ABSTRACT
Introduction: Since the outbreak of the COVID-19 pandemic, the paradigm has evolved such that virtual breast cancer clinics and surveillance has dominated patient follow-up. Breast cancer patients are routinely followed up for years in surgical, medical oncology and radiation oncology clinics. However, controversies surround follow-up, and its value is uncertain. The aim of this study was to assess whether breast cancer recurrences presenting at our breast unit were detected clinically or radiologically and proportion of the recurrences detected during routine physical exam. Methods: An observational cohort study of retrospective design was performed evaluating patients suffering breast cancer recurrence (locoregional and/or distant) between 2016 and 2020. Electronic hospital records were reviewed to update patient data. Basic descriptive statistics (Chi-square, Fisher's Exact tests) were performed using SPSS version 26.0. Results: In total, 181 patients presented to our unit with breast cancer recurrence during the period of this study. Overall, 88 recurrences were detected clinically and 93 were detected using radiology (48.6% and 51.4%). Interestingly, 77 recurrences were detected by the patient themselves (42%) and only 11 recurrences were detected by physical examination on scheduled appointments (6%). These eleven patients had asymptomatic recurrences identified by clinical exam, which could have been identified by surveillance imaging. Conclusion: Breast cancer recurrences are as likely to be detected clinically as using radiology. Keeping the substantially low cancer detection rate of asymptomatic recurrences, review of data in post covid period requires appropriate utilization of resources for breast cancer follow-up. Long term routine hospital follow-up appears to be inefficient in detecting recurrence.
ABSTRACT
The consulting world employs millions of people and moves billions of dollars around the world. The high number of mobile phones, coupled with the fact that more than half the world is online, leads to a new paradigm in the way we think and behave as consumers. The appearance of COVID-19 is forcing all areas to urgently rethink their educational offer. The consultancy area is not immune to this "tsunami." Spain was one of the countries most affected by the pandemic, as well as by the measures adopted in response to COVID-19, with very serious economic, financial, and social consequences. This chapter's focus will be on Grass Roots Spain, a consulting company, and on the way it adapted its business model as a result of the pandemic crisis. © 2021 by IGI Global. All rights reserved.
ABSTRACT
When Covid-19 appeared in the USA at the beginning of 2020, there was no treatment or vaccine. The only way to deal with the virus was containment, which resulted in business and agency closures. The impact on the economy was enormous, particularly on the lives of minorities and financially vulnerable people. The present study investigated the impact of COVID-19 on the lives of vulnerable people through qualitative interviews of major social service and healthcare agencies. The results show how the pandemic furthered existing disparities in access to a variety of services and supports.
ABSTRACT
BACKGROUND: COVID-19 has the potential to cause outbreaks in hospitals. Given the comorbid and elderly cohort of patients hospitalized, hospital-acquired COVID-19 infection is often fatal. Pathogen genome sequencing is becoming increasingly important in infection prevention and control (IPC). AIM: To inform the understanding of in-hospital SARS-CoV-2 transmission in order to improve IPC practices and to inform the future development of virological testing for IPC. METHODS: Patients detected COVID-19 positive by polymerase chain reaction on Ward A in April and May 2020 were included with contact tracing to identify other potential cases. Genome sequencing was undertaken for a subgroup of cases. Epidemiological, genomic, and cluster analyses were performed to describe the epidemiology and to identify factors contributing to the outbreak. FINDINGS: Fourteen cases were identified on Ward A. Contact tracing identified 16 further patient cases; in addition, eight healthcare workers (HCWs) were identified as being COVID-19 positive through a round of asymptomatic testing. Genome sequencing of 16 of these cases identified viral genomes differing by two single nucleotide polymorphisms or fewer, with further cluster analysis identifying two groups of infection (a five-person group and a six-person group). CONCLUSION: Despite the temporal relationship of cases, genome sequencing identified that not all cases shared transmission events. However, 11 samples were found to be closely related and these likely represented in-hospital transmission. This included three HCWs, thereby confirming transmission between patients and HCWs.