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1.
Topics in Antiviral Medicine ; 30(1 SUPPL):4, 2022.
Article in English | EMBASE | ID: covidwho-1880744

ABSTRACT

Sharp declines in the incidence of hepatitis C virus (HCV) have coincided with unrestricted access to direct-acting antivirals (DAA) against HCV, particularly among PLHIV in clinical care. However, rates of HCV reinfection are still high among specific key populations at risk of or living with HIV. This presentation begins with a case highlighting one individual's experience with PrEP use and HCV re-infection. An overview is then provided of the most recent data on the risk of HCV primary and re-infection among key populations, focusing on MSM and PWID. The potential effect of COVID-19 restrictions on HCV infection rates is also addressed. Issues regarding the role of testing, early diagnosis, and treatment in the acute phase of HCV infection, as well as the implications surrounding chemsex, are explored and recommendations for a comprehensive strategy to prevent new HCV infections are provided.

2.
2022 International Conference on Communication, Computing and Internet of Things, IC3IoT 2022 ; 2022.
Article in English | Scopus | ID: covidwho-1874251

ABSTRACT

There have been significant revolutions in various fields like medical and education on account of improved technological advancements. Furthermore, there have been numerous cases where Machine Learning has been of great help to healthcare by analyzing data and in decision making. Early diagnosis of Covid will help reduce the transmission rate and prevent an outbreak or slow down its spread. COVID-19 is a pandemic which is spreading really fast, affecting and killing millions around the globe and this needs to be addressed soon. Big data has been growing rapidly and there are many public datasets available related to COVID-19. ML could aid in the detection of the disease to bring the current chaotic situation under control. Various machine learning algorithms have been applied in this paper to build the most accurate model that can analyses symptoms of a person and predict if they are covid positive or not using a dataset from Kaggle. The performance of each model was analyzed according to different scoring metrics like accuracy measures, R squared, Precision, ROC curve and on how long the model took to be trained. It can be inferred from this paper that Decision Tree Classifier surpasses all the other algorithms by 98.29% accuracy. © 2022 IEEE.

3.
2022 International Conference on Decision Aid Sciences and Applications, DASA 2022 ; : 1391-1395, 2022.
Article in English | Scopus | ID: covidwho-1874173

ABSTRACT

The Covid-19 virus, which emerged in China and affected the whole world, resulted in the death of many people in a short time and caused many socio-economic problems. This virus, which is mostly seen in patients with chronic diseases, has been seen worldwide in cases where it progressed rapidly and resulted in death in healthy individuals. Early diagnosis is one of the most important things to be done for this virus, which has such great effects. It is necessary to minimize the risk by treating the patient after being diagnosed and isolated early. The long time elapsed while providing diagnosis in current diagnostic methods potentially increases the course of the virus. For this reason, it has been deemed necessary to investigate some alternative ways for the diagnosis of Covid-19. In this sense, a study area has been created because radiological images have the defining characteristics of the virus. In this study, Covid-19, pneumonia and normal classification was made using X-Ray images. Then, we tried to determine the area affected by the Covid-19 virus using the U-Net system for image tissue classification. It is aimed to provide early detection and reduce workload with deep learning techniques to be used to solve these problems. © 2022 IEEE.

4.
Turkiye Klinikleri Dermatoloji ; 32(1):29-36, 2022.
Article in English | EMBASE | ID: covidwho-1870006

ABSTRACT

Objective: The coronavirus disease-2019 (COVID-19) pandemic has caused delays in the diagnosis and treatment of some oncological diseases. This study aimed to reveal the effect of the COVID-19 pandemic on the frequency of diagnosis of non-melanoma skin cancers (NMSC) and the demographic characteristics of patients. Material and Methods: Patients aged over 18 years, who were histopathologically diagnosed with basal cell carcinoma (BCC) or squamous cell carcinoma (SCC) between March 12, 2019 and March 11, 2021 were included in the study. The demographic characteristics of these patients, the number of total skin biopsies, and the number of BCC and SCC biopsies were compared between the pre-pandemic and pandemic periods, based on the date of March 12, 2020, when the pandemic measures began to be implemented in Turkey. Results: With the pandemic, there was a 26.7% decrease in the total skin biopsies and a 21% decrease in the total NMSC biopsies. Despite a 34% decrease in the number of biopsies for the diagnosis of BCC, a 15.8% increase was observed in the number of biopsies for the diagnosis of SCC. The frequency of excisional biopsies was observed to increase among the patients with BCC and SCC during the pandemic period (p=0.004 and p=0.001, respectively). Conclusion: The number of total skin biopsies and total NMSC biopsies significantly decreased during the pandemic period. The health system should be reorganized to effectively handle pandemics and similar crisis periods, and new strategies should be determined regarding patient education, early diagnosis, and treatment approaches for NMSC.

5.
Neurologia Argentina ; 14(1):13-25, 2022.
Article in English | EMBASE | ID: covidwho-1867624

ABSTRACT

Introduction: The Argentine Hemorrhagic Fever (AHF) or stubble disease is one of the most frequent endemic zoonoses. Restricted to the farming areas of the Central West region of Argentina, it is produced by the Junín virus and it is transmitted by a rodent, the corn-mouse (Calomys musculinus). Objectives: To recognize the neurological signs and symptoms of AHF that appear in the first 24-48 hours of the onset of the disease. To describe the sequence of neurological manifestations in its common and severe clinical forms. Also, of the sequelae and late neurological complications Content: Early diagnosis and timely intervention define the clinical evolution and prognosis. Attention must be paid to previously healthy adult patients undergoing “acute nonspecific febrile syndrome” of an unknown cause for less than a week of evolution. Differential diagnosis should be made with other endemic infectious diseases, and the emerging infectious disease COVID 19, appraising epidemiological surveillance. Conclusions: Clinical examination, laboratory tests, serological diagnosis and images allow the early diagnosis. In Argentine Hemorrhagic Fever, immune plasma therapy within the 5 days of the onset of the disease prevents progression towards severe clinical forms with high mortality rates. The fatality rate for FHA without treatment is 30%. Early convalescent plasma treatment reduced the general mortality rate to 1%.

6.
National Journal of Physiology, Pharmacy and Pharmacology ; 12(5):632-638, 2022.
Article in English | EMBASE | ID: covidwho-1863185

ABSTRACT

Background: The most common teaching method in medical institutes in India and throughout the globe is standard lesson-based teaching. E-learning is the use of internet technology to facilitate conscious learning and increase knowledge and competences, notably during the COVID-19 epidemic. Aim and Objectives: The aim of study was to develop a module for an interactive disease-based e-learning teaching session to impart knowledge to undergraduate medical students regarding the microbiological diagnostic techniques for enteric fever/the given organism with objectives of the study was (i) to investigate how Phase II MBBS students feel about e-learning;(ii) to evaluate the impact of this intervention on students;and (iii) to encourage application of this imparted knowledge and skill for rapid, precise, and early diagnosis of the disease. Material and Methods: The research was conducted at the department of microbiology. This was done for the session 2020–2021 of Phase II undergraduate students. All the second professional MBBS were enrolled in the study n = 229 and were better informed about the definition of e-learning. The course material was provided in the form of PowerPoint presentations, questionnaires, and text questions using Google Docs. Students provided feedback in the form of a semi-structured pre-validated set of questions at the conclusion of the week, and the collected data were quantitatively analyzed. There were both closed-ended and open-ended questions in the survey. Results: The results of the feedback questionnaire revealed that the program was of benefit to the students. Nearly 77% of students felt the new teaching and learning method enhanced their grasp of the courses and that the issues presented were important to them. Conclusion: The students responded in a positive way to the new teaching and learning method. It was informative, applicable, and effective to the students. It also increased the level of communication and feedback between teacher and students. To conclude, in the medical program, e-resources may be used to enhance conventional lesson-based instruction.

7.
Acta Informatica Medica ; 30(1):76-80, 2022.
Article in English | EMBASE | ID: covidwho-1863180

ABSTRACT

Background: Acute left ventricular free wall rupture (LVFWR) is a life-threatening complication of myocardial infarction that requires urgent intervention. Surgical repair has continued to be the treatment of choice. Studies suggest a posterolateral or inferior infarction is more likely to result in free wall rupture than an anterior infarction. LVFWR generally results in death within minutes of the onset of recurrent chest pain, and on average was associated with a median survival time of 8 hours. Prompt diagnosis and management can lead to successful treatment for LVFWR. Objective: The aim of this article was to present an emergency case with an LVFWR in a COVID-19 patient who suffers from AMI and was treated with PCI stents in the ramus intermedius and circumflex coronary artery. Case report: We present an emergency case with an LVFWR in a COVID-19 patient who suffers from AMI and was treated with PCI stents in the ramus intermedius and circumflex coronary artery. Although dual antiplatelet therapy introduction and good outcome of PCI were achieved, soon after instant thrombosis of both stents appear to result in transmural necrosis and LVFWR. Urgent catheterization was performed and diagnosed in-stent thrombosis where the ventriculography confirmed LVFWR of the posteroinferior wall. Urgent surgery was performed. Transmural necrosis was noticed alongside the incision line. The incision is sawn with 4 U-stitches (Prolen 2.0 with Teflon buttressed stitches). Another layer of fixation was made by Prolen 2.0 running stitches reinforced with Teflon felts from both sides. A large PTFE patch was fixed to epicardium over the suture line by Prolen 6.0 running stitch and BioGlue was injected in-between patch and LV (Figures 8 and 9). After aortic cross-clamp removal, the sinus rhythm was restored. Conclusion: Despite the high mortality, the urgency and the complexity of surgical treatment the early diagnosis plays a key role in the management of postinfarction LVFWR patients presenting a case of preserved postoperative left ventricular function and accomplished good functional status as presented in our case.

8.
Egyptian Journal of Radiology and Nuclear Medicine ; 53(1), 2022.
Article in English | EMBASE | ID: covidwho-1862180

ABSTRACT

Mucormycosis is an aggressive invasive fungal infection caused by mycocetes fungi. It is an opportunistic infection, associated with high morbidity and mortality. In the current era of COVID-19 pandemic, the entire world has witnessed a dramatic upsurge in cases of Mucormycosis. Paranasal sinuses are the commonest site to be affected with the tendency for rapid spread to orbit, face, and brain. Early diagnosis and prompt medical or surgical intervention are the only ways for preventing morbidity and saving precious lives. Imaging plays a crucial role not only in diagnosis but also in defining the extent of the disease for presurgical mapping. Black turbinate sign in the nasal cavity, mucosal thickening in paranasal sinuses with periantral invasion, and bony erosion are the early diagnostic signs. This pictorial review shall provide a comprehensive review of the various imaging manifestations of rhino-orbito-cerebral mucormycosis with a final proposed reporting checklist.

9.
Diagnostics (Basel) ; 12(5)2022 May 01.
Article in English | MEDLINE | ID: covidwho-1862745

ABSTRACT

Diagnostic laboratory tools are essential to keep everyone safe and track newly emerging variants; on the other hand, "filter" screening tests recognizing positivity are valuable tools to avoid hectic laboratory work that, besides COVID-19, are also part of the routine. Therefore, complementary assays, such as rapid antigen tests (RATs), are essential in controlling and monitoring virus spread within the community, especially in the asymptomatic population. A subset of nasopharyngeal swab specimens resulted in SARS-CoV-2 positive and investigated for genomic characterization were used for RAT validation. RATs were performed immediately after sampling, following the manufacturer's instructions (reading at 15 min). RT-PCRs were carried out within 24 h of specimens' collection. Out of 603 patients, 145 (24.05%) tested positive by RT-PCR and RAT and 451 (74.79%) tested negative by both methods; discordant results (RT-PCR+/RAT- or RT-PCR-/RAT+) were obtained in 7 patients (1.16%). RATs' overall specificity and sensitivity were 96.03% (95%CI: 91.55-98.53%) and 99.78% (95%CI: 98.77-99.99%), respectively, taking RT-PCR as the reference. Overall, RAT negative predictive value was 98.69% (95%CI 97.17-99.40%). The GeneFinder COVID-19 Ag Plus Rapid Test performed well as a screening test for early diagnosis of COVID-19, especially in asymptomatic subjects. The data suggested that patients with RT-PCR-proven COVID-19 testing negative by RAT are unlikely to be infectious. GeneFinder COVID-19 Ag Plus Rapid Test also works on variants of concern (VOC) delta and omicron BA.1 and BA.2.

10.
Lung India ; 39(SUPPL 1):S140, 2022.
Article in English | EMBASE | ID: covidwho-1857660

ABSTRACT

Background: Pulmonary Mucormycosis was rare pulmonary fungal disease ,which was difficult to diagnose early and lack effective treatment but during COVID-19 pandemic the testing modalities have become handy , usually it used to occur in immune compromised patients , present days post Covid pulmonary mucor has become common. Case Study: A case of 60yrs old male patient , hypertensive, post Covid presented with cough associated with black coloured sputum, also with streaky haemoptysis and sob on exertion ,CT chest revealed left upper lobe thick walled cavity with reverse halo sign with lower septated cavity , with post covid lung fibrosis. Discussion: Pulmonary Mucormycosis may develop by inhalation of spores or by hematogenous or lymphatic spread, mostly seen in immune compromised patient, the sequelae include angioinvasion and direct tissue injury it may cause severe morbidity and mortality sputum and BAL cultures and radiological investigations are the crucial modalities for diagnosis sputum and BAL cytology may be inconclusive however early diagnosis will prevent the patient from life threatening complications and at times alternative drugs in unavoidable situations can prevent patient from life threatening complications. Conclusion: Different scenarios may be challenging.

11.
Lung India ; 39(SUPPL 1):S219-S220, 2022.
Article in English | EMBASE | ID: covidwho-1857659

ABSTRACT

Background: Invasive fungal infections are an important cause of morbidity and mortality in immunocompromised patients. These infections remain difficult to diagnose and their management is complicated by their aggressive course of disease. Discussion: A 50yrs old female, case of rheumatoid arthritis on treatment, post covid presented in a state of DKA with complaints of fever, cough, breathlessness and right sided pleuritic chest pain for >1 month with 2-3 episodes of minimal hemoptysis. CXR s/o Right middle lobe cavity lesion. Bronchoscopy: Right UL bronchial segments inflamed, irregular sloughed mucosa with endobronchial narrowing, biopsy obtained. HPE s/o mucormycosis Patient started on IV antibiotics & antifungals. Thoracotomy- Right upper and middle lobectomy done on day 8 of hospitalization. Right upper lobe had two large necrotic thick walled cavities with blackish slough. On post-op day 4 patient developed large air leak in ICD s/o BPF. Second thoracotomy for BPF repair done after 7weeks of 1stsurgery. Patient had respiratory distress after extubation. CXR showed right opaque hemithorax with pull of mediastinum. Required urgent bronchoscopy to remove endobronchial mucus plug. Conclusion: Prognosis and outcome have improved as a result of early diagnosis, newer antifungals agents & surgical debridement. Antifungal treatment, surgical interventions & high risk of post surgical complications in an immunocompromised elderly host is grave challenge. But our case had a positive clinical outcome.

12.
Lung India ; 39(SUPPL 1):S219, 2022.
Article in English | EMBASE | ID: covidwho-1857599

ABSTRACT

Background: Pulmonary mucormycosis, a rare pulmonary fungal disease, is difficult to diagnose and lacks effective treatment. Diabetes mellitus, systemic corticosteroid therapy, neutropenia, hematologic malignancies, stem cell transplant, Covid-19 infection and immunocompromised state are the predisposing situations for mucormycosis. There are no reliable serological, PCR-based, or skin tests. Bronchoscopy guided biopsy proved to be effective for early diagnosis. Case Study: A 47 years old female patient, known Diabetic, presented with complains of Dry Cough and fever. Patient had past history of COVID-19 pneumonia. HRCT showed mucus plugging with collapse of left lower lobe. During Bronchoscopy, mucus plug was difficult to extract despite using mucolytics;then biopsy was taken which turned out to be MUCORMYCOSIS. Patient was treated with injectable Amphotericin B for 4-weeks and then Tablet Posaconazole. Patient was improved on follow up. Discussion: Pulmonary Mucormycosis is a rapidly progressive infection that occurs after inhalation of spores. Most patients are presented with fever, cough and hemoptysis. After Covid-19 pandemic, cases of mucormycosis are on rise. Pulmonary Mucormycosis is rare entity than Rhino-orbito-cerebral mucormycosis. Biopsy remains mainstay for diagnosis. Conclusion: Pulmonary Mucormycosis being rare lifethreatening opportunistic infection;early diagnosis and treatment is necessary for better outcome and survival.

13.
Pharmacologyonline ; 3:67-72, 2021.
Article in English | EMBASE | ID: covidwho-1857570

ABSTRACT

Combined immunodeficiencies (CID) are a heterogeneous group of human inborn errors of immunity with varying severity. We present a clinical case of CID (T-B+NK+), suspected by TREC assay in a 2.5-month-old child. The peculiarity of this case is the course of the disease, which, on the one hand, was characterized by a recurrent pneumonia, which was confirmed by X-ray. On the other hand, there were sudden shortness of breath, which were accompanied by cyanosis, irritation and were resistant to bronchodilator and antibacterial therapy. Appearance of venous thrombosis and progressive multiple organ failure led to the death of the child. Thrombocytosis, increased D-dimer level, and signs of hypercoagulation, positive immunoglobulin G antibodies to SARS-CoV-2 cannot rule out the role of COVID-19 in the course of the disease. Early diagnosis of combined immunodeficiencies in children can be difficult due to the atypical course, unusual symptoms of the disease, especially when they combined with other conditions. The use of newborn screening for SCID using TREC assay will allow timely detection of inborn errors of immunity with T-lymphopenia.

14.
Lung India ; 39(SUPPL 1):S145-S146, 2022.
Article in English | EMBASE | ID: covidwho-1857522

ABSTRACT

Background: Pneumothorax has been noted to be a complication of covid19 pneumonia caused by SARSCOV2 requiring hospitalization and increasing mortality. Case Study: A series of 10 cases of spontaneous pneumothorax in patients with covid19 pneumonia either RTPCR positive or radiological positive admitted into a tertiary care centre from April 2021 to September 2021. Discussion: Of 10 cases of pneumothorax, 8 were confirmed covid19 positive by RTPCR and 2 were radiologically diagnosed based on CT imaging. None of them had previous lung disease, 2 were smokers and 1 had prolonged biomass fuel exposure. 3 of them were kept on NIV support and others required oxygen with facemask. All patients had moderate to severe disease with bilateral GGOs. All of them had acute onset of chest pain, drop in saturation and increased respiratory rate. All the patients were managed with ICD insertion and oxygen supplementation. Out 10 patients, 5 patients had favorable outcome and discharged and death occurred in 5 patients. Conclusion: Acute deterioration in a patient with covid19 pneumonia indicate a pneumothorax which may occur even in the absence of pre-existing lung disease and mechanical ventilation. Early diagnosis and management of this complication is necessary to prevent the risk of mortality.

15.
Lung India ; 39(SUPPL 1):S82, 2022.
Article in English | EMBASE | ID: covidwho-1857363

ABSTRACT

Introduction: Novel coronavirus disease started in December 2019 and declared pandemic on march 11 2020. Viral pneumonia increases patients susceptibility to bacterial and fungal infections and those who were admitted to ICU had a higher probability of infection. Case Report: A 33yr old female came to the hospital with chief complaints of cough with expectoration associated with streaky haemoptysis and generalised weakness since 20 days. There was a h/o hospital admission for covid and patient was on NIV support. Patient was denovo diabetic. On examination pallor present and decreased breath sounds in bilateral infrascapular and infraaxillary areas. Investigations: Chest X ray showed bilateral mid and lowerzone non-homogenous opacities. Sputum for AFB, CBNAAT and KOH were negative. Sputum culture & sensitivity showed streptococcus. HRCT chest was done which showed multiple cavitary lesions in bilateral lung fields. Bronchoscopy was done and washings showed branching septate hyphae on KOH mount suggestive of aspergillosis. Patient was started on antifungals and symptomatic improvement was seen. Conclusion: Pulmonary aspergillosis is a serious complication in postcovid patients and high index of clinical suspicion and focused diagnostic approach is essential for early diagnosis and treatment which may improve the outcome.

16.
Lung India ; 39(SUPPL 1):S157, 2022.
Article in English | EMBASE | ID: covidwho-1857209

ABSTRACT

Background: A patient presenting with cavitatory lung lesions offers a variety of differential diagnosis to the treating chest physician. It varies from acute and chronic infections, systemic illnesses and malignancy.[1] Arriving at a proper diagnosis and proceeding to next step of management is very challenging. Case Study: Case 1: 27 male, day 10 of COVID-19 infection, presented with hemoptysis. HRCT Thorax showed bilateral cavitatory lung lesions. Serum Aspergillus IgM and sputum Galactomannan positive. He was started on Injectable liposomal Amphotericin-B. Patient improved. Case 2: 48 male, post COVID, presented with breathlessness and headache. He was diagnosed with Right maxillary mucormycosis. HRCT Thorax showed right lung cavitatory lesion. Started on Injectable liposomal Amphotericin-B. The patient underwent Right side Bilobectomy as there was no improvement. Antifungal medications continued and patient improved. Case 3: 42 year old male, post COVID, presented with headache and fever and diagnosed as left maxillary mucormycosis. Chest X-ray showed right side cavitatory lung lesion. Started on liposomal Amphotericin-B and Posaconazole. Patient was inoperable as he developed bilateral pneumothorax, for which left sided ICD inserted. Patient improved with antifungal therapy. Discussion: Case 2 required surgical intervention, while case 1 and case 3 improved with medical management. A multidisciplinary team was involved in the management. Early diagnosis is the cornerstone for management. Conclusion: Each patient of post COVID cavitatory lung lesion should be assessed properly and to be treated by individualised approach rather than a generalised approach. Newer antifungals and combination antifungals should be further explored along with surgical management.

17.
Lung India ; 39(SUPPL 1):S233-S234, 2022.
Article in English | EMBASE | ID: covidwho-1857061

ABSTRACT

Background: Wegener's granulomatosis (Granulomatosis with polyangiitis) is a rare systemic autoimmune disease of unknown etiology characterised by triad of necrotising granulomatous inflammation of upper and lower respiratory tract, glomerulonephritis, and disseminated vasculitis. Case Study: A 50 year old female presented with complaints of running nose since last 8 months. Patient also had low grade fever, generalised body pain, productive cough, shortness of breath on exertion, pedal oedema for last 2 months. She had an 2-3 episodes of blood in sputum 15 days back. On examination saddle nose found. HRCT chest shows multiple cavitating nodules with consolidation. Lab findings shows raised ESR, CRP, COVID RT PCR negative and positive C-ANCA (Anti neutrophilic cytoplasmic antibody), red blood cell casts, and albumin present in urine. Sputum for AFB negative. Patient discharged on corticosteroids and cyclophosphamide and advised for regular follow up. Discussion: Wegener's granulomatosis is an antineutrophilic cytoplasmic antibody associated small vessel vasculitis. Prevalence of this disease varies from 3/1,00,000 to 16/1,00,000. Typically this involve the lungs and kidneys. It can be of generalised severe form or localised limited form. Our patient clinical course, CT findings and his strongly positive C-ANCA were considered diagnostic of wegener's granulomatosis. Treatment include corticosteroids and immunosuppressants. Conclusion: The early diagnosis and prompt treatment of multisystem disorder is necessary to prevent complication such as diffuse alveolar haemorrhage CT is the imaging modality of choice for diagnosis, surveillance and follow up in patients with wegener's granulomatosis.

18.
Lung India ; 39(SUPPL 1):S65, 2022.
Article in English | EMBASE | ID: covidwho-1856985

ABSTRACT

Background: TB and COVID 19 have similar presentation. This study Aims to identify the problems and difficulties faced by TB patients during COVID 19 pandemic and Lockdown. Methods: A 35 Questionnaire based study where a total of 100 diagnosed TB cases in DOTS OPD were asked regarding the difficulties faced by TB patients for Diagnosis of TB and starting treatment, and also the ease of availability of consultation, anti TB drugs, Investigations and counselling during the period of pandemic and lockdown. Results: Out of 100 patients diagnosed with TB, 42% were COVID 19 suspects, 38% had symptoms for <1month which helped in early diagnosis of TB. 6% patients had symptoms for > 6 months. 27% patients faced problems getting diagnosed, of which 51.8% had travel difficulty, 29.6 % - financial, 18.5 % - lack of health care access, 19% of the patients had no access to high protein diet during lockdown. 31% of patients had side effects due to AKT, Vomiting 74%, 16% Itching, 9.6% Joint pains. 57% patients required admission. All patients were satisfied about counselling regarding disease and treatment course. Patients reported for follow up after 6.7 days on average. Conclusion: TB patients faced difficulties during COVID 19 pandemic.

19.
Lung India ; 39(SUPPL 1):S70-S71, 2022.
Article in English | EMBASE | ID: covidwho-1856956

ABSTRACT

Objectives: Aspergillus is a ubiquitous mold, which causes a wide spectrum of illnesses. Pulmonary disease is caused mainly by Aspergillus fumigatus. Pulmonary aspergillosis is a common infection in the immunocompromised, but it is also seen in patients with chronic debilitating diseases who require corticosteroids and/or immunosuppressive therapy. The aim of this work was to focus on the diagnosis of invasive pulmonary aspergillosis (IPA), with the use of a relatively new test, Galactomannan assay. Methods: We report a case series of 6 patients with suspected fungal infection over the course of 2020-2021. The diagnosis of IPA was obtained by use of galactomannan assay. Patients underwent routine sputum examination, and when indicated, bronchoscopy. Sputum and/or BAL fungal cultures were negative for all patients. Results: The patients mean age was 48.3±12 years. The most common clinical presentation was cough with expectoration. Comorbidities included past history of pulmonary tuberculosis (1), severe COVID-19(1), HIV infection (1), chronic kidney disease (1) and diabetes mellitus (2). Galactomannan levels were obtained in BAL in five patients, and serum in one patient. All patients were given voriconazole. Outcome was favourable in all patients. Conclusion: Galactomannan is a polysaccharide cell wall component of Aspergillus species which is released during fungal growth. ELISA is capable of detecting galactomannan levels at concentrations as low as 0.5ng/ mL. It is a non- invasive test with high specificity that can be used both for diagnosis as well as for monitoring of patients. Serum galactomannan levels, though diagnostic, become positive later in the disease. BAL galactomannan provides an early diagnosis.

20.
Medicina (Brazil) ; 55(1), 2022.
Article in English | EMBASE | ID: covidwho-1856328

ABSTRACT

Introduction: despite being the country with the highest average age globally, Japan has stood out in the fight against the COVID-19 (Coronavirus Disease 2019) pandemic by presenting low contamination rates by the virus and mortality. Objective: we aim to discuss the health strategies adopted by Japan in the face of the COVID-19 disease pandemic, as well as to evaluate data on Japanese contamination and mortality compared to the other four countries with the highest average age in the world (Italy, Germany, Portugal and Spain) and Brazil. Methodology: the search was carried out to evaluate Japanese health strategies by using the following databases: PubMed, Cochrane, and Scielo using a combination of the terms "Japan", "covid", "coronavirus" and "health systems" in English, Spanish and Portuguese. The COVID-19 infection data was extracted from the Our World in Data website, from January 25, 2020, to July 30, 2020. Results: Among the measures adopted by the country to face the pandemic, the early diagnosis and response to infection, contact tracing, early diagnosis and availability of intensive care for critically ill patients, and encouraging behavioral distancing measures stand out. Among the countries analyzed, Japan has the lowest rates of contamination and mortality in absolute terms by COVID-19. Conclusions: social distancing measures, early diagnosis, and treatment seem to have contributed to the success in combating COVID-19 in Japan. In the studied period, in a million inhabitants, Japan had 6.13 cases of covid while Brazil had 218.26 cases. As for the number of deaths confirmed by the disease, the first had a rate of 0.23 while the second had 5.16 cases per million inhabitants. Based on the knowledge of these measures, it is possible to seek similar mechanisms when designing health policies to face pandemics in other countries.

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