scholarly journals Case series of coronavirus (SARS-CoV-2) in a military recruit school: clinical, sanitary and logistical implications

2020 ◽  
pp. bmjmilitary-2020-001482 ◽  
Author(s):  
Sascha J Baettig ◽  
A Parini ◽  
I Cardona ◽  
G B Morand
Keyword(s):  
Close Contact ◽  
Case Series ◽  
Armed Forces ◽  
Index Patient ◽  
Confined Space ◽  
Serological Testing ◽  
Military Recruit ◽  
First Case ◽  
Asymptomatic Patients ◽  
The Impact

IntroductionA new coronavirus, called Severe Acute Respiratory Syndrome-CoronaVirus-2 (SARS-CoV-2), has emerged from China in late 2019 and has now caused a worldwide pandemic. The impact of COVID-19 has not been described so far in a military setting. We therefore report a case series of infected patients in a recruit school in Switzerland and the herein associated challenges.MethodsRetrospective review of COVID-19 cases among Swiss Armed Forces recruits in the early weeks of SARS-CoV-2 pandemic in the canton of Ticino, the southernmost canton of Switzerland. Positive cases were defined with two positive PCR testing for SARS-CoV-2 from nasopharyngeal swabs. Serological testing was performed with a commercially available kit according to manufacturers’ instructions.ResultsThe first case was likely contaminated while skiing during weekend permission. He became symptomatic 4 days later, tested positive for SARS-CoV-2 and was put into isolation. He showed complete symptom resolution after 48 hours. Quarantine was ordered for all recruits with close contact in the past 2 days, a total of 55 persons out of 140 in the company. Seven out of nine recruits in one particular quarantine room became mildly symptomatic. SARS-CoV-2 PCR was positive in one of them. Seven days after initial diagnosis, the index patient and the other one from the quarantine retested positive for SARS-CoV-2, although they had been completely asymptomatic for over 96 hours. Serological testing revealed positive for both patients. All others showed negative IgM and IgG.ConclusionsYoung healthy recruits often showed a mild course of COVID-19 with rapid symptom decline but were persistent SARS-CoV-2 carriers. This illustrates how asymptomatic patients may be responsible for covert viral transmission. An early and prolonged establishment of isolation and quarantine for patients and close contacts is essential to slow down the spread of SARS-CoV-2, especially in the confined space of a military environment.

scholarly journals Characterization of an Asymptomatic Cohort of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infected Individuals Outside of Wuhan, China

2020 ◽  
Vol 71 (16) ◽  
pp. 2132-2138 ◽  
Author(s):  
Yubo Wang ◽  
Yong He ◽  
Jin Tong ◽  
Yalan Qin ◽  
Ting Xie ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Close Contact ◽  
Index Patient ◽  
Chest Ct ◽  
Rt Pcr ◽  
Laboratory Findings ◽  
Ct Findings ◽  
Normal Chest ◽  
Asymptomatic Individuals ◽  
The Impact

Abstract Purpose We aimed to further clarify the epidemiological and clinical characteristics of asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. Methods We identified close contacts of confirmed coronavirus disease 2019 (COVID-19) cases in northeast Chongqing, China, who were confirmed by real-time reverse transcription polymerase chain reaction-positive (RT-PCR+). We stratified this cohort by normal vs abnormal findings on chest computed tomography (CT) and compared the strata regarding comorbidities, demographics, laboratory findings, viral transmission and other factors. Results Between January 2020 and March 2020, we identified and hospitalized 279 RT-PCR+ contacts of COVID-19 patients. 63 (23%) remained asymptomatic until discharge; 29 had abnormal and 34 had normal chest CT findings. The mean cohort age was 39.3 years, and 87.3% had no comorbidities. Mean time to diagnosis after close contact with a COVID-19 index patient was 16.0 days, and it was 13.4 days and 18.7 days for those with abnormal and normal CT findings, respectively (P < .05). Nine patients (14.3%) transmitted the virus to others; 4 and 5 were in the abnormal and normal CT strata, respectively. The median length of time for nucleic acid to turn negative was 13 days compared with 10.4 days in those with normal chest CT scans (P < .05). Conclusions A portion of asymptomatic individuals were capable of transmitting the virus to others. Given the frequency and potential infectiousness of asymptomatic infections, testing of traced contacts is essential. Studies of the impact of treatment of asymptomatic RT-PCR+ individuals on disease progression and transmission should be undertaken.

Intensity and Rate of COVID-19 Infection in Pakistan

2020 ◽  
Author(s):  
Anila Jaleel
Keyword(s):  
Close Contact ◽  
Developed Countries ◽  
Living Systems ◽  
Severity Of Disease ◽  
Asymptomatic Patients ◽  
The World ◽  
Family Living ◽  
The Impact ◽  
Local Transmission

Since the WHO has declared the Covid 19 pandemic, number of cases is on rise but not attained peak in Pakistan. Although people are affected by COVID-19 throughout the world but the impact of, the disease is different in various countries, which may be attributed to different factors. Scientifically it is point to ponder that though the official figures are in thousands but there may be many asymptomatic patients in our communities due to closed family living systems in Pakistan. There are more than 12 to 13 people living in single small apartments in Karachi, who are in so close contact with each other and the local transmission cannot be avoided in them. However, the positive thing is that the severity of disease and number of deaths in Pakistan are not as much as in developed countries. There could be a number of reasons, which are needed to be explored by researchers in Pakistan and world over.

Indirect bypass for maternal symptomatic moyamoya in the first trimester of pregnancy: case report

2020 ◽  
Vol 25 (2) ◽  
pp. 138-143
Author(s):  
Katie P. Fehnel ◽  
Craig D. McClain ◽  
Edward R. Smith
Keyword(s):  
Case Reports ◽  
Case Series ◽  
Index Patient ◽  
First Trimester ◽  
Childbearing Age ◽  
Surgical Revascularization ◽  
First Case ◽  
Risk Period ◽  
First Trimester Of Pregnancy ◽  
Term Baby

There are no practice guidelines for the treatment of moyamoya disease in pregnant women. The need for such guidelines, however, is evidenced by the numerous case reports, case series, and systematic reviews in the literature highlighting an at-risk period for female moyamoya patients of childbearing age. Here the authors review and interpret the existing literature as it applies to their index patient and expand the literature in support of treating select patients during pregnancy. The authors describe what is to their knowledge the first case reported in the literature of a patient successfully treated with indirect surgical revascularization during the first trimester, who went on to deliver a healthy term baby without complications.

scholarly journals Case Report: Pheochromocytoma and Synchronous Neuroblastoma in a Family With Hereditary Pheochromocytoma Associated With a MAX Deleterious Variant

2021 ◽  
Vol 12 ◽  
Author(s):  
Diana Borges Duarte ◽  
Lia Ferreira ◽  
Ana P. Santos ◽  
Cláudia Costa ◽  
Jorge Lima ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Age At Onset ◽  
Case Series ◽  
Bilateral Pheochromocytoma ◽  
First Case ◽  
Deleterious Variant ◽  
The One ◽  
Hereditary Pheochromocytoma ◽  
The Impact ◽  
Number Of Individuals

IntroductionPheochromocytomas are rare catecholamine-producing neuroendocrine tumours arising from chromaffin cells of the adrenal medulla or extra-adrenal sympathetic paraganglia. Recent studies have indicated that up to 40% of pheochromocytomas could be attributable to an inherited germline variant in an increasing list of susceptibility genes. Germline variants of the MYC-associated factor (MAX) gene have been associated with familial pheochromocytomas and paragangliomas with an autosomal dominant pattern of inheritance, a median age at onset of 33 years and an overall frequency estimated at 1.9%. We describe a deleterious MAX variant associated with hereditary pheochromocytoma in a family with four affected individuals.Case presentationThe first patient presented with bilateral pheochromocytoma in 1995; genetic testing was proposed to his oldest son, when he was diagnosed with a bilateral pheochromocytoma with a synchronous neuroblastoma. Upon the identification of the MAX variant c.97C>T, p.(Arg33Ter), in the latter individual, his two siblings and their father were tested and the same variant was identified in all of them. Both siblings were subsequently diagnosed with pheochromocytoma (one of them bilateral) and choose to remain on active surveillance before they were submitted to adrenalectomy. All the tumours secreted predominantly norepinephrine, accordingly to the typical biochemical phenotype ascribed to variants in the MAX gene.ConclusionThis case series is, to our knowledge, the one with the largest number of individuals with hereditary pheochromocytoma with a deleterious MAX variant in the same family. It is also the first case with a synchronous pheochromocytoma and neuroblastoma in carriers of a MAX deleterious variant. This report draws attention to some ill-defined features of pheochromocytoma and other malignancies associated with a MAX variant and highlights the importance of understanding the genotype-phenotype correlation in hereditary pheochromocytoma and the impact of oriented genetic testing to detect, survey and treat patients and kindreds at risk.

scholarly journals 512 The Management of Aural Foreign Bodies During the COVID-19 Pandemic - MKUH ENT Department Experience

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
G C Ho ◽  
R Thind ◽  
D Yap ◽  
A Hunt
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Case Series ◽  
Success Rates ◽  
First Case ◽  
Prolonged Duration ◽  
Successful Removal ◽  
The Impact ◽  
The Relationship

Abstract Aim During the initial wave of the COVID-19 pandemic, ENT UK published a clinical guide on surgical prioritisation which suggested that aural foreign bodies can be removed between one and three months from initial presentation. This case series aims to investigate the impact of leaving aural foreign bodies in situ for a prolonged period of time, including the risk of complications, success rates of subsequent removal attempts and whether foreign bodies can clear themselves without intervention. Method Retrospective study of all aural foreign body referrals to the ENT emergency clinic over a 6-month period. Results Thirty-four patients were identified. The duration of foreign bodies left in-situ ranged from 1 to 78 days. Four patients suffered from traumatic removal upon initial attempts, however there were no other significant complications. First attempts made by non-ENT specialists (68.8%) all failed and were associated with a high risk of trauma (36.4%). The chances of successful removal on second attempt (28.6%) reduced dramatically when compared to the first attempt (52.9%). Two patients had no foreign body visualised upon second attempt, suggesting it has cleared itself. A total of 7 patients (20.6%) required removal under general anaesthesia. Conclusions Due to the unique circumstances of the COVID-19 pandemic, this is the first case series to look specifically at the relationship between duration of aural foreign bodies left in situ for over 30 days from presentation and the risk of complications. Our data suggests that prolonged duration did not increase the incidence of complications.

#INCLUSION – THE IMPACT OF SOCIAL MEDIA COMMUNICATION ON THE LEGITIMACY OF ARMED FORCES

2019 ◽  
pp. 43-60
Author(s):  
EVA MOEHLECKE DE BASEGGIO ◽  
OLIVIA SCHNEIDER ◽  
TIBOR SZVIRCSEV TRESCH
Keyword(s):  
Social Media ◽  
Political Communication ◽  
Structural Equation ◽  
Armed Forces ◽  
Equation Model ◽  
Media Communication ◽  
The Public ◽  
Political Legitimation ◽  
Social Media Communication ◽  
The Impact

The Swiss Armed Forces (SAF), as part of a democratic system, depends on legitimacy. Democracy, legitimacy and the public are closely connected. In the public sphere the SAF need to be visible; it is where they are controlled and legitimated by the citizens, as part of a deliberative discussion in which political decisions are communicatively negotiated. Considering this, the meaning of political communication, including the SAF’s communication, becomes obvious as it forms the most important basis for political legitimation processes. Social media provide a new way for the SAF to communicate and interact directly with the population. The SAF’s social media communication potentially brings it closer to the people and engages them in a dialogue. The SAF can become more transparent and social media communication may increase its reputation and legitimacy. To measure the effects of social media communication, a survey of the Swiss internet population was conducted. Based on this data, a structural equation model was defined, the effects of which substantiate the assumption that the SAF benefits from being on social media in terms of broadening its reach and increasing legitimacy values.

Burden of Congenital Rubella Syndrome (CRS) in Bangladesh: Systematic Review of Existing Literature and Transmission Modelling of Seroprevalence Studies

2020 ◽  
Vol 20 (3) ◽  
pp. 284-290
Author(s):  
Jocelyn Chan ◽  
Yue Wu ◽  
James Wood ◽  
Mohammad Muhit ◽  
Mohammed K. Mahmood ◽  
...  
Keyword(s):  
Systematic Review ◽  
Deterministic Model ◽  
Case Series ◽  
Controlled Vocabulary ◽  
Congenital Rubella Syndrome ◽  
Free Text ◽  
Childbearing Age ◽  
Vaccination Programs ◽  
Congenital Rubella ◽  
The Impact

Background and Objectives: Congenital Rubella Syndrome (CRS) is the leading cause of vaccine-preventable congenital anomalies. Comprehensive country-level data on the burden of CRS in low and middle-income countries, such as Bangladesh, are scarce. This information is essential for assessing the impact of rubella vaccination programs. We aim to systematically review the literature on the epidemiology of CRS and estimate the burden of CRS in Bangladesh. Methods: We conducted a systematic review of existing literature and transmission modelling of seroprevalence studies to estimate the pre-vaccine period burden of CRS in Bangladesh. OVID Medline (1948 – 23 November 2016) and OVID EMBASE (1974 – 23 November 2016) were searched using a combination of the database-specific controlled vocabulary and free text terms. We used an age-stratified deterministic model to estimate the pre-vaccination burden of CRS in Bangladesh. Findings: Ten articles were identified, published between 2000 and 2014, including seven crosssectional studies, two case series and one analytical case-control study. Rubella seropositivity ranged from 47.0% to 86.0% among all age population. Rubella sero–positivity increased with age. Rubella seropositivity among women of childbearing age was 81.0% overall. The estimated incidence of CRS was 0·99 per 1,000 live births, which corresponds to approximately 3,292 CRS cases annually in Bangladesh. Conclusion: The estimated burden of CRS in Bangladesh during the pre-vaccination period was high. This will provide important baseline information to assess the impact and cost-effectiveness of routine rubella immunisation, introduced in 2012 in Bangladesh.

Impact of hydroxychloroquin/azithromycin protocol on COVID-19 case-fatality rate reduction in Algeria. (Preprint)

2020 ◽  
Author(s):  
Ahmed Youssef Kada
Keyword(s):  
Case Fatality Rate ◽  
Doubling Time ◽  
Case Fatality ◽  
World Health ◽  
Fatality Rate ◽  
Therapeutic Protocol ◽  
First Case ◽  
The World ◽  
The Impact ◽  
At Home

BACKGROUND Covid-19 is an emerging infectious disease like viral zoonosis caused by new coronavirus SARS CoV 2. On December 31, 2019, Wuhan Municipal Health Commission in Hubei province (China) reported cases of pneumonia, the origin of which is a new coronavirus. Rapidly extendable around the world, the World Health Organization (WHO) declares it pandemic on March 11, 2020. This pandemic reaches Algeria on February 25, 2020, date on which the Algerian minister of health, announced the first case of Covid-19, a foreign citizen. From March 1, a cluster is formed in Blida and becomes the epicentre of the coronavirus epidemic in Algeria, its total quarantine is established on March 24, 2020, it will be smoothly alleviated on April 24. A therapeutic protocol based on hydroxychloroquine and azithromycin was put in place on March 23, for complicated cases, it was extended to all the cases confirmed on April 06. OBJECTIVE This study aimed to demonstrate the effectiveness of hydroxychloroquin/azithromycin protocol in Algeria, in particular after its extension to all patients diagnosed COVID-19 positive on RT-PCR test. We were able to illustrate this fact graphically, but not to prove it statistically because the design of our study, indeed in the 7 days which followed generalization of therapeutic protocol, case fatality rate decrease and doubling time increase, thus confirming the impact of wide and early prescription of hydroxychloroquin/azithromycin protocol. METHODS We have analyzed the data collected from press releases and follow-ups published daily by the Ministry of Health, we have studied the possible correlations of these data with certain events or decisions having a possible impact on their development, such as confinement at home and its reduction, the prescription of hydroxychloroquine/azithromycin combination for serious patients and its extension to all positive COVID subjects. Results are presented in graphics, the data collection was closed on 31/05/2020. RESULTS Covid-19 pandemic spreads from February 25, 2020, when a foreign citizen is tested positive, on March 1 a cluster is formed in the city of Blida where sixteen members of the same family are infected during a wedding party. Wilaya of Blida becomes the epicentre of coronavirus epidemic in Algeria and lockdown measures taken, while the number of national cases diagnosed begins to increases In any event, the association of early containment measures combined with a generalized initial treatment for all positive cases, whatever their degree of severity, will have contributed to a reduction in the fatality rate of COVID 19 and a slowing down of its doubling time. CONCLUSIONS In Algeria, the rapid combination of rigorous containment measure at home and early generalized treatment with hydroxychloroquin have demonstrated their effectiveness in terms of morbidity and mortality, the classic measures of social distancing and hygiene will make it possible to perpetuate these results by reducing viral transmission, the only unknown, the reopening procedure which can only be started after being surrounded by precautions aimed at ensuring the understanding of the population. CLINICALTRIAL Algeria, Covid-19, pandemic, hydroxychloroquin, azithromycin, case fatality rate

Poland

2018 ◽  
Author(s):  
Andrew A. Michta
Keyword(s):  
Armed Forces ◽  
The European Union ◽  
Territorial Defence ◽  
Eastern Flank ◽  
Security Environment ◽  
North Eastern ◽  
And Control ◽  
The Impact ◽  
Command And Control System ◽  
T State

This chapter analyses the adaptation of Poland’s defence policy and armed forces to the rapidly changing security environment along NATO’s north-eastern flank. First, it examines the impact of a resurgent Russia on Poland’s security calculus, especially since Russia’s seizure of Crimea and the war in eastern Ukraine. Next, it addresses the evolution of Warsaw’s views on the relative utility of NATO and the European Union and its efforts to return NATO to its traditional territorial defence role. It then focuses on the modernization of Poland’s armed forces, with a special emphasis on doctrinal change, the reform of the command and control system, and the creation of the Territorial Defence units. It also reviews the t state of key hardware purchases as of mid-2017. The chapter concludes with an overall assessment of the level of capabilities and the readiness of the armed forces in the changing threat environment along NATO’s north-eastern flank.

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