Retrospective analysis of adverse effects associated with pyrethrins-containing products

The Pyrethrins Stewardship Program (PSP) was established to better understand adverse effects following exposure to pyrethrins-containing insecticide products. Running from April 2010 through December 2016, symptomatic dermal and inhalation exposures were entered into Phase I of the PSP and analyzed for exposure details and nature of the effects reported. Phase II consisted of an in-depth telephone interview using an enhanced questionnaire to investigate additional exposure details. Phase III scored the association between exposure and reported effects. Based on the data collected and analyzed, we conclude that: (1) Both in absolute number and relative to the wide distribution and use by consumers, adverse respiratory or dermal events after product exposure were rare; (2) Most outcomes for the reported events involving either dermal or respiratory effects were of minor severity and self-limiting; (3) None of the data collected and analyzed indicate that pyrethrins-containing products, including those formulated with synthetic pyrethroids and/or synergists, pose a significant risk of serious dermal or respiratory reactions even in cases where the exposed individual reported having allergies or asthma; (4) No additional label warnings or other mitigation techniques are warranted with pyrethrins-containing products formulated with or without synthetic pyrethroids and/or synergists.

Prioritizing COVID-19 Contact Tracing During a Surge Using Chatbot Technology

When COVID-19 cases surge, identifying ways to improve the efficiency of contact tracing and prioritize vulnerable communities for isolation and quarantine support services is critical. During a fall 2020 COVID-19 resurgence in San Francisco, California, prioritization of telephone-based case investigation by zip code and using a chatbot to screen for case participants who needed isolation support reduced the number of case participants who would have been assigned for a telephone interview by 31.5% and likely contributed to 87.5% of Latinx case participants being successfully interviewed. (Am J Public Health. 2022;112(1):43–47. https://doi.org/10.2105/AJPH.2021.306563 )

Mothers in Need of Lactation Support May Benefit from Early Postnatal Galactagogue Administration: Experience from a Single Center

Background: Galactagogues are substances that promote lactation, although data on their effects on humans remain limited. We investigated the efficacy of Silitidil to increase milk supply and duration of breastfeeding of a specific subgroup of mothers in need of lactation support. Methods: 161 mothers from November 2018 until January 2021 were the study subjects in this retrospective study; during their hospitalization, due to neonatal or maternal factors that inhibited lactation, they were prescribed galactagogues. Mothers were surveyed by telephone interview via a 13-item questionnaire. Results: 73.91%, were primigravidas, 78.26% gave birth by cesarean section (CS) and 72.05% continued to take galactagogues after hospital discharge. Of the neonates, 24.22% were preterm ≤37 weeks of gestation, and 55.9% had birth weight (BW) between 2500 and 3500 g. With respect to breastfeeding rates, 100% were breastfed during their first week, 98.8% breastfed during the first month, 87% during the first 4 months, dropping to 56.5% at 6 months, 41% at 1 year and 19.3% over 1 year of age. Conclusions: This study demonstrates that administration of a galactagogue containing Silitidil (Piulatte-Humana) improves breastfeeding rates at from 1 until 12 months of life in mothers with low milk supply during their hospital stay. Further studies are needed to generate evidence-based strategies to improve breastfeeding outcomes.

Community Outbreak Moderates the Association Between COVID-19-Related Behaviors and COVID-19 Fear Among Older People: A One-Year Longitudinal Study in Taiwan

Although health behavior theories indicate that fear is effective in activating preventive behaviors, the question of whether COVID-19 severity moderates the association between fear of COVID-19 and preventive behaviors remains unclear. The present study investigated the association between the fear of COVID-19 and preventive behaviors during the COVID-19 community outbreak of two severity levels in Taiwan. Data were obtained regarding the fear of COVID-19 and practice of preventive behaviors from 139 older people (mean age = 71.73 years; 30.2% men) through in-person interviews during a mild COVID-19 outbreak period (baseline assessment). Data from 126 of the 139 participants were obtained again through a telephone interview during a severe COVID-19 outbreak period (follow-up assessment). A significant increase in the fear of COVID-19 (d = 0.39, p < 0.001) and a decrease in preventive behaviors (d = 0.63, p < 0.001) were found in the follow-up assessment. The association between fear of COVID-19 and preventive behaviors was not significant at baseline (r = −0.07, p > 0.05) but became significant at the follow-up assessment (r = 0.32, p < 0.001). The severity of a COVID-19 outbreak may alter older people's psychological status and related behaviors.

Persistence of Fatigue among COVID-19 Survivors in Bangladesh: A Two-month after Follow-up Study

Background: A limited number of studies have exclusively assessed fatigue among post-COVID patients. Our study aimed to assess the persistence and associations of fatigue among COVID-19 survivors after two months of recovery from their primary illness. Methods: During hospital admission from August to September, 2020, a total of 400 patients were diagnosed to be suffering from fatigue using Chalder fatigue scale. After obtaining informed written consent, patients were followed up two months later over telephone. A total of 332 participants participated in the interview (63 patients could not be traced and another 5 patient died within two months). Patients were asked to categorize their present fatigue condition based on a simplified questionnaire developed for telephone interview. Results: Among study participants, 62.9% (n=207) were found to be still suffering from fatigue two months after their hospital discharge. A significant association of fatigue was found with age (p=0.000), hypertension (RR: 1.51; CI: 1.15-1.99; p=0.002), diabetes mellitus (RR: 1.45; CI: 1.08-1.95; p=0.010), ischemic heart disease (RR: 2.04; CI: 1.15-3.64; p=0.011), on admission SpO2 (p=0.000), on admission serum ferritin (p=0.000), d-dimer (p=0.000), CRP (p=0.000), and Hb% (p=0.019). Binary logistic regression model revealed significant association of age and onadmission SpO2 with persistence of fatigue. Conclusions: Fatigue is a highly prevalent symptom among the COVID-19 survivors with significant association between fatigue and patients clinical and laboratory markers. Bangladesh J Medicine July 2022; 33(1) : 57-63

Effects of the Co-Occurrence of Diabetes and Tooth Loss on Cognitive Function

Using data from the 2006, 2012, and 2018 waves of the Health and Retirement Study, we estimated effects of co-occurrence of diabetes mellitus (DM) and complete tooth loss (CTL), both self-reported, on cognitive function among 10,816 adults age 50+. Cognitive function was measured using a shortened version of the Telephone Interview for Cognitive Status. Results from the fixed effects linear regression model show that in comparison to those with neither condition, adults having both DM and CTL had the worst cognitive function (b = 1.49, p < 0.001), followed by having CTL alone (b = 0.78, p < 0.001), and having DM alone (b = 0.42, p < 0.001). Our study suggests that CTL is a stronger risk factor for lower cognitive function than DM, and the co-occurrence of DM and CTL poses additive risk. Further research is needed to investigate the pathway from DM and CTL to poor cognition.

Diagnosing selective mutism: a critical review of measures for clinical practice and research

Selective mutism (SM) is an anxiety disorder (prevalence 1–2%), characterized by the consistent absence of speaking in specific situations (e.g., in school), while adequately speaking in other situations (e.g., at home). SM can have a debilitating impact on the psychosocial and academic functioning in childhood. The use of psychometrically sound and cross-culturally valid instruments is urgently needed.The aim of this paper is to identify and review the available assessment instruments for screening or diagnosing the core SM symptomatology. We conducted a systematic search in 6 databases. We identified 1469 studies from the last decade and investigated the measures having been used in a diagnostic assessment of SM. Studies were included if original data on the assessment or treatment of SM were reported. It was found that 38% of published studies on SM reporting original data did not report the use of any standardized or objective measure to investigate the core symptomatology. The results showed that many different questionnaires, interviews and observational instruments were used, many of these only once. The Selective Mutism Questionnaire (SMQ), Anxiety Disorders Interview Schedule (ADIS) and School Speech Questionnaire (SSQ) were used most often. Psychometric data on these instruments are emerging. Beyond these commonly used instruments, more recent developed instruments, such as the Frankfurt Scale of SM (FSSM) and the Teacher Telephone Interview for SM (TTI-SM), are described, as well as several interesting observational measures. The strengths and weaknesses of the instruments are discussed and recommendations are made for their use in clinical practice and research.

EARLY TREATMENT WITH BAMLANIVIMAB ALONE DOES NOT PREVENT COVID-19 HOSPITALIZATION AND ITS POST-ACUTE SEQUELAE. A REAL EXPERIENCE IN UMBRIA, ITALY.

Background and Objective The use of monoclonal antibodies to the SARS-Cov-2 spike protein for early treatment of COVID-19 disease is being evaluated, with only phase 2 studies available, to date. Emergency authorization of bamlanivimab monotherapy was get in November 2020 by the FDA and in March 2021 by italian agency AIFA. Its use was then revoked in April 2021 by both. This study reports the results of bamlanivimab utilization in monotherapy in Umbria (Italian region), in order to verify whether, in a population with multiple risk factors, comparable results to phase 2 BLAZE1 trial had been obtained. Methods Retrospective observational study, between March and April 2021, in patients treated with bamlanivimab was performed. Demographic and clinical characteristics before and after infusion were evaluated. Moreover, a telephone interview about 30 days after the infusion was carried out to evaluate the overall course. Results All patients had an early infection (mean 4±1.73 days), almost all by alpha variant (97%). No adverse events to treatment were observed. Altogether within 30 days, the hospitalization rate was 20%, 15% for COVID-19 related pathologies , versus 4% at 11 days in BLAZE1 phase 2 study. Worsening of some symptoms observed at baseline such as asthenia (77 vs 51.3%), shortness of breath (38 vs 23%) was registered, as well as the onset of non-restorative sleep (41%). Conclusions The clinical outcome after bamlanivimab monotherapy was far below the expectation despite the patients had been infected by a theoretically sensitive viral variant.