RESUMEN
Of the 47 prefectures in Japan, Iwate had the fewest cases of coronavirus disease 2019 (COVID-19), with the first diagnosis officially confirmed on July 28, 2020. A baseline serological survey of COVID-19 antibodies is essential to accurately evaluate an epidemic outbreak. The primary purpose of this study was to determine pre-epidemic prevalence of COVID-19 antibodies among healthcare workers, using two laboratory-based quantitative tests. In addition, a point-of-care (POC) qualitative test, rapid, simple, and convenient for primary care clinics, was compared with the laboratory-based tests. All antibody tests were performed on serum from 1,000 healthcare workers (mean age, 40 ± 11 years) in Iwate Prefectural Central Hospital, May 29-31, 2020. A COVID-19 case was defined as showing positive results in both laboratory-based quantitative tests. None of 1,000 samples had positive results in both of the laboratory immunoassays. The POC test showed positive results in 33 of 1,000 samples (3.3%) (95% confidence interval:2.19-4.41), but no samples were simultaneously positive in both laboratory-based tests. In conclusion, COVID-19 cases were not serologically confirmed by a baseline control study of healthcare workers at our hospital in late May, 2020. Moreover, the POC qualitative test may offer no advantage in areas with very low prevalence of COVID-19, due to higher false-positive reactions compared with laboratory-based quantitative immunoassays.
Asunto(s)
Prueba Serológica para COVID-19 , COVID-19/diagnóstico , COVID-19/epidemiología , Personal de Salud , SARS-CoV-2 , Adulto , Anticuerpos Antivirales/sangre , Prueba Serológica para COVID-19/métodos , Prueba Serológica para COVID-19/estadística & datos numéricos , Epidemias , Reacciones Falso Positivas , Femenino , Humanos , Japón/epidemiología , Masculino , Persona de Mediana Edad , Pandemias , Pruebas en el Punto de Atención/estadística & datos numéricos , SARS-CoV-2/inmunología , Estudios Seroepidemiológicos , Centros de Atención Terciaria , Factores de TiempoRESUMEN
Liver trauma is a recognised rare complication of cardiopulmonary resuscitation (CPR) and may be difficult to detect. We report a case of intraperitoneal haemorrhage due to liver injury following CPR in a 50-year-old man admitted to the intensive care unit. The haemorrhage was diagnosed with focused assessment with sonography for trauma (FAST). FAST can rapidly and easily diagnose liver injury. FAST is recommended for excluding haemoperitoneum in patients who are haemodynamically unstable after resuscitation.
Asunto(s)
Traumatismos Abdominales/diagnóstico , Reanimación Cardiopulmonar/efectos adversos , Hemoperitoneo/diagnóstico , Hígado/lesiones , Ultrasonografía/métodos , Heridas no Penetrantes/diagnóstico , Traumatismos Abdominales/diagnóstico por imagen , Traumatismos Abdominales/etiología , Hemoperitoneo/diagnóstico por imagen , Hemoperitoneo/etiología , Humanos , Unidades de Cuidados Intensivos , Hígado/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Heridas no Penetrantes/diagnóstico por imagen , Heridas no Penetrantes/etiologíaRESUMEN
Oxaliplatin in combination with 5-fluorouracil (5-FU) and Leucovorin (FOLFOX) currently represents a valid approach for treating advanced colorectal cancer. In Japan, it is generally performed. Gastrointestinal, hematological and neurosensory toxicities are the most common. However, information concerning the pulmonary toxicity of this regimen is very limited. We report here two cases of interstitial lung disease occurring in association with the use of this combination chemotherapy. Reports of interstitial lung disease due to FOLFOX are infrequent, but could lead to severe complications. It is important to perform an X-ray examination regularly and detect symptoms early.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias Hepáticas/tratamiento farmacológico , Enfermedades Pulmonares Intersticiales/diagnóstico por imagen , Enfermedades Pulmonares Intersticiales/tratamiento farmacológico , Neoplasias del Recto/tratamiento farmacológico , Anciano , Antibacterianos/uso terapéutico , Fluorouracilo/uso terapéutico , Humanos , Leucovorina/uso terapéutico , Neoplasias Hepáticas/secundario , Masculino , Compuestos Organoplatinos/uso terapéutico , Neoplasias del Recto/patología , Tomografía Computarizada por Rayos XRESUMEN
Scrub typhus (Tsutsugamushi disease) is an acute febrile disease caused by infection with Orientia tsutsugamushi transmitted by mites. Although patients with scrub typhus commonly display mild liver injury, few die of acute liver failure. We describe herein an autopsy case of acute liver failure due to scrub typhus, which was complicated by disseminated intravascular coagulation and showed rapid progression of liver injury just before death. Histopathological findings revealed submassive hepatocellular necrosis, inflammatory cell infiltration in Glisson's capsules, and sporadic fibrin thrombi in the hepatic sinusoids. Cause of death was primarily associated with acute liver failure related to disseminated intravascular coagulation.