key: cord-0740367-x0o2by9h
authors: Simmons, Kay A.; Roberts, Morgan E.; Ray, Gannon J.; Bright, Andrew C.; Kinnard, Christopher M.; Lee, Yann-Leei L.; Mbaka, Maryann I.; Polite, Nate; Simmons, Jon D.; Butts, Charles
title: Impact of the State-mandated Stay-at-home Order for the COVID-19 Pandemic on an Academic Level I Trauma Center with a Large Rural Catchment Area
date: 2021-11-30
journal: Journal of the American College of Surgeons
DOI: 10.1016/j.jamcollsurg.2021.08.590
sha: 7c3cf2c3a42c83e1dfa1c53873fa65e95e056931
doc_id: 740367
cord_uid: x0o2by9h

nan

the management of Grade I to V bladder injuries decreased from 84% to 5%, respectively, GS reported a significantly higher comfort level with these injuries (Grade I: 88% and Grade V: 31%, p<0.001). Despite this, the likelihood that GS would consult urology increased significantly as the injury severity increases (Grade I injury: OR 1.95, 95% CI 1. p¼0.01; Grade V injury: OR 5.21, p¼0.01) . Contrary to urologists' perception, the majority of GS indicated that preoperative imaging demonstrating bladder injury, presentation outside of normal working hours, and an intraoperative diagnosis did not change whether urology would be consulted (all p¼0.00).

CONCLUSION: GS-reported comfort levels in the management of bladder injuries remained higher than urology-perceived comfort levels. Urologists' perception of possible consultation did not align with GS for most scenarios. While influenza and other viral infections are known to cause endothelial dysfunction, its effect on the EGX has not been described. We hypothesized that the influenza virus would cause EGX degradation.

METHODS: Human umbilical vein endothelial cells were exposed to varying multiplicities of infection (MOI) of the H1N1 strain of influenza virus for 24 hours. A dose dependent effect was examined by using an MOI of 5 (n¼541), 15 (n¼714), 30 (n¼596), and 60 (n¼653) and compared to a control group (n¼607). Cells were fixed and stained with FITC-labelled wheat germ agglutinin to quantify EGX.

RESULTS: There was no difference in EGX intensity after H1N1 exposure at an MOI of 5 as compared to control (6.20 vs. 6.56, p<0.001). EGX intensity was decreased at a MOI of 15 when compared to control (5.36 vs. 6.56, p<0.001). Degree of EGX degradation was worse at higher doses of the H1N1 virus, however, the decrease in EGX intensity was maximized at an MOI of 30. Injury at a MOI of 60 was not worse than 30. (4.17 vs. 4.47, p¼0.13).

CONCLUSION: The H1N1 virus induces endothelial dysfunction by causing EGX degradation in a dose dependent fashion. Further studies are needed to characterize the role of EGX damage in causing clinically significant lung injury during viral infection.

center during the mandatory stay-at-home order in April 2020 were compared to the same time-frame a year earlier

RESULTS: A total of 399 trauma patients met inclusion criteria out of 4,156 ED visits

There was no statistical difference in the following variables: percentage of patients that were transferred from another facility (31% vs. 36%, p¼0.34), injury severity score (10 vs. 10, p¼0.65), mechanism of injury

CONCLUSION: During the mandatory stay-at-home order, there was a significant increase in the rate of trauma patients presenting to the ED, as well as a significantly higher number of trauma patients who were intoxicated at presentation. Incidence and Patterns of Firework

US police organizations reported an increased number of firework-related calls. Furthermore, because of the COVID pandemic, many major e218