scholarly journals Dental care during the Covid-19 pandemic – To treat or not to treat?

2020 ◽  
Vol 14 (10) ◽  
pp. 1111-1116 ◽  
Author(s):  
Stefan Danilo Dacic ◽  
Milan Nebojsa Miljkovic ◽  
Milica Caslav Jovanovic
Keyword(s):  
Infected Individual ◽  
Virus Transmission ◽  
Severe Pneumonia ◽  
Vulnerable Groups ◽  
Health Concern ◽  
Aerosol Formation ◽  
Treatment Protocols ◽  
Dental Procedures ◽  
Number Of Patients ◽  
Spread Of Infection

The recent spread of COVID-19 presents a huge public health concern. Clinical presentations of COVID-19 range from asymptomatic cases to severe pneumonia that can lead to death. Drastic measures were necessary to prevent the disease from spreading and protect the most vulnerable groups in the general population. The rapid reorganization of the healthcare system and great efforts made by medical staff were needed to admit to hospitals and then treat a progressively growing number of patients. The predominant route of virus transmission is through direct contact with an infected individual or respiratory droplets, therefore, all dental procedures with aerosol-formation pose an extremely high risk for the spread of infection. The aim of this article is to provide an overview of the current epidemiological situation, routes of transmission, and specific recommendations for dental practices including patient screening and triage, infection control, and treatment protocols. In this situation, it is essential that all dental healthcare workers make wise clinical decisions and educate themselves and their patients on how to prevent the spread of infection.

Challenges in prevention & control of COVID - 19 pandemic in dentistry: A review. (Preprint)

2020 ◽  
Author(s):  
Sameera Begum ◽  
Riaz Abdulla ◽  
Akhter Hussain
Keyword(s):  
Healthcare Professionals ◽  
Preventive Measures ◽  
Health Concern ◽  
Front Line ◽  
Public Health Concern ◽  
College Hospital ◽  
Dental Clinics ◽  
Dental Procedures ◽  
Spread Of Infection ◽  
High Chance

UNSTRUCTURED The menace of COVID 19 pandemic has become a major public health concern all over the world. It is a pandemic outbreak that originated from Wuhan, Hubei province of China in December 2019. All healthcare professionals including dental surgeons are in the front line and a high chance of constantly getting infected. Droplet and aerosol transmissions are the utmost concern in dental clinics and dental college hospitals. Hence, COVID 19 has a high risk of spread through droplets and aerosols generated during dental procedures from infected patients. This review article highlights the dental perspective and discusses the various preventive measures undertaken to control the spread of infection in dental clinics and dental college hospital setups.

scholarly journals The Poor and the Pandemic- COVID 19

2021 ◽  
Vol 58 (2) ◽  
pp. 652-659
Author(s):  
Sanjeev Thakur
Keyword(s):  
Infected Individual ◽  
Health Concern ◽  
Poor People ◽  
Asymptomatic Individual ◽  
Public Health Concern ◽  
Face To Face ◽  
The Government ◽  
Spread Of Infection ◽  
Respiratory Droplets ◽  
The Impact

The pandemic of coronavirus disease commonly known as covid 19 is known to be caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to public health concern. The infection is known to be transmitted via respiratory droplets during close face to face contact with an infected individual or may be transmitted by asymptomatic individual. The time from exposure to symptom onset is estimated to be around 14 days. The most common symptoms are fever, dry cough and shortness of breath. In fight against the infection, the Government of India imposed nationwide lockdown from 24 March ,2020 onwards to prevent the spread of infection. The Government of India claims to have won battle against the pandemic by stating that the number of cases would have been higher if nationwide lockdown had not been imposed. However this claimed is being questioned as the number of cases is on the rise each day we see. In this brief review, we aim to discuss the impact of pandemic covid 19 on poor people of India.

scholarly journals A Legionnaires’ Disease Cluster in a Private Building in Italy

2021 ◽  
Vol 18 (13) ◽  
pp. 6922
Author(s):  
Maria Luisa Ricci ◽  
Maria Cristina Rota ◽  
Maria Grazia Caporali ◽  
Antonietta Girolamo ◽  
Maria Scaturro
Keyword(s):  
Severe Pneumonia ◽  
Control Measures ◽  
Health Concern ◽  
Human Consumption ◽  
Domestic Water ◽  
Quality Of Water ◽  
Legionnaires Disease ◽  
Prevention And Control Measures ◽  
Private Homes ◽  
And Control

Legionnaires’ disease (LD) is a severe pneumonia caused by bacteria belonging to the genus Legionella. This is a major public health concern and infections are steadily increasing worldwide. Several sources of infection have been identified, but they have not always been linked to human isolates by molecular match. The well-known Legionella contamination of private homes has rarely been associated with the acquisition of the disease, although some patients never left their homes during the incubation period. This study demonstrated by genomic matching between clinical and environmental Legionella isolates that the source of an LD cluster was a private building. Monoclonal antibodies and sequence-based typing were used to type the isolates, and the results clearly demonstrated the molecular relationship between the strains highlighting the risk of contracting LD at home. To contain this risk, the new European directive on the quality of water intended for human consumption has introduced for the first time Legionella as a microbiological parameter to be investigated in domestic water systems. This should lead to a greater attention to prevention and control measures for domestic Legionella contamination and, consequently, to a possible reduction in community acquired LD cases.

scholarly journals Are telephone consultations here to stay in rheumatology?

2020 ◽  
Author(s):  
Sabrina R Raizada ◽  
Natasha Cleaton ◽  
James Bateman ◽  
Diarmuid M Mulherin ◽  
Nick Barkham
Keyword(s):  
Older Patients ◽  
Online Survey ◽  
Vulnerable Groups ◽  
Age Group ◽  
Telephone Consultation ◽  
Survey Tool ◽  
Face To Face ◽  
Vulnerable Patients ◽  
Number Of Patients

Abstract Objectives During the COVID-19 pandemic, face-to-face rheumatology follow-up appointments were mostly replaced with telephone or virtual consultations in order to protect vulnerable patients. We aimed to investigate the perspectives of rheumatology patients on the use of telephone consultations compared with the traditional face-to-face consultation. Methods We carried out a retrospective survey of all rheumatology follow-up patients at the Royal Wolverhampton Trust who had received a telephone consultation from a rheumatology consultant during a 4-week period via an online survey tool. Results Surveys were distributed to 1213 patients, of whom 336 (27.7%) responded, and 306 (91.1%) patients completed all components of the survey. Overall, an equal number of patients would prefer telephone clinics or face-to-face consultations for their next routine appointment. When divided by age group, the majority who preferred the telephone clinics were <50 years old [χ2 (d.f. = 3) = 10.075, P = 0.018]. Prevalence of a smartphone was higher among younger patients (<50 years old: 46 of 47, 97.9%) than among older patients (≥50 years old: 209 of 259, 80.7%) [χ2 (d.f. = 3) = 20.919, P < 0.001]. More patients reported that they would prefer a telephone call for urgent advice (168, 54.9%). Conclusion Most patients interviewed were happy with their routine face-to-face appointment being switched to a telephone consultation. Of those interviewed, patients >50 years old were less likely than their younger counterparts to want telephone consultations in place of face-to-face appointments. Most patients in our study would prefer a telephone consultation for urgent advice. We must ensure that older patients and those in vulnerable groups who value in-person contact are not excluded. Telephone clinics in some form are here to stay in rheumatology for the foreseeable future.

scholarly journals New ways of working: COVID-19 as a catalyst for change in acute mental health services

BMJ Leader ◽  
2021 ◽  
pp. leader-2020-000366
Author(s):  
Kezanne Tong ◽  
Genevieve Crudden ◽  
Wen Xi Tang ◽  
David McGuinness ◽  
Margaret O'Grady ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Response Times ◽  
New Ways Of Working ◽  
Number Of Patients ◽  
Service Staff ◽  
Alternative Settings ◽  
Quality Response ◽  
Spread Of Infection

BackgroundA need arose to divert patients with psychiatric complaints from the emergency department to alternative settings for psychiatric consultations to reduce footfall during COVID-19. We assessed the effectiveness of alternative referral pathway in reducing COVID-19 infection in our service and its effect on service quality: response time and number of patients leaving before the review. We evaluated the satisfaction of patients, general practitioners (GPs) and mental health service staff with the pathway.MethodsAll patients referred to the mental health service over a 2-month period following the introduction of the pathway were included. Findings were compared against the cohort referred for emergency assessment during the same period in 2019. Feedback surveys were distributed to patients, staff and GPs. χ2 and independent sample t-test were used to compare the variables.ResultsOver 2 months, 255 patients received an emergency assessment via the pathway, representing a 22.3% decrease in the volume of presentations from the same period in 2019. There were no COVID-19 cases among our patients or staff on the roster for assessing patients. In comparison to 2019, response times were improved (p<0.001), and the numbers of patients who left the hospital before the review were reduced by 3.2% during the study period (p<0.001). Patients and GPs were highly satisfied with the referral pathway and believed that the pathway should be retained post-COVID-19. Mental health service staff were divided in their opinions about its sustainability.ConclusionThe pathway was successful in reducing the spread of infection, improving response times and reducing the numbers of patients who left without an assessment. Given the improved outcomes and acceptability, this is a preferable pathway for emergency referrals into the future.

scholarly journals A Novel Rubi-Like Virus in the Pacific Electric Ray (Tetronarce californica) Reveals the Complex Evolutionary History of the Matonaviridae

Viruses ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 585
Author(s):  
Rebecca M. Grimwood ◽  
Edward C. Holmes ◽  
Jemma L. Geoghegan
Keyword(s):  
Evolutionary History ◽  
Mammalian Species ◽  
Virus Transmission ◽  
Health Concern ◽  
Virus Species ◽  
Vast Number ◽  
The Pacific ◽  
Positive Sense ◽  
History Of ◽  
Fish Viruses

Rubella virus (RuV) is the causative agent of rubella (“German measles”) and remains a global health concern. Until recently, RuV was the only known member of the genus Rubivirus and the only virus species classified within the Matonaviridae family of positive-sense RNA viruses. Recently, two new rubella-like matonaviruses, Rustrela virus and Ruhugu virus, have been identified in several mammalian species, along with more divergent viruses in fish and reptiles. To screen for the presence of additional novel rubella-like viruses, we mined published transcriptome data using genome sequences from Rubella, Rustrela, and Ruhugu viruses as baits. From this, we identified a novel rubella-like virus in a transcriptome of Tetronarce californica—order Torpediniformes (Pacific electric ray)—that is more closely related to mammalian Rustrela virus than to the divergent fish matonavirus and indicative of a complex pattern of cross-species virus transmission. Analysis of host reads confirmed that the sample analysed was indeed from a Pacific electric ray, and two other viruses identified in this animal, from the Arenaviridae and Reoviridae, grouped with other fish viruses. These findings indicate that the evolutionary history of the Matonaviridae is more complex than previously thought and highlights the vast number of viruses that remain undiscovered.

scholarly journals The structure of acute chemical poisoning in patients with HIV infection in the emergency hospital

2018 ◽  
pp. 3-13
Author(s):  
М.М. Поцхверия ◽  
М.В. Белова ◽  
С.А. Солонин ◽  
М.А. Годков
Keyword(s):  
Hiv Infection ◽  
Virus Transmission ◽  
Pairwise Comparison ◽  
Simple Random Sampling ◽  
Immunoblot Analysis ◽  
Acute Poisoning ◽  
Economic Problem ◽  
High Risk Group ◽  
Emergency Hospital ◽  
Number Of Patients

Употребление психоактивных веществ (ПАВ) с немедицинскими целями является огромной медико-социальной, экономической проблемой, и становится наиболее частой причиной инфицирования ВИЧ. Наркозависимые лица представляют особо уязвимую группу для заражения. Цель исследования: изучить структуру веществ, вызвавших острые отравления у ВИЧ-инфицированных пациентов, госпитализированных в стационар скорой медицинской помощи. Пациенты и методы исследования: ретроспективно проанализированы структура острых отравлений химической этиологии (ООХЭ) и результаты освидетельствования на ВИЧ-инфекцию 19 061 пациента, госпитализированных (простая случайная выборка) в отделение лечения острых отравлений НИИ СП им. Н.В. Склифосовского (ОЛОО НИИ СП) в 2013-2016 гг. Диагноз ООХЭ верифицирован методом хромато-масс-спектрометрии. Диагностику ВИЧ-инфекции осуществляли с использованием иммуноферментного анализа и иммуноблотинга. Для попарного сравнения распределения частот выявляемости ВИЧ у лиц ООХЭ использовали точный тест Фишера. Различия оценивали как статистически значимые при p<0,05. Результаты исследования. Выявляемость ВИЧ-инфекции у пациентов с ООХЭ варьировала от 5,7 до 7,7%. Среди пациентов с ВИЧ подавляющее большинство обращений было связано с отравлениями опиатами, лекарственными средствами и различными смесями ПАВ. За три года количество пациентов с ВИЧ и передозировками опиатов сократилось в 2,3 раза (p<0,0001). Значительно чаще стали встречаться отравления психодислептиками, смесями ПАВ и веществами немедицинского назначения. Среди ВИЧ-инфицированных значительную долю составляли лица с отравлениями несколькими видами наркотических и/или лекарственных веществ. При этом снизились доли отравлений опиатами в сочетании с метадоном и психофармакологическими средствами. У пациентов с ВИЧ обнаружен высокий удельный вес интоксикации этанолом и его суррогатами. Выводы. Динамика выявляемости ВИЧ-инфекции у пациентов с ООХЭ свидетельствует о высокой поражённости этой категории лиц. Причины увеличения частоты обнаружения ВИЧ-инфекции могут быть связаны с изменением ассортимента принимаемых ПАВ и путей передачи вируса. Пациенты ОЛОО являются группой высокого риска распространения ВИЧ-инфекции и могут рассматриваться как фокусная группа, отражающая общие тенденции в потреблении наркотических и ПАВ в г. Москве. The use of psychoactive substances (PS) with non-medical purposes is a huge medical, social and economic problem. It becomes the most frequent cause of HIV infection. Drug addict individuals are vulnerable group for HIV. Aim: study the structure of substances that caused acute poisoning in HIV-infected patients hospitalized in an emergency hospital. The object and methods: it has been retrospectively analyzed the structure of acute poisoning of chemical etiology (APCE) and prevalence of HIV infection among 19061 patients hospitalized (simple random sampling) at N.V. Sklifosovsky’s Research Institute for Emergency Medicine department of acute poisoning treatment (DAPT) in 2013-2016 years. The diagnosis of APCE was verified by chromatography-mass spectrometry. Diagnosis of HIV infection was carried out using immunoassay and immunoblot analysis. Fisher’s exact test was used for a pairwise comparison of the prevalence HIV in individuals with APCE. Differences were assessed as statistically significant at p <0.05. Results. The prevalence of HIV infection in patients with APCE ranged from 5.7 to 7.7%. Among the patients with HIV the vast majority of cases were associated with poisoning with opiates, drugs and various PS mixtures. For the period from 2013 to 2016 the number of patients with HIV infection and opiate overdoses decreased by 2.3 times (p <0.0001). More common became poisoning with psychotomimetic substance, PS mixtures and non-medical substances. Among HIV infected patients significant share were people poisoned several types of drugs and/or medicines. At the same time, the share of poisoning with opiates decreased in combination with methadone and psychopharmacological medicines. In patients with HIV were detected a high proportion of ethanol and its surrogates’ intoxication. Conclusions. The prevalence of HIV infection in patients with APSE indicates of the high affection of this category persons. The reasons of increasing the prevalence of HIV infection can be associated with a change in PS consumption assortment and the ways of virus transmission. Patients with APSE are a high risk group for HIV spreading and can be considered as a focus group reflecting general trends in the drug consumption in Moscow.

scholarly journals Covid-19 Re-infection vs Prolonged Viral Shedding

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Richard J. Barohn ◽  
Mary Hindle ◽  
Lauren Peck ◽  
Syed Hasan Raza Naqvi
Keyword(s):  
Polymerase Chain Reaction ◽  
Acquired Immunity ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Initial Infection ◽  
Viral Shedding ◽  
Number Of Patients ◽  
The World ◽  
Polymerase Chain ◽  
Spread Of Infection

  Since December 2019, COVID 19 pandemic has devastated communities across the world. As number of patients recovered from COVID 19 continue to rise, question of acquired immunity versus chances of re-infection becomes critical to understand the future spread of infection. Here, we present a case of a patient previously recovered from COVID-19, develops new symptoms concerning for possible re-infection with positive reverse transcriptase-polymerase chain reaction (RT-PCR) after few months of initial infection.  

scholarly journals Challenges in Steroid and Anticoagulant Therapy in Severe COVID-19 Pneumonia: A Prospective Study

Antibiotics ◽  
2021 ◽  
Vol 10 (10) ◽  
pp. 1214
Author(s):  
Alaa Thabet Hassan ◽  
Alaa E. Abd Elmoniem ◽  
Marwa Mahmoud Abdelrady ◽  
Mona Embarek Mohamed ◽  
Mohamed A. Mokhtar ◽  
...  
Keyword(s):  
Treatment Protocol ◽  
Severe Pneumonia ◽  
High Risk Group ◽  
University Hospital ◽  
Treatment Protocols ◽  
Neutrophil Lymphocyte Ratio ◽  
Treatment Type ◽  
Acute Kidney Disease ◽  
Significant Difference ◽  
Group B

Background: As COVID-19 has neither a standard treatment protocol nor guidelines, there are many treatment protocols for anti-inflammatory corticosteroids and anti-coagulations for severe COVID-19 pneumonia patients. This study aimed to assess the most suitable modality in this high-risk group. Methods: A prospective, experimental study design was adopted that included 123 severe COVID-19 pneumonia patients admitted at Assiut University Hospital. Patients were divided into three groups according to a combined corticosteroid and anticoagulants therapy protocol. Group A included 32 patients, group B included 45 patients, and group C included 46 patients. Assessment of cases was conducted according to the treatment type and duration, weaning duration from oxygen therapy, length of hospital and ICU stay, and complications during treatment. Three months follow-up after discharge was performed. Results: the three patient groups showed significant differences regarding the 3-month outcome, whereas Group C showed the highest cure rate, lowest lung fibrosis, and lowest mortality rate over the other two groups. The in-hospital outcome, the development of pulmonary embolism, bleeding, hematoma, acute kidney disease, and myocardial infarction showed a significant difference between groups (p values < 0.05). Mortality predictors among severe COVID-19 patients by multivariable Cox hazard regression included treatment modality, history of comorbid diseases, increased C reactive protein, high neutrophil-lymphocyte ratio, and shorter ICU and hospital stay. Conclusion: the use of combined methylprednisolone and therapeutic Enoxaparin, according to a flexible protocol for COVID-19 patients with severe pneumonia, had two benefits; the prevention of disease complications and improved clinical outcome.

scholarly journals Trends in Burn Injuries in Northern Israel During the COVID-19 Lockdown

2020 ◽  
Author(s):  
Dani Kruchevsky ◽  
Maher Arraf ◽  
Shir Levanon ◽  
Tal Capucha ◽  
Yitzchak Ramon ◽  
...  
Keyword(s):  
Pediatric Population ◽  
Age Groups ◽  
Temporal Variations ◽  
Burn Injuries ◽  
Burn Patients ◽  
Outbreak Period ◽  
Number Of Patients ◽  
Study Results ◽  
Period Data ◽  
Spread Of Infection

Abstract Coronavirus disease 2019 obliged many countries to apply lockdown policies to contain the spread of infection. The restrictions in Israel included limitations on movement, reduction of working capacity, and closure of the educational system. The present study focused on patients treated at a referral center for burns in northern Israel. Their goal was to investigate temporal variations in burn injuries during this period. Data were retrospectively extracted from the medical records of burn patients treated at our hospital between March 14, 2020 and April 20, 2020 (ie, the period of aggravated lockdown). Data from this period were compared with that from paralleling periods between 2017 and 2019. During the lockdown and paralleling periods, 178 patients were treated for burn injuries, of whom 44% were under 18. Although no restrictions were enforced during the virus outbreak period with regard to seeking medical care, we noticed a decrease in the number of patients admitted to the emergency room for all reasons. Of particular interest was a 66% decrease in the number of adult burn patients (P &lt; .0001). Meanwhile, among the pediatric population, no significant decrease was observed. Nonetheless, subgroups with higher susceptibility to burn injuries included children aged 2 to 5 years (56.3% vs 23.8%, P = .016) and female patients from all pediatric age groups (57.1% vs 25%, P = .027). These findings may be explained by the presumably busier kitchen and dining areas during the lockdown. Overall, the study results can assist with building a stronger understanding of varying burn injuries and with developing educational and preventive strategies.

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