scholarly journals SARS-CoV-2 infection in 86 healthcare workers in two Dutch hospitals in March 2020

2020 ◽  
Author(s):  
Marjolein F.Q. Kluytmans-van den Bergh ◽  
Anton G.M. Buiting ◽  
Suzan D. Pas ◽  
Robbert G. Bentvelsen ◽  
Wouter van den Bijllaardt ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Respiratory Symptoms ◽  
Clinical Presentation ◽  
Case Definition ◽  
Northern Italy ◽  
Teaching Hospitals ◽  
Local Spread ◽  
Clinical Presentations ◽  
High Prevalence ◽  
History Of

ABSTRACTBackgroundOn February 27, 2020, the first patient with COVID-19 was reported in the Netherlands. During the following weeks, nine healthcare workers (HCWs) were diagnosed with COVID-19 in two Dutch teaching hospitals, eight of whom had no history of travel to China or Northern-Italy. A low-threshold screening regimen was implemented to determine the prevalence and clinical presentation of COVID-19 among HCWs in these two hospitals.MethodsHCWs who suffered from fever or respiratory symptoms were voluntarily tested for SARS-CoV-2 by real-time reverse-transcriptase PCR on oropharyngeal samples. Structured interviews were conducted to document symptoms for all HCWs with confirmed COVID-19.FindingsThirteen-hundred fifty-three (14%) of 9,705 HCWs employed were tested, 86 (6%) of whom were infected with SARS-CoV-2. Most HCWs suffered from relatively mild disease and only 46 (53%) reported fever. Eighty (93%) HCWs met a case definition of fever and/or coughing and/or shortness of breath. None of the HCWs identified through the screening reported a travel history to China or Northern Italy, and 3 (3%) reported to have been exposed to an inpatient known with COVID-19 prior to the onset of symptoms.InterpretationWithin two weeks after the first Dutch case was detected, a substantial proportion of HCWs with fever or respiratory symptoms were infected with SARS-CoV-2, probably caused by acquisition of the virus in the community during the early phase of local spread. The high prevalence of mild clinical presentations, frequently not including fever, asks for less stringent use of the currently recommended case-definition for suspected COVID-19.RESEARCH IN PERSPECTIVEEvidence before this studyThis study was conducted in response to the global spread of SARS-CoV-2, and the detection of eight healthcare workers (HCWs) in two Dutch teaching hospitals within two weeks after the first patient with COVID-19 was detected in the Netherlands who had no history of travel to China or Northern-Italy, raising the question of whether undetected community circulation was occurring.Added value of this studyTo the best of our knowledge, this report is the first to describe the prevalence, the clinical presentation and early outcomes of COVID-19 in HCWs, which may be helpful for others seeking to identify HCWs suspected for COVID-19 in an outbreak situation.Implications of all the available evidenceWe describe that within two weeks after the first Dutch case was detected, a substantial proportion of HCWs with fever or (mild) respiratory symptoms were infected with SARS-CoV-2, probably caused by acquisition of the virus in the community during the early phase of local spread. The high prevalence of mild clinical presentations, frequently not including fever, asks for less stringent use of the currently recommended case-definition for suspected COVID-19.

The Prevalence and Clinical Profile of Angiographic Coronary Ectasia

2003 ◽  
Vol 11 (2) ◽  
pp. 122-126 ◽  
Author(s):  
Peter Nyamu ◽  
Mullasari S Ajit ◽  
Peter K Joseph ◽  
Lakshmi Venkitachalam ◽  
Nancy A Sugirtham
Keyword(s):  
Coronary Artery ◽  
Clinical Presentation ◽  
Review Of Literature ◽  
Management Options ◽  
The Past ◽  
Left Anterior Descending Artery ◽  
Coronary Ectasia ◽  
High Prevalence ◽  
History Of ◽  
The Right

Coronary artery ectasia, a variant of coronary atherosclerosis, is a relatively rare entity. Review of literature did not reveal an exclusive study on isolated ectasia. We decided to analyse the clinical presentation and angiographic prevalence of this subset. A retrospective study of patients who underwent coronary angiogram in our institute over the past six years was carried out and the epidemiological, clinical and angiographic characteristics of patients with isolated ectasia were analysed. Distribution of ectasia was with a modification of the Markis classification. Among 6938 angiograms analysed, 134 (2%) had isolated ectasia. Of the 118 symptomatic patients, 34 (25%) had a history of or presented with infarction, with correlation between the territory of infarction and the ectatic vessel in 32 patients. Of 62 patients with lipid abnormality, Hypertriglyceridemia in 42 (65%) was the most common. The left anterior descending artery was the most common vessel involved. Diffuse ectasia most commonly involved the right coronary artery. One patient had spontaneous coronary dissection. There is a relatively high prevalence of isolated coronary ectasia with predominant involvement of the right coronary vessel when diffuse and the left anterior descending artery when discrete. This entity is not innocuous and warrants a detailed study on the available management options.

scholarly journals Significant predictive factors of the severity and outcomes of the first attack of acute angioedema in children

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yuan-Jhen Syue ◽  
Chao-Jui Li ◽  
Wen-Liang Chen ◽  
Tsung-Han Lee ◽  
Cheng-Chieh Huang ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Respiratory Symptoms ◽  
Clinical Presentation ◽  
Preschool Age ◽  
Short Term ◽  
Patient Demographics ◽  
Life Threatening ◽  
History Of ◽  
Initial Episode

Abstract Background The initial episode of angioedema in children can be potential life-threatening due to the lack of prompt identification and treatment. We aimed to analyze the factors predicting the severity and outcomes of the first attack of acute angioedema in children. Methods This was a retrospective study with 406 children (< 18 years) who presented in the emergency department (ED) with an initial episode of acute angioedema and who had subsequent follow-up visits in the out-patient department from January 2008 to December 2014. The severity of the acute angioedema was categorized as severe (requiring hospital admission), moderate (requiring a stay in the short-term pediatric observation unit [POU]), or mild (discharged directly from the ED). The associations among the disease severity, patient demographics and clinical presentation were analyzed. Result In total, 109 (26.8%) children had severe angioedema, and the majority of those children were male (65.1%). Most of the children were of preschool age (56.4%), and only 6.4% were adolescents. The co-occurrence of pyrexia or urticaria, etiologies of the angioedema related to medications or infections, the presence of respiratory symptoms, and a history of allergies (asthma, allergic rhinitis) were predictors of severe angioedema (all p < 0.05). Finally, the duration of angioedema was significantly shorter in children who had received short-term POU treatment (2.1 ± 1.1 days) than in those who discharged from ED directly (2.3 ± 1.4 days) and admitted to the hospital (3.5 ± 2.0 days) (p < 0.001). Conclusion The co-occurrence of pyrexia or urticaria, etiologies related to medications or infections, the presence of respiratory symptoms, and a history of allergies were predictors of severe angioedema. More importantly, short-term POU observation and prompt treatment might be benefit for patients who did not require hospital admission.

scholarly journals Natural history of SARS-CoV-2 infection in healthcare workers in Northern Italy

2020 ◽  
Vol 106 (4) ◽  
pp. 709-712 ◽  
Author(s):  
M. Bongiovanni ◽  
A.M. Marra ◽  
A. De Lauretis ◽  
F. Bini ◽  
D. Di Carlo ◽  
...  
Keyword(s):  
Natural History ◽  
Healthcare Workers ◽  
Northern Italy ◽  
History Of

scholarly journals 1209. Seroprevalence of Measles, Mumps, and Rubella in Korean Healthcare Workers and Strategy for Vaccination

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S434-S435
Author(s):  
Eun Ju Choo ◽  
Se Yoon Park
Keyword(s):  
Healthcare Workers ◽  
Linear Regression Analysis ◽  
Antibody Test ◽  
Vaccination Schedule ◽  
Teaching Hospitals ◽  
Immunization Programs ◽  
Antibody Testing ◽  
National Immunization ◽  
History Of ◽  
Antibody Tests

Abstract Background The measles, mumps, and rubella (MMR) vaccination to children was accelerated in South Korea as the National Immunization Programs in 1985. A two-dose MMR vaccination schedule was introduced in 1997. However, outbreaks of measles in healthcare institution continued to occur. Recent studies revealed that the seroprevalence of measles in healthcare workers (HCWs) was approximately 40–60% in twentieth. The purpose of this study was to determine the seroprevalence of MMR antibodies in HCWs to establish strategy for vaccination. Methods To prevent nosocomial transmission of measles, test for MMR antibody of HCWs was conducted in three teaching hospitals from January to February in 2019. The testing was conducted only in the patient contact departments. We excluded HCWs who did a history of vaccination after starting their work. Anti-measles IgG and anti-mumps IgG was detected using chemiluminescence immunoassay. Anti-rubella IgG was detected using chemiluninescence microparticle immunoassay. Equivocal value was treated as negative. We also compare the costs between strategies two-dose vaccination without antibody tests and vaccination after antibody testing. Results Total 598 HCWs were included in analysis. Of the HCWs tests, 92.6% were seropositive to measles, 86.6% to mumps, and 79.7% to rubella. In the linear regression analysis, the seropositive of measles and rubella antibodies was increased in proportion to age (β-coefficient 43.4, 95% CI 35.1–51.6, P < 0.001 and β-coefficient 10.2, 95% CI 7.2–13.2, respectively). But, the seropositive to mumps was not related to age (β-coefficient 2.6, 95% CI -5.4–10.7, P = 0.52). The HCWs who has seropositive to all MMR was 67.2%. It was highest in 1970th birthyear (77.1%) and lowest in 1980th birthyear (60.6%). It costs less 18,000 wons ($15.5) per HCWs in strategy of vaccination after antibody testing than two-dose vaccination without antibody testing. Conclusion Our data warrant the needs for routine antibody test for MMR, followed by MMR vaccination in Korean HCWS. We expect that this strategy can save costs and avoid unnecessary vaccination. Disclosures All authors: No reported disclosures.

The presentation of congenital adrenal hyperplasia in an unscreened population

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Tracey A. Conlon ◽  
Colin P. Hawkes ◽  
Jennifer J. Brady ◽  
Nuala P. Murphy
Keyword(s):  
Congenital Adrenal Hyperplasia ◽  
Clinical Presentation ◽  
Adrenal Hyperplasia ◽  
Republic Of Ireland ◽  
Salt Wasting ◽  
Clinical Presentations ◽  
Life Threatening ◽  
History Of ◽  
The Republic ◽  
Study Inclusion

Abstract Background The aim of this study was to describe the incidence and spectrum of early clinical presentations of congenital adrenal hyperplasia (CAH) in an unscreened population. Methods A national retrospective observational study was undertaken to identify all children diagnosed with CAH in the Republic of Ireland, between January 2005 and December 2019. Reporting clinicians completed anonymized clinical questionnaires. Results There were 103 cases of CAH reported and 69 cases met the study inclusion criteria. The estimated annualized incidence of CAH in the Republic of Ireland was 1:14,754 or 0.07 cases per 1,000 live births. Forty-seven children presented clinically in the first six months of life, but only 17 of these had a confirmed diagnosis by day 10. Of these early presentations, there were 28 infants with salt-wasting, 15 females presented with virilized genitalia and four infants were detected due to a family history of CAH. Female infants presented at a median age of 0 days [IQR 0–1] and males at 14 days [IQR 9–21]. Seventy-eight percent of salt-wasting presentations occurred after day 10. Delays in clinical presentation, biochemical diagnosis and treatment initiation were identified. Conclusions The incidence of CAH is higher in Ireland than in other unscreened populations. In the absence of screening, clinicians should be aware of the possibility of CAH and appropriate investigations should be urgently requested. Life-threatening salt-wasting is the most frequent clinical presentation and many cases could be detected prior to decompensation if newborn screening were introduced.

scholarly journals The prevalence of clinical features associated with primary ciliary dyskinesia in a heterotaxy population: results of a web-based survey

2014 ◽  
Vol 25 (4) ◽  
pp. 752-759 ◽  
Author(s):  
Adam J. Shapiro ◽  
Sue Tolleson-Rinehart ◽  
Maimoona A. Zariwala ◽  
Michael R. Knowles ◽  
Margaret W. Leigh
Keyword(s):  
Clinical Features ◽  
Primary Ciliary Dyskinesia ◽  
Respiratory Symptoms ◽  
Respiratory Pathogens ◽  
Web Based ◽  
High Prevalence ◽  
History Of ◽  
Ciliary Dyskinesia ◽  
Or History

AbstractPrimary ciliary dyskinesia and heterotaxy are rare but not mutually exclusive disorders, which result from cilia dysfunction. Heterotaxy occurs in at least 12.1% of primary ciliary dyskinesia patients, but the prevalence of primary ciliary dyskinesia within the heterotaxy population is unknown. We designed and distributed a web-based survey to members of an international heterotaxy organisation to determine the prevalence of respiratory features that are common in primary ciliary dyskinesia and that might suggest the possibility of primary ciliary dyskinesia. A total of 49 members (25%) responded, and 37% of the respondents have features suggesting the possibility of primary ciliary dyskinesia, defined as (1) the presence of at least two chronic respiratory symptoms, or (2) bronchiectasis or history of respiratory pathogens suggesting primary ciliary dyskinesia. Of the respondents, four completed comprehensive, in-person evaluations, with definitive primary ciliary dyskinesia confirmed in one individual, and probable primary ciliary dyskinesia identified in two others. The high prevalence of respiratory features compatible with primary ciliary dyskinesia in this heterotaxy population suggests that a subset of heterotaxy patients have dysfunction of respiratory, as well as embryonic nodal cilia. To better assess the possibility of primary ciliary dyskinesia, heterotaxy patients with chronic oto-sino-respiratory symptoms should be referred for a primary ciliary dyskinesia evaluation.

scholarly journals A Rare Case of Malignant Lung Cancer in a 20-Year-Old Patient: Possible Diagnostic Pitfalls

2020 ◽  
pp. 1-2
Author(s):  
Iride Porcellini ◽  
Iride Porcellini ◽  
Miriam Patella ◽  
Antonio Valenti ◽  
Stefano Cafarotti
Keyword(s):  
Lung Cancer ◽  
Surgical Treatment ◽  
Respiratory Symptoms ◽  
Rare Case ◽  
Pulmonary Infection ◽  
Clinical Presentation ◽  
Diagnostic Process ◽  
Rare Form ◽  
History Of ◽  
Diagnostic Pitfalls

We present a case of a 20-year-old male with a rare form of malignant lung cancer. The patient had a long history of respiratory symptoms that have been repeatedly treated as a pulmonary infection. Despite several hints of the ineffectiveness of the therapy, the diagnosis and definitive surgical treatment were made 4 months after the onset of symptoms. Our aim is to highlight the importance of an efficient diagnostic process within multidisciplinary discussion and to warn clinicians on potential pitfalls related to unusual clinical presentation.

Incidence and natural history of HCV infection in Northern Italy: Results of an epidemiological study

2001 ◽  
Vol 120 (5) ◽  
pp. A366-A366
Author(s):  
C MAZZEO ◽  
F AZZAROLI ◽  
A COLECCHIA ◽  
S DISILVIO ◽  
A DORMI ◽  
...  
Keyword(s):  
Natural History ◽  
Epidemiological Study ◽  
Northern Italy ◽  
Hcv Infection ◽  
History Of

Clinical and anamnestic characteristics of patients with adenomyosis, accompanied by pelvic pain syndrome

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (6) ◽  
pp. 77-80
Author(s):  
M R Orazov ◽  
V E Radzinsky ◽  
M B Khamoshina ◽  
A O Dukhin ◽  
L R Toktar ◽  
...  
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain Syndrome ◽  
Pain Syndrome ◽  
Reproductive Age ◽  
Pelvic Pain Syndrome ◽  
Common Disease ◽  
Contributing Factors ◽  
High Prevalence ◽  
Inflammatory Processes ◽  
History Of

Pelvic pain syndrome associated with adenomyosis is a common disease in women of reproductive age. Frequency of detection in the population varies from 10 to 53%. The aim - to study the clinical and anamnestic risk factors of pelvic pain, with adenomiose. Materials and methods. The study included 120 (n=120) patients with diffuse adenomyosis with pain and painless form of the disease who underwent examination and treatment in the gynecological Department of the Central clinical hospital №6 of Russian Railways in Moscow. Each patient was provided with an individual card, which was encrypted 171 sign. The studied parameters reflected the passport and anthropometric data, information about education, social status, presence of occupational hazards, complaints, illness. Results. Burdened gynecological and somatic histories, manifested a low health index, a more pronounced hereditary a family history of neoplastic diseases are contributing factors, and high prevalence of postponed surgeries, chronic, long-term ongoing inflammatory processes of the pelvic organs to create a favorable background for the further progression of chronic pelvic pain syndrome in adenomiose.

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