Patient Characteristics, Knowledge of the COVID-19 Disease, Risk Behaviour and Mental State in Patients Visiting an Emergency Room with COVID-19 Symptoms in the Netherlands

2020 ◽  
Author(s):  
J.P.M van der Valk ◽  
F.W.J. Heijboer ◽  
H. van Middendorp ◽  
A.W.M. Evers ◽  
J.C.C.M. in 't Veen
Keyword(s):  
The Netherlands ◽  
Emergency Room ◽  
Mental State ◽  
Disease Risk ◽  
Risk Behaviour ◽  
Patient Characteristics

scholarly journals Case-control study of patient characteristics, knowledge of the COVID-19 disease, risk behaviour and mental state in patients visiting an emergency room with COVID-19 symptoms in the Netherlands

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249847
Author(s):  
J. P. M. van der Valk ◽  
F. W. J. Heijboer ◽  
H. van Middendorp ◽  
A. W. M. Evers ◽  
J. C. C. M. in ‘t Veen
Keyword(s):  
The Netherlands ◽  
Emergency Room ◽  
Mental State ◽  
Disease Risk ◽  
Risk Behaviour ◽  
Patient Characteristics ◽  
Control Group ◽  
P Value ◽  
Hygiene Measures ◽  
Pharmaceutical Interventions

Background Coronavirus disease 2019 is a serious respiratory virus pandemic. Patient characteristics, knowledge of the COVID-19 disease, risk behaviour and mental state will differ between individuals. The primary aim of this study was to investigate these variables in patients visiting an emergency department in the Netherlands during the COVID-19 pandemic and to compare the “COVID-19 suspected” (positive and negative tested group) with the “COVID-19 not suspected” (control group) and to compare in the “COVID-19 suspected” group, the positive and negative tested patients. Methods Consecutive adult patients, visiting the emergency room at the Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands, were asked to fill out questionnaires on the abovementioned items on an iPad. The patients were either “COVID-19 suspected” (positive and negative tested group) or “COVID-19 not suspected” (control group). Results This study included a total of 159 patients, 33 (21%) tested positive, 85 (53%) negative and 41 (26%) were COVID-19 not suspected (control group). All patients in this study were generally aware of transmission risks and virulence and adhered to the non-pharmaceutical interventions. Working as a health care professional was correlated to a higher risk of SARS-Cov-2 infection (p- value 0.04). COVID-19 suspected patients had a significantly higher level of anxiety compared to COVID-19 not suspected patients (p-value < 0.001). The higher the anxiety, the more seriously hygiene measures were followed. The anxiety scores of the patients with (pulmonary) comorbidities were significantly higher than without comorbidities. Conclusion This is one of the first (large) study that investigates and compares patient characteristics, knowledge, behaviour, illness perception, and mental state with respect to COVID-19 of patients visiting the emergency room, subdivided as being suspected of having COVID-19 (positive or negative tested) and a control group not suspected of having COVID-19. All patients in this study were generally aware of transmission risks and virulence and adhered to the non-pharmaceutical interventions. COVID-19 suspected patients and patients with (pulmonary) comorbidities were significantly more anxious. However, there is no mass hysteria regarding COVID-19. The higher the degree of fear, the more carefully hygiene measures were observed. Knowledge about the coping of the population during the COVID-19 pandemic is very important, certainly also in the perspective of a possible second outbreak of COVID-19.

scholarly journals The Genetic Research in Alzheimer Disease (GERALD) Initiative Finds rs9320913 as a Neural eQTL of lincRNA AL589740.1

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Lidia Lopez-Gutierrez ◽  
José María García-Alberca ◽  
Silvia Mendoza ◽  
Esther Gris ◽  
María Paz De la Guía ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Alzheimer Disease ◽  
Mental State ◽  
Fluid Intelligence ◽  
Educational Achievement ◽  
Disease Risk ◽  
Genetic Research ◽  
Gene Desert ◽  
Factors Affecting

Alzheimer’s disease is the most common cause of dementia worldwide, and longitudinal studies are crucial to find the factors affecting disease development. Here, we describe a novel initiative from southern Spain designed to contribute in the identification of the genetic component of the cognitive decline of Alzheimer’s disease patients. The germline variant rs9320913 is a C>A substitution mapping within a gene desert. Although it has been previously associated to a higher educational achievement and increased fluid intelligence, its role on Alzheimer’s disease risk and progression remains elusive. A total of 407 subjects were included in the study, comprising 153 Alzheimer disease patients and 254 healthy controls. We have explored the rs9320913 contribution to both Alzheimer disease risk and progression according to the Mini-Mental State Exams. We found that rs9320913 maps within a central nervous system lincRNA AL589740.1. eQTL results show that rs9320913 correlated with the brain-frontal cortex ( beta = − 0.15 , p value = 0.057) and brain-spinal cord (beta of -0.23, p value = 0.037). We did not find rs9320913 to be associated to AD risk, although AA patients seemed to exhibit a less pronounced Mini-Mental State Exam score decline.

Abstract P311: Outpatient Evaluation of Transient Ischemic Attack and Minor, Non-Disabling Stroke During the COVID-19 Pandemic

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Paul Wechsler ◽  
Babak B Navi ◽  
Alan Z Segal ◽  
Neal S Parikh ◽  
Halina White
Keyword(s):  
Ischemic Stroke ◽  
Emergency Room ◽  
Median Time ◽  
Symptom Onset ◽  
Transient Global Amnesia ◽  
Patient Characteristics ◽  
Quality Data ◽  
Minor Stroke ◽  
Laboratory Diagnostics ◽  
Global Amnesia

Introduction: Reductions in hospital visits for stroke have been seen during the COVID-19 pandemic, partly reflecting perceived risks of in-hospital care. We recently implemented an evidence-based protocol for outpatient rapid evaluation of transient and minor, non-disabling stroke symptoms for patients seeking care 24 hours after symptom onset. We present our early experience through the pandemic. Methods: We conducted a retrospective review of patients evaluated in the RESCUE-TIA ( R apid E valuation of minor S troke and C erebrovasc U lar E vents including TIA ) clinic from December 2019-August 2020. The clinic sees patients with TIA symptoms or with fixed, non-disabling deficits seeking care > 24 hours after symptom onset. We introduced telemedicine in March 2020. Magnetic resonance brain and vascular imaging is available within 24 hours of visit. We summarized patient characteristics and quality data with standard descriptive statistics. Results: A total of 21 patients were seen in the RESCUE-TIA clinic, including 15 patients during the height of the pandemic in NY; 67% were seen by telemedicine. The median age was 75 years (interquartile range [IQR], 61-82), and 71% were women. The median NIH Stroke Score for patients with minor stroke was 0 (IQR, 0-1), and the median ABCD 2 score for TIA patients was 3 (IQR, 2-3). Median time from symptom onset to evaluation was 3 days (IQR, 2.5-17.5). Median time from evaluation to laboratory diagnostics was 8 hours (IQR, 2-21), and to completion of imaging was 1 day (IQR, 0-5). Outpatient telemetry commenced in a median of 5 days (IQR, 1-9), and echocardiography was completed in a median of 8 days (IQR, 0-10). One patient was referred to the emergency room for a carotid occlusion. Final diagnoses were TIA (n=12), ischemic stroke (n=5), transient global amnesia (n=2), migraine (n=1), and non-aneurysmal, distal subarachnoid hemorrhage (n=1). Secondary prevention was initiated or optimized in 94% of TIA and stroke patients. Recurrent TIA occurred in 1 patient after 67 days, and ischemic stroke occurred in 1 patient 55 days after TIA. Conclusion: Timely outpatient evaluation of patients with recent TIA and minor, non-disabling stroke is feasible and may be useful during the pandemic, especially during emergency room crowding.

scholarly journals Cohort profile: the Swedish Prescribed Drugs and Health Cohort (SPREDH)

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e023155 ◽  
Author(s):  
Shao-Hua Xie ◽  
Giola Santoni ◽  
Fredrik Mattsson ◽  
Eivind Ness-Jensen ◽  
Jesper Lagergren
Keyword(s):  
Causes Of Death ◽  
Disease Risk ◽  
Healthcare Utilisation ◽  
Patient Characteristics ◽  
Population Based ◽  
Health Data ◽  
Case Control Studies ◽  
Swedish Population ◽  
Drug Register ◽  
Incident Cancer

PurposeThe Swedish Prescribed Drugs and Health Cohort (SPREDH) is a Swedish population-based cohort based on data from four nationwide health data registers, created with the aim of investigating how the use of selected medications influences cancer risk and other outcomes.ParticipantsThe cohort includes 8 421 115 users of selected common medications who have been followed-up for a total of 82 281 720 person-years from 1 July 2005 to 31 December 2015.Finding to dateThe data in SPREDH were prospectively collected from the following national health data registers in Sweden: Prescribed Drug Register, Patient Register, Cancer Register and Causes of Death Register. Data on basic patient characteristics, use of the selected common medications, healthcare utilisation, diagnoses (including detailed information on cancers), and dates and causes of death are available for all cohort participants. The cohort currently includes 801 766 incident cancer cases.Future plansThe data in SPREDH can be used for various types of epidemiological research, particularly for examining how the use of the selected medications influences disease risk and other outcomes. We are initially planning cohort studies and nested case-control studies on selected medications in relation to the risk and prognosis of oesophageal and gastric cancers.

scholarly journals Emergency room resource utilization by patients with low-back pain

2016 ◽  
Vol 24 (5) ◽  
pp. 686-693 ◽  
Author(s):  
Doniel Drazin ◽  
Miriam Nuño ◽  
Chirag G. Patil ◽  
Kimberly Yan ◽  
John C. Liu ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
African American ◽  
Low Back Pain ◽  
Back Pain ◽  
Emergency Room ◽  
Patient Characteristics ◽  
Primary Diagnosis ◽  
Low Back ◽  
Factors Associated ◽  
Risk Of Mortality

OBJECTIVE The objective of this study was to determine factors associated with admission to the hospital through the emergency room (ER) for patients with a primary diagnosis of low-back pain (LBP). The authors further evaluated the impact of ER admission and patient characteristics on mortality, discharge disposition, and hospital length of stay. METHODS The authors conducted a retrospective analysis of patients with LBP discharged from hospitals according to the Nationwide Inpatient Sample (NIS) between 1998 and 2007. Univariate comparisons of patient characteristics according to the type of admission (ER versus non-ER) were conducted. Multivariate analysis evaluated factors associated with an ER admission, risk of mortality, and nonroutine discharge. RESULTS According to the NIS, approximately 183,151 patients with a primary diagnosis of LBP were discharged from US hospitals between 1998 and 2007. During this period, an average of 65% of these patients were admitted through the ER, with a significant increase from 1998 (54%) to 2005 (71%). Multivariate analysis revealed that uninsured patients (OR 2.1, 95% CI 1.7–2.6, p < 0.0001) and African American patients (OR 1.5, 95% CI 1.2–1.7, p < 0.0001) were significantly more likely to be admitted through the ER than private insurance patients or Caucasian patients, respectively. Additionally, a moderate but statistically significant increase in the likelihood of ER admission was noted for patients with more preexisting comorbidities (OR 1.1, 95% CI 1.0–1.2, p < 0.001). An 11% incremental increase in the odds of admission through the ER was observed with each year increment (OR 1.1, 95% CI 1.0–1.2, p < 0.001). Highest income patients ($45,000+) were more likely to be admitted through the ER (OR 1.3, 95% CI 1.1–1.6, p = 0.007) than the lowest income cohort. While ER admission did not impact the risk of mortality (OR 0.95, 95% CI 0.60–1.51, p = 0.84), it increased the odds of a nonroutine discharge (OR 1.39, 95% CI 1.26–1.53, p < 0.0001). CONCLUSIONS A significant majority of patients discharged from hospitals in the US from 1998 to 2007 with a primary diagnosis of LBP were admitted through the ER, with more patients being admitted via this route each year. These patients were less likely to be discharged directly home compared with patients with LBP who were not admitted through the ER. Uninsured and African American patients with LBP were more likely to be admitted through the ER than their counterparts, as were patients with more preexisting health problems. Interestingly, patients with LBP at the highest income levels were more likely to be admitted through hospital ERs. The findings suggest that socioeconomic factors may play a role in the utilization of ER resources by patients with LBP, which in turn appears to impact at least the short-term outcome of these patients.

scholarly journals Adrenocortical Carcinoma Treatment in the Netherlands: An Analysis From the Netherlands Cancer Registry From 2014 to 2019

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A76-A76
Author(s):  
Rebecca Steenaard ◽  
Marieke Rutjens ◽  
Harm Reinout Haak
Keyword(s):  
The Netherlands ◽  
Cancer Registry ◽  
Adrenocortical Carcinoma ◽  
Survival Benefit ◽  
Cox Regression ◽  
Stage Iv ◽  
Patient Characteristics ◽  
Cox Regression Analysis ◽  
Netherlands Cancer Registry ◽  
Number Of Patients

Abstract Background: Adrenocortical carcinoma (ACC) is a rare disease with often poor prognosis. Previous research has shown that surgery in a Dutch Adrenal Network (DAN) center increases the chance of survival. We aim to explore the determinants and survival of patients with ACC recently treated in the Netherlands both within and outside DAN centers. Methods: We analyzed retrospectively collected data from 172 adult patients with newly diagnosed ACC and 97 patients with recurrence or new metastases, registered between 2014 and 2019 in the Netherlands Cancer Registry. Differences in survival were analyzed with cox-regression analysis. Results: More than half of the new cases presented with advance disease (25.7% stage III, 34.6% stage IV) and the median survival was 29 months. The majority of treatments occurred within a DAN center (87.2% of surgery, compared to 56.4% between 1999 and 2009; and 94.5% of medical treatment). There were no differences in patient characteristics between the centers apart from a relatively high number of patients with stage IV disease outside DAN centers (47.2% vs. 28.7%). Adrenal resection and mitotane therapy both resulted in a significant survival benefit (resection HR 0.29, CI95%[0.17–0.49]; mitotane HR 0.61, CI95%[0.37–0.99], corrected for stage). Still, a remarkable proportion of patients with advanced disease received no mitotane treatment (39.8%). Due to the small number of patients treated outside DAN centers, survival benefits could not be tested. Conclusions: Centralization of ACC care in the Netherlands has improved since the previous report, but a further improvement in centralization of surgery can be made. Adrenal resection and mitotane treatment remain the main form of treatment, with a clear survival benefit. Further research is necessary to determine why mitotane treatment is withheld in a large proportion of patients with advance disease.

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