Influenza virus infection: an approach to identify predictors for in-hospital and 90-day mortality from patients in Vienna during the season 2017/18.

BACKGROUND: Seasonal influenza outbreaks are associated with increased mortality and hospitalisation rates. Herein we tried to identify predictors of mortality in hospitalised patients with influenza virus infection. MATERIALS/METHODS: In this exploratory retrospective observational single-centre-study we included all influenza-positive patients older than 18 years who were hospitalised and treated at the flu-isolation-ward during the influenza season 2017/18. Diagnosis was based on point-of-care-test with the Alere™ i. First we performed χ2 tests and Mann-Whitney U tests to identify predictors of mortality. Significant variables were used in a stepwise-forward-logistic-regression-model to predict in-hospital and 90-day mortality. RESULTS: Of the 396 patients who tested positive for influenza 96 (24.2%) had influenza A and 300 (75.8%) influenza B. Twenty-two (5.6%) died in hospital and the 90-day mortality rate was 9.4%. In the stepwise logistic regression older age (OR 1.1 per year 95% CI 1.03-1.17), history of atrial fibrillation (OR 5.91 95% CI 1.91-18.34), dementia (OR 3.98 95% CI 1.24-12.78), leucocyte count (OR 1.11 per G/L 95% CI 1.03-1.20), pneumonia (OR 4.39 95% CI 1.44-13.39) and acute heart failure (OR 23.15 95% CI 4.33-123.76) increased the risk of in-hospital mortality. The risk for 90-day mortality was increased by older age (OR 1.04 per year 95% CI 1.01-1.07), history of atrial fibrillation (OR 3.1, 95% CI 1.36-7.05), history of congestive heart failure (OR 4.7 95% CI 1.94-11.48), pneumonia (OR 3.2 95% CI 1.45-6.91) and decreased by statin use (OR 0.28 95% CI 0.10-0.78). CONCLUSIONS: Older age, history of atrial fibrillation and pneumonia are associated with increased risk of influenza-associated in-hospital and 90-day mortality. Statin use may decrease 90-day mortality.

[Medical ID and emergency apps: A useful tool in emergency situations or a waste of time?] / Notfall-Apps: vergeudete Zeit oder sinnvolles Instrument in der präklinischen Versorgung von Traumapatienten?

BACKGROUND: In order to provide safe care to a patient in an emergency situation, it is useful to know something about the patient's previous medical conditions and medication. For this very reason smartphones have been equipped with so-called emergency apps (e.g. medical-ID, emergency-ID). The aim of our study was to find out whether the owners of smartphones are using the apps and whether medical professionals are trying to access this information. METHODS: We conducted a survey among patients in our outpatient clinic at a level one trauma center. We collected data over 3 months regarding the usage behavior of the aforementioned apps. We simultaneously asked emergency physicians at various hospitals about their experiences with these apps. RESULTS: We were able to interview 192 patients and 103 emergency physicians. The emergency apps were unknown to 45% (n = 79) of the respondents; only 10% (n = 19) of the respondents had the app with data stored. Furthermore, it was found that a total of 21% (n = 41) of the persons carried a note on themselves with previous illnesses and medication. Of the surveyed physicians, 42% (n = 44) stated that they had heard of the app before; however, only 6% (n = 5) routinely searched the smartphone for relevant information in the case of nonresponsive patients. Only 14% of physicians (n = 14) have successfully used the app so far. CONCLUSION: The collected data show that the emergency apps are still unknown to many patients and emergency physicians alike. Due to the low distribution it does not seem to be recommendable to search the smartphone for the apps in time-critical situations after accidents. For patients over 55 years of age, it currently seems more promising to search their wallets for information regarding their previous illnesses.

Comparison of motor unit action potentials using monopolar vs. concentric needle electrodes in the middle deltoid and abductor digiti minimi muscles.

UNLABELLED: Electromyography readings are analyzed noting abnormalities in the parameters of amplitude, duration, and number of phases. Previous studies have demonstrated variability between monopolar needle electrodes (MNEs) and concentric needle electrodes (CNEs) in regard to the above parameters. We hypothesized that a difference in measured parameters would be observed due to the physical differences between the needles. Twenty-three subjects participated in this study. Five readings were recorded from the middle deltoid and the abductor digiti minimi muscles using the MNE, and five readings were recorded using the CNE. A minimal isometric contraction of the tested muscle in the subjects dominant arm was performed. A significant difference was found in amplitudes recorded by the MNE and CNE in both muscles. A significant difference was found in the ADM, and not in the deltoid, with regard to duration. The difference found in the number of phases was clinically insignificant. DISCUSSION: The MNE detected larger amplitudes and durations because of its larger recording territory. The duration may also be affected by the distance between the active/reference electrodes.

[Patients born in autumn more frequently develop atopic eczema]. / Im Herbst Geborene erkranken häufiger am atopischen Ekzem.

Data of birth from 4040 atopic dermatitis patients born in the Berlin area were analyzed in view of their distribution over the 12 months of the year. For comparison the data of birth of all people being born during two years were treated the same way. There was a marked increase of atopic dermatitis with the persons born during the months August to October. On the other hand, the prevalence of atopic dermatitis was diminished with that persons who were born from February till July (with exception of May). Obviously, during the first months of life seasonally differing external factors influence directly o indirectly the decision, whether atopic dermatitis later on will manifest or not. These results should been taken into consideration for family planning in high-risk families.