Prolonged Severe Acute Respiratory Syndrome Coronavirus 2 Replication in an Immunocompromised Patient

We describe a case of chronic coronavirus disease 2019 (COVID-19) in a patient with lymphoma and associated B-cell immunodeficiency. Viral cultures and sequence analysis demonstrate ongoing replication of infectious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) for at least 119 days. The patient had 3 admissions related to COVID-19 over a 4-month period and was treated twice with remdesivir and convalescent plasma with resolution of symptoms. The patient's lack of seroconversion and prolonged course illustrate the importance of humoral immunity in resolving SARS-CoV-2 infection. This case highlights challenges in managing immunocompromised hosts, who may act as persistent shedders and sources of transmission.http://deepblue.lib.umich.edu/bitstream/2027.42/174139/2/Prolonged Severe Acute Respiratory Syndrome Coronavirus 2 Replication in an Immunocompromised Patient.pdfPublished versionDescription of Prolonged Severe Acute Respiratory Syndrome Coronavirus 2 Replication in an Immunocompromised Patient.pdf : Accepted versio

Uso dos recursos de Internet na Enfermagem: uma revisão Uso de los recursos de la Internet en la Enfermería: una revisión Use of Internet resources in Nursing: a review

Os recursos do sistema Internet estão cada vez mais popularizados em todas as áreas das atividades humanas na sociedade. Este artigo teve como objetivo identificar e descrever as principais modalidades de utilização da Internet pela enfermagem nas áreas de Educação, Assistência e Pesquisa. Trata-se de um estudo bibliográfico cuja fonte de dados foi a base de dados MEDLINE, usando-se expressões de pesquisa pertinentes às áreas enfocadas. Dos trabalhos referidos, 63 artigos foram selecionados. A principal utilização na área de Educação é o desenvolvimento de aplicações para promover ensino à distância; na área de Educação ao Paciente é a disponibilização de informação de saúde; na área de Assistência são as aplicações que oferecem protocolos assistenciais para promover a prática baseada em evidências e na área de Pesquisa é a coleta de dados on-line. Conclui-se que a enfermagem vem utilizando satisfatoriamente os recursos do sistema Internet e, isto tem contribuído para o próprio desenvolvimento da profissão.<br>Los recursos del sistema Internet son amplamente popularizados en la mayoria de las actividades humanas en la sociedad. Esto artículo objectiva identificar y describir las principales modalidades de utilización de la Internet por la enfermería en las areas de Educación, Asistencia y Pesquisa. Es un estudio de revisión bibliográfica cuya fuente de datos fue la base de datos MEDLINE, usandose descriptores pertinentes a las areas enfocadas. De los trabajos referidos, 63 articulos fueran selecionados. La principal utilización en la area de Educación es el desarrollo de aplicaciones para promover la educacion a distancia; en la area de Educación al Paciente es la disponibilización de información de salud; en la area de Asistencia son las aplicaciones con protocolos asistenciales para promover la practica basada en evidencias y en la area de Pesquisa es la recolecta de datos online. Se ha concluyido que la enfermería utiliza satisfactoriamente los recursos del sistema Internet y esto ha contribuido para el proprio desarrollo de la profesión.<br>Resources of Internet system are widely popularized in most of all human activities in the society. This paper aims to identify and to describe major modalities of Internet utilization in nursing areas of Education, Care, and Research. This is a bibliographic review which data source was MEDLINE database, using pertinent descriptors for the focused areas. From referred publications, it was selected 63 articles. Major utilization in Education area is the development of applications to promote distance education; in Patient Education area is the development of applications to make health information available; in Care area are the applications to make care protocols available to promote evidence-based practice, and in Research area is online data collection. It was concluded that nursing is using Internet resources in a satisfactory way, and it has contributed for the profession evolution

Common surgical procedures in pilonidal sinus disease: A meta-analysis, merged data analysis, and comprehensive study on recurrence

Abstract We systematically searched available databases. We reviewed 6,143 studies published from 1833 to 2017. Reports in English, French, German, Italian, and Spanish were considered, as were publications in other languages if definitive treatment and recurrence at specific follow-up times were described in an English abstract. We assessed data in the manner of a meta-analysis of RCTs; further we assessed non-RCTs in the manner of a merged data analysis. In the RCT analysis including 11,730 patients, Limberg & Dufourmentel operations were associated with low recurrence of 0.6% (95%CI 0.3–0.9%) 12 months and 1.8% (95%CI 1.1–2.4%) respectively 24 months postoperatively. Analysing 89,583 patients from RCTs and non-RCTs, the Karydakis & Bascom approaches were associated with recurrence of only 0.2% (95%CI 0.1–0.3%) 12 months and 0.6% (95%CI 0.5–0.8%) 24 months postoperatively. Primary midline closure exhibited long-term recurrence up to 67.9% (95%CI 53.3–82.4%) 240 months post-surgery. For most procedures, only a few RCTs without long term follow up data exist, but substitute data from numerous non-RCTs are available. Recurrence in PSD is highly dependent on surgical procedure and by follow-up time; both must be considered when drawing conclusions regarding the efficacy of a procedure