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Objectives: Chilblain lupus erythematosus (LE) is a rare chronic cutaneous lupus erythematosus (CCLE) characterized by the appearance of violaceous plaques in acral regions most exposed to cold. The isolated form affects middle-aged women, while the familial form manifests in early childhood and is associated with mutations in the TREX1 gene. Result(s): A 13-year-old adolescent, with no relevant family history, was referred in March 2021 for suspected chilblain-like lesions associated with COVID-19 infection. The patient presented with multiple violaceous papules on hands and feet. The lesions were slightly painful. Small hyperkeratotic papules were also observed on finger pads. Physical examination also revealed some aphthae affecting the lips. No other systemic symptoms were reported. A skin biopsy and blood tests were performed due to presumed chilblain LE with probable systemic involvement. Histology revealed basal vacuolar damage and intense perivascular and periadnexal lymphocytic inflammatory dermal infiltrate. Remarkably, mucin was noted among the collagen bundles. Leukopenia and positive ANA antibodies (titre 1:320) were detected. Complement levels were normal. SARS-CoV2 infection was ruled out. Skin lesions disappeared within 1 month under topical corticosteroids. Hydroxychloroquine was afterwards started by Rheumatology without recurrence of skin symptoms until last follow-up. Discussion(s): We present an uncommon case of an adolescent with systemic LE presenting as chilblain LE. Chilblain LE can be accompanied by other discoid CCLE. It can progress to systemic LE in up to 20% of patients, especially when concomitant CCLE is present. This rare presentation of CCLE should be differentiated from typical chilblain and other resembling lesions, such as SARS-CoV2-associated chilblain and acral purpuric lesions (COVID toes). The Mayo Clinic diagnostic criteria can be helpful, particularly in this last SARS-CoV2 outbreak scenario, when the reporting of similar skin lesions has been significant.
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Objective: To determine the prevalence and risk factors associated with SARS-CoV-2 infection among workers of Instituto Nacional de Salud del Nino (INSN) from April 2020 to March 2021. Material(s) and Method(s): A non-experimental, descriptive, cross-sectional study. The sample consisted of 608 workers who tested positive for COVID-19 using a rapid antigen test. The COVID-19 clinical-epidemiological research sheets prepared by the Ministry of Health of Peru and self-administered by the workers were reviewed. The INSN Department of Epidemiology staff verified the completion of the sheets. The data was entered into a database, which was used for the respective statistical analysis. The study was approved by the INSN Institutional Research Ethics Committee (registration code: PI-17/21). Result(s): COVID-19 prevalence among INSN workers was 7.24 % from April 2020 to March 2021. Out of the workers with COVID-19, 71.4 % were women;83.4 % were in the 30 to 59 age range with an average age of 44.71 years;65.6 % were healthcare workers, most of whom were nursing technicians;and 56.9 % experienced symptoms, mainly fever/chills (12.2 %), cough (8.9 %), malaise (7.7 %), sore throat (6.7 %), stuffy nose (2.5 %) and headache (1.3 %). Most workers lived in Lima Centro districts (33.2 %). A significant association between sex, age groups, worker type and worker profile was found. Conclusion(s): COVID-19 prevalence among INSN workers was 7.24 %;the most frequent characteristics, which showed significant differences with the rest of the factors, were being a woman, healthcare worker and nursing technician. A total of 56.9 % of the workers experienced symptoms, only 20.9 % developed clinical signs and 10.9 % had comorbidities.Copyright © La revista. Publicado por la Universidad de San Martin de Porres, Peru.
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Background: The diagnosis of drug allergy requires a previous medical history suggestive of a Drug Hypersensitivity Reaction (DHR). DHRs caused by vaccines are rare (< 1/100.000 doses) and are mainly due to excipients. At the beginning of the COVID-19 vaccination, occasional cases of severe reactions were reported in patients with allergy history. This warning led to an increased demand for allergy testing to evaluate pre-vaccination risk assessment, especially due to the refusal of allergic patients to receive the vaccine. Method(s): Twenty patients were evaluated between May to July 2021, referred for allergology study prior to receiving the vaccine against COVID-19. All patients tested had allergy history. Skin tests were performed with the available excipients of the COVID-19 vaccine: polyethylene glycol (PEG-1500, 10% prick ROXALL), polysorbate 80 (tween 80 prick 0.04 -ID 0.004 mg/ml), and trometamol (prick 1 -ID 0.1 mg/ml). A telephone follow-up was subsequently performed to assess tolerance to the vaccine. Result(s): The median age of the patients was 54.5 years and ninety percent were female. (Table 1) The most frequent allergy history was adverse drug reactions (ADRs) in 18 patients (90%), followed by bronchial asthma (35%), rhinitis (25%), food allergy (25%), and dermatitis (15%). 12 patients (60%) had multiple allergic diseases. The drugs implicated in these ADRs were beta-lactam antibiotics (40%), NSAIDs (20%), radiographic contrast media (15%), and vaccines (15%). Skin tests with the excipients studied were negative in all cases. Subsequently, the COVID-19 vaccine was administered in 16 patients (80%). Six patients (30%) reported side effects expected from the vaccine and no DHRs were described. Although vaccination was recommended to all patients after the study, 4 patients (20%) refused the administration. Conclusion(s): Patients with atopic history do not require an allergology study prior to the administration of the COVID-19 vaccine. Exceptionally, it may be necessary if the patient has a history of suspected DHRs to the excipients involved. The previous allergology assessment did not prevent refusal of vaccination in 20% of the patients. (Table Presented).
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The COVID-19 pandemic caused that most countries established the closure of many beaches, affecting the scientific monitoring of thousands of coastal sectors. This article shows the status of beach litter in South America before and after COVID-19 closure. The data were obtained during the years 2019, 2020 and 2022 on 25 beaches using a technique BLAT-QQ. The results show that cigarette butts were the most frequent type of litter, meanwhile Brazil should improve cleanliness of general gross litter and gross polystyrene. Colombia gross vegetation litter and small vegetation litter, and Ecuador organic litter from animals. The results shown in qualitative and quantitative manner facilitate their understanding for managers, scholars and activists interested on beach litter monitoring. This baseline is useful to analyse regional and worldwide marine litter trends with the purpose to start or restart monitoring of tourist beaches from a science-based method.
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COVID-19 , Waste Products , Humans , Waste Products/analysis , Environmental Monitoring/methods , Pandemics , Plastics , Bathing Beaches , BrazilABSTRACT
BACKGROUND: The aim was to determine the impact of COVID-19 pandemic on urolithiasis presentation and management. METHODS: In this retrospective study, we comparatively evaluated urgent and elective procedures due to urolithiasis during the early eight months of the COVID-19 pandemic (March 1, 2020, to October 31, 2020) compared to the same period a year before, and between waves. The student's t-test, chi-square test, Mann-Whitney U test and Fisher's exact test were used to compare the patients' characteristics and outcomes between the two periods and waves. RESULTS: Five hundred and thirty procedures were included. The overall numbers of surgical procedures due to urolithiasis were similar between pre-pandemic and pandemic periods. Regarding elective surgery, our data draw attention to the increased complication rate in the pandemic times, but no statistically significant differences in terms of types of procedures and need for complementary treatments were observed. We noted that patterns of presentation of complicated renal colic were different during COVID-19 pandemic, with a higher number of days after the onset of symptoms and a higher proportion of patients presenting acute kidney injury. Furthermore, a significant increase of creatinine levels at presentation in first wave was detected, and a growth in the number of urgent procedures after the first wave was noted, owing to the delay in urolithiasis treatment and diagnosis. CONCLUSION: The COVID-19 pandemic has negatively affected both urgent and elective management of urolithiasis. Lessons about the management of urolithiasis in this context should be learned to avoid fatal complications and improve standards of care.
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Background The aim was to determine the impact of COVID-19 pandemic on urolithiasis presentation and management. Methods In this retrospective study, we comparatively evaluated urgent and elective procedures due to urolithiasis during the early eight months of the COVID-19 pandemic (March 1, 2020, to October 31, 2020) compared to the same period a year before, and between waves. The student’s t-test, chi-square test, Mann-Whitney U test and Fisher’s exact test were used to compare the patients’ characteristics and outcomes between the two periods and waves. Results Five hundred and thirty procedures were included. The overall numbers of surgical procedures due to urolithiasis were similar between pre-pandemic and pandemic periods. Regarding elective surgery, our data draw attention to the increased complication rate in the pandemic times, but no statistically significant differences in terms of types of procedures and need for complementary treatments were observed. We noted that patterns of presentation of complicated renal colic were different during COVID-19 pandemic, with a higher number of days after the onset of symptoms and a higher proportion of patients presenting acute kidney injury. Furthermore, a significant increase of creatinine levels at presentation in 1st wave was detected. A growth in the number of urgent procedures after the 1st wave was noted, owing to the delay in urolithiasis treatment and diagnosis. Conclusion The COVID-19 pandemic has negatively affected both urgent and elective management of urolithiasis. Lessons about the management of urolithiasis in this context should be learned to avoid fatal complications and improve standards of care.
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The current global situation with a dominant economic development model producing social inequality, increment and intensification of urbanization has generated severe environmental degradation and an associated increase in the likelihood of pandemics. New strategies that strengthen sustainable food production are urgent in highly unequal countries as Mexico. In Mexico City, the most populated city of the country, a wetland system, named Xochimilco, still holds chinampas, a unique and ingenious food system dating from pre-Hispanic times. These days chinampas are the best example of urban sustainable agriculture production. Unfortunately, this system is under threat due to urbanization and industrial land-use changes. Among the strategies to promote sustainable modes of production and consumption is eco or green labeling, consisting of a voluntary environmental certification approach, and marketing and advertising tool, that can change producers' and consumers' behavior toward long-term sustainability. Although widely used, the benefits of green labels for producers are not always realized. This study aimed to learn more about the agro-ecological production process and commercialization challenges in Xochimilco and San Gregorio Atlapulco in Southern Mexico City to understand chinampa producers' needs and determine whether a green label can offer solutions in this vulnerable socio-ecological system, particularly suffering the effects of the COVID-19 pandemics. For this, a literature review and producers' mental model analysis based on network theory, were developed. Results show that non-resolved issues such as commercialization problems, consumers' unwillingness to pay a fair price, loss of healthy soil, and degraded water quality used for irrigation persist and can affect the benefits of a green label including to improve chinampa production and farmers' income. Farmers' current necessities comprised increasing profits, receiving financial advice to set prices of agro-ecological vegetables and production costs, among others. Under the current production and commercialization scenarios complying with the assessment cost of certification will be difficult for most producers;then, implementing the green label would probably fail to fulfill the benefits. Attending to former and persistent conflicts and satisfying chinampa producers' neglected necessities are essential before implementing any program. Copyright © 2022 Arroyo-Lambaer, Zambrano, Rivas, Vázquez-Mendoza, Figueroa, Puente-Uribe, Espinosa-García, Tapia-Palacios, Mazari-Hiriart, Revollo-Fernández, Jiménez-Serna, Covarrubias and Sumano.
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The present study seeks to determine the characteristics of the information about COVID-19 obtained through social networks in health sciences students in Lima. A sample of 384 health sciences students using social networks during the pandemic stage was taken and the survey technique was used to obtain relevant information. The results reveal that the most used social network for searching, and consulting information related to the pandemic were WhatsApp and Facebook. The presence fakenews about COVID-19 was observed 4 out of 5 times and more than half were about medicines for the treatment of the disease. Among the most important sources of information was the COVID Situational Room of the Peruvian government. Publications in research journals were found to be the main source of scientific information. It was perceived that the Peruvian Ministry of Health was the institution with the greatest presence in social networks and that the Peruvian Government and other public agencies were the main sources for sharing information on COVID-19 in social networks.
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Introduction & Objectives: Urolithiasis is a very common disease that can be potentially life-threatening. This study aimed to evaluate the impact of the COVID-19 pandemic on elective and urgent surgery of urolithiasis. Materials & Methods: We reviewed all surgeries due to urolithiasis during the COVID-19 pandemic (1st March- 31th October 2020) and during the same time pre-COVID-19 period in 2019. Student t-test, Mann-Whitney U, Chi square and Fisher's exact test were used to compare the two periods. Results: 530 procedures were analysed. The number of surgical procedures were similar between the two periods. Regarding elective surgery (table 1), we found no statistically significant differences in types of procedures, hospital stay and need for complementary treatments. We identified an increased complication rate in the pandemic times. (Table Presented) Conclusions: The COVID-19 pandemic has impacted on urgent and elective management of urolithiasis. It represents a challenge for urologists and lessons should be learnt in order to avoid fatal complications.
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Background: The Hospital Virgen de la Poveda, (Villa del Prado, Spain), assists patients in need of Continuous medical care, Rehabilitation or Palliative care;these patients have many risk-factors of COVID-19 morbility and mortality. With both health-care humanization and contagion-prevention purpo-ses, in July 2020 two patient visit protocols were im-plemented. The objective of this study is to describe these measures qualitatively and quantitatively. Methods: A context is provided regarding COVID-19 measures in this institution. The content and follow-up indicators of visit protocols (number of visits, of outbreaks, inpatients, etc.) and of their con-text were provided. The empirical outbreak probabi-lities were calculated, and hypothesis contrast was performed against no-visits (0%) and no visit-control (7-day cumulative incidence/habitant). Results: Two protocols were created. Accompanying was applied to Palliative Care cases (no appointments required, no time limits), and a short visits protocol was applied to the other patients (appointments for 1 weekly visit for 1-2 persons were given and visits last up to 45 minutes). In both protocols, visitors with symptoms or fever or particularly susceptible were for-bidden entrance. Between July and April 2021, 4,759 short-visit appointments were given and 7,544 total vi-sits took place (short visits, accompanying, exceptions). An outbreak was possibly attributed to short visits (pro-bability=0.021% [CI95%: 0.0005-0.1171%]) and two outbreaks were possibly attributed to visits globally (probability=0.0265% [IC95%: 0.0032-0.0958%]). Conclusions: Elaborating adapted, applica-ble and prospectively-evaluated protocols with pre-vention measures at multiple levels might succeed in minimizing the risk of adverse events (in this case, COVID-19
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Background: Inducible Urticaria (IU) is a type of Chronic Urticaria (CU) that occurs after exposure to physical and non-physical stimuli The diagnosis is based on patient history and provocation tests, which reproduce the symptoms after exposure to an appropriate triggering stimulus. IU may be present in patients with history of Chronic Spontaneous Urticaria (CSU) Our objective was to establish standardized protocols through diagnostic circuits that included tests for different stimuli in the same visit, reduce consultation time and evaluate their effectiveness and safety. Method: We designed 4 circuits where different test instruments for IU were included: Temptest, Fric-Test, Calibrated Dermographometer, Standard laboratory vortex and suspension of weights (7 kg.) over the shoulder. The circuits were: • Basic Circuit (BC): Dermographism, Temperature (cold and heat), Pressure (delayed an acute) and Vibratory Urticaria (Diagram 1) • Cold Urticaria Circuit (CUC): CB plus Ice Cube Test • Aquagenic Urticaria Circuit (AqUC): CB plus Aquagenic test • Autoimmune Urticaria Circuit (AuUC): CB plus Autologous Serum Skin Test (ASST) Cholinergic Urticaria tests were not included due to COVID pandemic restrictions, nor tests for Solar Urticaria as the necessary technical means were not available. For 6 months, we selected 51 patients with urticaria history lasting for more than 6 weeks. The circuit chosen for the study depended on the initial clinical suspicion. If there was no clear triggering stimulus, the BC was performed which includes the most frequent causes of IU. Results: Of the total number of patients studied, BC was applied to 82.4%, CUC to 7.8%, AqUC to 7.8% and AuUC to 2%. The most frequent diagnosis was Dermographism in 47.05% of the patients. This diagnosis was also present in some patients with CSU. The maximum time to perform these circuits was 30 minutes. None of the patients studied presented systemic reactions, anaphylaxis or other unexpected reactions. Conclusion: We observed that the use of standardized circuits in patients with suspected UI makes it possible to study more than one stimulus and to give the appropriate recommendations in each case. These tests are easy to apply and help to optimize study time. Besides, they allow the detection of physical or non-physical stimuli associated with SCU. Given that no patient presented adverse reactions, it appears to be a safe test. (Figure Presented).
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OBJECTIVE: The Hospital Virgen de la Poveda, (Villa del Prado, Spain), assists patients in need of Continuous medical care, Rehabilitation or Palliative care;these patients have many risk-factors of COVID-19 morbility and mortality. With both healthcare humanization and contagion-prevention purposes, in July 2020 two patient visit protocols were implemented. The objective of this study is to describe these measures qualitatively and quantitatively. METHODS: A context is provided regarding COVID-19 measures in this institution. The content and follow-up indicators of visit protocols (number of visits, of outbreaks, inpatients, etc.) and of their context were provided. The empirical outbreak probabilities were calculated, and hypothesis contrast was performed against no-visits (0%) and no visit-control (7-day cumulative incidence/habitant). RESULTS: Two protocols were created. Accompanying was applied to Palliative Care cases (no appointments required, no time limits), and a short visits protocol was applied to the other patients (appointments for 1 weekly visit for 1-2 persons were given and visits last up to 45 minutes). In both protocols, visitors with symptoms or fever or particularly susceptible were forbidden entrance. Between July and April 2021, 4,759 short-visit appointments were given and 7,544 total visits took place (short visits, accompanying, exceptions). An outbreak was possibly attributed to short visits (probability=0.021% [CI95%: 0.0005-0.1171%]) and two outbreaks were possibly attributed to visits globally (probability=0.0265% [IC95%: 0.0032-0.0958%]). CONCLUSIONS: Elaborating adapted, applicable and prospectively-evaluated protocols with prevention measures at multiple levels might succeed in minimizing the risk of adverse events (in this case, COVID-19 outbreaks).
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COVID-19 is a viral disease produced by SARS-CoV-2 that was declared a global pandemic by the World Health Organization (WHO) on March 2020. The pandemic has caused a great impact in several medical disciplines, including radiology. Radiologists have a fundamental role in identifying characteristic imaging findings of the COVID-19 disease. The studies regarding extra pulmonary findings of COVID-19 are relatively new. These findings include cardiac, thoracic and abdominal manifestations as a result of the pro-thrombotic state produced by the virus. Unexpected extrapulmonary imaging findings of COVID-19 patients from two different institutions are presented. In addition, we conducted a literature review of extra pulmonary manifestations and complications of this disease. The aim of this study is to provide information for an early recognition and optimal management of these complications. © 2021, Sociedad Chilena de Radiologia. All rights reserved.