Acute kidney injury (AKI) and sudden exacerbation of chronic kidney disease (CKD) frequently necessitate urgent kidney replacement therapy (UKRT). Peritoneal dialysis (PD) is recognized as a viable modality for managing such patients. Urgent-start peritoneal dialysis (USPD) may be associated with an increased number of complications and is rarely utilized. This review examines recent literature investigating the clinical outcomes of USPD in CKD and AKI. Relevant research was identified through searches of the MEDLINE (PubMed), Scopus, Web of Science, and Google Scholar databases using MeSH terms and relevant keywords. Included studies focused on the emergency use of peritoneal dialysis in CKD or AKI and reported treatment outcomes. While no official recommendations exist for catheter implantation in USPD, the impact of the technique itself on outcomes was found to be less significant compared with the post-implantation factors. USPD represents a safe and effective treatment modality for AKI, although complications such as catheter malfunctions, leakage, and peritonitis were observed. Furthermore, USPD demonstrated efficacy in managing CKD, although it was associated with a higher incidence of complications compared to conventional-start peritoneal dialysis. Despite its cost-effectiveness, PD requires greater technical expertise from medical professionals. Close supervision and pre-planning for catheter insertion are essential for CKD patients. Whenever feasible, an urgent start should be avoided. Nevertheless, in emergency scenarios, USPD does remain a safe and efficient approach.
(1) Alcohol consumption contributes to the development of numerous diseases and is a big organizational burden on emergency departments (EDs). (2) We examined data on alcohol-related ED admissions in Poznan, Poland between 1 April 2019 and 31 March 2022. A total of 2290 patients’ records were collected and analysed. The main goal was to determine the impact that these visits had on the functioning of the ED and the hospital. (3) The alcohol-related admission rate was significantly higher in males (78.95% vs. 21.05%), and the median blood alcohol concentration (BAC) level was 2.60 (1.78–3.38) ‰. Most of the visits took place at weekends and in the evening. Patients with higher BAC tended to stay longer in the ED, but had a lower chance of being admitted. A majority of patients required radiology and laboratory testing, 20.44% needed psychiatric examination, and 19.69% suffered trauma, mainly to the head. (4) Injuries and mental problems were the most common medical emergencies. This study presents trends in alcohol-related ED attendances, examines reasons for visits, and makes an attempt to assess overall burden on EDs.
Introduction:The COVID-19 (Coronavirus infectious disease 2019) pandemic has caused global behavioural changes due to the need to remain in quarantine by large groups of the population. Earlier work on the effects of other epidemics on the human psyche has revealed a possible increase in the number of people who abuse alcohol as a method of coping with mental stress. Despite this, the studies on the COVID-19 pandemic have not shown a clear correlation between lockdowns and quarantines and an increase in alcohol consumption. This study focused on examining the impact of the pandemic on the number of alcohol-related attendances in the Emergency Department in Poznan (Poland). Material and methods:The periods of one year before the pandemic (control trial) and the first year of the COVID-19 pandemic (study group) were analysed retrospectively using the data of ED patients who were under the documented influence of alcohol. Total number, alcohol concentration, waiting time for a medical examination, the patient's aggressive behaviour, length of stay in the ED, the need for additional examinations, suturing wounds or endotracheal intubation were analysed.Results: 954 patients were identified, which constituted 2.9% of all patients admitted to the ED during this period (the total number of patients admitted was 33510). During the control period, the total number of ED admissions was 30388 and 794 (2.6%) of them were in the control group. The median body alcohol concentration was 2.6%%. It has been shown that during the pandemic more women and fewer men under the influence of alcohol were admitted to the ED (212 (22.2%) females and 742 (77.8%) males) than in the pre-pandemic period [135 (17.0%) females and 659 (83.0%) males]. Additional examinations were performed less frequently (84.1% vs. 73.9%; p = 0.00000) and patients were admitted to other departments more often (25.7% vs. 40.9%; p = 0.00000). Other examined parameters did not change significantly. Conclusions:The study shows an increase in the number of patients under the influence of alcohol during the pandemic presenting to the ED and a noticeable change in management patterns' variables such as shorter LOW, fewer performed laboratory tests and more admissions to wards. However, this data requires further analysis and comparison with studies from other centres to draw more general conclusions.
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