Experiences in the use of multiple doses of convalescent plasma in critically ill patients with COVID-19: An early phase 1 descriptive study.

Background: At the beginning of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, transfusion of coronavirus disease 2019 (COVID-19) convalescent plasma (CCP) emerged as a potential therapeutic strategy to help patients severely afflicted by COVID-19. The efficacy of CCP has been controversial as it depends on many variables pertaining to the plasma donor and the patient with COVID-19, for example, time of convalescence or symptoms onset. This feasibility and descriptive study aimed to assess the safety of multiple doses of CCP in mechanically ventilated, intubated patients with respiratory failure due to COVID-19. Methods: A cohort of 30 patients all experiencing severe respiratory failure and undergoing invasive mechanical ventilation in an intensive care unit, received up to five doses of 300-600 mL of CCP on alternate days (0, 2, 4, 6, and 8) until extubation, futility, or death. Results: Nineteen patients received five doses, seven received four, and four received two or three doses. At 28-day follow-up mark, 57% of patients recovered and were sent home, and the long-term mortality rate was 27%. Ten severe adverse events reported in the study were unrelated to CCP transfusion. Independent of the number of transfused doses, most patients had detectable levels of total and neutralizing antibodies in plasma. Conclusion: This study suggests that transfusion of multiple doses of CCP is safe. This strategy may represent a viable option for future studies, given the potential benefit of CCP transfusions during the early stages of infection in unvaccinated populations and in settings where monoclonal antibodies or antivirals are contraindicated or unavailable.

Dietary patterns, social determinants, and emotions during COVID-19 confinement in Panama: An online survey.

Aim: We aimed to evaluate health and nutrition behaviors among the Panamanian population during the confinement period corresponding to the first wave of the COVID-19 pandemic. Methods: We conducted a cross-sectional study using an online survey for data collection with a total of 2475 participants over the age of 18 using an online survey. We also completed 64 face-to-face interviews. After data validation, 1561 surveys were included in the study. Most respondents were women (74.2%) between 18 and 49 years old. Among the respondents, 83.3% had a university education level, and 49.9% reported a monthly family income of fewer than 1000 USD. In addition, more than 50% self-reported as overweight or obese. Results: We identified three dietary patterns: a healthy, a non-healthy, and a mixed dietary pattern. The respondents with healthy and nonhealthy dietary patterns reported better socioeconomic conditions than participants from the mixed dietary pattern. Individuals with mixed dietary patterns had lower incomes, less education, and higher unemployment rates. Regarding emotions, we found that women experienced more negative emotions, such as fear, worry, and anxiety, during the lockdown period. Conclusions: Taken together, these results indicate that the mobility restriction measures imposed during the COVID-19 pandemic could have affected dietary patterns by exacerbating existing inequalities. Directing resources toward promoting healthy nutrition strategies with the most significant positive impacts on public health is a priority, especially in critical situations such as the COVID-19 pandemic.

Diagnostic accuracy of prenatal imaging for the diagnosis of congenital Zika syndrome: Systematic review and meta-analysis.

Objective: The aim of this study was to assess the accuracy of prenatal imaging for the diagnosis of congenital Zika syndrome. Data sources: Medline (via Pubmed), PubMed, Scopus, Web of Science, and Google Scholar from inception to March 2022. Two researchers independently screened study titles and abstracts for eligibility. Study eligibility criteria: Observational studies with Zika virus-infected pregnant women were included. The index tests included ultrasound and/or magnetic resonance imaging. The reference standard included (1) Zika infection-related perinatal death, stillbirth, and neonatal death within the first 48 h of birth, (2) neonatal intensive care unit admission, and (3) clinically defined adverse perinatal outcomes. Synthesis methods: We extracted 2 × 2 contingency tables. Pooled sensitivity and specificity were estimated using the random-effects bivariate model and assessed the summary receiver operating characteristic (ROC) curve. Risk of bias was assessed using QUADAS 2 tool. The certainty of the evidence was evaluated with grading of recommendations. Results: We screened 1,459 references and included 18 studies (2359 pregnant women, 347 fetuses with confirmed Zika virus infection). Twelve studies (67%) were prospective cohorts/case series, and six (37%) were retrospective cohort/case series investigations. Fourteen studies (78%) were performed in endemic regions. Ten studies (56%) used prenatal ultrasound only, six (33%) employed ultrasound and fetal MRI, and two studies (11%) used prenatal ultrasound and postnatal fetal MRI. A total of six studies (ultrasound only) encompassing 780 pregnant women (122 fetuses with confirmed Zika virus infection) reported relevant data for meta-analysis (gestation age at which ultrasound imagining was captured ranged from 16 to 34 weeks). There was large heterogeneity across studies regarding sensitivity (range: 12 to 100%) and specificity (range: 50 to 100%). Under a random-effects model, the summary sensitivity of ultrasound was 82% (95% CI, 19 to 99%), and the summary specificity was 97% (71 to 100%). The area under the ROC curve was 97% (95% CI, 72 to 100%), and the summary diagnostic odds ratio was 140 (95% CI, 3 to 7564, P < 0.001). The overall certainty of the evidence was "very low". Conclusion: Ultrasound may be useful in improving the diagnostic accuracy of Zika virus infection in pregnancy. However, the evidence is still substantially uncertain due to the methodological limitations of the available studies. Larger, properly conducted diagnostic accuracy studies of prenatal imaging for the diagnosis of congenital Zika syndrome are warranted. Systematic review registration: Identifier [CRD42020162914].

Serie de Casos Retrospectiva de las Características Clínicas, del Manejo y Resultados de los Pacientes con COVID-19 en hospitales privados de la región metropolitana en la República de Panamá

Introducción: El 9 de marzo de 2020 se confirma el primer caso de COVID-19 en la República de Panamá. Según el reporte #46 de Panamá emitido por la OPS el 26 de enero de 2021, Panamá es el segundo país de las Américas con más alta incidencia después de Estados Unidos. Métodos: El diseño del estudio es observacional retrospectivo. En este estudio participaron 140 pacientes de 3 instituciones privadas localizadas en el área metropolitana de la República de Panamá. Resultados: De la muestra, 65.71% eran hombres y 34.29% eran mujeres, 72 (51.43%) pacientes fueron hospitalizados. La edad media fue de 48.39 años. El 49% de los pacientes presentaron antecedentes personales patológicos, el más común fue hipertensión arterial (63.27%). Los síntomas más frecuentes encontramos fiebre (71.43%), tos (61.43%), fatiga (50.71%) y disnea (32.86%). Del total de pacientes, 55.71% recibió tratamiento intrahospitalario, 11.51% fue admitido a UCI, 9.29% sufrió complicaciones y las más frecuente fue falla respiratoria (61.54%). De los medicamentos utilizados en ese periodo de tiempo lo más comúnmente usado fue la hidroxicloroquina (91.03%) y la azitromicina (84.62%). Conclusiones: Se encontraron resultados similares a estudios descriptivos realizados en distintos países con modelos similares al nuestro.   (provisto por Infomedic International)

Introduction: The first case of COVID-19 in the Republic of Panama was confirmed on March 9 2020. In the Panama #46 report issued by PAHO on January 26, 2021, Panama was the second country in the Americas with the highest incidence of COVID-19 after the United States. Methods: The design of the study is a retrospective observational study of 140 patients from 3 private hospitals located in the metropolitan area of the Republic of Panama. Results: Of the sample, 65.71% were men and 34.29% were women, 72 (51.43%) patients were hospitalized. The median age was 48.39 years. 49% of the patients presented a pathological personal history, the most common was arterial hypertension (63.27%).  Of the sample, 65.71% were men and 34.29% were women, 72 (51.43%) patients were hospitalized. The average age was 48.39 years. 49% of patients had a pathological personal history where high blood pressure was the most frequent (63.27%). The most common symptoms were fever (71.43%), cough (61.43%), fatigue (50.71%) and dyspnea (32.86%). Of the total number of patients, 55.71% received in-hospital treatment, 11.51% were admitted to the ICU, 9.29% suffered complications, the most frequent was respiratory failure (61.54%). Of the drugs used in that time period, the most commonly used were hydroxychloroquine (91.03%) and azithromycin (84.62%). Conclusions: Similar results were found to descriptive studies carried out in different countries with models similar to ours. (provided by Infomedic International)

Overweight, Obesity, and Older Age Favor Latent Tuberculosis Infection among Household Contacts in Low Tuberculosis-Incidence Settings within Panama.

Latent tuberculosis infection (LTBI) remains the main source of new active tuberculosis (TB) cases worldwide. Household close contacts (HCCs) are at high risk of acquiring LTBI and subsequent development of TB. In this study, we aim to identify risk factors associated with LTBI in HCCs of TB patients living in a low TB-incidence setting. Our results revealed that HCCs who are aged more than 50 years (OR = 4.05) and overweight (OR = 15.3) are at higher risk of acquiring LTBI. None of these LTBI household contacts progressed to active TB. These findings suggest that HCCs who are young adults and children with normal and low body mass index are less likely to acquire LTBI after exposure to TB patients, even in low TB-incidence settings.

Applying Ecological Positive Youth Development Theory to Address Co-Occurring Health Disparities Among Immigrant Latino Youth.

This article outlines the theory and resulting approach employed in a multilevel, integrated, collaborative community intervention called Adelante, implemented by a university-community partnership in a Latino immigrant community to address co-occurring health disparities of substance abuse, sex risk, and interpersonal violence among youth. The basis for the intervention is a social-ecological interpretation of positive youth development theory, which focuses on changes in the person environment context and community assets as a preventive mechanism. This approach is viewed as appropriate for a community facing multiple barriers to health equity. The article describes the translation of this positive youth development model to practice, including the design of the intervention, intervention components, and the protocol for evaluation. The Adelante intervention is intended to reduce health disparities and, in addition, to add a broader community model to the evidence base.

DEFINING THE "COMMUNITY" FOR A COMMUNITY-BASED PUBLIC HEALTH INTERVENTION ADDRESSING LATINO IMMIGRANT HEALTH DISPARITIES: AN APPLICATION OF ETHNOGRAPHIC METHODS.

Although Latino and other immigrant populations are the driving force behind population increases in the U.S., there are significant gaps in knowledge and practice on addressing health disparities in these populations. The Avance Center for the Advancement of Immigrant/Refugee Health, a health disparities research center in the Washington, DC area, includes as part of its mission a multi-level, participatory community intervention (called Adelante) to address the co-occurrence of substance abuse, violence and sex risk among Latino immigrant youth and young adults. Research staff and community partners knew that the intervention community had grown beyond its Census-designated place (CDP) boundaries, and that connection and attachment to community were relevant to an intervention. Thus, in order to understand current geographic and social boundaries of the community for sampling, data collection, intervention design and implementation, the research team conducted an ethnographic study to identify self-defined community boundaries, both geographic and social. Beginning with preliminary data from a pilot intervention and the original CDP map, the research included: geo-mapping de-identified addresses of service clients from a major community organization; key informant interviews; and observation and intercept interviews in the community. The results provided an expanded community boundary profile and important information about community identity.