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7-93.3% lower during the corresponding time periods (P < 0.001 for each).

The results were consistent with an early protective effect of BNT162b2 vaccine against all degrees of SARS-CoV-2 severity.

The results were consistent with an early protective effect of BNT162b2 vaccine against all degrees of SARS-CoV-2 severity.

A 3-year prospective study was conducted to evaluate the efficacy of Xpert MTB/RIF (Xpert) in the diagnosis of pleural tuberculosis (pTB) on contrast -enhanced ultrasound (CEUS)-guided pleural biopsy specimens.

Patients suspected with pTB were prospectively enrolled to receive CEUS-guided biopsy. Specimens (pleural tissue and fluid) were submitted for Xpert and other routine examinations. Surgical thoracoscopy was performed on undiagnosed cases.

A total of 316 patients were enrolled, including 280 cases of pTB (definite 195, possible 85) and 36 cases of non-pTB. The sensitivity of Xpert was 69.64% (195/280) in biopsy specimens, which was significantly higher than that in pleural effusion specimens (p < 0.01). In 195 definite cases, the highest sensitivity of 100% (195/195) and NPV of 29.75% (36/121) were achieved by Xpert on biopsy specimens. Xpert-positive results were obtained in 149 culture-negative cases and 90 histopathological MTB PCR-negative cases. The incidence of necrosis by CEUS in Xpert-positive pTB was significantly higher than that in Xpert-negative pTB (χ

= 72.41; p < 0.01). No serious complications occurred.

Xpert achieved highly diagnostic sensitivity in pTB through CEUS-guided biopsy sampling, especially on necrotic lesions, which was proven to be efficient, minimally invasive and safe.

Xpert achieved highly diagnostic sensitivity in pTB through CEUS-guided biopsy sampling, especially on necrotic lesions, which was proven to be efficient, minimally invasive and safe.

Healthcare workers (HCWs) are at increased risk of exposure to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), compared with the general population. Therefore, they are given priority for the COVID-19 vaccine in the national COVID-19 vaccination campaign in Indonesia. However, while the daily number of new COVID-19 cases remains high, and data regarding the efficacy of the vaccine in healthcare settings remain unavailable, vaccinated HCWs remain at risk of COVID-19 infection and further transmission.

To identify cases of COVID-19 among vaccinated HCWs at Siloam Teaching Hospital, Indonesia via active and passive surveillance conducted by the hospital's COVID-19 infection prevention and control unit.

Of 1040 HCWs who had received two doses of the COVID-19 vaccine, 13 (1.25%) tested positive for SARS-CoV-2 RNA on reverse transcriptase polymerase chain reaction between 2 and 11 days (median 5 days) after the second vaccination.

Laboratory-confirmed COVID-19 among vaccinated HCWs soon after the second vaccination indicates that HCWs remain at risk of COVID-19. Therefore, the presence of symptoms soon after full vaccination cannot be considered as vaccine-related symptoms, and regular COVID-19 testing should be conducted among HCWs.

Laboratory-confirmed COVID-19 among vaccinated HCWs soon after the second vaccination indicates that HCWs remain at risk of COVID-19. Therefore, the presence of symptoms soon after full vaccination cannot be considered as vaccine-related symptoms, and regular COVID-19 testing should be conducted among HCWs.

How physicians use opioids for dyspnea in imminently dying cancer patients (terminal dyspnea) varies markedly, which could hamper quality care.

To examine the adherence to an algorithm-based treatment for terminal dyspnea, and explore its outcomes over 24 hours.

This was a pre-planned subgroup analysis of a multicenter prospective observational study. Inclusion criteria were advanced cancer patients admitted to palliative care units, ECOG performance status=3-4, and a dyspnea intensity ≥2 on the Integrated Palliative care Outcome Scale (IPOS). We developed an algorithm to visualize how palliative care physicians would use parenteral opioids. Participating physicians (palliative care specialists) initiated parenteral opioids, choosing whether to use the algorithm based on their preference. We measured the adherence rate to the algorithm over 24 hours (predefined goal=70%), and compared dyspnea IPOS scores and adverse events between patients with and without algorithm-based treatment.

Of 164 patients (median survival=5 days), 71 (43%) received algorithm-based treatment, and 70 (99%; 95% confidence interval=92%-100%) adhered to it over 24 hours. Selleck U18666A In a complete case analysis, mean dyspnea IPOS scores significantly decreased from 2.9 (standard error=0.1) to 1.5 (0.1) in the algorithm group (n=54; P < 0.001), and 2.9 (0.1) to 1.6 (0.1) in the non-algorithm group (n=72; P < 0.001). There was no significant between-group difference in changes in dyspnea IPOS scores (P=0.65). Adverse events were rare (n=5).

The algorithm-based treatment was feasible, and might be as effective and safe as the usual care by palliative care specialists. Its implementation may help physicians provide quality care for terminal dyspnea.

The algorithm-based treatment was feasible, and might be as effective and safe as the usual care by palliative care specialists. Its implementation may help physicians provide quality care for terminal dyspnea.

Caring for people with advanced illness has an impact on caregivers' physical, psychological, and emotional health. Patients being evaluated for lung transplantation or those on the transplant waitlist are required to have identified social support. However, little is known about the caregivers' specific supportive care needs.

The aim of this study was to determine the supportive care needs of informal caregivers of patients who are being evaluated for or awaiting lung transplantation.

A cross sectional survey of the caregivers of lung transplant candidates using the Carers' Support Needs Assessment Tool (CSNAT) was conducted.

The sample (n=78) included caregivers from a single-center academic institution in the United States. Participants were predominantly Caucasian and female, mean age 58 years (SD13). Most were the patient's spouse or partner and over half reported needs in the following areas what to expect in the future; who to call with healthcare concerns; financial, legal and work issues; and caregivers' feelings and worries.