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Copper-based bactericides have appeared as a new tool in crop protection and offer an effective solution to combat bacterial resistance. In this work, two copper nanoparticle products that were previously synthesized and evaluated against major bacterial and fungal pathogens were tested on their ability to control the bacterial spot disease of tomato. Growth of Xanthomonas campestris pv. vesicatoria, the causal agent of the disease, was significantly suppressed by both nanoparticles, which had superior function compared to conventional commercial formulations of copper. X-ray fluorescence spectrometry measurements in tomato leaves revealed that bioavailability of copper is superior in the case of nanoparticles compared to conventional formulations and is dependent on synthesis rather than size. This is the first report correlating bioavailability of copper to nanoparticle efficacy.
Antibacterial Activity of Copper Nanoparticles against Xanthomonas campestris pv. vesicatoria in Tomato Plants
Introduction: Coronavirus Disease 2019 (COVID 19) is a viral illness caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). We report a patient with COVID-19 pneumonia leading to ARDS and subsequent development of an alveolopleural fistula who was successfully treated with multiple endobronchial valves. Case: The Patient was a 55-year-old Hispanic male who presented with 2 days of dry cough and shortness of breath. Vital signs on admission showed an oxygen saturation of 68% on ambient air and respiratory rate of 30 breaths per minute. He was admitted with acute hypoxic respiratory failure and found to have a positive SARS-Cov2 infection. Initial CT chest without contrast showed diffuse bilateral ground-glass opacities. His oxygen requirement increased as well as his work of breathing requiring BiPAP, and subsequent intubation. On the 10th day of admission, he developed a right-sided pneumothorax, requiring chest tube placement. A tracheostomy was completed on day 14 for further ventilator weaning. On day 20, he developed persistent air leak concerning for an alveolopleural fistula, repeat CT chest concerning for a moderate-sized pneumothorax and findings concerning for post ARDS fibrotic lungs. He continued to have persistent air leak but was not deemed to be a surgical candidate hence he was referred for endobronchial valve placement to facilitate chest tube removal and ventilator weaning. Bronchoscopy was done on day 41 of admission. Total 6 endobronchial valves were placed (right middle and lower lobes). Over next few days his leak completely resolved. Patient was weaned off of positive pressure a week later to trach collar, and the chest tube was subsequently removed. Discussion: Alveolopleural fistula is a communication or fistula between a alveoli and the pleural space. Patient's with ARDS secondary to COVID-19 requiring high amounts of PEEP and are at higher risk in developing a pneumothorax. Endobronchial valves (EBV) have been used since 2005 to treat alveolopleural and bronchopleural fistula in patients who are not considered a good surgical candidate. This is the first documented use of an EBV in the setting of COVID-19 that we could find. The placement of the valves, allowed a significant reduction in the air leak. This assisted in the patient's breathing trials on the ventilator and tracheostomy collar trials by reducing the overall volume loss through the fistula, ultimately allowing the patient to successfully liberated from the ventilator and have his chest tubes removed.
Use of endobronchial valve to treat covid-19 adult respiratory distress syndrome related alveolopleural fistula
BACKGROUND: The rapid emergence of the COVID-19 pandemic globally collapsed health care organizations worldwide. Incomplete knowledge of best practices, progression of disease, and its impact could result in fallible care. Data on symptoms and advancement of the SARS-CoV-2 virus leading to critical care admission have not been captured or communicated well between international organizations experiencing the same impact from the virus. This led to the expedited need for establishing international communication and data collection on the critical care patients admitted with COVID-19. OBJECTIVE: Developing a global registry to collect patient data in the critical care setting was imperative with the goal of analyzing and ameliorating outcomes. METHODS: A prospective, observational global registry database was put together to record extensive deidentified clinical information for patients hospitalized with COVID-19. RESULTS: Project management was crucial for prompt implementation of the registry for synchronization, improving efficiency, increasing innovation, and fostering global collaboration for valuable data collection. The Society of Critical Care Medicine Discovery VIRUS (Viral Infection and Respiratory Illness Universal Study): COVID-19 Registry would compile data for crucial longitudinal outcomes for disease, treatment, and research. The agile project management approach expedited establishing the registry in 15 days and submission of institutional review board agreement for 250 participating sites. There has been enrollment of sites every month with a total of 306 sites from 28 countries and 64,114 patients enrolled (as of June 7, 2021). CONCLUSIONS: This protocol addresses project management lessons in a time of crises which can be a precept for rapid project management for a large-scale health care data registry. We aim to discuss the approach and methodology for establishing the registry, the challenges faced, and the factors contributing to successful outcomes. TRIAL REGISTRATION: ClinicalTrials.gov NCT04323787; https://clinicaltrials.gov/ct2/show/NCT04323787
Lessons From a Rapid Project Management Exercise in the Time of Pandemic: Methodology for a Global COVID-19 VIRUS Registry Database
This study aimed to evaluate the psychological symptoms of children and adolescents with rheumatological diseases (RD) and their parents during the outbreak. A web-based questionnaire survey was conducted in a cross-sectional design in RD patients and healthy controls. The Hospital Anxiety and Depression Scale was used to evaluate parental psychiatric status; while the State-Trait Anxiety Inventory for Child was used for children. Four hundred and fifty-nine patients with RD and their parents completed the present study, as well as 336 healthy peers. The age and gender of the children were similar across groups. Under 12 years of age, the trait anxiety of the children and the psychological symptoms of parents were similar across groups; while over 13 years of age, anxiety and depression scores of the parents, as well as trait anxiety of the children were higher than the control groups' (7.3 3.4 vs 6.3 3.8, p = 0.006 for parental anxiety; 6.6 3.8 vs. 5.3 3.9, p < 0.001 for parental depression; 36.1 8.7 vs. 33.3 7.9, p = 0.002 for child trait anxiety). In patient group, there were no differences in scale scores according to variables such as rheumatological disease diagnosis, the consulting of doctor for treatment, thinking that RD increases the risk of COVID-19, the history of rheumatic disease attack during the pandemic process, and the use of biological agents. The children's trait anxiety was positively correlated with their parents' anxiety (r = 0.414, p < 0.001) and depression (r = 0.300, p < 0.001) scores. These findings suggest that clinicians should pay attention to the psychiatric symptoms of both children with RD and their parents during the pandemic.
Psychosocial and clinical effects of the COVID-19 pandemic in patients with childhood rheumatic diseases and their parents
BACKGROUND: The COVID-19 pandemic has negatively impacted psychosocial well-being and mental health of students across the world. Although students are vulnerable to depression and suicidal ideation, few studies have been conducted in Uganda. This study aimed to determine the prevalence of depression and suicidal ideation, and associated factors among undergraduate university students in Uganda. METHODS: A cross-sectional study was conducted among undergraduates [N = 540; 363 males; mean age = 23.3 ( 2.64) years] recruited from four universities using an online questionnaire that explored sociodemographic factors, depression, and other associated factors. The Patient Health Questionnaire (PHQ-9) was used to assess depression, and Item 9 was used to assess suicidal ideation in the past 2 weeks. Multivariable logistic regression analyses were performed to determine the factors associated with depression and suicidal ideation. RESULTS: The prevalence of moderate to severe depression was 20% (n = 108) (cut-off: 10/27 based on the PHQ-9), and the prevalence of past-2-week suicidal ideation was 13.89% (n = 75) (cut-off: 1/3 based on the PHQ-9 Item 9). About half of the individuals who screened positive for depression had suicidal ideation. Factors associated with depression were: having relationship issues [adjusted odds ratio (aOR) = 1.79, 95% confidence interval (CI) = 1.13C2.81, p = 0.012], and having a history of sexual abuse (aOR = 2.06, 95% CI = 1.10C3.84, p = 0.023). Factors associated with reducing the risk of depression were: satisfaction with current academic performance (aOR = 0.50, 95% CI = 0.32C0.79, p = 0.003), and being in the fifth year of academic study (aOR = 0.16, 95% CI = 0.03C0.73, p = 0.018). Factors associated with suicidal ideation were: smoking cigarettes and/or marijuana (aOR = 4.83, 95% CI = 1.10C21.12, p = 0.037), and having financial tuition constraints (aOR = 1.85, 95% CI = 1.08C3.16, p = 0.024), However, satisfaction with current academic performance reduced the likelihood of suicidal ideation (aOR = 0.40, 95% CI = 0.23C0.70, p = 0.001). CONCLUSION: Approximately one-fifth of undergraduate university students were moderately to severely depressed, especially those who had relationship issues and those with a history of sexual abuse. Suicidal ideation was common among smokers and those having financial tuition constraints. Therefore, it is recommended that the university authorities implement measures to provide psychological support for the students with problems concerning financial tuition constraints, relationships, and sexual abuse. Also, all students with depression should be screened for suicidality.
Prevalence and Factors Associated With Depression and Suicidal Ideation During the COVID-19 Pandemic Among University Students in Uganda: A Cross-Sectional Study
This study assessed relationships of duration of family Special Supplemental Nutrition Program for Women, Infants and Children (WIC) participation with racial/ethnic disparities in child sugar-sweetened beverage (SSB) and water intake. Child beverage intake and family duration on WIC were collected during three cross-sectional surveys of WIC-participating families in Los Angeles County, California (2014, 2017 and 2020; n = 11,482). The associations of family duration of WIC participation, a proxy for the amount of WIC services received, with daily intake of total SSBs, fruit-flavored SSBs and water were assessed in race/ethnicity strata with multivariable negative binomial and Poisson regression models. Among English-speaking Hispanic children, those of families reporting 10 years of WIC participation consumed 33% and 27% fewer servings of total and fruit-flavored SSBs compared to those of families reporting 1 year on WIC. Among Black children, those from families reporting 5 and 10 years of participation in WIC consumed 33% and 45% more daily servings of fruit-flavored SSBs than those from families reporting 1 year on WIC. Disparities in daily total and fruit-flavored SSB intake between Black and White children increased with longer family duration on WIC. Duration of family WIC participation is associated with healthier beverage choices for infants and children, but does not appear to be equally beneficial across racial/ethnic groups in Los Angeles County.
Longer Participation in the Special Supplemental Nutrition Program for Women, Infants, and Children Is Not Associated with Reduced Sugar-Sweetened Beverage Intake among Black Participants
Diabetes is considered an epidemic of the 21st century. On 11 March 2020, two months after the outbreak of COVID-19 (coronavirus disease of 2019) epidemic in China, the World Health Organization announced COVID-19 to be a pandemic. From that time, many hospitals and wards have started to function as both infectious and non-infectious ones; so did the Diabetes Clinic Institute of Rural Health in South-Eastern Poland. Considering the global importance of diabetes and its prevalence worldwide, it seemed important to investigate how the Diabetes Clinic passed through the individual phases of the pandemic, and the possibility of protecting hospitalized patients against future pandemic infection. We present detailed characteristics of the situation in a ward which used to treat non-infectious patients with diabetes only and, nowadays, has been obliged to take into account the risk of spreading SARS-Cov-2 (severe acute respiratory syndrome coronavirus-2) infection also. Moreover, we suggest solutions to avoid cases of infectious diseases in non-infectious wards in the future.
Is It Possible to Prevent Sars-Cov-2 Infection in a Non-Infectious Diseases Ward during the Pandemic on the Example of a Diabetes Clinic Institute of Rural Health, Lublin, Poland?
BackgroundEffective emergency care (EC) reduces mortality, aids disaster and outbreak response, and is necessary for universal health coverage Surge events frequently challenge Pacific Island Countries and Territories (PICTs), where robust routine EC is required for resilient health systems We aimed to describe the current status, determine priority actions and set minimum standards for EC systems development across the Pacific region
Emergency care status, priorities and standards for the Pacific region: A multiphase survey and consensus process across 17 different Pacific Island Countries and Territories
The COVID-19 pandemic has a significant impact on the routine care of patients with chronic illnesses. Patients with existing conditions such as diabetes, and cardiovascular disease are more susceptible to COVID-19 and are likely to experience more severe illnesses. COVID-19 infection leads to adverse clinical outcomes, more severe disease, higher mortality, and poor prognosis in patients with chronic kidney disease. The patient and caregiver would be in extreme distress with the fear of getting infected from the frequent exposure. The present study attempts to explore the perception of social workers on the psychosocial issues of persons with End-Stage Renal Disease during the COVID-19 pandemic period by using social cognitive theory and the social-ecological model as theoretical frameworks. Our study followed a qualitative design that employed a thematic analysis approach. We conducted in-depth telephonic interviews with six social workers in the nephrology setting. Three theme categories emerged as per data analysis. The first was the social worker's perception of psychosocial issues of patients with End-Stage Renal Disease. The second theme was related to the emerging role of the social worker and the skills acquired during this period and the third theme was the challenges experienced and the resilience of social workers in the nephrology setting. The study shows that patients are in extreme distress as they are more vulnerable to COVID-19 infection and it also highlighted the significance of social work practice in the nephrology setting.
Perception of Social Workers on the Psychosocial Issues of End-Stage Renal Disease Patients during COVID-19: A Qualitative Study
The progressive increase in the amount of glass waste produced each year in the world made it necessary to start the search for new recycling methods. This work summarizes the experimental results of the study on mortar samples containing dispersed reinforcement in the form of glass fibers, fully made from melted glass waste (bottles). Mortar mixes were prepared according to a new, laboratory-calculated recipe containing glass fibers, granite as aggregate, polycarboxylate-based deflocculant and Portland cement (52.5 MPa). This experimental work involved three different contents (600, 1200, and 1800 g/m(3)) of recycled glass fibers. After 28 days, the mechanical properties such as compressive, flexural, and split tensile strength were characterized. Furthermore, the modulus of elasticity and Poisson coefficient were determined. The initial and final setting times, porosity, and pH of the blends were measured. Images of optical microscopy (OM) were taken. The addition of glass fibers improves the properties of mortar. The highest values of mechanical properties were obtained for concrete with the addition of 1800 g/m(3) of glass fibers (31.5% increase in compressive strength, 29.9% increase in flexural strength, and 97.6% increase in split tensile strength compared to base sample).
Mechanical and Material Properties of Mortar Reinforced with Glass Fiber: An Experimental Study
The last decades have brought important insight and updates in the diagnosis, management and immunopathology of female genital schistosomiasis (FGS) and male genital schistosomiasis (MGS). Despite sharing a common parasitic aetiological agent, FGS and MGS have typically been studied separately. Infection with Schistosoma haematobium manifests with gender-specific clinical manifestations and consequences of infection, albeit having a similar pathogenesis within the human genital tract. Schistosoma haematobium is a known urinary bladder carcinogen, but its potential causative role in other types of neoplasia, such as cervical cancer, is not fully understood. Furthermore, the impact of praziquantel treatment on clinical outcomes remains largely underexplored, as is the interplay of FGS/MGS with relevant reproductive tract infections such as HIV and Human Papillomavirus. In non-endemic settings, travel and immigrant health clinics need better guidance to correctly identify and treat FGS and MGS. Our review outlines the latest advances and remaining knowledge gaps in FGS and MGS research. We aim to pave a way forward to formulate more effective control measures and discuss elimination targets. With a growing community awareness in health practitioners, scientists and epidemiologists, alongside the sufferers from these diseases, we aspire to witness a new generation of young women and men free from the downstream disabling manifestations of disease.
An update on female and male genital schistosomiasis and a call to integrate efforts to escalate diagnosis, treatment and awareness in endemic and non-endemic settings: The time is now.
Background: Increased exercise and physical activity levels are recommended throughout cancer therapy and survivorship. Nonetheless, the COVID-19 pandemic and consequent social distancing are likely to cause a decline in physical activity. Objective: to evaluate the level of unsupervised physical activity of breast cancer survivors during the COVID-19 pandemic, and the factors associated with difficulties in engaging and maintaining recommended physical activity levels. Methods: This is a cross-sectional epidemiological study with a sample of 37 breast cancer survivors. They participated in a canoeing training program (project Remama) at the University of S?o Paulo before the COVID-19 pandemic. Socioeconomic aspects, engagement in physical activity, motivation, and potential exposure to COVID-19 were investigated through an online survey, administered in September of 2020. Results: During the pandemic, participants increased their body weight (5 3.4 kg); 90% reported decreasing physical activity levels associated with increased sedentary time. Twenty-one (58%) participants exhibited some COVID-19-related symptoms, most used public transportation (59%), or returned to work during the period of a high incidence of COVID-19. The only factor associated with perceived difficulty in engaging in physical activities was having had more than three cancer treatments (RR: 2.14; 95% CI: 1.07C4.27). Conclusion: The COVID-19 pandemic led to a group of previously active breast cancer survivors to decrease their physical activity, gain weight, and have sedentary behavior. Specific tailored-care interventions are needed to prevent these occurrences, as overweight and physical inactivity may impose an additional risk for breast cancer recurrence and a severe course of COVID-19 in cancer patients.
Determinants of Health and Physical Activity Levels Among Breast Cancer Survivors During the COVID-19 Pandemic: A Cross-Sectional Study
BACKGROUND: Regional variation in lung transplantation practices due to local coronavirus disease 2019 (COVID-19) prevalence may cause geographic disparities in access to lung transplantation. METHODS: Using the United Network for Organ Sharing registry, we conducted a descriptive analysis of lung transplant volume, donor lung volume, new waitlist activations, and waiting list deaths at high-volume lung transplant centers during the first 3 months of the pandemic (March 1. 2020, to May 30, 2020) and we compared it to the same period in the preceding 5 years. RESULTS: Lung transplant volume decreased by 10% nationally and by a median of 50% in high COVID-19 prevalence centers (range -87% to 80%) compared with a median increase of 10% (range -87% to 80%) in low prevalence centers (P-for-trend 0.006). Donation services areas with high COVID-19 prevalence experienced a greater decrease in organ availability (-28% range, -72% to -11%) compared with low prevalence areas (+7%, range -20% to + 55%, P-for-trend 0.001). Waiting list activations decreased at 18 of 22 centers. Waiting list deaths were similar to the preceding 5 years and independent of local COVID-19 prevalence (P-for-trend 0.36). CONCLUSIONS: Regional variation in transplantation and donor availability in the early months of the pandemic varied by local COVID-19 activity.
Geographic Differences in Lung Transplant Volume and Donor Availability During the COVID-19 Pandemic
BACKGROUND: First-line health professionals are uniquely positioned to recognise suicidal behaviours in patients. However, the opportunities are often missed or poorly managed. Self-confidence and knowledge of suicide prevention and assessment by health professionals can lead to prompt recognition and management of at-risk individuals. This study evaluates the first-line health professionals self-confidence and knowledge of suicide assessment in Nelson Mandela Bay Municipality (NMBM), South Africa. METHODS: A cross-sectional study was conducted in six healthcare facilities across NMBM between January 2020 and March 2020. Five hundred first-line healthcare professionals were recruited to respond to a validated self-administered questionnaire to collect demographic characteristics, self-confidence levels and knowledge of suicide assessment and associated factors. RESULTS: A total of 344 first-line health professionals completed the questionnaire (68.8% response rate); 40% of the respondents work in emergency units and 77.3% reported frequent encounters with patients who attempted suicide. Most participants had not received suicide assessment training during their undergraduate or postgraduate years (59.6% and 81.1%, respectively). They also lacked adequate knowledge and self-confidence in suicide assessment. Younger age, minimal work experience and attendance of two or more hours of suicide prevention training were associated with higher knowledge of suicide assessment. CONCLUSION: Findings revealed gaps in self-confidence and knowledge of suicide management, attributed to lack of training in suicide management. Health authorities should prioritise upskilling of front-line workers in suicide prevention and assessment, specifically targeting older nurses in the region.
Self-confidence and knowledge of suicide assessment and prevention amongst first-line health professionals in Nelson Mandela Bay, South Africa
INTRODUCTION: Diabetic ketoacidosis (DKA) is an acute complication associated with poorly managed or undiagnosed diabetes. DKA is associated with significant morbidity, mortality, and healthcare costs, but can be prevented with appropriate management of diabetes. The FreeStyle Libre is flash glucose monitoring device that measures glucose levels in the interstitial subcutaneous tissue and has been shown to reduce HbA1c, time in hypoglycemia and hyperglycemia, as well as improve health-related quality of life. METHODS: A retrospective chart review of patients with type 1 diabetes mellitus (T1DM) and recurrent DKA and who initiated FreeStyle Libre (Abbott Diabetes Care, Alameda, CA, USA) was conducted. DKA frequency and severity, glycated hemoglobin (HbA1c), and frequency of blood glucose monitoring were compared between the 2-year period before FreeStyle Libre initiation and the 2-year period after FreeStyle Libre initiation. RESULTS: A total of 47 patients with T1DM with recurrent DKA were included. FreeStyle Libre was associated with a reduction in the frequency of DKA events, with a mean of 0.2 (standard deviation [SD] 0.4) events per person during the 2 years after FreeStyle Libre initiation versus 2.9 (SD 0.9) during the 2 years before FreeStyle Libre initiation. Severity of DKA events was also reduced, with fewer severe (before mean 0.3 [SD 0.5] versus after 0.0 [SD 0.0]; p < 0.001) DKA events. A reduction in HbA1c (mean 7.4% [SD 0.5] after versus 9.9% [SD 1.2] before [p < 0.001]) and an increase in frequency of blood glucose testing (mean 8.1 scans/day [SD 1.7] after versus 2.2 finger-pricks/day [SD 0.7] at before [p < 0.001]) were also observed. CONCLUSION: FreeStyle Libre is associated with a reduction in the frequency and severity of DKA events, reduction in HbA1c, and increase in frequency of blood glucose testing in patients with T1DM and recurrent DKA. The use of such a glucose monitoring tool can help to reduce the burden of morbidity, mortality, and healthcare costs associated with complications of diabetes.
Frequency of Diabetic Ketoacidosis in Patients with Type 1 Diabetes Using FreeStyle Libre: A Retrospective Chart Review
Following the outbreak of what would become the COVID-19 pandemic, social distancing measures were quickly introduced across East Asia-including drastic shelter-in-place orders in some cities-drawing on experience with the outbreak of severe acute respiratory syndrome (SARS) almost two decades ago. "Smart City" technologies and other digital tools were quickly deployed for infection control purposes, ranging from conventional thermal scanning cameras to digital tracing in the surveillance of at-risk individuals. Chatbots endowed with artificial intelligence have also been deployed to shift part of healthcare provision away from hospitals and to support a number of programmes for self-management of chronic disease in the community. With the closure of schools and adults working from home, digital technologies have also sustained many aspects of both professional and social life at a pace and scale not considered to be practicable before the outbreak. This paper considers how these new experiences with digital technologies in public health surveillance are spurring digitalization in East Asian societies beyond the conventional public health context. It also considers some of the concerns and challenges that are likely to arise with rapid digitalization, particularly in healthcare.
Heralding the Digitalization of Life in Post-Pandemic East Asian Societies
OBJECTIVES To evaluate the methodological quality and thematic completeness of existing clinical practice guidelines, addressing early mobilization of adults in the ICU. DATA SOURCES Systematic review of Medline, Embase, CINAHL, Cochrane, and grey literature from January 2008 to February 2020. STUDY SELECTION Two reviewers independently screened titles and abstracts and then full texts for eligibility. Ten publications were included. DATA EXTRACTION A single reviewer extracted data from the included publications and a second reviewer completed cross-checking. Qualitative data were extracted in five categories relating to the key factors influencing delivery of early mobilization to critically ill patients. DATA SYNTHESIS Methodological quality was appraised using the Appraisal of Guidelines for Research and Evaluation II tool. Appraisal of Guidelines for Research and Evaluation II scores for applicability were low. Median quality scores for editorial independence, rigor of development, and stakeholder engagement were also poor. Narrative synthesis of publication content was undertaken. All publications supported implementation of early mobilization. Most documents agreed upon seven topics: 1) early mobilization is safe and may reduce healthcare costs, 2) safety criteria should be provided, 3) a protocolized or structured approach should be used, 4) collaborative teamwork is required, 5) staff require specific skills or experience, 6) patient and family engagement is important, and 7) program evaluation and outcome measurement are a key component of implementation. There was no consensus on dosage and patient selection. The areas of team culture and leadership were poorly addressed. CONCLUSIONS Despite significant variation in the methodological quality of clinical practice guidelines for early mobilization, there were important consistencies in recommendations internationally. Future research should address gaps related to patient selection, dosage, team culture, and expertise. Future clinical practice guidelines in this area should focus on engagement of patients and families in the development process and provision of resources to support implementation based on the consideration of known barriers and facilitators.
Clinical Practice Guidelines for Early Mobilization in the ICU: A Systematic Review.
There is increasing evidence of sex differences in the action of anti-inflammatory drugs, with women being at significantly higher risk of adverse effects Nevertheless, clinicians awareness of the implications of these sex differences on dosing and adverse event monitoring in routine practice is still in need of improvement We reviewed the literature evaluating sex differences in terms of pharmacokinetics and pharmacodynamics of anti-inflammatory drugs The anti-thrombotic activity of selective and non-selective COX-inhibitors tends to be stronger in men than women Side effect profiles differ with regards to gastro-intestinal, renal and hepatic complications Glucocorticosteroids were found to be more effective in men;women were more sensitive to corticosteroids when their oestradiol levels were high, a finding important for women taking hormonal contraception TNF-alpha inhibitors have a longer half-life in men, leading to stronger immunosuppression and this a higher incidence of infections as side effects Although research on sex differences in the effectiveness and safety of drugs is increasing, findings are often anecdotal and controversial There is no systematic sex-differentiated reporting from clinical trials, and women are often under-represented As personalized medicine is gaining in importance, sex, and gender aspects need to become integral parts of future research and policy making
Sex-related differences in drugs with anti-inflammatory properties
BACKGROUND: Type 2 diabetes mellitus patients complicated with infections experience severe vitamin D deficiency. High-dose vitamin D is applied to the treatment of corona virus disease 2019 (COVID-19) by some researchers, and good results have been achieved. However, the efficacy of vitamin D in the treatment of infections in COVID-19 patients with diabetes remains unclarified. This study aims to explore the effect of oral high-dose vitamin D in the treatment of diabetic patients with COVID-19. METHODS: Randomized controlled trials about the application of high-dose vitamin D in the treatment of diabetic patients with COVID-19 will be retrieved from such electronic databases as Embase, PubMed, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure database, Chinese Wanfang database and Chinese Biomedical Literature database. The retrieval time is from their inception to December 2020. According to the pre-designed inclusion/exclusion criteria, the data will be extracted independently by two researchers. The risk of bias of the included studies will be assessed by the Cochrane collaboration's tool. Meta-analysis will be conducted by using Revman 5.3 software. RESULTS: A high-quality and comprehensive evaluation of oral high-dose vitamin D for the treatment of diabetic patients with COVID-19 will be made. CONCLUSION: The article will provide more convincing evidence and evidence-based guidance for clinical practice. ETHICS AND DISSEMINATION: The private information of individuals will not be made public, and this systematic evaluation will also not infringe on the rights of participants. Ethical approval is not required. Research results may be published in a peer-reviewed journal or disseminated in relevant conferences. PROSPERO REGISTRATION NUMBER: CRD42020214284.
Oral high dose vitamin D for the treatment of diabetic patients with COVID-19: A protocol for systematic review and meta-analysis
Background: Cross-reactivity against human coronaviruses with Flebogamma? DIF and Gamunex?-C, two available intravenous immunoglobulins (IVIG), has been reported. In this study, these IVIG were tested for neutralization activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), SARS-CoV and Middle East respiratory syndrome CoV (MERS-CoV). Materials & methods: Neutralization capacity of lots of IVIG manufactured prior to COVID-19 pandemic was assessed against these viruses in cell culture. Infectivity neutralization was quantified by percent reduction in plaque-forming units and/or cytopathic/cytotoxic methods. Results: All IVIG preparations showed neutralization of SARS-CoV-2 isolates. All IVIG lots produced neutralization of SARS-CoV. No IVIG preparation showed significant neutralizing activity against MERS-CoV. Conclusion: The tested IVIG contain antibodies with significant in vitro cross-neutralization capacity against SARS-CoV-2 and SARS-CoV, but not MERS-CoV. These preparations are currently under evaluation as potential therapies for COVID-19.
Cross-neutralization activity against SARS-CoV-2 is present in currently available intravenous immunoglobulins