Search

• COVID-19 is a prothrombotic disorder. • We found that mortality for PE increased significantly in the first two years of the pandemic. • Mortality for PE has returned to pre-pandemic values in 2022. [ABSTRACT FROM AUTHOR]

A systematic literature review and meta-analysis was undertaken of the lateral flow-based FebriDx immunoassay for triaging patients with suspected coronavirus disease 2019 (COVID-19) upon admission to healthcare facilities. An electronic search was conducted in Scopus and Medline using the keywords 'FebriDx' AND 'COVID-19' OR 'SARS-CoV-2', with no language or date (i.e. up to 4th February 2022) limits, selecting studies where FebriDx was used for triaging patients with suspected COVID-19 in acute care settings, and reporting sufficient data to construct a 2×2 table. Five studies were included in the final analysis, totalling 2309 patients. The pooled diagnostic sensitivity and specificity were 0.91 [95% confidence interval (CI) 0.88-0.93] and 0.92 (95% CI 0.90-0.93), whilst the area under the curve, accuracy and kappa statistics were 0.971 (95% CI 0.962-0.980), 91.4% (95% CI 90.2-92.5%) and 0.762 (95% CI 0.731-0.793), respectively, thus reflecting substantial agreement with reference molecular testing techniques. Negative and positive predictive values were 0.974 (95% CI 0.966-0.981) and 0.742 (95% CI 0.711-0.770), respectively. This pooled analysis demonstrated that FebriDx has clinical value for rapid screening of patients with suspected COVID-19 in acute care settings, especially in regions with high viral circulation in which the pre-test probability is high, and enables prioritization for confirmatory laboratory testing. [ABSTRACT FROM AUTHOR]

Diseases of the aorta, such as aortic aneurysm, dissection, and rupture, account for a large proportion of acute clinical emergencies. The red blood cell distribution width (RDW), which directly reflects anisocytosis (i.e., the heterogeneity of erythrocyte volumes), has emerged as a promising biomarker for many cardiovascular pathologies. Thus, we aimed to explore the implication of RDW in aortic pathologies. We searched Scopus and PubMed using the keywords "RDW" OR "red blood cell distribution width" AND "aortic aneurysm" OR "aortic dilatation" OR "aortic dissection" for identifying studies in which RDW values were measured in patients with these aortic diseases. Ten observational studies were finally included. In all studies, RDW value was increased in patients with aortic diseases. In the four studies in which sufficient RDW data were available for pooling, the weighted mean difference (WMD) of RDW in patients with or without complicated aortic pathologies was 0.575 (95 %CI, 0.254–0.896). RDW may be a valuable diagnostic and prognostic biomarker in patients with aortic pathologies. [ABSTRACT FROM AUTHOR]

• Mortality for pulmonary embolism differs among the different periods of the year in the US. • Higher mortality for pulmonary embolism was found in December and January. • Lower mortality for pulmonary embolism was found between April and June. [ABSTRACT FROM AUTHOR]

Background and Aim: an increased value of low-density lipoprotein cholesterol (LDL-C) is now universally considered a major cardiovascular disease (CVD) risk factor. LDL-C is included in the vast majority of worldwide cardiovascular risk prediction algorithms, as well as in the guidelines for cardiovascular risk prevention. We aimed to provide an overview of the worldwide adverse healthcare impact of low-density lipoprotein cholesterol (LDL-C).Methods and Results: Data on the epidemiologic burden of LDL-C >1.3 mmol/L were retrieved from Global Health Data Exchange (GHDx) registry. The current burden is 94.92 million disability-adjusted life years (DALYs), with an exponential increase occurred during the past 25 years. 4.32 million deaths can be attributed to LDL cholesterol values > 1.3 mmol/L. DALYs and deaths due to LDL-C have significantly increased in all countries except those with high socio-demographic index.Conclusion: More effective structural healthcare policies shall be planned at a worldwide scale for contrasting the epidemics of LDL-C attributable heath loss. [ABSTRACT FROM AUTHOR]

• Vaccination of children reduces by ∼40% risk of COVID-19 related hospitalization • Vaccination of children tends to reduce critical COVID-19 illness • Vaccination ultimately reduces severe COVID-19 complications in children [ABSTRACT FROM AUTHOR]

• Lower severity of illness caused by the SARS-CoV-2 Omicron variant and the efficacy of vaccination generated -82% hospitalizations. • Lower severity of illness caused by the SARS-CoV-2 Omicron variant and the efficacy of vaccination generated -84% ICU admissions. • Lower severity of illness caused by the SARS-CoV-2 Omicron variant and the efficacy of vaccination contributed to lower SARS-CoV-2 pathogenicity. We retrieved data from the online database of the Italian Ministry of Health concerning the previous and ongoing waves of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic in Italy. We analyzed the prevalence of variants, the number of SARS-CoV-2 diagnoses, hospitalization, and intensive care unit (ICU) admissions for patients with coronavirus disease 2019 (COVID-19). We compared 2 similar days: January 12, in 2021and 2022. Although the number of positive cases in 2022 was nearly fourfold higher compared with the same period in 2021, presumably owing to higher transmissibility of Omicron variant, a considerable decrease of COVID-19 related hospitalizations (-82%) and ICU admissions (-84%) could be observed in the more recent period, when the Omicron variant was largely prevalent and COVID-19 vaccination was widespread. [ABSTRACT FROM AUTHOR]

Identification errors have emerged as critical issues in health care, as testified by the ample scientific literature on this argument. Despite available evidence suggesting that the frequency of misidentification in vitro laboratory diagnostic testing may be relatively low compared to that of other laboratory errors (i.e., usually comprised between 0.01 and 0.1% of all specimens received), the potential adverse consequences remain particularly worrying, wherein 10–20% of these errors not only would translate into serious harm for the patient, but may also erode considerable human and economic resources, so that the entire healthcare system should be re-engineered to act proactively and limiting the burden of this important problem. The most important paradigms for reducing the chance of misidentification in healthcare entail the widespread use of more than two unique patient identifiers, the accurate education and training of healthcare personnel, the delivery of more resources for patient safety (i.e., implementation of safer technological tools), and the use of customized solutions according to local organization and resources. Moreover, after weighing advantages and drawbacks, labeling blood collection tubes before and not after venipuncture may be considered a safer practice for safeguarding patient safety and optimizing phlebotomist's activity. [ABSTRACT FROM AUTHOR]

Dietary habits play a substantial role for increasing or reducing cancer risk. We performed a critical review of scientific literature, to describe the findings of meta-analyses that explored the association between meat consumption and cancer risk. Overall, 42 eligible meta-analyses were included in this review, in which meat consumption was assumed from sheer statistics. Convincing association was found between larger intake of red meat and cancer, especially with colorectal, lung, esophageal and gastric malignancies. Increased consumption of processed meat was also found to be associated with colorectal, esophageal, gastric and bladder cancers. Enhanced intake of white meat or poultry was found to be negatively associated with some types of cancers. Larger beef consumption was significantly associated with cancer, whereas the risk was not increased consuming high amounts of pork. Our analysis suggest increased risk of cancer in subjects consuming large amounts of red and processed meat, but not in those with high intake of white meat or poultry. [ABSTRACT FROM AUTHOR]

Several lines of evidence attest that diet may strongly influence the cardiovascular risk. We performed an electronic search in Medline (with PubMed interface), Scopus and ISI Web of Science, to identify epidemiological studies on the association between red meat intake and the overall risk of ischemic heart disease (IHD). Eleven studies (8 prospective and 3 case–control) were finally selected for this systematic literature review. Although a larger intake of red meat was found to be a significant risk factor for IHD in four studies (2 prospective and 2 case–control), no significant association was found in five other trials (4 prospective and 1 case–control). We suggest that future diet recommendations for prevention of cardiovascular disease should take into account that the current literature data does not support the existence of a clear relationship between large intake of red meat and increased risk of myocardial ischemia. [ABSTRACT FROM AUTHOR]

This study contributes to the quality assessment of atmospherically corrected Landsat surface reflectance data that are routinely generated by the Landsat Ecosystem Disturbance Adaptive Processing System (LEDAPS). This dataset, named Landsat Surface Reflectance Climate Data Record (Landsat CDR), is available at global scale and offers unprecedented opportunities to land monitoring and management services that require atmospherically corrected Earth observation (EO) data. Our assessment is based on the comparison of the Landsat CDR data against a set of Landsat and DEIMOS-1 images processed to a high degree of accuracy using an industry-standard atmospheric correction algorithm (ATCOR-2). The software package has been used for many years and its correction procedures can be considered consolidated and well-established. The dataset of Landsat and DEIMOS-1 images was acquired over a semi-arid agricultural area located in Lower Austria and was independently corrected by using a manual fine-tuning of ATCOR-2 parameters to reach the highest possible accuracy. Results show a very good correspondence of the surface reflectance in each of the six reflective spectral channels as well as for the NDVI (Normalized Difference Vegetation Index). An additional comparison against a NDVI time series from MODIS revealed also a good correspondence. Coefficients of determination ( R 2 ) between the two multi-year and multi-seasonal Landsat/DEIMOS datasets range between 0.91 (blue band) and 0.98 (nIR, SWIR-1 and SWIR-2). The results obtained for our semi-arid test site in Austria confirm previous findings and suggest that automatic atmospheric procedures, such as the one implemented by LEDAPS are accurate enough to be used in land monitoring services that require consistent multi-temporal surface reflectance data. [ABSTRACT FROM AUTHOR]

Antifungal prophylaxis is routinely given to patients with hematologic malignancies at high risk for invasive fungal infections (IFI), yet breakthrough IFI may still occur. Posaconazole emerged as an excellent alternative for fungal prophylaxis in high-risk patients. There is limited data about pharmacokinetics and plasma concentrations of posaconazole when given as prophylaxis in patients with hematologic malignancies. We recruited 20 adult patients for prospective, open label trial of posaconazole given as a prophylaxis in patients with newly diagnosed acute myeloid leukemia (AML) undergoing induction chemotherapy or first salvage therapy. The median age of all patients was 65 years and received prophylaxis for a median of 38 days (range: 5–42 days).Ten patients (50%) completed 42 days on posaconazole prophylaxis. Median plasma posaconazole levels showed no statistical difference across gender, body surface area, patients developing IFI, and patients acquiring grade 3 or 4 elevation of liver enzymes. However, there was an overall trend for higher trough concentrations among patients with no IFI than those with IFI. Pharmacokinetics of posaconazole varies from patient to patient, and AML patients receiving induction chemotherapy who never develop IFI tend to have higher plasma concentrations after oral administration of posaconazole. [ABSTRACT FROM AUTHOR]

Abstract: Recent evidence suggests that migraine is associated with an increased risk of cardiovascular disorders, so that it is increasingly hypothesized that this primary form of headache may be linked to thrombotic diseases by some biological pathways and risk factors. Homocysteine, a sulfur-containing molecule, is now recognized as an independent risk factor for a variety of thrombotic disorders, especially ischemic heart disease and stroke. This article is hence aimed to provide an overview of epidemiological evidence about the association between homocysteine and migraine published in cross-sectional, prospective or interventional studies. Overall, the evidence gathered from cross-sectional studies that measured plasma homocysteine levels suggests that the epidemiological link between the plasma concentration of this biomarker and migraine is very weak, at best. Contradictory evidence emerged from interventional studies, in which treatment of hyperhomocysteinemia with folic acid or vitamin B supplementation was effective to lower plasma homocysteine and decrease frequency and/or severity of migraine. The association remains largely speculative, however, since it could not be clearly demonstrated that these two biological effects were directly linked. The only study that has assessed homocysteine in cerebrospinal fluid reported that the concentration of this biomarker in migraine patients was significantly increased compared to controls. Although this evidence must be obviously confirmed in larger trials, some putative mechanisms may support a causal link between increased generation of homocysteine in the brain environment and migraine. [Copyright &y& Elsevier]

The aim of this article was to evaluate the mean speed progression of the three major cycling stage races in order to empirically establish whether excellent in performance in professional cycling is to some extent correlated with the trend of blood doping and anti-doping throughout more than a century of official cycling competitions. We retrieved data about the mean speed of the winners of the Tour de France, Giro d’Italia and Vuelta a Espana, since their beginning. A linear correlation has then been calculated between the years and the mean speed in km/h for each single major cycling stage race, as well as for the mean speed of the winners of the three major cycling stage races in the same year. Although a highly significant correlation was found between years and mean speed of the winners of each single major cycling stage race during the same year ( r = 0.941; p < 0.001), a number of differential trends were observed. More specifically, from 1903 to 1925 the association was inverse, between 1926 and 2000 the relationship was positive, whereas in the period 2001–2013 the relationship became virtually flat. This data suggests that a strengthened policy of anti-doping testing may have been effective in the past 15 years for curbing the use of performance-enhancing substances. [ABSTRACT FROM AUTHOR]

Identification of environmental and hospital indicators that may influence coronavirus disease 2019 (COVID-19) mortality in different countries is essential for better management of this infectious disease. Correlation analysis between healthcare system indicators and COVID-19 mortality rate in Europe. For each country in the European Union (EU), the date of the first diagnosed case and the crude death rate for COVID-19 were retrieved from the John Hopkins University website. These data were then combined with environmental, hospital and clinical indicators extracted from the European Health Information Gateway of the World Health Organization. The COVID-19 death rate in EU countries (mean 1.9 ± 0.8%) was inversely associated with the number of available general hospitals, physicians and nurses. Significant positive associations were also found with the rate of acute care bed occupancy, as well as with the proportion of population who were aged older than 65 years, overweight or who had cancer. Total healthcare expenditure, public sector health expenditure and the number of hospital and acute care beds did not influence COVID-19 death rate. Some common healthcare system inadequacies, such as limited numbers of general hospitals, physicians and nurses, in addition to high acute care bed occupancy, may be significant drivers of nationwide COVID-19 mortality rates in EU countries. • Coronavirus disease 2019 (COVID-19) mortality in European Union countries is inversely associated with the number of general hospitals, physicians and nurses. • Positive associations were found between COVID-9 mortality and acute care bed occupancy. • Populations with high numbers of individuals who were aged >65 years, who were overweight or who had cancer showed increased COVID-19 mortality rates. • Total healthcare expenditure, public sector health expenditure and the number of hospital and acute care beds did not influence COVID-19 mortality. [ABSTRACT FROM AUTHOR]

Abstract: An early diagnosis is crucial for effective triage and management of patients with suspected acute myocardial infarction (AMI). Although troponin testing is the cornerstone of diagnosis, the sensitivity of this biomarker is still suboptimal at patient admission. The heart-type fatty acid binding protein (H-FABP) is an early and sensitive biomarker of myocardial ischemia, whose appropriate setting is in combination with troponin testing. We performed a systematic review and meta-analysis of articles that have assessed the combination of troponin and H-FABP in the early diagnosis of AMI. Eight studies, totaling 2735 patients, met the inclusion criteria but none of them used a high-sensitivity troponin immunoassay. The between-study variation was high (98.5%), and attributable to heterogeneity. When considered alone, troponin exhibited a significantly greater pooled area under the curve (AUC) than H-FABP alone (0.820 versus 0.784; p<0.001). The pooled specificity was also higher for troponin alone than for H-FABP alone (0.94 versus 0.83; p<0.001), whereas the cumulative sensitivity was lower for troponin than for H-FABP (0.73 versus 0.80; p=0.02). The combination of both biomarkers exhibited a greater AUC than troponin alone (0.881; p<0.001), as well as a higher pooled sensitivity (0.91; p<0.001), which was however counterbalanced by a lower specificity (0.82; p<0.001). These results attest that the combination of H-FABP with a conventional troponin immunoassay seems advantageous for increasing the sensitivity of the former biomarker, at the expense of a lower specificity. The introduction of H-FABP testing would hence require careful assessment of laboratory data or clinical signs and symptoms for excluding sources of elevation different from AMI. Further studies are needed to assess the diagnostic effectiveness of combining H-FABP with a high-sensitivity troponin immunoassay. [Copyright &y& Elsevier]

Purpose The Deep Inspiration Breath Hold (DIBH) technique was introduced in order to freeze the breathing motion in a mid-inhale position with a computer controlled valve, with the purpose of lowering heart dose in left breast radiotherapy. A training project with FMECA analysis was started, aiming to write and implement a protocol, improved by proactive clinical risk analysis and feedback from the operators (radiotherapists, radiographers and medical physicists). Methods and materials At first, few operators were involved to take knowledge and dexterity with the system. They became the tutors and the core of the improvement group for the subsequent training project. The project was comprised of four stages: (1) implementation of the technique (tutors); (2) field training (tutors and operators); (3) training course on FMEA/FMECA analysis (all operators and clinical governance department); (4) implementation of the FMECA analysis in left breast radiotherapy DIBH treatments (tutors and FMEA-workgroup; the FMEA workgroup consisted of these professional roles: radiotherapists, radiographers, medical physicists and clinical governance area's physicians). Results The outputs for each stage were: (1) redact the protocol and the training checklist; (2) training of all operators and application of the self-evaluation checklist; (3) understanding the clinical risk principles; (4) application of the FMEA analysis, data processing and final report. The self-evaluation checklist was comprised of 37 targets, with achieved/partially-achieved/not-achieved check boxes. The FMEA table was comprised of 48 activities, subdivided in 5 phases (DIBH-suitable-patients detection, treatment simulation, planning, radiotherapy treatment delivery, quality control), with pertinent Risk Probability Numbers associated. Points 1–3 were completed, while completion of point 4 is expected for the first half of 2018. Conclusion The application of the FMEA/FMECA method allowed us to introduce proactive methods to analyze and manage the clinical risk related to the introduction of the new DIBH technique. The FMEA/FMECA method was included in a training project which allowed to obtain feedback from all the involved operators, improving the understanding of the work process, the skill and safety in the practical use and the redaction of a multidisciplinary protocol. [ABSTRACT FROM AUTHOR]

Weightlifting is a dynamic strength and power discipline, in which two different whole-body lifts (snatch and clean & jerk) are performed sequentially. To assess the relationship between body weight and total weight lifted by professional weightlifters, we retrieved data about results of the 2013 World Weightlifting Championships for all male and female weight categories. A highly significant correlation was found between total weight lifted and weight category in both females ( r = 0.996; p < 0.0001) and males ( r = 0.982; p < 0.0001). The total weight lifted could be predicted by the equations “[total weight lifted] = 2.73 × [body weight] + 172” in males, and “[total weight lifted] = 3.29 × [body weight] + 36” in females, respectively. The mean ratio between total weight lifted by males and females of corresponding body weights was 1.34 (95% CI, 1.24–1.44; range 1.19–1.54). The results of this analysis demonstrate that a highly significant linear relationship exists between total weight lifted and body weight of top-class weightlifters. Male athletes also displayed a mean 34% greater power than women. The equation developed from official data may represent a reliable basis for identifying suspect performance. [ABSTRACT FROM AUTHOR]