Occupational effects in patients with post-COVID-19 syndrome.

BACKGROUND: It is well recognized that some individuals experience persistent symptoms following an initial SARS-CoV-2 infection. Symptoms affect physical, cognitive and mental well-being and can adversely impact activities of daily living, including the ability to work. AIMS: To examine the impact of post-COVID-19 syndrome with respect to effects on quality of life and impact on work in a cohort of people referred to a 'Long COVID' service. METHODS: All triaged patients (over 18 years with symptoms more than 12 weeks since the initial infection) completed a symptom assessment questionnaire. Occupation and working status (at work, at work struggling with symptoms and off work) were also recorded. Impact on function and quality of life was assessed using the EQ5D5L questionnaire. RESULTS: A total of 214 patients (median age 51.0 years, 135 females) were seen from January to September 2021. Analysis of occupational status showed: 18% were working, 40% were working but struggling and 35% had stopped working due to symptoms. Those unable to work reported significantly more fatigue, a greater perception of the need for support and lower quality-of-life scores. CONCLUSIONS: This study shows the extensive impact of post-COVID-19 syndrome on the ability to return to work. Specific return-to-work guidance is needed to support a large proportion of those struggling with the condition. The involvement of the Occupational Health team should form part of the multidisciplinary, collaborative approach to support rehabilitation and improve long-term outcomes for this condition.

Demographic predictors of treatment attendance among adolescent suicide attempters.

The relationship between age and gender and treatment attendance was prospectively examined among a consecutive series of 143 adolescent emergency room attendees referred for outpatient therapy after a suicide attempt. Consistent with previous reports, nonadherence was high. Over 40% of patients had their cases terminated because of nonattendance; on average, however, patients received almost 6 sessions of treatment and 91% attended at least 1 therapy session. Adolescents terminated from treatment for nonadherence were significantly older than those completing treatment. Younger male patients were scheduled for significantly more therapy sessions than older male patients and kept significantly more scheduled sessions than did older male and female patients. Vigorous case-tracking procedures may have a significant impact on treatment attendance. Nevertheless, therapists must design strategies to increase treatment adherence among older adolescent, especially male, patients.

Distribution of a hematopoietic-specific differentiation antigen of K562 cells in the human myeloid and lymphoid cell lineages.

BALB/c mice were immunized with uninduced K562 erythroleukemia cells and hybridomas were isolated after fusion of immune spleen cells to P3/NS1 murine myeloma cells. One selected hybrid, designated 10L-30, secreted an antibody of subclass immunoglobulin G2a which was specific for hematopoietic cells. Analysis of 10L-30 binding by complement-mediated cytotoxicity, indirect immunofluorescence, solid-phase radioimmunoassay, and mixed hemadsorption assay indicated that the 10L-30 antigen was expressed on the myeloid cell lines K562, KG-1A, KG-1, some B- and T-lymphoid cell lines, and all normal human peripheral blood T-lymphocyte samples tested, but was absent on the more differentiated myeloid cell lines HL-60, ML-2, ML-3, and normal blood granulocytes. Induction of erythroid differentiation in hemin-treated K562 cells caused a 10-fold reduction in 10L-30 binding. Human erythroid and granulocytic progenitor cells, platelets, erythrocytes, and reticulocytes were nonreactive, as were a variety of nonhematopoietic human tumor cell lines. Freshly isolated leukemic bone marrow samples from patients with M5 (2 of 5), M6 (2 of 2), acute lymphoid leukemia (9 of 14), and chronic myeloid leukemia in lymphoid blast crisis (1 of 1) were 10L-30 positive. The combined evidence indicates that the 10L-30 antigen is a normal, hematopoietic-specific differentiation antigen which is strongly expressed on both immature cells of the myeloid lineage and more generally in lymphoid ontogeny. The 10L-30 antigen may be a useful marker of both normal and leukemic hematopoietic differentiation.

Localization of the genes shaking-B, small optic lobes, sluggish-A, stoned and stress-sensitive-C to a well-defined region on the X-chromosome of Drosophila melanogaster.

Using deletion mapping and complementation tests, we have localized 5 behavioral mutations: shaking-B2, small optic lobesKS58, sluggish-AEE85, stonedts1, and stress-sensitive-C1 to 4 genetic complementation groups at the base of the X-chromosome. Shaking-B2 is an allele of the lethal complementation group R-9-29 near band 19E3; small optic lobesKS58 and sluggish-AEE85 belong to adjacent complementation groups, between lethals W2 and A112 near band 19F4; and stonedts1 and stress-sensitive-C1 are both alleles of the 8P1 lethal complementation group between lethals 114 and 13E3 near bands 20B-C.

Molecular localization, developmental expression and nucleotide sequence of the alpha-methyldopa hypersensitive gene of Drosophila.

The region surrounding the dopa decarboxylase gene of Drosophila contains a cluster of functionally related genes, many of which affect cuticle development and/or catecholamine metabolism. In this report we describe the molecular mapping and sequencing of a full-length cDNA copy of a transcript that maps to the alpha-methyldopa hypersensitive region. Developmental RNA blots show stage-specific patterns of transcription and multiple RNA transcripts. A 2-kb transcript is most abundant at about 12 hr of embryogenesis, and lower levels are detected throughout most of embryogenesis. Lower levels of this transcript are also detected in adults. Smaller stage-specific transcripts are detected in late third-instar larvae. This pattern of transcription is consistent with the known lethal phases and phenotypes of the alpha-methyldopa hypersensitive gene (amd). Based on map position, pattern of transcription, homology with dopa decarboxylase and association with altered DNA in mutants, we conclude that this transcript represents the amd gene.

Quantitative analysis of the role of accessory cells in the development of human blood BFU-E-derived erythroid colonies.

A simplified method for the purification of human peripheral blood erythroid progenitor cells (BFU-E) using standard immunological techniques is described. Following removal of platelets, erythrocytes, nylon-wool-adherent cells, and sheep erythrocyte rosette-forming cells (RFC), BFU-E are routinely concentrated tenfold in the null cell fraction. Null cells plated at low density in erythroid cell cultures containing optimal amounts of methylcellulose, erythropoietin, and fetal calf serum did not give rise to spontaneous erythroid colonies. Coculture of null cells with highly purified, autologous RFC at a ratio of 1:25 yielded well-hemoglobinized erythroid colonies which were noticeably smaller than those found in cultures containing unfractionated peripheral blood mononuclear cells. However, further addition of very low numbers of purified adherent cells to null plus RFC dramatically increased the total hemoglobin content as well as the size and number of BFU-E-derived erythroid colonies. Addition of adherent cells alone to null cells had virtually no effect. Under conditions of optimal stimulation by adherent cells and RFC, the number of erythroid bursts was linearly related to null cells plated over an eightfold range. The synergism exhibited between adherent cells and RFC was not restricted by mismatched histocompatibility antigens. This system should be generally useful in quantitating the roles of more highly purified cellular and molecular populations in human erythropoiesis.

Induction of iatrogenic electrocardiographic patterns during electrophysiologic studies.

Indwelling cardiac catheters by producing local mechanical stimulation or trauma can induce electrocardiographic (ECG) patterns which simulate known electrophysiologic phenomena. Catheter-induced ECG patterns were analyzed in 447 consecutive patients undergoing electrophysiologic studies. Iatrogenic nature of these patterns was suggested by 1) absence prior to placement of catheter; 2) sudden appearance with catheter placement and disappearance with catheter repositioning; 3) reoccurrence with remanipulation of catheters; and 4) simulation (in some cases) by programmed electrical stimulation from the catheter. Common catheter-induced patterns were 1) right bundle branch block (RBBB) lasting less than 24 hours occurred in 19 patients; 2) transient third degree atrioventricular block in His-Purkinje system developed in 3/13 patients with pre-existing left BBB; 3) catheter-induced ventricular pre-excitation which simulated ECG patterns of type B Wolff-Parkinson-White syndrome; 4) fortuitous synchronization of right ventricular excitation from the catheter, and left ventricular excitation from sinus beat resulted in normalization of the QRS complexes in 5/68 patients with pre-existing RBBB; 5) premature beats from the atria, right ventricle, and His bundle, which were common, resulted in complex ECG patterns. These iatrogenic ECG patterns must be identified in order to avoid errors in interpretation.

Fluoroscope-generated electromagnetic interference in an external demand pacemaker: report of a case.

Electromagnetic interference presented as inhibition and resetting of the demand circuitry of a ventricular-inhibited temporary external pacemaker in a 70-year-old man undergoing surgical implantation of a permanent bipolar pacemaker generator and lead. The arrhythmia was found to be due to oversensing of waveforms modulated to simulate myocardial potentials emitted by a faulty fluoroscopy unit used in the vicinity of external temporary transvenous pacing equipment. The documentation of this disruption of pacemaker rhythm reinforces the need for continuous monitoring of patients treated with external demand pacemakers and for the careful maintenance of all electrical equipment.

Characteristics and coexistence of two forms of ventricular echo phenomena.

During the scanning of paced basic ventricular cycle lengths (V1V1) with extrastimulus method (V2) two forms of ventricular echo phenomena (Ve) were recognized. The Ve resulting from A-V nodal re-entry (VeAVN) occurred in 12 of 45 patients, from re-entry in the His-Purkinje system (Ve-HPS) in 20 of 45 patients, and simultaneous dual re-entry (Ve-AVN and Ve-HPS) occurred in five of 45 patients. The Ve-AVN (1) appeared at longer V1V2 intervals, (2) was dependent on retrograde A-V nodal conduction delay, (3) had normal QRS complexes and H-V intervals, and (4) did not occur when V2 blocked in the A-V node. (5) Ve-AVN had aberrant QRS complexes when preceded by Ve-HPS. The Ve-HPS (1) appeared at shorter V1V2 intervals, (2) was dependent upon retrograde conduction delay in the HPS, (3) its QRS morphology and axis orientation resembled V2, i.e., left bundle branch block pattern, when right ventricular apex was the site of stimulation, (4) persisted when V2 blocked in the A-V node and was abolished when V2 blocked below the bundle of His, and (5) rarely occurred in patients with pre-existing right bundle branch block. It is concluded that (1) at least two forms of Ve can result from induced premature ventricular beats, (2) Ve-HPS is more common than Ve-AVN in the presence of normal QRS complexes, and (3) coexistence of Ve-AVN and Ve-HPS can give rise to complex ECG pattern mimicking multiple multifocal premature ventricular beats.