scholarly journals Prehospital characteristics of COVID-19 patients in Helsinki – experience of the first wave of the pandemic

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Markku Kuisma ◽  
Heini Harve-Rytsälä ◽  
Jussi Pirneskoski ◽  
James Boyd ◽  
Mitja Lääperi ◽  
...  
Keyword(s):  
Foreign Language ◽  
World Health Organisation ◽  
Prehospital Setting ◽  
Tympanic Temperature ◽  
World Health ◽  
Who Criteria ◽  
Laboratory Confirmation ◽  
Patient Groups ◽  
Mode Of Transportation ◽  
Time Urgency

Abstract Background There is a lack of knowledge how patients with COVID-19 disease differ from patients with similar signs or symptoms (but who will have a diagnosis other than COVID-19) in the prehospital setting. The aim of this study was to compare the characteristics of these two patient groups met by the emergency medical services. Methods All prehospital patients after the World Health Organisation (WHO) pandemic declaration 11.3.2020 until 30.6.2020 were recruited for the study. The patients were screened using modified WHO criteria for suspected COVID-19. Data from the electronic prehospital patient reporting system were linked with hospital laboratory results to check the laboratory confirmation for COVID-19. For comparison, we divided the patients into two groups: screening- and laboratory-positive patients with a hospital diagnosis of COVID-19 and screening-positive but laboratory-negative patients who eventually received a different diagnosis in hospital. Results A total of 4157 prehospital patients fulfilled the criteria for suspected COVID-19 infection during the study period. Five-hundred-thirty-six (12.9%) of the suspected cases received a laboratory confirmation for COVID-19. The proportion of positive cases in relation to suspected ones peaked during the first 2 weeks after the declaration of the pandemic. In the comparison of laboratory-positive and laboratory-negative cases, there were clinically insignificant differences between the groups in age, tympanic temperature, systolic blood pressure, heart rate, on-scene time, urgency category of the call and mode of transportation. Foreign-language-speakers were overrepresented amongst the positive cases over native language speakers (26,6% vs. 7,4%, p < 0,001). The number of cases in which no signs or symptoms of COVID-19 disease were reported, but patients turned out to have a positive test result was 125 (0,3% of the whole EMS patient population and 11,9% of all verified COVID-19 patients encountered by the EMS). Conclusions In a sample of suspected COVID-19 patients, the laboratory-positive and laboratory-negative patients were clinically indistinguishable from each other during the prehospital assessment. Foreign-language-speakers had a high likelihood of having Covid-19. The modified WHO criteria still form the basis of screening of suspected COVID-19 patients in the prehospital setting.

scholarly journals EP02 A rare case of Reactive arthritis secondary to COVID-19

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Arslan Sidhu ◽  
Shilpa Selvan ◽  
Ziad Alkutobi
Keyword(s):  
Case Report ◽  
Reactive Arthritis ◽  
Rare Case ◽  
World Health Organisation ◽  
World Health ◽  
Cutaneous Manifestations ◽  
Who Criteria ◽  
Urticarial Rash ◽  
History Of ◽  
Criteria For Diagnosis

Abstract Case report - Introduction In December 2019, the first cluster of Coronavirus disease 2019 (COVID-19) cases caused by the novel coronavirus SARS-CoV-2 was identified in Wuhan, China. The disease was declared a global pandemic on 11th March 2020. COVID-19 was initially thought to cause respiratory complications only, however several extra pulmonary manifestations of the infection have since emerged. We report a rare case of reactive arthritis (ReA), urticarial rash and angioedema in a young female secondary to COVID-19 infection. Rashes were recently added to the World Health Organisation (WHO) criteria for diagnosis of COVID-19 demonstrating their significance. Case report - Case description A 31-year-old female doctor was admitted with acute swelling of her lips, dysphagia, and a widespread urticarial rash. Preceding this she had a one-week history of fever, cough, and constitutional symptoms of malaise and weight loss. Her symptoms had started at the end of April 2020 during the peak of the COVID-19 pandemic in the United Kingdom. Three days later she developed painful swelling of her wrists, elbows, knees, and hands. She reported no back or sacroiliac joint pain, enthesitis or any previous history of inflammatory joint pains. She had a history of platelet dysfunction and was treated with Desmopressin. Clinical examination revealed a widespread urticarial rash over her face, limbs, and trunk, with no nail abnormalities. She had active synovitis in her right wrist, elbow, and mild bilateral knee effusions. All other joints including spine and sacroiliac joints were normal. She had no dactylitis or enthesitis. Systemic examination was normal. Investigations revealed Hb 113 g/L, MCV 88.2 fL, Platelets 282 x 109/L, WCC 6.6 x 109/L and Lymphocytes of 0.63 x 109/L with normal neutrophil and eosinophil count. CRP was raised at 107mg/L. She had a negative autoimmune screen including ANA, ANCA, IgM-RF, anti-CCP antibodies and HLA B27. Plain radiographs of knees were normal. SARS CoV-2 PCR was positive following a nasal swab. Urine and blood cultures were negative. Treatment was commenced with intravenous hydrocortisone and antihistamines with resolution of her angioedema symptoms; however, her rash and arthritis persisted. The patient was diagnosed with Reactive Arthritis (ReA), urticarial rash and angioedema secondary to COVID-19 infection. Prednisolone 30mg daily was started, and within a week her arthritis and rash markedly improved. Prednisolone was tapered over six weeks. By her two-month clinic follow up, she reported no further joint swelling and was functioning normally. Case report - Discussion The most common complication of COVID-19 is Acute Respiratory Distress Syndrome (ARDS) however several other serious complications have been identified including cardiac injury, thromboembolic events, neurological abnormalities, and an aggravated inflammatory response causing a cytokine storm. ReA is a post infectious arthritis commonly seen following gastrointestinal or genitourinary infections and is yet to be recognised as a complication of this disease. ReA most commonly presents as an asymmetrical peripheral or axial spondyloarthropathy. The affected joints do not contain pathogen. More than half of ReA cases resolve spontaneously within six months without requiring long-term treatments. Up to 20% of patients with COVID-19 infection have been shown to develop cutaneous manifestations including erythematous rash, vesicular rash, acral ischaemia, rash with petechiae, and widespread urticaria. This has led to the recent addition of rashes to the World Health Organisation (WHO) Criteria for diagnosis of COVID-19 infection. Additionally, as COVID-19 has an incubation period of 14 days where patients can be asymptomatic, cutaneous manifestations may serve as an early indicator of infection, aiding in a more rapid diagnosis. Case report - Key learning points We present a rare case of ReA secondary to COVID-19 infection, with complete resolution of symptoms following administration of oral glucocorticoids. A detailed history and examination of the musculoskeletal system should be undertaken in all patients presenting with COVID-19. Urticarial rashes should be considered as an early symptom of COVID-19 infection as per the WHO criteria for diagnosis. Glucocorticoids can be considered in treating patients with this presentation, where traditional anti-inflammatory agents have been refractory or contraindicated.

scholarly journals PECULIARITIES OF HEALTHCARE SPECIALISTS’ COMMUNICATIVE COMPETENCE IN ENGLISH AS A FOREIGN LANGUAGE

2021 ◽  
Vol 5 ◽  
pp. 599-614
Author(s):  
Olga Pašinska
Keyword(s):  
Foreign Language ◽  
Scientific Literature ◽  
Communicative Competence ◽  
Healthcare Providers ◽  
World Health Organisation ◽  
Target Language ◽  
World Health ◽  
Verbal Cues ◽  
Wide Range ◽  
The Given

Healthcare specialists are expected to possess competences essential for a successful fulfilment of their duties. Although specialists’ practical competences enabling them to deal with a wide range of health conditions are the key ones, communicative competence, implying an ability to use a target language “accurately, appropriately, and flexibly” (Yule, 2010, p.194), has also had an immense impact on the accomplishment of professional duties (World Health Organisation, 2005). It follows that apart from giving opportunities to acquire knowledge about medicine and practical skills, medical education institutions are expected to teach 21st century students to communicate effectively using various linguistic tools applicable in their professional context (Zethsen and Askehave, 2006). The present article aims to elucidate the peculiarities of communicative competence that practising or future healthcare providers should possess in order to demonstrate how it enables them to accomplish their responsibilities by communicating with patients and, thus, provide them with qualitative care or treatment in a foreign language, specifically English as a foreign language. With the aim to reach the goal, a scientific literature review was conducted. The theoretical implications were supported by the examples of medical encounters; in the given encounters, the use of the selected language aspects and participants’ non-verbal cues were interpreted. 

A Collaborative Study to Establish the Second International Standard for Streptokinase

1990 ◽  
Vol 64 (02) ◽  
pp. 267-269 ◽  
Author(s):  
A B Heath ◽  
P J Gaffney
Keyword(s):  
High Purity ◽  
Collaborative Study ◽  
World Health Organisation ◽  
World Health ◽  
Clot Lysis ◽  
Current Standard ◽  
International Standard ◽  
Accelerated Degradation ◽  
The World ◽  
International Collaborative Study

SummaryAn International Standard for Streptokinase - Streptodomase (62/7) has been used to calibrate high purity clinical batches of SK since 1965. An international collaborative study, involving six laboratories, was undertaken to replace this standard with a high purity standard for SK. Two candidate preparations (88/826 and 88/824) were compared by a clot lysis assay with the current standard (62/7). Potencies of 671 i.u. and 461 i.u. were established for preparations A (88/826) and B (88/824), respectively.Either preparation appeared suitable to serve as a standard for SK. However, each ampoule of preparation A (88/826) contains a more appropriate amount of SK activity for potency testing, and is therefore preferred. Accelerated degradation tests indicate that preparation A (88/826) is very stable.The high purity streptokinase preparation, coded 88/826, has been established by the World Health Organisation as the 2nd International Standard for Streptokinase, with an assigned potency of 700 i.u. per ampoule.

A Collaborative Study to Establish an International Standard for Alpha-Thrombin

1992 ◽  
Vol 67 (04) ◽  
pp. 424-427 ◽  
Author(s):  
P J Gaffney ◽  
A B Heath ◽  
J W Fenton II
Keyword(s):  
Elevated Temperatures ◽  
Collaborative Study ◽  
World Health Organisation ◽  
Significant Loss ◽  
Thrombin Inhibitors ◽  
World Health ◽  
Expert Committee ◽  
International Standard ◽  
Assay Procedure ◽  
And Control

SummarySince 1975 an International Standard for Thrombin of low purity has been used. While this standard was stable and of value for calibrating thrombins of unknown potency the need for a pure a-thrombin standard arose both for accurate calibration and for precise measurement of thrombin inhibitors, notably hirudin. An international collaborative study was undertaken to establish the potency and stability of an ampouled pure a-thrombin preparation. A potency of 97.5 international units (95% confidence limits 86.5-98.5) was established for the new a-thrombin standard (89/ 588) using a clotting-assay procedure. Stability data at various elevated temperatures indicated that the standard could be transported and stored with no significant loss of potency.Ampoules of lyophilised a-thrombin (coded 89/588) have been recommended as an International Standard for a-thrombin with an assigned potency of 100 international units per ampoule by the International Society for Thrombosis and Haemostasis (Thrombin and its Inhibitors Sub-Committee) in Barcelona, Spain in July 1990 while the Expert Committee on Biological Standardisation and Control of the World Health Organisation will consider its status at its next meeting in Geneva in 1991.

ANTARA SUNNAH DAN TRADISI (Khitan Muallaf Perempuan Baligh di Jayapura, Papua)

1970 ◽  
Vol 9 (2) ◽  
pp. 271-284
Author(s):  
Hendra Yulia Rahman
Keyword(s):  
World Health Organisation ◽  
World Health

Masyarakat Indonesia pada umumnya khususnya yang bergama Islam, memiliki kebiasaan mengkhitankan anak perempuannya dan memandang ini sebagai sunnah, hal ini juga dilakukan masyarakat di negara-negara lain yang memiliki penduduk pemeluk agama Islam. Pada umumnya masyarakat megkhitankan anak perempuannya, ketika masih bayi dan meyakininya sebagai bentuk kewajiban dari perintah agama. Badan kesehatan dunia World Health Organisation (WHO) melakukan pelarangan segala bentuk khitan pada perempuan, karena dianggap sebagai bentuk kekerasan pada perempuan dengan menyakiti dan merusak alat reproduksi perempuan. Khitan perempuan dianggap sebagai tradisi yang sudah lama ada tengah-tengah masyarakat baik yang muslim maupun yang non muslim, yang dalam pelaksanaannya lebih dimaksudkan sebagai upaya pengontrolan seksualitas perempuan. Muallaf perempuan baligh khususnya di wilayah kota Jayapura, Papua rata-rata melakukan khitan, yang menurut mereka merupakan bagian dari perintah agama. Bahwasanya khitan muallaf perempuan baligh di kota Jayapaura merupakan sebuah tradisi yang terus berlangsung, dan tradisi tersebut sejalan dengan sunnah.

Comparative docking of SARS-CoV-2 receptors antagonists from repurposing drugs

2020 ◽  
Author(s):  
Micael Davi Lima de Oliveira ◽  
Kelson Mota Teixeira de Oliveira
Keyword(s):  
World Health Organisation ◽  
World Health ◽  
Lung Cells ◽  
The Novel ◽  
High Modulation ◽  
Main Protease ◽  
The World ◽  
Novel Coronavirus ◽  
Viral Receptors ◽  
Theoretical Results

According to the World Health Organisation, until 16 June, 2020, the number of confirmed and notified cases of COVID-19 has already exceeded 7.9 million with approximately 434 thousand deaths worldwide. This research aimed to find repurposing antagonists, that may inhibit the activity of the main protease (Mpro) of the SARS-CoV-2 virus, as well as partially modulate the ACE2 receptors largely found in lung cells, and reduce viral replication by inhibiting Nsp12 RNA polymerase. Docking molecular simulations were performed among a total of 60 structures, most of all, published in the literature against the novel coronavirus. The theoretical results indicated that, in comparative terms, paritaprevir, ivermectin, ledipasvir, and simeprevir, are among the most theoretical promising drugs in remission of symptoms from the disease. Furthermore, also corroborate indinavir to the high modulation in viral receptors. The second group of promising drugs includes remdesivir and azithromycin. The repurposing drugs HCQ and chloroquine were not effective in comparative terms to other drugs, as monotherapies, against SARS-CoV-2 infection.

Osseointegrated Implants: A Comprehensive Review

2021 ◽  
Vol 2 (1) ◽  
pp. 24-30
Author(s):  
Matheus Marquez Cruvinel Santos ◽  
◽  
Flávio Barros da Silva ◽  
Idiberto José Zotarelli-Filho ◽  
Elias Naim Kassis ◽  
...  
Keyword(s):  
Dental Implants ◽  
Pharmacological Action ◽  
World Health Organisation ◽  
World Health ◽  
Density Level ◽  
Mineral Density ◽  
Osseointegrated Implants ◽  
Bone Mineral Density Level ◽  
The Mean ◽  
Normal Women

The most common bone disorder found by implant dentists is osteoporosis, which is a systemic skeletal disorder associated with aging, which is characterized by loss of bone mass, making bones fragile and more susceptible to fractures. The World Health Organisation has defined osteoporosis as a bone mineral density level greater than 2.5 standard deviations below the mean of young normal women. After 60 years of age, a third of the population have this disorder, it occurs twice as often in women than in men. It is estimated that 1.3 million fractures and 133,000 all hip fractures occur every year as a result of osteoporosis. This study aimed to discuss aspects of the pharmacological action of Bisphosphonates (BP) and their influence on the bone tissue when associated with treatment with dental implants. There are several types of treatments that prevent or prevent the progression of osteoporosis. So, BP, such as alendronate, are inhibitors of bone resorption. Act as controlling the development of osteoporosis by increasing the process of bone density and decrease its reabsorption, often acting as supporting the process of osseointegration of dental implants.

Use of Phosphatidylcholine in the Treatment of Localized Fat Deposits. Results and expectations

2017 ◽  
Vol 68 (7) ◽  
pp. 1438-1441 ◽  
Author(s):  
Sorin Berbece ◽  
Dan Iliescu ◽  
Valeriu Ardeleanu ◽  
Alexandru Nicolau ◽  
Radu Cristian Jecan
Keyword(s):  
World Health Organisation ◽  
Normal Weight ◽  
World Health ◽  
Basic Substance ◽  
Physical Exercises ◽  
Fat Deposits ◽  
The World ◽  
The Common ◽  
Global Health Problem ◽  
Over Time

Obesity represents a global health problem. According to the latest studies released by the World Health Organisation (WHO), 1.7 billion currently in excess of normal weight individuals, of which approx. 75% are overweight (body mass index - BMI 25 to 30). The common form of excess adipose tissue manifestation in overweight individuals is localized fat deposits with high (abdominal) or low (buttocks and thighs) disposition. Although the overweight can be corrected relatively easy by changing behavioral habits or food, a constant physical exercises program or following a diet food are not accessible to all through the efforts of will, financial and time involved. Several methods have been studied and tested over time to eliminate more or less invasive fat deposits with varying efficacy and adverse effects. Chemical lipolysis using phosphatidylcholine as the basic substance was initially used in hypercholesterolemia and its complications and was rapidly adopted in mesotherapy techniques for the treatment of fat deposits. This study reveals the results obtained using Dermastabilon on a sample of 16 patients, the time allocated to treatment and discomfort being minimal, and rapid and notable results. There were no side effects.

The Undiscovered Potential of Essential Oils for Treating SARS-CoV-2 (COVID-19)

2020 ◽  
Vol 26 (41) ◽  
pp. 5261-5277
Author(s):  
Peter J. Wilkin ◽  
Minnatallah Al-Yozbaki ◽  
Alex George ◽  
Girish K. Gupta ◽  
Cornelia M. Wilson
Keyword(s):  
Essential Oils ◽  
Clinical Symptoms ◽  
Synergistic Effects ◽  
World Health Organisation ◽  
Diagnostic Techniques ◽  
World Health ◽  
Clinical Aspects ◽  
Traditional Use ◽  
In Silico Studies ◽  
The World

On 11th March 2020, the World Health Organisation (WHO) announced a pandemic caused by a novel beta-coronavirus SARS-CoV-2, designated COVID-19. The virus emerged in December 2019 in Wuhan, China, has spread across the world as a global pandemic. The traditional use of medicines from plants can be traced back to 60,000 years. Global interest in the development of drugs from natural products has increased greatly during the last few decades. Essential oils (EOs) have been studied through the centuries and are known to possess various pharmaceutical properties. In the present review, we have highlighted the current biology, epidemiology, various clinical aspects, different diagnostic techniques, clinical symptoms, and management of COVID-19. An overview of the antiviral action of EOs, along with their proposed mechanism of action and in silico studies conducted, is described. The reported studies of EOs&#039; antiviral activity highlight the baseline data about the additive and/or synergistic effects among primary or secondary phytoconstituents found in individual oils, combinations or blends of oils and between EOs and antiviral drugs. It is hoped that further research will provide better insights into EOs&#039; potential to limit viral infection and aid in providing solutions through natural, therapeutically active agents.

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