Prevalence of COVID-19 in medical school and residency in Porto Alegre, RS

SUMMARY OBJECTIVE: A multicentric, cross-sectional study was carried out to determine the prevalence and risk factors for Coronavirus disease 2019 in medical students and residents from four universities and affiliated hospitals in Brazil. METHODS: A survey about contamination risk and symptoms was sent to all participants through email and WhatsApp. Prevalence was measured by the self-report of positive polymerase chain reaction or serological test. Univariate and multivariate analyses were performed, and odds ratio and 95% confidence interval were calculated. RESULTS: Prevalence of infection by Sars-CoV-2 was 14.9% (151/1011). The disease was more prevalent in residents and interns than in undergraduate students. Contact with an infected relative outside the hospital or with colleagues without using personal protective equipment was associated with higher contamination. Contact with patients without wearing goggles and higher weekly frequency of contact were the two factors independently associated with the infection by Coronavirus disease 2019 in the multivariate analysis. CONCLUSIONS: Medical students, interns, and residents have a higher prevalence of Coronavirus disease 2019 than the general population, in which the last two groups are significantly at higher risk. Contacting patients at a higher weekly frequency increases the risk for infection. The use of goggles should be reinforced when contacting patients.

Effects of heterologous platelet-rich plasma gel on standardized dermal wound healing in rabbits

PURPOSE: To evaluate the potential of heterologous platelet-rich plasma (PRP) gel for surgical skin wound healing in rabbits METHODS: Blood from a single healthy dog was used for PRP production, with calcium gluconate added to the PRP to form the gel. Two surgical excisions, one to the right and the other to the left of the dorsal midline, were made in six rabbits. One side was randomly allocated to topical application of a physiological solution, and the other was allocated to treatment with heterologous PRP gel. Clinical assessments (weight, pain sensitivity, coloring, edema, hyperemia, exudation, crust, and granulation) and morphometric evaluations were performed 0, 3, 7, 10, 14, and 17 days postoperatively. Histological analysis was performed on the 17th day. RESULTS: With the exception of the presence of a crust at day 10, clinical variables did not differ significantly between the experimental groups. In both the control and PRP-treated groups, differences were identified when comparing time-points in terms of wound area reduction. Histological results indicated no significant differences between the control group and the PRP-treated group. CONCLUSION: Heterologous platelet-rich plasma gel promoted dermal wound healing in rabbits with no adverse effects. .

Respiratory immunohistochemical study in rats exposed to cigarette smoke and alcohol

PURPOSE: To investigate the effects of exposure to cigarette and alcohol on immunohistochemical disorders caused by these attacks to respiratory system of rats. METHODS: Sixty male Wistar rats in four groups: control, cigarette smoke, alcohol and cigarette smoke + alcohol during 260 days. Immunohistochemistry was performed by researching survivin and protein P53 expressions and apoptotic index in parenchymal lung and trachea using TUNEL technique. RESULTS: There was body growth impairment in all experimental groups. Both smoker groups animals had higher trachea survivin expression and bronchial higher apoptotic index. The trachea apoptotic index was also higher in the cigarette smoke group as well as in the alveoli in the cigarette smoke + alcohol group. The three experimental groups showed negative immunoexpression for P53. CONCLUSIONS: this model resulted in immunohistochemical changes caused mainly by exposure to cigarette smoke. There was a synergistic action between alcohol and tobacco in the growth impairment in animals as well as in the cellular apoptotic index. The positive immunoexpression for tracheal survivin in animals from both groups exposed to tobacco smoke and associated with a negative P53 immunoexpression suggests that despite the aggression, carcinogenesis has not happened yet. In addition, the bronchial higher apoptotic index in smokers may be responsible for emphysema. .

Clotting Factor XIII and desmopressin improve hemostasis in uncontrolled bleeding

PURPOSE: To investigate hemostatic effects of supplementary factor XIII and desmopressin (DDAVP) in resuscitation of uncontrolled bleeding. METHODS: Fifty-four rabbits were randomized in nine groups: G1: Sham; G2: FXIII and normotensive resuscitation (NBP); G3: FXIII and permissive hypotension (PH) (MAP 60% baseline); G4: FXIII/DDAVP/NBP; G5: FXIII/DDAVP/PH; G6: NBP only; G7: FXIII no hemorrhage; G8: FXIII/DDAVP no hemorrhage; G9: PH only. Thromboelastometry and intra-abdominal blood loss were assessed. Scanning electron microscopy (EM) of the clots was performed. RESULTS: Compared to Sham, only G8 (FXIII/DDAVP w/o hemorrhage) showed clotting time (CT) significantly lower (p<0.05). NBP alone (G6) resulted in significantly prolonged CT compared to G2, G3 and G5 (p<0.05). Similarly, median alpha angle was significantly larger in G3,4,5, and 9 compared to G6 (p<0.05). Area under the curve was significantly greater in G5 than G2. Intra-abdominal blood loss was lower in G5 and G9 compared to G2 and G6. FXIII/DDAVP and PH resulted in more robust fibrin mesh by EM. CONCLUSIONS: Normotensive resuscitation provokes more bleeding and worsens coagulation compared to pH, that is partially reversed by factor XIII and desmopressin. FXIII and DDAVP can synergistically improve coagulation. Permissive hypotension reduces bleeding regardless of those agents. .

Comorbidity Study on Type 2 Diabetes Mellitus Using Data Mining

BACKGROUND/AIMS: The aim of this study was to analyze comorbidity in patients with type 2 diabetes mellitus (T2DM) by using association rule mining (ARM). METHODS: We used data from patients who visited Keimyung University Dongsan Medical Center from 1996 to 2007. Of 411,414 total patients, T2DM was present in 20,314. The Dx Analyze Tool was developed for data cleansing and data mart construction, and to reveal associations of comorbidity. RESULTS: Eighteen associations reached threshold (support, > or = 3%; confidence, > or = 5%). The highest association was found between T2DM and essential hypertension (support, 17.43%; confidence, 34.86%). Six association rules were found among three comorbid diseases. Among them, essential hypertension was an important node between T2DM and stroke (support, 4.06%; confidence, 8.12%) as well as between T2DM and dyslipidemia (support, 3.44%; confidence, 6.88%). CONCLUSIONS: Essential hypertension plays an important role in the association between T2DM and its comorbid diseases. The Dx Analyze Tool is practical for comorbidity studies that have an enormous clinical database.

An Epidemiological Study of Hyperhidrosis Patients Visiting the Ajou University Hospital Hyperhidrosis Center in Korea

Hyperhidrosis is a disorder of perspiration in excess of the body's physiologic need and significantly impacts one's occupational, physical, emotional, and social life. The purpose of our study was to investigate the characteristics of primary hyperhidrosis in 255 patients at Ajou University Hospital Hyperhidrosis Center from March 2006, to February 2008. Information collected from the medical records was: sex, sites of hyperhidrosis, age at visit, age of onset, aggravating factors, hyperhidrosis disease severity scale (HDSS) rank, family history, occupation, and past treatment. A total of 255 patient records were reviewed; 57.6% were male. Patients with a family history (34.1%) showed a lower age of onset (13.21+/-5.80 yr vs. 16.04+/-9.83 yr in those without family history); 16.5% had previous treatment, most commonly oriental medicine. Palmar and plantar sites were the most commonly affected, and 87.9% of patients felt their sweating was intolerable and always interfered with their daily activities. Our study provides some original information on the Korean primary hyperhidrosis population. Patients who have a family history show signs of disease in early age than those without family history.

A study to find out the proportion of prediabetes in patients with acute coronary syndrome in a medical college of Kolkata.

Prediabetes is now considered as a definite entity for increased incidence of cardiovascular disease and a potent risk for progression to type 2 diabetes mellitus. As macrovascular disease is the commonest cause of increased mortality in dysglycaemic individuals (prediabetes and diabetes) by 2-4 times as opposed to normal individuals, clinicians do encounter patients with cardiovascular disease of varying severity regularly. There are increased constellation of other cardiovascular risk factors (hypertension, dyslipidaemia, etc), in prediabetes as compared to normal population. Here a study was carried out among 62 acute coronary syndrome patients who were admitted in a tertiary care hospital in Kolkata to find out the proportion of prediabetes in them. Majority of the patients (54.8%) were in the age group of 45-64 years and were males (77.4%). The study showed 48.4% of all acute coronary syndrome patients were prediabetic and 25% were diabetic. The proportion of impaired fasting glucose and impaired glucose tolerance were 19.4% and 22.6% respectively. So, altogether 72.4% patients were dysglycaemic. Out of all acute coronary syndrome patients, non-ST elevated myocardial infarction group had 50% prediabetic patients, ST elevated myocardial infarction group had 50% prediabetic patients and unstable angina group have 45.8% prediabetic patients. So, all patients of acute coronary syndrome should be screened to detect hyperglycaemia in early stage to prevent further development of diabetes mellitus and also further cardiovascular events.

Evaluation of Internet websites about floaters and light flashes in patient education

PURPOSE: Flashes of light and floaters are most commonly caused by posterior vitreous separation but may be associated with sight-threatening disorders. Prevention of severe sequelae requires prompt dilated eye examination. Thus, information dissemination is crucial. This study aimed to evaluate the quality of information about floaters and light flashes available for patients on the Internet. METHODS: Cross-sectional study. In July 2005 we evaluated information available on the Internet regarding floaters and light flashes, using two search engines (MetaCrawler and MSN) and three key terms ("floaters", "dark spots eye", and "light flashes eye"). The quality of each website was evaluated using a score system. The sites were classified as academic, organizational or commercial. Readability, general quality of the website (based on: ownership, purpose, authorship, author qualification, attribution, interactivity, and currency) and quality of the specific content (definition, causes, epidemiology, diagnosis, treatment, and prognosis) were analyzed. RESULTS: Of 145 websites evaluated, 49 were included. Four sites (8.2 percent) were academic, 9 (18.4 percent) organizational, and 36 (73.4 percent) commercial. In the majority of the sites (53.0 percent) information was poor and quality was not correlated with website classification. CONCLUSIONS: Information about floaters and light flashes available on the Internet is poor.

OBJETIVOS: Fotopsias e miopsias são geralmente causadas pelo descolamento do vítreo posterior, mas podem estar associadas a doenças oculares. A prevenção de seqüelas importantes requer o exame rápido e apropriado do paciente. Portanto, o conhecimento pelo paciente é crucial. Este estudo objetivou avaliar a qualidade da informação sobre miopsias e fotopsias disponíveis para acesso dos pacientes na Internet. MÉTODOS: Estudo de corte transversal. Em julho de 2005, avaliamos as informações disponíveis na Internet sobre miopsias e fotopsias, usando duas ferramentas de busca (MSN e MetaCrawler) e três palavras-chave ("floaters", "dark spots eye", "light flashes eye"). A qualidade de cada site foi avaliada por uma escala de pontos. Os sites foram classificados como acadêmicos, organizacionais ou comerciais. Avaliamos a confiabilidade, a qualidade do site (baseada no autor, propósito, qualificação do autor, interatividade, atualizações) e qualidade do conteúdo (definição, causas, epidemiologia, diagnóstico, tratamento e prognóstico). RESULTADOS: Dos 145 sites avaliados, 49 foram incluídos no estudo. Quatro sites (8,2 por cento) foram acadêmicos, 9 (18,4 por cento) organizacionais e 36 (73,4 por cento) foram comerciais. Em sua grande maioria (53 por cento), as informações contidas nos sites foram consideradas como pobres e a qualidade não estava correlacionada com a classificação do site. CONCLUSÃO: As informações disponíveis na Internet sobre miopsias e fotopsias são insuficientes.

Septic abortions: a descriptive study in a teaching hospital at North Bengal, Darjeeling.

A hospital based cross sectional study for one year done among 57 diagnosed and admitted septic abortion cases, revealed that 71.9% septic abortions were performed by untrained persons, 63.2% mothers were illiterate, 22.8% mothers were in adolescent age group. Exploratory Laparotomy was needed in 46.3% cases and important complications for referring were severe anaemia and septic shock.

Improving access to liver transplantation: the University of Puerto Rico experience

Liver transplantation is the only treatment for end-stage liver disease. It is costly, difficult, and not performed in Puerto Rico. For these reasons, it has been a limited option for Puerto Ricans with advanced cirrhosis, especially for those with no medical insurance to cover for the procedure. In an effort to improve access to the procedure and offer this chance of life to more Puerto Ricans facing death from complications of advanced liver disease, the Gastroenterology and Liver Diseases Division of the University of Puerto Rico, in collaboration with LifeLink Transplant Institute in Tampa, Florida and the Office of Catastrophic Funds of the Commonwealth of Puerto Rico, opened a clinic for liver transplant evaluation at the Medical Sciences Campus. The purpose of this clinic is to coordinate the pre-transplant evaluation of candidates for this therapy, provide the evaluation by the transplant surgeon in Puerto Rico, expedite the process in seriously ill patients, and offer post-transplant follow-up upon the patient's return to Puerto Rico. The purpose of this article is to describe the experience in this clinic from 1999 to 2003. One hundred ninety-three patients were seen from September 1999 to January 2003. The most common causes for liver disease were hepatitis C and alcohol, alone or in combination. One hundred thirty four were accepted as candidates for evaluation. Of these, 63 had completed the process, 33 were listed for transplantation and 21 had been transplanted by January 2003. Neither education level, marital status, health insurance nor Child score were associated with successful outcome. This clinic offers Puerto Ricans, especially those with limited resources, with a viable access to liver transplantation.