scholarly journals Impact of the COVID-19 Lockdown on Ophthalmological Assistance in the Emergency Department at a Spanish Primary Level Hospital

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Julio González-Martín-Moro ◽  
Elena Guzmán-Almagro ◽  
Carlos Izquierdo Rodríguez ◽  
Ana Fernández Hortelano ◽  
Inmaculada Lozano Escobar ◽  
...  
Keyword(s):  
Emergency Department ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Ocular Tissue ◽  
Clinical Expression ◽  
Age And Gender ◽  
Primary Level ◽  
And Gender ◽  
Level Hospital ◽  
Similar Decrease

Purpose. To analyze the changes in ophthalmological emergencies during the COVID-19 pandemic lockdown at a Spanish primary level hospital. Methods. The number and type of emergencies attended in the emergency department of Hospital Universitario del Henares between March 10 and August 31, 2020 (COVID-19 cohort) were compared with the emergencies attended during the same period of 2019 (pre-COVID-19 cohort). Data on the diagnosis, patient age, and gender was retrospectively collected from the electronic medical records of the hospital. The different diagnoses were organized into “clusters,” which include those conditions that affect the same ocular tissue and that have similar clinical expression. Results. The number of ophthalmological emergencies during the study period was 841, compared to 1343 during the same month of 2019, which represents a reduction of 37.4%. The percentage reduction in each cluster was as follows: conjunctiva (−65.4%), cornea (−35.8%), uveitis (−3.6%), eyelid and orbital and lacrimal (−35.5%), strabismus (−60%), neuro-ophthalmology (−11.8%), retina (−10.6%), cataract (+16.4%), glaucoma (−37%), and miscellaneous (−45.1%). The number of people seen with viral conjunctivitis decreased by −87.1% compared to 2019. Patients with complications due to conjunctivitis also decreased: patients with pseudomembranes dropped from 16 to 4 cases and patients with corneal subepithelial infiltrates from 9 to 3 cases. Conclusions. Most diagnostic clusters showed a similar decrease. Clusters that included vision-threating conditions (retina, neuro-ophthalmology, and uveitis) remained mostly stable. During the COVID-19 lockdown, the diagnosis of adenoviral conjunctivitis decreased nearly 10 times. This fact may represent a decrease in the transmission of these infections.

Abstract MP07: Rising Incidence and Prevalence of Atrial Fibrillation from 2004 to 2013: A Community-Based Study Using Electronic Medical Records

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Brent Williams ◽  
Peter Berger
Keyword(s):  
Health Care ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Incidence Rates ◽  
Community Based ◽  
Age And Gender ◽  
Annual Increase ◽  
And Gender ◽  
Gender Groups ◽  
Large Health Care System

Introduction: Atrial fibrillation (AF) is the most common cardiac arrhythmia observed in clinical practice and is associated with an elevated risk of stroke and mortality. Evaluating community-level temporal trends in AF incidence and prevalence serve to describe the evolving public health and clinical burden of AF, however recent studies describing AF trends in community-based settings have been inconsistent, with no recent data evaluating trends among individuals under 65 years of age. Accordingly, this study sought to describe community-level trends in AF incidence and prevalence from 2004 to 2013 using the electronic medical records (EMR) of a single, large health care system. Methods: This study includes 329,634 patients receiving primary care and other health care services through the Geisinger Health System (Geisinger) over at least a two-year period. Geisinger consists of over 40 outpatient and seven inpatient facilities spread throughout central and northeastern Pennsylvania. Geisinger’s extensive EMR data repository contains information on demographics, vital signs, social history, diagnoses, medical history, problem lists, medications, procedures, laboratory results, and billing information from all Geisinger encounters since 2001. Incident and prevalent AF were identified by ICD-9 codes observed within any EMR domain. For incident AF, cases had no AF ICD-9 code in the EMR for at least two years prior to the diagnosis. Incidence and prevalence rates were age- and sex-adjusted to the 2010 US census and reported per 1000 person-years (persons). Stratified rates are reported across age groups (<45, 45-54, ¼, >85) and sex. Results: Age- and sex-adjusted AF incidence rates remained relatively stable from 2004 to 2008, but increased sharply thereafter. Incidence rates were 5.0, 5.2, and 8.4 cases per 1000 person-years in 2004, 2008, and 2013, respectively. The overall annual increase was 5.5% per year (95% CI: 4.8, 6.3%). Incidence rates increased significantly in all age and gender groups, with the largest relative increase observed among patients <45 years of age (annual increase in males: 10.8%, females: 11.6%). Prevalence rates increased consistently throughout the entire 10-year period from 23.5 to 39.2 AF cases per 1000 persons from 2004 to 2013 (6.0% annual increase; 95% CI: 5.7, 6.4%). Conclusions: AF incidence and prevalence have been increasing in the community over the last 10 years. Increases were observed in all age and gender groups, with notable increases in the very young. Prevailing trends may be attributable to increased application of AF diagnostics in an aging population and/or an increased clinical recognition of AF due to the recent availability of novel oral anticoagulants for stroke prevention. A mature EMR system functioning within a large health care system can be a powerful tool for performing epidemiologic studies and disease surveillance.

scholarly journals The burden of hip and knee osteoarthritis in Finnish occupational healthcare

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Milla Summanen ◽  
Liisa Ukkola-Vuoti ◽  
Samu Kurki ◽  
Samuli Tuominen ◽  
Rami Madanat
Keyword(s):  
Sick Leave ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Matched Control ◽  
Registry Study ◽  
Control Cohort ◽  
Age And Gender ◽  
Knee Oa ◽  
And Gender ◽  
Occupational Healthcare

Abstract Background Osteoarthritis (OA) is a leading cause of disability and pain especially among older adults, but it is also known to affect working age individuals, often leading to reduced productivity and increased healthcare usage. The aim of this study was to determine the burden of hip and knee OA in Finnish occupational healthcare. Methods This was a retrospective registry study utilizing the electronic medical records of the largest private and occupational healthcare provider in Finland. All consented patients with hip or knee OA were identified. A subcohort of occupational healthcare (OCH) patients was then compared to an age- and gender-matched control group without OA. Patient demographics including comorbidities were determined and healthcare contacts, medication prescriptions, and sick leaves were compared between the two groups. The study period was from January 1st, 2012 to April 30th, 2020. Results 51,068 patients with hip or knee OA were identified (all OA cohort) and 35,109 of these formed the occupational healthcare subcohort. Most of the OA patients were female and belonged to the age group 50–59 years. The point prevalence of hip/knee OA at the end of the study period was 5.6% for the occupational healthcare subcohort. OA patients had 2.2 times more healthcare contacts and 2.8 times more overall sick leave days compared to the age- and gender-matched control cohort. Etoricoxib was the most commonly prescribed medication at OA-related visits (21.8% of patients). Opioids were prescribed to 10.6% of patients at OA-related visits and the most prescribed opioid was a combination of codeine and paracetamol (4.8% of patients). 5054 OA patients (14.4%) had a contraindication for non-steroidal anti-inflammatory drugs (NSAIDs). Conclusions This retrospective registry study utilizing real-world data provides new evidence on the disease burden of hip or knee osteoarthritis from the electronic medical records of Finnish occupational healthcare customers. OA patients had more comorbidities, more healthcare contacts, more sick leave days, and more analgesic prescriptions compared to an age- and gender-matched control cohort without OA.

scholarly journals Profile of Colorectal Tumor in Gastroentero-Hepatology Center, Department of Internal Medicine, Dr Soetomo Hospital, Surabaya

2020 ◽  
Vol 56 (1) ◽  
pp. 15
Author(s):  
Husin Thamrin ◽  
Khafidhotul Ilmiah ◽  
Ni Wajan Tirthaningsih
Keyword(s):  
Colorectal Cancer ◽  
Medical Records ◽  
Colorectal Tumor ◽  
Age And Gender ◽  
Male And Female ◽  
The Third ◽  
Common Cancer ◽  
Significant Difference ◽  
And Gender ◽  
Ethical Clearance

Colorectal cancer has became burden in the world.The latest study shows that colorectal cancer is the third most common cancer in men and second most common cancer in women globally. There are difference characteristic of epidemiology in every countries. Moreover, there is no study that represents epidemiology of colorectal cancer in Indonesia yet, especially in East Java. The aim of this study was to describe colorectal tumor profile by age and gender in Gastroentero-Hepatology Center, Dr Soetomo Hospital. This study has received a certificate of Ethical Clearance No.273/Panke.KKE/IV/2015, a descriptive retrospective study. We collected data using medical records, and patients who have been colonoscopy examination and suspected colorectal tumor were included. There were 201 patients, divided to 100 males and 101 females. The peak of incidence was on 51-60 years old group, but on the 31-40 years old incidence of colorectal tumor was increased. The youngest patient was 17 years old. And tumors are more likely develop in distal area, especially in rectum. This study shows a different characteristic profile of colorectal tumor, where tumor is developed at young people and there is no significant difference between male and female for the incidence.

scholarly journals Influence of Age and Gender on the Clinical Expression of Acute Intermittent Porphyria Based on Molecular Study of Porphobilinogen Deaminase Gene Among Swiss Patients

2001 ◽  
Vol 7 (8) ◽  
pp. 535-542 ◽  
Author(s):  
Macé M. Schuurmans ◽  
Xiaoye Schneider-Yin ◽  
Urszula B. Rüfenacht ◽  
Cécile Schnyder ◽  
Christoph E. Minder ◽  
...  
Keyword(s):  
Acute Intermittent Porphyria ◽  
Molecular Study ◽  
Porphobilinogen Deaminase ◽  
Clinical Expression ◽  
Age And Gender ◽  
And Gender

scholarly journals Not All Patients with Hemiplegia Need Alteplase: A Case of Hemiplegic Migraine

2020 ◽  
Author(s):  
Sumeet Yadav ◽  
Michelle Talukder ◽  
Jacky Duong
Keyword(s):  
Emergency Department ◽  
Early Diagnosis ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Cerebrovascular Accident ◽  
Sensory Impairment ◽  
Hemiplegic Migraine ◽  
Rare Type ◽  
Head Ct ◽  
Work Up

Hemiplegic migraine (HM) is a rare type of migraine which presents with motor and sensory impairment like a cerebrovascular accident (CVA). We present a case of a 36-year-old female, with a prior CVA treated with alteplase, who presented to the emergency department with stroke-like symptoms with a duration of 1 hour. The NIH Stroke Scale score was 22 at presentation. The patient received alteplase under the supervision of a neurologist after head CT confirmed no bleed. Further work-up revealed no acute or remote ischaemia or infarction. This case demonstrates the importance of a thorough history, intercommunication between health systems and integrated Electronic Medical Records (EMR) for early diagnosis and management of HM.

scholarly journals Frequent Mobile Electronic Medical Records Users Respond More Quickly to Emergency Department Consultation Requests: Retrospective Quantitative Study

10.2196/14487 ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. e14487 ◽  
Author(s):  
Kwang Yul Jung ◽  
SuJin Kim ◽  
Kihyung Kim ◽  
Eun Ju Lee ◽  
Kyunga Kim ◽  
...  
Keyword(s):  
Emergency Department ◽  
Response Time ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Inverse Relationship ◽  
Secondary Outcome ◽  
Time Interval ◽  
Care Providers ◽  
Significant Inverse Relationship ◽  
The Relationship

Background Specialty consultation is a critical aspect of emergency department (ED) practice, and a delay in providing consultation might have a significant clinical effect and worsen ED overcrowding. Although mobile electronic medical records (EMR) are being increasingly used and are known to improve the workflow of health care providers, limited studies have evaluated their effectiveness in real-life clinical scenarios. Objective For this study, we aimed to determine the association between response duration to an ED specialty consultation request and the frequency of mobile EMR use. Methods This retrospective study was conducted in an academic ED in Seoul, South Korea. We analyzed EMR and mobile EMR data from May 2018 to December 2018. Timestamps of ED consultation requests were retrieved from a PC-based EMR, and the response interval was calculated. Doctors’ log frequencies were obtained from the mobile EMR, and we merged data using doctors’ deidentification numbers. Pearson’s product-moment correlation was performed to identify this association. The primary outcome was the relationship between the frequency of mobile EMR usage and the time interval from ED request to consultation completion by specialty doctors. The secondary outcome was the relationship between the frequency of specialty doctors’ mobile EMR usage and the response time to consultation requests. Results A total of 25,454 consultations requests were made for 15,555 patients, and 252 specialty doctors provided ED specialty consultations. Of the 742 doctors who used the mobile EMR, 208 doctors used it for the specialty consultation process. After excluding the cases lacking essential information, 21,885 consultations with 208 doctors were included for analysis. According to the mobile EMR usage pattern, the average usage frequency of all users was 13.3 logs/day, and the average duration of the completion of the specialty consultation was 51.7 minutes. There was a significant inverse relationship between the frequency of mobile EMR usage and time interval from ED request to consultation completion by specialty doctors (coefficient=–0.19; 95% CI –0.32 to –0.06; P=.005). Secondary analysis with the response time was done. There was also a significant inverse relationship between the frequency of specialty doctors’ mobile EMR usage and the response time to consultation requests (coefficient=–0.18; 95% CI –0.30 to –0.04; P=.009). Conclusions Our findings suggest that frequent mobile EMR usage is associated with quicker response time to ED consultation requests.

Evaluation of the effects of pain scale and analgesic administration on radiological imaging methods and hospitalization in trauma patients admitted to the emergency service

2021 ◽  
Keyword(s):  
Emergency Department ◽  
Pain Intensity ◽  
Pain Scale ◽  
Trauma Patients ◽  
Radiological Imaging ◽  
Age And Gender ◽  
Imaging Methods ◽  
Trauma Types ◽  
And Gender ◽  
Analgesic Administration

Background: Trauma, one of the major concerns in today’s world, exposes societies to important economic, social and health-related problems. Trauma is known to account for 10% of the world’s deaths. Objective: The aim of the study is to evaluate the demographic characteristics of trauma, which is common in emergency services and causes significant loss of workload and function when appropriate diagnosis and treatment methods are not applied, with radiological imaging methods, pain scale and analgesics. Materials and Methods: This prospective study included 1267 patients over the age of 18, who were admitted to the emergency department due to trauma between 1 January and 31 December 2019. The mean age of patients was 47.01 ± 14.97 year, with a male/female ratio of 1.46. 59.3% of the patients were male and 40.7% were female. Patients’ trauma types, radiology results, mortality, numerical pain scale and analgesic administration were evaluated. Results: Numerical pain scale score of trauma patients in the emergency department was 6.23 ± 2.02. Analysis of radiological imaging methods showed significance with age, numerical pain scale, thoracic and lumbar vertebrae, thoracic and abdominal injuries, types of trauma, consultation, hospitalization, analgesics administration and pain severity. Trauma types were insignificant with age and gender, but a significant relationship was found with all other parameters. Pain intensity was not correlated with gender and tetanus application but was significant with other variables. There was significance in radiological imaging methods and diagnostic types between injury types. Types of diagnosis were found to be correlated with imaging methods, orthopedic consultation, numerical pain scale and injury types. There was a significant correlation with the types of diagnosis, analgesia administration, consultation, and pain classification according to the pain rating scale. There was no correlation between age and gender according to pain intensity. However, there was a strong positive correlation with pain scale scores, consultation, hospitalization, types of trauma, administration of analgesia, and a weak correlation with radiological imaging methods. Conclusion: Early pain scale with radiological imaging and analgesic administration in trauma patients can reduce morbidity rates and shorten hospital stay.

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