ABSTRACT
OBJECTIVE: The pandemic effects due to the coronavirus SARS-CoV-2 caused a health emergency. We decided to carry out a study with the aim to investigate the changes in patients' tendencies for admission to the emergency department for surgical diseases, and the related hospitalizations and urgent surgery rates. PATIENTS AND METHODS: We carried out a retrospective, observational study on patients who received emergency general surgery consultation at our University Hospital during the two COVID-19 pandemic periods and on the same dates one year before. The patients' demographic characteristics, their hospitalization in surgical department and the data about those who underwent urgent surgery were retrospectively recorded. RESULTS: In the period March-April 2020 there were 95 surgical visits recorded; among these patients, 25% required hospitalization and 12.63% underwent urgent surgery. In the period November-December-January 2020-2021 there were 156 surgical consultations, of which 35.26% required hospitalization and 21.15% underwent urgent surgery. In both considered periods we found that the number of surgical consultations decreased compared to the same periods of the previous year. Moreover, we found a higher rate of hospitalization and need for urgent surgery. CONCLUSIONS: We documented a significant reduction in the overall number of surgical consultations and an increase of hospitalization and urgent surgery rates.
Subject(s)
COVID-19 , Humans , Pandemics , Referral and Consultation , Retrospective Studies , SARS-CoV-2ABSTRACT
Background: SARS-CoV-2-induced severe acute respiratory syndrome is associated with high mortality in the general population;however, the data on chronic haemodialysis (HD) patients are currently scarce.
ABSTRACT
Background : An increased incidence of thrombo-embolic events has been described in Coronavirus Disease 2019 (COVID-19) patients, especially in critically-ill patients. In response, ISTH guidelines consider use of intermediate-dose low-molecular-weight heparins (LMWH) in critically-ill COVID-19 patients. Therefore, twice daily nadroparin dosing can been applied to prevent thrombo-embolic events. Although population pharmacokinetic (PK) parameters of nadroparin are unknown in ICU COVID-19 patients, these parameters would allow evaluation of the proposed dosing schemes from current guidelines. Aims : To construct a population PK model describing anti-Xa levels subsequent to nadroparin administration, allowing assessment of population PK parameters and their associated interpatient variability (IIV) in COVID-19 Intensive Care Unit (ICU)-patients. Methods : Retrospective data of 65 ICU patients with at least one positive SARS-CoV-2 RT-PCR test were included (Table 1/Results). At start of ICU admission, patients received twice daily 5700 IU nadroparin according to local protocol. Anti-Xa sampling was applied routinely daily. Population PK parameters were estimated using nonlinear mixed-effect modelling (NONMEM v7.4.1). Data collection was approved by the local ethics committee Results : Anti-Xa level versus time profiles were adequately described using a population PK model with one elimination and one absorption compartment (Figure 2). Including a transit-compartment did not result in significantly better data description. Population PK parameter estimates and IIV (%) were: Absorption rate: 0.245 h -1 , clearance (CL): 2010 mL/h (33.9%), V1: 10.0 L. CL increased exponentially with rising CRP, D-dimer and renal function (CKD-EPI eGFR). When applying corticosteroids or vasopressors, CL was decreased by 22.4% and 20.3% respectively. Conclusions : In critically-ill COVID-19 patients, measured anti-Xa levels were adequately described by the established population PK model. Our model shows that nadroparin clearance, reported as anti-Xa levels, is influenced by inflammation. This model will be used to evaluate limited sampling schemes for anti-Xa to facilitate blood sampling in clinical practice.
ABSTRACT
Background and aims: We investigated cognitive and affective disorders in patients with SARS-CoV-2 hospitalized in Intensive Care Unit (ICU). Care givers quality of life, psychological distress and satisfaction with the information received by health-care professionals were assessed. Methods: From March 1 to April 30, 2020, 22 consecutive patients with SARS-CoV-2 infection, confirmed by PCR on oronasopharyngeal swab, requiring ICU admission were recruited together with a caregiver. Patients with previous cognitive disorders were excluded. Three months after ICU discharge, patients underwent a comprehensive neuropsychological evaluation and filled out validated questionnaires. Results: Seven of 22 resulted mildly cognitively impaired. Memory was the most impaired domain, followed by attention and verbal fluency. Three out of 22 patients reported an average high level of anxiety but no depression. Quality of life was mild impaired for 19 patients. Lower performances at MoCA were related to higher APACHE score at T0 (r = −.44;p <.04). Lower performances in working memory, short- and long-term memory and verbal fluency were correlated to longer ICU stay, duration of mechanical ventilation and longer treatment with opioid and antipsychotics drugs (rs > −.48;ps <.04). Long term memory performances were related to higher Sequential Organ Failure assessment (SOFA) score and longer treatment with propofol and benzodiazepines (rs > −.53;ps <.02). Higher patient’s anxiety was correlated to higher psychological distress of the caregiver (r = −.64;p <.001). Higher SOFA score is related to lower caregiver quality of life and lower satisfaction with information received (rs > −.53;ps <.02). Conclusions: At 3 months from ICU admission, cognitive and psychological distress sequelae can be observed in SARS-CoV2 ICU patients.
ABSTRACT
The period of lockdown, which occurred in many nations as a result of the COVID-19 pandemic, represented, for scholars, who deal with the complex dynamics connected to emissions and concentrations of atmospheric pollutants, an excellent opportunity to deepen their studies. However, to date, scientific papers, relating to correlation studies between the spatial and temporal variations of thue main pollutants present in our cities (among all, NO2 and particulates), during the long and atypical period of the almost total block of vehicular traffic and many productive activities during pandemic peak, are still very few. This analysis focuses on the Greater Salento region (Italy) and aims to monitor the changes, and the related interrelationships, of the tropospheric concentrations of NO2, PM2.5 and PM10, elaborating the overall data of average daily concentrations of these pollutants as recorded by the ARPA-Puglia ground-based monitoring stations. Nitrogen dioxides and PM emissions are notoriously related to vehicular traffic exhausts and, in general, to fossil fuel combustion processes. This analyzed Italian territory is very unusual because there are two provinces with large industrial settlements, Taranto, with the steel area of ex-ILVA, and Brindisi, with petrochemical and thermoelectric power plants, which enclose a territory, the province of Lecce, free of any industrial plants of such sizes and impacts. From the results of this study, in addition to confirming the obvious and overall decrease of NO2 concentrations during and after the lockdown period, interesting and distinctive local correlations of the concentrations variability of these pollutants have also emerged. In fact, the conclusions of this paper are so significant as to allow broader considerations regarding other similar international areas, regarding, i.e., the ineffectiveness of government containment local measures concerning the tropospheric pollution of our cities.
ABSTRACT
No Abstract Available.