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2.
Epidemiol Health ; 43: e2021007, 2021.
Artículo en Inglés | MEDLINE | ID: covidwho-1094290

RESUMEN

OBJECTIVES: This study explored socioeconomic disparities in Korea using health insurance type as a proxy during the ongoing coronavirus disease 2019 (COVID-19) pandemic. METHODS: We conducted a retrospective cohort study using Korea's nationwide healthcare database, which contained all individuals who received a diagnostic test for COVID-19 (n=232,390) as of May 15, 2020. We classified our cohort by health insurance type into beneficiaries of the National Health Insurance (NHI) or Medicaid programs. Our study outcomes were infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and COVID-19-related outcomes, a composite of all-cause death, intensive care unit admission, and mechanical ventilation use. We estimated age-, sex-, and Charlson comorbidity index score-adjusted odds ratios (aORs) with 95% confidence intervals (CIs) using a multivariable logistic regression analysis. RESULTS: Of the 218,070 NHI and 14,320 Medicaid beneficiaries who received COVID-19 tests, 7,777 and 738 tested positive, respectively. The Medicaid beneficiaries were older (mean age, 57.5 vs. 47.8 years), more likely to be males (47.2 vs. 40.2%), and had a higher comorbidity burden (mean CCI, 2.0 vs. 1.7) than NHI beneficiaries. Compared to NHI beneficiaries, Medicaid beneficiaries had a 22% increased risk of SARS-CoV-2 infection (aOR, 1.22; 95% CI, 1.09 to 1.38), but had no significantly elevated risk of COVID-19-related outcomes (aOR 1.10, 95% CI 0.77 to 1.57); the individual events of the composite outcome yielded similar findings. CONCLUSIONS: As socioeconomic factors, with health insurance as a proxy, could serve as determinants during the current pandemic, pre-emptive support is needed for high-risk groups to slow its spread.


Asunto(s)
/estadística & datos numéricos , Disparidades en Atención de Salud/economía , Seguro de Salud/estadística & datos numéricos , Pandemias , Adulto , Anciano , Anciano de 80 o más Años , Bases de Datos Factuales , Femenino , Humanos , Revisión de Utilización de Seguros , Masculino , Persona de Mediana Edad , República de Corea/epidemiología , Estudios Retrospectivos , Factores Socioeconómicos , Adulto Joven
3.
Int J Mol Sci ; 22(4)2021 Feb 09.
Artículo en Inglés | MEDLINE | ID: covidwho-1094249

RESUMEN

BACKGROUND: Preexisting immunity to SARS-CoV-2 could be related to cross-reactive antibodies to common human-coronaviruses (HCoVs). This study aimed to evaluate whether human milk antibodies against to S1 and S2 subunits SARS-CoV-2 are cross-reactive to S1 and S2 subunits HCoV-OC43 and HCoV-229E in mothers with a confirmed COVID-19 PCR test, in mothers with previous viral symptoms during COVID-19 pandemic, and in unexposed mothers; Methods: The levels of secretory IgA (SIgA)/IgA, secretory IgM (SIgM)/IgM, and IgG specific to S1 and S2 SARS-CoV-2, and reactive to S1 + S2 HCoV-OC43, and HCoV-229E were measured in milk from 7 mothers with a confirmed COVID-19 PCR test, 20 mothers with viral symptoms, and unexposed mothers (6 Ctl1-2018 and 16 Ctl2-2018) using ELISA; Results: The S2 SARS-CoV-2 IgG levels were higher in the COVID-19 PCR (p = 0.014) and viral symptom (p = 0.040) groups than in the Ctl1-2018 group. We detected a higher number of positive correlations between the antigens and secretory antibodies in the COVID-19 PCR group than in the viral symptom and Ctl-2018 groups. S1 + S2 HCoV-OC43-reactive IgG was higher in the COVID-19 group than in the control group (p = 0.002) but did not differ for the other antibodies; Conclusions: Mothers with a confirmed COVID-19 PCR and mothers with previous viral symptoms had preexisting human milk antibodies against S2 subunit SARS-CoV-2. Human milk IgG were more specific to S2 subunit SARS-CoV-2 than other antibodies, whereas SIgA and SIgM were polyreactive and cross-reactive to S1 or S2 subunit SARS-CoV-2.


Asunto(s)
Anticuerpos Antivirales/inmunología , Coronavirus Humano 229E/metabolismo , Coronavirus Humano OC43/metabolismo , Leche Humana/metabolismo , Glicoproteína de la Espiga del Coronavirus/inmunología , Adulto , Reacciones Antígeno-Anticuerpo , Reacciones Cruzadas , Femenino , Humanos , Inmunoglobulina G/inmunología , Inmunoglobulina G/metabolismo , Inmunoglobulina M/inmunología , Madres , Reacción en Cadena de la Polimerasa , ARN Viral/metabolismo , /aislamiento & purificación , /metabolismo
4.
Cells ; 10(2)2021 02 10.
Artículo en Inglés | MEDLINE | ID: covidwho-1094233

RESUMEN

Clinical manifestations of coronavirus disease 2019 (COVID-19) in pregnant women are diverse, and little is known of the impact of the disease on placental physiology. Severe acute respiratory syndrome coronavirus (SARS-CoV-2) has been detected in the human placenta, and its binding receptor ACE2 is present in a variety of placental cells, including endothelium. Here, we analyze the impact of COVID-19 in placental endothelium, studying by immunofluorescence the expression of von Willebrand factor (vWf), claudin-5, and vascular endothelial (VE) cadherin in the decidua and chorionic villi of placentas from women with mild and severe COVID-19 in comparison to healthy controls. Our results indicate that: (1) vWf expression increases in the endothelium of decidua and chorionic villi of placentas derived from women with COVID-19, being higher in severe cases; (2) Claudin-5 and VE-cadherin expression decrease in the decidua and chorionic villus of placentas from women with severe COVID-19 but not in those with mild disease. Placental histological analysis reveals thrombosis, infarcts, and vascular wall remodeling, confirming the deleterious effect of COVID-19 on placental vessels. Together, these results suggest that placentas from women with COVID-19 have a condition of leaky endothelium and thrombosis, which is sensitive to disease severity.


Asunto(s)
/complicaciones , Placenta/irrigación sanguínea , Placenta/patología , Complicaciones Cardiovasculares del Embarazo/etiología , Complicaciones Infecciosas del Embarazo/etiología , Trombosis/etiología , Adulto , Antígenos CD/análisis , /virología , Cadherinas/análisis , Claudina-5/análisis , Endotelio/irrigación sanguínea , Endotelio/patología , Endotelio/virología , Femenino , Humanos , Recién Nacido , Microvasos/patología , Microvasos/virología , Embarazo , Complicaciones Cardiovasculares del Embarazo/patología , Complicaciones Cardiovasculares del Embarazo/virología , Complicaciones Infecciosas del Embarazo/patología , Complicaciones Infecciosas del Embarazo/virología , Trombosis/patología , Trombosis/virología , Adulto Joven , Factor de von Willebrand/análisis
7.
Medicine (Baltimore) ; 100(7): e24668, 2021 Feb 19.
Artículo en Inglés | MEDLINE | ID: covidwho-1091183

RESUMEN

ABSTRACT: We aimed to retrospectively analyze the clinical and computed tomography (CT) characteristics of young adults with Coronavirus Disease 2019 (COVID-19) pneumonia who were critically ill and to identify the features associated with non-survival.Thirty-eight COVID-19 patients (20-45 years old, 28 men) who had been admitted in the intensive care unit were included, including 18 non-survivors (group 1) and 20 survivors (group 2). Their clinical characteristics and initial and follow-up CT were compared between groups.In group 1, the days from illness onset to death were 21.1 ±â€Š10.3 days; 7 patients had underlying comorbidities. At admission, group 1 exhibited higher serum ferritin and interleukin-6 (IL-6) levels (1142.6 ±â€Š242.4 mg/L and 33.8 ±â€Š18.6 mmol/L) compared with group 2 (728.3 ±â€Š150.9 mg/L and 15.2 ±â€Š6.9 mmol/L, P < .01). Group 1 exhibited more rapidly progressive opacities and consolidation in follow-up CT (16.7 ±â€Š3.1 scores, 15.7 ±â€Š3.1 segments) than group 2 (11.4 ±â€Š4.0 scores, 10.3 ±â€Š4.6 segments, P < .01). The oxygenation index was lower (87.6 ±â€Š19.2 vs 99.1 ±â€Š20.4 mm Hg) and the mechanical ventilation duration was longer (14.7 ±â€Š6.9 vs 9.7 ±â€Š3.7 days) in group 1 compare with group 2 (P < .01).Compared with the survivors, the non-survivors showed higher serum ferritin and IL-6 levels, more rapidly progressive opacities in CT, lower oxygenation index, and longer mechanical ventilation durations. Special attention to ferritin/IL-6 levels and oxygenation index as well as early CT application and timely reexaminations are important to identify the individuals who may be at risk of becoming critically ill.


Asunto(s)
/diagnóstico , Neumonía Viral/diagnóstico , Neumonía Viral/inmunología , Neumonía Viral/mortalidad , Tomografía Computarizada por Rayos X/métodos , Adulto , Enfermedad Crítica , Progresión de la Enfermedad , Femenino , Humanos , Masculino , Neumonía Viral/virología , Estudios Retrospectivos , Análisis de Supervivencia
8.
Medicine (Baltimore) ; 100(7): e24821, 2021 Feb 19.
Artículo en Inglés | MEDLINE | ID: covidwho-1091181

RESUMEN

ABSTRACT: The COVID-19 pandemic has disrupted teaching in a variety of institutions, especially in medical schools. Electronic learning (e-learning) became the core method of teaching the curriculum during the pandemic. After 8 weeks of only online learning, a survey was conducted to investigate perception of this type of learning among medical students.A survey was conducted by distributing an online questionnaire to Polish medical students. Data gathered from the survey were analyzed with routine statistical software.Eight hundred four students answered the questionnaire. According to respondents' answers, the main advantages of online learning were the ability to stay at home (69%), continuous access to online materials (69%), learning at your own pace (64%), and comfortable surroundings (54%). The majority of respondents chose lack of interactions with patients (70%) and technical problems with IT equipment (54%) as the main disadvantages. There was no statistical difference between face-to-face and online learning in terms of opinions on the ability of the learning method to increase knowledge (P = .46). E-learning was considered less effective than face-to-face learning in terms of increasing skills (P < .001) and social competences (P < .001). Students assessed that they were less active during online classes compared to traditional classes (P < .001). E-learning was rated as enjoyable by 73% of respondents.E-learning is a powerful tool for teaching medical students. However, successful implementation of online learning into the curriculum requires a well thought-out strategy and a more active approach.


Asunto(s)
/epidemiología , Educación a Distancia/métodos , Educación de Pregrado en Medicina/métodos , Estudiantes de Medicina/psicología , Adulto , Femenino , Humanos , Masculino , Pandemias , Polonia/epidemiología , Encuestas y Cuestionarios
9.
BMC Infect Dis ; 21(1): 192, 2021 Feb 18.
Artículo en Inglés | MEDLINE | ID: covidwho-1090689

RESUMEN

BACKGROUND: Coronavirus disease 2019 (COVID-19) has caused a global pandemic that has raised worldwide concern. This study aims to investigate the correlation between the extent of lung infection and relevant clinical laboratory testing indicators in COVID-19 and to analyse its underlying mechanism. METHODS: Chest high-resolution computer tomography (CT) images and laboratory examination data of 31 patients with COVID-19 were extracted, and the lesion areas in CT images were quantitatively segmented and calculated using a deep learning (DL) system. A cross-sectional study method was carried out to explore the differences among the proportions of lung lobe infection and to correlate the percentage of infection (POI) of the whole lung in all patients with clinical laboratory examination values. RESULTS: No significant difference in the proportion of infection was noted among various lung lobes (P > 0.05). The POI of total lung was negatively correlated with the peripheral blood lymphocyte percentage (L%) (r = - 0.633, P < 0.001) and lymphocyte (LY) count (r = - 0.555, P = 0.001) but positively correlated with the neutrophil percentage (N%) (r = 0.565, P = 0.001). Otherwise, the POI was not significantly correlated with the peripheral blood white blood cell (WBC) count, monocyte percentage (M%) or haemoglobin (HGB) content. In some patients, as the infection progressed, the L% and LY count decreased progressively accompanied by a continuous increase in the N%. CONCLUSIONS: Lung lesions in COVID-19 patients are significantly correlated with the peripheral blood lymphocyte and neutrophil levels, both of which could serve as prognostic indicators that provide warning implications, and contribute to clinical interventions in patients.


Asunto(s)
/diagnóstico por imagen , Pulmón/patología , Aprendizaje Automático , Adulto , Técnicas de Laboratorio Clínico , Estudios Transversales , Femenino , Humanos , Pulmón/diagnóstico por imagen , Pulmón/virología , Recuento de Linfocitos , Linfocitos/citología , Masculino , Persona de Mediana Edad , Neutrófilos/citología , Pandemias , Pronóstico , Índice de Severidad de la Enfermedad , Tomografía Computarizada por Rayos X
10.
BMC Infect Dis ; 21(1): 187, 2021 Feb 18.
Artículo en Inglés | MEDLINE | ID: covidwho-1090687

RESUMEN

BACKGROUND: Thresholds for SARS-CoV-2 antibody assays have typically been determined using samples from symptomatic, often hospitalised, patients. In this setting the sensitivity and specificity of the best performing assays can both exceed 98%. However, antibody assay performance following mild infection is less clear. METHODS: We assessed quantitative IgG responses in a cohort of healthcare workers in Oxford, UK, with a high pre-test probability of Covid-19, in particular the 991/11,475(8.6%) who reported loss of smell/taste. We use anosmia/ageusia and other risk factors as probes for Covid-19 infection potentially undiagnosed by immunoassays by investigating their relationship with antibody readings either side of assay thresholds. RESULTS: The proportion of healthcare workers reporting anosmia/ageusia increased at antibody readings below diagnostic thresholds using an in-house ELISA (n = 9324) and the Abbott Architect chemiluminescent microparticle immunoassay (CMIA; n = 11,324): 426/906 (47%) reported anosmia/ageusia with a positive ELISA, 59/449 (13.1%) with high-negative and 326/7969 (4.1%) with low-negative readings. Similarly, by CMIA, 518/1093 (47.4%) with a positive result reported anosmia/ageusia, 106/686 (15.5%) with a high-negative and 358/9563 (3.7%) with a low-negative result. Adjusting for the proportion of staff reporting anosmia/ageusia suggests the sensitivity of both assays in mild infection is lower than previously reported: Oxford ELISA 89.8% (95%CI 86.6-92.8%) and Abbott CMIA 79.3% (75.9-82.7%). CONCLUSION: Following mild SARS-CoV-2 infection 10-30% of individuals may have negative immunoassay results. While lowered diagnostic thresholds may result in unacceptable specificity, our findings have implications for epidemiological analyses and result interpretation in individuals with a high pre-test probability. Samples from mild PCR-confirmed infections should be included in SARS-CoV-2 immunoassay evaluations.


Asunto(s)
Anticuerpos Antivirales/análisis , /diagnóstico , Inmunoglobulina G/análisis , Adulto , Ageusia/virología , Infecciones Asintomáticas , Ensayo de Inmunoadsorción Enzimática/normas , Femenino , Personal de Salud , Humanos , Inmunoensayo/normas , Masculino , Persona de Mediana Edad , Sensibilidad y Especificidad , Enfermedades no Diagnosticadas , Reino Unido
11.
Malar J ; 20(1): 88, 2021 Feb 12.
Artículo en Inglés | MEDLINE | ID: covidwho-1090664

RESUMEN

BACKGROUND: Malaria remains a serious health threat in the Amazonas Region of Peru and approximately 95% of the cases, mainly Plasmodium vivax, are found in native communities of The Rio Santiago District, Condorcanqui Province. In 2019, more than one thousand malaria cases were reported, with an unusual number of Plasmodium falciparum autochthonous cases. The present study aims to report this P. falciparum outbreak while describing the epidemiology of malaria and the risk factors associated in the native communities of Amazonas, Peru. METHODS: The DIRESA-Amazonas in collaboration with the Condorcanqui Health Network and the Institute of Tropical Diseases of the UNTRM carried out a malaria Active Case Detection (ACD III) between January 31st and February 10th of 2020. A total of 2718 (47.4%) individuals from 21 native communities grouped in eight sanitary districts, were screened for malaria infections. Each participant was screened for malaria using microscopy. Follow-up surveys were conducted for all malaria positive individuals to collect socio-demographic data. Spatial clustering of infection risk was calculated using a generalized linear model (GLM). Analysis of risk considered factors such as gender, age, type of infection, symptomatology, and parasitaemia. RESULTS: The study suggests that the P. falciparum index case was imported from Loreto and later spread to other communities of Rio Santiago during 2019. The ACD III reported 220 (8.1%) malaria cases, 46 P. falciparum, 168 P. vivax and 6 mixed infections. SaTScan analysis detected a cluster of high infection risk in Middle Rio Santiago and a particular high P. falciparum infection risk cluster in Upper Rio Santiago. Interestingly, the evaluation of different risk factors showed significant associations between low parasitaemia and P. falciparum asymptomatic cases. CONCLUSION: This is the first report of a P. falciparum outbreak in native communities of Condorcanqui, Amazonas. Timely identification and treatment of symptomatic and asymptomatic cases are critical to achieve malaria control and possible elimination in this area. However, the current malaria situation in Condorcanqui is uncertain, given that malaria ACD activities have been postponed due to COVID-19.


Asunto(s)
Brotes de Enfermedades , Malaria Falciparum/epidemiología , Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Perú/epidemiología , Población Rural , Adulto Joven
12.
Rev Bras Enferm ; 74Suppl 1(Suppl 1): e20200281, 2021.
Artículo en Inglés, Portugués | MEDLINE | ID: covidwho-1090511

RESUMEN

OBJECTIVE: to report the experience of professors and students of a graduate course on nursing care in coping with the new coronavirus (COVID-19) based on Self-Care Theory. METHOD: the active methodologies used were a literature search and seminar presentations, with an understanding of Orem's theoretical concepts: health; man; self-care; universal, developmental and health deviation requirements; self-care activities; self-care deficits; the required therapeutic demand; nursing systems. The pandemic was considered a health deviation that requires critical thinking and nursing care planning. Methodological frameworks to classify nursing diagnoses, interventions, and outcomes were used. RESULTS: for each health deviation, nursing systems were identified; self-care deficits, diagnoses; actions, interventions; and the form of assessment, outcomes. FINAL CONSIDERATIONS: theoretical-practical reflections of the academic context support nursing care planning.


Asunto(s)
/diagnóstico , Educación de Postgrado en Enfermería/organización & administración , Atención de Enfermería/normas , Técnicas de Planificación , Guías de Práctica Clínica como Asunto , Adulto , Brasil , Curriculum , Femenino , Política de Salud , Humanos , Masculino , Teoría de Enfermería , Adulto Joven
13.
Rev Bras Enferm ; 74Suppl 1(Suppl 1): e20200576, 2021.
Artículo en Inglés, Portugués | MEDLINE | ID: covidwho-1090510

RESUMEN

OBJECTIVE: Reflect, in the light of the Health Belief Model, on the adoption of behavioral measures in the context of COVID-19. METHODS: Theoretical-reflective essay, based on the Health Belief Model, to reflect on adherence to preventive behaviors in the pandemic of COVID-19. RESULTS: Adherence to preventive behaviors is strongly influenced by socioeconomic, territorial, political and individual factors in the face of critical health situations. In addition, the spread of false news modulates the thinking and execution of behavioral actions in the population. FINAL CONSIDERATIONS: It is necessary to understand the importance of health communication processes and the use of tools aimed at responsible human behavior and engaged in the adoption of a preventive posture.


Asunto(s)
Actitud Frente a la Salud , /psicología , Adhesión a Directriz/estadística & datos numéricos , Conductas Relacionadas con la Salud , Pandemias/prevención & control , Participación del Paciente/psicología , Adulto , Anciano , Anciano de 80 o más Años , Brasil , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios
14.
Rev Bras Enferm ; 74Suppl 1(Suppl 1): e20200602, 2021.
Artículo en Inglés, Portugués | MEDLINE | ID: covidwho-1090509

RESUMEN

OBJECTIVE: To report the experience of a Virtual Culture Circle with Brazilian families about coping with COVID-19, as a space that promotes health during the pandemic. METHOD: Experience resulting from an extension action, the Virtual Culture Circle was held based on Paulo Freire's Research Itinerary. It counted with the participation of seven families from different locations in Brazil. During the dialogues, a house was built: the foundation represented the thematic research; walls and roof, coding and decoding; doors and windows, the critical unveiling. RESULTS: The action-reflection-action process favored the approach and integration of the participants of the Culture Circle; despite the geographical distance, it is an innovative strategy for empowerment and health promotion. FINAL CONSIDERATIONS: The Virtual Culture Circle constituted a soft technology for health care and can be explored as a tool for promoting health, especially in scenarios where face-to-face meetings are an impossibility.


Asunto(s)
Adaptación Psicológica , Promoción de la Salud/métodos , Educación del Paciente como Asunto/métodos , Realidad Virtual , Adulto , Anciano , Anciano de 80 o más Años , Brasil , Femenino , Humanos , Masculino , Persona de Mediana Edad , Investigación Cualitativa
15.
JSLS ; 24(4)2020.
Artículo en Inglés | MEDLINE | ID: covidwho-1090243

RESUMEN

Objective: To evaluate the use of social media platforms by medical students, surgical trainees, and practicing surgeons for surgical education during the Covid-19 pandemic. Methods: An online, 15-question survey was developed and posted on Facebook and WhatsApp closed surgeon groups. Results: The online survey was completed by 219 participants from South America (87%), North America (7%), Europe (5%), Central America, and Asia. Respondents included medical students (6.4%), surgical residents/fellows (24.2%), and practicing surgeons (69.4%). The most common age group was 35-44 years. When asked which social media platforms they preferred, the video sharing site YouTube (33.3%), the messaging app WhatsApp (21%), and "other" (including videoconferencing sites) (22.3%) were most popular. Respondents reported using social media for surgical education either daily (38.4%) or weekly (45.2%), for an average of 1-5 hours/week. Most (85%) opined that surgical conferences that were cancelled during the pandemic should be made available online, with live discussions. Conclusion: Social media use for surgical education during Covid-19 appears to be increasing and evolving.


Asunto(s)
Educación a Distancia/métodos , Educación Médica/métodos , Cirugía General/educación , Medios de Comunicación Sociales/tendencias , Adolescente , Adulto , Anciano , Américas/epidemiología , Asia/epidemiología , /prevención & control , Estudios Transversales , Educación a Distancia/estadística & datos numéricos , Educación Médica/tendencias , Europa (Continente)/epidemiología , Femenino , Cirugía General/tendencias , Salud Global , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Encuestas y Cuestionarios , Adulto Joven
16.
J Glob Health ; 11: 05001, 2021 Jan 16.
Artículo en Inglés | MEDLINE | ID: covidwho-1090198

RESUMEN

Background: On 12 June 2020, Brazil reached the second position worldwide in the number of COVID-19 cases. Authorities increased the number of tests performed, including the identification of antibodies to SARS-CoV-2 (IgG, IgA, and IgM). There was an overflooding of the market with several tests, and the presence of possible false-positive results became a challenge. The purpose of this study was to describe the seroprevalence and immunoglobulin blood levels in a group of asymptomatic individuals using the reference levels provided by the manufacturer. Methods: Levels of IgG and IgA antibodies to SARS-CoV-2 were determined in blood serum by the same ELISA (enzyme-linked immunoassay) test. Patients must be free of symptoms. Results: From 20 to 22 May 2020, 938 individuals were tested. There were 441 (47%) men, age 53 years (interquartile range (IQR) = 39-63.2). The sample included 335 (35.7%) subjects aged ≥60 years old. Subjects with a positive test were 54 (5.8%) for IgG and 96 (10.2%) for IgA and 42 (4.5%) for both IgG and IgA. The prevalence of IgG and IgA positive test was not different in men and women and not different in individuals under 60 and over 60 years of age. Conversely, analysing only individuals with positive tests, the levels of IgG in positive subjects were significantly higher than those with an IgA positive test, 3.00 (IQR = 1.68-5.65), and 1.95 (IQR = 1.40-3.38), respectively; P = 0.017. Additionally, individuals with isolated IgA positive tests had significantly lower levels of IgA than those with both IgA and IgG positive tests: 1.95 (IQR = 1.60-2.40) and 3.15 (IQR = 2.20-3.90), respectively, P = 0.005. These latter data suggest that IgA shows a deviation of the distribution to the left in comparison to IgG distribution data. Indeed, many subjects reported as IgA positive had immunoglobulin levels slightly elevated. Conclusions: In conclusion, we strongly suggest caution in the interpretation of IgA test results. This recommendation is more important for those with positive IgA just above the reference level.


Asunto(s)
Anticuerpos Antivirales/sangre , Reacciones Falso Positivas , Inmunoglobulina A/sangre , /inmunología , Adulto , Brasil/epidemiología , Estudios Transversales , Femenino , Humanos , Inmunoglobulina G/sangre , Masculino , Persona de Mediana Edad , Valores de Referencia , Estudios Seroepidemiológicos
17.
MMWR Morb Mortal Wkly Rep ; 70(7): 250-253, 2021 Feb 19.
Artículo en Inglés | MEDLINE | ID: covidwho-1089244

RESUMEN

Certain hazard controls, including physical barriers, cloth face masks, and other personal protective equipment (PPE), are recommended to reduce coronavirus 2019 (COVID-19) transmission in the workplace (1). Evaluation of occupational hazard control use for COVID-19 prevention can identify inadequately protected workers and opportunities to improve use. CDC's National Institute for Occupational Safety and Health used data from the June 2020 SummerStyles survey to characterize required and voluntary use of COVID-19-related occupational hazard controls among U.S. non-health care workers. A survey-weighted regression model was used to estimate the association between employer provision of hazard controls and voluntary use, and stratum-specific adjusted risk differences (aRDs) among workers reporting household incomes <250% and ≥250% of national poverty thresholds were estimated to assess effect modification by income. Approximately one half (45.6%; 95% confidence interval [CI] = 41.0%-50.3%) of non-health care workers reported use of hazard controls in the workplace, 55.5% (95% CI = 48.8%-62.2%) of whom reported employer requirements to use them. After adjustment for occupational group and proximity to others at work, voluntary use was approximately double, or 22.3 absolute percentage points higher, among workers who were provided hazard controls than among those who were not. This effect was more apparent among lower-income (aRD = 31.0%) than among higher-income workers (aRD = 16.3%). Employers can help protect workers from COVID-19 by requiring and encouraging use of occupational hazard controls and providing hazard controls to employees (1).


Asunto(s)
/prevención & control , Programas Obligatorios/estadística & datos numéricos , Enfermedades Profesionales/prevención & control , Salud Laboral/estadística & datos numéricos , Programas Voluntarios/estadística & datos numéricos , Adolescente , Adulto , Accesibilidad Arquitectónica/estadística & datos numéricos , Femenino , Humanos , Masculino , Máscaras/estadística & datos numéricos , Persona de Mediana Edad , Equipo de Protección Personal/estadística & datos numéricos , Encuestas y Cuestionarios , Estados Unidos/epidemiología , Lugar de Trabajo/estadística & datos numéricos , Adulto Joven
18.
MMWR Morb Mortal Wkly Rep ; 70(7): 229-235, 2021 Feb 19.
Artículo en Inglés | MEDLINE | ID: covidwho-1089241

RESUMEN

During 2018, Black or African American (Black) persons accounted for 43% of all diagnoses of human immunodeficiency virus (HIV) infection in the United States (1). Among Black persons with diagnosed HIV infection in 41 states and the District of Columbia for whom complete laboratory reporting* was available, the percentages of Black persons linked to care within 1 month of diagnosis (77.1%) and with viral suppression within 6 months of diagnosis (62.9%) during 2018 were lower than the Ending the HIV Epidemic initiative objectives of 95% for linkage to care and viral suppression goals (2). Access to HIV-related care and treatment services varies by residence area (3-5). Identifying urban-rural differences in HIV care outcomes is crucial for addressing HIV-related disparities among Black persons with HIV infection. CDC used National HIV Surveillance System† (NHSS) data to describe HIV care outcomes among Black persons with diagnosed HIV infection during 2018 by population area of residence§ (area). During 2018, Black persons in rural areas received a higher percentage of late-stage diagnoses (25.2%) than did those in urban (21.9%) and metropolitan (19.0%) areas. Linkage to care within 1 month of diagnosis was similar across all areas, whereas viral suppression within 6 months of diagnosis was highest in metropolitan areas (63.8%). The Ending the HIV Epidemic initiative supports scalable, coordinated, and innovative efforts to increase HIV diagnosis, treatment, and prevention among populations disproportionately affected by or who are at higher risk for HIV infection (6), especially during syndemics (e.g. with coronavirus disease 2019).


Asunto(s)
Afroamericanos/estadística & datos numéricos , Infecciones por VIH/etnología , Infecciones por VIH/terapia , Disparidades en Atención de Salud/etnología , Población Rural/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Adolescente , Adulto , Ciudades , Femenino , Humanos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Estados Unidos , Adulto Joven
20.
BMC Public Health ; 21(1): 367, 2021 02 17.
Artículo en Inglés | MEDLINE | ID: covidwho-1088589

RESUMEN

BACKGROUND: The use of face masks remains contentious, with international variation in practice. Their prevalence in the UK, is likely to increase due to new legislation. Clear information regarding the appropriate use of masks is needed, to ensure compliance with policies to reduce transmission of COVID-19. We aimed to assess the impact of visual representations of guidance, or infographics, upon the knowledge of appropriate face mask usage in a representative UK cohort. METHODS: Adult patients were recruited to this randomised internet-based questionnaire study during the 12-14 May 2020 from across the UK. Respondents viewed one of five public health stimuli regarding the use of face masks, or no stimulus. The groups accessed aids by the European Centre for Disease Control (EUCDC), World Health Organisation (WHO), Singaporean Ministry of Health (SMOH), text from the UK government (UK Gov), or an infographic designed by the Behavioural Insights Team (BIT). The primary outcome was to evaluate the effect of each infographic upon participants' recall of face mask technique, sentiments and willingness to wear a face covering. Secondary outcomes included the effect of symptomology and socio-demographic factors. RESULTS: 4099 respondents were randomised (1009 control, 628 EUCDC, 526 WHO, 639 SMOH, 661 UKGOV and 606 BIT). Stimuli from the WHO, SMOH and BIT demonstrated significantly higher average recall scores compared to the controls (7.40 v. 7.38 v. 7.34 v. 6.97, P < 0.001). BIT's stimulus led to the highest confidence about mask-wearing (87%). Only 48.2% of the cohort felt stimuli reduced anxiety about COVID-19. However, willingness to use a mask was high, (range 84 to 88%). CONCLUSIONS: To ensure the appropriate use of masks, as mandated by UK law, guidance must provide sufficient information, yet remain understandable. Infographics can aid the recall of correct mask techniques by highlighting salient steps and reducing cognitive burden. They have also demonstrated greater trustworthiness than text-only guidance. The effect of infographics upon COVID-19-related anxiety was poor, and they should be further developed to address this sentiment. A willingness to wear face masks has, however, been demonstrated.


Asunto(s)
Recursos Audiovisuales , Educación en Salud/métodos , Conocimientos, Actitudes y Práctica en Salud , Máscaras/estadística & datos numéricos , Adolescente , Adulto , Estudios de Cohortes , Femenino , Humanos , Internet , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Reino Unido/epidemiología , Adulto Joven
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