Respiratory syncytial and influenza virus detecting rapid tests in children younger than 5 years of age in Armenia

Introduction: Acute respiratory infections (ARIs) are major causes of morbidity in early childhood. They are mainly caused by viruses, including influenza (INF) and respiratory syncytial viruses (RSV). We aimed to investigate the role of RSV and INF in children hospitalized for ARIs and to show the impact of RSV/INF rapid testing on management of patients. Methodology: Cross-sectional study using data of inpatient care of children younger than five years hospitalized in Arabkir Medical Center due to ARI from November 1, 2013 to April 1, 2014. Nasopharyngeal swabs were tested for RSV and INF types A and B by direct antigen detection tests. Results: A total of 915 patients, 583 (63.7%) boys and 332 (36.3%) girls were included in the study with the mean age of 18.8 ± 16.3 months. Among them, 390 (42.6%) were tested positive, 3 (0.3%) subjects tested positive both for RSV and INF: 269 (29.4%) for RSV and 124 (13.6%) for INF (A – 121, B – 3). Out of 915 children, 209 (23%) were pretreated with antibiotics, most often with oral amoxicillin/clavulanic acid (n = 54, 25.8%), sulfamethoxazole/trimethoprim (n = 46, 22%), and amoxicillin (n = 38, 18.2%), followed by intramuscular ceftriaxone (n = 37, 17.7%). Conclusions: The usage of antigen tests for detection of respiratory viruses allowed to document high rates of RSV and INF in children admitted to the hospital. In settings where polymerase chain reaction method is not readily available, implementation of rapid tests for detection of respiratory viruses is important in the management of pediatric patients including cohorting and more targeted use of antibiotics.

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Differential Effect of Recurrent Concussions on Symptom Clusters in Sport Concussion Assessment Tool

Journal of Sport Rehabilitation ◽

10.1123/jsr.2018-0166 ◽

2019 ◽

Vol 28 (7) ◽

pp. 735-739

Author(s):

Jian Chen ◽

Bruce Oddson ◽

Heather C. Gilbert

Keyword(s):

Assessment Tool ◽

Cross Sectional Study ◽

Physical Symptoms ◽

Symptom Clusters ◽

Cross Sectional ◽

Sport Concussion ◽

Comprehensive Survey ◽

Using Data ◽

Composite Scores ◽

The Impact

Context: Symptom checklist in Sport Concussion Assessment Tool has been widely used in preseason assessment and in concussion diagnosis, but the impact of prior concussions on the graded symptoms after a new concussion has not been evaluated. Objective: This study was undertaken to examine reported symptoms associated with recurrent concussions using data of a comprehensive survey among athletes. Design: Retrospective survey and cross-sectional study. Setting: College athletes. Participants: Student athletes who sustained one or more concussions. Main Outcome Measures: Concussion history and graded symptoms of the most recent concussion at time of the survey were surveyed. The impact of prior concussions was examined over symptoms and aggregated symptoms. Results: Multiple concussions were associated with greater reporting of individual symptoms related to emotion and physical symptoms of sensitivity to light and noise: more emotional (z = 2.3, P = .02); sadness (z = 2.4, P = .02); nervousness (z = 2.4, P = .02); irritability (z = 3.6, P = .01); sensitivity to light (z = 2.6, P = .01); and sensitivity to noise (z = 2.4, P = .04). The composite scores of emotional symptom and sensitivity symptom clusters were significantly higher: t = 2.68 (P < .01) and t = 3.35 (P < .01), respectively. Conclusions: The significant rises in emotional and sensitivity symptoms may be an important additive effect of concussive injury. Closer attention should be given to these symptom clusters when evaluating concussion injury and recovery.

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Hospitalized Patients Accessing Information on Prescribed Medications from the Bedside Terminal: A Cross-Sectional Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17134850 ◽

2020 ◽

Vol 17 (13) ◽

pp. 4850

Author(s):

Jungwon Cho ◽

Seungyeon Kim ◽

Sangyoon Shin ◽

Hyejin Yoo ◽

Gi Hyue Park ◽

...

Keyword(s):

Associated Factors ◽

Cross Sectional Study ◽

Hospitalized Patients ◽

Health Care Information ◽

Sectional Study ◽

Cross Sectional ◽

Expert Review ◽

Medication Information ◽

Using Data ◽

The Impact

Studies have documented the impact of various types of health care information technology (HIT) on patient outcomes. However, literature on the HIT products is largely for outpatients and little is known about those for hospitalized patients. In 2014, a Korean hospital developed an inpatient portal known as the Smart Bedside Station (SBS). A retrospective cross-sectional study was conducted to evaluate the associated factors for accessing the medication view menu (Today’s Medication) on the SBS using data from October 2018 through September 2019. A root cause analysis with expert review was conducted to identify additional barriers for accessing the medication view menu. Approximately 92.58% of the study population accessed the SBS at least once during their hospital stay. However, 99.20% of accessed patients used the SBS for entertainment purposes (e.g., television) and 40.16% viewed the medication information. Younger age, higher education, and certain jobs were significant associated factors for accessing the medication information. In conclusion, this study revealed strong associations between accessing the medication view menu on the SBS and a number of associated factors. Based on the results, further research is warranted to suggest new items to access the medication view menu by hospitalized patients.

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Clinical, Bacteriological and Radiological Study of Community Acquired Pneumonia Cases at Tertiary Medical Center in Kathmandu, Nepal

Nepal Medical College Journal ◽

10.3126/nmcj.v22i1-2.29995 ◽

2020 ◽

Vol 22 (1-2) ◽

pp. 1-7

Author(s):

S Shah ◽

Prabin Adhikari ◽

P Upadhaya ◽

P Shah

Keyword(s):

Hospital Stay ◽

Respiratory Infections ◽

Medical Center ◽

Gastrointestinal Symptoms ◽

Severe Pneumonia ◽

Cross Sectional Study ◽

Community Acquired Pneumonia ◽

Chronic Obstructive ◽

Cross Sectional ◽

Obstructive Pulmonary Disease

Community-acquired pneumonia (CAP) remains a common and serious illness, in spite of the availability of potent new antimicrobials and effective vaccines. Despite Nepal being one of the four developing countries accounting for 40.0% of global acute respiratory infections, studies on CAP are limited and the status of adult pneumonia in our community is unknown. This cross-sectional study reviewed the clinical, bacteriological, radiological profile of 100 cases of adult CAP and followed them during the hospital stay for the outcome. The age group with the highest incidence was 60-79 years with females (55.0%) being more affected than males (45.0%). Risk factors were present in 86.0% of cases, chronic obstructive pulmonary disease (COPD), and smoking was the most common, each present in 43.0% of cases. The most common presenting feature was cough (89.80%) followed by sputum production (78.60%), fever (67.30%), shortness of breath (63.30%), chest pain (38.80%), gastrointestinal symptoms (26.50%), altered sensorium (13.30%), and hemoptysis (13.30%). Only 48.0% of patients had leukocytosis. Klebsiella pneumoniae was the most frequent organism isolated (n=4) followed by Pseudomonas aeruginosa (n=3). Fungi were isolated in 3 cases. Lobar pneumonia was seen in 99.0% of cases with the right lower zone being the most commonly involved zone on chest x-ray. Severe pneumonia with CURB-65 (confusion, blood urea nitrogen, respiratory rate, blood pressure, age>65) Score ≥3 was seen in 15.0% of cases. The mean hospital stay was 7.55 days with 28 cases requiring ICU admission and 5 cases of mortality.

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Correlation Between Psychological Rumination and Symptoms of Traumatic Stress in Patients with Mild Paralysis in Acute Phase of Stroke: A Cross-sectional Study

10.21203/rs.3.rs-59444/v1 ◽

2020 ◽

Author(s):

Tetsuya Okihara ◽

Kohei Koizumi ◽

Hidetoshi Takahashi ◽

Mayumi Suzuki ◽

Tomonori Takeda ◽

...

Keyword(s):

Traumatic Stress ◽

Medical Center ◽

Japanese Version ◽

Cross Sectional Study ◽

Post Traumatic Stress ◽

Cross Sectional ◽

Impact Of Event Scale ◽

Event Scale ◽

Post Traumatic ◽

The Impact

Abstract Background: Research shows that post-traumatic stress symptoms (PTSS) are common in survivors of acute life-threatening illnesses, and rumination is considered to be associated with PTSS. Additionally, post-stroke symptoms of post-traumatic stress disorder (sPTSD) usually manifest as a type of anxiety disorder after a stroke. This study investigated the prevalence of sPTSD and the relationship between PTSS and rumination.Methods: The participants comprised 29 patients admitted to the Saitama Medical University International Medical Center within one week after experiencing a stroke. The Impact of Event Scale-Revised Japanese version (IES-R-J) and Leuven Adaptation of the Rumination on Sadness Scale Japanese version (LARSS-J) were employed for the evaluation of PTSS, sPTSD, and rumination.Results: The 29 patients (15 males, mean age: 63 ± 11 years) were classified as follows: 17 patients with cerebral infarction, 10 patients with cerebral hemorrhage, and 2 patients with subarachnoid hemorrhage. The ratio of persons with sPTSD (IES-R-J total score > 25) was 34% (10 patients). A significant positive correlation was found between PTSS and rumination (r = 0.460, p < 0.05).Conclusion: The findings indicated that approximately 30% of acute stroke patients experienced sPTSD, and that the severity of PTSS is related to rumination.

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Procalcitonin Uptake and Effect on Antibiotics Stewardship: A Single Institution Experience

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol05-i09/947 ◽

2020 ◽

Vol 5 (09) ◽

pp. 395-399

Author(s):

Hycienth Ahaneku, MD DrPH ◽

Chukwuemeka A. Umeh, MD DrPH ◽

Mike Cao, MD ◽

Bradley Kapten, MD ◽

Baher Elhalwagi, MD ◽

...

Keyword(s):

Logistic Regression ◽

Respiratory Infections ◽

Medical Center ◽

Demographic Data ◽

Public Health Problem ◽

Antibiotic Use ◽

Cross Sectional Study ◽

Antibiotics Resistance ◽

Cross Sectional ◽

Antibiotics Use

Background: In the face of antibiotics resistance and adverse effects, emerging evidence suggests that procalcitonin guided therapy can help enhance appropriate use of antibiotics especially in patients with respiratory infections and sepsis. We seek to assess the uptake of procalcitonin among clinicians in a US hospital and assess its correlation with amount and duration of antibiotics use. We also seek to identify factors significantly associated with antibiotic use. Methodology: Retrospective cross-sectional study of patients with sepsis and COPD at a Medical Center in Texas USA. A total 48 COPD and 62 Sepsis patients were assessed. We collected demographic data such as age, weight, height, gender, and race/ethnicity. We also collected data on procalcitonin, number of antibiotics used, duration of antibiotics, and WBC levels at admission. We conducted bivariate analyses and logistic regression analyses to assess factor associated with procalcitonin, number of antibiotics used and duration of antibiotics. Results: We had 48 COPD patients and 62 sepsis patients in this study. Overall physicians ordered Procalcitonin on only 11.8% of patients. Procalcitonin was not significantly associated with antibiotics use. However, patients who had procalcitonin ordered had significantly lower WBC count than those without procalcitonin (10.1 vs. 12.9, p:0.026). Number of antibiotics was significantly associated with type of diagnosis (Sepsis 66.7% vs. COPD 50.7%, p = 0.001). In the logistic regression analysis, after adjusting for other variables patients with sepsis were significantly more likely to be on higher number antibiotics (OR 6.08, p <0.001) and longer duration of antibiotics (OR 7.44, p < 0.001). Conclusion: Inappropriate use of antibiotics is a public health problem. Procalcitonin has been touted as a biomarker that is effective in reducing use of antibiotics. Our study showed a low utilization of Procalcitonin by physicians and that patients with lower WBC counts were more likely to have procalcitonin ordered. However, our study did not find any association between procalcitonin and the number and duration of antibiotics use.

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Free hospitalization for acute respiratory infections in children: what effect and how much does it cost for Armenia?

The Journal of Infection in Developing Countries ◽

10.3855/jidc.11158 ◽

2019 ◽

Vol 13 (05.1) ◽

pp. 051S-056S

Author(s):

Sergey Sargsyan ◽

Diana Andreasyan ◽

Samvel Kharazyan ◽

Olga Denisiuk ◽

Karapet Davtyan ◽

...

Keyword(s):

Program Implementation ◽

Respiratory Infections ◽

Cross Sectional Study ◽

Health Coverage ◽

Cross Sectional ◽

Under Five ◽

Icd 10 ◽

Out Of Pocket Expenses ◽

Using Data ◽

National Databases

Introduction: The “Child Certificate” program, launched in Armenia in 2011, made hospitalization for children less than seven years free in order to improve access to hospitalization, reduce out-of-pocket expenses and ensure Universal Health Coverage. We aimed to estimate trends in the number of outpatient and hospitalized acute respiratory infection (ARI) cases and related under-five mortality. Methodology: Cross-sectional study using data from national databases before (2008-2011) and after (2012-2017) Program implementation. The diagnosis of ARI was based on the International Classification of Disease (ICD-10). Results: The average hospitalization per 1000 children under 14 and infants increased by 85% and 75% respectively, compared with the period before the introduction of the Program, while the frequency of outpatient visits remained unchanged. The ARI-related mortality in children less than five years and in infants decreased by 11% and 19%, respectively. Financial allocations for ARI-associated hospitalizations amounted to 2.1 billion Armenian drams in 2011 and increased to 3.3 billion drams in 2016 (an increase of 57%). For pneumonia, this increase was 108% (from 0.35 to 0.72 billion). Conclusions: The introduction of free hospitalization for ARI led to an increase in the hospitalization rates. There was a favorable decline in under-five mortality and an exponential increase in financial allocations. The reasons for hospitalization should be investigated to ensure rational hospitalization with parallel improvement of primary care to reduce delayed presentations. It is necessary to find ways addressing the growing financial allocations for ARI-associated hospitalization.

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Clinical Trial Data Sharing: A Cross-Sectional Study of Outcomes Associated with Two NIH Models

10.1101/2021.09.10.21263404 ◽

2021 ◽

Author(s):

Anisa Rowhani-Farid ◽

Alexander C. Egilman ◽

Audrey D. Zhang ◽

Cary P. Gross ◽

Harlan M. Krumholz ◽

...

Keyword(s):

Clinical Trial ◽

Data Sharing ◽

Clinical Trial Data ◽

Cross Sectional Study ◽

Trial Data ◽

Cross Sectional ◽

Shared Data ◽

Using Data ◽

Meta Analyses ◽

The Impact

AbstractBackgroundThe impact and value of clinical trial data sharing, including the number and quality of publications that result from shared data – “shared data publications” – may differ depending on the data sharing model used.MethodsWe characterized the outcomes associated with two data sharing models previously used by Institutes of the U.S. National Institutes of Health (NIH): NHLBI’s centralized model, which uses a repository to manage data sharing requests, and NCI’s decentralized model, which entrusted research groups to independently manage data sharing requests. We identified trials completed in 2010 that met NIH data sharing criteria and matched studies sponsored by each Institute based on cost or size, determining whether trial data were shared and the frequency of shared data publications.ResultsWe identified 14 NHLBI-funded trials and 48 NCI-funded trials that met NIH data sharing criteria. We matched 14 NCI-funded trials to the 14 NHLBI-funded trials; among these, 4 NHLBI-sponsored trials (29%) and 2 NCI-sponsored trials (14%) shared data. From the 2 NCI-sponsored trials sharing data, we identified 2 shared data publications, one per trial, both of which were meta-analyses. From the 4 NHLBI-sponsored trials sharing data, we identified 7 shared data publications, all using data from 1 trial, 5 of which were pooled analyses and 2 reported secondary outcomes.ConclusionWhen characterizing the outcomes associated with two NIH data sharing models, both the NHLBI and the NCI models resulted in only 21% of trials sharing data and few shared data publications. There are opportunities to optimize clinical trial data sharing efforts both to enhance clinical trial data sharing and increase the number of shared data publications.

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Racial and ethnic disparities in opioid use for adolescents at US emergency departments

BMC Pediatrics ◽

10.1186/s12887-021-02715-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Michael T. Phan ◽

Daniel M. Tomaszewski ◽

Cody Arbuckle ◽

Sun Yang ◽

Candice Donaldson ◽

...

Keyword(s):

Black Women ◽

Ethnic Disparities ◽

Cross Sectional Study ◽

Opioid Use ◽

Cross Sectional ◽

Opioid Agonists ◽

Ed Visits ◽

Race Ethnicity ◽

Using Data ◽

The Impact

Abstract Background Racial/ethnic disparities in the use of opioids to treat pain disorders have been previously reported in the emergency department (ED). Further research is needed to better evaluate the impact race/ethnicity may have on the use of opioids in adolescents for the management of pain disorders in the ED. Methods This was a cross-sectional study using data from the National Hospital Ambulatory Medical Care Survey from 2006 to 2016. Multivariate models were used to evaluate the role of race/ethnicity in the receipt of opioid agonists while in the ED. All ED visits with patients aged 11–21 years old were analyzed. Races/ethnicities were stratified as non-Hispanic Whites, non-Hispanic Blacks, and Hispanics. In addition to race, statistical analysis included the following covariates: pain score, pain diagnosis, age, region, sex, and payment method. Results There was a weighted total of 189,256,419 ED visits. Those visits involved 109,826,315 (58%) non-Hispanic Whites, 46,314,977 (24%) non-Hispanic Blacks, and 33,115,127 (18%) Hispanics, with 21.6% (95% CI, 21.1%-22.1), 15.2% (95% CI, 14.6–15.9%), and 17.4% (95% CI, 16.5–18.2%) of those visits reporting use of opioids, respectively. Regardless of age, sex, and region, non-Hispanic Whites received opioids at a higher rate than non-Hispanic Blacks and Hispanics. Based on diagnosis, non-Hispanic Whites received opioids at a higher rate in multiple pain diagnoses. Additionally, non-Hispanic Blacks and Hispanics were less likely to receive an opioid when reporting moderate pain (aOR = 0.738, 95% CI 0.601–0.906, aOR = 0.739, 95% CI 0.578–0.945, respectively) and severe pain (aOR = 0.580, 95% CI 0.500–0.672, aOR = 0.807, 95% CI 0.685–0.951, respectively) compared to non-Hispanic Whites. Conclusions Differences in the receipt of opioid agonists in EDs among the races/ethnicities exist, with more non-Hispanic Whites receiving opioids than their minority counterparts. Non-Hispanic Black women may be an especially marginalized population. Further investigation into sex-based and regional differences are needed.

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Multidisciplinary team decision is rare and decreasing in percutaneous vascular interventions despite positive impact on in-hospital outcomes

VASA ◽

10.1024/0301-1526/a000771 ◽

2019 ◽

Vol 48 (3) ◽

pp. 262-269 ◽

Cited By ~ 3

Author(s):

Christian-Alexander Behrendt ◽

Tilo Kölbel ◽

Thea Schwaneberg ◽

Holger Diener ◽

Ralf Hohnhold ◽

...

Keyword(s):

Multidisciplinary Team ◽

Positive Impact ◽

Cross Sectional Study ◽

Invasive Treatment ◽

Cross Sectional ◽

Hospital Outcomes ◽

Vascular Intervention ◽

Medical Specialties ◽

Team Decision ◽

The Impact

Abstract. Background: Worldwide prevalence of peripheral artery disease (PAD) is increasing and peripheral vascular intervention (PVI) has become the primary invasive treatment. There is evidence that multidisciplinary team decision-making (MTD) has an impact on in-hospital outcomes. This study aims to depict practice patterns and time changes regarding MTD of different medical specialties. Methods: This is a retrospective cross-sectional study design. 20,748 invasive, percutaneous PVI of PAD conducted in the metropolitan area of Hamburg (Germany) were consecutively collected between January 2004 and December 2014. Results: MTD prior to PVI was associated with lower odds of early unsuccessful termination of the procedures (Odds Ratio 0.662, p < 0.001). The proportion of MTD decreased over the study period (30.9 % until 2009 vs. 16.6 % from 2010, p < 0.001) while rates of critical limb-threatening ischemia (34.5 % vs. 42.1 %), patients´ age (70 vs. 72 years), PVI below-the-knee (BTK) (13.2 % vs. 22.4 %), and rates of severe TASC C/D lesions BTK (43.2 % vs. 54.2 %) increased (all p < 0.001). Utilization of MTD was different between medical specialties with lowest frequency in procedures performed by internists when compared to other medical specialties (7.1 % vs. 25.7 %, p < 0.001). Conclusions: MTD prior to PVI is associated with technical success of the procedure. Nonetheless, rates of MTD prior to PVI are decreasing during the study period. Future studies should address the impact of multidisciplinary vascular teams on long-term outcomes.

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