scholarly journals Studying the pathophysiology of coronavirus disease 2019 – a protocol for the Berlin prospective COVID-19 patient cohort (Pa-COVID-19)

2020 ◽  
Author(s):  
Florian Kurth ◽  
Maria Roennefarth ◽  
Charlotte Thibeault ◽  
Victor M. Corman ◽  
Holger Müller-Redetzky ◽  
...  
Keyword(s):  
Data Collection ◽  
Medical Care ◽  
Clinical Course ◽  
National Standards ◽  
Ordinal Scale ◽  
Standards Of Care ◽  
Sample Collection ◽  
Comprehensive Data ◽  
Deep Phenotyping

AbstractPurposeSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide causing a global health emergency. Pa-COVID-19 aims to provide comprehensive data on clinical course, pathophysiology, immunology and outcome of COVID-19, in order to identify prognostic biomarkers, clinical scores, and therapeutic targets for improved clinical management and preventive interventions.MethodsPa-COVID-19 is a prospective observational cohort study of patients with confirmed SARS-CoV-2 infection treated at Charité - Universitätsmedizin Berlin. We collect data on epidemiology, demography, medical history, symptoms, clinical course, pathogen testing and treatment. Systematic, serial blood sampling will allow deep molecular and immunological phenotyping, transcriptomic profiling, and comprehensive biobanking. Longitudinal data and sample collection during hospitalization will be supplemented by long-term follow-up.ResultsOutcome measures include the WHO clinical ordinal scale on day 15 and clinical, functional and health-related quality of life assessments at discharge and during follow-up. We developed a scalable dataset to (i) suit national standards of care (ii) facilitate comprehensive data collection in medical care facilities with varying resources and (iii) allow for rapid implementation of interventional trials based on the standardized study design and data collection. We propose this scalable protocol as blueprint for harmonized data collection and deep phenotyping in COVID-19 in Germany.ConclusionWe established a basic platform for harmonized, scalable data collection, pathophysiological analysis, and deep phenotyping of COVID-19, which enables rapid generation of evidence for improved medical care and identification of candidate therapeutic and preventive strategies. The electronic database accredited for interventional trials allows fast trial implementation for candidate therapeutic agents.

An audit on the management of pelvic inflammatory disease in the West Midlands, UK

2007 ◽  
Vol 18 (10) ◽  
pp. 717-719 ◽  
Author(s):  
M Walzman ◽  
A Tariq ◽  
S Bhaduri ◽  
J D C Ross
Keyword(s):  
Data Collection ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
National Standards ◽  
National Standard ◽  
Standards Of Care ◽  
National Guidelines ◽  
The West ◽  
West Midlands

The potential complications of pelvic inflammatory disease (PID) make optimizing its management a high priority. A clinical audit of PID against current national management guidelines was conducted in 14 departments of genitourinary medicine in the West Midlands for women presenting with PID between January and December 2005. There were a total of 810 diagnoses of PID made from a total of 49,390 female attendees for that year, giving an incidence of 164 cases per 10,000 attendees. Of these 810 cases, data collection and analysis for this audit were performed on 139. An ofloxacin 400 mg twice daily (b.i.d.) based regimen was prescribed in 91 (65%, 95% confidence interval [CI] 57–73%) cases. Doxycycline 100 mg b. i. d. for 14 days plus metronidazole 400 mg b. i. d. for 5–14 days was prescribed in 44 (32%, 95% CI 25–40%) cases, but a third-generation cephalosporin was only given with this regimen in three cases. Partner notification was performed in 101 (73%, 95% CI 65–79%) cases. A total of 130 male contacts were recorded on the data collection forms, and of these 58 (45%) were traced and 51 (39%), treated. A follow-up appointment was given to 133 (96%, 95% CI 91–98%) women, although in most cases this was for seven days or more, and 104 (78%, 95% CI 67–81%) women attended for follow-up. Adherence to the national guidelines in this cohort of patients did not reach the national standard for choice of treatment regimen nor did it attain the target for proportion of male partners traced. Barriers preventing adherence to the national guidelines need to be explored and appropriate assistance given to physicians to help meet national standards of care.

Evaluating quality of care for rheumatoid arthritis for the population of Alberta using system-level performance measures

2020 ◽  
pp. jrheum.200420
Author(s):  
Claire E. H. Barber ◽  
Diane Lacaille ◽  
Peter Faris ◽  
Dianne Mosher ◽  
Steven Katz ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Performance Measures ◽  
Case Definition ◽  
National Standards ◽  
System Level ◽  
Standards Of Care ◽  
One Year ◽  
Incident Cases ◽  
Level Performance

Objective We evaluated 4 national rheumatoid arthritis (RA) system-level performance measures (PMs) in Alberta, Canada. Methods Incident and prevalent RA cases ≥ 16 years of age since 2002 were identified using a validated case definition applied in provincial administrative data. Performance was ascertained through analysis of health data between fiscal years 2012/13-2015/16. Measures evaluated were: proportion of incident RA cases with a rheumatologist visit within one year of first RA diagnosis code (PM1); proportion of prevalent RA patients dispensed a disease modifying anti-rheumatic drug (DMARD) annually (PM2); time from first visit with an RA code to DMARD dispensation, and proportion of incident cases where the 14-day benchmark for dispensation was met (PM3); and proportion of patients seen in annual follow-up (PM4). Results There were 31566 prevalent and 2730 incident RA cases (2012/13). Over the analysis period, the proportion of patients seen by a rheumatologist within 1 year of onset (PM1) increased from 55 to 63%; however, the proportion of RA patients dispensed DMARDs annually (PM2) remained low at 43%. While the median time to DMARD from first visit date in people who received DMARDs improved over time from 39 to 28 days, only 38-41% of patients received treatment within the 14-day benchmark (PM3). The percentage of patients seen in yearly follow-up (PM4) varied between 73-80%. Conclusion The existing Alberta health care system for RA is suboptimal, indicating barriers to accessing specialty care and treatment. The results inform quality improvement initiatives required within the province to meet national standards of care.

Melatih Kepemimpinan Perangkat Desa Kebonharjo Kulonprogo: Membangun Sikap Anti Korupsi

2018 ◽  
Vol 1 ◽  
pp. 107
Author(s):  
Adi Heryadi ◽  
Evianawati Evianawati
Keyword(s):  
Transformational Leadership ◽  
Data Collection ◽  
Paired Samples ◽  
Significant Difference ◽  
Before And After ◽  
Post Test ◽  
Sample Test ◽  
Corruption Perception ◽  
Measuring Tool

This study aims to prove whether transformational leadership training is effective for building anti-corruption attitudes of villages in Kebonharjo village, subdistrict Samigaluh Kulonprogo. This research is an experimental research with one group pre and posttest design.Subject design is 17 people from village of 21 candidates registered. Measuring tool used in this research is the scale of anti-corruption perception made by the researcher referring to the 9 anti-corruption values with the value of reliability coefficient of 0.871. The module used as an intervention made by the researcher refers to the transformational leadership dimension (Bass, 1990). The data collected is analyzed by statistical analysis of different test Paired Sample Test. Initial data collection results obtained sign value of 0.770 which means> 0.05 or no significant difference between anti-corruption perception score between before and after training. After a period of less than 1 (one) month then conducted again the measurement of follow-up of the study subjects in the measurement again using the scale of anti-corruption perception. The results of the second data collection were analysed with Paired Samples Test and obtained the value of 0.623 sign meaning p> 0.05 or no significant difference between post test data with follow-up data so that the hypothesis of this study was rejected.

PERSEPSI WISATAWAN TERHADAP OBJEK WISATA PULAU BOKORI DI DESA BOKORI KECAMATAN SOROPIA KABUPATEN KONAWE

2018 ◽  
Vol 3 (2) ◽  
pp. 181
Author(s):  
Rahmat Rahmat
Keyword(s):  
Data Analysis ◽  
Data Collection ◽  
Qualitative Method ◽  
Average Score ◽  
Questionnaire Data ◽  
Sample Collection ◽  
Average Rating ◽  
Quota Sampling ◽  
Descriptive Qualitative

This study aims to determine the Tourist Perception of Bokori Island Tourism Object in Bokori Village, Soropia District of Konawe Regency. This study used descriptive qualitative method. Subjects in this study were tourists visiting attractions Bokori Island. Traveler sampling in this study set out in the quota sampling 50 respondents, in this study the sample collection technique by accidental sampling.Methods of  data collection using questionnaires, observation and documentation. Questionnaire data analysis in this research is the analysis presented in the table percentage and distribution. Based on the results obtained show that, according to the perception of tourists attractions of the Bokori Island (1) appeal to the average score - average rating of 3.31 with the perception of being in either category, (2) accessibility with a mean score - average of 3.40 with the perception of tourists are in good category, (3) visitor facilities with a mean score - average rating of 3.12 with the perception of being in either category, (4) infrastructure with a mean score - average 3.53 with the perception of tourists were in the excellent category, (5) security with a mean score - average of 3.24 with the perceptions of visitors are in good category, (6) the promotion with a mean score - average of 3.32 with the perceptions of visitors are in either category. Thus the perception of the overall rating showed a mean score - average rating of 3.32 with the perception of being in either category.

THYROID TYPE CARCINOMA ARISING IN STRUMA OVARII. SIX CLINICAL CASES AND REVIEW

2018 ◽  
Vol 64 (6) ◽  
pp. 708-715
Author(s):  
Natalya Severskaya ◽  
Andrey Rodichev ◽  
Aleksey Ilin ◽  
Dmitriy Semin ◽  
Pavel Isaev ◽  
...  
Keyword(s):  
Radioiodine Therapy ◽  
Clinical Course ◽  
Case Reports ◽  
Thyroid Tissue ◽  
Follicular Carcinoma ◽  
Complete Response ◽  
Pelvic Surgery ◽  
Ovarian Teratoma ◽  
Struma Ovarii

Struma ovarii is a rare variant of the mature ovarian teratoma composed of more than 50% thyroid tissue. Thyroid type carcinoma can occur in 5% of struma ovarii. Given the rarity of this pathology, as well as the different clinical course, approaches to the treatment of this disease are controversial. The proposed approaches to treatment vary from ovarian resection to total hysterectomy with bilateral salpingo-oophorectomy and adjuvant therapy. We present here 6 case reports of thyroid type carcinoma in struma ovarii and outcome of patients treated in our clinic. All patients had pelvic surgery of different extent, followed by thyroidectomy and radioiodine therapy. The incidence of metastasis is 67% (4/6), 2 - intraperitoneal metas-tases, 2 - bone metastases. Among patients with metastases, 2 have reached a complete response, one with a good response continues treatment, one had progression. The follow-up period is 1 to 15 years (median 4 years). One patient with follicular carcinoma died of progression 8 years after diagnosis. The remaining patients are alive.

Evaluation of medical care for Diabetic and Hypertensive patients in primary care in Mexico: Observational retrospective study (Preprint)

2020 ◽  
Author(s):  
Agustin Lara-Esqueda ◽  
Sergio A Zaizar-Fregoso ◽  
Violeta M Madrigal-Perez ◽  
Mario Ramirez-Flores ◽  
Daniel A Montes-Galindo ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Medical Care ◽  
Serum Lipids ◽  
Quality Care ◽  
Premature Death ◽  
Current Standard ◽  
Anonymized Data ◽  
Quality Of Medical Care

BACKGROUND Diabetes Mellitus is a worldwide health problem and the leading cause of premature death with increasing prevalence over time. Usually, along with it, Hypertension presents and acts as another risk factor that increases mortality risk. Both diseases impact the country's health while also producing an economic burden for society, causing billions of dollars to be invested in their management. OBJECTIVE The present study evaluated the quality of medical care for patients diagnosed with diabetes mellitus (DM), hypertension (HBP), and both pathologies (DM+HBP) within a public health system in Mexico, according to the official Mexican standard for each pathology. METHODS 45,498 patients were included from 2012 to 2015. All information was taken from the electronic medical records database, exported as anonymized data for research purposes. Each patient record was compared against the standard to test the quality of medical care. RESULTS Glycemia with hypertension goals reached 29.6% in DM+HBP, 48.6% in DM, and 53.2% in HBP. The goals of serum lipids were reached by 3% in DM+HBP, 5% in DM, and 0.2% in HBP. Glycemia, hypertension, and LDL cholesterol reached 0.04%. 15% of patients had an undiagnosed disease of diabetes or hypertension. Clinical follow-up examinations reached 20% for foot examination and clinical eye examination in the whole population. Specialty referral reached 1% in angiology or cardiology in the whole population. CONCLUSIONS Goals for glycemic and hypertension reached 50% in the overall population, while serum lipids, clinical follow-up examinations, and referral to a specialist were deficient. Patients who had both diseases had more consultations, better control for hypertension and lipids, but inferior glycemic control. Overall, quality care for DM and/or HBP has not been met according to the standards. While patients with DM and HBP do not have a current standard to evaluate their own needs.

scholarly journals Severe tricuspid regurgitation 14 years after diagnosis of “transient neonatal tricuspid regurgitation”

Heart ◽  
2001 ◽  
Vol 86 (1) ◽  
pp. 88-90
Author(s):  
D Boshoff ◽  
L Mertens ◽  
M Gewillig
Keyword(s):  
Tricuspid Regurgitation ◽  
Neonatal Period ◽  
Clinical Course ◽  
Subsequent Evolution ◽  
Severe Tricuspid Regurgitation ◽  
Echocardiographic Examination ◽  
Long Term Follow Up ◽  
Transient Tricuspid Regurgitation

A 14 year old girl presented with severe tricuspid regurgitation after she was diagnosed with “transient tricuspid regurgitation of the newborn”. In the neonatal period she had presented with severe tricuspid regurgitation without an obvious underlying anatomical cause. This spontaneously regressed during the first months of life. She was dismissed from follow up at the age of 5 years after complete normalisation of the clinical and echocardiographic examination. The subsequent evolution and management of the patient, as well as the possible pathogenesis responsible for the unusual clinical course, is discussed. This case stresses the importance of long term follow up of patients with transient tricuspid regurgitation.

scholarly journals Ophthalmic Screening in Patients with Coronavirus Disease 2019: A Prospective Cohort Study

2021 ◽  
Vol 10 (5) ◽  
pp. 896
Author(s):  
Anthia Papazoglou ◽  
Anna Conen ◽  
Sebastian Haubitz ◽  
Markus Tschopp ◽  
Viviane J. Guignard ◽  
...  
Keyword(s):  
Animal Studies ◽  
Clinical Course ◽  
Intraocular Inflammation ◽  
Ocular Motility ◽  
Corrected Visual Acuity ◽  
Published Evidence ◽  
Laboratory Results ◽  
Minimum Angle ◽  
Observation Period

Postmortem pathological examinations, animal studies, and anecdotal reports suggest that coronavirus disease 2019 (COVID-19) could potentially affect intraocular tissue. However, published evidence is scarce and conflicting. In our study, we screened 100 eyes of 50 patients hospitalized for COVID-19. Relevant medical and ophthalmological history was assessed as well as symptoms, laboratory results, specific treatments, clinical course, and outcome. Ophthalmic exams including assessment of best corrected visual acuity (BCVA), intraocular pressure (IOP), color perception, ocular motility, ophthalmoscopy as well as optical coherence tomography (OCT) of the macula and the optic disc was performed at hospital admission and 29 to 192 days later. Of the 50 patients included, 14 (28%) were female. Median age was 64.5 (range 29–90) years. COVID-19 severity was mild in 15 (30%), severe in 30 (60%), and critical in five cases (10%). At baseline, median BCVA was 0.1 (0–1.8) Logarithm of the Minimum Angle of Resolution (LogMAR) and median IOP was 16 (8–22) mmHg. At follow-up, no relevant changes in BCVA and IOP were documented. No signs of active intraocular inflammation or optic nerve affection were found and OCT findings were widely stable during the observation period. Our findings suggest that COVID-19 does not regularly affect intraocular tissue.

scholarly journals 71 Ultrasound directed reduction of Colles’ type distal radial fractures in ED (UDiReCT): a feasibility randomized controlled trial

2020 ◽  
Vol 37 (12) ◽  
pp. 835.3-836
Author(s):  
Hamza Malik ◽  
Andrew Appelboam ◽  
Gordon Taylor ◽  
Daryl Wood ◽  
Karen Knapp
Keyword(s):  
Data Collection ◽  
Controlled Trial ◽  
Wrist Fracture ◽  
Recruitment Rate ◽  
Feasibility Trial ◽  
Point Of Care Ultrasound ◽  
Distal Radial Fractures ◽  
Definitive Trial ◽  
Randomised Controlled

Aims/Objectives/BackgroundWrist fractures are among the commonest injuries seen in the emergency department (ED). Around 25% of these injuries have Colles’ type fracture displacement and undergo manipulation in the ED. In the UK, these manipulations are typically done ‘blind’ without real time imaging and recent observational studies show that over 40% of the injuries go on to require surgical fixation (due to inadequate initial reduction or re-displacement). Point of care ultrasound has been used to guide and improve wrist fracture reductions but it’s effect on subsequent outcome is not established. We set up and ran the UK’s first randomised controlled feasibility trial comparing standard and ultrasound guided ED wrist fracture manipulations to test a definitive trial protocol, data collection and estimate recruitment rate towards a future definitive trial.Methods/DesignWe conducted a 1:1, single blind, parallel group, randomised controlled feasibility trial in two UK hospitals. Adults with Colles’ type distal radial fractures requiring manipulation in the ED were recruited by supervising emergency physicians supported by network research nurses. Participants were randomised to ultrasound directed fracture manipulation (intervention) or standard care with sham ultrasound (controls). The trial was run through Exeter Clinical Trials Unit and consent, randomisation and data collection conducted electronically in REDCap cloud. All participants were followed up at 6 weeks to record any surgical intervention and also underwent baseline and 3 month quality of life (EQ-5D-5L) and wrist function (Patient Rated Wrist Evaluation (PRWE) assessments.Results/ConclusionsWe recruited 47 patients in total, with 23 randomised to the interventional arm and 24 randomised to the control arm. We were able to follow up 100% of the patients for the 6 week follow up. Data analysis and results will be presented at the time of the conference.

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