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Hematology and Hemotherapy
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‘Nature’
‘Nature’
In a phase I trial, the menin inhibitor revumenib achieves a complete response in 18 patients with AML, revealing a cause of resistance to this potential new treatment.
After three years of the pandemic, the impact of COVID on the health and social services workforce is immense. Since 2020, more than 112,000 of the 291,000 network employees have been compensated by the CNESST due to COVID, for sick leave or preventive withdrawal. And this already very heavy toll does not include the thousands of other infected employees compensated by salary insurance who also had to forfeit.
According to the commission that deals with compensation claims for work-related injuries or illnesses, no less than 92,252 (as of March 5) of the 104,683 claims accepted since March 2020 in connection with COVID have been for workers of health. Added to this enormous burden are nearly 22,000 compensation payments made to employees who were taken off duty preventively to avoid infection due to health conditions, including pregnancy.
According to figures from the Canadian government, employees and professionals in the health sector have been hit harder by the virus in Quebec than anywhere else in Canada. At the start of 2022, 9% of Quebec health care workers reported having been infected, almost three times more than in Ontario (3.3%), more than in British Columbia (5.4%) and that in Alberta (6%). Thirteen of the forty-six deaths deplored among nursing staff in Canada occurred in Quebec.
If the first year of the pandemic (2020) generated more than 15,000 absences due to COVID recognized by the CNESST, it was the year 2022, with the arrival of Omicron, which caused the number of claims to explode in the health network, to more than 61,000. In 2023, some 6,087 workers have been compensated for COVID to date, proof that the pandemic is far from having disappeared from the landscape.
The Ministry of Health measures the impact of absences due to COVID on the network in the ratio of hours paid in CNESST and in salary insurance. Thus, the ratio of hours paid in CNESST went from 1.5% in 2019-2020 to 2.09% in 2022-2023 (until February 11).
In three years, these outbreaks of infections have also led to many prolonged absences among affected employees. Since 2020, nearly 500 network employees compensated by the CNESST have withdrawn for more than three months, including 40% for more than six months. Even today, 634 workers compensated for COVID for more than three months — nearly 80% of them for more than six months — have still not returned to work.
But these figures represent only the tip of the iceberg, say several unions. Because since the end of 2021, claims related to COVID for work-related illnesses are only accepted in dribs and drabs by the CNESST. This is because the commission judges that the majority of employees contracted the disease in the community and not at work.
Indeed, figures obtained from the Fédération interprofessionnelle de la santé du Québec (FIQ) and the CSN show that since 2021, the compensation paid by the CNESST is no longer representative of the burden that COVID places on the health network. , and that salary insurance claims have exploded.
From January to April 2022, there were thus more than 68,000 absences due to illness, of which barely 12,000 were covered by the CNESST. “The rate of acceptance of claims by the CNESST took a nose dive, while salary insurance claims soared. Concretely, this means that many employees who are sick with COVID are given a two-week waiting period, and dip into their personal leave or their vacation to make up for the loss of salary,” explains Isabelle Groulx, health and safety spokesperson for the FIQ. .
The same observation is made at the Federation of Health and Social Services (FSSS-CSN). “There is no longer any presumption that the employee is infected in his environment, so no compensation from the CNESST in the majority of cases. Those who have symptoms therefore almost all end up on salary insurance, which also implies a lack of referral and specific medical follow-up,” laments Réjean Leclerc, president of the FSSS-CSN. “Yet they are just as sick with COVID. We see that salary insurance claims follow exactly the curves of the waves of the pandemic, ”he says.
According to one study conducted in 2022 among 6,000 health care workers with COVID by the National Institute of Public Health of Quebec (INSPQ), 40% of them said they still had symptoms more than 12 weeks following their infection.
According to Réjean Leclerc, the decline in requests accepted by the CNESST will have direct consequences on several employees of contracted private establishments suffering from long-term COVID and persistent symptoms who are on salary insurance. “After 24 months, if they are not deemed totally disabled, they are not entitled to long-term salary insurance, even if they still have symptoms preventing them from returning to their jobs. They find themselves with nothing, he explains. If the establishment does not have positions that can accommodate the sick employee, we might end up with what are called administrative dismissals. »
Since 1is March, a new CNESST rule further complicates matters, adds the FIQ spokesperson. While a positive PCR test result was enough to recognize an absence due to COVID, the organization now requires a medical note to confirm a COVID diagnosis.
“Imagine the heaviness that this imposes for the doctors, who have better things to do, and for the nurses who will have to be absent to obtain these certificates. Does that make sense? relaunches Isabelle Groulx. Every day, more than 1,500 healthcare workers are still absent due to COVID. “It’s still not nothing,” she said. This is in addition to other absences and the exodus to private agencies, ”she adds.
According to the FIQ, the weight of absences aggravated by the pandemic has made certain questionable ways of doing things more common, sometimes irreconcilable with the code of ethics of health professionals. “There are constant shifts to other tasks. The head nurses no longer even hide to say to reduce the contingencies of tasks, suggests Isabelle Groulx. This means that we go below what our profession requires for various tasks, in particular the monitoring of vital signs, or medication. However, we can see the consequences, with the numerous investigations launched into failures in the emergency room. And that plays a big role in the moral distress of health professionals. »
Jessica de La Peña may not be having her best personal moment, according to what has been seen on her social networks. Followers are concerned regarding the health of the presenter’s father, since he might be living his last days of life.
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Definitely, the death of a loved one is not easy, but the death of the parents is much more difficult to overcome.
According to the last published photos of La Peña, the presenter He has not separated for a single second from his father’s hand, who apparently is going through a very bad spell of health.
In the last photo of Jessica de la Peña, the public presenter starts from her father’s face with an emotional message:
“You have always supported me, always, even now, you don’t know who I am, but do you know something? Now I hold you. I am always here to help you, love you, pamper you and run when you need me! One more war you win, you don’t stop impressing me. You are my hero of a thousand battles. I LOVE YOU DADDY”
Undoubtedly, many users assure that Due to the age of Don Ricardo de la Peña, it will not be easy for there to be a noticeable recovery.
However, hope is not lost considering that Don Ricardo has come out of several health problems throughout his life that seemed to have no return.
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Many colleagues of the Colombian presenter They have left you many messages of support in a situation as difficult as this.
It seems that several famous family problems due to the health of their parents, well remember that Shakira is going through a difficult process as well.
We speak of phlebitis, or venous thrombosis, whena blood clotcalled thrombus (hence the name thrombosis), occurs at the level of a vein and obstructs it. Moreover, if this one can form at the level of any vein of the organism, however, it is generally located in the lower limbs : calf, thigh, leg…
Indeed, the venous network of the lower limbs (pelvis, thighs, knees) counts a so-called deep and superficial network :
Generally benign, phlebitis should nevertheless encourage you to consult a doctor quickly. Indeed, it happens that in some cases, the clot migrates to the lower limbs to go to the pulmonary circulation . What can cause pulmonary embolism.
However, this is particularly the third leading cause of death following cardiovascular diseases and cancers and leading cause of death during pregnancy. In other words, do not ignore the signs of a pulmonary embolism.
Several factors can explain the formation of phlebitis. This is particularly the case of pregnancy and postpartum. “This is a risk situation for venous thromboembolic disease (VTE), because it promotes blood stagnation”explains the specialist at Medisite. “Phlebitis is regarding five times more common in pregnant women. than in the general population.
More precisely, pregnant women are four times more likely to suffer from phlebitis than outside of pregnancy. A pregnant woman, who has already suffered from phlebitis, requires specific management, as a preventive measure, with treatment administered by injection to thin the blood. Subcutaneous injections of heparin are then received daily during pregnancy and for six weeks following delivery.
But so far, the dose of the injections given to pregnant women was still uncertain. So, to get to the bottom of this debate, an international study called Highlow, published in the journal The Lancet, compared two different doses of LMWH.
The first corresponded to a standard dose, fixed and not adapted to the weight, while the other was higher, adapted according to the weight of the woman and increased with weight gain.
The purpose of this research was to “compare, between the two groups, the number of phlebitis, pulmonary embolisms and the number of major bleedings in order to determine the dose that presented the best risk/benefit ratio for thromboembolic prevention”say the experts.
This is the largest clinical trial carried out in this field with the participation of 25 University Hospitals in France and 70 hospitals worldwide, which included 1,110 patients, including nearly 400 in France.
The prescription of a fixed standard dose is therefore the optimal dose recommended for this population at risk of recurrence, the researchers indicate.
The results finally showed that the fixed standard dose of LMWH is as effective as the weight-adjusted dose to prevent phlebitis during pregnancy. “The prescription of a fixed standard dose is therefore the optimal dose recommended for this population at risk of recurrence”, explain the researchers. “Major bleeding did not show a significant difference between the two groups.”
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