Palmellington1004

Computed Tomography (CT) scans help diagnose and triage life-threatening and time-sensitive emergency conditions, but most rural hospitals in British Columbia do not have access to a local CT scanner. We investigate how many transfers from a rural British Columbia hospital were for CT scans and describe the time delays to emergent CT imaging.

This was a prospective cohort study, over a 1-year period, on all patients requiring a transfer from the Golden and District Hospital, located 247km from the closest CT scanner. Data collection forms were completed prospectively and the main measurements included age, transport triage level, reason for transfer, referral hospital, transfer request time, and CT scan time. The time interval between the CT request and CT imaging was calculated and represents the 'delay to CT scan' interval.

The study hospital received 8672 emergency department (ED) visits and 220 were transferred to referral centres (2.5%). 61% of all transfers received a CT scan. Transfers for time-sensitive emergencies took an average of 6h 52min. Patients with acute stroke experienced a 4h 44min time interval. Less urgent and non-urgent conditions entailed an even greater time delay.

This study highlights that the lack of a rural CT scanner is associated with increased transfers and significant time delays. Improving access to CT scanners for rural communities may be one of the many steps in addressing healthcare disparities between rural and urban communities.

This study highlights that the lack of a rural CT scanner is associated with increased transfers and significant time delays. Improving access to CT scanners for rural communities may be one of the many steps in addressing healthcare disparities between rural and urban communities.

Magnetically controlled growing rods (MCGRs) offer non-invasive distractions in Early-Onset Scoliosis (EOS). However, implant-related complications are common, reducing its cost-effectiveness. To improve MCGRs functionality and cost-effectiveness, we often combine a single MCGR with a contralateral sliding rod (hybrid MCGR). Recently, we developed the spring distraction system (SDS) as an alternative, which provides continuous distraction forces through a helical spring. This study aims to identify complication rates and failure modes of EOS patients treated with either of these innovative systems.

This single-centre retrospective study included EOS patients treated with a (hybrid) MCGR or SDS between 2013 and 2018. Baseline demographics, and data regarding complications and implant growth were measured. Complication rate, complication profile, complication-free survival and implant growth were compared between groups.

Eleven hybrid- and three bilateral MCGR patients (4.1-year follow-up) and one unilateral, eleven hybrid and six bilateral SDS patients (3.0-year follow-up) were included. Entinostat mouse Groups had similar age, sex, aetiologydistribution, and pre-operative Cobb angle. Complication rate was 0.35 complications/patient/year for MCGR patients and 0.33 complications/patient/year for SDS patients. The most common complications were failure to distract (MCGR-group; 8/20 complications) and implant prominence (SDS-group; 5/18 complications). Median complication-free survival was 2.6years, with no differences between groups (p = 0.673). Implant growth was significantly higher in the SDS-group (10.1mm/year), compared to the MCGR-group (6.3mm/year).

(Hybrid) MCGR and SDS patients have similar complication rates and complication-free survival. Complication profile differs between the groups, with frequent failure to distract leading to significantly reduced implant growth in (hybrid) MCGR patients, whereas SDS patients frequently exhibit implant prominence and implant kyphosis.

III.

III.This is a report about a 44-year-old woman, with morbid obesity (BMI = 43) who was a candidate for bariatric surgery (BS) in Mother and Child Hospital in Shiraz, Iran. She had obsessive-compulsive disorder (OCD), so she refused surgery because she was afraid of getting the coronavirus. Psychiatric diagnostic interview and EyleBrown questionnaire that consists of 10 items were performed by a psychiatrist for the patient. After diagnosis of OCD, the patient underwent cognitive behavioral therapy (CBT) for 8 sessions. Results show that CBT is effective in reducing symptoms of OCD during COVID-19. Therefore, preoperative psychological interventions help increase patients' readiness for BS during COVID-19.

Type 2 diabetes is associated with an increased cardiovascular risk. Use of aspirin has been shown to be of benefit for secondary prevention of cardiovascular disease in patients with type 2 diabetes; benefits in primary prevention have not been clearly proven.

This study aims to (a) determine if aspirin is prescribed appropriately in type 2 diabetes for primary or secondary prevention of cardiovascular disease (CVD) and (b) evaluate whether there are differences in aspirin prescribing according to where people receive their care.

Cross-sectional study METHODS The medical records of individuals with type 2 diabetes aged over 18years and attending Elmwood Primary Care Centre and Cork University Hospital Diabetes outpatient clinics (n=400) between February and August 2017 were reviewed.

There were 90 individuals exclusively attending primary care and 310 persons attending shared care. Overall, 49.0% (n=196) of those were prescribed aspirin, of whom 42.3% were using it for secondary prevention. Aspirin was used significantly more in people attending shared care (p<0.001). About 10.8% of individuals with diabetes and CVD attending shared care met guidelines for, but were not prescribed aspirin.

A significant number of people with type 2 diabetes who should have been prescribed aspirin for secondary prevention were not receiving it at the time of study assessment. In contrast, a substantial proportion who did not meet criteria for aspirin use was prescribed it for primary prevention.

A significant number of people with type 2 diabetes who should have been prescribed aspirin for secondary prevention were not receiving it at the time of study assessment. In contrast, a substantial proportion who did not meet criteria for aspirin use was prescribed it for primary prevention.