National long COVID impact and risk factors.

OBJECTIVE: Our objective was to estimate the prevalence and risk factors for long COVID symptoms among polymerase chain reaction-confirmed COVID-19 patients (hospitalised and community) in Malta. STUDY DESIGN: This was a national cross-sectional survey among COVID-19 patients in Malta during 2020. METHODS: Patients were sent a questionnaire 3-6 months after testing positive. Data were analysed descriptively to estimate symptom prevalence, and multivariable logistic regressions were used to determine the risk factors for long COVID symptoms. Age, sex, initial symptoms, hospitalisation, and healthcare worker status were used as risk factors and symptoms (cough, shortness of breath, fatigue, anxiety, sadness, and memory loss) 2.5 months or more after COVID-19 onset were used as outcomes. RESULTS: Of 8446 eligible participants, 2665 (31.55%) responded with a median age of 37 years. Initial symptoms were reported in 82% of responders, and 7.73% were hospitalised. Among the long COVID symptoms, fatigue persisted among most non-hospitalised responders, whereas anxiety, shortness of breath, and sadness were the most common symptoms. Female sex, hospitalisation, and initial symptoms were associated with higher odds of fatigue, shortness of breath, cough, anxiety, sadness, and memory loss as long COVID symptoms. CONCLUSIONS: Our study is the first to highlight long COVID symptoms and risk factors in Malta, showing that long COVID is common among hospitalised and non-hospitalised patients. These data should increase awareness of long COVID and facilitate support to those affected nationally.

National outbreak of Salmonella Give linked to a local food manufacturer in Malta, October 2016.

Salmonella Give is a rare serotype across Europe. In October 2016, a national outbreak of S. Give occurred in Malta. We describe the epidemiological, environmental, microbiological and veterinary investigations. Whole-genome sequencing (WGS) was performed on human, food, environmental and veterinary isolates. Thirty-six human cases were reported between October and November 2016, 10 (28%) of whom required hospitalisation. Twenty-six (72%) cases were linked to four restaurants. S. Give was isolated from ready-to-eat antipasti served by three restaurants which were all supplied by the same local food manufacturer. Food-trace-back investigations identified S. Give in packaged bean dips, ham, pork and an asymptomatic food handler at the manufacturer; inspections found inadequate separation between raw and ready-to-eat food during processing. WGS indicated two genetically distinguishable strains of S. Give with two distinct clusters identified; one cluster linked to the local food manufacturer and a second linked to veterinary samples. Epidemiological, environmental and WGS evidence pointed towards cross-contamination of raw and ready-to-eat foods at the local manufacturer as the likely source of one cluster. Severity of illness indicates a high virulence of this specific serotype. To prevent future cases and outbreaks, adherence to food safety practices at manufacturing level need to be reinforced.

Prevalence of latent tuberculosis, syphilis, hepatitis B and C among asylum seekers in Malta.

BACKGROUND: In the last few years, Malta has witnessed increasing immigration flows from the Libyan coasts. Public health policies are focused on screening migrants for tuberculosis, whereas no systematic actions against STIs are implemented. The aim of this study is to define the epidemiological profile of asylum seekers in Malta as regards syphilis, hepatitis B, C and latent tuberculosis, thus supporting screening policies. METHODS: Five hundred migrants living in open centres were screened between December 2010 and June 2011. RESULTS: 83.2% of people was from Somalia, 81.2% males, average age 26.5 years. The tuberculin skin test (TST) was positive in 225 migrants (45%). Latent syphilis was diagnosed in 11 migrants, hepatitis C in 3 and 31 migrants were HBsAg positive. CONCLUSION: Systematic screening for asymptomatic migrants in Malta is not recommended for hepatitis C and syphilis, given the low prevalence observed. On the contrary, it should be considered for hepatitis B. TST could be indicated as the first step of a two step screening for migrants from countries with high TB incidence. Efficacy and cost-effectiveness could be achieved by further targeting screening to specific subgroups at higher risk of reactivation, such as people living with HIV and subjects affected by chronic diseases.

Risk of hospitalization and death for healthcare workers with COVID-19 in nine European countries, January 2020-January 2021.

This article presents and compares coronavirus disease 2019 attack rates for infection, hospitalization, intensive care unit (ICU) admission and death in healthcare workers (HCWs) and non-HCWs in nine European countries from 31st January 2020 to 13th January 2021. Adjusted attack rate ratios in HCWs (compared with non-HCWs) were 3.0 [95% confidence interval (CI) 2.2-4.0] for infection, 1.8 (95% CI 1.2-2.7) for hospitalization, 1.9 (95% CI 1.1-3.2) for ICU admission and 0.9 (95% CI 0.4-2.0) for death. Among hospitalized cases, the case-fatality ratio was 1.8% in HCWs and 8.2% in non-HCWs. Differences may be due to better/earlier access to treatment, differential underascertainment and the healthy worker effect.

Challenges and opportunities facing the Ohio College of Podiatric Medicine.

This article presents the problems and challenges facing the Ohio College of Podiatric Medicine in the view of its President and its Chief Academic Officer. It explores the progress made and the challenges facing the Ohio College overall and in the areas of education. It presents an exciting new vision of the style of podiatric medical education, and the methods that are and will be used to assess the quality of the educational program.

Evaluation of fibrocartilage regeneration and bone response at full-thickness cartilage defects in articulation with pyrolytic carbon or cobalt-chromium alloy hemiarthroplasties.

Hemiarthroplasty is one method used to treat osteoarthritic joints. Often, however, an adverse response of the articular cartilage to the metal implants occurs. The purpose of this study was to evaluate and compare the response of a surgically created defect to pyrolytic carbon and cobalt-based alloy hemiarthroplasties. The cartilage on the lateral side of the tibial plateau of a canine knee joint was abraded to create a full-thickness defect. Two small holes were drilled into the exposed subchondral bone. Next, either a carbon or metal implant was placed in the lateral femoral condyle. The implantation period was 1 year. Histologic examination of the tibial defects revealed a smooth bony surface for both implant groups. In addition, there was no evidence of a residual adverse inflammatory response nor of a significant increase in subchondral bone formation for either group. Surface cracks resulting from the presence of the implant were seen in 14% of the carbon implant specimens and in 100% of the metal implants. Fibrocartilage regeneration was seen in 86% of the carbon implants and in 25% of the metal implants. Thus the carbon appears to be better tolerated mechanically compared to wrought cobalt-chromium alloy. Pyrolytic carbon shows promise for use in hemiarthroplasty.

The tear-drop capsulectomy and capsulorrhaphy: a new approach in aiding the soft tissue repair of hallux abducto valgus.

Capsular correction is an important part of the repair of hallux abducto valgus. In this paper, the authors discuss the tear-drop method of capsular repair--a method that can be used in all hallux valgus corrections, either alone or in conjunction with the dorsolinear capsulotomy and repair. They believe the tear-drop method has many advantages, among which is the fact that severe splinting and/or casting is not needed and the patient can walk in a surgical shoe almost immediately after surgery. Excellent results were obtained in a high percentage of their 288 cases.