Testing efforts for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been burdened by the scarcity of testing materials and personal protective equipment for health care workers. The ...simple and painless process of saliva collection allows for widespread testing, but enthusiasm is hampered by variable performance compared to that of nasopharyngeal swab (NPS) samples. We prospectively collected paired NPS and saliva samples from a total of 300 unique adult and pediatric patients. SARS-CoV-2 RNA was detected in 32.2% (97/300) of the individuals using the TaqPath COVID-19 Combo kit (Thermo Fisher). Performance of saliva and NPS was compared against the total number of positives regardless of specimen type. The overall concordances for saliva and NPS were 91.0% (273/300) and 94.7% (284/300), respectively. The values for positive percent agreement (PPA) for saliva and NPS were 81.4% (79/97) and 89.7% (87/97), respectively. Saliva yielded detection of 10 positive cases that were negative by NPS. For symptomatic and asymptomatic pediatric patients not previously diagnosed with COVID-19, the performances of saliva and NPS were comparable (PPA, 82.4% versus 85.3%). The overall values for PPA for adults were 83.3% and 90.7% for saliva and NPS, respectively, with saliva yielding detection of 4 fewer cases than NPS. However, saliva performance for symptomatic adults was identical to NPS performance (PPA of 93.8%). With lower cost and self-collection capabilities, saliva can be an appropriate sample choice alternative to NPS for detection of SARS-CoV-2 in children and adults.
Aloe Vera has different therapeutic effects, including wound healing. The objective of this review is to determine the potential efficacy of the topical use of Aloe Vera in the healing of skin ...wounds. A bibliographic search of preclinical and clinical studies was carried out from 1999 to 2020, which included the therapeutic use of Aloe vera in the healing of: burns, surgical wounds, lactation disorders, anal fissure and anal fistula; in the databases of the VHL regional portal, PubMed and Google Scholar. It was obtained that the topical administration of Aloe vera was effective in the healing of the mentioned wounds by mainly increasing epithelization and collagen content. In conclusion, the evidence suggests that the properties and pharmacological presentation, chemical components and the effectiveness of Aloe vera to reduce the healing time of wounds make this plant a great therapeutic alternative; however, more studies are required regarding its antimicrobial property.
Studies of household transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) focused on households with children are limited. We investigated household secondary attack rate ...(SAR), transmission dynamics, and contributing factors in households with children.
In this prospective case-ascertained study in Los Angeles County, California, all households members were enrolled if ≥1 member tested positive for SARS-CoV-2 by polymerase chain reaction (PCR). Nasopharyngeal PCRs, serology, and symptom data were obtained over multiple visits.
A total of 489 individuals in 105 households were enrolled from June to December 2020. The majority (77.3%) reported a household annual income of <$50,000, and most (92.9%) were of Hispanic/Latinx ethnicity. Children <18 years old accounted for 46.9% index cases, of whom 45.3% were asymptomatic. Household index cases were predominantly children during low community transmission and adults during the high community transmission period (χ
= 7.647,
= 0.0036. The mean household SAR was 77.0% (95% CI: 69.4-84.6%). Child and adult index cases both efficiently transmitted SARS-CoV-2 within households 81.9%, (95% CI: 72.1-91.9%) vs. 72.4% (95% CI: 59.8-85.1%),
= 0.23. Household income and pets were significantly associated with higher SAR in the multivariable analysis of household factors (
= 0.0013 and 0.004, respectively).
The SAR in households with children in an urban setting with a large ethnic minority population is much higher than previously described. Children play important roles as index cases. SAR was disproportionately impacted by household income. Vaccination and public health efforts need special focus on children and vulnerable communities to help mitigate SARS-CoV-2 spread.
Resumen Introducción: Muchas veces se propagan mitos y creencias sobre la higiene íntima femenina, que podrían traer consecuencias en muchos aspectos. Objetivo: Determinar la asociación entre los ...mitos y creencias del cuidado e higiene íntima y los cuidados reales de higiene íntima en mujeres peruanas jóvenes. Método: Se realizó un estudio transversal analítico, que presentó una revisión del tema para realizar una encuesta de 21 interrogantes, en temas comunes en la higiene íntima, post piloto, se preguntó de su realización y la frecuencia semanal; esta última se asoció a variables socio-educativas. Resultados: De las 600 mujeres jóvenes encuestadas, hubo diferencia en cuanto la edad según la percepción del uso de ropa interior de algodón (p=0,013), la limpieza de la zona íntima de adelante hacia atrás (p<0,001), el uso de ropa interior no muy ajustada (p<0,001), el uso de ropa sintética (p=0,045), el uso de jabón exclusivo para la zona íntima (p<0,001), la edad de inicio de relaciones sexuales (p=0,031) y el uso de métodos anticonceptivos como causantes de flujo (p=0,008). En cuanto al ser o no estudiantes, hubo diferencia en la percepción de que el rasurado del pubis para la limpieza (p=0,018) y que los ejercicios de relajación disminuyen el flujo vaginal (p=0,030). Conclusiones: Se describió algunos mitos y creencias en cuanto a la limpieza íntima; a su vez, se encontró que algunas prácticas de higiene tienen asociación con la edad y el ser estudiante. Esto debe ser estudiado a profundidad, ya que, esto podría llevar a problemas mayores.
Improved treatment for advanced cervical cancer is needed; currently, treatment options include combined chemotherapy and bevacizumab or pembrolizumab monotherapy for PD-L1 positive disease. PIK3CA ...and KRAS mutations have been reported in cervical cancers; this study therefore tested dual inhibition of PI3K and RAS signaling by combining the MEK inhibitor trametinib and the AKT inhibitor GSK2141795 in recurrent cervical cancer.
This was an investigator-initiated phase II study combining trametinib and GSK2141795 in patients with recurrent cervical cancer. Primary endpoint was best tumor response; secondary endpoints included progression free survival, overall survival, and safety assessment. Translational objectives included characterization of molecular alterations in PI3K and RAS signaling pathway genes.
Planned accrual was 35 patients; 14 patients were enrolled and received at least one dose of study drug before the study was terminated due to discontinuation of GSK2141795 development. There were no confirmed responses; 1 patient had an unconfirmed PR, 8 had stable disease, 3 had progression as best response, and 2 were unevaluable. Toxicities were mostly grade 1 and 2, although 57% of patients experienced grade 3/4 adverse events and 50% patients required a dose reduction.
The combination of trametinib and GSK2141795 was feasible but required dose holds and modifications for adverse events; however, anti-cancer activity was minimal, even in patients with PI3K or RAS pathway alterations. Although the study was terminated early after GSK2141795 development was halted, the findings in these 14 patients do not support further development of this combination in cervical cancer.
•Strong pre-clinical rationale supports combining PI3K/AKT and MEK inhibitors in cervical cancer.•The combination of the MEK inhibitor trametinib and the pan-AKT inhibitor GSK2141795 had limited activity.•Major toxicities of the combination included rash, diarrhea, nausea, and ALT elevation.•Alterations in PI3K or RAS signaling did not predict for activity of the combination.
Background
Age and obesity status are associated with severe outcomes among hospitalized individuals with COVID‐19. It remains unclear whether age and obesity are risk factors for milder COVID‐19 ...illness.
Methods
We prospectively enrolled SARS‐CoV‐2‐exposed individuals. Participants recorded symptoms for 28 days and were tested for SARS‐CoV‐2 by reverse transcription polymerase chain reaction (RT‐PCR) and serology. Type, number, and duration of symptoms and SARS‐CoV‐2 laboratory parameters were compared by age and obesity status.
Results
Of 552 individuals enrolled from June 2020 to January 2021, 470 (85.1%) tested positive for SARS‐CoV‐2 including 261 (55.5%) adults ≥18 years, 61 (13.0%) adolescents 12–17 years, and 148 (31.5%) children <12 years. Children had fewer symptoms (median 2 vs. 3, p < 0.001) lasting fewer days (median 5 vs. 7, p < 0.001) compared with adolescents/adults. Body mass index of 300 (63.8%) individuals classified with overweight or obesity (OWOB). Individuals with OWOB suffered more symptoms compared with individuals without OWOB (median 3 vs. 2, p = 0.037), including more cough and shortness of breath (p = 0.023 and 0.026, respectively). Adolescents with OWOB were more likely to be symptomatic (66.7% vs. 34.2%, p = 0.008) and have longer respiratory symptoms (median 7 vs. 4 days, p = 0.049) compared with adolescents without OWOB. Lower RT‐PCR Ct values were found in children and symptomatic individuals compared with adolescent and adults and asymptomatic individuals, respectively (p = 0.001 and 0.022).
Conclusions
Adolescents and adults with OWOB experience more respiratory symptoms from COVID‐19 despite similar viral loads. These findings underscore the importance of vaccinating individuals with OWOB.
This article describes a university-based virtual nurse managed clinic designed to address the healthcare needs of underserved inner city residents of the Watts, Inglewood, and Compton communities of ...South Los Angeles County. The broad objectives of this federally-funded nurse-led initiative are: (1) to establish an interprofessional collaborative practice model to improve access to primary health care in a medically underserved community, (2) to increase the diversity of the nursing and health professions workforce by improving recruitment, retention, and graduation rates of minority students enrolled in the nursing and health professions programs, (3) to improve the quality of care by preparing the interprofessional collaborative practice team of nursing as well as health professions faculty and students to provide culturally competent and sensitive care, (4) to increase the effectiveness of educational and community-based programs by empowering the community to engage in the health education and referral process, and (5) to utilize telehealthcare technologies in the delivery of primary care services to extend access beyond traditional clinic walls. Person-centered care principles serve as the conceptual framework supporting this initiative.
Systemic Lupus Erythematosus is a chronic pathology characterized by its autoimmune response, in addition to the fact that it occurs mainly in females and in populations such as Hispanic-American, ...African-American and Asian. Being a systemic pathology, it presents clinical manifestations such as cutaneous, neurological, hematological, renal, pulmonary and dental. Discomfort in the oral cavity affects the quality of life of patients with SLE. The objective of this research is to present general but relevant aspects of systemic lupus erythematosus, its especially dental manifestations and how it affects them. In addition to knowing how a patient diagnosed with SLE should be managed. Method: a search of scientific articles was carried out in Google Academic, Pubmed, Scielo, Elsevier, Scopus and Medline.
El Lupus Eritematoso sistémico es una patología crónica caracterizada por su respuesta autoinmunitaria además de que se presenta mayormente en el sexo femenino y en poblaciones como la hispanoamericana, afroamericana y asiática Al ser una patología sistémica presenta manifestaciones clínicas como cutáneas, neurológicas, hematológicas, renales, pulmonares y odontológicas. Las molestias en la cavidad oral afectan en la calidad de vida de los pacientes con LES. El objetivo de esta investigación es presentar aspectos generales pero relevantes de lupus eritematoso sistémico, sus manifestaciones especialmente odontológicas y como los afecta Además de saber cómo se debe manejar un paciente con diagnóstico de LES. Método se realizó una búsqueda de artículos científicos en Google Academico, Pubmed, Scielo, Elsevier, Scopus y Medline.
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