scholarly journals Prehospital period in patients with COVID-19 and community acquired pneumonia: age characteristics, cardiovascular comorbidity and pharmacotherapy during epidemic wave (the data of hospital registry)

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
M Lukiyanov ◽  
S Y Martsevich ◽  
A A Pulin ◽  
N P Kutishenko ◽  
E Y Andreenko ◽  
...  

Abstract Aim To estimate age characteristics, proportion of concomitant cardiovascular diseases (CVD), cardiovascular pharmacotherapy during prehospital period in patients with COVID-19 and community acquired pneumonia (CAP) according the data of hospital registry. Methods The registry included all patients admitted to the special COVID-19 center from April 6 to June 2, 2020 with suspected or confirmed COVID-19 and CAP. This enrollment period was corresponding to the main part of the first epidemic wave of COVID-19 in megapolis (the number of new cases on April 6 and July 2, 2020 was 591 and 662, respectively, the maximal number, 6703 cases, was registered on May 7). COVID-19 was diagnosed in cases of positive polymerase chain reaction test (60.7%) or according to computed tomography data. Results The registry included 1.130 patients (age 57.5±12.8 years, 51.2% men). CAP was diagnosed in 94% of cases, CVD - in 52.9%. Mean age values (from the 1-st up to the 11-th weeks of enrollment period) were, respectively, week by week: 52.8; 54.3; 57.3; 59.6; 56.9; 60.0; 57.2; 62.7; 59.3; 57.4 and 62.2 years (p<0.001; β-coefficient 0.78; 95% Confidential Interval, CI 0.50–1.07). The proportion of patients with CVD was for each of these weeks, respectively: 34.2%; 43.0%; 52.9%; 53.5%; 50.5%; 61.4%; 53.9%; 68.9; 63.1%; 54.8% and 66.7% (p<0.001; Odds Ratio 1.04; 95% CI 1.02–1.06). So, during enrollment period the mean age of patients increased significantly (on average by 0.78 years per week) as well as the proportion of CVD cases increased from 34.2% up to 66.7% (average 51.5%). The mean duration of period from the first day of clinical symptoms until the date of hospitalization was 8.3±5.9 days (median 7; with Q1-Q3 from 5 to 10). There were no significant difference for the length of this period between groups of patients with and without CVD: 8.4±6.2 and 8.3±5.7 days (median 7; with Q1-Q3 from 5 to 10 for both groups), p=0.82; between age groups of ≥65 years and <65 years: 8.8±7.2 and 8.1±5.3 days (median 7 with Q1-Q3 from 5 to 10, and 7 with Q1-Q3 from 4 to 10, respectively), p=0.07. Antihypertensive therapy during prehospital period was administered in 78.4% cases of hypertension, ACE inhibitors/sartans in patients with chronic heart failure (CHF) and history of myocardial infarction (MI) - in 64.6% and 52.3%, beta-blockers in CHF and history of MI – 54.4% and 42.2%, statins in coronary artery disease (CAD) – 28.9%, antiplatelets in CAD without atrial fibrillation (AF) – 50.4%, anticoagulants in AF – 57.5%. Conclusions Prehospital period in patients with COVID-19, community-acquired pneumonia enrolled into the hospital registry was characterized by rising of age and proportion of CVD cases during enrollment period. The correspondence of cardiovascular pharmacotherapy to clinical guidelines was insufficient that must be improved in clinical practice during time interval between first symptoms and hospitalization date. FUNDunding Acknowledgement Type of funding sources: None.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1188.1-1188
Author(s):  
C. Daldoul ◽  
N. El Amri ◽  
K. Baccouche ◽  
H. Zeglaoui ◽  
E. Bouajina

Background:Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), is considered as a risk factor of low bone mineral density (BMD). In fact, the prevalence of osteoporosis ranges from 17% to 41% in IBD patients. The possible contributing factors may include malabsorption, glucocorticoid treatment and coexisting comorbiditiesObjectives:The purpose of our work was to determine the frequency and the determinants of osteoporosis in patients with IBD and to assess whether there is a difference in BMD status between UC and CD.Methods:This is a retrospective study, over a period of 5 years (from January 2014 to December 2018) and including patients followed for IBD who had a measurement of BMD by DEXA. Clinical, anthropometric and densitometric data (BMD at the femoral and vertebral site) were recorded. The WHO criteria for the definition of osteoporosis and osteopenia were applied.Results:One hundred and five patients were collected; among them 45 were men and 60 were women. The average age was 45.89 years old. The average body mass index (BMI) was 25.81 kg/m2 [16.44-44.15]. CD and UC were diagnosed in respectively 57.1% and 42.9%. A personal history of fragility fracture was noted in 4.8%. Hypothyroidism was associated in one case. Early menopause was recorded in 7.6%. 46.8% patients were treated with corticosteroids. The mean BMD at the vertebral site was 1.023 g/cm3 [0.569-1.489 g/cm3]. Mean BMD at the femoral site was 0.920g/cm3 [0.553-1.286g / cm3]. The mean T-score at the femoral site and the vertebral site were -1.04 SD and -1.27 SD, respectively. Osteoporosis was found in 25.7% and osteopenia in 37.1%. Osteoporosis among CD and UC patients was found in respectively 63% and 37%. The age of the osteoporotic patients was significantly higher compared to those who were not osteoporotic (52.23 vs 43.67 years, p = 0.01). We found a significantly higher percentage of osteoporosis among men compared to women (35.6% vs 18.3%, p=0.046). The BMI was significantly lower in the osteoporotic patients (23.87 vs 26.48 kg/m2, p=0.035) and we found a significant correlation between BMI and BMD at the femoral site (p=0.01). No increase in the frequency of osteoporosis was noted in patients treated with corticosteroids (27.9% vs 21.6%, p=0.479). Comparing the UC and CD patients, no difference was found in baseline characteristics, use of steroids or history of fracture. No statistically significant difference was found between UC and CD patients for osteoporosis(p=0.478), BMD at the femoral site (p=0.529) and at the vertebral site (p=0.568).Conclusion:Osteoporosis was found in 25.7% of IBD patients without any difference between CD and UC. This decline does not seem to be related to the treatment with corticosteroids but rather to the disease itself. Hence the interest of an early screening of this silent disease.Disclosure of Interests:None declared


2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Mefkure Eraslan Sahin ◽  
Erdem Sahin ◽  
Yusuf Madendag ◽  
Ilknur Col Madendag ◽  
Ahter Tanay Tayyar ◽  
...  

Background. Primary dysmenorrhea, defined as painful menstrual cramps originating in the uterus without underlying pathology, is a gynecological disease that affects quality of life and school success. Our goal was to determine the effect of anterior uterocervical angle on primary dysmenorrhea and disease severity. Methods. A total of 200 virgin adolescents, 16 to 20 years of age, were included in the study. The Andersch and Milsom scale was used to determine dysmenorrhea severity. Those with pathologies causing secondary dysmenorrhea were excluded from the study. Study subjects were grouped based on severity of pain. Demographic characteristics and uterocervical ultrasonographic measurements were compared among groups. Results. Of the 200 participants enrolled in the study, 50 were healthy controls and 150 had primary dysmenorrhea. Those with primary dysmenorrhea had a significant family history of primary dysmenorrhea compared with controls (P<0.001). Age (P=0.668), body mass index (P=0.898), menarche age (P=0.915), and length of menstrual cycles (P=0.740) were similar in all groups. The uterine corpus longitudinal axis, uterine corpus transverse axis, and uterine cervix longitudinal axis were also similar (P=0.359, P=0.279, and P=0.369, resp.). The mean uterocervical angle was 146.8 ± 6.0 in controls and 143.3 ± 7.3 in those with mild pain with no significant difference between the groups. In those with moderate pain, the mean uterocervical angle was 121.2 ± 7.3 compared with 101 ± 9.2 in those with severe pain, which was a significant difference. Additionally, there was also a significant difference in the uterocervical angle among those with mild, moderate, and severe pain (P<0.001). Conclusion. Our results indicate that a narrower anterior uterocervical angle is associated with primary dysmenorrhea and disease severity.


Author(s):  
Dr. Hitesh Kumar Solanki ◽  
Dr. Omnath P Yadav ◽  
Dr. Anita J Gojiya

The study was conducted in department of physiology, B J Medical College, Ahmedabad from Mar. 2012 to Feb. 2013. This was a cross-sectional study to evaluate the effect of smoking on lung   function and serum lipids in asymptomatic smokers   and comparable non   smokers. The mean of the various spirometric parameters were calculated of the subjects for both the groups. The mean FVC in group I and group II was 2.60 ± 0.62 L and 4.10 ± 0.64L respectively. The mean FEV1 in group I was 1.91 ± 0.57L and     3.19 ± 0.77L in group II Group I had mean FEF25% - 75% and PEFR of 1.98 ± 0.67L/sec and 4.50 ± 1.57L/sec respectively. Group II had mean FEF25 – 75% of 4.22 ± 1.23L/sec and a mean PEFR of 7.22 ± 1.42L/sec. In young smokers and asymptomatic, still the spirometric values were significantly deranged as compared to controls. Even smokers with history of less pack years of smoking also had significant abnormalities of lung function. All he spirometric values in the two groups had statistically highly significant difference and were higher in non-smokers as compared to smokers. The spirometric values were reduced in smokers with history of smoking for as low as two pack years. Keywords: Progression, PFT, Asymptomatic & Smokers


Author(s):  
Abolfazl Dashti- Rahmat Abadi ◽  
Hassan Mozaffari- Khosravi ◽  
Mahdieh Nemayandeh ◽  
Mohammad Hosein Soltani ◽  
Masoud Mirzaei ◽  
...  

Background: Studies on the relationship of urinary sodium with overweight and obesity led to controversial results. Furthermore, no study has ever investigated the association between sodium status and obesity in Iranian adults. The present study examined the association of urinary sodium levels with overweight and obesity in adults living in Yazd, Iran. Methods: The present study recruited 240 adults randomly selected from adults, who participated in Yazd Health Study (YaHS). A 24-hour urine sample was collected from the participants. Participants' demographic information, history of chronic diseases, and smoking status were obtained. The height and weight of the participants were also assessed using standard methods. We compared the weight and body mass index (BMI) of the participants based on the urinary sodium excretion tertiles. The logistic regression model in crude and multivariable adjusted models was used to compare the odds of obesity between urinary sodium tertiles. Results: The findings showed that the mean urinary sodium was not significantly different among overweight, obese, and individuals with normal BMI (P > 0.05) using the crude and multivariable models. Furthermore, no significant difference was observed in the mean BMI according to urinary sodium excretion tertiles. In addition, the analyses showed that the sodium status was not significantly associated with odds of developing obesity in crude and in multivariable adjusted models. Conclusion: No significant relationship was seen between sodium status and overweight or obesity. Future prospective studies are highly recommended to confirm these results.


2021 ◽  
pp. 279-282
Author(s):  
Chairul Adilla Ardy ◽  
Muara Panusunan Lubis ◽  
Cut Adeya Adella ◽  
Hotma Partogi Pasaribu ◽  
Muhammad Rusda ◽  
...  

Background: Preeclampsia with severe features is an endothelial disease that causes renal system disorders during pregnancy. Preeclampsia is an important cause of acute kidney injury and risk for chronic kidney disease. Methods: This study was a case series conducted at the Department of Obstetrics and Gynecology, H. Adam Malik General Hospital Medan, Indonesia starting from December 2019 until January 2020. Total sampling technique was employed obtaining 31 subjects with a history of preeclampsia with severe features for at least 3 months to 2 years postpartum, without a history of chronic disease, diabetes mellitus, and congenital kidney disorders. Proteinuria, serum creatinine, and GFR calculations were performed. Results: There were 31 patients who met the inclusion and exclusion criteria. At a time interval of 4 - ≤13 months postpartum, 2 levels of proteinuria +1 (0-2), serum creatinine 0.81 ± 0.21 mg/dl, and levels of GFR 109.57 ± 25.13 (ml/min/1.73 m ). Whereas at the time interval of >13 - 24 months postpartum, levels of proteinuria +1 (0-3), serum creatinine 0.85 ± 0.23 mg/dl, and GFR 2 levels of 104. 41 ± 28.45 (ml/min/1.73 m ). The mean of serum creatinine before delivery was 0.69 ± 0.15 mg/dl and after delivery was 0.83 ± 0.22 mg/dl. The mean of GFR postpartum at group of history of early onset preeclampsia was 103.07 ± 25.23 2 2 (ml/min/1.73 m ) and group of history of late onset preeclampsia was 113.40 ± 28.24 (ml/min/1.73 m ). Conclusion: There was a tendency for a decrease in renal function among women with a history of preeclampsia with severe features with ndings of persistent proteinuria from more than 3 to 24 months postpartum, an increase in mean of serum creatinine levels from before and after delivery and a decrease in GFR, but it was not signicant. This was related to the slow course of chronic kidney disease, so it had to be followed up periodically.


2019 ◽  
Vol 104 (2) ◽  
pp. 276-281 ◽  
Author(s):  
Sang Yeop Lee ◽  
Eun Woo Kim ◽  
Wungrak Choi ◽  
Chan Keum Park ◽  
Sangah Kim ◽  
...  

AimsIn this study, we tested the hypothesis that intraocular pressure (IOP) parameters measured by dynamic contour tonometry (DCT) would be more relevant in progression of glaucoma when there is a history of laser refractive surgery (LRS) than the IOP parameters measured by Goldmann applanation tonometry (GAT) or calculated by correction formulae.MethodsNinety-eight eyes in 54 patients with open-angle glaucoma and a history of LRS were included in this retrospective study. IOP was measured by both GAT and DCT during follow-up. Baseline, mean, and peak IOP, IOP fluctuation, and IOP reduction were measured by each tonometry method. Corrected IOP parameters using central corneal thickness and mean keratometry values were also analysed. Clustered logistic regression was used to identify variables correlated with progression of glaucoma. Areas under the curve (AUCs) for correlated variables were also compared.ResultsThe mean DCT value (OR 1.36, p=0.024), peak DCT value (OR 1.19, p=0.02) and pattern SD (OR 1.10, p=0.016) were significant risk factors for progression. There was a significant difference in the predictive ability of the mean DCT and GAT values (AUC 0.63 and 0.514, respectively; p=0.01) and of the peak DCT and GAT values (0.646 and 0.503, respectively, p=0.009). The AUCs for corrected IOP did not exceed those of DCT.ConclusionsIOP measurements were more associated with progression of glaucoma when measurements were obtained by DCT than by GAT or correction formulae in eyes with a history of LRS.


1996 ◽  
Vol 33 (1) ◽  
pp. 67-73 ◽  
Author(s):  
Thomas Watterson ◽  
Julie Hinton ◽  
Stephen Mcfarlane

The use of novel stimuli for obtaining nasalance measures in young children was the focus of this study. The subjects were 20 children without a history of communication disorders and 20 children at risk for velopharyngeal insufficiency (VPI). Each subject recited three passages; the standard Zoo Passage, and two novel stimuli that were named the Turtle Passage and the Mouse Passage. Like the Zoo Passage, the Turtle Passage contained no normally nasal consonants. The Mouse Passage was about 11% nasal consonants, which is similar to the Rainbow Passage. Statistical analysis showed no significant difference between the mean nasalance for the Zoo Passage and the Turtle Passage for either the subjects without risk of VPI (15.4% vs 15.7%) or for those at risk (30.4% vs 28.8%). Nasalance measures for the Mouse Passage were significantly higher than for either the Zoo Passage or the Turtle Passage. Listeners rated the stimuli on a 5-point equal-appearing intervals scale. The correlation coefficient between listener judgments of hypernasality and nasalance was significant for the Zoo Passage (r = 0.70) and for the Turtle Passage (r = 0.51) but not significant for the Mouse Passage (r = 0.32). Using cut-off scores of 22% for nasalance and 2.25 for hypernasality, the sensitivity for the Zoo Passage was 0.72, and for the Turtle Passage, 0.83.


Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 2338-2338
Author(s):  
Lena Coïc ◽  
Suzanne Verlhac ◽  
Emmanuelle Lesprit ◽  
Emmanuelle Fleurence ◽  
Francoise Bernaudin

Abstract Abnormal TCD defined as high mean maximum velocities &gt; 200 cm/sec are highly predictive of stroke risk and justify long term transfusion program. Outcome and risk factors of conditional TCD defined as velocities 170–200 cm/sec remains to be described. Patients and methods Since 1992, 371 pediatric SCD patients (303 SS, 44 SC, 18 Sß+, 6 Sß0) were systematically explored once a year by TCD. The newborn screened cohort (n=174) had the first TCD exploration between 12 and 18 months of age. TCD was performed with a real-time imaging unit, using a 2 MHz sector transducer with color Doppler capabilities. Biological data were assessed at baseline, after the age of 1.5 years and remotely of transfusion or VOC. We report the characteristics and the outcome in patients (n=43) with an history of conditional TCD defined by mean maximum velocities ranging between 170 and 200 cm/s in the ACM, the ACA or the ICA. Results: The mean follow-up of TCD monitoring was 5,5 years (0 – 11,8 y). All patients with an history of conditional doppler were SS/Sb0 (n=43). Mean (SD) age of patients at the time of their first conditional TCD was 4.3 years (2.2) whereas in our series the mean age at abnormal TCD (&gt; 200 cm/sec) occurrence was 6.6 years (3.2). Comparison of basal parameters showed highly significant differences between patients with conditional TCD and those with normal TCD: Hb 7g4 vs 8g5 (p&lt;0.001), MCV 82.8 vs 79 (p=0.047). We also had found such differences between patients with normal and those with abnormal TCD (Hb and MCV p&lt; 0.001). Two patients were lost of follow-up. Two patients died during a trip to Africa. Conditional TCD became abnormal in 11/43 patients and justified transfusion program. Mean (SD) conversion delay was 1.8 (2.0) years (range 0.5–7y). No stroke occurred. 16 patients required a treatment intensification for other indications (frequent VOC/ACS, splenic sequestrations): 6 were transplanted and 10 received HU or TP. Significant risk factors (Pearson) of conversion to abnormal were the age at time of conditional TCD occurrence &lt; 3 y (p&lt;0.001), baseline Hb &lt; 7g/dl (p=0.02) and MCV &gt; 80 (p=0.04). MRI/MRA was performed in 31/43 patients and showed ischemic lesions in 5 of them at the mean (SD) age of 7.1 y (1.8) (range 4.5–8.9): no significant difference was observed in the occurrence of lesions between the 2 groups. Conclusions This study confirms the importance of age as predictive factor of conditional to abnormal TCD conversion with a risk of 64% when first conditional TCD occured before the age of 3 years. TCD has to be frequently controled during the 5 first years of life.


1980 ◽  
Vol 94 (4) ◽  
pp. 498-502 ◽  
Author(s):  
Toshio Tanaka ◽  
Shoichi Katayama ◽  
Kanji Kuma ◽  
Hajime Tamai ◽  
Fumio Matsuzuka ◽  
...  

Abstract. The clinical picture and serum antithyroid antibodies in 16 pairs of siblings with Graves' disease were compared with an age and sex matched group of 32 patients with Graves' disease who did not have a family history of any thyroid disease (control patients). There was a significant difference in frequency and mean titres of antibodies to thyroglobulin between sibling patients. (positive 76.0%) and control patients (positive 40.0%), but not in microsomal antibodies (sibling; positive 92.0%, control; 92.0%). There were no significant differences in the mean values of 24 h 131I-thyroidal uptake, serum T3U, serum T4 and T3 concentrations before treatment between the two groups. Lymphoid follicles and degeneration of the epithelia were more often found in the thyroid glands of sibling patients than in those of the control patients, when 32 (16 sibling, 16 control) thyroid glands from the same groups in the clinical study, including antibody series, were examined pathologically after subtotal thyroidectomy for Graves' disease. Moreover, there was a strong tendency to increased lymphocyte and plasma cell infiltration in the thyroid glands of sibling patients with Graves' disease. The findings might indicate that Graves' disease is closely related to Hashimoto's thyroiditis, especially in sibling patients with Graves' disease.


2020 ◽  
Vol 24 (1) ◽  
pp. 52-58
Author(s):  
Zahra Mariyam ◽  
Laibah Safdar ◽  
Shafaq Fatima ◽  
Jawad Zaheer

Background: Preoperative apprehension is a widespread global problem. This anxiety and apprehension can significantly affect all aspects of anesthesia and surgery. Thus, it is essential to detect and address the patient's anxiety to assist in recovery after surgery and improve the patient's outcome. Materials and Methods: This is a cross-sectional study conducted over one year in the allied hospitals of Rawalpindi Medical University (RMU). Our sample size was 380 preoperative patients, who were selected by convenience sampling. The Amsterdam Preoperative Anxiety and Information Scale (APAIS) was used.Results: The overall prevalence of anxiety was 30.5%, while the prevalence of information requirement was 33.2%. The mean total APAIS was 12.73±8.56, the mean anxiety subscore was 8.25±5.58, and the mean need for information subscore was 4.48±3.16. A statistically significant difference was found in the scores of the patients based on age, gender, education, type of anesthesia, and type of surgery (p< 0.05). The previous history of anesthesia and the presence of comorbidities did not bring a significant difference in the scores of the patients (p>0.05). Postoperative pain was the most important concern, found in 32% of the patients. Conclusion: Younger age group, female gender, having no formal education, surgery under regional anesthesia, and undergoing C-section, IOL implantation and septoplasty are associated with higher preoperative anxiety, while the presence of comorbidities and previous history of anesthesia are factors that do not significantly affect preoperative anxiety in our population.


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