Subject(s)
Cold Urticaria , Dermatology , Urticaria , Humans , Urticaria/diagnosis , Urticaria/drug therapy , Urticaria/etiology , Chronic DiseaseABSTRACT
INTRODUCTION: The 2009 pandemic influenza A (H1N1) virus has emerged to cause the first pandemic of the 21st century. On July 3, 2009, novel swine-origin influenza A (H1N1) virus (S-OIV) was identified in Reunion Island, French overseas department located in the southern hemisphere. The present study describes the characteristics and the impact of the epidemic on the activity of an emergency department (ED) from July 3 to August 31, 2009. METHOD: Patients consulting the ED with a discharge diagnosis of influenza-like illness were analyzed. RESULTS: The ED activity in 2009, compared to 2008, increased by 0.5% in July and 9.7% in August. In July and August, respectively 7.1 and 20.0% cases of S-OIV infection were hospitalized. For the 394 patients studied (186 males, 36.2+/-18.5 years), 199 (50.5%) were reported to have comorbidity or risk factor (RF) for complications. Complications occurred in 112 patients (28.4%). The most common complications were bronchospasme (52.7%), pneumonia (32.1%), decompensation caused by comorbidity (17.9%). Seventy-three patients (18.5%) required hospitalization. Patients aged 65 and over accounted for 10.9% of all patients, 31.5% of hospitalized patients and 21.4% of complicated S-OIV infection. Regardless of age, comorbidity and / or RF was reported in 80.2% of complicated S-OIV infection and 86.3% of hospitalized patients. The circuit of patients with S-OIV infection was initially focused on "consultation S-OIV" localized in ED. This organization mobilized several health professionals, disorganized the various medical departments involved, and was unsuitable for the childcare or patient's monitoring with signs of poor tolerance. This organization, even identifying S-OIV patients at their arrival, referred patients to different areas of the hospital and various consultation rooms in ED. CONCLUSION: Recommendations for surveillance, prevention and policy for persons with RF, particularly respiratory disease, are justified. This feedback can raise questions about the patient's circulation in hospital and adjust plans for the organization.
Subject(s)
Disease Outbreaks , Influenza A Virus, H1N1 Subtype , Influenza, Human/epidemiology , Adult , Aged , Emergency Service, Hospital , Female , Humans , Male , ReunionABSTRACT
INTRODUCTION: Marine activities and water sports in tropical countries entail some dangers. In our emergency department, stonefish (Synancae verrucosa) stings are second only to those by sea urchins among the 400 consultations a year for wounds by marine animals. METHOD: We retrospectively collected data for all emergency department visits for stonefish stings over a 5-year period from 2001 through 2005. RESULTS: The study included 57 patients (42 men; mean age 31.2+/-15.9 years, range 3-63 years) at 61 consultations. The reason for the emergency department visit was pain, often described as intense. Injuries occurred to the foot in 79% of cases and the hand in 21%. Local signs included a wound (100%), edema (74%), local inflammation (21%), bruising (23%), necrosis (19%), and, in one patient, cellulitis. Pain was reported in 95% of cases. Local care consisted of immersing the stung area in hot water (79%) or in situ lidocaine injection (16%). Analgesics were administered in 75% of the cases, including morphine (54%) and anti-inflammatory drugs in 47%. Other analgesic techniques included ketamine (3.5%), nitrous oxide (3.5%), and local or regional anesthesia (3.5%); 29% of patients received antibiotics. Patients requiring admission (46%) differed from those who did not by a need for more intense analgesia and by greater wound inflammation and necrosis. Three patients required surgery and three others, hyperbaric oxygen therapy. CONCLUSION: Stonefish stings present the risk of local complications. Analgesia is also a major concern for emergency physicians and prophylactic antibiotics must be considered.
Subject(s)
Bites and Stings/therapy , Fishes , Pain Management , Adolescent , Adult , Analgesics/therapeutic use , Animals , Anti-Bacterial Agents/therapeutic use , Bites and Stings/epidemiology , Child , Child, Preschool , Emergency Service, Hospital , Female , Humans , Hyperbaric Oxygenation , Immersion , Male , Middle Aged , Pain/etiology , Retrospective StudiesABSTRACT
Facial baroparesis is an ischemic neurapraxia of the facial nerve. It occurs after airplane trips or prolonged diving. This paralysis is due to the tympanic promontory. Several promoting factors have been identified, including tubal dysfunction, hypotension, and neurotropic virus. Simple maneuvers can make it disappear: yawning, swallowing, or a Toynbee maneuver. Treatment is based on normobaric or even hyperbaric oxygen therapy. During airplane flights, the paralysis often disappears at landing.
