The working of the urology department during the COVID-19 epidemic

2020 ◽  
Vol 10 (4) ◽  
pp. 301-307
Author(s):  
Ekaterina V. Kul’chavenya ◽  
Denis P. Kholtobin ◽  
Alexander I. Neymark
Keyword(s):  
Medical Center ◽  
Total Duration ◽  
World Health ◽  
Medical Attention ◽  
Malignant Neoplasms ◽  
City Hospital ◽  
Strict Adherence ◽  
Number Of Patients ◽  
Coronavirus Infection ◽  
Research Institute

Introduction. In March 2020, the World Health Organization declared the outbreak of the novel coronavirus infection (COVID-19) a pandemic. The pandemic also significantly affected all academic, scientific and educational activities. Material and methods. We compared the work of the urological departments of the private (Medical Center Avicenna, Novosibisk) and municipal (City Clinical Hospital No. 11, Barnaul) clinics, as well as the urogenital department of the Novosibirsk Research Institute of Tuberculosis of the Ministry of Healthcare of Russia for 6 months of calm 2019, and the first half of 2020, which coincided with the start of the COVID-19 coronavirus pandemic. Results. In March 2020, the urogenital department of the Novosibirsk Research Institute of Tuberculosis of the Ministry of Healthcare of Russia was redesigned into an observational one. In the first half of 2020, patients with malignant neoplasms, varicocele, chronic pyelonephritis, hydronephrosis, dropsy of the testicular membranes and with phimosis/paraphimosis were admitted to the urology department of the City Hospital No. 11 in Barnaul in the first half of 2020. On the contrary, statistically significant in 2020 the number of patients admitted for kidney abscess and acute prostatitis prevailed. It can be assumed that, due to the tense epidemic situation, patients postponed seeking medical attention until their condition required emergency intervention. In the Medical Center Avicenna (Novosibirsk) in the first half of 2020 the number of visits to the pediatric urologist significantly decreased, the inpatient and average bed-day decreased. On the contrary the total duration of the patients' stay in the day hospital has significantly increased, which is logically explained by the epidemic situation; there was a statistically significant decrease in the number of most operations and outpatient procedures. Conclusion. The new coronavirus infection has affected all spheres of human life, to a maximum extent on medicine. In the first six months, no unified approaches to the management of urological patients in epidemic conditions were developed; clinics worked according to internal standards. Our analysis showed that strict adherence to sanitary and hygienic standards and the implementation of anti-epidemic measures allows us to provide urological care to patients in full-even in such unfavorable conditions.

scholarly journals Adverse Effects and Choice between the Injectable Agents Amikacin and Capreomycin in Multidrug-Resistant Tuberculosis

2017 ◽  
Vol 61 (9) ◽  
Author(s):  
Amber Arnold ◽  
Graham S. Cooke ◽  
Onn Min Kon ◽  
Martin Dedicoat ◽  
Marc Lipman ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Adverse Effects ◽  
Total Duration ◽  
Multidrug Resistant ◽  
World Health ◽  
Fluoroquinolone Resistance ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Number Of Patients ◽  
Mdr Tb

ABSTRACT The prolonged use of injectable agents in a regimen for the treatment of multidrug-resistant tuberculosis (MDR-TB) is recommended by the World Health Organization, despite its association with ototoxicity and nephrotoxicity. We undertook this study to look at the relative adverse effects of capreomycin and amikacin. We reviewed the case notes of 100 consecutive patients treated at four MDR-TB treatment centers in the United Kingdom. The median total duration of treatment with an injectable agent was 178 days (interquartile range [IQR], 109 to 192 days; n = 73) for those with MDR-TB, 179 days (IQR, 104 to 192 days; n = 12) for those with MDR-TB plus fluoroquinolone resistance, and 558 days (IQR, 324 to 735 days; n = 8) for those with extensively drug-resistant tuberculosis (XDR-TB). Injectable use was longer for those started with capreomycin (183 days; IQR, 123 to 197 days) than those started with amikacin (119 days; IQR, 83 to 177 days) (P = 0.002). Excluding patients with XDR-TB, 51 of 85 (60%) patients were treated with an injectable for over 6 months and 12 of 85 (14%) were treated with an injectable for over 8 months. Forty percent of all patients discontinued the injectable due to hearing loss. Fifty-five percent of patients experienced ototoxicity, which was 5 times (hazard ratio [HR], 5.2; 95% confidence interval [CI], 1.2 to 22.6; P = 0.03) more likely to occur in those started on amikacin than in those treated with capreomycin only. Amikacin was associated with less hypokalemia than capreomycin (odds ratio, 0.28; 95% CI, 0.11 to 0.72), with 5 of 37 (14%) patients stopping capreomycin due to recurrent electrolyte loss. There was no difference in the number of patients experiencing a rise in the creatinine level of >1.5 times the baseline level. Hearing loss is frequent in this cohort, though its incidence is significantly lower in those starting capreomycin, which should be given greater consideration as a first-line agent.

scholarly journals Specifics of the perioperative management of the patients undergoing surgery for malignant neoplasms during the COVID-19 pandemic

2020 ◽  
Vol 48 ◽  
pp. 68-72
Author(s):  
A. S. Allakhverdyan ◽  
A. N. Anipchenko ◽  
N. N. Anipchenko
Keyword(s):  
Molecular Weight ◽  
Surgical Treatment ◽  
Cancer Patients ◽  
Malignant Tumors ◽  
Malignant Neoplasms ◽  
Low Molecular Weight ◽  
Low Molecular Weight Heparins ◽  
Strict Adherence ◽  
Malignant Skin Tumors ◽  
Coronavirus Infection

Background: The worse prognosis in cancer patients with COVID-19 infection in the context of the pandemic, compared to that in the general population, poses new challenges to ensure the perioperative safety.Aim: To reduce the risk of infection for cancer patients in the perioperative period and to prevent severe COVID-19.Materials and methods: During two months of the COVID-19 (from March to April 2020), we performed 158 surgical interventions: 49 for breast cancer, 31 for lung cancer (videothoracoscopic segmental and lobar resections), 12 for stomach cancer (8 distal and 1 proximal laparoscopic subtotal gastric resections, 3 gastrectomies), 16 laparoscopic resections for colorectal cancer, 29 resections with a reconstructive plastic for malignant skin tumors, 21 palliative and diagnostic operations (diagnostic thoracoscopy and laparoscopy, laparoscopic colostomy).Results: Preventive administration during preparation for surgery (interferon-al-pha2b and low molecular weight heparins) and for suspected infection (antibiotics, low molecular weight heparins and dexamethasone 12 mg/day intravenously) allowed for lower rates of the new coronavirus infection (1.3%) and its severe cases (0%) during surgical treatment of malignant tumors.Conclusion: Surgical treatment of cancer patients in the context of a new coronavirus infection pandemic should be carried out with strict adherence to anti-epidemic measures.

scholarly journals The dynamics of the incidence of breast cancer in the Moscow region (2011–2018)

2020 ◽  
pp. 166-173
Author(s):  
L. M. Kogoniya ◽  
V. I. Astashov ◽  
S. N. Minakov
Keyword(s):  
Breast Cancer ◽  
Medical Care ◽  
Clinical Symptoms ◽  
Medical Center ◽  
Mortality Rates ◽  
Diagnostic Methods ◽  
Moscow Region ◽  
Malignant Neoplasms ◽  
Number Of Patients ◽  
Incidence And Mortality

Introduction. Breast cancer is a serious medical and social challenge and the statistics around the world look daunting.Relevance. The incidence of breast cancer is increasing in most countries and this may be due to a number of reasons. First of all, it should be noted the improvement of diagnostic methods, in particular, mass mammographic screening, which allows detecting neoplasms at early stages, before the onset of clinical symptoms. As for mortality rates, in recent years, world statistics show a downward trend in rates.Goal. To analyze the incidence and mortality rates of breast cancer (BC) in the Moscow Region (MO) for the period from 2011 to 2018. The study of indicators in one of the regions of Russia – MO – is of great importance for determining and predicting the true needs of the population in specialized medical care.The purpose of the study was to analyze the incidence of breast cancer (breast cancer) in the Moscow Region (MO) for a period of time from 2011 to 2018.Materials and methods. Some data of the territorial cancer registry of the Ministry of Defense of the Russian Federation on the diagnosis and treatment of patients with breast cancer were used, which will make it possible to determine the needs of this cohort of patients in specialized care.Results. From 2011 to 2018, 26755 new cases of breast cancer were diagnosed in the Moscow Region. The analysis of the comparative stratification in breast cancer in the medical district made it possible to obtain statistically significant differences indicating an increase in the incidence in the period from 2015–2018 in comparison with the period of 2011–2014. The presented data also indicate a trend towards a decrease in the one-year mortality rate over 8 years: from 6.33% in 2011 to 5.32% in 2018. For the period from 2011 to 2018 (8 years) there is an increase in the number of patients with breast cancer who have been in the medical center under dispensary supervision for 5 years or more.Conclusions. Analysis of the data obtained on the indicators of morbidity and mortality from malignant neoplasms is of great importance for determining the needs of the population in specialized medical care.

scholarly journals HEALTHY LIVING PATTERNS TO PREVENT COVID-19

2020 ◽  
Vol 2 (1) ◽  
pp. 107-112
Author(s):  
Indri Seta Septadina
Keyword(s):  
Epidemiological Data ◽  
World Health ◽  
Viral Diseases ◽  
Number Of Patients ◽  
The World ◽  
New Type ◽  
Coronavirus Infection ◽  
Novel Coronavirus ◽  
Health Organization ◽  
Influenza H1n1

Viruses are one of the causes of infectious diseases that need to be watched out for. In the last 20 years, several viral diseases have caused epidemics such as severe acute respiratory syndrome coronavirus (SARS-CoV) in 2002-2003, influenza H1N1 in 2009 and Middle East Respiratory syndrome (MERS-CoV) which was first identified in Saudi Arabia in year 2012. On December 31, 2019, China reported a case of mysterious pneumonia of unknown cause. Within 3 days, the number of patients with these cases was 44 patients and continues to increase until now there are millions of cases. Initially, the epidemiological data showed that 66% of patients were related to or exposed to a seafood market or live market in Wuhan, Hubei Province, China. Samples of isolates from patients were studied with the results showing the presence of coronavirus infection, a new type of betacoronavirus, named 2019 novel Coronavirus (2019-nCoV). On February 11, 2020, the World Health Organization named the new virus SARS-CoV-2 and the disease name as Coronavirus Disease 2019 (COVID-19). The corona virus is the main pathogen causing an outbreak of respiratory disease. On March 11, 2020, WHO announced that COVID-19 was becoming a pandemic in the world.

The Covid-19 Pandemic and Dental Practice (Literature review)

2020 ◽  
Vol 1 (12) ◽  
pp. 5-7
Author(s):  
S. N. Razumova ◽  
A. S. Brago ◽  
Y. S. Kozlova ◽  
A. S. Manvelyan ◽  
M. N. Razumov ◽  
...  
Keyword(s):  
Literature Review ◽  
World Health ◽  
Dental Practice ◽  
Strict Adherence ◽  
Professional Activities ◽  
The World ◽  
Coronavirus Infection ◽  
Health Organization ◽  
Practice Literature ◽  
Dental Appointments

In the context of the Covid-19 pandemic, the world and our professional activities are changing. The issue of preventing transmission of the virus and protecting medical stuff has become very acute all over the world. The vaccine is only in the process of development. WHO (World Health Organization) has directed all efforts to limit the spread of the virus in all countries of the world. In our article, we presented an overview of the experience of international colleagues on new protocols for conducting dental appointments and protecting medical stuff. We concluded that only strict adherence to the new protocols by staff and patients will help to prevent the spread of coronavirus infection.

The Causative Organisms of Bacterial Meningitis and their Antimicrobial Resistance Profiles in Iranian Children in 2011-2016

2020 ◽  
Vol 20 (2) ◽  
pp. 229-236
Author(s):  
Sepideh Keshavarz Valian ◽  
Shima Mahmoudi ◽  
Babak Pourakbari ◽  
Maryam Banar ◽  
Mohammad Taghi Haghi Ashtiani ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Bacterial Meningitis ◽  
Medical Center ◽  
Blood Cultures ◽  
Gram Positive ◽  
Gram Negative ◽  
Number Of Patients ◽  
Resistance Patterns ◽  
Iranian Children ◽  
Surgery Department

Objective: The study aimed to describe the identity and antimicrobial resistance patterns of the causative agents of bacterial meningitis in children referred to Children’s Medical Center (CMC) Hospital, Tehran, Iran. Methods: This retrospective study was performed at CMC Hospital during a six-year period from 2011 to 2016. The microbiological information of the patients with a diagnosis of bacterial meningitis was collected and the following data were obtained: patients’ age, sex, hospital ward, the results of CSF and blood cultures, and antibiotic susceptibility profiles of isolated organisms. Results: A total of 118 patients with bacterial meningitis were admitted to CMC hospital. Sixty-two percent (n=73) of the patients were male. The median age of the patients was ten months (interquartile range [IQR]: 2 months-2 years) and the majority of them (n=92, 80%) were younger than two years of age. The highest number of patients (n=47, 40%) were admitted to the surgery department. Streptococcus epidermidis was the most frequent isolated bacterium (n=27/127, 21%), followed by Klebsiella pneumoniae (n=20/127, 16%), and Staphylococcus aureus (n=16/127, 12.5%). Blood culture was positive in 28% (n=33/118) of patients. Ampicillin-sulbactam and imipenem were the most effective antibiotics against Gram-negative bacteria isolated from CSF cultures. In the case of Gram-positive organisms, ampicillinsulbactam, vancomycin, and linezolid were the best choices. Imipenem was the most active drug against Gram-negative blood pathogens. Also, ampicillin and vancomycin had the best effect on Gram-positive bacteria isolated from blood cultures. Conclusion: Results of this study provide valuable information about the antibiotic resistance profiles of the etiologic agents of childhood meningitis, which can be used for prescription of more effective empirical therapies.

scholarly journals Hand Hygiene Compliance Study at a Large Central Hospital in Vietnam

2019 ◽  
Vol 16 (4) ◽  
pp. 607 ◽  
Author(s):  
Cam Le ◽  
Erik Lehman ◽  
Thanh Nguyen ◽  
Timothy Craig
Keyword(s):  
Quality Assurance ◽  
Hand Hygiene ◽  
Healthcare Workers ◽  
Medical Center ◽  
Compliance Rate ◽  
World Health ◽  
Limiting Factors ◽  
Cultural Attitudes ◽  
Knowledge And Attitude ◽  
Hygiene Compliance

Lack of proper hand hygiene among healthcare workers has been identified as a core facilitator of hospital-acquired infections. Although the concept of hand hygiene quality assurance was introduced to Vietnam relatively recently, it has now become a national focus in an effort to improve the quality of care. Nonetheless, barriers such as resources, lack of education, and cultural norms may be limiting factors for this concept to be properly practiced. Our study aimed to assess the knowledge and attitude of healthcare workers toward hand hygiene and to identify barriers to compliance, as per the World Health Organization’s guidelines, through surveys at a large medical center in Vietnam. In addition, we aimed to evaluate the compliance rate across different hospital departments and the roles of healthcare workers through direct observation. Results showed that, in general, healthcare workers had good knowledge of hand hygiene guidelines, but not all believed in receiving reminders from patients. The barriers to compliance were identified as: limited resources, patient overcrowding, shortage of staff, allergic reactions to hand sanitizers, and lack of awareness. The overall compliance was 31%; physicians had the lowest rate of compliance at 15%, while nurses had the highest rate at 39%; internal medicine had the lowest rate at 16%, while the intensive care unit had the highest rate at 40%. In summary, it appears that addressing cultural attitudes in addition to enforcing repetitive quality assurance and assessment programs are needed to ensure adherence to safe hand washing.

scholarly journals Clinicopathological features of Egyptian colorectal cancer patients regarding somatic genetic mutations especially in KRAS gene and microsatellite instability status: a pilot study

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Neemat M. Kassem ◽  
Gamal Emera ◽  
Hebatallah A. Kassem ◽  
Nashwa Medhat ◽  
Basant Nagdy ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Microsatellite Instability ◽  
Cpg Island ◽  
Human Cancer ◽  
Statistical Significance ◽  
Public Health Problem ◽  
World Health ◽  
Cpg Island Methylator Phenotype ◽  
Number Of Patients ◽  
The Impact

Abstract Background Colorectal cancer (CRC) is the third most common cause of cancer-related deaths which contributes to a significant public health problem worldwide with 1.8 million new cases and almost 861,000 deaths in 2018 according to the World Health Organization. It exhibits 7.4% of all diagnosed cancer cases in the region of the Middle East and North Africa. Molecular changes that happen in CRCs are chromosomal instability, microsatellite instability (MSI), and CpG island methylator phenotype. The human RAS family (KRAS, NRAS, and HRAS) is the most frequently mutated oncogenes in human cancer appearing in 45% of colon cancers. Determining MSI status across CRCs offers the opportunity to identify patients who are likely to respond to targeted therapies such as anti-PD-1. Therefore, a method to efficiently determine MSI status for every cancer patient is needed. Results KRAS mutations were detected in 31.6% of CRC patients, namely in older patients (p = 0.003). Codons 12 and 13 constituted 5/6 (83.3%) and 1/6 (16.7%) of all KRAS mutations, respectively. We found three mutations G12D, G12C, and G13D which occur as a result of substitution at c.35G>A, c.34G>T, and c.38G>A and have been detected in 4/6 (66.6%), 1/6 (16.7%), and 1/6 (16.7%) patients, respectively. Eleven (57.9%) patients had microsatellite instability-high (MSI-H) CRC. A higher percentage of MSI-H CRC was detected in female patients (p = 0.048). Eight patients had both MSI-H CRC and wild KRAS mutation with no statistical significance was found between MSI status and KRAS mutation in these studied patients. Conclusion In conclusion, considering that KRAS mutations confer resistance to EGFR inhibitors, patients who have CRC with KRAS mutation could receive more tailored management by defining MSI status. MSI-high patients have enhanced responsiveness to anti-PD-1 therapies. Thus, the question arises as to whether it is worth investigating this association in the routine clinical setting or not. Further studies with a larger number of patients are needed to assess the impact of MSI status on Egyptian CRC care.

scholarly journals An evidence-based systematic review on emerging therapeutic and preventive strategies to treat novel coronavirus (SARS-CoV-2) during an outbreak scenario

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Anupama M. Gudadappanavar ◽  
Jyoti Benni
Keyword(s):  
Antiviral Drug ◽  
Drug Repurposing ◽  
Respiratory Illness ◽  
World Health ◽  
Recombinant Vaccines ◽  
Subunit Vaccines ◽  
Coronavirus Infection ◽  
Novel Coronavirus ◽  
Health Organization ◽  
Full Length Genome

AbstractA novel coronavirus infection coronavirus disease 2019 (COVID-19) emerged from Wuhan, Hubei Province of China, in December 2019 caused by SARS-CoV-2 is believed to be originated from bats in the local wet markets. Later, animal to human and human-to-human transmission of the virus began and resulting in widespread respiratory illness worldwide to around more than 180 countries. The World Health Organization declared this disease as a pandemic in March 2020. There is no clinically approved antiviral drug or vaccine available to be used against COVID-19. Nevertheless, few broad-spectrum antiviral drugs have been studied against COVID-19 in clinical trials with clinical recovery. In the current review, we summarize the morphology and pathogenesis of COVID-19 infection. A strong rational groundwork was made keeping the focus on current development of therapeutic agents and vaccines for SARS-CoV-2. Among the proposed therapeutic regimen, hydroxychloroquine, chloroquine, remdisevir, azithromycin, toclizumab and cromostat mesylate have shown promising results, and limited benefit was seen with lopinavir–ritonavir treatment in hospitalized adult patients with severe COVID-19. Early development of SARS-CoV-2 vaccine started based on the full-length genome analysis of severe acute respiratory syndrome coronavirus. Several subunit vaccines, peptides, nucleic acids, plant-derived, recombinant vaccines are under pipeline. This article concludes and highlights ongoing advances in drug repurposing, therapeutics and vaccines to counter COVID-19, which collectively could enable efforts to halt the pandemic virus infection.

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