scholarly journals SP4.1.12 The impact of COVID-19 on the pattern of presentations with acute lower gastrointestinal bleeding

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Neale Marlow ◽  
John McNamara ◽  
Roshneen Ali ◽  
Michaela James ◽  
Tom Bentley ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Search Strategy ◽  
Graphical Representation ◽  
Negative Impact ◽  
Lower Gastrointestinal Bleeding ◽  
University Hospital ◽  
Emergency Unit ◽  
Clinical Coding ◽  
Context Data ◽  
The Impact

Abstract Aims Following the initial surge of COVID-19 cases in Spring 2020, data began to emerge on the negative impact of the disease on outcomes for serious medical conditions such as heart disease and stroke. However, the impact of COVID-19 on the pattern of emergency presentations with lower gastrointestinal bleeding (LGIB) has not been published to date. Methods We designed a clinical coding search strategy to identify all adult patients with acute LGIB presenting to the Emergency Department (ED) and the Surgical Emergency Unit (SEU) at a UK university hospital from January to July 2020. For context, data on number of overall presentations to ED and SEU were also collated for the same period. Results 169 patients (median age 63 (16-94) years, 54.4% male) with acute LGIB were identified across the six months. A graphical representation of these data demonstrated notable trends. Overall weekly ED attendances dropped by 52.0% after the national lockdown (from 1500 to 720 patients), before returning to 77.7% of pre-lockdown levels by the end of the study period (1165 patients). Pre-lockdown, there was a fluctuating number of weekly attendances with acute LGIB. After lockdown, consistently fewer patients presented and there was a reduction in the variability of numbers week on week. Conclusions These novel data support recently published trends demonstrating a post-lockdown fall in emergency attendances, although the decrease in weekly attendance with acute LGIB was less marked, perhaps reflecting the concerning nature of this symptom for patients.

708 Examining the Management of Acute Lower GI Bleeds in Order to Improve Policies and Reflect Safe and Updated Guidance

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
L Han ◽  
H White ◽  
K Bosch ◽  
M Nair
Keyword(s):  
Gastrointestinal Bleeding ◽  
Surgical Intervention ◽  
Lower Gastrointestinal Bleeding ◽  
University Hospital ◽  
British Society ◽  
Shock Index ◽  
Surgical Department ◽  
Upper Gi ◽  
Cardiovascular Comorbidities ◽  
New Guidelines

Abstract Introduction Acute lower gastrointestinal bleeding (LGIB) tends to occur in elderly patients with complex comorbidities. At North Middlesex University Hospital (NMUH), LGIB patients are primarily managed by the surgical department. We amended local policies by integrating aspects of new guidelines published by the British Society of Gastroenterology (BSG). Method Handover documentation between November 2019 and January 2020 established patients admitted with LGIB (n = 45). Further data regarding the management of these patients was collated from clinical software and compared to standards set from BSG guidelines. Results We found NMUH to be efficient in ruling out upper GI bleeds via 24-hour OGDs and had low surgical intervention rates (0.02%). 40% of patients were transfused with an admission haemoglobin above suggested NICE thresholds, accounting for cardiovascular comorbidities. 56% of patients were discharged without a documented anticoagulation plan. Over 50% of patients did not have BSG recommended inpatient investigations. Conclusions Updated Trust guidelines aim to uphold areas that NMUH were shown to excel in, while reiterating NICE transfusion thresholds and include guidance regarding anticoagulant and antiplatelet medications. The Oakland score and shock index have been integrated into local protocols and will aid clinicians in making safe decisions in the management of LGIB patients.

scholarly journals POS0998 SPONDYLOARTHRITIS AND SLEEP DISORDERS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 767.2-768
Author(s):  
S. Lahrichi ◽  
K. Nassar ◽  
S. Janani
Keyword(s):  
Functional Impairment ◽  
Sleep Disturbances ◽  
Negative Impact ◽  
University Hospital ◽  
Quality Of Sleep ◽  
The Mean ◽  
Sleep Deficit ◽  
Impaired Sleep ◽  
The Impact

Background:Spondyloarthropathies (SpA) are a group of chronic and progressive diseases, characterized in particular by a progressive stiffening of the spine, spreading to neighboring joints or to certain tissues, which could lead in the long term to progressive stiffening and functional impairment. This conditioncancauseinsomnia problems and impaired sleep quality.Objectives:To assess the impact of SpA on the quality of sleep.Methods:This is a retrospective study over a period of 4 years from January 2015 to December 2019, including all the medical records of patients with SpA followed in the Department of Rheumatology of the University Hospital of Ibn Rochd, Casablanca. We evaluated for each patient two validated scores: the Epworth somnolence scale rated from 0 to 24, and the Pittsburgh sleep score rated from 0 to 21 with 7 components. Patients with a psychiatric history or who were followed up for neurological pathologies were excluded.Results:178 patients were included. 60.67% were men with an average age of 36.32 years (14-68 years). 45.01% had axial SpA, 29.77% had psoriatic arthritis, and 25.22% were followed for SpA associated with inflammatory bowel disease. 45% had associated comorbidities: there were 18 diabetics and 34 hypertensive, 16.58% were smokers. Clinically, 85.42% presented a back pain initially on examination, 55% presented a polyarthralgia, and 39.88% an oligoarthritis. 63% had radiological sacroiliitis, and 35.14% had bilateral coxitis. 13.48% had a positive HLA B27 and 58.89% had a positive inflammatory assessment with very high activity indices,with a mean of 4.6. 64.66% of the patients received NSAIDs,of which 11% responded well. 57% were treated with csDMARDs, and 17.86% were treated with biologics. At the time of our study, the mean visual analog scale was 5.84 ± 1.7 out of 10 (2-9). The mean Epworth score was 8.38 ± 5.2 (0-21). 56.1% of patients had no sleep debt, 33.3% had a sleep deficit, and only 10.6% had signs of drowsiness. For the overall Pittsburgh score, the mean was 7.02 ± 3.6 (1-18). The mean of “subjective quality of sleep” was 1.12, “sleep latency” was 1.22, “duration of sleep” was 1.06, “usual sleep efficiency” was 0.74, “Sleep disturbance” of 1.28, “use of a sleep medication” of 0.54, and the average of the component concerning “poor shape during the day” was 1.03 out of 3. The LEQUESNE index went from an average of 6 to 8, which corresponds to an average handicap (P = 0.2) over a period of 3 years. 68% of the patients had an alteration in the quality of sleep, starting on average three years after the onset of symptoms. 11% reported having experiencedanxiety and depressive symptoms, and reported having used antidepressants or anxiolytics in the past 5 years.Conclusion:Our study showed the negative impact of SpA on the duration and overall quality of sleep. The degree of pain as well as functional impairment can cause and worsen sleep disturbances in SpA. We have shown that the Pittsburg score increases significantly with the increase of pain.The Lequesne score and that the Epworth score increase with disease activity[1].References:[1]StolwijkC,vanTubergenA,Castillo-OrtizJD,BoonenA.Prevalenceofextra-articularmanifestationsinpatientswithankylosingspondylitis:asystematicreviewandmeta-analysis.AnnRheumDis2015;74:65—73.Disclosure of Interests:None declared.

scholarly journals A STUDY OF FERROFLUID LUBRICATION BASED ROUGH SINE FILM SLIDER BEARING WITH ASSORTED POROUS STRUCTURE

2019 ◽  
Vol 59 (2) ◽  
pp. 144-152
Author(s):  
Mohmmadraiyan M. Munshi ◽  
Ashok R. Patel ◽  
Gunamani B. Deheri
Keyword(s):  
Porous Structure ◽  
Carrying Capacity ◽  
Graphical Representation ◽  
Negative Impact ◽  
Positive Impact ◽  
Numerical Approach ◽  
Load Carrying Capacity ◽  
Slider Bearing ◽  
Load Carrying ◽  
The Impact

This paper attempts to study a ferrofluid lubrication based rough sine film slider bearing with assorted porous structure using a numerical approach. The fluid flow of the system is regulated by the Neuringer-Rosensweig model. The impact of the transverse surface roughness of the system has been derived using the Christensen and Tonder model. The corresponding Reynolds’ equation has been used to calculate the pressure distribution which, in turn, has been the key to formulate the load carrying capacity equation. A graphical representation is made to demonstrate the calculated value of the load carrying capacity which is a dimensionless unit. The numbers thus derived have been used to prove that ferrofluid lubrication aids the load carrying capacity. The study suggests that the positive impact created by magnetization in the case of negatively skewed roughness helps to partially nullify the negative impact of the transverse roughness. Further investigation implies that when the Kozeny-Carman’s model is used, the overall performance is enhanced. The Kozeny-Carman’s model is a form of an empirical equation used to calculate permeability that is dependent on various parameters like pore shape, turtuosity, specific surface area and porosity. The success of the model can be accredited to its simplicity and efficiency to describe measured permeability values. The obtained equation was used to predict the permeability of fibre mat systems and of vesicular rocks.

scholarly journals Quality of Life in Patients with Psoriasis Seen in the Department of Dermatology, Antananarivo, Madagascar

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Fandresena Arilala Sendrasoa ◽  
Naina Harinjara Razanakoto ◽  
Volatantely Ratovonjanahary ◽  
Onivola Raharolahy ◽  
Irina Mamisoa Ranaivo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Negative Impact ◽  
Young Patients ◽  
The Body ◽  
University Hospital ◽  
Medical Decision ◽  
Cross Sectional ◽  
The Difference ◽  
The Impact

Background. Psoriasis is a chronic, inflammatory, and multifactorial dermatosis that impairs quality of life (QoL). Health-related QoL has become an important element in medical decision-making along with the effectiveness and the harmlessness of the treatments. Objective. To assess the impact of psoriasis in the QoL of patients with psoriasis by using the DLQI scales. Methods. A cross-sectional study from January to June 2018 was conducted in the Department of Dermatology of the University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar, including patients more than 18 years old with mild to severe psoriasis. The severity of psoriasis was assessed using the “Psoriasis Area and Severity Index (PASI)”. QoL of patients with psoriasis was evaluated by using the DLQI scales. Results. 80 patients were included, their mean age was 36.5 years, and the male to female was 1.5 : 1. The mean DLQI score was 13.8. Symptoms, feelings, and psychic were the most altered dimensions. QoL was impaired in young patients, single, having medium level education. Even though patients with disease duration more than 5 years had higher DLQI score than other patients, the difference was not statistically significant (p=0.36). Furthermore, the clinical presentation of psoriasis did not influence the patient’s QoL (p=0.73). Patients with nail involvement had QoL impaired but the difference with another localization was not statistically significant (p=0.2). The quality of life was influenced by body area involved. The higher the body surface area involved, the more QoL is impaired (p=0.002). Furthermore, the higher the PASI, the more QoL is altered (p=0.002). Conclusion. Psoriasis has a negative impact in the quality of life in Malagasy patients with psoriasis, especially in younger and single patients. Worse quality of life is correlated to severity of psoriasis.

scholarly journals Total Blood Lymphocyte Count Alteration During and after Pregnancy

2016 ◽  
pp. 1 ◽  
Author(s):  
Gökçen Örgül ◽  
Burcu Soyak ◽  
Oytun Portakal ◽  
Meral Beksaç ◽  
M. Sinan Beksaç
Keyword(s):  
Lymphocyte Count ◽  
Blood Lymphocyte ◽  
Complete Blood Count ◽  
Negative Impact ◽  
Post Partum ◽  
University Hospital ◽  
Base System ◽  
Total Blood ◽  
The Mean ◽  
The Impact

<p><strong>Objective:</strong> To investigate the impact of gestational changes on blood lymphocyte count in healthy pregnancies. <br /><strong>Study Design:</strong> This retrospective study is consisted of 108 consecutive normal pregnancies who delivered at our department in December 2015. High-risk pregnancies with poor neonatal outcome and pregnancies with maternal disorders which may affect lymphocyte counts were excluded from the study. “Complete blood count” results of the patients were obtained from the computerized data base system of Hacettepe University Hospital. Blood samples of patients which were withdrawn a) prior to pregnancy (1-6 months before getting pregnant), b) during pregnancy (11-14th gestational weeks) and c) post-partum first day were used in this study.<br /><strong>Results:</strong> The mean blood lymphocyte count was 2049.07 (±758.69) in patients before their pregnancies. The mean lymphocyte count decreased to 1850.93 and 1625 during pregnancy and after delivery respectively. A statistically significant decrease was found between three periods (before, during, and postpartum 1st day) (p:0.003).<br /><strong>Conclusion:</strong> We have shown a significant decrease in total lymphocyte levels during pregnancy, consistent with the data presented in the literature. Pregnancy and related hormones have a negative impact on total blood lymphocyte level.<br /><br /></p>

scholarly journals Psoriasis – the impact on an individual´s mental state and quality of life

2019 ◽  
Vol 5 (2) ◽  
pp. 187-195
Author(s):  
Šárka Vévodová ◽  
Filip Havelka ◽  
Jiří Vévoda ◽  
Bronislava Grygová
Keyword(s):  
Quality Of Life ◽  
Social Relations ◽  
Negative Correlation ◽  
Negative Impact ◽  
University Hospital ◽  
Control Group ◽  
Healthy Population ◽  
Level Of Significance ◽  
The Impact

Introduction: Psoriasis is a chronic skin disease characterized by scaly patches affecting approximately 2-5% of the population. The disease has a negative impact on quality of life and, therefore, psoriatic patients often develop depression. Our work deals with quality of life and depression in psoriasis sufferrers and strives to determine the correlation between their quality of life and depression. Methods: The research took place in the University Hospital Olomouc in 2017 and used questionnaires WHOQOL-BREF and BDI-II. 50 patients with psoriasis were chosen randomly. To process the data we used Mann-Whitney test (the level of significance = 5%) and Spearman´s correlation coefficient (the level of significance = 1%). Results: The results proved that psoriasis has a significant impact on quality of life. The scores for the overall life quality as well as for individual domains were significantly lower in psoriatic patients than in the control group (p&lt;0.001). The degree of depression in patients with psoriasis showed statistically significant correlation in all domains of the quality of life. We proved negative correlation in the overall quality of life (rs =- 0.691**), physical condition (rs =-0.499**), social relations (rs =-0.546**), overall health (rs =-0.396**), and environment (rs =-0.386**). Conclusion: With regard to the ascertained negative correlation between psoriasis and depression and lower quality of life of the sufferers compared to the healthy population, it is essential for healthcare professionals to pay attention not only to somatic manifestations of the disease but also to the patients´ mental health.

scholarly journals A Survey of Psychiatric Healthcare Workers' Perception of Working Environment and Possibility to Recover Before and After the First Wave of COVID-19 in Sweden

2021 ◽  
Vol 12 ◽  
Author(s):  
Eirini Alexiou ◽  
Steinn Steingrimsson ◽  
Magnus Akerstrom ◽  
Ingibjörg H. Jonsdottir ◽  
Linda Ahlstrom ◽  
...  
Keyword(s):  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Negative Impact ◽  
Working Environment ◽  
University Hospital ◽  
Protective Equipment ◽  
Web Based ◽  
Before And After ◽  
Survey Responses ◽  
The Impact

Objective: This study aimed to investigate the impact of the first wave of the COVID-19 pandemic on perceived working environment, including the possibility to recover, among psychiatric healthcare workers (PHCWs) in comparison with pre-pandemic measures.Method: A link to an anonymous, web-based COVID-19 related survey was sent via email to all PHCWs at a university hospital in Sweden (n = 1,618) in September 2020. The response rate was 38% (566 of 1,507 eligible participants). Working environment survey responses collected in 2019 were used as pre-pandemic comparators. Statistical analyses were performed to assess overall impact over time on work demands, support, motivation, and recovery, stratified by professional role, and considering variables such as access to personal protective equipment.Results: The percentage of individuals responding negatively to statements about working environment increased significantly for most items after the first wave. Similarly, the increase of five of the investigated factors indicated a more negative perception of recovery during the pandemic. Registered nurses reported a greater negative impact of the pandemic on perceived working conditions and ability to recover than other professional groups. PHCWs working with patients with COVID-19 (35%) who reported being worried about becoming infected (12%) or infecting others (17%), or lacking adequate personal protective equipment (22%) were more negatively impacted regarding work environment-related items than those who did not.Conclusions: PHCWs' working environment and possibility for recovery were impacted by the first wave of the COVID-19 pandemic, nurses being most affected. Although psychiatric services do not directly care for patients with severe COVID-19 infection, the results from this study suggests that mental health services should also prepare for future pandemics.

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