Mental health consequences of COVID-19 suppression strategies in Victoria, Australia: a narrative review.

The COVID-19 pandemic has imposed significant mental health burdens upon the general population worldwide, either directly owing to the disease or indirectly through aggressive public health measures to control spread of the virus that causes COVID-19. In this narrative review, we used a systematic approach to summarize the impact of restrictive lockdown measures on the general mental health of people living in Victoria, Australia during 2020 and to identify the groups with an increased risk of adverse mental health outcomes. A systematic database search (Ovid Medline, PsycINFO, Embase) for articles examining the mental health of Victorians in the context of the COVID-19 pandemic during 2020 yielded 88 articles, of which 15 articles were finally included in this review. We found that the general mental health of Victorians was negatively affected by COVID-19 restrictions during 2020. Although studies reported heterogeneous mental health outcomes, we found that the general population consistently used coping strategies and demonstrated mental health help-seeking behaviors in response to the restrictions. Women, children, young people, carers, people who became unemployed owing to the pandemic, and those with pre-existing psychiatric conditions had a higher risk of adverse mental health consequences during the COVID-19 pandemic in 2020.

Epidemiology, clinical presentations and outcome of patients presenting to the emergency department after a COVID-19 vaccination: An observational study.

OBJECTIVE: The World Health Organization declared the COVID-19 pandemic on 11 March 2020. In 2021, several vaccines were provisionally approved to reduce the risk of transmission and hospitalisation of COVID-19 infection. A surge in COVID-19 vaccination was seen between August and October 2021 in Victoria, Australia. We hypothesised this led to an increase in ED presentations. METHODS: Patients in the present study were adults who presented to the ED within 21 days of receiving a dose of a COVID-19 vaccine between 11 August 2021 and 14 November 2021. All cases underwent chart reviews to extract epidemiological features, clinical presentations, ED assessments, investigations and disposition. RESULTS: Notably, 968 patients were included in the study, comprising 6.1% of all ED presentations during the study period. The median age was 31 years. 82.9% of patients were younger than 45 years. 20.1% of patients arrived by ambulance. Chest pain was the most common presenting complaint (43.6%), followed by headache (10.3%) and palpitations (8.2%). The most common investigations were a full blood examination (73.5%), an ECG (63.8%) and serum troponin (49.1%). 64.8% of patients were directly discharged home and 22.1% were sent home after a short stay admission. Only 2.2% of patients were admitted to the hospital. CONCLUSION: A majority of patients who presented to the ED after their COVID vaccinations were young and discharged home after the initial assessment. These presentations have significantly increased the workload in prehospital settings and EDs, contributing to increased investigation usage, ED treatment space occupancy, and increased costs to the health system.

Elimination of oral contrast leads to faster scans in the workup of abdominal pain in the emergency setting without compromising diagnostic accuracy.

INTRODUCTION: The aim of this study was to study how the effect of eliminating oral contrast for computed tomography of the abdomen and pelvis (CTAP) in the workup of abdominal pain in the emergency department (ED) would affect the time from patient review to scan and time from review to discharge. METHODS: In this retrospective study, we analysed all ED presentations with abdominal pain to our university affiliated tertiary hospital before and after a protocol that eliminated oral contrast-enhanced CTAPs were implemented in September 2018. Two equivalent periods between September and November of 2017 and 2018 were analysed. Patients were excluded if they had a history of anatomy-altering gastrointestinal surgery, history of inflammatory bowel disease, trauma, suspicion of foreign body ingestion or suspected gastrointestinal bleeding. RESULTS: A total of 176 pre-protocol and 197 post-protocol patients were included in the study. We found that the elimination of oral contrast was associated with a decrease in mean time between ED review and scan by 110 min (379 vs. 269 min). We also found that the elimination of oral contrast did not significantly alter the pattern of radiological diagnoses seen between the two study periods, suggesting the absence of oral contrast does not affect diagnostic accuracy. CONCLUSION: Thus, eliminating the use of oral contrast in the workup of abdominal pain in the ED can lead to increased throughput and more timely patient care.

Intramural oesophageal haematoma following traumatic neck injury.

This case describes a previously well 90-year-old woman who presented with neck pain, swelling, dysphagia and hoarseness following a motor vehicle collision. Oesophageal oedema was visualised on CT of cervical spine and subsequent CT angiography highlighted an actively bleeding intramural oesophageal haematoma (IOH) extending from the cervical oesophagus to the carina. This rare phenomenon (IOH) has been described as a possible consequence of blunt trauma to the neck; however, we found no cases resulting from acceleration/deceleration injury. Although this was a potentially life-threatening injury, our patient made a full recovery with conservative management.

Vision in the palm of your hand.

Here we show that pointing movements made to visual targets projected onto the palm of the hand are more precise and accurate than those made to targets projected onto back of the hand. This advantage may be related to the fact that the number of cortical bimodal neurons coding both visual and tactile stimuli increases with tactile receptor density, which is known to be higher in glabrous than in hairy skin.

Repetition suppression in occipital-temporal visual areas is modulated by physical rather than semantic features of objects.

Functional magnetic-resonance imaging was used to identify areas involved in naming objects and to examine which of these areas adapted to either physical or semantics features of objects. We presented successive pairs of objects that were either the same exemplar of an object, different exemplars of that object, or different objects. By controlling for differences in physical features between pairs of different exemplars and different objects, visual areas in the occipital-temporal cortex were subject to repetition suppression when the same exemplars of an object were repeated, but not when different exemplars of an object were repeated. This was true independent of whether or not participants named objects. Repetition suppression in visual areas appeared therefore bound to physical features. Nevertheless, repetition suppression for physical features was greater in left visual areas when objects were named, suggesting that naming, known to depend on mechanisms in the left hemisphere, may induce greater attentional modulation in the left than in the right visual areas. Taken together, we propose that the difference between our findings and those of earlier studies that report semantic influences can be explained by the failure of those studies to control for differences in the appearance of different exemplars. Left frontal areas showed repetition suppression when either the same or different exemplars of an object were repeated, but only when participants named objects. These results suggest that visual areas process information about physical features without semantic modulation by higher-order areas, and that left frontal areas process semantic features, but the engagement of these processes is task modulated.