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Objectives. To examine the impact of COVID-19 shutdowns on food insecurity among a predominantly African American cohort residing in low-income racially isolated neighborhoods.Methods. Residents of 2 low-income African American food desert neighborhoods in Pittsburgh, Pennsylvania, were surveyed from March 23 to May 22, 2020, drawing on a longitudinal cohort (n = 605) previously followed from 2011 to 2018. We examined longitudinal trends in food insecurity from 2011 to 2020 and compared them with national trends. We also assessed use of food assistance in our sample in 2018 versus 2020.Results. From 2018 to 2020, food insecurity increased from 20.7% to 36.9% (t = 7.63; P less then .001) after steady declines since 2011. As a result of COVID-19, the United States has experienced a 60% increase in food insecurity, whereas this sample showed a nearly 80% increase, widening a preexisting disparity. Participation in the Supplemental Nutrition Assistance Program (52.2%) and food bank use (35.9%) did not change significantly during the early weeks of the pandemic.Conclusions. Longitudinal data highlight profound inequities that have been exacerbated by COVID-19. Existing policies appear inadequate to address the widening gap.During the first wave of the COVID-19 pandemic in the United States, many state governors faced an increasing number of acts of defiance as well as political and legal challenges to their public health emergency orders. Less well studied are the similar acts of protest that occurred during the 1918-1919 influenza pandemic, when residents, business owners, clergy, and even local politicians grew increasingly restless by the ongoing public health measures, defied public health edicts, and agitated to have them rescinded. We explore several of the themes that emerged during the late fall of 1918 and conclude that, although the nation seems to be following the same path as it did in 1918, the motivations for pushback to the 2020 pandemic are decidedly more political than they were a century ago.
In contrast to the well-described association between early-life weight-for-age, body mass index (BMI) and later lung disease in people with cystic fibrosis (CF), the relationship between height-for-age (HFA) percentiles and respiratory morbidity is not as well-studied. We hypothesized that changes in HFA in children with CF in the first 6 years of life would be associated with pulmonary function at ages 6-7 years.
To determine if an association exists between changes in HFA in early life and pulmonary function in school-age children with CF.
We performed a retrospective longitudinal cohort study of children with CF followed in the CF Foundation Patient Registry (CFFPR), born between 2003 and 2010, diagnosed before age 2 years, and followed through at least age 7 years. Evofosfamide Changes in annualized HFA were classified into mutually exclusive categories. Multivariable ANCOVA models were used to test for an association between forced expiratory volume in 1 second (FEV
) % predicted at age 6-7 years and height t50
percentile remains an important achievable goal for children with CF, but is not the sole marker that should be examined in evaluating nutrition.
50th percentile remains an important achievable goal for children with CF, but is not the sole marker that should be examined in evaluating nutrition.We report a case of neuro-ophthalmological complications of congenital toxoplasmosis, a parasitic infection caused by Toxoplasma gondi. Its congenital form occurs either as a primary infection or as reactivation of the same due to immunosuppression during pregnancy. With an incidence rate of 1.5/1000 live births, this disease is an important cause of visual loss from chorio-retinal lesions in >82%. Recent studies have shown that treatment given in utero and in the first year of life can reduce ophthalmological complications.We report a case who presented with decreased vision, significant hypotropia, proptosis and gross limitation of extraocular motility for one year. Suspecting an orbital tumour, we asked for a computed tomography of the orbit which revealed a mass lesion in the inferior orbit. However, incisional biopsy reported inflammatory infiltration. Diagnosing it as orbital inflammatory disease, a course of oral steroids was given for four weeks. It was only after the reduction in inflammation that a foreign body was palpable in the inferior fornix. Surgical exploration revealed a large wooden foreign body measuring 3.3 × 1 × 0.3 cm. Though intraorbital foreign bodies are not rare, ambiguous history, delayed presentation and nonspecific CT findings made this case diagnostically challenging.Purpose To report a case of intraretinal tubercular granuloma successfully treated with photodynamic therapy (PDT).Methods Retrospective case report. Multimodal imaging was performed at each follow-up visit.Results The tuberculoma did not regress and did not significantly reduce its exudation after anti-tubercular therapy (ATT), systemic steroid therapy and intravitreal anti-VEGF. Second line treatment with PDT was attempted. The lesion showed a regression with reduced sub-retinal fluid and intra-retinal exudates. A second PDT was performed for reactivation of the lesion 5 months after the first treatment. Further regression of the lesion was observed.Conclusion PDT may be a valuable second-line therapeutic approach for vascularized intraretinal granulomas.This paper aims to verify the association between the combined relationship of physical inactivity and sedentary behaviour (SB) at leisure-time and the prevalence of noncommunicable chronic diseases (NCDs) in Brazilian adults and elderly. This is a cross-sectional study, derived from the VIGITEL system, with individuals ≥18 years old (n = 52,675). The presence of NCDs (diabetes, hypertension, and obesity) and the independent variables were defined by self-report. Binary logistic regression was used. While adults with the presence of, at least, one risky behaviour had a higher odds to have obesity (OR active + high SB 1.25; 95%CI 1.01;1.54; OR inactive + low SB 1.47; 95%CI 1.25;1.73; OR inactive + high SB 1.77; 95%CI 1.47;2.12), the elderly had an increased risk for this outcome only when classified as inactive (OR inactive + low SB 1.43; 95%CI 1.17;1.75; OR inactive + high SB 1.87; 95%CI 1.47;2.38). Inactive adults with low SB were more likely to have diabetes (OR inactive + low SB 1.31; 95%CI 1.00;1.71) and hypertension (OR inactive + low SB 1.
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