Older adults (65+) are at an increased risk of contracting COVID-19 and have higher incidences of adverse events. Nursing home residents are particularly vulnerable due to congregate living and the need for personal care. CMS has issued many guidelines on best nursing home practice and care since March of 2020. In June of 2020, the ISDH conducted statewide nursing home testing for all residents and staff.
To assess the attitudes and beliefs of nursing home staff, regarding their experience with COVID-19 testing, working in a pandemic, and uptake of a future vaccine.
Malignant mesothelioma typically presents in patients with asbestos exposure, with respiratory symptoms caused by primary pleural involvement with associated pleural effusion. Instead, this patient presented with a rapidly growing posterior mediastinal mass, without a pleural lesion or known asbestos exposure. Common differential diagnosis for posterior mediastinal masses usually indudes neurogenic tumors (accounts for 60%), meningoceles, and spinal lesions. and did not include mesothelioma prior to this encounter (1 ). Repeated pleural fluid analyses and EBUS-FNA tissue samples were insufficient to yield a definitive diagnosis and resulted in delay of diagnosis and subsequently significant growth and progression of the patient's disease. Treatment options remain mostly palliative with prognosis typically less than 12 months, but if detected early, a combination of chemotherapy/ surgery regimens can prolong survival to an average of 22 months (2).
Ambulances are a target for theft and reportings of ambulance thefts has been increasing in the past several years. There is a paucity of research in this area, as a PubMed search of the terms "ambulance theft" yields only one relevant article: Alves OW, Bissel RA. Ambulance Snatching: How vulnerable are we? J Emerg Med. 2003; 25(2):211-214.
Rubella was first described in the 1750s but took until 1941 when Congenital Rubella Syndrome was characterized to become medically significant. Similarly, zika virus was discovered in 1947 but only made headlines in 2016 when its infection during pregnancy was associated with fetal microcephaly. Interestingly, despite zika being primarily a disease of the developing world and rubella historically being a world wide disease. Zika was found to have been studied and controlled al a much faster rate than rubella - particularly in the United Slates (U.S.). This correlation is further highlighted by the fact that there are currently no therapies or vaccines available for zika. A review of Thomas McKeown's work, the McKeown Thesis, provides insight into the U.S.'s successful zika control. The Thesis posits that broad based social efforts at the population level are more significant at affecting public health than narrow•based medical interventions at the individual level. The swift control of zika despite the lack of specific therapeutics suggests the McKeown Thesis's applications. This presentation will reflect on the progress and history of medicine within the past century and demonstrate the need for continued vigilance within the medical community.
Reported cases of isolated fetal ascites determined to be idiopathic have been shown to carry a favorable prognosis with frequent spontaneous resolution in utero (1,2,3). These cases generally reported better fetal outcomes with delivery of normal neonates as compared to cases with associated conditions such as gastrointestinal and genitourinary abnormalities, intrauterine infections, and overlapping cases with hydrops (1). No existing reports of antenatally resolving fetal ascites with a discovered gastrointestinal anomaly describe concurrent resolution of the underlying abnormality without surgical correction or postpartum regression with medical management In this case, fetal ascites was prenatally diagnosed on ultrasound at 32 weeks secondary to a suspected gastrointestinal abnormality and was found to have spontaneously resolved in utero with a normal neonatal course.
Over 1.25 million people reside in nursing facilities in the United States. Nursing facilities have reported 268,707 confirmed cases of COVID-19 and 61,765 COVID-19 deaths as of the week of November 2, 2020. Indiana was one of the first states to implement guidance to re-open nursing facility visitation, starting with outdoor visits in March of 2020. Without family visits or other outside social contacts, residents may become lonely, despondent, and have feelings of abandonment which may lead to depression, weight loss, and worsened behavioral symptoms of dementia.