Medicina
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Multicenter Study
[Factors associated with the risk of COVID-19 in health-care workers].
Although healthcare personnel are considered a high-risk group for SARS-CoV-2 infection due to their exposure, research on the factors associated with their infection is limited. The objective was to identify factors associated with the acquisition of COVID-19 in healthcare personnel. ⋯ This study allowed us to identify different potentially modifiable factors on which action should be taken to reduce the risk of acquiring COVID-19 by the healthcare personnel.
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Multicenter Study
Multicenter study of diffuse pleural mesothelioma. Histopathological and immunohistochemical features.
The pathological diagnosis of diffuse pleural mesothelioma (DPM) contributes to treatment selection and clinical trials interpretation. To know its characteristics and evaluate the viability of comprehensive pathological diagnosis of DPM in Argentina we did a retrospective descriptive study of DPM cases reported from 2009 to 2018. We analyzed 398 cases corresponding to 238 (60%) men and 160 (40%) women, median age 66 years, from surgical biopsies (78%), small biopsies (16.5%) and surgical resections (5.5%). ⋯ The immunohistochemical antibody panel used included pan-cytokeratin, calretinin, WT-1, cytokeratin 5, CEA and TTF-1. The expression of cytokeratin 5, calretinin and WT-1 was lower in the sarcomatoid type (43%, 87 and 37%) than in the epithelioid type (92%, 98% and 93%). This study highlights the tumor heterogeneity of DPM that shows the diagnostic difficulty, and the feasibility of evaluating histological aggressiveness in E-DPM, B-DPM and S-DPM in our country.
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The use of high-flow nasal therapy (HFNT) in patients with severe acute respiratory failure (SARF) due to COVID-19 pneumonia (NCOVID-19) is debated. Given the lack of beds in Intensive Care Units in the Public Health System of the Province of Neuquén, their use was implemented in general wards. This restrospective multicenter study was carried out to describe the experience of using HNFT in patients with SARF due to NCOVID-19. ⋯ The general IHM was 48.5% (145/299), 70.4% (93/132) in patients with IMV, 4.2% (5/120) died after successful weaning from HFNT and 100% (47/47) in the group not candidates for intubation. Patients with TNAFO had a statistically significant decrease in MIH and days of hospitalization. TNAFO in general wards achieved a decrease in the use of IMV, with a reduction in mortality and days of stay in hospitalized for NCOVID-19 with SARF.
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Multicenter Study
[Multicenter study of COVID-19 incidence and determinants in Argentinian physicians].
Information about COVID infection in physicians is limited. This knowledge would allow the implementation of actions to reduce its impact. The objective was determining the incidence of SARSCoV-2 infection in physicians from health institutions in Argentina, its characteristics, and associated factors. ⋯ The number of close contact isolation increased considerably the risk of infection. Living in Buenos Aires City, individual transportation and working in high-risk areas reduced it. Given the high frequency of close contact in the workplace, we strongly recommend the reinforcement of prevention measures in rest areas and non-COVID-wards.
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Achieving glycemic control in type 2 diabetes(T2D) prevents or delays chronic complications and extends survival. ⋯ of 1329 DMT2 cases included, 60.2% achieved the goal. Regarding pharmacological treatment in diabetes: 5.1% were without medication, 47.5% with 1 drug, 34.5% with 2, 12.9% with 3 or more; in turn, with insulin (alone or combined) 38.1%. According to the questionnaire, 68.4% adhered to treatment and 72.6% reached A1C <7%. Among the non-adherents, 27.4% reached the goal. Achieving the glycemic goal was associated with age = 65 years (p < 0.0001), higher adherence score (p < 0.0001), private health insurance (p < 0.0001), and physical activity (p < 0.02). The worst metabolic control was associated with time of DMT2 diagnosis (p <0.0001), insulin therapy (p < 0.0001) and symptoms of depression (p < 0.002) Conclusions: The youngest and most vulnerable presented lower values for adherence; intervening and intensifying the treatment earlier in them would allow better results.