Clinical and paraclinical manifestations in patients suspected of being infected with COVID-19

Background: It was intended to study the structure of the symptoms in patients suspected of having SARS-CoV-2 virus infection, as well as to find any correlations between the clinical, paraclinical and radiological manifestations in positive versus negative patients, in order to further facilitate the diagnosis and triage of patients. Material and methods: 101 patients seeking medical attendance at the COVID-19 Triage Center in Chisinau have been examined, presenting various respiratory symptoms. The frequency of symptoms and the results of the paraclinical investigations were evaluated based on the results of the PCR tests for SARS-CoV-2 infection and the assessment of correlations (Pearson). Results: Out of 101 subjects, 50 tested SARS-CoV-2 positive, and the remaining 51 – negative. The clinical manifestations of SARS-CoV-2 suspects were as follows: fatigue – 72%, sweating – 54%, chills – 52%, fever – 49%, subfebrility – 39%, myalgias and arthralgias – 37%, cough – 35% (sputum – 17% and hemoptysis – 2%), dyspnea – 34%, chest pain – 23%, anosmia – 12%, headache – 11%, dyspeptic syndrome – 8%. Infiltrates on chest radiography were found in 22% of cases. A weak inverse correlation (R = -0.22, P <0.05) between the leukocyte count and SARS-CoV-2 test results was found. An average direct correlation between the presence of fever (R = 0.36, P <0.05) and a positive COVID-19 test was also noticed. Conclusions: Certain symptoms such as anosmia were more commonly seen in patients with positive COVID-19 tests. The absence of pulmonary infiltrates and the presence of dyspnoea have been negative predictive factors for COVID-19. Leukopenia has been noticed only in SARS-CoV-2 positive patients. Subfebrility has not shown a predictive significance of COVID-19

Efficiency and resource allocation: the Hungarian managed health care system

The managed health care system (MHCS) was introduced and applied in Hungary between 1999 and 2009. The gradually expanding system covered only 22% of the population and included exclusively the curative-preventive health care, subsidy on medicaments, subsidy on therapeutic appliances and the spa service. Like anywhere else it was cost-effectiveness that was expected from the MHCS without the adverse effect in the quality of the health service. To decide whether the MHCS was successful in Hungary or not, we compare it with the results of those segments of the health system where the MHCS was not introduced. We use the method of the incremental cost analysis. We are making our comparison exclusively on the basis of health economics aspects, because no difference has evolved in the quality of the medical attendances. We will see that where the MHCS was applied, the medical attendance became cheaper, at those places where the MHCS was not applied the medical attendance became more expensive, causing a chronic financial deficit (137785 million HUF). Although the MHCS managed from less money, it gained 17767 million HUF during the mentioned ten years. We are going to present the general features of the MHCS and support the fact that the outcome of the managed care concept was rationalized and the savings in several segments of health care, by means of empirical evidence. Journal of Economic Literature (JEL) classification: I150, I180, G220, G320, H520.

The Impact of Fires in Amazon Rainforest on Public Health

Brazil's public health situation is harmed in regions such as amazon rainforest in the face of natural disasters. Recently, the fires in Amazon region contributed to the growth of organic and psychosocial diseases index and to the increase of medical attendance numbers, generating high repercussions and concerns in this scenario.Keywords: Public health; wildfires; natural disasters; respiratory tract disease; mental health.

A Study On Stress Management Among Doctors And Nurses Working In Government Hospitals In Salem And Dharmapuri District

This study aimed to analyze and compare differences in occupational stress, depressive symptoms, work ability and working environment among residents working in various medical specialties. Occupational stress will result in decreasing the efficiency and increasing the occupational hazards inside and outside the work environment.It have been introduced as the most important ones for job stress in nursing is equipment and medicine shortages, lack of standard equipment, inappropriate physical environment of hospital, disease transmission, lack of timely medical attendance, and poor communication with co-workers. In occurrence of emergency situations, conflict with the authorities, work rotation, and frequent change of tasks are among the stressful factors for nurses. Hence, conducting a qualitative study in this regard can help to clarify the stress factors in medical field.

Anatomy of a “Mass” Mass Gathering

Introduction:Mass gatherings are growing in frequency. Religious, or in this case, “mass” mass gatherings are also growing in complexity, requiring considerable effort from nations hosting a Papal Mass. Ireland hosted a papal mass in 1979 when the prospect of terrorism at such events was significantly lower. Large high-profile events such as a Papal Mass offer a platform via the media and social media to gain widespread coverage of adverse events. In 2018, a predicted 500,000 guests were scheduled to attend a Papal Mass gathering in Phoenix Park, Dublin, a bounded 1,700-hectare park in the center of Dublin.Aim:To develop a medical plan estimating numbers of people requiring medical attention at a Papal Mass held in Ireland late August 2018, and compare same with actual numbers treated post-event. This study aims to reduce the medical impact of such an event on local receiving hospitals through plans that effectively manage medical- and trauma-related presentations on site.Methods:A literature review of medical reports regarding medical care at Papal Mass gatherings worldwide found a range of predicted medical attendance from 21-61 per 10,000 attendees. On that basis we had prepared on-site facilities, facilities on travel routes and access point system for medical care for a crowd of 500,000 were selected.Results:One of 6 receiving hospitals in Dublin had an increase in average presentations on the day. Attendance was reduced significantly due to weather. 261 patients were treated on site, falling in line with lower rate predicted of 31 patients treated in hospital on site and 17 transports off-site.Discussion:A predictable number of patients presented for medical care. On-site medical services reduced transports to hospital. Reduced attendance ensured facilities were sufficient, but could have been under the pressure of the predicted attendance of 500,000.

Respiratory disorders

Respiratory diseases commonly cause sickness absence, unemployment, medical attendance, illness, and handicap. Collectively, in the UK, these disorders cause 19 million days/year of certified sickness absence in men and 9 million days/year in women (with substantial additional lost time from short-term self-certified illness) and, among adults of working age, a general practitioner consultation rate of 48.5 per 100/year with more than 240,000 hospital admissions/year. Prescriptions for bronchodilator inhalers run at some 24 million/year, and mortality from respiratory disease causes an estimated loss of 164,000 working years by the age of 64 and an estimated annual production loss of £1.6 billion.

Active surveillance of 2017 seasonal influenza vaccine safety: an observational cohort study of individuals aged 6 months and older in Australia

ObjectiveTo actively solicit adverse events experienced in the days following immunisation with quadrivalent inactivated influenza vaccine using Australia’s near real-time, participant-based vaccine safety surveillance system, AusVaxSafety.Design and settingObservational cohort study conducted in 194 sentinel surveillance immunisation sites (primary care, hospital and community-based clinics) across Australia.ParticipantsIndividuals aged ≥6 months who received a routine seasonal influenza vaccine at a participating site (n=102 911) and responded to a survey (via short message service or email) sent 3 days after vaccination about adverse events experienced (n=73 892; 71.8%).Main outcome measureNear real-time and cumulative participant-reported rates of any adverse event, fever or medical attendance experienced within 3 days after vaccination overall, by brand, age, pregnancy status and concomitant vaccine receipt.ResultsParticipant median age was 57 years (range: 6 months to 102 years); 58.1% (n=42 869) were female and 2.7% (n=2018) were pregnant. Near real-time fast initial response cumulative summation and Bayesian analyses of weekly event rates did not demonstrate a safety signal. Children aged 6 months to 4 years had higher event rates (522/6180; 8.4%) compared with older ages; participants aged ≥65 years reported fewer events (1695/28 154; 6.0%). There were no clinically significant differences in safety between brands, by age group or overall. Cumulative data analysis demonstrated that concomitant vaccination was associated with increased rates of fever (2.1% vs 0.8%) and medical attendance (0.8% vs 0.4%), although all rates were low and did not exceed expected levels.ConclusionsNovel, postmarketing AusVaxSafety surveillance demonstrated comparable and expected safety outcomes for the 2017 quadrivalent inactivated influenza vaccine brands used in Australia. These near real-time, participant-reported data are expected to encourage confidence in vaccine safety and promote uptake.

Sonographic Detection of Iron Oxide Nanoparticles Employing Shear Waves

Research in biomedical nanotechnology led already to a variety of applications of nanoparticles in diagnosis as well as in therapy. One of these medical applications is Magnetic Drug Targeting, a promising cancer treatment technique. The aim of this medical attendance is a local chemotherapeutic treatment of the cancerous tissue. For this purpose, chemotherapeutic drugs are bound to magnetic nanoparticles and accumulated in the tumor area by means of an external static magnetic field. Hereby, a well-defined particle concentration in the cancerous tissue requires monitoring of the particle accumulation. Therefore, we present an ultrasound imaging technique that is capable of detecting quantitatively the concentration of iron oxide nanoparticles in biological tissue. The evaluation is based on the variation of the speed of sound of an induced shear wave with respect to the particle concentration.