Efecto de la pandemia COVID en las urgencias traumatológicas pediátricas en tres zonas de España con distinta incidencia / Effect of the COVID pandemic on pediatric trauma emergencies in three areas of Spain with different incidence

Introducción y objetivos: Aunque se ha publicado mucho sobre el efecto de la pandemia en las urgencias traumatológicas, no se ha analizado si la incidencia de la infección o la distinta organización de los recursos disponibles según la comunidad autónoma fueron factores influyentes. Presentamos un estudio multicéntrico de tres hospitales terciarios de tres ciudades españolas con distintas características para estudiar cómo estos factores influyeron a las urgencias traumatológicas pediátricas durante la primera ola de la pandemia. Material y métodos: Presentamos un estudio retrospectivo de cohortes que compara y analiza las urgencias traumatológicas pediátricas en tres hospitales distintos durante el periodo de la primera ola de la pandemia COVID-19 y comparamos sus resultados con los del mismo periodo del año anterior, analizando el número de urgencias, la gravedad de la patología, la edad media de los pacientes, los días de ingreso y el tiempo de espera de los casos que requirieron tratamiento quirúrgico. Resultados: Se han analizado 6.474 episodios de urgencias traumatológicas infantiles. Se produjo una drástica reducción de la actividad en los tres hospitales, pero en distinta cuantía: del 83,5% en el hospital localizado en Madrid, del 75% en el hospital localizado en Valencia y del 65,9% en el ubicado en Palma de Mallorca. Las urgencias atendidas fueron de mayor gravedad en el año 2020 en comparación con el año 2019. La edad media de los pacientes atendidos durante la pandemia fue menor en comparación con el año anterior. No hubo diferencias en los días de ingreso, pero sí en la demora de la cirugía de las fracturas quirúrgicas. Conclusiones: La repercusión de la primera ola de la pandemia COVID-19 y el confinamiento decretado tuvieron una repercusión distinta en las urgencias traumatológicas pediátricas en los distintos hospitales según la incidencia de la infección y las medidas adoptadas en las diferentes comunidades autónomas.(AU)

Introduction and objectives: Although much has been published on the effect of the pandemic on trauma emergencies, it has not been analyzed whether the incidence of infection or different organization of available resources according to the Spanish region were influential factors. We present a multicenter study of three tertiary hospitals in three Spanish cities with different characteristics to study how these factors influenced pediatric trauma emergencies during the first wave of the pandemic. Material and methods: We present a retrospective cohort study that compares and analyzes pediatric trauma emergencies in three different hospitals during the period of the first wave of the COVID-19 pandemic and we compare them with the same period of the previous year, analyzing the number of emergencies, the severity of the pathology, the average age of the patients, the days of admission and the waiting time of the cases that required surgical treatment. Results: A total of 6,474 pediatric trauma emergency episodes have been analyzed. There was a drastic reduction in activity in the three hospitals, but in different amounts: 83.5% in the hospital located in Madrid, 75% in the hospital located in Valencia and 65.9% in the one located in Palma, Majorca. The emergencies attended were more serious in 2020 compared to 2019. The average age of patients treated during the pandemic was lower compared to the previous year. There were no differences in the days of admission, but there were differences in the delay in surgery for surgical fractures. Conclusions: The impact of the first wave of the COVID-19 pandemic and the decreed confinement had a different impact on pediatric trauma emergencies in the different hospitals according to the incidence of infection and the measures adopted in the different regions.(AU)

[Translated article] Effect of the COVID pandemic on paediatric trauma emergencies in three areas of Spain with different incidence / Efecto de la pandemia COVID en las urgencias traumatológicas pediátricas en 3 zonas de España con distinta incidencia

ntroducción y objetivos: Aunque se ha publicado mucho sobre el efecto de la pandemia en las urgencias traumatológicas, no se ha analizado si la incidencia de la infección o la distinta organización de los recursos disponibles según la comunidad autónoma fueron factores influyentes. Presentamos un estudio multicéntrico de tres hospitales terciarios de tres ciudades españolas con distintas características para estudiar cómo estos factores influyeron a las urgencias traumatológicas pediátricas durante la primera ola de la pandemia. Material y métodos: Presentamos un estudio retrospectivo de cohortes que compara y analiza las urgencias traumatológicas pediátricas en tres hospitales distintos durante el periodo de la primera ola de la pandemia COVID-19 y comparamos sus resultados con los del mismo periodo del año anterior, analizando el número de urgencias, la gravedad de la patología, la edad media de los pacientes, los días de ingreso y el tiempo de espera de los casos que requirieron tratamiento quirúrgico. Resultados: Se han analizado 6.474 episodios de urgencias traumatológicas infantiles. Se produjo una drástica reducción de la actividad en los tres hospitales, pero en distinta cuantía: del 83,5% en el hospital localizado en Madrid, del 75% en el hospital localizado en Valencia y del 65,9% en el ubicado en Palma de Mallorca. Las urgencias atendidas fueron de mayor gravedad en el año 2020 en comparación con el año 2019. La edad media de los pacientes atendidos durante la pandemia fue menor en comparación con el año anterior. No hubo diferencias en los días de ingreso, pero sí en la demora de la cirugía de las fracturas quirúrgicas. Conclusiones: La repercusión de la primera ola de la pandemia COVID-19 y el confinamiento decretado tuvieron una repercusión distinta en las urgencias traumatológicas pediátricas en los distintos hospitales según la incidencia de la infección y las medidas adoptadas en las diferentes comunidades autónomas.(AU)

Introduction and objectives: Although much has been published on the effect of the pandemic on trauma emergencies, it has not been analyzed whether the incidence of infection or different organization of available resources according to the Spanish region were influential factors. We present a multicenter study of three tertiary hospitals in three Spanish cities with different characteristics to study how these factors influenced pediatric trauma emergencies during the first wave of the pandemic. Material and methods: We present a retrospective cohort study that compares and analyzes pediatric trauma emergencies in three different hospitals during the period of the first wave of the COVID-19 pandemic and we compare them with the same period of the previous year, analyzing the number of emergencies, the severity of the pathology, the average age of the patients, the days of admission and the waiting time of the cases that required surgical treatment. Results: A total of 6,474 pediatric trauma emergency episodes have been analyzed. There was a drastic reduction in activity in the three hospitals, but in different amounts: 83.5% in the hospital located in Madrid, 75% in the hospital located in Valencia and 65.9% in the one located in Palma, Majorca. The emergencies attended were more serious in 2020 compared to 2019. The average age of patients treated during the pandemic was lower compared to the previous year. There were no differences in the days of admission, but there were differences in the delay in surgery for surgical fractures. Conclusions: The impact of the first wave of the COVID-19 pandemic and the decreed confinement had a different impact on pediatric trauma emergencies in the different hospitals according to the incidence of infection and the measures adopted in the different regions.(AU)

[Translated article] Effect of the COVID pandemic on paediatric trauma emergencies in three areas of Spain with different incidence.

INTRODUCTION AND OBJECTIVES: Although much has been published on the effect of the pandemic on trauma emergencies, it has not been analysed whether the incidence of infection or different organisation of available resources according to the Spanish region were influential factors. We present a multicenter study of three tertiary hospitals in three Spanish cities with different characteristics to study how these factors influenced paediatric trauma emergencies during the first wave of the pandemic. MATERIAL AND METHODS: We present a retrospective cohort study that compares and analyzes paediatric trauma emergencies in three different hospitals during the period of the first wave of the COVID-19 pandemic and we compare them with the same period of the previous year, analyzing the number of emergencies, the severity of the pathology, the average age of the patients, the days of admission and the waiting time of the cases that required surgical treatment. RESULTS: A total of 6474 paediatric trauma emergency episodes have been analysed. There was a drastic reduction in activity in the three hospitals, but in different amounts: 83.5% in the hospital located in Madrid, 75% in the hospital located in Valencia and 65.9% in the one located in Palma, Majorca. The emergencies attended were more serious in 2020 compared to 2019. The average age of patients treated during the pandemic was lower compared to the previous year. There were no differences in the days of admission, but there were differences in the delay in surgery for surgical fractures. CONCLUSIONS: The impact of the first wave of the COVID-19 pandemic and the decreed confinement had a different impact on paediatric trauma emergencies in the different hospitals according to the incidence of infection and the measures adopted in the different regions. In all cases there was a significant reduction in activity, a greater proportion of medium and severe pathologies were attended to, the average age of the patients attended was lower and a delay was observed in surgeries performed in the emergency room, probably due to the need to request a PCR test to detect a COVID-19 infection.

Effect of the COVID pandemic on pediatric trauma emergencies in three areas of Spain with different incidence. / Efecto de la pandemia COVID en las urgencias traumatológicas pediátricas en tres zonas de España con distinta incidencia.

INTRODUCTION AND OBJECTIVES: Although much has been published on the effect of the pandemic on trauma emergencies, it has not been analyzed whether the incidence of infection or different organization of available resources according to the Spanish region were influential factors. We present a multicenter study of three tertiary hospitals in three Spanish cities with different characteristics to study how these factors influenced pediatric trauma emergencies during the first wave of the pandemic. MATERIAL AND METHODS: We present a retrospective cohort study that compares and analyzes pediatric trauma emergencies in three different hospitals during the period of the first wave of the COVID-19 pandemic and we compare them with the same period of the previous year, analyzing the number of emergencies, the severity of the pathology, the average age of the patients, the days of admission and the waiting time of the cases that required surgical treatment. RESULTS: A total of 6,474 pediatric trauma emergency episodes have been analyzed. There was a drastic reduction in activity in the three hospitals, but in different amounts: 83.5% in the hospital located in Madrid, 75% in the hospital located in Valencia and 65.9% in the one located in Palma, Majorca. The emergencies attended were more serious in 2020 compared to 2019. The average age of patients treated during the pandemic was lower compared to the previous year. There were no differences in the days of admission, but there were differences in the delay in surgery for surgical fractures. CONCLUSIONS: The impact of the first wave of the COVID-19 pandemic and the decreed confinement had a different impact on pediatric trauma emergencies in the different hospitals according to the incidence of infection and the measures adopted in the different regions. In all cases there was a significant reduction in activity, a greater proportion of medium and severe pathologies were attended to, the average age of the patients attended was lower and a delay was observed in surgeries performed in the emergency room, probably due to the need to request a PCR test to detect a COVID-19 infection.

Theoretical study of the O(3P) + C2H6 reaction based on a new ab initio-based global potential energy surface.

A new analytical potential energy surface was developed for the first time for the nine-body O(3P) + C2H6 hydrogen abstraction reaction, named PES-2020, which was fitted to explicitly-correlated high-level electronic structure calculations. This surface simulates the topography of the reactive system, from reactants to products, OH(v,j) + C2H5. The adiabatic energy of reaction, ΔHr(0 K) = -2.33 kcal mol-1, reproduces the experimental evidence, and the barrier height, 10.70 kcal mol-1, agrees with the ab initio calculations used as input. In addition, an intermediate complex in the exit channel is observed, which is stabilized with respect to the products of the reaction. Based on PES-2020 a dynamics study was carried out, where quasi-classical trajectory calculations were performed for collision energies in the range of 7.0-60.0 kcal mol-1, which covers high collision energy regions. The reaction cross section increases with collision energy; the largest fraction of available energy is deposited as translational energy (44-66%), and the scattering distribution evolves from backward to forward with collision energy. These findings reproduce previous theoretical calculations using electronic structure calculations of lower levels. However, where these previous studies failed, viz. in rotational and vibrational OH(v,j) distributions, PES-2020 reproduces practically quantitatively the experimental evidence, i.e., cold vibration and rotation, the rotational distribution peaking at j = 1-3 depending on the collision energy. In sum, this behaviour is typical of gas-phase hydrogen abstraction reactions with direct mechanism and high reaction barrier.

Kinetics and dynamics study of the OH + C2H6 → H2O + C2H5 reaction based on an analytical global potential energy surface.

To describe the gas-phase hydrogen abstraction reaction between the hydroxyl radical and the ethane molecule, an analytical full-dimensional potential energy surface was developed within the Born-Oppenheimer approximation. This reactive process is a ten-body system with 24 degrees of freedom, which represents a theoretical challenge. The new surface, named PES-2020, presents low barrier, 3.76 kcal mol-1, high exothermicity, -16.20 kcal mol-1, and intermediate complexes in the entrance and exit channels. To test the quality and accuracy of the analytical surface several stringent tests were performed and, in general, PES-2020 reasonably simulates the theoretical information used as input, it is a continuous and smooth potential, without spurious minima, it presents great versatility and a reasonable description of this ten-body reaction. Based on this surface, an exhaustive kinetics and dynamics study was performed with a double objective: to analyze the capacity of the new surface to simulate the experimental evidence, and to help understand the mechanism of reaction and the role of the ethyl group in the reaction. In the kinetics study, three approaches were used: variational transition-state theory with multidimensional tunnelling (VTST/MT), ring polymer molecular dynamics (RPMD) and quasi-classical trajectory (QCT) results, in the temperature range 200-2000 K. There is general agreement between the three approaches and they reasonably simulate the experimental behaviour, which gives confidence to the fitness of the new surface to describe the system. In the dynamics study, QCT calculations were performed at 298 K for a direct comparison with the only experimental result reported. We found that ethyl fragment presents a noticeable internal energy (∼20%) and so cannot be considered as a spectator. The water product vibrational energy is reasonably reproduced, though when a level-by-level distribution is analyzed the agreement is only qualitative.

Role of an ethyl radical and the problem of HF(v) bimodal vibrational distribution in the F(2P) + C2H6→ HF(v) + C2H5 reaction.

A theoretical study of the dynamics of the F(2P) + C2H6 hydrogen abstraction reaction was presented using quasi-classical trajectories propagated on an ab initio fitted global potential energy surface, PES-2018. The results were compared with experimental information at a collision energy of 3.2 kcal mol-1. We found a small fraction of available energy, 13%, deposited as C2H5 internal energy, the largest fraction, 67%, being deposited as HF(v) vibration, where the HF(v,j) rotational distribution is colder when the vibrational level increases. These results reproduce the experimental evidence. In addition, the reaction cross section scarcely changes with energy, and the scattering distribution shifts from isotropic to forward when the HF(v) vibrational state increases. These last two findings await experimental confirmation. Finally, two important issues related to the title reaction were analysed: the role of an ethyl radical, and the theory/experiment controversy about the HF(v) bimodal vibrational distribution. We found that in spite of its low internal energy, the ethyl product does not act as a spectator of the reaction, and that the controversy can be explained by the net result of two opposite effects: strong couplings between vibrational modes, which are the rule and complicate dynamics analysis in polyatomic systems, and an artificial energy transfer from the ethyl radical to the HF molecule due to the classical nature of the quasi-classical trajectory calculations. As is seen, the ethyl radical actively participates in both effects.

F(2P) + C2H6 → HF + C2H5 kinetics study based on a new analytical potential energy surface.

An exhaustive kinetics study was performed for the title reaction using two theoretical approaches: variational transition-state theory and quasi-classical trajectory calculations, based on an original new analytical full-dimensional potential energy surface, named PES-2018, which has been fitted to high-level ab initio calculations. The theoretical results were compared with the available experimental data in the temperature range 189-350 K, a difficult comparison because of experimental controversies about the final rate constants (factor of about two) and on the activation energy (positive and negative values have been reported). There is agreement between the two theoretical approaches, with differences of less than 20%, and with the most recent experiments, with differences of less than 30%. Both theories gave small and positive activation energies, reasonably reproducing the most recent experiments, although they showed less dependence on temperature. To understand the theory/experiment differences, several sources of error were analysed, without discarding experimental uncertainties, such as limitations of the theoretical tools (PES and kinetics approaches), and the manner in which spin-orbit effects were included in the present non-relativistic study. Finally, H/D and 12C/13C kinetics isotope effects were reported for the first time for the title reaction, though unfortunately no experimental data are available for comparison.