A COVID-19 Patient with Simultaneous Renal Infarct, Splenic Infarct and Aortic Thrombosis during the Severe Disease

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been associated with a high incidence of arterial and venous thrombotic complications. However, thromboembolic events in unusual sites such as limb and visceral arterial ischemia are reported rarely in the literature. Herein, we describe a rare case of a patient with severe coronavirus disease 2019 (COVID-19) infection who experienced severe abdominal pain during the hospitalization and presented simultaneously renal artery, splenic artery and vein as well as aortic thrombi despite prophylactic antithrombotic treatment. Information about his follow-up post discharge is also provided. This case report raises significant clinical implications regarding the correct dose of antithrombotic treatment during the acute phase of the severe COVID-19 infection and highlights the need for incessant vigilance in order to detect thrombosis at unusual sites as a possible diagnosis when severe abdominal pain is present in severe COVID-19 patients.

National hospital readiness for COVID-19 in Lesotho: evidence for oxygen ecosystem strengthening

SETTING:Sub-Saharan African country, Lesotho, during the SARS-CoV-2 COVID-19 pandemic.OBJECTIVE: To evaluate COVID-19 hospital capacity in Lesotho.DESIGN: We conducted a pragmatic assessment of all public hospitals in Lesotho using a WHO COVID-19 hospital assessment tool during July 2020 (baseline), with targeted follow-up in December 2020. We adapted the WHO tool into a questionnaire with a focus on hospital services and included oxygen ecosystem elements (pulse oximeters, oxygen, and advanced respiratory care). We converted qualitative questionnaire answers into quantitative ordinal variables and used standard statistics for analysis.RESULTS: At baseline, we found all 12 questionnaire domains demonstrate both hospital preparedness and weakness in infection prevention and control. Key baseline gaps were lack of a dedicated team, and insufficient personal protective equipment and space for donning and doffing. Substantial limitations were noted in hypoxemia diagnosis and treatment; information management and care coordination pathways were also suboptimal. Targeted follow-up after 5 months revealed improvement in the availability of pulse oximetry, oxygen capacity, and heated high-flow nasal cannula devices.CONCLUSION: Our baseline findings may reflect uneven early pandemic care quality; targeted follow-up suggests strengthening of the oxygen ecosystem.

The Comparison of Breast Cancer in Southern China and America: a Multicentre Study in China Versus SEER Database

Background and Objective: There are different characteristics of BC in developing countries and developed countries. We intend to study the factors which influence the survival and prognosis of BC between southern China and the United States. Methods: To study the two groups BC patients in southern China from 2001 to 2016 and SEER database from 1975 to 2016. To register, collect and analyze the clinicopathological features and treatment information. Results: Our study found that there are significant differences in tumor size, positive lymph node status and KI-67 between southern China and SEER cohort (P<0.000). Conclusions: The age, tumor size, positive-node and KI-67 may cause the difference of morbidity and mortality of BC patients in southern China and SEER cohort.

Medical Record Encryption Storage System Based on Internet of Things

The Internet of Things takes data as the center, and its core is data storage and management. With the emergence and rapid development of wireless communication technology, with the huge number of terminals in human society, massive data will be generated. Undoubtedly, data storage and management technology will attract much attention. In view of this, this paper proposes a data storage scheme based on the Internet of Things. This paper introduces the Internet of Things technology, designs it from the perspective of the massive data storage system of the Internet of Things, realizes the intelligent processing of data storage, and provides security guarantee for information services. By combing the business process management of doctors, nurses and patients, this paper constructs a medical record encryption management system, makes a comparative analysis before and after the system goes online, and carries out simulation experiments. The simulation results show that (1) the cost of paper is significantly reduced, and the related forms of medical records are more unified and standard, (2) medical record inquiry and reading are more convenient and controllable, and (3) the safety of medical records is well guaranteed. Except that the relevant doctors and nurses of patients can view the relevant medical records, and others have no authority to query and access them. Therefore, the encrypted medical record storage system based on Internet of Things technology can effectively solve the collection, statistics, and integration of patient treatment information, which can be summarized into a unified, shared, and interconnected electronic medical record management system to realize the collection of patient treatment information in the whole process.

A Randomized Open Clinical Study of the Atherosclerosis Treatment Information Video Effect on Adherence to Long-Term Therapy in Patients with Cardiovascular Diseases

Aim. Study the effect of a study video, which was created by researchers and devoted to the atherosclerosis development and the effect of statin therapy on atherosclerotic plaque, on adherence to long-term therapy in patients with high or very high risk of cardiovascular complications.Material and methods. 120 patients admitted to hospital with cardiovascular diseases were included in the study. Patients were randomized into 2 groups: in the main group (n=60), the information video edited by the researchers was shown to patients on the eve of discharge, in addition to a printed brochure on lifestyle and diet modification, and in the control group (n=60), patients were given only a standard brochure. The motivating video shows the damage to the cardiovascular system by the atherosclerotic process and the beneficial effect on the body of constant intake of statins. After 1 and 3 months after discharge from the hospital, telephone calls were made, after which the patients had to visit the center for an objective examination by a researcher and control of laboratory parameters. After 1 month, 110 patients visited the center, after 3 months, 98 respondents visited the center.Results. The group with the information video demonstration noted more frequent adherence to medical recommendations compared to the control: after 1 month, 52 (96%) patients continued treatment versus 48 (86%) patients, 3 months after discharge 48 (96%) patients continued treatment versus 38 (79%) patients (p<0.05). After 1 month, 38 (70%) patients in the intervention group continued taking statins versus 29 (43%) respondents in the control group (p<0.05), 3 months after discharge, 40 (80%) patients in the intervention group continued to take statins versus 33 (69%) control patients (p<0.09).Conclusion. Demonstration of a motivating video about the effect of statins on the atherosclerosis course increases patient adherence to medicinal therapy, including adherence to statins.

Retroperitoneal Liposarcoma: An Unusual Presentation of a Rare Cancer

Retroperitoneal liposarcomas (RLPS) are rare tumors that have variable clinical behavior and complex treatment strategies based on presentation, histopathology, and genomics. Early identification is critical, and complete surgical resection remains the primary treatment, although chemotherapy and radiation are used on individual bases. Presenting symptoms are often nonspecific; therefore, a high degree of suspicion is essential for early diagnosis. In this report, the management of a 37-year-old otherwise healthy male with a large RLPS causing right groin/testicular pain is presented. After three evaluations in the emergency department, the patient was diagnosed and received two cycles of doxorubicin/ifosfamide/mesna (AIM) neoadjuvant chemotherapy. His physical exam on presentation for second opinion demonstrated a large palpable abdominal mass and fullness around the right spermatic cord. There was no appreciable change in tumor size or distant metastases on repeat scanning. Given some obstructive symptoms, a multidisciplinary team advised neoadjuvant radiation followed by radical resection of RLPS. Final pathology demonstrated a 31-cm grade II well-differentiated (WD) liposarcoma with low-grade dedifferentiation. Scattered foci of microscopic positive WD margins were noted, and the remainder of margins were negative. Genomic evaluation showed amplification of CDK4, MDM2, and FRS2. A concise literature review of common presentations, histopathology, genomics, and treatment information is discussed herein. Thorough physical exams, attention to subtle findings, appropriate medical imaging studies, and a high index of suspicion when evaluating vague symptomatology can lead to earlier diagnosis and treatment of RLPS, and ultimately better patient outcomes.

P.124 Baseline Assessment of Attention and Executive Function Deficits in Children with Neurodevelopmental Disorders: Data from a Speciality Attention Clinic

Background: Attention and executive function (EF) deficits in children negatively impact academics, social interactions, and overall quality of life. Children with other brain-based disorders are at high risk for attention and EF concerns, but the effects of these impairments are not well studied in the literature. The Complex Attention and Executive Function Clinic at the Alberta Children’s Hospital collected baseline data on patients referred for concerns of attention deficits co-occurring with diagnosed neurologic illness/injury, or neurodevelopmental disorder (NDD). Methods: The Behaviour Rating Inventory of Executive Function (BRIEF-2), Behaviour Assessment System for Children (BASC-3), Parenting Stress Index (PSI-4) and medical and past treatment information were collected on initial clinic visit for patients aged 5-15 years. Results: BRIEF-2 Global Executive Composite demonstrated 88.9% of children had clinically elevated scores. Clinically significant scores were observed in 55.5% for BASC-3 Adaptive Skills index and 40% of parents in PSI-4 Total Stress scores. Conclusions: Children with neurologic illness/NDDs are at high risk of clinical impairments in attention and EF. In children referred for attention and behavioural regulation, there is clinically significant increased reporting of executive function impairment out of proportion to other behavioural difficulties. The clinic aims to improve overall functioning through treatment of unmanaged attention and EF deficits.

Risk factors and clinical analysis of peripherally inserted central catheter-related fungal colonization in premature infants

We aimed to analyze the risk factors of positive peripherally inserted central catheter (PICC)-related fungal colonization in preterm infants. This retrospective study collected data from 2018 to 2020. The enrolled infants who underwent PICC insertion were born at < 32 weeks’ gestation or birth weight < 1500 g. The demographics, PICC-related characteristics, and treatment information were collected. Univariate and multivariate analyses were performed to investigate risk factors for PICC-related fungal colonization. The receiver operating characteristic (ROC) curve was used to determine the optimal cut-off values for the duration of antibiotics and parenteral nutrition. In total, 124 premature infants underwent PICC insertion. Among them, 19 patients had positive results of fungi on the PICC tips. The duration of antibiotics (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.02–1.31), parenteral nutrition infusion (OR 1.27, 95% CI 1.05–1.54), and postnatal glucocorticoid exposure (OR 9.48, 95% CI 1.06–84.98) were independent risk factors for fungal colonization in PICCs. The ROC curves showed that the risk increased after 15 days of antibiotic use and 28 days of parenteral nutrition infusion. Appropriate clinical management should be used to prevent fungal colonization and fungemia.

Cardiovascular diseases in combination with SARS-CoV-2 viral infection: cours and forecast

In a pandemic, a special group is made up of patients with cardiovascular pathology. Cardiovascular diseases are largely associated with an increase in mortality and an increased risk of complications in patients infected with the SARS-CoV-2 virus. This determines the importance of risk stratification, the choice of optimal personalized therapy and the study of the long-term prognosis of myocardial infarction against the background of infection caused by SARS-CoV-2. Despite the rapidly growing attention to this issue, the mechanisms of the relationship between cardiovascular disease and COVID-19 are not completely clear. We conducted a systematic review to summarize important aspects of COVID-19 for cardiologists. The authors discuss both well-studied factors of the infectious process leading to acute myocardial damage and decompensation of existing chronic cardiac diseases, and new, fundamental, determining prognosis and treatment. Information on the topic was used from publications based on the PubMed, Google Scholar and eLibrary.ru databases. This work was carried out within the framework of a research grant № 67573613 of Pfizer.