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INTRODUCTION: Mass screening for SARS-CoV-2 using nasopharyngeal swabs (NPS) is costly, uncomfortable for patients, and increases the chance of virus exposure to health care workers. Therefore, this study focused on determining if self-collected unpreserved saliva can be an effective alternative to NPS collection in COVID-19 surveillance. MATERIALS AND METHODS: In this study, patients being tested for SARS-CoV-2 using NPS were asked to provide a saliva sample to compare their results. NPS samples were evaluated for SARS-CoV-2 using BioFire® FilmArray® Torch® or Cepheid® GeneXpert® systems while saliva samples were evaluated using an in-house developed reverse transcriptase polymerase chain reaction (RT-PCR) which targeted the Envelope (E) and Nucleocapsid (N) genes. RESULTS: Detection of SARS-CoV-2 using self-collected saliva was found to be only slightly less accurate (<5%) than testing using NPS. In addition, initial saliva RT-PCR identified 27 positive subjects, 18 of which provided amplicons sufficient for confirmatory sequencing. The sequencing data showed a genetic shift in the virus within our population sometime between 22 June and July 8, 2021 from Alpha to Delta variant. CONCLUSIONS: The saliva sample collection method identifies the E gene in SARS COVID-2 samples which provides an alternative specimen source to the NPS. This identifies the S gene and ORF1ab. Saliva collection is more convenient to the patient, yields comparable results to NPS collection, and potentially increases Covid-19 surveillance.
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Prueba de Ácido Nucleico para COVID-19 , COVID-19 , SARS-CoV-2 , Saliva , Manejo de Especímenes , Humanos , Saliva/virología , SARS-CoV-2/genética , SARS-CoV-2/aislamiento & purificación , COVID-19/diagnóstico , COVID-19/virología , Manejo de Especímenes/métodos , Prueba de Ácido Nucleico para COVID-19/métodos , Prueba de Ácido Nucleico para COVID-19/instrumentación , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/métodos , Nasofaringe/virología , Prueba de COVID-19/métodos , Adulto , Femenino , MasculinoRESUMEN
Background: Rheumatoid arthritis is a debilitating and destructive disease for which limited therapeutic options exist. Objective: This report summarizes serial magnetic resonance imaging (MRI) findings from nine study participants treated with hyperbaric oxygen (HBO2) therapy and expands upon an earlier pilot study that showed improvement in disease activity and joint pain as determined by multiple, validated clinical measures. Methods: Rheumatoid arthritis patients received 30 hyperbaric oxygen treatments over six to 10 weeks. MRI with and without contrast was completed at baseline, and at three- and six-month intervals following initiation of HBO2 therapy. Ratings were based on Outcome Measures in Rheumatology Clinical Trials (OMERACT) Rheumatoid Arthritis Magnetic Resonance Imaging Score (RAMRIS) criteria, the standard method for quantification of inflammation and damage by MRI in RA trials. Results: Using RAMRIS criteria, nine of nine patients demonstrated no radiologic progression of erosions, synovitis, or bone marrow edema at three- and six-month scans. Conclusion: Our findings suggest that HBO2 therapy may be useful as an adjunctive or alternative treatment to disease-modifying drugs for rheumatoid arthritis.
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Artritis Reumatoide , Oxigenoterapia Hiperbárica , Humanos , Proyectos Piloto , Imagen por Resonancia Magnética/métodos , Artritis Reumatoide/tratamiento farmacológico , Artritis Reumatoide/patología , Inflamación , Oxígeno/uso terapéutico , Índice de Severidad de la EnfermedadRESUMEN
Introduction: This lessons learned paper provides recommendations for novice investigators to consider when writing a research protocol; specifically when it involves clinical staff with varying levels of research experience, multiple departments, and is conducted at a non-academic medical center. It further explores each specific lesson with generalizability to help future novice investigators successfully develop and implement their own research study. Methods: There were several lessons learned during the development and implementation of the research teams' original study. These lessons include: (1) Conduct feasibility assessments; (2) Assess external factors; (3) Partner with stakeholder(s); (4) Develop tools that promote transparency; (5) Coordinate with Information Technology personnel; and (6) Engage and educate stakeholders. Conclusion: The aim of this study was to determine if unrestricted oral intake of low fat, low residue foods during labor impacts maternal and neonatal outcomes, with the goal of contributing an adequately powered study to the current literature. Due to the challenges experienced in executing this study, the findings were not able to be generalized. However, the challenges encountered are not specific to the original focus of the researchers' study. Each of the lessons are generalizable and can be applied to nursing research. As nurses begin to develop clinical research protocols, utilizing the lessons learned in this paper may help ensure successful implementation and completion of their research.
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BACKGROUND/OBJECTIVE: This case series pilot study assessed the effects of hyperbaric oxygen therapy (HBO2) for treating rheumatoid arthritis (RA). METHODS: Ten RA subjects received 30 HBO2 treatments over 6 to 10 weeks. Serial rheumatologic evaluations (ie, the Disease Activity Scale [DAS28], the Routine Assessment of Patient Index Data 3, and the Pain and Sleep Quality Questionnaire) were completed at baseline, throughout the course of the study, and at the 6-month follow-up. RESULTS: There was a statistically significant effect of HBO2 therapy over time on the DAS28-Global Health (p = 0.01), the DAS28-C-reactive protein (p = 0.002), and the DAS28-erythrocyte sedimentation rate (p = 0.008) measures; these analyses excluded 2 patients who were in clinical remission at baseline. Selected post hoc comparisons showed significantly lower DAS28-Global Health, DAS28-C-reactive protein, and DAS28-erythrocyte sedimentation rate scores at 3 and 6 months relative to baseline. In addition, statistically significant decreases in pain as measured by the Routine Assessment of Patient Index Data 3 and Pain and Sleep Quality Questionnaire were observed at the end of HBO2 relative to baseline. CONCLUSIONS: Hyperbaric oxygen therapy is effective for joint pain in patients with RA based on data from multiple, validated clinical measures. Further research with more subjects and the use of a control group is necessary.