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Sample records for general hospital pemex

  1. Specialized consultant in radiological safety to the Ciudad del Carmen general hospital, PEMEX; Asesoria especializada en seguridad radiologica al hospital general Ciudad del Carmen, PEMEX

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Hernandez C, J. E.; Rodriguez A, F.; Garcia A, J

    2003-02-15

    The Ciudad del Carmen general hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  2. Specialized consultant in radiological safety to the Tula general hospital, PEMEX. VI. - December of 2001; Asesoria especializada en seguridad radiologica al hospital general Tula, PEMEX. VI.- Diciembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F

    2002-01-15

    The Tula general hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  3. Specialized consultant in radiological safety to the Tula general hospital, PEMEX. III.- September of 2001; Asesoria especializada en seguridad radiologica al hospital general Tula, PEMEX. III.- Septiembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Rodriguez A, F.; Garcia A, J

    2001-12-15

    The Tula general hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  4. Specialized consultant in radiological safety to the Tula general hospital, PEMEX. I.- July of 2001; Asesoria especializada en seguridad radiologica al hospital general Tula, PEMEX. I.- Julio de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J

    2001-09-15

    The Tula general hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic. The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  5. Specialized consultant in radiological safety to the Tula general hospital, PEMEX. II.- August of 2001; Asesoria especializada en seguridad radiologica al hospital general Tula, PEMEX. II.- Agosto de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Rodriguez A, F.; Garcia A, J

    2001-10-15

    The Tula general hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  6. Specialized consultant in radiological safety to the Tula general hospital, PEMEX. IV. - October of 2001; Asesoria especializada en seguridad radiologica al hospital general Tula, PEMEX. IV.- Octubre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F

    2002-01-15

    The Tula general hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  7. Specialized consultant in radiological safety to the Tula general hospital, PEMEX. V. - November of 2001; Asesoria especializada en seguridad radiologica al hospital general Tula, PEMEX. V.- Noviembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F

    2002-01-15

    The Tula general hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  8. Specialized consultant in radiological safety to the Ciudad del Carmen general hospital, PEMEX. III.- September and October of 2002; Asesoria especializada en seguridad radiologica al hospital general Ciudad del Carmen, PEMEX. III.- Septiembre y Octubre de 2002

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Rodriguez A, F.; Garcia A, J

    2003-02-15

    The Ciudad del Carmen general hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  9. Specialized consultant in radiological safety to the north central hospital of high speciality, PEMEX. I. - May-June of 2003; Asesoria especializada en seguridad radiologica al hospital central norte de alta especialidad, PEMEX I.- Mayo-Junio de 2003

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Camacho V, B.; Rodriguez A, F

    2003-09-15

    The north central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  10. Specialized consultant in radiological safety to the south central hospital of high speciality, PEMEX. V. - November of 2001; Asesoria especializada en seguridad radiologica al hospital central sur de alta especialidad, PEMEX. V.- Noviembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F

    2002-01-15

    The south central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Autho000.

  11. Specialized consultant in radiological safety to the clinical north central hospital of high speciality, PEMEX. IV. - December of 2001; Asesoria especializada en seguridad radiologica a la clinica hospital central norte de alta especialidad, PEMEX. IV.- Diciembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F

    2002-01-15

    The clinical north central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  12. Specialized consultant in radiological safety to the Salamanca regional hospital, PEMEX. VI. - December of 2001; Asesoria especializada en seguridad radiologica al hospital regional Salamanca, PEMEX. VI.- Diciembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F

    2002-01-15

    The Salamanca regional hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  13. Specialized consultant in radiological safety to the Salamanca regional hospital, PEMEX. IV. - October of 2001; Asesoria especializada en seguridad radiologica al hospital regional Salamanca, PEMEX. IV.- Octubre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F

    2002-01-15

    The Salamanca regional hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  14. Specialized consultant in radiological safety to the Villahermosa regional hospital, PEMEX. IV. - November and December of 2002; Asesoria especializada en seguridad radiologica al Villahermosa hospital regional, PEMEX, IV.- Noviembre y Diciembre de 2002

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Hernandez C, J.E.; Rodriguez A, F.; Garcia A, J

    2003-02-15

    The Villahermosa regional hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  15. Specialized consultant in radiological safety to the Salamanca regional hospital, PEMEX. III. - September of 2001; Asesoria especializada en seguridad radiologica al hospital regional Salamanca, PEMEX. III.- Septiembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F

    2002-01-15

    The Salamanca regional hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  16. Specialized consultant in radiological safety to the north central hospital of high speciality, PEMEX. I. - July of 2001; Asesoria especializada en seguridad radiologica al hospital central norte de alta especialidad, PEMEX I.- Julio de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A

    2001-09-15

    The north central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  17. Specialized consultant in radiological safety to the north central hospital of high speciality, PEMEX. II. - August of 2001; Asesoria especializada en seguridad radiologica al hospital central norte de alta especialidad, PEMEX II.- Agosto de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Rodriguez A, F.; Garcia A, J

    2001-10-15

    The north central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)0.

  18. Specialized consultant in radiological safety to the north central hospital of high speciality, PEMEX. III. - September of 2001; Asesoria especializada en seguridad radiologica al hospital central norte de alta especialidad, PEMEX III.- Septiembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Rodriguez A, F.; Garcia A, J

    2001-12-15

    The north central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  19. Specialized consultant in radiological safety to the Salamanca regional hospital, PEMEX. I. - July of 2001; Asesoria especializada en seguridad radiologica al hospital regional Salamanca, PEMEX. I.- Julio de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A

    2001-09-15

    The Salamanca regional hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  20. Specialized consultant in radiological safety to the Villahermosa regional hospital, PEMEX. III. - September and October of 2002; Asesoria especializada en seguridad radiologica al hospital regional Villahermosa, PEMEX, III.- Septiembre y Octubre de 2002

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Rodriguez A, F.; Garcia A, J

    2003-02-15

    The Villahermosa regional hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiolpogic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  1. Specialized consultant in radiological safety to the Salamanca regional hospital, PEMEX. II. - August of 2001; Asesoria especializada en seguridad radiologica al hospital regional Salamanca, PEMEX. II.- Agosto de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F

    2002-01-15

    The Salamanca regional hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  2. Specialized consultant in radiological safety to the south central hospital of high speciality, PEMEX. III.- September of 2001; Asesoria especializada en seguridad radiologica al hospital central sur de alta especialidad, PEMEX III.- Septiembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Rodriguez A, F.; Garcia A, J

    2001-12-15

    The south central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  3. Specialized consultant in radiological safety to the south central hospital of high speciality, PEMEX. IV. - October of 2001; Asesoria especializada en seguridad radiologica a la clinica al hospital central sur de alta especialidad, PEMEX. IV.- Octubre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F

    2002-01-15

    The south central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  4. Specialized consultant in radiological safety to the south central hospital of high speciality, PEMEX. I. - July of 2001; Asesoria especializada en seguridad radiologica al hospital central sur de alta especialidad, PEMEX I.- Julio de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J

    2001-09-15

    The south central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  5. Specialized consultant in radiological safety to the south central hospital of high speciality, PEMEX. II.- August of 2001; Asesoria especializada en seguridad radiologica al hospital central sur de alta especialidad, PEMEX II.- Agosto de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Rodriguez A, F.; Garcia A, J

    2001-12-15

    The south central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  6. Specialized consultant in radiological safety to the Salamanca regional hospital, PEMEX. V. - November of 2001; Asesoria especializada en seguridad radiologica al hospital regional Salamanca, PEMEX. V.- Noviembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F

    2002-01-15

    The Salamanca regional hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  7. Specialized consulting in radiological safety to the North Central Hospital of high specialty, PEMEX. V. November of 2001; Asesoria especializada en seguridad radiologica al Hospital Central Norte de alta especialidad, PEMEX. V. Noviembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F. [ININ, 52045 Ocoyoacac, Estado de Mexico (Mexico)

    2002-01-15

    It is a report of a specialized consulting in radiological safety that to be carried the ININ to PEMEX for the North Central Hospital of High Specialty, to maintain the sanitary license for the use of X ray equipment of medical diagnostic, and guarantee these services with a program of quality assurance. To give fulfilment to that requests it is programmed a technical assistance monthly, with reports of results during the development of the service. In this document it is carried a report of the advances and results in the month of November of the 2001, where the following documents are analyzed: Manual of radiological safety, program of quality assurance, operation procedures, procedure of maintenance team, procedure of medical radiological control of the specialized personnel; also are annotate the obtained results and their observations. (Author)

  8. Specialized consulting in radiological safety to the south central hospital of high specialty, PEMEX. VI. December of 2001; Asesoria especializada en seguridad radiologica al hospital central sur de alta especialidad. PEMEX. VI. Diciembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J.A.; Garcia A, J.; Rodriguez A, F. [ININ, 52045 Ocoyoacac, Estado de Mexico (Mexico)

    2002-01-15

    It is a report of a specialized consulting in radiological safety that to be carried the ININ to PEMEX for the South Central Hospital of High Specialty, to maintain the sanitary license for the use of X-ray equipment of medical diagnostic, and guarantee these services with a program of quality assurance. To give fulfilment to that requests it is programmed a technical assistance monthly, with reports of results during the development of the service. In this document it is carried a report of the advances and results in the month of december of the 2001, where the following documents are analyzed: Manual of radiological safety, program of quality assurance, operation procedures, procedure of maintenance team, procedure of medical radiological control of the specialized personnel; also are annotate the obtained results and their observations. (Author)

  9. Reflections for a healthy development of PEMEX; Reflexiones para un sano desarrollo de PEMEX

    Energy Technology Data Exchange (ETDEWEB)

    Mondragon M, Francisco [Petroleos Mexicanos (PEMEX), Mexico, D.F. (Mexico)

    2006-11-15

    Petroleos Mexicanos (PEMEX) is a company badly administered, with excess of personnel, on the brink of financial collapse and straggler in technology, to verify this is enough to compare the oil potential of the country and the financial results of PEMEX with oil companies of the world - considered here -. To revert those present tendencies and still to satisfy the future demand of hydrocarbons PEMEX will have, on its own, evolve its infrastructure whereas the legislative power must grant greater autonomy to PEMEX as well as approve a new fiscal regime that gradually allow the company more financial resources and not on indebtedness. [Spanish] Petroleos Mexicanos (PEMEX) es una empresa mal administrada, con exceso de personal, al borde del colapso financiero y rezagada en tecnologia, para comprobarlo basta comparar el potencial petrolero del pais y los resultados financieros de PEMEX con empresas petroleras del mundo -aqui estimados-. Para revertir esas tendencias actuales y aun satisfacer la futura demanda de hidrocarburos PEMEX debera, por su parte, evolucionar su infraestructura mientras que el poder legislativo debera otorgar mayor autonomia a PEMEX asi como aprobar un nuevo regimen fiscal que le permitan a la empresa gradualmente mas recursos financieros y no un sobre endeudamiento.

  10. Restructuring proposed for Mexico's Pemex

    Energy Technology Data Exchange (ETDEWEB)

    1992-06-22

    Mexican President Carlos Salinas de Gortari soon will send a legislative proposal to Congress that splits state owned Petroleos Mexicanos into four subsidiaries. This paper reports that Pemex functions will be divided into Pemex Exploration Production, Pemex Refining, Pemex Gas Basic Petrochemicals, and Pemex Secondary Chemicals. An earlier report the the company would be split into seven units. Each of the four new operating companies will be an independent business unit with a separate board of directors and its own staff and support functions.

  11. Cogeneration projects in PEMEX refining; Proyectos de cogeneracion en PEMEX Refinacion

    Energy Technology Data Exchange (ETDEWEB)

    Becerra O' Leary, Jose [Petroleos Mexicanos (Mexico)

    2006-10-15

    Mexican Petroleum proposes the electric power cogeneration, the energy consumption and rationalization as well as the operative performance improvement. This is the reason Pemex refining considers the cogeneration projects development possibility related with the Refining National System to supply the six refineries with steam and electric power. And also the energy auto-supply to other Pemex refining, using the liquid and solid residuals as fuels for petroleum refining. [Spanish] Petroleos Mexicanos propone la Cogeneracion de energia electrica, el aprovechamiento y la racionalizacion del consumo de energia, asi como el mejoramiento del desempeno operativo, por lo cual Pemex Refinacion plantea la posibilidad del desarrollo de proyectos de Cogeneracion asociados a las refinerias del Sistema Nacional de Refinacion, para abastecer de vapor y energia electrica a cada una de las seis refinerias, asi como el autoabastecimiento de energia a otras instalaciones de Pemex Refinacion, utilizando como combustibles los residuales liquidos y solidos de la refinacion del petroleo.

  12. QECH general hospital strike

    African Journals Online (AJOL)

    Malawi's only medical school and also hosts the Blantyre cam- pus for the ... 1993 when general civil disobedience in form of street demon- strations, riots and strikes ... However their own rights are limited by their responsibility to save life and ...

  13. Private sector cautious on Pemex reorganization

    Energy Technology Data Exchange (ETDEWEB)

    Sissell, K.

    1997-03-19

    Private sector interest in the privatization of the petrochemical subsidiaries of Mexico`s state oil company Petroleos Mexicanos (Pemex) will hinge on the government`s decisions on minority ownership, says Raul Millares, president of Aniq, the Mexican chemical industry association. The murkiest issues are how the subsidiaries will be operated and what rights minority owners will have. {open_quotes}The question is who is going to manage the subsidiaries on a day-to-day basis,{close_quotes} says Millares. {open_quotes}There is a lot of doubt as to whether private companies will be able to get the flexibility they need.{close_quotes}

  14. [Family and psychiatric hospitalization in a general hospital].

    Science.gov (United States)

    de Mello, Rita Mello; Schneider, Jacó Fernando

    2011-06-01

    This study aims to identify the reasons that lead relatives to hospitalize patients in a psychiatric unit of a general hospital. It is a qualitative study based on Alfred Schutz' phenomenological sociology. Fourteen relatives, each with one family member hospitalized, were interviewed from August to October 2009. The guiding question of the phenomenological interview was "What do you expect from psychiatric hospitalization in a general hospital?". Phenomenological sociology was used to understand and interpret the interviews. Statements showed three concrete categories, that lead to the reasons for: treatment guidelines and continuity; prospects for improvement; ideas about normality. This research shows the experiences of relatives, contributing with mental health professionals' reflection about their actions and about the involvement of families in a general hospital's psychiatric unit.

  15. PEMEX exploration and production (E and P) projects

    Energy Technology Data Exchange (ETDEWEB)

    Guevara, H. [PEMEX Exploracion y Produccion, Mexico City (Mexico)

    1999-10-01

    The investment that PEMEX`s exploration and production (PEP) has made in Mexico`s energy sector was discussed. PEP has invested more than US$7 billion over the last two years. Capital expenditures have been driven by market forces. This will provide opportunities for several companies, particularly those in NAFTA (North American Free Trade Agreement) countries. The implications of Canadian companies doing business in Mexico were also discussed. PEMEX`s operating companies were listed along with a PEP ranking for 1997. Crude oil and gas production charts show a gradual increase in production for both, from 1995 to 1998. Capital expenditures have increased from US$ 2.2 billion in 1996 to US$ 4.0 billion in 1998. The megaprojects currently underway in Mexico include the Cantarell, Burgos, and the Delta del Grijalva projects. A comparison in investment for onshore and offshore projects was presented. It was concluded that in order to help Canadian companies invest in the Mexican E and P services sector, it would be helpful to have a transparent bidding process guaranteed by the existing institutional framework. 1 tab., 9 figs.

  16. [Crisis unit at the general hospital: Determinants of further hospitalization].

    Science.gov (United States)

    Norotte, C; Omnès, C; Crozier, C; Verlyck, C; Romanos, M

    2016-10-10

    The availability of short-stay beds for brief admission (less than 72hours) of crisis patients presenting to the emergency room is a model that has gained a growing interest because it allows time for developing alternatives to psychiatric hospitalization and favors a maintained functioning in the community. Still, the determinants influencing the disposition decision at discharge after crisis intervention remain largely unexplored. The primary objective of this study was to determine the factors predicting aftercare dispositions at crisis unit discharge: transfer for further hospitalization or return to the community. Secondary objectives included the description of clinical and socio-demographic characteristics of patients admitted to the crisis unit upon presentation to the emergency room. All patients (n=255) admitted to the short-stay unit of the emergency department of Rambouillet General Hospital during a one-year period were included in the study. Patient characteristics were collected in a retrospective manner from medical records: patterns of referral, acute stressors, presenting symptoms, initial patient demand, Diagnostic and Statistical Manual, 5th edition (DSM-5) disorders, psychiatric history, and socio-demographic characteristics were inferred. Logistic regression analysis was used to determine the factors associated with hospitalization decision upon crisis intervention at discharge. Following crisis intervention at the short-stay unit, 100 patients (39.2%) required further hospitalization and were transferred. Statistically significant factors associated with a higher probability of hospitalization (P<0.05) included the patient's initial wish to be hospitalized (OR=4.28), the presence of a comorbid disorder (OR=3.43), a referral by family or friends (OR=2.89), a history of psychiatric hospitalization (OR=2.71) and suicidal ideation on arrival in the emergency room (OR=2.26). Conversely, significant factors associated with a lower probability of

  17. Pemex within the context of its reserves and production crisis; Pemex en el contexto de su crisis de reservas y produccion

    Energy Technology Data Exchange (ETDEWEB)

    Shields, David [Energia a debate (Mexico)

    2007-07-15

    The Pemex's future is unknown. The Mexican enterprise (state-owned oil monopoly) has problems in the following aspects: operative, financial, administrative and labour. The deposits decrease with regard to the productivity, in fact, the confines production is worrisome. This is the moment of asking what is it going to happen with Pemex with regard to its current structure, and then to accept that the answer would be not the wanted one. [Spanish] El futuro de Pemex es incierto. La empresa estatal monopolica mexicana presenta problemas en los ambitos operativo, financiero, administrativo y laboral. Los yacimientos declinan en productividad y el horizonte de produccion es preocupante. Es hora de preguntarse que sucedera con Pemex con su estructura actual, y aceptar que esta puede no ser compatible con lo que se espera de ella.

  18. PEMEX exploration and production (E and P) projects

    Energy Technology Data Exchange (ETDEWEB)

    Guevara, H. (PEMEX Exploracion y Produccion, Mexico City (Mexico))

    1999-01-01

    The investment that PEMEX's exploration and production (PEP) has made in Mexico's energy sector was discussed. PEP has invested more than US$7 billion over the last two years. Capital expenditures have been driven by market forces. This will provide opportunities for several companies, particularly those in NAFTA (North American Free Trade Agreement) countries. The implications of Canadian companies doing business in Mexico were also discussed. PEMEX's operating companies were listed along with a PEP ranking for 1997. Crude oil and gas production charts show a gradual increase in production for both, from 1995 to 1998. Capital expenditures have increased from US$ 2.2 billion in 1996 to US$ 4.0 billion in 1998. The megaprojects currently underway in Mexico include the Cantarell, Burgos, and the Delta del Grijalva projects. A comparison in investment for onshore and offshore projects was presented. It was concluded that in order to help Canadian companies invest in the Mexican E and P services sector, it would be helpful to have a transparent bidding process guaranteed by the existing institutional framework. 1 tab., 9 figs.

  19. The General Hospital Colombo Rehabilitation Project.

    Science.gov (United States)

    Jayasuriya, L

    1992-12-01

    The General Hospital Colombo (GHC) Rehabilitation Project was to be implemented in 6 phases in about 25 years. The proposed funding was a grant of 100% from Finland for technical assistance and training, and 85% for investments. The development objective was to reinforce the status of the hospital as the apex of the medical care system. In Phase I (1985-1990) an 8 storeyed accident and orthopaedic services building with modern facilities has been commissioned. A water tower and a 'septic' operating theatre have been built. Infection control and maintenance organizations have been started. Phase I cost Rs.960 million. In the Bridging Phase, the existing six storeyed building is being renovated. Phase II has been drastically curtailed. It will concentrate on infrastructure development such as water supply, kitchen, stores and transport, and the construction of four new medical wards. The project will end in 1993.

  20. Use of neuroleptics in a general hospital

    Directory of Open Access Journals (Sweden)

    Castellanos Virgilio

    2002-05-01

    Full Text Available Abstract Background This study investigates the clinical use of neuroleptics within a general hospital in acutely ill medical or surgical patients and its relation with dementia three months after admission compared with control subjects. Methods Cases were defined as every adult patient to whom a neuroleptic medication was prescribed during their hospitalization in our Hospital from February 1st, to June 30th, 1998. A control matched by age and sex was randomly selected among patients who had been admitted in the same period, in the same department, and had not received neuroleptics drugs (205 cases and 200 controls. Demographic, clinical and complementary data were compared between cases and controls. Crude odds ratios estimating the risk of dementia in non previously demented subjects compared with the risk in non-demented control subjects were calculated. Results 205 of 2665 patients (7.7% received a neuroleptic drug. The mean age was 80.0 ± 13.6 years and 52% were females. They were older and stayed longer than the rest of the population. Only 11% received a psychological evaluation before the prescription. Fifty two percent were agitated while 40% had no reason justifying the use of neuroleptic drug. Three months after neuroleptic use 27% of the surviving cases and 2.6% of the surviving controls who were judged non-demented at admission were identified as demented. Conclusions The most common reason for neuroleptic treatment was to manage agitation symptomatically in hospitalised patients. Organic mental syndromes were rarely investigated, and mental status exams were generally absent. Most of neuroleptic recipients had either recognised or unrecognised dementia.

  1. Neuritic Patient at Sanglah General Hospital Denpasar

    Directory of Open Access Journals (Sweden)

    Ni Putu Dita-Rinjani

    2012-05-01

    Full Text Available Objective: Treatment of optic neuritic as recommended by the Optic Neuritic Treatment Trial (ONTT was intravenous methylprednisolon followed by oral prednisone. This study aims to describe  characteristics and response to intravenous methylprednisolon followed by oral prednisone treatment of optic neuritic patient in Sanglah General Hospital Denpasar. Method: This report is an analytical cross sectional study. Data were collected retrospectively from medical report of optic neuritic patient who came to Sanglah General Hospital during a period of January 1st 2010 until December 31st 2011. Patient characteristics were analyzed with descriptive analyses and presented as frequency, percentage, mean and standar deviation. Visual acuity and contrast sensitivity improvement after intravenous methylprednisolon followed by oral prednisone treatment were statistically analyzed with Wilcoxon test Results:  Optic neuritic were found in twenty-three patients (33 eyes, majority was in age group of 15-40 years (56.5% with female predominance (65.2% and unilateral involvement was 56.3%. Mean onset patient presented to the hospital was 21.7±2.21 days and the most common symptom was decreasing vision (87.9%.  The majority of patient presented with papillitis (54.5%, totally color blindness found in 39.4% eyes, and the type of visual field defect at presentation was central scotoma (18.2%. All cases show lesion of optic nerve from visual evoked potential (VEP examination and magnetic resonance imaging (MRI shows normal results (39.1% patient. The mean of pretreatment logMAR visual acuity and contrast sensitivity were significant improve after treatment from 1.59±0.47 to 0.59±0.62 (p=0.0001 and 0.31±0.56 to 1.25±0.56 (p=0.0001, respectively. All cases in this study were idiopathic. Recurrences were seen in 2 eyes and none of patient had clinical features suggestive of multiple sclerosis. Conclusions: Visual acuity and contrast sensitivity improvement

  2. Alternate Level of Care Patients in Public General Hospital Psychiatry.

    Science.gov (United States)

    Marcos, Luis R.; Gil, Rosa M.

    1984-01-01

    Analyzes the interaction between psychiatric services in public general hospitals and in other institutional settings. A one-day census of patients in a New York general hospital showed the hospital was providing care to a large number of patients in need of other, less intensive institutional settings. (BH)

  3. [Neuropediatric healthcare demand in a general hospital].

    Science.gov (United States)

    Herrera Martín M; Gracia Remiro R; Santana Rodríguez C; Jiménez Moya A; Ayala Curiel J; Cuadrado Bello P

    2000-08-01

    The few existing studies on the demand for neuropediatric care in Spain offer information of enormous value, contributing to our knowledge of this specialty and of the needs of specialists and their training, as well as to the correct planning and use of economic and human resources. To determine the real demand, predominant disorders and usefulness of complementary examinations with a view to determining the need for neuropediatric care in a general hospital. Descriptive, retrospective study of patients attending the neuropediatric department for the first time during a 7-year period and for follow-up visits during a 4-year period. The periods were randomly selected. During this period 1130 children, generating 5033 consultations, were assessed. The total number of visits amounted to 25% of all consultations in the Pediatric Department, involving 31% of the children under 14 years of age in the pediatric population of Segovia. The overall rate of reexaminations/new patients was 3.4. The most frequent diagnosis was headache (32%), followed by non-epileptic paroxysms, febrile convulsions and epilepsy. The disorders requiring the greatest number of follow-up consultations were epilepsy (20%), headache (9%) and febrile convulsions (5%). The rate of reexamination/new patients was significantly higher in pediatric cerebral palsy and epilepsy. Electroencephalogram was the most frequently requested complementary examination, followed by neuroradiological studies. Demand for neuropediatric care mainly involves headaches, epilepsy, convulsions, non-epileptic paroxysmal disorders, and neonatal neurology in the first years of life. Pressure on neuropediatric departments is great due to the number of patients attending consulting rooms because of functional or self-limiting disorders. This pressure could be reduced by appropriate neurological training of general pediatricians or family doctors.

  4. Experiences of PEMEX in CO{sub 2} re-injection; Experiencias de Pemex en reinyeccion de CO{sub 2}

    Energy Technology Data Exchange (ETDEWEB)

    Sanchez Bujanos, Jose Luis [PEMEX (Mexico)

    2008-07-15

    Mexico enters the processes of secondary oil recovery the years 50s, by means of water injection. The CO{sub 2} injection is one of the techniques that better results produce in the oil recovery. In this presentation the strategic goals that have been determined within PEMEX Exploracion y Produccion (PEP) are mentioned, and which are the projects of CO{sub 2} injection for oil recovery already existing in Mexico. [Spanish] Mexico entra a los procesos de recuperacion secundaria de petroleo en los anos 50s, mediante inyeccion de agua. La inyeccion de CO{sub 2} es una de las tecnicas que mejores resultados produce en la recuperacion de petroleo. En esta presentacion se mencionan las metas estrategicas que se han fijado dentro de Pemex Exploracion y Produccion (PEP) y cuales son los proyectos de inyeccion de CO{sub 2} para recuperacion de petroleo, existentes actualmente en Mexico.

  5. Diagnosis and treatment of schizophrenia in a general hospital ...

    African Journals Online (AJOL)

    Diagnosis and treatment of schizophrenia in a general hospital based acute ... Conclusion: The study contributed by identifying these predictive indicators for the acute ... Key words: Acute management; Schizophrenia; Diagnosis; Treatment; ...

  6. LIGASURE (PRECISION HAEMORROIDECTOMY AT GOVT. GENERAL HOSPITAL

    Directory of Open Access Journals (Sweden)

    Anand

    2015-09-01

    Full Text Available BACKGROUND : Haemorrhoids is a common problem throughout the world. Many procedures are available for management of grade II and grade III hemorrhoids. The main postoperative complications associated with any of these procedures are pain and bleeding per rectum and pro longed healing time. Liga Surel TM haemorroidectomy was evaluated in this study for post - operative complications and symptomatic relief. METHODS: We analyzed 50 patients of hemorrhoids of grade II, III and IV who underwent Ligasure Precise haemorroidectomy by a classical Milligan - Morgan technique. The outcome factors analyzed were total operative time, blood loss, post - operative pain on visual analogue scale, any other complication and days of hospital stay. RESULTS: Of all the 50 patients, the operative ti me was less than 10 minutes in 27 patients (54% and the blood loss, as was measured by number of soaked gauze pieces only one gauze piece was soaked in 31 patients (62%. The Average Post - operative pain score measured on Visual Analogue Scale (VAS at 12, 24 & 48 hours were 6.54, 4.52 and 3.12 respectively. In all patients postoperative period and follow up was uneventful except for one patient who developed transient flatus incontinence. With physiotherapy and dietary management this problem resolved ther eafter. CONCLUSIONS: Liga Sure Hemarrhoidectomy is a safe, Technically easy and fast modality of treatment for 2 nd , 3 rd & 4 th degree of hemorrhoids whether single or multiple, requiring very less operating ti me, with no major post - operative complications an d early return to day to day activities

  7. Provision of general paediatric surgical services in a regional hospital.

    LENUS (Irish Health Repository)

    Zgraj, O

    2012-01-31

    BACKGROUND: In Ireland, specialist paediatric surgery is carried out in paediatric hospitals in Dublin. General surgeons\\/consultants in other surgical specialities provide paediatric surgical care in regional centres. There has been a failure to train general surgeons with paediatric skills to replace these surgeons upon retirement. AIM: To assess paediatric surgical workload in one regional centre to focus the debate regarding the future provision of general paediatric surgery in Ireland. METHODS: Hospital in-patient enquiry (HIPE) system was used to identify total number of paediatric surgical admissions and procedures. Cases assessed requiring hospital transfer. RESULTS: Of 17,478 surgical patients treated, 2,584 (14.8%) were under 14 years. A total of 2,154 procedures were performed. CONCLUSION: Regional centres without dedicated paediatric surgeons deliver care to large numbers of paediatric patients. The demand for care highlights the need for formal paediatric services\\/appropriate surgical training for general surgical trainees.

  8. Evolution and results of the energy conservation programs in PEMEX-REFINACION; Evolucion y resultados de los programas de ahorro de energia en PEMEX-REFINACION

    Energy Technology Data Exchange (ETDEWEB)

    Machado Soberanes, J.A. [PEMEX-REFINACION, Mexico, D. F. (Mexico)

    1995-12-31

    The nature of the industrial activities of PEMEX-REFINACION aimed at the energy production area in the refineries of the system, requires for its operation of an energy consumption that represents a highly significant amount among its total operation costs. These energy costs are being reduced in figures higher than 50% in 1990 to 43% in 1993 through coordination programs and investments oriented to the efficient use of energy and losses control. This paper presents the historical description of the developments, advances and achievements that have been obtained up to date in this subject in the production plant of PEMEX-REFINACION, beginning with the intensification of the program of energy conservation and efficient use of energy in 1990. As a substantial part of this paper the different actions being applied are listed right from the beginning of the program with their corresponding cost-benefit analysis, in order to eliminate the energy wastes that correspond fundamentally to short term measures requiring minimum investments and medium term actions with moderate investments. Likewise, the plan of action to be implemented is presented for the operation optimization of the system and the existing equipment, with the long term actions that for their execution require of large investments. The efforts made in the last 4 years in the system oil refineries have been important, which has been reflected in the reduction of energy consumption in an average of 10,000 equivalent barrels of oil (EBCO) per day; nevertheless there are still great opportunity areas to reach the energy efficiency levels and profitability of the world leading refineries, which is consistent with the conceptual frame of the 1995- 2000 business plan structured for PEMEX-REFINACION. [Espanol] La naturaleza misma de las actividades industriales de PEMEX-REFINACION, enfocada al area de produccion de energeticos en las refinerias del sistema, requiere para sus operaciones de un consumo de energia que

  9. Improving the smoking patterns in a general hospital psychiatric unit

    OpenAIRE

    Celso Iglesias García; María José Alonso Villa; Juan Carlos Bernaldo de Quirós; Elena Bocanegra Suárez; Julia Cueta Gonzalo; Rosario García del Valle; José Manuel González González; Álvaro Miranda García; Ana Belén Palacio Bande

    2009-01-01

    Objectives: The purpose of the present paper is to evaluate the effects of a smoking ban in a general hospital psychiatric unit. Methods: We study the effects of smoking ban in 40 consecutive psychiatric inpatients. The staff registered socio-demographic and tobacco-related variables. We also registered any kind of behavioral effects of smoking ban.Results: The patients were willing to stop smoking during their hospital stay (with or without nicotine replacement) with two mild behavioural inc...

  10. General surgery at rural Tennessee hospitals: a survey of rural Tennessee hospital administrators.

    Science.gov (United States)

    Cofer, Joseph B; Petros, Tommy J; Burkholder, Hans C; Clarke, P Chris

    2011-07-01

    Rural communities face an impending surgical workforce crisis. The purpose of this study is to describe perceptions of rural Tennessee hospital administrators regarding the importance of surgical services to their hospitals. In collaboration with the Tennessee Hospital Association, we developed and administered a 13-item survey based on a recently published national survey to 80 rural Tennessee hospitals in August 2008. A total of 29 responses were received for an overall 36.3 per cent response rate. Over 44 per cent of rural surgeons were older than 50 years of age, and 27.6 per cent of hospitals reported they would lose at least one surgeon in the next 2 years. The responding hospitals reported losing 10.4 per cent of their surgical workforce in the preceding 2 years. Over 53 per cent were actively recruiting a general surgeon with an average time to recruit a surgeon of 11.8 months. Ninety-seven per cent stated that having a surgical program was very important to their financial viability with the mean and median reported revenue generated by a single general surgeon being $1.8 million and $1.4 million, respectively. Almost 11 per cent of the hospitals stated they would have to close if they lost surgical services. Although rural Tennessee hospitals face similar difficulties to national rural hospitals with regard to retaining and hiring surgeons, slightly more Tennessee hospitals (54 vs 36%) were actively attempting to recruit a general surgeon. The shortage of general surgeons is a threat to the accessibility of comprehensive hospital-based care for rural Tennesseans.

  11. Chicxulub Impact Crater and Yucatan Carbonate Platform - PEMEX Oil Exploratory Wells Revisited

    Science.gov (United States)

    Pérez-Drago, G.; Gutierrez-Cirlos, A. G.; Pérez-Cruz, L.; Urrutia-Fucugauchi, J.

    2008-12-01

    Geophysical oil exploration surveys carried out by PEMEX in the 1940's revealed occurrence of an anomalous pattern of semi-circular concentric gravity anomalies. The Bouguer gravity anomalies covered an extensive area over the flat carbonate platform in the northwestern Yucatan Peninsula; strong density contrasts were suggestive of a buried igneous complex or basement uplift beneath the carbonates, which was referred as the Chicxulub structure. The exploration program carried out afterwards included a drilling program, starting with Chicxulub-1 well in 1952 and comprising eight deep boreholes through the 1970s. An aeromagnetic survey in late 1970's showed high amplitude anomalies in the gravity anomaly central sector. Thus, research showing Chicxulub as a large complex impact crater formed at the K/T boundary was built on the PEMEX decades-long exploration program. Despite frequent reference to PEMEX information and samples, original data and cores have not been openly available for detailed evaluation and integration with results from recent investigations. Core samples largely remain to be analyzed and interpreted in the context of recent marine, aerial and terrestrial geophysical surveys and the drilling/coring projects of UNAM and ICDP. In this presentation we report on the stratigraphy and paleontological data for PEMEX wells: Chicxulub- 1 (1582m), Sacapuc-1 (1530m), Yucatan-6 (1631m), Ticul-1 (3575m) Yucatan-4 (2398m), Yucatan-2 (3474m), Yucatan-5A (3003m) and Yucatan-1 (3221m). These wells remain the deepest drilled in Chicxulub, providing samples of impact lithologies, carbonate sequences and basement, which give information on post- and pre-impact stratigraphy and crystalline basement. We concentrate on stratigraphic columns, lateral correlations and integration with UNAM and ICDP borehole data. Current plans for deep drilling in Chicxulub crater target the peak ring and central sector, with offshore and onshore boreholes proposed to the IODP and ICDP

  12. The dynamics of psychiatric bed use in general hospitals.

    Science.gov (United States)

    Slade, Eric P; Goldman, Howard H

    2015-03-01

    This study examines general hospitals' adjustments in psychiatric bed utilization practices in response to increases in psychiatric inpatient admissions. Using panel data from 439 hospitals, monthly observations (N = 7,831) between 2007 and 2010 on psychiatric admissions, psychiatric bed occupancy rates, and average length-of-stay were created for psychiatric inpatients. In fixed-effects regressions, an increase in psychiatric admissions was associated with an increase in the probability of psychiatric bed use exceeding 100 % occupancy and with a reduction of mean length-of-stay. These results were confirmed in instrumental variables models. General hospitals may dynamically adjust bed utilization practices in response to changing psychiatric bed needs. An implication of this dynamic adjustment model is that bed shortages are likely to be local, transitory events.

  13. The dynamics of psychiatric bed use in general hospitals

    Science.gov (United States)

    Slade, Eric P; Goldman, Howard H

    2014-01-01

    This study examines general hospitals' adjustments in psychiatric bed utilization practices in response to increases in psychiatric inpatient admissions. Using panel data from 439 hospitals, monthly observations (N=7831) between 2007 and 2010 on psychiatric admissions, psychiatric bed occupancy rates, and average length-of-stay were created for psychiatric inpatients. In fixed-effects regressions, an increase in psychiatric admissions was associated with an increase in the probability of psychiatric bed use exceeding 100% occupancy and with a reduction of mean length-of-stay. These results were confirmed in instrumental variables models. General hospitals may dynamically adjust bed utilization practices in response to changing psychiatric bed needs. An implication of this dynamic adjustment model is that bed shortages are likely to be local, transitory events. PMID:24756929

  14. Chicxulub Impact Crater and Yucatan Carbonate Platform - Stratigraphy and Petrography of PEMEX Borehole Cores

    Science.gov (United States)

    Gutierrez-Cirlos, A. G.; Perez-Drago, G.; Perez-Cruz, L.; Urrutia-Fucugauchi, J.

    2008-12-01

    Chicxulub impact crater is the best preserved of the three large multi-ring structures documented in the terrestrial record. Chicxulub, formed 65 Ma ago, is associated with the Cretaceous/Tertiary (K/T) boundary layer and the impact related to the organism extinctions and events marking the boundary. The crater is buried under Tertiary sediments in the Yucatan carbonate platform in the southern Gulf of Mexico. The structure was initially recognized from gravity and magnetic anomalies in the PEMEX exploration surveys of the northwestern Yucatan peninsula. The exploration program included eight deep boreholes completed from 1952 through the 1970s. The investigations showing Chicxulub as a large complex impact crater formed at the K/T boundary have relayed on the PEMEX decades-long exploration program. However, despite frequent use of PEMEX information and core samples, significant parts of the database and cores remain to be evaluated, analyzed and incorporated with results from recent efforts. Access to PEMEX Core Repository has permitted to study the cores and collect new samples from some of the boreholes. We analyzed cores from Yucatan-6, Chicxulub-1, Sacapuc-1, Ticul-1, Yucatan-1 and Yucatan-4 boreholes to make new detailed stratigraphic correlations and petrographic characterization, using information from PEMEX database and the recent studies. In C-1 cores, breccias show 4-8 cm clasts of fine grained altered melt dispersed in a medium to coarse grained matrix composed of pyroxene and feldspar with little macroscopic alteration. Clasts contain 0.2 to 0.1 cm fragments of silicate material (basement) that show variable degrees of digestion. Melt samples from C-1 N10 comes from interval 1,393-1,394 m, and show a fine-to-medium grained coherent microcrystalline groundmass. Melt and breccias in Y-6 extend from about 1,100 m to more than 1,400 m. Sequence is well sorted, with an apparent gradation in both the lithic and melt clasts. In this presentation we report on

  15. Discharge against medical advice at a general hospital in Catalonia.

    Science.gov (United States)

    Duñó, Rosó; Pousa, Esther; Sans, Jordi; Tolosa, Carles; Ruiz, Ada

    2003-01-01

    Some studies on discharge against medical advice (AMA) in general hospitals report a prevalence between 0.7-7% with 11-42% of this population identified as psychiatric patients. To study the sociodemographic and psychopathological features of patients who leave AMA, we performed a retrospective case-control comparison study of length of hospitalization and presence of psychiatric disturbances on patients who left AMA from the University General Hospital in Catalan Spain over a two-year period. An analysis of the hospital epidemiological discharge register and retrospective chart review for presence of psychiatric disturbances found that AMA prevalence was 0.34%, the total discharge number in the 2-year period being 41,648. AMA rates by medical department were 0.44% for the internal medicine department; 0.24% for surgery; 0.26% for orthopedic surgery, 0.32% for obstetrics-gynecology and 0.93% for rehabilitation. The mean age for AMA patients was 38.63 years, with a higher number of men (59.9%). A total of 45.8% AMA discharges were from the internal medicine department. No significant differences were found in the average length of hospitalization between the AMA and control groups. The presence of psychiatric pathology was significantly higher among the AMA group (Phistory of psychiatric pathology, mainly narcotic dependence.

  16. Perfil del embarazo prolongado en pacientes de un hospital general

    OpenAIRE

    Chavarry Valencia, Flor de Maria; Cabrera Epiquen, Ronald Alfredo; Diaz Herrera, Jorge Antonio

    2012-01-01

    Objetivo: Determinar las características maternas y perinatales de las pacientes con diagnóstico de embarazo prolongado (EP) en un hospital general. Material y métodos: Estudio retrospectivo tipo serie de casos, realizado en el Hospital Nacional Cayetano Heredia del 1° de enero de 2000 al 31 de diciembre de 2004. Se incluyeron 341 pacientes con diagnóstico de EP (>42 semanas) basado en la fecha de último periodo menstrual o ecografía del primer trimestre. Resultados: El 76% de pacientes te...

  17. Martin Luther King, Jr., General Hospital and community involvement.

    Science.gov (United States)

    Humphrey, M M

    1973-07-01

    Community involvement is not just one facet of the new Martin Luther King, Jr., General Hospital's existence. It is the mainstream from which all other activities flow. In addition to meeting the conventional needs of a conventional hospital staff with the core collection of texts and journals, this library goes one step further. It acts as a resource for its community health workers, dietitians, and nurses in their various outreach programs. It serves as a stimulus for the high school or community college student who may be curious about a health career. It also finds time to provide reading material for its patients.

  18. Neonatal outbreak of salmonella worthington in a general hospital

    Directory of Open Access Journals (Sweden)

    Muley V

    2004-01-01

    Full Text Available This is a report of an outbreak of Salmonella worthington in neonates at Sassoon General Hospitals, Pune, which occurred during August and September 2000. A total of 148 blood, 4 CSF and 6 stool specimens were received from neonates admitted to the hospital. Salmonella worthington could be isolated from 17 clinical specimens [15 blood (10.8%, 1 CSF (25% and 1 stool (16.6% sample]. Environmental swabs were also processed. An attempt was made to detect carriers in health care personnel. However, no source or carrier of Salmonella worthington in the hospital environment could be identified. Intensive cleaning measures and fumigation were undertaken. All these measures succeeded in aborting the outbreak.

  19. [The practice of the mental health in the general hospital].

    Science.gov (United States)

    Kuroki, Nobuo

    2012-01-01

    On December 2, 2011 a new reform bill concerning the Labor Safety and Hygiene law was presented to parliament. The bill states that all companies and businesses regardless of size are obliged to have all employees take a stress test once a year in addition to the regular health check. In September 2010 the employees fo Toho University Sakura Hospital were given this new stress. The test included categories for occupation and the various departments in the hospital. There were 40 employees found to test high for stress and to have depressive tendencies. We interviewed about 16 of these employees. One employee started to receive medicine to help reduce the stress and 4 employees received counseling only. The other 11 employees did not need to receive counseling or medicine. From April 2005 to September 2011, we conducted another study. The subjects this time were 92 employees of the hospital who have received treatment at other facilities for mental problems from occupational physicians. We categorized the subjects by sex, age occupation, length of time employed at the hospital, department and period of time from the onset of symptoms to the time they sought treatment. In this paper I will present my findings and suggestions for improving mental health care for employees of general hospital throughout Japan.

  20. The Factors Affecting Performance of Nurse at Paniai General Hospital

    Directory of Open Access Journals (Sweden)

    Elias Tatogo

    2017-02-01

    Full Text Available General hospital of Paniai regency health service institution under Local Government Paniai Regency with amount of nurse resource counted 69 one who have duty to remain to can improve more certifiable service and reached by society, so to be form degree of health which at the farthest, so that nurse performance of vital importance in giving of health service. The goal of research: To knowing of factors affecting performance of nurse at Paniai general hospital. Method: Type research is causal associative by using quantitative approach. Sample is all of nurse as much 69 nurse with date implemented in October 2016. Data obtained used questioner and analyzed by chi square test. Result of research is obtained that factor’s affecting of nurse performance in Paniai General Hospital is motivation (p-value = 0,001; RP = 3,000; CI95%= 1,607 - 5,601, [job/activity] discipline (p-value = 0,043; RP = 2,068; CI95%= 1,150 - 3,719, reward (p- value = 0,001; RP = 5,008; CI95%= 1,656 - 15,142, punishment (p- value = 0,000 ; RP= 16,839; CI95%= ( 4,310 - 65,784 and style leadership [of] director (p- value = 0,000; RP = 3,333; CI95%= 1,742 - 6,380. The factor’s not related of nurse performance at Paniai general hospital is age (p- value = 1,000 ; RP = 0,908; CI95%= 0,456 - 1,806, long working (p- value = 1,000; RP = 0,908; CI95%= 0,456 - 1,806 and job rotation (p- value = 0,843; RP = 1,190; CI95%= 0,603 – 2,348.

  1. [Use of antibiotics in a general hospital (author's transl)].

    Science.gov (United States)

    Escolar, A; Gómez, J; Andreo, J; García-Estany, J; Espi, F; Amorós, T

    1980-10-25

    The utilization of antibiotics at a general hospital has been assessed by retrospectively studying the clinical histories of all patients admitted during the month of April 1978 to the Residencia General de la Ciudad Sanitaria Virgen de la Arrixaca (Murcia, Spain). Medical records were reviewed according to a preestablished protocol. Out of 1.057 patients admitted antibiotics were used in 419 (46%), of whom 189 belonged to the medical services and 302 to the surgical ones. Overall, the surgical services utilized more antibiotics and had less bacteriologic data on their patients. Antibiotics more utilized were ampicillin, which use was generally correct, followed by gentamicin, the G-penicillins, and trimethoprim-sulfamethoxazol. Undesirable side-effects of antibiotic treatment were found in 13 cases (2,6%). Infectious disease of bacterial origin was correctly diagnosed in 40% of the cases, while the diagnosis was doubtful or incorrect in the remaining 60% of cases treated with antibiotics. Appropriate bacteriological data were obtained only in 164 cases (33,4%), with positive results in 75 (49,9%). Independent antibiotics were given in association in 157 cases (31,9%). From this study it can be concluded that the more frequent causes of improper antibiotic utilization were the incorrect clinical diagnosis of bacterial infectious disease, the prophylactic use of antibiotics and the scarcity of bacteriological data. It is therefore suggested that systems of supervision of in-hospital antibiotic prescription be updated and continuous education programs for hospital staff be instituted.

  2. Energy conservation programs of Pemex exploration and production, south region; Programas de ahorro de energia en Pemex exploracion y produccion, region sur

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez Milla, Guillermo; Garcia Juarez, Francisco; Alarcon Aleman, Jose Mauricio [Instituto de Investigaciones Electricas, Cuernavaca (Mexico)

    1998-12-31

    The technological developments of energy economizing equipment constitute a powerful tool for the conservation and saving of the electric energy in new or existing installations. Petroleos Mexicanos (PEMEX) Exploration and Production initiated in 1997 a program for energy economizing in the South region, for which the Instituto de Investigaciones Electricas, through its Unit for the Use of Energy, collaborated performing energy assessments in 115 buildings of the above mentioned region. This paper describes the employed methodology to carry on the energy assessment, which consisted in an analysis of each building and different options for energy economizing were presented, which was accompanied with cost-benefit studies. The results obtained show that the air conditioning equipment and lighting represent the most important loads permanently connected, therefore the study was concentrated in these two loads [Espanol] Los desarrollos tecnologicos de equipos ahorradores de energia constituyen una poderosa herramienta para la conservacion y el ahorro de energia electrica en instalaciones nuevas o existentes. Petroleos Mexicanos (PEMEX) Exploracion y Produccion inicio en 1997 un programa para el ahorro de energia en la region sur, para lo cual el Instituto de Investigaciones Electricas, a traves de la Unidad de Uso de Energia, colaboro realizando diagnosticos energeticos en 115 edificios de dicha region. En este documento se describe la metodologia utilizada para realizar el diagnostico energetico, el cual consistio en un analisis de cada edificio y se presentaron diversas opciones para ahorrar energia, lo cual se acompano de estudios de costo-beneficio. Los resultados obtenidos muestran que los equipos de aire acondicionado e iluminacion representan la parte mas importante de las cargas conectadas permanentemente, por lo que el estudio se concentro en estas dos cargas

  3. Terapia ocupacional en un hospital general de pacientes agudos = Occupational therapy in a general hospital for acute pacients

    Directory of Open Access Journals (Sweden)

    Ocello, M. G

    2006-09-01

    Full Text Available RESUMEN Desde su creación, el Hospital Provincial “Dr. José María Cullen” posee la característica de ser un hospital de emergencias, sostenido por la Sociedad de Beneficencia y la Hermanas de la Caridad.Su funcionamiento responde a un Modelo Clínico-Asistencial, lo cual influye en la inserción de Terapia Ocupacional debiendo adaptar sus funciones a las características de la Institución.Los marcos de referencia teóricos y programas que se implementandeber ser acordes con las necesidades surgidas de un Hospital General de Agudos y de emergencias.En el Sector de Terapia Ocupacional se desarrolla la actividad docente cumpliendo con los requisitos reglamentados por el Ministerio de Salud de la Provincia de Santa Fe.ABSTRACT Ever since its start the Provincial Hospital “Dr. José María Cullen” is characterised for being an emergency hospital under the guidance of the Benfit Society of Hermanas de la Caridad.Its function responds to a Clinical Assistential Model, which influences the insertion of Occupational Therapy, adapting its functiones to the characteristics of the Institution as and when called for.The theoretical points of reference and programmes that are used must be in accordance with tehe necessities that appear in an Acute and Emergency General Hospital.In the Occupational Therapy Sector the teaching activity is developed as required by rules and regulations of the Ministry of Health for the Province of Santa Fe.

  4. [Neuropaediatric care in the Hospital General Universitario de Guadalajara].

    Science.gov (United States)

    Peña-Segura, J L; López-Pisón, J; Marco-Olloqui, M; Mateos-Hernández, J; Adrados-Razola, I; Jiménez-Bustos, J M

    Influenced by medical, scientific and social advances, the changes that have taken place in the needs of the population have given rise to a growing demand for health care in neuropaediatric pathology. The aim of this study was to determine the neuropaediatric health care requirements at the Hospital General Universitario de Guadalajara, a secondary care hospital that is a reference centre for the province of Guadalajara. We studied the children up to the age of 10 years with a neurological pathology attended at the Hospital General Universitario de Guadalajara over an 8-year period, since the Neuropaediatric unit was opened on 1 July 1992. In all 1,236 children were evaluated, which represents 8.45% of all the children below the age of 10 in the province of Guadalajara, with an average of 154.5 new patients per year. There was a predominance of males, 56.4%, and a high percentage of very young children: 26.05% under the age of 1 year and 50.56% under the age of 3. There has been a progressive increase in the number of Neuropaediatric outpatients, which in the year 2000 accounted for 20% of first visits and 16% of the total number (first and successive) of Paediatric outpatients. 12.94% of the patients in our series had also been examined in different tertiary care hospitals. There is a very high demand for neuropaediatric care in Guadalajara and it is growing in a significant and progressive manner. We suggest it would be advisable to have a tertiary reference hospital available to help cope with this situation.

  5. Hospital Anxiety and Depression Scale (HADS: validation in a Greek general hospital sample

    Directory of Open Access Journals (Sweden)

    Patapis Paulos

    2008-03-01

    Full Text Available Abstract Background The Hospital Anxiety and Depression Scale (HADS has been used in several languages to assess anxiety and depression in general hospital patients with good results. Methods The HADS was administered to 521 participants (275 controls and 246 inpatients and outpatients of the Internal Medicine and Surgical Departments in 'Attikon' General Hospital in Athens. The Beck Depression Inventory (BDI and the State-Trait Anxiety Inventory (STAI were used as 'gold standards' for depression and anxiety respectively. Results The HADS presented high internal consistency; Cronbach's α cofficient was 0.884 (0.829 for anxiety and 0.840 for depression and stability (test-retest intraclass correlation coefficient 0.944. Factor analysis showed a two-factor structure. The HADS showed high concurrent validity; the correlations of the scale and its subscales with the BDI and the STAI were high (0.722 – 0.749. Conclusion The Greek version of HADS showed good psychometric properties and could serve as a useful tool for clinicians to assess anxiety and depression in general hospital patients.

  6. Improving the smoking patterns in a general hospital psychiatric unit

    Directory of Open Access Journals (Sweden)

    Celso Iglesias García

    2009-01-01

    Full Text Available Objectives: The purpose of the present paper is to evaluate the effects of a smoking ban in a general hospital psychiatric unit. Methods: We study the effects of smoking ban in 40 consecutive psychiatric inpatients. The staff registered socio-demographic and tobacco-related variables. We also registered any kind of behavioral effects of smoking ban.Results: The patients were willing to stop smoking during their hospital stay (with or without nicotine replacement with two mild behavioural incidences registered throughout the study. Conclusions: The benefits of non-smoking policy in a psychiatric unit can be significant. The introduction of smoking bans in psychiatric inpatients settings is possible and safe.

  7. Dispositivos clínicos em hospital geral Clinical dispositives in the general hospital

    Directory of Open Access Journals (Sweden)

    Ana Cleide Guedes Moreira

    2006-01-01

    Full Text Available Este trabalho participa de investigação sobre a inserção da Psicanálise no campo institucional e hospitalar de saúde, objetivando formular contribuições, a partir da clínica da melancolia e dos estados depressivos, para a construção de dispositivos clínicos em hospital geral do Sistema Único de Saúde.This paper is a part of a research project that investigates the insertion of Psychoanalysis into the health institutional field and hospitals; the objective is to formulate contributions from the clinic of melancholic and depressive states to the construction of clinical dispositives in general hospital of the "Sistema Único de Saúde (Unified Health System.

  8. Optimising neuroimaging effectiveness in a district general hospital.

    Science.gov (United States)

    McCarron, M O; Wade, C; McCarron, P

    2014-01-01

    Diagnostic accuracy in neurology frequently depends on clinical assessment and neuroimaging interpretation. We assessed neuroimaging discrepancy rates in reported findings between general radiologists and neuroradiologists among patients from a district general hospital (DGH). A neuroradiologist's report was sought on selected DGH patients over 28 months. Pre-planned outcomes included comparisons of primary findings (main diagnosis or abnormality), secondary findings (differential diagnoses and incidental findings) and advice from neuroradiologists for further investigations. A total of 233 patients (119 men and 114 women), mean age 47.2 (SD 17.8) years were studied: 43 had a computed tomography (CT) brain scan only, 37 had CT and magnetic resonance imaging (MRI) scans and 153 had only MRI scans. Discrepancies in the primary diagnosis/abnormality were identified in 33 patients (14.2%). This included 7 of 43 patients (16.3%) who had a CT brain scan as their only neuroimaging. Secondary outcomes differed in 50 patients (21.5%). Neuroradiologists recommended further neuroimaging for 29 patients (12.4%). The most common discrepancies in the primary diagnosis/abnormality were misinterpreting normal for hippocampal sclerosis and missed posterior fossa lesions. There was no evidence of temporal changes in discrepancy rates. Selecting CT and MR neuroimaging studies from general hospitals for reviewing by neuroradiologists is an important and effective way of optimising management of neurological patients.

  9. [Treatment with tuberculostatic drugs: compliance at a general hospital].

    Science.gov (United States)

    Polo Friz, H; Kremer, L; Acosta, H; Abdala, O; Canova, S; Rojo, S; Roca, G; Daín, A

    1997-01-01

    The purpose of this study was to assess the compliance with tuberculostatic drugs treatment in a public hospital from Córdoba City and to establish the causes of noncompliance. All the patients to which treatment with tuberculostatic drugs was indicated from January 1991 up to December 1994 were included. 45 patients were included: 18 females (40%) and 29 males. Sixteen (35.6%) did not complete the time of treatment indicated. Nine (56.3%) abandoned the treatment 2 months after having initiated it. In the group that did not complete the treatment there was a higher percentage of female patients (62.5%) than in the group that did complete it (27.6%), p = 0.02. There were not statistically significant differences in age, percentages of pulmonar and extrapulmonar tuberculosis and months of treatment indicated between both groups. Thirty-six percent of the patients who abandoned the treatment referred having interrupted it due to their own negligency, knowing the risk of such behavior; 36% suffered side effects and did not come back to hospital; 21% referred having consulted another physician who indicated to interrupt the treatment without performing other tests; and 7% misunderstood the indications. It is concluded that in a general hospital from Córdoba City, the percentage of patients who abandoned tuberculostatic treatment is high. In most cases the cause was related to failures in the conduct of patients, physicians or both.

  10. General medications utilization and cost patterns in hospitalized children

    Directory of Open Access Journals (Sweden)

    Kassis I

    2009-03-01

    Full Text Available Drug utilization in the in-patient setting can provide mechanisms to assess drug prescribing trends, efficiency and cost-effectiveness of hospital formularies and examine sub-populations such as children for which prescribing habits are different from adults. Objectives: The aim of this descriptive study was to analyze general medication utilization patterns and costs excluding antimicrobials prescriptions and to compare two pediatric admission units in a tertiary care university hospital. Methods: The total number of admitted children was 1,521 and 1,467 for the A and B admission units, respectively. The electronic data from 252 and 253 hospitalized children in the A and B admission unit were prospectively screened for general medication prescriptions, children on antimicrobials were excluded from the analysis. Their electronic charts were viewed once weekly from October 15, 2007 up to April 7, 2008 using the prescription-point prevalence method. One medication was considered to be one prescription. Results: The general medications prescription number was 790 for 94 children (8.4 prescription/patient in A and 959 for 88 children (10.9 prescription/patient in B (p=0.02. The general medications defined daily dose (DDD and drug utilization 90% (DU90% index were 2,509.63, 2,259 for A; and 6,110.35, 5,499 for B, respectively. The DU90% index placed salbutamol inhalation with 835 DDD and sodium heparin with 2,102 DDD in the first place for the A and B admission units, respectively. A net increment in medication cost was registered according to the calculated cost from the depicted DU90% when the A (20,263 NIS and B (6,269 NIS admission units were compared (p=0.04. Conclusions: A significant difference in the prescription utilization of general medications was shown between the A and B admission units. The A admission unit had lower prescriptions measured by the DU90% index with higher medication cost. Potential drug-drug interactions were depicted in

  11. Alcohol misuse in the general hospital: some hard facts.

    LENUS (Irish Health Repository)

    Bradshaw, P

    2012-02-03

    AIMS: To examine (1) the prevalence of alcohol use disorders in adult general hospital inpatients; (2) the accuracy of documentation in relation to alcohol use. METHODS: A total of 210 random patients were interviewed out of 1,448 consecutive new admissions to CUH over 7 days. Case notes were reviewed for 206 (98%). Alcohol consumption was assessed using the Fast Alcohol Screening Test (FAST) and weekly drinking diary. FAST-positive (and a random sample of FAST-negative) patients then had a standardized interview. RESULTS: A total of 82% admitted for drinking alcohol. Among them 22% were drinking in excess of guidelines, 9% had DSM-IV Alcohol Abuse and 7% dependence. The sensitivity and specificity of the FAST for detecting those drinking above guidelines were 89 and 94% and for detecting a DSM-IV diagnosis was 100 and 73%. The majority of case notes contained inadequate information about alcohol intake. CONCLUSION: Alcohol use disorders are common and often undetected in the general hospital setting.

  12. Recurrence of inguinal hernias repaired in a large hernia surgical specialty hospital and general hospitals in Ontario, Canada.

    Science.gov (United States)

    Malik, Atiqa; Bell, Chaim M; Stukel, Thérèse A; Urbach, David R

    2016-02-01

    The effect of hospital specialization on the risk of hernia recurrence after inguinal hernia repair is not well described. We studied Ontario residents who had primary elective inguinal hernia repair at an Ontario hospital between 1993 and 2007 using population-based, administrative health data. We compared patients from a large hernia specialty hospital (Shouldice Hospital) with those from general hospitals to determine the risk of recurrence. We studied 235 192 patients, 27.7% of whom had surgery at Shouldice hospital. The age-standardized proportion of patients who had a recurrence ranged from 5.21% (95% confidence interval [CI] 4.94%-5.49%) among patients who had surgery at the lowest volume general hospitals to 4.79% (95% CI 4.54%-5.04%) who had surgery at the highest volume general hospitals. In contrast, patients who had surgery at the Shouldice Hospital had an age-standardized recurrence risk of 1.15% (95% CI 1.05%-1.25%). Compared with patients who had surgery at the lowest volume hospitals, hernia recurrence among those treated at the Shouldice Hospital was significantly lower after adjustment for the effects of age, sex, comorbidity and income level (adjusted hazard ratio 0.21, 95% CI 0.19-0.23, p hernia repair at Shouldice Hospital was associated with a significantly lower risk of subsequent surgery for recurrence than repair at a general hospital. While specialty hospitals may have better outcomes for treatment of common surgical conditions than general hospitals, these benefits must be weighed against potential negative impacts on clinical care and the financial sustainability of general hospitals.

  13. Deep Drilling Into the Chicxulub Impact Crater: Pemex Oil Exploration Boreholes Revisited

    Science.gov (United States)

    Fucugauchi, J. U.; Perez-Cruz, L.

    2007-05-01

    The Chicxulub structure was recognized in the 1940´s from gravity anomalies in oil exploration surveys by Pemex. Geophysical anomalies occur over the carbonate platform in NW Yucatan, where density and magnetic susceptibility contrasts with the carbonates suggested a buried igneous complex or basement uplift. The exploration program developed afterwards included several boreholes, starting with the Chicxulub-1 in 1952 and eventually comprising eight deep boreholes completed through the 1970s. The investigations showing Chicxulub as a large impact crater formed at the K/T boundary have relayed on the Pemex decades-long exploration program. Despite frequent reference to Pemex information, original data have not been openly available for detailed evaluation and incorporation with results from recent efforts. Logging data and core samples remain to be analyzed, reevaluated and integrated in the context of recent marine, aerial and terrestrial geophysical surveys and the drilling/coring projects of UNAM and ICDP. In this presentation we discuss the paleontological data, stratigraphic columns and geophysical logs for the Chicxulub-1 (1582m), Sacapuc-1 (1530m), Yucatan-6 (1631m) and Ticul-1 (3575m) boreholes. These boreholes remain the deepest ones drilled in Chicxulub and the only ones providing samples of the melt-rich breccias and melt sheet. Other boreholes include the Y1 (3221m), Y2 (3474m), Y4 (2398m) and Y5A (3003m), which give information on pre-impact stratigraphy and crystalline basement. We concentrate on log and microfossil data, stratigraphic columns, lateral correlation, integration with UNAM and ICDP borehole data, and analyses of sections of melt, impact breccias and basal Paleocene carbonates. Current plans for deep drilling in Chicxulub crater focus in the peak ring zone and central sector, with proposed marine and on-land boreholes to the IODP and ICDP programs. Future ICDP borehole will be located close to Chicxulub-1 and Sacapuc-1, which intersected

  14. Contratos de servicios múltiples en Pemex: eficacia, eficiencia y rentabilidad

    Directory of Open Access Journals (Sweden)

    Víctor Rodríguez Padilla

    2010-01-01

    Full Text Available Este artículo analiza el desempeño de los Contratos de Servicios Múltiples (CSM en términos de eficacia, eficiencia y rentabilidad para Pemex Exploración y Producción. Los resultados indican fuertes contrastes. Han conseguido atraer capacidades técnicas y financieras del sector privado, sin embargo, el volumen incremental de gas entregado por los contratistas ha quedado muy por debajo de las metas anuales, el costo de producción supera el precio del gas importado y, en seis de nueve contratos, el organismo público pierde dinero después de impuestos. Algunos objetivos secundarios se han cumplido plenamente, pero otros de manera parcial o escasa.

  15. General Characteristics of HIV/AIDS Patients in Ditan Hospital

    Institute of Scientific and Technical Information of China (English)

    刘彦春; 徐克沂; 张福杰; 赵红心; 李兴旺; 李秀兰; 闫会文

    2004-01-01

    Objective: To elucidate general characteristics of HIV/AIDS patients seeking care at Ditan Hospital in an attempt to guide early diagnosis in routine medical care. Materials and methods: A retrospective analysis of 185 HIV/AIDS cases from January 1990 to June 2002 was completed using SPSS statistical analysis. Results: Male to female ratio was 1.8:1. Subjects ranged in age from 1 year old to 64 years old. 16 cases were younger than 20 years old with the median age among the younger subset at 7.7 years. 169 cases were older than 20 years old with a median age of 36 years old. 29% of the subjects were peasants. The remaining 71%, were of other unspecifiedoccupations. 90.8% of individuals were of Han descent while 3.7% of individuals were of a minority heritage. 50.3% of subjects were married; 23.8% have never married; 8.1% were divorced; and the remaining 17.8% were of unknown marital status. Of those represented in this study, 36.8% came from the Henan province; 17.8% were from Beijing; 8.6% were from Shanxi; 31.4% from the other 20 provinces of China; and 5.4% from outside of China. Mode of transmission: 40.0% (74/185) contracted HIV through unprotected sexual contact; 29.2% (54/185) through receiving blood or plasma transfusions; 21.1%(39/185) through donating plasma; 7 cases were intravenous drug users; 7 cases were vertically transmitted. Mode of transmission was unknown in 4 cases. Clinical categories: An included 45 cases; B included 85 cases: C consisted of 76 cases. 12 cases were deceased. Initial presentation: 39 cases presented with_fever ,cough and diarrhea. 37 cases had fever and cough only-38 cases presented with chronic diarrhea. 16 cases were discovered incidentally at time of operation. 8 cases presented with fungal infection of the oral cavity or in esophagus. The common HIV associated symptoms and opportunistic infections were: weight loss and diarrhea, respiratory diseases, dermatologic diseases, anemia, neutropenia. Diseases of other organ

  16. Profilaxia para tromboembolia venosa em um hospital geral Venous thromboembolism prophylaxis in a general hospital

    Directory of Open Access Journals (Sweden)

    Fernanda Fuzinatto

    2011-04-01

    Full Text Available OBJETIVO: Avaliar a prática de profilaxia para tromboembolia venosa (TEV em pacientes em um hospital geral. MÉTODOS: Estudo de coorte transversal conduzido no Hospital Nossa Senhora da Conceição, localizado na cidade de Porto Alegre (RS, com uma amostra constituída de pacientes internados selecionados randomicamente entre outubro de 2008 e fevereiro de 2009. Foram incluídos pacientes maiores de 18 anos e internados por mais de 48 h. Os critérios de exclusão foram pacientes em uso de anticoagulantes, história de doença tromboembólica, gestação e puerpério. A adequação da profilaxia foi avaliada seguindo as recomendações de um protocolo criado pela instituição e tendo como base principal a diretriz da American College of Chest Physician, oitava edição. RESULTADOS: Foram incluídos 262 pacientes com média de idade de 59,1 ± 16,6 anos. Os fatores de risco mais comuns foram imobilização (70,6%, infecção (44,3%, câncer (27,5%, obesidade (23,3% e cirurgia maior (14,1%. Na avaliação do nível de risco para TEV, 143 (54,6% e 117 pacientes (44,7%, respectivamente, foram classificados como de risco alto e moderado. No geral, 46,2% dos pacientes tiveram profilaxia adequada, assim como 25% dos pacientes com três ou mais fatores de risco e 18% dos pacientes com câncer, e houve diferenças estatisticamente significativas entre esses grupos quando comparados àqueles com menos de três fatores de risco e sem câncer (p OBJECTIVE: To evaluate the use of venous thromboembolism (VTE prophylaxis in a general hospital. METHODS: A cross-sectional cohort study at the Hospital Nossa Senhora da Conceição, located in the city of Porto Alegre, Brazil, involving a random sample of patients admitted between October of 2008 and February of 2009. We included patients over 18 years of age and hospitalized for more than 48 h. The exclusion criteria were anticoagulant use, pregnancy, puerperium, and a history of thromboembolic disease. The

  17. An analysis of acute admissions to a general hospital psychiatric unit

    African Journals Online (AJOL)

    QuickSilver

    Statistics for 1999 showed that Helen Joseph Hospital admits on the average 53 new .... Lund C & Flisher AJ. South African Mental Health Process Indicators. .... paper) will fall well on the ears of general hospital management. Moosa and ...

  18. Specialized consultant in radiological safety to the Reforma peripheral clinic, PEMEX. - I. - May-June of 2003; Asesoria especializada en seguridad radiologica a la clinica periferica Reforma, PEMEX.- I.- Mayo-Junio de 2003

    Energy Technology Data Exchange (ETDEWEB)

    Torres P, A.; Garcia A, J.; Rodriguez A, F

    2003-07-15

    The Reforma peripheral clinic, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the clinic can conserve its respective sanitary license.(Author)

  19. Specialized consultant in radiological safety to the Macuspana peripheral clinic, PEMEX. - IV. - November and December of 2002; Asesoria especializada en seguridad radiologica a la clinica periferica Macuspana, PEMEX.- IV.- Noviembre y Diciembre de 2002

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Hernandez C, J. E.; Garcia A, J.; Rodriguez A, F

    2003-02-15

    The Macuspana peripheral clinic, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the clinic can conserve its respective sanitary license.(Author)

  20. Specialized consultant in radiological safety to the Reforma peripheral clinic, PEMEX. - III. - September and October of 2002; Asesoria especializada en seguridad radiologica a la clinica periferica Reforma, PEMEX.- III.- Septiembre y Octubre de 2002

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Rodriguez A, F.; Garcia A, J

    2003-02-15

    The Reforma peripheral clinic, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the clinic can conserve its respective sanitary license.(Author)

  1. Specialized consultant in radiological safety to the Reforma peripheral clinic, PEMEX. - IV. - November and December of 2002; Asesoria especializada en seguridad radiologica a la clinica periferica Reforma, PEMEX.- IV.- Noviembre y Diciembre de 2002

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Hernandez C, J. E.; Rodriguez A, F.; Garcia A, J

    2003-02-15

    The Reforma peripheral clinic, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray quipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the clinic can conserve its respective sanitary license.(Author)

  2. Perfil del embarazo prolongado en pacientes de un hospital general

    Directory of Open Access Journals (Sweden)

    Flor de Maria Chavarry Valencia

    2009-10-01

    Full Text Available Objetivo: Determinar las características maternas y perinatales de las pacientes con diagnóstico de embarazo prolongado (EP en un hospital general. Material y métodos: Estudio retrospectivo tipo serie de casos, realizado en el Hospital Nacional Cayetano Heredia del 1° de enero de 2000 al 31 de diciembre de 2004. Se incluyeron 341 pacientes con diagnóstico de EP (>42 semanas basado en la fecha de último periodo menstrual o ecografía del primer trimestre. Resultados: El 76% de pacientes tenían una edad entre 20 a 35 años con una media de 25,8 ± 6,1 años. El 47,5% eran nulíparas. El 71,3% había ya iniciado una labor de parto espontánea; 16,4% fueron inducidas y 12,3% tuvieron indicación de cesárea al ingreso. Del grupo con inicio de trabajo de parto espontáneo el 71,6% terminó en parto vaginal; 19,3% cesárea, y 9,1% parto vaginal instrumentado. De las inducciones, el 71,4% tuvo parto vaginal espontáneo, 23,2% cesárea y 5,4% instrumentado. El 62% terminó en parto vaginal espontáneo, 29,9% en cesárea y 7,4% instrumentado. El 85,9% fue adecuado para EG, 11,1% grande para la EG, y 3% pequeño para la EG. El 53,4% de RN tuvo de 37 a 41 semanas por Capurro; 45,7% fueron >42 semanas y 0,9% tuvo < 37 semanas. El Apgar a los 5 minutos fue de 7 a 10 en 333 casos, < 7 en 4 RN. Ocurrieron 4 óbitos fetales (1,1%. Conclusión: El EP se encontró en mayor frecuencia en pacientes adultas y nulíparas, el inicio del trabajo de parto espontáneo fue el más frecuente y la vía de parto vaginal la más frecuente. Las complicaciones fueron bajas en los RN vivos, sin embargo la tasa de mortalidad fetal fue elevada de 11 por mil. La indicación más frecuente de cesárea fue DCP y sufrimiento fetal agudo. (Rev Med Hered 2009;20:200-205.

  3. Hospitable archean climates simulated by a general circulation model.

    Science.gov (United States)

    Wolf, E T; Toon, O B

    2013-07-01

    Evidence from ancient sediments indicates that liquid water and primitive life were present during the Archean despite the faint young Sun. To date, studies of Archean climate typically utilize simplified one-dimensional models that ignore clouds and ice. Here, we use an atmospheric general circulation model coupled to a mixed-layer ocean model to simulate the climate circa 2.8 billion years ago when the Sun was 20% dimmer than it is today. Surface properties are assumed to be equal to those of the present day, while ocean heat transport varies as a function of sea ice extent. Present climate is duplicated with 0.06 bar of CO2 or alternatively with 0.02 bar of CO2 and 0.001 bar of CH4. Hot Archean climates, as implied by some isotopic reconstructions of ancient marine cherts, are unattainable even in our warmest simulation having 0.2 bar of CO2 and 0.001 bar of CH4. However, cooler climates with significant polar ice, but still dominated by open ocean, can be maintained with modest greenhouse gas amounts, posing no contradiction with CO2 constraints deduced from paleosols or with practical limitations on CH4 due to the formation of optically thick organic hazes. Our results indicate that a weak version of the faint young Sun paradox, requiring only that some portion of the planet's surface maintain liquid water, may be resolved with moderate greenhouse gas inventories. Thus, hospitable late Archean climates are easily obtained in our climate model.

  4. Attitudes of Malaysian general hospital staff towards patients with mental illness and diabetes

    OpenAIRE

    Minas, H.; Zamzam, R; Midin, M; Cohen, A

    2011-01-01

    Abstract Background The context of the study is the increased assessment and treatment of persons with mental illness in general hospital settings by general health staff, as the move away from mental hospitals gathers pace in low and middle income countries. The purpose of the study was to examine whether general attitudes of hospital staff towards persons with mental illness, and extent of mental health training and clinical experience, are associated with different attitudes and behaviours...

  5. Behavior Assessment in Children Following Hospital-Based General Anesthesia versus Office-Based General Anesthesia

    Directory of Open Access Journals (Sweden)

    LaQuia A. Vinson

    2016-08-01

    Full Text Available The purpose of this study was to determine if differences in behavior exist following dental treatment under hospital-based general anesthesia (HBGA or office-based general anesthesia (OBGA in the percentage of patients exhibiting positive behavior and in the mean Frankl scores at recall visits. This retrospective study examined records of a pediatric dental office over a 4 year period. Patients presenting before 48 months of age for an initial exam who were diagnosed with early childhood caries were included in the study. Following an initial exam, patients were treated under HBGA or OBGA. Patients were followed to determine their behavior at 6-, 12- and 18-month recall appointments. Fifty-four patients received treatment under HBGA and 26 were treated under OBGA. OBGA patients were significantly more likely to exhibit positive behavior at the 6- and 12-month recall visits p = 0.038 & p = 0.029. Clinicians should consider future behavior when determining general anesthesia treatment modalities in children with early childhood caries presenting to their office.

  6. End-of-life hospital transfers in out-of-hours general practice.

    NARCIS (Netherlands)

    Korte-Verhoef, M.C. de; Pasman, H.R.W.; Schweitzer, B.P.M.; Francke, A.L.; Onwuteaka-Philipsen, B.D.; Deliens, L.

    2012-01-01

    Background: During the end of life, many patients experience transfers from home to hospital, and the majority of them die in a hospital. Aim: To explore the reasons for hospital transfers of palliative care patients in out-of-hours general practices. Methods: A retrospective descriptive chart study

  7. A comparison of antibiotic point prevalence survey data from four Irish regional/general hospitals.

    LENUS (Irish Health Repository)

    Naughton, C

    2011-06-01

    Point prevalence surveys (PPS) are increasingly used to examining and compare hospital antibiotic consumption. The aim of this study was to identify the (1) point prevalence of antibiotic use in one regional hospital and (2) compare PPS data from similar regional\\/general hospitals.

  8. Evaluation of Outpatient Antibiotic Use in Beijing General Hospitals in 2015

    Directory of Open Access Journals (Sweden)

    Chuan Yang

    2017-01-01

    Conclusions: Antibiotic use in Beijing general hospitals is generally low; however, inappropriate antibiotic use still exists. Inappropriately used antibiotics should be subject to rigorous control and management, and public policy initiatives are required to promote the judicious use of antibiotics.

  9. Transferable and non-transferable drug resistance in enteric bacteria from hospital and from general practice

    DEFF Research Database (Denmark)

    Møller, JK; Bak, AL; Bülow, P

    1976-01-01

    Drug resistance to 8 different antibiotics in Enterobacteriaceae isolated from different hospitals and two groups of general practitioners was studied. Escherichia coli dominated among the 632 strains investigated. Drug resistance was found in 62% of the 512 hospital strains and in 38% of the 120...... strains from general practice. Multiple resistance was common especially in strains from hospital. R factors was found in 23% of the 317 drug-resistant strains from hospital and in 11% of the 46 drug-resistant strains from general practice. Resistance to streptomycin, sulphonamide and tetracycline either...

  10. Mortality during first hospital admission in a population that begins chronic dialysis in a general hospital

    OpenAIRE

    Herrera Añazco, Percy; Médico Asistente, Servicio de Nefrología, Hospital Nacional 2 de Mayo, Lima, Perú; Docente de la Facultad de Medicina, Universidad Científica del Sur, Lima, Perú; Docente de la Facultad de Medicina, Universidad Nacional de Piura, Piura, Perú.; Palacios Guillén, Melissa; Médico Asistente, Servicio de Nefrología, Hospital Daniel Alcides Carrión, Lima, Perú; Docente, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú.; Chipayo Gonzales, David; Médico Residente, Servicio de Nefrología, Hospital Nacional 2 de Mayo, Lima, Perú.; Silveira Chau, Manuela; Médico Asistente, Unidad Médica Empresarial, Clínica Internacional, Lima, Perú.

    2013-01-01

    The Health Ministry attends Peruvian population without social security and without a national dialysis program. Attention is limited to a few hospitals with dialysis centers. objectives: To determine mortality in the first hospitalization for dialysis in a population without social security. design: Descriptive study. Setting: Hospital Nacional Dos de Mayo, Lima, Peru. Patients: Patients with chronic renal disease. Interventions: We studied patients who started dialysis from January to Decem...

  11. Microbiological etiology of bacterial prostatitis in general hospital and primary care clinic in Korea

    Directory of Open Access Journals (Sweden)

    Yong Sun Choi

    2013-09-01

    Conclusions: The total portion of chronic bacterial prostatitis was 59.3% (174/293. Culture-positive patients in the PCC were significantly higher than in the general hospital, but the number of PCR positive patients in the PCC was the same as in the general hospital.

  12. Implementation of a Prototype Generalized Network Technology for Hospitals *

    OpenAIRE

    Tolchin, S. G.; Stewart, R. L.; Kahn, S. A.; Bergan, E. S.; Gafke, G. P.; Simborg, D.W.; Whiting-O'Keefe, Q. E.; Chadwick, M. G.; McCue, G. E.

    1981-01-01

    A demonstration implementation of a distributed data processing hospital information system using an intelligent local area communications network (LACN) technology is described. This system is operational at the UCSF Medical Center and integrates four heterogeneous, stand-alone minicomputers. The applications systems are PID/Registration, Outpatient Pharmacy, Clinical Laboratory and Radiology/Medical Records. Functional autonomy of these systems has been maintained, and no operating system c...

  13. Factors affecting the technical efficiency of general hospitals in Iran: data envelopment analysis.

    Science.gov (United States)

    Kalhor, Rohollah; Amini, Saeed; Sokhanvar, Mobin; Lotfi, Farhad; Sharifi, Marziye; Kakemam, Edris

    2016-03-01

    Restrictions on resource accessibility and its optimal application is the main challenge in organizations nowadays. The aim of this research was to study the technical efficiency and its related factors in Tehran general hospitals. This descriptive analytical study was conducted retrospectively in 2014. Fifty-four hospitals with private, university, and social security ownerships from the total 110 general hospitals were randomly selected for inclusion into this study on the basis of the share of ownership. Data were collected using a checklist with three sections, including background variables, inputs, and outputs. Seventeen (31.48%) hospitals had an efficiency score of 1 (highest efficiency score). The highest average efficiency score was in social security hospitals (84.32). Private and university hospitals ranked next with an average of 84.29 and 79.64, respectively. Analytical results showed that there was a significant relationship between hospital ownership, hospital type in terms of duty and specialization, educational field of the chief executive officer, and technical efficiency. There was no significant relationship between education level of hospital manager and technical efficiency. Most of the studied hospitals were operating at low efficiency. Therefore, policymakers should plan to improve the hospital operations and promote hospitals to an optimal level of efficiency.

  14. Adverse events in hospitalised cancer patients: a comparison to a general hospital population

    DEFF Research Database (Denmark)

    Haukland, Ellinor; von Plessen, Christian; Nieder, Carsten

    2017-01-01

    ) compared to a general hospital population. Material and methods: A total of 6720 patient records were retrospectively reviewed comparing AEs in hospitalised cancer patients to a general hospital population in Norway, using the IHI Global Trigger Tool method. Results: 24.2 percent of admissions for cancer...... risk. The rate of AEs increases by 1.05 times for each day spent in hospital. For every year increase in age, the risk for AEs increases by 1.3%. Cancer patients more often have hospital-acquired infections, other surgical complications and AEs related to medications. Conclusions: Because of higher age...

  15. Can the use of Electronic Health Records in General Practice reduce hospitalizations for diabetes patients?

    DEFF Research Database (Denmark)

    Kongstad, Line Planck; Mellace, Giovanni; Rose Olsen, Kim

    on Electronic Health Records (EHR) on diabetes patients total hospitalizations, diabetes related hospitalizations and hospitalizations with diabetes and cardiovascular related Ambulatory Care Sentive Conditions (ACSC). We use a rich nationwide panel dataset (2004-2013) with information of stepwise enrolment......Disease management programmes (DMP) in the general practice sector are increasingly used to improve health of chronically ill patients, reduce hospitalizations and thereby costs. The aim of this paper is to estimate the causal effects of the enrolment of general practices (GP) in a DMP based...

  16. Collaboration between physicians and a hospital-based palliative care team in a general acute-care hospital in Japan

    Directory of Open Access Journals (Sweden)

    Nishikitani Mariko

    2010-06-01

    Full Text Available Abstract Background Continual collaboration between physicians and hospital-based palliative care teams represents a very important contributor to focusing on patients' symptoms and maintaining their quality of life during all stages of their illness. However, the traditionally late introduction of palliative care has caused misconceptions about hospital-based palliative care teams (PCTs among patients and general physicians in Japan. The objective of this study is to identify the factors related to physicians' attitudes toward continual collaboration with hospital-based PCTs. Methods This cross-sectional anonymous questionnaire-based survey was conducted to clarify physicians' attitudes toward continual collaboration with PCTs and to describe the factors that contribute to such attitudes. We surveyed 339 full-time physicians, including interns, employed in a general acute-care hospital in an urban area in Japan; the response rate was 53% (N = 155. We assessed the basic characteristics, experience, knowledge, and education of respondents. Multiple logistic regression analysis was used to determine the main factors affecting the physicians' attitudes toward PCTs. Results We found that the physicians who were aware of the World Health Organization (WHO analgesic ladder were 6.7 times (OR = 6.7, 95% CI = 1.98-25.79 more likely to want to treat and care for their patients in collaboration with the hospital-based PCTs than were those physicians without such awareness. Conclusion Basic knowledge of palliative care is important in promoting physicians' positive attitudes toward collaboration with hospital-based PCTs.

  17. La incursión de Pemex en Repsol: un experimento fallido propiciado por la reforma energética

    OpenAIRE

    Gutiérrez Rodríguez, Roberto

    2012-01-01

    We analyze the operation of doubling Pemex shareholding in Repsol-YPF in late 2011, and the syndication of that possession with SyV so as to enhance control over the decisions-making process of R-YPF with the possibly to make a takeover bid. We show that, between late 2011 and January 2013, this investment reported the country a loss, including interest on a loan taken to buy the shares of R-YPF, near to 920 million dollar, making it clear the misuse of part of the country’s fiscal resources ...

  18. Parasuicide among youth in a general hospital in South Africa

    Directory of Open Access Journals (Sweden)

    T Mhlongo

    1999-09-01

    Full Text Available Parasuicide cases among youth (15-24 years referred to the clinical psychology section of a regional hospital from 1995 to 1998 were reviewed. In all 100 cases (37 males and 63 females were identified being about 10% of the caseload. As part of the clinical psychological assessment sociodemographic, clinical characteristics, trigger factors, employed methods and suicide intentions were analysed. Most patients were students (79% or unemployed (16%. The major method employed to attempt suicide was ingestion of harmful substances (like paraffin, pesticides or battery acid(73%. Acute social conflicts (38%, socio-economic deprivation (17%, AIDS phobia (17%, academic failure (14%, teenage pregnancy (10% and mental illness (5% triggered suicide attempts. Fifty-eight percent of the attempts were categorised as demonstrative and 27% as genuine. The psychodynamics of parasuicides are discussed in case studies and with reference to other studies.

  19. Evaluation of thromboprophylaxis in medium-sized general hospital

    Directory of Open Access Journals (Sweden)

    Cesar Roberto Busato

    2014-03-01

    Full Text Available CONTEXT: Deep vein thrombosis (DVT is a serious, common disease whose complications include pulmonary thromboembolism (PTE and postthrombotic syndrome. The importance and benefits of correct and effective pharmacological prophylaxis for DVT are well documented. OBJECTIVES: The aims of this study were to evaluate adequacy of prophylaxis for DVT and PTE at the Santa Casa de Misericórdia de Ponta Grossa (SCMPG, Paraná, Brazil, and determine risk stratification for patients hospitalized in this institution. METHODS: A cohort study was conducted to assess DVT prophylaxis of patients hospitalized on May 15th, 2009. The study population consisted of a sample of 104 patients, subdivided into clinical and surgical groups and stratified into different specialties. Correct use of DVT prophylaxis was evaluated according to recommendations published by The Brazilian Society for Angiology and Vascular Surgery and took into account prophylactic methods specified explicitly in information found in each patient's medical chart. RESULTS: Of the 104 patients interviewed, 51 (49.04% were clinical patients and 53 (50.96% surgical. Based on risk stratification, 17 (16.35% were classified as low risk, 37 (35.58% as moderate risk, 46 (44.23% as high risk and 4 (3.85% as extremely high risk for DVT/PTE. A total of 68 patients (65.38% received prophylaxis, but of these only 56 (53.85% received the correct prophylaxis, and 36 (34.62% did not receive any prophylaxis. CONCLUSION: The rates of prophylaxis use for DVT and PTE in this service are higher than rates published in the literature.

  20. Epidemiology of carbapenemase producing Enterobacteriaceae in a general hospital

    Directory of Open Access Journals (Sweden)

    Amina Kandeel

    2015-06-01

    Full Text Available Objective: Detect the presence of carbapenemases producing Enterobacteriaceae (CPE and associated epidemiologi­cal, microbiological, and clinical characteristics of patients in our hospital Methods: During 15 months period, all non duplicate Enterobacteriaceae isolates with reduced susceptibility to car­bapenem detected by MicroScan WalkAway system and confirmed by E test were collected. These suspected isolates were further screened by modified Hodge test and carbapenemase inhibition discs to identify CPE. Results: Out of 54 suspected Enterobacteriaceae isolates, 44 (88.5% isolates were either extended spectrum beta-lac­tamases (ESBLs or AmpC producers with porin loss whereas 10 isolates (18.5% were confirmed to produce carbapen­emase representing (0.74% of the total Enterobacteriaceae. Among these 10 isolates, 6 were OXA 48 producers and 2 isolates were class B and class A each. Six out of the 10 CPE were detected in ICU and specimen source was tracheal aspirate in 5 CPE isolates. All CPE isolates were sensitive to colistin and all but one to tigecycline. All patients had history of previous antibiotic exposure and hospital stays for more than 5 days. Conclusion: Although CPE is not the main cause of carbapenem resistance in Enterobacteriaceae in our setting, its emergence there represents a serious infection control and therapeutic challenge. This mandates its early detection using MHT and carbapenemase inhibition tests together with strict infection control measures to limit its spread. J Mi­crobiol Infect Dis 2015;5(2: 57-62

  1. Care complexity in the general hospital - Results from a European study

    NARCIS (Netherlands)

    de Jonge, P; Huyse, FJ; Slaets, JPJ; Herzog, T; Lobo, A; Lyons, JS; Opmeer, BC; Stein, B; Arolt, [No Value; Balogh, N; Cardoso, G; Fink, P; Rigatelli, M; van Dijck, R; Mellenbergh, GJ

    2001-01-01

    There is increasing pressure to effectively treat patients with complex care needs from the moment of admission to the general hospital. In this study, the authors developed a measurement strategy for hospital-based care complexity. The authors' four-factor model describes the interrelations between

  2. A cost study of a general practitioner hospital in the Netherlands.

    NARCIS (Netherlands)

    Hakkart-van Roijen, L.; Moll van Charante, E.P.; Bindels, P.J.E.; Yzermans, C.J.; Rutten, F.F.H.

    2004-01-01

    To perform a cost study of the first general practitioner (GP) hospital in the Netherlands. We conducted a cost study in a GP hospital in the Netherlands. Data on healthcare utilisation from 218 patients were collected for a period of one year. The costs of admission to the GP hosptial were compared

  3. Researches regarding the Morton ether inhaler at Massachusetts General Hospital, Boston.

    Science.gov (United States)

    Haridas, Rajesh P; Mifflin, Jeffrey A

    2013-11-01

    The Morton ether inhaler in the possession of Massachusetts General Hospital, Boston, MA, was traced back to 1906 when the earliest known photograph of it was published. The authors believe that the inhaler was given by William T. G. Morton, MD, to J. Mason Warren, MD, in January 1847. The inhaler was acquired by the Warren Anatomical Museum at an unknown date, loaned to Massachusetts General Hospital in October 1946, and placed on permanent loan to Massachusetts General Hospital in April 1948. Many documents relating to the inhaler have disappeared, and it was only identified in 2009 as the inhaler that probably belonged to J. Mason Warren, MD. The inhaler is not believed to be the one that Morton used on October 16, 1846, at Massachusetts General Hospital. It is the only known example of a Morton ether inhaler with valves (excluding replicas or reproduction inhalers) and is probably of similar design to the inhaler that Morton used on October 16, 1846.

  4. Injectional anthrax at a Scottish district general hospital.

    Science.gov (United States)

    Inverarity, D J; Forrester, V M; Cumming, J G R; Paterson, P J; Campbell, R J; Brooks, T J G; Carson, G L; Ruddy, J P

    2015-04-01

    This retrospective, descriptive case-series reviews the clinical presentations and significant laboratory findings of patients diagnosed with and treated for injectional anthrax (IA) since December 2009 at Monklands Hospital in Central Scotland and represents the largest series of IA cases to be described from a single location. Twenty-one patients who fulfilled National Anthrax Control Team standardized case definitions of confirmed, probable or possible IA are reported. All cases survived and none required limb amputation in contrast to an overall mortality of 28% being experienced for this condition in Scotland. We document the spectrum of presentations of soft tissue infection ranging from mild cases which were managed predominantly with oral antibiotics to severe cases with significant oedema, organ failure and coagulopathy. We describe the surgical management, intensive care management and antibiotic management including the first description of daptomycin being used to treat human anthrax. It is noted that some people who had injected heroin infected with Bacillus anthracis did not develop evidence of IA. Also highlighted are biochemical and haematological parameters which proved useful in identifying deteriorating patients who required greater levels of support and surgical debridement.

  5. [Mental Health in the General Hospital: Results of the Patient Health Questionnaire (PHQ) in Four Hospital Services].

    Science.gov (United States)

    Castro-Camacho, Leonidas; Escobar, Juan Manuel; Sáenz-Moncaleano, Camilo; Delgado-Barrera, Lucía; Aparicio-Turbay, Soraya; Molano, Juan Carlos; Noguera, Efraín

    2012-03-01

    Few individuals have access to mental health services due in part to underdetection. As it is more likely to consult for medical conditions, primary care may be a useful gateway for early detection of mental health problems. Detection of the frequency of mental health problems in four hospital services at the Fundación Santa Fe de Bogotá: Outpatient unit, hospitalization, emergency department, and primary care through a brief detection questionnaire, the Patient Health Questionnaire (PHQ). Cross-sectional study of patients seen at the four services who answered a Demographic Data Questionnaire and the PHQ together with information gathered about current medical diagnosis, history of visits, and hospitalizations during the last year. 1094 patients seen at the four hospital services between September 2010 and May 2011 were selected at random. A mental health problem was detected in 36.7% of the total sample. Major depressive disorder (7.3%), alcohol abuse (14.4%), and any anxiety disorder (7.7%) showed the highest prevalence with the emergency department showing the highest frequency of detection. The usefulness of a brief detection questionnaire such as the PHQ in hospital settings is demonstrated and implications in the design of mental health programs in the general hospital are discussed. The need to replicate this study in other settings and to undertake further research is outlined. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  6. A 5-year audit of outcome of apicectomies carried out in a district general hospital.

    OpenAIRE

    Lyons, A. J.; Hughes, C E; Dixon, E. J.

    1995-01-01

    Success rates of up to 90% have been claimed for apicectomy. However, the conditions that this procedure is carried out under at district general hospitals may be at variance with such studies. A 5-year audit of outcome was therefore carried out within a district general hospital. It was found that 89% of apicected teeth still remained at 5 years. Outcome was not influenced by any of the factors examined, and could not be predicted radiographically. Most failures occurred after the average po...

  7. Psychiatric wards in general hospitals - the opinions of psychiatrists employed there

    Directory of Open Access Journals (Sweden)

    Janusz Chojnowski

    2016-04-01

    The psychiatrists employed in the psychiatric wards in general hospitals in Poland evaluate this organisational model positively. However, the destabilisation of economic foundations of these wards reported in the world literature was also reflected in the results of a survey conducted in Poland. There is a need to develop standards for the organisation and financing departments of psychiatry in general hospitals providing them stable status in the healthcare system in Poland.

  8. Well-Differentiated Thyroid Cancer: The Philippine General Hospital Experience

    Directory of Open Access Journals (Sweden)

    Tom Edward N. Lo

    2016-03-01

    Full Text Available BackgroundWell-differentiated thyroid cancer (WDTC is the most common form of thyroid malignancy. While it is typically associated with good prognosis, it may exhibit higher recurrence and mortality rates in selected groups, particularly Filipinos. This paper aims to describe the experience of a Philippine Hospital in managing patients with differentiated thyroid cancer.MethodsWe performed a retrospective cohort study of 723 patients with WDTC (649 papillary and 79 follicular, evaluating the clinicopathologic profiles, ultrasound features, management received, tumor recurrence, and eventual outcome over a mean follow-up period of 5 years.ResultsThe mean age at diagnosis was 44±13 years (range, 18 to 82, with a majority of cases occurring in the younger age group (<45 years. Most tumors were between 2 and 4 cm in size. The majority of papillary thyroid cancers (PTCs, 63.2% and follicular thyroid cancers (FTCs, 54.4% initially presented as stage 1, with a greater proportion of FTC cases (12.7% vs. 3.7% presenting with distant metastases. Nodal metastases at presentation were more frequent among patients with PTC (29.9% vs. 7.6%. A majority of cases were treated by complete thyroidectomy, followed by radioactive iodine therapy and thyroid stimulating hormone suppression, resulting in a disease-free state. Excluding patients with distant metastases at presentation, the recurrence rates for papillary and FTC were 30.1% and 18.8%, respectively.ConclusionOverall, PTC among Filipinos was associated with a more aggressive and recurrent behavior. FTC among Filipinos appeared to behave similarly with other racial groups.

  9. Etiological study of generalized lymphadenopathy in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Subrata Halder

    2016-08-01

    Results: Among 116 patients of generalized lymphadenopathy 59.5% were non-malignant causes where 40.5% diagnosed as malignant causes. Among them tuberculosis consist of 39 (33.6%, NHL 18 (15.5%, reactive lymphadenopathy 16 (13.8%, CLL and HD 8 (6.9% each, ALL 7 (6%, SLE 5(4.3%, Kikuchi's disease 4 (3.4%, AML and RA 3 (2.6% each and castleman's disease, phenytoin lymphadenopathy, metastatic lung and breast carcinoma 1 (0.9% each. Cervical groups of lymph nodes were most commonly involved 86 patients (74.1% followed by axillary groups 73 patients (62.9%. Lymph nodes size 1.5cm were due to malignant and non-malignant granulomatous cases. FNAC give definite diagnosis 80.9% malignant cases where 76.8% in non-malignant cases. HPE shown definite diagnosis in 100% cases both malignant and non-malignant diseases. Conclusions: Tuberculosis is most common cause of generalized lymphadenopathy followed by lymphoma. And reactive lymphadenitis is also an important consideration. [Int J Res Med Sci 2016; 4(8.000: 3542-3548

  10. A review of governance of maternity services at South Tipperary general hospital

    LENUS (Irish Health Repository)

    Flory, David

    2015-09-01

    This review of the governance of maternity services at South Tipperary General Hospital has focussed on the systems and processes for assurance of service quality, risk management and patient safety primarily inside the hospital but also in the Hospital Group structure within which it operates. The effectiveness of the governance arrangements is largely determined by the quality of the leadership and management – both clinical and general – which designs, implements, and oversees those systems and processes and is ultimately responsible and accountable.\\r\

  11. DRUG MANAGEMENT REVIEWS IN DISTRICT DRUG MANAGEMENT UNIT AND GENERAL HOSPITAL

    Directory of Open Access Journals (Sweden)

    Max Joseph Herman

    2009-12-01

    Full Text Available Drug is one of the essential elements in healthcare that should be effectively and efficiently managed. Following thedecentralization in 2001 in Indonesia, drug management has changed in district drug management units and also in District General Hospitals. Certainly this condition influences the sustainability of drug access in primary health care such as in Community Health Center and District General Hospital, especially in drug financing policy. A cross sectional descriptive study to obtain information on drug management in public healthcare in district had been carried out between July and December 2006 in 10 District Public Drug Management Units from 10 district health offices and 9 district general hospitals as samples. Data were collected by interviewing heads of Drug Section in District Health Offices and heads of Hospital Pharmacies using structured questionnaires and observing drug storage in District Drug Management Units, Community Health Centers, and Hospital Pharmacies. Results of the study show that drug planning in District Health Offices and General Hospitals did not meet the basic real need in some districts nor District Hospitals. The minimum health service standards had no been achieved yet. Furthermore, drug procurement, storage and recording as well as reporting was not good enough either, such as shown by the existence of expired drugs. Lead time for drug delivery to community health centers in some districts was longer than the average of lead time in the past 3 years.

  12. HOSPITAL PATIENT DATABASE MANAGEMENT SYSTEM ‘A Case Study of General Hospital NORTH-BANK Makurdi- Nigeria’

    Directory of Open Access Journals (Sweden)

    Oye Nathaniel David

    2014-03-01

    Full Text Available Health care in Nigeria as in many other countries is confronted with growing demand for medical treatment and services. The medical records must appropriately have all of the patients’ medical history. Physicians must maintain flawless records, because this document serves a number of purposes. This study on hospital patient datable management system was design to transform the manual way of searching, sorting, keeping and accessing patient medical information (files into electronic medical record (EMR in order to solve the problem associate with manual method. The existing system (manual has been studied and hence a computer based application was provided to replace this manual method. These computer based systems generate the patient report as the patient register in and out of the hospital. This paper generally looks for a more accurate, reliable and efficient method of computer to facilitate patient record’s keeping in General Hospitals to ensure efficient outcome that will lessen time consuming. The study proposed that the design of hospital patient database record will be a solution to the problem being experienced by the current manual method of keeping patient medical record.

  13. Internal and External Perspectives on Quality of Healthcare Services at Sanglah General Hospital Denpasar

    Directory of Open Access Journals (Sweden)

    Made Nopy Diah Sundari

    2015-04-01

    Full Text Available Background and purpose: Customer satisfaction is a primary indicator of the quality of public healthcare services. This study investigated internal (hospital staff and external (hospital clients perspectives in order to gain insight into the quality of care at Sanglah General Hospital.Methods: The study used both qualitative and quantitative methodologies with 11 informants and 106 respondents. Qualitative data obtained through in-depth interviews with hospital staff were analyzed thematically. Quantitative data obtained through self-administered questionnaire were analyzed using univariate analysis.Results: Informants from the qualitative data collection stated that Sanglah General Hospital has a relatively high level of service and that existing structures to mitigate issues are in place, which act as reinforcing factors. Data from the quantitative survey indicated that clients were satisfied with the quality of service (ServQual, with an overall percentage of 83.82%.Conclusion: Further efforts could be made in order to improve healthcare provision at Sanglah Hospital, particularly from the perspective of hospital facilities, staff support and increased implementation of clinical governance.Keywords: quality of service, internal perspectives, external perspectives, Sanglah Hospital

  14. [Pharmaceutical Service after the Fukushima Disaster: A Case Report of Soma General Hospital].

    Science.gov (United States)

    Fukunaga, Hisanori; Momonoi, Toshiyuki; Kumakawa, Hiromi

    2016-01-01

      Despite being damaged by the 2011 Tohoku earthquake, tsunami, and nuclear disaster, Soma General Hospital, located approximately 40 km north of Fukushima Daiichi nuclear power plant, was able to fulfill its role as a key regional hospital in northeast Fukushima. To elucidate the pharmaceutical service in response to the disaster, we investigated the hospital's operations in 2011 according to the medical records and prescriptions. One of the difficulties that the department of pharmaceutical service faced at that time was the increase in emergency healthcare requests by evacuated patients from other hospitals and clinics. Herein, we propose the following countermeasures to be considered in future disaster preparations: (1) establishing a medical and pharmaceutical service coordinator for disaster relief; (2) sharing all local patients' medical information in emergencies (at least contraindicated drugs or allergy history); and (3) reviewing disaster stockpiles, especially pharmaceuticals (both at the hospital and in nearby locations).

  15. MANAGEMENT OF DIABETES IN ACUTE MYOCARDIAL INFARCTION IN CELJE GENERAL HOSPITAL IN 1999

    Directory of Open Access Journals (Sweden)

    Gregor Veninšek

    2001-12-01

    Full Text Available Background. DIGAMI study showed that intrahospital mortality and mortality at one year after myocardial infarction can be significantly reduced in diabetics treated in acute phase of myocardial infarction by GI infusion and afterwards for at least three months with intensive insulin treatment. Mortality can be reduced for more than 50% in a subgroup of patients younger than 70 years, without congestive heart failure, with first myocardial infarction, not treated with insulin or digitalis. In this perspective we reviewed treatment of diabetics with acute myocardial infarction in 1999 in Celje General Hospital.Methods. We reviewed documentation of treatment of all diabetics with acute myocardial infarction treated in Celje General Hospital in 1999. We collected data on number of newly discovered diabetes, on previous treatment of diabetes, on treatment of diabetes during hospitalization and at discharge, on drugs used for treatment of diabetes and on mortality during hospitalization.Results. Diabetics presented 20% of all patients with acute myocardial infarction treated in Celje General Hospital in 1999. None of patients received GI infusion, none had intensively managed blood sugar. 24% of patients were treated with sulfonylureas in acute phase of myocardial infarction. 33% of patients were discharged from hospital with insulin therapy. Intrahospital mortality was 9%, comparable with patients without diabetes.Conclusions. In 1999 was intrahospital treatment of diabetics with acute myocardial infarction in Celje General Hospital successful as their intrahospital mortality equaled non-diabetics. Treatment of diabetes itself, during hospitalization and after discharge, on the other hand, in 1999 had not been up to date according to results of recent studies. In our opinion, it is mandatory for diabetologist to make part of the team that treats diabetic with acute myocardial infarction

  16. Recreational activities performed with neoplasia carrier Inpatients in a general hospital

    OpenAIRE

    2012-01-01

    This study aims at apprehending the contribution of recreational activities in the treatment of hospitalized cancer patients and identifying the most stimulating resources for them. This is a qualitative research of phenomenological nature, it was approved by the Ethics in Research Committee, Protocol 139/2010. It was conducted with patients with cancer in a general hospital, located in Alfenas, in March and April, 2011.The research began from these guiding questions: What are your thoughts o...

  17. [Hip fracture in older adults: prevalence and costs in two hospitals. Tabasco, Mexico, 2009].

    Science.gov (United States)

    Quevedo-Tejero, Elsy del Carmen; Zavala-González, Marco Antonio; Hernández-Gamas, Arianna del Carmen; Hernández-Ortega, Hilda María

    2011-01-01

    To determine hip fracture prevalence and direct healthcare costs in elderly users of the reference hospitals of the Mexican Institute of Social Insurance (IMSS by spanish initials) and Mexican Oils (PEMEX by spanish initials), from Villahermosa, Tabasco, Mexico, during 2009. This is a cross-sectional study. The information was based on the registers of surgical interventions and institutional reports of the elderly inpatients who had a registered attention in their institution. Descriptive statistical analysis was performed considering the following variables: age, gender, hip fracture type, occurrence month, direct healthcare cost. Out of 10,765 records of hospitalized elderly, 57 hip fracture cases were found (33 in the IMSS and 24 in PEMEX). Hip fracture prevalence was 0.5%, (IMSS 1.1% and PEMEX 0.3%), being more frequent in women and older than 69. The most frequent fracture type was the femur neck one (78.9%). The estimated cost of healthcare in the hospital per patient was USD 5,803 in the IMSS and USD 11,800 in PEMEX. The hip fracture prevalence was higher in the IMSS users. Estimated healthcare costs per patient were higher than the reported in other institutions of the of the mexican health national system.

  18. A 5-year audit of outcome of apicectomies carried out in a district general hospital.

    Science.gov (United States)

    Lyons, A. J.; Hughes, C. E.; Dixon, E. J.

    1995-01-01

    Success rates of up to 90% have been claimed for apicectomy. However, the conditions that this procedure is carried out under at district general hospitals may be at variance with such studies. A 5-year audit of outcome was therefore carried out within a district general hospital. It was found that 89% of apicected teeth still remained at 5 years. Outcome was not influenced by any of the factors examined, and could not be predicted radiographically. Most failures occurred after the average postoperative review period of 10.5 months. Patient satisfaction with the procedure was high at over 90%. Based on these results it was concluded that apicectomy was an effective procedure when carried out by staff of all grades within the district general hospital, and that repeated follow-up appointments with radiographs over the first postoperative year were not useful. PMID:7574319

  19. Control costs, enhance quality, and increase revenue in three top general public hospitals in Beijing, China.

    Directory of Open Access Journals (Sweden)

    Lue-Ping Zhao

    Full Text Available BACKGROUND: With market-oriented economic and health-care reform, public hospitals in China have received unprecedented pressures from governmental regulations, public opinions, and financial demands. To adapt the changing environment and keep pace of modernizing healthcare delivery system, public hospitals in China are expanding clinical services and improving delivery efficiency, while controlling costs. Recent experiences are valuable lessons for guiding future healthcare reform. Here we carefully study three teaching hospitals, to exemplify their experiences during this period. METHODS: We performed a systematic analysis on hospitalization costs, health-care quality and delivery efficiencies from 2006 to 2010 in three teaching hospitals in Beijing, China. The analysis measured temporal changes of inpatient cost per stay (CPS, cost per day (CPD, inpatient mortality rate (IMR, and length of stay (LOS, using a generalized additive model. FINDINGS: There were 651,559 hospitalizations during the period analyzed. Averaged CPS was stable over time, while averaged CPD steadily increased by 41.7% (P<0.001, from CNY 1,531 in 2006 to CNY 2,169 in 2010. The increasing CPD seemed synchronous with the steady rising of the national annual income per capita. Surgical cost was the main contributor to the temporal change of CPD, while medicine and examination costs tended to be stable over time. From 2006 and 2010, IMR decreased by 36%, while LOS reduced by 25%. Increasing hospitalizations with higher costs, along with an overall stable CPS, reduced IMR, and shorter LOS, appear to be the major characteristics of these three hospitals at present. INTERPRETATIONS: These three teaching hospitals have gained some success in controlling costs, improving cares, adopting modern medical technologies, and increasing hospital revenues. Effective hospital governance and physicians' professional capacity plus government regulations and supervisions may have played a role

  20. Attitudes of Malaysian general hospital staff towards patients with mental illness and diabetes

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    Midin Marhani

    2011-05-01

    Full Text Available Abstract Background The context of the study is the increased assessment and treatment of persons with mental illness in general hospital settings by general health staff, as the move away from mental hospitals gathers pace in low and middle income countries. The purpose of the study was to examine whether general attitudes of hospital staff towards persons with mental illness, and extent of mental health training and clinical experience, are associated with different attitudes and behaviours towards a patient with mental illness than towards a patients with a general health problem - diabetes. Methods General hospital health professionals in Malaysia were randomly allocated one of two vignettes, one describing a patient with mental illness and the other a patient with diabetes, and invited to complete a questionnaire examining attitudes and health care practices in relation to the case. The questionnaires completed by respondents included questions on demographics, training in mental health, exposure in clinical practice to people with mental illness, attitudes and expected health care behaviour towards the patient in the vignette, and a general questionnaire exploring negative attitudes towards people with mental illness. Questionnaires with complete responses were received from 654 study participants. Results Stigmatising attitudes towards persons with mental illness were common. Those responding to the mental illness vignette (N = 356 gave significantly lower ratings on care and support and higher ratings on avoidance and negative stereotype expectations compared with those responding the diabetes vignette (N = 298. Conclusions Results support the view that, in the Malaysian setting, patients with mental illness may receive differential care from general hospital staff and that general stigmatising attitudes among professionals may influence their care practices. More direct measurement of clinician behaviours than able to be implemented

  1. A comparative analysis of exposure doses between the radiation workers in dental and general hospital

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Nam Hee; Chung, Woon Kwan; Dong, Kyung Rae; Ju, Yong Jin; Song, Ha Jin [Dept. of Nuclear Engineering, Chosun University, Gwangju (Korea, Republic of); Choi, Eun Jin [Dept. of Public Health and Medicine, Dongshin University, Naju (Korea, Republic of)

    2015-02-15

    Research and investigation is required for the exposure dose of radiation workers to work in the dental hospital as increasing interest in exposure dose of the dental hospital recently accordingly, study aim to minimize radiation exposure by making a follow-up study of individual exposure doses of radiation workers, analyzing the status on individual radiation exposure management, prediction the radiation disability risk levels by radiation, and alerting the workers to the danger of radiation exposure. Especially given the changes in the dental hospital radiation safety awareness conducted the study in order to minimize radiation exposure. This study performed analyses by a comparison between general and dental hospital, comparing each occupation, with the 116,220 exposure dose data by quarter and year of 5,811 subjects at general and dental hospital across South Korea from January 1, 2008 through December 31, 2012. The following are the results obtained by analyzing average values year and quarter. In term of hospital, average doses were significantly higher in general hospitals than detal ones. In terms of job, average doses were higher in radiological technologists the other workers. Especially, they showed statistically significant differences between radiological technologists than dentists. The above-mentioned results indicate that radiation workers were exposed to radiation for the past 5 years to the extent not exceeding the dose limit (maximum 50 mSv y{sup -1}). The limitation of this study is that radiation workers before 2008 were excluded from the study. Objective evaluation standards did not apply to the work circumstance or condition of each hospital. Therefore, it is deemed necessary to work out analysis criteria that will be used as objective evaluation standard. It will be necessary to study radiation exposure in more precise ways on the basis of objective analysis standard in the future. Should try to minimize the radiation individual dose of

  2. Review of paediatric cardiology services in district general hospitals in the United Kingdom.

    Science.gov (United States)

    Andrews, Hannah; Singh, Yogen

    2016-03-01

    Following the Safe and Sustainable review of Paediatric Services in 2012/2013, National Health Service England recommended that local paediatric cardiology services should be provided by specially trained paediatricians with expertise in cardiology in all non-specialist hospitals. To understand the variation in local paediatric cardiology services provided across district general hospitals in the United Kingdom. An internet-based questionnaire was sent out via the Paediatrician with Expertise in Cardiology Special Interest Group and the Neonatologists with Interest in Cardiology and Haemodynamics contact databases and the National Health Service directory. Non-responders were followed-up via telephone. The response rate was 80% (141 of 177 hospitals), and paediatricians with expertise in cardiology were available in 68% of those. Local cardiology clinics led by paediatricians with expertise in cardiology were provided in 96 hospitals (68%), whereas specialist outreach clinics were held in 123 centres (87%). A total of 11 hospitals provided neither specialist outreach clinics nor any local cardiology clinics led by paediatricians with expertise in cardiology. Paediatric echocardiography services were provided in 83% of the hospitals, 12-lead electrocardiogram in 96%, Holter electrocardiogram in 91%, and exercise testing in only 47% of the responding hospitals. Telemedicine facilities were established in only 52% of the centres, where sharing echocardiogram images via picture archiving and communication system was used most commonly. There has been a substantial increase in the availability of paediatricians with expertise in cardiology since 2008. Most of the hospitals are well-supported by specialist cardiology centres via outreach clinics; however, there remains significant variation in the local paediatric cardiology services provided across district general hospitals in the United Kingdom.

  3. Psychological impact of the pandemic (H1N1) 2009 on general hospital workers in Kobe.

    Science.gov (United States)

    Matsuishi, Kunitaka; Kawazoe, Ayako; Imai, Hissei; Ito, Atsushi; Mouri, Kentaro; Kitamura, Noboru; Miyake, Keiko; Mino, Koichi; Isobe, Masanori; Takamiya, Shizuo; Hitokoto, Hidefumi; Mita, Tatsuo

    2012-06-01

    In order for hospitals to work efficiently in a pandemic, it is important to know how a pandemic affects the hospital staff. The aim of the present study was to investigate the psychological impact of the pandemic (H1N1) 2009 on hospital workers and how it was affected by the characteristics of the hospital, gender, age, job and work environment. In late June 2009, soon after the pandemic had ended in Kobe city, Japan, a questionnaire was distributed consisting of questions on sociodemographic characteristics, 19 stress-related questions and the Impact of Event Scale (IES) to all 3635 employees at three core general hospitals in Kobe. Exploratory factor analysis was applied to the 19 stress-related questions, and this produced four factors for evaluation (anxiety about infection, exhaustion, workload, and feeling of being protected). Multiple regression models were used to evaluate the association of personal characteristics with each score of the four factors and the IES. Valid answers were received from 1625 employees. Workers at a hospital with intense liaison psychiatric services felt less psychological impact. Workers at a hospital that provided staff with information about the pandemic less frequently, felt unprotected. Workers in work environments that had a high risk of infection felt more anxious and more exhausted. The total IES score was higher in workers in high-risk work environments. It is important for hospitals to protect hospital workers during a pandemic and to rapidly share information about the pandemic. Liaison psychiatric services can help to reduce the impact of the pandemic on hospital workers. © 2012 The Authors. Psychiatry and Clinical Neurosciences © 2012 Japanese Society of Psychiatry and Neurology.

  4. The use of the truth and deception in dementia care amongst general hospital staff.

    Science.gov (United States)

    Turner, Alex; Eccles, Fiona; Keady, John; Simpson, Jane; Elvish, Ruth

    2017-08-01

    Deceptive practice has been shown to be endemic in long-term care settings. However, little is known about the use of deception in dementia care within general hospitals and staff attitudes towards this practice. This study aimed to develop understanding of the experiences of general hospital staff and explore their decision-making processes when choosing whether to tell the truth or deceive a patient with dementia. This qualitative study drew upon a constructivist grounded theory approach to analyse data gathered from semi-structured interviews with a range of hospital staff. A model, grounded in participant experiences, was developed to describe their decision-making processes. Participants identified particular triggers that set in motion the need for a response. Various mediating factors influenced how staff chose to respond to these triggers. Overall, hospital staff were reluctant to either tell the truth or to lie to patients. Instead, 'distracting' or 'passing the buck' to another member of staff were preferred strategies. The issue of how truth and deception are defined was identified. The study adds to the growing research regarding the use of lies in dementia care by considering the decision-making processes for staff in general hospitals. Various factors influence how staff choose to respond to patients with dementia and whether deception is used. Similarities and differences with long-term dementia care settings are discussed. Clinical and research implications include: opening up the topic for further debate, implementing staff training about communication and evaluating the impact of these processes.

  5. Care for patients with cerebrovascular disease in a general hospital. 2 years experience

    Directory of Open Access Journals (Sweden)

    Joan Omar Rojas Fuentes

    2010-08-01

    Full Text Available Background: The care of patients with cerebrovascular disease requires an organized system from pre-hospital care until discharge of the patient, to ensure the continuity of rehabilitation. In order to provide differentiated services to patients with this condition was created in the General Hospital Universitario "Dr. Gustavo Lima Aldereguía "a specialized room for attention to these diseases and the rehabilitation of patients. Objective: To determine the benefits obtained with differentiated services to patients with cerebrovascular disease in a general hospital. Methods: Descriptive case series that included 1038 patients admitted to the specialized chamber for cerebrovascular disease. We analyzed the following variables: stay, type of cerebrovascular disease, clinical classification, the Barthel index and discharge status. Results: 972 patients suffered from cerebrovascular disease, hospital stay was reduced by two days, the attention of specialized equipment increased from 51.75% to 79.2% patients were discharged with a mild degree of functional dependence. Conclusions: The differentiated services to cerebrovascular disease in general hospitals shows benefits for patients.

  6. Care of severe head injury patients in the Sarawak General Hospital: intensive care unit versus general ward.

    Science.gov (United States)

    Sim, S K; Lim, S L; Lee, H K; Liew, D; Wong, A

    2011-06-01

    Intensive care for severe head injury patients is very important in the prevention and treatment of secondary brain injury. However, in a resources constraint environment and limited availability of Intensive Care Unit (ICU) beds in the hospitals, not all severe head injury patients will receive ICU care. This prospective study is aimed to evaluate the outcome of severe head injured patients who received ICU and general ward care in Sarawak General Hospital (SGH) over a 6-month period. A total of thirty five severe head injury patients were admitted. Twenty three patients (65.7%) were ventilated in general ward whereas twelve patients (34.3%) were ventilated in ICU. Overall one month mortality in this study was 25.7%. Patients who received ICU care had a lower one month mortality than those who received general ward care (16.7% vs 30.4%), although it was not statistically different. Multivariate analysis revealed only GCS on admission (OR 0.731; 95% CI 0.460 to 0.877; P=0.042) as the independent predictive factor for one month mortality in this study.

  7. Short and medium-term outcomes for general surgery in nonagenarian patients in a district general hospital.

    Science.gov (United States)

    Hayes, A J; Davda, A; El-Hadi, M; Murphy, P; Papettas, T

    2016-07-01

    Introduction Surgeons are increasingly performing surgery on older patients. There are currently no tools specifically for risk prediction in this group. The aim of this study was to review general surgical operations carried out on patients aged over 90 years and their outcome, before comparing these with predictors of morbidity and mortality. Methods A retrospective review was carried out at our district general hospital of all general surgery patients aged over 90 years who underwent a general surgical operation over a period of 14 years. Information collected included demographics, details of procedures, P-POSSUM (Portsmouth Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity), complications and outcomes. Results A total of 119 procedures were carried out, 72 involving entry into the peritoneal cavity. Overall, 14 patients (12%) died within 30 days and 34 (29%) died within one year. Postoperative complications included infection (56%), renal failure (24%), need for transfusion (17%) and readmission within 30 days (11%). Logistical regression analysis showed that the P-POSSUM correlated well with observed mortality and infection was a significant predictor of in-hospital mortality (p=0.003). Conclusions The P-POSSUM correlates significantly with outcome and should be used when planning major elective or emergency surgery in patients over 90 years of age. Infective complications appear to be a significant predictor of postoperative mortality. This study supports operative intervention as an option in this extreme age group but we emphasise the importance of appropriate patient selection and judicious clinical care.

  8. Relationship between psychiatric nurse work environments and nurse burnout in acute care general hospitals.

    Science.gov (United States)

    Hanrahan, Nancy P; Aiken, Linda H; McClaine, Lakeetra; Hanlon, Alexandra L

    2010-03-01

    Following deinstitutionalization, inpatient psychiatric services moved from state institutions to general hospitals. Despite the magnitude of these changes, evaluations of the quality of inpatient care environments in general hospitals are limited. This study examined the extent to which organizational factors of the inpatient psychiatric environments are associated with psychiatric nurse burnout. Organizational factors were measured by an instrument endorsed by the National Quality Forum. Robust clustered regression analysis was used to examine the relationship between organizational factors in 67 hospitals and levels of burnout for 353 psychiatric nurses. Lower levels of psychiatric nurse burnout was significantly associated with inpatient environments that had better overall quality work environments, more effective managers, strong nurse-physician relationships, and higher psychiatric nurse-to-patient staffing ratios. These results suggest that adjustments in organizational management of inpatient psychiatric environments could have a positive effect on psychiatric nurses' capacity to sustain safe and effective patient care environments.

  9. Upper urinary tract stone disease: the changing management in a district general hospital.

    OpenAIRE

    Goble, N M; Hammonds, J C; Wells, I P

    1987-01-01

    The advent of percutaneous nephrolithotomy (PCN) and ureteroscopy, in combination with stone disruption techniques, has dramatically altered the management of upper urinary tract stone disease. These advances are not necessarily confined to the teaching centres. The problems encountered introducing these techniques in a District General Hospital and their impact on the surgical management of upper urinary tract stones is presented.

  10. Critical care research in a district general hospital: the first year.

    Science.gov (United States)

    Camsooksai, Julie; Barnes, Helena; Reschreiter, Henrik

    2013-09-01

    Until recently, research in critical care units has usually taken place in university teaching hospitals. The 'general' critical care unit patient population is broader than this and the research needs to reflect this. As a general critical care unit in a district general hospital we wanted to set-up research within our own department, as part of the critical care team and part of our culture. With extensive background communication, drive and hard work, the support of the hospital Research and Development department was gained and Comprehensive Local Research Network funding successfully applied for. A research team was established and a model for the Research Nurse role was developed and implemented. This model is described. Participation in national trials commenced and the research portfolio is growing. Networking with other teams also proved valuable. Research has been established as part of the 'culture' of the day-to-day work and the staff have embraced this. Dedicated Research Nurse posts and education of the whole team have ensured successful implementation and recruitment of the studies. Experiences of the first year are shared and discussed here. Sharing experience of developing research within a critical care unit in a district general hospital, and a suggested model for a new Research Nurse role, may benefit other similar units in their efforts to establish research.

  11. Two decades of external peer review of cancer care in general hospitals; the Dutch experience

    NARCIS (Netherlands)

    Kilsdonk, M.J.; Siesling, S.; Otter, R.; Harten, van W.H.

    2015-01-01

    External peer review was introduced in general hospitals in the Netherlands in 1994 to assess and improve the multidisciplinary team approach in cancer care. This paper aims to explore the value, perceived impact, and (future) role of external peer review in cancer care. Semistructured interviews we

  12. TRANSPORT OF PATIENTS FOR PRIMARY PTCA FROM GENERAL HOSPITAL NOVO MESTO TO LJUBLJANA IN 2002

    Directory of Open Access Journals (Sweden)

    Renata Okrajšek

    2004-12-01

    Full Text Available Background. The treatment of acute coronary syndrome (ACS with ST-segment elevation with primary percutaneous transluminal coronary angioplasty (PTCA is the best way to treat these patients. Primary PTCA is also practicable with patients who are admitted into institution without catheter laboratory. The transport of patients into the tertiary institution is safe, but it is important to keep the time of ischemia as short as possible and to reach the time interval of door-balloon as recommended by the guidelines. The ACS patients with ST-segment elevation that were directed into General Hospital Novo mesto after examination at the internistic emergency department have been redirected to KC Ljubljana for realization of PTCA since October 2001.Methods. A prospective analysis of patients with ACS with STsegment elevation, who had been transferred from General Hospital Novo mesto to KC Ljubljana in the period from January 1, 2002 to December 31, 2002 to have a primary PTCA, was performed. The analysis comprised the following: the time interval of handling the patients at Internistic department of General Hospital Novo mesto, the time of transport of patients to Ljubljana and total time interval from the arrival of patients to General Hospital Novo mesto to the first inflation of balloon in Ljubljana. We monitored the complications that occurred during the treatment of the patients.Results. In the above mentioned period 29 patients (24 males and 5 females were transported from the General Hospital Novo mesto to the KC Ljubljana to have a primary PTCA performed. The total time interval measured between the patients’ arrival to General Hospital Novo mesto to the first inflation of balloon in Ljubljana in the year 2002 was 145 minutes, which is 17 minutes better than in the previous period. The time interval recommended by the guidelines was achieved with four patients.Conclusions. By recognizing the problems that had encountered with directing the

  13. Study of Patients Absconding Behavior in a General Hospital at Southern Region of Iran

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    Mohammad Khammarnia

    2015-03-01

    Full Text Available Background Patients’ escape from hospital imposes a significant cost to patients as well as the health system. Besides, for these patients, exposure to adverse events (such as suicide, self-harm, violence and harm to hospital reputation are more likely to occur compared to others. The present study aimed to determine the characteristics of the absconding patients in a general hospital through a case-control design in Shiraz, Iran. Methods This case-control study was conducted on 413 absconded patients as case and 413 patients as control in a large general hospital in Shiraz, southern Iran. In this study, data on the case and control patients was collected from the medical records using a standard checklist in the period of 2011–3. Then, the data were analyzed using descriptive and analytical statistics, through SPSS 16. Results The finding showed that 413 patients absconded (0.50% and mean of age in case group was 40.98 ± 16.31 years. In univariate analysis, variables of gender [Odds Ratio (OR= 2], ward (OR= 1.22, insurance status (OR= 0.41, job status (OR= 0.34 and residence expenditure were significant. However, in multivariate analysis significant variables were age (ORadj= 0.13, gender (ORadj= 2.15, self-employment/unemployed (ORadj= 0.47, emergency/admission (ORadj= 2.14, internal/admission (ORadj= 3.16, insurance status (ORadj= 4.49 and residence expenditure (ORadj= 1.15. Conclusion Characteristics such as middle age, male gender, no insurance coverage, inability to afford hospital expenditures and admission in emergency department make patients more likely abscond from the hospital. Therefore, it may be necessary to focus efforts on high-risk groups and increase insurance coverage in the country to prevent absconding from hospital.

  14. Comparing salivary cotinine concentration in non-smokers from the general population and hospitality workers in Spain.

    Science.gov (United States)

    Martínez-Sánchez, Jose M; Fu, Marcela; Pérez-Ríos, Mónica; López, María J; Moncada, Albert; Fernández, Esteve

    2009-12-01

    The objective was to compare the pattern of exposure to second-hand smoke (SHS) among non-smokers in the general population and in hospitality workers. We used the adult (16-64 years) non-smokers of two independent studies (general population and hospitality workers) in Spain. We assessed the exposure to SHS by means of questionnaire and salivary cotinine concentration. The salivary cotinine concentration by sex, age, educational level, day of week of saliva collection, and exposure to SHS were always higher in hospitality workers than in the general population. Our results indicated that non-smoker hospitality workers have higher levels of exposure to SHS than general population.

  15. Perfil clínico del adulto mayor atendido ambulatoriamente en un hospital general.

    OpenAIRE

    Casas, Paola; Médico Geriatra, Hospital Nacional Cayetano Heredia. Lima.; Varela, Luis; Médico Internista-Geriatra, Hospital Nacional Cayetano Heredia. Instituto de Gerontología, Universidad Peruana Cayetano Heredia. Lima.; Tello, Tania; Médico Geriatra, Hospital Nacional Cayetano Heredia. Instituto de Gerontología, Universidad Peruana Cayetano Heredia. Lima.; Ortiz, Pedro; Médico Internista, Hospital Nacional Arzobispo Loayza. Instituto de Gerontología, Universidad Peruana Cayetano Heredia. Lima.; Chávez, Helver; Médico Internista-Geriatra, Hospital Nacional Cayetano Heredia. Instituto de Gerontología, Universidad Peruana Cayetano Heredia. Lima.

    2012-01-01

    Objetivo: Describir el perfil clínico del adulto mayor atendido ambulatoriamente en un hospital general. Material y métodos: Estudio descriptivo, transversal, realizado a través de encuestas aplicadas a pacientes en la consulta ambulatoria de geriatría del Hospital Nacional Cayetano Heredia (HNCH), entre agosto de 2011 y enero 2012. Resultados: Se evaluaron 290 pacientes, el 69,3% fueron mujeres; el 65,5% tenía entre 60 y 79 años. La hipertensión arterial fue el diagnóstico más frecuente (55,...

  16. [Participatory planning in health organizations: the case of the Bonsucesso General Hospital, Rio de Janeiro, Brazil].

    Science.gov (United States)

    Lima, Juliano de Carvalho; Faveret, Ana Cecília; Grabois, Victor

    2006-03-01

    This article presents the experience with participatory planning in the Bonsucesso General Hospital in Rio de Janeiro, Brazil, from 2003 to 2004. The participatory and communicative characteristics and the resulting institutional format are identified for guaranteeing the implementation of collective decisions from the planning workshops. The limits of implementation in participatory planning and management proposals are argued from the perspective of change and power relations in these institutions. The results support the notion that projects involving changes in hospitals and failing to take into account the different internal rationalities and power relations end up having reduced potential for implementation.

  17. Awareness and utilization of peer support programs in Singapore public general hospitals.

    Science.gov (United States)

    Chan, Angelina O M; Kee, Jass P C; Chan, Yiong Huak

    2012-01-01

    To address the effects of acute, chronic and cumulative stress in the healthcare environment in Singapore, the Ministry of Health provided funding to develop a comprehensive crisis response management system (peer support programs/PSPs) that increases mental health awareness, provides emotional support to affected staff during work-related critical incidents and assists hospital management to better understand the emotional needs of the employees. This paper reports the awareness and utilization of PSPs in Singapore public general hospitals about one year after they were set up.

  18. Perfil clínico del adulto mayor atendido ambulatoriamente en un hospital general.

    OpenAIRE

    Paola Casas; Luis Varela; Tania Tello; Pedro Ortiz; Helver Chávez

    2012-01-01

    Objetivo: Describir el perfil clínico del adulto mayor atendido ambulatoriamente en un hospital general. Material y métodos: Estudio descriptivo, transversal, realizado a través de encuestas aplicadas a pacientes en la consulta ambulatoria de geriatría del Hospital Nacional Cayetano Heredia (HNCH), entre agosto de 2011 y enero 2012. Resultados: Se evaluaron 290 pacientes, el 69,3% fueron mujeres; el 65,5% tenía entre 60 y 79 años. La hipertensión arterial fue el diagnóstico más frecuente (55,...

  19. Procedures to enter the international market of the carbon and PEMEX electrical generation projects; Procedimientos para ingresar al mercado internacional del carbono y proyectos de generacion electrica de PEMEX

    Energy Technology Data Exchange (ETDEWEB)

    Zeferino Abundis, Yolanda [Universidad Nacional Autonoma de Mexico (UNAM), Mexico, D.F. (Mexico)

    2006-11-15

    The consumption and production of the electrical energy contribute to the gas emission that has the property of retaining heat in the atmosphere, giving rise to an increment in the global average temperature of the Earth, and causing a climatic change that the international scientific consensus describes as important alterations in the meteorological patterns. As a result of this, international actions were taken. The most ambitious agreement and by its quantified and obligatory character is presented the Kyoto Protocol, that forces the countries listed in Annex 1 to reduce their emissions through national measures and flexible mechanisms, within these last ones is the Clean Development Mechanism (CDM) that contemplates the mutual cooperation between developed and developing countries in the participation of projects tending to the reduction of gas emissions of greenhouse effect. Petroleos Mexicanos (PEMEX) has large necessities of electrical energy and steam, and counts on projects with characteristics that under the CDM cover the characteristics to be technical and economically viable. [Spanish] El consumo y produccion de la energia electrica contribuye a la emision de gases que tienen la propiedad de retener calor en la atmosfera, dando lugar a un incremento en la temperatura promedio global de la Tierra, y provocando un cambio climatico que el consenso cientifico internacional describe como alteraciones importantes en los patrones meteorologicos. A raiz de esto, se tomaron acciones internacionales. El acuerdo mas ambicioso y por su caracter cuantificado y obligatorio lo representa el Protocolo de Kyoto, quien obliga a los paises listados en el Anexo 1 a reducir sus emisiones a traves de medidas nacionales y mecanismos flexibles, dentro de estos ultimos se encuentra el Mecanismo de Desarrollo Limpio (MDL) que contempla la cooperacion mutua entre paises desarrollados y en vias de desarrollo en la participacion de proyectos tendientes a la reduccion de emisiones

  20. Troponin T: role in altering patient management and enabling earlier discharge from a district general hospital.

    Science.gov (United States)

    Owen, A; Khan, W; Griffiths, K D

    2001-03-01

    The use of troponin T to facilitate early patient discharge was investigated in a prospective study in a district general hospital. Troponin T was measured in 91 patients admitted over a period of 6 months with chest pain but without evidence of myocardial infarction. The main outcome measure was length of hospital stay. A negative troponin T was found in 70 patients. Fifty of these were discharged within 24 h of the troponin result being available and they had a significantly shorter hospital stay than a case control group and a historical control group from the previous 6 months. Troponin T measurement has a role in altering patient management by enabling early discharge, resulting in significant cost savings and increasing bed availability.

  1. Factors Affecting The Adoption Of Mhealth In Maternal Health Care In Nakuru Provincial General Hospital

    Directory of Open Access Journals (Sweden)

    Simon Munyua

    2015-08-01

    Full Text Available Abstract Access to timely and quality maternal health care remains to be a major development challenge in many developing economies particularly in Kenya. The countrys system of providing maternal health care also continue to be anchored on conventional methods of physical presence of the patient and the doctor in a hospital setup. The countrys ICT and health policies also place very little emphasis on the use of these platforms. This study therefore sought to establish the factors affecting the adoption of mHealth by focusing on maternal health in Nakuru Provincial General Hospital. Objectives of the study were to determine the extent to knowledge and awareness affects the adoption of mHealth in maternal health care at Nakuru PGH to identify the government policies affecting the adoption of mHealth in maternal health care at Nakuru PGH to assess how access to technology affects the adoption of mHealth in maternal healthcare to establish the effects of ICT infrastructure on the adoption of mHealth in maternal health care and to identify the cost aspects affecting the adoption of mHealth in maternal health care at Nakuru Provincial General Hospital. It is envisaged that the study could provide useful information on the adoption of mHealth in managing maternal health care in Nakuru Provincial General Hospital. Descriptive survey research design will be used where all the medical staff and patients of Nakuru Provincial General Hospital was surveyed. The study population therefore was made up of 24 medical staff and 3460 mothers visiting the antenatal clinic selected using clustered random sampling technique. The main instrument for primary data collection was the questionnaire. Data analysis was then done using both descriptive and inferential statistics. Descriptive statistics to be used include frequency counts percentages and measures of central tendency. Inferential statistics on the other hand include t-test analysis and spearman correlation

  2. Factors associated with readmission to a general hospital in Brazil Fatores associados às readmissões hospitalares em um hospital geral brasileiro

    OpenAIRE

    Mônica Silva Monteiro de Castro; Marilia Sá Carvalho; Cláudia Travassos

    2005-01-01

    The objective of this study was to compare different modeling strategies to identify individual and admissions characteristics associated with readmission to a general hospital. Routine data recorded in the Hospital Information System on all admissions to the Regional Public Hospital of Betim, Minas Gerais State, Brazil, from July 1996 to June 2000 were analyzed. Cox proportional hazards model and variants designed to deal with multiple-events data, like Andersen-Gill (AG), Prentice, Williams...

  3. [General information system through whole hospital and electronic medical record system].

    Science.gov (United States)

    Goto, Takaaki

    2006-02-01

    A new system has been introduced and implemented at the Nagoya City University Hospital since January 2004 in order to improve services for patients and general operation for management of the hospital. General Information System has been consisted with Electronic Medical Record System (EMRS), which is the core of all system and divisional system such as Clinical Laboratory Tests, Images, Medical Accounting and so on. A new system has been built and operated to work with the EMRS at the Department of Central Clinical Laboratory (CCL). To cooperate with the new system, we have constructed and operated directly the EMRS such as automatic registration the latest information on infectious diseases and blood transfusions, clinical reports on laboratory test through the hospital news and/or e-mail, introducing laboratory pre test before the consultation, rapid reports of panic values to the doctor in charge of the patients directly, the new system build up a closer cooperation between division of blood transfusion division and that of immuno-chemistry in CCL through EMRS. The new system has been brought not only efficiency and strengthen of function in CCL but also strengthen the service to patients in the hospital.

  4. Noise at night in hospital general wards: a mapping of the literature.

    Science.gov (United States)

    Fillary, Julie; Chaplin, Hema; Jones, Gill; Thompson, Angela; Holme, Anita; Wilson, Patricia

    English NHS inpatient surveys consistently identify that noise at night in hospitals and its impact on patients' sleep is a persisting problem that needs addressing. To identify how noise at night in hospital affects patients on general wards and the range of interventions aimed at reducing the problem, a systematic mapping of the literature was undertaken. All primary studies and relevant literature published January 2003-July 2013 were included. Key issues identified in the literature included noise levels and causes, impact on patient experience, and lack of staff awareness. Interventions to reduce noise were targeted at staff education, behaviour modification, care organisation and environmental solutions. The scoping suggested that when compared with specialist units, there is little evidence on effective interventions reducing disturbance from night-time noise on general wards. The available evidence suggests a whole systems approach should be adopted to aid quality sleep and promote recovery.

  5. Psiquiatría de Enlace. Experiencia en el Hospital General de México

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    I.C. González-Salas

    2014-07-01

    El objetivo de este trabajo es revisar algunos antecedentes históricos de la Salud Mental en México y en el Hospital General de México «Dr. Eduardo Liceaga» (HGM-DEL considerando la evolución institucional y las características de los pacientes que recibe el Servicio de Salud Mental, como parte del equipo multidisciplinario de salud.

  6. Trends in surgical site infections in general surgery at a tertiary hospital

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    B. Ravinder Reddy

    2012-01-01

    Full Text Available Surgical site infections (SSI are a preventable cause of hospital acquired infections, which increase morbidity and mortality. This is a retrospective analysis of SSIs in patients undergoing general surgical and gastroenterological operations. The observed incidence was 3.63%. The commonest procedures resulting in SSI were those who underwent laparotomy for bowel resections. The commonest organisms isolated were Enterococcus and Klebsiella species. SSIs can be further reduced by strict adherence to SSI prevention guide-lines.

  7. A qualitative study on nurses' reactions to inpatient suicide in a general hospital

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    Shujie Wang

    2016-12-01

    Conclusions: Nurses who experienced inpatient suicide became stressed. Effective interventions must be implemented to improve the coping mechanisms of nurses against the negative consequences of inpatient suicide. The findings of this study will allow administrators to gain insight into the impacts of inpatient suicides on nurses in general hospitals. Such information can be used to develop effective strategies and provide individual support and ongoing education. Consequently, nurses will acquire suicide prevention skills and help patients achieve swift recovery.

  8. Analysis of referrals received by a psychiatric unit in a general hospital Part 2

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    VJ Ehlers

    2002-01-01

    Full Text Available The study sought to analyse the referrals received by a psychiatric unit in a general hospital in the Western Cape by studying the referral letters and the referral responses.

    Opsomming
    Hierdie navorsing het gepoog om verwysings te ontleed wat deur 'n psigiatriese eenheid in 'n algemene hospitaal in die Wes Kaap ontvang is. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

  9. The Difference in the Online Medical Information Searching Behaviors of Hospital Patients and Their Relatives versus the General Public

    Science.gov (United States)

    Wang, Hung-Yuan; Liang, Jyh-Chong; Tsai, Chin-Chung

    2014-01-01

    The purpose of this study is two-fold: to explore the differences in online medical information searching behaviors, including evaluative standards and search strategies, of the general public (general group) and those of hospital patients and their relatives (hospital group); and to compare the predictive relationship between the evaluative…

  10. Knowledge and Attitude of 851 Nursing Personnel toward Depression in General Hospitals of Korea.

    Science.gov (United States)

    Park, Seon-Cheol; Lee, Hwa-Young; Lee, Dong-Woo; Hahn, Sang-Woo; Park, Sang-Ho; Kim, Yeo-Ju; Choi, Jae Sung; Lee, Ho-Sung; Lee, Soyoung Irene; Na, Kyoung-Sae; Jung, Sung Won; Shim, Se-Hoon; Choi, Joonho; Paik, Jong-Woo; Kwon, Young-Joon

    2015-07-01

    Our study aimed to examine the knowledge and attitude of nursing personnel toward depression in general hospitals of Korea. A total of 851 nursing personnel enrolled at four university-affiliated general hospitals completed self-report questionnaires. Chi-square tests were used to compare the knowledge and attitude of registered or assistant nurses toward depression. In addition, binary logistic regression analysis was used to adjust for the following confounders: age-group and workplace. Registered and assistant nurses differed in their knowledge and attitude toward depression. The proportion of rational and/or correct responses were higher in registered nurses than assistant nurses for the following: constellation of depressive symptoms defined by DSM-IV (adjusted odds ratio [aOR], 3.876; Ppsychological stress as a cause of depression (aOR, 4.370; Ppersonnel need to be developed in Korea. Our findings can contribute to the development of a general hospital-based model for early detection of depression in patients with chronic medical diseases.

  11. Indications of Tonsillectomy and Adenoidectomy in Dr. Hasan Sadikin General Hospital Bandung

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    Dini Atiyah

    2015-03-01

    Full Text Available Background: Tonsillectomy is the intervention to take out the palatine tonsils either whole or sub capsular, while adenoidectomy is the intervention of extraction of the adenoid gland which is commonly done with curettage method. Both interventions are done to eliminate repeated infections and also obstructions due to inflammation and hypertrophy of the tonsils and adenoids. This study was conducted to examine the indications of tonsillectomy and adenoidectomy in the Departement of Otorhinolaryngology and Head Neck Surgery Dr. Hasan Sadikin General Hospital Bandung in the period of January 2009–December 2011. Methods: A cross-sectional descriptive study was conducted in October–November of 2012 using 207 medical records of patients who had tonsillectomy and adenoidectomy executed in the Department of Otorhinolaryngology and Head Neck Surgery Dr. Hasan Sadikin General Hospital, Bandung in the period of January 2009–December 2011. Data collected were age, gender, main complaint, tonsil size, history of repeated infections, history of snoring as well as of Obstructive Sleep Apnea Syndrome (OSAS. The indication for tonsillectomy and adenoidectomy such as infection, obstruction and neoplasia was selected. Results: The indications of tonsillectomy and adenoidectomy were infection at 106 (51.2% patients, obstruction at 100 (48.3% patients, and neoplasia at 1 (0.05% patient. Conclusions: The most numerous indications for tonsillectomy and tonsilloadenoidectomy in the Department of Otorhinolaryngology and Head Neck Surgery Dr. Hasan Sadikin General Hospital were infection.

  12. Obsessive-compulsive disorder in general hospital outpatients: prevalence, correlates, and comorbidity in Lanzhou, China.

    Science.gov (United States)

    Lihua, Ma; Tao, Zhang; SiYong, Huang; Suwen, Wei; Xiaoxuan, Yuan; Yichen, Guo; Caiyun, Zhang; Yan, Bai

    2014-09-01

    The prevalence of obsessive-compulsive disorder (OCD), risk factors, and comorbidity rates of Chinese outpatients in Lanzhou general hospitals are unknown. The prevalence rate of OCD was estimated in a representative sample of outpatients in three classes of general hospitals in Lanzhou, China. The rate of OCD within the sample, which was composed of 1,576 individuals aged 16 years or older, was assessed using the World Health Organization Composite International Diagnostic Interview Version 3.0. The weighted prevalence of OCD were 4.31% (lifetime), 2.86% (12-month), and 1.97% (30-day). Multivariate logistic regression identified the following independent predictors of having lifetime OCD: having a higher level of education, being unemployed, an internal medicine outpatient, a female, 16-35 years old, divorced/widowed/separated, and having a low family income. OCD had a significant comorbid association with neuroses, based on the International Statistical Classification of Diseases and Related Health Problems-10th Revision. These findings show a lower prevalence rate of OCD in Lanzhou general hospitals than that reported for some specialized outpatient clinics in Western countries. Further investigations are required to explore the relationships between OCD and the risk factors identified in the current study. Resolving methodological problems may lead to more accurate prevalence estimates in future epidemiological studies. Our findings suggest that there is an urgent need to improve the ability of clinicians to detect OCD in outpatients. © 2013 Wiley Publishing Asia Pty Ltd.

  13. Trends in fatalities due to poisoning at Umtata General Hospital, Mthatha (1993–2005

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    Banwari L. Meel

    2009-04-01

    Full Text Available Poisoning is a common method of committing suicide in this region of South Africa. Females generally ingest poisons but it is increasingly becoming common in males too. This is a record review of autopsies carried out at the Umtata (Mthatha General Hospital mortuary, which forms part of the teaching hospital of the Walter Sisulu University Medical School. There were 10 230 unnatural deaths between 1993 and 2005. Of these deaths, 161 (1.6% were deaths due to poisoning. There was a marked increase in death by poisoning from 2.5% in 1993 to 13.7% in 2004. The highest percentage (17.4% of poison-related deaths was in 2001, and the lowest (2.5% was in 1993 and 1994. About two-thirds of victims (66% were males, and more than half of the victims (51.5% were in the 11 to 30 age group. There is an increasing trend in fatalities due to poisoning at Umtata General Hospital, Mthatha.

  14. Insurance status of patients admitted to specialty cardiac and competing general hospitals: are accusations of cherry picking justified?

    Science.gov (United States)

    Cram, Peter; Pham, Hoangmai H; Bayman, Levent; Vaughan-Sarrazin, Mary S

    2008-05-01

    There has been widespread concern that procedurally oriented specialty hospitals select well-insured patients for admission, while avoiding the underinsured, but data are limited. To determine if specialty cardiac hospitals admit a higher proportion of well-insured patients than general hospitals and/or preferentially transfer patients with less generous insurance to other acute care hospitals. A retrospective study of patients admitted to specialty cardiac and general hospitals with acute myocardial infarction (AMI; N = 41,863), congestive heart failure (CHF; N = 51,696), percutaneous coronary intervention (PCI; N = 73,966), and coronary artery bypass grafting (CABG; N = 33,327) using 2000-2004 all-payor data from Arizona, California, and Texas. Proportion of all admissions in specialty and general hospitals with more generous insurance (Medicare or private insurance), interhospital transfer patterns of patients with less generous insurance by specialty and general hospitals. Specialty hospitals admitted a higher proportion of patients with more generous insurance for both the medical cohort (AMI and CHF) (92.4% vs. 89.0%; P hospital, odds of admission to specialty hospitals were significantly higher for patients with more generous insurance compared to patients with less generous insurance for the medical cohort [odds ratio (OR), 1.16; 95% confidence interval (CI), 1.07-1.27; P hospitals were more or less likely to transfer patients with more or less generous insurance to another hospital. The analysis was limited to 3 states and we were unable to track the care of patients after transfer. Patients with more generous insurance are significantly more likely to gain admission to specialty hospitals. Alternatively, we found no evidence that specialty hospitals preferentially transfer patients with less generous insurance who are admitted. Overall, these findings suggest that specialty hospitals may contribute to segregation of the healthcare system along

  15. Stenotrophomonas maltophilia infections in a general hospital: patient characteristics, antimicrobial susceptibility, and treatment outcome.

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    George Samonis

    Full Text Available INTRODUCTION: Stenotrophomonas maltophilia is acquiring increasing importance as a nosocomial pathogen. METHODS: We retrospectively studied the characteristics and outcome of patients with any type of S. maltophilia infection at the University Hospital of Heraklion, Crete, Greece, between 1/2005-12/2010. S. maltophilia antimicrobial susceptibility was tested with the agar dilution method. Prognostic factors for all-cause in-hospital mortality were assessed with multivariate logistic regression. RESULTS: Sixty-eight patients (median age: 70.5 years; 64.7% males with S. maltophilia infection, not related to cystic fibrosis, were included. The 68 patients were hospitalized in medical (29.4%, surgical (26.5%, hematology/oncology departments (23.5%, or the intensive care units (ICU; 20.6%. The most frequent infection types were respiratory tract (54.4%, bloodstream (16.2%, skin/soft tissue (10.3%, and intra-abdominal (8.8% infection. The S. maltophilia-associated infection was polymicrobial in 33.8% of the cases. In vitro susceptibility was higher to colistin (91.2%, trimethoprim/sulfamethoxazole and netilmicin (85.3% each, and ciprofloxacin (82.4%. The empirical and the targeted treatment regimens were microbiologically appropriate for 47.3% and 63.6% of the 55 patients with data available, respectively. Most patients received targeted therapy with a combination of agents other than trimethoprim/sulfamethoxazole. The crude mortality and the mortality and the S. maltophilia infection-related mortality were 14.7% and 4.4%, respectively. ICU hospitalization was the only independent prognostic factor for mortality. CONCLUSION: S. maltophilia infection in a general hospital can be associated with a good prognosis, except for the patients hospitalized in the ICU. Combination reigmens with fluoroquinolones, colistin, or tigecycline could be alternative treatment options to trimethoprim/sulfamethoxazole.

  16. IRS General Counsel Memorandum threatens some hospital-physician joint ventures.

    Science.gov (United States)

    Driscoll, T L; Schieble, M T

    1992-03-01

    To defend against the heightened scrutiny of hospital-physician relations expected from the IRS, hospital management should closely examine any activities now conducted with physicians to determine whether each activity, as organized and operated, furthers the hospital's charitable mission of promoting the health of its community, rather than merely enhancing the financial health of the institution itself. Any arrangements that do not appear to satisfy the principles enunciated in GCM 39862 should be examined to see if they should be restructured or dissolved. In structuring new transactions and examining existing arrangements, the following principles should be kept in mind: 1. Transactions should not be premised upon increased utilization or physician referrals. Enhancing or protecting market share, even for the purpose of preserving an institution's presence in the community, will likely no longer be accepted as a justification for pursuing joint venture arrangements. In justifying such ventures, management must distinguish between benefit to the community and benefit to the institution. 2. Transactions whereby existing services or equipment are "spun off" to a hospital-physician joint venture run a serious risk of enhanced IRS scrutiny. 3. Transactions creating or providing new facilities or services should be more favorably perceived, particularly where participants other than the hospital take an active role in managing the venture. Where the hospital is the sole general partner and merely manages what it would have managed had there been no physician investors, the question of why physicians are involved will likely be of greater concern than it has been in the past.(ABSTRACT TRUNCATED AT 250 WORDS)

  17. Diagnoses, Requests and Timing of 503 Psychiatric Consultations in Two General Hospitals

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    Elahe Sahimi Izadian

    2012-01-01

    Full Text Available The high comorbidity of medical and psychiatric diagnoses in the general hospital population requires collaboration between various medical fields to provide comprehensive health care. This study aims to find the rate of psychiatric consultations, their timing and overall diagnostic trend in comparison to previous studies. Tehran University of Medical Sciences has got an active psychiatric consultation-liaison service which includes services provided by four faculty psychiatrists (two full-time and two part-time. This study was done in two general hospitals by simple sampling in available cases. For each consultation, a board-certified faculty psychiatrist conducted a clinical evaluation based on DSM-IV-TR. Other than psychiatric diagnoses, socio-demographic variables, relative consultation rates, reasons for referral, medical diagnoses and the time stay after admission were assessed. Among 503 patients who were visited by the consultation-liaison service, there were 54.3% female with mean age of 39.8 years. In 90.1% of consultations, at least one DSM-IV-TR diagnosis was made. The most frequent diagnosis groups were mood disorder (43.5%, adjustment disorder (10.9% and cognitive disorder (7.6%. In about 10.9% of the consultations, multiple psychiatric diagnoses were made. The mean length of hospital stay before the consultation was 12.56 days (range=1-90, SD=13. Based on our findings, the mood and cognitive disorders still remain major foci of consultation-liaison practice in general hospitals; however our findings showed high rate of adjustment disorders diagnosis and ambiguous request for psychiatric consultation which need more interdisciplinary interaction.

  18. Physical Violence against General Practitioners and Nurses in Chinese Township Hospitals: A Cross-Sectional Survey

    Science.gov (United States)

    Xing, Kai; Jiao, Mingli; Ma, Hongkun; Qiao, Hong; Hao, Yanhua; Li, Ye; Gao, Lijun; Sun, Hong; Kang, Zheng; Liang, Libo; Wu, Qunhong

    2015-01-01

    Purpose The purpose of this study is to identify risk factors of physical violence in Chinese township hospitals. Methods A cross-sectional survey was used in a sample of 442 general practitioners and 398 general nurses from 90 township hospitals located in Heilongjiang province, China (response rate = 84.8%). Results A total of 106 of the 840 (12.6%) respondents reported being physically attacked in their workplace in the previous 12 months. Most perpetrators were the patients’ relatives (62.3%), followed by the patient (22.6%); 73.6% of perpetrators were aged between 20 and 40 years. Of the physical violence incidents, about 56.6% (n = 60) resulted in a physical injury, and 45.4% of respondents took two or three days of sick leave. Reporting workplace violence in hospitals to superiors or authorities was low (9.4%). Most respondents (62.8%) did not receive training on how to avoid workplace violence. Logistic regression analyses indicated that general nurses, aged 35 years or younger, and with a higher-level professional title were more likely to experience physical violence. Healthcare workers with direct physical contact (washing, turning, lifting) with patients had a higher risk of physical violence compared to other health care workers. Procedures for reporting workplace violence were a protective factor for physical violence; when in place, reporting after psychological violence (verbal abuse, bullying/mobbing, harassment, and threats) was more protective than waiting until an instance of physical violence (beating, kicking, slapping, stabbing, etc.). Conclusions Physical violence in Chinese township hospitals is an occupational hazard of rural public health concern. Policies, procedures, and intervention strategies should be undertaken to manage this issue. PMID:26571388

  19. Physical Violence against General Practitioners and Nurses in Chinese Township Hospitals: A Cross-Sectional Survey.

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    Kai Xing

    Full Text Available The purpose of this study is to identify risk factors of physical violence in Chinese township hospitals.A cross-sectional survey was used in a sample of 442 general practitioners and 398 general nurses from 90 township hospitals located in Heilongjiang province, China (response rate = 84.8%.A total of 106 of the 840 (12.6% respondents reported being physically attacked in their workplace in the previous 12 months. Most perpetrators were the patients' relatives (62.3%, followed by the patient (22.6%; 73.6% of perpetrators were aged between 20 and 40 years. Of the physical violence incidents, about 56.6% (n = 60 resulted in a physical injury, and 45.4% of respondents took two or three days of sick leave. Reporting workplace violence in hospitals to superiors or authorities was low (9.4%. Most respondents (62.8% did not receive training on how to avoid workplace violence. Logistic regression analyses indicated that general nurses, aged 35 years or younger, and with a higher-level professional title were more likely to experience physical violence. Healthcare workers with direct physical contact (washing, turning, lifting with patients had a higher risk of physical violence compared to other health care workers. Procedures for reporting workplace violence were a protective factor for physical violence; when in place, reporting after psychological violence (verbal abuse, bullying/mobbing, harassment, and threats was more protective than waiting until an instance of physical violence (beating, kicking, slapping, stabbing, etc..Physical violence in Chinese township hospitals is an occupational hazard of rural public health concern. Policies, procedures, and intervention strategies should be undertaken to manage this issue.

  20. Qualitative Performance Evaluation of Hospitals Using DEA, Balanced Scorecard and Servqual; A Case Study of General Hospitals of Yazd

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    M Asadi

    2011-02-01

    Full Text Available Introduction: Evaluation is an important factor in productivity context, and acts as a control system for other areas of productivity. Hospitals are large organizations incurring heavy expenses in every country. The level of efficiency in a hospital is a good criterion to understand how hospitals consume their resources. The goal of this research was to determine relative efficiency of 13 public hospitals in Yazd province by using integrated DEA, BSC and SERVQUAL model. Methods: In this study, relative efficiency of 13 public hospitals of Yazd province was calculated using data envelopment analysis technique(DEA and balanced score card and servqual. BSC was used as a tool for designing of performance evaluation indexes, while DEA was used as a tool of evaluating performance and ranking. Results: The mean relative efficiency of hospitals under study was about 0.945 in the Persian calendar year 2008-9. The efficiency levels of nine hospitals were borderline and the efficiency of four hospitals was less than 1. Hospital no.3 had the highest efficiency levels and hospital no.10 had the lowest efficiency level. Conclusion: In this stage, on the basis of references presented by the DEA model, solutions for increasing the quality performance levels of inefficient hospitals in fourth dimensions were determined and some suggestions were proposed. Although all performance indices of the inefficient hospitals need to be addressed, priorities have to be determined by the respective managers.

  1. [Characteristics of health seeking behaviors for patients with psoriasis in a general hospital].

    Science.gov (United States)

    Li, Xia; Luo, Dan; Qiu, Yangyang; Chen, Mingliang; Su, Juan; Yi, Mei

    2016-06-28

    To explore the characteristics of health seeking behaviors and relevant factors among the outpatients with psoriasis in a general hospital, and to provide scientific evidence to modify the inappropriate health seeking behaviors for psoriasis patients and improve the therapeutic effect. 
 Using cross-sectional study design, a dermatological clinic in a general hospital was selected for this study. Two hundred psoriasis outpatients from 1st April to 30th September in 2014 were enrolled. A series of questionnaires were used to collect information regarding the social-demographic characteristics, health seeking behaviors, knowledge on psoriasis, and depressive and anxious symptoms.
 Among 200 psoriasis outpatients, 141 patients (70.5%) experienced transfer treatment. One hundred and eighty-two patients (91.0%) went to formal hospitals in county for treatment when symptoms were firstly displayed; the other 18 patients (9.0%) went to village or community clinics, or the private clinics. Over 50% patients chose municipal hospital and 35.0% patients went to provincial hospital for medical treatment among the 182 patients. Ninety-one percent of the patients made decision for the first treatment after consulting with their spouses or relatives. According to the definition of the appropriate health seeking behavior in this study, 50 patients (25%) had inappropriate health seeking behaviors. Logistic regression analysis showed inappropriate health seeking behaviors correlated with the family whose income was less than 3 000 yuan per person per month (OR=2.232, 95%CI 1.086 to 4.585), patients who made the decision for the treatment with no discussion with other people when the symptoms appeared (OR=3.016, 95%CI 1.023 to 8.893), and the high score of the International Psoriasis Severity Index (OR=1.043, 95%CI 1.001 to 1.088). 
 The dermatological practitioner should pay more attention to the factors, such as social-demographical characteristics, especially the low level of

  2. Idosos asilados em hospitais gerais Long-term care elderly residents in general hospitals

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    Milton Luiz Gorzoni

    2006-12-01

    Full Text Available Instituições de longa permanência para idosos interagem periodicamente com hospitais gerais para internações de casos agudos ou dos que necessitam de métodos diagnósticos complexos e da atenção de várias especialidades simultaneamente. A decisão de indicar hospitalização é multifatorial, sendo influenciada por circunstâncias como a gravidade do quadro clínico e a infra-estrutura das instituições de longa permanência para idosos. Internações hospitalares apresentam benefícios e riscos, como o desenvolvimento de iatrogenias, delirium e declínios funcionais, podendo resultar em piora do estado geral e da qualidade de vida do idoso asilado durante e/ou após a hospitalização. O objetivo do estudo foi abordar aspectos peculiares na avaliação, tratamento e manejo de idosos asilados em internações hospitalares, particularmente quanto a cuidados que os auxiliem efetivamente nessas circunstâncias. Discutiram-se situações freqüentes como delirium, iatrogenias, desnutrição, declínio funcional e cuidados paliativos e características próprias de residentes em instituições para idosos durante internações em hospitais gerais.Long-term care facilities for the elderly have regularly to work together with general hospitals to provide care to acutely ill residents or when they require all together more complex diagnostic procedures and multi-specialty care. The decision to hospitalize a nursing home elderly resident is multifactorial and it is based on factors such as illness severity and care facility infrastructure. Hospitalizations have benefits and risks such developing iatrogenic diseases, delirium, and functional decline, which may deteriorate patients' general condition and their quality of life during and/or after hospitalization. This study aimed at addressing specific aspects of assessment, treatment and management of nursing home elderly who require to be hospitalized, especially focusing on their effective care

  3. Use of antibacterial drugs in Jesenice General hospital in years 1998 to 2004

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    Brigita Mavsar-Najdenov

    2007-11-01

    Full Text Available Background: Continuous monitoring of drug consumption is an important strategy for prudent and cost-effective use of drugs. Antimicrobials are among the most prescribed drugs in outpatient practice and in hospital care. In most cases antimicrobials are improperly prescribed or are even misused. Irrational use of antimicrobials is clinically ineffective and leads to higher treatment costs. Clinical ineffectiveness due to irrational use additionally leads to loss of confidence in antimicrobial drugs, unnecessary exposure of patients and development of antimicrobial resistance. Antimicrobial resistance has become a major global health problem as it presents an imperative for development of new potent antimicrobials which are necessarily associated with markedly higher treatment costs.Material and methods: This survey was focused on rational prescribing of antimicrobial drugs. The data on consumption of antimicrobials for various clinical departments of the Jesenice General Hospital were collected by the hospital pharmacy. WHO ATC 2005 classification system, which ranks antimicrobials in a large group J01: drugs for systemic treatment of bacterial infections and Defined Daily Dose as a measuring unit according to the WHO ATC/DDD methodology was used. Antimicrobial use at the Jesenice General Hospital in the period between 1998 and 2004 was estimated by the Department of Infectious Diseases, Medical Centre Ljubljana as a part of European Surveillance on Antibiotic Consumption project (ESAC. Statistical part of survey was performed by the Chair of Biopharmaceutics and Pharmacokinetics, Faculty of Pharmacy, University of Ljubljana.Results: After year 2000 a trend of decrease in antimicrobial consumption was observed. Compared to European Surveillance on Antibiotic Consumption results in the year 2003 higher usage of penicillins with extended spectrum, fluoroquinolones and 3rd generation cephalosporins in Slovenian hospitals was estimated. These three

  4. Changing Smoking Behavior of Staff at Dr. Zainoel Abidin Provincial General Hospital, Banda Aceh

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    Said Usman

    2014-01-01

    Full Text Available Smoking tobacco is a habit of individuals. Determinants of smoking behavior are multiple factors both within the individual and in the social environment around the individual. Staff smoking has been an undesirable phenomenon at Dr. Zainoel Abidin Provincial General Hospital in Banda Aceh. Health promotion efforts are a strategy that has resulted in behavioral changes with reductions in smoking by staff. This action research was designed to analyze changes in smoking behavior of hospital staff. The sample for this research was all 152 male staff who were smokers. The results of this research showed that Health Promotion Interventions (HPI consisting of personal empowerment plus social support and advocacy to improve employee knowledge and attitudes influenced staff to stop or to significantly. HPI employed included counseling programs, distribution of antismoking leaflets, putting up antismoking posters, and installation of no smoking signs. These HPI proved effective to increase knowledge and create a positive attitude to nonsmoking that resulted in major reductions in smoking by staff when offsite and complete cessation of smoking whilst in the hospital. Continuous evaluation, monitoring, and strengthening of policies banning smoking should be maintained in all hospitals.

  5. Incidence of ocular emergencies in the emergency room of the University General Hospital of Cienfuegos

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    Armando Rafael Milanés Armengol

    2015-02-01

    Full Text Available Background: There are few international and national studies on the incidence of ocular emergencies though there are frequent complaints. Objective: To determine the incidence and types of emergencies attended by the department of Ophthalmology at the General University Hospital of Cienfuegos. Methods: Case series study of all patients attended in the Emergency Department of Ophthalmology in Cienfuegos Hospital from March 2013 to March 2014. There were analyzed: name of the patient, sex, age, origin, diagnosis emergency, classification code colors, total of patients requiring surgical treatment and hospitalization. Results: Predominated aged 41-60 years (35.8%, males (58.6% and the largest number of cases attended corresponded to patients in the provincial capital. There was a predominance of green code (70.9%; the conditions most represented were inflammations of annexes followed by injuries; 72 patients needed surgery, (0.38% and 59 required hospitalizations, the rest of the patients were on ambulatory treatment with follow up in outpatient department ( 0.31%. Conclusions: The incidence of true ophthalmologic emergencies was low, for inflammatory conditions of Annexes classified as green code, were the most frequent cause of patient care; conditions that can be treated in primary services, indicating to mismanagement of physicians in the treatment of these ophthalmic conditions with consequent social and economic burden involving secondary services.

  6. The utilization of a paediatric emergency room in a general hospital in Kuwait.

    Science.gov (United States)

    al-Hay, A A; Boresli, M; Shaltout, A A

    1997-12-01

    A descriptive study was conducted in Al-Amiri Hospital, Kuwait to evaluate the use of the paediatric emergency room (PER) by children under 12 years of age over an 11-week period. Socio-demographic data on the families, reasons for the visits, the pattern of referral and the diagnoses were reviewed and analyzed. A total of 277 children were enrolled in the study, the majority of whom (81%) were generally well, only 4% requiring admission to hospital. The paediatrician in the emergency room considered that 64% of visits were not emergencies. Some form of treatment and one to two routine investigations were needed in 21% and 21.6%, respectively. Stated reasons for seeking medical care were: symptoms of the child (34%), unavailability of primary clinic at night (22%) and perceived better services in hospital (20%). The median of parental satisfaction at the end of the visit was 95%. We conclude that most visits to the PER at Al-Amiri Hospital are inappropriate and that intensive health education is required to improve use of the PER and to increase public awareness of the difference between primary care and paediatric emergency facilities.

  7. Management of Sigmoid Volvulus in Three General Community Hospitals of the Cuban Medical Mission in Bolivia

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    Jorge Luís Estepa Pérez

    2013-02-01

    Full Text Available Background: Sigmoid volvulus is an emergency that occurs very frequently in the South American Andean area hospitals. It accounts for over 50% of all intestinal obstructions and still retains high mortality rates. Objective: To characterize the management of sigmoid volvulus. Methods: A prospective and descriptive study was conducted including all patients with sigmoid volvulus who attended three general community hospitals of the Cuban medical mission in Bolivia from June 2006 to June 2007 and were treated trough general surgery. We analyzed the following variables: age, sex, medical history, surgical diagnosis, classification and type of surgery, surgery performed, evolution, complications, use of antibiotic-prophylaxis and admission to intensive care units. The information was obtained from medical records, operative reports and a data collector model. Results: Sigmoid volvulus occurred more frequently in the Yapacaní hospital, department of Santa Cruz; the predominant age group was that from 55 to 64 years old as well as the predominant sex was that of males. Chagas disease was detected in most of the patients studied. Among symptoms those that predominated were distension, abdominal pain and stool detention. Decompression, devolvulation and surgical treatment were the processes followed in all cases, being the Rankin-Mikulicz colostomy the most widely used. No patients underwent a second surgery, and there were no mortality rates. Conclusions: Decompression, devolvulation and surgical treatment were the processes followed in all cases, being the Rankin-Mikulicz colostomy the most widely used. Most patients had a satisfactory evolution.

  8. Doctors as managers: moving towards general management? The case of unitary management reform in Norwegian hospitals.

    Science.gov (United States)

    Mo, Tone Opdahl

    2008-01-01

    The paper seeks to explore whether the development in department management in Norwegian hospitals after the unitary management reform in 2001 constitutes a development in the direction of general management. Interviews were conducted with ten managers from different levels in a large Norwegian university hospital in 2001-2002, as a unitary management model was implemented. There is an emerging change of practice among the physician managers according to this study. The manager function is more explicit and takes a more general responsibility for the department and the professions. However, the managerial function is substantiated by conditions related to the professional field of knowledge, which gives legitimacy within a medical logic. Contact with the clinic is stressed as important, but it is possible to adjust both amount and content of a clinical engagement to the demands of the new manager position. This has both a symbolic and a practical significance, as it involves both legitimacy and identity issues. The paper shows that the institutionalised medical understanding of management has a bearing on managerial reforms. Managerial changes need to relate to this if they are to have consequences for the managerial roles and structures on department level in hospitals. The paper suggests that the future development of this role will depend on the way the collectivist and individualist aspects of responsibility are handled, as well as on the further development of managerial knowledge of physicians.

  9. Twenty years of electroconvulsive therapy in a psychiatric unit at a university general hospital

    Directory of Open Access Journals (Sweden)

    Amilton dos Santos Jr.

    2013-01-01

    Full Text Available Objective: To describe the sociodemographic and clinical profile of patients who underwent electroconvulsive therapy (ECT at a university general hospital. Method: In this retrospective study, records from all patients undergoing ECT between January 1988 and January 2008 at the psychiatric unit of the general hospital of Universidade Estadual de Campinas (UNICAMP were reviewed. Telephone contact was made with patients/relatives to collect follow-up data. Results: A total of 200 charts were reviewed. The majority of patients were women, with a mean age of 39 years, and history of psychiatric hospitalization. The main indications for ECT were depression and catatonia. Complications were observed in less than half of the cases, and most were temporary and not severe. There was a good psychiatric outcome for 89.7% of the patients, especially for catatonic patients (100%, p = 0.02. Thirty-four percent of the cases were later contacted by telephone calls, at a mean of 8.5 years between the procedure and the contact. Among these, three (1.5% reported persistent memory disorders and 73% considered ECT a good treatment. Conclusion: ECT has been performed according to international guidelines. In the vast majority of cases, undesirable effects were temporary and not severe. Response to ECT was positive in most cases, particularly in catatonic patients.

  10. Clinical Presentation of General Paralysis of the Insane in a Dutch Psychiatric Hospital, 1924-1954.

    Science.gov (United States)

    Daey Ouwens, Ingrid M; Lens, C Elisabeth; Fiolet, Aernoud T L; Ott, Alewijn; Koehler, Peter J; Verhoeven, Willem M A

    2015-01-01

    General paralysis of the insane (GPI) or dementia paralytica was once a fatal complication of syphilitic infection and a major reason for psychiatric hospitalization. Nowadays, physicians consider GPI to be exceptional. It should be noted, however, that syphilis re-emerged worldwide at the turn of the 20th to 21st century and a revival of GPI can, therefore, be expected. Advanced diagnosis is crucial in that treatment in the early, inflammatory phase is warranted before irreversible tissue damage occurs. Therefore, a renewed clinical awareness of the broad spectrum of psychiatric and neurologic signs and symptoms of GPI is needed. In this historical cohort study, comprising 105 patients with GPI admitted to the Dutch Vincent van Gogh Psychiatric Hospital in the period 1924-1954, the clinical presentation of this invalidating disorder is investigated and described in detail.

  11. [Standardized management of acupuncture-moxibustion clinic in Singapore General Hospital].

    Science.gov (United States)

    Cui, Shu-Li; Tan, Kian Hian; Ong, Biauw Chi; Lim, Shih hui; Yong, Yang; Seah, Cheng Ngee; Huang, Youyi; Han, Seong Ng

    2014-02-01

    The standardized management of acupuncture-moxibustion in Singapore General Hospital is introduced. With gradual improvement of outpatient infrastructure, re-training of medical staff, strict disinfection of manipulation, periodical inspection of medical instruments, unified management of writing, saving and processing in medical records and public education of TCM knowledge, a standardized management system in accordance with modernized hospital is gradually established. As a result, efficiency and quality of clinical treatment is continuously increasing. From April of 1998 to December of 2012, a total of 74 654 times of treatment were performed, and treatment amount per day is gradually increased. The unusual condition of acupuncture is avoided. Periodical strict inspection of joint committee authenticated by domestic and overseas medical health organization is repeatedly passed and accepted. Additionally, three clinical researches funded by Singapore Health-care Company are still in progress in acupuncture-moxibustion department.

  12. Recreational activities performed with neoplasia carrier Inpatients in a general hospital

    Directory of Open Access Journals (Sweden)

    Caroline de Castro Moura

    2012-09-01

    Full Text Available This study aims at apprehending the contribution of recreational activities in the treatment of hospitalized cancer patients and identifying the most stimulating resources for them. This is a qualitative research of phenomenological nature, it was approved by the Ethics in Research Committee, Protocol 139/2010. It was conducted with patients with cancer in a general hospital, located in Alfenas, in March and April, 2011.The research began from these guiding questions: What are your thoughts on the recreational team work and the activities they do? What do you suggest for this group to be developed? It was perceived that ludic activities help patients to face the disease, that they eased the interaction between the recreational group and the multiprofessional team, besides providing a happy and welcoming environment. The most well accepted activities were music and games the clowns provided. We suggest implementing the humanization by using ludic resources.

  13. STUDY ON THE USE PATTERN OF NSAIDS IN SOME GENERAL AND SPECIALIZED HOSPITALS OF BANGLADESH

    Directory of Open Access Journals (Sweden)

    Hasan Md. Mahadi

    2012-02-01

    Full Text Available This study was designed to assess the present use pattern of both traditional nonsteroidal anti-inflammatory drugs (tNSAIDs and cyclooxygenase 2 (COX-2-selective NSAIDs (coxibs in terms of demographic characteristics, prevalence of use of NSAIDs type, gastro-protective drug use frequency among the patients of four general hospitals and another five specialized hospitals of Dhaka city. The study was conducted during 3 May to 18 May 2011. Total 480 patients were asked to answer the questions of the previously designed questionnaire covered with some closed ended dichotomous and multichotomous questions. Most prevalent age group of the patients was between 40-65years. Again, use of tNSAIDs was relatively higher than that of coxibs. Besides, among the NSAIDs, ketorolac tromethamine (a tNSAID was the most frequently used drug (29.3% in the general hospitals (GnH whereas diclofenac sodium (a tNSAID was common (58% in the specialized hospitals (SpH counterpart. Moreover, a significant number of patients did not use gastro-protective medication whenever taking NSAIDs. Most prevailing gastroprotectives were Proton Pump Inhibitor (PPI and H2 receptor antagonist. Apart from these, another critical observation from this study was the lack of following proper indication related to medication specially for taking the gastroprotective drugs. In conclusion, it can be said that although in most cases, the use pattern of NSAIDs is proper and justified but to avoid unwanted complications and misuse of the drugs, both physicians as well as drug users need to be more aware.

  14. Prevalence of acute pulmonary embolism among patients in a general hospital and at autopsy.

    Science.gov (United States)

    Stein, P D; Henry, J W

    1995-10-01

    The purpose of this investigation is to estimate the prevalence of acute pulmonary embolism (PE) in a general hospital, its frequency among patients who died, and the ability of physicians to diagnose PE antemortem. The prevalence of acute PE among 51,645 patients hospitalized over a 21-month period was assessed in 1 of the 6 clinical centers (Henry Ford Hospital) that participated in the collaborative study, prospective investigation of pulmonary embolism diagnosis (PIOPED). The diagnosis of PE was made by pulmonary angiography, or in those who did not undergo pulmonary angiography because they declined or were ineligible for randomization to angiography in PIOPED, the diagnosis was based on the ventilation/perfusion (V/Q) lung scan. Based on data in PIOPED, PE was considered to be present in 87% of patients with high probability V/Q scam interpretations, 30% with intermediate probability interpretations, 14% with low probability interpretations, and 4% with nearly normal V/Q scans. The estimated prevalence of acute PE in hospitalized patients was 526 of 51,645 (1.0%; 95% confidence interval [CI], 0.9 to 1.1%). Based on extrapolated data from autopsy, PE was estimated to have caused or contributed to death in 122 of 51,645 (0.2%; 95% CI, 0.19 to 0.29%). Pulmonary embolism was observed at autopsy in 59 of 404 (14.6%; 95% CI, 11.3 to 18.4%). Among patients with PE at autopsy, the PE caused or contributed to death in 22 of 59 (37.3%; 95% CI, 25.0 to 50.9%) and PE was incidental in 37 of 59 (62.7%; 95% CI, 49.1 to 75.0%). Among patients at autopsy who died from PE, the diagnosis was unsuspected in 14 of 20 (70.0%; 95% CI, 45.7 to 88.1%). Most of these patients had advanced associated disease. In these patients, death from PE occurred within 2.5 h in 13 of 14 (92.9%; 95% CI, 66.1 to 99.8%). Pulmonary embolism is common in a general hospital. The prevalence of PE at autopsy has not changed over 3 decades. The frequency of unsuspected PE in patients at autopsy has not

  15. 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...

  16. Relations Between Alcohol Consumption and Gastric Perforation at Haji Adam Malik General Hospital Medan-Indonesia

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    Kamsir Koto

    2016-10-01

    Full Text Available Background: Gastric perforation may develop into chemical peritonitis due to gastric acid leakage into abdominal cavity. Perforation is one case of a surgery emergency. One of the most important risk factor of gastric perforation is alcohol consumption. To date there is no report concerning relations between gastric perforation and alcohol consumption at Haji Adam Malik General Hospital Medan, therefore we aimed to investigate it. Methods: This was an analytical study with case control design at Haji Adam Malik General Hospital Medan. Population in this study was all patients of digestive surgery division at emergency department from January 2013 until December 2015. Research’s subjects were digestive surgery patient who underwent operation due to gastric perforation, as many as 35 patients. Inclusion criteria were patients with gastric perforation and medical records data were recorded at emergency department of Haji Adam Malik General Hospital Medan. Exclusion criteria were incomplete medical records data and peritonitis caused by trauma. Bivariate analysis with chi-square test was used. Results: A total of 70 subjects were enrolled, consisted of 35 patients with gastric perforation and without gastric perforation, respectively. Mean of age was 43.69 ± 15.14 years old, majority of the subjects was male (74.2%. There were no significant differences on age and gender between gastric perforation and without gastric perforation group. Alcohol consumption had significant statistical difference with p = 0.015 and OR 3.431 (95% CI: 1.25-9.44. Conclusions: There was a relation between alcohol consumption and gastric perforation. 

  17. [Investigation on Entamoeba histolytica infection in diarrhea patients from general hospitals in Shanghai City].

    Science.gov (United States)

    Zhang, Xiao-ping; He, Yan-yan; Wang, Zhen-yu; Zhang, Yao-guang; Zhu, Qian; Jiang, Shou-fu; Li, Ying; Cheng, Yu-ping; Yin, Ming-min

    2015-12-01

    To understand the status of Entamoeba histolytica infection in diarrhea patients in general hospitals, so as to provide the evidences for the prevention and control of the disease. The diarrhea patients in intestinal disease clinics of 3 general hospitals in Shanghai City were chosen as the investigation objectives, and their fecal and blood samples were collected, and then were detected by the normal saline direct smear method and iodine solution staining, immunochromatographic method and ELISA respectively to understand the infection status of E. histolytica, and the characteristics of the infected persons were analyzed. RESULTS Totally 1 015 fecal samples were detected, and among which 36 positive ones were detected by parasitological examinations, with a general positive rate of 3.55%. There were no statistically significant differences among the positive rates of patients from the three hospitals (P > 0.05), nor between or among those of the patients with different sexes, ages, occupations and education levels (all P > 0.05). The positive rate of E. histolytica in bloody purulent stools was higher than those in loose stools and watery stools (both P histolytica were 8.18% (83/1 015) and 7.12% (48/675) respectively when detected by the immunochromatographic method and ELISA. Summer and autumn are the high risk seasons for E. histolytica infection, and the surveillance should be strengthened in this period. The positive rate of E. histolytica in samples of bloody purulent stools is high, and the combined application of several detection methods can increase the detection rate.

  18. CD4 lymphocyte response following anti-retroviral therapy in HIV/AIDS patients - A study in Osmania General Hospital

    OpenAIRE

    Srinivasa Rao Nanyam; Ravala Siddeswari; Budithi Sudarsi; Barla Suryanarayana; Challagali Prabhu Kumar; Thatikala Abhilash

    2016-01-01

    The present study aims serial four year assessment of CD4 cell response after initiation of anti-retroviral therapy (ART) in patients with HIV/AIDS attending Osmania General Hospital, Hyderabad. It was a retrospective hospital based observational study. We included 110 HIV/AIDS who were on ART. Data was collected over a period of 04 years from 2005 to 2008 in the ART Centre, Upgraded Department of General Medicine, Osmania General Hospital. Data regarding CD4 cell count over 4 years was asse...

  19. Road traffic accidents before and after seatbelt legislation--study in a district general hospital.

    Science.gov (United States)

    Thomas, J

    1990-01-01

    Injuries among samples of car accident cases attending the Accident & Emergency (A & E) department of a District General Hospital (DGH) in the year before and after the introduction of seat belt legislation were classified applying the Abbreviated Injury Scale using information recorded in the patient case notes. Those who died or did not attend an A & E department were not included in the sampling frame. The number of those who escaped injury increased by 40% and those with mild and moderate injuries decreased by 35% after seatbelt legislation. There was a significant reduction in soft tissue injuries to the head. Only whiplash injuries to the neck showed a significant increase. PMID:2319551

  20. Suitable time of treating maxillofacial trauma caused by traffic accident in general hospitals

    Institute of Scientific and Technical Information of China (English)

    桑修文; 赵宏伟; 等

    1999-01-01

    Objective To explore sutitable time of treating maxillofacial trauma caused by traffic accident in general hospitals to decrease adverse effect caused by delayed therapy.Methods:In recent 10 years we have treated 154 cases of maxillofacial trauma by traffic accidents and their data were analyzed.Results:Early surgical therapy could be done in maxillofacial soft tissue trauma.The therapy of returning occlusion relation or temporary fixing was performed in bone fracture before porosis.Conclusions:For maxilloficial trauman and trauman of other parts caused by traffic accidents.early treatment should be done in order to decrease dysfunction and deformity caused by maxillofacial trauma.

  1. Validating the General Sleep Disturbance Scale among Chinese American parents with hospitalized infants.

    Science.gov (United States)

    Lee, Shih-Yu

    2007-04-01

    The purpose of this cross-sectional descriptive study was to assess the reliability and validity of the English and Chinese versions of the General Sleep Disturbance Scale (GSDS) among Chinese American parents with hospitalized infants. A convenience sample of 22 mothers and 22 fathers in the San Francisco area participated in this study. Cronbach alpha coefficients were .85 and .81 for the English and Chinese versions, respectively. Concurrent validity was demonstrated through correlations with wrist actigraphy readings. Although results of the study indicate that the GSDS is an acceptable instrument to measure parents' sleep disturbance among the Chinese American population, a need for further work was identified.

  2. When Suicide Is Not Suicide: Self-induced Morbidity and Mortality in the General Hospital

    Directory of Open Access Journals (Sweden)

    J. Michael Bostwick

    2015-04-01

    Full Text Available Suicidal phenomena in the general hospital can take a variety of forms that can be parsed by taking into account whether or not the patient 1 intended to hasten death, and 2 included collaborators, including family and health care providers, in the decision to act. These two criteria can be used to distinguish entities as diverse as true suicide, non-compliance, euthanasia/physician-assisted suicide, and hospice/palliative care. Characterizing the nature of “suicide” events facilitates appropriate decision-making around management and disposition.

  3. Bloqueo regional axilar en trauma de miembro superior en el Hospital General Luis Vernaza.

    OpenAIRE

    Mendoza Ligua, Rosa Mariluz

    2015-01-01

    El objetivo del trabajo fue determinar tiempo de analgesia en el posoperatorio, medir analgesia mediante escala visual análoga (EVA), protocolizar el bloqueo axilar del plexo braquial como anestesia de elección en el trauma de miembro superior antebrazo muñeca y mano para disminuir losrequerimientos analgésico posquirúrgicos, valoración demográfica por edad sexo y ASA en el Hospital General Luis Vernaza. Materiales y métodos: El estudio fue prospectivo analítico experi...

  4. Planning Development for a Family Planning Centre in Nursing Unit of the General Hospital of Argolida

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    Koukoufilippou J

    2015-01-01

    Full Text Available Introduction: The family planning centres must be upgraded to a cornerstone of primary health care, and prevent, advise and protect the citizen's health while reducing hospitalization costs for hospitals. Aim: The purpose of this literature review is the family planning centre development in general hospital of Argolida that has a similar clinic. Material and Methods: Literature review was conducted of published English and Greek Articles from bibliographic databases Medline, Google Scholar and Scopus for the period 2001-2014, using keywords like: "Family Planning», «SWOT analysis", "functional design" "prevention", "health promotion", "economic cost". The option of creating inpatient center was made after analysis SWOT, by defining objectives, performance indicators and existing alternatives. Also the timing of implementation and functional design, provide the springboard effort for effective operation. Conclusions: The development of family planning centres in the country and abroad is designed to address very important problems in the bud, in order to improve the quality of citizens' health, then reduce the financial burden on the health system as a result of prevention, and contribute indirectly to the mental balance of citizens.

  5. [The department budget, in the context of the hospital global budget. Initial results in general medicine].

    Science.gov (United States)

    Besançon, F

    1984-02-23

    In a general hospital (Hôtel-Dieu, in the center of Paris), run with a global budget, budgets determined for each unit were introduced as an experiment in 1980. Physicians were in charge of certain expenses, mainly: linen, drugs, transportation of patients to and from other hospitals within Paris, and blood fractions. The whole does not exceed 4% of the turnover (FF 20 millions in 1980) of a 67 bed internal medicine unit. Other accounts deal with the stays, admissions, prescriptions of technical acts, laboratory analyses, and X-rays. In 1980, expenses were 11% more than budgeted, but the increase in stays and particularly in admissions was significantly greater. The resulting savings were 8.8% and 18.7% for stays and admissions respectively. Psychic reactions were variable. The subsequent budgets followed the fluctuations of recorded expenses, which were fairly important in both directions. The unit budget may be an advance or a regression, in a restrictive and past-perpetuating context. The coherence between the unit budget and the global hospital budget is questionable. Physicians were willing to take part in accounting and saving. They have good reason for not enlarging their financial responsibilities. Conversely, they may give more attention to diseases of public opinion.

  6. A survey of dental treatment under general anesthesia in a Korean university hospital pediatric dental clinic.

    Science.gov (United States)

    Shin, Bisol; Yoo, Seunghoon; Kim, Jongsoo; Kim, Seungoh; Kim, Jongbin

    2016-09-01

    In South Korea, the number of cases of dental treatment for the disabled is gradually increasing, primarily at regional dental clinics for the disabled. This study investigated pediatric patients at a treatment clinic for the disabled within a university hospital who received dental treatment under general anesthesia. This data could assist those that provide dental treatment for the disabled and guide future treatment directions and new policies. This study was a retrospective analysis of 263 cases in which patients received dental treatment under general anesthesia from January 2011 to May 2016. The variables examined were gender, age, reason for anesthesia, type of disability, time under anesthesia, duration of treatment, type of procedure, treatment details, and annual trends in the use of general anesthesia. Among pediatric patients with disabilities who received dental treatment under general anesthesia, the most prevalent age group was 5-8 years old (124 patients, 47.1%), and the primary reason for administering anesthesia was dental anxiety or phobia. The mean time under anesthesia was 132.7 ± 77.6 min, and the mean duration of treatment was 101.9 ± 71.2 min. The most common type of treatment was restoration, accounting for 158 of the 380 treatments performed. Due to increasing demand, the number of cases of dental treatment performed under general anesthesia is expected to continue increasing, and it can be a useful method of treatment in patients with dental anxiety or phobia.

  7. Trastornos psicóticos en el servicio de urgencias de un Hospital General.

    Directory of Open Access Journals (Sweden)

    AI González Vázquez

    1994-01-01

    Full Text Available El presente artículo pretende reflexionar acerca del papel que los Servicios de Urgencia Psiquiátrica están teniendo en la atención del paciente psicótico no institucionalizado, en el marco particular de un Area Sanitaria en plena reestructuración. Para ello se analizan diversos datos de los pacientes atendidos en el Servicio General de Urgencias de un Hospital General que fueron diagnosticados como trastornos psicóticos, tratándose de valorar los factores que influyen en la decisión de ingreso así como la interrelación entre la Urgencia Psiquiátrica y el resto de los dispositivos asistenciales.

  8. Implementation of a pre-hospital decision rule in general practice. Triage of patients with suspected myocardial infarction

    NARCIS (Netherlands)

    E.W.M. Grijseels (Els); J.W. Deckers (Jaap); A.W. Hoes (Arno); H. Boersma (Eric); J.A.M. Hartman; E. van der Does (Emiel); M.L. Simoons (Maarten)

    1996-01-01

    textabstractOBJECTIVE: To improve pre-hospital triage of patients with suspected acute cardiac disease. DESIGN: Prospective study. SUBJECTS. Patients with symptoms suggestive of acute cardiac pathology, who were seen by a general practitioner, for whom acute admission into hospital was requested, an

  9. A survey assessing the impact of a hospital-based general practice residency program on dentists and dental practice.

    Science.gov (United States)

    Tejani, Asif; Epstein, Joel B; Gibson, Gary; Le, Nhu

    2002-01-01

    The purpose of this survey was to evaluate the outcome of completing a general practice hospital-based dental residency program. A survey was mailed to all individuals who had completed a general practice residency program (resident) between 1980 and 1996 and to dentists who had not completed a hospital program (undergraduate). The responses were evaluated by Fisher's exact test. Seventy-four percent of the resident group and 68% from the undergraduate sample group returned the questionnaire. Approximately half the residents were in general dental practice. Twenty-six percent were involved in specialty dentistry, 7% in hospital dentistry, and 20% in teaching at a dental school. Of the undergraduate dentists, more than three-quarters were in general practice, 5% were entered into specialty programs, 1% were involved in hospital dentistry, and 15% taught at a dental school. Half of the residents held staff privileges in a hospital or ambulatory setting, compared with 16% of undergraduates. Forty-three percent of the residents provided consultation in a hospital or long-term-care facility, compared with 21% of the undergraduates. Practice characteristics suggested enhanced clinical skills in oral surgery, periodontics, emergency dental care, and oral medicine/pathology in those completing the hospital program. The findings of this study confirm that the outcome of completing a hospital program is a change in practice profile, site of practice, services for complex patients, and continuing involvement in teaching.

  10. [Study of Staphylococcus aureus infections in a general acute care hospital (2002-2013)].

    Science.gov (United States)

    Togneri, Ana M; Podestá, Laura B; Pérez, Marcela P; Santiso, Gabriela M

    A twelve-year retrospective review of Staphylococcus aureus infections in adult and pediatric patients (AP and PP respectively) assisted in the Hospital Interzonal General de Agudos Evita in Lanús was performed to determine the incidence, foci of infection, the source of infection and to analyze the profile of antimicrobial resistance. An amount of 2125 cases of infection in AP and 361 in PP were documented. The incidence in AP decreased significantly in the last three years (χi(2); p<0.05); in PP it increased significantly during the last five years (χ(2); p<0.0001). In both populations was detected a notable increase in skin infections and associated structures (PEA) in bacteremia to the starting point of a focus on PEA, and in total S. aureus infections of hospital-onset (χ(2); p < 0.005). Methicillin-resistance (MRSA) increased from 28 to 78% in PP; in AP it remained around 50%, with significant reduction in accompanying antimicrobial resistance to non-β-lactams in both groups of MRSA. In S. aureus documented from community onset infections (CO-MRSA) in the last three years, the percentage of methicillin-resistance was 57% in PP and 37% in AP; in hospital-onset infections it was 43% and 63% respectively. Although data showed that S. aureus remains a pathogen associated with the hospital-onset, there was an increase of CO-MRSA infections with predominance in PEA in both populations. Copyright © 2016 Asociación Argentina de Microbiología. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Professional nurses' perception of nursing mentally ill people in a general hospital setting.

    Science.gov (United States)

    Mavundla, T R

    2000-12-01

    The aim of this study was to explore professional nurses' perception of nursing mentally ill patients in a tertiary hospital in Durban. An explorative, qualitative, descriptive and contextual design was followed as the basis for conducting the study. The above-mentioned research design was achieved through field work conducted in an urban-based general hospital. A sample of 12 professional nurses was selected from a population of 800 professional nurses employed in this setting using a purposive sampling technique. This sample size was determined by saturation of data as reflected in repeating themes. Both individual phenomenological semistructured interviews and field notes in the form of observations were used as methods of data collection. The field work was conducted without any preset theoretical framework of reference by using bracketing and intuiting. During interviews, participants were asked only one research question, namely: 'How do you perceive nursing mentally ill patients in your unit or ward?' Communication skills were employed to encourage participants to verbalize their perception of nursing mentally ill patients in a general hospital setting. A tape recorder was used to collect data and the data was transcribed verbatim. Data collected was analysed following the descriptive method of Giorgi (1986). Coding was carried out by the researcher and an independent expert who is a psychiatric nursing specialist and a qualitative research expert. After data analysis, the results were reflected within universal categories of the Nursing for the Whole Person Theory in order to give them structure. The four themes that emerged from the findings are: perception of self, perception of a patient, perception of feelings that hinder nursing the mentally ill, and perception of the environment. The measures for ensuring trustworthiness proposed by Guba (Lincoln Y.S. & Guba E.G. (1985) Naturalistic Inquiry. Sage, Beverly Hills) were used as the basis for ensuring

  12. The Frequency and Pattern of Substance Use in Outpatients of General Hospitals

    Directory of Open Access Journals (Sweden)

    Behrouz Birashk

    2010-11-01

    Full Text Available Background:Patients with addictions have many acute and chronic medical illnesses, both related and unrelated to their addictions. In spite of high incidence of   substance-related disabilities, substance abuse is usually underdiagnosed in general   hospitals. The objective of the present study was to investigate the frequency and pattern of substance use in patients with different medical complaints.Methods: In this descriptive cross-sectional study , 1000 outpatients, aged 17 and   older with various medical complaints were participated. The patients were attending   neurology, ENT, nephrology, ophthalmology, cardiology, orthopedic, gastroenterology, surgical and dermatology clinics of four selected general hospitals. A 93 item clinicians-made scale, Rapid Situation Assessment of Drug Abuse in Iran, was used in this survey, and 30 items which focused on drug use were selected.   Results: 8.7% of the patients reported lifelong or recent substance use and Opium   was the most used substance, reported by 65.5% of the patients. Patients of neurology   ,ophthalmology and orthopedic clinics showed the highest consumption . Smoking   and injestion were the most frequent routes of substance used and the most reported   pattern of use were 2 or 4 times a day and once a week.   Conclusions: The current cohort of substance users were relatively young, and   many had reported detectable nervous system and orthopedic complications. Further   research must investigate -their outcomes in the long term.

  13. [Burnout syndrome in medical residents at the General Hospital of Durango, México].

    Science.gov (United States)

    Terrones-Rodríguez, Jovany Francisco; Cisneros-Pérez, Vicente; Arreola-Rocha, José Jesús

    2016-01-01

    The burnout syndrome is commonly spread among health workers and students, due to the excessive demands they feel on their workspaces. Depersonalization, emotional exhaustion and personal accomplishment are the areas assessed. To determine the prevalence of burnout syndrome in medical residents at the General Hospital of Durango; a descriptive, prolective, cross-sectional study was designed and applied to residents of different specialties of the General Hospital of Durango who agreed to participate, the "Maslach Burnout Inventory" was applied. We surveyed 116 residents, 43.1 % (50) women and 56.89 % (66) men. The overall prevalence was 89.66 % (95 % CI: 82.63- 94.54). Affected in a single area the 48.28 % (95 % CI: 38.90-57.74), in two areas the 35.34 % (95 % CI: 26.69-44.76) and in the three areas 6.03 % (95 % CI: 2.46-12.04). Stratified by areas, high emotional exhaustion was 41.38 % (95 % CI: 32.31-50.90), high depersonalization in 54.31 % (95 % CI: 44.81-63.59), and low personal accomplishment 41.38 % (95 % CI: 32.31-50.90). The prevalence is higher than the reported. The most frequently affected is depersonalization, followed by emotional exhaustion and finally the personal accomplishment. In the areas of Gynecology and obstetrics, Internal medicine, Pediatrics and Orthopedics, the 100 % of the residents are affected.

  14. Aetiology and prognosis of encephalopathic patterns on electroencephalogram in a general hospital.

    LENUS (Irish Health Repository)

    O'Sullivan, S S

    2012-02-03

    The purpose of this study was to investigate the frequency and clinical outcome of patients with encephalopathic electroencephalograms (EEGs) in a neurophysiology department based in a general hospital. We performed a retrospective review of all EEGs obtained during an 18-month period in a large tertiary referral hospital. The referral reasons for EEG, the diagnoses reached, and patient outcomes were reviewed according to EEG severity. One hundred and twenty-three patients with encephalopathic EEGs were reviewed. The most common referral reason found was for an assessment of a possible first-onset seizure. The most common diagnosis found was one of dementia or learning disability. Of patients who were followed-up for a median of 19 months, 20.7% had died. The mortality rate generally increased according to the severity of the encephalopathy on EEG. However, 21.4% of those patients with excessive theta activity only on EEG had died. This study highlights an increased mortality even in the apparently \\'milder\\' degrees of EEG abnormalities.

  15. Epidemiology of Giant Cell Tumor in Dr. Hasan Sadikin General Hospital Bandung from 2010-2013

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    Kirtana Gunasegaran

    2016-06-01

    Full Text Available Background: Giant cell tumor (GCT of bone is a primary bone tumor. It is commonly seen in South East Asia and found in female around 20–45 years old. The GCT mostly occurs in epiphysis around the knee. The patients normally suffer from pain, swelling, limitation of joint movement, and pathologic fracture. This study aimed to determine the epidemiology of GCT of the bone based on age, sex, location, type, metastases, and recurrence in Dr. Hasan Sadikin General Hospital Bandung. Methods: A descriptive study with retrospective cohort using total sampling method was used to obtain 33 medical records of patients with GCT of bone in Department of Orthopedic & Traumatology and Anatomical Pathology Dr. Hasan Sadikin General Hospital Bandung in the period of January 2010–December 2013. Results: The GCT of bone was mostly found in female of 20 to 29 years old and around 32 years old in male. Distal femur will be the most common site while zygoma, mandibular vertebrae, proximal tibia were rare sites. Twenty nine cases were benign lesion and the rest (4 cases were malignant. The probability of GCT of bone to metastasize to lungs was very low. Four recurrences occurred within a year. Conclusions: The GCT of bone in male mostly occurs in the third and fourth decade of age. It is found around the knee, mostly benign, rarely metastasize to the lungs and recurrence happens within a year.

  16. Surveillance of nosocomial infections in Dr. Cipto Mangunkusumo National General Hospital, Jakarta, 1999-2002

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    Djoko Widodo

    2004-06-01

    Full Text Available Nosocomial infection are one of the main problem in hospital which are associated with significant morbidity, mortality and increased economic cost. Surveillance should be attempted regularly to obtain local data of incidence of nosocomial infections, types of infection, pathogen and resistance pattern. We reported the results of nosocomial surveillance in Dr. Cipto Mangunkusumo National General Hospital, Jakarta, in year 1999 to 2002. The data were obtained from surveillance, conducted by Nosocomial Infection Control Committee. Surveillance were performed to patient in risk of nosocomial infections such as underwent surgical procedure, urinary catheter, peripheral or central venous catheter, ventilator and other invasive procedure. Criteria for nosocomial infection which were used, based on technical guidelines of nosocomial infection in Dr. Cipto Mangunkusumo National General Hospital, year 1999; which referred to CDC definition of nosocomial infections. Incidence rate of nosocomial infections in year 1999, 2000, 2001 and 2002 were 1.1, 0.9, 0.6 and 0.4 % respectively. Type of nosocomial infection include catheter related, surgical wound, urinary tract and respiratory tract infections, ranged between 0 to 5.6 %. Gram negative bacteria consist of Pseudomonas sp, Enterobacter aerogenes, Escherichia coli, Proteus mirabilis were the most common nosocomial pathogen. Gram positive bacteria consist of Staphylococcus epidermidis, Staphylococcus aureus and Streptococcus anhemolyticus. Trend of increasing incidence of Gram positive nosocomial infection also showed in our surveillance. Mostly Gram negative bacteria had been resistant to penicillin, co amoxicillin-clavulanic acid and 3rd generation cephalosporin, but still sensitive to 4th generation cephalosporin and aminoglycoside. The Gram positive bacteria were still sensitive to penicillin, co amoxicillin-clavulanic acid, 4th generation cephalosporin and aminoglycoside. (Med J Indones 2004; 13: 107

  17. Our experiences with vancomycin-resistant enterococci in Jesenice General hospital

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    Helena Ribič

    2007-11-01

    Full Text Available Background: Vancomycin-resistant enterococci (VRE present a great problem in health care, especially because of their resistance to many groups of antibiotics and because of the way of their spreading in health care and long-term care institutions. Genes responsible for resistance to vancomycin can be transmitted to other species of enterococci and also to other grampositive cocci, for example Staphylococcus aureus. Experts anticipate that failure to control methicilin-resistant S. aureus and VRE may make control of vancomycin-resistant S. aureus impossible.Methods: In the medical microbiology laboratory of Institute Public Health Kranj we perform microbiology diagnosis for Jesenice General Hospital, where surveillance culturing for VRE started in May 2007. Until 15th June, 364 surveillance samples for VRE were taken from 92 patients. We also analysed the results of enterococci that were isolated in our laboratory during routine work in the period from 2004 to 2006.Results: In the three-year period we isolated 1593 strains of enterococci and among them 7 strains were VRE. In the Jesenice General Hospital, the first strain of vancomycin-resistant Enterococcus faecium was isolated in May 2007 in a patient, treated in internal intensive care unit. Nine strains of VRE with the same resistance type in nine patients followed the first case. The first four patients with VRE were moved from the same hospital. Among next six patients the common risk factor was contact with VRE positive patient.Conclusions: Control of VRE strains claims for intensive action. Active surveillance of colonised and infected patients, contact precautions with barrier isolation, intensive hand hygiene measures, aggressive environmental decontamination and prudent use of antimicrobials are needed.

  18. Utilization of a consultation liaison psychiatry service in a general hospital.

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    Gobar, A H; Collins, J L; Mathura, C B

    1987-05-01

    This retrospective study was conducted in response to a need to evaluate the overall utilization rates of the psychiatric consultation liaison service by nonpsychiatric units within Howard University Hospital, which deals almost exclusively with a black, inner-city population. The study covers a three-year period (July 1982 to July 1985). During this time only 815 patients (2 percent) were referred for psychiatric evaluation out of the total number of hospital admissions (40,000 patients).Patient characteristics and general attitudes appear to have had a major role in this low ratio of referrals, particularly a lack of awareness and bias against psychiatry. This latter finding is in disparity with other published reports. Diagnostically, depression, organic mental disorders (acute), and substance abuse (mainly PCP) constituted the greater bulk of the patients seen by the consultation liaison psychiatry service. The review of a random sample of psychiatric inpatients (n = 100) revealed that in 50 percent of the cases there was a coexisting physical illness or abnormality.The role of mental health education and the liaison function needs to be emphasized. It is suggested that efforts should be directed toward a wider acceptance and utilization of consultation liaison psychiatry by primary care physicians in general hospitals. The factors listed by physicians and patients that may account for the observed underutilization of consultation liaison services are discussed. The results of 20 interviews and the reasons given by referring physicians as to whether or not they will seek consultation from the consultation liaison services are also reviewed.

  19. Psychopathology of the General Population Referred by Primary Care Physicians for Urgent Assessment in Psychiatric Hospitals

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    Judith McLenan

    2016-12-01

    Full Text Available Objective: The aim of this study was to evaluate the type, severity and progression of psychiatric pathologies in a sample of 372 outpatients (age range 18–65 years referred by their primary general practitioners (GPs to an Urgent Referral Team (URT based in a psychiatric hospital in Aberdeen, Scotland. This team offers immediate appointments (1- to 7-day delays for rapid assessments and early interventions to the outpatients referred by their primary family doctors.Method: One-sample t-test and z statistic were used for data analysis. From the total population, a convenience sample of 40 people was selected and assessed to evaluate whether follow-up appointments after the first visit could reduce the severity of suicidal ideation, depression and anxiety in the outpatients seen by the URT. A two-sample t-test and a Wilcoxon signed-rank test were used to assess the variations in the scores during the follow-up visits.Results: We found a statistically significant prevalence of depressive disorders, comorbid with anxiety at first presentation in people who were females, white, never married, living with a partner, not studying and not in paid employment. The common presentation of borderline personality disorder and dysthymia in this population underscores its vulnerability to major socioeconomic challenges.Conclusion: The data confirmed the impact that primary care cooperation with psychiatric hospitals can have on the psychiatric system, and as a reflection, on the population’s mental health and well-being. In fact, active cooperation and early diagnosis and intervention will help detect cases at risk in the general population and reduce admissions into hospitals.

  20. Low Serum Vitamin C Status Among Pregnant Women Attending Antenatal Care at General Hospital Dawakin Kudu, Northwest Nigeria

    National Research Council Canada - National Science Library

    Ugwa, Emmanuel Ajuluchukwu; Iwasam, Elemi Agbor; Nwali, Matthew Igwe

    2016-01-01

    Vitamin C levels are low in pregnancy. The purpose of this study was to determine serum Vitamins C levels among pregnant women attending antenatal care at a General Hospital in Dawakin Kudu, Kano, and this can help further research...

  1. [Enrichment of the functions of the psychiatric department in a general hospital and collaboration within the area].

    Science.gov (United States)

    Koishikawa, Hiraki; Ookami, Toshihiko

    2014-01-01

    Psychiatric disease has been included in the five main diseases, and a medical care plan is required. In it, there are many problems, for example, physical complications and which general hospital should chiefly deal with it. Here, we present a way to cope with these problems on the basis of achievements in the psychiatric department of Kameda General Hospital. Specifically, we would like to assert that creating a consultation-liaison team and enriching the section of clinical psychiatry are very important and effective. The activities of the consultation-liaison team, created to address various issues after establishing a psychiatric ward, have led to the possibility of a psychiatric department in a general hospital. Experience to date indicates that, in the context of a general hospital with a psychiatric inpatient unit, the existence of a multidisciplinary liaison team working across departmental boundaries is crucial to determining and managing the treatment of patients with psychiatric emergencies, as well as patients with psychiatric issues and physical complications. Additionally, in order to increase the effectiveness of the hospital liaison team, it is critical to realize seamless, prompt collaboration with facilities outside the hospital. In this respect, the role of a patient care coordinator is expected to become increasingly important. Additionally, enriching and guarding activities of clinical psychologists have contributed to the growth of psychiatric departments in general hospitals and proved to be effective in combination with activities of the consultation-liaison team.

  2. Interconsulta psicológica: demanda e assistência em hospital geral Interconsulta psicológica: demanda y asistencia en hospital general Consultation-liaison psychology: demand and assistance in general hospital

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    Nátali Castro Antunes Santos

    2011-06-01

    Full Text Available A interconsulta psicológica no hospital geral representa uma modalidade de atendimento clínico e um instrumento metodológico utilizado pelo psicólogo na assistência ao paciente internado, mediante solicitação de outros profissionais da saúde. O estudo objetivou caracterizar a demanda da interconsulta psicológica em um hospital geral, a partir da análise dos registros de solicitação de atendimento. Cento e sete pacientes foram atendidos entre janeiro e junho de 2010, dos quais 53% eram do sexo masculino e 57% eram adultos acima de 45 anos. A maioria das solicitações foi realizada por médicos (44% e enfermeiros (38%, formalmente (59%, e mediante contato prévio entre interconsultor e solicitante (85%. Os principais motivos alegados para a solicitação da interconsulta foram sintomas psicológicos relacionados ao adoecimento (43% e identificação de comprometimento na adaptação do paciente à hospitalização (41%. O modelo de interconsulta psicológica adotado no contexto estudado foi adequado, havendo engajamento da equipe multiprofissional na efetivação da prática.La interconsulta psicológica en los hospitals generales representan una modalidad de clínica y una herramienta metodológica utilizada por los psicólogos en la atención hospitalaria del paciente, a petición de los profesionales de la salud. El objetivo del estudio fue caracterizar la demanda psicológica para referirlo a un hospital general, desde el análisis del servicio de solicitud de registros. Ciento siete pacientes fueron tratados entre enero y junio de 2010, siendo 53% hombres y 57% de los adultos mayores de 45 años. La mayoría de las solicitudes fueron realizadas por los médicos (44% y enfermeras (38%, de manera formal (59% y el contacto previo entre interconsultor y su interés (85%. Las razones principales de la solicitud de remisión fueron: síntomas psicológicos relacionados con la enfermedad (43% y la identificación de la deficiencia en la

  3. Quality of life in children with primary headache in a general hospital.

    Science.gov (United States)

    Bruijn, J; Arts, W-F; Duivenvoorden, H; Dijkstra, N; Raat, H; Passchier, J

    2009-06-01

    Knowledge on the quality of life of children with headache is lacking. Until now only a few studies in this field have provided information on a limited number of life domains. The aim of this study was to assess the quality of life in a comprehensive number of life domains in children with primary headache presenting at an out-patient paediatric department in a general hospital. From October 2003 to October 2005 all children referred to the out-patient paediatric department of the Vlietland Hospital because of primary headache were investigated by protocol. A thorough history was taken and a general physical and neurological examination was performed. The International Headache Society criteria were used for classification. Quality of life (QoL) was measured using the Dutch version of the Child Health Questionnaire (CHQ-PF50 Dutch edition) and compared with data from a previously investigated cohort of healthy children from the same region, and with data from a cohort of children from the USA with asthma or with attention deficit hyperactivity disorder (ADHD), investigated with the CHQ-PF50. A total of 70 primary headache patients were included in the study (25 with tension-type headache, 36 with migraine, seven with chronic tension-type headache, two with both tension-type headache and migraine). Their mean age was 10.6 years (range 4-17 years); 37 children were male. On all but one subscale (self-esteem) the QoL of the children with primary headache was decreased compared with the cohort of healthy children, especially on the domains of mental health, parental impact time and family cohesion. Compared with the cohort of children with asthma the QoL was significantly worse for our headache group on seven subscales and significantly better on one subscale (general health perception). Compared with the cohort of children with ADHD, the QoL was significantly worse on six subscales but significantly better on three subscales. There were no significant differences on

  4. A STUDY ON CLINICAL AND AETIOLOGICAL PROFILE OF HEART FAILURE AT KBN TEACHING AND GENERAL HOSPITAL

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    Chandrakala Guruprasad Yelwanti

    2016-10-01

    Full Text Available BACKGROUND The heart failure is a worldwide health problem with ever increasing proportion and is a major health problem in elderly persons. It has many aetiological factors. It is one of the most frequently encountered illnesses in day-to-day practice and most common cause of death in patients with cardiac disease. This study was done to determine the age and sex distribution and to evaluate clinical features and aetiological factors in patients admitted with heart failure at Khaja Banda Nawaz Teaching and General Hospital, Gulbarga, on the basis of clinical assessment, electrocardiography and echocardiography. MATERIALS AND METHODS A prospective study was done in Department of General Medicine at Khaja Banda Nawaz Teaching and General Hospital, Gulbarga, from January 2015 to June 2016 on patients with heart failure to determine the clinical and aetiological profile. A total of 100 cases above the age of 20 years were included in the study. The patients below the age of 20 years and known cases of congenital heart disease were excluded. RESULTS Out of 100 patients, the heart failure was seen more commonly in men than in women between the age groups of 46-65 years of age. Breathlessness was the most common presentation followed by pedal oedema, orthopnoea, etc. In our study, the primary aetiology for heart failure was found to be coronary artery disease (47% followed by dilated cardiomyopathy (20%, hypertension (14%, rheumatic heart disease (7%, anaemia (6%, cor pulmonale (4% and others (2%. Dyslipidaemia was the common risk factor followed by obesity and smoking. CONCLUSION The heart failure commonly occurs in elderly people and the incidence was higher in men than in women. The commonest presentation was breathlessness followed by pedal oedema. The commonest cause of heart failure was coronary artery disease followed by dilated cardiomyopathy and then hypertension combined with ischaemic heart disease.

  5. [Maternal mortality rate in the Aurelio Valdivieso General Hospital: a ten years follow up].

    Science.gov (United States)

    Noguera-Sánchez, Marcelo Fidias; Arenas-Gómez, Susana; Rabadán-Martínez, Cesar Esli; Antonio-Sánchez, Pedro

    2013-01-01

    Antecedentes: en México, la mortalidad materna ha disminuido en las últimas décadas. En Oaxaca esto no se ha manifestado porque se incrementó la tasa de mortalidad materna. Este estado se ubica entre las entidades con más muertes maternas. Objetivo: analizar 10 años de mortalidad materna en el Hospital General Dr. Aurelio Valdivieso de los Servicios de Salud de Oaxaca, para conocer el comportamiento epidemiológico y caracterización de los decesos. Material y métodos: estudio retrospectivo, transversal y descriptivo efectuado mediante la revisión de expedientes clínicos de mortalidad materna en la División de Gineco-Obstetricia. Se consideraron variables sociales, obstétricas y circunstanciales y las comprobaciones se efectuaron con estadística general y descriptiva. Resultados: entre el 1 de enero de 2000 y el 31 de diciembre de 2009 se registraron 109 muertes maternas, excluidas dos que no fueron obstétricas; es decir, que hubo 107 muertes maternas: 75 directas y 32 indirectas. La tasa de mortalidad materna fue de 172.14 × 100,000 nacidos vivos. De las muertes maternas revisadas 89 pudieron evitarse (83%) y 18 no (17%), esto con base en el dictamen del Comité ad hoc del Hospital General Dr. Aurelio Valdivieso. La enfermedad hipertensiva aguda del embarazo fue la de mayor mortalidad; la escolaridad y el puerperio ueron el mayor riesgo. Conclusiones: las variables atribuibles a bajo índice de desarrollo humano, como: baja escolaridad y paridad elevada incrementaron el riesgo de mortalidad materna, que fue intrahospitalaria y durante el puerperio. La tasa de mortalidad materna fue la mayor encontrada en publicaciones nacionales con respecto a este referente.

  6. Factor Affecting Hipertension Incidence to Papuan Ethnic at Yowari General Hospital Sentani Jayapura Regency Papuan Province

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    Elpida Elpida

    2017-01-01

    Full Text Available High blood pressure or hupertension often being called silent killer and mortality that excelsior because kill gently ala. Mark sense urbanization to Province Papuaning to cause changing Regency Papuan society life style Jayapura experiences changing. Of RSUD Yowari's data hypertension instance experiences step-up. There is purpose was to know factor affecting Hiptension Incidence To Papuan Ethnic At Yowari General Hospital Sentani Jayapura Regency Papuan Province. Observasional by designs studi case control. Population all patient comes from Papuan ethnic that visits at Poli Disease In Yowari general hospital Sentani Jayapura Regency on month of May until July 2016 totals 379 person. Outgrow sample as much 41 cases and 41 controls. Data approach used questionaire and analyzed by chi square and odd ratio. The results shows that there is corelatyion afecting hypertension incidence on Papuan ethnic at Yowari general hospital is aged (p value 0,039; OR= 2,952; CI95%= 1,154 – 7,556, genetic (p value 0,001; OR= 5,260; CI95%= 2,043 – 13,539, activity phisic (p value 0,001; OR= 3,733; CI95%= 1,496 – 9,318, obesity (p value 0,008; OR = 3,733; CI95%= 1,496 – 9,318, smoking (p value 0,008; OR= 3,563; CI95%= 1,328 – 9,555, coffe drunk (p value 0,013; OR= 3,589; CI95%= 1,401 – 6,227, diseased history (p value 0,000; OR= 6,445; CI95%= 2,383 – 17,436 and stress (p value 0,000; OR= 6,445; CI95%= 2,383 – 17,436. Meanwhile variable that not corelation affecting is sex (p value 0,376; OR = 1,635; CI95%= 0,683 – 3,915, education (p value 0,825; OR = 0,822; CI95%= 0,345 – 1,960, work (p value 0,180; OR = 0,494; CI95%= 0,203 – 1,202, income (p value 0,252; 0,539; CI95% (0,212 – 1,317, alcohol drunk (p value 0,103; OR = 2,426; CI95%= 0,945 – 6,227. Dominan factor incidence hpertension is aged, genetic, activity, obesity, salt consumption and hystory disease.

  7. Comparison Patients and Staffs Satisfaction in General Versus Special Wards of Hospitals of Jahrom.

    Science.gov (United States)

    Taheri, Leila; Kargar Jahromi, Marzieh; Hojat, Mohsen

    2015-04-02

    Patient satisfaction is the most important indicator of high-quality health care and is used for the assessment and planning of health care. Also, Job satisfaction is an important factor on prediction and perception of organizational manner. The aim of this study is to identify and compare patient and staff satisfaction in general versus special wards. In order to identify the various indicators of satisfaction and dissatisfaction, a descriptive study (cross sectional) was done to assess patients' satisfaction with in-patient care at Jahrom University of Medical Science hospitals. The sample size was 600 patients that selected by sequential random sampling technique and are close to their discharge from the hospital. Patients were asked to indicate the scale point which best reflected their level of satisfaction with the treatment or service. Also we assess the staff satisfaction (sample size was 408 staffs) in general ward using a researcher made questionnaire. It should be noted that the participants were anonymous and there was no obligation to participation. We tried to set a secure and comfortable environment for filling out the questionnaire. Among 600 patients, 239 (n=38.67%) were men and 368 (61.33%) were female. Number of nurses was 408, of which 135 (33.08%) were men and 273 (66.92%) female. There was a significant correlation between working experience and professional factors of personnel. The mean total patient satisfaction in general and special wards is (2.75±.35, 3.03±.53) respectively. Differences of patient satisfaction in domains such respect, care and confidence in general wards versus special ward were statistically significant, but there was no difference in expect time of patients in these wards. Differences Between the mean patient and staff satisfaction in the general wards versus special wards were statistically significant using independent t-tests (p=.018, p=.029). Spearman test showed a statistically significant correlation between

  8. Bloodstream infection among children presenting to a general hospital outpatient clinic in urban Nepal.

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    Rahul Pradhan

    Full Text Available BACKGROUND: There are limited data on the etiology and characteristics of bloodstream infections in children presenting in hospital outpatient settings in South Asia. Previous studies in Nepal have highlighted the importance of murine typhus as a cause of febrile illness in adults and enteric fever as a leading bacterial cause of fever among children admitted to hospital. METHODS: We prospectively studied a total of 1084 febrile children aged between 2 months and 14 years presenting to a general hospital outpatient department in Kathmandu Valley, Nepal, over two study periods (summer and winter. Blood from all patients was tested by conventional culture and by real-time PCR for Rickettsia typhi. RESULTS: Putative etiological agents for fever were identified in 164 (15% patients. Salmonella enterica serovar Typhi (S. Typhi was identified in 107 (10%, S. enterica serovar Paratyphi A (S. Paratyphi in 30 (3%, Streptococcus pneumoniae in 6 (0.6%, S. enterica serovar Typhimurium in 2 (0.2%, Haemophilus influenzae type b in 1 (0.1%, and Escherichia coli in 1 (0.1% patient. S. Typhi was the most common organism isolated from blood during both summer and winter. Twenty-two (2% patients were PCR positive for R. typhi. No significant demographic, clinical and laboratory features distinguished culture positive enteric fever and murine typhus. CONCLUSIONS: Salmonella infections are the leading cause of bloodstream infection among pediatric outpatients with fever in Kathmandu Valley. Extension of immunization programs against invasive bacterial disease to include the agents of enteric fever and pneumococcus could improve the health of children in Nepal.

  9. INCIDENCE OF PNEUMONIA IN CRITICALLY ILL PATIENTS ON VENTILATOR IN BASAVESHWAR TEACHING AND GENERAL HOSPITAL

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    Basavaraj R

    2014-11-01

    Full Text Available BACKGROUND AND OBJECTIVES: Nosocomial pneumonia (NP is defined as parenchymal lung infection, occurring after the first 48 hours of hospital admission. Ventilator Associated Pneumonia (VAP is the most common cause of nosocomial pneumonia. The clinical presentation and organisms causing the VAP are different in different set ups. Hence early diagnosis and management of these patients will decrease morbidity and also the mortality. AIM OF STUDY: Is to find the most common organism, sensitivity, and clinical profile of the patients suffering from VAP. MATERIALS AND METHODS: All patients on mechanical ventilation admitted in Intensive Care Units (ICU of Basaweshwar Teaching and General Hospital attached to M.R.M.C Gulbarga for approximately 2 years from September 2010 to June 2012 were considered. Patients under study were those satisfying inclusion criteria and a detail history and clinical examination of the selected patients was taken. RESULTS: 224 patients were put on mechanical ventilator during the study period of them 60 patients developed VAP. Out of 60patients, 29 developed early onset and 31 developed late onset VAP. The most common sign in early onset VAP was crepitation (83% and late onset were fever and tachycardia (61%. Commonest organism isolated in early onset VAP was Pseudomonas and Staphylococcus aureus (21% and Pseudomonas (52% in late onset. Piperacillin, meropenem and vancomycin were the most common antibiotics for which cultures were sensitive in early onset VAP, as compared to meropenem, vancomycin and levofloxacin in late onset VAP. Commonest risk factors in early and late onset VAP was use of H2 blockers (97% and 100% respectively. late onset VAP had very high mortality rate of 71% as compared to only 17% in early onset VAP. CONCLUSION: Keen observation, clinical, radiological examination and culture sensitivity of respiratory secretions of ventilated patients in ICU would help to detect early onset of VAP. This early

  10. An Outbreak of SARS in a Diabetes Room of a General Hospital without Infected Medical Staff

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    Objective To investigate the epidemiologic features of an outbreak of SARS that occurred in a single diabetes room of a general hospital in Beijing in late March 2003. Methods Field investigation was carried out in the ward, the nursing log and the hospitalization medical record of correlative patients were consulted. SARS-CoV in serum specimen from SARS patient was detected by PCR. Results The room where SARS outbreak occurred was on the 13th lfoor of the 16-story main ward building. There were 6 beds in the room, living with 6 female patients (aged 45-67) who were all hospitalized due to type 2 diabetes. On March 24, 2003, Patient 1 began to have a fever and cough, chest X-ray showed pneumonia. Five and six days later, Patient 2 and Patient 3 began to have a fever, respectively. Finally, all of these 3 patients died. Their beds were all at the same side of the room, and the other 3 patients at the opposite side were not infected. Serum SARS CoV-RNA of the Patient 3 was positive by nest-PCR. The daughter-in-law of Patient 1 who accompanied Patient 1 by the bedside several days, mainly near the window, upwind of Patient 1, was not infected. Medical staff, family members and visitors of the 6 patients were not infected. Conclusions This outbreak was not transmitted by aerosol. The distance droplets travels could be up to 3.43 meters. Droplet spread has direction, and the droplets direction of propagation is closely related with the wind direction and speed. Those at the downwind position of SARS patients were susceptible to be infected. Medical staff wore face masks and good natural ventilation of this ward building may be important reasons for the prevention of infection.

  11. Investigation of Hepatitis C Virus Infection Rate of Patients in a General Hospital

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    Objective To investigate the infection rate of hepatitis C virus among the ambulatory patients and in-patients of a tertiary teaching hospital, and study the demographic factors related to the prevalence of hepatitis C virus infection. Methods All patients tested for hepatitis C virus antibody from July 2008 to July 2009 in Peking Union Medical College Hospital were enrolled in this cross-sectional analysis. The prevalence of hepatitis C virus infection was compared according to age, gender, and departments, respectively. Among patients with positive serology hepatitis C virus marker, the positivity of hepatitis C virus RNA was analysed. Results Among 29 896 subjects included, the hepatitis C virus antibody of 494 patients were positive (1.7%). When patients were divided into 9 age groups, the age speciifc prevalence of hepatitis C virus antibody were 0.2%, 1.7%, 1.2%, 1.1%, 1.5%, 1.9%,2.6%, 2.4%and 2%, respectively. The prevalence of hepatitis C virus antibody in non-surgical department and surgical department was 3%and 1%, respectively. The prevalence of hepatitis C virus antibody of males was higher than that of the females. Total of 194 patients with positive hepatitis C virus antibody were tested for hepatitis C virus RNA, the RNA level of 113 patients (58.2%) were higher than the low detection limit. Conclusions The prevalence of hepatitis C virus antibody was relatively high among patients of general tertiary hospital. Age group of 60-69, males and patients in non-surgical departments were factors associated with high rate of hepatitis C virus infection.

  12. Postoperative complications of pediatric dental general anesthesia procedure provided in Jeddah hospitals, Saudi Arabia

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    Almushayt Abdullah

    2009-02-01

    Full Text Available Abstract Background Review of post-operative morbidity reports for pediatric dental care under general anesthesia (GA show great variations. Until now, no morbidity data has been available to estimate the safety of pediatric patients under GA for dental rehabilitation in Saudi Arabia. The purposes of this study were to (1 investigate post-operative complications associated with dental care under GA and (2 correlate morbidity reports with patient's characteristics, dental procedures, and hospital protocol. Methods Study sample included 90 children attending GA for dental treatment at major governmental hospitals in Jeddah. Data were collected from every patient on three occasions, intra-operatively at the operating room, and post-operatively via phone calls in the first and third days after operation. Results Results showed that 99% of the children had one or more complaints in the first day in contrast to only 33% in the third day. Inability to eat (86%, sleepiness (71%, and pain (48% were the most common complaints in the first day, followed by bleeding (40%, drowsiness (39%, sore throat (34%, vomiting (26%, psychological changes (24%, fever (21%, cough (12%, and nausea (8%. A great significant complaints reduction was reported by the third post-operative day. Age, gender, admission type of the patients and GA duration were the factors that showed a significant relationship with post-operative complaints. Conclusion Post-operative morbidity was common, but mostly of mild severity and limited to the first day. Hospital staff efforts should be directed to control commonly reported postoperative complaints.

  13. Profile of Vitamin D in patients attending at general hospital Mahad India

    Science.gov (United States)

    Bawaskar, Parag Himatrao; Bawaskar, Himmatrao Saluba; Bawaskar, Pramodini Himmatrao; Pakhare, Abhijit Patilbuwa

    2017-01-01

    Background: Despite abundant sunshine, Vitamin D deficiency is prevalent in urban India. However, reports on analyzing Vitamin D status from rural Indian population are scanty. Here, we have evaluated Vitamin D status in patients attending outpatient department (OPD) in a rural Indian hospital setting. Methods: A hospital-based cross-sectional study was conducted at a secondary level rural hospital in patients attending medicine OPD. After obtaining informed consent, demographic information was collected from consecutive adult patients along with 3 ml blood sample for Vitamin D analysis using electro chemiluminescene on cobas elecys E411 fully automated system. Vitamin D levels were compared across various groups by using Mann–Whitney or Kruskal–Wallis tests, and multiple linear regression analysis was performed to identify the predictors of Vitamin D level. Results: A total of 640 patients were enrolled in the study, and the prevalence of Vitamin D deficiency (<20 ng/ml) was found to be 65.4% with 95% confidence interval of 61.7–69.1%. On univariate analysis, Vitamin D levels were statistically significantly lower among younger age group, those who have dark complexion, wearing Burkha (veil), and those who were not adequately exposed to sunlight. After multiple linear regressions, dark complexion, wearing Burkha, inadequate exposure to sunlight, and presence of diabetes were identified as statistically significant predictors of Vitamin D deficiency. Conclusion: We report a high prevalence of Vitamin-D deficiency in patients attending medicine OPD. Thus, patients with generalized complaints may be evaluated for serum Vitamin D levels. PMID:28217511

  14. Using path analysis to examine causal relationships among balanced scorecard performance indicators for general hospitals: the case of a public hospital system in Taiwan.

    Science.gov (United States)

    Yang, Ming-Chin; Tung, Yu-Chi

    2006-01-01

    Examining whether the causal relationships among the performance indicators of the balanced scorecard (BSC) framework exist in hospitals is the aim of this article. Data were collected from all twenty-one general hospitals in a public hospital system and their supervising agency for the 3-year period, 2000-2002. The results of the path analyses identified significant causal relationships among four perspectives in the BSC model. We also verified the relationships among indicators within each perspective, some of which varied as time changed. We conclude that hospital administrators can use path analysis to help them identify and manage leading indicators when adopting the BSC model. However, they should also validate causal relationships between leading and lagging indicators periodically because the management environment changes constantly.

  15. [A proposal to improve nursing fee differentiation policy for general hospitals using profitability-analysis in the national health insurance].

    Science.gov (United States)

    Kim, Sungjae; Kim, Jinhyun

    2012-06-01

    The purpose of this study was to propose optimal hospitalization fees for nurse staffing levels and to improve the current nursing fee policy. A break-even analysis was used to evaluate the impact of a nursing fee policy on hospital's financial performance. Variables considered included the number of beds, bed occupancy rate, annual total patient days, hospitalization fees for nurse staffing levels, the initial annual nurses' salary, and the ratio of overhead costs to nursing labor costs. Data were collected as secondary data from annual reports of the Hospital Nursing Association and national health insurance. The hospitalization fees according to nurse staffing levels in general hospitals are required to sustain or decrease in grades 1, 2, 3, 4, and 7, and increase in grades 5 and 6. It is suggested that the range between grade 2 and 3 be sustained at the current level, the range between grade 4 and 5 be widen or merged into one, and the range between grade 6 and 7 be divided into several grades. Readjusting hospitalization fees for nurse staffing level will improve nurse-patient ratio and enhance the quality of nursing care in hospitals. Follow-up studies including tertiary hospitals and small hospitals are recommended.

  16. Functional recovery of elderly patients hospitalized in geriatric and general medicine units. The PROgetto DImissioni in GEriatria Study.

    Science.gov (United States)

    Palleschi, Lorenzo; De Alfieri, Walter; Salani, Bernardo; Fimognari, Filippo Luca; Marsilii, Alberto; Pierantozzi, Andrea; Di Cioccio, Luigi; Zuccaro, Stefano Maria

    2011-02-01

    To investigate the characteristics of patients who regain function during hospitalization and the differences in terms of functional outcomes between patients admitted to geriatric and general medicine units. Multicenter, prospective cohort study. Acute care geriatric and medical wards of five Italian hospitals. One thousand forty-eight elderly patients hospitalized for acute medical diseases. Functional status 2 weeks before hospital admission (baseline), at admission, and at discharge, as measured using the Barthel Index (BI). Geriatric patients were older (P<.001) and had lower preadmission functional levels (P<.001) than medical patients. Between baseline and discharge, 43.2% of geriatric and 18.9% of medical patients declined in physical function. In the subpopulation of 464 patients who had declined before hospitalization (between baseline and admission), 59% improved during hospitalization (45% of geriatric and 75% of medical patients), whereas only approximately 1% declined further. High baseline function (odds ratio (OR)=1.03, 95% confidence interval (CI)=1.02-1.04, per point of BI) and greater functional decline before hospitalization (OR 0.95, 95% CI 0.94-0.97, per % point of BI decline) were significant predictors of in-hospital functional improvement; type of hospital ward and age were not. Although geriatric patients have overall worse functional outcomes, in-hospital functional recovery may be frequent even in geriatric units, particularly in patients with greater preadmission functional loss and high baseline level of function. © 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.

  17. [Prevalence of negative stereotypes towards old age among personnel of a general hospital].

    Science.gov (United States)

    Franco S, Mireya; Villarreal R, Enrique; Vargas D, Emma R; Martínez G, Lidia; Galicia R, Liliana

    2010-08-01

    Social representations are value systems. Social stereotypes are a social consensus of traits associated with a specific group. Stereotypes about older subjects, generally have negative connotations. To assess the prevalence of negative stereotypes towards older subjects among health care personnel. A questionnaire about stereotypes towards old age, with Likert type questions that included health, social motivations and personality-character domains, was applied to 52 doctors, 12 residents, 80 general nurses, 36 auxiliary nurses, four social workers and 10 medical assistants, working at a general hospital. The mean age of the professionals who answered the questionnaire was 38 years (95% confidence intervals (CI) 37-39 years) and 78% were women. The prevalence of a Global negative stereotype was 65.0%(95% CI: 59.5-70.5). The figure for the health domain was 64.5% (IC95%; 59.0-70.0), for the social motivation domain was 60%(5%CI: 54.3-65.7) and for the character personality domain was 64% (95%CI: 58.4-69.6). There is a high prevalence of a negative stereotype towards old age among health care personnel.

  18. [Clinical and epidemiological characteristics of humeral supracondylar fractures in pediatric patients in a Regional General Hospital].

    Science.gov (United States)

    Barrón-Torres, Erika Alejandrina; Sánchez-Cruz, Juan Francisco; Cruz-Meléndez, José Ramses

    2015-01-01

    Supracondylar humerus fractures are common in children between 5-7 years of age and more frequent in the males, 90-95% of these fractures are in extension mechanism, the urgency of immediate attention is to prevent complications and sequelae. To establish the clinical and epidemiological profile of supracondylar humerus fractures, in a General Regional Hospital from the Instituto Mexicano del Seguro Social in Yucatan Mexico, during 2011-2013. A cross-sectional study. Strength association was measured by odds ratios and statistical significance with chi(2) test, p value was considered in < 0.05 RESULTS: 56 cases were analyzed, the mean age was 2.6 ± 5.33 years, the mechanism of injury was falling over at home, male gender is associated with extent injure mechanism (OR 5.6, 95% CI 1.0-30.1, p = 0.03), we observed that at most time elapsed between injury and medical means more hospital days (r = 0.40; p = 0.002), surgical treatment was established in 44 cases (78.6%), 18 (40.9%) with closed technique and placement of cloves and 26 (59.1%) with open reduction, in 100% cross configuration was used, ten complications were reported. Supracondylar humerus fractures are a common injury in children, males are more likely to be injured by extension, and the speed in medical treatment is an important issue. Copyright © 2015. Published by Masson Doyma México S.A.

  19. Finger Replantation in Sanglah General Hospital: Report of Five Cases and Literature Review

    Directory of Open Access Journals (Sweden)

    Agus Roy Rusly Hariantana Hamid

    2016-11-01

    Full Text Available Background: Replantation is the prime treatment for amputated hands and fingers due to functional and aesthetic advantages. The absolute indications for replantation are amputations of the thumb, multiple fingers, trans metacarpal or hand, and any upper extremity in a child, regardless of the amputation level. A fingertip amputation distal to the insertion of the flexor digitorum superficialis (FDS is also a good indication. Indications have been expanded to include amputation at nail level, and when there is a request from the patient, replantation is attempted even for a single finger amputation regardless of the amputation level. Based on the mechanism of injury, a clean-cut sharp amputation is more likely replanted compare to a crush and avulsion injuries. With a proper management of the amputated finger, replantation can be attempted even after 24 hours. This report was written to provide examples of finger replantation cases and the measures that can be taken in a resource-limited hospital in order to conduct a replantation. Case Series: We reported five out of nine digital replantation cases in Sanglah General Hospital between January and July 2014. Two patients were a six and an eleven years old boys who accidentally cut their finger while playing, the rests were male labors between 20-30 years old whose amputations due to machine injuries. Result: A 100% replant survival was achieved. After a period of follow up with occupational therapy, all patients regain good functional and cosmetic results. 

  20. Large-eddy simulation of airflow and heat transfer in a general ward of hospital

    Science.gov (United States)

    Hasan, Md. Farhad; Himika, Taasnim Ahmed; Molla, Md. Mamun

    2016-07-01

    In this paper, a very popular alternative computational technique, the Lattice Boltzmann Method (LBM) has been used for Large-Eddy Simulation (LES) of airflow and heat transfer in general ward of hospital. Different Reynolds numbers have been used to study the airflow pattern. In LES, Smagorinsky turbulence model has been considered and a discussion has been conducted in brief. A code validation has been performed comparing the present results with benchmark results for lid-driven cavity problem and the results are found to agree very well. LBM is demonstrated through simulation in forced convection inside hospital ward with six beds with a partition in the middle, which acted like a wall. Changes in average rate of heat transfer in terms of average Nusselt numbers have also been recorded in tabular format and necessary comparison has been showed. It was found that partition narrowed the path for airflow and once the air overcame this barrier, it got free space and turbulence appeared. For higher turbulence, the average rate of heat transfer increased and patients near the turbulence zone released maximum heat and felt more comfortable.

  1. 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.

  2. Liver biopsy in a district general hospital: Changes over two decades

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To study liver biopsy practice over two decades in a district general hospital in the United Kingdom. METHODS: We identified all patients who had at least one liver biopsy between 1986 and 2006 from the databases of the radiology and gastroenterology departments. Subjects with incomplete clinical data were excluded from the study. RESULTS: A total of 103 liver biopsies were performed. Clinical data was available for 88 patients, with 95 biopsies. Between 1986 and 1996, 18 (95%) out of the 19 liver biopsies performed were blind and 6 (33%) were for primary biliary cirrhosis. Between 1996 and 2006, 14 (18%) out of 76 biopsies were blind; and the indications were abnormal liver tests (33%), hepatitis C (12%) and targeted-biopsies (11%). Liver biopsies were unhelpful in 5 (5%) subjects. Pain was the most common complication of liver biopsy (5%). No biopsy-related mortality was reported. There was a trend towards more technical failures and complications with the blind biopsy technique. CONCLUSION: Liver biopsies performed in small district hospitals are safe and useful for diagnostic and staging purposes. Abnormal liver tests, non-alcoholic fatty liver disease and targeted biopsies are increasingly common indications. Ultrasound-guided liver biopsies are now the preferred method and are associated with fewer complications.

  3. Motivation and job satisfaction among medical and nursing staff in a Cyprus public general hospital

    Science.gov (United States)

    2010-01-01

    Background The objective of this study was to investigate how medical and nursing staff of the Nicosia General Hospital is affected by specific motivation factors, and the association between job satisfaction and motivation. Furthermore, to determine the motivational drive of socio-demographic and job related factors in terms of improving work performance. Methods A previously developed and validated instrument addressing four work-related motivators (job attributes, remuneration, co-workers and achievements) was used. Two categories of health care professionals, medical doctors and dentists (N = 67) and nurses (N = 219) participated and motivation and job satisfaction was compared across socio-demographic and occupational variables. Results The survey revealed that achievements was ranked first among the four main motivators, followed by remuneration, co-workers and job attributes. The factor remuneration revealed statistically significant differences according to gender, and hospital sector, with female doctors and nurses and accident and emergency (A+E) outpatient doctors reporting greater mean scores (p 55 years of age reported higher job satisfaction when compared to the other groups. Conclusions The results are in agreement with the literature which focuses attention to management approaches employing both monetary and non-monetary incentives to motivate health care professionals. Health care professionals tend to be motivated more by intrinsic factors, implying that this should be a target for effective employee motivation. Strategies based on the survey's results to enhance employee motivation are suggested. PMID:21080954

  4. Motivation and job satisfaction among medical and nursing staff in a Cyprus public general hospital

    Directory of Open Access Journals (Sweden)

    Kontodimopoulos Nick

    2010-11-01

    Full Text Available Abstract Background The objective of this study was to investigate how medical and nursing staff of the Nicosia General Hospital is affected by specific motivation factors, and the association between job satisfaction and motivation. Furthermore, to determine the motivational drive of socio-demographic and job related factors in terms of improving work performance. Methods A previously developed and validated instrument addressing four work-related motivators (job attributes, remuneration, co-workers and achievements was used. Two categories of health care professionals, medical doctors and dentists (N = 67 and nurses (N = 219 participated and motivation and job satisfaction was compared across socio-demographic and occupational variables. Results The survey revealed that achievements was ranked first among the four main motivators, followed by remuneration, co-workers and job attributes. The factor remuneration revealed statistically significant differences according to gender, and hospital sector, with female doctors and nurses and accident and emergency (A+E outpatient doctors reporting greater mean scores (p 55 years of age reported higher job satisfaction when compared to the other groups. Conclusions The results are in agreement with the literature which focuses attention to management approaches employing both monetary and non-monetary incentives to motivate health care professionals. Health care professionals tend to be motivated more by intrinsic factors, implying that this should be a target for effective employee motivation. Strategies based on the survey's results to enhance employee motivation are suggested.

  5. The occurrence of Enterobacteriaceae producing KPC carbapenemases in a general hospital in Curacao

    Science.gov (United States)

    2014-01-01

    Background Although the presence of Carbapenemase-producing Enterobacteriaceae (CPE) are extensively documented in North and South America. CPE have not been reported from Curacao. However, recently intercontinental spread was suggested of a KPC carbapenemase producing Klebsiella pneumoniae in a patient in the United Kingdom with previous admission to a hospital in Curacao in 2009. Findings After the introduction of the CLSI 2010 revised breakpoints, seven patients with carbapenemase-producing Enterobacteriaceae were found in a general hospital in Curacao over a period of 16 months. Four patients carried KPC-2 positive Klebsiella pneumoniae, ST11. Two patients carried KPC-3 positive Klebsiella pneumoniae ST258 and one patient carried a KPC-3 positive Citrobacter freundii. Furthermore, our Klebsiella pneumoniae KPC-2 ST11 strain was matched to the Klebsiella pneumoniae KPC-2 ST11 strain in the United Kingdom. Conclusions Introduction of new laboratory methods, and adoption of new guidelines and breakpoints led to the first detection of CPE in Curacao. By matching our Klebsiella pneumoniae KPC-2 ST11 strain to a Klebsiella pneumoniae KPC-2 ST11 strain in the United Kingdom, we suggest that carbapenemase-producing Enterobacteriaceae are probably more prevalent in Curacao than previously recognized. PMID:25132965

  6. FLU IN CHILDREN AFTER A PANDEMIC IN ST. PETERSBURG GENERAL HOSPITAL

    Directory of Open Access Journals (Sweden)

    E. A. Dondurey

    2014-01-01

    Full Text Available Flu monitoring was carried out in children’s general hospital in St. Petersburg within three epidemic seasons (2010–2011, 2011–2012 and 2012–2013. 1916 patients under the age of 18 years were examined with the complex of virologic tests . The natural decreasing of flu incidence and predominant diagnosing in etiologic structure one of the virus serotypes [in the first A(H1N1pdm09, in the second — A(H3N2] have been observed during the first two years after a pandemic. In the third season restoration of the main characteristics of epidemic flu situation were detected: polietiology with annual change of serotypes proportions, late start (winter and spring, majority of younger children among hospitalaized patients and a mild course of disease. The most probable candidates [viruses of a subtype A(H3N2] are revealed as a causal factor of significant increasing of disease incidence with the severe forms in the near future. Laboratory data were confirmed by increase in frequency of the complicated by pneumonia ARI at hospitalized patients during the periods of their maximum registration. All isolates received during the study were corresponded to the referens-strains included in vaccines. Thus, timely and appropriate vaccination during the studied period had to become an effective protection against a flu.

  7. Client perception of service quality at the outpatient clinics of a General hospital in Lagos, Nigeria.

    Science.gov (United States)

    Ogunnowo, Babatunde Enitan; Olufunlayo, Tolulope Florence; Sule, Salami Suberu

    2015-01-01

    Service quality assessments have assumed increasing importance in the last two decades. They are useful in identifying gaps in services been provided with the ultimate aim of guaranteeing quality assurance. The objective of this study was to assess the client perception of service quality at the outpatient clinics of Randle General hospital, Lagos. A descriptive cross sectional study was conducted from March to May 2013. A multistage sampling technique was used to select respondents and data was collected with the aid of modified SERVQUAL questionnaires. The data was analysed with aid of EPI-INFO 2002 and statistical significance was set at a P value 0.05 for statistical significance. Total of 400 respondents were interviewed. The mean age was 40 years with a standard deviation of 15.2 yrs. The highest mean score of 4.35 out of a possible maximum of 5 was recorded in assurance domain while the lowest mean score of 4.00 was recorded in the responsiveness domain. The overall mean score of all the domains was 4.20 with standard deviation of 0.51. Overall majority (80.8%) of respondents rated the overall service quality as good/ very good. After linear regression, the assurance domain was the most important predictor of the overall perceived service quality (pservice quality was good. The major deficiencies were in the responsiveness domain and especially the waiting time. The hospital management should implement measures to improve the responsiveness of services by ensuring prompt delivery of services.

  8. Quality of stroke care at an Irish Regional General Hospital and Stroke Rehabilitation Unit.

    LENUS (Irish Health Repository)

    Walsh, T

    2012-01-31

    BACKGROUND: Robust international data support the effectiveness of stroke unit (SU) care. Despite this, most stroke care in Ireland are provided outside of this setting. Limited data currently exist on the quality of care provided. AIM: The aim of this study is to examine the quality of care for patients with stroke in two care settings-Regional General Hospital (RGH) and Stroke Rehabilitation Unit (SRU). METHODS: A retrospective analysis of the stroke records of consecutive patients admitted to the SRU between May-November 2002 and April-November 2004 was performed applying the UK National Sentinel Audit of Stroke (NSAS) tool. RESULTS: The results of the study reveal that while SRU processes of care was 74% compliant with standards; compliance with stroke service organisational standards was only 15 and 43% in the RGH and SRU, respectively. CONCLUSION: The quality of stroke care in our area is deficient. Comprehensive reorganisation of stroke services is imperative.

  9. Patient profile and outcome of pilomatrixoma in district general hospital in United Kingdom

    Directory of Open Access Journals (Sweden)

    Mahmoud AbdelDayem

    2013-01-01

    Full Text Available Introduction: A pilomatrixoma is a benign appendage tumour related to hair cells matrix. Most of the literature review about pilomatrixoma is in the form of case reports with fewer cohort studies. The objective of this cohort is to study the variable demographic characteristics, presentation and histopathology of this condition among a larger group of patients. Materials and Methods: We conducted a retrospective study of patients who had excision of pilomatrixoma between February 1998 and August 2011 in a District General Hospital in UK. Results: The study included 67 patients with histopathologically diagnosed pilomatrixoma. The mean age was 32 years. Male to Female ratio was 35:32. The average diameter of the lesion at presentation was 13 mm (range: 2-30 mm. 66 of 67 (98.5% patients presented with solitary lesion, while 1 patient (1.5% had two lesions. Conclusion: Pilomatrixoma is not an uncommon benign lesion. It is more common in the maxillofacial area.

  10. [Professional practice of nurses who care for cancer patients in general hospitals].

    Science.gov (United States)

    da Silva, Josiane Travençolo; Matheus, Maria Clara Cassuli; Fustinoni, Suzete Maria; de Gutiérrez, Maria Gaby Rivero

    2012-01-01

    The present article discusses a qualitative study which aimed to understand the typical of nurses' professional practice caring for patient with cancer in general hospitals. In order to find out the reasons that motivate nurse's action, and to put in evidence what is original, significant, specific and typical about this phenomenon, we have taken into consideration the premises of the philosopher Alfred Schütz, which provide us with subsidies to unveil them. The data collected through semi-structured interviews reported that nurses admit not having the required theoretical knowledge and experience or enough practice to take care of a cancer patient. Thus, they don't feel capable of developing actions which may positively influence care on patients and their family members.

  11. [Histrionic personality disorder in a psychiatry department at a general hospital].

    Science.gov (United States)

    Abril, A; Valle, J; Moreno, D; de Miguel, D; Molina, D

    1991-01-01

    The personality disturbances imply problem within the psychiatric assistance, both for its difficult delimitation and classification and for the limited results and bad use obtained from therapeutic resources. We studied 402 patients psychiatric service of a general hospital over a period approximately 2 years, 70 (17.5%) were diagnosed DSM-III with Personality disturbances: 44 females (62.9%) and 26 males (37.1%), of an age group between 18 and 67 years old. The most frequent diagnosis was of histrionic of the personality followed by unspecific and border-line. Within the histrionic disturbance of the personality there was a clear predominance of women, whereas in the others types, no significant differences were observed.

  12. The Montreal General Hospital Pain Centre (1974-2000: The Contributions of Ronald Melzack

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    Mary Ellen Jeans

    2000-01-01

    Full Text Available This paper chronicles the development of the Montreal General Hospital Pain Centre from its inception in 1974 to the present. Highlighted in particular are the contributions of Ronald Melzack to this history. Data for the article arose, in the main, from an interview with Dr Melzack carried out earlier in the year. Discussions with former and present members of the pain centre team, including former graduate students, provided additional information. The article begins with a recounting of those individuals and events that inspired Ron early in his 'pain career' to pursue his dream of a multidisciplinary pain centre, the first of its kind in Canada. The forces that helped shape the development of this centre and the challenges that had to be overcome are described.

  13. STUDY OF DROPOUTS FROM A PSYCHIATRIC CLINIC OF A GENERAL HOSPITAL

    Science.gov (United States)

    Gill, H.P.S.; Singh, Gurmeet; Sharma, Kuldip C.

    1990-01-01

    SUMMARY During the study period of three months, out of 425 patients attending the psychiatric clinic of a general hospital, for the first time, 165 (38.8%) did not complete the treatment as prescribed by the doctors and were considered as dropouts. They were contacted at their homes to find out the reasons of the dropping out, were compared with patients, who completed the treatment fully on socio-demographic variables and attitude towards treatment. Dropouts significantly differed from treatment acceptors regarding their income, place of domicile and occupation. Maximum number of patients (59.9%) dropped out after the first visit. Dropouts were the maximum among epileptics, and minimum among the mentally retarded patients. Dropouts were dissatisfied with their experience at the clinic as treatment advised was not of their choice, and they feared bad side effects from ECT and drugs. Long distance of residence from clinic was an important reason for dropping out, besides social and economic reasons. PMID:21927444

  14. Prevalence trends of oral squamous cell carcinoma. Mexico City’s General Hospital experience

    Science.gov (United States)

    Hernández-Guerrero, Juan C.; Jacinto-Alemán, Luís F.; Jiménez-Farfán, María D.; Macario-Hernández, Alejandro; Hernández-Flores, Florentino

    2013-01-01

    Objective: Recent reports suggest an increase in oral squamous cell carcinoma (OSCC) frequency. To improve programs in public health, it is necessary to understand the epidemiological conditions. The aim of this study was to analyze the trend in gender, age, anatomic zone and OSCC stage from Mexico City’s General Hospital patients from 1990 to 2008. Study design: A retrospective review of all OSCC cases diagnosed by the Pathology Department of the Mexico City General Hospital was performed. Demographic data, in addition to anatomic zone and histological degree of differentiation were obtained. Central tendency, dispersion and prevalence rate per 100,000 individuals were determined. Results: A total of 531 patients were diagnosed with OSCC; 58.4% were men, giving a male:female ratio of 1.4:1, and the mean age was 62.5 ± 14.9 years. The predominant anatomic zone was the tongue (44.7%), followed by the lips (21.2%) and gums (20.5%). The most frequent histological degree was moderately differentiated in 325 cases (61.2%). The rates of OSCC prevalence showed similar patterns in terms across time. A significant correlation (P = 0.007) between anatomic zone and age was observed. Conclusion: According to our results, the prevalence of OSCC does not show important variations; however, a relationship between age and anatomic zone was observed. These data could be used as parameters for the diagnosis of OSCC as well as for the development and dissemination of preventive programs for the early detection of oral cancer. Key words:Oral squamous cell carcinoma, prevalence, histology degree and anatomic zone. PMID:23385493

  15. Herniated Nucleus Pulposus in Dr. Hasan Sadikin General Hospital Bandung Indonesia

    Directory of Open Access Journals (Sweden)

    Annisa Ikhsanawati

    2015-06-01

    Full Text Available Background: Herniated nucleus pulposus (HNP is one of the most common diseases of the spine. For an optimal management and prevention, there’s a need for data on factors related to the onset of complaints because this disease lowers the quality of life and increases morbidity. This study is aimed to see the scale and pattern of the HNP in Dr. Hasan Sadikin General Hospital, Bandung. Methods: This is a descriptive study with the design of case series, data was obtained from medical records of patients with the diagnosis of HNP in the inpatient care of Dr. Hasan Sadikin General Hospital in the period of 2007–2011. Results: According to the study on 79 patients, with 43 men and 36 women, the highest incidence was at the age group of 51–60 years old (31.6% and most common occupation was civil servant (11.4%. The most common clinical symptoms were sciatica (51.9% and low back pain (51.9%. Most frequent location was in the lumbar vertebrae at the level of L5–S1 (58.2%. Trauma was found to be the highest relatable history in the patients (39.2%. Therapy of choice was primarily conservative (58.2% and most patients went home after the progression (84.8%. The year 2007 showed the highest prevalence of HNP at 25.3%. The most common clinical symptoms were sciatica (51.9% and low back pain (51.9% Conclusions: The most common clinical symptoms were sciatica and low back pain. Most frequent location was in the lumbar vertebrae at the level L5–S1.

  16. Comparative heart failure profile over a 3-year period in a Romanian general hospital

    Directory of Open Access Journals (Sweden)

    Pop D

    2013-07-01

    Full Text Available Dana Pop,1 Oana Maria Penciu,1 Adela Viviana Sitar-Taut,2 Dumitru Tudor Zdrenghea11Department of Cardiology, Clinical Rehabilitation Hospital, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania; 2"Babes-Bolyai" University, Cluj-Napoca, RomaniaBackground: Heart failure (HF has become an increasingly significant public health problem, associated with repeated hospitalizations, high costs, low quality of life, and decreased survival rate. The progress of the disease may be slowed if treatment is administered in accordance with current guidelines.Objectives: To compare the clinical profile of HF patients in a Romanian general hospital over a 3-year period.Methods and results: We studied two cohorts of patients admitted in the cardiology department of a rehabilitation hospital with a diagnosis of chronic HF New York Heart Association class II–IV. The first, in 2006, included 415 patients, 67.08 ± 10.59 years; the second, in 2009, included 500 patients, 67.31 ± 11.27 years. Considering all patients, the left ventricle ejection fraction (LVEF was not statistically different in the two cohorts. Compared to the 2006 cohort, the 2009 female cohort had higher LVEF (60.49% ± 13.41% vs 64.42% ± 13.79%, P < 0.05, while males over 65 years of age had lower LVEF (52.75% ± 15.02% vs 54.37% ± 15.23%, P = NS. For females, the probability of having LVEF ,45% was higher in 2006 (odds ratio = 1.573. HF with preserved LVEF was more common in females, both in 2006 (78.2% vs 54.2% and 2009 (87.2% vs 57.3%. In the 2009 cohort, LVEF was higher both in young patients (59.08% ± 14.22% vs 55.35% ± 14.92% and patients ≥ than 75 years of age (62.28% ± 13.81% vs 56.79% ± 14.81% compared to the 2006 cohort. Ischemic heart disease was the main underlying cause for HF in both cohorts.Conclusion: HF appeared to have the same clinical profile over a 3-year period. Females diagnosed with HF showed higher rates of preserved LVEF.Keywords: heart

  17. PREVALENCE AND QUALITY OF LIFE OF PEMPHIGUS PATIENTS AT SANGLAH GENERAL HOSPITAL BALI-INDONESIA

    Directory of Open Access Journals (Sweden)

    M Wardhana

    2013-01-01

    Full Text Available Objectives: Pemphigus vulgaris (PV is an autoimmune-blistering disease of the skin and mucous membranes caused by auto-antibodies against desmoglein-3 (Dsg-3 on the keratinocyte cell surface of squamous stratified epithelia. Pemphigus is a life-threatening autoimmune bullous disease resulting in the widespread denudation of skin and mucous membrane and severe impact of quality of life. Thepurpose of this study was to evaluate retrospectively the prevalence of pemphigus and to elucidate the clinical variants, clinical course, prognosis and quality of life (QOL of pemphigus patients after discharge from hospitalized.Method: Observational non analytical retrospective study was conducted by observation of the medical records of all the newly registered patients with pemphigus at SanglahGeneral Hospital in Bali-Indonesia during the period of January 1995 and December 2002, and analyzed with regard to personal statistic, history of the diseases including onset, site of affected, symptoms, clinical diagnosis, severity, associated illness, therapy, and quality of life based on theFinlay’s methods.Results: During the 8-year periods studies, 33 pemphigus patients were admitted, represented 5.8 % of all patients admitted in our in-patient ward during the periods. Our patients consist of female 20 patients (60.6 % and male 13 patients (39.4 %. The most common of clinicaltype was pemphigus vulgaris 26 patients (78.78 %, followed by pemphigus foleaceous and pemphigus vegetans. Six patients (18.18 % of 16 severe patients with severe condition at the clinical course of the diseases was death during the course of hospitalized. A number of 2 patients, in thisstudy were observed with severe impact of quality of life.Conclusion: Our finding showed that pemphigus vulgaris is common type of our cases has a relatively high prevalence our hospital (5.8 %, and relatively high death rate (18.18 %. In our study, systemic corticosteroid was still applied

  18. hospital

    African Journals Online (AJOL)

    Pattern of congenital orthopaedic malformations in an African teaching hospital ... malformation in this environment while congenital hip dislocation (CDH) is rare when .... malformations of radial dysplasia and other congenital malformations.

  19. Composition and production rate of pharmaceutical and chemical waste from Xanthi General Hospital in Greece.

    Science.gov (United States)

    Voudrias, Evangelos; Goudakou, Lambrini; Kermenidou, Marianthi; Softa, Aikaterini

    2012-07-01

    The objective of this work was to determine the composition and production rates of pharmaceutical and chemical waste produced by Xanthi General Hospital in Greece (XGH). This information is important to design and cost management systems for pharmaceutical and chemical waste, for safety and health considerations and for assessing environmental impact. A total of 233 kg pharmaceutical and 110 kg chemical waste was collected, manually separated and weighed over a period of five working weeks. The total production of pharmaceutical waste comprised 3.9% w/w of the total hazardous medical waste produced by the hospital. Total pharmaceutical waste was classified in three categories, vial waste comprising 51.1%, syringe waste with 11.4% and intravenous therapy (IV) waste with 37.5% w/w of the total. Vial pharmaceutical waste only was further classified in six major categories: antibiotics, digestive system drugs, analgesics, hormones, circulatory system drugs and "other". Production data below are presented as average (standard deviation in parenthesis). The unit production rates for total pharmaceutical waste for the hospital were 12.4 (3.90) g/patient/d and 24.6 (7.48) g/bed/d. The respective unit production rates were: (1) for vial waste 6.4 (1.6) g/patient/d and 13 (2.6) g/bed/d, (2) for syringe waste 1.4 (0.4) g/patient/d and 2.8 (0.8) g/bed/d and (3) for IV waste 4.6 (3.0) g/patient/d and 9.2 (5.9) g/bed/d. Total chemical waste was classified in four categories, chemical reagents comprising 18.2%, solvents with 52.3%, dyes and tracers with 18.2% and solid waste with 11.4% w/w of the total. The total production of chemical waste comprised 1.8% w/w of the total hazardous medical waste produced by the hospital. Thus, the sum of pharmaceutical and chemical waste was 5.7% w/w of the total hazardous medical waste produced by the hospital. The unit production rates for total chemical waste for the hospital were 5.8 (2.2) g/patient/d and 1.1 (0.4) g/exam/d. The respective

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

    OpenAIRE

    Aleksic Dejan; Bukonjic Andriana; Stefanovic Srdjan

    2015-01-01

    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.

  1. 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.

  2. CLINICAL STUDY ON PA NCREATIC CANCER IN G OVERNMENT GENERAL HOSPITAL, GU NTUR, AP, INDIA

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    Ch. Kalyan

    2015-03-01

    Full Text Available Pancreatic cancer has a lower incidence than many other types of cancer, but is the fourth most common cause of death from cancer, among men and women, being responsible for 6% of all cancer - related deaths. The global annual incidence rate for pancreas cancer is about 8/100,000 persons. Pancreatic cancer disease is notoriously difficult to diagnose in its early stages. Study was carried out in the Department of General Surgery, Government General Hospital, Guntur from October 2010 to 2012, in which 16 cases with a diagnosis of carcinoma pancreas. They were investigated with routine blood investigations. They were treated accordingly with Pylorus preserving pancreaticodenectomy (PPPD or palliative bypass or with non - operative palliative measures. Carcinoma pancreas is an aggressive disease with male preponderance with peak incidence in 5th and 6th decade. Important risk factors are Smoking and alcohol consumption. Nearly 75% of the cases presented in the late stage of the disease. Resection of the tumour had better survival. The limitations of our study are small number of patients and short follow - up

  3. Nurses' experiences of caring for South Asian minority ethnic patients in a general hospital in England.

    Science.gov (United States)

    Vydelingum, Vasso

    2006-03-01

    Healthcare provision for minority ethnic groups in the UK has generally revealed inequalities in access and differential service provision. British healthcare policy has started to address such issues. However, very few studies have specifically examined the experiences of nurses caring for minority ethnic patients. This paper focuses on the focus group interviews of a broader ethnographic study, aimed at describing nurses' experiences of caring for South Asian minority ethnic patients, in a general hospital in the south of England. A sample of 43 nurses of all grades from six medical wards took part in the focus groups: three ward sisters, 22 staff nurses and 18 care assistants; 40 participants were white, one was African-Caribbean and two were South Asian. Data analysis revealed eight themes: changes in service provision; false consciousness of equity; limited cultural knowledge; victim blaming; valuing of the relatives; denial of racism; ethnocentrism, and self-disclosure. The study revealed a good local service response to government policies in addressing inequality. However, there was a tendency to treat all minority ethnic patients the same, with evidence of ethnocentric practices, victim-blaming approaches and poor cultural competence in nursing staff, which raise questions about the quality of service provision. The study indicates that ongoing training and development in the area of cultural competence is necessary.

  4. Contribution of the outpatient surgery unit ITO the general surgery department of a district hospital.

    Science.gov (United States)

    Carrasco; Flores; Aguayo; de Andres B; Moreno Egea A; Cartagena; De Vicente JP; Martin

    2000-07-01

    Introduction: The creation of Outpatient Surgery (OPS) units to combine the quality of medical attention and rationalize costs allows for greater efficiency in the use of resources. Aim: To report our series of patients undergoing surgery at the OPS units integrated into our Hospital (Type II): Patients and method: Between May 1994 and March 1998, 832 outpatients, of a total of 5230, underwent surgery at our General Surgery Unit. The criteria for exclusion from the programme depended on the patient and the enviroment or resulted from the operation itself. Results: Mean patient age was 47.5 years; there were 420 males and 412 females. Surgery was performed for 229 inguinofemoral hernias, 47 umbilical-epigastric hernias, nine incisional hernias, 193 pilonidal sinuses, 156 mammary nodules, 65 varicose veins, 64 arteriovenous fistulae and 69 proctology operations. The most common anesthesia techniques performed were rachianesthesia and local anesthesia. Eight point seven percent of the patients required admission (OPS failure), the most frequent causes being excessive pain, orthostatic-syncopal hypotension, nausea and vomiting and urine retention. There was no morbidity or mortality. Conclusion: OPS is a highly efficient procedure for resolving the most common pathologies in General Surgery. The anesthesia technique was an important factor in the rate of failure.

  5. Pattern of traumatic brain injury treated by general surgeons in a tertiary referral hospital.

    Science.gov (United States)

    Chattopadhyay, Shankar Das; Karmakar, Nisith Chandra; Sengupta, Ritankar; SenGupta, Tamal Kanti; Ray, Debasis; Basus, Shibaji

    2013-09-01

    The number of polytrauma patient with associated brain injury or commonly referred as 'head injury' has increased tremendously in recent times courtesy to road traffic accident or other causes. This prospective observational study was conducted in patients of head injury admitted through emergency in the department of general surgery in NRS Medical College, Kolkata during the year 2011 to determine the pattern of head injury patients admitted and nature of intervention. A total number of 3861 patients were admitted in a single year. Obviously this represents the tip of the iceburg. Traumatic brain injury was the highest in the age group of 31-40 years (33.5%) followed by 21-30 years (29.1%) in the most fruitful phase of life. The traumatic brain injury death was more common in males. The maximum number of cases was from rural areas ie, farmers and labours. To minimise the morbidity and mortality resulting from head injury there is need for better maintenance of roads, improvement of road visibility and lighting, rigid enforcement of traffic rules and imparting road safety education to school children. Despite valiant efforts and advancement in medical sciences and infrastructure in the form of neurosurgery departments and trauma care units to cope with the changing world of trauma, there still remains a huge responsibility and a definite part to be played by the general surgeons to manage head injury patient even in tertiary hospitals.

  6. Current Status of Management in Type 2 Diabetes Mellitus at General Hospitals in South Korea

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    Jin-Hee Jung

    2015-08-01

    Full Text Available BackgroundIn Korea, the prevalence, complications, and mortality rate of diabetes are rapidly increasing. However, investigations on the actual condition of diabetes management are very limited due to lack of nation-wide research or multicenter study. Hence, we have minutely inquired the current status of diabetes management and achievement of glucose target goal in general hospital offering education program. That way, we are able to furnish data for policy making of diabetes education and draw up guideline which may allow us to reduce the morbidity and mortality of diabetes.MethodsThe subjects consisted of 2,610 patients with type 2 diabetes who visited the 13 general hospital in Seoul or Gyeonggi region from March 19 to May 29, 2013. General characteristics, associated diseases, complications, and management status were investigated.ResultsThe mean age was 61.0±11.6 years, body mass index was 25.0±3.3 kg/m2, and family history of diabetes was 50.5%. The mean duration of diabetes was 10.7±7.9 years and 53% received education about diabetes. The prevalence of hypertension and dyslipidemia were 59.2% and 65.5%, respectively, and 18.3% of the subjects were accompanied by liver disease. Diabetic retinopathy appeared in 31.6%, nephropathy in 28.1%, and neuropathy in 19.9% of the subjects. The mean glycosylated hemoglobin (HbA1c level was 7.3%±1.3% and the achieving rate based on Korean Diabetes Association guideline (HbA1c <6.5% was 24.8%, blood pressure (130/80 mm Hg or less was 49.4%, and low density lipoprotein cholesterol (<100 mg/dL was 63.6%. The reaching rate to the target level in four parameters (blood glucose, blood pressure, lipids, and body weight was 7.8%.ConclusionThe blood glucose control rate was lower than other parameters, and the implementation rate of diabetes education was only 53%. Thus more appropriate glucose control and systematic diabetes education are imperative.

  7. Prevalence of hepatitis B virus in patients with diabetes mellitus: a comparative cross sectional study at Woldiya General Hospital, Ethiopia

    OpenAIRE

    Mekonnen, Daniel; Gebre-Selassie, Solomon; Fantaw, Surafel; Hunegnaw, Andualem; Mihret, Adane

    2014-01-01

    Introduction The overall prevalence of HBV in Ethiopia varies from 4.7-16.8% for Hepatitis B surface antigen (HBsAg) and 70-76.38% for at least one marker positive. Patients suffering from type I Diabetes Mellitus (DM) incur high risk of infection with hepatotropic viruses because of frequent hospitalization and blood tests. Methods A comparative cross sectional study was conducted at Woldiya General Hospital using 108 consented study populations from Diabetes and 108 non diabetes control gro...

  8. Frecuencia e incidencia de la tromboembolia venosa en un hospital general Frequency and incidence of venous thromboembolism in a general hospital

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    Juan A. Mazzei

    2005-08-01

    Full Text Available El objetivo de este estudio fue determinar la frecuencia y la incidencia de la tromboembolia venosa (TEV, objetivamente diagnosticada, en un hospital universitario argentino. Se utilizó un diseño retrospectivo, observacional y longitudinal. Se analizaron las historias clínicas de todos los pacientes mayores de 16 años que habían egresado o fallecido en las unidades de internación clínica, obstétrica y quirúrgica del Hospital de Clínicas José de San Martín con el diagnóstico de TEV durante un período de 24 meses. La frecuencia y la incidencia de TEV fueron 0.92% y 0.40% (intervalo de confianza de 95% (IC95%: 0.37 a 0.42% respectivamente. La incidencia más alta de TEV se presentó en la novena década de la vida (0.80%; IC95%: 0.78% a 0.82%. Solamente el 31% de los pacientes que desarrollaron TEV durante la internación habían recibido tromboprofilaxis con heparina. La mortalidad intrahospitalaria global de los pacientes con TEV fue 19%.The objective of this study was to determine the frequency and incidence of venous thromboembolism (VTE in an Argentine universitary hospital. We used a longitudinal, retrospective, observational design. Participants were all over-16 year patients who were discharged or died in clinical, obstetrical and surgical units in the Hospital de Clínicas José de San Martín during a 24 month period between July 1, 2001 and June 30, 2003, with a diagnosis on release of VTE. VTE frequency reached 0.92% and incidence was 0.40%; 95% confidence interval (95% CI: 0.37 to 0.42%. Incidence was highest in the 9th decade of life (0.80%; 95% CI: 0.78% to 0.82%. Only 31% of patients who developed VTE during hospitalization had received thromboprophylaxis. Total in-hospital mortality of VTE patients was 19%.

  9. Awareness of Stroke Risk after TIA in Swiss General Practitioners and Hospital Physicians.

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    Sven Streit

    Full Text Available Transient ischemic attacks (TIA are stroke warning signs and emergency situations, and, if immediately investigated, doctors can intervene to prevent strokes. Nevertheless, many patients delay going to the doctor, and doctors might delay urgently needed investigations and preventative treatments. We set out to determine how much general practitioners (GPs and hospital physicians (HPs knew about stroke risk after TIA, and to measure their referral rates.We used a structured questionnaire to ask GPs and HPs in the catchment area of the University Hospital of Bern to estimate a patient's risk of stroke after TIA. We also assessed their referral behavior. We then statistically analysed their reasons for deciding not to immediately refer patients.Of the 1545 physicians, 40% (614 returned the survey. Of these, 75% (457 overestimated stroke risk within 24 hours, and 40% (245 overestimated risk within 3 months after TIA. Only 9% (53 underestimated stroke risk within 24 hours and 26% (158 underestimated risk within 3 months; 78% (473 of physicians overestimated the amount that carotid endarterectomy reduces stroke risk; 93% (543 would rigorously investigate the cause of a TIA, but only 38% (229 would refer TIA patients for urgent investigations "very often". Physicians most commonly gave these reasons for not making emergency referrals: patient's advanced age; patient's preference; patient was multimorbid; and, patient needed long-term care.Although physicians overestimate stroke risk after TIA, their rate of emergency referral is modest, mainly because they tend not to refer multimorbid and elderly patients at the appropriate rate. Since old and frail patients benefit from urgent investigations and treatment after TIA as much as younger patients, future educational campaigns should focus on the importance of emergency evaluations for all TIA patients.

  10. Aeromycological study at the intensive care unit of the "Dr. Manuel Gea Gonzalez" General Hospital

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    José Manuel Ríos-Yuil

    2012-10-01

    Full Text Available INTRODUCTION: An aeromycological study verifies the presence and quantifies the concentration of fungal propagules in the air. It is very important in the hospital setting because of the increasing numbers of immunosuppressed and severely ill patients. The objective of this study was to determine the concentration of fungi in the air of the intensive care unit (ICU of "Dr. Manuel Gea González" General Hospital. METHODS: This is a descriptive, observational cross-sectional study. Air samples were obtained with a single stage Thermo-Andersen Viable Particle Sampler (Thermo Electron Corporation -Massachusetts, U.S.A. in a Petri dish with potato dextrose agar for 15 minutes at two different times (morning and afternoon and heights (1 and 1.5 meters. The Petri dishes were incubated for five to seven days at 27ºC, the number of colonies was counted, and the total CFU/m³ was determined. The isolated fungal genera were identified by morphological features. Epi Info v. 3.4.3 © was used for statistical analysis. RESULTS: The mean concentration of fungi in the air of the ICU was 85.08 ± 29.19 CFU/m³; while in the outside air it was 84.3 ± 17.23 CFU/m³ (p = 0.96. The fungi isolated were: Cladosporium spp., Penicillium spp., Aspergillus spp. (non-fumigatus, Fusarium spp., Exophiala spp., Syncephalastrum spp., and Acremonium spp. DISCUSSION: Fungal spores were found in the air of the ICU and Cladosporium spp. was the most frequently isolated fungi. There was no difference according to sampling time or height.

  11. Estimation of potential donors after cardiocirculatory death in Elche University General Hospital (Alicante, Spain).

    Science.gov (United States)

    Tenza, E; Valero, R; Arraez, V

    2017-04-01

    To evaluate the number and characteristics of potential organ donors among cardiocirculatory death cases. A retrospective observational study was made of individuals between 15-65 years of age who died in the period 2006-2014 in Elche University General Hospital (Alicante, Spain). A univariate analysis and binary logistic regression predictive model were performed to discriminate factors related to donation contraindication. Identification of patients with donation contraindication. Of the 1510 patients who died in the mentioned period, 1048 were excluded due to the application of exclusion criteria; 86 due to evolution towards brain death; and 20 due to losses. A total of 356 patients were analyzed, divided into two groups: 288 in non-heart beating donation II and 68 in non-heart beating donation III. Seventy patients were found to be potential non-heart beating donation II and 10 were found to be potential non-heart beating donation III, which could increase donation activity by 8-9 donors a year. The patients died in the ICU, Resuscitation, Emergency Care, Internal Medicine, Digestive Diseases and Neurology. The following protective factors against organ donation contraindication were identified: death in Emergency Care, cardiorespiratory arrest before or during admission, and heart, respiratory and neurological disease as the cause of admission. Death in Internal Medicine was associated to an increased risk of donation contraindication. Implementing a non-heart beating donation protocol in our hospital could increase the donation potential by 8-9 donors a year. Copyright © 2016 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  12. Exploration of burnout syndrome in nurses of general hospital in Larnaka of Cyprus

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    Maritsa Gourni

    2012-10-01

    Full Text Available Health professionals belong to the group of high risk to develop burn out syndrome. According to Maslach & Jackson, "emotional exhaustion", "depersonalization" and the "reduced feeling of personal accomplishment" are the three parameters that consist the burn out syndrome. The aim of the present study was to explore burn out syndrome among nursing workforce in General Hospital of Larnaka in Cyprus. Method and material: The sample studied consisted of 100 nurses coming from 10 different departments of the hospital. Data were collected by the completion of a specially designed questionnaire for the needs of the research which apart from the socio-demographic variables included Maslach burn out questionnaire. Data analysis was conducted by the statistical package SPSS 16 and the statistical method was t-test and Anova. Results: From the 100 participants, 76% were women and 24% men. The mean age of the participants was 35,8 years old. The results showed that the participants experienced median level of burnout syndrome. Men of the sample studied experienced higher level of "emotional exhaustion" with average value 19,4 and "depersonalization" with average value 7,5 whereas reduced feeling of personal accomplishment with average 39,7. Married participants had "emotional exhaustion" with average value 20,2, "depersonalization" with average 7,6 and "feeling of personal accomplishment" with average 38,5. Presence of children had positive relation with all subscales and more specifically those who had 3 and more children had 21,1 average value of "emotional disturbance", 7,9 average "depersonalization" and 40,5 average value of "feeling of personal accomplishment". Nurses with 1-5 years previous experience had 19,9 average value of "emotional exhaustion", 7,7 of "depersonalization" and 38,7 of "feeling of personal accomplishment". Statistical analysis showed no relation with socio-demographic variables of nurses with burn out syndrome.Conclusions: It is

  13. Mortality Analysis of Trauma Patients in General Intensive Care Unit of a State Hospital

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    İskender Kara

    2015-08-01

    Full Text Available Objective: The aim of this study was to determine the mortality rate and factors affecting the mortality of trauma patients in general intensive care unit (ICU of a state hospital. Material and Method: Data of trauma patients hospitalized between January 2012 and March 2013 in ICU of Konya Numune Hospital were retrospectively analyzed. Demographic characteristics and clinical data of patients were recorded. Patients were divided into two groups as survivors and dead. Mortality rate and factors affectin mortality were examined. Results: A total of 108 trauma patients were included in the study. The mortality rate of overall group was 19.4%. Median age of the patients was 44.5 years and 75.9% of them were males. Median Glasgow Coma Scale of death group was lower (5 (3-8 vs. 15 (13-15, p<0.0001, median APACHE II score was higher (20 (15-26 vs. 10 (8-13, p<0.0001 and median duration of ICU stay was longer (27 (5-62,5 vs. 2 (1-5, p<0.0001 than those in the survival group. The most common etiology of trauma was traffic accidents (47.2% and 52.7% of patients had head trauma. The rate of patients with any fracture was significantly higher in the survival group (66.7% vs. 33.3%, p=0.007. The rate of erythrocyte suspension, fresh frozen plasma, trombocyte suspension and albumin were 38.9%, 27.8%, 0.9% and 8.3%, respectively in all group. The number of patients invasive mechanically ventilated was 27.8% and median length of stay of these patients were 5 (1.75-33.5 days. The rate of operated patients was 42.6%. The rate of tracheostomy, renal replacement therapy, bronchoscopy and percutaneous endoscopic gastrostomy enforcements were higher in the death group. The advanced age (p=0.016, OR: 1.054; 95% CI: 1.010-1100 and low GCS (p<0.0001, OR: 0.583; 95% CI: 0.456-0.745 were found to be independent risk factors the ICU mortality of trauma patients in logistic regression analysis. Conclusion: We believe that the determination of these risk factors affecting

  14. Cuidado ecológico: o significado para profissionais de um hospital geral Cuidado ecológico: el significado para profesionales de un hospital general Ecological care: meaning for health care professionals from a general hospital

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    Marli Terezinha Stein Backes

    2009-01-01

    Full Text Available OBJETIVO: Compreender à luz do pensamento complexo, o significado do cuidado ecológico e como este vem sendo associado à prática de profissionais que trabalham em um hospital geral. MÉTODOS: Estudo descritivo de natureza qualitativa realizado com 15 profissionais que atuam em três diferentes setores: Serviço de Lavanderia, Serviço de Nutrição e uma Unidade de Internação. Os dados foram coletados por meio de um questionário semi-estruturado e submetidos à análise de conteúdo proposta por Bardin. RESULTADOS: As categorias encontradas foram: Significando o cuidado ecológico, Salientando a importância do cuidado ecológico para a prática profissional e Medidas preventivas em saúde associadas ao cuidado ecológico. CONCLUSÕES: O estudo evidenciou que existe uma preocupação geral, ainda que incipiente, a respeito da problemática ambiental. A preocupação principal está relacionada à separação, reciclagem e destino adequado do lixo, mesmo que alguns profissionais tenham sinalizado para a importância de medidas preventivas como a lavagem das mãos, utilização de produtos biodegradáveis, entre outros.OBJETIVO: Comprender a La luz del pensamiento complejo, el significado del cuidado ecológico y cómo éste viene siendo asociado a la práctica de profesionales que trabajan en un hospital general. MÉTODOS: Estudio descriptivo de naturaleza cualitativa realizado con 15 profesionales que actúan en tres diferentes sectores: Servicio de Lavandería, Servicio de Nutrición y una Unidad de Internamiento. Los datos fueron recolectados por medio de un cuestionario semi-estructurado y sometidos al análisis de contenido propuesto por Bardin. RESULTADOS: Las categorías encontradas fueron: Significando el cuidado ecológico, resaltando la importancia del cuidado ecológico para la práctica profesional y Medidas preventivas en salud asociadas al cuidado ecológico. CONCLUSIONES: El estudio evidenció que existe una preocupaci

  15. Contributing factors to influenza vaccine uptake in general hospitals: an explorative management questionnaire study from the Netherlands

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    Riphagen-Dalhuisen Josien

    2012-12-01

    Full Text Available Abstract Background The influenza vaccination rate in hospitals among health care workers in Europe remains low. As there is a lack of research about management factors we assessed factors reported by administrators of general hospitals that are associated with the influenza vaccine uptake among health care workers. Methods All 81 general hospitals in the Netherlands were approached to participate in a self-administered questionnaire study. The questionnaire was directed at the hospital administrators. The following factors were addressed: beliefs about the effectiveness of the influenza vaccine, whether the hospital had a written policy on influenza vaccination and how the hospital informed their staff about influenza vaccination. The questionnaire also included questions about mandatory vaccination, whether it was free of charge and how delivered as well as the vaccination campaign costs. The outcome of this one-season survey is the self-reported overall influenza vaccination rate of health care workers. Results In all, 79 of 81 hospitals that were approached were willing to participate and therefore received a questionnaire. Of these, 42 were returned (response rate 52%. Overall influenza vaccination rate among health care workers in our sample was 17.7% (95% confidence interval: 14.6% to 20.8%. Hospitals in which the administrators agreed with positive statements concerning the influenza vaccination had a slightly higher, but non-significant, vaccine uptake. There was a 9% higher vaccine uptake in hospitals that spent more than €1250,- on the vaccination campaign (24.0% versus 15.0%; 95% confidence interval from 0.7% to 17.3%. Conclusions Agreement with positive statements about management factors with regard to influenza vaccination were not associated with the uptake. More economic investments were related with a higher vaccine uptake; the reasons for this should be explored further.

  16. Western University (No. 10 Canadian Stationary Hospital and No. 14 Canadian General Hospital): a study of medical volunteerism in the First World War.

    Science.gov (United States)

    Istl, Alexandra C; McAlister, Vivian C

    2016-12-01

    The Canadian government depended on chaotic civilian volunteerism to staff a huge medical commitment during the First World War. Offers from Canadian universities to raise, staff and equip hospitals for deployment, initially rejected, were incrementally accepted as casualties mounted. When its offer was accepted in 1916, Western University Hospital quickly adopted military decorum and equipped itself using Canadian Red Cross Commission guidelines. Staff of the No. 10 Canadian Stationary Hospital and the No. 14 Canadian General Hospital retained excellent morale throughout the war despite heavy medical demand, poor conditions, aerial bombardment and external medical politics. The overwhelming majority of volunteers were Canadian-born and educated. The story of the hospital's commanding officer, Edwin Seaborn, is examined to understand the background upon which the urge to volunteer in the First World War was based. Although many Western volunteers came from British stock, they promoted Canadian independence. A classical education and a broad range of interests outside of medicine, including biology, history and native Canadian culture, were features that Seaborn shared with other leaders in Canadian medicine, such as William Osler, who also volunteered quickly in the First World War.

  17. Cardiovascular disease in human immunodeficiency virus-infection as a cause of hospitalization: a case-series in a General Hospital in Peru.

    Science.gov (United States)

    Valenzuela-Rodríguez, Germán; Mezones-Holguín, Edward; Mendo-Urbina, Fernando; Rodríguez-Morales, Alfonso J

    2015-01-01

    Cardiovascular disease in the context of human immunodeficiency virus infection has become a major clinical concern in recent years. In the current report we assess hospitalizations due to cardiovascular disease in human immunodeficiency virus patients in a Social Security reference hospital in Peru. A retrospective study was carried out between January 1996 and December 2012 in a General Hospital in Lima, Peru. We included 26 patients hospitalized due to cardiovascular disease. Mean age was 46.3 years (SD 12.5), predominantly male (57.7%). Ten patients (38.4%) were in Acquired Immunodeficiency Syndrome stages. Seventeen (65.4%) received high-active-antiretroviral therapy. Eleven (42.3%) had cardiac involvement and 15 (57.7%) had non-cardiac vascular involvement. The most frequent causes of cardiac involvement were pericardial effusion and myocardial infarction. On the other hand, deep vein thrombosis and stroke were the most frequent for non-cardiac vascular involvement. Cardiovascular disease is an important cause of hospitalization in Peruvian human immunodeficiency virus patients, with differences between immunosuppression stages. Further studies analyzing associated factors are warranted. Copyright © 2015 Elsevier Editora Ltda. All rights reserved.

  18. Performance of European system for cardiac operative risk evaluation in Veterans General Hospital Kaohsiung cardiac surgery.

    Science.gov (United States)

    Shih, Hsin-Hung; Kang, Pei-Luen; Pan, Jun-Yen; Wu, Tung-Ho; Wu, Chieh-Ten; Lin, Chun-Yao; Lin, Yu-Hsin; Chou, Wan-Ting

    2011-03-01

    The European System for Cardiac Operative Risk Evaluation (EuroSCORE) model is a widely-used risk prediction algorithm for in-hospital or 30-day mortality in adult cardiac surgery patients. Recent studies indicated that EuroSCORE tends to overpredict mortality. The aim of our study is to evaluate the validity of EuroSCORE in Veterans General Hospital Kaohsiung (VGHKS) cardiac surgery including a number of different surgical and risk subgroups. From January 2006 to December 2009, 1,240 adult patients who underwent cardiac surgery in VGHKS were included in this study. The study was followed the guidelines of the Ethics Committee of Kaohsiung Veterans General Hospital, Taiwan. Both additive and logistic score of all patients were calculated depending on the formula in the official EuroSCORE website. The entire cohort, different surgical type and risk stratification subgroups were analyzed. Model discrimination was tested by determining the area under receiver operating characteristic (ROC) curve. Model calibration was tested by the Hosmer-Lemeshow chi-square test. Clinical performance of model was assessed by comparing the observed and predicted mortality rates. There were significant differences between the VGHKS and European cardiac surgical populations. The additive score and logistic score for the overall group were 7.16% and 12.88%, respectively. Observed mortality was 10.72% overall, 5.68% for isolated coronary artery bypass grafting (CABG), 4.67% for the mitral valve only and 4.25% for the aortic valve only group. The discriminative ability EuroSCORE was very good in all and various surgical subgroups, with area under the ROC curve from 0.75 to 0.87. The addictive and logistic models of EuroSCORE showed excellent accuracy, 0.839 and 0.845, respectively. Good calibration power was recognized by p value higher than 0.05 for the entire cohort and all subgroups of patients except for isolated CABG. The logistic EuroSCORE model overestimated mortality to different

  19. Effectiveness of a clinical pathway for acute stroke care in a district general hospital: an audit

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    Siegert Richard J

    2006-02-01

    Full Text Available Abstract Background Organised stroke care saves lives and reduces disability. A clinical pathway might be a form of organised stroke care, but the evidence for the effectiveness of this model of care is limited. Methods This study was a retrospective audit study of consecutive stroke admissions in the setting of an acute general medical unit in a district general hospital. The case-notes of patients admitted with stroke for a 6-month period before and after introduction of the pathway, were reviewed to determine data on length of stay, outcome, functional status, (Barthel Index, BI and Modified Rankin Scale, MRS, Oxfordshire Community Stroke Project (OCSP sub-type, use of investigations, specific management issues and secondary prevention strategies. Logistic regression was used to adjust for differences in case-mix. Results N = 77 (prior to the pathway and 76 (following the pathway. The median (interquartile range, IQR age was 78 years (67.75–84.25, 88% were European NZ and 37% were male. The median (IQR BI at admission for the pre-pathway group was less than the post-pathway group: 6 (0–13.5 vs. 10 (4–15.5, p = 0.018 but other baseline variables were statistically similar. There were no significant differences between any of the outcome or process of care variables, except that echocardiograms were done less frequently after the pathway was introduced. A good outcome (MRS Conclusion A clinical pathway for acute stroke management appeared to have no benefit for the outcome or processes of care and may even have been associated with worse outcomes. These data support the conclusions of a recent Cochrane review.

  20. Quality of Services and Health Financing efficiency of Community Health Insurance (Jamkesmas at 21 General and Specialty Hospitals in Indonesia

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    Ristrini Ristrini

    2014-08-01

    Full Text Available Background: Community Health Insurance (Jamkesmas has been implementing maintained since 2008 with 76.4million individual quota increased to 86.4 million in 2012. The major problem of involved is unfairness (inequity in the quality and financing of health services for participants. This study aims to analyse the quality and financing of health perspective of Jamkesmas participants in the hospital. Method: This study was conducted in 21 general and specialty hospitals in Indonesia, The sample were selected purposively They were 9 Central Government hospitals (RSUP, Regional hospital and 3 specialty hospital ie cancer hospital, cardiologie hospital and stroke hospital. Those hospital involved covers 8 RSU Class A General Hospital. 8 RSU Class B, 2 RSU Class Cand 3 Specialty Hospital. Primary data wascollected by interviewing 1700 outpatient and inpatients, and 280 hospital staffs. Secondary data were human resources, finance and coverage. Results: Quality of services review on the adequacy of the physician’s quality was very varied.There were 570–2372 outpatient visits per physician, and 37-674 inpatients per doctor visit. Adequacy of nursing staff(nurses and midwives was better, 123–671 outpatient visits per nursing staff and 3–127 inpatient visits per nursing staff.Quality of services according to health officers perceptions on equipment and facilities was good and complete. Quality ofservices according to patients’ expectations and reality was appropriate, never the less the direct heath services, were low. Hospital financing was very large, 33–460 billion, and one third for Jamkesmas and Regency Community Health Insurance (Jamkesda services. Proportion Jamkesda funding in RSUD was larger than Jamkesmas while in RSUP, Jamkesda was smaller than Jamkesmas. Jamkesmas financing perspective according to the staff, was most of them stated that funding for Jamkesmas was matched and appropriate the number of served patients served

  1. 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

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

    OpenAIRE

    Marcelo J. Melero; Vanina L. Pagotto; Juan A. Mazzei

    2012-01-01

    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...

  3. ARAC--The Montreal Jewish General Hospital Alzheimer Risk Assessment Clinic.

    Science.gov (United States)

    Schipper, Hyman M; Liberman, Adrienne; Kelner, Nora; Babins, Lennie; Fried, Lynda; Bilbul, Melanie; Goodman, Rachel

    2011-07-01

    In parallel with robust efforts world-wide to develop effective neuroprotection for established disease, resources are being mobilized to delineate risk factors and implement preventive measures in a concerted effort to forestall the anticipated Alzheimer disease (AD) epidemic. A review of heritable and 'acquired' dementia risk factors, many operating at midlife, is presented in a companion paper. In 2009, an Alzheimer Risk Assessment Clinic (ARAC) was established at the Jewish General Hospital (Montreal) to address the concerns increasingly being voiced by active middle-aged individuals at risk for AD. A positive family history of AD and/or perceived changes in personal cognitive function (predominantly short-term memory) are main reasons for referral. The primary objectives of ARAC are to (i) ascertain, inform and mitigate the risks of developing AD in cognitively-healthy persons aged 40-65 based on best available medical and epidemiological evidence, (ii) conduct scientific research on midlife dementia risk and prevention in this population and (iii) provide instruction in dementia risk assessment and management to health professionals, clinical/research fellows, medical residents and students. ARAC infrastructure, evaluation protocol, risk profile classification scheme, interventions, knowledge dissemination program, case vignettes, and seminal research projects are described. It is hoped that ARAC and similar initiatives will help prevent or delay dementia by innovating effective interventions based on increasingly nuanced estimation of modifiable AD risk in presymptomatic persons.

  4. Prevalence and Predisposing Factors of Urinary Tract Infections among Pregnant Women in Abha General Hospital

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    Mona Abdullah Almushait

    2013-06-01

    Full Text Available This study aimed to assess the prevalence of urinary tract infection (UTI in pregnant women, to identify infectious agents causing the infection, and to explore relationship of specific socio–cultural factors with UTI. This study was conducted at the antenatal clinic of Abha General Hospital, Saudi Arabia from September 2012 to January 2013 on 402 pregnant Saudi women. Midstream urine sample was obtained. A urine analysis test and culture were done as well as socio-demographic data sheet was completed. Among the 402 studied pregnant women, 12.7% were affected with UTI. The main causative agent was escherichia coli(e-coli followed by staphylococci. It was found that UTI was strongly affected by the presence of previous history of reproductive tract inflammation, history of previous UTI attacks, the presence of UTI related complaints, washing and drying the perineum area, the direction of washing and drying the perineum area, frequency of changing diaper during menstruation and the average of cleaning the bathtub (P= 0.002, 0.000, 0.000, 0.000, 0.05, 0.000 and 0.002 respectively. Our study showed a significant percentage on prevalence of UTI among Saudi pregnant women.

  5. [Effect of reproductive health services restructuring on antenatal care at Marcory General Hospital, Ivory Coast].

    Science.gov (United States)

    Benie Bi, Joseph Vroh; Tiembre, Issaka; Ahoussou, Éric Martial; Tchiny, Koutoua; Dagnan, N Cho Simplice; Tagliante-Saracino, Janine

    2015-01-01

    Improvement of the work environment and staff training are health promotion strategies that can contribute to improving the supply of health care. This study evaluated the effects of reorganization of health services on antenatal care (ANC) activities. A cross-sectional study was conducted over a period of 4 months in the ANC unit of Marcory General Hospital in Abidjan. The study population was health workers in charge of ANC and pregnant women attending the health facility. Self-administered questionnaires and observation sheets were used to collect data that were analysed with Epi Info 3.5.1 software. results: After reorganization, health workers said they were satisfied with the work environment and the care provided in 91% and 96.9% of cases, respectively. These results were confirmed by all pregnant respondents (100%) attending the centre, who said they were satisfied with the quality of care received. This could explain the ANC 4 coverage rate, which increased from 39.4% in 2010 to 56.7% in 2012 and tetanus vaccination coverage which increased from 59.4% to 87.5%, although the waiting time was still too long. This study showed an increase of ANC activity indicators, such as ANC 4 and tetanus vaccination coverage rate, after reorganization of health care services. This strategy could be an opportunity to strengthen ANC services.

  6. Consumption of psychiatric drugs by patients of medical and surgical clinics in a general hospital

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    Flavio Hiroshi Shirama

    2013-07-01

    Full Text Available PURPOSES: to identify the prevalence of the use of psychiatric drugs among patients admitted to medical and surgical clinics of a general hospital, and also the factors related to the consumption of this type of medication. METHOD: this is a transversal, descriptive, correlational study with quantitative analysis. For the collection of data, there was use of structured interviews and also reference to medical files. RESULTS: there was confirmation of a high prevalence of users of psychiatric drugs, which was associated to the female sex, to people who do not practice Roman Catholicism, and admittance to the clinic not covered by the Single Health System (Sistema Único de Saúde - SUS, as well as the presence of common mental disorders. Benzodiazepine drugs were the most commonly used psychiatric drugs. Among the total number of users, there has been the identification of patients who were not aware that they were receiving such medication. Doctors who are not psychiatrists were responsible for most prescriptions of psychiatric drugs. CONCLUSIONS: this signals the need to prepare health professionals to deal with psychological and social problems commonly found in clinical practice, in order to promote the rational use of psychiatric drugs.

  7. [Chronic Chagasic Cardiomyopathy at the Hospital General de Zona no. 24 IMSS. Poza Rica, Veracruz].

    Science.gov (United States)

    Olivera-Mar, Amonario; Hernández-Vicencio, Catalina; Camacho-Marie, Margarita; Hernández-Becerril, Nidia; Monteón-Padilla, Víctor M; Vallejo, Maite; Reyes, Pedro A

    2006-01-01

    Northern Veracruz has conditions, biotic and abiotic, to support Triatomine bugs and vectorial transmission of Trypanosoma cruzi to human beings. Therefore we explore seroprevalence of antibodies to this parasite and the presence of Chronic Chagasic Cardiopathy (CCC) at Cardiology ward in a General Hospital serving North of Veracruz State, and neighbord states Hidalgo, Puebla San Luis Potosi and Tamaulipas. We search for consecutive adult patients attending outpatient and beds assigned to Cardiology between March through September, 2003. An epidemiology questionnaire, clinical work up, chest roentgenogram, 12 lead peripheral EKG and transthoracic echocardiogram were performed in 240 female/males patients. All of them were bled to blindly search for T. cruzi antibodies. Seroprevalence was 8%, 49 cases of dilated cardiomyopathy were diagnosed 23 attributed to chronic diseases such as systemic hypertension diabetes mellitus or ischemic heart disease 12 with idiopathic disease and 14 (29%) had CCC. The latter accumulated epidemiologic features suggestive of vectorial infection. Four additional individuals without CCC but having specific antibodies were considered indeterminate Chagasic cases. This case series identify American Trypanosomiasis among 19 people attending a Cardiology Service, and 14 of them had a severe heart disease linked to progressive and fatal course. This observation points out that Chagas disease could be a regional public health problem in Northern Veracruz.

  8. 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.

  9. Application of a neural network for gentamicin concentration prediction in a general hospital population.

    Science.gov (United States)

    Corrigan, B W; Mayo, P R; Jamali, F

    1997-02-01

    Neural network (NN) computation is computer modeling based in part on simulation of the structure and function of the brain. These modeling techniques have been found useful as pattern recognition tools. In the present study, data including age, sex, height, weight, serum creatinine concentration, dose, dosing interval, and time of measurement were collected from 240 patients with various diseases being treated with gentamicin in a general hospital setting. The patient records were randomly divided into two sets: a training set of 220 patients used to develop relationships between input and output variables (peak and trough plasma concentrations) and a testing set (blinded from the NN) of 20 to test the NN. The network model was the back-propagation, feed-forward model. Various networks were tested, and the most accurate networks for peak and trough (calculated as mean percent error, root mean squared error of the testing group, and tau value between observed and predicted values) were reported. The results indicate that NNs can predict gentamicin serum concentrations accurately from various input data over a range of patient ages and renal function and may offer advantages over traditional dose prediction methods for gentamicin.

  10. Chemical restraint in routine clinical practice: a report from a general hospital psychiatric ward in Greece

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    Papamichael Georgios

    2011-02-01

    Full Text Available Abstract Background There is a dearth of studies regarding chemical restraint in routine clinical psychiatric practice. There may be wide variations between different settings and countries. Methods A retrospective study on chemical restraint was performed in the 11-bed psychiatric ward of the General Hospital of Arta, in northwestern Greece. All admissions over a 2-year-period (from March 2008 to March 2010 were examined. Results Chemical restraint was applied in 33 cases (10.5% of total admissions. From a total of 82 injections, 22 involved a benzodiazepine and/or levomepromazine, whereas 60 injections involved an antipsychotic agent, almost exclusively haloperidol (96.7% of cases, usually in combination with a benzodiazepine (61.7% of cases. In 36.4% of cases the patient was further subjected to restraint or seclusion. Conclusions In our unit, clinicians prefer the combined antipsychotic/benzodiazepine regimen for the management of patients' acute agitation and violent behaviour. Conventional antipsychotics are administrated almost exclusively and in a significant proportion of cases further coercive measures are applied. Studies on the practice of chemical restraint should be regularly performed in clinical settings.

  11. Evaluation of tumor markers for the detection of hepatocellular carcinoma in Yangon General Hospital, Myanmar.

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    Taketa K

    2002-12-01

    Full Text Available Levels of alpha-fetoprotein (AFP, its glycoforms AFP-L3 and AFP-P4, and proteins induced by vitamin K absence or antagonist-II (PIVKA-II were determined in sera obtained from patients in Yangon General Hospital (20 with hepatocellular carcinoma (HCC, 29 with chronic liver diseases, including 3 with chronic hepatitis and 26 with cirrhosis of the liver, and 9 with other hepatobiliary diseases. Forty-five percent of the patients with HCC had serum AFP levels above 10,000 ng/ml, indicating that nearly half of the HCC patients were at an advanced stage of the disease. Thus, the AFP sensitivity was as high as 70% with 100% specificity for a cutoff level of 200 ng/ml. The sensitivity of AFP-L3 was 75% and a specificity 90% for a cutoff level of 15%. AFP-P4 showed a higher sensitivity of 80% and a similar specificity of 86% for a cutoff level of 12%. Combined evaluation of AFP-L3 and/or AFP-P4 increased the sensitivity to 90% with the same specificity of 86%, indicating that AFP-L3 and AFP-P4 are useful as adjuncts for diagnosis of HCC in the present population. PIVKA-II had a high sensitivity of 90%, although the specificity was lower than 45%, probably due to the low cutoff level, as some cholestatic patients were included in the control group.

  12. Study of Sound Environment Influenced by the Crowd in Waiting Areas in General Hospitals

    Institute of Scientific and Technical Information of China (English)

    Xin Qin; Jian Kang; Hong Jin

    2014-01-01

    In this study, the crowd has been investigated and analyzed in waiting areas in large general hospitals in China in order to find the rules the variations of sound environment with the change of crowd. The field investigation, questionnaire, field-testing and computer simulation have been adopted. The results show that:the social/demographic characteristics of staff and patients are not significantly related to the satisfaction evaluation of sound environment;there is a significant correlation between the population density and LAeq of the background noise in waiting areas;when population density is 0, the LAeq of background noise is not 0 in waiting areas; the loudspeaker should be set in the waiting areas. Loudspeaker arrangements should be integrated into the ceiling lamp or construct facilities along the depth direction of the layout, and the two adjacent speakers recommended distance should be controlled at about 4 m. If the population density is controlled in the reasonable range, and sound absorption, noise reduction processing and electronic queuing system are adopted, sound environment of waiting areas will be built with noise interference relatively small in different population densities.

  13. NUTRITIONAL ASSESSMENT IN PATIENTS PREDICTED TO MAJOR ABDOMINAL SURGERY AT THE GENERAL HOSPITAL CELJE

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    Ernest Novak

    2001-12-01

    Full Text Available Background. Malnutrition has serious implications for recovery after surgery. Early detection of malnutrition with nutritional support minimizes postoperative complications. Nutritional assessment tools need to be simple and suitable for use in everyday practice. In our study we wanted to determine, how many patients might benefit from nutritional support.Methods. From April to August 1999 fifty consecutively admitted patients predicted to major abdominal surgery have been examined. We used Mini nutritional assessment (MNA, Buzby’s nutrition risk index (NRI, blood albumin level and weight loss in the last 3 months period prior to the examination, to assess nutritional status.Results. We examined 50 patients (27 males and 23 females, age 76.5 ± 16.5 and confirmed malnutrition in 40% of patients with MNA and serum albumin level. The increased risk for nutrition-associated complications was confirmed by NRI and weight loss in 44%.Conclusions. A confident diagnosis of malnutrition and increased risk for nutrition-associated complications can be established by using a combination of simple methods like MNA, NRI, weight loss and serum albumin level. Almost half of the patients admitted for major abdominal surgery in General hospital Celje suffer from malnutrition and they may benefit with early nutritional intervention.

  14. [Abdominal unplanned reoperations in the Service of General Surgery, University Hospital of Puebla].

    Science.gov (United States)

    León-Asdrúbal, Samuel Báez; Juárez-de la Torre, Juan Carlos; Navarro-Tovar, Fernando; Heredia-Montaño, Mónica; Quintero-Cabrera, José Eduardo

    2016-01-01

    The reoperation is considered as the access to the abdominal cavity before complete healing of the surgical wound from a previous operation within the first 60 days after the first procedure. It occurs in 0.5 to 15% of patients undergoing abdominal surgery and generates significant increase in morbidity and mortality in patients undergoing abdominal surgery. Identify the number of unplanned abdominal surgical reoperations and identify the causes of these unplanned reoperations were performed in our department. This is a retrospective study conducted at the University Hospital of Puebla in the period between April 2009 to February 2012, a total of 1,709 abdominal surgeries performed by the Service of General Surgery were included. Ninety-seven cases of reoperation of which 50 cases were not planned surgery cases were identified; 72% (36 cases) from emergency operations, and 28% of elective surgery. The incidence found in our study is low compared to similar studies. Prospective studies and focus on risk factors and causes of unplanned reoperations are required, in order to know them in detail and, consequently, reduce its incidence and morbidity and mortality they add.

  15. Quality of psychiatric care in the general hospital: referrer perceptions of an inpatient liaison psychiatry service.

    Science.gov (United States)

    Solomons, Luke C; Thachil, Ajoy; Burgess, Caroline; Hopper, Adrian; Glen-Day, Vicky; Ranjith, Gopinath; Hodgkiss, Andrew

    2011-01-01

    To explore the experience of senior staff on acute medical wards using an established inpatient liaison psychiatry service and obtain their views on clinically relevant performance measures. Semistructured face-to-face interviews with consultants and senior nurses were taped, transcribed and analyzed manually using the framework method of analysis. Twenty-five referrers were interviewed. Four key themes were identified - benefits of the liaison service, potential areas of improvement, indices of service performance such as speed and quality of response and expanded substance misuse service. Respondents felt the liaison service benefited patients, staff and service delivery in the general hospital. Medical consultants wanted stepped management plans devised by consultant liaison psychiatrists. Senior nurses, who perceived themselves as frontline crisis managers, valued on-the-spot input on patient management. Consultants and senior nurses differed in their expectations of liaison psychiatry. Referrers valued speed of response and regarded time from referral to definitive management plan as a key performance indicator for benchmarking services. Copyright © 2011 Elsevier Inc. All rights reserved.

  16. Characteristic of Older Adult with Balance Disorder in Rehabilitation Clinic Dr. Hasan Sadikin General Hospital 2014

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    Ku Shi Yun

    2016-03-01

    Full Text Available Background: Older adult population is increasing worldwide. Balance has an important role in conducting daily activities and mobility, with impaired balance it can lead to negative impacts for example fall. This study is conducted to obtain common factors and characteristics of older adults with balance disorder to provide better rehabilitation services. Method: A descriptive study was conducted in the Physical Medicine and Rehabilitation Clinic of Dr. Hasan Sadikin General Hospital, Bandung from August-October 2014 using total sampling method and a 5 times sit-to-stand (5STS test was conducted. The total sample obtained was 34. Result: The characteristics of older adult with balance disorder in this study were mostly from young old (n=17, male gender (n=19, and mean 5STS test is 18.48 seconds. Most of the patients had high blood pressure (n=29, normal body mass index (BMI (n=22, independent activity of daily living (ADL (n=21, and use of greater than 3 medication (n=21.The most common disease found is musculoskeletal disease and majority of patients had one medical disease. Conclusion: Older adults categorized as young old has the greatest frequency of having balance disorder. Increase in age, increases the duration of 5STS test conducted. The most common problem among older adult is high blood pressure, musculoskeletal disease and hypertension and majority of the patients consume greater than 3 medication. Lastly, most of the BMI and the ADL of the older adults were normal.

  17. Major depressive disorder in the general hospital: adaptation of clinical practice guidelines.

    Science.gov (United States)

    Voellinger, Rachel; Berney, Alexandre; Baumann, Pierre; Annoni, Jean Marie; Bryois, Christian; Buclin, Thierry; Büla, Christophe; Camus, Vincent; Christin, Laurent; Cornuz, Jacques; de Goumoëns, Pierre; Lamy, Olivier; Strnad, Jindrich; Burnand, Bernard; Stiefel, Frederic

    2003-01-01

    Major Depressive Disorder is particularly frequent among physically ill inpatients. Despite the considerable human burden and financial costs, Major Depressive Disorder remains under-detected and under-treated. To improve this situation, clinical practice guidelines for the management of Major Depressive Disorder were developed for patients in the general hospital. They were adapted from existing good quality guidelines. A literature search has been conducted to identify guidelines and systematic reviews about the management of Major Depressive Disorder. The quality of the existing guidelines was evaluated by means of the AGREE instrument (Appraisal of Guidelines for Research and Evaluation). Complementary literature searches were necessary to answer questions such as "depression and physical illness" or "antidepressants and somatic medication". The guidelines were discussed by a multidisciplinary internal panel. The final version was reviewed by an external panel. This paper presents the development process and a summary of these guidelines for the management of Major Depressive Disorder. The adaptation of good quality guidelines to local needs requires much time, effort and skills. Easier ways for the adaptation and use of high quality guidelines at the local level may result from better coordination, organization and updating of guidelines at a national or supranational level.

  18. Profile of Hand Compartment Syndrome in Dr. Hasan Sadikin General Hospital, West Java, 2008−2012

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    Kajendaran Manogaran

    2015-12-01

    Full Text Available Background: Compartment syndrome is a serious disorder caused by elevated pressure in a muscle compartment that can progress to muscle and nerve damage. This disorder can happen to anyone but more frequently in young adults. The occurrence frequency of hand compartment syndrome is relatively low. The aim of this study is to identify the profile of compartment syndrome in patients hand Methods: A descriptive study was perfomed to 15 cases that were collected from medical records from 2008-2012, in Dr. Hasan Sadikin General Hospital. The profile of the case consisted of age, sex, symptoms and signs, etiology, facsiotomy schedule after admission, length of stay and patient’s outcome. The collected data were presented using tables. Results: The study showed that 12 out of 15 cases were males and 7 out of 15 cases were 20−39 years old patients. The common clinical findings were swelling, pain, limited range of motion and normal sensibility. The faciotomy procedure was conducted 1 day after the admission with length of stay more than 1 week. The patients condition were improved after operation. Conclusions: Hand compartment syndrome is a rare case, mostly affects younger adults and male. Most of the symptoms and signs are swelling, limitation of movement, pain in the location area with normal sensibility. The faciotomy procedure is conducted 1 day after admission. The length of stay is more than 1 week with an improved outcome.

  19. Service quality and patient experiences of ambulatory care in a specialized clinic vs. a general hospital.

    Science.gov (United States)

    De Regge, Melissa; De Groote, Hélène; Trybou, Jeroen; Gemmel, Paul; Brugada, Pedro

    2017-04-01

    Health care organizations are constantly looking for ways to establish a differential advantage to attract customers. To this end, service quality has become an important differentiator in the strategy of health care organizations. In this study, we compared the service quality and patient experience in an ambulatory care setting of a physician-owned specialized facility with that of a general hospital. A comparative case study with a mixed method design was employed. Data were gathered through a survey on health service quality and patient experience, completed with observations, walkthroughs, and photographic material. Service quality and patient experiences are high in both the investigated health care facilities. A significant distinction can be made between the two facilities in terms of interpersonal quality (p = 0.001) and environmental quality (P ≤ 0.001), in favor of the medical center. The difference in environmental quality is also indicated by the scores given by participants who had been in both facilities. Qualitative analysis showed higher administrative quality in the medical center. Environmental quality and patient experience can predict the interpersonal quality; for environmental quality, interpersonal quality and age are significant predictors. Service quality and patient experiences are high in both facilities. The medical center has higher service quality for interpersonal and environmental service quality and is more process-centered.

  20. 解放军总医院群体工程电气设计%Electrical Design of General Hospital of PLA Project Hospital of PLA Project

    Institute of Scientific and Technical Information of China (English)

    王漪; 涂路; 奚传栋

    2013-01-01

      本文从供电可靠性、安全用电、绿色建筑等角度简要介绍了解放军总医院群体工程强电专业设计的特点。%This article describes the characteristics of electrical design of General Hospital of PLA Project, such as the reliability of power supply , electrical safety and green buildings.

  1. The Toronto General Hospital Transitional Pain Service: development and implementation of a multidisciplinary program to prevent chronic postsurgical pain

    Directory of Open Access Journals (Sweden)

    Katz J

    2015-10-01

    Full Text Available Joel Katz,1–3 Aliza Weinrib,1,2 Samantha R Fashler,2 Rita Katznelzon,1,3 Bansi R Shah,1 Salima SJ Ladak,1 Jiao Jiang,1 Qing Li,1 Kayla McMillan,1 Daniel Santa Mina,5,6 Kirsten Wentlandt,7 Karen McRae,1,3 Diana Tamir,1,3 Sheldon Lyn,1,3 Marc de Perrot,8 Vivek Rao,9 David Grant,10 Graham Roche-Nagle,11 Sean P Cleary,12 Stefan OP Hofer,13 Ralph Gilbert,14 Duminda Wijeysundera,1,3 Paul Ritvo,15 Tahir Janmohamed,16 Gerald O’Leary,1,3 Hance Clarke1,3 1Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, 2Department of Psychology, York University, 3Department of Anesthesia, University of Toronto, 4Palliative Care, University Health Network, University of Toronto, 5Princess Margaret Cancer Centre, University Health Network, University of Toronto, 6Faculty of Kinesiology and Physical Education, University of Toronto, 7Department of Family and Community Medicine, University of Toronto, 8Division of Thoracic Surgery, Toronto General Hospital, 9Division of Cardiovascular Surgery, Toronto General Hospital, 10Multiorgan Transplant Program, Toronto General Hospital, 11Division of Vascular Surgery, Toronto General Hospital, 12Division of General Surgery, Toronto General Hospital, 13Division of Plastic Surgery, Toronto General Hospital, 14Division of Otolaryngology – Head and Neck Surgery, Toronto General Hospital, 15Department of Kinesiology and Health Science, York University, 16ManagingLife, Toronto, ON, CanadaAbstract: Chronic postsurgical pain (CPSP, an often unanticipated result of necessary and even life-saving procedures, develops in 5–10% of patients one-year after major surgery. Substantial advances have been made in identifying patients at elevated risk of developing CPSP based on perioperative pain, opioid use, and negative affect, including depression, anxiety, pain catastrophizing, and posttraumatic stress disorder-like symptoms. The Transitional Pain Service (TPS at

  2. Pemex increasing offshore activity

    Energy Technology Data Exchange (ETDEWEB)

    Beachy, D.

    1985-05-01

    Although austere by boom-year standards, Mexico's National Energy Program for 1984-1988 calls for forty wildcats and 90 to 144 development wells off the coast, primarily in the prolific Campeche Bay area. Platform additions will include nine drilling platforms, each for twelve wells, and eight eight platforms to drill injection wells. Additionally, 7 production, 6 accomodation, 6 linkage and 8 compression platforms and 13 tetrapods will be installed. The main objectives of the plan are energy self-sufficiency through the turn of the century, and energy diversification, savings and productivity. The most controversial portion of Mexico's energy program is that calling for nuclear energy development. The energy program lists three basic goals in hydrocarbon production: continuing research on better techniques of secondary recovery; increasing capacity for refining primary and secondary crude products and improving production of heavy crudes; and increasing storage capacity and installing pipelines capable of carrying a greater volume of crude.

  3. Alcohol-related hospital admissions: Missed opportunities for follow up? A focus group study about general practitioners' experiences

    DEFF Research Database (Denmark)

    Lid, Torgeir Gilje; Oppedal, Kristian; Pedersen, Bolette

    2012-01-01

    in the hospital had been recognised by the GP and how this knowledge affected their follow up of the patient's alcohol problem. Systematic text condensation was applied for analysis. Findings: A majority of the GPs had experienced patients with already recognised alcohol problems being rediscovered......Aims: To explore general practitioners' (GPs') follow-up experiences with patients discharged from hospital after admittance for alcohol-related somatic conditions. Design and participants: Two focus groups with GPs (four women and 10 men), calling for stories about whether the intervention given...... by the hospital staff. Still, they presented examples of how seeing the patient in a different context might present new opportunities. Few participants had received adequate information from the hospital about their patient's alcohol status, and they emphasised that a report about what had happened and what...

  4. [Assessment of functional food of general version of diet in cardiac hospital].

    Science.gov (United States)

    Nepovinnykh, N V; Lyamina, N P; Ptichkina, N M

    2015-01-01

    The efficacy of functional food was evaluated in general embodiment diet of cardiological hospital in patients receiving oxygen-containing products (oxygen smoothies) based on protein-carbohydrate raw materials (dairy whey) with dietary fiber. 60 patients were included in local open, prospective, parallel-group study; among them 36 men and 24 women aged 60-75 years, meeting the following criteria: patients with chronic heart failure I-IV functional class, are hospitalized in the cardiology department, have no contraindications to enteral oxygen therapy and sign an informed consent form. The main group comprised 30 patients, which along with standard therapy received enteral oxygen therapy. 30 patients from the control group received standard therapy and aerated non-oxygen mixture (placebo). Standard therapy included cardioprotective drugs, diuretics and concomitant therapy (enzyme preparations) depended upon the clinical status of the patient. Patients received 500 ml of a cocktail within 10-15 minutes daily for 10 days for 1-1,5 hours before the main meal. The studies revealed the most pronounced clinical effect of enteral oxygen therapy in relation to clinical symptoms and side effects caused by drug administrations. After 3-4 procedures patients with chronic heart failure treated with enteral oxygen therapy had a decrease in fatigue, increase physical performance, improve appetite, emotional lability. By the end the positive dynamics of oxygen therapy on the above grounds was detected in 90% of patients. Monitoring pulse oximetry showed a significant increase of oxygen saturation as a result of the course of enteral oxygen therapy: oxygen saturation increased from 98.13 ± 0.13 to 99.17 ± 0.13% (p < 0.001) while in the control group from 98.12 ± 0.20 to 98.19 ± 0.19% (p < 0.01). Physical activity increased from 318 ± 15 to 389 ± 13 m (p < 0.001), in the control group--from 331 ± 17 to 362 ± 15 m (p < 0.05) in the main group on the test results with the 6

  5. Prevalence of Drug Resistance Mycobacterium Tuberculosis among Patients Seen in Coast Provincial General Hospital, Mombasa, Kenya

    Science.gov (United States)

    Ombura, Ida Pam; Onyango, Noel; Odera, Susan; Mutua, Florence; Nyagol, Joshua

    2016-01-01

    Background Although prevention and control of spread of multi-drug resistant tuberculosis strains is a global challenge, there is paucity of data on the prevalence of DR-TB in patients diagnosed with TB in referral hospitals in Kenya. The present study assessed patients’ characteristics and prevalence of drug resistant TB in sputa smear positive TB patients presenting to Coast Provincial General Hospital (CPGH) in Mombasa, Kenya. Methods Drug resistance was evaluated in 258 randomly selected sputa smear TB positive cases between the periods of November 2011 to February 2012 at the CPGH-Mombasa. Basic demographic data was obtained using administered questionnaires, and clinical history extracted from the files. For laboratory analyses, 2mls of sputum was obtained, decontaminated and subjected to mycobacteria DNA analyses. Detection of first line drug resistance genes was done using MDRTDR plus kit. This was followed with random selection of 83 cases for second line drug resistance genes testing using Genotype MDRTBsl probe assay kit (HAINS Lifesciences, GmbH, Germany), in which ethambutol mutation probes were included. The data was then analyzed using SPSS statistical package version 19.0. Results Male to female ratio was 1:2. Age range was 9 to 75 years, with median of 30 years. New treatment cases constituted 253(98%), among which seven turned out to be PTB negative, and further grouped as 4 (1.6%) PTB negative and 3(1.1%) NTM. 237(91.7%) new cases were fully susceptible to INH and RIF. The remaining, 8 (3.1%) and 1(0.4%) had mono- resistance to INH and RIF, respectively. All the retreatment cases were fully susceptible to the first line drugs. HIV positivity was found in 48 (18.6%) cases, of which 46(17.8%) were co-infected with TB. Of these, 44 (17.1%) showed full susceptibility to TB drugs, while 2 (0.8%) were INH resistant. For the second line drugs, one case each showed mono resistance to both and FQ. Also, one case each showed drug cross poly resistance to

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

    Directory of Open Access Journals (Sweden)

    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

  7. Perfil clínico del adulto mayor atendido ambulatoriamente en un hospital general

    Directory of Open Access Journals (Sweden)

    Paola Casas

    2012-10-01

    Full Text Available Objetivo: Describir el perfil clínico del adulto mayor atendido ambulatoriamente en un hospital general. Material y métodos: Estudio descriptivo, transversal, realizado a través de encuestas aplicadas a pacientes en la consulta ambulatoria de geriatría del Hospital Nacional Cayetano Heredia (HNCH, entre agosto de 2011 y enero 2012. Resultados: Se evaluaron 290 pacientes, el 69,3% fueron mujeres; el 65,5% tenía entre 60 y 79 años. La hipertensión arterial fue el diagnóstico más frecuente (55,5%. El 83,1% consumía algún tipo de medicamento y el 45% más de 3 fármacos. En la valoración por esferas: el 83,5% era autónomo, el 18,1% tenía deterioro cognitivo, el 7,7% depresión, el 79,3% riesgo social, el 23,8% disfunción familiar, el 31,4% riesgo de malnutrición, el 23,4% obesidad, el 96% mala higiene del sueño y el 4,9% riesgo de caídas. El síndrome geriátrico más frecuente fue caídas en 23,8% y de los problemas geriátricos, el edentulismo en 77,6%; 17,4% eran frágiles según la velocidad de la marcha; se encontró asociación entre fragilidad y edad avanzada, género femenino y la presencia de riesgo social. Conclusión: Los pacientes que acuden a la consulta externa de Geriatría fueron mayoritariamente mujeres, funcionalmente autónomos, sin deterioro cognitivo, con riesgo social y adecuada funcionalidad familiar, prefrágiles y con enfermedades crónicas no transmisibles principalmente.

  8. [Prevalence of antibodies against Trypanosoma cruzi in blood bank donors from the IMSS General Hospital in Orizaba, Veracruz, Mexico].

    Science.gov (United States)

    Ramos-Ligonio, Angel; Ramírez-Sánchez, Michaía Elián; González-Hernández, Juan Carlos; Rosales-Encina, José Luis; López-Monteon, Aracely

    2006-01-01

    To estimate the prevalence of antibodies against Trypanosoma cruzi in blood donors from Hospital General Regional (HGRO) of the Mexican Institute of Social Security (IMSS per its abbreviation in Spanish). Between October 2001 and January 2002, blood samples were collected from voluntary donors at the blood bank of the Hospital General Regional of IMSS in Orizaba; Veracruz, Mexico. The samples were assayed for anti-T. cruzi by ELISA, Western blot and IFI, using a recombinant protein (MBP::Hsp70), and crude extract from epimastigotes. A total of 420 blood donors were studied; two of them were seropositive for ELISA,Western blot and IFI, with a seroprevalence of 0.48%. Some blood donors at the HGRO hospital were seropositive for T. cruzi, showing the risk of contamination by blood transfusion. Routine serologic screening with highly sensitive and specific immunological techniques are needed.

  9. Care for patients with cerebrovascular disease in a general hospital. 2 years experience Atención a pacientes con enfermedad cerebrovascular en un hospital general. Experiencia de 2 años

    Directory of Open Access Journals (Sweden)

    Julio López Arguelles

    2010-08-01

    Full Text Available Background: The care of patients with cerebrovascular disease requires an organized system from pre-hospital care until discharge of the patient, to ensure the continuity of rehabilitation. In order to provide differentiated services to patients with this condition was created in the General Hospital Universitario "Dr. Gustavo Lima Aldereguía "a specialized room for attention to these diseases and the rehabilitation of patients. Objective: To determine the benefits obtained with differentiated services to patients with cerebrovascular disease in a general hospital. Methods: Descriptive case series that included 1038 patients admitted to the specialized chamber for cerebrovascular disease. We analyzed the following variables: stay, type of cerebrovascular disease, clinical classification, the Barthel index and discharge status. Results: 972 patients suffered from cerebrovascular disease, hospital stay was reduced by two days, the attention of specialized equipment increased from 51.75% to 79.2% patients were discharged with a mild degree of functional dependence. Conclusions: The differentiated services to cerebrovascular disease in general hospitals shows benefits for patients.Fundamento: la atención a pacientes con enfermedad cerebrovascular requiere un sistema organizado desde la atención prehospitalaria hasta el egreso del paciente, que asegure la continuidad de la rehabilitación. En aras de brindar una atención diferenciada a los pacientes con esta afección se creó en el Hospital General Universitario “Dr. Gustavo Aldereguía Lima” una sala especializada para la atención a estas enfermedades y la rehabilitación de los pacientes. Objetivo: determinar los beneficios que se obtienen con la atención diferenciada a pacientes con enfermedad cerebrovascular en un hospital general. Métodos: estudio

  10. Immediate Impact of Uni-nephrectomy among Bangladeshi Healthy Live Kidney Donors: BIRDEM General Hospital Experience

    Directory of Open Access Journals (Sweden)

    Palash Mitra

    2016-05-01

    Full Text Available Background: Kidney transplantation is the preferred treatment option for end stage kidney disease. Live kidney donation is an established form of organ donation; but it carries the risk of an unnecessary surgery in a normal individual. These donors remain at an increased risk of multiple medical problems for the rest of their life. Objective: In this study, we evaluated the immediate impact of uninephrectomy among kidney donors during the period of post-transplant hospital stay. Materials and Methods: This cross-sectional study was done at BIRDEM General Hospital from January 2006 to June 2014. All kidney donors who had undergone graft nephrectomy during the study period were the study population. All the donors underwent Tc-99m diethylene triamine pentaacetic acid (Tc-99m DTPA renogram for measurement of glomerular filtration rate (GFR. GFR was also estimated by different equations in both pre-transplant and post-transplant periods. Pre-uninephrectomy GFR and post-uninephrectomy GFR of donors were compared. Results: Total number of subjects was 81, male 48 and female 33. Mean age was 36.3 ± 9.9 years. Mean postoperative hospital stay was 8.2 ± 2.0 days. The mean pre-operative measured glomerular filtration rate (mGFRDTPA was 99.54 ± 19.06 mL/min/1.73 m2 and mean estimated glomerular filtration rate (eGFRCKD-EPI was 99.0 ± 18.55 mL/min/1.73 m2 (p=0.855. In post-nephrectomy period mean urine output decreased from 2708.1 ± 842.8 to 2228.4 ± 702.4 mL/day (p=0.000. Mean SBP lowered from 120.3 ± 12.5 to 115.6 ± 9.2 mm of Hg (p=0.000 after nephrectomy. There was significant increase in blood urea (from 19.7 ± 5.7 to 30.4 ± 9.5 mg/dL, p=0.000 and serum creatinine (from 0.90 ± 0.16 to 1.26 ± 0.24 mg/dL, p=0.000 in post-uninephrectomy period. Mean mGFRDTPA of the subjects of non-nephrectomized kidney of the donors was 49.18 ± 9.50 mL/min/1.73 m2 and mean eGFRCKD-EPI of same kidneys was 69.09 ± 16.79 mL/min/1.73m2 (p=0.000 after uni

  11. Serviço de Emergência Psiquiátrica em hospital geral: estudo retrospectivo Servicio de emergencia psiquiátrica en hospital general: estudio retrospectivo Emergency psychiatric service in general hospitals: a retrospective study

    Directory of Open Access Journals (Sweden)

    Fernando Sérgio Pereira de Sousa

    2010-09-01

    Full Text Available O Serviço de Emergência Psiquiátrica em Hospital Geral (SEPHG é uma proposta articulada com o movimento da reforma psiquiátrica. Objetivou-se caracterizar os clientes com sofrimento psíquico assistidos no SEPHG Dr. Estevam, em Sobral-CE. Este é um estudo do tipo documental, com abordagem quantitativa, envolvendo 191 clientes atendidos no SEPHG no período de janeiro a dezembro de 2007. Os dados foram coletados a partir de um livro de registro, cujas informações nele contidas foram retiradas dos prontuários dos clientes. Observou-se predomínio de pacientes do sexo masculino (70,15%, com idade entre 30-49 anos (48,71% e solteiros (74,86%. A maioria era proveniente da cidade de Sobral (69,64 %. Em 42,40% dos casos, o diagnóstico foi transtorno do uso de álcool. Grande parte da clientela (66,50% deu entrada no serviço por demanda espontânea. Após avaliação do SEPHG, 43,45% desses clientes foram encaminhados ao CAPS-ad. Pelos resultados, depreende-se o quão imprescindíveis são os serviços de saúde mental.El Servicio de Emergencia Psiquiátrica en Hospital General (SEPHG es una propuesta vinculada al movimiento de la reforma psiquiátrica. Se objetivó caracterizar a los pacientes con trastornos psiquiátricos atendidos en el SEPHG Dr. Estevam, en Sobral-Ceará-Brasil. Estudio de tipo documental con abordaje cualitativa, involucrando 191 pacientes atendidos en el SEPHG entre enero y diciembre de 2007. Los datos fueron recogidos a partir de un libro de registro, cuyas informaciones fueron extraídas de las historias clínicas de los pacientes. Se observó prevalencia de pacientes de sexo masculino (70,15%, con edad entre 30-49 años (48,71% y solteros (74,86%. La mayoría provenía de la ciudad de Sobral (69,64%. En el 42,40% de los casos, el diagnóstico fue trastorno provocado por abuso de alcohol. Una gran cantidad de pacientes (66,50% se presentó en el servicio en forma espontánea. Con posterioridad a la evaluación del

  12. Claroscuros en la gestión de la potencialidad de la cogeneración en las instalaciones de PEMEX

    Directory of Open Access Journals (Sweden)

    Gabriel de León

    2005-01-01

    Full Text Available Los esquemas de cogeneración son ampliamente rentables en plantas que realizan procesos industriales que presentan una elevada relación calor-electricidad, y es en éstos en los que se presentan los mayores beneficios económicos de los proyectos de cogeneración. Los procesos de PEMEX caen dentro de esta situación. En esta empresa existe un gran potencial de cogeneración, mucho mayor que toda la capacidad instalada actualmente en México. Se están buscando crear las posibilidades legales para que pueda ser realizado con la mayor eficiencia posible. Pero también se observa que existen posturas que no ven con buenos ojos esta alternativa tecnológica.

  13. Technical Introduction to Modular Drilling Rigs for PEMEX Platforms in Gulf of Mexico%PEMEX海洋模块钻机技术方案的实施

    Institute of Scientific and Technical Information of China (English)

    胡鹏飞; 冯翠鑫

    2010-01-01

    墨西哥国家石油公司(PEMEX)四套模块钻机为我国第一次自主设计、自主建造的钻深可达7 000 m的海洋钻机,其国产化率达到了92%,该钻机凭借其技术、价格优势成功地打入了国际市场,实现我国海上钻机出口零的突破.文章介绍了PEMEX模块钻机的技术要求、设计思路、总体布置、钻机主要设备参数、高压泥浆及泥浆处理系统、泥浆混合及储存系统、固井系统、辅助系统等.

  14. Implicaciones de las reformas energéticas de 1973-2008. Naturaleza y régimen fiscal de PEMEX

    OpenAIRE

    María Flor Lilia Chávez Presa

    2009-01-01

    En México, la industria química-petroquímica está integrada por más de 400 plantas productivas, ubicadas principalmente en el Estado de México, Veracruz, Nuevo León, Tamaulipas y el Distrito Federal. La petroquímica privada, así como la industria química extranjera establecida en México, están íntimamente vinculadas con pemex como compradoras de insumos. En esta dirección, la finalidad de este reporte de investigación es presentar los primeros avances sobre la respuesta a la pregunta ¿cuáles ...

  15. Estudio de utilización de analgésicos opiáceos en un hospital general universitario Study of opioid analgesic use in a general university hospital

    Directory of Open Access Journals (Sweden)

    P. Gómez Salcedo

    2009-10-01

    Full Text Available Objetivo: El objetivo de este trabajo ha sido realizar un estudio de utilización de analgésicos opiáceos en el Hospital Universitario La Paz (Madrid en el año 2008 para conocer cómo se está utilizando este grupo de medicamentos y cuál es la tendencia del consumo. Para ello, se presentan los datos de uso de opiáceos en pacientes ingresados de forma global, por hospitales y por servicios clínicos. Se exponen los datos de consumo de los 5 últimos años y se ha cuantificado el uso del resto de principios activos empleados como analgésicos en nuestro hospital. Material y métodos: Haciendo uso de la metodología recomendada por la Organización Mundial de la Salud para los estudios de utilización de medicamentos en hospitales, presentamos nuestros datos en dosis diarias definidas (DDD por 100 estancias. Los datos de consumo se han obtenido del programa de gestión de medicamentos del Servicio de Farmacia Farma Tools (Dominion® Resultados: El valor global de utilización de opiáceos en 2008 ha sido de 8,1 DDD/100 estancias. Los principios activos más consumidos han sido la morfina parenteral y el fentanilo transdérmico, y entre los 2 representan el 83% del consumo total de opiáceos. En el análisis por hospitales apreciamos que el Hospital General y el de Traumatología son los que presentan un mayor empleo de opiáceos y siguen el mismo patrón de utilización que el global. Los servicios más representativos del consumo de opiáceos han sido las reanimaciones del Hospital General y de Traumatología, los Servicios de Oncología, Cuidados paliativos y Hematología. En estos últimos 5 años se ha producido un incremento global del consumo de aproximadamente el 20%, viéndose implicados todos los principios activos. Con relación al consumo total de analgésicos, los datos reflejan una amplia utilización en el hospital (104 DDD/100 estancias. Los opiáceos representan un 7,4% del consumo total de analgésicos, siendo el paracetamol y

  16. Influenza and pneumococcal vaccinations in dialysis patients in a London district general hospital.

    Science.gov (United States)

    Wilmore, Stephanie M S; Philip, Keir E; Cambiano, Valentina; Bretherton, Christopher P; Harborne, Josephine E; Sharma, Aditi; Jayasena, Shyama D

    2014-02-01

    Patients on dialysis mount reduced immune responses compared with the general population. The Department of Health advises that these patients receive influenza and pneumococcal vaccinations at regular intervals-once yearly and every five years, respectively. This article investigates the uptake of these vaccinations in this patient population and seeks to examine factors that may influence vaccination status such as patient's language and presence of a general practitioner (GP) electronic vaccination reminder system. It also explores preferred site of vaccination for patients and GPs as these are primary care vaccinations yet patients have more frequent contact with their dialysis unit than their GP, blurring the boundaries between primary and specialized care. This is a retrospective study of all patients registered as dialysing at the North Middlesex University Hospital NHS Trust (NMUH) in September 2011. Information was obtained through GP letters, GP and patient questionnaires. Of 154 patients, 133 were included in the data analysis. Nineteen per cent were up-to-date with both vaccinations and 67% with their influenza vaccination. Fifty per cent had received the influenza vaccination in the last two consecutive years. Thirty per cent were not up-to-date with either vaccination. There was no evidence of a difference in uptake in 2009 (P = 0.7564) and in 2010 (P = 0.7435) among those who could and could not speak English. Twenty-five per cent of GPs and 58.6% of patients preferred vaccination to occur in the dialysis unit. Unfortunately a high number of GPs did not provide information on whether they used an electronic vaccination reminder but the analysis from the information provided by the few respondents did not reveal any correlation between the presence of an electronic reminder and vaccination status. Most dialysis patients were not up-to-date with both vaccinations. They were, however, more up-to-date with their influenza than their pneumococcal

  17. Occupational stress and coping resources in physiotherapists: a survey of physiotherapists in three general hospitals.

    Science.gov (United States)

    Santos, M C; Barros, L; Carolino, E

    2010-12-01

    To identify occupational stressors and coping resources in a group of physiotherapists, and to analyse interactions between subjective levels of stress, efficacy in stress resolution and coping resources used by these professionals. A sample of 55 physiotherapists working in three general hospitals in Portugal completed the Coping Resources Inventory for Stress, the Occupational Stressors Inventory and two subjective scales for stress and stress resolution. Most physiotherapists perceived that they were moderately stressed (19/55, 35%) or stressed (20/55, 36%) due to work, and reported that their efficacy in stress resolution was moderate (25/54, 46%) or efficient (23/54, 42%). Issues related to lack of professional autonomy, lack of organisation in the hierarchical command chain, lack of professional and social recognition, disorganisation in task distribution and interpersonal conflicts with superiors were identified as the main sources of stress. The most frequently used coping resources were social support, stress monitoring, physical health and structuring. Perceived efficacy in stress resolution was inversely related to perceived level of occupational stress (r=-0.61, P<0.01). Significant correlations were found between several coping resources and the perceived level of stress and efficacy in stress resolution. Associations between problem solving, cognitive restructuring and stress monitoring and both low levels of perceived stress and high levels of perceived efficacy were particularly strong. The importance of identifying stressors and coping resources related to physiotherapists' occupational stress, and the need for the development of specific training programmes to cope with stress are supported. Copyright © 2010 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  18. A Prototype Multi-Modality Picture Archive And Communication System At Victoria General Hospital

    Science.gov (United States)

    Nosil, J.; Justice, G.; Fisher, P.; Ritchie, G.; Weigl, W. J.; Gnoyke, H.

    1988-06-01

    The Medical Imaging Department at Victoria General Hospital is the first in Canada to implement an integrated multi-modality picture archive and communication system for clinical use. The aim of this paper is to present the current status of the picture archive and communication system components and to describe its function. This system was installed in April of 1987, and upgraded in November of 1987. A picture archive and communication system includes image sources, an image management system, and image display and reporting facilities. The installed image sources (digital radiography, digital fluoroscopy, computed tomography, and digital subtraction angiography) provide digital data for the image management system. The image management system provides facilities for receiving, storing, retrieving, and transmitting images using conventional computers and networks. There are two display stations, a viewing console and an image processing workstation, which provide various image display and manipulation functions. In parallel with the implementation of the picture archive and communication system there are clinical, physical, and economic evaluations being pursued. An initial examination of digital image transfer rates indicate that users will experience similar image availability times as with conventional film imaging. Clinical experience to date with the picture archive and communication system has been limited to that required to evaluate digital imaging as a diagnostic tool, using digital radiography and digital fluoroscopy studies. Computed tomography and digital subtraction angiography have only recently been connected to the picture archive and communication system. Clinical experience with these modalities is limited to several cases, but image fidelity appears to be well above clinically acceptable levels.

  19. Parallel rapid HIV testing in pregnant women at Tijuana General Hospital, Baja California, Mexico.

    Science.gov (United States)

    Viani, Rolando M; Araneta, Maria Rosario G; Spector, Stephen A

    2013-03-01

    The objectives of this study were to evaluate the performance of parallel rapid HIV testing and the presence of HIV-associated risk factors in pregnant women with unknown HIV status in Baja California, Mexico. Pregnant women attending the delivery unit or the prenatal clinic at Tijuana General Hospital had blood drawn for parallel rapid HIV testing with Determine™ HIV-1/2 and Uni-Gold™ Recombigen(®) HIV. The parallel rapid HIV test performance was compared to the enzyme immunoassay (EIA) and western blot. From September 2007 to July 2008, 1,383 (94%) of 1,464 women in labor and 1,992 (96%) of 2,075 women in prenatal care were enrolled. The HIV seroprevalence among women screened during labor (19/1,383, 1.37%, 95% CI: 0.85-2.18%) was significantly higher compared to those seeking prenatal care (5/1,992, 0.25%, 95% CI: 0.09-0.62%; pwomen testing positive by parallel rapid HIV testing 24 had a positive confirmatory western blot and one (0.03%) was confirmed as false positive. Additionally, two (0.06%) women had parallel rapid HIV discordant testing results; both tested negative by western blot. All women who tested negative by rapid testing had negative results on pooled EIA antibody testing. The overall sensitivity, specificity, and positive and negative predictive values of parallel rapid HIV testing were 100%, 99.9%, 96%, and 100%, respectively. These findings document a very high acceptance rate and an excellent performance of the parallel rapid HIV testing strategy during pregnancy.

  20. A STUDY OF RISK FACTORS IN STROKE PATIENTS IN GOVT., GENERAL HOSPITAL, KURNOOL, A.P

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    B.S. Isaac

    2013-10-01

    Full Text Available ABSTRACT : A study was undertaken on 50 patients admitted in Govt. General Hospital, Kurnool with acute cerebrovascular disease by using a pretested questionnaire. Parameters studied were age, sex, blood pressure, diabetes mellitus, smoking, alcohol, and hypercholesterolemia. 30(60% patients gave the history of hypertension in the past and were on treatment, apart from 10 more pa tients recorded a high blood pressure (>140/90 at the time of admission, making a total of 40(80% patients with hypertension. Out of 40 cases of hypertension, 30(75% had cerebral infarction and 10(25% had cerebral hemorrhage. 18 patients gave the hist ory of diabetes, and 14 more had blood sugar more than 140 mgs% at the time of admission, making a total of 32(64%. Out of 30 cases of diabetes, 20(66% had infarction and 10(33% had hemorrhage. 25 (50% patients were in the habit of smoking at a frequen cy of 5 - 25 cigarettes per day. Out of 25 patients with smoking 20(80% had infarction and 5(20% had hemorrhage. 16 patients gave the history of alcoholism. Out of which 7(43.7% had infarction and 9(56.3% had hemorrhage. Out of the 25 patients with smok ing habit 16 were hypertensive patients and 9 patients revealed raised serum cholesterol. Out of 16 patients with alcohol habit, 11 were hypertensive patients and 5 had raised serum cholesterol. Out of these 11 hypertensive patients 5 had infarction and 6 had hemorrhage. The 5 patients who had raised cholesterol 3 had infarction and 2 had hemorrhage. Out of the 32 diabetes cases, 21 had hypertension, and 11 had raised serum cholesterol. Out of 21 hypertensive’s, 12 had infarction and 9 had hemorrhage. Out o f 11 patients who had raised serum cholesterol, 8 had infarction and 3 had hemorrhage

  1. Dislipidemia en pacientes con artritis reumatoide atendidos en un hospital general

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    Jose Galindo

    2011-04-01

    Full Text Available Objetivo: Determinar la frecuencia de dislipidemia en pacientes con artritis reumatoide (AR atendidos en un hospital general. Material y métodos: Estudio observacional, descriptivo y transversal. Se incluyeron 44 pacientes a quienes se les determinó perfil lipídico sérico. Los resultados se clasificaron según el reporte modificado en el 2004 del tercer panel de tratamiento del adulto (ATP III. Además, se determinó el índice de masa corporal (IMC, la puntuación para la actividad de la enfermedad (DAS-28 y la limitación funcional medida con el cuestionario de evaluación de salud - versión peruana (HAQ-P. Resultados: La frecuencia de dislipidemia en pacientes con AR fue 75%. El 54,5% tuvo un IMC fuera de los límites normales. En el DAS-28, la mayoría de pacientes se encontraron con actividad severa de la enfermedad. Sin embargo, hubo más pacientes con dislipidemia en el grupo con moderada actividad. En la escala de HAQ-P, la mitad tuvo incapacidad funcional moderada a severa y mayor número de sujetos con dislipidemia. El 69,7% de los pacientes con alteraciones en el perfil lipídico presentó dislipidemia mixta. Conclusiones: La dislipidemia en los pacientes con AR del estudio se presentó con una alta frecuencia y con diversas formas de alteración en el perfil lipídico sin un patrón uniforme. Por lo tanto, el tratamiento de la dislipidemia sería individualizado en cada paciente para prevenir eventos cardiovasculares.(Rev Med Hered 2011;22:47-53.

  2. Suspectable Risk Factors of Congenital Anomaly in Dr. Hasan Sadikin General Hospital Bandung, Indonesia

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    Pradistya Syifa Yudiasari

    2017-06-01

    Full Text Available Background: Congenital anomaly is a disease of structural or functional alteration since birth. The cause of congenital anomaly is genetic, environtment, and unknown. The cause of congenital anomaly is unknown, made congenital anomaly is difficult to detect. Therefore, the objective of this study was to identify the suspectable risk factors of congenital anomaly. Methods: This was a descriptive study. About 78 samples were taken by purposive sampling from medical records of patients with congenital anomaly in pediatric surgery ambulatory unit at Dr. Hasan Sadikin General Hospital (RSHS, Bandung from September to November 2014. From the selected medical records, an interview was carried out to the parents’ patient to identify some suspectable risk factors. The collected data were analyzed and presented in tables. Results: From 78 medical records,  hirschprung disease was the highest among all type of congenital anomaly (29%. The characteristic of congenital anomaly was mothers in the age of 20–35 years (65%, fathers’ age was  more than 20 years old, family history of congenital anomaly was 1%, there was no history of previous congenital anomaly in previous pregnancy, infection history was 3%, history of medication was 11.5%, mother’s BMI was in normal term (18.5─24.9 as much as 65%, no history of radiation, there was no history of chronic alcohol. History of smoking/passive smoking was high (65%. Conclusions: Hirschprung disease is the highest rate disease in congenital anomaly and smoking is a highest suspectable risk factor contribute to congenital anomaly.   DOI: 10.15850/amj.v4n2.1095

  3. [The pattern of fresh frozen plasma transfusion in Veterans General Hospital-Taichung].

    Science.gov (United States)

    Tsai, C S; Jour, J H; Lirn, J Y

    1992-09-01

    Conducted a survey at Veterans General Hospital in Taichung, to compile a statistical analysis on the usage of fresh frozen plasma (FFP) transfusions. The investigation was conducted from July 1st to September 30, 1991. According to the distribution of usage of FFP, we investigated 726 transfusions (4,216 units) based on our grouping criteria. We found the following: 532 units were used for clotting support which accounts for 12.6% of total, 815 units (19.3%) for blood pressure support, 148 units (3.5%) for combination of clotting and blood pressure support, 681 units (16.2%) for albumin replacement, 436 units (10.3%) for therapeutic pheresis, 396 units (9.4%) for packed red cell concurrently, 819 units (19.4%) for burn cases, and the remaining (9.2%) for other or unidentified reasons. If it was classified by the departments applying FFP; 76% (3,200 units) were used by surgery, 22.4% (947 units) by internal medicine, and 1.6% (69 units) by other departments. Having classified all the reasons for FFP transfusion, we found that FFP was commonly used as a volume expander, for nutrition support, and reconstituted whole blood. These reasons are out of the range of indications for FFP transfusion. This misuse of FFP transfusion increases the chance of transmission infections therefore, we will thoroughly investigate these treatment modalities in order to ensure our blood source is being used in an appropriate manner. This will allow patients the best possible treatment available.

  4. Current Status of Prescription in Type 2 Diabetic Patients from General Hospitals in Busan

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    Ji Hye Suk

    2014-06-01

    Full Text Available BackgroundData regarding the prescription status of individuals with diabetes are limited. This study was an analysis of participants from the relationship between cardiovascular disease and brachial-ankle pulse wave velocity in patients with type 2 diabetes (REBOUND Study, which was a prospective multicenter cohort study recruited from eight general hospitals in Busan, Korea. We performed this study to investigate the current status of prescription in Korean type 2 diabetic patients.MethodsType 2 diabetic patients aged 30 years or more were recruited and data were collected for demographics, medical history, medications, blood pressure, and laboratory tests.ResultsThree thousands and fifty-eight type 2 diabetic patients were recruited. Mean age, duration of diabetes, and HbA1c were 59 years, 7.6 years, and 7.2%, respectively. Prevalence of hypertension was 66%. Overall, 7.3% of patients were treated with diet and exercise only, 68.2% with oral hypoglycemic agents (OHAs only, 5.3% with insulin only, and 19.2% with both insulin and OHA. The percentage of patients using antihypertensive, antidyslipidemic, antiplatelet agents was similar as about 60%. The prevalence of statins and aspirin users was 52% and 32%, respectively.ConclusionIn our study, two thirds of type 2 diabetic patients were treated with OHA only, and one fifth with insulin plus OHA, and 5% with insulin only. More than half of the patients were using each of antihypertensive, antidyslipidemic, or antiplatelet agents. About a half of the patients were treated with statins and one third were treated with aspirin.

  5. Association between atopy and allergic contact dermatitis in Dr. Sardjito General Hospital Yogyakarta

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    Fitria Retno Danarti Hardyanto Soebono

    2014-04-01

    Full Text Available Association between atopy and development of allergic contact dermatitis (ACD remains controversial. T cell disfunctions in a patient with atopy complicate the process of nickel sensitization. On the other, the decrease of the skin barrier function and overexpression of Langerhans cells in the patient facilitate the sensitization.  This study aimed to evaluate the association between atopy and incidence of nickel ACD. A case-control study was carried out in Allergic and Immunology Sub Department of Dermato-Venereology Policlinic, Dr. Sardjito General Hospital, Yogyakarta, involving 54 nickel ACD patients as case group and 74 healthy subjects as control group. All subjects underwent prick test allergens i.e. house dust, dust mite, cockroach, mixed fungi, nuts and egg white. The skin reaction was considered as a positive result if a wheal diameter of at least 3 mm larger than the negative control or a minimum of half of the positive control. The relationship between atopy and the nickel ACD incidence was analyzed using Chi-Square test with confidence interval (CI of 95%. A significant association between atopy and the nickel ACD incidence was observed in this study. Subjects with atopy to  ≥1 allergen had risk of nickel ACD 3.74 higher than subjects without atopy (odds ratio/OR=3.74; 95%CI = 1.64-8.53.  Furtheremore, subjects with atopy to  ≥2 allergens had risk of nickel ACD 3.74 higher than subjects without atopy (OR=2.08; 95%CI = 1.01-4.29. In conclusion, atopy is a risk factor of nickel ACD. Key words: atopy - allergic contact dermatitis - nickel allergy – prick test – allergen

  6. Histopathologic Distribution of Appendicitis at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia, in 2012

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    Tara Zhafira

    2017-03-01

    Full Text Available Background: Appendicitis is a medical emergency and a common cause of emergency surgeries worldwide. Its frequency is varied based on many factors, including age and sex. Histopathologic examination is a gold standard for diagnosis, and complications like gangrene formation and perforation lead to high mortality and morbidity in almost all age groups. This study was conducted to describe the distribution pattern of appendicitis according to age, sex, and histopathologic type. Methods: This cross-sectional study was carried out in the Department of Pathology Anatomy, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia, from August–October 2013. Secondary data were obtained from medical records of January 1st to December 31st, 2012. A total of 503 out of 516 cases were included to be reviewed. Age, sex, and histopathologic type from medical records were then evaluated. Any specific case and perforation were also noted. Results: Data showed the highest prevalence of appendicitis occurred in the 10- 19 age group (28.4% and in the female group (52.3%. Acute appendicitis was more common than chronic appendicitis in both sexes and all age groups. Perforation rate was high (41.4%, and was more prevalent in male (54.9% and in the 0–9 age group (65.7%. Conclusions: Appendicitis, both acute and chronic, is more distributed in the second decade, and is slightly more prevalent in females. Acute cases are more common than chronic. Perforation rate is significant and peaks in the first decade and in males. [AMJ.2017;4(1:36–41

  7. A família e a internação psiquiátrica em hospital geral La familia y la internación psiquiátrica en hospital general Patient's relatives and the psychiatric hospitalization in a general hospital

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    Rita Mello de Mello

    2011-06-01

    Full Text Available Estudo com abordagem qualitativa de natureza na sociologia fenomenológica, de Alfred Schutz, que teve como objetivo identificar os motivos para- relacionados à Internação Psiquiátrica em um Hospital Geral (UIPHG para os familiares. Para tanto, foram entrevistados 14 familiares que possuíam um de seus membros internados na UIPHP no período de agosto a outubro de 2009. Utilizou-se como questão orientadora da entrevista fenomenológica: "o que você espera da Internação Psiquiátrica em um Hospital Geral?". Para compreensão e interpretação dos depoimentos, utilizou-se o referencial teórico da sociologia fenomenológica. Os discursos revelaram três categorias concretas que remeteram aos motivos para: orientação e continuidade no tratamento; perspectivas de melhora e projeções sobre normalidade. Com essa investigação é possível mostrar o tipo vivido desses familiares e contribuir para que os profissionais de saúde mental reflitam sobre suas ações e sobre o envolvimento da família em uma unidade de internação psiquiátrica em hospital geral.Estudio cualitativo con enfoque en la sociología fenomenológica de Alfred Schutz tiene el objetivo de identificar los motivos relacionados a la internación psiquiátrica en un hospital general de los familiares. Para eso se entrevistaron 14 familiares que tenían uno de sus miembros internados en la unidad psiquiátrica de un hospital general entre Agosto y Octubre del 2009. Se utilizará como pregunta orientadora de la entrevista fenomenológica: "qué espera de la internación psiquiátrica en un hospital general?" Para el análisis de los testimonios se utilizó el referencial de la sociología fenomenológica, surgiendo tres categorías concretas que remitían a los motivos para: orientación y continuidad del tratamiento; perspectivas de mejoría; proyecciones sobre normalidad. Con esta investigación podemos indicar el tipo vivido de esos familiares, contribuyendo para que los

  8. Determinants and Countermeasures Strategy of Stock out High on Drug Use in the Abepura General Hospital

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    Rosliah Rosliah

    2016-12-01

    Full Text Available This study aims to determine: (1 To determine the level of knowledge and engagement of staffs Abepura hospital pharmacy in the selection process of pharmaceuticals in Abepura IFRS. (2 To determine the level of knowledge and staffs engagement in installation Abepura hospital pharmacy in the planning process of pharmaceuticals in Abepura IFRS. (3 To know level of knowledge and engagement of staffs Abepura hospital pharmacy in the process of procurement of pharmaceuticals in Abepura IFRS. (4 To determine the level of knowledge and staffs engagement Abepura hospital pharmacy distribution process of pharmaceuticals in Abepura IFRS. (5 To determine the level of knowledge and employee involvement Installation Abepura hospital pharmacy in the evaluation process which includes recording and reporting in IFRS Abepura. (6 To know the strengths and weaknesses based on SWOT analysis in Abepura hospital pharmacy installation. (7 To determine the opportunities and threats based on SWOT analysis in Abepura hospital pharmacy installation. This study was conducted installed Abepura Hospital Pharmacy. Data taken with data collection by filling the questionnaire chief clerk pharmaceutical Installation Abepura Hospital, with the data needed for research and observation techniques done by observation and recording with a direct review of the factors internal and external to the Abepura hospital pharmacy installation. Analysis of the data used is descriptive qualitative analysis. The results showed that the pharmaceutical supply management process involves less labor Pharmacy Installation and knowledge of management of the drug in Abepura IFRS employee is still lacking and SWOT analysis states that the Abepura hospital pharmacy installation has been able to compete in the market competitive rivalry. Based on the SWOT analysis, Abepura Hospital Pharmacy Installation can take advantage of existing strengths and opportunities and minimize weaknesses and threats

  9. An eight-year follow-up national study of medical school and general hospital ethics committees in Japan

    Science.gov (United States)

    Akabayashi, Akira; Slingsby, Brian T; Nagao, Noriko; Kai, Ichiro; Sato, Hajime

    2007-01-01

    Background Ethics committees and their system of research protocol peer-review are currently used worldwide. To ensure an international standard for research ethics and safety, however, data is needed on the quality and function of each nation's ethics committees. The purpose of this study was to describe the characteristics and developments of ethics committees established at medical schools and general hospitals in Japan. Methods This study consisted of four national surveys sent twice over a period of eight years to two separate samples. The first target was the ethics committees of all 80 medical schools and the second target was all general hospitals with over 300 beds in Japan (n = 1457 in 1996 and n = 1491 in 2002). Instruments contained four sections: (1) committee structure, (2) frequency of annual meetings, (3) committee function, and (4) existence of a set of guidelines for the refusal of blood transfusion by Jehovah's Witnesses. Results Committee structure was overall interdisciplinary. Frequency of annual meetings increased significantly for both medical school and hospital ethics committees over the eight years. The primary activities for medical school and hospital ethics committees were research protocol reviews and policy making. Results also showed a significant increase in the use of ethical guidelines, particularly those related to the refusal of blood transfusion by Jehovah's Witnesses, among both medical school and hospital ethics committees. Conclusion Overall findings indicated a greater recognized degree of responsibilities and an increase in workload for Japanese ethics committees. PMID:17598923

  10. A cure for the soul? The benefit of live music in the general hospital.

    Science.gov (United States)

    Moss, H; Nolan, E; O'Neill, D

    2007-01-01

    From 2005 to 2006 a professional orchestra (the Irish Chamber Orchestra) performed in a university teaching hospital with the aims of bringing live music to patients who could not access traditional concert venues and of improving quality of life for patients and staff. This was the first time an orchestra was resident in a hospital in the Republic of Ireland. An independent contemporaneous evaluation was carried out to assess the benefit of live music for patients. Live music in hospital was found to enhance the quality of the aesthetic environment of the hospital, with both patients and staff stating that listening to live music helped them to relax, feel happier and more positive. Patients' perception of the hospital was affected positively by live music in waiting areas. Music was found to have strong emotional effect and the individual preferences and experiences of patients need to be carefully taken into account when programming music in hospital. Listening to live music while in hospital has positive benefits with few negative effects.

  11. Charnley low-friction arthroplasty of the hip. Five to 25 years survivorship in a general hospital

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    Suárez-Vazquez Abelardo

    2008-05-01

    Full Text Available Abstract Background Some studies have raised the question about whether the good results obtained with the Charnley prosthesis could be replicated at general hospitals when it comes to the frequency of early complications and failure rates, both of which would be higher than those published by centres devoted to hip arthroplasties. Methods We reviewed the results of 404 Low Friction Arthroplasties of the hip implanted between 1976 and 1993 in a general hospital by general orthopaedic surgeons. For the survival analysis, the end-point chosen would be the chirurgical revision of any of the prosthetic components for whatever reason. Results The complications were 16 dislocations (4%, 14 deep infections (3.5%, 2 neurological injuries (0,5% and 5 clinical deep venous thromboses (1.2% (2 pulmonary embolisms. The survival rate at 25 years, both for stem and cup, was 83%. Survival was higher in those arthroplasties implanted in patients older than 60 years, with statistical significance. Conclusion Low Friction Arthroplasty undertaken at general hospitals by general orthopaedic surgeons feature similar outcomes to those found in centres devoted to hip surgery.

  12. Lower respiratory tract infection hospitalizations among American Indian/Alaska Native children and the general United States child population

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    Eric M. Foote

    2015-11-01

    Full Text Available Background: The lower respiratory tract infection (LRTI-associated hospitalization rate in American Indian and Alaska Native (AI/AN children aged <5 years declined during 1998–2008, yet remained 1.6 times higher than the general US child population in 2006–2008. Purpose: Describe the change in LRTI-associated hospitalization rates for AI/AN children and for the general US child population aged <5 years. Methods: A retrospective analysis of hospitalizations with discharge ICD-9-CM codes for LRTI for AI/AN children and for the general US child population <5 years during 2009–2011 was conducted using Indian Health Service direct and contract care inpatient data and the Nationwide Inpatient Sample, respectively. We calculated hospitalization rates and made comparisons to previously published 1998–1999 rates prior to pneumococcal conjugate vaccine introduction. Results: The average annual LRTI-associated hospitalization rate declined from 1998–1999 to 2009–2011 in AI/AN (35%, p<0.01 and the general US child population (19%, SE: 4.5%, p<0.01. The 2009–2011 AI/AN child average annual LRTI-associated hospitalization rate was 20.7 per 1,000, 1.5 times higher than the US child rate (13.7 95% CI: 12.6–14.8. The Alaska (38.9 and Southwest regions (27.3 had the highest rates. The disparity was greatest for infant (<1 year pneumonia-associated and 2009–2010 H1N1 influenza-associated hospitalizations. Conclusions: Although the LRTI-associated hospitalization rate declined, the 2009–2011 AI/AN child rate remained higher than the US child rate, especially in the Alaska and Southwest regions. The residual disparity is likely multi-factorial and partly related to household crowding, indoor smoke exposure, lack of piped water and poverty. Implementation of interventions proven to reduce LRTI is needed among AI/AN children.

  13. Junior doctor dementia champions in a district general hospital (innovative practice).

    Science.gov (United States)

    Wilkinson, Iain; Coates, Anna; Merrick, Sophie; Lee, Chooi

    2016-03-01

    Dementia is a common condition in the UK with around 25% of patients in acute hospitals having dementia. In the UK, there is national guidance on the assessment of cognitive impairment in acute hospitals. This article is a qualitative study of junior doctors' experiences as part of a dementia and delirium team involved in changing the care of patients with dementia in a hospital in the UK. It draws on data from a focus group and follow-up questionnaire in two hospital trusts. We examine what drives doctors to become involved in such projects and the effects of this experience upon them. We suggest a typology for getting junior doctors involved in projects generating change when working with patients with dementia. Being more actively involved in caring for and developing services for patients with dementia may represent the crossing of an educational threshold for these junior doctors.

  14. Non-Invasive Continuous Respiratory Monitoring on General Hospital Wards : A Systematic Review

    NARCIS (Netherlands)

    van Loon, Kim|info:eu-repo/dai/nl/341748501; van Zaane, Bas|info:eu-repo/dai/nl/311475361; Bosch, Els J; Kalkman, Cor J|info:eu-repo/dai/nl/078251818; Peelen, Linda M|info:eu-repo/dai/nl/314038426

    2015-01-01

    BACKGROUND: Failure to recognize acute deterioration in hospitalized patients may contribute to cardiopulmonary arrest, unscheduled intensive care unit admission and increased mortality. PURPOSE: In this systematic review we aimed to determine whether continuous non-invasive respiratory monitoring i

  15. Obstetric regional analgesia in the Jesenice General hospital in year 2006

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    Aleksandra Kern

    2007-11-01

    Full Text Available Background: The aim of this retrospective analysis of the obstetric regional analgesia (ORA in Jesenice General Hospital in year 2006 was to evaluate our work and present results. We analysed workload, quality of the analgesia and patients’ satisfaction. We also estimated the OR for vacuum extraction (VE in nulliparous labouring women having ORA. We compared quality of analgesia and total local analgesic consumption in nulliparous women having VE or spontaneous delivery.Methods: We performed retrospective analysis of labours with ORA in year 2006. All women received epiduraly mixture of 0.1 % bupivacaine with 2 µg of fentanyl per ml in intermittent boluses.The labour pain was assessed using visual analogue scale (VAS. We used median and interquartile range to describe distribution of these values and mean with standard deviation to describe distribution of other data (local anaesthetic consumption. We considered patient with pain VAS 3 or less adequately treated, VAS 4 and 5 sufficiently and VAS 6 and more insufficiently treated. We used odds ratio as measurement of risk for VE, t-test for differences in local anaesthetic consumption and Mann-Whitney test to evaluate differences in pain between tested groups.Results: 225 labouring women opted for ORA or 38 % of all labouring women in year 2006. We performed 224 ORA, 59 % during regular work, 41 % during turn of duty. 18 % of ORA were performed between 10 p.m. and 7.00 a.m. In 98 % of cases epidural analgesia was used. Anaesthesiologic work took 16 minutes in average (SD 6.06. Analgesia was started at VAS median 5 (IQR 4–6.5 and at average cervical dilatation 4.1 cm (SD 1.4. Average consumption of bupivacaine was 55 mg (SD 23.7 and fentanyl 91.7 µg (SD 46.5. Most common complications were inadequate analgesia, and misplacement of epidural catheter (10/222, dural tap (6/222, and unilateral analgesia (2/222. 70 labours were ended with VE (13 %; n = 532. There were 27 (8.7 %; n = 309 VE in

  16. The Factor Relate to Job Performance of Nurse with Health Nursing Documentation at Paniai General Hospital Papuan Province

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    Pebur Mote

    2016-12-01

    Full Text Available Nurse as tip of spear in health care at Hospital, having task gives upbringing in to care. Upbringing documentation to care as medium of communication, accountability and takes on sue, statistical information, education medium, observational data source, ministering quality surety, planning data source upbringing to extended care. Data documents helat nursing at Paniai General Hospital upbringing was maximal being done. The goal of this research is to know the regard factor job performance of nurse with health nursing documentation at paniai general hospital. Observational method : This observational type is descriptive analytic with approaching crossectional study. Research is done on month of September- October 2016 at Paniai general hospital. Population is overall nurse at spatial nursed Paniaigeneral hospital as much 81 person consisting of room HCU as much 14 person, room dissects 18 person, coherent room 17 person, mature room 18 person and spatial childs 13 person. The result of this research shwes that there is corelations among nurse age(ρ-value = 0,927; RP = 0,937; CI95%= 0,937; 0,667 – 1,316, gender(ρ -value = 0,933; RP = 1,058; CI95%= 0,768 – 1,457, education (ρ -value = 0,092; RP = 2,080; CI95%= 0,664 – 6,514, working life(ρ -value = 0,927, RP = 0,927; CI95%= 0,667 – 1,316 and nurse science(ρ-value = 0,125, RP= 1,367; CI95%= 1,031 – 1,814 to helath nursing documentation at Paniai General Hospital. Meanwhile there is no corelation among nurse attitude(ρ -value = 0,002; RP = 1,711; CI95%= 1,206 – 2,426, nurse motivation(ρ -value = 0,047, RP = 1,447; CI95%= 1,015 – 2,062, supervision to nurse care(ρ -value = 0,024; RP = 1,484; CI95%= 1,123 – 1,960 and reward (ρ-value= 0,002; RP = 1,855; CI95%= 1,206 – 2,855 to helath nursing documentation at Paniai General Hospital.

  17. Alcohol screening for older adults in an acute general hospital: FAST v. MAST-G assessments

    OpenAIRE

    Knightly, Rachel; Tadros , George; Sharma, Juhi; Duffield, Peter; Carnall, Emma; Fisher, Jacqui; Salman, Shaza

    2016-01-01

    Aims and method Documented prevalence of alcohol misuse among older adult patients at Birmingham Heartlands Hospital is significantly lower than the national prevalence. We aimed to evaluate our alcohol misuse screening protocol for older adults to identify possible shortcomings. Hospital protocol is to screen all adults for alcohol misuse in the accident and emergency (A&E) department using the Fast Alcohol Screening Test (FAST). One hundred consecutive consenting in-patients aged 65-94 admi...

  18. General Practitioners' and Hospital Physicians' Preference for Morphine or Oxycodone as First-Time Choice for a Strong Opioid

    DEFF Research Database (Denmark)

    Poulsen, Karen K; Andersen, Stig E; Moreno, Søren I

    2013-01-01

    opioid naive. The odds ratio (OR) was calculated to investigate whether general practitioners (GPs) and hospital physicians had similar preferences for oxycodone over morphine for strong opioid-naive patients. We included 69,110 first-time prescriptions, of which 59,316 (86%) were for strong opioid......-naive patients. Opioid-naive patients received 79% of the first-time prescriptions for morphine and 91% of the prescriptions for oxycodone. Hospital physicians had a greater preference for oxycodone over morphine than GPs (OR 1.34, 95% CI 1.29-1.39). However, GPs were responsible for approximately 61% of all...... first-time prescriptions for both oxycodone and morphine for strong opioid-naive patients. In conclusion, oxycodone is to a great extent prescribed as the first-choice strong opioid, and both GPs and hospital physicians seem to contribute to this prescribing pattern of strong opioids to outpatients....

  19. Vascular disease in women: comparison of diagnoses in hospital episode statistics and general practice records in England

    Directory of Open Access Journals (Sweden)

    Wright F

    2012-10-01

    Full Text Available Abstract Background Electronic linkage to routine administrative datasets, such as the Hospital Episode Statistics (HES in England, is increasingly used in medical research. Relatively little is known about the reliability of HES diagnostic information for epidemiological studies. In the United Kingdom (UK, general practitioners hold comprehensive records for individuals relating to their primary, secondary and tertiary care. For a random sample of participants in a large UK cohort, we compared vascular disease diagnoses in HES and general practice records to assess agreement between the two sources. Methods Million Women Study participants with a HES record of hospital admission with vascular disease (ischaemic heart disease [ICD-10 codes I20-I25], cerebrovascular disease [G45, I60-I69] or venous thromboembolism [I26, I80-I82] between April 1st 1997 and March 31st 2005 were identified. In each broad diagnostic group and in women with no such HES diagnoses, a random sample of about a thousand women was selected for study. We asked each woman’s general practitioner to provide information on her history of vascular disease and this information was compared with the HES diagnosis record. Results Over 90% of study forms sent to general practitioners were returned and 88% of these contained analysable data. For the vast majority of study participants for whom information was available, diagnostic information from general practice and HES records was consistent. Overall, for 93% of women with a HES diagnosis of vascular disease, general practice records agreed with the HES diagnosis; and for 97% of women with no HES diagnosis of vascular disease, the general practitioner had no record of a diagnosis of vascular disease. For severe vascular disease, including myocardial infarction (I21-22, stroke, both overall (I60-64 and by subtype, and pulmonary embolism (I26, HES records appeared to be both reliable and complete. Conclusion Hospital admission data

  20. A strategy for enhancing financial performance: a study of general acute care hospitals in South Korea.

    Science.gov (United States)

    Choi, Mankyu; Lee, Keon-Hyung

    2008-01-01

    In this study, the determinants of hospital profitability were evaluated using a sample of 142 hospitals that had undergone hospital standardization inspections by the South Korea Hospital Association over the 4-year period from 1998 to 2001. The measures of profitability used as dependent variables in this study were pretax return on assets, after-tax return on assets, basic earning power, pretax operating margin, and after-tax operating margin. Among those determinants, it was found that ownership type, teaching status, inventory turnover, and the average charge per adjusted inpatient day positively and statistically significantly affected all 5 of these profitability measures. However, the labor expenses per adjusted inpatient day and administrative expenses per adjusted inpatient day negatively and statistically significantly affected all 5 profitability measures. The debt ratio negatively and statistically significantly affected all 5 profitability measures, with the exception of basic earning power. None of the market factors assessed were shown to significantly affect profitability. In conclusion, the results of this study suggest that the profitability of hospitals can be improved despite deteriorating external environmental conditions by facilitating the formation of sound financial structures with optimal capital supplies, optimizing the management of total assets with special emphasis placed on inventory management, and introducing efficient control of fixed costs including labor and administrative expenses.

  1. Incidence rates of in-hospital carpal tunnel syndrome in the general population and possible associations with marital status

    Directory of Open Access Journals (Sweden)

    Melani Carla

    2008-10-01

    Full Text Available Abstract Background Carpal tunnel syndrome (CTS is a socially relevant condition associated with biomechanical risk factors. We evaluated age-sex-specific incidence rates of in-hospital cases of CTS in central/northern Italy and explored relations with marital status. Methods Seven regions were considered (overall population, 14.9 million over 3–6-year periods between 1997 and 2002 (when out-of-hospital CTS surgery was extremely rare. Incidence rates of in-hospital cases of CTS were estimated based on 1 codified demographic, diagnostic and intervention data in obligatory discharge records from all Italian public/private hospitals, archived (according to residence on regional databases; 2 demographic general population data for each region. We compared (using the χscore test age-sex-specific rates between married, unmarried, divorced and widowed subsets of the general population. We calculated standardized incidence ratios (SIRs for married/unmarried men and women. Results Age-standardized incidence rates (per 100,000 person-years of in-hospital cases of CTS were 166 in women and 44 in men (106 overall. Married subjects of both sexes showed higher age-specific rates with respect to unmarried men/women. SIRs were calculated comparing married vs unmarried rates of both sexes: 1.59 (95% confidence interval [95% CI], 1.57–1.60 in women, and 1.42 (95% CI, 1.40–1.45 in men. As compared with married women/men, widows/widowers both showed 2–3-fold higher incidence peaks during the fourth decade of life (beyond 50 years of age, widowed subjects showed similar trends to unmarried counterparts. Conclusion This large population-based study illustrates distinct age-related trends in men and women, and also raises the question whether marital status could be associated with CTS in the general population.

  2. Experiencia acerca del traslado de un hospital general y su repercusión en la actividad asistencial Experience of the moving day of a general hospital and effect on clinical activity

    Directory of Open Access Journals (Sweden)

    Antoni Juan

    2012-02-01

    Full Text Available Objetivos: Describir el proceso del día del traslado de un hospital general. Analizar el impacto en la actividad asistencial en los primeros meses después del traslado. Método: Hospital general de ámbito comarcal, en Cataluña, que se traslada a un nuevo edifico. Se describe el proceso del traslado de los pacientes y se analiza el impacto en la actividad (se comparan 3 meses a partir del traslado [período 2] con los mismos meses del año anterior [período 1]. Resultados: Se trasladaron 37 pacientes sin incidencias. Se atendieron 18.786 urgencias en el período 1 y 21.266 en el período 2 (+13,2%. El número de ingresos urgentes/programados fue de 1314/803 en el período 1 y de 1427/979 en el período 2 (+8,59%/+21,91%. Las visitas realizadas en consultas externas fueron 32.116 en el período 1 y 30.777 en el período 2 (-4,16% Conclusiones: Una adecuada planificación y coordinación permitió realizar un traslado de hospital sin incidencias y sin reducir la actividad asistencial.Objectives: To describe the moving day of a general hospital and to analyze the impact on clinical activity in the first few months after the move. Methods: We describe the process of patient transfer and analyze the impact on activity of moving a regional general hospital in Catalonia (Spain to a new building. Activity was compared in two periods: the first 3 months after the move (period 2 and the same 3 months in the previous year (period 1. Results: We moved 37 patients without incidents. A total of 18,786 patients were admitted to the emergency room in period 1 and 21,266 were admitted in period 2 (+13.2%. The number of admissions from the emergency room vs elective admissions was 1,314/803 in period 1 and 1,427/979 in period 2 (+8.59%/+21.91%. The number of outpatient visits in period 1 was 32,116 and 30,777 in period 2 (-4.16%. Conclusions: Proper planning and coordination allowed the hospital to be moved without incidents and without decreasing activity.

  3. [The home palliative care transition manual for the regional cooperation from the general ward at Shizuoka Red Cross Hospital].

    Science.gov (United States)

    Shiraishi, Ko

    2007-12-01

    Recently, a home palliative care has been recommended for terminal stage cancer patients. However, a few clinics are available providing a home palliative care. As a result of that, there have been many cases of the terminal stage cancer patients who could not receive a peace of mind care and die peacefully at home. Home palliative care has been promoted in Shizuoka City by starting Shizuoka city regional cooperation conference of cancer management with a help from Shizuoka city medical association and the general hospital. It is important to have the knowledge and technique put into practice by clinics and home visiting nurses for a further improvement of the palliative care. In order to transfer patient smoothly, the palliative care team conference is held in the general ward and the homecare transition manual is used at the hospital. An application of homecare insurance, the visiting doctor and nurse are arranged in parallel to management of physical and psychological symptoms of the patient, the visiting doctor and nurse are arranged. Before a patient is discharged from the hospital, the meeting will be held among the ward staff, visiting nurse and the patient's family. We intervened 8 cases from April to July 2007. Six out of 8 cases were transferred to home, and 2 patients were died at home. The home care transition manual will be shared with other hospitals from now on.

  4. Reducing transfers of psychiatric inpatients to emergency rooms of general hospitals in Singapore: a clinical practice improvement project.

    Science.gov (United States)

    Low, Tchern Kuang Lambert; Tay, Kai Hong; Fang, Tina; Fung, Daniel Shuen Sheng

    2017-03-01

    Patients admitted to a psychiatric hospital commonly suffer from comorbid medical problems which sometimes require urgent medical attention. Twenty-two percent of emergency medical transfers from the Institute of Mental Health (IMH) to the emergency rooms of general hospitals were preventable and could be managed at IMH itself. We undertook a quality improvement project to understand the reasons behind such preventable referrals and implemented changes to address this. Using the model for improvement, we deconstructed our processes and analysed root causes for such preventable referrals. Thereafter changes were implemented with Plan-Do-Study-Act (PDSA) cycles to analyse their outcomes. During the 6-month study period, we achieved a 100% reduction in preventable referrals through strategies aimed at reducing pressure on our on-call physicians in the making of medical decisions, maximising usage of our medical resources, constant education and raising awareness of this issue. Reducing preventable transfer of inpatients from a psychiatric hospital to the emergency departments of general hospitals is a worthwhile endeavour. Such initiatives optimise use of healthcare resources, improve patient care and increase satisfaction.

  5. Surgical management of pneumothorax: significance of effective admission or communication strategies between the district general hospitals and specialized unit.

    Science.gov (United States)

    Aslam, Muhammad I; Martin-Ucar, Antonio E; Nakas, Apostolos; Waller, David A

    2011-11-01

    A preoperative delay in emergency surgery for spontaneous pneumothorax is associated with a poor outcome after surgery and a prolonged hospital stay. To reduce preoperative delays, all tertiary referrals from district general hospitals to our thoracic surgery unit were processed through a 'clinical decisions unit' (CDU). Prior to the establishment of the CDU, these patients were added to a waiting list for a surgical bed. This study has reviewed the effect of this change in admission policy on the efficiency of treatment for non-elective spontaneous pneumothorax. An intergroup comparison (pre-CDU group vs. post-CDU group) was made of the following parameters: referral to transfer time, transfer to surgery time and length of inpatient stay in the referring and tertiary hospitals. There were no significant differences in gender, diagnosis, treatment in the referring hospitals, postoperative clinical outcome, or indications for or type of surgery. The total length of inpatient stay in the referring and tertiary hospitals was significantly reduced for the post-CDU group (12 vs. 15 days; P<0.001), which was attributed to the earlier transfer of patients (18 vs. 78 hours; P<0.001) hours. Allowing surgical access to a traditional medical admission unit is therefore, cost-effective and significantly improves the efficiency of non-elective pneumothorax surgery.

  6. [Mortality associated with nosocomial infection, occurring in a general hospital of Sumaré-SP, Brazil].

    Science.gov (United States)

    Guimarães, Aline Caixeta; Donalisio, Maria Rita; Santiago, Thaiana Helena Roma; Freire, June Barreiros

    2011-01-01

    This study investigated the socio-demographic profile, clinical procedures and etiology of nosocomial infection associated with deaths in the Hospital Estadual Sumaré, state of São Paulo, Brazil, from 2007 to 2008. The retrospective study of medical records (n = 133) revealed an average of 35 days of hospitalization. Most patients (97%) underwent some invasive procedure associated with nosocomial infection (p ≤ 0.05), including: 90 (67.7%) pneumonia, 62 (46.6%), urinary infections and 97 (73%) septicemia. Infection was the leading cause of death in 75 (56.4%) cases, with defined etiology in 110 (82.7%); 34 (30.9%) because of microorganisms that were multidrug-resistant. The most common was Staphylococcus aureus (25%), related to pneumonia and blood stream infection. The monitoring of hospital infection contributed to intervention at risk situation and death.

  7. Fixed airways obstruction among patients with severe asthma: findings from the Singapore General Hospital-Severe Asthma Phenotype Study

    OpenAIRE

    Yii, Anthony Chau Ang; Tan, Gan Liang; Tan, Keng Leong; Lapperre, Therese Sophie; Mariko Siyue KOH

    2014-01-01

    Background A subset of severe asthma patients has fixed airways obstruction, which is characterized by incomplete reversibility to bronchodilator challenge. We aimed to elucidate the factors associated with fixed airways obstruction in a cohort of patients with severe asthma in Singapore. Methods 245 patients from the Singapore General Hospital-Severe Asthma Phenotype Study (SGH-SAPS) were screened. These patients fulfilled World Health Organization criteria for "treatment-resistant severe as...

  8. Evaluation of efficacy of restorative dental treatment provided under general anesthesia at hospitalized pediatric dental patients of Isfahan

    OpenAIRE

    Eshghi, Alireza; Samani, Mahdi Jafarzadeh; Najafi, Naghme Feyzi; Hajiahmadi, Maryam

    2012-01-01

    Background: General anesthesia (GA) allows dental treatment to be rendered under optimal conditions, theoretically ensuring ideal outcomes. The aim of this study was to determine the efficacy of restorative dental procedures performed under GA. Materials and Methods: In this cross-sectional retrospective study, 305 pediatric patients who had been treated under GA 6 to 24 months before our survey at Isfahan's hospitalized dentistry center were examined. The examination was performed on dental ...

  9. Factors affecting poor attendance for outpatient physiotherapy by patients discharged from Mthatha General Hospital with a stroke

    OpenAIRE

    N.P. Ntamo; D. Buso; Longo-Mbenza, B

    2013-01-01

    Background: Stroke is a major cause of disability inthe world and its long term effects require adherence to physiotherapyprotocols for optimal rehabilitation. Clinical impression of data fromMthatha General Hospital (MGH) Physiotherapy Department revealedthat there was poor attendance of outpatient physiotherapy by strokepatients discharged from MGH and this had negative effects on outcomesand health care costs.Objective: To determine the extent and the socio-demographic reasonsfor poor atte...

  10. [原著]Effects of personality traits and work-related attitudes on job stress among nurses in general hospitals

    OpenAIRE

    2013-01-01

    Purpose: We aimed to clarify whether personality traits and work-related attitudes affect job stress among medical care professionals. Methods: Subjects were 455 nurses (59 males, 396 females) working in general hospitals. Seven dimensions of personality traits, i.e., novelty seeking (NS), harm avoidance (HA), reward dependence (RD), persistence (P), self-directedness (SD), cooperativeness (C) and selftranscendence (ST), were assessed by using the Temperament Character Inventory-125. A 15-ite...

  11. STUDY OF PREMATURE BABIES IN RELATION TO ITS OUTCOME AND ANTENATAL RISK FACTORS AT GENERAL HOSPITAL SANGLI

    OpenAIRE

    Satish D; Suresh K; Renuka S

    2014-01-01

    : OBJECTIVE: To know the neonatal outcome and antenatal risk factors among premature babies. MATERIAL & METHODS: STUDY DESIGN: A retrospective study. SETTING: Neonatal Intensive Care Unit (NICU) of General Hospital Sangli under Government Medical College, Miraj. SAMPLE SIZE: 134 Premature babies admitted during the year 2013 in NICU. DATA COLLECTION: From the case sheet of the study subjects, with the help of pre structured proforma. STUDY PERIOD: January 2013 to December ...

  12. Sexual life satisfaction and its associated socio-demographic and workplace factors among Chinese female nurses of tertiary general hospitals.

    Science.gov (United States)

    Ji, Feng; Jiang, Deguo; Lin, Xiaodong; Zhang, Wei; Zheng, Weifang; Cheng, Ce; Lin, Chongguang; Hu, Lirong; Zhuo, Chuanjun

    2017-08-15

    Adverse workplace factors such as job stress are reported to be associated with poor physical and mental health of nurses. However, associations between occupational factors and sexual life satisfaction (SLS) of nurses remain understudied. This study investigated SLS of Chinese female nurses of tertiary general hospitals and socio-demographic and occupational factors associated with reduced SLS of nurses. In this cross-sectional survey, 393 Chinese female nurses of four tertiary general hospitals completed a standardized socio-demographic and occupational characteristics questionnaire, Zung's Self-rating Scale for Depression, Job Content Questionnaire, and a self-report SLS question. Multiple ordinal logistic regression was used to identify factors related to reduced SLS. Fourteen point five percent female nurses were dissatisfied with their current sex lives. In multiple regression, related factors for decreased SLS included being unmarried (OR = 1.49), shift work (OR = 1.92), contract employment (OR = 1.63), high job demands (OR = 2.21), low job control (OR = 1.88), inadequate social support (OR = 2.32), and depression (OR = 3.14). Chinese female nurses of tertiary general hospitals have poor SLS. Reducing job stress and providing psycho-social support may help improve SLS of nurses.

  13. Antibiotic utilization evaluation of inpatient and outpatient prescriptions in a rural general hospital in Iran

    Directory of Open Access Journals (Sweden)

    Aida Sefidani Forough

    2015-06-01

    Conclusion: Our study showed that implementation of strict regulations for antibiotic use is extremely needed in this rural hospital. Establishing local guidelines, providing adequate education for healthcare professionals and putting restrictions for broad-spectrum antibiotic use can be beneficial. [Int J Basic Clin Pharmacol 2015; 4(3.000: 531-536

  14. The responses of nursing system to the outbreak of SARS in a general hospital

    Institute of Scientific and Technical Information of China (English)

    张黎明; 王建荣; 冯志英; 杨晓秋; 刘钰; 袁彬

    2003-01-01

    Severe Acute Respiratory Syndrome (SARS), referred to as "contagious atypical pneumonia" is the fastest spreading communicable disease known in recent history. This disease is different from other kinds of respiratory contagion due to the following aspects: the syndrome happens quickly and the infectivity is high. New problems encountered by the nursing management staff are the precipitate, pestiferous, and large numbers of in-patients and the understanding of appropriate responses, within large complex hospitals, to ensure patient care is actively supported and infectivity is prevented. To deal with these problems, we implemented the following strategies: reinforcement of the management system; optimization of the nursing flow; amendments to related hospital policies;collection of relevant information; adherence to stringent disinfection protocols; isolation of areas; reallocation of hospital resources and more efficient utilization of resources. The above strategies have reinforced the nursing management system's active response, guaranteed daily operation of the hospital'snursing activities, including the quality of care provided by the nurses, and ensured the health of patients, nurses and doctors.

  15. Generalization of the Right Acute Stroke Prevention Strategies in Reducing in-Hospital Delays.

    Directory of Open Access Journals (Sweden)

    Qiang Huang

    Full Text Available The aim of this study was to reduce the door-to-needle (DTN time of intravenous thrombolysis (IVT in acute ischemic stroke (AIS through a comprehensive, hospital-based implementation strategy. The intervention involved a systemic literature review, identifying barriers to rapid IVT treatment at our hospital, setting target DTN time intervals, and building an evolving model for IVT candidate selection. The rate of non-in-hospital delay (DTN time ≤ 60 min was set as the primary endpoint. A total of 348 IVT cases were enrolled in the study (202 and 146 in the pre- and post-intervention group, respectively. The median age was 61 years in both groups; 25.2% and 26.7% of patients in the pre- and post-intervention groups, respectively, were female. The post-intervention group had higher rates of dyslipidemia and minor stroke [defined as National Institutes of Health Stroke Scale (NIHSS ≤ 3]; less frequent atrial fibrillation; higher numbers of current smokers, heavy drinkers, referrals, and multi-model head imaging cases; and lower NIHSS scores and blood sugar level (all P 0.05. These findings indicate that it is possible to achieve a DTN time ≤ 60 min for up to 60% of hospitals in the current Chinese system, and that this logistical change can yield a notable improvement in the outcome of IVT patients.

  16. [Carotid endarterectomy: review of 10 years of practice of general and locoregional anesthesia in a tertiary care hospital in Portugal].

    Science.gov (United States)

    Lobo, Mercês; Mourão, Joana; Afonso, Graça

    2015-01-01

    Retrospective and prospective randomized studies have compared general and locoregional anesthesia for carotid endarterectomy, but without definitive results. Evaluate the incidence of complications (medical, surgical, neurological, and hospital mortality) in a tertiary center in Portugal and review the literature. Retrospective analysis of patients undergoing endarterectomy between 2000 and 2011, using a software for hospital consultation. A total of 750 patients were identified, and locoregional anesthesia had to be converted to general anesthesia in 13 patients. Thus, a total of 737 patients were included in this analysis: 74% underwent locoregianal anesthesia and 26% underwent general anesthesia. There was no statistically significant difference between the two groups regarding perioperative variables. The use of shunt was more common in patients undergoing general anesthesia, a statistically significant difference. The difference between groups of strokes and mortality was not statistically significant. The average length of stay was shorter in patients undergoing locoregional anesthesia with a statistically significant difference. We found that our data are overlaid with the literature data. After reviewing the literature, we found that the number of studies comparing locoregional and general anesthesia and its impact on delirium, cognitive impairment, and decreased quality of life after surgery is still very small and can provide important data to compare the two techniques. Thus, some questions remain open, which indicates the need for randomized studies with larger number of patients and in new centers. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  17. Carotid endarterectomy: review of 10 years of practice of general and locoregional anesthesia in a tertiary care hospital in Portugal.

    Science.gov (United States)

    Lobo, Mercês; Mourão, Joana; Afonso, Graça

    2015-01-01

    Retrospective and prospective randomized studies have compared general and locoregional anesthesia for carotid endarterectomy, but without definitive results. Evaluate the incidence of complications (medical, surgical, neurological, and hospital mortality) in a tertiary center in Portugal and review the literature. Retrospective analysis of patients undergoing endarterectomy between 2000 and 2011, using a software for hospital consultation. A total of 750 patients were identified, and locoregional anesthesia had to be converted to general anesthesia in 13 patients. Thus, a total of 737 patients were included in this analysis: 74% underwent locoregional anesthesia and 26% underwent general anesthesia. There was no statistically significant difference between the two groups regarding per operative variables. The use of shunt was more common in patients undergoing general anesthesia, a statistically significant difference. The difference between groups of strokes and mortality was not statistically significant. The average length of stay was shorter in patients undergoing locoregional anesthesia with a statistically significant difference. We found that our data are overlaid with the literature data. After reviewing the literature, we found that the number of studies comparing locoregional and general anesthesia and its impact on delirium, cognitive impairment, and decreased quality of life after surgery is still very small and can provide important data to compare the two techniques. Thus, some questions remain open, which indicates the need for randomized studies with larger number of patients and in new centers. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  18. Carotid endarterectomy: review of 10 years of practice of general and locoregional anesthesia in a tertiary care hospital in Portugal

    Directory of Open Access Journals (Sweden)

    Mercês Lobo

    2015-08-01

    Full Text Available BACKGROUND: Retrospective and prospective randomized studies have compared general and locoregional anesthesia for carotid endarterectomy, but without definitive results.OBJECTIVES: Evaluate the incidence of complications (medical, surgical, neurological, and hospital mortality in a tertiary center in Portugal and review the literature.METHODS: Retrospective analysis of patients undergoing endarterectomy between 2000 and 2011, using a software for hospital consultation.RESULTS: A total of 750 patients were identified, and locoregional anesthesia had to be converted to general anesthesia in 13 patients. Thus, a total of 737 patients were included in this analysis: 74% underwent locoregional anesthesia and 26% underwent general anesthesia. There was no statistically significant difference between the two groups regarding per operative variables. The use of shunt was more common in patients undergoing general anesthesia, a statistically significant difference. The difference between groups of strokes and mortality was not statistically significant. The average length of stay was shorter in patients undergoing locoregional anesthesia with a statistically significant difference.CONCLUSIONS: We found that our data are overlaid with the literature data. After reviewing the literature, we found that the number of studies comparing locoregional and general anesthesia and its impact on delirium, cognitive impairment, and decreased quality of life after surgery is still very small and can provide important data to compare the two techniques. Thus, some questions remain open, which indicates the need for randomized studies with larger number of patients and in new centers.

  19. [Infectious diseases in the adult population admitted to a general hospital].

    Science.gov (United States)

    Ramos, José M; Pinargote, Héctor; Torrús, Diego; Sánchez-Martínez, Rosario; Merino, Esperanza; Portilla, Joaquín

    2015-10-01

    To determine the infectious diseases (ID) that led to hospital admission of the foreign population>14 years. A retrospective study of foreign patients admitted to hospital (2000-2012). A total of 3,087 foreigners were admitted with infectious diseases. Of these, 73.6% were from low income countries, and 26.4% from high income countries. Most of them (86.9%) were admitted with common ID, 11.8% with transmissible ID, and 1.6% with tropical ID. Tropical ID and transmissible ID were higher in patients from low income countries (14.7%) than from high income countries (9.7%, pEnfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  20. General Disinfection in Medical and Dental Hospitals, Selection of Disinfectant Type and Problems Encountered

    OpenAIRE

    Akça, Gülin

    2015-01-01

    Hospitals are the places where, either the patients or other health workers can encounter with dangerous problem of several bacterial, fungal, viral, parasitic infectious agents, especially the emerging and life threatening ones such as, methicillin-resistant Staphylococcus aureus (MRSA), vancomycin resistant Enterococcus faecalis (VRE), Stenotrophomonas sp., and multi drug resistant Acinetobacter sp., Pseudomonas sp.. The reasons of these resistant microorganisms that can threaten the life o...

  1. The Current Status of Integrative Therapies in Treating Parkinson's Disease in Six General Hospitals in Shanghai

    OpenAIRE

    Lu, Hua; Pan, Weidong; Wang, Jun; Wu, Chunlan; Gong, Fan; Sun, Yan; Liu, Yun; LIU Jun; Liu, Yi; Bai, Yu

    2013-01-01

    Objective: To investigate the current use of Western medicine and integrative therapies in the treatment of patients with Parkinson’s disease (PD). Methods: A crosssectional, multicentre clinical epidemiological survey was conducted in six hospitals in Shanghai. We investigated the varieties and frequencies of use of prescriptions of Chinese herb decoctions and compounds as well as the frequencies of other selected therapies. Results: All of the patients with PD were t...

  2. Orthogeriatric activity in a general hospital of Castilla-La Mancha, Spain.

    Science.gov (United States)

    Fernández-Ibáñez, J M; Morales-Ballesteros, M C; Crespo-Romero, E; Gómez-Gómez, S; Fraga-Fuentes, M D; Cruz-Tejado, J; Hernández-Zegarra, P A; Arias-Arias, Á; García-Baltasar, M M

    To describe the orthogeriatric activity in the elderly with hip fractures in the Hospital Mancha Centro, based on the recommendations of the main guidelines. Observational prospective study, comprising all patients over 65 years of age admitted to the Traumatology Unit with a hip fracture between April 2015 and December 2015. Patients were admitted under the care of the Traumatology Unit with cross-consultation carried out with the Geriatrics Department, which then carried out a pre-operative geriatric assessment and the post-operative follow-ups. The mean pre-surgery waiting time was 48h and the overall time in hospital was 10.3±8.2 days. Patients who suffered from delirium (42.1%) did not improve as well, and were referred to nursing homes. Blood transfusions were received by 54.7% of the patients, despite 53.5% of them having received intravenous and/or oral iron after the surgery. Treatment with calcium and vitamin D was prescribed in 79% of the patients on discharge. The Rehabilitation Unit assessed 36% of the patients, with 4.8% fully, and 16.7% partially recovering their prior functional status. Upon discharge, 55% of the patients returned to their homes, and 22% were referred to short-term assisted living facilities. This article describes how the main clinical problems are handled in the elderly with hip fractures in our hospital, based on recommendations of the main guidelines and publications. Our hospital follows the recommended guidelines. Aspects for improvement include the management of anaemia during admission and rehabilitation. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Histerectomia Laparoscópica em um Hospital Geral Comunitário Experiência Inicial e Comparação de Custos Hospitalares Laparoscopic Hysterectomy in a Community General Hospital Initial Experience and Comparison of Hospital Costs

    Directory of Open Access Journals (Sweden)

    Randal Henrique de Oliveira

    2000-03-01

    Full Text Available Objetivo: comparar os custos hospitalares entre a histerectomia vaginal assistida por laparoscopia (HVAL e a histerectomia total abdominal (HTA, relatando a experiência inicial com a nova abordagem em um hospital geral comunitário. Pacientes e Métodos: foram comparados 11 casos de HVAL e 23 de HTA, realizados de setembro de 1998 a julho de 1999. Prontuários e demonstrativos das despesas hospitalares de cada paciente foram revistos para coletar as variáveis analisadas. Resultados: não houve diferença estat��stica entre os grupos quanto à idade, paridade e cirurgia abdominal prévia. A principal indicação cirúrgica para ambos os grupos foi leiomiomatose uterina. O grupo das HVAL apresentou tempo de internação menor, com mediana de 1 dia e o das HTA, de 2 dias (pPurpose: to compare hospital costs between laparoscopically assisted vaginal hysterectomy (LAVH and total abdominal hysterectomy (TAH, reporting the initial experience with the new approach in a communitary general hospital. Patients and Methods: eleven cases of LAVH and 23 of TAH, carried out from September 1998 to July 1999, were compared. Each patient's records and hospital charges were reviewed to collect the analyzed variables. Results: there was no statistical difference between the groups in relation to age, parity, and previous abdominal surgery. The main surgical indication for both groups was uterine leiomyomatosis. The LAVH group presented a shorter hospital stay with a median of one day, and the TAH group, of two days (p<0.01. LAVH showed to be 40.2% more expensive than TAH (p<0.01. Operating room charges contributed to the major part of hospital costs for both groups, corresponding to 79.8 and 57.9% of the total, for LAVH and TAH, respectively. LAVH infirmary charges were smaller than for TAH, with a statistically significant difference (p = 0.002. Conclusion: with shorter hospital stay and smaller infirmary costs, we demonstrated that LAVH provides better

  4. Impact of cerebral cardiopulmonary resuscitation maneuvers in a general hospital: prognostic factors and outcomes

    Directory of Open Access Journals (Sweden)

    Bartholomay Eduardo

    2003-01-01

    Full Text Available OBJECTIVE: To assess survival of patients undergoing cerebral cardiopulmonary resuscitation maneuvers and to identify prognostic factors for short-term survival. METHODS: Prospective study with patients undergoing cardiopulmonary resuscitation maneuvers. RESULTS: The study included 150 patients. Spontaneous circulation was re-established in 88 (58% patients, and 42 (28% were discharged from the hospital. The necessary number of patients treated to save 1 life in 12 months was 3.4. The presence of ventricular fibrillation or tachycardia (VF/VT as the initial rhythm, shorter times of cardiopulmonary resuscitation maneuvers and cardiopulmonary arrest, and greater values of mean blood pressure (BP prior to cardiopulmonary arrest were independent variables for re-establishment of spontaneous circulation and hospital discharge. The odds ratios for hospital discharge were as follows: 6.1 (95% confidence interval [CI] = 2.7-13.6, when the initial rhythm was VF/VT; 9.4 (95% CI = 4.1-21.3, when the time of cerebral cardiopulmonary resuscitation was 70 mmHg. CONCLUSION: The presence of VF/VT as the initial rhythm, shorter times of cerebral cardiopulmonary resuscitation and of cardiopulmonary arrest, and a greater value of BP prior to cardiopulmonary arrest were independent variables of better prognosis.

  5. [Geriatric emergencies versus adult emergencies: retrospective analysis of medical emergencies at a general hospital].

    Science.gov (United States)

    Rodríguez Artalejo, F; González Montalvo, J I; Sanz Segovia, F; Jaramillo Gómez, E; Banegas Banegas, J R; Rodríguez Mañas, L; Carbonell Collar, A

    1989-10-14

    The aim of the study was to evaluate the process of the attention to emergencies in patients older than 65 years and to compare it with the same process in adult patients. To this end, 965 clinical records of medical emergencies from the Hospital Central de la Cruz Roja in Madrid were retrospectively evaluated, and data were obtained regarding age, the cause for consultation, the investigations performed and their yield, the administration of drug therapy, the major diagnosis at the time of discharge from the service and the clinical course. It was found that all evaluated diagnostic investigations were carried out with equal or higher frequency in patients older than 65 years and that their mean clinical effectiveness was also higher. In addition, it was found that the patients older than 65 years were more commonly admitted to the hospital through the emergency service than the rest of the population. It was concluded, therefore, that the process of attention to emergencies has differential characteristics in the elderly population, and that if the number and proportion of old people increase as it will presumably happen during the two next decades, the cost of attention to emergencies and the number of emergency hospital admissions will also increase.

  6. Admission of foreign citizens to the general teaching hospital of bologna, northeastern Italy: An epidemiological and clinical survey

    Directory of Open Access Journals (Sweden)

    Sergio Sabbatani

    2006-04-01

    Full Text Available BACKGROUND: The emergency regarding recent immigration waves into Italy makes continued healthcare monitoring of these populations necessary. METHODS: Through a survey of hospital admissions carried out during the last five years at the S. Orsola-Malpighi General Hospital of Bologna (Italy, all causes of admission of these subjects were evaluated, together with their correlates. Subsequently, we focused on admissions due to infectious diseases. All available data regarding foreign citizens admitted as inpatients or in Day-Hospital settings of our teaching hospital from January 1, 1999, to March 31, 2004, were assessed. Diagnosis-related group (DRG features, and single discharge diagnoses, were also evaluated, and a further assessment of infectious diseases was subsequently made. RESULTS: Within a comprehensive pool of 339,051 hospitalized patients, foreign citizen discharges numbered 7,312 (2.15%, including 2,542 males (34.8% and 4,769 females (65.2%. Males had a mean age of 36.8±14.7 years, while females were aged 30.8±12.2 years. In the assessment of the areas of origin, 34.6% of hospitalizations were attributed to patients coming from Eastern Europe, 15.3% from Northern Africa, 7.3% (comprehensively from Western Europe and United States, 6.9% from the Indian subcontinent, 5.9% from sub-Saharan Africa, 5.7% from Latin America, 4.1% from China, 2.5% from the Philippines, and 1.1% from the Middle East. Among women, most hospitalizations (58.8% were due to obstetrical-gynecological procedures or diseases, including assistance with delivery (27.1%, and pregnancy complications (18.7%, followed by psycho-social disturbances (5.9%, malignancies (5.1%, gastrointestinal diseases (4.7%, and voluntary pregnancy interruption (4.4%. Among men, the most frequent causes of admissions were related to trauma (15.9%, followed by gastroenteric disorders (12%, heart-vascular diseases (8.9%, psycho-social disorders (8.4%, respiratory (7.1%, kidney (6.1%, liver

  7. Admission of foreign citizens to the general teaching hospital of bologna, northeastern Italy: An epidemiological and clinical survey

    Directory of Open Access Journals (Sweden)

    Sergio Sabbatani

    Full Text Available BACKGROUND: The emergency regarding recent immigration waves into Italy makes continued healthcare monitoring of these populations necessary. METHODS: Through a survey of hospital admissions carried out during the last five years at the S. Orsola-Malpighi General Hospital of Bologna (Italy, all causes of admission of these subjects were evaluated, together with their correlates. Subsequently, we focused on admissions due to infectious diseases. All available data regarding foreign citizens admitted as inpatients or in Day-Hospital settings of our teaching hospital from January 1, 1999, to March 31, 2004, were assessed. Diagnosis-related group (DRG features, and single discharge diagnoses, were also evaluated, and a further assessment of infectious diseases was subsequently made. RESULTS: Within a comprehensive pool of 339,051 hospitalized patients, foreign citizen discharges numbered 7,312 (2.15%, including 2,542 males (34.8% and 4,769 females (65.2%. Males had a mean age of 36.8±14.7 years, while females were aged 30.8±12.2 years. In the assessment of the areas of origin, 34.6% of hospitalizations were attributed to patients coming from Eastern Europe, 15.3% from Northern Africa, 7.3% (comprehensively from Western Europe and United States, 6.9% from the Indian subcontinent, 5.9% from sub-Saharan Africa, 5.7% from Latin America, 4.1% from China, 2.5% from the Philippines, and 1.1% from the Middle East. Among women, most hospitalizations (58.8% were due to obstetrical-gynecological procedures or diseases, including assistance with delivery (27.1%, and pregnancy complications (18.7%, followed by psycho-social disturbances (5.9%, malignancies (5.1%, gastrointestinal diseases (4.7%, and voluntary pregnancy interruption (4.4%. Among men, the most frequent causes of admissions were related to trauma (15.9%, followed by gastroenteric disorders (12%, heart-vascular diseases (8.9%, psycho-social disorders (8.4%, respiratory (7.1%, kidney (6.1%, liver

  8. Ten Years, Forty Decision Aids, And Thousands Of Patient Uses: Shared Decision Making At Massachusetts General Hospital.

    Science.gov (United States)

    Sepucha, Karen R; Simmons, Leigh H; Barry, Michael J; Edgman-Levitan, Susan; Licurse, Adam M; Chaguturu, Sreekanth K

    2016-04-01

    Shared decision making is a core component of population health strategies aimed at improving patient engagement. Massachusetts General Hospital's integration of shared decision making into practice has focused on the following three elements: developing a culture receptive to, and health care providers skilled in, shared decision making conversations; using patient decision aids to help inform and engage patients; and providing infrastructure and resources to support the implementation of shared decision making in practice. In the period 2005-15, more than 900 clinicians and other staff members were trained in shared decision making, and more than 28,000 orders for one of about forty patient decision aids were placed to support informed patient-centered decisions. We profile two different implementation initiatives that increased the use of patient decision aids at the hospital's eighteen adult primary care practices, and we summarize key elements of the shared decision making program.

  9. Nurses and care workers’ perceptions of their nurse-patient therapeutic relationship in private general hospitals, Gauteng, South Africa

    Directory of Open Access Journals (Sweden)

    Anna E. van den Heever

    2013-09-01

    Full Text Available Facilitation of a therapeutic relationship is an essential skill in nursing, particularly in mental-health care. Nurses and care workers in private general hospitals are exposed to the emotional effects of physical illness as well as the increase in admission of patients with mental-health needs. Poor nurse-patient relationships have been reported by patients and in the media. The researchers experienced incidents of apparent misunderstandings during nurse-patient interactions whilst working in private general hospitals. No studies have been done regarding how nurses and care workers perceive a therapeutic relationship with patients in terms of the patients’ emotional and mental-health needs. A quantitative, contextual and deductive study was conducted in three private general hospitals in Gauteng, South Africa with a purposive sample of 154 nurses and 30 care workers. Based on the concepts of a therapeutic relationship, empathy, positive regard, genuineness, concreteness and self-exploration, nurses and care workers’ perceptions of facilitating a therapeutic relationship were self-assessed using five-point scales in a questionnaire. Data were analysed using descriptive statistics and non-parametric statistical techniques. Specific hypotheses were tested to identify whether statistically-significant differences existed between the perceptions of two or more groups of nurses and care workers. Results showed a general insensitivity and lack of awareness and reflection on the part of nurses and care workers with regard to the patients’ emotional needs. When categories of nurses were compared, no statistically-significant differences were found between the perceptions of the various groups tested. There is a need for self-awareness, continued interpersonal skills training and supervision of nurses and care workers. A large percentage of the participants were younger than 40 years, subprofessional, with less than 10 years’ experience as

  10. Tromboprofilaxis en pacientes no quirúrgicos internados en un hospital general

    OpenAIRE

    Marcelo J. Melero; Vanina L. Pagotto; Juan A. Mazzei

    2012-01-01

    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...

  11. [Testing the hemalog D in a hematology department of a general hospital in Paris (author's transl)].

    Science.gov (United States)

    Lortholary, P; Lejeune, F; Ganon, J P; Mathiot, C; Turpin, F

    1978-06-10

    Europe's firs Hemalog D was installed in the Hematology Laboratory of the Franco-Musulman Hospital at Bobigny, just outside Paris, in March 1975. The authors' experience with the apparatus since that date has enabled them to analyze the significance of "alarms", "high peroxidase", "large unstained cells", "remainder" and "low rate" in patients with and without hematologic disorders. On the basis of these results it has been possible to define the fate of the various blood cells in the Hemalog D, the role of the apparatus in the ivestigation of hematologic disorders and the type of "cooperation" between the hematologist and the Hemalog D.

  12. Who needs chaplain's visitation in general hospitals? Assessing patients with psychosocial and religious needs.

    Science.gov (United States)

    Winter-Pfändler, Urs; Morgenthaler, Christoph

    2011-01-01

    Owing to the declining length of patients' hospital stay in recent years, chaplains need evidence-based criteria to decide which patients are likely to have the greatest psychosocial and/or religious-spiritual needs. Therefore, the present pilot study aims at sorting out evidence-based criteria to assess patients with lack of coping resources. A total of 610 patients in the German-speaking part of Switzerland were surveyed with regard to their psychosocial health. The results suggest that lack of vitality (including health condition), lack of support and lack of faith (including spiritual struggle) are valid and reliable criteria for chaplains as internal triggers for pastoral visitation.

  13. Perception of nurse experts on the contribution of nursing interventions to NOC nursing outcomes in general hospitals in Korea.

    Science.gov (United States)

    Lee, Byoungsook

    2005-06-01

    The purpose of this study was to identify the perception of nurse experts on the contribution of nursing interventions to Nursing Outcomes Classification NOC nursing outcomes. A nursing outcome is a nursing-sensitive patient outcome primarily affected by nursing interventions. As one of the standardized language systems of nursing outcomes, the NOC must be examined for applicability before it is used in Korea. Data were collected in February and March 2003 using a 5-point Likert scale. For data collection, 230 quality improvement (QI) or quality assurance (QA) nurses from general hospitals in Korea were asked to rate the extent that nursing interventions contribute to each of the NOC nursing outcomes (2,000) in their hospitals. Ninety-six nurses from 63 hospitals responded and the response rate was 41.7%. Mean scores for perception of contribution of nursing interventions to each of the NOC nursing outcomes ranged from 2.18 to 4.54. Vital Signs Status had the highest score (M=4.54), and Abuse Recovery: Financial, the lowest score (M=2.18). Of the seven NOC domains, the mean score was highest for Physiologic Health (M=3.91) and lowest for Community Health (M=2.92). Of the 29 NOC classes, the mean score for perceived contribution was highest for Metabolic Regulation (M=4.32) and lowest for Community Well-Being (M=2.92). Participants perceived that nursing interventions in general hospitals in Korea contributed, at least to a certain extent, to most of the NOC nursing outcomes. Based on these results, NOC should have relatively good applicability in Korea.

  14. Bare Below the Elbows: A comparative study of a tertiary and district general hospital.

    Science.gov (United States)

    Collins, A M; Connaughton, J; Ridgway, P F

    2013-10-01

    A 'Bare Below the Elbows' (BBTE) dress code policy has been introduced by the majority of NHS trusts in the UK. The aim of this Irish study was to evaluate the impact of an educational intervention on perception of medical attire. The study was carried out in two centres: a tertiary referral centre (Beaumont Hospital) and a district hospital (MRH, Portlaoise). Two questionnaires, incorporating photographic evaluation of appropriate attire for consultants and junior doctors, were completed pre and post BBTE education. One hundred and five patients participated. Analysis pre BBTE education indicated patients considered formal attire and white coats most appropriate for consultants and junior doctors respectively. Post-intervention analysis revealed a significant reduction in the popularity of both (p <0.001), with scrubs and smart casual attire gaining significant support in both cohorts (p <0.001). Our findings demonstrated that patient opinion on medical attire is malleable. The support of such a policy may be achieved if patients are informed that the aim is to reduce the spread of healthcare-associated infections.

  15. Profile of patients attended as psychiatric emergencies at a university general hospital

    Directory of Open Access Journals (Sweden)

    Vitoria Mantoan Padilha

    Full Text Available CONTEXT AND OBJECTIVE: The prevalence of psychiatric conditions in clinical settings is high, particularly in emergency services. This is a challenge for healthcare professionals and an essential element in the functioning of the mental health network. The objective here was to describe the sociodemographic and clinical profile and the practices among patients treated psychiatrically in the Emergency Unit. DESIGN AND SETTING: Descriptive and quantitative study, conducted at Hospital das Clínicas (HC, Universidade Estadual de Campinas (Unicamp. METHODS: Sociodemographic data, reasons for attendance, diagnostic hypotheses and practices were analyzed. RESULTS: Psychiatric staff attended 1,835 cases over the study period, corresponding to 1465 patients. The patients were predominantly women (53.7% and white (79.6%; their mean age was 37 years and 41.3% lived with their parents. The commonest reasons for attendance were depressive symptoms (28.1%, agitation (23.6% and problems with psychoactive substances (19.5%. The commonest diagnoses were psychoactive substance-related disorders (23% and depressive disorders (18.5%. 31.6% of the patients were referred to healthcare centers and 29.2% to specialized outpatient clinics, while 8.2% were hospitalized. CONCLUSIONS: This study emphasizes that it is important for professionals working in emergency service to have information about the patients' profile and the main reasons that lead them to seek psychiatric care, and to establish a diagnosis that will allow proper management at the emergency service and case referral.

  16. Laparoscopic management of pancreatic pseudocysts: experience at a general hospital in Mexico City.

    Science.gov (United States)

    Crisanto-Campos, B A; Arce-Liévano, E; Cárdenas-Lailson, L E; Romero-Loera, L S; Rojano-Rodríguez, M E; Gallardo-Ramírez, M A; Cabral-Oliver, J; Moreno-Portillo, M

    2015-01-01

    Invasive management of pancreatic pseudocysts (PP) is currently indicated in those patients with symptoms or complications. Treatment options are classified as surgical (open and laparoscopic) and non-surgical (endoscopic and radiologic). To describe the morbidity, mortality, and efficacy in terms of technical and clinical success of the laparoscopic surgical approach in the treatment of patients with PP in the last 3 years at our hospital center. We included patients with PP treated with laparoscopic surgery within the time frame of January 2012 and December 2014. The morbidity and mortality associated with the procedure were determined, together with the postoperative results in terms of effectiveness and recurrence. A total of 38 patients were diagnosed with PP within the last 3 years, but only 20 of them had invasive treatment. Laparoscopic surgery was performed on 17 of those patients (mean pseudocyst diameter of 15.3, primary drainage success rate of 94.1%, complication rate of 5.9%, and a 40-month follow-up). The results obtained with the laparoscopic technique used at our hospital center showed that this approach is feasible, efficacious, and safe. Thus, performed by skilled surgeons, it should be considered a treatment option for patients with PP. Copyright © 2015 Asociación Mexicana de Gastroenterología. Published by Masson Doyma México S.A. All rights reserved.

  17. Total hip arthroplasty in Jesenice General hospital 1985–2006 – what has been done and look forward

    Directory of Open Access Journals (Sweden)

    Tomaž Silvester

    2007-11-01

    Full Text Available Background: Total arthroplasty is one of the most interesting and fast developing fields in orthopaedic surgery. Practically every joint in the human body is involved, total hip arthroplasties (THA being most frequent and with the longest history. Information on long-term results and survival of different types of prosthesis is invaluable for both patients and surgeons.Patients and methods: Between 1985 and 2006 there were 1563 THAs performed in Jesenice General Hospital. Average age at the time of operation was 67 years, almost two thirds of patients were women. The reason for operation was in 72 % idiopathic arthrosis and in 14 % sequaele of dysplasia.Results: There were 1370 primary procedures and 193 revisions (12.6 %. Aseptic loosening of the implant was the most frequent reason for revision (74 % and infection was observed in 1.5 %. In the first ten years of this research hybrid type of prosthesis was most frequently used, but nowadays, non-cemented prosthesis is used in majority of cases.Conclusions: Total hip arthroplasty is well established procedure at the Jesenice General Hospital. It considerably improves quality of life of the patient, for both, short- and long term, results are very good. New minimal invasive surgical techniques make postoperative rehabilitation faster and easier. The Register of prosthesis enables us to regularly analyze the results and provides treatment outcome information concerning the choice of prosthesis and the optimal surgical technique. Jesenice General Hospital is well recognized as one of the centers for arthroplasties in our country.

  18. Effects of a humor-centered activity on disruptive behavior in patients in a general hospital psychiatric ward

    OpenAIRE

    Antonio Higueras; Hugo Carretero-Dios; José P. Muñoz; Esther Idini; Ana Ortiz; Francisco Rincón; David Prieto-Merino; María M. Rodríguez del Águila

    2006-01-01

    El objetivo de este estudio cuasi-experimental es analizar lo efectos de una actividad centrada en el humor sobre las conductas disruptivas de pacientes hospitalizados en un servicio de Psiquiatría. Se han comparado, teniendo en cuenta dos grupos homogéneos de pacientes hospitalizados en un servicio de Psiquiatría de hospital general (unidad de agudos), dos periodos temporales de 83 días cada uno, siendo el período 1 el de línea base, y el período 2, el de intervención. Para am...

  19. Prevalencia y factores asociados a desnutrición hospitalaria en un hospital general: Perú, 2012

    OpenAIRE

    L. E. Veramendi-Espinoza; J. H. Zafra-Tanaka; O. Salazar-Saavedra; J. E. Basilio-Flores; E. Millones-Sánchez; G. A. Pérez-Casquino; L. M. Quispe-Moore; M. E. Tapia-Vicente; D. I. Ticona-Rebagliati; N. B. Asato; L. Quispe-Calderón; H. J. Ruiz García; A. Chia-Gil; D. E. Rey-Rodríguez; B. T. Surichaqui

    2013-01-01

    Introducción: La desnutrición hospitalaria es un problema prevalente que genera mayor morbi-mortalidad, peor respuesta al tratamiento, mayor estancia y costo hospitalario. Objetivos: Determinar la prevalencia y factores asociados a desnutrición hospitalaria en un hospital general peruano. Métodos: Estudio analítico transversal de 211 pacientes en servicios de Medicina y Cirugía. Se analizó variables demográficas, clínicas e indicadores antropométricos. El análisis multivariado fue de regresió...

  20. Professional nurses' experience of violence when nursing mentally ill people in general hospital settings: A phenomenological study

    Directory of Open Access Journals (Sweden)

    Marie Poggenpoel

    1998-03-01

    Full Text Available Due to a lack of the knowledge and skills required for nursing mentally ill people, professional nurses in general hospital settings tend to not apply appropriate techniques when dealing with mentally ill people.

    Opsomming
    Weens die gebrek aan kennis en vaardighede benodig vir die verpleging van geestesversteurde persone, hanteer professionele verpleegkundiges in algemene hospitale geestesversteurde persone sonder bogenoemde kennis en vaardighede. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

  1. INJURIES AMONG THE HEALTH AND THERAPEUTIC EMPLOYEES IN A GENERAL HOSPITAL IN TEHRAN

    Directory of Open Access Journals (Sweden)

    J. Adl F. Fayaz

    2008-04-01

    Full Text Available The health and therapeutic employees are facing with some particular hazards. The existing insurance system has a lot of different shortcomings. Determination of the frequency and type of accidents in a hospital was the main objective. All accidents were recorded and the study period was divided in to 3 periods. The victims who reported their accident were classified from personality point of view and the accidents of highly reliable employees were analyzed. Although number of needle-stick was relatively high (4.5%, cuts (45.4% were on top. Youngsters had the highest injury rate. Creation of a unique record keeping system for the country or even for the world was the final conclusion.

  2. SPECTRUM OF ACUTE GLOMERULO NEPHRITIS IN CHILDREN AT GOVERNMENT GENERAL HOSPITAL, ANANTAPURAMU

    Directory of Open Access Journals (Sweden)

    Ravi Kumar

    2015-04-01

    Full Text Available AIM: Aim of the study is to study the spectrum of AGN in children and to assess the age, sex and seasonal incidence and prognostic factors. Acute glomerulonephritis is one of the most common condition seen in children. The study group included 50 children. In most of the children presenting complaints s of are puffiness of face, haematuria and oliguria. METHODS AND MATERIALS: Fifty children who were admitted in the government hospital during the period of September 2013 to January 2015 were included in the stud y. RESULTS: The maximum admissions were seen from the months of September to December. Common age group was between 3 and 8 years. Rare age group was below 2 years. Hypertension was noticed in 32 out of 50 children. Albuminuria and hematuria were commonest urinary abnormalities. CONCLUSION: acute glomerulonephritis is less common below 2 years. Hypertension was of varying degree. Cardiomegaly by x - ray was an added feature.

  3. An assessment of the utility of unselected coagulation screening in general hospital practice.

    LENUS (Irish Health Repository)

    McHugh, Johnny

    2011-03-01

    Coagulation screening using prothrombin time (PT) and activated partial thromboplastin time (APTT) is widely used. We performed an audit of coagulation screening in an Irish teaching hospital. We analysed PT and\\/or APTT results received during normal working hours during a 1-week period in our hospital. Abnormal results due to anticoagulants were excluded from further study. In samples with PT longer than 15.5 s and\\/or APTT longer than 42 s, we proceeded to 1: 1 mixing studies if the PT was prolonged and 1: 1 mixing studies, factor XII assay and lupus screen if the APTT was prolonged. We also obtained referral source for all samples and clinical details for abnormal samples. Six hundred and seventy-one coagulation requests were received during the study period. Three hundred and eighteen of 671 (47.4%) coagulation requests were for monitoring of anticoagulation. Three hundred and fifty-three of 671 (52.6%) requests were for coagulation screening rather than anticoagulant monitoring. In the coagulation screens received, PT was prolonged in 19 of 353 (5.4%). PT was longer than 20 s in four of 353 cases (1.1%). APTT was prolonged in 19 of 353 (5.4%). APTT was longer than 50 s in four of 353 (1.1%). No patients with abnormal PT or APTT had any bleeding sequelae during the study period. Unregulated coagulation screening has a low yield of abnormal results; the majority of these abnormal results show mild prolongation of PT or APTT with no evidence that they are associated with an increased bleeding risk.

  4. [Gallstone ileus, experience in the Dr. Eduardo Liceaga General Hospital of Mexico].

    Science.gov (United States)

    Sánchez-Pérez, Eder Alejandro; Álvarez-Álvarez, Sinuhé; Madrigal-Téllez, Marco Antonio; Gutiérrez-Uvalle, Gabriela Elaine; Ramírez-Velásquez, Jorge Enrique; Hurtado-López, Luis Mauricio

    Gallstone ileus is a rare cause of intestinal obstruction (1-4%). It results from the migration of a gallstone through a bilio-enteric fistula. Treatment begins with fluid therapy, followed by enterolithotomy, fistula closure, and cholecystectomy. To determine the clinical presentation in patients with gallstone ileus and subsequent medical -surgical management outcomes. A retrospective, observational, descriptive and transversal study was conducted on patients diagnosed with intestinal obstruction secondary to a gallstone ileus from May 2013 to October 2014. The following variables were recorded: age, sex, comorbidities, mean time of onset of symptoms, length of preoperative and postoperative stay, imaging studies, biochemical tests, type of surgical management, stone location and size, complications, mortality, and postoperative follow-up. The study included 10 patients (male: female ratio 1:4), with a mean age of 61.9 years. The mean time of onset symptoms 15.4 days, and preoperative stay was 2days. On admission, 80% of patients had leukocytosis and neutrophilia, and 70% with renal failure. The most common surgical management was enterolithotomy with primary closure (50%), finding 80% of the stones in the terminal ileum. Recurrence was found in 2 cases. Mean postoperative hospital stay was 6.3 days. Mortality was 20%. Gallstone ileus most commonly presented in women in the seventh decade of life, with intermittent bowel obstruction. On hospital admission, they presented with systemic inflammatory response, electrolyte imbalance and abnormal liver function tests. Initial treatment must include fluid-electrolyte replacement, and tomography scans must be made in all cases. In our experience, the best procedure is enterolithotomy and primary closure, which presented lower morbidity and mortality. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  5. General hospital costs in England of medical and psychiatric care for patients who self-harm: a retrospective analysis.

    Science.gov (United States)

    Tsiachristas, Apostolos; McDaid, David; Casey, Deborah; Brand, Fiona; Leal, Jose; Park, A-La; Geulayov, Galit; Hawton, Keith

    2017-09-07

    psychosocial assessments were £228 for adults and £392 for individuals younger than 18 years. If our findings are extrapolated to England, the estimated overall annual cost of general hospital management of self-harm is £162 million per year. More use of psychosocial assessment and other preventive measures, especially for young people and against self-poisoning, could potentially lower future costs at a time of major cost pressures in the NHS. National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research, Care Oxford at Oxford Health NHS Foundation Trust, and Department of Health. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

  6. Incidence and risk factors for unplanned transfers to acute general hospitals from an intermediate care and rehabilitation geriatric facility.

    Science.gov (United States)

    Colprim, Daniel; Inzitari, Marco

    2014-09-01

    Unplanned acute hospital transfers (AT) from post-acute or long-term care facilities represent critical transitions, which expose patients to negative health outcomes and increase the burden of the emergency departments that receive these patients. We aim at determining incidence and risk factors for AT during the first 30 days of admission at an intermediate care and rehabilitation geriatric facility (ICGF). Prospective cohort study conducted in an ICGF of Barcelona, Spain. Sociodemographics, main diagnostics, and variables of the comprehensive geriatric assessment were recorded at admission. At the moment of AT, suspected diagnostic motivating the transfer was recorded. Multivariable Cox proportional hazard models were used to evaluate the association between admission characteristics and AT. We included 1505 patients (mean age + standard deviation = 81.31 ± 7.06, 65.7% women). AT were 217 (14.4%, 5.64/1000 days of stay) resulting in only 81 final hospitalizations (37% of AT), whereas 136 patients returned to ICGF after visiting the emergency department. Principal triggers of AT were cardiovascular, falls/orthopedic, and gastrointestinal problems. Being admitted to ICGF after a general surgery [hazard ratio (HR) 1.88; 95% confidence interval (CI) 1.21-2.94; P hospital, suggesting perhaps some avoidable AT. Identification of risk factors might be relevant to design strategies to reduce AT. Copyright © 2014 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  7. [An analysis of cost and profit of a nursing unit using performance-based costing: case of a general surgical ward in a general hospital].

    Science.gov (United States)

    Lim, Ji Young

    2008-02-01

    The aim of this study was to analyze net income of a surgical nursing ward in a general hospital. Data collection and analysis was conducted using a performance-based costing and activity-based costing method. Direct nursing activities in the surgical ward were 68, indirect nursing activities were 10. The total cost volume of the surgical ward was calculated at won 119,913,334.5. The cost volume of the allocated medical department was won 91,588,200.3, and the ward consumed cost was won 28,325,134.2. The revenue of the surgical nursing ward was won 33,269,925.0. The expense of a surgical nursing ward was 28,325,134.2. Therefore, the net income of a surgical nursing ward was won 4,944,790.8. We suggest that to develop a more refined nursing cost calculation model, a standard nursing cost calculation system needs to be developed.

  8. Knowledge of carbohydrate counting and insulin dose calculations among hospital staff in a regional general paediatrics unit.

    Science.gov (United States)

    O'Gorman, Jennifer R; O'Leary, Orla; Finner, Natalie; Quinn, Anne; O'Gorman, Clodagh S

    2015-01-01

    The aim of this study was to assess the carbohydrate and insulin knowledge of the staff at Children's Ark at the University Hospital, Limerick. Carbohydrate counting and insulin dose calculations based on carbohydrates and blood sugars are integral to intensive insulin management of type 1 diabetes mellitus (T1DM). The PedCarbQuiz, a validated questionnaire, was modified, and applied to the staff on our general paediatrics ward. 48/70 eligible staff responded (rate 68 %). Overall knowledge was good: 75.5 % was the average score for correctly identifying foods containing carbohydrate. However, poor scores were obtained for calculating multiple items and meal values (average score 29 %), and exact values of insulin required (average score 38 %). These results highlight the need for re-education among staff on a general paediatrics ward, to empower ward staff to contribute effectively to the education and management of patients with T1DM.

  9. Epidemia de influenza A(H1N1 en la Argentina: Experiencia del Hospital Nacional Profesor Alejandro Posadas Influenza A(H1N1 epidemic in Argentina: Experience in a National General Hospital (Hospital Nacional Profesor Alejandro Posadas

    Directory of Open Access Journals (Sweden)

    2009-10-01

    Full Text Available Se describe la preparación y la atención médica durante la epidemia de influenza A(H1N1 (junio 2009 en un hospital general de agudos, público, de alta complejidad; con diagnóstico de laboratorio, internación general y cuidados intensivos (UCI. Se elaboró un plan para aumentar la capacidad asistencial, reasignar recursos y garantizar la bioseguridad. La consulta fue 7.1 ± 3.8 veces mayor que en 2006-2008. La detección de casos de A(H1N1 fue confirmada por PCR-RT en 186/486 (38.3% pacientes internados y en 56/176 (31.8% ambulatorios. Internados: mediana de edad 20 años; 75% menores de 45 y 32.3% menores de 15. Mortalidad global: 6.8%; 9.1% en los positivos. Adultos: recepción en un área de atención ambulatoria, internación (aislamiento y ventilación mecánica. Sala general: ingresaron 110 pacientes (5 veces más que 1999-2006 con saturación de oxígeno The preparation and medical care during the influenza A(H1N1 outbreak (June 2009 in a high complexity level, public, general hospital with laboratory diagnosis, general and intensive care (ICU hospitalization is described. A plan was designed to increase the hospital's surge capacity, reallocate resources and guarantee bio-safety. The number of consultations was 7.1 ± 3.8 times higher than during June 2006-2008. Detection of A(H1N1 cases were confirmed by PCR-RT in 186/486 (38.3% in-patients and 56/176 (31.8% out-patients. Median age among in-patients was 20 years; 75% < 45 and 32.3% < 15. Global mortality: 6.8%; 9.1% among confirmed cases. Adults were directed to a reception area of out-patient care, hospitalization (isolation and mechanical ventilation. General ward: 110 patients with oxygen saturation < 96% and/or risk factors (65.5% had asthma, chronic obstructive pulmonary disease, obesity, pregnancy or other were admitted (5 times more than in 1999-2006. Chest X-ray showed lung infiltrates and/or lung consolidation in 97.3%. Severe hypoxemia: 43.5%. There were no significant

  10. Venous thromboembolism-related mortality and morbidity in King Fahd General Hospital, Jeddah, Kingdom of Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Abo-El-Nazar Essam

    2011-01-01

    Full Text Available Background: Venous thromboembolism (VTE is a serious and underestimated potentially fatal disease with an effective prophylactic antithrombotic therapy that is usually underused. Objectives: The primary study objective is to determine the percentage of VTE patients who received prophylactic antithrombotic therapy according to ACCP guidelines. Secondary study objectives are determining prevalence of confirmed VTE mortality among all cause hospital mortalities, measuring adherence to anticoagulation treatment after discharge and number of VTE events among those patients. Methods: During the period from first of July 2008 till 30 of June 2009, we collected all hospital deaths, all patients with confirmed VTE diagnosis at King Fahd General Hospital, Jeddah, Kingdom of Saudi Arabia. Only patients with confirmed VTE diagnosis were included in the analysis. Results: Five hundred cases with clinical diagnosis of VTE were identified. Out of them 178 were confirmed to be VTE. 36.5% of them received prophylactic antithrombotic therapy. Case fatality rate was 20.8% representing 1.9% of hospital deaths. Case fatality rate was 31% and 3.1% for patients who did not receive thromboprophylaxis and patients who received it, respectively ( P < 0.0001. 66.3% and 33.7% of confirmed VTE cases occurred in surgical and medical patients respectively. Only 44.1% of surgical patients and 21.7% of medical patients received prophylaxis ( P < 0.01. Case fatality rate is 11% for surgical patients and 40% for medical patients (P < 0.001. Of 141 survived cases, 118 (83.7% were adherent to anticoagulation therapy after discharge. Conclusions: VTE prophylaxis guideline is not properly implemented and extremely underutilized. Mortality from VTE is significantly higher in patients who did not receive VTE prophylaxis. In the absence of regular post-mortem practice VTE related mortality rate would be difficult to estimate and likely will be underestimated. Health authorities should

  11. [Nutritional assessment of alcoholic liver cirrhotic patients treated in the liver Clinic of the Mexico's General Hospital].

    Science.gov (United States)

    Landa-Galván, H V; Milke-García, Ma P; León-Oviedo, C; Gutiérrez-Reyes, G; Higuera-de la Tijera, F; Pérez-Hernández, J L; Serralde-Zúñiga, A E

    2012-01-01

    Malnutrition in the cirrhotic patient is associated to a higher morbidity and mortality rate; however, the diagnosis is complex, so the study objective was to assess the nutritional status using different methods. Adult patients with alcoholic liver cirrhosis treated in the Liver Clinic of the Mexico's General Hospital were evaluated. Anthropometric measurements and a 24 hours recall were made; screening tools (Malnutrition Universal Screening Tool, Nutritional Risk Screening-2002) and a method for assessing nutritional status specifically in cirrhotic patients (Royal Free Hospital Global Assessment) were used. We included 62 patients, 51.6% of them were men. Malnutrition by arm muscle area was 31.3% in men and 10% in women, and by arm fat area was 23.3% in women and 3.1% in men (p malnutrition risk were 43.5% and 54.8% respectively, vs. 1.6% identified as "low weight" with the Body Mass Index. With the Royal Free Hospital Global Assessment tool the percentage of malnutrition was 45.2%. Patients with malnutrition had an energy and protein intake significantly lower than the well-nourished: 19.7 kcal/kg and 0.89 g/kg vs 30 kcal/kg and 1.25 g/kg (p Malnutrition is a common complication in patients with liver cirrhosis. Men have higher depletion of muscle mass and women a higher loss of body fat. The Body Mass Index is not a reliable tool for assessing malnutrition. It's advisable to use tools with indicators of body composition such as the Royal Free Hospital Global Assessment.

  12. Hospital Discharge Information After Elective Total hip or knee Joint Replacement Surgery: A clinical Audit of preferences among general practitioners

    Directory of Open Access Journals (Sweden)

    Andrew M Briggs

    2012-05-01

    Full Text Available AbstractThe demand for elective joint replacement (EJR surgery for degenerative joint disease continues to rise in Australia, and relative to earlier practices, patients are discharged back to the care of their general practitioner (GP and other community-based providers after a shorter hospital stay and potentially greater post-operative acuity. In order to coordinate safe and effective post-operative care, GPs rely on accurate, timely and clinically-informative information from hospitals when their patients are discharged. The aim of this project was to undertake an audit with GPs regarding their preferences about the components of information provided in discharge summaries for patients undergoing EJR surgery for the hip or knee. GPs in a defined catchment area were invited to respond to an online audit instrument, developed by an interdisciplinary group of clinicians with knowledge of orthopaedic surgery practices. The 15-item instrument required respondents to rank the importance of components of discharge information developed by the clinician working group, using a three-point rating scale. Fifty-three GPs and nine GP registrars responded to the audit invitation (11.0% response rate. All discharge information options were ranked as ‘essential’ by a proportion of respondents, ranging from 14.8–88.5%. Essential information requested by the respondents included early post-operative actions required by the GP, medications prescribed, post-operative complications encountered and noting of any allergies. Non-essential information related to the prosthesis used. The provision of clinical guidelines was largely rated as ‘useful’ information (47.5–56.7%. GPs require a range of clinical information to safely and effectively care for their patients after discharge from hospital for EJR surgery. Implementation of changes to processes used to create discharge summaries will require engagement and collaboration between clinical staff

  13. Analysis of cost outliers within APR-DRGs in a Belgian general hospital: two complementary approaches.

    Science.gov (United States)

    Pirson, Magali; Dramaix, Michèle; Leclercq, Pol; Jackson, Terri

    2006-03-01

    The objective of this study was to find factors that could explain high and low resource use outliers, by associating an explanatory analysis with a statistical analysis. High resource use outliers were selected according to the following rule: 75th percentile + 1.5* inter-quartile range. Low resource use outliers were selected according to: 25th percentile - 1.5* inter-quartile range. The statistical approach was based on a multivariate analysis using logistic regression. A decision tree approach using predictors from this analysis (intensive care unit (ICU) stay, high severity of illness and social factors associated with longer length of stay) was also tested as a more intuitive tool for use by hospitals in focussing review efforts on "not explained" cost outliers. High resource use outliers accounted for 6.31% of the hospital stays versus 1.07% for low resource use outliers. The probability of a patient being a high resource use outlier was higher with an increase in the length of stay (odds ratios (OR) = 1.08), when the patient was treated in an intensive care unit (OR = 3.02), with a major or extreme severity of illness (OR=1.46), and with the presence of social factors (OR = 1.44). The probability of being a low outlier is lower for older patients (OR = 0.98). The probability of being a low outlier is also lower without readmission within the year (OR = 0.55). The more intuitive decision tree method identified 92.26% of the cases identified through residuals of the regression model. One quarter of the high cost outliers were flagged for additional review ("not justified" on the basis of the model), with nearly three-quarters "justified" by clinical and social factors. The analysis of cost outliers can meet different aims (financing of justifiable outliers, improvement of the care process for the outliers not justifiable on medical or social grounds). The two methods are complementary, by proposing a statistical and a didactic approach to achieve the goal of

  14. [Feasibility of consultation - liaison psychiatry in a large general hospital: quantitative description of services and personnel expenditure].

    Science.gov (United States)

    Windhager, Elmar; Thaler, Katharina; Selberis-Vahl, Wilia Vasiliki; Friedl-Wörgetter, Petra; Windhager, Isabella; Zauner, Katharina

    2015-01-01

    The integration of psychiatric departments in general hospitals lead to an increasing demand of psychiatric consultation, which often overstrains personnel resources of short staffed psychiatric services. To provide consulting service, as it is demanded by guidelines, a multidisciplinary consulting team could be a possible solution. A retrospective descriptive analysis of all consultations made by the psychosocial consultation and liaison service at the general hospital Wels-Grieskirchen in the years 2012 and 2013. There was an increase in referrals overall of 22 % from 2012 to 2013. The largest increase was observed in the group of psychiatrists, who carried out 33.1 % of all consultations. Most consultations, 39.5 %, were done by the group of clinical psychologists, partly substituting medical attendance. Taking together both occupational groups, the expected number of consultations of at least 3 % of all admissions could be achieved. A multidisciplinary consulting team consisting of psychiatrists, psychologists, psychosomatic physicians and social workers staffed with 5.11-6.79 full-time personnel is able to provide psychosocial consultation service at a quantitative level required by international guidelines.

  15. Clinical and Histopathological Characteristic of Salivary Gland Carcinoma in Dr. Hasan Sadikin General Hospital in 2009–2012

    Directory of Open Access Journals (Sweden)

    Fatimah Lidya Andriani

    2016-03-01

    Full Text Available Background: Salivary gland neoplasm is one of the rare neoplasm. The frequency of this neoplasm is lower than 2% of all type of tumors in human. Malignant salivary gland tumor comprises 6% of all head and neck tumors. Data about salivary gland carcinoma are still limited. The aim of this study was to determine the frequency of malignant salivary gland based on the patients’ age, gender, site of lesion and histopathology type. Methods: This study was conducted descriptively. There were 97 subjects found from histopathological form that had been examined in Department of Anatomical Pathology, Dr. Hasan Sadikin General Hospital in 2009–2012. Total sampling technique was used and all data about patients’ age, gender, site of lesion and histopathology type were collected and analyzed. Results: Of 97 cases, age group 50–59 years old had the highest frequency (29%. The prevalence in male was more frequent than female with male:female ratio was 1.4:1. The most common site of carcinoma was found in parotid gland (45%. Mucoepidermoid carcinoma was the most common histopathology type found in this study (28%. Conclusions: Salivary gland carcinoma is still a rare malignant case in Dr. Hasan Sadikin General Hospital. Carcinoma in parotid gland was the most common site and mucoepidermoid carcinoma was the most common histopathology type.

  16. Low serum Vitamin C status among pregnant women attending antenatal care at general hospital Dawakin Kudu, Northwest Nigeria

    Directory of Open Access Journals (Sweden)

    Emmanuel Ajuluchukwu Ugwa

    2016-01-01

    Full Text Available Background: Vitamin C levels are low in pregnancy. The purpose of this study was to determine serum Vitamins C levels among pregnant women attending antenatal care at a General Hospital in Dawakin Kudu, Kano, and this can help further research to determine the place of Vitamin C supplementation in pregnancy. Methods: This was a prospective study of 400 pregnant women who presented for antenatal care in General Hospital Dawakin Kudu, Kano, Nigeria. Research structured questionnaire was administered to 400 respondents. Determination of serum Vitamin C was done using appropriate biochemical methods. Results: Vitamin C deficiency was found in 79.5% of the participants. The values for Vitamin C were 0.20 ± 0.18 mg/dl during the first trimester, 0.50 ± 0.99 mg/dl in the second trimester, and 0.35 ± 0.36 mg/dl in the third trimester and P = 0.001. Conclusions: There is a significant reduction in the serum Vitamins C concentration throughout the period of pregnancy with the highest levels in the second trimester. Therefore, Vitamin C supplementation is suggested during pregnancy, especially for those whose fruit and vegetable consumption is inadequate.

  17. Clinical Characteristics of Trigeminal Neuralgia Patients at Dr. Hasan Sadikin General Hospital Bandung Indonesia in 2010–2012

    Directory of Open Access Journals (Sweden)

    Sri Hudaya Widihastha

    2017-03-01

    Full Text Available Background: Trigeminal neuralgia is a frequently found craniofacial neuralgia. The clinical characteristics of trigeminal neuralgia patients at Dr. HasanSadikin General Hospital, Bandung, Indonesia has never been described before. This study conducted an overview of clinical characteristics of trigeminal neuralgia to determine the characteristic features of trigeminal neuralgia. Methods: This was a non-experimental study using secondary data with a retrospective descriptive method. Data related to medical records of 76 patients with trigeminal neuralgia was collected over a period of 2010 to 2012, treated at Dr.HasanSadikin General Hospital Bandung, Indonesia. Results: Mean age was 57.6 years (range 11 to 84 years, no significant difference in gender (male:females 51.3%:48.7%. Chewing and swallowing was reported as triggering stimuli to 42 (55% patients. Two patients (2.7% had suffered pain on bilateral side of the face, 46 (60.5% patients the right side, and 28 patients (36.8% on the left side. Pain on maxillary nerve division was found in 58 (76.3% patients. Sixty one of the patients (80% received Carbamazepine. Conclusions: The peak age was between the fifth and sixth decades of life with equal representation of male to female incidence. Right side and the maxillary division was found to be the most frequently site of pain. Chewing and swallowing was reported to be the most frequent triggering stimuli and most of patients received Carbamazepine as therapy. [AMJ.2017;4(1:47–51

  18. [From the Principle of Beneficence to the Principle of Autonomy. Assessment of Patients' Mental Competency in the General Hospital].

    Science.gov (United States)

    Diana, Restrepo B; Carlos, Cardeño C; Marle, Duque G; Santiago, Jaramillo

    2012-06-01

    Refusing a medical procedure is a valid way of exercising every patient's right to autonomy. From the legal point of view, autonomy is based on the right to privacy. In recent decades the legal right to self-determination has gradually expanded and today patients in full possession of their mental faculties, have the moral and legal right to make their own decisions and these decisions take precedence over physician and family. Often liaison psychiatrists are called in to assess the mental competence of patients in the general hospital. To determine the psychiatrist's role in evaluating these patients. The assessment of a patient's ability to decide and self-determine is a common clinical problem in general hospitals. Evaluation of these patients requires a proper understanding of the philosophical, ethical, and legal issues that guide the appropriate treatment of these complex clinical problems. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  19. 综合性医院的医院感染管理%Nosocomial infection managements in general hospital

    Institute of Scientific and Technical Information of China (English)

    杨梅

    2011-01-01

    OBJECTIVE To explore the effective measures of management of nosocomial infection in general hospital, so as to control nosocomial infection. METHODS The training and promotion of the knowledge about nosocomial infection were reinforced, the inspecting management was strengthened. Its emphasis was put on the key departments and links. RESULTS The awareness of the medical staff to nosocomial infection management was improved, and each management system and measure were implemented and the nosocomial infection was well controlled. CONCLUSIONS The management of nosocomial infection in general hospital should be emphasized, the strict supervision and checking can effectively control the nosocomial infection.%目的 探讨综合性医院感染管理的有效方法,以控制医院感染.方法 加强医院感染宣传和培训,加强重点环节和重点科室的督查管理.结果 提高了医护人员对医院感染管理的认识,使各项医院感染管理制度与措施得以落实,有效控制了医院感染.结论 重视综合性医院感染管理工作,加强督查、严格把关,可有效预防控制医院感染.

  20. Risk factors associated with calcium oxalate urolithiasis in dogs evaluated at general care veterinary hospitals in the United States.

    Science.gov (United States)

    Okafor, Chika C; Lefebvre, Sandra L; Pearl, David L; Yang, Mingyin; Wang, Mansen; Blois, Shauna L; Lund, Elizabeth M; Dewey, Cate E

    2014-08-01

    Calcium oxalate urolithiasis results from the formation of aggregates of calcium salts in the urinary tract. Difficulties associated with effectively treating calcium oxalate urolithiasis and the proportional increase in the prevalence of calcium oxalate uroliths relative to other urolith types over the last 2 decades has increased the concern of clinicians about this disease. To determine factors associated with the development of calcium oxalate urolithiasis in dogs evaluated at general care veterinary hospitals in the United States, a retrospective case-control study was performed. A national electronic database of medical records of all dogs evaluated between October 1, 2007 and December 31, 2010 at 787 general care veterinary hospitals in the United States was reviewed. Dogs were selected as cases at the first-time diagnosis of a laboratory-confirmed urolith comprised of at least 70% calcium oxalate (n=452). Two sets of control dogs with no history of urolithiasis diagnosis were randomly selected after the medical records of all remaining dogs were reviewed: urinalysis examination was a requirement in the selection of one set (n=1808) but was not required in the other set (n=1808). Historical information extracted included urolith composition, dog's diet, age, sex, neuter status, breed size category, hospital location, date of diagnosis, and urinalysis results. Multivariable analysis showed that the odds of first-time diagnosis of calcium oxalate urolithiasis were significantly (P30 mg/dL (OR: 1.55, 1.04-2.30). Patient demographics and urinalysis results are important factors that can support risk assessment and early identification of canine oxalate urolithiasis. Therefore, periodic urolith screening and monitoring of urine parameters should be encouraged for dogs at risk of developing these uroliths.

  1. A Study to Identify the Optimum Method of Providing Biomedical Engineering/Maintenance Support of Radiologic Equipment at General Leonard Wood Army Community Hospital

    Science.gov (United States)

    1988-01-01

    This study was done to determine the optimum method of providing biomedical engineering /maintenance support of diagnostic radiologic equipment at...General Leonard Wood Army Community Hospital (GLWACH). The study concluded that the optimum method of providing biomedical engineering /maintenance

  2. Sociodemographic and clinical overview of the indigenous population admitted to the Hospital General de México “Dr. Eduardo Liceaga”

    National Research Council Canada - National Science Library

    Colmenares-Roa, T; Cervantes Molina, L; Ruesga Vázquez, M; Lino-Pérez, L; Campos-Navarro, R; Peláez-Ballestas, I

    2017-01-01

    ... (identified by determining whether they speak an indigenous language) hospitalised between January 2014 and January 2015 at the Hospital General de Mexico, and to analyse these characteristics using a vulnerability classification...

  3. Child and Adolescent Inpatient Unit in General Hospital “Tzaneio”

    Directory of Open Access Journals (Sweden)

    E. Tseva

    2017-01-01

    Full Text Available The Child and Adolescent Psychiatry Inpatient Service offers comprehensive diagnostic evaluation and treatment of children and adolescents (typical age ranges from 3-16 years old with a variety of emotional and behavioral problems including mood disorders, anxiety disorders, psychotic disorders, severe disruptive behavior, and suicide attempts. Treatment Team. The inpatient treatment team includes psychiatrists, psychologists, registered nurses, special education teacher, social worker, speech and occupational therapists. In addition, pediatricians from a full range of medical subspecialties are available for consultations. The multi-disciplinary staff emphasizes a family-oriented approach and parents and care-givers are encouraged to be active participants in the treatment team throughout a child’s stay. Treatment Program. The program offers developmentally appropriate therapeutic activities in a closely supervised environment. Extensive opportunities for observation, assessment, and intervention are possible in this intensive setting. Specialized assessments including neuropsychological testing, speech and language testing, and occupational therapy assessments are all available. Treatment plans typically include a combination of individual psychotherapy, behavior management, family counseling and medications. Staff members develop an individualized treatment plan emphasizing safety for each patient during the hospital stay. The plan is closely coordinated with families, outpatient providers, and resource programs to coordinate aftercare plans and facilitate a smooth transition to home.

  4. [Hospital and general therapeutic patient education practices: example of diabetes and obesity in Belgium].

    Science.gov (United States)

    Pétré, Benoît; Degrange, Sophie; Tittaferante, Séverine; Legrand, Catherine; Vanmeerbeek, Marc; Froidcoeur, Xavier; Guillaume, Michèle

    2016-01-01

    Introduction/Objectives: Therapeutic Patient Education (TPE) is now part of the new medical landscape, including for the prevention and treatment of diabetes and obesity. While some countries, such as France, have decided to give priority to TPE in public health policy by means of legal recognition, no such framework has been developed in Belgium. The purpose of this article is to describe the actual TPE practices of health professionals (HP) in this environment.Methods: 82 face-to-face interviews (20 GPs and 62 hospital healthcare professionals) were conducted according to a semi-structured interview guide developed from the French Health Authority guidelines. Qualitative content analysis was performed on the data collected.Results/Discussion: For the majority of respondents, TPE is limited to brief information about the disease, its risk factors and complications. This representation of TPE determines the practical modalities of the educational activity right from the educational diagnosis. The possibilities for developing the patient’s capacities are limited. Practices reflect a lack of pedagogical structuring and do not correspond to a real multidisciplinary approach.Conclusion: Healthcare professionals must develop a clear vision of the implications of the concept of TPE and must therefore receive adequate training to ensure good quality development and implementation.

  5. Anaerobic bacteremia in a general hospital: retrospective five-year analysis.

    Science.gov (United States)

    Vazquez, F; Mendez, F J; Perez, F; Mendoza, M C

    1987-01-01

    Anaerobic bacteremia (116 cases) represented 5.4% of the total cases of bacteremia in the Hospital Nuestra Señora de Covadonga of Oviedo, Spain, during a five-year period (1981-1985). Microbiologic data for all 116 cases and clinical data for 63 patients were analyzed. A total of 129 isolates were identified as gram-negative bacilli (45.7%), gram-positive bacilli (38.0%), gram-positive cocci (14.0%), and gram-negative cocci (2.3%). Bacteroides fragilis and Clostridium perfringens were the most frequently occurring species. Anaerobic polymicrobial infection was detected in 21 patients. The most relevant clinical features were fever (79%), metastatic abscesses (33%), anemia (27%), septic shock (25%), and disseminated intravascular coagulation (6%). The overall mortality rate was 25.4%, and the factors associated with a poor prognosis were age over 60 years, lack of adequate surgical treatment, severe underlying disease, metastatic foci, and polymicrobial and/or nosocomial infection.

  6. Tromboprofilaxis en pacientes no quirúrgicos internados en un hospital general

    Directory of Open Access Journals (Sweden)

    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.

  7. [Tuberculosis in 7 general hospitals in Andalusia. Grupo Andaluz para el Estudio de las Enfermedades Infecciosas].

    Science.gov (United States)

    Gómez Camacho, E; Cuello, J A; Muñoz Lucena, F; Pérez Pérez, M; Causse, M; Torres, M; Kindelan, J M

    1992-05-01

    To know the clinical features of tuberculosis in our environment, to evaluate its diagnostic techniques and therapeutic options as well as the evolution of patients. Multicenter retrospective study of 1115 patients with tuberculosis, diagnosed between 1984 and 1988 in the population based areas of 7 Hospitals from Andalusia (Spain). The mean age was less than 40 ages, the exponential growing of the number of cases a year in which the influence of drug addicts could be an important factor, an elevated proportion (45%) of extrapulmonary tuberculosis and disseminated forms, and a social environment of 20% of cases being alcoholics or drug addicts. A good use of diagnostic techniques is recorded, although the use of culture as diagnostic tools is lacking. The usual treatment was three drugs for nine months. The global evolution seems good. However a global mortality of 6.4% is recorded, mainly in disseminated forms and among patients with risk factors for developing tuberculosis. We have seen an increment among tuberculosis cases, as well as a change in the clinical spectrum of the disease, linked to social illness and drug addiction. The diagnostic approach to tuberculosis seems to be appropriate. The follow up of patients is somewhat confusing.

  8. [Descriptive study of malaria cases in a general hospital in Madrid between 1996 and 2011].

    Science.gov (United States)

    Paredes, P; Pérez, E; Guizar, M; Penín, M; Gómez Carrasco, J A

    2014-11-01

    Malaria causes around 863,000 deaths per year, mostly of them in children under 5 years old. We have reviewed the epidemiological data of malaria cases in a pediatric department in a Hospital in the Community of Madrid, in the period 1996-2011. In the period reviewed, 103 cases of malaria were diagnosed in children under 14 years old. Sixty percent were males and the average age was 4.5 years. In most cases, the infection arose during a visit to relatives in the country of origin. The vast majority did not have malaria prophylaxis. Twenty-five percent of the cases were diagnosed as complicated malaria, the main criteria being hyperparasitemia, of which 80% of the patients did not present any other complications A high level of suspicion must be maintained in any patient who comes from a malaria endemic area. The key factor responsible for the infection was the lack of chemoprophylaxis. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  9. Pediatric referrals to psychiatry in a Tertiary Care General Hospital: A descriptive study

    Directory of Open Access Journals (Sweden)

    Bheemsain Tekkalaki

    2017-01-01

    Full Text Available Background: Children with chronic physical illnesses frequently have psychiatric comorbidities, which often go un-noticed and may lead to more resource utilization and morbidity. Pediatric liaison services can be effectively used to bridge this gap. Literature on pediatric liaison services is sparse. Aims: To study the referral patterns, reasons for referrals, psychiatric diagnoses and interventions in children and adolescents referred to psychiatry department in a tertiary care hospital. Materials and Methods: A retrospective chart analysis of all children and adolescents below 19 years of age, referred to psychiatry department from 2010 to 2015, was done. Data was collected and statistical analysis was done. Results: Two hundred and nine subjects were included in the study. Mean age of sample was 12.15 (±4.20 years, with about 66.02% being males. About 54.06% of the participants were referred from pediatricians. Almost three fourth (72.25% of children had no diagnosable physical illness. Intellectual disability (19.62% was the most common psychiatric diagnosis, followed by depressive disorders (14.35%, and dissociative disorders (12.92%. Conclusions: In our study, majority of the referrals were the adolescent males from pediatric department. Intellectual disability, depressive disorder, and stress-related disorders were the common diagnoses. The fact that three-fourth of the referred children had no physical illness implies lack of awareness, stigma toward mental illness, and pathway of care.

  10. Risk factors of stroke patients admitted to a general hospital in Kuwait.

    Science.gov (United States)

    Ashkanani, Abdulaziz; Hassan, Khalid Ali; Lamdhade, Shekhar

    2013-02-01

    There are limited data on stroke incidence in the Middle East, and only one study from Kuwait. The aim of this study was to establish a baseline status of stroke in Kuwait. We performed a retrospective chart review of all patients admitted from January 1st to December 31st, 2008 to the Amiri Hospital, Kuwait, who either were discharged or passed away with a diagnosis of stroke. Documented risk factors for stroke were analyzed for the total cohort and for male and female subgroups. Stroke subtypes were defined in accordance with the Trial of Org 10172 in acute stroke treatment (TOAST) criteria. There were 151 cases of stroke, of which 90.1% were ischemic. Eighty-five (56.3%) of the patients had diabetes mellitus, 86 (57.0%) had hyperlipidemia, and 104 (68.9%) had hypertension. Statins were used by 42.4% of the 86 hyperlipidemic patients prior to their presentation, and only 66 hypertensive patients (63.5%) were receiving treatment for hypertension prior to their presentation. Atrial fibrillation was diagnosed in 4% of the patients prior to their presentation, and 4% more were diagnosed afterward. History of ischemic heart disease was present in 28.5% of the subjects. This study shows similar rates of risk factors to regionally published reports and provides an updated picture of stroke in Kuwait.

  11. Employment and satisfaction trends among general surgery residents from a community hospital.

    Science.gov (United States)

    Cyr-Taro, Amy E; Kotwall, Cyrus A; Menon, Rema P; Hamann, M Sue; Nakayama, Don K

    2008-01-01

    Physician satisfaction is an important and timely issue in health care. A paucity of literature addresses this question among general surgeons. To review employment patterns and job satisfaction among general surgery residents from a single university-affiliated institution. All general surgery residents graduating from 1986 to 2006, inclusive, were mailed an Institutional Review Board-approved survey, which was then returned anonymously. Information on demographics, fellowship training, practice characteristics, job satisfaction and change, and perceived shortcomings in residency training was collected. A total of 31 of 34 surveys were returned (91%). Most of those surveyed were male (94%) and Caucasian (87%). Sixty-one percent of residents applied for a fellowship, and all but 1 were successful in obtaining their chosen fellowship. The most frequent fellowship chosen was plastic surgery, followed by minimally invasive surgery. Seventy-one percent of residents who applied for fellowship felt that the program improved their competitiveness for a fellowship. Most of the sample is in private practice, and of those, 44% are in groups with more than 4 partners. Ninety percent work less than 80 hours per week. Only 27% practice in small towns (population training in pancreatic, hepatobiliary, and thoracic surgery. Eighty-three percent agreed that they would again choose a general surgery residency, 94% of those who completed a fellowship would again choose that fellowship, and 90% would again choose their current job. Twenty-three percent agreed that they had difficulty finding their first job, and 30% had fewer job offers than expected. Thirty-five percent of the graduates have changed jobs: 29% of the residents have changed jobs once, and 6% have changed jobs at least twice since completing training. Reasons for leaving a job included colleague issues (82%), financial issues (82%), inadequate referrals (64%), excessive trauma (64%), and marriage or family reasons (55

  12. General self-efficacy and the effect of hospital workplace violence on doctors’ stress and job satisfaction in China

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    Yongcheng Yao

    2014-08-01

    Full Text Available Objectives: This study aims at exploring associations of general self-efficacy (GSE, workplace violence and doctors' work-related attitudes. Material and Methods: In this study a cross-sectional survey design was applied. Questionnaires were administrated to 758 doctors working in 9 hospitals of Zhengzhou, Henan province, China, between June and October 2010. General information on age, gender, and years of working was collected, and the doctors' experience and witnessing workplace violence, job satisfaction, job initiative, occupational stress as well as GSE were measured. General linear regression analysis was performed in association analyses. Results: Both experiencing and witnessing workplace violence were significantly positively correlated with the level of occupational stress but significantly negatively correlated with job satisfaction, job initiative, and GSE. General self-efficacy significantly modified relationships between both experiencing and witnessing workplace violence with occupational stress (β = 0.49 for experiencing violence; β = 0.43 for witnessing violence; p 0.05. The levels of occupational stress declined significantly with the increase of GSE, while job satisfaction increased significantly along with its increase. The effects of GSE on occupational stress and job satisfaction weakened as the frequency of violence increased. Conclusions: The findings suggest that GSE can modify effects of workplace violence on health care workers' stress and job satisfaction. Enhancing GSE in combination with stress reduction may lead to facilitating health care workers' recovery from workplace violence, and thereby improving their work-related attitudes.

  13. General self-efficacy and the effect of hospital workplace violence on doctors' stress and job satisfaction in China.

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    Yao, Yongcheng; Wang, Wei; Wang, Faxuan; Yao, Wu

    2014-06-01

    This study aims at exploring associations of general self-efficacy (GSE), workplace violence and doctors' work-related attitudes. In this study a cross-sectional survey design was applied. Questionnaires were administrated to 758 doctors working in 9 hospitals of Zhengzhou, Henan province, China, between June and October 2010. General information on age, gender, and years of working was collected, and the doctors' experience and witnessing workplace violence, job satisfaction, job initiative, occupational stress as well as GSE were measured. General linear regression analysis was performed in association analyses. Both experiencing and witnessing workplace violence were significantly positively correlated with the level of occupational stress but significantly negatively correlated with job satisfaction, job initiative, and GSE. General self-efficacy significantly modified relationships between both experiencing and witnessing workplace violence with occupational stress (β = 0.49 for experiencing violence; β = 0.43 for witnessing violence; p 0.05). The levels of occupational stress declined significantly with the increase of GSE, while job satisfaction increased significantly along with its increase. The effects of GSE on occupational stress and job satisfaction weakened as the frequency of violence increased. The findings suggest that GSE can modify effects of workplace violence on health care workers' stress and job satisfaction. Enhancing GSE in combination with stress reduction may lead to facilitating health care workers' recovery from workplace violence, and thereby improving their work-related attitudes.

  14. Factors associated with nonattendance at clinical medicine scheduled outpatient appointments in a university general hospital

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    Giunta D

    2013-11-01

    Full Text Available Diego Giunta,1,2 Agustina Briatore,3 Analía Baum,3 Daniel Luna,3 Gabriel Waisman,2 Fernán Gonzalez Bernaldo de Quiros1–31Internal Medicine Research Unit, 2Internal Medicine Department, 3Health Informatics Department, Hospital Italiano de Buenos Aires, Buenos Aires, ArgentinaIntroduction: Nonattendance at scheduled outpatient appointments for primary care is a major health care problem worldwide. Our aim was to estimate the prevalence of nonattendance at scheduled appointments for outpatients seeking primary care, to identify associated factors and build a model that predicts nonattendance at scheduled appointments.Methods: A cohort study of adult patients, who had a scheduled outpatient appointment for primary care, was conducted between January 2010 and July 2011, at the Italian Hospital of Buenos Aires. We evaluated the history and characteristics of these patients, and their scheduling and attendance at appointments. Patients were divided into two groups: those who attended their scheduled appointments, and those who did not. We estimated the odds ratios (OR and corresponding 95% confidence intervals (95% CI, and generated a predictive model for nonattendance, with logistic regression, using factors associated with lack of attendance, and those considered clinically relevant. Alternative models were compared using Akaike's Information Criterion. A generation cohort and a validation cohort were assigned randomly.Results: Of 113,716 appointments included in the study, 25,687 were missed (22.7%; 95% CI: 22.34%–22.83%. We found a statistically significant association between nonattendance and age (OR: 0.99; 95% CI: 0.99–0.99, number of issues in the personal health record (OR: 0.98; 95% CI: 0.98–0.99, time between the request for and date of appointment (OR: 1; 95% CI: 1–1, history of nonattendance (OR: 1.07; 95% CI: 1.07–1.07, appointment scheduled later than 4 pm (OR: 1.30; 95% CI: 1.24–1.35, and specific days of the week (OR: 1

  15. Cost accounting of radiological examinations. Cost analysis of radiological examinations of intermediate referral hospitals and general practice.

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    Lääperi, A L

    1996-01-01

    The purpose of this study was to analyse the cost structure of radiological procedures in the intermediary referral hospitals and general practice and to develop a cost accounting system for radiological examinations that takes into consideration all relevant cost factors and is suitable for management of radiology departments and regional planning of radiological resources. The material comprised 174,560 basic radiological examinations performed in 1991 at 5 intermediate referral hospitals and 13 public health centres in the Pirkanmaa Hospital District in Finland. All radiological departments in the hospitals were managed by a specialist in radiology. The radiology departments at the public health care centres operated on a self-referral basis by general practitioners. The data were extracted from examination lists, inventories and balance sheets; parts of the data were estimated or calculated. The radiological examinations were compiled according to the type of examination and equipment used: conventional, contrast medium, ultrasound, mammography and roentgen examinations with mobile equipment. The majority of the examinations (87%) comprised conventional radiography. For cost analysis the cost items were grouped into 5 cost factors: personnel, equipment, material, real estate and administration costs. The depreciation time used was 10 years for roentgen equipment, 5 years for ultrasound equipment and 5 to 10 years for other capital goods. An annual interest rate of 10% was applied. Standard average values based on a sample at 2 hospitals were used for the examination-specific radiologist time, radiographer time and material costs. Four cost accounting versions with varying allocation of the major cost items were designed. Two-way analysis of variance of the effect of different allocation methods on the costs and cost structure of the examination groups was performed. On the basis of the cost analysis a cost accounting program containing both monetary and

  16. Intravenous midazolam sedation in pediatric diagnostic upper digestive endoscopy. A prospective study in a general hospital.

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    Verhage, Jan; Mulder, Chris J J; Willekens, Frans L A

    2003-12-01

    The positive role of benzodiazepines (Midazolam) in conscious sedation in pediatric patients is widely known. However, problems concerning the role of sedation in diagnostic upper endoscopy are a matter for debate as little is known about dosage and timing. We prospectively evaluated the efficacy, safety and optimal intravenous sedation dosage of midazolam in 257 consecutive patients, aged 2 months to 18 years old, who underwent upper endoscopy of the gastrointestinal tract. The initial midazolam dosage was 0.2 mg/kg Bw (Body weight) i.v. for 1 minute and, if necessary, another 0.1 mg/kg Bw was administered 5 minutes later. If sedation was sufficient, the procedure would be started 4-5 minutes later; if not, another 0.1 - 0.2 mg/kg Bw would be administered. All procedures were performed by a pediatrician together with a gastroenterologist. No serious complications occurred in any of the procedures. Oxygen saturation (OS) was maintained at over 90%, if necessary with blowby oxygen. Flumazenil was administered to 7 children (OS < 90%). Endoscopy could not be completed in 1 child. All endoscopies were completed within 10 minutes. No unexpected hospital admissions were necessary. The mean midazolam dosage was 0.4 mg/kg Bw in patients up to 6 years, for the over 6 years-olds the mean dosage was decreased to 0,2 mg/kg Bw. Particular attention was paid to the importance of informing patients before the procedure. Endoscopic diagnostic procedures can be performed safely and effectively in children with intravenous sedation in a well equipped pediatric endoscopy unit.

  17. DELirium Prediction Based on Hospital Information (Delphi) in General Surgery Patients.

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    Kim, Min Young; Park, Ui Jun; Kim, Hyoung Tae; Cho, Won Hyun

    2016-03-01

    To develop a simple and accurate delirium prediction score that would allow identification of individuals with a high probability of postoperative delirium on the basis of preoperative and immediate postoperative data.Postoperative delirium, although transient, is associated with adverse outcomes after surgery. However, there has been no appropriate tool to predict postoperative delirium.This was a prospective observational single-center study, which consisted of the development of the DELirium Prediction based on Hospital Information (Delphi) score (n = 561) and its validation (n = 533). We collected potential risk factors for postoperative delirium, which were identified by conducting a comprehensive review of the literatures.Age, low physical activity, hearing impairment, heavy alcoholism, history of prior delirium, intensive care unit (ICU) admission, emergency surgery, open surgery, and increased preoperative C-reactive protein were identified as independent predictors of postoperative delirium. The Delphi score was generated using logistic regression coefficients. The maximum Delphi score was 15 and the optimal cut-off point identified with the Youden index was 6.5. Generated area under the (AUC) of the receiver operating characteristic (ROC) curve was 0.911 (95% CI: 0.88-0.94). In the validation study, the calculated AUC of the ROC curve based on the Delphi score was 0.938 (95% Cl: 0.91-0.97). We divided the validation cohort into the low-risk group (Delphi score 0-6) and high-risk group (7-15). Sensitivity of Delphi score was 80.8% and specificity 92.5%.Our proposed Delphi score could help health-care provider to predict the development of delirium and make possible targeted intervention to prevent delirium in high-risk surgery patients.

  18. Intimate partner violence among female drug users admitted to the general hospital: screening and prevalence.

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    Caldentey, Clara; Tirado Muñoz, Judit; Ferrer, Tessie; Fonseca Casals, Francina; Rossi, Paola; Mestre-Pintó, Juan Ignacio; Torrens Melich, Marta

    2016-09-29

    Intimate partner violence (IPV) is a public health problem worldwide. Several factors have been found to be associated with an increased prevalence of IPV, such as substance use. A cross-sectional study was conducted with the aim of determining the prevalence of IPV among women entering Hospital del Mar (Barcelona) for any medical/surgical reason, and who had a diagnosis of substance use disorder. Secondly, it was intended to psychometrically validate the Spanish version of the Hurt, Insulted, Threatened with Harm, Screamed (HITS) questionnaire. All patients were assessed by two IPV questionnaires, the Composite Abuse Scale (CAS) and HITS. Out of 52 patients interviewed, 46 answered both questionnaires. According to the CAS questionnaire, 23 patients (50%) experienced IPV at some point in their lives and 11 (23.9%) in the last year. Cannabis consumption was also associated with an increased severity of IPV (95% CI 3.5-28.9, p = .013).According to the HITS questionnaire, there was a prevalence of 39.1% (18 patients) in the last 12 months. HITS had a specificity of 100% and a sensitivity of 78% relative to the CAS questionnaire. A cut-off score x∈ [6.7], derived through ROC analysis, correctly discriminated 91% of the victims and 100% of the non-victims. The results obtained showed that the prevalence of IPV was very high among women who suffered from more than one substance use disorder. Therefore, it is highly recommended to systematically screen for IPV victimization by putting the HITS questionnaire into practice.

  19. Hypertension in employees of a University General Hospital Hipertensão arterial em funcionários de um Hospital Universitário

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    Decio Mion Jr.

    2004-01-01

    Full Text Available PURPOSE: To find out the prevalence of hypertension in employees of the Hospital and relate it to social demographic variables. METHODS: Blood pressure measurement was performed with a mercury sphygmomanometer, using an appropriate cuff size for arm circumference, weight, and height in a population sample of 864 individuals out of the 9,905 employees of a University General Hospital stratified by gender, age, and job position. RESULTS: Hypertension prevalence was 26% (62% of these reported being aware of their hypertension and 38% were unaware but had systolic/diastolic blood pressures of >140 and/or >90 mm Hg at the moment of the measurement. Of those who were aware of having hypertension, 51% were found to be hypertensive at the moment of the measurement. The prevalence was found to be 17%, 23%, and 29% (P 50 years, work unit being the Institute of Radiology and the Administration Building, educational level 10 years, and body mass index >30 kg/m². The multivariate logistic regression model revealed a statistically significant association of hypertension with the following variables: gender, age, skin color, family income, and body mass index. CONCLUSIONS: Hypertension prevalence was high, mainly in those who were not physicians or members of the nursing staff. High-risk groups (obese, non-white, men, low family income should be better advised of prevention and early diagnosis of hypertension by means of special programs.OBJETIVO: Conhecer a prevalência de hipertensão arterial em funcionários de um complexo hospitalar e relacionar com variáveis sócio demográficas. MÉTODOS: Foi medida a pressão arterial com aparelho de coluna de mercúrio e manguito adequado à circunferência do braço, o peso e a altura em amostra de 864 dos 9.905 funcionários do Hospital Universitário estratificada de acordo com sexo, idade e ocupação. RESULTADOS: A prevalência de hipertensão foi de 26% (hipertensão referida = 62% ou pressão sistólica > 140

  20. Generalized psychological distress among HIV-infected patients enrolled in antiretroviral treatment in Dilla University Hospital, Gedeo zone, Ethiopia

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    Solomon H. Tesfaye

    2014-05-01

    Full Text Available Background: Psychological disorders like depression and anxiety are potentially dangerous conditions. In the context of HIV/AIDS, this can influence health-seeking behavior or uptake of diagnosis and treatment for HIV/AIDS, add to the burden of disease for HIV patients, create difficulty in adherence to treatment, and increase the risk of mortality and morbidity. The objective of this study was to assess the prevalence and correlates of generalized psychological distress among HIV-infected subjects on antiretroviral treatment (ART. Design: An institution-based cross-sectional study was conducted. Interviews were conducted with 500 patients initiating ART at Dilla Referral Hospital. Generalized psychological distress was measured using the Hospital Anxiety and Depression Scale (HADS. A cutoff score ≥19 was used to identify possible cases of patients with generalized psychological distress. Multivariable logistic regression analysis using SPSS Version 20 was performed to identify factors associated with psychological distress. Results: The prevalence of generalized psychological distress among the population of this study was 11.2% (HADS≥19. Factors independently associated with generalized psychological distress were moderate stress (OR=6.87, 95% CI 2.27–20.81, low social support (OR=10.17, 95% CI 2.85–36.29, number of negative life events of six and above (OR=3.99, 95% CI 1.77–8.99, not disclosing HIV status (OR=5.24, 95% CI 1.33–20.62, and CD4 cell count of <200 cells/mm3 (OR=1.98, 95% CI 0.45–0.83 and 200–499 cells/mm3 (OR=3.53, 95% CI 1.62–7.73. Conclusions: This study provides prevalence of psychological distress lower than the prevalence of common mental disorders in Ethiopia and comparable to some other studies in sub-Saharan Africa. The findings are important in terms of their relevance to identifying high-risk groups for generalized psychological distress and preventing distress through integrating mental health

  1. Suicide risk among inpatients at a university general hospital Risco de suicídio em pacientes internados em um hospital geral universitário

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    Marianne Herrera Falceti Ferreira

    2007-03-01

    Full Text Available OBJECTIVE: To estimate the proportion of inpatients at a university general hospital who are at risk of committing suicide. METHOD: A random sample of 253 patients (57% males aged 18 years old or older, admitted to surgical and clinical wards, was assessed using the the Mini International Neuropsychiatric Interview, which has a section that evaluates the risk for suicide. Uni- and multivariate analyses were performed. RESULTS: There were 58 (23% patients with a risk for suicide, 13 (5% of total of whom presented a high risk. The prevalence of suicide risk was greater in young adult patients, those with no matrimonial relationship and those diagnosed with major depression (univariate analysis, Chi-squared test; p = 0.01, 0.03 and 0.0001, respectively. The multivariate analysis revealed that the risk for suicide in individuals younger than 30 years old was two fold higher than in those individuals between the ages of 30 and 59 years (OR = 0.45, 95% CI = 0.22-0.93; p = 0.03 and four fold greater than in those who were 60 years old or older (OR = 0.25, 95% CI = 0.1-0.64; p = 0.004. CONCLUSION: When young adults are admitted to general hospitals they should receive special attention due to their suicidal potential.OBJETIVO: Estimar a proporção de pacientes internados em um hospital geral universitário que têm risco de suicídio. MÉTODO: Uma amostra aleatória de 253 pacientes (57% do sexo masculino com 18 anos ou mais, internados em enfermarias clínicas e cirúrgicas, foi avaliada por meio do Mini International Neuropsychiatric Interview, o qual possui uma seção que avalia risco de suicídio. Foram realizadas analises uni e multivariadas. RESULTADOS: Cinqüenta e oito (23% pacientes tinham risco de suicídio, 13 dos quais (5% do total risco elevado. A prevalência de risco de suicídio foi maior em adultos jovens, nos que não tinham vínculo matrimonial e nos que tiveram um diagnóstico de depressão maior (análise univariada, teste do Qui

  2. Prevalencia de factores de riesgo de enfermedad coronaria en trabajadores del Hospital General de México Prevalence of risk factors of coronary disease in personnel of the General Hospital of Mexico

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    GUILLERMO FANGHÄNEL-SALMÓN

    1997-09-01

    Full Text Available Objetivo. Conocer la prevalencia de algunos factores de riesgo coronario en trabajadores de una institución de salud. Material y métodos. De 1993 a 1995 se evaluaron 2 228 trabajadores del Hospital General de México, 1 531 mujeres (68.7% y 697 hombres (31.2% con edades entre 16 a 65 años, y se les clasificó por áreas de trabajo: en Intendencia hubo 477 participantes (21.4%; en Administración, 697 (31.2%; en Personal Médico, 495 (22.2%, y en Enfermería, 559 (25.0%. Se les practicó historia clínica, mediciones antropométricas y determinación de glucosa, colesterol total, LDL, HDL y triglicéridos. Resultados. Trescientos sesenta y siete sujetos (14.9% tenían colesterol por arriba de 240 mg/dl, con valores altos en las mujeres del área administrativa (17.1% y en los hombres del departamento de enfermería (26% que presentó la mayor tendencia (26%. Se encontraron niveles de triglicéridos por arriba de los 200 mg/dl en 471 personas (19.1%; obesidad, en 329 (13.5%; hipertensión arterial, en 549 sujetos (22.2%, y tabaquismo positivo, en 32% de los trabajadores. La prevalencia de diabetes mellitus fue de 6.24%. Conclusiones. Se confirma la elevada prevalencia de factores de riesgo de enfermedad cardiovascular entre los trabajadores del Hospital General de México, factores que en muchos casos son modificables, lo que confiere la posibilidad de realizar acciones preventivas.Objective. To evaluate the prevalence of risk factors of coronary heart disease in the personnel of the General Hospital in Mexico City. Material and methods. We studied 2 228 workers, 1 531 female (68.7% and 697 male (31.2% whose ages ranged from 16 to 65 years old in the period of 1993 to 1995. They were divided in work areas: Intendancy 477 (21.4%, Administrative, 697 (31.2%, Physicians, 495 (22.2% and Nurses, 559 (25.0%. We collected clinical histories, anthropometric measures, and laboratory determinations of glucose, total cholesterol, LDL, HDL and

  3. Midazolam sedation to produce complete amnesia for bronchoscopy: 2 years' experience at a district general hospital.

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    Williams, T J; Bowie, P E

    1999-05-01

    Patients may find bronchoscopy without sedation unpleasant. There is some evidence that patient satisfaction correlates with amnesia for the procedure. For several years we have used doses of midazolam sufficient to put patients lightly asleep hoping to produce complete amnesia. We looked at practical aspects of this technique over a 2-year period. We studied 337 consecutive patients. They were 219 men and 118 women of mean age 63 +/- 12.4 (SD). Sixty-seven patients were aged 75 years or over and the eldest was 86. Sixty-three patients were already hospital inpatients but the remainder were seen as day cases. Midazolam was given by slow i.v. injection over several minutes until the patient was judged to be lightly asleep. Patients were given supplemental oxygen (3 l min-1) and monitored by ECG and pulse oximetry. A note was made of the time at which they awakened, defined as when nursing staff felt the patients were awake enough to have a cup of tea and toast. Patients were asked if they had any memory of the procedure both on awakening and when seen a few days later to discuss the results. The procedures were carried out in a well-staffed Day Case Unit with a recovery area. The mean dose of midazolam used was 10.8 mg (mean +/- SD = 0.16 +/- 0.095 mg kg-1). The midazolam was given over a median of 4 min (range 1-15 min). Patients took 59 +/- 45 min (mean +/- SD) to wake up. Twenty-eight patients were given flumazanil to reverse the sedation (11 for concern over bleeding following biopsies, three for desaturation during and three after procedure, four as they were frail, two as they were restless, two as they were hypotensive after procedure and three for miscellaneous reasons). Only nine patients could remember any part of the procedure. Incremental doses of midazolam given slowly until patients are lightly asleep almost invariably produce complete amnesia for bronchoscopy. This is a safe technique but patients need careful monitoring and may require reversal of

  4. Causes of Death in an Acute Psychiatric Inpatient Unit of a Portuguese General Hospital.

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    Barbosa, Sofia; Sequeira, Márcia; Castro, Sara; Manso, Rita; Klut Câmara, Catarina; Trancas, Bruno; Borja-Santos, Nuno; Maia, Teresa

    2016-08-01

    Introdução: Os doentes afectos de patologia psiquiátrica apresentam maior risco de morte, tanto por causas naturais como não naturais. Este estudo avalia as causas de morte de todos os doentes de uma unidade de internamento de agudos de Psiquiatria num hospital geral em Portugal, ao longo de dezasseis anos (de 1998 a 2013). Material e Métodos: Vinte e um doentes morreram na unidade de internamento de doentes agudos entre 1998 e 2013 (média 1,3 por ano). As características demográficas, os diagnósticos médicos e psiquiátricos foram recolhidos através de um estudo retrospectivo que consistiu na análise dos processos clínicos da amostra selecionada. Os doentes transferidos para outras enfermarias durante o internamento não foram incluídos no estudo. Resultados: As doenças do sistema circulatório foram as causas de morte mais prevalentes, ocorrendo em 2/3 dos doentes, incluindo embolismo pulmonar (n = 6), acidente vascular cerebral (n = 3), arritmia cardíaca (n = 2), enfarte agudo do miocárdio (n = 1), rutura de aneurisma da aorta abdominal (n = 1) e insuficiência cardíaca (n = 1). Dois doentes morreram de pneumonia e em quatro casos a causa de morte foi indeterminada. Apenas um caso de suicídio foi registado. Discussão: As doenças do aparelho circulatório foram as causas de morte mais frequentes nesta unidade de agudos. O suicídio em doentes internados, apesar de constituir um evento raro, é uma realidade que comporta consequências complexas para os profissionais de saúde, familiares e restantes doentes, devendo permanecer como foco de prevenção continuada. Conclusão: Os estudos de mortalidade são importantes para determinar a qualidade dos cuidados de saúde e criar recomendações para medidas preventivas.

  5. Neurasthenia, Generalized Anxiety Disorder, and the Medicalization of Worry in a Vietnamese Psychiatric Hospital.

    Science.gov (United States)

    Tran, Allen L

    2017-06-01

    This article examines two forms of the medicalization of worry in an outpatient psychiatric clinic in Ho Chi Minh City, Vietnam. Biomedical psychiatrists understand patients' symptoms as manifestations of the excessive worry associated with generalized anxiety disorder (GAD). Drawing on an ethnopsychology of emotion that reflects increasingly popular models of neoliberal selfhood, these psychiatrists encourage patients to frame psychic distress in terms of private feelings to address the conditions in their lives that lead to chronic anxiety. However, most patients attribute their symptoms to neurasthenia instead of GAD. Differences between doctors' and patients' explanatory models are not just rooted in their understandings of illness but also in their respective conceptualizations of worry in terms of emotion and sentiment. Patients with neurasthenia reject doctors' attempts to psychologize distress and maintain a model of worry that supports a sense of moral selfhood based on notions of obligation and sacrifice. © 2016 by the American Anthropological Association.

  6. Comportamiento clínico de la celulitis facial odontógena. Hospital Universitario "General Calixto García" Clinical behavior of odontogenic facial cellulitis: "General Calixto García" University Hospital

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    Denia Morales Navarro

    2009-12-01

    Full Text Available Las infecciones dentarias afectan a un gran número de personas a nivel mundial, a pesar de ser prevenibles, por lo que nos sentimos motivados a realizar un estudio observacional, descriptivo, transversal para caracterizar el comportamiento de la celulitis facial odontogénica en los pacientes hospitalizados en el Hospital "General Calixto García". La muestra estuvo constituida por 75 pacientes que presentaron síntomas y signos de celulitis para lo cual se les realizó un minucioso examen físico general y regional, tanto extraoral como intraoral. El sexo masculino resultó ser el más afectado con 42 pacientes y el grupo de edades más dañado fue el de 35 a 59 años. La región anatómica superficial externa mentoniana estuvo involucrada en 36 casos. La misma región mentoniana pero en su porción vestibular inferior se destacó con 51 pacientes. De las regiones anatómicas profundas, la submandibular predominó en 51 individuos para un 68,0 %. Predominó la pulpa dental necrótica y los restos radiculares como mecanismos patogénicos fundamentales. El diagnóstico clínico de celulitis facial odontógena moderada resaltó en 40 pacientes (53,3 %.Dental infections involved many persons at worldwide level, being in many occasions avoidable, thus, a cross-sectional, descriptive and observational study was conducted to characterize the odontogenic facial cellulitis course in patients admitted in "General Calixto García" University Hospital. Sample included 75 patients with symptoms and signs of cellulitis underwent a meticulous intraoral and extraoral regional and general physical examination, where male sex was the more involved with 42 patients and the age group of 35-39 years with 35 patients. The menton external superficial anatomical region includes 36 cases, and of this kind but the internal one, the inferior vestibular sulcus had 51 cases. From the deep anatomical regions, the submandibular one had 51 cases for a 68.0 % with

  7. Workplace violence in different settings and among various health professionals in an Italian general hospital: a cross-sectional study

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    Ferri P

    2016-09-01

    Full Text Available Paola Ferri,1 Monica Silvestri,1 Cecilia Artoni,2 Rosaria Di Lorenzo3 1Department of Diagnostic, Clinical and Public Health Medicine, School of Nursing, 2School of Psychiatry, University of Modena and Reggio, 3Department of Mental Health, Service of Psychiatric Diagnosis and Treatment, Modena, Italy Background: Workplace violence (WPV against health professionals is a global problem with an increasing incidence. The aims of this study were as follows: 1 to examine the frequency and characteristics of WPV in different settings and professionals of a general hospital and 2 to identify the clinical and organizational factors related to this phenomenon. Methods: The study was cross-sectional. In a 1-month period, we administered the “Violent Incident Form” to 745 professionals (physicians, head nurses, nurses, nursing assistants, who worked in 15 wards of a general hospital in northern Italy. Results: With a response rate of 56%, 45% of professionals reported WPV. The most frequently assaulted were nurses (67%, followed by nursing assistants (18% and physicians (12%. The first two categories were correlated, in a statistically significant way, with the risk of WPV (P=0.005, P=0.004, multiple logistic regression. The violent incidents more frequently occurred in psychiatry department (86%, emergency department (71%, and in geriatric wards (57%. The assailants more frequently were males whereas assaulted professionals more often were females. Men committed physical violence more frequently than women, in a statistically significant way (P=0.034, chi-squared test. Verbal violence (51% was often committed by people in a lucid and normal state of consciousness; physical violence (49% was most often perpetrated by assailants affected by dementia, mental retardation, drug and substance abuse, or other psychiatric disorders. The variables positively related to WPV were “calling for help during the attack” and “physical injuries suffered in violent

  8. Perfil social de los cuidadores familiares de pacientes dependientes ingresados en el Hospital General Universitario de Elche Social profile of the family caregiver of dependant patients in the University General Hospital of Elche

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    Pablo López-Casanova

    2009-12-01

    Full Text Available El objetivo de este estudio es describir el perfil social de los cuidadores familiares en el Hospital General Universitario de Elche y conocer el tipo de necesidades que cubren. Metodología: Investigación de tipo descriptivo y transversal, mediante 32 encuestas realizadas entre enero y febrero de 2008, en el Servicio de Medicina Interna. Se efectuó un análisis descriptivo y las variables fueron edad, sexo, ingresos económicos, vivienda, trabajo, parentesco del cuidador y permanencia en el centro hospitalario. Resultados: El perfil del cuidador informal corresponde a una mujer, con una media de edad de 54 años y que permanece todo el día en el hospital. Las necesidades que el cuidador distingue como más importantes estuvieron relacionadas con la compañía, la vigilancia y las necesidades básicas. Conclusiones: El perfil del cuidador familiar es de cónyuges o madres. La realización de las tareas de cuidador supone un gasto de tiempo, dinero, desgaste físico, psicológico y social. Parte de las necesidades del paciente son cubiertas por los cuidadores informales, que reciben poca información y asesoramiento del personal de enfermería sobre cómo realizarlas. Por tanto, ampliar la mirada enfermera es una exigencia y demanda de nuestra sociedad.The aim of this study is to describe the social profile of the family caregivers in the University General Hospital of Elche, and to know the sort of needs that they cater for. Methodology: This is a descriptive and transversal piece of research, performed by means of 32 surveys done between January and February 2008 in the Internal Medicine service. A descriptive analysis was carried out; such analysis bore in mind the following variables: the caregivers´ age, sex, income, dwelling, employment, their kinship with the patient and the lenght of stay at the hospital. Results: The profile of the average informal caregiver corresponds to a woman of approximately 54 years old who stays all day in

  9. Investigating an outbreak of non-specific building-related symptoms in workers of a general hospital

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    Inés Gómez-Acebo

    2013-08-01

    Full Text Available Objective:To obtain a case definition and to describe variables associated with a cluster of unspecific symptoms in healthcare workers (HCW in a hospital building. Materials and Methods: A cross-sectional study was performed. All people working at the Residencia Cantabria building (a 200-bed building belonging to University Hospital Marqués de Valdecilla in June 2009 were invited to complete a self-administered questionnaire, including questions on demographic data, working place and shift, working conditions and current symptoms. A cluster analysis was developed to obtain the case definition. The strength of the association between the studied variables and accomplishing the case definition was measured using odds ratios (OR with the 95% confidence interval (CI. Multiple logistic regression was used to obtain a predictive model; its general validity was estimated with Receiver Operating Curves (ROC and their Area Under the Curve (AUC. Results: 357 completed questionnaires were obtained. The case was defined as having at least 5 symptoms out of the eleven included. Not being ascribed to a specific shift was the strongest protective variable related with "being a case" (OR = 0.30; 95% CI: 0.17-0.54, whereas the personal antecedent of distal pain or inflammation in arms or legs was the main risk factor (OR = 4.33, 95% CI: 2.75-6.82. A six-variable predictive model has AUC equaling to 0.7378. Conclusions: A disease associated with the indoor environment quality in a hospital was characterized. A multivariate score was drafted for identifying HCW with higher risk of developing the disease in order to apply administrative prevention measures.

  10. Geriatric day hospital: opportunity or threat? A qualitative exploratory study of the referral behaviour of Belgian general practitioners

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    Vyncke Veerle

    2010-07-01

    Full Text Available Abstract Background In order to address the challenges of an ageing population the Belgian government decided to allocate resources to the creation of geriatric day hospitals (GDHs. Although GDHs are meant to be a strategy to support general practitioners (GPs caring for the frail elderly, few Belgian GPs seem to refer to a GDH. This study aims to explore the barriers and facilitating factors of GPs' referral to GDHs. Methods A qualitative study using focus group discussions (FGDs was conducted. Fifteen FGDs were organized in the different Belgian regions (Flanders, Wallonia, Brussels. Results Contextual factors such as the unsatisfactory cooperation between hospital and GPs and organizational barriers such as the lack of communication on referral procedures between hospital and primary health care (PHC were identified. Lack of basic knowledge about the concept or the local organization of GDH seemed to be a problem. Unclear task descriptions, responsibilities and activities of a GDH formed prominent points of discussion in all FGDs. Nevertheless a lot of possible advantages and disadvantages of GDHs for the patient and for the GP were mentioned. Conclusions In the case of poor referral to GDHs, focusing on improving overall collaboration between primary and secondary health care is essential. This can be achieved by actively delivering adequate information, permanent communication and more involvement of PHC in the organization and functioning of GDHs. The absence of a transparent health care system with delineated role definitions, seems to hinder the integration of new initiatives like GDHs in the care process. Strategies to enhance referral to GDHs should use a comprehensive approach.

  11. Tentativas de suicídio em um hospital geral no Rio de Janeiro, Brasil Suicide attempts recorded at a general hospital in Rio de Janeiro, Brazil

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    Guilherme L. Werneck

    2006-10-01

    Full Text Available A história pregressa de tentativa de suicídio é um importante preditor do suicídio e de novas tentativas. Este artigo apresenta o perfil dos casos de tentativas de suicídio detectados por meio de um sistema de monitoramento para esses agravos em um hospital geral no Rio de Janeiro, Brasil. Entre abril de 2001 e março de 2002 foram registrados 160 tentativas de suicídio, sendo 68% entre mulheres e 26% entre adolescentes. A ingestão de pesticidas e o abuso de medicamentos foram os principais métodos utilizados. Mulheres utilizaram os dois métodos na mesma proporção, enquanto 2/3 dos homens empregaram pesticidas. Em relação à prevalência dos fatores de risco para tentativas de suicídio, identificou-se que 21% dos pacientes haviam procurado serviços de saúde nos trinta dias anteriores ao evento, 28% referiram tentativas anteriores, 23% fizeram referência a casos de tentativas ou suicídio na família. Ainda que os dados populacionais disponíveis sejam escassos, as tentativas de suicídio parecem ser um evento importante de morbidade, particularmente entre adolescentes e adultos jovens. Sistemas de vigilância para esse agravo podem ser úteis para um melhor conhecimento do problema.Previous suicide attempts are an important predictor of both repeated attempts and suicide. This paper presents the profile of patients who had attempted suicide and were admitted to a general hospital in Rio de Janeiro, Brazil. From April 2001 to March 2002, 160 suicide attempts were recorded (68% women; 26% adolescents. Ingestion of pesticides and prescription drugs were the two most common methods used. The two methods had been used by similar numbers of women, while two-thirds of men had used pesticides. As for prevalence of factors associated with attempted suicide, 21% of patients had been in contact with health services within 30 days prior to the event, 28% mentioned previous suicide attempts, and 23% reported other cases of suicide or

  12. Divertículo único do ceco: experiência de um hospital geral brasileiro Solitary diverticulum of the cecum: experience of a Brazilian general hospital

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    Aljamir Duarte Chedid

    2003-12-01

    Full Text Available RACIONAL: A diverticulite cecal é uma condição rara, especialmente em populações ocidentais. Sua importância reside no fato de fazer parte do diagnóstico diferencial da apendicite aguda e do carcinoma ulcerado de ceco. CASUÍSTICA E MÉTODOS: Apresenta-se a experiência de um hospital geral do sul do Brasil no tratamento da diverticulite cecal. Descrevem-se quatro casos de divertículo único inflamado de ceco. Um destes teve diagnóstico pré-operatório através de tomografia computadorizada de abdome, tendo o paciente tratado clinicamente com remissão do quadro de diverticulite. Os outros três pacientes foram submetidos a colectomia direita com íleo-transverso anastomose. RESULTADOS: A mortalidade foi nula e nos casos operados não houve complicações pós-operatórias. Quando se consegue obter diagnóstico pré-operatório, pode-se optar por manejo clínico. CONCLUSÃO: Recomendamos laparotomia exploradora quando não há certeza diagnóstica. Preconizamos manejo cirúrgico radical quando o diagnóstico é efetuado através de laparotomia.BACKGROUND: Cecal diverticulitis is a rare condition, specially in western people. Its importance concerns of being part of the differential diagnosis of acute appendicitis and ulcerated cecal carcinoma. AIM: To present the experience of southern Brazilian general hospital in the treatment of cecal diverticulitis. MATERIAL AND METHODS: We present four cases of single inflamed cecal diverticulum. One was diagnosed by pre-operatively computer tomography and was treated medically without complications. The other three cases were diagnosed during operation and treated by right hemicolectomy and ileotransverse anastomosis. RESULTS:There were no deaths or complications. When cecal diverticulitis is pre-operatively diagnosed it may be treated medically. We preclude laparotomy when the diagnosis is uncertain. CONCLUSION: We recommend radical surgical management when the diagnosis is made during operation.

  13. Waiting times before dental care under general anesthesia in children with special needs in the Children's Hospital of Casablanca.

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    Badre, Bouchra; Serhier, Zineb; El Arabi, Samira

    2014-01-01

    Oral diseases may have an impact on quality of children's life. The presence of severe disability requires the use of care under general anesthesia (GA). However, because of the limited number of qualified health personnel, waiting time before intervention can be long. To evaluate the waiting time before dental care under general anesthesia for children with special needs in Morocco. A retrospective cohort study was carried out in pediatric dentistry unit of the University Hospital of Casablanca. Data were collected from records of patients seen for the first time between 2006 and 2011. The waiting time was defined as the time between the date of the first consultation and intervention date. 127 children received dental care under general anesthesia, 57.5% were male and the average age was 9.2 (SD = 3.4). Decay was the most frequent reason for consultation (48%), followed by pain (32%). The average waiting time was 7.6 months (SD = 4.2 months). The average number of acts performed per patient was 13.5. Waiting times were long, it is necessary to take measures to reduce delays and improve access to oral health care for this special population.

  14. The clinical pathway for hypertensive patient of local health unit, hospitals and general practitioners, the Milan experience.

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    Donzelli, Alberto; Sghedoni, Donatella; Carelli, Francesco A; Chirchiglia, Saverio; Manunta, Paolo

    2011-01-01

    The Clinical Pathway (in its complete definition Diagnostic, Clinical and Therapeutic Pathway - Percorso Diagnostico Terapeutico Assistenziale - PDTA), originally started to deal with the newly diagnosed hypertensive patient, developed also recommendations for the first-line drugs in case of specific indications/contraindications and organ damages. It has been developed by a working group of specialists in cardiology, nephrology, internal medicine (faculty included) designated by their hospitals (both public and private accredited), including all the main city hospitals, by general practitioners designated by the Medical Unions SNAMI, FIMMG, SMI and SiMI and by public health doctors belonging to the Local Health Unit of Milan, who have coordinated the proceedings and have guaranteed that possible conflicts of interest of single participants could not interfere with the PDTA, anyway approved by all in July 2009. The PDTA deals with the measuring and self- home-monitoring of blood pressure (BP) and the diagnosis of hypertension; it revises, sometimes "dries up" and rationalizes the recommendations for diagnostic tests and specialist evaluations; it develops prevention and non-pharmacological treatments, proposing also tools for patients and for prescribing correct nutrition and physical activity and a structured program for BP monitoring; but the main feature is the innovations brought in the proposed drug treatment in comparison with the current clinical practice.

  15. The effect of a whole-system approach in an antimicrobial stewardship programme at the Singapore General Hospital.

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    Teo, J; Kwa, A L H; Loh, J; Chlebicki, M P; Lee, W

    2012-06-01

    Inappropriate antibiotic use contributes to antimicrobial resistance. Multi-faceted antimicrobial stewardship programmes (ASPs) are recommended for sustainable changes in prescribing practices. A multi-disciplinary ASP was established in October 2008 and piloted in the Departments of General Surgery, Renal Medicine and Endocrinology sequentially. To improve the quality of patient care via optimising the (1) choice, (2) dose, (3) route and (4) duration of antibiotics, a "whole-system" approach incorporating prospective review with immediate concurrent feedback (ICF), prescriber education (public or individualised), de-escalation of therapy, dose optimisation and parenteral-to-oral conversion, while recognising the autonomy of primary prescribers, was adopted. The audited department received a quarterly outcomes report and any common unaccepted practices would be addressed. Outcomes were analysed for 12 months post-ASP implementation. A total of 1,535 antibiotic prescriptions were reviewed. Antimicrobial use in 376 (24.5%) prescriptions was inappropriate. Of 596 interventions made, 70.2% were accepted. A reduction in audited antibiotics consumption resulted in acquisition cost savings of S$198,575 for the hospital. Patients' cost-savings attributable to ASP-initiated interventions were $91,194. The overall all-cause mortality rate and median monthly inpatient-days pre- and post-intervention remained stable. A "whole-system" ASP was effective in optimising antibiotic use in our hospital, without compromising clinical outcomes.

  16. Meaning of work in nursing professionals at the general hospital Significado del trabajo de los profesionales de enfermería en el hospital general Significado do trabalho dos profissionais de enfermagem no hospital geral

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    SANTOS ALVES MARIA DALVA

    2010-12-01

    Full Text Available

    Objective: analyze how nursing professionals express their feelings and reactions at work.

    Methods: descriptive study of qualitative approach. The research was conducted from July to September 2008 in a public hospital located at the city of Fortaleza, Ceará (Brazil. 22 nursing professional, 10 nurses and 12 technicians, participated in the study. The study was approved by the institution’s Ethics Research Committee. Data collection was made using semi-structured scripts in face-to-face interviews.

    Results: answers were categorized as follows: meaning of work at the recovery room and post-operatory therapy unit; factors that affect the physical and psychical health of nursing professional, and factors that affect professional performance.

    Discussion: day-to-day work at intensive care units was assessed as stressful but highly pleasant. Physical suffering, as an expression of workload, became evident as corporal pains. The workplace factors affecting professional performance were the following: lack of materials, noise of equipment and ergonomic factors.

    Conclusions: Working, at intensive care units, raises a debate that is everything but new, however, it is a warning for the implementation of stress defensive strategies. The study allowed for creating spaces to embrace and listen to nursing professionals with a view to reduce the physical and psychical suffering at work.

    Objetivo: analizar como los profesionales de enfermería expresan sus sentimientos y reacciones en el trabajo.

    Métodos: estudio descriptivo de enfoque cualitativo. Se realizó en el período comprendido entre julio y septiembre de 2008 en un hospital público en la ciudad de Fortaleza, Ceará (Brasil. Los

  17. Clinical Characteristics of Patients with Adrenal Insufficiency in a General Hospital

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    Lee, Ye Yeon; Cho, Nan Hee; Lee, Jong Won; Kim, Nam Kyung; Kim, Hye Soon

    2017-01-01

    Background Adrenal insufficiency (AI) is a life-threatening disorder caused by the deficiency of adrenal steroid hormones. This retrospective cross-sectional study investigated the characteristics of patients with AI in Korea. Methods All consecutive patients with suspected AI who received care at a tertiary referral center in Korea in 2014 and underwent adrenocorticotropic hormone stimulation or insulin-tolerance testing were identified through a review of medical charts. Patients diagnosed with AI were enrolled. Their demographic, clinical, and treatment details were extracted. Results Of 771 patients with suspected AI, 183 (23.7%) received a definitive diagnosis. The most common reason for testing was the presence of suspicious AI-related symptoms (30.0%), followed by a history of steroid medications (23.5%). Their mean age was 66.7 years, and females predominated (67.8%). The most common symptoms were general weakness, anorexia, arthralgia, and fever. Approximately half (53.6%) had a history of steroid use. Hydrocortisone was the most common treatment (71.6%), with most patients taking a 30 mg dose (44.2%). The most common dose frequency was twice a day (78.6%). Fourteen patients were treated for adrenal crisis (n=10, 5.5%) or an intercurrent illness (n=4, 2.2%). Conclusion AI may have been caused by steroid medication use in many of the patients included in this study. The detection of AI can be improved by careful history-taking and being alert to the possibility that a patient has used steroids. PMID:28256113

  18. [Profile and sensitivity to antibiotics of 115 staphylococcal strains implicated in septicemia in a Tunisian general hospital].

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    Boukadida, J; Ben Abdallah, H; Boukadida, N

    2003-11-01

    Staphylococci remain among the main responsible bacteria for septicemia. The resistance to antibiotics already makes a prognosis difficult. We carried out a study on Staphylococcus isolated from blood culture on 3 years in general hospital in Tunisia. We present the different species and their sensitivity to antibiotics. S. aureus is the predominant isolated species. S. epidermidis is essentially isolated in newborn intensive care unit. The meticillino-resistance concerns 14% of the whole strains and 5.2 of the S. aureus. No resistance is found as regard the vancomycin and the pristinamycin; ofloxacine is inactive on 14.8% of strains and the gentamicine on 11.3%. The resistance of staphylococci of our study is lower than the rates reported in southern Europe and in North America.

  19. Spectrum of digestive tract diseases 1985-1987 at the Pediatric Gastroenterology Outpatient Clinic of Dr. Pirngadi General Hospital, Medan.

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    Siregar, C D; Sinuhaji, A B; Sutanto, A H

    1990-01-01

    A retrospective study has been done on infants and children attending to the Pediatric Gastroenterology Outpatient Clinic of Dr. Pirngadi General Hospital in Medan, from 1985 through 1987. During the study there were 874 patients, 477 (54.58%) suffered from diarrhea, 209 (23.91%) had bloody stool, 20 (2.99%) jaundice, 57 (6.52%) abdominal pain, 48 (5.49%) abdominal distention, 30 (3.43%) vomiting, 13 (1.49%) constipation, and 20 (2.29%) others. Of all cases with diarrhoea, watery diarrhoea were found in only 319 (66.88%), diarrhoea with vomiting 84 (17.61%), and bloody diarrhoea 74 (15.51%). Stool examination in patients with diarrhoea revealed 144 (30.19%) cases with Candida albicans, while 16 (3.35%) of them with steatorrhoea. Of 63 patients with diarrhoea on which the clinitest had been performed, sugar intolerance were found in 30 (47.62%) cases.

  20. Recognition of depression in children in general hospital-based paediatric units in Kenya: practice and policy implications

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    Mutiso Victoria N

    2009-10-01

    Full Text Available Abstract Background Physical disorders are commonly comorbid with depression in children attending general medical facilities. However, the depression component is rarely recognised. Methods A questionnaire on sociodemographics and history of presenting medical conditions was administered together with the Children's Depression Inventory (CDI to all 11-year-old to 17-year-old children attending at nine medical facilities. Results In all, 408 children were recruited from 9 health facilities. Whereas the clinicians diagnosed a mental disorder in only 2.5% of the sample studied, 41.3% had CDI scores that suggested mild to moderate depression. The highest proportion of children with depressive symptomatology was found at the Kenyatta National and Teaching Referral Hospital. Conclusion Although prevalence rate for depression among children is high, detection rates remain low. This finding has clinical practice and policy implications within and outside Kenya.

  1. Nursing Care Given to the Plague Infected Patients in the Hospital General of Madrid (Spain in the 17th Century.

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    Manuel Jesús García Martínez

    2016-12-01

    Full Text Available This study reveals the work developed by the nurses of the Hospital general of Madrid (Spain in the treatment of the plague, and the training they received for their welfare tasks in the 17th century. Since the end of the 16th century, nurses knew and implemented a set of techniques and medicines to alleviate the terrible disease of the plague and, despite the scarce knowledge about the disease existing at the time, they sought to prevent the contagion with hygienic and dietary measures, and physical isolation. This study shows through which actions and in which conditions nurses worked to deal with such a terrible disease. All this helps to get a full knowledge of the development of the work done by nurses in the last five centuries and, therefore, to determine the evolution and shaping of the nursing profession in our country.

  2. Role of the General Practitioner in the Care of Patients Recently Discharged From the Hospital After a First Psychotic Episode: Influence of Length of Stay

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    Rivoiron-Besset, Emmanuelle; David, Michel; Jaussent, Isabelle; Prudhomme, Cindy; Boulenger, Jean-Philippe; Mann, Anthony H.; Ritchie, Karen A.; Capdevielle, Delphine

    2011-01-01

    Objective: It is unclear to what extent general practitioners are involved in the postdischarge care of patients hospitalized for a first psychotic episode and whether this involvement is influenced by length of stay in the hospital. The objectives of this study were to describe the role of the general practitioner in providing postdischarge care to patients with first-episode psychosis in terms of frequency and type of consultation and the extent of collaboration with hospital-based specialist services and to determine whether decreasing length of stay was accompanied by a modification in this role. Method: Six months after hospital discharge, a postal questionnaire was sent to the general practitioners of patients recruited to the French STEP cohort (Schizophrenie et son Traitement: une Evaluation de la Prize en charge), a prospective study of the clinical and social determinants of care pathways and prognosis for patients hospitalized for a first psychotic episode (DSM-IV criteria) in 5 services of the La Colombière Psychiatric Hospital, Montpellier, France. Length of stay in the hospital was dichotomized according to the median value of 35 days. Data collection took place from February 2008 to March 2009. Results: Of the 121 STEP patients, 65% (n=79) had a regular general practitioner. The general practitioners had been informed by the hospital of the admission of their patient in only 17.9% (7/39) of cases. Of the general practitioners, 78.3% (47/60) had seen the patient at least once since discharge, with a median number of visits standardized over 6 months of 0.86 (range, 0–8.6). General practitioners were better informed with regard to diagnosis, date of discharge, name of psychiatrist, treatment, and community follow-up at discharge for patients with a short length of stay in the hospital, who were also more likely than those with a long length of stay to be consulting for mental health problems. Conclusions: Our findings suggest a low level of

  3. Attitudes and relationship between physicians and the pharmaceutical industry in a public general hospital in Lima, Peru.

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    Aldo De Ferrari

    Full Text Available BACKGROUND: The interaction between physicians and the pharmaceutical industry influences physicians' attitudes and prescribing behavior. Although largely studied in the US, this topic has not been well studied in resource-poor settings, where a close relationship between physicians and industry still exists. OBJECTIVE: To describe physician interactions with and attitudes towards the pharmaceutical industry in a public general hospital in Lima, Peru. DESIGN: Descriptive, cross-sectional study through an anonymous, self-filled questionnaire distributed among faculty and trainee physicians of five different clinical departments working in a Peruvian public general hospital. A transcultural validation of an existing Spanish questionnaire was performed. Exposure to marketing activities, motivations to contact pharmaceutical representatives and attitudes towards industry were studied. Collected data was analyzed by degree of training, clinical department, gender and teaching status. Attitudes were measured on a four-point LIKERT scale. RESULTS: 155 physicians completed the survey, of which 148 were included in the study sample. 94.5% of attending physicians reported ongoing encounters with pharmaceutical representatives. The most common industry-related activities were receiving medical samples (91.2%, promotional material (87.8% and attending meetings in restaurants (81.8%. Respondents considered medical samples and continuing medical education the most ethically acceptable benefits. We found significant differences between attendings and residents, and teaching and non-teaching attendings. An association between the amount of encounters with pharmaceutical representatives, and attitudes towards industry and acceptance of medical samples was found. CONCLUSIONS: A close physician-industry relationship exists in the population under study. The contact is established mainly through pharmaceutical representatives. Medical samples are the most received

  4. Epidemiologic profile of otorhinolaryngological, head and neck disorders in a tertiary hospital unit in Greece: a challenge for general practitioners?

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    Rachiotis Georgios

    2006-06-01

    Full Text Available Abstract Background In Greece, primary care is still developing. The aim of this study was to define the epidemiologic profile of common otorhinolaryngological, head and neck disorders in order to help general practitioners to deal with them in a primary care future. Methods A total of 6771 patients attended the Otorhinolaryngology emergency department of the University General Hospital of Heraklion (Crete, between January and December 2004. All cases were included in this retrospective study. The registry of the Otorhinolaryngology emergency department was analysed and age, sex, seasonality and clinical diagnosis were tabulated. All patients were evaluated by Otorhinolaryngologists. The classification of the cases was based on the main symptom or clinical sign that conditioned the reason for seeking care. Diagnoses were also coded according to the International Classification of Diseases (ICD-10. Results The male to female ratio was 1:1. The mean age for females was 36.3 years standard deviation (SD: 21.1 and for males was 36.8 years (SD = 22.0. Eight hundred eighty six patients (13.1% formed the paediatric sub-group. Over 60% of the cases were classified in ten major groups of diagnosis. Acute tonsillitis (12.3% and acute pharyngitis (9.0% were the most common causes of all medical visits, followed by otitis media (7.6% and external ear canal obstruction by ear wax (6.2%. Oedema of the larynx was detected in 0.4%. A negative diagnosis of otorhinolaryngological, head and neck disorder was formulated in 553 patients (8.2%. Hospitalization rate was 5.2%. The highest rate of visits was registered in March. Conclusion Most patients used the facility as a primary care service. Real emergencies were a minority. Recovering data about which areas of Otorhinolaryngology deserve more emphasis might help primary health care providers to diagnose and manage the common otorhinolaryngological, head and neck disorders properly.

  5. Attitudes and relationship between physicians and the pharmaceutical industry in a public general hospital in Lima, Peru.

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    De Ferrari, Aldo; Gentille, Cesar; Davalos, Long; Huayanay, Leandro; Malaga, German

    2014-01-01

    The interaction between physicians and the pharmaceutical industry influences physicians' attitudes and prescribing behavior. Although largely studied in the US, this topic has not been well studied in resource-poor settings, where a close relationship between physicians and industry still exists. To describe physician interactions with and attitudes towards the pharmaceutical industry in a public general hospital in Lima, Peru. Descriptive, cross-sectional study through an anonymous, self-filled questionnaire distributed among faculty and trainee physicians of five different clinical departments working in a Peruvian public general hospital. A transcultural validation of an existing Spanish questionnaire was performed. Exposure to marketing activities, motivations to contact pharmaceutical representatives and attitudes towards industry were studied. Collected data was analyzed by degree of training, clinical department, gender and teaching status. Attitudes were measured on a four-point LIKERT scale. 155 physicians completed the survey, of which 148 were included in the study sample. 94.5% of attending physicians reported ongoing encounters with pharmaceutical representatives. The most common industry-related activities were receiving medical samples (91.2%), promotional material (87.8%) and attending meetings in restaurants (81.8%). Respondents considered medical samples and continuing medical education the most ethically acceptable benefits. We found significant differences between attendings and residents, and teaching and non-teaching attendings. An association between the amount of encounters with pharmaceutical representatives, and attitudes towards industry and acceptance of medical samples was found. A close physician-industry relationship exists in the population under study. The contact is established mainly through pharmaceutical representatives. Medical samples are the most received and ethically accepted benefit. The attitudes of physicians on the

  6. Workplace violence in different settings and among various health professionals in an Italian general hospital: a cross-sectional study.

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    Ferri, Paola; Silvestri, Monica; Artoni, Cecilia; Di Lorenzo, Rosaria

    2016-01-01

    Workplace violence (WPV) against health professionals is a global problem with an increasing incidence. The aims of this study were as follows: 1) to examine the frequency and characteristics of WPV in different settings and professionals of a general hospital and 2) to identify the clinical and organizational factors related to this phenomenon. The study was cross-sectional. In a 1-month period, we administered the "Violent Incident Form" to 745 professionals (physicians, head nurses, nurses, nursing assistants), who worked in 15 wards of a general hospital in northern Italy. With a response rate of 56%, 45% of professionals reported WPV. The most frequently assaulted were nurses (67%), followed by nursing assistants (18%) and physicians (12%). The first two categories were correlated, in a statistically significant way, with the risk of WPV (P=0.005, P=0.004, multiple logistic regression). The violent incidents more frequently occurred in psychiatry department (86%), emergency department (71%), and in geriatric wards (57%). The assailants more frequently were males whereas assaulted professionals more often were females. Men committed physical violence more frequently than women, in a statistically significant way (P=0.034, chi-squared test). Verbal violence (51%) was often committed by people in a lucid and normal state of consciousness; physical violence (49%) was most often perpetrated by assailants affected by dementia, mental retardation, drug and substance abuse, or other psychiatric disorders. The variables positively related to WPV were "calling for help during the attack" and "physical injuries suffered in violent attack" (P=0.02, P=0.03, multiple logistic regression). This study suggests that violence is a significant phenomenon and that all health workers, especially nurses, are at risk of suffering aggressive assaults. WPV presented specific characteristics related to the health care settings, where the aggression occurred. Prevention programs

  7. Prevalence and factors associated with diabetic retinopathy among diabetic patients at Arbaminch General Hospital, Ethiopia: Cross sectional study

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    Chisha, Yilma; Terefe, Wondwossen; Assefa, Huruy; Lakew, Serawit

    2017-01-01

    Background Currently 93 million people are estimated as living with diabetic retinopathy worldwide. The prevalence and risk factors of diabetic retinopathy in developed countries have been well documented; but in Ethiopia, data on prevalence and associated factors of diabetic retinopathy is lacking. Objective To determine prevalence and factors associated with development of diabetic retinopathy among diabetic patients at Arbaminch General Hospital, Ethiopia. Method Cross-sectional study design with record review of 400 diabetic patients was conducted at Arbaminch General Hospital from November to January 2015. Among 400 diabetic patients, 270 patients with baseline information and without history of hypertension at baseline were included in this study. But patients with gestational diabetes and with retinopathy at baseline were excluded from the study. Consecutive sampling technique was applied to select study participants. Data of cohorts was extracted from medical record using pre tested structured extraction check list. Data cleaning, coding, categorizing, merging and analysis carried out by STATA version 12. Descriptive statistics was done and presented accordingly. Bivariate binary logistic regression analysis was done to select potential candidates for the full model at P-value cutoff point ≤ 0.25 and multivariable binary logistic regression analysis was made to estimate the independent effect of predictors on the occurrence of diabetic retinopathy. Model diagnostic tests were done, final model fitness was checked using Hosmer and Lemeshow chi square test. Finally, statistical significance was tested at P-value 140 mmhg, duration of diabetes ≥6 years and patients with family history of diabetes were statistically and significantly related with diabetic retinopathy, special care should be given in addition to routine care. PMID:28253261

  8. Evaluation of the determinants of maternal mortality in H. Adam Malik General Hospital, Medan during 2010-2012

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    Morel Sembiring

    2017-07-01

    Full Text Available Background: Maternal mortality rate is one indicator used to assess overall women health status. According to the WHO, 99% of maternal deaths are delivery related and dominantly occur in developing countries. Objective: To determine the causes of maternal deaths at H. Adam Malik General Hospital Medan based on the following factors: remote determinants, the intermediate determinants, and outcome determinants as a risk factor of maternal deaths. Methods: This retrospective analytical study reviewed medical records of women who underwent delivery at H. Adam Malik General Hospital, Medan from January 1st 2010 until December 31th 2012. Data were statiscally analysed using a descriptive and inferential approach. Univariate, bivariate, and multivariate logistic regression analysis were used. Results: This study obtained as much as 681 complete medical records for 3 years, with 37 maternal deaths. Pre-eclampsia / eclampsia is the most common cause of death by 20 cases (54.1%. Maternal education degree, referral systems, facilities for delivery, history of systemic diseases, pregnancy and postpartum related complications were significantly correlated to the outcome of labor with OR of 1.97; 10.11; 41.36; 5.818; 3.49; and 685.7, respectively and p<0.05. Based on the multiple logistic regression test, maternal history of systemic diseases, pregnancy and postpartum related complications were the three factors that most significantly correlated to maternal mortality with p <0.05. Conclusion: Delivery outcomes were significantly associated with the followingfacrors: formal education, referral status, facilities for delivery, history of systemic diseases, mode of delivery, pregnancy and postpartum related complications. Maternal history of systemic diseases, pregnancy and postpartum related complicationswere the three factors that most significantly correlated to maternal mortality.

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

    Directory of Open Access Journals (Sweden)

    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. Prevalencia de factores de riesgo de enfermedad coronaria en trabajadores del Hospital General de México

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    FANGHÄNEL-SALMÓN GUILLERMO

    1997-01-01

    Full Text Available Objetivo. Conocer la prevalencia de algunos factores de riesgo coronario en trabajadores de una institución de salud. Material y métodos. De 1993 a 1995 se evaluaron 2 228 trabajadores del Hospital General de México, 1 531 mujeres (68.7% y 697 hombres (31.2% con edades entre 16 a 65 años, y se les clasificó por áreas de trabajo: en Intendencia hubo 477 participantes (21.4%; en Administración, 697 (31.2%; en Personal Médico, 495 (22.2%, y en Enfermería, 559 (25.0%. Se les practicó historia clínica, mediciones antropométricas y determinación de glucosa, colesterol total, LDL, HDL y triglicéridos. Resultados. Trescientos sesenta y siete sujetos (14.9% tenían colesterol por arriba de 240 mg/dl, con valores altos en las mujeres del área administrativa (17.1% y en los hombres del departamento de enfermería (26% que presentó la mayor tendencia (26%. Se encontraron niveles de triglicéridos por arriba de los 200 mg/dl en 471 personas (19.1%; obesidad, en 329 (13.5%; hipertensión arterial, en 549 sujetos (22.2%, y tabaquismo positivo, en 32% de los trabajadores. La prevalencia de diabetes mellitus fue de 6.24%. Conclusiones. Se confirma la elevada prevalencia de factores de riesgo de enfermedad cardiovascular entre los trabajadores del Hospital General de México, factores que en muchos casos son modificables, lo que confiere la posibilidad de realizar acciones preventivas.

  11. Workplace violence in different settings and among various health professionals in an Italian general hospital: a cross-sectional study

    Science.gov (United States)

    Ferri, Paola; Silvestri, Monica; Artoni, Cecilia; Di Lorenzo, Rosaria

    2016-01-01

    Background Workplace violence (WPV) against health professionals is a global problem with an increasing incidence. The aims of this study were as follows: 1) to examine the frequency and characteristics of WPV in different settings and professionals of a general hospital and 2) to identify the clinical and organizational factors related to this phenomenon. Methods The study was cross-sectional. In a 1-month period, we administered the “Violent Incident Form” to 745 professionals (physicians, head nurses, nurses, nursing assistants), who worked in 15 wards of a general hospital in northern Italy. Results With a response rate of 56%, 45% of professionals reported WPV. The most frequently assaulted were nurses (67%), followed by nursing assistants (18%) and physicians (12%). The first two categories were correlated, in a statistically significant way, with the risk of WPV (P=0.005, P=0.004, multiple logistic regression). The violent incidents more frequently occurred in psychiatry department (86%), emergency department (71%), and in geriatric wards (57%). The assailants more frequently were males whereas assaulted professionals more often were females. Men committed physical violence more frequently than women, in a statistically significant way (P=0.034, chi-squared test). Verbal violence (51%) was often committed by people in a lucid and normal state of consciousness; physical violence (49%) was most often perpetrated by assailants affected by dementia, mental retardation, drug and substance abuse, or other psychiatric disorders. The variables positively related to WPV were “calling for help during the attack” and “physical injuries suffered in violent attack” (P=0.02, P=0.03, multiple logistic regression). Conclusion This study suggests that violence is a significant phenomenon and that all health workers, especially nurses, are at risk of suffering aggressive assaults. WPV presented specific characteristics related to the health care settings, where

  12. Internal and External Validation of a Computer-Assisted Surveillance System for Hospital-Acquired Infections in a 754-Bed General Hospital in the Netherlands

    NARCIS (Netherlands)

    Streefkerk, H Roel A; Lede, Ivar O; Eriksson, John L V; Meijling, Marije G; van der Hoeven, Conrad P; Wille, Jan C; Hopmans, Titia E M; Friedrich, Alex W; Verbrugh, Henri A; Naiemi, Nashwan Al

    2016-01-01

    OBJECTIVE To evaluate a computer-assisted point-prevalence survey (CAPPS) for hospital-acquired infections (HAIs). DESIGN Validation cohort. SETTING A 754-bed teaching hospital in the Netherlands. METHODS For the internal validation of a CAPPS for HAIs, 2,526 patients were included. All patient reco

  13. Prevalencia del "síndrome de quemarse por el trabajo" (burnout en pediatras de hospitales generales Burnout prevalence in pediatricians of general hospitals

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    Pedro R Gil-Monte

    2008-06-01

    37,4% pelos critérios da Argentina e considerando os critérios clínicos estabelecidos na Holanda, a percentagem foi de 3,2%. CONCLUSÕES: Os níveis de prevalência variaram significativamente em função dos critérios aplicados devido às influências transculturais.OBJECTIVE: To assess the prevalence of burnout in pediatricians of general hospitals. METHODS: Non-randomized cross-sectional study carried out in the city of Buenos Aires, Argentina, in 2006. The study sample comprised 123 pediatricians working in pediatrics services of general hospitals, 89 women (72.4% and 34 men (27.6%. Data were gathered through an anonymous, self-administered questionnaire. Burnout was measured using the Maslach Burnout Inventory, and different approaches were employed to estimate burnout prevalence. RESULTS: The prevalence of burnout was different according to the approach used: the prevalence was 10.6% by the United States criteria; 24.4% by the Spanish criteria; 37.4% by the Argentinean criteria and 3.25% by the Dutch clinical criteria. CONCLUSIONS: Burnout prevalences varied significantly depending on the approach used due to cross-cultural influences.

  14. The Impact of the Hospital Volume on the Performance of Residents on the General Medicine In-Training Examination: A Multicenter Study in Japan.

    Science.gov (United States)

    Mizuno, Atsushi; Tsugawa, Yusuke; Shimizu, Taro; Nishizaki, Yuji; Okubo, Tomoya; Tanoue, Yusuke; Konishi, Ryota; Shiojiri, Toshiaki; Tokuda, Yasuharu

    2016-01-01

    Objective Although several studies have been conducted worldwide on factors that might improve residents' knowledge, the relationship between the hospital volume and the internal medicine residents' knowledge has not been fully understood. We conducted a cross-sectional study to compare the relationships of the hospital volume and hospital resources with the residents' knowledge assessed by the In-training Examination. Methods We conducted a retrospective survey and a clinical knowledge evaluation of postgraduate year 1 and 2 (PGY-1 and -2) resident physicians in Japan by using the General Medicine In-training Examination (GM-ITE) in 2014. We compared the ITE score and the hospital volume. Results A total of 2,015 participants (70.6% men; age, 27.3±2.9 years old) from 208 hospitals were retrospectively analyzed. Generalized estimating equations were used, and the results revealed that an increasing number of hospitalizations, decreasing staff number, decreasing age and PGY-2 were significantly associated with higher GM-ITE scores. Conclusion The hospital volume, such as the number of hospitalizations, is thus considered to have a positive impact on the GM-ITE scores.

  15. Economic Evaluation of a General Hospital Unit for Older People with Delirium and Dementia (TEAM Randomised Controlled Trial.

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    Lukasz Tanajewski

    Full Text Available One in three hospital acute medical admissions is of an older person with cognitive impairment. Their outcomes are poor and the quality of their care in hospital has been criticised. A specialist unit to care for older people with delirium and dementia (the Medical and Mental Health Unit, MMHU was developed and then tested in a randomised controlled trial where it delivered significantly higher quality of, and satisfaction with, care, but no significant benefits in terms of health status outcomes at three months.To examine the cost-effectiveness of the MMHU for older people with delirium and dementia in general hospitals, compared with standard care.Six hundred participants aged over 65 admitted for acute medical care, identified on admission as cognitively impaired, were randomised to the MMHU or to standard care on acute geriatric or general medical wards. Cost per quality adjusted life year (QALY gained, at 3-month follow-up, was assessed in trial-based economic evaluation (599/600 participants, intervention: 309. Multiple imputation and complete-case sample analyses were employed to deal with missing QALY data (55%.The total adjusted health and social care costs, including direct costs of the intervention, at 3 months was £7714 and £7862 for MMHU and standard care groups, respectively (difference -£149 (95% confidence interval [CI]: -298, 4. The difference in QALYs gained was 0.001 (95% CI: -0.006, 0.008. The probability that the intervention was dominant was 58%, and the probability that it was cost-saving with QALY loss was 39%. At £20,000/QALY threshold, the probability of cost-effectiveness was 94%, falling to 59% when cost-saving QALY loss cases were excluded.The MMHU was strongly cost-effective using usual criteria, although considerably less so when the less acceptable situation with QALY loss and cost savings were excluded. Nevertheless, this model of care is worthy of further evaluation.ClinicalTrials.gov NCT01136148.

  16. Fractura de cadera en adultos mayores: prevalencia y costos en dos hospitales. Tabasco, México, 2009 Hip fracture in older adults: prevalence and costs in two hospitals. Tabasco, Mexico, 2009

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    Elsy del Carmen Quevedo-Tejero

    2011-09-01

    Full Text Available Objetivos. Determinar la prevalencia y costos directos de atención de fractura de cadera en adultos mayores derechohabientes usuarios de los hospitales de referencia del Instituto Mexicano del Seguro Social (IMSS y de Petróleos Mexicanos (PEMEX en Villahermosa, Tabasco, México, en el año 2009. Materiales y métodos. Estudio transversal. La información se basó en los registros de intervenciones quirúrgicas e informes institucionales de adultos mayores hospitalizados con registro de su atención.Se realizó análisis estadístico descriptivo considerando las variables: edad, sexo,tipo de fractura de cadera, mes de ocurrencia y costo directo de atención. Resultados.De 10765 registros de adultos mayores hospitalizados se encontró 57 casos de fractura de cadera (33 en el IMSS y 24 en PEMEX. La prevalencia de fractura de cadera fue 0,5% (IMSS 1,1% y PEMEX 0,3%, siendo más frecuente en mujeres y en mayores de 69 años de edad. El tipo de fractura más frecuente fue en el cuello del fémur (78,9% del total. El costo estimado de atención médica hospitalaria por paciente fue de USD 5 803 en el IMSS y USD 11 800 en PEMEX. Conclusiones. La prevalencia de fractura de cadera fue mayor en los usuarios del IMSS. Los costos estimados de atención por paciente fueron mayores a los reportados en otras instituciones del sistema nacional de salud mexicano.Objectives. To determine hip fracture prevalence and direct healthcare costs in elderly users of the reference hospitals of the Mexican Institute of Social Insurance (IMSS by spanish initials and Mexican Oils (PEMEX by spanish initials, from Villahermosa, Tabasco, Mexico, during 2009. Materials and methods. This is a cross-sectional study. The information was based on the registers of surgical interventions and institutional reports of the elderly inpatients who had a registered attention in their institution. Descriptive statistical analysis was performed considering the following variables: age

  17. Neutropenia relacionada con la quimioterapia en tumores sólidos. Hospital General Universitario Camilo Cienfuegos Enero 2009- 2013

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    Yania Luisa Jiménez Madrigal

    2015-09-01

    Full Text Available Se realizó un estudio descriptivo de corte transversal y retrospectivo referente al comportamiento de la neutropenia relacionada con la quimioterapia en tumores sólidos en el período comprendido Enero 2009- 2013 atendido en el servicio de oncología del Hospital General Universitario Camilo Cienfuegos de la provincia Sancti-Spíritus. La población la conformaron 230 enfermos neutropénicos relacionados con la quimioterapia. La investigación describe de forma general la relación existente entre la neutropenia con la quimioterapia, localización tumoral, entidades nosológicas asociadas, edad, sexo, tratamientos quimioterapéuticos y antibióticos más utilizados. Pudo observarse que existe alta incidencia de neutropenia relacionada con la quimioterapia en pacientes con cáncer de pulmón, el grupo más afectado fue el de 50-59 años predominando el sexo femenino con un alto índice de hipertensos asociados. Los tratamientos más utilizados fueron Etopóxido-Platino y Ceftrixone-Amikacina.

  18. Hip resurfacing in a district general hospital: 6-year clinical results using the ReCap hip resurfacing system

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    van der Weegen Walter

    2012-12-01

    Full Text Available Abstract Background The purpose of our study was to prospectively report the clinical results of 280 consecutive hips (240 patients who received a ReCap Hip Resurfacing System implant (Biomet Inc., Warsaw, USA in a single district general hospital. Literature reports a large variation in clinical results between different resurfacing designs and published results using this particular design are scarce. Methods Mean follow up was 3.3 years (1.0 to 6.3 and four patients were lost to follow-up. All patients were diagnosed with end-stage hip osteoarthritis, their mean age was 54 years and 76.4% of all patients were male. Results There were 16 revisions and four patients reported a Harris Hip Score Conclusions This independent series confirms that hip resurfacing is a demanding procedure, and that implant survival of the ReCap hip resurfacing system is on a critical level in our series. In non-revised patients, reported outcomes are generally excellent. Trial registration ClinicalTrials.gov Identifier: NCT00603395

  19. Relationship between nurse's general health and their personal occupational traits in Al-Zahra Hospital of Isfahan, 2015

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    Mahnaz Adibi

    2016-11-01

    Full Text Available Health state is one of the most important factors in their life. Individuals may be subject to threatening factors in different ways. Nurses are one main group of community whose health may be threatened due to their occupational environment. Therefore, this study aimed at investigating general health of nurses and their personal occupational traits. Method: This study is correlation-descriptive research. Statistical population consists of 220 nurses working in Al-Zahra hospital selected by random sampling. Instrument of this study includes a demographic questionnaire and a standard Goldberg 28-question questionnaire. The data were analyzed by SPSS software. Findings: in this study, nurses are subject to occupational events, physical and chemical harmful materials, biologic harmful materials, mental/ ergonomic harmful occupational factors. And there exists relation between their general health and their age, number of children and marital status. But no relation has been seen with their surgery records, rate of sport they do, vaccination, the unit in which they work, their occupational environment, their occupational record and posts.

  20. 精神科及综合医院护理人员心理健康状况及人格特征调查%A Study on Mental Health Status and Personality Characteristics of Nurses in Mental and General Hospitals

    Institute of Scientific and Technical Information of China (English)

    李沛亨; 王耀华; 程庭静; 童芳

    2001-01-01

    Objective:To examine mental health status and personality characteristics in hospital nurses. Methods:166 nurses in mental hospital and 344 nurses in general hospital were assessed by SCL-90 and MMPI. Results: Scaled scores on SCL-90 and MMPI of the two groups were found to be higher than the Chinese norms. Conclusion:The study revealed poorer mental health among nurses in mental and general hospitals when compared to the general population.

  1. 试论2011年全国综合医院效益分析%On the Benefit Analysis of the National General Hospital in 2011

    Institute of Scientific and Technical Information of China (English)

    李敏

    2012-01-01

    2011年全国综合性医院运营良好,资产规模扩张快,流动资金利用力强.加强资产管理、加强成本核算,控制成本支出,提高医院管理水平,公立医院要注意医院资产借债筹资比重,私立医院应加强运用外部资金能力.%In 2011, general hospital operated well and their expansion of the assets scale was fast, and the utilization of liquidity was strong. In order to strengthen asset management, and cost accounting, control costs, and improve the level of hospital management, the public hospitals should pay attention to the proportion of debt financing for hospital assets, and the private hospitals should strengthen the use of external funds.

  2. Characteristics of patients who are admitted with or acquire Pressure Ulcers in a District General Hospital; a 3 year retrospective analysis

    OpenAIRE

    Worsley, Peter R.; Smith, Glenn; Schoonhoven, Lisette; Bader, Dan L.

    2016-01-01

    Abstract Aim The study aimed to characterize demographic and clinical practice factors associated with community (CAPU) and hospital acquired pressure ulcers (HAPU). Design A comparative retrospective evaluation of pressure ulcer data, collected from a district general hospital. Methods Demographic and pressure ulcer related data were collected from patients at risk of developing a pressure ulcer, collated by a single observer using a standardized tool. Comparisons were made within and betwee...

  3. Study of the treatment of oil-based muds from PEMEX's storage centres using thermal plasma in a deoxygenated atmosphere; Estudio del tratamiento de lodos aceitosos provenientes de los centros de acopio de PEMEX mediante plasma termico en ausencia de oxigeno

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-07-01

    In this project, evaluation of plasma thermal process applied for degradation of hazardous waste was performed when the process was operated without oxigen, for degradation of oily sludge. Such wastes are produced from petroleum refineries and represent a problem due to the fact that they hazardous and great amount of them are generated in Mexico and the world; moreover there are not current with high efficiency to treat them. In this study the degradation experiments were made using two different sludge samples, one them was free of sediments, the bigger portion was water and hydrocarbons and the other sample was characterized by to had a high amount of sediments. These samples were obtained from a storing center of PEMEX. Process was operated utilizing different characteristics of the by-product. The biggest decrease in volume obtained with the sample of high amount of sediments was 85%, and such by-product resulted inert. For the sludge free of sediment the highest decrease of volume obtained was 95.5% and this by-product contained high amount of carbon in the form of dust, almost 50% of carbon mixes with clay material. The degradation efficiency of organic material was higher than to 99.99%. The residual gases formed during the degradation had low molecular weight.

  4. Antimicrobial susceptibility of bacteria, isolated from patients treated at Jesenice General hospital in the period between 2004 and 2006

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    Helena Ribič

    2007-11-01

    Full Text Available Background: Antimicrobial resistance of bacteria is still one of the mayor problems in medicine. In the year 2006, microbiologists of the Institute of Public Health Kranj together with clinicians and pharmacist of Jesenice General Hospital prepared the programm of antimicrobial resistance surveillance of patients treated in the hospital. Some of the results are presented in this article.Methods: In the retrospective study, bacterial strains, isolated from different samples were analysed. The strains were isolated and studied during the routine work of microbiology laboratory of IPH Kranj in the period between 2004 and 2006.Results: The most frequently isolated bacteria from haemocultures was Escherichia coli (35.4 %. In the years 2004 and 2006, susceptibility of strains for ciprofloxacin was 95.7 % and 97.2 %, for parenteral cefuroxime (95.7 % and 94.4 %, for cefotaxime and gentamicin in both years 100 %. Susceptibility of E. coli strains from urine samples in patients from the department for internal medicine was in 2004 and 2006 for co-amoxiclav 88.5 % and 70.1 %, for co-trimoxazole 60.3 % and 81.3 %, for cefaclor 94.9 % and 89.7 %, for ciprofloxacin 83.3 % and 82.2 %. Among strains of Staphylococcus aureus, 100 % were sensitive to vancomycin and 99.3 % to linezolid in 2006. Among methicillin susceptible strains, sensitivity to erythromycin, clindamycin and ciprofloxacin lowered slightely in the three years period; in 2006 it was 87.6 %, 90.6 % and 89.1 %. Susceptibility of strains Pseudomonas aeruginosa was in 2006 similar comparing to 2004; it was 92 % for ceftazidime, 75 % for gentamicin, 64.6 % for ciprofloxacin and 96 % for imipenem. Among strains of Acinetobacter spp., sensitivity rate to ciprofloxacin, ceftazidime, piperacillin with tazobactam and gentamicin significantly fell in the year 2005 and stayed low in 2006.Conclusions: The results of antimicrobial susceptibility surveillance and trends of susceptibility are intended to guide

  5. Prevalence of Hepatitis B surface antigen (HBsAg among visitors of Shashemene General Hospital voluntary counseling and testing center

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    Medhin Girmay

    2011-02-01

    Full Text Available Abstract Background Hepatitis B virus (HBV infection is significant health problem, as it can lead to chronic hepatitis, liver cirrhosis, and hepatic carcinoma. Due to shared routes of transmission, HBV and human immunodeficiency virus (HIV co-infection is common and is an emerging concern in the clinical management of patients because of increased mortality, accelerated hepatic disease progression, and the frequent hepatotoxicity caused by anti-retroviral therapy. The aim of this study was to determine the prevalence of Hepatitis B surface antigen (HBsAg and its risk factors, among individuals visiting Shashemene General Hospital VCT center. Findings Institution based cross-sectional study was performed from November 3, 2008 to December 29, 2008 and 384 voluntary counseling and testing (VCT clients were investigated. Data on socio demographic and HBV risk factors was collected using structured questionnaires. Blood samples were collected and screened for hepatitis B surface antigen (HBsAg and HIV by commercially available rapid test kits. The prevalence of HBsAg in this study group was 5.7%. Fourteen percent of HIV positive subjects (8/57 and 4.3% (14/327 of HIV negative subjects were positive for HBsAg. Significantly high prevalence of HBsAg was observed among individuals who had history of invasive procedures, like tooth extraction, abortion and ear piercing; history of hospital admission, history of unsafe inject and HIV positives. Conclusions Although HBsAg prevalence is much higher among subjects who are HIV positive (14.0% versus 4.3%, the prevalence of HBsAg in HIV negative subjects is high enough to warrant a recommendation to screen all clients at VCT centers irrespective of HIV status.

  6. Evolution of nutritional status of pediatric in patients of a tertiary care general hospital in Brazil Evolución del estado nutritivo de pacientes pediátricos ingresados en hospital general terciario de Brasil

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    C. R. De Moraes Silveira

    2008-12-01

    Full Text Available Justification and objective: Identify changes in the nutritional status of hospitalized children is fundamental for the early establishment of interventions. This study aims at describing the prevalence of undernutrition at admission and over the weeks of in-hospital stay in pediatric patients and evaluate the association between nutritional status and length of in-hospital stay. Materials and methods: A cohort study was carried out. It followed all the in-patients admitted to the general pediatric unit, composed of 72 beds, in the Hospital de Clínicas de Porto Alegre (HCPA, in the south of Brazil, from 20 march to 20 october in 2004. Patients who were between 1 month and 12 years of age and who had been admitted for clinical or/and surgical reasons were included. Those with Down Syndrome or without clinical condition and/or stature for weight measurement were excluded. Anthropometric data were collected up to 48 hours after admission and, weekly, up to hospital discharge (at admission, on 7th, 14th, and 21st day after admission. In children below 5 years of age, the standard defined by the World Heath Organization (WHO/2006 for the classification of the z-score for the stature/age (S/A, weight/age (W/A and weight/stature (W/S scores was used. In children from 5 to 10 years of age, the standards of the National Center for Health Statistics (NCHS, 1977 were used to classify the same rates as reference values. In children above 10 years of age, the classification of the Body Mass Index (BMI was used (OMS/1995. In order to compare the z-scores over the four evaluation moments, analysis of variance (ANOVA was used for repeated measurements, with Bonferroni's Post-Hoc test, and, for the evaluation of the in-hospital stay length, according to the nutritional status, Kaplan-Meier's survival curve, in the SPSS program, version 12.0, was used. Results: 426 patients were included in the study. 57% of them were male and 50.7% were below one year of age

  7. 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.

  8. Job Stress of Medical Staffs in General Hospital%综合医院一线医务人员工作应激调查

    Institute of Scientific and Technical Information of China (English)

    王玉林; 刘碧英; 王锐

    2003-01-01

    Objective: To explore the job stress status of medical staffs in general hospital. Methods: A total of 201 medical staffs were sampled from a general hospital in Changsha City, Hunan Province, and their job stress levels were evaluated by the Medical Job Stress Invemory. Results:The subjects from internal medicine department showed silgnificantIy higher job stress level than those from surgical departmem;and the doctors group showed higher stress level in the interpersonal subscale than the nurses group. Condusion:It is important to pay attention to medical staff''s job stress and job burnout in order to improve their mental health levels.

  9. Practice of the Construction of Hospital Management Ethics in a General Hospital%某综合医院在医院管理伦理的做法

    Institute of Scientific and Technical Information of China (English)

    唐月红; 陈瑛瑛; 石慧; 姚华

    2016-01-01

    Hospital management ethics is a management model that has been developed in recent years . This paper reviews domestic and overseas researches on hospital management ethics , introduces the current situation of ethics establishment in hospital management , and analyzes problems and challenges in hospital management eth-ics.The key finding of this paper is that many scholars have proposed an expanding ethics management model , which covers research ethics , clinic ethics and management ethics .This paper also introduces some practices of the First Affiliated Hospital of Xinjiang Medical University .Finally, the paper puts forward some strategies and meas-ures to improve the establishment and improvement of hospital management ethics .%医院管理伦理是近年来发展起来的管理方式,从国内外学者关于医院管理伦理的研究情况、医院管理在伦理建设方面的基本现状、存在的问题进行分析,并发现有学者提出医院管理“大伦理”的管理模式:即涵盖研究伦理、临床伦理、管理伦理三方面;同时,介绍作者所在医院的几点做法。在文章的最后,作者提出关于提升医院管理伦理建设水平的对策。

  10. The hospital educational environment and performance of residents in the General Medicine In-Training Examination: a multicenter study in Japan

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    Shimizu T

    2013-07-01

    Full Text Available Taro Shimizu,1 Yusuke Tsugawa,2,3 Yusuke Tanoue,4 Ryota Konishi,5 Yuji Nishizaki,6 Mitsumasa Kishimoto,7 Toshiaki Shiojiri,8 Yasuharu Tokuda9 1Hospitalist Division, Department of Medicine, Nerima Hikarigaoka Hospital, Tokyo, Japan; 2Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; 3Center for Clinical Epidemiology, St Luke's Life Science Institute, 4Department of Vascular and Oncological Surgery, Hospital of Tokyo University, 5Department of General Internal Medicine, Kanto Rousai Hospital, 6Department of Cardiology, Juntendo University School of Medicine, 7Division of Rheumatology, St Luke's International Hospital, Tokyo, Japan; 8Asahi Chuo Hospital, Chiba, Japan; 9Department of Medicine, Tsukuba University Mito Kyodo General Hospital, Mito City, Ibaraki, Japan Background: It is believed that the type of educational environment in teaching hospitals may affect the performance of medical knowledge base among residents, but this has not yet been proven. Objective: We aimed to investigate the association between the hospital educational environment and the performance of the medical knowledge base among resident physicians in Japanese teaching hospitals. Methods: To assess the knowledge base of medicine, we conducted the General Medicine In-Training Examination (GM-ITE for second-year residents in the last month of their residency. The items of the exam were developed based on the outcomes designated by the Japanese Ministry of Health, Labor, and Welfare. The educational environment was evaluated using the Postgraduate Hospital Educational Environment Measure (PHEEM score, which was assessed by a mailed survey 2 years prior to the exam. A mixed-effects linear regression model was employed for the analysis of variables associated with a higher score. Results: Twenty-one teaching hospitals participated in the study and a total of 206 residents (67 women participated and

  11. Effects of a humor-centered activity on disruptive behavior in patients in a general hospital psychiatric ward

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    Antonio Higueras

    2006-01-01

    Full Text Available El objetivo de este estudio cuasi-experimental es analizar lo efectos de una actividad centrada en el humor sobre las conductas disruptivas de pacientes hospitalizados en un servicio de Psiquiatría. Se han comparado, teniendo en cuenta dos grupos homogéneos de pacientes hospitalizados en un servicio de Psiquiatría de hospital general (unidad de agudos, dos periodos temporales de 83 días cada uno, siendo el período 1 el de línea base, y el período 2, el de intervención. Para ambos periodos, se codificaron y registraron un total de diez conductas disruptivas. En los 83 días del periodo de intervención, y con una frecuencia de dos días semanales, dos actores profesionales llevaban a cabo las actividades centradas en el humor. Se calculó un Indice de Disrupción Global (IGD, teniendo en cuenta conjuntamente todas las conductas disruptivas, al igual que un Indice de Disrupción Específico (IDE para cada una de las conductas disruptivas. Usando para las comparaciones la corrección de Bonferroni, los resultados indican que el IGD descendió significativamente durante el periodo de intervención, siendo tres las conductas disruptivas que mostraron un descenso significativo (intentos de fuga, autolesiones y peleas.

  12. [Validation of the Rockall score in elderly patients with non variceal upper gastrointestinal bleeding in a third level general hospital].

    Science.gov (United States)

    García Encinas, Carlos; Bravo Paredes, Eduar; Guzmán Rojas, Patricia; Gallegos López, Roxana; Corzo Maldonado, Manuel; Aguilar Sánchez, Víctor

    2015-01-01

    To validate the Rockall score in elderly patients with non variceal upper gastrointestinal bleeding, in terms of mortality and recurrent bleeding at 30 days follow-up. Patients older than 60 year-old, with non variceal upper gastrointestinal bleeding demonstrated by endoscopy, who were attended in a third level general hospital from June 2009 to June 2013, were included. Data was analyzed with the ROC (Receiver Operating Characteristic) curve. The area under curve was obtained to assess the Rockall score. One hundred ninety patients were included, 64.2% were males, with an average age of 74 years old. Overall mortality was 16.8% and respiratory failure with second bleeding episode was the most common cause of death (34.3% and 31.3% respectively). 5.52% of patients presented a second bleeding episode. A transfusion of more than 2 blood-packs was needed in the 24.7% of the patients. The area under ROC curve using the Rockall score was 0,76 (IC: 0.68-0.84) for mortality risk, 0.71 (IC: 0.55-0.88) for the risk of rebleeding and 0.66 (IC: 0.58-0.74) for needing a more than 2 blood-packs transfusion. Rockall score is a good predictor for mortality and rebleeding during the 30 day-period after a non-variceal bleeding episode in elderly patients. The best sensibility and specificity was obtained with the scores of 5 and 6, respectively.

  13. Generation of Leukemia Inhibitory Factor-Dependent Induced Pluripotent Stem Cells from the Massachusetts General Hospital Miniature Pig

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    Dae-Jin Kwon

    2013-01-01

    Full Text Available The generation and application of porcine induced pluripotent stem cells (iPSCs may enable the testing for safety and efficacy of therapy in the field of human regenerative medicine. Here, the generation of iPSCs from the Massachusetts General Hospital miniature pig (MGH minipig established for organ transplantation studies is reported. Fibroblasts were isolated from the skin of the ear of a 10-day-old MGH minipig and transduced with a cocktail of six human factors: POU5F1, NANOG, SOX2, C-MYC, KLF4, and LIN28. Two distinct types of iPSCs were generated that were positive for alkaline phosphatase activity, as well as the classical pluripotency markers: Oct4, Nanog, Sox2, and the surface marker Ssea-1. Only one of two porcine iPSC lines differentiated into three germ layers both in vitro and in vivo. Western blot analysis showed that the porcine iPSCs were dependent on LIF or BMP-4 to sustain self-renewal and pluripotency. In conclusion, the results showed that human pluripotent factors could reprogram porcine ear fibroblasts into the pluripotent state. These cells may provide a useful source of cells that could be used for the treatment of degenerative and genetic diseases and agricultural research and application.

  14. Mycobacterial species diversity at a general hospital on the island of Crete: first detection of Mycobacterium lentiflavum in Greece.

    Science.gov (United States)

    Neonakis, Ioannis K; Gitti, Zoe; Kourbeti, Irene S; Michelaki, Helen; Baritaki, Maria; Alevraki, Georgia; Papadomanolaki, Evangelia; Tsafaraki, Ekaterini; Tsouri, Anna; Baritaki, Stavroula; Krambovitis, Elias; Spandidos, Demetrios A

    2007-01-01

    The objective of the present study was to investigate the diversity of mycobacterial isolates in a general hospital in Crete, Greece. 48 positive Lowenstein-Jensen cultures over a 3-y period were analysed by means of AccuProbe and GenoType assays. Non-tuberculous mycobacteria (NTM) comprised the majority of the isolates (56.3%, 27/48) vs 33.3% (16/48) of M. tuberculosis; 10.4% of the isolates could not be classified. Among NTM, M. lentiflavum was the predominant species isolated (9/27) followed by M. kansasii, M. gordonae and M. peregrinum, whereas no M. avium complex isolates were detected. This is the first detection of M. lentiflavum in Greece. The susceptibilities of the M. lentiflavum isolates to an extended panel of antibiotics were determined by the proportions method and the medical files of the 9 patients were reviewed. Three isolates were from urine, which is an unusual site. All strains exhibited multidrug resistance. The patients were adults with immunosuppression or predisposing conditions for NTM infection. Diagnosis of true infection was either not pursued or the patients died shortly after isolation.

  15. Factors affecting poor attendance for outpatient physiotherapy by patients discharged from Mthatha General Hospital with a stroke

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    N.P. Ntamo

    2013-12-01

    Full Text Available Background: Stroke is a major cause of disability inthe world and its long term effects require adherence to physiotherapyprotocols for optimal rehabilitation. Clinical impression of data fromMthatha General Hospital (MGH Physiotherapy Department revealedthat there was poor attendance of outpatient physiotherapy by strokepatients discharged from MGH and this had negative effects on outcomesand health care costs.Objective: To determine the extent and the socio-demographic reasonsfor poor attendance for outpatient physiotherapy by stroke patients.Methods: An observational descriptive study was conducted using arandomly selected sample of 103 stroke patients from a population of 139who attended physiotherapy in MGH in 2007. Structured interviews wereconducted and SPSS was used for data analysis.Results: The majority (86% of patients did not attend physiotherapy until discharge from the Physiotherapy Department. Themajor reasons for poor attendance were lack of finances (95%, migration to other areas (36%, and living a long distance fromMGH (38%.Conclusion: Almost 9 out of 10 stroke patients fail to attend for outpatient physiotherapy because of lack of finances.Recommendation: Development of a Provincial Rehabilitation Policy with specific reference to decentralization of rehabilitationservices to address unavailability of physiotherapy services at clinics and health care centers which are proximal to the patients’residential areas is recommended.

  16. Specificity and sensitivity of SPECT myocardial perfusion studies at the Nuclear Medicine Department of the Limassol General Hospital in Cyprus

    Science.gov (United States)

    Koumna, S.; Yiannakkaras, Ch; Avraamides, P.; Demetriadou, O.

    2011-09-01

    The aim is to determine the sensitivity and specificity of Myocardial Perfusion Imaging (MPI) performed at the Nuclear Medicine Department of the Limassol General Hospital in Cyprus. Through a retrospective analysis, patient results obtained by MPI were compared to results obtained by Invasive Angiography. We analyzed data from 96 patients that underwent both MPI and Angiography during the years 2009-2010, with a maximum time interval of ± 9 months between the two types of medical exams. For 51 patients, the indication was the detection of CAD. For 45 patients, the indication was to assess viability and/or ischemia after MI, PCI or CABG. Out of 84 patients with CAD confirmed by angiography, 80 patients resulted in abnormal MPI (sensitivity of 95% and positive predictive value of 98%). Out of 12 patients with normal coronaries, 10 patients resulted in normal MPI (specificity of 83% and negative predictive value of 71%).In conclusion, for the patients with abnormal MPI and confirmed CAD, MPI was a useful aid for further therapy management.

  17. Adaptação transcultural da Massachusetts General Hospital (MGH Hairpulling Scale para o idioma português (Brasil

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    Edson Luiz Toledo

    2011-01-01

    Full Text Available CONTEXTO: A tricotilomania (TTM caracteriza-se pelo ato de arrancar, de forma recorrente, os próprios cabelos por prazer, gratificação ou alívio de tensão, acarretando perda capilar perceptível. A Massachusetts General Hospital (MGH Hairpulling Scale é um instrumento utilizado recentemente em muitos estudos para avaliar sintomas de TTM. OBJETIVO: O presente trabalho teve como objetivo adaptar essa escala para o idioma português. MÉTODOS: Envolveu cinco etapas: (1 tradução; (2 retradução; (3 revisão técnica e avaliação das equivalências semântica e conceitual por especialistas em saúde mental; (4 avaliação do instrumento por estudantes, por meio da avaliação do grau de compreensão e (5 análise da consistência interna do instrumento pelo coeficiente alfa de Cronbach. RESULTADOS: O instrumento foi traduzido e adaptado para o idioma português. Demonstrou ser de fácil compreensão e o valor da consistência interna correspondeu a 0,96. CONCLUSÃO: O instrumento encontra-se traduzido e adaptado para o idioma português. São necessárias análises de equivalência de mensuração e reprodutibilidade.

  18. Development and validation of the Chinese version of the Massachusetts General Hospital Acupuncture Sensation Scale: an exploratory and methodological study.

    Science.gov (United States)

    Yu, David Tai Wai; Jones, Alice Yee Man; Pang, Marco Yiu Chung

    2012-09-01

    The Massachusetts General Hospital Acupuncture Sensation Scale (MASS) is a tool to measure needle sensations. The aims of the present study were to develop a Chinese version and to assess its psychometric properties. This study was a methodological and exploratory study. The English version of the MASS was translated into Chinese using standardised translation procedures. Content validity was conducted by nine acupuncture experts. The prefinal Chinese version (C-MASS) was then administered to 30 acupuncture-naïve, healthy subjects. Electroacupuncture was performed on the right LI4 and LI11 acupoints for 30 min. A test-retest reliability measurement was administered 1-2 weeks later. Construct validity was examined by comparing results from C-MASS and the Short-Form McGill Pain Questionnaire (SF-MPQ). The construct validity was further assessed by the principle component analysis. C-MASS demonstrated a content validity ratio on relevance and importance from -0.04 to 1.00. Convergent validity was demonstrated by its significant association with the sensory dimension of SF-MPQ (γ=0.63, pdeqi, this was removed from C-MASS. We renamed the scale as the Modified MASS-Chinese version (C-MMASS). A 12-descriptor C-MMASS was established and shown to be a reliable and valid tool in reporting needle sensations associated with deqi among healthy young Chinese people.

  19. STUDY OF PREMATURE BABIES IN RELATION TO ITS OUTCOME AND ANTENATAL RISK FACTORS AT GENERAL HOSPITAL SANGLI

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    Satish D

    2014-07-01

    Full Text Available : OBJECTIVE: To know the neonatal outcome and antenatal risk factors among premature babies. MATERIAL & METHODS: STUDY DESIGN: A retrospective study. SETTING: Neonatal Intensive Care Unit (NICU of General Hospital Sangli under Government Medical College, Miraj. SAMPLE SIZE: 134 Premature babies admitted during the year 2013 in NICU. DATA COLLECTION: From the case sheet of the study subjects, with the help of pre structured proforma. STUDY PERIOD: January 2013 to December 2013. STATISTICAL ANALYSIS: Data analyzed with percentages. RESULTS: Out of 134 premature babies 34 (25.3% were SGA, 24 (17.9% LGA and 78 (58.2% were AGA. Jaundice (44.7 %, RDS (37.3 % and Sepsis (14.9 % were the commonest morbidities among the premature babies. RDS (85.4%, Sepsis (10.4 % and Aspiration Pneumonia (4.1 % were the causes of mortality. Mortality was higher among premature babies with birth weight < 1400grams. PROM (50.7 %, Anemia (35.8 % and Twin (17.9 % were the maternal risk factors. CONCLUSION: Jaundice, RDS and Sepsis were the common morbidities among the premature babies. Overall mortality among premature babies was 35.8 %. PROM and Anemia are the commonest maternal risk factors for the premature births.

  20. Prevalence of Depression among Type 2 Diabetic Outpatients in Black Lion General Specialized Hospital, Addis Ababa, Ethiopia

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    Tesfa Dejenie Habtewold

    2015-01-01

    Full Text Available Background. The emotional consequences of diabetes have been scrutinized by a number of investigative teams and there are varying reports about the association of depression with type 2 diabetes mellitus. However, there is limited data about this in Ethiopia. Therefore, the purpose of this study was to assess the prevalence of comorbid depression among type 2 diabetic outpatients. Methods and Materials. Institution based cross-sectional study design was conducted on a random sample of 276 type 2 diabetic outpatients from Black Lion General Specialized Hospital. Systematic random sampling technique was used to get these individual patients from 920 type 2 diabetic outpatients who have an appointment during the data collection period. Patients’ depression status was measured using Patient Health Questionnaire 9 (PHQ 9. Result. Totally 264 type 2 diabetic outpatients were interviewed with a response rate of 95.6%. The prevalence of depression among type 2 diabetic outpatients was 13%. Based on PHQ 9 score, 28.4% (75 fulfilled the criteria for mild depression, 12.1% (32 for moderate depression, 2.7% (7 for moderately severe depression, and 1.5% (4 for severe depression. But 45.8% (121 of patients had no clinically significant depression. Conclusion. This study demonstrated that depression is a common comorbid health problem in type 2 diabetic outpatients with a prevalence rate of 13%.

  1. The impact of audit in a district general hospital on post-operative nausea and vomiting after major gynaecological surgery.

    Science.gov (United States)

    Hadji, F; Eastwood, D; Fear, S; Corfield, H J

    1998-09-01

    An audit of post-operative nausea and vomiting (PONV) was undertaken in 935 female patients who used morphine patient-controlled analgesia (PCA) for pain relief after major gynaecological operations in a district general hospital. We investigated retrospectively five different antiemetic policies and a reference group without policy from January 1993 to July 1995. The department's computerized audit system was used to analyse the observations. At the beginning of the audit, the incidence of nausea and vomiting was as high as 71.5%. But as a consequence of this audit, a departmental policy was adopted 3 years later, which had an incidence of PONV of only 51.7%. During this time the compliance with antiemetic protocols increased from 41% to 76%. There was significantly less PONV if an antiemetic protocol was followed (P = 0.002). This emphasizes the importance of corporate involvement in the development, formulation and evaluation of departmental protocols if compliance is to be high. We conclude that audit as a corporate effort improves the acceptance of departmental protocols. This reduces PONV significantly irrespective of the type of antiemetic drug used.

  2. Stigma, medication adherence and coping mechanism among people living with HIV attending General Hospital, Lagos Island, Nigeria

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    Adekemi O. Sekoni

    2012-02-01

    Full Text Available Background: People living with HIV and AIDS (PLWHA experience some form of stigma which could lead to poor medication adherence.Objectives: This study assessed the various domains of stigma experienced by PLWHAs attending an HIV clinic at General Hospital, Lagos Island, their medication adherence patterns and their coping mechanisms for ensuring adherence to antiretroviral therapy.Method: A cross-sectional study design with a sample size of 200 was used. Respondents were selected using systematic random sampling. Interviewers administered structured questionnaires were used to collect information on the domains of stigma. Data was analysed using EPI info©. This was followed by a focus group discussion (FGD with seven participants at the clinic using an interview guide with open-ended questions.Results: Overall, stigma was experienced by 35% of the respondents. Within this group, 6.6%, 37.1%, 43.1% and 98.0% of the respondents reported experiencing negative self image stigma, personalised stigma, disclosure stigma and public attitude stigma respectively. Almost 90% of the respondents were adherent. The FGD revealed that disclosure was usually confined to family members and the coping mechanism for achieving adherence was to put antiretroviral (ARVs in unlabelled pill boxes.Conclusion: This study found that stigma was low and that the most common domain of stigma experienced was public attitude stigma. Medication adherence of respondents was good as a result of the coping mechanism, which involves putting ARVs in unlabelled pill boxes.

  3. Specificity and sensitivity of SPECT myocardial perfusion studies at the Nuclear Medicine Department of the Limassol General Hospital in Cyprus

    Energy Technology Data Exchange (ETDEWEB)

    Koumna, S [Athens Anticancer - Oncology Hospital ' AgiosSavvas' , Athens (Greece); Yiannakkaras, Ch [Medical Physics Department, Nicosia General Hospital, Nicosia (Cyprus); Avraamides, P [Cardiology Clinic, Limassol General Hospital, Limassol (Cyprus); Demetriadou, O, E-mail: stelkoum@gmail.com [Nuclear Medicine Department, Limassol General Hospital, Limassol (Cyprus)

    2011-09-23

    The aim is to determine the sensitivity and specificity of Myocardial Perfusion Imaging (MPI) performed at the Nuclear Medicine Department of the Limassol General Hospital in Cyprus. Through a retrospective analysis, patient results obtained by MPI were compared to results obtained by Invasive Angiography. We analyzed data from 96 patients that underwent both MPI and Angiography during the years 2009-2010, with a maximum time interval of {+-} 9 months between the two types of medical exams. For 51 patients, the indication was the detection of CAD. For 45 patients, the indication was to assess viability and/or ischemia after MI, PCI or CABG. Out of 84 patients with CAD confirmed by angiography, 80 patients resulted in abnormal MPI (sensitivity of 95% and positive predictive value of 98%). Out of 12 patients with normal coronaries, 10 patients resulted in normal MPI (specificity of 83% and negative predictive value of 71%).In conclusion, for the patients with abnormal MPI and confirmed CAD, MPI was a useful aid for further therapy management.

  4. Use of a Hospital-Wide Screening Program for Early Detection of Sepsis in General Surgery Patients.

    Science.gov (United States)

    MacQueen, Ian T; Dawes, Aaron J; Hadnott, Tracy; Strength, Kristen; Moran, Gregory J; Holschneider, Christine; Russell, Marcia M; Maggard-Gibbons, Melinda

    2015-10-01

    Sepsis remains a significant source of mortality among hospitalized patients. This study examines the usage of a vital sign-based screening protocol in identifying postoperative patients at risk for sepsis at an academic-affiliated medical center. We identified all general surgery inpatients undergoing abdominopelvic surgery from January to June 2014, and compared those with positive screening tests to a sample of screen-negative controls. Multivariate logistic regression was used to identify predictors of positive screening tests and progression to severe sepsis. In total, 478 patients underwent abdominopelvic operations, 59 had positive screening tests, 33 qualified for sepsis, and six progressed to severe sepsis. Predictors of a positive screening test were presence of cancer [odds ratio (OR) 30.7, 95% confidence interval (CI) 2.2-420], emergency operation (OR 6.5, 95% CI 1.7-24), longer operative time (OR 2.2/h, 95% CI 1.2-4.1), and presence of postoperative infection (OR 6.4, 95% CI 1.5-27). The screening protocol had sensitivity 100 per cent and specificity 88 per cent for severe sepsis. We identified no predictors of severe sepsis. In conclusion, vital sign-based screening provides value by drawing early attention to patients with potential to develop sepsis, but escalation of care for these patients should be based on clinical judgment.

  5. General Hospital and Personal Use Devices: Renaming of Pediatric Hospital Bed Classification and Designation of Special Controls for Pediatric Medical Crib; Classification of Medical Bassinet. Final rule.

    Science.gov (United States)

    2016-12-19

    The Food and Drug Administration (FDA) is issuing a final rule to rename pediatric hospital beds as pediatric medical cribs and establish special controls for these devices. FDA is also establishing a separate classification regulation for medical bassinets, previously under the pediatric hospital bed classification regulation, as a class II (special controls) device. In addition, this rule continues to allow both devices to be exempt from premarket notification and use of the device in traditional health care settings and permits prescription use of pediatric medical cribs and bassinets outside of traditional health care settings.

  6. Entrance surface dose and image quality: comparison of adult chest and abdominal X-ray examinations in general practitioner clinics, public and private hospitals in Malaysia.

    Science.gov (United States)

    Hambali, Ahmad Shariff; Ng, Kwan-Hoong; Abdullah, Basri Johan Jeet; Wang, Hwee-Beng; Jamal, Noriah; Spelic, David C; Suleiman, Orhan H

    2009-01-01

    This study was undertaken to compare the entrance surface dose (ESD) and image quality of adult chest and abdominal X-ray examinations conducted at general practitioner (GP) clinics, and public and private hospitals in Malaysia. The surveyed facilities were randomly selected within a given category (28 GP clinics, 20 public hospitals and 15 private hospitals). Only departmental X-ray units were involved in the survey. Chest examinations were done at all facilities, while only hospitals performed abdominal examinations. This study used the x-ray attenuation phantoms and protocols developed for the Nationwide Evaluation of X-ray Trends (NEXT) survey program in the United States. The ESD was calculated from measurements of exposure and clinical geometry. An image quality test tool was used to evaluate the low-contrast detectability and high-contrast detail performance under typical clinical conditions. The median ESD value for the adult chest X-ray examination was the highest (0.25 mGy) at GP clinics, followed by private hospitals (0.22 mGy) and public hospitals (0.17 mGy). The median ESD for the adult abdominal X-ray examination at public hospitals (3.35 mGy) was higher than that for private hospitals (2.81 mGy). Results of image quality assessment for the chest X-ray examination show that all facility types have a similar median spatial resolution and low-contrast detectability. For the abdominal X-ray examination, public hospitals have a similar median spatial resolution but larger low-contrast detectability compared with private hospitals. The results of this survey clearly show that there is room for further improvement in performing chest and abdominal X-ray examinations in Malaysia.

  7. Ten-year mortality is increased after hospitalization for atopic dermatitis compared with the general population, but reduced compared with psoriasis.

    Science.gov (United States)

    Egeberg, Alexander; Skov, Lone; Andersen, Yuki M F; Mallbris, Lotus; Gislason, Gunnar H; Silverberg, Jonathan I; Wu, Jashin J; Thyssen, Jacob P

    2017-01-01

    Psoriasis and atopic dermatitis (AD) are chronic inflammatory skin disorders. Mortality is increased in psoriasis, yet no studies on mortality in AD are currently available. We investigated 10-year mortality after hospitalization for AD compared with psoriasis and the general population. Between 1996 and 2002 all Danes aged 18 years or older with a first-time hospitalization as a result of AD or psoriasis and AD-matched healthy control subjects were examined in nationwide registers. Multivariable (adjusted for age, sex, socioeconomic status, Charlson Comorbidity Index score, smoking, and medication) hazard ratios were estimated by Cox regression. The study comprised 576 and 951 hospitalized patients with AD and psoriasis, respectively, with a maximum follow-up time of 10 years. During the study period, there were 65 and 286 deaths among patients with AD and psoriasis. Risk of death was decreased in patients with AD versus psoriasis (hazard ratio 0.75; 95% confidence interval 0.57-1.00), but higher than in general population control subjects (n = 5760) (hazard ratio 1.71; 95% confidence interval 1.20-2.44). Patients hospitalized with AD died on average 8.3 years younger than control subjects. Lifestyle may have affected the risk. The 10-year mortality was significantly lower after hospitalization for AD compared with psoriasis, but increased when compared with the general population. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  8. Improving hospital bed utilisation through simulation and optimisation: with application to a 40% increase in patient volume in a Norwegian General Hospital.

    Science.gov (United States)

    Holm, Lene Berge; Lurås, Hilde; Dahl, Fredrik A

    2013-02-01

    This paper analyses the problem of allocating beds among hospital wards in order to minimise crowding. We present a generic discrete event simulation model of patient flow through the wards of a hospital. In the generic model, each ward can have separate probability distributions for arrival times and length of stay, which may be time dependent. Output of the model is a matrix, with statistics on the utilisation of different hypothetical numbers of beds for each ward. This matrix is fed into an allocation algorithm, which distributes the available beds among the wards in an optimal way. We define bed utilisation either in terms of how often it is in use (prevalence), or in terms of how often a newly arriving patient is placed in it (incidence). For these classes of utilisation measures we develop efficient allocation algorithms, which we prove to be optimal. The model was applied to Akershus University Hospital in Norway. In 2011, some of the wards of this hospital experienced a high occupancy rate, while others had a lower utilisation. Our model was applied in order to reallocate the hospital beds among the wards. For each ward, acute arrivals were modelled with Poisson-distributions with time-varying intensity, while elective arrivals were programmed to arrive in specific numbers at specific times. The arrival rates were based on empirical data for 2010, scaled up by an expected increase of 40% due to a restructuring of the hospital districts in Oslo and the greater metropolitan area in 2011. Length of stay was modelled as beta-distributions, using a combination of subject matter experts' evaluations and empirical data from 2010. The model has been verified and validated. Intuitively, both prevalence (average number of crowding beds in use) and incidence (number of patients placed in crowding beds) might seem like relevant optimisation criteria. However, our experiments show that prevalence optimisation gives more sensible solutions than incidence optimisation

  9. Food production and wastage in relation to nutritional intake in a general district hospital - wastage is not reduced by training the staff

    DEFF Research Database (Denmark)

    Almdal, T.; Viggers, L.; Beck, Anne Marie

    2003-01-01

    Background and Aims: To assess the amount of food produced in a hospital kitchen and the amount wasted. To assess the amount of food eaten by patients in relation to their energy needs. To assess whether the food production and wastage could be reduced by training members of the staff. Methods......: The study was carried out in a general district hospital in Denmark. The amount of food produced in the hospital kitchen and returned uneaten (wasted) was determined. In a representative sample of patients, the energy expenditure was calculated and in the same patients, the energy and protein intake....... Following training of the hospital staff, a new investigation showed no significant changes in the amount of food ordered and wasted. Conclusion: Despite a supply of food, which was much higher than the patients' needs, the patients have only approx. 60% of their energy need covered. We suggest...

  10. Sepsis in the department of infectious diseases and febrile conditions of General hospital Celje in the years 2000–2003

    Directory of Open Access Journals (Sweden)

    Gorazd Lešničar

    2005-01-01

    Full Text Available Background: The aim of our study was to establish the incidence of sepsis, as well as to identify the causes and source of infection in patients treated at the Department of Infectious Diseases and Febrile Conditions of General Hospital Celje in the years 2000–2003.Patients and methods: By means of a retrospective research we reviewed medical records of 7,260 patients who were hospitalized in our ward in the years 2000–2003. The retrospective study revealed that 816 (11.2% out of 7,260 patients admitted in the period 2000–2003 met the criteria for the diagnosis of sepsis. Our definition of patients with sepsis was based on additional and stricter criteria than those reported in the literature.Results: The source of sepsis was known in all 816 patients included in the study, the causative agent was proved in 460 (56.4% of them. Of the later, only in 70 (8.6% patients it was isolated from hemoculture, while in the remaining 390 (47.8% patients the causative agent was isolated from other infectious cultures. In p