COVID-19 outbreak lead to nationwide lockdown in Finland on the March 16th, 2020. Previous data regarding to the patient load in the emergency departments during pandemics is scarce. Our aim is to describe the effect of national lockdown and social distancing on the number and reasons for emergency department (ED) visits and inpatient admissions in three large volume hospitals prior to and after the outbreak of the COVID-19 epidemic in Finland.
Data for this register-based retrospective cohort study were collected from three large ED's in Finland, covering 1/6 of the Finnish population. All patients visiting ED's six weeks before and six weeks after the lockdown were included. Pediatric and gynecological patients were excluded. Numbers and reasons for ED visits and inpatient admissions were collected. Corresponding time period in 2019 was used as reference.
A total of 40,653 ED visits and 12,226 inpatient admissions were analyzed. The total number of ED visits decreased 16% after the lockdown, whereas the number of inpatient admissions decreased 15% (p?
Social distancing measures are used to reduce the spreading of infection. Our aim was to assess the immediate effects of national lockdown orders due to coronavirus disease 2019 (COVID-19) on pediatric emergency room (ER) visits and respiratory tract infections in hospitals and nationwide in Finland.
This register-based study used hospital patient information systems and the Finnish national infectious disease register. The participants were all patients visiting pediatric ER in 2 Finnish hospitals (Kuopio University Hospital, Mikkeli Central Hospital) covering 1/5th of the Finnish children population, 4 weeks before and 4 weeks after the start of the nationwide lockdown on March 16, 2020. Nationwide weekly numbers of influenza (A + B) and respiratory syncytial virus (RSV) in children were assessed from the infectious disease register from 2015 to 2020.
A major decrease in the rate of daily median pediatric ER visits was detected in both hospitals in the study during the nationwide lockdown compared with the study period before the lockdown (Mikkeli, 19 vs. 7, P
Background and purpose - There have been few studies on the effect of THR on pregnancy or delivery, and they have mainly been based on small and regional data. We evaluated the birth rate nationwide in patients of fertile age with THR. Patients and methods - This nationwide population-based cohort study was based on registry data on 5,863 Finnish THR patients who had undergone a THR between 1985 and 2006, and who were aged 15-45 years (females) or 15-50 years (males) at the time of THR. The matched reference cohort consisted of 17,575 sex- and age-matched individuals (3 for each patient) who were alive and resident in Finland at the time of the patient's THR. Birth rate and Cox hazard ratios (HRs) with 95% CI for live births were calculated. Results - The birth rate after THR was approximately 20-60% lower in the male and female patient groups than in the reference individuals. The probability of having a live birth after THR was lower in female patients than in reference individuals, in all but the oldest age group (40-45 years). The same phenomenon was seen in male patients in all but the youngest age group (15-19 years). Adjustment for potential confounders increased the probability of THR patients having a live birth compared to reference individuals, but the birth rate was still clearly reduced (in men, adjusted HR =0.80, 95% CI: 0.69-0.92; in women, adjusted HR =0.56, 95% CI: 0.46-0.68). Interpretation - THR has a substantial effect on the birth rate of offspring, in both women and men. THR patients had a lower birth rate and probability of having a child after surgery, even after taking possible confounders into account.
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Background and purpose - Previous small studies have suggested that delivery does not adversely affect the survivorship of total hip replacement (THR). We investigated whether delivery after primary THR affects hip implant survivorship in a large population-based study sample Patients and methods - In this register-based nationwide cohort study, all women aged 15-45 who underwent primary THR in Finland from 1987 to 2007 were included from the Finnish Arthroplasty Register. Data on deliveries were obtained from the medical birth register. After primary THR, 111 women (133 THRs) delivered and formed the delivery group. In the reference group, 1,878 women (2,343 THRs) had no deliveries. We used Kaplan-Meier analysis with 95% confidence intervals (CI) to study implant survivorship at 6 and 13 years, and Cox multiple regression to assess survival and hazard ratios (HRs), with revision for any reason as an endpoint with adjustment for age, rheumatoid arthritis, and stem and cup fixation. Results - 51 (38%) revisions were recorded in the delivery group and 645 (28%) revisions in the reference group. The 6-year implant survivorship was 91% (CI 85-96) in the delivery group and 88% (CI 87-90) in the reference group. The 13-year survival rates were 50% (CI 39-62) and 61% (CI 59-64). The adjusted HR for revision after delivery was 0.7 (CI 0.4-1.2) in = 6.8 years' follow-up and 1.1 (CI 0.8-1.6) in > 6.8 years' follow-up. Interpretation - Based on the findings in this nationwide study of hip replacement in fertile-aged women, delivery does not seem to decrease THR implant survivorship; women should not be afraid of or avoid becoming pregnant after THR.
The COVID-19 pandemic suspended nearly all team sports globally. The pro series have resumed playing by creating safe bubbles or massive testing protocols. Amateur level sports have also restarted seasons without possibility for such precautions. Our aim was to report the epidemiology of COVID-19 in an amateur ice hockey team and the team-to-team transmission during two games.
A descriptive brief report based on public statements by the local health authorities and the teams involved.
An asymptomatic carrier of COVID-19 in a U-20 ice hockey team infected 22 of 28 team mates. The day before the first players had symptoms, the team had returned from a two games away trip. A few days later COVID-19 was detected in both opposing teams and they were ordered to quarantine. During the two weeks quarantine a total of 24 players from the two opposing teams tested positive. Some of these players were training with senior teams and three additional infected players were detected in two senior teams. In total, 49 infections were detected in five ice hockey teams, and six teams were in quarantine for two weeks.
An asymptomatic player can potentially endanger the whole season of a team and put opponents in danger as well. We report massive team-to-team transmission of COVID-19 in the U-20 Finnish National Hockey League. In order to prevent spread of COVID-19 in amateur-level team sports, suitable protocols should be established and adopted into daily use.