ABSTRACT
This case study describes a 45-year-old Caucasian male with a past medical history of obesity, hypertension, and non-insulin-dependent diabetes mellitus, who in the setting of coronavirus disease 2019 (COVID-19) pneumonia, developed portal vein thrombosis (PVT) presenting as an acute abdomen after hospital discharge from a cholecystitis episode. PVT is a very infrequent thromboembolic condition, classically occurring in patients with systemic conditions such as cirrhosis, malignancy, pancreatitis, diverticulitis, autoimmunity, and thrombophilia. PVT can cause serious complications, such as intestinal infarction, or even death, if not promptly treated. Due to the limited number of reports in the literature describing PVT in the COVID-19 setting, its prevalence, natural history, mechanism, and precise clinical features remain unknown. Therefore, clinical suspicion should be high for PVT, in any COVID-19 patient who presents with abdominal pain or associated signs and symptoms. To the best of our knowledge, this is the first report of COVID-19-associated PVT causing extensive thrombosis in the portal vein and its right branch, occurring in the setting of early-stage cirrhosis after a preceding episode of cholecystitis.
ABSTRACT
The objective of the research was to analyze the situation of tour guides in Latin America, particularly in Colombia, Ecuador, Mexico, Costa Rica and Peru, in relation to the presence of the covid-19 pandemic. The study was carried out by means of the non-experimental exploratory method with a mixed approach, using three research instruments: the virtual forum, which made it possible to identify the vision of the guides regarding the pandemic;the survey, validated by Cronbach's Alpha statistic, directed at tourist guides belonging to federations and official associations;and the interview applied to key representatives of the countries involved in the study. The results are presented in four dimensions: work situation;job security;associativity and future prognosis, highlighting the economic, emotional and psychological crisis that tourist guides went through due to the pandemic.
ABSTRACT
Introduction: The 2019 coronavirus disease (COVID-19) pandemic, should be an opportunity to ensure greater visibility of nursing in health systems and society worldwide. Objective: Review and synthesize the patterns on COVID-19 and nursing research, identifying the main journals, country of origin, language, topics, designs, and area of applicability of the results. Materials and Methods: Systematic review. Searches in PubMed, CINAHL, LILACS, and EMBASE databases (from the inception of the pandemic to May 15, 2020) were performed. Articles of any language related were related to SARS-CoV-2 infection or COVID-19 disease and nursing in any of its roles (care, management, education, among others) and using any epidemiological design or a scientific report were included. Two reviewers independently selected the studies and extracted the data. The main findings from the included studies were summarized through narrative synthesis and descriptive tables. The characteristics of the studies were presented as absolute values and proportions. Results: Three hundred and sixty-five articles were assessed for eligibility. Thirty-eight were included, published in 28 journals. Of those, 53.57% (n=15) were nursing specific. Most articles were "narrative reviews", accounting for 23.68% (n=9). Most studies were conducted in China (n=18, 47.37%), followed by the United Kingdom and the United States. Thirty-four (89.47%) articles were published in English, followed by Portuguese and Chinese. We identified five areas of application of the results, and the most frequent was the "clinical" setting with 47.00% (n=18). Discussion: These findings are crucial to give visibility to nursing work during the emergency of the COVID-19 pandemic. Mental health was the main research topic, while the clinical setting concentrates the major number of articles. This pattern was aligned with the challenges of the initial phase of the pandemic. Conclusion: Future research should explore the current state of evidence in the main topics identified in this review and continue to give visibility to work carried out by nursing in the emergency of the COVID-19 pandemic. © Revista Cuidarte.All rights reserved.
ABSTRACT
Objective: To identify demographic, clinical, laboratory and treatment characteristics associated with mortality in hospitalized patients with SARS-CoV-2 pneumonia in a Level I Hospital of Peruvian Social Security, at La Libertad Network. Material(s) and Method(s): Retrospective cohort study. Cox proportional hazards model was used, calculating crude and adjusted hazard ratios (HR), and the Kaplan-Meier estimator was used to evaluate the overall survival curve and for each factor. Result(s): Of the 158 patients, the diagnosis was confirmed in 79.11%. Nearly 70% (68.99%) were men, the global median age was 65 years (IQR: 52-77), and it was higher in deceased subjects 69 years old (IQR: 61-80 years). Little more than half of this population (53.80%) had comorbidities, such as high blood pressure (27.85%), obesity (22.78%), and diabetes mellitus (13.92%). The median duration of symptoms prior to admission was 9 days (IQR: 6-11 days). HRs were determined for oxygen saturation less than 80% on admission with 0.21 FIO2, leukocytosis with associated lymphopenia, oxygen requirement at 0.80 FIO2 on admission, and moderate-severe ARDS. Such values were 1.54, 1.98, 2.07 and 2.91, respectively. Conclusion(s): The development of moderate-severe ARDS on admission, leukocytosis associated with lymphopenia, less than 80% hypoxemia on admission at 0.21 FIO2, and high-flow oxygen requirement since admission with 0.80 FIO2, were the only risk factors for mortality. Copyright © 2022 by Begell House, Inc.