A Coronavirus Outbreak Linked to a Funeral Among a Romani Community in Central Italy

Background: The epidemic dynamics of COVID-19 in the Molise region, central Italy, has dramatically changed from the beginning of May 2020, which was when infections were reported amongst Romani people. The aims of this study were to describe the characteristics of an outbreak that occurred in the Romani community and the interventions implemented for control.Methods: A retrospective analysis of outbreak data was performed to describe the SARS-CoV-2 transmission dynamics.Results: A young Romani woman was the first case reported and epidemiological investigation established a possible link with the funeral of a deceased member of this community. In total, 150 close contacts within 34 family groups in two cities were traced, and 109 (72.7%) Romani individuals were found to be infected by COVID-19. The patient's median age was 31 years, 58% were female, and the highest (20.2%) incidence occurred in the 0–9 years age group. A total of 26 (23.8%) patients developed typical SARS-CoV-2 symptoms, 15 (57.8%) were hospitalized, and 21 (22.1%) had comorbidities [most commonly hypertension (28.6%) and/or coronary heart diseases (23.8%)]. The outbreak was effectively controlled through compulsory quarantine and enhanced active surveillance.Conclusions: This is the first study providing insight into COVID-19 transmission dynamics among a Romani population living in Italy. These findings support general conclusions about the role of crowded social gatherings in SARS-CoV-2 spread, the high communicability among close contacts and household settings, and the impact of asymptomatic carriers. These features are of relevance to certain Romani customs where family gatherings are a fundamental pillar of their lives. Although difficulties emerged in interacting with Romani people related to cultural drivers, beliefs, and lifestyle, the outbreak management was effective and should be considered as a valuable model applicable to similar incidents occurring in minority populations.

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Effect of Thyroid Hormone Therapy on Fatigability in Older Adults With Subclinical Hypothyroidism: A Nested Study Within a Randomized Placebo-Controlled Trial

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa123 ◽

2020 ◽

Vol 75 (9) ◽

pp. e89-e94

Author(s):

Mirah J Stuber ◽

Elisavet Moutzouri ◽

Martin Feller ◽

Cinzia Del Giovane ◽

Douglas C Bauer ◽

...

Keyword(s):

Older Adults ◽

Subclinical Hypothyroidism ◽

Heart Diseases ◽

Controlled Trial ◽

Community Dwelling ◽

Group Differences ◽

Coronary Heart Diseases ◽

Starting Dose ◽

The Mean ◽

The Impact

Abstract Background Fatigue often triggers screening for and treatment of subclinical hypothyroidism. However, data on the impact of levothyroxine on fatigue is limited and previous studies might not have captured all aspects of fatigue. Method This study is nested within the randomized, placebo-controlled, multicenter TRUST trial, including community-dwelling participants aged ≥65 and older, with persistent subclinical hypothyroidism (TSH 4.60–19.99 mIU/L, normal free thyroxine levels) from Switzerland and Ireland. Interventions consisted of daily levothyroxine starting with 50 μg (25 μg if weight <50 kg or known coronary heart diseases) together with dose adjustments to achieve a normal TSH and mock titration in the placebo group. Main outcome was the change in physical and mental fatigability using the Pittsburgh Fatigability Scale over 1 year, assessed through multivariable linear regression with adjustment for country, sex, and levothyroxine starting dose. Results Among 230 participants, the mean ± standard deviation (SD) TSH was 6.2 ± 1.9 mIU/L at baseline and decreased to 3.1 ± 1.3 with LT4 (n = 119) versus 5.3 ± 2.3 with placebo (n = 111, p < .001) after 1 year. After adjustment we found no between-group difference at 1 year on perceived physical (0.2; 95% CI −1.8 to 2.1; p = .88), or mental fatigability (−1.0; 95% CI −2.8 to 0.8; p = .26). In participants with higher fatigability at baseline (≥15 points for the physical score [n = 88] or ≥13 points for the mental score [n = 41]), the adjusted between-group differences at 1 year were 0.4 (95% CI −3.6 to 2.8, p = .79) and −2.2 (95% CI −8.8 to 4.5, p = .51). Conclusions Levothyroxine in older adults with mild subclinical hypothyroidism provides no change in physical or mental fatigability.

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Prospective Descriptive Study to Evaluate the Impact of Clinical Pharmacist in Antiplatelet Utilization and Safety in Coronary Heart Disease Patients

European Heart Journal Supplements ◽

10.1093/eurheartj/suab069.012 ◽

2021 ◽

Vol 23 (Supplement_D) ◽

Author(s):

Hisham Ah Nematalla ◽

Rasha Wafaie ◽

Enas Abd Elaziz ◽

Asser Ghoneem ◽

Ahmed Abd Elaaty

Keyword(s):

Adverse Effects ◽

Clinical Pharmacist ◽

Heart Diseases ◽

Admission Rate ◽

Team Approach ◽

Bleeding Events ◽

Coronary Insufficiency ◽

Coronary Heart Diseases ◽

Significant Difference ◽

The Impact

Abstract Aim To evaluate the interventions associated with integration of a clinical pharmacist for antiplatelets best utilization and safety as multidisciplinary team approach is recommended to improve patient outcomes. Methods prospective observational study on coronary heart diseases patients (stable angina, unstable angina, MI, post PCI or post CABG) on antiplatelets therapy (single antiplatelet; SAPT, or dual antiplatelet; DAPT) at governmental and private hospitals. Detailing pharmacist-initiated interventions targeting pharmacotherapy optimization (Dose, duplicate and interactions), also adverse effects detection, and hospital re-admission (re-event of coronary insufficiency). Collecting patients' data by interviews and hospital records using validated check list. Statistical software IBM SPSS software package version 20.0, The Kolmogorov-Smirnov was used to verify the normality of distribution of variables, Mann Whitney test was used to compare between two categories for not normally distributed quantitative variables. Kruskal Wallis test was used to compare different categories for abnormally distributed quantitative variables. Spearman coefficient was used to correlate between quantitative variables. Linear Regression was used to detect the most affecting factor for affecting DAPT score and Precise DAPT. Significance of the obtained results was judged at the 5% level, calculate sample size by G Power3. Results There is a significant correlation between cardiac related readmission and Precise DAPT score (P = 0.013).A statistically significant correlation is found between smoking and DAPT score (p = 0.015) but not with precise DAPT (P = 0.152). Also a significant linear association exists between DAPT type and DAPT score, for Aspirin + Clopidogrel (P = 0.010) (95%CI=-1.000 (-1.754 – -0.246), Aspirin + Ticagrilor (P = 0.012) (95%CI= 1.001 (0.228 – 1.774). The highly significant influencing variable in both scores, is the dose value, for DAPT score (P = 0.038), Precise DAPT (P = 0.001). The distribution of Myocardial infarction as cardiac related readmission and smoking are higher in males than females without statistically significant difference (P = 0.08), (P = 0.39), the absence of adverse effects and bleeding events is statistically significant in DAPT score (P = 0.041, 95%CI=1.706 (0.071 – 3.341) & precise DAPT score (P = 0.002, 95% CI= -15.95 (-25.832 – -6.074). Conclusions Impact of a clinical pharmacist within cardiology department generated substantial pharmacotherapy optimization which improve the medication adherence, safety and clinical outcomes. Our study suggests pre-calculating DAPT and precise DAPT for all patients before treatment and commitment on DAPT period administration may decrease re-admission rate of patients.

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Scar on my heart: effects of unemployment experiences on coronary heart disease

International Journal of Manpower ◽

10.1108/ijm-02-2016-0044 ◽

2017 ◽

Vol 38 (1) ◽

pp. 62-92 ◽

Cited By ~ 6

Author(s):

Chiara Ardito ◽

Roberto Leombruni ◽

Michele Mosca ◽

Massimiliano Giraudo ◽

Angelo d’Errico

Keyword(s):

Treatment Period ◽

Negative Impact ◽

Heart Diseases ◽

Administrative Database ◽

Content Type ◽

Affect Studies ◽

Coronary Heart Diseases ◽

Relative Risks ◽

Pre Treatment ◽

The Impact

Purpose The purpose of this paper is to study the impact of unemployment on coronary heart diseases (CHD) in Italy on a sample of male manual workers in the private sector. Design/methodology/approach The authors investigate the association between CHD and different unemployment experiences (ever unemployed; short, mid and long cumulative unemployment), exploiting a large Italian administrative database on careers and health. The study design is based on the balancing of individuals' characteristics during a 12-year pre-treatment period; the measurement of unemployment occurrence during a seven-year treatment period; the observation of CHD occurrence during a five-year follow up. The workers characteristics and the probability of receiving the treatment are balanced by means of propensity score matching. Standard diagnostics on the balancing assumption are discussed and satisfied, while the robustness to violations of the unconfoundedness assumption is evaluated by a simulation-based sensitivity analysis. Findings The authors find a significant increase of CHD probability was found among workers who experience more than three years of unemployment (relative risks (RR)=1.91, p<0.1), and among those who exit unemployment starting a self-employment activity (RR=1.70, p<0.1). Using different selections of the study population, a clear pattern emerges: the healthier and more labour market attached are workers during pre-treatment, the greater is the negative impact of long-term unemployment on health (RR=2.79, p<0.01). Originality/value The very large representative sample (n=69,937) and the deep longitudinal dimension of the data (1985-2008) allowed the authors to minimize the risks of health selection and unemployment misclassification. Moreover, the adopted definition of unemployment corrected some undercoverage and misclassification issues that affect studies based on a purely administrative definition and that treat unemployment as a unique career event disregarding the duration of the experience.

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The Impact of Isolation on the Transmission of COVID-19 and Estimation of Potential Second Epidemic in China

10.20944/preprints202003.0456.v1 ◽

2020 ◽

Author(s):

Haitao Song ◽

Fang Liu ◽

Feng Li ◽

Xiaochun Cao ◽

Hao Wang ◽

...

Keyword(s):

Virus Disease ◽

Hubei Province ◽

Healthy People ◽

Transmission Risk ◽

Initial Time ◽

Peak Time ◽

Cumulative Number ◽

First Case ◽

The Impact ◽

Close Contacts

The first case of Corona Virus Disease 2019 (COVID-19) was reported in Wuhan, China in December 2019. Since then, COVID-19 has quickly spread out to all provinces in China and over 150 countries or territories in the world. With the first level response to public health emergencies (FLRPHE) launched over the country, the outbreak of COVID-19 in China is achieving under control in China. We develop a mathematical model based on epidemiology of COVID-19, incorporating the isolation of healthy people, confirmed cases and close contacts. We calculate the basic reproduction numbers 2.5 in China (excluding Hubei province) and 2.9 in Hubei province with the initial time on January 30 which show the severe infectivity of COVID-19, and verify that the current isolation method effectively contains the transmission of COVID-19. Under the isolation of healthy people, confirmed cases and close contacts, we find a noteworthy phenomenon that is the potential second epidemic of COVID-19, and estimate the peak time and value and the cumulative number of cases. Simulations show that the isolation of close contacts tracked measure can efficiently contain the transmission of the potential second epidemic of COVID-19. With isolation of all susceptible people or all infected people or both, there is no potential second epidemic of COVID-19. Furthermore, resumption of work and study can increase the transmission risk of the potential second epidemic of COVID-19.

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Association and treatment of diabetes in patients affected by Covid-19

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11ispl1.3591 ◽

2020 ◽

Vol 11 (SPL1) ◽

pp. 1198-1201

Author(s):

Syed Yasir Afaque

Keyword(s):

Diabetes Mellitus ◽

Prognostic Value ◽

Heart Diseases ◽

The Novel ◽

The World ◽

Treatment Of Diabetes ◽

Coronavirus Infection ◽

Composite Outcomes ◽

Novel Coronavirus ◽

The Impact

In December 2019, a unique coronavirus infection, SARS-CoV-2, was first identified in the province of Wuhan in China. Since then, it spread rapidly all over the world and has been responsible for a large number of morbidity and mortality among humans. According to a latest study, Diabetes mellitus, heart diseases, Hypertension etc. are being considered important risk factors for the development of this infection and is also associated with unfavorable outcomes in these patients. There is little evidence concerning the trail back of these patients possibly because of a small number of participants and people who experienced primary composite outcomes (such as admission in the ICU, usage of machine-driven ventilation or even fatality of these patients). Until now, there are no academic findings that have proven independent prognostic value of diabetes on death in the novel Coronavirus patients. However, there are several conjectures linking Diabetes with the impact as well as progression of COVID-19 in these patients. The aim of this review is to acknowledge about the association amongst Diabetes and the novel Coronavirus and the result of the infection in such patients.

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Impact of hydroxychloroquin/azithromycin protocol on COVID-19 case-fatality rate reduction in Algeria. (Preprint)

10.2196/preprints.20886 ◽

2020 ◽

Author(s):

Ahmed Youssef Kada

Keyword(s):

Case Fatality Rate ◽

Doubling Time ◽

Case Fatality ◽

World Health ◽

Fatality Rate ◽

Therapeutic Protocol ◽

First Case ◽

The World ◽

The Impact ◽

At Home

BACKGROUND Covid-19 is an emerging infectious disease like viral zoonosis caused by new coronavirus SARS CoV 2. On December 31, 2019, Wuhan Municipal Health Commission in Hubei province (China) reported cases of pneumonia, the origin of which is a new coronavirus. Rapidly extendable around the world, the World Health Organization (WHO) declares it pandemic on March 11, 2020. This pandemic reaches Algeria on February 25, 2020, date on which the Algerian minister of health, announced the first case of Covid-19, a foreign citizen. From March 1, a cluster is formed in Blida and becomes the epicentre of the coronavirus epidemic in Algeria, its total quarantine is established on March 24, 2020, it will be smoothly alleviated on April 24. A therapeutic protocol based on hydroxychloroquine and azithromycin was put in place on March 23, for complicated cases, it was extended to all the cases confirmed on April 06. OBJECTIVE This study aimed to demonstrate the effectiveness of hydroxychloroquin/azithromycin protocol in Algeria, in particular after its extension to all patients diagnosed COVID-19 positive on RT-PCR test. We were able to illustrate this fact graphically, but not to prove it statistically because the design of our study, indeed in the 7 days which followed generalization of therapeutic protocol, case fatality rate decrease and doubling time increase, thus confirming the impact of wide and early prescription of hydroxychloroquin/azithromycin protocol. METHODS We have analyzed the data collected from press releases and follow-ups published daily by the Ministry of Health, we have studied the possible correlations of these data with certain events or decisions having a possible impact on their development, such as confinement at home and its reduction, the prescription of hydroxychloroquine/azithromycin combination for serious patients and its extension to all positive COVID subjects. Results are presented in graphics, the data collection was closed on 31/05/2020. RESULTS Covid-19 pandemic spreads from February 25, 2020, when a foreign citizen is tested positive, on March 1 a cluster is formed in the city of Blida where sixteen members of the same family are infected during a wedding party. Wilaya of Blida becomes the epicentre of coronavirus epidemic in Algeria and lockdown measures taken, while the number of national cases diagnosed begins to increases In any event, the association of early containment measures combined with a generalized initial treatment for all positive cases, whatever their degree of severity, will have contributed to a reduction in the fatality rate of COVID 19 and a slowing down of its doubling time. CONCLUSIONS In Algeria, the rapid combination of rigorous containment measure at home and early generalized treatment with hydroxychloroquin have demonstrated their effectiveness in terms of morbidity and mortality, the classic measures of social distancing and hygiene will make it possible to perpetuate these results by reducing viral transmission, the only unknown, the reopening procedure which can only be started after being surrounded by precautions aimed at ensuring the understanding of the population. CLINICALTRIAL Algeria, Covid-19, pandemic, hydroxychloroquin, azithromycin, case fatality rate

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Ontogenetic shift in the trophic role of the invasive killer shrimp Dikerogammarus villosus: a stable isotope study

Biological Invasions ◽

10.1007/s10530-021-02472-0 ◽

2021 ◽

Author(s):

Francesco Mancini ◽

Raffaele De Giorgi ◽

Alessandro Ludovisi ◽

Salvatrice Vizzini ◽

Giorgio Mancinelli

Keyword(s):

Dietary Habits ◽

Trophic Position ◽

Ecological Impact ◽

Central Italy ◽

Local Conditions ◽

Dikerogammarus Villosus ◽

Isotopic Signatures ◽

Depth Analysis ◽

Stable Isotope Study ◽

The Impact

AbstractThe introduction of the amphipod Dikerogammarus villosus in European fresh waters is to date recognized as a threat to the integrity of invaded communities. Predation by D. villosus on native benthic invertebrates is assumed as the key determinant of its ecological impact, yet available information describe the species as a primary consumer as well as a carnivore depending on local conditions. Here, we assessed the trophic position (TP) of D. villosus in Lake Trasimeno, a recently invaded lentic system in central Italy, using the CN isotopic signatures of individuals captured in winter spanning two orders of magnitude in body size. TP estimations were compared with those characterizing the native amphipod Echinogammarus veneris and other representative invertebrate predators. On average, D. villosus showed a trophic position higher than E. veneris, and comparable with that of odonate nymphs. An in-depth analysis revealed that large-sized individuals had a trophic position of 3.07, higher than odonates and close to that of the hirudinean predator Erpobdella octoculata, while small-sized specimens had a trophic position of 2.57, similar to that of E. veneris (2.41). These findings indicate that size-related ontogenetic shifts in dietary habits may per se vary the nature of the interaction between Dikerogammarus villosus and native invertebrates from competition to predation. Information collated from published isotopic studies corroborated the generality of our results. We conclude that intra-specific trophic flexibility may potentially amplify and make more multifaceted the impact of the species on other invertebrate species in invaded food webs.

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Modelling the impact of detection on COVID-19 transmission dynamics in Ghana

RMS: Research in Mathematics & Statistics ◽

10.1080/27658449.2021.1953722 ◽

2021 ◽

Vol 8 (1) ◽

pp. 1953722

Author(s):

Josiah Mushanyu ◽

Zviiteyi Chazuka ◽

Frenick Mudzingwa ◽

Chisara Ogbogbo

Keyword(s):

Transmission Dynamics ◽

The Impact

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Diet among oil-workers on off-shore oil installations in the Norwegian sector of the North Sea

British Journal Of Nutrition ◽

10.1079/bjn19920062 ◽

1992 ◽

Vol 68 (1) ◽

pp. 11-19 ◽

Cited By ~ 2

Author(s):

A. Oshaug ◽

L. I. Østgård ◽

K. U. Trygg

Keyword(s):

North Sea ◽

Heart Diseases ◽

Daily Intake ◽

Minor Role ◽

Coronary Heart Diseases ◽

Average Daily Intake ◽

The North ◽

The North Sea ◽

Oil Workers ◽

A Minor

Dietary studies based on 24 h recalls were carried out on four oil installations in the Norwegian sector of the North Sea. Two hundred and three persons were interviewed about what they had eaten the previous 24 h. Food purchased for the installations in the previous 5 months was recorded. Results based on 24 h recalls showed that average daily intake of energy was 12.2 MJ of which 17% came from protein, 44% from fat and 39% from carbohydrate, including 8% from sugar. Meat, vegetables, fresh fruits, seafood (shellfish), french fries, eggs, cream and ice-cream were important components of the diet, while bread, fish and cereals played a minor role. Average daily intake (mg) of nutrients were: calcium 1244, iron 15, vitamin A 1049 μg, vitamin D 4.1 μg, thiamin 1.6, riboflavin 2.2, nicotinic acid 22, ascorbic acid 143. Dietary fibre intake, estimated as unavailable carbohydrate, was on average 19 g, and the average daily intake of cholesterol was 755 mg. Intakes were compared with the Norwegian recommended dietary allowance. Most of the employees chose a diet which when eaten over a longer period of time may contribute to the development of coronary heart diseases (CHD) and thereby increase the morbidity and mortality from CHD in the oil industry.

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Consumption of dairy products and cardiovascular disease risk: results from the French prospective cohort NutriNet-Santé

British Journal Of Nutrition ◽

10.1017/s0007114521001422 ◽

2021 ◽

pp. 1-37

Author(s):

Laury Sellem ◽

Bernard Srour ◽

Kim G. Jackson ◽

Serge Hercberg ◽

Pilar Galan ◽

...

Keyword(s):

Cardiovascular Disease ◽

Dairy Products ◽

Disease Risk ◽

Heart Diseases ◽

Cardiovascular Disease Risk ◽

Dietary Intakes ◽

Cvd Risk ◽

Dairy Consumption ◽

Fermented Dairy ◽

The Impact

Abstract In France, dairy products contribute to dietary saturated fat intake, of which reduced consumption is often recommended for cardiovascular disease (CVD) prevention. Epidemiological evidence on the association between dairy consumption and CVD risk remains unclear, suggesting either null or inverse associations. This study aimed to investigate the associations between dairy consumption (overall and specific foods) and CVD risk in a large cohort of French adults. This prospective analysis included participants aged ≥ 18 years from the NutriNet-Santé cohort (2009–2019). Daily dietary intakes were collected using 24h-dietary records. Total dairy, milk, cheese, yogurts, fermented and reduced-fat dairy intakes were investigated. CVD cases (n=1,952) included cerebrovascular (n=878 cases) and coronary heart diseases (CHD, n=1,219 cases). Multivariable Cox models were performed to investigate associations. This analysis included n=104,805 French adults (mean age at baseline 42.8 years (SD 14.6)), mean follow-up 5.5 years (SD 3.0, i.e. 579,155 persons years). There were no significant associations between dairy intakes and total CVD or CHD risks. However, the consumption of at least 160 g/d of fermented dairy (e.g. cheese and yogurts) was associated with a reduced risk of cerebrovascular diseases compared to intakes below 57 g/d (HR=0.81 [0.66-0.98], p-trend=0.01). Despite being a major dietary source of saturated fats, dairy consumption was not associated with CVD or CHD risks in this study. However, fermented dairy was associated with a lower cerebrovascular disease risk. Robust randomized controlled trials are needed to further assess the impact of consuming different dairy foods on CVD risk and potential underlying mechanisms.

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