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3.
Int J Equity Health ; 19(1): 184, 2020 10 19.
Artículo en Inglés | MEDLINE | ID: covidwho-873998

RESUMEN

In healthcare, we find an industry that typifies the unique blend of racism, classism, and other forms of structural discrimination that comprise the U.S. caste system-the artificially-constructed and legally-reinforced social hierarchy for assigning worth and determining opportunity for individuals based on race, class, and other factors. Despite myths of meritocracy, healthcare is actually a casteocracy; and conversations about racism in healthcare largely occupy an echo chamber among the privileged upper caste of hospital professionals. To address racism in healthcare, we must consider the history that brought us here and understand how we effectively perpetuate an employee caste system within our own walls.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Prestación de Atención de Salud/organización & administración , Neumonía Viral/epidemiología , Racismo/prevención & control , Clase Social , Humanos , Pandemias , Estados Unidos/epidemiología
5.
Ethn Dis ; 30(3): 425-428, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-841851

RESUMEN

Religious institutions have historically been an essential resource in African American communities and can serve as indispensable partners during a public health crisis. The purpose of this perspective is to establish African American churches, mosques, and temples as essential for an immediate, comprehensive, and sustained response to the elevated risk for and spread of COVID-19 among African Americans.


Asunto(s)
Infecciones por Coronavirus , Transmisión de Enfermedad Infecciosa/prevención & control , Pandemias , Neumonía Viral , Religión y Medicina , Afroamericanos/psicología , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/psicología , Humanos , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Neumonía Viral/psicología , Misiones Religiosas/organización & administración , Estados Unidos
6.
J Clin Invest ; 130(9): 4791-4797, 2020 09 01.
Artículo en Inglés | MEDLINE | ID: covidwho-840726

RESUMEN

BACKGROUNDConvalescent plasma is the only antibody-based therapy currently available for patients with coronavirus disease 2019 (COVID-19). It has robust historical precedence and sound biological plausibility. Although promising, convalescent plasma has not yet been shown to be safe as a treatment for COVID-19.METHODSThus, we analyzed key safety metrics after transfusion of ABO-compatible human COVID-19 convalescent plasma in 5000 hospitalized adults with severe or life-threatening COVID-19, with 66% in the intensive care unit, as part of the US FDA expanded access program for COVID-19 convalescent plasma.RESULTSThe incidence of all serious adverse events (SAEs), including mortality rate (0.3%), in the first 4 hours after transfusion was <1%. Of the 36 reported SAEs, there were 25 reported incidences of related SAEs, including mortality (n = 4), transfusion-associated circulatory overload (n = 7), transfusion-related acute lung injury (n = 11), and severe allergic transfusion reactions (n = 3). However, only 2 of 36 SAEs were judged as definitely related to the convalescent plasma transfusion by the treating physician. The 7-day mortality rate was 14.9%.CONCLUSIONGiven the deadly nature of COVID-19 and the large population of critically ill patients included in these analyses, the mortality rate does not appear excessive. These early indicators suggest that transfusion of convalescent plasma is safe in hospitalized patients with COVID-19.TRIAL REGISTRATIONClinicalTrials.gov NCT04338360.FUNDINGMayo Clinic, Biomedical Advanced Research and Development Authority (75A50120C00096), National Center for Advancing Translational Sciences (UL1TR002377), National Heart, Lung, and Blood Institute (5R35HL139854 and R01 HL059842), National Institute of Diabetes and Digestive and Kidney Diseases (5T32DK07352), Natural Sciences and Engineering Research Council of Canada (PDF-532926-2019), National Institute of Allergy and Infectious Disease (R21 AI145356, R21 AI152318, and AI152078), Schwab Charitable Fund, United Health Group, National Basketball Association, Millennium Pharmaceuticals, and Octapharma USA Inc.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/terapia , Neumonía Viral/terapia , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Ensayos de Uso Compasivo , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/mortalidad , Femenino , Humanos , Inmunización Pasiva/efectos adversos , Inmunización Pasiva/mortalidad , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/epidemiología , Seguridad , Reacción a la Transfusión/epidemiología , Reacción a la Transfusión/etiología , Lesión Pulmonar Aguda Postransfusional/epidemiología , Lesión Pulmonar Aguda Postransfusional/etiología , Estados Unidos/epidemiología , United States Food and Drug Administration , Adulto Joven
7.
Cancer Cytopathol ; 128(10): 679-680, 2020 10.
Artículo en Inglés | MEDLINE | ID: covidwho-840101
10.
Clin J Oncol Nurs ; 24(5): 591, 2020 10 01.
Artículo en Inglés | MEDLINE | ID: covidwho-823697

RESUMEN

As an oncology advanced practice nurse, I find myself asking, "How can I continue to provide the same level of competent, quality care while meeting the unique, holistic needs of this population leveraged with self-care during the COVID-19 pandemic?" In talking with colleagues, we find ourselves torn between providing fluid oncology care that is compassionate and comprehensive while managing our uncertainties with our family since the beginning of this pandemic. I practice in a state that is known nationally to have the worst rates of cancer-associated deaths and comorbidities, which predisposes patients to poor outcomes with COVID-19 (Centers for Disease Control and Prevention, 2020). Providers grasp that patients are at higher risk, yet patients with active cancer must be seen in person regularly and providers are tasked with how to protect them.


Asunto(s)
Enfermeras Clínicas/psicología , Enfermería Oncológica , Pandemias , Resiliencia Psicológica , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Humanos , Neumonía Viral/epidemiología , Neumonía Viral/virología , Estados Unidos/epidemiología
13.
Cancer Cytopathol ; 128(10): 679-680, 2020 10.
Artículo en Inglés | MEDLINE | ID: covidwho-812771
14.
Catheter Cardiovasc Interv ; 96(3): 659-663, 2020 09 01.
Artículo en Inglés | MEDLINE | ID: covidwho-806095

RESUMEN

The coronavirus disease-2019 (COVID-19) pandemic has strained health care resources around the world, causing many institutions to curtail or stop elective procedures. This has resulted in an inability to care for patients with valvular and structural heart disease in a timely fashion, potentially placing these patients at increased risk for adverse cardiovascular complications, including CHF and death. The effective triage of these patients has become challenging in the current environment, as clinicians have had to weigh the risk of bringing susceptible patients into the hospital environment during the COVID-19 pandemic against the risk of delaying a needed procedure. In this document, the authors suggest guidelines for how to triage patients in need of structural heart disease interventions and provide a framework for how to decide when it may be appropriate to proceed with intervention despite the ongoing pandemic. In particular, the authors address the triage of patients in need of transcatheter aortic valve replacement and percutaneous mitral valve repair. The authors also address procedural issues and considerations for the function of structural heart disease teams during the COVID-19 pandemic.


Asunto(s)
Procedimientos Quirúrgicos Cardíacos/estadística & datos numéricos , Infecciones por Coronavirus/epidemiología , Cardiopatías/cirugía , Pandemias/estadística & datos numéricos , Neumonía Viral/epidemiología , Guías de Práctica Clínica como Asunto , Triaje/normas , Procedimientos Quirúrgicos Cardíacos/métodos , Cardiología/métodos , Cardiología/normas , Infecciones por Coronavirus/prevención & control , Infección Hospitalaria/prevención & control , Femenino , Cardiopatías/diagnóstico por imagen , Humanos , Masculino , Salud Laboral/estadística & datos numéricos , Pandemias/prevención & control , Seguridad del Paciente , Neumonía Viral/prevención & control , Sociedades Médicas , Triaje/estadística & datos numéricos , Estados Unidos
18.
Biol Blood Marrow Transplant ; 26(7): e161-e166, 2020 07.
Artículo en Inglés | MEDLINE | ID: covidwho-799190

RESUMEN

With the COVID-19 pandemic and the ensuing barriers to the collection and transport of donor cells, it is often necessary to collect and cryopreserve grafts before initiation of transplantation conditioning. The effect on transplantation outcomes in nonmalignant disease is unknown. This analysis examined the effect of cryopreservation of related and unrelated donor grafts for transplantation for severe aplastic anemia in the United States during 2013 to 2019. Included are 52 recipients of cryopreserved grafts who were matched for age, donor type, and graft type to 194 recipients who received noncryopreserved grafts. Marginal Cox regression models were built to study the effect of cryopreservation and other risk factors associated with outcomes. We recorded higher 1-year rates of graft failure (hazard ratio [HR], 2.26; 95% confidence interval, 1.17 to 4.35; P = .01) and of 1-year overall mortality (HR, 3.13; 95% CI, 1.60 to 6.11; P = .0008) after transplantation of cryopreserved compared with noncryopreserved grafts, with adjustment for sex, performance score, comorbidity, cytomegalovirus serostatus, and ABO blood group match. The incidence of acute and chronic graft-versus-host disease did not differ between the 2 groups. Adjusted probabilities of 1-year survival were 73% (95% CI, 60% to 84%) in the cryopreserved graft group and 91% (95% CI, 86% to 94%) in the noncryopreserved graft group. These data support the use of noncryopreserved grafts whenever possible in patients with severe aplastic anemia.


Asunto(s)
Anemia Aplásica/terapia , Trasplante de Médula Ósea/métodos , Infecciones por Coronavirus/epidemiología , Criopreservación/métodos , Rechazo de Injerto/patología , Enfermedad Injerto contra Huésped/patología , Trasplante de Células Madre de Sangre Periférica/métodos , Neumonía Viral/epidemiología , Enfermedad Aguda , Adolescente , Adulto , Anciano , Anemia Aplásica/inmunología , Anemia Aplásica/mortalidad , Anemia Aplásica/patología , Niño , Preescolar , Femenino , Rechazo de Injerto/inmunología , Rechazo de Injerto/mortalidad , Enfermedad Injerto contra Huésped/inmunología , Enfermedad Injerto contra Huésped/mortalidad , Prueba de Histocompatibilidad , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Estudios Retrospectivos , Hermanos , Análisis de Supervivencia , Acondicionamiento Pretrasplante/métodos , Estados Unidos/epidemiología , Donante no Emparentado
19.
BMC Public Health ; 20(1): 1453, 2020 Sep 25.
Artículo en Inglés | MEDLINE | ID: covidwho-796312

RESUMEN

BACKGROUND: This study examines the relationships between childhood food allergy and parental unhealthy food choices for their children across attitudes towards childhood obesity as mediators and parental gender, income and education as potential moderators. METHODS: We surveyed parents with at least one child between the ages of 6 and 12 living in Canada and the United States. We received 483 valid responses that were analysed using structural equation modelling approach with bootstrapping to test the hypothetical path model and its invariance across the moderators. RESULTS: The analysis revealed that pressure to eat fully mediated the effects of childhood food allergy and restriction on parental unhealthy food choices for their children. Finally, we found that parental gender moderated the relationship between childhood food allergy and the pressure to eat. CONCLUSIONS: The paper contributes to the literature on food allergies among children and the marginalisation of families with allergies. Our explorative model is a first of its kind and offers a fresh perspective on complex relationships between variables under consideration. Although our data collection took place prior to Covid-19 outbreak, this paper bears yet particular significance as it casts light on how families with allergies should be part of the priority groups to have access to food supply during crisis periods.


Asunto(s)
Hipersensibilidad a los Alimentos/epidemiología , Preferencias Alimentarias/psicología , Relaciones Padres-Hijo , Padres/psicología , Canadá/epidemiología , Niño , Preescolar , Femenino , Humanos , Masculino , Modelos Psicológicos , Obesidad Pediátrica/epidemiología , Encuestas y Cuestionarios , Estados Unidos/epidemiología
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