Long-Term Outcomes of Patients with Coronavirus Disease 2019 at One Year after Hospital Discharge

Background: The long-term effects of COVID-19 remain largely unclear. This study aims to investigate post-acute health consequences and mortality one year after hospital discharge. Methods: All surviving adult patients who were discharged after hospital admission due to acute COVID-19 in the first wave of the pandemic underwent a comprehensive interview. Functional assessment was performed in patients aged over 65. Clinical and hospital records were reviewed and mortality causes assessed. Results: A total of 587 patients with COVID-19 were discharged from hospital, including 266 after hospital admission and 321 from the emergency room. Mortality within the following year occurred in 34/266 (12.8%) and 10/321 (3.1%), respectively, due to causes directly or possibly related to COVID-19 in 20.5% and 25% of patients. Post-COVID-19 syndrome was assessed in 543 patients at one year from discharge. Any clinical complaint was reported by 90.1% of patients who needed hospitalization and 80.4% of those discharged from the emergency room (p = 0.002), with breathlessness (41.6%), tiredness (35.4%), ageusia (30.2%), and anosmia (26.3%) being the most common complaints. Ongoing symptoms attributed to COVID-19 were reported by 66.8% and 49.5% of patients, respectively (p < 0.001). Newly developed COPD, asthma, diabetes, heart failure, and arthritis—as well as worsening of preexisting comorbidities—were found. Conclusions: One-year mortality among survivors of acute COVID-19 was 7.5%. A significant proportion of COVID-19 patients experienced ongoing symptoms at 1 year from onset of the disease.

Development and implementation of an LIS-based validation system for autoverification toward zero defects in the automated reporting of laboratory test results

Background Validation of the autoverification function is one of the critical steps to confirm its effectiveness before use. It is crucial to verify whether the programmed algorithm follows the expected logic and produces the expected results. This process has always relied on the assessment of human–machine consistency and is mostly a manually recorded and time-consuming activity with inherent subjectivity and arbitrariness that cannot guarantee a comprehensive, timely and continuous effectiveness evaluation of the autoverification function. To overcome these inherent limitations, we independently developed and implemented a laboratory information system (LIS)-based validation system for autoverification. Methods We developed a correctness verification and integrity validation method (hereinafter referred to as the "new method") in the form of a human–machine dialog. The system records personnel review steps and determines whether the human–machine review results are consistent. Laboratory personnel then analyze the reasons for any inconsistency according to system prompts, add to or modify rules, reverify, and finally improve the accuracy of autoverification. Results The validation system was successfully established and implemented. For a dataset consisting of 833 rules for 30 assays, 782 rules (93.87%) were successfully verified in the correctness verification phase, and 51 rules were deleted due to execution errors. In the integrity validation phase, 24 projects were easily verified, while the other 6 projects still required the additional rules or changes to the rule settings. Taking the Hepatitis B virus test as an example, from the setting of 65 rules to the automated releasing of 3000 reports, the validation time was reduced from 452 (manual verification) to 275 h (new method), a reduction in validation time of 177 h. Furthermore, 94.6% (168/182) of laboratory users believed the new method greatly reduced the workload, effectively controlled the report risk and felt satisfied. Since 2019, over 3.5 million reports have been automatically reviewed and issued without a single clinical complaint. Conclusion To the best of our knowledge, this is the first report to realize autoverification validation as a human–machine interaction. The new method effectively controls the risks of autoverification, shortens time consumption, and improves the efficiency of laboratory verification.

The Burden of Reoperations and Timeline of Problems in 1,530 Cases of Mesh-Related Complications

<b><i>Background:</i></b> Mesh-related complications resulting from pelvic organ prolapse (POP) reconstruction operations may be a devastating experience leading to multiple and complex interventions. <b><i>Objectives:</i></b> The aim of the study was to describe the experience and time frame of management of mesh-related complications in women treated for POP or stress urinary incontinence in a tertiary center. <b><i>Methods:</i></b> 1,530 cases of mesh-related complications were accessed regarding their clinical presentation, number of surgeries, and timeline of surgical treatments to treat multiple clinical complaints until the ultimate operation where all the meshes were removed in a single tertiary center. <b><i>Results:</i></b> The studied population revealed to be a highly referred one with only 10.2% of the cases implanted at our center. Clinical presentation varied widely with 48.7% referring pain as the chief complaint, while 31.3% complained of voiding dysfunctions, 2.5% reported genital prolapses, 2.2% complained of vaginal problems, and 1.2% noted intestinal problems as the main clinical complaint. Only 4.8% of the cases presented mesh erosion at examination; 57.8% of the cases required more than 1 operation to address the mesh-related problems. Sixty-eight cases had more than 10 operations up to complete removal. Three clusters of patients could be identified: (i)–those from whom the mesh was promptly removed after clinical problems emerged, (ii) those with slowly evolving problems, and (iii) those with escalating problems despite treatment attempts. <b><i>Conclusions:</i></b> Mesh-related complications after pelvic floor reconstruction are an evolving disease with diverse clinical presentation. The identified time-related problems and the multiple failed attempts to treat their complications warrant attention with continuous monitoring of these patients and aggressive removal of the mesh if the clinical complaint cannot be swiftly managed.

Will it ever grow back? The psychosocial impacts of alopecia

Alopecia is a common clinical complaint in the offices of family physicians and dermatologists. Here, we discuss common subtypes of alopecia, including androgenic alopecia and alopecia areata. Unfortunately, few resources have been invested in researching the effectiveness of psychological treatment for alopecia Pharmacological treatments alone are not enough. Medications can be a frustrating experience for both patients and their physicians due to their limited effectiveness. A case is made for health professionals taking an all-encompassing approach with patients is critical for skin conditions including alopecia.

Development and Implementation of A LIS-Based Validation System for Autoverification Toward Zero Defects in The Automated Reporting of Laboratory Test Results

BackgroundValidation of the autoverification function is the most critical step to confirm its effectiveness before use. It is crucial to verify whether the programmed algorithm follows the expected logic and produces the expected results. In recent years, this process has always been centered on the assessment of human-machine consistency and mostly takes the form of manual recording, which is a time-consuming activity with inherent subjectivity and arbitrariness, and cannot guarantee a comprehensive, timely and continuous effectiveness evaluation of the autoverification function. To overcome these inherent limitations, we independently developed and implemented a laboratory information system (LIS)-based validation system for autoverification.MethodsWe developed a correctness verification and integrity validation method (hereinafter referred to as the "new method") in the form of a human-machine dialogue. The system records the personnel’s review steps and determines if the human-machine review results are consistent. If they are inconsistent, the laboratory personnel analyze the reasons for the inconsistency according to the system prompts, add to or modify the rules, reverify, and finally improve the accuracy of autoverification.ResultsThe validation system was successfully established and implemented. For a dataset consisting of 833 rules for 30 assays, 782 rules (93.87%) were successfully verified in the correctness verification phase, and 51 rules were deleted due to execution errors. In the integrity validation phase, 24 projects were easily verified, while the other 6 projects still required the addition of new rules or changes to the rule settings. From setting the rules to the automated reportion, the time difference between manual validation and the new method, was statistically significant (χ2=11.06, p=0.0009), with the new method greatly reducing validation time. Since 2017, the new method has been used in 32 laboratories, and 15.8 million reports have been automatically reviewed and issued without a single clinical complaint.ConclusionTo the best of our knowledge, this is the first report to realize autoverification validation in the form of a human-machine interaction.The new method can effectively control the risks of autoverification, shorten time consumption, and improve the efficiency of laboratory verification.

Rare case of granular cell tumor of perianal region: a case report and literature review

Granular cell tumors (GCTs) are rare submucosal neoplasms, with tumors in the oral mucosa accounting for about a third of all cases. In contrast, GCT is a rare anal neoplasm, with fewer than 30 cases of perianal GCT reported in the literature. We report the case of a 36-year-old woman with a perianal lump with no obvious local lesion as the main clinical complaint. The tumor was completely resected and histologically confirmed as a GCT. The patient remained under continuous follow-up. GCT is difficult for surgeons and pathologists to diagnose, and biopsy and immunohistochemical analysis are prerequisites for an accurate diagnosis. An integrated understanding of GCT in terms of its differential diagnosis will contribute to better identification and more appropriate treatment of this disease.

Contralateral migration of Kirschner wire from right acromioclavicular joint to left side of neck: a case report

Background Kirschner wire migration is one of the most common complications after internal fixation of fracture or dislocation in the shoulder region. However, cases of contralateral wire migration are rare. We present a case of contralateral loosened Kirschner wire migration from the right acromioclavicular joint to the left side of the neck without damage to any important structures or great vessels. Case presentation We report a case of a loosened Kirschner wire migrating from the right acromioclavicular joint to the left side of the neck in a 34-year-old Taiwanese man following a route of transversal, descendant, and then ascendant directions. The Kirschner wire was removed by exploratory neck dissection under C-arm fluoroscopy assistance without complication. Conclusion Wire migration may occur after surgical treatment with or without clinical complaint. Several hypotheses for the mechanism of wire migration have been postulated, including muscular activity, respiratory motion, gravity, and motion of upper extremity. Therefore, the importance of follow-up should be communicated to the patient. Once wire loosening or migration is noted, the implant should be removed immediately under intraoperative C-arm fluoroscopy or ultrasound assistance.

HUBUNGAN TINGKAT PENGETAHUAN TENTANG KEPUTIHAN DENGAN PENANGANAN KEPUTIHAN PADA SISWI KELAS X SMK YPE SUMPIUH KABUPATEN BANYUMAS TAHUN 2018

ABSTRACT One of the clinical complaint from adolescent reproduction is leucorrhea. Leucorrhea is vagina’s liquid expenditure that not shaped blood. It is sometimes caused infection that always wet and make irritation, feel itchy and disturbance to the sufferer. The purpose of this research is to know about relation between knowledge of leucorrhea and handling of leucorrhea in student of SMK YPE Sumpiuh 2018 grade X, Banyumas regency. This research use analytic survey method with cross sectional approach. The subject of this research is students of SMK YPE Sumpiuh grade X. The number of students are 71 person. The analysis method of the statistic that used is chi square. The result from this research is 42 student (59,2%) have good level of knowledge about leucorrhea. And 39 student (54,9%) can handles leucorrhea correctly. The Conclusion of his research is there any relationship between knowledge of leucorrhea and handling of leucorrhea in class of student SMK YPE Sumpiuh grade X (c2hitung=5,722> c2tabel=3,481). Keyword : level of knowledge, leucorrhea handling. Bibliography : 29 ( 2005-2016)

The Effectiveness of Calcaneal Drilling for Treatment of Resistance Cases of Plantar Heel Pain

Background: Plantar heel pain is a clinical syndrome characterized by pain and tenderness beneath the heel which is typically worse in the morning and improves after the first few steps in the day. It is a common and frequently disabling clinical complaint that may be caused by a broad spectrum of osseous or soft tissue disorders. Objective: To evaluate the effectiveness of an operation of multiple drilling of calcaneum for resistant plantar heel pain syndrome. Methods: During the period from November 2012 to August 2016, 17 patients (17heels) were enrolled in a cohort clinical study at the orthopedic unit in AL-Sheikh Zayed and Al-Wassity Hospitals. Result: Drilling of the calcaneum is a simple procedure achieving 70.6% cure in resistant ases with few complications provided good patient selection was done. Conclusion: Abnormalities in the intraosseous pressure within the calcaneum are a possible cause of plantar heel pain in some patients who failed to respond to conservative treatment