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Motivation to obtain potential COVID-19 vaccinations pursuing the COVID-19 outbreak throughout Shanghai, Cina.
Purpose The purpose of this study was to investigate the reported rates and characteristics of injuries among CrossFit athletes with specific attention to the hand and wrist. We further sought to identify trends and associations of these injuries by examining demographic data. Methods A questionnaire was created to capture self-reported information on the incidence of hand or wrist injuries and their associations in CrossFit athletes. It was distributed between April 2020 and July 2020 to athletes training at CrossFit affiliated gyms in the New York and Pennsylvania regions. Bivariate logistic regression analysis was used to identify factors correlated with an injury. Results A total of 270 responses (97.5% response rate) were available for final analysis. The median age of respondents was 34 years and 72.2% had been participating in CrossFit for at least two years. CrossFit athletes reported injury rates of 62.2% while engaged in CrossFit training and 20.4% reported an injury specific to the hand or wrist. Tfindings and address both therapies and preventative measures for these types of injuries with their patients.Tumor lysis syndrome, an oncological emergency, is characterized by laboratory parameters such as hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia, as well as renal injury with an elevated creatinine. Tumor lysis syndrome is seen in patients with aggressive malignancies and high tumor burden. More frequently, it occurs in individuals with hematologic malignancies such as high-grade lymphomas (such as Burkitt lymphoma) and leukemia (such as acute lymphocytic leukemia). It also, albeit less commonly, can be seen in patients with widespread solid tumors that are rapidly proliferating and are markedly sensitivity to antineoplastic therapy. Tumor lysis syndrome is usually preceded by cancer-directed therapy; however, the syndrome can present spontaneously prior to the individual receiving malignancy-directed treatment. We reported a man with metastatic salivary duct carcinoma who had cutaneous metastases that presented as carcinoma hemorrhagiectoides. Microscopic examination demonstrated that the metastatic tumor cells had infiltrated and replaced the entire dermis. After the patient received his first dose of antineoplastic therapy, he had an excellent response and the cutaneous metastases developed into ulcers; we hypothesize that most of the dermis, which had been replaced by tumor cells, disappeared as a result of the therapeutic response, and the overlying epidermis became necrotic and shed, leaving an ulcer. His dramatic response to treatment prompted us to propose a new classification of tumor lysis syndrome, which should include the systemic form of the condition as well as the new variant cutaneous tumor lysis syndrome. We anticipate that, with improvement in targeted therapies, there may be an increase in therapy-associated cutaneous tumor lysis syndrome.Capnocytophaga canimorsus is a gram-negative rod that is part of the commensal flora of dogs' mouths. Among splenectomized patients who maintain close contact with dogs, the bacteria can lead to infection and fulminant sepsis even without evidence of a skin breach. In this report, we describe the case of a 71-year-old woman who had undergone splenectomy 35 years ago. She came to our emergency department complaining of back pain, myalgia, asthenia, and a fever of 40.2ºC. No other symptoms were noted upon her admission. Blood workup revealed hyperlacticaemia, increased C-reactive protein, and lymphopenia. A urinalysis and chest radiography were ordered, with no abnormal findings, and the SARS-CoV-2 test was negative. The patient developed persistent hypotension and drowsiness that did not improve with intravenous fluids. Therefore, she was started on a norepinephrine infusion. Cultures were collected, and intravenous antibiotic therapy was started with amoxicillin/clavulanic acid 2.2 mg and azithromycin 500 mg. Besides all the diagnostic tests, no infectious cause was found. On the second day of hospitalization, she started to deteriorate, and antibiotic therapy was escalated to piperacillin/tazobactam 4.5 g, resulting in a good clinical response. On the third day after admission, thanks to a group discussion, we were able to identify C. canimorsus in the patient's blood cultures. A review of history revealed that the patient was in close contact with her pet dog. This case highlights the importance of a multidisciplinary discussion, including the microbiology team, in order to reach an uncommon diagnosis. When dealing with splenectomized individuals presenting with the septic shock of unclear origin, a history of close contact with dogs must lead clinicians to consider C. canimorsus as a causative agent.We present the case of a 91-year-old patient scheduled for a preoperative telehealth evaluation who was found to have altered mental status from an acute stroke. Her care, if delayed, could have caused permanent morbidity during the coronavirus disease 2019 (COVID-19) pandemic. This case highlights the digital leap the pandemic spurred 1. telehealth in the elderly, 2. PY-60 nmr meaningful history and physical during telehealth visit, 3. family engagement and education, and 4. meaningful impact on patient outcomes.Chylothorax is a rare postoperative complication of congenital heart surgery. It has high morbidity with increased hospital stay and cost of treatment. Damage to the thoracic duct, disruption of accessory lymphatic vessels, and increased venous pressure exceeding that in the thoracic duct have been proposed as the possible causes of chylothorax after surgery for congenital heart disease. Prompt diagnose with early initiation of treatment will reduce the duration of drainage. Staged treatment is the general principle in managing this serious complication. Loss of chyle leads to volume, nutritional and electrolyte depletion, immunological deficiencies and hematological complications. Identifying the underlying cause and addressing it is crucial to definitive management.Infective endocarditis and vertebral osteomyelitis are rare infections, most commonly caused by methicillin-sensitive Staphylococcus aureus (MSSA). The eustachian valve is an embryological remnant of the inferior vena cava that has the potential to harbor a nidus leading to infective endocarditis. Eustachian valve endocarditis has been documented in the literature on less than 50 occasions and has yet to be documented in the presence of concomitant vertebral osteomyelitis. In this case, we present a 43-year-old male presenting with vertebral osteomyelitis caused by methicillin-resistant Staphylococcus aureus (MRSA). Persistent bacteremia prompted the identification of vegetative growth on a eustachian valve remnant. This case helps mend the gap in the literature by documenting the treatment considerations in a patient with eustachian valve endocarditis in the presence of osteomyelitis caused by MRSA.
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