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Bestilleiro RS, Señaris DM, Rodríguez MJP, Vázquez RG, Rodríguez RG, Rodriguez MTG, Martín CG, Pillado MTS, Barreiro VB, Valiña VV, Díaz SP. Nosocomial Infection Outbreak due to SARS-COV-2 in a Hospital Unit of Particularly Vulnerable Patients. Int J Med Sci 2021; 18:2146-2154. [PMID: 33859521 PMCID: PMC8040424 DOI: 10.7150/ijms.53270] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 01/19/2021] [Indexed: 01/08/2023] Open
Abstract
Objectives: To report a COVID-19 outbreak among workers and inpatients at a medical ward for especially vulnerable patients. Methods: Descriptive study of a nosocomial COVID-19 outbreak registered in March-April 2020 at medical ward of onco-hematological patients in an Spanish hospital. Confirmed cases were hospitalized patients, healthcare and non-healthcare workers who tested positive by PCR on a nasopharyngeal swab. Results: Twenty-two COVID-19 cases (12 workers and 10 inpatients) were laboratory-confirmed. Initial cases were a healthcare provider and a visitor who tested positive. The median patients age was 73 years (range 62-88). The main reason of admission was haematological in 8 patients and oncologic in 2. All patients followed an immunosuppressive treatment, 5/10 with high-flow oxygen nebulizations. Five patients presented a moderate/serious evolution, and 5 patients died. The mean workers age was 42.1±10.9. One healthworker required Intensive Care Unit admission, and all of them recovered completely. Conclusions: In the hospital setting, close patients surveillance for SARS-CoV-2 is essential, especially in immunosuppressed patients. Replacing nebulizations or high-flow oxygen therapies, when other equivalent options were available, to reduce dispersion, and controlling ventilation ducts, together with hygiene measures and an active follow-up on inpatients, visitors and workers appear to be important in preventing nosocomial outbreaks.
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Affiliation(s)
- Rocío Seijo Bestilleiro
- Research group in Nursing and Health Care, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade da Coruña, A Coruña, Spain
- Haematology and Haemotherapy Department, Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, A Coruña, Spain
| | - Diana Martinez Señaris
- Haematology and Haemotherapy Department, Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, A Coruña, Spain
| | - María José Pereira Rodríguez
- Preventive Medicine Department, Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, A Coruña, Spain
| | - Rita Galeiras Vázquez
- Intensive Care Unit, Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, A Coruña, Spain
| | - Raquel García Rodríguez
- Preventive Medicine Department, Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, A Coruña, Spain
| | - María Teresa García Rodriguez
- Research group in Nursing and Health Care, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade da Coruña, A Coruña, Spain
| | - Cristina González Martín
- Research group in Nursing and Health Care, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade da Coruña, A Coruña, Spain
- Research group in Rheumatology and Health, Universidade da Coruña, A Coruña, Spain
| | - María Teresa Seoane Pillado
- Research group in Nursing and Health Care, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade da Coruña, A Coruña, Spain
- Research group in Rheumatology and Health, Universidade da Coruña, A Coruña, Spain
| | - Vanesa Balboa Barreiro
- Research group in Nursing and Health Care, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade da Coruña, A Coruña, Spain
- Research group in Rheumatology and Health, Universidade da Coruña, A Coruña, Spain
| | - Valentín Valdés Valiña
- Haematology and Haemotherapy Department, Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, A Coruña, Spain
| | - Sonia Pértega Díaz
- Research group in Nursing and Health Care, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade da Coruña, A Coruña, Spain
- Research group in Rheumatology and Health, Universidade da Coruña, A Coruña, Spain
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García Novoa A, Acea Nebril B, Díaz I, Builes Ramírez S, Varela C, Cereijo C, Mosquera Oses J, López Calviño B, Seoane Pillado MT. Axillary radiotherapy in conservative surgery for early-stage breast cancer (stage I and II). Cir Esp 2016; 94:331-8. [PMID: 27256280 DOI: 10.1016/j.ciresp.2016.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Revised: 04/04/2016] [Accepted: 04/06/2016] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Several clinical studies analyze axillary treatment in women with early-stage breast cancer because of changes in the indication for axillary lymph node dissection. The aim of the study is to analyze the impact of axillary radiotherapy in disease-free and overall survival in women with early breast cancer treated with lumpectomy. METHODS Retrospective study in women with initial stages of breast carcinoma treated by lumpectomy. A comparative analysis of high-risk women with axillary lymph node involvement who received axillary radiotherapy with the group of women with low risk without radiotherapy was performed. Logistic regression was used to determine factors influencing survival and lymphedema onset. RESULTS A total of 541 women were included in the study: 384 patients (71%) without axillary lymph node involvement and 157 women (29%) with 1-3 axillary lymph node involvement. Patients with axillary radiotherapy had a higher number of metastatic lymph node compared to non-irradiated (1.6±0.7 vs. 1.4±0.6, P=.02). The group of women with axillary lymph node involvement and radiotherapy showed an overall and disease-free survival at 10 years similar to that obtained in patients without irradiation (89.7% and 77.2%, respectively). 3 lymph nodes involved multiplied by more than 7 times the risk of death (HR=7.20; 95% CI: 1.36 to 38.12). The multivariate analysis showed axillary lymph node dissection as the only variable associated with the development of lymphedema. CONCLUSION The incidence of axillary relapse on stage I and II breast cancer is rare. In these patients axillary radiotherapy does not improve overall survival, but contributes to regional control in those patients with risk factors.
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Affiliation(s)
- Alejandra García Novoa
- Unidad de Mama, Servicio de Cirugía General y del Aparato Digestivo, Complejo Hospitalario Universitario de A Coruña, La Coruña, España.
| | - Benigno Acea Nebril
- Unidad de Mama, Servicio de Cirugía General y del Aparato Digestivo, Complejo Hospitalario Universitario de A Coruña, La Coruña, España
| | - Inma Díaz
- Servicio de Radioterapia, Centro Oncológico de Galicia, La Coruña, España
| | - Sergio Builes Ramírez
- Unidad de Mama, Servicio de Cirugía General y del Aparato Digestivo, Complejo Hospitalario Universitario de A Coruña, La Coruña, España
| | - Cristina Varela
- Unidad de Mama, Servicio de Cirugía General y del Aparato Digestivo, Complejo Hospitalario Universitario de A Coruña, La Coruña, España
| | - Carmen Cereijo
- Unidad de Mama, Servicio de Cirugía General y del Aparato Digestivo, Complejo Hospitalario Universitario de A Coruña, La Coruña, España
| | - Joaquín Mosquera Oses
- Unidad de Mama, Servicio de Cirugía General y del Aparato Digestivo, Complejo Hospitalario Universitario de A Coruña, La Coruña, España
| | - Beatriz López Calviño
- Unidad de Estadística y Epidemiología, Complejo Hospitalario Universitario de A Coruña, La Coruña, España
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