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Spontaneous intraparenchymal cerebral hemorrhages (SIPH) account for 10–15% of acute strokes. Sorting these patients according to the risk of harboring an underlying vascular etiology may help selecting the patients who would mostly benefit from Multidetector CT Angiography (MDCTA). The aim of this study was to evaluate the accuracy of Non-Contrast brain CT (NCCT) in predicting possible vascular etiologies in patients with SIPH. In this retrospective study, we evaluated the NCCT of 334 patients who presented with SIPH from March 2017 to March 2021 and we looked for vascular etiologies in the CTA which was performed for these patients. We used NCCT criteria to predict the presence of any vascular etiologies in SIPH patients and proposed a scoring system based on these criteria which might predict the risk of vascular ICH (VICH score). Out of 334 evaluated patients, 9.3% had an underlying vascular etiology. Independent predictors of the vascular etiology included: age < 46 years, no history of hypertension and coagulation disorders, lobar hemorrhages, and presence of significant perilesional edema. We used these criteria and NCCT classification to create a practical scoring system to predict the risk of vascular ICH (VICH). In our study, VICH score ≥ 4 had 51.6% sensitivity and 96.4% specificity for predicting a positive MDCTA as the maximum optimal cut-off point. The VICH score seemed to be successful in predicting vascular etiologies in this retrospective cohort of 334 patients. This scoring system can be used to select patients if there are limited resources to perform CT angiography. [ABSTRACT FROM AUTHOR]

Background: SARS-CoV-2 has spread globally, and COVID-19 is labeled a public health emergency of global concern by the World Health Organization. Since 2019-nCoV has a long incubation period and strong infectivity, e-Health and its subset medical informatics has emerged as one viable solution to allow the continuity of the provision of health services. Also, new health care models are needed during the COVID-19 pandemic. The proposed systematic review will examine and summarize the evidence on the applications of medical informatics in covid-19 crisis as evidence-based approaches. Objective: A research team that includes medical informatics and systematic review method experts guided this review according to the Cochrane Handbook and PRISMA reporting guidelines. We search PubMed and Scopus. Eligibility criteria for reviewed studies will be randomized and non-randomized control trails, English language. We will identify articles across 2019-2020 applying the medical informatics in COVID-19 pandemic. Two independent reviewers will assess article eligibility and extract data into a spreadsheet using a structured pilot-tested form. We will synthesize evidence by a thematic synthesis approach. We will evaluate risk of bias in all included studies by favor tools. Material and Methods: The primary result showed a total of 1882 and 854 articles were retrieved from the PubMed and Scopus databases, respectively. After removing duplicates, 2716 articles remained for screening by title and abstract. We expect that our results serve as the basis for helping researchers, decision makers, MI specialist and politicians and other to develop, implement and evaluate IT-based tools and interventions to help medical staff in elimination COVID-19. Results: The primary result showed a total of 1882 and 854 articles were retrieved from the PubMed and Scopus databases, respectively. After removing duplicates, 2716 articles remained for screening by title and abstract. We expect that our results serve as the basis for helping researchers, decision makers, MI specialist and politicians and other to develop, implement and evaluate IT-based tools and interventions to help medical staff in elimination COVID-19. Conclusion: This systematic review aims to identify applications of medical informatics in COVID-19 pandemic. This review is the first attempt to develop an evidence-based methods using a systematic review approach, to the best of our knowledge. The proposed systematic review will inform further research and innovation in terms of benefits and shortcomings that MI may have in the health system. [ABSTRACT FROM AUTHOR]

Background: The rapid progression of the coronavirus SARS-CoV-2 presents a real challenge for the whole world. As the usual capacity for citizen care is exceeded, health professionals and governments struggle. One of the most important strategies to reduce and mitigate the advance of the epidemic are social distance measures; this is where telemedicine can help, and provide support to the healthcare systems, especially in the areas of public health, prevention and clinical practices. Objective: To determine the usage of telemedicine in the COVID-19 pandemic. Material and Methods: We use a six-step process reflecting the systematicity and transparency which is implemented using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). A comprehensive survey was performed on Medline and Scopus in September 2020. Following studies were considered eligible: randomized and non-randomized clinical trial, and observational studies (cross-sectional, cohort study, case-control), and studies which evaluated at least one outcome. The articles were categorized based type of technology and outcomes. The risk of bias was evaluated by considering type of studies. Results: In this review, 26 out of 2716 retrieved articles met the full-text inclusion criteria. Our study recognized twenty-six studies in the telemedicine domain. Twenty four of these studies applied synchronous methods, e.g. phone or video call consultation, while two of them used asynchronous approaches for the communication in their telemedicine services. Moreover, eight (30%) studies designed online consultation. Forty two outcomes investigated by twenty six studies. All of outcomes in reviewed studies were process of care outcomes. It must be presented in the form of text, not tables or illustrations. Conclusion: Telemedicine has been promoted and scaled up to reduce the risk of transmission, by increasing social distance and reducing contact. During the coronavirus epidemic, telemedicine has been the doctors' first choice to slow down the spread of the disease. The discovery of the important role of telemedicine in disease pandemic is necessary. Especially, video conferences are popular in telemedicine technology. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the accuracy of the five-level triage system using the emergency severity index (ESI) and to determine the compliance of the triage level with patient outcomes., Methods: This was a cross-sectional study which was performed in the emergency department of Imam Reza Hospital of Mashhad during 2017. We included all the adult patients (≥15 years of age) referring to the emergency department. The data were recorded in a questionnaire containing three sections including demographic information, results of triage by ESI and final outcome of the patient. Patients referred to the triage unit were simultaneously triaged by triage nurse and some emergency medicine physicians. The triage was performed by a nurse with an emergency medicine physician (EMP) was considered as a gold standard and the outcome was compared in 24 hours later., Results: Overall, we included 400 patients with a mean age of 46.40 ± 18.52 years among whom there were 211 (52.8%) men and 189 (47.3%) women. Finally, 123 patients were hospitalized, 12 died, 256 were discharged by a physician, and 9 people left the hospital with their own consent. The calculated weight kappa was used to determine the agreement between the observers (nurse triage and physician) at 0.701 so that the agreement between the triage performed by a nurse and an EMP was in an excellent level ( p <0.001). There was a significant relationship between the triage levels (determined by physicians) and the outcome of the patient ( p <0.001), and the five-level system had a high overlap and significant relation with patient's outcome., Conclusion: The results of the current study revealed that the five-level triage system using the ESI has a high accuracy in triage and estimates the patient outcomes effectively and thus, could be used as an effective system in hospital triage., (© 2020 Trauma Research Center, Shiraz University of Medical Sciences.)