Current prevalence of self-reported interpersonal violence among adult patients seen at a university hospital emergency department in Switzerland.

To evaluate the current prevalence of self-reported interpersonal violence amongst patients consulting at the emergency department (ED) of a university hospital and to describe the characteristics of the violence sustained. Ours was a cross-sectional study using a modified version of the Partner Violence Screen questionnaire, which was distributed to every patient over 16 years old consulting at the ED between the 1st and 30th September 2016. Excluded were those incapable of decision-making, unable to understand owing to language difficulties, or in police detention. Questions pertained to violence endured during the year prior to their attendance at the ED and, where relevant, the date, place, and type of violence (physical or psychological), the perpetrator and the means used (firearms or other weapons). Demographic details were taken from the hospital records. Of 628 patients included (participation rate 86%), 19% were victims of violence, for 27% of whom it was the motive for ED attendance. The median age of these victims of violence was 28 years (interquartile range 22–43), 39% were female, 71% single and 38% foreign nationals. Typical characteristics of self-reported violence were: (1) violence sustained within the previous 24 h (26%); (2) perpetrators unknown (35%); (3) occurrence at a café, bar, restaurant or nightclub (32%); (4) use of knives (19%); (5) prior consumption of alcohol by the victims themselves (28%). Females were more susceptible to domestic violence than males (45 vs 7%), the latter mostly reporting public violence (64 vs 43% in women). The prevalence of self-reported interpersonal violence has reached one patient in five in our ED. Our results underline the importance of screening for this, as well as providing the means to offer specific follow-up. &nbsp

A first update on mapping the human genetic architecture of COVID-19

peer reviewe

Hochkalorische Ernährung bei chronischer obstruktiver Lungenkrankheit [High-caloric nutrition in chronic obstructive lung disease]

A body weight lower than 90% of the optional value has an unfavorable influence on the prognosis of chronic obstructive pulmonary disease (COPD). Short term studies of up to three months duration have shown improved function of respiratory muscle exercise tolerance and immunologic parameters by an increased caloric intake of 45 kcal/kg body weight. In a randomized trial of twelve months 14 of 30 patients with an average FEV1 of 0.8 l were instructed to take a high calorie diet. For simplicity a part of the calories were administered as Fresubin, a fluid nutrient formula. Although a weight gain of 7 kg (p = 0.003) was obtained the difference to the control group was statistically not significant (p = 0.08). The same was true for skin fold thickness (12.4 vs 5.7 mm), change of ventilatory parameters and the 6 minute walking distance (-33 vs -86 m). Subjective improvement was, however, impressive in all patients with dietary intervention, explainable probably by increased attention. Dietary counselling for increased intake of calories, vitamins and also calcium is thus very important in the treatment of patients with COPD

A potential role of hypophosphatemia for diagnosing convulsive seizures: A case-control study.

Transient loss of consciousness (TLOC) is a common presentation in the emergency room, where patient history can usually differentiate syncope from generalized tonic-clonic (GTC) seizures. Several serum markers, such as creatine kinase and lactate, can be helpful, especially when history is unreliable. Here, we explore a potential supporting role of electrolyte plasma levels in a case-control study. In our electroencephalographic database, we retrospectively identified consecutive episodes of loss of consciousness in adults seen over 3 years in our hospital emergency department for a case-control study. We investigated plasma levels of several electrolytes (sodium, potassium, phosphate, calcium, magnesium) at the emergency visit, as well as demographics, diagnosis, blood-sample delay time, and history of alcohol abuse. Of the 126 patients identified, 75 had GTC seizures and 46 had other TLOC causes. Among electrolyte levels, only hypophosphatemia was associated with GTC seizures (median = 0.79 mmol·L <sup>-1</sup> , range = 0.34-1.37 in GTC seizures vs 0.93 mmol·L <sup>-1</sup> , range = 0.52-1.56, P = 0.001 in TLOC). After adjusting for blood sampling delay, alcohol abuse, and other electrolyte levels, only hypophosphatemia was associated with GTC seizures, occurring in 37 (51%) of GTC seizures and 12 (22%) of other TLOC (odds ratio = 3.5, 95% confidence interval = 1.5-8.3, P = 0.003). Hypophosphatemia < 0.6 mmol·L <sup>-1</sup> was 93% specific and 20% sensitive for GTC seizure occurrence. In follow-ups, hypophosphatemia was transitory. Transient hypophosphatemia is common after GTC seizures and could represent an additional biological marker to help differentiate GTC seizures from other TLOC, especially when history is unclear. This hypothesis needs to be tested prospectively