Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 54.967
Filtrar
Añadir filtros

Intervalo de año
1.
Cutis ; 106(6): 318-320, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: covidwho-1225960

RESUMEN

Varicella-zoster virus infection causes 2 distinct forms of disease: varicella (commonly known as chickenpox) and herpes zoster (HZ)(commonly known as shingles). Primary varicella-zoster virus infection results in the diffuse vesicular rash that is characteristic of chickenpox. Following primary infection, varicella-zoster virus remains dormant in the dorsal root ganglia. This latent phase usually lasts for several decades before reactivation occurs. Varicella-zoster virus reactivation normally presents as HZ in middle-aged adults. A number of cutaneous skin manifestations have appeared in relation to the newly diagnosed coronavirus disease 2019 (COVID-19) pandemic and continue to emerge every day. We report a case of HZ complication in a COVID-19-positive woman who was 27 weeks pregnant.


Asunto(s)
/complicaciones , Herpes Zóster/diagnóstico , Complicaciones Infecciosas del Embarazo/virología , Activación Viral , Adulto , Femenino , Herpes Zóster/virología , Herpesvirus Humano 3/aislamiento & purificación , Humanos , Embarazo
2.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 43(2): 216-221, 2021 Apr 28.
Artículo en Chino | MEDLINE | ID: covidwho-1225868

RESUMEN

Objective To analyze the CT characteristics of consolidation type of pulmonary cryptococcosis in immunocompetent patients,and thus improve the diagnosis of this disease. Methods A total of 20 cases with consolidation-type pulmonary cryptococcosis confirmed by pathological examinations were studied.Each patient underwent breath-hold multislice spiral CT,and 10 patients underwent contrast enhanced CT.The data including lesion number,lesion distribution,lesion density,performance of enhanced CT scan,accompanying signs,and prognosis were analyzed. Results The occurrence rates of single and multiple lesions were 80.0%(n=16)and 20.0%(n=4),respectively.In all the 16 multiple-lesion patients,the occurrence rate of unilateral lobar distribution was 56.0%(n=9).The 76 measurable lesions mainly presented subpleural distribution(71.1%,n=54)and lower pulmonary distribution(75.0%,n=57).A total of 39 lesions were detected in the 10 patients received contrast enhanced CT,in which 31 lesions(79.5%)showed homogeneous enhancement,34 lesions(87.2%)showed moderate enhancement,and all the lesions manifested angiogram sign.Consolidation lesions were accompanied by many CT signs,of which air bronchogram sign had the occurrence rate of 63.2%(n=48),including types Ⅲ(n =37)and Ⅳ(n=11).Other signs included halo signs(43/76,56.6%),vacuoles or cavities(9/76,11.8%),pleural thickening(14/20,70.0%),and pleural effusion(2/20,10.0%).After treatment,the lesions of 7 patients were basically absorbed and eventually existed in the form of fibrosis. Conclusions The lesions in the immunocompetent patients with consolidation type of pulmonary cryptococcosis usually occur in the lower lobe and close to the pleura,mainly presenting unilateral distribution.The CT angiogram signs,proximal air bronchogram signs,and halo signs are the main features of this disease,which contribute to the diagnosis.


Asunto(s)
Criptococosis , Enfermedades Pulmonares Fúngicas , Criptococosis/diagnóstico por imagen , Humanos , Pulmón , Enfermedades Pulmonares Fúngicas/diagnóstico por imagen , Estudios Retrospectivos , Tomografía Computarizada por Rayos X
9.
BMC Res Notes ; 14(1): 176, 2021 May 10.
Artículo en Inglés | MEDLINE | ID: covidwho-1223779

RESUMEN

OBJECTIVE: This randomised controlled trial (RCT) aimed to investigate the effects of a simple cognitive task intervention on intrusive memories ("flashbacks") and associated symptoms following a traumatic event. Patients presenting to a Swedish emergency department (ED) soon after a traumatic event were randomly allocated (1:1) to the simple cognitive task intervention (memory cue + mental rotation instructions + computer game "Tetris" for at least 20 min) or control (podcast, similar time). We planned follow-ups at one-week, 1-month, and where possible, 3- and 6-months post-trauma. Anticipated enrolment was N = 148. RESULTS: The RCT was terminated prematurely after recruiting N = 16 participants. The COVID-19 pandemic prevented recruitment/testing in the ED because: (i) the study required face-to-face contact between participants, psychology researchers, ED staff, and patients, incurring risk of virus transmission; (ii) the host ED site received COVID-19 patients; and (iii) reduced flow of patients otherwise presenting to the ED in non-pandemic conditions (e.g. after trauma). We report on delivery of study procedures, recruitment, treatment adherence, outcome completion (primary outcome: number of intrusive memories during week 5), attrition, and limitations. The information presented and limitations may enable our group and others to learn from this terminated study. Trial registration ClinicalTrials.gov: NCT04185155 (04-12-2019).


Asunto(s)
Trastornos por Estrés Postraumático , Cognición , Servicio de Urgencia en Hospital , Humanos , Trastornos por Estrés Postraumático/terapia
10.
BMC Ophthalmol ; 21(1): 206, 2021 May 10.
Artículo en Inglés | MEDLINE | ID: covidwho-1223766

RESUMEN

BACKGROUND: COVID-19, a highly contagious respiratory virus, presents unique challenges to ophthalmology practice as a high-volume, office-based specialty. In response to the COVID-19 pandemic, many operational changes were adopted in our ophthalmology clinic to enhance patient and provider safety while maintaining necessary clinical operations. The aim of this study was to evaluate how measures adopted during the pandemic period affected retina clinic performance and patient satisfaction, and to model future clinic flow to predict operational performance under conditions of increasing patient and provider volumes. METHODS: Clinic event timestamps and demographics were extracted from the electronic medical records of in-person retina encounters from March 15 to May 15, 2020 and compared with the same period in 2019 to assess patient flow through the clinical encounter. Patient satisfaction was evaluated by Press Ganey patient experience surveys obtained from randomly selected outpatient encounters. A discrete-events simulation was designed to model the clinic with COVID-era restrictions to assess operational performance under conditions of increasing patient and provider volumes. RESULTS: Retina clinic volume declined by 62 % during the COVID-19 health emergency. Average check-in-to-technician time declined 79 %, total visit length declined by 46 %, and time in the provider phase of care declined 53 %. Patient satisfaction regarding access nearly doubled during the COVID-period compared with the prior year (p < 0.0001), while satisfaction with overall care and safety remained high during both periods. A model incorporating COVID-related changes demonstrated that wait time before rooming reached levels similar to the pre-COVID era by 30 patients-per-provider in a 1-provider model and 25 patients-per-provider in a 2-provider model (p < 0.001). Capacity to maintain distancing between patients was exceeded only in the two 2-provider model above 25 patients-per-provider. CONCLUSIONS: Clinic throughput was optimized in response to the COVID-19 health emergency. Modeling these clinic changes can help plan for eventual volume increases in the setting of limits imposed in the COVID-era.


Asunto(s)
Telemedicina , Humanos , Pandemias , Satisfacción del Paciente , Retina
11.
Public Health Rep ; 136(3): 327-337, 2021 05.
Artículo en Inglés | MEDLINE | ID: covidwho-1223668

RESUMEN

INTRODUCTION: Few US studies have examined the usefulness of participatory surveillance during the coronavirus disease 2019 (COVID-19) pandemic for enhancing local health response efforts, particularly in rural settings. We report on the development and implementation of an internet-based COVID-19 participatory surveillance tool in rural Appalachia. METHODS: A regional collaboration among public health partners culminated in the design and implementation of the COVID-19 Self-Checker, a local online symptom tracker. The tool collected data on participant demographic characteristics and health history. County residents were then invited to take part in an automated daily electronic follow-up to monitor symptom progression, assess barriers to care and testing, and collect data on COVID-19 test results and symptom resolution. RESULTS: Nearly 6500 county residents visited and 1755 residents completed the COVID-19 Self-Checker from April 30 through June 9, 2020. Of the 579 residents who reported severe or mild COVID-19 symptoms, COVID-19 symptoms were primarily reported among women (n = 408, 70.5%), adults with preexisting health conditions (n = 246, 70.5%), adults aged 18-44 (n = 301, 52.0%), and users who reported not having a health care provider (n = 131, 22.6%). Initial findings showed underrepresentation of some racial/ethnic and non-English-speaking groups. PRACTICAL IMPLICATIONS: This low-cost internet-based platform provided a flexible means to collect participatory surveillance data on local changes in COVID-19 symptoms and adapt to guidance. Data from this tool can be used to monitor the efficacy of public health response measures at the local level in rural Appalachia.


Asunto(s)
/epidemiología , Recolección de Datos/métodos , Intervención basada en la Internet , Vigilancia en Salud Pública/métodos , Autoinforme , Evaluación de Síntomas , Adolescente , Adulto , Anciano , Región de los Apalaches/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Participación del Paciente , Adulto Joven
12.
Am J Respir Crit Care Med ; 203(9): 1070-1087, 2021 05 01.
Artículo en Inglés | MEDLINE | ID: covidwho-1223640

RESUMEN

Background: This document provides evidence-based clinical practice guidelines on the diagnostic utility of nucleic acid-based testing of respiratory samples for viral pathogens other than influenza in adults with suspected community-acquired pneumonia (CAP).Methods: A multidisciplinary panel developed a Population-Intervention-Comparison-Outcome question, conducted a pragmatic systematic review, and applied Grading of Recommendations, Assessment, Development, and Evaluation methodology for clinical recommendations.Results: The panel evaluated the literature to develop recommendations regarding whether routine diagnostics should include nucleic acid-based testing of respiratory samples for viral pathogens other than influenza in suspected CAP. The evidence addressing this topic was generally adjudicated to be of very low quality because of risk of bias and imprecision. Furthermore, there was little direct evidence supporting a role for routine nucleic acid-based testing of respiratory samples in improving critical outcomes such as overall survival or antibiotic use patterns. However, on the basis of direct and indirect evidence, recommendations were made for both outpatient and hospitalized patients with suspected CAP. Testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was not addressed in the literature at the time of the evidence review.Conclusions: The panel formulated and provided their rationale for recommendations on nucleic acid-based diagnostics for viral pathogens other than influenza for patients with suspected CAP.


Asunto(s)
Infecciones Comunitarias Adquiridas/virología , ADN Viral/análisis , Neumonía/virología , Sociedades Médicas , Virus/genética , Infecciones Comunitarias Adquiridas/diagnóstico , Humanos , Neumonía/diagnóstico
13.
BMJ Case Rep ; 14(5)2021 May 10.
Artículo en Inglés | MEDLINE | ID: covidwho-1223565

RESUMEN

Teprotumumab (Tepezza), an insulin-like growth factor type 1 receptor antagonist, was approved for treatment of thyroid eye disease in 2020. Teprotumumab is administered intravenously every 3 weeks for a total of eight doses. Common side effects include nausea, diarrhoea, muscle spasms, hearing impairment, dysgeusia, headaches, dry skin, infusion reactions and hyperglycaemia. We report here a 76-year-old man with Graves-related thyroid eye disease who developed a rapidly progressive cognitive decline after receiving four out of eight doses of teprotumumab (cumulative dose 4620 mg). He was admitted for workup and teprotumumab infusions were discontinued. Intravenous glucocorticoids and immunoglobulin were given which showed no improvement in clinical symptoms. He subsequently underwent plasmapheresis with resolution of his symptoms, suggesting a teprotumumab-induced encephalopathy. Further studies involving larger populations and longer durations are needed.


Asunto(s)
Disfunción Cognitiva , Oftalmopatía de Graves , Anciano , Anticuerpos Monoclonales Humanizados , Oftalmopatía de Graves/tratamiento farmacológico , Humanos , Masculino
14.
BMJ Case Rep ; 14(5)2021 May 10.
Artículo en Inglés | MEDLINE | ID: covidwho-1223562

RESUMEN

We describe the case of a 31-year-old man who presented with a 3-day history of right iliac fossa pain with associated nausea and vomiting. He denied any previous incidents of abdominal pain and had no relevant medical history or family history to note. Given the typical history, examination findings of localised peritonism and infection risk, he was taken to theatre for laparoscopic appendicectomy without diagnostic imaging. Intraoperatively, we noted gut malrotation and an inflammatory jejunal mass which was resected after converting to a mini-laparotomy. The inflammatory mass was reported to be an ectopic pancreatic tissue from histology. Given that this patient had tested positive for SARS-CoV-2 on admission, we propose a possible case of SARS-CoV-2 infection triggering inflammation of the ectopic pancreatic tissue.


Asunto(s)
Vólvulo Intestinal , Adulto , Humanos , Ilion , Vólvulo Intestinal/diagnóstico , Vólvulo Intestinal/diagnóstico por imagen , Masculino , Páncreas/diagnóstico por imagen , Páncreas/cirugía
18.
Adv Exp Med Biol ; 1318: 937-964, 2021.
Artículo en Inglés | MEDLINE | ID: covidwho-1222756

RESUMEN

Netting individuals separated from each other by vast distances; the present condition of COVID-19 needs art and its extraordinary capacity to connect human beings and integrate scientific disciplines. We can predict that the COVID-19 pandemic would leave the mind lonely and vulnerable to diseases, for, on the one hand, the COVID-19 pandemic and related problems, in particular social isolation, are itself stressor. On the other hand, studies confirm the potential of COVID-19 to involve the central nervous system by affecting the immune system, either directly or indirectly. The COVID-19 condition, thus, calls for a necessary compensation of loneliness to reduce the psychological impact of the pandemic. Not only art can fulfill this purpose by meeting social affiliation needs, but also its related creativity is a definite achievement of the performer while acting as a motivation facilitator of creation for the observer. Besides, artworks that illustrate effective hygiene behaviors and physical distancing in an easy-to-understand manner could help health information systems to control the spread of COVID-19. The integration of art with biomedical science applied for simulation of the infected population, lung imaging data, and the viral surface has been useful for prediction of the spread of disease and earlier diagnosis of COVID-19 by imaging techniques and might be a contributor to drug discovery for COVID-19. Also, arts admirably influence the immunoemotional regulatory system so that not only would it enable humanity to tolerate quarantine but also enhance antiviral immunity. More interestingly, the effects of dance have been observed in children, elderly, healthcare workers, and pregnant women, which have been of special attention during the COVID-19 pandemic. In summary, arts provide us powerful tools for tolerating the quarantine time and enhancing the immune system, educating behavioral tips for hygiene practices and physical distancing and in psychosocial care of vulnerable populations during the pandemic.


Asunto(s)
Pandemias , Anciano , Niño , Femenino , Humanos , Pandemias/prevención & control , Embarazo , Cuarentena , Aislamiento Social
19.
Adv Exp Med Biol ; 1318: 923-936, 2021.
Artículo en Inglés | MEDLINE | ID: covidwho-1222755

RESUMEN

The coronavirus disease 2019 (COVID-19) pandemic has been a significant concern worldwide. The pandemic has demonstrated that public health issues are not merely a health concern but also affect society as a whole. In this chapter, we address the importance of bringing together the world's scientists to find appropriate solutions for controlling and managing the COVID-19 pandemic. Interdisciplinary cooperation, through modern scientific methods, could help to handle the consequences of the pandemic and to avoid the recurrence of future pandemics.


Asunto(s)
Pandemias , Humanos , Pandemias/prevención & control , Salud Pública
20.
Adv Exp Med Biol ; 1318: 911-921, 2021.
Artículo en Inglés | MEDLINE | ID: covidwho-1222754

RESUMEN

In the COVID-19 era, while we are encouraged to be physically far away from each other, social and scientific networking is needed more than ever. The dire consequences of social distancing can be diminished by social networking. Social media, a quintessential component of social networking, facilitates the dissemination of reliable information and fighting against misinformation by health authorities. Distance learning, telemedicine, and telehealth are among the most prominent applications of networking during this pandemic. Additionally, the COVID-19 pandemic highlights the importance of collaborative scientific efforts. In this chapter, we summarize the advantages of harnessing both social and scientific networking in minimizing the harms of this pandemic. We also discuss the extra collaborative measures we can take in our fight against COVID-19, particularly in the scientific field.


Asunto(s)
Medios de Comunicación Sociales , Humanos , Pandemias , Socialización
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA