Comparison of the efficacy of ShotBlocker and cold spray in reducing intramuscular injection-related pain in adults. A prospective, randomized, controlled trial

Objective Coronavirus disease 2019 (COVID-19) is an emerging, fast-spreading, highly mortal and worldwide infectious disease. The pulmonary system was defined as the main target of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but the mortality concept of this disease presented with more severe and systemic disease. The present study investigated the relationship between the patient characteristics at the initial hospital administration and fatality in COVID-19 patients. Methods In this retrospective and comparative cohort study, all the 767 hospitalised COVID-19 patients, treated between 18 March and 15 May 2020 in the Covid Clinics of Gulhane Training and Research Hospital in Ankara, Turkey, were evaluated. Results The fatality rate was significantly increased in patients with any comorbid disease except asthma. The initial laboratory test results indicated highly significant differences according to the patient's outcome. A multifactor logistic regression analysis was performed to calculate the adjusted odds ratios for predicting patient outcomes. Being older than 60 years increased the death risk with an adjusted OR of 7.2 (95% CI: 2.23-23.51; P = .001). The presence of a cancer and the extended duration of intensive care unit treatment were other significant risk factors for nonsurvival. Azithromycin treatment was determined as significantly reduced the death ratio in these patients (P = .002). Conclusion It was revealed that being older than 60 years, presence of a cancer and extended duration of ICU treatment were the major risk factors for predicting fatality rate in hospitalised COVID-19 patients.

Background Early prediction of return of spontaneous circulation (ROSC) for cardiac arrest (CA) patients is a major challenge. Different biomarkers have been studied as an early predictor for ROSC, but a consensus has not been achieved in this regard. This study’s goal was to investigate the value of the carboxyhemoglobin (COHb) and methemoglobin (MetHb) levels as a predictive marker for ROSC and prognostic marker for patients who achieve ROSC. Methods A total of 241 adult patients (109 female, 132 male) diagnosed as non-traumatic CA were included in the study. The patients were divided into two groups based on whether they achieved ROSC. The ROSC group was divided into two sub-groups, survivors and non-survivors. Complete blood count parameters, routine biochemistry measurements, coagulation parameters, and blood gas analysis, and cardiac markers values were compared between the groups. Results COHb levels were significantly lower in the non-ROSC group than in the ROSC group (p = 0.002). Urea, creatinine, potassium, and cTn (cardiac troponin) levels in the non-ROSC group were significantly higher than in the ROSC group (p < 0.001, 0.001, 0.014, and 0.005, respectively). COHb levels were significantly lower in the non-survivor group than in the survivor group (p = 0.022). Urea, creatinine, potassium, lactate dehydrogenase, and cTn levels were significantly higher in the non-survivor group than the survivor group (p = 0.001, 0.005, 0.001, 0.010, and 0.008, respectively). There was no significant difference between the ROSC and non-ROSC groups and survivor group and non-survivor groups in terms of MetHb levels (p = 0.769 and 0.668, respectively). Moreover, CPR duration is significantly shorter in the survivor group than the non-survivor group (p ˂ 0.001). Conclusion COHb levels in the blood gas analysis at the time of admission could be used as a predictive marker for ROSC and prognostic marker for the patients who achieved ROSC.