ABSTRACT
Aim: To confirm safety of treatment of acute uncomplicated diverticulitis (AUD) without antibiotics, developing a standarized protocol for selected patients. Method(s): Prospective observational multicentre study carried out between january 1st 2021 and april 15th 2022. Inclusion criteria: Age between 18 and 80, AUD diagnosed by computarized tomography (CT), adequate family support and cognitive capacity, good symptom control, adequate oral intake, signed informed consent. Exclusion criteria: diabetes mellitus, cardiologic event in the last 3 months, chronic liver disease, advanced chronic renal failure, active neoplasic pathology, HIV active infection, corticoidsteroid or immunosuppresant therapy, transplant, splenectomy, inflamatory bowel disease, previous episode of diverticulitis during last 3 months and antibiotic treatment during last 2weeks. Maximum 1 of the following: T >38degreeC-<36degreeC, L >12,000/ml-<4000/ ml, heart rate>90 bpm, CPR >15 mg/dL. Patients were proposed to take part of the study and those who accepted were treated as outpatient with ibuprofen 600mg/8 h, paracetamol 1 g/8 h and omeprazol 40 mg/24h during 7days. Follow-up was carried out by telephone during first 24 h, and attending the emergency department at 48 h and at 7days. Result(s): 157 patients were diagnosed of acute diverticulits, 132 were Hinchey Ia, with 37 (28.1%) patients that fullfilled criteria for the study. 67.6% of patients were male, with median age of 57.6+/-9.7years. Among 37 patients included in the study, 36 were contacted by telephone 24 h. after first visit to emergency department. Only one of them had fever 48 h after diagnosis all patients were clinically reevaluated and only two of them needed a change of strategy, one because of fever, so we started antibiotic therapy and the other because COVID-19 infection. None of the patients needed urgent surgical intervention nor hospitalisation during the study and follow up. Conclusion(s): Our results confirm that treatment of AUD without antibiotics in selected patients is safe.
ABSTRACT
Changes in primary emissions due to the COVID-19 lockdowns in Europe for the year 2020 have been estimated by considering fully open-access and near-real-time measured activity data from a wide range of information sources and with simple computational techniques. The estimates consist on a dataset of reduction factors that are both time- and country-dependent and provided for the following source categories: energy industry (power plants), manufacturing industry, road traffic, aviation, shipping and other stationary combustion activities such as residential and commercial-institutional activities. Inspired in other authors’ estimates for COVID reductions, the advantage of this methodology is that there is no use of machine learning, making this procedure more accessible to the general scientific community. We have followed a fast methodology that takes advantage of observed relationships between variables (e.g. temperature and energy demand) without needing special algorithms for finding those relationships. The comparison of our estimates with others from other authors indicate a reasonable agreement and pointing out that emissions dropped by a 17% on average in Europe, with large differences between sectors of activities and spatial heterogeneity. The most affected sector was aviation, with a spatial-averaged variation of −63% in emissions since the implementation of first restrictions with respect business-as-usual values. 2020 emission changes with respect to business-as-usual values in countries ranges from a −13% in Norway and Poland to a more than −20% in several Mediterranean countries as well as the United Kingdom. Two main periods of emission reductions have been identified. © 2022 Turkish National Committee for Air Pollution Research and Control
ABSTRACT
OBJECTIVE: The purpose of this paper was to describe the diagnosis, treatment and follow-up of patients diagnosed with congenital hypothyroidism (CH) by the Neonatal Screening Program in the Autonomous Community of Madrid during the state of alarm due to the COVID-19 health crisis. METHODS: The data were extracted from the retrospective analysis of patients diagnosed with CH and treated at the Clinical Diagnosis and Follow-up Center of CH located in the Pediatric Endocrinology Unit of the General University Hospital Gregorio Maranon. RESULTS: During the period between March 14 and June 21, 2020, 7 neonates were diagnosed with congenital hypothyroidism. The Screening Center contacted the Clinical Diagnosis and Follow-up Center urgently, with the location and clinical assessment of the patient on the same day, performing the usual complementary examinations in all of them according to clinical pathway. The median age of diagnosis was 15.5 days (range 7.00-24.00). The subsequent clinical and analytical follow-up was carried out in all cases according to the recommended times. All patients presented normalization of the thyroid function after two weeks of treatment. CONCLUSIONS: All patients seen at the Congenital Hypothyroidism Clinical Diagnosis and Follow-up Center during the alarm state period were diagnosed, treated and reevaluated following the usual clinical pathways without incidents. The current epidemiological situation of the COVID-19 pandemic has revealed the correct functioning of the circuit of the Congenital Hypothyroidism Screening Program in less favorable circumstances.