Association of prior treatment with nitrogen-containing bisphosphonates on outcomes of COVID-19 positive patients

COVID-19 infection has resulted in significant morbidity and mortality globally, especially among older adults. Repurposed drugs have demonstrated activity in respiratory illnesses, including nitrogen-containing bisphosphonates. In this retrospective longitudinal study at 4 academic medical centers, we show no benefit of nitrogen-containing bisphosphonates regarding ICU admission, ventilator use, and mortality among older adults with COVID-19 infection. We specifically evaluated the intravenous bisphosphonate zoledronic acid and found no difference compared to oral bisphosphonates.

BACKGROUND

Widely used in osteoporosis treatment, nitrogen-containing bisphosphonates (N-BP) have been associated with reduced mortality and morbidity among older adults. Based on prior studies, we hypothesized that prior treatment with N-BP might reduce intensive care unit (ICU) admission, ventilator use, and death among older adults diagnosed with COVID-19.

METHODS

This retrospective analysis of the PCORnet Common Data Model across 4 academic medical centers through 1 September 2021 identified individuals age >50 years with a diagnosis of COVID-19. The composite outcome included ICU admission, ventilator use, or death within 15, 30, and 180 days of COVID-19 diagnosis. Use of N-BP was defined as a prescription within 3 years prior. ICU admission and ventilator use were determined using administrative codes. Death included both in-hospital and out-of-hospital events. Patients treated with N-BP were matched 1:1 by propensity score to patients without prior N-BP use. Secondary analysis compared outcomes among those prescribed zoledronic acid (ZOL) to those prescribed oral N-BPs.

RESULTS

Of 76,223 COVID-19 patients identified, 1,853 were previously prescribed N-BP, among whom 559 were prescribed ZOL. After propensity score matching, there were no significant differences in the composite outcome at 15 days (HR 1.22, 95% CI: 0.89-1.67), 30 days (HR 1.24, 95% CI: 0.93-1.66), or 180 days (HR 1.17, 95% CI: 0.93-1.48), comparing those prescribed and not prescribed N-BP. Compared to those prescribed oral N-BP, there were no significant differences in outcomes among those prescribed ZOL.

CONCLUSION

Among older COVID-19 patients, prior exposure to N-BP including ZOL was not associated with a reduction in ICU admission, ventilator use, or death.

Marine litter footprint in the Azores Islands: A climatological perspective

Marine litter (ML) consists of any item of anthropogenic origin that has been lost, discarded or intentionally disposed of into the environment, being acknowledged as a worldwide environmental and ecological threat. In the last decade, there has been an attempt across different sectors to tackle, reduce and mitigate sources of litter. In this study, meso and macrodebris between 2 and 30 cm was recorded and classified in two established study areas (Porto Pim and Conceição beaches), throughout five monitoring years (2012-2018). The litter abundance, density and weighted average by abundance were evaluated in eight main categories: plastics, cloths/fabrics, glass, metals, rubber, processed lumber, other and large. Field surveys provided evidence that plastic represented 95% of all litter. ML abundance was treated as an "environmental variable" and used to determine its anomalies, temporal trends and forecasts. Results from this time-series addressed possible periodic oscillations and density peaks of litter. Reference values of ML presence were obtained and could potentially be used for developing a diagnostic tool for anthropogenic pollution in the Azores.

Application of Matrix Scoring Techniques to evaluate marine debris sources in the remote islands of the Azores Archipelago

Three-quarters of all marine debris (MD) consists of plastic, a reflection of their worldwide use, production and waste mismanagement. Data on MD distributions can improve our ability to effectively reduce debris that escapes onto shorelines and the ocean. In this study, the Matrix Scoring Technique (Marine Strategy Framework Directive Technical Group on Marine Litter) was applied as an approach to calculate the likelihood of single debris items originating from a series of potential sources. Factors considered were: identity and function of debris, beach location, influential activities, "mix" of debris found, presence of indicator items, and quantity of MD. The standing-stock (abundance and composition) of MD was investigated in two sandy beaches (Conceição and Porto Pim) of the Azores Archipelago (NE Atlantic) for the period 2012-2018. The results of this study show promise towards the implementation of a new classification method to determine beach debris sources in remote open-ocean areas.

Beach debris in the Azores (NE Atlantic): Faial Island as a first case study

Marine debris is widely recognised as a global environmental problem. This study assesses density, type, and temporal trends of marine debris in two sandy beaches of Faial Island (Azores, NE-Atlantic). During seven months (six days per month) the beaches were surveyed by performing 10 random transects at each site. Recorded items within the range 2-30 cm were organised into seven categories. Densities of total debris varied from 0 to 1.940 items m(-2), with plastics dominating both areas. Both beaches, presented the highest debris abundance in February, most probably related to prevailing winds and swell. Location and/or time of year also seemed to influence the type of debris present. These findings provide new insights into debris accumulation rates in the Azores, where no previous studies were made. It also confirms the global trend of increased plastics accumulation on shorelines, highlighting the need for further research in remote islands.

Bildgebung der Tränendrüse und der Tränenwege

Die Tränendrüse kann von einer Vielzahl neoplastischer, infektiöser und autoimmunologischer Erkrankungen betroffen sein. Eine radiologische Charakterisierung der Veränderungen kann Hinweise für die differenzialdiagnostische Einordnung liefern. Erkrankungen der ableitenden Tränenwege, insbesondere Tränenwegsverschlüsse, verursachen durch dauerhaftes Tränenträufeln häufig einen ausgeprägten Leidensdruck. Auch hier können radiologische Verfahren die Einleitung einer adäquaten Therapie in interdisziplinärer Zusammenarbeit leiten bzw. durch minimalinvasive interventionell-radiologische Methoden (z. B. Ballon-Dakryozystoplastie) das Spektrum der Therapieoptionen erweitern.

Evidence-based lifestyle interventions in the workplace--an overview

BACKGROUND

Lifestyle-related health issues affect the economic position of organizations and contribute to reduced productivity, increased absenteeism and health care costs.

AIMS

To summarize the effectiveness of different workplace health interventions for promoting healthy lifestyle, preventing diseases and reducing health care costs.

METHODS

We searched MEDLINE via Pubmed, EMBASE, Cochrane Library, NelH, HighWire Press and Google Scholar in March 2012. Systematic reviews and meta-analyses of workplace interventions aimed at promoting physical activity, healthy weight and good nutrition were included. Three authors assessed the quality of the reviews and extracted data on methods, interventions, outcomes, results and effect sizes.

RESULTS

We identified 15 publications covering a total of 379 original studies. Three systematic reviews found beneficial effects of workplace nutrition interventions on employees' dietary behaviour. Three reviews found multi-component physical activity interventions to be effective in increasing employees' physical activity and fitness. The other activity promotion interventions were less effective regarding physical activity and weight-related outcomes. In terms of weight management, our findings favour multi-component interventions that focus on both physical activity and nutrition over single dietary programmes.

CONCLUSIONS

Workplace health promotion interventions may improve physical activity, dietary behaviour and healthy weight. There is no evidence of increased efficacy associated with specific intervention types. Workplace health promotion should focus on either physical activity or weight or nutrition behaviour to maximize effectiveness. Best evidence is available for multi-component interventions.