scholarly journals Infected hip prosthesis in patient with suspected Covid-19 infection

Arthroplasty ◽  
2021 ◽  
Vol 3 (1) ◽  
Author(s):  
A. Cosentino ◽  
G. Odorizzi ◽  
W. Berger
Keyword(s):  
Health Care Providers ◽  
Hip Prosthesis ◽  
Clinical Symptoms ◽  
Care Providers ◽  
Correct Treatment ◽  
E Coli ◽  
Negative Results ◽  
Total Arthroplasty ◽  
Hip Infection ◽  
Chest X Ray

Abstract Background Infections following arthroplasty are one of the major risks during this type of surgery. Moreover, the outbreak of coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2 (Severe Acute Respiratory Syndrome CoronaVirus Disease 2), has developed into an unprecedented pandemic, posing enormous pressure on health-care providers around the world. Case presentation Four and half years after right hip arthroplasty, the patient came back to our attention with pain at the same hip. The instrumental examinations showed signs of cup detachment. After carefully analyzing the case, we decided to perform a sterile aspiration of the hip in the operating room under C-arm fluoroscopy. Microbiological examinations showed positivity for E. coli. The patient underwent surgery by which the prosthesis was removed and a spacer was implanted. A therapy with Cefotaxim 2 g three times a day for 6 weeks was then set, and then a total arthroplasty was performed. During this period, the COVID-19 pandemic occurred and therefore the patient received nasal-throat swabbing two times, and both yielded negative results. However, 1 week after the final surgery, his respiratory conditions deteriorated and chest X-ray and CT scan showed images of ground-glass opacification patterns (GGO). Due to the clinical symptoms and the characteristic images of the instrumental examinations, the patient was transferred to an observation ward. Thereafter, two more swab tests gave negative results. The patient was then transferred to the ward for patients with typical symptoms of COVID-19 but with negative swab tests for 2 weeks and was subsequently discharged home. Conclusion The purpose of this case report was to point out the correct treatment of a PJI after the outbreak of COVID-19. Despite the ongoing COVID-19 pandemic, the guidelines in the case of periprosthetic hip infection further confirmed the correct management of the patient.

scholarly journals Infected hip prosthesis in patient with suspected Covid-19 infection

2020 ◽  
Author(s):  
Andrea Cosentino ◽  
Gianni Odorizzi ◽  
Wilhelm Berger
Keyword(s):  
Hip Arthroplasty ◽  
Hip Prosthesis ◽  
Case Presentation ◽  
X Ray ◽  
Total Arthroplasty ◽  
Hip Infection ◽  
Chest X Ray ◽  
Respiratory Conditions ◽  
Arthroplasty Surgery ◽  
Type Of Surgery

Abstract Background: Infections following arthroplasty are one of the major risks during this type of surgery.Case presentation: Four and half years after right hip arthroplasty surgery, the patient came back to our attention with pain at the same hip. The instrumental examinations showed signs of cup detachment and therefore, after carefully analyzing the case, we decided to perform a sterile aspiration of the hip in the operating room under C-arm fluoroscopy. Microbiological examinations showed positivity for E.Coli. The patient underwent to surgery to remove the prosthesis and implant a spacer. A therapy with Cefotaxim 2g 1-1-1 for 6 weeks was then set, after which a total arthroplasty was implanted. During this period, the Covid-19 pandemic occurred and therefore the patient performed two nasal-throat swabs, both negative. However, one week after the final surgery, respiratory conditions worsened and we performed a chest X-ray and CT scan, with suggestive images of ground-glass opacification patterns (GGO). Due to the clinic and the characteristic images of the instrumental examinations, the patient was transferred to the observation ward, waiting for the response of two additional swabs, also negative. The patient was then transferred to the ward for patients with typical symptoms of Covid-19 but with negative swabs for two weeks and subsequently discharged at home.Conclusion: Despite the concomitant Covid-19 pandemic, the guidelines in case of periprosthetic hip infection further confirm the correct management of the patient.

Genetic similarities of Escherichia coli isolated from hospitalized patients

2017 ◽  
Vol 7 (1) ◽  
pp. 0-0
Author(s):  
M.J. Żórawski ◽  
D. Dudzik ◽  
D. Musiałowska
Keyword(s):  
Escherichia Coli ◽  
Health Care Providers ◽  
Digestive System ◽  
Hospitalized Patients ◽  
Etiologic Factor ◽  
Laboratory Diagnostics ◽  
Care Providers ◽  
E Coli ◽  
The Moment

Introduction: Escherichia coli is a component of human physiological flora. Pathogenic E. coli strains are a significant etiologic factor for numerous infections, mainly the urinary system, digestive system, respiratory system as well as bacteraemia and post-operative infections. Purpose: To compare the genetic similarity of Escherichia coli strains, isolated from biological material collected for routine microbiological diagnostics. Materials and methods: The examination performed on the Escherichia coli strains, isolated from material collected from patients hospitalized in various clinics and delivered for routine laboratory diagnostics. The analysis was conducted using the ADRSSR method.Results: As a result of the analysis of genetic similarities of examined strains using the ADRSSR method, nine clones were distinguished, clones A and B considered being most numerous. Clone A was predominant in samples from internal diseases clinics while cloning B – from neonatological clinics. Conclusions: The results point to a significant role of monitoring of homogeneity of bacteria strains isolated in the range of the health care providers. It is directly connected with the safety of hospitalized patients as well as effectiveness and course of the treatment. The use of the ADSRRS method gives the opportunity of early detection of the moment of colonization in the monitored place

scholarly journals Pre and Post Test Clinical Study to Assess the Combined Effect of Brihatyadi Ksheera Kashaya, Chandraprabhavati and Shweta Parpati in Urinary Tract Infection

2021 ◽  
pp. 21-26
Author(s):  
Anjana.S ◽  
Mahesh.C.Kundagol ◽  
Devipriya Soman ◽  
James Chacko
Keyword(s):  
Urinary Tract ◽  
Health Care Providers ◽  
Urine Analysis ◽  
Clinical Symptoms ◽  
Urine Culture ◽  
Combined Effect ◽  
Rank Test ◽  
P Value ◽  
Care Providers ◽  
Post Test

Purpose: UTI is the broad term used to describe infection of any part of urinary tract and is a problem frequently encountered by health care providers today. E.coli is found to be the main causative agent for causing UTI (80%). The prevalence of UTI are increasing and the present standard of care includes the usage of antibiotics. The alarming and exponential use of nonspecific antibiotics, increased resistance and the high cost of prescribed medications for the management of the infective microorganisms will raise the need for alternate and safe medication. The signs and symptoms of Mutrakruchra and UTI are similar in nature. The combination of Brihatyadi Ksheera Kashaya, Chandraprabhavati and Shweta Parpati is widely practiced in Mutrakruchra. The present study was aimed at exploring the combined effect of the above combination in UTI. Materials and Methods: The present study was a single group study with pre and post test study design. 20 diagnosed cases of UTI based on ICD10N39.0 diagnostic criteria and proper exclusion were selected from IPD and OPD of Amrita Ayurveda Hospital. They were administered Brihatyadi Ksheera Kashaya, Chadraprabhavati and Shweta Parpati for 15 days. Result: The obtained data were analyzed statistically with symptoms of UTI, Urine analysis and urine culture by using Wilcoxon signed rank test done on the 0th and 16th day. There was significant change with 100% of improvement in clinical symptoms of UTI after treatment. Statistically significant result was obtained in reduction of WBC with p value 0.001, Epithelial cells with p value 0.005, and Nitrites, Leucocyte esterase, Bacteria with p value 0.0001. There was reduction in growth of E.coli in urine culture with statistically significant p value 0.0001. Conclusion: The combination of Brihatyadi Ksheera Kashaya, Chandraprabhavari and Shwetaparpati is effective in UTI.

Management of perinatal HPP during critical illness/ECMO

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Neetu Krishnan ◽  
Nancy Dunbar
Keyword(s):  
Critical Illness ◽  
Respiratory Distress ◽  
Health Care Providers ◽  
Influenza A ◽  
Bone Mineralization ◽  
Close Monitoring ◽  
Care Providers ◽  
Enzyme Replacement ◽  
Life Saving ◽  
Chest X Ray

Abstract Objectives With the advent of asfotase alfa, the enzyme replacement therapy (ERT) approved for hypophosphatasia (HPP), health care providers need to navigate management of ERT during critical illness. Case presentation We present the case of a young girl, treated with ERT for severe perinatal HPP, who had cardiorespiratory arrest in the setting of influenza A. Her life-saving treatment involving extra corporeal membrane oxygenation (ECMO) required a two-week interruption of ERT leading to persistent hypercalcemia and hyperphosphatemia. A three year old female presented with respiratory distress and blood tinged secretions. She was influenza A positive with bilateral opacities on chest X-ray (CXR). Worsening respiratory distress and bradycardic arrest required intubation, CPR and venoarterial ECMO cannulation. She remained on ECMO for 10 days with anticoagulation restrictions requiring her thrice-weekly subcutaneous ERT to be held. Hypercalcemia (12.3 mg/dL) and hyperphosphatemia (7.6 mg/dL) developed two weeks after restarting ERT and resolved six weeks later. Conclusions We highlight that the obligatory cessation of ERT while on ECMO led to the loss of functional TNSALP with a profound decrease in bone mineralization leading to excess circulating calcium and phosphorus. In cases where it is necessary to interrupt ERT, we advise close monitoring of calcium and phosphorous levels.

New Challenges for Public Health Care: Biological and Chemical Weapons Awareness, Surveillance, and Response

2003 ◽  
Vol 4 (4) ◽  
pp. 244-250 ◽  
Author(s):  
Joseph P. Dudley
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Providers ◽  
Clinical Symptoms ◽  
The United States ◽  
Public Health Care ◽  
Surveillance Systems ◽  
Care Providers ◽  
First Line ◽  
Nursing Professionals

Recent events in the United States have demonstrated a critical need for recognizing nurses and emergency health care providers as important elements of the nation’s first line of defense and response against terrorist attacks involving biological, chemical, or radiological weapons. The anthrax letter attacks of September/October 2001 demonstrate the importance of vigilance and attention to detail while interviewing and attending patients and when entering, reviewing, and cataloging patient records. Nursing professionals, emergency care responders, and physicians can perform a crucial role in our first-line defense against terrorism by detecting and reporting unusual or anomalous illness(es) consistent with possible exposure to biological or chemical agents. Nursing professionals should become more familiar with the etiology and clinical symptoms of biological agents of greatest current concern (smallpox, anthrax, tularemia, plague) and be alert for potentially anomalous or unfamiliar combinations of symptoms that could point to unwitting exposure to biological toxins, toxic chemicals, or cryptic radiological agents. Public health surveillance systems must be developed that encourage and facilitate the rapid reporting and follow-up investigation of suspect illnesses and potential disease outbreaks that will ensure early identification and response for covert attacks involving biological, chemical, or radiological weapons.

scholarly journals A retrospective cohort study on European Reference Network for Rare Vascular Diseases 5 outcome measures for Hereditary Haemorrhagic Telangiectasia in Denmark

2021 ◽  
Author(s):  
Troels Hvelplund ◽  
Bibi Lange ◽  
Susanne Djernes Bird ◽  
Malene Korsholm ◽  
Anette Kjeldsen
Keyword(s):  
Iron Deficiency ◽  
Outcome Measures ◽  
Health Care Providers ◽  
Clinical Symptoms ◽  
Vascular Diseases ◽  
Reference Network ◽  
Hereditary Haemorrhagic Telangiectasia ◽  
Care Providers ◽  
Autosomal Dominant Disorder ◽  
European Reference Network

Abstract Background Hereditary Haemorrhagic Telangiectasia (HHT) is an autosomal dominant disorder characterized by several clinical symptoms including epistaxis, arteriovenous malformations (AVM), and telangiectasia. In 2018, European Reference Network for Rare Vascular Diseases (VASCERN) recommended five outcome measures for HHT-patients to guide health care providers, some with limited experience in treating HHT, and thereby maximizing the number of HHT-patients receiving good care. The outcome measures cover the following aspects: 1) 90% of the patients should receive a pulmonary AVM (PAVM) screening; 2) 90% of the patients should receive written advice on nosebleed; 3) 70% should be assessed for iron deficiency; 4) 100% of the patients should receive written advice on antibiotic (AB) prophylaxis prior to dental and surgical procedures, and; 5) 100% of relevant patients should receive written advice on pregnancy. We have introduced the outcome measures as Benchmarks in our HHT-centre and wanted to evaluate the extend of implementation we have achieved. We constantly struggle to secure the best possible treatment of our HHT-patients.Methods The study was a non-interventional retrospective study. All data was collected from medical journals and from the Danish HHT-database. Results A total of 180 HHT-patients were included, all diagnosed in the period from January 1st 2016 to December 31st 2020. All patients were screened for PAVM. We could confirm that 66% of patients who had epistaxis received thoroughly advice. Assessment for iron deficiency was performed in 80 % of the adult patients. Thoroughly advice on antibiotic prophylaxis was documented in 75%. Thoroughly advice on pregnancy was documented in 80% of female patients 15-45 years of age. There were no significant differences over time for any of the outcome measures. Conclusions The Danish HHT-centre reached the target threshold for outcome measures 1 and 3. We could not document reaching the target thresholds for outcome measures 2, 4, and 5. As information and education is a very important part of HHT care, we will focus on and document that all patients receive the relevant advice and as part of our care, we will in the near future implement an electronic solution with advice for HHT patients.

scholarly journals Bacterial profile and antimicrobial resistance patterns of common bacteria among pregnant women with bacteriuria in Ethiopia: a systematic review and meta-analysis

2022 ◽  
Author(s):  
Legese Chelkeba ◽  
Korinan Fanta ◽  
Temesgen Mulugeta ◽  
Tsegaye Melaku
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Pregnant Women ◽  
Health Care Providers ◽  
Urine Samples ◽  
Resistance Pattern ◽  
Care Providers ◽  
E Coli ◽  
Stewardship Program ◽  
Significant Bacteriuria

Abstract Background Globally, antimicrobial resistance (AMR) restricted the armamentarium of the health care providers against infectious diseases, mainly due to the emergence of multidrug resistant. This review is aimed at providing contemporary bacterial profile and antimicrobial resistance pattern among pregnant women with significant bacteriuria. Methods Electronic biomedical databases and indexing services such as PubMed/MEDLINE, Web of Science, EMBASE and Google Scholar were searched. Original records of research articles, available online from 2008 to 2021, addressing the prevalence of significant bacteriuria and AMR pattern among pregnant women and written in English were identified and screened. The relevant data were extracted from included studies using a format prepared in Microsoft Excel and exported to STATA 14.0 software for the outcome measure analyses and subgrouping. Results The data of 5894 urine samples from 20 included studies conducted in 8 regions of the country were pooled. The overall pooled estimate of bacteriuria was 15% (95% CI 13–17%, I2 = 77.94%, p < 0.001) with substantial heterogeneity. The pooled estimate of Escherichia coli recovered from isolates of 896 urine samples was 41% (95% CI 38–45%) followed by coagulase-negative Staphylococci, 22% (95% CI 18–26%), Staphylococcus aureus, 15% (95% CI 12–18%), Staphylococcus saprophytic, 12% (95% CI 6–18%) Proteus mirabilis, 7% (95% CI 4–10%), Enterococcus species, 6% (0–12%), Pseudomonas aeruginosa, 4% (2–6%), Citrobacter species, 4% (95% CI 2–4%), Group B streptococcus, 3% (1–5%), and Enterobacter species, 2% (1–4%). Multidrug resistance proportions of E. coli, Klebsiella species, Staphylococcus aureus and Coagulase negative staphylococci, 83% (95% CI 76–91%), 78% (95% CI 66–90%), 89% (95% CI 83–96%), and 78% (95% CI 67–88%), respectively. Conclusion The result of current review revealed the occurrence of substantial bacteriuria among pregnant women in Ethiopia. Resistance among common bacteria (E. coli, Klebsiella species, Staphylococci species) causing UTIs in pregnant women is widespread to commonly used antibiotics. The high rate of drug resistance in turn warrants the need for regular epidemiological surveillance of antibiotic resistance and implementation of an efficient infection control and stewardship program.

scholarly journals Clinical manifestations of Covid-19 disease; Exploring the experiences of infected health-care providers.

2020 ◽  
Author(s):  
Tahereh Toulabi ◽  
Atefeh Veiskramian ◽  
Abas Azadi ◽  
Heshmatolah Heydari
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Phone Call ◽  
Care Providers ◽  
Purposeful Sampling ◽  
Content Analysis Method ◽  
Conventional Content Analysis ◽  
Specific Disorders

Abstract BackgroundCovid-19 is a novel disease with many unknown clinical and managemental dimensions. To effectively diagnose, control, and treat the disease, it is required to divulge its clinical symptoms and their qualities. On the other hand, no one can better interpret the clinical symptoms than the caregivers infected by the disease. So, the aim of this study was to exploring the experiences of infected health-care providers about clinical manifestations of Covid-19 disease.MethodsThe present qualitative research was conducted using the conventional content analysis method in Iran from March to Jun 2020. Participants in this study included infected health care providers with Covid-19, who were selected based on purposeful sampling method. The data was collected by 18 phone call interviews and analyzed according Lundman and Graneheim approach.ResultsQualitative data analysis revealed 10 categories including respiratory disorders, fever and chills, body pain, fatigue, headache, skin disorders, gastrointestinal disorders, taste and olfactory disturbances, insomnia and also stress and anxiety.ConclusionPatients with Covid-19 may experience specific or non-specific disorders. It is necessary to consider people with non-specific manifestations as suspicious cases and screen them with proper diagnostic tests. This can help to identify true positive patients and provide them with more effective health cares, and prevent further spread of the disease by isolating suspected individuals.Trial registration numberNot applicable

scholarly journals Patient and Physician Perspectives on Systemic Sclerosis–Associated Interstitial Lung Disease

2020 ◽  
Vol 14 ◽  
pp. 117954842091328
Author(s):  
Tariq J Cheema ◽  
Meilin Young ◽  
Erica Rabold ◽  
Ashley N Barbieri ◽  
Nancy Baldwin ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Interstitial Lung Disease ◽  
Disease Management ◽  
Lung Disease ◽  
Health Care Providers ◽  
Clinical Symptoms ◽  
Treatment Options ◽  
Clinical Situation ◽  
Care Providers ◽  
Psychosocial Effects

Systemic sclerosis–associated interstitial lung disease is challenging to diagnose and treat. Patients and physicians can perceive the disease differently and have different views on its management. Communication issues between them can lead to suboptimal disease management. Despite a clear need for improvement in the speed and accuracy of the diagnostic workup, the heterogeneity of clinical symptoms renders the process long and challenging. When considering treatment options, physicians may be more focused on the evidence supporting a particular treatment or on a patient’s pulmonary function test results, as opposed to the realities of the patient’s difficulties with symptoms or the psychosocial effects of systemic sclerosis–associated interstitial lung disease. Disease management plans should be determined by the patient’s own preferences and goals as well as the objective clinical situation. Health care providers must consider their patients as partners on a journey in which treatment decisions are reached jointly. This review will focus on the perspectives of physicians and patients in relation to the diagnosis and management of systemic sclerosis–associated interstitial lung disease. Similarities and differences in these perspectives will be identified, and strategies for achieving optimal disease management will be proposed.

scholarly journals Epidemiology of COVID-19 in Indonesia: common source and propagated source as a cause for outbreaks

2021 ◽  
Vol 15 (05) ◽  
pp. 646-652
Author(s):  
Isna Hikmawati ◽  
Ragil Setiyabudi
Keyword(s):  
Health Care Providers ◽  
Clinical Symptoms ◽  
Task Force ◽  
The Elderly ◽  
Total Sample ◽  
Common Source ◽  
Care Providers ◽  
Government Interventions ◽  
Indonesian Government ◽  
Children Health

Introduction: The COVID-19 outbreak first occurred in China and has developed throughout the world, including Indonesia. The Indonesian government reports that up to May 22, 2020 there have been 21,430 confirmed cases. The purpose of this study is to describe the epidemiology, clinical symptoms and comorbidities of COVID-19 as well as the various government interventions to reduce the rate of incidence. Methodology: A retrospective cohort study was designed. The population in this study is based data from the official Indonesian government website run by the Task Force for the Acceleration of Handling COVID-19. The sample was observed b March 2 to April 24, 2020. The total sample included 8,211 cases of patients diagnosed with COVID-19, among these 1,002 recovered and 689 died. Data analysis used percentages from various recorded epidemiological variables. Results: The results showed that COVID-19 epidemiological features were mostly observed in men (56.5%) and patients of productive age (31-59 of age) by 57.5%; most deaths were recorded in patients aged > 60 years (43.6%). The most recurrent clinical symptom was cough (77.8%), the most recurrent comorbidity was hypertension (52.4%), and the province with the highest COVID-19 incidence was DKI Jakarta (34.3%). Conclusions: The combination of common sources and propagated source was observed during the COVID-19 outbreak in Indonesia. Special attention should be given to protecting vulnerable populations such as children, health care providers, and the elderly. The community is expected to participate in preventing the transmission of COVID-19 by complying with health protocols.

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