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1.
J Clin Med ; 12(1)2022 Dec 24.
Article in English | MEDLINE | ID: covidwho-2242025

ABSTRACT

Maxillofacial injuries result from a variety of daily activities. Traffic accidents, interpersonal violence, and falls represent some of the most common etiological factors behind maxillofacial fractures. During the COVID-19 outbreak, the social distancing measures imposed by healthcare authorities aimed at abolishing the spread of the viral infection. This study aimed to evaluate the effect of social distancing measures on the incidence of maxillofacial injuries. METHODS: Data were retrieved from the medical file registry at the Galilee Medical Center, Nahariya, Israel. Incidence, gender, age, etiology, and cost of hospitalization during the COVID-19 lockdown and the previous periods were retrieved. RESULTS: A decrease in maxillofacial fractures was registered during the 2020 lockdown; younger patients had the largest share of maxillofacial traumas during this period. The midface was the most involved facial region in both periods, and a reduction of 62.3% in the cost of OMF fracture treatment was observed during the COVID-19 era. CONCLUSIONS: The occurrence, etiology, and cost of treatment of maxillofacial injuries during the COVID-19 period were different from those in the corresponding period in the pre-COVID-19 era. These results can provide a guide to help design programs for the prevention of OMF trauma.

2.
Int J Qual Health Care ; 34(4)2022 Nov 17.
Article in English | MEDLINE | ID: covidwho-2087792

ABSTRACT

BACKGROUND: Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic in 2019, several countries have reported a substantial drop in the number of patients admitted with non-ST-segment myocardial infarction (NSTEMI). OBJECTIVE: We aimed to evaluate the changes in admissions, in-hospital management and outcomes of patients with NSTEMI in the COVID-19 era in a nationwide survey. METHOD: A prospective, multicenter, observational, nationwide study involving 13 medical centers across Israel aimed to evaluate consecutive patients with NSTEMI admitted to intensive cardiac care units over an 8-week period during the COVID-19 outbreak and to compare them with NSTEMI patients admitted at the same period 2 years earlier (control period). RESULTS: There were 624 (43%) NSTEMI patients, of whom 349 (56%) were hospitalized during the COVID-19 era and 275 (44%) during the control period. There were no significant differences in age, gender and other baseline characteristics between the two study periods. During the COVID-19 era, more patients arrived at the hospital via an emergency medical system compared with the control period (P = 0.05). Time from symptom onset to hospital admission was longer in the COVID-19 era as compared with the control period [11.5 h (interquartile range, IQR, 2.5-46.7) vs. 2.9 h (IQR 1.7-6.8), respectively, P < 0.001]. Nevertheless, the time from hospital admission to reperfusion was similar in both groups. The rate of coronary angiography was also similar in both groups. The in-hospital mortality rate was similar in both the COVID-19 era and the control period groups (2.3% vs. 4.7%, respectively, P = 0.149) as was the 30-day mortality rate (3.7% vs. 5.1%, respectively, P = 0.238). CONCLUSION: In contrast to previous reports, admission rates of NSTEMI were similar in this nationwide survey during the COVID-19 era. With longer time from symptoms to admission, but with the same time from hospital admission to reperfusion therapy and with similar in-hospital and 30-day mortality rates. Even in times of crisis, adherence of medical systems to clinical practice guidelines ensures the preservation of good clinical outcomes.


Subject(s)
COVID-19 , Myocardial Infarction , Non-ST Elevated Myocardial Infarction , Percutaneous Coronary Intervention , Humans , Pandemics , COVID-19/epidemiology , Non-ST Elevated Myocardial Infarction/epidemiology , Non-ST Elevated Myocardial Infarction/therapy , Prospective Studies , Israel/epidemiology , Myocardial Infarction/epidemiology , Myocardial Infarction/therapy
3.
Clin Med (Lond) ; 22(5): 403-408, 2022 09.
Article in English | MEDLINE | ID: covidwho-2056337

ABSTRACT

As the COVID-19 pandemic continues to evolve, different clinical manifestations are better understood and studied. These include various haematologic disorders that have been shown to be associated with increased morbidity and mortality. We studied the prevalence of one unusual manifestation, heparin-induced thrombocytopenia (HIT) and its clinical implications in patients who are severely ill with COVID-19 in a single tertiary centre in Israel. The presence of thrombocytopenia, disseminated intravascular coagulation (DIC) and HIT, and their association with clinical course and outcomes were studied. One-hundred and seven patients with COVID-19 were included. Fifty-seven (53.2%) patients developed thrombocytopenia, which was associated with the worst outcomes (ventilation, DIC and increased mortality). Sixteen (28.0%) patients with thrombocytopenia were positive for HIT, all of which were supported by extracorporeal devices. HIT was independently associated with ventilation days, blood product transfusions, longer hospitalisation and mortality.Platelet abnormalities and HIT are common in patients who are critically ill with COVID-19 and are associated with the worst clinical outcomes. The mechanisms underlying HIT in COVID-19 are yet to be studied; HIT may contribute to the dysregulated immunologic response associated with COVID-19 critical illness and may play a significant part in the coagulopathy seen in these patients. As many patients with COVID-19 require aggressive thromboprophylaxis, further understanding of HIT and the implementation of appropriate protocols are important.


Subject(s)
COVID-19 , Thrombocytopenia , Venous Thromboembolism , Humans , Critical Illness , Heparin/adverse effects , Anticoagulants/adverse effects , Pandemics , COVID-19/complications , Thrombocytopenia/chemically induced , Thrombocytopenia/epidemiology
4.
Advances in Oral and Maxillofacial Surgery ; 2021.
Article in English | EuropePMC | ID: covidwho-1489771

ABSTRACT

Objectives To assess the effect of the COVID-19 pandemic on self-rated stress levels among dentists who treated children during the outbreak and pediatric patient cooperation during dental treatments. Methods and materials This cross-sectional study was assessed by enrolling an online questionnaire among dental practitioners treated children during April 2020. Results Dentists with higher COVID-19-induced distress reported a lower degree of pediatric patient cooperation during dental treatments than dentists with lower reported stress (p value < 0.01). Additional factors negatively impacting patient cooperation were degree of professional practitioner seniority in pediatric dentistry, and perceived knowledge about the COVID-19 disease infectivity and feeling protective against viral transmission with Personal Protective Equipment (PPE). Also, stress levels among dentists treating children influenced medical decisions, such as the selected treatment approach influenced by COVID-19 considerations. Conclusion The COVID-19 pandemic has adverse effects on clinicians and pediatric patients. Educational programs should be developed to advance dental staff.

5.
Quintessence Int ; 53(2): 186-191, 2022 Jan 07.
Article in English | MEDLINE | ID: covidwho-1448705

ABSTRACT

OBJECTIVES: This study aimed to assess the degree of dental practitioner adherence to recommendations made during the COVID-19 pandemic. METHOD AND MATERIALS: An online questionnaire was distributed via social media among dental practitioners in Israel who worked during the COVID-19 outbreak. RESULTS: In total, 144 dental practitioners completed the survey; it was found that dental practitioner adherence to all the official PPE use recommendations was 69.8%, whereas 36.8% of dental practitioners reported the use of N95 when needed. Knowledge of self-protection against COVID-19 was rated as "very good" by 37.5% of responders. However, only 25.7% felt "highly protected" by personal protective equipment. Interestingly, many dental practitioners (46.8%) reported adherence to extra protection in addition to the required PPE communicated by the Ministry of Health guidelines. CONCLUSION: Stricter regimens should be applied for dealing with the current challenging pandemic, especially in clinical work with a higher risk for viral transmission. Specific strategies should be followed to ensure good practice to improve dental practitioners' and patients' safety.


Subject(s)
COVID-19 , Pandemics , Dentists , Humans , Professional Role , SARS-CoV-2 , Surveys and Questionnaires
6.
PLoS One ; 16(6): e0253524, 2021.
Article in English | MEDLINE | ID: covidwho-1278202

ABSTRACT

BACKGROUND: We aimed to describe the characteristics and in-hospital outcomes of ST-segment elevation myocardial infarction (STEMI) patients during the Covid-19 era. METHODS: We conducted a prospective, multicenter study involving 13 intensive cardiac care units, to evaluate consecutive STEMI patients admitted throughout an 8-week period during the Covid-19 outbreak. These patients were compared with consecutive STEMI patients admitted during the corresponding period in 2018 who had been prospectively documented in the Israeli bi-annual National Acute Coronary Syndrome Survey. The primary end-point was defined as a composite of malignant arrhythmia, congestive heart failure, and/or in-hospital mortality. Secondary outcomes included individual components of primary outcome, cardiogenic shock, mechanical complications, electrical complications, re-infarction, stroke, and pericarditis. RESULTS: The study cohort comprised 1466 consecutive acute MI patients, of whom 774 (53%) were hospitalized during the Covid-19 outbreak. Overall, 841 patients were diagnosed with STEMI: 424 (50.4%) during the Covid-19 era and 417 (49.6%) during the parallel period in 2018. Although STEMI patients admitted during the Covid-19 period had fewer co-morbidities, they presented with a higher Killip class (p value = .03). The median time from symptom onset to reperfusion was extended from 180 minutes (IQR 122-292) in 2018 to 290 minutes (IQR 161-1080, p < .001) in 2020. Hospitalization during the Covid-19 era was independently associated with an increased risk of the combined endpoint in the multivariable regression model (OR 1.65, 95% CI 1.03-2.68, p value = .04). Furthermore, the rate of mechanical complications was four times higher during the Covid-19 era (95% CI 1.42-14.8, p-value = .02). However, in-hospital mortality remained unchanged (OR 1.73, 95% CI 0.81-3.78, p-value = .16). CONCLUSIONS: STEMI patients admitted during the first wave of Covid-19 outbreak, experienced longer total ischemic time, which was translated into a more severe disease status upon hospital admission, and a higher rate of in-hospital adverse events, compared with parallel period.


Subject(s)
COVID-19/prevention & control , Hospitalization/statistics & numerical data , Outcome Assessment, Health Care/statistics & numerical data , Registries/statistics & numerical data , SARS-CoV-2/isolation & purification , ST Elevation Myocardial Infarction/therapy , Aged , COVID-19/epidemiology , COVID-19/virology , Comorbidity , Epidemics , Female , Humans , Incidence , Logistic Models , Male , Middle Aged , Multivariate Analysis , Outcome Assessment, Health Care/methods , Prospective Studies , SARS-CoV-2/physiology , ST Elevation Myocardial Infarction/diagnosis , ST Elevation Myocardial Infarction/epidemiology
7.
Advances in Oral and Maxillofacial Surgery ; : 100031, 2021.
Article in English | ScienceDirect | ID: covidwho-1084503

ABSTRACT

Introduction The current corona virus disease 2019 (COVID-19) outbreak set new challenges to nearly all health plans and large health organizations worldwide, including movement restrictions, strict limitations in healthcare services, especially in the dental profession, and patient fears regarding potential infection. Telehealth can serve as an effective platform for remote connection between dental healthcare providers and patients, and can help reduce the risk of infection when social distancing is required. Objective The current study aimed to evaluate the quality of treatment provided via teledentistry, as perceived by patients using the service, as well as their willingness to use online distant medical consultation in the future. Methods Since March 2020, a new online service was implemented in the Oral Medicine Unit and Oral and Maxillofacial Surgery Department in the Galilee Medical Center, to expand the range of services beyond merely emergency treatments. Results The current study examined the quality of teledentistry services as perceived by 89 patients participating in at least one teleconsultation, and their acceptance of remote healthcare. Satisfaction rates were high in patients who received both full and partial solution to their chief complaint. Moreover, acceptance of the teledentistry platform was high, even in the older age groups. Conclusions We propose to implement teledentistry services in current and future pandemics, as well as during routine times, to strengthen our health care system with digital technologies.

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