scholarly journals Triage tool for suspected COVID-19 patients in the emergency room: AIFELL score

2020 ◽  
Author(s):  
Ian Levenfus ◽  
Enrico Ullmann ◽  
Edouard Battegay ◽  
Macé M. Schuurmans
Keyword(s):  
Time Frame ◽  
University Hospital ◽  
Emergency Setting ◽  
Clinical Experiences ◽  
Emergency Rooms ◽  
Laboratory Findings ◽  
Student’S T ◽  
The University ◽  
Post Hoc ◽  
Short Time

Clinical prediction scores support the assessment of patients in the emergency setting to determine the need for further diagnostic and therapeutic steps. During the current COVID-19 pandemic, physicians in emergency rooms (ER) of many hospitals have a considerably higher patient load and need to decide within a short time frame whom to hospitalize. Based on our clinical experiences in dealing with COVID-19 patients at the University Hospital Zurich, we created a triage score with the acronym AIFELL consisting of clinical, radiological and laboratory findings. The score was then evaluated in a retrospective analysis of 122 consecutive patients with suspected COVID-19 from March until mid-April 2020. Descriptive statistics, Student's t-test, ANOVA and Scheffe's post hoc analysis confirmed the diagnostic power of the score. The results suggest that the AIFELL score has potential as a triage tool in the ER setting intended to select probable COVID-19 cases for hospitalization in spontaneously presenting or referred patients with acute respiratory symptoms.

scholarly journals Effective Treatment of Neurological Symptoms with Normal Doses of Botulinum Neurotoxin in Wilson’s Disease: Six Cases and Literature Review

Toxins ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 241
Author(s):  
Harald Hefter ◽  
Sara Samadzadeh
Keyword(s):  
Botulinum Neurotoxin ◽  
Wilson’S Disease ◽  
Animal Experiments ◽  
Symptomatic Treatment ◽  
Wilson's Disease ◽  
University Hospital ◽  
Laboratory Findings ◽  
Dose Information ◽  
High Doses ◽  
The University

Background: Recent cell-based and animal experiments have demonstrated an effective reduction in botulinum neurotoxin A (BoNT/A) by copper. Aim: We aimed to analyze whether the successful symptomatic BoNT/A treatment of patients with Wilson’s disease (WD) corresponds with unusually high doses per session. Methods: Among the 156 WD patients regularly seen at the outpatient department of the university hospital in Düsseldorf (Germany), only 6 patients had been treated with BoNT/A during the past 5 years. The laboratory findings, indications for BoNT treatment, preparations, and doses per session were extracted retrospectively from the charts. These parameters were compared with those of 13 other patients described in the literature. Results: BoNT/A injection therapy is a rare (<4%) symptomatic treatment in WD, only necessary in exceptional cases, and is often applied only transiently. In those cases for which dose information was available, the dose per session and indication appear to be within usual limits. Conclusion: Despite the evidence that copper can interfere with the botulinum toxin in preclinical models, patients with WD do not require higher doses of the toxin than other patients with dystonia.

scholarly journals Comparing the first and second waves of COVID-19 in a tertiary university hospital in Barcelona

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 1197
Author(s):  
Yolima Cossio ◽  
Marta-Beatriz Aller ◽  
Maria José Abadias ◽  
Jose-Manuel Domínguez ◽  
Maria-Soledad Romea ◽  
...  
Keyword(s):  
Tertiary Hospital ◽  
Healthcare Systems ◽  
University Hospital ◽  
Emergency Rooms ◽  
Daily Number ◽  
Patient Demographics ◽  
Significant Difference ◽  
The University ◽  
Hospital Wards ◽  
Second Wave

Background: Hospitals have constituted the limiting resource of the healthcare systems for the management of the COVID-19 pandemic. As the pandemic progressed, knowledge of the disease improved, and healthcare systems were expected to be more adapted to provide a more efficient response. The objective of this research was to compare the flow of COVID-19 patients in emergency rooms and hospital wards, between the pandemic's first and second waves at the University Hospital of Vall d’Hebron (Barcelona, Spain), and to compare the profiles, severity and mortality of COVID-19 patients between the two waves. Methods: A retrospective observational analysis of COVID-19 patients attending the hospital from February 24 to April 26, 2020 (first wave) and from July 24, 2020, to May 18, 2021 (second wave) was carried out. We analysed the data of the electronic medical records on patient demographics, comorbidity, severity, and mortality. Results: The daily number of COVID-19 patients entering the emergency rooms (ER) dropped by 65% during the second wave compared to the first wave. During the second wave, patients entering the ER were significantly younger (61 against 63 years old p<0.001) and less severely affected (39% against 48% with a triage level of resuscitation or emergency; p<0.001). ER mortality declined during the second wave (1% against 2%; p<0.000). The daily number of hospitalised COVID-19 patients dropped by 75% during the second wave. Those hospitalised during the second wave were more severely affected (20% against 10%; p<0.001) and were referred to the intensive care unit (ICU) more frequently (21% against 15%; p<0.001). Inpatient mortality showed no significant difference between the two waves. Conclusions: Changes in the flow, severity and mortality of COVID-19 patients entering this tertiary hospital during the two waves may reflect a better adaptation of the health care system and the improvement of knowledge on the disease.

Neurological Presentation of Severe Dengue in Children From a Colombian Hyperendemic Area

2020 ◽  
Author(s):  
Jaime E. Castellanos ◽  
Paula Esteban ◽  
Juanita Panqueba-Salgado ◽  
Daniela Benavides-del-Castillo ◽  
Valentina Pastrana ◽  
...  
Keyword(s):  
Fungal Infections ◽  
Hypovolemic Shock ◽  
University Hospital ◽  
Severe Dengue ◽  
Laboratory Findings ◽  
Dengue Disease ◽  
Neurological Signs ◽  
Csf Analysis ◽  
Neurological Patients ◽  
The University

Abstract Objective: Dengue transmission is sustained in Colombia with increasing prevalence mainly in children. This work was aimed to describe a cases series of children diagnosed with dengue presenting neurological disease in the Huila province of Colombia. Eleven pediatric febrile patients confirmed to dengue disease and presenting neurological signs were studied in the University Hospital of Neiva, Huila province. Clinical and laboratory findings, CSF cytochemical analysis, neurology images, and serology and molecular studies were performed. Results. Viral RNA was detected in all patients’ sera by RT-PCR. Nine out of 11 were primary infections. Tonic-clonic seizures (73%), consciousness alterations (27%), irritability (27%) and ataxia (18%) were the most frequent neurological signs. None of the patients had plasma leakage, hypovolemic shock or liver disease, confirming the encephalitis diagnosis. Diagnostic images did not show abnormal findings neither bacterial or fungal infections were detected in CSF analysis. All patients survived without sequelae except in one patient that presented ataxia for months. In conclusion, we described a group of children with neurological signs during severe dengue disease as the main finding, indicating the importance of include dengue as a differential diagnosis in neurological patients from endemic areas.

scholarly journals [Availability and use of emergency services in Tunisia:main results of a comprihensive national survey]

2001 ◽  
Vol 7 (4-5) ◽  
pp. 805-811
Author(s):  
M. K. Chahed ◽  
N. Somrani ◽  
H. Achour
Keyword(s):  
Emergency Service ◽  
Emergency Services ◽  
Health Workers ◽  
University Hospital ◽  
Emergency Rooms ◽  
Hospital Emergency ◽  
Public Emergency ◽  
Use Of Emergency Services ◽  
The University

In order to assess hospital emergency rooms, a comprehensive national epidemiological investigation was conducted in all 155 public emergency structures in Tunisia. Here we present the main results of the levels of availability and use of emergency services. Coverage of the population by services is adequate [one emergency service per 60, 000 people]. Emergency wards admit about 2, 500, 000 patients every year [a quarter of the population of the country]. The university hospital emergency services are the most heavily used [150 patients per day on average]. Emergency services are sought for medical [60%], surgical [18%], paediatric [14%] and gynaecological reasons [5%]. It would be useful to assess the quality of care delivered and the satisfaction of citizens and health workers.

A Case on University and Community Collaboration

2012 ◽  
pp. 947-969
Author(s):  
S. Ann Becker ◽  
Robert Keimer ◽  
Tim Muth
Keyword(s):  
Small Businesses ◽  
Local Community ◽  
Swot Analysis ◽  
Time Frame ◽  
Economic Downturn ◽  
Community Collaboration ◽  
Diverse Group ◽  
Entrepreneurial Training ◽  
The University ◽  
Short Time

Small businesses are viewed as the backbone of America and integral in the recovery of any economic downturn. Creative approaches to university and community collaboration are being explored to achieve high rates of success in launching, sustaining, and growing small businesses. One such approach, the Entrepreneurial Training Services (ETS) program, is being studied by Sci-Tech University as a means of technology innovation and regional economic development. The ETS Program has several unique features including: the entrenchment of a large number of adults in the program, an intensive training approach that is implemented in a short time frame, personalized mentoring offered to each entrepreneur in the program, and the leveraging of resources with a large, diverse group of community partners. The case profiles the region using Strengths, Weaknesses, Opportunities, and Threats (SWOT) Analysis, identifies an ETS framework on which the program is based and explains the process of implementation. The case concludes with challenges facing the university and local community in offering the ETS Program to a large and diverse group of entrepreneurs. It also summarizes benefits and successes from initial implementation efforts.

scholarly journals Rhythms and prognosis of patients with cardiac arrest, emphasis on pseudo-pulseless electrical activity: another reason to use ultrasound in emergency rooms in Colombia

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
German Devia Jaramillo ◽  
Norberto Navarrete Aldana ◽  
Zaira Rojas Ortiz
Keyword(s):  
Cardiac Arrest ◽  
Electrical Activity ◽  
Cardiac Activity ◽  
Pulseless Electrical Activity ◽  
Cardiac Arrest Patient ◽  
University Hospital ◽  
Bedside Ultrasound ◽  
Emergency Rooms ◽  
Significant Difference ◽  
The University

Abstract Background The cardiac arrest is still an emergency with a bad prognosis. The growing adoption of bedside ultrasound allowed to classify PEA in two groups: the true PEA and the pseudo-PEA. pPEA is used to describe a patient who has a supposed PEA in the absence of pulse, with evidence of some cardiac activity on the bedside ultrasound. Objective This work aims to assess the bedside ultrasound use as a predictor for ROSC and survival at discharge in cardiac arrest patients and compare the pseudo-pulseless electrical activity to other cardiac arrest rhythms, including shockable rhythms. Materials and methods This is an observational, historic cohort study carried out in the emergency room of the University Hospital Mayor Méderi. Data were collected from all the adult patients treated for cardiac arrest from June 2018 to 2019. An ultrasound was performed to every cardiac arrest patient. Results Of a total of 108 patients, the median of the age was 71 years, 65.8% were male subjects, and the most frequent cause for cardiac arrest was the cardiogenic shock (32.4%). ROSC was observed in 41 cases (37.9%) and survival at discharge was 18 cases (16.7%). VF/VT and pPEA were the two rhythms that showed the highest ROSC and survival at discharge. For the pPEA group, we were able to conclude that the cardiac activity type is related to ROSC. Conclusion There is a significant difference for ROSC and survival at discharge prognosis among the cardiac arrest rhythms, with better outcomes for VF/VT and pPEA. Among patients with PEA, a routine ultrasound assessment is recommended. The type of cardiac activity recorded during the ultrasound of the cardiac arrest patient might be related to the ROSC and survival at discharge prognosis.

scholarly journals Innovative Uses of Visual Technologies in Initial Teacher Education: Changing Policy to Support Practice during covid-19

2021 ◽  
pp. 1-23
Author(s):  
Megan Adams ◽  
Tim Brooks ◽  
Angela Fitzgerald ◽  
Sindu George ◽  
Rebecca Cooper
Keyword(s):  
Preservice Teachers ◽  
Degree Completion ◽  
Time Frame ◽  
Initial Teacher Education ◽  
Innovative Solutions ◽  
Faculties Of Education ◽  
The University ◽  
Short Time ◽  
Visual Technologies ◽  
Collaborative Efforts

Abstract In Australia, schools and faculties of education are mandated to abide by a policy requiring preservice teachers (pst s), to complete supervised professional placement (pe) in schools. The pe are drawn upon to meet the assessment criteria for degree completion. Two strategies are reported that supported individuals and education institutions to meet policy requirements while in lockdown. First, technology was used to overcome the challenge of providing pe for hundreds of pst s by supporting online learning experiences. In the second, visual technologies were used to support pst s to meet the needs of an assessment criterion. Findings indicate that innovative solutions to challenges with pe and related assessments at the university can be mobilized in a short time frame using visual technologies. Further findings indicate that, in unprecedented times, policies developed for use in different contexts can be met with innovative collaborative efforts with a focused goal that transcend seemingly insurmountable challenges.

A Case on University and Community Collaboration

2010 ◽  
pp. 68-90
Author(s):  
S. Ann Becker ◽  
Robert Keimer ◽  
Tim Muth
Keyword(s):  
Small Businesses ◽  
Local Community ◽  
Swot Analysis ◽  
Time Frame ◽  
Economic Downturn ◽  
Community Collaboration ◽  
Diverse Group ◽  
Entrepreneurial Training ◽  
The University ◽  
Short Time

Small businesses are viewed as the backbone of America and integral in the recovery of any economic downturn. Creative approaches to university and community collaboration are being explored to achieve high rates of success in launching, sustaining, and growing small businesses. One such approach, the Entrepreneurial Training Services (ETS) program, is being studied by Sci-Tech University as a means of technology innovation and regional economic development. The ETS Program has several unique features including: the entrenchment of a large number of adults in the program, an intensive training approach that is implemented in a short time frame, personalized mentoring offered to each entrepreneur in the program, and the leveraging of resources with a large, diverse group of community partners. The case profiles the region using Strengths, Weaknesses, Opportunities, and Threats (SWOT) Analysis, identifies an ETS framework on which the program is based and explains the process of implementation. The case concludes with challenges facing the university and local community in offering the ETS Program to a large and diverse group of entrepreneurs. It also summarizes benefits and successes from initial implementation efforts.

scholarly journals Menstrual Problems and Lifestyle among Spanish University Women

2020 ◽  
Vol 17 (20) ◽  
pp. 7425
Author(s):  
Elia Fernández-Martínez ◽  
Tania Fernández-Villa ◽  
Carmen Amezcua-Prieto ◽  
María Morales Suárez-Varela ◽  
Ramona Mateos-Campos ◽  
...  
Keyword(s):  
Descriptive Analysis ◽  
Binary Logistic Regression ◽  
Emergency Rooms ◽  
Chi Square ◽  
University Women ◽  
Dietary Preferences ◽  
Chi Square Test ◽  
Spanish Universities ◽  
Student’S T ◽  
The University

Menstrual problems affect many young women worldwide, conditioning both their academic performance and quality of life. This study sought to analyse the prevalence of menstrual problems and their possible relationship with lifestyle among Spanish university women, as part of a research project (UniHcos Project) involving a cohort of 11 Spanish universities with 7208 university students. A descriptive analysis was performed using the bivariate chi-square test and the Student’s t-test together with a binary logistic regression, in which the dependent variable was ‘suffering from menstrual problems’. Menstrual problems were identified in 23.8% of the students, representing women who paid more visits to the doctor and to emergency rooms, and who consumed more painkillers and contraceptives. In relation to dietary preferences, menstrual problems were 1.39 (CI 95% 1.22–1.61; p = 0.000) times more likely among women classified as high-risk alcohol users according to the AUDIT questionnaire, and 1.187 (CI 95% 1.029–1.370; p = 0.019) times greater among those who consumed sweets daily, 1.592 (CI 95% 1.113–2.276; p = 0.011) times more frequent among those who eat fish daily, and 1.199 (CI 95% 1.004–1.432; p = 0.045) times greater among those who were dieting. Menstrual problems affect many college students and potentially modifiable lifestyle variables exist which may influence their prevalence. It would be interesting to develop programmes to promote women’s health in the university context.

scholarly journals Clinical and Laboratoy Characteristics of Parvovirus B19 Infection During 2013/2014 Outbreak in Zagreb, Croatia

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S319-S320
Author(s):  
Mia Ajdukovic ◽  
Lucija Pejic ◽  
Neven Papic ◽  
Adriana Vince
Keyword(s):  
Clinical Presentation ◽  
Parvovirus B19 ◽  
Age Groups ◽  
Clinical Manifestations ◽  
University Hospital ◽  
Complication Rates ◽  
Laboratory Findings ◽  
Mild Anemia ◽  
Parvovirus B19 Infection ◽  
The University

Abstract Background Human Parvovirus B19 (HPV-B19) occurs worldwide and causes mild, acute exanthematous disease that occurs in a form of cyclic local epidemics. The aim of this study was to analyze clinical features and complication rates of acute HPV-B19 infection in different age groups. Methods We retrospectively reviewed the charts of 718 consecutive patients clinicaly diagnosed with acute HPV-B19 infection who visited outpatient department at the University Hospital for Infectious Diseases in Zagreb, Croatia during 2013–2014 outbreak. In 212 patients (of 298 tested) diagnosis was confirmed by positive IgM antibodies and/or HPV-B19 DNA in peripheral blood. Results Outbreak started in June 2013 and had a peak in April 2014, with highest prevalence in schoolchildren. There were no difference in clinical presentation or laboratory findings between clinicaly and serologicaly diagnosed patients. Biphasic presentation, fever, myalgia, arthralgia, headache and peripheral edema were more frequent in adults, but „slapped cheeks” was found predominantly in children. Complications were more common in adults, most commonly hematological disordes (mild anemia, thrombocytopenia and leukopenia), vasculitis, hepatitis and aseptic meningitis. There were no deaths in our cohort. Conclusion Parvovirus B19 infection has different clinical presentation, laboratory findings and complications in children and adults. Since the diversity of the clinical manifestations in adults may be misleading, the infection in adults should be suspected when disease is prevalent in children. Disclosures `All authors: No reported disclosures.

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