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1.
Scand J Trauma Resusc Emerg Med ; 30(1): 53, 2022 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-36242052

RESUMO

BACKGROUND: Handling emergency calls in French emergency medical call centres (EMCCs) can be challenging considering the frequent lack of relevant information. Tele-transmission device use in regular ambulances seems like a good solution to provide the EMCC physician with a more accurate assessment of the scene, particularly for mild traumatic injury (MTI). We measured the impact of ambulance staff tele-transmitted photography on prehospital dispatching optimisation for patients calling the EMCC with MTI. METHODS: We conducted a prospective, single-centre, randomised-controlled trial comparing two groups of patients calling the EMCC with MTI who were or were not allocated to photography tele-transmission by ambulance staff. The primary outcome was the proportion of patients referred away from the nearest hospital (left at home for outpatient care; referred to a higher-level hospital; handled by a medical intensive care ambulance for advanced pre-hospital care) used as a marker of better orientation. RESULTS: Between 29 April 2019 and 21 July 2020, 165 patients were randomised and 152 analysed. Photography tele-transmission resulted in better patient dispatching (24/73 [33%] patients in the intervention group vs 9/79 [11%] patients in the control group, OR 3.80 [1.63-8.90]; p = 0.03), without increasing the proportion of patients initially left at home for outpatient care and visiting an ED within 10 days for secondary trauma-related care (1/14 [7%] vs 1/4 [25%], OR 0.25 [0.01-24.1]; p = 0.41). The proportion of patients unnecessarily referred to an ED was 7% [4/59 patients] in the intervention group vs 16% [12/75 patients] in the control group (OR 0.38 [0.09-1.36]; p = 0.10). CONCLUSION: Photography tele-transmission by regular ambulance staff could improve the dispatching of patients calling French EMCCs with MTI. Trial registration The study is registered with Clinicaltrials.gov (NCT04034797).


Assuntos
Ambulâncias , Serviços Médicos de Emergência , Serviços Médicos de Emergência/métodos , Hospitais , Humanos , Fotografação , Estudos Prospectivos , Encaminhamento e Consulta
2.
J Hosp Infect ; 120: 123-126, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34822950

RESUMO

Few data are available on the efficacy of 0.5% aqueous sodium hypochlorite (SH) for skin disinfection before peripheral catheter insertion. A total of 239 patients were randomly assigned to either one application of SH alone or one application of SH preceded by one application of 70% ethanol (ET-SH). Catheter colonization, defined as a catheter tip culture growing >1000 cfu of a micro-organism per millilitre, occurred in 29 patients (33% of 89 colonizations per 1000 catheter-days) in the SH group and in 31 patients (33% of 126 colonizations per 1000 catheter-days) in the ET-SH group.


Assuntos
Anti-Infecciosos Locais , Cateterismo Venoso Central , Catéteres , Desinfecção , Etanol/farmacologia , Humanos , Projetos Piloto , Pele , Hipoclorito de Sódio/farmacologia
3.
Scand J Trauma Resusc Emerg Med ; 27(1): 72, 2019 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-31387626

RESUMO

BACKGROUND: Dizziness is a frequent reason for visiting emergency departments (EDs). Differentiating stroke from other causes is challenging for physicians. The role of biomarkers has been poorly assessed. We evaluated whether copeptin and S100b protein (PS100b) assessment, alone or in combination, could rule out stroke in patients visiting EDs for dizziness. METHODS: We included patients 18 years of age or older, visiting the adult ED of a French university hospital for a new episode of dizziness evolving for less than 72 h. All patients underwent standardized physical examination (HINT [Head Impulse test, Nystagmus, test of skew deviation] maneuvers), copeptin and S-100b protein (PS100) measurement and injected brain imaging. Stroke diagnosis involved diffusion-weighted magnetic resonance imaging or, if not available, neurological examination and contrast brain CT scan compatible with the diagnosis. RESULTS: Of the 135 patients participating in the study, 13 (10%) had stroke. The sensitivity, specificity and positive and negative predictive values of copeptin/PS100 combination were 100% (95%CI, 77-100%), 48% (40-57%), 14% (11-27%) and 100% (94-100%), respectively. Values for copeptin alone were 77% (CI95% 0.50-0.91), 50% (CI95% 0.49-0.58), 14% (CI95% 0.08-0.24), 93% (CI95% 0.87-0.98), and for PS100 alone were 54% (CI95% 0.29-0.77), 97% (CI95% 0.92-0.99), 64% (CI95% 0.35-0.84), 95% (CI95% 0.90-0.98). CONCLUSIONS: Absence of copeptin and PS100 elevation seems to ruling out the diagnosis of stroke in patients visiting the ED for a new episode of dizziness. These results need to be confirmed in a large-scale study.


Assuntos
Tontura/diagnóstico , Serviço Hospitalar de Emergência , Glicopeptídeos/sangue , Subunidade beta da Proteína Ligante de Cálcio S100/sangue , Acidente Vascular Cerebral/diagnóstico , Adulto , Idoso , Biomarcadores/sangue , Imagem de Difusão por Ressonância Magnética/métodos , Tontura/sangue , Tontura/etiologia , Feminino , Humanos , Medições Luminescentes , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Estudos Prospectivos , Acidente Vascular Cerebral/sangue , Acidente Vascular Cerebral/etiologia
5.
J Theor Biol ; 351: 47-57, 2014 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-24594370

RESUMO

Viral antagonism of host responses is an essential component of virus pathogenicity. The study of the interplay between immune response and viral antagonism is challenging due to the involvement of many processes acting at multiple time scales. Here we develop an ordinary differential equation model to investigate the early, experimentally measured, responses of human monocyte-derived dendritic cells to infection by two H1N1 influenza A viruses of different clinical outcomes: pandemic A/California/4/2009 and seasonal A/New Caledonia/20/1999. Our results reveal how the strength of virus antagonism, and the time scale over which it acts to thwart the innate immune response, differs significantly between the two viruses, as is made clear by their impact on the temporal behavior of a number of measured genes. The model thus sheds light on the mechanisms that underlie the variability of innate immune responses to different H1N1 viruses.


Assuntos
Vírus da Influenza A Subtipo H1N1/imunologia , Influenza Humana/imunologia , Modelos Imunológicos , Células Dendríticas/imunologia , Células Dendríticas/virologia , Expressão Gênica/imunologia , Interações Hospedeiro-Patógeno , Humanos , Evasão da Resposta Imune , Imunidade Inata/genética , Imunidade Inata/imunologia , Vírus da Influenza A Subtipo H1N1/classificação , Vírus da Influenza A Subtipo H1N1/patogenicidade , Influenza Humana/genética , Influenza Humana/virologia , Interferon beta/biossíntese , Proteínas não Estruturais Virais/fisiologia
6.
Stud Health Technol Inform ; 68: 306-10, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10724894

RESUMO

Database on clinically treated patients in Belgrade served as an example for analysis of possibilities for the use of Personal Identifying Number (PIN) as an Unique Patient Identifier. In the first part of the paper we analyzed filling up of the fields which contained data on PIN within complete databases in 1981, 1991 and 1996. Filling up of PIN was significantly changed in the three observed years: it was 18% in 1981; 68% in 1991, and 56% in 1996 respectively. Analysis of interactions among the chosen factors (type of hospital, demographic and social characteristics of patients, length of stay in hospital, manner of treatment, main diagnosis, treatment outcome) and measuring time, showed a different degree of statistical significance. In the second part of our paper we analyzed the unexpected decrease in filling up of PIN in 1996 (as compared to 1991) ussing the method of logistic regression, on 1% samples from the databases for the two respective years. On the basis of obtained models of filling up of UPI data, taken as dependent variable and the above factors (predictors) we analyzed the advantages and drawbacks of UPI application as an unique patient identifier.


Assuntos
Redes de Comunicação de Computadores , Sistemas de Informação Hospitalar , Sistemas Computadorizados de Registros Médicos , Sistemas de Identificação de Pacientes , Sistemas de Gerenciamento de Base de Dados , Humanos , Avaliação de Resultados em Cuidados de Saúde , Iugoslávia
7.
Nahrung ; 42(1): 36-8, 1998 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-9584276

RESUMO

A method for determination of zinc, cadmium, lead and copper in wines by means of potentiometric stripping analysis (PSA) is described. Cadmium, lead and copper are determined directly, whereas the zinc determination is possible only after the wine samples decomposition. The results for five red and white Yugoslav wines are given. The content of zinc, cadmium, lead and copper in analyzed samples were in the range of 0.16-0.79, 0.010-0.045, 0.13-0.27 and 0.10-0.46 mg/l, respectively. The contents of the all analyzed metals were below the maximum ordered by the Yugoslav law.


Assuntos
Contaminação de Alimentos/análise , Metais Pesados/análise , Vinho/análise , Cádmio/análise , Cobre/análise , Chumbo/análise , Potenciometria , Espectrofotometria Atômica , Zinco/análise
8.
Gene ; 143(1): 79-83, 1994 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-8200542

RESUMO

The nucleotide (nt) sequence of the gene encoding penicillin G amidase (PA) of Arthrobacter viscosus strain ATCC 15,294 was determined. The sequence contained an open reading frame of 2406 nt with a G+C content of 37%. The deduced amino-acid sequence shows significant homology with other so far identified beta-lactam amidases of Gram- bacteria.


Assuntos
Arthrobacter/enzimologia , Proteínas de Bactérias/genética , Genes Bacterianos/genética , Penicilina Amidase/genética , Sequência de Aminoácidos , Arthrobacter/genética , Proteínas de Bactérias/química , Sequência de Bases , Regulação Bacteriana da Expressão Gênica , Regulação Enzimológica da Expressão Gênica , Bactérias Gram-Negativas/enzimologia , Bactérias Gram-Negativas/genética , Dados de Sequência Molecular , Penicilina Amidase/metabolismo , Filogenia , Mapeamento por Restrição , Alinhamento de Sequência , Análise de Sequência de DNA , Homologia de Sequência de Aminoácidos , beta-Lactamases/química , beta-Lactamases/genética
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