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Ortega AN, Roby DH.
Journal of the American Medical Association, 17.08.2021
Tilføjet 17.08.2021
Racial and ethnic inequities in the US health care system have been unremitting since the beginning of the country. In the 19th and 20th centuries, segregated black hospitals were emblematic of separate but unequal health care. Racism resulted in hospitals refusing to desegregate despite the passage of the Civil Rights Act in 1964 until they were forced to under threat of losing federal funds from the newly enacted Medicaid and Medicare programs in 1966. For American Indian and Alaska Native persons, health care has always been and remains to be segregated. Recently, the COVID-19 pandemic has highlighted long-standing, persistent inequities, with American Indian, Black, Latino, and Native Hawaiian and Pacific Islander communities being at high risk of morbidity and mortality.
Læs mere Tjek på PubMedKuehn BM.
Journal of the American Medical Association, 17.08.2021
Tilføjet 17.08.2021
In response to increasing foodborne illness outbreaks linked with the Cyclospora cayetanensis bacterium, the FDA and the US Centers for Disease Control and Prevention (CDC) have developed an action plan focused on detection, prevention, and education.
Læs mere Tjek på PubMedRouten A, Pareek M, Khunti K.
Journal of the American Medical Association, 17.08.2021
Tilføjet 17.08.2021
To the Editor The recent Editorial “The Reporting of Race and Ethnicity in Medical and Science Journals,” is timely, given the well-described racial and ethnic inequalities in COVID-19 outcomes, in part due to long-standing disparities in health. We concur with the key arguments of Ms Flanagin and colleagues but believe there are 2 areas that require further consideration.
Læs mere Tjek på PubMedKoh HK, Choi JK, Caballero JB.
Journal of the American Medical Association, 17.08.2021
Tilføjet 17.08.2021
This Viewpoint discusses the racist rhetoric that has been aimed at Asian American, Native Hawaiian, and Pacific Islander individuals throughout the COVID-19 pandemic and highlights the importance of recognizing the special challenges of this population in achieving health equity for all.
Læs mere Tjek på PubMedEvans A, Webster J, Flores G.
Journal of the American Medical Association, 17.08.2021
Tilføjet 17.08.2021
This Viewpoint discusses the low rates at which Black and Latino individuals in the US are being vaccinated against COVID-19 and how the National Black Church Initiative plans to address gaps in vaccination as well as other health care disparities.
Læs mere Tjek på PubMedKuehn BM.
Journal of the American Medical Association, 17.08.2021
Tilføjet 17.08.2021
Affordable preexposure prophylaxis (PrEP) for HIV prevention led to an approximate 10-fold reduction in the incidence of new infections, according to results from what’s thought to be the largest and longest study of its kind.
Læs mere Tjek på PubMedAbbasi J.
Journal of the American Medical Association, 17.08.2021
Tilføjet 17.08.2021
This Medical News article describes how ultrapotent antibodies discovered in patients who recovered from COVID-19 could be key players in new treatments and vaccines.
Læs mere Tjek på PubMedShaochen Guo Bin Wang Lei Fu Xi Chen Weiyan Zhang Haihong Huang Yu Lu aBeijing Key Laboratory of Drug Resistance Tuberculosis Research, Department of Pharmacology, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University, Beijing 101149, P. R. China bBeijing Key Laboratory of Active Substance Discovery and Druggability Evaluation, Chinese Academy of Medical Sciences Key Laboratory of Anti-DR TB Innovative Drug Research, Institute of Materia Medica, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100050, PR China
Antimicrobial Agents And Chemotherapy, 16.08.2021
Tilføjet 17.08.2021
Antimicrobial Agents and Chemotherapy, <a href="https://journals.asm.org/toc/aac/0/ja">Volume 0, Issue ja</a>, -Not available-.
Læs mere Tjek på PubMedCindy S Chu James A Watson Aung Pyae Phyo Htun Htun Win Widi Yotyingaphiram Suradet Thinraow Nay Lin Soe Aye Aye Aung Pornpimon Wilaisrisak Kanokpich Kraft Mallika Imwong Warunee Hanpithakpong Daniel Blessborn Joel Tarning Stéphane Proux Clare Ling François H Nosten Nicholas J White 1 Shoklo Malaria Research Unit, Mahidol–Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand 2 Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK 3 Mahidol–Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand 4 Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Antimicrobial Agents And Chemotherapy, 16.08.2021
Tilføjet 17.08.2021
Antimicrobial Agents and Chemotherapy, <a href="https://journals.asm.org/toc/aac/0/ja">Volume 0, Issue ja</a>, -Not available-.
Læs mere Tjek på PubMedChristopher M. Rubino Shawn Flanagan 1 Institute for Clinical Pharmacodynamics (ICPD), Schenectady, NY 2 Cidara Therapeutics, San Diego, CA
Antimicrobial Agents And Chemotherapy, 16.08.2021
Tilføjet 17.08.2021
Antimicrobial Agents and Chemotherapy, <a href="https://journals.asm.org/toc/aac/0/ja">Volume 0, Issue ja</a>, -Not available-.
Læs mere Tjek på PubMedKamonporn Poramathikul Mariusz Wojnarski Somethy Sok Sokh Vannara Sivhour Chiek Seng Heng Krang Sidonn Ly Sovann Samon Nou Chann Soklyda Siriporn Sornsakrin Woradee Lurchachaiwong Worachet Kuntawunginn Paphavee Lertsethtakarn Aaron Farmer Brett Swierczewski Norman Waters Samandra Demons Brian Vesely Prom Satharath Chanthap Lon Ladaporn Bodhidatta aArmed Forces Research Institute of Medical Sciences, Bangkok, Thailand bRoyal Cambodian Armed Forces cBattambang Referral Hospital, Battambang, Cambodia dCambodia Communicable Disease Department, Ministry of Health, Phnom Penh, Cambodia eArmed Forces Research Institute of Medical Sciences, Phnom Penh, Cambodia
Antimicrobial Agents And Chemotherapy, 16.08.2021
Tilføjet 17.08.2021
Antimicrobial Agents and Chemotherapy, <a href="https://journals.asm.org/toc/aac/0/ja">Volume 0, Issue ja</a>, -Not available-.
Læs mere Tjek på PubMedChristian M. Gill Elif Aktaþ Wadha Alfouzan Lori Bourassa Adrian Brink Carey-Ann Burnham Rafael Canton Yehuda Carmeli Marco Falcone Carlos Kiffer Anna Marchese Octavio Martinez Spyros Pournaras Harald Seifert Abrar K. Thabit Maria Virginia Villegas Lars F. Westblade David P. Nicolau 1Center for Anti-Infective Research & Development Hartford Hospital, Hartford, CT, USA 2University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Clinical Microbiology Laboratory, Istanbul, Turkey 3Laboratory Medicine- Farwania Hospital, Ministry of Health, Kuwait, Department of Microbiology, Faculty of Medicine, Kuwait University, Jabriya, Kuwait 4Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA 5Division of Medical Microbiology, Department of Pathology, Faculty of Health Sciences, National Health Laboratory Services, University of Cape town, Cape town, South Africa 6Washington University in St. Louis School of Medicine, St. Louis, MO, USA 7Servicio de Microbiologia. Hospital Ramón y Cajal-IRYCIS, Madrid, Spain 8National Institute for Infection Control and Antibiotic Resistance, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel 9Infectious Diseases Division, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy 10Internal Medicine Department and LEMC-Alerta Lab, Escola Paulista de Medicina, UNIFESP, São Paulo, Brazil 11Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, and Clinical Microbiology Unit, San Martino Policlinico Hospital—IRCCS for Oncology and Neuroscience, Genoa, Italy 12Department of Pathology and Microbiology, University of Miami Miller School of Medicine, Miami, FL 13Laboratory of Clinical Microbiology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece 14Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Goldenfelsstrasse 19-21, 50935 Köln, Germany 15Pharmacy Practice Department, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia 16Grupo de Resistencia Antimicrobiana y Epidemiología Hospitalaria (RAEH), Universidad El Bosque, Bogotá, Colombia 17Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA 18Division of Infectious Diseases, Hartford Hospital, Hartford, CT, USA
Antimicrobial Agents And Chemotherapy, 16.08.2021
Tilføjet 17.08.2021
Antimicrobial Agents and Chemotherapy, <a href="https://journals.asm.org/toc/aac/0/ja">Volume 0, Issue ja</a>, -Not available-.
Læs mere Tjek på PubMedShan-shan Liu, Chang Liu, Xiao-xi Lv, Bing Cui, Jun Yan, Yun-xuan Li, Ke Li, Fang Hua, Xiao-wei Zhang, Jiao-jiao Yu, Jin-mei Yu, Feng Wang, Shuang Shang, Ping-ping Li, Zhi-guang Zhou, Yang Xiao, Zhuo-wei Hu
Immunity, 17.08.2021
Tilføjet 17.08.2021
Pulmonary fibrosis therapies require improved understanding of the underlying inflammatory mechanisms of disease. Liu et al. demonstrate that immune-derived CCL1 promotes lung fibrosis by two pathways: (1) recruiting CCR8-expressing fibroblasts to the lung and (2) activating lung fibroblasts into pathological myofibroblasts by binding AMFR on fibroblasts, which enhances Ras-ERK signaling and synthesis of profibrotic proteins.
Læs mere Tjek på PubMedPrashant Bhat, Jagadeesha H S, Mohan Kumar R, Sudheerchandra Sooda, Premanand K, Ravi Kumar
International Journal of Infectious Diseases, 17.08.2021
Tilføjet 17.08.2021
Kyasanur Forest Disease (KFD) is a zoonosis prevailing in the Western Ghats region of Karnataka. (Snapshot 2021) The disease was first reported in Kyasanur village forest in Shivamogga district of Karnataka, India, in 1957. (Work et al., 1959, New Virus Disease-Kyasanur Forest Disease 2021) Hence the name was coined. (Work et al., 1957) KFD remained restricted to Shivamogga district and surrounding forests of Uttara Kannada, Udupi, and Dakshina Kannada districts (Figure 1) for decades. (New Virus Disease-Kyasanur Forest Disease 2021, Work et al., 1957, Bhat, 1983) The recent spread of disease to distant places is a public health concern.
Læs mere Tjek på PubMedAmr Elmoheen, Ibrahim Abdelhafez, Waleed Awad, Mohamed Bahgat, Ali Elkandow, Amina Tarig, Nauman Arshad, Khoulod Mohamed, Maryam Al-Hitmi, Mona Saad, Fatima Emam, Samah Taha, Khalid Bashir, Aftab Azad
International Journal of Infectious Diseases, 17.08.2021
Tilføjet 17.08.2021
Illness from coronavirus first appeared almost 20 years ago through severe acute respiratory syndrome (SARS) and the Middle East respiratory syndrome (MERS). At the end of 2019, COVID-19 (SARS-CoV-2) took the world by storm, spreading even to the most remote places. Unfortunately, COVID-19 proved to be far more challenging than its predecessors. The World Health Organization (WHO) reported that as of April 8, 2021, the number of confirmed cases of COVID-19 was 132,730,691, with staggering 2,880,726 deaths worldwide.
Læs mere Tjek på PubMedAaron J. Schmitz, Jackson S. Turner, Zhuoming Liu, Julian Q. Zhou, Ishmael D. Aziati, Rita E. Chen, Astha Joshi, Traci L. Bricker, Tamarand L. Darling, Daniel C. Adelsberg, Clara G. Altomare, Wafaa B. Alsoussi, James Brett Case, Laura A. VanBlargan, Tingting Lei, Mahima Thapa, Fatima Amanat, Trushar Jeevan, Thomas Fabrizio, Jane A. O’Halloran, Pei-Yong Shi, Rachel M. Presti, Richard J. Webby, Florian Krammer, Sean P.J. Whelan, Goran Bajic, Michael S. Diamond, Adrianus C.M. Boon, Ali H. Ellebedy
Immunity, 16.08.2021
Tilføjet 17.08.2021
SARS-CoV-2 variants with increased transmissibility are a public health threat. Schmitz et al. characterize 2C08, a human monoclonal antibody derived from a SARS-CoV-2 vaccine-induced germinal center B cell. 2C08 possesses a broad and potent neutralization capacity and protects hamsters against challenge with D614G, B.1.351, or B.1.617.2 strains. Public 2C08-like clones can be elicited by both SARS-CoV-2 infection and vaccination.
Læs mere Tjek på PubMedNicola Cirillo, Richard Doan
Lancet Infectious Diseases, 17.08.2021
Tilføjet 17.08.2021
In the past 100 days, more than 3 billion doses of SARS-CoV-2 vaccines have been administered globally.1 With 20 vaccines currently authorised in at least one country and 108 under clinical development as of July 20, 2021,2 there is ongoing public concern regarding the possible adverse effects of SARS-CoV-2 immunisation. An adverse event reported in the product information of two vaccines developed with a novel mRNA technology is Bell's palsy, a form of acute facial nerve paralysis.3 So far there has been no clear evidence of association between COVID-19 vaccination and facial paralysis.
Læs mere Tjek på PubMedEd Moran, Tim Cook, Anna L Goodman, Ravindra K Gupta, Stephen Jolles, David K Menon, David J Roberts, Sinisa Savic, Manu Shankar-Hari, Michael Brown, David M Lowe
Lancet Infectious Diseases, 17.08.2021
Tilføjet 17.08.2021
The management of patients presenting to health-care services with SARS-CoV-2 infection has developed rapidly over the past year, driven by the findings of high-quality randomised trials. These trials have been justifiably focused on preventing severe disease in patients with very early infection and on the treatment of acutely unwell patients. However, although applicable to the majority of patients, it has become apparent that there are specific patient cohorts not well served by these studies, to whom their conclusions might not apply, and who as a consequence risk missing out on access to potentially beneficial treatments.
Læs mere Tjek på PubMedEric Yuk Fai Wan, Celine Sze Ling Chui, Francisco Tsz Tsun Lai, Esther Wai Yin Chan, Xue Li, Vincent Ka Chun Yan, Le Gao, Qiuyan Yu, Ivan Chun Hang Lam, Raccoon Ka Cheong Chun, Benjamin John Cowling, Wing Chi Fong, Alexander Yuk Lun Lau, Vincent Chung Tong Mok, Frank Ling Fung Chan, Cheuk Kwong Lee, Lot Sze Tao Chan, Dawin Lo, Kui Kai Lau, Ivan Fan Ngai Hung, Gabriel Matthew Leung, Ian Chi Kei Wong
Lancet Infectious Diseases, 17.08.2021
Tilføjet 17.08.2021
Our findings suggest an overall increased risk of Bell's palsy after CoronaVac vaccination. However, the beneficial and protective effects of the inactivated COVID-19 vaccine far outweigh the risk of this generally self-limiting adverse event. Additional studies are needed in other regions to confirm our findings.
Læs mere Tjek på PubMedAdolfo Di Crosta, Irene Ceccato, Daniela Marchetti, Pasquale La Malva, Roberta Maiella, Loreta Cannito, Mario Cipi, Nicola Mammarella, Riccardo Palumbo, Maria Cristina Verrocchio, Rocco Palumbo, Alberto Di Domenico
PLoS One Infectious Diseases, 16.08.2021
Tilføjet 16.08.2021
by Adolfo Di Crosta, Irene Ceccato, Daniela Marchetti, Pasquale La Malva, Roberta Maiella, Loreta Cannito, Mario Cipi, Nicola Mammarella, Riccardo Palumbo, Maria Cristina Verrocchio, Rocco Palumbo, Alberto Di Domenico
The COVID-19 pandemic is far more than a health crisis: it has unpredictably changed our whole way of life. As suggested by the analysis of economic data on sales, this dramatic scenario has also heavily impacted individuals’ spending levels. To better understand these changes, the present study focused on consumer behavior and its psychological antecedents. Previous studies found that crises differently affect people’s willingness to buy necessities products (i.e., utilitarian shopping) and non-necessities products (i.e., hedonic shopping). Therefore, in examining whether changes in spending levels were associated with changes in consumer behavior, we adopted a fine-grained approach disentangling between necessities and non-necessities. We administered an online survey to 3833 participants (age range 18–64) during the first peak period of the contagion in Italy. Consumer behavior toward necessities was predicted by anxiety and COVID-related fear, whereas consumer behavior toward non-necessities was predicted by depression. Furthermore, consumer behavior toward necessities and non-necessities was predicted by personality traits, perceived economic stability, and self-justifications for purchasing. The present study extended our understanding of consumer behavior changes during the COVID-19 pandemic. Results could be helpful to develop marketing strategies that consider psychological factors to meet actual consumers’ needs and feelings.
Læs mere Tjek på PubMedJosefine Beck-Friis, Susannah Leach, Elmir Omerovic, Rickard Zeijlon, Magnus Gisslen, Aylin Yilmaz
PLoS One Infectious Diseases, 16.08.2021
Tilføjet 16.08.2021
by Josefine Beck-Friis, Susannah Leach, Elmir Omerovic, Rickard Zeijlon, Magnus Gisslen, Aylin Yilmaz
Background Chloroquine was promoted as a COVID-19 therapeutic early in the pandemic. Most countries have since discontinued the use of chloroquine due to lack of evidence of any benefit and the risk of severe adverse events. The primary aim of this study was to examine if administering chloroquine during COVID-19 imposed an increased risk of ischemic heart injury or heart failure.
Methods Medical records, laboratory findings, and electrocardiograms of patients with COVID-19 who were treated with 500 mg chloroquine phosphate daily and controls not treated with chloroquine were reviewed retrospectively. Controls were matched in age and severity of disease.
Results We included 20 patients receiving chloroquine (500 mg twice daily) for an average of five days, and 40 controls. The groups were comparable regarding demographics and biochemical analyses including C-reactive protein, thrombocytes, and creatinine. There were no statistically significant differences in cardiac biomarkers or in electrocardiograms. Median troponin T was 10,8 ng/L in the study group and 17.9 ng/L in the control group, whereas median NT-proBNP was 399 ng/L in patients receiving chloroquine and 349 ng/L in the controls.
Conclusions We found no increased risk of ischemic heart injury or heart failure as a result of administering chloroquine. However, the use of chloroquine to treat COVID-19 outside of clinical trials is not recommended, considering the lack of evidence of its effectiveness, as well as the elevated risk of fatal arrythmias.
Læs mere Tjek på PubMedRishi Trikha, Danielle Greig, Troy Sekimura, Nicolas Cevallos, Benjamin Kelley, Zeinab Mamouei, Christopher Hart, Micah Ralston, Amr Turkmani, Adam Sassoon, Alexandra Stavrakis, Nicholas M. Bernthal
PLoS One Infectious Diseases, 16.08.2021
Tilføjet 16.08.2021
by Rishi Trikha, Danielle Greig, Troy Sekimura, Nicolas Cevallos, Benjamin Kelley, Zeinab Mamouei, Christopher Hart, Micah Ralston, Amr Turkmani, Adam Sassoon, Alexandra Stavrakis, Nicholas M. Bernthal
Introduction Periprosthetic joint infection (PJI) represents a devastating complication of total joint arthroplasty associated with significant morbidity and mortality. Literature suggests a possible higher incidence of periprosthetic joint infection (PJI) in patients with rheumatoid arthritis (RA). There is, however, no consensus on this purported risk nor a well-defined mechanism. This study investigates how collagen-induced arthritis (CIA), a validated animal model of RA, impacts infectious burden in a well-established model of PJI.
Methods Control mice were compared against CIA mice. Whole blood samples were collected to quantify systemic IgG levels via ELISA. Ex vivo respiratory burst function was measured via dihydrorhodamine assay. Ex vivo Staphylococcus aureus Xen36 burden was measured directly via colony forming unit (CFU) counts and crystal violet assay to assess biofilm formation. In vivo, surgical placement of a titanium implant through the knee joint and inoculation with S. aureus Xen36 was performed. Bacterial burden was then quantified by longitudinal bioluminescent imaging.
Results Mice with CIA demonstrated significantly higher levels of systemic IgG compared with control mice (p = 0.003). Ex vivo, there was no significant difference in respiratory burst function (p = 0.89) or S. aureus bacterial burden as measured by CFU counts (p = 0.91) and crystal violet assay (p = 0.96). In vivo, no significant difference in bacterial bioluminescence between groups was found at all postoperative time points. CFU counts of both the implant and the peri-implant tissue were not significantly different between groups (p = 0.82 and 0.80, respectively).
Conclusion This study demonstrated no significant difference in S. aureus infectious burden between mice with CIA and control mice. These results suggest that untreated, active RA may not represent a significant intrinsic risk factor for PJI, however further mechanistic translational and clinical studies are warranted.
Læs mere Tjek på PubMedThanat Chookajorn, Theerarat Kochakarn, Chaiwat Wilasang, Namfon Kotanan, Charin Modchang
Nature, 16.08.2021
Tilføjet 16.08.2021
Nature Medicine, Published online: 16 August 2021; doi:10.1038/s41591-021-01471-x
Southeast Asia is an emerging hotspot for COVID-19
Læs mere Tjek på PubMedHale, C., Crocker, J., Vanka, A., Ricotta, D. N., McSparron, J. I., Huang, G. C.
BMJ Open, 16.08.2021
Tilføjet 16.08.2021
Objectives
Hospitalists are expected to be competent in performing bedside procedures, which are associated with significant morbidity and mortality. A national decline in procedures performed by hospitalists has prompted questions about their procedural competency. Additionally, though simulation-based mastery learning (SBML) has been shown to be effective among trainees whether this approach has enduring benefits for independent practitioners who already have experience is unknown. We aimed to assess the baseline procedural skill of hospitalists already credentialed to perform procedures. We hypothesised that simulation-based training of hospitalists would result in durable skill gains after several months.
Design
Prospective cohort study with pretraining and post-training measurements.
Setting
Single, large, urban academic medical centre in the USA.
Participants
Twenty-two out of 38 eligible participants defined as hospitalists working on teaching services where they would supervise trainees performing procedures.
Interventions
One-on-one, 60 min SBML of lumbar puncture (LP) and abdominal paracentesis (AP).
Primary and secondary outcome measures
Our primary outcome was the percentage of hospitalists obtaining minimum passing scores (MPS) on LP and AP checklists; our secondary outcomes were average checklist scores and self-reported confidence.
Results
At baseline, only 16% hospitalists met or exceeded the MPS for LP and 32% for AP. Immediately after SBML, 100% of hospitalists reached this threshold. Reassessment an average of 7 months later revealed that only 40% of hospitalists achieved the MPS. Confidence increased initially after training but declined over time.
Conclusions
Hospitalists may be performing invasive bedside procedures without demonstration of adequate skill. A single evidence-based training intervention was insufficient to sustain skills for the majority of hospitalists over a short period of time. More stringent practices for certifying hospitalists who perform risky procedures are warranted, as well as mechanisms to support skill maintenance, such as periodic simulation-based training and assessment.
Læs mere Tjek på PubMedBatool, H., Chughtai, O., Khan, M. D., Chughtai, A. S., Ashraf, S., Khan, M. J.
BMJ Open, 16.08.2021
Tilføjet 16.08.2021
Objective
In this study, we aimed to find the seroprevalence of healthcare workers (HCWs) of Pakistan involved in the treatment and care of patients with COVID-19.
Setting
This was a cross-sectional study and total of 15 000 HCWs involved in providing services and care to the patients with COVID-19 were randomly selected from all over Pakistan.
Participants
Informed consent was taken from all participants and were included according to inclusion and exclusion criteria. All testing was done on serum samples for the qualitative detection of SARS-CoV-2 IgG antibodies using Abbott Chemiluminescent microparticle immunoassay. An index of 1.4 was used as a cut-off to mark reactive and non-reactive cases. SPSS V.23.0 was used for data analysis.
Outcome
Immune status of the study population depicting seroprevalence among HCWs.
Results
Out of all the candidates, majority of the HCWs were men (61.9%) and were doctors (62.4%). The mean age of participants was 32.8 years (SD 8.7) and majority were asymptomatic (51.8%). In this study, 33% of the HCWs were reactive for SARS-CoV-2 IgG antibody. Around 44% of the reactive cases were asymptomatic. The symptoms more significantly associated with seropositivity were: fever (OR 1.31; 95% CI 1.16 to 1.48), headache (OR 2.43; 95% CI 2.16 to 2.73), cough and shortness of breath (OR 2.10; 95% CI 1.91 to 2.31), loss of sense of smell or taste (OR 3.70; 95% CI 3.29 to 4.17) (p<0.001). Factors which showed significant association with the presence of antibodies were professional category (absolute risk (AR) 0.09; OR 1.46; 95% CI 1.36 to 1.56), availability of protective masks (AR 0.02; OR 0.90; 95% CI 0.84 to 0.96), safety goggles (AR 0.02; OR 0.90; 95% CI 0.84 to 0.97) and living arrangements (AR 0.03; OR 1.12; 95% CI 1.04 to 1.20) (p<0.05).
Conclusion
Our study showed a high seropositivity of HCWs dealing with patients with COVID-19 in Pakistan revealing significant association with professional category, nature of work place and precautions taken while performing duties.
Læs mere Tjek på PubMedCai, M., Bowe, B., Xie, Y., Al-Aly, Z.
BMJ Open, 16.08.2021
Tilføjet 16.08.2021
Objectives
To investigate the temporal trends of 30-day mortality and hospitalisation in US Veterans with COVID-19 and 30-day mortality in hospitalised veterans with COVID-19 and to decompose the contribution of changes in the underlying characteristics of affected populations to these temporal changes.
Design
Observational cohort study.
Setting
US Department of Veterans Affairs.
Participants
49 238 US veterans with a positive COVID-19 test between 20 March 2020 and 19 September 2020; and 9428 US veterans hospitalised with a positive COVID-19 test during the same period.
Outcome measures
30-day mortality rate and hospitalisation rate.
Results
Between 20 March 2020 and 19 September 2020 and in COVID-19 positive individuals, 30-day mortality rate dropped by 9.2% from 13.6% to 4.4%; hospitalisation rate dropped by 16.8% from 33.8% to 17.0%. In hospitalised COVID-19 individuals, 30-day mortality rate dropped by 12.7% from 23.5% to 10.8%. Among COVID-19 positive individuals, decomposition analyses suggested that changes in demographic, health and contextual characteristics, COVID-19 testing capacity, and hospital occupancy rates accounted for 40.2% and 33.3% of the decline in 30-day mortality and hospitalisation, respectively. Changes in the underlying characteristics of hospitalised COVID-19 individuals accounted for 29.9% of the decline in 30-day mortality.
Conclusion
Between March and September 2020, changes in demographic and health characteristics of people infected with COVID-19 contributed measurably to the substantial decline in 30-day mortality and hospitalisation.
Læs mere Tjek på PubMedDres, M., Estellat, C., Baudel, J.-L., Beloncle, F., Cousty, J., Galbois, A., Guerin, L., Labbe, V., Labro, G., Lebut, J., Mira, J.-P., Prat, G., Quenot, J.-P., Dessap, A., The Reseau Europeen de Recherche en Ventilation Artificielle (REVA) research network
BMJ Open, 16.08.2021
Tilføjet 16.08.2021
Introduction
Fluid overload is associated with a poor prognosis in the critically ill patients, especially at the time of weaning from mechanical ventilation as it may promote weaning failure from cardiac origin. Some data suggest that early administration of diuretics would shorten the duration of mechanical ventilation. However, this strategy may expose patients to a higher risk of haemodynamic and metabolic complications. Currently, there is no recommendation for the use of diuretics during weaning and there is an equipoise on the timing of their initiation in this context.
Methods and analysis
This study is a multicentre randomised controlled trial comparing two strategies of fluid removal during weaning in 13 French intensive care units (ICU). The preventive strategy is initiated systematically when the fluid balance or weight change is positive and the patients have criteria for clinical stability; the curative strategy is initiated only in case of weaning failure documented as of cardiac origin. Four hundred and ten patients will be randomised with a 1:1 ratio. The primary outcome is the duration of weaning from mechanical ventilation, defined as the number of days between randomisation and successful extubation (alive without reintubation nor tracheostomy within the 7 days after extubation) at day 28. Secondary outcomes include daily and cumulated fluid balance, metabolic and haemodynamic complications, ventilator-associated pneumonia, weaning complications, number of ventilator-free days, total duration of mechanical ventilation, the length of stay in ICU and mortality in ICU, in hospital and, at day 28. A subgroup analysis for the primary outcome is planned in patients with kidney injury (Kidney Disease: Improving Global Outcomes class 2 or more) at the time of randomisation.
Ethics and dissemination
The study has been approved by the ethics committee (Comité de Protection des Personnes Paris 1) and patients will be included after informed consent. The results will be submitted for publication in peer-reviewed journals.
Trial registration number
NCT04050007.
Protocol version
V.1; 12 March 2019.
Læs mere Tjek på PubMedBrooks, S. K., Greenberg, N., Wessely, S., Rubin, G. J.
BMJ Open, 16.08.2021
Tilføjet 16.08.2021
Objective
The 2019–2020 outbreak of novel coronavirus has raised concerns about nosocomial transmission. This review’s aim was to explore the existing literature on emerging infectious disease outbreaks to identify factors associated with compliance with infection control measures among healthcare staff.
Methods
A rapid evidence review for primary studies relevant to healthcare workers’ compliance with infection control measures.
Results
Fifty-six papers were reviewed. Staff working in emergency or intensive care settings or with contact with confirmed cases appeared more likely to comply with recommendations. There was some evidence that anxiety and concern about the risk of infection were more associated with compliance, and that monitoring from superiors could improve compliance. Observed non-compliance of colleagues could hinder compliance. Staff identified many barriers to compliance related to personal protective equipment, including availability, perceived difficulty and effectiveness, inconvenience, discomfort and a negative impact on patient care. There were many issues regarding the communication and ease of understanding of infection control guidance.
Conclusion
We recommend provision of training and education tailored for different occupational roles within the healthcare setting, managerial staff ‘leading by example’, ensuring adequate resources for infection control and timely provision of practical evidence-based infection control guidelines.
Læs mere Tjek på PubMedRapa, E., Hanna, J. R., Mayland, C. R., Mason, S., Moltrecht, B., Dalton, L. J.
BMJ Open, 16.08.2021
Tilføjet 16.08.2021
Objective
The objectives of this study were to investigate how families prepared children for the death of a significant adult, and how health and social care professionals provided psychosocial support to families about a relative’s death during the COVID-19 pandemic.
Design/setting
A mixed methods design; an observational survey with health and social care professionals and relatives bereaved during the COVID-19 pandemic in the UK, and in-depth interviews with bereaved relatives and professionals were conducted. Data were analysed thematically.
Participants
A total of 623 participants completed the survey and interviews were conducted with 19 bereaved relatives and 16 professionals.
Results
Many children were not prepared for a death of an important adult during the pandemic. Obstacles to preparing children included families’ lack of understanding about their relative’s declining health; parental belief that not telling children was protecting them from becoming upset; and parents’ uncertainty about how best to prepare their children for the death. Only 10.2% (n=11) of relatives reported professionals asked them about their deceased relative’s relationships with children. This contrasts with 68.5% (n=72) of professionals who reported that the healthcare team asked about patient’s relationships with children. Professionals did not provide families with psychosocial support to facilitate preparation, and resources were less available or inappropriate for families during the pandemic. Three themes were identified: (1) obstacles to telling children a significant adult is going to die, (2) professionals’ role in helping families to prepare children for the death of a significant adult during the pandemic, and (3) how families prepare children for the death of a significant adult.
Conclusions
Professionals need to: provide clear and honest communication about a poor prognosis; start a conversation with families about the dying patient’s significant relationships with children; and reassure families that telling children someone close to them is dying is beneficial for their longer term psychological adjustment.
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