scholarly journals Demographic, Clinical and Radiological Features of Healthcare Workers and Two Index Cases That Were Infected with COVID-19 (SARS-Cov-2)

2021 ◽  
Author(s):  
Ayse Erturk ◽  
Ugur Kostakoglu ◽  
Ilknur Esen Yildiz ◽  
Nur Hursoy ◽  
Sevda Ozdemir Al ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Clinical Situation ◽  
Symptom Duration ◽  
Laboratory Measurements ◽  
Health Authorities ◽  
The Mean ◽  
Medicine Education ◽  
Index Cases ◽  
Pcr Test

To evaluate the index cases leading to the transmission of healthcare workers (HCWs) in Rize/Turkey Recep Tayyip Erdogan University Faculty of Medicine Education and Research Hospital with COVID-19 infection and the clinical features of infected HCWs. The first two COVID-19 test positive patients treated at Rize/Turkey between 10.03.2020 and 12.04.2020 and HCWs those who examined these two patients whose COVID-19 PCR test results were positive were included in this study. In Rize/Turkey, the first and second cases of positive COVID-19 which was recorded on 13.03.2020 on 25.03.2020, 27 HCWs (female, 63%, n = 17 and male, 37%, n = 10 and the mean age was 33.2 ± 6.9 years) who contacted during the treatment of these cases and became COVID-19 positive were examined. The median of symptom duration (days) of the HCWs was 5 days (range: 0–17 days). Fever, 55.6% (n = 15); malaise, 44.4% (n = 12); cough, 40.7% (n = 11); sore throat, 33.3% (n = 9); myalgia, 33.3% (n = 9); dyspnea, 14.8% (n = 4); diarrhea, 22.2% (n = 6); vomiting, 14.8% (n = 4); anosmia, 18.5% (n = 5); ageusia, 22.2% (n = 6) and headache, 37% (n = 10) of the cases. The rates of headache in female HCWs infected with COVID-19 were found to be significantly higher compared to men (52.9%). None of them had severe clinical situation requiring intensive care follow-up or acute respiratory distress syndrome (ARDS). Laboratory measurements of HCWs were carried out at the first when they had symptoms and when they recovered, and results were compared accordingly. The thorax computerized tomography (CT) findings of HCWs were normal in 74.1% (n = 20) of total. HCWs were initially affected by the COVID-19 pandemic. Early measures provided by the Health authorities, access to diagnosis and treatment, and the young age average in HCWs prevented severe outcomes such as severe clinical course and mortality at the beginning of the outbreak.

scholarly journals Failed Surgery for Patellar Tendinopathy in Athletes: Midterm Results of Further Surgical Management

2021 ◽  
Vol 9 (3) ◽  
pp. 232596712199455
Author(s):  
Nicola Maffulli ◽  
Francesco Oliva ◽  
Gayle D. Maffulli ◽  
Filippo Migliorini
Keyword(s):  
Surgical Management ◽  
Revision Surgery ◽  
Case Series ◽  
Sports Participation ◽  
Patellar Tendinopathy ◽  
Symptom Duration ◽  
Level Of Evidence ◽  
Training Time ◽  
The Mean

Background: Tendon injuries are commonly seen in sports medicine practice. Many elite players involved in high-impact activities develop patellar tendinopathy (PT) symptoms. Of them, a small percentage will develop refractory PT and need to undergo surgery. In some of these patients, surgery does not resolve these symptoms. Purpose: To report the clinical results in a cohort of athletes who underwent further surgery after failure of primary surgery for PT. Study Design: Case series; Level of evidence, 4. Methods: A total of 22 athletes who had undergone revision surgery for failed surgical management of PT were enrolled in the present study. Symptom severity was assessed through the Victorian Institute of Sport Assessment Scale for Patellar Tendinopathy (VISA-P) upon admission and at the final follow-up. Time to return to training, time to return to competition, and complications were also recorded. Results: The mean age of the athletes was 25.4 years, and the mean symptom duration from the index intervention was 15.3 months. At a mean follow-up of 30.0 ± 4.9 months, the VISA-P score improved 27.8 points ( P < .0001). The patients returned to training within a mean of 9.2 months. Fifteen patients (68.2%) returned to competition within a mean of 11.6 months. Of these 15 patients, a further 2 had decreased their performance, and 2 more had abandoned sports participation by the final follow-up. The overall rate of complications was 18.2%. One patient (4.5%) had a further revision procedure. Conclusion: Revision surgery was feasible and effective in patients in whom PT symptoms persisted after previous surgery for PT, achieving a statistically significant and clinically relevant improvement of the VISA-P score as well as an acceptable rate of return to sport at a follow-up of 30 months.

Waiting times during the management of head and neck tumours

2002 ◽  
Vol 116 (4) ◽  
pp. 275-279 ◽  
Author(s):  
T. M. Jones ◽  
O. Hargrove ◽  
J. Lancaster ◽  
J. Fenton ◽  
A. Shenoy ◽  
...  
Keyword(s):  
Head And Neck ◽  
Waiting Times ◽  
Symptom Duration ◽  
Head And Neck Tumours ◽  
Magnetic Resonance Scan ◽  
Primary Radiotherapy ◽  
The Mean ◽  
Mean Time ◽  
Referral Letters

The waiting times incurred during the management of 75 consecutive head and neck oncology patients attending for post-treatment follow-up were reviewed. Data were gleaned from general practitioner (GP) referral letters, patient case-notes as well as radiology and histology reports. The mean time for GP referral to ENT was 5.1 weeks. From ENT to endoscopy was 3.1 weeks, to histology 3.5 weeks, to computed tomography (CT) scan 5.6 weeks, to magnetic resonance scan (MR) 4.1 weeks, to primary radiotherapy 10.3 weeks and to surgery 5.5 weeks. The mean symptom duration prior to referral was 4.9 months.Our results compare unfavourably with the standards recommended by the BAO-HNS. Local modifiations may improve matters, but significant increases in funding, manpower and equipment are required to achieve the stipulated standards. Moreover, criteria for referral have to be re-emphasized and patient education has to be addressed as these appear to contribute the longest delay in the diagnosis of head and neck tumours.

scholarly journals Impact of BNT162b2 vaccination and isolation on SARS-CoV-2 transmission in Israeli households: an observational study

2021 ◽  
Author(s):  
Maylis Layan ◽  
Mayan Gilboa ◽  
Tal Gonen ◽  
Miki Goldenfeld ◽  
Lilac Meltzer ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Data Augmentation ◽  
Medical Center ◽  
Credible Interval ◽  
Control Measures ◽  
Risk Of Infection ◽  
Household Transmission ◽  
Index Cases

Background Massive vaccination rollouts against SARS-CoV-2 infections have facilitated the easing of control measures in countries like Israel. While several studies have characterized the effectiveness of vaccines against severe forms of COVID-19 or SARS-CoV-2 infection, estimates of their impact on transmissibility remain limited. Here, we evaluated the role of vaccination and isolation on SARS-CoV-2 transmission within Israeli households. Methods From December 2020 to April 2021, confirmed cases were identified among healthcare workers of the Sheba Medical Centre and their family members. Households were recruited and followed up with repeated PCR for a minimum of ten days after case confirmation. Symptoms and vaccination information were collected at the end of follow-up. We developed a data augmentation Bayesian framework to ascertain how age, isolation and BNT162b2 vaccination with more than 7 days after the 2nd dose impacted household transmission of SARS-CoV-2. Findings 210 households with 215 index cases were enrolled. 269 out of 687 (39%) household contacts developed a SARS-CoV-2 infection. Of those, 170 (63%) developed symptoms. Children below 12 years old were less susceptible than adults/teenagers (Relative Risk RR=0.50, 95% Credible Interval CI 0.32-0.79). Vaccination reduced the risk of infection among adults/teenagers (RR=0.19, 95% CI 0.07-0.40). Isolation reduced the risk of infection of unvaccinated adult/teenager (RR=0.11, 95% CI 0.05-0.19) and child contacts (RR=0.16, 95% CI 0.07-0.31) compared to unvaccinated adults/teenagers that did not isolate. Infectivity was significantly reduced in vaccinated cases (RR=0.22, 95% CI 0.06-0.70). Interpretation Within households, vaccination reduces both the risk of infection and of transmission if infected. When contacts were not vaccinated, isolation also led to important reductions in the risk of transmission. Vaccinated contacts might reduce their risk of infection if they isolate, although this requires confirmation with additional data. Funding Sheba Medical Center.

scholarly journals Characteristics and Transmission Dynamics of COVID-19 in Resident Physicians at a Mexico City Teaching Hospital

2021 ◽  
Vol 2 (3) ◽  
pp. 72-76
Author(s):  
Jessica G. Azcorra-Lopez ◽  
Jesus Reyna-Figueroa ◽  
Eva M. Luna-Rivera ◽  
Berenice Cabañas-Espinosa ◽  
Yamile N. Esquivel-Torruco ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Infection Prevention ◽  
Case Control Study ◽  
Transmission Dynamics ◽  
Central Tendency ◽  
Resident Physicians ◽  
Significant Difference ◽  
The Mean ◽  
Control Study

Introduction: During the COVID-19 pandemic, hospitals have been busy controlling their spread among healthcare workers, including resident doctors. We seek to characterize and know the transmission dynamics of the SARS-COV-2 infection in the personnel of our hospital. Methodology: 204 resident physicians were followed up, in three parts: Part 1. Training, Part 2. follow-up through the WhatsApp application, Part 3. case-control study; looking for risk factors. The statistical analysis was carried out using measures of central tendency and dispersion, comparison of proportions and rates. As well as the calculation of the odds ratio with a 95% confidence interval; p <0.05 was considered significant. Results: 66 resident physicians were included, 31.8% had a positive result. The mean age was 28.9. The most frequent clinical manifestation was myalgia (66.6%), followed by headache (47%). When comparing with symptomatic resident physicians, with a negative test, there was a significant difference in arthralgia (p = 0.01) and dyspnea (0.05). Noncompliance with training (OR 7.0; 95% CI 2.2-26 and p = 0.000) was significant as a risk factor for infection. Conclusions: Resident physicians must be mostly supervised during infection prevention and containment training.

scholarly journals Autologous Osteochondral Transplantation for Osteochondral Lesions of the Talus: Does Gender Impact Outcomes?

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0022
Author(s):  
Arianna L. Gianakos ◽  
Olasunmbo Okedele ◽  
Sean Flynn ◽  
John G. Kennedy ◽  
Christopher W. DiGiovanni
Keyword(s):  
Osteochondral Lesions ◽  
Symptom Duration ◽  
Osteochondral Transplantation ◽  
Autologous Osteochondral Transplantation ◽  
Duration Of Symptoms ◽  
Male And Female ◽  
Female Patients ◽  
Male Patients ◽  
The Mean

Category: Ankle; Arthroscopy Introduction/Purpose: Autologous osteochondral transplantation (AOT) is commonly used in the treatment of osteochondral lesions (OCL) of the talus. There is limited data comparing gender differences in the incidence, presentation, and outcomes following AOT. The purpose of this study is to compare these differences between male and female patients. Methods: Eighty-five consecutive patients who underwent AOT were retrospectively reviewed. Patients were divided into two groups based on gender. Demographic data and OCL defect characteristic data were recorded. Functional outcomes were assessed pre- and post-operatively using the Foot and Ankle Outcome Score (FAOS). The Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score was used to assess cartilage incorporation. The mean clinical follow-up was 47.2 months, with mean MRI follow-up of 24.8 months. Results: Fifty-five (65%) males and 30 (35%) females were included. OCL defect size was significantly larger in men (112.8mm2) when compared with women (88.7mm2) (p<0.0001). Male patients had a significantly longer duration of symptoms (p<0.001) and OCLs were more likely traumatic in nature (p=0.0006) when compared with female patients. Mean FAOS improved pre- to postoperatively from 50 to 81(P < .001) with a statistically significant increase in men (p<0.0001). The mean MOCART score was 82.1 and 86.7 in male and female patients, respectively (p<0.0001). Lesion size was negatively correlated with MOCART score (r = -0.36,P = .004). No differences were found in knee donor site morbidity, complication rate, or revision surgery. Conclusion: Our study demonstrates that male patients typically present with talar OCLs that are larger in size, traumatic in nature, and with longer symptom duration when compared with female patients. In addition, male patients had greater improvement in FAOS scores following AOT. Therefore, understanding these differences may influence the management and treatment of talar OCLs in male and female patients.

scholarly journals Clinical Characteristics of Pregnancy-Associated Central Serous Chorioretinopathy in the Chinese Population

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Jia Yu ◽  
Lei Li ◽  
Chunhui Jiang ◽  
Qing Chang ◽  
Gezhi Xu
Keyword(s):  
Visual Acuity ◽  
Central Serous Chorioretinopathy ◽  
Chinese Population ◽  
Clinical Characteristics ◽  
Subretinal Fluid ◽  
Symptom Duration ◽  
Initial Visit ◽  
Half Dose ◽  
The Mean

Purpose. To investigate the clinical characteristics of pregnancy-associated central serous chorioretinopathy (CSC) in the Chinese population. Methods. The medical records of patients diagnosed with pregnancy-associated CSC from February 2012 to October 2019 were retrospectively reviewed. Best-corrected visual acuity (BCVA), symptom duration, pregnancy-related medical information, and optical coherence tomography (OCT) images were collected. Results. Nine patients (11 eyes) were included. Five women were in their first pregnancy and four were in their second pregnancy, two of whom experienced CSC in their first pregnancy as well. The mean age was 35.00 ± 3.97 years. The mean symptom duration at the initial visit was 19.73 ± 13.65 days. The mean gestational age at the time of development of CSC was 27.11 ± 2.09 weeks. The mean BCVA (logarithm of the minimum angle of resolution (logMAR)) at the initial visit was 0.36 ± 0.18 (Snellen 20/45, range 20/100–20/25). All eyes showed subretinal hyperreflective fibrin on OCT images at the initial visit. Four patients (4 eyes) were lost to follow-up before fluid resolution. The mean BCVA at the final visit was logMAR 0.10 ± 0.15 (Snellen 20/25, range 20/50–20/20)). One eye in the oldest patient had persistent subretinal fluid at 26 months postpartum. The subretinal fluid resolved completely after half-dose photodynamic therapy (PDT); however, the ellipsoid zone at the fovea remained discontinuous at 30 months after half-dose PDT. The remaining six eyes all showed spontaneous resolution of subretinal fluid around delivery and regained intact ellipsoid zone. Conclusions. Pregnancy-associated CSC in Chinese developed mostly in the third trimester and usually recovered spontaneously around delivery with good final visual acuity. However, patients might require long-term follow-up until complete resolution of subretinal fluid and to detect recurrences. Half-dose PDT can be administered early if there is little reduction in the amount of subretinal fluid after delivery.

scholarly journals The presentation, diagnosis and management of non-traumatic wrist pain: an evaluation of current practice in secondary care in the UK NHS

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
◽  
Benjamin J F Dean ◽  
Andrew Carr ◽  
Ryan W Trickett ◽  
Stefan Kluzek ◽  
...  
Keyword(s):  
Secondary Care ◽  
Wrist Pain ◽  
Symptom Duration ◽  
Surgical Interventions ◽  
Significant Burden ◽  
The Mean ◽  
Uk National Health Service ◽  
The Uk ◽  
Patient Referrals

Abstract Objectives The study aims were to assess the burden of non-traumatic wrist pain in terms of numbers of referrals to secondary care and to characterize how patients present, are diagnosed and are managed in secondary care in the UK National Health Service. Methods Ten consecutive patients presenting with non-traumatic wrist pain were identified retrospectively at each of 16 participating hospitals, and data were extracted for 12 months after the initial referral. Results The 160 patients consisted of 100 females and 60 males with a median age of 49 years, accounting for ∼13% of all new hand/wrist referrals. The dominant wrist was affected in 60% of cases, and the mean symptom duration was 13.3 months. Diagnoses were grouped as follows: OA (31%), tendinopathy (13%), ganglion (14%), ulnar sided pain (17%) and other (25%). The OA group was significantly older than other groups, and other groups contained a predominance of females. The non-surgical interventions, in decreasing frequency of usage, were as follows: CS injections (39%), physiotherapy (32%), splint (31%) and analgesics (12%). Of those who underwent surgery, all patients had previously received non-surgical treatment, but 42% had undergone only one non-surgical intervention. Conclusions Non-traumatic wrist pain represents a significant burden to secondary care both in terms of new patient referrals and in terms of investigation, follow-up and treatment. Those presenting with OA are more likely to be older and male, whereas those presenting with other diagnoses are more likely to be younger and female.

scholarly journals Functional improvement of bilateral frozen shoulder by unilateral intra-articular corticosteroid injection: a retrospective study

2021 ◽  
Vol 49 (10) ◽  
pp. 030006052110505
Author(s):  
Minchul Kim ◽  
Ki-Yong Kim ◽  
Yool-Gang Huh ◽  
Sang Hyeok Ma ◽  
Kil-Yong Jeong ◽  
...  
Keyword(s):  
Rating Scale ◽  
External Rotation ◽  
Corticosteroid Injection ◽  
Frozen Shoulder ◽  
Numeric Rating Scale ◽  
Functional Improvement ◽  
Symptom Duration ◽  
The Mean ◽  
Numeric Rating

Objective Bilateral frozen shoulder (FS) is often treated with intra-articular corticosteroid injection (IACI). No studies have been performed to establish whether IACI must be administered in both shoulders or in only one shoulder to improve function. This study was therefore performed to determine whether unilateral IACI improves shoulder pain and passive range of motion (pROM) in bilateral FS. Methods The medical records of 165 patients with bilateral primary FS who underwent ultrasonography-guided IACI (2 mL of 10-mg/mL triamcinolone acetonide mixed with 5 mL of 1% lidocaine) in one shoulder were retrospectively reviewed. The outcome measures, namely the numeric rating scale (NRS) scores and pROM values (abduction, external rotation, flexion, hyperextension, and internal rotation), were evaluated pre- and post-injection. Results The patients’ mean age was 54.0 ± 8.0 years. The mean symptom duration was 6.5 ± 2.8 months. The mean follow-up period after injection was 6.7 ± 0.8 weeks. The NRS scores and pROM values significantly improved in both the injected and non-injected shoulders. Conclusions This study showed that unilateral IACI in patients with bilateral FS improves the clinical outcome of the non-injected shoulder. We suggest that physicians observe the non-injected shoulder after unilateral injection rather than performing bilateral injections.

Role of Healthcare Workers in Outbreaks of Methicillin-ResistantStaphylococcus aureus: A 10-Year Evaluation From a Dutch University Hospital

2003 ◽  
Vol 24 (9) ◽  
pp. 679-685 ◽  
Author(s):  
Hetty E. M. Blok ◽  
Annet Troelstra ◽  
Titia E. M. Kamp-Hopmans ◽  
Ada C. M. Gigengack-Baars ◽  
Christina M. J. E. Vandenbroucke-Grauls ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Healthcare Workers ◽  
Methicillin Resistance ◽  
Medical Center ◽  
University Hospital ◽  
Work Assessment ◽  
Index Cases

AbstractBackground and Objective:The benefit of screening healthcare workers (HCWs) at risk for methicillin-resistantStaphylococcus aureus(MRSA) carriage and furloughing MRSA-positive HCWs to prevent spread to patients is controversial. We evaluated our MRSA program for HCWs between 1992 and 2002.Setting:A university medical center in the Netherlands, where methicillin resistance has been kept below 0.5% of all nosocomial S.aureusinfections using active surveillance cultures and isolation of colonized patients.Design:HCWs caring for MRSA-positive patients or patients in foreign hospitals were screened for MRSA. MRSA-positive HCWs had additional cultures, temporary exclusion from patient-related work, assessment of risk factors for persisting carriage, decolonization therapy with mupirocin intranasally and chlorhexidine baths for skin and hair, and follow-up cultures.Results:Fifty-nine HCWs were colonized with MRSA. Seven of 840 screened employees contracted MRSA in foreign hospitals; 36 acquired MRSA after contact with MRSA-positive patients despite isolation precautions (attack rate per outbreak varied from less than 1% to 15%). Our hospital experienced 17 MRSA outbreaks, including 13 episodes in which HCWs were involved. HCWs were index cases of at least 4 outbreaks. In 8 outbreaks, HCWs acquired MRSA after caring for MRSA-positive patients despite isolation precautions.Conclusion:Postexposure screening of HCWs allowed early detection of MRSA carriage and prevention of subsequent transmission to patients. Where the MRSA prevalence is higher, the role of HCWs may be greater. In such settings, an adapted version of our program could help prevent dissemination.

Sound Production Treatment for Acquired Apraxia of Speech: An Examination of Dosage in Relation to Probe Performance

2020 ◽  
pp. 1-16
Author(s):  
Julie L. Wambaugh ◽  
Lydia Kallhoff ◽  
Christina Nessler
Keyword(s):  
Retrospective Analysis ◽  
Sound Production ◽  
Apraxia Of Speech ◽  
Practice Schedule ◽  
Practice Schedules ◽  
Baseline Performance ◽  
The Mean ◽  
Number Of Treatment ◽  
The Impact

Purpose This study was designed to examine the association of dosage and effects of Sound Production Treatment (SPT) for acquired apraxia of speech. Method Treatment logs and probe data from 20 speakers with apraxia of speech and aphasia were submitted to a retrospective analysis. The number of treatment sessions and teaching episodes was examined relative to (a) change in articulation accuracy above baseline performance, (b) mastery of production, and (c) maintenance. The impact of practice schedule (SPT-Blocked vs. SPT-Random) was also examined. Results The average number of treatment sessions conducted prior to change was 5.4 for SPT-Blocked and 3.9 for SPT-Random. The mean number of teaching episodes preceding change was 334 for SPT-Blocked and 179 for SPT-Random. Mastery occurred within an average of 13.7 sessions (1,252 teaching episodes) and 12.4 sessions (1,082 teaching episodes) for SPT-Blocked and SPT-Random, respectively. Comparisons of dosage metric values across practice schedules did not reveal substantial differences. Significant negative correlations were found between follow-up probe performance and the dosage metrics. Conclusions Only a few treatment sessions were needed to achieve initial positive changes in articulation, with mastery occurring within 12–14 sessions for the majority of participants. Earlier occurrence of change or mastery was associated with better follow-up performance. Supplemental Material https://doi.org/10.23641/asha.12592190

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