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1.
Cureus ; 14(11): e31146, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-36382318

RESUMEN

Background Effective and efficient use of operating theatres is essential to the smooth running of a trauma service. The paper aims to understand the effect of meteorological factors on the number of referrals and volume and nature of trauma operating cases within our local area. Methods Trauma data over two seasons were analysed in our database, a digital clinical platform that coordinates all admissions and trauma theatre activity. Data consisted of the number of referrals per day, patient age, mechanism of injury, and type of orthopaedic injury. Weather data were gathered from 'Weather Underground', https://www.wunderground.com/history, which records daily weather observations, located 12 miles away from our trauma unit. Results During the study period's last two seasons, 1160 consultations were analysed and 779 required operative intervention. The neck of femur fractures and ankle trauma were the two most common causes of trauma, accounting for 27% and 15%, respectively. The neck of femur fracture pathologies were not significantly correlated with any meteorological factor studied. On the contrary, ankle trauma was the only injury significantly correlating with temperature (p < 0.03) and dew point (p < 0.04). The most common mechanism of trauma was a ground-level fall (n = 590) whilst the least common was a motor vehicle accident (n = 39). Analysing the effect of weather and its effect on the age group of presentation, temperature (p < 0.01), sunlight (p < 0.002), and dew point (p < 0.03) were all significantly correlated with trauma in patients aged younger than 21 years of age. Conclusion The weather has no effect on the neck of femur fractures, the most common trauma pathology treated in our department. In all seasons, allocated specific trauma lists for the latter should be arranged irrelevant of the weather conditions. A strong correlation was identified between ankle trauma and weather. We identified that Tuesdays and Fridays received the highest referral rate and peaked between the months of October-November. These data lay the groundwork for local clinical directors to shape the future on-call trauma service.

2.
Mol Genet Genomic Med ; 9(12): e1674, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-33811480

RESUMEN

BACKGROUND: Polycystic kidney disease with hyperinsulinaemic hypoglycaemia (HIPKD) is a recently described disease caused by a single nucleotide variant, c.-167G>T, in the promoter region of PMM2 (encoding phosphomannomutase 2), either in homozygosity or compound heterozygosity with a pathogenic coding variant in trans. All patients identified so far are of European descent, suggesting a possible founder effect. METHODS: We generated high density genotyping data from 11 patients from seven unrelated families, and used this information to identify a common haplotype that included the promoter variant. We estimated the age of the promoter mutation with DMLE+ software, using demographic parameters corresponding to the European population. RESULTS: All patients shared a 0.312 Mb haplotype which was absent in 503 European controls available in the 1000 Genomes Project. The age of this mutation was estimated as 105-110 generations, indicating its occurrence around 600 BC, a time of intense migration, which might explain the presence of the same mutations in Europeans around the globe. CONCLUSION: The shared unique haplotype among seemingly unrelated patients is consistent with a founder effect in Europeans.


Asunto(s)
Efecto Fundador , Hipoglucemia/epidemiología , Hipoglucemia/genética , Mutación , Fosfotransferasas (Fosfomutasas)/genética , Enfermedades Renales Poliquísticas/epidemiología , Enfermedades Renales Poliquísticas/genética , Regiones Promotoras Genéticas , Alelos , Mapeo Cromosómico , Familia , Femenino , Estudios de Asociación Genética , Predisposición Genética a la Enfermedad , Estudio de Asociación del Genoma Completo , Genotipo , Humanos , Hipoglucemia/diagnóstico , Masculino , Enfermedades Renales Poliquísticas/diagnóstico , Polimorfismo de Nucleótido Simple , España , Reino Unido , Estados Unidos
3.
J Health Popul Nutr ; 23(4): 320-30, 2005 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-16599102

RESUMEN

This prospective randomized trial was carried out to test the efficacy of a specific intervention for reducing the extent of their malnutrition and to change behaviour of mothers relating to child-feeding practices, care-giving, and health-seeking practices under the Bangladesh Integrated Nutrition Project (BINP). The study was conducted in rural Bangladesh among 282 moderately-malnourished (weight-for-age between 61% and 75% of median of the National Center for Health Statistics standard) children aged 6-24 months. Mothers of the first intervention group received intensive nutrition education (INE group) twice a week for three months. The second intervention group received the same nutrition education, and their children received additional supplementary feeding (INE+SF group). The comparison group received nutrition education from the community nutrition promoters twice a month according to the standard routine service of BINP. The children were observed for a further six months. After three months of interventions, a significantly higher proportion of children in the INE and INE+SF groups improved (37% and 47% respectively) from moderate to mild or normal nutrition compared to the comparison group (18%) (p < 0.001). At the end of six months of observation, the nutritional status of children in the intervention groups improved further from moderate to mild or normal nutrition compared to the comparison group (59% and 86% vs 30%, p < 0.0001). As the intensive nutrition education and supplementation given were highly effective, more children improved from moderate malnutrition to mild or normal nutritional status despite a higher incidence of morbidity. The frequency of child feeding and home-based complementary feeding improved significantly (p < 0.001) in both the intervention groups after three months of interventions and six months of observation. Body-weight gain was positively associated with age, length-for-age, weight-for-length, frequency of feeding of khichuri, egg, and potato (p < 0.05). Ability of mothers to identify malnutrition improved from 15% to 99% in the INE group and from 15% to 100% in the INE+SF group, but reduced from 24% to 21% in the comparison group. Use of separate feed pots, frequency of feeding, and cooking of additional complementary feeds improved significantly in the INE and INE+SF groups compared to the comparison group after three months of interventions and six months of observation. It can be concluded from the findings of the study that intensive nutrition education significantly improves the status of moderately-malnourished children with or without supplementary feeding.


Asunto(s)
Trastornos de la Nutrición del Niño/epidemiología , Alimentos Fortificados/estadística & datos numéricos , Madres/educación , Ciencias de la Nutrición/educación , Estado Nutricional/fisiología , Análisis de Varianza , Bangladesh/epidemiología , Trastornos de la Nutrición del Niño/prevención & control , Ciencias de la Nutrición del Niño/educación , Preescolar , Femenino , Promoción de la Salud/métodos , Humanos , Lactante , Masculino , Estudios Prospectivos , Población Rural/estadística & datos numéricos , Análisis de Supervivencia , Factores de Tiempo , Resultado del Tratamiento
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