ABSTRACT
Background: COVID-19 pandemic times forced health education to go online, and, due to this necessity, long-term difficulties in education such as bibliographic search in databases like PubMed might have worsened even when platforms such as PubMed provide helping mechanisms to the user. These difficulties or even complete lack of knowledge are, unfortunately, not well documented in the literature. Therefore, this study aimed to describe doubts, lack of knowledge and questions of researchers regarding bibliographic research in PubMed as well as to solve all of those doubts by developing a didactic e-book in relation to bibliographic research in PubMed. Methods: This cross-sectional and populational-based study was conducted between January and April 2021. In northern Brazil, a total of 105 dentistry undergraduate students (DUS) received an anonymous digital form (Google® Forms Platform) using a non-probabilistic "snowball” sampling technique. The digital form was composed of four blocks of dichotomous and multiple-choice questions. After signing the informed consent term, the DUS were divided into three groups according to their period/semester in the dentistry program during the study time (G1: 1st period/semester;G2: 5th period/semester and G3: 10th period/semester). A total of 25 questions referring to demographic, educational and knowledge data about how to do scientific research and how to use bibliographic search in PubMed were asked, and all data were presented as descriptive percentages and then analyzed using the Chi square and G tests. Results: From 105 (100%), G1 had 29/105 (27.6%);G2 had 37/105 (35.2%);G3 had 39/105 (37.2%), the average age was 22.34 years and most participants were female 85/105 (81%). Among our sample, 56/105 (53.4%) had not used any type of search strategy, and 96/105 (91.4%) used database research methods. The main database for literature search used was Scielo 92/105 (87.6%), and 63/105 (60%) had general questions or doubts about bibliographic research. All these data had statistical significance p < 0.0001. Conclusions: The results demonstrate a lack of knowledge and doubts in DUS from three different periods/semesters, and this collected information can help in the formation of didactic material to solve such doubts. © 2023 by the authors.
ABSTRACT
INTRODUCTION & Objectives: The World Health Organisation (WHO) announced the coronavirus disease-19 (COVID-19) a pandemic on 12th March 2020. The subsequent diversion of healthcare and public attention towards virus exposure avoidance resulted in an alarming change in emergency department (ED) presentations for many serious medical conditions, namely acute obstructive pyelonephritis (AOP). We sought to assess the impact inflicted by the COVID-19 pandemic on the presentation severity of patients diagnosed with AOP who attended the ED before and after the disease was declared a pandemic. Materials & Methods: We conducted an observational retrospective study analysing data from patients submitted to a temporary urinary diversion with a ureteral double J stent (JJ) from January 2017 to December2020, in a tertiary care centre. Patient cohorts before and after 12th March 2020 were compared. We included patients admitted to the EDwho underwent ureteral stenting in the setting of AOP. We excluded patients submitted to percutaneous urinary diversion and those who underwent JJ placement due to indications other than AOP. Patients' demographics, comorbidities (Charlson Comorbidity Index - CCI), vital signs, chemistry and imaging results at ED admission and during ED stay were analysed. Sequential OrganFailure Assessment (SOFA) score at admission was obtained and the need foradmission in an Intensive Care Unit (ICU)was recorded. The duration of the hospital stay was evaluated. Results: A total of 130 patients were analysed, 97 of those weresubmitted to JJ placement before the COVID-19 outbreak and 33 after. The mean number of patients monthly undergoing a JJ placement raised from 2 to 4 before and after March 2020, respectively. They had comparable age (58±18 vs. 59±18 years old) and comorbidities (as depicted by the CCI) as well as stone location (p=0.292), laterality (p=0.419) and dimension (8mm, p=0.715). Computed Tomography (CT) had a significantly higher use as imaging modality in the ED during the post-COVID-19 era (5.2% vs. 33.3%, p<0.001). There was a non-statistically significant tendency towards a longer time to ED visit in the post-COVID-19 cohort (48 vs. 72 hours,p=0.052). The severity at ED presentation, as evaluated by SOFA score, was identical (p=0.160). Nevertheless, a greater number of patients presented to the ED with sepsis criteria (21.6% vs. 36.4%, p=0.093) and a significantly higher number of patients were admitted to an ICU in the post-COVID-19 period (1% vs. 15.2%, p=0.004) spending 7 days there (on average). Conclusions: The COVID-19 pandemic determined an increase in the number of patients admitted to the ED due to AOP and a higher rate of ICU admission. These findings may be related to the deferral in stone disease elective procedures. The virus exposure avoidance might have led, concurrently, to a longer time until ED visit from the symptom onset.