Resident physicians physical activity during on-call shifts: smartphone-based assessment.

BACKGROUND: Physical activity of resident physicians (RPs) during on-call shifts is difficult to objectively evaluate. The integration of smartphones in our daily routines may allow quantitative assessment, employing pedometric assessment. AIMS: To evaluate the number of steps that RPs walk during on-call shifts as a marker of physical activity by using smartphone-based pedometers. METHODS: Step counts were collected from 100 RPs' smartphones who volunteered to participate in the study between January 2018 and May 2019. The conversion rate was 1400 steps = 1 km (application's default). A shift was defined as regular morning work followed by an in-house on-call stay, totalling 26 hours. Statistical analyses included univariate and multivariate linear mixed models, and Fisher exact test. A P-value < 0.05 was considered statistically significant. RESULTS: The average walking distance was 12 118 steps (8.6 km/RP/shift). Paediatric intensive care unit and neurosurgery residents recorded the longest walking distances 16 347 and 15 630 steps (11.67 and 11.16 km/shift), respectively. Radiology residents walked the shortest distances 4718 steps (3.37 km/shift). Physically active RPs walked significantly longer distances during their shifts than non-physically active RPs: 12 527 steps versus 11 384 steps (8.95 versus 8.13 km/shift, P < 0.05), respectively. Distances covered during weekday shifts were longer than weekend shifts: 12 092 steps versus 11 570 steps (8.63 versus 8.26 km/shift, P < 0.05), respectively. CONCLUSIONS: Smartphone-based pedometers can aid in analysing physical activity and workload during on-call shifts; such information can be valuable for human resource department, occupational health authorities and medical students with impaired physical mobility when choosing a speciality.

Listeriosis in pregnancy: under-diagnosis despite over-treatment.

OBJECTIVE: To compare the symptomatology of pregnant women with suspected listeriosis to culture confirmed listeriosis. STUDY DESIGN: All cases of suspected and culture confirmed pregnancy-associated listeriosis from a single center were retrospectively reviewed assessing demographics, clinical, laboratory and pathological findings, and maternal, fetal and neonatal outcomes. RESULTS: Listeriosis was identified in seven patients, none of whom belonged to the 117 women with suspected listeriosis. Women with confirmed infection were more likely to exhibit fever (P=0.01), flu-like symptoms (P=0.006), threatened preterm labor (P=0.05) and inflammatory markers (P=0.02), but less likely to exhibit gastrointestinal complaints (P=0.004) in comparison with suspected non-confirmed cases. Confirmed cases resulted in preterm delivery (n=5) and stillbirth (n=2). Neonatal complications included meningitis, respiratory disease and sepsis. Maternal outcomes were favorable. CONCLUSION: Although 'febrile gastroenteritis' is a poor predictor of listeriosis in pregnancy, fever, premature contractions and inflammatory markers are important risk indices prompting workup and adequate empiric treatment.