scholarly journals Clinical Presentation, Management and Outcome of Staffs with COVID-19 Disease: a large tertiary Oil and Refinery Grand Hospital Study

2021 ◽  
Author(s):  
Bahram Dehghan ◽  
Ahmad abeshtan ◽  
Abdullah Sarami ◽  
Saied Saeidimehr ◽  
Elham Maraghi ◽  
...  
Keyword(s):  
Clinical Care ◽  
Cross Sectional Study ◽  
Oil Refinery ◽  
Cross Sectional ◽  
Referral Center ◽  
Specimen Collection ◽  
Polymerase Chain ◽  
Hospital Study ◽  
Detection Unit ◽  
Test Result

Abstract Objective The aim of the present study was to assess clinical characteristics, managing and controlling, and in-hospital outcome of COVID-19 among oil refinery workers in a single referral center. Methods This cross-sectional study was conducted in a non-COVID single referral center from March to August 2020. At the Naft grand Hospital, the COVID-19 specimen collection and molecular detection unit was established with staff trained to collect suitable samples (sufficiently deep swabs), storage, packaging, and transportation. The diagnosis of COVID-19 infection (SARS-CoV-2) was confirmed by real-time reverse transcription polymerase chain reaction (RT-PCR) assay. Results Overall, 500 patients with confirmed COVID-19 infection were included, of which the most common comorbidities were hypertension (52.2%) and diabetes (45.6%). Moreover, 298 patients (59.6%) had one to three comorbidities, 148 patients (29.6%) had four to six cases, and two patients (0.4%) had seven and more comorbidities. Finally, 23 people (4.6%) have cancer and 206 people (41.2%) have other diseases. 390 (78.8%) received Kaletra, and 387 (78.02%) receive Azithromycin. Overall, PCR test result was positive in 377 (75.4%) patients, computed tomography scan (CT-scan) test was positive in 413 (82.6%) patients, and CRP test had positive result in 335 patients (67%) patients. Conclusion Most referred cases were survivors with mild to moderate symptoms, and a few of them were unfortunately non-survivor. This could be due to those people with mild COVID-19 symptoms may respond well to the treatment and institutional isolation. Thus, good and evidence-based clinical care combined with strong public health interventions will save the lives of thousands, if not millions, worldwide.

scholarly journals Clinical Presentation, Management, and Outcomes of Patients with COVID-19 Disease: A Report from a Large Tertiary Hospital in Iran

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Bahram Dehghan ◽  
Ahmad Abeshtan ◽  
Abdullah Sarami ◽  
Saied Saeidimehr ◽  
Elham Maraghi ◽  
...  
Keyword(s):  
Clinical Care ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Oil Refinery ◽  
Cross Sectional ◽  
Referral Center ◽  
Specimen Collection ◽  
Polymerase Chain ◽  
Detection Unit ◽  
Positive Results

Objectives: The aim of the present study was to assess clinical characteristics, management, and in-hospital outcomes of COVID-19 among oil refinery workers in a single referral center. Methods: This cross-sectional study was conducted in a non-COVID single referral center from March to August 2020. At the Naft Grand Hospital, a COVID-19 specimen collection and molecular detection unit was established, and staff were trained how to collect suitable samples (sufficiently deep swabs), store, pack, and transport them. The diagnosis of COVID-19 infection (SARS-CoV-2) was confirmed by real-time reverse transcription polymerase chain reaction (RT-PCR). Results: Overall, 500 patients with confirmed COVID-19 infection were included, among whom the most common comorbidities were hypertension (52.2%) and diabetes (45.6%). Moreover, 298 patients (59.6%) had one to three comorbidities; 148 patients (29.6%) had four to six comorbidities, and two patients (0.4%) suffered from seven and more comorbidities. Out of these, 23 patients (4.6%) had cancer, and 206 (41.2%) suffered from other diseases. Most of the patients (390, 78.8%) received Kaletra, and 387 (78.02%) were treated with Azithromycin. Overall, PCR results were positive in 377 (75.4%) patients; computed tomography scan (CT-scan) was positive in 413 (82.6%), and CRP test rendered positive results in 335 patients (67%). Conclusions: Most referred cases were survivors with mild to moderate symptoms, and a few of them were unfortunately non-survivors. This could be due to the appropriate responses to treatment and institutional isolation of people with mild COVID-19 symptoms. Thus, good and evidence-based clinical care combined with intense public health interventions will save the lives of thousands, if not millions, worldwide.

scholarly journals 425. The Utility of Paired Upper and Lower COVID-19 Sampling in Patients with Artificial Airways

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S279-S279
Author(s):  
Eimear Kitt ◽  
Julia S Sammons ◽  
Kathleen Chiotos ◽  
Susan E Coffin ◽  
Susan E Coffin ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Diagnostic Testing ◽  
Cross Sectional Study ◽  
Upper Respiratory Tract ◽  
Cross Sectional ◽  
Mechanically Ventilated ◽  
Paired Samples ◽  
Control And Prevention ◽  
Polymerase Chain

Abstract Background The Centers for Disease Control and Prevention (CDC) recommends upper respiratory tract (URT) polymerase chain reaction (PCR) testing as the initial diagnostic test for Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Lower respiratory tract (LRT) testing for patients requiring mechanical ventilation is also recommended. The goal of this study was to evaluate concordance between paired URT and LRT specimens in children undergoing pre-admission/procedure screening or diagnostic testing. We hypothesized that < 10% of paired tests would have discordant results. Methods Single center cross-sectional study including children with artificial airways who had paired URT and LRT SARS-CoV-2 PCR testing between 4/1/2020 and 6/8/2020. URT specimens included nasopharyngeal (NP) swabs and aspirates. LRT specimens included tracheal aspirates and bronchoalveolar lavages. URT and LRT specimens were classified as paired if the two specimens were collected within 24 hours. Artificial airways included tracheostomies and endotracheal tubes. Tests were classified as diagnostic versus screening based on the indication selected in the order. Results 102 paired specimens were obtained during the study period. Fifty-nine were performed for screening and 43 were performed for diagnosis of suspected SARS-CoV-2. Overall, 94 specimens (92%) were concordant, including 89 negative from both sources and 5 positive from both sources. Eight specimens (8%) were discordant, all of which were positive from the URT and negative from the LRT (Figure 1). Among patients undergoing screening, 3 of 4 positive tests were discordant and among symptomatic patients, 5 of 9 positive tests were discordant. There were no instances of a positive LRT specimen with a negative URT specimen. Figure 1. Performance of upper and lower respiratory tract SARS-CoV-2 PCR testing in children with artificial airways Conclusion Overall, most paired samples from the URT and LRT yielded concordant results with no pairs positive from the LRT and negative from the URT. These data support the CDC recommendation that URT specimens are the preferred initial SARS-CoV-2 test, while LRT specimens should be collected only from mechanically ventilated with suspected SARS-CoV-2. Disclosures All Authors: No reported disclosures

scholarly journals Thyroid cancer overdiagnosis and overtreatment: a cross- sectional study at a thyroid cancer referral center in Ecuador

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Paola Solis-Pazmino ◽  
Jorge Salazar-Vega ◽  
Eddy Lincango-Naranjo ◽  
Cristhian Garcia ◽  
Gabriela Jaramillo Koupermann ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Cancer Mortality ◽  
Incidental Finding ◽  
Cross Sectional Study ◽  
Anaplastic Carcinoma ◽  
Treatment Modalities ◽  
Sectional Study ◽  
Cross Sectional ◽  
Referral Center ◽  
Clinical Records

Abstract Background In contrast to the rapid increase in thyroid cancer incidence, the mortality has remained low and stable over the last decades. In Ecuador, however, thyroid cancer mortality has increased. The objective of this study is to determine possible drivers of high rates of thyroid cancer mortality, through a cross-sectional analysis of all patients attending a thyroid cancer referral center in Ecuador. Methods From June 2014 to December 2017, a cross-sectional study was conducted at the Hospital de Especialidades Eugenio Espejo, a regional reference public hospital for endocrine neoplasia in adults in Quito, Ecuador. We identified the mechanism of detection, histopathology and treatment modalities from a patient interview and review of clinical records. Results Among 452 patients, 74.8% were young adults and 94.2% (426) were female. 13.7% had a family history of thyroid cancer, and patients’ median tumor size was 2 cm. The incidental finding was 54.2% whereas 45.8% was non-incidental. Thyroid cancer histology reported that 93.3% had papillary thyroid cancer (PTC), 2.7% follicular, 1.5% Hurtle cells, 1.6% medullary, 0.7% poor differentiated, and 0.2% anaplastic carcinoma. The mean MACIS (metastasis, age, completeness, invasion, and size) score was 4.95 (CI 4.15–5.95) with 76.2% of the thyroid cancer patients having MACIS score less than or equal to 6. The very low and low risk of recurrence was 18.1% (79) and 62% (271) respectively. An analysis of 319 patients with non-metastatic thyroid cancer showed that 10.7% (34) of patients had surgical complications. Moreover, around 62.5% (80 from 128 patients with thyroglobulin laboratory results) of TC patients had a stimulated-thyroglobulin value equal or higher than 2 ng/ml. Overall, a poor surgical outcome was present in 35.1% (112) patients. Out of 436 patients with differentiated thyroid carcinoma, 86% (375) received radioactive iodine. Conclusion Thyroid cancer histological characteristics and method of diagnosis are like those described in other reports without any evidence of the high frequency of aggressive thyroid cancer histology. However, we observed evidence of overtreatment and poor surgical outcomes that demand additional studies to understand their association with thyroid cancer mortality in Ecuador.

West Nile Virus Chorioretinitis in the Presence of Negative Cerebrospinal Fluid Polymerase Chain Reaction Results

2021 ◽  
pp. 247412642097925
Author(s):  
Kareem Moussa ◽  
Karen W. Jeng-Miller ◽  
Leo A. Kim ◽  
Dean Eliott
Keyword(s):  
Cerebrospinal Fluid ◽  
West Nile Virus ◽  
Cross Sectional Study ◽  
Nucleic Acid Amplification ◽  
Sectional Study ◽  
Chain Reaction ◽  
West Nile ◽  
Cross Sectional ◽  
Positive Serum ◽  
Polymerase Chain

Purpose: This work aims to evaluate the utility of nucleic acid amplification testing (NAAT) and serology in confirming West Nile Virus (WNV) infection in patients with suspected WNV chorioretinitis. Methods: A retrospective cross-sectional study was conducted of a cluster of patients who presented to the Retina Service of Massachusetts Eye and Ear between September and October 2018. Results: Three patients were identified with classic WNV chorioretinitis lesions with negative cerebrospinal fluid NAAT and positive serum serology findings. The diagnosis of WNV chorioretinitis was made based on the appearance of the fundus lesions and the presence of characteristic findings on fluorescein angiography as previously described in the literature. Conclusions: This report highlights 3 unique cases of WNV chorioretinitis in which NAAT of cerebrospinal fluid failed to identify WNV as the inciting agent. These cases stress the importance of serum serologic testing in diagnosing WNV infection.

scholarly journals Breathlessness and opioid prescribing in COPD in general practice: a cross-sectional, observational study

2020 ◽  
Vol 6 (2) ◽  
pp. 00299-2019
Author(s):  
David C. Currow ◽  
Miriam J. Johnson ◽  
Allan Pollack ◽  
Diana H. Ferreira ◽  
Slavica Kochovska ◽  
...  
Keyword(s):  
General Practice ◽  
Clinical Care ◽  
Cross Sectional Study ◽  
Prescribing Patterns ◽  
Pain Patient ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Opioid Prescription ◽  
Obstructive Pulmonary Disease ◽  
Health Database

Chronic breathlessness is a disabling syndrome, prevalent in people with advanced chronic obstructive pulmonary disease (COPD). Regular, low-dose, oral sustained-release morphine is approved in Australia to reduce symptomatic chronic breathlessness. We aimed to determine the current prescribing patterns of opioids for chronic breathlessness in COPD in Australian general practice and to define any associated patient and practitioner characteristics.Five years (2011 to 2016) of the Bettering the Evaluation and Care of Health database, an Australian national, continual, cross-sectional study of clinical care in general practice were used. The database included 100 consecutive clinical encounters from almost 1000 general practitioners annually (n=488 100 encounters). Descriptive analyses with subsequent regression models were generated.Breathlessness as a patient-defined reason for encounter was identified in 621 of 4522 encounters where COPD was managed. Opioids were prescribed in 309 of 4522 encounters where COPD was managed (6.8%; (95% CI) 6.1–7.6), of which only 17 were prescribed for breathlessness, and the rest for other conditions almost entirely related to pain. Patient age (45–64 years versus age 80+ years, OR 1.68; 1.19–2.36), Commonwealth Concession Card holders (OR 1.70; 1.23–2.34) and socioeconomic disadvantage (OR 1.30; 1.01–1.68) were associated with increased likelihood of opioid prescription at COPD encounters. The rate of opioid prescriptions rose over the 5 years of study.In primary care encounters for COPD, opioids were prescribed in 6.8% of cases, but almost never for breathlessness. These data create a baseline against which to compare changes in prescribing as the treatment of chronic breathlessness evolves.

scholarly journals Lack of HPV in pterygium with no evidence of autoinoculation and the role of cytokines in pterygium with dry eye

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lita Uthaithammarat ◽  
Ngamjit Kasetsuwan ◽  
Yuda Chongpison ◽  
Pimpetch Kasetsuwan ◽  
Usanee Reinprayoon ◽  
...  
Keyword(s):  
Dry Eye ◽  
Hpv Infection ◽  
Cross Sectional Study ◽  
Urine Samples ◽  
Vascular Endothelial ◽  
Cross Sectional ◽  
Hpv Dna ◽  
Polymerase Chain ◽  
Endothelial Growth Factor

AbstractThis study evaluated human papillomavirus’s (HPV) role in pterygium pathogenesis, its autoinoculation from genitalia to ocular surface, potential cytokines involved, and crosstalk cytokines between pterygium and dry eye (DE). This cross-sectional study enrolled 25 healthy controls (HCs) and 116 pterygium patients. Four subgroups of pterygium and DE were used in cytokine evaluations. Conjunctival and pterygium swabs and first-void urine samples (i.e., genitalia samples) were collected for HPV DNA detection using real-time polymerase chain reaction. Tear cytokines interleukin (IL)-6, IL-18, and vascular endothelial growth factor (VEGF) in tears were evaluated. No HPV DNA was detected in conjunctival or pterygium swabs. No association was found between HPV DNA in urine samples and that from conjunctival or pterygium swabs. Tear VEGF levels were significantly higher in pterygium patients than in HCs, with no markedly different levels between primary and recurrent pterygia. Tear IL-6, IL-18, and tear VEGF were significantly higher in participants with DE, regardless of pterygium status. In conclusion, HPV infection was not a pathogenic factor of pterygia. The hypothesis of HPV transmitting from the genitals to ocular surfaces was nullified. Tear VEGF was involved in both pterygia and DE, whereas tear IL-6 and IL-18 played roles only in DE.

scholarly journals The patient profile of individuals with Alpha-1 antitrypsine gene mutations at a referral center in Brazil

2018 ◽  
Vol 44 (5) ◽  
pp. 383-389
Author(s):  
Manuela Brisot Felisbino ◽  
Frederico Leon Arrabal Fernandes ◽  
Maria Cecília Nieves Maiorano de Nucci ◽  
Regina Maria de Carvalho Pinto ◽  
Emilio Pizzichini ◽  
...  
Keyword(s):  
Gene Mutation ◽  
Respiratory Symptoms ◽  
Gene Mutations ◽  
Lower Lobe ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Referral Center ◽  
Patient Profile ◽  
Significant Difference ◽  
Alpha 1 Antitrypsin

ABSTRACT Objective: The clinical, functional, radiological and genotypic descriptions of patients with an alpha-1 antitrypsin (A1AT) gene mutation in a referral center for COPD in Brazil. Methods: A cross-sectional study of patients with an A1AT gene mutation compatible with deficiency. We evaluated the A1AT dosage and genotypic, demographic, clinical, tomographic, and functional characteristics of these patients. Results: Among the 43 patients suspected of A1AT deficiency (A1ATD), the disease was confirmed by genotyping in 27 of them. The A1AT median dosage was 45 mg/dL, and 4 patients (15%) had a normal dosage. Median age was 54, 63% of the patients were male, and the respiratory symptoms started at the age of 40. The median FEV1 was 1.37L (43% predicted). Tomographic emphysema was found in 77.8% of the individuals. The emphysema was panlobular in 76% of them and 48% had lower lobe predominance. The frequency of bronchiectasis was 52% and the frequency of bronchial thickening was 81.5%. The most common genotype was Pi*ZZ in 40.7% of participants. The other genotypes found were: Pi*SZ (18.5%), PiM1Z (14.8%), Pi*M1S (7.4%), Pi*M2Z (3.7%), Pi*M1I (3.7%), Pi*ZMnichinan (3.7%), Pi*M3Plowell (3.7%), and Pi*SF (3.7%). We did not find any significant difference in age, smoking load, FEV1, or the presence of bronchiectasis between the groups with a normal and a reduced A1AT dosage, neither for 1 nor 2-allele mutation for A1ATD. Conclusions: Our patients presented a high frequency of emphysema, bronchiectasis and bronchial thickening, and early-beginning respiratory symptoms. The most frequent genotype was Pi*ZZ. Heterozygous genotypes and normal levels of A1AT also manifested significant lung disease.

Predictors of Desire to Institutionalization in Dementia Caregivers From a Developing Country

2017 ◽  
Vol 32 (5) ◽  
pp. 245-251 ◽  
Author(s):  
Preeti Sinha ◽  
Sherin Yohannan ◽  
A. Thirumoorthy ◽  
Palanimuthu Thangaraju Sivakumar
Keyword(s):  
Developing Country ◽  
Caregiver Burden ◽  
Clinical Care ◽  
Cross Sectional Study ◽  
Dementia Caregivers ◽  
Cross Sectional ◽  
Developed Country ◽  
Caregiver Education ◽  
Sociocultural Differences ◽  
Personal Strain

Older adults with dementia have higher rates of institutionalization than those without dementia. Desire to institutionalization (DTI) is an important factor influencing the actual institutionalization but is less well studied. This cross-sectional study examines the DTI with the scale of same name developed by Morycz, in 1985, in a sample of 50 caregivers of patients with dementia in a tertiary clinical care setting in a developing country. Caregiver burden associated with personal strain (by factor analyzed Zarit Burden Interview scale), and stress perceived out of caregiving (by Perceived Stress Scale) predicted higher DTI. Besides, those who were married had lower DTI scores. The factors which didn’t affect DTI were total caregiver burden, family and social support, age of patient and caregiver, education of caregiver, severity and duration of dementia, and treatment duration. These results were different from those of developed country-based DTI studies and may indicate sociocultural differences.

scholarly journals Kondisi Kebersihan Lingkungan Berhubungan dengan Risiko Penularan Kasus Leptospirosis di Area Pasar Tradisional

2020 ◽  
pp. 199-208
Author(s):  
Dyah Widiastuti ◽  
Dwi Priyanto
Keyword(s):  
Cross Sectional Study ◽  
Market Area ◽  
Chi Square ◽  
Pathogenic Leptospira ◽  
Cross Sectional ◽  
Chi Square Test ◽  
History Of ◽  
Polymerase Chain ◽  
Gathering Place ◽  
The Relationship

Leptospirosis is associated with occupations which exposed workers to contaminated environments. The risk of leptospirosis exposure in the market as a gathering place for many people needs to be assessed, to obtain the basis for decision making to anticipate leptospirosis transmission. This study aimed to determine the relationship between market environmental conditions including market sanitation conditions, the level of rat density and the presence of leptospira-positive rats  toward the history of leptospirosis exposure among market workers (traders and janitors). A cross sectional study conducted in 35 markets in Banjarnegara and 175 market workers randomly selected. Blood samples analysed using ELISA against 40 Kda pathogenic Leptospira protein. Rat trapping  conducted in each market for two days with 100 traps. The caught mice examined with Polymerase Chain Reaction (PCR) to detect the presence of Leptospira bacteria in their kidneys. Leptospirosis exposure was spread in 17 markets in Banjarnegara. The PCR examination showed that the pathogenic Leptospira infected rats were spread in four markets in Banjarnegara. Chi square test showed that the hygene condition in market area was significantly associated with the leptospirosis exposure. Markets workers (traders and janitors) were at risk for leptospirosis proved by high seroprevalence of leptospirosis in this study.

Sign in / Sign up

Export Citation Format

Share Document