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1.
Pamukkale Medical Journal ; 14(2):438-442, 2021.
Article in Turkish | ProQuest Central | ID: covidwho-1965064

ABSTRACT

Giriş: 11 Mart tarihinde, Dünya Sağlık Örgütü (DSÖ) tarafından ilan edilen COVÍD-19 salgını sonrası, Mart’ın ikinci haftasından itibaren ülkemizde olgular bildirilmiştir. COVÍD-19 olgularının %5’inde hastalığın seyri sırasında yoğun bakıma ünitesine (YBÜ) yatış ihtiyacı gelişmektedir. Bu çalışma ile YBÜ’de izlediğimiz kritik durumdaki COVÍD-19 hastalarının klinik özelliklerinin tanınması, takip ve tedavisinin değerlendirilmesi amaçlanmıştır. Gereç ve yöntem: Bu çalışmada;Mart-Haziran 2020 tarihleri arasında, COVÍD-19 enfeksiyonu tanısı alan 180 hastanın, Dahiliye YBÜ’ye kabul edilen 18 (%12,2) hasta değerlendirilmiştir. Bulgular: YBÜ'ye kabul edilen 18 hastadan 13'ünün (%72,2) invaziv solunum desteğine ihtiyacı vardı. Geri kalan hastalara (5 hasta, %27,8) non-invaziv ventilasyon tedavisi uygulandı. Hastaların 16'sında (%88,9) en az bir komorbiditeye rastlandı. Yoğun bakım ünitesine yatan hastaların, 28 günlük mortalitesi %55,6 iken hastane mortalitesi %61,1 idi. 60 günlük mortalite ise %66,7 olarak bulundu. Tartışma: YBÜ’ye kabul oranımız ve ölüm oranlarımız Çin, Amerika ve Ítalya’dan bildirilen çalışmalara göre daha yüksek bulunmuş ve bunun muhtemel sebeplerinin hastaların ciddiyeti, invaziv mekanik ventilasyon ihtiyacı olduğu düşünülmüştür. Sonuç: Bu çalışma sonuçlarına göre COVÍD-19 kritik seyirli hastaların risk faktörleri, takip ve tedavisinde kullandığımız yöntemler ortaya konulmuştur. Bu sonuçların gelecekteki takip ve tedavi yöntemlerine katkı sağlayabileceği düşünülmekle birlikte yeni çalışmalara ihtiyaç vardır.Alternate :Introduction: After the COVID-19 outbreak announced by the World Health Organization (WHO) on March 11, cases have been reported in our country since the second week of March. In COVID-19 cases, the need for intensive care hospitalization develops in 5% during the course of the disease. With this study, it was aimed to recognize the characteristics, follow-up and treatment of patients in critical condition for COVID-19 in the intensive care unit (ICU). Materials and methods: Between March and June 2020, 180 adult patients were diagnosed with COVID-19, and 18 (12.2%) of them were admitted to Internal Medicine ICU Results: Thirteen (72.2%) of 18 patients admitted to the ICU needed invasive respiratory support. Non-invasive ventilation therapy was applied to the remaining patients (5 patients, 27.8%). At least one comorbidity was found in 16 of the patients (88.9%). 28-day mortality of patients hospitalized in the intensive care unit was 55.6%, while hospital mortality was 61.1%. 60-day mortality was found as 66.7%. Discussion: Although our admission rate to the Intensive Care Unit and our mortality rates were higher than the studies reported from China, America and Italy, it was thought that the possible reasons for this were due to the severity of the patients, the higher need for invasive mechanical ventilation. Conclusion: This study, in which the risk factors of COVID-19 patients with critical course, and the results of the methods we use in their follow-up and treatment, are thought to contribute to future follow-up and treatment methods, but new studies are needed.

2.
Biology ; 11(7):992, 2022.
Article in English | ProQuest Central | ID: covidwho-1963699

ABSTRACT

Simple SummaryWearing a face mask can block and reduce the exposure of the oronasopharyngeal region to viruses. It is unclear whether wearing a surgical mask (SM) or a three-dimensional (3D) SM (3DSM) during high-intensity, short-rest resistance exercise could influence the cardiac capacity, pulmonary function, and comfort in weightlifters. Wearing both SM and 3DSM during whole-body, high-intensity, short-rest resistance exercise exerted no detrimental effect on blood pressure (BP) or pulmonary function and promoted postexercise hypotension (PEH). Furthermore, wearing a typical SM during exercise produced higher breathing resistance and tightness than did wearing a 3DSM or no mask.This study investigated the effect of wearing a typical surgical mask (SM) or a three-dimensional (3D) SM (3DSM) during whole-body, high-intensity, short-rest resistance exercise on cardiorespiratory, respiratory, and perceptual comfort responses in weightlifters. Twenty elite weightlifters (6 women and 14 men;age = 24.1 ± 4.9 years;height: 167.45 ± 7.60 cm;body mass = 76.48 ± 19.86 kg) who participated in this study performed 3 resistance exercise sessions in a randomized order: (1) without a mask (NM), (2) while wearing a typical SM, and (3) while wearing a 3DSM. Resistance exercise consisted of a descending pyramid scheme starting at 10 repetitions, with a decrease of one repetition per set for the back squat, bench press, and deadlift, as fast as possible at 75% of the one-repetition maximum. Cardiorespiratory and pulmonary function and comfort were measured. Across all conditions, effective postexercise hypotension (PEH) was noted in terms of decreased systolic blood pressure (−4.64%), diastolic BP (−5.36%), mean arterial pressure (−5.02%), and ankle–brachial index (−6.84%). However, the heart rate (40.34%) and rate of pressure product (33.60%) increased, and no effects on pulmonary function were observed in the three conditions. The participants reported higher breathing resistance and tightness when wearing a typical SM than when wearing a 3DSM or no mask. Therefore, both wearing and not wearing a face mask during whole-body, high-intensity, short-rest resistance exercise promoted PEH and exerted no detrimental effect on pulmonary function. Coaches, trainers, and athletes should consider wearing a 3DSM during resistance exercise.

3.
IEEE Access ; : 1-1, 2022.
Article in English | Scopus | ID: covidwho-1961361

ABSTRACT

Recently, healthcare stakeholders have orchestrated steps to strengthen and curb the COVID-19 wave. There has been a surge in vaccinations to curb the virus wave, but it is crucial to strengthen our healthcare resources to fight COVID-19 and like pandemics. Recent researchers have suggested effective forecasting models for COVID-19 transmission rate, spread, and the number of positive cases, but the focus on healthcare resources to meet the current spread is not discussed. Motivated from the gap, in this paper, we propose a scheme, <italic>ABV-CoViD</italic> (Availibility of Beds and Ventilators for COVID-19 patients), that forms an ensemble forecasting model to predict the availability of beds and ventilators (ABV) for the COVID-19 patients. The scheme considers a region-wise demarcation for the allotment of beds and ventilators (BV), termed resources, based on region-wise ABV and COVID-19 positive patients (inside the hospitals occupying the BV resource). We consider an integration of artificial neural network (ANN) and auto-regressive integrated neural network (ARIMA) model to address both the linear and non-linear dependencies. We also consider the effective wave spread of COVID-19 on external patients (not occupying the BV resources) through a θ- ARNN model, which gives us long-term complex dependencies of BV resources in the future time window. We have considered the COVID-19 healthcare dataset on 3 USA regions (Illinois, Michigan, and Indiana) for testing our ensemble forecasting scheme from January 2021 to May 2022. We evaluated our scheme in terms of statistical performance metrics and validated that ensemble methods have higher accuracy. In simulation, for linear modelling, we considered the <italic>ARIMA</italic>(1, 0, 12) model, and <italic>N</italic>8-3-2 model for ANN modelling. We considered the θ- <italic>ARNN</italic>(12, 6) forecasting. On a population of 2, 93, 90, 897, the obtained mean absolute error (MAE) on average for 3 regions is 170.5514. The average root means square error (RMSE) of θ-ARNN is 333.18, with an accuracy of 98.876%, which shows the scheme’s efficacy in ABV measurement over conventional and manual resource allocation schemes. Author

4.
IEEE Robotics and Automation Letters ; : 1-8, 2022.
Article in English | Scopus | ID: covidwho-1961414

ABSTRACT

We design a central controller system (CCS) and a tele-controlled system (TCS) with an aim of developing the integrated tele-monitoring/operation system that can enable the medical staff to tele-monitor the state of therapeutic devices utilized in the isolation intensive care unit (ICU) and to tele-operate its user interfaces. To achieve this aim, we survey the medical staff for medical requirements first and define the design guideline for tele-monitoring/operation functionality and field applicability. In designing the CCS, we focus on realizing the device having intuitive and user-friendly interfaces so that the medical staff can use the device conveniently without pre-training. Further, we attempt to implement the TCS capable of manipulating various types of user interfaces of the therapeutic device (e.g., touch screen, buttons, and knobs) without failure. As two core components of the TCS, the precision XY-positioner having a maximum positioning error of about 0.695 mm and the end-effector having three-degrees-of-freedom motion (i.e., pressing, gripping, and rotating) are applied to the system. In the experiment conducted for assessing functionality, it is investigated that the time taken to complete the tele-operation after logging into the CCS is less than 1 minute. Furthermore, the result of field demonstration for focus group shows that the proposed system could be applied practically to the medical fields when the functional reliability is improved. IEEE

5.
Era's Journal of Medical Research ; 8(2):190-193, 2021.
Article in English | ProQuest Central | ID: covidwho-1955360

ABSTRACT

Serum cortisol concentration indicates the severity of the underlying condition. More severe disease results in increased cortisol concentrations in the blood, increasing the probability of a catastrophic outcome. A high level of serum cortisol is found in patients with community-acquired pneumonia, and these patients are more likely to develop major complications and death. Corticosteroids are endogenous hormones that are produced by the hypothalamus pituitary adrenal pathway, which is involved for stress response. Considering, known risk factors of endocrine disturbance, there has been minimal discussion on measuring the serum cortisol concentration in COVID-19 patients. SARS-CoV-2 mediated pathogenetic pathways, may also affect endogenous steroid synthesis, particularly cortisol. For the purpose of improving survival rate in severe COVID-19 individuals, we discuss briefly about the current and new findings in the support of measuring the serum cortisol levels in severe COVID-19 individuals and facilitate better treatment management in this article.

6.
International Journal of Medical Dentistry ; 26(2):178-186, 2022.
Article in English | ProQuest Central | ID: covidwho-1939847

ABSTRACT

COVID-19 was recognized by the World Health Organization (WHO) as a pandemic disease since most of the countries reported significant numbers of deaths and infected people starting with December 2019 (WHO, 2020). The diversity of COVID-19 manifestations can be attributed to the sites where the SARS-Cov-2 receptors Angiotensin-converting Enzymes 2 (ACE2) were found, which include, but were not limited to, lung, kidney, salivary glands and gastrointestinal tract [1,12-14]. Dealing with COVID-19 had shown that many oral manifestations could be in direct relation to the infection itself. [...]another study [15] reported that at least one oral manifestation concerning the oral cavity and salivary gland was found on 67.2% of the 58 observed patients, in whom a dry mouth had the highest prevalence and gingival bleeding - the lowest. A P-value < 0.05 was considered significant. 3.RESULTS The link was distributed to a total of 515 patients tested positive with COVID-19, 512 of them having responded to the questionnaire (a response rate of 99%).

7.
Diabetes ; 71, 2022.
Article in English | ProQuest Central | ID: covidwho-1933502

ABSTRACT

Aim: To analyze the relationship between diagnosis of DM, Hyperglycemia of hospital admission and evolution of patients hospitalized for COVID-19 in the Sanatorium "Las Lomas" Asunción, Paraguay. Materials and methods: Observational, analytical, case-control, retrospective design. Total population: 304 patients. Study period: September 2020 to March 2021. Definitions: Controls (Group 1) : Demographically similar patients without diagnosis of DM or Hyperglycemia at hospital admission. Non-probabilistic sampling, consecutive cases. Cases: adult patients ≥18 years, both sexes, hospitalized for COVID-19 with diagnosis of DM (Group 2) or Hyperglycemia at admission without prior diagnosis of DM (Group 3) Admission hyperglycemia was considered 140 mg/dl. Results: Of the 304 patients selected: 100 were from Group 1 (G1) , 102 from Group 2 (G2) and 102 from Group 3 (G3) . The length of hospital stay was 7, 10 and 10 days, for G1, G2 and G3 respectively. Mortality was 5%, 10.7% (OR: 2.3 p: 0.12) and 11.7% (OR: 2.5 P: 0.08) for G1, G2 and G3 respectively. It was observed in G1, G2 and G3: the need for O2: 56%, 57.8% (OR: 1.07 p: 0.79) and 71.5% (OR: 2 p: 0.02) ;the use of high-flow cannula was necessary in 7%, 10,7% (OR: 1.6 p: 0.34) and 17.6% (OR: 2.8 p: 0.02) ;ICU admission in 11%, 25.4% (OR: 2.8 p: 0.007) 27.4% (OR: 3 p: 0.003) ;need for mechanical ventilation: 8%, 22.5% (OR: 3.3 p: 0.004) , 21.5% (OR: 3.1 p: 0.006) ;need for dialysis: 2%, 3.9% (OR: 2 p: 0.42) , 6.8% (OR: 3.6% p: 0.09) . The occurrence of complications: 11%, 30.3% (OR: 3.5 p: 0.000) , 34.3% (OR: 4,2 p: 0,000) Conclusion: The need for admission to ICU, mechanical ventilation, and occurrence of complications were significantly more frequent in patients with DM than controls. Mortality was no different statistically. In patients with hyperglycemia without prior diagnosis of DM, mortality was more frequent, but without statistical significance. The rest of the variables of bad evolution except the need for dialysis were all more frequent.

8.
Diabetes ; 71, 2022.
Article in English | ProQuest Central | ID: covidwho-1923969

ABSTRACT

Introduction: Diabetes is a risk factor for severe COVID-course. In this one-center report, we assessed clinical characteristics and risk factors associated with unfavorable outcomes in diabetic patients (DP) hospitalized due to COVID-19. Methods: We retrospectively analyzed data from a cohort of patients with confirmed SARS-CoV2 infection admitted to the University Hospital in Krakow (Poland) , a regional reference center for COVID-19, between March 6th 2020 and May 15th 2021. The data was collected from electronic medical records. Results: We included 5191 patients, mean age 61.98±16.66 years, 2348 (45.2%) women, 1364 (26.3%) DP. DP were older as compared to non-diabetics (median age 70 vs. 62 years, IQR 62-77 and 47-72, p<0.001) with similar gender distribution. DP were characterized by higher mortality (26.4% vs. 15.6%, p<0.001) , longer hospital stay (median 15 vs. 13 days, IQR 10-24 and 9-20, p<0.001) , more frequent ICU admission (15.7% vs. 11%, p<0.001) and more frequent requirement for mechanical ventilation (15.5% vs. 11.3%, p<0.001) . When adjusted for sex and age, the relative risk for in-hospital death, ICU admission and mechanical ventilation was 1.32 (95%CI 1.13-1.54) , 1.4 (95%CI 1.17-1.69) and 1.3 (95%CI 1.08-1.57) , respectively. Multivariable logistic regression showed age, CRP and D-dimer level, history of heart failure, and loop diuretic use were associated with higher risk of death, whereas anticoagulation therapy, ACEI/sartan/mineralocorticoid receptor antagonist use and thiazide use were associated with lower risk. Conclusions: In this large COVID-cohort, DP constituted more than one fourth of hospitalized patients. Their risk of death was ca. 30% higher as compared to non-diabetics, as was the risk of other important clinical outcomes. We identified a number of clinical, laboratory and therapeutical variables associated with risk of hospital death in DP with COVID-19.

9.
Diabetes ; 71, 2022.
Article in English | ProQuest Central | ID: covidwho-1923964

ABSTRACT

Background: To determine the factors associated with mortality in adult patients diagnosed with type 2 diabetes hospitalized for COVID-in a hospital of Latin America. Methods: Prospective cohort study from June 2020-june 2021. Patients with a diagnosis of type 2 diabetes older than 18 years with a confirmed diagnosis of COVID-infection were included. Results: A total of 813 adults were included. The mean age was 61.2 years, 575 (70.5%) were male. The most frequent comorbidities were hypertension (34.1%) and obesity (25.9%) . A total of 114 (14.0%) patients received mechanical ventilation, 38 (4.7%) were admitted to the Intensive Care Unit and 377 (46.4%) died. The requirement for ventilatory support, increased lung involvement, comorbidities and inflammatory markers were associated with mortality. Admission to the intensive care unit and the need for mechanical ventilation increased 1.39 (95% CI: 1.13 to 1.69) and 1.97 (95% CI: 1.69 to 2.29) the mortality. Those patients whose glycosylated hemoglobin on admission was greater than 10%, for every 1% increase above 10%, this increased the risk of death by 32% (RR: 1.32 95% CI: 1.25 to 1.38) . Conclusion: The mortality found in our study was associated with age, poor control of type 2 diabetes and respiratory compromise. Ensuring a satisfactory metabolic control of the patient with type 2 diabetes would decrease complications related to COVID-infection.

10.
Pakistan Journal of Medical Sciences Quarterly ; 38(1):287, 2022.
Article in English | ProQuest Central | ID: covidwho-1918984

ABSTRACT

Objectives: To identify association of underlying pre-morbidities with disease severity and mortality in hospitalized patients with Corona virus disease 2019. Methods: Total 884 COVID RT-PCR positive patients admitted to KRL Hospital Islamabad from April 2020 to August 2020 were included in this cross-sectional study. Pre-morbidities recorded were hypertension, diabetes mellitus, ischemic heart disease, chronic respiratory disease, chronic kidney disease, chronic liver disease, chronic neuro-psychiatric conditions (stroke and depression) and malignancy. Oxygen requirement, requirement of invasive ventilation, and outcome (recovered versus died) was documented. WHO categories for disease severity were used. Demographic profile and symptoms were also noted. SPSS 22 was used for data analysis. Pearson's Chi square test was used to see association between premorbidities and disease severity categories, oxygen requirement, invasive ventilation and outcome. Pearson's correlation was applied to analyze the correlation between individual pre-morbidities and disease severity categories. P-value < 0.05 was considered statistically significant. Results: The mean age was 40 ± 12.21 years with 98.5% being males. Majority patients (74.8%) were asymptomatic. Fever was the most common symptom. Diabetes mellitus and hypertension were the most commonly recorded co-morbidity. Significant correlation (p-value < 0.05) was found between the presence of underlying pre-morbidities and disease severity as well as oxygen requirement, requirement of invasive ventilation and mortality. Conclusion: Results are compatible with worldwide studies and underlying pre-morbidities are convincing risk factors for disease severity and mortality.

11.
Pakistan Journal of Medical Sciences Quarterly ; 38(4):1056, 2022.
Article in English | ProQuest Central | ID: covidwho-1918918

ABSTRACT

The COVID-19 pandemic has highlighted the vulnerability of countries worldwide and their abilities to cope with the fast-paced demands of the research and medical community. A key to promoting ethical decision-making frameworks is by calibrating the sustainability at regional, national, and global levels to incorporate coordinated reforms. We performed a sustained ethical analysis and critically reviewed evidence addressing country-level responses to practices during the COVID-19 pandemic using PubMed (MEDLINE), Scopus, and CINAHL. The World Health Organization's ethical framework proposed for the entire population during the pandemic was applied to thematically delineate findings under equality, best outcomes (utility), prioritizing the worst off, and prioritizing those tasked with helping others. The findings demarcate ethical concerns about the validity of drug and vaccine trials in developing and developed countries, hints of unjust healthcare organizational policies, lack of equal allocation of pertinent resources, miscalculated allocation of resources to essential workers and stratified populations.

13.
Pakistan Journal of Medical Sciences Quarterly ; 38(5):1243, 2022.
Article in English | ProQuest Central | ID: covidwho-1918771

ABSTRACT

Objectives: To evaluate the clinical value of intravesical gemcitabine combined with immunotherapy in patients with non-muscle-invasive bladder carcinoma (NMIBC) after transurethral resection of bladder tumor (TURBT). Methods: Eighty patients with non-muscle-invasive urothelial carcinoma treated in Baoding No.1 Hospital from November 2016 to November 2019 were randomly divided into two groups, with 40 patients in each group. Both groups underwent TURBT. After surgery, the research group was treated with intravesical chemotherapy using gemcitabine combined with ubenimex, while the control group was given 40 mg pirarubicin by intravesical instillation. Postoperative condition was evaluated by cystoscopy every three months in both groups. The recurrence six months, one year and two years after treatment, the incidence of lower urinary tract symptoms such as dysuria, hematuria and frequent urination, general adverse drug reactions such as rashes, liver function damage and gastrointestinal reaction, as well as the changes in CD3+, CD4+, CD8+ and CD4+/CD8+ T lymphocyte subsets before and after treatment were comparatively analyzed between the two groups. Results: The recurrence rate showed no statistical significance between the two groups 6 months after treatment (p=0.17), but significant differences one year (p=0.04) and two years (p=0.03) after treatment, which were significantly lower in the research group than the control group. The incidence of adverse drug reactions was 22.5% in the research group and 7.5% in the control group, without significant difference (p=0.36). The incidence of lower urinary tract symptoms was 32.5% and 55%, respectively, in the research group and the control group. The incidence of lower urinary tract symptoms in the research group was significantly lower compared with the control group, with a statistically significant difference (p=0.04). After treatment, CD3+, CD4+ and CD4+/CD8+ levels in the research group increased significantly than those in the control group, with statistically significant differences (CD3+, p=0.01;CD4+, p=0.00;CD4+/CD8+, p=0.00). Conclusions: For NMIBC patients receiving bladder-preserving surgery, intravesical gemcitabine combined with immunotherapy can reduce the recurrence rate, relieve lower urinary tract symptoms, increase the tolerance of patients to intravesical chemotherapy and significantly improve the function of T lymphocytes, without obvious increase in adverse drug reactions. Therefore, it is safe and effective, and has certain clinical value.

14.
Pakistan Journal of Medical Sciences Quarterly ; 38(5):1150, 2022.
Article in English | ProQuest Central | ID: covidwho-1918576

ABSTRACT

Objectives: To study the application effect of negative pressure sealing drainage technology combined with silver ion sterilization nursing solution in the nursing of necrotizing fasciitis. Methods: Medical records of patients with necrotizing fasciitis, treated in our hospital from June 2019 to June 2021, were selected. Patients were retrospectively assigned into two groups based on the debridement method used: debridement with silver ion sterilization nursing solution Group-I, or debridement with negative pressure sealing drainage technology combined with silver ion sterilization nursing solution. Group-II. Wound healing, dressing change times, healing time, treatment cost and patient satisfaction in both groups were statistically compared. Results: The wound healing rate of patients in Group-II group was higher than that of Group-I on the 5th, 10th and 15th day after operation (P < 0.05). Dressing change times, healing time and treatment cost of patients in the Group-II were lower than those of Group-I (P < 0.05). Patient satisfaction in the Group-II was 91.4% (54 / 59), which was higher than that of Group-I (75.4% (40 / 53) (P < 0.05). Conclusions: Negative pressure sealing drainage technology combined with silver ion sterilization nursing solution in the nursing of necrotizing fasciitis is effective. It can promote wound healing, shorten the healing time, reduce the times of wound dressing change and treatment cost. It also improves the overall patient satisfaction, making it an efficient method in clinical application.

15.
Pakistan Journal of Medical Sciences Quarterly ; 38(4):1064, 2022.
Article in English | ProQuest Central | ID: covidwho-1918538

ABSTRACT

India's public healthcare system is reeling under the pressure of the COVID-19 pandemic, with the country reporting over 30 million cases and 481,000 deaths by the end of 2021. The rise of the omicron variant threatens to add further strain on a chronically underfunded public health system, which a considerable proportion of the population living in poverty depend on. The pandemic has aggravated the shortage of supplies and capacity, pushing the Indian healthcare system to its breaking point. This write up calls for a major and urgent reform of the doctor and patient experience, achievable through prioritized funding to strengthen healthcare infrastructure, improving job security and satisfaction for healthcare workers, and improving the quality and safety of care delivered to patients throughout the nation. India must build a healthcare system focused on ensuring patient satisfaction and a positive patient experience by offering convenient healthcare access and high standards of care and treatment delivery.

16.
Trace Elements and Electrolytes ; 38(2):98, 2021.
Article in English | ProQuest Central | ID: covidwho-1918434
17.
Lancet Reg Health West Pac ; : 100516, 2022 Jul 06.
Article in English | MEDLINE | ID: covidwho-1914789

ABSTRACT

Background: The COVID-19 pandemic highlighted challenges for all health systems worldwide. This research aimed to explore the impact of COVID-19 across the Pacific especially with regards to emergency care (EC) and clinicians' preparations and responses. Methods: A collaboration of Australia and Pacific researchers conducted prospective qualitative research over 18 months of the pandemic. In this three phase study data were gathered from Emergency Clinicians and stakeholders through online support forums, in-depth interviews and focus groups. A phenomenological methodological approach was employed to explore the lived experience of participants. This paper discusses the findings of the study regarding the EC building block of 'Infrastructure and Equipment.' Findings: Pre-existing infrastructure and equipment were not sufficient to help control the pandemic. Adequate space and correct equipment were essential needs for Pacific Island emergency clinicians, with donations, procurement and local ingenuity required for suitable, sustainable supplies and facilities. Adequate personal protective equipment (PPE) conferred a sense of security and increased Health Care Workers willingness to attend to patients. Interpretation: Investing in adequate infrastructure and appropriate equipment is crucial for an effective response to the COVID-19 pandemic. The sustainability of such investments in the Pacific context is paramount for ongoing EC and preparation for future surge responses and disasters. Funding: Phases 1 and 2A of this study were part of an Epidemic Ethics/World Health Organization (WHO) initiative, supported by Foreign, Commonwealth and Development Office/Wellcome Grant 214711/Z/18/Z. Co-funding for this research was received from the Australasian College for Emergency Medicine Foundation via an International Development Fund Grant.

18.
South African Journal of Science ; 118(5/6):1-3, 2022.
Article in English | ProQuest Central | ID: covidwho-1912364

ABSTRACT

The Commentary outlines the lived experience of a liaison psychiatrist working as part of a frontline COVID - team in a large public hospital in Cape Town, South Africa and explores several important themes including vulnerability in health care, connection with patient experience, group processing of trauma, reintegration following trauma, and the importance of embedded mental health care in all health systems. The frontline psychological experience has been similar to wartime combat and the collective stressors experienced by healthcare workers must be recognised as such to ensure appropriate support is provided to help them recover.

19.
Dicle Tip Dergisi ; 49(2):287-296, 2022.
Article in English | ProQuest Central | ID: covidwho-1903802

ABSTRACT

According to the reported basic reproduction number (Ro), the COVID-19 carrier infects an average of 2.2 people, while the incubation period and average series interval are 5.2 days and 7.5 days, respectively3. [...]especially in patients with low viral loads, the falsenegativity of RT-PCR may reach up to 16.7%;that's why repeated testing is undertaken for symptomatic patients who had negative RT-PCR tests upon admission6. Besides molecular and serological testing, computed tomography (CT) examination is a very important diagnostic step especially in symptomatic but RT-PCR false-negative patients7,8. According to Wung et al. reported the ground glass opacities (GGO) with or without consolidation in posterior and peripheral lungs as a cardinal hallmark of COVID-19 pneumonia observed on CT9. Despite all these relatively valuable diagnostic tests and advanced treatment methods, the infection process can be bothersome in some patients. [...]this study endeavors to determine the risk factors that may predict a severe course of the disease with particular emphasis on symptoms, laboratory, and CT findings on admission.

20.
Eastern Journal of Medicine ; 27(2):343-350, 2022.
Article in English | ProQuest Central | ID: covidwho-1876775

ABSTRACT

Pulmonary hypertension (PH) is a pulmonary vascular disease described by pulmonary arterial vasoconstriction and remodeling , which may lead to an increased pulmonary artery pressure with varying clinical course and severity depending on the etiology and eventually to right heart failure. Because of associated comorbidities, patients with PH are likely to face a potential risk of severe complications and mortality and unfortunately, they may have worse outcomes than other patients. COVID-19 emerges as one of the biggest threats facing society in this century. Besides its many medical consequences, the epidemic has psychological, social, and economic prices. [...]it is essential to understand its pathophysiology and clinical outcomes and to determine appropriate treatment strategies. Pathological characteristics of the endothelial cell structures of PH patients infected with COVID-19, down-regulation of angiotensin-converting enzyme 2 (ACE-2) receptors, which play a fundamental role in both the entry and replication of coronaviruses and also pulmonary arterial hypertension (PAH)-specific drugs used in its treatment may contribute to this (5,6).

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