scholarly journals Trends in obstetric emergency department attendance the first months of the coronavirus pandemic

2021 ◽  
Vol 17 (2) ◽  
Author(s):  
Sahr Yambasu ◽  
Eve Gaughan
Keyword(s):  
Emergency Department ◽  
Administrative Data ◽  
Cross Sectional ◽  
Paired Sample ◽  
Emergency Department Attendance ◽  
Obstetric Emergency ◽  
Significant Difference ◽  
The Republic ◽  
Medical Disciplines ◽  
Sectional Analysis

Many medical disciplines reported a decline in patient attendance during the coronavirus pandemic. Our paper examines the effects that the coronavirus pandemic had on obstetric Emergency Department (ED) attendances in a tertiary maternity centre in the Republic of Ireland. A retrospective cross-sectional analysis was performed on administrative data regarding the number of obstetric patients attending the ED from January to July in 2019 and 2020. These numbers were compared to the number of reported coronavirus cases in Ireland as released in official government publications. A paired sample t-test was carried out to see if there was a significant difference in attendance in the obstetric ED in 2020 compared to in 2019. When COVID-19 cases peaked at 17,377 in April 2020, ED attendance showed their largest decline of 27%. The cumulative decline in ED attendances from January to July in 2019 to 2020 was 13%. However, this decline was not found to be statistically significant. In contrast to other disciplines, the COVID-19 pandemic did not cause a decrease in obstetric ED attendance.

Renal Phosphate Handling in Antiretroviral-naïve HIV-infected Patients

2020 ◽  
Vol 20 ◽  
Author(s):  
Tewogbade Adeoye Adedeji ◽  
Simeon Adelani. Adebisi ◽  
Nife Olamide Adedeji ◽  
Olusola Akanni Jeje ◽  
Rotimi Samuel Owolabi
Keyword(s):  
Hiv Infection ◽  
Plasma Phosphate ◽  
Cross Sectional ◽  
Phosphate Retention ◽  
Significant Difference ◽  
Immunodeficiency Virus ◽  
Life Threatening ◽  
Moderate Chronic Kidney Disease ◽  
One Year ◽  
Sectional Analysis

Background: Human immunodeficiency virus (HIV) infection impairs renal function, thereby affecting renal phosphate metabolism. Objectives: We prospectively estimated the prevalence of phosphate abnormalities (mild, moderate to life-threatening hypophosphataemia, and hyperphosphataemia) before initiating antiretroviral therapy (ART). Methods: A cross-sectional analysis was performed on 170 consecutive newly diagnosed ART-naïve, HIV-infected patients attending our HIV/AIDS clinics over a period of one year. Fifty (50) screened HIV-negative blood donors were used for comparison (controls). Blood and urine were collected simultaneously for phosphate and creatinine assay to estimate fractional phosphate excretion (FEPi %) and glomerular filtration rate (eGFR). Results: eGFR showed significant difference between patients’ and controls’ medians (47.89ml/min/1.73m2 versus 60ml/min/1.73m2, p <0.001); which denotes a moderate chronic kidney disease in the patients. Of the 170 patients, 78 (45.9%) had normal plasma phosphate (0.6-1.4 mmol/L); 85 (50%) had hyperphosphataemia. Grades 1, 2 and 3 hypophosphataemia was observed in 3 (1.8%), 3 (1.8%), and 1(0.5%) patient(s) respectively. None had grade 4 hypophosphataemia. Overall, the patients had significantly higher median of plasma phosphate than the controls, 1.4 mmol/L (IQR: 1.0 – 2.2) versus 1.1 mmol/L (IQR: 0.3 – 1.6), p <0.001, implying hyperphosphataemia in the patients; significantly lower median urine phosphate than the controls, 1.5 mmol/L (IQR: 0.7 -2.1) versus 8.4 mmol/L (IQR: 3.4 – 16), p <0.001), justifying the hyperphosphataemia is from phosphate retention; but a non-significantly lower median FEPi% than the controls, 0.96 % (IQR: 0.3 -2.2) versus 1.4% (IQR: 1.2 -1.6), p > 0.05. Predictors of FEPi% were age (Odds ratio, OR 0.9, p = 0.009); weight (OR 2.0, p < 0.001); CD4+ cells count predicted urine phosphate among males (p = 0.029). Conclusion: HIV infection likely induces renal insufficiency with reduced renal phosphate clearance. Thus, hyperphosphataemia is highly prevalent, and there is mild to moderate hypophosphataemia but its life-threatening form (grade 4) is rare among ART-naïve HIV patients.

scholarly journals Adolescents’ pain and distress during peripheral intravenous cannulation in a paediatric emergency setting

2021 ◽  
Author(s):  
Giorgio Cozzi ◽  
Marta Cognigni ◽  
Riccardo Busatto ◽  
Veronica Grigoletto ◽  
Manuela Giangreco ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pain Relief ◽  
Local Anaesthesia ◽  
Cross Sectional Study ◽  
Emergency Setting ◽  
Older Children ◽  
Cross Sectional ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency ◽  
Significant Difference

AbstractThe objective of the study is to investigate pain and distress experienced by a group of adolescents and children during peripheral intravenous cannulation in a paediatric emergency department. This cross-sectional study was performed between November 2019 and June 2020 at the paediatric emergency department of the Institute for Maternal and Child Health of Trieste, Italy. Eligible subjects were patients between 4 and 17 years old undergoing intravenous cannulation, split into three groups based on their age: adolescents (13–17 years), older children (8–12 years), and younger children (4–7 years). Procedural distress and pain scores were recorded through validated scales. Data on the use of topical anaesthesia, distraction techniques, and physical or verbal comfort during procedures were also collected. We recruited 136 patients: 63 adolescents, 48 older children, and 25 younger children. There was no statistically significant difference in the median self-reported procedural pain found in adolescents (4; IQR = 2–6) versus older and younger children (5; IQR = 2–8 and 6; IQR = 2–8, respectively). Furthermore, no significant difference was observed in the rate of distress between adolescents (79.4%), older (89.6%), and younger (92.0%) children. Adolescents received significantly fewer pain relief techniques.Conclusion: This study shows that adolescents experience similar pain and pre-procedural distress as younger children during peripheral intravenous cannulation. What is Known:• Topical and local anaesthesia, physical and verbal comfort, and distraction are useful interventions for pain and anxiety management during intravenous cannulation in paediatric settings. • No data is available on pain and distress experienced by adolescents in the specific setting of the emergency department. What is New:• Adolescents experienced high levels of pre-procedural distress in most cases and similar levels of pain and distress when compared to younger patients• The number of pain relief techniques employed during procedures was inversely proportional to patient’s age, topical or local anaesthesia were rarely used

PREVALENCE OF ESSENTIAL ARTERIAL HYPERTENSION IN CHILDREN AND ADOLESCENTS OF DAGESTAN AND THE CONTENT OF Mg, K, Ca, Zn, Pb IN SOILS AND NATURAL WATERS OF THE TERRITORY

2021 ◽  
Vol 100 (5) ◽  
pp. 203-208
Author(s):  
Sh.K. Salikhov ◽  
◽  
D.Z. Alieva ◽  
U.A. Magomedova ◽  
S.О. Abdulkadyrova ◽  
...  
Keyword(s):  
Arterial Hypertension ◽  
Natural Waters ◽  
Chemical Elements ◽  
The Body ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Significant Difference ◽  
Geochemical Factors ◽  
Essential Arterial Hypertension ◽  
The Republic

The aim of the study is to determine the role of geochemical factors (the content of Mg, K, Ca, Zn, Pb in soils and natural waters of the plain zone of Dagestan) in the prevalence of essential arterial hypertension (EAH) among the population of children. Materials and methods of research: an observational cross-sectional (one-step) study of the prevalence of EAH in the child population was carried out. The prevalence rates of EAH among children in the plain zone of the Republic of Dagestan are calculated for 100,000 children 0–17 years old, without taking into account gender differences. The content of elements (Mg, K, Ca, Zn, Pb) in the environment (soil, natural waters) was determined by atomic absorption spectroscopy. Results: one-way analysis of variance (One-Way ANOVA) of indicators of the content of metals (Mg, K, Ca, Zn, Pb) in the regions and objects (soils, natural waters) of the study revealed a statistically significant difference in the data (for soils: F=81,06772, p<0,0002; for natural waters: F=58,86451, p<0,00001). The dependence of children's EAH on the content of chemical elements in the objects of the biosphere of Dagestan was determined, which was expressed in an increase in the number of patients with EAH when Pb content exceeded (r=+ 0,576, r=+ 0,759) and with the decrease of Mg (r=–0,668, r=–0,173), K (r=–0,440, r=–0,636), Ca (r=–0,693, r=–0,533), Zn (r=–0,051, r=–0,827) in soils and natural waters. Conclusion: when assessing the pathogenesis of EAH in the population of children, the content of Mg, K, Ca, Zn, Pb in soil and water should be taken into account, since these microelements, entering the body with water and food, affect the elemental status of child's body.

Polypharmacy and Potentially Inappropriate Medication Use in Older Blacks with Diabetes Mellitus Presenting to the Emergency Department

2021 ◽  
pp. 089826432110455
Author(s):  
Ginah Nightingale ◽  
Emily M. Scopelliti ◽  
Robin Casten ◽  
Monica Woloshin ◽  
Shu Xiao ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Emergency Department ◽  
Controlled Trial ◽  
Inappropriate Medication ◽  
Medication Use ◽  
Potentially Inappropriate Medication ◽  
Cross Sectional ◽  
Randomized Controlled ◽  
Inappropriate Medication Use ◽  
Sectional Analysis

Background: Medication-related problems in older Blacks with diabetes mellitus (DM) are not well established. Objectives: To describe the frequency of medication-related problems in older Blacks with DM presenting to the emergency department (ED). Methods: The study was a cross-sectional analysis of baseline data from a randomized controlled trial evaluating Blacks aged ≥60 years of age presenting to the ED. Polypharmacy, potentially inappropriate medication (PIM) use, and anticholinergic score were evaluated. Results: Of 168 patients (median age = 68, range 60–92), most ( n = 164, 98%) were taking ≥5 medications, and 67 (39.9%) were taking a PIM. A majority ( n = 124, 74%) were taking a medication with an anticholinergic score ≥1. Number of medications was correlated with number of PIMs ( r = .22, p = .004) and anticholinergic score ( r = .50, p < .001). Conclusion: Polypharmacy and PIM use was common in older Blacks with DM.

scholarly journals A comparison of pain registration by Visual Analog Scale and Numeric Rating Scale – a cross-sectional study of primary triage registration

2020 ◽  
Author(s):  
Jofrid Kollltveit ◽  
Malin Osaland ◽  
Marianne Reimers ◽  
Magnus Berle
Keyword(s):  
Emergency Department ◽  
Visual Analog Scale ◽  
Rating Scale ◽  
Emergency Admission ◽  
Numeric Rating Scale ◽  
University Hospital ◽  
Analog Scale ◽  
Cross Sectional ◽  
Significant Difference ◽  
Numeric Rating

BackgroundPain is a subjective sensation; self-reporting is important for quantifying pain intensity. There are several different validated tools for this, such as Visual Analog Scale and Numeric Rating Scale. In the clinic, these terms are often used as equivalent. The objective of this study was to examine correlation and agreement between the pain registration tools in triage in an emergency department.Materials and MethodsThe study was performed in the Department of Emergency Medicine at Haukeland University Hospital in the period June-August 2019. We registered the pain score with two tools in 200 unselected patients in emergency admission with pain. In addition, we registrered gender, age, triage and general department affiliation.ResultsWe found a strong correlation between the pain registration tools by Spearmans correlation test (rho=0,930, p<0,001). There were no significant difference between the pain registration tools within the subgroups. Bland-Altman analysis show agreement between the two pain registration tools.ConclusionsIn an Emergency Department triage is it acceptable to use Visual Analog Scale and Numeric Rating Scale as equivalent, as long as the correct terminology is used.

scholarly journals Nurse staffing and patient outcomes in Belgian acute hospitals: Cross-sectional analysis of administrative data

2009 ◽  
Vol 46 (7) ◽  
pp. 928-939 ◽  
Author(s):  
Koen Van den Heede ◽  
Walter Sermeus ◽  
Luwis Diya ◽  
Sean P. Clarke ◽  
Emmanuel Lesaffre ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Administrative Data ◽  
Nurse Staffing ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Acute Hospitals ◽  
Sectional Analysis
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