COVID-19 Incidence in Asymptomatic Cancer Patients Undergoing Chemotherapy

COVID-19 is an infectious disease caused by the virus SARS-CoV-2, which was first described at the end of 2019. Since then, it has affected a growing portion of the world's population because of its high transmissibility. Most patients are asymptomatic or present with mild symptoms, but approximately 5-10% of cases can develop more serious manifestations, such as severe acute respiratory syndrome, acute kidney injury, shock, myocardial injury and even death. These features seem to occur more commonly in patients with essential hypertension, diabetes mellitus, obesity and chronic pulmonary disease. However, there are few studies that clarify the natural history of the disease and its broad clinical spectrum owing to the fact that it is a new entity. Since individuals with malignancies tend to present some degree of immunological deficiency and are more prone to opportunistic infections, especially those being treated with immunosuppressive drugs, it is possible that this group has a higher incidence of COVID-19. The current recommendations of oncology specialists advise to postpone treatments and to use less toxic drugs when possible. However, we still do not know how much these measures will affect in cancer mortality. Also, the incidence of COVID-19 in this population remains undetermined. We do not know if infectious symptoms are a good parameter to motivate these therapeutic changes or if there is benefit to test asymptomatic patients. In this context, this research submitted 100 patients with hematological malignancies or solid tumors on chemotherapy at the Ribeirão Preto Medical School of the University of São Paulo's Hospital, asymptomatic for COVID-19, to RT PCR to determine the SARS-CoV-2 infection incidence in this population. Only two patients were diagnosed with COVID-19. Both had gastrointestinal cancer. One of them developed symptoms, but none presented severe manifestations. Both had their treatment postponed initially and reinitiated after the appropriate period of isolation. Hence, we believe that it's reasonable not to test every asymptomatic patient when the resource for that is scarce, prioritizing those at greater risk of infection and those more prone to severe outcomes as long as the appropriate preventive measures are being taken. Disclosures Calado: Team Telomere, Inc.: Membership on an entity's Board of Directors or advisory committees; Agios: Membership on an entity's Board of Directors or advisory committees; Instituto Butantan: Consultancy; Alexion Brasil: Consultancy; AA&MDS International Foundation: Research Funding; Novartis Brasil: Honoraria.

PREVALENCE OF CLINICAL FORMS OF CHRONIC SINUSITIS IN HIV INFECTED PATIENTS

Purpose: to identify patterns in the prevalence of various clinical forms of chronic sinusitis (exudative, proliferative, alterative) depending on the clinical and immunological stages of HIV infection. The study involved 108 HIV-infected patients who were diagnosed with chronic sinusitis. The prevalence of each of the clinical forms of chronic inflammation of the paranasal sinuses (exudative, proliferative, alterative) at different immunological and clinical stages of HIV infection was determined. The majority of HIV-infected persons with chronic sinusitis were diagnosed with a proliferative form of inflammation of the paranasal sinuses (61.1 ± 4.7). As the clinical stage of HIV infection progressed (WHO classification), a decrease in the prevalence of exudative forms of chronic sinusitis (from 84.8 ± 6.2 at the first stage to 4.0 ± 3.9 at the fourth) and, accordingly, an increase in proliferative forms (with 15.2 ± 6.2 at the first stage to 92.0 ± 5.4 at the fourth). As the number of CD4-lymphocytes in the blood of HIV-infected patients decreased, a significant decrease in the frequency of detection of exudative forms of chronic sinusitis was observed (from 85.0 ± 8.0 with a CD4-lymphocyte level of more than 500 uL-1 to 12.9 ± 4.3 with the level of CD4 lymphocytes is less than 200 uL-1) and, accordingly, an increase in the prevalence of proliferative forms of chronic inflammation of the paranasal sinuses (from 15.0 ± 8.0 to 83.9 ± 4.7, respectively). As immunological deficiency progresses in HIV-infected patients, the prevalence of proliferative forms of chronic inflammation of the paranasal sinuses increases, which is a factor determining the tactics of treating chronic sinusitis in this group of patients.

ANALYSIS OF ABDOMINAL TYPHOID INCIDENCE IN THE SOUTH REGION OF THE KYRGYZ REPUBLIC

The article analyze the long-term morbidity, spread of typhoid fever in the southern regions of the Kyrgyz republic, and remains a permanent epidemic focus in the Jalal-Abad region, where against the low availability of the population to high-quality drinking water, an additional factor on the body for more than two generations and radiation factor, which we confirmed by the spread among the inhabitants of Mailuu-Suu of nosological forms of the syndrome of immunological deficiency, as a predictor of risk groups for infectious diseases, including typhoid fever.

Bacterial overgrowth of the small intestine

Small intestinal bacterial overgrowth can be defined as the presence of excessive bacteria in the small intestine which can interfere with digestion and absorption. Predisposing causes include sustained hypochlorhydria induced by proton pump inhibitors, small intestinal dysmotility and stasis due to anatomical or motor abnormalities, and reduced antibacterial activity as seen in immunological deficiency and chronic pancreatitis. Presentation is predominantly from consequences of malabsorption, including gastrointestinal symptoms (e.g. diarrhoea or steatorrhoea) and features of specific nutrient malabsorption (e.g. osteoporosis, anaemia, neuropathy, and night blindness). Definitive diagnosis is difficult, requiring a properly collected and appropriately cultured aspirate from the proximal small intestine revealing a total concentration of a mixed growth of bacteria generally greater than 105 organisms/ml. Alternative investigations frequently used include glucose/lactulose breath tests or either the 13C- or 14C-xylose breath test, with elevated levels of 13CO2 or 14CO2 found in the breath. There may be low levels of cobalamin (metabolized by Gram-negative anaerobes), increased serum folate (synthesized by overgrowth flora), and increased urinary indicans (intraluminal product of bacterial tryptophan metabolism). Aside from treatment of any nutritional deficiencies, specific treatment is with an antimicrobial that is effective against both aerobic and anaerobic enteric bacteria (e.g. doxycycline, amoxicillin–clavulanic acid, rifaximin, or ciprofloxacin), which can be administered in rotation to reduce antibiotic resistance. Where possible and appropriate, correction of any underlying cause should also be performed.

GAMBARAN STRES PADA MAHASISWA PENDIDIKAN PROFESI PROGRAM STUDI KEDOKTERAN GIGI FAKULTAS KEDOKTERAN UNIVERSITAS SAM RATULANGI YANG MEMILIKI PENGALAMAN STOMATITIS AFTOSA REKUREN

Stomatitis Aftosa Rekuren (SAR) merupakan kelainan ulkus pada mukosa mulut dengan ciri khas ulkus single atau multiple, kambuhan (berulang), kecil, bulat atau oval dengan batas jelas kemerahan dan dasar abu-abu atau kuning. Stomatitis Aftosa Rekuren dapat dipicu oleh beberapa faktor predisposisi antara lain stres, trauma, alergi, genetik, siklus menstruasi, defisiensi hematinik dan imunologi.Tujuan dalam penelitian ini ialah untuk mengetahui gambaran stress pada mahasiswa pendidikan profesi Program Studi Kedokteran Gigi Fakultas Kedokteran Universitas Sam Ratulangi yang memiliki pengalaman Stomatitis Aftosa Rekuren. Metode penelitian yang digunakan yaitu penelitian deskriptif dengan penelitian studi cross sectional. Metode pengambilan sampel yaitu purposive sampling. Sampel pada penelitian ini berjumlah 62 orang. Cara pengambilan data mengisi kuesioner SAR dan PSS (Perceived Stress Scale) dengan wawancara.Hasil penelitian menunjukan bahwa gambaran stres pada mahasiswa pendidikan profesi Program Studi Kedokteran Gigi Fakultas Kedokteran Universitas Sam Ratulangi yang memiliki pengalaman Stomatitis Aftosa Rekuren sebesar 59,7% dengan tingkat stres yang tinggi.Kata Kunci : SAR, tingkat stresAbstractRecurrent aphthous stomatitis (RAS) is an ulcer on the oral mucosal abnormalities characterized by a single or multiple ulcers, recurrent (repeated), a small, round or oval with clear boundaries and basic reddish gray or yellow. RAS can be triggered by several predisposing factors such as stress, trauma, allergies, genetic, menstrual cycle and immunological deficiency haematinics.The purpose of this study was overview the stress on professional education student of Dentistry Program Medical Faculty, University of Sam Ratulangi. The research method used is descriptive research with a cross- sectional study design. Sampling method by purposive sampling. Samples in this study amounted to 62 people. The data were collected through questionnaires SAR and PSS (Perceived Stress Scale).The results showed that the description of stress on professional education students of Dentistry Program Medical Faculty, University of Sam Ratulangi experiencing SAR by 59.7 % with high level of stress.Keywords: SAR, stress level