Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 10 de 10
Filter
1.
J Appl Clin Med Phys ; : e13770, 2022.
Article in English | Web of Science | ID: covidwho-2013307

ABSTRACT

PURPOSE: This study aims to investigate practice changes among Southern and Northern California's radiation oncology centers during the COVID-19 pandemic. METHODS: On the online survey platform SurveyMonkey, we designed 10 survey questions to measure changes in various aspects of medical physics practice. The questions covered patient load and travel rules;scopes to work from home;new protocols to reduce corona virus disease-2019 (COVID-19) infection risk;availability of telemedicine;and changes in fractionation schedules and/or type of treatment plans. We emailed the survey to radiation oncology centers throughout Northern and Southern California, requesting one completed survey per center. All responses were anonymized, and data were analyzed using both qualitative and quantitative research methods. RESULTS: At the end of a 4-month collection period (July 2, 2021 to October 11, 2021), we received a total of 61 responses throughout Southern and Northern California. On average, 4111 patients were treated per day across the 61 centers. New COVID-19-related department and hospital policies, along with hybrid workflow changes, infectious control policies, and changes in patient load have been reported. Results also showed changes in treatment methods during the pandemic, such as increased use of telemedicine, hypofractionation for palliative, breast cancer, and prostate cancer cases;and simultaneous boosts, compared to sequential boosts. CONCLUSION: Our California radiation oncology center population study shows changes in various aspects of radiation oncology practices during the COVID-19 pandemic. This study serves as a pilot study to identify possible correlations and new strategies that allow radiation oncology centers to continue providing quality patient care while ensuring the safety of both staff and patients.

2.
Cureus Journal of Medical Science ; 14(8), 2022.
Article in English | Web of Science | ID: covidwho-2006498

ABSTRACT

COVID-19 occurs due to infection by the SARS-CoV-2 virus (severe acute respiratory syndrome coronavirus 2), which has caused havoc globally. It presents with a wide range of symptoms, mainly respiratory symptoms, but with time various neurological manifestations of the disease have also been noted, like myelitis. This case report aims to shed light on COVID-19-associated myelitis so that potential neurological complications of COVID-19 can be identified and treated timely. We report a case of a 41-year-old male who presented with weakness of all limbs with urinary complaints. He also had a cough and sore throat for the past few days. The MRI scan of the spine showed long segment myelitis in the cervical cord extending from the cervicomedullary junction to the upper end of the C4 vertebral body. COVID-19 myelitis is a rare but severe complication of COVID-19 infection and needs to be discussed.

4.
Gastroenterology ; 162(7):S-720-S-721, 2022.
Article in English | EMBASE | ID: covidwho-1967367

ABSTRACT

Introduction: At the onset of the COVID-19 pandemic, all patients undergoing endoscopic surveillance for Barrett's Oesophagus (BE) in the UK were indefinitely postponed. As well as the potential for missed progression to dysplasia, the negative impact on patients' quality of life is immeasurable. The Cytosponge® is a minimally invasive cell sampling device which has been researched in screening for BE. We describe the first worldwide use of the Cytosponge® outside of a clinical trial to support the triage of BE patients unable to undergo endoscopic surveillance due to COVID-19. Aims and Methods: Consecutive patients with non-dysplastic BE (NDBE) or those deemed to be low risk after previous treatment for BErelated dysplasia, DBE (more than 18 months after completion of therapy with no visible BE and no intestinal metaplasia/dysplasia at last endoscopy) with no prior history of stenosis who were overdue endoscopy (OGD) were invited to have the Cytosponge®. The sample was analysed for TFF3 (a marker of intestinal metaplasia), cellular atypia and p53. Fisher's test was used to examine the association between the overall cytosponge result and its individual components with follow-up OGD outcomes. Results: To date, 153 patients (mean age 66 years, 126 male) have undergone the Cytosponge® procedure. The median maximal length of BE was 3cm (1-15cm). Three patients were unable to swallow the device and 19 (12%) needed a repeat procedure as no columnar cells were present suggesting that the sponge had not entered the stomach. 87 patients (80%) with NDBE had a either a low-risk result (TFF3 positive only – 62) or required a repeat Cytosponge® routinely (TFF3/atypia/ p53 negative – 25). The remaining 21 patients (20%) needed an OGD within 3 months, 17 of which have since had an OGD. Of these 17 patients, 4 had a new diagnosis of dysplasia (indefinite - 2, low grade dysplasia – 1, intramucosal cancer - 1) and 2 a new diagnosis of cancer. 18/87 patients in the low-risk NDBE cohort have undergone follow-up OGD (NDBE 17/18, high grade dysplasia 1/18). Of the 23 patients in the post-treatment BE cohort, 1 patient had a high-risk result and subsequent OGD confirmed HGD (Table 1). A high-risk cytosponge result and the presence of both p53 and typia were all associated with a positive OGD result. Over-expression of p53 appeared to be the most sensitive marker (Table 2). In treatment naive patients, a low-risk cytosponge result was closely associated with no dysplasia detected at follow-up OGD with a negative predictive value of 94%. Conclusions: Cytosponge® has proved to be a useful non-endoscopic tool for patients with BE under surveillance where OGD is not possible. Preliminary data are promising to help triage patients and may in turn offer a less invasive approach to monitoring patients compared to endoscopy, particuarly for low risk patients. (Table Presented) (Table Presented)

6.
Gut ; 70(SUPPL 4):A136, 2021.
Article in English | EMBASE | ID: covidwho-1554179

ABSTRACT

Introduction Waiting times for endoscopy are rising rapidly following the COVID-19 pandemic. In addition, cancers may be missed as patients are placed on routine waiting lists but not monitored. Some hospitals use the Edinburgh Dysphagia Score to assess and prioritise patients for investigation. This offers a sensitivity of 98.4% and specificity of 9.3% to detect malignancy in patients presenting with dysphagia.4 However, it is not designed for detecting gastric cancer. We aimed to create a more accurate screening questionnaire as an aid to triaging referrals. Methods Patients were recruited as part of the Saliva to Predict rIsk of disease using Transcriptomics and epigenetics (SPIT) study. Patients were recruited from 2 week-wait suspected upper gastrointestinal cancer pathway referrals at 20 hospitals in the United Kingdom. The cohort was further enriched with patients found to have oesophageal adenocarcinoma on emergency hospital admission. They completed over 200 questions about a wide variety of symptoms and risk factors. After data cleaning, 800 patients were available for evaluation. Of these, 80 had upper GI cancer. A machine learning model was developed to identify those at highest risk of having upper GI cancer using a 'cost-based' approach which maximises the chance of detecting cancer. Information gain was followed by correlated feature selection and a multivariable logistic regression curve was created with scores from 0 (cancer very unlikely) to 100 (cancer very likely). The training dataset used 80% of the data and the model was tested with the other 20%. Results 20 features were found to be important and reproducible. They included age, sex, dysphagia, odynophagia, early satiety, weight loss, duration of chest pain and regurgitation, frequency of acid taste in the mouth, a previous history of smoking, cancer or psychological disorders, current anxiety level and frequency of vegetable intake. The area under the receiver operator curve to detect cancer was 0.83. 50% of cancers scored greater than 85 whereas 50% of normals scored less than 25. At a cut-off score of 10, sensitivity was 98.7% with specificity 26.8% to detect cancer (figure). Conclusions We have created a simple, reproducible risk score to identify patients at high and low risk of upper GI cancer. It performs better than previous scores but now needs testing in the real world. It might be usable to both upgrade routine patients to urgent endoscopy and remove patients at very low risk from waiting lists, thereby helping to prioritise patients with a greater clinical need and reducing the endoscopic backlog.

7.
Biomedical and Pharmacology Journal ; 14(3):1519-1523, 2021.
Article in English | EMBASE | ID: covidwho-1502803

ABSTRACT

Novel coronavirus disease COVID-19 has emerged as a pandemic, claiming over 1,431,513 lives (till Nov. 27,2020) worldwide involving 191 countries . The objective of the study is to evaluate age and gender as a risk factor for COVID -19 related mortality . It is a retrospective cohort study, where the database of indoor COVID-19 positive patients was assessed for the study. Evaluation of the role of age and gender in mortality of COVID infection by comparing dataset of 2,142 indoor COVID positive patients with two outcome groups namely, death and discharged groups was done. The age comparison between two groups namely, death and discharged groups showed a median age of 60 years (IQR 50-70) for patients who died and 52 years (IQR 36–62) for the patients who recovered from COVID (p value-<0.001). There were 9 (0.65%) pediatric patients (<12 yrs) in the group of patients who recovered .For gender analysis (n=2129), COVID patients who died were 32.5%(n=692),out of which 63.6%(n=440) were males and 36.4%(n=252) were females. COVID positive patients in discharged group were 67.5%(n=1437),out of which 61.2%(n=880) were males and 38.8%(n=557) were females. There was no statistical difference between the two groups for mortality risk based on gender for COVID -19 infection (chi square value of 1.09, p value=.296) and the relative risk of death in males and females who died of COVID was 1.052 (95% CI=0.92-1.204). COVID-19 infection is showing predilection for male gender in both death and discharged group but the males and females are equally susceptible to the risk of death .

8.
United European Gastroenterology Journal ; 9(SUPPL 8):302, 2021.
Article in English | EMBASE | ID: covidwho-1490962

ABSTRACT

Introduction: Waiting times for endoscopy are rising rapidly following the COVID-19 pandemic, leading to significant backlogs.1 Modelling has demonstrated that delays in presentation to health services and delays in completing diagnostic procedures will lead to excess mortality.2 In addition, many cancers are likely to be missed as patients are placed on routine waiting lists but are not regularly monitored. Some hospitals use the Edinburgh Dysphagia Score to risk assess and prioritise patients for investigation.3 This offers a sensitivity of 98.4% and specificity of 9.3% to detect malignancy in patients presenting with dysphagia.4 However, it is primarily not designed for detecting gastric cancer. We aimed to create a more accurate screening questionnaire to risk assess patients and prioritise those who need early endoscopy. Aims & Methods: Patients were recruited as part of the Saliva to Predict rIsk of disease using Transcriptomics and epigenetics (SPIT) study. Ethical approval was gained from the Coventry and Warwickshire Regional Ethics Committee (17/WM/0079). Patients were recruited from 2 week-wait pathway referrals at 20 hospitals in the United Kingdom, which is used by physicians to refer patients who have may suspected cancer for further investigation The cohort was further enriched with patients found to have oesophageal adenocarcinoma on emergency hospital admission. They completed over 200 questions about a wide variety of symptoms and risk factors. After data cleaning, 800 patients were available for evaluation. Of these, 80 had upper GI cancer. A machine learning model was developed to identify those at highest risk of having upper GI cancer using a 'cost-based' approach which maximises the chance of detecting cancer. Information gain was followed by correlated feature selection and a multivariable logistic regression curve was created with scores from 0 (cancer very unlikely) to 100 (cancer very likely). The training dataset used 80% of the data and the model was tested with the other 20%. Results: 20 features were found to be important and reproducible. They included age, sex, dysphagia, odynophagia, early satiety, weight loss, duration of chest pain and regurgitation, frequency of acid taste in the mouth, a previous history of smoking, cancer or psychological disorders, current anxiety level and frequency of vegetable intake. The area under the receiver operator curve to detect cancer was 0.83. 50% of cancers scored greater than 85 whereas 50% of normals scored less than 25. At a cut-off score of 10, sensitivity was 98.7% with specificity 26.8% to detect cancer. Conclusion: We have created a simple, reproducible risk score to identify patients at high and low risk of upper GI cancer. It performs better than previous scores but now needs testing in the real world. It might be usable to both upgrade routine patients to urgent endoscopy and remove patients at very low risk from waiting lists, thereby helping to prioritise patients with a greater clinical need and reducing the endoscopic backlog.

9.
European Journal of Molecular and Clinical Medicine ; 8(4):529-534, 2021.
Article in English | EMBASE | ID: covidwho-1414371

ABSTRACT

The novel corona virus has wreaked havoc in both developing and developed countries. The respiratory effects of the virus were well reported early on but with each passing day, effects of covid-19 on others systems came to light. In this report, we bring forward the series of Guillain-barre syndrome (GBS) cases with the varying presentation in covid infected patients. In our cases, GBS either occurred during ongoing covid symptoms or within the two weeks of resolution of covid related pulmonary symptoms. Through this case series, we are reporting one case each of garden variety, AMAN variety and Miller Fisher variant of GBS. We aim to supplement the already existing limited data available on other systemic illnesses associated with covid-19 and to make physicians aware of the potential neurological diagnosis in covid cases.

10.
European Journal of Molecular and Clinical Medicine ; 8(4):535-541, 2021.
Article in English | EMBASE | ID: covidwho-1414276

ABSTRACT

COVID vaccinations have been developed in the record time frame. But with such rapid inventions, there comes a risk of potential side effects. Not many serious side effects linked to vaccinations have been reported to date. Through our case report, we wish to present a 50-year-old patient who suffered from a NeuromyelitisOptica-like presentation just 2 weeks after the COVID vaccination. We aim to bring a potential side effect of the vaccine to physicians' notice so that any patient with similar symptoms does not go undiagnosed. We do not want to discourage people from taking vaccinations as these side effects are quite rare.

SELECTION OF CITATIONS
SEARCH DETAIL