We compared the mortality rate among patients suspected of having Crimean-Congo hemorrhagic fever (CCHF) who received treatment with oral ribavirin and those who did not. Ninety-seven (69.8%) of 139 treated patients suspected of having CCHF survived, and 61 (88.9%) of 69 treated patients with confirmed CCHF survived. The efficacy of oral ribavirin was 80% among patients with confirmed CCHF and 34% among patients suspected of having CCHF. Considering the limitations of observational studies, we conclude that oral ribavirin is an effective treatment for the hemorrhagic form of CCHF.
To determine the need and appropriate timing of catheter removal in patients with candidemia, the records for 404 patients with cancer and central venous catheters (CVCs) who developed candidemia during the period of 1993-1998 were retrospectively reviewed. Of the total 404 cases of candidemia, 241 (60%) were due to a primary source, 111 (27%) were catheter related, and 52 (13%) were secondary cases of candidemia caused by a source other than the catheter. Multivariate analysis showed that catheter removal р72 h after onset improved response to antifungal therapy exclusively in patients with catheter-related candidemia ( ). P p .04 Clinical characteristics that suggested a noncatheter source for the candidemia were disseminated infection ( ), previous chemotherapy ( ), previous corticosteroid therapy ( ), and poor response to P ! .01 P ! .01 P p .02 antifungal therapy ( ). CVC removal р72 h after onset should be considered in patients with suspected P ! .03 catheter-related candidemia who have no evidence of dissemination, recent corticosteroid therapy, or chemotherapy.
Objective
We aimed to explore anxiety status across a broad range of HCWs supporting patients with COVID-19 in different global regions.
Method
This was an international online survey in which participation was on voluntary basis and data were submitted via Google Drive, across a two-week period starting from March 18, 2020. The Beck Anxiety Inventory was used to quantify the level of anxiety.
Results
1416 HCWs (70.8% medical doctors, 26.2% nurses) responded to the survey from 75 countries. The distribution of anxiety levels was: normal/minimal (
n
= 503, 35.5%), low (
n
= 390, 27.5%); moderate (
n
= 287, 20.3%), and severe (
n
= 236, 16.7%). According to multiple generalized linear model, female gender (
p
= 0.001), occupation (ie, being a nurse dealing directly with patients with COVID-19 [
p
= 0.017]), being younger (
p
= 0.001), reporting inadequate knowledge on COVID-19 (
p
= 0.005), having insufficient personal protective equipment (p = 0.001) and poor access to hand sanitizers or liquid soaps (
p
= 0.008), coexisting chronic disorders (p = 0.001) and existing mental health problems (p = 0.001), and higher income of countries where HCWs lived (
p
= 0.048) were significantly associated with increased anxiety.
Conclusions
Front-line HCWs, regardless of the levels of COVID-19 transmission in their country, are anxious when they do not feel protected. Our findings suggest that anxiety could be mitigated ensuring sufficient levels of protective personal equipment alongside greater education and information
.
This study aimed to investigate the clinical and epidemiologic features of Crimean-Congo hemorrhagic fever among 34 children and adolescents (mean age, 13.3 +/- 4.6 years) from a highly endemic region. Clinical manifestations were similar to those in adults. The case-fatality ratio was 26.5% (9 of 34). Compared with adult patients, children and adolescents may be more vulnerable to severe and fatal Crimean-Congo hemorrhagic fever.
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