scholarly journals Updated overview on the interplay between obesity and COVID-19

Diagnosis ◽  
2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Diletta Onorato ◽  
Giovanni Carpenè ◽  
Giuseppe Lippi ◽  
Mairi Pucci
Keyword(s):  
Disease Severity ◽  
Clinical Characteristics ◽  
Literature Search ◽  
Scientific Literature ◽  
Population Sample ◽  
Obese Patients ◽  
Health Crisis ◽  
Keywords Obesity ◽  
Negative Prognostic Factor ◽  
The Impact

AbstractThe worldwide spread of coronavirus disease 2019 (COVID-19) has generated a global health crisis and more than a million deaths so far. Epidemiological and clinical characteristics of COVID-19 are increasingly reported, along with its potential relationship with overweight and/or obesity. Therefore, we aim here to review the current scientific literature on the impact of overweight and/or obesity among hospitalized patients who have developed severe or critical forms of COVID-19. Following PRISMA guidelines, our literature search identified over 300 scientific articles using the keywords “obesity” and “COVID-19”, 22 of which were finally selected for reporting useful information on the association between overweight/obesity and disease severity. In particular, in 11 out of the 14 studies (79%) which evaluated the association between obesity and disease severity providing also a risk estimate (i.e., the odd ratio; OR), the OR value was constantly >2. Although the studies were found to be heterogeneous in terms of design, population, sample size and endpoints, in most cases a significant association was found between obesity and the risk of progressing to severe COVID-19 illness, intensive care unit admission and/or death. We can hence conclude that an increased body mass index shall be considered a negative prognostic factor in patients with COVID-19, and more aggressive prevention or treatment shall hence be reserved to overweight and/or obese patients.

Manuscript title: “COVID-19 pandemic: care for Indian cancer patients”

Coronaviruses ◽  
2020 ◽  
Vol 01 ◽  
Author(s):  
Sandeep Kumar
Keyword(s):  
Cancer Patients ◽  
Literature Search ◽  
Health Crisis ◽  
Patients With Cancer ◽  
Cancer Management ◽  
Care Facilities ◽  
Containment Measures ◽  
The Impact ◽  
Significant Health ◽  
Practical Recommendations

Background:: Current COVID-19 pandemic poses a significant health crisis caused by SARS-CoV-2 coronavirus around the globe, including India. Patients with cancer, especially those who underwent treatment, may have a higher risk of getting sicker with COVID-19 disease. Medical care facilities aim to provide proper treatment to cancer patients while minimizing the possibilities of COVID-19 transmission. Objective:: The perspective article summarizes practical recommendations and perspective answers to all difficulties so that we can better treat and care for cancer patients. Method:: The literature search includes recent publications and guidelines/recommendation of the central institutes of India. Results:: Social distancing, guidelines, rescheduling the treatment of stable patients, nutritional care and telecommunication are some of the containment measures that can be applied in clinical practice in cancer management in COVID-19 pandemic. Conclusion:: With these interventions discussed above, we can reduce the impact of this pandemic and deliver the best care to cancer patients.

scholarly journals Impact of a Search Engine on Clinical Decisions Under Time and System Effectiveness Constraints: Research Protocol (Preprint)

2018 ◽  
Author(s):  
Anton van der Vegt ◽  
Guido Zuccon ◽  
Bevan Koopman ◽  
Anthony Deacon
Keyword(s):  
Literature Search ◽  
Clinical Decision Making ◽  
Scientific Literature ◽  
Clinical Decision ◽  
Clinical Decisions ◽  
Search System ◽  
Clinical Questions ◽  
The Impact ◽  
System Effectiveness ◽  
Search Systems

BACKGROUND Many clinical questions arise during patient encounters that clinicians are unable to answer. An evidence-based medicine approach expects that clinicians will seek and apply the best available evidence to answer clinical questions. One commonly used source of such evidence is scientific literature, such as that available through MEDLINE and PubMed. Clinicians report that 2 key reasons why they do not use search systems to answer questions is that it takes too much time and that they do not expect to find a definitive answer. So, the question remains about how effectively scientific literature search systems support time-pressured clinicians in making better clinical decisions. The results of this study are important because they can help clinicians and health care organizations to better assess their needs with respect to clinical decision support (CDS) systems and evidence sources. The results and data captured will contribute a significant data collection to inform the design of future CDS systems to better meet the needs of time-pressured, practicing clinicians. OBJECTIVE The purpose of this study is to understand the impact of using a scientific medical literature search system on clinical decision making. Furthermore, to understand the impact of realistic time pressures on clinicians, we vary the search time available to find clinical answers. Finally, we assess the impact of improvements in search system effectiveness on the same clinical decisions. METHODS In this study, 96 practicing clinicians and final year medical students are presented with 16 clinical questions which they must answer without access to any external resource. The same questions are then represented to the clinicians; however, in this part of the study, the clinicians can use a scientific literature search engine to find evidence to support their answers. The time pressures of practicing clinicians are simulated by limiting answer time to one of 3, 6, or 9 min per question. The correct answer rate is reported both before and after search to assess the impact of the search system and the time constraint. In addition, 2 search systems that use the same user interface, but which vary widely in their search effectiveness, are employed so that the impact of changes in search system effectiveness on clinical decision making can also be assessed. RESULTS Recruiting began for the study in June 2018. As of the April 4, 2019, there were 69 participants enrolled. The study is expected to close by May 30, 2019, with results to be published in July. CONCLUSIONS All data collected in this study will be made available at the University of Queensland’s UQ eSpace public data repository. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/12803

Alteraciones sistémicas y metabólicas producidas por lesión medular

2019 ◽  
Vol 1 (1) ◽  
pp. 59-75
Author(s):  
Gabriel Guízar Sahagún
Keyword(s):  
Spinal Cord ◽  
Daily Living ◽  
Autonomic Function ◽  
Clinical Presentation ◽  
Scientific Literature ◽  
International Standards ◽  
Therapeutic Approaches ◽  
Cord Injury ◽  
Life Threatening ◽  
The Impact

Besides the well-known loss of motor and sensory capabilities, people with spinal cord injury (SCI) experience a broad range of systemic and metabolic abnormalities including, among others, dysfunction of cardiovascular, respiratory, gastrointestinal, urinary, and endocrine systems. These alterations are a significant challenge for patients with SCI because such disorders severely interfere with their daily living and can be potentially life-threatening. Most of these disorders are associated with impairment of regulation of the autonomic nervous system, arising from disruption of connections between higher brain centers and the spinal cord caudal to the injured zone. Thus, the higher and more complete the lesion, the greater the autonomic dysfunction and the severity of complications.This article summarizes the medical scientific literature on key systemic and metabolic alterations derived of SCI. It provides information primarily focused on the pathophysiology and clinical presentation of these disorders, as well as some guides to prevent and alleviate such complications. Due to the impact of these alterations, this topic must be a priority and diffuse to those involved with the care of people with SCI, including the patient himself/herself. We consider that any collaborative effort should be supported, like the development of international standards, to evaluate autonomic function after SCI, as well as the development of novel therapeutic approaches.

Novel Applications of Nanotechnology in Controlling HIV and HSV Infections

2020 ◽  
Vol 12 ◽  
Author(s):  
Sai Akilesh M ◽  
Ashish Wadhwani
Keyword(s):  
Drug Delivery ◽  
Viral Infections ◽  
Polymeric Nanoparticles ◽  
Volume Ratio ◽  
Fold Increase ◽  
Multi Drug Resistance ◽  
Health Crisis ◽  
Pharmaceutical Properties ◽  
Simplex Virus ◽  
The Impact

: Infectious diseases have been prevalent since many decades and viral pathogens have caused global health crisis and economic meltdown on a devastating scale. High occurrence of newer viral infections in the recent years, in spite of the progress achieved in the field of pharmaceutical sciences defines the critical need for newer and more effective antiviral therapies and diagnostics. The incidence of multi-drug resistance and adverse effects due to the prolonged use of anti-viral therapy is also a major concern. Nanotechnology offers a cutting edge platform for the development of novel compounds and formulations for biomedical applications. The unique properties of nano-based materials can be attributed to the multi-fold increase in the surface to volume ratio at the nano-scale, tunable surface properties of charge and chemical moieties. Idealistic pharmaceutical properties such as increased bioavailability and retention times, lower toxicity profiles, sustained release formulations, lower dosage forms and most importantly, targeted drug delivery can be achieved through the approach of nanotechnology. The extensively researched nano-based materials are metal and polymeric nanoparticles, dendrimers and micelles, nano-drug delivery vesicles, liposomes and lipid based nanoparticles. In this review article, the impact of nanotechnology on the treatment of Human Immunodeficiency Virus (HIV) and Herpes Simplex Virus (HSV) viral infections during the last decade are outlined.

Impact of influenza virus during pregnancy: from disease severity to vaccine efficacy

2020 ◽  
Vol 15 (7) ◽  
pp. 441-453
Author(s):  
Ana Vazquez-Pagan ◽  
Rebekah Honce ◽  
Stacey Schultz-Cherry
Keyword(s):  
Influenza Virus ◽  
Virus Infection ◽  
Immune Responses ◽  
Pregnant Women ◽  
Disease Severity ◽  
Influenza A ◽  
Antiviral Treatment ◽  
Influenza Virus Infection ◽  
Severe Influenza ◽  
The Impact

Pregnant women are among the individuals at the highest risk for severe influenza virus infection. Infection of the mother during pregnancy increases the probability of adverse fetal outcomes such as small for gestational age, preterm birth and fetal death. Animal models of syngeneic and allogeneic mating can recapitulate the increased disease severity observed in pregnant women and are used to define the mechanism(s) of that increased severity. This review focuses on influenza A virus pathogenesis, the unique immunological landscape during pregnancy, the impact of maternal influenza virus infection on the fetus and the immune responses at the maternal–fetal interface. Finally, we summarize the importance of immunization and antiviral treatment in this population and highlight issues that warrant further investigation.

scholarly journals Be Aware of Burnout! The Role of Changes in Academic Burnout in Problematic Facebook Usage among University Students

2021 ◽  
Vol 18 (15) ◽  
pp. 8055
Author(s):  
Katarzyna Tomaszek ◽  
Agnieszka Muchacka-Cymerman
Keyword(s):  
Regression Coefficient ◽  
Population Sample ◽  
Cross Sectional ◽  
Academic Burnout ◽  
Independent Variables ◽  
Social Motive ◽  
Explained Variance ◽  
The Impact ◽  
The Relationship

Most previous research has examined the relationship between FB addiction and burnout level by conducting cross-sectional studies. Little is known about the impact of changes in burnout on FB addiction in an educational context. Through a two-way longitudinal survey of a student population sample (N = 115), this study examined the influence of changes in academic burnout over time and FB motives and importance (measured at the beginning and the end of the semester) on FB intrusion measured at the end of the academic semester. The findings show that: (1) increases in cynicism and in FB motives and importance significantly predicted time2 FB intrusion; (2) FB importance enhanced the prediction power of changes in the academic burnout total score, exhaustion and personal inefficacy, and reduced the regression coefficient of changes in cynicism; (3) the interaction effects between FB social motive use and changes in academic burnout, as well as between FB importance and personal inefficacy and exhaustion, accounted for a significant change in the explained variance of time2 FB intrusion. About 20–30% of the variance in time2 FB intrusion was explained by all the examined variables and by the interactions between them. The results suggest that changes in academic burnout and FB motives and importance are suppressive variables, as including these variables in the regression model all together changed the significance of the relationship between independent variables and FB intrusion.

scholarly journals Effect of Obesity on Clinical Failure of Patients Treated with Beta-Lactams

2021 ◽  
Author(s):  
Nathan A Pinner ◽  
Natalie G Tapley ◽  
Katie E Barber ◽  
Kayla R Stover ◽  
Jamie L Wagner
Keyword(s):  
Treatment Failure ◽  
Clinical Outcomes ◽  
Hospital Length Of Stay ◽  
Source Control ◽  
Definitive Treatment ◽  
Therapeutic Drug ◽  
Obese Patients ◽  
Definitive Therapy ◽  
All Cause Mortality ◽  
The Impact

Abstract Background Altered pharmacokinetics in obese patients raise concerns over worse clinical outcomes. This study assessed whether obese patients receiving a beta-lactam (BL) have worse clinical outcomes compared to non-obese patients and to identify if therapeutic drug monitoring (TDM) may be beneficial. Methods This multi-center, retrospective cohort included hospitalized adults admitted from July 2015-July 2017 treated with a BL as definitive monotherapy against a Gram-negative bacilli for ≥72 hours. Patients were excluded if there was lack of source control or if polymicrobial infections required >1 antibiotic for definitive therapy. Patients were classified based on body mass index (BMI): non-obese (BMI ≤29.9 kg/m 2) and obese (BMI ≥30.0 kg/m 2). The primary outcome was clinical treatment failure, and secondary were hospital length of stay (LOS), inpatient all-cause mortality, and 30-day all-cause readmission. Results There were 257 (43.6%) obese patients and 332 (56.4%) non-obese patients included. The most common infections were urinary (50.9%) and respiratory (31.4%). Definitive treatment was driven by 3 rd generation cephalosporins (46.9%) and cefepime (44.7%). Treatment failure occurred in 131 (51%) obese patients and 109 (32.8%) non-obese patients (p<0.001). Obesity and respiratory source were independently associated with increased likelihood of treatment failure. Obese patients were hospitalized longer than non-obese patients (p=0.002), but no differences were found for all-cause mortality (p=0.117) or infection-related readmission (0=0.112). Conclusions Obese patients treated with BLs have higher rates of treatment failure and longer hospitalization periods than non-obese patients. Future studies are needed to assess the impact of TDM and specific dosing recommendations for targeted infection types.

scholarly journals Clinical Characteristics and Outcomes of Patients with High Ankle-Brachial Index from the IMPACT-ABI Study

PLoS ONE ◽  
2016 ◽  
Vol 11 (11) ◽  
pp. e0167150 ◽  
Author(s):  
Hitoshi Nishimura ◽  
Takashi Miura ◽  
Masatoshi Minamisawa ◽  
Yasushi Ueki ◽  
Naoyuki Abe ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Ankle Brachial Index ◽  
The Impact

scholarly journals Ethnic comparison in takotsubo syndrome: novel insights from the International Takotsubo Registry

2021 ◽  
Author(s):  
Yoichi Imori ◽  
Ken Kato ◽  
Victoria L. Cammann ◽  
Konrad A. Szawan ◽  
Manfred Wischnewsky ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Clinical Characteristics ◽  
Ethnic Disparities ◽  
Japanese Patients ◽  
Learning Approach ◽  
Takotsubo Syndrome ◽  
Unique Identifier ◽  
Hospital Outcomes ◽  
Machine Learning Approach ◽  
The Impact

Abstract Background Ethnic disparities have been reported in cardiovascular disease. However, ethnic disparities in takotsubo syndrome (TTS) remain elusive. This study assessed differences in clinical characteristics between Japanese and European TTS patients and determined the impact of ethnicity on in-hospital outcomes. Methods TTS patients in Japan were enrolled from 10 hospitals and TTS patients in Europe were enrolled from 32 hospitals participating in the International Takotsubo Registry. Clinical characteristics and in-hospital outcomes were compared between Japanese and European patients. Results A total of 503 Japanese and 1670 European patients were included. Japanese patients were older (72.6 ± 11.4 years vs. 68.0 ± 12.0 years; p < 0.001) and more likely to be male (18.5 vs. 8.4%; p < 0.001) than European TTS patients. Physical triggering factors were more common (45.5 vs. 32.0%; p < 0.001), and emotional triggers less common (17.5 vs. 31.5%; p < 0.001), in Japanese patients than in European patients. Japanese patients were more likely to experience cardiogenic shock during the acute phase (15.5 vs. 9.0%; p < 0.001) and had a higher in-hospital mortality (8.2 vs. 3.2%; p < 0.001). However, ethnicity itself did not appear to have an impact on in-hospital mortality. Machine learning approach revealed that the presence of physical stressors was the most important prognostic factor in both Japanese and European TTS patients. Conclusion Differences in clinical characteristics and in-hospital outcomes between Japanese and European TTS patients exist. Ethnicity does not impact the outcome in TTS patients. The worse in-hospital outcome in Japanese patients, is mainly driven by the higher prevalence of physical triggers. Trial Registration URL: https://www.clinicaltrials.gov; Unique Identifier: NCT01947621.

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