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The epidemic of coronavirus disease 2019 (COVID-19) has seriously affected people's normal work, life, and medical treatment. Since Mar. 2022, there has been a pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) omicron variant in Shanghai. In order to meet the needs of hospitalization for patients, and at the same time for better control of epidemic and nosocomial infections, a large hospital in Shanghai innovatively set up a centralized transition ward in the hospital, and established scientific rules of medical work, regulations for prevention of nosocomial infections and efficient norms for patient admission. During the operation of the ward, a total of 211 patients were treated and one of the patients was confirmed of COVID-19 recurrence. All work was carried out methodically, and neither hospitalized patients nor medical staff had nosocomial infection of COVID-19. The preparation, operation and management of the central transition ward in our hospital are summarized here to provide guidance and reference for general hospitals to carry out similar work under the epidemic.Copyright © 2022, Second Military Medical University Press. All rights reserved.
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Objective To summarize and analyze the features of liver function in pediatric patients infected with Delta variant versus Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS - CoV - 2). Methods In this study,an analysis was performed for the liver function test results of the locally transmitted or imported pediatric patients with SARS - CoV - 2 infection during isolation who were admitted to Guangzhou Eighth People's Hospital,Guangzhou Medical University,since May 21,2021,and the clinical data and the constituent ratio of liver injury were compared between the pediatric patients infected with Delta variant and those infected with Omicron variant. The independent samples t - test or the Mann - Whitney U test was used for comparison of continuous data between two groups,and the chi - square test or the Fisher's exact test was used for comparison of categorical data between two groups. Results A total of 85 pediatric patients infected with SARS - CoV - 2 were enrolled,among whom there were 32 (37. 6%)pediatric patients infected with Delta variant and 53 (62. 4%)pediatric patients infected with Omicron variant,and there were no significant differences between the two groups in age,sex, body height,body weight,and comorbidities (all P > 0. 05). There were no significant differences between the two groups in alanine aminotransferase (ALT),aspartate aminotransferase (AST),alkaline phosphatase (ALP),gamma - glutamyl transpeptidase,total bilirubin,albumin,and cholinesterase (all P > 0. 05),and the pediatric patients infected with Omicron variant had a significantly higher level of total bile acid (TBA)than those infected with Delta variant (Z = - 2. 336,P = 0. 020). However,the median values of TBA were within the normal range and the ratios of abnormal TBA were no significant difference between the two groups (P > 0. 05). Among the 85 pediatric patients,10 (11. 8%)had a mild increase in liver function parameters,among whom 7 had an increase in TBA,1 had an increase in ALT, 1 had increases in ALT and AST,and 1 had an increase in ALP. The analysis of liver injury in the pediatric patients infected with Delta variant or Omicron variant showed that there was no significant difference in the constituent ratio of liver injury caused by the two variants (6. 3% vs 15. 1%,chi2 = 0. 691,P = 0. 406). Conclusion Mild liver injury is observed in pediatric patients infected with Delta and Omicron variants of SARS - CoV - 2,but further studies are needed to evaluate the long - term influence of such infection on liver function.Copyright © 2022 Editorial Board of Jilin University
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Introduction: Patients' negligence and difficult access to healthcare have an impact on the worsening of emergency conditions, which require immediate treatment due to the possibility of exacerbation in a short period of time. Untreated intra- and extraoral abscesses can have serious consequences on the patient's health and in many cases are life-threatening conditions increasing risk of respiratory obstruction, thrombophlebitis, meningitis, mediastinitis and septicemia. Background: The aim of this study is to investigate the impact of the pandemic and the resulting impediments to accessing medical care on the incidence and type of emergencies in the Oral Surgery Department. Material and methods: This was a retrospective study of 85375 patients aged 2 months to 90 years old with diagnosed intra- and extraoral abscesses before COVID-19 pandemic (2018,2019), and during pandemic (2020, 2021) in the Department of Oral Surgery of the Medical University in Lublin. The obtained results were statistically analyzed with the use of a computer program. Conclusions: The fewest patients were admitted in 2020, and the most in 2021, where we can already see the effects of the pandemic. Emergencies occurred most frequently in people aged 21-30, then 31-40. In 365 cases, tooth extraction was performed, and only in 28 cases, root canal treatment was attempted. Conclusions. Oral health service provision has been significantly affected by COVID-19. Patients came to their appointments too late, which in most cases resulted in the necessity of tooth extraction without attempting root canal treatment.
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Aim: People with type 1 or type 2 diabetes have a higher hospital admission rate following Covid-19 infection. This study aims to determine the degree to which the results of a previous study in Greater Manchester (GM) could be replicated in national-level data for England. Method(s): We focussed on the univariable regression analysis, which shows the association between admission and Covid-19 infection in people with diabetes. Modelling was conducted using logistic regression on data from the Covid-IMPACT database. Odds ratios were compared descriptively with the previous study. Result(s): In people with type 2 diabetes, factors associated with an increased risk of hospitalisation similar to the previous study were: older age, male sex, higher social deprivation, higher body mass index (BMI), higher cholesterol, lower eGFR, taking an ACE-inhibitor/ ARB, not taking metformin, and having asthma or hypertension. Patients with COPD, and those taking aspirin or clopidogrel also had increased risk, but the national data showed a greater risk (GM COPD odds ratio 1.89 [1.63-2.19] vs national 2.34 [2.28-2.40] / aspirin 1.49 [1.34-1.66] vs 1.66 [1.63-1.70] / clopidogrel 1.71 [1.47-1.98] vs 1.99 [1.94-2.04]). Similar results were observed in patients with type 1 diabetes. However, due to the increase in sample size, many factors which were previously not statistically significant have become significant, such as in type 2 diabetes BMI, low HDL-cholesterol. Conclusion(s): We have successfully replicated the methods, results and conclusions of our previous study in relation to factors associated with increased risk of hospital admission in diabetes individuals. Regional databases are suitable for large cohort studies, and in this instance produced similar results to a national database, validating our previous findings.
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Severe pneumonia is a condition with a high risk of death and mandatory hospitalization in the intensive care unit. The incidence of severe pneumonia has increased dramatically during the pandemic of new coronavirus infection. Timely diagnosis and early initiation of adequate treatment of severe pneumonia are crucial for improving survival of critically ill patients. The aim of this review was to analyze published scientific research on molecular markers that allow to objectively assess the severity of pneumonia and to determine treatment tactics based on the predicted outcome upon admission to the hospital. A systematic search was conducted in the electronic databases PubMed, Medline, Web of Science for the period 2019 - 2022. Conclusion. The review focuses on the prognostic role of a number of markers of immune response, vascular transformation, as well as angiotensin II and angiotensin converting enzyme-2. Further prospective studies of potential predictors of severe pneumonia will enable using marker molecules in a comprehensive clinical and laboratory diagnosis for early prediction of the hospitalized patient's condition and expected outcome.Copyright © Volchkova E.V. et al., 2023.
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The onset of mental disorders typically occurs between the ages of 12 and 25, and the burden of mental health problems is the most consequential for this group. Indicated prevention interventions to target individuals with subclinical symptoms to prevent the transition to clinical levels of disorders, even leading to suicide, have shown to be effective. However, the threshold to seek help appears to be high. Digital interventions could offer a solution, especially during the Covid-19 pandemic. In this talk, the presenters will take you on a journey through the background, effects and experience of the digital indicated prevention intervention ENgage YOung people Early (ENYOY). ENYOY specifically addresses young people with emerging mental health complaints, and offers a new approach for treatment in the Netherlands through a clinical- and peer- moderated treatment platform. Considering the waiting lists in (child and adolescent)- psychiatry and the increase in suicides amongst youth, early lowthreshold and non-stigmatizing help to support young people with emerging psychiatric symptoms is of crucial importance. Moreover, this project aims to bridge the gap between child and adolescent and adult psychiatry. We included 125 young people with subclinical mental health problems (stage 1b), age 16-25 years. Using a combined peer and clinical support approach participants followed their personalized digital therapeutic treatment journey for up to 12 months. The first results demonstrate that at 3 and 6 months follow-up complaints significantly decrease (K-10) and social functioning increase (SOFAS) (p < .05). This new approach may offer perspective for young people and the healthcare system.
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Disparities in the incidence, prevalence, and morbidity and mortality rates of many respiratory diseases are evident among ethnic groups. Biological, cultural and environmental factors related to ethnicity can all contribute to the differences in respiratory health observed among ethnic minority groups, but the inequalities observed are most commonly due to lower socioeconomic position. People who migrate within a country or across an international border may experience an improvement in respiratory health associated with improvements in socioeconomic position. However, migrants may also experience worse health outcomes in destination countries, as they are faced by barriers in language and culture, discrimination, exclusion and limited access to health services. While some high-quality studies investigating ethnicity and respiratory health are available, further research into ethnic differences is needed. Improving the recording of ethnicity in health records, addressing barriers to accessing respiratory healthcare and improving cultural literacy more generally are some of the ways that inequalities can be tackled.Copyright © ERS 2023.
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Background: People living with cancer are reported to be at increased risk of hospitalization and death following infection with acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This is proposed to be dependent on a combination of intrinsic patient and cancer factors such as cancer subtype, and emerging SARS-CoV-2 variants with differing pathogenicity. However, COVID-19 phenotype evolution across the pandemic from 2020 has not yet been systematically evaluated in cancer patients. Method(s): This study is a population-scale real-world evaluation of Coronavirus outcomes in the United Kingdom for cancer patients from 1st November 2020-31st August 2022. The cancer cohort comprises individuals from Public Health England's national cancer dataset, excluding individuals less than 18 years old. Case-outcome rates, including hospitalization, intensive care and casefatality rates were used to assess the evolution in disease phenotype of COVID-19 in cancer patients. Multivariable logistic regression models were fitted to compare risk of Coronavirus outcomes in the cancer cohort relative to the non-cancer population during the Omicron wave in 2022. Result(s): The cancer cohort comprised of 198,819 positive SARS-CoV-2 tests from 127,322 individual infections. Coronavirus case-outcome rates were evaluated by reference to 18,188,573 positive tests from 15,801,004 individual infections in the non-cancer population. From 2020 to 2022, the SARS-CoV-2 disease phenotype became less severe in both patients with cancer and the non-cancer population, though cancer patients remain at higher risk. In 2022, the relative risk of Coronavirus hospital admission, inpatient hospitalization, intensive care admission and mortality in cancer patients was 3.02x, 2.10x, 2.53x and 2.54x compared to the non-cancer population following multivariable adjustment, respectively. Higher risk of hospital admission and inpatient hospitalization were associated with receipt of B/T cell antibody and/or targeted therapy which also corresponded with an increased risk of Coronavirus mortality. Conclusion(s): The disease phenotype of SARS-CoV-2 in cancer patients in 2022 has evolved significantly from the disease phenotype in 2020. Direct effects of the virus in terms of SARS-CoV-2 hospitalization, intensive care and case fatality rates have fallen significantly over time. However, relative to the general population, people living with cancer and hematological malignancies remain at elevated risk. In order to mitigate the indirect effects of the SARS-CoV-2 pandemic in terms of disruption to cancer care, there should be increased focus on preventative measures. Used in conjunction with vaccination and early treatment programs, this will maximize quality of life for those with cancer during the ongoing pandemic and ensure the best cancer outcomes.
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Background: The clinical course of coronavirus disease-2019 (COVID-19) varies from those who are asymptomatic, experience mild symptoms such as fever, cough, and dyspnea, to more severe outcomes including acute respiratory distress, pneumonia, renal failure, and death. Early reports suggested severe outcomes in patients with primary immunodeficiency (PID), particularly those with type 1 interferon signalling defects. This prompted a rigid approach to social distancing to protect this patient population, particularly children. To date, real-world data describing the course and outcome of COVID-19 in paediatric PID patients remains scarce. Method(s): In this retrospective case series, we describe the clinical course of 36 paediatric patients with underlying primary immunodeficiency (PID) followed by SickKids Hospital (Toronto, Canada) who were symptomatic and tested positive for SARS-CoV-2 infection between October 2020 to November 2022. Result(s): Our cohort consisted of patients with combined immunodeficiency (66.7%), antibody deficiency (22.2%), neutrophil dysfunction (8.3%), and immune dysregulation (2.8%). The median age was 7.5 years (range: 8 months - 17 years), with 21 male and 15 female patients. Three (8.3%) patients were post-hematopoietic stem cell transplant (HSCT) and 12 (33%) patients were on immunoglobulin replacement. Nine (25%) patients had underlying lung problems including bronchiectasis (1), interstitial lung disease on home oxygen therapy (1), and underlying asthma (7). Most patients had mild clinical course and were managed at home. The most common symptoms were fever (80%), cough (75%) and other upper respiratory tract symptoms (72%). Nineteen (52.7%) patients experienced other symptoms which included headache, lethargy, or gastrointestinal upset. At the time of the infection, 13 patients (36.1%) had received 2 doses of a SARS-CoV-2 vaccine, 5 patients (13.9%) had received 1 dose, and 18 (50%) were not vaccinated. None of the patients received antiviral or monoclonal antibody as prophylaxis or treatment. Only 1 patient required hospital admission out of precaution given the close proximity to HSCT. All patients recovered without complications. Conclusion(s): The paediatric patients with PID followed by our centre experienced mild to moderate COVID-19 symptoms and recovered fully without complications. These findings support the return of much needed social interactions among children, which were impacted severely during the COVID-19 pandemic.Copyright © 2023 Elsevier Inc.
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Background: Sickle cell disease (SCD) is one of the most common single gene disorders worldwide and is characterised by significant morbidity and early mortality.[1] Pregnancy in SCD is associated with an increased risk of maternal and foetal complications.[2,3] The 2011 RCOG and the 2021 BSH guidelines[5,6] on the management of pregnancy in SCD have provided the basis for best practice care in the UK over the past decade and is the guidance which we follow in Ireland. To date, there is no published data on outcomes for pregnant women with SCD in Ireland. The number of Irish patients with SCD has risen over the past 20 years. Without a national database, the exact prevalence is not known but currently there are at least 600 adults and children with SCD in Ireland, whose population is just over 5 million.[4] Aims: Our study assesses outcomes of pregnant patients with SCD from 2015 to 2022. Our aims were to: * Assess adherence to current guidelines * Assess pregnancy outcomes and maternal complications * Assess transfusion rates amongst our patient cohort. Method(s): This is a retrospective cohort study. We do not have a directly matched cohort, but have compared our findings to published data on Irish pregnancy outcomes from the Irish Maternity Indicator System National Report and have correlated our findings with studies of women with SCD who were managed in UK centres.[8,9,10] Results: We reviewed outcomes of 29 pregnancies in 19 women over a 7-year period. The median age was 29 (range 20-41) and the predominant maternal sickle genotype was HbSS (65.5%). Before conception, 55.2% of cases had pre-existing complications of SCD, including acute chest syndrome (ACS), pulmonary hypertension (PHTN) and prior stroke. In accordance with current guidelines, 100% of women (n=29) were prescribed folic acid, penicillin, and aspirin prophylaxis. 51.7% (n=15) of women had documented maternal complications during pregnancy, including ACS (34%), vaso-occlusive crisis (34%), gestational diabetes (10%), VTE (3%) and UTI (3%). Two women (7%) developed Covid-19 pneumonitis despite vaccination. There was one case of maternal bacteraemia (3%). 65.5% of cases (n=19) required blood transfusion during pregnancy. One woman was already on a blood transfusion programme for disease modification prior to pregnancy. In 6 cases (20.6%), a transfusion programme was commenced during pregnancy due to prior pregnancy complications or intrauterine growth restriction. During pregnancy, 27.6% (n=8) of women required emergency red cell exchange for ACS. Prior studies have suggested that between 30% and 70% of pregnant women with SCD require at least one blood transfusion during pregnancy.[8,9,10] By comparison, only 2.6% of the Irish general obstetric population required transfusion during pregnancy.[7] 20.6% (n=6) of births were preterm at <37 weeks' gestation. There was one live preterm birth (3%) at <34 weeks and one intrauterine death (3%) at 23 weeks' gestation. Similar to UK data[9], 31% of women required critical care stay (n=9) during pregnancy, in comparison with 1.44% nationwide in 2020.[7] Conclusion(s): It is well established that pregnancy in SCD is high risk, and despite adherence to current guidelines, we have shown very high rates of critical care admission, significant transfusion requirement and hospital admissions. Our findings are comparable to published UK outcomes and they further support the need for a comprehensive specialist care setting for this patient cohort.
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Introduction: Abdominal wall surgery has been one of the major victims of the COVID-19 pandemic, with a large number of patients who have seen their surgery delayed and many are still waiting to be operated on today. On the other hand, botulinum toxin is one of the main protagonists in optimizing abdominal wall surgery, especially important in complex hernia, but we must not forget that it can have adverse effects. Case report: We present the case of a 54-year-old man with a history of obesity, diabetes, hypertension, chronic renal failure and kidney transplant in 2000, who presented a midline incisional hernia as a result of an epigastric hernia operated on in 2006 and subsequently two onlay permanent synthetic mesh in 2010 and 2015. In February 2020 he presented an incisional hernia M2-4W3R3 with a volume of 35%, botox was infiltrated as optimization for surgery and while awaiting placement of a pneumoperitoneum catheter, the surgery was suspended due to the COVID-19 situation. He returns to our clinics in 2022 with a growth of the hernia and a volume of 95%. Weight loss, botulinum toxin and preoperative pneumoperitoneum were indicated. We performed a reconstruction of the abdominal wall with bilateral transversus abdominal release and preperitoneal 45x60cm polyvinylidene fluoride mesh and abdominoplasty. Discussion(s): Botulinum toxin can facilitate abdominal surgery, especially in complex hernias, but we must not forget that blocking the abdominal muscles can have adverse effects. The COVID-19 pandemic has been especially hard on surgical waiting lists, delaying surgeries and aggravating pathologies.
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Introduction: The Covid-19 pandemic has led to an uncomfortable and often recurrent situation in foot care services in the UK which frequently manifests in the older, White British, overweight, lone male population who often are manual workers. Result(s): These patients are unaware of local or national health promotion campaigns (e.g. iDEAL group's ACT NOW campaign, Diabetes UK's Putting Feet First) so have little awareness and education regarding potential foot problems. They are not aware of 5-to drive, eat 5 portions of fruit and vegetables a day, check your feet every day or walk 10,000 steps initiatives. They do not access public health materials and do not follow social media platforms, magazines, or newspapers. Therefore when they present in clinic, often after an emergency appointment with their GP, or an attendance at A&E, they present with significant soft tissue damage or systemic infection, frequently catastrophic tissue loss and serious co-morbidity (often in the form of renal or cardiac failure). Many require immediate hospital admission, intra-venous antibiotics, surgical debridement, vascular intervention and/or amputation. Unfortunately for some early mortality (often from an overwhelming cardio-vascular event) is the reality before they get as far as a major amputation. Discussion(s): Patients with more long-term conditions have increased risk of missing GP appointments (after controlling for number of appointments made) and are at increased risk of all-cause mortality, with those with long-term mental-health conditions who miss >2 appointments per year having >8x risk of all-cause mortality compared with those similar diagnoses who missed no appointments (McQueenie et al. 2019).
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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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Background: The coronavirus disease 2019 (COVID-19) pandemic and its associated morbidities are a great global concern. Diabetes mellitus (DM) is associated with adverse clinical outcomes and high mortality in patients with COVID-19. Objective(s): This study examined the frequency of BM, newly diagnosed hyperglycemia, and their impacts on hospitalized patients with COVID-19. Method(s): This retrospective study examined 810 medical records of PCR-confirmed COVID-19 patients admitted to Razi Hospital, Ahvaz, Iran. The clinical presentations, severity, and impacts of COVID-19 were compared between patients with and without DM. Disease severity was determined based on the NEWS2 scoring system. Result(s): This study included 810 medical records of COVID-19 patients, of whom 326 had pre-existing DM, and 484 were non-DM. The rates of diabetes and newly diagnosed hyperglycemia were 40.2% and 11.2%, respectively. The most common underlying diseases were hypertension (35.3%), ischemic heart disease (17.9%), and chronic kidney disease (11.9%), which were higher in people with diabetes than non-diabetics. The rate of acute kidney injury was higher in patients with diabetes than in non-diabetics (30.7% vs. 19.2%;P < 0.001) and in patients with severe COVID-19 than in those whose disease was not severe (27.8% vs. 21.5%;P = 0.04). The rates of severe COVID-19 (46.3% vs. 34.7%;P = 0.093), ICU admission (40.7% vs. 27.4%;P = 0.012), and mortality (18.5% vs. 10.5%;P = 0.079) were higher in patients with newly diagnosed hyperglycemia than in euglycemic patients. Conclusion(s): This study showed that COVID-19 infection is linked with newly diagnosed hyperglycemia and pre-existing DM, both associated with severe COVID-19, more need for ICU admission, and mortality.Copyright © 2023, Author(s).
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Objective: This study aimed to evaluate the development of adjustment disorder according to the ADNM-20 (Adjustment Disorder New Module-20) scale in participants who were followed up for Covid-19 infection. Methods: A cross-sectional survey was conducted from September to November 2020. After sample size calculation, we aimed to reach minimum 170 people out of 1290 people who applied to the hospital for Covid-19 disease treatment. Participants were selected from the patients admitted to the hospital using a simple stratified random sampling method. We reached 182 people after treating the patients who were followed up with Covid-19 infection in a University Hospital in Istanbul, Turkey. A questionnaire and the Adjustment Disorder New Module-20 scale were applied via phone / mail at the end of the 6th month after Covid-19 related hospital admission by researchers. Results: Adjustment disorder was found in 28.8% (n=42) of the participants disorder according to the ADNM-20 scale. While the rate of development of adjustment disorder due to Covid-19-related stress was 26.7% (n=39);the rate of development of adjustment disorder due to non-Covid-19 stress was found to be 2.1% (n=3). With the increase in stress load, the development of adjustment disorder increased significantly. The frequency of developing Covid-19-related stress-related adjustment disorder was statistically significantly increased with the duration of exposure to stress. Conclusion: We have found out that one out of every four people who apply to the hospital for healthcare services due to Covid-19 infection may develop an adjustment disorder. Assessment of the adjustment disorder more frequently and making early interventions may contribute to the prevention of progressive mental disorders.
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The most common causes of acute hepatitis in children are hepatitis A and autoimmune hepatitis. Hepatitis in the course of Wilson's disease is sporadically registered in adolescents. An increase of activity of aminotransferases both in the course of multisystem inflammatory syndrome in children (MIS-C) and in the course of COVID-19 has been observed. Hepatitis is common in children with MIS-C and is associated with a more severe presentation and persistent elevation of liver function tests. To date, no cases of acute hepatitis in children due to COVID-19 have been reported. We present 2 cases of acute hepatitis in children where the only cause seems to be a previous asymptomatic SARS-CoV-2 infection.Copyright © 2023 Termedia Publishing House Ltd.. All rights reserved.
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Background: Patients with obstructive sleep apnea (OSA), related to their disease consequences and treatment modalities, are physically and mentally vulnerable during the outbreak. Objectives: To investigate the association between pandemic-related changes and positive airway pressure (PAP) adherence and sleep quality in OSA patients. Methods: This was a multi-center cross-sectional study, and the necessary data were collected prospectively. A total of 221 patients were included in the study, who were invited from four different centers from June 1 - December 1, 2020. Pittsburgh Sleep Quality Index (PSQI) was administered to evaluate sleep quality. Information on demographics positive airway pressure (PAP) device use, Coronavirus disease (COVID-19) a questionnaire collected related changes. Patients >18 years with a diagnosis of OSA and prescribed PAP treatment before the pandemic period were included in the study. Lack of cooperation with the questionnaires and incompliant with PAP treatment for longer than one year were the exclusion criteria. Results: Of the 221 participants, 79.2% were men. The mean apnea-hypopnea index was obtained at 40.8+or-24.3. A positive COVID-19 test was reported in nine cases, and three patients had hospitalization. During the pandemic, 102 (46.2%) subjects were retired, 26 (11.8%) lost their jobs, and 34 (15.3%) reported home office work or on-call or on leave. Poor sleep quality was found in 54 (24.4%) individuals. It was also reported that poor sleep quality was more common in those who reported mask use difficulty (38.7% vs. 18.9%;P=0.004) and increased or decreased PAP use (increased, decreased, no change in PAP use: 45.5%, 36.0%, 19.4%, respectively;P=0.01). The good sleep quality group had higher PAP use than the poor sleep quality group (6.2+or-1.5 vs. 5.3+or-2.4 night/week;P=0.002;6.2+or-1.5 vs. 5.5+or-2.2 hour/night;P=0.01). Conclusions: Pandemic period had several negative effects on sleep apnea patients regarding sleep quality and social lives which also influenced PAP adherence in OSA patients. Most patients did not change their regular PAP use attitudes during this period. Similar to the pre-COVID-19 disease period, PAP adherence and compliance positively influenced sleep quality;people who were "good sleepers" were the ones who were the "good PAP device users".
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'You do not know what you will find, you may set out to find one thing and end up discovering something entirely different'-Alexander Fleming As the pace at which medicine is advancing continues to accelerate, haematologists will increasingly find themselves practising unfamiliar medicine and using novel treatments. Whilst most scientific breakthroughs hopefully lead to an overall improvement in quality of life and prognosis, it is imperative that enough attention is paid to the shortcomings of new treatments and adverse events. The recent COVID-19 pandemic is a stark reminder of the cyclical nature of history and the need for healthcare professionals to utilise lessons learnt by our predecessors. Fleming and the discovery of penicillin highlights how mistakes in practice can sometimes lead to unexpected but useful revelations. The use of thalidomide as a treatment for hyperemesis gravidarum in the 1960s devastatingly lead to birth defects in thousands of people. Today, the repurposing of thalidomide, through lateral thinking and further study, has contributed to significant improvements in the prognosis of patients with Multiple Myeloma.1 Mortality following allogenic stem cell transplant continues to decrease overtime as knowledge surrounding complications and how to manage these improves, despite the fact that patients receiving stem cell transplants are becoming increasingly complex.2 These examples from history demonstrate the merit in studying adverse events and undesired outcomes. National reviews of patient health records indicate that errors currently occur in 10% of hospital admissions.3 With new treatments and more complex patients this will likely increase. It is estimated that voluntary reporting by healthcare professionals of such events only occurs 70% of the time.3 History should be used to guide essential changes in attitudes towards error reporting and help to create an ethos where 'failings' are more willingly recognised as a tool to guide improvement and innovation.