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Post-intervention antibiotic use was 1.61-fold (1.60-1.62) and 2.24-fold (2.10-2.37) lower for antibiotics used against Enterobacteriaceae and NFGNB, respectively. There were also reductions in the number of days of antibiotic use by 1.29-fold (1.22-1.36), number of MRB days by 1.84-fold (1.63-2.08), and number of patient isolation days by 1.51-fold (1.38-1.66).

The results suggest that the intervention had a favourable impact on the consumption of antibiotics, as well as on the number of days on antibiotics, MRB, and isolation.

The results suggest that the intervention had a favourable impact on the consumption of antibiotics, as well as on the number of days on antibiotics, MRB, and isolation.

There is growing evidence regarding the imaging findings of coronavirus disease 2019 (COVID-19) in chest X-rays and computed tomography scans; however, their availability during this pandemic outbreak might be compromised. Currently, the role of point-of-care ultrasonography (POCUS) has yet to be explored.

To describe the POCUS findings of COVID-19 in patients with the disease admitted to the emergency department (ED), correlating them with vital signs, laboratory and radiologic results, therapeutic decisions, and the prognosis.

Prospective study performed in the ED of 2 academic hospitals. Patients with highly suspected or confirmed COVID-19 underwent a lung ultrasonography (lung POCUS), focused cardiac ultrasound (FOCUS), and inferior vena cava (IVC) exam.

Between March and April 2020, 96 patients were enrolled. The mean age was 68.2 years (SD 17.5). The most common findings in the lung POCUS were an irregular pleural line (63.2%), bilateral confluence (55.2%), and isolated B-lines (53.1%), which were associated with a positive RT-PCR (odds ratio 4.327; 95% CI 1.216-15.401; p<.001), and correlated with IL-6 levels (rho=0.622; p=.002). The IVC negatively correlated with levels of expiratory pO

(rho=-0.539; p=.014) and inspiratory pO

(rho=-0.527; p=0.017), and expiratory diameter positively correlated with troponin I (rho=0.509; p=.03). After the POCUS exam, almost 20% of the patients had an associated condition that required a change in their treatment or management.

POCUS parameters have the potential to impact the diagnosis, management, and prognosis of patients with confirmed or suspected COVID-19.

POCUS parameters have the potential to impact the diagnosis, management, and prognosis of patients with confirmed or suspected COVID-19.

To describe macular vessel density and perfusion in COVID-19 patients using coherence tomography angiography (OCTA) and to investigate whether there is a correlation between retinal vascular abnormalities and clinical and laboratory parameters.

Cross-sectional analysis conducted at the Hospital Clinico San Carlos in Madrid, Spain. Patients with laboratory-confirmed COVID-19 that were attended in the Emergency Department (ED) from March 23 to March 29, 2020 were included. Fundus examination and OCTA were performed 4 weeks after being attended in ED. Macular OCTA parameters were analyzed and correlated with clinical (severity and hypoxemia- oxygen saturation<92%) and laboratory parameters during hospital stay (D-Dimer-DD, lactate dehydrogenase-LDH and C-reactive protein-CRP).

80 patients were included, mean age 55(SD9) years old; 46.3% male. We reported macular vessel density and perfusion measurements in COVID-19 patients. Those patients with D-Dimer≥500ng/ml during SARS-CoV-2 infection had a decrease research is needed to establish whether patients with increased D-Dimer levels require more careful assessment and follow-up after COVID-19.

Lateral canthotomy is a vision-saving procedure. However, the low incidence of orbital compartment syndrome and the expense of simulators to practice this procedure can lead to low confidence and delays in the performance of the procedure by emergency physicians.

We used a simple, inexpensive, easily assembled eye model for lateral canthotomy education at a residency program and a national conference obtaining feedback from simulation participants. Residents rated procedure laboratories that included the lateral canthotomy model as 4.9 to 5 (on a 5-point Likert scale, with 5 being the best score). National conference participants rated the model a 9 as a useful training model for practitioners on a 10-point Likert scale.

This simple task trainer is practical, inexpensive, quickly assembled, and useful as a tool for practicing emergency medicine providers.

This simple task trainer is practical, inexpensive, quickly assembled, and useful as a tool for practicing emergency medicine providers.

Many of the measures taken by countries to contain the spread of COVID-19 have resulted in disruptions to child protection services. Despite this, many countries have worked to ensure that child helplines remain operational, making such mechanisms even more critical for reporting and referring cases of violence and for providing support to victims.

The purpose of this paper is to document what has occurred, and been reported, to child helplines during the COVID-19 pandemic.

The study entailed primary data collection from child helplines and a search of media articles and news stories.

Child helplines submitted data on the contacts received during the first six months of 2020. Data on contacts related to violence were also available from 2019, and used as baseline. The media search used a combination of search terms to identify relevant articles and news stories published between March 1 and June 17, 2020.

Overall, the number of contacts to child helplines seems to have drastically increased since the beginning of the pandemic. However, the number of contacts related to violence has increased in some countries, while it decreased in others.

While a mixed picture emerges with respect to violence, the increase in overall contacts made to child helplines provides evidence that such services are a critical lifeline for many children and women during times of crisis. Child helplines should be strengthened; and child protection services should be designated as essential during emergencies to ensure children receive the support they need.

While a mixed picture emerges with respect to violence, the increase in overall contacts made to child helplines provides evidence that such services are a critical lifeline for many children and women during times of crisis. Child helplines should be strengthened; and child protection services should be designated as essential during emergencies to ensure children receive the support they need.The latest global health threat is the ongoing outbreak of respiratory disease, which was named COVID-19 and multiple ever-evolving neurological complications have since been reported. We present the case of a patient with a bilateral tonic pupil in the postinfectious context of COVID-19. Brain magnetic resonance imaging and laboratory tests were normal, a 0.125% pilocarpine test confirmed the diagnosis.We present here a new selection criterion for prioritizing research on efficacious drugs for the fight against COVID-19 the relative toxicity versus safety of herbal medications, which were effective against SARS in the 2002/2003 epidemic. We rank these medicines according to their toxicity versus safety as basis for preferential rapid research on their potential in the treatment of COVID-19. The data demonstrate that from toxicological information nothing speaks against immediate investigation on, followed by rapid implementation of Lonicera japonica, Morus alba, Forsythia suspensa, and Codonopsis spec. for treatment of COVID-19 patients. Glycyrrhiza spec. and Panax ginseng are ranked in second priority and ephedrine-free Herba Ephedrae extract in third priority (followed by several drugs in lower preferences). Rapid research on their efficacy in the therapy - as well as safety under the specific circumstances of COVID-19 - followed by equally rapid implementation will provide substantial advantages to Public Health including immediate availability, enlargement of medicinal possibilities, in cases where other means are not successful (non-responders), not tolerated (sensitive individuals) or just not available (as is presently the case) and thus minimize sufferings and save lives. Moreover, their moderate costs and convenient oral application are especially advantageous for underprivileged populations in developing countries.

Pheochromocytoma (PCC) and paraganglioma (PGL) are rare tumors in childhood. They are catecholamine secreting tumors and present with signs or symptoms related to their excess. Most common signs and symptoms are hypertension, headache and diaphoresis. The management of children usually depend on experience of adulthood. This study is conducted to present the clinical characteristics, surgical management and outcome of childhood PCC and PGL in a tertiary care center.

We reviewed clinical records of all patients operated for PCC and PGL between 2000 and 2020 retrospectively.

There were 18 children operated for PCC and PGL in the study period. The female to male ratio was 11. The median age at diagnosis was 13 (IQR, 9-15) years. The most common presenting symptoms were headache and diaphoresis. Hypertension was the most common sign. Three patients had von Hippel-Lindau (VHL). Tumors of two patients with VHL were detected during routine follow-up. Three patients had multifocal disease. Medical preparation fnt and surveillance of PCC and PGL. Detection of associated familial cancer susceptibility syndromes and long-term follow-up is essential to detect late recurrences and new tumors.

Multidisciplinary approach is necessary to achieve safe surgical treatment and surveillance of PCC and PGL. Detection of associated familial cancer susceptibility syndromes and long-term follow-up is essential to detect late recurrences and new tumors.

Daytime urinary incontinence (DUI) and fecal incontinence (FI) are common disorders in children. Although standard treatment is highly effective, subgroups of incontinence (combinations of nocturnal enuresis (NE), DUI and/or FI, or with psychological comorbidity) can relapse or take a chronic course. For these complex, therapy-resistant cases, a manualized outpatient bladder and bowel training program was developed. The aim of the study was to evaluate prospectively treatment effects of this training program, including a follow-up assessment.

The training program was developed for small groups of 2-6 children (of same age and sex) aged 5-12 years with adaptations for 13-16 year-old adolescents. It consists of 7-9 weekly sessions for group training and 3 weekly sessions for individual training. The training comprises information about anatomy/physiology of the urogenital tract, pathophysiology, hygiene and balanced nutrition. Voiding and drinking diaries, stress management, relaxation and emotion regulatioen with DUI had a complete response after training and 47.6% at follow-up after 6 months. In children with FI, 33.3% reached a complete response at the end of the training and 25% at follow-up. Additionally, psychological symptoms, especially internalizing, decreased significantly during training. Further, in 14 children with comorbid NE, nighttime wetting reduced from 5.9 before training to 1.5 episodes/week at follow-up.

This bladder and bowel training program is an effective and successful treatment option for children with therapy-resistant subtypes of incontinence. Symptoms still improved 6 months after training in DUI. selleck chemicals llc Additionally, the training program is helpful to decrease psychological symptoms.

This bladder and bowel training program is an effective and successful treatment option for children with therapy-resistant subtypes of incontinence. Symptoms still improved 6 months after training in DUI. Additionally, the training program is helpful to decrease psychological symptoms.