The immune response to breast implants after COVID-19 disease or COVID-19 vaccine administration includes acute inflammatory manifestations, capsular contracture and seroma. Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a very rare tumor in which numerous up-regulated pro-inflammatory immunological pathways activate a T cell lymphoproliferative disorder.The first reported case of a BIA-ALCL hidden mass clinically manifesting with inflammatory signs after SARS-CoV-2 infection and vaccinations is here described.Complete capsulectomy and adjuvant chemotherapy were performed and immediately after the surgical procedure local inflammatory signs disappeared; no evidence of disease was present 1 year later.Immunological stimulation by COVID-19 disease and vaccines may highlight some rare clinical manifestations of BIA-ALCL; persistent inflammatory symptomatology over breast implants should be investigated using second-level imaging.This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Shortly after the advent of severe acute respiratory syndrome and the avian influenza, the emergence of the influenza A(H1N1)2009 pandemic caused significant vibrations to the public health authorities and stressed the health systems worldwide. We sought to investigate whether this experience has altered our knowledge and our current and future practice on the management of severe acute respiratory infections (SARI) and community-acquired pneumonia.A changing epidemiology was demonstrated, with obesity and pregnancy beyond established risk groups for influenza A, other clinical syndromes beyond primary viral pneumonia, possible coinfections by other viral beyond bacterial pathogens and a disappointing performance of all available severity assessment tools. On the treatment topic, accumulating evidence suggesting worse outcomes argues against the use of corticosteroids, but some noninvasive ventilating modalities require further assessment.The recent influenza A(H1N1)2009 pandemic has highlighted our weaknesses relating to the diagnosis and assessment of severity of SARI, compromising early treatment and ultimate outcomes; further research based on this experience will help to improve prognosis and boost our future preparedness. An important message is the necessity of international collaboration for the rapid dissemination of locally acquired knowledge.
COVID-19 has compromised and disrupted sexual and reproductive health (SRH) across multiple dimensions: individual-level access, health systems functioning, and at the policy and governance levels. Disruptions to supply chains, lockdown measures and travel restrictions, and overburdened health systems have particularly affected abortion access and service provision. The pandemic, rather than causing new issues, has heightened and exposed existing fractures and fissures within abortion access and provision. In this viewpoint, we draw on the concept of “structural violence” to make visible the contributing causes of these ruptures and their inequitable impact among different groups.
Background: Coronavirus disease 2019 (COVID-19) is a serious emerging public health issue and it has been identified as a major risk to human health in 2020. Egypt has more than 100 million population, of whom in poor economic conditions and with low education levels could be vulnerable to COVID-19 infection. Physicians are at the frontiers in battles against the emergence, spread, and control of COVID-19 pandemic. Research data are needed to develop evidence-based strategies to prepare health care systems to deal with the current epidemic. Aim: The aim of this study is to assess the level of knowledge and attitudes to COVID-19 pandemic among a group of Egyptian physicians. Methods: From March 15th to March 25th, 2020, we conducted a cross-sectional online survey using non-probability accessibility sampling technique. The structured questionnaire was distributed online through E-mails and social networks to identify the knowledge and attitude among a group of Egyptian physicians regarding COVID-19 pandemic. Result: The study included 256 physicians. Of the participants, 48% were males 49.6% were females. The mean of total score was (19.6±2.3) out of 23 gained mainly from the social media (50.7%). About 67% of the participants heard of Coronaviruses before this pandemic, 78.5% identified other Coronaviruses. All the participants correctly identified the incubation period and 81.6% correctly identified the typical clinical symptoms. Most of the participants (97.6%) could estimate the fatality of COVID-19. Approximately 95% of the respondents knew no vaccination and 88% correctly answered that no current specific treatment for COVID-19 available. Almost all 98% of the participants knew the recommended general infection control precautions. Most of the participants showed positive attitude, about (97%) agreed that health care workers must avail themselves of all information about the COVID-19. Conclusion: The finding of this survey indicating that, faced with the COVID-19 pandemic, this studied group of Egyptian physicians showed positive attitude and satisfactory knowledge about emerging COVID-19 infection. Recommendations: Although the Egyptian Ministry of Health (MOH) has taken several major steps to prepare the health care system to be ready dealing with COVID-19 pandemic, it is important to develop educational programs to ensure continuous updated knowledge of the physicians.
AbstractCOVID-19 pandemic has burdened healthcare systems, necessitating the development of mortality prediction scores to guide clinical decisions and resource allocation. 4C ISARIC mortality score was developed and validated on a British cohort.ObjectivesExternal validation of the score in the setting of a large Saudi Arabian ICU.MethodRetrospective chart review of COVID-19 patients admitted to ICU of King Saud Medical City, Riyadh, Saudi Arabia. Collecting data to calculate the score, then fitting a ROC curve against known patients’ outcome.ResultsCohort included 1493 patients with 38% mortality, AUC of the score was 0.81 (95% CI: 0.79 – 0.83, p < 0.001), correctly classifying 72.67% of the cohort. Cut-off value of > 9 had sensitivity of 70.5% (95% CI: 66.6 – 74.3), specificity 73.97% (95% CI: 71 – 76.8), positive predictive value 62.4% (95% CI: 59.5 – 65.2), and negative predictive value 80.2% (95% CI: 78.2 – 82.4).Conclusion4C ISARIC mortality risk score performed well with a good discriminatory ability for critically ill patients admitted to ICU in our setting. Cut-off > 9 was the optimal criterion.
Salah satu persoalan yang meresahkan adalah munculnya infodemi yang dianggap WHO sama berbahayanya dengan pandemi. Infodemi adalah keberlimpahan informasi terkait pandemi yang justru menimbulkan berbagai bentuk kekacauan informasi seperti misinformasi, disinformasi, dan malinformasi. Tenaga pengajar atau Guru, adalah bagian dari dunia akademis yang memilki peranan penting dalam menyampaikan pesan dan informasi. sangatlah penting bagi tenaga pengajar (guru) untuk memiliki Literasi digital yang valid dan beragam untuk menghindarkan guru dari bagian yang ikut menyebarkan misinformasi mengenai covid 19 ini. Tujuan dari penelitian ini adalah untuk mengetahui Sikap Tenaga Pengajar (Guru) tingkat SMP dan SMA di Kota Bengkulu dalam menghadapi gempuran informasi pandemi covid 1 serta bekal literasi digital para guru dalam menghadapi disinfodemi yang beredar. Metode pengkajian yang digunakan dalam penelitian ini adalah pendekatan kualitatif. Sedangkan tipe penelitian ini menggunakan tipe deskriptif kualitatif. Lokasi penelitian dilakukan di Kota Bengkulu dengan subjek penelitian adalah para guru SMP dan SMA di Lingkungan Kota Bengkulu dengan informan berjumlah 13 orang. Data dikumpulkan melalui dua cara yaitu wawancara mendalam terhadap subjek penelitian dan pengisian formulir survey dari google form. Hasil penelitian menunjukkan bahwa para guru tingkat SMP dan SMA di Kota Bengkulu, sudah memiliki kesadaran akan pentingnya Literasi Digital dan sudah melakukan Cek Ulang kebenaran infromasi yang diterima mengenai pandemi covid 19 melalui media digital online maupun berkonsultasi langsung dengan tenaga kesehatan yang ada di sekitarnya. Mereka juga secara aktif menjadi penyaring bagi lingkungan keluarganya atas berita yang tersebar yang beum tentu kebenarannya
Kata Kunci : Infodemi, literasi digital, Tenaga pengajar, Guru
Item does not contain fulltext To meet surge capacity and to prevent hospitals from being overwhelmed with COVID-19 patients, a regional crisis task force was established during the first pandemic wave to coordinate the even distribution of COVID-19 patients in the Amsterdam region. Based on a preexisting regional management framework for acute care, this task force was led by physicians experienced in managing mass casualty incidents. A collaborative framework consisting of the regional task force, the national task force, and the region's hospital crisis coordinators facilitated intraregional and interregional patient transfers. After hospital admission rates declined following the first COVID-19 wave, a window of opportunity enabled the task forces to create, standardize, and optimize their patient transfer processes before a potential second wave commenced. Improvement was prioritized according to 3 crucial pillars: process standardization, implementation of new strategies, and continuous evaluation of the decision tree. Implementing the novel "fair share" model as a straightforward patient distribution directive supported the regional task force's decisionmaking. Standardization of the digital patient transfer registration process contributed to a uniform, structured system in which every patient transfer was verifiable on intraregional and interregional levels. Furthermore, the regional task force team was optimized and evaluation meetings were standardized. Lines of communication were enhanced, resulting in increased situational awareness among all stakeholders that indirectly provided a safety net and an improved integral framework for managing COVID-19 care capacities. In this article, we describe enhancements to a patient transfer framework that can serve as an exemplary system to meet surge capacity demands during current and future pandemics.
Healthcare workers are on the front lines of COVID-19 pandemic. Nurses and medical doctors have been the most exposed population. From all specialties involved in dealing with SARS-CoV2 disease, some of them seem to be more exposed than the others. From all specialties, infectious diseases, anesthesiology, emergency medicine, dentists and ophthalmology doctors, were at greatest risk of contracting COVID-19. Dentists have lived with the fear of self-contamination and transmission of the virus, as well as taking the risk of neglecting emergencies and chronic pathologies, or prosthetic work postponed, due to the pandemic, which drastically reduced the number of interventions. The SARS-Cov2 pandemic generated a new problem within the first three months of 2021, apart from the one created by the disease itself: allergic reactions, even fatal, that occured after the COVID-19 vaccination. Could dental practices add, under these circumstances, a supplemental risk for the newly vaccinated COVID-19, this is the main question we need to answer.
descriptionPublicationkeyboard_double_arrow_right Article 2021 Catalan; Valencian Universitat Oberta de Catalunya
Authors: Jacob González; Tamara Vázquez;
Jacob González; Tamara Vázquez;
La crisis de la COVID-19 ha tenido repercusiones tanto en la sociedad española como en sus instituciones. Es el caso del Congreso de los Diputados, obligado a adaptar su funcionamiento a la situación de la pandemia, lo cual afecta, en consecuencia, al trabajo de los medios tradicionales, encargados de cubrir la actividad parlamentaria. En este contexto, en el que la información es clave, las redes sociales pasan a adoptar un rol fundamental como canal de comunicación social. Esta investigación estudia la comunicación online de la Cámara Baja desde el 10 de marzo de 2020, con el anuncio de la suspensión de la actividad parlamentaria, hasta el 30 de abril, cuando se ultima el proceso de desescalada. El objetivo principal consistía en conocer qué utilización ha hecho el Congreso de sus redes sociales: Facebook y Twitter, durante este periodo de crisis, al tiempo que se valora la reacción que dichos contenidos han generado en la comunidad de usuarios. Tal y como se demuestra en este artículo, el Congreso de los Diputados no consigue poner en marcha una comunicación a la altura del estado de crisis que generó la COVID-19.
PT Raja Indonesia Perkasa is engaged in the manufacturing industry in the textile sector by producing equipment and wholesale trade in household appliances and furniture trying to evaluate the company's performance. The purpose of this study was to determine the evaluation of the strategy according to the vision and mission applied to PT Raja Indonesia Perkasa using the balanced scorecard concept. Strategy evaluation in the company is useful for assessing the performance of a company, knowing the company's position in an effort to achieve its goals. The increasingly fierce competition in the 21st century and the economic turmoil during the global pandemic due to Covid-19 require PT Raja Indonesia Perkasa as a company that also carries out exports and imports to stay afloat. Descriptive quantitative research methodology with two sources of primary and secondary data. Data processing method using Balanced Scorecard analysis. The researcher chose this method because, from a subjective point of view, the researcher saw the success of the business run by the company PT Raja Indonesia Perkasa which is getting more and more enthusiasts or consumers in the midst of fierce competition in the business world that is happening today. The results of this study indicate that the indicators for measuring the performance of the financial perspective are the best with a score of 145,06%, followed by the customer perspective on average 55% said to be good, the business perspective on average 31.19% said to be good, growth and learning an average of 2.4% is said to be less good.
We model a society with two types of citizens: healthy and vulnerable individuals. While both types can be exposed to the virus and contribute to its spread, the vulnerable people tend to be more cautious as being exposed to the virus can be fatal for them due to their conditions, e.g., advanced age or prior medical conditions. We assume that both types would like to participate in in-person social activities as freely as possible and they make this decision based on the total number of infected people in the society. In this model, we assume that a local governmental authority imposes and administers social distancing regulations based on the infection status of the society and revises it accordingly in each time period. We model and solve for the steady state in four scenarios: (i) non-cooperative (Nash), (ii) cooperative, (iii) egoistic, and (iv) altruistic. The results show that the Altruistic scenario is the best among the four, i.e., the healthy citizens put the vulnerable citizens' needs first and self-isolate more strictly which results in more flexibility for the vulnerable citizens. We use a numerical example to illustrate that the Altruistic scenario will assist with pandemic control for both healthy and vulnerable citizens in the long run. The objective of this research is not to find a way to resolve the pandemic but to optimally live in a society which has been impacted by pandemic restrictions, similar to what was experienced in 2020 with the spread of COVID-19.
ABSTRACT A significant cyclic sesquiterpenoid known as Zerumbone was extracted from Zingiber roseum using the volume liquid chromatographic (VLC) technique. It’s a naturally occurring phytochemical having a variety of physiological properties, including antioxidant, anti-ulcer, and antiproliferative action. This study's major goal was to evaluate Zerumbone's anti-inflammatory effectiveness against the inflammation receptors-Secretory Phospholipase A2 (sPLA2), Cyclooxygenase-2 (COX-2), Tumor Necrosis Factor (TNF-alpha), and Inducible Nitric Oxide Synthase 4 using various in-silico methods. The targeted receptors were obtained from Protein Data Bank, and the ligand was accessed in the Pubchem database. Utilizing the Autodock PyRx platform, which supports Autodock Vina, molecular docking was carried out. Even in the computational prediction, it was revealed that this substance was non-toxic. Receptors exhibiting the highest binding affinity for our ligand were further investigated using molecular dynamics (MD) simulations with WebGRO, CABS-flex, and iMODS web servers. The molecular docking outcomes showed that our ligand molecule exhibited the highest binding affinity for the sPLA2 receptor. MD simulation studies also showed good leads to sPLA2. In conclusion, our outcomes suggest that Zerumbone is an important inhibitor of sPLA2 and might be further utilized as a potential anti-inflammatory agent. Keywords: Zerumbone, Inflammation, Docking, QSAR, ADMET, MD Simulation References Harvey, A., Strategies for discovering drugs from previously unexplored natural products. Drug discovery today, 2000. 5(7): p. 294-300. Bakhotmah, B.A. and H.A. Alzahrani, Self-reported use of complementary and alternative medicine (CAM) products in topical treatment of diabetic foot disorders by diabetic patients in Jeddah, Western Saudi Arabia. BMC Research Notes, 2010. 3(1): p. 1-8. 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Funding: Canadian Institute for Advanced Research. In this paper, we analyse the conditions under which the COVID‐19 pandemic will lead either to social order (adherence to measures put in place by authorities to control the pandemic) or to social disorder (resistance to such measures and the emergence of open conflict). Using examples from different countries (principally the United Kingdom, the United States, and France), we first isolate three factors which determine whether people accept or reject control measures. These are the historical context of state‐public relations, the nature of leadership during the pandemic and procedural justice in the development and operation of these measures. Second, we analyse the way the crisis is policed and how forms of policing determine whether dissent will escalate into open conflict. We conclude by considering the prospects for order/disorder as the pandemic unfolds. Publisher PDF Peer reviewed
The usage of antivirals According to The Norwegian Drug Wholesales Statistics Database, the sales of antiviral drugs measured in defined daily doses (DDDs) were reduced in 2021, after several years of increase. This reduction was primarily due to a small decrease in sales of antivirals against HIV, which make up a large proportion of the antiviral drugs sold in Norway. There was no decrease in the number of people being treated with HIV drugs compared to previous years, but as a growing proportion of patients is treated with single tablet regimens, the number of drugs sold is reduced. When looking at the number of persons treated with antiviral drugs, the antiviral treatment received by the highest number of patients are drugs used against herpes viruses. In 2021, the sale of antivirals against herpes virus, especially valaciclovir, increased even further. There was a decrease in the sales of agents against hepatitis C and influenza, while treatments for hepatitis B were unchanged. Influenza virus Similar to the previous influenza season, the season of 2021/2022 was also unusual, mainly due to the infection control measures implemented in response to the pandemic. There was a very low incidence of influenza at the beginning of the season, followed by a short period with significant spread of infection during the spring of 2021. No drug resistance against neuraminidase inhibitors was detected, but a mutation conferring resistance to the new drug baloxavir marboxil was found in one sample. Human immunodeficiency virus-1 The decreasing trend in the number of new HIV-infections has continued in 2021, which is also reflected in a reduction in the number of samples received for surveillance of primary drug resistance. A total of 64 samples were analysed as part of the surveillance in 2021, and only 13 of these were from patients infected in Norway. For the first time, we have been able to classify cases according to site of residence at the time of infection. Among those living in Norway at the time of infection, as much as 88% of the cases reported to MSIS were also reported to RAVN. This indicates that national routines for follow-up of newly diagnosed patients with regard to antiviral resistance are good. Resistance mutations were detected in 11% of the examined samples, which is comparable to previous years. In 2021, only mutations affecting reverse transcriptase inhibitors and none affecting protease inhibitors were found. Hepatitis B virus In 2021, a total of 134 samples with hepatitis B virus (HBV) were analysed for resistance mutations. Most of these samples (n=117) had been submitted to the reference laboratory for genotyping prior to treatment. These samples constitute the Norwegian surveillance of primary resistance. The remaining 17 samples were from patients with ongoing antiviral treatment and were submitted for investigation of resistance as a possible cause of treatment failure. Relevant resistance mutations were found in five of the 17 samples from patients with treatment failure. No resistance mutations were found in any of the surveillance samples. Human herpes viruses: Cytomegalovirus In 2021, 19 samples were submitted for resistance testing at the reference laboratory for cytomegalovirus (CMV). Relevant resistance mutations were detected in five of these samples. Low or moderate resistance to ganciclovir was found in four of these samples, while moderate resistance to the new drug maribavir was found in one sample. There is no systematic surveillance of resistance in CMV, and the true incidence of drug resistance cannot be determined. Human herpes viruses: Herpes simplex virus In 2021, only five samples with herpes simplex virus (HSV) were analysed for resistance. Two of the samples had mutations conferring resistance to aciclovir. Despite an increase in the use of aciclovir both as treatment and prophylaxis, samples are rarely submitted for resistance testing. Like CMV, there is no systematic surveillance of HSV drug resistance. Hepatitis C virus A systematic surveillance system for newly diagnosed HCV infections was launched in May 2022. In 2021, resistance testing was performed on a limited number of samples submitted for resistance testing. Drug resistance data is cross-referenced with epidemiological data from MSIS to enable comparisons of different subgroups. Resistance associated substitutions were detected in seven out of eight samples analysed for resistance, two of which were from treatment experienced patients, one sample was from a patient with no previous treatment exposure and the remaining four were from patients where treatment exposure was not known. SARS-CoV-2 Surveillance of antiviral resistance in SARS-CoV-2 has not been collected to RAVN in 2021. Oral drugs for the treatment of COVID-19 will be available in Norway from the autumn of 2022, and a system for surveillance of antiviral resistance will probably be implemented from the beginning of 2023. This surveillance will be based on the same sequence data that is part of the national monitoring of variants.
Severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2), the virus strain that causes coronavirus disease 2019 (COVID-19), was first identified in Wuhan, China in December 2019. It spread to several countries across continents and infected more than one million people within three months. While there is no consensus on the treatment of the disease yet, understanding the virus and its transmission is a cardinal priority. SARS-CoV-2 can be transmitted through bodily fluid. Upon inoculation, the surface enzyme angiotensin-converting enzyme 2 (ACE2) acts as a receptor protein for viral entry. The mean incubation period is 5.1 days, and infected individuals can exhibit a variety of symptoms from fever, cough, dyspnea, and respiratory failure to even multiorgan failure. Given the current situation, it is of paramount importance to understand the virus as thoroughly as possible. In this review, we discuss the background, epidemiology, possible pathophysiology, clinical presentation, and diagnostic studies related to SARS-CoV-2 infection. We also elaborate on the current research and evidence on treatment options and vaccine development based on the literature.