Covid-19: Pulmonary and Extra-Pulmonary Manifestations

Introduction: The coronavirus disease-2019 (COVID-19) pandemic has been the most significant event in 2020, with ~86.8 million cases and 1.88 million deaths worldwide. It is a highly infectious disease, wherein the virus (severe acute respiratory syndrome coronavirus 2) rapidly multiplies and spreads to all parts of the body. Therefore, COVID-19 is not only respiratory disease but also a multisystem disease. Many people, including physicians, incorrectly believe that the disease affects only the respiratory tract. In this study, we aimed to describe COVID-19 manifestations and the underlying pathophysiology to provide the readers with a better understanding of this disease to achieve good management and to control the spread of this disease. Methods: Secondary data were obtained from PubMed, Google Scholar, and Scopus databases. The keywords used for the search were as follows: COVID-19, COVID-19 pulmonary manifestations, COVID-19 extra pulmonary manifestations, and pathophysiology of COVID-19. We collected secondary data from systemic reviews, metaanalyses, case series, and case reports in the form of public data that was published on websites of the government, medical corporations, medical peer-reviewed journals, and medical academies, all of which were indexed in PubMed, Google Scholar, or Scopus. Our questions were as follows: Is COVID-19 a respiratory disease only? and What are the extrapulmonary manifestations of COVID-19? Results: From our data, we found that a patient with COVID-19 may be either asymptomatic or symptomatic. Symptomatic cases may have either pulmonary or extrapulmonary manifestations. Pulmonary manifestations occur as mild, moderate, or severe cases. In mild and moderate cases, extrapulmonary manifestations such as gastroenteritis, fever, or vomiting may present alone. Some of these cases may be missed for diagnosis, and the patient may receive symptomatic treatment without a COVID-19 diagnosis, leading to increased spread of the infection. Extrapulmonary manifestations may occur in severe and critical cases as complications of severe infections (high viral overload) or the cytokine storm, such as in acute kidney injury (AKI), heart failure (HF), and venous thromboembolic (VTE) manifestation. Conclusion: COVID-19 is not a respiratory disease alone; rather, it is a multisystem disease. Pulmonary and extrapulmonary manifestations should be considered for early diagnosis and to control the spread of the infection

The Leaderbuild Theory.

In the last two years, due to the COVID-19 pandemic, many educational and academic activities have undergone numerous changes; the number of online educational activities, e-Learning, and blended learning have radically increased, and the need to train personnel quickly and with increasing specialist skills has increased. The inclusion of the ‘Leaderbuild’ and ‘Leaderfit’ concept thus becomes one of the factors useful to prepare professionals specialized in every field, ready to lead in every modern environment and need, with structured leadership

The Role of Nutrient Supplementation to Prevent Perinatal Depression. A Narrative Review

Background: Micronutrient supplements are widely available and can play a crucial role in the prevention of perinatal depression; however, their benefits are still not well studied.Objectives: The authors performed this literature review to assess the effectiveness of micronutrients to prevent perinatal depression.Method: The authors searched electronic databases (PubMed, Scopus, and USW Library) until May 1, 2023. The studies were included if they were evaluating the preventive effect of micronutrients on perinatal depression.Results: The authors identified 3218 articles, of which 14 were eligible to be included in the review (8 RCTs, 3 Cohort studies, and 3 cross-sectional studies). Results of the review illustrate some degree of effectiveness of vitamin D supplementation, calcium, selenium, manganese, and probiotics to provide preventive effects against perinatal depression, while there is no evidence of a significant preventive effect for PUFAS (fish oil) supplementation.Conclusion: Despite the popular information. PUFA supplements had no role in preventing perinatal depression. Other nutrients such as vitamin D, calcium, selenium, manganese, and probiotics showed some protective effects, which warranted more research in this area and preferably in women with a history of perinatal depression for a better understanding of their preventive effects

Mental healthcare services support: the social role of medical educator involved in the destigmatization process to generate inclusion.

Introduction: The stigmatization of mental healthcare services and users is a barrier to the achievement of mental wellness present on a global level. 800000 suicides are estimated each year, 25 suicide attempts for every suicide (ratio of 25:1), and in 2017 estimated a prevalence > 10% of people suffering from mental disorder or substance abuse (global data). The stigmatization is a multifactorial phenomenon and process that involves different factors, which overall cause health, social and economic damage. Slowing down and reducing access to mental health and well-being pathways due to their influence in the community, also affect social relationships and self-determination. Purpose: to identify and describe the process, causes, and factors of stigmatization. Propose destigmatization activities led by the medical educator. Methodology: The manuscript develops a proposal focused on the destigmatization process of mental health/wellbeing services and users, through the guidance of the medical educator as a figure of connection between different professions (interdisciplinary and multidisciplinary), and between different stakeholders. Conclusion: each identifies factor described, can be involved in the destigmatization process to generate inclusion, through different social interventions led by the role of the medical educator, with the aim of supporting access to patient support processes and quality of life in communities, generating inclusion through destigmatizatio

Current status of graft choice in adults for anterior cruciate ligament reconstruction: a systematic review and meta-analysis

The anterior cruciate ligament (ACL) is a frequently performed surgical procedure in the field of sports medicine, and graft selection is an essential aspect of ACL reconstruction (ACLR) that has been shown to optimize post-operative rehabilitation, facilitate return to full sporting function and reduce the risk of complications. However, there needs to be more agreement regarding optimal graft choice. The present study aims to identify the optimal graft choice in the adult population undergoing ACLR. The current systematic review explores the electronic database of online libraries of academic institutions from 2011 to 30 September 2022 and compared the clinical outcomes of autograft and allograft for ACLR, which provides an evidence-based approach for graft selection. The findings of our present study delineate that ACLR in adult populations with autograft is the most promising choice for ligament tear over allograft based on lower failure rate, reduced complications, and high cost-effectiveness. However, there was no significant difference in overall IKDC, pivot shift, Lachman test, and Tegner activity. This critical analysis recommends that for an adult population, ACLR with autograft can provide better clinical results than an allograft, but further studies carried out about other parameters affecting the long-term stability, quick return, and physical therapy adopted outside the supervision of the respective surgeon would be required

Mistaken-for-Game Hunting Accidents: A Human Factors Review

Hunting accidents can have devastating consequences. One of the most common causes of hunting fatalities in this country, and others, are target identification failures—mistaking people for game. A golden rule in firearm safety is to identify your target beyond all doubt. Despite this message being constantly repeated, accidents are still occurring. Hunter education and awareness about high visibility clothing have reduced accident rates, but these statistics have since plateaued. Contrary to what most people think, the hunters committing these accidents are often experienced and considered to be safe and competent. Crucially, they often believe they have, 100%, correctly identified their target. Psychology and human factors can provide insight into how these situations might occur. When interpreting information, we rely heavily upon mental rules of thumb called heuristics. Heuristics operate outside of our conscious awareness and are utilised even more in stressful or emotionally charged situations. However, they can also make us susceptible to cognitive biases which may lead us astray—we underestimate the impact heuristics will have on our decisions. Attempts to manage heuristics and cognitive biases are often futile because we normally cannot detect them when they occur. Hunters are constantly told that they need to treat every sound or movement as human in an attempt to change their mind-set. However, given the difficulty in detecting cognitive biases, it is unlikely a hunter’s conscious management of heuristics would be consistently possible in the long term. Cognitive biases undoubtedly occur in hunting as in most activities we do. Analyses of accidents and anecdotal reports point to their involvement, as does research showing their involvement in other critical environments, including firearms operations in the military and the police. Given the impracticality of preventing heuristics and cognitive biases from affecting a hunter’s target identification, an additional approach is required. One method to prevent mistaken-for-game hunting accidents may involve the use of objective warning systems, such as those used to prevent friendly fire in the military. This white paper discusses four key cognitive biases which we believe play a role in mistaken-for-game hunting accidents: the availability heuristic, expectancy, confirmation bias, and optimism bias. We also present the assertion that experience may not safeguard a hunter, and may in fact do the opposite. Other contributing factors—buck fever, poor choice of clothing, and snap shooting—are discussed in relation to cognitive biases. However, there is currently a notable lack of research on the role of cognitive biases in hunting accidents per se. As a result, more work needs to be conducted to verify the conclusions of this white paper, for which a human factors approach must be taken