CYTOMEGALOVIRUS (CMV) DISEASE IN RENAL ALLOGRAFT RECIPIENTS IN THE NEW IMMUNOSUPPRESSION ERA

Despite aggressive prophylaxis with antivirals, CMV infection remains a major complication of immunosuppression in renal transplantation with remarkable health and economic impacts. The incidence of new and recurrent CMV disease in adult renal transplant recipients at a single tertiary care hospital were studied, and multivariable analyses conducted to identify major predictors for CMV disease in the current immunosuppression era. Patients transplanted between January 1, 1999 and December 31, 2002 were included and followed prospectively until December 31, 2006. The primary end point was development of CMV disease and the incidence was 14.6% (95% Cl, 11.7-18%). None had recurrent CMV disease. Using multivariable analysis, factors associated with increased risk of developing CMV disease were CMV sero-status and positive B- cell cross match at time of transplantation. Patients with a positive B-cell crossmatch had a 3 times greater associated risk for developing CMV disease than those with a negative cross-match (OR = 3.23, 95% Confidence Interval, 1.16 - 9.0, p = 0.025). This association has not been previously reported and should be considered when identifying risks and complications with patients

Residents’ Training in COVID-19 Pandemic Times: An Integrated Survey of Educational Process, Institutional Support, Anxiety and Depression by the Saudi Commission for Health Specialties (SCFHS)

In late December of 2019, the outbreak of coronavirus disease (COVID-19) was first reported in the city of Wuhan, the capital of Hubei province in China, and was declared a pandemic by the World Health Organization in March 2020. Globally, as of 8 July 2020, there have been 11,669,259 confirmed cases of COVID-19, including 539,906 deaths. In Saudi Arabia, the confirmed cases have already reached 223,327, with 161,096 patients confirmed to have recovered, and 2100 deaths. This study aims to determine the effect of the COVID-19 pandemic on the training programs of the Saudi Commission for Health Specialties (SCFHS) and assess trainees’ mental health status (i.e., anxiety and depression). Trainee evaluations on training programs were also sought in order to obtain insights for strategic planning necessary for curricular modifications or improvements to address the clinical learning needs of trainees during this pandemic. The main contribution of our work is an investigation of the incidence of depression and anxiety regarding COVID-19 within the community of residents and fellows. Furthermore, we elaborate on key responsive actions towards the enhancement of the mental health of trainees. Last but not least, we propose the Saudi Commission for Health Specialties (SCFHS) Model for Residents’ Mental Health Enhancement during the COVID-19 Pandemic, which consists of five integrative value layers for medical education and training, namely: the knowledge creation process and innovation; technological capabilities for personalized medicine and patient-centric healthcare with a social impact; innovative applications of technology-enhanced learning and web-based active learning approaches for medical training and education; residents’ wellbeing and the impact of COVID-19 in strategic layers. In our future work, we intend to enhance the proposed framework with studies on trainee satisfaction and the efficiency of different technology-enhanced learning platforms for medical education