scholarly journals Coronavirus Disease-2019, Diabetes and Dialysis in Southern Italy: The Second Wave Follow-up

2020 ◽  
Vol 6 (2) ◽  
pp. 37-46
Author(s):  
Felice Strollo ◽  
◽  
Ersilia Satta ◽  
Carmine Romano ◽  
Carmelo Alfarone ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Public Transportation ◽  
Strong Association ◽  
World Health ◽  
Campania Region ◽  
Social Community ◽  
Containment Measures ◽  
Health Organization

Background After the official coronavirus (severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)) pandemic declaration by the World Health Organization (WHO), Italy had the second-largest number of confirmed cases, after China. The Italian government introduced progressive infection-mitigation measurements, thus dramatically reducing social interactions and preventing virus spread. During the summer, infection containment measures progressively loosened until, due to an unjustified interpretation of some permissions and the excessive utilization of public transportation at school reopening, the contagion rate progressively increased until causing a severe challenge for our National Health Service (NHS) again. Aim To assess the efficiency of our previously described protocol in 18 Campania region-located Nefrocenter Consortium dialysis centers (DCs) as further adapted to new knowledge under the new ubiquitous contagion conditions and to identify SARS-CoV-2-infection mortality rate and risk factors. Methods 381 HCP members underwent regular monitoring on April 1 and November 13, 2020. Dialysis patients did so too during that period according to the expected shifting prevalence over time (mean±SD:853±30 per month; range 825 to 873) vs (11.8% in April, and 14.8% in November vs. a pre-coronavirus disease-2019 (COVID-19) 12.0% rate in January). Results More patients got infected in November (10.19%) than in April (0,24%), and 22 patients of the 89 from the SARS-CoV-2 November positive subjects required hospitalization for moderate-severe symptoms (24.72%), with death unavoidably coming in 19 (86.36% of hospitalized and 21.35% of infected patients) compared to the only one recorded in April (0.12%). The pandemic’s two periods showed a strong association between mortality rate and often co-existing comorbidities, primarily represented by arterial hypertension, type 2 diabetes mellitus (T2DM), and chronic kidney disease (CKD). Conclusion The previously efficient contagion containment measures adopted by our DCs were not enough in November to fight the global infection risk pending on the whole Italian social community around. The author, discuss possible reasons and put forward further suggestions for the best handling of any future infection waves.

scholarly journals MO644:DIABETES AND DIALYSIS:PROPOSAL FOR  A CONTAGION  PREVENTION PROTOCOL IN COVID-19 PANDEMIA

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Ersilia Satta ◽  
Carmine Romano ◽  
Tersa Della Corte ◽  
Ilaria Raiola ◽  
Carmelo Alfarone ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Social Interactions ◽  
Public Transportation ◽  
Strong Association ◽  
Campania Region ◽  
Social Community ◽  
Italian Government ◽  
Containment Measures ◽  
Prevention Protocol

Abstract Background and Aims After the official coronavirus (SARS-CoV-2) pandemic declaration by the WHO, Italy had the second-largest number of confirmed cases, after China. The Italian government introduced progressive infection-mitigation measurements, thus dramatically reducing social interactions and preventing virus spread. During the summer, infection containment measures progressively loosened until, due to an unjustified interpretation of some permissions and the excessive utilization of public transportation at school reopening, the contagion rate progressively increased until causing a severe challenge for our NHS again. Aim of the study: to assess the efficiency of our previously described protocol in 18 Campania region-located Nefrocenter Consortium DCs as further adapted to new knowledge under the new ubiquitous contagion conditions and to identify SARS-CoV-2-infection mortality rate and risk factors. Method Dialysis patients did so too during that period according to the expected shifting prevalence over time (mean ± SD: 853 ± 30 per month; range 825 to 873) ± (11.8% in April, and 14.8% in November vs. a pre-COVID-19 12.0% rate in January). Results More patients got infected in November (10.19%) than in April (0,24%), and 22 patients of the 89 from the SARS-CoV-2 November positive subjects required hospitalization for moderate-severe symptoms (24.72%), with death unavoidably coming in 19 (86.36% of hospitalized and 21.35% of infected patients) compared to the only one recorded in April (0.12%). The pandemic's two periods showed a strong association between mortality rate and often co-existing comorbidities, primarily represented by arterial hypertension, type 2 diabetes mellitus (T2DM), and chronic kidney disease (CKD). Conclusion The prevously efficient contagion containment measures adopted by our DCs were not enough in November to fight the global infection risk pending on the whole Italian social community around. The Authors discuss possible reasons and put forward further suggestions for the best handling of any future infection waves

scholarly journals The epidemiology of tuberculosis-associated hyperglycemia in individuals newly screened for type 2 diabetes mellitus: systematic review and meta-analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sonia Menon ◽  
Rodolfo Rossi ◽  
Alfred Dusabimana ◽  
Natasha Zdraveska ◽  
Samit Bhattacharyya ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Meta Analysis ◽  
World Health ◽  
Tb Treatment ◽  
Search Terms ◽  
Total Burden ◽  
Health Organization

Abstract Background There is scarce evidence that tuberculosis (TB) can cause diabetes in those not previously known to be diabetic. Whilst the World Health Organization (WHO) recommends screening for Diabetes Mellitus (DM) at the onset of TB treatment, nevertheless, it remains to be elucidated which patients with TB-associated hyperglycemia are at higher risk for developing DM and stand to benefit from a more regular follow-up. This review aims to firstly quantify the reduction of newly detected hyperglycemia burden in TB patients who are on treatment over time; secondly, determine the burden of TB-associated hyperglycemia after follow-up, and thirdly, synthesize literature on risk factors for unresolved TB-associated hyperglycemia in previously undiagnosed individuals. Methods We searched PUBMED, EMBASE, SCOPUS, and Global Health for articles on TB-associated hyperglycemia up to September 30th, 2019. Search terms included Tuberculosis and hyperglycemia/DM, and insulin resistance. We appraised studies, extracted data, and conducted a meta-analysis to assess the change of the burden of hyperglycemia in prospective studies. The review is registered in the PROSPERO database (CRD42019118173). Results Eleven studies were included in the meta-analysis yielding a total of 677 (27,3%) of patients with newly detected hyperglycemia at baseline. The mean quality score of eligible studies using the Newcastle-Ottawa Quality Assessment Scale was 7.1 out of 9 (range 6-9). The pooled unresolved new cases of hyperglycemia at the end of follow up was 50% (95% CI: 36–64%) and the total pooled burden of hyperglycemia at 3–6 months of follow up was 11% (95% CI: 7–16%), with both estimates displaying a high heterogeneity, which remained significant after performing a sub-analysis by DM diagnostic method and 3 months of follow up. As only 2 studies explored risk factors for unresolved hyperglycemia, no meta-analysis was performed on risk factors. Conclusion Our meta-analysis showed that although in half of the patients with newly observed hyperglycemia at baseline, it remained unresolved at a follow-up of 3 to 6 months, the total burden of hyperglycemia is slightly above 10%, 3 months after initiating TB treatment. Studies are warranted to assess whether risk factors including HIV positivity, smoking, and extensive pulmonary TB disease put patients at higher risk for DM.

The Impact of the World Health Organization Classification and Clonality Assessment of Posttransplant Lymphoproliferative Disorders on Disease Management

2006 ◽  
Vol 130 (11) ◽  
pp. 1649-1653
Author(s):  
Walid A. Mourad ◽  
Asma Tulabah ◽  
Adher Al Sayed ◽  
Madras Raja ◽  
Yasser Khafaga ◽  
...  
Keyword(s):  
World Health Organization ◽  
Lymphoproliferative Disorders ◽  
World Health ◽  
World Health Organization Classification ◽  
The World ◽  
Health Organization ◽  
Type 3 ◽  
Posttransplant Lymphoproliferative Disorders

Abstract Context.—The World Health Organization classification of posttransplant lymphoproliferative disorders divides them into 4 main categories. Objective.—To classify cases of posttransplant lymphoproliferative disorders diagnosed in our institution according to the World Health Organization scheme and correlate the classification and clonality with clinical data. Design.—Cases of posttransplant lymphoproliferative disorders were reviewed. They were classified according to the World Health Organization scheme. Clonality was determined by flow cytometry and/or polymerase chain reaction. Patients' charts were reviewed. Results.—Thirty-one cases were identified. Median age was 33 years. There were 19 cases of kidney, 8 cases of liver, and 4 cases of bone marrow transplant. Immunosuppression consisted of cyclosporin A and prednisone (N = 24) or FK506 and prednisone (N = 7). Twenty cases (63%) were World Health Organization type 3, 7 cases (23%) type 2, 3 cases (6.4%) type 1, and 1 case type 4 posttransplant lymphoproliferative disorder. Ten patients received chemotherapy, 20 patients had reduction of immunosuppression, and 1 had no treatment. Follow-up was available on 25 patients. Seven (43.75%) of 16 with type 3 lesions with available follow-up died of their disease. Five of these patients received reduction of immunosuppression alone. Only 2 of 9 patients with type 3 disease who received chemotherapy died of disease. Two patients with type 2 disease died of unrelated causes. One patient is alive with disease; the remaining patients with types 1 and 2 disease are alive with no disease. Conclusions.—The World Health Organization classification of posttransplant lymphoproliferative disorders is valuable in the identification of subtypes. It helps identify early lesions (1 and 2) requiring reduction of immunosuppression and type 3 disease, which requires chemotherapy from the outset.

scholarly journals Project for the Notification and Follow-up of COVID-19 at Hospital CUF Sintra

2020 ◽  
Author(s):  
Patrícia Mora ◽  
Matilde Lagoa ◽  
Carolina Baltazar ◽  
Diogo Carvalho ◽  
Gonçalo Da Câmara ◽  
...  
Keyword(s):  
Health Professionals ◽  
Active Role ◽  
World Health ◽  
Epidemiological Surveillance ◽  
Senior Year ◽  
Response Strategies ◽  
Official Statement ◽  
Containment Measures ◽  
Health Organization

First discovered in the Chinese province of Wuhan, in early December 2019, the infection by the new coronavirus led to a pandemic prompting the declaration of an International Public Health Emergency by the World Health Organization on the 30th of January 2020. In Portugal, the first cases date from the 3rd of March 2020 with more than 24 600 positive cases of the 247 000 suspected cases within only two months. Given the seriousness of the situation, a National State of Emergency was declared on the 18th of March and extended on April 2nd and 17th 2020. Consequently, and according to the official statement issued by NOVA Medical School in accordance with the previous statement from the NOVA University of Lisbon and the Council of Portuguese Medical Schools regarding the containment measures to be implemented, all clinical practise activities were suspended. In light of this reality, the senior year finalists revealed motivation in playing an active role during the outbreak, showing availability to collaborate with the local authorities and health professionals. A partnership was hence established with the José de Mello Saúde/CUF Health Unit, that supported this initiative by integrating students at the CUF Sintra Hospital (one of its COVID-free units) in administrative tasks under guidance and tutoring of Patrícia Mora, MD. The project started on the 31st of March 2020, with the students collaborating in case notifications on the platform of the National Epidemiological Surveillance System, an instrument that has been essential in collecting representative data for the elaboration of national response strategies, and later updating the internal database. This project contributed to significantly reduce the administrative burden of health professionals with appreciable gains in the availability of doctors and nurses for the assistance and provision of differentiated care and follow-up of clients with or without infection with the new coronavirus

scholarly journals Programme for Harmonization to the International Scale in Latin America for BCR-ABL1 quantification in CML patients: findings and recommendations

2020 ◽  
Vol 58 (12) ◽  
pp. 2025-2035
Author(s):  
María Sol Ruiz ◽  
María Belén Sánchez ◽  
Yuly Masiel Vera Contreras ◽  
Evangelina Agrielo ◽  
Marta Alonso ◽  
...  
Keyword(s):  
Latin America ◽  
Myeloid Leukemia ◽  
World Health ◽  
Molecular Response ◽  
Limit Of Quantification ◽  
International Scale ◽  
Deep Molecular Response ◽  
Health Organization ◽  
First Time

AbstractObjectivesThe quantitation of BCR-ABL1 mRNA is mandatory for chronic myeloid leukemia (CML) patients, and RT-qPCR is the most extensively used method in testing laboratories worldwide. Nevertheless, substantial variation in RT-qPCR results makes inter-laboratory comparability hard. To facilitate inter-laboratory comparative assessment, an international scale (IS) for BCR-ABL1 was proposed.MethodsThe laboratory-specific conversion factor (CF) to the IS can be derived from the World Health Organization (WHO) genetic reference panel; however, this material is limited to the manufacturers to produce and calibrate secondary reference reagents. Therefore, we developed secondary reference calibrators, as lyophilized cellular material, aligned to the IS. Our purpose was both to re-evaluate the CF in 18 previously harmonized laboratories and to propagate the IS to new laboratories.ResultsOur field trial including 30 laboratories across Latin America showed that, after correction of raw BCR-ABL1/ABL1 ratios using CF, the relative mean bias was significantly reduced. We also performed a follow-up of participating laboratories by annually revalidating the process; our results support the need for continuous revalidation of CFs. All participating laboratories also received a calibrator to determine the limit of quantification (LOQ); 90% of them could reproducibly detect BCR-ABL1, indicating that these laboratories can report a consistent deep molecular response. In addition, aiming to investigate the variability of BCR-ABL1 measurements across different RNA inputs, we calculated PCR efficiency for each individual assay by using different amounts of RNA.ConclusionsIn conclusion, for the first time in Latin America, we have successfully organized a harmonization platform for BCR-ABL1 measurement that could be of immediate clinical benefit for monitoring the molecular response of patients in low-resource regions.

scholarly journals Trials and Tribulations: mHealth Clinical Trials in the COVID-19 Pandemic

2021 ◽  
Author(s):  
Praveen Indraratna ◽  
Uzzal Biswas ◽  
Jennifer Yu ◽  
Guenter Schreier ◽  
Sze-Yuan Ooi ◽  
...  
Keyword(s):  
Decompensated Heart Failure ◽  
Hospital Staff ◽  
Outpatient Setting ◽  
World Health ◽  
Randomised Control Trial ◽  
Contact Method ◽  
Model Of Care ◽  
Coronary Syndrome ◽  
Health Organization

Introduction: Mobile phone-based interventions in cardiovascular disease are growing in popularity. A randomised control trial (RCT) for a novel smartphone app-based model of care, named TeleClinical Care - Cardiac (TCC-Cardiac), commenced in February 2019, targeted at patients being discharged after care for an acute coronary syndrome or episode of decompensated heart failure. The app was paired to a digital sphygmomanometer, weighing scale and a wearable fitness band, all loaned to the patient, and allowed clinicians to respond to abnormal readings. The onset of the COVID-19 pandemic necessitated several modifications to the trial in order to protect participants from potential exposure to infection. The use of TCC-Cardiac during the pandemic inspired the development of a similar model of care (TCC-COVID), targeted at patients being managed at home with a diagnosis of COVID-19. Methods: Recruitment for the TCC-Cardiac trial was terminated shortly after the World Health Organization announced COVID-19 as a global pandemic. Telephone follow-up was commenced, in order to protect patients from unnecessary exposure to hospital staff and patients. Equipment was returned or collected by a ‘no-contact’ method. The TCC-COVID app and model of care had similar functionality to the original TCC-Cardiac app. Participants were enrolled exclusively by remote methods. Oxygen saturation and pulse rate were measured by a pulse oximeter, and symptomatology measured by questionnaire. Measurement results were manually entered into the app and transmitted to an online server for medical staff to review. Results: A total of 164 patients were involved in the TCC-Cardiac trial, with 102 patients involved after the onset of the pandemic. There were no hospitalisations due to COVID-19 in this cohort. The study was successfully completed, with only three participants lost to follow-up. During the pandemic, 5 of 49 (10%) of patients in the intervention arm were readmitted compared to 12 of 53 (23%) in the control arm. Also, in this period, 28 of 29 (97%) of all clinically significant alerts received by the monitoring team were managed successfully in the outpatient setting, avoiding hospitalisation. Patients found the user experience largely positive, with the average rating for the app being 4.56 out of 5. 26 patients have currently been enrolled for TCC-COVID. Recruitment is ongoing. All patients have been safely and effectively monitored, with no major adverse clinical events or technical malfunctions. Patient satisfaction has been high. Conclusion: The TCC-Cardiac RCT was successfully completed despite the challenges posed by COVID-19. Use of the app had an added benefit during the pandemic as participants could be monitored safely from home. The model of care inspired the development of an app with similar functionality designed for use with patients diagnosed with COVID-19.

Orthokeratinized Odontogenic Cyst: A Clinicopathologic Study of 61 Cases

2010 ◽  
Vol 134 (2) ◽  
pp. 271-275 ◽  
Author(s):  
Qing Dong ◽  
Shuang Pan ◽  
Li-Sha Sun ◽  
Tie-Jun Li
Keyword(s):  
Odontogenic Cyst ◽  
World Health ◽  
Keratocystic Odontogenic Tumor ◽  
Impacted Tooth ◽  
Ki 67 ◽  
Orthokeratinized Odontogenic Cyst ◽  
Clinicopathologic Study ◽  
Mandibular Molar ◽  
Health Organization

Abstract Context.—Orthokeratinized odontogenic cyst (OOC) is a relatively uncommon developmental cyst comprising about 10% of cases that had been previously coded as odontogenic keratocysts. Odontogenic keratocyst was designated as keratocystic odontogenic tumor (KCOT) in the new World Health Organization classification and OOC should be distinguished from KCOT for differences in histologic features and biologic behavior. Objective.—To analyze the clinicopathologic features of 61 cases of OOC in a Chinese population. Design.—Clinicopathologic analysis was performed on 61 cases of OOC. Immunohistochemical expression of Ki-67 and p63 was evaluated in 15 OOCs and 15 typical KCOTs. Results.—The 61 patients with OOC ranged from 13 to 75 years (average, 38.93 years). The lesions developed mainly in the third and fourth decades (57.38%) with a distinct predilection for males (72.13%). Six (9.84%) lesions were found in the maxilla and 55 (90.16%) in the mandible. The most common sites were in the mandibular molar and ramus region. Of the 54 cases with radiographic record, 47 (87.04%) were unilocular and 7 (12.96%) were multilocular radiolucencies. Twenty-seven of the 54 cysts were associated with an impacted tooth. Follow-up of 42 patients revealed no recurrence during an average period of 76.8 months after surgery. Compared with KCOTs, expression level of Ki-67 and p63 was significantly lower in OOCs, suggesting a lower proliferative activity. Conclusion.—Orthokeratinized odontogenic cyst is clinicopathologically distinct from KCOT and should constitute its own clinical entity.

Reasons for Vaccine Rejection in 0 to 2 Years Old Children Registered to Family Health Centers in Konya

2021 ◽  
Vol 16 (02) ◽  
pp. 074-079
Author(s):  
Hasan Kucukkendirci ◽  
Fatih Kara ◽  
Gulsum Gulperi Turgut
Keyword(s):  
Health Personnel ◽  
Family Health ◽  
Cross Sectional Study ◽  
World Health ◽  
University Graduates ◽  
Cross Sectional ◽  
Vaccination Programs ◽  
Vaccine Preventable Diseases ◽  
Health Organization

AbstractObjective According to the 2017 report of the World Health Organization (WHO), ∼1.5 million people die from vaccine preventable diseases. The WHO is working to generate and popularize effective vaccination programs. However, the concept of “vaccine rejection,” which first started in Europe and United States, has started to make an impact in Turkey during the past 10 years. It is therefore seen as a growing danger in future. This study was conducted to determine, detect, and prevent the reasons of vaccine rejection that have increased in recent years.Methods A cross-sectional study was conducted between June and December at 2015. In all districts of Konya (n = 31), it was aimed to reach all 242 families who rejected vaccination to their 0 to 2 years old babies. Families having more than one child refused to vaccinate all of their children. A questionnaire consisting of 47 questions was prepared by the researchers, using the standard trainings of the Ministry of Health and the literature. A total of 172 families agreed to participate in this study. The questionnaire was applied to the parents using the telephone interview technique. Data were presented as mean ± standard deviation and percentage.Results About 41.3% (n = 71) of the mothers were high school graduates, 50.6% (n = 87) of their fathers were university graduates. About 82.6% (n = 142) of the participants received examination, treatment and follow-up services from family physicians and family health personnel. About 20.9% (n = 36) of the children were the only children of the family. About 55.8% (n = 96) of the families also refused the vaccination for other children. About 83.7% (n = 144) of the unvaccinated children had infants/children follow-up care. While all participants stated that vaccines had side effects, 31.4% (n = 54) of these believed that vaccines cause autism or paralysis in infants. About 62.2% (n = 107) of their mothers did not receive tetanus vaccine during pregnancy. The highest rate of nonvaccination was with the second dose of hepatitis A vaccine, which 96.5% (n = 166) refused. The most accepted vaccine was the first dose of hepatitis B vaccine, which was refused by 18.0% (n = 31). About 79.7% (n = 137) of the participants did not know the reason for the vaccination and 95.9% (n = 165) thought that the vaccines were not required. All participants received information from the health personnel about the vaccines. While 9.9% (n = 17) of the families thought that vaccines cause infertility, 44.8% (n = 77) did not receive vaccination because the vaccines were produced abroad.Conclusion A growing number of families refuse to have their babies vaccinated. The production of vaccines abroad is a major cause of insecurity. There are also beliefs that vaccines cause infertility. Vaccine production in Turkey should be accelerated and public education about vaccines should be reviewed. Training provided to families about vaccines should also be reviewed.

scholarly journals Molluscicidal activity of crown of Christ (Euphorbia splendens var. hislopii) (Euphorbiaceae) latex submitted to pH variation

2003 ◽  
Vol 46 (3) ◽  
pp. 415-420 ◽  
Author(s):  
Maurício Carvalho Vasconcellos ◽  
José Augusto Albuquerque dos Santos ◽  
Ivonise Paz da Silva ◽  
Fátima Eliana Ferreira Lopes ◽  
Virgínia Torres Schall
Keyword(s):  
Mortality Rate ◽  
Aqueous Solutions ◽  
Schistosoma Mansoni ◽  
World Health Organization ◽  
Biomphalaria Glabrata ◽  
World Health ◽  
Ph Variation ◽  
Health Organization ◽  
Minor Concentration ◽  
Molluscicidal Activity

Laboratory and field bioassays have confirmed the specificity of the molluscicidal activity of the Euphorbia splendens var. hislopii latex (crown of Christ) (Euphorbiaceae) over snails of the species Biomphalaria glabrata, B. tenagophila, B. straminea, B. pfeifferi and Bulinus sp. in the control of Schistosoma mansoni. In the present study, the effect of the pH variation on lethal concentration (LC90) over B. tenagophila was evaluated. Bioassays with the aqueous solutions of the latex ranging from 0.4 to 12 µl/l were adjusted for pH of 5.0; 6.0; 7.0 and 8.0, and tested in accordance with methods standardized by World Health Organization. The results obtained indicated that the minor concentration of the latex occurred at pH 6.0 (LC90 = 3.2 µl/l) and the maximum at pH 8.0 (LC90 = 10.3 µl/l). Lethal concentrations adjusted for pH 5.0 and 7.0 were 3.4 µl/l and 4,7µl/l, respectively. From the results it could be concluded that the molluscicidal toxicity was not altered when the concentrations were adjusted for pH 5.0 and 6.0, as we observed that mortality rate was 100% starting at a concentration of 2.0 µl/l, not the same for the concentrations with adjustment for pH 7.0 and 8.0.

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