Assuntos
Infecções Assintomáticas/epidemiologia , Infecções por Coronavirus/epidemiologia , Militares , Medicina Naval , Pneumonia Viral/epidemiologia , Adulto , Ageusia/fisiopatologia , Assistência Ambulatorial/estatística & dados numéricos , Betacoronavirus , COVID-19 , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/fisiopatologia , Tosse/fisiopatologia , Surtos de Doenças , Feminino , Febre/fisiopatologia , Cefaleia/fisiopatologia , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Transtornos do Olfato/fisiopatologia , Pandemias , Isolamento de Pacientes , Pneumonia Viral/mortalidade , Pneumonia Viral/fisiopatologia , Quarentena , SARS-CoV-2 , Navios , Adulto JovemRESUMO
Drive-through coronavirus disease 2019 screening can evaluate large numbers of patients while reducing healthcare exposures and personal protective equipment use. We describe the characteristics of screened individuals as well as drive-through process and outcome measures. Optimal drive-through screening involves rapid turnaround of test results and linkage to follow-up care.
RESUMO
OBJECTIVE: People living with HIV (PLHIV) are at increased risk for cardiovascular disease (CVD) and development of subclinical echocardiographic abnormalities. However, there is scant evidence of the echocardiographic changes that occur shortly after seroconversion. In this study we describe the echocardiographic evaluations of asymptomatic US Air Force members who were diagnosed with HIV infection and evaluated at the San Antonio Military Medical Center between September 1, 2015 and September 30, 2016. RESULTS: Patients (n = 50) were predominantly male (96%), mostly African American (60%), with a mean age of 28 years. At HIV diagnosis, the mean viral load was 112,585 copies/mL and CD4 count was 551 cells/µL. All were found to have normal left ventricular systolic ejection fraction (EF) and global longitudinal strain (GLS) however evidence of right ventricular dilatation and left ventricular remodeling was observed in 7 (14%) and 13 (26%) patients, respectively. Subgroup analyses showed no significant differences in echocardiographic findings by HIV disease severity or CVD risk factors (p > 0.05 for all).This study suggests that untreated HIV may have a low impact on the development of echocardiographic abnormalities shortly after seroconversion. Longitudinal studies are warranted to determine the optimal CVD risk assessment strategies for PLHIV.
Assuntos
Ecocardiografia , Infecções por HIV/diagnóstico por imagem , Militares , Adulto , Feminino , Infecções por HIV/fisiopatologia , Humanos , Masculino , Estados Unidos , Remodelação VentricularRESUMO
BACKGROUND: Colorectal cancer is the third leading cause of cancer in the United States. Surveillance colonoscopy has been shown to reduce colorectal cancer risk. Medical institutions have implemented polyp tracking and notification programs (registries) to ensure adequate surveillance. AIM: To assess the effectiveness of a registry notification program initiated in January 2006 on the surveillance colonoscopy completion rate and adherence to surveillance guidelines. METHODS: Retrospective record review of beneficiaries with an adenomatous polyp between 2004 and 2007, with expected repeat surveillance colonoscopy between 2007 and 2012. Records were divided in 2 groups: Pre-Registry (4/04-12/05) and Registry (1/06-6/07). Successful surveillance was defined as beneficiaries who completed or were offered a colonoscopy within 12 months after the recommended interval. RESULTS: A total of 853 beneficiary records were reviewed, with 88 records excluded. Pre-Registry mean age was 60.1 years and %male gender was 63.5%, compared to Registry mean age of 60.9 years and %male gender of 58.4%. Significantly more beneficiaries completed or were offered colonoscopy surveillance in the Registry group, compared to the Pre-Registry group, (85.1% vs. 43.7%, p < 0.001). CONCLUSION: The use of a polyp tracking registry and notification program improves adherence to current polyp surveillance guidelines.