Impact of lockdown during the COVID-19 outbreak on ophthalmological emergencies in a referral center in France

Purpose

In March 2020, the sudden rise in the number of SARS-CoV-2 infections in France led the government to impose a strict lockdown during which all non-urgent medical consultations were postponed. From March 17 to May 10, 2020, private medical practices were closed, and telemedicine was encouraged. The consequences on ophthalmic care were dramatic, with over 90% of scheduled consultations canceled. The goal of this study was to describe consultations during the 2-month strict lockdown in Paris and to analyze its impact on the visual outcomes of patients consulting in the ophthalmology emergency department (OED).

Methods

Data of patients who presented to the OED of the A. de Rothschild Foundation Hospital (RFH), a tertiary ophthalmology center in Paris, France, during the lockdown period and its immediate aftermath were analyzed. The results were compared to the same time periods in the years 2018 and 2019. Four time periods were defined and numbered chronologically: March 17 to May 10, 2018 (period 1); March 17 to May 10, 2019 (period 2); March 17 to May 10, 2020 (period 3, the lockdown period); May 11 to June 9, 2020 (period 4, the post-lockdown period).

Results

The number of consultations was reduced by more than 50% during the lockdown period (n = 2909 patients) and by 30% during the post-lockdown period (n = 2622) when compared to periods 1 (n = 7125) and 2 (n = 8058). Even though LP4 saw an increase in the number of patients consulting, there was no increase in the rate of severe diseases (12.8% during LP3 vs. 11.1% during LP4), and the proportion of patients who were admitted was statistically similar (4.3% vs. 3.6%). Neuro-ophthalmic diseases were the most common during LP3 and LP4. Neovascular glaucoma was twice as common during post-LP4 (P = 0.08). We noted a significant increase in patients with graft rejection consulting in our OED during the post-LP4 (P < 0.001). These results were likely related to a delay in follow-up consultations due to the lockdown measures.

Conclusion

The reduction in the number of consultations in our OED during the lockdown period affected both minor emergencies and severe ophthalmic diseases, but with no significant delay in diagnosis. More longitudinal and longer study is needed to confirm this and to retrospectively analyze the effects of the COVID-19 outbreak and lockdown.

Adolescents’ attitudes towards e-cigarette in Tunisia

Introduction

E-cigarette use has increased over the last years. Many studies have examined teenagers’ attitudes towards smoking, but did not examine adolescents’ attitudes towards e-cigarettes.

Objectives

The aim of this study was to examine high school students’ attitudes regarding e-cigarette safety, addictive properties and social norms and to compare e-cigarettes perceptions among e-cigarette users and non-users in Tunisia.

Methods

A survey was conducted with a sample of 234 students in Mohamed Ali high school in Sfax, a town in South of Tunisia, in February 2020. Socio-demographic data and questions about vaping and attitudes towards e-cigarettes were used to evaluate students’ perceptions towards e-cigarettes.

Results

Among high school students aged 15 to 20, 58,8% have ever used e-cigarette, 38,3% had done so within the previous 30 days and 20,5 % were regular users of vapes. 53.8% of students believed that e-cigarettes are harmful. 78.4% of them thought they were less harmful than regular cigarettes and 50.5% thought they could be addictive, 45.4% of students believed e-cigarette smoking decreased anxiety and a third thought it made them sociable (33.3%) and confident (30.6%).Adolescents who used e-cigarettes had significantly more favorable e-cigarette attitudes than non-users: they believed they were less harmful than tobacco (p=0,019), they were not addictive (p=0,005), they decreased anxiety (p=0,001) and they made the user sociable (p<0,001) and confident (p=0,01).

Conclusions

Our results suggest the need to provide teenagers with the correct information about e-cigarettes risks, and the balance risk-benefit of their use.

Disclosure

No significant relationships.

Predictors of male sexual dysfunction in post traumatic stress disorder

Introduction

Post-traumatic stress disorder affects emotional, social and professional functioning. It can also affect physical and sexual health.

Objectives

The aim of this study is to write down the prevalence of sexual dysfunction in men with PTSD and to economize on potential predictors of sexual dysfunction.

Methods

A total of 30 male patients with PTSD were included in this study. We collected socio-demographic and clinical data and we used Post-Traumatic Stress Disorder (PCLS) and International Erectile Function Index (IIEF15) scales.

Results

The mean PTSD severity score was 65.43 ± 2.95. The mean score for revitalization, avoidance, cognitive and mood alteration, and hypervigilance were 15.80 ± 1.44, respectively; 8 ± 0; 24.07 ± 1.20 and 17.57 ± 2.95. The mean IIEF-15 score was 51.16 ± 6.82. The mean sub-scores were 3.93 ± 0.52 for sexual desire; 18.80 ± 5.68 for erectile function; 8.93 ± 8.97 for orgasmic function; 5.13 ± 1.10 for satisfaction with intercourses and 4.13 ± 1.16 for overall satisfaction. The IIEF15-EF score was negatively correlated with the presence of a personal medical history (p = 0.02) and the impairment cognitions and mood score (p = 0.023). The IIEF-OF score was significantly associated with reviviscence, hypervigilance, cognition and mood alterations (p = 0.015; 0.041; 0.045). The IIEF-15 SD score was negatively correlated with altered cognition and mood (p = 0.007).

Conclusions

Our study focused on the importance of assessing sexual function in men followed for PTSD and helps to understand the association of PTSD with different types of sexual dysfunction.

Sexual function assessment in men with PTSD

Introduction

Exposure to extreme traumatic events can lead to post-traumatic stress disorder (PTSD). This disorder affects emotional, social and professional functioning. Recent studies suggest that it can lead to sexual dysfunction.

Objectives

The aim of this study is to compare the level of sexual dysfunction between men with PTSD and control subjects.

Methods

A total of 30 male PTSD patients and 30 controls were included in this study. We used the Post-Traumatic Stress Disorder Check Scale (PCLS) to assess the intensity of PTSD symptoms and the International Erectile Function Index (IIEF15) to assess sexual dysfunction of both patients and controls.

Results

The mean IIEF-15 score was 51.16 ± 6.82 in patients followed for PTSD versus 77.33 ± 2.02 in healthy controls with a non-significant difference (p = 0.26). Three patients (10%) had an alteration of desire while the control reported only dysfunction but there was no significant difference between the mean scores of IIEF-SD (p = 0.22). No patient or control had erectile dysfunction and there was no significant difference between the IIEF-EF sub-scores in the 2 groups (p = 0.20). The mean sexual intercourse satisfaction (SD) score in the patients was 5.13 ± 1.10 versus 8.86 ± 0.40 with a non-significant difference (p = 0.09). Altered satisfaction with intercourse was noted in 15% (n = 5) of subjects with PTSD versus a single control.

Conclusions

It is important that practitioners address the subject of sexuality in patients followed for PTSD and refer their patients, if necessary, to a sexology consultation.

Electronic cigarettes use among teenagers in Tunisia

Introduction

Electronic cigarettes (e-cigarettes) are battery-powered devices developed with the goal of mimicking the action of smoking. Their use has increased over the past years.

Objectives

The aim of this study was to evaluate the prevalence of the use of e-cigarettes among teenagers in high school and to examine the predictor factors.

Methods

A survey was conducted with a sample of 234 students in Mohamed Ali high school in Sfax, a town in the south of Tunisia, in February 2020. We estimated e-cigarette prevalence among adolescents and the predictor factors of vaping.

Results

Among high school students aged 15 to 20, 58,8% have ever used e-cigarette, 38,3% had done so within the previous 30 days and 20,5 % were regular users of vapes. The mean age of e-cigarette users was 16,59 +/- 0,908 years old, 83,3% of e-cigarettes users were males. Male gender, high socio-economic level, practicing leisure activities, smoking cigarettes and drinking alcohol were associated with regular use of e-cigarettes. Overall, 51, 6% of never smoking students reported ever use of e-cigarettes. The main reason for initiating e-cigarettes use was curiosity (65%).

Conclusions

Our findings showed the significant use of e-cigarettes among high school students thus it would be interesting to provide adolescents with information about the use of e-cigarettes and other tobacco products.

Disclosure

No significant relationships.

Antidepressants effect on sexual dysfunction in men with PTSD

Introduction

Various therapeutic approaches for post-traumatic stress disorder have been the subject of numerous studies. Antidepressants are sometimes used in PTSD. They improve the symptoms of PTSD. But their effect is not clear on the sexual dysfunctions that accompany this disorder.

Objectives

The aim of this study is to display the effect of antidepressants on sexual dysfunctions in men with PTSD.

Methods

A total of 30 male patients with PTSD were included in this study. The International Erectile Function Index (IIEF15) was used to assess sexual dysfunction in participants before treatment and two months after starting antidepressant treatment.

Results

Half of the patients (50%) used sertraline, 23% paroxetine, 20% fluoxetine and 7% escitalopram.The mean IIEF-15 score was 51.16 ± 6.82 in patients with PTSD before initiation of treatment. The average scores of the areas of sexuality studied by this scale were 3.93 ± 0.52 for sexual desire; 18.80 ± 5.68 for erectile function; 8.93 ± 8.97 for orgasmic function; 5.13 ± 1.10 for satisfaction with intercourse and 4.13 ± 1.16 for overall satisfaction. After 2 months of use of the antidepressant treatment, there was a statistically significant improvement in sexual functions: significant increase in the total score of the IIEF15 (p <0.001), and in the mean scores of the areas of sexuality.

Conclusions

Antidepressant treatment could, by improving post-traumatic symptoms, improve sexual dysfunction.

The Effect of Solvents and Rare-Earth Element (Er, Yb) Doping on Suspension Stability of Sol-Gel Titania Nanoparticles

The effects of solvent on the suspension stability of titanium dioxide (TiO₂) nanoparticle (NP)-doped rare-earth elements (Er and Yb) were evaluated. Pure and doped TiO₂ NPs were successfully prepared by the sol-gel method under the supercritical drying conditions of ethanol. Doped nanopowders were prepared with 5 mol% Er or 5 mol% Yb concentration, and co-doped nanopowders were prepared with fixed 5 mol% Er concentration and various Yb concentrations of 5 and 10 mol%. TiO₂ NP suspensions with diverse solvents, such as water, ethanol, methanol, and butanol, were prepared. The nanopowders were characterized by studying their structural and morphology properties. The NP size analysis revealed the average size of TiO₂ as approximately around 7-12 nm. Suspensions of TiO₂ NPs in different solvents were prepared by a two-step powder dispersion process using several ultrasonication methods. The aim of this paper was to prepare a stable suspension for a certain time period and then to produce doped and undoped TiO₂ NP coatings for photovoltaic application. The effects of concentration, dopants, and solvents on the dispersibility and stability of TiO₂ suspensions were evaluated. The UV-visible spectroscopy, zeta potential measurements, particle size distribution, SEM, and Hamaker 2 software confirm that the 5%Er-10%:TiO₂ suspension exhibits a good stability and stable suspension improved by co-doped rare.

Enhanced up-conversion and temperature-sensing behaviour of Er(3+) and Yb(3+) co-doped Y2Ti2O7 by incorporation of Li(+) ions

Y2Ti2O7:Er(3+)/Yb(3+) (EYYTO) phosphors co-doped with Li(+) ions were synthesized by a conventional solid-state ceramic method. X-ray diffraction studies show that all the Li(+) co-doped EYYTO samples are highly crystalline in nature with pyrochlore face centred cubic structure. X-ray photon spectroscopy studies reveal that the incorporation of Li(+) ions creates the defects and/or vacancies associated with the sample surface. The effect of Li(+) ions on the photoluminescence up-conversion intensity of EYYTO was studied in detail. The up-conversion study under ∼976 nm excitation for different concentrations of Li(+) ions showed that the green and red band intensities were significantly enhanced. The 2 at% Li(+) ion co-doped EYYTO samples showed nearly 15- and 8-fold enhancements in green and red band up-converted intensities compared to Li(+) ion free EYYTO. The process involved in the up-conversion emission was evaluated in detail by pump power dependence, the energy level diagram, and decay analysis. The incorporation of Li(+) ions modified the crystal field around the Er(3+) ions, thus improving the up-conversion intensity. To investigate the sensing application of the synthesized phosphor materials, temperature-sensing performance was evaluated using the fluorescence intensity ratio technique. Appreciable temperature sensitivity was obtained using the synthesized phosphor material, indicating its applicability as a high-temperature-sensing probe. The maximum sensitivity was found to be 0.0067 K(-1) at 363 K.

Highly efficient NIR to visible upconversion in a ZnO:Er,Yb thin film deposited by a AACVD atmospheric pressure process

A ZnO:Er,Yb hexagonal wurtzite phase structured thin film with highly efficient NIR to visible upconversion emissions.

[Use of the rapid antigen detection test in group A streptococci pharyngitis diagnosis in Tunis, Tunisia]

The aims of this study were to determine the contribution of commercial rapid antigen detection test (RADT) in the rapid diagnosis of pharyngitis caused by group A streptococci. A total of 292 children with pharyngitis was included. A duplicate throat swabs was taken simultaneously from each patient. One of them was used for RADT achievement and the other for culture. When cultures were positive, a semi-quantitative evaluation was done. Throat culture and RADT were positive in 59 and 72 cases respectively. Fifty four specimens were positive simultaneously with RADT and culture and 215 specimens were negative using both methods. Eighteen specimens were positive only with RADT, 5 of them were treated by amoxicillin. Regarding to the group of patients with a negative RADT and a positive culture (5 cases), all of them had a culture evaluation at "+" or "++". Specificity and sensibility of the RADT were 92.2% and 91.5% respectively. RADT use by physicians can reduce antibiotic prescription among paediatric population. Because of the high specificity of RADT, therapeutic decisions can be made on the basis of a positive test.