scholarly journals CLINICAL FEATURES OF THE COURSE AND ASSESSMENT OF TREATMENT STRATEGY IN CHILDREN WITH BRONCHITIS

2021 ◽  
Vol 9 (2) ◽  
pp. 157-165
Author(s):  
Olena К. Koloskova ◽  
Tatiana М. Bilous ◽  
Galyna A. Bilyk ◽  
Roman V. Tkachuk ◽  
Maryana V. Dikal
Keyword(s):  
Relative Risk ◽  
Odds Ratio ◽  
Inpatient Treatment ◽  
Respiratory Diseases ◽  
Family Doctor ◽  
Significant Proportion ◽  
Bronchial Tree ◽  
Community Acquired Pneumonia ◽  
Clinical Severity ◽  
Clinical Group

Respiratory diseases always account for a significant proportion of visits to the pediatrician or family doctor, and bronchitis is usually a frequent clinical manifestation of acute respiratory diseases. The doctor often faces the question of how to objectively assess the clinical picture of bronchitis, and now the assessment of respiratory symptoms is often based on criteria such as cough, shortness of breath or wheezing on auscultation. However, today there are practically no data on the severity of bronchitis in children depending on the above criteria. A cohort of 158 children with bronchitis was created at the pulmonology and allergology Department of the Municipal Medical Institution "Regional Children's Clinical Hospital" in Chernivtsi. The severity of bronchitis was assessed at the beginning and on the 3rd and 7th day of inpatient using the Bronchitis Severity Score (BSS). According to this scale, mild bronchitis was verified in 30 patients which formed the I clinical group, and 128 children had moderate bronchitis (II clinical comparison group). Aggressive inflammation of the bronchi in children with moderate inflammation of the bronchial tree compared with patients with mild bronchitis was accompanied 1.6 times more often by recurrence, a history of episodes of community-acquired pneumonia in 9.4% of patients, long-term inpatient treatment (odds ratio 2.6) and halving the duration of the outpatient treatment period. The study of clinical severity of bronchitis in children of the comparison groups made it possible to establish an increase in the chances of a more severe course of the disease on the 7th day of hospitalization in children with moderate bronchitis (odds ratio 4.8) with persistence of cough in 68.7% of children in this group (odds ratio 3.8). Evaluation of inpatient treatment tactics indicated the need to increase the volume of complex therapy in patients with moderate bronchitis relative to children with mild disease (odds ratio 12.0, relative risk 8.8), as well as increasing the risk of the need for antibacterial therapy (odds ratio 3.7, relative risk 2.8) and the appointment of intravenous antibiotics for more than 3 days (odds ratio 5.0, relative risk 1.1).

scholarly journals COVID-19 pandemic in children of Сhernivtsi region: clinical features and annual treatment experience

2021 ◽  
Vol 16 (3) ◽  
pp. 225-232
Author(s):  
O.K. Кoloskova ◽  
T.M. Bilous ◽  
N.V. Gopko ◽  
M.B. Myroniuk
Keyword(s):  
Dynamic Analysis ◽  
Clinical Features ◽  
Odds Ratio ◽  
Inpatient Treatment ◽  
Clinical Symptoms ◽  
Community Acquired Pneumonia ◽  
Upper Respiratory Tract ◽  
The Third ◽  
Upper Respiratory ◽  
Inflammatory Syndrome

Background. The pandemic of coronavirus disease (COVID-19) has been going on for more than a year and is a problem for the health care system worldwide. At the same time, there are few studies on the peculiarities of COVID-19 in children, in particular how clinical symptoms have changed during the year with the change of types of coronavirus SARS-CoV-2. Objective was to conduct a retrospective generalized analysis of the clinical course, laboratory markers and features of treatment in pediatric cases of ­COVID-19 in Chernivtsi region. Materials and me­thods. Using the retrospective cohort method, 263 clinical cases of ­COVID-19 in children of the Chernivtsi region hospitalized for the period of March 2020 — March 2021 were analyzed. Results. In this work, a dynamic analysis was performed of the clinical features of ­COVID-19 course in the population of children of Chernivtsi region, who were hospitalized during March 2020 — March 2021 at inpatient departments with signs of infection caused by ­SARS-CoV-2. The first group included 65 patients who were treated in the second quarter of 2020, the second group consisted of 90 children who underwent inpatient treatment in the third quarter of 2020, the third group included 87 children who were treated in the fourth quarter of 2020, and the fourth group consisted of 21 children who underwent inpatient treatment in the first quarter of 2021. It was found that the frequency of complaints of malaise was due to infectious-inflammatory, intoxication and catarrhal symptom complexes, although in contrast to the onset of the pandemic, the complaints and signs of intoxication and asthenic syndromes, infectious-inflammatory syndromes, nonspecific neurological symptoms increased with a relatively stable rate of lesions of the upper respiratory tract. In the first quarter of 2021, there was an increase in cases of multisystem inflammatory syndrome (odds ratio = 6.5) and community-acquired pneumonia (odds ratio = 2.7). Conclusions. A dynamic analysis of the course of COVID-19 in children has demonstrated phenotypic deviations of the disease with torpidity to the prescribed treatment for nonspecific symptoms of disorders of the nervous system and gastrointestinal tract with a decrease in duration and severity of fever, increased incidence of pneumonia (odds ratio = 2.7) and multisystem inflammatory syndrome (odds ratio = 6.5).

scholarly journals THE MANIFESTATON FEATURES OF ACUTE RESPIRATORY DISEASES IN INFANTS

2019 ◽  
Vol 19 (4) ◽  
pp. 38-42 ◽  
Author(s):  
S.M. Tsvirenko ◽  
N.S. Artiomova ◽  
O.I. Ananevych ◽  
I.I. Adruschenko ◽  
O.V. Bеlan
Keyword(s):  
Medical Records ◽  
Inpatient Treatment ◽  
Respiratory Diseases ◽  
Viral Infections ◽  
General Structure ◽  
Underlying Disease ◽  
Community Acquired Pneumonia ◽  
Bronchial Obstruction ◽  
Respiratory Pathology ◽  
Acute Respiratory Diseases

According to WHO, acute respiratory diseases are at the forefront of the incidence rate of infants and are among the most common diseases due to which children are hospitalized. The aim of the research was to analyze the structure of morbidity and features of the course in acute respiratory diseases in infants with the study of the frequency of leading nosological forms that required inpatient treatment. A retrospective analysis of the medical records of inpatients (3845 children), treated during 2016-2018 was conducted. The study found that there is a tendency for an increase in the number of infants who require inpatient treatment, as well as an increased number of nosologies in the treated children. As the underlying disease, the first place in the structure of the morbidity belonged to acute respiratory viral infections. In the dynamics of the studied years, an increase in the frequency of acute obstructive bronchitis was noted. This pathology has the second place in the structure of morbidity among hospitalized children. The permanent third place in the structure of nosologies belongs to acute pneumonia. The premorbid background of most children with bronchial obstruction syndrome and acute community-acquired pneumonia was aggravated. The most commonly determined disorders were I-II degree anemia, overweight, impaired calcium metabolism, aggravated allergic history, transient immune deficiency. Conclusions. Our analysis of the structure of acute respiratory pathology in infants who required inpatient treatment showed that in the dynamics of 2016-2018, there was an increase in cases of acute obstructive bronchitis and acute community-acquired pneumonia. The study of general structure of nosologies in children treated at the inpatient department revealed an increase in their number and a tendency for the formation of comorbid pathology in infants.

scholarly journals Personalised high tibial osteotomy has mechanical safety equivalent to generic device in a case–control in silico clinical trial

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Alisdair R. MacLeod ◽  
Nicholas Peckham ◽  
Gil Serrancolí ◽  
Ines Rombach ◽  
Patrick Hourigan ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Relative Risk ◽  
Knee Osteoarthritis ◽  
High Tibial Osteotomy ◽  
Fatigue Failure ◽  
In Silico ◽  
Odds Ratio ◽  
Case Control ◽  
Tibial Osteotomy ◽  
3D Printed

Abstract Background Despite favourable outcomes relatively few surgeons offer high tibial osteotomy (HTO) as a treatment option for early knee osteoarthritis, mainly due to the difficulty of achieving planned correction and reported soft tissue irritation around the plate used to stablise the osteotomy. To compare the mechanical safety of a new personalised 3D printed high tibial osteotomy (HTO) device, created to overcome these issues, with an existing generic device, a case-control in silico virtual clinical trial was conducted. Methods Twenty-eight knee osteoarthritis patients underwent computed tomography (CT) scanning to create a virtual cohort; the cohort was duplicated to form two arms, Generic and Personalised, on which virtual HTO was performed. Finite element analysis was performed to calculate the stresses in the plates arising from simulated physiological activities at three healing stages. The odds ratio indicative of the relative risk of fatigue failure of the HTO plates between the personalised and generic arms was obtained from a multi-level logistic model. Results Here we show, at 12 weeks post-surgery, the odds ratio indicative of the relative risk of fatigue failure was 0.14 (95%CI 0.01 to 2.73, p = 0.20). Conclusions This novel (to the best of our knowledge) in silico trial, comparing the mechanical safety of a new personalised 3D printed high tibial osteotomy device with an existing generic device, shows that there is no increased risk of failure for the new personalised design compared to the existing generic commonly used device. Personalised high tibial osteotomy can overcome the main technical barriers for this type of surgery, our findings support the case for using this technology for treating early knee osteoarthritis.

Risky Business: Making Sense of Estimates of Risk

1998 ◽  
Vol 43 (4) ◽  
pp. 411-415 ◽  
Author(s):  
David L Streiner
Keyword(s):  
Relative Risk ◽  
Odds Ratio ◽  
Risk Difference ◽  
Attributable Risk ◽  
Absolute Difference ◽  
Number Needed To Treat ◽  
Making Sense ◽  
Specific Outcome ◽  
Relative Differences ◽  
Risky Business

This article describes various indices of risk, which is the probability that a person will develop a specific outcome. The risk difference is the absolute difference in risks between 2 groups and can be used either to compare the outcome of 2 groups, one of which was exposed to some genetic or environmental factor, or to see how much of an effect a treatment may have. The reciprocal of the risk difference, the number needed to treat, expresses how many patients must receive the intervention in order for 1 person to derive some benefit. Attributable risk reflects the proportion of cases due to some putative cause and indicates the number of cases that can be averted if the cause were removed. Finally, the relative risk and odds ratio reflect the relative differences between groups in achieving some outcome, either good (a cure) or bad (development of a disorder).

Non-COVID community-acquired pneumonia in the practice of a family doctor

2021 ◽  
pp. 49-57
Author(s):  
Vsevolod Vladimirovich Skvortsov ◽  
Ekaterina Mikhailovna Skvortsova ◽  
\Andrey Andreevich Eremenko ◽  
Nataliya Vladimirovna Yasko
Keyword(s):  
Family Doctor ◽  
Community Acquired Pneumonia ◽  
Basic Information

This article provides basic information about the etiology, classification and diagnosis of community-acquired pneumonia. The main approaches to the treatment of this disease are outlined. The modern approaches to the treatment of this disease at the outpatient stage are considered.

scholarly journals Meta-Analysis of the Relationship Between Ethnicity, Obesity, and Type 2 Diabetes of Adults in Urban Populations of Central America

2016 ◽  
Vol 5 (3) ◽  
pp. 274
Author(s):  
William G Wuenstel ◽  
James A. Johnson ◽  
James Humphries ◽  
Cheryl Samuel
Keyword(s):  
Type 2 Diabetes ◽  
Relative Risk ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Central American ◽  
Significance Level ◽  
Study Participants ◽  
The Impact ◽  
The Relationship

<table width="593" border="1" cellspacing="0" cellpadding="0"><tbody><tr><td rowspan="2" valign="top" width="387">The purpose of this meta-analysis was to examine the impact of ethnicity and obesity as it relates to Type-2 Diabetes (T2D) in specific Central American countries. A meta-analysis was conducted to determine the association of ethnicity, obesity, and T2D.  Four studies that qualified for inclusion were identified by searching MEDLINE and PubMed databases. The studies on the association of ethnicity and T2D had a combined population resulted in 265,858 study participants. Two studies on the association of obesity and T2D had 197,899 participants. An analysis of the data was conducted utilizing the relative risk ration, odds ratio, and forest plots. The comparison of the relative risk of T2D across ethnic categories by studies range for Blacks was 1.59 to 2.74, Asians was 1.43 to 2.08, and Hispanics .92 to 2.91.  The ethnic difference in the prevalence of diabetes was almost two-fold higher in all ethnic groups than among the Caucasians with a significance level of 95%. A comparison of relative risk of T2D across weight categories was significantly higher among those with a diagnosed of diabetes in all reported areas. The odds ratio was very close to the risk ratio in both ethnicity and obesity to the development of T2D. The meta-analysis findings documented that an association does exist between ethnicity and obesity to the development of type 2 diabetes.</td><td width="0" height="85"> </td></tr><tr><td width="0" height="82"> </td></tr></tbody></table>

scholarly journals Hospital Trainees Worries, Perceived Sufficiency of Information and Reported Psychological Health During The COVID-19 Pandemic

2020 ◽  
Author(s):  
Nikoo Aziminia ◽  
Aria Khani ◽  
Colette Smith ◽  
Ameet Bakhai ◽  
Clifford Lisk
Keyword(s):  
Psychological Distress ◽  
Psychological Health ◽  
Influenza Pandemic ◽  
Significant Proportion ◽  
Psychological Support ◽  
Clinical Severity ◽  
Alternative Methods ◽  
Liaison Psychiatry ◽  
Cross Sectional ◽  
Support Unit

Introduction: The COVID-19 pandemic has been unsurpassed in clinical severity or infectivity since the 1918 Spanish influenza pandemic and continues to impact the world. During the A/H1N1 influenza pandemic, healthcare workers presented frequent concerns regarding their ownand their families health, as well as high levels of psychological distress. Objectives: To assess hospital trainees concerns, perceived sufficiency of information, behaviour and reported psychological health during the COVID-19 pandemic in the NHS Design: Cross-sectional 39-point questionnaire study conducted in May 2020 Setting: A large NHS foundation trust in London Participants: 204 hospital trainee doctors Outcome measures: Quantitative analysis of trainees worries and concerns while working during the COVID-19 pandemic were assessed across 8 domains: trainee demographics; concerns and worries regarding COVID-19; perceived sufficiency of information about the COVID-19 pandemic; social distancing; use of personal protective equipment (PPE) and training in PPE; COVID-19 acquisition and risk; reported psychological health; and medical education. Results: 91.7% looked after COVID-19 patients. 91.6% were worried about COVID-19; the most frequent concern was that of family and friends dying from COVID-19 (74.6%). 22.2% reported being infected with COVID-19. 6.8% of trainees were so concerned about COVID-19 infection that they would avoid going to work. Perceived sufficiency of information about COVID-19 was moderately high. 25.9% reported that they were able to socially distance at work compared to 94.4% able to socially distance outside work. 98.2% reported using PPE and 24.7% were confident the provided PPE protected them against infection with COVID-19. 41.9% reported that their psychological health had been affected by their work with the commonest being anxiety (56.6%), emotional distress (50.9%) and burnout (37.7%). 95.6% felt it is important to have a service that provides psychological support during this pandemic and 62.5% reported they would consider using this at work. Conclusions: A significant proportion of hospital trainees are worried about the COVID-19 pandemic with high levels of reported psychological distress. Given that almost a third would not use psychological support services at work, hospital leaders and liaison psychiatry need to explore the reasons for not wanting to use services at work and highlight the provision of psychological services provided outside work such that provided by the London deaneries professional support unit (PSU). Seeking solutions to support trainee wellbeing in addition to this, such as larger offices, adequate rest facilities and alternative methods of teaching, with their input would enable empowerment of trainees and improve their health and morale while working in a pandemic.

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