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Neurological symptomatology is a crucial component of neurological expertise. The committee for fostering board-certified neurologists in the Japanese Society of Neurology (JSN) has hosted an educational activity for residents before the board examination, "The seminar for fostering board-certified neurologists" since 2004. In particular, the autumn seminar has been characterized by small group hands-on of neurological examinations and the evaluations of higher brain function. Besides this, hands-on seminar of neurological examinations by regional branches has been promoted by the JSN. In the Kanto Ko-shin-etsu branch, "The first hands-on seminar of neurological examinations" started in 2023 after a 3-year-suspension due to COVID-19. The most important educational activities in neuromuscular electrodiagnosis (EDx) is the "Neuromuscular diagnostics seminar" hosted since 2004 by the Japanese Society of Clinical Neurophysiology (JSCN). The majority of tutors and participants are neurologists. This seminar is also characterized by small-group, hands-on workshops. We have also run the overseas seminar, "Tokyo Super EMG hands-on," since 2013. These have undoubtedly contributed to enhancing the level of neuromuscular electrodiagnosis not only in Japan but also in other Asian countries. I have conducted studies on neurological symptomatology and neuromuscular electrodiagnosis, which are directly linked to enhancing clinical practice of neurologists through educational activities such as review articles or lectures. Due to the fact that symptomatology is crucial in neurological expertise, neurology is a basic specialty around the world except in Japan. In 2018, the JSN decided to aim to make neurology a basic specialty and continues to make efforts to attain this goal.Copyright © 2023 Japanese Society of Neurology and John Wiley & Sons Australia, Ltd.
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Objectives: To estimate the public health impact of COVID-19 booster vaccination in the UK during Omicron predominance, and to explore the impact in counterfactual scenarios with different booster eligibility or uptake. Method(s): A dynamic transmission model was developed to compare public health outcomes for actual and hypothetical UK Spring and Autumn 2022 booster programs. Outcomes were projected over an extended time horizon from April 2022-April 2023, assuming continued Omicron predominance as in Jan-Mar 2022. Health outcomes included averted cases, hospitalizations, long COVID cases, and deaths. NHS resource use outcomes were averted general ward and intensive care unit bed days and general practitioner visits. Patient productivity loss outcomes considered productive days lost for those in and outside the paid work force. Analyses used publicly available data. Result(s): Model output suggested that actual Spring and Autumn 2022 programs, which offered boosters to older adults and vulnerable populations, would avert approximately 716,000 hospitalizations, 1.9M long COVID cases and 125,000 deaths compared to not offering boosters in Spring and Autumn 2022. In a scenario that broadened eligibility to individuals aged >=5 years, an estimated 1.6M hospitalizations, 8.3M long COVID cases, and 222,000 deaths were averted. A scenario assuming broadened eligibility and increased uptake produced the greatest benefit among scenarios analyzed: 1.6M hospitalizations, 9.2M long COVID cases, and 228,000 deaths averted;and 953M productive days saved. Scenarios offering boosters only to high-risk individuals (aged >=5 years) were also estimated to improve benefit relative to actual programs. High-risk-only programs assuming increased uptake provided about half to two-thirds of the benefit estimated for programs assuming broadened eligibility and increased uptake. Conclusion(s): UK booster vaccination programs were estimated to provide substantial benefit to public health during Omicron predominance. Public health benefits could be maximized by broadening booster eligibility to younger age groups and increasing uptake.Copyright © 2023
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Objectives: The United Kingdom (UK) implemented an autumn 2022 booster programme that allowed those at higher risk from COVID-19, including those >= 50 years, to receive a booster to increase protection against infection and subsequent severe outcomes. As the UK transitions out of the pandemic, future booster campaigns may be required to maintain protection against such outcomes. The objective of this analysis was to estimate the value-based price (VBP) for a bivalent COVID-19 vaccine used in a future autumn 2023 campaign in the UK to protect people aged >= 50 years. Method(s): A Susceptible-Exposed-Infected-Recovered (SEIR) model was used to predict infections across a 1-year time horizon starting September 2023 with and without an autumn booster campaign. Initial effectiveness was predicted to be 89% and 97% against infection and hospitalization respectively based on BA.4/BA.5 antibody titers and correlates of protection. A monthly decline in protection of 1.4% and 4.8%, respectively, was assumed based on monovalent vaccine data. A decision tree was used to predict the quality-adjusted life-years (QALY) lost and costs associated with infections. Result(s): Considering a willingness-to-pay (WTP) threshold of 20,000/QALY, the VBP associated with an autumn 2023 booster campaign is 343/dose. Considering a WTP threshold of 30,000, the VBP increases to 476. In sensitivity analyses, excluding the post-infection costs (e.g., long COVID), reduces the VBP by 11%. Varying the hospitalization rates by +/-25% changes the VBP by +/- 6%. Varying hospitalization unit costs only impacts the VBP by 1%. Doubling the rate of waning for booster effectiveness increases the VBP by 54% because the effectiveness provided from past campaigns falls faster and an autumn 2023 booster becomes more valuable. Conclusion(s): While the trajectory of COVID-19 incidence is highly uncertain, pricing the bivalent booster lower than the VBP is expected to result in a cost-effective strategy for the UK.Copyright © 2023
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The additional impact of emission-reduction measures in North China (NC) during autumn and winter on the air quality of downwind regions is an interesting but less addressed topic. The mass concentrations of routine air pollutants, the chemical compositions, and sources of fine particles (PM2.5) for January 2018, 2019, and 2020 at a megacity of Central China were identified, and meteorology-isolated by a machine-learning technique. Their variations were classified according to air mass direction. An unexpectedly sharp increase in emission-related PM2.5 by 22.7% (18.0 mug m-3) and 25.7% (19.4 mug m-3) for air masses from local and NC in 2019 was observed compared to those of 2018. Organic materials exhibited the highest increase in PM2.5 compositions by 6.90 mug m-3 and 6.23 mug m-3 for the air masses from local and NC. PM2.5 source contributions related to emission showed an upsurge from 1.39 mug m-3 (biomass burning) to 24.9 mug m-3 (secondary inorganic aerosol) in 2019 except for industrial processes, while all reduced in 2020. From 2018 to 2020, the emission-related contribution of coal combustion to PM2.5 increased from 10.0% to 19.0% for air masses from the local area. To support the priority natural gas quotas in northern China, additional coal in cities of southern China was consumed, raising related emissions from transportation activities and road dust in urban regions, as well as additional biofuel consumption in suburban or rural regions. All these activities could explain the increased primary PM2.5 and related precursor NO2. This study gave substantial evidence of air pollution control measures impacting the downwind regions and promote the necessity of air pollution joint control across the administration.Copyright © 2023 Elsevier Ltd
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Background: The coronavirus disease 2019 (COVID-19) pandemic has had an immense impact on psychic health. Children and adolescents are considered especially vulnerable which is why health promotion and prevention programs are important and should be designed in a motivating way to be attractive to this age group. The aim of this work is to investigate whether young people can be reached with the help of innovative digital formats for health promotion. Methods: An app-based training to promote self-regulation was offered to adolescents in lower secondary education in autumn 2020. Data were collected using an app. The types of motivation to participate in the training were analyzed. In addition, the students were able to rate the attractiveness of the training with the help of a self-designed evaluation sheet. Results: Of the 91 registered participants, 39.56% completed the study. In all, 40.91% of the students stated that the training was "very" helpful and 36.36% rated it as "quite" helpful. Although 50% of the respondents found the app-based training "modern and motivating", the other half would have preferred more personal support. Conclusion: The results confirm previous study results with health apps in children and adolescents. This age group is interested in digital formats, but health apps are not used continuously in this age group unless obligatory.
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Aim of the study was to evaluate the impact of anti-epidemic measures (CAM) complex on the dynamics of the epidemic process of COVID-19 in a controlled cohort of patients. Material and methods. Patients from 30 social long-term care institutions of the city were included in the study, including neuropsychiatric boarding schools, boarding houses for labor veterans, gerontological centers, and houses for stage veterans. A total of 8303 patients participated in the study, of which 4237 were men (mean age 53.6 years) and 4066 were women (mean age 62.0 years). Vaccination was carried out with Gam-Covid-Vac. Results and discussion. For the entire observation period from March 2020 to August 2021, 1619, cases of COVID-19 or 19.5% of the total number of patients were registered among patients. At the initial epidemic stage (spring-summer 2020), the incidence of COVID-19 among patients was explosive. At the same time, in the autumn-winter period of 2020, an increase in the incidence of COVID-19 was also observed. However, much less pronounced than in April 2020. Despite the progress, it was decided to strengthen the sanitary and anti-epidemic regime in institutions with the introduction of additional preventive measures. One of the most effective long-term algorithms for reducing the infectious disease incidence was vaccination. In this regard, the Moscow Department of Healthcare suggested the need for voluntary vaccination of 100% of patients in all institutions at the beginning of 2021. In the spring of 2021, the number of cases began to increase in the city. The increase in the incidence of COVID-19 was insignificant among the patients of institutions: the maximum number of cases detected in one month during this period was 13 people (in April), or 60.5 times less than in April 2020, and 2.5 times less than in October 2020. The incidence of COVID-19 has become sporadic rather than epidemic. Conclusion. The introduction of CAM in long-term care social institutions in the early stages of the epidemic contributed to a decrease in the incidence of COVID 19. 100% vaccination of patients in combination with other prevention measures reduced the incidence of COVID-19 by more than 28 times. At the same time, it was found that there is a trend of increasing incidence depending on the increase in the level of independent activity of patients.Copyright © 2023 The authors.
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A prerequisite for effective vaccination is the formation of proper collective immunity in society. The attitudes of healthcare professionals towards vaccination directly impact the population's adherence to this method. Objective. To study the attitude of healthcare professionals toward COVID-19 vaccination. Material and methods. The sociological survey method with the author's questionnaire based on GoogleForm was used. In the sur-vey, 450 physicians aged 25 to 70 participated voluntarily. It was a cross-sectional study carried out in the autumn of 2021. Results. Of those surveyed, the majority (86.8%) of physicians and almost all (96.1%) nurses were vaccinated against COVID-19. When studying the motivation for vaccine prophylaxis, a direct average strength of a statistically significant correlation between the adherence to COVID-19 vaccination and the emergence of a sense of safety was established (rxy =0.346;p<0.05). The most common reasons for the refusal of doctors from vaccination were the fear of complications, beliefs about low protection against infection and the subsequent decrease in immunity. According to healthcare professionals, the most effective means of prevention, in descending order, were a healthy lifestyle, the absence of fear of becoming ill, vaccination, drugs that stimulate immunity, the use of barrier measures, and other means. Conclusion. The ambiguous attitude of healthcare professionals towards vaccination against COVID-19 does exist and deserves the closest attention. Considering the issue's complexity, further research on the attitude of healthcare professionals toward vaccination is required.Copyright © 2023, Media Sphera Publishing Group. All rights reserved.
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Background/Aims We report the features of chronic chilblain-like digital lesions newly presenting since the start of the covid-19 pandemic. Comparison with primary perniosis and acrocyanosis, reveals a unique phenotype which appears to be a long-covid phenomenon. Methods The case records of 26 patients with new onset persistent chilblain-like lesions presenting to the Rheumatology service of St George's University Hospital, London between Autumn 2020 and Spring 2022 were reviewed. Demographic and clinical features, serology, imaging, treatment response and outcome up to Summer 2022 were collated retrospectively. Results Chilblain-like lesions first occurred between September and March;2019/ 2020 6 cases, 2020/2021 18 cases and 2021/2022 2 cases. Mean age 35.4 (17-60) years, 88% female, 85% white, all non-smokers. Median body mass index (BMI) 20.2, range 17.0 - 33.2. BMI underweight (<18.5) in 27%. All cases reported new red-purple-blue colour changes of the fingers, some with pain, swelling and pruritis, affecting both hands in 12, one hand in 6, and both hands and feet in 8 cases. There was a past history of cold sensitivity or primary Raynaud's in 54%. Covid was confirmed in 3 cases, 2 - 8 months prior to onset of chilblain-like symptoms. Possible covid, unconfirmed, was suspected in 5 cases, 1 - 11 months earlier. Affected digits appeared diffusely erythro-cyanotic in 81%, with blotchy discrete maculo-papular erythematous lesions in 42%, some with both features. Involvement was asymmetric in 54%, thumbs spared in 69%. Complement was low in 50% (8/16), ANA positive in 26% (6/23). MRI of hands showed phalangeal bone marrow oedema in keeping with osteitis in 4 of 7 cases. More severe signs and symptoms were associated with low BMI, low C3/4 and a past history of cold sensitivity or Raynauds. Cold avoidance strategies were sufficient for 58%. Pain prompted a trial of NSAIDs, aspirin, nitrates, calcium channel blockers, hydroxychloroquine, oral or topical corticosteroid or topical tacrolimus in 42%. In general, these were minimally effective or not tolerated. 4 severe cases received sildenafil or tadalafil, effective in 2. In 27% complete remission occurred during the first summer season after symptoms commenced, median duration 6 (range 2 - 10) months. In the remaining 19 cases, chilblain-like symptoms returned or worsened in the subsequent second winter period, with 6 of 19 entering remission the following summer. For the remaining 13 persistent cases the total duration of symptoms spans more than a year, and in four cases more than 2 years. Conclusion This series illustrates a distinct chronic chilblain-like condition. Features similar to primary perniosis include female predominance, middle age, pruritic painful blotchy lesions, asymmetry and low BMI. Features in keeping with acrocyanosis include chronicity, extensive diffuse erythro-cyanotic discoloration, relative improvement in warm weather and lack of association with smoking.
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Enteroviruses, beyond poliovirus, are important pathogens. Several non-polio enteroviruses (NPEVs) are causing epidemics all around the world. Limited data is available on the prevalence and diversity of these viruses from India. Objective(s): Detection and characterization of NPEVs in respiratory samples during the COVID-19 pandemic period. Material(s) and Method(s): COVID-19 negative samples from acute respiratory infections (ARI) [n = 105] and severe-acute respiratory infections (SARI) [n = 148] during the period 2021-22 were screened for NPEVs. Detection was carried out using the one step RT-PCR method targeting the 5'UTR region followed by molecular analysis. Results and Conclusion(s): Total positivity of NPEVs was noted in 35.23% and 31.08% of the ARI and SARI cases, respectively. Comparison within the two groups studied, showed significant difference in the age-wise distribution for cases>18 years of age. Year round seasonality for ARI cases while autumn seasonality for SARI cases was observed. Sequencing of representative samples of ARI cases showed prevalence of Rhinovirus A (RVA), Rhinovirus B (RVB), Rhinovirus C (RVC) and Echovirus, while predominance of RVC followed by RVA was observed for the SARI cases. Phylogenetic analysis of all the strains showed clustering of RVC strains in different clusters. Divergence was also noted in RVA and RVB strains studied. Circulation of a rare Echovirus-29 strain was noted in the ARI cases. The study highlighted significant divergence in the Rhinovirus strains studied. It warrants the need for surveillance of NPEVs, whole-genome sequencing of the circulating strains for better understanding of biodiversity among the NPEVs and the potential health burden.
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Objective: The coronavirus disease (COVID-19) is a problem for the health care systems of many countries around the world. Seasonal nature of influenza and other the respiratory viral diseases is commonly known. The nature of the relationship between the frequency of registration of cases of COVID-19 and natural factors is still being studied by researchers. The purpose is to determine the influence of air temperature, relative humidity, wind speed, and atmospheric pressure on the incidence of the coronavirus disease COVID-19 in the conditions of Ukraine. Materials and methods. Official reports of the Ministry of Health of Ukraine and data from daily monitoring of meteorological indicators conducted by the Sumy Regional Hydrometeorology Center were used in the paper. Descriptive and analytical ways of epidemiological method of investigation were applied. The search for parameters of interrelation between the frequency of registration of COVID-19 cases and meteorological cases took place using of program "Statistica", namely the relevant tools of this program: "Analysis"/ "Multiple regression". Results and Discussion: In the period under study from March 25, 2020 to December 31, 2021 in Sumy Oblast of Ukraine, three waves of rise in the incidence were registered. In the third wave of rise in the incidence, in autumn 2021 the frequency of registration of COVID-19 cases reached 1684.9 per 100 thousand of people, despite the fact that almost 70 % of the population had already recovered or were vaccinated. Meteorological factors in the conditions of Ukraine have little influence on the rate of spread of COVID-19. The value of multiple correlation coefficients was within those limits, which are considered moderate in terms of influence. A moderate inverse correlation was established between the frequency of registration of COVID-19 cases and indicators of air temperature, and a direct correlations-with indicators of relative air humidity. Conclusion(s): In the conditions of Ukraine, the studied meteorological factors (air temperature, relative humidity, wind speed, atmospheric pressure) indirectly influenced the intensity of the epidemic process of COVID-19. the strength of this influence was either weak or moderate.Copyright © 2023, Ibn Sina Trust. All rights reserved.
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Aim of the study was to evaluate the impact of anti-epidemic measures (CAM) complex on the dynamics of the epidemic process of COVID-19 in a controlled cohort of patients. Material and methods. Patients from 30 social long-term care institutions of the city were included in the study, including neuropsychiatric boarding schools, boarding houses for labor veterans, gerontological centers, and houses for stage veterans. A total of 8303 patients participated in the study, of which 4237 were men (mean age 53.6 years) and 4066 were women (mean age 62.0 years). Vaccination was carried out with Gam-Covid-Vac. Results and discussion. For the entire observation period from March 2020 to August 2021, 1619, cases of COVID-19 or 19.5% of the total number of patients were registered among patients. At the initial epidemic stage (spring-summer 2020), the incidence of COVID-19 among patients was explosive. At the same time, in the autumn-winter period of 2020, an increase in the incidence of COVID-19 was also observed. However, much less pronounced than in April 2020. Despite the progress, it was decided to strengthen the sanitary and anti-epidemic regime in institutions with the introduction of additional preventive measures. One of the most effective long-term algorithms for reducing the infectious disease incidence was vaccination. In this regard, the Moscow Department of Healthcare suggested the need for voluntary vaccination of 100% of patients in all institutions at the beginning of 2021. In the spring of 2021, the number of cases began to increase in the city. The increase in the incidence of COVID-19 was insignificant among the patients of institutions: the maximum number of cases detected in one month during this period was 13 people (in April), or 60.5 times less than in April 2020, and 2.5 times less than in October 2020. The incidence of COVID-19 has become sporadic rather than epidemic. Conclusion. The introduction of CAM in long-term care social institutions in the early stages of the epidemic contributed to a decrease in the incidence of COVID 19. 100% vaccination of patients in combination with other prevention measures reduced the incidence of COVID-19 by more than 28 times. At the same time, it was found that there is a trend of increasing incidence depending on the increase in the level of independent activity of patients.Copyright © 2023 The authors.
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A prerequisite for effective vaccination is the formation of proper collective immunity in society. The attitudes of healthcare professionals towards vaccination directly impact the population's adherence to this method. Objective. To study the attitude of healthcare professionals toward COVID-19 vaccination. Material and methods. The sociological survey method with the author's questionnaire based on GoogleForm was used. In the sur-vey, 450 physicians aged 25 to 70 participated voluntarily. It was a cross-sectional study carried out in the autumn of 2021. Results. Of those surveyed, the majority (86.8%) of physicians and almost all (96.1%) nurses were vaccinated against COVID-19. When studying the motivation for vaccine prophylaxis, a direct average strength of a statistically significant correlation between the adherence to COVID-19 vaccination and the emergence of a sense of safety was established (rxy =0.346;p<0.05). The most common reasons for the refusal of doctors from vaccination were the fear of complications, beliefs about low protection against infection and the subsequent decrease in immunity. According to healthcare professionals, the most effective means of prevention, in descending order, were a healthy lifestyle, the absence of fear of becoming ill, vaccination, drugs that stimulate immunity, the use of barrier measures, and other means. Conclusion. The ambiguous attitude of healthcare professionals towards vaccination against COVID-19 does exist and deserves the closest attention. Considering the issue's complexity, further research on the attitude of healthcare professionals toward vaccination is required.Copyright © 2023, Media Sphera Publishing Group. All rights reserved.
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Background: According to the international recommendations, patients with inflammatory bowel disease (IBD) should be vaccinated against SARS-CoV-2 at the earliest opportunity to do so. The aim of this study was to assess the morbidity and mortality from COVID-19 in the adult IBD population in Poland with respect to their vaccin-ation status. Method(s): We conducted a retrospective analysis of administrative health claims collected by the National Health Fund, the sole public payer in Poland. We identified adult IBD patients as of December 31th, 2021 who had at least two or more records with K50 or K51 code and two or more prescriptions for IBD drugs reimbursed or else in-testinal surgery preceding the record. The vaccination status in 2021 was assessed using the database maintained by the Ministry of Health. We examined the vaccination process against SARS-CoV-2 among IBD patients along with morbidity and mortality from COVID-19. We conducted a Cox proportional hazard model analysis to determine the hazard ratio of SARS-CoV-2 infection, hospitalization and death in re-spect to the vaccination status during the autumn wave of the COVID-19 pandemic (October-December 2021). Result(s): As of December 31th, 2021 there were 93 068 adult patients diagnosed with IBD. The vaccination rate in IBD patients was significantly higher than in the general population of Poland (72.1% vs those aged 70-79 years (88.2%) [Figure 1]. 87 353 IBD patients were included into the Cox proportional hazard analysis of autumn pan-demic wave, during which there were 4 042 registered COVID-19 cases in IBD population. The peak value of a weekly average of incidence than for unvaccinated ones (13.0/10000). The risk of being infected 0.5-0.57;p<0.001). The cumulative risk of being positively tested for COVID-19 shows Figure 2. The most notable protective effect of vac-cination against SARS-CoV-2 was found in patients aged 60-69 years (HR 0.47;95%CI 0.39-0.55) and in those aged 80 years and above (HR 0.44;95%CI 0.32-0.63). The risk of hospitalization due to COVID-19 was also significantly lower among the vaccinated IBD patients (HR 19 was more than 3 times decreased in vaccinated IBD patients in com-parison to the remaining IBD population (HR 0.29, 95%CI 0.17-0.43, p<0.001) [Table 1]. Conclusion(s): Adult patients with IBD were more likely to get vaccinated against SARS-COV-2 than adults in the general population of Poland. The vaccination significantly decreased the risk of the infection, hospitalization and death due to COVID-19.
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Objectives: This study aimed to describe the pathogen spectrum of bacteria and viruses of RTIs in hospitalized children during the Coronavirus disease 2019 (COVID-19) epidemic in Shenzhen. Method(s): From October 2020 to October 2021, the results of pathogenic tests causing RTIs were retrospectively analyzed in hospitalized children in Shenzhen Luohu Hospital Group. Result(s): 829 sputum samples for bacterial isolation and 1,037 nasopharyngeal swabs for virus detection in total. The positive detection rate (PDR) of bacteria was 42.1%. Staphylococcus aureus (18.8%) was the predominant bacteria detected in positive cases, with Moraxella catarrhalis (10.9%), Streptococcus pneumoniae (9.5%) following. The PDR of the virus was 65.6%. The viruses ranking first to third were Human Rhinovirus (HRV), Respiratory syncytial virus (RSV), and Human Parainfluenza (HPIV), with rates of 28.0, 18.1, and 13.5%, respectively. Children under 3 years were the most susceptible population to RTIs. The pathogens of S. aureus, M. catarrhalis, S. pneumoniae, HRV, and HPIV were more prevalent in autumn. Meanwhile, RSV had a high rate of infection in summer and autumn. S. aureus and HRV had higher co-infection rates. Conclusion(s): Our findings demonstrate the pathogen spectrum of 1,046 hospitalized children with RTIs in Shenzhen, China, during the COVID-19 outbreak.Copyright © 2022 the author(s), published by De Gruyter, Berlin/Boston.
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Introduction: Due to the high risk of Covid-19 disease, especially delta variant in pregnant women, as well as the novelty of this epidemic in the world and the lack of similar studies in Iran and the region, it seems necessary to perform a study on mortality rate and laboratory and clinical findings of the disease in pregnant women. Therefore, this study was performed aimed to determine the laboratory and clinical findings in hospitalized pregnant women with Covid -19 based on disease outcome during the outbreak of Delta variant (summer and autumn 2021) in Ardabil province. Method(s): In this cross-sectional and descriptive study, all pregnant women with Covid-19 admitted to the hospitals of Ardabil province in summer and autumn 2021 at the time of delta outbreak were included. Finally, 187 infected pregnant mothers were studied. Demographic information, clinical signs and laboratory findings were studied in all mothers. Data were analyzed by SPSS (version 24) and Fisher Exact test and Pearson Correlation. P<0.05 was considered statistically significant. Result(s): Of the 187 infected pregnant women, 8 mothers died. Comorbidity was observed in 41 pregnant women. The most common clinical finding was shortness of breath (Dyspnea) and cough, and the most common laboratory finding was lymphopenia. Comparing the cured and dead mothers according to laboratory findings using Fisher's exact test showed that the difference between ALT (p <0.05), lactate dehydrogenase (p <0.001), AST (p <0.001), BS (P <0.05), creatinine (p <0.05) and total bilirubin (p<0.05) were statistically significant between the two groups. Conclusion(s): Infection to delta variant of Covid-19 disease resulted in 187 hospitalizations and 8 deaths of pregnant mothers in Ardabil province. Shortness of breath (Dyspnea) and cough were the most common clinical findings and lymphopenia was the most common laboratory finding.Copyright © 2022, Mashhad University of Medical Sciences. All rights reserved.
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Introduction: Due to the high risk of Covid-19 disease, especially delta variant in pregnant women, as well as the novelty of this epidemic in the world and the lack of similar studies in Iran and the region, it seems necessary to perform a study on mortality rate and laboratory and clinical findings of the disease in pregnant women. Therefore, this study was performed aimed to determine the laboratory and clinical findings in hospitalized pregnant women with Covid -19 based on disease outcome during the outbreak of Delta variant (summer and autumn 2021) in Ardabil province. Method(s): In this cross-sectional and descriptive study, all pregnant women with Covid-19 admitted to the hospitals of Ardabil province in summer and autumn 2021 at the time of delta outbreak were included. Finally, 187 infected pregnant mothers were studied. Demographic information, clinical signs and laboratory findings were studied in all mothers. Data were analyzed by SPSS (version 24) and Fisher Exact test and Pearson Correlation. P<0.05 was considered statistically significant. Result(s): Of the 187 infected pregnant women, 8 mothers died. Comorbidity was observed in 41 pregnant women. The most common clinical finding was shortness of breath (Dyspnea) and cough, and the most common laboratory finding was lymphopenia. Comparing the cured and dead mothers according to laboratory findings using Fisher's exact test showed that the difference between ALT (p <0.05), lactate dehydrogenase (p <0.001), AST (p <0.001), BS (P <0.05), creatinine (p <0.05) and total bilirubin (p<0.05) were statistically significant between the two groups. Conclusion(s): Infection to delta variant of Covid-19 disease resulted in 187 hospitalizations and 8 deaths of pregnant mothers in Ardabil province. Shortness of breath (Dyspnea) and cough were the most common clinical findings and lymphopenia was the most common laboratory finding.Copyright © 2022, Mashhad University of Medical Sciences. All rights reserved.
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Introduction: Due to the high risk of Covid-19 disease, especially delta variant in pregnant women, as well as the novelty of this epidemic in the world and the lack of similar studies in Iran and the region, it seems necessary to perform a study on mortality rate and laboratory and clinical findings of the disease in pregnant women. Therefore, this study was performed aimed to determine the laboratory and clinical findings in hospitalized pregnant women with Covid -19 based on disease outcome during the outbreak of Delta variant (summer and autumn 2021) in Ardabil province. Methods: In this cross-sectional and descriptive study, all pregnant women with Covid-19 admitted to the hospitals of Ardabil province in summer and autumn 2021 at the time of delta outbreak were included. Finally, 187 infected pregnant mothers were studied. Demographic information, clinical signs and laboratory findings were studied in all mothers. Data were analyzed by SPSS (version 24) and Fisher Exact test and Pearson Correlation. P<0.05 was considered statistically significant. Results: Of the 187 infected pregnant women, 8 mothers died. Comorbidity was observed in 41 pregnant women. The most common clinical finding was shortness of breath (Dyspnea) and cough, and the most common laboratory finding was lymphopenia. Comparing the cured and dead mothers according to laboratory findings using Fisher's exact test showed that the difference between ALT (p <0.05), lactate dehydrogenase (p <0.001), AST (p <0.001), BS (P <0.05), creatinine (p <0.05) and total bilirubin (p <0.05) were statistically significant between the two groups. Conclusion: Infection to delta variant of Covid-19 disease resulted in 187 hospitalizations and 8 deaths of pregnant mothers in Ardabil province. Shortness of breath (Dyspnea) and cough were the most common clinical findings and lymphopenia was the most common laboratory finding.
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Objective: To describe the burden of COVID-19 in a children's multidisciplinary hospital for two years of the pandemic, taking into account of age, severity of the disease, the spectrum of underlying conditions and the intensive care need. Method(s): An assessment of 6048 cases of COVID-19 in patients under 18 years of age hospitalized from March 26, 2020 to December 31, 2021 was carried out. The diagnosis was confirmed by PCR on an outpatient basis or after hospitalization with the help of diagnostic kits registered in the Russian Federation. The features of the work of a children's multidisciplinary hospital in new conditions, the dynamics of hospitalization, age characteristics and new coronavirus (CV) infection severity in the pandemic development process are presented. The analysis of the underlying condition's structure depending on the severity of the disease, as well as the need and volume of therapy in the intensive care unit. The frequency and main characteristics of children's multisystem inflammatory syndrome (MIS-C) in hospital conditions, long-term PCR positivity and its effect on the duration of inpatient treatment of children have been established. Result(s): The spread of SARS-COV-2 in St. Petersburg required a radical change in the work of the children's multidisciplinary hospital. During the two years of the pandemic, four waves of hospitalization of children with new CV were revealed, differing in duration, intensity, and frequency of lung damage, but having no significant differences in the proportion of severe forms of the disease (1.7-2.8% of cases). Intensive therapy was required in 3.6% of cases, of which only 1/3 was due to the severe course of COVID-19 with a lung lesion volume of up to 100%. In 1/3 of cases, patients had risks of developing severe forms and in 1/3 - other pathology. Severe course of new CV was significantly more often accompanied by the need for respiratory support, anticoagulants and anti-inflammatory therapy. Contributing factors of severe forms and unfavorable outcomes were: pathology of the central nervous system, genetic diseases and malformations, obesity, as well as chronic bronchopulmonary pathology. Mortality in the hospital was recorded only among children with severe underlying conditions (0.1% of cases). D-MVS was registered significantly more often in boys (7 out of every 10 patients), accounting for 1.2% of cases of hospitalization of children with new CV over the entire period. Convalescent PCR-positivity in the outcome of COVID-19 was detected in 1/3 of children, significantly more often during the autumn-winter waves of the pandemic and among patients of high school age. Conclusion(s): New CV is gradually strengthening its position in the structure of acute respiratory pathology in children. Some of SARS-COV-2 infection cases is accompanied by extensive lung damage, as well as severe systemic inflammation independently or in the other infectious diseases structure, induction of the debut of various somatic pathology is not excluded. The presented data confirm the need for increased attention at high risk of adverse respiratory diseases outcomes children. All severe cases of COVID-19 in children require a personalized approach, taking into account the existing background diseases and possible options for the progression of the process. MIS-C should be considered as a systemic inflammatory response syndrome within the framework of an infectious disease of various etiologies, differentiated with Kawasaki disease and the debut of systemic diseases. The long-term PCR-positivity in the outcome of COVID-19 requires further study to address the need and nature of therapy in order to prevent further spread of infection in the population.Copyright © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.
ABSTRACT
An 11-year-old boy presented to the children's Emergency Department in Autumn 2020 with acute blistering of his palms. No other parts of the body or mucosal surfaces were involved. He was systemically well, with no significant past medical history except for eczema in early childhood. He had recently started back at school and was using hand gel regularly as part of precautions to reduce SARS-CoV-2 (COVID-19) transmission during the pandemic. There had been no other contact with chemicals, plants, crafting materials, glues, paints or homemade slime. Clinical photographs showed swelling and large bullae on the thenar eminence and lateral fingers. There was no erythema, nail involvement or significant scaling. The clinical diagnosis was acute pompholyx that was either irritant or allergic in origin. Testing to the standard series showed inconclusive results to some fragrances in the standard series. The patch testing to fragrance in the standard series was repeated and the fragrance series was added. The repeat test confirmed allergic contact dermatitis to fragrance with a positive to Myroxylon pereirae, linalool, limonene, sandalwood oil and majantol. The hand gels were found to contain linalool and limonene. To curb the spread of COVID-19, regular handwashing and the use of alcohol-based hand sanitizers/gels are part of everyday hygiene guidance for the general public. Therefore, the incidence of hand dermatitis is likely to rise. The World Health Organization and the Food and Drugs Administration advise that a minimum alcohol content of 60% is required to inactivate viral particles;however, it is also important to be aware that hand sanitizers/gels may also contain other constituents, including thickeners, humectants (e.g. propylene glycol) and fragrance. Research into the ingredients of 10 widely used hand sanitizers recently investigated by an independent watchdog for their alcohol content found that six had their ingredients listed online and five contained fragrance. The patient responded to topical treatment with a superpotent topical steroid cream (Dermovate) twice daily, white soft paraffin 50 : 50, an antiseptic emollient (Dermol 500) to wash the hands and allergen avoidance. We highlight to other dermatologists that contact allergy to fragrance or other components in hand sanitizer/gels may present acutely with pompholyx and to consider testing to the standard and fragrance series if this is suspected.
ABSTRACT
To analyze the epidemiological characteristics and related factors of norovirus in Guangxi from 2015 to 2020, and to provide scientific recommendations for norovirus prevention and control. Methods The foodborne diseases surveillance data were collected from 11 sentinel hospitals through the National Foodborne Disease Monitoring and Reporting System from 2015 to 2020. R software with version 4.0.3 was used for descriptive and statistical analysis, including epidemic curve, chi-square test, and trend chi-square and so on. Logistic regression was used to analyze norovirus-related factors, OR values and 95% confidence intervals were calculated respectively with the statistical test level of P < 0.05. Results There were 1 008 norovirus cases detected, with a detection rate of 12.75% (1 008/7 903). Children with age less than 5 years (OR=1.43, 95%CI: 1.13-1.82) and patients at age 20-45 (OR=1.45, 95%CI: 1.13-1.87) were high risk population. The detection rate was higher in autumn (OR=1.29, 95%CI: 1.08-1.53) but lower in summer (OR=0.67, 95%CI: 0.55-0.80). In addition, the tourist area (Guilin City) presented a higher detection rate than other areas (OR=1.41, 95%CI: 1.10-1.80). Aquatic products (OR=1.40, 95%CI: 1.03-1.91), meat and dairy products (OR=1.31, 95%CI: 1.06-1.61) were high-risk foods for norovirus infection. The prevention and control policies of COVID-19 can reduce the possibility of norovirus by 61% (OR=0.39, 95%CI: 0.31-0.49) showed a declining trend (Trend X2=85.33, P < 0.001). In addition, prolonged visit time can lead to 19%-23% decrease in the detection rate of norovirus (OR24-48 hours=0.81, 95%CI: 0.70-0.95;OR>48 hours=0.77, 95%CI: 0.63-0.93). Conclusions The epidemic of norovirus presented seasonal and regional distribution in Guangxi with a declining detection rate trend in diarrhea patients during recent 6 years. Young children were high-risk population in infection norovirus. The intake of seafood can increase the risk of norovirus infection. The prevention and control policies of COVID-19 can sharply decrease the possibility of infection norovirus. The monitoring of key foods such as seafood should be strengthened, and the early screening of suspected cases should be taken. The norovirus monitoring should be improved to ensure the health of the population.