scholarly journals Post-acute COVID-19 syndrome: Prolonged effort intolerance after SARS-CoV-2 infection

2021 ◽  
Author(s):  
Murat Duyan ◽  
Ahmet Serbülent Savcıoğlu ◽  
Ibrahim Ulas Ozturan
Keyword(s):  
Emergency Department ◽  
Female Patients ◽  
Persistent Symptoms ◽  
Male Patients

Abstract Many new complications have been arising after being infected with SARS-CoV-2. Post-acute COVID-19 syndrome is a new definition for patients with persistent symptoms and prolonged complications beyond 4 weeks of acute COVID-19. In this report, we present two cases of prolonged dyspnea and reduced effort capacity for 4 and 5 months, respectively. A 29-year-old male and 40-year-old female patients, found to be positive in rRT-PCR tests for SARS-CoV-2, had recurrent admission to the emergency department after having treated for COVID-19. Both of the patients were followed for 6 months. Although all potential cardiovascular, pulmonary and other system pathologies were ruled out, the prolonged dyspnea and reduced effort capacity started to improve after 4 months in the female and 5 months in the male patients. The patients were diagnosed with post-acute COVID-19 syndrome. It should be kept in mind that the post-acute COVID-19 syndrome may be a complication in patients with persistent symptoms after COVID-19.

Gender Differences and Characteristics of Psychiatric Patients assessed in The Emergency Department of a Regional Hospital in Canada

2016 ◽  
Vol 33 (S1) ◽  
pp. S439-S440 ◽  
Author(s):  
V. agyapong ◽  
M. Juhas ◽  
a. Ritchie ◽  
a. Kavanagh
Keyword(s):  
Emergency Department ◽  
Oil Sands ◽  
Depressive Disorders ◽  
Assessment Tool ◽  
Psychiatric Patients ◽  
Health Centre ◽  
Schizophrenia Spectrum Disorders ◽  
Audit Process ◽  
Female Patients ◽  
Male Patients

BackgroundEpidemiological studies of emergency room (ER) psychiatric settings can help monitor unmet needs and improve the quality of care.ObjectivesTo characterize the patients presenting to emergency department with psychiatric complaints in a medium sized health centre in oil sands region of the Northern alberta.Methodsinformation on a data assessment tool designed to capture all relevant demographic and clinical characteristics of psychiatric patients in the ER was compiled as part of a clinical audit process.ResultsOverall, 477 patients were assessed by the psychiatric team over the 12 month period, comprising 230 (48.2%) males and 247 (51.8%) females. There was a fairly balanced distribution by age, ethnic background, and relationship status between the male and female patients. The majority of patients with a history of self-harm or childhood sexual abuse were female while male patients were significantly more likely to report medication non-compliance. a higher proportion of the female patients had depressive disorders and personality disorders while a higher proportion of male patients had anxiety disorders, bipolar and related disorders, schizophrenia spectrum disorders, and substance-related disorders. approximately half of all the patients had an impaired clinical insight. Majority of the patients had a G aF score of 70 or less. Nearly one in five patients were admitted for inpatient treatment with a significantly higher proportion of male patients being admitted involuntarily.ConclusionThere are sex-specific differences in many of the demographic and clinical measures collected in our ER psychiatric sample.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Epidemiological characteristics and initial clinical presentation of patients with laboratory-confirmed MERS-CoV infection in an emergency department

2021 ◽  
Keyword(s):  
Emergency Department ◽  
Middle East ◽  
Clinical Presentation ◽  
Invasive Mechanical Ventilation ◽  
Middle East Respiratory Syndrome ◽  
Upper Respiratory Tract ◽  
Female Patients ◽  
Male Patients ◽  
Coronavirus Infection ◽  
Epidemiological Characteristics

Emergency departments have been implicated as a source of index cases of the Middle East Respiratory Syndrome (MERS) coronavirus infection. We describe the epidemiological characteristics and initial clinical presentation of patients with Middle East respiratory syndrome coronavirus infection in an emergency department at a hospital in Riyadh, in the Kingdom of Saudi Arabia. The records of all patients presenting to the emergency department who tested positive for Middle East respiratory syndrome coronavirus infection on real-time reverse transcriptase polymerase chain reaction testing from April 2014 to November 2019 were reviewed, and the outcomes were assessed. The clinical presentations and outcomes were compared according to sex. A total of 68 patients with Middle East respiratory syndrome coronavirus infection were identified, of whom 40 (58.8%) were female, and 28 (41.2%) were male. The mean age was 50.7 (standard deviation: 16.4) years, and female patients were younger (44.7 ± 13.1 years) than male patients (59.4 ± 16.9 years). Nineteen of the 68 patients (27.9%) were asymptomatic of whom the majority (16/19, 84%) were female (p = 0.012). The most common symptoms were fever (n = 29, 42.6%), cough (n = 25, 36.8%), upper respiratory tract infection (n = 23, 33.8%), and pneumonia (n = 15, 22.1%). Pneumonia, diarrhea, dyspnea, and vomiting/diarrhea were more common among male patients. Male patients were more likely than female patients to require hospital admission (78.6% vs. 30.0%), intensive care unit admission (64.3% vs. 15.0%), and invasive mechanical ventilation (32.1% vs. 10.0%). The most common presentation of Middle East respiratory syndrome coronavirus infection in this cohort was asymptomatic infection. A high proportion of asymptomatic infections has not been reported previously. The study did not identify typical clinical features of MERS patients. Male patients tended to develop more severe disease than female patients. A larger study is needed to confirm these findings.

GAMBARAN ANGKA KEJADIAN STROKE AKIBAT HIPERTENSI DI INSTALASI REHABILITASI MEDIK BLU RSUP PROF. DR. R. D. KANDOU MANADO PERIODE JANUARI – DESEMBER 2011

e-CliniC ◽  
2013 ◽  
Vol 1 (2) ◽  
Author(s):  
Ariesta Zubiah Ramadhini ◽  
L. S. Angliadi ◽  
Engeline Angliadi
Keyword(s):  
Descriptive Study ◽  
Medical Rehabilitation ◽  
Stroke Patients ◽  
Female Patients ◽  
Male Patients

Abstract: Stroke may cause a serious problem that leads to a disability or even mortality. The purpose is to determine such an incidence caused by hypertension at the Installation of Medical Rehabilitation RSUP Prof. dr. R. D. Kandou Manado based on the characteristic of age, gender and occupation. This research was taken at the Installation of Medical Rehabilitation RSUP Prof. R. D. Kandou Manado by using retrospective descriptive study method as well as examining 228 new cases of stroke patients that correlated with conclusion criteria. The result showed 8,3% patients at ≤44th years old, 33,3% patients at 45th – 54th years old, 32% patients at 55th – 64th years old, 20,25% patients at 65th – 74th years old, 6,1% patients at 75th – 84th years old. 53,1% male patients, 46,9% female patients. 33,3% retirement, 18% farmers, 18% government officers, 5,3% private employees, 2,2% drivers, 0,9% teachers and, 3,1% housewives. Keywords: incidence, hypertension, stroke   Abstrak: Stroke dapat menimbulkan masalah besar karena menyebabkan kecacatan dan kematian. Tujuan, mengetahui gambaran angka kejadian stroke akibat hipertensi di Instalasi Rehabilitasi Medik RSUP Prof. Dr. R. D. Kandou Manado sesuai dengan karakteristik umur, jenis kelamin, dan jenis pekerjaan. Penelitian dilakukan di Instalasi Rehabilitasi Medik BLU RSUP Prof. dr. R. D. Kandou Manado, dilakukan secara retrospektif deskriptif dan didapatkan sampel sebanyak 228 data pasien kunjungan baru kasus stroke sesuai kriteria inklusi yang ditetapkan. Hasil penelitian, pasien stroke berumur ≤44 tahun 8,3%, berumur 45 – 54 tahun 33,3%, berumur 55 – 64 tahun 32%, berumur 65 – 74 tahun 20,25%, berumur 75 – 84 tahun 6,1%. Pasien stroke berjenis kelamin laki – laki 53,1%, perempuan 46,9%. Pasien stroke yang berstatus pekerjaan pensiunan 33,3%, petani 18%, PNS 18%, pegawai swasta 5,3%, supir 2,2%, guru 0,9%, IRT 3,1%. Kata Kunci: gambaran angka kejadian, hipertensi, stroke

scholarly journals Differences in Outcomes Between Anterior and Posterior Shoulder Instability After Arthroscopic Bankart Repair: A Systematic Review and Meta-analysis

2021 ◽  
Vol 9 (5) ◽  
pp. 232596712110064
Author(s):  
Matthew L. Vopat ◽  
Reed G. Coda ◽  
Nick E. Giusti ◽  
Jordan Baker ◽  
Armin Tarakemeh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Shoulder Instability ◽  
Anterior Shoulder Instability ◽  
Posterior Shoulder Instability ◽  
Anterior Instability ◽  
Posterior Instability ◽  
Female Patients ◽  
Posterior Shoulder ◽  
Male Patients ◽  
Postoperative Instability

Background: The glenohumeral joint is one of the most frequently dislocated joints in the body, particularly in young, active adults. Purpose: To conduct a systematic review and meta-analysis to evaluate and compare outcomes between anterior versus posterior shoulder instability. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was performed using the PubMed, Cochrane Library, and MEDLINE databases (from inception to September 2019) according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies were included if they were published in the English language, contained outcomes after anterior or posterior shoulder instability, had at least 1 year of follow-up, and included arthroscopic soft tissue labral repair of either anterior or posterior instability. Outcomes including return-to-sport (RTS) rate, postoperative instability rate, and pre- and postoperative American Shoulder and Elbow Surgeons (ASES) scores were recorded and analyzed. Results: Overall, 39 studies were included (2077 patients; 1716 male patients and 361 female patients). Patients with anterior instability had a mean age of 23.45 ± 5.40 years (range, 11-72 years), while patients with posterior instability had a mean age of 23.08 ± 8.41 years (range, 13-61 years). The percentage of male patients with anterior instability was significantly higher than that of female patients (odds ratio [OR], 1.36; 95% CI, 1.04-1.77; P = .021). Compared with patients with posterior instability, those with anterior instability were significantly more likely to RTS (OR, 2.31; 95% CI, 1.76-3.04; P < .001), and they were significantly more likely to have postoperative instability (OR, 1.53; 95% CI, 1.07-2.23; P = .018). Patients with anterior instability also had significantly higher ASES scores than those with posterior instability (difference in means, 6.74; 95% CI, 4.71-8.77; P < .001). There were no significant differences found in postoperative complications between the anterior group (11 complications; 1.8%) and the posterior group (3 complications; 1.6%) (OR, 1.12; 95% CI, 0.29-6.30; P = .999). Conclusion: Patients with anterior shoulder instability had higher RTS rates but were more likely to have postoperative instability compared with posterior instability patients. Overall, male patients were significantly more likely to have anterior shoulder instability, while female patients were significantly more likely to have posterior shoulder instability.

An Audit of Treatment of Genital Warts: Opening the Feedback Loop

1993 ◽  
Vol 4 (4) ◽  
pp. 226-231 ◽  
Author(s):  
M Reynolds ◽  
M Murphy ◽  
M A Waugh ◽  
C J N Lacey
Keyword(s):  
Specific Treatment ◽  
Genital Warts ◽  
Therapeutic Modality ◽  
First Episode ◽  
Anogenital Warts ◽  
Treatment Protocols ◽  
Female Patients ◽  
General Infirmary ◽  
Male Patients ◽  
Time Of Presentation

An audit of the treatment of patients (100 men and 90 women) presenting with a first episode of anogenital warts to the Genitourinary Medicine Department at Leeds General Infirmary was performed. Treatment of patients was monitored for a period of 6 months from the time of presentation. The management of patients with genital warts lacked a clearly defined strategy and treatment was unselective and poorly monitored. Excluding patients who defaulted, at follow-up 44 (44%) men and 36 (38%) women still had genital warts at 3 months. Of those patients clear of warts at 3 months, the mean time to remission for men and women was 7.1 and 8.3 weeks respectively. Podophyllin 25% in tincture of benzoin was by far the predominant therapeutic modality used. A total of 96 (96%) men and 76 (84%) women received treatment with podophyllin. Both male and female patients had a mean of 5 treatments with podophyllin 25% (range 1–19 and 1–12 respectively). Physical methods of treatment i.e. cryotherapy and electrocautery, were underutilized, both as primary therapies and when topical agents had failed. Patients saw an average of 3 (range 1–7) doctors over the course of their treatment. Patients with warts affecting 2 or more sites, male patients with anal/perianal warts, and female patients with cervical and vaginal warts had higher failure rates from treatment at 3 months. On the basis of these findings, specific treatment protocols for the management of anogenital warts have been devised.

scholarly journals Comparison of Clinical Features Between Patients with Positive and Negative Appendectomy

2020 ◽  
Author(s):  
Guner Cakmak ◽  
Baris Mantoglu ◽  
Emre Gonullu ◽  
Kayhan Ozdemir ◽  
Burak Kamburoglu
Keyword(s):  
Acute Appendicitis ◽  
Clinical Features ◽  
Total Bilirubin ◽  
Negative Appendectomy ◽  
C Reactive Protein ◽  
Future Studies ◽  
Female Patients ◽  
Reactive Protein ◽  
Male Patients ◽  
The Mean

Abstract Background: The objective of this study was to retrospectively compare clinical features and prognostic values between the patients who were referred to the general surgery clinic of our hospital with the presumed diagnosis of acute appendicitis and underwent positive or negative appendectomy.Methods: Patients were divided into two groups as positive (PA) (n:362) and negative appendectomy (NA) (n:284) and the data obtained were compared between these two groups.Laboratory investigations were performed in all patients, and white blood cell (WBC), mean platelet volume (MPV), neutrophils count (NEU), neutrophils (%) (NEU%), C-reactive protein (CRP) and total bilirubin (TBIL) values were studied.Results: The mean MPV value was found as 7.88 fl in PA groups and 8.09 fl in NA group, and the mean MPV value was not statistically significantly difference in PA group, compared to NA groups (p=0.012). Laboratory parameters were also compared between genders. Accordingly, the mean MPV value was statistically significantly higher in female patients compared to male patients in PA group (p = 0.04). The mean TBIL value was 0.97 mg/dl in PA group and 0.69 mg/dl in NA group, and the mean TBIL value was statistically significantly higher in PA group (p< 0.001). Finally, TBIL value was statistically significantly lower in female patients compared to male patients in NA and PA group (p < 0.05).Conclusions: According to the results of our study, MPV and T. BIL values differ in PA and NA groups depending on gender. Therefore, these values may not be used as specific biomarkers in predicting positive acute appendicitis. We believe that these results will contribute to the literature and will be guiding for future studies.

scholarly journals 88 Evidence of enhanced immune activation within the tumor microenvironment and the circulation of female patients with high-risk melanoma compared to males

2021 ◽  
Vol 9 (Suppl 3) ◽  
pp. A96-A96
Author(s):  
Mariam Saad ◽  
Aik Choon Tan ◽  
Issam El Naqa ◽  
Sandra Lee ◽  
F Stephen Hodi ◽  
...  
Keyword(s):  
Gene Expression ◽  
T Cells ◽  
Expression Profiling ◽  
Female Gender ◽  
National Institutes Of Health ◽  
Female Patients ◽  
High Risk Melanoma ◽  
Risk Melanoma ◽  
Male Patients ◽  
Written Informed Consent

BackgroundSex differences in tumor immunity and response to immunotherapy were shown in murine models and descriptive analyses from recent clinical trials. We recently reported that female gender is a favorable prognostic marker for survival benefit following ipilimumab and high dose interferon-alfa (HDI) adjuvant therapy of high-risk melanoma in the ECOG-ACRIN E1609 trial (N=1670). Therefore, we investigated differences in candidate immune biomarkers in the circulation and tumor microenvironment (TME) of female and male patients.MethodsGene expression profiling (GEP) was performed on the tumor biopsies of 718 (454 male, 264 female) patients. The primary endpoint was mRNA expression profiling using U133A 2.0 Affymetrix gene chips. Raw microarray data sets were normalized by using the Robust Multi-array Average (RMA) method using Affymetrix Power Tools (APT) as previously published. Multiple probe sets representing the same genes were collapsed by using the probe with maximum gene expression. Gene set enrichment analysis (GSEA) was performed by comparing the female and male tumor samples, and gene sets with FDR q-value <0.1 were deemed as significant. Similarly, peripheral blood (serum and PBMC) samples were tested for soluble (Luminex) and cellular (multicolor flow cytometry) prognostic biomarkers in a subset of patients (N=321; 109 female and 212 male). All patients provided an IRB-approved written informed consent.ResultsAmong the subset of patients tested for circulating biomarkers, females were significantly younger than males (P=0.03). Testing PBMCs, the percentages of CD3+ T cells (P=0.04) and CD3+CD4+ helper T cells (P=0.0005) were significantly higher in female patients compared to males. Also, there were trends toward higher levels of proinflammatory cytokines IL1beta (P=0.07) and IL6 (P=0.06) in females. On the other hand, males had significantly higher percentages of monocytes (P=0.03). Further, there were trends toward higher percentages of CD3+/CD4+/CD25hi+/Foxp3+ (P=0.1) and CD3+/CD4+/CD25+/CD127low+ (P=0.1) T-reg in male patients compared to females. Among the cohort of patients (N=718) with tumor GEP data, females were significantly younger than males (P=0.0009). GEP identified pathways and genes related to immune cell infiltration and activation that were significantly enriched in the tumors of females compared to males (table 1).Abstract 88 Table 1Immune pathways significantly enriched in tumors of femalesConclusionsFemale gender was associated with adjuvant immunotherapeutic benefits and female patients were more likely to have evidence of immune activation within the TME and the circulation, supporting a potentially important role for female related factors in the immune response against melanoma, and these require further investigation.AcknowledgementsWe are grateful to the patients and family members who participated in the E1609 trial and the E1609 trial investigators. This study was conducted by the ECOG-ACRIN Cancer Research Group (Peter J. O’Dwyer, MD and Mitchell D. Schnall, MD, PhD, Group Co-Chairs) and supported by the National Cancer Institute of the National Institutes of Health under the following award numbers: U10CA180794, U10CA180820, U10CA180888, UG1CA233180, UG1CA233184. Biomarkers studies were supported under the following award number: P50CA12197310 (Tarhini and Kirkwood). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.Trial RegistrationNCT01274338Ethics ApprovalThe E1609 study protocol was approved by the institutional review board of each participating institution and conducted in accordance with Good Clinical Practice guidelines as defined by the International Conference on Harmonization. All patients provided an IRB-approved written informed consent.ConsentNot applicable.

scholarly journals Sex-Disaggregated Data on Clinical Characteristics and Outcomes of Hospitalized Patients With COVID-19: A Retrospective Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Mengdie Wang ◽  
Nan Jiang ◽  
Changjun Li ◽  
Jing Wang ◽  
Heping Yang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Clinical Characteristics ◽  
Random Effect ◽  
Hospitalized Patients ◽  
Male And Female ◽  
Female Patients ◽  
Disease Outcomes ◽  
Male Patients

BackgroundSex and gender are crucial variables in coronavirus disease 2019 (COVID-19). We sought to provide information on differences in clinical characteristics and outcomes between male and female patients and to explore the effect of estrogen in disease outcomes in patients with COVID-19.MethodIn this retrospective, multi-center study, we included all confirmed cases of COVID-19 admitted to four hospitals in Hubei province, China from Dec 31, 2019 to Mar 31, 2020. Cases were confirmed by real-time RT-PCR and were analyzed for demographic, clinical, laboratory and radiographic parameters. Random-effect logistic regression analysis was used to assess the association between sex and disease outcomes.ResultsA total of 2501 hospitalized patients with COVID-19 were included in the present study. The clinical manifestations of male and female patients with COVID-19 were similar, while male patients have more comorbidities than female patients. In terms of laboratory findings, compared with female patients, male patients were more likely to have lymphopenia, thrombocytopenia, inflammatory response, hypoproteinemia, and extrapulmonary organ damage. Random-effect logistic regression analysis indicated that male patients were more likely to progress into severe type, and prone to ARDS, secondary bacterial infection, and death than females. However, there was no significant difference in disease outcomes between postmenopausal and premenopausal females after propensity score matching (PSM) by age.ConclusionsMale patients, especially those age-matched with postmenopausal females, are more likely to have poor outcomes. Sex-specific differences in clinical characteristics and outcomes do exist in patients with COVID-19, but estrogen may not be the primary cause. Further studies are needed to explore the causes of the differences in disease outcomes between the sexes.

scholarly journals Impacted Upper Central Incisors – Frequency and Factors Complicating the Treatment Protocol

Folia Medica ◽  
2021 ◽  
Vol 63 (3) ◽  
pp. 405-412
Author(s):  
Greta Yordanova ◽  
Gergana Gurgurova
Keyword(s):  
Medical Records ◽  
Treatment Protocol ◽  
Mixed Dentition ◽  
Successful Outcome ◽  
Central Incisor ◽  
Supernumerary Teeth ◽  
Impacted Tooth ◽  
Female Patients ◽  
Male Patients ◽  
Bone Coverage

Introduction: Eruption of central incisors occurs at a time when the mixed dentition starts to develop and their impaction is mostly a severe esthetic problem.Aim: Our aim was to assess the frequency of impaction of an upper central incisor and to analyse the factors which affect the successful outcome and the protocols for orthodontic treatment in cases of impacted upper central incisors.Materials and methods: In the present study, we used all medical records of 651 patients treated in our private practice over the last 3 years and also the medical records of 18 patients we diagnosed and treated for this problem over the last 8 years.Results: We found the ratio of impacted upper central incisors to be 1.4% as there were more male than female patients affected. There were 2.8% male patients and 0.7% female patients. The most frequent cause of impaction of the upper central incisor was the presence of mesiodentes and supernumerary teeth (55.5%), followed by presence of follicular cysts (44.4%) and odontoma collections (22.2%) or a combination of these.Several approaches have been used in treating the different positions of impacted incisors. It is necessary first to rotate the axle of the incisor and assure its root full bone coverage. We used directly TPA for support. In other patients, we waited for the spontaneous eruption after removal of the etiological factor and in another patient, we used conventional fixed techniques.Conclusions: It is important that dental doctors should monitor the formation of the dentition so that they detect the impacted tooth early in its development.

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