Adequacy of a novel qualitative fit test kit and protocol during the COVID-19 pandemic

Objectives@#To develop our own qualitative fit test kit and protocol for respirators and validate this against the manufacturer-issued kit.@*Methods@#This is a crossover study of 50 healthcare workers in a tertiary government hospital. Some healthcare workers were tested multiple times according to the number of respirators they want tested. Qualitative fit testing was done according to manufacturer protocol for the commercial kits or according to our own protocol for the novel kits.@*Results@#A total of 63 fit tests were analyzed. This novel kit was determined to be noninferior to manufacturer-issued kits in detecting leaks among worn respirators (p=0.005). @*Conclusion@# A fit test kit can be successfully created from readily available household and hospital materials. Fit tests with these novel kits using our validated protocol are shown to be noninferior to commercial test kits. This can greatly aid in qualitative fit testing of respirators in a logistically constrained pandemic setting.

Clinical characteristics and outcomes of coronavirus disease 2019-infected adult cancer patients in the Philippines from March to December 2020

Background@#Data on the clinical characteristics and outcomes of Filipino cancer patients who acquired the coronavirus disease 2019 (COVID-19) are limited and local information is lacking. Here we characterize the outcomes of patients with cancer and COVID-19.@*Methods@#Medical records of Filipino cancer patients with COVID-19 from the University of the Philippines – Philippine General Hospital (UP-PGH), Southern Philippines Medical Center (SPMC), De La Salle – University Medical Center (DLS- UMC), and St Luke’s Medical Center (SLMC) from March to December 2020 were reviewed.@*Results@#Sixty-nine cancer patients were identified to have COVID-19. The mean age was 53 years (range 19-88) and 45 (65%) patients were female. The most prevalent malignancies were from the gastrointestinal tract (16 [23%]) and the breast (14 [20%]). The majority (34 [49%]) had metastatic disease and had a functional status of Eastern Cooperative Oncology Group (ECOG) 2 or worse (39 [57%]). Forty-two (61%) patients had active oncologic treatment given for the past three months and twenty-four (35%) of these patients were on chemotherapy. The most common symptoms upon presentation were cough (34 [49%]) followed by dyspnea (28 [41%]). COVID-19 severity of this series was as follows: 15 mild (22%), 32 moderate (46%), 7 severe (10%), and 15 critical (22%). The majority received intravenous antibiotics (54 [78%]), investigational treatments (27 [39%]), and steroids (20 [29%]). Common complications were acute respiratory failure (20 [29%]), acute respiratory distress syndrome (17 [25]), and septic shock (15 [22%]). At the end of the collection period, 21 (30%) cancer patients died. The mean length of hospital stay was 22 days.@*Conclusion@#Based on the findings of our case series, ECOG 2 and higher, metastatic stage, higher neutrophil to lymphocyte ratio showed a trend to worse outcomes. Cancer-related treatment within the past months did not appear to affect outcomes.

Outcomes of COVID-19 positive and COVID-19 negative adult patients who underwent tracheostomy for prolonged intubation in a COVID-19 referral center during the pandemic

Objective@#To compare outcomes of COVID-19 positive and COVID-19 negative patients who underwent tracheostomy for prolonged intubation in terms of weaning duration, length of ICU and hospital stay, overall and 30-day mortality, and explore risk factors for particular outcomes (mortality, 30-day mortality and weaning duration post tracheostomy). @*Methods@#Design: Retrospective Cohort Study Setting: Tertiary National University Hospital Participants: Of 122 adult patients that underwent tracheotomy between March 30, 2020 and March 30, 2021; 76 adult patients underwent tracheostomy for prolonged intubation were analyzed.@*Results@#Open tracheotomy was performed on 122 adult patients. Seventy six (62.3%) due to prolonged intubation and 46 (37.7%) for airway prophylaxis. Among the former, the mean age was 58.46±16.81 and 54 (71.05%) patients were female, 22 (28.95%) tested COVID-19 positive and 54 (71.05%) tested negative. Mean APACHE II score was 16.62±6.78. Average days of intubation prior to tracheostomy was 29.14±17.66 days. No statistically significant difference in outcomes (weaning days, length of stay, days discharge from ICU and hospital, 30-day mortality, days to death) were noted between COVID19 positive and negative patients who underwent tracheostomy for prolonged intubation. Mortality rates post tracheostomy in this institution appear to be higher than existing literature. On multiple linear regression analysis, days of intubation prior to tracheostomy was associated with increased weaning time post-tracheostomy (OR: 0.35 CI:0.18-0.51 95% p = <.001). This implies that for every additional day of intubation prior to tracheostomy, weaning days increase by 0.35 of a day. @*Conclusion@#Outcomes of COVID-19 compared to non-COVID-19 patients undergoing tracheostomy for prolonged intubation do not seem to be significantly different which is consistent with existing literature.

Female voluntary sterilization - an annual report 1974

It can be stated that acceptance of sterilization for limitation of family size has definitely set a new trend in obstetrical practice in this country. It portends the beginning of smaller families in the context of Asian culture and society. Integrating a sterilization program in an OB-GYN Department has demonstrated that it is feasible, practical, effective, and responsive to patient needs. However, since the mean age of our acceptors is 34.2 years and the mean parity is 4.4, future efforts have to be directed to delivery of these services to women of lower age and parity in order to achieve more effective limitation of family size. (Summary)