scholarly journals Telehealth Outpatient Monitoring of a SARS-CoV-2 Familial Cluster Infection in Peru: Adapting to a Healthcare Crisis

2021 ◽  
Keyword(s):  
Familial Cluster ◽  
Outpatient Monitoring ◽  
Healthcare Crisis

Addressing the importance of Stem cell-based therapy: a Perspective in the treatment of COVID-19’

2020 ◽  
Vol 20 ◽  
Author(s):  
Christine Ibrahim ◽  
Hanna Semaan ◽  
Marwan El-Sabban ◽  
Fadia Najjar ◽  
Aline Hamade
Keyword(s):  
Stem Cell ◽  
Drug Repositioning ◽  
World Health ◽  
Unknown Etiology ◽  
Cell Based Therapy ◽  
Pathogenic Virus ◽  
Lung Injuries ◽  
Healthcare Crisis ◽  
Health Organization ◽  
Potential Use

: Severe acute respiratory syndrome-associated corona virus 2 (SARS-CoV-2), is an extremely pathogenic virus belonging to the family of Coronaviridae. First identified in Wuhan China in December 2019 after an epidemiological investigation of an emerging cluster of pneumonia of unknown etiology, SARS-CoV-2 was declared the cause of a pandemic on March 11 by the World Health Organization (WHO) pointing to the over 118000 cases of Coronavirus disease 2019 (COVID- 19) in over 110 countries. Despite the promising results of drug repositioning studies in the treatment of COVID-19, the evidence of their safety and efficacy remains inconclusive. Cell based therapy has been proven safe and possibly effective in treating multiple lung injuries and diseases but its potential use in the treatment of COVID-19 has not been yet elucidated. Our aim in this review is to provide an overview on the immunomodulatory effect and the regenerative capacity of stem cells and their secretome in the treatment of many diseases including lung injuries. Those findings may contribute to a better understanding of the potential of stem cell therapy in SARS-CoV-2 infection and its potential use in order to find a solution for this healthcare crisis.

scholarly journals Early prognostication of COVID-19 to guide hospitalisation versus outpatient monitoring using a point-of-test risk prediction score

Thorax ◽  
2021 ◽  
pp. thoraxjnl-2020-216425
Author(s):  
Felix Chua ◽  
Rama Vancheeswaran ◽  
Adrian Draper ◽  
Tejal Vaghela ◽  
Matthew Knight ◽  
...  
Keyword(s):  
Operating Characteristic ◽  
Predictive Accuracy ◽  
Fatal Outcome ◽  
Individual Characteristics ◽  
Adverse Outcomes ◽  
Hospital Death ◽  
Outpatient Monitoring ◽  
Characteristic Values ◽  
Large Random Sample ◽  
Mortality Predictors

IntroductionRisk factors of adverse outcomes in COVID-19 are defined but stratification of mortality using non-laboratory measured scores, particularly at the time of prehospital SARS-CoV-2 testing, is lacking.MethodsMultivariate regression with bootstrapping was used to identify independent mortality predictors in patients admitted to an acute hospital with a confirmed diagnosis of COVID-19. Predictions were externally validated in a large random sample of the ISARIC cohort (N=14 231) and a smaller cohort from Aintree (N=290).Results983 patients (median age 70, IQR 53–83; in-hospital mortality 29.9%) were recruited over an 11-week study period. Through sequential modelling, a five-predictor score termed SOARS (SpO2, Obesity, Age, Respiratory rate, Stroke history) was developed to correlate COVID-19 severity across low, moderate and high strata of mortality risk. The score discriminated well for in-hospital death, with area under the receiver operating characteristic values of 0.82, 0.80 and 0.74 in the derivation, Aintree and ISARIC validation cohorts, respectively. Its predictive accuracy (calibration) in both external cohorts was consistently higher in patients with milder disease (SOARS 0–1), the same individuals who could be identified for safe outpatient monitoring. Prediction of a non-fatal outcome in this group was accompanied by high score sensitivity (99.2%) and negative predictive value (95.9%).ConclusionThe SOARS score uses constitutive and readily assessed individual characteristics to predict the risk of COVID-19 death. Deployment of the score could potentially inform clinical triage in preadmission settings where expedient and reliable decision-making is key. The resurgence of SARS-CoV-2 transmission provides an opportunity to further validate and update its performance.

scholarly journals The impact of the Covid-19 pandemic on adult diagnostic neuroradiology in Europe

2021 ◽  
Author(s):  
Marion Smits ◽  
M. W. Vernooij ◽  
N. Bargalló ◽  
A. Ramos ◽  
T. A. Yousry
Keyword(s):  
Online Courses ◽  
Mental Wellbeing ◽  
Personal Protection Equipment ◽  
Work Training ◽  
Healthcare Crisis ◽  
Area Of Concern ◽  
Media Channels ◽  
The Impact ◽  
Second Wave ◽  
Diagnostic Neuroradiology

Abstract Purpose The purpose of this survey was to understand the impact the Covid-19 pandemic has or has had on the work, training, and wellbeing of professionals in the field of diagnostic neuroradiology. Methods A survey was emailed to all ESNR members and associates as well as distributed via professional social media channels. The survey was held in the summer of 2020 when the first wave had subsided in most of Europe, while the second wave was not yet widespread. The questionnaire featured a total of 46 questions on general demographics, the various phases of the healthcare crisis, and the numbers of Covid-19 patients. Results One hundred sixty-seven responses were received from 48 countries mostly from neuroradiologists (72%). Most commonly taken measures during the crisis phase were reduction of outpatient exams (87%), reduction of number of staff present in the department (83%), reporting from home (62%), and shift work (54%). In the exit phase, these measures were less frequently applied, but reporting from home was still frequent (33%). However, only 22% had access to a fully equipped work station at home. While 81% felt safe at work during the crisis, fewer than 50% had sufficient personal protection equipment for the duration of the entire crisis. Mental wellbeing is an area of concern, with 61% feeling (much) worse than usual. Many followed online courses/congresses and considered these a viable alternative for the future. Conclusion The Covid-19 pandemic substantially affected the professional life as well as personal wellbeing of neuroradiologists.

Resistant gram-negative bacilli: A neglected healthcare crisis?

2007 ◽  
Vol 64 (23_Supplement_14) ◽  
pp. S3-S21 ◽  
Author(s):  
Ebbing Lautenbach ◽  
Ron E. Polk
Keyword(s):  
Gram Negative ◽  
Healthcare Crisis

Foreign nurse recruitment

2013 ◽  
Vol 21 (1) ◽  
pp. 76-85 ◽  
Author(s):  
A Christine Delucas
Keyword(s):  
Developing Countries ◽  
Social Inequalities ◽  
Cost Effective ◽  
Industrialized Countries ◽  
International Treaty ◽  
Ethical Implications ◽  
Industrialized Nations ◽  
Healthcare Crisis ◽  
Source Countries ◽  
Foreign Nurse

Recruitment of nurses by industrialized nations from developing countries has been common practice for decades. Globalization, a crucial trend of the 21st century, raises the world’s awareness of the economic and social disparities between nations. The direct impact on nurse emigration emphasizes the ethical, economic, and social inequalities between source and destination countries. It is often more cost-effective for industrialized countries to recruit from developing countries; however, the depletion of source country resources has created a global healthcare crisis. Destination countries are being challenged on the ethical implications of aggressive recruitment and their lack of developing a sustainable self-sufficient domestic workforce. Similarly, source countries are confronting the same challenges as they struggle to fund and educate adequate numbers of nurses for domestic needs and emigrant replacement. This article will review the ethical, economic, and social impacts of continued unrestricted international recruitment of nurses and present a proposal for development of an international treaty addressing global sustainability.

scholarly journals Culturally Grounded Scapegoating in Response to Illness and the COVID-19 Pandemic

2021 ◽  
Vol 12 ◽  
Author(s):  
Qian Yang ◽  
Isaac F. Young ◽  
Jialin Wan ◽  
Daniel Sullivan
Keyword(s):  
Healthcare Providers ◽  
The United States ◽  
Single Individual ◽  
Cultural Variation ◽  
Sense Of Control ◽  
Exploratory Investigation ◽  
Individual Doctor ◽  
Healthcare Crisis ◽  
Path Models ◽  
Culture Effects

For years, violence against doctors and healthcare workers has been a growing social issue in China. In a recent series of studies, we provided evidence for a motivated scapegoating account of this violence. Specifically, individuals who feel that the course of their (or their family member's) illness is a threat to their sense of control are more likely to express motivation to aggress against healthcare providers. Drawing on existential theory, we propose that blaming and aggressing against a single individual represents a culturally afforded scapegoating mechanism in China. However, in an era of healthcare crisis (i.e., the global COVID-19 pandemic), it is essential to understand cultural variation in scapegoating in the context of healthcare. We therefore undertook two cross-cultural studies examining how people in the United States and China use different scapegoating responses to re-assert a sense of control during medical uncertainty. One study was conducted prior to the pandemic and allowed us to make an initial validating and exploratory investigation of the constructs of interest. The second study, conducted during the pandemic, was confirmatory and investigated mediation path models. Across the two studies, consistent evidence emerged that, both in response to COVID-related and non-COVID-related illness scenarios, Chinese (relative to U.S.) individuals are more likely to respond by aggressing against an individual doctor, while U.S. (relative to Chinese) individuals are more likely to respond by scapegoating the medical industry/system. Further, Study 2 suggests these culture effects are mediated by differential patterns of primary and secondary control-seeking.

scholarly journals Survival and Pulmonary Injury After Neonatal Sepsis: PD1/PDL1's Contributions to Mouse and Human Immunopathology

2021 ◽  
Vol 12 ◽  
Author(s):  
Eleanor A. Fallon ◽  
Chun-Shiang Chung ◽  
Daithi S. Heffernan ◽  
Yaping Chen ◽  
Monique E. De Paepe ◽  
...  
Keyword(s):  
Neonatal Sepsis ◽  
Intrauterine Infection ◽  
Organ Injury ◽  
Experimental Sepsis ◽  
Neonatal Mice ◽  
Neonatal Lung ◽  
Healthcare Crisis ◽  
Septic Neonate ◽  
Zona Occludens ◽  
The Impact

Morbidity and mortality associated with neonatal sepsis remains a healthcare crisis. PD1−/− neonatal mice endured experimental sepsis, in the form of cecal slurry (CS), and showed improved rates of survival compared to wildtype (WT) counterparts. End-organ injury, particularly of the lung, contributes to the devastation set forth by neonatal sepsis. PDL1−/− neonatal mice, in contrast to PD1−/− neonatal mice did not have a significant improvement in survival after CS. Because of this, we focused subsequent studies on the impact of PD1 gene deficiency on lung injury. Here, we observed that at 24 h post-CS (but not at 4 or 12 h) there was a marked increase in pulmonary edema (PE), neutrophil influx, myeloperoxidase (MPO) levels, and cytokine expression sham (Sh) WT mice. Regarding pulmonary endothelial cell (EC) adhesion molecule expression, we observed that Zona occludens-1 (ZO-1) within the cell shifted from a membranous location to a peri-nuclear location after CS in WT murine cultured ECs at 24hrs, but remained membranous among PD1−/− lungs. To expand the scope of this inquiry, we investigated human neonatal lung tissue. We observed that the lungs of human newborns exposed to intrauterine infection had significantly higher numbers of PD1+ cells compared to specimens who died from non-infectious causes. Together, these data suggest that PD1/PDL1, a pathway typically thought to govern adaptive immune processes in adult animals, can modulate the largely innate neonatal pulmonary immune response to experimental septic insult. The potential future significance of this area of study includes that PD1/PDL1 checkpoint proteins may be viable therapeutic targets in the septic neonate.

scholarly journals Metagenome of SARS-Cov2 patients in Shenzhen with travel to Wuhan shows a wide range of species - Lautropia, Cutibacterium, Haemophilus being most abundant - and Campylobacter explaining diarrhea

2020 ◽  
Author(s):  
Sandeep Chakraborty
Keyword(s):  
Secondary Infection ◽  
Bacterial Species ◽  
Bacterial Load ◽  
San Diego County ◽  
Opportunistic Pathogens ◽  
Sequencing Data ◽  
Familial Cluster ◽  
Chinese Study ◽  
Wide Range ◽  
Initial Results

The metagenome of patients infected with SARS-Cov2 [1] has shown Prevotella to be a key player in immune response [2] in one Chinese study [3], just starting in another [4] and a host of other opportunistic pathogens in a study from San Diego county [5]. The metagenome can also be queried to find host response genes [5], as was done in monkey cells infected with SARS-Cov2 [6]Nanopore sequencing data from a familial cluster in ShenzhenThe patients were tested for 4 bacterial species - Bordetella pertussis, Bordetella parapertussis, Chlamydophila pneumoniae, and Mycoplasma pneumoniae. The sequencing data (Accid:SRR10948474, Nanopore) from five patients in a family cluster from Shenzhen who presented with unexplained pneumonia after returning from Wuhan (Table 1) shows a wide range of bacterial species - Lautropia, Cutibacterium, Haemophilus being most abundant. The presence of Campylobacter explains diarrhea seen in the patient [7,8]. Also, their tests should have detected Mycoplasma, since it is there in the data.Significant bacterial load with some bacterial species predominatingThe bacterial reads are about 20% (95K out of 500K reads). The viral load is also significant here (70K reads) [2]. They are in SI.familial/allsequences.fa. The number of bacterial species (with at least two reads) is 876 (SI.familial/list.allbacteria.txt). Thus, it is important to consider secondary infection, a possible reason why azithromycin (in addition to hydroxychloroquine) has given good initial results in a clinical trial [9].

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