4 e-Letters

published between 2020 and 2023

  • Micro-nanoplastics as carriers of Toxoplasma gondii and other protozoa in the open sea: Impacts to cetacean health and conservation

    Six years ago, Dr James T. Carlton and coworkers reported an unprecedented, tsunami-driven, transoceanic spread of marine organisms following the dramatic earthquake occurred in March 2011 in Eastern Japan (1). This really impressive spread of living organisms was greatly enhanced by micro-nanoplastics, which likely acted as “rafts” for them (1). Among the large number of (mostly) invertebrate species
    affected by the aforementioned phenomenon, special emphasis should be also placed upon microbial pathogens, some of which are known to impact the health and conservation of free-ranging cetaceans (2). A paradigmatic example in this direction is represented by Toxoplasma gondii, a protozoan and zoonotic agent of major concern (3), which may also infect striped dolphins (Stenella coeruleoalba), with subsequent development of severe brain lesions leading to stranding and death (4).
    Although a general consensus seems to exist on a land-to-sea flow as the most plausible mechanism through which T. gondii oocysts, similarly to other oro-fecally transmitted microorganisms, may gain access to the marine environment (2), this becomes questionable when dealing with striped dolphins and other T. gondii-susceptible species of aquatic mammals living in the open sea (5). In other words, how striped dolphins and other pelagic cetaceans may acquire T. gondii infection is still far from being understood. Consequently, among the different hypotheses drawn to explain this phenomenon,...

    Show More
  • "Optimizing Healthcare: Strategies for Enhancing the Use of Machine Learning Algorithms in Patient Care"

    Dear Editor,

    We read with interest the article by Kulkarni et al. [1], which highlights the advances in EKG pattern-recognition to help screen and identify patients with early-stage chronic diseases, particularly type 2 Diabetes (T2D).

    While we recognize the rationale behind the inclusion criteria of the DISFIN study, the included population has a high insulin resistance-diabetes prevalence. However, it is important to note that the participants have a uniformly low A1c value and the time of exposure to hyperglycemia and treatment regimens are unknown. [1] These two variables are essential to consider since both have been described to have a direct relationship with micro and macrovascular complications that could impact EKG features and, thus, the performance of this model. [2]

    Kulkarni et al. [1] do not clarify time since diagnosis of pre-diabetes or T2D and what treatment regimen each patient is undergoing. We ponder if patient classification based on the time of diagnosis, level of hyperglycemia and treatment regimen could help us better understand the onset and biological mechanisms behind EKG feature changes that help better identify subjects with hyperglycemia in all of its spectrum from pre-diabetes to T2D.

    When choosing the ML technique, we noticed that the authors used a K-Fold Cross-Validation scenario for the six candidates. In our opinion, this may result in inconsistencies and skewness on the “K” folds of subsets of the dataset,...

    Show More
  • TELEMEDICINE WITH URINE EXAMINATION IN HOME SELF-DIAGNOSIS: we can monitor the kidney and other organs, as in Covid19 disease as in other challenging pictures derived from other aetiology.

    For home manage in the territorial context in which I work, the Covid19 patient is advised to have a thermometer and oximeter , possibly also check blood pressure and blood sugar (if previously monitored ).
    The simple urinalysis is not mentioned: it is cheap and can be performed at home.
    In fact, through a strip that is immersed in urine, after 1-2 minutes we can obtain about 10 parameters.
    They indicate not only kidney damage (presence of proteins, red blood cells, white blood cells, nitrites for urinary infections) but also important systemic metabolic indices.
    The values of pH, urinary density, glycosuria and ketonuria indicate whether metabolic decompensations, dehydration, etc. are in progress; finally, also bilirubin and urobilinogen, for what concerns the liver or eventual haemolytic anemia.
    I say this because unfortunately Covid19 can also compromise not only the kidney system, as well as a series of complications with a sneaky onset, not always quickly diagnosed.
    There remains the problem of the stripes packaging, not available individually, from which a single dose will have to be obtained.
    But it is probably a problem that can be overcome

  • Taiwan health department encourages video consultation during Covid-19

    Dear Editor,
    We read with great interest the paper by Clement et al. With the advancement of technology, the digital consultations got a lot of attention in a good way and become more useful during the pandemic for both patients with disability as well as the normal patients. Though, some people still prefers to see the doctor face to face for more self-satisfaction. The digital consultation still have a long way to go for its acceptance within people specifically who are not used to and just begin.

    As we know that telemedicine or video consultation can be used if you want to have look at a patient in care home, are working in a remote practice or the patient is bed bound. It saves patients an unnecessary trip to the practice, and the practitioner may have time freed up to see the sickest patients first. [1] Under the COVID-19 pandemic situation, people have to beware of the existence of such approaches to consultations, during the pandemic people were afraid to go to the hospital or clinic to have a treatment or appointment with doctor, especially for the aging population.

    In Taiwan, the COVID-19 case raised up to hundreds local cases per day since Mid of May 2021 and the situation is going up to stage 3, the ministry of the health in Taiwan announced that people should prefer to use the digital consultation or telemedicine services to prevent the patients hospital visits and infection spread. Taiwan has a well-structured Health IT infrastructure an...

    Show More