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CT-guided percutaneous approach for the treatment of peripheral lung artery pseudoaneurysm: A case report.
This Italian observational real-world study aims to assess in chronic hepatitis C virus (HCV) patients treated with pangenotypic direct acting agents (pDAAs) glecaprevir/pibrentasvir (GLE/PIB) or sofosbuvir/velpatasvir (SOF/VEL) the potential drug-drug interactions (DDIs) with concomitant medications prescribed, with a focus on cardiovascular and system nervous (CNS) co-medications. Data were collected from administrative databases covering 6.9 million health-assisted individuals. All patients prescribed SOF/VEL or GLE/PIB between 11/2017 and 12/2018 were included. Patients were analyzed while on DAA. DDIs were identified according to the Liverpool University tool. Overall, 3181 HCV patients were included 1619 in the GLE/PIB cohort and 1562 in the SOF/VEL cohort. SOF/VEL patients were generally older than GLE/PIB ones (mean age 58.4 vs. 53.1, p less then 0.001) and had more cardiovascular and CNS comorbidities (58% vs. 42%, p less then 0.001 and 33% vs. 28%, p = 0.002, respectively). Contraindications due to DDIs in the GLE/PIB cohort affected 9.3% and 3.2% of patients before and on DAA, respectively, while the percentages in the SOF/VEL cohort were 3.2% before and 0.4% after pDAAs initiation. Among GLE/PIB patients, 2.7% had cardiovascular drugs (all statins) contraindicated while on DAA. The potential DDIs between cardiovascular drugs and SOF/VEL were mainly with statins (5%). SOF/VEL was prescribed in patients with older age and with more cardiovascular and CNS comorbidities. Despite this, a proportion of contraindicated drugs lower than that of GLE/PIB was registered.The study aimed to evaluate hospitalizations in a COVID-dedicated facility during the "spring wave" of the epidemic in 2020 in Poland and analyze changes in access to hospital treatment in the country in the early phase of the pandemic. We investigated all referrals and admissions to the Ministry of Interior and Administration hospital in Białystok from 14 April to 14 August 2020. A total of 238 patients were referred to the hospital (with a median age of 64.5 years; IQR, 44-78), most commonly with fever (n = 151; 63.5%). Only 135 (56.7%) were admitted (5.5% of the number hospitalized in the same period in 2019). SARS-CoV-2 was confirmed in 42 (17.7%) cases. Older people with concomitant diseases and disabilities dominated. Seventeen patients (12.6%) required ICU treatment, and 19 (14%) died. Based on the National Health Fund data, we also examined changes in the rate of hospitalizations in Poland and in selected Polish COVID/ and non-COVID hospitals between February and August 2019 and 2020. The number of hospitalizations in Poland decreased dramatically in comparison to 2019. A very low hospitalization rate, significantly lower than in structurally similar non-COVID hospitals, was observed in transformed hospitals. Better use of hospital resources was observed when the hospital was semi-transformed and had the flexibility to adapt to epidemiological needs. The study seems to confirm that the system of transformed COVID hospitals resulted in unused healthcare resources and limited patient access to medical services in the early period of the epidemic. As a consequence, systemic modifications allowing the maximization and adequate use of the Polish healthcare system's limited resources have been implemented.The impact of climate change on farmers' livelihoods has been observed in various forms at the local and regional scales. It is well known that the Himalayas region is affected by climate change, as reflected in the basic knowledge of farmers in the region. A questionnaire-based survey involving a total of 747 households was conducted to gather information on climate change and its impact, where the survey addressed four physiographic regions of the trans-boundary Koshi River Basin (KRB). Moreover, climatic data were used to calculate climatic trends between 1980 and 2018. The Mann-Kendall trend test was performed and the Sen's slope calculated to analyze the inter-annual climatic trends over time. The survey noted that, for the basin, there was an increase in temperature, climate-induced diseases of crops, an increase in the frequency of pests as well as drought and floods and a decrease in rainfall, all which are strong indicators of climate change. It was perceived that these indicators had adverse impacts on crop production (89.4%), human health (82.5%), livestock (68.7%) and vegetation (52.1%). The observed climatic trends for all the physiographic regions included an increasing temperature trend and a decreasing rainfall trend. The rate of change varied according to each region, hence strongly supporting the farmers' local knowledge of climate change. The highest increasing trend of temperature noted in the hill region at 0.0975 °C/a (p = 0.0002) and sharpest decreasing trend of rainfall in the mountain region by -10.424 mm/a (p = 0.016) between 1980 and 2018. Formulation of suitable adaptation strategies according to physiographic region can minimize the impact of climate change. New adaptation strategies proposed include the introduction of infrastructure for irrigation systems, the development of crop seeds that are more tolerant to drought, pests and disease tolerance, and the construction of local hospitals for the benefit of farming communities.An effective approach for assessing a drug's potential to induce autoimmune diseases (ADs) is needed in drug development. click here Here, we aim to develop a workflow to examine the association between structural alerts and drugs-induced ADs to improve toxicological prescreening tools. Considering reactive metabolite (RM) formation as a well-documented mechanism for drug-induced ADs, we investigated whether the presence of certain RM-related structural alerts was predictive for the risk of drug-induced AD. We constructed a database containing 171 RM-related structural alerts, generated a dataset of 407 AD- and non-AD-associated drugs, and performed statistical analysis. The nitrogen-containing benzene substituent alerts were found to be significantly associated with the risk of drug-induced ADs (odds ratio = 2.95, p = 0.0036). Furthermore, we developed a machine-learning-based predictive model by using daily dose and nitrogen-containing benzene substituent alerts as the top inputs and achieved the predictive performance of area under curve (AUC) of 70%.
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