The Usefulness of the Erythrocyte Sedimentation Rate and C-reactive Protein for the Differential Diagnosis of Non-Arteritic Anterior Ischemic Optic Neuropathy in the Era of Microinflammation.

PURPOSE: The presence of a microinflammatory response is one of the possible pathological mechanisms related to the development of nonarteritic anterior ischemic optic neuropathy (NAAION), a common cause of optic neuropathy in old age.We tested whether individuals with NAAION harbor a heightened microinflammatory response compared to controls. METHODS: We measured the erythrocyte sedimentation rate (ESR) and high sensitivity C-reactive protein (hs-CRP) in NAAION patients during hospital admission and in four matched controls for each patient, retrieved from a large cohort of 20,000 apparently healthy individuals. RESULTS: We included 128 NAAION patients and 512 controls. No significant differences were found between patients and controls regarding the inflammatory biomarkers. CONCLUSIONS: This is the first report showing a lack of difference in ESR and hs-CRP levels between NAAION patients and matched controls, suggesting NAAION is not associated with a heightened inflammatory response, such as the one associated with multiple atherothrombotic risk factors.

Burns in the Military Setting-Analyzing 12,799 Routine and Combat Cases.

Burns are a major trauma source in civilian and military settings, with a huge impact on patient's well-being, health system, and operation status of the force in the military setting. The purpose of our study was to summarize characteristics of all burn cases seen by the Israel Defense Forces primary care physicians during the years 2008 to 2016. This can help understand what causes most burns, in what units, at which stages and settings and consequently will allow commanders to make decisions regarding safety rules, protective equipment and uniforms, medical education for soldiers, etc. Data were collected from the military database system. All burn-related visits were analyzed using a designated big data computerized algorithm that used keywords and phrases to retrieve data from the database. 12,799 burn injuries were found presented in 65,536 burn-related visits which were analyzed according to the demographics, burn mechanism, and military unit. It was observed that most of the burns (70.7%) occurred during routine noncombat setting and there was a gradual decrease in burn injuries during the investigated period, from 17.6% of the cases in 2008 to 2.3% in 2016. Most of the burns occurred in the Air Force (19.4%), and the leading etiology was chemical (35%). The average TBSA was 7.5%. Since most of the burns occurred in a routine setting and were occupational-related, investment in education and improving fire protection has proven itself, leading to the decrease in burn prevalence, we recommend that more emphasis should be given on proper handling of chemicals.

Management Strategies for Pediatric Burns During the COVID-19 Pandemic.

The coronavirus disease 2019 (COVID-19) pandemic has been challenging global health, in many countries all non-urgent medical treatments were postponed in order to focus health systems, workforce and other resources on crucial treatments for COVID-19 patients. The pediatric cases are a minority of all COVID-19 patients and might present atypically. Due to an increase in pediatric burn cases we decided to establish an outpatient pre-hospital clinic as an intermediate "station", in order to triage pediatric burn patients into those who present at our hospital, and those treated via telemedicine. We divided our tactics into environmental and patient management both in hospitalized and outpatient patients, also medical staff management including preventive care, surgery, and bedside procedures. We found that patients and their escorts waited longer before arriving to the Emergency Room, apparently trying to avoid the hospital visit. A higher proportion of patients was hospitalized during the pandemic (4.5% in 2020, compared to 2.6% and 2.0% in 2019 and 2018, respectively). However, the length of stay was similar to routine periods, the surgery rate and length of follow up until healing was similar to that of the same month in previous years. We assume that these factors reflect treatment quality, which was not affected, due to the use of telemedicine, and that our treatment standards were maintained. It is important to have a good regulation system of prevention and care, including the tactics described below.