General Characteristics Of Patients Research Articles

Aconitine Neurotoxicity According to Administration Methods.

We evaluated the toxic effects of aconitine on the human nervous system and its associated factors, and the general clinical characteristics of patients who visited the emergency room due to aconitine intoxication between 2008 and 2017. We also analyzed the differences related to aconitine processing and administration methods (oral pill, boiled in water, and alcohol-soaked), and the clinical characteristics of consciousness deterioration and neurological symptoms. Of the 41 patients who visited the hospital due to aconitine intoxication, 23 (56.1%) were female, and most were older. Aconitine was mainly used for pain control (28 patients, 68.3%) and taken as oral pills (19 patients, 46%). The patients showed a single symptom or a combination of symptoms; neurological symptoms were the most common (21 patients). All patients who took aconitine after processing with alcohol showed neurological symptoms and a higher prevalence of consciousness deterioration. Neurological symptoms occurred most frequently in patients with aconitine intoxication. Although aconitine intoxication presents with various symptoms, its prognosis may vary with the processing method and prevalence of consciousness deterioration during the early stages. Therefore, the administration method and accompanying symptoms should be comprehensively investigated in patients who have taken aconitine to facilitate prompt and effective treatment and better prognoses.

Mortality predictors in acute kidney injury patients who underwent continuous venovenous hemodiafiltration: A retrospective, single-center study

Continuous renal replacement therapy (CRRT) is an increasingly preferred treatment that is easier to use in patients with hemodynamic impairment and can be applied in critical care settings. There are various subtypes of CRRT, one of which is continuous venovenous hemodiafiltration (CVVHDF). In this study, we examined the general characteristics of intensive care patients who underwent CVVHDF.
 Methods. The clinical and biochemical data of 123 patients who underwent CVVHDF in the intensive care units of our center between February 2012 and November 2014 were analyzed retrospectively. Patients who died during the course of therapy were compared with those who survived.
 Results. The study included 123 patients, 73 males (59.3%) and 50 females (40.7%). The mean age was 64.4 years. Eighty-eight patients (71.5%) died during CVVHDF while 35 patients survived (28.5%). Hemodynamic parameters such as systolic and diastolic arterial blood pressure, mean arterial pressure, and pulse pressure were significantly lower in patients who died compared to survivors (p<0.001). Mean lactic acid level was significantly higher in the deceased group than in the surviving group (8.54 mmol/L vs. 3.68 mmol/L, p<0.001, chi-square test).
 Conclusions. Low bicarbonate level, low systolic arterial blood pressure, and older age were significant independent predictors of mortality in this study. Mortality rates were significantly higher among patients with lactic acidosis and those over 66 years of age. Lactic acid levels can be used to predict mortality in patients undergoing CVVHDF.

Factors associated with the level of prolactin in patients under remission from Alcohol Use Disorder: A gender perspective.

BackgroundProlactin mirrors the dopaminergic activity in the brain which is key to understanding alcohol use disorders (AUD). Still, patients with AUD are a heterogenous group and there seem to be gender differences in the relationship between alcohol use and the level of prolactin. In this study, we examined gender‐wise relationship of alcohol use trait‐ and state‐related factors with the level of prolactin among AUD inpatients in remission.MethodsThis cross‐sectional study examined the level of prolactin along with general patient characteristics and alcohol use trait‐ and state‐related factors that could influence the level of prolactin in 112 AUD inpatients at three rehabilitation clinics in Norway. Logistic regression was performed to identify the gender‐specific predictors of level of prolactin.ResultsMale and female AUD patients had similar level of prolactin. Among females, younger age, early alcohol debut, and absence of parental drinking problem predicted higher level of prolactin. In males, presence of other substance dependence predicted a lower level of prolactin.ConclusionsThere were gender differences in the factors associated with the level of prolactin among the AUD patients. Especially in the female AUD patients under remission, alcohol use trait‐related factors were better predictors of the level of prolactin than the alcohol use state‐related factors, indicating that individuals might characteristically have varying degree of dopamine reactivity.

The implementation, use and sustainability of a clinical decision support system for medication optimisation in primary care: A qualitative evaluation.

The quality and safety of prescribing in general practice is important, Clinical decision support (CDS) systems can be used which present alerts to health professionals when prescribing in order to identify patients at risk of potentially hazardous prescribing. It is known that such computerised alerts may improve the safety of prescribing in hospitals but their implementation and sustainable use in general practice is less well understood. We aimed to understand the factors that influenced the successful implementation and sustained use in primary care of a CDS system. Participants were purposively recruited from Clinical Commissioning Groups (CCGs) and general practices in the North West and East Midlands regions of England and from the CDS developers. We conducted face-to-face and telephone-based semi-structured qualitative interviews with staff stakeholders. A selection of participants was interviewed longitudinally to explore the further sustainability 1-2 years after implementation of the CDS system. The analysis, informed by Normalisation Process Theory (NPT), was thematic, iterative and conducted alongside data collection. Thirty-nine interviews were conducted either individually or in groups, with 33 stakeholders, including 11 follow-up interviews. Eight themes were interpreted in alignment with the four NPT constructs: Coherence (The purpose of the CDS: Enhancing medication safety and improving cost effectiveness; Relationship of users to the technology; Engagement and communication between different stakeholders); Cognitive Participation (Management of the profile of alerts); Collective Action (Prescribing in general practice, patient and population characteristics and engagement with patients; Knowledge);and Reflexive Monitoring (Sustaining the use of the CDS through maintenance and customisation; Learning and behaviour change. Participants saw that the CDS could have a role in enhancing medication safety and in the quality of care. Engagement through communication and support for local primary care providers and management leaders was considered important for successful implementation. Management of prescribing alert profiles for general practices was a dynamic process evolving over time. At regional management levels, work was required to adapt, and modify the system to optimise its use in practice and fulfil local priorities. Contextual factors, including patient and population characteristics, could impact upon the decision-making processes of prescribers influencing the response to alerts. The CDS could operate as a knowledge base allowing prescribers access to evidence-based information that they otherwise would not have. This qualitative evaluation utilised NPT to understand the implementation, use and sustainability of a widely deployed CDS system offering prescribing alerts in general practice. The system was understood as having a role in medication safety in providing relevant patient specific information to prescribers in a timely manner. Engagement between stakeholders was considered important for the intervention in ensuring prescribers continued to utilise its functionality. Sustained implementation might be enhanced by careful profile management of the suite of alerts in the system. Our findings suggest that the use and sustainability of the CDS was related to prescribers' perceptions of the relevance of alerts. Shared understanding of the purpose of the CDS between CCGS and general practices particularly in balancing cost saving and safety messages could be beneficial.

The lipid profile for the prediction of prednisolone treatment response in patients with inflammatory hand osteoarthritis: The HOPE study

ObjectiveTo explore the use of lipidomics for prediction of prednisolone treatment response in patients with inflammatory hand osteoarthritis. DesignThe Hand Osteoarthritis Prednisolone Efficacy (HOPE) study included patients (n ​= ​92) with symptomatic inflammatory hand osteoarthritis, fulfilling the ACR criteria. The present analyses comprised only patients randomized to prednisolone treatment (10 ​mg daily, n ​= ​40). Response to prednisolone treatment was defined according to the OARSI-OMERACT responder criteria at six weeks. Baseline blood samples were obtained non-fasted. Lipid species were quantified in erythrocytes with the Lipidyzer™ platform (Sciex). Oxylipins were analyzed in plasma using an in-house LC-MS/MS platform. Elastic net regularized regression was used to predict prednisolone treatment response based on common patient characteristics alone and including the patients’ lipid profile. ROC analyses with 1000 bootstrapped area under the curve (AUC) was used to determine the discriminatory accuracy of the models. ResultsAmong included patients, 78% fulfilled the OARSI-OMERACT responder criteria. From the general patient characteristics, elastic net selected baseline hand function as only predictor of treatment response, with an AUC of 0.78 (0.56; 0.97). Addition of lipidomics resulted in an AUC of 0.92 (0.78; 0.99) and 0.85 (0.65; 0.98) for inclusion of the Lipidyzer™ platform and oxylipin platform, respectively. ConclusionOur results suggest that the patients’ lipid profile may improve the discriminative accuracy of the prediction of prednisolone treatment response in patients with inflammatory hand osteoarthritis compared to prediction by commonly measured patient characteristics alone. Hence, lipidomics may be a promising field for biomarker discovery for prediction of anti-inflammatory treatment response.

Assessment of General Characteristics of Geriatric Patients Admitted in a Tertiary Care Teaching Hospital

Assessment of General Characteristics of Geriatric Patients Admitted in a Tertiary Care Teaching Hospital

Effects of Real-Time Dosimetry on Staff Radiation Exposure in the Cardiac Catheterization Laboratory.

Radiation protection is essential for staff of cardiac catheterization laboratories in order to prevent long-term radiation- associated injury and disease. Instant feedback about the actual received dose may help operators to optimize the use of existing shielding devices. Therefore, the current study was designed to investigate whether routine use of real-time dosimetry may be able to reduce staff radiation exposure. Over a period of 72 days, operators and assisting nurses were equipped with RaySafe i3 real-time dosimeters (Unfors RaySafe AB), but had no access to the dosimetry results during the first half of the study. This was followed by a second period that allowed operators to modify their behavior according to the dosimetry results. Compared with the first phase, the knowledge of real-time dosimetry results led to a uniform reduction in radiation exposure of all team members by approximately 60%, independent of the chosen vascular access. There were no significant changes in fluoroscopy time, dose-area product, or patient characteristics. Real-time dosimetry effectively reduced staff radiation exposure in the cardiac catheterization laboratory. This change was caused by optimized use of existing shielding equipment since no modifications of the general procedural approach or patient characteristics had occurred.

POS-727 Surgical complications and cardiovascular comorbidity : confounders of survival after kidney transplantation

Surgical complications following kidney transplantation compromise immediate graft survival. However, the role of early surgical complications in the impairment of long-term survival can be distort due to patient cardio-vascular comorbidities. In this study we characterize surgical complications and identify patient comorbidities. We compare the impact of surgical complications on graft function and survival after kidney transplantation in the presence or absence of comorbidities. The study was conducted in the nephrology department: Kidney transplant unit, at the Fattouma Bourguiba hospital in Monastir. It’s a retrospective and descriptive study. From 2007 to 2019,103 patients undergoing kidney transplantation. Surgical complications were analyzed (Graft artery stenosis, ureter necrosis, lymphocele, hematoma, wound infection, double J probe obstruction). Graft and patient survival, general patient characteristics, cardio-vascular comorbidities (diabetes mellitus, arterial hypertension, vein thrombosis), immunosuppression, and immunological characteristics were determined. Post-transplant graft function as well as long-term graft and patient survival were quantified. An overall estimate of renal survival was 69.4 months : 63.8/75.83 months with/without comorbidities. Graft survival was 87% /97% (1year), 83%/92% (3years), and 43%/52% (5years) with/without comorbidities respectively. Patient survival was 100%/100%% (1year), 50%/85%(3years), and 15%/18%(5years) with/without comorbidities respectively. Whereas pre-existing cardio-vascular disease affected graft loss and patient survival. These observations were confirmed by Cox regression the long-term prognosis of kidney transplants is to some degree determined by the occurrence of surgical complications. However, this effect is interlinked with the influence of cardiovascular comorbidities.

Is it enough for COVID-19 screening test? Limitation of swab test and general characteristics of mild symptom patients.

The most common method for SARS-CoV-2 testing is throat or nasal swabbing by real-time reverse transcription polymerase chain reaction (RT-PCR) assay. In South Korea, drive-through swab test is used for screening system and community treatment centers (CTCs), which admit and treat confirmed COVID-19 patients with mild symptoms, are being used. This retrospective study was conducted on patients admitted to a CTC on March 6, 2020. A total of 313 patients were admitted. The nasal and throat swabs were collected from the upper respiratory tract, and a sputum test was performed to obtain lower respiratory samples. The positive rate of the first set of test, sputum test was higher than that of the swab test (p = 0.011). In the second set of test, 1 week after the first ones, the rate of positive swab tests was relatively high (p = 0.026). In the first set of test, 66 of 152 (43.4%) patients showed 24-h consecutive negative swab test results, when the sputum test results were considered together, that number fell to 29 patients (19.1%) (p < 0.001). Also, in the second set of test, 63 of 164 (38.4%) patients met the discharge criteria only when the swab test was considered; that number fell to 30 (18.3%) when the sputum test results were also considered (p < 0.001). Using the swab test alone is insufficient for screening test and discharge decision. Patients who may have positive result in the sputum test can be missed.

Liver Resections Can Be Safely Performed in Cirrhotic Patients after Careful Patient Selection

Hepatocellular Carcinoma (HCC) is the most frequent malignant primary liver tumour in a cirrhotic liver. Liver transplantation and resection are the only curative treatment options in compensated liver cirrhosis, but liver resections are associated with increased perioperative morbidity and mortality. We identified 108 cirrhotic patients, who underwent liver resections at the University Hospital of Mainz between January 2008 and December 2019. During the same period, 185 liver resections were performed for HCC in non-cirrhotic livers. Furthermore, 167 liver resections served as control group, which were performed for colorectal liver metastases (CRLM) with comparable extent of resection to HCC in cirrhotic livers. Preoperatively, we assessed the Charlson Comorbidity Index (CCI), MELD and Child scores in addition to the general patient characteristics. Perioperative morbidity was graded according to the Clavien-Dindo classification. Resections of HCC in cirrhosis and liver metastases were additionally compared by a matched-pair analysis. The three groups were comparable in age. Preoperative liver function was best in patients with CRLM (p < 0.001). Resections for HCC in non-cirrhotic livers were more extended than in cirrhotic livers (p < 0.001). The overall morbidity (Clavien/Dindo stage III - IV) was higher after resections in cirrhotic livers than in CRLM resections (p = 0.026). Postoperative mortality was comparably low in all three groups (2.2%). Neither MELD nor Child score was predictive for postoperative morbidity or mortality (area under the curve: AUC < 0.6, each). Preoperative CCI was predictive for postoperative mortality (AUC = 0.78). Liver resections in cirrhotic livers are feasible after adequate patient selection and limitation of the extent of surgery. Comorbidities additionally increase the postoperative mortality in addition to impaired liver function and should therefore always be included into the preoperative assessment of patients undergoing liver surgery.

P0288 / #1207: CHALLENGE IN CARE OF THE NEUROSURGICAL PATIENT ADMITTED IN A UNIT OF PEDIATRIC INTENSIVE CARE.

Aims & Objectives: In recent years, different systems have been perfected to control the neurosurgical patient and monitor variables such as intracranial pressure, brain electrical activity, brain flow, tissue oxygen pressure and microdialysis. However, the deprivation of these resources in our country, especially in public institutions, has represented a real challenge in the care of these patients, thus optimizing the continuous monitoring of the physiological variables, as well as the clinical evaluation making it the main element of Attention. Objective: to describe the general characteristics of the neurosurgical patients treated who were admitted to a pediatric intensive care unit (PICU). Methods: A descriptive and retrospective study was carried out, using the database of a PICU. All neurosurgical patients admitted between January 1, 2014 and December 31, 2019 were included, the diagnosis of admission, stay in PICU, days of invasive mechanical ventilation and survival Results: We analyzed data from 726 patients in ages from 1 month to 18 years (65% men), which represents 9% of patients income during the study period. The time spent in the PICU was 1-3 days 60%, in relation to the days in mechanical ventilation 1-3 days 74%. Regarding mortality in PICU 7.5%. Among the most common diagnoses we found the tumor exeresis with 75.5%, of which 40% were tumors located in the posterior fossa, with a surgical resolution time that fluctuated from a minimum of 13 days to a maximum of 2 years. Conclusions: Despite the limitations in the care of neurosurgical patients, our mortality rate is very low.

Mycetoma spatial geographical distribution in the Eastern Sennar locality, Sennar State, Sudan.

Mycetoma is a unique neglected tropical disease caused by a substantial number of different fungi or bacteria. Many of the disease's epidemiological characteristics are an enigma. Hence, understanding the spatial geographic distribution of mycetoma may clarify the association between the local environmental indicators, the spatial geographical distribution of mycetoma and its epidemiology. This study set out to determine the spatial geographical distribution of mycetoma in the Eastern Sennar locality, Sennar State, one of the highly endemic states in Sudan. It included 594 patients with confirmed mycetoma seen at the Mycetoma Research Centre, University of Khartoum, Khartoum, Sudan, from 1991 to 2020. The spatial geographical distribution of these mycetoma patients was studied. The study area geographic information system data, which included geological, soil, temperature and land cover details, were collected in different geographic information forms. Different geographical analytical techniques were used. The patients' demographic characteristics were similar to those of the general characteristics of mycetoma patients in Sudan. Eumycetoma was the predominant type of mycetoma encountered in the studied patients. The data studied showed that most patients were located in the southern part of the locality along the Blue Nile river. The study showed an association between patients' spatial geographical distribution and soil types. Most patients' localities had light clay soil (475 patients [80%]), followed by sandy loam soil (79 [13%]) then loam soil (40 [6.71%]). Also, 85% of patients' localities had the same land cover and vegetation. There was no significant correlation between patients' localities with temperature or any other geological characteristic. The present study showed certain associations between mycetoma spatial geographical distribution and certain environmental indicators. However, a further in-depth study to provide greater insight into the disease's epidemiological characteristics is needed.

Treating patients with a new coronavirus infection in the clinic of Izmerov Research Institute of Occupational Health

Introduction. To comply with the order of the Government of the Russian Federation and the Ministry of Education and Science, the clinic of Izmerov Research Institute of Occupational Health received the necessary conditions for the provision of medical care to patients with a new coronavirus infection. The study aims to identify possible criteria for the positive dynamics of pneumonia caused by the SARS-CoV-2 virus and to describe the general characteristics of patients hospitalized in the COVID center of Izmerov Research Institute of Occupational Health. Materials and methods. The article describes the clinical, laboratory, and instrumental data of 68 patients with pneumonia caused by the SARS-CoV-2 virus hospitalized to continue treatment. Statistical analysis included descriptive statistics. The significance level was less than 0.05. Results. The COVID-center received patients with complaints of shortness of breath on exertion, an unproductive cough, general weakness, myalgias, headaches, and an impaired sense of smell and taste. The condition of the patients was moderate. O2 saturation in ambient air was 93% and higher. Computed tomography of the chest revealed lesions of the lung tissue (numerous peripheral seals of the "frosted glass" type of various shapes and lengths with areas of consolidation), mainly corresponding to bilateral polysegmental viral pneumonia CT 1-2 degrees. The most frequent changes in laboratory parameters in patients were increased values of ESR (51.16% of cases), D-dimer (50% of cases), CRP (22.06% of cases), relative values of monocytes (58.14% of cases), as well as low hemoglobin concentrations (23% of cases). Conclusions. In patients with a new coronavirus infection hospitalized to continue treatment in the COVID center of Izmerov Research Institute of Occupational Health, lung tissue lesions were detected, mainly corresponding to the moderate-severe form of bilateral polysegmental viral pneumonia (CT of the 1-2 degree). The most frequent changes in laboratory parameters in patients with COVID-19 were increased ESR values, D-dimer, CRP, relative values of monocytes, and low hemoglobin concentrations. Monocytes, being one of the indicators of activation of the immune defense, are a laboratory criterion for the positive dynamics of the course of new coronavirus infection.

Utility of a pediatric observation unit for the management of children admitted to the emergency department

BackgroundObservation Units (OU), as part of emergency department (ED), are areas reserved for short-term treatment or observation of patients with selected diagnoses to determine the need for hospitalization or home referral.MethodsIn this retrospective cohort study, we analyzed similarities and differences of children admitted to the pediatric ED of the Fondazione Policlinico Universitario A. Gemelli IRCCS hospital in the first 2 years of OU activity, analyzing general patient characteristics, access modalities, diagnosis, triage, laboratory and instrumental examinations, specialist visits, outcome of OU admission and average time spent in OU. Furthermore, we compared total numbers and type of hospitalization of the first 2 years of OU activity with those of previous 2 years.ResultsThe most frequent diagnoses were abdominal pain, minor head injury without loss of consciousness, vomiting, epilepsy and acute bronchiolitis. The most performed laboratory examinations were blood count. The most commonly performed instrumental examination was abdominal ultrasound. Neurological counseling was the most commonly requested.Average time spent in OU was 13 h in 2016 and 14.1 h in 2017. Most OU admissions did not last longer than 24 h (90.5% in 2016 and 89.5% in 2017).In the years 2014–2015, 13.4% of pediatric patients accessing the ED were hospitalized, versus 9.9% the years 2016–2017 reducing pediatric hospital admissions by 3.6% (p < 0.001).ConclusionsThis study demonstrate that OU is a valid alternative to ordinary wards for specific pathologies. In accordance with the literature, our study showed that, in the first 2 years of the OU activity, admissions to hospital ward decreased compared with the previous 2 years with an increase of complex patients.

Study of epidemiological, clinical and evolutionary characteristics of a population of patients hospitalized for COVID-19 in Morocco

The outbreak of COVID-19 still represents a real risk for the increased death rate for the whole of human kind. In this context, the present research work aims at describing evolutionary data in a population of hospitalized COVID-19 positive patients based on selected epidemiological, clinical and paraclinical data at admission. In this cross-sectional study, we examined the data obtained from 108 patients hospitalized with COVID-19 in the VINCI clinic, Casablanca (Morocco) between August and September 2020. General characteristic, clinical, radiological and biological data as well as therapeutic management were assessed. The patients’ median age was 45-50 years old. Among our studied patients, 4.6% were transferred to the intensive care unit (ICU), 16.7% were cured after more than 15 days, while 78.7% were cured within 15 days. Those transferred to the ICU unit were either smokers, obese, or over 65 years of age. The majority of patients with normal radiological and cardiac parameters were cured within&lt;15 days, while biological disorders were observed in approximately all cases that were transferred to ICU. Regarding therapeutic treatment, 98.1% of the subjects were treated with hydroxychloroquine + azithromycin in combination with vitamin C and zinc supplementation. The study shows that the minimal healing time is well conditioned by the general and clinical characteristics of patients. Furthermore, the administration of hydroxychloroquine + azithromycin showed a beneficial effect with no associated adverse effects in the study cases.

Patterns of Mortality Occurrence in a Cardiology Unit of a Low-Income Country: A Critical Analysis at the Yaound&amp;#233; Central Hospital

Background: In-hospital mortality is high in low-income countries. Currently, little is known in Cameroon concerning the characteristics of patients who die in cardiology units. Our objectives were to determine the in-hospital mortality rate; describe the general characteristics of death patients, and factors associated with mortality. Material and Methods: We conducted a retrospective cross-sectional study by reviewing the medical records of all patients admitted to the cardiology unit of the Yaounde Central Hospital (CHY) between January 2018 andJanuary 2019. The files of all death patients were studied for socio-demographical, clinical and therapeutical variables. Bivariate analysis was conducted to order to check the association between independents variables and time of death. A p-value 0.05 was considered statistically significant. Results: A total number of 860 patients were admitted in the cardiology unit of CHY during the study period. Amongst the 860 patients admitted 78 had a fatal outcome, hence, an in-hospital mortality rate of 9.06%. The male gender was predominant amongst the deceased patients (n = 45). The mean age at death was 69 ± 15.19 years. The median time before death was 6 days and they ranged between 1 to 25 days. Hypertension was the most frequent comorbidity (65.4%). Stroke was the principal cause of admission (40.3%), whereas the main presenting complaint was dyspnea (26.9%). Before being admitted to the cardiology department, the majority of the deceased patients were from the emergency department. The major clinical sign of death was respiratory distress (39.74%). Shock on admission was the sole factor found to be associated with the mean time of death (p = 0.012). The patients with deep venous thrombosis compared to other diagnoses were less like to die early (r = 16, p = 0.016). Conclusion: The patient admitted in the cardiology unit of Yaounde Central Hospital died mainly from stroke and the death is earlier when the patient has signs of shock on admission. These results emphasize the need for a good primary evaluation at the emergency room, to better manage patients with cardiovascular diseases in the cardiology ward.

Changes in Clinical Characteristics among Febrile Patients Visiting the Emergency Department before and after the COVID-19 Outbreak.

PurposeConsidering the risk of coronavirus disease (COVID-19) transmission through infected droplets, emergency department (ED) operations in response to febrile patients should be planned. We investigated the general and clinical characteristics of febrile patients visiting the ED and changes in admission rates via the ED during the COVID-19 outbreak.Materials and MethodsWe performed a retrospective analysis of prospectively collected patients who visited 402 EDs in the Republic of Korea with febrile symptoms between January 27 and May 31, 2020 and compared them to those enrolled before the COVID-19 outbreak. The primary outcome was admission rate; the secondary outcome was length of stay (LOS) in the ED.ResultsIn total, 266519 patients had febrile symptoms at ED presentation after the COVID-19 outbreak. In 2019, before the outbreak, there were 437762 patients. The rate of ED visits among pediatric patients (aged <15 years) decreased to 21.4% after the COVID-19 outbreak, compared with 41.8% in 2019. The proportion of patients admitted after ED management was higher after the outbreak (31.3%) than before (25.2%). The adjusted odds ratio for admission was 1.04 (95% confidence interval: 1.02–1.05) after the outbreak. Compared to before the COVID-19 outbreak, the median ED LOS increased by 16 min after the outbreak.ConclusionThis study confirmed that admission rates and ED LOS increased for febrile patients visiting the ED after the COVID-19 outbreak. This could provide evidence for developing ED-related strategies in response to the ongoing COVID-19 outbreak and other infectious disease pandemics.

Awareness and Use of Complementary and Alternative Medicine in Korean Lung Cancer Patients.

BackgroundComplementary and alternative medicine (CAM) has been used frequently, and its use continues to increase in lung cancer patients, despite insufficient scientific of its efficacy. To investigate this situation, we analyzed the current awareness and use of CAM in Korean lung-cancer patients.MethodsThis prospective survey–based study was performed at seven medical centers in South Korea between August and October 2019. The survey assessed general patient characteristics and the awareness and use of CAM. We analyzed differences in the clinical parameters of patients aware and not aware of CAM and of CAM non-users and users.ResultsOf the 434 patients included in this study, 68.8% responded that they were aware of CAM and 30.9% said they had experienced it. In univariate analysis, the patients aware of CAM were younger with poor performance status, had advanced-stage lung cancer, received more systemic therapy, and received concurrent chemoradiation therapy (CCRT). By multiple logistic regression, younger age, poor performance status, advanced stage, and prior CCRT were identified as independent risk factors for CAM awareness. There were no significant differences in the general characteristics and cancer-associated clinical parameters of CAM non-users and users.ConclusionSpecific clinical parameters were associated with patients’ awareness of CAM, although there were no significantly different characteristics between CAM users and non-users.

How do the influencing factors of health-related quality of life of the injured patient differ according to activity limitations?

This study aimed to ascertain the general characteristics of injured patients and use the Andersen Model to identify factors affecting health-related quality of life (QOL) in injured patients with or without activity limitations. We used data of 1602 injured patients from 2014 to 2017 from the population-based Korea National Health and Nutrition Examination Survey, South Korea. QOL was measured using the EQ-5D-3L, and activity limitations were analyzed alongside predisposing factors (gender, age, education level, and marital status), enabling factors (basic living security, health insurance type, private insurance status, household income, and living with family), need factors (number of chronic diseases, subjective health status, and unmet medical needs), and health behaviors (smoking status, alcohol consumption, physical activity, and health screening). Data were analyzed using homogeneity testing, t tests, and logistic and multiple regression. The mean EQ-5D index was 0.8 with activity limitations and 0.9 without activity limitations. In mobility domain, patients without activity limitations showed significant effects of age, education level, number of chronic diseases, subjective health status, and unmet medical needs on mobility, whereas patients with activity limitations only showed a significant effect of age. In self-care domain, age, household income, and number of chronic diseases showed significant factors on patients without activity limitations, but there was no significant factor associated with activity limitations. Among the factors affecting usual activities, gender was found to have a significant effect only on patients with activity limitations, and subjective health status was found to have a significant effect regardless of activity limitations. Among the factors affecting pain/discomfort, living with family only affected pain/discomfort in patients with activity limitations. Among the factors affecting anxiety/depression, gender and alcohol consumption had significant effects only on patients with activity limitations. Factors affecting the QOL of injured patients differed depending on whether patients had activity limitations. Therefore, when assessing injured patients, it may be necessary to ascertain the extent of activity limitations, and medical institutions and local communities need when implementing education and interventions to improve their QOL.

Thyroid Function in 35 Patients with Gitelman Syndrome

Objective. In this study, we aimed to analyze thyroid function and related risk factors for thyroid dysfunction in 35 patients with Gitelman syndrome (GS). Methods. This study included 35 patients with GS who were referred to West China Hospital of Sichuan University from Aug 2013 to Jan 2018. General patient characteristics were collected, and thyroid function was assessed. To evaluate the potential contribution of hypokalemia to thyroid dysfunction, 636 patients who were clinically diagnosed with primary aldosteronism (PA) during the same period were included as the control group; these patients were divided into a hypokalemia group ( N = 528 ) and a normokalemia group ( N = 108 ). Logistic regression was used to screen for significant determinants of thyroid dysfunction in the GS patients. Results. Patients with GS had a significantly different prevalence of subclinical hypothyroidism, hypothyroidism, and hyperthyroidism than patients with hypokalemic PA and normokalemic PA (28.6%, 2.9%, and 11.4% vs. 15.5%, 6.1%, and 0.7% vs. 8.3%, 4.6%, and 2.8%, P &lt; 0.001 ). No significant difference was observed in the distribution of thyroid function between the hypokalemic PA group and the normokalemic PA group ( P &gt; 0.05 ). No significant differences were seen in the positive rates of thyrotropin receptor antibody (TRAb), thyroglobulin antibody (TGAb), and thyroid peroxidase antibody (TPOAb) among the three groups ( P &gt; 0.05 ). In the logistic regression, only sex (OR, 7.4; 95% CI, 1.555-35.479; P = 0.012 ) was significantly correlated with thyroid dysfunction in GS patients. Conclusion. GS is complicated with a greater rate of thyroid dysfunction than primary aldosteronism. The risk of thyroid dysfunction in female patients with GS is higher than that in male patients.