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Compared to other respiratory viruses, the proportion of hospitalizations due to SARS-CoV-2 among children is relatively low. While severe illness is not common among children and young individuals, a particular type of severe condition called multisystem inflammatory syndrome in children (MIS-C) has been reported. The aim of this prospective cohort study, which followed a group of individuals under the age of 19, was to examine the characteristics of patients who had contracted SARS-CoV-2, including their coexisting medical conditions, clinical symptoms, laboratory findings, and outcomes. The study also aimed to investigate the features of children who met the WHO case definition of MIS-C, as well as those who required intensive care. A total of 270 patients were included between March 2020 and December 2021. The eligible criteria were individuals between 0-18 with a confirmed SARS-CoV-2 infection at the Infectious Disease Hospital "Prof. Ivan Kirov"in Sofia, Bulgaria. Nearly 76% of the patients were <= 12 years old. In our study, at least one comorbidity was reported in 28.1% of the cases, with obesity being the most common one (8.9%). Less than 5% of children were transferred to an intensive care unit. We observed a statistically significant difference in the age groups, with children between 5 and 12 years old having a higher likelihood of requiring intensive care compared to other age groups. The median values of PaO2 and SatO2 were higher among patients admitted to the standard ward, while the values of granulocytes and C-reactive protein were higher among those transferred to the intensive care unit. Additionally, we identified 26 children who met the WHO case definition for MIS-C. Our study data supports the evidence of milder COVID-19 in children and young individuals as compared to adults. Older age groups were associated with higher incidence of both MIS-C and ICU admissions.Copyright © 2023 P. Velikov et al., published by Sciendo.
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Objective: Intensive care units (ICUs) collapsed under the global wave of coronavirus disease 2019 (COVID-19). Thus, we designed a clinical decision-making model that can help predict at hospital admission what patients with COVID-19 are at higher risk of requiring critical care. Method(s): This was a cross-sectional study in 119 patients that met hospitalization criteria for COVID-19 including less than 30 breaths per minute, peripheral oxygen saturation < 93%, and/or >= 50% lung involvement on imaging. Depending on the need for critical care, patients were retrospectively assigned to ICU and non-ICU groups. Demographic, clinical, and laboratory parameters were collected at admission and analyzed by classification and regression tree (CRT). Result(s): Forty-five patients were admitted to ICU and 80% of them were men older than 57.13 +/- 12.80 years on average. The leading comorbidity in ICU patients was hypertension. The CRT revealed that direct bilirubin (DB) > 0.315 mg/dl together with the neutrophil-to-monocyte ratio (NMR) > 15.90 predicted up to correctly in 92% of the patients the requirement of intensive care management, with sensitivity of 93.2%. Preexisting comorbidities did not influence on the tree growing. Conclusion(s): At hospital admission, DB and NMR can help identify nine in 10 patients with COVID-19 at higher risk of ICU admission.Copyright © 2022 Sociedad Medica del Hospital General de Mexico.
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The novel coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2).Mortality attributable to COVID-19 remains considerably high, with case fatality rates as high as 8-11%. Early medical intervention in patients who are seriously and critically ill with COVID-19 reduces fatal outcomes. Thus, there is an urgent need to identify biomarkers that could help clinicians determine which patients with SARS-CoV-2 infection are at a higher risk of developing the most adverse outcomes, which include intensive care unit (ICU) admission, invasive ventilation, and death. In COVID-19 patients experiencing the most severe form of the disease, tests of liver function are frequently abnormal and liver enzymes are found to be elevated. For this reason, we examine the most promising liver biomarkers for COVID-19 prognosis in an effort to help clinicians predict the risk of ARDS, ICU admission, and death at hospital admission. In patients meeting hospitalization criteria for COVID-19, serum albumin < 36 g/L is an independent risk factor for ICU admission, with an AUC of 0.989, whereas lactate dehydrogenase (LDH) values > 365 U/L accurately predict death with an AUC of 0.943.The clinical scores COVID-GRAM and SOFA that include measures of liver function such as albumin, LDH, and total bilirubin are also good predictors of pneumonia development, ICU admission, and death, with AUC values ranging from 0.88 to 0.978.Thus, serum albumin and LDH, together with clinical risk scores such as COVID-GRAM and SOFA, are the most accurate biomarkers in the prognosis of COVID-19.Copyright © 2021 Sociedad Medica del Hospital General de Mexico. Published by Permanyer.
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BackgroundThe 6-Minute Walk Test (6MWT) is a standardised method routinely used to screen for and monitor interstitiel lunge disease and/or pulmonary arterial hypertension in patients with systemic sclerosis (SSc). Studies shows that esaturations during the 6MWT are associated with severity of pulmonary manifestations in patients with SSc [1]. Digital sensors are commonly used to measure peripheral oxygen saturation (SpO2) during the 6MWT. However, digital-based sensors may have important limitations in patients with SSc due to disease-related microangiopathy, Raynaud's phenomenon, sclerodactyly and motion artifacts during the 6MWT [2]. Sensors located at more central body positions may therefore be more accurate as these as less prone to Raynaud attacks.ObjectivesTo determine the validity and re-test reliability of peripheral oxygen saturation measured at the finger, forehead, and ear during the 6MWT in patients with SSc.Methods82 patients with SSc had an arterial line placed while performing the 6MWT. Peripheral oxygen saturation was simultaneously measured by finger, forehead, and earlobe sensors and compared to the arterial oxygen saturation (SaO2) measured before and after the 6MWT. 40 patients repeated the 6MWT one week later. We used Bland-Altman plots to display the agreement between SpO2 and SaO2, and between the minimal SpO2 (minSpO2) one week apart. The intraclass correlation coefficient (ICC, 95% confidence interval 95% CI]) for repeated measurement of minSpO2 was calculated.ResultsThe mean difference (SpO2 - SaO2, ± standard deviation [SD]) after the 6MWT was –3.3% (±4.82), 0.15% (±1.55), and 1.36% (±1.93) for the finger, forehead, and earlobe, respectively (Table 1).The finger minSpO2 also demonstrated the poorest re-test reliability: The mean difference in minSpO2 (visit2-visit1, ±SD) was 1.28% (±5.3), 0.74% (±4.36) and –1.10% (±2.87),). The ICC (95% CI) showed good agreement using the ear and forehead probe (ICCear = 0.89 [0.80;0.94];ICCforehead = 0.88 [0.60;0.87]), while a modest reliability was found using the finger probe (ICCfinger = 0.65 [0.43;0.80]).ConclusionPeripheral oxygen saturation should be measured using either the earlobe or forehead during the 6MWT in patients with SSc.References[1]Villalba, W. O. et al. Six-minute walk test for the evaluation of pulmonary disease severity in scleroderma patients. Chest 131, 217–222 (2007).[2]Pathania, Y. S. Alternatives for erroneous finger probe pulse oximetry in systemic sclerosis patients during COVID-19 pandemic. Rheumatol. Int. 41, 2243–2244 (2021).Table 1.Validity and re-test reliability of peripheral oxygen during the 6MWT (n= 82)Finger probeForehead probeEar probeMean difference SpO2 - SaO2 Mean difference pre-test (+/-SD)–0.68% (±1.88)0.13% (±1.26)1.54% (±0.69) Mean difference post--test (+/-SD)–3.30% (±4.82)0.15% (±1.55)1.36% (±1.93)Mean difference of the minSpO2 (visit2-visit1) Mean difference (±SD)1.28% (±5.3)0.74% (±4.36)1.10% (±2.87)Abbreviations: SpO2, Peripheral oxygen saturation;SaO2, Arterial oxygen saturation;SD, Standard deviation.Acknowledgements:NIL.Disclosure of InterestsAmanda Lynggaard Riis: None declared, Esben Naeser Paid instructor for: Boehringer Ingelheim Denmark, Katja Thorup Aaen: None declared, Henrik Hovgaard: None declared, Peter Juhl-Olsen: None declared, Elisabeth Bendstrup Speakers bureau: Hoffman-la-Roche.Boehringer Ingelheim.Glaxo Smith Kleine.Daichii Sankyo, Klaus Soendergaard Speakers bureau: Boehringer Ingelheim, Consultant of: Boehringer Ingelheim, Grant/research support from: Boehringer Ingelheim.
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Monitoring the SaO2 levels and other respiratory function parameters after recovering from COVID-19 can have essential meaning in the assessment of the efficacy of using physiotherapy methods, including classical massage. Purpose of the research was to assess the influence of an individual classical back massage session as well as the effects of an entire 8-session back massage therapy on SaO2, HR and spirometry parameters in a patient after recovering from COVID-19, with constant monitoring of massage areas' temperature changes. Data and methods. The study comprised a case study of a patient who recovered from COVID-19. The patient was subjected to a classical back and spine massage therapy utilising all the basic techniques. The design was based on the results of the following tests: lung x-ray, SaO2, HR, spirometry parameters, and the 6-minute walking distance test. The degree of the influence of the classical massage techniques was monitored using the infrared thermography. Results. Continuous oxygen saturation monitoring during the massage sessions enabled to observe a decrease in the level of this parameter during utilisation of rubbing and tapotement on muscles of both the right and the left side of the back. During the usage of the intense massage techniques SaO2 dropped maximally to 92-93%. Such decrease was noted after massaging the right as well as the left side of the back, during every massage session. I addition it was found that in the case of the patient who recovered from COVID-19 changing the body position from sitting down to lying down after the massage session the level of tissues saturation decreased. The observed changes in the VA/Q ratio that occurred in response to the 8-session massage therapy lasting for 3 weeks might indicate that better conditions for ventilation and oxygen perfusion at the alveolar surface were reached. This translated in the patient who recovered from COVID-19 into 2% increase in oxygen saturation level after completing the massage therapy. Conclusion. Utilising the intense rubbing and tapotement techniques has to be carefully considered due to their significant influence on decrease in the level of saturation.
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Telemedicine is a modality which utilizes technology to provide and support health care across large distances. It has redefined the practices of medicine in many specialties and continues to be a boon for clinicians on many frontiers. Its role in the branch of anesthesia remains largely unexplored but has shown to be beneficial in all the three phases: pre-operative, intra-operative, and post-operative. Now time has come that anesthesiologists across the globe reassess their strategies and utilize the telemedicine facilities in the field of anesthesia.Copyright © 2021 EDP Sciences. All rights reserved.
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Platypnea-orthodeoxia syndrome (POS) is an extremely rare condition. There are no other cases in the literature where tamsulosin has been reported to prolong POS treatment. A 67-year-old male patient was hospitalized due to COVID-19. He was followed up in the ward after being in the intensive care unit for ten days. There was a significant decrease in saturation (SaO2) when sitting and standing compared to lying. He was diagnosed with POS. However, there was no significant improvement in POS with exercises. After stopping the tamsulosin he was using, there was a dramatic improvement. He was discharged on the 72nd day of his hospitalization. Due to COVID-19, POS is more likely to appear than before. It is a condition that clinicians should recognize. The pathophysiology of POS has not been fully elucidated. The case we present suggests that alpha-blockers may also be related to pathophysiology.©Copyright 2020 by Emergency Physicians Association of Turkey -
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The COVID-19 pandemic is a challenge for health practitioners, where there are many suspected and confirmed patients with COVID-19, including obstetric patients. Perioperative treatment of COVID-19 patients must be under applicable standards, for both patients and the medical personnel. Personal protective equipment is essential for health workers who treat patients with COVID-19 to prevent the transmission of the virus. The method of delivery ideally should be adapted to the clinical condition of the patient. At the same time, the management of anesthesia for patients with cesarean sections should also be adjusted to the patient's clinical condition by taking into consideration the availability of facilities and infrastructure that we have. Through this report, we want to show how we manage COVID-19 in obstetric cases using the available resources in a third-world country.Copyright © 2021 Bali Journal of Anesthesiology. All rights reserved.
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Objectives: Severe acute respiratory syndrome-coronavirus 2/COVID-19 infection is still a global concern, with pregnant women are considered as vulnerable population. Until now, the characteristics of pregnant women in Indonesia who are infected with COVID-19, as well as pregnancy and neonatal outcomes, are still unknown. This study aims to obtain national data, which are expected to be useful for the prevention and management of COVID-19 in pregnant women in Indonesia. Method(s): There were 1,427 patients recruited in this retrospective multicenter study. This study involved 11 hospitals in 10 provinces in Indonesia and was carried out using secondary patient data from April 2020 to July 2021. COVID-19 severity was differentiated into asymptomatic-to-mild symptoms and moderate-to-severe symptoms. The collected data include maternal characteristics, laboratory examinations, imaging, pregnancy outcomes, and neonatal outcomes. Result(s): Leukocyte, platelets, basophil, neutrophils segment, lymphocytes, monocytes, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, alanine aminotransferase (ALT), aspartate aminotransferase (AST), C-reactive protein (CRP), urea, and creatinine were found to be significantly associated with severity differences (p < 0.05). Moderate-severe symptoms of COVID-19 also shown to have suggestive pneumonia findings on chest X-ray findings. Patients with asymptomatic-to-mild symptoms had significantly (p < 0.001) higher recovery rate, shorter hospital stay, less intensive care unit (ICU) admission, and had more vaginal delivery. Neonates from mother with mild symptoms also had significantly (p < 0.001) higher survival rate, higher birth weight, and higher APGAR score. Conclusion(s): Several laboratory and radiology components, as well as maternal and neonatal outcomes are related to the severity of COVID-19 in pregnant women in Indonesia.Copyright © The Author(s). 2023.
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The clinical evaluation of the patient with COVID-19 allows better care, application of safety criteria and preventive measures. The disease progresses from mild to severe and critical. In this work, is evaluated in patients with COVID-19 clinical format to identify moderate to severe stages of the disease. Following a cohort of male and female patients over 18 years of age admitted to the Infectology Service of the General Hospital of Mexico. Each patient is studied using the"COVID-19 Infectology"clinical format and in the first 24 hours of admission, a real-time RT-PCR molecular test is performed for SARS-CoV-2 infection. 65 patients classified as severe COVID-19 were studied, the RT-PCR was positive in 60 patients and negative in 5, clinical data did not differ from the positive ones and the 5 negative were considered false negative cases of the molecular test. There were no differences between positives and negatives with Fisher's test, and no difference in age, comorbidities, or prognostic evaluation with Student's t test. The conclusion is that the clinical format"COVID-19 Infectology"allows to recognize the cases and identify those that are in a severe evolution.Copyright /© 2021 Sociedad Medica del Hospital General de Mexico. Published by Permanyer.
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BACKGROUND: One-third of pregnant women will experience worsening asthma requiring emergency hospitalization. However, no report comprehensively discussed the management of asthma attacks in pregnant women in impoverished settings. We attempt to illuminate what general practitioners can do to stabilize and improve the outcome of severe acute asthma exacerbations in primary care with resource limitations. CASE REPORT: A nulliparous 29-year-old woman in her 21st week of pregnancy presented severe acute asthma exacerbation in moderate persistent asthma with uncontrolled asthma status along with gestational hypertension, uncompensated metabolic acidosis with a high anion gap, anemia, respiratory infection, and asymptomatic bacteriuria, all of which influenced her exacerbations. This patient was admitted to our resource-limited subdistrict hospital in Indonesia during the COVID-19 pandemic for optimal stabilization. Crystalloid infusions, oxygen supplementation, nebulized beta-agonist with anticholinergic agents, inhaled corticosteroids, intravenous methylprednisolone, broad-spectrum antibiotics, subcutaneous terbutaline, mucolytics, magnesium sulphate, oral antihypertensives, and continuous positive airway pressure were used to treat her life-threatening asthma. After she was stabilized, we referred the patient to a higher-level hospital with more advanced pulmonary management under the supervision of a multidisciplinary team to anticipate the worst scenario of pregnancy termination. CONCLUSION(S): Limitations in primary care, including the lack of sophisticated intensive care units and laboratory panels, may complicate challenges in managing severe acute asthma exacerbation during pregnancy. To enhance maternal-fetal outcomes, all multidisciplinary team members should be well-informed about key asthma management strategies during pregnancy using evidence-based guidelines regarding the drug, rationale, and safety profile.Copyright © 2023 Muhammad Habiburrahman, Triya Damayanti, Mohammad Adya Firmansha Dilmy, Hariyono Winarto.
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Introduction: Electrocardiographic (ECG) abnormalities in Coronavirus Disease 2019 (COVID-2019) patients are largely unknown. ECG changes in COVID-19 disease may guide to initiate therapeutic anticoagulation, more so in moderate and severe disease. Aims: To identify various ECG changes in moderate and severe COVID-19 patients and to ascertain the association between initial ECG changes and disease outcome. Materials and Methods: This was retrospective record-based study was conducted in the Department of Internal Medicine, Birsa Munda Medical College, Shahdol, Madhya Pradesh, India, on 216 patients with laboratory-confirmed COVID-19 in a tertiary care teaching hospital from March 2021 to June 2021. Demographic and clinical data including ECG were extracted from medical records of the patients and if needed, the patients were followed-up till outcome. COVID-19 disease severity was considered based on oxygen saturation at room air (moderate: 94%-90%;severe: <90%). Data were entered using the Epicollect5 mobile application to minimise errors. Results: A total of 216 patients were included (35 to 54 years), the majority were male. Mortality rate was 46.3%. Total 57.4% of ECG changes were classified as abnormal. Sinus tachycardia was the most common abnormality followed by ischaemic changes. Left axis deviation in ECG was more commonly seen than right axis deviation. Total 53.2% of patients with abnormal ECG findings and 36.9% with normal ECG findings died. Mortality was very high in patients with ischaemic changes. Conclusion: COVID-19 patients with ischaemic changes in ECG were significantly associated with increased mortality. Hence, early detection of these changes in COVID-19 patients is vital and will help primary care physicians to intervene early and help in deciding therapeutic anticoagulation requirements in patients with COVID-19. [ FROM AUTHOR] Copyright of Journal of Clinical & Diagnostic Research is the property of JCDR Research & Publications Private Limited and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
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Background: The purpose was to determine the frequency and duration of vital sign deviations in acutely admitted patients in general wards with confirmed COVID-19 infection using continuous wireless vital sign monitoring. Material(s) and Method(s): Patients were equipped with two wireless sensors live-transmitting respiratory rate (RR), heart rate (HR) and peripheral oxygen saturation (SpO2). Frequency and duration of vital sign deviations were compared with manual point measurements performed by clinical staff according to the national Early Warning Score (EWS), assuming linear relationship between EWS point measurements. Result(s): Continuous monitoring detected episodes of SpO2 < 92% for more than 60 consecutive min in 92% of patients versus 42% of patients detected by EWS (p < 0.0001). Events of desaturation with SpO2 < 88% for more than 10 min was registered in 87% with continuous monitoring versus 27% with EWS (p < 0.0001). Desaturation with SpO2 < 80% for more than 1 min was detected in 76% with continuous monitoring versus 6% with EWS (p < 0.0001). 70% of patients had episodes of tachypnea with RR >24 breaths per minute >5 min detected with continuous monitoring versus 36% assessed by EWS (p = 0.0001). Episodes of HR >111 for >60 min was recorded in 51% versus 24% (p = 0.0002). Conclusion(s): Moderate and severe episodes of desaturation, tachypnea, and tachycardia during hospital admission in patients with COVID-19 infection are common and most often not detected by routine manual measurements.
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Introduction: The Severe Acute Respiratory Syndrome Coronavirus-2 have been associated with cardiovascular adverse events including acute myocardial infarction due to a prothrombotic and hypercoagulable status, and endothelial dysfunction. Case report: We report the case of a 62-year-old women, admitted to the hospital via the emergency room for acute chest pain and dyspnea. A nasopharyngeal swab was positive for COVID19 real-time reverse transcriptase-polymerase chain reaction 11 day ago. On admission, she was hypotensive with systolic blood pressure measering 87 mmHg and tachycardic with 117 beats/min, oxygen saturation (SO2) was 94%. An 18-lead ECG revealed an infero-postero-lateral ST-elevation myocardial infarction with right ventricular involvement and a seconddegree- Mobitz Type 1 atrioventricular block. The coronary angiography from the right femoral artery showed acute thrombotic occlusion of the first diagonal branch with TIMI 0 flow and acute thrombotic occlusion of proximal right coronary artery with TIMI 0 flow. The most likely diagnosis was myocardial infarction secondary to a non-atherosclerotic coronary occlusion. The angioplasy was performed with dilatations with a semi compliant balloon, bailout implant of BMS, manual thrombus aspiration and intracoronary injection of tirofiban in the right coronary artery. The myocardial revascularization was ineffective. The patient developed significant severe hemodynamic instability and cardiac arrest for pulseless electric activity after 24 hours. Conclusion(s): The COVID-19 outbreak implies deep changes in the clinical profile and therapeutic management of STEMI patients who underwent PCI. At present, the natural history of coronary embolism is not well understood;however, the cardiac mortality rate are hight. This suggests these patients require further study to identify the natural history of the condition and to optimize management to improve outcome.
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Objectives: We aimed to demonstrate the difference between the premenopausal and postmenopausal women in respect of the clinical course and outcome of the Covid-19 disease. In addition, we investigated the epidemiological and hormonal factors which may have an influence on the progression, severity and mortality of the disease. Study design: A cross-sectional study. Main Outcome Measure(s): Our primary outcome was to demonstrate the poor clinical course and outcome of the Covid-19 disease in the postmenopausal women. Our secondary outcome was to establish the contribution of the hormonal status of the patients to the clinical course of the Covid-19 disease. Result(s): In our cohort, 86 women had mild, 128 women had moderate and 53 women had severe Covid-19 disease. 101 women were at premenopausal state while 152 women were at postmenopausal state. There was a statistically significant difference between the patients with mild, moderate and severe Covid-19 disease with respect to age, BMI, gravidity, parity, smoking, co-morbidities, being in pre-menopausal period, O2 saturation, diastolic blood pressure, parameters of complete blood count, biochemical tests, LH, FSH, E2, DHEA-S, length of hospital stay, body temperature, and the percentage of patients with dyspnea. In the total group, being one year younger decreased the odds of having severe Covid-19 disease 0.338 fold relative to the mild disease (CI: 0.164-0.697, p=0.003). Even though statistically less significant, younger age has a positive impact for the postmenopausal group (OR: 0.378, CI: 0.157-0.910, p=0.030). In the total group, the decrease in the serum DHEA-S level was associated with a 2.604 fold increase in the odds of having severe Covid-19 disease relative to the mild disease (CI:1.254-5.410, p=0.010). For the pre-menopausal group of patients, the decrease in serum DHEA-S level increased the odds of having severe disease by 3.864 fold (CI: 1.269-11.764, p=0.017). In the total group, 1 unit increase in the level of serum LH increased the odds of having mild disease compared to severe disease by 2.821 fold (CI:1.002-5.410, p=0.050). Conclusion(s): The prognosis of Covid-19 disease is more favorable in the premenopausal women with higher serum E2 levels compared to the postmenopausal women. The age and serum levels of DHEA-S and LH are important predictors of the severity of Covid-19 infection for women.Copyright © 2023
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Trauma-related hyoid fractures are rare entities. These fractures represent only 0.002% of head and neck region fractures. Victims of hanging and strangling constitute the great majority of cases. Fractures associated with trauma are extremely rare. These fractures are difficult to diagnose and can easily be overlooked during physical examination. However, they are also important traumas since airway safety is endangered in these rare cases. We describe a case of a young male presenting with isolated neck injury associated with hitting an electric cable while riding a motorbike. Tenderness was present in the anterior neck region at physical examination, but movement was not restricted and no respiratory difficulty was determined. Isolated hyoid fracture was detected at tomography of the neck performed in the emergency department. Hyoid bone fractures should not be forgotten in patients with pain and tenderness in the anterior neck region following blunt trauma to the neck.©Copyright 2020 by Emergency Physicians Association of Turkey - Available online at www.jemcr.com.
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Aim: While recent evidence describes atypical outcomes of coronavirus disease 2019 (COVID-19) in elderly patients, the frequency of delirium and associated outcomes in elderly patients with COVID-19 (coronavirus disease 2019) infection undergoing emergency surgery are not well defined. This study aims to determine the effect of COVID-19 on postoperative delirium and postoperative death in elderly patients undergoing emergency surgery. Material(s) and Method(s): This descriptive and cross-sectional study was conducted in general surgery, orthopedics, and cardiovascular surgery clinics of a public hospital, including 30 days of follow-up between April 1 and May 1, 2021. All patients who were admitted to these clinics for emergency surgery intervention on these dates constituted the study population, while a total of 140 patients aged >=65 years, who met the study criteria, formed the sample of the study. Descriptive Characteristics Form and Nursing Delirium Screening Scale (Nu-DESC) were used as data collection tools in the study. SPSS 25.0 statistical program was used for data analysis. Result(s): Thirty (42.85%) of the SARS-CoV-2 positive (n=70) patients developed delirium in the study. 12.9% (n=18) of the patients died within 30 days of follow-up after surgery. There were 30 (69.8) of 70 SARS-CoV-2 positive patients who developed delirium, and 12 patients (25.5) died after testing positive for COVID-19, with a mean of 8.08T1.56 days within 30 days of admission. Discussion(s): These findings may lead to a poor clinical prognosis for COVID-19 infection delirium and postoperative death in patients over 65 years of age undergoing emergency surgery.Copyright © 2023, Derman Medical Publishing. All rights reserved.
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Lung cancer is the most common cancer in males and the second most common among females both in Europe and worldwide. Moreover, lung cancer is the leading cause of death due to cancer in males. The European region accounts for 23% of total cancer cases and 20% of cancer-related deaths. Relationships have been described between a number of infectious agents and cancers, but our knowledge of the role of viruses, both respiratory and systemic, in the pathogenesis of lung cancer is still rudimentary and has been poorly disseminated. In this chapter, we review the available evidence on the involvement of HPV, Epstein-Barr virus, HIV, cytomegalovirus and measles virus in the epidemiology and pathogenesis of lung cancer.Copyright © ERS 2021.
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Backgrounds: The clinical and socioeconomic effects of COVID-19 are still being felt through-out the world. The disease affects people of all age groups, but it is known to have a milder clinical course in children including neonates. There is paucity of data from Sub-Saharan Africa on neonatal COVID-19 infection, and no such case has been reported in the literature in Ghana. Case presentation: This study presented a case report of a neonate who was found to be positive for COVID-19 infection after presenting symptoms such as respiratory distress, rhinorrhoea, and cough. This neonate was managed with in-hospital standard protocol for sepsis with a focus on pneumonia. Conclusion(s): The national guidelines on COVID-19 management were used for the neonate who was recovered and discharged.Copyright © 2021, TMU Press.