Viewport Size Code:
Login | Create New Account


About | Classical Genetics | Timelines | What's New | What's Hot

About | Classical Genetics | Timelines | What's New | What's Hot


Bibliography Options Menu

Hide Abstracts   |   Hide Additional Links
Long bibliographies are displayed in blocks of 100 citations at a time. At the end of each block there is an option to load the next block.

Bibliography on: covid-19

The Electronic Scholarly Publishing Project: Providing world-wide, free access to classic scientific papers and other scholarly materials, since 1993.


ESP: PubMed Auto Bibliography 02 Dec 2023 at 01:41 Created: 


Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS coronavirus 2, or SARS-CoV-2), a virus closely related to the SARS virus. The disease was discovered and named during the 2019-20 coronavirus outbreak. Those affected may develop a fever, dry cough, fatigue, and shortness of breath. A sore throat, runny nose or sneezing is less common. While the majority of cases result in mild symptoms, some can progress to pneumonia and multi-organ failure. The infection is spread from one person to others via respiratory droplets produced from the airways, often during coughing or sneezing. Time from exposure to onset of symptoms is generally between 2 and 14 days, with an average of 5 days. The standard method of diagnosis is by reverse transcription polymerase chain reaction (rRT-PCR) from a nasopharyngeal swab or sputum sample, with results within a few hours to 2 days. Antibody assays can also be used, using a blood serum sample, with results within a few days. The infection can also be diagnosed from a combination of symptoms, risk factors and a chest CT scan showing features of pneumonia. Correct handwashing technique, maintaining distance from people who are coughing and not touching one's face with unwashed hands are measures recommended to prevent the disease. It is also recommended to cover one's nose and mouth with a tissue or a bent elbow when coughing. Those who suspect they carry the virus are recommended to wear a surgical face mask and seek medical advice by calling a doctor rather than visiting a clinic in person. Masks are also recommended for those who are taking care of someone with a suspected infection but not for the general public. There is no vaccine or specific antiviral treatment, with management involving treatment of symptoms, supportive care and experimental measures. The case fatality rate is estimated at between 1% and 3%. The World Health Organization (WHO) has declared the 2019-20 coronavirus outbreak a Public Health Emergency of International Concern (PHEIC). As of 29 February 2020, China, Hong Kong, Iran, Italy, Japan, Singapore, South Korea and the United States are areas having evidence of community transmission of the disease.

NOTE: To obtain the entire bibliography (all 42852 citations) in bibtek format (a format that can be easily loaded into many different reference-manager software programs, click HERE.

Created with PubMed® Query: ( SARS-CoV-2 OR COVID-19 OR (wuhan AND coronavirus) AND review[SB] ) NOT pmcbook NOT ispreviousversion

Citations The Papers (from PubMed®)


RevDate: 2023-11-30

Wang X, Chang Z, Zhao T, et al (2023)

The role of post-transcriptional regulation in SARS-CoV-2 infection and pathogenicity.

Frontiers in immunology, 14:1256574.

The COVID-19 pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) virus has had a significant impact on global social and economic stability. To combat this, researchers have turned to omics approaches, particularly epitranscriptomics, to limit infection and develop effective therapeutic strategies. Multi-omics can provide the host response dynamics during multiple disease phases to reveal the molecular and cellular landscapes. Epitranscriptomics focuses on the mechanisms of gene transcription in cells and tissues and the relationship between genetic material and epigenetic regulation. This review highlights the role of post-transcriptional regulation in SARS-CoV-2, which affect various processes such as virus infection, replication, immunogenicity, and pathogenicity. The review also explains the formation mechanism of post-transcriptional modifications and how they can be regulated to combat viral infection and pathogenicity.

RevDate: 2023-11-30

Palomo M, Moreno-Castaño AB, Salas MQ, et al (2023)

Endothelial activation and damage as a common pathological substrate in different pathologies and cell therapy complications.

Frontiers in medicine, 10:1285898.

The endothelium is a biologically active interface with multiple functions, some of them common throughout the vascular tree, and others that depend on its anatomical location. Endothelial cells are continually exposed to cellular and humoral factors, and to all those elements (biological, chemical, or hemodynamic) that circulate in blood at a certain time. It can adapt to different stimuli but this capability may be lost if the stimuli are strong enough and/or persistent in time. If the endothelium loses its adaptability it may become dysfunctional, becoming a potential real danger to the host. Endothelial dysfunction is present in multiple clinical conditions, such as chronic kidney disease, obesity, major depression, pregnancy-related complications, septic syndromes, COVID-19, and thrombotic microangiopathies, among other pathologies, but also in association with cell therapies, such as hematopoietic stem cell transplantation and treatment with chimeric antigen receptor T cells. In these diverse conditions, evidence suggests that the presence and severity of endothelial dysfunction correlate with the severity of the associated disease. More importantly, endothelial dysfunction has a strong diagnostic and prognostic value for the development of critical complications that, although may differ according to the underlying disease, have a vascular background in common. Our multidisciplinary team of women has devoted many years to exploring the role of the endothelium in association with the mentioned diseases and conditions. Our research group has characterized some of the mechanisms and also proposed biomarkers of endothelial damage. A better knowledge would provide therapeutic strategies either to prevent or to treat endothelial dysfunction.

RevDate: 2023-11-30

Mishyiev V, Mykhaylov B, Grinevich E, et al (2023)

The COVID-19 pandemic: new challenges for the mental health protection system.

Postepy psychiatrii neurologii, 32(3):138-146.

PURPOSE: The comparative investigation of the scientific research materials and systematization of the latest data on the epidemiological state, pathogenetic mechanisms, clinical manifestations, risk factors, and psychopathological consequences of the impact of the COVID-19 pandemic on the mental health of the population is needed for the further targeted development of treatment and rehabilitation measures.

VIEWS: The COVID-19 pandemic has been increasingly viewed through the lens of serious global mental health issues. This article analyzes the results of original research and publications data on the etiopathogenesis, neuropsychiatric features, and risk factors of mental disorders associated with the pandemic. The study was carried out within the scope of the scientific research work of the Department of General, Children's Forensic Psychiatry, and Narcology of the Shupyk National Healthcare University of Ukraine. Its title was "Development of a multimodal system of restorative therapy and medical and psychological rehabilitation of patients with COVID-19, based on the study of leading pathogenetic mechanisms" (state registration number 0121U114707).

CONCLUSIONS: Despite the recent rapid increase in the number of sources in the literature devoted to the consequences of the COVID-19 pandemic, several questions remain unresolved. This especially applies to disorders in the mental sphere, concerning clinical phenomenology, features of emotional and cognitive disturbances, personal response, levels of social functioning and the quality of life of patients who have suffered from COVID-19. The data obtained can serve as the basis for the further development of a multimodal model of hierarchical structural-functional pathogenetic links of mental disorders, as well as a target-oriented system of restorative therapy and medical-psychological rehabilitation of patients who have suffered from COVID-19.

RevDate: 2023-11-30

Abdelouahed M, Yateem D, S Fredericks (2023)

FcγRIIa - dependent platelet activation identified in COVID-19 vaccine-induced immune thrombotic thrombocytopenia-, heparin-induced thrombocytopenia, streptokinase- and anisoylated plasminogen-streptokinase activator complex-induced platelet activation.

Frontiers in cardiovascular medicine, 10:1282637.

Coronavirus disease 2019 (COVID-19), which was caused by the coronavirus - severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was globally responsible for remarkable morbidity and mortality. Several highly effective vaccines for COVID-19 were developed and disseminated worldwide within an unprecedented timescale. Rare but dangerous clotting and thrombocytopenia events, and subsequent coagulation abnormalities, have been reported after massive vaccination against SARS-CoV-2. Soon after their global rollout, reports of a morbid clinical syndrome following vaccination with adenovirus-DNA-based vaccines appeared. In the spring of 2021, reports of a novel, rare and morbid clinical syndrome, with clinically devastating and fatal complication after vaccination with adenovirus-based coronavirus vaccines (Janssen/Johnson & Johnson and Astra-Zeneca vaccines) led to a brief suspension of their use by several countries. Those complications were associated with unusual cerebral and splanchnic venous thrombosis, and circulating autoantibodies directed against anti-platelet factor 4 (PF4), a protein secreted from platelets, leading to the designation: Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT). The reported VITT incidence remains very low and does not affect the overall benefit of immunization, however, if left untreated, VITT can be debilitating or even fatal. VITT resembled specific adverse drugs' reactions that also involved the production of autoantibodies and subsequent abnormal platelet activation through platelet FcγRIIa. These unusual but well-documented drug reactions were heparin-induced thrombocytopenia (HIT), streptokinase- (SK), and anisoylated plasminogen-streptokinase activator complex- (APSAC) associated with platelet-activating antibodies. There was considerable overlapping of clinical features between VITT, COVID-19 and these adverse drugs' reactions. We review the phenomenon of VITT against the backdrop of shared and common mechanisms that underlie HIT-, SK-, and APSAC-platelet FcγRIIa-dependent platelet activation. An understanding of VITT's pathogenesis may be achieved by comparing and contrasting VITT-, HIT-, SK- and APSAC-induced platelet activation mechanisms, their respective physiopathology and similarities. Discussing these conditions in parallel provides insight into complex immunological disorders and diseases associated with abnormal hemostasis and thrombosis in particular.

RevDate: 2023-11-30

Haq M, SV Deshpande (2023)

Effects of Antibodies in the Serum After the Administration of COVID Vaccines and Their Hematological and Cardiovascular Complications.

Cureus, 15(10):e47984.

The outbreak of COVID-19 was seen first in Wuhan, China, on December 31, 2019. Following this, the virus has emerged, mutated, and spread to all parts of the world, taking many lives. Scientists and healthcare workers all over the world have been involved in developing vaccines and drugs to prevent the deadly virus from spreading. In this review article, we focus on how the human body responds to immune responses by producing antibodies against our immune system and serum levels in different age groups. Few studies are being considered, which include data collected from adults in the UK community, health workers from Oxfordshire, studies from the UK, healthcare workers at a university healthcare center in Turkey, and lastly, non-seropositive and seronegative healthcare workers in the USA children's hospital, respectively, and their responses to the goal. In addition to focusing on this study and its results, we also discuss the role of different vaccines and their development and antibody responses in the body due to natural and post-vaccine infections that include both doses in humans. We focus mainly on immunoglobulin M (IgM) and immunoglobulin G (IgG) levels in the serum produced by plasma cells, as they are involved in the first line of defense against the disease. With the development of effective vaccines and their production, trial, and market distribution to needy people, there are certain prospects for slowing down the progression of the virus, reducing mortality, and preventing re-infection in humans. However impactful and beneficial these vaccines have proven, they also carry a certain amount of danger to the people taking them. We also discuss in this article certain infrequent hematological and cardiovascular complications of the vaccine and their effect on the population.

RevDate: 2023-11-30

Donkor KN, Jang H, R Sail (2023)

A Systematic Review of Clinical Practice Guidelines for Managing Pulmonary Toxicities Caused by Immune Checkpoint Inhibitors: Quality of Treatment Recommendations and Differences in Management Strategies Between Guidelines.

Clinical Medicine Insights. Oncology, 17:11795549231203153.

BACKGROUND: Pulmonary toxicities caused by immune checkpoint inhibitors are a prominent concern for clinicians. Clinical Practice Guidelines (CPGs) are critical for managing these toxicities.

METHODS: A systematic search of CPGs on checkpoint-associated pulmonary toxicities (ca-PT) was conducted in October 2022. PubMed, Embase, Cochrane Library, CINAHL, and Web of Science were searched. AGREE II and AGREE-REX were used to appraise CPGs and recommendations quality, respectively. Descriptive statistics, intraclass correlation coefficient, Kruskal-Wallis (H) test, and Spearman's correlation were used for analyses. P-values < .05 were considered statistically significant. Matrices were used to determine recommendation differences between CPGs. The study's design was based on the PRISMA 2020 checklist for systematic reviews. Protocol registration number: CRD42022358435.

RESULTS: Eight CPGs (two high-quality, three moderate-quality, and three low-quality) were identified. All CPGs covered pneumonitis. One CPG covered pleural effusions and pneumonitis/SARs-CoV-2-infection. Three CPGs covered sarcoidosis-like-reactions. CPGs for pulmonary fibrosis, airway disease, bronchiolitis, and diffuse alveolar damage, were unavailable. No CPG recommendation was based on a prospective study, and none were appraised as high-quality. Also, recommendations were not specific to histopathologic subtypes. AGREE II's "rigor of development," the domain that evaluates a guideline's methodological approach and strategies in gathering scientific evidence, correlated strongly with AGREE-REX's "overall quality" pneumonitis recommendations, r = .952; P < .01. Approximately 73% of recommendations on pneumonitis were similar between high-quality CPGs. About 16% to 74% of low-quality CPGs were similar to those recommended by high-quality CPGs.

CONCLUSION: Prospectively designed research projects focusing on all types of ca-PT and their histopathologic subtypes are urgently needed. Due to the lack of high-quality recommendations in available CPGs, the disparities in treatment recommendations between high-quality CPGs, and the similarities in recommendations that exists between high-quality and low-quality CPGs, clinicians should thoroughly assess and responsibly appraise all available CPG recommendations in formulating treatment strategies for ca-PT.

RevDate: 2023-12-01
CmpDate: 2023-12-01

Tam D, Norman H, LL Chen (2024)

An Integrative Review: Evaluating the Risks, Benefits, and Efficacy of Extracorporeal Membrane Oxygenation (ECMO) in Treating ARDS Secondary to COVID-19.

Critical care nursing quarterly, 47(1):2-8.

The onset of the COVID-19 pandemic has led to an increased use of extracorporeal membrane oxygenation (ECMO) for severe acute respiratory distress syndrome (ARDS); however, there are ongoing concerns about its associated risks and benefits, making a comprehensive understanding vital for clinical decision-making. This review aims to evaluate the efficacy, risks, and practical implications of ECMO as a therapeutic intervention in severe ARDS secondary to COVID-19. The results indicate that ECMO is a key therapeutic intervention for managing severe COVID-19, but due to its associated risks and resource constraints, its application needs careful consideration. Nurse practitioners need to acquire specialized skills to manage ECMO and stay updated with ongoing research and revised protocols. Given the potential for future virus mutations or pandemics, and finite resources, a multidisciplinary approach to ECMO therapy is necessary. Careful patient selection, strategic resource allocation, and continuous education are pivotal elements for improved patient outcomes.

RevDate: 2023-12-01
CmpDate: 2023-12-01

Woodward A, C Rivers (2023)

Building Case Investigation and Contact Tracing Programs in US State and Local Health Departments: A Conceptual Framework.

Disaster medicine and public health preparedness, 17:e540 pii:S1935789323002057.

OBJECTIVE: At the onset of the COVID-19 pandemic, and to this day, US state, tribal, local, and territorial health departments lacked comprehensive case investigation and contact tracing (CI/CT) guidelines that clearly define the capabilities and capacities of CI/CT programs and how to scale up these programs to respond to outbreaks. This research aims to identify the capabilities and capacities of CI/CT programs and to develop a conceptual framework that represents the relationships between these program components.

METHODS: This study conducted a narrative literature review and qualitative interviews with 10 US state and local health departments and 4 public health experts to identify and characterize the capacities and capabilities of CI/CT programs.

RESULTS: This research resulted in the first comprehensive analysis of the capabilities and capacities of CI/CT programs and a conceptual framework that illustrates the interrelationships between the capacities, capabilities, outcomes, and impacts of CI/CT programs.

CONCLUSIONS: Our findings highlight the need for further guidance to assist jurisdictional health departments in shifting CI/CT program goals as outbreaks evolve. Training the public health workforce on making decisions around CI/CT program implementation during outbreaks is critical to ensure readiness for a variety of outbreak scenarios.

RevDate: 2023-12-01
CmpDate: 2023-12-01

Zhou J, Yang X, Yang Y, et al (2023)

Human microbiota dysbiosis after SARS-CoV-2 infection have the potential to predict disease prognosis.

BMC infectious diseases, 23(1):841.

BACKGROUND: The studies on SARS-CoV-2 and human microbiota have yielded inconsistent results regarding microbiota α-diversity and key microbiota. To address these issues and explore the predictive ability of human microbiota for the prognosis of SARS-CoV-2 infection, we conducted a reanalysis of existing studies.

METHODS: We reviewed the existing studies on SARS-CoV-2 and human microbiota in the Pubmed and Bioproject databases (from inception through October 29, 2021) and extracted the available raw 16S rRNA sequencing data of human microbiota. Firstly, we used meta-analysis and bioinformatics methods to reanalyze the raw data and evaluate the impact of SARS-CoV-2 on human microbial α-diversity. Secondly, machine learning (ML) was employed to assess the ability of microbiota to predict the prognosis of SARS-CoV-2 infection. Finally, we aimed to identify the key microbiota associated with SARS-CoV-2 infection.

RESULTS: A total of 20 studies related to SARS-CoV-2 and human microbiota were included, involving gut (n = 9), respiratory (n = 11), oral (n = 3), and skin (n = 1) microbiota. Meta-analysis showed that in gut studies, when limiting factors were studies ruled out the effect of antibiotics, cross-sectional and case-control studies, Chinese studies, American studies, and Illumina MiSeq sequencing studies, SARS-CoV-2 infection was associated with down-regulation of microbiota α-diversity (P < 0.05). In respiratory studies, SARS-CoV-2 infection was associated with down-regulation of α-diversity when the limiting factor was V4 sequencing region (P < 0.05). Additionally, the α-diversity of skin microbiota was down-regulated at multiple time points following SARS-CoV-2 infection (P < 0.05). However, no significant difference in oral microbiota α-diversity was observed after SARS-CoV-2 infection. ML models based on baseline respiratory (oropharynx) microbiota profiles exhibited the ability to predict outcomes (survival and death, Random Forest, AUC = 0.847, Sensitivity = 0.833, Specificity = 0.750) after SARS-CoV-2 infection. The shared differential Prevotella and Streptococcus in the gut, respiratory tract, and oral cavity was associated with the severity and recovery of SARS-CoV-2 infection.

CONCLUSIONS: SARS-CoV-2 infection was related to the down-regulation of α-diversity in the human gut and respiratory microbiota. The respiratory microbiota had the potential to predict the prognosis of individuals infected with SARS-CoV-2. Prevotella and Streptococcus might be key microbiota in SARS-CoV-2 infection.

RevDate: 2023-12-01
CmpDate: 2023-12-01

Ijaz MK, Sattar SA, Nims RW, et al (2023)

Environmental dissemination of respiratory viruses: dynamic interdependencies of respiratory droplets, aerosols, aerial particulates, environmental surfaces, and contribution of viral re-aerosolization.

PeerJ, 11:e16420.

During the recent pandemic of COVID-19 (SARS-CoV-2), influential public health agencies such as the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC) have favored the view that SARS CoV-2 spreads predominantly via droplets. Many experts in aerobiology have openly opposed that stance, forcing a vigorous debate on the topic. In this review, we discuss the various proposed modes of viral transmission, stressing the interdependencies between droplet, aerosol, and fomite spread. Relative humidity and temperature prevailing determine the rates at which respiratory aerosols and droplets emitted from an expiratory event (sneezing, coughing, etc.) evaporate to form smaller droplets or aerosols, or experience hygroscopic growth. Gravitational settling of droplets may result in contamination of environmental surfaces (fomites). Depending upon human, animal and mechanical activities in the occupied space indoors, viruses deposited on environmental surfaces may be re-aerosolized (re-suspended) to contribute to aerosols, and can be conveyed on aerial particulate matter such as dust and allergens. The transmission of respiratory viruses may then best be viewed as resulting from dynamic virus spread from infected individuals to susceptible individuals by various physical states of active respiratory emissions, instead of the current paradigm that emphasizes separate dissemination by respiratory droplets, aerosols or by contaminated fomites. To achieve the optimum outcome in terms of risk mitigation and infection prevention and control (IPAC) during seasonal infection peaks, outbreaks, and pandemics, this holistic view emphasizes the importance of dealing with all interdependent transmission modalities, rather than focusing on one modality.

RevDate: 2023-12-01
CmpDate: 2023-12-01

Keegan D, Heffernan E, Clarke B, et al (2024)

Tools and methods for evaluating the change to health service delivery due to pandemics or other similar emergencies: A rapid evidence review.

Evaluation and program planning, 102:102378.

The novel coronavirus, SARS-CoV-2 and its associated disease COVID-19, were declared a pandemic in March 2020. Countries developed rapid response activities within their health services to prevent spread of the virus and protect their populations. Evaluating health service delivery change is vital to assess how adapted practices worked, particularly during times of crisis. This review examined tools and methods that are used to evaluate health service delivery change during pandemics and similar emergencies. Five databases were searched, including PubMed, CENTRAL, Embase, CINAHL, and PsycINFO. The SPIDER tool informed the inclusion criteria for the articles. Articles in English and published from 2002 to 2020 were included. Risk of bias was assessed using the Mixed-Methods Appraisal Tool (MMAT). A narrative synthesis approach was used to analyse the studies. Eleven articles met the inclusion criteria. Many evaluation tools, methods, and frameworks were identified in the literature. Only one established tool was specific to a particular disease outbreak. Others, including rapid-cycle improvement and PDSA cycles were implemented across various disease outbreaks. Novel evaluation strategies were common across the literature and included checklists, QI frameworks, questionnaires, and surveys. Adherence practices, experience with telehealth, patient/healthcare staff safety, and clinical competencies were some areas evaluated by the tools and methods. Several domains, including patient/practitioner safety and patient/practitioner experience with telemedicine were also identified in the studies.

RevDate: 2023-12-01
CmpDate: 2023-12-01

Granerod J, Huang Y, Davies NWS, et al (2023)

Global Landscape of Encephalitis: Key Priorities to Reduce Future Disease Burden.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 77(11):1552-1560.

Encephalitis affects people across the lifespan, has high rates of mortality and morbidity, and results in significant neurological sequelae with long-term consequences to quality of life and wider society. The true incidence is currently unknown due to inaccurate reporting systems. The disease burden of encephalitis is unequally distributed across the globe being highest in low- and middle-income countries where resources are limited. Here countries often lack diagnostic testing, with poor access to essential treatments and neurological services, and limited surveillance and vaccination programs. Many types of encephalitis are vaccine preventable, whereas others are treatable with early diagnosis and appropriate management. In this viewpoint, we provide a narrative review of key aspects of diagnosis, surveillance, treatment, and prevention of encephalitis and highlight priorities for public health, clinical management, and research, to reduce the disease burden.

RevDate: 2023-12-01
CmpDate: 2023-12-01

Maeshiro R, Jarris YS, Prunuske J, et al (2023)

Public and Population Health in U.S. Medical Education: A Review of Guidance in Extraordinary Times.

Academic medicine : journal of the Association of American Medical Colleges, 98(12):1366-1380.

Generations of medical educators have recommended including public and population health (PPH) content in the training of U.S. physicians. The COVID-19 pandemic, structural racism, epidemic gun violence, and the existential threats caused by climate change are currently unsubtle reminders of the essential nature of PPH in medical education and practice. To assess the state of PPH content in medical education, the authors reviewed relevant guidance, including policies, standards, and recommendations from national bodies that represent and oversee medical education for physicians with MD degrees.Findings confirm that guidance across the medical education continuum, from premedical education to continuing professional development, increasingly includes PPH elements that vary in specificity and breadth. Graduate medical education policies present the most comprehensive approach in both primary care and subspecialty fields. Behavioral, quantitative, social, and systems sciences are represented, although not uniformly, in guidance for every phase of training. Quantitative PPH skills are frequently presented in the context of research, but not in relation to the development of population health perspectives (e.g., evidence-based medicine, quality improvement, policy development). The interdependence between governmental public health and medical practice, environmental health, and the impact of structural racism and other systems of oppression on health are urgent concerns, yet are not consistently or explicitly included in curricular guidance. To prepare physicians to meet the health needs of patients and communities, educators should identify and address gaps and inconsistencies in PPH curricula and related guidance.Re-examinations of public health and health care systems in the wake of the COVID-19 pandemic support the importance of PPH in physician training and practice, as physicians can help to bridge clinical and public health systems. This review provides an inventory of existing guidance (presented in the appendices) to assist educators in establishing PPH as an essential foundation of physician training and practice.

RevDate: 2023-11-30

Le K, Kannappan S, Kim T, et al (2023)

Structural understanding of SARS-CoV-2 virus entry to host cells.

Frontiers in molecular biosciences, 10:1288686 pii:1288686.

Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a major global health concern associated with millions of fatalities worldwide. Mutant variants of the virus have further exacerbated COVID-19 mortality and infection rates, emphasizing the urgent need for effective preventive strategies. Understanding the viral infection mechanism is crucial for developing therapeutics and vaccines. The entry of SARS-CoV-2 into host cells is a key step in the infection pathway and has been targeted for drug development. Despite numerous reviews of COVID-19 and the virus, there is a lack of comprehensive reviews focusing on the structural aspects of viral entry. In this review, we analyze structural changes in Spike proteins during the entry process, dividing the entry process into prebinding, receptor binding, proteolytic cleavage, and membrane fusion steps. By understanding the atomic-scale details of viral entry, we can better target the entry step for intervention strategies. We also examine the impacts of mutations in Spike proteins, including the Omicron variant, on viral entry. Structural information provides insights into the effects of mutations and can guide the development of therapeutics and vaccines. Finally, we discuss available structure-based approaches for the development of therapeutics and vaccines. Overall, this review provides a detailed analysis of the structural aspects of SARS-CoV-2 viral entry, highlighting its significance in the development of therapeutics and vaccines against COVID-19. Therefore, our review emphasizes the importance of structural information in combating SARS-CoV-2 infection.

RevDate: 2023-11-30

Grieve R, Yang Y, Abbott S, et al (2023)

The importance of investing in data, models, experiments, team science, and public trust to help policymakers prepare for the next pandemic.

PLOS global public health, 3(11):e0002601 pii:PGPH-D-23-01019.

The COVID-19 pandemic has brought about valuable insights regarding models, data, and experiments. In this narrative review, we summarised the existing literature on these three themes, exploring the challenges of providing forecasts, the requirement for real-time linkage of health-related datasets, and the role of 'experimentation' in evaluating interventions. This literature review encourages us to broaden our perspective for the future, acknowledging the significance of investing in models, data, and experimentation, but also to invest in areas that are conceptually more abstract: the value of 'team science', the need for public trust in science, and in establishing processes for using science in policy. Policy-makers rely on model forecasts early in a pandemic when there is little data, and it is vital to communicate the assumptions, limitations, and uncertainties (theme 1). Linked routine data can provide critical information, for example, in establishing risk factors for adverse outcomes but are often not available quickly enough to make a real-time impact. The interoperability of data resources internationally is required to facilitate sharing across jurisdictions (theme 2). Randomised controlled trials (RCTs) provided timely evidence on the efficacy and safety of vaccinations and pharmaceuticals but were largely conducted in higher income countries, restricting generalisability to low- and middle-income countries (LMIC). Trials for non-pharmaceutical interventions (NPIs) were almost non-existent which was a missed opportunity (theme 3). Building on these themes from the narrative review, we underscore the importance of three other areas that need investment for effective evidence-driven policy-making. The COVID-19 response relied on strong multidisciplinary research infrastructures, but funders and academic institutions need to do more to incentivise team science (4). To enhance public trust in the use of scientific evidence for policy, researchers and policy-makers must work together to clearly communicate uncertainties in current evidence and any need to change policy as evidence evolves (5). Timely policy decisions require an established two-way process between scientists and policy makers to make the best use of evidence (6). For effective preparedness against future pandemics, it is essential to establish models, data, and experiments as fundamental pillars, complemented by efforts in planning and investment towards team science, public trust, and evidence-based policy-making across international communities. The paper concludes with a 'call to actions' for both policy-makers and researchers.

RevDate: 2023-11-30

Yerlikaya S, Broger T, Isaacs C, et al (2023)

Blazing the trail for innovative tuberculosis diagnostics.

Infection [Epub ahead of print].

The COVID-19 pandemic brought diagnostics into the spotlight in an unprecedented way not only for case management but also for population health, surveillance, and monitoring. The industry saw notable levels of investment and accelerated research which sparked a wave of innovation. Simple non-invasive sampling methods such as nasal swabs have become widely used in settings ranging from tertiary hospitals to the community. Self-testing has also been adopted as standard practice using not only conventional lateral flow tests but novel and affordable point-of-care molecular diagnostics. The use of new technologies, including artificial intelligence-based diagnostics, have rapidly expanded in the clinical setting. The capacity for next-generation sequencing and acceptance of digital health has significantly increased. However, 4 years after the pandemic started, the market for SARS-CoV-2 tests is saturated, and developers may benefit from leveraging their innovations for other diseases; tuberculosis (TB) is a worthwhile portfolio expansion for diagnostics developers given the extremely high disease burden, supportive environment from not-for-profit initiatives and governments, and the urgent need to overcome the long-standing dearth of innovation in the TB diagnostics field. In exchange, the current challenges in TB detection may be resolved by adopting enhanced swab-based molecular methods, instrument-based, higher sensitivity antigen detection technologies, and/or artificial intelligence-based digital health technologies developed for COVID-19. The aim of this article is to review how such innovative approaches for COVID-19 diagnosis can be applied to TB to have a comparable impact.

RevDate: 2023-11-30

Suman SK, Chandrasekaran N, CG Priya Doss (2023)

Micro-nanoemulsion and nanoparticle-assisted drug delivery against drug-resistant tuberculosis: recent developments.

Clinical microbiology reviews [Epub ahead of print].

SUMMARYTuberculosis (TB) is a major global health problem and the second most prevalent infectious killer after COVID-19. It is caused by Mycobacterium tuberculosis (Mtb) and has become increasingly challenging to treat due to drug resistance. The World Health Organization declared TB a global health emergency in 1993. Drug resistance in TB is driven by mutations in the bacterial genome that can be influenced by prolonged drug exposure and poor patient adherence. The development of drug-resistant forms of TB, such as multidrug resistant, extensively drug resistant, and totally drug resistant, poses significant therapeutic challenges. Researchers are exploring new drugs and novel drug delivery systems, such as nanotechnology-based therapies, to combat drug resistance. Nanodrug delivery offers targeted and precise drug delivery, improves treatment efficacy, and reduces adverse effects. Along with nanoscale drug delivery, a new generation of antibiotics with potent therapeutic efficacy, drug repurposing, and new treatment regimens (combinations) that can tackle the problem of drug resistance in a shorter duration could be promising therapies in clinical settings. However, the clinical translation of nanomedicines faces challenges such as safety, large-scale production, regulatory frameworks, and intellectual property issues. In this review, we present the current status, most recent findings, challenges, and limiting barriers to the use of emulsions and nanoparticles against drug-resistant TB.

RevDate: 2023-11-30

Cuomo A, Barillà G, Serafini G, et al (2023)

Drug-drug interactions between COVID-19 therapeutics and psychotropic medications.

Expert opinion on drug metabolism & toxicology [Epub ahead of print].

INTRODUCTION: The coronavirus (COVID-19) pandemic has led to as well as exacerbated mental health disorders, leading to increased use of psychotropic medications. Co-administration of COVID-19 and psychotropic medications may result in drug-drug interactions (DDIs), that may compromise both the safety and efficacy of both medications.

AREAS COVERED: This review provides an update of the current evidence on DDIs between COVID-19 and psychotropic medications. The interactions are categorized into pharmacokinetic, pharmacodynamic, serotonin syndrome, QT interval prolongation, and other relevant types. A thorough literature search was conducted using electronic databases to identify relevant studies, with data extracted and synthesized narratively to highlight potential DDIs, clinical implications, and management strategies.

EXPERT OPINION: Understanding and managing potential DDIs between COVID-19 and psychotropic medications is paramount to ensuring safe and effective treatment of patients with COVID-19 and mental illness. Awareness of the diverse spectrum of DDIs, vigilant monitoring, and judicious dose modifications, while choosing pharmacotherapeutic options with low risk of interaction whenever possible, are necessary. Ongoing and future investigations should continue to review and assess the dynamic landscape of COVID-19 therapeutic modalities and carefully elucidate their interactions with psychotropic medications. This ongoing commitment to research is critical to providing clinicians with contemporaneous insights, thereby enabling them to skillfully navigate the complexities of managing individuals struggling with mental health disorders in the context of the COVID-19 pandemic.

RevDate: 2023-11-30

Reis S, Metzendorf MI, Kuehn R, et al (2023)

Nirmatrelvir combined with ritonavir for preventing and treating COVID-19.

The Cochrane database of systematic reviews, 11:CD015395.

BACKGROUND: Oral nirmatrelvir/ritonavir (Paxlovid) aims to avoid severe COVID-19 in asymptomatic people or those with mild symptoms, thereby decreasing hospitalization and death. It remains to be evaluated for which indications and patient populations the drug is suitable.

OBJECTIVES: To assess the efficacy and safety of nirmatrelvir/ritonavir plus standard of care (SoC) compared to SoC with or without placebo, or any other intervention for treating COVID-19 or preventing SARS-CoV-2 infection. To explore equity aspects in subgroup analyses. To keep up to date with the evolving evidence base using a living systematic review (LSR) approach and make new relevant studies available to readers in-between publication of review updates.

SEARCH METHODS: We searched the Cochrane COVID-19 Study Register, Scopus, and World Health Organization COVID-19 Research Database, identifying completed and ongoing studies without language restrictions and incorporating studies up to 15 May 2023. This is a LSR. We conduct update searches every two months and make them publicly available on the open science framework (OSF) platform.

SELECTION CRITERIA: We included randomized controlled trials (RCTs) comparing nirmatrelvir/ritonavir plus SoC to SoC with or without placebo, or any other intervention for treatment of people with confirmed COVID-19 diagnosis, irrespective of disease severity or treatment setting, and for prevention of SARS-CoV-2 infection. We screened all studies for research integrity. Studies were ineligible if they had been retracted, or if they were not prospectively registered including appropriate ethics approval.

DATA COLLECTION AND ANALYSIS: We followed standard Cochrane methodology and used the Cochrane RoB 2 tool. We rated the certainty of evidence using the GRADE approach for the following outcomes: 1. to treat outpatients with mild COVID-19; 2. to treat inpatients with moderate to severe COVID-19: mortality, clinical worsening or improvement, quality of life, (serious) adverse events, and viral clearance; 3. to prevent SARS-CoV-2 infection in postexposure prophylaxis (PEP); and 4. pre-exposure prophylaxis (PrEP) scenarios: SARS-CoV-2 infection, development of COVID-19 symptoms, mortality, admission to hospital, quality of life, and (serious) adverse events. We explored inequity by subgroup analysis for elderly people, socially-disadvantaged people with comorbidities, populations from low-income countries and low- to middle-income countries, and people from different ethnic and racial backgrounds.

MAIN RESULTS: As of 15 May 2023, we included two RCTs with 2510 participants with mild and mild to moderate symptomatic COVID-19 in outpatient and inpatient settings comparing nirmatrelvir/ritonavir plus SoC to SoC with or without placebo. All trial participants were without previous confirmed SARS-CoV-2 infection and at high risk for progression to severe disease. Randomization coincided with the Delta wave for outpatients and Omicron wave for inpatients. Outpatient trial participants and 73% of inpatients were unvaccinated. Symptom onset in outpatients was no more than five days before randomisation and prior or concomitant therapies including medications highly dependent on CYP3A4 were not allowed. We excluded two studies due to concerns with research integrity. We identified 13 ongoing studies. Three studies are currently awaiting classification. Nirmatrelvir/ritonavir for treating people with asymptomatic or mild COVID-19 in outpatient settings Nirmatrelvir/ritonavir plus SoC compared to SoC plus placebo may reduce all-cause mortality at 28 days (risk ratio (RR) 0.04, 95% confidence interval (CI) 0.00 to 0.68; 1 study, 2224 participants; low-certainty evidence) and admission to hospital or death within 28 days (RR 0.13, 95% CI 0.07 to 0.27; 1 study, 2224 participants; low-certainty evidence). Nirmatrelvir/ritonavir plus SoC may reduce serious adverse events during the study period compared to SoC plus placebo (RR 0.24, 95% CI 0.15 to 0.41; 1 study, 2224 participants; low-certainty evidence). Nirmatrelvir/ritonavir plus SoC probably has little or no effect on treatment-emergent adverse events (RR 0.95, 95% CI 0.82 to 1.10; 1 study, 2224 participants; moderate-certainty evidence), and probably increases treatment-related adverse events such as dysgeusia and diarrhoea during the study period compared to SoC plus placebo (RR 2.06, 95% CI 1.44 to 2.95; 1 study, 2224 participants; moderate-certainty evidence). Nirmatrelvir/ritonavir plus SoC probably decreases discontinuation of study drug due to adverse events compared to SoC plus placebo (RR 0.49, 95% CI 0.30 to 0.80; 1 study, 2224 participants; moderate-certainty evidence). No studies reported improvement of clinical status, quality of life, or viral clearance. Nirmatrelvir/ritonavir for treating people with moderate to severe COVID-19 in inpatient settings We are uncertain whether nirmatrelvir/ritonavir plus SoC compared to SoC reduces all-cause mortality at 28 days (RR 0.63, 95% CI 0.21 to 1.86; 1 study, 264 participants; very low-certainty evidence), or increases viral clearance at seven days (RR 1.06, 95% CI 0.71 to 1.58; 1 study, 264 participants; very low-certainty evidence) and 14 days (RR 1.05, 95% CI 0.92 to 1.20; 1 study, 264 participants; very low-certainty evidence). No studies reported improvement or worsening of clinical status and quality of life. We did not include data for safety outcomes due to insufficient and inconsistent information. Subgroup analyses for equity For outpatients, the outcome 'admission to hospital or death' was investigated for equity regarding age (less than 65 years versus 65 years or greater) and ethnicity. There were no subgroup differences for age or ethnicity. For inpatients, the outcome 'all-cause mortality' was investigated for equity regarding age (65 years or less versus greater than 65 years). There was no difference between subgroups of age. No further equity-related subgroups were reported, and no subgroups were reported for other outcomes. Nirmatrelvir/ritonavir for preventing SARS-CoV-2 infection (PrEP and PEP) No studies available.

AUTHORS' CONCLUSIONS: Low-certainty evidence suggests nirmatrelvir/ritonavir reduces the risk of all-cause mortality and hospital admission or death in high-risk, unvaccinated COVID-19 outpatients infected with the Delta variant of SARS-CoV-2. There is low- to moderate-certainty evidence of the safety of nirmatrelvir/ritonavir. Very low-certainty evidence exists regarding the effects of nirmatrelvir/ritonavir on all-cause mortality and viral clearance in mildly to moderately affected, mostly unvaccinated COVID-19 inpatients infected with the Omicron variant of SARS-CoV-2. Insufficient and inconsistent information prevents the assessment of safety outcomes. No reliable differences in effect size and direction were found regarding equity aspects. There is no available evidence supporting the use of nirmatrelvir/ritonavir for preventing SARS-CoV-2 infection. We are continually updating our search and making search results available on the OSF platform.

RevDate: 2023-11-30

Singh M, Lo SH, Dubey R, et al (2023)

Plant-Derived Natural Compounds as an Emerging Antiviral in Combating COVID-19.

Indian journal of microbiology, 63(4):429-446.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a human virus that burst at Wuhan in China and spread quickly over the world, leading to millions of deaths globally. The journey of this deadly virus to different mutant strains is still ongoing. The plethora of drugs and vaccines have been tested to cope up this pandemic. The herbal plants and different spices have received great attention during pandemic, because of their anti-inflammatory, and immunomodulatory properties in treating viruses and their symptoms. Also, it has been shown that nano-formulation of phytochemicals has potential therapeutic effect against COVID-19. Furthermore, the plant derived compound nano-formulation specifically increases its antiviral property by enhancing its bioavailability, solubility, and target-specific delivery system. This review highlights the potentiality of herbal plants and their phytochemical against SARS-CoV-2 utilizing different mechanisms such as blocking the ACE-2 receptors, inhibiting the main proteases, binding spike proteins and reducing the cytokine storms.

RevDate: 2023-11-29

Dorgalaleh A, Shabannezhad A, S Hassani (2023)

COVID-19 vaccine-induced immune thrombotic thrombocytopenia: pathophysiology and diagnosis.

Annals of hematology [Epub ahead of print].

Coronavirus disease-19 (COVID-19) vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare but serious clinical condition with high mortality rate in apparently healthy individuals without noticeable risk factors. VITT typically arises due to the administration of vaccines that possess recombinant adenoviral vectors, including ChAdOx1 nCov-19 (AstraZeneca) and Ad26 COV2.S (Johnson & Johnson/Janssen). Thrombosis frequently occurs at atypical sites, such as the cerebral or splanchnic circulations, in this particular pathological state. Similar to heparin-induced thrombotic thrombocytopenia (HITT), it seems that the cause of VITT is the misdirection of anti-platelet factor 4 antibodies (anti-PF4 Abs), an ancient antimicrobial mechanism. Anti-PF4 Abs in patients with VITT activates the coagulation system, leading to thrombosis. This process occurs through the stimulation of platelets (Plts) and neutrophils and subsequently release of neutrophil extracellular traps (NETs). Due to the potentially fatal consequences of VITT, early diagnosis is mandatory. In addition to thrombocytopenia, thrombosis, and the presence of anti-PF4 Abs, the day of symptoms onset and the elevation of D-dimer are also required for definitive diagnosis of VITT. The absence of one or more criteria can result in the exclusion of definitive VITT and lead to the diagnosis of probable, possible, or unlikely VITT.

RevDate: 2023-11-29

Khurshid R, Schulz JM, Hu J, et al (2023)

Targeted degrader technologies as prospective SARS-CoV-2 therapies.

Drug discovery today pii:S1359-6446(23)00363-X [Epub ahead of print].

COVID-19 remains a severe public health threat despite the WHO declaring an end to the public health emergency in May 2023. Continual development of SARS-CoV-2 variants with resistance to vaccine-induced or natural immunity necessitates constant vigilance as well as new vaccines and therapeutics. Targeted protein degradation (TPD) remains relatively untapped in antiviral drug discovery and holds the promise of attenuating viral resistance development. From a unique structural design perspective, this review covers antiviral degrader merits and challenges by highlighting key coronavirus protein targets and their co-crystal structures, specifically illustrating how TPD strategies can refine existing SARS-CoV-2 3CL protease inhibitors to potentially produce superior protease-degrading agents.

RevDate: 2023-11-29

Schami A, Islam MN, Belisle JT, et al (2023)

Drug-resistant strains of Mycobacterium tuberculosis: cell envelope profiles and interactions with the host.

Frontiers in cellular and infection microbiology, 13:1274175.

In the past few decades, drug-resistant (DR) strains of Mycobacterium tuberculosis (M.tb), the causative agent of tuberculosis (TB), have become increasingly prevalent and pose a threat to worldwide public health. These strains range from multi (MDR) to extensively (XDR) drug-resistant, making them very difficult to treat. Further, the current and future impact of the Coronavirus Disease 2019 (COVID-19) pandemic on the development of DR-TB is still unknown. Although exhaustive studies have been conducted depicting the uniqueness of the M.tb cell envelope, little is known about how its composition changes in relation to drug resistance acquisition. This knowledge is critical to understanding the capacity of DR-M.tb strains to resist anti-TB drugs, and to inform us on the future design of anti-TB drugs to combat these difficult-to-treat strains. In this review, we discuss the complexities of the M.tb cell envelope along with recent studies investigating how M.tb structurally and biochemically changes in relation to drug resistance. Further, we will describe what is currently known about the influence of M.tb drug resistance on infection outcomes, focusing on its impact on fitness, persister-bacteria, and subclinical TB.

RevDate: 2023-11-29

Song Y, Yao L, Li S, et al (2023)

Psoriasis comorbidity management in the COVID era: a pressing challenge.

Frontiers in microbiology, 14:1294056.

The global COVID-19 pandemic has presented a significant, ongoing challenge since its emergence in late 2019. Today, the Omicron strain, which is less lethal but more contagious than the original outbreak strain, continues to pose substantial health risks. In this background, the management of psoriatic comorbidities has become even more complex, particularly for patients with underlying inflammatory, metabolic, or cardiovascular diseases. This review aims to summarize current research on comorbid COVID-19 and psoriasis, and provide insights into the development of evidence-based management strategies. By providing appropriate patient instruction, implementing protective measures, and re-evaluating medication prescriptions based on each patient's unique situation, healthcare professionals can effectively address the challenges faced by patients with comorbid psoriasis in the COVID-19 era.

RevDate: 2023-11-29

Farhat F, Sohail SS, Alam MT, et al (2023)

COVID-19 and beyond: leveraging artificial intelligence for enhanced outbreak control.

Frontiers in artificial intelligence, 6:1266560.

COVID-19 has brought significant changes to our political, social, and technological landscape. This paper explores the emergence and global spread of the disease and focuses on the role of Artificial Intelligence (AI) in containing its transmission. To the best of our knowledge, there has been no scientific presentation of the early pictorial representation of the disease's spread. Additionally, we outline various domains where AI has made a significant impact during the pandemic. Our methodology involves searching relevant articles on COVID-19 and AI in leading databases such as PubMed and Scopus to identify the ways AI has addressed pandemic-related challenges and its potential for further assistance. While research suggests that AI has not fully realized its potential against COVID-19, likely due to data quality and diversity limitations, we review and identify key areas where AI has been crucial in preparing the fight against any sudden outbreak of the pandemic. We also propose ways to maximize the utilization of AI's capabilities in this regard.

RevDate: 2023-11-29

Koulenti D, Karvouniaris M, Paramythiotou E, et al (2023)

Severe Candida infections in critically ill patients with COVID-19.

Journal of intensive medicine, 3(4):291-297.

The frequency of co-infections with bacterial or fungal pathogens has constantly increased among critically ill patients with coronavirus disease 2019 (COVID-19) during the pandemic. Candidemia was the most frequently reported invasive fungal co-infection. The onset of candidemia in COVID-19 patients was often delayed compared to non-COVID-19 patients. Additionally, Candida invasive infections in COVID-19 patients were more often linked to invasive procedures (e.g., invasive mechanical ventilation or renal replacement therapy) during the intensive care stay and the severity of illness rather than more "classic" risk factors present in patients without COVID-19 (e.g., underlying diseases and prior hospitalization). Moreover, apart from the increased incidence of candidemia during the pandemic, a worrying rise in fluconazole-resistant strains was reported, including a rise in the multidrug-resistant Candida auris. Regarding outcomes, the development of invasive Candida co-infection had a negative impact, increasing morbidity and mortality compared to non-co-infected COVID-19 patients. In this narrative review, we present and critically discuss information on the diagnosis and management of invasive fungal infections caused by Candida spp. in critically ill COVID-19 patients.

RevDate: 2023-11-29

Bahl S, Khanal S, Sangal L, et al (2023)

Measles and rubella elimination: protecting children through immunization in South-East Asia Region (SEAR).

The Lancet regional health. Southeast Asia, 18:100303.

The South-East Asia Region (SEAR) adopted the goal of "measles and rubella elimination by 2023". The goal was revised in 2019 to 'measles and rubella elimination by 2023' The strategies adopted to reach the goal included achieving ≥95% coverage with 2 doses of measles- and rubella-containing vaccine (MCV2; RCV2); establishing effective case-based surveillance supported by an accredited laboratory network; and implementing rapid response measures to control measles outbreaks. Of the 11 countries in the Region, to date five countries have eliminated measles and rubella and two more have controlled rubella. An estimated 242 million cases and 4.7 million deaths due to measles were averted between 2014 and 2022. The high-level political commitment, programmatic infrastructure and partnerships developed for the elimination of polio and maternal and neonatal tetanus played a critical role in this achievement. WHO, supported by key partners, provided technical support and strategic guidance for programmatic improvements, generated evidence to guide policy and strategic shifts, strengthened capacity of health workforce and conducted periodic programmatic reviews. However, unexpected occurrence of COVID-19 pandemic impacted vaccine coverage and quality of surveillance, thereby delaying achievement of the goal, and necessitating a revision of the target date of elimination.

RevDate: 2023-11-29

Dhillon I, Jhalani M, Thamarangsi T, et al (2023)

Advancing Universal Health Coverage in the WHO South-East Asia Region with a focus on Human Resources for Health.

The Lancet regional health. Southeast Asia, 18:100313.

The identification in 2014 of Universal Health Coverage, including focus on human resources for health, as a flagship priority for the WHO South-East Asia Region marked critical departure from the prior period of the Millennium Development Goals. The last decade witnessed strong political commitment and action to advance UHC across the Region. At regional level, UHC service coverage index improved from 47 in 2010 to 62 in 2021. Improved availability of human resources for health has been an important contributor, with the regional average of doctors, nurses and midwives increasing by approximately a third between 2014 and 2020. Progress on financial protection has been mixed: proportion of population impoverished declined significantly but catastrophic expenditure did not reduce. Despite important gains, progress is insufficient to achieve UHC targets by 2030. Covid-19 pandemic and subsequent economic challenges have created further urgency to accelerate progress towards UHC, with attention to strengthening primary health care.

RevDate: 2023-11-29

Bhatia V, Rijal S, Sharma M, et al (2023)

Ending TB in South-East Asia: flagship priority and response transformation.

The Lancet regional health. Southeast Asia, 18:100301.

Over the decades, the global tuberculosis (TB) response has evolved from sanatoria-based treatment to DOTS (Directly Observed Therapy Shortcourse) strategy and the more recent End TB Strategy. The WHO South-East Asia Region, which accounted for 45% of new TB patients and 50% of deaths globally in 2021, is pivotal to the global fight against TB. "Accelerate Efforts to End TB" by 2030 was adopted as a South-East Asia Regional Flagship Priority (RFP) in 2017. This article illustrates intensified and transformed approaches to address the disease burden following the adoption of RFP and new challenges that emerged during the COVID-19 pandemic. TB case notifications improved by 25% and treatment success rates improved by 6% between 2016 and 2019 due to interventions ranging from galvanising political commitments to empowering and engaging communities. Cumulative TB programme budget allocations in 2022 reached US$ 1.4 billion, about two and a half times the budget in 2016. An ambitious Regional Strategic Plan towards ending TB, 2021-2025, identifies priority interventions that will need investments of up to US$ 3 billion a year to fully implement them. Moving forward, countries in the Region need to leverage RFP and take up intensified, people-centred, holistic interventions for prevention, diagnosis, treatment and care of TB with commensurate investments and cross-ministerial and multi-sectoral coordination.

RevDate: 2023-11-29

Sihombing B, Bhatia R, Srivastava R, et al (2023)

Response to antimicrobial resistance in South-East Asia Region.

The Lancet regional health. Southeast Asia, 18:100306.

Antimicrobial resistance (AMR) inflicts significant mortality, morbidity and economic loss in the 11 countries in the WHO South-East Asia Region (SEAR). With technical assistance and advocacy from WHO, all countries have developed their respective National Action Plans on AMR that are aligned with the Global Action Plan. Historically, the WHO Regional Office has been proactive in advocacy at the highest political level. The past decade has seen an enhancement of the country's capacity to combat AMR through national efforts catalyzed and supported through several WHO initiatives at all levels-global, regional and country levels. Several countries including Bangladesh, India, Indonesia, Nepal, Sri Lanka and Thailand have observed a worrying trend of increasing drug resistance, despite heightened awareness and actions. Recent AMR data generated by the countries are indicative of fragmented progress. Lack of technical capacity, financial resources, weak regulatory apparatus, slow behavioural changes at all levels of the antimicrobial stewardship landscape and the COVID-19 pandemic have prevented the effective application of several interventions to minimize the impact of AMR.

RevDate: 2023-11-29

Nursetiawati S, Siregar JS, DP Josua (2023)

Understanding adaptability in the family environment in facing COVID-19: A review.

Heliyon, 9(11):e20618.

Adaptation is a research field that is trending in the face of the coronavirus disease 2019 (COVID-19) outbreak in various parts of the country. The ability to adapt is one way for individuals to survive in uncertain situations. This article reviews the adaptation process in a family environment focusing on finding models from various literatures on family institution adaptations and then mapping them into adaptations that families can implement during the COVID-19 pandemic. Our study showed that family resilience in dealing with changes in various areas of life was performed through family adaptations during the COVID-19 pandemic, such as: (a) the ability of family members to be more open and respect privacy when communicating during all activities at home, (b) culture and values applied in the family are the determining factors for individuals to be able to adapt to new habits, (c) the resources owned by the family determine the attitudes and ways in which the family develops its potential in dealing with limitations and negative emotions, (d) the adaptive power of men as husbands or fathers with women as wives or mothers is driven by different factors, where men are driven generally due to external factors, while women due to internal factors. Families with different environments produce different adaptability, depending on the social capital and support received by the family.

RevDate: 2023-11-30
CmpDate: 2023-11-30

El-Amaireh NAA, Al-Zoubi H, OA Al-Khashman (2023)

Hospital waste incinerator ash: characteristics, treatment techniques, and applications (A review).

Journal of water and health, 21(11):1686-1702.

The amount of medical waste generated has increased enormously since the COVID-19 outbreak. An incineration process is the main method that is usually used to treat this waste, causing an increase in both medical waste bottom ash (MWBA) and medical waste fly ash (MWFA). In this work, the physical and chemical characteristics of MWFA and MWBA were reviewed. This ash contains high levels of polychlorinated dibenzo-p-dioxin (PCDD), dibenzofurans (PCDFs), and heavy metals. Furthermore, medical waste ash appears to have high leachability in the toxicity characteristics leaching procedure (TCLP) test and the European standard test (EN 12457). Owing to its toxicity, medical ash can be treated using various methods prior to disposal based on the covered review. These techniques include chemical, supercritical fluid, cement-based, melting, microwave, and mechanochemical techniques. The shortcomings of some of these treatment methods have been identified, such as the emission of high levels of chlorine from the melting technique, limited applications of the flotation method on the industrial scale, long-term stability of leachate treated by cement-based methods that have not been confirmed yet, and high energy consumption in the supercritical technique. This review also covers possible applications of medical waste ash in cement production, agriculture, and road construction.

RevDate: 2023-11-30
CmpDate: 2023-11-30

Voropaeva SV, Segeda AS, AD Sazonova (2023)

[Medical rehabilitation features of patients suffered from new coronavirus infection].

Voprosy kurortologii, fizioterapii, i lechebnoi fizicheskoi kultury, 100(5):64-69.

UNLABELLED: Despite the development and implementation of preventive measures, new coronavirus infection (COVID-19) cases are still being registered among the population.

OBJECTIVE: To describe the methods of recovery treatment, used at different rehabilitation stages of patients suffered from COVID-19.

MATERIAL AND METHODS: An analytical review of rehabilitation methods of patients after COVID-19 was conducted. The literature reviews and original researches from Scopus, Web of Science, PubMed, CyberLeninka and eLibrary electronic databases were studied.

RESULTS AND CONCLUSION: Lungs, heart and vessels, gastrointestinal tract and central nervous system are most commonly affected by COVID-19. Due to this, the article considers key aspect of rehabilitation of patients with revealed disorders. Multidisciplinary approach is the main treatment type of patient with COVID-19. The effective result of comprehensive and multidisciplinary approach can be achieved only by the work of a team of specialists from different disciplines. The early onset, consistency and continuity of rehabilitation activities are important factors in the recovery of patients with post-COVID syndrome.

RevDate: 2023-11-30
CmpDate: 2023-11-30

Schwendinger F, Knaier R, Radtke T, et al (2023)

Response to Comment on: "Low Cardiorespiratory Fitness Post-COVID-19: A Narrative Review".

Sports medicine (Auckland, N.Z.), 53(12):2531-2532.

RevDate: 2023-11-30
CmpDate: 2023-11-30

da Silva LSL (2023)

Comment on: "Low Cardiorespiratory Fitness Post-COVID-19: A Narrative Review".

Sports medicine (Auckland, N.Z.), 53(12):2529-2530.

RevDate: 2023-11-29

Abuejheisheh AJ, Alshraideh JA, Amro N, et al (2023)

Effectiveness of blended learning basic life support module on knowledge and skills: A systematic review of randomized controlled trials.

Heliyon, 9(11):e21680 pii:S2405-8440(23)08888-6.

AIM: To examine the effectiveness of the BLS blended learning module on knowledge and skills of BLS compared to the traditional module.

METHOD: Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were utilized using key words to searched PubMed, Web of Science, and Cochrane Library for the studies published between January 2018 to May 2022. The risk of bias was assessed utilizing the Joanna Briggs Institute (JBI) critical appraisal checklist. Two reviewers separately extracted data from the included trials using a standardized data extraction form.

RESULTS: From 400 articles retrieved by the initial search, 11 studies were found to be eligible. Most studies' participants were laypersons (80.9 %), and the rest were either nursing (12.6 %) or medical students (6.5 %). The review shows superiority of utilizing the blended strategy in applying the BLS module in skills and knowledge retention, rather than using the traditional learning, which could improve the quality and outcomes of patients.

CONCLUSIONS: Blended learning is effective in teaching BLS like the traditional face-to-face method, but more advantages of the blended learning module include improvement in retaining knowledge, skills acquisition, patient outcomes, and cost saving. The COVID-19 pandemic made blended learning crucial and using this method in BLS was effective and efficient. Future research to assess the effectiveness of blended learning on patient outcomes is recommended.

RevDate: 2023-11-29

Wang L, Nicols A, Turtle L, et al (2023)

T cell immune memory after covid-19 and vaccination.

BMJ medicine, 2(1):e000468 pii:bmjmed-2022-000468.

The T cell memory response is a crucial component of adaptive immunity responsible for limiting or preventing viral reinfection. T cell memory after infection with the SARS-CoV-2 virus or vaccination is broad, and spans multiple viral proteins and epitopes, about 20 in each individual. So far the T cell memory response is long lasting and provides a high level of cross reactivity and hence resistance to viral escape by variants of the SARS-CoV-2 virus, such as the omicron variant. All current vaccine regimens tested produce robust T cell memory responses, and heterologous regimens will probably enhance protective responses through increased breadth. T cell memory could have a major role in protecting against severe covid-19 disease through rapid viral clearance and early presentation of epitopes, and the presence of cross reactive T cells might enhance this protection. T cell memory is likely to provide ongoing protection against admission to hospital and death, and the development of a pan-coronovirus vaccine might future proof against new pandemic strains.

RevDate: 2023-11-29

Blanta M, Karathanasi A, I Tzonichaki (2023)

The impact of the COVID-19 pandemic on children's occupations.

Hong Kong journal of occupational therapy : HKJOT, 36(2):69-83.

BACKGROUND: The COVID-19 pandemic changed the daily lives and limited everyday activities of children worldwide.

OBJECTIVES: To document the impact of the COVID-19 pandemic on children's occupations, the associated factors, and the impact on children's health, wellbeing, and development.

METHODS: A narrative review was conducted by searching four databases (Scopus, MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews).

RESULTS: A total of 35 articles met the inclusion criteria. Out of the 34 articles, 23 were relevant to the impact of the COVID-19 pandemic on occupations related to leisure (n = 17), productivity (n = 11), and self-care (n = 9). Ten articles highlighted specific factors that had been linked to changes in occupational engagement and child behavior. Ten articles focused on the impact of occupational disruption during COVID-19 on health, wellbeing, and general development.

CONCLUSION: The COVID-19 pandemic seems to have had a negative impact on children's occupations, while the restrictions were still in effect. Further research is needed to establish reliable conclusions.

RevDate: 2023-11-29

Mundy C, Bush J, Cheriyan J, et al (2023)

Association for Human Pharmacology in the Pharmaceutical Industry conference 2022: impending change, innovations and future challenges.

Frontiers in pharmacology, 14:1219591 pii:1219591.

The Association for Human Pharmacology in the Pharmaceutical Industry's annual meeting focused on current and impending challenges facing the United Kingdom's (UK) pharmaceutical industry and how these opportunities can inspire innovation and best practice. The UK pharmaceutical landscape is still evolving following Brexit and learnings from the coronavirus disease 2019 (COVID-19) pandemic. As such, the UK's clinical community is in a unique position to steer innovation in a meaningful direction. With the continuation of remote forms of working, further opportunities have arisen to support novel practices away from the clinic. The keynote speaker reflected on clinical development over the past 40 years and how the industry must continue to concentrate on patient welfare. The future of drug development was discussed regarding challenges associated with developing translational gene therapies, and the status of investment markets analyzed from a business strategy and consulting perspective. The patient viewpoint was a core theme throughout the conference with patient-centric blood sampling and decentralized clinical trials providing suggestions for how the industry can save costs and increase efficiency. Moreover, the patient perspective was central to a debate over whether ethics requirements should be the same for oncology patients taking part in first-in-human studies as those for healthy subjects. Discussions continued around the changing roles of the Qualified Person and Principal Investigators which underpins how sponsors may want to run future trials in the UK. Lessons learned from conducting challenge trials in healthy volunteers and patients were discussed following a presentation from the serving Chair of the COVID-19 challenge ethics committee. The current state of interactions with the Medicines and Healthcare products Regulatory Agency were also explored. It was considered how the immediate future for the UK clinical trials community is inevitably still linked with Europe; the newly implemented European Medicines Agency Clinical Trials Information System has been met with lukewarm responses, providing a promising opportunity to ensure UK Phase I units continue to play a vital role in global research.

RevDate: 2023-11-29

Adam D, Berschick J, Schiele JK, et al (2023)

Interventions to reduce stress and prevent burnout in healthcare professionals supported by digital applications: a scoping review.

Frontiers in public health, 11:1231266.

AIM: Healthcare professionals are at increased risk of burnout, primarily due to workplace-related stressors. The COVID-19 pandemic has further increased this risk. Different interventions exist with varying degrees of effectiveness; little is reported on the content and implementation of such programs. This review fills this gap, with attention to recent programs using digital components.

METHODS: PubMed, Embase, PsycInfo, and Google Scholar were searched between January 24th and 28th, 2022, limited to the last 5 years (≥2017). Articles were included if they (1) focused on stress reduction or burnout prevention for nurses and medical doctors within workplace health promotion for nurses or medical doctors, (2) included a digital program component, (3) were conducted in high-income country contexts, and (4) were clinical studies published in English or German. Data was extracted using a priori designed spreadsheets. A group of at least 2 authors at each stage carried out the screening, selection, and data extraction.

RESULTS: The search strategy identified 153 articles, all except 7 were excluded. Two studies were conducted in the USA, two in Spain, one in the Netherlands, Poland, and Korea each. Four studies used a randomized study design, all but one had a control group. A wide range of outcome measures was used. The types of interventions included an adapted mindfulness-based stress reduction program combined with aspects of behavioral therapies, cognitive behavioral therapy, or acceptance and commitment therapy. The digital components used were apps (4 studies), a digital platform, blended learning, and a web-based intervention (1 study each). Six studies focused on individual interventions, one included organizational interventions.

CONCLUSION: Despite an acute burnout crisis in the healthcare sector, only seven recent interventions were found that integrated digital components. Several problems emerged during the implementation of the interventions that made it clear that organizational support is urgently needed for successful implementation. Although interventions for stress reduction and burnout prevention should combine individual and organizational measures to be as successful as possible, this was only partially the case in one of the intervention programs. The results of this scoping review can be used to further develop or optimize stress and burnout prevention programs.

RevDate: 2023-11-29

Qi M, J Ren (2023)

An overview and visual analysis of research on government regulation in healthcare.

Frontiers in public health, 11:1272572.

OBJECTIVE: During the period of COVID-19, government regulation (GR) played an important role in healthcare. This study examines the current research situation of GR in healthcare, discusses the research hotspots, the most productive authors and countries, and the most common journals, and analyzes the changes in GR in healthcare before and after the outbreak of COVID-19.

METHODS: This study followed PRISMA guidelines to collect literature on GR in healthcare. And the VOSviewer software was used to perform a quantitative analysis of these documents to obtain a visual map, including year, country, institution, journal, author, and research topic.

RESULTS: A total of 1,830 papers that involved 976 academic journals, 3,178 institutions, and 133 countries were identified from 1985 to 2023. The United States was the country with the highest production (n = 613), followed by the United Kingdom (n = 289). The institution with the largest number of publications was the University of London in the UK (n = 103); In the author collaboration network, the biggest cluster is Bomhoff M, Bouwman R, Friele R, et al. The top five journals in terms of the number of articles were BMC Health Services Research (n = 70), Plos One (n = 35), Health Policy (n = 33), Social Science & Medicine (n = 29), Health Policy and Planning (n = 29), and Frontiers in Public Health (n = 27). The existing literature mainly focused on "health policy," "public health," "China," "mental health," "India," "qualitative research," "legislation," and "governance," et al. Since 2020, research on "COVID-19" has also become a priority in the domain of healthcare.

CONCLUSION: This study reveals the overall performance of the literature on GR published in healthcare. Healthcare needs GR, especially in response to the COVID-19 epidemic, which has played an irreplaceable role. The outbreak of COVID-19 not only tested the health systems of various countries, but also changed GR in healthcare. With the end of COVID-19, whether these changes will end remains to be further studied.

RevDate: 2023-11-29

Suhaimi SNAA, Zaki IAH, Noordin ZM, et al (2023)

COVID-19 vaccine-induced immune thrombotic thrombocytopenia: a review.

Clinical and experimental vaccine research, 12(4):265-290.

Rare but serious thrombotic incidents in relation to thrombocytopenia, termed vaccine-induced immune thrombotic thrombocytopenia (VITT), have been observed since the vaccine rollout, particularly among replication-defective adenoviral vector-based severe acute respiratory syndrome coronavirus 2 vaccine recipients. Herein, we comprehensively reviewed and summarized reported studies of VITT following the coronavirus disease 2019 (COVID-19) vaccination to determine its prevalence, clinical characteristics, as well as its management. A literature search up to October 1, 2021 using PubMed and SCOPUS identified a combined total of 720 articles. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline, after screening the titles and abstracts based on the eligibility criteria, the remaining 47 full-text articles were assessed for eligibility and 29 studies were included. Findings revealed that VITT cases are strongly related to viral vector-based vaccines, which are the AstraZeneca COVID-19 vaccine (95%) and the Janssen COVID-19 vaccine (4%), with much rarer reports involving messenger RNA-based vaccines such as the Moderna COVID-19 vaccine (0.2%) and the Pfizer COVID-19 vaccine (0.2%). The most severe manifestation of VITT is cerebral venous sinus thrombosis with 317 cases (70.4%) and the earliest primary symptom in the majority of cases is headache. Intravenous immunoglobulin and non-heparin anticoagulant are the main therapeutic options for managing immune responses and thrombosis, respectively. As there is emerging knowledge on and refinement of the published guidelines regarding VITT, this review may assist the medical communities in early VITT recognition, understanding the clinical presentations, diagnostic criteria as well as its management, offering a window of opportunity to VITT patients. Further larger sample size trials could further elucidate the link and safety profile.

RevDate: 2023-11-29

Islam Bhuiyan MR, Azam S, Montaha S, et al (2023)

Deep learning-based analysis of COVID-19 X-ray images: Incorporating clinical significance and assessing misinterpretation.

Digital health, 9:20552076231215915 pii:10.1177_20552076231215915.

COVID-19, pneumonia, and tuberculosis have had a significant effect on recent global health. Since 2019, COVID-19 has been a major factor underlying the increase in respiratory-related terminal illness. Early-stage interpretation and identification of these diseases from X-ray images is essential to aid medical specialists in diagnosis. In this study, (COV-X-net19) a convolutional neural network model is developed and customized with a soft attention mechanism to classify lung diseases into four classes: normal, COVID-19, pneumonia, and tuberculosis using chest X-ray images. Image preprocessing is carried out by adjusting optimal parameters to preprocess the images before undertaking training of the classification models. Moreover, the proposed model is optimized by experimenting with different architectural structures and hyperparameters to further boost performance. The performance of the proposed model is compared with eight state-of-the-art transfer learning models for a comparative evaluation. Results suggest that the COV-X-net19 outperforms other models with a testing accuracy of 95.19%, precision of 96.49% and F1-score of 95.13%. Another novel approach of this study is to find out the probable reason behind image misclassification by analyzing the handcrafted imaging features with statistical evaluation. A statistical analysis known as analysis of variance test is performed, to identify at which point the model can identify a class accurately, and at which point the model cannot identify the class. The potential features responsible for the misclassification are also found. Moreover, Random Forest Feature importance technique and Minimum Redundancy Maximum Relevance technique are also explored. The methods and findings of this study can benefit in the clinical perspective in early detection and enable a better understanding of the cause of misclassification.

RevDate: 2023-11-29

Ramasamy S, Galhotra A, S Agrawal (2023)

Adverse reactions after Covid-19 vaccination in persons affected by leprosy: A scoping review.

Journal of family medicine and primary care, 12(9):1771-1774.

BACKGROUND: Leprosy reactions are the main pathway leading to severe nerve damage and disability. These reactions can occur at any time. The coronavirus disease 2019 (Covid-19) pandemic led to a catastrophic loss of human life and has had a devastating impact on persons affected by leprosy.

OBJECTIVE: To achieve deep insight into the subject of adverse reactions acquired after Covid vaccinations in persons affected by leprosy through a literature review.

MATERIALS AND METHODS: A scoping review was conducted in the studies published between July 2021 and June 2022 using the Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) checklist.

RESULTS: Using the search strategy, a total of 130 articles were found, of which five were relevant to the study. The adverse reactions were acquired mostly in males [9 (81.8%)]; the majority of them belong to borderline tuberculoid [4 (36.4%)], and most of them were released from treatment (multi-drug therapy) [7 (63.6%)].

CONCLUSION: Surveillance and management of adverse events following immunization (AEFI) are essential; even minor AEFI should be reported and documented in a line list.

RevDate: 2023-11-29

Zumbro C, Davidson S, Daley WP, et al (2023)

Henoch-Schönlein purpura in the setting of COVID-19 infection: Two pediatrics cases and review of the literature.

Journal of family medicine and primary care, 12(9):1790-1795.

Henoch-Schönlein purpura (HSP) is the most common systemic vasculitis in children, often following a viral infection. Various types of rashes attributed to COVID-19 infection have been described in the literature; however, HSP has rarely been reported. We report two children with HSP associated with acute COVID-19 infection with a review of the available literature. We highlight the clinical presentation, medical management, outcome and age-related difference of reported patients. A limitation of this article is the retrospective nature, limiting full patient history and associated conditions. The findings of this review show that HSP in the setting of COVID-19 is more common in children than adults, with a male predominance, involving various body systems creating a constellation of presentations. Given that HSP can have long-term morbidity from renal disease if untreated, this review may help guide the practitioner's approach to HSP and recognition in the setting of COVID-19 infection.

RevDate: 2023-11-29

Vamshidhar IS, Rani SSS, Kalpana M, et al (2023)

Impact of COVID-19 on thyroid gland functions with reference to Graves' disease: A systematic review.

Journal of family medicine and primary care, 12(9):1784-1789.

Coronavirus disease 2019 (COVID-19) is caused due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Both immediate and long-term adverse effects arise out of this disease's aftermath. It involves various organs, which include endocrine glands, nervous system, musculoskeletal system, and other organs. The long-term outcomes of the SARS-CoV-2 infection are influenced by preexisting comorbidities. Genetic, environmental, and immunological factors contribute to the development of various autoimmune diseases, which include Graves' disease (GD). The growing mystery surrounding this virus is exacerbated by auto-inflammatory diseases, such as pediatric inflammatory multisystemic syndrome (PIMS) or multisystem inflammatory syndrome in children (MIS-C), which raises concerns about the nature of the virus' connection to the autoimmune and auto-inflammatory sequelae. There is a need to understand the underlying mechanisms of developing GD in post-COVID-19 patients. There are limited data regarding the pathogenesis involved in post-COVID-19 GD. Our goal was to understand the various mechanisms involved in post-COVID-19 GD among patients with confirmed COVID-19 infection. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for 2020, a literature search of medical databases (PubMed, Cochrane Central Register of Controlled Trials, and Scopus) from February 2021 to February 2022 was performed by five authors. The keywords used were "Post COVID-19," "Grave's disease," "Cytokine storm," "Autoimmunity," and "Molecular mimicry." This review revealed three underlying mechanisms that resulted in post-COVID GD, which included cytokine storm, molecular mimicry, ACE2 receptor concentration, and cell-mediated immunity. The full spectrum of the effects of COVID-19 needs to be researched.

RevDate: 2023-11-29

Pandya VS, Morsy MSM, Hassan AAA, et al (2023)

Ultraviolet disinfection (UV-D) robots: bridging the gaps in dentistry.

Frontiers in oral health, 4:1270959.

Maintaining a microbe-free environment in healthcare facilities has become increasingly crucial for minimizing virus transmission, especially in the wake of recent epidemics like COVID-19. To meet the urgent need for ongoing sterilization, autonomous ultraviolet disinfection (UV-D) robots have emerged as vital tools. These robots are gaining popularity due to their automated nature, cost advantages, and ability to instantly disinfect rooms and workspaces without relying on human labor. Integrating disinfection robots into medical facilities reduces infection risk, lowers conventional cleaning costs, and instills greater confidence in patient safety. However, UV-D robots should complement rather than replace routine manual cleaning. To optimize the functionality of UV-D robots in medical settings, additional hospital and device design modifications are necessary to address visibility challenges. Achieving seamless integration requires more technical advancements and clinical investigations across various institutions. This mini-review presents an overview of advanced applications that demand disinfection, highlighting their limitations and challenges. Despite their potential, little comprehensive research has been conducted on the sterilizing impact of disinfection robots in the dental industry. By serving as a starting point for future research, this review aims to bridge the gaps in knowledge and identify unresolved issues. Our objective is to provide an extensive guide to UV-D robots, encompassing design requirements, technological breakthroughs, and in-depth use in healthcare and dentistry facilities. Understanding the capabilities and limitations of UV-D robots will aid in harnessing their potential to revolutionize infection control practices in the medical and dental fields.

RevDate: 2023-11-29

Hulscher N, Procter BC, Wynn C, et al (2023)

Clinical Approach to Post-acute Sequelae After COVID-19 Infection and Vaccination.

Cureus, 15(11):e49204.

The spike protein of SARS-CoV-2 has been found to exhibit pathogenic characteristics and be a possible cause of post-acute sequelae after SARS-CoV-2 infection or COVID-19 vaccination. COVID-19 vaccines utilize a modified, stabilized prefusion spike protein that may share similar toxic effects with its viral counterpart. The aim of this study is to investigate possible mechanisms of harm to biological systems from SARS-CoV-2 spike protein and vaccine-encoded spike protein and to propose possible mitigation strategies. We searched PubMed, Google Scholar, and 'grey literature' to find studies that (1) investigated the effects of the spike protein on biological systems, (2) helped differentiate between viral and vaccine-generated spike proteins, and (3) identified possible spike protein detoxification protocols and compounds that had signals of benefit and acceptable safety profiles. We found abundant evidence that SARS-CoV-2 spike protein may cause damage in the cardiovascular, hematological, neurological, respiratory, gastrointestinal, and immunological systems. Viral and vaccine-encoded spike proteins have been shown to play a direct role in cardiovascular and thrombotic injuries from both SARS-CoV-2 and vaccination. Detection of spike protein for at least 6-15 months after vaccination and infection in those with post-acute sequelae indicates spike protein as a possible primary contributing factor to long COVID. We rationalized that these findings give support to the potential benefit of spike protein detoxification protocols in those with long-term post-infection and/or vaccine-induced complications. We propose a base spike detoxification protocol, composed of oral nattokinase, bromelain, and curcumin. This approach holds immense promise as a base of clinical care, upon which additional therapeutic agents are applied with the goal of aiding in the resolution of post-acute sequelae after SARS-CoV-2 infection and COVID-19 vaccination. Large-scale, prospective, randomized, double-blind, placebo-controlled trials are warranted in order to determine the relative risks and benefits of the base spike detoxification protocol.

RevDate: 2023-11-29

Ocanto A, Mielgo-Rubio X, Luna Tirado J, et al (2023)

Coronavirus disease 2019 and lung cancer: where are we?.

Exploration of targeted anti-tumor therapy, 4(5):1082-1094.

Oncology patients are more susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection due to hospital contact and an immunological system that can be compromised by antineoplastic therapy and supportive treatments. Certain similarities have been described in the physiopathology of coronavirus disease 2019 (COVID-19) and lung cancer (LC) that may explain the higher probability of these patients of developing a more serious disease with more frequent hospitalizations and even death, especially with the addition of smoking, cardiovascular and respiratory comorbidities, old age and corticosteroids use. Pre-existing lesions and cancer therapies change the normal architecture of the lungs, so diagnostic scales such as COVID-19 Reporting and Data System (CO-RADS) are of vital importance for a correct diagnosis and patient homogenization, with a high inter-observer correlation. Moreover, anticancer treatments have required an adaptation to reduce the number of visits to the hospital [hypofractionated radiotherapy (RT), larger intervals between chemotherapy cycles, delay in follow-up tests, among others]. In a way, this has also caused a delay in the diagnosis of new cancers. On the other hand, vaccination has had a positive impact on the mortality of these patients, who maintain a similar seroprevalence to the rest of the population, with a similar impact in mortality.

RevDate: 2023-11-29

Sokouti B (2023)

A review on in silico virtual screening methods in COVID-19 using anticancer drugs and other natural/chemical inhibitors.

Exploration of targeted anti-tumor therapy, 4(5):994-1026.

The present coronavirus disease 2019 (COVID-19) pandemic scenario has posed a difficulty for cancer treatment. Even under ideal conditions, malignancies like small cell lung cancer (SCLC) are challenging to treat because of their fast development and early metastases. The treatment of these patients must not be jeopardized, and they must be protected as much as possible from the continuous spread of the COVID-19 infection. Initially identified in December 2019 in Wuhan, China, the contagious coronavirus illness 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Finding inhibitors against the druggable targets of SARS-CoV-2 has been a significant focus of research efforts across the globe. The primary motivation for using molecular modeling tools against SARS-CoV-2 was to identify candidates for use as therapeutic targets from a pharmacological database. In the published study, scientists used a combination of medication repurposing and virtual drug screening methodologies to target many structures of SARS-CoV-2. This virus plays an essential part in the maturation and replication of other viruses. In addition, the total binding free energy and molecular dynamics (MD) modeling findings showed that the dynamics of various medications and substances were stable; some of them have been tested experimentally against SARS-CoV-2. Different virtual screening (VS) methods have been discussed as potential means by which the evaluated medications that show strong binding to the active site might be repurposed for use against SARS-CoV-2.

RevDate: 2023-11-29

Aldzhyan V, Tamamian C, JH Tabibian (2023)

Leveraging telemedicine in gastroenterology and hepatology: a narrative review.

mHealth, 9:36 pii:mh-09-23-27.

BACKGROUND AND OBJECTIVE: Over the years, telemedicine has played a prominent role in delivering healthcare to patients. Due to its flexibility and many benefits, telemedicine confers physicians the ability to guide and promote medical care remotely. The advent of the coronavirus disease 2019 (COVID-19) pandemic has changed the landscape of medicine and has accelerated the usage of digital and remote healthcare systems for clinical care. Herein, we provide an overview of telemedicine, its applications in managing inflammatory bowel disease (IBD), celiac disease (CD), and liver diseases, its advantages and limitations, and its use in educating the next generation of gastroenterologists.

METHODS: We conducted a review of scientific articles published in PubMed and Google Scholar. Articles were selected based on the search terms included in the search strategy summary. The language of the articles was restricted to English only.

KEY CONTENT AND FINDINGS: We report that telemedicine has the potential to streamline and improve patient care in gastroenterology (GI) and hepatology while also limiting health care expenses. Additionally, we noted the importance of tele-education for training the next generation of physicians who intend on practicing in rural settings. Furthermore, we identified barriers to telemedicine care that exacerbate health inequities and potential solutions to achieving digital health equity. Lastly, we briefly discuss the role of artificial intelligence (AI) in remote patient monitoring.

CONCLUSIONS: Although telemedicine has existed for many decades, over the past decade there have been many advancements in telemedicine applications in GI and hepatology. Despite its broad benefits, further research needs to be done to alleviate barriers to telemedicine care.

RevDate: 2023-11-29

Sharma S, Rawal R, D Shah (2023)

Addressing the challenges of AI-based telemedicine: Best practices and lessons learned.

Journal of education and health promotion, 12:338 pii:JEHP-12-338.

Telemedicine is the use of technology to provide healthcare services and information remotely, without requiring physical proximity between patients and healthcare providers. The coronavirus disease 2019 (COVID-19) pandemic has accelerated the rapid growth of telemedicine worldwide. Integrating artificial intelligence (AI) into telemedicine has the potential to enhance and expand its capabilities in addressing various healthcare needs, such as patient monitoring, healthcare information technology (IT), intelligent diagnosis, and assistance. Despite the potential benefits, implementing AI in telemedicine presents challenges that can be overcome with physician-guided implementation. AI can assist physicians in decision-making, improve healthcare delivery, and automate administrative tasks. To ensure optimal effectiveness, AI-powered telemedicine should comply with existing clinical practices and adhere to a framework adaptable to various technologies. It should also consider technical and scientific factors, including trustworthiness, reproducibility, usability, availability, and cost. Education and training are crucial for the appropriate use of new healthcare technologies such as AI-enabled telemedicine. This article examines the benefits and limitations of AI-based telemedicine in various medical domains and underscores the importance of physician-guided implementation, compliance with existing clinical practices, and appropriate education and training for healthcare providers.

RevDate: 2023-11-29

Narasimhan G, A Victor (2023)

Analysis of computational intelligence approaches for predicting disease severity in humans: Challenges and research guidelines.

Journal of education and health promotion, 12:334 pii:JEHP-12-334.

The word disease is a common word and there are many diseases like heart disease, diabetes, breast cancer, COVID-19, and kidney disease that threaten humans. Data-mining methods are proving to be increasingly beneficial in the present day, especially in the field of medical applications; through the use of machine-learning methods, that are used to extract valuable information from healthcare data, which can then be used to predict and treat diseases early, reducing the risk of human life. Machine-learning techniques are useful especially in the field of health care in extracting information from healthcare data. These data are very much helpful in predicting the disease early and treating the patients to reduce the risk of human life. For classification and decision-making, data mining is very much suitable. In this paper, a comprehensive study on several diseases and diverse machine-learning approaches that are functional to predict those diseases and also the different datasets used in prediction and making decisions are discussed in detail. The drawbacks of the models from various research papers have been observed and reveal countless computational intelligence approaches. Naïve Bayes, logistic regression (LR), SVM, and random forest are able to produce the best accuracy. With further optimization algorithms like genetic algorithm, particle swarm optimization, and ant colony optimization combined with machine learning, better performance can be achieved in terms of accuracy, specificity, precision, recall, and specificity.

RevDate: 2023-11-29

Treeza M M, Augustine S, Mathew AA, et al (2023)

Targeting Viral ORF3a Protein: A New Approach to Mitigate COVID-19 Induced Immune Cell Apoptosis and Associated Respiratory Complications.

Advanced pharmaceutical bulletin, 13(4):678-687.

Infection with SARS-CoV-2 is a growing concern to the global well-being of the public at present. Different amino acid mutations alter the biological and epidemiological characteristics, as well as immune resistance of SARS-CoV-2. The virus-induced pulmonary impairment and inflammatory cytokine storm are directly related to its clinical manifestations. But, the fundamental mechanisms of inflammatory responses are found to be the reason for the death of immune cells which render the host immune system failure. Apoptosis of immune cells is one of the most common forms of programmed cell death induced by the virus for its survival and virulence property. ORF3a, a SARS-CoV-2 accessory viral protein, induces apoptosis in host cells and suppress the defense mechanism. This suggests, inhibiting SARS-CoV-2 ORF3a protein is a good therapeutic strategy for the treatment in COVID-19 infection by promoting the host immune defense mechanism.

RevDate: 2023-11-29

Faghihi H, Mottaghi-Dastjerdi N, Sharifzadeh M, et al (2023)

ChAdOx1 nCoV-19 Vaccine and Thrombosis with Thrombocytopenia Syndrome among Adults: A Systematic Review.

Advanced pharmaceutical bulletin, 13(4):723-735.

Several vaccine-induced thrombotic thrombocytopenia syndrome (VITTS) cases have been reported after the ChAdOx1 nCov-19 vaccination. The current study systematically reviewed the reported post-ChAdOx1 nCoV-19 vaccination thrombotic thrombocytopenia cases. Their laboratory and clinical features, as well as the diagnostic and therapeutic measures, were investigated. Online databases were searched until 25 August 2021. Studies reporting post-ChAdOx1 nCov-19 vaccination thrombotic thrombocytopenia syndrome (TTS) were included. Overall, 167 cases (21-77 years old) from 53 publications were included showing a female dominance of 1.75 times. About 85% of the cases exhibited the primary symptoms within the first two weeks post-vaccination. Headache was the most common initial symptom (>44.2%), and hemorrhage/thrombotic problems (22.46%), as well as discoordination/weakness/numbness/ hemiparesis/cyanotic toes (19.6%), were the most prevalent uncommon initial symptoms. Prothrombin time (PT), D-dimers, and C-reactive protein were the most remarkable increased laboratory parameters in 50.6%, 99.1%, and 55.6% of cases, respectively. In comparison, platelet and fibrinogen were the most remarkable decreased laboratory parameters in 92.7% and 50.5% of cases, respectively. Most VITT cases presented with cerebral venous thrombosis/cerebral venous sinus thrombosis, supraventricular tachycardia, transverse sinus/cerebral thrombosis, pulmonary embolism, and cerebral hemorrhage. Anti-PF4 antibody measurement through immunoassays and functional assays were positive in 86.2% and 73% of cases, respectively. About 31% of the cases died. Early diagnosis and proper therapeutic measures are important in ChAdOx1 nCov-19 vaccine-induced VITTS patients. Therefore, experts are recommended to know the corresponding clinical and laboratory features, as well as diagnostic methods. Elucidation of the pathophysiologic mechanism of ChAdOx1 nCov-19 vaccine-induced TTS deserves further investigation.

RevDate: 2023-11-29

Poteko K, Coakley J, M Doupona (2023)

Elite athletes: what lessons for the future can be learned from their responses to the social disruption caused by the COVID-19 pandemic?.

Frontiers in sports and active living, 5:1260797.

In mid-March 2020, the Covid-19 pandemic was declared, disrupting established routines and impacting every aspect of our lives. Sport as a social phenomenon was no exception. On the one hand, with the suspension and postponement of competitions and the various restrictions, the pandemic seemed to stop time, destroying the previously familiar ways of functioning of the sports sector, and forcing it to constantly reinvent, restructure and adapt. On the other hand, the changed situation highlighted the problems and inequalities that sport had faced long before and that the pandemic had mostly exacerbated, but not caused. In this review article, we identify the lessons and insights the pandemic has brought, especially for elite athletes. Because many scientific articles have emerged in connection with the pandemic, we select and review them according to our focus on elite athletes and summarise their findings. We then use those findings to derive guidelines that can serve top athletes as a tool in potentially similar situations in the future. Our proposed guidelines are divided into macro-, meso-, and micro-social levels, encompassing national and international, organizational and individual perspectives.

RevDate: 2023-11-29

Maiese K (2023)

The impact of aging and oxidative stress in metabolic and nervous system disorders: programmed cell death and molecular signal transduction crosstalk.

Frontiers in immunology, 14:1273570.

Life expectancy is increasing throughout the world and coincides with a rise in non-communicable diseases (NCDs), especially for metabolic disease that includes diabetes mellitus (DM) and neurodegenerative disorders. The debilitating effects of metabolic disorders influence the entire body and significantly affect the nervous system impacting greater than one billion people with disability in the peripheral nervous system as well as with cognitive loss, now the seventh leading cause of death worldwide. Metabolic disorders, such as DM, and neurologic disease remain a significant challenge for the treatment and care of individuals since present therapies may limit symptoms but do not halt overall disease progression. These clinical challenges to address the interplay between metabolic and neurodegenerative disorders warrant innovative strategies that can focus upon the underlying mechanisms of aging-related disorders, oxidative stress, cell senescence, and cell death. Programmed cell death pathways that involve autophagy, apoptosis, ferroptosis, and pyroptosis can play a critical role in metabolic and neurodegenerative disorders and oversee processes that include insulin resistance, β-cell function, mitochondrial integrity, reactive oxygen species release, and inflammatory cell activation. The silent mating type information regulation 2 homolog 1 (Saccharomyces cerevisiae) (SIRT1), AMP activated protein kinase (AMPK), and Wnt1 inducible signaling pathway protein 1 (WISP1) are novel targets that can oversee programmed cell death pathways tied to β-nicotinamide adenine dinucleotide (NAD[+]), nicotinamide, apolipoprotein E (APOE), severe acute respiratory syndrome (SARS-CoV-2) exposure with coronavirus disease 2019 (COVID-19), and trophic factors, such as erythropoietin (EPO). The pathways of programmed cell death, SIRT1, AMPK, and WISP1 offer exciting prospects for maintaining metabolic homeostasis and nervous system function that can be compromised during aging-related disorders and lead to cognitive impairment, but these pathways have dual roles in determining the ultimate fate of cells and organ systems that warrant thoughtful insight into complex autofeedback mechanisms.

RevDate: 2023-11-29

Murished GM, Dandachi I, W Aljabr (2023)

Side effects of COVID-19 vaccines in the middle eastern population.

Frontiers in immunology, 14:1270187.

The COVID-19 pandemic has caused severe worldwide health concerns since its first description as the SARS-COV-2 virus in December 2019. The wide dissemination of this virus, together with the lack of treatment, prompted vaccine development within a short period of time to elicit a protective immunity against COVID-19. Due to their rapid development, potential subsequent side effects of COVID-19 vaccines were overlooked, which might lead to many health concerns. This is especially true for patients at a greater risk of harm from COVID-19, such as pregnant women, children, and patients with pre-existing chronic diseases. In this review, we provide a summary of common to rare side effects of administrated COVID-19 vaccines in a Middle Eastern population. We have found that the distinction between side effects from COVID-19 vaccines in terms of frequency and severity is attributed to the differences in study populations, gender, and age. Pain at the injection site, fever, headache, fatigue, and muscle pain were the most common reported side effects. Vaccinated subjects with previous COVID-19 infection exhibited an equivalent neutralizing response after just one dose compared to two doses of vaccine. Consequently, individuals who experienced more side effects had significantly higher antibody levels. This indicates that having better immunity correlates with higher antibody levels, leading to a higher frequency of vaccine side effects. Individuals with underlying comorbidities, particularly having known allergies and with illnesses such as diabetes and cancer, might be more prone to post-vaccination side effects. Studies of a high-risk population in Middle Eastern countries are limited. Future studies should be considered to determine long-term side effects, side effects after booster doses, and side effect differences in cases of heterologous and homologous vaccination for better understanding and proper handling of high-risk populations and patients who experience these side effects.

RevDate: 2023-11-29

Sivaprakasam DR, Ohiri HO, Asif MS, et al (2023)

COVID-19 Vaccination and Its Relation to New-Onset Diabetes: A Narrative Review.

Cureus, 15(10):e47056.

The COVID-19 vaccination has been effective in preventing a lot of complications caused by SARS-CoV-2 and its variants. Meanwhile, diabetes mellitus, one of the root causes of many co-morbidities, exhibited itself during the COVID-19 pandemic and after COVID-19 vaccination. Diabetes mellitus introduced itself in a new perspective, leading to a variety of presentations and causing a significant number of emergency admissions. Many of the pre-diabetes patients with no prior history of diabetes developed fulminant type 1 diabetes mellitus (T1DM) after the COVID-19 vaccination. Some cases of conversion of type 2 diabetes mellitus (T2DM) into T1DM were reported. Some prediabetes/diabetes patients presented with the development of diabetic ketoacidosis after COVID-19 vaccination, whereas some previously healthy people with no relation to diabetes also developed acute exacerbations of new-onset T1DM or T2DM along with lethal ketoacidosis. The purpose of writing this review was to explore what kind of people are more prone to develop new-onset diabetes or diabetic complications, including diabetic ketoacidosis, the typical presentation of these patients, possible mechanisms that lead to these complications occurring after the COVID-19 vaccination, how they can be managed, and whether there is a good prognosis after management or not.

RevDate: 2023-11-29

Gupta PP, Bankar NJ, Mishra VH, et al (2023)

The Efficient Disposal of Biomedical Waste Is Critical to Public Health: Insights from the Central Pollution Control Board Guidelines in India.

Cureus, 15(10):e47303.

Biomedical waste (BMW), encompassing hazardous medical materials, poses environmental and public health risks if not correctly managed. The Central Pollution Control Board (CPCB) in India is a statutory organization that oversees BMW disposal standards, aimed at mitigating these hazards. BMW mismanagement is a major problem and potentially poses threats to the environment as well as public health. During the coronavirus disease 2019 (COVID-19) pandemic, increased use of personal protective equipment (PPE) and other medical equipment was witnessed which led to a marked raised BMW generation. To ensure proper and optimized BMW management, CPCB established guidelines and rules to be followed by the medical facilities as well as the common BMW treatment facilities (CBWTFs). The challenges in implementing proper waste management practices were lack of awareness and inadequate infrastructure. Strategies for better BMW management were proposed, including color-coded bins, improved infrastructure, advanced technology, and awareness campaigns. Highlighting CPCB's vital role, this emphasizes healthcare facilities' proactive role in implementing and evolving regulations for sustainable BMW disposal, ensuring both public health and environmental well-being through compliance and responsible waste management partnerships.

RevDate: 2023-11-29

Wali R (2023)

Integration of Telehealth in Routine Perinatal Care: A Model of Care for Primary Healthcare Clinics in Saudi Arabia.

Cureus, 15(10):e47295.

This study aims to introduce a new model of antenatal/postnatal care that integrates virtual clinics with the current model of care, including a discussion on the current model, pre-existing barriers, and prenatal framework, and the need for transition to telehealth beyond the pandemic. In antenatal primary health care centers, such as King Abdulaziz Medical City (KAMC), low-risk antenatal/postnatal care receives clinical care through complete physical attendance in antenatal/postnatal clinics in primary care clinics for pregnancy follow-up and in tertiary hospitals for fetal ultrasound and invasive procedures if needed. Pregnancy is confirmed through a regular family medicine (FM) clinic where risk assessment through history, physical examination, and investigations are carried out. If the pregnant woman is at low risk, she will be started on folic acid, 1 mg or 5 mg based on the risk assessment (if it was not received before). Pregnant women will be given a telehealth appointment for the lab results. Concomitantly, the pregnant women will receive an appointment in the antenatal clinics, which board-certified family physicians run. High-risk patients will be referred to the hospital for further care. Current postnatal care is delivered through regular booking with the FM clinic through physical attendance sometimes, and virtual care is provided upon physican/patient request. Current care meets the past quality care and patient expectations. However, with the current Saudi Vision 2030 and after the experience with virtual care during the COVID-19 pandemic, the current services need to move a step forward to meet the rapidly developing medical care/needs in Saudi Arabia. Various challenges must be addressed, and new models must be included in clinical care for pregnant and postnatal women. Introducing virtual antenatal/postnatal care to the current care could be a new era in maternity primary health care; this model will move the clinical care provided to pregnant/postnatal women a step forward that meets the excellence of high-quality, evidence-based medical care.

RevDate: 2023-11-29

Jordan HR, Sahni S, Ahmed MM, et al (2023)

A Comprehensive Literature Review of Digital Health Interventions in the Treatment of Substance Use Disorder With Special Focus on Mobile Applications.

Cureus, 15(10):e47639.

COVID-19 quarantine showed an increase in opioid-related deaths partially due to the limited capacity of clinics and treatment centers. Digital health interventions (DHIs) such as telehealth have improved access to treatment, reduced psychosocial barriers, and helped patients with substance use disorder (SUD). An in-depth literature review was conducted to gauge the efficacy and usefulness of DHIs on substance use disorder. PubMed was used with string search terms to identify studies analyzing telehealth for substance use disorders. Studies were eligible and selected if they used health interventions (HIs) and reported outcomes on the efficacy of DHIs, benefits of DHIs, and limitations of DHIs. The Agency of Healthcare Research and Quality (AHRQ) was used to analyze the impact of DHIs on SUD. Lastly, Apple's App Store was used to identify the current DHI available. The analysis indicated that mobile phone apps were the most appropriate sources to use for patients with substance use disorders. The search also found 36 mobile applications available on the market for patients, containing mainly pain medication diaries and trackers. The study did not find any apps for clinical usage that met the standards necessary for adequate healthcare in the opioid crisis, largely due to a lack of clinician involvement in using applications. Developing adequate DHIs has the potential to improve outcomes in patients with SUD and aid in recovery time. The research concluded that physicians looking to develop DHIs should take into consideration the mode of delivery of DHI, the aim to produce specific health outcomes as opposed to multiple outcomes, and clinician involvement in DHI development. DHIs can become a vital tool for medical professionals, especially during the COVID-19 crisis, as the use of healthcare technology has limited in-person contact, maintained current doctor-patient relationships, and allowed for contact tracing of the disease.

RevDate: 2023-11-29

Antony MA, Patel S, Verma V, et al (2023)

The Role of Gut Microbiome Supplementation in COVID-19 Management.

Cureus, 15(10):e46960.

COVID-19, which is caused by the RNA virus, SARS-CoV-2, mainly affects the respiratory system and has a varied clinical presentation. However, several studies have shown that COVID-19 can also affect the gastrointestinal (GI) system. Patients can experience various GI symptoms, such as vomiting and diarrhea, and the virus has been detected in the stool samples of patients hospitalized with COVID-19. There have also been rare reports of COVID-19 presenting with isolated GI symptoms and lack of respiratory symptoms, and the virus has also been detected for prolonged periods in the fecal samples of COVID-19 patients. Major alterations in the gut microbiome in the form of depletion of beneficial organisms and an abundance of pathogenic organisms have been reported in the fecal samples of hospitalized COVID-19 patients. Although the US FDA has approved several drugs to manage COVID-19, their efficacy remains modest. So, there is a constant ongoing effort to investigate novel treatment options for COVID-19. Health supplements like probiotics, prebiotics, postbiotics, and synbiotics have been popularly known for their various health benefits. In this review, we have summarized the current literature, which shows the potential benefit of these health supplements to mitigate and/or prevent the clinical presentation of COVID-19.

RevDate: 2023-11-29

Potestio L, Megna M, Villani A, et al (2023)

Herpes Zoster and COVID-19 Vaccination: A Narrative Review.

Clinical, cosmetic and investigational dermatology, 16:3323-3331 pii:441898.

COVID-19 was a worldwide emergency, leading to a global health crisis, which completely revolutionized every aspect of human life. Several strategies were adopted to limit the spreading of the infection such as testing and contact tracing, quarantine and isolation, use of face mask, social distancing, lockdowns, travel restrictions, etc. Of these, vaccines were the most important measures to reduce the transmission of the virus and the severity of the infection, in order to overcome the pandemic. Fortunately, vaccination campaign was a success, showing to be efficient in controlling and preventing the COVID-19, reducing the risk of disease progression, hospitalization, and mortality. Monitoring and addressing vaccine-related adverse events have been essential for maintaining public confidence. Indeed, with the increasing number of vaccines administered, various cutaneous reactions have been reported, making dermatologists key players in their recognition and treatment. Particularly, several cutaneous diseases and cutaneous findings have been reported. Of note, also viral reactivations have been described following COVID-19 vaccination. Among these, varicella zoster virus (VZV) reactivation has been collected. Globally, an early diagnosis and an accurate treatment of herpes zoster (HZ) is mandatory to reduce possible complications. In this context, we conducted a review of the current literature investigating cases HZ following COVID-19 vaccination with the aim of understanding the possible causal correlation and underlying pathogenetic mechanisms to offer clinicians a wide perspective on VZV reactivation and COVID-19 vaccines.

RevDate: 2023-11-29

Skidmore KL, Rajabi A, Nguyen A, et al (2023)

Veno-venous Extracorporeal Membrane Oxygenation: Anesthetic Considerations in Clinical Practice.

Anesthesiology and pain medicine, 13(3):e136524.

CONTEXT: After the COVID-19 pandemic, multiple reviews have documented the success of veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Patients who experience hypoxemia but have normal contractility may be switched to veno-venous-ECMO (VV-ECMO).

PURPOSE: In this review, we present three protocols for anesthesiologists. Firstly, transesophageal echocardiography (TEE) aids in cannulation and weaning off inotropes and fluids. Our main objective is to assist in patient selection for the Avalon Elite single catheter, which is inserted into the right internal jugular vein and terminates in the right atrium. Secondly, we propose appropriate anticoagulant doses. We outline day-to-day monitoring protocols to prevent heparin-induced thrombocytopenia (HIT) or resistance. Once the effects of neuromuscular paralysis subside, sedation should be reduced. Therefore, we describe techniques that may prevent delirium from progressing into permanent cognitive decline.

METHODS: We conducted a PubMed search using the keywords VV-ECMO, TEE, Avalon Elite (Maquet, Germany), and quetiapine. We combined these findings with interviews conducted with nurses and anesthesiologists from two academic ECMO centers, focusing on anticoagulation and sedation.

RESULTS: Our qualitative evidence synthesis reveals how TEE confirms cannulation while avoiding right atrial rupture or low flows. Additionally, we discovered that typically, after initial heparinization, activated partial thromboplastin time (PTT) is drawn every 1 to 2 hours or every 6 to 8 hours once stable. Daily thromboelastograms, along with platelet counts and antithrombin III levels, may detect HIT or resistance, respectively. These side effects can be prevented by discontinuing heparin on day two and initiating argatroban at a dose of 1 μg/kg/min while maintaining PTT between 61 - 80 seconds. The argatroban dose is adjusted by 10 - 20% if PTT is between 40 - 60 or 80 - 90 seconds. Perfusionists assist in establishing protocols following manufacturer guidelines. Lastly, we describe the replacement of narcotics and benzodiazepines with dexmedetomidine at a dose of 0.5 to 1 μg/kg/hour, limited by bradycardia, and the use of quetiapine starting at 25 mg per day and gradually increasing up to 200 mg twice a day, limited by prolonged QT interval.

CONCLUSIONS: The limitation of this review is that it necessarily covers a broad range of ECMO decisions faced by an anesthesiologist. However, its main advantage lies in the identification of straightforward argatroban protocols through interviews, as well as the discovery, via PubMed, of the usefulness of TEE in determining cannula position and contractility estimates for transitioning from VA-ECMO to VV-ECMO. Additionally, we emphasize the benefits in terms of morbidity and mortality of a seldom-discussed sedation supplement, quetiapine, to dexmedetomidine.

RevDate: 2023-11-29

Mbim EN, Edet UO, Okoroiwu HU, et al (2022)

Arbovirus and its potential to lead the next global pandemic from sub-Saharan Africa: What lessons have we learned from COVID-19?.

Germs, 12(4):538-547 pii:germs.2022.1358.

Risk and predisposing factors for viral zoonoses abound in the sub-Saharan Africa (SSA) region with significant public health implications. For several decades, there have been several reports on the emergence and re-emergence of arbovirus infections. The lifetime burden of arboviral diseases in developing countries is still poorly understood. Studies indicate significant healthcare disruptions and economic losses attributed to the viruses in resource-poor communities marked by impairment in the performance of daily activities. Arboviruses have reportedly evolved survival strategies to aid their proliferation in favorable niches, further magnifying their public health relevance. However, there is poor knowledge about the viruses in the region. Thus, this review presents a survey of zoonotic arboviruses in SSA, the burden associated with their diseases, management of diseases as well as their prevention and control, mobility and determinants of infections, their vectors, and co-infection with various microorganisms. Lessons learned from the ongoing coronavirus disease 2019 (COVID-19) pandemic coupled with routine surveillance of zoonotic hosts for these viruses will improve our understanding of their evolution, their potential to cause a pandemic, control and prevention measures, and vaccine development.

RevDate: 2023-11-29

Goko C, Forster E, Mason M, et al (2023)

Effectiveness of fit testing versus fit checking for healthcare workers respiratory protective equipment: A systematic review.

International journal of nursing sciences, 10(4):568-578 pii:S2352-0132(23)00104-7.

OBJECTIVES: Respiratory protection is critical in healthcare to minimise the risk of airborne infections for healthcare workers (HCWs). It emphasizes the use of proper fitting of particulate filter respirators and equivalent respiratory protective equipment (RPE) to ensure a good facial seal. The systematic review aimed to compare the effectiveness of fit testing and fit checking for HCWs' respiratory protective equipment.

METHODS: A systematic review of the literature exploring RPE for HCWs to determine the effectiveness of fit-testing versus fit-checking from January 2003 to April 2022 was identified using CINAHL Complete via EBSCO Host, Cochrane Library, EMBASE, PubMed, and MEDLINE via Ovid electronic databases, and grey literature. The study protocol was registered with PROSPERO (registration number: CRD42020213968).

RESULTS: Of the 561 articles identified in the search, 25 articles (22 quantitative studies and three guidelines) were included in this review. Overall, these studies suggest fit-testing as a method that is more effective, widely adopted, and reliable in assessing the effectiveness of RPE; however, a respiratory program should include both fit-testing and fit-checking to maximise effectiveness of the RPE. The COVID-19 epidemic highlighted a lack of knowledge among HCWs regarding fit-checking and fit-testing, and relevant education increased the effectiveness of respiratory equipment protection.

CONCLUSION: It is imperative that both fit-testing and fit-checking is implemented in order to ensure HCW safety. It is recommended to integrate education, fit-testing and fit-checking into a comprehensive respiratory protective program run by trained fit-testers. There is also a need for practical testing methods that incorporate the clinical environment.

RevDate: 2023-11-29

SeyedAlinaghi S, Afsahi AM, Shahidi R, et al (2023)

Social stigma during COVID-19: A systematic review.

SAGE open medicine, 11:20503121231208273 pii:10.1177_20503121231208273.

OBJECTIVES: Stigmatization was reported throughout the COVID pandemic for COVID-19 patients and close contacts. The aim of this systematic review was to comprehensively examine the prevalence and impact of stigmatization during COVID-19 pandemic.

METHODS: English articles were searched using online databases that included PubMed, Scopus, Embase, and Web of Science up to 24 August 2022. A two-step screening and selection process was followed utilizing an inclusion and exclusion criteria and then data was extracted from eligible articles. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist was followed, and the risk of bias was assessed using the Newcastle-Ottawa Scale.

RESULTS: Seventy-six studies were eligible for inclusion. Twenty-two studies reported the prevalence of social stigma due to COVID-19 infection with social isolation being the most commonly reported stigma. There were 20 studies that reported the majority of participants experienced stigma due to COVID-19 infection, which was as high as 100% of participants in two studies. Participants in 16 studies reported blaming from others as the second most common type of stigma, with various other types reported such as psychological pressure, verbal violence, avoidance, and labeling. The most common effect of the stigma was anxiety followed by depression, and then reduction of socialization.

CONCLUSION: Findings from the present review have identified that COVID-19-related stigma studies have generally focused on its prevalence, type, and outcome. Greater awareness of this topic may assist with improving public education during pandemics such as COVID-19 as well as access to support services for individuals impacted by stigmatization.

RevDate: 2023-11-29

Wu J, Yang H, Yu D, et al (2023)

Blood-derived product therapies for SARS-CoV-2 infection and long COVID.

MedComm, 4(6):e426 pii:MCO2426.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is capable of large-scale transmission and has caused the coronavirus disease 2019 (COVID-19) pandemic. Patients with COVID-19 may experience persistent long-term health issues, known as long COVID. Both acute SARS-CoV-2 infection and long COVID have resulted in persistent negative impacts on global public health. The effective application and development of blood-derived products are important strategies to combat the serious damage caused by COVID-19. Since the emergence of COVID-19, various blood-derived products that target or do not target SARS-CoV-2 have been investigated for therapeutic applications. SARS-CoV-2-targeting blood-derived products, including COVID-19 convalescent plasma, COVID-19 hyperimmune globulin, and recombinant anti-SARS-CoV-2 neutralizing immunoglobulin G, are virus-targeting and can provide immediate control of viral infection in the short term. Non-SARS-CoV-2-targeting blood-derived products, including intravenous immunoglobulin and human serum albumin exhibit anti-inflammatory, immunomodulatory, antioxidant, and anticoagulatory properties. Rational use of these products can be beneficial to patients with SARS-CoV-2 infection or long COVID. With evidence accumulated since the pandemic began, we here summarize the progress of blood-derived product therapies for COVID-19, discuss the effective methods and scenarios regarding these therapies, and provide guidance and suggestions for clinical treatment.

RevDate: 2023-11-29

Zhang S, Wang Y, Mao D, et al (2023)

Current trends of clinical trials involving CRISPR/Cas systems.

Frontiers in medicine, 10:1292452.

The CRISPR/Cas9 system is a powerful genome editing tool that has made enormous impacts on next-generation molecular diagnostics and therapeutics, especially for genetic disorders that traditional therapies cannot cure. Currently, CRISPR-based gene editing is widely applied in basic, preclinical, and clinical studies. In this review, we attempt to identify trends in clinical studies involving CRISPR techniques to gain insights into the improvement and contribution of CRISPR/Cas technologies compared to traditional modified modalities. The review of clinical trials is focused on the applications of the CRISPR/Cas systems in the treatment of cancer, hematological, endocrine, and immune system diseases, as well as in diagnostics. The scientific basis underlined is analyzed. In addition, the challenges of CRISPR application in disease therapies and recent advances that expand and improve CRISPR applications in precision medicine are discussed.

RevDate: 2023-11-29

Ghoreishi Amin N, Khosravi S, Atefi N, et al (2023)

A systematic review and meta-analysis of investigating the mutual impact of COVID-19 and psoriasis: Focusing on COVID-19 course in psoriasis and the opinion on biologics in this setting.

Immunity, inflammation and disease, 11(11):e1063.

INTRODUCTION: This systematic review and meta-analysis aims to investigate the mutual impact of COVID-19 and psoriasis to inform clinical practice and future research.

METHODS: We followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis protocol for systematic reviews and searched PubMed, Web of Science, Scopus, and Google Scholar until May 1, 2022. Eligibility criteria included full-text articles in English reporting COVID-19 treatment outcomes in psoriasis patients. Studies on animals, letters to editors, non-English studies, and studies with no access to full articles were excluded. Search results were screened and data were extracted by two groups of reviewers with any discrepancies resolved by the senior author. The risk of bias was assessed using ROBINS-I for nonrandomized studies. The hospitalization rate, Intensive Care Unit (ICU) admission rate, case fatality rate, odds ratios of COVID-19 infection and hospitalization rate in psoriasis patients were extracted and analyzed using random effects analysis to calculate pooled prevalence and odds ratios, as well as to explore heterogeneity.

RESULTS: We found 1980 records from four databases and included 20 studies after screening and removing duplicates. These studies evaluated 185,000 psoriasis patients and included eight retrospective cohort studies, one case-control study, three cross-sectional studies, and eight case series studies. The impact of the COVID-19 pandemic on psoriasis treatment and the outcome of COVID-19 infection in psoriasis patients receiving different forms of treatment were evaluated. The pooled data from included studies showed that the incidence rate of COVID-19 infection among psoriasis patients was 0.03% (confidence interval [CI]: 0.01-0.06), with a pooled odds ratio of 1.97 (CI: 0.69-5.60) compared to the general population. The hospitalization rate, ICU admission rate, and case fatality rate for psoriasis patients with COVID-19 were 0.17 (CI: 0.10-0.31), 0.06 (CI: 0.06-0.46), and 0.02 (CI: 0.01-0.04), respectively. Additionally, psoriasis patients receiving systemic nonbiologic therapy had a pooled odds ratio of 2.32 (CI: 1.18-4.57) for hospitalization compared to those using biologic agents.

CONCLUSION: Studies have shown that biologic therapy for psoriasis did not increase the risk of hospitalization due to COVID-19 infection and may have even offered some protection. Treatment adherence was higher in psoriasis patients receiving biologic therapies than those receiving conventional therapies. These findings suggest that psoriasis treatment did not negatively impact COVID-19 infection and that treatment could be continued on a case-by-case basis during the pandemic.

RevDate: 2023-11-29

Al-Kuraishy HM, Al-Maiahy TJ, Al-Gareeb AI, et al (2023)

New insights on the potential effect of progesterone in Covid-19: Anti-inflammatory and immunosuppressive effects.

Immunity, inflammation and disease, 11(11):e1100.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a pandemic disease caused by severe acute respiratory syndrome CoV type 2 (SARS-CoV-2). COVID-19 is higher in men than women and sex hormones have immune-modulator effects during different viral infections, including SARS-CoV-2 infection. One of the essential sex hormones is progesterone (P4).

AIMS: This review aimed to reveal the association between P4 and Covid-19.

RESULTS AND DISCUSSION: The possible role of P4 in COVID-19 could be beneficial through the modulation of inflammatory signaling pathways, induction of the release of anti-inflammatory cytokines, and inhibition release of pro-inflammatory cytokines. P4 stimulates skew of naïve T cells from inflammatory Th1 toward anti-inflammatory Th2 with activation release of anti-inflammatory cytokines, and activation of regulatory T cells (Treg) with decreased interferon-gamma production that increased during SARS-CoV-2 infection. In addition, P4 is regarded as a potent antagonist of mineralocorticoid receptor (MR), it could reduce MRs that were activated by stimulated aldosterone from high AngII during SARS-CoV-2. P4 active metabolite allopregnanolone is regarded as a neurosteroid that acts as a positive modulator of γ-aminobutyric acid (GABAA) so it may reduce neuropsychiatric manifestations and dysautonomia in COVID-19 patients.

CONCLUSION: Taken together, the anti-inflammatory and immunomodulatory properties of P4 may improve central and peripheral complications in COVID-19.

RevDate: 2023-11-29

Sati H, Alzraikat N, Milan M, et al (2023)

Skin manifestations in children with MIS-C and COVID-19: a narrative review.

International journal of dermatology [Epub ahead of print].

This review aims to highlight the diverse skin manifestations in children and adolescents with COVID induced multisystem inflammatory syndrome in children (MIS-C). The symptoms of COVID-19 can vary greatly in severity between different age groups. Although most children infected with SARS-CoV-2 experience either no symptoms or only mild symptoms, some reported cases of severely affected children with a clinical presentation similar to incomplete Kawasaki disease have led to the definition of a new condition called MIS-C. MIS-C can involve multiple organs, including the skin, and may pose a life-threatening risk to affected children. Such cases highlight the need for continuous research into the possible skin manifestations associated with COVID-19 in pediatric populations to aid in early diagnosis and prompt treatment. We conducted a search of PubMed, Scopus, and ScienceDirect databases for studies published up until October 1, 2022. Three reviewers independently examined each study, and a fourth reviewer resolved any disagreements. A narrative review of all relevant papers was conducted. We present an overview of the clinical presentation, pathophysiology, diagnosis, and treatment of the various skin manifestations in children and adolescents with COVID-19 or MIS-C. The skin manifestations of COVID-19 and MIS-C can be diverse and are frequently overlooked. It is important to conduct further research to better understand the impact of this disease on children to provide appropriate care for these at-risk populations.

RevDate: 2023-11-29

Boccatonda A, Campello E, Simion C, et al (2023)

Long-term hypercoagulability, endotheliopathy and inflammation following acute SARS-CoV-2 infection.

Expert review of hematology [Epub ahead of print].

INTRODUCTION: both symptomatic and asymptomatic SARS-CoV-2 infections - coined Coronavirus disease 2019 (COVID-19) - have been linked to a higher risk of cardiovascular events after recovery.

AREAS COVERED: our review aims to summarize the latest evidence on the increased thrombotic and cardiovascular risk in recovered COVID-19 patients and to examine the pathophysiological mechanisms underlying the interplay among endothelial dysfunction, inflammatory response and coagulation in long-COVID. We performed a systematic search of studies on hypercoagulability, endothelial dysfunction and inflammation after SARS-CoV-2 infection.

EXPERT OPINION: endothelial dysfunction is a major pathophysiological mechanism responsible for most clinical manifestations in COVID-19. The pathological activation of endothelial cells by a virus infection results in a pro-adhesive and chemokine-secreting phenotype, which in turn promotes the recruitment of circulating leukocytes. Cardiovascular events after COVID-19 appear to be related to persistent immune dysregulation. Patients with long-lasting symptoms display higher amounts of proinflammatory molecules such as tumor necrosis factor-α, interferon γ and interleukins 2 and 6. Immune dysregulation can trigger the activation of the coagulation pathway. The formation of extensive microclots in vivo, both during acute COVID-19 and in long-COVID-19, appears to be a relevant mechanism responsible for persistent symptoms and cardiovascular events.

RevDate: 2023-11-29

Wang Y, Chen D, Pan Y, et al (2023)

Serological response and immune-related adverse events following COVID-19 vaccination in cancer patients treated with immune checkpoint inhibitors: A systematic review and meta-analysis.

Reviews in medical virology [Epub ahead of print].

With the popularity of Coronavirus disease 2019 (COVID-19) vaccine and the development of vaccination strategies, the impact of COVID-19 vaccine on cancer patients receiving immune checkpoint inhibitors (ICIs) is still unclear. In the systematic review and meta-analysis of patients with ICIs, we assessed the serological response of cancer patients receiving COVID-19 vaccine, and explored the risk of immune related adverse events (irAEs). We searched PubMed, EMBASE and Cochrane Library as of 10 June 2023, and included cancer patients who received ICIs and COVID-19 vaccine. The systematic review and meta-analysis include cohort study, cross-sectional study and case report. The outcome included the serological response, Spike-specific T-cell response, irAEs and rare adverse events. When possible, the data were analysed by random effect analysis, and the statistical heterogeneity was assessed by Q-test and I[2] statistics. We explored the sources of heterogeneity through L'Abbe plots, Galbraith radial plots, and sensitivity analysis. The publication bias was evaluated by Egger's, Begg's linear regression test and funnel plot, and the impact of publication bias was further analysed by trim and fill method. 27 studies were eligible (19 cohort studies, 1 cross-sectional study and 7 case reports), involving 8331 patients (with 4724 receiving ICIs). Most studies used mRNA vaccine (BNT162b2 or mRNA-1273). Compared with cancer patients receiving chemotherapy, cancer patients receiving ICIs were significantly more likely to have seroconversion (RR = 1.05, 95%CI 1.01-1.10, P = 0.02). There were no statistically significant differences in seroconversion rates when comparing cancer patients receiving ICIs with controls without cancer (RR = 0.95, 95% CI 0.89-1.01, P = 0.09) or with cancer patients receiving targeted therapy (RR = 1.05, 95% CI 0.79-1.39, P = 0.75). The incidence of irAEs in patients receiving ICIs before and after COVID-19 vaccination was (21.96%, 95%CI 16.66%-28.94%) and (14.88%, 95%CI 8.65%-25.57%), respectively. The most common irAEs were endocrine abnormalities, skin disorders, etc. The certainty of evidence was low in cancer patients with ICIs, compared with those receiving chemotherapy, and very low versus controls without cancer. Cancer patients treated with ICIs seem to be able to receive COVID-19 vaccine safely without increasing the incidence of irAEs.

RevDate: 2023-11-29

Guo B, Zhao C, He MZ, et al (2023)

Identifying patterns of reported findings on long-term cardiac complications of COVID-19: a systematic review and meta-analysis.

BMC medicine, 21(1):468.

INTRODUCTION: Prior reviews synthesized findings of studies on long-term cardiac complications of COVID-19. However, the reporting and methodological quality of these studies has not been systematically evaluated. Here, we conducted a systematic review and meta-analysis on long-term cardiac complications of COVID-19 and examined patterns of reported findings by study quality and characteristics.

METHODS: We searched for studies examining long-term cardiac complications of COVID-19 that persisted for 4 weeks and over. A customized Newcastle-Ottawa scale (NOS) was used to evaluate the quality of included studies. Meta-analysis was performed to generate prevalence estimates of long-term cardiac complications across studies. Stratified analyses were further conducted to examine the prevalence of each complication by study quality and characteristics. The GRADE approach was used to determine the level of evidence for complications included in the meta-analysis.

RESULTS: A total number of 150 studies describing 57 long-term cardiac complications were included in this review, and 137 studies reporting 17 complications were included in the meta-analysis. Only 25.3% (n = 38) of studies were of high quality based on the NOS quality assessment. Chest pain and arrhythmia were the most widely examined long-term complications. When disregarding study quality and characteristics, summary prevalence estimates for chest and arrhythmia were 9.79% (95% CI 7.24-13.11) and 8.22% (95% CI 6.46-10.40), respectively. However, stratified analyses showed that studies with low-quality scores, small sample sizes, unsystematic sampling methods, and cross-sectional design were more likely to report a higher prevalence of complications. For example, the prevalence of chest pain was 22.17% (95% CI 14.40-32.55), 11.08% (95% CI 8.65-14.09), and 3.89% (95% CI 2.49-6.03) in studies of low, medium, and high quality, respectively. Similar patterns were observed for arrhythmia and other less examined long-term cardiac complications.

CONCLUSION: There is a wide spectrum of long-term cardiac complications of COVID-19. Reported findings from previous studies are strongly related to study quality, sample sizes, sampling methods, and designs, underscoring the need for high-quality epidemiologic studies to characterize these complications and understand their etiology.

RevDate: 2023-11-28

Miscia ME, Lauriti G, Di Renzo D, et al (2023)

Management and outcomes of acute appendicitis in children during the COVID-19 pandemic: a systematic review and meta-analysis.

Pediatric surgery international, 40(1):11.

The COVID-19 pandemic has changed the way to manage the emergencies, as people faced fear of the hospitals, with possible delay in the diagnosis. Moreover, clinicians had to rearrange protocols for diagnosis and treatment. We aimed to assess whether COVID-19 pandemic influenced severity of inflammation, management, and outcomes of acute appendicitis (AA), when compared to the pre-COVID era. Using defined search strategy, two independent investigators identified those studies comparing pediatric AA during COVID-19 pandemic versus the pre-COVID-19 period. Meta-analysis was performed using RevMan 5.3. Data are mean ± SD. Of 528 abstracts, 36 comparative studies were included (32,704pts). Time from symptoms onset to surgery was longer during the pandemics compared to the pre-COVID-19 (1.6 ± 0.9 versus 1.4 ± 0.9 days; p < 0.00001). Minimally Invasive Surgery was similar during COVID-19 (70.4 ± 30.2%) versus control period (69.6 ± 25.3%; p = ns). Complicated appendicitis was increased during the pandemics (35.9 ± 14.8%) compared to control period (33.4 ± 17.2%; p < 0.0001). Post-operative complications were comparable between these two groups (7.7 ± 6.5% versus 9.1 ± 5.3%; p = ns). It seems that the COVID-19 pandemic influenced the time of diagnosis, severity of inflammation, and type of surgery. However, the number of post-operative complications was not different between the two groups, leading to the conclusion that the patients were correctly managed. LEVEL OF EVIDENCE: Level 3 Meta-analysis on Level 3 studies.

RevDate: 2023-11-28

Boardman E, Boffito M, Chadwick DR, et al (2023)

Tackling late HIV diagnosis: Lessons from the UK in the COVID-19 era.

International journal of STD & AIDS [Epub ahead of print].

INTRODUCTION: Late diagnosis of HIV is associated with increased morbidity and mortality, and an increased risk of non-infectious comorbidities. On a societal level, late diagnosis leads to higher treatment and healthcare costs and is a major driver of HIV transmission. Despite improvements in other areas of the HIV care pathway, late diagnosis remains an individual and public health concern globally.

OBJECTIVE: To examine the barriers to HIV testing and highlight successful strategies to improve prompt diagnosis. This review describes the prevalence of late diagnosis in the UK and discusses key factors that contribute to late diagnosis, including the effect of the COVID-19 pandemic. Late HIV diagnosis is lower in the UK than in most other European countries. In this review, pilot projects and ongoing initiatives that have reduced late diagnosis in the UK are highlighted; moreover, further strategies for improving prompt diagnosis are suggested.

CONCLUSIONS: Insufficient testing is the fundamental reason for late HIV diagnosis, with societal, systemic, and individual factors all contributing to inadequate testing. Improving access to testing, removing barriers to health-seeking behaviour, and ensuring all people with HIV indicator conditions are promptly tested are key to reducing the rates of late diagnosis globally.

RevDate: 2023-11-28

Jeong H, Choi Y, H Kim (2023)

Nonface-to-Face Visitation to Restrict Patient Visits for Infection Control: Integrative Review.

Interactive journal of medical research, 12:e43572 pii:v12i1e43572.

BACKGROUND: In the COVID-19 pandemic, a visit restriction policy for patients has been implemented in medical institutions worldwide and visits are being made using alternative communication technologies. This shift has also required the use of platforms to prevent negative consequences of these restrictions.

OBJECTIVE: The purpose of this review was to comprehensively explore nonface-to-face visits as an alternative during infection prevention and to synthesize the scientific evidence of their benefits and disadvantages.

METHODS: A comprehensive search was conducted via the PubMed, Embase, CINAHL, Cochrane, and Web of Science electronic databases; unpublished trials in the clinical trials register; and Virginia Henderson International Nursing Library up to September 10, 2021. The search query was developed according to the guidelines of the Peer Review of Electronic Search Strategies and included keywords on the topics of telemedicine and visitation restrictions. The inclusion criteria were a nonface-to-face modality using telemedicine with family in a hospital setting, experimental and observational studies, and articles written in English. The exclusion criteria were inaccessible in full text, not related to patient or family involvement, mainly focused on the study protocol, or only discussing the pros and cons of telemedicine.

RESULTS: Overall, patients' families experienced emotional distress due to restrictions on face-to-face visits. Nonface-to-face virtual visits compensating for these restrictions had a positive effect on reducing the risk of infection to the patient and the family. This further encouraged psychological and physical recovery and decreased psychological distress. However, nonface-to-face virtual technology could not replace the existence of actual families, and technical problems with networks and devices are reported as limitations.

CONCLUSIONS: Ensuring the availability of technology and educating on the same in alignment with the characteristics of patients and their families, nonface-to-face virtual visits need to show more potential as an effective patient-centered treatment strategy based on more research and advanced practice.

RevDate: 2023-11-28

Domingues KZA, Cobre AF, Lazo REL, et al (2023)

Systematic review and evidence gap mapping of biomarkers associated with neurological manifestations in patients with COVID-19.

Journal of neurology [Epub ahead of print].

OBJECTIVE: This study aimed to synthesize the existing evidence on biomarkers related to coronavirus disease 2019 (COVID-19) patients who presented neurological events.

METHODS: A systematic review of observational studies (any design) following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and the Cochrane Collaboration recommendations was performed (PROSPERO: CRD42021266995). Searches were conducted in PubMed and Scopus (updated April 2023). The methodological quality of nonrandomized studies was assessed using the Newcastle‒Ottawa Scale (NOS). An evidence gap map was built considering the reported biomarkers and NOS results.

RESULTS: Nine specific markers of glial activation and neuronal injury were mapped from 35 studies published between 2020 and 2023. A total of 2,237 adult patients were evaluated in the included studies, especially during the acute phase of COVID-19. Neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) biomarkers were the most frequently assessed (n = 27 studies, 77%, and n = 14 studies, 40%, respectively). Although these biomarkers were found to be correlated with disease severity and worse outcomes in the acute phase in several studies (p < 0.05), they were not necessarily associated with neurological events. Overall, 12 studies (34%) were judged as having low methodological quality, 9 (26%) had moderate quality, and 9 (26%) had high quality.

CONCLUSIONS: Different neurological biomarkers in neurosymptomatic COVID-19 patients were identified in observational studies. Although the evidence is still scarce and conflicting for some biomarkers, well-designed longitudinal studies should further explore the pathophysiological role of NfL, GFAP, and tau protein and their potential use for COVID-19 diagnosis and management.

RevDate: 2023-11-29
CmpDate: 2023-11-29

Lisi GRE, Appiani F, Basile ME, et al (2023)

Pathophysiological Hypothesis of COVID-19 Psychosis.

The Journal of nervous and mental disease, 211(12):890-895.

In December 2019, a new coronavirus called SARS-CoV-2 was discovered in patients with pneumonia of unknown cause. Although respiratory symptoms mainly characterize infection by this virus, neuropsychiatric manifestations of the disease are becoming more and more frequent. Among them, the appearance of psychotic outbreaks in patients experiencing the infection or after a short time after it has resolved is remarkable. This narrative review aims to describe the possible relationship between SARS-CoV-2 and the onset of psychosis by developing the neurotropic capacities of the virus and analyzing the neurobiology of psychoses.

RevDate: 2023-11-29
CmpDate: 2023-11-29

Sales PMG, Greenfield MJ, Pinkhasov A, et al (2023)

Drawing the Line Between Postacute Sequelae of COVID-19 and Functional Neurologic Disorders: A Daunting Clinical Overlap or Irrelevant Conundrum?.

The Journal of nervous and mental disease, 211(12):882-889.

Coronavirus disease 2019 (COVID-19) is an acute infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in its multiple variants that classically presents with cough, fatigue, fever, headache, myalgias, and diarrhea. As vaccination becomes widely available and infection rates facilitate herd immunity across the globe, more attention has been given to long-term symptoms that may persist after the index infection, which include impairments in concentration, executive dysfunction, sensory disturbances, depression, anxiety, fatigue, and cough, among other symptoms classified under the umbrella term of postacute sequelae of SARS-CoV-2 infection (PASC).Functional neurologic disorder (FND), also known as conversion disorder and functional neurologic symptom disorder, refers to the presence of one or more symptoms of altered voluntary motor or sensory function that are incompatible with and not better explained by a known neurological or medical condition that causes significant distress and functional impairment. Although the diagnosis of FND may not require the identification of an underlying psychological stressor, being diagnosed with an FND can worsen stigma and shift attention and resources away from other medical concerns that should be concomitantly addressed.This review summarizes the literature on the overlapping nature and discrimination of PASC from FND in COVID-19 survivors. Based on this, we develop a treatment framework that targets unique domains of these complex overlapping presentations, following a multidisciplinary approach with an individualized treatment plan inclusive of physical and psychological interventions focused on functional rehabilitation.

RevDate: 2023-11-29
CmpDate: 2023-11-29

Hadjikyriakou M, Martinez-Sosa N, Harvey PD, et al (2023)

Visit Data and Telehealth in a Clinic for Trafficked Persons: Virtual Care and Human Trafficking During the COVID-19 Pandemic.

Journal of health care for the poor and underserved, 34(3):989-1002.

BACKGROUND: Human trafficking involves coerced labor or sex. THRIVE, a multidisciplinary University of Miami clinic for trafficked persons, transitioned to a hybrid telehealth model during the COVID-19 pandemic. Th is paper presents appointment data across THRIVE clinic services during this transition.

METHODS: A review of appointments for THRIVE patients (n=156) was conducted to compare pre-pandemic (February 2019 to February 2020) and pandemic (March 2020 to December 2021) appointment trends.

RESULTS: There were 15% more scheduled (n=51.1 versus n=44) and 8% more completed (n=30.2 versus n=27.9) appointments per month early in the pandemic period with telehealth use compared to the pre-pandemic period. Telehealth was most used within psychiatry. Rescheduled and no-show appointments per month significantly increased during the pandemic period (p=0.010 in pandemic period 1 and and p=0.028 in pandemic period 2). There were few significant differences in appointment trends according to demographic variables.

CONCLUSION: Telehealth succeeded in connecting THRIVE patients during the pandemic, highlighting its potential for long-term use amongst trafficked persons.

RevDate: 2023-11-28

Volk P, Rahmani Manesh M, Warren ME, et al (2023)

Long-term neurological dysfunction associated with COVID-19: Lessons from influenza and inflammatory diseases?.

Journal of neurochemistry [Epub ahead of print].

As the COVID-19 pandemic persists, SARS-CoV-2 infection is increasingly associated with long-term neurological side effects including cognitive impairment, fatigue, depression, and anxiety, colloquially known as "long-COVID." While the full extent of long-COVID neuropathology across years or even decades is not yet known, we can perhaps take direction from long-standing research into other respiratory diseases, such as influenza, that can present with similar long-term neurological consequences. In this review, we highlight commonalities in the neurological impacts of influenza and COVID-19. We first focus on the common potential mechanisms underlying neurological sequelae of long-COVID and influenza, namely (1) viral neurotropism and (2) dysregulated peripheral inflammation. The latter, namely heightened peripheral inflammation leading to central nervous system dysfunction, is emerging as a shared mechanism in various peripheral inflammatory or inflammation-associated diseases and conditions. We then discuss historical and modern examples of influenza- and COVID-19-associated cognitive impairment, depression, anxiety, and fatigue, revealing key similarities in their neurological sequelae. Although we are learning that the effects of influenza and COVID differ somewhat in terms of their influence on the brain, as the impacts of long-COVID grow, such comparisons will likely prove valuable in guiding ongoing research into long-COVID, and perhaps foreshadow what could be in store for individuals with COVID-19 and their brain health.

RevDate: 2023-11-28

Dey S, Kusuma YS, Kant S, et al (2023)

COVID-19 vaccine acceptance and hesitancy in Indian context: a systematic review and meta-analysis.

Pathogens and global health [Epub ahead of print].

Vaccination against COVID-19 is vital for achieving herd immunity, and the Government of India has adopted several strategies to achieve coverage. Vaccine hesitancy was identified as a potential obstacle in combating COVID-19. This study aimed to review the COVID-19 vaccine acceptance and hesitancy, and factors associated with vaccine hesitancy based on studies conducted in Indian populations. The data sources (PubMed, Scopus, and Google Scholar) were searched by following PRISMA guidelines, and the search was done in September 2022. We performed a meta-analysis through a random effect model to estimate pooled hesitancy rate with 95% confidence intervals (CI). A total of 3,339 records were searched, of which 46 studies were found to be eligible for inclusion in the review. The included studies covered 65,551 respondents, 55% were female. Studies reported COVID-19 vaccine acceptance rate of 65.7% in January-February 2021, which increased to 92.8% in May-August 2021. Likewise, the rate of vaccine hesitancy in December 2020 was 37%, dropping to 12.1% through November 2021. The estimated pooled COVID-19 vaccine hesitancy was 31% [95% CI: 27% - 36%, I[2] = 99.3%]. Most studies highlighted that fear of the vaccine's side effects, efficacy, and safety were major barriers to vaccine acceptance. However, as the review indicates, it is important to consider and address all factors contributing to vaccine hesitancy.

RevDate: 2023-11-28

Sevilla JP (2023)

COVID-19 vaccines should be evaluated from the societal perspective.

Journal of medical economics [Epub ahead of print].

The COVID-19 pandemic demonstrates the importance of valuing vaccines from a broad societal perspective (SP), as opposed to a narrower health-payer perspective (HPP). COVID-19's catastrophic global impacts extend not only to its health-related effects, but also to the profound macroeconomic losses caused by lockdowns required for disease control, leading to the worst global economic crisis in a century. COVID-19 vaccination (CV) has been the central policy tool for resolving this economic crisis, and it has been hypothesized that this macroeconomic benefit alone justifies the cost of CV many times over.Yet HPP-based vaccine valuations are wholly insensitive to this enormous benefit, not allowing it to influence the allocation of given health budgets nor the determination of the magnitudes of such budgets, thereby risking inadequate societal spending on CV. HPP allocates given health budgets to maximize only health, giving no weight to macroeconomic outcomes, causing allocative inefficiency by not allowing welfare-improving trade-offs of health for wealth. HPP assumes health budgets are optimal, not scrutinizing whether their scale adequately reflects the macroeconomic benefits of health spending, thereby risking productive inefficiency by foregoing health spending increases such as on CV that could raise both population-level health and wealth. These allocative and productive inefficiencies in turn distort for-profit R&D incentives, risking dynamic inefficiency. And since the socio-economic and health burdens of COVID-19 are disproportionately borne by the worse off, HPP's failure to promote optimal levels of societal investment in CV may disproportionately burden the worse off as well, exacerbating inequality. Vaccine valuations from the societal perspective allow the allocation and determination of health budgets to reflect macroeconomic and distributional values, thereby promoting allocative, productive, and dynamic efficiency, as well as equity. These considerations of efficiency and equity support evaluating CV, and to ensure a level playing field, all vaccines, from a societal perspective.

RevDate: 2023-11-29

Hausburg MA, Williams JS, Banton KL, et al (2022)

C1 esterase inhibitor-mediated immunosuppression in COVID-19: Friend or foe?.

Clinical immunology communications, 2:83-90.

From asymptomatic to severe, SARS-CoV-2, causative agent of COVID-19, elicits varying disease severities. Moreover, understanding innate and adaptive immune responses to SARS-CoV-2 is imperative since variants such as Omicron negatively impact adaptive antibody neutralization. Severe COVID-19 is, in part, associated with aberrant activation of complement and Factor XII (FXIIa), initiator of contact system activation. Paradoxically, a protein that inhibits the three known pathways of complement activation and FXIIa, C1 esterase inhibitor (C1-INH), is increased in COVID-19 patient plasma and is associated with disease severity. Here we review the role of C1-INH in the regulation of innate and adaptive immune responses. Additionally, we contextualize regulation of C1-INH and SERPING1, the gene encoding C1-INH, by other pathogens and SARS viruses and propose that viral proteins bind to C1-INH to inhibit its function in severe COVID-19. Finally, we review the current clinical trials and published results of exogenous C1-INH treatment in COVID-19 patients.

RevDate: 2023-11-29

Moreira A, Alves C, Machado J, et al (2023)

An Overview of Omnichannel Interaction in Health Care Services.

Mayo Clinic Proceedings. Digital health, 1(2):77-93.

The adoption of omnichannel interaction services in health care can bring significant benefits to both health care institutions and their patients. The ongoing health pandemic caused by coronavirus disease has further emphasized the need for health care providers to implement an omnichannel strategy to provide seamless personalized experiences to their patients through multiple access channels. This study aimed to examine the current state of research on omnichannel interaction services in health care with a focus on the benefits, challenges, and issues that health care institutions may encounter when adopting this strategy. A systematic literature review was conducted to synthesize the current state of research and provide a comprehensive overview of the field. The results of the review were used to perform a strengths, weaknesses, opportunities, and threats analysis of omnichannel services in health care and identify 5 key criteria that health care institutions should consider when implementing an omnichannel strategy. This study contributes to the field by offering an updated and comprehensive understanding of omnichannel interaction services in health care and provides valuable insights for health care providers considering this strategy. The ultimate goal of an omnichannel strategy in health care is to improve patient engagement, increase access to care, and reduce costs while improving communication and collaboration among health care providers. The successful implementation of this strategy requires a well-defined plan, robust technology, infrastructure, data analytics, capabilities, trained professionals, and a basic understanding of the communication channels among patients. The adoption of an omnichannel strategy in health care can lead to new business growth and increased patient engagement, but health care institutions must be properly aligned and patients must be prepared for its implementation.

RevDate: 2023-11-29
CmpDate: 2023-11-29

Khalid N, M Umer (2023)

Utilization Of The Complete Blood Count In Diagnosing Endemic Diseases In Pakistan.

JPMA. The Journal of the Pakistan Medical Association, 73(11):2219-2225.

Numerous infectious diseases, including enteric fever, malaria, dengue fever, and, most recently, coronavirus disease-2019, are prevalent in Pakistan. All these diseases have overlapping clinical symptoms and can present a diagnostic challenge for the general practitioner. Since definitive testing for these disorders is time-consuming and expensive, basic clinical testing, such as a complete blood count, should be utilised to supplement clinical diagnosis, when possible. The current narrative review was planned to present specific alterations in haematological parameters for each of these disorders. The review was intended as a guide for practising physicians in their decision-making.

RevDate: 2023-11-29
CmpDate: 2023-11-29

Cho Y, Yeo IH, Lee DE, et al (2023)

Coronavirus disease pandemic impact on emergency department visits for cardiovascular disease in Korea: A review.

Medicine, 102(47):e35992.

The coronavirus disease (COVID-19) pandemic has affected patient visits to the hospital, including visits to the emergency department (ED). This study aimed to analyze the impact of the COVID-19 pandemic on the patterns of ED visits and treatment in hospitals for diseases requiring urgent diagnosis and treatment. We analyzed entries from the South Korea National Emergency Department Information System claims database between January 1, 2018 and December 31, 2020. We analyzed data of patients who visited the ED with acute myocardial infarction (AMI), acute ischemic stroke (AIS), and acute hemorrhagic stroke (AHS). We found that the COVID-19 pandemic had impacted ED utilization and fatality in patients with AMI, AIS, and AHS.

RevDate: 2023-11-29
CmpDate: 2023-11-29

Tian Z, Guo W, Zhai M, et al (2023)

Job preference of preventive medicine students during the COVID-19 pandemic: a discrete choice experiment survey in Shandong Province, China.

BMC medical education, 23(1):890.

BACKGROUND: Public health workers are a crucial part of the health workforce, particularly during the coronavirus disease (COVID-19) pandemic. They play an important role in achieving universal health coverage and sustainable development goals. Human resources in public health in China are in short supply, their distribution is unequal, and their turnover rate is high. A discrete choice experiment (DCE) was applied to investigate preventive medicine students' preferred job choice criteria and trends in trade-offs by calculating the marginal rate of substitution between these criteria. This study identified the properties of jobs primarily selected by preventive medicine students and estimated the monetary value of each attribute.

METHODS: Based on discussions and in-depth interviews with preventive medicine students and a literature review, we developed a DCE that assessed how students' stated preferences for a certain choice were influenced by several job attributes, including location, salary, bianzhi, career development opportunities, working environment, and workload. We applied this DCE to preventive medicine students in Shandong Province, China, using a brief, structured questionnaire. Conditional logit models were used to estimate the utility of each job's attributes. Willingness to pay (WTP) was estimated as the ratio of the value of the coefficient of interest to the negative value of the cost attribute.

RESULTS: A total of 307 respondents completed the questionnaire, and 261 passed the internal consistency test. All the attributes were statistically significant. Career development opportunities and work locations were the most important factors for the respondents. Preference heterogeneity existed among respondents, e.g., 3-year medical education college students placed a higher value on jobs with bianzhi compared to 5-year medical education college students. Furthermore, rural students' WTP for a job located in the county or city is much lower than that of urban students.

CONCLUSIONS: The heterogeneity of attributes indicates the complexity of job preferences. Monetary and nonmonetary job characteristics significantly influenced the job preferences of preventive medicine students in China. A more effective policy intervention to attract graduates to work in rural areas should consider both job incentives and the backgrounds of preventive medicine graduates.

RevDate: 2023-11-29
CmpDate: 2023-11-29

Hartmann-Boyce J, Rees K, Onakpoya I, et al (2023)

An Update to the Overview of Reviews: Risks of and From SARS-COV-2 Infection and COVID-19 in People With Diabetes.

Diabetes care, 46(12):e215-e216.

RevDate: 2023-11-29
CmpDate: 2023-11-29

Ozguler Y, Esatoglu SN, G Hatemi (2024)

Epidemiology of systemic vasculitis.

Current opinion in rheumatology, 36(1):21-26.

PURPOSE OF REVIEW: Epidemiology of vasculitides exhibit geographic variation and data from some parts of the world are still scarce. Increased recognition of these rare diseases and improvement in diagnosis and patient care may lead to changes in their epidemiology. In this review, we aimed to highlight the most recent work on the epidemiology of systemic vasculitis.

RECENT FINDINGS: New data from countries where information on the epidemiology of giant cell arteritis, Takayasu arteritis and Behçet syndrome were limited have revealed that these conditions are not as rare as previously believed. The incidence rates during the coronavirus disease 2019 pandemic highlight the link between Kawasaki disease and respiratory pathogens. The use of different classification criteria hampers the comparison of true incidence and prevalence rates in antineutophil cytoplasmic antibody (ANCA)-associated vasculitis and its subtypes between geographies and over time.

SUMMARY: Recent studies have highlighted the epidemiology of vasculitides in different parts of the world and changing trends. Standardization of study design and disease definitions is needed to improve the reliability and comparability of the results.

RevDate: 2023-11-29
CmpDate: 2023-11-29

Amirizad K, Ghazanfari M, Javidnia J, et al (2023)

Central nervous system Aspergillus quadrilineatus infection in a COVID-19 patient, a case report and literature review.

Journal of clinical laboratory analysis, 37(19-20):e24971.

BACKGROUND: Viral pneumonia such as COVID-19-associated aspergillosis could increase susceptibility to fungal super-infections in critically ill patients.

METHODS: Here we report a pediatric case of Aspergillus quadrilineatus cerebral infection in a recently diagnosed COVID-19-positive patient underlying acute lymphocytic leukemia. Morphological, molecular methods, and sequencing were used to identify this emerging species.

RESULTS: Histopathological examination showed a granulomatous necrotic area containing dichotomously branching septate hyphae indicating a presumptive Aspergillus structure. The species-level identity of isolate growing on brain biopsy culture was confirmed by PCR sequencing of the β-tubulin gene as A. quadrilineatus. Using the CLSI M38-A3 broth microdilution methodology, the in vitro antifungal susceptibility testing demonstrated 0.032 μg/mL MIC for posaconazole, caspofungin, and anidulafungin and 8 μg/mL against amphotericin B. A combination of intravenous liposomal amphotericin B and caspofungin therapy for 8 days did not improve the patient's condition. The patient gradually continued to deteriorate and expired.

CONCLUSIONS: This is the first COVID-19-associated cerebral aspergillosis due to A. quadrilineatus in a pediatric patient with acute lymphocytic leukemia. However, comprehensive screening studies are highly recommended to evaluate its frequency and antifungal susceptibility profiles. Before being recommended as first-line therapy in high-risk patients, more antifungal susceptibility data are needed.

RevDate: 2023-11-29
CmpDate: 2023-11-29

Williamson J, AJ Spicer (2023)

Review of the impact of the FDA's Fast Track Designation on biotechnology companies' share prices.

Drug discovery today, 28(11):103771.

This study examines the effect of the FDA's Fast Track Designation (FTD) on biotech company share prices. Using an event-study approach on 25 FTD announcements between June 2019 and June 2020, notable short- and long-term share price hikes were observed, with a 5-day cumulative average abnormal returns of 21.59%, 30-day at 38.34%, 1-year at 76.64% and 3-year at 111.37% against the XBI benchmark. These surges surpass prior research findings, indicating stronger investor reactions. The role of the COVID-19 pandemic as a confounder is discussed. Although the sample size is limited, the results offer valuable insights for investors and small pharma firms. Further research is recommended to delve into the driving market factors.

RevDate: 2023-11-29

Khazeei Tabari MA, Najary S, Khadivi G, et al (2022)

Oral lesions after COVID-19 vaccination: Immune mechanisms and clinical approach.

Infectious medicine, 1(3):171-179.

COVID-19 vaccination, although is a promising tool to overcome the pandemic, has side effects. There are increasing reports of oral lesions after COVID-19 vaccination. The aim of this review is to identify the occurrence of some oral lesions after COVID-19 vaccination, and highlight the underlying immune mechanisms involved. A narrative literature review was performed by searching electronic databases including PubMed, Scopus and Web of Science to investigate the oral lesions after COVID-19 vaccination. The inclusion criteria were original studies, including the case reports, case series, letter to the editor, and cross-sectional studies. The exclusion criteria included the studies which examined the oral lesions caused by COVID-19 infection. The information, including the number of participant(s) receiving vaccine, type of vaccine, dose number, side effect(s), time of onset following vaccination, healing time, treatment strategies for the existing lesions, and related mechanisms were then summarized in a data extraction sheet. The results of this review showed that some vaccines had side effects with oral involvement such as pemphigus vulgaris, bullous pemphigoid, herpes zoster, lichen planus, Stevens-Johnson syndrome and Behçet's disease. Future research needs to elucidate the physiopathology of oral manifestations after the COVID-19 vaccination, and better understand the risk factors associated with such responses. Sometimes vaccine's side effects may be due to the nocebo effect, which means that the person expects some adverse events to occur following the vaccine administration.

RevDate: 2023-11-29

de Souza Santos D, Bittencourt EA, de Moraes Malinverni AC, et al (2022)

Domestic violence against women during the Covid-19 pandemic: A scoping review.

Forensic Science International. Reports, 5:100276.

OBJECTIVES: This scoping review aims to assess the situation of violence against women during the COVID-19 pandemic in Latin America, mainly in Brazil.

METHODS: This study consists of a Scoping Review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. To conduct this review, we mapped scientific evidence on domestic violence during the COVID-19 pandemic. The inclusion criteria were: journal articles on domestic violence set in Latin American countries, particularly Brazil, in the context of social isolation during the COVID-19 pandemic, published between March 2020 and June of 2021. Articles that were not published in journals, studies focusing on child violence or the elderly population, suicide-related approaches, editorials and letters to readers were excluded. The databases used were: National Library of Medicine (PubMed), Embase, COVID-19 Global literature on coronavirus disease, Scopus Preview, Web of Science, LILAC's, Database of the best Evidence-Based Health (Epistemonikos) with the following strategic keywords: "domestic violence" "female'/exp OR female" "domestic violence AND women" "SARS-CoV-19") AND ("domestic violence") SARS-CoV-2" OR "2020-nCoV". The databases above were accessed in July 2021. The articles selected from the databases were synthetized following the double-check procedure and the topics that were most relevant to the subject discussed were separated. The articles used were in English, Portuguese, and Spanish.

RESULTS: We discussed domestic violence against women in the context of social isolation, showing a significant increase and highlighting aggravating factors - financial instability, exacerbation of the female workload, increase in drug and alcohol consumption, lack of access to care services - and statistics that demonstrate the significant increase in countries such as Argentina, Ecuador, Paraguay and Brazil, especially in São Paulo, Rio de Janeiro, Paraná, among other states. Despite the meaningful increase in the number of cases and the aggravating factors for domestic violence against women in Latin America and Brazil during the COVID-19 pandemic, the reality of underreporting, resulting, among others, from limited legal, social and economic support and the lack of well-prepared intersectoral services may be a limitation in this scenario, since the situation can be even more acute. We presented measures adopted in Brazil and alternatives to confront the critical situation of domestic violence against women, aggravated by social isolation during the COVID-19 pandemic.The 18 most relevant articles were read twice by each author, following the "Double-Check" protocol. The articles used addressed important questions around the established goals: (a) characteristics of the current scenarios in Latin America and, specifically, in Brazil, with regard to violence against women; (b) factors that intensify this type of violence; (c) numbers that demonstrate an increase in cases; and finally (e) strategies to combat domestic violence against women. A total of 595 articles were found, then, based on the abstracts presented, 18 articles were used to write this scoping review.

RevDate: 2023-11-28

Zahid A, R Sharma (2023)

Personalized Health Care in a Data-Driven Era: A Post-COVID-19 Retrospective.

Mayo Clinic Proceedings. Digital health, 1(2):162-171.

RevDate: 2023-11-28

Cate G, Barnes J, Cherney S, et al (2023)

Current status of virtual reality simulation education for orthopedic residents: the need for a change in focus.

Global surgical education : journal of the Association for Surgical Education, 2(1):46.

INTRODUCTION: Advances in technology are changing surgical education. Simulation provides an important adjunct to operative experience. This pedagogy has arguably become more important in light of the COVID-19 pandemic, with resultant reduction in operative exposure for trainees. Virtual reality (VR) simulators may provide significant contribution to experiential learning; however, much of the investigative focus to date has, correctly, been on establishing validity evidence for these constructs. The aim of this work was to perform a scoping review to assess the current status of VR simulation education to determine curricular development efforts for orthopedic residents.

METHODS: With a trained medical librarian, searches of PubMed, EMBASE, and Web of Science were conducted for all articles in the last 10 years (September 2011-September 2021). Controlled vocabulary Medical Subject Headings (MeSH) terms and natural language developed with subject matter experts describing virtual reality or VR simulation and orthopedic training were used. Two trained reviewers evaluated all abstracts for inclusion. Exclusion criteria were all articles that did not assess VR simulation education involving orthopedic residents. Data were extracted from the included full-text articles including: study design, type of participants, type of VR simulation, simulated orthopedic skill, type of educational event, learner assessment including Kirkpatrick's level, assessment of quality using the Medical Education Research Study Quality Instrument (MERSQI), and level of effectiveness (LoE).

RESULTS: Initial search identified 1,394 articles, of which 61 were included in the final qualitative synthesis. The majority (54%) were published in 2019- 2021, 49% in Europe. The commonest VR simulator was ArthroS (23%) and the commonest simulated skill was knee arthroscopy (33%). The majority of studies (70%) focused on simulator validation. Twenty-three studies described an educational module or curriculum, and of the 21 (34%) educational modules, 43% were one-off events. Most modules (18/21, 86%) assessed learners at Kirkpatrick level 2. With regard to methodological quality, 44% of studies had MERSQI 11.5-15 and 89% of studies had LoE of 2. Two studies had LoE of 3.

CONCLUSION: Current literature pertaining to VR training for orthopedic residents is focused on establishing validity and rarely forms part of a curriculum. Where the focus is education, the majority are discrete educational modules and do not teach a comprehensive amalgam of orthopedic skills. This suggests focus is needed to embed VR simulation training within formal curricula efforts guided by the work of Kern, and assess the efficacy of these against patient outcomes.

RevDate: 2023-11-28

Rasic G, Parikh PP, Wang ML, et al (2023)

The silver lining of the pandemic in surgical education: virtual surgical education and recommendations for best practices.

Global surgical education : journal of the Association for Surgical Education, 2(1):59.

Virtual education is an evolving field within the realm of surgical training. Since the onset of the COVID-19 pandemic, the application of virtual technologies in surgical education has undergone significant exploration and advancement. While originally developed to supplement in-person curricula for the development of clinical decision-making, virtual surgical education has expanded into the realms of clinical decision-making, surgical, and non-surgical skills acquisition. This manuscript aims to discuss the various applications of virtual surgical education as well as the advantages and disadvantages associated with each education modality, while offering recommendations on best practices and future directions.


ESP Quick Facts

ESP Origins

In the early 1990's, Robert Robbins was a faculty member at Johns Hopkins, where he directed the informatics core of GDB — the human gene-mapping database of the international human genome project. To share papers with colleagues around the world, he set up a small paper-sharing section on his personal web page. This small project evolved into The Electronic Scholarly Publishing Project.

ESP Support

In 1995, Robbins became the VP/IT of the Fred Hutchinson Cancer Research Center in Seattle, WA. Soon after arriving in Seattle, Robbins secured funding, through the ELSI component of the US Human Genome Project, to create the original ESP.ORG web site, with the formal goal of providing free, world-wide access to the literature of classical genetics.

ESP Rationale

Although the methods of molecular biology can seem almost magical to the uninitiated, the original techniques of classical genetics are readily appreciated by one and all: cross individuals that differ in some inherited trait, collect all of the progeny, score their attributes, and propose mechanisms to explain the patterns of inheritance observed.

ESP Goal

In reading the early works of classical genetics, one is drawn, almost inexorably, into ever more complex models, until molecular explanations begin to seem both necessary and natural. At that point, the tools for understanding genome research are at hand. Assisting readers reach this point was the original goal of The Electronic Scholarly Publishing Project.

ESP Usage

Usage of the site grew rapidly and has remained high. Faculty began to use the site for their assigned readings. Other on-line publishers, ranging from The New York Times to Nature referenced ESP materials in their own publications. Nobel laureates (e.g., Joshua Lederberg) regularly used the site and even wrote to suggest changes and improvements.

ESP Content

When the site began, no journals were making their early content available in digital format. As a result, ESP was obliged to digitize classic literature before it could be made available. For many important papers — such as Mendel's original paper or the first genetic map — ESP had to produce entirely new typeset versions of the works, if they were to be available in a high-quality format.

ESP Help

Early support from the DOE component of the Human Genome Project was critically important for getting the ESP project on a firm foundation. Since that funding ended (nearly 20 years ago), the project has been operated as a purely volunteer effort. Anyone wishing to assist in these efforts should send an email to Robbins.

ESP Plans

With the development of methods for adding typeset side notes to PDF files, the ESP project now plans to add annotated versions of some classical papers to its holdings. We also plan to add new reference and pedagogical material. We have already started providing regularly updated, comprehensive bibliographies to the ESP.ORG site.


SUPPORT ESP: Order from Amazon
The ESP project will earn a commission.

With the world now in the middle of a new and rapidly spreading pandemic, now is the time to read this book, originally published in 2012, that describes animal infections and the next human pandemic (that's actually the book's subtitle). You would be hard pressed to find a more relevant explanation of how this got started and why there will be more after this one. R. Robbins

Electronic Scholarly Publishing
961 Red Tail Lane
Bellingham, WA 98226

E-mail: RJR8222 @

Papers in Classical Genetics

The ESP began as an effort to share a handful of key papers from the early days of classical genetics. Now the collection has grown to include hundreds of papers, in full-text format.

Digital Books

Along with papers on classical genetics, ESP offers a collection of full-text digital books, including many works by Darwin (and even a collection of poetry — Chicago Poems by Carl Sandburg).


ESP now offers a much improved and expanded collection of timelines, designed to give the user choice over subject matter and dates.


Biographical information about many key scientists.

Selected Bibliographies

Bibliographies on several topics of potential interest to the ESP community are now being automatically maintained and generated on the ESP site.

ESP Picks from Around the Web (updated 07 JUL 2018 )