scholarly journals Clinical and Psychological Impact of COVID-19 Infection in Adult Patients with Eosinophilic Gastrointestinal Disorders during the SARS-CoV-2 Outbreak

2020 ◽  
Vol 9 (6) ◽  
pp. 2011 ◽  
Author(s):  
Edoardo Vincenzo Savarino ◽  
Paola Iovino ◽  
Antonella Santonicola ◽  
Matteo Ghisa ◽  
Giorgio Laserra ◽  
...  
Keyword(s):  
Ad Hoc ◽  
Psychological Impact ◽  
Clinical Information ◽  
Female Gender ◽  
Gastrointestinal Diseases ◽  
University Hospital ◽  
Telemedicine Service ◽  
Web Based ◽  
Gastrointestinal Conditions ◽  
The University

Eosinophilic gastrointestinal diseases (EGIDs) are chronic gastrointestinal conditions requiring corticosteroid and immunosuppressive therapy for disease control. Patients with EGIDs usually report impaired quality of life. We aimed to report the clinical and psychological impact of COVID-19 infection in EGID patients. In this prospective web-based study we invited all consecutive EGID patients attending the University Hospital of Salerno (Campania) and Padua (Veneto) to fill an ad hoc COVID-19 survey. Moreover, a telemedicine service for direct consultation was organized. Data regarding the occurrence and perception of COVID-19 infection as well as clinical information were recorded. The study population included 102 EGID patients (mean age 36.6 years, 34 females), of whom 89 had eosinophilic esophagitis, nine had gastroenteritis, and four had colitis. No patient was diagnosed with COVID-19 or had recurrence of his/her primary disease. All of them were adherent to therapy and preventive measures adoption. Most patients were worried because of COVID-19 and social preventing measures but did not consider themselves at major risk or susceptible to COVID-19 or other infections due to their chronic condition or therapy. Female gender and low education level were associated to a higher psychological perception of COVID-19 compared to lockdown status or other demographic and clinical factors (p < 0.05). Overall, COVID-19 had a limited clinical impact on patients with EGIDs. The degree of education and sex, but not the fact of living in a lockdown area, influenced the perception of SARS-CoV-2 infection.

scholarly journals Web-based, rapid and contactless management of ambulatory patients for SARS-CoV-2-testing

2020 ◽  
Author(s):  
Jannik Stemler ◽  
Oliver A. Cornely ◽  
Torsten Noack-Schönborn ◽  
Corinna Forholz ◽  
Sofie Schumacher ◽  
...  
Keyword(s):  
Mass Casualty Incident ◽  
Mass Casualty ◽  
University Hospital ◽  
Test Results ◽  
Web Based ◽  
Duration Of Symptoms ◽  
Efficient Management ◽  
Ambulatory Patients ◽  
The University ◽  
Outpatient Appointments

Abstract BackgroundDuring the SARS-CoV-2 pandemic a mass casualty incident of ambulatory patients occurred at the COVID-19 rapid response infrastructure (CRRI) facility at the University Hospital of Cologne (UHC). We report the development of a patient-centred mobile-device solution to support efficient management of the facility, triage of patients and rapid delivery of test results.MethodsThe UHC-Corona Web Tool (CWT) was developed as a web-based application useable on each patient's smartphone. It provides, among others, a self-reported medical history including type and duration of symptoms and potential risk contacts and links all retrieved information to the digital patient chart via a QR code. It provides scheduling of outpatient appointments and automated transmission of SARS-CoV-2 test results.ResultsThe UHC-CWT was launched on April 9th, 2020. It was used by 28652 patients until August 31st,2020. Of those, 15245 (53,2%) consulted the CRRI, representing 43,1% of all CRRI patients during the observed period.There were 8304 (29,0%) specifications concerning travel history and 17145 (59,8%) indications of ≥1 symptom of SARS-CoV-2 infection. The most frequently indicated symptoms were sore throat (60,0%), headache (50,7%), common cold (45,1%) and cough (42,6%) while 11057 (40,2%) patients did not report any symptoms. After implementation of the UHC-CWT, the number of patient contacts per physician rose from 38 to 98,7 per day. The personnel for communication of test results was reduced from four on seven days to one on five days.ConclusionThe UHC-CWT is an effective digital solution for management of large numbers of outpatients for SARS-CoV-2 testing.

scholarly journals Quality-of-Life Evaluation in Coeliac Patients on a Gluten-Free Diet

Nutrients ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 2981 ◽  
Author(s):  
Ilaria Marsilio ◽  
Cristina Canova ◽  
Anna D’Odorico ◽  
Matteo Ghisa ◽  
Letizia Zingone ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Psychological Impact ◽  
Clinical Information ◽  
Subscale Score ◽  
Gluten Free Diet ◽  
University Hospital ◽  
Categorical Variables ◽  
Gluten Free ◽  
Health Concerns

The treatment for coeliac disease (CD) has a considerable psychological impact on patients, which may vary depending on subjects and clinical characteristics. The aim of this study was to describe the quality of life (QoL) in CD patients during follow-up, evaluating which factors can influence it. Patients with CD who consecutively visited the outpatient clinic of CD Unit of the University Hospital of Padua from January to September 2019 were enrolled. Demographics and clinical information were collected, and all patients were asked to answer the CD-QoL and Biagi’s validated questionnaires. Student’s t-test and chi-square test were used to compare the continuous and categorical variables, respectively. One hundred patients were enrolled (86 females, mean age at test ± SD: 39.73 ± 13.51; mean age at diagnosis ± SD: 33.09 ± 12.92), with 61% of them having been diagnosed with CD within the previous 5 years. At the time of diagnosis, 43 CD patients reported classical CD presentation, 32 non-classical features, 16 only anaemia and 9 were asymptomatic. The mean CD-QoL value was overall high (80.54 ± 11.91). We found that the “health concerns” subscale score was significantly lower in subjects aged more than 35 years compared to younger subjects (p = 0.03). We also observed that the CD-QoL score in gluten-free diet (GFD)-adherent patients tended to be higher compared to subjects who were non-compliant, with a significantly higher percentage of patients with low score for the “dysphoria” subscale (p = 0.05). This study showed an overall good QoL in subjects on a GFD. However, subjects older and non-compliant to GFD appear to experience more health concerns and suffer from dysphoria, respectively.

Clinical Data Retrieval: 25 Years of Temporal Query Management at the University of Vienna Medical School

2002 ◽  
Vol 41 (02) ◽  
pp. 89-97 ◽  
Author(s):  
W. Gall ◽  
G. Duftschmid ◽  
W. Dorda
Keyword(s):  
Clinical Data ◽  
Ad Hoc ◽  
Query Language ◽  
Clinical Information ◽  
Data Retrieval ◽  
University Of Vienna ◽  
Clinical Databases ◽  
Medical Computer ◽  
Statistical Background ◽  
The University

Summary Objectives: Today, many clinical information systems include analysis components which allow clinicians to apply a selection of predefined statistical functions that satisfy typical cases. They are mostly to inflexible to handle complex, non-standard problems, however. The focus of this paper, therefore, is to present an approach that enables clinicians to autonomously create ad hoc queries including temporal relations in an interactive environment. Methods: We developed the query language AMAS, which was specifically customized for users from the medical domain to flexibly retrieve and interpret temporal, clinical data. AMAS provides for a significant temporal expressiveness in data retrieval using timestamped clinical databases and relies on an operator-operand concept for the specification of a query. Results: Within the last 25 years, four different clinical retrieval systems have been implemented at the Department of Medical Computer Sciences, based on the AMAS query language. Currently, these systems allow access to the medical records of more than 2 million patients. Physicians of 46 different departments at the University of Vienna and Graz Medical Schools have made extensive use of these systems in the course of clinical research and patient care, executing more than 10.000 queries per year. Conclusions: We discuss a list of 20 issues that represent the most essential lessons we have learned in the development of the four systems mentioned above. Amongst others, our experiences indicate that the operator-operand concept allows an intuitive specification of complex, temporal queries. Further, customization to different user classes, based on their statistical background, is essential.

scholarly journals Impact and Strategies on Joint Surgery Centers without Lockdowns during the Peak of the COVID-19 Pandemic: A Multicenter Cross-Sectional Study

2021 ◽  
Vol 10 (22) ◽  
pp. 5392
Author(s):  
Chia-Hao Hsu ◽  
Nin-Chieh Hsu
Keyword(s):  
Community Hospital ◽  
Psychological Impact ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Cross Sectional ◽  
Joint Surgery ◽  
Daily Data ◽  
Number Of Patients ◽  
Total Knee ◽  
The University

The real psychological impact of COVID-19 remains difficult to quantify and may differ between hospital sizes and levels. Taiwan’s response to COVID-19 differed in that it successfully prevented its spread, without implementing any lockdowns before May 2021. Patients’ fear would be the major reason for the reduction of surgeries. The daily data for patients who underwent total knee arthroplasty (TKA), total hip arthroplasty, and hemiarthroplasty were collected from two major joint surgery centers of a university hospital and a community hospital in Taiwan. Compared with the previous year, the initial impact of the pandemic evidently reduced the total number of patients (outpatient: 20–29%; admission: 22–37%; surgery: 18–35%) in both hospitals. During the study period, the total number of TKAs decreased by 56–61% in both hospitals. The reduction in arthroplasty surgeries was attributable to patients’ fear. Even with confirmed COVID-19 cases, the university hospital experienced less impact than the community hospital. The TKA was the most affected of all surgery types. Even without local epidemics and restrictions in Taiwan, the worldwide pandemic inevitably led to a reduction of approximately 60% of the total TKA operation volume, especially for community hospitals. The surgery scheduling strategies helped maintain the routine arthroplasty services.

scholarly journals How can clinical biobanks and patient information be adapted for research – Establishing a hospital based data warehouse solution

2012 ◽  
Vol 21 (2) ◽  
Author(s):  
Wenche Reed ◽  
Sissel Jor ◽  
Roger Bjugn
Keyword(s):  
Data Warehouse ◽  
Data Exchange ◽  
Tracking System ◽  
Clinical Information ◽  
Basic Research ◽  
Information Model ◽  
Hospital Information Systems ◽  
University Hospital ◽  
Web Based ◽  
Human Biological Material

The use of human biological material and related clinical information is central in basic research, translational research and clinical research. Extracting this information from hospital information systems is time-consuming and labor intensive. Establishing a data warehouse is a possible solution to extract the information in an efficient and secure way. An information model for a data warehouse has been developed at the Oslo University Hospital in collaboration with Akershus University Hospital. Being hospitals, the overall information model is patientcentered. The model also allows for appropriate data exchange between different organizations. The model is described with a focus on some of the major conditions for success with respect to the legal and organizational framework of Norwegian hospitals. A web-based information and tracking system for clinical biobanks is an important element of the model, and one of the aims of the national project Biobank Norway

scholarly journals Extrapulmonary tuberculosis among immigrants in a low-TB burden and high immigrant receiving city of northern Italy

2018 ◽  
Vol 12 (02) ◽  
pp. 73-79 ◽  
Author(s):  
Mariachiara Di Nuzzo ◽  
Alessandro Trentini ◽  
Anastasio Grilli ◽  
Lorenzo Massoli ◽  
Enrico Biagi ◽  
...  
Keyword(s):  
Extrapulmonary Tuberculosis ◽  
Diagnostic Delay ◽  
Binary Logistic Regression ◽  
Female Gender ◽  
Viral Disease ◽  
University Hospital ◽  
Hiv Status ◽  
Asian Origin ◽  
Demographical Data ◽  
The University

Introduction: The constantly increasing immigration flows are influencing tuberculosis (TB) epidemiology in several European countries as well as in Italy. Extrapulmonary tuberculosis (EPTB) incidence rate is not decreasing and, among immigrants, it occurs in a remarkable number of cases. This study aimed to provide further insights regarding EPTB among natives and immigrants in a low TB burden and high immigrant receiving setting. Methodology: A total of 217 TB cases admitted to the University-Hospital of Ferrara from 2009 through 2015 were enrolled in the study. Clinical and demographical data including age, gender, origin, single comorbidities such as HIV status, chronic viral disease, chronic lung disease, diabetes, neoplasm, and multimorbidity were analyzed. Results: Of the 217 cases enrolled, 60.0% were immigrants and 40.0% natives, 68.7% presented pulmonary TB and 31.3% EPTB. By binary logistic regression, we observed that female gender (O.R. (95% C.I.): 1.95 (1.08-3.50), p < 0.05), Asian origin (5.70 (2.00-16.24), p < 0.001) and multimorbidity (6.42 (2.37-17.41), p < 0.001) were significantly associated to the development of EPTB compared to PTB. Nodal TB was the most common site of reactivation (56.5% among immigrants and 27.3% among natives). Conclusions: The data we found could be useful in increasing EPTB medical suspicion and decreasing EPTB diagnostic delay in low TB burden and high immigrant receiving settings.

scholarly journals How to develop a sustainable telemedicine service? A Pediatric Telecardiology Service 20 years on - an exploratory study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Mélanie Raimundo Maia ◽  
Eduardo Castela ◽  
António Pires ◽  
Luís Velez Lapão
Keyword(s):  
Healthcare Professionals ◽  
Scale Up ◽  
Cost Benefit ◽  
Clinical Information ◽  
Healthcare Services ◽  
University Hospital ◽  
Window Of Opportunity ◽  
Critical Factors ◽  
African Countries ◽  
Telemedicine Service

Abstract Background Telemedicine services are promoting more access to healthcare. Portugal was an early adopter of telemedicine to overcome both its geological barriers and the shortage of healthcare professionals. The Pediatric Cardiology Service (PCS) at Coimbra University Hospital Centre (CHUC) has been using telemedicine to increase access and coverage since 1998. Their Pediatric Telecardiology Service has been daily connecting CHUC with 13 other Portuguese national hospitals, and regularly connecting with Portuguese-speaking African countries, through a teleconsultation platform. Methods This study aims at exploring the Pediatric Telecardiology Service’s evolution, through a comprehensive assessment of the PCS’s development, evolution and impact in public health, to better understand the critical factors for implementation and sustainability of telemedicine, in the context of healthcare services digitalization. A case study was performed, with cost-benefit, critical factors and organizational culture assessment. Finally, the Kingdon’s framework helped to understand the implementation and scale-up process and the role of policy-making. Results With the total of 32,685 out-patient teleconsultations, growing steadily from 1998 to 2016, the Pediatric Telecardiology Service has reached national and international recognition, being a pioneer and an active promotor of telemedicine. This telemedicine service has saved significant resources, about 1.1 million euros for the health system (e.g. in administrative and logistic costs) and approximately 419 euros per patient (considering an average of 1777 patients per year). PCS presents a dominant “Clan” culture. The Momentum’s critical factors for telemedicine service implementation enabled us to understand how barriers were overcome (e.g. political forces). Willingness, perseverance and teamwork, allied with partnership with key stakeholders, were the foundation for professionals’ engagement and service networking development. Its positive results, new regulations and the increasing support from the hospital board, set up a window of opportunity to establish a sustainable telemedicine service. Conclusion The Pediatric Telecardiology Service enables real-time communication and the sharing of clinical information, overcoming many barriers (from geographical ones to shortage of healthcare professionals), improving access to specialized care both in Portugal and Africa. Motivation and teamwork, and perseverance, were key for the Pediatric Telecardiology Service to tackle the window of opportunity which created conditions for sustainability.

scholarly journals The role of the Sunfrail tool in the screening of frailty and in integrated community-hospital care pathways: a retrospective observational study

2021 ◽  
Author(s):  
Yari Longobucco ◽  
Fulvio Lauretani ◽  
Luciano Gionti ◽  
Sara Tagliaferri ◽  
Robbert Gobbens ◽  
...  
Keyword(s):  
Clinical Pathways ◽  
Area Under The Curve ◽  
Clinical Information ◽  
Falls Prevention ◽  
Social Model ◽  
University Hospital ◽  
List Type ◽  
Discriminating Power ◽  
The University

Abstract Background One of the most problematic expression of ageing is frailty, and an approach based on its early identification is mandatory. The Sunfrail-tool (ST), a 9-item questionnaire, is a promising instrument for screening frailty. Aims To assess the diagnostic accuracy and the construct validity between the ST and a Comprehensive Geriatric Assessment (CGA), composed by six tests representative of the bio-psycho-social model of frailty; To verify the discriminating power of five key-questions of the ST; To investigate the role of the ST in a clinical-pathway of falls’ prevention. Methods In this retrospective study, we enrolled 235 patients from the Frailty-Multimorbidity Lab of the University-Hospital of Parma. The STs’ answers were obtained from the patient’s clinical information. A patient was considered frail if at least one of the CGAs’ tests resulted positive. Results The ST was associated with the CGA’s judgement with an Area Under the Curve of 0.691 (CI 95%: 0.591–0.791). Each CGA’s test was associated with the ST total score. The five key-question showed a potential discriminating power in the CGA’s tests of the corresponding domains. The fall-related question of the ST was significantly associated with the Short Physical Performance Battery total score (OR: 0.839, CI 95%: 0.766–0.918), a proxy of the risk of falling. Discussion The results suggest that the ST can capture the complexity of frailty. The ST showed a good discriminating power, and it can guide a second-level assessment to key frailty domains and/or clinical pathways. Conclusions The ST is a valid and easy-to-use instrument for the screening of frailty.

scholarly journals Professional and Volunteer Refugee Aid Workers–Depressive Symptoms and Their Predictors, Experienced Traumatic Events, PTSD, Burdens, Engagement Motivators and Support Needs

2019 ◽  
Vol 16 (22) ◽  
pp. 4542 ◽  
Author(s):  
Andrea Borho ◽  
Ekaterini Georgiadou ◽  
Theresa Grimm ◽  
Eva Morawa ◽  
Andrea Silbermann ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Traumatic Event ◽  
Traumatic Events ◽  
Female Gender ◽  
Mental Illnesses ◽  
University Hospital ◽  
Traumatic Experiences ◽  
Aid Workers ◽  
Motivating Factor ◽  
The University

In 2016, the Department of Psychosomatic Medicine and Psychotherapy of the University Hospital of Erlangen started conducting training for professional and voluntary aid workers. In total, 149 aid workers took part in the training courses, of which 135 completed the corresponding questionnaires. Engagement motivators, perceived distress in refugee work and training needs were examined. Moreover, depressive symptoms, the prevalence of traumatic experiences and symptoms of posttraumatic stress disorder were explored. Participants named helping others as the highest motivating factor for their work with refugees and communication problems as the main burden. Thirteen aid workers (10.1%) showed clinically relevant depressive symptoms. In total, 91.4% of refugee aid workers had experienced at least one traumatic event personally or as a witness but only three (3.6%) fulfilled the psychometric requirements of a PTSD diagnosis. These three participants all belonged to the professional aid workers (6.3%). More severe symptoms of depression were significantly associated with female gender (β = 0.315, p = 0.001), higher perceived burdens of refugee work (β = 0.294, p = 0.002), and a larger number of experienced traumatic events (β = 0.357, p < 0.001). According to our results, we recommend psychological trainings and regular screenings for psychological stress in order to counteract possible mental illnesses.

scholarly journals Psychological impact of Covid-19 pandemic on oncological patients: A survey in Northern Italy

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248714
Author(s):  
Eva Pigozzi ◽  
Daniela Tregnago ◽  
Lucia Costa ◽  
Jessica Insolda ◽  
Enrico Turati ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Ad Hoc ◽  
Psychological Impact ◽  
Female Gender ◽  
Vulnerability Index ◽  
Time Frame ◽  
Psychological Status ◽  
Psychological Consequences ◽  
Emotional Vulnerability ◽  
High Level

The psychological impact of the Covid 19 pandemic on cancer patients, a population at higher risk of fatal consequences if infected, has been only rarely evaluated. This study was conducted at the Departments of Oncology of four hospitals located in the Verona area in Italy to investigate the psychological consequences of the pandemic on cancer patients under active anticancer treatments. A 13-item ad hoc questionnaire to evaluate the psychological status of patients before and during the pandemic was administered to 474 consecutive subjects in the time frame between April 27th and June 7th 2020. Among the 13 questions, 7 were considered appropriate to elaborate an Emotional Vulnerability Index (EVI) that allows to separate the population in two groups (low versus high emotional vulnerability) according to observed median values. During the emergency period, the feeling of high vulnerability was found in 246 patients (53%) and was significantly associated with the following clinical variables: female gender, being under chemotherapy treatment, age ≤ 65 years. Compared to the pre-pandemic phase, the feeling of vulnerability was increased in 41 patients (9%), remained stably high in 196 (42%) and, surprisingly, was reduced in 10 patients (2%). Overall, in a population characterized by an high level of emotional vulnerability the pandemic had a marginal impact and only a small proportion of patients reported an increase of their emotional vulnerability.

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