scholarly journals Factors associated with SARS-CoV2 infection and care pathways among the most vulnerable populations living in Marseille: a case control study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ismaïl Alsaïdi ◽  
Frédéric De Sousa Santos ◽  
Bérengère Plard ◽  
Elise Janvier ◽  
Aurélie Tinland ◽  
...  

Abstract Background The Covid-19 pandemic has led to substantial and unexpected increases in morbidity and mortality in France. Vulnerable populations housed in accommodation centres have a greater risk of infection because collective housing and their dependence on social support services mean it is more difficult to apply preventive measures. They are also at greater risk of developing severe forms of Covid-19 and waiting longer before seeking healthcare (for Covid-19 or other) treatment. We aimed to identify the factors associated with SARS-CoV2 infection in the most vulnerable populations in the city of Marseille. Methods The study sample comprised users of various services provided by the association AAJT in Marseille, France, some presenting symptoms suggestive of Covid-19 and others not. All had routine health surveillance provided by AAJT’s dedicated healthcare team between March 2020 and May 2020. Using univariate and multivariate analyses, we studied the influence of several variables on morbidity associated with Covid-19. Results The study included 64 participants, 29 of whom tested positive for Covid-19 and 35 control subjects. Median age was 21.16 years old. Individuals in the ‘Covid-19 case’ group (p < 0.005) – which included persons testing positive and those suspected of being infected – were younger. The study sample’s male/female ratio was seven. In our multivariate analyses, living in a shared apartment and poor adherence to social distancing measures were factors associated with Covid-19 infection. Furthermore, mental health problems - such as anxiety disorder - were very frequent in the study sample. Conclusions Allocating more and specific housing units to structures providing accommodation services to the most vulnerable people would seem to be a decisive factor in controlling the spread of SARS-CoV2, and deserves more attention from public authorities.

2021 ◽  
Author(s):  
Ismaïl Alsaïdi ◽  
Frédéric De Sousa Santos ◽  
Bérangère Plard ◽  
Elise Janvier ◽  
Aurélie Tinland ◽  
...  

Abstract Background: Mainland France has been seriously affected by the Covid-19 epidemic, which has brought significant and unexpected morbidity and mortality. Precarious people cared for in accommodation centers are particularly at risk of infection because of collective housing, their dependence on the support system and therefore their difficulty in applying barrier measures. These populations are also subject to a risk of more severe infections or a delay in seeking treatment. This study aims to identify the factors associated with SARS-CoV2 infection in the most vulnerable populations in Marseille.Methods: The sample on which the study was carried out consists of association users, whether or not presenting a symptomatology suggestive of Covid-19, and routinely treated between March 2020 and May 2020. Through univariate and multivariate analyzes, we studied the influence of several variables on morbidity attributable to SARS-CoV2. Results: 64 participants were enrolled in the study with 29 cases and 35 control subject. Median age was 21.16 years old with a younger age in the case group (p < 0.005). Sex ratio was 7. Risk factors of SARS-CoV2 in multivariate analysis were living in a shared apartment and a low compliance for distancing measure. Participants presented frequent mental health problems such as anxiety. Conclusions: The allocation of housing to structures involved with the most precarious people appears to be a decisive factor in the fight against the spread of SARS-CoV2 and therefore deserves more attention from public authorities.


2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii383-iii384
Author(s):  
Gabriela Oigman ◽  
Diana Osorio ◽  
Joseph Stanek ◽  
Jonathan Finlay ◽  
Denizar Vianna ◽  
...  

Abstract BACKGROUND Medulloblastoma (MB), the most malignant brain tumor of childhood has survival outcomes exceeding 80% for standard risk and 60% for high risk patients in high-income countries (HIC). These results have not been replicated in low-to-middle income countries (LMIC), where 80% of children with cancer live. Brazil is an upper-middle income country according to World Bank, with features of LMIC and HIC. METHODS We conducted a retrospective review of 126 children (0–18 years) diagnosed with MB from 1997 to 2016 at INCA. Data on patients, disease characteristics and treatment information were retrieved from the charts and summarized descriptively; overall survival (OS) and event-free survival (EFS) were calculated using the Kaplan-Meier Method. RESULTS The male/female ratio was 1.42 and the median age at diagnosis was 7.9 years. Headache (79%) and nausea/vomiting (75%) were the most common presenting symptoms. The median time from onset of symptoms to surgery was 50 days. The OS for standard-risk patients was 69% and 53% for high-risk patients. Patients initiating radiation therapy within 42 days after surgery (70.6% versus 59.6% p=0.016) experienced better OS. Forty-five patients (35%) had metastatic disease at admission. Lower maternal education correlated with lower OS (71.3% versus 49% p=0.025). Patients who lived &gt;40km from INCA fared better (OS= 68.2% versus 51.1% p=0.032). Almost 20% of families lived below the Brazilian minimum wage. CONCLUSIONS These findings suggest that socioeconomic factors, education, early diagnosis and continuous data collection, besides oncological treatment must be adressed to improve the survival of children with MB.


2021 ◽  
Vol 49 (6) ◽  
pp. 030006052110244
Author(s):  
Yantao Cai ◽  
Chenfang Zhu ◽  
Qianqian Chen ◽  
Feng Zhao ◽  
Shanyu Guo

Objective The probability of malignancy in women who are diagnosed with a Breast Imaging Reporting and Data System (BI-RADS) 4A score is low. Application of a second opinion ultrasound (SOUS), which is low in cost and minimally invasive, may lower the biopsy rate for patients who fall into this category. This study aimed to apply SOUS to patients with a BI-RADS score of 4A and predict the pathological results of a biopsy. Methods One hundred seventy-eight patients were analyzed. Univariate and multivariate analyses were performed to screen for predictive factors that are associated with malignancy. Categorical alteration of downgraded, unchanged, or upgraded was made after SOUS results. Changes in category were compared with biopsies to determine their predictive value of benignancy or malignancy. Results Independent factors associated with malignancy were age (>50 years), tumor size (≥20 mm), margin (not circumscribed), orientation (not parallel), and peripheral location, and an upgraded categorical alteration from SOUS. Downgraded categorical alterations were associated with benignancy. Conclusions In BI-RADS 4A cases, a biopsy is recommended when independent factors are associated with malignancy. A downgraded result from an SOUS examination is a protective factor, supporting the likelihood of benignancy in these patients.


Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 119
Author(s):  
Norhafizah Sahril ◽  
Noor Ani Ahmad ◽  
Idayu Badilla Idris ◽  
Rajini Sooryanarayana ◽  
Mohamad Aznuddin Abd Razak

Mental health problems are a major public health issue, particularly among children. They impair children’s development, academic achievement, and ability to live a productive life. The present study aimed to determine the prevalence and factors associated with mental health problems among children aged 5 to 15 years old in Malaysia. Data from the National Health and Morbidity Survey (NHMS) 2015 were analyzed. A validated Strengths and Difficulties Questionnaire (SDQ) was used. The overall prevalence of mental health problems among children in Malaysia was 11.1%. Multiple logistic regression analysis revealed that for every year increment in age, mental health problems decreased by 5%. Further analysis found that children who had fathers with a non-formal education and worked in the private sector, had parents who were widowed or divorced, and had either parent with mental health problems were more likely to have mental health problems themselves. Children from the lower socioeconomic group and who had either parent with mental health problems had higher odds of having mental health problems in Malaysia.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tian Qi ◽  
Ting Hu ◽  
Qi-Qi Ge ◽  
Xiao-Na Zhou ◽  
Jia-Mei Li ◽  
...  

Abstract Background The COVID-19 pandemic has lasted for more than 1 year, causing far-reaching and unprecedented changes in almost all aspects of society. This study aimed to evaluate the long-term consequences of the COVID-19 pandemic on depression and anxiety, and explore the factors associated with it. Methods A cross-sectional study using an online survey was conducted to assess mental health problems from February 2 to February 9, 2021 by using patient health questionnaire-9 (PHQ-9) and generalized anxiety disorder-7 (GAD-7). The insomnia severity index (ISI), demographic data and COVID-19 related variables were measured by a self-designed questionnaire. The factors associated with depressive and anxiety symptoms were identified by Pearson chi-square test and binary logistic regression analysis. Results In the study that 1171 participants enrolled, the overall prevalence of depressive and anxiety symptoms among general people was 22.6 and 21.4% respectively in the present study. Living alone was a potential risk factor for depressive symptoms, while regular exercises was a potential protective factor. The prevalence of depressive and anxiety symptoms was significantly associated with the severity of insomnia symptoms and the negative feelings about pandemic. Conclusion COVID-19 pandemic- related chronic stress has brought about profound impacts on long-term mental health in the general population. The level of insomnia and a negative attitude towards the pandemic are significantly correlated with unfavorable mental health. However, we failed to found a significant association of age and gender with the mental health symptoms, although they were recognized as well-established risk factors during the outbreak by some other studies. This discrepancy may be because the acute and chronic effects of the pandemic are influenced by different factors, which reminds that more attention should be paid to the intrinsic psychological factors and physical reactions towards COVID-19.


2021 ◽  
Vol 18 (2) ◽  
pp. 79-84
Author(s):  
Olusola Ayodele Sogebi ◽  
Emmanuel Abayomi Oyewole

Background: Nasal septum collections (hematoma and abscess) can lead to structural and functional abnormalities. Our objective was to assess the clinical characteristics, management and complications of nasal septal collections, and document factors associated withtheir complications. Methods: This was a retrospective study of patients managed for nasal septal collections. Socio-demographic and clinical information was recorded, and the main investigations and results noted. Follow-up and complications of septal collections were documented and the clinical factors associated with the complications explored. Results: Twenty-four patients records were studied: male: female ratio=2:1, mean age 40.1±13.1years,62.5% presented with complaints of nasal obstruction, 66.7% had antecedent nasal trauma, presentation was from 2 to 13 days,25%had co-morbid disease(s). All patients had incision and drainage of the septal collection within 1–7 h; 41.2% of the aspirated collections cultured microorganisms, 20.8% developed complications. Increased age above 45 years, co-morbidity, delayed presentation, culture-positive aspirate was all significantly associated with development of complications. Conclusion: Nasal septal collections were more common in adult males with antecedent nasal trauma; 20% developedcomplications associated with the presence of culturepositive abscesses, increased age, and duration of septal collection. Keywords: Nasal trauma, Septal hematoma, Septal abscess, Complications


2020 ◽  
Vol 32 (6) ◽  
pp. 486-492
Author(s):  
Marisa Felsher ◽  
Scarlett Bellamy ◽  
Brogan Piecara ◽  
Barbara Van Der Pol ◽  
Rose Laurano ◽  
...  

This study used Behavioral Model for Vulnerable Populations (BMVP) to identify factors associated with pre-exposure prophylaxis (PrEP) initiation among women who inject drugs (WWID) when PrEP was offered at a syringe services program (SSP). Participants (n = 89) were WWID, $ge18 years, and eligible for PrEP. Most (69) initiated PrEP. Chi square and t tests were used to identify bivariate relationships between BMVP factors and PrEP initiation. A greater proportion of PrEP initiators (compared to non-initiators) reported sexual assault, frequent SSP attendance, earning $ge$5,000 annually and inconsistent condom use. Findings can inform the development of gender-specific strategies to promote PrEP among WWID.


Author(s):  
Parasappa Joteppa Yaranal ◽  
N Prasanna ◽  
Anantharao Shankar Anand

Introduction: Gastrointestinal Stromal Tumour (GIST) is one of the most common mesenchymal tumours of GIT. They have been proved to be arising from the smooth muscle pacemaker interstitial cells of Cajal, these cells are involved in gut motility and peristaltic movements. They can also rarely arise outside the Gastrointestinal Tract (GIT) from retroperitoneum, mesentery and omentum called as Extragastrointestinal Stromal Tumor (EGIST). Single best defining feature of GIST is positivity for Cytoplasmic Tyrosine Kinase (c-KIT). Aim: The aim of the study was to analyse clinicopathological features and c-KIT expression in both gastrointestinal and EGISTs. Materials and Methods: This was a retrospective observational (cohort) study; over a period of two years from January 2018 to December 2019, done at Navodaya Medical College and Hospital, Raichur, Karnataka, which comprised of 12 cases of GIST. All the cases were a resected specimens and thorough evaluation of clinical, imaging and histopathological studies were done and forwarded for immunohistochemistry for c-KIT expression. Results: Age of cases ranged from 04-70 years, mean age being 50.6 years and male to female ratio 2:1. Presenting symptoms of most of GIST were pain abdomen, diarrhea and few with vomiting whereas, rectosigmoid GISTs (2 cases and one with metastasis to liver) were associated with pain abdomen, bleeding per rectum and constipation. One case of retroperitoneal (extraintestinal) GIST was asymptomatic and other presented with pain in the right hip due to secondaries and one benign gastric serosal GIST was associated with gastric adenocarcinoma. The CT scan in two of malignant GISTs, confirmed metastasis and c-KIT study was negative in these 2 malignant GISTs. Conclusion: This study reaffirms importance of CD117 in diagnosis of GIST and EGIST, however, the negativity of CD117 does not rule out GIST, which requires thorough clinico-radiological and pathological correlation.


Author(s):  
Samuel I Imeh‐Nathaniel ◽  
Oreoluwa O Coker‐Ayo ◽  
Liddy Agbomi ◽  
Nneoma Madubike ◽  
Chika Pamela ◽  
...  

Introduction : Alzheimer dementia (AD) has been reported in both men and women. However, factors contributing to gender differences are not fully understood. We tested the hypothesis that specific pharmacological, demographic, and risk factors contribute to gender difference in AD. Methods : A retrospective analytical approach was used to analyze data from 12,632 AD patients, comprising 4,584 men and 8,048 women. Univariate and multivariate analyses determined the factors contributing to the gender difference in AD patients. Results : About 36% of AD patients were men, and 64% were women. Citalopram (OR = 1.187, 95% CI, 1.044 – 1.350, P = 0.009) was associated with men, while escitalopram (OR = 1.213, 95% CI, 1.119 – 1.315, P<0.001) was associated with women. In both men and women, increasing age (OR = 1.075, 95% CI, 1.071 – 1.079, P<0.001/OR = 1.096, 95% CI, 1.093 – 1.100, P<0.001), tobacco use (OR = 1.150, 95% CI, 1.054 – 1.254, P = 0.002/OR = 1.150, 95% CI, 1.073 – 1.233, P<0.001), and black patients (OR = 2.380, 95% CI, 2.120 – 2.674, P<0.001/OR = 1.395, 95% CI, 1.268 – 1.535, P<0.001) were associated with AD. Conclusions : Our findings reveal similarities and differences in factors associated with both men and women AD patients, suggesting the development of management strategies for the care of AD.


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