Effect of the COVID-19 pandemic at a major Danish trauma center in 2020 compared with 2018-2019: A retrospective cohort study.

BACKGROUND: The COVID-19 pandemic demanded changes in societal behavior and health care worldwide. Previous studies have compared trauma patient admissions in COVID-19-related lockdowns to prior years. This study describes the COVID-19 impact on trauma patient admissions during entire 2020 at a major trauma center in Denmark. METHODS: We retrospectively analyzed trauma patients received by a trauma team and admitted at Aarhus University Hospital in 2020 compared with 2018-2019. The incidence of injuries, mechanism of injury, 30-day mortality, and Injury Severity Score (ISS) were investigated. RESULTS: The incidence of minor injuries (ISS 1-15) increased by 24% in 2020 compared with 2018-2019 (incidence rate ratio 1.24 [95% CI: 1.11-1.39]). The incidence of severe injuries (ISS >15) in 2020 did not change compared with 2018-2019 (incidence rate ratio 0.97 [95% CI: 0.80-1.17]). The 30-day mortality was similar in 2020 compared with 2018-2019. Comparing 2020 with 2018-2019, the risk ratio of traffic injuries decreased (0.90 [95% CI: 0.82-0.99]), risk ratio for fall injuries was 1.13 (95% CI: 0.97-1.30), for violence 1.13 (95% CI: 0.51-2.50), and for self-harm 1.94 (95% CI: 0.95-3.94). During the first lockdown of 2020, trauma team activations declined from 49.5 to 42 and the risk ratio for traffic injuries was 0.74 (95% CI: 0.50-1.10) compared with the same period in 2018-2019. CONCLUSION: The incidence of minor injuries increased, but the incidence of severe injuries was similar in 2020 compared with 2018-2019. Societal restrictions might alter the mechanism of injuries. The first lockdown indicated an association with reduced traffic injuries.

Dobutamine aggravates haemodynamic deterioration induced by pleural effusion: A randomised controlled porcine study.

BACKGROUND: Pleural effusion is a common finding in critically ill patients and may contribute to circulatory instability and the need for inotropic support. OBJECTIVE: We hypothesised that dobutamine would affect the physiological determinants preload, afterload, contractility and changes of inferior vena cava characteristics during experimental pleural effusion. DESIGN: A randomised, controlled laboratory study. SETTING: Animal laboratory, conducted from March 2013 to May 2013. ANIMALS: Twenty-four Landrace and Yorkshire female piglets (21.3 ±â€Š1.7 kg). INTERVENTION: Twenty piglets were included in the analyses. After inducing bilateral pleural effusion (30 ml kg), the piglets were block randomised to either incremental dobutamine infusion (n = 10) or control (n = 10). MAIN OUTCOME MEASURES: Ultrasonographic measures of left ventricular end-diastolic area, left ventricular afterload, left ventricular fractional area change and inferior vena cava diameter and distensibility were used to assess the basic physiological effect of incremental dobutamine administration during experimental pleural effusion. RESULTS: In the dobutamine group, preload, measured as left ventricular end-diastolic area, decreased from 11.3 ±â€Š2.0 cm after creation of the pleural effusion to 8.1 ±â€Š1.5 cm at a dobutamine infusion rate of 20 µg kg min (P < 0.001). In the same period, central venous pressure and the expiratory diameter of the inferior vena cava decreased from 9 ±â€Š3 to 7 ±â€Š4 mmHg (P < 0.001) and from 1.1 ±â€Š0.2 to 0.9 ±â€Š0.1 cm (P = 0.008), respectively. CONCLUSION: In a porcine model of pleural effusion, dobutamine affected basic haemodynamic determinants substantially by decreasing left ventricular preload. Changes in central venous pressure and inferior vena cava characteristics were minimal, discouraging their use as indices of preload. This study underlines the significance of evaluating basic haemodynamic determinants to avoid inappropriate, potentially harmful treatment.

Inactivation of pathogens on pork by steam-ultrasound treatment.

The objective of the study was to evaluate a new pathogen inactivation concept that combines application of pressurized steam simultaneously with high-power ultrasound through a series of nozzles. On skin and meat surfaces of pork jowl samples, counts of total viable bacteria were reduced by 1.1 log CFU/cm(2) after treatment for 1 s and by 3.3 log CFU/cm(2) after treatment for 4 s. The mean reduction of 1.7 to 3.3 log CFU/cm(2) on the skin surface was significantly higher than the reduction of 1.1 to 2.5 log CFU/cm(2) on the meat surface. The inactivation of Salmonella Typhimurium, Salmonella Derby, Salmonella Infantis, Yersinia enterocolitica, and a nonpathogenic Escherichia coli was studied on inoculated samples that were treated for 0.5 to 2.0 s. With one exception, no significant differences in reduction were observed among the bacterial types. After treatment for 0.5 s, the 0.9-to 1.5-log reductions of E. coli were significantly higher than the 0.4- to 1.1-log reductions for Salmonella and Y. enterocolitica. Overall, reductions increased by increasing treatment time; reductions were 0.4 to 1.5 log CFU/cm(2) after treatment for 0.5 s and 2.0 to 3.6 log CFU/cm(2) after treatment for 2 s. Reductions on the skin (1 to 3.6 log CFU/cm(2)) were significantly higher than reductions on the meat surface (1 to 2.5 log CFU/cm(2)). The reduced effect on the meat surface may be explained by greater protection of bacteria in deep structures at the muscle surface. No significant difference in reduction was observed between samples inoculated with 10(4) CFU/cm(2) and those inoculated with 10(7) CFU/cm(2), and cold storage of samples for 24 h at 5°C after steam-ultrasound treatment did not lead to changes in recovery of bacteria.

Direct detection and quantification of horizontal gene transfer by using flow cytometry and gfp as a reporter gene.

A new cultivation-independent method for studying conjugal gene transfer between bacteria was evaluated. The method was based on direct detection and enumeration of donor and transconjugant bacterial cells by flow cytometry. Specific detection of transconjugants was obtained by using a conjugative plasmid tagged with a reporter gene (gfp) encoding green fluorescent protein. A chromosomal encoded repressor (lacI(ql)) repressed expression of GFP in the donor bacteria. Enumeration of the donor cells was performed after induction of GFP expression by the addition of inducer isopropyl-thio-beta-D-galactoside (IPTG). The method presented here provided simple and precise quantification of horizontal gene transfer between both Escherichia coli and Pseudomonas putida strains.