Irish journal of medical science
-
Randomized Controlled Trial
A randomized trial to compare procalcitonin and C-reactive protein in assessing severity of sepsis and in guiding antibacterial therapy in Egyptian critically ill patients.
Procalcitonin (PCT) and C-reactive protein (CRP) are the main used biomarkers for sepsis and in guiding antibiotic therapy, although PCT high cost limits its use in developing countries. ⋯ PCT is a more accurate diagnostic and prognostic biomarker than CRP in patients with sepsis. PCT significantly shortened patients' exposure to antibacterial therapy and hospital length of stay.
-
SARS-CoV-2, causing the lethal disease COVid-19, is a public health emergency in the 2020 global pandemic. The outbreak and fast spreading of SARS-CoV-2 have a high morbidity and mortality specifically in elder patients with chronic diseases such as diabetes mellitus, arterial hypertension, chronic kidney disease, and organ transplanted patients with immunosuppressive therapy. Preliminary results support different treatments such as chloroquine and convalescent plasma infusion in severe cases, with good outcome. ⋯ The data available today regarding the beneficial protective effect of vitamin D is unclear and with conflicting results. Large randomized control trials are necessary to test this hypothesis. In this review, we will explain the cross talk between the active vitamin D and the angiotensin-converting enzyme 2, and summarize the data from the literature.
-
The Covid-19 pandemic has caused worldwide upheaval from early 2020. Trauma and orthopaedic services are no different. A fundamentally important and significant portion of trauma services is the treatment of fragility fractures of the proximal femur, otherwise known as hip fractures. The hip fracture "Blue book Standards", the key performance indicators (KPIs) associated with appropriate hip fracture care are challenging during non-crisis times. We aim to review Blue Book compliance during the Covid-19 crisis and review outcomes of hip fractures, including Covid-19 infection rates. ⋯ Despite improvements in hip fracture care KPIs, the Covid-19 crisis was associated with increased 30-day mortality in hip fracture patients. A positive Covid-19 swab was associated with higher mortality. These observations are of paramount importance to ensure adequate service planning and provision in the face of a potential "second wave" of Covid-19 infections leading into the winter months of 2020.
-
The brutal COVID-19 pandemic has majorly impacted populations and health systems, and surgeons have observed dramatic changes in their daily clinical activities. A survey of French digestive surgeons was conducted to assess these changes. ⋯ This study highlighted the deviations in general emergency surgery patients and provided implications for the solutions that should be implemented during a new health crisis.
-
To investigate the impact of COVID-19 on trauma referrals to a National Neurosurgical Centre during the first wave of COVID-19 in Ireland. ⋯ COVID-19 has had a significant impact on both the volume and mechanism of trauma referrals to the National Neurosurgical Centre in Ireland, with falls below 2 m the most common mechanism of trauma referral across both years. The workload remains substantial and a fully resourced neurosurgical department is essential in any future COVID-19 waves.