Neuro-ophthalmic Consequences of Firearms-Related Trauma in the United States

The United States has the highest rate of firearms-related injuries amongst all affluent nations. Neuro-ophthalmic injuries, often associated with traumatic brain injury (TBI), may result in long-term disabilities. Our study seeks to characterize neuro-ophthalmic consequences of firearms-related trauma

The Epidemiology of Pediatric Visual Pathway Injuries - Analysis of the National Trauma Data Bank

Traumatic visual pathway injuries (VPI) often are associated with severe head trauma can have profound and deleterious effects on developing children. We sought to elucidate the epidemiology of pediatric VPI in the US

A comparison of pediatric ocular injuries based on intention in patients admitted with trauma

Abstract Purpose Pediatric ocular trauma is a major source of morbidity and blindness and the number of epidemiological studies is incommensurate with its significance. We sought to determine differences in epidemiologic patterns of pediatric ocular injuries based on intention. Methods A retrospective review of the National Trauma Data Bank (2008–2014) was performed and patients < 21 years old, admitted with trauma and ocular injury, were identified using ICD-9CM codes. Demographic data, types of injury and external circumstances including intention were tabulated and analyzed with students’ t and chi-squared tests and logistic regression. Statistical significance was set at p < 0.05. Results Fifty-eight thousand seven hundred sixty-five pediatric patients were admitted for trauma and ocular injuries. The mean(SD) age was 11.9(6.9) years. Most patients were male (68.7%) and White (59.1%). Unintentional injuries (76.3%) were mostly associated with falls (OR = 13.4, p < 0.001), assault (16.3%) with firearms (OR = 9.15, p < 0.001) and self-inflicted trauma (0.7%) also with firearms (OR = 44.66, p < 0.001). There was increasing mean(SD) age from unintentional, 12.9(6.6) years and assault 12.3(8.1) years to self-inflicted trauma, 17(3.4) years. The 0-3 year age group had highest odds of open adnexa wounds (OR = 30.45, p < 0.001) from unintentional trauma, and traumatic brain injury (TBI) (OR = 5.77, p < 0.001) and mortality (OR = 8.52, p < 0.001) from assault. The oldest 19-21 year group, had highest odds visual pathway injuries (OR = 8.34, p < 0.001) and TBI (OR = 1.54, p = 0.048) from self-inflicted trauma and mortality (OR = 2.08, p < 0.001) from unintentional trauma. Conclusion Sight-threatening injuries were mostly associated with unintentional trauma in the youngest group and self-inflicted trauma in the oldest group. Patterns emerged of associations between demographic groups, mechanisms, types of injury and associated TBI with intention of trauma

Current State and Future Perspectives of Telemedicine Use in Surgery During the COVID-19 Pandemic: A Scoping Review Protocol

Introduction: The biggest concerns in the current pandemic are enormous workload pressure, psychological distress, caregiver burnout, and, even worse, transmission of the virus among healthcare workers. One of the potentially beneficial tools in reducing the above-mentioned risks for overwhelming the healthcare system is telemedicine. Although the role of telemedicine and related interventions as a crisis management tool has increased, the current state of the implementation of telemedicine in surgery and surgical subspecialties has not been adequately evaluated. Objective and significance: The objective of this review is to screen the literature, extract expert opinions, qualitative, and quantitative data on the current use and future directions in the implementation of telemedicine in surgery and surgical subspecialties during the COVID-19 pandemic. The findings would potentially help in understanding the challenges and future directions of telemedicine use in surgery. Methods and analysis: The databases to be searched include PubMed, EMBASE, and MEDLINE (via Ovid). In addition, ClinicalTrials.gov and medRxiv.org will be searched for any ongoing and/or unpublished studies. The reference lists of articles included in the review will be screened to assess the sensitivity of the search. Literature search, quality assessment, followed by data extraction will be performed by two independent researchers. The findings of the data synthesis will be reported in diagrams, tables, and text. This review will consider reports that include expert opinions, qualitative and quantitative data on the implementation of telemedicine in surgery and surgical subspecialties (including patients with surgical disease of any age) during the COVID-19 pandemic. In addition, future perspectives reported based either on the evidence provided by the data or on expert opinions will be considered. Ethics and dissemination: This study does not require an institutional review board approval given its summary design nature. Findings of this systematic review will be published in a peer-reviewed journal. Systematic review registration number: PROSPERO does not currently accept registrations for scoping reviews, literature reviews or mapping reviews

Cabo Verde Telemedicine Program: An Update Report and Analysis of 2,442 Teleconsultations

Introduction: The Cabo Verde Telemedicine program (CVTP) was established by the International Virtual e-Hospital Foundation using the Initiate-Build-Operate-Transfer strategy to improve access to specialty care for the population in the archipelago of Cabo Verde in 2012. Since its inception, the CVTP has proven a great success story of telemedicine in Africa. Our first report on the initial results of a nationwide CVTP was published in 2014. The aim of this article is to analyze the follow-up data and analyze the activity of CVTP. Methods: All telemedicine consultations of the CVTP from 2014 to 2018 were analyzed. Patient demographics, clinical discipline, and transfer status were analyzed. Categorical variables were compared with a chi-squared test. Results: There were 2,442 telemedicine consultations in 24 clinical programs performed during the study period. The most common clinical disciplines with \u3e100 consultations were neurology, cardiology, orthopedic surgery, general surgery, endocrinology, otolaryngology, urology, and dermatology. Overall, the transfer rate was 34.3%. Conclusion: The nationwide CVTP continues to increase access to specialized care, prevent unnecessary and costly transfers, and has become a great success story of telemedicine in Africa. Moreover, this program should serve as a model for establishing island-nations telemedicine programs worldwide

The prevalence of asthma and allergic disorders among school children in Gorgan

BACKGROUND: The prevalence of allergy and asthma among children is increasing in many countries. However, such inclination has not been completely cleared in North of Iran. This study was carried out to evaluate the prevalence of asthma and allergic diseases in school children in Gorgan and also to evaluate the association between allergies and sex, family history of atopic disorders, and personal symptomatic atopy. METHODS: This was a cross-sectional study and the study population included 2800 school children aged 12 to 13 (53% female and 47% male). All participants completed an ISAAC (International Study of Asthma and Allergies in Childhood) written questionnaire. RESULTS: Among the selected children, 7% were asthmatic, 19% had eczema during the last 6 months, and 35.3% had rhinitis. Family history of allergy included 8.4% asthma, 22.1% rhinitis and 12% eczema. CONCLUSIONS: The prevalence of asthma is higher in boys compared with girls. There was a strong relation between family history of atopy and allergic diseases and asthma in children

Increased Access to Care through Telemedicine in Albania: An Analysis of 2,724 Patients

Introduction: The Integrated Telemedicine and e-Health program (ITeHP) of Albania, built by the International Virtual e-Hospital Foundation (IVeH), has improved access to high-quality health care, particularly in high demanding specialty disciplines. We aimed to test the hypothesis that the majority of patients in remote and regional hospitals can be managed using telemedicine and will prevent unnecessary transfers. Methods: A retrospective analysis of prospectively collected data of patients seen between January 2014 and September 2018 was conducted. Patient demographics, type of teleconsultation modality used, and patient disposition were analyzed. The comparison of continuous data was performed with t-test or Mann-Whitney test. The categorical data were tested with chi-squared test and analysis of variance. Results: There were 2,842 patients seen in all the clinical disciplines during the study period. We excluded tele-autism and incomplete data. There were 2,724 records eligible for study. The most frequent consulting clinical programs (82.9%) were teleradiology (39.0%), teleneurotrauma (27.2%), and teletestroke (16.7%). The majority of patients (77.9%) were kept at regional centers and did not require transfer (p \u3c 0.001) to a tertiary center. Of those transferred, 70.3% were male (p \u3c 0.001), of which 81.6% were for transferred due to neurotrauma. Conclusion: The telemedicine program in Albania has improved access to specialized care in a number of specialty clinical disciplines, particularly in potentially life-threatening and time-sensitive conditions such as neurotrauma. Almost 80% of patients did not require transfer to tertiary centers and were kept for further treatment at the regional centers