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 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 Assessment of biochemistry request forms

2017 ◽  
Vol 5 (3) ◽  
pp. 18-24 ◽  
Author(s):  
S Singh ◽  
S Khatiwada
Keyword(s):  
Laboratory Data ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Successful Outcome ◽  
Ethical Review ◽  
Sample Type ◽  
Cross Sectional ◽  
Laboratory Errors ◽  
Specimen Collection ◽  
Drug History

Oversight of information on biochemistry requisition forms may lead to laboratory errors. The aim of this study was to evaluate the level of completion of these forms. The observational cross-sectional study was conducted between December 2014 and March 2015 in the biochemistry department of a tertiary hospital in Kathmandu after approval by the Institutional Ethical Review Committee. Two thousand and thirty nine request forms were randomly assessed for the completeness of information provided by the requesting physician. Microsoft excels software and SPSS-17 was used for analysis. Patient confidentiality was maintained. Out of 2039 request forms examined, the only 100% documented parameter was the pa­tient’s name. Date of specimen collection was recorded in 79.74% of forms and age in 98.53%. The working diagnosis was recorded in 28.44% but no information regarding patient preparation. While the consultants name were stated in 13.29% of cases, drug history in 0.24%. Parameters like gender were recorded in 98.82%, sample type in 0.29%. Whether the patient was present in the ward or in the outpatient department was documented in 15.11% whereas patient number in 38.35%. Doctors were more likely to sign the forms rather than providing their name/designation. This study demonstrates that the custom of completion of request forms was poor. As laboratory data plays a significant role in medical diagnosis and re­search, incomplete data provided to the laboratory could significantly impact on the comments and successful outcome of treatment. Closer interaction between clinicians and laboratory personnel by means of request forms can improve the quality of services to patients.

scholarly journals Evaluation of Children with COVİD-19 in the First Month of the Outbreak in Turkey; Initial Pediatric Data from a Tertiary Hospital

2021 ◽  
Author(s):  
Aybüke Akaslan Kara ◽  
Elif Kıymet ◽  
Elif Böncüoğlu ◽  
Şahika Şahinkaya ◽  
Ela Cem ◽  
...  
Keyword(s):  
Medical Records ◽  
Age Groups ◽  
Case Series ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Republic Of China ◽  
Training And Research ◽  
Polymerase Chain ◽  
The City

Objective: SARS-CoV-2, emerged in December 2019 in the city of Wuhan in the People’s Republic of China affects children as well as all age groups. The aim of the study was to evaluate the clinical features and outcomes of pediatric cases with COVID-19 in the first month of the epidemic in Turkey. Method: This single center cross-sectional study was conducted in University of Health Sciences Dr Behçet Uz Child Diseases and Pediatric Surgery Training and Research Hospital during the period of March 11 – April 20, 2020. Demographic, epidemiological and clinical data were collected from medical records. All patients were confirmed by real time reverse transcription- polymerase chain reaction. Chidren were classified as asymptomatic, mild, moderate, severe, and critically ill patients. Results: In this study, we reported the clinical characteristics of a case series involving 30 chilren with COVID-19 aged from 23 days to 16 years. Twenty-nine (96.7%) patients had confirmed contact with family members for COVİD-19. The majority of patients were asymptomatic (50%) or had mild symptoms (26.7%). Fever (46.6%) and cough (33.3%) were the most common symptoms. Conclusion: Our study indicated that COVID 19 in children exhibited less severe symptoms and had better outcomes

scholarly journals Perspectives for Early Genetic Screening of Lactose Intolerance: - 13910C/T Polymorphism Tracking in the MCM6 Gene

2010 ◽  
Vol 3 (1) ◽  
pp. 66-71
Author(s):  
Marta A.S. Arroyo ◽  
Ana Cláudia P. Lopes ◽  
Vania B. Piatto ◽  
José Victor Maniglia
Keyword(s):  
Lactose Intolerance ◽  
Fragment Length Polymorphism ◽  
Female Gender ◽  
Cross Sectional Study ◽  
Specific Primers ◽  
Cross Sectional ◽  
Lactose Tolerance ◽  
Polymerase Chain ◽  
Positive Results

Introduction: For many years Lactose intolerance has been, considered as a universal problem in many children and adults. Objective: The aim is to investigate the prevalence of polymorphism -13910C/T, in a neonatal tracking, for early diagnosis of lactose tolerance/intolerance. Materials and Methods: In a cross-sectional study of 310 Brazilian newborns, DNA was extracted from leukocyte umbilical cord and specific primers were used to amplify the region that encloses the -13910C/T polymorphism of the MCM6 gene, using the polymerase chain reaction and the restriction fragment length polymorphism tests. Results: One hundred and sixty (52%) male newborns and 150 (48%) female new borns were evaluated. Out of these, 191 (62%) presented CC genotype (lactose intolerant), 95 (31%) CT genotype, and 24 (7%) TT genotype, comprising a total of 119 (38%) lactose tolerant newborns. Accordingly the newborns´ gender distribution in relation to the phenotypes has been found; 97 (32%) of male gender and 94 (30%) of female gender lactose intolerant, and 63 (20%) male and 56 (18%) female lactose tolerant newborns, not being such distribution statistically significant (p = 0.801). Conclusions: The molecular analysis made possible the identification of the presence or absence of lactase persistence variant in the Brazilian newborns. The neonatal molecular diagnosis can optimize the follow-up of positive results in newborn screening for lactose intolerance.

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.

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