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Sample records for admitting department hospital

  1. Prevalence and causes of hospitalization in victims admitted to emergency department of Imam Hossein hospital in Shahroud

    OpenAIRE

    Mohammadreza Khatibi; Hosein Bagheri; Malehe Khakpash; Zahra Movahhed-Khalilabadi

    2007-01-01

    Introduction: Accidents are second cause of disabilities and could lead to physical and psycological disorders and even death. The aims of this study were to evaluate the prevalence and causes of hospitalization in victims that admitted to emergency department of Imam Hossein hospital in Shahroud. Methods: This study is a descriptive analytic and cross-sectional research that has been done on 3027 victims of different accidents referred to emergency department of Imam Hossein hospital in Shah...

  2. Prevalence and causes of hospitalization in victims admitted to emergency department of Imam Hossein hospital in Shahroud

    Directory of Open Access Journals (Sweden)

    Mohammadreza Khatibi

    2007-01-01

    Full Text Available Introduction: Accidents are second cause of disabilities and could lead to physical and psycological disorders and even death. The aims of this study were to evaluate the prevalence and causes of hospitalization in victims that admitted to emergency department of Imam Hossein hospital in Shahroud. Methods: This study is a descriptive analytic and cross-sectional research that has been done on 3027 victims of different accidents referred to emergency department of Imam Hossein hospital in Shahroud. Necessary data were obtained through questionnaire and archived file during one year in hospital.The data was analyzed by using descriptive and analytic statistic methods. Results: Upon to results, from all 3027 victims, 73.7% were male and 26.3% were female. Also, the majority of victims had 15-20 years old and the most of them were married. 42% of accidents were included traffic accidents and from 51.3% of accidents that their placed were determined, 83.4% of them were happened in street and in summer and in September and also in evenfall. In this study, significant correlation have seen between accident type and age, sex, accident place, season and month and accident time (P0.05. Conclusion: Accidents are preventable and require improving knowledge of people about importance of safety principles during driving and also increasing the safety factor in roads and streets. Effective heath and therapeutic planning in medical and emergency centers is essential for decreasing the rate of mortality from accidents.

  3. Incidence and prevalence of hospital-acquired infections in a cohort of patients admitted to medical departments

    DEFF Research Database (Denmark)

    Petersen, Martin Haubro; Holm, Morten Olskjær; Pedersen, Svend Stenvang;

    2010-01-01

    INTRODUCTION: Hospital-acquired infections (HAI) are a significant cause of morbidity and mortality. Only point prevalence analyses of HAI have been recorded in Denmark. The aim of this study was to investigate the incidence and prevalence of HAI in patients admitted to departments of internal.......7-10.6). Exposure to bladder catheter was associated with an increased risk of urinary tract infection, incidence rate ratio 4.9; (95% CI 1.8-11.5). For the initial 14 days of hospitalization, the incidence of HAI was independent, while the prevalence increased linearly with duration of admittance. CONCLUSION......: The incidence of HAI was relatively constant during the initial 14-day-period of hospitalization, suggesting that shortening the period will have no major impact on the incidence of HAI. The prevalence was 9.7%, which is in line with results from prior studies....

  4. Characteristics of Older Adults Admitted to Hospital versus Those Discharged Home, in Emergency Department Patients Referred to Internal Medicine

    Science.gov (United States)

    Hominick, Kathryn; McLeod, Victoria; Rockwood, Kenneth

    2016-01-01

    Background Frail older adults present to the Emergency Department (ED) with complex medical, functional, and social needs. When these needs can be addressed promptly, discharge is possible, and when they cannot, hospital admission is required. We evaluated the care needs of frail older adults in the ED who were consulted to internal medicine and seen by a geriatrician to determine, under current practices, which factors were associated with hospitalization and which allowed discharge. Methods We preformed a chart-based, exploratory study. Data were abstracted from consultation records and ED charts. All cases had a standard Comprehensive Geriatric Assessment (CGA which records a Clinical Frailty Scale (CFA) and allows calculation of a Frailty Index (FI). Results Of 100 consecutive patients, 2 died in the ED, 75 were admitted, and 23 were discharged, including one urgent placement. Compared with discharged patients (0.39 ± SD 0.16), those admitted had a higher mean FI-CGA (0.48 ± 0.13; p < .01). Greater mobility dependence (2% in discharged vs. 32% in admitted; p < .05) was notable. Conclusions Discharge decisions require assessment of medical, functional, and social problems. Ill, frail patients often can be discharged home when social and nursing support can be provided. The degree of frailty, impaired mobility, and likely delirium must be taken into account when planning for their care. PMID:27076860

  5. The crucial factor of hospital readmissions: a retrospective cohort study of patients evaluated in the emergency department and admitted to the department of medicine of a general hospital in Italy

    OpenAIRE

    Fabbian, Fabio; Boccafogli, Arrigo; De Giorgi, Alfredo; Pala, Marco; Salmi, Raffaella; Melandri, Roberto; Gallerani, Massimo; Gardini, Andrea; Rinaldi, Gabriele; Manfredini, Roberto

    2015-01-01

    Background Early hospital readmissions, defined as rehospitalization within 30 days from a previous discharge, represent an economic and social burden for public health management. As data about early readmission in Italy are scarce, we aimed to relate the phenomenon of 30-day readmission to factors identified at the time of emergency department (ED) visits in subjects admitted to medical wards of a general hospital in Italy. Methods We performed a retrospective 30-month observational study, ...

  6. The formation and design of the TRIAGE study--baseline data on 6005 consecutive patients admitted to hospital from the emergency department

    DEFF Research Database (Denmark)

    Plesner, Louis Lind; Iversen, Anne Kristine Servais; Langkjær, Sandra;

    2015-01-01

    (3.6 %) died within 30 days. A higher triage acuity level was associated with numerous events, including acute surgery, endovascular intervention, i.v. treatment, cardiac arrest, stroke, admission to intensive care, hospital transfer, and mortality within 30 days (p ... that necessitates in-hospital care), vital signs and routine laboratory tests taken in the ED were aslo included in the database. RESULTS: Between September 5(th) 2013 and December 6(th) 2013, 6005 patients were included in the database and the biobank (94.1 % of all admissions). Of these, 1978 (32.9 %) were...... categorized as green, 2386 (39.7 %) yellow, 1616 (26.9 %) orange and 25 (0.4 %) red. Median age was 62 years (IQR 46-76), 49.8 % were male and median length of stay was 1 day (IQR 0-4). No events were found in 2658 (44.2 %) and 158 (2.6 %) were admitted to intensive or intermediate-intensive care unit and 219...

  7. Prospective Analysis of Geriatric Patients Admitted to Emergency Department With Trauma

    OpenAIRE

    Aktürk, Abdulkadir; Avci, Akkan; Gülen, Müge; Ay, Mehmet Oğuzhan; İçme, Ferhat; Satar, Salim

    2013-01-01

    Objective: The aim of this study is to reveal the demographic characteristics, causes of trauma, physical examination findings, the presence of fractures and the status of the outcome of the geriatric trauma patients admitted to the emergency department of an educational research hospital. Material and Methods: This study covers all the cases over 65 years who were admitted to emergency department with trauma between September 1 2011-31 August 2012. The demographic characteristics of the pat...

  8. Prospective Analysis of Geriatric Patients Admitted to Emergency Department With Trauma

    OpenAIRE

    Abdulkadir Akturk; Akkan Avci; Muge Gulen; Mehmet Oguzhan Ay; Ferhat Icme; Salim Satar

    2013-01-01

    Objective: The aim of this study is to reveal the demographic characteristics, causes of trauma, physical examination findings, the presence of fractures and the status of the outcome of the geriatric trauma patients admitted to the emergency department of an educational research hospital. Material and Methods: This study covers all the cases over 65 years who were admitted to emergency department with trauma between September 1 2011-31 August 2012. The demographic characteristics of the pati...

  9. Malaria in rural Mozambique. Part II: children admitted to hospital

    Directory of Open Access Journals (Sweden)

    Macete Eusébio

    2008-02-01

    Full Text Available Abstract Background Characterization of severe malaria cases on arrival to hospital may lead to early recognition and improved management. Minimum community based-incidence rates (MCBIRs complement hospital data, describing the malaria burden in the community. Methods A retrospective analysis of all admitted malaria cases to a Mozambican rural hospital between June 2003 and May 2005 was conducted. Prevalence and case fatality rates (CFR for each sign and symptom were calculated. Logistic regression was used to identify variables which were independent risk factors for death. MCBIRs for malaria and severe malaria were calculated using data from the Demographic Surveillance System. Results Almost half of the 8,311 patients admitted during the study period had malaria and 13,2% had severe malaria. Children under two years accounted for almost 60% of all malaria cases. CFR for malaria was 1.6% and for severe malaria 4.4%. Almost 19% of all paediatric hospital deaths were due to malaria. Prostration (55.0%, respiratory distress (41.1% and severe anaemia (17.3% were the most prevalent signs among severe malaria cases. Severe anaemia and inability to look for mother's breast were independent risk factors for death in infants younger than eight months. For children aged eight months to four years, the risk factors were malnutrition, hypoglycaemia, chest indrawing, inability to sit and a history of vomiting. MCBIRs for severe malaria cases were highest in children aged six months to two years of age. MCBIRs for severe malaria per 1,000 child years at risk for the whole study period were 27 in infants, 23 in children aged 1 to Conclusion Malaria remains the number one cause of admission in this area of rural Mozambique, predominantly affecting young children, which are also at higher risk of dying. Measures envisaged to protect children during their first two years of life are likely to have a greater impact than at any other age.

  10. Characteristics of patients with measles admitted to allied hospital rawalpindi

    International Nuclear Information System (INIS)

    Measles, a virus borne droplet infection, is one of the leading causes of death among young children worldwide despite presence of a safe and cost-effective vaccine. Objective of our study was to identify the characteristics of measles patients admitted to Allied Hospitals, Rawalpindi. Methods: This cross-sectional study was conducted amongst patients admitted with measles in paediatric units of Rawalpindi Medical College Allied Hospitals, Rawalpindi. A standard proforma was used to collect data from the respondents. Results: A total of 55 patients (mean age-29.36 months) with measles were included in the study. 65.5% children were vaccinated while 34.5% were not vaccinated. Among those vaccinated 14 were male. Out of the vaccinated children 52.6% were residents of middle class areas, 31.6% lower middle class area, 10.5% upper middle class areas and 5.3% rural areas. In 55.0% of patients who were vaccinated with at least one dose of measles at nine month of age the estimated calendar months of vaccination was March to April while in 30% the overall climatic period of vaccination was of summer (May to September). Twenty one study subjects were exposed to a case of measles in the family and thirty five out of all developed at least one known complication of the disease. Pneumonia was the most common complication reported in patients (63.6%) followed by diarrhoea (27.3%). Conclusion: Majority of the patients suffering from measles were not vaccinated and the most common reason for failure to immunize children was lack of awareness. Educated and well off fathers were more likely to get their children immunized. The vaccinated children who developed measles majority were vaccinated during months of March, April and May. (author)

  11. In-hospital mortality among a cohort of cirrhotic patients admitted to a Tertiary Hospital

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    Mohammad A Alsultan

    2011-01-01

    Full Text Available Background/Aim : To determine the mortality rate in a cohort of hospitalized patients with cirrhosis and examine their resuscitation status at admission. Materials and Methods : A retrospective chart review was conducted of patients with cirrhosis who were admitted to a tertiary care hospital in Riyadh, Saudi Arabia, from January 1, 2009, to December 31, 2009. Results: We reviewed 226 cirrhotic patients during the study period. The hospital mortality rate was 35%. A univariate analysis revealed that worse outcomes were seen in patients with advanced age or who had worse child-turcotte-pugh (CPT scores, worse model for end-stage liver disease (MELD scores, low albumin and high serum creatinine. Using a multivariate analysis, we found that advanced age (P=0.004 and high MELD (P=0.001 scores were independent risk factors for the mortality of cirrhotic patients. The end-of-life decision were made in 34% of cirrhotic patients, and the majority of deceased patients were "no resuscitation" status (90% vs. 4%, P<0.001. Conclusions : The relatively high mortality in cirrhotic patients admitted for care in a tertiary hospital, Saudi Arabia was comparable to that reported in the literature. Furthermore, end-of-life discussions should be addressed early in the hospitalization of cirrhotic patients.

  12. Cranial computed tomography findings in patients admitted to the emergency unit of Hospital Universitario Cajuru

    International Nuclear Information System (INIS)

    Objective: to identify and analyze the prevalence of cranial computed tomography findings in patients admitted to the emergency unit of Hospital Universitario Cajuru. Materials and methods: cross-sectional study analyzing 200 consecutive non contrast-enhanced cranial computed tomography reports of patients admitted to the emergency unit of Hospital Universitario Cajuru. Results: alterations were observed in 76.5% of the patients. Among them, the following findings were most frequently observed: extracranial soft tissue swelling (22%), bone fracture (16.5%), subarachnoid hemorrhage (15%), nonspecific hypodensity (14.5%), paranasal sinuses opacification (11.5%), diffuse cerebral edema (10.5%), subdural hematoma (9.5%), cerebral contusion (8.5%), hydrocephalus (8%), retractable hypodensity /gliosis/ encephalomalacia (8%). Conclusion: the authors recognize that the most common findings in emergency departments reported in the literature are similar to the ones described in the present study. This information is important for professionals to recognize the main changes to be identified at cranial computed tomography, and for future planning and hospital screening aiming at achieving efficiency and improvement in services. (author)

  13. Perfil epidemiológico do trauma de face dos pacientes atendidos no pronto socorro de um hospital público Epidemiology of facial trauma of patients admitted to a public hospital emergency department

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    Jefferson Lessa Soares de Macedo

    2008-02-01

    Full Text Available OBJETIVO: Avaliar os dados epidemiológicos e a localização dos traumas de face de pacientes atendidos no Hospital Regional da Asa Norte (HRAN, Brasília, Distrito Federal. MÉTODO: Trata-se de um estudo retrospectivo, realizado no pronto socorro do HRAN-DF, visando avaliar o perfil epidemiológico dos pacientes atendidos pela equipe da Unidade de Cirurgia Plástica vítimas de trauma de face no período de 1 de janeiro a 31 dezembro de 2004. RESULTADOS: O estudo compreendeu 711 pacientes, destacando-se o sexo masculino (72,8%. Quanto à causa, predominou a agressão física, seguida por acidente com veículos/motos. As quedas foram a causa predominante das lesões em crianças, mas verificou-se a participação cada vez maior da agressão física como mecanismo de trauma facial com o aumento da idade. A relação de homem:mulher foi de 3:1. A faixa etária mais atingida foi de 21 a 30 anos, representando 35,3% dos pacientes. As fraturas foram encontradas em 24,9% das lesões faciais. O nariz foi o local mais acometido nas fraturas de face (76,8%. CONCLUSÃO: A violência interpessoal foi a principal causa de trauma de face. A queda da própria altura mostrou-se como importante mecanismo de trauma nos extremos de idade.BACKGROUND: To evaluate the etiology, age, gender and location of the lesions of facial trauma in patients arriving at our hospital. METHODS: The data were evaluated through retrospective analysis of patient charts from January 1st to December 31st, 2004. RESULTS: The group comprised 711 patients with facial trauma. Blunt assault was the most common cause, followed by motor vehicle crashes. Falls were, by far, the predominant cause of injury in children, but with increasing age, assaults became more common. It was observed a male:female ratio of 3:1. The most frequent age group was the 21-30 years one, with 52%. Facial fractures were found in 24.9% of facial injuries. The most frequent fracture was nasal (76.8%. CONCLUSION

  14. Meningitis admitted to a military hospital: a retrospective case series.

    Science.gov (United States)

    Harrell, Travis; Hammes, John S

    2012-10-01

    Meningitis is a common admission diagnosis. No case series or descriptive studies on meningitis have recently been published. Additionally, no recent data exist on meningitis in the U.S. Military Health System. We reviewed charts of adult patients admitted to Naval Medical Center San Diego between January 2004 and December 2008 with an admission diagnosis of meningitis. Charts were excluded if they did not meet our case definition of meningitis, if missing data, or if meningitis was nosocomial or iatrogenic. We reviewed results of cerebrospinal fluid cultures during this period. We compared rates and characteristics, and outcomes of bacterial and aseptic meningitis. Two hundred twenty-one cases met our criteria. Of these, 208 were aseptic. Cerebrospinal fluid polymerase chain reaction testing was positive for enteroviruses and herpes simplex viruses in 42 (20.2%) and 17 (8.2%) cases, respectively. Of culture/polymerase chain reaction/serologically positive cases, the pathogens were Neisseria meningitidis (3), Streptococcus pneumoniae (3), viridans streptococci (2), Cryptococcus neoformans (2), Coccidioides immitis (2), and Mycobacterium tuberculosis (1). Three patients had poor outcomes: one died from S. pneumoniae and two had long-term neurologic deficits. Meningitis is a common admission diagnosis, but serious virulent pathogens are uncommon and adverse outcomes are rare.

  15. Comparison of nursing home residents admitted from home or hospital.

    OpenAIRE

    Tracey, F.; Crawford, V. L.; Montgomery, E. A.; Gilmore, D. H.; Beringer, T. R.

    1995-01-01

    A growing elderly population coupled with a reduction in hospital long term care has led to an increase in the independent nursing home sector. This is an expensive resource. Proper placement is therefore essential to ensure its efficient use. Prior to the introduction of care management there was no standard assessment procedure for admission to nursing home care from different sources. A nursing home population (n = 624) in North and West Belfast was studied and mental scores, levels of dis...

  16. Acute intoxication patients presenting to an emergency department in The Netherlands: admit or not? Prospective testing of two algorithms.

    NARCIS (Netherlands)

    Ambrosius, R.G.; Vroegop, M.P.; Jansman, F.G.A.; Hoedemaekers, C.W.E.; Aarnoutse, R.E.; Wilt, G.J. van der; Kramers, C.

    2012-01-01

    STUDY OBJECTIVE: After acute intoxication, most patients presenting to the emergency department (ED)--76% of them in The Netherlands--are admitted to hospital. Many will not need medical treatment on the ward. The authors tested two algorithms in the ED, based on vital parameters, ECG findings, and

  17. Bacteremia in burned patients admitted to Sina Hospital, Tabriz, Iran

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    Parviz Saleh

    2014-11-01

    Full Text Available Introduction: One of the most important causes of mortality and morbidity in burn wards is infection, and it is the major reason of death in burn injuries. There are several reasons that make burn victims predisposed to infection. The current study aimed to investigate the role of different factors that have an effect on bacteremia occurrence in burn patients and factors which are relevant to mortality in these patients. Methods: This descriptive-analytic study conducted in a 1 year period in Sina Hospital, Tabriz University of Medical Sciences, Iran, and 81 burn were included. We collected patients’ data about their age, body weight, cause of burn, lesion color, place and percentage of burn by getting history and studying of their files. Then we documented all interventions. Blood tests and cultures and colonies criteria were recorded. Results: In this study, 39 patients were male (48.1%, and 42 was female (51.9%. Mean age was 32.06 ± 17.46 years. In patients without bacteremia, 57 patients did not need catheterization (89.1%, however in patients with bacteremia 9 patients demanded catheter insertion (52.9%. In patients with bacteremia 12 patients survived (70.9%, however in the without bacteremia group 56 patients survived (92.2%. Then, the relationship between type of burn, wound infection and bacterial species investigated, (P = 0.650, P = 0.210 and P = 0.110 respectively. Conclusion: We concluded, invasive interventions increased bacteremia susceptibility in our studied burned patients. Mortality rate is directly related to bacteremia prevalence and increased by extent of burn area in these patients. The three most frequent microbial agents responsible for bacteremia were Pseudomona aeruginosa, Klebsiella and Staphylococcus aureus.

  18. Characteristics of Children Admitted to Hospital for Constipation

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    Sevim Savaşer

    2011-12-01

    Full Text Available Introduction: The aim of this study was to determine the sociodemographic characteristics of children with constipation, the causes of constipations in these children and the common practices of the parents to solve the problem of constipation.Materials and Methods: The population of the study was comprised of children aged 1 to 16 years followed with the diagnosis of functional constipation in the outpatient clinics of pediatric surgery at a university hospital in Istanbul between 1 June 2009-1 June 2010. A total of 146 children and their parents who agreed to participate in the study were included. The data of this descriptive cross-sectional study were obtained by using a questionnaire which was evaluated by appropriate statistical analysis.Results: About half of the children in the study were between 1-3 years old and females. We detected that in approximately half of the children constipation problem began during transition period from solid foods before age 1. The majority of children experienced abdominal pain, bloating, stool retention, fear and anxiety during bowel movements, hard/painful defecation, increased stool volume and fecal mass; and that though it varied according to age groups, most of the children drank olive oil and fruit juice to overcome constipation. Families of children in all age groups affected in similar proportions by constipation problem and this problem did not affect sibling relations.Discussion: Risk factors for constipation were found to be under 4 years of age, starting additional/solid foods before 6 months, starting school, having family members with constipation, feeling fear and anxiety during defecation and having symptoms arising from stool retention such as abdominal pain, abdominal bloating, and hard and painful defecation. (Journal of Current Pediatrics 2011; 9: 103-9

  19. Reduced in-hospital mortality after improved management of children under 5 years admitted to hospital with malaria

    DEFF Research Database (Denmark)

    Biai, Sidu; Rodrigues, Amabelia; Gomes, Melba;

    2007-01-01

    OBJECTIVE: To test whether strict implementation of a standardised protocol for the management of malaria and provision of a financial incentive for health workers reduced mortality. DESIGN: Randomised controlled intervention trial. SETTING: Paediatric ward at the national hospital in Guinea......)/month for nurses and $160 for doctors) and their compliance with standard case management was closely monitored. MAIN OUTCOME MEASURES: In-hospital mortality and cumulative mortality within 4 weeks of hospital admission. RESULTS: In-hospital mortality was 5% for the intervention group and 10% in the control group......-Bissau. All children admitted to hospital with severe malaria received free drug kits. PARTICIPANTS: 951 children aged 3 months to 5 years admitted to hospital with a diagnosis of malaria randomised to normal or intervention wards. INTERVENTIONS: Before the start of the study, all personnel were trained...

  20. Prospective Analysis of Geriatric Patients Admitted to Emergency Department With Trauma

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    Abdulkadir Akturk

    2013-08-01

    Full Text Available Objective: The aim of this study is to reveal the demographic characteristics, causes of trauma, physical examination findings, the presence of fractures and the status of the outcome of the geriatric trauma patients admitted to the emergency department of an educational research hospital. Material and Methods: This study covers all the cases over 65 years who were admitted to emergency department with trauma between September 1 2011-31 August 2012. The demographic characteristics of the patients such as, age, gender, date of application and as well as the causes of trauma, physical examination findings and outcome situation in the emergency department were evaluated. The study was performed prospectively. SPSS V.20 was used for statistical analysis of the data obtained. Results: Total 175 patients were included to the study, 74 were male (42.28% and 101 were female (57.72%. The mean age of male patients were 75.01 ± 6.557 while the mean age of female patients were 76.10 ± 7.353. The most common cause of trauma in both gender was falls. This rate was 91.1% in female and 8.9% in male patients. 40.6% of the female patients and 27% of the male patients were admitted to the hospital before because of any trauma. The most common form of trauma according to exposed body localization in both gender was extremity traumas. It was seen in 51.5% of the females and 56.8% of the males. 30 female patients (29.7% and 13 male patients (17.6% had fracture in limbs. 78.3% of all patients were discharged from the emergency department and 21.7% of the patients were hospitalised. None of the patients were died in emergency department and none of the patients were referred to another institution from the emergency department. Total 38 patients were hospitalised, 32 of them were discharged, 2 of them were referred to another institution, and 4 of them were died. 26 of 38 hospitalised patients had undergone surgery while 20 of them were orthopedic surgeries

  1. Focused cardiac ultrasound in the emergency department for patients admitted with respiratory symptoms

    DEFF Research Database (Denmark)

    Laursen, C. B.

    2015-01-01

    In patients admitted with respiratory failure, a large proportion is diagnosed incorrectly in the emergency department and an even larger proportion seems to receive inappropriate treatment. Inappropriate initial treatment of these patients in the emergency department is associated with increased...

  2. Risk Factors for Recurrent Hypoglycemia in Hospitalized Diabetic Patients Admitted for Severe Hypoglycemia

    OpenAIRE

    Lin, Yen-Yue; Hsu, Chin-Wang; Sheu, Wayne Huey-Herng; Chu, Shi-Jye; Wu, Chin-Pyng; Tsai, Shih-Hung

    2010-01-01

    Purpose Severe hypoglycemia can result in neural damage, impaired cognitive function, coma, seizures, or death. The decision to admit diabetic patients after initial treatment in the emergency department remains unclear. Our purpose is to identify risk factors for developing recurrent hypoglycemia in diabetic patients admitted for severe hypoglycemia. Materials and Methods We reviewed the records of 233 subjects (92 males, 141 females; mean age, 74.1 ± 9.8 years) with type 2 diabetes treated ...

  3. Risk of low back pain in people admitted to hospital for traffic accidents and falls.

    OpenAIRE

    Walsh, K; Cruddas, M.; Coggon, D.

    1992-01-01

    STUDY OBJECTIVE--The aim was to assess the risk of back symptoms in people admitted to hospital because of traffic accidents and falls. DESIGN--The study was a cross sectional survey with information collected by postal questionnaire. Main outcome measures were associations between hospital admission for a traffic accident or fall and reported first onset of back symptoms at the same age and at later ages. SETTING--General practices in seven towns and one rural district. SUBJECTS--1172 men an...

  4. Bacteriology in acute exacerbation of chronic obstructive pulmonary disease in patients admitted to hospital

    DEFF Research Database (Denmark)

    Larsen, Mette V; Janner, Julie H; Nielsen, Susanne D;

    2009-01-01

    We investigated the bacterial flora and antimicrobial sensitivity in sputum from patients admitted to hospital with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in order to recommend the best empirical treatment for these patients. The survey was a retrospective study of a...... for AECOPD we recommend either cefuroxime for intravenous treatment or amoxicillin-clavulanate for oral treatment....

  5. Factors predicting early outcome in patients admitted at emergency department with severe head trauma

    Institute of Scientific and Technical Information of China (English)

    Rejeb Belfekih Imen; Chakroun Olfa; Chtara Kamilia; Boujelbene Meriam; Ksibi Hichem; Chaari Adel; Bahloul Mabrouk; Rekik Noureddine

    2015-01-01

    Objective:To determine predictive factors of early mortality among severe traumatic brain injury in emergency department. Methods: This study is based on a retrospective analysis of 198 admitted in emergency depatment with severe head injury (Glasgow coma scale score≤8) of an university hospital (Sfax, Tunisia). Basic demographic, clinical, biological and radiological data were recorded on admission and during emergency department stay. Results: Forty two patients were died. Univariate analysis showed that the presence of shock, cardiac arrest, bilateral mydriasis, high value of injury severity score and low value of Glasgow coma scale were associated with mortality. Moreover, meningeal hemorrhage, cerebral and subdural haematoma were associated with poorer outcome. Multivariate analysis showed that factors associated with a poor prognosis were cardiac arrest cerebral and the presence of cerebral haematoma. Conclusions: Improving pre-hospital care and ovoid futile resuscitation to given priority in resource allocation and urgent CT scan of the head to look for operable mass lesions as early detection should improve the prognosis of severe head injury at emergency department.

  6. CLINICAL PROFILE OF MEASLES IN CHILDREN ADMITTED TO A RURAL TERTIARY CARE HOSPITAL

    OpenAIRE

    Deepa

    2015-01-01

    Measles affects about 20 million people a year. Even with greater than 80% immunization cover, the number of children with measles has registered a steep rise. A retrospective chart review was carried out on all cases of measles admitted to the paediatric wards of a tertiary care medical college hospital in a rural area in north Kerala. A total of 31 cases of measles (n=31) were admitted to the paediatric ward. Age at admission of 67.8% of the patients was above 6 years. ...

  7. Evaluation of pregnant patients admitted to the emergency department with suicide attempt

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    Yılmaz Zengin

    2015-06-01

    Full Text Available Objective: In the pregnancy period, the incidence of suicide attempt is lower compared to other life-periods. However, according to the recent studies, suicide attempts may lead life-threatening consequences in high-risk pregnant women. The aim of this study is to compare pregnant patients admitted to the emergency department for suicide attempt in terms of their sociodemographic and clinical properties and suicide attempt methods. Methods: In this study, 56 patients admitted to the emergency department of university for suicide attempt between January 1, 2009, and December 31, 2014, were included and they were classified according to suicide attempt methods into 2 groups as violent ones. Group 1 included violent methods as hanging, jumping, shooting and Group 2 included non-violent method as drugs. The study was a retrospective cross-sectional study. The sociodemographic, psychiatric and clinical properties of the patients were identified by patient registry system and patient files, and inter-group differences were compared. Results: In this study, 15 (26.7% patients in the violent suicide attempt group, and 41 (73.3% patients in the non-violent suicide attempt group, totally 56 patients were included. In the non-violent suicide attempt group, cigarette smoking, suicide attempt due to boredom, and live birth was significantly higher as compared to violent group; hospitalization period and fetal death was lower (p=0.04; p=0.006; p=0.004; p=0.004, respectively. Conclusion: Most of our pregnant suicide attempt patients are in the non-violent group, however, violent suicide attempt increased hospitalization period and fetal mortality significantly. J Clin Exp Invest 2015; 6 (2: 115-120

  8. The effect of hospital volume on mortality in patients admitted with severe sepsis.

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    Sajid Shahul

    Full Text Available IMPORTANCE: The association between hospital volume and inpatient mortality for severe sepsis is unclear. OBJECTIVE: To assess the effect of severe sepsis case volume and inpatient mortality. DESIGN SETTING AND PARTICIPANTS: Retrospective cohort study from 646,988 patient discharges with severe sepsis from 3,487 hospitals in the Nationwide Inpatient Sample from 2002 to 2011. EXPOSURES: The exposure of interest was the mean yearly sepsis case volume per hospital divided into tertiles. MAIN OUTCOMES AND MEASURES: Inpatient mortality. RESULTS: Compared with the highest tertile of severe sepsis volume (>60 cases per year, the odds ratio for inpatient mortality among persons admitted to hospitals in the lowest tertile (≤10 severe sepsis cases per year was 1.188 (95% CI: 1.074-1.315, while the odds ratio was 1.090 (95% CI: 1.031-1.152 for patients admitted to hospitals in the middle tertile. Similarly, improved survival was seen across the tertiles with an adjusted inpatient mortality incidence of 35.81 (95% CI: 33.64-38.03 for hospitals with the lowest volume of severe sepsis cases and a drop to 32.07 (95% CI: 31.51-32.64 for hospitals with the highest volume. CONCLUSIONS AND RELEVANCE: We demonstrate an association between a higher severe sepsis case volume and decreased mortality. The need for a systems-based approach for improved outcomes may require a high volume of severely septic patients.

  9. The epidemiological profile of pediatric patients admitted to the general intensive care unit in an Ethiopian university hospital

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    Abebe T

    2015-01-01

    Full Text Available Teshome Abebe, Mullu Girmay, Girma G/Michael, Million Tesfaye Department of Anesthesia, Jimma University, Jimma, Ethiopia Background: In least developing countries, there are few data on children's critical care. This makes the provision of aid and improvement of outcome difficult. Objectives: To describe admission and outcome patterns of children managed in a general intensive care unit at Jimma University Specialized Hospital (JUSH, Ethiopia, over a 5-year period. Methods: A retrospective cross-sectional study design was used. All children from birth to 14 years of age who were admitted to the general ICU of the hospital from 2009–2013 were included. Patient charts and ICU documentation log were reviewed. Results: A total of 170 children were admitted to the ICU of JUSH over the study period. The greater share was taken by males (54.7%, with a male-to-female ratio of 1.2:1. The overall mortality rate was 40%. The majority of the children were in the age range of 10–14 years (38.8%. Of the total number of patients admitted, 34.7% were trauma cases, 45.8% of whom died. The highest percentage, 69.5%, of trauma patients were admitted for head injuries. Among the trauma cases, burn and polytrauma were the second and third leading causes (15.3% of admission. Postoperative patients and medical patients accounted for the rest of the admitted cases (28.2% and 27.6% of the cases respectively. Conclusion: The leading cause of admission and death was trauma. Postoperative and medical causes of admission were also significant. The mortality rate in the ICU was very high, and this could be due to various factors. Further research benchmarking and interventions are highly recommended. Keywords: trauma, critical care, pediatric, ICU, ventilation, oxygenation

  10. Etiologies and Management of Aseptic Meningitis in Patients Admitted to an Internal Medicine Department.

    Science.gov (United States)

    Jarrin, Irène; Sellier, Pierre; Lopes, Amanda; Morgand, Marjolaine; Makovec, Tamara; Delcey, Veronique; Champion, Karine; Simoneau, Guy; Green, Andrew; Mouly, Stéphane; Bergmann, Jean-François; Lloret-Linares, Célia

    2016-01-01

    Several studies have focused on the clinical and biological characteristics of meningitis in order to distinguish between bacterial and viral meningitis in the emergency setting. However, little is known about the etiologies and outcomes of aseptic meningitis in patients admitted to Internal Medicine.The aim of the study is to describe the etiologies, characteristics, and outcomes of aseptic meningitis with or without encephalitis in adults admitted to an Internal Medicine Department.A retrospective cohort study was conducted in the Internal Medicine Department of the Lariboisière Hospital in Paris, France, from January 2009 to December 2011. Clinical and biological characteristics of aseptic meningitis were recorded. These included cerebrospinal fluid analysis, results of polymerase chain reaction testing, final diagnoses, and therapeutic management.The cohort included 180 patients fulfilling the criteria for aseptic meningitis with (n = 56) or without (n = 124) encephalitis. A definitive etiological diagnosis was established in 83 of the 180 cases. Of the cases with a definitive diagnosis, 73 were due to infectious agents, mainly enteroviruses, Herpes Simplex Virus 2, and Varicella Zoster Virus (43.4%, 16.8%, and 14.5% respectively). Inflammatory diseases were diagnosed in 7 cases. Among the 97 cases without definitive diagnoses, 26 (26.8%) remained free of treatment throughout their management whereas antiviral or antibiotic therapy was initiated in the emergency department for the remaining 71 patients. The treatment was discontinued in only 10 patients deemed to have viral meningitis upon admission to Internal Medicine.The prevalence of inflammatory diseases among patients admitted to internal medicine for aseptic meningitis is not rare (4% of overall aseptic meningitis). The PCR upon admission to the emergency department is obviously of major importance for the prompt optimization of therapy and management. However, meningitis due to viral agents or

  11. Comparison of mortality in patients with acute myocardial infarction accidentally admitted to non-cardiology departments versus that in patients admitted to coronary care units

    DEFF Research Database (Denmark)

    D'Souza, Maria; Saaby, Lotte; Poulsen, Tina S;

    2014-01-01

    The aim of this study was to prospectively investigate the clinical characteristics including symptoms and long-term mortality in patients with acute myocardial infarction (AMI) accidentally admitted to non-cardiology departments (NCDs). For comparison, similar observations in patients admitted...

  12. The relationship of air pollution and asthma patients admitted to hospitals in Kermanshah (2008-2009

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    Razieh Khamutian

    2015-01-01

    Full Text Available Background: Industrialization and urbanization have had a devastating impact on public health. Asthma is considered as one of the major challenges of public health. The purpose of this study was to determine the association between air pollution and the number of asthma patients admitted to hospitals in Kermanshah, Iran. Methods: In this cross-sectional and ecological study, the data on the number of asthma patients, the concentration levels of air pollutants and weather conditions were collected from the city of Kermanshah. To determine the association between asthma patients admitted to hospitals and air pollutants, Poisson regression was used (P<0.05. Results: according to the statistical analysis, air pollutants had significant correlation with each other. Based on the results of multiple Poisson regression, among air pollutants CO and O3 were significantly correlated with the number of asthma patients referred to hospitals, with relative risk of 1.18 and 1.016, respectively, and based on the results of single Poisson regression, among air pollutants NOx, NO, NO2 and CO were significantly correlated with the number of asthma patients referred to hospitals with relative risk of 1.011, 1.012, 1.054 and 1.247, respectively. Conclusion: according to the results of the present study, there was a significant association between air pollutants (mainly carbon monoxide and ozone and the total number of asthma patients referred to the hospitals in Kermanshah.

  13. The pattern of neurological disorders in patients admitted to El shaab teaching hospital

    International Nuclear Information System (INIS)

    This thesis was designed to study the pattern of neurological disorders of admitted patients to the neurology centre at El shaab teaching hospital in the period from january 1997 to december 1998. 402 cases were admitted. (35%) were in the age group 21-40, 30% in 41-60, 20% in 61-80, 14% in 0-20 and 1% in >81 males constituted 72% and females 28%. Cerebrovascular diseases top the list with 18.9%, followed by paraplegia's with 17.4%, peripheral neuropathies 11.7, (guillain barre was the most common). Brain space occupying lesions 10.4% (tumors and tuberculomas was the most common),movement disorders with 10% (Parkinson's disease was the most encountered), muscle disorders 6.2% (myasthenia gravis was the commonest). Ataxias 5.5%, headache and migraine was the least group of disorders

  14. Structured discharge procedure for children admitted to hospital with acute asthma: a randomised controlled trial of nursing practice

    OpenAIRE

    Wesseldine, L; McCarthy, P.; Silverman, M

    1999-01-01

    BACKGROUND—Discharge planning is becoming an important part of the management of childhood asthma in hospital. Readmission to hospital, although often inevitable, might represent a failure of the opportunity for intervention presented by a brief period of supervised care in hospital.
AIM—To examine the impact of a structured, nurse-led discharge package for children admitted to hospital with acute asthma on readmission to hospital, reattendance at the accident and emergen...

  15. Pattern of gastrointestinal diseases in adult patients admitted to Samtah General Hospital, Gizan region, Saudi Arabia

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    Aderoju Emmanuel

    1999-01-01

    Full Text Available To determine the relative frequencies of gastrointestinal diseases (GI in patients admitted to Samtah General Hospital, Gizan, the records of 2,442 adults admitted to the medical and surgical services for gastrointestinal diseases during the period 1413 to 1416 were analyzed retrospectively. 1,028 patients had acute appendicitis. The remaining 1,414 patients were admitted for various other GI diseases. In these 1,414 patients the commonest diseases were gastrointestinal infections (36.4%, peptic ulcer disease (19%, gall bladder disease (18.5%, viral hepatitis and its sequelae (20.7%. Despite the high prevalence of cholelithiasis, acute pancreatitis was uncommon (0.1 %. Inflammatory bowel disease was rare. There was no gender - related difference in the prevalence of gastrointestinal infections, peptic ulcer disease and carcinoma of the stomach. Males were significantly more afflicted than females with viral hepatitis (p< 0.0001, cirrhosis of the liver (p< 0.0001, hepatocellular carcinoma (p< 0.0005, variceal bleeding (p< 0.0005, and peptic ulcer bleeding (p< 0.005. As a large proportion of our patients had preventable diseases, it is expected that immunization and other public health measures will reduce the frequency of these diseases in the future.

  16. Admission Patterns and Outcomes of Paediatric Patients Admitted at the Diarrhea Unit of Muhimbili National Hospital (MNH )

    OpenAIRE

    Sanyiwa, John; Penza, Nuru

    2008-01-01

    To determine patterns of admissions due to diarrhea and their outcomes of paediatric patients at uhimbili National Hospital (MNH). A hospital-based prospective study including all children admitted to the Diarrhea Unit during the study period. Data was collected using content analysis checklists. Ethical clearance was sought from MNH and confidentiality in handling the information was observed. Data was analyzed using Epi-info 2002 statistical software. A total of 50 children were admitted d...

  17. Pattern of Pulmonary Involvement and Outcome of Aspiration Pneumonia in Patients with Altered Consciousness Admitted in Dhaka Medical College Hospital.

    Science.gov (United States)

    Chowdhury, R A; Azad, A K; Sardar, H; Siddiqui, M R; Saad, S; Rahman, S; Sikder, A S

    2016-01-01

    Aspiration is well recognized as a cause of pulmonary disease and is not uncommon in patients with altered consciousness.The mortality rate of aspiration pneumonia is approximately 1% in outpatient setting and upto 25% in those requiring hospitalization. This study was done to see the pattern of pulmonary involvement and outcome of aspiration pneumonia in patients with altered consciousness admitted in medicine department of a tertiary care hospital in our country. This was a prospective observational study conducted among the 52 adult patients of aspiration pneumonia with altered consciousness admitted in the medicine department of Dhaka Medical College Hospital (DMCH), during June 2010 to December 2010. Aspiration pneumonia was confirmed by clinical examination and laboratory investigations. Hematologic measurements (TC of WBC, Hb%, ESR, platelet count), chest X-ray, blood gas analysis, blood urea, creatinine and random blood sugar, sputum for Gram staining, sputum for culture sensitivity and blood culture were done in all patients.Assessment of altered conscious patient was done by application of the Glasgow Coma Scale. Case record forms with appropriate questionnaire were filled for all patients. The mean±SD age was 57.42±13.63 years with ranged from 25 to 90 years. Out of 52 patients, 37(71.15%) patients were male and 15(28.85%) patients were female. Following aspiration 76.92% patients developed pneumonitis, 13.46% patients developed lung abscess and only 9.62% patients developed ARDS. Most (33) of the patients had opacity in right lower zone and 13 patients had opacity in the left lower zone, 6 patients had opacity in right mid zone. Only 10 patients had opacity in both lower zones. In this study overall mortality rate was 23%. If only one lobe was involved radiologically, mortality was 8.33%. If two or more lobes on one or both sides were involved, mortality was in the range of 25-91%.

  18. Psychological Dimensions in Patients admitted in Imam Khomeini General Hospital in Tehran

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    Ali Reza Shalbafan

    2010-06-01

    Full Text Available "n Objectives:The aim of this study was to assess the mental health of patients admitted in Internal medicine, Surgery and Gynecology wards of Imam Khomeini Hospital of Tehran in 2009. Method:The symptom chec klist-90-R (SCL-90-R questionnaire was administered for 93 patients in internal, surgical and gynecological wards of Imam Khomeini hospital in 2009.  Result: In this study, the mean age was (32.89 ± 12.69 with a range of 14 to 70 years old. 42 patients (44.7% were male and 52 (59.6% were female ; 56 patients (59.6% were married and 37 (40.4% were single. There is a significant relationship between gender& marital status (P<0.04. According to cut of point of Global Severity Index (GSI which was reported in a study (0.7, 58.1 percent of the patients have different levels of psychiatric problems (GSI>0.7. In psychiatric symptoms, somatization has the highest prevalence (90.5% ,and depression (77.9% and anxiety (71.6% have a higher prevalence than other symptoms among patients who suffer from psychiatric problems. "n Conclusion:According to the result of the current study, there is a high prevalence of psychiatric problems among the admitted patients in Internal medicine, Surgery and Gynecology wards of a general hospital according to SCL-90-R questionnaire. This study advises that more attention be given to mental health in general  hospitals.

  19. [Determinants of induced abortion among poor women admitted to hospitals in a locality of northeastern Brazil].

    Science.gov (United States)

    Fonseca, W; Misago, C; Correia, L L; Parente, J A; Oliveira, F C

    1996-02-01

    In Brazil, abortion is legally allowed only when it is necessary to save a woman's life or when pregnancy has occurred following rape. Despite this law, induced abortion is widely carried out. This study presents the findings as to the determinants of 2,084 abortions admitted to two major obstetric hospitals in Fortaleza, Brazil, between October 1992 and September 1993. Most of these women (2,074) have admitted an attempt to terminate pregnancy and 10 women were classified as induced abortion cases based on the findings of signs of intervention such as cervical laceration, perforation or foreign bodies in the vagina or uterus. The study findings indicate that self-administration of medicines plays an important role in terminating pregnancy. Among the 2,074 women who admitted to terminating the pregnancy 66% reported using misoprostol to induce abortion. Misoprostol, a prostaglandin E1 analogue indicated for ulcer treatment, has been widely used as an abortifacient by women in Brazil. Misoprostol has some uterine effects but it is not effective in inducing abortion. Among women who were hospitalized for complications resulting from abortion about 59.7% were 20 to 29 years old and 22.6% were aged less than 20. The majority of the women (91.6%) were Catholic and only 4.3% were illiterate. About 62% of the abortion cases lived alone or did not have a stable partner. Most of the women (59.2%) reported less than 2 live births and 11.8% had experienced a previous abortion; 61.1% of the women were not using a contraceptive method at the time of conception. The main reasons for this were "fear of side effects", "did not expect to have sexual intercourse" and "did not expect to get pregnant". The authors suggest that the situation of a high rate of self-inflicted abortion may be changed by the application of an appropriate contraceptive and reproductive health programme. PMID:9008918

  20. Hospital-admitted COPD patients treated at home using telemedicine technology in The Virtual Hospital Trial

    DEFF Research Database (Denmark)

    Jakobsen, Anna Svarre; Laursen, Lars C; Østergaard, Birte;

    2013-01-01

    Recent reviews suggest that telemedicine solutions for patients with chronic obstructive pulmonary disease (COPD) may prevent hospital readmissions and emergency room visits and improve health-related quality of life. However, the studies are few and only involve COPD patients who are in a stable...... phase or in-patients who are ready for discharge. COPD patients hospitalized with an acute exacerbation may also benefit from telemedicine solutions. The overall aim is to investigate a telemedicine-based treatment solution for patients with acute exacerbation of COPD at home as compared to conventional...

  1. CLINICAL PROFILE OF MEASLES IN CHILDREN ADMITTED TO A RURAL TERTIARY CARE HOSPITAL

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    Deepa

    2015-06-01

    Full Text Available Measles affects about 20 million people a year. Even with greater than 80% immunization cover, the number of children with measles has registered a steep rise. A retrospective chart review was carried out on all cases of measles admitted to the paediatric wards of a tertiary care medical college hospital in a rural area in north Kerala. A total of 31 cases of measles (n=31 were admitted to the paediatric ward. Age at admission of 67.8% of the patients was above 6 years. The average age of the sample was 7.52 years (S. D = 3.19. Amongst the clinical features, fever and rash were seen in 100%, coryza in 83.8% and conjunctivitis in 67.7%. Koplik spots, pathognomonic of measles were seen only in 32.3%. About 61.3% of those with measles were previously immunized. Regarding the vitamin A supplementation status , only 19.4% of the childr en were administered vitamin A. The fact that 61% of children who developed measles had actually received measles vaccination during infancy , and that majority (67% of them were >6 years at the time of presentation , points to the drop in the protective im munity , after a single dose of measles vaccine, as age advances. To conclude , Measles is now a re - emerging infectious disease and a second dose of measles vaccine to boost up the existing immunity would turn out to be a corner stone in subsequent measles e limination.

  2. Severe metapneumovirus infections among immunocompetent and immunocompromised patients admitted to hospital with respiratory infection.

    Science.gov (United States)

    Souza, Juliana Sinohara; Watanabe, Aripuana; Carraro, Emerson; Granato, Celso; Bellei, Nancy

    2013-03-01

    Human metapneumovirus (hMPV) is considered an important cause of acute respiratory infections. hMPV can cause morbidity in hematopoietic stem cell transplant recipients and recent research has demonstrated that it is an important virus in patients admitted to hospital with respiratory infections and suspected of having pandemic 2009 influenza A (H1N1pdm09) virus. The purpose of this study was to investigate infections caused by hMPV in two groups of patients admitted to hospital: Immunocompromized patients with a potential risk of severe outcomes and immunocompetent patients with severe acute respiratory syndrome. A total of 288 samples were tested: 165 samples were collected from patients with suspected influenza A (H1N1) pdm09 infection during the first pandemic wave in 2009; and 123 samples were collected from patients of a hematopoietic stem cell transplantation program in 2008-2009. Amplification of the hMPV genes was performed by polymerase chain reaction. This was followed by sequencing and phylogenetic analysis. hMPV was detected in 14.2% (41/288) of all samples: 17% (28/165) of immunocompetent patients with suspected H1N1 infection and 10.6% (13/123) among hematopoietic stem cell transplant recipients. hMPV accounted for 12.1% (8/66) of immunocompetent adults patients with severe respiratory infections (median age, 55.9 years). Two hMPV subtypes were identified, A2 (26.9%; 7/26) and B2 (73.1%; 19/26) but no difference was observed between the patient groups in terms of age or immunosuppression level. This study highlights the significance of hMPV in immunocompetent adult patients with severe infections and further investigations are recommended for understanding the impact of this virus.

  3. Historical review: First facial pain patient admitted to Massachusetts General Hospital, February 1823 and first case series.

    Science.gov (United States)

    Keith, David A; Dodson, Thomas B; Kaban, Leonard B

    2013-08-01

    Founded in 1811, the Massachusetts General Hospital recently celebrated its bicentennial. The War of 1812 delayed construction of the building so the first patient actually was admitted to the hospital 10 years later, on September 3, 1821. By 1823, the 60 hospital beds were full. Patient 66 was admitted on February 28, 1823, and his hospital course, as described in the admissions book, was transcribed for the Massachusetts General Hospital bicentennial celebration. That case history is reproduced and a case series of 6 similar patients published in 1828 by Dr John Warren, surgeon-in-chief and a founder of the hospital, is presented. In this report, the authors comment on the diagnosis, treatment, and outcome of these patients in the context of the contemporaneous health care environment and in light of the current knowledge of facial pain disorders. This article was adapted from the authors' commentary for the bicentennial celebration. PMID:23866949

  4. The satisfaction levels of the patients admitted to a university hospital

    Directory of Open Access Journals (Sweden)

    Abdurrahim Emhan

    2010-09-01

    Full Text Available Objectives: The aim of this study was to determine various aspects of satisfaction levels and related socio-demographical variables of both inpatients and outpatients admitted to a university hospital.Material and Method: Two different questionnaires were prepared to evaluate the satisfaction levels of both inpa-tients and outpatients. Face to face interview was conducted with a total of 820 patients; 379 (%46.2 inpatients and 441 (%53.8 outpatients, to fill out the prepared questionnaires.Results: Among the inpatients 79.5% reported that they were generally satisfied at the level of or above their expec-tations, whereas it was the case for 76.2% of outpatients in the study. When the satisfaction levels of the inpatients and outpatients were compared; inpatients were more satisfied with the care provided by their doctors, the radiology services and patient security than the outpatients. In terms of general hospital hygiene outpatients reported a greater satisfaction than the inpatients. Among inpatients, the patients with advanced age were found to be more satisfied in terms of meal quality and hygiene of the clinic than the younger patients. Literate patients reported higher degrees of satisfaction of general hygiene and intent to re-prefer the hospital than high school graduates. Almost half of the pa-tients in the study (48% were from lower socioeconomical status and in some dimensions they reported less satis-faction than the patients from higher socioeconomical status.Conclusion: Low socioeconomical status is associated with decreased patient satisfaction. Although general satis-faction levels of inpatients and outpatients are similar, the care provided by doctors, the radiology services, patient security and general hospital hygiene may show some differences between these two groups.

  5. The characteristics of advanced cancer patients followed at home, but admitted to the hospital for the last days of life.

    Science.gov (United States)

    Mercadante, Sebastiano; Masedu, Francesco; Valenti, Marco; Mercadante, Alessandro; Aielli, Federica

    2016-08-01

    Information regarding advanced cancer patients followed at home who are admitted to the hospital in the last days of life are lacking. The aim of this study was to assess the characteristics of patients who were hospitalized in the last days of life after being assisted by a home palliative care team. The secondary outcome was to identify possible risk factors for hospitalization. The charts were analyzed of a consecutive sample of advanced cancer patients admitted to hospital wards in the last days of life after being followed at home by a palliative care team. Of 550 consecutive patients followed at home, 138 (25.1 %) were admitted to the hospital. Younger patients were more likely to die in the hospital. In a logistic risk analysis adjusted for age, patients with lung and head-neck cancer were more likely to die in the hospital. Patients having a female relative or a female consort as a caregiver were more likely to die at home. CAGE-positive patients (7.25 %), and patients with a shorter period of home assistance were more likely transported to hospital before dying (p = 0.00 and p risk factors of hospitalization at the end of life for advanced cancer patients followed at home. PMID:26895033

  6. PROFILE OF HUMAN RABIES CASES ADMITTED AT EPIDEMIC DISEASES HOSPITAL, BANGALORE, INDIA

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    Mahendra

    2014-05-01

    Full Text Available OBJECTIVES: The present study was carried out with the following objectives 1. To describe the socio demographic profile of human rabies cases 2. To describe the pattern of clinical presentation 3. To assess the quality of data in the case record forms of the human rabies cases TYPE OF STUDY: Case Record Analysis. MATERIAL AND METHODS: Case records of suspect human rabies cases. Data analyzed using proportions. STUDY PERIOD: April 2009 to March 2012. RESULTS: 75 suspected human rabies cases were admitted to the epidemic diseases hospital during the study period. 64 (85.33% of the cases were from the state of Karnataka, 11 (14.67% were from Andhra Pradesh and Tamilnadu. 61 (81.33% were males. 17 (22.67% were children aged ≤ 15 years. 44 (58.67% of the cases were from rural areas. In 71 (94.67% of the victims, the exposure was to dogs. Mean duration of time since bite to seeking admission was 118 days. Category of the wound was documented for 43 (57.33% of the 75 cases. Of these, 40 (93.02% had category III exposure. 61 (81.33% of the case records had data regarding wound toilet and only 12 (19.68% of the victims had performed wound toilet. Only 1 (1.47% of the victims had received rabies immunoglobulin, but had not completed the scheduled vaccination regimen. 43 (67.19% had not received any post exposure prophylaxis. Clinical signs and symptoms of rabies had been entered in 68 (90.67% of the case records, and all had hydrophobia. CONCLUSION: Most of the suspected human rabies cases admitted had not received post exposure prophylaxis or had received incomplete post exposure prophylaxis. The data entered into the case record forms of the patients was mostly incomplete.

  7. Psychiatric disorders and clinical correlates of suicidal patients admitted to a psychiatric hospital in Tokyo

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    Ishimoto Kayo

    2010-12-01

    Full Text Available Abstract Background Patients admitted to a psychiatric hospital with suicidal behavior (SB are considered to be especially at high risk of suicide. However, the number of studies that have addressed this patient population remains insufficient compared to that of studies on suicidal patients in emergency or medical settings. The purpose of this study is to seek features of a sample of newly admitted suicidal psychiatric patients in a metropolitan area of Japan. Method 155 suicidal patients consecutively admitted to a large psychiatric center during a 20-month period, admission styles of whom were mostly involuntary, were assessed using Structured Clinical Interviews for DSM-IV Axis I and II Disorders (SCID-I CV and SCID-II and SB-related psychiatric measures. Associations of the psychiatric diagnoses and SB-related characteristics with gender and age were examined. Results The common DSM-IV axis I diagnoses were affective disorders 62%, anxiety disorders 56% and substance-related disorders 38%. 56% of the subjects were diagnosed as having borderline PD, and 87% of them, at least one type of personality disorder (PD. SB methods used prior to admission were self-cutting 41%, overdosing 32%, self-strangulation 15%, jumping from a height 12% and attempting traffic death 10%, the first two of which were frequent among young females. The median (range of the total number of SBs in the lifetime history was 7 (1-141. Severity of depressive symptomatology, suicidal intent and other symptoms, proportions of the subjects who reported SB-preceding life events and life problems, and childhood and adolescent abuse were comparable to those of the previous studies conducted in medical or emergency service settings. Gender and age-relevant life-problems and life events were identified. Conclusions Features of the studied sample were the high prevalence of affective disorders, anxiety disorders and borderline PD, a variety of SB methods used prior to admission

  8. TRANSFUSION REQUIREMENT AND COMPLICATION IN CHILDREN ADMITTED IN A TERTIARY HOSPITAL

    Directory of Open Access Journals (Sweden)

    Booma

    2016-05-01

    Full Text Available BACKGROUND Indications for transfusion include symptomatic anaemia, haemolytic anaemia, haematological malignancy, acute sickle cell crisis, and acute blood loss of more than 30 percent of blood volume, sepsis, etc. Fresh frozen plasma infusion can be used for reversal of anticoagulant effects. Platelet transfusion is indicated to prevent haemorrhage in patients with thrombocytopenia or platelet function defects. Cryoprecipitate is used in cases of hyperfibrinogenaemia, which most often occurs in the setting of massive haemorrhage or consumptive coagulopathy, factor VIII deficiency and Von Willebrand disease as an alternate to specific component therapy. Transfusion-related infections are less common than non-infectious complications. All non-infectious complications of transfusion are classified as non-infectious serious hazards of transfusion. Acute complications occur within minutes to 24 hours of the transfusion, whereas delayed complications may develop days, months or even years later. Blood transfusion can be a lifesaving procedure, but it has risks, including infectious and non-infectious complications. There is debate in the medical literature concerning the appropriate use of blood and blood products. Clinical trials investigating their use suggest that waiting to transfuse at lower haemoglobin levels is beneficial. This study will consider the indications for transfusion of blood and blood products, and will discuss common non-infectious complications associated with transfusion. Requirement of blood and blood component transfusions in children admitted in a tertiary care hospital and its related complications. OBJECTIVE To evaluate the pattern of transfusion requirement in children admitted in a tertiary care hospital and the frequency of transfusion related complications. METHODS Children of various age groups presenting with clinical profile like symptomatic anaemia, haemolytic anaemia, haematological malignancy, acute sickle cell

  9. Dengue fever in patients admitted in tertiary care hospitals in Pakistan

    International Nuclear Information System (INIS)

    Objectives: To assess the gaps in the diagnosis and management of dengue fever cases. Methods: The retrospective descriptive analytical study was done with a case record analysis of patients with dengue fever admitted from January to December 2010 at five tertiary care hospitals in different Pakistani cities. Using a questionnaire, information was gathered on demography, haematological profile, management, use of blood and platelet transfusions and the outcome. For comparison, data of serologically-confirmed dengue patients from a private laboratory in Islamabad was collected to see the age, gender and month-wise distribution of cases tested over the same period. SPSS 16 was used for statistical analysis. Results: Out of the 841 confirmed dengue cases, 514 (79%) were males and 139 (21%) females. The overall mean age was 31.3+-14.0 years. Dengue fever was seen in 653 (78%) and dengue haemorrhagic fever (DHF) in 188 (22%) patients. Most cases were between 20 and 49 years of age. A gradual increase in dengue fever and dengue haemorrhagic fever was seen from August, with a peak in October/November. Tourniquet test was done only in 20 (2.3%) cases, out of which 11 (55%) were positive and 9 (45%) were negative. Serial haematocrit was not done in any case. Total deaths were 5 (0.6%). Conclusions: Most cases were seen in October/November with the majority being in the 20-39 age group. Tourniquet test and serial haematocrit were infrequently used. No standard national guidelines were employed. (author)

  10. Evaluation of animal-related injuries from the perspective of 7423 cases admitted to Emergency Department

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    Erdal Demirtaş

    2016-03-01

    Full Text Available Objective: Animal-related injuries are major issues of public health in all over the world and in our country as well. These animal-related injuries may result in serious complications like infections. In our study we aimed to investigate the sociodemographic characteristics, the features of contact related to animal bites or exposure to rabies risk, prophylactic treatment strategies and appropriateness of post-exposure prophylaxis in patients with animal-related injuries. Method: This study was retrospectively designed by collecting data of the patients with animal related and bite wound injuries admitted to the emergency department of Ankara Training and Research Hospital during the years of 2010 and 2011. The data was analysed by using SPSS 11.5 software programme. Results: The study was consisted of 7423 patients. Animal related injuries were mostly seen in male patients (66.4% and the mean age of the patients was 31±18. These injuries were mostly during spring and summer. In 80.8% of the patients the injuries were due to animal bites. Of the 7423 patients; 69.8% were injured by dogs, 27.5% by cats and 0.2% by wild animals. The location of the bite wounds were in the upper extremities in 51.6%, lower extremities in 39.7%, head and neck in 4.6%, chest in 2.4% and back in 1.7% of the patients. Lacerations were the most common type of injury. Of the patients 43.6% received 2+1+1 rabies vaccination schedule, 7.1% received 2+1+1 rabies vaccination schedule and immunoglobulin, 12.9% received 5 dosage vaccination schedule. Of the patients 34.4% followed up for 10 days without any rabies prophylaxis. Conclusions: According to the results of our study; most of the animal related injuries are caused by dogs. Dogs mostly cause bite injuries whereas cats cause scatch injuries. Wounds are located generally in the extremities. Head and neck injuries are more common in pediatric group compared with other age groups. Rabies prophylaxis application

  11. In-hospital mortality and long-term survival of patients with acute intoxication admitted to the ICU

    NARCIS (Netherlands)

    Brandenburg, Raya; Brinkman, Sylvia; De Keizer, Nicolette F.; Meulenbelt, Jan; De Lange, Dylan W.

    2014-01-01

    OBJECTIVE: To assess in-hospital and long-term mortality of Dutch ICU patients admitted with an acute intoxication. DESIGN: Cohort of ICU admissions from a national ICU registry linked to records from an insurance claims database. SETTING: Eighty-one ICUs (85% of all Dutch ICUs). PATIENTS: Seven tho

  12. [Evaluation of the oropharyngeal tularemia cases admitted to our hospital from the provinces of Central Anatolia].

    Science.gov (United States)

    Uyar, Melek; Cengiz, Buğra; Unlü, Murat; Celebi, Bekir; Kılıç, Selçuk; Eryılmaz, Adil

    2011-01-01

    Tularemia caused by the bacterium Francisella tularensis is a zoonotic infection which has re-emerged in Turkey in recent years as water-borne endemics. Oropharyngeal form is the most frequently reported form of the disease from Turkey. The aim of this study was to evaluate the clinical and laboratory findings of oropharyngeal tularemia patients admitted to ear, nose & throat outpatient clinic between January-March 2010. A total of 10 patients (age range: 16-80 years, mean age: 43.9 years; nine were male) inhabiting in the provinces in Central Anatolia, Turkey, were admitted to our hospital with the complaints of fever, sore throat and painful cervical lump. They have been previously diagnosed as tonsillo-pharyngitis at different medical centers and empirical antibiotic therapy has initiated, however, their complaints have not recovered. Endoscopic laryngoscopic examination revealed that oropharynx, larynx and hypopharynx were normal. Physical examination of the neck yielded localized fixed masses with diameters between 2-7 cm. The lesions were localized at right submandibular (n= 4), upper jugular (n=3) and one of each at left posterior cervical, left submandibular and left jugulodigastric regions. The patients were hospitalized with the pre-diagnosis of "neck mass with unknown origin" for further investigation and treatment. The mean white blood cell count of the cases was 9730 (7500-15.100) cells/µl; the mean erythrocyte sedimantation rate was 68.7 (46-85) mm3/hours and the mean C-reactive protein level was 4.3 (1.5-7.4) µg/dl. Salmonella, Brucella, Toxoplasma gondii, rubella, cytomegalovirus, herpes simplex virus, Epstein-Barr virus and viral hepatitis serology did not indicate acute infections. Serum and tissue samples were sent to Refik Saydam National Public Health Agency in order to test for tularemia, namely culture, microagglutination test (MAT), direct fluorescence antibody (DFA) test and in-house polymerase chain reaction (PCR). All of the patients

  13. Intestinal parasitic infection among children and neonatus admitted to Ibn-Sina Hospital, Sirt, Libya.

    Science.gov (United States)

    Kasssem, Hamed H; Zaed, Hana Abdalsalam; Sadaga, Gazala A

    2007-08-01

    A total of 350 stool samples from 196 males and 154 female children and neonatus admitted in Ibn-Sina hospital, Sirt, were examined from June 2001 to May 2002, to determine the prevalence of intestinal parasites. Intestinal parasitic infections were identified in 196 (56%) of children and neonates. No intestinal helminthic parasites were detected but 13 intestinal protozoan parasites were detected. The most prevalent protozoan was Entamoeba histolytica /E. dispar (36.57%); Blastocystis hominis (12.57%), Giardia lamblia (10.29%), Isospora belli (3.14%) and Balantidium coli (0.86%), the latter was detected in non-Libyan children. The non-pathogenic ones were Entamoeba coli (15.14%), Endolimax nana (13.71%), Entamoeba hartmanni (4.29%), Chilomastix mesnilli (4.29%), Retortamonas intestinalis (3.43%), Dientamoeba fragilis (2%), Iodamoeba butschlii (0.86%) and Trichomonas hominis (0.86%). The result showed a significant difference exists between the prevalence of pathogenic and non-pathogenic protozoan parasites (P coli, E. nana, B. hominis and G. lamblia in both sexes of children, while the prevalence of other intestinal parasites were low in both sexes, significantly different existed in the prevalence of intestinal parasites between males and females children (t = 24.68; P < 0.05). Age groups had no effect on the prevalence of intestinal parasites (F = 0.66; P < 0.05). Significant differences existed in the prevalence between single and multiple infections with pathogenic protozoa. The socio-economic status of children parents revealed that high prevalence in children from medium socio-economic status. The family size had no significant effect on the prevalence of the intestinal parasites. PMID:17985574

  14. Epidemiology of admitted cases of childhood injuries in Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria

    Directory of Open Access Journals (Sweden)

    Ekwunife Okechukwu Hyginus

    2015-01-01

    Full Text Available Introduction: Injuries have become a leading cause of childhood death, and majority of these occur in developing countries. The range of injuries also varies among age groups, sex, populations and economies. Within the same population, injury pattern changes over time. Statistics of trauma from most developing countries are still not very many. To aid sound policies, documentation of trauma epidemiology from different cultures and geographies is still needful. Methodology: Hospital records of all children aged 18 years and below that presented between January 2007 and December 2011 were studied retrospectively. Results: A total of 217 patients were admitted, 125 (57.6% males and 92 (42.4% females. Multiple injuries occurred in 24 (11.1% of children. Road crashes accounted for the greatest number of injuries; 109 cases (50.2% followed by falls 60; (27.6%. Motor cycle related injuries accounted for 67 (61.5% of the 109 road traffic injuries. The age group most commonly affected is 0-5 years accounting for 98 (45.2% cases. Head injury was the commonest injury sustained 83 (33.9%. Majority of the injuries, 72 (66.1% occurred in or near home. Injuries were more frequent during the weekdays 132 (60.8% compared to the weekends 85 (39.2%. Long term functional or physical disability was seen in 62 (28.6% of cases. Six children died giving a mortality rate of 2.8%. Conclusion: Childhood trauma rate is still high, with motorcycle related road traffic accidents constituting a major cause. Education and enforcement of road traffic regulations and limiting motorcycle transportation may help in reducing the trauma rate in children.

  15. Liver stiffness and 30-day mortality in a cohort of patients admitted to hospital

    DEFF Research Database (Denmark)

    Lindvig, Kristoffer; Mössner, Belinda K; Pedersen, Court;

    2012-01-01

    Eur J Clin Invest 2011 ABSTRACT: Background  Transient elastography (TE) is a new noninvasive method to assess the degree of liver fibrosis by measuring liver stiffness. The objective of this study was to determine whether increased liver stiffness in patients admitted to medical wards was associ......Eur J Clin Invest 2011 ABSTRACT: Background  Transient elastography (TE) is a new noninvasive method to assess the degree of liver fibrosis by measuring liver stiffness. The objective of this study was to determine whether increased liver stiffness in patients admitted to medical wards...

  16. Analysis of injuries in children aged 0-4 years admitted to the emergency department of a Shantou hospital%汕头市某综合性医院0~4岁婴幼儿意外伤害原因分析

    Institute of Scientific and Technical Information of China (English)

    韩溟; 谢扬; 黄铿; 蔡桂嘉; 邹培标

    2014-01-01

    Objective To investigate the leading causes of injury in children aged 0-4 years .Methods 0-4 years old patients from January 2008 to December 2012 ,who admitted to Emergency Department of Second Affili-ated Hospital ,Shantou University Medical College ,were enrolled in this study .The causes of injury were ana-lyzed by single year using injury sub-mechanisms .Results The commonest five reasons of unintentional injuries in children aged 0-4 years were fall from tripping or stumbling (20 .6% ) ,fall involving playground equipment (15 . 8% ) ,traffic accident (15 .5% ) ,fall involving bed or other furniture (14 .3% ) ,and burn (11 .7% ) ,respectively . No sex difference was found in this study ( P>0 .05) .The leading cause of injury for children aged <1 was falls while being carried ,while ,falls involving playground equipment ranked first for children aged 3-4 years .Conclu-sion Fall from tripping or stumbling was the leading cause of unintentional injury in children aged 0-4 years , which need prevention strategy .%目的:分析汕头大学医学院第二附属医院意外伤害急诊就诊0~4岁婴幼儿意外伤害发生的原因及年龄特征,为开展低龄幼儿伤害预防干预提供参考依据。方法调查2008年1月至2012年12月期间汕头大学医学院第二附属医院意外伤害急诊就诊患儿的流行病学特征、意外伤害类型,探讨分析0~4岁年龄段儿童在较小年龄区间的伤害机制的差异。结果在该研究群体中,顺位前5位意外伤害原因依次为跑跳中跌倒或坠落(20.6%)、从活动器材中跌倒或坠落(15.8%)、交通事故(15.5%)、从床或其他家具上跌倒或坠落(14.3%)及烧烫伤(11.7%)。在这5个致伤因素中,男女比例差异无统计学意义。1岁以下的婴儿期的主要意外伤害来自从怀抱者或牵拉者中跌倒或坠落。随着年龄增长,坠落或跌倒主要发生在跑跳中或游戏的活动器材中

  17. Prognosis and risk factors for deterioration in patients admitted to a medical emergency department

    DEFF Research Database (Denmark)

    Henriksen, Daniel Pilsgaard; Brabrand, Mikkel; Lassen, Annmarie Touborg

    2014-01-01

    OBJECTIVE: Patients that initially appear stable on arrival to the hospital often have less intensive monitoring of their vital signs, possibly leading to excess mortality. The aim was to describe risk factors for deterioration in vital signs and the related prognosis among patients with normal...... presentation, 1440/4292 (33.6%) had all normal vital signs and were included in study, 44.0% were male, median age 64 years (5th/95th percentile: 21-90 years) and 446/1440 (31.0%) deteriorated within 24 hours. Independent risk factors for deterioration included age 65-84 years odds ratio (OR): 1.79 (95.......2-3.0%) among the non-deteriorating, hazard ratio 4.11 (95% CI: 2.38-7.10). CONCLUSIONS: Among acutely admitted medical patients who arrive with normal vital signs, 31.0% showed signs of deterioration within 24 hours. Risk factors included old age, Do-not-attempt-to-resuscitate order, admission from the open...

  18. Lab-score is a valuable predictor of serious bacterial infection in infants admitted to hospital.

    Science.gov (United States)

    Markic, Josko; Kovacevic, Tanja; Krzelj, Vjekoslav; Bosnjak, Nada; Sapunar, Ada

    2015-12-01

    Parents frequently bring their children to the Emergency Department (ED) because of the fever without apparent source (FWAS). To avoid possible complications, it is important to recognize serious bacterial infection (SBI) as early as possible. Various tests, including different clinical scores and scales, are used in the laboratory evaluation of patients. However, it is still impossible to predict the presence of SBI with complete certainty. Galetto-Lacour et al. developed and validated a risk index score, named Lab-score. Lab-score is based on the three predictive variables independently associated with SBI: procalcitonin (PCT), C-reactive protein (CRP), and urinary dipstick. The objective of this study was to assess the performance of the Lab-score in predicting SBI in well-appearing infants ≤ 180 days of age with FWAS, who presented to ED and were hospitalized with suspicion of having SBI. Based on this study findings, white blood cells count (WBC), CRP, PCT, and lab-score ≥ 3 were confirmed as useful biomarkers for differentiation between SBI and non-SBI. Also, receiver operating characteristic curve (ROC) analysis confirmed that all of them were useful for differentiation between SBI and non-SBI patients with the highest area under curve (AUC) calculated for the Lab-score. The results of this research confirmed its value, with calculated sensitivity of 67.7% and specificity of 98.6% in prediction of SBI in infants aged ≤ 180 days. Its value was even better in infants aged ≤ 90 days with sensitivity of 75% and specificity of 97.7%. In conclusion, we demonstrated the high value of lab-score in detecting SBI in infants under 6 months of age with FWAS.

  19. Depression as a Predictor of Length of Hospital Stay in Elderly Patients Admitted to Ain Shams University Hospitals

    OpenAIRE

    Sherine M. Elbanouby, Sarah A.Hamza,Samia A. Abdel Rahman and Ahmed Kamel Mortagy

    2013-01-01

    Background: Depression among the physically ill is common and frequently under-diagnosed. Elderly patients with depressive symptoms are at higher risk of hospital admission for non psychiatric conditions and are more likely to have longer hospital stays and worse hospital outcomes, compared with non depressed patients. Objectives: The aim of this study was to find out if depression can be considered a predictor of prolonged hospital stay in elderly patients. Design: A prospective cohor...

  20. Refeeding syndrome is uncommon in alcoholics admitted to a hospital detoxification unit.

    Science.gov (United States)

    Manning, S; Gilmour, M; Weatherall, M; Robinson, G M

    2014-05-01

    The refeeding syndrome is increasingly recognised. It is a serious change in electrolytes when nutrition is reintroduced to malnourished patients. Alcohol dependence is a risk factor for the refeeding syndrome. We report a prospective cohort study of 36 alcoholics hospitalised for withdrawal management. We found no evidence of refeeding syndrome in any patient after 3 days of hospitalisation, despite hypomagnesaemia, a risk factor for the refeeding syndrome being prevalent (44% of subjects). Low thiamine levels were infrequent affecting 3/29 (10%). We recommend that in alcoholics admitted for managed withdrawal, risk of refeeding syndrome appears to be low, and routine testing of repeat electrolytes appears unnecessary.

  1. A STUDY ON HYPERTENSION AMONG CHRONIC KIDNEY DISEASE PATIENTS ADMITTED IN THE NEPHROLOGY DEPARTMENT OF GGH, KURNOOL

    Directory of Open Access Journals (Sweden)

    Padma Sri

    2015-04-01

    Full Text Available BACKGROUND: Hypertension is both a risk factor and complication of chronic renal disease. Managing hypertension plays a significant role in preventing complications and slowing down the progression as well. OBJECTIVES: 1. To study the association between hypertension and CKD. 2. To study the other known risk factors associated with hypertension. METHODOLOGY: Study design - Cross sectional descriptive study period - June to November 2012, Study area - The Department of Nephrology, Government General Hospital, Kurnool. STUDY SUBJECTS: All the chronic kidney disease patients admitted in the Nephrology ward from June to November 2012 are included in the study and are interviewed with a Pre - designed semi structured questionnaire. STATISTICAL ANALYSIS: proportions, percentages, chi - square . RESULTS: A total of 153 subjects were included in the study. T heir mean age was 4 7 . 96±11 . 14 years. Hyper tension was present in 126 (82. 35% of the patients with CKD. CONCLUSIONS: Smoking and Alcohol consumption had a significant association with hypertension among CKD patients. Presence of hypertension had an increased risk for heart d isease among CKD patients. Inadequately controlled hypertension had significant association with occurrence of heart disease.

  2. Socio-demographic and clinical factors related to mortality among the geriatric suicide attempters admitted to the emergency department

    Directory of Open Access Journals (Sweden)

    Yılmaz Zengin

    2015-09-01

    Full Text Available Objective: The ratio of elderly people in Turkey is rapidly growing. Accordingly, psychiatric problems and suicidality among elderly people are growing concerns. In this study, we aimed to investigate the socio-demographic characteristics of older people who attempted suicide by drug and to identify risk factors affecting mortality. Methods: Patients who were over 65 years old and admitted to the emergency department of a university hospital due to drug-related suicide attempt between January 1, 2004 and December 30, 2014, were included into this retrospective cross-sectional study. Relationship between suicide attempt and mortality was investigated in regard to socio-demographic and clinical factors. Patients were divided into two groups according to whether they survived or died. Results: Of the 107 patients included in the study, 68.2% were female and 31.8% were male; 34.6% were married. Common reasons for suicide attempt were depression (34.6% and domestic violence (30.8%. Analgesics (33.6% were the most common drugs used in suicide attempts. The analysis of the factors related to suicide attempt and mortality revealed that significant factors were loneliness, being widowed, being retired, having adjustment disorder and anxiety disorder. Conclusion: Loneliness, being widowed, being retired, adjustment disorder, and anxiety disorder were found as the risk factors affecting mortality in geriatric suicide attempts.

  3. Heterogeneity of Rotavirus Testing and Admitting Practices for Gastroenteritis among 12 Tertiary Care Pediatric Hospitals: Implications for Surveillance

    Directory of Open Access Journals (Sweden)

    Julie A. Bettinger

    2011-01-01

    Full Text Available BACKGROUND: The Canadian Immunization Monitoring Program, ACTive (IMPACT surveillance for rotavirus relies on monitoring hospital admissions. Because a diagnosis of rotavirus is not necessary for treatment purposes, and rotavirus is not a reportable disease, wide variation may exist in the admitting and testing practices for this disease. From 2005 to 2007, the number of rotavirus admissions differed significantly among IMPACT centres, and this variation could not be explained by population differences alone. Understanding this variation is important when interpreting surveillance data and estimating the cost-effectiveness of rotavirus vaccination programs.

  4. Blood Glucose as a Predictor of Mortality in Children Admitted to the Hospital with Febrile Illness in Tanzania

    OpenAIRE

    Nadjm, Behzad; Mtove, George; Amos, Ben; Hildenwall, Helena; Najjuka, Anne; Mtei, Frank; Todd, Jim; Reyburn, Hugh

    2013-01-01

    Data from a prospective study of 3,319 children ages 2 months to 5 years admitted with febrile illness to a Tanzanian district hospital were analyzed to determine the relationship of blood glucose and mortality. Hypoglycemia (blood sugar < 2.5 mmol/L and < 45 mg/dL) was found in 105 of 3,319 (3.2%) children at admission, and low-normal blood glucose (2.5-5 mmol/L and 45-90 mg/dL) was found in 773 of 3,319 (23.3%) children. Mortality was inversely related to admission blood sugar; compared wit...

  5. Risk of venous thromboembolism in people admitted to hospital with selected immune-mediated diseases: record-linkage study

    Directory of Open Access Journals (Sweden)

    Handel Adam E

    2011-01-01

    Full Text Available Abstract Background Venous thromboembolism (VTE is a common complication during and after a hospital admission. Although it is mainly considered a complication of surgery, it often occurs in people who have not undergone surgery, with recent evidence suggesting that immune-mediated diseases may play a role in VTE risk. We, therefore, decided to study the risk of deep vein thrombosis (DVT and pulmonary embolism (PE in people admitted to hospital with a range of immune-mediated diseases. Methods We analysed databases of linked statistical records of hospital admissions and death certificates for the Oxford Record Linkage Study area (ORLS1:1968 to 1998 and ORLS2:1999 to 2008 and the whole of England (1999 to 2008. Rate ratios for VTE were determined, comparing immune-mediated disease cohorts with comparison cohorts. Results Significantly elevated risks of VTE were found, in all three populations studied, in people with a hospital record of admission for autoimmune haemolytic anaemia, chronic active hepatitis, dermatomyositis/polymyositis, type 1 diabetes mellitus, multiple sclerosis, myasthenia gravis, myxoedema, pemphigus/pemphigoid, polyarteritis nodosa, psoriasis, rheumatoid arthritis, Sjogren's syndrome, and systemic lupus erythematosus. Rate ratios were considerably higher for some of these diseases than others: for example, for systemic lupus erythematosus the rate ratios were 3.61 (2.36 to 5.31 in the ORLS1 population, 4.60 (3.19 to 6.43 in ORLS2 and 3.71 (3.43 to 4.02 in the England dataset. Conclusions People admitted to hospital with immune-mediated diseases may be at an increased risk of subsequent VTE. Our findings need independent confirmation or refutation; but, if confirmed, there may be a role for thromboprophylaxis in some patients with these diseases.

  6. Risk of death and readmission of hospital-admitted COPD exacerbations: European COPD Audit.

    Science.gov (United States)

    Hartl, Sylvia; Lopez-Campos, Jose Luis; Pozo-Rodriguez, Francisco; Castro-Acosta, Ady; Studnicka, Michael; Kaiser, Bernhard; Roberts, C Michael

    2016-01-01

    Studies report high in-hospital and post-discharge mortality of chronic obstructive pulmonary disease (COPD) exacerbations varying depending upon patient characteristics, hospital resources and treatment standards. This study aimed to investigate the patient, resource and organisational factors associated with in-hospital and 90-day post-discharge mortality and readmission of COPD exacerbations within the European COPD Audit. The audit collected data of COPD exacerbation admissions from 13 European countries.On admission, only 49.7% of COPD patients had spirometry results available and only 81.6% had blood gases taken. Using logistic regression analysis, the risk associated with in-hospital and post-discharge mortality was higher age, presence of acidotic respiratory failure, subsequent need for ventilatory support and presence of comorbidity. In addition, the 90-day risk of COPD readmission was associated with previous admissions. Only the number of respiratory specialists per 1000 beds, a variable related to hospital resources, decreased the risk of post-discharge mortality.The European COPD Audit identifies risk factors associated with in-hospital and post-discharge mortality and COPD readmission. Addressing the deficiencies in acute COPD care such as making spirometry available and measuring blood gases and providing noninvasive ventilation more regularly would provide opportunities to improve COPD outcomes. PMID:26493806

  7. CLINICAL PRESENTATION, RADIOLOGICAL FEATURES AND COURSE OF THE DISEASE IN SWINE FLU POSITIVE PATIENTS ADMITTED IN THE RESPIRATORY INTENSIVE CARE UNIT OF A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Aruna

    2015-06-01

    Full Text Available BACKGROUND : Since the 2009 pandemic of H1N1 or Swine Flu influenza , there have been respiratory emergencies every year throughout India , but in the early part of this year that is between January and April 2015 an explosion of cases was seen throughout the country , and so also in our state , Andhra Pradesh. The study of clinical presentation , radiological features and course of the disease helps in early suspicion , isolation , detection and institution of treatment in swine flu positive patients so that further spread of the disease can be co ntrolled and the patients saved . MATERIAL AND METHODS : This is a cross - sectional study conducted at the Department of Pulmonary Medicine , S.V.R.R. Govt. General Hospital , Tirupathi , between January 2015 and April 2015. Study sample was the total number of swine flu suspects who were admitted in the Respiratory Intensive Care Unit and swine flu wards of the Department of Pulmonary Medicine. SUMMARY : Out of 32 suspects admitted , 13 tested positive for swine flu. 8 of the 13 were females (61% and 5 were males (39%. Cold , cough and breathlessness were present in all the patients (100%. Sore throat was present in only 4 patients (30%. 11 out of the 13 patients were in respiratory failure (85%. 9 out of the 13 had comorbidities like diabetes , bronchial asthma and chronic kidney disease (70%. Chest X - ray and CT chest showed ARDS like pic ture and pneumonia in 11 out of the 13 patients (85%.

  8. Reduced consumption of analgesics in patients with diabetes mellitus admitted to hospital for acute myocardial infarction

    DEFF Research Database (Denmark)

    Nielsen, F E; Gram-Hansen, P; Christensen, J H;

    1991-01-01

    .05). There was no statistically significant trend for the duration of pain to be shorter in the diabetes group. There was no difference between the two groups with respect to number of patients with Q-wave infarct, initial heart rate-blood pressure product or body weight, all of which are possible confounders. We conclude......In a case-control study, the consumption of analgesics was analysed in 39 patients with diabetes, admitted with acute myocardial infarction (MI). The control group comprised of non-diabetics with MI was computer-matched to the diabetic group with respect to age and sex as well as enzyme......-estimated size of the infarction. The median number of injections of opioid analgesics in the diabetes and non-diabetes groups was 2 and 5, respectively (0.01 less than P less than 0.05), and the median consumption of morphine was 20 mg and 35 mg, respectively (0.01 less than P less than 0...

  9. Epidemiological investigation on Wenchuan earthquake-struck trauma patients admitted to two hospitals of Chongqing

    Institute of Scientific and Technical Information of China (English)

    JIAN Hua-sheng; L(U) Zu-ming; LI Yin-yan

    2010-01-01

    Objective: To study epidemiological characteristics and influential factors of in-hospital patients struck by the Wenchuan earthquake disaster.Methods: The clinical data of 196 cases were collected from 2 hospitals of Chongqing city, including age, sex, occupation, injury site, dwelling and injury severity score.Results: In this series, 31.63% victims' age was over 60 years, and 54.08% were farmers.Multiple trauma ac-counted for 35.71%, and lower limb injury for 33.67%.There was no significant difference on injury severity score be-tween city dwellers and rural ones (P>0.05).Conclusion: The earthquake injury is influenced by many factors.More attention should be paid to the treat-ment at first 5 days after injury and high risk population.

  10. Assessment of the sexually abused female children admitted to a tertiary care hospital: Eight year experience

    OpenAIRE

    Mollamahmutoglu, Leyla; Uzunlar, Ozlem; Kahyaoglu, Inci; Ozyer, Sebnem; Besli, Mustafa; Karaca, Mujdegul

    2014-01-01

    Objective: To discuss the medical, social and legal characteristics of the child sexual abuse and to provide a perspective for gynecologists on this topic. Methods: A retrospective analysis was carried out of the medicolegal records of female children below the age of 18 referred to a tertiary teaching hospital and diagnosed as being exposed to sexual abuse within the family between the years of 2004 to 2012. Results: One hundred and thirty-nine cases were diagnosed as being exposed to sexual...

  11. [Acute alcohol intoxication among children and adolescents admitted to the Department of Pediatrics, Pediatric Endocrinology and Diabetes, Medical University of Silesia, Katowice during 2000-2010--preliminary study].

    Science.gov (United States)

    Kamińska, Halla; Agnieszka, Zachurzok-Buczyńska; Gawlik, Aneta; Małecka-Tendera, Ewa

    2012-01-01

    The alcohol drinking at the young age is a risk factor of alcohol addiction later in life, and is connected with school problems, binge drinking, tobacco addiction, illegal drug use, violence, crime commitment, and risky sexual behaviors. Alcohol drinking in the last 12 months is declared by 78% Polish children. The aim of the study was to evaluate the frequency of admissions due to alcohol intoxication to the Department of Pediatrics, Pediatric Endocrinology and Diabetes, Pediatric Center of Silesia and the identification of the risk factors of the acute alcohol intoxication among Polish children and adolescents. Ten-year retrospective study includes investigation of patients medical records from the Department of Pediatrics. Among 8048 patients hospitalized in the Department of Pediatrics between the years 2000-2010, 220 (2.7%) cases of acute alcohol poisoning occurred The detailed data analysis from 139 patients [66 (47.5%) girls, 73 (52,5%) boys] was done. In the years 2006-2010 the number of girls admitted to the department increased in comparison to boys. The largest group of patients was at age between 14 and 16 years [61 (44%) children]. The blood alcohol concentration at the moment of admission to the hospital was 0.1 to 4.0 per thousand. In most cases (92.8%) the alcohol intoxication was intentional. Five percent of them were suicide attempts. In the youngest group of children alcohol abuse was unintentional. 23 (16.5%) of patients initially needed admission to the intensive care unit. In 30 (21.6%) patient the family was incomplete and five times more often father was absent. The alcohol addiction occurs in 18 (13.0%) fathers and 10 (7.2%) mothers of our patients. It is concluded that over the last decade the number of girls admitted due to alcohol abuse increased. Children at school grade between 7-9 are intoxicated most often. One six of intoxicated patents needed hospitalization at intensive care unit.

  12. The pattern of femoral diaphyseal fractures in children admitted in Sarawak General Hospital.

    Science.gov (United States)

    Rasit, A H; Mohammad, A W; Pan, K L

    2006-02-01

    Trend towards changing the face of management for pediatric femoral fractures tends to advocate operative treatment. This study was undertaken to review our current practice in the wake of recent progress in the management of pediatric femoral fractures. Fifty patients with femoral diaphyseal fracture treated in Sarawak General Hospital were reviewed retrospectively after an average follow-up of 2.6 years. There were 36 boys and 14 girls, with a mean age of 6.2 years (range five months to 14 years). Children under six years of age constituted the majority of the patients. Half of the fractures were caused by road traffic accident. Nine patients had associated injuries. The most common site of fracture was at the middle third (N=31). The treatment regimens were delayed hip spica (DHS) in 16, immediate hip spica (IHS) in 24, plate osteosynthesis (PO) in five, titanium elastic nailing (TEN) in five, and external fixation (EF) in one. The minimum hospital stay was two days, and the maximum 33 days (mean, 9.7 days). Malunion was the commonest complication. Conservative treatment is the preferred option for children under six years of age. It is cost-effective with minimal complication. The other treatment options are reserved for specific indication in older children. Diaphyseal fractures of the femur in children can be adequately managed non-operatively.

  13. Incidence and clinical characteristics of group A rotavirus infections among children admitted to hospital in Kilifi, Kenya.

    Directory of Open Access Journals (Sweden)

    D James Nokes

    2008-07-01

    Full Text Available BACKGROUND: Rotavirus, predominantly of group A, is a major cause of severe diarrhoea worldwide, with the greatest burden falling on young children living in less-developed countries. Vaccines directed against this virus have shown promise in recent trials, and are undergoing effectiveness evaluation in sub-Saharan Africa. In this region limited childhood data are available on the incidence and clinical characteristics of severe group A rotavirus disease. Advocacy for vaccine intervention and interpretation of effectiveness following implementation will benefit from accurate base-line estimates of the incidence and severity of rotavirus paediatric admissions in relevant populations. The study objective was to accurately define the incidence and severity of group A rotavirus disease in a resource-poor setting necessary to make informed decisions on the need for vaccine prevention. METHODS AND FINDINGS: Between 2002 and 2004 we conducted prospective surveillance for group A rotavirus infection at Kilifi District Hospital in coastal Kenya. Children 2% of children are admitted to hospital with group A rotavirus diarrhoea in the first 5 y of life. This translates into over 28,000 vaccine-preventable hospitalisations per year across Kenya, and is likely to be a considerable underestimate. Group A rotavirus diarrhoea is associated with acute life-threatening metabolic derangement in otherwise healthy children. Although mortality is low in this clinical research setting this may not be generally true in African hospitals lacking rapid and appropriate management.

  14. Detection and characterization of carbapenemase-producing Enterobacteriaceae in wounded Syrian patients admitted to hospitals in northern Israel.

    Science.gov (United States)

    Lerner, A; Solter, E; Rachi, E; Adler, A; Rechnitzer, H; Miron, D; Krupnick, L; Sela, S; Aga, E; Ziv, Y; Peretz, A; Labay, K; Rahav, G; Geffen, Y; Hussein, K; Eluk, O; Carmeli, Y; Schwaber, M J

    2016-01-01

    Since 2013, four hospitals in northern Israel have been providing care for Syrian nationals, primarily those wounded in the ongoing civil war. We analyzed carbapenemase-producing Enterobacteriaceae (CPE) isolates obtained from these patients. Isolate identification was performed using the VITEK 2 system. Polymerase chain reaction (PCR) was performed for the presence of bla KPC, bla NDM, and bla OXA-48. Susceptibility testing and genotyping were performed on selected isolates. During the study period, 595 Syrian patients were hospitalized, most of them young men. Thirty-two confirmed CPE isolates were grown from cultures taken from 30 patients. All but five isolates were identified as Klebsiella pneumoniae and Escherichia coli. Nineteen isolates produced NDM and 13 produced OXA-48. Among a further 29 isolates tested, multilocus sequence typing (MLST) showed that ST278 and ST38 were the major sequence types among the NDM-producing K. pneumoniae and OXA-48-producing E. coli isolates, respectively. Most were resistant to all three carbapenems in use in Israel and to gentamicin, but susceptible to colistin and fosfomycin. The source for bacterial acquisition could not be determined; however, some patients admitted to different medical centers were found to carry the same sequence type. CPE containing bla NDM and bla OXA-48 were prevalent among Syrian wounded hospitalized patients in northern Israel. The finding of the same sequence type among patients at different medical centers implies a common, prehospital source for these patients. These findings have implications for public health throughout the region. PMID:26581423

  15. Cranial computed tomography findings in patients admitted to the emergency unit of Hospital Universitario Cajuru; Achados tomograficos de pacientes submetidos a tomografia de cranio no pronto-socorro do Hospital Universitario Cajuru

    Energy Technology Data Exchange (ETDEWEB)

    Lara Filho, Lauro Aparecido; Omar, Samir Sari; Biguelini, Rodrigo Foletto; Santos, Rony Augusto de Oliveira, E-mail: samir176@gmail.com [Pontificia Universidade Catolica do Parana (PUCPR), Curitiba, PR (Brazil). Cuso de Medicina

    2013-05-15

    Objective: to identify and analyze the prevalence of cranial computed tomography findings in patients admitted to the emergency unit of Hospital Universitario Cajuru. Materials and methods: cross-sectional study analyzing 200 consecutive non contrast-enhanced cranial computed tomography reports of patients admitted to the emergency unit of Hospital Universitario Cajuru. Results: alterations were observed in 76.5% of the patients. Among them, the following findings were most frequently observed: extracranial soft tissue swelling (22%), bone fracture (16.5%), subarachnoid hemorrhage (15%), nonspecific hypodensity (14.5%), paranasal sinuses opacification (11.5%), diffuse cerebral edema (10.5%), subdural hematoma (9.5%), cerebral contusion (8.5%), hydrocephalus (8%), retractable hypodensity /gliosis/ encephalomalacia (8%). Conclusion: the authors recognize that the most common findings in emergency departments reported in the literature are similar to the ones described in the present study. This information is important for professionals to recognize the main changes to be identified at cranial computed tomography, and for future planning and hospital screening aiming at achieving efficiency and improvement in services. (author)

  16. A retrospective study on malaria cases admitted to the University Hospital, Kuala Lumpur, 1984-1988.

    Science.gov (United States)

    Sidhu, P S; Ng, S C

    1991-06-01

    A review of malaria cases over a five year period from 1984-1988 at the University Hospital, Kuala Lumpur, Malaysia is presented. A total of 64 cases were recorded; 50% of which were due to Plasmodium falciparum, 40.6% were due to Plasmodium vivax, 6.2% due to Plasmodium malariae and 3.1% due to a mixed infection of Plasmodium falciparum and Plasmodium vivax. The breakdown of species type compared similarly with other studies conducted in the region. Of this total, sixteen cases were imported from Pakistan, India, Thailand, Indonesia, Sri Lanka, Vietnam, Madagascar and Mali. The presenting symptoms and the clinical findings were typical of a malaria infection. The main problem in the future will be the increase in imported cases of malaria.

  17. Effect of age on short and long-term mortality in patients admitted to hospital with congestive heart failure

    DEFF Research Database (Denmark)

    Gustafsson, Finn; Torp-Pedersen, Christian; Seibaek, Marie;

    2004-01-01

    age was 71.7+/-10.2 years, 60% were male and 63% were in NYHA class III-IV. Moderate to severe left ventricular (LV) systolic dysfunction was present in 41%. Short and long-term survival status was obtained after 30 days and 5-8 years, respectively. Older patients less frequently had LV systolic......AIMS: To describe the association between age and risk factors in patients hospitalised with congestive heart failure (CHF) and to determine the effect of age on mortality. METHODS AND RESULTS: Consecutive patients admitted to 34 hospitals with CHF during a period of 2 years were registered. Mean...... dysfunction, were under treated with ACE-inhibitors and were more often female. The prevalence of hypertension, diabetes and ischaemic heart disease increased with age, until the oldest age group (>80 years). Age was an independent predictor of short-term mortality (risk ratio (RR) per 10-year increase was 1...

  18. An observational study in psychiatric acute patients admitted to General Hospital Psychiatric Wards in Italy

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    Margari Francesco

    2007-01-01

    Full Text Available Abstract Objectives this Italian observational study was aimed at collecting data of psychiatric patients with acute episodes entering General Hospital Psychiatric Wards (GHPWs. Information was focused on diagnosis (DSM-IV, reasons of hospitalisation, prescribed treatment, outcome of aggressive episodes, evolution of the acute episode. Methods assessments were performed at admission and discharge. Used psychometric scales were the Brief Psychiatric Rating Scale (BPRS, the Modified Overt Aggression Scale (MOAS and the Nurses' Observation Scale for Inpatient Evaluation (NOSIE-30. Results 864 adult patients were enrolled in 15 GHPWs: 728 (320 M; mean age 43.6 yrs completed both admission and discharge visits. A severe psychotic episode with (19.1% or without (47.7% aggressive behaviour was the main reason of admission. Schizophrenia (42.8% at admission and 40.1% at discharge and depression (12.9% at admission and 14.7% at discharge were the predominant diagnoses. The mean hospital stay was 12 days. The mean (± SD total score of MOAS at admission, day 7 and discharge was, respectively, 2.53 ± 5.1, 0.38 ± 2.2, and 0.21 ± 1.5. Forty-four (6.0% patients had episodes of aggressiveness at admission and 8 (1.7% at day 7. A progressive improvement in each domain/item vs. admission was observed for MOAS and BPRS, while NOSIE-30 did not change from day 4 onwards. The number of patients with al least one psychotic drug taken at admission, in the first 7 days of hospitalisation, and prescribed at discharge, was, respectively: 472 (64.8%, 686 (94.2% and 676 (92.9%. The respective most frequently psychotic drugs were: BDZs (60.6%, 85.7%, 69.5%, typical anti-psychotics (48.3%, 57.0%, 49.6%, atypical anti-psychotics (35.6%, 41.8%, 39.8% and antidepressants (40.9%, 48.8%, 43.2%. Rates of patients with one, two or > 2 psychotic drugs taken at admission and day 7, and prescribed at discharge, were, respectively: 24.8%, 8.2% and 13.5% in mono-therapy; 22.0%, 20

  19. 42 CFR 424.16 - Timing of certification for individual admitted to a hospital before entitlement to Medicare...

    Science.gov (United States)

    2010-10-01

    ... a hospital before entitlement to Medicare benefits. 424.16 Section 424.16 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM CONDITIONS FOR MEDICARE PAYMENT Certification and Plan Requirements § 424.16 Timing of certification...

  20. Assessment of Mental Disorders in Cerebral Stroke Patients Admitted at Rasool Hospital

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    B Farzinrad

    2009-07-01

    Full Text Available Introduction: Cerebrovascular disorders are the third leading cause of death in individuals over the age of 50; mental disorders of this origin are reported in up to 50 and even 78 percent of patients. The global goal of this study was to assess mental disorders of stroke patients. Methods: In a cross-sectional study, 100 consecutive stroke patients in the neurology clinic of Rasool hospital were evaluated by accidental sampling and use of Neuropsychotic Inventory (NPI. Data was analyzed using Chi square and t-test. Results: 37 men and 63 women with mean age of 62.5 years were assessed over 1 to 12 months after their stroke. The results of Chi square suggested men patients had higher frequency in subscales of delusion, aphaty, disinhibition and sleep disorders and women patients in subscale of anxiety. The results of t-test reported that there was a correlation between right hemisphere lesions and euphory. Conclusion: Depression, anxiety and aggression were the most common mental disorders after stroke, respectively.

  1. Risk Factors for Hospital and Long-Term Mortality of Critically Ill Elderly Patients Admitted to an Intensive Care Unit

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    A. Mukhopadhyay

    2014-01-01

    Full Text Available Background. Data on long-term outcomes of elderly (≥65 years patients in ICU are sparse. Materials and Methods. Adult patients (n=1563, 45.4% elderly admitted over 28 months were analyzed by competing risks regression model to determine independent factors related to in-hospital and long-term mortality. Results. 414 (26.5% and 337 (21.6% patients died in-hospital and during the 52 months following discharge, respectively; the elderly group had higher mortality during both periods. After discharge, elderly patients had 2.3 times higher mortality compared to the general population of the same age-group. In-hospital mortality was independently associated with mechanical ventilation (subdistribution hazard ratio (SHR 2.74, vasopressors (SHR 2.56, neurological disease (SHR 1.77, and Mortality Prediction Model II score (SHR 1.01 regardless of age and with malignancy (SHR, hematological 3.65, nonhematological 3.4 and prior renal replacement therapy (RRT, SHR 2.21 only in the elderly. Long-term mortality was associated with low hemoglobin concentration (SHR 0.94, airway disease (SHR 2.23, and malignancy (SHR hematological 1.11, nonhematological 2.31 regardless of age and with comorbidities especially among the nonelderly. Conclusions. Following discharge, elderly ICU patients have higher mortality compared to the nonelderly and general population. In the elderly group, prior RRT and malignancy contribute additionally to in-hospital mortality risk. In the long-term, comorbidities (age-related, anemia, airway disease, and malignancy were significantly associated with mortality.

  2. Lactose intolerance among severely malnourished children with diarrhoea admitted to the nutrition unit, Mulago hospital, Uganda

    Directory of Open Access Journals (Sweden)

    Mworozi Edison

    2010-05-01

    Full Text Available Abstract Background Lactose intolerance is a common complication of diarrhoea in infants with malnutrition and a cause of treatment failure. A combination of nutritional injury and infectious insults in severe protein energy malnutrition reduces the capacity of the intestinal mucosa to produce lactase enzyme necessary for the digestion of lactose. The standard management of severe malnutrition involves nutritional rehabilitation with lactose-based high energy formula milk. However, some of these children may be lactose intolerant, possibly contributing to the high rate of unfavorable treatment outcomes. This study was therefore designed to establish the prevalence of lactose intolerance and associated factors in this population. Methods A descriptive cross sectional study involving 196 severely malnourished children with diarrhoea aged 3-60 months was done in Mwanamugimu Nutrition Unit (MNU, Mulago hospital between October 2006 and February 2007. Results During the study period, 196 severely malnourished children with diarrhoea were recruited, 50 (25.5% of whom had evidence of lactose intolerance (stool reducing substance ≥ 1 + [0.5%] and stool pH Other factors that were significantly associated with lactose intolerance on bi-variate analysis included: young age of 3-12 months; lack of up to-date immunization; persistent diarrhoea; vomiting; dehydration, and abdominal distension. Exclusive breastfeeding for less than 4 months and worsening of diarrhoea on initiation of therapeutic milk were the other factors. Conclusions The prevalence of lactose intolerance in this study setting of 25.5% is relatively high. Routine screening by stool pH and reducing substances should be performed especially in the severely malnourished children with diarrhoea presenting with oedematous malnutrition, perianal skin erosion, higher mean stool frequency and having had ≥2 diarrhoea episodes in the previous 3 months. Use of lactose-free diets such as yoghurt

  3. Risk of bloodstream infection in children admitted to paediatric intensive care units in England and Wales following emergency inter-hospital transfer.

    OpenAIRE

    Harron, K.; Mok, Q; Parslow, R.; Muller-Pebody, B; Gilbert, R.; Ramnarayan, P

    2014-01-01

    Purpose Adherence to full sterile procedures may be compromised when central venous catheters are inserted as part of emergency resuscitation and stabilisation, particularly outside the intensive care unit. Half of emergency admissions to paediatric intensive care units (PICU) in the UK occur after stabilisation at other hospitals. We determined whether bloodstream infection (BSI) occurred more frequently in children admitted to PICU after inter-hospital transfer compared to within-hospital a...

  4. Spectrum of Opportunistic Infections and Risk Factors for In-Hospital Mortality of Admitted AIDS Patients in Shanghai.

    Science.gov (United States)

    Luo, Bin; Sun, Jianjun; Cai, Rentian; Shen, Yinzhong; Liu, Li; Wang, Jiangrong; Zhang, Renfang; Shen, Jiayin; Lu, Hongzhou

    2016-05-01

    To investigate the frequency and the spectrum of major opportunistic infections (OIs), evaluate the major clinical factors associated with each specific OI, and identify the risk factors for in-hospital death among HIV patients in East China.A retrospective cohort study was made including all the HIV-infected patients who were admitted for the first time to the Shanghai Public Health Clinical Center during June 1, 2013 to June 1, 2015. The demographic and clinical data were collected. Comparison of continuous variables was analyzed by one-way ANOVA and rank sum test. Person χ test and Fisher exact test were applied to analyze the categorical variables. A Cox proportional hazards regression model was used to determine the risk for the occurrence of in-hospital death.In total, 920 patients were enrolled with age of 41.59 ± 13.36 years and 91% male. Median CD4 was 34 (IQR, 13-94) cells/μL. Among these patients, 94.7% acquired OIs while the rest developed malignancies. Pneumocystis pneumonia and bacterial coinfection (42.1%) was found to be the most common OIs, followed by tuberculosis (31.4%), CMV (20.9%), Cryptococcosis (9.0%), and MAC infection (5.2%). Of the above 5 major OIs, CMV-infected patients had the lowest median CD4 cell count 22.50 (IQR, 7.50-82.00) while the patients with tuberculosis infection had the highest count 61.00 (IQR, 27.00-176.00). In-hospital death rate was 4.2 per 100 person-years among these patients. Of note, admitted patients with 2 types of OIs (2.20, 95% CI 1.39-3.48) and those patients who were 40-year old or older (1.75, 95% CI 1.10-2.78) had a higher risk of such death.Pneumocystis pneumonia and tuberculosis were still the leading causes for the admission of HIV-infected patients in East China, and these patients tended to have very low CD4 cell counts. It is believed that expanding the HIV screening test and pushing the infected ones get ART earlier is required for generating a more successful HIV management strategy.

  5. Comparison of Routine Health Management Information System Versus Enhanced Inpatient Malaria Surveillance for Estimating the Burden of Malaria Among Children Admitted to Four Hospitals in Uganda

    Science.gov (United States)

    Mpimbaza, Arthur; Miles, Melody; Sserwanga, Asadu; Kigozi, Ruth; Wanzira, Humphrey; Rubahika, Denis; Nasr, Sussann; Kapella, Bryan K.; Yoon, Steven S.; Chang, Michelle; Yeka, Adoke; Staedke, Sarah G.; Kamya, Moses R.; Dorsey, Grant

    2015-01-01

    The primary source of malaria surveillance data in Uganda is the Health Management Information System (HMIS), which does not require laboratory confirmation of reported malaria cases. To improve data quality, an enhanced inpatient malaria surveillance system (EIMSS) was implemented with emphasis on malaria testing of all children admitted in select hospitals. Data were compared between the HMIS and the EIMSS at four hospitals over a period of 12 months. After the implementation of the EIMSS, over 96% of admitted children under 5 years of age underwent laboratory testing for malaria. The HMIS significantly overreported the proportion of children under 5 years of age admitted with malaria (average absolute difference = 19%, range = 8–27% across the four hospitals) compared with the EIMSS. To improve the quality of the HMIS data for malaria surveillance, the National Malaria Control Program should, in addition to increasing malaria testing rates, focus on linking laboratory test results to reported malaria cases. PMID:25422396

  6. Profile of patients admitted to a triage dermatology clinic at a tertiary hospital in São Paulo, Brazil*

    Science.gov (United States)

    Bertanha, Fernanda; Nelumba, Erica Judite Pimentel; Freiberg, Alyne Korukian; Samorano, Luciana Paula; Festa Neto, Cyro

    2016-01-01

    Background Knowledge of epidemiological data on skin diseases is important in planning preventive strategies in healthcare services. Objective To assess data from patients admitted to a triage dermatology clinic. Methods A retrospective study was performed of patients admitted over a one-year period to the Triage Dermatology Clinic at the Hospital das Clínicas of the University of São Paulo Medical School. Data were obtained from record books. The variables analyzed were: patient age, gender, dermatologic disease (initial diagnosis), origin (from where the patient was referred) and destination (where the patient was referred to). Results A total of 16,399 patients and 17,454 diseases were identified for analysis. The most frequent skin disorders were eczema (18%), cutaneous infections (13.1%), erythematous squamous diseases (6.8%) and malignant cutaneous neoplasms (6.1%). Atopic dermatitis was the most common disease in children. Acne was more common among children and adults, as were viral warts. Basal cell carcinoma and squamous cell carcinoma were more common in the elderly. Contact dermatitis and acne predominated in women. The most frequent origins were: the primary/secondary health system (26.6%), other outpatient specialties (25.5%), emergency care (14.9%); while the destinations were: discharged (27.5%), follow-up in our Dermatology Division (24.1%), return (14.1%) and the primary/secondary health system (20.7%). Conclusion Understanding the incidence of skin diseases is fundamental in making decisions regarding resource allocation for clinical care and research. Thus, we believe our findings can contribute to improving public health policies. PMID:27438199

  7. Epidemiologic Evaluation of Ocular Trauma in Patients Admitted to Ophthalmology Ward of Farshchian Hospital in Hamadan in 2012

    Directory of Open Access Journals (Sweden)

    N. Bazzazi

    2014-04-01

    Full Text Available Introduction & Objective: Ocular trauma is one of the important reasons of visual loss which can cause multiple damages to eyelid, eyeball and adenexal tissues. Furthermore, ocular trauma is one of the major causes of unilateral blindness and the third leading cause of hospi-talization in ophthalmology wards. The aim of this study is to determine the prevalence and characteristics of eye trauma at Farshchian hospital in Hamadan in 2012. Material & Methods: In this cross-sectional descriptive study, 70 patients with ocular trauma, admitted to Farshchian hospital, were studied. We assessed the age, sex, job , educational level, location, cause of trauma, its type and site of injury. The data was analyzed by SPSS 16 software and t, ?2 statistical tests. Results: The mean age of patients in this study was 24.01 years (SD= 16.04. Among 70 pa-tients, 58 people (82.1% were males and 12 patients (17.1% were females. The most com-mon cause of trauma was observed in 19 patients (27.1%. The most common location of the trauma in this study was homing, seen in 28 patients (40%. Among the 70 patients, 29 peo-ple (41.4% had open globe injuries, 25 people had (35.7% closed globe injuries, 5 patients (7.1% had burning and 11 patients (15.7% had adenexal injury. Conclusions: The results showed that most ocular traumas occur in the early ages and in males. The most common type of them is open globe injury and the most common cause is a sharp object. (Sci J Hamadan Univ Med Sci 2014; 21 (1:25-31

  8. L-asparaginase-induced abnormality in plasma glucose level in patients of acute lymphoblastic leukemia admitted to a tertiary care hospital of Odisha

    Directory of Open Access Journals (Sweden)

    Mousumee Panigrahi

    2016-01-01

    Full Text Available Objectives: The objective of this study was to evaluate any abnormal change in plasma glucose levels in patients treated with L-asparaginase (L-Asp-based chemotherapy regimen in patients of acute lymphoblastic leukemia (ALL. Materials and Methods: This retrospective, hospital-based study was conducted in patients of ALL, admitted to the Clinical Haematology Department of a tertiary care hospital of Odisha from August 2014 to July 2015. Indoor records of 146 patients on multi-centered protocol-841 were evaluated for any alteration in plasma glucose level, time of onset of hypo/hyperglycemia, and persistence of plasma glucose alteration. Results: Twenty-one percent of patients showed abnormal plasma glucose level. Most of these patients developed hypoglycemia and were of lower age group. Most of these patients developed hypoglycemia and were of lower age group, whereas a majority of higher age group patients developed hyperglycemia. In majority of the cases, abnormal glucose developed after three doses of L-Asp. Hypoglycemia subsided whereas hyperglycemia persisted till the end of our observation period. Conclusions: L-Asp produces more incidences of hypoglycemia than hyperglycemia in a good number of ALL patients towards which clinicians should be more vigilant. However, hyperglycemia persists for a longer duration than hypoglycemia.

  9. High Prevalence of Infectious Diseases and Drug-Resistant Microorganisms in Asylum Seekers Admitted to Hospital; No Carbapenemase Producing Enterobacteriaceae until September 2015.

    Directory of Open Access Journals (Sweden)

    Sofanne J Ravensbergen

    Full Text Available The current refugee crisis emphasizes the need for information on infectious diseases and resistant microorganisms in asylum seekers with possible consequences for public health and infection control.We collected data from asylum seekers admitted to our university hospital or who presented at the Emergency Department (n = 273. We collected general and demographic characteristics including country of origin, the reason of presentation, and the screening results of multi-drug resistant organisms.67% of the patients were male with a median age of the study group of 24 years (IQR 15-33; 48% of the patients had an infectious disease-predominantly malaria with P. vivax or tuberculosis. Patients also reported with diseases which are less common-e.g. leishmaniasis, or even conditions rarely diagnosed in Europe-e.g. louse borne relapsing fever. A carriage rate of 31% for multi-drug resistant microorganisms (MDRO was observed, with ESBL-expressing E.coli (n = 20 being the most common MDRO. No carriage of Carbapenemase Producing Enterobacteriaceae was found.The current refugee crisis in Europe challenges hospitals to quickly identify and respond to communicable diseases and the carriage of MDRO. A rapid response is necessary to optimize the treatment of infectious diseases amongst asylum seekers to maximize infection control.

  10. The influence of episodic mood disorders on length of stay among patients admitted to private and non-profit hospitals with alcohol dependence syndrome.

    Science.gov (United States)

    Dickerson, Justin B

    2011-02-22

    Episodic mood disorders are often associated with alcohol dependence. Few studies have explored the contribution of episodic mood disorders to length of stay among those hospitalized with alcohol dependence syndrome. Filling this research gap could improve care for patients while minimizing hospital utilization costs. This study was a cross-sectional analysis of the National Hospital Discharge Survey. ICD-9-CM diagnosis codes were used to identify those admitted to a private or non-profit hospital with alcohol dependence syndrome, and a co-morbid diagnosis of an episodic mood disorder (n=358). Descriptive statistics were used to highlight differences in key demographic and hospital variables between those with and without episodic mood disorders. Negative binomial regression was used to associate episodic mood disorders with hospital length of stay. Incidence rate ratios were calculated. Co-morbid episodic mood disorders (β=0.31, P=0.001), referral to a hospital by a physician (β=0.35, P=0.014), and increasing age (β= 0.01, P=0.001) were associated with longer hospital stays. Hospital patients with an admitting diagnosis of alcohol dependence syndrome were 36% more likely to have a longer hospital stay if they also had a co-morbid diagnosis of an episodic mood disorder (IRR=1.36, CI=1.14-1.62). Patients admitted to a hospital with alcohol dependence syndrome should be routinely screened for episodic mood disorders. Opportunities exist for enhanced transitional care between acute, ambulatory, and community-based care settings to lower hospital utilization.

  11. Epidemiology and short-term mortality in traumatic patients admitted to Shariati Hospital in Iran between 2012 and 2013

    Institute of Scientific and Technical Information of China (English)

    Sima Sheikhghomi; Vafa Rahimi-Movaghar; Saba Jafarpour; Soheil Saadat

    2015-01-01

    Purpose:Trauma is an inevitable part of the health burden in every country.Both the preventive and rehabilitative aspects of traumatic injuries are expensive.Since most of the injuries happen in low-and middle-income developing countries,a judicious allocation of the limited resources to the most costefficient strategies is necessary.The present study was designed to report the causes of trauma,injured body regions,trauma severity scores and the one year survival rate of a randomly selected sample of trauma patients in a major referral hospital in Tehran,Iran.Methods:We chose and analyzed a random subgroup of traumatic patients admitted during the oneyear period of May 2012 to May 2013 to Shariati Hospital,a major University Teaching Hospital in Tehran,Iran.Patients who stayed at the hospital for less than 24 h were excluded.In total,73 traumatic patients were registered.The mean age was (40.19 ± 20.34) years and 67.1% of them were male.Results:In general,the most common cause of injury was falls (47.9g),followed by road traffic crashes (RTCs,40.8%).Assault and exposure to inanimate mechanical forces each were only associated with 5.6% of all injuries.The only cause of injury in ages of more than 65 years was fall.The most common cause of injury in ages between 15 and 45 years was RTCs.During the study,two deaths occurred:one was at ICU and the other was at home.The most commonly injured body region was the head (23.8%),followed by the elbow and forearm (19%),hip and thigh (15.9%),and multiple body regions (14.3%).The mean abbreviated injury score was 2.23 ± 1.02;injury severity index was 7.26 ± 7.06;and revised trauma score was 7.84,calculated for 38 patients.Conclusion:Prevention strategy of traumatic injury should focus on falls and RTCs,which are respectively the most common cause of trauma in older aged people and young males.

  12. Frequency of lower limb injuries and their Causes among motorcycle accident admitted into Imam Hossein hospital during one year

    Directory of Open Access Journals (Sweden)

    Ali Arhami Dolatabadi

    2013-01-01

    Full Text Available Abstract Background and Aim: Motor vehicle accidents are common cause of mortality, morbidity and disability. Human factors are principle cause for frequency of motor vehicle accident. In most studies, 52-40% lower limb injuries are trauma from a motorcycle accident. These accidents cause high financial cost and harm for society. Materials and Methods: In this study, patients with lower limb injuries referred to the hospital trauma ward of Imam Hussein were evaluated during one year. Questionnaire forms were designed and completed for patients then data of these forms was inserted in a database. The information was analyzed by statistical software SPSS 18. Results: from 766 patients with lower limb traumas which were examined and evaluated, 92 % were male and mean age of patients was 25± 12 years. 156 patients suffered from head and neck trauma and 134 persons had skin damage in addition to lower limb trauma. Injury to leg was most common injuries in lower leg and tibia shaft fracture was more frequent than lower bone fracture. Most injuries in pelvic trauma associated with fractures of the superior pubic ramus and coccyx bone. Seventy percent of related knee injuries included injury to patella and tibia plateau. The most observed injuries in ankle and foot were lateral malleolus fracture and lisferanc injuries. About 11 percent of patients were discharged from emergency room after primary management and other patients were admitted in hospital.Conclusion: Given the high incidence of lower extremity injuries, especially the leg, in the accident of motorcycle riders, procurement and construction of an efficient protective equipment, especially protective guard can be effective in reducing accidents.

  13. The incidence of human herpesvirus 6 infection in children with febrile convulsion admitted to the University Hospital, Kuala Lumpur.

    Science.gov (United States)

    Chua, K B; Lam, S K; AbuBakar, S; Koh, M T; Lee, W S

    1997-12-01

    From October 1996 to March 1997, 31 children with febrile convulsions were admitted to the University Hospital, Kuala Lumpur. Human Herpesvirus 6 (HHV 6) was virologically and/or serologically confirmed to be the cause of the febrile episode in 5 of these children (16.1%). Age, sex and other associated clinical features (diarrhoea, cough, running nose and type of seizure) were not useful in differentiating cases of febrile convulsion due to HHV 6 from those of other aetiology. However, uvulo-palatoglossal junctional ulcers were noted in children in whom the cause of the seizure could be attributed to HHV 6 but not in the remaining cases in the study group. HHV 6 DNA was detected in peripheral blood mononuclear cells from all patients with febrile convulsions attributed to HHV6, and in patients shown serologically to have already been exposed to the virus by nested polymerase chain reaction amplification. Only genotype HHV 6B was detected from patients with seizure due to HHV 6 but both genotype 6A and 6B were detected in the remaining cases studied. PMID:10968110

  14. Postnatal demoralisation among women admitted to a hospital mother-baby unit: validation of a psychometric measure.

    Science.gov (United States)

    Bobevski, I; Rowe, H; Clarke, D M; McKenzie, D P; Fisher, J

    2015-12-01

    Demoralisation is a psychological state characterised by experiences of distress and sadness, helplessness, subjective incompetence and hopelessness, in the context of a stressful situation. Experiences of demoralisation may be particularly relevant to women who have recently given birth, who can feel incompetent, isolated and helpless. The psychometric properties of the Demoralisation Scale among women in the postnatal period participating in a clinical program were examined. Women admitted with their infants to a hospital mother-baby unit in Australia for five nights were recruited consecutively (N = 209) and assessed at admission and discharge. The Demoralisation Scale was perceived as relevant and exhibited high reliability, acceptable construct validity and good sensitivity to change. The mean demoralisation score was high (M = 30.9, SD = 15.5) and associated with negative experiences of motherhood and functional impairment, independent of depression and anxiety symptoms. Mean demoralisation decreased significantly after program completion (M = 18.4, SD = 12.4). More participants showed a significant improvement in demoralisation (57.5 %) than in depression (34.8 %) and anxiety (9.8 %) symptoms. Demoralisation can provide a useful framework for understanding and measuring the experiences of women participating in postnatal clinical programs and in directing treatment towards helping women to acquire the necessary caregiving skills and increasing parental efficacy. The Demoralisation Scale is a useful clinical tool for assessing intervention effects. PMID:25520260

  15. Microbial Etiology of Community-Acquired Pneumonia Among Infants and Children Admitted to the Pediatric Hospital, Ain Shams University

    Science.gov (United States)

    El Seify, Magda Yehia; Fouda, Eman Mahmoud; Ibrahim, Hanan Mohamed; Fathy, Maha Muhammad; Husseiny Ahmed, Asmaa Al; Khater, Walaa Shawky; El Deen, Noha Nagi Mohammed Salah; Abouzeid, Heba Galal Mohamed; Hegazy, Nancy Riyad Ahmed; Elbanna, Heba Salah Sayed

    2016-01-01

    Background While recognizing the etiology of community-acquired pneumonia is necessary for formulating local antimicrobial guidelines, limited data is published about this etiology in Egyptian pediatric patients. Objectives To determine the frequency of bacterial and viral pathogens causing community-acquired pneumonia (CAP) among immunocompetent Egyptian infants and preschool children. Methods Ninety infants and preschool-age children admitted to our hospital with CAP were prospectively included in the study. Etiological agents were identified using conventional bacteriological identification methods and IgM antibodies detection against common atypical respiratory bacteria and viruses. Results An etiology was identified in 59 patients (65.5%). Bacterial pathogens were detected in 43 (47.8%) of the cases while viral pathogens were detected in 23 (25.5%). Coinfection with more than one etiologic agent was evident in seven patients (7.8%). The most common typical bacterial cause of pneumonia was Staphylococcus aureus (n = 12, 13.3%), followed by Streptococcus pneumoniae and Klebsiella pneumoniae (n = 7, 7.8%, each). The commonest atypical bacterium was Mycoplasma pneumoniae (n = 10, 11.1%), whereas the commonest viral etiology was influenza viruses (n = 11, 12.2%). Conclusion Although we could not determine the causative agent in some studied cases, this study provides preliminary data regarding the spectrum and frequency of microorganisms causing CAP in Egyptian infants and preschool children.

  16. The incidence of human herpesvirus 6 infection in children with febrile convulsion admitted to the University Hospital, Kuala Lumpur.

    Science.gov (United States)

    Chua, K B; Lam, S K; AbuBakar, S; Koh, M T; Lee, W S

    1997-12-01

    From October 1996 to March 1997, 31 children with febrile convulsions were admitted to the University Hospital, Kuala Lumpur. Human Herpesvirus 6 (HHV 6) was virologically and/or serologically confirmed to be the cause of the febrile episode in 5 of these children (16.1%). Age, sex and other associated clinical features (diarrhoea, cough, running nose and type of seizure) were not useful in differentiating cases of febrile convulsion due to HHV 6 from those of other aetiology. However, uvulo-palatoglossal junctional ulcers were noted in children in whom the cause of the seizure could be attributed to HHV 6 but not in the remaining cases in the study group. HHV 6 DNA was detected in peripheral blood mononuclear cells from all patients with febrile convulsions attributed to HHV6, and in patients shown serologically to have already been exposed to the virus by nested polymerase chain reaction amplification. Only genotype HHV 6B was detected from patients with seizure due to HHV 6 but both genotype 6A and 6B were detected in the remaining cases studied.

  17. The Frederic Joliot hospital department

    International Nuclear Information System (INIS)

    The Service Hospitalier Frederic Joliot (SHFJ) of the CEA, has got a scientific and a medical mission: to develop techniques allowing the functional study of human organs. The paper presents the main activities of this department: the positron emission tomography to visualize in real time markers in the organism in neurology and cardiology, researches on epilepsy to localize the epileptic centre, the nuclear medicine in cardiology with the use of the gamma photon emission tomography and the radiopharmacology to visualize the drugs effects in the organism. (A.L.B.)

  18. Comparison of Routine Health Management Information System Versus Enhanced Inpatient Malaria Surveillance for Estimating the Burden of Malaria Among Children Admitted to Four Hospitals in Uganda

    OpenAIRE

    Mpimbaza, Arthur; Miles, Melody; Sserwanga, Asadu; Kigozi, Ruth; Wanzira, Humphrey; Rubahika, Denis; Nasr, Sussann; Bryan K Kapella; Yoon, Steven S.; Chang, Michelle; Yeka, Adoke; Staedke, Sarah G.; Kamya, Moses R.; Dorsey, Grant

    2015-01-01

    The primary source of malaria surveillance data in Uganda is the Health Management Information System (HMIS), which does not require laboratory confirmation of reported malaria cases. To improve data quality, an enhanced inpatient malaria surveillance system (EIMSS) was implemented with emphasis on malaria testing of all children admitted in select hospitals. Data were compared between the HMIS and the EIMSS at four hospitals over a period of 12 months. After the implementation of the EIMSS, ...

  19. High Prevalence of Infectious Diseases and Drug-Resistant Microorganisms in Asylum Seekers Admitted to Hospital; No Carbapenemase Producing Enterobacteriaceae until September 2015

    NARCIS (Netherlands)

    Ravensbergen, Sofanne J.; Lokate, Mariette; Cornish, Darren; Kloeze, Eveline; Ott, Alewijn; Friedrich, Alex W.; van Hest, Rob; Akkerman, Onno W.; Lange, de Wiel C.; van der Werf, Tjip S.; Bathoorn, Erik; Stienstra, Ymkje

    2016-01-01

    Introduction The current refugee crisis emphasizes the need for information on infectious diseases and resistant microorganisms in asylum seekers with possible consequences for public health and infection control. Methods We collected data from asylum seekers admitted to our university hospital or w

  20. The influence of volume and intensive care unit organization on hospital mortality in patients admitted with severe sepsis: a retrospective multicentre cohort study.

    NARCIS (Netherlands)

    Peelen, L.; Keizer, N.F. de; Peek, N.; Scheffer, G.J.; Voort, P.H. van der; Jonge, E. de

    2007-01-01

    INTRODUCTION: The aim of the study was to assess the influence of annual volume and factors related to intensive care unit (ICU) organization on in-hospital mortality among patients admitted to the ICU with severe sepsis. METHODS: A retrospective cohort study was conducted using the database of the

  1. Pandemic Influenza A H1N1 in Oman: Epidemiology, Clinical Features, and Outcome of Patients Admitted to Sultan Qaboos University Hospital in 2009

    Directory of Open Access Journals (Sweden)

    Mujahid Al-Busaidi

    2016-07-01

    Full Text Available Objectives: Oman experienced the H1N1 pandemic in 2009 that initially started in Mexico and the United States. We present the epidemiology, clinical features, and outcome of cases admitted to Sultan Qaboos University Hospital. Methods: We retrospectively reviewed all patients admitted with confirmed influenza A H1N1 infection from August to December 2009. The study included adults and pediatric patients. We looked at the clinical and laboratory factors associated with increased length of hospital stay. Results: There were 68 patients admitted with influenza A H1N1 infection, and their median age was 23 years. The most common symptoms were fever (100% and cough (79.4%. The most common reason for admission was the severity of illness (69.1%. Lymphopenia was the most common hematological abnormality (41.8%. All patients received treatment with oseltamivir. One patient died secondary to multi-organ failure. On multivariate analysis, severity of illness, use of steroids, anemia, lymphopenia, and abnormal alanine amino transferase levels were associated with increased length of stay. Conclusions: The H1N1 pandemic in Oman followed the international trends in terms of clinical presentation and laboratory values for patients admitted to the hospital.

  2. Pandemic Influenza A H1N1 in Oman: Epidemiology, Clinical Features, and Outcome of Patients Admitted to Sultan Qaboos University Hospital in 2009

    Science.gov (United States)

    Al-Busaidi, Mujahid; Al Maamari, Khuloud; Al’Adawi, Badriya; Alawi, Fatma Ba; Al-Wahaibi, Adil; Belkhair, Abdullah

    2016-01-01

    Objectives Oman experienced the H1N1 pandemic in 2009 that initially started in Mexico and the United States. We present the epidemiology, clinical features, and outcome of cases admitted to Sultan Qaboos University Hospital. Methods We retrospectively reviewed all patients admitted with confirmed influenza A H1N1 infection from August to December 2009. The study included adults and pediatric patients. We looked at the clinical and laboratory factors associated with increased length of hospital stay. Results There were 68 patients admitted with influenza A H1N1 infection, and their median age was 23 years. The most common symptoms were fever (100%) and cough (79.4%). The most common reason for admission was the severity of illness (69.1%). Lymphopenia was the most common hematological abnormality (41.8%). All patients received treatment with oseltamivir. One patient died secondary to multi-organ failure. On multivariate analysis, severity of illness, use of steroids, anemia, lymphopenia, and abnormal alanine amino transferase levels were associated with increased length of stay. Conclusions The H1N1 pandemic in Oman followed the international trends in terms of clinical presentation and laboratory values for patients admitted to the hospital. PMID:27403242

  3. Ventilator Associated Pneumonia in Critically-Ill Neonates Admitted To Neonatal Intensive Care Unit, Zagazig University Hospitals

    Directory of Open Access Journals (Sweden)

    Ehab A M Albanna

    2011-12-01

    Full Text Available Objective: ventilator associated pneumonia (VAP is defined as nosocomial pneumonia in mechanically ventilated patients. It is considered to be most important cause of infection-related death in intensive care unit. We studied the characteristics and risk factors of VAP in critically-ill neonates.Methods: Fifty six consecutive neonates with different diagnosis admitted from January to October 2010 to neonatal intensive care unit (NICU, Zagazig University Hospitals who needed mechanical ventilation were included in the study. There were 32 neonates, 18 males and 14 females with proven diagnosis of VAP, and 24 neonates, 11 males and 13 females without VAP served as control group. All studied neonates were subjected to history taking, clinical examination, routine investigations (Complete blood count, C-reactive protein, arterial blood gases, blood culture and liver and kidney function tests, and chest X-ray daily as well as non-bronchoscopic alveolar lavage culture for VAP group only.Findings: Of 56 neonates who needed mechanical ventilation, 57.1% developed VAP. Prematurity, low birth weight and prolonged duration of mechanical ventilation were risk factors for developing VAP. Increased total leucocytic count, CRP and hypoalbuminemia were significantly presented in VAP-group. There were significant differences between VAP and non-VAP groups regarding hypothermia, mucopurulent endotracheal tube secretion, PaCO2 and PaO2. Microorganisms associated with blood stream infection in VAP diagnosed group were Klebsiella (15.6%, S. aureus (12.5%, Pseudomonas (9.4%, E. coli (6.2%, Candida (3.1%; 53.1% of obtained blood cultures were sterile. Of non-bronchoscopic alveolar lavage cultures obtained from VAP patients, 68.6% showed gram negative infection, 21.8% showed gram positive organisms and 9.3% revealed Candida infection.Conclusion: The most important risk factors of VAP are prematurity, low birth weight, prolonged duration of mechanical ventilation

  4. Antibiotic resistance of Helycobacter pylori isolated from patients admitted to Imam Hospital, Sari, IRAN, 2002-2003

    Directory of Open Access Journals (Sweden)

    F. Naghshvar

    2005-01-01

    Full Text Available Background and purpose : -Helicobacter pylori is a gram negative spiral bacilus which infects gastric mucosa and causes a wide range of gastro intestinal diseases.Unfortunately the prevalence of the infection by this organism in developing countries is high and despite numerous existing drug regimens, treatment fails to eradicate the organism in many occasions. To reach an effective and curative regimen, invitro determination of suscepibility and resistance of the organism, to various antimicrobials, is pradent. The goal of this study was to determine the prevalence of antimicrobial resistance in Helicobacter pylori,s isolated from cultures. Biopsies from 67 patients admitted to the Sari Imam Hospital were used to cultur Helicobacter pylori and determine their susceptibility and resistance to metronidazole, claritromycin and amoxycillin.Materials and methods : Disc diffusion tecniqu was used to determine the minimum inhibitory concentration , (MIC and resistance pattern of the isolated Helicobacter pylori.In this method we used the cutoff point of MIC 90 ie , a concentration at which 90% or more of culture plates show inhibition zone around the antimicrobial test disc. Results : MIC 90 for amoxycillin and claritramycin in our study was 0.25 g/ml and all isolates were susceptible to amoxycillin. Only one isolate was resistant to claritramycin. MIC 90 for metronidzole was 16 and 4 resistant cases were isolated.Conclusion : This stndy showed low level of resistance to metronidazole and claritramycin which were comparable to the reported results from other studies. No resistance was observed to amoxycillin which was also the same as other reported results. According to the pattern of antimicrobial resistance, we can recommend the studied drugs, against Helicobacter pylori.

  5. AN OBSERVATIONAL STUDY REGARDING PREVALENCE OF S UPERSTITIOUS BELIEFS AMONG PATIENTS ADMITTED AT A TERTIARY HOSPITAL IN INDORE

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    Bansal

    2015-03-01

    Full Text Available INTRODUCTION: Superstitions have always been deep rooted in the Indian culture, and an integral part of everyday lives. Moreover, the people are t ightly locked up in religious taboos thus taking useless Practices. A ny cure for this disease brought about by means other than medical treatment, has a dramatic effect on people and strengthens their belief in supernatural powers. Ignorance of scientific reasons behind these phenomena increases the mystery and consequently gives a boost to superstition. MATERIALS AND METHODS: The present study was conducted to find out the prevalence of superstitious practices pertaining to medical conditions - i.e. typhoid, jaundice and psychiatric illness among 300 patients admitted at tertiary care hospital as studied in an interval of 3 months. A pre tested semi - structured questionnaire framed to assess the prevalence of superstitious practices in them. RESULTS: Superstit ious practices were found more common in literate /Uneducated/Unemployed peoples. The most common age group involved was found to be 20 - 40 yr. group. Males are more involved in superstitious practices. The main reason found for the ignorance of scientific m edical care are like - large distance from medical care, poor financial condition, fear of investigations, less trust on doctors, more belief on faith healing mid - way . However at last they convinced that the cure of any grave illness is not possible with me ans of faith healing alone. CONCLUSION: The present study clearly shows that superstitious beliefs still prevail in this modern world. This prevalence may block the wellbeing of the individuals and hinder their positive personal growth. Thus, steps should be taken to alleviate or at least reduce such superstitious beliefs, thus urging the people to think rationally and logically.

  6. Clinical Study of Obesity and associated morbidities in patients admitted to College of Medical Sciences Teaching-Hospital, Bharatpur

    Directory of Open Access Journals (Sweden)

    Manohar Pradhan

    2015-12-01

    Full Text Available Background and Objectives: The present study was conducted with objective to study the incidence of obesity and associated co-morbidities in patients admitted to CMS-TH, Bharatpur.Materials and Methods: One hundred and fifty consecutive overweight patients from the January 2009 to December 2012 with Basal metabolic index (BMI>25 and obese patients (BMI>30 were included in this hospital based prospective study. Detailed evaluation of risk factors and family history of other diseases were taken, other obesity related indicators like WPRO, 2000 for BMI, waist circumference (NCEP ATP III and NCEP for South Asian ethnicity NCEP– National Cholesterol Education Program and waist hip ratio (WHO criteria were measured and comparison done in order to detect best method for application. These cases were evaluated for associated co-morbid condition and metabolic syndrome which were diagnosed using NCEP ATP III criteria.Results: The mean age of patients was 52.7 years. Commonest co-existing risk factors were alcohol consumption, smoking, hypertension and type 2 diabetes mellitus. Evaluation based on WHO criteria revealed that 56.7% patients were overweight, 38.7 % were obese class II and 4.6 % were class II. While 45.1% male and 69.1% female patients had central obesity. The figure was 81.7 % for males and 94.1% for females with WHO criteria using waist hip ratio. Risk factors like alcohol consumption (52.7%, smoking (52.7% and fatty liver disease (22.66% were the commonest co-morbid conditions.Conclusion: In the present study, risk factors of alcohol, smoking and hypertension and co-morbid conditions diabetes mellitus, dyslipidemia, ischemic heart disease, stroke and fatty liver were noted. Waist hip ratio was the best indicator to detect central obesity and co-morbid conditions and recommended to be used for Nepali population.JCMS Nepal. 2015;11(3:16-19

  7. Managerial roles in contemporary hospital departments.

    Science.gov (United States)

    Longest, B B

    1997-01-01

    The emergence of managed care and more integrated healthcare delivery systems brings new challenges to managers in hospital departments. Managers can effectively respond to these challenges by assuming three roles--those of strategist, designer, and leader--described in the following article.

  8. Oxigenoterapia inalatória em pacientes pediátricos internados em hospital universitário Oxygen inhalation therapy in children admitted to an university hospital

    Directory of Open Access Journals (Sweden)

    Paula Angeleli B. de Camargo

    2008-03-01

    Full Text Available OBJETIVO: Avaliar o uso da oxigenoterapia inalatória em crianças internadas em hospital universitário. MÉTODOS: Estudo prospectivo de crianças atendidas no Pronto-Socorro Pediátrico do Hospital das Clínicas da Faculdade de Medicina de Botucatu e que receberam oxigenoterapia durante a internação, de maio a setembro de 2005. Indicou-se oxigenoterapia se saturação de oxigênio inferior a 90% e frequência respiratória elevada para idade. Crianças em uso crônico de oxigênio ou com necessidade de ventilação mecânica foram excluídas. Foram avaliados: sintomas respiratórios, diagnósticos clínicos, saturação de oxigênio, método e tempo de oxigenoterapia e responsável pela prescrição. RESULTADOS: Foram atendidas 8.709 crianças no pronto-socorro, sendo que 2.769 (32% apresentaram doenças respiratórias e 97 necessitaram de internação na enfermaria. Destas, 62 (64% receberam oxigenoterapia. Das 62 crianças, 37 eram do sexo masculino e a idade variou de 2 meses a 14 anos (mediana: 8 meses. A causa de hipóxia foi pneumonia em 52 crianças (84%, asma em cinco, bronquiolite em quatro e traqueomalácia em uma. As prescrições de oxigenoterapia foram feitas por médicos, com monitoração de saturação de oxigênio por oxímetro de pulso. O tempo mediano de administração de O2 foi 6 dias e o cateter nasal foi usado em 94% dos casos, sendo raro o uso de máscaras ou capuz de oxigênio. CONCLUSÕES: A oxigenoterapia inalatória foi mais frequente em crianças com menor idade e em pacientes com pneumonia, sendo sua indicação compatível com critérios internacionais. O uso do cateter nasal mostrou-se seguro, simples, efetivo e de baixo custo.OBJECTIVE: To evaluate inalatory oxygen therapy in children admitted to a university hospital. METHODS: Prospective study of children assisted at the Emergency Room of the University Hospital of Botucatu Medical School and submitted to oxygen therapy during hospitalization, from May to

  9. Risk scoring systems for adults admitted to the emergency department: a systematic review

    DEFF Research Database (Denmark)

    Brabrand, Mikkel; Folkestad, Lars; Clausen, Nicola G;

    2010-01-01

    . Even though most scoring systems are not meant to be used on an individual level, they can support the more inexperienced doctors and nurses in assessing the risk of deterioration of their patients. We therefore performed a systematic review on the level of evidence of literature on scoring systems...... developed or validated in the MAU. We hypothesized that existing scoring systems would have a low level of evidence and only few systems would have been externally validated. METHODS: We conducted a systematic search using Medline, EMBASE and the Cochrane Library, according to the PRISMA guidelines......, on scoring systems developed to assess medical patients at admission. The primary endpoints were in-hospital mortality or transfer to the intensive care unit. Studies derived for only a single or few diagnoses were excluded. The ability to identify patients at risk (discriminatory power) and agreement...

  10. Nutritional assessment of adult patients admitted to a hospital of the Amazon region Evaluación nutricional de pacientes adultos ingresados en un hospital de la región amazónica

    OpenAIRE

    K. Acuña; Portela, M; A. Costa-Matos; L. Bora; M. Rosa Teles; D. L. Waitzberg; T. Cruz

    2003-01-01

    Changes in nutritional status are important in clinical practice because they relate to an increase in morbidity and mortality. Studies about nutritional problems in hospitalized adults have been reported since the 1970s. The prevalence of malnutrition has varied from 10 to 70%, depending on the diagnostic criteria used. The hospital studied and the duration of admission. Aim: To assess, in the first day of hospital stay, the nutritional status of adults admitted to undergo elective surgery i...

  11. Nutritional status of adults and elderly patients admitted in an university hospital Perfil nutricional de pacientes adultos e idosos admitidos em um hospital universitário

    Directory of Open Access Journals (Sweden)

    Nathálie Crestani

    2011-12-01

    Full Text Available Objective: To identify the nutritional status of adults and elderly patients admitted in an university hospital. Materials and Methods: This is a cross-sectional, retrospective and descriptive study. The nutritional assessment was conducted by using the body mass index (BMI and the subjective global assessment (SGA, which classifies patients into three categories: well nourished (A, moderately or suspected of being malnourished (B or severely malnourished (C. All data (SGA, BMI and primary condition were collected from information present in the evaluation forms filled in the nutritional routine, which are performed within seventy-two hours after admission. The study was approved by the Scientific and Ethics Committee for Research of PUCRS. Results: The study included 32 adults and 36 elderly (n=68. In relation to the SGA, 46,9% of adults were classified as well nourished (A and 53,1% as moderately (or suspected of being malnourished (B. Among elderly patients, 25% were classified as well nourished (A and 75% as moderately (or suspected of being malnourished (B. The BMI showed 37,5% of adults as eutrophic and 62,5% as overweight or obesity; the elderly were classified as 50% eutrophic, 36,1% overweight and 13,9% underweight. Conclusion: The nutritional status of the studied patients was characterized by the high prevalence of nutritional risk and overweight/obesity in both groups. This reality seems to translate, at the hospital level, the situation of nutritional transition experienced in our country today. In addition, the results point the importance of using more than one method of nutrition screening in patients admitted in hospitals, in order to obtain greater precision in the assessment.Objetivo: Identificar o perfil nutricional de pacientes adultos e idosos admitidos em um hospital universitário. Materiais e Métodos: Trata-se de um estudo transversal, retrospectivo e descritivo. Foram utilizados para avaliação nutricional o

  12. Relationship between Para Clinical Findings of First Seizure and One Year Recurrence Rate in Children Admitted at Shaheed Sadoughi Hospital-Yazd

    OpenAIRE

    N Owaisi; Z Eslami; M. Golestan; M Sadr- Bafghi; R Fallah; Akhavan Karbasi, S

    2007-01-01

    Introduction: Seizure is the most common pediatric neurology problem that occurs in 10% of children. The purpose of this study was to determine the recurrence rate of seizures after one year and its relationship with paraclinical findings of the first attack. Methods : In a historical cohort analytic study , 131 children with first seizure admitted to Shaheed Sadoughi Hospital between March 2004 to August 2005 were evaluated for recurrence rate during one year and its relationship with serum ...

  13. Survival status and predictors of mortality in severely malnourished children admitted to Jimma University Specialized Hospital from 2010 to 2012, Jimma, Ethiopia: a retrospective longitudinal study

    OpenAIRE

    Jarso, Habtemu; Workicho, Abdulhalik; Alemseged, Fessahaye

    2015-01-01

    Background Although community based treatment of severe acute malnutrition has been advocated for in recent years, facility based treatment of severe acute malnutrition is still required. Therefore, information on the treatment outcomes of malnutrition and potential predictors of mortality among severely malnourished children admitted to hospitals is critical for the improvement of quality care. Thus, the aim of this study was to assess survival status and predictors of mortality in severely ...

  14. An organizational metamodel for hospital emergency departments.

    Science.gov (United States)

    Kaptan, Kubilay

    2014-10-01

    I introduce an organizational model describing the response of the hospital emergency department. The hybrid simulation/analytical model (called a "metamodel") can estimate a hospital's capacity and dynamic response in real time and incorporate the influence of damage to structural and nonstructural components on the organizational ones. The waiting time is the main parameter of response and is used to evaluate the disaster resilience of health care facilities. Waiting time behavior is described by using a double exponential function and its parameters are calibrated based on simulated data. The metamodel covers a large range of hospital configurations and takes into account hospital resources in terms of staff and infrastructures, operational efficiency, and the possible existence of an emergency plan; maximum capacity; and behavior both in saturated and overcapacitated conditions. The sensitivity of the model to different arrival rates, hospital configurations, and capacities and the technical and organizational policies applied during and before a disaster were investigated. This model becomes an important tool in the decision process either for the engineering profession or for policy makers. PMID:25397658

  15. Clinical pharmacist evaluation of medication inappropriateness in the emergency department of a teaching hospital in Malta

    OpenAIRE

    West LM; Cordina M; Cunningham S

    2012-01-01

    Appropriate prescribing remains an important priority in all medical areas of practice. Objective The objective of this study was to apply a Medication Appropriateness Index (MAI) to identify issues of inappropriate prescribing amongst patients admitted from the Emergency Department (ED). Methods This study was carried out at Malta's general hospital on 125 patients following a two-week pilot period on 10 patients. Patients aged 18 years and over and on medication therapy were included. Medic...

  16. From the emergency department to the general hospital: hospital ownership and market factors in the admission of the seriously mentally ill.

    Science.gov (United States)

    Shen, Jay J; Cochran, Christopher R; Moseley, Charles B

    2008-01-01

    General hospitals are becoming the safety net provider for the seriously mentally ill (SMI) in the United States, but these patients are faced with a number of potential barriers when accessing these hospitals. Hospital ownership and market forces are two potential organizational and healthcare system barriers that may affect the SMI patient's access, because the psychiatric and medical services they need are unprofitable services. This study examines the relationship among hospital ownership, market forces, and admission of the SMI patient from the emergency department into the general hospital. This was a cross-sectional study of a large sample of SMI patients from the 2002 State Inpatient Datasets for five states. Multiple logistic regression was applied in the multivariable analysis. After controlling for patient, hospital, and county covariates and when compared with not-for-profit hospitals, public hospitals were more likely to admit while investor-owned hospitals were less likely to admit SMI patients. Hospitals in competitive markets were less likely to admit while hospitals with capitation revenues were slightly less likely to admit these patients. Policy options that can address this "market failure" include strengthening the public psychiatric inpatient care system, making private health insurance coverage of the SMI more equitable, revising Medicare prospective payment system to better reimburse the treatment of the SMI, and allowing not-for-profit hospitals to count care of the SMI as a community benefit. Results of this study will be useful to healthcare managers searching for ways to reduce unnecessary administrative costs while continuing to maintain the level of administrative activities required for the provision of safe, effective, and high-quality care. PMID:18720688

  17. Medical and household characteristics associated with methicillin resistant Staphylococcus aureus nasal carriage among patients admitted to a rural tertiary care hospital.

    Directory of Open Access Journals (Sweden)

    Leah Schinasi

    Full Text Available BACKGROUND: Methicillin resistant Staphylococcus aureus (MRSA poses a threat to patient safety and public health. Understanding how MRSA is acquired is important for prevention efforts. This study investigates risk factors for MRSA nasal carriage among patients at an eastern North Carolina hospital in 2011. METHODS: Using a case-control design, hospitalized patients ages 18 - 65 years were enrolled between July 25, 2011 and December 15, 2011 at Vidant Medical Center, a tertiary care hospital that screens all admitted patients for nasal MRSA carriage. Cases, defined as MRSA nasal carriers, were age and gender matched to controls, non-MRSA carriers. In-hospital interviews were conducted, and medical records were reviewed to obtain information on medical and household exposures. Multivariable conditional logistic regression was used to derive odds ratio (OR estimates of association between MRSA carriage and medical and household exposures. RESULTS: In total, 117 cases and 119 controls were recruited to participate. Risk factors for MRSA carriage included having household members who took antibiotics or were hospitalized (OR: 3.27; 95% Confidence Interval (CI: 1.24-8.57 and prior hospitalization with a positive MRSA screen (OR: 3.21; 95% CI: 1.12-9.23. A lower proportion of cases than controls were previously hospitalized without a past positive MRSA screen (OR: 0.40; 95% CI: 0.19-0.87. CONCLUSION: These findings suggest that household exposures are important determinants of MRSA nasal carriage in hospitalized patients screened at admission.

  18. Risk of maltreatment-related injury: a cross-sectional study of children under five years old admitted to hospital with a head or neck injury or fracture.

    Directory of Open Access Journals (Sweden)

    Joseph Jonathan Lee

    Full Text Available OBJECTIVES: To determine the predictive value and sensitivity of demographic features and injuries (indicators for maltreatment-related codes in hospital discharge records of children admitted with a head or neck injury or fracture. METHODS: STUDY DESIGN: Population-based, cross sectional study. SETTING: NHS hospitals in England. SUBJECTS: Children under five years old admitted acutely to hospital with head or neck injury or fracture. DATA SOURCE: Hospital Episodes Statistics, 1997 to 2009. MAIN OUTCOME MEASURE: Maltreatment-related injury admissions, defined by ICD10 codes, were used to calculate for each indicator (demographic feature and/or type of injury: i the predictive value (proportion of injury admissions that were maltreatment-related; ii sensitivity (proportion of all maltreatment-related injury admissions with the indicator. RESULTS: Of 260,294 childhood admissions for fracture or head or neck injury, 3.2% (8,337 were maltreatment-related. With increasing age of the child, the predictive value for maltreatment-related injury declined but sensitivity increased. Half of the maltreatment-related admissions occurred in children older than one year, and 63% occurred in children with head injuries without fractures or intracranial injury. CONCLUSIONS: Highly predictive injuries accounted for very few maltreatment-related admissions. Protocols that focus on high-risk injuries may miss the majority of maltreated children.

  19. Being in a process of transition to psychosis, as narrated by adults with psychotic illnesses acutely admitted to hospital

    OpenAIRE

    Sebergsen, K; Norberg, A; Talseth, A-G

    2014-01-01

    Accessible summary Early intervention to prevent and reduce new episodes of psychosis involves patients, relatives and mental health personnel recognizing the early signs of psychosis. Twelve participants with psychotic illnesses narrated how they experienced becoming psychotic before they were admitted to acute psychiatric wards. The results of this study demonstrate that participants and their close others who sensed, understood and articulated experienced changes as signs of psychosis esta...

  20. Are AMI patients with comorbid mental illness more likely to be admitted to hospitals with lower quality of AMI care?

    Directory of Open Access Journals (Sweden)

    Xueya Cai

    Full Text Available OBJECTIVE: Older patients with comorbid mental illness are shown to receive less appropriate care for their medical conditions. This study analyzed Medicare patients hospitalized for acute myocardial infarction (AMI and determined whether those with comorbid mental illness were more likely to present to hospitals with lower quality of AMI care. METHODS: Retrospective analyses of Medicare claims in 2008. Hospital quality was measured using the five "Hospital Compare" process indicators (aspirin at admission/discharge, beta-blocker at admission/discharge, and angiotension-converting enzyme inhibitor or angiotension receptor blocker for left ventricular dysfunction. Multinomial logit model determined the association of mental illness with admission to low-quality hospitals (rank of the composite process score 90(th percentile, compared to admissions to other hospitals with medium quality. Multivariate analyses further determined the effects of hospital type and mental diagnosis on outcomes. RESULTS: Among all AMI admissions to 2,845 hospitals, 41,044 out of 287,881 patients were diagnosed with mental illness. Mental illness predicted a higher likelihood of admission to low-quality hospitals (unadjusted rate 2.9% vs. 2.0%; adjusted odds ratio [OR]1.25, 95% confidence interval [CI] 1.17-1.34, p<0.01, and an equal likelihood to high-quality hospitals (unadjusted rate 9.8% vs. 10.3%; adjusted OR 0.97, 95% CI 0.93-1.01, p = 0.11. Both lower hospital quality and mental diagnosis predicted higher rates of 30-day readmission, 30-day mortality, and 1-year mortality. CONCLUSIONS: Among Medicare myocardial infarction patients, comorbid mental illness was associated with an increased risk for admission to lower-quality hospitals. Both lower hospital quality and mental illness predicted worse post-AMI outcomes.

  1. Assessment for benign paroxysmal positional vertigo in medical patients admitted with falls in a district general hospital.

    Science.gov (United States)

    Abbott, Joel; Tomassen, Sylvia; Lane, Laura; Bishop, Katie; Thomas, Nibu

    2016-08-01

    Having benign paroxysmal positional vertigo (BPPV) puts patients at a significantly higher risk of falling. It is poorly recognised and diagnosis is frequently delayed. BPPV has been studied in outpatient settings, but there have been no studies looking at the prevalence in patients admitted with falls. This study aims to establish how common BPPV is in these patients.For a 4-month period, patients admitted on an unselected medical take were screened for an admission precipitated by a fall. Patients who consented were assessed for BPPV using the Dix-Hallpike manoeuvre. Patients who tested positive were treated using the Epley manoeuvre. The assessments were carried out by specialist physiotherapists who were experienced at assessing and diagnosing patients with peripheral vestibular disorders. Out of the 111 patients initially identified, 37 (33%) were considered to be appropriate and consented to be part of the study. Of these, 20 patients (54%) had a positive Dix-Hallpike manoeuvre.Of the patients included in the study, over half tested positive for BPPV. This merits further study. Potentially, there is a proportion of patients admitted with falls who have an easily treatable contributing factor that is not being identified with standard practice. PMID:27481376

  2. Inappropriate prescribing to older patients admitted to hospital: A comparison of different tools of misprescribing and underprescribing

    OpenAIRE

    San-José, Antonio; Agustí, Antonia; Vidal, Xavier; Formiga Pérez, Francesc; López-Soto, Alfonso; Fernández Moyano, Antonio; García, Juana; Ramírez Duque, Nieves; Torres, Olga H.; Barbé, José

    2014-01-01

    Purpose: This study aims to assess inappropriate prescribing (IP) to elderly patients during the month prior to hospitalization and to compare different IP criteria. Methods: An observational, prospective and multicentric study was carried out in the internal medicine services of seven Spanish hospitals. Patients aged 75 years and older were randomly selected after hospital admission for a year. To assess potentially inappropriate medicines (PIMs), the Beers and STOPP criteria were used and t...

  3. Factors associated with nursing home placement of all patients admitted for inpatient rehabilitation in Singapore community hospitals from 1996 to 2005: a disease stratified analysis.

    Directory of Open Access Journals (Sweden)

    Cynthia Chen

    Full Text Available OBJECTIVES: To (1 identify social and rehabilitation predictors of nursing home placement, (2 investigate the association between effectiveness and efficiency in rehabilitation and nursing home placement of patients admitted for inpatient rehabilitation from 1996 to 2005 by disease in Singapore. DESIGN: National data were retrospectively extracted from medical records of community hospital. DATA SOURCES: There were 12,506 first admissions for rehabilitation in four community hospitals. Of which, 8,594 (90.3% patients were discharged home and 924 (9.7% patients were discharged to a nursing home. Other discharge destinations such as sheltered home (n = 37, other community hospital (n = 31, death in community hospital (n = 12, acute hospital (n = 1,182 and discharge against doctor's advice (n = 24 were excluded. OUTCOME MEASURE: Nursing home placement. RESULTS: Those who were discharged to nursing home had 33% lower median rehabilitation effectiveness and 29% lower median rehabilitation efficiency compared to those who were discharged to nursing homes. Patients discharged to nursing homes were significantly older (mean age: 77 vs. 73 years, had lower mean Bathel Index scores (40 vs. 48, a longer median length of stay (40 vs. 33 days and a longer time to rehabilitation (19 vs. 15 days, had a higher proportion without a caregiver (28 vs. 7%, being single (21 vs. 7% and had dementia (23 vs. 10%. Patients admitted for lower limb amputation or falls had an increased odds of being discharged to a nursing home by 175% (p<0.001 and 65% (p = 0.043 respectively compared to stroke patients. CONCLUSIONS: In our study, the odds of nursing home placement was found to be increased in Chinese, males, single or widowed or separated/divorced, patients in high subsidy wards for hospital care, patients with dementia, without caregivers, lower functional scores at admission, lower rehabilitation effectiveness or efficiency at discharge and primary diagnosis groups such

  4. Prevalence of potentially inappropriate prescribing in an acutely ill population of older patients admitted to six European hospitals.

    LENUS (Irish Health Repository)

    Gallagher, Paul

    2011-11-01

    Potentially inappropriate prescribing is common in older people presenting to hospital with acute illness in Ireland. The aim of this study was to determine if this phenomenon is unique to Ireland or whether it is a more widespread problem in hospitals across Europe.

  5. Trauma in elderly patients evaluated in a hospital emergency department in Konya, Turkey: a retrospective study

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    Kara H

    2013-12-01

    Full Text Available Hasan Kara,1 Aysegul Bayir,1 Ahmet Ak,1 Murat Akinci,1 Necmettin Tufekci,1 Selim Degirmenci,1 Melih Azap21Department of Emergency Medicine, Selçuk University, Konya, Turkey; 2Department of Emergency Medicine, Konya Numune Hospital, Konya, TurkeyPurpose: Trauma is a common cause of admission to the hospital emergency department. The purpose of this study was to evaluate the cause of admission, clinical characteristics, and outcomes of patients aged ≥65 years admitted to an emergency department in Turkey because of blunt trauma.Materials and methods: Medical records were retrospectively reviewed for 568 patients (314 women and 254 men aged ≥65 years who were admitted to an emergency department of a tertiary care hospital.Results: Trauma was caused by low-energy fall in 379 patients (67%, traffic accident in 79 patients (14%, high-energy fall in 69 patients (12%, and other causes in 41 patients (7%. The most frequent sites of injury were the lower extremity, thorax, upper extremity, and head. The femur was the most frequent fracture site. After evaluation in the emergency department, 377 patients (66% were hospitalized. There were 31 patients (5% who died. Risk of hospitalization after trauma was significantly associated with trauma to the lower extremity, thorax, and spine; fractures of the femur and rib; and intracranial injury.Conclusion: Emergency department admission after trauma in patients aged $65 years is common after low-energy falls, and most injuries occur to the extremities. It is important to focus on prevention of falls to decrease the frequency of trauma in the elderly.Keywords: fall, femur, fracture, injury

  6. A STUDY TO EVALUATE THE EFFECT OF NUTRITIONAL INTERVENTION MEASURES ON CHILDREN WITH SEVERE ACUTE MALNUTRITION ADMITTED IN NUTRITION REHABILITATION CENTER AT CIVIL HOSPITAL BAIRAGARH, BHOPAL, MADHYA PRADESH

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    Ritesh

    2015-02-01

    Full Text Available BACKGROUND: The state of Madhya Pradesh has 1.3 million severely malnourished children. Nutrition rehabilitation centers (NRCs were started in the state to control severe malnutrition and decrease the prevalence of severe malnourished children to less than 1% among c hildren aged 1 – 5 years. OBJECTIVE: To assess the effect of nutritional interventional measures for children with severe acute malnutrition (SAM admitted in Nutrition Rehabilitation Center by reviewing anthropometric indicators. Material and methods: The p resent study was conducted from July 2014 to December 2014; all children admitted during the study period in NRC civil hospital Bairagarh, Bhopal were observed during their stay at NRC to analyze the effect of interventional measures on select anthropometr ic and outcome indicators. The data were entered into Microsoft excel spreadsheet and analyzed. RESULT: 61.8 % of the total 102 children admitted were female, 42.1% were in the age group of 13 – 24 months and 34.3% in the age group of 0 - 12 months. About 60% of the population belonged to schedule caste and tribe. The mean weight at admission was 6.4 kg and on discharge 7.09 kg. Of the total 102, 8 children defaulted and 92 were discharged amongst them 66.3% were recovered. CONCLUSION: The study reveals a propo rtion of 66.3% children amongst the study group recovered with at least 15% weight gain of initial weight

  7. The experience of daily life of acutely admitted frail elderly patients one week after discharge from the hospital

    DEFF Research Database (Denmark)

    Andreasen, Jane; Lund, Hans; Aadahl, Mette;

    2015-01-01

    of the frail elderly shortly after discharge seems important to address these issues. The aim of this study was to explore how frail elderly patients experience daily life 1 week after discharge from an acute admission. METHODS: The qualitative methodological approach was interpretive description. Data were...... participants, whereas the less frail experienced this less. CONCLUSION AND DISCUSSION: Several elements and stressors were affecting the well-being of the participants in daily life 1 week after discharge. In particular, contact with the health care system created frustrations and worries, but also physical...... disability, loneliness, and inactivity were issues of concern. These elements should be addressed by health professionals in relation to the transition phase. Future interventions should incorporate a multidimensional and bio-psycho-social perspective when acutely admitted frail elderly are discharged...

  8. CLINICAL AND DEMOGRAPHIC STUDY OF JAPANESE ENCEPHALITIS PATIENTS ADMITTED IN GAUHATI MEDICAL COLLEGE AND HOSPITAL, GUWAHATI, ASSAM, INDIA DURING 2014 EPIDEMIC

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    Bhaskar

    2015-11-01

    Full Text Available BACKGROUND Japanese Encephalitis is one of the most common causes of Acute Encephalitic Syndrome in Asia. During the period of June to August in 2014 an epidemic occurred in Assam, a northestern state of India. METHODS Patients admitted in the Medicine Department in Gauhati Medical College and Hospital (GMCH, Guwahati, Assam, India, with clinical features of Acute Encephalitic Syndrome (AES i.e. acute onset fever and a change in mental status (including symptoms such as confusion, disorientation, coma, or inability to talk and/or new onset seizures (excluding simple febrile seizures from June to August 2014 underwent ELISA for Japanese Encephalitis Immunoglobulin M in cerebrospinal fluid (CSF at the time of admission. Clinical features, demographic profile and laboratory investigations were recorded in positive patients. RESULTS 226 AES patients were admitted in 6 different units of Medicine ward in GMCH, out of which 76 patients were diagnosed to be JE positive with CSF IgM ESLIA, coming from 17 districts of Assam. Out of 76 patients, 69 patients were from rural area, only 7 patients were from urban area. 59 (77.63% patients were farmers or daily labourers by occupation and 23 (30.26% patients were illiterate. Mean age of patients was 47.7 years and male to female ratio was 1.7:1. Mean duration of fever was 6.5 days, convulsion was found in 13.15% patients, out of which most common was generalised seizure (9.2%. 55.2% patients had meningeal signs, 23.68% patients had focal neurological deficits in the form of hemiparesis and monoparesis and mean GCS score was 9.28. Extra pyramidal features present in patients were rigidity (23.68%, abnormal posturing (15.78% and abnormal movements (23.68%. 23.68% patients had Leukocytosis and Thrombocytopenia was found in 21 (27.6% patients. Mean CSF cell count was 34.34 cells/mm3 with mean 29.67% polymorphs, mean CSF protein and sugar was 56.15 mg/dl and 66.92 mg/dl respectively. Serum bilirubin level was

  9. Pattern, Clinical Characteristics, and Outcome of Meningitis among HIV-Infected Adults Admitted in a Tertiary Hospital in North Western Tanzania: A Cross-Sectional Study.

    Science.gov (United States)

    Boaz, Matobogolo M; Kalluvya, Samuel; Downs, Jennifer A; Mpondo, Bonaventura C T; Mshana, Stephen E

    2016-01-01

    Background. Limited information exists on the etiologies, clinical characteristics, and outcomes of meningitis among HIV-infected patients in Africa. We conducted a study to determine the etiology, clinical characteristics, and outcomes of meningitis among HIV-infected adults. Methods. A prospective cross-sectional hospital based study was conducted among HIV-infected patients aged ≥18 years admitted to the medical wards with symptoms and signs of meningitis. Sociodemographic and clinical information were collected using a standardized data collection tool. Lumbar puncture was performed to all patients; cerebrospinal fluid samples were sent for analysis. Results. Among 60 HIV-infected adults clinically diagnosed to have meningitis, 55 had CSF profiles consistent with meningitis. Of these, 14 (25.5%) had a laboratory-confirmed etiology while 41 (74.5%) had no isolate identified. Cryptococcus neoformans was the commonest cause of meningitis occurring in 11 (18.3%) of patients followed by Mycobacterium tuberculosis (6.7%). The in-hospital mortality was 20/55 (36.4%). Independent predictors of mortality were low baseline CD4 count and turbid CSF appearance. Conclusion. Cryptococcal meningitis is the most prevalent laboratory-confirmed etiological agent among adult HIV-infected patients with suspected meningitis admitted to medical wards in Western Tanzania. Mortality rate in this population remains unacceptably high. Improving diagnostic capacity and early treatment may help to decrease the mortality rate. PMID:27651801

  10. Profile of Under-Five Malnourished Children Admitted in a Tertiary Care Teaching Hospital in Pune, India

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    Dhrubajyoti J Debnath

    2014-01-01

    Full Text Available Background: Malnutrition is a major public health problem in a developing country like India. Keeping this in mind a study was carried out to find the proportion of under-five children suffering from malnutrition among the under-five hospitalized children and to study co-morbid illnesses and epidemiological factors associated with malnutrition. Methods: This was a hospital-based cross sectional study carried out in the pediatric ward of a tertiary care teaching hospital in Pune, India. All under-five children suffering from malnutrition were studied over a period of 1 month. Results: Total number of under five children diagnosed as malnourished were 47 (39.83%. Moderate and severe/very severe malnutrition was statistically significantly higher in a girl child. The proportion of moderate and severe/very severe malnutrition was higher in low birth weight babies, children who were incompletely immunized for age. Faulty infant feeding practice was observed in 28 (59.6% children. Some of the co-morbid illnesses contributing to morbidity in the malnourished child were acute diarrheal diseases, acute respiratory infection, anemia, and septicemia. Conclusion: A large proportion of hospitalized children were malnourished. Girl child suffered from moderate to severe forms of malnutrition as compared to male child and this was the only statistically significant association. This may be due to neglect of girl child.

  11. Antimicrobial resistance in Salmonella spp. recovered from patients admitted to six different hospitals in Tehran, Iran from 2007 to 2008

    DEFF Research Database (Denmark)

    Tajbakhsh, Mercedeh; Hendriksen, Rene S.; Nochi, Zahra;

    2012-01-01

    The objective of this study was to assess the genotypic diversity associated with antimicrobial susceptibility of Salmonella serovars isolated from patients arriving with diarrhoea to six hospitals of Tehran, Iran. During 2007–2008, a cross-sectional convenience study was performed. Stool samples...

  12. Does informed consent influence therapeutic outcome? A clinical trial of the hypnotic activity of placebo in patients admitted to hospital.

    OpenAIRE

    Dahan, R.; Caulin, C; Figea, L; Kanis, J. A.; Caulin, F; Segrestaa, J M

    1986-01-01

    To examine whether written informed consent might influence the results of clinical trials the effect of placebo when given with or without informed consent to patients suffering from insomnia was studied. The study was a single blind observer blinded trial, and patients were paired according to sex, age, and hospital environment. Randomisation assigned the first patient of each pair to the control group (without informed consent) or the group to give informed consent. Of the 56 patients, 26 ...

  13. STUDY OF CERTAIN EPIDEMIOLOGICAL FACTORS AFFECTING OUTCOME OF ACUTE RESPIRATORY INFECTIONS IN CHILDREN ADMITTED IN A TERTIARY CARE HOSPITAL OF WESTERN MAHARASHTRA

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    Jayashree D

    2015-11-01

    Full Text Available : BACKGROUND: The incidence of acute respiratory infections (ARI is high among under-fi ve children, especially in developing countries. However, the data on ARI from urban areas in India are scarce. AIM: To assess various socio-demographic and environmental factors of ARI cases admitted in tertiary care hospital and to determine their association with outcome of disease. STUDY DESIGN AND SETTING: A Cross-sectional descriptive study conducted in a tertiary care hospital in Western Maharashtra, targeting all ARI cases admitted over a period of 1 yr. in the Pediatric ward at Govt. Medical College & Hospital, Miraj, from 1 January to 31 December 2011. METHODS AND MATERIALS: A pre- tested structured questionnaire with details regarding socio demographic characteristics and Environmental factors influencing outcome of ARI cases was used to collect the information from person accompanying ARI child preferably mother. STATISTICAL ANALYSIS: Statistical software SPSS 16 for proportions, chi square test and odds ratio. RESULTS: Out of all (352 cases of ARI, 93.75% (330 were cured and 6.25% (22 were died. In this study majority of cases were less than one year, mostly among boys from joint family, urban area, Hindu religion. Socioeconomic status and family history of smoking, were statistically significant while overcrowding, seasonal variation and Type of fuel for cooking were not significantly associated with outcome of ARI. CONCLUSION: Efforts should be made to improve the socio-economic and environmental status of the parents by the administration. Improving them can reduce the incidence of the Acute respiratory infection among the under five children and better outcome of disease.

  14. INVESTIGATION OF THE RISK FACTORS FOR CORONARY ARTERY DISEASES IN EMPLOYEES AND THEIR SPOUSES OF THE ELAZIG SECURITY DEPARTMENT WHO ADMITTED TO MEDICAL DEPARTMENT OF THIS HEADQUARTER

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    Suleyman Erhan DEVECI

    2006-08-01

    Full Text Available This study was carried out with the aim of identifying risk factors coronary artery disease (CAD in the employees of Elazig Security Department. Questionnaires were applied to members and/or spouses (313 individuals of Elazig Security Department admitting to the Health Office for any reason in November-December 2003. Measurements for fasting blood sugar, serum cholesterol levels and blood pressure values were carried out. Of the individuals participating in this study, 1.9% reported having diabetes, 2.9% heart disease and 5.4% hypertension. Mean blood pressure measurements were; systolic 114.1±15.9 and diastolic 74.6±10.3 mmHg, mean fasting blood glucose values were reported as 90.9±16.6 mg/dl. 8.9% had high systolic and 7.7% had high diastolic blood pressure measurements, 16.0% had elevated total cholesterol and 3.5% had elevated fasting blood sugar levels. 36.7% reported to be current smokers, 20.8% reported having regular physical activity. 65.5% reported skipping meals and 47.3% reported eating snacks between the meals. In the group that was analyzed, the rates of smoking, sedentary life style and irregular eating habits that are considered as risk factors for CAD were high. [TAF Prev Med Bull 2006; 5(4.000: 235-243

  15. Feasibility of telecare solution for patients admitted with COPD exacerbation: screening data from a pulmonary ward in a university hospital

    DEFF Research Database (Denmark)

    Gottlieb, Magnus; Marså, Kristoffer; Andreassen, Helle;

    2014-01-01

    to assess the reasons for the exclusion of patients, and the reasons for patients not consenting to participate, as well as to identify the predictors for consenting or not consenting among the subgroup of eligible patients. Methods: In this study, all data in the screening log were collected over a...... help patients manage their disease at home and thereby possibly reduce the risk of readmission. Purpose: The primary aim of this study is to assess the feasibility of a telehealth care solution when offered in connection with discharges from a pulmonary ward at a university hospital. Secondary aims are...

  16. EFFECTIVENESS OF NUTRITIONAL INTERVENTION MEASURES ON CHILDREN ADMITTED IN NUTRITIONAL REHABILITATION CENTER (NRC KING GEORGE HOSPITAL- VISAKHAPATNAM

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    Rama Rao

    2015-12-01

    Full Text Available BACKGROUND NRC was started in Visakhapatnam (KGH in December’ 2012 to nutritionally rehabilitate severely acute malnourished children. This study was conducted to assess the effectiveness of rehabilitation services provided at Nutritional Rehabilitation Center. OBJECTIVES 1 To evaluate the effectiveness of Nutritional interventional measures undertaken at Nutritional Rehabilitation Center through review of selected anthropometric measure indicators. 2 To assess the nutritional status after discharge from Nutritional Rehabilitation center. METHODS A Retrospective record based (secondary data study conducted in the month of November 2013.Sevevnty five children were admitted in Nutritional Rehabilitation Center (NRC of KGH, Visakhapatnam in the months of April to October 2013. The data was obtained from NRC records including anthropometric measurements at admission, discharge and follow-up. RESULTS Twenty percent of the children were less than 12 months of age and 34.7% were in the age group of 13–24 months. Forty eight percent were female and 52% were male children. Majority (93% of the children stayed in the NRC for more than 14 days. There was significant difference in the weight of children at the time of admission and at the time of discharge (t= - 15.942, p=0.001. There was no significant difference in Mid Arm Circumference at the time of admission and at the time of discharge (t = -0.942, p=0.349. Fourteen percent were defaulted. There was significant difference in weight of children at the time of discharge and at the time of first follow-up (t=2.203, p=0.03 and third follow-up (t= -8.903, p=0.001. CONCLUSIONS NRCs are effective in improving the nutritional status of severely acute malnourished children and the follow-up also shows the children are having catch-up growth. RECOMMENDATIONS: 1 Adequate number of NRCs should be available for severely acute malnourished children in all the areas. 2 Effective counseling measures should be

  17. Clinical features of influenza disease in admitted children during the first postpandemic season and risk factors for hospitalization: a multicentre Spanish experience.

    Science.gov (United States)

    Launes, C; García-García, J J; Martínez-Planas, A; Moraga, F; Soldevila, N; Astigarraga, I; Arístegui, J; Korta, J; Quintana, J M; Torner, N; Domínguez, A

    2013-03-01

    The main objectives of this study were to describe the characteristics of children with influenza infection during the postpandemic outbreak, and to compare sociodemographic and clinical data between patients who required hospitalization and those managed on an outpatient basis with a matched case-control study design. This is a multicentre paediatric study in Spain that included patients aged 6 month to 18 years in whom influenza infection was confirmed by real-time reverse transcription-polymerase chain reaction between December 2010 and March 2011. Among the 143 admitted patients, the main reason for admission was respiratory failure (123/143). In 55 there was some previously known disease. The median age was lower in patients without comorbidity (1.8 years: interquartile range 1.0-3.0 versus 5.3 years: interquartile range 1.3-10.7); p lag time from onset of symptoms to starting antiviral treatment was correlated with the length of hospital stay (Rho Spearman = + 0.32; p 0.01). Twenty patients required admission to the paediatric intensive care units, all due to respiratory failure. Children with chest X-ray opacities in more than one quadrant more frequently required admission to intensive care. Having a neurological disease conferred the highest risk of requiring hospitalization (OR 17.18) in a multivariate analysis. This study concludes that influenza in the paediatric population requiring hospitalization during the postpandemic season affected mainly children with neurological or pulmonary comorbidities and children of parents with a lower educational level. Most of the influenza infections caused respiratory symptoms, although neurological manifestations were also observed. Early initiation of oseltamivir was associated with a shorter length of hospital stay. PMID:23305123

  18. Suicide attempts and related factors in patients admitted to a general hospital: a ten-year cross-sectional study (1997-2007

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    Lantes-Louzao Sara

    2011-03-01

    Full Text Available Abstract Background Suicide and suicide attempts represent a severe problem for public health services. The aim of this study is to determine the socio-demographic and psychopathological variables associated with suicide attempts in the population admitted to a General Hospital. Methods An observational-descriptive study of patients admitted to the A Coruña University Hospital (Spain during the period 1997-2007, assessed by the Consultation and Liaison Psychiatric Unit. We include n = 5,234 admissions from 4,509 patients. Among these admissions, n = 361 (6.9% were subsequent to a suicide attempt. Admissions arising from a suicide attempt were compared with admissions occurring due to other reasons. Multivariate generalised estimating equation logistic regression models were used to examine factors associated with suicide attempts. Results Adjusting by age, gender, educational level, cohabitation status, being employed or unemployed, the psychiatric diagnosis at the time of the interview and the information on previous suicide attempts, we found that the variables associated with the risk of a suicide attempt were: age, psychiatric diagnosis and previous suicide attempts. The risk of suicide attempts decreases with age (OR = 0.969. Psychiatric diagnosis was associated with a higher risk of suicide attempts, with the highest risk being found for Mood or Affective Disorders (OR = 7.49, followed by Personality Disorders (OR = 7.31, and Schizophrenia and Other Psychotic Disorders (OR = 5.03. The strongest single predictive factor for suicide attempts was a prior history of attempts (OR = 23.63. Conclusions Age, psychopathological diagnosis and previous suicide attempts are determinants of suicide attempts.

  19. Comparison of the process of care of acute severe asthma in adults admitted to hospital before and 1 yr after the publication of national guidelines.

    Science.gov (United States)

    Pearson, M G; Ryland, I; Harrison, B D

    1996-10-01

    This study set out to assess the effect of publication of the British Guidelines on Asthma Management on the processes and outcomes of the inpatient care of acute severe asthma in the U.K. A criterion-based audit of all acute asthma admissions during August and September 1990 (immediately before) and in 1991 (1 yr after publication of the Guidelines) using eight criteria of process and outcome was performed. Thirty-six teaching and district general hospitals in England, Scotland and Wales took part. In total, 766 patients admitted in 1990, and 900 patients admitted in 1991, were studied. The 1990 and 1991 cohorts were very similar demographically and had asthma of comparable severity. Respiratory physicians achieved similar high performance rates of between 75 and 91% for seven of the eight criteria for both years. Respiratory physicians were significantly more likely to provide patients with a written management plan in 1991. General physicians' performance was significantly lower in both years, but overall there was a very small, but just significant, improvement in their performance in 1991. Some hospitals performed consistently well in both years. It is concluded that respiratory physicians consistently provide better asthma care than general physicians. Though statistically significant, the small degree of improvement was disappointing. Possible reasons include: insufficient time for the Guidelines to be incorporated into practice; inaccessibility of the Guidelines to general physicians; failure to accept responsibility for implementing the good practice reflected in the Guidelines; and an explicit need for strategies to implement the Guidelines beyond publication in a widely-read general medical journal.

  20. Determination of Potential Parameters Effective on the Outcomes of Admitted Patients with Primary Varicella Infections in Tehran Aliasghar Children Hospital (1996-2009

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    A.R. Nateghian

    2011-07-01

    Full Text Available Introduction & Objective: There is a need to study the outcomes of admitted patients with primary varicella infections especially for immunocompromised cases like patients with various cancers in our country in which there is no routine vaccination against such a virus.Materials & Methods: We performed a retrospective descriptive-analytic study on the admitted cases with primary varicella infections in Aliasghar children hospital, Tehran, since 1996 to 2009;The patients were put in two different groups for comparison:1Immunosuppressed patients including patients with acute lymphoblastic leukemia ,patients with other types of cancers ,and patients who were receiving high doses of corticosteroids 2previously healthy patients. Demographic as well as some indicators of poor general condition on admission like respiratory distress ,hypotension and decreased level of consciousness were compared within the groups; we also looked for ataxia as an important indication of admission and the time period since the onset of disease up to admission in each group; appropriate statistical methods were used for statistical analysis.Results: 88 cases including 24 cases of ALL (27%,9 cases with various types of cancers (10.5%,and 13 cases who were receiving high dose of corticosteroid were included. Mean age of the patients was 6 years(SD=3.5.47 cases(53.4%were male. Hypotension on admission was significantly more common in patients under four years of age(P=0.006; The patients in the first 3 groups were admitted significantly earlier(P=0.027; Hypotension and ataxia were more significantly seen in the previously healthy group(P=0.01 and 0.04 respectively. Just one case of mortality occurred in a case of ALL during the study period.Conclusion: We concluded that immunocompromised cases comprise more than half of the admissions due to primary varicella infections in our referral center; interestingly ,however, in comparison with previously healthy cases they have been

  1. Causes of poisoning in patients evaluated in a hospital emergency department in Konya, Turkey

    International Nuclear Information System (INIS)

    Objectives: To evaluate demographic and clinical characteristics of patients with poisoning at a community hospital. Methods: The retrospective study comprised records of patients who were admitted to the emergency department of Konya Numune Hospital, Turkey, because of poisoning between January 1, 2009, and December 31, 2011. Data was evaluated for age, gender, educational status, occupation, arrival time, mechanism of intoxication , body temperature, pulse, respiratory rate, Glasgow Coma Scale score, treatment applied, duration of hospital stay, duration of follow-up, test results, final diagnosis, clinical disposition, and outcome. Agents causing the poisoning were also determined. Results: Records of 1036 patients were evaluated. Of them, 764(74%) were female and 272(26%) were male. The predominant age range was 15-24 years in 617(60%) patients. The median time from substance exposure to admission to the emergency department was 2 hours. The most common cause of poisoning was attempted suicide in 955 (92%) patients and drug intoxication was the agent involved in 932 (90%). In the 15-24 year age range, there were 469(76%) female patients. Of the total female population in the study, 716(94%) attempted suicide. The median hospital stay was 24 hours. There were 908(88%) patients who were advised to seek further evaluation at the psychiatry clinic, and 9 (0.9%) patients were admitted to the psychiatry inpatient units after medical treatment. In patients who were hospitalized and followed up, 1 (0.1%) died because of multiple drug poisoning. Conclusion: Most admissions to the emergency department for poisoning related to young women had used drugs during a suicide attempt. (author)

  2. Epidemiology and Drug Susceptibility of Pseudomonas aeruginosa Strains isolated from Patients admitted to Zabol hospitals: Short Communication

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    Forough Heydari

    2015-12-01

    Full Text Available Background and Aim: Pseudomonas aeruginosa is one of the most important causative agents of nosocomial infections that threatens many lives .. Regarding the innate and adaptive ability of the bacteria species to become resistant to many antimicrobial agents, recognition of different antibiotic resistance patterns is extremely significant in assessing the validity of the monitoring programs. Also, the pattern of genetic isolates is essential in the management of infections caused by these bacteria. The purpose of this study was to determine genetic diversity and patterns of antimicrobial resistance of P. aeruginosa isolates using RAPD-PCR. Materials and Methods: The present study aimed at assessing the genetic diversity and antibiotic resistant pattern of P. aeruginosa isolates in the educational Zabol hospitals. Thus, antibiotic susceptibility of 100 isolates was determined applying Kirby-Bauer disk diffusion method. Results: RAPD-PCR data revealed  a high level of polymorphism among the isolates of P. aeruginosa in Sistan. But, no association was observed between antibiotic susceptibility and genetic diversity pattern. Conclusion: In the present study, we RAPD-PCR technique was found to be a useful means for the investigation of the genetic variation and epidemiological study among P. aeruginosa isolates collected from Sistan region.

  3. Etiological study of fever of unknown origin in patients admitted to medicine ward of a teaching hospital of Eastern India

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    Dipanjan Bandyopadhyay

    2011-01-01

    Full Text Available Background: In a developing country, infectious disease remains the most important cause of fever, but the noncommunicable diseases, like malignancy, are fast becoming important differential diagnoses. An important clinical problem is the cases labeled as fever of unknown origin (FUO, which often evade diagnosis. Objective: The present study was undertaken to find the cause of FUO in a tertiary care hospital of eastern India. Materials and Methods: This is a prospective study of inpatients, with regard to both clinical signs and investigations. Results: The main diagnosis in the end was tuberculosis, closely followed by hematological malignancy. A substantial number of cases remained undiagnosed despite all investigations. The provisional diagnosis matched with the final in around two thirds of the cases. While for younger patients leukemia was a significant diagnosis, for older ones, extra-pulmonary tuberculosis was a main concern. Interpretation: In India, infectious disease still remains the most important cause of fever. Thus the initial investigations should always include tests for that purpose in a case of FUO. Conclusion: Geographic variations and local infection profiles should always be considered when investigating a case of FUO. However, some of the cases always elude diagnosis, although the patients may respond to empirical therapy.

  4. Investigation of Trichomonas Vaginalis by Parasitological and Cytological Methods in Patients Admitted to Gynecology Outpatient Clinics in a University Hospital

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    Özlem Aycan-Kaya

    2015-11-01

    Full Text Available Aim: In this study, it was aimed to compare parasitological and cytological diagnostic methods to detect T. Vaginalis in samples taken from posterior fornix of vagina. Methods: In this cross-sectional study, study population (n=104 were selected from women applying to gynecology outpatient clinic of Mustafa Kemal University Hospital with different complaints between March- August 2013. The presence of T. vaginalis was investigated by parasitological and cytological diagnostic methods. While direct microscopy, giemsa staining and culture in Cysteine-Peptone-Liver-Maltose medium (CPLM were performed for parasitological diagnosis of T. vaginalis in samples taken from posterior fornix of vagina, cervical smear stained by Papanicolaou (PAPS was used for cytological diagnosis. Results: T. vaginalis was detected in 12 (11.5%, 12 (11.5%, 14 (%13.4 of materials by direct microscopy, giemsa staining and culture, respectively. T. vaginalis was detected only 5 (4.8% of materials by cytology. This difference was statistically significant (p<0.05. Conclusion: Our study results showed that parasitological methods are more sensitive than cytological methods in diagnosis of T. vaginalis. Therefore, T. vaginalis should be screened in women with non-specific symptoms in under developed countries where lack of periodic examination and polygamy were seen.

  5. Pattern and risk factors of stroke in the young among stroke patients admitted in medical college hospital, Thiruvananthapuram

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    Praveen Prasannakumar Subha

    2015-01-01

    Full Text Available Background: Stroke in the young is particularly tragic because of its potential to create a long-term burden on the victims, their families, and the community. There had been relatively few studies on young stroke in Kerala′s socio-economic setup, that too encapsulating the mentioned apparently relevant dimensions of stroke in the young . Objective: To study the prevalence, patterns and risk factors of young stroke. Settings and Design: A cross-sectional study with case control comparison at Government Medical College Hospital, Thiruvananthapuram, Kerala, India. Materials and and Methods: Total 100 stroke patients were identified over a period of 2 months, and data were collected on the basis of questionnaire developed for the purpose. Results: Of 100 stroke patients, 15 had stroke in the young, among which 9 (60% had ishaemic stroke. Hypertension was the most common risk factor. Smoking, alcohol, atrial fibrillation, and hyperlipidemia were found to be more common in cases (young stroke when compared with controls. Alcohol use and atrial fibrillation were significantly higher among young stroke patients. Physical inactivity was significantly lesser in those with stroke in the young than elderly. Atrial fibrillation emerged as an independent risk factor of stroke in the young with adjusted odds ratio of 6.18 (1.31-29.21. Conclusion: In all, 15% of total stroke occurred in young adults <50 years. The proportion of hemorrhagic stroke in young adults is higher than in elderly. Atrial fibrillation is identified as an independent risk factor of stroke in the young. Compared with stroke in elderly alcohol use, smoking, hyperlipidemia, and cardiac diseases, which are known risk factors, are higher in young stroke.

  6. Prevalence of malaria, prevention measures, and main clinical features in febrile children admitted to the Franceville Regional Hospital, Gabon

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    Maghendji-Nzondo Sydney

    2016-01-01

    Full Text Available Recently, major progress has been made in controlling malaria in Africa. However, in Gabon, little information is available on the role of malaria in childhood febrile syndromes, the use and efficacy of preventive measures, and Plasmodium species distribution. Here, we characterized malaria in febrile children in Franceville, Gabon through a cross-sectional study at the pediatric unit of the Franceville Regional Hospital. We registered 940 febrile children. Their general condition was markedly altered in 11.7% of cases (n = 89/760; among them 19 (21.4% had a severely altered condition. Malaria was the second most frequent etiology (22.0%; n = 162/738, after respiratory tract infections (37.3%; n = 275/738. Children with malaria (63 ± 39 months were older than children without malaria (40 ± 37 months (p = 0.0013. Hemoglobin, red blood cell, white blood cell, and platelet values were lower in children with malaria than in those without malaria (p < 0.0001. Anemia was the most common feature of severe malaria (70.6%; n = 12/17, followed by neurological involvement (23.5%; n = 4/17. The prevalence of malaria was significantly higher in children older than 60 months than in younger children (40% vs. 15.5%; p < 0.0001. Plasmodium falciparum accounted for 97.5% of cases (158/162, followed by Plasmodium malariae (2.5%; n = 4/162. Bed net use was high (74.4%; n = 697/936 and contributed to malaria prevention (p = 0.001. Good basic knowledge of malaria also had a preventive effect (p < 0.0001. The prevalence of malaria in children in Franceville did not decrease significantly from 2009 to 2012, remaining at about 20%, highlighting that preventive measures should be reinforced.

  7. The Epidemiological and Clinical Assessment of Admitted Burned Pregnant Women in Shahid Mottahary Hospital Burn Center Between January 1998 and October 2003

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    A. Tavassoli-Ashrafi, M.D.

    2007-09-01

    Full Text Available Background and purpose: Treatments of burn pregnant women is a difficult task because the vulnerable fetus is highly dependent on the health of the mother. This study was conducted to determine the epidemiology, etiology, clinical assessment and outcome of pregnant patients between January 1998 and October 2003.Materials and Methods: A 6-year retrospective descriptive study of burns in pregnant women hospitalized at Mottahary hospital (burn center in Tehran was performed. A short structured questionnaire was used to collect data. The questionnaire covered demographic information, etiology, clinical manifestations, and outcomes.Results: 74 (5% of the 1480 women of reproductive age who were admitted for burn treatment during this period were pregnant. The mean age of 74 patients was 22.54 years (SD = 4.78 with a range of 16-35. The majority of the women (50% were between 20 and 30 weeks of gestational age. The most common cause of burn was kerosene fire 52 (70%. Most of the women 50 (68% suffered from severe burns with TIBC>40%. 49 (66% mothers and 50 (67.5% died as a result of the burn damages. Conclusion: Burn size, TIBC, follow up of clinical manifestations for pregnant women, fetus and performance of proportional treatment protocols were the strongest predictor of mortality for mother and fetus.

  8. Epidemiological profile of tuberculosis infection and disease among cocaine users admitted to hospitals of the Greater São Paulo city

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    Olavo Franco Ferreira Filho

    2003-06-01

    Full Text Available OBJECTIVE: To evaluate the prevalence and the risk factors for tuberculosis (TB infection and disease among hospitalized cocaine users. METHOD: A cross-sectional study performed on a sample of 440 addicts over 18 years of age, admitted to hospitals of the metropolitan area of the Greater São Paulo city, whose clinical conditions allowed them to answer a standard questionnaire, and who agreed to participate in the study. The prevalence of TB infection was assessed through positive tuberculin testing (PPD, and of TB disease by the finding of M. tuberculosis in the sputum of patients with respiratory symptoms. RESULTS: Respiratory symptoms were present in 21% of the patients, the most frequent being weight loss and cough, which disappeared when cocaine use was discontinued. The general prevalence of TB infection was 28%. The prevalence of TB disease was 0.6%. The factors which were associated with positive PPD were: age, color/race, time spent in prison, and drug use in prison. CONCLUSION: No increased prevalence of TB infection and disease was found in these patients. Older addicts had a higher probability of having TB infection, and so had those who had been in prison.

  9. Antimicrobial Resistance Patterns of Acinetobacter baumannii, Pseudomonas aeruginosa and Staphylococcus aureus Isolated From Patients With Nosocomial Infections Admitted to Tehran Hospitals

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    Fallah

    1970-01-01

    Full Text Available Background Nosocomial infections constitute a global health problem, leading to a high rate of morbidity and mortality. The choice of antimicrobial treatment for nosocomial infections is often empirical and based on the knowledge of local antimicrobial activity patterns of the most common bacteria causing such infections. Objectives The aim of this study was to determine the 3 most prevalent bacterial pathogens including Acinetobacter baumannii, Pseudomonas aeruginosa and Staphylococcus aureus causing nosocomial infections and their antimicrobial resistant profiles in patients admitted to three hospitals in Tehran city, Iran. Materials and Methods In this cross-sectional study, the A. baumannii, P. aeruginosa and S. aureus isolates were obtained from different samples of patients with nosocomial infections admitted to different wards of three hospitals including Milad, Motahary and Loghman from November 2014 to April 2015. Nosocomial infections were defined as a culture-proven infection, which occurred more than 48 hours after admission. Antimicrobial susceptibility testing was performed using the disk diffusion method according to Clinical and Laboratory Standards Institute (CLSI guidelines. Results In total, 539 samples were collected during the study period from patients with nosocomial infections. Overall, 198, 75 and 98 A. baumannii, P. aeruginosa and S. aureus isolates were obtained, respectively. Cefepim and meropenem were found to be the most effective antibiotics for nosocomial infections caused by S. aureus with only 1 resistant isolate. Resistance to gentamicin and amikacin and susceptibility to cefepim was the highest compared to other antibiotics amongst P. aeruginosa isolates which is in consistent with the fact that cephalosporins remain useful agents for the management of nosocomial infections caused by P. aeruginosa. Acinetobacter baumannii isolates showed lower susceptibility rates to imipenem and ciprofloxacin than other

  10. Evaluating the Quality of Multiple Trauma Patient Records in the Emergency Department of Imam Khomeini Hospital in Urmia

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    Gholamreza Faridaalaee; Behzad Boushehri; Neda Mohammadi; Omid Safari

    2015-01-01

    Introduction: Medical profile is an important source of data regarding the patient, the illness, the doctor’s performance and leads to adequate diagnosis and treatment. Filling out medical profiles correctly, greatly decreases medical errors and leads to accurate diagnosis and proper treatment of the patients. This study aims to evaluate the quality of the patient records of trauma patients admitted to the emergency department of Emam Khomeini Hospital, Urmia, Iran. Methods: In a cross-sectio...

  11. Influenza epidemiology, vaccine coverage and vaccine effectiveness in children admitted to sentinel Australian hospitals in 2014: the Influenza Complications Alert Network (FluCAN).

    Science.gov (United States)

    Blyth, Christopher C; Macartney, Kristine K; Hewagama, Saliya; Senenayake, Sanjaya; Friedman, N Deborah; Simpson, Graham; Upham, John; Kotsimbos, Tom; Kelly, Paul; Cheng, Allen C

    2016-07-28

    The Influenza Complications Alert Network (FluCAN) is a sentinel hospital-based surveillance programme operating in all states and territories in Australia. We summarise the epidemiology of children hospitalised with laboratory-confirmed influenza in 2014 and reports on the effectiveness of inactivated trivalent inactivated vaccine (TIV) in children. In this observational study, cases were defined as children admitted with acute respiratory illness (ARI) with influenza confirmed by PCR. Controls were hospitalised children with ARI testing negative for influenza. Vaccine effectiveness (VE) was estimated as 1 minus the odds ratio of vaccination in influenza positive cases compared with test-negative controls using conditional logistic regression models. From April until October 2014, 402 children were admitted with PCR-confirmed influenza. Of these, 28% were aged < 1 year, 16% were Indigenous, and 39% had underlying conditions predisposing to severe influenza. Influenza A was detected in 90% of cases of influenza; influenza A(H1N1)pdm09 was the most frequent subtype (109/141 of subtyped cases) followed by A(H3N2) (32/141). Only 15% of children with influenza received antiviral therapy. The adjusted VE of one or more doses of TIV for preventing hospitalised influenza was estimated at 55.5% (95% confidence intervals (CI): 11.6-77.6%). Effectiveness against influenza A(H1N1)pdm09 was high (91.6% , 95% CI: 36.0-98.9%) yet appeared poor against H3N2. In summary, the 2014 southern hemisphere TIV was moderately effective against severe influenza in children. Significant VE was observed against influenza A(H1N1)pdm09. PMID:27494798

  12. Validation of a case definition for leptospirosis diagnosis in patients with acute severe febrile disease admitted in reference hospitals at the State of Pernambuco, Brazil

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    Alfredo Pereira Leite de Albuquerque Filho

    2011-12-01

    Full Text Available INTRODUCTION: Leptospirosis is often mistaken for other acute febrile illnesses because of its nonspecific presentation. Bacteriologic, serologic, and molecular methods have several limitations for early diagnosis: technical complexity, low availability, low sensitivity in early disease, or high cost. This study aimed to validate a case definition, based on simple clinical and laboratory tests, that is intended for bedside diagnosis of leptospirosis among hospitalized patients. METHODS: Adult patients, admitted to two reference hospitals in Recife, Brazil, with a febrile illness of less than 21 days and with a clinical suspicion of leptospirosis, were included to test a case definition comprising ten clinical and laboratory criteria. Leptospirosis was confirmed or excluded by a composite reference standard (microscopic agglutination test, ELISA, and blood culture. Test properties were determined for each cutoff number of the criteria from the case definition. RESULTS: Ninety seven patients were included; 75 had confirmed leptospirosis and 22 did not. Mean number of criteria from the case definition that were fulfilled was 7.8±1.2 for confirmed leptospirosis and 5.9±1.5 for non-leptospirosis patients (p<0.0001. Best sensitivity (85.3% and specificity (68.2% combination was found with a cutoff of 7 or more criteria, reaching positive and negative predictive values of 90.1% and 57.7%, respectively; accuracy was 81.4%. CONCLUSIONS: The case definition, for a cutoff of at least 7 criteria, reached average sensitivity and specificity, but with a high positive predictive value. Its simplicity and low cost make it useful for rapid bedside leptospirosis diagnosis in Brazilian hospitalized patients with acute severe febrile disease.

  13. Faecal Escherichia coli isolates show potential to cause endogenous infection in patients admitted to the ICU in a tertiary care hospital.

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    Nagarjuna, D; Mittal, G; Dhanda, R S; Verma, P K; Gaind, R; Yadav, M

    2015-09-01

    Nosocomial infections are acquired during hospital treatment or in a hospital environment. One such infecting agent, Escherichia coli, harbours many virulence genes that enable it to become pathogenic, causing damage to the host. The mechanism of the E. coli virulence factors provenance to cause infection in host environments is not clearly elucidated. We investigated the virulence and pathogenicity of E. coli affected by the host environment. For this, blood (n = 78) and faecal (n = 83) E. coli isolates were collected from patients with and without sepsis, respectively, who had been admitted to the intensive care unit. The E. coli genomic DNA was isolated; the phylogenetic grouping was conducted by triplex PCR. The occurrence of nine virulence genes among the all the isolates was confirmed by gene-specific PCR. The prevalence of E. coli in blood isolates was more in phylogenetic groups B2 and D compared to groups A and B1. However, in faecal isolates, there was no significant difference. The prevalence of adhesin and toxin (papG, sfa, afa, cnf1, hlyA) genes was higher in blood compared to faecal E. coli isolates. However, the prevalence of aer, traT and PAI was similar as well as higher among both of these groups. These observations indicate a role of external environment (hospital setting) on host susceptibility (development of infection) in the faecal E. coli isolates, thereby making the patient prone to a sepsis condition. PMID:26257914

  14. A multicentre randomised controlled trial evaluating lactobacilli and bifidobacteria in the prevention of antibiotic-associated diarrhoea in older people admitted to hospital: the PLACIDE study protocol

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    Allen Stephen J

    2012-05-01

    Full Text Available Abstract Background Antibiotic associated diarrhoea complicates 5–39% of courses of antibiotic treatment. Major risk factors are increased age and admission to hospital. Of particular importance is C. difficile associated diarrhoea which occurs in about 4% of antibiotic courses and may result in severe illness, death and high healthcare costs. The emergence of the more virulent 027 strain of C. difficile has further heightened concerns. Probiotics may prevent antibiotic associated diarrhoea by several mechanisms including colonization resistance through maintaining a healthy gut flora. Methods This study aims to test the hypothesis that administration of a probiotic comprising two strains of lactobacilli and two strains of bifidobacteria alongside antibiotic treatment prevents antibiotic associated diarrhoea. We have designed a prospective, parallel group trial where people aged 65 years or more admitted to hospital and receiving one or more antibiotics are randomly allocated to receive either one capsule of the probiotic or a matching placebo daily for 21 days. The primary outcomes are the frequency of antibiotic associated and C. difficile diarrhoea during 8–12 weeks follow-up. To directly inform routine clinical practice, we will recruit a sufficient number of patients to demonstrate a 50% reduction in the frequency of C. difficile diarrhoea with a power of 80%. To maximize the generalizability of our findings and in view of the well-established safety record of probiotics, we will recruit a broad range of medical and surgical in-patients from two different health regions within the UK. Discussion Antibiotic associated diarrhoea constitutes a significant health burden. In particular, current measures to prevent and control C. difficile diarrhoea are expensive and disrupt clinical care. This trial may have considerable significance for the prevention of antibiotic associated diarrhoea in hospitals. Trial registration International

  15. Faecal Escherichia coli isolates show potential to cause endogenous infection in patients admitted to the ICU in a tertiary care hospital

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    D. Nagarjuna

    2015-09-01

    Full Text Available Nosocomial infections are acquired during hospital treatment or in a hospital environment. One such infecting agent, Escherichia coli, harbours many virulence genes that enable it to become pathogenic, causing damage to the host. The mechanism of the E. coli virulence factors provenance to cause infection in host environments is not clearly elucidated. We investigated the virulence and pathogenicity of E. coli affected by the host environment. For this, blood (n = 78 and faecal (n = 83 E. coli isolates were collected from patients with and without sepsis, respectively, who had been admitted to the intensive care unit. The E. coli genomic DNA was isolated; the phylogenetic grouping was conducted by triplex PCR. The occurrence of nine virulence genes among the all the isolates was confirmed by gene-specific PCR. The prevalence of E. coli in blood isolates was more in phylogenetic groups B2 and D compared to groups A and B1. However, in faecal isolates, there was no significant difference. The prevalence of adhesin and toxin (papG, sfa, afa, cnf1, hlyA genes was higher in blood compared to faecal E. coli isolates. However, the prevalence of aer, traT and PAI was similar as well as higher among both of these groups. These observations indicate a role of external environment (hospital setting on host susceptibility (development of infection in the faecal E. coli isolates, thereby making the patient prone to a sepsis condition.

  16. Characteristics of Patients Who Admitted to the Emergency Department Because of Burns Due to Dens Liquids Such as Hot Milk/Oil

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    Bayramoglu, Atif; Sener, M. Talip; Cakir, Zeynep; Aslan, Sahin; Emet, Mucahit; Akoz, Ayhan

    2016-01-01

    Objective: Burn is the tissue damage on body caused due to various reasons. Although all burns caused by hot liquids are investigated as scalding burns, dense liquid burns (DLB) caused by such as milk and oil are different from other burns. The aim of this study was to report the properties of DLB. Materials and Methods: Patients admitted to the Emergency Service of Atatürk University Hospital, with DLB from June 2003 to December 2008, were examined retrospectively. Results: During the study, 28 DLB patients were admitted to the emergency service. The most common admission were found in autumn 28.6% (n=8), and in May and June, 17.9% (n=5). The frequency of burns on the right upper extremity was seen in 50% (n=14) of the patients. The burn degree of all patients was determined as 2nd degree. Seventy-five percent (n=21) of the patients were discharged, 14.3% (n=4) were hospitalized. None of the patients died. Conclusion: Dense liquid burns is a burn type that is commonly seen in women, absolutely causing 2nd degree burns, frequently reported in upper extremity and head/neck regions, and in contrast to other studies, in our region it is completely seen in patients living in city centre. PMID:27026759

  17. Use of an accident and emergency department by hospital staff.

    OpenAIRE

    Mann, C J

    1996-01-01

    OBJECTIVE: To assess the number of attendances by hospital staff at an accident and emergency (A&E) department, and reasons for their attendance. METHODS: A&E attendances by hospital staff were studied for a 12 month period. Comparison was made with attendances by non-hospital staff in full or part time employment. Differences between the observed and expected numbers of attendances were analysed using chi 2 analysis. RESULTS: 560 staff attendances were recorded out of 78,103 total attendance...

  18. Cyst infection in hospital-admitted autosomal dominant polycystic kidney disease patients is predominantly multifocal and associated with kidney and liver volume

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    Balbo, B.E.P. [Divisão de Nefrologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP (Brazil); Sapienza, M.T.; Ono, C.R. [Divisão de Medicina Nuclear, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP (Brazil); Jayanthi, S.K. [Divisão de Radiologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP (Brazil); Dettoni, J.B. [Divisão de Patologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP (Brazil); Castro, I.; Onuchic, L.F. [Divisão de Nefrologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP (Brazil)

    2014-06-13

    Positron-emission tomography/computed tomography (PET/CT) has improved cyst infection (CI) management in autosomal dominant polycystic kidney disease (ADPKD). The determinants of kidney and/or liver involvement, however, remain uncertain. In this study, we evaluated clinical and imaging factors associated with CI in kidney (KCI) and liver (LCI) in ADPKD. A retrospective cohort study was performed in hospital-admitted ADPKD patients with suspected CI. Clinical, imaging and surgical data were analyzed. Features of infected cysts were evaluated by PET/CT. Total kidney (TKV) and liver (TLV) volumes were measured by CT-derived multiplanar reconstruction. CI was detected in 18 patients who experienced 24 episodes during an interval of 30 months (LCI in 12, KCI in 10 and concomitant infection in 2). Sensitivities of CT, magnetic resonance imaging and PET/CT were 25.0, 71.4, and 95.0%. Dysuria (P<0.05), positive urine culture (P<0.01), and previous hematuria (P<0.05) were associated with KCI. Weight loss (P<0.01) and increased C-reactive protein levels (P<0.05) were associated with LCI. PET/CT revealed that three or more infected cysts were present in 70% of the episodes. TKV was higher in kidney-affected than in LCI patients (AUC=0.91, P<0.05), with a cut-off of 2502 mL (72.7% sensitivity, 100.0% specificity). TLV was higher in liver-affected than in KCI patients (AUC=0.89, P<0.01) with a cut-off of 2815 mL (80.0% sensitivity, 87.5% specificity). A greater need for invasive procedures was observed in LCI (P<0.01), and the overall mortality was 20.8%. This study supports PET/CT as the most sensitive imaging method for diagnosis of cyst infection, confirms the multifocal nature of most hospital-admitted episodes, and reveals an association of kidney and liver volumes with this complication.

  19. Profile and mortality outcome of patients admitted with cryptococcal meningitis to an urban district hospital in KwaZulu-Natal, South Africa

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    Benjamin Adeyemi

    2014-11-01

    Full Text Available Introduction: Cryptococcal meningitis (CCM is one of the leading causes of early mortality among HIV-infected patients. This study was a part of clinical audit (1 aimed at improving care for patients with CCM at an urban district hospital in South Africa. Methods: Clinical records of all patients (age>13 years admitted to the hospital with a diagnosis of CCM (based on a positive India ink, positive cryptococcal latex agglutination test (CLAT or a positive culture of Cryptococcus neoformans between June 2011 and December 2012 were retrospectively reviewed. Descriptive statistics and Chi-square analysis were generated with Epi Info 7.1.2.0. 95% confidence intervals were reported where appropriate. Results: Of the 127 patients admitted with CCM, only 97 (76.4% knew their HIV status. Only 44.8% (43/96 of those who knew they were HIV positive were on antiretroviral therapy (ART. Seventeen out of 25 patients (68% previously treated for CCM had defaulted fluconazole and only 60% (15/25 were on ART. Acute mortality (death within 14 days of CCM diagnosis was 55.9% (71/127. The median time to death from diagnosis was four days (IQR 2–9. The association between CSF WBC count<20cells/mL and increased risk of death within 14 days was statistically significant (OR 2.2; 95% CI 1.1–4.6, p=0.03. Patients with heavy cryptococcal burden (reported as numerous yeasts seen on microscopy at diagnosis were three times more likely to die within 14 days of diagnosis of CCM (OR 3.2; 95% CI 0.9–10.7, p=0.06. Even though a CD4 count<100cells/mm3 was associated with a 1.6 times increased acute mortality risk, the association was not statistically significant (OR 1.6; 95% CI 0.6–4.6, p=0.3. The role of elevated CSF opening pressure at diagnosis was not assessed because only two (1.6% patients had their baseline opening pressure measured. Conclusions: Acute CCM-related mortality remains high. The number of patients who do not know their HIV status, the number of HIV

  20. Department head appointed for Hospitality and Tourism Management

    OpenAIRE

    Ho, Sookhan

    2004-01-01

    James R. Lang, of Blacksburg, professor of management and Strickler Professor of Entrepreneurial Studies at Virginia Tech•À_ó»s Pamplin College of Business, has been appointed interim head of the Department of Hospitality and Tourism Management.

  1. Hospitality and tourism department members receive national awards

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    Ho, Sookhan

    2009-01-01

    Faculty members, graduate students, and an alumnus of the hospitality and tourism management department at Virginia Tech's Pamplin College of Business received national honors for their research at the 14th annual Graduate Student Research Conference in Hospitality and Tourism, held recently in Las Vegas, Nev.

  2. Tromboprofilaxis en pacientes no quirúrgicos internados en un hospital general Venous thromboembolism prevention in non-surgical adult patients admitted in a general hospital

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    Marcelo J. Melero

    2012-10-01

    Full Text Available Los pacientes adultos internados por una enfermedad no quirúrgica tienen un riesgo alto de padecer una tromboembolia venosa y pueden desarrollar alguna forma de esta enfermedad cuando no reciben un tratamiento preventivo adecuado. Los objetivos de este estudio prospectivo, analítico, observacional y transversal, fueron: 1 determinar cuál es el porcentaje de pacientes adultos internados por una enfermedad aguda no quirúrgica en el Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, que tienen indicación de tromboprofilaxis, 2 establecer cuántos de ellos reciben un tratamiento preventivo para la tromboembolia venosa, y 3 comprobar cuántos estaban medicados con alguna forma de tromboprofilaxis sin tener causas que justificaran este tratamiento. Se estudiaron 93 pacientes durante un lapso de 72 horas consecutivas. Se encontró que el 90.3% de ellos necesitaba un tratamiento preventivo para la tromboembolia venosa y el 76.2% de estos enfermos recibían tromboprofilaxis farmacológica. Un 33.3% de los pacientes internados tenía indicado un tratamiento farmacológico preventivo sin tener una causa que justificara esta prescripción. El porcentaje encontrado de pacientes tratados con tromboprofilaxis es más alto que el comunicado en otros estudios observacionales.Adult patients hospitalized for a non-surgical condition, usually have a high risk of venous thromboembolism and may develop some form of this disease when they do not receive appropriate preventive treatment. The objectives of this prospective, analytical, observational and cross-sectional study were: 1 to determine what percentage of adult patients hospitalized for a non-surgical acute condition at the Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, had indication for preventive thromboprophylaxis, 2 to establish how many of them had been prescribed a preventive treatment of venous thromboembolism, 3 to establish how many of them had been

  3. Effect of a multi-faceted quality improvement intervention on inappropriate antibiotic use in children with non-bloody diarrhoea admitted to district hospitals in Kenya

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    Opondo Charles

    2011-11-01

    Full Text Available Abstract Background There are few reports of interventions to reduce the common but irrational use of antibiotics for acute non-bloody diarrhoea amongst hospitalised children in low-income settings. We undertook a secondary analysis of data from an intervention comprising training of health workers, facilitation, supervision and face-to-face feedback, to assess whether it reduced inappropriate use of antibiotics in children with non-bloody diarrhoea and no co-morbidities requiring antibiotics, compared to a partial intervention comprising didactic training and written feedback only. This outcome was not a pre-specified end-point of the main trial. Methods Repeated cross-sectional survey data from a cluster-randomised controlled trial of an intervention to improve management of common childhood illnesses in Kenya were used to describe the prevalence of inappropriate antibiotic use in a 7-day period in children aged 2-59 months with acute non-bloody diarrhoea. Logistic regression models with random effects for hospital were then used to identify patient and clinician level factors associated with inappropriate antibiotic use and to assess the effect of the intervention. Results 9, 459 admission records of children were reviewed for this outcome. Of these, 4, 232 (44.7% were diagnosed with diarrhoea, with 130 of these being bloody (dysentery therefore requiring antibiotics. 1, 160 children had non-bloody diarrhoea and no co-morbidities requiring antibiotics-these were the focus of the analysis. 750 (64.7% of them received antibiotics inappropriately, 313 of these being in the intervention hospitals vs. 437 in the controls. The adjusted logistic regression model showed the baseline-adjusted odds of inappropriate antibiotic prescription to children admitted to the intervention hospitals was 0.30 times that in the control hospitals (95%CI 0.09-1.02. Conclusion We found some evidence that the multi-faceted, sustained intervention described in this

  4. Effectiveness of a drinking-motive-tailored emergency-room intervention among adolescents admitted to hospital due to acute alcohol intoxication - A randomized controlled trial.

    Science.gov (United States)

    Wurdak, Mara; Wolstein, Jörg; Kuntsche, Emmanuel

    2016-06-01

    The aim of this study is to develop and test the effectiveness of a drinking-motive-tailored intervention for adolescents hospitalized due to alcohol intoxication in eight cities in Germany between December 2011 and May 2012 against a similar, non-motive-tailored intervention. In a randomized controlled trial, 254 adolescents received a psychosocial intervention plus motive-tailored (intervention group; IG) or general exercises (control group; CG). Adolescents in the IG received exercises in accordance with their drinking motives as indicated at baseline (e.g. alternative ways of spending leisure time or dealing with stress). Exercises for the CG contained alcohol-related information in general (e.g. legal issues). The data of 81 adolescents (age: M = 15.6, SD = 1.0; 42.0% female) who participated in both the baseline and the follow-up were compared using ANOVA with repeated measurements and effect sizes (available case analyses). Adolescents reported lower alcohol use at the four-week follow-up independently of the kind of intervention. Significant interaction effects between time and IG were found for girls in terms of drinking frequency (F = 7.770, p effect sizes of drinking frequency (d = - 1.18), binge drinking (d = - 1.61) and drunkenness (d = - 2.87) were much higher than the .8 threshold for large effects. Conducting psychosocial interventions in a motive-tailored way appears more effective for girls admitted to hospital due to alcohol intoxication than without motive-tailoring. Further research is required to address the specific needs of boys in such interventions. (German Clinical Trials Register, DRKS ID: DRKS00005588). PMID:26844193

  5. Abnormal Blood Glucose as a Prognostic Factor for Adverse Clinical Outcome in Children Admitted to the Paediatric Emergency Unit at Komfo Anokye Teaching Hospital, Kumasi, Ghana

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    Emmanuel Ameyaw

    2014-01-01

    Full Text Available Dysglycaemia (hyper- or hypoglycaemia in critically ill children has been associated with poor outcome. We compared the clinical outcomes in children admitted to Pediatric Emergency Unit (PEU at Komfo Anokye Teaching Hospital (KATH for acute medical conditions and presenting with euglycaemia or dysglycaemia. This is a prospective case matching cohort study. Eight hundred subjects aged between 3 and 144 months were screened out of whom 430 (215 with euglycaemia and 215 with dysglycaemia were enrolled. The median age was 24 months (range: 3–144 months. In the dysglycaemia group, 28 (13% subjects had hypoglycemia and 187 (87% had hyperglycemia. Overall, there were 128 complications in 116 subjects. The number of subjects with complications was significantly higher in dysglycaemia group (n=99, 46% compared to euglycaemia group (n=17, 8% (P<0.001. Forty subjects died out of whom 30 had dysglycaemia (P=0.001. Subjects with dysglycaemia were 3 times (95% CI: 1.5–6.0 more likely to die and 4.8 times (95% CI: 3.1–7.5 more likely to develop complications (P=0.001. Dysglycaemia is associated with increased morbidity and mortality in children with acute medical conditions and should lead to intensive management of the underlying condition.

  6. HIV-Associated Central Nervous System Disease in Patients Admitted at the Douala General Hospital between 2004 and 2009: A Retrospective Study

    Directory of Open Access Journals (Sweden)

    Henry Namme Luma

    2013-01-01

    Full Text Available Background. Studies on HIV-associated central nervous system (CNS diseases in Cameroon are rare. The aim of this study was to describe the clinical presentation, identify aetiological factors, and determine predictors of mortality in HIV patients with CNS disease. Methods. From January 1, 2004 and December 31, 2009, we did at the Douala General Hospital a clinical case note review of 672 admitted adult (age ≥ 18 years HIV-1 patients, and 44.6% (300/672 of whom were diagnosed and treated for HIV-associated CNS disease. Results. The mean age of the study population was years, and median CD4 count was 49 cells/mm3 (interquartile range (QR: 17–90. The most common clinical presentations were headache (83%, focal signs (40.6%, and fever (37.7%. Toxoplasma encephalitis and cryptococcal meningitis were the leading aetiologies of HIV-associated CNS disease in 32.3% and 25% of patients, respectively. Overall mortality was 49%. Primary central nervous system lymphoma (PCNSL and bacterial meningitis had the highest case fatality rates of 100% followed by tuberculous meningitis (79.8%. Low CD4 count was an independent predictor of fatality (AOR: 3.2, 95%CI: 2.0–5.2. Conclusions. HIV-associated CNS disease is common in Douala. CNS symptoms in HIV patients need urgent investigation because of their association with diseases of high case fatality.

  7. Relationship between Para Clinical Findings of First Seizure and One Year Recurrence Rate in Children Admitted at Shaheed Sadoughi Hospital-Yazd

    Directory of Open Access Journals (Sweden)

    N Owaisi

    2007-12-01

    Full Text Available Introduction: Seizure is the most common pediatric neurology problem that occurs in 10% of children. The purpose of this study was to determine the recurrence rate of seizures after one year and its relationship with paraclinical findings of the first attack. Methods : In a historical cohort analytic study , 131 children with first seizure admitted to Shaheed Sadoughi Hospital between March 2004 to August 2005 were evaluated for recurrence rate during one year and its relationship with serum levels of sodium, potassium , glucose, calcium , Hb , MCV and PMN during the first attack. Results: 79.4% of cases were in febrile seizure group and 20.6% in first unprovoked seizure group (FUS.Of the total, 27.84 % of patients had seizure recurrence ( 27.9% in febrile and 25.9% in afebrile group. Mean survival recurrence rate was 10.11±0.32 SD months (10.25±0.33 SD months in febrile group and 9.57±0.83 SD months in FUS. Survival analysis showed that seizures recurred later in older patients. Younger age and lower Hb levels in the febrile seizure group and lower MCV in the FUS group were associated with an increased risk of recurrence. Conclusion: In this study, anemia and microcytic RBC were risk factors for seizure recurrence. Therefore, more studies should be done so as to decrease seizure recurrence by treating and preventing anemia.

  8. A Study to Assess the Factors and Out of Pocket Expenditures in the Patients of Road Traffic Accidents Admitted in a Tertiary Care Hospital in a Central India District

    Directory of Open Access Journals (Sweden)

    Srivastava DK

    2014-12-01

    Full Text Available Background: Road traffic injuries are estimated to be the eighth leading cause of death globally, with an impact similar to that caused by many communicable diseases, such as malaria. road traffic injuries are estimated to cost low- and middle-income countries between 1–2 % of their Gross Domestic Product (GDP, an estimate of about US$ 100 billion a year. Objectives: To study the epidemiological profile of Road Traffic Injuries among the patients admitted in a tertiary care centre and too find out the various out of pocket expenditure in the patients of Road Traffic Accidents. Material and Method: The present study was a hospital based Descriptive Prospective Study. A list of all the patients admitted due to Road Traffic Accident in last one week was obtained from the ward sisters of Orthopedic Department. All the selected participants were interviewed on the two fixed days. A pre tested structured open ended questionnaire was used for data collection. Results: Of the 48 participants interviewed, 34male and 14 females. Most common age group affected was 21-25 years followed by 16-20 years. The rate of accidents was most common on the weekends. The rate of accidents was more in users of two wheelers. Majority of the expenditure in the First week of admission was on the purchase of medicines followed by diagnosis. Majority of the victims also suffered huge financial loss due to loss of salary, closure of shop, loss due to daily wages etc. Conclusion: The present study hereby concludes that there is an urgent need for creating awareness about Road Traffic Accident. The study also concludes that majority of the out of pocket expenditure in the first week of admission is on the medication.

  9. High Mortality Risk in Hypoglycemic and Dysglycemic Children Admitted at a Referral Hospital in a Non Malaria Tropical Setting of a Low Income Country

    Science.gov (United States)

    Barennes, Hubert; Sayavong, Eng; Pussard, Eric

    2016-01-01

    Introduction Hypoglycemia is a recognized feature of severe malaria but its diagnosis and management remain problematic in resource-limited settings. There is limited data on the burden and prognosis associated with glycemia dysregulation in non-neonate children in non-malaria areas. We prospectively assessed the abnormal blood glucose prevalence and the outcome and risk factors of deaths in critically ill children admitted to a national referral hospital in Laos. Methods Consecutive children (1 month-15 years) admitted to the pediatric ward of Mahosot hospital, were categorized using the integrated management of childhood illness (IMCI). Blood glucose was assessed once on admission through a finger prick using a bedside glucometer. Glycemia levels: hypoglycemia: 8.3 mmol/L (≥150 mg⁄ dl), were related to the IMCI algorithm and case fatality using univariate and multivariate analysis. Results Of 350 children, 62.2% (n = 218) were severely ill and 49.1% (n = 172) had at least one IMCI danger sign. A total of 15 (4.2%, 95%CI: 2.4–6.9) had hypoglycemia, 99 (28.2%, 95%CI: 23.6–33.3) low glycemia, 201 (57.4%, 95% CI: 52.0–62.6) euglycemia and 35 (10.0%, 95% CI: 7.0–13.6) hyperglycemia. Hypoglycemia was associated with longer fasting (p = 0.001) and limited treatment before admission (p = 0.09). Hypoglycemia and hyperglycemia were associated with hypoxemia (SaO2) (p = 0.001). A total of 21 (6.0%) of the children died: 66.6% with hypoglycemic, 6.0% with low glycemic, 5.7% with hyperglycemic and 1.4% with euglycemic groups. A total of 9 (2.5%) deaths occurred during the first 24 hours of admission and 5 (1.7%) within 3 days of hospital discharge. Compared to euglycemic children, hypoglycemic and low glycemic children had a higher rate of early death (20%, p<0.001 and 5%, p = 0.008; respectively). They also had a higher risk of death (OR: 132; 95%CI: 29.0–596.5; p = 0.001; and OR: 4.2; 95%CI: 1.1–15.6; p = 0.02; respectively). In multivariate analyses

  10. Prevalence and associated factors of viral hepatitis and transferrin elevations in 5036 patients admitted to the emergency room of a Swiss university hospital: cross-sectional study

    Directory of Open Access Journals (Sweden)

    Printzen Gert

    2007-02-01

    Full Text Available Abstract Background The epidemiology of liver disease in patients admitted to emergency rooms is largely unknown. The current study aimed to measure the prevalence of viral hepatitis B and C infection and pathological laboratory values of liver disease in such a population, and to study factors associated with these measurements. Methods Cross-sectional study in patients admitted to the emergency room of a university hospital. No formal exclusion criteria. Determination of anti-HBs, anti-HCV, transferrin saturation, alanine aminotransferase, and obtaining answers from a study-specific questionnaire. Results The study included 5'036 patients, representing a 14.9% sample of the target population during the study period. Prevalence of anti-HBc and anti-HCV was 6.7% (95%CI 6.0% to 7.4% and 2.7% (2.3% to 3.2%, respectively. Factors independently associated with positive anti-HBc were intravenous drug abuse (OR 18.3; 11.3 to 29.7, foreign country of birth (3.4; 2.6 to 4.4, non-white ethnicity (2.7; 1.9 to 3.8 and age ≥60 (2.0; 1.5 to 2.8. Positive anti-HCV was associated with intravenous drug abuse (78.9; 43.4 to 143.6, blood transfusion (1.7; 1.1 to 2.8 and abdominal pain (2.7; 1.5 to 4.8. 75% of all participants were not vaccinated against hepatitis B or did not know their vaccination status. Among anti-HCV positive patients only 49% knew about their infection and 51% reported regular alcohol consumption. Transferrin saturation was elevated in 3.3% and was associated with fatigue (prevalence ratio 1.9; 1.2 to 2.8. Conclusion Emergency rooms should be considered as targets for public health programs that encourage vaccination, patient education and screening of high-risk patients for liver disease with subsequent referral for treatment if indicated.

  11. Variation in the rates of adverse events between hospitals and hospital departments.

    NARCIS (Netherlands)

    Zegers, M.; Bruijne, M.C. de; Spreeuwenberg, P.; Wagner, C.; Wal, G. van der; Groenewegen, P.P.

    2011-01-01

    Objective: The objective of this study was to analyze the variation in the rates of adverse events (AEs), and preventable AEs, between hospitals and hospital departments in order to investigate the room for improvement in reducing AEs at both levels. In addition, we explored the extent to which pati

  12. Parasuicide and drug self-poisoning: analysis of the epidemiological and clinical variables of the patients admitted to the Poisoning Treatment Centre (CAV, Niguarda General Hospital, Milan

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    Manfré Sergio

    2005-04-01

    Full Text Available Abstract Epidemiological knowledge of parasuicides and drug self-poisoning is still limited by a lack of data. A number of preliminary studies, which require further analysis, evidenced that parasuicidal acts occur more often among females, that the peak rate is generally recorded between the ages of 15 and 34 years and psychotropic medications seems to be the most frequently used. The aim of this study was to describe the demographic and clinical variables of a sample of subjects admitted to the Posisoning Treatment Centre (CAV, Niguarda General Hospital, Milan, following drug self-poisoning. Furthermore, this study is aimed to identify the risk factors associated to parasuicidal gestures, with special care for the used drugs, the presence of psychiatric or organic disorders, alcoholism and drug addiction. The study included the 201 patients attending the CAV in 1999 and 2000 who satisfied the criteria of self-poisoning attempts: 106 cases in 1999 and 95 in 2000. The sample had a prevalence of females (64%. The peak rates of parasuicides from drug self-poisoning were reached between 21 and 30 years among the females, and 31 and 40 years among the males. 81.6% of the patients used one or more psychoactive drugs, the most frequent being the benzodiazepines (58.7%, classic neuroleptics (16.9% and new-generation antidepressants (SSRIs, SNRIs, NARIs (12.9%. The prevalence of mood disorders was higher among females (64% vs 42%, whereas schizophrenia was more frequently diagnosed in males (22% vs 10%. 61% (33% had a history of previous attempted suicides. The presence of clinically relevant organic diseases was observed in 24.9% of the sample.

  13. Retrospective cohort analysis of chest injury characteristics and concurrent injuries in patients admitted to hospital in the Wenchuan and Lushan earthquakes in Sichuan, China.

    Directory of Open Access Journals (Sweden)

    Xi Zheng

    Full Text Available BACKGROUND: The aim of this study was to compare retrospectively the characteristics of chest injuries and frequencies of other, concurrent injuries in patients after earthquakes of different seismic intensity. METHODS: We compared the cause, type, and body location of chest injuries as well as the frequencies of other, concurrent injuries in patients admitted to our hospital after the Wenchuan and Lushan earthquakes in Sichuan, China. We explored possible relationships between seismic intensity and the causes and types of injuries, and we assessed the ability of the Injury Severity Score, New Injury Severity Score, and Chest Injury Index to predict respiratory failure in chest injury patients. RESULTS: The incidence of chest injuries was 9.9% in the stronger Wenchuan earthquake and 22.2% in the less intensive Lushan earthquake. The most frequent cause of chest injuries in both earthquakes was being accidentally struck. Injuries due to falls were less prevalent in the stronger Wenchuan earthquake, while injuries due to burial were more prevalent. The distribution of types of chest injury did not vary significantly between the two earthquakes, with rib fractures and pulmonary contusions the most frequent types. Spinal and head injuries concurrent with chest injuries were more prevalent in the less violent Lushan earthquake. All three trauma scoring systems showed poor ability to predict respiratory failure in patients with earthquake-related chest injuries. CONCLUSIONS: Previous studies may have underestimated the incidence of chest injury in violent earthquakes. The distributions of types of chest injury did not differ between these two earthquakes of different seismic intensity. Earthquake severity and interval between rescue and treatment may influence the prevalence and types of injuries that co-occur with the chest injury. Trauma evaluation scores on their own are inadequate predictors of respiratory failure in patients with earthquake

  14. Tentativa de suicídio entre pacientes com uso nocivo de bebidas alcoólicas internados em hospital geral Suicide attempt amongst patients with alcohol misuse admitted to a general hospital

    Directory of Open Access Journals (Sweden)

    Daniela Dantas Lima

    2010-01-01

    Full Text Available OBJETIVO: Detectar fatores associados a histórico de tentativa de suicídio (TS em pacientes internados em hospital geral que fazem uso nocivo de bebidas alcoólicas. MÉTODO: 4.352 pacientes admitidos consecutivamente foram avaliados utilizando-se um rastreamento do qual constavam as escalas AUDIT (Alcohol Use Disorder Identification Test e HAD (Escala Hospitalar de Ansiedade e Depressão. Fixando-se histórico de tentativa de suicídio ao longo da vida como variável dependente, foram realizados testes do qui-quadrado e regressão logística múltipla. RESULTADOS: Uso nocivo de álcool (AUDIT > 8 foi detectado em 423 pacientes. Dentre eles, 60 (14,2% apresentavam sintomas de depressão (HAD > 8 e 34 (8% tinham histórico de TS. Este se associou a ser adulto jovem [razão de chance (RC = 3,4], depressão (RC = 6,6, uso pregresso de psicofármaco (RC = 7 e ter SIDA (RC = 24. CONCLUSÃO: Os resultados fortalecem a necessidade de detectar e tratar adequadamente condições que, combinadas, aumentam consideravelmente o risco de suicídio.OBJECTIVE: To detect factors associated to previous suicide attempt among patients admitted to a general hospital who presented harmful alcohol drinking pattern. METHOD: 4.352 patients consecutively admitted were screened by means of the AUDIT (Alcohol Use Disorder Identification Test and HAD (Hospital Anxiety and Depression Scale. Qui-squared tests and multiple logistic regression were performed. RESULTS: 423 individuals presented alcohol harmful use or dependence (AUDIT > 8, 60 (14.2% of which had depression (HAD > 8 and 34 (8% previous suicide attempt. The latter was more frequent among young adults [odds ratio (OR = 3.4], those who were depressed (OR = 6.6, had previously taken psychotropic medicines (OR = 7 and had AIDS (OR = 24. CONCLUSION: Our findings reinforce the need for detection and adequate treatment of conditions that, when together, strongly increase the suicide risk.

  15. Clinical features and predictors of mortality in admitted patients with community- and hospital-acquired legionellosis: A Danish historical cohort study

    Directory of Open Access Journals (Sweden)

    Fine Michael J

    2010-05-01

    Full Text Available Abstract Background Legionella is a common cause of bacterial pneumonia. Community-acquired [CAL] and hospital-acquired legionellosis [HAL] may have different presentations and outcome. We aimed to compare clinical characteristics and examine predictors of mortality for CAL and HAL. Methods We identified hospitalized cases of legionellosis in 4 Danish counties from January 1995 to December 2005 using the Danish national surveillance system and databases at departments of clinical microbiology. Clinical and laboratory data were retrieved from medical records; vital status was obtained from the Danish Civil Registration System. We calculated 30- and 90-day case fatality rates and identified independent predictors of mortality using logistic regression analyses. Results We included 272 cases of CAL and 60 cases of HAL. Signs and symptoms of HAL were less pronounced than for CAL and time from in-hospital symptoms to legionellosis diagnosis was shorter for CAL than for HAL (5.5 days vs. 12 days p 65 years (OR = 2.6, 95% CI: 1.1-5.9 and Charlson comorbidty index ≥2 (OR = 2.7, 95% CI: 1.1-6.5 were associated with an increased risk of death in CAL. We identified no statistically significant predictors of 30-day mortality in HAL. Conclusions Signs and symptoms were less pronounced in HAL compared to CAL. Conversely, 30-day case fatality was almost 3 times higher. Clinical awareness is important for the timely diagnosis and treatment especially of HAL. There is a need for further studies of prognostic factors in order to improve the therapeutic approach to legionellosis and potentially reduce mortality.

  16. Networks in the radiology department and the hospital

    International Nuclear Information System (INIS)

    Data networks are a basic technology with regard to an appropriate design of the information technology (IT) infrastructure for the hospital. Due to the distributed workflow within the hospital, an integrated Hospital Information System (HIS) is based mostly on a set of network applications facing specific items. Medical communication standards, i. e., HL 7, DICOM, and in the near future the migration towards XML, support the interoperability between the IT subsystems and pave the way to patient information systems with access to unified and complete electronic medical records (EMR). Furthermore, with standardized communication techniques, such as CORBAmed, an object-oriented design of Healthcare applications will be possible in the near future. The intent of this paper is to give an overview of which basic technologies are suitable for building comprehensive, flexible, and reliable hospital networks and which also meet the special demands of the radiology department. (orig.)

  17. The Impact of Cannabis Use on the Dosage of Antipsychotic Drugs in Patients Admitted on the Psychiatric Ward at the University Hospital of the West Indies

    Directory of Open Access Journals (Sweden)

    P Thomas

    2015-03-01

    Full Text Available Objective: To assess the impact of cannabis use on the efficacy of antipsychotic drugs in male subjects presenting to the University Hospital of the West Indies (UHWI with psychotic episodes. Methods: Male subjects, 18–40 years old, admitted to the psychiatric ward of the UHWI between February 2013 and May 2013, diagnosed with schizophrenia, schizophreniform disorder and who tested positive for ∆9-tetrahydrocannabinol were recruited for the study. On day one, consenting subjects were assessed using the Brief Psychiatric Rating Scale (BPRS. Patients were prescribed seven days of an oral antipsychotic medication (haloperidol, chlorpromazine, risperidone, quetiapine, olanzapine. Medicated subjects were then reassessed using the BPRS on days three and seven. Statistical analysis involved the use of Student’s t-test and repeated measure analysis of variance. Results: In total, 20 subjects were recruited (mean age = 26.00 ± 5.96 years. Subjects were grouped based on the daily chlorpromazine equivalent (CPZE dose given on day one into CPZE1 (CPZE dose of 100–300mg; n = 8 and CPZE2 (CPZE dose of 400–1250 mg; n = 12. There was no significant difference in the total BPRS score between the groups on day one (CPZE1 = 41.38 ± 16.47 versus CPZE2 = 49.42 ± 25.58; p = 0.44; similar findings were obtained for the positive (26.75 ± 9.27 versus 31.83 ± 17.30; p = 0.46 and negative (14.63 ± 7.73 versus 17.58 ± 9.74; p = 0.48 symptom component on the BPRS. For subjects in CPZE1, there was no significant decrease in total BPRS score [F(2,21 = 0.07, p = 0.93] over the study period. For CPZE2, significant reduction in total BPRS scores was achieved [F(2,33 =7.12, p = 0.01], contributed by significant decrease in the positive [F(2,33 = 5.64, p = 0.02 and negative [F(2,33 = 7.53, p = 0.01 symptom components of the BPRS. Conclusion: The findings of this study purport that male cannabis users presenting with psychotic disorders may not achieve optimal

  18. Molecular epidemiology of group A rotavirus among children admitted to hospital in Salto, Uruguay, 2011-2012: first detection of the emerging genotype G12.

    Science.gov (United States)

    Tort, Luis Fernando López; Victoria, Matías; Lizasoain A, Andrés; Castells, Matías; Maya, Leticia; Gómez, Mariela Martínez; Arreseigor, Edit; López, Patricia; Cristina, Juan; Leite, Jose Paulo Gagliardi; Colina, Rodney

    2015-05-01

    Group A rotavirus (RVA) is the most important etiologic agent of infant acute gastroenteritis (AGE) worldwide. Detection and molecular characterization of RVA in Salto department, Northwestern region of Uruguay, was conducted on 175 clinical samples, being 153 stool and 22 vomit samples, collected from hospitalized children with AGE, between 0-15 years old, from two hospitals of Salto city during 2011 and 2012. RVA was detected and genotyped by seminested multiplex RT-PCR in order to determine G- and P-genotypes. Positive samples were sequenced and phylogenetic analyses were carried out in order to determine lineages and sub-lineages. RVA were detected in 64 (37%) of the samples and the G and P genotypes observed were: 6% G1P[8], 23% G2P[4]/G2P[X]/GXP[4], 23% G3P[8]/G3P[X], 14% G12P[8]/G12P[X], 16% GXP[8], 1,5% G12P[9], 3% G2P[4]/[8], and 16% non-typeable. VP7 and VP4 genotypes related to DS-1 like gene constellation were prevalent during 2011 and those VP7 and VP4 genotypes related to Wa-like constellation were prevalent during 2012 (mainly represented by G3P[8]). Interestingly, RVA was detected in vomit samples in a high prevalence (41%). RVA was observed mainly in the age group between 1 and 5 years old (75% of the cases), and seasonality with a high detection rate in winter season was observed for the two consecutive years of surveillance. To our knowledge, this study represents the first detection and molecular characterization of RVA in Salto department, Northwestern region of Uruguay; and the first identification of the emerging genotype G12 in the country.

  19. Predictive factors for hospitalization of nonurgent patients in the emergency department.

    Science.gov (United States)

    Ng, Chip-Jin; Liao, Pei-Ju; Chang, Yu-Che; Kuan, Jen-Tze; Chen, Jih-Chang; Hsu, Kuang-Hung

    2016-06-01

    Nonurgent emergency department (ED) patients are a controversial issue in the era of ED overcrowding. However, a substantial number of post-ED hospitalizations were found, which prompted for investigation and strategy management. The objective of this study is to identify risk factors for predicting the subsequent hospitalization of nonurgent emergency patients. This was a retrospective study of a database of adult nontrauma ED visits in a medical center for a period of 12 months from January 2013 to December 2013. Patient triages as either Taiwan Triage and Acuity Scale (TTAS) level 4 or 5 were considered "nonurgent." Basic demographic data, primary and secondary diagnoses, clinical parameters including blood pressure, heart rate, body temperature, and chief complaint category in TTAS were analyzed to determine if correlation exists between potential predictors and hospitalization in nonurgent patients.A total of 16,499 nonurgent patients were included for study. The overall hospitalization rate was 12.47 % (2058/16,499). In the multiple logistic regression model, patients with characteristics of males (odds ratio, OR = 1.37), age more than 65 years old (OR = 1.56), arrival by ambulance (OR = 2.40), heart rate more than 100/min (OR = 1.47), fever (OR = 2.73), and presented with skin swelling/redness (OR = 4.64) were predictors for hospitalization. The area under receiver-operator calibration curve (AUROC) for the prediction model was 0.70. Nonurgent patients might still be admitted for further care especially in male, the elderly, with more secondary diagnoses, abnormal vital signs, and presented with dermatologic complaints. Using the TTAS acuity level to identify patients for diversion away from the ED is unsafe and will lead to inappropriate refusal of care for many patients requiring hospital treatment. PMID:27368040

  20. Cannabis abuse : a phenomenological study of the causative factors as perceived by patients with a history of Cannabis use, admitted at Bophelong Psychiatric Hospital in the North West Province / Boitumelo Susan Patricia Ramphomane

    OpenAIRE

    Ramphomane, Boitumelo Susan Patricia

    2005-01-01

    A phenomenological study was carried out to find out from patients with a history of cannabis use. admitted at Bophelong Psychiatric Hospital, reasons or factors that caused them to use/abuse cannabis. An original sample of 30 male patients between the ages of 16-30 years was selected from chronic (rehabilitation) wards of mentally stable patients awaiting discharge. Out of the 30 subjects, 10 protocols were selected for phenomenological explication. An unstructured type of interview was c...

  1. 急诊内科育龄女性常规尿早孕检测的必要性%The Necessity Analysis of Routine Urine Pregnancy Test in Women of Reproductive Age Admitted in Emergency Medicine Department

    Institute of Scientific and Technical Information of China (English)

    张晓东; 董磊; 张海燕; 吴彩军

    2015-01-01

    目的:明确在急诊内科就诊的育龄女性进行常规尿早孕检测的临床重要性。方法选取两所医院急诊科2014年6月1日-2014年12月31日内科就诊育龄期女性患者行尿早孕检测资料,记录尿早孕检测结果并进行病例资料中年龄、月经史以及急诊就诊主诉等资料进行统计分析。结果共计入选育龄期女性患者1266例,尿早孕检测阳性患者150例,阳性率11.8%;150例尿早孕检测阳性患者就诊时主诉以消化系统症状人数为最多,达到40%;规律月经史并且尿早孕检测结果为阳性患者有33人,占尿早孕检测阳性总人数的22.0%。结论对于急诊内科就诊的育龄期女性不能简单的通过月经史判断排除其早孕可能,在急诊内科就诊的育龄女性均应该进行常规尿早孕检测。%ObjectivesTo clear and definite the clinical importance of routine urine pregnancy test in women of reproductive age admitted in emergency medicine department.Methods The urine pregnancy test materials of reproductive age women who admitted in emergency medicine department of the two hospitals from 1st Jane 2014 to 31st December 2014 were selected, then recorded the examination results and conducted a statistical analysis on the age, menses history and chief complaint in the medical records materials.Results 1266 patients were enrolled into the study and 150(11.8%) had a positive results of pregnancy test, the positive rate was 11.8%. The most common chief complaint admitted were symptoms in digestive system, which accounted for 40%. 33 cases had regular menses history and positive results, which accounted for 22.0% in all of the patients with positive results of urine pregnancy test.Conclusions We could not judge and exclude the pregnancy possibility of reproductive age women admitted in emergency medicine department only through menses history, and urine pregnancy test should be performed routinely in women of reproductive age in

  2. Hospitals

    Data.gov (United States)

    Department of Homeland Security — This database contains locations of Hospitals for 50 states and Washington D.C. , Puerto Rico and US territories. The dataset only includes hospital facilities and...

  3. [Hospitality for elderly patients in the emergency department].

    Science.gov (United States)

    Boulet, Marie-Claude; Dami, Fabrice; Hugli, Olivier; Renard, Delphine; Foucault, Eliane; Carron, Pierre-Nicolas

    2015-12-01

    Demographic evolution results in a growing use of emergency department by elderly patients. They require special care to avoid any further degradation of cognitive and functional abilities already compromised by the disease or injury that led them to hospital in the first place. Through a clinical case, we list the risks related to the care of these particular patients in the emergency department. Early recognition of those risks and careful management of these patients' specific needs can significantly contribute to reduce lengths of stay, an important outcome from both the individual patient's and society's perspective.

  4. [Hospitality for elderly patients in the emergency department].

    Science.gov (United States)

    Boulet, Marie-Claude; Dami, Fabrice; Hugli, Olivier; Renard, Delphine; Foucault, Eliane; Carron, Pierre-Nicolas

    2015-12-01

    Demographic evolution results in a growing use of emergency department by elderly patients. They require special care to avoid any further degradation of cognitive and functional abilities already compromised by the disease or injury that led them to hospital in the first place. Through a clinical case, we list the risks related to the care of these particular patients in the emergency department. Early recognition of those risks and careful management of these patients' specific needs can significantly contribute to reduce lengths of stay, an important outcome from both the individual patient's and society's perspective. PMID:26790241

  5. Group therapy in mental hospital department. Challenges, capabilities, hopes.

    OpenAIRE

    Łukasz Mateusz Majchrzak

    2015-01-01

    Group psychotherapy is common and useful disorder treatment process, especially using in outpatient system. The situation in stationary system such as mental hospitals and their acute departments is quite different, because it is more exacting work environment for group and therapists. The clinical observations shows that for great part of stationary system patients the psychodynamic group therapy is new experience. Hence it is very important to prepare therapeutic program which is well thoug...

  6. INCIDENCE OF FLUOROQUINOLONES INDUCED PSYCHOTIC DISORDERS IN PATIENTS ADMITTED TO DEPARTMENT OF MEDICINE IN A GENERAL HOSPITAL SETUP

    OpenAIRE

    Dnyanda V; Vidyut A; Shrikant B.; Ashish V

    2015-01-01

    Toxic psychosis in adults although it is relatively uncommon side-effect in proportion to the large worldwide consumption of the drugs, there has been a number of case reports of Fluoroquinolone-associated psychosis. Our study was first of its kind as no other prospective cohort study on the use of fluoroquinolones and its relation to development of psychosis has yet been carried out. 2007 patients who were prescribed fluoroquinolones were followed for one month for develo...

  7. INCIDENCE OF FLUOROQUINOLONES INDUCED PSYCHOTIC DISORDERS IN PATIENTS ADMITTED TO DEPARTMENT OF MEDICINE IN A GENERAL HOSPITAL SETUP

    Directory of Open Access Journals (Sweden)

    Dnyanda V

    2015-10-01

    Full Text Available Toxic psychosis in adults although it is relatively uncommon side-effect in proportion to the large worldwide consumption of the drugs, there has been a number of case reports of Fluoroquinolone-associated psychosis. Our study was first of its kind as no other prospective cohort study on the use of fluoroquinolones and its relation to development of psychosis has yet been carried out. 2007 patients who were prescribed fluoroquinolones were followed for one month for development of any signs of psychosis out of which 22 patients that is 1.11% was found to have fluoroquinolones induced psychosis. We also discuss the possible neurophysiological mechanisms behind fluoroquinolones induced psychosis.

  8. Comparison of diagnostic performance between single- and multiphasic contrast-enhanced abdominopelvic computed tomography in patients admitted to the emergency department with abdominal pain: potential radiation dose reduction

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Shin Hye; You, Je Sung; Choi, Jin-Young; Kim, Myeong-Jin; Chung, Yong Eun [Yonsei University College of Medicine, Department of Radiology, Research Institute of Radiological Science, Seodaemun-gu, Seoul (Korea, Republic of); Song, Mi Kyong [Yonsei University, Biostatistics Collaboration Unit, College of Medicine, Seoul (Korea, Republic of)

    2015-04-01

    To evaluate feasibility of radiation dose reduction by optimal phase selection of computed tomography (CT) in patients who visited the emergency department (ED) for abdominal pain. We included 253 patients who visited the ED for abdominal pain. They underwent multiphasic CT including precontrast, late arterial phase (LAP), and hepatic venous phase (HVP). Three image sets (HVP, precontrast + HVP, and precontrast + LAP + HVP) were reviewed. Two reviewers determined the most appropriate diagnosis with five-point confidence scale. Diagnostic performances were compared among image sets by weighted-least-squares method or DeLong's method. Linear mixed model was used to assess changes of diagnostic confidence and radiation dose. There was no difference in diagnostic performance among three image sets, although diagnostic confidence level was significantly improved after review of triphasic images compared with both HVP images only or HVP with precontrast images (confidence scale, 4.64 ± 0.05, 4.66 ± 0.05, and 4.76 ± 0.04 in the order of the sets; overall P = 0.0008). Similar trends were observed in the subgroup analysis for diagnosis of pelvic inflammatory disease and cholecystitis. There is no difference between HVP-CT alone and multiphasic CT for the diagnosis of causes of abdominal pain in patients admitted to the ED without prior chronic disease or neoplasia. (orig.)

  9. Risk factors for intracerebral hemorrhage and coronary heart diseases over a 3-year period in patients admitted to some hospitals of Tongliao city of Nei Monggol Autonomous Region Retrospective analysis on case data

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: Intracerebral hemorrhage(ICH) and coronary heart disease (CHD) have the same pathological base, atherosclerosis, and the similar risk factors, such as smoking ,drinking, hypertension,hyperlipemia, diabetes mellitus, etc; but the distributions of two diseases are very different in the populations.This may be related to the exposure of risk factors and different effects of risk factors on two diseases.OBJECTIVE: To analyze the distribution difference of risk factors for ICH and CHD in the populations of Tongliao city of Nei Monggol Autonomous Region.DESIGN: Retrospective analysis.SETTING: School of Radiation Medicine and Public Health, Soochow University; Tongliao Hospital, Nei Monggol Autonomous Region.PARTICIPANTS: Random sampling was used toselect 6 hospitals from 10 hospitals affiliated to Tongliao City ofNei Monggot Autonomous Region. Totally 1 672 medical records of patients with ICH and 2 195 medical records of patients with CHD admitted to Department of Neurology and Department of Cardiovascular Internal Medicine of above-mentioned 6 hospitals between January 2003 and December 2005 were collected according to the investigation need.METHODS: The subjects, whose medical records were involved, were performed retrospective analysis with pre-prepared questionnaire "Stroke and Coronary Heart Disease Epidemiologic Questionnaire". The main contents included: ①Social demography condition: The distributions of gender, age, nationality, etc. ②Previous history of disease: hypertension, diabetes mellitus, etc. ③Related risk factors: systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride, high-density lipoprotein cholesterol,low-density lipoprotein cholesterol, smoking, drinking and glucose (GLU). The database of Epidata was transformed to SPSS database. Single-and multiple-factor non-conditional Logistic regression analysis were performed on the data, and OR value and 95% CI were calculated. The distribution differences of

  10. A STUDY TO EVALUATE THE EFFECT OF NUTRITIONAL INTERVENTION MEASURES ON CHILDREN WITH SEVERE ACUTE MALNUTRITION ADMITTED IN NUTRITION REHABILITATION CENTER AT CIVIL HOSPITAL BAIRAGARH, BHOPAL, MADHYA PRADESH

    OpenAIRE

    Ritesh; Priyesh

    2015-01-01

    BACKGROUND: The state of Madhya Pradesh has 1.3 million severely malnourished children. Nutrition rehabilitation centers (NRCs) were started in the state to control severe malnutrition and decrease the prevalence of severe malnourished children to less than 1% among c hildren aged 1 – 5 years. OBJECTIVE: To assess the effect of nutritional interventional measures for children with severe acute malnutrition (SAM) admitted in Nutrition Rehabilitation Center by ...

  11. Epidemiology and Outcome of Chemical Burn Patients Admitted in Burn Unit of JNMC Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh, India: A 5-year Experience

    OpenAIRE

    Akhtar, Md Sohaib; Ahmad, Imran; Khurram, M. Fahud; Kanungo, Srikanta

    2015-01-01

    Aims and Objective: The objectives of this study were to evaluate the epidemiology, clinical variable of chemical burns, and their outcomes to prevent or reduce the frequency and morbidity of such injuries. Materials and Methods: A retrospective analysis was performed on all the patients with chemical burns admitted at author's center between November 2008 and December 2013. All the patients were evaluated in terms of age, sex, total body surface area, etiology, treatment given, morbidity, mo...

  12. Group therapy in mental hospital department. Challenges, capabilities, hopes.

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    Łukasz Mateusz Majchrzak

    2015-06-01

    Full Text Available Group psychotherapy is common and useful disorder treatment process, especially using in outpatient system. The situation in stationary system such as mental hospitals and their acute departments is quite different, because it is more exacting work environment for group and therapists. The clinical observations shows that for great part of stationary system patients the psychodynamic group therapy is new experience. Hence it is very important to prepare therapeutic program which is well thought out and contains realistic goals. As the research shows, patients suffering for deeper pathology needs more safety and more compact therapeutic environment. Then they can make some substantial changes. Presented statistics of patients which was participating in this therapy (n 53 shows that although they have different diagnosis, more of them (64,2% accomplished this process. Providing group psychotherapy in mental hospital department is exacting but possible task. Furthermore it is practicable and efficient method. Benefits both are strong for patients and for hospital (better realization of government schedule.

  13. Early detection of abnormal patient arrivals at hospital emergency department

    KAUST Repository

    Harrou, Fouzi

    2015-10-21

    Overcrowding is one of the most crucial issues confronting emergency departments (EDs) throughout the world. Efficient management of patient flows for ED services has become an urgent issue for most hospital administrations. Handling and detection of abnormal situations is a key challenge in EDs. Thus, the early detection of abnormal patient arrivals at EDs plays an important role from the point of view of improving management of the inspected EDs. It allows the EDs mangers to prepare for high levels of care activities, to optimize the internal resources and to predict enough hospitalization capacity in downstream care services. This study reports the development of statistical method for enhancing detection of abnormal daily patient arrivals at the ED, which able to provide early alert mechanisms in the event of abnormal situations. The autoregressive moving average (ARMA)-based exponentially weighted moving average (EWMA) anomaly detection scheme proposed was successfully applied to the practical data collected from the database of the pediatric emergency department (PED) at Lille regional hospital center, France.

  14. Hospital Factors Impact Variation in Emergency Department Length of Stay More Than Physician Factors

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    Scott P. Krall

    2014-03-01

    Full Text Available Introduction: To analyze the correlation between the many different emergency department (ED treatment metric intervals and determine if the metrics directly impacted by the physician correlate to the “door to room” interval in an ED (interval determined by ED bed availability. Our null hypothesis was that the cause of the variation in delay to receiving a room was multifactorial and does not correlate to any one metric interval.Methods: We collected daily interval averages from the ED information system, Meditech©. Patient flow metrics were collected on a 24-hour basis. We analyzed the relationship between the time intervals that make up an ED visit and the “arrival to room” interval using simple correlation (Pearson Correlation coefficients. Summary statistics of industry standard metrics were also done by dividing the intervals into 2 groups, based on the average ED length of stay (LOS from the National Hospital Ambulatory Medical Care Survey: 2008 Emergency Department Summary.Results: Simple correlation analysis showed that the doctor-to-discharge time interval had no correlation to the interval of “door to room (waiting room time”, correlation coefficient (CC (CC=0.000, p=0.96. “Room to doctor” had a low correlation to “door to room” CC=0.143, while “decision to admitted patients departing the ED time” had a moderate correlation of 0.29 (p <0.001. “New arrivals” (daily patient census had a strong correlation to longer “door to room” times, 0.657, p<0.001. The “door to discharge” times had a very strong correlation CC=0.804 (p<0.001, to the extended “door to room” time. Conclusion: Physician-dependent intervals had minimal correlation to the variation in arrival to room time. The “door to room” interval was a significant component to the variation in “door to discharge” i.e. LOS. The hospital-influenced “admit decision to hospital bed” i.e. hospital inpatient capacity, interval had a

  15. Do Medicare Advantage enrollees tend to be admitted to hospitals with better or worse outcomes compared with fee-for-service enrollees?

    Science.gov (United States)

    Friedman, Bernard; Jiang, H Joanna

    2010-06-01

    The hospitals selected by or for Medicare beneficiaries might depend on whether the patient is enrolled in a Medicare Advantage (MA) plan. A theoretical model of profit maximization by MA plans takes into account the tradeoffs of consumer preferences for annual premium versus outcomes of care in the hospital and other attributes of the plan. Hospital discharge databases for 13 states in 2006, maintained by the Agency for Healthcare Research and Quality, are the main source of data. Risk-adjusted mortality rates are available for all non-maternity adult patients in each of 15 clinical categories in about 1,500 hospitals. All-adult postoperative safety event rates covering 9 categories of events are calculated for surgical cases in about 900 hospitals. Instrumental variables are used to address potential endogeneity of the choice of a MA plan. The key findings are these: enrollees in MA plans tend to be treated in hospitals with lower resource cost and higher risk-adjusted mortality compared to Fee-for-Service (FFS) enrollees. The risk-adjusted mortality measure is about 1.5 percentage points higher for MA plan enrollees than the overall mean of 4%. However, the rate of safety events in surgical patients favors MA plan enrollees--the rate is 1 percentage point below the average of 3.5%. These discrepant results are noteworthy and are plausibly due to greater discretion by the health plan in approving patients for elective surgery and as well as selecting hospitals for surgical patients. Emergency patients are generally excluded for the safety outcome measures. In addition, the current mortality measures may not adequately represent all surgical patients. Such caveats should be prominently highlighted when presenting comparative data. With that proviso, the study justifies informing Medicare beneficiaries about the mortality and safety outcome measures for hospitals being used by a MA plan compared to hospitals used by FFS enrollees. PMID:20140642

  16. Adhesion Following First-Time C-Section and its Effects on Mother and Neonate in Patients Admitted to Shahid Sadoughi Hospital in Yazd during 2012-2014

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    R Dehghani Firouzabadi

    2016-04-01

    Conclusion: In this study, a significant relationship was detected between the degree of adhesion and hemoglobin loss, duration of hospitalization, duration of fetus delivery from uterus, as well as the overall duration of operation.

  17. The Epidemiological and Clinical Assessment of Admitted Burned Pregnant Women in Shahid Mottahary Hospital Burn Center Between January 1998 and October 2003

    OpenAIRE

    A. Tavassoli-Ashrafi, M.D.; H. Khani, M.D.

    2007-01-01

    Background and purpose: Treatments of burn pregnant women is a difficult task because the vulnerable fetus is highly dependent on the health of the mother. This study was conducted to determine the epidemiology, etiology, clinical assessment and outcome of pregnant patients between January 1998 and October 2003.Materials and Methods: A 6-year retrospective descriptive study of burns in pregnant women hospitalized at Mottahary hospital (burn center) in Tehran was performed. A short structured ...

  18. Medical information system in hospital emergency departments' organizational perspectives.

    Science.gov (United States)

    Dumont, V; Rousseau, A

    2002-01-01

    The study reported in this article examines the implementation of the same software in 3 emergency departments from different Belgian hospitals. It was experienced and perceived very differently as a failure or a success by the units' staff. The software integrates different functionalities, which can be chosen and customized by some members of the units themselves. We will look at the three processes of implementation to find out different plausible explanation for their 'failure or success'. Our approach is developed through the qualitative methodology of case studies. The translation theory is presented as a renewal way of thinking the perceived 'successful or failed' implementation of a new information system and a guide for new project in emergency department. PMID:15058415

  19. Nutritional assessment of adult patients admitted to a hospital of the Amazon region Evaluación nutricional de pacientes adultos ingresados en un hospital de la región amazónica

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    K. Acuña

    2003-06-01

    Full Text Available Changes in nutritional status are important in clinical practice because they relate to an increase in morbidity and mortality. Studies about nutritional problems in hospitalized adults have been reported since the 1970s. The prevalence of malnutrition has varied from 10 to 70%, depending on the diagnostic criteria used. The hospital studied and the duration of admission. Aim: To assess, in the first day of hospital stay, the nutritional status of adults admitted to undergo elective surgery in a public hospital of the State of Acre, Amazon Region, Brazil. Study design: Sectional study from April 7 to May 22, 2002. Patients and methods: 155 consecutive nutritional evaluations were performed using several parameters - global subjective assessment (GSA, anthropometric measurement and some laboratory tests. For the diagnosis of malnutrition the Index Suggestive of Malnutrition (ISM, as proposed by Waitzberg, was adopted. In the evaluation of obesity the BMI (Body Mass Index, with cutoffs suggested by WHO was used. Results: 75.2% were women. Average age was 34.4 ± 10.1 years. Mulatto (63.1% was the prevailing racial group. Gynecological (43.6% was the most frequent surgery. ISM disclosed a 12.1% prevalence of malnutrition. BMI classified 2.0% of the patients as grade I overweight and 15.4% as being obese. Among 76 patients classified as normal by BMI, 15 (19.7% were considered malnourished by ISM criteria. Concordance between ISM and BMI was weak (k = 0.07. GSA classified 100% of the cases as well nourished. Conclusion: Lack of a golden standard to make the diagnosis of changes in nutritional status has been one of the determinants of the wide variations observed in the pertinent literature and it has hindred valid comparisons. The present study suggests that BMI should be used as an indicator of proportion and not of nutritional status. GSA underestimates the diagnosis of malnutrition. This paper concludes that establishing uniform standards for

  20. Estudio piloto de un plan de mejora de la calidad con cribaje nutricional sistemático de pacientes ingresados en un hospital comarcal A pilot study on a quality improvement plan with systematic nutritional screening in patients admitted to a regional hospital

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    M. Gimeno

    2009-04-01

    Full Text Available Objetivo: Estudio piloto para evaluar la factibilidad de la instauración de un protocolo hospitalario de cribaje nutricional sistemático de pacientes ingresados. Método: Estudio descriptivo transversal. Se incluyeron de forma sistemática, en las primeras 48 horas de estancia hospitalaria, los pacientes ingresados en el Servicio de Traumatología del Hospital Comarcal de Alcañiz desde febrero a septiembre del 2007. Los sistemas de cribaje que se utilizaron fueron el Indice de Riesgo Nutricional (IRN, el sistema de Control Nutricional CONUT y un indicador basado en las recomendaciones de la SENPE. Se definió como necesidad de soporte nutricional la presencia de cualquiera de las siguientes circunstancias: desnutrición moderada o grave según los métodos IRN o CONUT o desnutrición según las recomendaciones adaptadas de la SENPE. Resultados: 36,4% de los pacientes valorados necesitan soporte nutricional. El grado de desnutrición según CONUT es del 13,6%, según criterios SENPE de 27,3% y según IRN de 29,5%. La concordancia entre los métodos comparados entre sí es estadísticamente significativa y clínicamente aceptable: Kappa entre IRN y CONUT de 0,547, entre IRN y SENPE de 0,609, entre CONUT y SENPE de 0,593. Conclusiones: La aplicación de un protocolo estructurado de recogida de parámetros antropométricos y bioquímicos, con implicación de un equipo hospitalario multidisciplinar, es capaz de identificar pacientes en los que un soporte nutricional adecuado puede mejorar el pronóstico durante su estancia hospitalaria.Objective: A pilot study to assess the feasibility of implementing a hospital protocol for systematic nutritionalscreening of admitted patients. Method: Descriptive cross-sectional study. Patients admitted to the Orthopedic Surgery Department of the Regional Hospital of Alcañiz were systematically included within the first 48 hours of hospitalization, from February to September of 2007. The screening methods used

  1. Demographics, Clinical Characteristics, and Treatment of Aggressive Patients Admitted to the Acute Behavioral Unit of a Community General Hospital: A Prospective Observational Study

    OpenAIRE

    Nourse, Rosemary; Reade, Cynthia; Stoltzfus, Jill; Mittal, Vikrant

    2014-01-01

    Objective: Aggressive patients are not uncommon in acute inpatient behavioral health units of general hospitals. Prior research identifies various predictors associated with aggressive inpatient behavior. This prospective observational study examines the demographic and clinical characteristics of aggressive inpatients and the routine medications these patients were receiving at discharge.

  2. Effectiveness of a drinking-motive-tailored emergency-room intervention among adolescents admitted to hospital due to acute alcohol intoxication: A randomized controlled trial

    NARCIS (Netherlands)

    Wurdak, M.; Wolstein, J.; Kuntsche, E.N.

    2016-01-01

    The aim of this study is to develop and test the effectiveness of a drinking-motive-tailored intervention for adolescents hospitalized due to alcohol intoxication in eight cities in Germany between December 2011 and May 2012 against a similar, non-motive-tailored intervention. In a randomized contro

  3. Clinical features and therapeutic management of patients admitted to Italian acute hospital psychiatric units: the PERSEO (psychiatric emergency study and epidemiology survey

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    Russo Federico

    2007-11-01

    Full Text Available Abstract Background The PERSEO study (psychiatric emergency study and epidemiology is a naturalistic, observational clinical survey in Italian acute hospital psychiatric units, called SPDCs (Servizio Psichiatrico Diagnosi e Cura; in English, the psychiatric service for diagnosis and management. The aims of this paper are: (i to describe the epidemiological and clinical characteristics of patients, including sociodemographic features, risk factors, life habits and psychiatric diagnoses; and (ii to assess the clinical management, subjective wellbeing and attitudes toward medications. Methods A total of 62 SPDCs distributed throughout Italy participated in the study and 2521 patients were enrolled over the 5-month study period. Results Almost half of patients (46% showed an aggressive behaviour at admission to ward, but they engaged more commonly in verbal aggression (38%, than in aggression toward other people (20%. A total of 78% of patients had a psychiatric diagnosis at admission, most frequently schizophrenia (36%, followed by depression (16% and personality disorders (14%, and no relevant changes in the diagnoses pattern were observed during hospital stay. Benzodiazepines were the most commonly prescribed drugs, regardless of diagnosis, at all time points. Overall, up to 83% of patients were treated with neuroleptic drugs and up to 27% received more than one neuroleptic either during hospital stay or at discharge. Atypical and conventional antipsychotics were equally prescribed for schizophrenia (59 vs 65% during stay and 59 vs 60% at discharge, while atypical drugs were preferred in schizoaffective psychoses (72 vs 49% during stay and 70 vs 46% at discharge and depression (41 vs 32% during stay and 44 vs 25% at discharge. Atypical neuroleptics were slightly preferred to conventional ones at hospital discharge (52 vs 44%. Polypharmacy was in general widely used. Patient attitudes toward medications were on average positive and self

  4. Effectiveness of a drinking-motive-tailored emergency-room intervention among adolescents admitted to hospital due to acute alcohol intoxication — A randomized controlled trial

    OpenAIRE

    Wurdak, M.; Wolstein, J; Kuntsche, E.N.

    2015-01-01

    The aim of this study is to develop and test the effectiveness of a drinking-motive-tailored intervention for adolescents hospitalized due to alcohol intoxication in eight cities in Germany between December 2011 and May 2012 against a similar, non-motive-tailored intervention. In a randomized controlled trial, 254 adolescents received a psychosocial intervention plus motive-tailored (intervention group; IG) or general exercises (control group; CG). Adolescents in the IG received exercises in ...

  5. Clinical features and therapeutic management of patients admitted to Italian acute hospital psychiatric units: the PERSEO (psychiatric emergency study and epidemiology) survey

    OpenAIRE

    Russo Federico; Righi Roberto; Minervini Lina; Margari Francesco; Casacchia Massimo; Boncompagni Giancarlo; Boccalon Roberto M; Ballerini Andrea; Salteri Andrea; Frediani Sonia; Rossi Andrea; Scatigna Marco

    2007-01-01

    Abstract Background The PERSEO study (psychiatric emergency study and epidemiology) is a naturalistic, observational clinical survey in Italian acute hospital psychiatric units, called SPDCs (Servizio Psichiatrico Diagnosi e Cura; in English, the psychiatric service for diagnosis and management). The aims of this paper are: (i) to describe the epidemiological and clinical characteristics of patients, including sociodemographic features, risk factors, life habits and psychiatric diagnoses; and...

  6. Characteristics of pregnant Women admitted with 2009 H1N1 Influenza in a referral maternity hospital at Al-Madinah, Saudi Arabia

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    Inass Taha

    2013-07-01

    Full Text Available Background: To date there has been no study done in Saudi Arabia to identify the risk factors for poor outcome of H1N1 infection in pregnancy. Objectives: we aimed to evaluate the epidemiological data, clinical course, treatment modalities, and maternal and fetal outcomes of 33 pregnant women diagnosed with H1N1 Influenza A in a referral maternity and children hospital at Al- Madinah Saudi Arabia on the period from June 2009 till February 2010.Methods: This retrospective cohort study reported 33 pregnant women (9.1% primigravida aged 27.7±5.6 years who were laboratory-confirmed cases diagnosed with H1N1 Influenza A in a referral maternity and children hospital at Al- Madinah Saudi Arabia on the period from June 2009 till February 2010. Their mean gestation age was 23.5±10.9 weeks with history of bronchial asthma in 45.5%.Results: The mean duration between symptoms’ onset and hospital presentation was 5.0±2.2 days with late presentation in 10 cases (30,3%. Large number of cases presented with fever more than 39 (24 (72.7%, sore-throat (24 (72.7% and cough (29 (87.9% while 19 patients presented with dyspnea (57.6%. Pregnant patients with H1N1 received Tamiflu (oseltamivir from 2 to 7 days with a mean of 4.7±1.3 days. They stayed at hospital for variable periods from 2 to 28 days with a mean of 7.9±6.6 days (Table 4. Most patients (31(93.9% received antibiotics. Maternal poor outcome included hypoxia in 6 patients (18.2%, ICU admission for 2-3 days with mechanical ventilation in 4(12.1%. The main fetal poor outcome was intrauterine fetal death in 2 (6.1% babies .Conclusion:The main presentation of H1N1 among pregnant women was typical influenza-like illness. Considerable percentage of patients presented late (30.3%. The duration of hospital admission is variable up to 28 days. Bronchial asthma was prevalent (45.5% among pregnant women with H1N1 infection. The main poor outcomes were maternal respiratory failure (18.2% and intrauterine fetal

  7. Antibiotic Resistance of Urinary Tract Infection of Children Under 14 Years Admitted To The Pediatric Clinic of Imam Sajjad Hospital, 2012

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    F Asadi Manesh F

    2014-08-01

    Full Text Available Background & aim: Urinary tract infection is the most common childhood infections after upper respiratory tract infection. Early diagnosis, proper treatment and appropriate patient follow-up can lead to a significant reduction in symptoms. The purpose of this study was to determine the antimicrobial resistance of urinary tract infection in children under 14 years admitted to the pediatric clinic of Imam Sajjad (AS Yasooj. Methods: Methods: In this cross-sectional study antibiotic sensitivity of 145 positive urine cultures were evaluated by disc diffusion method. Urine specimens were collected by suprapubic aspiration and catheterization urethral in children without urinary incontinence and Mid Stream Clean-Catch method. Data were analyzed by chi square test. Results: Among the patients were studied, 60.68% female and 39.31% were male. The most common cause of urinary tract infections in children, Escherichia coli (72.41%, followed by Klebsiella (34/10.34%. Antibiotic resistance patterns including ampicillin (85.51%, amoxicillin (/83.44%, cephalexin (69.65%, cephalothin (62.06%, cotrimoxazole (37.61%, nalidixic acid (44.82%, cefixime (24.37%, nitrofurantoin (36.55%, gentamicin (35.17%, ceftriaxone (28.27%, ciprofloxacin (26.89%, amikacin (25.51%, and cefotaxime (24.82% were respectively. Conclusion: Conclusion: Antibiotic resistance in urinary tract infections of children in Yasuj in 2012 was higher than previous years except for amikacin, But it was a remarkable increase in ciprofloxacin and co-trimoxazole. The use of nitrofurantoin, cefotaxime, third generation cephalosporins and aminoglycosides is recommended for empirical treatment.

  8. Clinical pharmacist evaluation of medication inappropriateness in the emergency department of a teaching hospital in Malta

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    West LM

    2012-12-01

    Full Text Available Appropriate prescribing remains an important priority in all medical areas of practice. Objective: The objective of this study was to apply a Medication Appropriateness Index (MAI to identify issues of inappropriate prescribing amongst patients admitted from the Emergency Department (ED.Method: This study was carried out at Malta’s general hospital on 125 patients following a two-week pilot period on 10 patients. Patients aged 18 years and over and on medication therapy were included. Medication treatment for inappropriateness was assessed by using the MAI. Under-prescribing was also screened for. Results: Treatment charts of 125 patients, including 697 medications, were assessed using a MAI. Overall, 115 (92% patients had one or more medications with one or more MAI criteria rated as inappropriate, giving a total of 384 (55.1% medications prescribed inappropriately. The mean SD MAI score per drug was 1.78 (SD=2.19. The most common medication classes with appropriateness problems were supplements (20.1%, antibiotics (20.0% and steroids (19.8%. The most common problems involved incorrect directions (26% and incorrect dosages (18.5%. There were 36 omitted medications with untreated indications. Conclusion: There is considerable inappropriate prescribing which could have significant negative effects regarding patient care.

  9. The Study of the Demographic and Clinical and Laboratory Findings in Naltrexone Poisoning Patients Admitted to Razi Hospital, Rasht, During 2007-08

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    Morteza Rahbar Taromsar

    2012-08-01

    Full Text Available Background: Naltrexone is a competitive opioid receptor antagonist blocking the euphoric effects of exogenous opioids. When used concomitantly with opioids, naltrexone causes severe withdrawal symptoms. The main aim of the study is to determine the symptomatology and outcome of patients who consumed naltrexone in conjunction with an opioid substance. Methods: This cross-sectional study was performed on the patients hospitalized with history of naltrexone usage coincided with opioid substances at Razi Hospital, Rasht, Iran. The collected data were demographic information, abuse information, clinical signs and symptoms, laboratory findings, and therapeutic measures taken. Data analysis was performed by descriptive tests using SPSS software version 16. Results: The mean age of the patients was 33.7±10.2. The majority of the cases were male (95.6% and urban (96.7%. The main cause of withdrawal symptoms in 91.1% of the patients was inappropriate naltrexone usage. The main poisoning agent in 80% of the cases was consumed naltrexone alone. The route of consumption in 90.1% of the cases was oral and in 9.9% the cases was IV injection. The major clinical features were nausea, vomiting, and agitation. The main therapeutic measures were supportive intravenous fluids (94.8% and opioid administration in the form of methadone. The mean hospitalization period was 21.8±18 hours. Conclusion: Severity, clinical course, and outcome of opioid withdrawal by accidental or intentional naltrexone abuse varies greatly among patients and is unpredictable. Common findings upon presentation were gastrointestinal symptoms and agitation and the main therapeutic measures for these patients were support with intravenous fluids and anti-nausea drugs administration as plasil and opioid administration as methadone.

  10. A study on maternal and perinatal out comes in cases of eclampsia admitting to government medical college and general hospital, Anantapuramu, Andhra Pradesh, India

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    Shamshad Begum Shaikh

    2016-07-01

    Conclusions: Eclampsia continues to be an important etiological factor for maternal/perinatal morbidity and mortality. The contributory factors for this being lack of proper antenatal care, low socio economic status and lack of education. There is an urgent need for proper antenatal care, proper medication (magnesium sulfate, intensive monitoring of women with eclampsia and timely hospitalization to improve both the maternal and perinatal outcome. Early presentation and timely decision to terminate pregnancy will improve the maternal and perinatal outcome. [Int J Reprod Contracept Obstet Gynecol 2016; 5(7.000: 2146-2150

  11. Evaluation of emergency medical technicians intermediate prediction about their transported patients final disposition in emergency department of Imam Khomeini Hospital.

    Science.gov (United States)

    Afzalimoghadam, Mohammad; Mozafari, Javad; Talebian, Mohammad Taghi; Mohammadnejad, Esmaeil; Kasaeian, Amir

    2013-08-07

    This was a prospective cross-sectional study of consecutive transported patients by emergency medical service (EMS) to a referral hospital. The goal of this study was the evaluation of emergency medical technician intermediate prediction about their transported patients disposition in Emergency Department of Imam Khomeini Hospital. 2950 patients were transported to this hospital, Questionnaires were submitted in 300 of consecutive patient transports and completed data were obtained and available upon arrival at hospital for 267 of these cases. Emergency medical technicians intermediate (EMT-I) were asked to predict whether the transported patient would require admission to the hospital, and if so, what will be their prediction of patient actual disposition. Their predictions were compared with emergency specialist physicians. EMT-I predicted that 208 (78%) transports would lead to admission to the hospital, after actual disposition, 232 (%87) patients became admitted. The sensitivity of predicting any admission was 65%, with positive predictive value (PPV) of 39% and specificity of 86% with negative predictive value (NPV) of 94%. The sensitivity of predicting trauma patients (56.2% of total patients) was 55% with PPV of 38%, specificity of 86% and for Non-trauma patients' sensitivity was 80% with PPV of 40% and specificity of 82%. EMT-I in our emergency medical system have very limited ability in prediction of admission and disposition in transported patients and their prediction were better in Non-trauma patients. So in our EMS, the pre-hospital diversion and necessity of transporting policies should not be based on EMS personnel disposition.

  12. Evaluation of emergency medical technicians intermediate prediction about their transported patients final disposition in emergency department of Imam Khomeini Hospital.

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    Mohammad Afzalimoghadam

    2013-07-01

    Full Text Available This was a prospective cross-sectional study of consecutive transported patients by emergency medical service (EMS to a referral hospital. The goal of this study was the evaluation of emergency medical technician intermediate prediction about their transported patients disposition in Emergency Department of Imam Khomeini Hospital. 2950 patients were transported to this hospital, Questionnaires were submitted in 300 of consecutive patient transports and completed data were obtained and available upon arrival at hospital for 267 of these cases. Emergency medical technicians intermediate (EMT-I were asked to predict whether the transported patient would require admission to the hospital, and if so, what will be their prediction of patient actual disposition. Their predictions were compared with emergency specialist physicians. EMT-I predicted that 208 (78% transports would lead to admission to the hospital, after actual disposition, 232 (%87 patients became admitted. The sensitivity of predicting any admission was 65%, with positive predictive value (PPV of 39% and specificity of 86% with negative predictive value (NPV of 94%. The sensitivity of predicting trauma patients (56.2% of total patients was 55% with PPV of 38%, specificity of 86% and for Non-trauma patients' sensitivity was 80% with PPV of 40% and specificity of 82%. EMT-I in our emergency medical system have very limited ability in prediction of admission and disposition in transported patients and their prediction were better in Non-trauma patients. So in our EMS, the pre-hospital diversion and necessity of transporting policies should not be based on EMS personnel disposition.

  13. System of psycho-therapeutics influences in patients admitted to hospital with cardiovascular diseases. Sistema de influencias psicoterapéuticas en pacientes con afecciones cardiovasculares hospitalizados.

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    Teresa Rodríguez Rodríguez

    Full Text Available Fundaments: Within the restricted field of the patients' psychological environment, anxiety and depression seem ti play an important role although it is still pending how to clear it up definitely in the case of ischemic cardiopathy and coronary diseases. However, it isostensible that the patients who suffer from cardiovascular diseases frequently present psychological disorders, mainly emotional ones. Objective: To assess the effectiveness of a system of psychotherapy influences in patients with cardiovasular diseases. Method: Intervention study witha cuasi experimental design in patients with cardiovascular urgencies hospitalized at the Integral Care Unit of the Heart of the ¨Dr. Gustavo A. Lima¨ Hospital from June 1st 2002 to june 1st 2003 and who received relaxing, stimulating and sleeping treatment. Psychological and physiological modifications were assessed after having received treatment with these psychological techniques. Result: Acute Myocardial infarction and Angina pectoris were the most common causes of admission. The variation of respiratory and cardiac frequency as well as blood pressure tend tomaintain, diminish or keep normal values. The psychological state of the patient was favoured after treatment. Conclusion: The effect of the system of psychotherapy influences were beneficial both organically and psychologically.
    Fundamento: Dentro del campo estricto del entorno psicológico de los pacientes, la ansiedad y la depresión parecen jugar un papel importante, aunque todavía queda por dilucidar de forma definitiva en el determinismo de la cardiopatía isquemica y las enfermedades coronarias, sin embargo, es ostensible que los pacientes portadores de enfermedades cardiovasculares presenten con marcada frecuencia alteraciones de índole psicológica, fundamentalmente alteraciones emocionales.

  14. Epidemiological profile of hospitalised injuries among electric bicycle riders admitted to a rural hospital in Suzhou: a cross-sectional study.

    Science.gov (United States)

    Du, Wei; Yang, Jie; Powis, Brent; Zheng, Xiaoying; Ozanne-Smith, Joan; Bilston, Lynne; He, JingLin; Ma, Ting; Wang, Xiaofei; Wu, Ming

    2014-04-01

    Police reports indicate an increasing burden of electric bike (E-bike) casualties in China; however, hospitalised injury data have not been reported. The aim of the present work was to describe hospitalised injury patterns for E-bikers involved in road crashes and explore injury risk disparities among them. For the period October 2010 to April 2011, this cross-sectional study retrospectively collected information for hospitalised E-bikers involved in road crashes from hospital records, in Suzhou China, using the International Classification of Diseases, 10th revision (ICD-10) injury diagnosis codes. Injury nature and body region were further categorised using ICD-10 codes. Multivariate logistic regression was used to assess the risk of specific injury types. We found that hospitalised E-biker injuries (n=323) accounted for 57.2% of road traffic hospitalisations over the 6-month study period. The average age, length of stay and hospitalisation cost were 43.8 years, 10.0 days and ¥8229 (US$1286), respectively. Fractures and head injuries were common. The odds of traumatic brain injuries were significantly elevated for night-time E-bike crashes and incidents other than colliding with motor vehicles. These findings confirm E-bike injuries as an important population health problem and identify elevated injury odds in different E-biker groups. Future injury prevention initiatives should include encouraging helmet use among E-bikers. PMID:23728530

  15. Epidemiological profile of hospitalised injuries among electric bicycle riders admitted to a rural hospital in Suzhou: a cross-sectional study.

    Science.gov (United States)

    Du, Wei; Yang, Jie; Powis, Brent; Zheng, Xiaoying; Ozanne-Smith, Joan; Bilston, Lynne; He, JingLin; Ma, Ting; Wang, Xiaofei; Wu, Ming

    2014-04-01

    Police reports indicate an increasing burden of electric bike (E-bike) casualties in China; however, hospitalised injury data have not been reported. The aim of the present work was to describe hospitalised injury patterns for E-bikers involved in road crashes and explore injury risk disparities among them. For the period October 2010 to April 2011, this cross-sectional study retrospectively collected information for hospitalised E-bikers involved in road crashes from hospital records, in Suzhou China, using the International Classification of Diseases, 10th revision (ICD-10) injury diagnosis codes. Injury nature and body region were further categorised using ICD-10 codes. Multivariate logistic regression was used to assess the risk of specific injury types. We found that hospitalised E-biker injuries (n=323) accounted for 57.2% of road traffic hospitalisations over the 6-month study period. The average age, length of stay and hospitalisation cost were 43.8 years, 10.0 days and ¥8229 (US$1286), respectively. Fractures and head injuries were common. The odds of traumatic brain injuries were significantly elevated for night-time E-bike crashes and incidents other than colliding with motor vehicles. These findings confirm E-bike injuries as an important population health problem and identify elevated injury odds in different E-biker groups. Future injury prevention initiatives should include encouraging helmet use among E-bikers.

  16. Survival of male patients with spinal cord injury after cardiac arrest in Department of Veterans Affairs hospital: Pilot study

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    Deborah Caruso, MD

    2014-11-01

    Full Text Available Survivability characteristics after cardiopulmonary resuscitation in the population with spinal cord injury (SCI are unclear but may be useful for advanced care planning discussions with patients. Retrospective evaluation from records of all SCI patients over 10 yr at a Department of Veterans Affairs medical center who experienced in-hospital cardiac arrest was performed. Demographic data and other common measurements were recorded. Thirty-six male subjects were identified, and only two patients survived to discharge (5.5% survival rate, both of whom were admitted for nonacute issues and were asymptomatic shortly before the cardiac arrest. The mean age at the time of cardiopulmonary arrest was 62.4 yr, with a mean time from cardiac arrest to death of 3.02 d. No significant demographic parameters were identified. Overall, SCI likely portends worse outcome for acutely ill patients in the situation of a cardiac arrest. Conclusions are limited by sample size.

  17. The effect of an active on-ward participation of hospital pharmacists in Internal Medicine teams on preventable Adverse Drug Events in elderly inpatients: protocol of the WINGS study (Ward-oriented pharmacy in newly admitted geriatric seniors

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    Dijkgraaf Marcel G

    2011-05-01

    Full Text Available Abstract Background The potential of clinical interventions, aiming at reduction of preventable Adverse Drug Events (preventable ADEs during hospital stay, have been studied extensively. Clinical Pharmacy is a well-established and effective service, usually consisting of full-time on-ward participation of clinical pharmacists in medical teams. Within the current Hospital Pharmacy organisation in the Netherlands, such on-ward service is less feasible and therefore not yet established. However, given the substantial incidence of preventable ADEs in Dutch hospitals found in recent studies, appears warranted. Therefore, "Ward-Oriented Pharmacy", an on-ward service tailored to the Dutch hospital setting, will be developed. This service will consist of multifaceted interventions implemented in the Internal Medicine wards by hospital pharmacists. The effect of this service on preventable ADEs in elderly inpatients will be measured. Elderly patients are at high risk for ADEs due to multi-morbidity, concomitant disabilities and polypharmacy. Most studies on the incidence and preventability of ADEs in elderly patients have been conducted in the outpatient setting or on admission to a hospital, and fewer in the inpatient setting. Moreover, recognition of ADEs by the treating physicians is challenging in elderly patients because their disease presentation is often atypical and complex. Detailed information about the performance of the treating physicians in ADE recognition is scarce. Methods/Design The design is a multi-centre, interrupted time series study. Patients of 65 years or older, consecutively admitted to Internal Medicine wards will be included. After a pre-measurement, a Ward-Oriented Pharmacy service will be introduced and the effect of this service will be assessed during a post-measurement. The primary outcome measures are the ADE prevalence on admission and ADE incidence during hospital stay. These outcomes will be assessed using structured

  18. Searching for the Human Herpes 6, 7 (PCR in CSF of Children Admitted to the Pediatric Ward of Hazrat Rasool Hospital of Tehran

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    F. Ebrahimi Taj

    2011-04-01

    Full Text Available Introduction & Objective: The role and frequency of HHV-6 and HHV-7 in central nervous system (CNS diseases of our children are unclear. The aim of this study was to search for the presence of HHV-6 & HHV-7 DNA-s in CSF samples in children with meningoencephalitis. Materials & Methods: In a cross- sectional study (2007-2009 done in the pediatric ward in Hazrat Rasoul hospital, Tehran ,Iran ,150 CSF samples were obtained from children with meningoencephalitis. The conventional and BACTEC Ped Plus medium; Latex agglutination tests; and in some cases bacterial PCR assay were used. We examined the DNA-s of HHV-6 & HHV-6 quantitavively by real time - PCR in the CSF samples. Results: Cases were 91 (60.7% male; 59 (39.3% female; 1-180 months old. Fever (>38.5 C was observed in 74%; irritability in 70% and convulsion in 53% of cases. All herpes viruses were detected in 18 (12% cases, HHV-6 DNA was detected in 6 cases and HHV-7 DNA detected in 2 cases with no correlation with age, sex and clinical signs. Conclusion: HHV-6 & HHV-7 were found in nearly 6% of all studied cases. HHV-6 was slightly more frequent than HHV-7 and its incidence is lower .Our data indicates that herpes viruses are not uncommon causes in children with meningoencephalitis. Our findings are different from those of previous studies perhaps due to the epidemiologic and geographic variations (differences in methods and age groups should be added to this. (Sci J Hamadan Univ Med Sci 2011;18(1:37-41

  19. Methadone Overdose and Its Complications in Patients Admitted to the Toxicology Emergency Ward of Baharloo Hospital of Tehran in 2011-2012

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    Behnam Behnoush

    2014-11-01

    Full Text Available Background: To date, studies on methadone overdose in adults have not been reported in Iran. Hence, this study was performed to determine the frequency of methadone overdose and its associated complications in Baharloo Hospital of Tehran between August 2011 and August 2012. Methods: This cross-sectional study was done on 390 cases. All patients with methadone overdoses and positive urine screen test for methadone were included in this case study through census method. Demographic data and overdose complications, such as loss of consciousness, respiratory complications, arrhythmia, hemodynamic disturbances, and QTC interval, were recorded in the questionnaire. Data were analyzed by SPSS software and Kolmogorov Smirnov, t-test, and Chi-square tests were used for data analysis. Results: Overall, 84.1% of the samples were male and the mean age of the samples was 35.53±11.25 years (range: 15-84 years. Mean of the methadone dose used in current admissions was 96.13±52.34 mg. Concomitant drug abuse and concomitant uses of medications were seen in 25.9% and 36.9% of the patients, respectively. Respiratory depression, pulmonary edema, pneumonia, aspiration, and arrhythmia were seen in 87.9%, 26.2%, 3.3%, 7.4%, and 15.4% of the patients, respectively. There were significant differences between concomitant medications, duration of methadone use, and QTc interval prolongation and arrhythmia (P<0.05. Conclusion: Based on the findings of the present study, initial screening of ECG changes and QT interval prolongation as well as arrhythmias should be considered in patients on methadone therapy and concurrent drug abuse and co-administration of medications that lead to QT prolongation should be avoided in them.

  20. A study to assess the psychological impact of fetal loss among the postnatal mothers admitted in selected hospitals of district Faridkot, Punjab, India

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    Anmol Bhatia

    2016-05-01

    Full Text Available Background: Miscarriage, spontaneous abortion of a fetus and the loss of an infant through stillbirth, or neonatal death is recognized as a traumatic life event before the expected point of viability. Women's response ranges from relief to devastation. Predictors of development of complicated grief after prenatal loss include lack of social support, pre-existing relationship difficulties, or absence of surviving children, as well as ambivalent attitudes or heightened perception of the reality of the pregnancy. The study aimed to assess the psychological impact of fetal loss among the postnatal mothers. Methods: The research design selected for the study was non-experimental descriptive design. Study was conducted from Dec 2014 to Jan 2015 in obstetrics and gynaecology unit of G.G.S medical hospital, Faridkot, Punjab, India. 60 postnatal women were selected by convenience sampling. The perinatal grief scale (standardized tool was used to assess fetal loss. Results: The majority of women i.e. 76.7% had more psychological impact, 23.3% women had less psychological impact of fetal loss. The range of score varies from 62-129 with mean score 102.82 ,SD 15.21 ,standard error mean 1.963, and median 103.50 and a statistically significant relation was found between psychological impact of fetal loss and gravida, Number of fetal loss, Number of live births and period of gestation at p<0.05. Conclusion: Hence it can be concluded that majority of women had more psychological impact of fetal loss and association of psychological impact of fetal loss was found between number of previous loss, number of live births, gravida and period of gestation. [Int J Reprod Contracept Obstet Gynecol 2016; 5(5.000: 1607-1612

  1. Profile of confirmed H1N1 virus infected patients admitted in the swine flu isolation ward of tertiary care hospitals of Baroda district, Gujarat, India

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    Arunkumar Ishwarbhai Chaudhari

    2015-09-01

    Results: Out of total 54 influenza A H1N1 cases, 23 patients (42.59% were males. 4 (12.91% female patients were pregnant. Majority (75% of the cases were between 21-50 years of age group. Majority (90.7% of the patients were from urban areas. Majority cases (94.4% presented with cough, followed by 36 cases (66.7% exhibiting high grade fever, 35 Cases (64.8% had complain of breathlessness and 25 cases(46.3% presented with sore throat. 19 cases (35% had co-morbid condition with the influenza A H1N1 disease. In this study among patients with associated Comorbid condition, 16(84% were discharged and only 3(16% patients died. Whereas among patients without Comorbid condition, 29(83% were discharged and 6(17% died. This difference was not statistically significant (p=0.940.15 cases (27% required ventilator support. Mortality of 9 cases (17% occurred in the given duration of study and rest of cases 45(83% were discharged from the hospital. Out of 54 cases, 4 cases had diabetes mellitus and from that 3 case were died. The difference was statistically significant (p=0.012. Conclusions: Influenza A H1N1 infection predominantly affects young age and equally affecting both genders. One fourth of total cases had severe illness and required ventilator support. Majority of patients died within 8 day of critical illness. All deaths were reported from urban area. Most common symptom in fatal cases of influenza A H1N1 was cough followed by breathlessness, high grade fever, mild fever and sore throat and the most common co morbidity was Diabetes Mellitus. [Int J Res Med Sci 2015; 3(9.000: 2174-2180

  2. Point-of-care ultrasonography in patients admitted with respiratory symptoms

    DEFF Research Database (Denmark)

    Laursen, Christian B; Sloth, Erik; Lassen, Annmarie Touborg;

    2014-01-01

    of the heart, lungs, and deep veins in addition to the usual initial diagnostic testing in this patient population. METHODS: In a prospective, parallel-group trial in the emergency department at Odense University Hospital, Odense, Denmark, patients (≥18 years) with a respiratory rate of more than 20 per min......BACKGROUND: When used with standard diagnostic testing, point-of-care ultrasonography might improve the proportion of patients admitted with respiratory symptoms who are correctly diagnosed 4 h after admission to the emergency department. We therefore assessed point-of-care ultrasonography...... diagnosis within 4 h. It should therefore be considered for routine use as part of the standard diagnostic tests in the emergency department for patients admitted with respiratory symptoms. FUNDING: University of Southern Denmark, Odense University Hospital, and Højbjerg Fund....

  3. Evaluating the Quality of Multiple Trauma Patient Records in the Emergency Department of Imam Khomeini Hospital in Urmia

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    Gholamreza Faridaalaee

    2015-05-01

    Full Text Available Introduction: Medical profile is an important source of data regarding the patient, the illness, the doctor’s performance and leads to adequate diagnosis and treatment. Filling out medical profiles correctly, greatly decreases medical errors and leads to accurate diagnosis and proper treatment of the patients. This study aims to evaluate the quality of the patient records of trauma patients admitted to the emergency department of Emam Khomeini Hospital, Urmia, Iran. Methods: In a cross-sectional study, the medical profiles of trauma patients admitted to the emergency department of Emam Khomeini Hospital, Urmia, Iran in November 2013 were evaluated aiming to determine the quality of filling the profiles. All the patients’ medical profiles were evaluated regarding accurate recording of trauma mechanism; size, site of injuries; vital signs recordings; diagnostic and treatment plan. Based on the Likert scale, the quality of data recording was rated as: not recorded, recorded with high quality, recorded with low quality. The data were statistically analyzed using SPSS 21. Results: In this study, 795 profiles were studied and evaluated (66.7% male. The most accurate data recording belonged to mechanism of trauma (92.5% and the least accurate data recording belonged to diagnostic plan (9%. The highest frequency of incomplete data belonged to the site of injuries caused by trauma (71.7%, the number of injuries (34% and anatomical depth and severity of trauma (34%. Most cases of missing data belonged to diagnostic plan (91%. In 142 (17.8% profiles only 1, in 241 (30.3% profiles 2, and in 277 (34.8% profiles 3 categories were incomplete and data recording in 135 (16.9% profiles were incomplete in all categories. In total, 82% of the profiles had 1 or more incomplete categories. Conclusion: Based on the results of this study, the quality of data recordings of trauma patients admitted to the studied emergency department was not satisfying. The highest

  4. Operation of a support service team in the emergency department of a general hospital.

    OpenAIRE

    Condra, M; Groll, L; Walker, D M; Abrams, M O; Sims, P.

    1987-01-01

    We describe the development and operation of an emergency support service team in the Emergency Department of the Kingston General Hospital, Kingston, Ont. The team, composed of professionals from other departments of the hospital, provides emotional and practical support to family members or survivors in medical emergencies. We discuss the roles of the team members and their procedures for dealing with distress and grief.

  5. 不同等级医院老年住院患者环境安全评价研究%Environmental safety assessment of elderly patients admitted in different grade hospitals

    Institute of Scientific and Technical Information of China (English)

    邓秀琳; 陈茜; 李运枭

    2015-01-01

    Objective To provide evidences for fall prevention through environmental safety assessment of elderly patients admitted in different grade hospitals. Methods 24 different levels hospitals located in 10 cities in southwest of China were surveyed with assessment form of fall-related factors of hospital environment for elderly patients. Results Hospital public environment and ward public environment were assessed well by elderly patients which were 4.10 points and 4.06 points, but the scores for ground channel environment and toilet environment were lower which were 3.92 points and 3.65 points;Scores of tertiary-class hospitals were better than that in second-class hospitals, including ward facilities (t=-2.756, P0.05). Conclusions Public hospital environment and public ward environment got higher scores, and the scores of ground-channel environment and the bathroom environment were relatively lower. Environment in second-class hospitals need to improve in order to prevent fall of elderly patients. Assessment form of fall-related factors of hospital environment for elderly patients is helpful to disclose the unsafety factors of the hospital environment, and should be windely used in futher clinical practice.%目的 了解住院老年患者对医院环境安全评价情况, 为临床跌倒预防提供依据. 方法用老年跌倒相关住院环境安全因素评估表调查中西南地区10个城市共24所不同等级医院,分析住院环境中的不安全因素. 结果 老年患者对医院公用环境、 病房公用环境评分较好, 分别为4.10分和4.06分;地面通道环境及卫生间环境评分较低,分别为3.92分和3.65分;与二级医院比较,三级医院在病房设施(t=-2.756, P0.05.结论 所调查医院公用环境和病房公用环境评分较好,较低的是地面通道环境、卫生间环境方面.二级医院相比三级医院环境安全评分较低,不利于住院老年患者的跌倒防范,需要进一步改善. 老年跌倒相关住

  6. Trends in computed tomography utilization and association with hospital outcomes in a Chinese emergency department.

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    Jian-Cang Zhou

    Full Text Available BACKGROUND: Excessive use of computed tomography (CT in emergency departments (EDs has become a concern due to its expense and the potential risks associated with radiation exposure. Although studies have shown a steady increase in the number of CT scans requested by ED physicians in developed countries like the United States and Australia, few empirical data are available regarding China. METHODS AND FINDINGS: We retrospectively analyzed a database of ED visits to a tertiary Chinese hospital to examine trends in CT utilization and their association with ED outcomes between 2005 and 2008. A total of 197,512 ED visits were included in this study. CT utilization increased from 9.8% in 2005 to 13.9% in 2008 (P<.001 for trend. The ED length of stay for visits with CT utilization was 0.6 hour longer than those in which CT was not obtained. CT utilization increased the ED cost by an average $48.2. After adjustment for patients' demographics, arrival hours and clinical condition, CT utilization during ED visits was significantly associated with high ED cost (Odds Ratio [OR]: 21.70; 95% confidence interval [CI], 17.00-27.71, long ED length of stay (OR: 1.22; 95%CI, 1.12-1.34, and more likely to receive emergency operations (OR: 2.31; 95%CI, 1.94-2.76. However, there was no significant correlation between CT use and the possibility to be admitted to inpatient wards (OR: 0.82; 95%CI, 0.65-1.04. With respect to the time-related trends, CT utilization during ED visits in all study years was significantly associated with high ED cost and more likely to receive emergency operations. CONCLUSION: CT utilization was associated with higher ED cost, longer ED length of stay and more likely to receive emergency operations, but did not correlate with a significant change in the admission rate.

  7. Retrospective analysis on infectious diseases admitted to Nanjing Second Hospital nearly 16 years%近16年南京市第二医院收治传染病病种的回顾性分析

    Institute of Scientific and Technical Information of China (English)

    魏洪霞; 姚文虎; 徐永林; 池云; 成骢

    2011-01-01

    目的:了解近16年来东南大学附属第二医院(南京市第二院,简称南京二院)传染病收治情况和流行趋势,为该院传染病的诊治提供依据.方法:回顾性分析1994至2009年南京二院每年收治的传染病总数变化、每种传染病总数的变化及具体分布情况.结果:南京二院收治的传染病总数呈现曲线上升的趋势,其中发病总数处于前5位的为麻疹、流行性腮腺炎、水痘、急性细菌性痢疾、百日咳.梅毒、艾滋病等性传播性疾病以及疟疾、狂犬病等病发率呈现上升趋势,严重急性呼吸综合征、人禽流感和甲型H1N1流感等新发传染病均有发生.结论:急性呼吸道传染病仍然是防治的重点,要加强对梅毒、艾滋病的健康宣教,时刻警惕新发传染病的入侵.%Objective: To study the distribution of infectious diseases admitted to Nanjing Second Hospital nearly 16 years in order to provide the theoretical basis of prevention of infectious diseases. Methods: Analyze retrospectively the incidence change of the infectious diseases admitted to Nanjing Second Hospital each year from 1994 to 2009. Results: The total number of infectious diseases showed a rising trend and the top 5 of the total incidence were measles, mumps, chicken pox, acute bacillary dysentery, whooping cough. The morbidities of syphilis, AIDS, malaria and rabies were increasing and the new infectious diseases such as severe acute respiratory syndrome, avian flu and influenza A (H1N1) occurred. Conclusion: Acute respiratory infection is our primary concern. We should strengthen the health education on A1DS and syphilis, keep alert to the emerging of new infectious diseases all the time.

  8. Frequency of medication errors in an emergency department of a large teaching hospital in southern Iran

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    Vazin A

    2014-12-01

    Full Text Available Afsaneh Vazin,1 Zahra Zamani,1 Nahid Hatam2 1Department of Clinical Pharmacy, Faculty of Pharmacy, 2School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran Abstract: This study was conducted with the purpose of determining the frequency of medication errors (MEs occurring in tertiary care emergency department (ED of a large academic hospital in Iran. The incidence of MEs was determined through the disguised direct observation method conducted by a trained observer. A total of 1,031 medication doses administered to 202 patients admitted to the tertiary care ED were observed over a course of 54 6-hour shifts. Following collection of the data and analysis of the errors with the assistance of a clinical pharmacist, frequency of errors in the different stages was reported and analyzed in SPSS-21 software. For the 202 patients and the 1,031 medication doses evaluated in the present study, 707 (68.5% MEs were recorded in total. In other words, 3.5 errors per patient and almost 0.69 errors per medication are reported to have occurred, with the highest frequency of errors pertaining to cardiovascular (27.2% and antimicrobial (23.6% medications. The highest rate of errors occurred during the administration phase of the medication use process with a share of 37.6%, followed by errors of prescription and transcription with a share of 21.1% and 10% of errors, respectively. Omission (7.6% and wrong time error (4.4% were the most frequent administration errors. The less-experienced nurses (P=0.04, higher patient-to-nurse ratio (P=0.017, and the morning shifts (P=0.035 were positively related to administration errors. Administration errors marked the highest share of MEs occurring in the different medication use processes. Increasing the number of nurses and employing the more experienced of them in EDs can help reduce nursing errors. Addressing the shortcomings with further research should result in reduction

  9. Determinantes do aborto provocado entre mulheres admitidas em hospitais em localidade da região Nordeste do Brasil Determinants of iduced abortion among poor women admitted to hospitals in locality of the region northeast Brazil

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    Walter Fonseca

    1996-02-01

    Full Text Available Com o objetivo de identificar os determinantes do aborto provocado entre mulheres admitidas por complicações decorrentes dos abortos, nos hospitais-maternidades públicos em Fortaleza, CE (Brasil foram entrevistadas 4.359 pacientes entre 1º de outubro de 1992 e 30 de setembro de 1993. Os dados foram coletados através de questionário estruturado. São apresentados os determinantes dos abortos provocados em 2.084 (48% mulheres classificadas como tendo induzido aborto. Dois terços (66% das mulheres relataram a indução do aborto com o uso isolado do Cytotec(R (misoprostol ou associado a outro meio abortivo. Os resultados indicam que, na população estudada, a indução do aborto é prática comum entre jovens, solteiras (ou que vivem sem um parceiro estável, de baixa paridade, com escolaridade incipiente e não-usuárias de métodos contraceptivos. Recomenda-se a realização de estudos que investiguem os conhecimentos relacionados a percepções, conceitos culturais do aborto, e às razões por que mulheres pobres fracassam na adoção de métodos de planejamento familiar.In Brazil, abortion is legally allowed only when it is necessary to save a woman's life or when pregnancy has occurred following rape. Despite this law, iduced abortion is widely carried out. This study presents the findings as to the determinants of 2,084 abortions admitted to two major obstetric hospitals in Fortaleza, Brazil, between October 1992 and September 1993. Most of these women (2,074 have admitted an attempt to terminate pregnancy and 10 women were classified as induced abortion cases based on the findings of signs of intervention such as cervical laceration, perforation or foreign bodies in the vagina or uterus. The study findings indicate that self-administration of medicines plays an important role in terminating pregnancy. Among the 2,074 women who admitted to terminating the pregnancy 66% reported using misoprostol to induce abortion. Misoprostol, a

  10. Application of Lean Six Sigma techniques to optimize hospital laboratory Emergency Department Turnaround time across a multi-hospital system

    OpenAIRE

    Hagg, Heather (Woodward); Scachitti, Susan; Mapa, Lash; Brandford, Lillie; Vanni, Chris; Cox, Catherine

    2007-01-01

    In January 2005, Indiana University, Purdue University at Indianapolis (IUPUI) and Purdue- Calumet were invited to partner with the Alverno Clinical Labs in adapting Lean Six Sigma methodologies for use within healthcare. Our initial project focused on optimization of lab services for the emergency department at the Saint Margaret Mercy Hospitals in Hammond, IN. This project resulted in reduction of lab test report time to the emergency department from 75 minutes to less than 35 minutes. Thes...

  11. Hospital Based Emergency Department Visits Attributed to Child Physical Abuse in United States: Predictors of In-Hospital Mortality

    OpenAIRE

    Veerajalandhar Allareddy; Rahimullah Asad; Min Kyeong Lee; Romesh P Nalliah; Sankeerth Rampa; Speicher, David G; Rotta, Alexandre T; Veerasathpurush Allareddy

    2014-01-01

    OBJECTIVES: To describe nationally representative outcomes of physical abuse injuries in children necessitating Emergency Department (ED) visits in United States. The impact of various injuries on mortality is examined. We hypothesize that physical abuse resulting in intracranial injuries are associated with worse outcome. MATERIALS AND METHODS: We performed a retrospective analysis of the Nationwide Emergency Department Sample (NEDS), the largest all payer hospital based ED database, for the...

  12. Hospital Based Emergency Department Visits Attributed to Child Physical Abuse in United States: Predictors of In-Hospital Mortality

    OpenAIRE

    Allareddy, Veerajalandhar; Asad, Rahimullah; Lee, Min Kyeong; Romesh P Nalliah; Rampa, Sankeerth; Speicher, David G; Rotta, Alexandre T; Allareddy, Veerasathpurush

    2014-01-01

    Objectives: To describe nationally representative outcomes of physical abuse injuries in children necessitating Emergency Department (ED) visits in United States. The impact of various injuries on mortality is examined. We hypothesize that physical abuse resulting in intracranial injuries are associated with worse outcome. Materials and Methods We performed a retrospective analysis of the Nationwide Emergency Department Sample (NEDS), the largest all payer hospital based ED database, for the ...

  13. 医院在"被精神病"中面临的伦理困境及法学思考%Ethical Dilemma and Legal Consideration those Hospitals Admitting and Treating Patients with Suspected Mental Illness

    Institute of Scientific and Technical Information of China (English)

    姜贤飞; 王莉

    2011-01-01

    通过分析当事人"被精神病"的因为及医院在强制收治疑似精神病人中可能面临的伦理及法律问题,提出了解决问题的思路:立法确立非危害性疑似精神病人送治的自愿性原则、建立疑似精神病人非自愿住院的第三方鉴定机制以及对具有社会危害性的精神病人实施免费强制治疗.%Through analyzing the reasons, ethical and legal problems that hospitals faced when they admitted and treated the patients with suspected mental illness, we proposed the solutions to address the problems, including the voluntary admission principle of patients with suspected, harmless mental illness by regulations, establishing the third- party mechamsm to certificate the involuntary admission for patients with suspected mental illness, and free compulsory treatment for patients with severe mental diseases, which will do a harm to himself or society.

  14. A time and motion study of patients presenting at the accident and emergency department at Mater Dei Hospital

    Directory of Open Access Journals (Sweden)

    Ellul Robert

    2011-10-01

    Full Text Available Abstract Background To carry out a time and motion study of patients presenting at the Emergency Department (ED by measuring waiting times at the ED dept throughout the day. The objectives were: • to determine whether waiting times are prolonged, and • if prolonged, at which station(s bottlenecks occur most often in terms of duration and frequency. Results will be compared to the United Kingdom guidelines of stay at the emergency department. Methods A group of 11 medical students monitored all patients who attended ED between 0600 hours on the 25th August and 0600 hours on the 1st September 2008. For each 24 hour period, students were assigned to the triage room and the 3 priority areas where they monitored all patient-related activity, movement and waiting times so that length of stay (LOS could be recorded. The key data recorded included patient characteristics, waiting times at various ED process stages, tests performed, specialist consultations and follow up until admitted, discharged, or referred to another hospital area. Average waiting times were calculated for each priority area. Bottle-necks and major limiting factors were identified. Results were compared against the United Kingdom benchmarks - i.e. 1 hour until first assessment, and 4 hours before admitting/discharge. Results 1779 patients presented to the ED in the week monitored. As expected, patients in the lesser priority areas (i.e. 2 & 3 waited longer before being assessed by staff. Patients requiring laboratory and imaging investigations had a prolonged length of stay, which varied depending on specific tests ordered. Specialty consultation was associated with longer waiting times. A major bottleneck identified was waiting times for inpatient admission. Conclusions In conclusion, it was found that 30.3% of priority 1 patients, 86.3% of priority 2 patients and 76.8% of priority 3 patients waited more than 1 hour for first assessment. We conclude by proposing several changes

  15. Non-Opioid Analgesics Consumption At The Surgery Departments Of A Secondary Care Hospital In General Hospital In Kraljevo, Serbia

    Directory of Open Access Journals (Sweden)

    Aleksic Dejan

    2015-09-01

    Full Text Available The aim of this study was to determine the amount of non-opioid analgesics consumed at the surgical departments of a secondary care hospital in Serbia, a developing country undergoing a socioeconomic transition that thus lacks sufficient funds to finance and invest in the healthcare system.

  16. Prevalencia de desnutrición en pacientes ingresados en un hospital de rehabilitación y traumatología Malnutrition prevalence in patient admitted to a rehabilitation and orthopedic surgery hospital

    Directory of Open Access Journals (Sweden)

    A. M.ª Sánchez López

    2005-04-01

    Full Text Available Objetivo: Diferentes estudios ponen de manifiesto la escasa atención concedida al estado nutricional en la historia y práctica clínica, lo que determina el desconocimiento del estado nutricional del paciente a su ingreso en el hospital y por tanto la imposibilidad de prevenir la malnutrición hospitalaria. El objetivo de nuestro estudio ha sido determinar la prevalencia de desnutrición de pacientes ingresados en un Hospital de Traumatología y Rehabilitación. Métodos: Estudio observacional analítico en 250 pacientes (60% hombres y 40% mujeres seleccionados aleatoriamente, a los que se realizó una evaluación nutricional al ingreso hospitalario, mediante antropometría (Peso, talla, IMC, PB, PCT, PCSA y PCSE y pruebas bioquímicas (Albúmina, Prealbúmina y Transferrina. Resultados: Según el IMC la prevalencia de desnutrición fue del 8%, el promedio de desnutrición de tipo calórico fue del 2,8% (según antropometría y la prevalencia de desnutrición proteica se eleva al 54,8% (según marcadores bioquímicos. Conclusiones: La elevada prevalencia de malnutrición proteica o visceral (54,8% demostrada en este estudio, pone de manifiesto la importancia de determinar el estado nutricional al ingreso hospitalario, particularmente en los pacientes de tipo quirúrgico, como es el caso de la mayoría de los que ingresan en los hospitales traumatológicos.Objective: Different studies show the scarce attention granted to the nutritional state in historical and clinical practice, what determines the ignorance of the patient's nutritional status to their entrance in the hospital and, therefore, the impossibility to prevent the hospital malnutrition. The objective of our study has been to determine the prevalence of patients' malnutrition entered in a Hospital of Orthopedic surgery and Rehabilitation. Methods: Observational and analytical study in 250 randomized patients (60% men and 40% women, who were nutritionally evaluated when entering, the

  17. Adolescent alcohol intoxication in the dutch hospital departments of pediatrics: A 2-year comparison study

    NARCIS (Netherlands)

    Hoof, J.J. van; Lely, N. van der; Bouthoorn, S.H.; Dalen, W.E. van; Pereira, R.R.

    2011-01-01

    Purpose: To monitor the prevalence of, and the circumstances leading to, adolescent alcohol intoxication admissions in Dutch hospital departments of pediatrics. Methods: Data were collected in 2007 and 2008, using the Dutch Pediatric Surveillance System, in which pediatricians received questionnaire

  18. Admit: Alma Data Mining Toolkit

    Science.gov (United States)

    Friedel, Douglas; Looney, Leslie; Xu, Lisa; Pound, Marc W.; Teuben, Peter J.; Rauch, Kevin P.; Mundy, Lee; Kern, Jeffrey S.

    2015-06-01

    ADMIT (ALMA Data Mining Toolkit) is a toolkit for the creation and analysis of new science products from ALMA data. ADMIT is an ALMA Development Project written purely in Python. While specifically targeted for ALMA science and production use after the ALMA pipeline, it is designed to be generally applicable to radio-astronomical data. ADMIT quickly provides users with a detailed overview of their science products: line identifications, line 'cutout' cubes, moment maps, emission type analysis (e.g., feature detection), etc. Users can download the small ADMIT pipeline product (data mining between many astronomical sources and line transitions will be possible. Users will also be able to enhance the capabilities of ADMIT by creating customized ADMIT tasks satisfying any special processing needs. Future implementations of ADMIT may include EVLA and other instruments.

  19. A limited-service rural hospital model: the freestanding emergency department.

    Science.gov (United States)

    Avery, S

    1999-01-01

    A rural hospital that has been downsized to a freestanding emergency department is an important model in that it offers a possible solution to a community's need to have emergency-care services locally available. This model could include other important local services, such as skilled-nursing and outpatient services. This study looks at the financial feasibility of a rural hospital shutting down acute-care services and maintaining emergency services. Expenses were determined, and changes to revenue and expenses were estimated. Reimbursement was assumed static. Medicare cost reports and hospital financial disclosure reports were used in investigating three model categories: an urgent-care clinic with emergency services; a hospital-based emergency department with an outpatient clinic; a hospital-based emergency department with an outpatient clinic and a hospital-based skilled-nursing facility. Even with best-case assumptions regarding continued reimbursement, results show only a small increase in net income and, in two cases, large losses compared with the size of the hospital operations. A subsidy would be required from the community or an affiliated hospital or network for the model to remain financially stable. The regulatory barriers to implementation are noted, as well as the potential problems with the human aspects of implementation--staffing, recruitment and retention, professional education and quality. If the model rural hospital is an affiliate or partner with one or more health care facility, which could assist with financial and staffing needs, it may be feasible. PMID:10511753

  20. Vulnerabilities of children admitted to a pediatric inpatient care unit

    OpenAIRE

    Larissa Natacha de Oliveira; Márcia Koja Breigeiron; Sofia Hallmann; Maria Carolina Witkowski

    2014-01-01

    OBJECTIVE: To identify the vulnerabilities of children admitted to a pediatric inpatient unit of a university hospital.METHODS: Cross-sectional, descriptive study from April to September 2013 with36 children aged 30 days to 12 years old, admitted to medical-surgical pediatric inpatient units of a university hospital and their caregivers. Data concerning sociocultural, socioeconomic and clinical context of children and their families were collected by interview with the child caregiver and fro...

  1. Vulnerabilities of children admitted to a pediatric inpatient care unit☆

    OpenAIRE

    Oliveira, Larissa Natacha de; Breigeiron, Márcia Koja; Hallmann, Sofia; Witkowski, Maria Carolina

    2014-01-01

    OBJECTIVE: To identify the vulnerabilities of children admitted to a pediatric inpatient unit of a university hospital. METHODS: Cross-sectional, descriptive study from April to September 2013 with36 children aged 30 days to 12 years old, admitted to medical-surgical pediatric inpatient units of a university hospital and their caregivers. Data concerning sociocultural, socioeconomic and clinical context of children and their families were collected by interview with the child caregiver and fr...

  2. Prevalencia y factores asociados a desnutrición entre pacientes ingresados en un hospital de media-larga estancia Prevalence and factors associated to malnutrition in patients admited to a medium-long stay hospital

    OpenAIRE

    A. J. Pardo Cabello; S. Bermudo Conde; M.ª V. Manzano Gamero

    2011-01-01

    Objetivos: Determinar la prevalencia de desnutrición al ingreso en un hospital de media-larga estancia. Analizar posibles factores asociados a la misma; la posible relación con la mortalidad y los tratamientos de desnutrición realizados. Material y métodos: Estudio descriptivo a partir de datos analíticos obtenidos de 140 pacientes. Para el diagnóstico de desnutrición, se aplicó una herramienta basada en niveles de albúmina, colesterol total y linfocitos (CONUT). Se recogieron datos demográfi...

  3. Emergency Contraception: a survey of Hospital Emergency Departments Staffs

    OpenAIRE

    Marco Bo; Ivo Casagranda; Mario Galzerano; Lorena Charrier; Maria Michela Gianino

    2011-01-01

    The World Health Organization defines emergency contraception (EC) as a means to prevent unwanted pregnancy. In countries where EC is dispensed behind the counter, emergency departments are a preferred point of care for its prescription and dispensing. In light of this situation and as no studies on emergency contraception in emergency departments in Italy have been conducted to date, this study was designed with a view to analyze the responses of emergency room physicians in relation to thei...

  4. Does outsourcing paramedical departments of teaching hospitals affect educational status of the students?

    Science.gov (United States)

    Moslehi, Shandiz; Atefimanesh, Pezhman; Sarabi Asiabar, Ali; Ahmadzadeh, Nahal; Kafaeimehr, Mohamadhosein; Emamgholizadeh, Saeid

    2016-01-01

    Background: There is an increasing trend of outsourcing public departments. Teaching hospitals also outsourced some of their departments to private sectors. The aim of this study was to investigate and compare the educational status of students in public and outsourced departments of teaching hospitals affiliated to Iran University of Medical Sciences. Methods: This study was conducted in six teaching hospitals of Iran University of Medical Sciences, which had public and outsourced teaching departments in 2015. One hundred fifty students from the departments of radiology, physiotherapy and laboratory participated in this study and their perceptions about their educational status were assessed. A valid and reliable questionnaire was used; participation in the study was voluntary. Descriptive statistics such as mean (SD), t-test and Kolmogorov-Smirnov were used. Results: No difference was detected between the educational status of students in public and outsourced departments of radiology, physiotherapy and laboratory (p>0.05). Conclusion: Based on the students’ perception, the private sectors could maintain the educational level of the teaching departments similar to the public departments. It is recommended to involve all the stakeholders such as hospital administrators, academic staff and students in the decision- making process when changes in teaching environments are being considered.

  5. Does outsourcing paramedical departments of teaching hospitals affect educational status of the students?

    Science.gov (United States)

    Moslehi, Shandiz; Atefimanesh, Pezhman; Sarabi Asiabar, Ali; Ahmadzadeh, Nahal; Kafaeimehr, Mohamadhosein; Emamgholizadeh, Saeid

    2016-01-01

    Background: There is an increasing trend of outsourcing public departments. Teaching hospitals also outsourced some of their departments to private sectors. The aim of this study was to investigate and compare the educational status of students in public and outsourced departments of teaching hospitals affiliated to Iran University of Medical Sciences. Methods: This study was conducted in six teaching hospitals of Iran University of Medical Sciences, which had public and outsourced teaching departments in 2015. One hundred fifty students from the departments of radiology, physiotherapy and laboratory participated in this study and their perceptions about their educational status were assessed. A valid and reliable questionnaire was used; participation in the study was voluntary. Descriptive statistics such as mean (SD), t-test and Kolmogorov-Smirnov were used. Results: No difference was detected between the educational status of students in public and outsourced departments of radiology, physiotherapy and laboratory (p>0.05). Conclusion: Based on the students’ perception, the private sectors could maintain the educational level of the teaching departments similar to the public departments. It is recommended to involve all the stakeholders such as hospital administrators, academic staff and students in the decision- making process when changes in teaching environments are being considered. PMID:27683645

  6. [The neurology department of the Lankwitz Hospital. A contribution to the history of emigration, psychotherapy and the Berlin hospital].

    Science.gov (United States)

    Müller, Thomas

    2004-01-01

    At Lankwitz near Berlin the Jewish physicians James Fraenkel and Albert Oliven founded a private hospital in 1890. This hospital, which integrated seven departments, became one of the biggest private asylums in the Reich during the first decade of the 20th century. Parts of the hospital served the military during WWI. As most of the physicians at Lankwitz were Jewish, the year 1933 meant an immense moral and scientific decline, since these physicians were forced to leave and later threatened. We know of one physician killed in a concentration camp. Hardly any research about this hospital had been published until the 1990's. This contribution is the first portraying one department--that of neurology. From the early years of the hospital, therapists involved with psycho-dynamic psychiatry and psychoanalysis were attracted to it. Lankwitz was a major experience for a number of later famous psychiatrists and psychoanalysts. This continued to be the case during the years of the Weimar Republic, after the hospital had been leased [verpachtet] to the insurance companies [gesetzliche Krankenkassen] of Greater Berlin. Revealing more about the history of Berlin's private clinics, this article also contributes to the city's history of neurology, psychiatry and psychotherapy. For the example of Lankwitz, the myth of a 'marginalized psychoanalysis', rejected by the contemorary medicine, cannot be corroborated. On the contrary, the Lankwitz physicians portrayed here seemed to have combined and integrated clinical work with psychoanalytic theory and practice. Germany's turn towards National Socialism however meant an immediate end for the Lankwitz clinic and the mode of therapy described. PMID:15291149

  7. [The neurology department of the Lankwitz Hospital. A contribution to the history of emigration, psychotherapy and the Berlin hospital].

    Science.gov (United States)

    Müller, Thomas

    2004-01-01

    At Lankwitz near Berlin the Jewish physicians James Fraenkel and Albert Oliven founded a private hospital in 1890. This hospital, which integrated seven departments, became one of the biggest private asylums in the Reich during the first decade of the 20th century. Parts of the hospital served the military during WWI. As most of the physicians at Lankwitz were Jewish, the year 1933 meant an immense moral and scientific decline, since these physicians were forced to leave and later threatened. We know of one physician killed in a concentration camp. Hardly any research about this hospital had been published until the 1990's. This contribution is the first portraying one department--that of neurology. From the early years of the hospital, therapists involved with psycho-dynamic psychiatry and psychoanalysis were attracted to it. Lankwitz was a major experience for a number of later famous psychiatrists and psychoanalysts. This continued to be the case during the years of the Weimar Republic, after the hospital had been leased [verpachtet] to the insurance companies [gesetzliche Krankenkassen] of Greater Berlin. Revealing more about the history of Berlin's private clinics, this article also contributes to the city's history of neurology, psychiatry and psychotherapy. For the example of Lankwitz, the myth of a 'marginalized psychoanalysis', rejected by the contemorary medicine, cannot be corroborated. On the contrary, the Lankwitz physicians portrayed here seemed to have combined and integrated clinical work with psychoanalytic theory and practice. Germany's turn towards National Socialism however meant an immediate end for the Lankwitz clinic and the mode of therapy described.

  8. Geriatric Patients Presenting to the Emergency Department of a Japanese University Hospital

    OpenAIRE

    EZAKI, TAKAHIRO; YAMADA, Tomomi; Yasuda, Mitsuhiro; Setoguchi, Hidekazu; Noda, Eiichiro; Kannna, Tomoo; Shiraishi, Kiminori; Zaitshu, Akinori; Hashizume, Makoto

    2006-01-01

    To evaluate the trend of elderly patients visiting the emergency department of a Japanese University Hospital, out patient-based records were reviewed of the emergency department of Kyushu University Hospital from 2000 to 2004. A total number of 7610 emergency patients visited the department during the five year period. The median(25%, 75%)of age was 32(22, 56). Patients aged 65 years and over accounted for 16% of all attendances. All the patients were classified into 6 groups according to t...

  9. Initial approach of patients admitted to third level hospitals with systemic inflamatory response syndrome Enfoque inicial de los pacientes admitidos a hospitales de tercer nivel con síndrome de respuesta inflamatoria sistémica (SRIS

    Directory of Open Access Journals (Sweden)

    Fabián Alberto Jaimes Barragán

    2000-04-01

    Full Text Available Objective: To know the initial approach of patients with diagnosis of SIRS from infectious origin in emergency rooms. Design: Analytic observational study of a concurrent cohort. Setting: Emergency rooms of Hospital Universitario San Vicente de Paúl (HUSVP and Hospital General de Medellín (HGM. Patients: Admitted through emergency rooms with non-traumatic SIRS between August, 1998, and March, 1999, older than 14 and with suspicion of infection as one of the main diagnosis at admission. Measurements: Description of the associated diseases frequency, the risk factors and findings on basic physical examination; also the usefulness of diagnostic tools, previous antibiotic use and empirical antibiotic therapy at the time of admission. We used chi2 or Fisher´s exact test to compare proportions. Results: 502 patients were admitted. The main antecedents were chronic obstructive pulmonary disease (COPD (21.5% and trauma or previous surgery (18.7%; vital signs were determined as follows: heart rate in 100%, breath rate in 94.8%, blood pressure in 99.2%, temperature in 80.3%, Glasgow scale in 75.6% of the patients. Laboratory requests were done in the following proportions : white blood cell count in 98.4%, chest X rays in 71.1%, platelet count in 94.4% and creatinine determination in 89% of patients. In 26.5% of the patients cultures were not requested; blood cultures were done in 48.8% of the patients and results were positive in 19.2% of the specimens. In 22.3% of the patients antibiotics had previously been used but this fact did not show association with the growth of microorganisms or the prescription of empiric antibiotic therapy in the emergency room (p=0.65. Conclusions: All of the signs that define SIRS are not determined in patients with suspected infection; neurological state, as determined by the Glasgow scale, and temperature, although being mandatory parameters in emergency room patients, are not determined in 25% of the patients

  10. The Frederic Joliot hospital department; Le service hospitalier Frederic Joliot

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-02-01

    The Service Hospitalier Frederic Joliot (SHFJ) of the CEA, has got a scientific and a medical mission: to develop techniques allowing the functional study of human organs. The paper presents the main activities of this department: the positron emission tomography to visualize in real time markers in the organism in neurology and cardiology, researches on epilepsy to localize the epileptic centre, the nuclear medicine in cardiology with the use of the gamma photon emission tomography and the radiopharmacology to visualize the drugs effects in the organism. (A.L.B.)

  11. Time and department distribution of hypoglycemia occurrences in hospitalized diabetic patients

    OpenAIRE

    Cun-mei Yang; Yan-lan Ma; Jun Kang; Zhe Jia; Yan-yan Wang; Hong-ying Ma; Jie Wang

    2015-01-01

    Hypoglycemia occurred on hospitalized patients would result in severe complications. So we monitored the blood glucose of hospitalized patients with diabetes in 14 clinical departments from January to December 2013. Totally 105728 cases of blood glucose were monitored and 1374 cases of hypoglycemia were detected. The incidence of hypoglycemia was 1.29%. Among which, 317 cases of severe hypoglycemia were detected and the incidence of severe hypoglycemia was 0.29%. The peak periods of hypoglyce...

  12. Resilience-based design of a hospital Emergency Department considering human behavior

    OpenAIRE

    Piqué Saboya, Marta

    2013-01-01

    The paper presents a hospital testbed which aims to help the earthquake engineering community moving another step toward th e realization and implementation of resilience(based design strategie s for health care facilities. An organizational model describing the response of the Hospital Emergency Department (ED) has been implemented using a discre te events simulation model (DES). The waiting time is the main response parame ter used to evaluate the resilie...

  13. Hospital based emergency department visits attributed to child physical abuse in United States: predictors of in-hospital mortality.

    Directory of Open Access Journals (Sweden)

    Veerajalandhar Allareddy

    Full Text Available OBJECTIVES: To describe nationally representative outcomes of physical abuse injuries in children necessitating Emergency Department (ED visits in United States. The impact of various injuries on mortality is examined. We hypothesize that physical abuse resulting in intracranial injuries are associated with worse outcome. MATERIALS AND METHODS: We performed a retrospective analysis of the Nationwide Emergency Department Sample (NEDS, the largest all payer hospital based ED database, for the years 2008-2010. All ED visits and subsequent hospitalizations with a diagnosis of "Child physical abuse" (Battered baby or child syndrome due to various injuries were identified using ICD-9-CM (International Classification of Diseases, 9th Revision, Clinical Modification codes. In addition, we also examined the prevalence of sexual abuse in this cohort. A multivariable logistic regression model was used to examine the association between mortality and types of injuries after adjusting for a multitude of patient and hospital level factors. RESULTS: Of the 16897 ED visits that were attributed to child physical abuse, 5182 (30.7% required hospitalization. Hospitalized children were younger than those released treated and released from the ED (1.9 years vs. 6.4 years. Male or female partner of the child's parent/guardian accounted for >45% of perpetrators. Common injuries in hospitalized children include- any fractures (63.5%, intracranial injuries (32.3% and crushing/internal injuries (9.1%. Death occurred in 246 patients (13 in ED and 233 following hospitalization. Amongst the 16897 ED visits, 1.3% also had sexual abuse. Multivariable analyses revealed each 1 year increase in age was associated with a lower odds of mortality (OR = 0.88, 95% CI = 0.81-0.96, p < 0.0001. Females (OR = 2.39, 1.07-5.34, p = 0.03, those with intracranial injuries (OR = 65.24, 27.57-154.41, p<0.0001, or crushing/internal injury (OR = 4.98, 2.24-11.07, p<0.0001 had higher odds of

  14. Cutaneous adverse drug reactions seen at a university hospital department of dermatology

    DEFF Research Database (Denmark)

    Borch, Jakob E; Andersen, Klaus E; Bindslev-Jensen, Carsten

    2006-01-01

    Patients with suspected cutaneous adverse drug reactions are often referred to allergy clinics or departments of dermatology for evaluation. These patients are selected compared with patients identified in prospective and cross-sectional studies of hospital populations. This explains the observed...... variation in prevalence of specific reactions and of eliciting drugs. This study investigated the prevalence of cutaneous adverse drug reactions in a university hospital department of dermatology that is specially focused on allergy. An 8-month survey was carried out during the period April-December 2003...

  15. Quality of life, dietary intake and nutritional status assessment in hospital admitted cancer patients Calidad de vida, ingesta dietética y valoración del estado nutricional en pacientes ingresados con cáncer

    Directory of Open Access Journals (Sweden)

    J. Trabal

    2006-08-01

    Full Text Available Objectives: The objectives of this study were to assess the quality of life (QoL, nutritional status, and quantitative food intakes of non-terminal admitted cancer patients receiving oral feeding. As well as to evaluate what kind of relation exists between the quality of life, and the nutritional status and current intake Scope: Medical Oncology and Radiotherapy Service ward at the Hospital Clínic de Barcelona. Subjects: Fifty admitted patients in the Service ward. Interventions: There was a follow-up of the dietary intake during 3 working days through direct observation, as well as an assessment of anthropometrical and biochemical parameters, a record of symptomatology related data, and a QoL assessment through the EORTC QLQC30 questionnaire. Results: Our data show that 32.6% of the patients did not reach 25 kcal/kg/day, and 23.3% did not even fulfill 1g protein/kg/day. Concerning QoL, mean score for global health status and overall QoL for all patients was 46.2. Compared to the general population, there were important deficits among cancer patients regarding physical, role and social functioning. The most pronounced differences in the symptom scales were for fatigue, and in single items for appetite loss and constipation. A low protein intake was associated to a poorer perception on physical functioning (p=0.01, and fatigue was close to significance (p=0.058. No significant differences were found regarding caloric intake and QoL. Conclusions: A significant percentage of patients who received exclusive oral feeding did not cover a minimum acceptable quantity of their protein-energy requirements. Our results point-out that poor food intakes can affect QoL by themselves.Objetivos: Los objetivos de este estudio fueron valorar la calidad de vida (QoL, el estado nutricional y la ingesta dietética cuantitativa realizada en pacientes oncológicos no terminales ingresados que recibieron alimentación oral. Así mismo evaluar qué tipo de relaci

  16. [Estimating the grade of patient satisfaction at the bone marrow transplantation department in Florence hospitals].

    Science.gov (United States)

    Marsullo, M; Tozzi, S; Biagini, S; Rinaldi, L

    2000-01-01

    The satisfaction of the patients admitted to the bone marrow transplant unit of Careggi Hospital was evaluated by the nursing team. The aim of the evaluation was to measure the level of satisfaction for the nursing care and services and the areas of improvement. The questionnaire, with 23 questions referring to 5 areas (hotel care, Nurses' reliability, Ability to reassure, to answer to patients' needs and Empathy) derived from the conceptual model of Servqual. Ninety patients were given (or mailed) the questionnaire during a follow-up visit. Patients were asked to answer the questions evaluating each aspect on a scale from 1 (falls short of expectation) to 10 (exceeds all expectations). The answers show a very high satisfaction (> 8) for all the areas except for the food that reported a medium score of 5.2. Further analysis will allow a better understanding of the causes of dissatisfaction.

  17. [Estimating the grade of patient satisfaction at the bone marrow transplantation department in Florence hospitals].

    Science.gov (United States)

    Marsullo, M; Tozzi, S; Biagini, S; Rinaldi, L

    2000-01-01

    The satisfaction of the patients admitted to the bone marrow transplant unit of Careggi Hospital was evaluated by the nursing team. The aim of the evaluation was to measure the level of satisfaction for the nursing care and services and the areas of improvement. The questionnaire, with 23 questions referring to 5 areas (hotel care, Nurses' reliability, Ability to reassure, to answer to patients' needs and Empathy) derived from the conceptual model of Servqual. Ninety patients were given (or mailed) the questionnaire during a follow-up visit. Patients were asked to answer the questions evaluating each aspect on a scale from 1 (falls short of expectation) to 10 (exceeds all expectations). The answers show a very high satisfaction (> 8) for all the areas except for the food that reported a medium score of 5.2. Further analysis will allow a better understanding of the causes of dissatisfaction. PMID:11107367

  18. Valor preditivo da mieloperoxidase na identificação de pacientes de alto risco admitidos por dor torácica aguda Predictive value of myeloperoxidase to identify high risk patients admitted to the hospital with acute chest pain

    Directory of Open Access Journals (Sweden)

    Roberto Esporcatte

    2007-12-01

    adverse events in healthy individuals, patients with heart disease or those undergoing chest pain investigations. OBJECTIVE: To analyze the contribution of MPO to identify patients with acute chest pain, non-ST elevation ECG and at high risk for in-hospital adverse events. METHODS: Patients presenting acute chest pain and a non-ST elevation ECG, were admitted to the hospital and submitted to serum MPO level measurements and a structured examination protocol. RESULTS: From a cohort of 140 patients, 49 (35% were diagnosed with acute coronary syndrome, of which 13 patients (9.3% were diagnosed with non-ST elevation acute myocardial infarction (AMI (troponin I >1.0 ng/mL. The best MPO cut-off point for AMI was identified as >100 pM using the ROC curve (AUC=0.662; CI 95%=0.532-0.793 revealing elevated sensitivity (92.3% and negative predictive value (98.1%, however with low specificity (40.2%. In the multivariate analysis, MPO proved to be the only independent variable to diagnose AMI in evolution, with an odds ratio of 8.04 (p=0.048. CONCLUSION: In patients with acute chest pain and no ST elevation, high MPO levels upon admission to the hospital are an important tool to predict in-hospital adverse events, with an odds ratio of eight for the diagnosis of AMI.

  19. Tissue expander, a modality in the treatment of burn induced deformities: A 6-year study of patients with burn deformities admitted to Plastic Surgery Department of Imam Hospital

    Directory of Open Access Journals (Sweden)

    Farah Vash. MR

    2000-06-01

    Full Text Available Use of tissue expander in the recent decade has revolutionized the plastic surgery. The tissue expansion technique is advantageous in body reconstruction because it makes it possible to resurface the defects resulting from excision of burn scars with neighboring skin similar in color and texture and superior to skin grafts or distant flaps. Treatment of burn alopecia was a major problem in the past, but with the application of tissue expander this deformity is treated. We have learned by experience that tissue expander should not be used in the limbs, because of the high risk of complications. The best locations for tissue expander are in order: Scalp, face, neck and trunk. The incidence of burn induced deformities in Iran is high. In this research, I analyze the use of TE in 130 patients with burn deformities. The variables studied were: Sex of patients (43.1% male, 56.9% female, age groups, level of education, occupation, the anatomical site of burn, extension of burn, volume of tissue expansion, the location of placing the TE and complications.

  20. Relationship between commitment to hospital goals and job satisfaction: a case study of a nursing department.

    Science.gov (United States)

    Alpander, G G

    1990-01-01

    Why is it that people in the same occupation doing similar work in the same department experience different levels of intrinsic satisfaction? This article sheds light on this question and provides hospital administrators with guidelines for improving employee motivation through intrinsic job satisfaction. PMID:2266009

  1. Clinical profiles of serious suicide attempters consecutively admitted to a university-based hospital: a cluster analysis study Perfis clínicos de indivíduos que fizeram tentativas graves de suicídio internados em um hospital universitário: análise de agrupamento

    Directory of Open Access Journals (Sweden)

    Claudemir Benedito Rapeli

    2005-12-01

    Full Text Available OBJECTIVE: To verify the presence of different groups of medically serious suicide attempters who had more clinical or surgical seriousness and required admission to a general hospital. METHODS: 121 patients admitted consecutively were assessed. A questionnaire containing items on the patient characteristics and psychometric scales to assess the suicidal intent and lethality were used. A cluster analysis was performed using the K-means method. RESULTS: Three groups were identified: 1 43 subjects (mostly female characterized by self-poisoning with medication and low suicidal intent, with highly impulsive suicide attempts; 2 53 subjects (mostly males who ingested pesticides and presented both moderate degrees of lethality and suicidal intent; 3 17 subjects (predominantly males who used more violent methods and presented high levels of lethality and suicidal intent. CONCLUSIONS: Grouped data of these inpatients could be misleading for follow-up research purposes as our findings indicate that there are relatively distinct clinical profiles among suicide attempters admitted to a general hospital.OBJETIVO: Verificar a existência de diferentes grupos entre os indivíduos que tentaram o suicídio com maior gravidade clínica ou cirúrgica e que necessitaram de internação no Hospital das Clínicas da UNICAMP. MÉTODOS: Avaliaram-se 121 pacientes admitidos consecutivamente. Foram utilizados um questionário para avaliar características dos indivíduos e escalas psicométricas para avaliar a intencionalidade suicida e o grau de letalidade da tentativa de suicídio. Para a análise de agrupamento usou-se o método K-means. RESULTADOS: Três grupos foram identificados: 1 43 sujeitos (maioria de sexo feminino que utilizaram como principal método o envenenamento com medicação. Este grupo caracterizou-se por apresentar menor intencionalidade suicida e maior impulsividade na tentativa de suicídio; 2 53 sujeitos (maioria do sexo masculino que tomaram

  2. Rates of TBI-related Emergency Department Visits, Hospitalizations, and Deaths — United States, 2001–2010

    Data.gov (United States)

    U.S. Department of Health & Human Services — In general, total combined rates for traumatic brain injury (TBI)-related emergency department (ED) visits, hospitalizations and deaths have increased over the past...

  3. Hospital admissions for hypertensive crisis in the emergency departments: a large multicenter Italian study.

    Science.gov (United States)

    Pinna, Giuliano; Pascale, Claudio; Fornengo, Paolo; Arras, Sebastiana; Piras, Carmela; Panzarasa, Pietro; Carmosino, Gianpaolo; Franza, Orietta; Semeraro, Vincenzo; Lenti, Salvatore; Pietrelli, Susanna; Panzone, Sergio; Bracco, Christian; Fiorini, Roberto; Rastelli, Giovanni; Bergandi, Daniela; Zampaglione, Bruno; Musso, Roberto; Marengo, Claudio; Santoro, Giancarlo; Zamboni, Sergio; Traversa, Barbara; Barattini, Maddalena; Bruno, Graziella

    2014-01-01

    Epidemiological data on the impact of hypertensive crises (emergencies and urgencies) on referral to the Emergency Departments (EDs) are lacking, in spite of the evidence that they may be life-threatening conditions. We performed a multicenter study to identify all patients aged 18 years and over who were admitted to 10 Italian EDs during 2009 for hypertensive crises (systolic blood pressure ≥220 mmHg and/or diastolic blood pressure ≥120 mmHg). We classified patients as affected by either hypertensive emergencies or hypertensive urgencies depending on the presence or the absence of progressive target organ damage, respectively. Logistic regression analysis was then performed to assess variables independently associated with hypertensive emergencies with respect to hypertensive urgencies. Of 333,407 patients admitted to the EDs over the one-year period, 1,546 had hypertensive crises (4.6/1,000, 95% CI 4.4-4.9), and 23% of them had unknown hypertension. Hypertensive emergencies (n = 391, 25.3% of hypertensive crises) were acute pulmonary edema (30.9%), stroke (22.0%,), myocardial infarction (17.9%), acute aortic dissection (7.9%), acute renal failure (5.9%) and hypertensive encephalopathy (4.9%). Men had higher frequency than women of unknown hypertension (27.9% vs 18.5%, phypertensive patients, a larger proportion of men than women reported not taking anti-hypertensive drug (12.6% among men and 9.4% among women (phypertensive emergencies than urgencies (OR = 1.34, 95% CI 1.06-1.70), independently of presenting symptoms, creatinine, smoking habit and known hypertension. This study shows that hypertensive crises involved almost 5 out of 1,000 patients-year admitted to EDs. Sex differences in frequencies of unknown hypertension, compliance to treatment and risk of hypertensive emergencies might have implications for public health programs.

  4. Prescription audit of corticosteroid usage in the department of dermatology at a tertiary care teaching hospital

    Directory of Open Access Journals (Sweden)

    Mirshad PV

    2013-08-01

    Full Text Available Background: Corticosteroids are a group of commonly used drugs in dermatology practice whose non judicious use frequently results in undesirable and unwanted effects. Prescribing them rationally with care allows us to derive the maximum benefit out of them with minimal side effects. Methods: Retrospective analysis of 112 case files belonging to patients admitted in the department of dermatology over a period of one year was undertaken to ascertain the usage pattern of corticosteroids in relation to their potency, strength, frequency, duration, route, quantity to be applied. The data thus collected was expressed in terms of averages, ratios and proportions. Results: The total number of formulations prescribed were 929 out of which 10.8% were corticosteroids. The average number of formulations prescribed per patient was 8.29. About 78(70% patients admitted in dermatology received corticosteroids. Topical steroids were prescribed in 50 patients (44.7 % out of whom 36 (72% received only topical, the remaining 14(28% were prescribed both systemic and topical corticosteroids. Brand names were used in all cases. Highly potent corticosteroids like clobetasol, halobetasol and mometasone were prescribed to 39(50% of all cases who received topical corticosteroids. Conclusion: The study reveals the deficiencies which exist in the present prescribing pattern of corticosteroids. Educational interventions among the doctors as well as students should be carried out to in order to promote rational drug use. [Int J Basic Clin Pharmacol 2013; 2(4.000: 411-413

  5. Epidemiological, clinical and laboratory findings of children fewer than 15 years with diabetic ketoacidosis admitted at San Vicente Fundación Hospital in Medellín, Colombia, between January 2001 and December 2010 = Características epidemiológicas y clínicas y hallazgos de laboratorio de los niños menores de 15 años con cetoacidosis diabética atendidos en el Hospital Universitario San Vicente Fundación en Medellín, Colombia, entre enero de 2001 y diciembre de 2010

    OpenAIRE

    Ballesteros Calderón, Alicia Lucía; Meneses Muñoz, Angela Patricia; Ríos Patiño, David; Flórez Gómez, Iván Darío; Quevedo Vélez, Augusto

    2013-01-01

    Introduction: Diabetic ketoacidosis (DKA) is the most important acute complication in children with diabetes mellitus. There are several publications regarding the characteristics of children with DKA admitted to hospital care in developed countries, however, in our population there is no information concerning the characteristics of these children. Our aim is to determinate these characteristics. Methods: Retrospective study of DKA events in children fewer than 15 years admitted t...

  6. Emergency department visits and hospitalizations for respiratory disease on the island of Hawaii, 1981 to 1991.

    Science.gov (United States)

    Mannino, D M; Ruben, S; Holschuh, F C; Holschuh, T C; Wilson, M D; Holschuh, T

    1996-03-01

    This study examined trends in and patterns of emergency department visits and hospitalizations for respiratory disease on the island of Hawaii from 1981 to 1991. We found that emergency department visit rates and hospitalization rates for both asthma and COPD for 1987 to 1991 increased in all regions of the island in comparison with such rates for 1981 to 1986. Rates of emergency department visits and hospitalizations for chronic obstructive pulmonary disease or COPD, but not asthma, were significantly higher in the high-exposure Kona side of the island than in the intermittent-exposure Hilo side of the island during 1983 and 1988 to 1990. We also found that during the weeks that winds were from the west, blowing volcanic air pollution toward Hilo, emergency department visits for asthma increased 15%. Some of the results of our study support the hypothesis that volcanic air pollution affects respiratory health on the island of Hawaii, while other results do not. Any future studies should include measurements of air pollutant levels. PMID:8882554

  7. Goldratt’s Theory Applied to the Problems Associated with an Emergency Department at a Hospital

    Directory of Open Access Journals (Sweden)

    Soumya Nayak

    2012-10-01

    Full Text Available Healthcare costs continue to increase dramatically, while quality remains a significant problem. Reform measures initiated by the government will drive expansion of these costs, further stressing taxpayers and employers, and forcing hospitals to adopt fundamental changes as they try to adjust to increased demands for services and to lessening reimbursements from all payers. This struggle is best seen at the point of entry for many at a hospital: the emergency department (ED. It is at the emergency department that patients’ expectations regarding staff communication with patients, wait times, the triage process, capacity and payment will determine a significant part of a hospital’s revenue. Using Dr. Eliyahu M. Goldratt’s Thinking Process, we will determine what core problem(s are causing a 362-bed regional West Texas hospital emergency department to lose revenue. Evaluation of the current emergency department will determine the Undesirable Effects (UDE. Using that information will lead to the construction of the Current Reality Tree (CRT, which will bring focus to the core problem(s. To break the constraints, which are the core problem(s, an Evaporative Cloud (EC is generated. And, the end result will be to construct a Future Reality Tree (FRT, which will validate the idea(s generated in the EC. It was determined that there are ten major UDE’s that affected this hospital’s emergency department. They were focused around staff communication, wait times, triage process, information management, service provided and bill collections. A conclusion was made that the core problem dealt with triaging patients and utilization of the services provided by the hospital. Since the reimbursement rate is affected by the patient’s satisfaction, the areas to focus on would be: triage, education, communication and retention. Although it may be neither feasible nor desirable to meet all the patient’s expectations, increased focus on those areas may

  8. Mental Disorders among Children and Adolescents Admitted to a French Psychiatric Emergency Service

    OpenAIRE

    Laurent Boyer; Jean-Marc Henry; Jean-Claude Samuelian; Raoul Belzeaux; Pascal Auquier; Christophe Lancon; David Da Fonseca

    2013-01-01

    The aim of this study was to describe the characteristics of children and adolescents admitted to the psychiatric emergency department (ED) of a French public teaching hospital over a six-year study period (2001–2006). Data for all episodes of care in the psychiatric ED from January 1, 2001, to December 31, 2006, delivered to adolescents aged less than 18 years were retrospectively analyzed. During the six-year study period, 335 episodes of care in the psychiatric ED were experienced by 264 d...

  9. The AdMit Package

    NARCIS (Netherlands)

    D. David (David); L.F. Hoogerheide (Lennart); H.K. van Dijk (Herman)

    2008-01-01

    textabstractThis short note presents the R package AdMit which provides flexible functions to approximate a certain target distribution and it provides an efficient sample of random draws from it, given only a kernel of the target density function. The estimation procedure is fully automatic and thu

  10. Causes of death in 1 162 elderly patients admitted to our hospital%我院1162例老年男性住院患者死亡原因分析

    Institute of Scientific and Technical Information of China (English)

    孙般若; 成晓玲; 李春霖; 田慧

    2014-01-01

    目的:研究1996-2011年于我院老年病房住院的老年男性患者死亡原因构成特点。方法以1162例年龄≥65岁长期定居北京并于我院老年病房住院死亡的男性患者为研究对象,通过查阅死亡记录确定死亡原因。结果15年间于我院老年病房死亡的老年男性患者共1162例,平均死亡年龄(83.3±6.5)岁。死因构成前4位依次为恶性肿瘤、心血管疾病、呼吸系统疾病和脑血管病,分别占总死因的41.7%、20.7%、20.4%和6.4%。肺癌、缺血性心脏病、脑梗死及肺炎分别是恶性肿瘤、心血管疾病、脑血管病及呼吸系统疾病死亡的首要原因。与<80岁年龄组相比,≥80岁年龄组恶性肿瘤所致死亡比例减少,呼吸系统疾病、消化系统疾病所致死亡比例增加(P<0.01);心、脑血管疾病死亡在两年龄组比例相当(P>0.05);近15年来呼吸系统疾病所致死亡比例增加(P<0.01);心血管疾病死亡有下降趋势,但差异无统计学意义;恶性肿瘤和脑血管疾病所致死亡比例变化不大。结论恶性肿瘤、心脑血管疾病和呼吸系统疾病是老年男性主要死亡原因。随年龄增长,恶性肿瘤死亡比例降低,呼吸系统疾病死亡比例升高。近年来,呼吸系统疾病所致死亡有上升趋势。%Objective To study the causes of death in elderly patients admitted to our hospital from 1996 to 2011. Methods A total of 1 162 elderly patients with their age≥65 years were included in this study. The causes of their death were summarized by reviewing their medical records. Results The average death age of the 1 162 elderly patients was 83.3±6.5 years. The top 4 causes of death were malignant tumors, cardiovascular diseases, respiratory diseases and cerebrovascular diseases, which accounted for 41.7%, 20.7%, 20.4% and 6.4%, respectively. Lung cancer, ischemic heart disease, pneumonia and cerebral infarction were the leading causes of malignant

  11. Prescription pattern of fixed dose drug combination in cardiology department in a tertiary care hospital

    OpenAIRE

    Pramod Kumar Manjhi; Lalit Mohan; Manish Kumar; Harihar Dikshit; Singh, B. P.; Anuj Kumar Pathak; Sanjeev Kumar

    2016-01-01

    Background: A cardiovascular disease (CVD) is one of the most common causes of mortality and morbidity globally. The drastic change in the lifestyle of population during 21st century has had a great impact on health especially cardiovascular diseases. Objective of this study was to assess the prescription pattern of fixed dose drug combinations (FDCs) in the department of cardiology in a tertiary care hospital. Methods: The prescriptions of 210 patients suffered by cardiovascular disorders...

  12. Factors associated with hospital admissions and repeat emergency department visits for adults with asthma

    OpenAIRE

    Adams, R; B. Smith; Ruffin, R

    2000-01-01

    BACKGROUND—A small proportion of patients with asthma account for a disproportionate number of acute health service events. To identify whether factors other than severity and low socioeconomic status were associated with this disproportionate use, a prospective study was undertaken to examine management and psychosocial factors associated with increased risk for admission to hospital with asthma and repeat visits to the emergency department over a 12month period.
METHODS...

  13. Accreditation of Emergency Department at a Teaching Hospital in Tehran University of Medical Sciences in 2010

    Directory of Open Access Journals (Sweden)

    Fereshteh Farzianpour

    2011-01-01

    Full Text Available Problem statement: Considering the importance of emergency departments in healthcare system and the high mortality rate of patients referred to these departments, it is crucial to provide quality services in emergency departments. Accreditation is a systematic process for improving quality of care and it enables managers to assess and evaluate the healthcare system. Accreditation of an organization provides an obvious commitment for improving quality of safety, quality of patient care, ensuring safety surveillance and continuous activities for reducing dangers which threaten patients and staff. Therefore, given the vital role as well as and the perpetual and indispensable service provided by the emergency departments, it is necessary to re-evaluate the manner of service provision in these departments according to the standards and criteria of accreditation, so that an observance of these criteria will lead to improvement of emergency medicine in Iran. Thus, the present study was undertaken with the purpose of accreditation of emergency department of a teaching hospital of Tehran University of Medical Sciences according to the standards of Iranian Deputy of Health and the JCI. Approach: This is a descriptive-analytic study with a cross-sectional structure. Our study population consisted of 50 individuals of the healthcare staff (physicians and nurses working in morning and evening work shifts of the emergency department in the teaching hospital. Data collection tools consisted of standard questionnaires of the Deputy of Health (9 series and questionnaires developed by authors based on the standards of the Joint Commission International (JCI regarding patient satisfaction with services provided in emergency departments. In order to determine the reliability and validity of the data collection tools, professors and experts reviewed the questionnaire of quality and patient safety in accordance with standards of quality patient safety from the

  14. Contribution of ED admissions to inpatient hospital revenue.

    Science.gov (United States)

    Sacchetti, Alfred; Harris, Russell H; Warden, Todd; Roth, Sandra

    2002-01-01

    Emergency department (ED) practices are traditionally profiled in terms of their patient encounters. Such evaluations reflect a preponderance of outpatient visits while crediting income from admitted patients to traditional hospital-based services. This study evaluates the contribution of ED admissions to inpatient hospital revenue. The study was set at an urban tertiary care community hospital with university affiliation. Information referable to ED patients was collected from the hospital's Universal Billing Code (UB-92)-based patient information warehouse. Data fields referable to hospital charges, insurance type, and disposition were used for analysis of a 1-year period from September 1, 1998 to August 31, 1999. Statistical analysis was through chi square and ANOVA. During the study period 33,174 patients were treated in the ED with 6,671 (20%) admitted to inpatient services. Total hospital charges for all ED patients during this time were $107 million dollars with $9.1 million (8.5%) generated from discharged patients and $98.0 million (91.5%) from admitted ED patients (P revenue for inpatient services for the study period was $288 million of which 34% was contributed from admitted ED patients. ED services represent a major source of inpatient hospital revenue. The recognition of the ED's potential in this area may be lost if income from patients admitted through the ED is credited to traditional hospital-based services.

  15. Hospital admissions for hypertensive crisis in the emergency departments: a large multicenter Italian study.

    Directory of Open Access Journals (Sweden)

    Giuliano Pinna

    Full Text Available Epidemiological data on the impact of hypertensive crises (emergencies and urgencies on referral to the Emergency Departments (EDs are lacking, in spite of the evidence that they may be life-threatening conditions. We performed a multicenter study to identify all patients aged 18 years and over who were admitted to 10 Italian EDs during 2009 for hypertensive crises (systolic blood pressure ≥220 mmHg and/or diastolic blood pressure ≥120 mmHg. We classified patients as affected by either hypertensive emergencies or hypertensive urgencies depending on the presence or the absence of progressive target organ damage, respectively. Logistic regression analysis was then performed to assess variables independently associated with hypertensive emergencies with respect to hypertensive urgencies. Of 333,407 patients admitted to the EDs over the one-year period, 1,546 had hypertensive crises (4.6/1,000, 95% CI 4.4-4.9, and 23% of them had unknown hypertension. Hypertensive emergencies (n = 391, 25.3% of hypertensive crises were acute pulmonary edema (30.9%, stroke (22.0%,, myocardial infarction (17.9%, acute aortic dissection (7.9%, acute renal failure (5.9% and hypertensive encephalopathy (4.9%. Men had higher frequency than women of unknown hypertension (27.9% vs 18.5%, p<0.001. Even among known hypertensive patients, a larger proportion of men than women reported not taking anti-hypertensive drug (12.6% among men and 9.4% among women (p<0.001. Compared to women of similar age, men had higher likelihood of having hypertensive emergencies than urgencies (OR = 1.34, 95% CI 1.06-1.70, independently of presenting symptoms, creatinine, smoking habit and known hypertension. This study shows that hypertensive crises involved almost 5 out of 1,000 patients-year admitted to EDs. Sex differences in frequencies of unknown hypertension, compliance to treatment and risk of hypertensive emergencies might have implications for public health programs.

  16. Complexity in hospital internal medicine departments: what are we talking about?

    Directory of Open Access Journals (Sweden)

    Roberto Nardi

    2013-09-01

    Full Text Available Internal medicine (IM patients are mostly elderly, with multiple complex co-morbidities, usually chronic. The complexity of these patients involves the intricate entanglement of two or more systems (e.g. body and disease, family-socio-economic and environmental status, coordination of care and therapies and this requires comprehensive, multi-dimensional assessment (MDA. Despite attempts to improve management of chronic conditions, and the availability of several MDA tools, defining the complex patient is still problematic. The complex profile of our patients can only be described through the best assessment tools designed to identify their characteristics. In order to do this, the Federation of Associations of Hospital Doctors on Internal Medicine FADOI has created its own vision of IM. This involves understanding the different needs of the patient, and analyzing diseases clusters and the possible relationships between them. By exploring the real complexity of our patients and selecting their real needs, we can exercise holistic, anthropological and appropriate choices for their treatment and care. A simpler assessment approach must be adopted for our complex patients, and alternative tools should be used to improve clinical evaluation and prognostic stratification in a hierarchical selection of priorities. Further investigation of complex patients admitted to IM wards is needed.

  17. Hospitals - HOSPITALS_CLINICS_ISDH_IN: Hospitals and Rural Health Clinics in Indiana in 2007 (Indiana State Department of Health, Point Shapefile)

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — HOSPITALS_CLINICS_ISDH_IN is a point shapefile showing the locations of 160 hospitals included in a "Hospital Directory" that appears on a Web page of the Indiana...

  18. Radiation Protection in Radiology Departments of Ahvaz University of Medical Sciences Teaching Hospitals, Ahvaz, Iran, 2015

    Directory of Open Access Journals (Sweden)

    Fouladi Dehaghi

    2015-07-01

    Full Text Available Background Application of ionizing radiation in many fields especially in medicine is growing, and can cause adverse health effects. Objectives The current study aimed to evaluate the radiation protection principles in radiology departments, based on national standards. Materials and Methods The current study was conducted in all radiology departments of the teaching hospitals in Ahvaz, Iran, and their radiation protection status was investigated using Audit technique. For this purpose Audit checklist was prepared and essential information gathered by observation, interview with radiology department managers, and documentary surveying. At the end, standard situations were classified in three levels: poor (˂ 50%, medium (50 - 75%,s and good (75 - 100%. Results The mean of radiation protection in the studied radiology departments was 70.53%. The highest and lowest levels of radiation protection were in quality control and suitable ventilation, respectively. Radiation protection was evaluated as medium in 71.4% and good in 28.6% of the studied radiology departments. Conclusions The state of observed radiation protection principles was relatively in the weak level in the studied radiology departments especially in facilities such as ventilation system, radiography entrance, and darkroom situation. More important reason was usage changing of sections as radiology billet from related organizations.

  19. Temporal dynamics of emergency department and hospital admissions of pediatric asthmatics

    Science.gov (United States)

    Kimes, Daniel; Levine, Elissa; Timmins, Sidey; Weiss, Sheila R.; Bollinger, Mary E.; Blaisdell, Carol

    2004-01-01

    Asthma is a chronic disease that can result in exacerbations leading to urgent care in emergency departments (EDs) and hospitals. We examined seasonal and temporal trends in pediatric asthma ED (1997-1999) and hospital (1986-1999) admission data so as to identify periods of increased risk of urgent care by age group, gender, and race. All pediatric ED and hospital admission data for Maryland residents occurring within the state of Maryland were evaluated. Distinct peaks in pediatric ED and hospital asthma admissions occurred each year during the winter-spring and autumn seasons. Although the number and timing of these peaks were consistent across age and racial groups, the magnitude of the peaks differed by age and race. The same number, timing, and relative magnitude of the major peaks in asthma admissions occurred statewide, implying that the variables affecting these seasonal patterns of acute asthma exacerbations occur statewide. Similar gross seasonal trends are observed worldwide. Although several environmental, infectious, and psychosocial factors have been linked with increases in asthma exacerbations among children, thus far they have not explained these seasonal patterns of admissions. The striking temporal patterns of pediatric asthma admissions within Maryland, as described here, provide valuable information in the search for causes.

  20. Bacterial etiology in acute hospitalized chronic obstructive pulmonary disease exacerbations

    OpenAIRE

    Asli Gorek Dilektasli; Ezgi Demirdogen Cetinoglu; Nilufer Aylin Acet Ozturk; Funda Coskun; Guven Ozkaya; Ahmet Ursavas; Cuneyt Ozakin; Mehmet Karadag; Esra Uzaslan

    2016-01-01

    Introduction. The most common cause of acute COPD exacerbation (AECOPD) is the respiratory tract infections. We sought to determine the bacteriological etiology of hospitalized acute exacerbations of COPD requiring hospitalization in consecutive two years. Methods. We aimed to determine the bacteriological etiology underlying in patients whom admitted to Uludag University Faculty of Medicine, Department of Pulmonary Medicine and hospitalized with AECOPD in the last two years. Medical records ...

  1. A system model of work flow in the patient room of hospital emergency department.

    Science.gov (United States)

    Wang, Junwen; Li, Jingshan; Howard, Patricia K

    2013-12-01

    Modeling and analysis of patient flow in hospital emergency department (ED) is of significant importance. In a hospital ED, the patients spend most of their time in the patient room and most of the care delivery services are carried out during this time period. In this paper, we propose a system model to study patient (or work) flow in the patient room of an ED when the resources are partially available. A closed and re-entrant process model is developed to characterize the care service activities in the patient room with limited resources of doctors, nurses, and diagnosis tests. Analytical calculation of patient's length of stay in the patient room is derived, and monotonic properties with respect to care service parameters are investigated. PMID:23589322

  2. Disaster preparation and the functioning of a hospital social work department during the Gulf War.

    Science.gov (United States)

    Ben Shahar, I

    1993-01-01

    The nature of the Gulf War and its consequences for the public at the personal and community levels, called for considerable alterations in organization and management at the Chaim Sheba Medical Center, the largest government general hospital in Israel, with constant adaptation to the changing situation. The preparations and exercises preceding the state of emergency, combined with the knowledge and experience gained in similar situations in the past, equipped the staff of the Social Work Department to function adequately and to make appropriate decisions and changes in the face of moral and ethical dilemmas, as well as immediate physical threat. This article presents the rationale for the model of intervention that guided the hospital during the Gulf War in offering services to casualty victims and their families. Also discussed are the process of developing an organizational framework and its content that meets wartime demands, and the implications for social work practice in dealing with a war crisis.

  3. Achieve Sustainable Hospital Excellence Through 5-S in an Emergency Department in Hong Kong

    Directory of Open Access Journals (Sweden)

    Tsoi Vincent F. K.

    2014-11-01

    Full Text Available 5-S is the first step towards TQM. Over the last century, the Japanese have formalised the technique and named it as 5-S Practice. Since 1993, Sam Ho has improved and defined its terms in English/Chinese and developed the world's first 5-S Audit Checklist. In the article, an emergency department of a Hong Kong hospital was examined against 5-S 50-point Checklist for the improvement of their quality assurance systems towards its accreditation process with Australian standards. The findings evidently reveal that the impact of 5-S on hospital quality assurance in the unit are positive. Riding on the above scenario, the research aim is to identify whether the 5-S practice is a suitable and effective tool for healthcare quality assurance in an emergency setting which is led towards its accreditation process set by other mechanisms.

  4. 78 FR 21631 - Fiscal Year 2013 Cost of Hospital and Medical Care Treatment Furnished by the Department of...

    Science.gov (United States)

    2013-04-11

    ... BUDGET Fiscal Year 2013 Cost of Hospital and Medical Care Treatment Furnished by the Department of Defense Medical Treatment Facilities; Certain Rates Regarding Recovery From Tortiously Liable Third... the cost of inpatient medical services furnished by military treatment facilities through...

  5. Patients’ receptiveness for Medical students during consultation in Out patient department of a teaching hospital in Karachi Pakistan

    OpenAIRE

    Laiq-uz-Zaman Khan, Muhammad; Jawaid, Masood; Hafeez, Kamran

    2013-01-01

    Objective: Patients’ attitude towards medical students’ presence during treatment depends on the cultural values of the society. This study was conducted to find out the patients’ receptiveness in our society to be involved in teaching process for medical students during consultation in out patient department of a teaching hospital in Karachi Pakistan. Methodology: This cross sectional study was conducted in the surgical Out Patient Department (OPD) at Dow University Hospital from May 2012 to...

  6. The effect of an active on-ward participation of hospital pharmacists in Internal Medicine teams on preventable Adverse Drug Events in elderly inpatients: protocol of the WINGS study (Ward-oriented pharmacy in newly admitted geriatric seniors)

    NARCIS (Netherlands)

    J.E. Klopotowska; P.C. Wierenga; S.E. de Rooij; C.C. Stuijt; L. Arisz; P.F. Kuks; M.G. Dijkgraaf; L. Lie-A-Huen; S.M. Smorenburg

    2011-01-01

    The potential of clinical interventions, aiming at reduction of preventable Adverse Drug Events (preventable ADEs) during hospital stay, have been studied extensively. Clinical Pharmacy is a well-established and effective service, usually consisting of full-time on-ward participation of clinical pha

  7. Hospitals

    DEFF Research Database (Denmark)

    Mullins, Michael

    2013-01-01

    The challenge could be briefly seen in these terms: hospitals as places for treatment where there’s a technology focus and hospitals for healing where there’s a human focus. In the 60s - 70s wave of new hospital building, an emphasis on technology can be seen. It’s time to move from the technology...... is to minimize the negative effects of stress inducing environments based on research results. Which stress inducing factors? We can look around at some old hospitals and see they are noisy, confusing, ugly, monotonous, hard, cold, artificial, and dark; qualitative terms which can indicate what we shouldn......’t be doing in hospitals. Design factors which should be carefully considered include: Light, as in daylight, artificial light, its color, its temperature, the level and quality of lighting and the effects of light on circadian rhythms. There is documented evidence in: users’ satisfaction, orientation, 24...

  8. [Social integration and contacts to reference persons of the normal social environment in inpatient treatment in the psychiatric hospital. A prospective catamnestic study of patients admitted for the first time with schizophrenic and cyclothymic psychoses].

    Science.gov (United States)

    Böcker, F M

    1984-01-01

    Fifty first-admission inpatients (27 women, 23 men; mean age 35.1 years) with schizophrenia (n = 35) or affective disorders (n = 15) participated in a standardized, half-open interview about contact with people outside the hospital. The frequency of contact was compared with outcome, as based on a 1-year follow-up. Nearly all patients (48 of 50) had "direct" contact with relatives and friends during the week (means = 3/week): 45 patients had visitors, 13 went home on weekends. Thirty-five patients had contact with the outside by telephone, and 21 by letter; only 12 patients indicated no "indirect" contact. The frequency of contact had no relationship to sex, age or diagnosis. The significant factors were: structure of the patient's family, his/her educational and occupational level, social network, means of admission, conditions of hospitalization, and length of stay. The distance between the patient's residence and the hospital markedly influenced the frequency of visits and weekend holidays. The importance of frequent interaction with the usual social environment was verified by follow-up: 11 patients with rare or only average contact had unfavorable results (readmission or suicide by 1 year after discharge or long-term hospitalization); on the other hand, none of the patients with frequent direct contact outside the hospital showed poor results. There is no reason for indiscriminate criticism of the relatives of psychiatric inpatients according to etiological hypotheses of "family research"; above all, patients without relationships with a family or friends have to be regarded as at risk.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:6526062

  9. The preliminary experience in the emergency department of a newly opened penitentiary institution hospital in Turkey

    Directory of Open Access Journals (Sweden)

    Bora Koc

    2014-01-01

    Full Text Available Background: Emergency cases become a widespread problem in prisons across Turkey. The opening of a new prison hospital in January 2012 within the catchment of Silivri Penitentiary Institution gave a unique opportunity to treat the inmates quickly. Aims: The study was to conduct an extensive review for documentation of prisoners′ healthcare problems leading to emergency admission following the first year after the opening of Penitentiary Institution Hospital and point to decrease redundant hospital transfers of this individual cohort. Materials and Methods: A cross-sectional study was carried out where 12,325 visits to the Silivri Penitentiary Institution Hospital for emergency visits from the period of 1 st January 2012 to the 31 st December 2012 were identified from electronic medical records. After obtaining consent from the local IRB, data including details of the type, cause and nature of the complaints of the illnesses were processed. Results: In the 12-month period, there were 12,325 visits to the emergency department, of which 4328 for surgical conditions (35.1%, 2684 for medical disorders (21.8%, 1867 for sports injuries (15.2%, 1327 for Ear Nose Throat (ENT problems (10.8%, 827 for psychiatric disorders (6.70%, 396 for violence injury (3.2%, 169 for self harm (1.4%, and 727 for miscellaneous (5.8%. The most common cause of emergency visits was sports injuries, followed by non-specific abdominal pain and ENT problems. Eighteen prisoners re-attended 243 times, ranging from 8 visits to a maximum of 56 visits. Conclusion: Inmates in prison have a wide range of complaints, and sometimes these complaints do not suggest an illness. Prison population exhibited substantially higher prevalence rates of diseases than the civilian population. We conclude that this new healthcare system in prisons will prevent redundant hospital transfers and guarantee detainees have access to the same health care that is offered to non-detained population.

  10. Emergency department physician training in Jamaica: a national public hospital survey

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    Williams Eric W

    2008-10-01

    Full Text Available Abstract Background Emergency Department (ED medical officers are often the first medical responders to emergencies in Jamaica because pre-hospital emergency response services are not universally available. Over the past decade, several new ED training opportunities have been introduced locally. Their precise impact on the health care system in Jamaica has not yet been evaluated. We sought to determine the level of training, qualifications and experience of medical officers employed in public hospital EDs across the nation. Methods A database of all medical officers employed in public hospital EDs was created from records maintained by the Ministry of Health in Jamaica. A specially designed questionnaire was administered to all medical officers in this database. Data was analyzed using SPSS Version 10.0. Results There were 160 ED medical officers across Jamaica, of which 47.5% were males and the mean age was 32.3 years (SD +/- 7.1; Range 23–57. These physicians were employed in the EDs for a mean of 2.2 years (SD +/- 2.5; Range 0–15; Median 2.5 and were recent graduates of medical schools (Mean 5.1; SD +/- 5.9; Median 3 years. Only 5.5% of the medical officers had specialist qualifications (grade III/IV, 12.8% were grade II medical officers and 80.5% were grade I house officers or interns. The majority of medical officers had no additional training qualifications: 20.9% were exposed to post-graduate training, 27.9% had current ACLS certification and 10.3% had current ATLS certification. Conclusion The majority of medical officers in public hospital EDs across Jamaica are relatively inexperienced and inadequately trained. Consultant supervision is not available in most public hospital EDs. With the injury epidemic that exists in Jamaica, it is logical that increased training opportunities and resources are required to meet the needs of the population.

  11. The Prevalence of Pemphigus (Razi Hospital and Department of Oral Pathology, Tehran University of Medical Sciences

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    Eshghyar N

    1999-12-01

    Full Text Available The aim of this retrospective statistical study was to determine the prevalcence and frequency of"nage and sex distributions of pemphigus disease. Pemphigus disease classified as autoimmune bullous"ndermatoses which is a chronic mucocutaneous disease."nThis study was performed in Razi Hospital and department of oral pathology of dental school, Tehran"nUniversity of Medical Sciences. The most frequently effected area was buccal moucosa of oral cavity. The"nmost rate of recurrence was found in oral cavity which being more common in middle age females (25-44"nyears.

  12. [Simulation of a hospital emergency department and its potential use in management].

    Science.gov (United States)

    Barber Pérez, P; González López-Valcárcel, B

    1994-01-01

    We developed a computer simulation model of Emergency Department Operations of the Hospital Ntra. Sra. del Pino as a queue system. We designed and analyzed alternative functional structures of the Department and their implications on resources organization and reallocation. We programmed the operations, relations and flows between the components of the system with the simulation language SIMSCRIPT II.5. We have designed alternative configurations to assess how technical efficiency could be improved through the reallocation of human resources; how the system react would to interarrival time of patients changes; and what decisions must be taken about resources allocation in order to improve efficiency. Triage, Emergency Laboratory and radiology have the maximum average waiting times (11, 31 and 12 minutes, respectively). Some alternative organization patterns may improve this problem. Their social cost is also quantified in this work.

  13. An Empirical Analysis of the Current Need for Teleneuromedical Care in German Hospitals without Neurology Departments.

    Science.gov (United States)

    Ickenstein, G W; Groß, S; Tenckhoff, D; Hausn, P; Becker, U; Klisch, J; Isenmann, S

    2010-01-01

    Indroduction. At present, modern telemedicine methods are being introduced, that may contribute to reducing lack of qualified stroke patient care, particularly in less populated regions. With the help of video conferencing systems, a so-called neuromedical teleconsultation is carried out. Methods. The study included a multicentered, completely standardized survey of physicians in hospitals by means of a computerized on-line questionnaire. Descriptive statistical methods were used for data analysis. Results. 119 acute hospitals without neurology departments were included in the study. The most important reasons for participating in a teleneuromedical network is seen as the improvement in the quality of treatment (82%), the ability to avoid unnecessary patient transport (76%), easier and faster access to stroke expertise (72%) as well as better competitiveness among medical services (67%). The most significant problem areas are the financing system of teleneuromedicine with regard to the acquisition costs of the technical equipment (43%) and the compensation for the stroke-unit center with the specialists' consultation service (31%) as well as legal aspects of teleneuromedicine (27%). Conclusions. This investigation showed that there is a high acceptance for teleneuromedicine among co-operating hospitals. However these facilities have goals in addition to improved quality in stroke treatment. Therefore the use of teleneuromedicine must be also associated with long term incentives for the overall health care system, particularly since the implementation of a teleneuromedicine network system is time consuming and associated with high implementation costs. PMID:20671991

  14. An Empirical Analysis of the Current Need for Teleneuromedical Care in German Hospitals without Neurology Departments

    Directory of Open Access Journals (Sweden)

    G. W. Ickenstein

    2010-01-01

    Full Text Available Indroduction. At present, modern telemedicine methods are being introduced, that may contribute to reducing lack of qualified stroke patient care, particularly in less populated regions. With the help of video conferencing systems, a so-called neuromedical teleconsultation is carried out. Methods. The study included a multicentered, completely standardized survey of physicians in hospitals by means of a computerized on-line questionnaire. Descriptive statistical methods were used for data analysis. Results. 119 acute hospitals without neurology departments were included in the study. The most important reasons for participating in a teleneuromedical network is seen as the improvement in the quality of treatment (82%, the ability to avoid unnecessary patient transport (76%, easier and faster access to stroke expertise (72% as well as better competitiveness among medical services (67%. The most significant problem areas are the financing system of teleneuromedicine with regard to the acquisition costs of the technical equipment (43% and the compensation for the stroke-unit center with the specialists' consultation service (31% as well as legal aspects of teleneuromedicine (27%. Conclusions. This investigation showed that there is a high acceptance for teleneuromedicine among co-operating hospitals. However these facilities have goals in addition to improved quality in stroke treatment. Therefore the use of teleneuromedicine must be also associated with long term incentives for the overall health care system, particularly since the implementation of a teleneuromedicine network system is time consuming and associated with high implementation costs.

  15. Hospitals - HOSPITALS_HSIP_IDHS_IN: Hospitals in Indiana as Developed for the Homeland Security Infrastructure Program (Indiana Department of Homeland Security, Point Shapefile)

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — HOSPITALS_HSIP_IDHS_IN is a point shapefile that contains hospital locations, as developed for the Homeland Security Infrastructure Program (HSIP). The data were...

  16. Glass injuries seen in the emergency department of a South African district hospital

    Directory of Open Access Journals (Sweden)

    Doudou Nzaumvila

    2015-02-01

    Full Text Available Background: The emergency department of Embhuleni Hospital frequently manages patients with glass-related injuries. This study assessed these injuries and the glass that caused them in more detail.Aim: The objectives of our study included determining the type of glass causing these injuries and describing the circumstances associated with different types of glass injuries.Setting: The emergency department of Embhuleni Hospital in Elukwatini, Mpumalanga province, South Africa.Methods: This was a cross-sectional study with a sample size of 104 patients. Descriptive statistics were used to assess the characteristics of the glass injuries.Results: Five different types of glass were reported to have caused the injuries, namely car glass (7.69%, glass ampoules (3.85%, glass bottles (82.69%, glass windows (3.85% and street glass shards (1.92%. Glass bottle injuries were mainly caused by assaults (90.47% and most victims were mostly young males (80.23%. The assaults occurred at alcohol-licensed premises in 65.11% of cases. These injuries occurred mostly over weekends (83.72%, between 18:00 and 04:00. The face (34.23% and the scalp (26.84% were the sites that were injured most often.Conclusion: Assault is the most common cause of glass injuries, usually involving young men at alcohol-licensed premises. Glass injuries generally resulted in minor lacerations, with few complications (2.68%.

  17. 76 FR 15349 - Fiscal Year 2011 Cost of Hospital and Medical Care Treatment Furnished by the Department of...

    Science.gov (United States)

    2011-03-21

    ... BUDGET Fiscal Year 2011 Cost of Hospital and Medical Care Treatment Furnished by the Department of Defense Medical Treatment Facilities; Certain Rates Regarding Recovery From Tortiously Liable Third... furnished by military treatment facilities through the Department of Defense (DoD). The rates have...

  18. 75 FR 24754 - Cost of Hospital and Medical Care Treatment Furnished by the Department of Defense Military...

    Science.gov (United States)

    2010-05-05

    ... BUDGET Cost of Hospital and Medical Care Treatment Furnished by the Department of Defense Military Treatment Facilities; Certain Rates Regarding Recovery From Tortiously Liable Third Persons AGENCY: Office... inpatient medical services furnished by military treatment facilities through the Department of Defense...

  19. 急性横贯性脊髓炎患者住院时间及其影响因素分析%Factors associated with length of hospitalization in patients admitted with transient acute transverse myelitis

    Institute of Scientific and Technical Information of China (English)

    昌传良; 王翔

    2015-01-01

    目的 探讨急性横贯性脊髓炎患者的住院时间及其影响因素,为减少住院时间寻找有效解决方法.方法 回顾性分析以"急性横贯性脊髓炎"为第一诊断的158例出院患者的病历资料.通过病案号查阅原始病历,补充相关资料.主要包括人口学资料以及神经功能缺损程度、合并症、并发症方面资料.结果 住院时间4.00~41.00 d,平均(17±6)d,其中住院时间≤10 d组23例(14.56%)、>10~<20 d组83例(52.53%)、≥20 d组52例(32.91%).3组年龄、神经功能评分比较差异均有统计学意义(F值分别为60.90、8.68,P均<0.05);3组自费、高血压、糖尿病、尿路感染、深静脉血栓形成比较差异均有统计学意义(x2值分别为20.04、14.27、12.17、9.37、7.05,JP均<0.05).急性横贯性脊髓炎与年龄、神经功能评分、交费方式相关(OR值分别为1.140、0.500、83.930和0.041,P均<0.05).结论 疾病本身所致神经功能缺损程度轻重是影响住院时间的最主要因素;控制院内感染、预防深静脉血栓形成、强化医保管理是缩短平均住院日的有效措施.%Objective To evaluate the days of hospitalization of acute transverse myelitis and its influencing factors.Methods File's of 158 patients with acute transverse myelitis as the first diagnosis in Feicheng Mining Centre Hospital were analyzed retrospectively.Access to the original medical records through the medical record number, and supplemented information, mainly including demographic data, neurological function defect degree, complications and complications.Results Hospitalization time was 4-41 d, an average of (17±6) d,including 23 patients hospitalized time ≤ 10 d(14.56%), 83 cases were > 10-<20 d(52.53%), 52 cases was≥20 d(32.91%).Age and Neurological score comparative differences are statistically significant (F=60.90,8.68, P<0.05).Payment method, deep vein thrombosis, comparative differences were statistically

  20. Evaluation of natural language processing from emergency department computerized medical records for intra-hospital syndromic surveillance

    Directory of Open Access Journals (Sweden)

    Pagliaroli Véronique

    2011-07-01

    Full Text Available Abstract Background The identification of patients who pose an epidemic hazard when they are admitted to a health facility plays a role in preventing the risk of hospital acquired infection. An automated clinical decision support system to detect suspected cases, based on the principle of syndromic surveillance, is being developed at the University of Lyon's Hôpital de la Croix-Rousse. This tool will analyse structured data and narrative reports from computerized emergency department (ED medical records. The first step consists of developing an application (UrgIndex which automatically extracts and encodes information found in narrative reports. The purpose of the present article is to describe and evaluate this natural language processing system. Methods Narrative reports have to be pre-processed before utilizing the French-language medical multi-terminology indexer (ECMT for standardized encoding. UrgIndex identifies and excludes syntagmas containing a negation and replaces non-standard terms (abbreviations, acronyms, spelling errors.... Then, the phrases are sent to the ECMT through an Internet connection. The indexer's reply, based on Extensible Markup Language, returns codes and literals corresponding to the concepts found in phrases. UrgIndex filters codes corresponding to suspected infections. Recall is defined as the number of relevant processed medical concepts divided by the number of concepts evaluated (coded manually by the medical epidemiologist. Precision is defined as the number of relevant processed concepts divided by the number of concepts proposed by UrgIndex. Recall and precision were assessed for respiratory and cutaneous syndromes. Results Evaluation of 1,674 processed medical concepts contained in 100 ED medical records (50 for respiratory syndromes and 50 for cutaneous syndromes showed an overall recall of 85.8% (95% CI: 84.1-87.3. Recall varied from 84.5% for respiratory syndromes to 87.0% for cutaneous syndromes. The

  1. Racial Disparity in Duration of Patient Visits to the Emergency Department: Teaching Versus Non-teaching Hospitals

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    Zynal Karaca

    2013-09-01

    Full Text Available Introduction: The sources of racial disparity in duration of patients’ visits to emergency departments (EDs have not been documented well enough for policymakers to distinguish patient-related factors from hospital- or area-related factors. This study explores the racial disparity in duration of routine visits to EDs at teaching and non-teaching hospitals.Methods: We performed retrospective data analyses and multivariate regression analyses to investigate the racial disparity in duration of routine ED visits at teaching and non-teaching hospitals. The Healthcare Cost and Utilization Project (HCUP State Emergency Department Databases (SEDD were used in the analyses. The data include 4.3 million routine ED visits encountered in Arizona, Massachusetts, and Utah during 2008. We computed duration for each visit by taking the difference between admission and discharge times.Results: The mean duration for a routine ED visit was 238 minutes at teaching hospitals and 175 minutes at non-teaching hospitals. There were significant variations in duration of routine ED visits across race groups at teaching and non-teaching hospitals. The risk-adjusted results show that the mean duration of routine ED visits for Black/African American and Asian patients when compared to visits for white patients was shorter by 10.0 and 3.4%, respectively, at teaching hospitals; and longer by 3.6 and 13.8%, respectively, at non-teaching hospitals. Hispanic patients, on average, experienced 8.7% longer ED stays when compared to white patients at non-teaching hospitals.Conclusion: There is significant racial disparity in the duration of routine ED visits, especially in non-teaching hospitals where non-White patients experience longer ED stays compared to white patients. The variation in duration of routine ED visits at teaching hospitals when compared to non-teaching hospitals was smaller across race groups. [West J Emerg Med. 2013;14(5:529–541.

  2. A Simple Clinical Score “TOPRS” to Predict Outcome in Pediatric Emergency Department in a Teaching Hospital in India

    OpenAIRE

    Ravinder Kumar Soni; Bains, Harmesh S.

    2012-01-01

    Objective: To develop a simple clinical scoring system for severity of illness to help prioritize care and predict outcome in emergency department.Methods: Prospective hospital based observational study. Out of a total of 874 children who attended emergency department in one year, 777 were included in the study. Data was collected at the time of admission in emergency department. The baseline information like age, gender, etc and variables of ‘toprs’ score viz temperature, oxygen saturation, ...

  3. Closed pelvic fractures: characteristics and outcomes in older patients admitted to medical and geriatric wards

    OpenAIRE

    Morris, R.; Sonibare, A.; Green, D.; Masud, T.

    2000-01-01

    OBJECTIVE—To investigate the characteristics and outcomes of older patients with pelvic fracture admitted to medical and geriatric wards.
METHODS—All patients admitted to medical and geriatric wards with a pelvic fracture over a four year period were identified using the hospital clinical coding database. Data were collected from casenotes, hospital and Family Health Services Authority databases. Where available, pelvic radiographs were graded according to the Singh index.
RESULTS—The casenot...

  4. Analysis of epidemiological and clinical characteristics of patients admitted diagnosed with acute ischemic cerebrovascular event in internal medicine services and neurology of the Hospital Mexico in March 2013 to March 2014

    International Nuclear Information System (INIS)

    Records of 100 patients were revised with diagnosis of ischemic cerebrovascular event in the neurology and internal medicine at the Hospital Mexico since March 2013 to March 2014. A total of 46 patients were men and 54 were women. The overall mean age was 69 years, for men have been 66 years and for women from 71. Patients of all provinces were entered main of San Jose with 56% followed by 19% Alajuela. The hospital management by specialty was distributed 60% to internal medicine and 40% neurology. The risk factors most frequently found were: hypertension 85%, diabetes mellitus 40%, smoking 35%, and dyslipidemia 35%. Overweight was observed in 23% of patients and 22% obese. As for the initial clinical manifestations documented in the first physical examination, the 6 most frequently found have been: faciobrachiocrural hemiparesis 60%, delirium 22%, dysarthria 22%, headache 20%, nausea and/or vomiting 17% and aphasia 15%. A total of 13% of patients have altered the consciousness and 5% have required ventilatory support for first 24 hours of evolution. 27% of patients have arrived within the first 3 hours of onset of symptoms, 11% between 3 to 4.5 hours and the remaining 62% beyond 4.5 hours of duration. 70% of patients have had 1 or more comorbidities prior to the event, the top 5 have been: ischemic heart disease 31%, 29% atrial fibrillation, cerebrovascular disease 19%, 16% chronic kidney disease and congestive heart failure by 12%. Regarding the topographic classification of stokes, 16% were TACI, PACI 46%, 27% LACI and POCI only 11%. The average NIHSS scale has been 9 points to admission, 10 to 48 hours and 6 points at the time of discharge. Regarding brain scan on admission to 98% of the patients were performed while that between 48-72 hours alone to 74%. The most common initial tomographic CT findings have been: 49% lucency of more than 1/3 of middle cerebral artery territory, without alteration 46%, 8% cerebral edema data and 8% midline deviation. Hemorrhagic

  5. Abnormal vital signs are strong predictors for intensive care unit admission and in-hospital mortality in adults triaged in the emergency department - a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Barfod Charlotte

    2012-04-01

    Full Text Available Abstract Background Assessment and treatment of the acutely ill patient have improved by introducing systematic assessment and accelerated protocols for specific patient groups. Triage systems are widely used, but few studies have investigated the ability of the triage systems in predicting outcome in the unselected acute population. The aim of this study was to quantify the association between the main component of the Hillerød Acute Process Triage (HAPT system and the outcome measures; Admission to Intensive Care Unit (ICU and in-hospital mortality, and to identify the vital signs, scored and categorized at admission, that are most strongly associated with the outcome measures. Methods The HAPT system is a minor modification of the Swedish Adaptive Process Triage (ADAPT and ranks patients into five level colour-coded triage categories. Each patient is assigned a triage category for the two main descriptors; vital signs, Tvitals, and presenting complaint, Tcomplaint. The more urgent of the two determines the final triage category, Tfinal. We retrieved 6279 unique adult patients admitted through the Emergency Department (ED from the Acute Admission Database. We performed regression analysis to evaluate the association between the covariates and the outcome measures. Results The covariates, Tvitals, Tcomplaint and Tfinal were all significantly associated with ICU admission and in-hospital mortality, the odds increasing with the urgency of the triage category. The vital signs best predicting in-hospital mortality were saturation of peripheral oxygen (SpO2, respiratory rate (RR, systolic blood pressure (BP and Glasgow Coma Score (GCS. Not only the type, but also the number of abnormal vital signs, were predictive for adverse outcome. The presenting complaints associated with the highest in-hospital mortality were 'dyspnoea' (11.5% and 'altered level of consciousness' (10.6%. More than half of the patients had a Tcomplaint more urgent than Tvitals

  6. A proposed simulation optimization model framework for emergency department problems in public hospital

    Science.gov (United States)

    Ibrahim, Ireen Munira; Liong, Choong-Yeun; Bakar, Sakhinah Abu; Ahmad, Norazura; Najmuddin, Ahmad Farid

    2015-12-01

    The Emergency Department (ED) is a very complex system with limited resources to support increase in demand. ED services are considered as good quality if they can meet the patient's expectation. Long waiting times and length of stay is always the main problem faced by the management. The management of ED should give greater emphasis on their capacity of resources in order to increase the quality of services, which conforms to patient satisfaction. This paper is a review of work in progress of a study being conducted in a government hospital in Selangor, Malaysia. This paper proposed a simulation optimization model framework which is used to study ED operations and problems as well as to find an optimal solution to the problems. The integration of simulation and optimization is hoped can assist management in decision making process regarding their resource capacity planning in order to improve current and future ED operations.

  7. An audit of letters of referral to a prosthodontic department in a dental teaching hospital.

    Science.gov (United States)

    Fenlon, Michael R; Glick, Shiri; Sherriff, Martyn

    2008-09-01

    The purpose of this study was to investigate the quality and number of letters of referral for new patients received in the Prosthodontics Department of a Dental Teaching Hospital. Letters received during the month of May 2006 were included. Each letter of referral was tested against five criteria which might be expected in an appropriate letter of referral. These were information on the following: relevant dental history, relevant medical history, teeth present, diagnosis, and treatment plan. The results showed that only 8% of letters met all five criteria and 11% met none of them. Letters requesting better information were sent to referring practitioner as a result of this audit. However a re-audit in May 2007 showed that 9% of letters met all five criteria and 15% met none of them. A need has been identifiedfor better referral letters and ways of achieving this were discussed.

  8. Needlestick injury among medical personnel in Accident and Emergency Department of two teaching hospitals.

    Science.gov (United States)

    Ng, Y W; Hassim, I Noor

    2007-03-01

    Needlestick injury has been recognized as one of the occupational hazards which results in transmission of bloodborne pathogens. A cross-sectional study was carried out among 136 health care workers in the Accident and Emergency Department of two teaching hospitals from August to November 2003 to determine the prevalence of cases and episodes of needlestick injury. In addition, this study also assessed the level of knowledge of blood-borne diseases and Universal Precautions, risk perception on the practice of Universal Precautions and to find out factors contributing to needlestick injury. Prevalence of needlestick injury among the health care workers in the two hospitals were found to be 31.6% (N = 43) and 52.9% (N = 87) respectively. Among different job categories, medical assistants appeared to face the highest risk of needlestick injury. Factors associated with needlestick injury included shorter tenure in one's job (p risk of needlestick injury while performing procedures on patients. Therefore, comprehensive infection control strategies should be applied to effectively reduce the risk of needlestick injury. PMID:17682562

  9. A structured approach to transforming a large public hospital emergency department via lean methodologies.

    Science.gov (United States)

    Naik, Trushar; Duroseau, Yves; Zehtabchi, Shahriar; Rinnert, Stephan; Payne, Rosamond; McKenzie, Michele; Legome, Eric

    2012-01-01

    Emergency Departments (EDs) face significant challenges in providing efficient, quality, safe, cost-effective care. Lean methodologies are a proposed framework to redesign ED practices and processes to meet these challenges. We outline a systematic way that lean principles can be applied across the entire ED patient experience to transform a high volume ED in a safety net hospital. We review the change in ED performance metrics prior to and after lean implementation. We discuss critical insights and key lessons learned from our lean transformation to date. The steps to implementing lean principles across the patient's ED experience are described with specific attention to executive planning of rapid improvement experiments and the subsequent roll-out of lean transformation over an 18-month time frame. Basic ED performance data were compared to the year prior. Results of the exploratory analysis (using median and interquartile ranges and nonparametric tests for group comparisons) have shown improvement in several performance metrics after initiating lean transformation. The approach, lessons learned, and early data of our transformation can provide critical insights for EDs seeking to incorporate continuous improvement strategies. Key lessons and unique challenges encountered in safety net hospitals are discussed.

  10. Demographic Analysis of Emergency Department Patients at the Ruijin Hospital, Shanghai

    Directory of Open Access Journals (Sweden)

    Wim Lammers

    2011-01-01

    Full Text Available Emergency medicine is an upcoming discipline that is still under development in many countries. Therefore, it is important to gain insight into the organization and patients presenting to the Emergency Department (ED. The aim of this cross-sectional study was to provide an epidemiological description of complaints and referrals of the patients visiting the ED of the Ruijin Hospital in Shanghai, China. A questionnaire was developed and completed for a convenience sample of all patients presenting to the Triage Desk of the ED. The study was performed in June 2008. A total of 2183 questionnaires were completed. The most common complaints were fever (15%, stomach/abdominal pain (15%, vertigo/dizziness (11%, and cough (10%. Following triage, patients were predominantly referred to an internist (41%, neurologist (14%, pulmonologist (11%, or general surgeon (9%. This study provides a better understanding of the reason for the ED visit and the triage system at the ED of the Ruijin Hospital. The results can be used in order to improve facilities appropriate for the specific population in the ED.

  11. Drug utilization study in the otorhinolaryngology department in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    S. A. Sridevi

    2013-06-01

    Full Text Available Background: Drug utilization is defined by the World Health Organization (WHO as the marketing, distribution, prescription, and use of drugs in society, with special emphasis on the resulting medical, social, and economic consequences. The aim of this study was to evaluate the pattern of prescription and then drug utilization in outpatient (OPD of the Department of Otolaryngology in a tertiary care teaching hospital. Methods: This was a retrospective study conducted at the A.C.S. medical college and hospital, Chennai for a period of 7 months. All the patients who attended the Ear Nose and Throat (ENT OPD were included. The total number who attended the OPD was 10,249 which include 6,956 new cases and 3313 old cases. Results: The antibacterials commonly used were β Lactams (56%, macrolides (14%, fluoroquinolones (12%, aminoglycosides (8%. Among the penicillin group, the commonest drug prescribed was a combination of amoxicillin and clavulanic acid (27%, in cephalosporins was cefixime + clavulanic acid (19%. Aminoglycosides include gentamycin in refractory cases. Fluoroquinolones include ciprofloxacin and levofloxacin. Others Drugs like antihistamines and mucolytics were prescribed in 27%, anti- ulcer drugs in 36% cases, analgesics in 33% cases and herbal medicines in 4%. The average number of drugs used in each prescription was 3.20. All the drugs were prescribed with brand names. The average cost per prescription per day for OPD patients is 37 Rupees. Conclusions: β Lactams were commonly used antibacterials in the otorhinolaryngology department. [Int J Basic Clin Pharmacol 2013; 2(3.000: 306-310

  12. Characteristics of patients presenting to the vascular emergency department of a tertiary care hospital: a 2-year study

    Directory of Open Access Journals (Sweden)

    Kotsikoris Ioannis

    2011-11-01

    Full Text Available Abstract Background The structure of health care in Greece is receiving increased attention to improve its cost-effectiveness. We sought to examine the epidemiological characteristics of patients presenting to the vascular emergency department of a Greek tertiary care hospital during a 2-year period. We studied all patients presenting to the emergency department of vascular surgery at Red Cross Hospital, Athens, Greece between 1st January 2009 and 31st December 2010. Results Overall, 2452 (49.4% out of 4961 patients suffered from pathologies that should have been treated in primary health care. Only 2509 (50.6% needed vascular surgical intervention. Conclusions The emergency department of vascular surgery in a Greek tertiary care hospital has to treat a remarkably high percentage of patients suitable for the primary health care level. These results suggest that an improvement in the structure of health care is needed in Greece.

  13. ANALYSIS OF COST STRUCTURE FOR PHARMACOTHERAPY OF PATIENTS WITH STABLE ANGINA (THE CASE OF CARDIOLOGY DEPARTMENT OF TVER REGIONAL CLINICAL HOSPITAL

    Directory of Open Access Journals (Sweden)

    M. A. Demidova

    2015-12-01

    Full Text Available Aim. To analyze the cost structure for pharmacotherapy of patients with stable angina (SA, in particular, to compare the cost of pharmacotherapy with drugs, both included and not included into the official Standard of care (SC. Material and methods. Medical records of patients with SA (n=100 admitted to the cardiology department of Tver Regional Clinical Hospital in January-July 2010 were studied retrospectivelly. Costs of treatment with drugs specified in SC for patients with SA as well as drugs not included in SC were considered. Costs of pharmacotherapy and cost structure were determined. Pharmacoeconomical methods, especially ABC analysis, were partially used.  Results. Totally 65502.39 ruble was spent for pharmacotherapy of 100 patients with SA. Cost structure was the following: 32679.34 ruble was spent for drugs recommended by SC, 23698.18 ruble — for drugs not included in SC, and 9124.87 ruble — for drugs to treat concomitant diseases which are not taken into account by SC for patients with SA. Conclusion. SA pharmacotherapy counts 50% of the total cost for drugs recommended by SC, 36% — for drugs not included in SC but belonged to pharmacological class presented in SC, and 14% — drugs from pharmacological class not included in SC. In the process of new SC elaboration for SA patients it is necessary to take into account treatment costs of concomitant diseases especially diabetes mellitus which can account up to 9.5% of total treatment cost of SA patients.

  14. 国外节假日入院的危重患者死亡率高的启示%Enlightenment of High Death Rate of Critically Ill Patients Admitted to Hospital during Holiday

    Institute of Scientific and Technical Information of China (English)

    黄建

    2012-01-01

    In industrial countries, medical personnel on duty in hospital are often less than usual during weekend or holidays, but the emergency patients were in accord with and usual number, which may cause a high mortality rate. In order to prevent relative medical risk, through the introduction of the references published in the New England Journal of Medicine, this paper summarized the experiences: making clear about the time limit, strictly in diseases and control; objectively analyzing large quantities of data, expounding the possible causes of the results; paying attention to solving issues, reduce the medical risk for patients.%在工业化国家,周末或节假日在医院值班的医护人员往往比平时少,但每天的急症患者数量与平时大体一致,这可能导致周末或节假日入院的危重患者死亡率较高.为了防范相关医疗风险,需要关注、解决有关问题.通过介绍发表在《新英格兰医学杂志》上的资料,总结经验:明确时限范围,严格病种纳入与对照;客观分析大量数据,阐述结果的可能原因;关注解决相关问题,降低患者医疗风险.

  15. Quality control programme established in the Nuclear Medicine Department of the Vancouver Coastal Health Authority Hospitals

    International Nuclear Information System (INIS)

    The Vancouver Coastal Health Authority (VCH) covers a large area of Southern British Columbia that includes 14 hospitals. Five of them have Nuclear Medicine (NM) departments with a total of 18 cameras of different ages and produced by different manufacturers. A flawless operation of these cameras is of paramount importance for the accuracy of diagnostic studies. Consequently, a comprehensive quality control (QC) programme has been designed to detect changes in their performance that might degrade the accuracy of clinical images. The most extensive testing is done at acceptance of the new equipment, simpler tests continue regularly throughout the whole period of camera operation. The tests are based on the National Electrical Manufacturers Association (NEMA) recommendations on how to perform QC experiments and how to analyse the results. The QC programme in all five NM departments follows the same principles. It is supervised by a 'regional' physicist. Initially, however, problems were encountered. At first, analysis of the QC data coming from these different cameras was seriously hindered by the lack or rigidity of the proprietary manufacturers' software. In particular, it was very difficult, if not impossible, to reliably compare the performance of different systems. An additional problem was caused by the large distances between hospital departments which made regular consultations by the physicist and test supervision difficult. In this paper, we present a practical solution to these problems and discuss our particular implementation of a QC programme that covers 18 cameras and unites five busy NM departments. To address the first problem and make the analysis of test results reliable and camera independent, we have developed a software application 'Nuclear Medicine QC' (NMQC) which implements the basic scintillation camera QC analyses and follows exactly the most recent NEMA standard. Our software allows multiple types of QC tests to be analysed within a single

  16. 非血液肿瘤和儿科重症监护病房内儿童侵袭性真菌病的高危因素分析%Risk factors of invasive fungal infections in patients admitted to non-hematological oncology department and pediatric intensive care unit

    Institute of Scientific and Technical Information of China (English)

    赵成松; 赵顺英; 刘钢; 徐樨巍

    2013-01-01

    Objective To determine risk factors of invasive fungal infections (IFI) in patients admitted to non-hematological oncology department and pediatric intensive care unit (PICU),in order to improve diagnostic level of invasive fungal infections.Method We retrospectively assessed 85 hospitalized pediatric patients with invasive fungal infections in Beijing Children's Hospital Affiliated to Capital Medical University from Jan.2007 to Nov.2012.All the cases were either from non-hematological oncology department or the PICU.We reviewed risk factors of invasive fungal infections.Result Among 85 patients,42 had invasive candida infection,20 invasive aspergillus infection,21 cryptococcus infection,I Histoplasma capsulatum infection and 1 Mucor mucedo infection.In the 42 patients with invasive candida infection,5 were young infants,3 had combined immunodeficiency,1 cellular immunodeficiency,25 secondary infection due to long term use of corticosteroids and/or combined use of more than 2 kinds of antibiotics with primary disease,5 prior intestinal tract surgery or chronic diarrheal disease,1 reflux gastritis.In the 20 patients with invasive aspergillosis infection,10 patients had chronic granulomatous disease,5 long term use of corticosteroids ≥ 1 month,3 long term use of corticosteroids and combined use of more than 2 kinds of antibiotics,2 had no apparent host factors.In the 21 patients with cryptococcus infection,2 patients had used corticosteroids ≥ 1 month,2 had immunodeficiency mainly for lack of antibodies,while others had no apparent host factors.The child with Mucor mucedo infection had diabetes mellitus.And the one with Histoplasma capsulatum infection had immunodeficiency.Conclusion High risk factors for IFI in patients admitted to non-hematological oncology department and PICU are primary immunodeficiency disease and long term use of corticosteroids and/or long term combined use of more than 2 kinds of antibiotics.Besides,young infant is also a high risk factor

  17. In-Hospital Outcome of Patients with Cardiogenic Shock Complicating Acute Myocardial Infarction: Results from Royal Hospital Percutaneous Coronary Intervention Registry, Oman

    OpenAIRE

    Islam, Mohammad S.; Prashanth Panduranga; Mohammed Al-Mukhaini; Abdullah Al-Riyami; Mohammad El-Deeb; Said Abdul Rahman; Mohammed B. Al-Riyami

    2016-01-01

    Objectives: Cardiogenic shock (CS) is still the leading cause of in-hospital mortality in patients presenting with acute myocardial infarction (AMI). The aim of this study was to determine the in-hospital mortality and clinical outcome in AMI patients presenting with CS in a tertiary hospital in Oman. Methods: This retrospective observational study included patients admitted to the cardiology department between January 2013 and December 2014. A purposive sampling technique was used, and 6...

  18. HCAHPS - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...

  19. Hospital Compare

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Compare has information about the quality of care at over 4,000 Medicare-certified hospitals across the country. You can use Hospital Compare to find...

  20. 50th Year Anniversary of Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University.

    Science.gov (United States)

    Lertakyamanee, Jariya

    2016-05-01

    Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, has started to be a formal anesthesia division, divided from division of Surgery in 1965; hence our 50th year anniversary in 2015. Research is now a priority and mandatory mission, according to the vision of Mahidol University. Second mission is to teach and train, and we produce the highest number of states-of-the-art anesthesiologists and anesthetic nurses each year Curriculum and training are being continuously improved. From a small unit, now it is one of the largest departments and extends the service, our third mission, to more than only in the operating theaters. We look after pre-anesthesia assessment, inside and outside operating room anesthesia, post-operative pain relief Intensive Care Unit, and chronic pain management. The number of patients and their diseases increase; so do the complexities of surgeries. There are tremendous changes in drugs and equipment. There is the fourth mission on administration, IT and resource management. And the fifth mission which is corporate social responsibility. However, we still believe that compassion, responsibility and integrity are most important. We have taught and tried to live by the teaching of HRH the King's Father. And these will contribute to our progress and shine in the next 50 years. PMID:27501620

  1. Perfil dos idosos internados no Hospital Geral em Belém (Pará Perfil de los ancianos internados en el Hospital General en Belém (Pará Brasil Profile of the elderly admited in a General Hospital at Belém (Pará - Brazil

    Directory of Open Access Journals (Sweden)

    Maria Izabel Penha de Oliveira Santos

    2007-03-01

    Full Text Available O estudo objetivou identificar o perfil dos idosos internados em um hospital geral da rede pública de saúde em Belém (Pará. Estudo transversal, retrospectivo, analítico. Foram analisadas variáveis sociodemográficas, causas da internação, tempo de permanência, complicações e dependência para cuidados de enfermagem, em 160 prontuários, em 2001. A análise estatística foi processada pelo programa eletrônico Epi-info 6.04. Os resultados apontam: A idade variou entre 65 e 74 anos (43,1%, e os idosos eram do sexo masculino (53,1%. A maior freqüência das internações foi por doenças respiratórias (53,7%; os sintomas evidentes foram dispnéia, hipertemia e hipertensão; e o tempo médio de permanência foi de 16 dias. O tempo de internação prolongado aparece como um fator de risco no desenvolvimento de incapacidades, pela imobilidade no leito, complicações como úlceras de decúbito e demais iatrogenias. Houve dependência para os cuidados de enfermagem e necessidade de intervenção interdisciplinar.El estudio tiene como objetivo identificar el perfil de ancianos hospitalizados en hospital general de salud pública, en Belém, Estado Pará. Estudio cuantitativo, retrospectivo y analitico. Analizadas variables sócio-demográficas, causas de internación, tiempo de permanencia, complicaciónes y dependencias de la enfermería en muestra de 160 historias en 2001. Analisys estadística fué a través del programa electrónico Epi-info 6.04. Los resultados apuntaran: La edad varió de 64 a 74 años (43, y 85 (53,1% y los ancianos eran del sexo masculino, la major frecuencia de la internaciónes fueron enfermedades respiratorias (53,7%, los síntomas evidentes disnea, hipertermia na hipertensión, tiempo promedio de 16 dias. Los ancianos se internaron en media dos veces al año , tiempo de internación largo aparece como factor de riesgo en el desarrollo de incapacidad, por la inmobilidad en las camas, complicaciónes como úlceras

  2. Perfil dos idosos internados no Hospital Geral em Belém (Pará) Perfil de los ancianos internados en el Hospital General en Belém (Pará Brasil) Profile of the elderly admited in a General Hospital at Belém (Pará - Brazil)

    OpenAIRE

    Maria Izabel Penha de Oliveira Santos

    2007-01-01

    O estudo objetivou identificar o perfil dos idosos internados em um hospital geral da rede pública de saúde em Belém (Pará). Estudo transversal, retrospectivo, analítico. Foram analisadas variáveis sociodemográficas, causas da internação, tempo de permanência, complicações e dependência para cuidados de enfermagem, em 160 prontuários, em 2001. A análise estatística foi processada pelo programa eletrônico Epi-info 6.04. Os resultados apontam: A idade variou entre 65 e 74 anos (43,1%), e os ido...

  3. Admissions and transfers from a rural emergency department.

    OpenAIRE

    De Freitas, T. L.; Spooner, G. R.; Szafran, O.

    1998-01-01

    OBJECTIVE: To examine the characteristics of patients transferred from a rural hospital emergency department, to compare them with patients admitted on an emergency basis, and to use this information to help plan physician education. DESIGN: Descriptive study using records for the period January 1, 1991, to June 30, 1992. SETTING: The emergency department at Bonnyville Health Centre, an acute care rural hospital located 240 km northeast of Edmonton, serving a catchment population of approxima...

  4. How do patients come to the Accident and Emergency Department of RIPAS Hospital?

    Directory of Open Access Journals (Sweden)

    Po Thaw DA

    2012-06-01

    Full Text Available Introduction: The mode and speed of transportation to the Accident and Emergency Department (AED of hospitals is very important for critically ill patients. This study looked at the mode of transportation to the AED at the Raja Isteri Pengiran Anak Saleha (RIPAS Hospital. Materials and Methods: Three different time periods: Period A from 15th May to 31st May 2004, (17 days, n=2,170 without prioritising, Period B from 1st January 2004 to 31st July 2006 (31 months, n=235 dead on arrival and resuscitation cases, and Period C from 20th to 26th November 2006 (7 days, all Priority Cases 1 to 3 were reviewed. Data on mode of transportation and triage categories were extracted from the ambulance response sheets. Results: During Period A, the main mode of transportation to the AED was private vehicles (90.7% followed by ambulance (7.9%, and other transportation (1.4%. During study Period B, the main mode of transportation was also private transports (50.2% followed closely by ambulance (48.5% and other transportation (1.3%. During Period C, Priority 1 cases (life-threatening conditions, n=7, most were transported with private transport (71.4% followed by ambulance (28.6%; Priority 2 (n=232 cases, majority were transported with private transport (89.2%, followed by ambulance (10.3%, and one case used police transportation; and in Priority 3 cases (non-life threatening conditions, n=1,010, almost all were transported with private transport (98.7%, followed by police (0.9% and ambulance (0.4% respectively. Conclusion: Utilisation of designated emergency transportation is low especially for the moderate to seriously ill (Priority 1 and 2 patients when compared to other well developed countries. More needs to be done to improve the usage of emergency transportations especially for the seriously ill cases.

  5. Services quality in emergency department of Nemazee Hospital: Using SERVQUAL model

    Directory of Open Access Journals (Sweden)

    Maryam Gholami

    2016-10-01

    Full Text Available Introduction: Patient satisfaction is crucial to the long-run success in health care center. With regard to the highest patients’ referral to the emergency department and the existing challenges due to the patient’s need to urgent care, we aimed to evaluate health care services quality in this unit to find out whether the patients have different expectations from health care providers and if they perceive some dimensions of care more important than others. Method: The SERVQUAL scale method was used in this cross-sectional study on 100 patients in June 2015. Patient satisfaction questionnaire based on SERVQUAL model was evaluated with high content validity and the reliability was 0.97 and 0.81. The data collected were analyzed using SPSS, version 20.0 (IBM, USA. Statistical analyses included descriptive statistics, paired and independence sample t-test and ANOVA at the significance level 0.05. Results:The results showed that the quality gap in all dimensions was significant (P<0.001. The largest quality gap was related to responsiveness (-1.08 and the lowest belonged to assurance (-0.8. Demographic characteristics were analyzed and the number of referrals was significant in tangibility and assurance dimensions (P = 0.04; also, in all cases the patients’ expectations (total Mean=4.35 were higher than their perception (total Mean = 3.295. Conclusion: In order to improve emergency services, it is recommended that the hospital management should provide appropriate facilities, reduce waiting time, increase in attention to ordering system based on the patients’ condition, and improve the behavior of health care personnel to patient is placed on the agenda of hospital management.

  6. Internal quality audit and quality standards as a method of quality improvement at the Department of Ophthalmology, University Hospital.

    Science.gov (United States)

    Nasić, Mirjana; Pokupec, Rajko; Katusić, Damir; Miklić, Pavle; Suić, Ivan; Galić, Slobodan

    2005-01-01

    Quality assessment of clinical health care with the programme of quality standard is a method of health management, through which better efficiency and safety of health outcomes can be achieved. In the period from 2002 to 2004, a pilot program of quality has been carried out on the Department of Ophthalmology, University Hospital Center in Zagreb. Seven internal audit teams of hospital commission and teams of hospital departments were evaluating introducing practice for quality standards every three months. In the period of two years improvement in all standards of quality has been noticed (expressed in percent of progress towards the ideal result of 100%): personnel 20%, patient rights 15%, medical equipment 40%, quality of emergency service 60%, implementation of clinical guidelines and criteria for elective admission 55%, quality of risk prevention 70%, quality of medical records 60%. The two-years-improvement dynamics of about 46%, first year 24%.

  7. A Descriptive Survey of the Information Needs of Parents of Children Admitted for Same Day Surgery.

    LENUS (Irish Health Repository)

    Healy, Kathy

    2012-08-11

    Going to the hospital for surgery is an event that most people may find daunting. Anticipation of the unknown, lack of control over events and unfamiliarity with the environment may result in feelings of anxiety and stress. This research paper used a quantitative descriptive survey to establish the information needs of parents of children admitted for same day surgery. The main aims of this study were to establish what information parents had received prior to their child\\'s admission for same day surgery, and how they perceived this information. It also determined what other information they required. The findings demonstrated that the majority of parents in this study were satisfied with the information they had received. However they wanted further advice on the waiting times involved, the equipment used in the operating room department, pain relief and the procedures in the recovery room.

  8. Physician Assistant and Advance Practice Nurse Care in Hospital Outpatient Departments: United States, 2008-2009

    Science.gov (United States)

    ... Index, Updated July 15, 2006" and "Hospital Market Profiling Solution, Second Quarter, 2006." The OPD visit response ... by year, hospital size, and location. About the authors Esther Hing and Sayeedha Uddin are with CDC's ...

  9. Frequent Users of Hospital Emergency Departments in Korea Characterized by Claims Data from the National Health Insurance: A Cross Sectional Study.

    Directory of Open Access Journals (Sweden)

    Jung Hoon Woo

    Full Text Available The Korean National Health Insurance, which provides universal coverage for the entire Korean population, is now facing financial instability. Frequent emergency department (ED users may represent a medically vulnerable population who could benefit from interventions that both improve care and lower costs. To understand the nature of frequent ED users in Korea, we analyzed claims data from a population-based national representative sample. We performed both bivariate and multivariable analyses to investigate the association between patient characteristics and frequent ED use (4+ ED visits in a year using claims data of a 1% random sample of the Korean population, collected in 2009. Among 156,246 total ED users, 4,835 (3.1% were frequent ED users. These patients accounted for 14% of 209,326 total ED visits and 17.2% of $76,253,784 total medical expenses generated from all ED visits in the 1% data sample. Frequent ED users tended to be older, male, and of lower socio-economic status compared with occasional ED users (p < 0.001 for each. Moreover, frequent ED users had longer stays in the hospital when admitted, higher probability of undergoing an operative procedure, and increased mortality. Among 8,425 primary diagnoses, alcohol-related complaints and schizophrenia showed the strongest positive correlation with the number of ED visits. Among the frequent ED users, mortality and annual outpatient department visits were significantly lower in the alcohol-related patient subgroup compared with other frequent ED users; furthermore, the rate was even lower than that for non-frequent ED users. Our findings suggest that expanding mental health and alcohol treatment programs may be a reasonable strategy to decrease the dependence of these patients on the ED.

  10. Frequent Users of Hospital Emergency Departments in Korea Characterized by Claims Data from the National Health Insurance: A Cross Sectional Study.

    Science.gov (United States)

    Woo, Jung Hoon; Grinspan, Zachary; Shapiro, Jason; Rhee, Sang Youl

    2016-01-01

    The Korean National Health Insurance, which provides universal coverage for the entire Korean population, is now facing financial instability. Frequent emergency department (ED) users may represent a medically vulnerable population who could benefit from interventions that both improve care and lower costs. To understand the nature of frequent ED users in Korea, we analyzed claims data from a population-based national representative sample. We performed both bivariate and multivariable analyses to investigate the association between patient characteristics and frequent ED use (4+ ED visits in a year) using claims data of a 1% random sample of the Korean population, collected in 2009. Among 156,246 total ED users, 4,835 (3.1%) were frequent ED users. These patients accounted for 14% of 209,326 total ED visits and 17.2% of $76,253,784 total medical expenses generated from all ED visits in the 1% data sample. Frequent ED users tended to be older, male, and of lower socio-economic status compared with occasional ED users (p < 0.001 for each). Moreover, frequent ED users had longer stays in the hospital when admitted, higher probability of undergoing an operative procedure, and increased mortality. Among 8,425 primary diagnoses, alcohol-related complaints and schizophrenia showed the strongest positive correlation with the number of ED visits. Among the frequent ED users, mortality and annual outpatient department visits were significantly lower in the alcohol-related patient subgroup compared with other frequent ED users; furthermore, the rate was even lower than that for non-frequent ED users. Our findings suggest that expanding mental health and alcohol treatment programs may be a reasonable strategy to decrease the dependence of these patients on the ED. PMID:26809051

  11. Toward a sustainable and wise healthcare approach: potential contributions from hospital Internal Medicine Departments to reducing inappropriate medical spending

    Directory of Open Access Journals (Sweden)

    Roberto Nardi

    2013-04-01

    Full Text Available All countries are facing the question of how to maintain quality of care with shrinking health budgets, in the presence of a persistent increase in life expectancy, and with a significant growing demand for health care from aging populations and chronically ill patients. Current implementation of legislative measures is largely presented as a cost-cutting policy. With this political approach, there is a risk of services and the number of hospital beds being drastically reduced, mainly to detriment of the most vulnerable groups of the population and without considering the results obtained by each regional healthcare organization according to explicit evaluation markers. In our Scientific Society of Internal Medicine (the Federation of Associations of Hospital Doctors on Internal Medicine, FADOI, we want to support good medical practice because essential medicine is still a goal to be achieved throughout medical hospital care. We are looking for original ways to implement a sustainable and frugal hospital Internal Medicine policy by searching for wise and efficient clinical methodology to be applied in the care of patients admitted to internal medicine wards according to their real needs. We firmly believe that reinforcing a common agenda between medicine and public health, and sharing a common vision among professionals and decision makers in the planning of care, may be the greatest opportunity for any every health care reform. The future of the health care system cannot be restricted to mere cost reduction, but should aim to deliver better health care in relation to the money spent. Even in this period of austerity, new opportunities can still be found and doctors must lead efforts to meet this challenge.

  12. Study of the New Patients of Acupuncture and Moxibustion Department in Dongeui Oriental Medical Hospital

    Directory of Open Access Journals (Sweden)

    Su-Min Kim

    2007-12-01

    Full Text Available Purpose : In order to profits to investigator who want to know acupuncture and moxbustion treatments are available to what symptoms today and how goes on the clinical lecture for oriental medical students, this research was carried out. Methods : The following conclusion were derived from 745 of patients who treated in acupunture & moxibustion department of Dongeui Oriental Medical hospital from the July in 2006 till January in 2007. Results : 1. There were 203(27.25% persons of Lumbago, 101(13.56% persons of Bell's palsy, 94(12.62% persons of Omalgia, 80(10.74% persons of paralysis of limb, 74(9.94% persons of disordinary sense of limb and etc. 2. There were 395 females(53.02% and 350 males(46.98%. 3. The patients over 60th were 26.72%, the 50th were 23.08%, the 40th were 22.14%, the 30th were 15.44%, 20th were 8.45%. So the older the more patients. Conclusion : In accordance with the above results, acupuncture & moxibustion teatments are good to use degenerative musculoskeletal disease, pain, paralysis and etc.

  13. Film reject analysis and image quality in diagnostic Radiology Department of a Teaching hospital in Ghana

    Directory of Open Access Journals (Sweden)

    J. Owusu-Banahene

    2014-10-01

    Full Text Available Patients usually undergo repeated X-ray examinations after their initial X-ray radiographs are rejected due to poor image quality. This subjects the patients to an excess radiation exposure and extra cost and necessitates the need to investigate the causes of reject. The use of reject analysis as part of the overall quality assurance programs in clinical radiography and radiology services is vital in the evaluation of image quality of a well-established practice. It is shown that, in spite of good quality control maintained by the Radiology Department of a Teaching hospital in Ghana, reject analysis performed on a number of radiographic films developed indicated 14.1% reject rate against 85.9% accepted films. The highest reject rate was 57.1 ± 0.7% which occurs in cervical spine and the lowest was7.7 ± 0.5% for lumbar spine. The major factors contributing to film rejection were found to be over exposure and patient positioning in cervical spine examinations. The most frequent examination was chest X-ray which accounts for about 42.2% of the total examinations. The results show low reject rates by considering the factors for radiographic rejection analysis in relation to both equipment functionality and film development in the facility.

  14. An evaluation of hospital emergency department (HED) adherence to universal precautions.

    Science.gov (United States)

    Rydman, R J; Tannebaum, R D; Zalenski, R J

    1994-08-01

    A longitudinal cross sectional study of Hospital Emergency Department (HED) procedures over a nine month period was conducted. A total of 1,541 procedures were observed on 56 randomly selected 8-h work shifts. Shifts were distributed: 34% day shift; 34% evening shift; and 32% on the night shift. Observations on the evening shift were oversampled to capture an adequate number of trauma patients. Observations were distributed: 33% day shift; 39% evening shift; and 28% on the night shift. Measurements included: type of procedure; adherence to specific barrier technique, i.e., use of gloves, gowns, masks, and eye protection; and occurrence of adverse exposure. Ten types of HED procedures were documented and analyzed. Computerized tracking of study observations established periodic rates of HED health care worker (HCW) adherence to universal precautions. These data are important for internal quality control/assurance programs and rate comparisons within and across institutions over time. The longitudinal evaluation of the database revealed that glove compliance increased over the period of the study and adverse exposure decreased. Conducting ongoing or periodic observational studies of this kind are important and necessary in order to gauge HED response to the epidemiologic challenges of urban society. PMID:7829982

  15. 科主任的能力培养探讨%Study on Ability Improvement of Department Director in Hospital

    Institute of Scientific and Technical Information of China (English)

    保志军

    2009-01-01

    Hospital management was based on the department management. The competenees of department director influ-enced the branch directly, even overall hospital construction. Therefore, it was very important to enhance department director's competence. The department directors in hospital should firmly grasp the direction of academic subject. It was described in detail as following: strategizing the academic subject development plans for a long-term, training talented people for department, culti-vating a sense of competition, and having ability of acquisition of information, foreign languages and technological innovation.%科室是医院组织管理的基础,科主任的能力直接影响医院的建设.提高科主任的能力水平对医院的发展至关重要.科主任应具备长远目光、培养人才的意识及竞争意识和良好的心态,同时具备信息获取、技术创新等能力,从而把握学科发展方向,推动科室与医院的可持续发展.

  16. One year survey of hospitalized psoriatic patients and their treatment in Razi Hospital

    OpenAIRE

    Farnaghi F; Moin A

    1998-01-01

    During one year survey, 77 psoriatic patients were hospitalized in the dermatology department of Razi Hospital. This comprised 19% of admitted patients in this period. 29% (n=22) of psoriatic patients had previous history of hospitalization. On admission, the mean age of patients was 32.8 years, the mean and peak age of disease onset were 26.46 and between 11-20 years, respectively. 14% (n=10) of the patients had a family history of psoriasis and 70% (n=7) of those with a positive family hist...

  17. Bacteremia in burned patients admitted to Sina Hospital, Tabriz, Iran

    OpenAIRE

    Parviz Saleh; Hamid Noshad

    2014-01-01

    Introduction: One of the most important causes of mortality and morbidity in burn wards is infection, and it is the major reason of death in burn injuries. There are several reasons that make burn victims predisposed to infection. The current study aimed to investigate the role of different factors that have an effect on bacteremia occurrence in burn patients and factors which are relevant to mortality in these patients. Methods: This descriptive-analytic study conducted in a 1...

  18. Incidence of pterygium in patients admitted to a university hospital

    Directory of Open Access Journals (Sweden)

    Fethiye Gülden Turgut

    2013-12-01

    Full Text Available Objectives: This study aimed to investigate the incidence of pterygium in a particular district of Istanbul, its association with age, and gender, and the severity of the disease. Methods: All patients aged ≥ 30 years referred to our outpatient clinics between January 2009 and December 2009 were included in this retrospective study. Age, gender, anterior segment photos, and findings of biomicroscopic eye examination were evaluated. Results: The incidence of pterygium for all age groups was 2.91% (male 1.75%, female 3.67% with an increasing incidence with age. A significant difference was detected in its incidence favoring female patients in 40-49, and 70-79, and male patients in ≥ 80 age groups, respectively. In addition, pterygium was seen in one (75.4% or both eyes (24.6% preferring right or left eye in 50.7%, and 49.3% of the patients, respectively. Pterygium was in nasal or temporal region in 98%, and 2% of the patients, respectively. The disease state in 59.9% of the patients was consistent with Stage 2 pterygium. The distance of pterygium from limbus was observed greatest in 60-69, and at a minimum in 40-49 age groups. No relationship was found between eye colour and development of pterygium. Conclusion: The incidence of pterygium increases with age. Incidence of pterygium differs between genders but without any significant difference. Its occurrence in one or both eyes and in right and left eyes was not influenced by gender of the patients. A statistically significant impact of eye colour of the patient on the development of pterygium was not disclosed. J Clin Exp Invest 2013; 4 (4: 436-442

  19. Validity of the International Classification of Diseases 10th revision code for hyperkalaemia in elderly patients at presentation to an emergency department and at hospital admission

    OpenAIRE

    Fleet, Jamie L; Shariff, Salimah Z; Gandhi, Sonja; Matthew A Weir; Jain, Arsh K; Garg, Amit X.

    2012-01-01

    Objectives Evaluate the validity of the International Classification of Diseases, 10th revision (ICD-10) code for hyperkalaemia (E87.5) in two settings: at presentation to an emergency department and at hospital admission. Design Population-based validation study. Setting 12 hospitals in Southwestern Ontario, Canada, from 2003 to 2010. Participants Elderly patients with serum potassium values at presentation to an emergency department (n=64 579) and at hospital admission (n=64 497). Primary o...

  20. Designing and evaluating a balanced scorecard for a health information management department in a Canadian urban non-teaching hospital.

    Science.gov (United States)

    Nippak, Pria Md; Veracion, Julius Isidro; Muia, Maria; Ikeda-Douglas, Candace J; Isaac, Winston W

    2016-06-01

    This report is a description of a balanced scorecard design and evaluation process conducted for the health information management department at an urban non-teaching hospital in Canada. The creation of the health information management balanced scorecard involved planning, development, implementation, and evaluation of the indicators within the balanced scorecard by the health information management department and required 6 months to complete. Following the evaluation, the majority of members of the health information management department agreed that the balanced scorecard is a useful tool in reporting key performance indicators. These findings support the success of the balanced scorecard development within this setting and will help the department to better align with the hospital's corporate strategy that is linked to the provision of efficient management through the evaluation of key performance indicators. Thus, it appears that the planning and selection process used to determine the key indicators within the study can aid in the development of a balanced scorecard for a health information management department. In addition, it is important to include the health information management department staff in all stages of the balanced scorecard development, implementation, and evaluation phases. PMID:24948412

  1. Designing and evaluating a balanced scorecard for a health information management department in a Canadian urban non-teaching hospital.

    Science.gov (United States)

    Nippak, Pria Md; Veracion, Julius Isidro; Muia, Maria; Ikeda-Douglas, Candace J; Isaac, Winston W

    2016-06-01

    This report is a description of a balanced scorecard design and evaluation process conducted for the health information management department at an urban non-teaching hospital in Canada. The creation of the health information management balanced scorecard involved planning, development, implementation, and evaluation of the indicators within the balanced scorecard by the health information management department and required 6 months to complete. Following the evaluation, the majority of members of the health information management department agreed that the balanced scorecard is a useful tool in reporting key performance indicators. These findings support the success of the balanced scorecard development within this setting and will help the department to better align with the hospital's corporate strategy that is linked to the provision of efficient management through the evaluation of key performance indicators. Thus, it appears that the planning and selection process used to determine the key indicators within the study can aid in the development of a balanced scorecard for a health information management department. In addition, it is important to include the health information management department staff in all stages of the balanced scorecard development, implementation, and evaluation phases.

  2. Vulnerabilities of children admitted to a pediatric inpatient care unit

    Directory of Open Access Journals (Sweden)

    Larissa Natacha de Oliveira

    2014-12-01

    Full Text Available OBJECTIVE: To identify the vulnerabilities of children admitted to a pediatric inpatient unit of a university hospital.METHODS: Cross-sectional, descriptive study from April to September 2013 with36 children aged 30 days to 12 years old, admitted to medical-surgical pediatric inpatient units of a university hospital and their caregivers. Data concerning sociocultural, socioeconomic and clinical context of children and their families were collected by interview with the child caregiver and from patients, records, and analyzed by descriptive statistics.RESULTS: Of the total sample, 97.1% (n=132 of children had at least one type of vulnerability, the majority related to the caregiver's level of education, followed by caregiver's financial situation, health history of the child, caregiver's family situation, use of alcohol, tobacco, and illicit drugs by the caregiver, family's living conditions, caregiver's schooling, and bonding between the caregiver and the child. Only 2.9% (n=4 of the children did not show any criteria to be classified in a category of vulnerability.CONCLUSIONS: Most children were classified has having a social vulnerability. It is imperative to create networks of support between the hospital and the primary healthcare service to promote healthcare practices directed to the needs of the child and family.

  3. Benefit or burden? A sociotechnical analysis of diagnostic computer kiosks in four California hospital emergency departments.

    Science.gov (United States)

    Ackerman, Sara L; Tebb, Kathleen; Stein, John C; Frazee, Bradley W; Hendey, Gregory W; Schmidt, Laura A; Gonzales, Ralph

    2012-12-01

    High expectations for new technologies coexist with wide variability in the actual adoption and impact of information technology (IT) projects in clinical settings, and the frequent failure to incorporate otherwise "successful" projects into routine practice. This paper draws on actor-network theory to present an in-depth, sociotechnical analysis of one such project--a computer kiosk designed to diagnose and expedite treatment of urinary tract infections (UTI) in adult women. Research at a hospital urgent care clinic demonstrated the kiosk program's effectiveness at diagnosing UTI and reducing patient wait times, and the kiosk was subsequently adopted by the clinic for routine patient care. However, a study promoting the adoption of the device at emergency departments (ED) was characterized by persistent staff resistance and lower-than-expected patient eligibility for kiosk-assisted care. The device was ultimately abandoned at all but one of the new sites. Observations and interviews with ED staff and the design/research team were conducted at four California EDs between April and July 2011 and point to conflicting understandings of evidence for the device's usefulness and reasons for its (non)adoption. The kiosk program's designers had attempted to "rationalize" medical work by embedding a formal representation of triage practices in the kiosk's software. However, the kiosk's "network" failed to stabilize as it encountered different patient populations, institutional politics, and the complex, pragmatic aspects of ED work at each site. The results of this evaluation challenge the persistent myth that a priori qualities and meanings inhere in technology regardless of context. The design and deployment of new IT projects in complex medical settings would benefit from empirically informed understandings of, and responses to, the contingent properties of human-technology relations. PMID:23063214

  4. DRUG UTILIZATION PATTERN IN OPTHALMOLOGY DEPARTMENT AT A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Pooja Prajwal

    2013-08-01

    Full Text Available The objective of the study is to assess the average number of drugs per prescription, formulations being prescribed, various categories of drugs being prescribed and the category most often used in ophthalmology. This is a retrospective hospital based study carried out in the department of ophthalmology at A.J institute of medical sciences, Mangalore, India. The study period was from July 2012 to July 2013. Total number of prescriptions analyzed were 3543, in which total of 15,324 drugs were prescribed. Analysis of the prescriptions showed that average number of drugs per prescription was 4.325. The maximum number of drugs prescribed were in the form of eye drops (67.65 %, followed by ointments (11.66 %, tablet (7.8 %, capsules (7.23 %, syrup (3.54 % and injection (2.12 %. The dosage form was indicated for 91 %, frequency of drug administration for 97 % drugs and duration of treatment for only 69 % of the drugs prescribed. Around 56.44 % of diagnosis accounted for senile immature cataract. Rest 15.33 % and 9.81 % acconting for pseudophakia and senile mature cataract respectively. The number of antibiotics prescribed was 8,955 (58.43 %, out of these 5,981 (66.79 % antibiotics were prescribed in the form of drops, 2,782 (31.06 % as ointment and 191 (2.13 % orally. Number of encounters with anti-inflammatory and anti allergic drugs was 1,547 (10.1 %, mydriatics and cycloplegics 1,317 (8.6 %, miotics 474 (3.1 %, lubricant and miscellaneous eye drops 2,869 (18.72 % and multivitamins 161 (1.05 %. Prescription writing errors were at its minimum thereby avoiding irrational prescriptions. Duration of treatment and prescribing by generic name were very low.

  5. Cough Variant Asthma in Medical Outpatient Department of a Tertiary Care Hospital in Bangladesh

    Directory of Open Access Journals (Sweden)

    Rukhsana Parvin

    2013-01-01

    Full Text Available Background: Cough variant asthma (CVA is a subset of asthma where the only symptom is chronic persistent cough. Many cases go unrecognized due to lack of proper evaluation. Response to asthma medication with features supportive of airway hypersensitivity helps in management of this disease. Objective: To find out the proportion of cough variant asthma among the patients attending medicine outpatient department of Enam Medical College, Savar, Dhaka. Materials and Methods: This cross sectional study was conducted in Enam Medical College Hospital, Savar, Dhaka over a period of two years from July 2009 to July 2011. Cough variant asthma was diagnosed mainly on clinical ground as chronic cough without wheezing, fever, weight loss, shortness of breath or sputum or any other apparent cause that persisted for more than eight weeks with absolutely normal physical examination of chest, normal chest radiography and blood count except raised eosinophil count and IgE level. Patients who met these criteria were given 2 weeks course of inhaler beclomethasone propionate and were assessed for improvement. Those who improved after steroid inhalation were categorised as having cough variant asthma. Results: Out of purposively selected 148 patients complaining only of chronic dry cough for more than eight weeks, 92 patients met the primary selection criteria for cough variant asthma. These 92 patients were given 2 weeks trial of 250 ìgm beclomethasone inhalation twice daily. Seventy nine patients reported almost complete recovery from chronic cough after 2 weeks and were categorized as having CVA. Thirteen patients did not improve and were not categorized as CVA. Conclusion: These findings suggest that cough variant asthma is the most common among the patients with chronic cough not due to any apparent cause. The efficacy of inhaled corticosteroid suggests that early intervention is effective in the treatment of this disease.

  6. The value of modified early warning score in predicting early mortality of critically ill patients admitted to emergency department%改良早期预警评分在急诊重症患者早期死亡中的预测价值

    Institute of Scientific and Technical Information of China (English)

    顾明; 付阳阳; 李晨; 陈铭裕; 张晓毳; 徐军; 于学忠

    2015-01-01

    目的:探讨改良早期预警评分(MEWS)对急诊重症患者早期预后的预测价值。方法采用前瞻性队列研究方法,连续入选2014年2月13日至4月20日在北京协和医院急诊抢救室就诊患者,记录患者临床资料,进行MEWS评分并随访患者临床转归,比较MEWS阳性组(MEWS≥5分)和MEWS阴性组(MEWS 0~4分)患者主要终点(3 d内死亡)及次要终点〔所有死亡,以及转入重症加强治疗病房(ICU)、心肺复苏(CPR)和死亡联合终点〕的发生率,采用多因素回归分析主要终点的影响因素。结果入选176例临床资料完整的患者,平均年龄(56.86±21.46)岁;男性98例,占55.68%;平均MEWS评分(4.30±2.74)分。MEWS阳性组74例,MEWS阴性组102例。共有41例患者出现主要终点,MEWS阳性组3 d内病死率显著高于MEWS阴性组〔37.84%(28/74)比12.74%(13/102),优势比(OR)=4.167,95%可信区间(95%CI)=1.973~8.804,P<0.001〕。次要终点事件中,MEWS阳性组所有死亡〔54.05%(40/74)比17.65%(18/102),OR=5.490,95%CI=2.770~10.883,P<0.001〕以及转入ICU、CPR和死亡联合终点〔64.86%(48/74)比25.49%(26/102),OR=5.396,95%CI=2.809~10.366,P<0.001〕发生率也显著高于MEWS阴性组。多因素回归分析显示,意识状态异常是3 d内死亡的预测因子(OR=3.606,95%CI=1.541~8.436,P=0.003),而MEWS≥5分则不是(OR=1.672,95%CI=0.622~4.494,P=0.308)。结论尽管MEWS≥5分的急诊重症患者较MEWS 0~4分患者发生严重不良事件风险显著增加,但MEWS≥5分不能有效预测患者3 d内死亡的风险,而意识状态改变对急诊重症患者的早期死亡具有一定预测意义。%ObjectiveTo evaluate the value of modified early warning score (MEWS) in predicting mortality of critically ill patients admitted to emergency department.Methods A prospective cohort

  7. Validity of tests performed to diagnose acute abdominal pain in patients admitted at an emergency department Validez de las pruebas diagnósticas realizadas a pacientes con dolor abdominal agudo en un servicio de urgencias hospitalario

    OpenAIRE

    J. A. Navarro Fernández; P. J. Tárraga López; J. A. Rodríguez Montes; M. A. López Cara

    2009-01-01

    Objective: to determine the real importance of anamnesis, physical examination, and various tests in the assessment of acute abdominal pain. Methods: a retrospective observational study with patients complaining of abdominal pain at the Emergency Department, Altiplano Health Area (Murcia) was performed. In our study we considered the following variables: socio-demographic data, history of previous surgery, symptoms, place and type of pain. Imaging tests were labeled as positive, negative, or ...

  8. Risk factors for mortality in patients admitted to intensive care units with pneumonia

    OpenAIRE

    Li, Guowei; Cook, Deborah J.; Thabane, Lehana; Friedrich, Jan O.; Crozier, Tim M.; Muscedere, John; Granton, John; Mehta, Sangeeta; Steven C. Reynolds; Lopes, Renato D.; Francois, Lauzier; Freitag, Andreas P; Levine, Mitchell A. H.; ,

    2016-01-01

    Background Despite the high mortality in patients with pneumonia admitted to an ICU, data on risk factors for death remain limited. Methods In this secondary analysis of PROTECT (Prophylaxis for Thromboembolism in Critical Care Trial), we focused on the patients admitted to ICU with a primary diagnosis of pneumonia. The primary outcome for this study was 90-day hospital mortality and the secondary outcome was 90-day ICU mortality. Cox regression model was conducted to examine the relationship...

  9. Consumer satisfaction about hospital services: A study from the outpatient department of a private medical college hospital at Mangalore

    Directory of Open Access Journals (Sweden)

    Prasanna K

    2009-01-01

    Full Text Available Background: Consumer satisfaction is an important parameter for assessing the quality of patient care services. There is a need to assess the health care systems regarding the consumer satisfaction as often as possible. Objectives: To assess the consumer satisfaction regarding the services provided in our outpatient department in terms of clinical care, availability of services, waiting time, and cost. Materials and Methods: A 27-item pre-tested questionnaire was given to 100 patients (caretakers in pediatric patients at the end of their O.P.D visit from 3 to 4 pm for 5 days from November 7, 2005 to November 11, 2005. The items in the questionnaire referred to particulars of the patients such as age, sex, occupation, department requested, lab, and medical stores. While analyzing, they were grouped into categories like availability, clinical care, waiting time, and cost. The responses were expressed in proportions. Results: The availability of services and clinical care was found to be satisfactory. 81% of the respondents found the communication by the doctor good, 97% of the respondents were satisfied about the explanation of the disease by the doctor The average time required for consulting the doctor was 46.5 ± 20.9 min. But when time spent in pharmacy was considered, it was not significantly satisfactory. The cost of investigation was significantly moderate or high in 97% of the respondents. Conclusions: Recommendations are required for reduction of time spent in the pharmacy and the cost of investigations to improve consumer satisfaction.

  10. Measuring nutritional risk in hospitals

    Directory of Open Access Journals (Sweden)

    Henrik H Rasmussen

    2010-09-01

    Full Text Available Henrik H Rasmussen1,2, Mette Holst3, Jens Kondrup41Centre for Nutrition and Bowel Disease, Department of Medical Gastroenterology, Aarhus University Hospital, Aalborg, Denmark; 2Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 3Centre for Nutrition and Bowel Disease, Aarhus University Hospital, Aalborg, Denmark; 4Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, Clinical Nutrition Unit, Rigshospitalet University Hospital, Copenhagen, DenmarkAbstract: About 20%–50% of patients in hospitals are undernourished. The number varies depending on the screening tool amended and clinical setting. A large number of these patients are undernourished when admitted to the hospital, and in most of these patients, undernutrition develops further during hospital stay. The nutrition course of the patient starts by nutritional screening and is linked to the prescription of a nutrition plan and monitoring. The purpose of nutritional screening is to predict the probability of a better or worse outcome due to nutritional factors and whether nutritional treatment is likely to influence this. Most screening tools address four basic questions: recent weight loss, recent food intake, current body mass index, and disease severity. Some screening tools, moreover, include other measurements for predicting the risk of malnutrition. The usefulness of screening methods recommended is based on the aspects of predictive validity, content validity, reliability, and practicability. Various tools are recommended depending on the setting, ie, in the community, in the hospital, and among elderly in institutions. The Nutrition Risk Screening (NRS 2002 seems to be the best validated screening tool, in terms of predictive validity ie, the clinical outcome improves when patients identified to be at risk are treated. For adult patients in hospital, thus, the NRS 2002 is recommended.Keywords: nutritional risk screening

  11. Clinical features of children hospitalized with influenza A and B infections during the 2012–2013 influenza season in Italy

    OpenAIRE

    Mancinelli, Livia; Onori, Manuela; Concato, Carlo; Sorge, Roberto; Chiavelli, Stefano; Coltella, Luana; Raucci, Umberto; Reale, Antonio; Menichella, Donato; Russo, Cristina

    2016-01-01

    Background Influenza is a major public health issue worldwide. It is characterized by episodes of infection that involve hundreds of millions of people each year. Since that in the seasons 2010–2011 and 2011–2012 the circulation of FLUB was decreasing we evaluated the clinical presentation, demographic characteristics, admitting department, and length of stay in children who contracted influenza admitted to Bambino Gesù Children’s Hospital, during the 2012–2013 influenza season, with the aim ...

  12. A study of occupational health and safety measures in the Laundry Department of a private tertiary care teaching hospital, Bengaluru

    Directory of Open Access Journals (Sweden)

    M. Shashi Kumar

    2014-01-01

    Full Text Available Introduction: The Laundry Department plays an important role in preventing the spread of infection and continuously supplying clean linen to various departments in any hospital. Objectives of the Study: To identify existing practices and occupational safety and health (OSH measures in the Laundry Department and to assess the use of personal protective equipments (PPEs among health care workers. Materials and Methods: A cross-sectional study was carried out in a private tertiary care teaching hospital. An observation checklist was developed, which was partially based on occupational hazard checklist of OSHA for Laundry Department. This was field tested and validated for applicability for this study. Results: The potential biological hazards are infections through exposure to aerosols, spills and splashes during various activities, fungal infection due to wet clothes and environment and infections through fomites. The potential physical hazards are injuries due to slips and falls, exposure to heat, humidity, dust, noise, and vibration. The potential chemical hazards are contact dermatitis and allergic asthma due to exposure to detergents, phenyl solution, bleaching powder, and soap oil solution. The potential ergonomic hazards are musculoskeletal diseases and repetitive stress injuries at the shoulder, elbow, and small joints of the hands. PPEs were not used consistently in most areas of the department.

  13. A study conducted on the demographic factors of victims of violence in support and administrative departments of hospital in 2013

    OpenAIRE

    Keyvanara, Mahmoud; Maracy, Mohammad Reza; Ziari, Najmeh Bahman

    2015-01-01

    Background: Violence is now regarded as a serious problem and its complication causes heavy costs on the healthcare systems. The present study aimed to investigate the correlation between some demographic characteristics and confrontation with violence. Since there is no study on the prevalence of violence among the support and administration staff of hospitals in Iran, this study was conducted to investigate violence in these departments. Materials and Methods: This descriptive–analytical an...

  14. Hospitals; hospitals13

    Data.gov (United States)

    University of Rhode Island Geospatial Extension Program — Hospital Facilities information was compiled from several various sources. Main source was the RI Department of Health Facilities Regulation database, License 2000....

  15. SEXUAL DIMORPHISM OF GOUT CLINIC (adapted from the materials of the rheumatology departments of Saransk hospitals

    Directory of Open Access Journals (Sweden)

    Valentina Antipova

    2016-03-01

    Full Text Available Over the past decades the incidence of gout has increased in the world. Despite the well studied mechanisms of development and characteristics of the clinical picture of the di-sease, gout is diagnosed late. Gout is believed to occur in 1 - 3% of the population of the developed countries, predominantly in men over 45, but in modern literature there is information about the age reduction for the gout onset and the incidence of gout in women. An ever-increasing incidence, an early disability, impaired quality of life, and a high risk of death make the gout problem highly relevant one and require the improvement of the detection methods, early gout detection and optimization of tactics for managing patients with gout. The object of the present research is the identification of sexual dimorphism of gout clinic (adapted from the materials of rheumatology departments of Saransk hospitals. Materials and Methods The study included 195 patients with gout (169 men and 26 women surveyed in 2011– 2015 in reumatology сlinices GBUZ “MRCB” and GBUZ “RCH № 5” of Saransk. The average age of women was 52,3 ± 12,3, of men – to 54,3 ± 13,2, median disease du-ration was 5,2 (2,6–7,8 years for women and 9 (3,5–14,5 years for men. Results Chronic arthritis was detected in 58,8 % of women and 67,5 % of men. The formation of tophi in women was observed earlier and in greater numbers than in men: the average duration of the disease before the formation of tophi in women was 3,1 years, and for men 5,7 years. In the group of women the average duration of the first artrit bout was 13 days, in the group of men – 10 days. The metobolic syndrome components such as arte¬rial hypertension, diabetes mellitus of the 2nd type, dyslipidemia were observed more often in women than in men Discussion and Conclusions Clinical course of women’s gout has its features. Since gout in women is more severe, the chronic tophy gout develops earlier than in men. Women

  16. Implementing Lean Six Sigma Methodologies in the Radiology Department of a Hospital Healthcare System

    OpenAIRE

    Workman-Germann, Jamie; Hagg, Heather (Woodward)

    2007-01-01

    Increased focus is being placed on the quality of care provided by Hospitals and Healthcare Systems around the country. Caught in the middle between tightening govenment standards, stricter compliance guidelines for insurance companies, and the basic mission to serve those in need with quality and compassion, hospitals are searching for ways to improve their processes and services for the benefit of all. CT (Computed Tomography - CAT Scan) and MRI (Magnetic Resonance Imaging) services in the ...

  17. Evaluation of Radiation Protection in Nuclear Medicine Department in Namazi Hospital According to Global Accepted Standards

    OpenAIRE

    Mohammad Mehdi Movahedi; Alireza Mehdizadeh

    2013-01-01

    Background & Objective: In the recent years, nuclear medicine has enjoyed remarkable growth thanks to such novel technologies as SPECT-CT and PET, which are utilized for the recognition of new detectable molecules and radiopharmaceutical medicines. Therefore, the current regulations on radiation protection require revision. Namazi Hospital of Shiraz is one of the first nuclear medicine centers in Iran. Many patients visit this hospital every year; consequently, radiation protection must b...

  18. Team building with information system departments: a hospital librarian's experience in coexisting, collaborating, and cooperating.

    OpenAIRE

    Grosman, J; Larson, B.

    1996-01-01

    Hospital librarians and information systems (IS) staff regard themselves as information professionals and have coexisted in the same institutions for many years. While hospital librarians have increased their computer literacy, IS staff have begun to recognize the value of knowledge-based information as an IS resource. Parallel growth and mutual interest have resulted in increased opportunities for information professionals to share skills and network for mutual advantage. Creating positive r...

  19. Children's Motives for Admitting to Prosocial Behavior.

    Science.gov (United States)

    Watanabe, Yayoi; Lee, Kayo

    2016-01-01

    There has been extensive research on children's moral evaluation of lying in prosocial situations. Current knowledge regarding the concept of lying has been derived from studies showing that cultural differences exist, whereby non-Western children tend to rate lie telling more positively than Western children do. These findings suggest that there are different views about whether children should publicize their prosocial behaviors and that children have universal motives when they admit to engaging in prosocial behavior. A gender difference has also been found in relation to prosocial behavior. However, previous studies did not investigate in detail children's motives for admission or non-admission to prosocial behavior, and if there is a gender difference. Therefore, this study examined the diversity in and development of motives for admitting or not admitting to engaging in prosocial behavior, with the aim of clarifying these behaviors as a function of children's grade level in school, and how such motives differ with age and gender. Questionnaires from 1345 elementary and junior high school students in Japan were analyzed. Results showed that children's communication tendency with regard to prosocial behavior reports peaked in the fourth grade of elementary school and gradually decreased thereafter. From the third grade of elementary school onwards, children reported that they refrained from admitting prosocial behaviors. Younger children more likely cited honesty as a crucial motive for admitting to prosocial behaviors. Girls were more likely to endorse honesty as a motive than boys were. Moreover, among younger children, girls feared others' negative evaluation and wanted to comply with modesty norms when not admitting. Further research is needed to examine the developmental process for motives behind prosocial behaviors. PMID:26925025

  20. Emergency Department Visits and Injury Hospitalizations for Female and Male Victims and Perpetrators of Intimate Partner Violence

    Directory of Open Access Journals (Sweden)

    Catherine L. Kothari

    2015-01-01

    Full Text Available Introduction. The potential for hospital-based interventions for male victims of intimate partner violence (IPV as well as adult perpetrators of both genders has been largely unexplored despite early evidence of acute-care utilization that may be as high as female victims. The current investigation compared the emergency department (ED and injury-related-hospitalization rates of IPV-involved individuals against standardized national norms, assessing differences by gender and victim/perpetrator-status. Methods. This cross-sectional study collected one-year ED and in-patient visit data from hospital records for individuals listed as victim or perpetrator in an IPV criminal charging request in a Midwestern county (N=2,937. Expected rates were calculated based upon age-adjusted national norms. Results. The IPV-involved population generated ED rates 4.1 times higher than expected and injury-related-hospitalization rates that were 4.0 times higher than expected. Bi-directionally-violent individuals (both victim and perpetrator in IPV charges consistently had the highest utilization rates (ED 8.4 RR, injury-hospitalization 22.5 RR. Victims, primarily female, had higher ED-visits than perpetrators, primarily male (victims = 4.6 RR, perpetrator = 3.1 RR. Perpetrators, though, had higher injury hospitalizations (victims = 0.8RR, perpetrators = 5.5 RR. Conclusions. Substantial opportunities exist within acute-care medical settings to intervene with IPV-involved women, men, victims, and perpetrators, although the magnitude of the opportunity varied by setting, gender and victim/perpetrator-status.

  1. Guidelines for safe handling of cytotoxic drugs in pharmacy departments and hospital wards.

    Science.gov (United States)

    1981-01-01

    The Specialty Practice Committee on Parenteral Services is one of a number of subcommittees of the Federal Council of The Society of Hospital Pharmacists of Australia (SHPA) having responsibility for development of professional practice in particular areas, such as drug distribution, drug information, clinical pharmacy, radiopharmaceuticals, and a number of others. Parenteral Services has been, perhaps, the major area of growth in Australian hospital pharmacy over the last three years. The pattern of growth of Australia has deviated somewhat from that which has emerged in the United States. Whereas the typical I.V. admixture service is relatively uncommon in Australian hospitals, the emphasis is towards specialization into Parenteral Nutrition and Oncology Support Services. Developments in Oncology Support have been particularly rapid, with many pharmacists becoming exclusively involved in this specialty. Concern is felt that operators intensively reconstituting and preparing cytotoxic drugs may be at risk from a variety of factors. Australian hospital pharmacists share the growing international opinion that this work is potentially hazardous and that safety guidelines governing every aspect of handling these substances are urgently required. The Specialty Practice Committee on Parenteral Services has conducted a study of safety aspects of this work as its major project for 1980 and has produced the document presented below. This is an official statement of the Society of Hospital Pharmacists of Australia.

  2. Evaluation of the in vitro ocular toxicity of the fortified antibiotic eye drops prepared at the Hospital Pharmacy Departments.

    Science.gov (United States)

    Fernández-Ferreiro, Anxo; González-Barcia, Miguel; Gil-Martínez, María; Santiago Varela, María; Pardo, María; Blanco-Méndez, José; Piñeiro-Ces, Antonio; Lamas Díaz, María Jesús; Otero-Espinar, Francisco J

    2016-01-01

    The use of parenteral antibiotic eye drop formulations with non-marketed compositions or concentrations, commonly called fortified antibiotic eye drops, is a common practice in Ophthalmology in the hospital setting. The aim of this study was to evaluate the in vitro ocular toxicity of the main fortified antibiotic eye drops prepared in the Hospital Pharmacy Departments. We have conducted an in vitro experimental study in order to test the toxicity of gentamicin, amikacin, cefazolin, ceftazidime, vancomycin, colistimethate sodium and imipenem-cilastatin eye drops; their cytotoxicity and acute tissue irritation have been evaluated. Cell-based assays were performed on human stromal keratocytes, using a cell-based impedance biosensor system [xCELLigence Real-Time System Cell Analyzer (RTCA)], and the Hen's Egg Test for the ocular irritation tests. All the eye drops, except for vancomycin and imipenem, have shown a cytotoxic effect dependent on concentration and time; higher concentrations and longer exposure times will cause a steeper decline in the population of stromal keratocytes. Vancomycin showed a major initial cytotoxic effect, which was reverted over time; and imipenem appeared as a non-toxic compound for stromal cells. The eye drops with the highest irritating effect on the ocular surface were gentamicin and vancomycin. Those antibiotic eye drops prepared at the Hospital Pharmacy Departments included in this study were considered as compounds potentially cytotoxic for the ocular surface; this toxicity was dependent on the concentration used. PMID:27570987

  3. The formation and design of the 'Acute Admission Database'- a database including a prospective, observational cohort of 6279 patients triaged in the emergency department in a larger Danish hospital

    Directory of Open Access Journals (Sweden)

    Barfod Charlotte

    2012-04-01

    Full Text Available Abstract Background Management and care of the acutely ill patient has improved over the last years due to introduction of systematic assessment and accelerated treatment protocols. We have, however, sparse knowledge of the association between patient status at admission to hospital and patient outcome. A likely explanation is the difficulty in retrieving all relevant information from one database. The objective of this article was 1 to describe the formation and design of the 'Acute Admission Database', and 2 to characterize the cohort included. Methods All adult patients triaged at the Emergency Department at Hillerød Hospital and admitted either to the observationary unit or to a general ward in-hospital were prospectively included during a period of 22 weeks. The triage system used was a Danish adaptation of the Swedish triage system, ADAPT. Data from 3 different data sources was merged using a unique identifier, the Central Personal Registry number; 1 Data from patient admission; time and date, vital signs, presenting complaint and triage category, 2 Blood sample results taken at admission, including a venous acid-base status, and 3 Outcome measures, e.g. length of stay, admission to Intensive Care Unit, and mortality within 7 and 28 days after admission. Results In primary triage, patients were categorized as red (4.4%, orange (25.2%, yellow (38.7% and green (31.7%. Abnormal vital signs were present at admission in 25% of the patients, most often temperature (10.5%, saturation of peripheral oxygen (9.2%, Glasgow Coma Score (6.6% and respiratory rate (4.8%. A venous acid-base status was obtained in 43% of all patients. The majority (78% had a pH within the normal range (7.35-7.45, 15% had acidosis (pH 7.45. Median length of stay was 2 days (range 1-123. The proportion of patients admitted to Intensive Care Unit was 1.6% (95% CI 1.2-2.0, 1.8% (95% CI 1.5-2.2 died within 7 days, and 4.2% (95% CI 3.7-4.7 died within 28 days after admission

  4. Admissions for drug-related problems at the Emergency Department of a University Hospital in the Kingdom of Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Mastour S Alghamdy

    2015-01-01

    Full Text Available Background and Aim: Medication Errors can result in drug-related problems (DRPs. Insight into the frequency, type, and severity of DRPs could help reduce their incidence. The aim of the present study was to estimate the prevalence of admissions as a result of DRPs at the Emergency Department (ED of a university hospital in the Kingdom of Saudi Arabia. Materials and Methods: Files of suspected cases of DRPs reporting to ED in the year 2012 were scrutinized. Suspicion arose from the hospital record system based on Diagnosis Code Numbers (ICD-9-CM, Professional 2010 and from triggers, such as some drugs, laboratory tests, and signs and symptoms pointing to DRPs. Results: Of 5574 admissions, 253 (4.5% were DRPs and were categorized as: Overdose toxicity and side effects of drugs 50 (19.8%, drug-interactions 29 (11.5%, accidental and suicidal drug ingestions 26 (10.3%, drug abuse 18 (7.1%, drug allergy 10 (4%, super-infections 8 (3.2%, and noncompliance to treatment 112 (44.3%. About 70% of DRPs were preventable; 67 (26.5% required hospital admission for 7-102 days and 10 (4% died. Conclusions: Noncompliance to treatment, overdose toxicity, drug interactions, and drug abuse are important causes of hospital admissions as a result of DRPs. Awareness of prescribers to the problem and their education would help to prevent them and improve patient care.

  5. Monitoring compliance with transfusion guidelines in hospital departments by electronic data capture

    DEFF Research Database (Denmark)

    Norgaard, Astrid; De Lichtenberg, Trine Honnens; Nielsen, Jens;

    2014-01-01

    BACKGROUND: The practice of transfusing red blood cells is still liberal in some centres suggesting a lack of compliance with guidelines recommending transfusion of red blood cells at haemoglobin levels of 6-8 g/dL in the non-bleeding patient. Few databases provide ongoing feedback of data on pre-transfusion...... haemoglobin levels at the departmental level. In a tertiary care hospital, no such data were produced before this study. Our aim was to establish a Patient Blood Management database based on electronic data capture in order to monitor compliance with transfusion guidelines at departmental and hospital levels....... MATERIALS AND METHODS: Hospital data on admissions, diagnoses and surgical procedures were used to define the populations of patients. Data on haemoglobin measurements and red blood cell transfusions were used to calculate pre-transfusion haemoglobin, percentage of transfused patients and transfusion...

  6. Insuficiência cardíaca descompensada na unidade de emergência de hospital especializado em cardiologia Decompensated heart failure in the emergency department of a cardiology hospital

    Directory of Open Access Journals (Sweden)

    Sandrigo Mangini

    2008-06-01

    égias terapêuticas mais avançadas.BACKGROUND: National studies on decompensated heart failure (DHF are key to the understanding of this condition in our midst. OBJECTIVE: To determine the characteristics of DHF patients in an emergency department. METHODS: A total of 212 patients diagnosed with decompensated heart failure who had been admitted to an emergency department (EU of a cardiology hospital were prospectively evaluated. Clinical variables, form of presentation and causes of decompensation were studied. In 100 patients, ancillary tests, prescription of vasoactive drugs, length of hospital stay and mortality were also analyzed. RESULTS: There was a predominance of the male gender (56% and the most frequent etiology was ischemia (29,7% despite high frequency of valvular (15% and chagasic (14,7% etiologies. The most common form of presentation and cause of decompensation were congestion (80.7% and poor compliance/inadequate medication (43.4%, respectively. In the subanalysis of the 100 patients, systolic dysfunction was the most common cause of decompensation (55%; use of vasoactive drugs occurred in 20%, and mortality was 10%. The comparative analysis between the patients who were discharged and those who died during hospitalization confirmed some criteria of poor prognosis: reduced systolic blood pressure, low cardiac output associated with congestion, need for vasoactive drugs, reduced left ventricular ejection fraction, increased left ventricular diastolic diameter (LVDD and hyponatremia. CONCLUSION: This study presents information about the profile of decompensated heart failure patients attended on the emergency unit of a brazilian southeast cardiology hospital. Clinical, hemodynamical and ancillary data may provide information for risk assessment in the initial evaluation helping the decision on hospitalization and advanced strategic therapies.

  7. PRESCRIPTION AUDIT OF ACNE VULGARIS IN SKIN OUTPATIENT DEPARTMENT OF A TERTIARY CARE TEACHING HOSPITAL

    Directory of Open Access Journals (Sweden)

    Vishal Prakash

    2014-10-01

    Full Text Available : OBJECTIVE: To evaluate prescribing pattern in acne vulgaris cases at a tertiary care teaching hospital in south India. METHODS: Prescriptions of 120 patients of acne vulgaris who attended Dermatology OPD of a tertiary care teaching hospital were selected for study and their drug data were analyzed. RESULTS: Topical Benzoyl peroxide, adapalene, ketoconazole were prescribed as monotherapy, while aloevera, liquid paraffin and white soft paraffin as polytherapy. Azithromycin, antibiotics, anti histaminics were prescribed as systemic monotherapy and polytherapy. Statistical analysis revealed p-value was > 0.05. CONCLUSIONS: Prescription patterns were in consensus with the general guidelines, with few changes, in the choice of established therapeutic agents.

  8. Accreditation of Emergency Department at a Teaching Hospital in Tehran University of Medical Sciences in 2010

    OpenAIRE

    Fereshteh Farzianpour; Roholah Askari; Amin T. Hamedani; Gholamosien Khorshidi; Sanaz Amirifar; Shadi Hosseini

    2011-01-01

    Problem statement: Considering the importance of emergency departments in healthcare system and the high mortality rate of patients referred to these departments, it is crucial to provide quality services in emergency departments. Accreditation is a systematic process for improving quality of care and it enables managers to assess and evaluate the healthcare system. Accreditation of an organization provides an obvious commitment for improving quality of safety, quality of patient care, ensuri...

  9. Suicide Assessment in Hospital Emergency Departments: Implications for Patient Satisfaction and Compliance

    OpenAIRE

    Mitchell, Ann M; Garand, Linda; Dean, Diane; Panzak, George; Taylor, Melissa

    2005-01-01

    Suicide is a complex, multidimensional event with a host of contributing factors. Suicidal emergencies are among other behavioral and psychiatric emergencies that provide the basis for emergency department visits. Therefore, emergency departments are ideal clinical environments for the assessment of suicidal patients. A case example from an emergency department visit is provided as a basis of discussion as we describe subpopulations at high risk for suicide and review critical assessment para...

  10. Implementing "lean" principles to improve the efficiency of the endoscopy department of a community hospital: a case study.

    Science.gov (United States)

    Laing, Karen; Baumgartner, Katherine

    2005-01-01

    Many endoscopy units are looking for ways to improve their efficiency without increasing the number of staff, purchasing additional equipment, or making the patients feel as if they have been rushed through the care process. To accomplish this, a few hospitals have looked to other industries for help. Recently, "lean" methods and tools from the manufacturing industry, have been applied successfully in health care systems, and have proven to be an effective way to eliminate waste and redundancy in workplace processes. The "lean" method and tools in service organizations focuses on providing the most efficient and effective flow of service and products. This article will describe the journey of one endoscopy department within a community hospital to illustrate application of "lean" methods and tools and results.

  11. [The Asahi Model-Regional Mental Health Services at Department of Psychiatry and Child Psychiatry, Asahi General Hospital].

    Science.gov (United States)

    Aoki, Tsutomu

    2015-01-01

    The Asahi model, Psychiatric Services of Department of Psychiatry and Child Psychiatry, Asahi General Hospital, is characterized by multiple dimensions of mental health services, such as multidisciplinary team approach, medical cooperation, specialized psychiatric treatment of acute care, clozapine and modified ECT, outreach services of home nursing and assertive community treatment, and the close and mutual coordination with housing services and social welfare services. The Asahi Model makes it possible to be deinstitutionalized, to improve patients satisfaction, to shorten hospitalization, to decrease psychiatric emergency visits and to be of service in a natural disaster. It also might prevent the relapse of schizophrenics within twelve months after discharge and improve the quality of mental health staffs trainings to support patients better. In the future, we will need to work on providing sectorized care, early psychosis intervention programs, to construct networking systems of clozapine and modified ECT, to strengthen growth of home nursing, and to take place mental health anti-stigma campaigns. PMID:26552318

  12. Validity of tests performed to diagnose acute abdominal pain in patients admitted at an emergency department Validez de las pruebas diagnósticas realizadas a pacientes con dolor abdominal agudo en un servicio de urgencias hospitalario

    Directory of Open Access Journals (Sweden)

    J. A. Navarro Fernández

    2009-09-01

    Full Text Available Objective: to determine the real importance of anamnesis, physical examination, and various tests in the assessment of acute abdominal pain. Methods: a retrospective observational study with patients complaining of abdominal pain at the Emergency Department, Altiplano Health Area (Murcia was performed. In our study we considered the following variables: socio-demographic data, history of previous surgery, symptoms, place and type of pain. Imaging tests were labeled as positive, negative, or inconclusive for assumed diagnoses, which were retrospectively assessed by an external radiologist who was unaware of the patient's final diagnosis. Results: our study includes 292 patients with a mean age of 45.49 years; 56.8% of these patients were women. Regarding the frequency of the different acute abdomen diagnoses, appendicitis was the main cause (approx. 25%, followed by cholecystitis (10%. We found a significant diagnostic correlation between pain location in the right hypochondrium (RHC and a diagnosis with cholecystitis. This location was also significant for acute appendicitis (up to 74%. Regarding clinical signs, we only observed a significant correlation between fever and viscera perforation, and between Murphy's sign and cholecystitis. Sensitivity and specificity found in relation to the psoas sign were similar to those seen in other series, 16 and 95% respectively, and slightly lower than the Blumberg or rebound sign, which we found to be around 50 and 23%, respectively. Conclusions: a anamnesis and physical examination offer limited accuracy when assessing acute abdomen; b ultrasound scans offer a low diagnostic agreement index for appendicitis; and c laparoscopy may prove useful for diagnosis, and is also a possible treatment for acute abdominal pain despite its low diagnostic efficiency.Objetivo: determinar la importancia real que en sí tienen la anamnesis, la exploración física y las diferentes pruebas complementarias en la valoraci

  13. ADMIT: The ALMA Data Mining Toolkit

    Science.gov (United States)

    Teuben, P.; Pound, M.; Mundy, L.; Rauch, K.; Friedel, D.; Looney, L.; Xu, L.; Kern, J.

    2015-09-01

    ADMIT (ALMA Data Mining ToolkiT), a toolkit for the creation of new science products from ALMA data, is being developed as an ALMA Development Project. It is written in Python and, while specifically targeted for a uniform analysis of the ALMA science products that come out of the ALMA pipeline, it is designed to be generally applicable to (radio) astronomical data. It first provides users with a detailed view of their science products created by ADMIT inside the ALMA pipeline: line identifications, line ‘cutout' cubes, moment maps, emission type analysis (e.g., feature detection). Using descriptor vectors the ALMA data archive is enriched with useful information to make archive data mining possible. Users can also opt to download the (small) ADMIT pipeline product, then fine-tune and re-run the pipeline and inspect their hopefully improved data. By running many projects in a parallel fashion, data mining between many astronomical sources and line transitions will also be possible. Future implementations of ADMIT may include EVLA and other instruments.

  14. Oral hygiene awareness and practice amongst patients visiting the Department of Periodontology at a Dental College and Hospital in North India

    OpenAIRE

    Kapoor, Daljit; Gill, Sanjeet; Singh, Arshdeep; Kaur, Inderpreet; Kapoor, Pooja

    2014-01-01

    Objective: This study was carried out to assess the oral hygiene awareness and practices amongst patients visiting the Department of Periodontology at Gian Sagar Dental College and Hospital, Ramnagar (Patiala). Methods: A cross-sectional study was carried out amongst the patients visiting the Department of Periodontology of Gian Sagar Dental College and Hospital, Ramnagar, Patiala. This proposed study was reviewed by the Institutional ethical committee and their clearance was obtained. A tota...

  15. The use of shared medication record as part of medication reconciliation at hospital admission is feasible

    DEFF Research Database (Denmark)

    Munck, Lars K; Hansen, Karina R; Mølbak, Anne Grethe;

    2014-01-01

    studied whether our SMR integration could facilitate medication reconciliation. MATERIAL AND METHODS: Patients admitted to the emergency department for hospitalization were randomised to consultation using EMR with or without the integrated SMR access. Observed time used for medication reconciliation was...... national SMR into a hospital EMR was feasible and useful, and it did not increase time expenditure for medication reconciliation. FUNDING: not relevant. TRIAL REGISTRATION: not relevant....

  16. Audit of high energy therapy beams in hospital oncology departments by the National Radiation Laboratory

    International Nuclear Information System (INIS)

    In 1993 the output of every high energy radiotherapy beam used clinically in New Zealand was measured by National Radiation Laboratory (NRL) staff using independent dosimetry equipment. The purpose of this was to audit the dosimetry that is used by hospital physicists for the basis of patient treatments, and to uncover any errors that may be clinically significant. This report analyses the uncertainties involved in comparing the NRL and hospital measurements, and presents the results of the 1993 audit. The overall uncertainty turns out to be about 1.5%. The results for linear accelerator photon beams are consistent with a purely random variation within this uncertainty. Electron beams show some small errors beyond the expected uncertainty. Gamma beams have the potential to be the most accurately measured, but in practice are less accurately measured than linear accelerator beams. None of the disagreements indicated an error of clinical significance. 8 refs., 3 figs., 2 tabs

  17. Influence of atmospheric states in semi-arid areas on hospital admission in cardio-surgical department

    Science.gov (United States)

    Yackerson, Naomy S.; Zilberman, Arkadi; Aizenberg, Alexander

    2016-10-01

    The influence of the changes in atmospheric state, typical for areas close to big deserts, on acute myocardial infarction (AMI) was analyzed. Under test was the group of 3256 patients (77 % males, 23 % females), hospitalized in the Cardio-Surgical Department of Soroka Medical Center at Ben-Gurion University (BGU, Israel) during 2000-2008. To explore the relationship between atmospheric parameters and AMI, multivariate regression analysis has been performed. AMI was most frequent in winter to spring and least in summer. The highest number of cases was recorded in December and the lowest in September. Hospital admissions showed a higher prevalence in men than in women; the ratio is 3.3/1.0. About 60 % of males were aged between 45 and 65 years old with maximum ˜55 (21 %), whereas 60 % of women hospital admissions were aged between 65 and 80 years old with maximum ˜72 (24 %). The result suggested that the monthly mean relative humidity at daytime and its overall daily differences, wind speed, and respirable fraction of particulate concentration are associated with the admission for AMI. The results of the study confirm the importance of atmospheric state variability for cardiovascular diseases.

  18. Psychological Evaluation of Patients in Critical Care/Intensive Care Unit and Patients Admitted in Wards

    OpenAIRE

    Sharma B, Gaurav; EVS, Maben; MS, Kotian; B., Ganaraja

    2014-01-01

    Background: Psychological assessment for depression, anxiety and stress among ICU patients and the patients admitted to ward in a hospital in India. This aspect did not get much attention in India so far. Such studies were common in developed countries. Therefore we decided in this study, to analyse the psychological status responses from the hospitalised patients in Mangalore using a validated questionnaire.

  19. Children's Motives for Admitting to Prosocial Behavior

    OpenAIRE

    Watanabe, Yayoi; Lee, Kayo

    2016-01-01

    There has been extensive research on children's moral evaluation of lying in prosocial situations. Current knowledge regarding the concept of lying has been derived from studies showing that cultural differences exist, whereby non-Western children tend to rate lie telling more positively than Western children do. These findings suggest that there are different views about whether children should publicize their prosocial behaviors and that children have universal motives when they admit to en...

  20. The association of longitudinal and interpersonal continuity of care with emergency department use, hospitalization, and mortality among Medicare beneficiaries.

    Directory of Open Access Journals (Sweden)

    Suzanne E Bentler

    Full Text Available BACKGROUND: Continuity of medical care is widely believed to lead to better health outcomes and service utilization patterns for patients. Most continuity studies, however, have only used administrative claims to assess longitudinal continuity with a provider. As a result, little is known about how interpersonal continuity (the patient's experience at the visit relates to improved health outcomes and service use. METHODS: We linked claims-based longitudinal continuity and survey-based self-reported interpersonal continuity indicators for 1,219 Medicare beneficiaries who completed the National Health and Health Services Use Questionnaire. With these linked data, we prospectively evaluated the effect of both types of continuity of care indicators on emergency department use, hospitalization, and mortality over a five-year period. RESULTS: Patient-reported continuity was associated with reduced emergency department use, preventable hospitalization, and mortality. Most of the claims-based measures, including those most frequently used to assess continuity, were not associated with reduced utilization or mortality. CONCLUSION: Our results indicate that the patient- and claims-based indicators of continuity have very different effects on these important health outcomes, suggesting that reform efforts must include the patient-provider experience when evaluating health care quality.

  1. Análise retrospectiva das intoxicações admitidas no hospital universitário da UFJF no período 2000-2004 A retrospective study of intoxications admitted to the university hospital/UFJF from 2000 to 2004

    Directory of Open Access Journals (Sweden)

    Cícero da Silva Moreira

    2010-05-01

    Full Text Available Intoxicações podem ter suas consequências minimizadas através da ampliação do conhecimento sobre suas origens, evoluções e providências quanto a medidas preventivas. No Brasil, o aumento progressivo das emergências tóxicas justifica a sua análise, de forma descentralizada e regionalizada. Este trabalho objetivou caracterizar dados sobre a ocorrência de intoxicações admitidas no Hospital Universitário/UFJF, entre 2000 e 2004. A coleta foi realizada mediante pesquisa em prontuários cadastrados no banco de dados do referido hospital. Os dados foram analisados através de estatística descritiva, permitindo estabelecer o perfil do grupo quanto às variáveis idade, sexo, local de origem do paciente, profissão, período de hospitalização, etiologia, razão da intoxicação, classe terapêutica de fármacos envolvidos e via de exposição ao agente toxicante. Crianças de zero a cinco anos e indivíduos do sexo masculino foram os mais acometidos, representando 24% e 68%, respectivamente. A maioria dos casos ocorreu em Juiz de Fora (78% e a via oral foi a mais frequente. Os psicotrópicos foram os principais agentes toxicantes (60%. Os resultados evidenciaram a importância de atividades educativas dirigidas às comunidades e a relevância dos serviços de informação para prevenir e reduzir as intoxicações e o uso irracional de fármacos.Poisonings may have their consequences minimized by the acquisition of knowledge concerning its etiologies, evolutions and means of prevention. In Brazil, the progressive increase of toxic emergencies justifies the acquisition and analysis of regional and decentralized data concerning toxic emergencies. The aim of this retrospective and descriptive study was to evaluate data on the toxicology occurrence registered at the University Hospital/UFJF from 2000 to 2004. Data were collected using a structured instrument which comprised: age range, gender, profession, average hospitalization time

  2. Pattern of Dermatological Cases Attending Skin-VD Outpatient Department in a Medical College Hospital of Bangladesh

    Directory of Open Access Journals (Sweden)

    Abu Baker

    2011-07-01

    Full Text Available Background: The pattern of skin diseases varies from one country to another and even from region to region of the same country. We are geographically placed in the tropical region with natural outcome of communicable diseases. We conducted this cross sectional study in a tertiary hospital of Bangladesh keeping the proposition in mind that infectious diseases occupy maximum percentage among skin and venereal diseases in outpatients in Bangladesh. Objectives: To classify the diseases attending the Skin & VD outpatient department of Enam Medical College Hospital (EMCH and to draw comments and recommendations on the basis of findings. Materials and Methods: All patients irrespective of age and sex attending the OPD of Skin-VD Department of Enam Medical College Hospital during a 2-year time-period (from January 2009 to December 2010 were included in the study. Structured questionnaire, check-list and face-to-face interview (whenever necessary were used as tools of data collection. Statistical analyses were done by SPSS version Windows 11.1. Results: Total number of patients was 12100. Most of the patients were aged (>18 years; 64.28%, dominated by male (61.63%, married (56.1%, literate (71.11%, coming from far (>5 km; 63.5% and of middle class origin (59.73%. Out of the total cases, maximum (23.42% were diagnosed as eczema, followed by infectious diseases (17%, acne (8.69% and psoriasis (6.36%. Conclusion: In this study we found infectious diseases to occupy the second position next to eczema and our findings nullify the proposition that infectious diseases occupy maximum percentage among skin and venereal diseases in outpatients in Bangladesh.

  3. Evaluation of Head Trauma Cases in the Emergency Department

    OpenAIRE

    Alim Cokuk; Nalan Kozaci; Mehmet Oguzhan Ay; Ayca Acikalin; Meltem Seviner; Salim Satar

    2013-01-01

    Aim: In this study, we aimed to determine the epidemiological characteristics, morbidity and mortality rates of patients admitted to the emergency department with head trauma. Material and Methods: In this study, ambulatory and hospitalized patients over the age of 18 brought to the Emergency Department because of head trauma between 01.12.2009 - 31.12.2010 were analyzed retrospectively. Patient data were recorded to standard data entry form. SPSS 17.0 package program was used for statistical...

  4. Management of Pneumothorax in Emergency Medicine Departments: Multicenter Trial

    OpenAIRE

    Ince, Abdulkadir; Ozucelik, Dogac Niyazi; Avci, Akkan; Nizam, Ozgur; Dogan, Halil; Topal, Mehmet Ali

    2013-01-01

    Background: Pneumothorax is common and life-threatening clinical condition which may require emergency treatment in Emergency Medicine Departments. Objectives: We aimed to reveal the epidemiological analysis of the patients admitted to the Emergency Department with pneumothorax. Material and Methods: This case-control and multi-center study was conducted in the patients treated with the diagnosis of pneumothorax between 01.01.2010-31.12.2010. Patient data were collected from hospital automati...

  5. Munchausen Syndrome By Proxy Admitting with Bloody Urine and Stool

    Directory of Open Access Journals (Sweden)

    Tugba Koca

    2014-02-01

    Full Text Available Munchausen syndrome by Proxy is a severe form of child abuse. Disease symptoms and signs are fabricated or imitated by parents or caregivers The child is usually presented to doctors, persistently. A delay in diagnosis may cause severe negative impact on spiritual, physical, mental and social development of the cases and even death. Symptoms usually disappear in the absence of the perpetrators. The diagnosis is extremely difficult. A 21-month-old boy who had applied to many centers due to bleeding from various parts of the body for last six months, and whose symptoms could not be explained with any physical reason after tests were conducted. Finally he was admitted to our center with bloody urine and stools, and diagnosed Munchausen syndrome by proxy. In cases with recurrent hospital admission in whom no apparent disease is diagnosed, Munchausen syndrome by Proxy should be among the differential diagnosis.

  6. HERITAGE SECURITY APPLIED INTO STOCKS IN SUPPLY DEPARTMENT IN UNIVERSITIES HOSPITALS

    Directory of Open Access Journals (Sweden)

    DINO CÉSAR APARECIDO OIJAN

    2010-06-01

    Full Text Available The objective of this project is to suggest improvements to the security of stocks of materials supply sector of the Hospital das Clinicas, Faculty of Medicine of Botucatu. For this investigation was conducted in situ in order to collect data regarding: inflow and exit of people and material, receiving, storage and internal distribution for faults and security holes. Were used in the analysis, historical data, industry supplies, such as: items busiest and most expensive, detailed observation of the operations carried out in the stores, from arrival until the internal distribution of items by the hospital. Interviews conducted through structured questionnaires, in order to know the opinion of employees and clients of this institution, which could contribute greatly to the goals were achieved. The questionnaires were created from theoretical concepts found in books and scholarly articles. Documents and file records were collected and tabulated on a spreadsheet, with all the data at hand, it was possible to develop indicators that can guide future actions. Among the improvements that have been suggested, there is a proposal to develop a booklet with operating instructions that standardizes the procedures regarding the security of stocks, it was felt the need to create a system of indicators to facilitate the interpretation of data in the sector supplies.

  7. Institutional Effectiveness Assessment Process, 1993-94. Executive Summary. Hospitality and Service Occupations Division, Cosmetology Department.

    Science.gov (United States)

    South Seattle Community Coll., Washington.

    A study was conducted to evaluate student and student employer satisfaction with the services provided by the South Seattle Community College (SSCC) Cosmetology Department. Specifically, the study gathered data related to four outcomes: that students receive an educational experience allowing them to meet their goals; that former and current…

  8. Process mapping of PTA and stent placement in a university hospital interventional radiology department

    OpenAIRE

    de Bucourt, Maximilian; Busse, Reinhard; Güttler, Felix; Reinhold, Thomas; Vollnberg, Bernd; Kentenich, Max; Hamm, Bernd; Teichgräber, Ulf K

    2012-01-01

    Objective To apply the process mapping technique in an interdisciplinary approach in order to visualize, better understand, and efficiently organize percutaneous transluminal angioplasty (PTA) and stent placement procedures in a university hospital’s interventional radiology department. Methods After providing an overview of seven established mapping techniques for medical professionals, the process mapping technique was chosen and applied in an interdisciplinary approach including referrers ...

  9. Performance measurement in a radiology department at a Danish non-profit hospital

    DEFF Research Database (Denmark)

    Traberg, Andreas; Jacobsen, Peter

    The purpose of this article is to describe a Lean and dynamic model to measure the performance in the health care area. The empiric work has been done at an X-ray department with 85 employees and daily treatment of about 145 patients. The present case is based on a Master Thesis where the goal wa...

  10. The changing power equation in hospitals.

    Science.gov (United States)

    Rayburn, J M; Rayburn, L G

    1997-01-01

    This research traces the origins, development, and reasons for change in the power equation in the U.S. hospitals between physicians, administrators and accountants. The paper contains three major sections: a review of the literature concerning authority, power, influence, and institutional theory; a review of the development of the power of professions, especially physicians, accounting and healthcare administrators, and the power equilibrium of a hospital; and, a discussion of the social policy implications of the power struggle. The basis for physicians' power derives from their legal ability to act on which others are dependent, such as choosing which hospital to admit patients, order tests and procedures for their patients. The Federal Government's prospective payment system and the hospitals' related case-mix accounting systems appear to influence the power structure in hospitals by redistributing that power. The basis of the accountants' power base is control of financial information. Accountants have a definite potential for influencing which departments receive financial resources and for what purpose. This moves hospital accountants into the power equation. The basis of the hospital administrators' power is their formal authority in the organization. Regardless of what actions federal government agencies, hospital accountants, or hospital administrators take, physicians are expected to remain the dominant factor in the power equation. Without major environmental changes to gain control of physician services, only insignificant results in cost containment will occur. PMID:10163913

  11. A study to assess burnout among nurses of maternity department in Gauhati Medical College Hospital, Assam

    OpenAIRE

    Marami Baishya; Bivarani Goswami

    2016-01-01

    Background: Burnout in healthcare workers, especially among nurses, can have an impact on overall healthcare delivery system. For health in general and maternal health in particular, wellbeing of healthcare workers, including nurses, is of paramount importance. Material and methods: This study aimed to assess burnout among nurses working in the maternity department. One hundred nurses of a tertiary care centre, selected by non-purposive convenient sampling, were examined by a standardised...

  12. Does increased medication use among seniors increase risk of hospitalization and emergency department visits?

    OpenAIRE

    Sara Allin; David Rudoler; Audrey Laporte

    2015-01-01

    Objective: to examine the extent of the health risks of consuming multiple medications among the older population. Data sources/study setting: Secondary data from the period 2004-2006. The study setting was the province of Ontario, Canada, and the sample consisted of individuals aged 65 years or older who responded to a national health survey. Study design: We estimated a system of equations for inpatient and emergency department (ED) services to test the marginal effect of medication use on ...

  13. Avaliação da necessidade da solicitação de exames complementares para pacientes internados em unidade de terapia intensiva de hospital universitário Laboratory exams necessity for patients admitted to an university hospital intensive care unity

    Directory of Open Access Journals (Sweden)

    Fernando Osni Machado

    2006-12-01

    influence the morbidity and mortality in the ICU patients. The purpose of this study was to appraise the frequency of the most ordering tests in the ICU of HU-UFSC and to check if there was connection between them and the age, the destiny until the ICU discharge and the estimate severity of their diseases. METHODS: Prospective cohort study with qualitative approach. The blood samples of admitted patients were analyzed, from July to December 2005. Clinical and demographic features were collected and the most frequently blood-samples were quantified per day. In the sequence the daily rate of exams were calculated during all the admission period. The patients were analyzed according to three criterions: age, destiny until the ICU discharge and estimate severity according to APACHE II index. Data were analyzed using Fisher Exact, Chi-square and ANOVA tests. RESULTS: One hundred and thirteen patients were enrolled to this study. The average test-ordering was 11.50 per day. These numbers didn't have statistical difference when they were compared between survivor and non-survivor patients, and between those whose the death estimated tax was bigger or smaller than 50 per cent. CONCLUSIONS: The test-ordering didn't show clinical and prognostic relation to its request. There were no statistic relation between the patient's age, ICU discharge and the estimate severity.

  14. A Simple Clinical Score “TOPRS” to Predict Outcome in Pediatric Emergency Department in a Teaching Hospital in India

    Directory of Open Access Journals (Sweden)

    2012-03-01

    Full Text Available Objective: To develop a simple clinical scoring system for severity of illness to help prioritize care and predict outcome in emergency department.Methods: Prospective hospital based observational study. Out of a total of 874 children who attended emergency department in one year, 777 were included in the study. Data was collected at the time ofadmission in emergency department. The baseline information like age, gender, etc and variables of ‘toprs’score viz temperature, oxygen saturation, pulse rate, respiratory rate, sensorium and seizures were recorded.Variables were categorized as normal (score zero or abnormal (score 1 based on systemic inflammatory response syndrome (SIRS criteria and criteria mentioned in advanced pediatric life support (APLS and the total scores were computed for each child. The outcome (death/discharge was correlated with the studyvariables and total score. The predictive ability of score was calculated using receiver operating characteristic (ROC curve analysis.Findings: Of the six variables, temperature, oxygen saturation and respiratory rate were found to be significantly associated with mortality. Mortality increased with the increase in the number of abnormal variables. Based on the regression coefficients, maximum possible score was 6.68. The predictive ability of score was 81.7 calculated using ROC curve. Maximum discrimination was observed at a score of 2.5.Conclusion: For triage in emergency, any patient with 2 or more abnormal variables should be closely monitored and evaluated. These patients require admission as they have a potential risk of death.

  15. Effectiveness and Safety of Low Dose Vaginal Misoprostol Compared to Trans Cervical Foley Catheter for Cervical Ripening and Induction of Labor in Post Term Pregnant Women Admitted to Gandi Memorial Hospital, Addis Ababa and Felege Hiwot Referral Hospital, Bahir Dar, Ethiopia

    Directory of Open Access Journals (Sweden)

    Hailemariam Segni

    2015-12-01

    Full Text Available Background: Post term pregnancy is one of the common indications of induction of labor in contemporary obstetric practice. However, the majority of women with post term pregnancy have unfavorable cervices. Therefore, it is mandatory to achieve cervical ripening in this group of women before proceeding to labor induction. These cervical ripening methods often result in onset of labor which makes them also labor inducing agents. There is paucity of studies comparing the effectiveness and safety of the aforementioned methods. Thus, this study compared the effectiveness and safety of low dose vaginal misoprostol with trans cervical Foley catheter for cervical ripening and induction of labor in post term pregnant women. Method: The study was conducted from January to December 2014 at Gandi Memorial Hospital and Felege Hiwot Referral Hospital. Quasi-experimental study design was employed and 111 post term pregnant women were enrolled to each group of cervical ripening methods. Foley catheter, number 18 gauge, was inserted trans cervically and inflated with 50 ml of normal saline in women of group I at FHRH. Women in group II received 25 μg of misoprostol vaginally every 6 hrs for a maximum of 2 doses at GMH. Oxytocin infusion began when an indication comes to picture. Results were tabulated and statistically analyzed. Results: Baseline obstetric variables such as gestational age and parity were not statistically different in both groups. Maternal age was found to be statistically significant (28.40 vs. 26.02 yrs; P=0.000. Change in Bishop score is marginally significant in favour of the Foley catheter group even after controlling for maternal age (5.67 vs. 5.33; P=0.040. Vaginal delivery within 24 hours and ripening to delivery intervals were not statistically different in both groups. Rate of vaginal delivery was found to be marginally significant being higher in the Foley catheter group (84.7% vs. 72.2%; P=0.013. When stratified for parity, the

  16. Abnormal vital signs are strong predictors for Intensive Care Unit admission and in-hospital mortality in adults triaged in the Emergency Department - A prospective cohort study

    DEFF Research Database (Denmark)

    Barfod, Charlotte; Laurtizen, Marlene Mp; Danker, Jakob K;

    2012-01-01

    ABSTRACT: BACKGROUND: Assessment and treatment of the acutely ill patient have improved by introducing systematic assessment and accelerated protocols for specific patient groups. Triage systems are widely used, but few studies have investigated the ability of the triage systems in predicting...... for the two main descriptors; vital signs, Tvitals, and presenting complaint, Tcomplaint. The more urgent of the two determines the final triage category, Tfinal. We retrieved 6279 unique adult patients admitted through the Emergency Department (ED) from the Acute Admission Database. We performed regression...

  17. Association between sociodemographic characteristics and anxiety levels of violence-exposed patients admitted to emergency clinic

    Directory of Open Access Journals (Sweden)

    Hocagil H

    2016-02-01

    Full Text Available Hilal Hocagil,1 Filiz Izci,2 Abdullah Cüneyt Hocagil,1 Ebru Findikli,3 Sevda Korkmaz,4 Merve Iris Koc5 1Department of Emergency, School of Medicine, Bulent Ecevit University, Zonguldak, 2Department of Psychiatry, School of Medicine, Istanbul Bilim University, Istanbul, 3Department of Psychiatry, School of Medicine, Sutcu Imam University, Kahramanmaras, 4Department of Psychiatry, School of Medicine, Firat University, Elazig, 5Department of Psychiatry, Erenkoy Training and Research Hospital for Psychiatric and Neurological Disorders, Istanbul, Turkey Background: Here we aimed to investigate sociodemographic characteristics, psychiatric history, and association between sociodemographic characteristics and anxiety levels of violence-exposed patients admitted to emergency clinic.Methods: This study consists of 73 violence-exposed patients admitted to emergency clinic who were literate and agreed to participate in the study. A sociodemographic data form created by us to investigate alcohol-substance abuse, suicide attempt, previous history of trauma, self and family history of psychiatric disorders and Beck Anxiety Inventory was given to the patients.Results: Of the patients exposed to violence 63% (n=46 were female and 27% (n=27 were male. Of these patients, 68.5% (n=50 were married, 43.8% (n=25 were workers, 34.2% were housewives, 11% were unemployed, and 11% were civil servants. Of the violence-exposed patients, 56.2% (n=41 were primary school, 21.9% (n=16 were high school, and 21.9% (n=16 were university graduates. Smoking and alcohol use rates were 54.8% (n=40 and 17.8% (n=13, respectively. The most common trauma type was assault using physical force with a ratio of 78.1% (n=57. In addition, anxiety scores were high in 42.5% (n=31 and moderate in 9.6% (n=7 of the patients. Mentioned psychiatric disorder was present in 17.8% (n=13 of the patients and 19.2% (n=14 of the patients’ relatives. The correlation between sociodemographic

  18. Drug utilization pattern in outpatient department of Government Medical College and C.P.R. Hospital, Kolhapur

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    Rama R. Bhosale

    2013-08-01

    Full Text Available Background: Drug utilization studies are used to analyze different aspects of the use of drugs and to implement methods of improving therapeutic quality. This study was conducted to study drug prescription pattern in outpatient department of Government Medical College and C.P.R. Hospital, Kolhapur which is one of the important medical college in western Maharashtra. Methods: One thousand prescriptions were screened & analyzed as per the study parameters from OPD of Government Medical College & C.P.R. Hospital, Kolhapur. Study parameters like demographic profile of the patient like age, sex and diagnosis were recorded. Also groups of drugs commonly prescribed, number of drugs per patient, drug profile and drawbacks of prescription if any were recorded and analyzed. Results: Most common group of drugs prescribed by physicians was Analgesics (32.83%, followed by Antimicrobials (22.82%, Multivitamins (16.42% and Antacids (9.14%. The average number of drugs prescribed per patient was four; the average number of analgesic was one. The incidence of polypharmacy was common occurrence and some prescriptions had small drawbacks like absence of diagnosis, absence of doctor’s signature, etc. Conclusions: We conclude that most of the prescriptions which were analyzed at R.C.S.M. Government Medical College and C.P.R. Hospital, Kolhapur, were according to the standard norms of WHO prescriptions and also most of the drugs prescribed were from the list of essential drug list. But still there is scope for improvement in prescription pattern. [Int J Basic Clin Pharmacol 2013; 2(4.000: 403-406

  19. RETROSPECTIVE STUDY OF RELAPAROTOMY IN DEPARTMENT OF OBSTRETRICS, GYNAECOLOGY AND FAMILY PLANNING IN, RURAL TERTIARY CARE HOSPITAL, ANDHRA PRADESH, INDIA

    Directory of Open Access Journals (Sweden)

    Uma Thombarapu, Prabha Devi Kodey, GangadharaRao Koneru

    2015-07-01

    Full Text Available Introduction: Relaparotomy is biggest dilemma to the surgeon and critical to the patient to undergo second surgery within short span of time .It is challenging both physically and mentally to the patient. Aim: Aim of the study was to determine incidence of relaparotomy and its indication, management and outcome in the department of Obstetrics, Gynaecology and Family Planning (OBGYN & FP in NRI Medical College & General Hospital at Guntur District. Materials and Methods: It is a retrospective observational study for the duration of 3 and ½ years. Total number of surgeries -7, 718. Total number of relaparotomy- 27 which include referral cases. Results: Incidence for relaparotomy was 0.34%. Most important cause for relaparotomy was haemorrhagic causes (44.4%, followed by burst abdomen (33.3%. Relaparotomy can increase morbidity, mortality (14.8% of patients with increased hospital stay on an average of 27 days including Intensive Care Unit, further increasing the financial burden to the patient. Conclusion: Emergency relaparotomy is a life saving procedure. Good expertise in selection of primary surgery and right surgical technique, intra operative hemostasis, control of post operative infection can avoid relaparatomy

  20. Managing bioterrorism mass casualties in an emergency department: lessons learned from a rural community hospital disaster drill.

    Science.gov (United States)

    Vinson, Eric

    2007-01-01

    Bioterrorism represents a threat for which most emergency departments (EDs) are ill prepared. In order to develop an evidence-based plan for ED and hospital management of contaminated patients, a review was conducted of the most effective strategies developed during the severe acute respiratory syndrome (SARS) epidemic, as well as Centers for Disease Control and Prevention and military guidelines on biowarfare. Six basic steps were identified: 1) lock down the hospital and control access to the ED; 2) protect emergency care personnel with appropriate personal protective equipment; 3) decontaminate and triage patients; 4) isolate patients; 5) treat patients with appropriate medications or measures, including decontamination of wounds; and 6) use restrictive admission and transfer guidelines. By emphasizing these six basic concepts, a rural ED passed an annual state-run bioterrorism mass-casualty drill. The drill provided health care personnel with the knowledge and skills necessary to prepare for future bioterrorism casualties. These same concepts could also be used to manage highly virulent viral or bacterial outbreaks.

  1. Trial of a small image network system in a radiology department of an university hospital

    International Nuclear Information System (INIS)

    This paper describes the construction of an image network system in Shinshu University Hospital, and some of its current issues and advantages. Our discussion is based on our experience with a PACS system. SAIPACS, which was installed in 1990 for use in clinical conferencing and pre- and post-graduate education, and with a new CT and MRI network, which was subsequently introduced in 1993. The SAIPACS interconnects eight digital imaging modalities, including CT, MRI, XTV-DR (including digital tomosynthesis), FCR, nuclear medicine (RI), DSA, US, and a film digitizer (FD), with a workstation. Transmission time from the magnetic disk of each imaging modality to the SAIPACS image disk is not rapid enough. Therefore, we need to select image for transfer that are pertinent to our specific purpose, to complete image transmission within a practically acceptable period of time. The new CT/MRI network is composed of two CT units, two MRI systems, an image processing unit and a Universal Gateway. It provides faster image transmission than the SAIPACS system, because there is no need to reform image data to send them in a reversible compressed form. A versatile network system connected to the SAIPACS and CT/MRI network enables digital image data to be processed and edited and images to be transferred back to SAIPACS for clinical or educational use. (author)

  2. Topical negative pressure therapy Recent experience of the department of plastic surgery at Ibn Sina University Hospital, Rabat, Morocco

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    Abdelmoughit Echchaoui

    2014-12-01

    Full Text Available IntroductionThe topical negative pressure therapy (TNP is a non-invasive method to treat chronic and acute wounds locally, using a continuous or intermittent negative pressure.The objective of this study is to present the first experience of this type of treatment used in clinical cases in our department. By presenting these cases, we highlight indication and efficiency of this new technique applied in relatively complicated situations, at the same time it also allows a significant improvement in treating injuries and chronic wounds.Materials and methodsIn this study, we present the recent experience of the Department of Reconstructive and Plastic Surgery of the University Hospital Center of Avicenne in Rabat. This therapy was used for the first time this year (in 2014, in three young patients who presented with chronic wounds associated with local and general factors that are unfavorable for the healing process.ResultsIn all three of our cases we obtained highly satisfactory clinical results.TNP allows wounds to bud in a shorter time, as well as a fast healing by second intention due to controlled wound healing or split-skin graft without using flaps. This enables to decrease the margin of error, the time and the number of dressing replacements, and to reduce the length of hospital stay.ConclusionThis is an expensive and specific equipment. However, the cost-benefit ratio analysis shows that it is an essential method that should be part of our therapeutic strategies.Keywords: loss of substance, negative pressure, budding, healing.  

  3. Mental Disorders among Children and Adolescents Admitted to a French Psychiatric Emergency Service

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    Laurent Boyer

    2013-01-01

    Full Text Available The aim of this study was to describe the characteristics of children and adolescents admitted to the psychiatric emergency department (ED of a French public teaching hospital over a six-year study period (2001–2006. Data for all episodes of care in the psychiatric ED from January 1, 2001, to December 31, 2006, delivered to adolescents aged less than 18 years were retrospectively analyzed. During the six-year study period, 335 episodes of care in the psychiatric ED were experienced by 264 different adolescents. They accounted for 2.0% of the 16,754 care episodes of the ED; 164 patients (62.1 were female and the average age was 16.5 (SD = 1.6. The neurotic, stress-related, and somatoform disorders were the most frequent (25.4% and concerned mainly anxiety disorders (15.2%. The frequency of the absence of psychiatric diagnosis (22.7% was high. A total of 48 children and adolescents (18.2% benefited from more than one episode of care. Several factors were associated to a higher number of visits to the ED: substance use, schizophrenia, disorders of adult personality and behaviour, disorders occurring in childhood and adolescence, and dual diagnosis. In conclusion, mental health disorders in children and adolescents are a serious problem associated with several potentially modifiable factors.

  4. A study to assess burnout among nurses of maternity department in Gauhati Medical College Hospital, Assam

    Directory of Open Access Journals (Sweden)

    Marami Baishya

    2016-01-01

    Full Text Available Background: Burnout in healthcare workers, especially among nurses, can have an impact on overall healthcare delivery system. For health in general and maternal health in particular, wellbeing of healthcare workers, including nurses, is of paramount importance. Material and methods: This study aimed to assess burnout among nurses working in the maternity department. One hundred nurses of a tertiary care centre, selected by non-purposive convenient sampling, were examined by a standardised questionnaire. Data were analysed by descriptive statistics. Results: Burnout in depersonalisation was moderate while that in emotional exhaustion and personal achievement were of low-levels. Conclusion: Understanding the nature of the problem of burnout can guide in better management.

  5. Assessment and Management of Work-Related Stress in Hospital Emergency Departments in Italy.

    Science.gov (United States)

    d'Ettorre, Gabriele; Greco, Maria Rita

    2016-01-01

    Recent changes in the organization of the healthcare system, triggered by the current economic crisis in Italy, require interventions aimed at minimizing the impact of work-related stress (WRS) on healthcare workers' health status and well-being. Emergency department (ED) personnel appear to be particularly vulnerable to WRS as a consequence of specific occupational risk factors. The aim of this retrospective observational study was to analyze the level of WRS after improvement interventions implemented by the management staff of the ED and focused on work context factors. The assessment of WRS showed that nurses and physicians of the ED are exposed to a medium level of risk; the improvement interventions aimed at reducing WRS were focused on: (1) function and organizational culture; (2) role within the occupational organization; and (3) relationships at work policy. These interventions were found to be significantly effective in reducing the risk of WRS. PMID:27249877

  6. Assessment and Management of Work-Related Stress in Hospital Emergency Departments in Italy.

    Science.gov (United States)

    d'Ettorre, Gabriele; Greco, Maria Rita

    2016-01-01

    Recent changes in the organization of the healthcare system, triggered by the current economic crisis in Italy, require interventions aimed at minimizing the impact of work-related stress (WRS) on healthcare workers' health status and well-being. Emergency department (ED) personnel appear to be particularly vulnerable to WRS as a consequence of specific occupational risk factors. The aim of this retrospective observational study was to analyze the level of WRS after improvement interventions implemented by the management staff of the ED and focused on work context factors. The assessment of WRS showed that nurses and physicians of the ED are exposed to a medium level of risk; the improvement interventions aimed at reducing WRS were focused on: (1) function and organizational culture; (2) role within the occupational organization; and (3) relationships at work policy. These interventions were found to be significantly effective in reducing the risk of WRS.

  7. Methodology for establishing of a control and assurance program on a Radiology Department of a university hospital

    International Nuclear Information System (INIS)

    The purpose of this work is to present a proposal of a quality assurance program developed for a typical diagnostic radiology department of a University Hospital. The aim of this program is to reduce the number of films lost due to several kinds of problems, equipment malfunction, incorrect selection of the physical parameters of the X-ray equipment, poor conditions of the film ecrans and chassis, excessive temperature fluctuations on the processor, personnel training and organizational related aspects. The preliminary results shows that the main causes of problems are film overexposure, film under exposure, unexposed films taken back to the dark room, inadequate positioning of the film in the couch, inadequate positioning of the patient and the X-ray processor in addition to others of minor importance. It is very important to emphasize that the data acquisition methodology must contemplate a professional posture of respect for those involved in the procedures and as result of this one would expect their active participation in the program. As result of the first year of study, this program has demonstrated that the annual losses in the department studied are over US$ 125.000,00 and the goal of this program now is to reduce this figure to an acceptable number, US$40.000,00 a reasonable value for a large diagnostic radiology facility. (author). 6 refs., 4 figs

  8. Transition from hospital to daily life

    DEFF Research Database (Denmark)

    Missel, Malene; Schønau, Mai Nanna; Pedersen, Jesper Holst;

    2014-01-01

    PURPOSE: To assess the effect of nurse-led systematic rehabilitation counseling performed before discharge to prevent concerns in the hospital-to-home gap in rehabilitation of lung cancer patients after surgery. DESIGN AND METHOD: A quasi-experimental intervention study. One hundred twenty patients...... with operable non-small cell lung cancer admitted for surgery participated. Outcome was assessed by a validated self-rating questionnaire. The intervention was performed at the Department of Thoracic Surgery, University Hospital of Copenhagen, Denmark. RESULTS: Following nurse-led rehabilitation counseling...... in the transition from hospital to daily life. CLINICAL RELEVANCE: Despite promising results, there is still a need to improve support for patients with lung cancer requiring rehabilitation....

  9. AdMit: adaptive mixtures of student-t distributions

    NARCIS (Netherlands)

    D. David (David); L.F. Hoogerheide (Lennart); H.K. van Dijk (Herman)

    2009-01-01

    textabstractThis note presents the package AdMit (Ardia et al., 2008, 2009), an R implementation of the adaptive mixture of Student-t distributions (AdMit) procedure developed by Hoogerheide (2006); see also Hoogerheide et al. (2007); Hoogerheide and van Dijk (2008). The AdMit strategy consists of t

  10. Evaluation of Performance Indexes of Emergency Department

    Directory of Open Access Journals (Sweden)

    Alireza Baratloo

    2015-02-01

    Full Text Available Introduction: The importance of evaluating performance indicators in the emergency department, as one of the most important departments of hospital, is obvious to everyone. Therefore, in this study we aimed to appraise the five performance indicators, approved by the ministry of health, in Shohadaye Tajrish hospital, Tehran, Iran. Methods: In a descriptive cross-sectional study based on the profiles of all the patients admitted to the emergency department, performance indicators in the emergency department were evaluated. The study was divided into 2 parts about the establishment of emergency medicine system and training the medical staff: the first 6 months of 1392 and the second. Then these 2 periods were compared using Mann-Whitney U test while P< 0.05 was considered as the level of significance. Results: Of the studied indicators, mean triage time was 6.04 minutes in the first 6 months which was reduced to 1.5 minutes in the second 6 months (p=0.016. In addition, the percentage of patients who moved out of the department in 12 hours was lowered from 97.3% in the first period to 90.4% in the second (p=0.004. While, the percentage of patients who were decided upon in 6 hours (p=0.2, unsuccessful CPR percentage (p=0.34 and patients discharged against medical advice (p=0.42 showed no significant difference. Conclusion: The results of this study showed that the establishment of the emergency medicine system in the emergency department could lead to more efficient triage. Due to the differences made after their establishment including: different pattern of the patients admitted, increased stay of the patients in the department due to their need for prolonged intensive care, a raise in patient referral to the hospital by pre-hospital services and a higher percentage of occupied hospital beds, other indicators have not shown a significant improvement.

  11. Structural Measures - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospitals and the availability of structural measures at that hospital. A structural measure reflects the environment in which hospitals care for...

  12. Patient survey (HCAHPS) - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...

  13. Screening for older emergency department inpatients at risk of prolonged hospital stay: the brief geriatric assessment tool.

    Directory of Open Access Journals (Sweden)

    Cyrille P Launay

    Full Text Available The aims of this study were 1 to confirm that combinations of brief geriatric assessment (BGA items were significant risk factors for prolonged LHS among geriatric patients hospitalized in acute care medical units after their admission to the emergency department (ED; and 2 to determine whether these combinations of BGA items could be used as a prognostic tool of prolonged LHS.Based on a prospective observational cohort design, 1254 inpatients (mean age ± standard deviation, 84.9±5.9 years; 59.3% female recruited upon their admission to ED and discharged in acute care medical units of Angers University Hospital, France, were selected in this study. At baseline assessment, a BGA was performed and included the following 6 items: age ≥85years, male gender, polypharmacy (i.e., ≥5 drugs per day, use of home-help services, history of falls in previous 6 months and temporal disorientation (i.e., inability to give the month and/or year. The LHS in acute care medical units was prospectively calculated in number of days using the hospital registry.Area under receiver operating characteristic (ROC curves of prolonged LHS of different combinations of BGA items ranged from 0.50 to 0.57. Cox regression models revealed that combinations defining a high risk of prolonged LHS, identified from ROC curves, were significant risk factors for prolonged LHS (hazard ratio >1.16 with P>0.010. Kaplan-Meier distributions of discharge showed that inpatients classified in high-risk group of prolonged LHS were discharged later than those in low-risk group (P<0.003. Prognostic value for prolonged LHS of all combinations was poor with sensitivity under 77%, a high variation of specificity (from 26.6 to 97.4 and a low likelihood ratio of positive test under 5.6.Combinations of 6-item BGA tool were significant risk factors for prolonged LHS but their prognostic value was poor in the studied sample of older inpatients.

  14. Hospital Inspections

    Data.gov (United States)

    U.S. Department of Health & Human Services — Welcome to hospitalinspections.org, a website run by the Association of Health Care Journalists (AHCJ) that aims to make federal hospital inspection reports easier...

  15. Inclusive growth between mental department in general hospital and special mental hospital%综合医院精神科与精神病专科医院的包容性增长

    Institute of Scientific and Technical Information of China (English)

    陈育庆

    2011-01-01

    在综合医院就诊的患者中,不少患者同时伴有精神障碍.介绍了综合医院精神医学服务的现状,从社会偏见导致患者不愿到精神专科医院求治、对伴有躯体疾病精神患者的非精神疾病的综合救治能力和设施不足、资源有限导致无法满足不同层次需求等方面指出精神病专科医院的服务局限,从而提出综合医院开设精神科的必要性.认为在收治对象、人才培养、服务宗旨等方面,综合医院精神科与精神病专科医院是互为补充的,是可以通过合作竞争来达到和谐共存,实现包容性增长的局面的.%Some of patients visiting doctors in general hospital often accompany with mental disease. Status of mental service in general is introduced. Shortages in special mental hospital are discussed. First, social prejudice makes patient do not willing to see a doctor in special mental hospital. Second, lack of capacity and equipment to treat mental patients those who accompany with physiological disease. Third, limited resource makes special mental hospital not matching patient demands at all levels. So it is necessary to run mental department in general hospital. Special mental hospital and mental department in general hospital is complementary in parts of patient population, human resource training and service mission. Cooperative competition relation makes reconciliation between special mental hospital and mental department in general hospital and achieves inclusive growth.

  16. The effectiveness of the South African Triage Toll use in Mahalapye District Hospital – Emergency Department, Botswana

    Science.gov (United States)

    Ogunbanjo, Gboyega A.; Mbuka, Deogratias O.

    2016-01-01

    Background The study aimed to determine the proportion of each priority level of patients, time of performance in each priority level, and the reliability of the South African Triage Scale (SATS) tool at the Mahalapye District Hospital - Emergency Department (MDH-ED), a setting where the majority of the nurses were not formally trained on the use of the SATS. Methods This was a cross-sectional study using case records in MDH-ED from 1 January 2014 to 31 December 2014. A panel of experts from the Mahalapye site of the Family Medicine Department, University of Botswana, reviewed and scored each selected case record that was compared with the scores previously attributed to the nurse triage. Results From the 315 case records, both the nurse triage and the panel of expert triage assigned the majority of cases in the routine category (green), 146 (46%) and 125 (40%), respectively, or in the urgent category (yellow), they assigned 140 (44%) and 111 (35%) cases, respectively. Overall, there was an adequate agreement between the nurse triage and the panel of expert triage (k = 0.4, 95% confidence interval: 0.3–0.5), although the level of agreement was satisfactory. Conclusion Findings of the study reported that the profile of the priority-level categories in MDH-ED was made in the majority of routine and urgent patients, only the routine and the emergency patients were seen within the targeted time and they had a satisfactory level of reliability (between 0.4 and 0.6). PMID:27543284

  17. A STUDY ON IMPLEMENTATION OF COMMUNITY HEALTH INSURANCE SCHEME IN THE CARDIOLOGY DEPARTMENT OF A TERTIARY CARE GOVERNMENT HOSPITAL

    Directory of Open Access Journals (Sweden)

    Kalyani

    2015-02-01

    Full Text Available In many parts of the developing world, health care expenditure is largely met out of pocket, and illness can drive individuals and families into poverty and debt. India ranks third in the World Health Organization's 2012 list of "countries with highest out of pocket (OOP expenditure on health" in the south - east Asia region with almost 60% of total health expenditure paid by the common man in 2009 (World Health Organization 2009 . 1 The Rajiv Aarogyasri Community Health Insurance (RACHI in Andhra Pradesh (AP has been very popular social insurance scheme with a private public partnership model to deal with the problems of catastrophic medical expenditures at tertiary level care for the poor households is achieved AIM OF THE STUDY: To study implementation of Aarogyasri community health insurance scheme in the department of cardiology of a tertiary care government hospital. MATERIAL : A total number of 27 cases of cardiac patients recruited over a period of ten weeks from 5 - 9 - 14 to 15 - 11 - 14 in the department of cardiology K.G.H Visakhapatnam. DISCUSSION: Community health insurance scheme is one of the models for providing health security for the people below poverty line. The Aarogyasri scheme of Andhra Pradesh aims to ensure health care for the BPL population at the time of critical and catastrophic illness. All the cases in the study group underwent surgical treatment, PTCA with one stent and for one case an additional stent was placed. Cash less packages also covered free food and transportation charges. Medicines are given for ten days at the time of discharge. Many states, and even the central government, are believed to be looking at the scheme to see if this can be replicated across the country . 6 CONCLUSSION: The case travel time from registration to final claims disposal is less than two weeks because of the organization pattern of the Arogyasri community health insurance scheme.

  18. Evaluating laboratory request forms submitted to haematology and blood transfusion departments at a hospital in Northwest Nigeria

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    Feyisayo Jegede

    2016-02-01

    Full Text Available Background: The laboratory request form (LRF is a communication link between laboratories, requesting physicians and users of laboratory services. Inadequate information or errors arising from the process of filling out LRFs can significantly impact the quality of laboratory results and, ultimately, patient outcomes.Objective: We assessed routinely-submitted LRFs to determine the degree of correctness, completeness and consistency.Methods: LRFs submitted to the Department of Haematology (DH and Blood Transfusion Services (BTS of Aminu Kano Teaching Hospital in Kano, Nigeria, between October 2014 and December 2014, were evaluated for completion of all items on the forms. Performance in four quality indicator domains, including patient identifiers, test request details, laboratory details and physician details, was derived as a composite percentage.Results: Of the 2084 LRFs evaluated, 999 were from DH and 1085 from BTS. Overall, LRF completeness was 89.5% for DH and 81.2% for BTS. Information on patient name, patient location and laboratory number were 100% complete for DH, whereas only patient name was 100% complete for BTS. Incomplete information was mostly encountered on BTS forms for physician’s signature (60.8% and signature of laboratory receiver (63.5%. None of the DH and only 9.4% of BTS LRFs met all quality indicator indices.Conclusion: The level of completion of LRFs from these two departments was suboptimal. This underscores the need to review and redesign the LRF, improve on training and communication between laboratory and clinical staff and review specimen rejection practices.

  19. Supporting-emotional needs of Iranian parents with premature infants admitted to Neonatal Intensive Care Units

    OpenAIRE

    Aliabadi, Faranak; Kamali, Mohammad; Borimnejad, Leili; Rassafiani, Mehdi; Rasti, Mehdi; Shafaroodi, Narges; Rafii, Foroogh; Askary Kachoosangy, Reihaneh

    2014-01-01

    Background: Having an infant in the neonatal intensive care unit (NICU) is a stressful and painful experience. Unlike to normal births, this birth is associated with admission and separation of infant from parents. The aim of this study was to compile the supporting-emotional needs of Iranian parents who have a premature infant admitted in (NICU). Methods: This study was performed using qualitative research approach. Twelve participants including 9 parents whose infant had been hospitalized i...

  20. Retrospective study of choroidal melanomas at the 1st Department of Ophthalmology, AHEPA hospital, Thessaloniki, from 2002 to 2011

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    A A Chranioti

    2016-01-01

    Full Text Available Aim: Retrospective study of cases of choroidal melanoma examined at the 1st Department of Ophthalmology, University Hospital American Hellenic Educational Progressive Association, during the 10-year period, from January 2002 to December 2011. Materials and Methods: The study group consists of 84 patients (84 eyes with newly diagnosed choroidal melanoma. The documentation of the location and the dimensions of the melanomas, based on B-Ultrasonography findings (apical height, diameter, were included. A total of 58 patients were referred to a specialized center abroad for conservative irradiation therapy. Twenty six eyes were enucleated due to large size of the tumor and the histopathological type was determined. Results: Of the 84 cases, 44 were located at the posterior pole while 40 anteriorly. Based on size, 6% (5/84 were small, 58% (49/84 were medium and 36% (30/84 large. Based on the histopathological analysis of 22 of the 26 eyes enucleated, 36% were mixed-cell, 32% were spindle cell and 27% were epithelioid cell melanomas. Conclusions: Our study is the first documentation and classification of newly diagnosed cases of choroidal melanomas. The large number of mandatory enucleations, due to large size, is surprising. Patients need to be better informed about preventive fundoscopy for diagnosis of asymptomatic melanoma at an earlier stage.

  1. The one-stop clinic as the standard of out-patient care in a hospital urology department

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    Alvaro Páez

    2011-10-01

    Full Text Available PURPOSE: To evaluate the performance of a 'one-stop' clinic in terms of proportion of discharges or inclusion in surgical waiting lists. MATERIALS AND METHODS: All patients were referred from primary care facilities (population 220.646 and from different departments in the hospital. Eight senior urologists, two registered nurses and two nurse attendants participated in the experience. Prior to the start of the project, referral protocols had been agreed with the primary care physicians involved. Compliance with the protocols was periodically tested. Eventually 5537 first visits (January-December 2009 where evaluable. RESULTS: Overall, the 'one-stop' format proved feasible in 74.2% of the patients (4108/5537. Patients, who successfully used the 'one-stop' format, were significantly younger than those who required additional consultations (43 vs 50 years old, respectively, Student's t test < 0.001. For obvious reasons the 'one-stop' format was universally possible in male sterilization and penile phimosis patients. Similarly, the 'one-stop' policy was applied in most consultations due to male sexual dysfunction (75% and urinary tract infection (73%. Other health problems, such as haematuria (62% and renal colic (46%, required more than one visit so that care of the patient reverted to the traditional, outpatient care model. CONCLUSION: A 'one-stop' philosophy is feasible for a number of procedures in a urological outpatient clinic. The costs to implement such an approach would be limited to managerial expenditure.

  2. The Prevalence of Clubfoot in the Neonates who were Referred to the Emergency Department of Mofid Children Hospital

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    Hamid Reza Seyyed Hossein Zadeh Ardebili

    2011-05-01

    Full Text Available ObjectiveClub-foot is one of the most prevalent congenital anomalies of the lowerextremities. Since there is no epidemiologic study on the prevalence of thisdisease in Iran, we decided to assess it in a sample population in Tehran.Materials and MethodsWe assessed all neonates who were referred to the emergency department ofmofid children hospital between October 2007 and November 2008, due to apaediatric emergency problem. None of the patients had chief complaints oflower extremity deformity.ResultsDuring this time period (13 months, we could examine 682 neonates. Noneof the parents of these neonates had complaints regarding anomaly of lowerextremities of their neonates at the time of the emergency referral. Of them, 371(54% were female and 311 (46% were male. The age of the mother at the timeof pregnancy was 35 yr in 86 (13% neonates. There was a previous historyof clubfoot in the siblings of one of the neonates who was under orthopaedictreatment.Among all these neonates, we found two cases of clubfoot (0.3%, with bilateralinvolvement. In one of these cases, the older sibling also had clubfoot.ConclusionThe incidence of clubfoot has been reported between 0.39 and 6 cases in 1000live birth in the literature. In the present study, we found a prevalence of 0.3 forclubfoot in every 1000 neonates.

  3. Clinical analysis of 138 cases with trigeminal neuralgia at the Department of Neurosurgery, Tokyo Dental College Ichikawa General Hospital

    International Nuclear Information System (INIS)

    We reviewed clinical data from a total of 138 trigeminal neuralgia patients treated at the Department of Neurosurgery, Tokyo Dental College Ichikawa General Hospital. In 10 patients, MRI scan revealed a brain tumor or a cerebral arteriovenous malformation, which was recognized as the cause of the trigeminal neuralgia. The remaining patients were treated with Tegretol, and side effects necessitating discontinuation of the drug occurred in six patients, including two with severe adverse reactions that required inpatient treatment. When Tegretol therapy was not applicable or proved to be less effective, the patients underwent surgical therapy or gamma knife radiosurgery. Since no symptom can predict the presence of a tumor, brain MRI is considered to be essential for all patients with trigeminal neuralgia. Although Tegretol is effective in the treatment of neuralgia, the occurrence of side effects should be carefully monitored during therapy. Considering that 116 patients (84%) were referred by oral-dental surgeons, trigeminal neuralgia is likely to be a disorder commonly encountered by these specialists, thereby indicating the importance of medical cooperation between neurosurgeons and oral-dental surgeons. (author)

  4. Hospital-acquired infections - when are hospitals legally liable?

    Science.gov (United States)

    McQuoid-Mason, David

    2012-04-12

    Hospital-acquired infections (nosocomial infections) are acquired in healthcare settings by patients admitted for reasons unrelated to the infection or not previously infected when admitted to the facility. Liability for hospital-acquired infections depends on whether the hospital: (i) has introduced best practice infection control measures; (ii) has implemented best practice infection control measures; or (iii) will be vicariously liable for negligent or intentional failures by staff to comply with the infection control measures implemented. A hospital and hospital administrators may be held directly liable for not introducing or implementing best practice infection control measures, resulting in harm to patients. The hospital may also be held vicariously liable where patients have been harmed because hospital staff negligently or intentionally failed to comply with the infection control measures that have been implemented by the hospital, during the course and scope of their employment.

  5. Outcome and periprocedural time management in referred versus directly admitted stroke patients treated with thrombectomy

    Science.gov (United States)

    Weber, Ralph; Reimann, Gernot; Weimar, Christian; Winkler, Angela; Berger, Klaus; Nordmeyer, Hannes; Hadisurya, Jeffrie; Brassel, Friedhelm; Kitzrow, Martin; Krogias, Christos; Weber, Werner; Busch, Elmar W.; Eyding, Jens

    2015-01-01

    Background: After thrombectomy has shown to be effective in acute stroke patients with large vessel occlusion, the potential benefit of secondary referral for such an intervention needs to be validated. Aims: We aimed to compare consecutive stoke patients directly admitted and treated with thrombectomy at a neurointerventional centre with patients secondarily referred for such a procedure from hospitals with a stroke unit. Methods: Periprocedure times and mortality in 300 patients primarily treated in eight neurointerventional centres were compared with 343 patients referred from nine other hospitals in a prospective multicentre study of a German neurovascular network. Data on functional outcome at 3 months was available in 430 (76.4%) patients. Results: In-hospital mortality (14.8% versus 11.7%, p = 0.26) and 3 months mortality (21.9% versus 24.1%, p = 0.53) were not statistically different in both patient groups despite a significant shorter symptom to groin puncture time in directly admitted patients, which was mainly caused by a longer interfacility transfer time. We found a nonsignificant trend for better functional outcome at 3 months in directly admitted patients (modified Rankin Scale 0–2, 44.0% versus 35.7%, p = 0.08). Conclusions: Our results show that a drip-and-ship thrombectomy concept can be effectively organized in a metropolitan stroke network. Every effort should be made to speed up the emergency interfacility transfer to a neurointerventional centre in stroke patients eligible for thrombectomy after initial brain imaging. PMID:27006695

  6. Feasibility and Inter-Rater Reliability of Physical Performance Measures in Acutely Admitted Older Medical Patients

    DEFF Research Database (Denmark)

    Bodilsen, Ann Christine; Juul-Larsen, Helle Gybel; Petersen, Janne;

    2015-01-01

    OBJECTIVE: Physical performance measures can be used to predict functional decline and increased dependency in older persons. However, few studies have assessed the feasibility or reliability of such measures in hospitalized older patients. Here we assessed the feasibility and inter-rater reliabi......OBJECTIVE: Physical performance measures can be used to predict functional decline and increased dependency in older persons. However, few studies have assessed the feasibility or reliability of such measures in hospitalized older patients. Here we assessed the feasibility and inter......-rater reliability of four simple measures of physical performance in acutely admitted older medical patients. DESIGN: During the first 24 hours of hospitalization, the following were assessed twice by different raters in 52 (≥ 65 years) patients admitted for acute medical illness: isometric hand grip strength, 4......, and 30-s chair stand were 8%, 7%, and 18%, and the SRD95% values were 22%, 17%, and 49%. CONCLUSION: In acutely admitted older medical patients, grip strength, gait speed, and the Cumulated Ambulation Score measurements were feasible and showed high inter-rater reliability when administered by different...

  7. Length of Hospital Stay After Stroke: A Korean Nationwide Study

    Science.gov (United States)

    2016-01-01

    Objective To investigate the length of hospital stay (LOS) after stroke using the database of the Korean Health Insurance Review & Assessment Service. Methods We matched the data of patients admitted for ischemic stroke onset within 7 days in the Departments of Neurology of 12 hospitals to the data from the database of the Korean Health Insurance Review & Assessment Service. We recruited 3,839 patients who were hospitalized between January 2011 and December 2011, had a previous modified Rankin Scale of 0, and no acute hospital readmission after discharge. The patients were divided according to the initial National Institute of Health Stroke Scale score (mild, ≤5; moderate, >5 and ≤13; severe, >13); we compared the number of hospitals that admitted patients and LOS after stroke according to severity, age, and sex. Results The mean LOS was 115.6±219.0 days (median, 19.4 days) and the mean number of hospitals was 3.3±2.1 (median, 2.0). LOS was longer in patients with severe stroke (mild, 65.1±146.7 days; moderate, 223.1±286.0 days; and severe, 313.2±336.8 days). The number of admitting hospitals was greater for severe stroke (mild, 2.9±1.7; moderate, 4.3±2.6; and severe, 4.5±2.4). LOS was longer in women and shorter in patients less than 65 years of age. Conclusion LOS after stroke differed according to the stroke severity, sex, and age. These results will be useful in determining the appropriate LOS after stroke in the Korean medical system.

  8. Epidemiological, clinical and laboratory findings of children fewer than 15 years with diabetic ketoacidosis admitted at San Vicente Fundación Hospital in Medellín, Colombia, between January 2001 and December 2010 = Características epidemiológicas y clínicas y hallazgos de laboratorio de los niños menores de 15 años con cetoacidosis diabética atendidos en el Hospital Universitario San Vicente Fundación en Medellín, Colombia, entre enero de 2001 y diciembre de 2010

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    Ballesteros Calderón, Alicia Lucía

    2013-07-01

    Full Text Available Introduction: Diabetic ketoacidosis (DKA is the most important acute complication in children with diabetes mellitus. There are several publications regarding the characteristics of children with DKA admitted to hospital care in developed countries, however, in our population there is no information concerning the characteristics of these children. Our aim is to determinate these characteristics. Methods: Retrospective study of DKA events in children fewer than 15 years admitted to HUSVF between 2001 and 2010. The information was collected from medical records and characteristics are depicted by descriptive statistics. Results: We included 98 events of DKA in 77 patients, 64.3% were women, uninsured 23.5%. DKA was the debut of the disease in 53.1%, the average age was 8.7 years (DE 4.35. Patients with known diagnosis didn’t have treatment adherence in 57%, 42,8 % of patients had urinary tract, gastrointestinal, respiratory or another febrile illness at admission. The time between the onset of symptoms and admission was 109 hours (1-720 hours. Ketoacidosis was mild in 29.5%, moderate in 28.7% and severe in 41.8%. The pH at admission was 7,12 (SD 0,12. It took 12.6 hours (SD 8,98 to reach pH 7,30. 14.4% showed hypokalemia, hyponatremia 28.6%, 28.6% hypoglycemia, 5% had cerebral edema and mortality was 2%. Conclusions: Clinical and laboratory characteristics of our population are similar to those reported in other studies. Lack of adherence can be an important and preventable cause of decompensation.

  9. Assisted vaginal deliveries in mothers admitted as public or private patients in Western Australia.

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    Kristjana Einarsdóttir

    Full Text Available BACKGROUND: Mothers delivering as private patients in Australia have a high rate of assisted deliveries, which could lead to adverse infant outcomes in this group of patients. We investigated whether the risk of adverse infant outcomes after assisted deliveries was different for mothers admitted as public or private patients for delivery, when compared with unassisted deliveries. METHODS AND FINDINGS: We included 158,241 vaginal, singleton, term birth admissions in our study where the infant was live born and without birth defects. The study population was identified from statutory birth and hospital data collections held by the Western Australian (WA Department of Health. We estimated odds ratios and confidence intervals using logistic regression models adjusted for a range of maternal demographic, pregnancy and birth characteristics. Interaction was assessed by including interaction terms in the models. Outcomes included low Apgar scores at five minutes (< 7, neonatal resuscitation and special care admission. Mothers delivering as private patients had an increased risk of assisted vaginal delivery compared with public patients (adjusted OR 1.74, 95% CI  =  1.68-1.80. Compared with unassisted vaginal deliveries, assisted deliveries were associated with increased risk of Apgar scores at five minutes below 7 (OR 1.25, 1.08-1.45, neonatal resuscitation (OR  =  1.69, 1.42-2.00 and admission to special care nursery (OR  =  1.64, 1.53-1.76. The increased risk of neonatal resuscitation was higher for mothers admitted as private patients for delivery (OR  =  2.13 than public patients (OR  = 1 .55, p(interaction  =  0.03. CONCLUSIONS: Our results suggested that the high risk of neonatal resuscitation following assisted vaginal deliveries compared to unassisted is higher in private patients than public patients. Whether this phenomenon is due to the twofold higher rate of assisted vaginal deliveries in this group of patients or a

  10. Disease profile and Outcome of Newborn admitted to Neonatology unit of BPKIHS

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    Piush Kanodia

    2015-12-01

    Full Text Available Background & Objectives: Neonatal period is a vulnerable time in which the newborn has to adapt to a totally new environment and is susceptible to many problems, which may even be life threatening. Every year, millions of neonates are born and a large proportion of them are admitted to the neonatal intensive care unit (NICU for various indications. It is found that neonatal mortality rate is decreasing in Nepal but at a slower pace than infant and child mortality. In order to improve neonatal outcome, it is crucial to identify the areas where health care can be improved. Therefore, this study was conducted to identify the clinical profile, pattern of diseases and common causes of mortality and morbidity in neonates admitted to neonatology unit.Materials & Methods: A retrospective study was conducted at neonatology unit of BPKIHS, from January 2014 to December 2014. A total of 1009 neonates (both inborn and out-born were admitted to neonatology division during the study period. Data was collected from the hospital record section. Ethical clearance was taken from the institutional ethical committee before the initiation of the study. Data was entered and descriptive analysis was done by using SPSS 20.0.Results: Total of 1009 neonates were admitted in neonatology unit. Among them, 349(34.5% cases were admitted due neonatal sepsis, 236 (23.3% due to prematurity and 233 (23.1% with birth asphyxia. Among birth asphyxia, 102(43.7% were in HIE III, 34.3% and 21.8% in HIE II and HIE I, respectively. The overall mortality was 47 (4.7% during hospital stay.Conclusion: Sepsis, prematurity and birth asphyxia were major causes for admission in NICU. All these etiologies are preventable up to some extent and, if detected earlier, can be effectively treated in order to reduce morbidity and mortalityJCMS Nepal. 2015;11(3:20-24.

  11. Development of a minimization instrument for allocation of a hospital-level performance improvement intervention to reduce waiting times in Ontario emergency departments

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    Anderson Geoff

    2009-06-01

    Full Text Available Abstract Background Rigorous evaluation of an intervention requires that its allocation be unbiased with respect to confounders; this is especially difficult in complex, system-wide healthcare interventions. We developed a short survey instrument to identify factors for a minimization algorithm for the allocation of a hospital-level intervention to reduce emergency department (ED waiting times in Ontario, Canada. Methods Potential confounders influencing the intervention's success were identified by literature review, and grouped by healthcare setting specific change stages. An international multi-disciplinary (clinical, administrative, decision maker, management panel evaluated these factors in a two-stage modified-delphi and nominal group process based on four domains: change readiness, evidence base, face validity, and clarity of definition. Results An original set of 33 factors were identified from the literature. The panel reduced the list to 12 in the first round survey. In the second survey, experts scored each factor according to the four domains; summary scores and consensus discussion resulted in the final selection and measurement of four hospital-level factors to be used in the minimization algorithm: improved patient flow as a hospital's leadership priority; physicians' receptiveness to organizational change; efficiency of bed management; and physician incentives supporting the change goal. Conclusion We developed a simple tool designed to gather data from senior hospital administrators on factors likely to affect the success of a hospital patient flow improvement intervention. A minimization algorithm will ensure balanced allocation of the intervention with respect to these factors in study hospitals.

  12. Newly Diagnosed Anemia in Admitted Diabetics, Frequency, Etiology and Associated Factors

    International Nuclear Information System (INIS)

    Objective:To determine the frequency of newly-diagnosed anemia in diabetics admitted to the Internal Medicine Department and its etiology and contributing factors. Study Design: A cross-sectional, analytical study. Place and Duration of Study: Department of Internal Medicine, Sir Syed Trust Hospital and College of Medical Sciences, Karachi, from July 2011 to December 2012. Methodology: Adult diabetic patients first diagnosed as having anemia upon hospital admission during the specified duration were included. Patients with active bleed, acute renal impairment, critical illness, pregnancy and previously diagnosed anemia were excluded. Etiology and risk factors of anemia were determined in each case on the basis of history, clinical findings and relevant laboratory investigations i.e. complete blood picture, red cell indices, iron profile, renal function tests, urine and stool examination. Association of anemia was determined using chi-square and t-tests with p-value < 0.05 taken as significant. Results: One hundred and thirty patients (34 males and 96 females) were included. Mean age was 51 ± 12.4 years, with mean BMI of 25.4 ± 5.2 kg/m2, mean duration of diabetes of 7.6 ± 5.5 years and mean glycated haemoglobin (HbA1c) 8.47 ± 1.58%, with 75% diabetics having unsatisfactory glycemic control. Mean haemoglobin was 11.6 ± 1.96 g/dl. Anemia was present in 63% diabetics (18 males and 64 females). It was normocytic in 59.8%, microcytic in 37.8% and macrocytic in 2.4%. Chronic Kidney Disease (CKD) was present in 44%, iron deficiency in 23%, mixed etiology in 6%, vitamin B-12 deficiency in 2% and thalassemia minor in 1% cases. Statistically significant association of anemia was found with poor glycemic control (p=0.002), dietary restriction for red meat (p < 0.001), history of blood loss (p < 0.001), gastrointestinal disorders (p < 0.001), CKD (p < 0.001) and retinopathy (p=0.011). Conclusion: Anemia in two out of every three diabetics in this study points to need for

  13. Clinical and microbiological features of community-acquired and nosocomial bloodstream infections in the surgical department of a tertiary-care hospital in Beijing

    Institute of Scientific and Technical Information of China (English)

    L(U) You; GUO Peng; YE Ying-jiang; WANG Hui; SHEN Zhan-long; WANG Qi; ZHAO Chun-jiang

    2013-01-01

    Background Bloodstream infections (BSls) remain a major cause of morbidity and mortality in patients undergoing surgery.This study aimed at elucidating the clinical characteristics of community-acquired BSls (CABs) and nosocomial BSls (nBSls) in patients admitted to the surgical wards of a teaching hospital in Beijing,China.Methods This cross-sectional study compared 191 episodes of BSls in 4074 patients admitted to the surgical wards between January 2008 and December 2011.Cases of BSls were classified as CABs or nBSls,and the characteristics,relevant treatments,and outcomes of CABs and nBSls were compared.Results Of the 191 BSls,52 (27.2%) and 139 (72.8%) were CABs and nBSls,respectively.Eschedchia coli,coagulasenegative staphylococci,and Klebsiella spp,were the most frequently isolated microorganisms.There were significant differences between CABs and nBSls with respect to the use of hormonal drugs,ventilation,acute physiology and chronic health evaluation (APACHE) Ⅱ and American Society of Anesthesiologists scores,and prevalence of cancer (P <0.05).Empirical antibacterial therapy did not decrease the crude mortality,but multivariate analysis showed that high APACHE Ⅱ was independently associated with a risk of mortality (odds ratio =0.97,95% confidence interval:0.93-1.02 for APACHE Ⅱ).Conclusions We found significant differences in the clinical characteristics of surgical patients with CABs and nBSls.The outcome of patients seems to be related to high APACHE Ⅱ scores.

  14. Evaluation of severe trauma at the Emergency Department of the San Paolo Hospital of Savona: two years of experience

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    F. Frumento

    2012-12-01

    Full Text Available The authors analyze the major trauma recorded in a couple of years in the Emergency Room of the San Paolo Hospital of Savona after the setting, in the same district, of the trauma center at the Santa Corona Hospital of Pietra Ligure. Despite the policy of centralization adopted the amount of major trauma seen at the San Paolo Hospital remained unchanged over time and the number of patients who are not rescued by medicalized ambulance is still significant. These observations underline the importance of periodically reviewing the protocols and make training on trauma also in hospitals that are not recognized as trauma center.

  15. PATTERN OF MORBIDITY AND MORTALITY IN PRETERM NEWBORNS IN A TERTIARY CARE TEACHING HOSPITAL

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    Sumit

    2015-08-01

    Full Text Available OBJECTIVE: To study the morbidity and the mortality patterns in inborn preterm newborns admitted in NICU at a tertiary care teaching hospital. DESIGN: Retrospective study. The medical records of all the inborn preterm neonates (G. age ≤36W+6 days who were admitted to the NICU were analyzed by using a pre - set proforma. SETTINGS: Neonatal Intensive Care Unit (NICU, Department of Pediatrics, Adesh Institute of Medical Science & Research Institute (AIMSR Bathinda, Punjab. The study was carried out over a period of 2 years from J anuary 2012 to December 2014. PARTICIPANTS: 80 preterm neonates who were born in AIMSR and were admitted with some illness to the NICU. OUTCOME: The patterns of the morbidity and the mortality among the preterm neonates who were admitted to the NICU. ‘Survival’ was defined as the discharge of a live neonate/ infant from the hospital. RESULTS: A total of 80 premature inborn infants were analyzed for the complications they encountered after birth while admitted in NICU. Out of 80 premature babies, 32 (40% were male and 48 (60% were female babies. Mean gestational age was and Mean birth weight was. Neonatal hyper - bilirubinemia , HMD/RDS and Neonatal sepsis were the commonest causes of morbidity. Among 80 premature babies 15(18.7% died. The highest mortality was seen in babies those weighing less than 800 grams (100%. Male mortality is 34.4% and female mortality is 8.3%.

  16. Cow-related trauma: a 10-year review of injuries admitted to a single institution.

    LENUS (Irish Health Repository)

    Murphy, Colin G

    2012-02-01

    INTRODUCTION: Bovine-related injuries to farmers are common in rural communities. Many injuries are significant requiring hospital admission and surgery. We reviewed all cattle-related injuries admitted to a regional trauma centre over 10 years and detail the nature of the injuries. METHOD: A retrospective review was undertaken, using hospital inpatient coding system (HIPE) to identify patients admitted following cow-related trauma for the last 10 years. From retrieved charts mechanism of injury was identified, demographics recorded and Injury Severity Score (ISS) and Trauma Injury Severity Score (TRISS) calculated based on the injuries sustained. RESULTS: 47 patients were identified, with a median age of 53 years. 4 injuries occurred in children, and 12 in patients over 65 years old. Three-quarters of those injured were male. Kicking was the most common mechanism of injury (n=21), but charge\\/head-butt injuries and trampling injuries were associated with more serious injury scores. 72% of patients were admitted under Orthopaedics as their primary care team, 25% under General Surgeons, with one patient admitted medically. Mean ISS score was 6.9 (range 1-50). 41 operative interventions were performed on 30 patients during their admission. 6.3% of patients required admission to Intensive Care with a mean length of stay of 12.3 days (range 2-21 days). There was no mortality. CONCLUSION: Cow-related trauma is a common among farming communities and is a potentially serious mechanism of injury that appears to be under-reported in a hospital context. Bovine-related head-butt and trampling injuries should be considered akin to high-velocity trauma.

  17. Treatment compliance of self-reported dog bite cases attending outpatient department of Tertiary Care Hospital, Maharashtra

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    Vijay Kishanrao Domple

    2015-01-01

    Full Text Available Objectives: To assess treatment compliance of self-reported dog bite cases and to assess associated demographic and exposure factors. Materials and Methods: The present prospective study was conducted during January 2013 to July 2013 among 260 dog bite cases by purposive sampling at the outpatient department of a tertiary hospital. After obtaining verbal informed consent, a predesigned questionnaire was used. The assessment of treatment compliance of postexposure prophylaxis (PEP regimen was considered on the basis of intramuscular anti-rabies vaccine (ARV regimen by classifying completed PEP and defaulted PEP. At the end of PEP regimen of every participant, we obtained information about received ARV doses using telephone survey method. Data were analyzed using statistical software Epi info Version 7. Results: Of 260 dog bite cases, 76.5% cases were completed PEP. The majority, 22.3% cases from age group ≤10 years, 56.2% males, 48.1% from urban area, 25% had primary school education, 32.7% students, 53.8% had bite mark on lower limb, 58.5% were category III exposure, and 70.8% who had received previously immunization against rabies, were completed PEP. The bite due to 54.6% pet dog, 58.1% observable dog, 40% provoked bite, 71.9% cases who had not known about the rabid status of the dog, were completed PEP. The unconditional logistic regression analysis found that demographic and exposure factors were not independently associated with treatment compliance (P > 0.05 except literacy status (P < 0.05. The present study showed maximum completed PEP cases, however, it showed the demographic and exposure factors of dog bite cases were not independently associated with treatment compliance except literacy status.

  18. Characteristics of patients who made a return visit within 72 hours to the emergency department of a Singapore tertiary hospital

    Science.gov (United States)

    Chan, Amy Hui Sian; Ho, Shu Fang; Fook-Chong, Stephanie Man Chung; Lian, Sherman Wei Qiang; Liu, Nan; Ong, Marcus Eng Hock

    2016-01-01

    INTRODUCTION 72-hour emergency department (ED) reattendance is a widely-used quality indicator for quality of care and patient safety. It is generally assumed that patients who return within 72 hours of ED discharge (72-hour re-attendees) received inadequate treatment or evaluation. The current literature also suggests considerable variation in probable causes of 72-hour ED reattendances internationally. This study aimed to understand the characteristics of these patients at the ED of a Singapore tertiary hospital. METHODS We conducted a retrospective cohort study on all ED visits between 1 January 2013 and 31 December 2013. 72-hour re-attendees were compared against non-re-attendees based on patient demographics, mode of arrival, patient acuity category status (i.e. P1/P2/P3/P4), seniority ranking of doctor-in-charge and medical diagnoses. Multivariate analysis using the generalised linear model was conducted on variables associated with 72-hour ED re-attendance. RESULTS Among 104,751 unique patients, 3,065 (2.93%) were in the 72-hour re-attendees group. Multivariate analysis showed that the following risk factors were associated with higher risk of returning within 72 hours: male gender, older age, arrival by ambulance, triaged as P2, diagnoses of heart problems, abdominal pain or viral infection (all p < 0.001), and Chinese ethnicity (p = 0.006). There was no significant difference in the seniority ranking of the doctor-in-charge between both groups (p = 0.419). CONCLUSION Several patient and event factors were associated with higher risk of being a 72-hour re-attendee. This study forms the basis for hypothesis generation and further studies to explore reasons behind reattendances so that interventions can be developed to target high-risk groups. PMID:27353286

  19. Hospital Outpatient PPS Partial Hospitalization Program LDS

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Outpatient Prospective Payment System (OPPS) Partial Hospitalization Program LDS This file contains select claim level data and is derived from 2010 claims...

  20. Variables affecting compliance with treatment of post-hospitalized patients with chronic mental illness

    OpenAIRE

    Linsky, Miles A.

    1981-01-01

    The subjects in this study were 33 patients aged 18 to 60 years who were first admitted to an outpatient mental health department in a 1-year period and were known to have had two or more hospitalizations in State or private psychiatric institutions in the 2 years before intake. The relationships between four patient variables and compliance with recommended treatment were studied. The four variables were (a) severity of psychopathology at intake, (b) evidence of negative communication in a p...

  1. [Quality management according to the new SN EN ISO-Norm 9001:2000--experiences from initial certification of a hospital department].

    Science.gov (United States)

    Steffen, Th; Hochberger, G; Eisner, L

    2002-04-24

    Those who want to implement a quality-management system at a hospital these days cannot fall back on a broad-based system proven over the years. Though quality management as defined by ISO norm 9001 has been established as the central standard in many industrial areas, applicability of this ISO norm in the hospital sector has stirred up much controversy during recent years. Introduction of the new ISO norm 9001:2000 has changed the situation. The 2000 version of the new standard seeks to meet the demand for service operations--especially by establishing a clear procedural orientation. This report describes the new standard and its introduction in the Department of Surgery at the Cantonal Hospital in Olten, Canton Solothurn, Switzerland. It indicates the steps taken, for instance in the spheres of top management, quality management, procedural guidance, as well as customer and staff counselling. It also discusses the project's cost/benefit ratio for the organization.

  2. Clinical feature analysis of hospital infections in department of urology based on 39 hospitalized patients%39例泌尿外科住院患者合并医院感染临床特征观察

    Institute of Scientific and Technical Information of China (English)

    肖玮琳; 甘艺平; 余强国; 宋小松

    2016-01-01

    Objective To explore the clinical features of hospital infections in hospitalized patients of urology department. Methods The clinical data of 39 patients suffered hospital infections and 40 patients without infections who were in the urology department of our hospital were compared and analyzed.ResultsThere were 52 pathogenic bacteria cultured from 39 patients with hospital infections, whose main infection sites were urinary tract infections and other infections. There was no relationship between patients’ gender and hospital infections,P>0.05, which was not statistically significant. For patients, the age, underlying disease, indwelling catheter, indwelling time, operation time, hospitalization time, and not using antibiotic drugs were the main reasons of hospital infections, P<0.05, which were statistically significant.ConclusionThere is a high hospital infection rate in the hospitalized patients of urology department, and the infections have complex clinical manifestations. The medical staff should probe into the infection causes and take effective measures to reduce the hospital infection rate.%目的:探讨泌尿科外科住院患者合并医院感染的临床特征。方法回顾性分析2012年10月~2015年10月来我院治疗的39例泌尿外科住院患者临床资料并选取同一时期来泌尿外科住院治疗未发生感染的40例患者对照分析,观察临床特征。结果39例院内感染患者共培养出52例病原菌。主要感染部位为泌尿道路感染及其他感染。患者性别与院内感染无关,无统计学意义(P>0.05)。年龄、基础疾病、留置尿管、留置时间、不使用抗生素、手术时间、住院时间均是导致院内感染的主要因素,有统计学意义(P<0.05)。结论泌尿外科住院患者发生感染机率较高并且临床表现复杂,要求医护人员要对感染原因深入分析并且采取有效措施预防,从而把医院感染机率降低。

  3. 38 CFR 3.1605 - Death while traveling under prior authorization or while hospitalized by the Department of...

    Science.gov (United States)

    2010-07-01

    ... hospitalized under section 5 of Executive Order 10122 (15 FR 2173; 3 CFR 1950 Supp.) issued pursuant to Pub. L... funeral, burial, plot, or interment expenses of a person who dies while in a hospital, domiciliary, or... purpose of: (1) Examination; or (2) Treatment; or (3) Care dies enroute, burial, funeral, plot,...

  4. Evaluating Fluoroquinolone Use in Patients Admitted to the Tuberculosis Outpatient Clinic

    Directory of Open Access Journals (Sweden)

    Sinem İliaz

    2016-08-01

    Full Text Available Objective: Inelaborate use of new quinolones with strong anti-tuberculosis (TB activity leads to difficulty in diagnosis and more importantly, quinolone-resistant Mycobacterium tuberculosis. We aimed to determine the frequency of quinolone use in patients who were referred to our hospital for suspected TB and to evaluate the association between quinolone use and different clinical laboratory parameters. Methods: Between November 15 and December 15, 2013, all patients who were admitted to the TB outpatient clinic with no previous diagnosis of TB were included in this study. Demographic and clinical laboratory findings and history of antibiotic use were recorded. Patients’ quinolone use were questioned by showing fluoroquinolone antibiotic boxes’ photographs available on the market. The departments of the doctors who prescribed quinolones were recorded. Results: The mean age of 179 patients included in the study was 37±16 (15–89 years. Among these, 113 patients (63.1% were male. Seventy five patients (41.9% were diagnosed as tuberculosis according to the clinical-radiological and/or bacteriological findings. Of 179 patients, 58.1% (n=104 had been prescribed antibiotics for current complaints before referral to our clinic. Sixteen patients (15% had been recommended fluoroquinolones. Fluoroquinolones were prescribed by seven internal medicine specialists, five pulmonologists, three emergency medicine specialists, and one family medicine practitioner. Among 16 fluoroquinolones prescribed, nine were moxifloxacin, four were levofloxacin, and three were gemifloxacin. Quinolone use revealed a significant inverse relationship only with the presence of hemoptysis (p=0.04. Conclusion: Besides increased educational activities regarding the rational use of antibiotics in recent years, the quinolone group of antibiotics is still prescribed for suspected TB cases. To avoid quinolone-resistant M. tuberculosis strains, further education is required.

  5. Dynamic statistics on radiology-related examinations of the department of dental radiology at the Kyushu Dental College Hospital during the past 10 years

    International Nuclear Information System (INIS)

    We have reported dynamic statistics on radiology-related examinations and patients in our department every 10 years in order to clarify the role and characteristics of the Department of Dental Radiology at the Kyushu Dental College Hospital. In the last 10 years, the latest models of X-ray CT and magnetic resonance imaging (MRI) equipment have been used, as they were installed when the newly built Kyushu Dental College hospital was opened in September 1999. Therefore, we can now treat more types of disease in the soft tissues of the oral and maxillofacial regions than before. In the present study, we examined the precise numbers of radiology-related examinations and patients, and analyzed the purpose of radiology-related examinations in each modality. Plain radiography, X-ray CT scanning, MRI and ultrasonography were performed at our department from April 1, 1995 to March 31, 2007, and were analyzed for examination number and purpose. The results were as follows. The number of patients visiting our hospital and our department increased markedly when the newly built hospital was opened 10 years ago. The annual number of imaging examinations during the same period also increased substantially. However, the annual number of patients has remained relatively constant since the initial increase. There is an apparent relationship between the number of outpatients and the number of imaging examinations. Because our department began to offer MRI examinations in September 1999, the frequency of these examinations has increased annually for the purpose of soft tissue-related diseases in the oral and maxillofacial regions. X-ray CT examination was mainly used for the detection of diseases occurring in the maxilla and mandible, or of calcification-related diseases such as sialolithiasis. On the other hand, the purpose of MRI examination was the precise detection of diseases occurring in the soft tissues, such as salivary glands. The results suggest that the dentists in our

  6. The Roles of Public Relations Department in the Military Hospital%论军队医院外联办的地位与作用

    Institute of Scientific and Technical Information of China (English)

    杨志刚; 王标; 曾诚

    2013-01-01

    本文结合实际,对医院外联办的职能、地位、作用及效果阐述和分析,指出医院管理者应当将“内涵建设”和“外联宣传”有机的统一,为医院对外联络工作创造良好环境.%The roles of public relations department were analysed deeply in this article.Then the effects of the work of the public relations department in the military hospital were discussed in detail.At last it was suggested that the work of "qulity construction" and "public relations activity" should be combined organically in the hospital,with which to provide a good environment to carry out public relations work.

  7. Challenges and Perspectives for Tertiary Level Hospitals in Bolivia: The case of Santa Cruz de La Sierra Department.

    Science.gov (United States)

    Medici, André

    2015-01-01

    Current legislation transferred public tertiary hospitals in Bolivia from the Municipalities to the Regional Level. However, the Regional Governments are experiencing technical and financial constraints to reform infrastructure, modernize equipment and introduce reforms to allow better governance, management and sustainability of these hospitals. This articles summarizes the recent experience of the Government of Santa Cruz de la Sierra in Bolivia where five tertiary hospitals and blood bank (most of them in precarious working conditions) has been transferred in 2012 from the Municipal Government of Santa Cruz (the capital) to the Regional Government of Santa Cruz. To face the challenges, the Regional Government of Santa Cruz implement several improvements, such as contract new clinical and administrative personal, increases hospital budgetary autonomy, outsource hospitals' auxiliary services, take measures to eliminate waiting lists and make several new investments to modernize and equip the hospitals. The World Bank was contracted to evaluated the future financial sustainability of these investments and to advice the Government to propose changes to increase the hospitals' management performance. The article describes the remaining challenges in these hospitals and the proposals from the World Bank Study. In the area of quality of care, the main challenge is to improve client satisfaction and continuous outcomes monitoring and evaluation according quality standards. In the area of financing, the challenge is how to assure the sustainability of these hospitals with the current level of health financing and the insufficient financial transfers from the National Government. In the area of Governance, reforms to streamline and simplify internal processes need to be introduced in order to establish mechanisms to increase transparency and accountability, allowing the hospital to have a good administration and adequate participation of the main actors in the guidance of

  8. 浅析医院洁净手术部平面设计%Analysis of Graphic Design for Hospital Clean Operation Department

    Institute of Scientific and Technical Information of China (English)

    李成乐

    2012-01-01

    In view of graphic design work for hospital clean operation department, the partition design and process design principles are elaborated, and all types of room's graphic design of clean operation department is analyzed in detail.%针对医院洁净手术部的平面设计工作,阐述了分区设计和流程设计的总体原则,并对洁净手术部各类用房的平面设计进行了详细分析。

  9. 27 CFR 71.65 - Answer admitting facts.

    Science.gov (United States)

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Answer admitting facts. 71... Hearing Procedure Answers § 71.65 Answer admitting facts. If the respondent desires to waive the hearing on the allegations of fact set forth in the order to show cause, and does not contest the facts,...

  10. Sources of occupational stress and coping strategies among nurses who work in Admission and Emergency Departments of Hospitals related to Shiraz University of Medical Sciences

    OpenAIRE

    Gholamzadeh, Sakineh; Sharif, Farkhondeh; Rad, Fereshteh Dehghan

    2011-01-01

    BACKGROUND: Occupational stress is a recognized problem in health care workers. Nursing has been identified as an occupation that has high levels of stress. This study aimed to investigate the sources of job stress and the adopted coping strategies of nurses who were working in an Accident and emergency department. METHODS: In this descriptive survey ninety emergency ward nurses from three large teaching hospitals in Shiraz were involved. The data was collected through a self-administered que...

  11. A Correlation Study between Student Performance in Food and Beverage Services Course and Internship in F&B Department of Hospitality Business

    OpenAIRE

    Dexter R. Buted; Sevillia S. Felicen; Abigail I. Manzano

    2014-01-01

    One of the biggest challenges hospitality educators face today is determining clear goals and objectives for the curriculum to the constantly changing needs of the industry. It is crucial to close the gap between what is taught to students and what the industry expects from the graduates being hired. This study aimed to assess the relationship between the performance of the students on Food and Beverage Services Course and their internship performance in Food and Beverage department in differ...

  12. An audit of the quality of referral letters received by the Department of Oral and Maxillofacial Surgery, Dublin Dental School and Hospital.

    LENUS (Irish Health Repository)

    Moloney, Justin

    2010-10-01

    One hundred consecutive referral letters, sent by dental practitioners to the Department of Oral and Maxillofacial Surgery, Dublin Dental School and Hospital, were audited in terms of quality. The audit was based on the Scottish Intercollegiate Guidelines Network (SIGN) recommendations of 1998. The audit demonstrated that in general referral letters required modification and did not give the clinician the required information. This paper sets out the results of the audit and suggests a template that should be used for future referrals.

  13. An audit of the quality of referral letters received by the Department of Oral and Maxillofacial Surgery, Dublin Dental School and Hospital.

    LENUS (Irish Health Repository)

    Moloney, Justin

    2010-11-01

    One hundred consecutive referral letters, sent by dental practitioners to the Department of Oral and Maxillofacial Surgery, Dublin Dental School and Hospital, were audited in terms of quality. The audit was based on the Scottish Intercollegiate Guidelines Network (SIGN) recommendations of 1998. The audit demonstrated that in general referral letters required modification and did not give the clinician the required information. This paper sets out the results of the audit and suggests a template that should be used for future referrals.

  14. The Financial Impact of Emergency Department Crowding

    Directory of Open Access Journals (Sweden)

    Foley, Mathew

    2011-05-01

    Full Text Available Objective: The economic benefits of reducing emergency department (ED crowding are potentially substantial as they may decrease hospital length of stay. Hospital administrators and public officials may therefore be motivated to implement crowding protocols. We sought to identify a potential cost of ED crowding by evaluating the contribution of excess ED length of stay (LOS to overall hospital length of stay. Methods: We performed a retrospective review of administrative data of adult patients from two urban hospitals (one county and one university in Brooklyn, New York from 2006-2007. Data was provided by each facility. Extrapolating from prior research (Krochmal and Riley, 2005, we determined the increase in total hospital LOS due to extended ED lengths of stay, and applied cost and charge analyses for the two separate facilities. Results: We determined that 6,205 (5.0% admitted adult patients from the county facility and 3,017 (3.4% patients from the university facility were held in the ED greater than one day over a one-year period. From prior research, it has been estimated that each of these patient’s total hospital length of stay was increased on average by 11.7% (0.61 days at the county facility, and 0.71 days at the university facility. The increased charges over one year at the county facility due to the extended ED LOS was therefore approximately $9.8 million, while the increased costs at the university facility were approximately $3.9 million. Conclusion: Based on extrapolations from Krochmal and Riley applied to two New York urban hospitals, the county hospital could potentially save $9.8 million in charges and the university hospital $3.9 million in costs per year if they eliminate ED boarding of adult admitted patients by improving movement to the inpatient setting. [West J Emerg Med. 2011;12(2:192-197.

  15. Validity of the International Classification of Diseases 10th revision code for hyperkalaemia in elderly patients at presentation to an emergency department and at hospital admission

    Science.gov (United States)

    Fleet, Jamie L; Shariff, Salimah Z; Gandhi, Sonja; Weir, Matthew A; Jain, Arsh K; Garg, Amit X

    2012-01-01

    Objectives Evaluate the validity of the International Classification of Diseases, 10th revision (ICD-10) code for hyperkalaemia (E87.5) in two settings: at presentation to an emergency department and at hospital admission. Design Population-based validation study. Setting 12 hospitals in Southwestern Ontario, Canada, from 2003 to 2010. Participants Elderly patients with serum potassium values at presentation to an emergency department (n=64 579) and at hospital admission (n=64 497). Primary outcome Sensitivity, specificity, positive-predictive value and negative-predictive value. Serum potassium values in patients with and without a hyperkalaemia code (code positive and code negative, respectively). Results The sensitivity of the best-performing ICD-10 coding algorithm for hyperkalaemia (defined by serum potassium >5.5 mmol/l) was 14.1% (95% CI 12.5% to 15.9%) at presentation to an emergency department and 14.6% (95% CI 13.3% to 16.1%) at hospital admission. Both specificities were greater than 99%. In the two settings, the positive-predictive values were 83.2% (95% CI 78.4% to 87.1%) and 62.0% (95% CI 57.9% to 66.0%), while the negative-predictive values were 97.8% (95% CI 97.6% to 97.9%) and 96.9% (95% CI 96.8% to 97.1%). In patients who were code positive for hyperkalaemia, median (IQR) serum potassium values were 6.1 (5.7 to 6.8) mmol/l at presentation to an emergency department and 6.0 (5.1 to 6.7) mmol/l at hospital admission. For code-negative patients median (IQR) serum potassium values were 4.0 (3.7 to 4.4) mmol/l and 4.1 (3.8 to 4.5) mmol/l in each of the two settings, respectively. Conclusions Patients with hospital encounters who were ICD-10 E87.5 hyperkalaemia code positive and negative had distinct higher and lower serum potassium values, respectively. However, due to very low sensitivity, the incidence of hyperkalaemia is underestimated. PMID:23274674

  16. Impact of oral diseases on quality of life in subjects attending out-patient department of a dental hospital, India

    Directory of Open Access Journals (Sweden)

    N Saimadhavi

    2013-01-01

    Full Text Available Context: Currently there is a growing interest in oral health outcomes in how oral health affects quality of life. When oral health related quality of life measures are used alongside traditional clinical methods of measuring oral health status, a more comprehensive assessment of the impact of oral diseases on the several dimensions of subjective wellbeing becomes possible. In this context, we attempted to study the impact of oral diseases on quality of life, so as to address the patient′s needs in an appropriate way and thereby improving one′s quality of life. Aims: To evaluate the impact of different oral diseases on quality of life using a modified OHIP-14 questionnaire, so as to address the patient′s needs in an appropriate way and thereby improving one′s quality of life. Settings and Design: The study was carried out among 302 subjects, attending the outpatient department a dental hospital, India, for check up and treatment of their oral condition. Subjects aged above 20 years, who gave their consent for the study were included. Materials and Methods: The study sample was categorized in to two groups based upon the duration of the affecting disease - group 1 consisted of subjects suffering with chronic diseases and group 2 of subjects suffering with acute diseases. All the subjects were asked to fill up their responses in the given OHIP-14 questionnaires. The completed questionnaires were then collected and statistically analyzed. Statistical Analysis Used: To evaluate the role of age on QOL, age was divided in to 2 groups using median split procedure. For inter and intragroup comparisions, independent sample t test, anova followed by post hoc test and Chi-square tests were employed. Results: Chi square test revealed a moderately impaired quality of life among all the diseases investigated. On comparing the mean domain and total OHIP score between the two groups, the domain of psychological discomfort and disability and the total

  17. The Pre-hospital Care and Nursing Care of Critically Urgent Ill Patients in the Department of Obstetrics and Gynecology%妇产科急危重症患者的院前急救及护理

    Institute of Scientific and Technical Information of China (English)

    翟丹; 熊焱

    2013-01-01

    Objective To explore the pre-hospital care and nursing care of critically urgent ill patients in the department of obstetrics and gynecology and provide the clinical basis for future applications. Methods The clinical data of 128 cases of acute and critically ill patients admitted to the obstetrics and gynecology from March 2010 to February 2012 were chosen in the research. The ambulance process and the effect were taken for retrospective analysis. The pre-hospital emergency care and experience for intensive patients in the department of obstetrics and gynecology were summarized. Results 128 cases of acute obstetrics and gynecology in critically ill patients were selected, 126 cases were successful and 2 died, the survival rate was 98.4%. Conclusion The pre-hospital first aid and care for intensive patients in the department of obstetrics and gynecology should be done:fast visits, try to understand the patient's symptoms on the road, and develop effective and accurate treatment programs;try every possible complications to make process, make the ambulance and medical staff memorize it in heart;comprehensively improve the overall quality of health care workers, and thereby improve the success rate for the intensive maternal.%  目的探讨妇产科急危重症患者的院前急救及护理的方法,为今后应用提供临床依据.方法本次研究选择我院2010年3月至2012年2月收治的妇产科急危重症患者128例的临床资料,对其救护过程、效果进行分析进行回顾性分析,总结妇产科急危重症患者的院前急救及护理的方法和经验.结果选取128例妇产科急危重症患者抢救成功126例,死亡2例,抢救成功率98.4%.结论妇产科急危重症患者的院前急救及护理应做到:出诊速度快,在路途中尽量了解患者的症状,并制订有效、准确的治疗方案;对每一种可能出现的并发症制订相应的救护流程,并让医护人员熟

  18. [Systemic Antimicrobials Consumption and Expenditures in Departments of Surgery of Multi-Profile Hospitals in the Russian Federation and the Republic of Belarus: Results of Multicentre Pharmacoepidemiological Study].

    Science.gov (United States)

    Belkova, Yu A; Rachina, S A; Kozlov, R S; Mishchenko, V M; Pavlukov, R A; Abubakirova, A I; Berezhanskiy, B V; Eliseeva, E V; Zubareva, N A; Karpov, I A; Kopylova, I A; Palyutin, Sh Kh; Portnyagina, U S; Pribytkova, O V; Samuylo, E K

    2016-01-01

    The results of the systemic antimicrobials (AM) consumption and expenditures assessment in the departments of surgery of multi-profile hospitals in different regions of the Russian Federation and the Republic of Belarus in 2009-2010 based on retrospective collection and analysis of the data from the hospital expenditure notes using ATC/DDD methodology are presented. The average AM consumption and expenditure rates in the above mentioned departments varied from 24.9 DDD/100 bed-days to 61.7 DDD/100 bed-days depending on the department profile, with beta-lactams (cephalosporins and penicillins) share in the consumption being as high as 70-90%, followed by fluoroquinolones and aminoglycosides. Only 55-70% of the consumed AM belonged to the drugs of choice, whereas the improper AM consumption and expenditure rates amounted up to 10-18%. The study outputs can be used for the budget allocation and AM distribution improvement in the departments of surgery, as well as for the development and efficacy control of the local antimicrobial stewardship programs.

  19. [Systemic Antimicrobials Consumption and Expenditures in Departments of Surgery of Multi-Profile Hospitals in the Russian Federation and the Republic of Belarus: Results of Multicentre Pharmacoepidemiological Study].

    Science.gov (United States)

    Belkova, Yu A; Rachina, S A; Kozlov, R S; Mishchenko, V M; Pavlukov, R A; Abubakirova, A I; Berezhanskiy, B V; Eliseeva, E V; Zubareva, N A; Karpov, I A; Kopylova, I A; Palyutin, Sh Kh; Portnyagina, U S; Pribytkova, O V; Samuylo, E K

    2016-01-01

    The results of the systemic antimicrobials (AM) consumption and expenditures assessment in the departments of surgery of multi-profile hospitals in different regions of the Russian Federation and the Republic of Belarus in 2009-2010 based on retrospective collection and analysis of the data from the hospital expenditure notes using ATC/DDD methodology are presented. The average AM consumption and expenditure rates in the above mentioned departments varied from 24.9 DDD/100 bed-days to 61.7 DDD/100 bed-days depending on the department profile, with beta-lactams (cephalosporins and penicillins) share in the consumption being as high as 70-90%, followed by fluoroquinolones and aminoglycosides. Only 55-70% of the consumed AM belonged to the drugs of choice, whereas the improper AM consumption and expenditure rates amounted up to 10-18%. The study outputs can be used for the budget allocation and AM distribution improvement in the departments of surgery, as well as for the development and efficacy control of the local antimicrobial stewardship programs. PMID:27337864

  20. 医院门诊部健康管理实践的几点做法%Some methods of health management practice in hospital outpatient department

    Institute of Scientific and Technical Information of China (English)

    曹晶; 张海蕾; 李贤卓

    2014-01-01

    With the update of medical concept and the formation of new biological-psychological-social medical model,the goal of hospital service is constantly updating and upgrading.The outpatient department is the service window and forward position of the hospital.The health management work is an important part of hospital outpatient department work.The activity of health management practice in hospital outpatient department include strengthening the health management idea renewal, setting up and perfect the functions of the health management of science, optimizing the health management professional team, creating good environment and health management throughout the overall comprehensive health management services.Summarized as follows..%随着医学理念更新和新的生物-心理-社会医学模式的形成,医院服务的目标在不断更新和提升。门诊部是医院的服务窗口和前沿阵地。健康管理工作是医院门诊部工作的重要部分。本院门诊部健康管理实践活动包括强化健康管理理念更新,科学设置和完善健康管理职能部门,优化健康管理专业团队,创建良好的健康管理环境,提供全程全方位健康管理的整体服务。

  1. Hospital-based stroke care in Ireland: results from one regional register.

    LENUS (Irish Health Repository)

    Fan, C W

    2000-01-01

    Most patients with acute stroke are admitted to hospital. If stroke services in this country are to be improved, we need accurate and reliable information about the types of stroke patients being admitted, their present management and outcome.

  2. Evaluation of Head Trauma Cases in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Alim Cokuk

    2013-02-01

    Full Text Available Aim: In this study, we aimed to determine the epidemiological characteristics, morbidity and mortality rates of patients admitted to the emergency department with head trauma. Material and Methods: In this study, ambulatory and hospitalized patients over the age of 18 brought to the Emergency Department because of head trauma between 01.12.2009 - 31.12.2010 were analyzed retrospectively. Patient data were recorded to standard data entry form. SPSS 17.0 package program was used for statistical analysis of data. The statistical significance level of all tests was p <0.05. Results: 5200 patients were included in this study. The average age of the patients was 39.97 ± 16.66 years. 4682'si patients (90 % were discharged from the emergency department. The most common reason for admission to the emergency department was falls (41.81 % in the discharged patients. 518 (10 % patients were hospitalized. Gender of these patients was 110 female (21:24% and 408 male (78.76%. 256 patients (48.35% were injured as a result of a traffic accident. 201(38.8% of the cerebral CT were reported as normal and 89 (17.2% of the cerebral CT were reported as traumatic subarachnoid hemorrhage (SAH in hospitalized patients. The fracture of lumbar spine (12 % was detected as an additional pathological disease in patients. 75 patients hospitalized because of head trauma (14.5% had died (1.44 % of all patients. Cervical spine fracture was the most common (14 patients, 18.68 % additional pathology in patients who died. Thoracic trauma was detected as the second most common (13 patients, 17.33 % additional pathology. Conclusion: Most of the patients admitted to the emergency department with head injury had a minor trauma. Patients can be discharged from the emergency department after a thorough physical examination and simple medical intervention. Most of the head injury patients admitted to hospital were male. The most common reason of the patients with head injury admitted to

  3. Declining trend in the use of repeat computed tomography for trauma patients admitted to a level I trauma center for traffic-related injuries

    Energy Technology Data Exchange (ETDEWEB)

    Psoter, Kevin J., E-mail: kevinp2@u.washington.edu [Department of Epidemiology, University of Washington, Box 357236, Seattle, WA 98195 (United States); Roudsari, Bahman S., E-mail: roudsari@u.washington.edu [Department of Radiology, Comparative Effectiveness, Cost and Outcomes Research Center, University of Washington, 325 Ninth Avenue, Box 359960, Seattle, WA 98104 (United States); Graves, Janessa M., E-mail: janessa@u.washington.edu [Department of Pediatrics, Harborview Injury Prevention and Research Center, University of Washington, 325 Ninth Avenue, Box 359960, Seattle, WA 98104 (United States); Mack, Christopher, E-mail: cdmack@uw.edu [Harborview Injury Prevention and Research Center, University of Washington, 325 Ninth Avenue, Box 359960, Seattle, WA 98104 (United States); Jarvik, Jeffrey G., E-mail: jarvikj@u.washington.edu [Department of Radiology and Department of Neurological Surgery, Comparative Effectiveness, Cost and Outcomes Research Center, University of Washington, 325 Ninth Avenue, Box 359960, Seattle, WA 98104 (United States)

    2013-06-15

    Objective: To evaluate the trend in utilization of repeat (i.e. ≥2) computed tomography (CT) and to compare utilization patterns across body regions for trauma patients admitted to a level I trauma center for traffic-related injuries (TRI). Materials and Methods: We linked the Harborview Medical Center trauma registry (1996–2010) to the billing department data. We extracted the following variables: type and frequency of CTs performed, age, gender, race/ethnicity, insurance status, injury mechanism and severity, length of hospitalization, intensive care unit (ICU) admission and final disposition. TRIs were defined as motor vehicle collisions, motorcycle, bicycle and pedestrian-related injuries. Logistic regression was used to evaluate the association between utilization of different body region repeat (i.e. ≥2) CTs and year of admission, adjusting for patient and injury-related characteristics that could influence utilization patterns. Results: A total of 28,431 patients were admitted for TRIs over the study period and 9499 (33%) received repeat CTs. From 1996 to 2010, the proportion of patients receiving repeat CTs decreased by 33%. Relative to 2000 and adjusting for other covariates, patients with TRIs admitted in 2010 had significantly lower odds of undergoing repeat head (OR = 0.61; 95% CI: 0.49–0.76), pelvis (OR = 0.37; 95% CI: 0.27–0.52), cervical spine (OR = 0.23; 95% CI: 0.12–0.43), and maxillofacial CTs (OR = 0.24; 95% CI: 0.10–0.57). However, they had higher odds of receiving repeat thoracic CTs (OR = 1.86; 95% CI: 1.02–3.38). Conclusion: A significant decrease in the utilization of repeat CTs was observed in trauma patients presenting with traffic-related injuries over a 15-year period.

  4. Applicability of the Chinese version of the Hypomania Symptom Checklist (HCL-32 scale for outpatients of psychiatric departments in general hospitals.

    Directory of Open Access Journals (Sweden)

    Xiao Huang

    Full Text Available OBJECTIVES: This study aimed to determine the suitability of the Chinese version of the Hypomania Symptom Checklist (HCL-32 scale for psychiatric department outpatients with mood disorders in Chinese general hospitals, and provide a theoretical basis for the application of the HCL-32 scale. METHODS: Outpatients with mood disorders receiving continuous treatment in the psychiatric medicine department of three top-ranking general hospitals in three cities completed scoring the HCL-32 scale. RESULTS: A total of 1010 patients were recruited. 417 were diagnosed with bipolar disorder (236 for type I and 181 for type II and 593 were depression. Four factors with eigenvalues >1 were considered. Factor 1 with an eigenvalue of 5.5 was labeled "active/cheerful". Factor 2 with an eigenvalue of 2.7 was labeled "adventurous/irritable." The coefficient of internal consistency reliability of the HCL-32 total scale was 0.84, and the coefficients for factors 1 and 2 were 0.84 and 0.88, respectively. With the total score of HCL-32≥14 as positive standard, the sensitivity of HCL-32 was calculated at 69.30% and the specificity was 97.81%. CONCLUSIONS: Results showed that HCL-32 had a preferable reliability and validity and was suitable as auxiliary means for bipolar disorder screening in general hospitals.

  5. Effects of neuromuscular electrostimulation in patients with heart failure admitted to ward

    Directory of Open Access Journals (Sweden)

    de Araújo Carlos José Soares

    2012-11-01

    Full Text Available Abstract Background Neuromuscular electrostimulation has become a promising issue in cardiovascular rehabilitation. However there are few articles published in the literature regarding neuromuscular electrostimulation in patients with heart failure during hospital stay. Methods This is a randomized controlled pilot trial that aimed to investigate the effect of neuromuscular electrostimulation in the walked distance by the six-minute walking test in 30 patients admitted to ward for heart failure treatment in a tertiary cardiology hospital. Patients in the intervention group performed a conventional rehabilitation and neuromuscular electrostimulation. Patients underwent 60 minutes of electrostimulation (wave frequency was 20 Hz, pulse duration of 20 us two times a day for consecutive days until hospital discharge. Results The walked distance in the six-minute walking test improved 75% in the electrostimulation group (from 379.7 ± 43.5 to 372.9 ± 46.9 meters to controls and from 372.9 ± 62.4 to 500 ± 68 meters to electrostimulation, p Conclusion The neuromuscular electrostimulation group showed greater improvement in the walked distance in the six-minute walking test in patients admitted to ward for compensation of heart failure.

  6. Substance abuse in patients admitted voluntarily and involuntarily to acute psychiatric wards: a national cross-sectional study

    Directory of Open Access Journals (Sweden)

    Anne Opsal

    2011-12-01

    Full Text Available Background: Substance abuse and mental disorder comorbidity is high among patients admitted to acute psychiatric wards. The aim of the study was to identify this co-occurrence as a reason for involuntary admission and if specific substance use-related diagnoses were associated with such admissions.Methods: The study was a part of a multicentre, cross-sectional national study carried out during 2005-2006 within a research network of acute mental health services. Seventy-five percent of Norwegian hospitals providing acute in-patient treatment participated. Substance use was measured using the Clinician Rating Scale and the ICD-10 diagnoses F10-19. Diagnostic assessments were performed by the clinicians during hospital stay.Results: Overall, 33.2% (n=1,187 of the total patient population (3,506 were abusing alcohol or drugs prior to admission according to the Clinician Rating Scale. No difference in the overall prevalence of substance abuserelated diagnoses between the two groups was found. Overall, 310 (26% of the admissions, 216 voluntarily and 94 involuntarily admitted patients received a double diagnosis. Frequent comorbid combinations among voluntarily admitted patients were; a combination of alcohol and either mood disorder (40% or multiple mental disorders (29%. Among involuntarily admitted patients, a combination of poly drug use and schizophrenia was most frequent (47%. Substance abusing patients diagnosed with mental and behavioral disorders due to the use of psychoactive stimulant substances had a significantly higher risk of involuntary hospitalization (OR 2.3.Conclusion: Nearly one third of substance abusing patients are involuntarily admitted to mental hospitals, in particular stimulant drug use was associated with involuntarily admissions.

  7. Validation of epilepsy diagnoses in the Danish National Hospital Register

    DEFF Research Database (Denmark)

    Christensen, Jakob; Vestergaard, Mogens; Olsen, Jørn;

    2007-01-01

    PURPOSE: To validate the diagnosis of epilepsy in the Danish National Hospital Register. METHODS: We randomly selected 200 patients registered with epilepsy in the Danish National Hospital Register between 1977 and 2002 and validated the diagnosis according to the guidelines developed...... by the International League Against Epilepsy. RESULTS: We reviewed the medical records of 188 (94%) persons from 57 departments at 41 hospitals. The epilepsy diagnoses were confirmed in 153 patients, providing a positive predictive value for epilepsy of 81% (95% confidence interval (95% CI): 75-87%). Among the 35...... patients who did not fulfill the criteria for epilepsy, 14 were admitted after a single, unprovoked seizure. Among patients registered with epilepsy the positive predictive value of seizure disorder was 89% (95% CI: 83-93%). Among patients classified with epilepsy syndromes, the positive predictive value...

  8. Combined determination of highly sensitive troponin T and copeptin for early exclusion of acute myocardial infarction: first experience in an emergency department of a general hospital

    Directory of Open Access Journals (Sweden)

    Müller K

    2011-08-01

    Full Text Available Ulrich Lotze1, Holger Lemm2, Anke Heyer2, Karin Müller31Department of Internal Medicine, German Red Cross Hospital Sondershausen, Sondershausen, 2Department of Internal Medicine, 3Department of Laboratory Medicine, Saale-Unstrut Hospital Naumburg, Naumburg, GermanyBackground: The purpose of this observational study was to test the diagnostic performance of the Elecsys® troponin T high-sensitive system combined with copeptin measurement for early exclusion of acute myocardial infarction (MI in clinical practice.Methods: Troponin T high-sensitive (diagnostic cutoff: <14 pg/mL and copeptin (diagnostic cutoff: <14 pmol/L levels were determined at admission in addition to other routine laboratory parameters in patients with suspected acute MI presenting to the emergency department of a general hospital over a period of five months.Results: Data from 142 consecutive patients (mean age 71.2 ± 13.5 years, 76 men were analyzed. Final diagnoses were acute MI in 13 patients (nine ST elevation MI, four non-ST elevation MI, 9.2% unstable angina pectoris in three (2.1%, cardiac symptoms not primarily associated with myocardial ischemia in 79 (55.6%, and noncardiac disease in 47 patients (33.1%. The patients with acute MI were younger and had higher troponin T high-sensitive and copeptin values than patients without acute MI. Seventeen patients had very high copeptin values (>150 pmol/L, one of whom had a level of >700 pmol/L and died of pulmonary embolism. A troponin T high-sensitive level of <14 pg/mL in combination with copeptin <14 pmol/L at initial presentation ruled out acute MI in 45 of the 142 patients (31.7%, each with a sensitivity and negative predictive value of 100%.Conclusion: According to this early experience, a single determination of troponin T high-sensitive and copeptin may enable early and accurate exclusion of acute MI in one third of patients, even in an emergency department of a general hospital.Keywords: highly sensitive troponin T

  9. Evaluation of a Computerized Problem-Oriented Medical Record in a Hospital Department: Does it Support Daily Clinical Practice?

    DEFF Research Database (Denmark)

    Bossen, Claus

    2007-01-01

     Purpose: Evaluation of a computerized problem-oriented medical record (CPOMR) for hospital work.Methods: A qualitative study of daily use of a CPOMR at an internal medicine hospital ward over a period of three months during which 66 patients were treated based on clinical information recorded...... led to more time spent documenting clinical work, fragmentation of patient situation into separate problems, and lack of overview.Conclusion: The problem-oriented method for structuring a computerized medical record may provide a description of how physicians think or ought to think, but does...

  10. [Management strategies and choice of antithrombotic treatment in patients admitted with acute coronary syndrome--executive summary for clinical practice. Consensus Document of the Regional Chapters of the Italian National Association of Hospital Cardiologists (ANMCO) and of the Italian Society of Emergency Medicine (SIMEU)].

    Science.gov (United States)

    Uguccioni, Massimo; Pugliese, Francesco; De Luca, Leonardo; Tubaro, Marco; Ruggieri, Maria Pia; Colivicchi, Furio; Ammirati, Fabrizio; Ansalone, Gerardo; Avella, Andrea; Azzolini, Paolo; Bertazzoni, Giuliano; Brama, Paolo; Cacciatore, Giuseppe; De Luca, Massimo; De Simone, Massimo; Di Fusco, Stefania Angela; Ferraiuolo, Giuseppe; Ferranti, Fabio; Granatelli, Antonino; Loschiavo, Paolo; Mezzanotte, Roberto; Mirante, Enrico; Monti, Francesco; Pajes, Giuseppe; Pandolfo, Luciano; Proiettil, Fabrizio; Revello, Alessandra; Rigattieri, Stefano; Sabetta, Francesco; Sciahbasi, Alessandro; Scioli, Roberto; Serdoz, Roberto; Susi, Beniamino; Vincentelli, Giovanni Maria; Zuccalà, Giuseppe; Zulli, Luigi

    2013-03-01

    This document has been developed by the Lazio regional chapters of two scientific associations, the Italian National Association of Hospital Cardiologists (ANMCO) and the Italian Society of Emergency Medicine (SIMEU), whose members are actively involved in the everyday management of Acute Coronary Syndromes (ACS). The document is aimed at providing a specific, practical, evidence-based guideline for the effective management of antithrombotic treatment (antiplatelet and anticoagulant) in the complex and ever changing scenario of ACS. The document employs a synthetic approach which considers two main issues: the actual operative context of treatment delivery and the general management strategy.

  11. Flat deformation of a spacetime admitting two Killing fields

    CERN Document Server

    Llosa, Josep

    2009-01-01

    It is shown that given an analytic Lorentzian metric on a 4-manifold, $g$, which admits two Killing vector fields, then it exists a local deformation law $\\eta = a g + b H$, where $H$ is a 2-dimensional projector, such that $\\eta$ is flat and admits the same Killing vectors. We also characterize the particular case when the projector $H$ coincides with the quotient metric. We apply some of our results to general stationary axisymmetric spacetimes

  12. Finite Groups in Which Sylow Normalizers Admit Supplements

    Institute of Scientific and Technical Information of China (English)

    Tian Ze LI

    2007-01-01

    For a group G and a subgroup M of G, we say that a subgroup A of G is a supplement to M in G,if G = MA. We prove that a finite group in which every Sylow normalizer admits a nilpotent supple ment is solvable. In particular we confirm a conjecture of Buchthal. Moreover we investigate finite groups in which Sylow normalizers admit solvable supplements.

  13. Hospital Compare - Archived Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Compare is a consumer-oriented website that provides information on how well hospitals provide recommended care to their patients. This information can...

  14. HCAHPS Hospital Survey

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Hospital Survey The intent of the HCAHPS initiative is to provide a standardized survey...

  15. Evaluation of trends of drug-prescribing patterns based on WHO prescribing indicators at outpatient departments of four hospitals in southern Ethiopia

    Directory of Open Access Journals (Sweden)

    Summoro TS

    2015-08-01

    Full Text Available Temesgen Sidamo Summoro,1 Kassa Daka Gidebo,2 Zewde Zemma Kanche,1 Eskinder Wolka Woticha2 1School of Medicine, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia; 2School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia Background: Rational prescribing is a primary step to ensure rational drug use. Often, half of the medicines are prescribed irrationally and half of these are even used incorrectly as the patients fail to take their medicines appropriately. The aim of this research was to evaluate drug-prescribing patterns of four hospitals in southern Ethiopia.Methods: A retrospective cross-sectional study was conducted between May 15 and June 25, 2014, to evaluate the drug-prescribing patterns based on the World health Organization (WHO prescribing indicators. The prescription papers, kept for the last 1 year in the outpatient departments of the four hospitals, were analyzed according to WHO guidelines. Also, prescriptions in the hospitals were analyzed to determine the most frequently prescribed drugs. All the statistical calculations were performed using SPSS® version 20.0 software.Results and discussion: The average number of drugs per prescription ranges from 1.82±0.90 to 2.28±0.90, whereas the percentage of use of antibiotics and injections ranged from 46.7 to 85 and 15 to 61.7, respectively. The average percentages of drugs prescribed by generic name and from the essential drugs list were 95.8 and 94.1, respectively. Anti-infective and analgesic drugs are found to be the most frequently prescribed medicines. In terms of polypharmacy, there was a slight deviation in prescribing patterns from what is acceptable according to the WHO criteria. Prescribing by generic name and from essential drug list was almost optimal. There was a significant deviation in the use of injectables in two of the four hospitals (50%, whereas their use in the other

  16. Acute hemorrhagic stroke in young adults-a study in a tertiary-care hospital of North India

    OpenAIRE

    Baidya, Omkar Prasad; Tiwari, Sunita; Usman, Kauser

    2015-01-01

    Objectives: To see the risk factors, clinical presentations and radiological profile of acute hemorrhagic stroke in young subjects in a tertiary-care hospital of North India.Methods: This study was carried out among 50 acute hemorrhagic stroke patients (clinically and radiologically confirmed) irrespective of sex within the age group of 15-45 years admitted to Department of Medicine after getting clearance from Institutional Ethical Committee (IEC). A proforma for each of the acute hemorrhagi...

  17. Correlation between timing of tracheostomy and duration of mechanical ventilation in patients with potentially normal lungs admitted to intensive care unit

    OpenAIRE

    Mehrdad Masoudifar; Omid Aghadavoudi; Lida Nasrollahi

    2012-01-01

    Background: There is insufficient evidence to conclude that the timing of tracheostomy alters the duration of mechanical ventilation, hence this study was designed to investigate the correlation between timing of tracheostomy and duration of mechanical ventilation for patients admitted to intensive care unit (ICU) with potentially normal lungs. Materials and Methods: In a retrospective study for a period of 2 years, all adult patients admitted to the medical ICU of Al-Zahra Hospital in Is...

  18. 医院放射科空调系统及防辐射设计%Radiation protection and air conditioning system design for hospital radiology department

    Institute of Scientific and Technical Information of China (English)

    王松涛; 李欣; 赵艳波; 杜艳利

    2015-01-01

    Describes the features of the different radiology rooms in hospital including X-ray,CT, ECT,PET-CT,MRI and other radiology departments.According to the functional characteristics of the rooms and requirements of medical and health environment,presents the air conditioning system design of the radiology department.States the producing mechanism of radiation,and takes different radiation protection measures according to the different types of rays,which can provide reasonable suggestions for the air conditioning system and radiation protection design of the hospital radiology department.%简单描述了医院 X 线,CT,ECT,PET-CT,MRI 等放射科房间的功能特性,根据房间的功能特性及医疗卫生环境要求,详细阐述了放射科各房间的空调系统设计类型。介绍了医院放射科射线的产生机理,根据射线类型的不同采取相应的辐射防护措施,为医院放射科的空调系统及射线防护设计提供合理的建议。

  19. Clinical Factors Associated with Morbidity and Mortality in Patients Admitted with Sickle Cell Disease

    Science.gov (United States)

    Galloway-Blake, K; Reid, M; Walters, C; Jaggon, J; Lee, MG

    2014-01-01

    ABSTRACT Objective: To determine the clinical factors associated with the length of hospitalization and mortality in patients with sickle cell disease (SCD). Methods: All patients with SCD admitted to the medical wards of the University Hospital of the West Indies, Jamaica, over a five-year period, January 1, 2005 to December 31, 2010, were reviewed. Data were extracted from hospital charts and comprised demographic and clinical information, investigations, interventions, duration of stay, pathological data and outcomes. Results: There were 105 patients reviewed; 84% were genotype Hb SS. Females accounted for 59% and males 41%. Overall mean age was 32.5 years (SD 13.7, range 12–66 years). The mean length of hospitalization was 10.2 days (SD 10.9, range 1–84 days). The main admission diagnoses were painful crisis, acute chest syndrome, severe anaemia, sepsis, hepatic sequestration, congestive cardiac failure and renal failure. The mean values for the following laboratory investigations were: haemoglobin 7.7 g/dL (SD 2.8), total white blood cell count 21.7 × 109/L (SD 14.2), platelet count 320 × 109/L (SD 191.9), blood urea 9.8 mmol/L (SD 11.9) and serum creatinine 198 umol/L (SD 267.9). Medical interventions included: blood transfusions in 20.9%, 55% received antibiotics and 74% received narcotic analgesia. There were 40 deaths with four autopsies done. The mortality rate for SCD was 38%. There were 189 repeat SCD admissions. Conclusion: Sickle cell disease still carries a high morbidity and mortality in patients admitted to hospital. Recurrent admissions are a concern, as they impact on patient's morbidity and quality of life. PMID:25867578

  20. 38 CFR 1.514 - Disclosure to private physicians and hospitals other than Department of Veterans Affairs.

    Science.gov (United States)

    2010-07-01

    ... beneficiary; or (3) Any physician or medical installation treating the veteran under emergency conditions. ... than Department of Veterans Affairs. (a) When a beneficiary elects to obtain medical attention as a private patient from a private practitioner or in a medical center other than a Department of...

  1. [Management and accounting solution required in clinical laboratory department in the hospital and the balanced scorecard (BSC)].

    Science.gov (United States)

    Takahashi, Toshiro

    2006-11-01

    This is to describe required accounting knowledge and the techniques for the clinical laboratory department management level people to operate their division from the viewpoint of management. Especially, the necessity and the efficacy of the BSC implementation in the clinical laboratory department are being explained.

  2. Hypoalbuminemia is a strong predictor of 30-day all-cause mortality in acutely admitted medical patients

    DEFF Research Database (Denmark)

    Jellinge, Marlene Ersgaard; Henriksen, Daniel Pilsgaard; Hallas, Peter;

    2014-01-01

    -day all-cause mortality in a cohort of acutely admitted medical patients. METHODS: We included all acutely admitted adult medical patients from the medical admission unit at a regional teaching hospital in Denmark. Data on mortality was extracted from the Danish Civil Register to ensure complete...... (precision of predictions) for hypoalbuminemia was determined. RESULTS: We included 5,894 patients and albumin was available in 5,451 (92.5%). A total of 332 (5.6%) patients died within 30 days of admission. Median plasma albumin was 40 g/L (IQR 37-43). Crude 30-day mortality in patients with low albumin...... was 16.3% compared to 4.3% among patients with normal albumin (pday mortality, were younger and were admitted for a shorter period...

  3. 中国中医科学院西苑医院肿瘤科%Department of Oncology of Xiyuan Hospital of China Academy of Chinese Medical Sciences

    Institute of Scientific and Technical Information of China (English)

    中国中医科学院西苑医院肿瘤科

    2011-01-01

    This article introduced in detail on the Department of Oncology, Xiyuan Hospital of China Academy of Chinese Medical Sciences since it was established. The main direction of this department is TCM comprehensive therapy on colorectal cancer treatment. Development of department of oncology is through continuous exploration on specific treatment methods and systematic evaluation construction. The Department of Oncology of Xiyuan Hospital is the head unit of colorectal cancer treatment by the State Administration of Traditional Chinese Medicine in the "Eleventh Five-Year" Plan. The study, which is cooperated with 26 hospitals in China and National Research Cen-ter in Complementary and Alternative Medicine (NAFKAM) in Norway, is on the verification of TCM treatment of colorectal cancer diagnosis and treatment. The Integrative Medicine Diagnosis and Treatment Option on Colorectal Cancer was made. Exploration has been made on the three-level colorectal cancer prevention and control network with community hospitals. The completed tasks have been widely proved by the medical field both at home and abroad.%本文较详细地介绍了中国中医科学院西苑医院肿瘤科成立以来,确立了以中医综合治疗结、直肠癌为主攻方向,不断探索具体治疗方法和建立系统评价体系的成长历程.他们作为国家中医药管理局“十一五”结直肠癌专病建设组长单位,牵头联合全国26家医院以及挪威国家补充替代医学研究中心,进行的中医结直肠癌的诊疗方案的验证工作,牵头制定《结直肠癌中西医结合诊疗方案》,以及探索建立辐射社区医院的结直肠癌中医三级防治网络等工作,得到国内外医学界的广泛认可,具有典范借鉴意义.

  4. The Exploration and Practice of the Management of the Nutrition Depart-ment in the Hospital%医院营养科饮食保障管理探索与实践

    Institute of Scientific and Technical Information of China (English)

    陈珵

    2015-01-01

    in the dietetic social security under the background of, nutrition department according to the "food sanitation law, the No.85 Hospital of food hygiene and safety supervision and management regulations", the establishment of a food safety responsibility system, formulated the conforms to the actual hospital food safety management system, strengthen man-agement practitioners, and play the role of department experts, in practice continue to touch Suo Li practice, in terms of food security has been a qualitative leap. Hospital of food hygiene and safety to get effective protection, the completion of several of the major tasks of the categories of food security, food poisoning events did not occur, to ensure the food security of the officers and men of the hospital.%在后勤饮食保障社会化背景下,营养科根据《食品卫生法》《第八五医院食品卫生安全监督管理条例》,建立了食品安全责任体系,制定了符合医院实际的食品安全管理制度,加强从业人员管理,发挥科室专家作用,在实践中不断地摸索历练,在餐饮保障方面有了质的飞越。医院食品卫生安全得到有效保障,多次完成重大任务的大项餐饮保障,未发生一起食物中毒事件,保证了医院官兵的饮食安全。

  5. An intensive monitoring of adverse drug reaction in indoor patients of medicine department at tertiary care teaching hospital

    OpenAIRE

    Nishita H. Darji; Shilpa Jadav; Chintan Doshi; Rutvij Hedamba; Rusva Mistry; Hiren Trivedi

    2016-01-01

    Background: Use of drugs itself may result into illness and death due to their adverse effects. In India 10-20% of inpatients developed adverse drug reactions. Most of these problems can be overcome by undertaking hospital based intensive monitoring. Objective of this study was to estimate the incidence and document the spectrum of ADRs in studied patients in terms of causality, severity, frequency, type and preventability. A prospective, observational, single centre study conducted among the...

  6. Performance of interventional procedures in a day-hospital system

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Jae Ik; Park, Auh Whan; Cho, Hye Seon; Park, Eun Hee; Choi, Gap Suk; Lee, Seon Ju; Kim, Yong Woo; Juhn, Je Ryang [Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

    2007-01-15

    We wanted to describe the practice and results of applying the day-hospital system in an interventional radiology clinic. From Oct. 2004 to Dec. 2005, the day-hospital system was applied to various interventional procedures with using a part of the recovery room of an angiography suite as a facility for hospital admission. The study included 91 cases in 73 patients. The source of the patient referral, the procedures, hospital courses and complications were analyzed and questionnaire surveys were conducted for the available 55 patients. Among the patients, 70% (n=64) were referred form other departments, 5% (n=5) from other hospitals, 5% (n=4) were new patients and 20% (n=18) were re-admissions. The procedures included gastrointestinal, biliary, urinary, hemodialysis related-and implantable port related interventions. 96% (n=87) of the patients were successfully discharged in a day and admission to the general ward was only 4% (n=4). Minor complications occurred after discharges in 3% (n=3). The questionnaire survey revealed that 96% (n=53) of the patients were satisfied with the service and they were not anxious after discharge. Most of common interventional procedures were safely done under the day-hospital system with the patients being highly satisfied. The day-hospital system can be a good tool for establishing admitting privileges for an interventional radiology clinic.

  7. Rates of TBI-related Emergency Department Visits, Hospitalizations, and Deaths by Sex — United States, 2001–2010

    Data.gov (United States)

    U.S. Department of Health & Human Services — Overall rates of TBI climbed slowly from 2001 through 2007, then spiked sharply in 2008 and continued to climb through 2010. The increase in TBI rates in 2008 was...

  8. Nosocomial Candiduria in Critically Ill Patients Admitted to Intensive Care Units in Qazvin, Iran

    Directory of Open Access Journals (Sweden)

    Ghiasian

    2014-08-01

    Full Text Available Background A broad variety of fungi, especially Candida species, are becoming increasingly common causes of urinary tract infections in hospital settings. Objectives The current cross-sectional descriptive study aimed to determine the causative agents, risk factors and incidence rate of candiduria in critically ill patients, hospitalized in intensive care units (ICUs of four Iranian hospitals. Patients and Methods A total of 155 children and adult patients, admitted to ICUs of the four university educational hospitals, who demonstrated Candida-positive urine cultures, were examined. Samples were processed via mycological procedures by direct microscopy and culture. Results Candiduria was confirmed in 50 (32.26 % patients and Candida albicans was the most frequently isolated species representing 60.0% of isolates, followed by 14.0% C. glabrata, 12.0% C. parapsilosis, 10.0% C. krusei, and 4.0% C. tropicalis. Most patients were female (58% with a mean age of 46.7 years old. Generally, 39.7% and 62% of adults and children showed candiduria, respectively. The commonest predisposing factors were antibiotic therapy (98.0%, urinary catheterization (92.0%, corticotherapy (84.0%, being female (42.6 %, use of feeding tube (56%, and extended hospitalization, respectively. Conclusions The high frequency of candiduria in ICU patients can be decreased by shortening the duration of urinary catheterization, avoiding extra antibiotics and corticosteroids, as well as controlling the predisposing factors and underlying conditions.

  9. Parental Perceptions of Hospital Care in Children with Accidental or Alleged Non-Accidental Trauma

    Science.gov (United States)

    Ince, Elif E.; Rubin, David; Christian, Cindy W.

    2010-01-01

    Objective: To determine whether a suspicion or diagnosis of child abuse during hospitalization influences parental perceptions of hospital care in families of children admitted with traumatic injuries. Method: Parents of children younger than 6 years of age admitted with traumatic injuries to a large urban children's hospital were recruited to…

  10. PATTERN OF BABIES WITH CONGENITAL MALFORMATIONS ADMITTED IN A TERTIARY NEWBORN CARE UNIT

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    Saminathan

    2015-05-01

    Full Text Available AIM: To determine the pattern of congenital malformation in the neonates admitted in Mahatma Gandhi Memorial government Hospital, Trichy. METHOD: 16,672 live birth babies delivered in Mahatma Gandhi Memorial government Hospital, Trichy were screened for external congenital malformation during the study period august 2011 to august 2013. Total of 232 neonates were diagnosed have congenital malformat ions. Radiological investigations was done to confirm internal anomalies in asymptomatic neonates. RESULTS: Study showed a prevalence of major con genit al malformation to be 13.9 / 1000 live births, neural tube defects being the commonest (25%. The inciden ce is significantly high in mother of age group >35 years, increasing parity, positive family history. Congenital malformation constitutes a significant proportion of neonatal mortality. CONCLUSION: Congenital malformations are higher in mothers age group of >35 increasing parity, maternal hyperglycemia and preterm babies. Periconceptional folic acid intake is important to prevent neural tube defects.

  11. Treatment needs, diagnoses and use of services for acutely admitted psychiatric patients in northwest Russia and northern Norway

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    Sørgaard Knut W

    2013-01-01

    Full Text Available Abstract Background We compared demography, diagnoses and clinical needs in acutely admitted psychiatric hospital patients in northwest Russia and northern Norway. Method All acutely admitted psychiatric patients in 1 psychiatric hospital in north-west Russia and 2 in northern Norway were in a three months period assessed with HoNOS and a Norwegian form developed to study acute psychiatric services (MAP. Data from a total of 841 patients were analysed (377 Norwegian, 464 Russian with univariate and multivariate statistics. Results Russian patients were more often males who had paid work. 2/3 were diagnosed with alcohol and organic disorders, and 70% reported problems related to sleep. Depression was widespread, as were problems associated with occupation. Many more Norwegian patients were on various forms of social security and lived in community supported homes. They had a clinical profile of affective disorders, use of drugs, suicidality and problems with activities involved of daily life. Slightly more Norwegian patients were involuntary admitted. Conclusion Acutely admitted psychiatric patients in North West Russia and Northern Norwegian showed different clinical profiles: alcohol, depression and organic disorders characterised Russian patients, affective disorders, suicidality and use of drugs characterised the Norwegians. Whereas Norwegian patients are mainly referred from GPs the Russians come via 1.line psychiatric services (“dispensaries”. Average length of stay for Russian patients was 2.5 times longer than that of the Norwegian.

  12. One year survey of hospitalized psoriatic patients and their treatment in Razi Hospital

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    Farnaghi F

    1998-05-01

    Full Text Available During one year survey, 77 psoriatic patients were hospitalized in the dermatology department of Razi Hospital. This comprised 19% of admitted patients in this period. 29% (n=22 of psoriatic patients had previous history of hospitalization. On admission, the mean age of patients was 32.8 years, the mean and peak age of disease onset were 26.46 and between 11-20 years, respectively. 14% (n=10 of the patients had a family history of psoriasis and 70% (n=7 of those with a positive family history had their age of onset under 20 years. Involvement of different regions was as follows: Scalp: 88% (n=68, nails: 53% (n=41 and joints (arthritis: 10% (n=8. Psoriasis was associated with scrotal tongue in 19% (n=13 and with geographic tongue in 10% (n=8 of patients. Regarding the medical treatment, the drugs which were used most frequently were tigason in 34% (n=41 and ditranol in 22% (n=26 of the cases. The mean duration of hospitalization was 39.29 days and most patients were discharged from the hospital in a good condition without any serious complication. During this period 9% of patients had a relapse of their disease.

  13. Discussion on Human Resource Construction of Hospital Administration Departments%医院行政部门人力资源建设的实践与思考

    Institute of Scientific and Technical Information of China (English)

    张冬娟; 张春芳; 王晶桐; 邵晓凤

    2015-01-01

    医院的管理水平是影响医院发展的重要因素之一。为切实提高医院管理水平,实现医院的科学化、专业化、精细化管理,北京大学人民医院通过改变招聘方式、建立有效培训培养平台、完善管理职称评审体系等多种方式不断优化行政职能部门人力资源结构,提高行政管理人员综合素质,加强行政职能部门人力资源建设,取得了良好效果。%The management level is one of the important factors which could influence the development of hospitals. In order to realize scientific, professional and elaborate hospital management, Peking University People's Hospital optimized the structure of human resource, improved the comprehensive quality of administrative staff, promoted the construction of human resource in administration departments and gained good effect through changing the recruitment methods, establishing effective training platforms, and improving the management of professional title evaluation system.

  14. Characteristics and determinants of adult patients with acute poisoning attending the accident and emergency department of a teaching hospital in Qatar.

    Science.gov (United States)

    Khudair, I F; Jassim, Z; Hanssens, Y; Alsaad, W A

    2013-09-01

    Data about etiologic and demographic characteristics of acute poisoning in adults in Qatar are lacking. This prospective observational study was undertaken to analyze characteristics and possible determinants of acute poisoning in adults in Qatar. During 2010, 18,073 patients attended the emergency department of Hamad General Hospital, a teaching hospital in Qatar. Out of them, 599 (3.3%) patients were diagnosed as "poisoning case" with either chemical or pharmaceutical substances. The prevalence rate of poisoning incidence was 35.3/100,000 population. Seven patients died, corresponding with a case-fatality rate of 0.39/1000. The majority were male (65%) and the mean age was 34 years. The poisons involved were mainly chemicals (61.6%) and pharmaceuticals (38.4%). Female, mainly single, suffered more intentional poisoning compared to male. Of the patients aged 60 years and above (7.2%), the majority (95.3%) suffered unintentional poisoning with pharmaceuticals; 56% with warfarin, 12% with digoxin and 7% with insulin. Multivariate analysis shows that female gender, single status, younger than 35 years of age, being poisoned by pharmaceutical products, and the need for hospitalization are significant determinants for acute intentional poisoning after adjusting all other possible covariates. The findings of this study can be used to establish awareness and prophylactic campaigns in Qatar.

  15. 公立医院客户服务部建设的探索——华山医院东院客户服务部六年实践总结%An exploration of the construction of the customer service department in a public hospital: 6-year experience of Customer Service Department in East Branch, Huashan Hospital

    Institute of Scientific and Technical Information of China (English)

    蔡丽莉

    2012-01-01

    在医院内建立一个功能完整的客户服务部是目前公立医院的创新举措,它整合了医院内除医疗护理外所有的行政事务类服务和管理,树立了一个用对客服务的理念向医院客户传递服务信息建立良好的公共关系的形象.通过与院内外各部门的协调和合作完成部门各岗位的工作运转,在建立一个服务高端人群的医疗模式的同时为病人提供方便、及时、高效、温馨的人性化服务.六年来,华山东院在这方面进行了尝试探索,创建了医院的客户服务工作模式.%The establishment of a functional Customer Service Department is creative and integrated of current public hospitals. It doesn' t only integrate all the service and management in the hospital administration except for nursing, but also conveys a customer-oriented motto to the patients in order to establish a good characteristic of the public relationship. This department works by the coordination with internal and external departments of the hospital. While endeavoring to build a new medical pattern of high-end service, our department has sustained to provide the patients with convenient, prompt, efficient, considerate and personal service as well. We have been exploring in the past 6 years and established the pattern of customer service in the public hospital.

  16. A study of factors delaying hospital arrival and predictors of mortality in patients presenting to emergency department with Stroke: A developing state scenario

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    Vinayak Nagaraja

    2010-10-01

    Full Text Available Background: Thrombolytic therapy for acute ischemic stroke has recently become available in India but its success depends on initiating the treatment in the narrow therapeutic time window. There is commonly a delay of several hours before patients with acute stroke seek medical attention. Materials and Methods: A prospective study was conducted to assess the factors influencing this delay in admission of acute stroke cases. 134cases (101 males, 33 females of acute stroke that arrived within 72 hours at our hospital casualty were recruited. A standardized structured questionnaire was given to patients or their attendants. Results: The median time to casualty arrival was 9 hours with 13.4% cases arriving within 3 hours and 36.5 % cases within 6 hours. Distances from hospital, referral, belief in myths and alternate medicine and low threat perception of symptoms of stroke were independent factors associated with delay in arrival. Living in city, day time onset, urgency shown by attendant, availability of transport and presence of family history were associated with early arrival. There was no correlation with patients' or attendants' sex, educational status, history of previous stroke or transient ischemic attack, subtype or severity of stroke, time of stroke and availability of transport. 134 patients (65.7% were from rural population, 55.22%-smokers, 46.76%-alcoholics with mean (SD age of 53.83+/-18.02years [significantly lower in females (mean difference=9.73years p=0.002], were admitted and diagnosed to have stroke. 87.3% had first episode of stroke and 12.7 had more than one episode of stroke. ICF rate was 26.1%. ICF rate has no relation with age (p=0.516, sex (p=0.460, number of episodes (0.795, underlying hypertension (p=0.905. Odds of diabetics dying were 12 times higher than non-diabetics. Inpatient mortality was also significantly higher in smokers compared with non-smokers (p=0.004, in patients with right-sided compared with left

  17. PO02 - Clinical profile of children admitted to a paediatric intensive care unit due to acute clinical deterioration

    DEFF Research Database (Denmark)

    Jensen, Claus Sixtus; Aagaard, Hanne; Olesen, Hanne Vebert;

    2016-01-01

    Theme: Intensive care Background: There has been an increased number of critically ill patients admitted to paediatric departments. Only a few studies have described the various causes of unplanned admission to paediatric intensive care units (PICU) due to clinical deterioration. However, an...... critical ill children in paediatric wards....

  18. Role of emergency department of a super specialty government hospital during a seasonal dengue epidemic in a developing country: A conundrum

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    Hem Chandra

    2013-11-01

    Full Text Available Main objectives of this study were to establish the role of the emergency department of an exclusive super specialty tertiary care hospital during a seasonal epidemic such as dengue and to further estimate the opportunity cost involved in treating such dengue patients. Retro-prospective six months study at the Emergency Receiving Station of a Super Specialty Government Hospital was done in India. 294 dengue patients were managed during the study period. 38% of these were cured in the Emergency Department itself where the treatment was given by an Emergency Medical Officer, a plain medical graduate. The average retention period of the dengue patients was significantly higher than that of the rest of the patients visiting the emergency (p=0.001. Treatment of the 294 dengue patients was achieved at an opportunity cost of 8 genuine super-specialty emergency patients per day. Dengue, being a seasonal epidemic in the developing world, assiduous measures are imperative to prevent any such recurrence. Health authorities should be more proactive to preclude such a situation, detrimental to the very concepts of regionalization of the healthcare delivery system and should disseminate correct timely information to the public vis-à-vis availability and requirement of medical services during such seasonal epidemics.

  19. Incidence of Road Traffic Injury and Associated Factors among Patients Visiting the Emergency Department of Tikur Anbessa Specialized Teaching Hospital, Addis Ababa, Ethiopia

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    Bewket Tadesse Tiruneh

    2014-01-01

    Full Text Available Background. Road traffic injuries are a major public health issue. The problem is increasing in Africa. Objective. To assess the incidence of road traffic injury and associated factors among patients visiting the emergency department of Tikur Anbessa Specialized Teaching Hospital, Addis Ababa, Ethiopia. Methods. Institutional based cross-sectional study design was conducted. A total of 356 systematically selected study subjects were included in the study. Bivariate and multivariate logistic regressions were performed to identify associated factors with road traffic injury. Odds ratios with 95% confidence interval were computed to determine the level of significance. Results. The incidence of road traffic injury in the emergency department of Tikur Anbessa Specialized Teaching Hospital was 36.8%. Being a farmer (AOR = 3.3; 95% CI = 1.06–10.13, conflict with family members (AOR = 7.7; 95% CI = 3.49–8.84, financial problem (AOR = 9.91; 95% CI = 4.79–6.48, psychological problem (AOR = 17.58; 95% CI = 7.70–12.14, and alcohol use (AOR = 2.98; 95% CI = 1.61–5.27 were independently associated with road traffic injury. Conclusion and Recommendation. In this study the incidence of road traffic injury was high. Alcohol is one of the most significant factors associated with Road Traffic Injury. Thus urgent education on the effect of alcohol is recommended.

  20. Determinants of mortality for adults with cystic fibrosis admitted in Intensive Care Unit: a multicenter study

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    Rabbat Antoine

    2006-01-01

    Full Text Available Abstract Background Intensive care unit (ICU admission of adults with cystic fibrosis (CF is controversial because of poor outcome. This appraisal needs re-evaluation following recent changes in both CF management and ICU daily practice. Objectives were to determine long-term outcome of adults with CF admitted in ICU and to identify prognostic factors. Methods Retrospective multicenter study of 60 ICU hospitalizations for 42 adult CF patients admitted between 2000 and 2003. Reason for ICU admission, ventilatory support provided and one-year survival were recorded. Multiple logistic analysis was used to determine predictors of mortality. Results Prior to ICU admission, all patients (mean age 28.1 ± 8 yr had a severe lung disease (mean FEV1 28 ± 12% predicted; mean PaCO2 47 ± 9 mmHg. Main reason for ICU hospitalization was pulmonary infective exacerbation (40/60. At admission, noninvasive ventilation was used in 57% of cases and was successful in 67% of patients. Endotracheal intubation was implemented in 19 episodes. Overall ICU mortality rate was 14%. One year after ICU discharge, 10 of the 28 survivors have been lung transplanted. Among recognized markers of CF disease severity, only the annual FEV1 loss was associated with a poor outcome (HR = 1.47 [1.18–1.85], p = 0.001. SAPSII (HR = 1.08 [1.03–1.12], p Conclusion Despite advanced lung disease, adult patients with CF admitted in ICU have high survival rate. Endotracheal intubation is associated with a poor prognosis and should be used as the last alternative. Although efforts have to be made in selecting patients with CF likely to benefit from ICU resources, ICU admission of these patients should be considered.