scholarly journals Emergence and Spread of B.1.1.7 Lineage in Primary Care and Clinical Impact in the Morbi-Mortality among Hospitalized Patients in Madrid, Spain

2021 ◽  
Vol 9 (7) ◽  
pp. 1517
Author(s):  
Laura Martínez-García ◽  
Marco Antonio Espinel ◽  
Melanie Abreu ◽  
José María González-Alba ◽  
Desirèe Gijón ◽  
...  
Keyword(s):  
Primary Care ◽  
Death Rate ◽  
Clinical Impact ◽  
Replacement Rate ◽  
Gene Target ◽  
The Third ◽  
Rapid Spread ◽  
Alpha Variant ◽  
Time Spread ◽  
Pandemic Wave

In December 2020, UK authorities warned of the rapid spread of a new SARS-CoV-2 variant, belonging to the B.1.1.7 lineage, known as the Alpha variant. This variant is characterized by 17 mutations and 3 deletions. The deletion 69–70 in the spike protein can be detected by commercial platforms, allowing its real-time spread to be known. From the last days of December 2020 and over 4 months, all respiratory samples with a positive result for SARS-CoV-2 from patients treated in primary care and the emergency department were screened to detect this variant based on the strategy S gene target failure (SGTF). The first cases were detected during week 53 (2020) and reached >90% of all cases during weeks 15–16 (2021). During this period, the B.1.1.7/SGTF variant spread at a rapid and constant replacement rate of around 30–36%. The probability of intensive care unit admission was twice higher among patients infected by the B.1.1.7/SGTF variant, but there were no differences in death rate. During the peak of the third pandemic wave, this variant was not the most prevalent, and it became dominant when this wave was declining. Our results confirm that the B.1.1.7/SGTF variant displaced other SARS-CoV-2 variants in our healthcare area in 4 months. This displacement has led to an increase in the burden of disease.

scholarly journals Rapid Spread of the SARS-CoV-2 Variant of Concern 202012/01 in Southern Italy (December 2020–March 2021)

2021 ◽  
Vol 18 (9) ◽  
pp. 4766
Author(s):  
Daniela Loconsole ◽  
Francesca Centrone ◽  
Caterina Morcavallo ◽  
Silvia Campanella ◽  
Anna Sallustio ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Large Scale ◽  
Southern Italy ◽  
Whole Genome ◽  
Third Wave ◽  
Gene Target ◽  
The Third ◽  
Rapid Spread ◽  
Pharmaceutical Interventions ◽  
Over Time

Epidemiological and virological studies have revealed that SARS-CoV-2 variants of concern (VOCs) are emerging globally, including in Europe. The aim of this study was to evaluate the spread of B.1.1.7-lineage SARS-CoV-2 in southern Italy from December 2020–March 2021 through the detection of the S gene target failure (SGTF), which could be considered a robust proxy of VOC B.1.1.7. SGTF was assessed on 3075 samples from week 52/2020 to week 10/2021. A subset of positive samples identified in the Apulia region during the study period was subjected to whole-genome sequencing (WGS). A descriptive and statistical analysis of the demographic and clinical characteristics of cases according to SGTF status was performed. Overall, 20.2% of samples showed SGTF; 155 strains were confirmed as VOC 202012/01 by WGS. The proportion of SGTF-positive samples rapidly increased over time, reaching 69.2% in week 10/2021. SGTF-positive cases were more likely to be symptomatic and to result in hospitalization (p < 0.0001). Despite the implementation of large-scale non-pharmaceutical interventions (NPIs), such as the closure of schools and local lockdowns, a rapid spread of VOC 202012/01 was observed in southern Italy. Strengthened NPIs and rapid vaccine deployment, first among priority groups and then among the general population, are crucial both to contain the spread of VOC 202012/01 and to flatten the curve of the third wave.

scholarly journals Osteopathic students and graduates matching into pathology residency, 2011–2020

2021 ◽  
Vol 121 (2) ◽  
pp. 149-156
Author(s):  
Ryan Philip Jajosky ◽  
Hannah C. Coulson ◽  
Abric J. Rosengrant ◽  
Audrey N. Jajosky ◽  
Philip G. Jajosky
Keyword(s):  
United States ◽  
Primary Care ◽  
Medical Education ◽  
Accreditation System ◽  
Senior Year ◽  
Medical Specialties ◽  
Residency Programs ◽  
The Third ◽  
The Past ◽  
Residency Match

Abstract Context In the past decade, two changes have affected the pathology residency match. First, the American Osteopathic Association (AOA) Match, which did not offer pathology residency, became accredited under a single graduate medical education (GME) system with the Main Residency Match (MRM), which offers pathology residency. Second, substantially fewer United States senior-year allopathic medical students (US MD seniors) matched into pathology residency. Objective To determine whether there were major changes in the number and percentage of osteopathic students and physicians (DOs) matching into pathology residency programs over the past decade. Methods Pathology match outcomes for DOs from 2011 to 2020 were obtained by reviewing AOA Match data from the National Matching Services and MRM data from the National Resident Matching Program (NRMP). The number of DOs that filled pathology positions in the MRM was divided by the total number of pathology positions filled in the MRM to calculate the percentage of pathology positions taken by DOs. Results Over the past decade, there was a 109% increase in the total number of DOs matching into pathology residency (34 in 2011 vs. 71 in 2020). During this time, there was a 23.3% increase in the total number of pathology positions filled in the MRM (476 in 2011 vs. 587 in 2020). Thus, the percentage of pathology residency positions filled by DOs increased from 7.1% in 2011 to 12.1% in 2020. The substantial increase of DOs in pathology occurred simultaneously with a 94.2% increase in the total number of DOs filling AOA/MRM “postgraduate year 1” (PGY-1) positions (3201 in 2011 vs. 6215 in 2020). Thus, the percentage of DOs choosing pathology residency has remained steady (1.06% in 2011 and 1.14% in 2020). In 2020, pathology had the third lowest percentage of filled PGY-1 residency positions taken by DOs, out of 15 major medical specialties. Conclusion The proportion of DOs choosing pathology residency was stable from 2011 to 2020 despite the move to a single GME accreditation system and the stark decline in US MD seniors choosing pathology. In 2020, a slightly higher percentage of DOs (1.14%) chose pathology residency than US MD seniors (1.13%). Overall, DOs more often choose other medical specialties, including primary care. Additional studies are needed to determine why fewer US MD seniors, but not fewer DOs, are choosing pathology residency.

Healthwise: Part 1. Maintaining a healthy body weight

2021 ◽  
Vol 15 (4) ◽  
pp. 169-173
Author(s):  
Linda Nazarko
Keyword(s):  
Body Weight ◽  
Death Rate ◽  
Healthcare Workers ◽  
Poor Health ◽  
The Third ◽  
Lifestyle Choices ◽  
The World ◽  
Healthy Body Weight ◽  
The Uk ◽  
Healthy Body

Coronavirus (COVID-19) has claimed the lives of over 150 000 people in the UK ( UK Government, 2021 ). The UK has the third highest death rate in the world and the fourth highest obesity rate ( Lobstein, 2021 ). Although the UK is a developed nation, many people in the UK experience poor health, as a result of being overweight and inactive. Healthcare workers are not immune from these issues. This article, the first in a series, explores how readers can remain healthy and well by making lifestyle choices that promote health.

scholarly journals Drug interactions in the pharmacotherapy of patients included in primary care comprehensive medication management services

2021 ◽  
Vol 12 (2) ◽  
pp. 545
Author(s):  
Hágabo M. SILVA ◽  
Djenane RAMALHO-DE-OLIVEIRA ◽  
Ursula M. MARTINS ◽  
Yone A. NASCIMENTO ◽  
Adriano M. REIS ◽  
...  
Keyword(s):  
Primary Care ◽  
Medication Management ◽  
Cross Sectional Study ◽  
Clinical Impact ◽  
Clinical Event ◽  
Cross Sectional ◽  
Indirect Measures ◽  
Clinical Consequences ◽  
Safety Parameters ◽  
Available Information

Objective: A drug interaction (DI) is the clinical event in which the effect or action of one drug is modified by the presence of another. Because of potential harms and low consistency of available information, it is critical to assess the clinical relevance of DI. This study aimed to identify and evaluate the clinical consequences of DI in the pharmacotherapy of patients followed in a primary care Comprehensive Medication Management (CMM) services. Methods: This observational cross-sectional study was based on the analysis of the CMM records all the patients that used at least two medications and attended to at least three CMM consultations from August 2015 to March 2016 (n=88). Potential DI were identified among the medications used in the initial consultation of CMM using Micromedex® Drug-Reax® software. The DI were classified as “monitorable” (when its clinical consequences could be monitored by effectiveness or safety paremeters) or non-monitorable, and their clinical consequences were evaluated by analysis of CMM records. Results: Among the studied population 95.5% of the patients had at least one potential DI in their pharmacotherapy, totaling 493 potential DI. Of all the potential DIs identified, 90.9% were monitorable, and the majority of these monitorable DI presented no clinical consequences (62.7%). For 63.9% of the DI with clinical impact, the pharmacist adopted direct or indirect measures that would favor the resolution or reduction of the clinical impact of DIs. Conclusion: The CMM service facilitates the management of DIs since its decision-making method calls for monitoring of the effectiveness and safety parameters, individualizing the management of DIs according to the patient’s needs and their clinical consequences.

scholarly journals Rapid spread of the SARS-CoV-2 Delta variant in some French regions, June 2021

2021 ◽  
Vol 26 (28) ◽  
Author(s):  
Samuel Alizon ◽  
Stéphanie Haim-Boukobza ◽  
Vincent Foulongne ◽  
Laura Verdurme ◽  
Sabine Trombert-Paolantoni ◽  
...  
Keyword(s):  
Public Health ◽  
Confidence Interval ◽  
Rapid Growth ◽  
Rt Pcr ◽  
Health Authorities ◽  
Rapid Spread ◽  
Public Health Authorities ◽  
Alpha Variant

We analysed 9,030 variant-specific RT-PCR tests performed on SARS-CoV-2-positive samples collected in France between 31 May and 21 June 2021. This analysis revealed rapid growth of the Delta variant in three of the 13 metropolitan French regions and estimated a +79% (95% confidence interval: 52–110%) transmission advantage compared with the Alpha variant. The next weeks will prove decisive and the magnitude of the estimated transmission advantages of the Delta variant could represent a major challenge for public health authorities.

Sorting Out the Plague

2021 ◽  
pp. 93-111
Author(s):  
Robert N. Wiedenmann ◽  
J. Ray Fisher
Keyword(s):  
Insect Vectors ◽  
Bacterial Dna ◽  
The Third ◽  
Complex Interactions ◽  
Rapid Spread ◽  
The World ◽  
Disease Reservoirs ◽  
The Way

This chapter explores the complex interactions among mammal hosts, insect vectors, bacteria and even amoebae implicated in the movement of the plague around the world. As it shows, trying to find the cause for the three plague pandemics is similar to the way a television detective solves a murder mystery. While the third pandemic established the roles of rats, rat fleas, and bacteria, that explanation has been incorrectly applied to explain the first two pandemics. The chapter shows how bacterial DNA collected from the teeth of 6th-Century plague victims, exhumed 1,400 years later, established greater understanding of the rate and geographic extent of the plague's spread. It goes on to relate how the age-old conclusions that brown rats were disease reservoirs and their fleas were vectors have been reconsidered, assigning rats and fleas specific roles and recognizing that humans and human lice as host and vector are more consistent with the plague’s rapid spread. Using clues from hosts and vectors to solve the mystery requires investigators to be like detectives.

scholarly journals Fetal Cardiac Interventions—Polish Experience from “Zero” to the Third World Largest Program

2020 ◽  
Vol 9 (9) ◽  
pp. 2888
Author(s):  
Marzena Debska ◽  
Adam Kolesnik ◽  
Beata Rebizant ◽  
Agnieszka Sekowska ◽  
Agnieszka Grzyb ◽  
...  
Keyword(s):  
Death Rate ◽  
Third World ◽  
Technical Success ◽  
Technical Aspects ◽  
Technical Success Rate ◽  
Live Births ◽  
The Third ◽  
Polish Experience ◽  
Gestational Age At Delivery ◽  
The Third World

This article presents the technical aspects of the Polish fetal cardiac interventions (FCI) program, including preparation of the team and modifications in the technique of the procedure that aim to increase its safety for the mother and the fetus. Over 9 years, 128 FCI in 113 fetuses have been performed: 94 balloon aortic valvuloplasties (fBAV), 14 balloon atrioseptoplasties (fBAS) with stent (BAS+), 5 balloon atrioseptoplasties without stent placement (BAS−), and 15 fetal pulmonary valvuloplasties (fBPS). The technical success rate ranged from 80% (BAS−) to 89% (fBAV), while the procedure-related death rate (defined as death within 72 hours following the procedure) ranged from 7% (fBAV and fBPV) to 20% (BAS). There were 98 live births after all FCI (3 pregnancies continue). Median gestational age at delivery was 39 weeks in our center and 38 weeks in other centers.

Has respiratory cryptosporidiosis spread to black grouseTetrao tetrix?

2017 ◽  
Vol 181 (20) ◽  
pp. 540-540 ◽  
Author(s):  
Nancy Parsons ◽  
Philip Warren ◽  
James Paul Duff ◽  
David Baines
Keyword(s):  
Clinical Signs ◽  
Conclusive Evidence ◽  
Postmortem Examination ◽  
Pcr Analysis ◽  
Black Grouse ◽  
Red Grouse ◽  
The Third ◽  
Rapid Spread ◽  
Single Positive ◽  
Cryptosporidium Baileyi

Infection byCryptosporidium baileyiwas first confirmed in red grouse in northern England in 2010 and within three years spread to 48 per cent of moors. These form the last English stronghold for the rarer black grouse, and given the rapid spread of respiratory cryptosporidiosis among red grouse, concern has been expressed about possible infection. In 2010, the authors started screening black grouse for cryptosporidiosis in (1) dead birds taken for postmortem examination, (2) sample birds caught at night and (3) an observational study of birds attending leks. Between 2011 and 2016, five males were sent for postmortem examination, of which three had suspected cryptosporidiosis. No disease was found in one; the second had extensive, subacute to chronic sinusitis; and the third had severe sinusitis and unilateral conjunctivitis. PCR analysis detected cryptosporidial DNA in the third bird only; however, the parasite was not seen in stained preparations or on histopathology. No cryptosporidiosis clinical signs were observed in 69 birds caught at night or in 170 birds attending leks. The authors have no conclusive evidence that cryptosporidiosis is causing sinusitis in black grouse. However, a single positive cryptosporidia PCR result from an affected bird does raise the possibility that they may be infected with the parasite.

Modal Personality and Values of Medical Students

1986 ◽  
Vol 58 (1) ◽  
pp. 33-34 ◽  
Author(s):  
Gordon J. Di Renzo
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Medical Training ◽  
Career Attitudes ◽  
The Third ◽  
D 20

30 men and 12 women in the third year of medical training completed the D-20 version of Rokeach's Dogmatism Scale, the Rokeach Scales for Terminal and Introductory Values, and items on career attitudes and background. Scores suggested these students are congenial to primary-care and patient-oriented medicine.

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