Aquino Williams, Britney M Clemen, S. Patel, N. Bhatti, I. Soliman
A 30-year-old African American male with past medical history of hemorrhoids initially presented with intractable abdominal pain and changes in stool caliber. Thorough history and physical relieved multiple risk factors including high risk behavior, unintentional weight loss and extensive purplish-red skin lesions which prompted evaluation for complications of HIV/AIDS. Gastrointestinal biopsies confirmed the diagnosis of Kaposi Sarcoma (KS) secondary to AIDS.
{"title":"An Unanticipated Case of Kaposi Sarcoma in A Young Male","authors":"Aquino Williams, Britney M Clemen, S. Patel, N. Bhatti, I. Soliman","doi":"10.52106/2769-2787.1002","DOIUrl":"https://doi.org/10.52106/2769-2787.1002","url":null,"abstract":"A 30-year-old African American male with past medical history of hemorrhoids initially presented with intractable abdominal pain and changes in stool caliber. Thorough history and physical relieved multiple risk factors including high risk behavior, unintentional weight loss and extensive purplish-red skin lesions which prompted evaluation for complications of HIV/AIDS. Gastrointestinal biopsies confirmed the diagnosis of Kaposi Sarcoma (KS) secondary to AIDS.","PeriodicalId":210663,"journal":{"name":"Advances in Infectious Diseases & Therapy","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130753032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Azithromycin (AZT) has been proposed as a treatment for COVID-19 on the basis of its immunomodulatory actions. Objective: To assess the association between exposure to AZT in patients with COVID-19, both admitted to the hospital and treated as outpatients, with respect to the duration of their clinical course and mortality. Methodology: An observational and retrospective case control-study paired by sex, age group (> and = <65 years), presence or absence of chronic diseases, and severity (presence or absence of pneumonia) was conducted March 15, 2020 to March 15, 2021, in a general medicine office in Toledo, Spain. Results: 19 cases and 19 controls were included. 26% of the cases and 42% of the controls had a positive clinical result (improvement or clinical cure before 13 days of the onset of the disease) (Fisher exact test = 0.1051; Paired OR = 0.4545 (Confidence intervals at 95%: 0.1579, 1.308). In the 19 cases there were no deaths vs. 2 deaths in the control group (Fisher exact test = 0.0001; paired OR = 0.1053 (Confidence intervals at 95 % = 0.02452, 0.4519). Conclusions: In the context of general medicine in Toledo (Spain), AZT did not shorten the duration of clinical symptoms, but it was shown to be a protective factor against mortality. Due to the limitations of the study design, the results should be considered with caution and the use of AZT in COVID-19 should be probably restricted, to date, to patients in whom there is an antimicrobial indication.
{"title":"Azithromycin Treatment in COVID-19 is Not Associated with Clinical Course Shortening, But it Is Associated with a Reduction in Mortality. A Case Control-Study Paired By Sex, Age Group, Chronic Diseases and Severity","authors":"J. Turabián","doi":"10.52106/2769-2787.1004","DOIUrl":"https://doi.org/10.52106/2769-2787.1004","url":null,"abstract":"Background: Azithromycin (AZT) has been proposed as a treatment for COVID-19 on the basis of its immunomodulatory actions. Objective: To assess the association between exposure to AZT in patients with COVID-19, both admitted to the hospital and treated as outpatients, with respect to the duration of their clinical course and mortality. Methodology: An observational and retrospective case control-study paired by sex, age group (> and = <65 years), presence or absence of chronic diseases, and severity (presence or absence of pneumonia) was conducted March 15, 2020 to March 15, 2021, in a general medicine office in Toledo, Spain. Results: 19 cases and 19 controls were included. 26% of the cases and 42% of the controls had a positive clinical result (improvement or clinical cure before 13 days of the onset of the disease) (Fisher exact test = 0.1051; Paired OR = 0.4545 (Confidence intervals at 95%: 0.1579, 1.308). In the 19 cases there were no deaths vs. 2 deaths in the control group (Fisher exact test = 0.0001; paired OR = 0.1053 (Confidence intervals at 95 % = 0.02452, 0.4519). Conclusions: In the context of general medicine in Toledo (Spain), AZT did not shorten the duration of clinical symptoms, but it was shown to be a protective factor against mortality. Due to the limitations of the study design, the results should be considered with caution and the use of AZT in COVID-19 should be probably restricted, to date, to patients in whom there is an antimicrobial indication.","PeriodicalId":210663,"journal":{"name":"Advances in Infectious Diseases & Therapy","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126938842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anthony Sophonsri, P. Ny, P. Nieberg, A. Wong-Beringer
Purpose: Remdesivir has become a part of the treatment standard for patients hospitalized with COVID-19 since its initial availability under the Expanded Access Program in March 2020. Here, we describe our evolving experience with remdesivir utilization during the pandemic. Methods: Medical records of patients prescribed remdesivir during March to December 2020 at a community teaching hospital were reviewed for baseline characteristics, clinical presentation and management, outcomes, and cost of remdesivir treatment. The pattern of remdesivir prescribing was compared pre- and post-formulary addition of the drug for use in hospitalized COVID-19 patients. Results: Criteria for remdesivir use evolved from requiring mechanical ventilation to requiring low oxygen supplementation during the study period. A 3.5-fold increase in remdesivir use outside of criteria was observed after formulary addition when much of the prescribing was shifted from Infectious Diseases (ID) and Pulmonary Critical Care Medicine (PCCM) to the Internal Medicine service. Compared to Pre-formulary patients, Post-formulary patients had lower requirements for oxygen supplementation and more achieved early clinical response with <5 days of remdesivir (29.7% vs. 9.2%, p<0.0001), had significantly shorter time to stability (median 4 vs. 6.5 days, p<0.0001) and length of stay (6 vs. 10 days, p<0.0001), and lower mortality (9.9% vs. 15.5%, p=0.19). None of the patients who achieved early response and received <5 days of remdesivir had a COVID-related readmission or emergency department (ED) visit within 30 days. Potential cost savings per 100 patients is estimated at $35,000 with strict adherence to criteria and an additional $15,444 when treatment duration is shortened to 4 days in the early responders. Conclusion: Prescribing of remdesivir outside of criteria increased after it was no longer restricted to ID or PCCM specialists upon formulary addition. Provider education is needed to improve adherence to criteria-based prescribing. Shortening treatment duration in early responders can lessen healthcare resource utilization and cost without negatively impacting patient outcomes.
目的:自2020年3月在扩大可及计划下首次供应以来，瑞德西韦已成为COVID-19住院患者治疗标准的一部分。在这里，我们描述了我们在大流行期间使用瑞德西韦的不断发展的经验。方法:回顾2020年3月至12月在一家社区教学医院接受瑞德西韦治疗的患者的医疗记录，包括基线特征、临床表现和管理、结局和瑞德西韦治疗的成本。比较住院COVID-19患者在处方前和处方后使用瑞德西韦的处方模式。结果:在研究期间，瑞德西韦的使用标准从需要机械通气发展到需要低氧补充。当大部分处方从传染病(ID)和肺部重症医学(PCCM)转移到内科服务时，在处方添加后，观察到标准外瑞德西韦的使用增加了3.5倍。与处方前患者相比，处方后患者的补氧需求较低，并且在使用瑞德西韦<5天时获得了更多的早期临床反应(29.7% vs. 9.2%， p<0.0001)，达到稳定的时间(中位4天vs. 6.5天，p<0.0001)和住院时间(6天vs. 10天，p<0.0001)显著缩短，死亡率较低(9.9% vs. 15.5%， p=0.19)。获得早期缓解且接受<5天瑞德西韦治疗的患者均未在30天内出现与covid相关的再入院或急诊(ED)就诊。如果严格遵守标准，每100名患者可能节省的费用估计为35,000美元，如果早期反应者的治疗时间缩短至4天，则可额外节省15,444美元。结论:处方添加后，瑞德西韦不再局限于ID或PCCM专家，标准外处方增加。需要对提供者进行教育，以提高对基于标准的处方的依从性。缩短早期应答者的治疗时间可以减少医疗资源的利用和成本，而不会对患者的预后产生负面影响。
{"title":"Evolving Pattern of Remdesivir Prescribing During the COVID-19 Pandemic: Outcome and Cost Implications","authors":"Anthony Sophonsri, P. Ny, P. Nieberg, A. Wong-Beringer","doi":"10.52106/2769-2787.1005","DOIUrl":"https://doi.org/10.52106/2769-2787.1005","url":null,"abstract":"Purpose: Remdesivir has become a part of the treatment standard for patients hospitalized with COVID-19 since its initial availability under the Expanded Access Program in March 2020. Here, we describe our evolving experience with remdesivir utilization during the pandemic. Methods: Medical records of patients prescribed remdesivir during March to December 2020 at a community teaching hospital were reviewed for baseline characteristics, clinical presentation and management, outcomes, and cost of remdesivir treatment. The pattern of remdesivir prescribing was compared pre- and post-formulary addition of the drug for use in hospitalized COVID-19 patients. Results: Criteria for remdesivir use evolved from requiring mechanical ventilation to requiring low oxygen supplementation during the study period. A 3.5-fold increase in remdesivir use outside of criteria was observed after formulary addition when much of the prescribing was shifted from Infectious Diseases (ID) and Pulmonary Critical Care Medicine (PCCM) to the Internal Medicine service. Compared to Pre-formulary patients, Post-formulary patients had lower requirements for oxygen supplementation and more achieved early clinical response with <5 days of remdesivir (29.7% vs. 9.2%, p<0.0001), had significantly shorter time to stability (median 4 vs. 6.5 days, p<0.0001) and length of stay (6 vs. 10 days, p<0.0001), and lower mortality (9.9% vs. 15.5%, p=0.19). None of the patients who achieved early response and received <5 days of remdesivir had a COVID-related readmission or emergency department (ED) visit within 30 days. Potential cost savings per 100 patients is estimated at $35,000 with strict adherence to criteria and an additional $15,444 when treatment duration is shortened to 4 days in the early responders. Conclusion: Prescribing of remdesivir outside of criteria increased after it was no longer restricted to ID or PCCM specialists upon formulary addition. Provider education is needed to improve adherence to criteria-based prescribing. Shortening treatment duration in early responders can lessen healthcare resource utilization and cost without negatively impacting patient outcomes.","PeriodicalId":210663,"journal":{"name":"Advances in Infectious Diseases & Therapy","volume":"184 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124672524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. S, Ishii K, K. H., Hara K, Wakabayashi M, M. Y., Fujihara J, Ito T, Konuma S, Aoki T, Tsubota T, Hayashi T
Background: The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has spread around the world and been classified as a global pandemic. This study aimed to determine the factors involved in the time to disappearance of SARS-CoV-2 from nasopharyngeal swabs in patients with COVID-19. Methods: The study participants were 22 patients diagnosed with COVID-19 whose nasopharyngeal swabs tested positive for SARS-CoV-2 by quantitative reverse transcription polymerase chain reaction (RT-qPCR) in quarantine before being admitted to our hospital. All patients underwent laboratory tests for anti-SARS-CoV-2 antibodies and chest X-ray on admission. Logistic regression analysis was conducted to investigate retrospectively the association between the number of days from nasopharyngeal to viral resolution and clinical factors. Results: In the univariate analysis, no clinical or laboratory factors, including age, sex, highest body temperature, lowest peripheral oxygen saturation, presence of symptoms during hospitalization, laboratory results, and chest X-ray findings, were associated with negative RT-qPCR results at 5, 7, and 10 days from first detection of the virus. Although no statistically significant differences were found, the median times required until achieving two consecutive negative RT-qPCR results for SARS-CoV-2 from first detection of the virus were 5 and 10 days in cases without and with anti-SARS-CoV-2 immunoglobulin M (IgM) and/or immunoglobulin M (IgG) antibodies, respectively. Conclusion: Although we only investigated the presence or absence of IgM and IgG antibodies to SARS-CoV-2 at the time of admission, our results suggest that humoral immunity may not be essential for the disappearance of SARS-CoV-2 in nasopharyngeal swabs.
{"title":"Clinical courses of COVID-19 cases with or without SARS-CoV-2 immunoglobulin antibodies identified during quarantine at international airports in Japan","authors":"T. S, Ishii K, K. H., Hara K, Wakabayashi M, M. Y., Fujihara J, Ito T, Konuma S, Aoki T, Tsubota T, Hayashi T","doi":"10.52106/2769-2787.1001","DOIUrl":"https://doi.org/10.52106/2769-2787.1001","url":null,"abstract":"Background: The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has spread around the world and been classified as a global pandemic. This study aimed to determine the factors involved in the time to disappearance of SARS-CoV-2 from nasopharyngeal swabs in patients with COVID-19. Methods: The study participants were 22 patients diagnosed with COVID-19 whose nasopharyngeal swabs tested positive for SARS-CoV-2 by quantitative reverse transcription polymerase chain reaction (RT-qPCR) in quarantine before being admitted to our hospital. All patients underwent laboratory tests for anti-SARS-CoV-2 antibodies and chest X-ray on admission. Logistic regression analysis was conducted to investigate retrospectively the association between the number of days from nasopharyngeal to viral resolution and clinical factors. Results: In the univariate analysis, no clinical or laboratory factors, including age, sex, highest body temperature, lowest peripheral oxygen saturation, presence of symptoms during hospitalization, laboratory results, and chest X-ray findings, were associated with negative RT-qPCR results at 5, 7, and 10 days from first detection of the virus. Although no statistically significant differences were found, the median times required until achieving two consecutive negative RT-qPCR results for SARS-CoV-2 from first detection of the virus were 5 and 10 days in cases without and with anti-SARS-CoV-2 immunoglobulin M (IgM) and/or immunoglobulin M (IgG) antibodies, respectively. Conclusion: Although we only investigated the presence or absence of IgM and IgG antibodies to SARS-CoV-2 at the time of admission, our results suggest that humoral immunity may not be essential for the disappearance of SARS-CoV-2 in nasopharyngeal swabs.","PeriodicalId":210663,"journal":{"name":"Advances in Infectious Diseases & Therapy","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131622549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fatma Al Fahdi, Mohammed Amin, P. Kurup, Lamya Al Balushi
Dengue is currently the most common mosquito-borne disease globally. In Oman, all reported dengue cases were travel-related until 2018 dengue outbreak in Seeb district. The aim of the study was to assess students’ level of knowledge about dengue fever, its symptoms, mode of transmission and prevention, attitudes and practices regarding DF in Seeb district in Muscat Governorate in Oman. Materials and Methods: A cross-sectional study was conducted among students of 13 governmental schools in Seeb district. Multistage stratified random sample method was used and1209 students participated in this study using a pre-structured and self-administered questionnaire. Results: We found that 92% of students have heard about the Aedes aegypti mosquito & 85% reported it as serious disease. 56.9% reported they don’t feel at risk of Dengue fever. The most common source of information was social media, Friends & relatives and TV. Almost half of students answered incorrectly for the mosquitoes’ bite time and most respondents were not able to correctly identify typical symptoms of DF apart from fever. 52% agreed it is important health problem in Muscat and can contribute to the fight of the Aedes aegypti mosquito. Majority of students stated good attitude in terms of importance of preventive and protective measure except for using mosquito repellent. Conclusion: Massive educational campaign targeting school students in addition to incorporating dengue preventive measures into school curriculum should be planned by the concerned stakeholders to enhance level of knowledge, attitude and practice regarding dengue as well as other vector borne diseases in Oman.
{"title":"Knowledge, Attitudes, and Practices Relating to Dengue Fever Prevention and Control among Governmental School Students in Seeb District in Muscat Governorate in Oman","authors":"Fatma Al Fahdi, Mohammed Amin, P. Kurup, Lamya Al Balushi","doi":"10.52106/2769-2787.1006","DOIUrl":"https://doi.org/10.52106/2769-2787.1006","url":null,"abstract":"Dengue is currently the most common mosquito-borne disease globally. In Oman, all reported dengue cases were travel-related until 2018 dengue outbreak in Seeb district. The aim of the study was to assess students’ level of knowledge about dengue fever, its symptoms, mode of transmission and prevention, attitudes and practices regarding DF in Seeb district in Muscat Governorate in Oman. Materials and Methods: A cross-sectional study was conducted among students of 13 governmental schools in Seeb district. Multistage stratified random sample method was used and1209 students participated in this study using a pre-structured and self-administered questionnaire. Results: We found that 92% of students have heard about the Aedes aegypti mosquito & 85% reported it as serious disease. 56.9% reported they don’t feel at risk of Dengue fever. The most common source of information was social media, Friends & relatives and TV. Almost half of students answered incorrectly for the mosquitoes’ bite time and most respondents were not able to correctly identify typical symptoms of DF apart from fever. 52% agreed it is important health problem in Muscat and can contribute to the fight of the Aedes aegypti mosquito. Majority of students stated good attitude in terms of importance of preventive and protective measure except for using mosquito repellent. Conclusion: Massive educational campaign targeting school students in addition to incorporating dengue preventive measures into school curriculum should be planned by the concerned stakeholders to enhance level of knowledge, attitude and practice regarding dengue as well as other vector borne diseases in Oman.","PeriodicalId":210663,"journal":{"name":"Advances in Infectious Diseases & Therapy","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115830410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Evela da Silva Magno, Inara Lima de Oliveira, Eyde Cristianne Saraiva-Bonatto, Maria das Graças Gomes Saraiva
Arterial hypertension and diabetes are serious concerns for public health in Manaus, Amazonas. The objective of the research was to identify the indicators of arterial hypertension and diabetes registered in the city of Manaus, Amazonas. Secondary data from VIGITEL, 2019, from the Ministry of Health were used. In adults aged ≥ 18 years, the percentage of those who reported medical diagnosis of arterial hypertension was higher in females. In treatment for arterial hypertension, the percentage was also more expressive in women. Regarding the medical diagnosis of diabetes in adults aged ≥ 18 years old, the female one stood out with the greatest record, as well as regarding the drug treatment of diabetes. In 2019, in Manaus, women had the highest record in both cases. In view of this situation, it is necessary to implement the actions, especially in primary care to guarantee the treatment of arterial hypertension and diabetes in people of both sexes aged ≥ 18 years.
{"title":"Systemic Arterial Hypertension and Diabetes Before the COVID-19 Scenario, in Manaus, Amazonas, Brazilian Amazon","authors":"Evela da Silva Magno, Inara Lima de Oliveira, Eyde Cristianne Saraiva-Bonatto, Maria das Graças Gomes Saraiva","doi":"10.52106/2769-2787.1003","DOIUrl":"https://doi.org/10.52106/2769-2787.1003","url":null,"abstract":"Arterial hypertension and diabetes are serious concerns for public health in Manaus, Amazonas. The objective of the research was to identify the indicators of arterial hypertension and diabetes registered in the city of Manaus, Amazonas. Secondary data from VIGITEL, 2019, from the Ministry of Health were used. In adults aged ≥ 18 years, the percentage of those who reported medical diagnosis of arterial hypertension was higher in females. In treatment for arterial hypertension, the percentage was also more expressive in women. Regarding the medical diagnosis of diabetes in adults aged ≥ 18 years old, the female one stood out with the greatest record, as well as regarding the drug treatment of diabetes. In 2019, in Manaus, women had the highest record in both cases. In view of this situation, it is necessary to implement the actions, especially in primary care to guarantee the treatment of arterial hypertension and diabetes in people of both sexes aged ≥ 18 years.","PeriodicalId":210663,"journal":{"name":"Advances in Infectious Diseases & Therapy","volume":"103 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121943118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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