ABSTRACT
The elderly or geriatric patients represent a significant portion of emergency department (ED) admissions. Factors affecting poor outcome in these patients suspected or diagnosed with sepsis include shock, hyperlactatemia, and organ failure. Atypical presentations should be emphasized in the training of triage and ED personnel due to difficulties and pitfalls in diagnostic processes for sepsis. The vital organ functions of the elderly, who are among the highest risk groups in the management of sepsis, may deteriorate rapidly with very few precursors, and aggressive methods should be used rapidly when necessary. Interactions of drug doses in the elderly, problems in excretion and differences in metabolism should be considered in treatment regimens. Healthcare workers should try to eliminate colonization risks such as vascular catheterization, unnecessary vascular access and urinary catheters should be removed.In the long term after recovery from sepsis, heart failure, peripheral vascular disease, dementia, and diabetes are the most common entities recorded in the literature. This review was intended to provide an overview of the overall management and give some practical tips for this fragile group of patients in the post-pandemic era.
ABSTRACT
Objective: Smoking, and also water pipe smoking (hookah), is a common method of tobacco use in Southwest Asia and Middle East countries. Although the relationship between coronavirus disease-2019 (COVID-19) infection and smoking has been evaluated in many studies, no study has been conducted to evaluate the relationship between COVID-19 infection and water pipe smoking. Methods: We enrolled 150 in-hospital patients. The severity of disease classified as mild, moderate, severe, and critically ill. The relationship between waterpipe smoker, smoker and non-smoker patients and severity of disease statistically evaluated. Results: Patients with minimal involvement (1-25%) on thorax computed tomography were found to be higher in the smoker and cigarette-hookah smoking group compared to the non-smoking group, and the patients with moderate involvement (51-75%) were found to be less in the smoking-hookah group. in terms of disease degree;It was found that there were more mild and moderate smokers in the smoking and smoking-hookah group than the non-smoking group. The C-reactive protein and sedimentation values of cigarette-waterpipe tabocco smokers were found to be lower than non-smokers. Conclusion: Waterpipe smoking does not aggravate the course of the disease in the young population, but new studies are needed for its effects on the elderly population.
ABSTRACT
Introduction: Although Covid 19 is a systemic disease lung involvement causes the main clinical outcomes. As chest ct, inflammatory markers were other important parameters that provide information about the disease course. Methods: We enrolled 150 in-hospital patients between 02 April 2020-03 May 2020. The severity of disease classified as mild, moderate, severe, and critically ill. Chest CT of the patients assessed and classified for the degree of parenchyma involvement and noted as following: No involvement (0%), Minimal involvement (1-25%) Mild involvement (26-50%), Moderate involvement (51-75%) and severe involvement 76-100%) The relationship between inflammatory markers, chest ct and severity of disease statistically evaluated. Results: There were no statistical differences between the Chest CT involvement and INR, Ast, Alt, Creatinine, Uric acid, Platelet, White blood cell and procalcitonin levels (all p > 0.05). A positive correlation was found between Ct involvement and fibrinogen, D-dimer, sedimentation rate, ferritin, NLR, Crp (r = 0.478, p = <0.001;r =0.311, p = <0.001;r =0.455, p = <0.001;r= 0.369, p = <0.001;r= 0.584, p = <0.001, respectively) Roc analysis revealed that CRP>9.5 mg/L predicted the severe disease with 96% sensitivity and 97.5% specificity. Conclusion: Evaluating Covid 19 infection with easily accessible markers is important. Crp, D-dimer, Ferritin and NLR stands out to as easily accessible, cheap, and reliable markers in determining the prognosis of disease. © 2021 A. CARBONE Editore. All rights reserved.