Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Técnicas de estudio

El proyecto propone la mejora en el proceso de enseñanza-aprendizaje a través de un buen conocimiento de las técnicas de estudio (lectura, subrayado, resumen). Se lleva a cabo con carácter voluntario entre los alumnos de primero de BUP en sesiones de una hora semanal. Los objetivos son: informar a los alumnos sobre los factores que condicionan el proceso de estudio; dar a conocer las técnicas necesarias para un estudio más eficaz; ejercitar estas técnicas; ayudar a crear hábitos de planificación del tiempo de estudio; y desarrollar la costumbre de la lectura-estudio. La experiencia se centra en la explicación, con ayuda del material elaborado por el profesor, de las distintas técnicas, y realización de ejercicios prácticos extraídos de los libros de texto utilizados por los alumnos. En principio sólo participan alumnos de primero pero en el segundo trimestre a instancia de alguna junta de evaluación se incorporan alumnos de segundo. La valoración del proyecto es positiva a pesar de que no se puede evaluar en su totalidad la incidencia práctica, porque la adquisición de los hábitos depende de su sistematización a lo largo del tiempo.Madrid (Comunidad Autónoma). Consejería de Educación y CulturaMadridMadrid (Comunidad Autónoma). Subdirección General de Formación del Profesorado. CRIF Las Acacias; General Ricardos 179 - 28025 Madrid; Tel. + 34915250893ES

Traumatismo Craneoencefálico Leve en Preescolares: Cambios Cognitivos durante la Fase Aguda de la Lesión

Traumatic Brain Injury (TBI) is one of the most important causes of child morbidity and mortality. Previous researches report cognitive sequelae even in mild injuries. The aim of the present study was to know the cognitive characteristics in Mexican preschoolers with acute mild TBI; as well as exploring the relationship between cognitive outcomes with the occurrence edge of injury and preinjury behavioral and adaptive characteristics, in comparison to an orthopedic injury group (OI) without neck or head damages. Were evaluated 16 children with mild TBI and 16 children with OI, ages 4-6, with Neuropsychological Battery LuriaInicial. Results showed less score in the mild TBI group than OI group in numeric operations task. Men had worst performance in gestures and praxias, visual memory, vocabulary in images and numeric operations; while, there were no differences between comparison women´s groups. No differences were found between the occurrence edge of injury and cognitive tests in TBI children. Also, there were no preinjury characteristics differences among groups. Results suggest that mild TBI preschoolers are more susceptible to less arithmetic performance during acute phase of the injury. Gender in early development could influence in cognitive outcomes follow acute mild TBI. Rather, the occurrence edge of the injury; as well as preinjury characteristics could not relationship with cognitive results in children with TBI.El traumatismo craneoencefálico (TCE) es una de las principales causas de morbilidad y mortalidad infantil. Investigaciones anteriores reportan secuelas cognitivas, incluso ante lesiones leves. El objetivo del presente estudio fue conocer las características cognitivas en preescolares mexicanos con TCE leve agudo, así como explorar la relación de los resultados cognitivos con la edad de ocurrencia de la lesión y las características conductuales y adaptativas premórbidas, en comparación con un grupo de traumatismo musculoesquelético (TME). Participaron 16 niños con TCE leve y 16 niños con TME, entre los 4 y 6 años. Fueron valorados con la Batería Neuropsicológica Luria Inicial. Los resultados mostraron un menor desempeño en la tarea de operaciones numéricas en el grupo con TCE, en comparación con el de TME. Los hombres con TCE presentaron un menor rendimiento en gestos y praxias, memoria visual, vocabulario en imágenes y operaciones numéricas; mientras que en las mujeres no existieron diferencias entre los grupos. No se encontró relación entre la edad de ocurrencia del TCE y las pruebas cognitivas. Tampoco hubo diferencias en las características premórbidas entre los grupos. Los resultados sugieren que los preescolares con TCE leve son susceptibles a un menor rendimiento enoperaciones aritméticas durante la etapa aguda de la lesión. El género en etapas tempranas del desarrollo podría influir en los resultados cognitivos posteriores al TCE leve agudo. En cambio, la edad de ocurrencia de la lesión, así como las características premórbidas no tuvieron relación con el desempeño cognitivo en los niños con TCE

Curso Didáctica de la Comunicación audiovisual

El objetivo del curso es permitir a los profesores que imparten la asignatura EATP de Imagen y Sonido en Educación Secundaria intercambiar experiencias, programaciones e ideas, para mejorar la calidad de la enseñanza. Cada uno de los asistentes al curso presenta una ponencia en la que expone su programa curricular. Explican los objetivos, los contenidos, la metodología y los materiales necesarios. Algunas de las materias tratadas son la radio, la cinematografía, el vídeo, la imagen, la publicidad, la prensa, la televisión y los medios de comunicación de masas en general.Madrid (Comunidad Autónoma). Dirección General de Educación. Servicio de Renovación PedagógicaMadridMadrid (Comunidad Autónoma). Subdirección General de Formación del Profesorado. CRIF Las Acacias; General Ricardos 179 - 28025 Madrid; Tel. + 34915250893ES

Effect of Photobiomodulation With Different Wavelengths on Radiodermatitis Treatment

Background:. Approximately 80% of patients submitted to radiotherapy develop radiodermatitis. Photobiomodulation based on light-emitted diode (LED) is one of the therapeutic strategies for treating inflammation. This study aimed to investigate the effect of the photobiomodulation with two wavelengths, in an acute radiodermatitis animal model. Methods:. Twenty rats were submitted to one radiotherapy session. After 15 days, the rats that developed radiodermatitis were divided into control groups, LED-630 nm, LED-850 nm, and LED-630 + 850 nm. The treatment regimen was one session lasting 10 minutes on alternate days for 21 days. We analyzed macroscopy aspects (RTOG scale), vascular density, dermal appendages, VEGF-a, TNF-alpha, MMP-9, and MMP-9 genic expression level. Results:. All LED groups revealed a two-point reduction on the radiodermatitis severity grade compared with the baseline classification. Dermal appendage and vascular analysis showed a higher counting in all LED groups compared to control. This study showed dermal appendages twice in the 630/850 nm group compared with the control group. The 630/850 nm group showed six times more arterioles than the control group. Regarding genic expression, this study showed a 10-fold decrease between LED-630 nm versus LED-630 + 850 nm (P = 0.02) interleukin-10 expression and a 12-fold decrease between control versus LED-630 nm (P = 0.006) and LED-850 nm (P = 0.002) in TNF-alpha. Conclusion:. LED (630 nm, 850 nm, and 630 nm + 850 nm) showed benefit in the treatment of radiodermatitis, and the association of the 630 nm + 850 nm and 630 nm parameters demonstrated the best macroscopic and microscopic results

Idiosyncrasie de l’indigénisme en Amérique latine. Pluralité des sources et des appropriations extra-latino-américaines

Ce numéro 12 d'Artelogie rassemble des articles traitant des sources extra-latino-américaines de l'indigénisme dans une approche diachronique et transdisciplinaire et invite à analyser cette thématique sous l'angle des transferts culturels, des processus d'appropriations intellectuelles et plastiques ou bien des refus d'adoptions de modèles politiques et artistiques. La « négociation » entre nationalisme et internationalisme est au cœur de la problématique de ce numéro qui propose de questionner un tel processus comme une stratégie de transculturation entre l’Amérique latine et le reste du monde. Jusqu’alors majoritairement étudié comme un mouvement centripète à cette aire géographique, il convient ici d’appréhender l’indigénisme comme un phénomène centrifuge, pluriséculaire et transculturel. Este número 12 de Artelogie reúne artículos sobre las fuentes extralatinoamericanas del indigenismo en un enfoque diacrónico y transdisciplinario e invita a analizar este tema desde el punto de vista de las transferencias culturales, los procesos de apropiación intelectual y plástica o incluso la negativa a adoptar modelos políticos y artísticos. La "negociación " entre nacionalismo e internacionalismo se ubica en el eje de nuestra propuesta que propone cuestionar una tal tendencia latinoamericana como estrategia de transculturación entre esta área geográfica y el resto del mundo. Hasta entonces estudiado principalmente como un movimiento centrípeto en América Latina, es apropiado aquí aprehender el indigenismo como un fenómeno centrífugo, plurisecular y transcultural

Reduction of cardiac imaging tests during the COVID-19 pandemic: The case of Italy. Findings from the IAEA Non-invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

Background: In early 2020, COVID-19 massively hit Italy, earlier and harder than any other European country. This caused a series of strict containment measures, aimed at blocking the spread of the pandemic. Healthcare delivery was also affected when resources were diverted towards care of COVID-19 patients, including intensive care wards. Aim of the study: The aim is assessing the impact of COVID-19 on cardiac imaging in Italy, compare to the Rest of Europe (RoE) and the World (RoW). Methods: A global survey was conducted in May–June 2020 worldwide, through a questionnaire distributed online. The survey covered three periods: March and April 2020, and March 2019. Data from 52 Italian centres, a subset of the 909 participating centres from 108 countries, were analyzed. Results: In Italy, volumes decreased by 67% in March 2020, compared to March 2019, as opposed to a significantly lower decrease (p &lt; 0.001) in RoE and RoW (41% and 40%, respectively). A further decrease from March 2020 to April 2020 summed up to 76% for the North, 77% for the Centre and 86% for the South. When compared to the RoE and RoW, this further decrease from March 2020 to April 2020 in Italy was significantly less (p = 0.005), most likely reflecting the earlier effects of the containment measures in Italy, taken earlier than anywhere else in the West. Conclusions: The COVID-19 pandemic massively hit Italy and caused a disruption of healthcare services, including cardiac imaging studies. This raises concern about the medium- and long-term consequences for the high number of patients who were denied timely diagnoses and the subsequent lifesaving therapies and procedures

International Impact of COVID-19 on the Diagnosis of Heart Disease

Background: The coronavirus disease 2019 (COVID-19) pandemic has adversely affected diagnosis and treatment of noncommunicable diseases. Its effects on delivery of diagnostic care for cardiovascular disease, which remains the leading cause of death worldwide, have not been quantified. Objectives: The study sought to assess COVID-19's impact on global cardiovascular diagnostic procedural volumes and safety practices. Methods: The International Atomic Energy Agency conducted a worldwide survey assessing alterations in cardiovascular procedure volumes and safety practices resulting from COVID-19. Noninvasive and invasive cardiac testing volumes were obtained from participating sites for March and April 2020 and compared with those from March 2019. Availability of personal protective equipment and pandemic-related testing practice changes were ascertained. Results: Surveys were submitted from 909 inpatient and outpatient centers performing cardiac diagnostic procedures, in 108 countries. Procedure volumes decreased 42% from March 2019 to March 2020, and 64% from March 2019 to April 2020. Transthoracic echocardiography decreased by 59%, transesophageal echocardiography 76%, and stress tests 78%, which varied between stress modalities. Coronary angiography (invasive or computed tomography) decreased 55% (p &lt; 0.001 for each procedure). In multivariable regression, significantly greater reduction in procedures occurred for centers in countries with lower gross domestic product. Location in a low-income and lower–middle-income country was associated with an additional 22% reduction in cardiac procedures and less availability of personal protective equipment and telehealth. Conclusions: COVID-19 was associated with a significant and abrupt reduction in cardiovascular diagnostic testing across the globe, especially affecting the world's economically challenged. Further study of cardiovascular outcomes and COVID-19–related changes in care delivery is warranted

Impact of COVID-19 on Diagnostic Cardiac Procedural Volume in Oceania: The IAEA Non-Invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

Objectives: The INCAPS COVID Oceania study aimed to assess the impact caused by the COVID-19 pandemic on cardiac procedure volume provided in the Oceania region. Methods: A retrospective survey was performed comparing procedure volumes within March 2019 (pre-COVID-19) with April 2020 (during first wave of COVID-19 pandemic). Sixty-three (63) health care facilities within Oceania that perform cardiac diagnostic procedures were surveyed, including a mixture of metropolitan and regional, hospital and outpatient, public and private sites, and 846 facilities outside of Oceania. The percentage change in procedure volume was measured between March 2019 and April 2020, compared by test type and by facility. Results: In Oceania, the total cardiac diagnostic procedure volume was reduced by 52.2% from March 2019 to April 2020, compared to a reduction of 75.9% seen in the rest of the world (p&lt;0.001). Within Oceania sites, this reduction varied significantly between procedure types, but not between types of health care facility. All procedure types (other than stress cardiac magnetic resonance [CMR] and positron emission tomography [PET]) saw significant reductions in volume over this time period (p&lt;0.001). In Oceania, transthoracic echocardiography (TTE) decreased by 51.6%, transoesophageal echocardiography (TOE) by 74.0%, and stress tests by 65% overall, which was more pronounced for stress electrocardiograph (ECG) (81.8%) and stress echocardiography (76.7%) compared to stress single-photon emission computerised tomography (SPECT) (44.3%). Invasive coronary angiography decreased by 36.7% in Oceania. Conclusion: A significant reduction in cardiac diagnostic procedure volume was seen across all facility types in Oceania and was likely a function of recommendations from cardiac societies and directives from government to minimise spread of COVID-19 amongst patients and staff. Longer term evaluation is important to assess for negative patient outcomes which may relate to deferral of usual models of care within cardiology