scholarly journals System of providing cancer care in the Netherlands during COVID-19 pandemic: assessing the consequences of the first wave

2021 ◽  
Vol 2 (3) ◽  
pp. 71-76
Author(s):  
Dmitry A. Andreev ◽  
Aleksander A. Zavyalov
Keyword(s):  
The Netherlands ◽  
Cancer Care ◽  
Diagnostic System ◽  
Screening Programs ◽  
Real Effects ◽  
First Case ◽  
Regular Care ◽  
Oncological Diseases ◽  
Huge Impact

The COVID-19 pandemic has had a huge impact on healthcare systems in many countries around the world, including the cancer care system in the Netherlands. During the first smart lockdown, the number of consultations by family physicians (general practitioners) decreased by 70%, and the number of referrals of patients to specialized centers (hospitals) decreased by 75 %. Since the 9th week of 2020, in which the first case of COVID-19 in the Netherlands was confirmed, there has been a marked decrease in the number of diagnosed oncological diseases. When compared with the first weeks of 2020, the number of diagnoses at the peak of the pandemic decreased by 20-4 0%. 20th week and onwards saw the recovery of the diagnostic system, although the number of detected cases of cancer remained low. Screening programs for breast, colon and cervical cancer have been suspended at 12th week of 2020. Further clinical studies are needed to identify the real effects of the pandemic on long-term outcomes (survival and quality of life) in cancer patients. It is important to remove unnecessary barriers for patients to seek care in primary health care and to ensure continued regular care during the pandemic.

scholarly journals COVID-19 Response in Thailand and Its Implications on Future Preparedness

2021 ◽  
Vol 18 (3) ◽  
pp. 1089
Author(s):  
Wijitbusaba Marome ◽  
Rajib Shaw
Keyword(s):  
Early Stage ◽  
Health Resources ◽  
Holistic Approach ◽  
Disaster Risk ◽  
Community Level ◽  
Multilateral Cooperation ◽  
First Case ◽  
Multiple Dimensions ◽  
Economic And Social Impacts

Thailand has been affected by COVID-19, like other countries in the Asian region at an early stage, and the first case was reported as early as mid-January 2020. Thailand’s response to the COVID-19 pandemic has been guided by the “Integrated Plan for Multilateral Cooperation for Safety and Mitigation of COVID-19”. This paper analyses the health resources in the country and focuses on the response through community-level public health system and legislative measures. The paper draws some lessons on future preparedness, especially with respect to the four priorities of Sendai Framework for Disaster Risk Reduction. At the end, the paper puts some key learning for future preparedness. While Thailand’s response to COVID-19 has been effective in limiting the spread of the disease, it falls short at being able to address the multiple dimensions of the crisis such as the economic and social impacts. The socioeconomic sectors have been hardest hit, with significant impact on tourism sectors. Sociopolitical system also plays an important role in governance and decision-making for pandemic responses. The analysis suggests that one opportunity for enhancing resilience in Thailand is to strive for more multilevel governance that engages with various stakeholders and to support grassroots and community-level networks. The COVID-19 pandemic recovery is a chance to recover better while leaving no one behind. An inclusive long-term recovery plan for the various impacted countries needs to take a holistic approach to address existing gaps and work towards a sustainable society. Furthering the Health Emergency Disaster Risk Management (HEDRM) Framework may support a coordinated response across various linked sectors rather than straining one particular sector.

scholarly journals COVID-19: first long-term care facility outbreak in the Netherlands following cross-border introduction from Germany, March 2020

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mitch van Hensbergen ◽  
Casper D. J. den Heijer ◽  
Petra Wolffs ◽  
Volker Hackert ◽  
Henriëtte L. G. ter Waarbeek ◽  
...  
Keyword(s):  
The Netherlands ◽  
Long Term Care ◽  
Care Facility ◽  
Control Measures ◽  
Border Region ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Cross Border

Abstract Background The Dutch province of Limburg borders the German district of Heinsberg, which had a large cluster of COVID-19 cases linked to local carnival activities before any cases were reported in the Netherlands. However, Heinsberg was not included as an area reporting local or community transmission per the national case definition at the time. In early March, two residents from a long-term care facility (LTCF) in Sittard, a Dutch town located in close vicinity to the district of Heinsberg, tested positive for COVID-19. In this study we aimed to determine whether cross-border introduction of the virus took place by analysing the LTCF outbreak in Sittard, both epidemiologically and microbiologically. Methods Surveys and semi-structured oral interviews were conducted with all present LTCF residents by health care workers during regular points of care for information on new or unusual signs and symptoms of disease. Both throat and nasopharyngeal swabs were taken from residents suspect of COVID-19, based on regional criteria, for the detection of SARS-CoV-2 by Real-time Polymerase Chain Reaction. Additionally, whole genome sequencing was performed using a SARS-CoV-2 specific amplicon-based Nanopore sequencing approach. Moreover, twelve random residents were sampled for possible asymptomatic infections. Results Out of 99 residents, 46 got tested for COVID-19. Out of the 46 tested residents, nineteen (41%) tested positive for COVID-19, including 3 asymptomatic residents. CT-values for asymptomatic residents seemed higher compared to symptomatic residents. Eleven samples were sequenced, along with three random samples from COVID-19 patients hospitalized in the regional hospital at the time of the LTCF outbreak. All samples were linked to COVID-19 cases from the cross-border region of Heinsberg, Germany. Conclusions Sequencing combined with epidemiological data was able to virtually prove cross-border transmission at the start of the Dutch COVID-19 epidemic. Our results highlight the need for cross-border collaboration and adjustment of national policy to emerging region-specific needs along borders in order to establish coordinated implementation of infection control measures to limit the spread of COVID-19.

scholarly journals Emergence of novel SARS-CoV-2 variants in the Netherlands

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Aysun Urhan ◽  
Thomas Abeel
Keyword(s):  
The Netherlands ◽  
Population Diversity ◽  
Genomic Variation ◽  
Population Variation ◽  
Reference Sequence ◽  
Viral Population ◽  
Phylogenetic Study ◽  
First Case ◽  
Novel Variants ◽  
Frequent Mutations

AbstractCoronavirus disease 2019 (COVID-19) has emerged in December 2019 when the first case was reported in Wuhan, China and turned into a pandemic with 27 million (September 9th) cases. Currently, there are over 95,000 complete genome sequences of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus causing COVID-19, in public databases, accompanying a growing number of studies. Nevertheless, there is still much to learn about the viral population variation when the virus is evolving as it continues to spread. We have analyzed SARS-CoV-2 genomes to identify the most variant sites, as well as the stable, conserved ones in samples collected in the Netherlands until June 2020. We identified the most frequent mutations in different geographies. We also performed a phylogenetic study focused on the Netherlands to detect novel variants emerging in the late stages of the pandemic and forming local clusters. We investigated the S and N proteins on SARS-CoV-2 genomes in the Netherlands and found the most variant and stable sites to guide development of diagnostics assays and vaccines. We observed that while the SARS-CoV-2 genome has accumulated mutations, diverging from reference sequence, the variation landscape is dominated by four mutations globally, suggesting the current reference does not represent the virus samples circulating currently. In addition, we detected novel variants of SARS-CoV-2 almost unique to the Netherlands that form localized clusters and region-specific sub-populations indicating community spread. We explored SARS-CoV-2 variants in the Netherlands until June 2020 within a global context; our results provide insight into the viral population diversity for localized efforts in tracking the transmission of COVID-19, as well as sequenced-based approaches in diagnostics and therapeutics. We emphasize that little diversity is observed globally in recent samples despite the increased number of mutations relative to the established reference sequence. We suggest sequence-based analyses should opt for a consensus representation to adequately cover the genomic variation observed to speed up diagnostics and vaccine design.

scholarly journals Cancer services in Sri Lanka: current status and future directions

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Umesh Jayarajah ◽  
Anuruddha M. Abeygunasekera
Keyword(s):  
Sri Lanka ◽  
Cancer Prevention ◽  
Systemic Therapy ◽  
Cancer Care ◽  
Current Status ◽  
Main Body ◽  
Prevention Measures ◽  
High Quality Research ◽  
Screening Programs ◽  
Cancer Services

Abstract Background The burden of cancer in Sri Lanka is on the rise. The overall incidence of cancer in Sri Lanka has doubled over the past 25 years with a parallel rise in cancer-related mortality. Cancer has become the second commonest cause of hospital mortality in Sri Lanka. In this review, we aim to provide an overview of the current status and future direction of cancer care in Sri Lanka. Main body In Sri Lanka, cancer services are predominantly provided by the state sector free of charge to the general public. With the establishment of national cancer policy on cancer prevention and control, there has been a commendable improvement in the cancer services provided island-wide. An increasing number of breast, oropharyngeal, thyroid, oesophageal, colorectal, lung, and gastric cancers are being diagnosed and treated annually. Primary prevention measures include restrictions in tobacco and HPV vaccination. Screening programs for selected cancers such as breast, oral and cervical cancers are delivered. Medical oncology units with facilities for systemic therapy and adequately supported by surgical, pathology, and radiology departments have been established in each district general hospital island-wide. Although the current progress is commendable, future changes are necessary to overcome the current limitations and to cater the ever increasing burden of cancer. Measures are necessary to enhance the coverage of Sri Lanka Cancer Registry. Timely high-quality research and audits are essential. Community participation in planning strategies for cancer prevention and treatment is minimal. Community-based palliative care facilities and radiation and other systemic therapy should be made available in all provinces. A culture of multi-disciplinary care with proper referral pathways would help to improve the current setting. Conclusion In conclusion, Sri Lanka has a reasonably balanced and continuously expanding program for prevention, screening, and treatment of cancers. Emphasis on preventive strategies related to reducing tobacco smoking, chewing betel, and obesity, making cancers a notifiable disease, involving the community in planning cancer care and prevention strategies, conducting research to evaluate cost-effectiveness of existing treatment and increasing radiotherapy facilities would further improve the cancer services in Sri Lanka.

scholarly journals Hypocalcemic cardiomyopathy after parathyroidectomy in a patient with uremia: A case report and literature review

2020 ◽  
Vol 48 (7) ◽  
pp. 030006052094211
Author(s):  
Wei Zhang ◽  
Feng Xue ◽  
Quandong Bu ◽  
Xuemei Liu
Keyword(s):  
Heart Failure ◽  
Case Report ◽  
Secondary Hyperparathyroidism ◽  
Calcium Supplementation ◽  
Severe Heart Failure ◽  
Cardiac Complications ◽  
Refractory Heart Failure ◽  
First Case ◽  
Insight Into

Hypocalcemia is a rare, but reversible, cause of dilated cardiomyopathy. Although cardiomyopathy may cause severe heart failure, calcium supplementation can reverse heart failure. We report here a patient with uremia and secondary hyperparathyroidism, who was complicated by persistent hypocalcemia and refractory heart failure. The cardiac failure was refractory to treatment with digitalis and diuretics, but dramatically responded to calcium therapy and restoration of normocalcemia. As a result, the patient was eventually diagnosed with hypocalcemic cardiomyopathy. To the best of our knowledge, this is the first case of this disease to be reported in a patient with uremia. Findings from our case may help clinicians to better understand hypocalcemic cardiomyopathy. Our case might also provide new insight into long-term cardiac complications and prognoses of patients undergoing parathyroidectomy due to secondary hyperparathyroidism.

scholarly journals The Impact of Function Focused Care From Acute Care to Home Care and Nursing Homes

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 629-629
Author(s):  
Silke Metzelthin ◽  
Sandra Zwakhalen ◽  
Barbara Resnick
Keyword(s):  
Older Adults ◽  
The Netherlands ◽  
Home Care ◽  
Acute Care ◽  
Long Term Care ◽  
Functional Decline ◽  
Term Care ◽  
The Us ◽  
The Impact

Abstract Functional decline in older adults often lead towards acute or long-term care. In practice, caregivers often focus on completion of care tasks and of prevention of injuries from falls. This task based, safety approach inadvertently results in fewer opportunities for older adults to be actively involved in activities. Further deconditioning and functional decline are common consequences of this inactivity. To prevent or postpone these consequences Function Focused Care (FFC) was developed meaning that caregivers adapt their level of assistance to the capabilities of older adults and stimulate them to do as much as possible by themselves. FFC was first implemented in institutionalized long-term care in the US, but has spread rapidly to other settings (e.g. acute care), target groups (e.g. people with dementia) and countries (e.g. the Netherlands). During this symposium, four presenters from the US and the Netherlands talk about the impact of FFC. The first presentation is about the results of a stepped wedge cluster trial showing a tendency to improve activities of daily living and mobility. The second presentation is about a FFC training program. FFC was feasible to implement in home care and professionals experienced positive changes in knowledge, attitude, skills and support. The next presenter reports about significant improvements regarding time spent in physical activity and a decrease in resistiveness to care in a cluster randomized controlled trial among nursing home residents with dementia. The fourth speaker presents the content and first results of a training program to implement FFC in nursing homes. Nursing Care of Older Adults Interest Group Sponsored Symposium

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