followed by activation of the antiviral pathway of type I interferons. VD also stabilizes intercellular junctions, including those in the airway epithelium, reducing their permeability to pathogens, stimulates the activity of angiotensin-converting enzyme-2, whose receptors are a conduit for SARS-CoV-2 into cells, and several pathophysiological responses associated with the disease symptoms and acute lung injury. Adequate vitamin D status can provide significant benefits during the pandemic. Conclusion. To date, ideas about the role of vitamin D in regulating the immune response in respiratory infections have significantly expanded. However, its use in the complex preventive measures and adjuvant therapy of viral infections, including COVID-19, should be the subject of further scientific research.

COVID-19 Risk Management in Dental Offices: A Review Article

BACKGROUND: As all the dental staff, including nurses and practitioners, are exposed to various routes of contamination due to the novel COVID-19 virus, which is still unknown to the scientific world, developing strategies to reduce the risk of transmission and decontaminate surfaces in a dental office would be of high importance. Although there is still insufficient data on managing this virus in dental offices, several studies have suggested protocols for improving care. AIM: This study aimed to review present investigations and reach a conclusion on what we know and need to know to combat this virus. MATERIALS AND METHODS: In this review, Scopus, PubMed, and MEDLINE databases were searched using the keywords "COVID-19,” "SARS-CoV-2,” "Medical Disinfectants,” "Personal Protective Equipment's,” and "Surface Decontamination.” Articles were reviewed, and finally, relevant articles published during 2000–2022 were included in the final paper. RESULTS: The present research concluded that using a combination of the face shield and N95 masks protected the eyes, nose, and mouth. To have more efficient protection, water-resistant long-sleeved gowns and gloves were highly suggested. To overcome aerosols, high-performance air filters and ultraviolet were found quite effective. Allowing the patient to use antiseptic mouthwash before starting the treatment could reduce oral microorganisms and the following airborne contamination. CONCLUSION: This review has gathered all available data regarding dentistry and COVID-19 in order to conclude what has been achieved yet in the prevention of this virus through dental offices;however, more investigations are needed to have a definitive protocol against the virus.

Prevalence of COVID-19 in connective tissue diseases

Propose: Due to severe acute respiratory syndrome coronavirus 2(SARS-CoV- 2), novel coronavirus pneumonia (COVID-19) is a systemic viral disease that mostly affects the respiratory tract. Studies have shown that COVID-19 may increase the risk of autoantibody development in patients with connective tissue diseases (CTD) .However, data regarding the impact of COVID-19 pandemic on patients with CTD and drug use were relatively scarce. The prevalence of COVID-19 in CTD patients was estimated by means of meta-analysis, and the effect of the use of anti-rheumatic drugs on the clinical outcome of CTD patients with COVID-19 was investigated. Method(s): Cross-sectional investigations and case series on CTD and COVID-19 published by CBM, CNKI, China Science and Technology Journal Database, Wan Fang Data, PubMed, Embase, Web of Science, Cochrane Library and Medline from its establishment to April 5, 2022 were searched. A random effects model was used to pool data. Heterogeneity and risk of bias was examined with I-squared index (I2) statistic. Inconsistency was evaluated with the I2. Egger tests were used for the evaluation of potential publication bias (STATA v.12.0). Result(s): A total 11 studies involving 75908 participants were included in the meta-analysis (Table 1). The overall prevalence of COVID-19 among CTD patients was 3.3% (95%CI: 2.3%-4.3%) (Figure 1A), the hospitalization rate was 17.6% (95%CI: 7.5%-27.6%;Figure 1B), with the rate of 4.4% (95%CI: 2.8%-6.0%;Figure 1C)in ICU admission, and the mortality rate was 4.5% (95%CI: 2.5%-6.4%;igure 1D). Six of the studies included patients who used hydroxychloroquine as part of their treatment regimen, with 15.5% (95%CI: 5.6%-25.3%) adverse outcome rates (Figure 1E). Conclusion(s): Patients with CTD had a higher risk of COVID-19. Hydroxychloroquine might increase adverse outcome rate of COVID-19.

Effects of antirheumatic drugs on prevalence and clinical outcome of COVID-19 in systemic lupus erythematosus: a meta-analysis

Purpose: Novel Coronavirus pneumonia 2019 (COVID-19) caused by the novel coronavirus severe acute respiratory syndrome (SARS) coronavirus- 2 (CoV-2) is a highly contagious infection with high morbidity and mortality1. Patients with systemic lupus erythematosus (SLE) are considered to be susceptible to coronavirus due to impaired immune function2. This study aims to systematically evaluate the prevalence of COVID-19 in SLE patients, and futher explore the impact of antirheumatic drug on the clinical outcome of COVID-19 in SLE patients. Method(s): Systematic searches of PubMed, EMBASE, Web of Science, the Cochrane Library and Medline, CNKI, CBM, China Science and Technology Journal Database and Wan Fang Data were performed. Cross-sectional investigations and case series on SLE and COVID-19 were included. Random effects model was used to pool data. Heterogeneity and risk of bias was examined with I squared index (I2) statistic and Egger tests were used for the evaluation of potential publication bias (STATA v.12.0). Result(s): A total of 14 studies comprising 5115 SLE patients and 698 COVID-19 patients were identified. Overall prevalence of COVID-19 in SLE patients was 6.7% (95%CI: 4.4-9.1%). The hospitalization rate was 31.6% (95%CI: 15.8%-47.3%), with the rate of 22.2% (95%CI: 6.2-38.2%) of patients were admitted to ICU, and the death rate was 19.3% (95%CI: 2.7%-35.9%). Eight of the studies included patients who used hydroxychloroquine as part of their treatment regimen, with 5.7% (95%CI: 3.3%-8.0%) prevalence rate. The hospitalisation rates for SLE patients with COVID-19 infection who received glucocorticoid was 69.2% (95%CI: 46.8%-91.6%). The rates of hospitalisation in patients who received hydroxychloroquine was 59.2% (95%CI: 45.8%-72.6%), and in patients who received biologic disease-modifying anti-rheumatic drugs (b-DMARD) was 61.8% (95%CI: 32.7%-90.9%). The adverse outcome rate due to COVID-19 in patients with SLE was 34.1% (95% CI: 4.3%-64%). The rate of adverse outcome in SLE patients diagnosed with COVID-19 who received glucocorticoid was 22.9% (95%CI: 9%-31.5%), and in patients who received hydroxychloroquine was 22.9% (95%CI: 0.1%-45.7%, Figure 1). Conclusion(s): Patients with SLE had a higher risk of COVID-19. Anti-rheumatic drugs may help reduce the prevalence and overall rate of adverse outcomes of COVID-19. Figure 1.

Prevalence and anti-rheumatic drugs on the clinical outcome of COVID-19 in autoimmune rheumatic diseases

Purpose: The pandemic of novel coronavirus disease 2019 (COVID-19) caused by the emerging severe acute respiratory syndrome coronavirus 2 (sars-cov- 2) has become a global health crisis (WHO, 2020b), leading to large number of infections and deaths. Autoimmune rheumatic diseases (ARD) are characterized by immune dysfunction and more susceptible to infection. The prevalence of COVID-19 in ARD patients was estimated by means of meta-analysis, and the effect of the use of anti-rheumatic drugs on the clinical outcome of ARD patients with COVID-19 was investigated. Method(s): Cross-sectional investigations and case series on ARD and COVID-19 published by CBM, CNKI, China Science and Technology Journal Database, Wan Fang Data, PubMed, Embase, Web of Science, Cochrane Library and Medline from its establishment to June 26, 2022 were searched. Random effects model was used to pool data. Heterogeneity and risk of bias was examined with I-squared index (I2) statistic. Egger tests were used for the evaluation of potential publication bias (STATA v.12.0). Result(s): A total of 65 studies comprising 135 515 patients were identified. Overall prevalence of COVID-19 in ARD patients was 5.4% (95%CI: 4.3%-6.5%). The hospitalisation rate due to COVID-19 was 35.9% (95% CI: 28.3%-43.4%). The hospitalisation rates for ARD patients diagnosed with COVID-19 who received glucocorticoid was 35.9% (95%CI: 31.4%-40.4%). The rates of hospitalisation in patients who received hydroxychloroquine was 39.9% (95%CI: 34.5%-45.3%), and in patients who received biologic disease-modifying anti-rheumatic drugs (b-DMARD) was 38.1% (95%CI: 33.6%-42.5%), which were both higher than total hospitalisation. The mortality due to COVID-19 in patients with ARD was 6.0% (95% CI: 5.1%-6.8%). The mortality in ARD patients diagnosed with COVID-19 who received glucocorticoid was 5.3% (95%CI: 4.3%-6.2%), and in patients who received b-DMARD was 5.8% (95%CI: 4.9%-6.7%). Mortality rates for patients who received hydroxychloroquine was 5.2% (95%CI: 4.2%-6.2%) (Figure 1). Conclusion(s): Patients with ARD had a higher risk of COVID-19. Use of glucocorticoids decrease mortality in these patients suffered from COVID-19 infection. Though patients had a higher hospitalisation rates but lower mortality among patients prescribed b-DMARD or hydroxychloroquine. (Figure Presented).

The relationship between serum vitamin D levels with infection and severity of Covid-19 Symptoms in women and children: A systematic review study.

Introduction: Serum levels of vitamin D on the development and exacerbation of symptoms of Covid-19 disease have been expressed and discussed in several studies. The present study was performed aimed to systematically review the studies performed on the relationship between serum level of vitamin D with the incidence and severity of Covid-19 symptoms disease in women and children. Method(s): In this systematic review study, to obtain the related studies, the English databases of Pubmed, Scopus and Web of Science were searched up to April 4, 2021 with the English keywords of Vitamin D and Covid-19 with combination of operators "AND" and "OR". Inclusion criteria were: cohort articles, case-control or cross-sectional and English language articles and the study population were women or children. The quality of articles was assessed using the Strobe checklist. Based on the Strobe criteria, studies which scored moderate and good in the assessment were included in the study. Result(s): Out of 315 articles, 23 qualified articles were reviewed. In these studies, the association between serum vitamin D levels and the incidence, severity, and mortality of Covid-19 was assessed. Two studies included the population of children and 21 studies of women. Conclusion(s): Low serum levels of vitamin D are significantly associated with an increase in the incidence of Covid-19 and the severity of the disease, but this relationship with the mortality rate from the disease provides contradictory results in several studies;therefore, more studies in this field are necessary to achieve more definite results, especially in children. Copyright © 2022, Mashhad University of Medical Sciences. All rights reserved.

"Fibromyalgia" and "Long COVID-19" as a chronic compartment-like syndrome of the whole body (Nineveh, the Shadow is in the Fascia)

Background: The Coronavirus pandemic has impact on our community far beyond the acute phase, "Long COVID-19" is recognized as a new medical entity and resembles "fibromyalgia" which, likewise, lacks a clear mechanism. "Fibromyalgia" is a prevalent and misunderstood condition with significant burden and morbidity. "Central sensitization" and biopsychosocial theories describe "fibromyalgia" as the misfortunate neurological fate of traumatized and stressed individuals that have behavioral, cognitive, social, and/or genetic predisposition for an "infinite-positive- feedback of pain with no peripheral organic lesion/injury". Diagnostic criteria seem biologically arbitrary, treatments are insufficient, and physicians are frustrated. This work suggests a theoretical model with an organic mechanical mechanism to help explain "fibromyalgia", "long COVID-19" and "functional psycho/ somatic syndromes", based on cross-disciplinary empirical studies. A practical evidence-based treatment arsenal, which is derived from this model, is discussed briefly. Method(s): Systematically searched multiple phrases in MEDLINE, EMBASE, COCHRANE, PEDro, and medRxiv, majority with no time limit. Inclusion/exclusion based on title and , then full-text inspection. Additional literature added on relevant side topics. Review follows PRISMA-ScR guidelines. Result(s): 831 records included. The theory of "facial-armoring" suggests fibromyalgia-like entities may be a disease of connective-tissue driven by myofibroblast-generated- tensegrity- tension. This mechanism may explain fibromyalgia's pain, distribution of pain, decreased pressure-pain threshold, tender spots, fatigue, cardiovascular and metabolic abnormalities, autonomic abnormalities, absence of clear inflammation, silent imaging investigations, and other phenomena (e.g., complete resolution soon after surgery). "Long-COVID- 19" is predicted to involve fascial armoring. Conclusion(s): "Fibromyalgia" is a mild-moderate- chronic- compartment- like- syndrome- of- the- whole- body. Treatment should focus on lifestyle and non-pharmacological modalities. Early detection is key. The body and the mind are one being.

Maternal and neonatal morbidity for SARS-CoV-2 infection

Objective: to carry out an updated bibliographic review focused on maternal and neonatal morbidity due to SARSCoV-2 infection with the purpose of evaluating the severity that could occur in these risk groups. Methodology: this study consisted of a systematic review between December 2019 and September 2020 using platforms such as: PubMed, Scopus, Digital Library of the Complutense University of Madrid, Google Scholar and Scielo. The data were tabulated according to the recommendations of the PRISMA guide. Result(s): Of 116 pregnant women with a positive diagnosis for COVID 19, 91.3% had a favorable evolution without requiring intensive care;8.62% presented severe pneumonia and mechanical respiratory assistance and none of them died. On the other hand, of 117 neonates, 93.2% had negative results for COVID-19 while 6.8% had positive results and there were three neonatal deaths not related to COVID-19. Conclusion(s): This indicates that SARS-CoV-2 does not generate greater susceptibility in obstetric patients or neonates and usually only manifests with mild to moderate symptoms. Copyright © 2022, Venezuelan Society of Pharmacology and Clinical and Therapeutic Pharmacology. All rights reserved.

Perspectives on the Pathophysiology, Management, and Relevance of Olfactory and Gustatory Dysfunction to COVID-19, Part One

Context: Amelioration of olfactory and gustatory dysfunction (OGD) disorders has become a common requirement due to COVID-19. Although it's hardly exclusive to COVID-19, OGD's prevalence requires exploration of therapeutic and restorative modalities, on the broadest scale possible. No specific medication or treatment of any noteworthy efficacy exists for OGD. Objective(s): As Part 1 of a three-part article, a narrative review intended to examine the known causes of OGD, not restricted to COVID-19, and frame their relevance for development of new treatments or the repurposing of existing ones. Design(s): The researcher performed a narrative review by searching databases including PubMed, Sciencedirect, Google Scholar, Old Dominion University Libraries, and the websites of various medical journals. Searches included numerous combinations of keywords accompanied by the phrases, loss of sense of smell and taste, olfactory and gustatory dysfunction disorders, as well as the terms anosmia, parosmia, ageusia, and parageusia. Such keywords included viruses, bacteria, fungi, protozoa, parasites, infection, COVID-19, treatments, medications, steroids, supplements, nutrients, alternative medicine, acupuncture, olfactory training, clinical trials, cranial nerves, pathogenesis, pathophysiology, and etiology. Setting(s): The Liebell Clinic, Virginia Beach, VA, USA. Result(s): Scientific investigation into mechanisms and treatment of OGD appears to be historically limited and unremarkable. Medical literature spanning decades reports a bleak clinical outlook with an abundance of speculation and hypotheses. Limited evidence of effective or reliable treatment exists, especially for chronic cases. Conclusion(s): With a dismal lack of medical support for a suddenly prevalent, but hardly novel set of maladies of taste and smell perception;the imperative for multifaceted and broad investigations across all medical disciplines is without question. Global urgency for the development of any treatment capable of reducing or resolving OGD triggered by COVID-19 is unprecedented. Part 2 of the current author's three-part series will address the details of current and past treatment approaches and clinical trials.

Rheumatology research output in the Arab world: Despite the challenges

Background: Rheumatology is a field of daily advancements in terms of diagnostics, pathophysiology, and management. Such advancements are the result of basic sciences, translational, and clinical research. Physical and financial support, which are provided by individuals and organizations, are vital for any form of research. The political and financial instability in the Arab world has affected the process of healthcare advancement and the research output. Material(s) and Method(s): This review looked into the number of rheumatological clinical publications that individual Arab countries produced from 2017 till 2021 which were cited by PubMed/MEDLINE. Publications that included authors from multiple countries were excluded. Publications were then sorted according to type;randomized controlled trial (RCT), cohort, cross-sectional, systematic review, narrative review, and case report. Publications were also sorted according to the Arab world regions;North and East Africa (NEA), Middle East (ME), and Arabian Peninsula (AP). Result(s): Egypt had the highest number of publication among NEA countries, and all Arab countries in general, with 261 publications including 23 RCTs. Saudi Arabia had the highest number of publications among AP countries with 81 publications. However, no individual AP country published a RCT. Lebanon had the highest number of publications among ME countries, but the majority of publications were reviews and case reports. Notably, the number of publications increased in certain countries during the COVID-19 era. Conclusion(s): Despite the political instability and lack of funds, the Arab world is still able to produce clinical rheumatological publications. The impact of such publications on the daily practice of Rheumatology remains questionable.

Economic evaluations of antivirals for pandemic influenza viruses

Background: The coronavirus, COVID-19, has caused a global pandemic of an unprecedented scale. The efficacy of antivirals and other drugs, considered for repurposing, is assessed in clinical trials. It is not clear, however, whether these treatments, when available, will be cost effective. Purpose(s): To systematically review published economic evaluations of antivirals for the management of pandemic influenza. Method(s): The following databases were searched from inception to 26 March 2020: Medline (EBSCO HOST), EMBASE (OVID), EconLit (OVID), NHS EED (OVID) and HTA (OVID). Citation tracking and reference checking were also used. Only full economic evaluations published in the last ten years were included. Studies were quality assessed using NICE economic evaluation checklist. Data were extracted into standard data extraction tables and narratively summarised. Result(s): Of 709 records identified, 14 studies were included. These were mostly conducted in high income countries. They were seven (50.0%) cost-utility analyses, four (28.6%) cost-effectiveness analyses, two (14.3%) cost-consequences analyses, and one (7.1%) cost-benefit analysis. Antiviral treatment-containing strategies were found to be either cost saving or cost effective. Empirical treatment was more cost effective than test-guided treatment for young adults but less for older adults. Infection rate, prevalence, antiviral efficacy and costs were the key drivers of cost effectiveness Conclusion(s): Antiviral treatment for managing pandemic influenza viruses that have high case fatality rate, similar to the COVID-19 pandemic, has shown to be cost effective, either as standalone intervention or part of a multifaceted strategy.

Impact of the COVID-19 pandemic on alcohol use and smoking habits

Background: It is very important to monitor changes in substance use during the pandemic period, as individuals dealing with substance use may be at greater risk for COVID-19, and stress factors and changes resulting from the pandemic may cause alterations in substance use models. Method(s): In this review, the existing literature on how COVID-19 affected people's alcohol consumption, smoking, and vaping use in different societies was evaluated. Articles that are relevant to the subject were searched using PubMed, ScienceDirect and Google Scholar and reviewed. Result(s): It was observed that due to COVID-19, there may be no alterations in these substance use types or it may result in a decrease of consumption of substances or a quit attempt due to health concerns about COVID-19 or it may cause an increase in the alcohol, or cigarette consumption. Conclusion(s): With this review we hope to present detailed information on the impact of the pandemic on alcohol consumption, and cigarette or e-cigarette use from various studies conducted in different societies all around the world and highlight the importance and necessity of new studies on this subject. Copyright © 2023 Taylor & Francis Group, LLC.