Surgical closure of patent ductus arteriosus in neonatal intensive care units: a scoping review

Patent ductus arteriosus (PDA) is common in preterm neonates. However, when pharmacological closure fails, surgical closure should be chosen. Recently, there is a trend to perform this procedure in neonatal intensive care units (NICU) instead of the operating room. Objective: To explore the recent literature regarding the surgical closure of PDA in the NICU. Materials and methods: A scoping review was carried out on studies published in the last twenty years that have evaluated the surgical closure of PDA in the NICU. Results: Thirteen studies were identified, of which 4 were comparative while another 9 were non-comparative. No death was due to the surgical procedure, but rather to comorbidities associated with prematurity. Shorter operating time and less hypothermia were reported as benefits. Conclusions: Surgical interventions in the NICU are feasible and performed in unstable preterm neonates requiring ventilation.La persistencia del conducto arterioso (PCA) es común en neonatos prematuros. Sin embargo, ante la falla de un cierre farmacológico, se debe optar por un cierre quirúrgico. Últimamente, hay una tendencia en realizar dicho procedimiento en las unidades de cuidados intensivos neonatales (UCIN) en lugar de la sala de operaciones. Objetivo: Explorar la literatura reciente respecto al cierre quirúrgico de PCA en UCIN. Materiales y métodos: Se realizó una revisión de alcance sobre estudios publicados en los últimos veinte años que hayan evaluado el cierre quirúrgico del PCA en UCIN. Resultados: Se identificaron 13 estudios, de los cuales 4 fueron comparativos, mientras que otros 9 fueron no comparativos. Ninguna muerte fue debida al procedimiento quirúrgico, sino más bien a comorbilidades asociadas a la prematuridad. Un menor tiempo operatorio y menor hipotermia fueron reportados como beneficios. Conclusiones: Las intervenciones quirúrgicas en UCIN son factibles y seguras, y pueden ser realizadas en neonatos s inestables que requieran ventilación

Association of vision impairment and blindness with socioeconomic status in adults 50 years and older from Alto Amazonas, Peru.

OBJECTIVE: To determine the relationship between socioeconomic status (SES) and visual impairment (VI) or blindness in the rural Peruvian Amazon, hypothesizing that higher SES would have a protective effect on the odds of VI or blindness. METHODS: In this cross-sectional study of 16 rural communities in the Peruvian Amazon, consenting adults aged ≥ 50 years were recruited from ~30 randomly selected households per village. Each household was administered a questionnaire and had a SES score constructed using principal components analysis. Blindness and VI were determined using a ministry of health 3-meter visual acuity card. RESULTS: Overall, 207 adults aged ≥ 50 were eligible; 146 (70.5%) completed visual acuity screening and answered the questionnaire. Of those 146 participants who completed presenting visual acuity screening, 57 (39.0%, 95% CI 30.2-47.1) were classified as visually impaired and 6 (4.1%, 95% CI 0.9-7.3) as blind. Belonging to the highest SES tercile had a protective effect on VI or blindness (OR 0.29, 95% CI 0.09 to 0.91, p = 0.034), with a linear trend across decreasing levels of SES (p = 0.019). This observed effect remained significant regardless of how SES groups were assigned. CONCLUSION: Belonging to a higher SES group resulted in a lower odds of VI or blindness compared to those in the lowest SES group. The observation of a dose response provides confidence in the observed association, but causality remains unclear. Blindness prevention programs could maximize impact by designing activities that specifically target people with lower SES

COVID-19 associated with cryptococcosis: a scoping review

Background: There is growing evidence of fungal infections associated with COVID-19. The development of cryptococcosis in these patients has been infrequently reported. However, it can be life-threatening. Objective: To identify cases of COVID-19 patients who developed cryptococcosis and to compare baseline characteristics and management between those who survived and those who died. Methods: We conducted a scoping review using PubMed, Scopus, Web of Science, and Embase to identify studies that reported patients with COVID-19 and cryptococcosis. No language restriction was applied. Single case reports, case series, and original articles were included. It is important to note that ‘ n ’ refers to the total number of individuals with the specified variable. Results: A total of 58 studies were included. Among these studies, 51 included individual patient data, detailing information on a total of 65 patients, whereas eight studies reported the proportion of cryptococcosis in COVID-19 patients. One study provided both individual and aggregate case information. From individual patient data, the majority were male (73.9%; n  = 48) with a median age of 60 years (range: 53–70). Severe COVID-19 and multiple comorbidities, led by arterial hypertension and diabetes mellitus, were frequently reported, but few had classic immunosuppression factors. On the other hand, HIV status, either negative or positive, was reported in just over half of the patients (61.5%; n  = 40). Most were admitted to the intensive care unit (ICU) (58.5%; n  = 31), received mechanical ventilation (MV) (50.0%; n  = 26), and developed disseminated cryptococcosis (55.4%; n  = 36). Secondary infection, mainly bacterial, was reported in 19 patients (29.2%). Mortality was 47.7% ( n  = 31). Of the studies that reported the proportion of cryptococcosis in COVID-19 cases, the majority were descriptive studies published as conference abstracts. Conclusion: Cryptococcosis in COVID-19 patients has been reported more frequently. However, it is still not as common as other fungal infections associated with COVID-19. Few patients have some classic immunosuppression factors. The factors associated with mortality were male sex, age, ICU admission, MV, secondary infections, and lymphopenia

sj-docx-1-tai-10.1177_20499361241232851 – Supplemental material for COVID-19 associated with cryptococcosis: a scoping review

Supplemental material, sj-docx-1-tai-10.1177_20499361241232851 for COVID-19 associated with cryptococcosis: a scoping review by Alvaro Quincho-Lopez, Nuvith Poma and Juan José Montenegro-Idrogo in Therapeutic Advances in Infectious Disease</p

sj-docx-2-tai-10.1177_20499361241232851 – Supplemental material for COVID-19 associated with cryptococcosis: a scoping review

Supplemental material, sj-docx-2-tai-10.1177_20499361241232851 for COVID-19 associated with cryptococcosis: a scoping review by Alvaro Quincho-Lopez, Nuvith Poma and Juan José Montenegro-Idrogo in Therapeutic Advances in Infectious Disease</p

sj-docx-3-tai-10.1177_20499361241232851 – Supplemental material for COVID-19 associated with cryptococcosis: a scoping review

Supplemental material, sj-docx-3-tai-10.1177_20499361241232851 for COVID-19 associated with cryptococcosis: a scoping review by Alvaro Quincho-Lopez, Nuvith Poma and Juan José Montenegro-Idrogo in Therapeutic Advances in Infectious Disease</p

Prevalence of and factors associated with childhood anaemia in remote villages of the Peruvian Amazon: a cross-sectional study and geospatial analysis.

BackgroundAnaemia is a public health problem in Peru. In the Loreto region of the Amazon, ≥50% of children may be anaemic, although insufficient information exists for rural villages.MethodsTo generate more data about childhood anaemia in the Peruvian Amazon, haemoglobin was measured as part of a trachoma survey in 21 randomly selected villages. All children 1-9&nbsp;y of age from 30 randomly selected households per village were recruited. Anaemia was classified according to the World Health Organization guidelines and a socio-economic status (SES) index was created for each household using principal component analysis. Spatial autocorrelation was determined using Moran's I and Ripley's K function.ResultsOf 678 children with complete haemoglobin data, 25.4% (95% confidence interval [CI] 21.2 to 30.1) had mild-or-worse anaemia and 22.1% (95% CI 15.6 to 30.3) had moderate-or-worse anaemia. Mild-or-worse anaemia was more common among children whose primary source of drinking water was surface water (prevalence ratio [PR] 1.26 [95% CI 1.14 to 1.40], p&lt;0.001) and who were in the lowest SES tercile (PR 1.16 [95% CI 1.02 to 1.32], p=0.021). Moderate-or-worse anaemia was more common among boys (PR 1.32 [95% CI 1.09 to 1.60], p=0.005). No evidence of geospatial clustering was found.ConclusionsRemote villages of the Amazon would benefit from interventions for childhood anaemia and the poorest households would have the most to gain. Integrating anaemia screening into neglected tropical diseases surveys is an opportunity to use public health resources more efficiently

Prognosis of Spontaneous Pneumothorax/Pneumomediastinum in Coronavirus Disease 2019: The CoBiF Score

Objectives: Pneumothorax and pneumomediastinum are associated with high mortality in invasively ventilated coronavirus disease 2019 (COVID-19) patients; however, the mortality rates among non-intubated patients remain unknown. We aimed to analyze the clinical features of COVID-19-associated pneumothorax/pneumomediastinum in non-intubated patients and identify risk factors for mortality. Methods: We searched PubMed Scopus and Embase from January 2020 to December 2021. We performed a pooled analysis of 151 patients with no invasive mechanical ventilation history from 17 case series and 87 case reports. Subsequently, we developed a novel scoring system to predict in-hospital mortality; the system was further validated in multinational cohorts from ten countries (n = 133). Results: Clinical scenarios included pneumothorax/pneumomediastinum at presentation (n = 68), pneumothorax/pneumomediastinum onset during hospitalization (n = 65), and pneumothorax/pneumomediastinum development after recent COVID-19 treatment (n = 18). Significant differences were not observed in clinical outcomes between patients with pneumomediastinum and pneumothorax (±pneumomediastinum). The overall mortality rate of pneumothorax/pneumomediastinum was 23.2%. Risk factor analysis revealed that comorbidities bilateral pneumothorax and fever at pneumothorax/pneumomediastinum presentation were predictors for mortality. In the new scoring system, i.e., the CoBiF system, the area under the curve which was used to assess the predictability of mortality was 0.887. External validation results were also promising (area under the curve: 0.709). Conclusions: The presence of comorbidity bilateral pneumothorax and fever on presentation are significantly associated with poor prognosis in COVID-19 patients with spontaneous pneumothorax/pneumomediastinum. The CoBiF score can predict mortality in clinical settings as well as simplify the identification and appropriate management of patients at high risk