Case report of congenital disorder of glycosylation type Ia combined with dilated cardiomyopathy.

Clinical data and follow-up of a case of congenital disorder of glycosylation type Ia (CDG-Ia) combined with dilated cardiomyopathy admitted to the Department of Cardiology, Children's Hospital of Nanjing Medical University were analyzed retrospectively.The 5-year-old female patient was admitted in December 2016 due to recu-rrent shortness of breath for 2 months.Clinical symptoms and signs included repeated attacks of shortness of breath, physical retardation, malnutrition, binocular esotropia, multiple episodes of hypoglycemia, hepatosplenomegaly, hypotonia and other multi-system damages.Cardiac echocardiography suggested the feature of dilated cardiomyopathy, including the significant enlargement of the left ventricle, and decreased systolic function.Genetic testing revealed a compound heterozygous mutation in the PMM2 gene, and as a result, the patient was diagnosed as CDG-Ia.The patient's condition improved after symptomatic treatments such as Cedilanid, Dopamine, Dobutamine, Furosemide, as well as support treatments like myocardium nutrition, blood sugar maintenance, liver protection, etc.After discharge, the patient was given oral Digoxin, Betaloc, Captopril and diuretics, and hypoglycemia-controlling agents.The patient was followed up every 3-6 months.After more than 2 years of follow-up, the heart function and heart enlargement gradually returned to normal.During the Corona Virus Disease 2019 outbreak, self-withdrawal continued for 2 months.Re-examinations showed decreased cardiac function and enlarged left ventricle again.Medications were resumed again, and the patient was followed up closely.This case report suggested that CDG-Ia may be associated with dilated cardiomyopathy, and the cardiac phenotype may be improved by symptomatic supportive treatment.Copyright © 2021 by the Chinese Medical Association.

Online Complex Decongestive Therapy (CDT) Initiation for Lymphoedema - A Case Study.

Lymphoedema is a chronic disease affecting millions. Standard treatment is Complex Decongestive Therapy (CDT) which entails physical interaction with a therapist to imitate the drainage of the edematous fluid along with training to continue self-care at home. We present a case study of initiating CDT totally online. The result showed that, though totally online lymphoedema care is possible, hurdles do exist. It can be an option to exercise even after the COVID period.

Challenges of diversity and inclusion in defence emergency management and preparedness during the COVID-19 pandemic

LAY SUMMARY The Canadian military's recent mission in support of long-term-care homes in Ontario, and the alleged abuses reported, demonstrates the urgent need to address challenges associated with diversity and inclusion in defence emergency management and preparedness during the COVID-19 pandemic. This article reviews the social and health impacts of the COVID-19 pandemic on diverse groups within the Canadian Defence Team and across Canada, with a particular focus on visible minorities, Indigenous people, women, older adults, persons with disabilities, and lesbian, gay, bisexual, transgender, queer or questioning, and two-spirit communities. The review indicates that the pandemic widened the existing physical and mental health disparities and socio-economic inequities affecting these groups. To address these challenges, and to better understand the needs of diverse groups in the pandemic context, several recommendations for the Defence Team are proposed to incorporate into daily encounters with diverse groups and communities affected by COVID-19. The recommendations are designed to enable the Defence Team to establish positive and sustainable relations with diverse communities and to increase community resilience and defence emergency operational readiness. The range of potential impacts of the COVID-19 pandemic on individuals, families, and communities emphasizes the importance of recognizing the diverse perspectives and needs of the Canadian Defence Team and the urgency of developing inclusive approaches for managing these impacts. Whether the Canadian Armed Forces (CAF) and Department of National Defence (DND) are providing support to their own diverse workforce, or responding with humanitarian relief in Canada and abroad, it is essential to understand how the COVID-19 crisis may affect diverse groups across Canada. As a result, this article provides a perspective on COVID-19's potential impacts on diverse groups and communities when examining emergency management and preparedness in the Canadian defence context. The potential challenges that may be experienced by diverse groups across Canada, including members of the Defence Team, are discussed, with a focus on racialized people, women, older adults, persons with disabilities, and members of lesbian, gay, bisexual, transgender, queer or questioning, and two-spirit communities who reside across the Canadian landscape. The article also includes evidence-based recommendations that are intended to complement existing efforts to mitigate the negative effects of COVID-19, and it further contributes to the well-being of the Defence Team and DND-CAF readiness.

Virtual system for early detection of COVID-19 infection "Etaware-CDT-2020 prototype design" (corroborated by rRT-PCR data).

The 2nd phase of COVID-19 infection outbreak experienced worldwide is an attestation to the decline in the efficiency of COVID-19 detection kits available worldwide. rRT-PCR still remains the best confirmatory test for COVID-19 infection. Sadly, most medical professionals are not conversant with the rRT-PCR protocols. Therefore, more easy-to-use alternatives are required as backup, to compensate for these lapses. "Etaware-CDT-2020" is a virtual system designed for early detection of COVID-19 infection. A comparative COVID-19 diagnosis was conducted using Etaware-CDT-2020, corroborated by rRT-PCR-confirmed COVID-19 results obtained from China (Latitude 35.8617oN and Longitude 104.1954oE), which was the epicentre for COVID-19 infection outbreak. A cross-comparison of results showed that there was a positive correlation between the output result from Etaware-CDT-2020 and rRT-PCR diagnosis from Wuhan (r = 0.92) and Hubei (r = 0.97). Furthermore, there was no significant difference between the diagnostic results of "Etaware-CDT-2020" and rRT-PCR, when compared by T-test (P(t = 0) > 0.05) and Pearson's Chi-Square test (0.04 ≥ P ≤ 0.12). Etaware-CDT-2020 is unique and can be used anywhere, anytime and by anyone. It is accessible, affordable, easy to install, simple to understand and user friendly.

Efficacy and efficiency of a new therapeutic approach based on activity-oriented proprioceptive antiedema therapy (TAPA) for edema reduction and improved occupational performance in the rehabilitation of breast cancer-related arm lymphedema in women: a controlled, randomized clinical trial.

BACKGROUND: Breast cancer (BC) is a major public health issue. More than one out of five women treated for breast cancer will develop lymphedema in an upper extremity. Current evidence advocates transdisciplinary oncological rehabilitation. Therefore, research in this area is necessary since limited consensus having been reached with regard to the basic essential components of this rehabilitation. Consensus has, however, been reached on the use of decongestive lymphedema therapy (DLT), but due to a lack of tests, the necessary dosages are unknown and its level is moderately strong. This study attempts to verify both the efficacy of activity-oriented proprioceptive antiedema therapy (TAPA), as compared to conventional treatments such as DLT or Complex Physical Therapy (CPT), as well as its efficiency in terms of cost-effectiveness, for patients affected by breast cancer-related arm lymphedema. METHODS: Controlled, randomized clinical trial with dual stratification, two parallel arms, longitudinal and single blind. 64 women with breast cancer-related arm lymphedema will take part in the study. The experimental group intervention will be the same for stage I and II, and will consist of neuro-dynamic exercises oriented to the activity, proprioceptive neuromuscular facilitation activities and proprioceptive anti-edema bandaging. The control group intervention, depending on the stage, will consist of preventive measures, skin care and exercise-prescribed training in the lymphedema workshop as well as compression garments (Stage I) or conservative Complex Decongestive Therapy treatment (skin care, multi-layer bandaging, manual lymphatic drainage and massage therapy) (Stage II). RESULTS: Sociodemographic and clinical variables will be collected for the measurement of edema volume and ADL performance. Statistical analysis will be performed on intent to treat. DISCUSSION: It has been recommended that patient training be added to DLT, as well as a re-designing of patient lifestyles and the promotion of health-related aspects. In addition, clinical trials should be undertaken to assess neural mobilization techniques and proprioceptive neuromuscular facilitation should be included in the therapy. Cohesive bandaging will also be performed as an early form of pressotherapy. The proposed study combines all of these aspects in order to increased comfort and promote the participation of individuals with lymphedema in everyday situations. LIMITATIONS: The authors have proposed the assessment of the experimental treatment for stages I and II. One possible limitation is the lack of awareness of whether or not this treatment would be effective for other stages as well as the concern for proper hand cleansing during use of bandages, given the current COVID-19 pandemic situation. TRIAL REGISTRATION: This trial was registered in ClinicalTrials.gov ( NCT03762044 ). Date of registration: 23 November 2018. Prospectively Registered.

Catheter-Directed Thrombolysis of Iliocaval Thrombosis in Patients With COVID-19 Infection.

We present the characteristics and outcomes of the first 2 cases of catheter-directed thrombolysis performed in patients presenting with coronavirus disease-2019 (COVID-19)-related iliocaval thrombosis. (Level of Difficulty: Beginner.).

Difficulties of Managing Submassive and Massive Pulmonary Embolism in the Era of COVID-19.

Acute pulmonary embolism (PE) is a potentially life-threatening manifestation of venous thromboembolic disease. Severe acute respiratory syndrome-coronavirus-2, a novel coronavirus that causes coronavirus disease-2019 (COVID-19), has been associated with an increased risk of thrombosis. We describe the therapeutic challenges of 3 patients presenting with PE and suspected or confirmed COVID-19. (Level of Difficulty: Beginner.).