ABSTRACT
Introduccion: Durante la pandemia del COVID-19 las sociedades endoscopicas recomendaron el uso de equipos de proteccion personal (EPP) y la realizacion de cuestionarios de cribado (CC) dirigidos a la deteccion de sintomas;sin quedar clara la necesidad de realizar test diagnosticos de SARS-Cov-2 (SCV-2). La seguridad de esta actitud no ha sido valorada adecuadamente. Metodos y objetivos: Nuestro objetivo primario es evaluar si para prevenir la infeccion por SCV-2 en los trabajadores de nuestra unidad (t-UE) es seguro hacer un CC a los pacientes con endoscopias programadas, sin realizarse test diagnosticos. Nuestro objetivo secundario es comparar la incidencia de SCV-2 en la poblacion de referencia (PR), los pacientes programados (SPs) y en t-UE. Se analizaron retrospectivamente los pacientes con endoscopias programadas de forma ambulatoria previamente a la vacunacion (junio/2020- diciembre/2020). Se realizo un CC en las 72h previas a la prueba y en el dia de la misma. Todos los trabajadores disponian de EPP. Resultados: Se programaron 7.089 endoscopias. Un 9,5% fueron canceladas: un 0,35% por sospecha de SCV-2 y un 0,1% por SCV-2 confirmado antes del procedimiento. 638 pruebas se suspendieron por motivos no relacionados con SCV-2. Se realizaron 6,419 endoscopias. Se diagnostico SCV-2 en 15 pacientes en los 15 dias siguientes a la endoscopia. De los 106 profesionales trabajaron en nuestra unidad se diagnostico SCV-2 en tres casos durante este periodo. En ninguno de ellos se demostro relacion con la exposicion laboral. En la tabla se muestra la densidad de incidencia (DI, x 100,000 habitantes) y la razon de tasas (RR) de la infeccion por SCV-2 en la PR, SPs y t-UE. [Table presented] Conclusiones: En ninguno de los trabajadores con diagnostico de SCV-2 se pudo atribuir la infeccion al medio laboral. La implementacion de CC de SVC-2 resulto seguro para los t-UE, incluso en ausencia de vacunacion global de la poblacion. La incidencia de SCV-2 fue menor en SPs y en los t-UE que en la PR.Copyright © 2023 Elsevier Espana, S.L.U. Todos los derechos reservados.
ABSTRACT
Online Social Networks (OSN s) are an integral part of modern life for sharing thoughts, stories, and news. An ecosystem of influencers generates a flood of content in the form of posts, some of which have an unusually high level of engagement with the influencer's fan base. These posts relate to blossoming topics of discussion that generate particular interest among users: The COVID-19 pandemic is a prominent example. Studying these phenomena provides an understanding of the OSN landscape and requires appropriate methods. This paper presents a methodology to discover notable posts and group them according to their related topic. By combining anomaly detection, graph modelling and community detection techniques, we pinpoint salient events automatically, with the ability to tune the amount of them. We showcase our approach using a large Instagram dataset and extract some notable weekly topics that gained momentum from 1.4 million posts. We then illustrate some use cases ranging from the COVID-19 outbreak to sporting events. © 2022 IEEE.
ABSTRACT
Introduction: Recommendations made by scientific societies regarding the need of pre-procedural testing for SARS-CoV-2 infection have been inconsistent throughout the pandemic. Several society guidelines advocated the use of personal protective equipment (PPE) and screening questionnaires for active COVID-19 disease without testing patients before endoscopy. The safety of this approach before the start of widespread vaccinations has not been properly assessed. Aims & Methods: Primary: To evaluate the safety of a screening questionnaire for active COVID-19 disease in the scheduled patients (SPs) for endoscopic procedures, without testing SARS-CoV-2, to prevent the infection in health-care workers of our endoscopy unit (EU-HCWs). Secondary: To compare the incidence of COVID-19 disease between the reference population (RP), SPs and EU-HCWs. Outpatient endoscopies scheduled from June 2020 to December 2020 were retrospectively analysed. Patients were screened by a questionnaire within 72 hours of their planned procedure and on the day of attendance. Healthcare professionals received appropriate training in infection control practices and handling of PPE. Patients were not tested for SARS-CoV-2 infection before endoscopy. Result(s): Seven thousand and eighty-nine outpatient endoscopies were scheduled. In 670 cases (9.5%) the procedures were cancelled. In 25 patients (0.35%) active COVID-19 disease was suspected before endoscopy. Two of the suspected cases had positive confirmatory tests (PT). Besides, 7 patients had a PT prior to endoscopy. Thus, 9 endoscopies (0.12%) were deferred because of confirmed COVID- 19 disease. The remaining 638 procedures were cancelled because the patient did not attend to the endoscopy unit (346) or due to a cancellation request other than COVID-19 disease from the physician or patient (292). A total of 6.419 endoscopies were performed. In 48 patients (0.75%) compatible symptoms with infection were present during the following 15 days after the procedure. COVID-19 disease was confirmed in 11 of these symptomatic patients. Besides, 4 asymptomatic patients had PT: two of them had close contact with a family member. There is no information about the reason for testing SARS-CoV-2 in the other 2 asymptomatic positive patients. In total 15 patients (0.2%) were positive within 15 days after endoscopy. One hundred and six professionals were working in our endoscopy unit (EU) during this period. Three EU-HCWs were diagnosed of COVID-19 disease. They were all physicians. None of these cases could be linked to occupational exposure. Table 1 shows the incidence rate (IR,) and rate ratio (RR, 95% confidence interval) of SARS-CoV-2 in our SPs, the RP and in our EU-HCWs. Conclusion(s): During the pre-vaccination period, 3 EU-HCWs were diagnosed of COVID-19 disease. None of them could be attributed to occupational exposure.The implementation of a COVID-19 infection screening questionnaire before the procedures without performing SARS-CoV-2 testing was safe enough for the EU-HCWs even in the absence of global vaccination of the population.The incidence of confirmed infections was lower in the SPs and EU-HCWs when compared to our RP.
ABSTRACT
Background: Dalbavancin is a lipoglycopeptide antibiotic approved for treatment of acute bacterial skin infection by GRAM +, also used for his long half-life in bone infection. Case Report: A 72 years old patient was admitted to hospital with low-grade fever for 40 days and back pain after two hospitalization for COVID19 infection and ischemic stroke. Blood examinations showed: elevated white blood cells count, increased inflammatory markers and anemia. CT showed bilateral pleural effusion, MRI configured vertebral alteration (D7-D9) suggesting infectious spondylodiscitis, blood and pleural liquid culture evidenced Staphylococcus Aureus MSSA. Levoxacin 500mg2/day and linezolid 600mg2/day IV were started with clinical improvement. Following the patient request, he was discharged with oral Linezolid. Two weeks later he showed worsening back pain and high inflammatory index. Levoxacin 500mg and Rifampicin 600mg were administered 2/day, soon Rifampicin substituted with Minocycline 100mg/day for side effect onset. After 4 week, MRI confirmed worsening of inflammatory state. Based on proven efficacy, Dalbavancin 1500mg/day IV on day 1 and 8 was started, with Minocycline for 24 week, with significant improvement in followup MRI;pleural effusion and inflammatory markers decreased. Conclusions: This case shows high efficacy of dalbavancin in spondylodiscitis pyogenic infection and pleural empyema, avoiding complications and high cost of long-term hospitalization during pandemic. In particular condition the use off label of dalbavancin is a safe and cost effective treatment.