Medicine
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COVID-19 pandemic caused a major crisis, affecting and straining health care systems, including some very advanced ones. The pandemic may have also indirectly affected access to health care for patients with other conditions, not related to COVID-19, even in countries not overwhelmed by an outbreak. We analyzed and compared visits to the emergency room (ER) department during the same calendar period of 2019 and 2020 (from March 1 to March 31 of each year) in our hospital, a medium size, tertiary center, located in the center of Athens, which is not a referral center for COVID-19. ⋯ Importantly, number of ER visits for infections remained unchanged, as well as the number of patients that required hospitalization for infection management; only few patients were diagnosed with COVID-19. During the initial period of the pandemic and lock-down in Greece, there was a major decrease in the patients visiting ER department, including decrease in the numbers of admissions for cardiovascular symptoms and complications. These observations may have implications for the management of non-COVID-19 diseases during the pandemic.
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Observational Study
Dizziness handicap and anxiety depression among patients with benign paroxysmal positional vertigo and vestibular migraine.
To investigate the dizziness handicap and anxiety depression among patients with benign paroxysmal positional vertigo (BPPV) and vestibular migraine (VM). A prospective cohort study in which patients came from the Department of Neurology, Beijing Tiantan Hospital, Capital Medical University was conducted. Patients were diagnosed with BPPV and VM from September 2016 to December 2017. ⋯ A Spearman correlation revealed a significantly moderate positive correlation (r = .455, P < .001) between DHI and HADS scores. The emotional, functional and physical effects of vertigo on VM patients were more significant than BPPV patients. The change of DHI scores in BPPV and VM patients was positively correlated with changes in the anxiety and depression in the HADS.
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There have been increasing calls for clinicians to document social determinants of health (SDOH) in electronic health records (EHRs). One potential source of SDOH in the EHRs is in the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) Z codes (Z55-Z65). In February 2018, ICD-10-CM Official Guidelines for Coding and Reporting approved that all clinicians, not just the physicians, involved in the care of a patient can document SDOH using these Z codes. ⋯ The SDOH Z codes are rarely used by clinicians. Providing clear guidelines and incentives for documenting the Z codes can promote their use in EHRs. Improvements in the EHR systems are probably needed to better document SDOH.
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To explore the effect and mechanism of Shenfu Injection on serum metabolomics in laparoscopic hysterectomy.1.5 mL/kg Shenfu injection was added to inject 200 mL of normal saline after the patients who entered the standard were admitted to the operating room. NMR metabolomics were performed at each time point before anesthesia (T0), immediately after pneumoperitoneum (T1), and at the end of surgery (T2). Multivariate trajectory analysis showed that SFI treatment could make laparoscopic hysterectomy interfere with the recovery of plasma metabolites to normal metabolic state, with a time-dependent trend. ⋯ The current findings provided, for the first time, sound evidence of the protective effects of SFI on laparoscopic hysterectomy from both biochemical and metabolomics perspectives. The mechanisms of SFI could be related to regulating amino acid metabolism, pyruvate metabolism, and energy metabolism. The present study lays an important foundation for further research and for the broad clinical application of SFI.