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BACKGROUND: Several countries have imposed a mandatory 14-day period of quarantine on individuals arriving from countries considered high-risk for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. However, it is not clear how long asymptomatic patients infected with SARS-CoV-2 can be an asymptomatic carrier. CASE PRESENTATION: We experienced a case of an asymptomatic female patient infected with SARS-CoV-2 with abnormal chest computed tomography findings. She did not develop a fever during hospitalized isolation. She remained reverse transcription-polymerase chain reaction-positive for 24 days. CONCLUSION: An asymptomatic patient diagnosed with SARS-CoV-2 infection remained reverse transcription-polymerase chain reaction-positive for 24 days, although she was quarantined in an isolation hospital. This finding suggests that an asymptomatic patient diagnosed with SARS-CoV-2 infection with abnormal chest computed tomography findings can be an asymptomatic carrier for more than 3 weeks.
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BACKGROUND: Pediatric clinical research in Japan has declined recently, and a new policy requiring manuscripts of residents for the pediatric board examination was established in 2017. However, pediatric faculties appear to be confused about research education in residencies. METHODS: Questionnaires on research activities in residencies were distributed during the spring of 2018 to 500 pediatric directors in all educational hospitals in Japan. We collected data and performed statistical analyses: principal component analysis, multivariate analysis of variance, and multiple comparisons. RESULTS: We received 252 (50.4%) responses and analyzed 243 (61 academic hospitals, 27 children's hospitals, 151 community hospitals, and 4 unknown). About 137 (56.4%) of them supported the new policy. There were three main contentious points on attitudes to pediatric research among respondents: passion for research, particularity about disease research, and public spirit. There was a difference in passion for research between academics and non-academics. A difference in pride in particular research was observed between PhDs and MDs. Differences in public spirit were not associated with scholarly degrees or hospital type. CONCLUSIONS: To promote research education in residencies, pediatric faculties should confirm and share the aim that pediatricians should be scientific physicians with a research mentality developed through research activities and should notice social problems. Through research education, pediatric residents could approach the five outcomes for pediatricians provided by the Japan Pediatric Society: being general physicians, child healthcare supporters, advocates for children, scholars, and professionals.
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Investigación Biomédica/educación , Pediatras/educación , Pediatría/educación , Hospitales Pediátricos , Humanos , Internado y Residencia , Japón , Encuestas y CuestionariosRESUMEN
Aim: The objective of this study was to investigate the incidence and characteristics of thoracic injuries associated with cardiopulmonary resuscitation (CPR) performed under the 2005 and the 2010 guidelines. Methods: We evaluated patients who had an out-of-hospital cardiac arrest in 2010 (2005 group) and 2012 (2010 group). We analyzed the incidence and characteristics of rib fractures and pneumothoraces received during CPR as determined by medical records and image studies. Results: Two hundred and ninety-two patients in the 2005 group and 243 in the 2010 group were enrolled. The number of patients with rib fractures was greater in the 2010 group than in the 2005 group (123 [42.1%] versus 167 [68.7%], P < 0.001), and the number of pneumothorax patients with rib fractures was also higher (8 [2.7%] versus 21 [8.6%], P = 0.004). Of the 21 patients, four had a tension pneumothorax. The anterior-posterior diameter of the chest (APD) was smaller in patients with a pneumothorax and rib fractures than those without the injuries (166.0 mm [standard deviation 22.8] versus 176.2 mm [standard deviation 21.0], P = 0.04), and the APD for patients of Japanese descent was smaller than that of patients of European descent by more than 50 mm. Conclusion: The number of rib fractures and pneumothoraces received during CPR increased significantly under the 2010 guidelines when compared with the 2005 guidelines. As the APD for patients of Japanese descent is smaller than that of patients of European descent, Japanese medical facilities need to be prepared for possible fatal adverse events associated with CPR under the current international guidelines.
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Genetic disorders and birth defects account for a high percentage of the admissions in children's hospitals. Congenital malformations and chromosomal abnormalities are the most common causes of infant mortality. So their effects pose serious problems for perinatal health care in Japan, where the infant mortality is very low. This paper describes the reasons for admissions and hospitalization at the high-care unit (HCU) of a major tertiary children's referral center in Japan. We retrospectively reviewed 900 admission charts for the period 2007-2008 and found that genetic disorders and malformations accounted for a significant proportion of the cases requiring admission to the HCU. Further, the rate of recurrent admission was higher for patients with genetic disorders and malformations than for those with acquired, non-genetic conditions. Over the past 30 years, admissions attributed to genetic disorders and malformations has consistently impacted on children's hospital and patients with genetic disorders and malformations form a large part of this facility. These results reflect improvements in medical care for patients with genetic disorders and malformations and further highlight the large proportion of cases with genetic disorders, for which highly specialized management is required. Moreover, this study emphasizes the need for involvement of clinical geneticists in HCUs at children's hospitals.