ABSTRACT
Social determinants of mental and physical health that influence young peoples' trajectories into adulthood are often remediable through law. To address inequalities, including those exacerbated since the COVID-19 pandemic, there is a need to better understand young people's need for and uptake of advice for social welfare legal problems. This scoping review aimed to review available evidence and identify gaps to inform further research. To identify studies relevant to social welfare legal advice among young adults we conducted searches of eight bibliographic databases (compiled between January 1998 and June 2020), hand searches of included article reference lists and targeted grey literature searches. 35 peer reviewed and grey literature studies were selected based on inclusion and exclusion criteria including evaluations of interventions to promote access to advice, general population surveys, observational studies, and audits of charity data or targeted surveys. Evidence suggests considerable and inequitable need for social welfare legal advice among young adults with adverse consequences for health and wellbeing. Needs among higher risk groups are likely underestimated. Evidence for interventions to enhance access/uptake of advice is limited and methodologically weak. We identify several gaps in the literature to inform research and to enable systematic reviews around more specific questions to inform practice.
ABSTRACT
Patients on maintenance hemodialysis (MHD) are highly susceptible to SARS-CoV-2 and with high mortality rates due to Coronavirus disease 2019, mainly because of the older age in this group of patients, comorbidities, compromised immune status due to uremia, as well as inability to keep social isolation because of the necessity for regular physical presence in dialysis facility. Several retrospective studies of patients on MHD in Europe, America and Asia, show high susceptibility to SARS-CoV-2 in this group of patients with very high rates of critical course of the disease and high mortality rates, reaching more than 40% The aim of this retrospective observational study was to identify risk factors among patients on intermittent hemodialysis for infection with SARS-CoV-2 as well as predictors of severe COVID-19 and fatal outcome. Materials and methods. We analyzed 69 patients receiving intermittent dialysis in Aleksandrovska University Hospital - Hemodialysis Unit. 34 of them have been tested positive for SARS-CoV-2 in the period from September 2020 (when the first case of the disease was registered for our dialysis center) up to March 2022, and are compared with a control group of 35 dialysis-dependent patients without COVID-19. Data about comorbidities, main laboratory and radiologic findings, need of hospitalization and treatment in ICU, as well as data for conducted treatment, are collected from electronic medical records. To identify predictors of severe COVID and poor outcome we compared the group of survivors with the one of non-survivors. Results. There are no significant differences between patients on MHD with and without COVID-19 except higher frequency of COPD and hypoproteinemia in the positive group. Older age, female gender, history of smoking, lymphopenia with neutrophilia, treatment in ICU and need of mechanical ventilation, signs of malnutrition - hypoproteinemia and lower levels of serum creatinine, are risk factors for severe disease and fatal outcomes. Conclusions. The course of COVID infection in dialysis-dependent patients is severe and with high mortality rate, in line with other studies worldwide. Malnutrition is the main risk factor for COVID and also main predictor for poor outcomes.
ABSTRACT
COVID-19 is a widespread contagious viral infection that can severely affect the respiratory system. Although many people recover from using the disease without special care or treatment, pregnant women are particularly vulnerable to pulmonary infections due to their hangers systems system and physiology. To investigate the treatment provided to pregnant women who are PCR-positive for COVID-19 in their early three months of pregnancy, a reanalyzed analyzed data from 84 participants who received treatment at Tangerang Regional Hospital in 2 study was the study conducted based on an ases of observational investigation with a cross-sectional approach. It assembled the data for analysis of the chi-square test. The results showed that 92.9% of participants underwent a cesarean section, while the remaining 7.1% were discharged after giving birth typically or recovering. Additionally, the study did not find any correlation between factors such as age, education, work, gravida, ANC visit, and the impact of COVID-19 on the third trimester of pregnancy at Tangerang Hospital in 2022. The study recommends that pregnant women seek information about pregnancy care from healthcare providers, particularly midwives, posyandu officers, and the media, to make well-known decisions about their health and well-being during this critical period, ensuring a safe and healthy pregnancy outcome.
ABSTRACT
Introduction: COVID-19 is an infectious disease caused by the SARS-CoV-2 virus that commonly involved the respiratory system. However, the virus can affect any organ in the body including the liver. Hepatic involvement in COVID-19 could be related to the direct cytopathic effect of the virus, an uncontrolled immune reaction, sepsis, or drug-induced liver injury. Background: The current study aims to evaluate the relevance of liver enzyme derangement in COVID-19. Methods: The sample size of 165 patients, tested positive for covid 19 and underwent liver enzyme testing. These patients were categorized into mild, severe, and critical diseases based on clinical evaluation, radiological findings, and biochemical parameters. Results: Of 165 patients selected 103 (62.4%) have mild disease, 40(24.2%) have severe and 12(7.2%) suffered from the critical disease. 48(29.1%) patients show deranged liver function. 83.3% of critical patients and 45% of severe patients show deranged liver function.9.09%of patients died due to severe COVID-19 infections showing moderately to severe liver function derangement. Conclusions: This study concludes that the severity of COVID-19 disease may increase due to chronic liver disease, particularly fatty liver. Atypical ALT and AST levels during hospitalization were indicative of liver injury and correlated with the severity of patients.
ABSTRACT
Background: COVID-19 infection can cause an exaggerated immune response. This immune response is associated with an increase in proinflammatory cytokines, especially interleukin-6 (IL-6). High IL-6 levels are found in the acute stage of COVID-19, and IL-6 can induce an excessive humoral inflammatory response. This study aimed to provide an overview of IL-6 levels in coronavirus disease 2019 (COVID-19) patients at Dr. M. Djamil General Hospital, Padang, Indonesia. Methods: Descriptive observational study of 102 research subjects. Observations on sociodemographic, clinical, and laboratory data were carried out in this study. Univariate analysis was carried out using SPSS version 25. Results: Patients with symptom onset <7 days had higher IL-6 levels than those with an onset of more than 7 days. Patients with critical degrees have the highest IL-6 levels compared to moderate and severe degrees. Patients with more than 1 comorbid had higher IL-6 levels than patients who had no comorbid or only had 1 comorbid. Patients with <21 days of treatment had higher IL-6 levels than patients with more than 21 days of treatment. Conclusion: COVID-19 patients at Dr. M. Djamil General Hospital, Padang, Indonesia, with an onset of less than 7 days, a critical degree, and more than 1 comorbidity have higher IL-6 levels.
ABSTRACT
Background: The COVID-19 pandemic has affected the performance of several sectors, one of which is the quality of maternal and child health services. One of the factors contributing to the decline in the quality of maternal and child health services is limited access during the COVID-19 pandemic. Telemedicine is here as one of the answers to overcome the problem of limited access to health services during the COVID-19 pandemic. This study aims to analyze the use of telemedicine applications by pregnant women during the COVID-19 pandemic using the ISO 9241-11 framework. Subjects and Method: This research method is an observational study with a descriptive approach to analyze usability in three measurement aspects namely effectiveness, efficiency, and satisfaction. The number of samples used was 42 pregnant women who had used telemedicine applications that had been determined during the COVID-19 period with a sampling technique using random sampling. The instrument used is an adaptation of the Standardized Usability Questionnaire (SUQ) which will be analyzed using the Structural Equation Modeling-Partial Least Square (SEM-PLS) technique to determine the usability score of the application. Results: Based on the results of the Structural Equation Model-Partial Least Square (SEM-PLS) analysis, the ISO 9241-11 model has a goodness-of-fit model with an R-square value of 0.760 and a Q-square value of 0.577 with a Goodness of Fit (GoF) of 0.780. The effectiveness variable has a significant effect on the usability variable of the Teman Bumil application at a significance level of 5% with a statistical T value of 1,955. There is not enough evidence for the efficiency and satisfaction variables to say they have a significant effect on the usability of the Teman Bumil application at a 5% significance level with T-statistic values of 0.866 and 1.452. The usability score for the Friends Pregnant application is 44.45. Conclusion: The usability score obtained by the Teman Bumil application is 44.45, which means that Sahabat Bumil application has not been accepted by users as a system product that can help effectively, efficiently and satisfactorily.
ABSTRACT
Am J Manag Care. 2023;29(6):In Press _____ Takeaway Points The value of direct-to-consumer (DTC) telemedicine services offered by academic health systems is understudied. * DTC telemedicine services for low-acuity or minor illnesses are increasingly offered as an employee benefit, but any per-episode unit cost advantage may be offset by overuse of care. * DTC telemedicine staffed by an academic health system and offered to its employees resulted in lower per-episode unit costs for care within 7 days and only marginally increased the use of services. * DTC telemedicine staffed by an academic health system and offered directly to employees was cost-saving. _____ Employers in the United States have increasingly been offering a direct-to-consumer (DTC) telemedicine benefit for low-acuity or minor illnesses to their employees.1-3 By 2021, more than 95% of employers with 50 or more employees provided some coverage for DTC telemedicine in their largest health plan;more than 75% felt that offering telemedicine was important and nearly 20% either limited or eliminated cost sharing for telemedicine.4 Despite these trends among general employers, few health systems have directly provided DTC telemedicine to their own employees. [...]because these services are easy to access (often available immediately, around the clock, and without travel), they may induce overuse of care, especially for self-limited conditions such as viral upper respiratory infections for which the alternative to in-person care is no care at all, thus increasing the overall cost of care.5-11 Telemedicine will save money relative to in-person care if any unit price advantages are not overwhelmed by the increased use of care overall, induced by its convenience. Employers provide health insurance coverage for 158 million Americans or nearly 50% of the population. Since the COVID-19 pandemic began, telemedicine has represented a significantly larger portion of all medical claims—consistently more than 5% of all medical claims by mid-202112-15—and the estimated value of the global telemedicine industry is projected to reach a quarter of a trillion dollars by 2024.13 Yet, the future of telemedicine remains undetermined with reimbursement rates in debate,16-18 driven in large part because its economic value is understudied and uncertain. Penn Medicine is self-insured and more than 95% of employees use its only employer-sponsored plan—a preferred provider organization (PPO) plan—rather than insurance obtained individually or through a family member. Since 2017, these PPO-insured employees have been offered Penn Medicine OnDemand,19 a 24/7 DTC telemedicine benefit to employees and their adult (≥ 18 years) dependents.
ABSTRACT
Objective: In this study, the effect of having had coronavirus disease-2019 (COVID-19) disease on anti-vaccination was investigated. Material and Methods: The study was conducted between February 2022-August 2022 in the COVID chest diseases clinic in our hospital. The cases who were COVID-19 vaccine hesitancy and not vaccinated against COVID-19 hospitalized in our clinic were included in the study. The level of anti-vaccination of the cases was measured with the Vaccine Hesitancy Scale (VHS). In addition, demographic informations such as age, gender, educational status, marital status, number of people living in the household, average monthly income, smoking history, and additional chronic diseases were recorded. Routine radiological and laboratory examinations, follow-up times in the clinic, and treatment results were recorded for cases like all patients hospitalized in our COVID chest diseases clinic. Results: 46 cases were included in the study. The mean age of the cases was 54.63+or-14.81 years, 24 (52.1%) were female. VHS was applied to all cases at the time of hospitalization. Since 6 cases were referred to the intensive care unit due to respiratory failure, the second VHS could not be applied to these cases, and these 6 cases were excluded from the study. A 2nd VHS was performed in the remaining 40 patients just before discharge. Each question score, A-B-C section score and total scale score were compared for the pre-COVID-19 and post-COVID-19 cases. While the VHS total score before COVID-19 infection was 36.48+or-7.36, the post-COVID-19 total score was found to be 25.65+or-9.10, a statistically significant decrease was observed (p < 0.001). It was observed that the mean scores of A-B-C decreased statistically in all sections (p < 0.001). Conclusion: As a result of our study, we found that the degree of anti-vaccine resistance decreased after the patients who were against the COVID-19 vaccine had the disease. As a result of our study, we found that the degree of COVID-19 vaccine hesitancy of patients decreased after they had the disease. We believe that conducting similar studies and sharing their results through mass media, can change the perspective of vaccine hesitancy individuals in society on this situation, especially during pandemic periods.
ABSTRACT
BackgroundInflammatory rheumatic and musculoskeletal diseases (iRMDs), including rheumatoid arthritis (RA) and juveneille inflammatory arthritsi (JIA), are common and cause a high disease burden globally. Early diagnosis of iRMDs and subsequent timely access to disease modifying therapies is associated with improved health and socio-economic outcomes. However, the COVID-19 pandemic meant that the way healthcare was delivered changed abruptly as all consultations were ‘remote by default' was widely implemented, replacing traditional ‘face-to-face' healthcare.ObjectivesTo describe the impact of the COVID-19 pandemic upon referral patterns and incident diagnosis of iRMDs.MethodsData from the Clinical Practice Research Datalink Aurum were analysed from 01/04/17 to 01/10/2021 to describe episodes of care for patients with musculoskeletal (MSK) conditions, in a primary care setting, for pre-COVID-19 (01/04/2017–31/03/2020), early-COVID-19 (01/04/2020–31/07/2021), and late-COVID-19 pandemic (01/08/2020–31/10/2021) periods. Prevalent and incident MSK consultations were determined. Referrals were matched to these consultations. Trends in referrals to MSK services and further incident diagnoses of iRMDs were described using Joinpoint regression and comparisons made between time-periods. Negative binomial regression was used to compare incident rates between time-periods: first MSK consultation to RA/JIA/iRMD diagnosis;first MSK consultation to first referral;first referral to RA/JIA/iRMD diagnosis. The number of consultations between first MSK consultation and referral/diagnosis were described. Results were adjusted for age and sex and further stratified by geographical region and deprivation.ResultsThe incidence of RA and JIA reduced by -13.3% (from 32.0 to 17.2 per 100,000) and -17.4% (from 1.8 to 0.97 per 1,000,000) per month respectively between January 2020 and April 2020, and then increased by 1.9% (from 17.2 to 25.2 per 100,000) and 3.7% (from 0.97 to 1.3 per 1,000,000) per month respectively between April 2020 and October 2021. The incidence of all diagnosed iRMDs was stable until October 2021. Referral incidence decreased between February 2020 and May 2020 by -16.8% (from 4.8 to 2.4 per 100) per month in patients presenting with a MSK condition. After May 2020, referrals increased significantly (16.8% per month from 2.4 to 4.5 per 100) to July 2020. Time from first MSK consultation to RA diagnosis, and referral to RA diagnosis increased in the early-pandemic period (rate ratio (RR) 1.11, 95% confidence interval (CI) 1.07-1.15;RR 1.23, 95%CI 1.17-1.30) and remained consistently higher in the late-pandemic (RR 1.13, 95%CI 1.11-1.16;RR 1.27, 95%CI 1.23-1.32) periods respectively, compared to the pre-COVID-19 period.ConclusionPatients with underlying RA/JIA that developed during the pandemic may be yet to present, or in the process of being referred and/or diagnosed. Primary care clinicians should remain alert to this possibility and consider the use of fast-track referral pathways where indicated. It is apparent that patients developing incident episodes of inflammatory arthropathies may display a prodrome of other MSK symptoms and conditions, which alone may not warrant referral but in combination require further investigation. Commissioners should be alert to these findings to allow for the appropriate planning and commissioning of services.References[1]Jordan KP, Kadam UT, Hayward R, et al. Annual consultation prevalence of regional musculoskeletal problems in primary care: an observational study. BMC Musculoskeletal Disorders 2010;11:144.[2]NHS England and NHS Improvement. Important and urgent - Next steps on NHS response to COVID-19 2020. Available at: https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/C0098-total-triage-blueprint-september-2020-v3.pdf Accessed Oct 2, 2021.AcknowledgementsWe wish to acknowledge: members of our PPIE group who helped to formulate the research question and provide insight into the implications of our results;and to Prof Edward Roddy, Prof Sa antha Hider and Dr Lorna Clarson for their insights as consultant rheumatologists and commissioners of healthcare services.Disclosure of InterestsNone Declared.
ABSTRACT
The current COVID-19 pandemic has generated a relevant changes in the normal development of human performance. Some changes detected in SARS-CoV-2 infected people have to do with possible effects of the infection in the bio-psycho-social sphere. The population in the Autonomous Community of the Canary Islands has not been oblivious to it and, therefore, a need demanded by society has roared. A multicentre observational study will be carried out to assess the physical and functional status of people from the Canary Islands who, after being infected with the SARS-CoV-2 virus, suffer sequelae that persist after twelve weeks of infection. With help from the Official Association of Physiotherapists of the Canary Islands a call will be made to the population. This association will oversee the dissemination of the information and will recruit among its members the collaborating/evaluating physiotherapists, also ensuring the protection and preservation of the data to be collected. People meeting the established criteria will be referred to the more accessible collaborating centre of the canarian community, where, after a preliminary interview, participating patients will self-complete scientifically validated questionnaires, and will be subjected to different validated tests to evaluate their physical and functional status. Patients will be individually informed of the results of their evaluation, and they will receive a dossier with individualized recommendations. After this evaluation, a follow-up of the participants for up to 6 months is anticipated. Data will be recorded, analysed, and interpreted, and the results will be disseminated through conventional means of communication to society and also by attempting publication in scientific journals.
ABSTRACT
Background: COVID-19 is caused by a novel virus that can cause lung abnormalities which can be measured with new chest x-ray scoring system named Brixia score. In COVID-19 patients, coagulation disorders are often found that can be seen through D-Dimer levels. This study aimed to prove the Brixia Score as a predictor of D-Dimer levels. Subjects and Method: This study was an observational analytic study with a cross-sectional approach. The subjects were 94 COVID-19 patients which taken from ICU Melati 1 Dr. Moewardi General Hospital, Surakarta from March 2021 to August 2021 who met the exclusion and inclusion criteria. The independent variable is the Brixia score performed by radiologists and the dependent variable is D-Dimer levels taken from laboratory results. Sampling was obtained by purposive sampling and the data were investigated using the receiver operating characteristic (ROC) curve. Results: 94 samples were obtained for analysis. The average Brixia Score of patients with D-Dimer <2 micro g/mL was Mean= 15.85;SD= 1.43 and D-Dimer 2 micro g/mL was Mean= 17.29;SD= 0.96. There was a significant difference between the Brixia Score of patients with D-Dimer <2 micro g/mL and D-Dimer 2 micro g/mL (p<0.001). Analysis with the ROC curve shows an area under the curve (AUC) of 0.793. The optimal cutoff value of the Brixia Score for predicting D-Dimer levels was 16.5 (sensitivity 77.9%, specificity 73.1%). Conclusion: Brixia Score proved to be a predictor of D-Dimer levels of COVID-19 patients in ICU care.
ABSTRACT
Background: Corona Virus (COVID-19) is a new respiratory viral infectious disease that can cause illnesses ranging from the common cold to severe acute respiratory syndrome. Subsequently, as of May 31, 2022, the government of South Sulawesi reported 143,276 confirmed cases, 2,463 deaths, and 140,395 recovered patients. Purpose: To analyze the impact of behavior, travel history, and comorbidities on the incidence of COVID-19 in South Sulawesi. Methods: This is observational research with a cross-sectional study design and was conducted from January-April 2022 in 7 districts of South Sulawesi Province. A population of 650 respondents with a total sample of 161 patients confirmed positive and 189 suspected of having COVID-19. The Chi-square test and multiple logistic regression were used to analyze the data. Results: There was a relationship between travel history (p 0.00;OR 2.19), knowledge (p 0.03;OR 1.74), and actions (p 0.00;OR 0.18) on the incidence of COVID-19. Additionally, no relationship was reported between comorbidities (p 0.85), attitudes (p 0.90), and level of knowledge (p 0.08 > (0.05)) on the incidence of COVID-19. The most influential variable in the rapid spread was travel history, with an exp(B) value of 2.19 CI (95%) (LL=1.26;UL=3.80). Conclusion: The results showed that travel history, knowledge, and actions made a major contribution to the spread of COVID-19 in South Sulawesi Province.
ABSTRACT
BACKGROUND: An ectoparasitic disease, scabies, caused by the mite Sarcoptes scabiei var hominis. Some of the predisposing factors are overcrowding, unhygienic surroundings, immunocompromised status, dementia, homelessness, and sexual contact. In this study, we wanted to evaluate the changed distribution of lesions of scabies during pandemic. METHODS: A cross sectional study was performed on 600 patients attending the skin department of our tertiary care hospital over a period of 6 months. The sites of the scabies lesions were noted along with types of lesions. Demographic data and history of regular hand washing and sanitization were also documented. RESULTS: Our study revealed an important correlation between change in pattern of distribution of scabies lesions from being less frequent on finger webs (19%) to being more frequent on abdomen (periumbilical area) (73%) and groins (67%) due to regular hand washing and frequent sanitization, in this pandemic era. CONCLUSIONS: A significant change in distribution of skin lesions in scabies can be noticed during this COVID-19 pandemic.
ABSTRACT
Background: Coronavirus disease 2019, first reported in December 2019 mainly presented with the symptoms of Cough, Fever, Shortness of breath, Myalgia, Weakness and anosmia. C-reactive Protein (CRP) is an acute-phase reactant protein which is synthesized by the liver in response to raised levels of interleukin-6 (IL-6) which is a biomarker of inflammation. Methods: This was a prospective observational study, done on 110 COVID-19 patients after applying inclusion and exclusion criteria. Detailed history, vaccination status, presence of comorbidities and thorough clinical examination was performed. Serum CRP levels was assessed and Computed Tomographic scan (CT scan) of Thorax was done. CORADS scoring and CT severity grading as per CT scan was done. All the above parameters were recorded in the preformed proforma and data was entered in excel spreadsheet and was analysed using SPSS v26 software. Results: Majority were males (56.3%) and majority were from 61-80 years of age. Majority (57.3%) patients were non-smokers. Hypertension was the most common associated comorbidity (86.4%) (r=0.743, p=0.000). There is a strong positive correlation between CRP levels and CTSS in COVID 19 patients and a strong negative correlation between the CRP levels and outcome of COVID-19 patients (r=-0.449, p=0.000). Conclusion: Elevated serum CRP value is associated with disease progression and poorer outcome.
ABSTRACT
Objective: Coronavirus disease-2019 (COVID-19) is a newly emerging infectious disease that has become a global pandemic. This study aimed to identify the risk factors at presentation to predict intensive care unit (ICU) admissions. Materials & Methods: This retrospective observational study recruited 188 confirmed laboratory COVID-19 patients who were hospitalized in Jidhafs Maternity Hospital (JMH) from 1st June to 5th July 2020. Univariate and multivariate analyses were used to Explore risk factors associated with the increased risk of ICU admission. Results: The study revealed that older age (>60 years old) (16[38.1%], P=0.044), male gender (30 [40.0%], P=0.000) were significantly associated with the increased risk of ICU admissions. The most prevalent symptoms in admission were myalgia (13[40.6%], P=0.035), fever (39[34.2%], P=0.002) and cough (37[31.4%], P=0.032). In addition, raised serum level of alanine amino-transferase (ALAT) (34.7% vs. 20.7%, P=0.033), D-dimers (30.7% vs 12.2%, P=0.012), lactate dehydrogenase (LDH) (31.6% vs 0.0%, P=0.025) and ferritin (37.7% vs 16.7%, P=0.011) found to be important predictor of ICU admission. Conclusion: The finding indicates that older age, male gender, with increased alanine transferase (ALT), increased lactate dehydrogenase (LDH), high D-dimer and high ferritin was associated with an increased risk of ICU admissions. Identification of such factors will help to detect people who are more likely to develop severe COVID-19 disease and will help physicians to determine if patients need regular health care or ICU admission.
ABSTRACT
Objective: To present in-hospital COVID-19 mortality and the associated factors at a public sector tertiary care hospital in Karachi Methodology: The current prospective, observational study was conducted at Jinnah Postgraduate Medical Center, Karachi, Pakistan from June 1 to August 30, 2021 with the approval of the hospital ethics committee. Data was collected prospectively from patients' medical record files. COVID-19 infection positive cases were diagnosed according to the guidelines of the WHO on laboratory investigation of real time polymerase chain reaction tests on a nasopharyngeal or oropharyngeal swab. Result: Total 143 patients were enrolled in the study with median (IQR) age of 58 (48-69). The majority of the patients were males (n=96, 67.13%) and had moderate to severe disease (n=128, 89.51%). During their hospital stay, patients developed the following complications;pneumonia (n=99, 69.23%), ARDS (n=19, 13.28%), sepsis (n=11, 7.69%), septic shock (n=5, 3.49%) and pedal edema (n=2, 1.39%). As many as 104 (72.72%), 69 (48.25%), and 42(29.37%) patients required pharmatherapy, non-invasive ventilation, and mechanical ventilation respectively. While 54 (37.76%) patients died during their hospital stay. On multivariable model, pneumonia, use of non-invasive ventilation, and mechanical ventilation, were identified as independent predictors of mortality. Conclusion: Most of the patients in our study had moderate to severe disease. Therefore, the study indicates that timely presentation to the hospital is of great importance to avoid adverse events which are significantly associated with mortality.
ABSTRACT
BACKGROUND: A common secondary effect after SARS-CoV-2 immunization is an increased in size of the axillary lymph nodes ipsilateral to the vaccinated site. Eventually, an increased in size of the axillary lymph nodes may lead to a misinterpretation of the breast screening mammogram, performed in asymptomatic women between the age 50 to 69 years old for early breast cancer diagnosis. The aim of our research was to evaluate the impact of the vaccination for SARS-CoV-2 in the breast screening programmes in terms of recall rates and number of false positive results. As a secondary purpose we would analysed the protocols adopted by different breast screening units around the world after SARS-CoV-2 vaccination. METHODS: Observational and retrospective study analysing breast screening mammograms from a single Breast Cancer Screening Unit in Madrid. The mammograms of previously vaccinated women were analysed, reviewing the axillary lymph nodes and the re-call rate secondary to axillary lymphadenopathies. RESULTS: Four hundred and twenty three screening mammograms were performed in May 2021 in the University Hospital Ramon y Cajal in Madrid, which is part of the Breast Screening Programme in Madrid, Spain. None of the women previously vaccinated for SARS-CoV-2 were recalled for complementary studies due to an increased in the axillary lymph nodes. CONCLUSIONS: The protocol stablished by the Spanish Society of Breast Image that stands up for a routine breast screening mammogram after SARS-CoV-2 immunization, has no increase in the recall rate or increase in number of false positives.
ABSTRACT
Background: COVID-19 has spread rapidly throughout the world with high morbidity and mortality estimated up to 20%. This number will increase with the presence of comorbidities. Comorbidities were associated with complex clinical management and impacted on COVID-19 disease outcomes. This study aims to determine the association between comorbidities and the outcome of COVID-19 patients at Dr. M. Djamil Hospital. Method: We conducted an observational study with a retrospective cohort design on COVID-19 patients treated at Dr. M. Djamil Hospital. Data were taken from medical records from January to March 2021. Association between comorbidities and the outcome of COVID-19 patients was analyzed by Chi-Square or Fisher Exact Test. Results: The majority patientss were female (56.4%) and ages above 50 years old (64.3%) were the majority of patients. The most common was hypertension (36.56%). The longest length of stay of COVID-19 patients was more than 21 days (52.9%). The outcomes of COVID-19 patients were recovered (59.5%), recovered with sequelae (5.7%), and died (34.8%). Diabetes mellitus affected the end of treatment outcome. There was no relationship of type of comorbidity with length of stay. The more co-morbidities a patient suffers, the condition when infected with COVID-19 will get worse. Conclusion: The number of comorbidities affects the outcome of COVID-19 patients. Diabetes mellitus is most common that affects the end of treatment outcome for COVID-19 patients at Dr. M. Djamil Hospital.
ABSTRACT
BACKGROUND: One of the problems associated to SARS-CoV-2 was its persistence in nasopharyngeal tract. The existence of markers that help to predict this situation could be useful to management of the patients. The objective of this paper was to determine the relationship between the CT value from the initial PCR of patients with COVID-19 and the persistence of the infection. METHODS: It was performed an observational retrospective study of patients with positive PCR to SARS-CoV-2 attended in emergency department of a general hospital. Data about compatible symptoms, radiological findings and the CT value obtained with each PCR kit were collected. The control group (G0) included patients with a positive PCR followed by two negative PCR results (P-N-N), while problem group (G1) included patients with at least three consecutive positive PCR results (P-P-P). Chronic infections were discarded selecting only patients with negative serology, and only were included those whose PCR were separated by a minimum of five and maximum of twenty days. The comparison between the study groups was carried out using the t-student test for quantitative variables and the X2 test for qualitative variables. RESULTS: The mean CT value were 30.8 and 21.5 (p<0.001) on G0 and G1, respectively. G0 reported higher CT values than G1, regardless of symptoms, radiological pattern and the PCR kit utilized. CONCLUSIONS: The CT value from the SARS-CoV-2 initial PCR is related to the persistence of its positivity, regardless of the patient's symptoms or radiological pattern. Thus, low CT values could be related to persistent infections.
ABSTRACT
Background: Coronavirus disease 2019 (COVID-19) is a rapidly spreading global emergency, causing significant damage to the global economy and health care. Knowledge and awareness are crucial elements in stimulating self-imposed preventive measures. Objectives: We evaluated the knowledge and awareness about COVID-19 and the practice of hygiene measures to prevent the spread of coronavirus disease. Methods: A prospective observational study was conducted in Karachi, Pakistan, between March 01 and March 25, 2020, using a non-probability consecutive sampling technique. All individuals aged 18 years or above were included in the study. The individuals who had no formal education were excluded from the study. A self-reported questionnaire assessing knowledge, awareness, and practices was distributed among the participants. Results: The mean age +or- SD of the study population was 29.11 +or- 7.8 years. In our study, 424 (98.6%) participants knew that a virus causes COVID-19, and most were knowledgeable about the disease's transmission mode. Higher education status and the medical profession were associated with the better practice of preventive measures. Conclusions: We recommend that knowledge about COVID-19 and preventive measures be spread across the country via electronic media.