The coronavirus disease 2019 pandemic is an unprecedented event, and in order to control its spread and minimize its damages, all efforts are immediately mobilized. Mass vaccination is considered a promising solution to combat this universal issue. However, given the urgent need for vaccine production, some of the side effects may not have been presented during trials and will only appear during the mass vaccination. Limited vasculitis cases have been reported so far following vaccination against COVID-19. We present a case of cutaneous leukocytoclastic vasculitis (LCV) induced following the first dose of the ChAdOx1 nCoV-19 vaccine in an otherwise healthy individual.
Prurigo pigmentosa (PP) is an uncommon inflammatory dermatosis first described in 1971. It is characterized by recurrent crops of pruritic erythematous papulovesicles that resolve with a macular reticulated hyperpigmentation. The exact etiology is yet to be determined, however with the expanded application of the ketogenic diet (KD) in recent years, conditions accompanied with ketosis are more commonly being described in association with PP. Antibiotics as well as resolution of ketosis can effectively treat the dermatitis. Given the publicity and growing popularity of the ketogenic diet and numerous references to the “Keto‐Rash” on social media, we reviewed the KD‐induced PP cases to raise awareness of this increasingly recognized entity and provide an update to clinicians, particularly dermatologists, regarding this possible side effect of KD.
Objectives Our aim was to compare some of the health outcomes and costs associated with value of care in emergency departments (ED) and walk-in clinics for ambulatory patients presenting with an acute respiratory disease. Methods A health records review was conducted from April 2016 through March 2017 in one ED and one walk-in clinic. Inclusion criteria were: (i) ambulatory patients at least 18 years old, (ii) discharged home with a diagnosis of upper respiratory tract infection (URTI), pneumonia, acute asthma, or acute exacerbation of chronic obstructive pulmonary disease. Primary outcome was the proportion of patients returning to any ED or walk-in clinic within three and seven days of the index visit. Secondary outcomes were the mean cost of care and the incidence of antibiotic prescription for URTI patients. The cost of care was estimated from the Ministry of Health's perspectives using time-driven activity-based costing. ResultsThe ED group included 170 patients and the walk-in clinic group 326 patients. The return visit incidences at three and seven days were, respectively, 25.9% and 38.2% in the ED vs. 4.9% and 14.7% in the walk-in clinic (adjusted relative risk (arr) of 4.7 (95% CI 2.6-8.6) and 2.7 (1.9-3.9)). The mean cost ($Cdn) of the index visit care was 116.0 (106.3-125.7) in the ED vs. 62.5 (57.7-67.3) in the walk-in clinic (mean difference of 56.4 (45.7-67.1)). Antibiotic prescription for URTI was 5.6% in the ED vs. 24.7% in the walk-in clinic (arr 0.2, 0.01-0.6). Conclusions This study is the first in a larger research program to compare the value of care between walk-in clinics and the ED. The potential advantages of walk-in clinics over EDs (lower costs, lower incidence of return visits) for ambulatory patients with respiratory diseases should be considered in healthcare planning. KeywordsValue of care • Health outcomes • Respiratory diseases • Outpatient visit • Emergency department • Return visits • Cost of care The results of this study were presented as a Poster at the annual conference of the Canadian Association of Emergency Physicians (CAEP), in Québec on May 30, 2022.
This paper studies the effect of natural ventilation on the spread of the COVID-19 virus from a patient room to an adjacent room with the help of airflow. The importance of this study is since COVID-19 virus contamination can easily transfer with the airflow from one room to the next room or adjacent corridor. This paper aims to determine the effect of natural ventilation on the contamination of the spaces next to the COVID-19 patients’ room.For this evaluation, we have used mechanical modelling and CFD simulation to evaluate the effect of natural ventilation on the transmission of COVID-19 with the airflow from a contaminated space to a clean space. During this study, we have calibrated the CFD model using one actual case, that was studied in a wind tunnel, and verified the modified model with the actual existing case. The simulated CFD model showed a reasonable accuracy for the prediction of ventilation in indoor spaces.Results showing the room geometries with air inlet/outlet that positioned at either bottom or top of the room will result in less COVID contamination dissemination through natural ventilation. In addition, in case of having the inlet/outlet in middle and positioning face to face and as well in the case of having max natural air velocity, the maximum contamination will exhaust from the space.
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