Browsing by Subject "Hospital care"

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    The calm before the storm: clinical observations of Middle East respiratory syndrome (MERS) patients
    (Taylor & Francis, 2018) Al-Tawfiq, Jaffar A.; Hinedi, Kareem; Medicine, School of Medicine
    Background: Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection emerged in 2012. The majority of cases occurred in the Kingdom of Saudi Arabia and the disease carries a high case fatality rate. Methods: We present three MERS-CoV cases and highlight the salient clinical features and laboratory, and radiographic characteristics. Results: Although all nasopharyngeal samples were negative, MERS CoV infection was confirmed by reverse transcription–polymerase chain reaction of the E gene (UpE) and open reading frame (ORF1b) on sputum samples. The Ct value of the ORF1 gene was 24.8–29.11. One patient had been on immune suppressive agent and two patients had diabetes mellitus. The average length of hospital stay was 10.6 days. Two patients received ribavirin and IFN-a2b in addition to supportive management. The clinical course for these patients started with a febrile period lasting five days, a reduction in fever was coinciding with increased respiratory rate and oxygen requirements. All patients were discharged home. None of the 50 contacts tested positive for MERS-CoV. Conclusion:Resolution of the fever was accompanied by an increase in oxygen requirements and respiratory rate also lasting several days. This was followed by resolution of all symptoms and return to normal.
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    Inpatient Mental Healthcare before and during the COVID-19 Pandemic
    (MDPI, 2021-11) McGuire, Alan B.; Flanagan, Mindy E.; Kukla, Marina; Rollins, Angela L.; Myers, Laura J.; Bass, Emily; Garabrant, Jennifer M.; Salyers, Michelle P.; Psychology, School of Science
    Prior studies have demonstrated disruption to outpatient mental health services after the onset of the COVID-19 pandemic. Inpatient mental health services have received less attention. The current study utilized an existing cohort of 33 Veterans Health Affairs (VHA) acute inpatient mental health units to examine disruptions to inpatient services. It further explored the association between patient demographic, clinical, and services variables on relapse rates. Inpatient admissions and therapeutic services (group and individual therapy and peer support) were lower amongst the COVID-19 sample than prior to the onset of COVID-19 while lengths of stay were longer. Relapse rates did not differ between cohorts. Patients with prior emergent services use as well as substance abuse or personality disorder diagnoses were at higher risk for relapse. Receiving group therapy while admitted was associated with lower risk of relapse. Inpatient mental health services saw substantial disruptions across the cohort. Inpatient mental health services, including group therapy, may be an important tool to prevent subsequent relapse.