Prestondolan8520
Objectives The aim of this study was to assess the impact of the COVID-19 pandemic and population lockdown on pediatric ED consultations. Methods A cross-sectional study on pediatric emergency department consultations before and during the current COVID-19 pandemic (March-May 2019 vs. March-May 2020) was performed in two hospitals in the Campania region (Southern Italy) [i.e., Salerno University Hospital (Salerno) and Pediatric Regional Referral Emergency Hub "AORN Santobono-Pausillipon" (Naples)]. Results 29,368 consecutive ED pediatric patients (13,430 females; mean age ± SD = 5.4 ± 4.7 years) were seen in March-May 2019 and 9,133 (4,494 females; mean age ± SD = 5.9 ± 4.2 years) in March-May 2020. Resuscitation/emergency and urgent care pediatric ED consultations were 1,388 (4.7%, 95% CI 4.5-4.9) in the 2019 trimester, while they were 648 (7.1%, 95% CI 6.6-7.6) in the 2020 trimester (p less then 0.01). Mean pediatric ED daily consultations were 326.3 (95% CI 299.9-352.7) in the considered period of 2019 and 101.4 (95%CI 77.9-124.9) in the same period of 2020 (p less then 0.001). COVID-19 nasal swabs were performed for 385 children; of those, six resulted positive and four of them were hospitalized. Conclusions This work provides a unique snapshot of the pediatric EDs demands in the era of COVID-19. We witnessed a significant reduction of non-urgent health care demands during the pandemic but an increase of more severe urgent cases. The COVID-19 pandemic and the following lockdown unveiled the inappropriateness of the majority of pediatric ED consultations. Nevertheless, the current scenario highlighted the need for appropriate and timely clinical evaluations in the pediatric primary care to tackle late and more severe diagnoses in EDs.
Real-time polymerase chain reaction (RT-PCR) and chest computed tomography (CT) scan are main diagnostic modalities of coronavirus disease 2019 (COVID-19). However, there is still no consensus on which of these methods is superior to the other. Therefore, the present meta-analysis was designed to answer to the question whether CT scan can be used in diagnosis of COVID-19 or not.
Searches were performed in Medline, Embase, Scopus, and Web of Science databases until the end of April 2020. Two researchers gathered the data of diagnostic accuracy studies that had attempted to evaluate sensitivity and specificity of CT scan in diagnosis of COVID-19.
Data of 9 studies were included. Area under the curve of ground glass opacity (GGO), consolidation, pleural effusion, other CT features, and simultaneous observation of GGO with other CT features was 0.64 (95% CI 0.60-0.69), 0.30 (95% CI 0.26-0.34), 0.60 (95% CI 0.56-0.64), 0.61 (95% CI 0.56-0.65), and 0.90 (95% CI 0.87-0.92), respectively. Sensitivity and specificity of simultaneous observation of GGO with other CT scan features was higher than all of the other signs. Sensitivity, specificity, and diagnostic odds ratio of this sign was calculated to be 0.90, 0.89, and 20, respectively.
Simultaneous observation of GGO and other features of viral pneumonia in CT scan had optimum performance in detection of COVID-19. However, it is suggested to make the final diagnosis based on both CT scan and RT-PCR, as none of the two diagnostic modalities are reliable alone.
Simultaneous observation of GGO and other features of viral pneumonia in CT scan had optimum performance in detection of COVID-19. However, it is suggested to make the final diagnosis based on both CT scan and RT-PCR, as none of the two diagnostic modalities are reliable alone.
is the causative agent of many diseases. Antimicrobial treatment disadvantages highlight the need to find other possible ways such as prophylaxis to manage infections. Current vaccines against this agent include inactivated bacteria, live-attenuated bacteria, and nonpathogenic bacteria, which have disadvantages such as lack of immunogenicity, reactogenicity, or reversion to virulence wild bacteria. Using bioinformatical approaches, potentially immunogenic and protective epitopes identified and merged to design the best epitope fusion form in case of immunogenicity as a vaccine candidate.
In this study, the fusion protein (
) and full
genes (
) were cloned in pET28a in BL21 (DE3) firstly and later in pBAD/gIII A and expressed in Top10
coli. Overlap polymerase chain reaction (PCR) using different primers for 5' and 3' end of each segment produced fusion segment 1 + 2 and (1 + 2) +3 fragments and was used for cloning.
Cloning of both
and
into the pET28a vector and their transform into the BL cases than native one. Purified proteins headed for further analysis as vaccine candidates.Suicide with cyanides is relatively rare but highly lethal. The lethal oral dose of cyanide salts is 200 mg, and concentrations >3 mg/L may be potentially lethal. The symptoms of poisoning are predominating in the central nervous system and cardiovascular system. We report the case of a 43-year-old goldsmith man who presented with self-poisoning by cyanide salt ingestion. Patient's symptoms included confusion, cardiac arrhythmias, hyperkalemia, leukocytosis, metabolic acidosis with high anion gap, hypotension, and then hypertension. The cause of the patients poisoning was not initially diagnosed. Intensive supportive treatment was performed. The patient died on the 3rd day of admission following cardiac arrest. At autopsy, hemorrhagic gastritis and cherry-red discoloration of the chest muscles were observed. Forensic toxicology showed cyanide in the blood and tissues. Cyanide poisoning could appear in different forms, and like our case, the symptoms can last for several days with nonspecific symptoms.
Substance abuse has turned into a great problem in the worldwide. Considering the increased prevalence of addiction in this study, we tried to assess the role of social skills aspects in tendency to addiction among the adolescents.
This cross-sectional study was conducted on 600 high school students studying in the Isfahan City, Iran, from 2016 to 2018. The studied population was assessed using addiction tendency questionnaire and Matson's social skills questionnaire. Data were analyzed by Statistical Package for the Social Sciences software and independent
-test, Pearson and Spearman correlation, and linear regression test.
Social behavior (
= 0.002,
= -0.124), high self-esteem (
< 0.001,
= -0.381), and peer-communication (
< 0.001,
= -0.361) were inversely associated with a tendency to addiction and were independent predictors of it (
< 0.05). Aggression was associated with increased tendency to the addiction (
= 0.01,
= 0.103) but not a predictor.
We found that appropriate social behaviors, inappropriate assertiveness, and functional communication were factors associated with less tendency to substance abuse in the adolescent.
We found that appropriate social behaviors, inappropriate assertiveness, and functional communication were factors associated with less tendency to substance abuse in the adolescent.Poisoning with any of the colchicine or chloroquine drugs is rare. These drugs exert therapeutic and toxic effects on tissues by different mechanisms. Colchicine is used to treat a number of rheumatologic diseases and heart problems. In addition, chloroquine is used to treat malaria and some inflammatory diseases. There is a small gap between the therapeutic and toxic doses of these drugs. Gastrointestinal symptoms are the initial causes of poisoning with these drugs and then widespread organ failure in later stages can lead to sudden cardiac death. We introduce a case of concurrent poisoning with both drugs, in which the patient presented with a headache, nausea, and vomiting several hours after suicide. On the 1st day, the patient's status was stable, but on the 2nd day, the patient suddenly becomes ill and died even though the patient received supportive therapy. Concurrent poisoning with chloroquine and colchicine is extremely lethal, and early aggressive management is recommended even in an apparently stable patient.Prolactinomas are the most common type of functional pituitary tumors. Dopamine agonists is the most important drugs used in prolactinoma,have antagonistic effect with antipsychotic drugs used in schizophrenia. Conversely, dopamine antagonist drugs increase prolactin in patients with simultaneous schizophrenia. In the present case, we report a 29-year-old single male with schizophrenia who treated for 8 years with risperidone and presented with macroprolactinoma. Iatrogenic hyperprolactinemia is a well-known side effect of dopamine antagonist drugs for treatment in a patient with schizophrenia. On the other hand, it appears these drugs have the other side effects, such as drug- induced prolactinoma or boost growth.
Acute liver failure (ALF) is characterized by severe and sudden liver cell dysfunction. Baseline demographic, clinical, and biochemical factors associated with the survival of ALF patients were identified in a few selected Western studies, but very few studies have been done in India. The aim of the current study is to provide an overview of the factors associated with the survival of ALF patients and to suggest an optimum cutoff value for clinically significant parameters.
The patients suffering from ALF were reviewed in this study. The factors studied were age, sex, total serum bilirubin, serum creatinine, serum albumin, urea, aspartate aminotransferase, alanine aminotransferase (ALT), and recent hepatitis E virus infection.
Total
= 41; Male 73%; median age 43 years. The median survival time of patients in the age group of 18-40 years was 238 days. The median survival time of patients >40 years of age was 129.10 days. Elevated serum urea and serum ALT levels at the time of admission were found to be significant predictors of mortality in patients suffering from ALF in our study. In Receiver Operator Characteristic (ROC) curve analysis, the optimum cutoff value of urea was found to be 42 mg/dL, and ALT was found to be 400 IU/L.
Elevated serum urea and serum ALT levels at the time of admission were found to be significant predictors of mortality in patients suffering from ALF in our study. The use of these two parameters, along with King's criteria for the prognosis of ALF, can be more useful in the management of such patients in India.
Elevated serum urea and serum ALT levels at the time of admission were found to be significant predictors of mortality in patients suffering from ALF in our study. The use of these two parameters, along with King's criteria for the prognosis of ALF, can be more useful in the management of such patients in India.Gastroenteritis is common among children and is usually caused by bacterial, viral, or parasitic gastrointestinal infections. The occurrence of gastroenteritis as the only symptom of coronavirus disease 2019 (COVID-19) is an uncommon condition. We present a 16-month-old girl that has recently been admitted to our hospital with vomiting, diarrhea, and lethargy, who was ultimately diagnosed with COVID-19. This case shows that the clinical manifestations of COVID-19 can be misleading in children.The Corona Virus Disease-2019 (COVID-19) pandemic has exposed the weaknesses in the public health care delivery system, and is extremely disheartening that thousands of people are losing their lives to a single disease. A single infectious disease is able to produce so much fear, uncertainty and disastrous impact predominantly because of its novelty and the fact that the many aspects of the disease are still not known. Even though, it has been proposed to strengthen multiple aspects of the disease control, but it is equally important to give immense priority to the research and development domain, as the findings of these results will reorganize the entire approach towards the disease. In conclusion, research and development is an important and integral component of the fight against the COVID-19 pandemic. It is high time that resources are pooled in and research activities are encouraged and accelerated to get answers for the unanswered aspects of this novel viral infection, which will aid all of us to mount an improved public health response against the first pandemic of the 21st century.
