MATERIALS AND METHODS: This was a single-centre retrospective cohort study comprising patients admitted to a state hospital in Selangor, Malaysia, between August and October 2021. The demographic data, clinical characteristics, presenting complaints, laboratory tests, organ dysfunction, use of invasive ventilation, intensive care unit (ICU) admissions, length of hospitalisation and mortality were collected and analysed.
RESULTS: The analysis involved a total of 195 cases. More than a quarter of the cases (52 [26.7%]) were related to the initial COVID-19 infection. Nine cases (4.6%) required mechanical ventilation, while eight cases (4.1%) were admitted to the ICU. The overall mortality was 17 cases (8.7%). Surviving patients were younger (49.5 vs. 58.4 years), less likely to have diabetes mellitus (48.3% vs. 82.4%), or chronic kidney disease (12.9% vs. 41.2%); had higher levels of admission haemoglobin (12.6 vs. 9.1g/dL) and albumin (33.0 vs. 21.0g/L); lower white blood cells (10.2 vs. 13.0 × 109/L), creatinine (81.2 vs. 151.9μmol/L) and C-reactive protein (18.2 vs. 135.0mg/L) at admission; less likely to have MI (6.7% vs. 23.5%), sepsis (3.4% vs. 47.1%), or acute kidney injury (3.4% vs. 17.6%) and organ dysfunction (25.3% vs. 94.1%).
CONCLUSION: Approximately a quarter of patients were admitted or readmitted due to direct COVID-19 complications between 21 and 90 days of illness. The baseline oxygen requirements at admission were independently associated with mortality, invasive mechanical ventilation and ICU admissions. Further research is needed to establish a risk model for patients returning to a hospital to predict their risk of post-COVID complications.
METHODS: A total of 50 SLPs and 67 speech-language pathology students completed the Clinician Attitudes Towards Stuttering (CATS) inventory. There were eight domains of attitudes toward stuttering: (a) etiology, (b) early intervention, (c) therapeutic efficacy, (d) personalities of PWS, (e) clinician expertise and roles, (f) teacher/counsellor roles and client/public reactions, (g) therapy strategies, and (h) parent attitudes. Descriptive data were presented and Multivariate Analysis of Variance was conducted to examine the effects of clinical certification on the eight domains of attitudes toward stuttering.
RESULTS: Participants who possessed a clinical certification were more accepting toward the personalities of people who stutter (PWS) and therapy strategies. On the other hand, participants without a clinical certification were more accepting toward clinician expertise and roles.
CONCLUSIONS: Current curriculum and professional training should be re-evaluated to remediate less accepting stereotypes held by SLPs and students toward PWS and to enhance essential skills such as counselling.
EDUCATIONAL ACTIVITY AND SETTING: A one day accelerated dispensing course using MyDispense software was delivered to 59 GE students. The accelerated dispensing course was identical to the standard three-week dispensing course delivered to UG students. The same assessment of dispensing skills was conducted after course completion for both UG and GE students and included dispensing four prescriptions of varying difficulty. The assessment scores of the UG and GE students were compared. Perception data from the accelerated course were also collected.
FINDINGS: The accelerated dispensing curriculum was well received by students. They found the simulation relevant to practice, easy to navigate, and helpful for preparing them for assessment. Overall, 5.1% of GE students failed the assessment, which was lower than the 32.6% failure rate in the UG cohort. Comparison of assessment grades between UG and GE students showed no notable disadvantage to attainment of learning outcomes with the accelerated curriculum. However, UG students were more likely to provide unsafe instructions compared to GE students in their labeling for three out of four prescriptions.
SUMMARY: An accelerated dispensing curriculum can be effectively delivered to mature learners with a prior science-related degree as no notable deficiencies were identified when comparing the assessment results of GE students against UG students when both student cohorts undertook the same dispensing assessment.
CASE REPORT: We present a rare case of metastatic alveolar RMS from a nasal primary to cervical lymph nodes (LNs) in an elderly patient, diagnosed on the fine-needle aspiration (FNA) biopsy. Smears showed malignant round cells featuring focal rhabdoid appearance, with rhabdomyoblastic differentiation further supported by immunocytochemical stains. Diagnosis of alveolar RMS was confirmed by fluorescence in situ hybridization (FISH) identifying FOXO1 gene involvement with dual colour break-apart probes at locus 13q14.
DISCUSSION: The differential diagnosis for a small round blue cell tumour in the elderly generally includes metastatic small cell carcinoma, lymphoma, malignant melanoma, RMS, desmoplastic small round cell tumour and Ewing's sarcoma/primitive neuroectodermal tumour. Subtle morphological analysis and expression pattern of immunostaining for skeletal muscle differentiation led to the diagnosis of RMS. Cytogenetic testing on the FOXO1 gene rearrangement helps definite subtyping of alveolar RMS.