Features of α-HBDH in COVID-19 patients with different ages,outcomes and clinical types: a cohort study
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Abstract Background Coronavirus disease-2019 (COVID-19) has spread all over the world and brought extremely huge losses. At present, there is no study to systematically analyse the features of hydroxybutyrate dehydrogenase (α-HBDH) in COVID-19 patients with different ages, clinical types and outcomes. Methods Electronic medical records including demographics, clinical manifestation, α-HBDH test results and outcomes of 131 hospitalized COVID-19 patients, with confirmed result of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral infection, were extracted and analyzed. Results The α-HBDH value in ≥61 years old group, severe group and critical group, death group all increased at first and then decreased, while no obvious changes were observed in other groups. And there were significant differences of the α-HBDH value among different age groups (P<0.001), clinical type groups (P<0.001) and outcome groups (P<0.001). The optimal scale regression model showed that α-HBDH value (P<0.001) and age (P<0.001) were related to clinical type. Conclusions α-HBDH value increases in some COVID-19 patients, obviously in ≥61 years old, death and critical group, indicating that patients in these three groups suffer from more serious tissues and organs damage, higher α -HBDH value and risk of death. The obvious difference between death and survival group in early stage may provide a approach to judge the prognosis. The accuracy of the model to distinguish severe/critical type and other types is 85.84%, suggesting that α-HBDH could judge the clinical type of COVID-19 patients accurately. In brief, α-HBDH is an important indicator to judge the severity and prognosis of COVID-19.Vitamin D deficiency is less common among HIV-infected African–American men than in a matched cohort
The aim of this study was to compare the prevalence of vitamin D sufficiency and deficiency in a HIV-infected cohort of African-American men with that of a general population. We found median vitamin D concentrations were significantly greater in the HIV-infected cohort, 18 ng/ml as compared to the National Health and Nutrition Examination Survey cohort, 14 ng/ml (P ≤ 0.0001). Thus, factors other than measured vitamin D are likely to be responsible for higher rates of bone disease in this population.
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Objectives
To investigate deaths recorded as lung cancer or COPD (as distinct from other non-malignant respiratory disease), in a cohort occupationally exposed to silica.Methods
Vital status and cause of death were ascertained for a cohort of 5115 pottery workers previously followed to 1992. SMRs were calculated for underlying cause of death 1985–2008 compared to reference data from Stoke on Trent. Analysis of ‘mentioned’ cause of death was restricted to 1993–2008. Information on duration of employment and smoking was available for the whole cohort but exposure data were restricted to those included in an earlier validation cohort and those who were still employed in 1981 or later.Results
Of 5115 in the original cohort, 27 were duplicates, 29 were not traced and 258 had died before 1985, leaving 4801, with 1904 deaths. Deaths from lung cancer (N=243) were raised SMR=1.15 (1.01–1.30) as were deaths from COPD (N=158) both as an underlying (SMR=1.46 (1.24–1.71)) and as a ‘mentioned’ (SMR=1.31 (1.14–1.50)) cause. In a survival analysis duration of exposure was not related to deaths recorded as lung cancer or COPD for the cohort as a whole. In those (N=1943) with exposure data, early deaths (before July 1992) from either lung cancer or COPD were related to mean exposure in smokers but this relation was not seen in those dying from these causes in more recent years.Conclusions
Silica exposure appears to have contributed to early, but not recent, deaths although an excess of COPD deaths continues to be recorded.Cite
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Цель – выявить эпидемиологические особенности формирования очагов COVID-19 с распространением в организованных коллективах Хабаровского края в период с апреля по сентябрь 2020 г.
Материалы и методы. В период наблюдения зарегистрирован 31 эпидемический очаг с массовым распространением CОVID-19 в организованных коллективах Хабаровского края. При проведении эпидемиологического анализа учитывался вклад групповой заболеваемости в общую заболеваемость COVID-19, индекс очаговости (среднее число заболевших в очаге), показатели первичной и вторичной (среди контактных лиц) заболеваемости в организованных коллективах в расчете на 1000 лиц, общавшихся в очаге, удельный вес клинических форм инфекции COVID-19, в том числе в зависимости от типа эпидемического очага. Статистическая обработка данных проводилась с использованием методов непараметрического анализа в программе STATISTICA 6.0. На основе установленных критериев активности эпидемического процесса (ЭП) осуществлялась оценка эпидемической значимости различных типов очагов групповой заболеваемости. Для присвоения ранговых номеров критериев применены методики Хи-квадрата Пирсона, Хи квадрата Пирсона с поправкой Йейтса, в отношении средней длительности существования очага использован метод Манна-Уитни.
Результаты и обсуждение. Самая высокая степень активности ЭП наблюдалась при формировании очагов групповой заболеваемости COVID-19 в социальных стационарных учреждениях, которая проявилась наибольшим (средним на 1 очаг) числом заболевших/инфицированных COVID-19, самыми высокими показателями общей и вторичной (то есть среди контактных в очагах) заболеваемости инфекцией и наибольшей длительностью активности ЭП в очагах. К критериям несколько меньшей, но достаточно существенной активности ЭП в очагах, сформированных в медицинских организациях, следует отнести высокий уровень общей заболеваемости COVID-19, приходящийся в среднем на 1 эпидемический очаг, регистрацию заболеваемости среди контактных с первично заболевшими лицами, наличие летальных исходов среди заболевших в очагах, а также большой вклад медицинских работников в общую групповую заболеваемость COVID-19, зарегистрированную в лечебно-профилактических учреждениях края. Меньшая степень активности ЭП COVID-19 выявлена в очагах групповой заболеваемости, зарегистрированных на крупных промышленных предприятиях и в образовательных организациях, для которых оказались не характерными случаи заболеваний среди контактных лиц и летальные исходы среди инфицированных в очагах. Статистически значимо наиболее высокий удельный вес острых респираторно-вирусных инфекций в структуре лиц, заболевших COVID-19, оказался свойственным для очагов с распространением в образовательных коллективах.
Заключение. На основе представленных критериев активности ЭП может быть использован дифференцированный подход к проведению мер профилактики в очагах групповой заболеваемости COVID-19. В коллективах с высоким риском распространения COVID-19, в которых вероятность возникновения вспышечной заболеваемости особенно велика, наиболее оправдан усиленный комплекс постоянно действующих упреждающих мер профилактики новой коронавирусной инфекции.
2019-20 coronavirus outbreak
Pandemic
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Introduction: Vitamin D deficiency has been documented across all age groups and both sexes from India. However, there is paucity of data on vitamin D deficiency in a particular cohort of population. Objectives: To assess the vitamin D status in a cohort of physicians and diabetologists in Kolkata. Material and Methods: An observational cross sectional study carried out in the month of December 2011 in a cohort of 40 physicians and diabetologists in Kolkata. Results: A total of 40 subjects were studied. Mean age of the cohort was 52.22 ± 10.91. Mean serum vitamin D level was 13.02 ± 4.77 ng/ml. Nearly 92.5% and 5.0% of subjects had vitamin D deficiency and insufficiency, respectively. Conclusions: Vitamin D deficiency is highly prevalent in physicians and diabetologists in Kolkata.
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The E3N (Etude Epidémiologique auprès de femmes de la Mutuelle Générale de l'Education Nationale) cohort was initiated in 1990 to investigate therisk factors associated with cancer and other major non-communicable diseases in women. The participants were insured through a national health system that primarily covered teachers, and were enrolled from 1990 after returning baseline self-administered questionnaires and providing informed consent. The cohort comprised nearly 100,000 women with baseline ages ranging from 40 to 65 years. Follow-up questionnaires were sent approximately every 2-3 years after the baseline and addressed general and lifestyle characteristics together with medical events (cancer, cardiovascular diseases, diabetes, depression, fractures and asthma, among others). The follow-up questionnaire response rate remained stable at approximately 80%. A biological material bank was generated and included blood samples collected from 25,000 women and saliva samples from an additional 47,000 women. Ageing among the E3N cohort provided the opportunity to investigate factors related to age-related diseases and conditions as well as disease survival. The new E4N complementary cohort (Epidemiology 4 kNowledge), which comprises the children and grandchildren of the E3N cohort as well as the children's fathers, will allow researchers to investigate key life periods during which exposures to environmental factors most strongly influence the later disease risk. The E3N and E4N cohort data will be used to investigate diseases and risk factors through a transgenerational approach. Requests for collaborations are welcome, particularly those in conjunction with rare diseases.
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ABSTRACT Purpose The Mother and Child Covid-19 study is a cohort recruiting pregnant women and their children in Cantabria, North of Spain, during COVID-19 pandemic in order to ascertain Consequences of SARS-CoV-2 infection on pregnant women and their descendants. This article reports the cohort profile and preliminary results as recruitment is still open. Participants Three sub-cohorts can be identified at recruitment. Sub-cohort 1 includes women giving birth between 23 rd March and 25 th May 2020; they have been retrospectively recruited and could have been exposed to COVID-19 only in their third trimester of pregnancy. Sub-cohort 2 includes women giving birth from 26 th May 2020 on; they are being prospectively recruited and could have been exposed to COVID-19 in both their second and third trimesters of pregnancy. Sub-cohort 3 includes women in their 12 th week of pregnancy prospectively recruited from 26 th May 2020 on; they could have been exposed to COVID-19 anytime in their pregnancy. All women are being tested for SARS-CoV-2 infection using both RT-PCR for RNA detection and ELISA for anti-SARS-CoV-2 antibodies. All neonates are being tested for antibodies using immunochemoluminiscency tests; if the mother is tested positive for SARS-CoV-2 RNA, a naso-pharyngeal swab is also obtained from the child for RT-PCR analysis. Findings to date As of 22 nd October, 1167 women have been recruited (266, 354 and 547 for sub-cohorts 1, 2 and 3, respectively). Fourteen women tested positive to SARS-CoV-2 RNA by the day of delivery. All fourteen children born from these women tested negative for SARS-CoV-2 RNA. Future plans Children from women included in sub-cohort 3 are expected to be recruited by the end of 2020. Children will be followed-up for one year in order to ascertain the effect that COVID-19 on their development. ARTICLE SUMMARY Strengths and limitations Strengths This cohort would ascertain the effect of COVID-19 in both mother and children whatever the trimester of the infection. It would also compare health care provided to pregnant women during the COVID-19 pandemic with that provided in the same hospital before the emergence of COVID-19. The cohort is recruited in Spain, one of the developed countries earlier and more affected by COVID-19. Limitations The study could be underpowered according to the prevalence reported in a Spanish national study. Information regarding exposure to people infected by SARS-CoV-2 or risk activities is self-reported.
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日本の医学部において国際認証に基づいた医学教育分野別評価を受審する中,クリニカルクラークシップにおける参加型クリニカルクラークシップ(以下,参加型CC)の実践が求められ,教育方略を再考する時期となっている.2020年に始まったCOVID-19パンデミックにより,目指した参加型CCは大きく後退した.また大学病院では手術件数増加など臨床が多忙化し,十分なマンパワーを教育に充てることが困難な状態となっている.このように臨床医が行う医学教育に対しては多くの問題が存在する一方,麻酔科学には医学生が獲得すべきコンピテンシーが多く含まれており,その教育の必要性は高い.どのようにすれば魅力的な,かつ医学生がより一層成長できる参加型CCを展開することができるのであろうか.本稿では島根大学麻酔科が取り組む参加型CCについて課題や問題点を明らかにする.
2019-20 coronavirus outbreak
Betacoronavirus
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Cohort Profile : The Epidemiology of Chronic Diseases and Multimorbidity. The EpiChron Cohort Study
Multimorbidity
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In this manuscript, we update the profile of the 1982 Pelotas Birth Cohort Study.In 1982, 5914 live births whose families lived in the urban are of Pelotas were enrolled in the cohort. In 2012-13, we tried to locate the whole original cohort; 3701 participants were interviewed who, added to the 325 known deaths, represented a follow-up rate of 68.1%. In contrast to the previous home interviews, in this wave all participants were invited to visit the research clinic to be interviewed and examined. The visit was carried out at a mean age of 30.2 years and mainly focused on four categories of outcomes: (i) mental health; (ii) body composition; (iii) precursors of complex chronic diseases; and (iv) human capital. Requests for collaboration by outside researchers are welcome.
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Longitudinal Study
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