Risultati per: Fisioterapia per il recupero post COVID-19

Background
During the COVID-19 pandemic, 40 mental health and well-being hubs were funded in England to support health and social care staff affected by the pandemic.

Aims
To describe the characteristics of staff accessing four hubs for support and identify characteristics associated with clinically significant mental health difficulties and work and social functioning.

Method
Routinely collected screening data were analysed from 1973 individuals across 4 hubs, including mental health, demographic and occupational data and pandemic-related stressors. Factors associated with clinically significant mental health difficulties were identified via logistic regression.

Results
Most hub clients identified as white women who worked for the UK National Health Service; other groups were less well represented. Hub clients reported high levels of clinically significant mental health difficulties: 60% had severe and often co-occurring difficulties (ie, depression, anxiety, post-traumatic stress disorder or alcohol use) and 80% reported significantly impaired functioning. Younger age, disability status, identifying as from a minority ethnic group, and sexual orientations excluding heterosexual were associated with higher likelihood of having clinically significant mental health difficulties. Suffering financial loss during the pandemic, and prepandemic emotional well-being concerns were the most consistent factors associated with higher difficulties.

Conclusions
The hubs supported health and social care staff with significant mental health difficulties. Outreach and engagement with under-represented groups should be undertaken to address potential barriers to service access. The findings add to the knowledge base on the support needs of the health and social care workforce and the planning of support in response to future crises.

This prospective, observational cohort study uses data from the Researching COVID to Enhance Recovery adult cohort to assess post–COVID-19 condition (or long COVID) with additional participant data and an expanded symptom list.

This Viewpoint examines poor uptake of the annual updated COVID vaccines among US residents despite strong evidence of their effectiveness in lowering the risk of death, serious illness, and hospitalization.

Noting that approximately 30% of individuals hospitalized with COVID-19 experience acute kidney injury, a study published in JAMA Network Open suggests that effects on the organ could persist over time.

Intervento con robot, tac e neuronavigazione a Catania

Objective
The purpose of the study is to compare the prevalence and associated risk factors of smell and/or taste disorders depending on different virus strains in Hiroshima, Japan.

Design
A cross-sectional design was used.

Setting and participants
Data were collected for all COVID-19-confirmed inpatients admitted to 27 hospitals in Hiroshima prefecture, Japan, between 8 April 2020 and 31 January 2023.

Main outcome measures
Smell and/or taste disorders were indicated by physicians on Hiroshima prefecture COVID-19 version J-SPEED forms completed at discharge.

Results
The COVID-19 data from this period corresponds to the following four strains: Wild-dominant, Alpha-dominant, Delta-dominant and Omicron-dominant. A total of 11 353 confirmed cases were analysed and 1261 cases (11.11%) were reported for smell and/or taste disorders.
Among patients with Wild-dominant, 241 out of 1141 cases (21.12%) exhibited smell and/or taste disorders. For Alpha, 223 out of 1265 cases (17.63%), for Delta, 480 out of 1516 cases (31.66%) and for Omicron, 317 out of 7431 cases (4.27%) presented with smell and/or taste disorders. For all four variants, age

Objectives
Despite widespread vaccination programmes and consensus recommendations, the understanding of the durability of COVID-19 vaccination against ensuing infection and transmission at the individual level is incomplete. The objective of this study was to estimate the effects of time-varying covariates including time since vaccination and symptoms on subsequent positive SARS-CoV-2 test results and assess the stability of these effects between March 2020 and April 2022.

Design
Prospective cohort study.

Setting
Urban university in the USA.

Participants
Drexel University students, faculty, and staff (n=15 527) undergoing mandatory COVID-19 symptom tracking, testing and vaccinations.

Intervention
Systematic symptom tracking and SARS-COV-2 testing starting in September 2020 and mandatory COVID-19 vaccination starting in September 2021.

Main outcomes and measures
COVID-19 vaccine effectiveness modified by time since vaccination and symptoms.

Results
Using fit-for-purpose digitally based symptom and vaccine tracking and mandatory comprehensive testing for SARS-CoV-2 infection, we estimate the time-dependent effects of vaccination, symptoms and covariates on the risk of infection with a Cox proportional hazards model based on calendar time scale. We found a strong protective effect of vaccination against symptomatic infection. However, there was strong evidence of a protective effect against infection only in the first 90 days after completed vaccination, and only against symptomatic versus asymptomatic infection. The overall estimated effect of vaccination within 30 days, including asymptomatic infections, was 37.3% (95% CI 26%, 47%). Vaccine effect modification by reported symptoms and time period was estimated, revealing the protective effect of vaccination within 90 days against symptomatic infection that varied from 90% (95% CI 84%, 94%) to 49%(95% CI –77%, 85%) across time periods.

Conclusions
This study is among the first to prospectively capture complete COVID-19 symptom, testing and vaccination data over a multiyear period. Overall effectiveness of the COVID-19 vaccine against subsequent infection, including transmissible asymptomatic infections, is modest and wanes after 90 days. Vaccination policies may need to take these issues into account.

Our novel risk prediction tool uses a simple method to adjust for temporal changes and can be implemented to facilitate uptake of evidence-based therapies. The study provides proof-of-concept for leveraging real-time data to support risk prediction that incorporates changing population-level trends and variation patient-level risk.

Objectives
The purpose of this European survey was to describe current preprocedural planning, procedure techniques and post-implantation management of left atrial appendage closure (LAAC).

Design
Prospective survey regarding current practice for LAAC between March and August 2023.

Setting
357 participating European LAAC centres in 14 countries.

Results
In 2022, the participating centres performed a total number of 9447 LAAC procedures, with a mean of 26 LAAC cases per centre (median 20; IQR 10–35). Preprocedure planning was performed with transoesophageal echocardiography (TOE) in 63% of centres, cardiac CT in 16%, or both in 21%. LAAC procedures were performed under general anaesthesia (59%), conscious sedation (36%) or with local anaesthesia only (5%). Device implantation was guided by conventional TOE (94%), intracardiac echocardiography (6%), miniaturised TOE probes (4%) or CT/fluoroscopy fusion (2%). The standard post-procedural antithrombotic regimen was dual antiplatelet therapy (73%), followed by single antiplatelet therapy (18%), conventional dose direct oral anticoagulant (DOAC) (7%) or half dose DOAC (1%), and no antithrombotic treatment (1%). There was a large heterogeneity between regions in terms of procedure volumes, hospital organisation, preprocedural planning, as well as procedural techniques and post-procedure management.

Conclusions
The present survey indicates that LAAC has become a widespread procedure in Europe. The findings highlight considerable heterogeneity among European countries in terms of preprocedural planning, procedural techniques including guidance and the post-procedural antithrombotic regimen. There is a need to evaluate the outcomes of different practices.

Objectives
This study aimed to compare mortality rates and length of hospital stay between patients with critical COVID-19 transferred to another hospital due to capacity constraints and those who remained at their initial admission hospital.

Design
Single-centre cohort study.

Setting and participants
665 patients were treated for SARS-CoV-2 at two intensive care units (ICUs) in Stockholm, Sweden, from 1 March 2020 to 30 June 2021. Data on interhospital transfers (IHTs) were retrieved from medical records and patient data management systems according to predefined protocols.

Main outcome measures
The outcomes were 30-day and 90-day mortality, days alive and out of ICU. HR with 95% CI were calculated using Cox proportional hazard models with adjustments for age, sex, body mass index, severity of illness, comorbidity, invasive ventilation, treatment limitations and pandemic waves.

Results
Of 665 patients, 133 (20%) were transferred to another hospital. The mortality rate of transferred patients compared with non-transferred patients at 30 days was 19% vs 26% (p=0.13) and at 90 days 26% vs 30% (p=0.43). In the adjusted Cox regression analysis, IHT was associated with a lower mortality risk at 30 days (HR 0.47, 95% CI 0.30 to 0.76) and 90 days (HR 0.52, 95% CI 0.34 to 0.79). However, the number of days alive and out of ICU was significantly lower for the IHT group at 30 days.

Conclusion
In our study, IHT due to capacity constraints among critically ill COVID-19 patients was not associated with a higher mortality risk. The suitability for transfer was likely associated with lower mortality, although residual confounding cannot be ruled out. The requirement for invasive ventilation among transferred patients might account for the extended length of ICU stay, rather than the transfer itself. However, the difficulty in studying this issue lies in the fact that while patients are likely exposed to risks during transfer, they are simultaneously the patients stable enough to be transported.

Palamara (Iss), ‘il virus va ancora monitorato anche senza emergenza’

Studio Usa su paziente con neuroblastoma, ‘record remissione’

Rehabilitation involving cognitive behavioral therapy could help improve functional capacity for those with post–COVID-19 condition, also known as long COVID, according to a randomized clinical trial published in JAMA Network Open. Patients who had undergone a brief outpatient program incorporating cognitive and behavioral approaches reported greater improvements in physical function after 1 year than those who had undergone rehabilitation care as usual.

FEP incidence in South London increased during the peak of the COVID-19 pandemic, particularly among Black and Asian individuals.

Sondaggio Cimo Fesmed tra camici bianchi del Ssn