INTRODUCTION: The role of the laboratory during the COVID-19 pandemic is not limited to just diagnosis of the disease, but also in clinical decision-making, by providing information on relevant laboratory biomarkers. Clinicians also use Ct value to guide patient management. There are limited studies available locally regarding the significance of Ct value and pertinent laboratory biomarkers in COVID-19 patients. This study aimed to assess the aforementioned laboratory data, along with the clinicopathologic characteristics of affected patients, and determined if this information may be useful for robust clinical decision-makin METHODOLOGY: In this retrospective analytic study, we identified 325 out of 1,049 adult Filipino inpatients diagnosed with COVID-19 and analyzed their Ct values and pertinent laboratory biomarkers such as neutrophil and lymphocyte count, platelet count, LDH, ferritin, procalcitonin, CRP, AST/SGOT, ALT/SGPT, PT/ INR, and D-dimer, and correlated them with the severity of the disease. RESULTS: Two hundred twenty (67.7%) patients had non-severe disease, while 105 (32.3%) had severe disease. Lower Ct values of ORF1ab (median = 26.4) and N (median = 24.8) genes were seen in the severe group compared to the non-severe group and were found to be significant (p<0.001). Laboratory markers (neutrophil, platelet counts, LDH, ferritin, procalcitonin, CRP, AST, PT/INR, and D-dimer) were associated with severe COVID-19. On the other hand, ALT was not associated with severe disease. CONCLUSION The laboratory biomarkers together with Ct value and overall clinical picture may provide valuable information to physicians for more robust clinical decision-making.
COVID-19 ; laboratory biomarkers ; SARS-CoV-2 ; RT-PCR

Background: Nanotechnology and nanomedicine are rising novel fields in plastic and reconstructive surgery (PRS).The use of nanomaterials often goes with regenerative medicine. Due to their nanoscale, these materials stimulate repair at the cellular and molecular levels. Nanomaterials may be placed as components of nanocomposite polymers allowing enhancement of overall biochemical and biomechanical properties with improved scaffold properties, cellular attachment, and tissue regeneration. They may also be formulated as nanoparticle-based delivery systems for controlled release of signal factors or antimicrobials, for example. However, more studies on nanoparticle-based delivery systems still need to be done in this field. Nanomaterials are also used as frameworks for nerves, tendons, and other soft tissues.Main body In this mini-review, we focus on nanoparticle-based delivery systems and nanoparticles targeting cells for response and regeneration in PRS. Specifically, we investigate their roles in various tissue regeneration, skin and wound healing, and infection control. Cell surface-targeted, controlled-release, and inorganic nanoparticle formulations with inherent biological properties have enabled enhanced wound healing, tumor visualization/imaging, tissue viability, and decreased infection, and graft/transplantation rejection through immunosuppression. Conclusions Nanomedicine is also now being applied with electronics, theranostics, and advanced bioengineering technologies. Overall, it is a promising field that can improve patient clinical outcomes in PRS.

Antibodies, Viral ; Antibody Formation ; BNT162 Vaccine ; COVID-19/prevention & control* ; Female ; Humans ; Milk, Human ; Pilot Projects ; RNA, Messenger ; Vaccination

This study aims to determine the diagnostic value of a 99mTc-pertechnetate (99m TcO-4) thyroid scan among patients with DTC who underwent thyroidectomy to assess functioning thyroid remnants before radioactive iodine therapy. A retrospective non-experimental cross-sectional design was done to compare the results of the 99m TcO-4 thyroid scan with the patient's post-RAI scan. A review of all our patients' charts was done for eight years, and after excluding those that did not fit the criteria, 70 patients were included in the study. Data collected was analyzed on a "per patient" basis– where patients either had a "positive scan" or "negative scan", and on a "per lesion" basis – where every lesion's presence and size were compared on both modalities. 99m TcO-4 thyroid scan in the "per patient" analysis showed a sensitivity of 73.91%, specificity of 100%, positive predictive value (PPV) or 100%, and accuracy of 74.29%, however, negative predictive value was determined to be 5.26%. In the "per lesion" analysis, the scan had a less favorable performance with the computed sensitivity of 61.69%, PPV of 94.93%, and accuracy at 59.41%. It was then concluded that 99mTc-pertechnetate scan may be useful in determining functioning remnant thyroid tissue and subsequent management of DTC patients after thyroidectomy, but must take note of its low negative predictive value.
Thyroid Neoplasms

INTRODUCTION: Chest radiographs (CXRs) are widely used for the screening and management of COVID-19. This article describes the radiographic features of COVID-19 based on an initial national cohort of patients. METHODS: This is a retrospective review of swab-positive patients with COVID-19 who were admitted to four different hospitals in Singapore between 22 January and 9 March 2020. Initial and follow-up CXRs were reviewed by three experienced radiologists to identify the predominant pattern and distribution of lung parenchymal abnormalities. RESULTS: In total, 347 CXRs of 96 patients were reviewed. Initial CXRs were abnormal in 41 (42.7%) out of 96 patients. The mean time from onset of symptoms to CXR abnormality was 5.3 ± 4.7 days. The predominant pattern of lung abnormality was ground-glass opacity on initial CXRs (51.2%) and consolidation on follow-up CXRs (51.0%). Multifocal bilateral abnormalities in mixed central and peripheral distribution were observed in 63.4% and 59.2% of abnormal initial and follow-up CXRs, respectively. The lower zones were involved in 90.2% of initial CXRs and 93.9% of follow-up CXRs. CONCLUSION In a cohort of swab-positive patients, including those identified from contact tracing, we found a lower incidence of CXR abnormalities than was previously reported. The most common pattern was ground-glass opacity or consolidation, but mixed central and peripheral involvement was more common than peripheral involvement alone.
COVID-19 ; Humans ; Lung/diagnostic imaging* ; Radiography, Thoracic ; Retrospective Studies ; SARS-CoV-2 ; Singapore

Background: COVID-19 caused educational institutions to transition online, necessitating tailored interventions in spreading factual information. Formal learning in the Philippines has yet to resume physically. Objectives: This methodological and formative research sought to develop a contextualized, home-based, and age-appropriate COVID-19 prevention curriculum for Filipinos within ages 5-8, 9-12, and 13-16. This articledescribes the process of co-developing the curriculum and identifying key themes in curriculum development which may be relevant to low-middle income countries (LMIC). Methodology: Preliminary curriculum materials were developed based on COVID-19 prevention literature and existing health promotion materials. A focus group discussion (FGD) with eight subject experts was conducted to explore the barriers and facilitators to knowledge and behavioral change. Results were analyzed thematically using predetermined themes: content, structure, delivery, and appropriateness to context. Results: The co-development provided insights through academic, professional, and cultural lenses. Subthemes were generated from content, delivery, structure, and appropriateness to context recommending the use of activities that are engaging and empowering to the child and providing support for carers. Curriculum key outcomes of this research include a clearer, comprehensive, accurate, and contextualized curriculum in relation to the target age groups. Conclusion Curriculum co-development may be improved by involving key persons in the community. To promote behavioral change and hygienic practices among Filipino children, active, constructive, and interactive learning methods, as well as a motivational approach, must be employed. Major findings for curriculum effectiveness highlighted the importance of the following: prevention-focused materials, accurate and updated information, summary provisions at the curriculum's end, availability of activity materials, household involvement, and open-ended activities. Future research may work on contextualizing other health literacy curricula to the local context and tailoring interventions at the community level.
COVID-19 ; Curriculum ; Hygiene ; Child

Objectives: Known for their poor outcomes, triple negative breast cancers (TNBCs) have been investigated for immune checkpoint inhibitors that target Programmed death ligand 1 (PD-L1). In the recent decade, tumor-infiltrating lymphocytes (TILs) have also become potential biomarkers. The aim of the study is to determine the reproducibility of PD-L1 scoring system for TNBC (SP142 clone) and TILs interpretation in the local setting through intra- and interobserver agreement. Methodology: Forty-three primary resection specimens TNBC were evaluated on two occasions with PD-L1 (Roche VENTANA SP142 assay) and TILs by two breast pathologists and one general pathologist on physical glass slides. PD-L1 expression was determined by at least 1% positivity among immune cells within the tumoral area and contiguous peritumoral stroma while TILs was assessed based on International Immuno-Oncology Biomarker Working Group on Breast Cancer. Kappa statistic for PD-L1 and TILs categories while intraclass correlation coefficient (ICC) were assessed, with cutoffs of 0.80 and 0.70, respectively. Results: The overall interrater kappa statistic for PD-L1 on the first and second rounds were weak at 0.506 (95% CI: 0.334-0.679) and minimal at 0.314 (95% CI: 0.142-0.487), respectively. Intraobserver kappa statistic for PD-L1 were varied across the three readers while interobserver kappa values for PD-L1 showed none (0.181) to moderate (0.789) agreement. The TILs intraobserver reliability showed poor to good agreement, with the highest ICC of 0.889 (95% CI: 0.805-0.938). Conclusion This study demonstrated variable intra and interobserver agreement for both TILs and PD-L1 expression. Although it is desirable to have strong to almost perfect agreement, the kappa and ICC values suggest additional room for improvement. In light of the repercussions in management of patients who will undergo immune checkpoint inhibitor therapy, regular training sessions, concurrences of equivocal results, and possible use of digital pathology as a medium in interpreting TILs and PD-L1 stains to achieve consistent results.
Breast Neoplasms ; Triple Negative Breast Neoplasms ; Immunohistochemistry