Annals of medicine
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In COVID-19 related end stage lung disease, there are two distinct phenotypes. The first phenotype is the COVID-19 related acute respiratory distress syndrome (CARDS) showing a classical histopathological pattern of fibrotic diffuse alveolar damage (DAD). The second phenotype is the post-COVID pulmonary fibrosis (PCPF), in which the diagnosis is based on the combined clinical, radiological and (if available) pathological information. ⋯ Key messagesTwo different phenotypes exist for COVID-19 related pulmonary fibrosis. The CARDS phenotype has a worse prognosis compared to the PCPF phenotype, which requires longer-term follow-up and evolves without ARDS picture. The best treatment options for the two different phenotypes, such as anti-fibrotic drugs or lung transplantation, still needs to be defined in future studies.
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Depression and sleep-wake disorders are recognized as one of the major problems among emergency physicians. While depression is more common in females than in males, the associated factors linking depression and sleep-wake disorders in emergency physicians, particularly females, remain unknown. ⋯ Approximately, one-third of EM residents report depression and sleep-wake problems, with female residents showing a higher risk than male residents. Several risk factors were identified, and future strategies should be aimed to address these issues to improve the training environment and overall wellbeing of EM residents.KEY MESSAGESThe prevalence of depression and sleep-related problems were, respectively, 1.95 and 1.81 times higher in female residents compared to their male colleagues.The associated risk factors for depression were flexibility of shift trade, level of training in the emergency medical centre, and frequency of night shifts.Improving the training environment and facilities, as well as offering more flexible duty trading options can provide potential opportunities to reduce the risk.
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Since the beginning of 2020, worldwide attention has been being focussed on SARS-CoV-2, the second strain of the severe acute respiratory syndrome virus. Although advances in vaccine technology have been made, particularly considering the advent of mRNA vaccines, up to date, no single antigen design can ensure optimal immune response. Therefore, new technologies must be tested as to their ability to further improve vaccines. ⋯ Key MessagesViral inactivation by using pulsed electric fields in the nanosecond frequency. DNA fragmentation by a Nanosecond Pulsed Electric Field (nsPEF). Opportunity to apply new technologies in vaccine development.
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Therapeutic studies against human immunodeficiency virus type 1 (HIV-1) infection have become one of the important works in global public health. ⋯ The above results provided potential target genes for early diagnosis and treatment of HIV + patients. IFI27 may be associated with the progression of HIV infection and may be a powerful target for immunotherapy.
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The syndemic between opioid use disorder (OUD), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) results in excessive burdens on the healthcare system. Integrating these siloed systems of care is critical to address all three conditions adequately. In this implementation project, we assessed the data capacity of the health system to measure a cascade of care (COC) across HIV, HCV and OUD services in five states to help guide public health planning. ⋯ It is difficult to assess the strategies needed or the progress made towards increasing treatment access and decreasing the burden of disease without the ability to construct an accurate baseline. Using integrated COCs with relevant benchmarks can not only guide public health planning, but also provide meaningful targets for intervention.KEY MESSAGESWhile HIV COCs are available for most states at least annually, they are not disaggregated for populations with co-occurring OUD or HCV.Data to calculate HCV COC are not available and data to calculate OUD COC are partially available, but only for specific payers.States do not have systems in place to measure the scope of the syndemic or to identify targets for quality improvement activities.