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1.
Front Public Health ; 10: 841013, 2022.
Article in English | MEDLINE | ID: covidwho-1776047

ABSTRACT

Background: In the Euregio-Meuse-Rhine (EMR), cross-border collaboration is essential for resource-saving and needs-based patient care within the emergency medical service (EMS) systems and interhospital transport (IHT). However, at the onset of the novel coronavirus SARS-COV-2 (COVID-19) pandemic, differing national measures highlighted the fragmentation within the European Union (EU) in its various approaches to combating the pandemic. To assess the consequences of the pandemic in the EMR border area, the aim of this study was to analyze the effects and "lessons learned" regarding cross-border collaboration in EMS and IHT. Method: A qualitative study with 22 semi-structured interviews was carried out. Experts from across the EMR area, including the City of Aachen, the City region of Aachen, the District of Heinsberg (Germany), South Limburg (The Netherlands), and the Province of Limburg, as well as Liège (Belgium), took part. The interviews were coded and analyzed according to changes in cross-border collaboration before and during the pandemic, as well as lessons learned and recommendations. Results: Each EU member country within the EMR area, addressed the pandemic individually with national measures. Cross-border collaboration between regional actors was hardly or not at all addressed at the national level during political decision- or policymaking. Previous direct communication at the personal level was replaced by national procedures, which made regular cross-border collaboration significantly more difficult. The cross-border transfer regulations of patients with COVID-19 proved to be complex and led, among other things, to patients being transported to hospitals far outside the border region. Collaboration continues to be seen as valuable and Euregional emergency services including hospitals work well together, albeit to different degrees. The information and data exchange should, however, be more transparent to use resources more efficiently. Conclusion: Effective Euregional collaboration of emergency services is imperative for public safety in a multi-border region with strong economic, cultural, and social cross-border links. Our findings indicate that existing (pre-pandemic) structures which included regular meetings of senior managerial staff in the region and a number of thematic working groups were helpful to deal with and to compensate for the disruptions during the crisis. Regional cross-border agreements that are currently based on mutual but more or less informal arrangements need to be formalized and better promoted and recognized also at the national and EU level to increase resilience. The continuous determination of synergies and good and best practices are further approaches to support cross-border collaboration especially in preparation for future crises.


Subject(s)
COVID-19 , Emergency Medical Services , COVID-19/epidemiology , European Union , Expert Testimony , Humans , SARS-CoV-2
2.
PLoS One ; 17(2): e0262740, 2022.
Article in English | MEDLINE | ID: covidwho-1686096

ABSTRACT

OBJECTIVES: Compare lay expectations of medical development to those of experts in the context of SARS-CoV-2 vaccine development. METHODS: A short online survey of experts and lay people measuring when participants believe important vaccine milestones would occur and how likely potential setbacks were. Samples of US and Canadian lay people recruited through Qualtrics. The expert sample was created through a contact network in vaccine development and supplemented with corresponding authors of recent scholarly review articles on vaccine development. RESULTS: In aggregate, lay people gave responses that were within 3 months of experts, tending to be later than experts for early milestones and earlier for later milestones. Median lay best estimates for when a vaccine would be available to the public were 08/2021 and 09/2021 for the US and Canadian samples, compared with 09-10/2021 for the experts. However, many individual lay responses showed more substantial disagreement with expert opinions, with 54% of lay best estimates of when a vaccine would be available to the public being before the median expert soonest estimate or after the median expert latest estimate. Lay people were much more pessimistic about vaccine development encountering setbacks than experts (median probability 59% of boxed warning compared with only 30% for experts). Misalignment between layperson and expert expectations was not explained by any demographic variables collected in our survey. CONCLUSION: Median lay expectations were generally similar to experts. At the individual level, however, lay people showed substantial variation with many believing milestones would occur much sooner than experts. Lay people were in general much more pessimistic about the prospect of setbacks than were experts.


Subject(s)
Expert Testimony , COVID-19/prevention & control , COVID-19/virology , COVID-19 Vaccines/administration & dosage , COVID-19 Vaccines/immunology , Canada , Female , Forecasting , Humans , Male , SARS-CoV-2/isolation & purification , Surveys and Questionnaires , Time Factors , United States
4.
Nurs Outlook ; 69(6): 961-968, 2021.
Article in English | MEDLINE | ID: covidwho-1586894

ABSTRACT

The purpose of this consensus paper was to convene leaders and scholars from eight Expert Panels of the American Academy of Nursing and provide recommendations to advance nursing's roles and responsibility to ensure universal access to palliative care. Part I of this consensus paper herein provides the rationale and background to support the policy, education, research, and clinical practice recommendations put forward in Part II. On behalf of the Academy, the evidence-based recommendations will guide nurses, policy makers, government representatives, professional associations, and interdisciplinary and community partners to integrate palliative nursing services across health and social care settings. The consensus paper's 43 authors represent eight countries (Australia, Canada, England, Kenya, Lebanon, Liberia, South Africa, United States of America) and extensive international health experience, thus providing a global context for the subject matter. The authors recommend greater investments in palliative nursing education and nurse-led research, nurse engagement in policy making, enhanced intersectoral partnerships with nursing, and an increased profile and visibility of palliative nurses worldwide. By enacting these recommendations, nurses working in all settings can assume leading roles in delivering high-quality palliative care globally, particularly for minoritized, marginalized, and other at-risk populations.


Subject(s)
Consensus , Expert Testimony , Hospice and Palliative Care Nursing , Palliative Care , Universal Health Care , Education, Nursing , Global Health , Healthcare Disparities , Humans , Nurse Administrators , Societies, Nursing
5.
Kardiologiia ; 61(10): 99-103, 2021 Oct 30.
Article in Russian | MEDLINE | ID: covidwho-1515681

ABSTRACT

The article presents recent data on possibilities of a broader use of mineralocorticoid receptor antagonists for existing indications and of expanding indications for the use of this pharmaceutical group in the context of the novel coronavirus infection COVID-19. The authors discussed prospects for expanded detection of aldosteronism using a new diagnostic approach, including an additional evaluation of blood pressure response to spironolactone.


Subject(s)
COVID-19 , Hypertension , Expert Testimony , Humans , Mineralocorticoid Receptor Antagonists , SARS-CoV-2 , Spironolactone
6.
J Pediatric Infect Dis Soc ; 11(2): 43-54, 2022 Feb 23.
Article in English | MEDLINE | ID: covidwho-1501084

ABSTRACT

The COVID-19 pandemic continues to generate challenges for pediatric solid organ transplant (SOT) recipients and their families. As rates of COVID-19 fluctuate, new SARS-CoV-2 variants emerge, and adherence to and implementation of mitigation strategies vary from community to community, questions remain about the best and safest practices to prevent COVID-19 in vulnerable patients. Notably, decisions about returning to school remain difficult. We assembled a team of specialists in pediatric infectious diseases, transplant infectious diseases, public health, transplant psychology, and infection prevention and control to re-address concerns about school re-entry, as well as COVID-19 vaccines, for pediatric SOT recipients in the United States in 2021. Based on available literature and guidance from national organizations, we generated expert statements specific to pediatric SOT recipients focused on school attendance in 2021.


Subject(s)
COVID-19 , Organ Transplantation , COVID-19 Vaccines , Child , Expert Testimony , Humans , Pandemics , Return to School , SARS-CoV-2 , Schools , United States , Vaccination
7.
G Ital Cardiol (Rome) ; 22(11): 894-899, 2021 Nov.
Article in Italian | MEDLINE | ID: covidwho-1496712

ABSTRACT

The coronavirus disease (COVID-19) pandemic has caused 2.69 million deaths and 122 million infections. Great efforts have been made worldwide to promptly develop effective vaccines and reduce morbidity and mortality rates from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Available vaccines have proven highly effective at preventing symptomatic disease in clinical trials and real-world reports and are playing an essential role in flattening the epidemiology curve and, mostly, in reducing COVID-19 hospitalizations. Some concerns have been raised after very rare cases of myocarditis and pericarditis recently reported by the Centers for Disease Control and Prevention (CDC) as potentially associated with COVID-19 mRNA vaccinations, namely the Pfizer-BioNTech mRNA vaccine (BNT162b2) and the Moderna mRNA vaccine (mRNA-1273). Therefore, the aim of this document is to explore the possible link between COVID-19 mRNA vaccination and the development of myocarditis and/or pericarditis by performing a critical analysis of available data and to provide indications for specific subgroups of individuals.


Subject(s)
COVID-19 , Cardiology , Myocarditis , Pericarditis , COVID-19 Vaccines , Expert Testimony , Humans , Italy/epidemiology , Myocarditis/etiology , Pericarditis/etiology , RNA, Messenger , SARS-CoV-2 , Vaccination
8.
Leuk Lymphoma ; 63(3): 538-550, 2022 03.
Article in English | MEDLINE | ID: covidwho-1475655

ABSTRACT

In the midst of the COVID-19 pandemic, different vaccines in front of SARS-CoV-2 have been approved and administered in different vulnerable populations. As patients with cancer were excluded from pivotal trials of vaccination, little is known on their immunogenic response to these vaccines, particularly in patients with severely impaired immune system. In response to that uncertainty, the Spanish Society of Hematology and Hemotherapy launched an initiative aimed to provide recommendations for vaccination of the main hematological conditions. This document is based on the available information on COVID-19 outcomes, prior knowledge on vaccination in hematological patients, recent published data on serological response in oncohematological patients and expert opinions. New information about SARS-CoV-2 vaccination will be gathered in the near future, providing new scientific grounds to delineate the most adequate management of vaccination in patients with hematological diseases. The current limited data on SARS-CoV-2 vaccines in hematological patients represents a major limitation of this expert consensus opinion. In fact, the speed in which this field evolves may reduce their validity in the near future.


Subject(s)
COVID-19 , Hematology , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/therapeutic use , Consensus , Expert Testimony , Humans , Pandemics/prevention & control , SARS-CoV-2 , Vaccination
9.
Eur J Endocrinol ; 185(4): G35-G42, 2021 Aug 27.
Article in English | MEDLINE | ID: covidwho-1448609

ABSTRACT

COVID-19 has changed the nature of medical consultations, emphasizing virtual patient counselling, with relevance for patients with diabetes insipidus (DI) or hyponatraemia. The main complication of desmopressin treatment in DI is dilutional hyponatraemia. Since plasma sodium monitoring is not always possible in times of COVID-19, we recommend to delay the desmopressin dose once a week until aquaresis occurs allowing excess retained water to be excreted. Patients should measure their body weight daily. Patients with DI admitted to the hospital with COVID-19 have a high risk for mortality due to volume depletion. Specialists must supervise fluid replacement and dosing of desmopressin. Patients after pituitary surgery should drink to thirst and measure their body weight daily to early recognize the development of postoperative SIAD. They should know hyponatraemia symptoms. Hyponatraemia in COVID-19 is common with a prevalence of 20-30% and is mostly due to SIAD or hypovolaemia. It mirrors disease severity and is an early predictor of mortality. Hypernatraemia may also develop in COVID-19 patients, with a prevalence of 3-5%, especially in ICU, and derives from different multifactorial reasons, for example, due to insensible water losses from pyrexia, increased respiration rate and use of diuretics. Hypernatraemic dehydration may contribute to the high risk of acute kidney injury in COVID-19. IV fluid replacement should be administered with caution in severe cases of COVID-19 because of the risk of pulmonary oedema.


Subject(s)
COVID-19/epidemiology , Diabetes Insipidus/therapy , Endocrinology/standards , Hyponatremia/therapy , Ambulatory Care/methods , Ambulatory Care/standards , Consensus , Diabetes Insipidus/epidemiology , Diabetes Insipidus/pathology , Distance Counseling/methods , Distance Counseling/standards , Endocrinology/history , Endocrinology/trends , Expert Testimony , History, 21st Century , Hospitalization/statistics & numerical data , Humans , Hyponatremia/epidemiology , Hyponatremia/pathology , Pandemics , Practice Patterns, Physicians'/history , Practice Patterns, Physicians'/standards , Practice Patterns, Physicians'/trends , SARS-CoV-2 , Severity of Illness Index , Telemedicine/history , Telemedicine/methods , Telemedicine/standards
10.
Front Public Health ; 9: 698995, 2021.
Article in English | MEDLINE | ID: covidwho-1399188

ABSTRACT

Objective: The first wave of the coronavirus SARS-COV-2 pandemic has revealed a fragmented governance within the European Union (EU) to tackle public health emergencies. This qualitative study aims: 1) to understand the current EU position within the field of public health emergencies taking the case of the COVID-19 as an example by comparing and contrasting experiences from EU institutions and experts from various EU Member States at the beginning of the pandemic; and, 2) to identify and to formulate future EU pandemic strategies and actions based on experts' opinions. Methods: Eighteen semi-structured interviews were conducted with public health experts from various European Member States and European Commission officials from May 2020 until August 2020. The transcripts were analyzed by Thematic Content Analysis (TCA), mainly a manifest content analysis. Results: This study demonstrated that the limited EU mandate in health hinders proper actions to prevent and tackle infectious disease outbreaks, such as the COVID-19 pandemic. The results showed that this limitation significantly impacted the ECDC, as the Member States' competence did not allow the agency to have more capacity. The European Commission has fulfilled its role of coordinating and supporting the Member States by facilitating networks and information exchange. However, EU intra- and inter-communication need further improvement. Although diverse EU instruments and mechanisms were found valid, their implementation needed to be faster and more efficient. The results pointed out that underlying political challenges in EU decision-making regarding health emergencies hinder the aligned response. It was stated that the Member States were not prepared, and due to the restriction of their mandate, EU institutions could not enforce binding guidelines. Additionally, the study explored future EU pandemic strategies and actions. Both, EU institutions and national experts suggested similar and clear recommendations regarding the ECDC, the investment, and future harmonized preparedness tools. Conclusion: The complex politics of public health at the EU level have led to the fragmentation of its governance for effective pandemic responses. This ongoing pandemic has shed light on the fragility of the political and structural systems in Europe in public health emergencies. Health should be of high importance in the political agenda, and robust health reforms at the local, regional, national, and EU levels are highly recommended.


Subject(s)
COVID-19 , Public Health , Emergencies , European Union , Expert Testimony , Humans , Pandemics/prevention & control , SARS-CoV-2
11.
Diabetes Metab Syndr ; 15(5): 102242, 2021.
Article in English | MEDLINE | ID: covidwho-1397297

ABSTRACT

INTRODUCTION: Emergence of COVID-19 pandemic has led to increased use of telemedicine in health care delivery. Telemedicine facilitates long-term clinical care for monitoring and prevention of complications of diabetes mellitus. GUIDELINES: Precise indications for teleconsultation, clinical care services which can be provided, and good clinical practices to be followed during teleconsultation are explained. Guidance on risk assessment and health education for diabetes risk factors, counselling for blood glucose monitoring, treatment compliance, and prevention of complications are described. CONCLUSION: The guidelines will help physicians in adopting teleconsultation for management of diabetes mellitus, facilitate access to diabetes care and improve health outcomes.


Subject(s)
COVID-19/epidemiology , Diabetes Mellitus, Type 2/therapy , Remote Consultation/standards , Biomedical Research/organization & administration , Biomedical Research/standards , COVID-19/prevention & control , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Communicable Disease Control/standards , Delivery of Health Care/organization & administration , Delivery of Health Care/standards , Diabetes Mellitus, Type 2/epidemiology , Expert Testimony , Humans , India/epidemiology , Pandemics , Remote Consultation/methods , Remote Consultation/organization & administration , Telemedicine/organization & administration , Telemedicine/standards
13.
Anaesth Intensive Care ; 49(4): 268-274, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1341368

ABSTRACT

The use of high flow nasal oxygen in the care of COVID-19-positive adult patients remains an area of contention. Early guidelines have discouraged the use of high flow nasal oxygen therapy in this setting due to the risk of viral spread to healthcare workers. However, there is the need to balance the relative risks of increased aerosol generation and virus transmission to healthcare workers against the role high flow nasal oxygen has in reducing hypoxaemia when managing the airway in high-risk patients during intubation or sedation procedures. The authors of this article undertook a narrative review to present results from several recent papers. Surrogate outcome studies suggest that the risk of high flow nasal oxygen in dispersing aerosol-sized particles is probably not as great as first perceived. Smoke laser-visualisation experiments and particle counter studies suggest that the generation and dispersion of bio-aerosols via high flow nasal oxygen with flow rates up to 60 l/min is similar to standard oxygen therapies. The risk appears to be similar to oxygen supplementation via a Hudson mask at 15 l/min and significantly less than low flow nasal prong oxygen 1-5 l/min, nasal continuous positive airway pressure with ill-fitting masks, bilevel positive airway pressure, or from a coughing patient. However, given the limited safety data, we recommend a cautious approach. For intubation in the COVID-positive or suspected COVID-positive patient we support the use of high flow nasal oxygen to extend time to desaturation in the at-risk groups, which include the morbidly obese, those with predicted difficult airways and patients with significant hypoxaemia, ensuring well-fitted high flow nasal oxygen prongs with staff wearing full personal protective equipment. For sedation cases, we support the use of high flow nasal oxygen when there is an elevated risk of hypoxaemia (e.g. bariatric endoscopy or prone-positioned procedures), but recommend securing the airway with a cuffed endotracheal tube for the longer duration procedures when theatre staff remain in close proximity to the upper airway, or considering the use of a surgical mask to reduce the risk of exhaled particle dispersion.


Subject(s)
COVID-19 , Obesity, Morbid , Adult , Continuous Positive Airway Pressure , Expert Testimony , Humans , Oxygen , SARS-CoV-2
14.
Intern Emerg Med ; 16(5): 1113-1119, 2021 08.
Article in English | MEDLINE | ID: covidwho-1287454

ABSTRACT

The amazing effort of vaccination against COVID-19, with more than 2 billion vaccine doses administered all around the world as of 16 June 2021, has changed the history of this pandemic, drastically reducing the number of severe cases or deaths in countries were mass vaccination campaign have been carried out. However, the people's rising enthusiasm has been blunted in late February 2021 by the report of several cases of unusual thrombotic events in combination with thrombocytopenia after vaccination with ChAdOx1 nCov-19 (Vaxzevria), and a few months later also after Ad26.COV2. S vaccines. Of note, both products used an Adenovirus-based (AdV) platform to deliver the mRNA molecule - coding for the spike protein of SARS-CoV-2. A clinical entity characterized by cerebral and/or splanchnic vein thrombosis, often associated with multiple thromboses, with thrombocytopenia and bleeding, and sometimes disseminated intravascular coagulation (DIC), was soon recognized as a new syndrome, named vaccine-induced immune thrombotic thrombocytopenia (VITT) or thrombosis with thrombocytopenia syndrome (TTS). VITT was mainly observed in females under 55 years of age, between 4 and 16 days after receiving only Adenovirus-based vaccine and displayed a seriously high fatality rate. This prompted the Medicine Regulatory Agencies of various countries to enforce the pharmacovigilance programs, and to provide some advices to restrict the use of AdV-based vaccines to some age groups. This point-of view is aimed at providing a comprehensive review of epidemiological issues, pathogenetic hypothesis and treatment strategies of this rare but compelling syndrome, thus helping physicians to offer an up-to dated and evidence-based counseling to their often alarmed patients.


Subject(s)
COVID-19 Vaccines/adverse effects , Thrombocytopenia/etiology , Vaccination/statistics & numerical data , Biomarkers/analysis , COVID-19 Vaccines/pharmacokinetics , COVID-19 Vaccines/therapeutic use , Correlation of Data , Expert Testimony , Humans , Thrombocytopenia/physiopathology , Vaccination/adverse effects , Vaccination/methods
15.
Postgrad Med ; 133(6): 592-598, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1281769

ABSTRACT

OBJECTIVES: COVID19 pandemic has forced physicians from different specialties to assist cases overload. Our aim is to assess gastroenterologist's assistance in COVID-19 by assessing mortality, ICU admission, and length of stay, and seek for risk factors for in-hospital mortality and longer hospital stay. METHODS: A total of 41 COVID-19 patients assisted by gastroenterologist (GI cohort) and 137 assisted by pulmonologist, internal medicine practitioners, and infectious disease specialists (COVID expert cohort) during October-November 2020 were prospectively collected. Clinical, demographic, imaging, and laboratory markers were collected and compared between both cohorts. Bivariate analysis and logistic regression were performed to search for risk factors of mortality and longer hospital stays. RESULTS: A total of 27 patients died (15.1%), 11 were admitted to ICU (6.1%). There were no differences between cohorts in mortality (14.6% vs 15.4%;p = 0.90), ICU admission (12.1% vs 4%;p = 0.13), and length of stay (6.67 ± 4 vs 7.15 ± 4.5 days; p = 0.58). PaO2/FiO2 on admission (OR 0.991;CI95% 0.984-0.998) and age > 70 (OR 17.54;CI95% 3.93-78.22) were independently related to mortality. Age > 70, history of malignancy, diabetes, and cardiovascular disease were related to longer hospital stays (p < 0.001, p = 0.03, p = 0.04, p = 0.02 respectively). CONCLUSIONS: COVID-19 assistance was similar between gastroenterologist and COVID experts when assessing mortality, ICU admission, and length of stay. Age>70 and decreased PaO2/FiO2 on admission were independent risk factors of mortality. Age and several comorbidities were related to longer hospital stay.


Subject(s)
COVID-19 , Expert Testimony , Gastroenterologists/statistics & numerical data , Length of Stay/statistics & numerical data , Age Factors , Aged , COVID-19/diagnosis , COVID-19/mortality , COVID-19/physiopathology , Comorbidity , Expert Testimony/methods , Expert Testimony/statistics & numerical data , Female , Hospital Mortality , Hospitalization/statistics & numerical data , Humans , Interdisciplinary Communication , Male , Prognosis , Risk Assessment/methods , Risk Assessment/statistics & numerical data , Risk Factors , SARS-CoV-2/isolation & purification , Spain/epidemiology
16.
Kardiol Pol ; 79(5): 595-603, 2021.
Article in English | MEDLINE | ID: covidwho-1268476

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic resulted in an urgent need to reorganize the work of echocardiography laboratories in order to ensure the safety of patients and the protection of physicians, technicians, and other staff members. In the previous Expert Opinion of the Working Group on Echocardiography of Polish Cardiac Society we provided recommendations for the echocardiographic services, in order to ensure maximum possible safety and efficiency of imagers facing epidemic threat. Now, with much better knowledge and larger experience in treating COVID-19 patients and with introduction of vaccination programs, we present updated recommendations for performing transthoracic and transesophageal examinations, including information on the potential impact of personnel and the patient vaccination program, and growing numbers of convalescents on performance of echocardiographic laboratories, with the goal of their ultimate reopening.


Subject(s)
COVID-19 , Pandemics , Echocardiography , Expert Testimony , Humans , Poland , SARS-CoV-2 , Vaccination
17.
Comput Math Methods Med ; 2021: 5527271, 2021.
Article in English | MEDLINE | ID: covidwho-1226786

ABSTRACT

The reverse transcriptase polymerase chain reaction (RT-PCR) is still the routinely used test for the diagnosis of SARS-CoV-2 (COVID-19). However, according to several reports, RT-PCR showed a low sensitivity and multiple tests may be required to rule out false negative results. Recently, chest computed tomography (CT) has been an efficient tool to diagnose COVID-19 as it is directly affecting the lungs. In this paper, we investigate the application of pre-trained models in diagnosing patients who are positive for COVID-19 and differentiating it from normal patients, who tested negative for coronavirus. The study aims to compare the generalization capabilities of deep learning models with two thoracic radiologists in diagnosing COVID-19 chest CT images. A dataset of 3000 images was obtained from the Near East Hospital, Cyprus, and used to train and to test the three employed pre-trained models. In a test set of 250 images used to evaluate the deep neural networks and the radiologists, it was found that deep networks (ResNet-18, ResNet-50, and DenseNet-201) can outperform the radiologists in terms of higher accuracy (97.8%), sensitivity (98.1%), specificity (97.3%), precision (98.4%), and F1-score (198.25%), in classifying COVID-19 images.


Subject(s)
COVID-19 Testing/methods , COVID-19/diagnostic imaging , Deep Learning , Radiologists , SARS-CoV-2 , Tomography, X-Ray Computed , COVID-19/epidemiology , COVID-19 Testing/statistics & numerical data , Databases, Factual , Diagnosis, Computer-Assisted/methods , Diagnosis, Computer-Assisted/statistics & numerical data , Diagnostic Errors/statistics & numerical data , Expert Testimony/statistics & numerical data , Humans , Lung/diagnostic imaging , Mathematical Concepts , Neural Networks, Computer , Pandemics , Radiologists/statistics & numerical data , Tomography, X-Ray Computed/statistics & numerical data
18.
Front Immunol ; 12: 656362, 2021.
Article in English | MEDLINE | ID: covidwho-1211814

ABSTRACT

Since March 2020, the outbreak of Sars-CoV-2 pandemic has changed medical practice and daily routine around the world. Huge efforts from pharmacological industries have led to the development of COVID-19 vaccines. In particular two mRNA vaccines, namely the BNT162b2 (Pfizer-BioNTech) and the mRNA-1273 (Moderna), and a viral-vectored vaccine, i.e. ChAdOx1 nCoV-19 (AstraZeneca), have recently been approved in Europe. Clinical trials on these vaccines have been published on the general population showing a high efficacy with minor adverse events. However, specific data about the efficacy and safety of these vaccines in patients with immune-mediated inflammatory diseases (IMIDs) are still lacking. Moreover, the limited availability of these vaccines requires prioritizing some vulnerable categories of patients compared to others. In this position paper, we propose the point of view about the management of COVID-19 vaccination from Italian experts on IMIDs and the identification of high-risk groups according to the different diseases and their chronic therapy.


Subject(s)
COVID-19 Vaccines/immunology , COVID-19/complications , COVID-19/prevention & control , Immune System Diseases/virology , Vaccination/methods , Diabetes Mellitus/immunology , Diabetes Mellitus/virology , Europe , Expert Testimony , Glomerulonephritis/complications , Glomerulonephritis/immunology , Glomerulonephritis/virology , Humans , Inflammation/immunology , Inflammation/virology , Inflammatory Bowel Diseases/complications , Inflammatory Bowel Diseases/immunology , Inflammatory Bowel Diseases/virology , Lung Diseases/complications , Lung Diseases/immunology , Lung Diseases/virology , Pandemics/prevention & control , Rheumatic Diseases/complications , Rheumatic Diseases/immunology , Rheumatic Diseases/virology , Skin Diseases/complications , Skin Diseases/immunology , Skin Diseases/virology , Uveitis/complications , Uveitis/immunology , Uveitis/virology
19.
Ann Ig ; 33(4): 360-370, 2021.
Article in English | MEDLINE | ID: covidwho-1206443

ABSTRACT

Introduction: The outbreak of Coronavirus Disease 2019 (COVID-19) have changed into a global crisis. Psychologically, this process of alteration can lead to feelings of fear, insecurity, and anxiety. This fear and anxiety can be caused by a variety of factors. However, due to the lack of extensive studies at this time, there are little data on these conditions related to COVID-19. Therefore, in this narrative review, we have tried to identify the most important possible causes of anxiety and fear due to this disease, based on logical shreds of evidence. Then we tried to discuss the consequences and ways to manage and prevent them. Methods: The current focus was on three major axes of corona-phobia, fear and anxiety. PubMed, Science Direct, Scopus, Google Scholar and authoritative news and information sources were considered as the data sources. Results: Findings from the analysis of the results revealed that, in addition to the real and the logical reasons which belong to the intrinsic properties of SARS-CoV-2, some misleadings and misconceptions induced by media, governmental policies, public awareness level, and non-scientific speculations and contradictory data expressed by experts, researchers and scientific societies, could provide the way for the development of corona-phobia, and fear. Conclusions: Each of these causal components, in its place, leads to some degrees of psychological disorders and subsequent consequences and complications. Finally, here we reviewed, summarized the previous research findings on how to prevent and manage this type of psychological disorder, and made comparisons.


Subject(s)
Anxiety/etiology , COVID-19/psychology , Fear/psychology , Pandemics , Phobic Disorders/etiology , SARS-CoV-2 , Anxiety/prevention & control , Anxiety/psychology , Communication , Consumer Health Information , Culture , Dissent and Disputes , Expert Testimony , Health Policy , Humans , Information Dissemination , Mass Media , Phobic Disorders/psychology , Quarantine/psychology , Trust
20.
Updates Surg ; 74(1): 325-335, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1174027

ABSTRACT

PURPOSE: The COVID-19 pandemic brought unprecedented conditions for overall health care systems by restricting resources for non-COVID-19 patients. As the burden of the disease escalates, routine elective surgeries are being cancelled. The aim of this paper was to provide a guideline for management of endocrine surgical disorders during a pandemic. METHODS: We used Delphi method with a nine-scale Likert scale on two rounds of voting involving 64 experienced eminent surgeons and endocrinologists who had the necessary experience to provide insight on endocrine disorder management. All voting was done by email using a standard questionnaire. RESULTS: Overall, 37 recommendations were voted on. In two rounds, all recommendations reached an agreement and were either endorsed or rejected. Endorsed statements include dietary change in primary hyperparathyroidism, Cinacalcet treatment in secondary hyperparathyroidism, alpha-blocker administration for pheochromocytoma, methimazole ± ß-blocker combination for Graves' disease, and follow-up for fine-needle aspiration results of thyroid nodules indicated as Bethesda 3-4 cytological results and papillary microcarcinoma. CONCLUSION: This survey summarizes expert opinion for the management of endocrine surgical conditions during unprecedented times when access to surgical treatment is severely disrupted. The statements are not applicable in circumstances in which surgical treatment is possible.


Subject(s)
COVID-19 , Pandemics , Consensus , Expert Testimony , Humans , SARS-CoV-2
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