scholarly journals Impact of COVID-19 on corneal esthesiometry

2021 ◽  
pp. bjophthalmol-2021-320003
Author(s):  
Lucas Baldissera Tochetto ◽  
Dalton de Freitas Santoro ◽  
Flavio Hirai ◽  
Danielle Dias Conte ◽  
Ana Luisa Höfling-Lima ◽  
...  
Keyword(s):  
Acute Phase ◽  
Symptom Onset ◽  
Statistical Difference ◽  
Disease Diagnosis ◽  
Additional Measurement ◽  
The Mean ◽  
Mean Time

Individuals with suspected COVID-19 symptoms (n=202) were tested using nasopharyngeal RT-qPCR. All individuals underwent corneal esthesiometry measurements using the Cochet-Bonnet esthesiometer during their first visit; 50 participants underwent an additional measurement at a mean interval of 32.5 (17.8) days. COVID-19 was confirmed in 101 subjects (50%) using nasopharyngeal PCR. The mean time from symptom onset to disease diagnosis and corneal esthesiometry was 4.2 (2.1) days. Mean corneal esthesiometry findings based on the positive and negative PCR status indicated no statistical difference. This study demonstrated that COVID-19 had no effect on corneal esthesiometry in individuals with acute-phase COVID-19.

Abstract TP232: A Biomarker Algorithm that Represents Time from Stroke Symptom Onset

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Danielle N Doll ◽  
Steven D Brooks ◽  
Stephanie L Rellick ◽  
Reyna L VanGilder ◽  
Alan Cantor ◽  
...  
Keyword(s):  
Gene Expression ◽  
Symptom Onset ◽  
Peripheral Blood ◽  
Stroke Onset ◽  
Stroke Severity ◽  
Blood Draw ◽  
Clinical Covariates ◽  
The Mean ◽  
Mean Time

Background and Purpose: Time of onset is critical when treating ischemic stroke (IS). The purpose of this project was to investigate the use of our 9 gene profile to develop a biomarker algorithm that represents time from stroke onset for use in the clinical setting to improve utilization of tissue plasminogen activator (tPA) and streamline appropriate secondary prevention. Methods: Peripheral blood samples were collected from n=34 IS patients’ ≥18 years of age within 24 hours from symptom onset and 24-48 hours later. Total RNA was extracted from whole blood in Paxgene RNA tubes, amplified, and hybridized to Illumina HumanRef-8v2 bead chips. Gene expression was compared in a univariate manner between patients at both time points using t -test in GeneSpring. Inflation of type one error was corrected by Bonferroni. A linear regression was used to model the change in gene expression as a linear function of time when controlling for age. Results: The mean age of the sample was 71.9± (14.6 sd ) years. Mean time from symptom onset to acute blood draw was 9:29± (6:2 sd ) hours (range 2:35-23:02); to follow up blood draw was 29:24± (7.1 sd ) hours (range 18:45-43:30); and time between acute and follow up blood draw was 19:55± (3.3 sd ) hours (range 13:30-27:32). CA4 and ARG1 expression significantly decreased >1.5 fold, and LY96 expression by >2-fold between baseline and follow up. This decrease in expression was associated with an increase from time of stroke onset and remained significant for only LY96 expression when controlling for age. ARG1 and CA4 expression were significantly lower in older patients. Conclusions: Our profile provides evidence that the expression of LY96 , CA4 , and ARG1 in the peripheral blood may serve as a surrogate for determining the time of stroke onset. In clinical practice, an algorithm based on this biomarker profile and other clinical covariates could be used when time of onset is unknown. To increase the accuracy of our biomarker algorithm, it will be important to determine the effects of age, stroke severity, and other clinical covariates on the expression of these genes over time.

Comparison between simple release and Z-plasty of retinaculum for de Quervain’s disease: a retrospective study

2019 ◽  
Vol 44 (4) ◽  
pp. 390-393
Author(s):  
Jin-young Kim ◽  
Jong-hun Baek ◽  
Jae-hoon Lee
Keyword(s):  
Daily Living ◽  
Analogue Scale ◽  
Statistical Difference ◽  
Level Of Evidence ◽  
De Quervain’S Disease ◽  
Surgical Methods ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Mean Time

We compared two surgical procedures for de Quervain’s disease that was not responsive to conservative treatment. Group A (simple release) consisted of 38 patients and group B (Z-plasty of the retinaculum) included 36 patients. The visual analogue scale score and the Disabilities of the Arm, Shoulder and Hand Score improved significantly after surgery; there were no statistical differences in outcome between the two groups. In group A, one patient required reoperation, two had subluxations of extensor tendons and two had temporary loss of sensation in the area of the radial nerve. In group B, two patients had temporary loss of sensation. The mean time to resolution of pain at the operative site was significantly shorter in group B. Both simple release and Z-plasty were effective surgical methods. Z-plasty allowed earlier return to activities of daily living but there was no statistical difference between the two groups in incidence of complication. Level of evidence: IV

scholarly journals EP39 Assessing the differences in times to general practitioner presentation and diagnosis, and outcomes, for axial spondyloarthritis patients in different ethnic groups

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Amanda Owusu-Agyei ◽  
Ayna Verdiyeva ◽  
Marian Chan
Keyword(s):  
General Practitioner ◽  
Median Time ◽  
Symptom Onset ◽  
Axial Spondyloarthritis ◽  
University Hospital ◽  
Response To Treatment ◽  
Caucasian Patients ◽  
The Mean ◽  
One Year ◽  
Mean Time

Abstract Background There is a documented delay to diagnosis of axial spondyloarthritis. The Luton & Dunstable University Hospital Rheumatology department looks after an ethnically diverse population of patients with the condition. This study aimed to compare time from symptom onset to general practitioner (GP) presentation, time from symptom onset to diagnosis, and response to treatment between different ethnic groups. Methods 124 patients with axial spondyloarthritis, according to the Luton & Dunstable University Hospital Infoflex database, were identified. 24 patients were excluded due to a peripheral spondyloarthritis diagnosis. A retrospective case note review of 100 case records was undertaken. Data were analysed using Microsoft Excel. Results The mean age was 44 years. 64 (64%) patients were male and 36 (36%) were female. Ethnicity breakdown showed 58 White British patients; 12 Pakistani; 7 White Other; 6 Bangladeshi; 5 White Irish; 5 Asian; 4 Indian and 3 Black Caribbean. There were 70 Caucasian (White British, Irish or Other) and 30 non-Caucasian patients. Based on available data for 57 patients, the median time of symptom onset to GP presentation was 48 months. Based on available data for 49 patients, the median time of symptom onset to diagnosis was 53 months. The mean time of symptom onset to GP presentation was 93 months in Caucasians vs. 66 months in non-Caucasians. The mean time of symptom onset to diagnosis was 91 months in Caucasians vs. 70 months in non-Caucasians. 12 patients presented within one year of symptom onset. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) data were available for 7/12 patients who presented within one year of symptom onset and 25/45 patients who presented after one year. Following NSAIDs or biologics, there was a larger decrease in the first measured BASDAI for those who presented within one year of symptom onset (Mean BASDAI decrease: 2.77 vs. 2.06). BASDAI data were available for 43/70 Caucasian patients and 18/30 non-Caucasian patients, regardless of time of presentation. The mean decrease in first measured BASDAI was smaller in Caucasian patients vs. non-Caucasian patients (Mean BASDAI decrease: 2.49 vs. 2.66). BASDAI data were available for 5/7 Caucasian and 2/5 non-Caucasian patients presenting within one year of symptom onset. The mean BASDAI decrease was 5.65 in non-Caucasian patients vs. 1.62 in Caucasian patients. BASDAI data were available for 15/26 Caucasian and 10/19 non-Caucasian patients presenting after one year of symptom onset. Mean BASDAI decrease was 2.26 in non-Caucasian vs. 1.93 in Caucasian patients. Conclusion There is a shorter mean time of symptom onset to GP presentation and diagnosis in non-Caucasians compared to Caucasians. There is a higher response to treatment in patients who present within one year of symptom onset, supporting the hypothesis that early diagnosis leads to better outcomes. Disclosures: A. Owusu-Agyei: None. A. Verdiyeva: None. M. Chan: None.

scholarly journals A150 ACCESS TIMES TO GASTROENTEROLOGY FOR HIGH-RISK IBD REFERRALS IN THE GREATER CALGARY REGION

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 14-15
Author(s):  
J St-Pierre ◽  
I Oshiomogho ◽  
G Bindra ◽  
G G Kaplan ◽  
R Panaccione ◽  
...  
Keyword(s):  
High Risk ◽  
Rectal Bleeding ◽  
Statistical Difference ◽  
Wait Time ◽  
Final Diagnosis ◽  
Adverse Outcomes ◽  
Wait Times ◽  
Cross Sectional ◽  
The Mean ◽  
Mean Time

Abstract Background Delay in the diagnosis of inflammatory bowel disease (IBD) can lead to adverse outcomes. In 2006, the CAG Wait Time Consensus Group recommended that wait times for patients with symptoms highly suggestive of IBD should be seen within two weeks. In 2007, the greater Calgary region established a central access and triage system to improve access to care as well as the “High-Risk IBD clinic” (HR-IBD) to further expedite the access of patients with IBD alarm symptoms. These included diarrhea, rectal bleeding, weight loss, abnormalities in laboratory and stool investigations. Aims The current study aimed to evaluate whether patient access to the HR-IBD clinic in the Calgary region was within recommended wait times. Methods We conducted a cross-sectional study of charts from consented patients pulled from the EMR of five Gastroenterologists in the Calgary region that received HR-IBD referrals from Feb 2014 to Jan 2018. Of the 206 patients included, the majority were female (139 vs 65) and the mean age was 34.4 y, with no statistical difference in age between genders (p=0.81). Data analysis was done with Stata (StataCorp 2019). Results The mean time to initial consult was 74.8 days (median 64), whereas time to endoscopy was 85.5 days (median 77). There was no statistical difference in the mean wait times between genders. Of the patient charts reviewed, 27% of referrals had a confirmed diagnosis of IBD (CD 17%, UC 11%). Patients with a diagnosis of UC waited a mean of 60.1 days (median 60) until initial consultation and patients with a diagnosis of CD waited 77 days (median 63.5), although this was not statistically different (p=0.27). The mean time to endoscopy for patients with UC was 77 days (median 67), and 85.4 days for patients with CD (median 78.5), again not statistically different. These wait times are below the reported wait times for all GI complaints, of 92 days from referral to consultation and 155 days from referral to procedure, as reported in the SAGE survey (2012). Although there were no differences in time to consult and endoscopy between groups, there were notable differences in alarm symptoms reported in the referral. For example, rectal bleeding was reported in 81.8% of referrals that culminated in a diagnosis of UC, as compared to 50% in CD and 47.6% of non-IBD patients. Further analysis in which alarm symptoms correlate with a final diagnosis of IBD may guide triaging of referrals to decrease the time to diagnosis. Conclusions Timely access for consultation and endoscopy for patients presenting with high-risk features for IBD by Gastroenterology in the Calgary region remains above the CAG recommended wait times. Further correlation of high-risk features with a final diagnosis of IBD will help risk-stratify referrals in order to decrease time to IBD diagnosis. Funding Agencies CIHRAlberta Innovates Health Solutions

scholarly journals Novel Coronavirus Outbreak in Wuhan, China, 2020: Intense Surveillance Is Vital for Preventing Sustained Transmission in New Locations

2020 ◽  
Vol 9 (2) ◽  
pp. 498 ◽  
Author(s):  
Robin N. Thompson
Keyword(s):  
Symptom Onset ◽  
Credible Interval ◽  
Imported Case ◽  
Global Pandemic ◽  
New Locations ◽  
Current Outbreak ◽  
The Mean ◽  
The Times ◽  
Novel Coronavirus ◽  
Mean Time

The outbreak of pneumonia originating in Wuhan, China, has generated 24,500 confirmed cases, including 492 deaths, as of 5 February 2020. The virus (2019-nCoV) has spread elsewhere in China and to 24 countries, including South Korea, Thailand, Japan and USA. Fortunately, there has only been limited human-to-human transmission outside of China. Here, we assess the risk of sustained transmission whenever the coronavirus arrives in other countries. Data describing the times from symptom onset to hospitalisation for 47 patients infected early in the current outbreak are used to generate an estimate for the probability that an imported case is followed by sustained human-to-human transmission. Under the assumptions that the imported case is representative of the patients in China, and that the 2019-nCoV is similarly transmissible to the SARS coronavirus, the probability that an imported case is followed by sustained human-to-human transmission is 0.41 (credible interval [0.27, 0.55]). However, if the mean time from symptom onset to hospitalisation can be halved by intense surveillance, then the probability that an imported case leads to sustained transmission is only 0.012 (credible interval [0, 0.099]). This emphasises the importance of current surveillance efforts in countries around the world, to ensure that the ongoing outbreak will not become a global pandemic.

scholarly journals 2019-20 Wuhan coronavirus outbreak: Intense surveillance is vital for preventing sustained transmission in new locations

2020 ◽  
Author(s):  
R.N. Thompson
Keyword(s):  
South Korea ◽  
Symptom Onset ◽  
Global Epidemic ◽  
Imported Case ◽  
The World ◽  
New Locations ◽  
Current Outbreak ◽  
The Mean ◽  
The Times ◽  
Mean Time

ABSTRACTThe outbreak of pneumonia originating in Wuhan, China, has generated 830 confirmed cases, including 26 deaths, as of 24 January 2020. The virus (2019-nCoV) has spread elsewhere in China and to other countries, including South Korea, Thailand, Japan and USA. Fortunately, there has not yet been evidence of sustained human-to-human transmission outside of China. Here we assess the risk of sustained transmission whenever the coronavirus arrives in other countries. Data describing the times from symptom onset to hospitalisation for 47 patients infected in the current outbreak are used to generate an estimate for the probability that an imported case is followed by sustained human-to-human transmission. Under the assumptions that the imported case is representative of the patients in China, and that the 2019-nCoV is similarly transmissible to the SARS coronavirus, the probability that an imported case is followed by sustained human-to-human transmission is 0.37. However, if the mean time from symptom onset to hospitalisation can be halved by intense surveillance, then the probability that an imported case leads to sustained transmission is only 0.005. This emphasises the importance of current surveillance efforts in countries around the world, to ensure that the ongoing outbreak will not become a large global epidemic.

Predicting Daily Maintenance Dose of Fluindione, an Oral Anticoagulant Drug

1996 ◽  
Vol 75 (05) ◽  
pp. 731-733 ◽  
Author(s):  
V Cazaux ◽  
B Gauthier ◽  
A Elias ◽  
D Lefebvre ◽  
J Tredez ◽  
...  
Keyword(s):  
Effective Dose ◽  
Maintenance Dose ◽  
Successive Approximations ◽  
Hemorrhagic Complication ◽  
Simple Method ◽  
Individual Variations ◽  
Anticoagulant Drug ◽  
The Mean ◽  
Mean Time ◽  
Daily Maintenance Dose

SummaryDue to large inter-individual variations, the dose of vitamin K antagonist required to target the desired hypocoagulability is hardly predictible for a given patient, and the time needed to reach therapeutic equilibrium may be excessively long. This work reports on a simple method for predicting the daily maintenance dose of fluindione after the third intake. In a first step, 37 patients were delivered 20 mg of fluindione once a day, at 6 p.m. for 3 consecutive days. On the morning of the 4th day an INR was performed. During the following days the dose was adjusted to target an INR between 2 and 3. There was a good correlation (r = 0.83, p<0.001) between the INR performed on the morning of day 4 and the daily maintenance dose determined later by successive approximations. This allowed us to write a decisional algorithm to predict the effective maintenance dose of fluindione from the INR performed on day 4. The usefulness and the safety of this approach was tested in a second prospective study on 46 patients receiving fluindione according to the same initial scheme. The predicted dose was compared to the effective dose soon after having reached the equilibrium, then 30 and 90 days after. To within 5 mg (one quarter of a tablet), the predicted dose was the effective dose in 98%, 86% and 81% of the patients at the 3 times respectively. The mean time needed to reach the therapeutic equilibrium was reduced from 13 days in the first study to 6 days in the second study. No hemorrhagic complication occurred. Thus the strategy formerly developed to predict the daily maintenance dose of warfarin from the prothrombin time ratio or the thrombotest performed 3 days after starting the treatment may also be applied to fluindione and the INR measurement.

Determination some Immunological Aspects in Pulmonary Tuberculosis Patients in Qadisiyah Province

2018 ◽  
Vol 9 (2) ◽  
Author(s):  
Syoof Khowman Alramahy ◽  
Akram Hadi Hamza
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Pulmonary Tuberculosis ◽  
Statistical Difference ◽  
Positive Culture ◽  
Control Group ◽  
Tuberculosis Patients ◽  
Significant Difference ◽  
Lowenstein Jensen ◽  
The Mean ◽  
Igg Level

This study was carried out to study of some immunological aspects among the pulmonary Tuberculosis patients infected with causative agent, Mycobacterium tuberculosis. A Total of 200 sputum samples were collected from patients attending the consultant Clinic for Chest and Respiratory disease center, Diwaniya. Control group (No=15) also included. According to acid fast stain of sputum, the patients were classified as positive (No=91,45.5%) and negative (No=109,54.5, Lowenstein Jensen medium used for the cultivation of samples, on which 70% of sputum samples where positive culture for this microorganism. The grown microorganism were identified as M. tuberculosis, based on positive A.F.B, Niacin producers ,negative for catlase at 68c. The mean IgG level was l184.053±76.684 mg/100 ml in tuberculosis group compared with 1016.533 ± 44.882 mg/100ml in control group, rendering the statistical difference significant. For IgA and IgM levels, they were at mean of 315.880±38.552 mg/100 ml and 119.527±8.464 mg/100 ml in control group compared with 396.358±38.776 mg/100 ml and 134.207±11.696 mg/100 ml in patients group respectively with significant difference

Retrospective analysis of mortality within 30 days of systemic anticancer therapy and comparison with a previous audit at an Australian Regional Cancer Centre

2021 ◽  
pp. 107815522110160
Author(s):  
Bernadatte Zimbwa ◽  
Peter J Gilbar ◽  
Mark R Davis ◽  
Srinivas Kondalsamy-Chennakesavan
Keyword(s):  
Checkpoint Inhibitors ◽  
Anticancer Therapy ◽  
Mortality Rates ◽  
Feedback Process ◽  
Time To Death ◽  
Cancer Centre ◽  
Haematology Patients ◽  
The Mean ◽  
Regional Cancer Centre ◽  
Mean Time

Purpose To retrospectively determine the rate of death occurring within 14 and 30 days of systemic anticancer therapy (SACT), compare this against a previous audit and benchmark results against other cancer centres. Secondly, to determine if the introduction of immune checkpoint inhibitors (ICI), not available at the time of the initial audit, impacted mortality rates. Method All adult solid tumour and haematology patients receiving SACT at an Australian Regional Cancer Centre (RCC) between January 2016 and July 2020 were included. Results Over a 55-month period, 1709 patients received SACT. Patients dying within 14 and 30 days of SACT were 3.3% and 7.0% respectively and is slightly higher than our previous study which was 1.89% and 5.6%. Mean time to death was 15.5 days. Males accounted for 63.9% of patients and the mean age was 66.8 years. 46.2% of the 119 patients dying in the 30 days post SACT started a new line of treatment during that time. Of 98 patients receiving ICI, 22.5% died within 30 days of commencement. Disease progression was the most common cause of death (79%). The most common place of death was the RCC (38.7%). Conclusion The rate of death observed in our re-audit compares favourably with our previous audit and is still at the lower end of that seen in published studies in Australia and internationally. Cases of patients dying within 30 days of SACT should be regularly reviewed to maintain awareness of this benchmark of quality assurance and provide a feedback process for clinicians.

Vitamin D Level Stability in Dystrophinopathy Patients on Vitamin D Supplementation

2021 ◽  
pp. 1-7
Author(s):  
Naomi Vather-Wu ◽  
Matthew D. Krasowski ◽  
Katherine D. Mathews ◽  
Amal Shibli-Rahhal
Keyword(s):  
Vitamin D ◽  
Retrospective Cohort ◽  
Vitamin D Supplementation ◽  
Hydroxyvitamin D ◽  
Frequent Monitoring ◽  
25 Hydroxyvitamin D ◽  
The Mean ◽  
Stable Maintenance ◽  
Mean Time

Background: Expert guidelines recommend annual monitoring of 25-hydroxyvitamin D (25-OHD) and maintaining 25-OHD ≥30 ng/ml in patients with dystrophinopathies. Objective: We hypothesized that 25-OHD remains stable and requires less frequent monitoring in patients taking stable maintenance doses of vitamin D. Methods: We performed a retrospective cohort study, using the electronic health record to identify 26 patients with dystrophinopathies with a baseline 25-OHD ≥30 ng/mL and at least one additional 25-OHD measurement. These patients had received a stable dose of vitamin D for ≥3 months prior to their baseline 25-OHD measurement and throughout follow-up. The main outcome measured was the mean duration time the subjects spent with a 25-OHD ≥30 ng/mL. Results: Only 19% of patients dropped their 25-OHD to <  30 ng/ml, with a mean time to drop of 33 months and a median nadir 25-OHD of 28 ng/mL. Conclusions: These results suggest that measurement of 25-OHD every 2–2.5 years may be sufficient in patients with a baseline 25-OHD ≥30 ng/mL and who are on a stable maintenance dose of vitamin D. Other patients may require more frequent assessments.

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