To evaluate the relationship between the incidence of complications and functionally monocular patients' emotional reactions during phacoemulsification under topical anesthesia.

We enrolled 22 functionally monocular patients (11 males and 11 females; group 1) and 19 age- and sex-matched controls (6 males and 13 females; group 2) in this prospective, interventional, cross-sectional, case control study. Demographics data, including age, sex, and educational background, were collected. Surgeries were performed by the same surgeon, and during surgery, the patients' vital signs (blood pressure and heart rate) and surgical events (duration, body movements, signs of increased vitreous cavity pressure, difficulty in performing capsulorhexis, and complications) were noted. Pre- and postoperative visual acuity was also analyzed.

The mean age of group 1 was 73.05 ± 13.31 years and of group 1 was 69.74 ± 16.81 years. There was no significant between-group difference in systolic and diastolic blood pressures. The average heart rate was similar in both groups, too. During surgery, the surgeon's perception of excessive eye, eyelid, or head movements in both groups was similar, in addition to signs of increased vitreous cavity pressure.

It is safe to perform phacoemulsification under topical anesthesia in functionally monocular patients, who apparently behave similarly to binocular patients.
It is safe to perform phacoemulsification under topical anesthesia in functionally monocular patients, who apparently behave similarly to binocular patients.Brazil is one of the most heavily impacted countries by the COVID-19 pandemic, and the real number of deaths from the disease makes the scenario even more challenging. This study aimed to estimate the excess deaths and their differences in adults 20 years and older in Manaus (Amazonas State), Fortaleza (Ceará State), Rio de Janeiro, and São Paulo, according to place of death, demographic characteristics, and trajectory over time. The data were obtained from the Mortality Information System and the Central Information Office of the National Civil Registry. The estimates of expected deaths were obtained from quasi-Poisson generalized additive models, adjusting for overdispersion. From February 23 to June 13, 2020, 74,410 natural deaths were recorded in the four cities, with 46% excess deaths (95%CI 44-47). The largest amount of excess deaths was in Manaus, with 112% (95%CI 103-121), followed by Fortaleza with 72% (95%CI 67-78), Rio de Janeiro with 42% (95%CI 40-45), and São Paulo with 34% (95%CI 32-36). Excess deaths were greater in males and non-significant in Epidemiologic Weeks (EW) 9-12, except in São Paulo, 10% (95%CI 6-14). The peak in excess deaths generally occurred in EW 17-20. The number of excess deaths not explained directly by COVID-19 and deaths at home or on public byways is high, especially in Manaus. The high percentages of excess deaths, deaths not explained directly by COVID-19, and deaths outside the hospital suggest high underreporting of deaths from COVID-19 and reinforce the extensive spread of SARS-CoV-2, as well as the need for epidemiological surveillance services to review all causes of deaths associated with respiratory symptoms.The aim was to assess the association between the organizational quality of children's healthcare in primary care services and variables in the management context. An evaluative survey in 151 primary care services in 40 municipalities (counties) in the interior of the State of São Paulo, Brazil, answered the QualiAB in 2014. Services were scored according to 41 children's health indicators which comprised quality groups distributed by quartiles and were associated with 17 management indicators. The following were not associated with the quality groups participation in the More Doctors Program/Provab-Médico (p = 0.102), availability of social services (p = 0.315), and high-risk pregnancy (p = 0.814). The association was significant for all the others. Although for some variables, groups G1 and G2 were similar to the more polar groups (G0 and G3), the latter showed differences in all the variables. The services belonging to the group considered as having the best quality (G3) were mostly organized in the Family Health Unit/Mixed model (p = 0.018), administered under outsourced management (p less then 0.001), regularly supplied prenatal care (p less then 0.001), had a general practitioner or family physician available on a 24/7 basis (p = 0.009), and had a support network consisting mainly of CAPSi and CAPSAd III and children's health services (p less then 0.001). They also reported holding weekly team meetings (p less then 0.001), studying cases of spontaneous demand (p less then 0.001), and changing the management and organization of care based on the evaluative process (p = 0.004). In conclusion, organizational quality does not depend only on practices by health professionals, but also on administrators' decisions.The lack of mass testing for COVID-19 diagnosis creates the need to determine the magnitude of the disease based on its clinical symptoms. https://www.selleckchem.com/products/gsk2126458.html The study aimed to analyze the profile of COVID-19 symptoms and related aspects in Brazil. The author analyzed the sample of participants from the Brazilian National Household Sample Survey (PNAD-COVID19) conducted in May 2020. Latent class analysis (LCA) was performed with sociodemographic covariables and 11 symptoms reported by 346,181 individuals. Rao-Scott test and standardized residual analysis were used to measure the association with the pattern of health services use. Spatial scan analysis was performed to identify areas at risk of COVID-19 cases. LCA showed six classes of symptoms based on the pattern of answers by participants (1) all the symptoms; (2) high prevalence of symptoms; (3) predominance of fever; (4) predominance of cough/sore throat; (5) mild symptoms with predominance of headache; and (6) absence of symptoms. Female sex, brown skin color, the North and Northeast regions of Brazil, and all three older age brackets showed stronger association with the class with all the symptoms (class 1). Most use of health services was also by this group of individuals, but with different profiles of use. Spatial analysis showed juxtaposition of this class with areas at greater risk of COVID-19. These finding underline the importance of investigating symptoms for the epidemiological identification of possible cases in a scenario with low population testing rates.

A 63-year-old Japanese male with stomach adenocarcinoma received oral 5-fluorouracil derivative, cisplatin and trastuzumab chemotherapy. On day 8, severe diarrhea and mucositis developed; chemotherapy was stopped. On day 14, the patient developed renal dysfunction and febrile neutropenia. He also suffered from pneumonia due to Candida albicans. Systemic symptoms improved after intensive conservative treatment. Best supportive care was continued until the patient died from gastric cancer. The dihydropyrimidine dehydroge-nase protein level was low at 3.18 U/mg protein. The result of DPYD genotyping revealed three variants at posi-tions 1615 (G > A), 1627 (A > G), and 1896 (T > C) in exons 13, 13, and 14, respectively.A minimally invasive posterolateral approach designed to avoid the lateral misplacement of midcervical pedicle screws was reported, but there is no technical report that describes this technique without C-arm fluoroscopy. We report the results of a 2.5 years follow-up of a 62-year-old female patient with C4 metastatic breast cancer. The patient suffered from severe neck pain and impending quadriplegia for 2 months after radiation therapy. We performed C-arm-free minimally invasive cervical pedicle screw fixation (MICEPS). The patient was suc-cessfully treated with surgery, and her neck pain was well controlled. She had neither neurological deficits nor neck pain at the final (2.5-year) follow-up. C-arm-free MICEPS is a useful technique; in addition, the sur-geons and staff have no risk of radiation exposure, there is a reduced need for postoperative imaging, and a decreased revision rate can be expected with C-arm-free MICEPS.Polymorphisms in methotrexate transporter pathways have been associated with methotrexate toxicities and clearance. Recent genome-wide association studies have revealed that the SLCO1B1 T521C variant is associated with methotrexate elimination. We present a case of a pediatric patient with acute lymphoblastic leukemia who suffered from persistently high plasma methotrexate concentrations and acute kidney injuries after the admin-istration of a medium dose of methotrexate. Subsequent genetic analysis showed that he was a carrier of dys-functional genetic variants associated with methotrexate clearance. This case highlights that polymorphisms of methotrexate transporter pathways can adversely affect methotrexate elimination in a clinically significant manner.Active treatment with intramedullary screw fixation is now common for athletes with Jones fracture. Outcomes are generally good, but complications can occur. We report 4 rare complications of intramedullary screw fixa-tion. Two cases developed osteomyelitis and pseudarthrosis caused by thermal necrosis. In the other two cases, screw-related complications occurred during the insertion of the tapered headless screw. Although thermal necrosis and screw insertion failures are considered rare complications and not widely reported in the litera-ture, they do occur occasionally. Knowing the mechanisms underlying these complications could help prevent them, and knowing their course could lead caregivers to appropriate interventions when they do occur.Soft tissue myoepitheliomas are often misdiagnosed due to their rarity. Herein, we describe a case of soft tissue myoepithelioma of the shoulder. A 72-year-old woman had a suspected sarcoma on her shoulder and under-went open biopsy. She was referred to our hospital, where the tumor was widely resected and the diagnosis of myoepithelioma was histologically confirmed. No recurrence has been observed in the 3 years since the sur-gery. https://www.selleckchem.com/products/hrs-4642.html Careful and prompt planning is necessary for the effective treatment of myoepithelioma.Cardiac metastasis originating from hepatocellular carcinoma (HCC) is a rare condition with a poor prognosis. No therapeutic standards for cardiac metastasis originating from HCC have been established. At 19 months after a curative hepatectomy, a 64-year-old Japanese hepatitis B virus-positive male patient experienced solitary cardiac metastasis originating from HCC. The cardiac tumor was discovered in the right ventricle. The patient received three courses of radiotherapy and chemotherapy and survived > 3 years after the initial diagnosis of cardiac metastasis. His case demonstrates that radiotherapy combined with chemotherapy can be an effective treatment for cardiac metastasis.We report a successful dissection of metastatic posterior thoracic para-aortic lymph node (No. 112aoP) via bilateral thoracoscopic surgery. With the anesthetized patient (a 73-year-old Japanese woman) in the prone position, two working ports were inserted for the left-side approach, and artificial pneumothorax was created. Thoracoscopic examination revealed a swollen LN posterior to the descending aorta. Fat and metastatic LNs posterior to the aorta were dissected from the aortic arch level to the diaphragm while preserving intercostal arteries. For the right-side approach, two working ports were inserted and a routine thoracoscopic esophagec-tomy was performed. Gastric conduit reconstruction was achieved laparoscopically. Operation time for the left thoracic procedure 54 min; estimated blood loss almost none. No recurrence was detected 24 months post-operatively. There are several surgical options for approaching No. 112aoP, including transhiatal, left thora-cotomy, and thoracoscopy. Although a wide dissection of the posterior thoracic para-aortic area has not been reported, it may be feasible and safe if the artery of Adamkiewicz and intercostal arteries are preserved. A min-imally invasive bilateral thoracoscopic approach for a thoracoscopic esophagectomy is safe and useful for esophageal cancer patients with solitary No. 112aoP metastasis.Few studies have investigated the influence of the Coronavirus Disease 2019 (COVID-19) pandemic on emer-gency medical service (EMS) systems, especially in areas less affected or unaffected by COVID-19. In this study, we investigated changes in prehospital EMS activity and transport times during the COVID-19 pandemic. All patients transported by EMS in the city of Okayama from March-May 2019 or March-May 2020 were included. Interfacility transports were excluded. The primary outcome was the time from a patient's first emergency call until hospital arrival (total prehospital time). Secondary outcomes included three segments of total prehospital time the response time, on-scene time, and transportation time. Total prehospital time and the durations of each segment were compared between corresponding months in 2020 (COVID19-affected) and 2019 (control). The results showed that total prehospital times in April 2020 were significantly higher than those in 2019 (33.8 ± 11.6 vs. 32.2 ± 10.8 min, p less then 0.001).

In patient education, there is a need for valid and reliable instruments to assess and tailor empowering educational activities. In this study, we summarize the process of producing two parallel instruments for analyzing hospital patients' expectations (Expected Knowledge of Hospital Patients, EKhp) and received knowledge (Received Knowledge of Hospital Patients, RKhp) and evaluate the psychometrics of the instruments based on international data. In the instruments, six elements of empowering knowledge are included (bio-physiological, functional, experiential, ethical, social, and financial).

The original Finnish versions of EKhp and RKhp were tested for the first time in 2003, after which they have been used in several national studies. For international purposes, the instruments were first translated into English, then to languages of the seven participating European countries, using double-checking procedure in each one, and subsequently evaluated and confirmed by local researchers and language expertssides surgical nursing is especially warranted.
EKhp and RKhp have potential for international use in the evaluation of empowering patient education. In the future, testing of the structure is needed, and validation in other fields of clinical care besides surgical nursing is especially warranted.Coronavirus disease 2019 (COVID19) is spreading rapidly and there is now much concern regarding different aspects of public health. Underlying disorders like cardiovascular diseases can increase the mortality rate. Understanding cardiovascular complications, manifestations and management in COVID19 is a necessary need. In this comprehensive review, we evaluated different aspects of cardiovascular disorders or complications related to COVID19 infection.
Imidacloprid is the most commonly used neonicotinoid insecticide worldwide. Despite its reputation for safety, there is increasing evidence regarding its toxicity. This study characterized the clinical manifestations and outcomes of acute imidacloprid poisoning.

This was a retrospective study of patients with imidacloprid poisoning who were referred to the Ramathibodi Poison Center in Bangkok, Thailand between 2010 and 2018.

A total of 163 patients with imidacloprid-only exposure were included. Most were exposed by ingestion (93.3%). The patients were predominantly male (55.8%), with a median age of 41.3 years. The common presenting features were gastrointestinal symptoms (63.8%) with no corrosive injuries and neurological effects (14.2%). The majority of medical outcomes was no (18.4%) to mild (76.1%) toxicity. One patient had symptoms mimicking cholinergic syndrome, three developed liver injury, and five died. Among the five deaths, two patients presented severe initial severity, and one presented modns including cardiovascular effects, central nervous system effects, dyspnea, and diaphoresis at the initial presentation should be considered for close observation and monitoring.
Developmental dysplasia of the hip (DDH) is an abnormal relationship between the acetabulum and the head of the femur. Plain x-ray of both hips at the age of 3 months is still in use in some countries. https://www.selleckchem.com/products/pf-562271.html On plain films, classic lines and angles are evaluated to meet current guidelines for positive DDH. Among these is the acetabular angle (AA), which most did not exceed 30° in normal pelvis regardless of gender. A flat promontory gives the impression of a high AA angle, whereas a sharp promontory gives the impression of a low AA angle.

All anteroposterior (AP) pelvic digital x-ray studies performed to rule out DDH were collected from the PACS systems. A novel angle was measured between a line parallel to the lateral aspect of the region of the inferior iliac spines and a line that extends along the acetabular roof to quantify the roundness of the iliac promontory. We called the former line the Miral line and the formed angle the iliac promontory angle.

We show that the promontory shape is significantly different between genders, and therefore it is mistaken to generalize an upper AA limit for males and females. In addition, we show that the current guideline of the upper limit of AA did not predict the incidence of DDH.

We suggest that the current practice is introducing a high rate of false positive, especially among females, and the current guidelines on AA should be reviewed and assigned separately for males and females. This is more important for countries that did not utilize the ultrasonographic assessment for DDH.
We suggest that the current practice is introducing a high rate of false positive, especially among females, and the current guidelines on AA should be reviewed and assigned separately for males and females. This is more important for countries that did not utilize the ultrasonographic assessment for DDH.
MicroRNAs (miRs) have been suggested to be biomarkers to inform the diagnosis of major depressive disorder (MDD). We have previously shown that exosome-derived miR-139-5p had potential in differentiating between patients with MDD and healthy control (HC) subjects.

To validate the potential of exosome-derived miR-139-5p as a biomarker for MDD, here we recruited 30 patients with MDD and 30 HC subjects, and used TaqMan probes to detect serum exosomal miR-139-5p levels.

The data showed that patients with MDD had significantly increased exosomal miR-139-5p levels when compared with controls. Correlation analysis suggested that sex, age, and body mass index did not significantly affect blood exosomal miR-139-5p levels in the tested subjects. The ROC curve showed that serum-derived miR-139-5p had reasonable performance in discriminating patients with MDD and HC subjects, with a sensitivity of 0.867 and specificity of 0.767, and the AUC was 0.807.

Taken together, these results demonstrated that patients with MDD were accompanied by significantly increased blood exosomal miR-139-5p levels, and exosomal miR-139-5p is a promising biomarker for the diagnosis of MDD.
Taken together, these results demonstrated that patients with MDD were accompanied by significantly increased blood exosomal miR-139-5p levels, and exosomal miR-139-5p is a promising biomarker for the diagnosis of MDD.

The rate of patients with an intelligence impairment (total IQ  less then  70) was higher for GE (40%) than for IGE/GGE (14%) and for IFE (7%) patients (p = 0.033). There were no significant differences between groups for behavior scores and behavioral problems. This study shows that the current ILAE classification of epilepsies with genetic etiology creates a heterogeneous group of patients with respect to cognitive performance but not behavior. These findings may help in further delineating epilepsies as regards cognitive performance, notwithstanding their closely related etiological classification.An electrosynthesis is presented to transform CO2 into an unusual nano and micron dimensioned morphology of carbon, termed Carbon Nano-Scaffold (CNS) with wide a range of high surface area graphene potential usages including batteries, supercapacitors, compression devices, electromagnetic wave shielding and sensors. Current CNS value is over $323 per milligram. The morphology consists of a series of asymmetric 20 to 100 nm thick flat multilayer graphene platelets 2 to 20 µm long orthogonally oriented in a 3D neoplasticism-like geometry, and appears distinct from the honeycomb, foam, or balsa wood cell structures previously attributed to carbon scaffolds. The CNS synthesis splits CO2 by electrolysis in molten carbonate and has a carbon negative footprint. It is observed that transition metal nucleated, high yield growth of carbon nanotubes (CNTs) is inhibited in electrolytes containing over 50 wt% of sodium or 30 wt% of potassium carbonate, or at electrolysis temperatures less than 700 °C. https://www.selleckchem.com/ Here, it is found that a lower temperature of synthesis, lower concentrations of lithium carbonate, and higher current density promotes CNS growth while suppressing CNT growth. Electrolyte conditions of 50 wt% sodium carbonate relative to lithium carbonate at an electrolysis temperature of 670 °C produced over 80% of the CNS desired product at 85% faradaic efficiency with a Muntz brass cathode and an Inconel anode.Numerous spine Finite Element (FE) models have been developed to assess spinal tolerances, spinal loadings and low back pain-related issues. However, justified simplifications, in terms of tissue decomposition and inclusion, for such a complex system may overlook crucial information. Thus, the purpose of this research was to develop and validate a comprehensive and representative spine FE model inclusive of an accurate representation of all major torso elements. A comprehensive model comprised of 273 tissues was developed via a novel FE meshing method to enhance computational feasibility. A comprehensive set of indirect validation tests were carried out to validate every aspect of the model. Under an increasing angular displacement of 24°-41°, the lumbar spine recorded an increasing moment from 5.5 to 9.3 Nm with an increase in IVD pressures from 0.41 to 0.66 MPa. Under forward flexion, vertical vertebral displacements simulated a 6% and 13% maximum discrepancy for intra-abdominal and intramuscular pressure results, all closely resembling previously documented in silico measured values. The developed state-of-the-art model includes most physiological tissues known to contribute to spinal loadings. Given the simulation's accuracy, confirmed by its validation tests, the developed model may serve as a reliable spinal assessment tool.Potentially neuroprotective effects of CI use were studied in 22 children with single sided deafness (SSD). Auditory-evoked EEG confirmed strengthened representation of the intact ear in the ipsilateral auditory cortex at initial CI activation in children with early-onset SSD (n = 15) and late-onset SSD occurring suddenly in later childhood/adolescence (n = 7). In early-onset SSD, representation of the hearing ear decreased with chronic CI experience and expected lateralization to the contralateral auditory cortex from the CI increased with longer daily CI use. In late-onset SSD, abnormally high activity from the intact ear in the ipsilateral cortex reduced, but responses from the deaf ear weakened despite CI use. Results suggest that (1) cortical reorganization driven by unilateral hearing can occur throughout childhood; (2) chronic and consistent CI use can partially reverse these effects; and (3) CI use may not protect children with late-onset SSD from ongoing deterioration of pathways from the deaf ear.The current outbreak of coronavirus disease 2019 (COVID-19) has become a global crisis due to its quick and wide spread over the world. A good understanding of the dynamic of the disease would greatly enhance the control and prevention of COVID19. However, to the best of our knowledge, the unique features of the outbreak have limited the applications of all existing dynamic models. In this paper, a novel stochastic model was proposed aiming to account for the unique transmission dynamics of COVID-19 and capture the effects of intervention measures implemented in Mainland China. We found that (1) instead of aberration, there was a remarkable amount of asymptomatic virus carriers, (2) a virus carrier with symptoms was approximately twice more likely to pass the disease to others than that of an asymptomatic virus carrier, (3) the transmission rate reduced significantly since the implementation of control measures in Mainland China, and (4) it was expected that the epidemic outbreak would be contained by early March in the selected provinces and cities in China.The introduction of femtosecond laser-assisted cataract surgery is an alternative approach to conventional cataract surgery. Our study aimed to determine the effectiveness of femtosecond laser-assisted capsulotomy in the presence of different ophthalmic viscoelastic devices (OVDs) in the anterior chamber. Fresh porcine eyes (n = 96) underwent LDV Z8-assisted anterior capsulotomy, either in the presence of an OVD (Viscoat, Provisc, Healon, Healon GV or HPMC) or without, using 90% and 150% energies respectively. Following that, the capsule circularity, tag's arc-length, tag-length, tag-area and rupture strength (mN) of the residual capsular bag were evaluated. We found that increasing energy from 90 to 150% across the OVD sub-groups improved the studied capsulotomy parameters. Amongst the 90% energy sub-groups, the circularity and tag-parameters were worse with Viscoat and Healon GV, which have higher refractive index and viscosity compared to the aqueous humour. Using 150% energy, Healon GV showed a significantly worse total arc-length (p = 0.

There is a scarcity of data regarding the effect of Type 2 diabetes mellitus (T2DM) and associated comorbidities on the clinical presentation and outcome of symptomatic patients with -COVID-19 infection in comparison with non-diabetic patients.

We described and compared the clinical presentation and radiological and hematological data of a cohort of symptomatic COVID19 positive T2DM diabetic patients (n = 59) versus another cohort of non-diabetic symptomatic COVID19 positive patients (n =244) diagnosed at the same time from January 2020 to May 2020. Associated comorbidities were -assessed, and the Charlson Comorbidity Index was calculated. The outcomes including duration of hospitalization, duration of Intensive Care Unit (ICU) stay, duration of mechanical ventilation, and duration of O2 -supplementation were assessed.

Prevalence of T2DM in symptomatic COVID19 positive patients was 59/303 (=19.5%). Diabetic patients had higher prevalence of hypertension, chronic kidney disease (CKD) and cardiac dysfunct lower lymphocytic and eosinophilic counts. Diabetic patients had more comorbidities and more aggressive course of the disease with higher rate of ICU admission and longer need for hospitalization and oxygen use.
T2DM patients showed higher inflammatory response to COVID 19 with higher absolute neutrophilic count (ANC) and CRP with lower lymphocytic and eosinophilic counts. Diabetic patients had more comorbidities and more aggressive course of the disease with higher rate of ICU admission and longer need for hospitalization and oxygen use.
In Italy, one of the country most affected by the COVID-19 pandemic, the first autochthonous case appeared in Lombardy on February 20th, 2020. One month later, the number of -COVID-19 patients in Lombardy exceeded 17000 and about 3500 had died. Because of this rapid increase in infected people scientists wonder whether SARS-CoV-2 was already highly circulating in Lombardy before such date. Plasma levels of aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) were shown to be -highly increased in COVID-19 patients. Monitoring their levels in Emergency Room patients during the months preceding February 20th, 2020, might shade light on the prevalence of the disease in the pre-COVID-19 period.

We retrospectively analyzed the AST and LDH levels from more than 30.000 patients admitted to the San Raffaele Hospital Emergency Room (ER) between September 2019 and May 2020 as well as between September 2018 and May 2019. The number of patients diagnosed with respiratory tract diseases were also analyzed.
ough asymptomatic individuals. https://www.selleckchem.com/products/ro-31-8220-mesylate.html Because of the high LDH and AST levels' variations induced by COVID-19, routine blood tests might be exploited as a surveillance indicator for a possible second wave.
There is a compelling need to identify clinical and laboratory predictors of unfavorable clinical course and death in patients with coronavirus disease (COVID-19). A trend towards low lymphocyte count and high neutrophil counts in patients with poor outcomes has been reported by earlier studies. We aim to synthesize existing data evaluating the relationship between clinical outcomes and abnormal neutrophil and lymphocyte counts at admission in COVID-19 patients.

An electronic search was carried out in PubMed, China National Knowledge Infrastructure (CNKI) and Cochrane Central Register of Controlled Trials (CENTRAL) to identify eligible studies reporting frequency data on neutrophilia and lymphopenia at admission in hospitalization in COVID-19 patients. Pooled odds ratios of clinical outcomes for each parameter were calculated using Comprehensive Meta-Analysis.

A total of 22 studies (4,969 patients) were included in this meta-analysis. Lymphopenia at admission was found to be significantly associated wit lymphocyte and high neutrophil counts. These variables may be useful in risk stratification models.
Coronavirus disease 2019 (COVID-19) outbreak is a global and challenging disease that is accompany with mortality and morbidity.

We evaluated the prevalence and the impact of comorbidities in thalassemia Iranian patients affected by COVID-19. Methods A multicenter, retrospective, cross-sectional study was conducted across all comprehensive thalassemia centers in Iran, from January to June 15th, 2020.

Forty-three confirmed COVID-19 thalassemia patients (32 TDT, and 11 NTDT) were detected. The mean age of patients was 35.3 ± 11.5 years (range 9 - 67); 21 females and 22 males. Overall, 78.1% of TDT and 90.9% of NTDT patients were complicated with at least one comorbidity (P 0.656). The overall mortality rate of thalassemia patients with COVID-19 was 18.6% while 27.3% was in NTDT patients compared to 15.6% in TDT patients (P0.401). The dead group had a non-significant higher frequency of endocrinopathies compared to the recovered group (62.5% versus 45.7% P0.457). Ten female thalassemia patients with positiis important to acknowledge that β-thalassemia patients, especially young adults/adults, have a chronic condition which may contribute to increase susceptibility to SARS-CoV-2 infection. A higher susceptibility to the infection was observed in patients with NTDT and in untreated hypogonadal female thalassemic patients. However, to confirm these data, more accurate designed studies are needed.
Digital epidemiology is increasingly used for supporting traditional epidemiology. This study was hence aimed to explore whether the Google search volume may have been useful to predict the trajectory of coronavirus disease 2019 (COVID-19) outbreak in Italy.

We accessed Google Trends for collecting data on weekly Google searches for the keywords "tosse" (i.e., cough), "febbre" (i.e., fever) and "dispnea" (dyspnea) in Italy, between February and May 2020. The number of new weekly cases of COVID-19 in Italy was also obtained from the website of the National Institute of Health.

The peaks of Google searches for the three terms predicted by 3 weeks that of newly diagnosed COVID-19 cases. The peaks of weekly Google searches for "febbre" (fever), "tosse"( cough) and "dispnea" (dyspnea) were 1.7-, 2.2- and 7.7-fold higher compared to the week before the diagnosis of the first national case. No significant correlation was found between the number of newly diagnosed COVID-19 cases and Google search volumes of "tosse" (cough) and "febbre" (fever), whilst "dyspnea" (dyspnea) was significantly correlated (r= 0.