Perioperative Anemia Management

AbstractAnemia is increasingly recognized as an interventional hematological target in patients before major surgery. Preoperative anemia increases the need for perioperative blood transfusion, and there is now a well-recognized association with increased patient complications, length of hospital stay, and worse outcomes. Patient Blood Management (PBM) is a World Health Organization endorsed, evidence-based management bundle of care in transfusion hemostasis that focuses on three main aspects: anemia management, prevention of blood loss, and appropriate transfusion practice. Implementation of PBM guidelines has been accompanied by reduced transfusion needs and improved patient outcomes. In a patient presenting with preoperative anemia or at risk of transfusion, this should initiate a program of PBM that manages the patient through the entire operative period. We review the current evidence on the three pillars of PBM and highlight those aspects with the strongest evidence in support of their impact.

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Management and Treatment of Hepatitis C: Are There Still Unsolved Problems and Unique Populations?

Viruses ◽

10.3390/v13061048 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1048

Author(s):

Virginia Solitano ◽

Maria Corina Plaz Torres ◽

Nicola Pugliese ◽

Alessio Aghemo

Keyword(s):

Hepatitis C ◽

Previous Treatment ◽

World Health ◽

Current Evidence ◽

Decompensated Cirrhosis ◽

Drug Side Effects ◽

Efficacy And Safety ◽

Current Scenario ◽

Health Organization ◽

Direct Acting

Direct-acting antivirals (DAA) have revolutionized the treatment of patients with chronic hepatitis C virus (HCV) infection, possibly leading to HCV elimination by 2030 as endorsed by the World Health Organization (WHO). However, some patients belonging to the so-called unique or special populations are referred to as difficult-to-treat due to unreached sustained virological response, potential drug side effects or interactions or co-morbidities. Several years after the DAA introduction and on the basis of excellent findings in terms of efficacy and safety, some doubts arise around the exact meaning of the special population designation and whether this group of patients actually exists. The aim of this review is to discuss and analyze current evidence on the management and treatment of the so-called “unique populations”. We placed particular emphasis on patients with decompensated cirrhosis, chronic kidney disease (CKD), coinfections, rare genotypes, and previous treatment failure, in order to provide physicians with an updated overview of the actual problems and needs in the current scenario.

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Unpuzzling COVID-19: tissue-related signaling pathways associated with SARS-CoV-2 infection and transmission

Clinical Science ◽

10.1042/cs20200904 ◽

2020 ◽

Vol 134 (16) ◽

pp. 2137-2160 ◽

Cited By ~ 3

Author(s):

Daniella S. Battagello ◽

Guilherme Dragunas ◽

Marianne O. Klein ◽

Ana L.P. Ayub ◽

Fernando J. Velloso ◽

...

Keyword(s):

Signaling Pathways ◽

Clinical Impact ◽

World Health ◽

Current Evidence ◽

Cellular Interaction ◽

Crucial Importance ◽

Future Perspectives ◽

Organ Systems ◽

Health Organization ◽

The City

Abstract The highly infective coronavirus disease 19 (COVID-19) is caused by a novel strain of coronaviruses – the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) – discovered in December 2019 in the city of Wuhan (Hubei Province, China). Remarkably, COVID-19 has rapidly spread across all continents and turned into a public health emergency, which was ultimately declared as a pandemic by the World Health Organization (WHO) in early 2020. SARS-CoV-2 presents similar aspects to other members of the coronavirus family, mainly regarding its genome, protein structure and intracellular mechanisms, that may translate into mild (or even asymptomatic) to severe infectious conditions. Although the mechanistic features underlying the COVID-19 progression have not been fully clarified, current evidence have suggested that SARS-CoV-2 may primarily behave as other β-coronavirus members. To better understand the development and transmission of COVID-19, unveiling the signaling pathways that may be impacted by SARS-CoV-2 infection, at the molecular and cellular levels, is of crucial importance. In this review, we present the main aspects related to the origin, classification, etiology and clinical impact of SARS-CoV-2. Specifically, here we describe the potential mechanisms of cellular interaction and signaling pathways, elicited by functional receptors, in major targeted tissues/organs from the respiratory, gastrointestinal (GI), cardiovascular, renal, and nervous systems. Furthermore, the potential involvement of these signaling pathways in evoking the onset and progression of COVID-19 symptoms in these organ systems are presently discussed. A brief description of future perspectives related to potential COVID-19 treatments is also highlighted.

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Exercise-Induced Biological and Psychological Changes in Overweight and Obese Individuals: A Review of Recent Evidence

ISRN Physiology ◽

10.1155/2014/964627 ◽

2014 ◽

Vol 2014 ◽

pp. 1-11 ◽

Cited By ~ 1

Author(s):

Petros C. Dinas ◽

Aleksandra S. Markati ◽

Andres E. Carrillo

Keyword(s):

Psychological Health ◽

Global Scale ◽

Endocrine Function ◽

World Health ◽

Current Evidence ◽

Health Indices ◽

Physical And Psychological Health ◽

Exercise Induced ◽

Health Organization ◽

The Impact

On a global scale, the most recent evidence indicates that over 400 million adults are obese while ~20 million children and 1.6 billion adults are overweight. The World Health Organization reveals that, by the year 2015, ~2.3 billion adults will be overweight and more than 700 million will be obese. In this review paper we summarized the current evidence to elucidate the impact of exercise training on biological and psychological health indices in overweight and obese individuals. Endocrine function indices that are discussed herein include leptin, adiponectin, growth hormone, and ghrelin levels. Psychological factors include anxiety and depression, body image, and motivation for exercise. Overall, exercise promotes physical and psychological health in overweight and obese individuals particularly because exercise-induced adaptations occur across a multitude of systems within the active human. The impact of exercise on specific biological and psychological health indices contributes to overall health in overweight and obese individuals.

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Is SARS-CoV-2 transmitted by asymptomatic and pre-symptomatic infected individuals?

Acta Medica Philippina ◽

10.47895/amp.v54i0.2644 ◽

2021 ◽

Vol 54 ◽

Author(s):

Abigail F. Melicor ◽

Katrina Loren R. Rey ◽

Leonila F. Dans

Keyword(s):

Case Reports ◽

Case Series ◽

The Philippines ◽

World Health ◽

Current Evidence ◽

Wide Confidence Interval ◽

Cross Sectional ◽

Viral Shedding ◽

Asymptomatic Patients ◽

Health Organization

KEY FINDINGSAsymptomatic and pre-symptomatic transmission of SARS-CoV-2 may occur.• Manifestations of COVID-19 are highly varied and may include asymptomatic cases, who do not manifest with anysigns and symptoms despite testing positive for COVID-19 by viral nucleic acid tests. Pre-symptomatic cases areinfected individuals who are still in their incubation period, hence do not exhibit any symptoms yet but eventuallydevelop symptoms.• As of June 2020, only 586 (2.8%) of the 20,990 active cases in the Philippines were classified as asymptomatic,but it is unclear whether cases are pre-symptomatic or carriers (true asymptomatic).• Based on 36 observational studies (case reports, case series, cross-sectional and cohort studies) and 9 statisticalmodeling analysis, asymptomatic and pre-symptomatic transmission of SARS-CoV-2 may occur. However, 3studies reported no transmission from pre-symptomatic and asymptomatic cases.• Studies on viral load comparing symptomatic cases with pre-symptomatic and asymptomatic cases reportedcontradicting results. The duration of viral shedding was significantly longer for symptomatic patients comparedto asymptomatic patients but similar for asymptomatic and pre-symptomatic patients.• Therewas no difference in the transmission rates of symptomatic and asymptomatic cases. However,the estimatedinfectivity and probability of transmission was higherfor symptomatic cases compared to asymptomatic cases, butresults were imprecise due to a wide confidence interval.• The World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) recognize thepossibility of pre-symptomatic and asymptomatic transmission. According to WHO, current evidence suggestsasymptomatic cases are less likely to transmit the virus than symptomatic cases.

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Epidemiological Models of SARS-CoV-2 (COVID-19) to Control the Transmission Based on Current Evidence: A Systematic Review

10.20944/preprints202007.0262.v1 ◽

2020 ◽

Cited By ~ 2

Author(s):

Swati Arora ◽

Rishabh Jain ◽

Harendra Pal Singh

Keyword(s):

Real Data ◽

World Health ◽

Current Evidence ◽

Epidemiological Models ◽

Medical Supplies ◽

The World ◽

The Usa ◽

Novel Coronavirus ◽

Health Organization ◽

The Uk

In Wuhan city of China, an episode of novel coronavirus (COVID-19) happened. during late December and it has quickly spread to all places in the world. Until May 29, 2020, cases were high in the USA with 1.7 Million, Russia with approximately 387 thousand, the UK with 271 thousand confirmed cases. Everybody on the planet is anxious to know when the coronavirus pandemic will end. In this scourge, most nations force extreme medication measures to contain the spread of COVID-19. Modeling has been utilized broadly by every national government and the World Health Organization in choosing the best procedures to seek after in relieving the impacts of COVID-19. Many epidemiological models are studied to understand the spread of the illness and its prediction to find maximum capacity for human-to-human transmission so that control techniques can be adopted. Also, arrangements for the medical facilities required such as hospital beds and medical supplies can be made in advance. Many models are used to anticipate the results keeping in view the present scenario. There is an urgent need to study the various models and their impacts. In this study, we present a systematic literature review on epidemiological models for the outbreak of novel coronavirus in India. The epidemiological dynamics of COVID-19 is also studied. Here, In addition, an attempt to take out the results from the exploration and comparing it with the real data. The study helps to choose the models that are progressive and dependable to predict and give legitimate methods for various strategies.

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Is COVID-19 a Disease of Poverty: The Relationship Between Food Insecurity and the Likelihood of Hospitalization in Patients with COVID-19

10.21203/rs.3.rs-132292/v1 ◽

2020 ◽

Author(s):

mohammad ariya ◽

Jalal Karimi ◽

Somayeh Abolghasemi ◽

Zeinab Hematdar ◽

Mohammad Mehdi Naghizadeh ◽

...

Keyword(s):

Food Security ◽

Food Insecurity ◽

Recovery Period ◽

Length Of Hospital Stay ◽

Cross Sectional Study ◽

World Health ◽

Chi Square ◽

Cross Sectional ◽

Health Organization ◽

The Relationship

Abstract Background: The World Health Organization (WHO) has declared the Corona pandemic as a public health emergency. This pandemic affects the main pillars of food security. This study aimed to investigate the relationship between food insecurity and the probability of hospitalization and the length of the recovery period after getting COVID-19.Methods: This cross-sectional study was performed through the census on COVID-19 patients diagnosed in Fasa, Iran. Informed consent, demographic, and food security questionnaire were completed over the phone. Then, all patients were followed up until recovery. Data were analyzed using SPSS26 and Chi-square test, t-test, and logistic regression (P> 0.05).Results: In this study, 219 COVID-19 patients [100 (54.7%) male and 119 female (54.3%)] with a mean age of 40.05±15.54 years old were examined. Possibility of hospitalization and the length of the recovery period of more than one month was significantly longer in the food insecure group (P = 0.001) and (P = 0.76), respectively, but the mean length of hospital stay in the two groups was not significantly different (P = 0.76). After adjusting for all confounding variables, people with food insecurity were 3.9 times more likely to be hospitalized than those with food security. Conclusions: We observed that food-insecure people were significantly more likely to be hospitalized than the secure group.

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Food insecurity arises the likelihood of hospitalization in patients with COVID-19

Scientific Reports ◽

10.1038/s41598-021-99610-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Mohammad Ariya ◽

Jalal Karimi ◽

Somayeh Abolghasemi ◽

Zeinab Hematdar ◽

Mohammad Mehdi Naghizadeh ◽

...

Keyword(s):

Food Security ◽

Food Insecurity ◽

Recovery Period ◽

Length Of Hospital Stay ◽

Cross Sectional Study ◽

World Health ◽

Chi Square ◽

Cross Sectional ◽

Chi Square Test ◽

Health Organization

AbstractThe World Health Organization (WHO) has declared the Corona pandemic as a public health emergency. This pandemic affects the main pillars of food security. This study aimed to investigate the relationship between food insecurity and the probability of hospitalization and the length of the recovery period after getting COVID-19. The cross-sectional study was performed through the census on COVID-19 patients diagnosed in Fasa, Iran. Informed consent, demographic, and food security questionnaire were completed over the phone. Then, all patients were followed up until recovery. Data were analyzed using SPSS26 and Chi-square test, t-test, and logistic regression (P < 0.05). In this study, 219 COVID-19 patients [100 (54.7%) male and 119 (54.3%) female] with a mean age of 40.05 ± 15.54 years old were examined. Possibility of hospitalization and the length of the recovery period of more than one month was significantly longer in the food-insecure group (P = 0.001) and (P = 0.37), respectively, but the mean length of hospital stay in the two groups was not significantly different (P = 0.76). After adjusting for all confounding variables, people with food insecurity were 3.9 times more likely to be hospitalized than those with food security. Overall, we observed that food-insecure people were significantly more likely to be hospitalized than the secure group.

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Nitrate levels in drinking water and their impact on the risk of developing gynecological diseases and adverse pregnancy outcomes

Hellenic Journal of Obstetrics and Gynecology ◽

10.33574/hjog.1930 ◽

2020 ◽

Vol 19 (1) ◽

pp. 27-34

Author(s):

Vasilios Pergialiotis ◽

Dimitrios Loutradis

Keyword(s):

Drinking Water ◽

World Health ◽

Current Evidence ◽

Future Research ◽

Gynecological Diseases ◽

Fetal Malformations ◽

Adverse Pregnancy ◽

Health Organization ◽

Nitrate And Nitrite ◽

The Impact

Nitrate is a nitrogen oxoanion formed by loss of a proton from nitric acid. It is an important source of nitrogen which is essential for protein formation. Regular levels of nitrate in the environment do not exceed 2-5 mg/L. Fertilizers, herbicides and pesticides increase, however, the amount of nitrate in drinking water. In 2011 the World Health Organization (WHO) has issued a revised document on nitrate and nitrite levels in drinking water to help establish a common guideline that will help countries. To date, the majority of guidelines on drinking water quality that is directly related to nitrate levels are based in its toxic effect in infants and neonates (primarily the occurrence of methemoglobinemia) and suggest as an arbitrary cut-off the existence of less than 10 mg/L as a measure of safety. Exposure to nitrate levels has been linked to adverse neurodevelopmental effects, fetal malformations and several forms of cancer. However, the associations remain scarce in several fields as the majority of available data is retrieved from articles that investigate the impact of nitrosatable drugs, rather than environmental exposure. In Greece, seven vulnerable regions have been recently identified, following the country`s referral to the Court of Justice by Commission. The aim of the present article is to summarize current evidence and provide recommendations for clinical practice and future research in the field.

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HUBUNGAN PELAKSANAAN SURGICAL SAFETY CHECKLIST DAN KEJADIAN INFEKSI POST OPERASI MAYOR

Jurnal Ilmu Kesehatan ◽

10.24929/jik.v2i1.394 ◽

2018 ◽

Vol 2 (1) ◽

pp. 29-33

Author(s):

Widiyaningsih Widiyaningsih ◽

Eni Kusyati ◽

Amri Hidayat

Keyword(s):

Postoperative Infection ◽

Survey Design ◽

Surgical Site Infections ◽

World Health ◽

Major Surgery ◽

Surgical Safety Checklist ◽

Surgical Safety ◽

Prolonged Length ◽

Checklist Implementation ◽

Health Organization

Background: wound postoperative infection (ILO) are infections caused by pathogenic microorganisms that contaminate the wound area during surgery or after surgery. The data from survey by World Health Organization (WHO) found that about ILO cuased infection as 5% - 34% of total nosocomial infections. The data from Centers for Disease Control and Prevention cited that annually there was 500,000 surgical site infections (SSI) and that caused 3% surgical mortality, prolonged length of stay in hospital, and increased medical costs. Objective: to know the correlation of Surgical Safety Checlist Implementation and post operative infection. Research method: the method was quantitative method with cohort analytic survey design. The population were all patients with major surgery at Public Hospital of Tugurejo Semarang periode December 2016 - January 2017 as many as 99 patients. Result:the result of this study were major surgery mostly have implementation of surgical safety checklist either 81 respondent (81,8%) and have no infection incidence were 84 responden (84,8%). There was no significant correlation between surgical safety checklist implementation and postoperative infection.

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Candidates for treatment of COVID-19: current scenario and way forwards

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20203413 ◽

2020 ◽

Vol 7 (8) ◽

pp. 3273

Author(s):

M. Abu Bashar

Keyword(s):

Clinical Efficacy ◽

Clinical Characteristics ◽

Treatment Options ◽

Therapeutic Agents ◽

World Health ◽

Current Evidence ◽

Efficacy And Safety ◽

Control And Prevention ◽

Current Scenario ◽

Health Organization

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), has spread across the globe resulting in a pandemic affecting 215 countries. At the time of this review, COVID-19 has been diagnosed in more than 15,000,000 patients and associated with over 1,00,000 deaths globally (Centers for Disease Control and Prevention, World Health Organization). In this review, we herein summarize the current evidence as on May 15, 2020 to provide guidance on potentially beneficial drugs in COVID-19 treatment or prophylaxis, their scientific rationale and their clinical efficacy and safety. New data continue to emerge daily regarding clinical characteristics, treatment options, and outcomes for COVID-19. Optimized supportive care remains the mainstay of therapy, and the clinical efficacy for many potential therapeutic agents is still under investigation.

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