Novel coronavirus and trauma surgery: successful infection control from a level I trauma centre

Abstract Purpose To evaluate the available tibial fracture non-union prediction scores and to analyse their strengths, weaknesses, and limitations. Methods The first part consisted of a systematic method of locating the currently available clinico-radiological non-union prediction scores. The second part of the investigation consisted of comparing the validity of the non-union prediction scores in 15 patients with tibial shaft fractures randomly selected from a Level I trauma centre prospectively collected database who were treated with intramedullary nailing. Results Four scoring systems identified: The Leeds-Genoa Non-Union Index (LEG-NUI), the Non-Union Determination Score (NURD), the FRACTING score, and the Tibial Fracture Healing Score (TFHS). Patients demographics: Non-union group: five male patients, mean age 36.4 years (18–50); Union group: ten patients (8 males) with mean age 39.8 years (20–66). The following score thresholds were used to calculate positive and negative predictive values for non-union: FRACTING score ≥ 7 at the immediate post-operative period, LEG-NUI score ≥ 5 within 12 weeks, NURD score ≥ 9 at the immediate post-operative period, and TFHS < 3 at 12 weeks. For the FRACTING, LEG-NUI and NURD scores, the positive predictive values for the development of non-union were 80, 100, 40% respectively, whereas the negative predictive values were 60, 90 and 90%. The TFHS could not be retrospectively calculated for robust accuracy. Conclusion The LEG-NUI had the best combination of positive and negative predictive values for early identification of non-union. Based on this study, all currently available scores have inherent strengths and limitations. Several recommendations to improve future score designs are outlined herein to better tackle this devastating, and yet, unsolved problem.

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The management of bite wounds in children—A retrospective analysis at a level I trauma centre

Injury ◽

10.1016/j.injury.2012.04.016 ◽

2012 ◽

Vol 43 (12) ◽

pp. 2117-2121 ◽

Cited By ~ 28

Author(s):

Manuela Jaindl ◽

Judith Grünauer ◽

Patrick Platzer ◽

Georg Endler ◽

Christiane Thallinger ◽

...

Keyword(s):

Retrospective Analysis ◽

Trauma Centre ◽

Level I ◽

Bite Wounds

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Coronavirus Disease 2019 (COVID-19): Emerging and Future Challenges for Dental and Oral Medicine

Journal of Dental Research ◽

10.1177/0022034520914246 ◽

2020 ◽

Vol 99 (5) ◽

pp. 481-487 ◽

Cited By ~ 364

Author(s):

L. Meng ◽

F. Hua ◽

Z. Bian

Keyword(s):

Public Health ◽

Infection Control ◽

Control Measures ◽

World Health ◽

Infection Control Measures ◽

Dental Practitioners ◽

The World ◽

Essential Knowledge ◽

Novel Coronavirus ◽

Health Organization

The epidemic of coronavirus disease 2019 (COVID-19), originating in Wuhan, China, has become a major public health challenge for not only China but also countries around the world. The World Health Organization announced that the outbreaks of the novel coronavirus have constituted a public health emergency of international concern. As of February 26, 2020, COVID-19 has been recognized in 34 countries, with a total of 80,239 laboratory-confirmed cases and 2,700 deaths. Infection control measures are necessary to prevent the virus from further spreading and to help control the epidemic situation. Due to the characteristics of dental settings, the risk of cross infection can be high between patients and dental practitioners. For dental practices and hospitals in areas that are (potentially) affected with COVID-19, strict and effective infection control protocols are urgently needed. This article, based on our experience and relevant guidelines and research, introduces essential knowledge about COVID-19 and nosocomial infection in dental settings and provides recommended management protocols for dental practitioners and students in (potentially) affected areas.

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Potential impact of seasonal forcing on a SARS-CoV-2 pandemic

10.1101/2020.02.13.20022806 ◽

2020 ◽

Cited By ~ 10

Author(s):

Richard A. Neher ◽

Robert Dyrdak ◽

Valentin Druelle ◽

Emma B. Hodcroft ◽

Jan Albert

Keyword(s):

Seasonal Variation ◽

Infection Control ◽

Transmission Rate ◽

Health Care Systems ◽

Control Measures ◽

Rate Variation ◽

Small Peak ◽

Infection Control Measures ◽

Care Systems ◽

Novel Coronavirus

A novel coronavirus (SARS-CoV-2) first detected in Wuhan, China, has spread rapidly since December 2019, causing more than 80,000 confirmed infections and 2,700 fatalities (as of Feb 27, 2020). Imported cases and transmission clusters of various sizes have been reported globally suggesting a pandemic is likely.Here, we explore how seasonal variation in transmissibility could modulate a SARS-CoV-2 pandemic. Data from routine diagnostics show a strong and consistent seasonal variation of the four endemic coronaviruses (229E, HKU1, NL63, OC43) and we parameterize our model for SARS-CoV-2 using these data. The model allows for many subpopulations of different size with variable parameters. Simulations of different scenarios show that plausible parameters result in a small peak in early 2020 in temperate regions of the Northern Hemisphere and a larger peak in winter 2020/2021. Variation in transmission and migration rates can result in substantial variation in prevalence between regions.While the uncertainty in parameters is large, the scenarios we explore show that transient reductions in the incidence rate might be due to a combination of seasonal variation and infection control efforts but do not necessarily mean the epidemic is contained. Seasonal forcing on SARS-CoV-2 should thus be taken into account in the further monitoring of the global transmission. The likely aggregated effect of seasonal variation, infection control measures, and transmission rate variation is a prolonged pandemic wave with lower prevalence at any given time, thereby providing a window of opportunity for better preparation of health care systems.

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Assessment of knowledge, attitude and practices among dental practitioners on methods of infection control while carrying out dental procedures during novel Coronavirus (COVID-19) pandemic

Pan African Medical Journal ◽

10.11604/pamj.2021.39.265.29003 ◽

2021 ◽

Vol 39 ◽

Author(s):

Neetha Shenoy ◽

Vasudev Ballal ◽

Usha Rani ◽

Himani Kotian ◽

Vani Lakshmi

Keyword(s):

Infection Control ◽

Dental Procedures ◽

Dental Practitioners ◽

Novel Coronavirus

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Stepping up infection control measures in ophthalmology during the novel coronavirus outbreak: an experience from Hong Kong

Graefe s Archive for Clinical and Experimental Ophthalmology ◽

10.1007/s00417-020-04641-8 ◽

2020 ◽

Vol 258 (5) ◽

pp. 1049-1055 ◽

Cited By ~ 122

Author(s):

Tracy H. T. Lai ◽

Emily W. H. Tang ◽

Sandy K. Y. Chau ◽

Kitty S. C. Fung ◽

Kenneth K. W. Li

Keyword(s):

Hong Kong ◽

Infection Control ◽

Control Measures ◽

The Novel ◽

Infection Control Measures ◽

Novel Coronavirus

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Did Amendments to the Ontario Highway Traffic Act in 2009-2010 Affect the Proportion of Alcohol-Related Motor Vehicle Collisions Seen at a Level I Trauma Centre over a 10-year Period?

CJEM ◽

10.1017/cem.2016.343 ◽

2016 ◽

Vol 19 (2) ◽

pp. 106-111

Author(s):

Meghan Garnett ◽

Tanya Charyk Stewart ◽

Michael R Miller ◽

Rodrick Lim ◽

Kristine Van Aarsen ◽

...

Keyword(s):

Injury Severity ◽

Trauma Registry ◽

Motor Vehicle ◽

Trauma Centre ◽

Trauma Patients ◽

Highway Traffic ◽

Motor Vehicle Collisions ◽

Vehicle Collisions ◽

Level I ◽

Legislative Amendments

AbstractObjectivesTo determine if changes to the Ontario Highway Traffic Act (OHTA) in 2009 and 2010 had an effect on the proportion of alcohol-related motor vehicle collisions (MVCs) presenting to a trauma centre over a 10-year period.MethodsA retrospective review of the trauma registry at a Level I trauma centre in southwestern Ontario was undertaken. The trauma registry is a database of all trauma patients with an injury severity score (ISS) ≥12 and/or who had trauma team activation. Descriptive statistics were calculated. Interrupted time series analyses with ARIMA modeling were performed on quarterly data from 2004-2013.ResultsA total of 377 drivers with a detectable serum ethanol concentration (SEC) were treated at our trauma centre over the 10-year period, representing 21% of all MVCs. The majority (330; 88%) were male. The median age was 31 years, median SEC was 35.3 mmol/L, and median ISS was 21. A total of 29 (7.7%) drinking drivers died from their injuries after arriving to hospital. There was no change in the proportion of drinking drivers after the 2009 amendment, but there was a significant decline in the average SEC of drinking drivers after changes to the law. There was no difference in the proportion of drinking drivers ≤21 years after introduction of the 2010 amendment for young and novice drivers.ConclusionsThere was a significance decline in the average SEC of all drinking drivers after the 2009 OHTA amendment, suggesting that legislative amendments may have an impact on drinking before driving behaviour.

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