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Surveillance of Fluoroquinolone Resistance in Wisconsin: Geographic Variation and Impact of Revised CLSI Breakpoints. 威斯康星州氟喹诺酮类药物耐药性监测:地理差异和修订CLSI断点的影响
IF 1.4
Clinical Medicine & Research Pub Date : 2022-06-01 Epub Date: 2022-01-27 DOI: 10.3121/cmr.2021.1718
Giovanna Lazzerini, Stephen C Lavey, Barry C Fox, Erik Munson
{"title":"Surveillance of Fluoroquinolone Resistance in Wisconsin: Geographic Variation and Impact of Revised CLSI Breakpoints.","authors":"Giovanna Lazzerini,&nbsp;Stephen C Lavey,&nbsp;Barry C Fox,&nbsp;Erik Munson","doi":"10.3121/cmr.2021.1718","DOIUrl":"https://doi.org/10.3121/cmr.2021.1718","url":null,"abstract":"<p><p><b>Objective:</b> Many clinical microbiology laboratories procure antimicrobial susceptibility testing data using guidelines established by Clinical and Laboratory Standards Institute (CLSI). When necessary, CLSI revises interpretive breakpoints in efforts to improve clinical correlation, with two revisions relative to fluoroquinolone agents occurring in 2019. The purpose of this investigation was to determine the impact of fluoroquinolone breakpoint revisions on Wisconsin clinical isolates of <i>Escherichia coli, Proteus mirabilis,</i> and <i>Pseudomonas aeruginosa.</i><b>Design:</b> Multi-center laboratory surveillance, with testing at a single location utilizing standardized media and susceptibility testing protocols.<b>Methods:</b> From the Surveillance of Wisconsin Organisms for Trends in Antimicrobial Resistance and Epidemiology (SWOTARE) program, levofloxacin and ciprofloxacin minimum inhibitory concentration (MIC) values for 1911, 1521, and 1463 Wisconsin isolates of <i>E. coli, P. mirabilis,</i> and <i>P. aeruginosa,</i> respectively, were determined by broth microdilution testing. In separate data analyses, all MIC data were interpreted using CLSI breakpoints published prior to 2019, then secondarily by using CLSI breakpoints published since 2019 (which reflect lower breakpoints for both levofloxacin and ciprofloxacin resistance). Findings were further stratified by Wisconsin Department of Health Services region.<b>Results:</b> Up to 3.2% decreased statewide fluoroquinolone susceptibility was observed for <i>E. coli</i> isolates, while 5.1% and 6.3% decreases in levofloxacin susceptibility were noted for <i>P. aeruginosa</i> and <i>P. mirabilis</i> isolates, respectively, when revised breakpoints were applied. <i>E. coli</i> isolates from the Western region and <i>P. mirabilis</i> isolates from the Southeastern region demonstrated significant shifts toward decreased fluoroquinolone susceptibility upon application of revised breakpoints. Northern region <i>P. mirabilis</i> isolates exhibited consistently decreased fluoroquinolone susceptibility.<b>Conclusions:</b> Fluoroquinolone resistance has been underreported in Wisconsin as a whole, yet geographic variability continues to exist. Targeted annual surveillance is important to identify and monitor resistance trending. Compilations of SWOTARE surveillance data can be utilized to predict the impact of future CLSI interpretive breakpoint revisions in Wisconsin.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9242736/pdf/0200081.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39865034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Complications Associated with Polydek Sutures Used in Eyelid Lateral Tarsal Strip Procedures. 眼睑外侧跗骨剥离手术中使用Polydek缝合线的并发症。
IF 1.4
Clinical Medicine & Research Pub Date : 2022-06-01 Epub Date: 2022-01-07 DOI: 10.3121/cmr.2021.1661
Lin Chen, Robert B Penne
{"title":"Complications Associated with Polydek Sutures Used in Eyelid Lateral Tarsal Strip Procedures.","authors":"Lin Chen,&nbsp;Robert B Penne","doi":"10.3121/cmr.2021.1661","DOIUrl":"https://doi.org/10.3121/cmr.2021.1661","url":null,"abstract":"<p><p>Suture-related complications can occur in response to a patient's immune system activation regardless of surgical site. However, there is minimal literature describing complications related to commonly used Polydek sutures. We report the diagnosis, treatment, and follow up of four cases of Polydek suture-related complications post-eyelid lateral tarsal strip procedures, including an early wound healing problem/infection and later granuloma formation and/or suture extrusion that only resolved after removal of the Polydek suture or granuloma tissue. Use of non-Polydek sutures may reduce the likelihood for post-operative suture complications.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9242731/pdf/0200107.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39794904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
The Use of Opioid Analgesia after Surgery: Assessing Postoperative Prescriptions from a Patient and Surgeon Perspective. 术后阿片类镇痛药的使用:从患者和外科医生的角度评估术后处方。
IF 1.4
Clinical Medicine & Research Pub Date : 2022-06-01 Epub Date: 2022-01-27 DOI: 10.3121/cmr.2021.1630
Roshini J Ramwani, Jessica A Wernberg
{"title":"The Use of Opioid Analgesia after Surgery: Assessing Postoperative Prescriptions from a Patient and Surgeon Perspective.","authors":"Roshini J Ramwani,&nbsp;Jessica A Wernberg","doi":"10.3121/cmr.2021.1630","DOIUrl":"https://doi.org/10.3121/cmr.2021.1630","url":null,"abstract":"<p><p><b>Purpose:</b> Nonmedical use of prescription opioids continues to be a public health crisis in the United States that disproportionately affects rural communities with diversion of pills from friends and family being the most common source. The primary goal of the study was to identify current opioid prescription practices, and to assess the discrepancy in amount of opioids prescribed by surgeons versus the amount needed post-operatively by patients. Patient factors that may influence postoperative analgesia needs and their management of leftover prescription opioids were also evaluated<b>Methods:</b> Patients ≥18 years-of-age who underwent a surgery between July and December 2018 by the subspecialty departments of Acute Care and General Surgery at a tertiary care facility in the rural Midwest were surveyed at their first post-operative visit to assess their postoperative analgesic needs. Resident and attending surgeons in the above departments were also surveyed to identify different factors that influenced their narcotic prescription practices.<b>Results:</b> Surveys from 252 patients, 12 attending surgeons, and 14 general surgery residents met inclusion criteria. Of patients who received a narcotic prescription, 19.9% did not fill their prescription, 64.1% of whom were >60 years old, and 72.1% resided within an hour of the hospital. Average reported prescription size was 11-40 pills; however, most used more than 5 pills regardless of the type of operation (<i>P</i>=0.59) and history of chronic pain (<i>P</i>=0.07). Inability to call in narcotic prescriptions and patients' distance from care influenced providers' prescription practices, with 77.9% of resident physicians and 68.3% of attending surgeons stating they would prescribe fewer if given the ability to call in a narcotic prescription.<b>Conclusions:</b> Regardless of the operation complexity, a majority of patients required fewer than five opioid pills after discharge and would be willing to return leftover pills. Development of opioid stewardship programs within the healthcare sector may reduce the number of opioids available for diversion and misuse.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9242732/pdf/0200089.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39865036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ketorolac and Predicted Severe Acute Pancreatitis: A Randomized, Controlled Clinical Trial. 酮咯酸与预测严重急性胰腺炎:一项随机对照临床试验。
IF 1.4
Clinical Medicine & Research Pub Date : 2022-06-01 Epub Date: 2022-01-07 DOI: 10.3121/cmr.2021.1663
Zahra Vahdat Shariatpanahi, Shaahin Shahbazi, Erfan Shahbazi
{"title":"Ketorolac and Predicted Severe Acute Pancreatitis: A Randomized, Controlled Clinical Trial.","authors":"Zahra Vahdat Shariatpanahi,&nbsp;Shaahin Shahbazi,&nbsp;Erfan Shahbazi","doi":"10.3121/cmr.2021.1663","DOIUrl":"https://doi.org/10.3121/cmr.2021.1663","url":null,"abstract":"<p><p><b>Objective:</b> We evaluated the effect of ketorolac on reducing the severity of acute pancreatitis.<b>Design and Setting:</b> Randomized clinical trial performed in a University hospital.<b>Participants:</b> There were 56 adult patients, with predicted severe acute pancreatitis, randomly divided into two groups.<b>Methods:</b> The patients in the study group received intravenous ketorolac, 10 mg, three times daily from the time of enrollment for a maximum of 5 days, as needed, along with standard medical treatment. Primary outcome measure was the change in the serum level of high sensitive C-reactive protein (hs-CRP). Patients were also followed up in terms of hospitalization duration, need for intensive care unit (ICU), organ failure development, persistent organ failure, pancreatic necrosis, nutritional assessment, and mortality. The study continued to gather clinical follow-up information up to 4 months.<b>Results:</b> Serum level of hs-CRP was significantly lower in the ketorolac group compared with the control group on days 3, 4, and 5. There were no significant differences in organ failure, pseudocyst formation, acute necrotic collection, mortality, and ICU transfer between groups. Days of hospitalization were significantly lower in the study group. The feeding start time was significantly shorter in the study group with no need for tube feeding in the ketorolac group. Frequency of NPO (not per oral) was significantly lower in the ketorolac group.<b>Conclusion:</b> The use of ketorolac may improve feeding outcomes and shorten length of hospitalization in predicted severe acute pancreatitis.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9242735/pdf/0200074.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39796792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Screening for Thyroid Disorders Among Resistant Hypertension Patients: Are We Doing Enough? 顽固性高血压患者甲状腺功能障碍筛查:我们做得够吗?
IF 1.4
Clinical Medicine & Research Pub Date : 2022-06-01 Epub Date: 2022-01-07 DOI: 10.3121/cmr.2021.1676
Nikos Pappan, Mian Tanveer Ud Din, Divya Venkat, Patrick Wedgeworth, Sheng Fu
{"title":"Screening for Thyroid Disorders Among Resistant Hypertension Patients: Are We Doing Enough?","authors":"Nikos Pappan,&nbsp;Mian Tanveer Ud Din,&nbsp;Divya Venkat,&nbsp;Patrick Wedgeworth,&nbsp;Sheng Fu","doi":"10.3121/cmr.2021.1676","DOIUrl":"https://doi.org/10.3121/cmr.2021.1676","url":null,"abstract":"Objective: To perform a quality assurance study assessing if hypo- and hyperthyroidism are appropriately screened for in patients with resistant hypertension. Design: Data was collected from patients diagnosed with resistant hypertension, defined as being on four or more different classes of anti-hypertensive medications. These patients were filtered to determine if thyroid stimulating hormone (TSH) measurement occurred within 90 days of the addition of a fourth medication class. Setting: Two internal medicine residency clinics in Pittsburgh, PA. Participants: Patients were selected who had a diagnosis of hypertension and were seen in clinic between January 1, 2018 and December 23, 2020. Methods: A single center retrospective review was performed. Results: A total of 1,125 patients were identified as having resistant hypertension. Of these, only 74 patients were found to have a TSH measurement taken within 90 days of having a fourth medication class prescribed. Seven TSH values were found to be abnormal with one patient being diagnosed with hyperthyroidism, demonstrating a screening rate of 6.6%. There were statistically significant differences in age, body mass index, and diastolic blood pressure in those screened versus not. Conclusions: Thyroid disease is under-screened as an etiology for resistant hypertension, particularly given the ease of diagnosis and reversibility of these conditions.","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9242733/pdf/0200070.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39796793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Management of Osteoporosis and Spinal Fractures: Contemporary Guidelines and Evolving Paradigms 骨质疏松症和脊柱骨折的管理:当代指南和不断发展的范例
IF 1.4
Clinical Medicine & Research Pub Date : 2022-04-27 DOI: 10.3121/cmr.2021.1612
Nasvin Imamudeen, A. Basheer, A. Iqbal, Nihal Manjila, N. Haroon, S. Manjila
{"title":"Management of Osteoporosis and Spinal Fractures: Contemporary Guidelines and Evolving Paradigms","authors":"Nasvin Imamudeen, A. Basheer, A. Iqbal, Nihal Manjila, N. Haroon, S. Manjila","doi":"10.3121/cmr.2021.1612","DOIUrl":"https://doi.org/10.3121/cmr.2021.1612","url":null,"abstract":"Physicians involved in treating spine fractures secondary to osteopenia and osteoporosis should know the pathogenesis and current guidelines on managing the underlying diminished bone mineral density, as worldwide fracture prevention campaigns are trailing behind in meeting their goals. This is a narrative review exploring the various imaging and laboratory tests used to diagnose osteoporotic fractures and a comprehensive compilation of contemporary medical and surgical management. We have incorporated salient recommendations from the Endocrine Society, the American Association of Clinical Endocrinology (AACE), and the American Society for Bone and Mineral Research (ASBMR). The use of modern scoring systems such as Fracture Risk Assessment Tool (FRAX®) for evaluating fracture risk in osteoporosis with a 10-year probability of hip fracture and major fractures in the spine, forearm, hip, or shoulder is highlighted. This osteoporosis risk assessment tool can be easily incorporated into the preoperative bone health optimization strategies, especially before elective spine surgery in osteoporotic patients. The role of primary surgical intervention for vertebral compression fracture and secondary fracture prevention with pharmacological therapy is described, with randomized clinical trial-based wisdom on its timing and dosage, drug holiday, adverse effects, and relevant evidence-based literature. We also aim to present an evidence-based clinical management algorithm for treating osteoporotic vertebral body compression fractures, tumor-induced osteoporosis, or hardware stabilization in elderly trauma patients in the setting of their impaired bone health. The recent guidelines and recommendations on surgical intervention by various medical societies are covered, along with outcome studies that reveal the efficacy of cement augmentation of vertebral compression fractures via vertebroplasty and balloon kyphoplasty versus conservative medical management in the elderly population.","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90081024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Primary Low Grade Follicular Lymphoma of the Conjunctivae Mimicking Nodular Anterior Scleritis: A Case Report 原发性低级别滤泡性结膜淋巴瘤,类似结节性前巩膜炎1例
IF 1.4
Clinical Medicine & Research Pub Date : 2022-04-27 DOI: 10.3121/cmr.2022.1674
Hui Yin Goh, Che Mahiran Binti Che Daud, Chandramalar T. Santhirathelagan, Shamala Retnasabapathy
{"title":"Primary Low Grade Follicular Lymphoma of the Conjunctivae Mimicking Nodular Anterior Scleritis: A Case Report","authors":"Hui Yin Goh, Che Mahiran Binti Che Daud, Chandramalar T. Santhirathelagan, Shamala Retnasabapathy","doi":"10.3121/cmr.2022.1674","DOIUrl":"https://doi.org/10.3121/cmr.2022.1674","url":null,"abstract":"Conjunctival lymphomas are rare entities and may present with non-specific ocular signs that resemble inflammation. They may mimic common ocular pathologies, leading to a delay in diagnosis and treatment. The treatment options of conjunctival lymphomas should be tailored to individuals due to their indolent nature compared to other adnexal lymphomas. Herein, the authors report a case of a primary follicular conjunctival lymphoma in a patient who presented with signs and symptoms of nodular anterior scleritis. The final histology of the conjunctiva lesion revealed primary follicular lymphoma. The patient was managed conservatively with active surveillance.","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90548838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Determinants of Atrial Fibrillation Development among Patients undergoing Ibrutinib Therapy. 接受伊鲁替尼治疗的患者心房颤动发展的决定因素。
IF 1.4
Clinical Medicine & Research Pub Date : 2022-03-01 Epub Date: 2022-01-12 DOI: 10.3121/cmr.2021.1693
Adedayo A Onitilo, Tinuade O Piwuna, Nazmul Islam, Luis Furuya-Kanamori, Sanjay Kumar, Suhail A R Doi
{"title":"Determinants of Atrial Fibrillation Development among Patients undergoing Ibrutinib Therapy.","authors":"Adedayo A Onitilo,&nbsp;Tinuade O Piwuna,&nbsp;Nazmul Islam,&nbsp;Luis Furuya-Kanamori,&nbsp;Sanjay Kumar,&nbsp;Suhail A R Doi","doi":"10.3121/cmr.2021.1693","DOIUrl":"https://doi.org/10.3121/cmr.2021.1693","url":null,"abstract":"<p><p><b>Objective:</b> Within the last decade, the use of ibrutinib, a first-generation, non-selective, irreversible Burton's tyrosine kinase inhibitor for the treatment of hematological malignancies has proven highly effective in improving patient outcomes.<b>Background:</b> Ibrutinib has been associated with an increase in atrial fibrillation (AF). The predisposing factors are thought to be pre-existing cardiovascular risk factors, but these have not been directly evaluated.<b>Methods:</b> We conducted a nested case-control study, recruiting consecutive ibrutinib treated subjects to evaluate cardiovascular risk factors associated with the development of AF in patients diagnosed with hematological B-cell malignancies.<b>Results:</b> Of the 189 patients treated with ibrutinib and without AF at baseline, 54 (29%) developed AF. Cardiovascular risk factors associated with AF development were, older age, prior hypertension (HTN), history of heart failure (HF) and congenital heart disease. A patient with HF at baseline had a 1, 2, 6, and 12 month cumulative hazard of AF of 40%, 48%, 64%, and 71%, respectively. Patients with prior HTN without HF at baseline had a 1, 2, 6, and 12 month cumulative hazard of AF of 5%, 10%, 23%, and 31%, respectively while on ibrutinib therapy.<b>Conclusions:</b> The relationship between ibrutinib, cardiovascular comorbidities, and AF is through pre-existing cardiovascular disease. An individualized, multidisciplinary approach involving cardiologists should be considered when initiating ibrutinib, particularly when there is a history of HTN, HF or congenital heart disease. In such patients, there should be close cardiovascular monitoring and prompt intervention when AF develops to improve patient outcomes.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9390851/pdf/0200016.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39814924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Reasons for Suicide Attempts in South India during the COVID-19 Pandemic. 2019冠状病毒病大流行期间南印度自杀企图的原因。
IF 1.4
Clinical Medicine & Research Pub Date : 2022-03-01 Epub Date: 2022-02-07 DOI: 10.3121/cmr.2022.1704
K Prabhakar, Anitha Aswathanarayana, K Hemanth Kumar Reddy
{"title":"Reasons for Suicide Attempts in South India during the COVID-19 Pandemic.","authors":"K Prabhakar,&nbsp;Anitha Aswathanarayana,&nbsp;K Hemanth Kumar Reddy","doi":"10.3121/cmr.2022.1704","DOIUrl":"https://doi.org/10.3121/cmr.2022.1704","url":null,"abstract":"<p><p><b>Objective:</b> By increasing the risk of isolation, fear, stigma, abuse, and economic fallout, COVID-19 has led to an increase in the risk of psychiatric disorders, chronic trauma, and stress. These factors eventually increase suicidality and suicidal behavior. This study intends to evaluate the reasons for suicide attempts due to the COVID-19 pandemic in the south Indian population.<b>Design:</b> Cross-sectional study<b>Setting:</b> The study was conducted in R. L. Jalappa Hospital and Research Centre, Kolar.<b>Participants:</b> This study was conducted on 91 patients admitted to the general medicine department for a suicide attempt because of the COVID 19 pandemic.<b>Methods:</b> A single examiner conducted a structured interview with a pretested questionnaire with each participant. Participants were asked to indicate the primary reason or motivation for their suicide attempt. Patients answered a set of questions regarding personal and family concerns (marginalization, fear and uncertainty, domestic abuse, loneliness, grief over loss of loved one) and work-related concerns (economic fallout, high-risk environment, shortage of personnel and personal protective equipment [PPE]). We employed mean and standard deviation to descriptively analyze quantitative variables. Categorical variables were expressed in terms of frequency and proportion. For non-normally-distributed quantitative parameters, medians and interquartile range (IQR) were compared across study groups using the Kruskal-Wallis test (> 2 groups). Data was analyzed using coGuide software, V.1.03.<b>Results:</b> The mean age of participants was 29.47±11.06 years, the majority (43.63%) of which were aged between 21 to 40 years of age. The majority (72.53%) of participants reported personal and family concerns as reasons/motivation for suicide, whereas only 17.58% reported work-related concerns. There was a statistically significant difference across reason or motivation for suicide with age (in years) and gender (<i>P</i> value < 0.001).<b>Conclusion:</b> The study concluded that more than half of the patients indicated personal and family concerns as the major reason for suicide attempts during the pandemic. It is vital to emphasize the mental health well-being of the population and take proactive steps to minimize its detrimental effects during the COVID-19 pandemic.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9390856/pdf/0200034.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39898186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Russian Physicians Burnout during the COVID-19 Pandemic: A Cross-Sectional Survey Study. 俄罗斯医生在COVID-19大流行期间的职业倦怠:一项横断面调查研究
IF 1.4
Clinical Medicine & Research Pub Date : 2022-03-01 Epub Date: 2022-02-07 DOI: 10.3121/cmr.2022.1642
Vladimir I Rozhdestvenskiy, Vlada V Titova, Irina A Gorkovaya, Dmitry O Ivanov, Yuri S Aleksandrovich
{"title":"Russian Physicians Burnout during the COVID-19 Pandemic: A Cross-Sectional Survey Study.","authors":"Vladimir I Rozhdestvenskiy,&nbsp;Vlada V Titova,&nbsp;Irina A Gorkovaya,&nbsp;Dmitry O Ivanov,&nbsp;Yuri S Aleksandrovich","doi":"10.3121/cmr.2022.1642","DOIUrl":"https://doi.org/10.3121/cmr.2022.1642","url":null,"abstract":"<p><p><b>Objective:</b> To study burnout of Russian physicians in the conditions of COVID-19 pandemic and how their work with coronavirus-infected patients influenced it. According to a three-factor model of burnout developed by Maslach and Jackson, this syndrome includes emotional exhaustion, depersonalization, and reduction of personal accomplishment.<b>Design:</b> A cross-sectional survey study.<b>Setting:</b> Large medical practice.<b>Participants:</b> Physicians of different specialties.<b>Methods:</b> Data collection was conducted from June 23 to July 12, 2020. We developed a Google form including a questionnaire and psychological inventories and placed it in a medical portal. Maslach Burnout Inventory - Human Services Survey for Medical Personnel was used to study burnout; the Hospital Anxiety and Depression Scale was used to determine anxiety and depression.<b>Results:</b> Of all the physicians who took part in the study (N = 599), 31.2 % worked with coronavirus-infected patients. Of the medical personnel who treated COVID-19 patients, 63.6% noted increased workload during the pandemic. Compared to other physicians, they more often had a high degree of emotional exhaustion (43.3 % vs 33.0 %, φ* = 2.404, <i>P</i> ≤ 0.01) and depersonalization (41.7 % vs 34, 0%, φ* = 1.803, <i>P</i> ≤ 0.05). An overwhelming majority of physicians, without any dependence on work with infected patients, had an absence of anxiety and depression. The identified interrelations between the symptoms of burnout, anxiety, depression; age and career stage in medical personnel were identical, except for weak correlations between age and emotional exhaustion (rs = -0.097, <i>P</i> ≤ 0.05), as well as career stage and personal accomplishment (rs = 0.102, <i>P</i> ≤ 0.05) in those physicians who worked with COVID-19 patients. The structure of burnout was identical in all physicians and did not depend on interaction with the infected patients.<b>Conclusion:</b> Public health authorities should reduce the workload on physicians involved in treating infected patients against the backdrop of the pandemic. Psychotherapeutic measures focused on preventing burnout should reduce its number among physicians interacting with patients infected with the coronavirus.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9390855/pdf/0200023.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39898187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
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