scholarly journals Decline in subarachnoid haemorrhage volumes associated with the first wave of the COVID-19 pandemic

2021 ◽  
pp. svn-2020-000695
Author(s):  
Thanh N Nguyen ◽  
Diogo C Haussen ◽  
Muhammad M Qureshi ◽  
Hiroshi Yamagami ◽  
Toshiyuki Fujinaka ◽  
...  
Keyword(s):  
Subarachnoid Haemorrhage ◽  
Control Period ◽  
International Classification Of Diseases ◽  
Relative Increase ◽  
Ruptured Aneurysm ◽  
Cross Sectional ◽  
Cumulative Volume ◽  
Classification Of Diseases ◽  
Relative Decline ◽  
Aneurysm Coiling

BackgroundDuring the COVID-19 pandemic, decreased volumes of stroke admissions and mechanical thrombectomy were reported. The study’s objective was to examine whether subarachnoid haemorrhage (SAH) hospitalisations and ruptured aneurysm coiling interventions demonstrated similar declines.MethodsWe conducted a cross-sectional, retrospective, observational study across 6 continents, 37 countries and 140 comprehensive stroke centres. Patients with the diagnosis of SAH, aneurysmal SAH, ruptured aneurysm coiling interventions and COVID-19 were identified by prospective aneurysm databases or by International Classification of Diseases, 10th Revision, codes. The 3-month cumulative volume, monthly volumes for SAH hospitalisations and ruptured aneurysm coiling procedures were compared for the period before (1 year and immediately before) and during the pandemic, defined as 1 March–31 May 2020. The prior 1-year control period (1 March–31 May 2019) was obtained to account for seasonal variation.FindingsThere was a significant decline in SAH hospitalisations, with 2044 admissions in the 3 months immediately before and 1585 admissions during the pandemic, representing a relative decline of 22.5% (95% CI −24.3% to −20.7%, p<0.0001). Embolisation of ruptured aneurysms declined with 1170–1035 procedures, respectively, representing an 11.5% (95%CI −13.5% to −9.8%, p=0.002) relative drop. Subgroup analysis was noted for aneurysmal SAH hospitalisation decline from 834 to 626 hospitalisations, a 24.9% relative decline (95% CI −28.0% to −22.1%, p<0.0001). A relative increase in ruptured aneurysm coiling was noted in low coiling volume hospitals of 41.1% (95% CI 32.3% to 50.6%, p=0.008) despite a decrease in SAH admissions in this tertile.InterpretationThere was a relative decrease in the volume of SAH hospitalisations, aneurysmal SAH hospitalisations and ruptured aneurysm embolisations during the COVID-19 pandemic. These findings in SAH are consistent with a decrease in other emergencies, such as stroke and myocardial infarction.

Increasing Sepsis Rates in the United States: Results From National Inpatient Sample, 2005 to 2014

2018 ◽  
Vol 35 (9) ◽  
pp. 858-868 ◽  
Author(s):  
Muni Rubens ◽  
Anshul Saxena ◽  
Venkataraghavan Ramamoorthy ◽  
Sankalp Das ◽  
Rohan Khera ◽  
...  
Keyword(s):  
International Classification Of Diseases ◽  
The United States ◽  
Relative Increase ◽  
National Inpatient Sample ◽  
Readmission Rates ◽  
Cross Sectional ◽  
Hospitalization Cost ◽  
Classification Of Diseases ◽  
Coding Rules ◽  
Age And Sex

Objectives:To examine the trends in hospitalization rates, mortality, and costs for sepsis during the years 2005 to 2014.Methods:This was a retrospective serial cross-sectional analysis of patients ≥18 years admitted for sepsis in National Inpatient Sample. Trends in sepsis hospitalizations were estimated, and age- and sex-adjusted rates were calculated for the years 2005 to 2014.Results:There were 541 694 sepsis admissions in 2005 and increased to 1 338 905 in 2014. Sepsis rates increased significantly from 1.2% to 2.7% during the years 2005 to 2014 (relative increase: 123.8%; Ptrend< .001). However, the relative increase changed by 105.8% ( Ptrend< .001) after adjusting for age and sex and maintained significance. Although total cost of hospitalization due to sepsis increased significantly from US$22.2 to US$38.1 billion ( Ptrend< .001), the mean hospitalization cost decreased significantly from US$46,470 to US$29,290 ( Ptrend< .001).Conclusions:Hospitalizations for sepsis increased during the years 2005 to 2014. Our study paradoxically found declining rates of in-hospital mortality, length of stay, and mean hospitalization cost for sepsis. These findings could be due to biases introduced by International Classification of Diseases, Ninth Revision, Clinical Modification coding rules and increased readmission rates or alternatively due to increased awareness and surveillance and changing disposition status. Standardized epidemiologic registries should be developed to overcome these biases.

Abstract 14: Global Impact of the Covid-19 Pandemic on Subarachnoid Hemorrhage

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Thanh N Nguyen ◽  
Diogo C Haussen ◽  
Muhammad M Qureshi ◽  
Hiroshi Yamagami ◽  
Toshiyuki Fujinaka ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Mechanical Thrombectomy ◽  
Relative Increase ◽  
Significant Decline ◽  
Ruptured Aneurysm ◽  
Global Impact ◽  
Ruptured Aneurysms ◽  
Cumulative Volume ◽  
Icd 10 ◽  
Aneurysm Coiling

Introduction: During the COVID-19 pandemic, decreased volumes of stroke admissions and mechanical thrombectomy were reported. The objective was to examine whether subarachnoid hemorrhage(SAH) hospitalizations and ruptured aneurysm coiling interventions demonstrated similar declines. Methods: We conducted a global, retrospective, observational study across 6 continents, 37 countries, and 140 comprehensive stroke centers. Patients with diagnosis of SAH, ruptured aneurysm coiling interventions, COVID-19 were identified using ICD-10 codes or by prospectively maintained stroke databases. The 3-month cumulative volume, monthly volumes for SAH hospitalizations and ruptured aneurysm coiling procedures were compared for the period before (1-year and immediately before) and during the COVID-19 pandemic (March 1 to May 31, 2020). Results: There was a significant decline in SAH hospitalizations with 2,044 admissions in the 3 months immediately before and 1,585 admissions during the pandemic, representing a decline of 22.5% (95%CI, -24.3 to -20.7, p<0.0001). Embolization of ruptured aneurysms declined with 1,170 to 1,035 procedures, respectively, representing an 11.5%(95%CI, -13.5 to -9.8, p=0.002) drop. Hospitals with higher COVID-19 hospitalization burden demonstrated greater declines in SAH and ruptured aneurysm coiling compared to lower COVID-19 burden. A relative increase in coiling of ruptured aneurysms was noted in low coiling volume hospitals of 41.1% (95%CI, 32.3-50.6, p=0.008) despite a decrease in SAH admissions in this tertile. Conclusions: There was a global decrease in subarachnoid hemorrhage admissions and ruptured aneurysm embolizations during the COVID-19 pandemic. Among low-volume coiling SAH hospitals, there was an increase in the ruptured aneurysm coiling intervention. These findings in SAH are consistent with a global decrease in other emergencies such as stroke and myocardial infarction.*On behalf of the SVIN COVID-19 Collaborators

scholarly journals ELEVATED UNCONJUGATED BILIRUBIN IN SCHIZOPHRENIC PATIENTS

2018 ◽  
Vol 3 (1) ◽  
pp. 20
Author(s):  
Ilhamuddin Aziz ◽  
Yuyun Widaningsih ◽  
Rosdiana Natzir ◽  
A. Jayalangkara Tanra
Keyword(s):  
Total Bilirubin ◽  
International Classification Of Diseases ◽  
Cross Sectional ◽  
Elevated Liver Enzymes ◽  
Two Samples ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Schizophrenic Patients ◽  
Schizophrenic Group ◽  
Cross Sectional Design

Strategies for schizophrenic treatment still have been developed in order to increase their effectively, based on latest findings in the etio-pathology. Coincidence of hyperbilirubinemia, especially related to Gilbert’s Syndrome (GS), and schizophrenia/other psychiatric disorders, was reported in several studies although the pattern of this alteration is still controversial.  Bilirubin could induce microglia to release pro-inflammatory cytokine that cause neuroinflammation, one of hypothetic etio-pathogenesis has been the most extensively studied recently. However, no data have been presented about this phenomenon in Indonesia. Therefore, this study aims to investigate plasma bilirubin concentration in psychotic spectrum.This study is cross sectional design that we examined both the total bilirubin and direct bilirubin of every psychotic patient admitted for the first time to Rumah Sakit Khusus Daerah (RSKD) Provinsi Sulawesi Selatan over a period of July—December 2012, by using health people as control. Diagnostic determination was set based on International Classification of Diseases (ICD) 10. Patients suffering from any disease such as anemia (decreased hemoglobin), liver diseases (elevated liver enzymes), or substance abuse were excluded.            From 73 samples, we found that plasma UCB level was significantly elevated, higher in psychotic patients, especially schizophrenic group, than in the control. Total bilirubin rate was slightly increased in schizophrenic group compare to the others and two samples in this group showed hyperbilirubinemia. Further investigations are needed to ensure that whether the elevated UCB was related to GS and whether this condition has inflammatory effect.

scholarly journals Vulnerability to fatal drowning among the population in Southern Bangladesh: findings from a cross-sectional household survey

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e027896 ◽  
Author(s):  
Aminur Rahman ◽  
Jagnoor Jagnoor ◽  
Kamran ul Baset ◽  
Dan Ryan ◽  
Tahera Ahmed ◽  
...  
Keyword(s):  
Urban Areas ◽  
Public Health Problem ◽  
Household Survey ◽  
Risk Groups ◽  
International Classification Of Diseases ◽  
Operational Definition ◽  
Cross Sectional ◽  
Increased Risk ◽  
Classification Of Diseases ◽  
Associated Risk Factors

ObjectivesThis study aimed to determine the fatal drowning burden and associated risk factors in Southern Bangladesh.SettingsThe survey was conducted in 39 subdistricts of all 6 districts of the Barisal division, Southern Bangladesh.ParticipantsAll residents (for a minimum 6 months prior to survey) of the Barisal division, Southern Bangladesh.Intervention/methodsA cross-sectional, divisionally representative household survey was conducted in all six districts of the Barisal division between September 2016 and February 2017, covering a population of 386 016. Data were collected by face-to-face interview with adult respondents using handheld electronic tablets. International Classification of Diseases (ICD)-v. 10 (ICD-10) Chapter XX: External causes of morbidity and mortality codes for drowning, W65–W74, X36–X39, V90, V92, X71 or X92, were used as the operational definition of a drowning event.ResultsThe overall fatal drowning rate in Barisal was 37.9/100 000 population per year (95% CI 31.8 to 43.9). The highest fatal drowning rate was observed among children aged 1–4 years (262.2/100 000/year). Mortality rates among males (48.2/100 000/year) exceeded that for females (27.9/100 000/year). A higher rate of fatal drowning was found in rural (38.9/100 000/year) compared with urban areas (29.3/100 000/year). The results of the multivariable logistic regression identified that the factors significantly associated with fatal drowning were being male (OR 1.7, 95% CI 1.2 to 2.3), aged 1–4 years (OR 3.0, 95% CI 1.4 to 6.4) and residing in a household with four or more children (four or more children OR 1.8, 95% CI 1.1 to 2.9; and five or more children OR 2.1, 95% CI 1.2 to 3.7).ConclusionDrowning is a public health problem, especially for children, in the Barisal division of Southern Bangladesh. Male gender, children 1–4 years of age and residing in a household with four or more children were associated with increased risk of fatal drowning events. The Barisal division demands urgent interventions targeted at high-risk groups identified in the survey.

The distinctive neural circuitry of complex posttraumatic stress disorder during threat processing

2020 ◽  
pp. 1-8
Author(s):  
Richard A. Bryant ◽  
Kim L. Felmingham ◽  
Gin Malhi ◽  
Elpiniki Andrew ◽  
Mayuresh S. Korgaonkar
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
International Classification Of Diseases ◽  
Complex Posttraumatic Stress Disorder ◽  
Cross Sectional ◽  
Amygdala Activation ◽  
Threat Processing ◽  
Dorsolateral Prefrontal ◽  
Classification Of Diseases

Abstract Background There is controversy over the extent to which the new International Classification of Diseases (ICD-11) diagnosis of complex posttraumatic stress disorder (CPTSD) is distinct from posttraumatic stress disorder (PTSD). This study aimed to conduct the first investigation of distinctive neural processes during threat processing in CPTSD relative to PTSD. Method This cross-sectional functional magnetic resonance study included 99 participants who met criteria for PTSD (PTSD = 32, CPTSD = 28) and 39 trauma-exposed controls. PTSD was assessed with the Clinician-Administered PTSD Scale (CAPS). CPTSD was assessed with an adapted version of the International Trauma Questionnaire. Neural responses were measured across the brain while threat or neutral faces were presented at both supraliminal and subliminal levels. Results During supraliminal presentations of threat stimuli, there was greater bilateral insula and right amygdala activation in CPTSD participants relative to PTSD. Reduced supraliminal right dorsolateral prefrontal cortex activation and increased subliminal amygdala and insula activation were observed as common dysfunction for both CPTSD and PTSD groups relative to trauma controls. There were no significant differences in terms of subliminal presentations and no differences in functional connectivity. Dissociative responses were positively associated with right insula activation (r = 0.347, p < 0.01). Conclusions These results provide the first evidence of distinct neural profiles of CPTSD and PTSD during threat processing. The observation of increased insula and right amygdala activation in CPTSD accords with the proposal that CPTSD is distinguished from PTSD by disturbances in emotion regulation and self-concept.

scholarly journals Comparative analysis of methods for identifying multimorbidity patterns: a study of ‘real-world’ data

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e018986 ◽  
Author(s):  
Albert Roso-Llorach ◽  
Concepción Violán ◽  
Quintí Foguet-Boreu ◽  
Teresa Rodriguez-Blanco ◽  
Mariona Pons-Vigués ◽  
...  
Keyword(s):  
Real World ◽  
Hierarchical Cluster ◽  
International Classification Of Diseases ◽  
Cross Sectional Study ◽  
Real World Data ◽  
Cross Sectional ◽  
World Data ◽  
Data Usage ◽  
Classification Of Diseases ◽  
Depth Study

ObjectiveThe aim was to compare multimorbidity patterns identified with the two most commonly used methods: hierarchical cluster analysis (HCA) and exploratory factor analysis (EFA) in a large primary care database. Specific objectives were: (1) to determine whether choice of method affects the composition of these patterns and (2) to consider the potential application of each method in the clinical setting.DesignCross-sectional study. Diagnoses were based on the 263 corresponding blocks of the International Classification of Diseases version 10. Multimorbidity patterns were identified using HCA and EFA. Analysis was stratified by sex, and results compared for each method.Setting and participantsElectronic health records for 408 994 patients with multimorbidity aged 45–64 years in 274 primary health care teams from 2010 in Catalonia, Spain.ResultsHCA identified 53 clusters for women, with just 12 clusters including at least 2 diagnoses, and 15 clusters for men, all of them including at least two diagnoses. EFA showed 9 factors for women and 10 factors for men. We observed differences by sex and method of analysis, although some patterns were consistent. Three combinations of diseases were observed consistently across sex groups and across both methods: hypertension and obesity, spondylopathies and deforming dorsopathies, and dermatitis eczema and mycosis.ConclusionsThis study showed that multimorbidity patterns vary depending on the method of analysis used (HCA vs EFA) and provided new evidence about the known limitations of attempts to compare multimorbidity patterns in real-world data studies. We found that EFA was useful in describing comorbidity relationships and HCA could be useful for in-depth study of multimorbidity. Our results suggest possible applications for each of these methods in clinical and research settings, and add information about some aspects that must be considered in standardisation of future studies: spectrum of diseases, data usage and methods of analysis.

scholarly journals Colchicine Use Is Associated with Decreased Prevalence of Myocardial Infarction in Patients with Gout

2012 ◽  
Vol 39 (7) ◽  
pp. 1458-1464 ◽  
Author(s):  
DARIA B. CRITTENDEN ◽  
R. AARON LEHMANN ◽  
LAURA SCHNECK ◽  
ROBERT T. KEENAN ◽  
BINITA SHAH ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
New York ◽  
Statistical Significance ◽  
International Classification Of Diseases ◽  
Serum Urate ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
All Cause Mortality ◽  
Classification Of Diseases ◽  
Level Versus

Objective.The ability of antiinflammatory strategies to alter cardiovascular risk has not been rigorously examined. Colchicine is an antiinflammatory agent that affects macrophages, neutrophils, and endothelial cells, all of which are implicated in the pathogenesis of cardiovascular disease. We examined whether colchicine use was associated with a reduced risk of myocardial infarction (MI) in patients with gout.Methods.We conducted a retrospective, cross-sectional study of all patients with an International Classification of Diseases, 9th ed, code for gout in the electronic medical record (EMR) of the New York Harbor Healthcare System Veterans Affairs network and ≥ 1 hospital visit between August 2007 and August 2008. Hospital pharmacy data were used to identify patients who had filled at least 1 colchicine prescription versus those who had not. Demographics and CV comorbidities were collected by EMR review. The primary outcome was diagnosis of MI. Secondary outcomes included all-cause mortality and C-reactive protein (CRP) level.Results.In total, 1288 gout patients were identified. Colchicine (n = 576) and no colchicine (n = 712) groups had similar baseline demographics and serum urate levels. Prevalence of MI was 1.2% in the colchicine versus 2.6% in the no-colchicine group (p = 0.03). Colchicine users also had fewer deaths and lower CRP levels, although these did not achieve statistical significance. Colchicine effects persisted when allopurinol users were excluded from the analysis.Conclusion.In this hypothesis-generating study, gout patients who took colchicine had a significantly lower prevalence of MI and exhibited trends toward reduced all-cause mortality and lower CRP level versus those who did not take colchicine.

scholarly journals DEPRESSION AND ANXIETY IN CORRELATION TO BODY AREAS INVOLVED IN PATIENTS OF BURNS

2021 ◽  
Vol 71 (3) ◽  
pp. 734-38
Author(s):  
Ghazanfar Ali ◽  
Sikander Ali Khan ◽  
Muzzafar Ahmed ◽  
Muhammad Sheraz Afzal Malik ◽  
Danish Almas ◽  
...  
Keyword(s):  
Severe Depression ◽  
International Classification Of Diseases ◽  
Cross Sectional Study ◽  
Anxiety And Depression ◽  
Military Hospital ◽  
Depression And Anxiety ◽  
Cross Sectional ◽  
High Prevalence ◽  
Classification Of Diseases ◽  
Burns Unit

Objective: To evaluate the severity of depression and anxiety among patients of burns and correlate depression and anxiety with areas of body involved in burns. Study Design: A cross-sectional study. Place and Duration of Study: The departments of Psychiatry and department of Plastic Surgery, Combined Military Hospital Multan, from Oct 2019 to Mar 2020. Methodology: Through consecutive sampling, 56 patients of burns reporting to burns unit were assessed for anxiety and/ or depression based on the diagnostic criteria of International Classification of Diseases version 10. Symptom severity was assessed using Beck Depressive Inventory for depression and Beck Anxiety Inventory for anxiety. Descriptive statistics like mean with standard deviation was calculated for age. Frequency along with percentages was calculated for sociodemographic variables, Anxiety and depression. Results: Depression was present among 30 (53%) of participants out of which 16 (53.5%) had mild, 11 (37.9%) had moderate while only 3 (12.5%) had severe depression. Anxiety was seen among 50 (89%) of participants out of which sixteen (32.1%) had mild, 26 (51.7%) had moderate while 8 (16%) had severe anxiety. Significant correlation existed among the major area involved in burn with both anxiety and depression (p<0.01). Conclusion: There is a very high prevalence of anxiety and depression among patients of burn. Significant positive correlation existed between the level of anxiety and the areas involved in burns.

scholarly journals CAPE for measuring callous-unemotional traits in disadvantaged families: a cross-sectional validation study

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 1027
Author(s):  
Luna C.M. Centifanti ◽  
Hannah Shaw ◽  
Katherine J. Atherton ◽  
Nicholas D. Thomson ◽  
Susanne MacLellan ◽  
...  
Keyword(s):  
International Classification Of Diseases ◽  
Preliminary Evidence ◽  
Test Methods ◽  
Classification Systems ◽  
Behaviour Problems ◽  
Cross Sectional ◽  
Distinct Subgroup ◽  
Cu Traits ◽  
Callous Unemotional ◽  
Classification Of Diseases

Background: Callous-unemotional (CU) traits are important for designating a distinct subgroup of children and adolescents with behaviour problems.  As a result, CU traits are now used to form the specifier “with Limited Prosocial Emotions” that is part of the diagnostic criteria for the Conduct Disorder in the Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5) and International Classification of Diseases 11th Revision (ICD-11).  Given this inclusion in major classification systems, it is important to develop and test methods for assessing these traits that can be used in clinical settings.  The present study aimed to validate a clinician rating of CU traits, the Clinical Assessment of Prosocial Emotions, Version 1.1 (CAPE 1.1), in a sample of hard-to-reach families referred to a government program designed to prevent the development of behaviour problems in high risk families. Methods: Clinical ratings of children were obtained from 34 families of children ages 3 to 19 (M=12.2; SD=4.3). The ratings on the CAPE 1.1 were based on interviews with both parent and child. Results: Of the sample, 21% (100% male) met the diagnostic cut-off for the specifier according to the CAPE 1.1, and CAPE 1.1 scores were associated with parent ratings of CU traits, psychopathic traits, and externalising behaviours. CAPE 1.1 ratings were also associated with risk for violence obtained from case files.  Conclusions: These findings provide preliminary evidence for the validity of the CAPE 1.1 as clinician rated measure of CU traits.

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