Arostegui, M.; Borba, M.; Caldarelli, D.; Eguiia, A.; Fernandez, E.; Peleteiro, M.; Pereira, C.; Vico, M.
This work was carried out by a nursery licensed group in the Clinicas Hospital - Dr. Manuel Quintela.The nature and functioning of Services and the allocation of resources, are essential for the analysis of the Survey of the hospitalized oncology patients in the Institution. To develop a model of care that constitutes a health care as well as teaching and research in the country regarding the quality of care was defined the following topics: lower risks for the patient, safer care, personal trained and specialized to promote relationship between the offering and the person receiving the service. The assessment and management performance of the services involved in the operation are the result of the degree of user satisfaction. Objective: To determine the human and material necessary for the care of cancer resources users, considering their number, treatment, complications and nursing care derived from each pathology and stage of disease. Methodology: A comparative descriptive study of the same population was conducted in two transverse sections in relation to two different times which are based on the design of a form that allowed hospitalized to collect information on users 6/12/03 and 6/16/04. Other instruments used were the clinical history and the daily census staff Patients and Nursing Division. Results and conclusions: A comparative descriptive analysis already mentioned are: increased internships and cancer patients; between 50 and 64 is the highest number of patients; diagnoses Face and Neck and maintain the Digestive System more cases; the number of patients doubles and Hematology Neurological from one to another period. Chemotherapy is the treatment choice and there is a decrease in the surgical and medical; more patients in the study; in the origin, Montevideo has the largest number of patients followed by Canelones. Line of nursing intervention will be carried out in short, medium and long term
Full Text Available Introduction: Patient acceptance to diet in fl uences patient intake during the hospitalization. Patient acceptance on meals provided by the hospital can be seen from the left over. Whilst factors which in fl uences patient motivation to finish their meals including addtional food, taste, and adaptation level to the hospital, the aim of this research was to identify factors that related to patient acceptance on meals provided by the hospital in class three ward dr. Soepraoen Hospital, Malang. Method: Descriptive analitic was used as research design with cross-sectional approach. As many as 51 samples were chosen with purposive sampling. Data was analyzed with chi square with 95%signi fi cance. Results: The results showed a signi fi cant relation between additional food and the leftover (p-Value = 0,018. There is signi fi cant relation on the taste and the leftover (p-Value = 0.032 and adaptation level and leftover (p-Value = 0.026. Discussion: It can be concluded that additional food, taste, and adaptation level to the hospital have signi fi cant relation with hospitalized patient acceptance on their diet. It is suggested that nurse pay more attention on these factors to fulfi ll patient nutrition needs during hospitalization.
Hartini, Resi; Hasyim, Hamzah; Ainy, Asmaripa
Background : The hospital is an institution that service activities of preventive, curative, rehabilitative and promotive health. These activities produce solid, liquid, and gas waste. Liquid waste can cause diseases and environment pollution so need special waste management. Dr. Mohammad Hoesin Palembang's Hospital producea lot of liquid waste. Method : This study is a descriptive research with qualitative approach. Sources of information consist four informants. The research are using dept...
Badilla Gonzalez, Ronald
This work establishes the associated factors to the early recurrence of gastric cancer in the patients who have received adjuvant chemoradiation in the Hospital Dr. R. A. Calderon Guardia. It was determined if the personal factors such as age and gender influence in the evolution of theses cases. The importance of characteristics of the tumour as T, N, location, Borrmann type and histological type in the evolution of the disease was estimated, too. It mentions the epidemiological characteristics of patients who have received the therapy and describes the toxicity of the treatment. A retrospective-descriptive method was utilized and the clinical records of the patients of the hospital with gastric cancer diagnosis were reviewed. These patients were surgery candidates and then they received adjuvant ia with chemoradiation from 2003 and with at lest 12 months of monitoring. The main conclusions are: Hospital Calderon Guardia practices the surgery with D2 ganglionar dissection as treatment of potentially curable gastric cancer. The population with gastric cancer has a predominance of men and people between seventh and fifth decade of life. The studied series had a recurrent tendency for female sex. To major pT (pathologic size) of the tumour there is more risks of recurrence. The pattern of regional recurrence in peritoneal carcinomathosis shape is which has a tendency to predominate after the adjuvant treatment in gastric cancer. The toxicity of the adjuvant treatment for gastric cancer is not severe and it is manageable without necessity of suspend the treatment in the majority of the cases [es
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.
Jakobsen, B K; Kristensen, T; Lamm, L U
lymphocyte typing (PLT) for HLA-D/DR region associated DP antigens. None of these studies gave evidence that the recombinations had occurred within the HLA region. Mixed leucocyte culture (MLC) tests within the families showed no detectable stimulation between the HLA identical siblings in two......The chromosome 6 markers, HLA-ABC, D, DR, MT, properdin factor Bf, and complement factors 2 (C2) and 5 (C4), were studied in three families, each of which included two HLA identical siblings, one or both of whom were known to be HLA-B: GLO recombinants. The families were also typed with primed...... to reactive reagents. One of these (GHx), reacted with a determinant which segregated within the GG family as if child G was a paternal recombinant between the HLA-D, DR, DP, and C4 loci, on the one hand, and on the other hand one or more loci governing other HLA-D/DR region controlled lymphocyte activating...
Silvia Shinta Devi
Sistem kesehatan di Indonesia mengalami perubahan besar dengan diberlakukannya program Asuransi Kesehatan Nasional. Resume medis memiliki peran penting dalam klaim asuransi kesehatan, sehingga resume medis yang terlambat dan tidak lengkap akan mengganggu proses klaim asuransi. Penelitian ini bertujuan untuk mengetahui pengaruh persepsi kemudahan penggunaan, persepsi manfaat, dan sikap pada penerimaan dokter dalam menyelesaikan resume medis. di Dr Radjiman Wedyodiningrat Psychiatric Hospital Lawang berdasarkan Technology Acceptance Model. Technology Acceptance Model digunakan sebagai model dalam penelitian ini karena resume medis merupakan salah satu bentuk teknologi informasi yang masih dilakukan secara manual. Pengumpulan data untuk penelitian ini dilakukan pada bulan Maret 2016 dengan menggunakan kuesioner yang diberikan kepada 32 dokter di Rumah Sakit Jiwa Dr Radjiman Wediodiningrat Lawang. Skala Likert lima tingkat digunakan untuk mengukur setiap item variabel. Data dianalisis dengan menggunakan Partial Least Square. Hasil penelitian menunjukan bahwa secara umum, acceptance dokter di RSJ Dr. Radjiman Wediodiningrat Lawang terhadap pengisian resume medis masuk dalam kategori ringgi dan memiliki perceived usefulness and attitude yang dalam kategori baik, sedangkan perceived ease of use dalam kategori sedang.
Jakobsen, B K; Kristensen, T; Lamm, L U
The chromosome 6 markers, HLA-ABC, D, DR, MT, properdin factor Bf, and complement factors 2 (C2) and 5 (C4), were studied in three families, each of which included two HLA identical siblings, one or both of whom were known to be HLA-B: GLO recombinants. The families were also typed with primed...... lymphocyte typing (PLT) for HLA-D/DR region associated DP antigens. None of these studies gave evidence that the recombinations had occurred within the HLA region. Mixed leucocyte culture (MLC) tests within the families showed no detectable stimulation between the HLA identical siblings in two...
In this study all of the personnel of Angiography of Dr.Faghihi hospital used TLD service During 2002-2003. This service was given by center for Radiation Protection and Application of the Shiraz University. These staff were divided in two group, one groups was technicians and the other group was the nurses. The result of this research shows that the maximum dose received to Technicians and nurses were 0.4mSv and 0.55mSV respectively. The average annual dose to technicians and nurses were 0.02 mSv and 0.19 mSv. This result shows that the nurses of this hospital receive more dose than the techniques
To evaluate the result of allograft transplantation to reconstruct bone defect. The study was case series. All of the cases have been evaluated clinically and radiologically. All of the operations were carried out at Dr. Soetomo Hospital as the referral hospital. Twenty one patients with bone defect were caused by tumour (11 patients), injury (7 patients) infection (1 patient), and congenitial anomaly (2 patients). Out of 21 patients, 15 (78.8%) were already radiologically united, and out of 21 patients 14 (73.7%) patients showed an excellent and good limb function, whereas 5 (26.3%) patients showed a fair and poor result respectively. Allograft transplantation gave a good result to reconstruct bone defect
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.
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
White, Richard T; McGee-Collett, Martin
The objective of this article is to provide a portrait of prefrontal lobotomy performed at the Royal Prince Alfred Hospital, Sydney by the Head of Neurosurgery Dr Rex Money and to describe Dr Money's role in the promotion of psychosurgery in Sydney. We draw attention to an oral presentation by Dr Rex Money in 1951, a journal article written by Money, archival information held at the Royal Prince Alfred Hospital, including Dr Money's accounts of his travels and his reports regarding neurosurgery - both internationally and in Australia. Dr Rex Money performed a series of 13 prefrontal lobotomies between 1945 and 1951, and presented the theoretical basis for his series, his operative procedures and the outcomes at the annual meeting of its medical officers' association. Notwithstanding various deficiencies in his clinical research, Money's descriptions give a relatively comprehensive account of one of the first series of prefrontal lobotomies performed in Australia. The current article also describes Dr Money's contributions to the promotion of psychosurgery in Sydney, and illustrates the participation of a senior neurosurgeon and of a major Sydney teaching hospital during the psychosurgery saga. © The Royal Australian and New Zealand College of Psychiatrists 2016.
Immer, K.; Cyganowski, C.; Reid, M. J.; Menten, K. M.
We present deep Very Large Array H66α radio recombination line (RRL) observations of the two cometary H II regions in DR 21. With these sensitive data, we test the "hybrid" bow shock/champagne flow model previously proposed for the DR 21 H II regions. The ionized gas down the tail of the southern H II region is redshifted by up to ~30 km s-1 with respect to the ambient molecular gas, as expected in the hybrid scenario. The RRL velocity structure, however, reveals the presence of two velocity components in both the northern and southern H II regions. This suggests that the ionized gas is flowing along cone-like shells, swept-up by stellar winds. The observed velocity structure of the well-resolved southern H II region is most consistent with a picture that combines a stellar wind with stellar motion (as in bow shock models) along a density gradient (as in champagne flow models). The direction of the implied density gradient is consistent with that suggested by maps of dust continuum and molecular line emission in the DR 21 region. The image cubes are only available as a FITS file at the CDS via anonymous ftp to http://cdsarc.u-strasbg.fr (ftp://220.127.116.11) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/563/A39Table 2, Fig. 4, and Appendices A and B are available in electronic form at http://www.aanda.org
Vito F. Jayalie
Full Text Available Nasopharyngeal carcinoma (NPC is the most common head and neck malignancy in Indonesia. NPCpresents numerous challenges from non-specific signs and symptoms until lack of awareness from generalpractitioners (GP, which lead to late or missed diagnosis. Early diagnosis and prevention are proposedas the best solutions for this problem. In order to do that, we need a complete and well-managed patients’data. This study aims to reveal the demographic, clinical and histopathologic characteristics of NPC inIndonesia. A cross-sectional study was conducted by collecting medical records of all NPC patients in 2010from Otorhinolaryngology Department of Dr. Cipto Mangunkusumo National Hospital. The extracted datawere then analyzed to describe the problem of NPC in Indonesia. Out of 167 patients, 68.3% of the patientsare male and most of them are Sundanese and Javanese. Palpable lump in the neck is the most commoncomplaint in presentation (58.1%, followed by nasal congestion (49.1%. Salted fish consumption was themost prevalent risk factor (29.9%. Based on the histopathologic findings, 75.4% of the cases were classifiedas WHO-3 and around half of the patients (51% were in stage IV upon diagnosis. Studying demographic andclinical characteristics of NPC patients is the first step to overcome problems caused by NPC in Indonesia. Keywords: head and neck cancer, nasopharyngeal carcinoma, epidemiology Profil Karsinoma Nasofaring di RSUPN Dr. Cipto Mangunkusumo, 2010 Abstrak Karsinoma nasofaring (KNF merupakan keganasan kepala leher yang paling sering di Indonesia.Tanda dan gejala KNF tidak spesifik dan dokter umum kurang waspada sehingga diagnosis terlambat ataugagal. Untuk mengatasi hal tersebut, diperlukan upaya pencegahan dan deteksi dini yang didasari profil KNF.Studi ini bertujuan untuk mengetahui gambaran demografi, gejala klinis dan karakteristik histopatologi pasienKNF di RSUPN Dr. Cipto Mangunkusumo. Penelitian menggunakan desain potong lintang dengan
Full Text Available Patient’s satisfaction is crucial for a hospital, and nursing as an integral part of health care in hospitals also determine the level of patient’s satisfaction. At the order of the clinic nurses deal directly with the public as their client. A direct relationship between the nurse and the client need a behaviour that can be accepted by the whole society. Caring as one of the basic values of nursing, is a phenomenon that affects the way to think, feel and relate to others. This study aimed to analyze the relationship between the nurses caring with patient’s satisfaction by using cross sectional design. Population of this study was patients who were treated in Internal Medicine Unit of Dr. Soetomo Hospital in November 2015. The sample size was 75 people, who were selected by simple random sampling technique. Data collection was done by filling out the questionnaire, then anayzed by using Chi-square test. Results showed 57.33% of the patients gave judgment of satisfactory to nurse caring behaviour and 42.67% gave a good assessment. 62.67% of the patients said they were satisfied with the caring services. There was a significant relationship between nurses caring with patient satisfaction.
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.
Rafael Ángel Formigo–Tejera
Full Text Available In the Guidelines for Economic and Social Policy of the Party and the Revolution adopted at the Sixth Congress of the PCC is a need to raise the quality of health care services and improve the attention to the health personnel. In this regard, it has prioritized improving budget planning spending at all levels. The results obtained by applying the method of Exponential Smoothing for 2012, in the General Hospital "Dr. Juan Bruno Zayas Alfonso" will meet the aforementioned objectives. Comparing these results with what really executed in the first quarter, the estimate is closer, in relation with the traditional method, meaning a decrease in expenses of 1,8 %.
Sayyida, Ghany; Fahma, Fakhrina; Iftadi, Irwan
RSUD dr. Soediran Mangun Sumarso is a public hospital in Wonogiri district which has an outpatient installation service. However, the waiting time of some services in outpatient installations exceeds the standard time set by the health minister of the Republic of Indonesia. It is known from the data waiting time in the outpatient installation. The purpose of this study is to provide improvements using lean hospital approach. Proposed improvement is done by eliminating waste that occurs in outpatient installation service. The methodology used in this study consists of four stages. The first stage is describing the service system using a cross-functional flowchart. The second stage is identifying waste using value stream mapping, observation and interview. The third stage is to determine critical waste by borda method and pareto diagram. The last stage is to provide recommendation improvement using fishbone diagram and FMEA. The result of this research is proposed improvements. The proposed improvements are adding special register counters, implementing an online reservation system, doctors schedule synchronization, adding doctors in polyclinics, fixing queue numbers, applying visual management concepts, making connecting glass in pharmacies and adding multifunction shelves in polyclinics.
Full Text Available Background: Pneumonia is an infection with the highest mortality rate in Indonesian hospitals. According to The American Thoracic Society and The Infectious Diseases Society of America (ATS/IDSA, empirical use of antibiotics is still effective for pneumonia treatment. Inappropriate use of antibiotics would cause negative effects such as prolonged hospitalization, a high cost of treatment, and increased antibiotic-resistant bacteria. The goal of this study was to clarify the empirical use of antibiotic conformity with a bacteria culture. Methods: This study was conducted from August to October 2013 using a descriptive retrospective method based on 116 medical records of pneumonia patients hospitalized in Melati Ward, Dr. Hasan Sadikin General Hospital Bandung during 2011–2012. The type of bacteria, conformity with antibiotics given to patients, and type of antibiotics were analyzed. The conformity of antibiotics was assessed based on the resistance test. If the results were sensitive, they would be put in the conforming group and in the non-conforming group if the results were resistant or intermediate. Data was derived with descriptive statistics, using percentage and frequency distribution, illustrated in tables and figures. Results: Based on culture results and sensitivity of antibiotic empirical therapy given, 55.17% cases were conformed. The most widely used antibiotic group was Third-generation Cephalosporin (60.34%. The most common bacterias were Klebsiella pneumonia (34.5% and Acinetobacter baumanni (13.8%. Conclusions: Most of the antibiotics given to pneumonia patients are still appropriate with results of the bacteria culture test and resistance test.
arsin, A. Arsunan
Dipresentasikan pada kegiatan " The 43rd APACPH Conference" di Graduate School of Public Health, Yonsei University, Korea. pada tanggal 20-22 Oktober 2011 RISK FACTORS AFFECTING THE INCIDENCE OF CORONARY HEART DISEASE AT THE DR. WAHIDIN SUDIROHUSODO GENERAL HOSPITAL IN MAKASSAR IN 2010 A. Arsunan Arsin, Wiwik, Ridwan Amiruddin Hasanuddin University, Indonesia Coronary heart disease is the first cause of death in the world and the fifth cause of death in all hospitals in Indonesi...
Full Text Available Background: Hemophilia A has the highest incidence, more than 80% of 172.323 cases worldwide in 2012. It is stated that clinical characteristics of hemophilia A is worse than others, so it is required to prove and to know further about the clinical characteristics and severity likelihood in all hemophilic patients in order to prevent re-bleeding and re-injury and also for a better medical response. Methods: A retrospective cross-sectional study was carried out to 43 medical records of hospitalized hemophilic patients from 2009 to 2013 in Dr Hasan Sadikin General Hospital. The inclusion criteria were a complete patient identity (name, age, sex, written chief complaint, complete physical examination (bleeding, edema, hematoma, hemarthrosis, anemic symptoms and laboratory test results (factor level, hemoglobin, hematocrit, platelet and Activated Partial Thromboplastin Time. The data was collected from August‒October 2014, analyzed and presented using frequency distribution. Results: Most of the patients were 5-10 years old, male and had hemophilia A. The most common complaint was external bleeding, followed by edema. From 43 patients, 38 (88% cases were classified as severe factor deficiency, had mild to severe anemia, however the platelet count in most of the cases was in normal value. About 91% cases had prolonged Activated Partial Thromboplastin Time in moderate to severe level. Conclusions: Similar with other studies worldwide, most of the hospitalized hemophilic patients have hemophilia A. Most of the patents has moderate to severe bleeding with laboratory test result between moderate to severe level as well.
Handi, A.; Husada, M. S.; Gultom, D. P.
Caring for schizophrenic patients can lead to emotional distress. It remains unclear about the level of depressive syndromes among female caregivers of schizophrenic patients. To determine the level of depression among female caregivers of schizophrenic patients. This is a descriptive study with a cross-sectional approach to describe the level of depression of female caregivers in Prof. dr. M. Ildrem Mental Hospital Medan, using HADS instruments. Most age group of caregivers is from age 51-60 years that is 48.15%, caregiver’s work status mostly not works (62.96%), marital status of caregiver mostly is married (59.26%), kinship with most patients are a biological mother (57.41%). Most patient age group is from age below 30 years (50%), work status of most patients is not working (81.48%), marital status of most caregiver is married (83.33%). Mostly of the depressive syndrome is mild depression (42.59%). Mostly of the depressive syndrome is from mild depression.
Shely Karma Astuti
Full Text Available Objective: To discover the factors affecting the occurrence of maternal deaths. The high maternal mortality rate (MMR in Indonesia is still a common problem which needs urgent solution. Methods: This is an analytic observational, cross-sectional study using a case control approach Fifty two cases were selected as cases, another 52 were selected as control. The sampling was performed by simple random sampling. The instruments used in this study were the medical records of mothers who gave birth in Dr. Hasan Sadikin General Hospital Bandung from 1 January 2009–31 December 2013. Data analysis was performed using chi-square test. Results: In this study, the results showed that the risk factors contributing to maternal deaths were pregnancy complication (p<0.001, delivery complication (p<0.001, puerpural complication (p=0.022, age (p=0.030, parity (p=0.427, prior medical history (p<0.001, antenatal care (p=0.007, maternal education (p=0.527, and area of residence (p=0.049. Conclusions: The risk factors that contribute to maternal deaths include pregnancy complication, delivery complication, puerpural complication, maternal age, prior medical history, antenatal care, and area of residence.
Yan, Xiaofei; Wu, Litao; DU, Xiaojuan; Li, Jing; Zhang, Fujun; Han, Yan; Lyu, Shemin; Li, Dongmin
Objective To prepare monoclonal antibodies against DR region (897DVEDSYGQQWTYEQR911) of Na + -K + -ATPase α1 subunit and identify their properties. Methods BALB/c mice were immunized with DR-keyholelimpet hemocyanin (KLH). Splenocytes from the immunized mice were collected and subsequently fused with SP2/0 mouse myeloma cells. Positive hybridoma clones were obtained after cell fusion and selection. ELISA was used to detect DR antibody titer in the cell supernatants. DR region-specific monoclonal antibodies were analyzed by dot blotting, Western blotting and immunofluorescence assay. Na + -K + -ATPase activity was detected by SensoLyte R FDP Protein Phosphatase Assay Kit and the protective effect of the monoclonal antibody against high glucose-induced cell injury was assessed in H9c2 cells. Results Three hybridoma cell lines which secreted stable DR monoclonal antibody were obtained. The strongest positive cell line, named DRm217, was selected to prepare ascites. Dot blotting, Western blotting and immunofluorescence assay showed that DRm217 recognized specially DR region of Na + -K + -ATPase and bound on H9c2 cell membranes. DRm217 stimulated Na + -K + -ATPase activity and alleviated high glucose-induced H9c2 cells injury. Conclusion The monoclonal antibodies against DR region of Na + -K + -ATPase α1 subunit is prepared.
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
Radistrya Sekaranti Brahmanti
Full Text Available Background: Dyspepsia is a disease with a high worldwide prevalence, including in Asia; however, the pathophysiology of the disease is still unclear. Recent studies suggest adapting a biopsychosocial model to understand the pathophysiology of dyspepsia that proposes the important role of anxiety. The aim of this study was to assess the anxiety level in dyspeptic patients who visited the Gastroenterohepatology Outpatient Clinic in Dr. Hasan Sadikin General Hospital Bandung. Methods: A cross-sectional descriptive study using total sampling method was conducted from September–November 2012 to 19 patients aged 36−85 years old who consisted of 11 women and 8 men patients dyspepsia syndrome in the Gastroenterohepatology outpatient clinic Dr Hasan Sadikin General Hospital Bandung. The anxiety levels were measured using the Zung Self-Rating Anxiety Scale. All data were analyzed based on gender, age, and occupational status of the patients. Results: Eleven of the nineteen patients had high anxiety levels. Women were more likely to experience high anxiety levels (8 of 11. The group with the highest number of patients with high anxiety was the 46−55 years old group, the high anxiety level was more common among patients who were government or private sector employees. Conclusion: The anxiety level in dyspeptic patients who visited the Gastroenterohepatology outpatient clinic in Dr. Hasan Sadikin General Hospital Bandung was high.
Full Text Available The aim of the study is to evaluate the accuracy of triple diagnostic test on thyroid nodules. The data from patients’ medical records who came to Cipto Mangunkusumo General Hospital for the first time or for evaluation of thyroid nodule and patients who underwent thyroidectomy during 2010 to 2011. Clinical examination was scored by McGill Thyroid Nodule Score. ROC procedure was performed to obtain clinical cut-off scores of diagnosis of malignant. Ultrasonography (USG result was considered malignant for TIRADS 4, 5, and 6. If clinical, USG and histopathology examinations of triple diagnostic give positive results, it will be classified as concordant malignant whereas if all those three show benign results, the classification is benign. Thyroid carcinoma was found in 134 out of 161 patients with thyroid nodule. There were 84 patients with concordant results for all three elements of the triple test. Out of 84 patients with concordant triple diagnostic results, there were 53 malignant cases (32.9% and 31 benign cases (19.3%. Main histopathological findings among patients with thyroid carcinoma was papillary (90.3%, follicular (3%, medullary (0.7%, and anaplastic (6%. The sensitivity and specificity of triple diagnostic was 77% and 94%, with positive predictive value of 98%, negative predictive value of 51,6% and accuracy of 80.9%. Combination of clinical findings, USG, and FNAB gave malignant probability of 92%, better than combination of clinical findings and USG (81.6% or clinical findings and FNAB (87%. Triple diagnostic cannot be used as an ideal test to replace frozen section examination in managing thyroid nodule. However, in cases with concordant results of each triple diagnostic’s element, the positive predictive value (98% and malignant probability (92% is high. Keywords: thyroid nodule, triple diagnostic, accuracy. Akurasi Metode Triple Diagnostic pada Pasien Nodul Tiroid di RSUPN Dr. Cipto Mangunkusumo Abstrak Tujuan
Mayo, E. A.; Troland, T. H.
We have used the Very Large Array to study the Zeeman effect in 21 cm H I absorption lines from two star-forming regions in the Cygnus X complex, DR 22 and ON 2. We measure the line-of-sight magnetic field toward these regions, finding B los = -84 ± 11 μG toward the DR 22 H II region and B los < 50 μG toward each of the two H II regions in ON 2. We interpret these results in terms of two different models. In one model, we assume that the H I Zeeman effect is a measure of magnetic fields in the associated molecular clouds. If so, then the DR 22 molecular cloud is magnetically subcritical, that is, magnetically dominated. The ON 2 molecular clouds are magnetically supercritical. In a second model, we assume that the H I Zeeman effect is a measure of magnetic fields in photon-dominated regions where the gas has been compressed (and the field amplified) by absorption of stellar radiation. We find that this second model, where the measured field strength has been affected by star formation, accounts well for the DR 22 H I Zeeman effect. This same model, however, overpredicts the magnetic field in ON 2. ON 2 may be a region where the magnetic field is energetically insignificant or where the field happens to lie nearly in the plane of the sky.
Alina Torreblanca Xiques
Se realizó un estudio descriptivo en pacientes con hemorragia digestiva alta por úlcera péptica que hicieron resangrado, con el objetivo de caracterizarlos. Se estudiaron las variables de grupos de edades y sexo afectados, los hallazgos endoscópicos, las formas de presentación, así como factores asociados. La población de estudio estuvo constituida por los 82 pacientes, que ingresaron en el servicio de gastroenterología del Hospital Provincial Docente “Dr. Ernesto Guevara de la Serna” de la p...
Full Text Available Antibiotic Stewardship Program (ASP is mandatory to all Indonesian hospitals, in accordance to the 2015 Minister of Health Decree No. 8. Dr. Ramelan Naval Hospital Surabaya is one among the many hospitals in Indonesia that has implemented the ASP. The study objective was to describe quantitative-qualitatively the use of antibiotics, along with clinical and microbiological outcomes observed in an Intensive Care Unit (ICU after ASP implementation in dr. Ramelan Naval Hospital Surabaya. The design was a 3-month (February–May 2016 cross-sectional observational study. Quantitative description was reported using Days of Therapy (DOT/100 patient-days, the qualitative description was reviewed using Gyssens’ flowchart. Clinical outcomes observed include nosocomial infection, infection-related mortality, and average length of stay (LOS. Microbiological outcome was observed through the occurences of multi-drug resistant organism. The results showed overall antibiotic use was 151.63 DOT/100 patient-days. Quality of antibiotic use were 52.73% definitely appropriate; 8.18% inappropriate regarding dose, intervals, durations, and timing; 7.27% no indication; and no mutual agreement in 31.82% (κ=0.59; p<0.05. Hospital Acquired Pneumonias (HAPs/Ventilator Associated Pneumonias (VAPs were the most observed nosocomial infection, infection-related mortality rate was 44.68%; and average LOS were 7.17±1.9 days (p<0.05. No incidents of Methicillin-resistant Staphylococcus aureus (MRSA or Extended Spectrum Beta-Lactamase (ESBL have been found, but there were two cases of Multi Drug Resistant (MDR Acinetobacter baumannii.
Full Text Available The Hospital facilities built under Evidence Based Design (EBD will create a safe and comfortable environment, lower the nosocomial infection, quicken the patient recovery, lower the treatment cost, and improve staffs’ performance. The emergency room of public hospital of Dr.R.Sosodoro Djatikoesoemo Bojonegoro needs to be redesigned because the existing design does not meet physical safety. The reparation should refer to Facilities and Safety Management (FMS, Indonesian regulation, EBD concept and benchmarking to RSCM Jakarta considered as an application sample. This research applies case study with descriptive single case study design. The result of the research shows that reparation should be done that includes site and location, building components, and rooms lay out. The width of the rooms should meet minimal standard. The placing of triage room and resuscitation should be in the front area. Sinks should be located near the entrance of every room. The isolation and decontamination rooms should be provided.
Mahir, Siham; Soulaymani, Abdelmajid; Hami, Hind; Mokhtari, Abdelrhani; Benali, Doha; Ouammi, Lahcen; Windy, Maria; Benchekh, Rachida Soulaymani
Deliberate self-poisoning is a serious problem in Morocco, including in the Souss-Massa-Drâa region. However, our understanding of the problem of suicidal poisoning remains limited. This paper aims to describe the characteristics of patients, toxic substances and poisoning and to identify the risk factors influencing patient outcomes. A retrospective study was conducted of all cases of deliberate self-poisoning recorded between 1981 and 2007 by the Centre Anti-Poison et de Pharmacovigilance du Maroc. 1,130 cases of self-poisoning were identified. The mean age was 25 ± 10.1 years and the sex ratio was 0.4. Paraphenylenediamine was the most common cause of death (48 deaths), followed by hydrochloric acid (15 deaths). A close relationship was found between progression to healing and female adolescents and between progression to death and men in other age groups. The study also found that patients who used paraphenylenediamine were twelve times more likely to die (CI95%: 7.4%-19.2%) than those who used other substances. Patients with respiratory and cardiovascular conditions had a relative risk of 9.8 (CI95%: 6.3%-16%) and 3.6 (CI95%: 2.3%-5.7%). Of the 937 cases with known outcome, 89 died (9.5%).
Full Text Available Background: The prevalence ulcerative colitis (UC in RSCM Jakarta in 1991-1995 is 2.5%. The disease affects men and women at similar rates or slightly more common in women than in men. Age of onset follows a bimodal pattern, with a peak at 15-25 years and a smaller one at 55-65 years, although the disease can occur in people of any age. The precise etiology of UC is not well understood. UC is precipitated by a complex interaction of environmental (cigarretes, diet, non-steroidal anti-inflammatory drug/NSAID, etc, genetic, and immunoregulatory factors. This study aimed to identify the prevalence, profile and risk factor of ulcerative colitis in Dr. Saiful Anwar General Hospital Malang. Method: This is a retrospective survey analysis from medical record which was taken from 2170 patients who underwent colonoscopy in Dr. Saiful Anwar General Hospital Malang from January 2010 to December 2014. Demographic setting (sex, age, clinical features, lifestyle, diagnosis based on colonoscopy were analyzed as the variables. Results: Total patients with UC was 176 patients. The prevalence of UC during 2010-2014 was 8.2% at Dr. Saiful Anwar General Hospital. There was a similar prevalence of sex between male and female patients, in which 95 (53.4% were male and 81 (46.6% were female. The average age of patients with UC was 41,6 years. Most patients were presented with abdominal pain (32.90% and weight loss (42.1%. The diagnosis based on colonoscopy were pancolitis (36%, proctosigmoiditis/proctitis (31.81%, and left-sided colitis (21.9%. The risk factors of UC identified in this study were current smoker, use of NSAIDs/traditional herbs/potion and fiber diet. Majority of ulcerative colitis study samples were non-smoker (75%, not consuming herbal treatment/NSAID (60.22%, and rarely consuming fiber (36.93%. There is a significan correlation between frequency of fiber diet and UC (r = -0.106, p = 0.000. Conclusion: The prevalence of UC was 8.2% in our hospital
Feb 16, 2012 ... Settings and subjects: This study included all medical and nursing staff working at ... Keywords: hospital reform, staff morale, quality of care, healthcare resources ..... of healthcare workers' goals to cure patients.3 This differs.
MIGUEL ÁNGEL ANDRADE-RAMOS
Full Text Available ABSTRACT Objective: To describe our experience on a case series treated with minimal invasive techniques in spine surgery, with short-term follow-up and identify complications. Methods: A prospective analysis was performed on 116 patients operated on by the same team from September 2015 to June 2016. Evaluating the short-term follow-up we registered the surgical time, bleeding, complications, hospital stay, pre- and postoperatively neurological status, as well as scales of disability and quality of life. Demographic and surgical procedure data were analyzed with SPSS version 20 program. Results: A total of 116 patients with a mean age of 49.7 + 15.7 (21-85 years underwent surgery being 76 (65% with lumbar conditions and 37 (32% with cervical conditions. The most common procedures were tubular discectomies (31, tubular bilateral decompression (17, lumbar MI-TLIFs (7, and anterior cervical discectomy and fusion (35. The mean blood loss was 50.6 cc, the hospital stay was 1.7 day, pre- and postoperative pain VAS were 7.4 % and 2.3%, respectively, pre- and postoperative Oswestry (ODI were 64.6% and 13.1%, respectively, pre- and postoperative SF-36 of 37.8% and 90.3%. There were no major complications, except for a surgical wound infection in diabetic patient and three incidental durotomies, one of these being a contained fistula, treated conservatively. Conclusions: The current tendency towards minimally invasive surgery has been justified on multiple studies in neoplastic and degenerative diseases, with the preservation of the structures that support the spine biomechanics. The benefits should not replace the primary objectives of surgery and its usefulness depends on the skills of the surgeon, pathology and the adequate selection of the techniques. We found that the tubular access allows developing techniques such as discectomy, corpectomy and fusion without limiting exposure, avoiding manipulation of adjacent structures, reducing complications and
Full Text Available Background: Diagnosis of myocarditis in children is still challenging due to its inconsistent and wide spectrum of clinical manifestations. There is no specific laboratory test available. This may obscure the true incidence of myocarditis. The purpose of this study was to describe clinical profile and outcome of myocarditis in children. Methods: A descriptive study was performed using 80 medical records of hospitalized pediatrics patients with myocarditis in Dr. Hasan Sadikin General Hospital Bandung from January 2008 to December 2012. The obtained data were age, gender, nutritional status, etiology, chief complaint, physical examination, laboratory findings, other examinations and outcome of the disease. The collected data were analyzed and presented in the form of frequency distribution. Results: The mean age of the patients was 91.46 (45.93 months old, predominantly male. The most etiology was dengue infections (61%. High fever was found as the most common chief complaint (38% and the most common found in physical examinations were tachypnea (65% and hepatomegaly (55%. Electrocardiography (ECG showed the first degree atrioventricular block (AV block (35%, aspartate aminotransferase (AST and creatine kinase myocardial band (CKMB was increased in more than 80% of patients. The majority of patient was improved. Shock was the common complication. Conclusions: Dengue is the most etiology of myocarditis etiology. Tachypnea, hepatomegaly, the first degree AV block in ECG, elevated AST and CKMB were the most common presentations. Most of the patients were improved during treatment.
Research result. The results using the ABC method showed that the unit cost to the cost of professional practice nurses in the hospital Dr. Soewandhi Surabaya is Rp. 460,000, - / month / person, while the cost of practice set by the RS Dr. Soewandhi is Rp. 1.200.000, - / month / person. There is a practice of the profession excess costs Rp. 740,000, -. RS Dr. Surabaya Soewandhi practice fees apply without using a standard based on the unit cost accordingly. Some educational institutions felt the cost was very heavy so the impact to the cancellation of the filing of the professional nurses student practice. Conclusions and recommendations. The hospital used a professional students practice nurses should use the standard fees in accordance with needs through precise calculations that the fees charged to students through educational institutions in accordance with the appropriate calculations. Keyword: ABC system - Profession nurses - Fee Practices
Romero Cabrera, J.L.
Considering the relation conditions existing in the Dr Gustavo Aldereguia Lima Hospital this work tries to analyze the critical ways that lead to the dossefication of radiopharmaceutical drugs that do not fit the ALARA criterion and to propose a program that in a general consensus with all medical specialists would determine the precise medical test needed to be done
Moreno, Guillermo E; Magliola, Ricardo; Pilán, María Luisa; Althabe, María; Balestrini, María; Lenz, Ana Miriam; Krysnki, Mariela; Rodríguez, Ricardo; Salgado, Gladys; Martin, Analía; Cardoso, Hugo; Ruffa, Pablo; Cornelis, Carlos Javier; Barreta, Jorge; García Delucis, Pablo
Mechanical circulatory support provides oxygen to the tissues in patients with cardiac and/or respiratory reversible disease refractory to conventional treatments. The aim of this study is to show our initial results of mechanical circulatory support in children with heart disease. Retrospective cohort between March 2006 and March 2012. Demographic data (age, sex, weight, cardiac diagnosis), surgery (technique, pump, aortic cross clamping time) and mechanical circulatory support (type of assistance, indication, duration, complications and outcome) were collected. Thirty-three patients were supported (1.3% of all surgeries), extracorporeal membrane oxygenation 32 cases and one ventricular assist device. The median age 7.4 months (one day-18 years) and weight 6kg (2.3-75). The most frequent cardiac malformations supported were the transpositions of the great arteries associated with other anomalies and the corrected transpositions (ventricular inversion or double discordance). The most common reason for admission was post-cardiotomy biventricular dysfunction. Twenty-eight patients were supported in the postoperative period, 4 in the preoperative period and in one with myocarditis. Median days of support were 3 days (1-10). The most common complications were infection (21%), bleeding (21%). Elective decannulation was achieved in 94% of cases. Hospital discharge survival: 52%. The mechanical circulatory support in our institution is a safe and standard procedure. We have been using it in a small number of cases with a similar survival to that reported internationally. This complex procedure is widely justified because it allows for the recovery of more than half of the patients who otherwise would have died. Copyright © 2013 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.
Langalibalele H. Mabuza
Full Text Available Background: Healthcare practitioners should provide patients with information regarding their clinical conditions. Patients should also feel free to seek clarity on information provided. However, not all patients seek this clarity. Objectives: To explore the reasons inpatients gave for not seeking clarity on information that was received but not understood. Methods: This was a qualitative arm of a larger study, titled ‘Are inpatients aware of the admission reasons and management plans of their clinical conditions? A survey at a tertiary hospital in South Africa’, conducted in 2010. Of the 264 inpatients who participated in the larger study, we extracted the unstructured responses from those participants (n = 152 who had indicated in the questionnaire that there was information they had not understood during their encounter with healthcare practitioners, but that they had nonetheless not sought clarity.Data were analysed thematically. Results: Themes that emerged were that inpatients did not ask for clarity as they perceived healthcare practitioners to be ‘too busy’, aloof, non-communicators and sometimes uncertain about patients’ conditions. Some inpatients had unquestioning trust in healthcare practitioners,whilst others had experiences of bad treatment. Inpatients had poor self-esteem, incapacitating clinical conditions, fear of bad news and prior knowledge of their clinical conditions. Some inpatients stated that they had no reason for not seeking clarity. Conclusion: The reasons for not seeking clarity were based on patients’ experiences with the healthcare practitioners and their perceptions of the latter and of themselves. A programme should be developed in order to educate inpatients on effective communication with their healthcare practitioners.
Full Text Available Infective endocarditis is an infection of the lining of the heart, particularly the cusps of valves characterized by fever and heart murmur, with or without malaise and fatigue. Clinical features can be divided into early manifestations of infection, embolic events, and late complications of sepsis and inflammation. It was reported that 60 years old man was brought to Kariadi hospital with prolong febris as his chief complaint. Patient has history of high grade fever and accompanied by weight loss, 3 kilograms for about 2 months. From physical examination result, in internal ward, we found he looked moderate ill. Heart systolic bruit at triscupidal valve and lungs were within normal limit. The result of blood culture from 3 different sites and throat swab culture were possitive, lead to the performance Streptococcus b haemolyticusâ€™s colonies. From the result of the ASTO, Echocardiography and physical examination show infective endocarditisâ€™s sign. The theraphy was Ceftriaxone 2 gram daily. Having obtained the results of negative cultures, and show an improvement of symptoms, finally the patient was getting improvement clinically and then treat as an outpatient. Patient was programmed to get Ceftriaxone 2 gram daily for 4 weeks. The decision of treatment not only from clinical manifestation but also from microbiology examination on the first admission in emergency unit. Blood culture with 3 bottles, interval 30 minutes is important for infective endocarditis. Furthermore, swab of throat area were taken to confirm for endocarditis cultures too. Finally there is no growth in culture until eighth day hospitalizasition. Spesific method on blood culture sampling is important to confirm the diagnostic of infective endocarditis and very useful for the clinicians to do the right clinical management for it. Subsequently, the role of clinical microbiologist in this case not only to support the clinical diagnostic but also the treatment in
Caracterización clínico-terapéutica del sangramiento digestivo alto: Hospital "Dr. Salvador Allende". Primer semestre 2006 Clinicotherapeutical characterization of upper digestive bleeding: "Dr. Salvador Allende" Hospital. First semester 2006
José de Jesús Rego Hernández
Full Text Available La hemorragia digestiva constituye una de las principales causas de ingreso hospitalario por enfermedades del tracto gastrointestinal, En la mayoría de casos se presenta de forma aguda y con importantes repercusiones sistémicas, por lo que obliga a adoptar medidas urgentes para estabilizar a los pacientes y permitir efectuar un tratamiento específico adecuado, Esta entidad sigue ocasionando una mortalidad elevada, que se acumula en determinados grupos de riesgo como son los pacientes con edad avanzada y enfermedades graves asociadas, por lo que se decide realizar la caracterización clínico-terapéutica del sangramiento digestivo alto en el Hospital "Dr, Salvador Allende" durante el primer semestre del 2006 mediante un estudio descriptivo que tomó como fuente la revisión de las 161 historias clínicas de los pacientes egresados con este diagnóstico en ese período, El 73,3 % de los pacientes con sangramiento digestivo alto fueron mayores de 60 años de edad; no existieron diferencias en cuanto al sexo; el café y el tabaquismo fueron los hábitos tóxicos más reportados; los antiinflamatorios no esteroides, el grupo farmacológico más relacionado con esta entidad y dentro de ellos, el ácido acetilsalicílico, y la melena, la manifestación clínica más frecuente, En el 91,9 % la pauta de tratamiento fue adecuada, así como el tratamiento en general; hubo solo la asociación irracional de un inhibidor de la bomba de protones con un anti-H2Digestive haemorrhage is one of the main cause of hospital admission due to gastrointestinal tract diseases. In most of the cases, it appears in an acute form, and with important systemic repercussions that lead to the adoption of emergency measures to stabilize the patients and to apply an adequate specific treatment. This entity is still causing a high mortality that is accumulated in certain risk groups as the elderly patients with severe associated diseases. That's why, it was decided to make the
Pesquisaje activo de sospechas de reacciones adversas a medicamentos en el Hospital "Dr. Salvador Allende: Primer semestre 2006 Active screening of suspicions of adverse reactions to drugs in "Dr. Salvador Allende" Hospital: First semester 2006
José de Jesús Rego Hernández
Full Text Available Se realizó un estudio descriptivo mediante la revisión diaria del movimiento hospitalario, obtenido en el Departamento de Registros Médicos del Hospital "Dr. Salvador Allende" desde enero hasta junio de 2006 a fin de poder identificar los ingresos susceptibles de ser reacciones adversas a medicamentos, con el objetivo de detectar la frecuencia de ingresos por sospechas de reacciones adversas a medicamentos, así como de caracterizar a estos pacientes. Se llenó una planilla de notificación para cada sospecha de reacción adversa y se analizaron los datos contenidos en las historias clínicas respectivas. Se utilizó una base de Excel diseñada al efecto por el Centro para el Desarrollo de la Farmacoepidemiología. Ingresaron 6 201 pacientes, de los cuales 384 eran susceptibles de tener una reacción adversa a medicamentos (6,2 % y finalmente, se consideraron 57 pacientes cuyo motivo de ingreso se relacionó con algún medicamento (0,9 %. El 66,7 % de los casos eran mayores de 60 años de edad, sin diferencias en cuanto al sexo. Los grupos farmacológicos con mayores afectaciones fueron los analgésicos no opiodes (59,7 % y los antibacterianos (19,4 %. El sangramiento digestivo alto resultó la reacción adversa que más se encontró (57,9 %, con predominio en mayores de 60 años de edad (72,7 %; el ácido acetilsalicílico estuvo presente en el 66,7 % de los casos con este diagnóstico. En el75,5 % de los casos la reacción se consideró como graveA descriptive study was conducted by the daily revision of hospital movement obtained in the Department of Medical Registries of "Dr. Salvador Allende" Hospital from January to June, 2006, aimed at identifying the admissions susceptible to adverse reactions to drugs to detect the frequency of admissions due to suspicions of adverse reactions to drugs, as well as to characterize these patients. A notification form was filled in per each suspicion of adverse reaction, and the data contained in the
Alina Torreblanca Xiques
Full Text Available Se realizó un estudio descriptivo en pacientes con hemorragia digestiva alta por úlcera péptica que hicieron resangrado, con el objetivo de caracterizarlos. Se estudiaron las variables de grupos de edades y sexo afectados, los hallazgos endoscópicos, las formas de presentación, así como factores asociados. La población de estudio estuvo constituida por los 82 pacientes, que ingresaron en el servicio de gastroenterología del Hospital Provincial Docente “Dr. Ernesto Guevara de la Serna” de la provincia de Las Tunas, desde febrero 2012 a febrero del 2014. El sexo más afectado fue el masculino, predominando en la sexta década de la vida, la gastritis erosiva hemorrágica es el hallazgo endoscópico que se presentó con mayor frecuencia, siendo la cara anterior del bulbo duodenal la ubicación topográfica más afectada. La hipertensión arterial fue la enfermedad asociada a la hemorragia digestiva alta que predominó, en 45 pacientes, presentando como factor frecuente la ingestión de antiinflamatorios no estereoideos (AINES, constituyendo la melena la forma de aparición más frecuente
Keena, Cecilia; Rossetto, Jorge; Somoza, Matías; De Lellis, Martín
The psychiatric hospital "Dr. Manuel A. Montes de Oca" has developed a Program for the Reform of the Model of Attention and Integral Rehabilitation that includes the implantation of community residential devices in the area of influence of the Institution. This program, which aims at the progressive replacement of asylum beds, has been the subject of an evaluative investigation that has included almost all the devices through a transversal and descriptive design, with instruments of survey created by the equipment and in agreement with the References of the Institution. The present article proposes to initiate a set of evaluative works in different dimensions concerning the institutional reform process, describing the antecedents, the objectives and the methodology and development of the study to achieve the general characterization of the devices. The main results of the study are summarized below on a set of aspects that we consider most signifcant for the characterization of the devices: a) Type of users served; B) Coverage of Care; C) Method of approach; D) Use of social and health services; E) Expenses and returns to the Institution; E) Main barriers encountered in the implementation of such devices. The work concludes with a series of proposals that are based on the survey carried out tending to promote the greatest possible sustainability in the implementation of the selected community devices.
Vally, M; Koto, M Z; Govender, M
Diverticular disease was previously thought to be non-existent in the black African population. Studies over the past four decades, however, have shown a steady increase in the prevalence of the disease. To report on the profile and current prevalence of diverticular disease in the black South African (SA) population at Dr George Mukhari Academic Hospital, Pretoria, SA. A retrospective descriptive study was performed in black SA patients who were diagnosed with diverticular disease by colonoscopy between 1 January and 31 December 2015. Of 348 patients who had undergone colonoscopies and who were eligible for inclusion in this study, 47 were diagnosed with diverticular disease - a prevalence of 13.50% (95% confidence interval 10.30 - 17.50). The greatest number of patients diagnosed were in their 7th and 8th decades, with an age range of 46 - 86 (mean 67) years. There was a female predominance of 57.45%. Lower gastrointestinal bleeding was the most common (65.96%) indication for colonoscopy. The left colon was most commonly involved (72.34%), followed by the right colon (55.31%). A substantial number of patients had pancolonic involvement (27.65%). This retrospective study suggests that there has been a considerable increase in the prevalence of diverticular disease among black South Africans, possibly owing to changes in dietary habits and socioeconomic status.
Full Text Available Background. Diverticular disease was previously thought to be non-existent in the black African population. Studies over the past four decades, however, have shown a steady increase in the prevalence of the disease. Objective. To report on the profile and current prevalence of diverticular disease in the black South African (SA population at Dr George Mukhari Academic Hospital, Pretoria, SA. Methods. A retrospective descriptive study was performed in black SA patients who were diagnosed with diverticular disease by colonoscopy between 1 January and 31 December 2015. Results. Of 348 patients who had undergone colonoscopies and who were eligible for inclusion in this study, 47 were diagnosed with diverticular disease – a prevalence of 13.50% (95% confidence interval 10.30 - 17.50. The greatest number of patients diagnosed were in their 7th and 8th decades, with an age range of 46 - 86 (mean 67 years. There was a female predominance of 57.45%. Lower gastrointestinal bleeding was the most common (65.96% indication for colonoscopy. The left colon was most commonly involved (72.34%, followed by the right colon (55.31%. A substantial number of patients had pancolonic involvement (27.65%. Conclusion. This retrospective study suggests that there has been a considerable increase in the prevalence of diverticular disease among black South Africans, possibly owing to changes in dietary habits and socioeconomic status.
Helmi Manggala Putri, Arum; Subekti, Retno; Binatari, Nikenasih
Dr Yap Eye Hospital Yogyakarta is one of the most popular reference eye hospitals in Yogyakarta. There are so many patients coming from other cities and many of them are BPJS (Badan Penyelenggara Jaminan Sosial, Social Security Administrative Bodies) patients. Therefore, it causes numerous BPJS patients were in long queue at counter C of the registration section so that it needs to be analysed using queue system. Queue system analysis aims to give queue model overview and determine its effectiveness measure. The data collecting technique used in this research are by interview and observation. After getting the arrival data and the service data of BPJS patients per 5 minutes, the next steps are investigating steady-state condition, examining the Poisson distribution, determining queue models, and counting the effectiveness measure. Based on the result of data observation on Tuesday, February 16th, 2016, it shows that the queue system at counter C has (M/M/1):(GD/∞/∞) queue model. The analysis result in counter C shows that the queue system is a non-steady-state condition. Three ways to cope a non-steady-state problem on queue system are proposed in this research such as bounding the capacity of queue system, adding the servers, and doing Monte Carlo simulation. The queue system in counter C will reach steady-state if the capacity of patients is not more than 52 BPJS patients or adding one more server. By using Monte Carlo simulation, it shows that the effectiveness measure of the average waiting time for BPJS patients in counter C is 36 minutes 65 seconds. In addition, the average queue length of BPJS patients is 11 patients.
Full Text Available Stereotactic radiosurgery (SRS is one of the treatment modalities for benign intra-cranial tumor, especiallyfor the tumor located next to the critical neural structure. The prescribed dose for radiosurgery depends onthe maximal tumor diameter and surrounding normal tissue tolerance dose. This cross sectional study wasconducted to evaluate the physician’s tendency in radiosurgery dose prescription. We observed treatmentplanning data of 32 patients with benign intra-cranial tumor, which had been treated with SRS at Dr. CiptoMangunkusumo National Hospital in 2009-2010. The peripheral dose, organ at risk (OAR dose limitiationand maximum tumor diameter were recorded. We compared our SRS dose with dose limitation, whichallowed safer dosing based on maximal tumor diameter perspective and the nearest OAR dose constraint.From maximal tumor diameter perspective, we prescribed mean±SD radiosurgery doses, which were11.63±2.21Gy, 10.21±1.29Gy and 9.88±1.07Gy for the tumor size ≤2cm, 2.01-3cm and 3,01-4cm respectively.Our radiosurgery dose was the lowest than dose limitation based on the nearest OAR perspective, followedby maximal tumor diameter perspective. It was concluded that radiosurgery dose had the tendency to beinfluenced by surrounding healthy tissue tolerance rather than maximal tumor diameter. Keywords: stereotactic, radiosurgery, benign tumor, dose. Kecenderungan Dokter dalam Menentukan Dosis StereotacticRadiosurgery untuk Tumor Jinak Intrakranial diRSUP Nasional dr. Cipto Mangunkusumo, Jakarta Abstrak Stereotactic radiosurgery (SRS merupakan salah satu modalitas pengobatan tumor jinak intra-kranialterutama untuk tumor yang berdekatan dengan struktur saraf penting. Penentuan dosis pada radiosurgerytergantung pada diameter tumor maksimal dan dosis toleransi jaringan sehat sekitarnya. Penelitian inidilakukan untuk mengevaluasi kecenderungan dokter dalam menentukan dosis radiosurgery. Penelitian crosssectional ini mengevaluasi data
Yadira Santiesteban Escalona
Full Text Available Se realizó un estudio analítico, de tipo caso control pareados 1:2, para determinar los factores de riesgo de neumonía nosocomial en pacientes ingresados en terapia intensiva del Hospital “Dr. Ernesto Guevara de la Serna” de Las Tunas, en el período de enero de 2010 a diciembre de 2011. El universo fue de 1035 pacientes ingresados en terapia intensiva (UCI, en dicho período, de ellos constituyeron la muestra, denominada “casos”, 56 pacientes que desarrollaron Neumonía Nosocomial durante su estadía en UCI. Para el “control” de los factores de confusión, por cada caso, se parearon dos pacientes sin diagnóstico de neumonía. La información se obtuvo de fuentes secundarias (historias clínicas. A los casos y a los controles se les llenó una planilla de vaciamiento de datos con las variables analizadas. Los datos se procesaron utilizando el paquete de programas estadísticos Epinfo, versión 6. Para el estudio de los factores de riesgo se realizaron análisis univariados, evaluándose: ODDS RATIO, intervalo de confianza y probabilidad. Resultaron ser factores de riesgo para presentar neumonía nosocomial: la intubación endotraqueal, los trastornos de conciencia, el aislamiento de bacilos no fermentadores, citrobacter diversus y/o klebsiella ssp., haber requerido neurocirugía, el uso de tratamiento antibiótico previo, antiácidos anti H2, nutrición parenteral y la estadía en UCI mayor de siete días.
Ni Made Mertaniasih
Full Text Available Objective/Background: The aim of this study was to analyze the detection of nontuberculous mycobacterial (NTM species derived from sputum specimens of pulmonary tuberculosis (TB suspects. Increasing prevalence and incidence of pulmonary infection by NTM species have widely been reported in several countries with geographical variation. Materials and Methods: Between January 2014 and September 2015, sputum specimens from chronic pulmonary TB suspect patients were analyzed. Laboratory examination of mycobacteria was conducted in the TB laboratory, Department of Clinical Microbiology, Dr. Soetomo Hospital, Surabaya. Detection and identification of mycobacteria were performed by the standard culture method using the BACTEC MGIT 960 system (BD and Lowenstein–Jensen medium. Identification of positive Mycobacterium tuberculosis complex (MTBC was based on positive acid-fast bacilli microscopic smear, positive niacin accumulation, and positive TB Ag MPT 64 test results (SD Bioline. If the growth of positive cultures and acid-fast bacilli microscopic smear was positive, but niacin accumulation and TB Ag MPT 64 (SD Bioline results were negative, then the isolates were categorized as NTM species. MTBC isolates were also tested for their sensitivity toward first-line anti-TB drugs, using isoniazid, rifampin, ethambutol, and streptomycin. Results: From 2440 sputum specimens of pulmonary TB suspect patients, 459 isolates (18.81% were detected as MTBC and 141 (5.78% as NTM species. Conclusion: From the analyzed sputum specimens, 18.81% were detected as MTBC and 5.78% as NTM species. Each pulmonary TB suspect patient needed clinical settings to suspect causative agents of MTBC and/or NTM species; clinicians have to understand the local epidemiological data for the evaluation of causes of lung infection to determine appropriate therapy.
Full Text Available Background: Tympanic membrane perforation is a hearing problem that has become a health problem in the society. In Indonesia, there are only a few studies regarding tympanic membrane perforation. This study was aimed to observe the frequency and clinical characteristics of tympanic membrane perforation patients. Methods: This was a descriptive study performed from August to September 2014. The data was taken retrospectively from medical records of tympanic membrane perforation patients at Dr. Hasan Sadikin General Hospital from January 2011 to December 2013. Results: Of 579 tympanic perforation patients, there were only 214 medical records met the inclusion criteria. The frequency of tympanic membrane perforation patients increased in 2011 it was 28%, in 2013 it was 37.6%. The number of male patients (53.3% was higher than female patients’. Most patients were in productive age (83.2%. Most patients came with the chief complaint of discharge from ear (36.4% and the most common etiology was infection (84.1%. Otological examination showed that most patients had unilateral perforation (73.8%. Based on the size of perforation, central perforation (52.3% was the most common otological finding. From audiogram, most patients had conductive hearing loss (41.5% with moderate degree of hearing loss (30.4%. Most patients were treated by medications (64.5%. Conclusions: The frequency of tympanic membrane steadily increases with clinical characteristic mostly in male patients in productive age admitted with chieft complain of discharge of ear. The most common etiology is infection. Majority of patients have unilateral central perforation that cause conductive hearing lost.
Adrizain, R.; Suryaningrat, F.; Alam, A.; Setiabudi, D.
Antibiotic resistance has become a global issue, with 700,000 deaths attributable to multidrug-resistance (MDR) occurring each year. Centers for Disease Control and Prevention (CDC) show rapidly increasing rates of infection due to antibiotic-resistant bacteria. The aim of the study isto describe the incidence of MDR, extensively drug-resistant (XDR) and pan drug-resistant (PDR) in Enterococcus spp., Staphylococcus aureus, K. pneumonia, Acinetobacter baumanii, P. aeruginosin, and Enterobacter spp. (ESKAPE) pathogens in children admitted to Dr. Hasan Sadikin Hospital. All pediatric patients having blood culture drawn from January 2015 to December 2016 were retrospectively studied. Data include the number of drawn blood culture, number of positive results, type of bacteria, sensitivity pattern. International standard definitions for acquired resistance by ECDC and CDC was used as definitions for MDR, XDR and PDR bacteria. From January 2015 to December 2016, 299 from 2.542 (11.7%) blood culture was positive, with Staphylococcus aureus, Enterococcus spp., Enterobacteriaceae, Pseudomonas aeruginosa, Acinetobacter spp., respectively 5, 6, 24, 5, 20 with total 60 (20%). The MDR and XDR pathogen found were 47 and 13 patients, respectively.
Guzman Campos, Jeremy; Vargas Navarro, Jonnathan
A measurement was made of the number of radiation doses emitted by fluoroscopy equipment used in Hospital Dr. Max Peralta, specifically at the Centro de Deteccion de Cancer Gastrico. The analysis has included the factors could be influencing on increase of the total dose to the patient, by means of indicators that directly affect the unnecessary increase in dose, such as: the procedure, sequences of images, indicators of dosage levels, varying conditions of actual studies, variations dose levels and production process factors. [es
Full Text Available Radiation therapy for head and neck cancer frequently caused severe salivary gland dysfunction. The salivary gland dysfunction possibly decreased the protective function of saliva and caused dental caries. The purpose of this study was to obtain an illustration about DMF-T index in patient undergoing radiation therapy with LINAC X-ray radiation for head and neck cancer at Department of Radiotherapy, Dr. Hasan Sadikin Hospital in January-February 2007. The study was a simple descriptive. The study was conducted on 7 males and 9 females undergoing radiation therapy with LINAC X-ray radiation for head and neck cancer. The ages of patient are between 37 years and 77 years. The severity of caries was measured by DMF-T index. DMF-T index in 16 patient undergoing radiation therapy with LINAC X-ray radiation for head and neck cancer at Dr. Hasan Sadikin Hospital is 10.6 as the result of this study. The conclusion of this study showed that the DMF-T index in 16 patient undergoing radiation therapy with LINAC X-ray radiation for head and neck cancer at Dr. Hasan Sadikin Hospital had very high grade based on WHO classification, which the value was over 6.6.
María Elena Márquez-Caraveo; Eduardo Arroyo-García; Armida Granados-Rojas; Angélica Ángeles-Llerenas
The activities concerning mental health care of psychiatric disorders during more than 50 years of service (1966-2016) at the Children’s Psychiatric Hospital “Dr. Juan N. Navarro”(HPI), as well as the progressive development of teaching and research, have contributed to its positioning as a leading institution in medical care of high specialization. This has been possible through the training of human resources that focus the quality of care to the children and their families. The hospital ha...
Full Text Available Background: Development of infection in burned patients is a crucial matter because it may increase morbidity and mortality. Factors contributing to high risk for infections are disrupted skin barrier, dysfunction of the immune system and prolonged hospitalization. Crowded hospital condition and transfer of patients from one unit to another can affect development of infection caused by environmental factors. The aim of the study was to identify the antimicrobial suspectibility of bacterial isolated from Burn Unit in Dr. Hasan Sadikin General Hospital, Bandung. Methods: A descriptive study was carried out in Burn Unit Dr. Hasan Sadikin General Hospital Bandung, Indonesia, from June to September 2013. A total of 30 environment samples were collected and cultured to identify the bacterias. Futhermore, the colonies found, underwent antimicrobial susceptibility test. Results: Most common bacteria found from the environmental samples in Burn Unit was Staphylococcus saprophyticus (24%. Other bacterias found were Klebsiella pneumonia (17%, Acinetobacter baumanii (15%, Staphylococcus epidermidis (12%, Bacillus sp.(12%, Pseudomonas sp.(7%, Staphylococcus aureus (5%, Enterobacter aerogenes (5% and Serratia sp. (2%. Some bacteria still had good sensitivity to antibiotics while the Enterobacteriaceae were almost completely resistant to antimicrobial used in the study. Conclusions: The most common bacteria found from the environment samples in Burn Unit is Staphylococcuss aprophyticus. Additionally, Klebsiella pneumoniae as one of the Enterobacteriaceae groups, appears as an emerging hospital associated infection pathogen with their resistant to many antimicrobials.
María del Carmen Jiménez Martínez
Full Text Available Introducción: las meningoencefalitis constituyen un grupo de gran importancia dentro de las enfermedades infecciosas, en las cuales la introducción de los antibióticos hizo posible que fuese curable, pero la morbilidad y la mortalidad de esta enfermedad continúan siendo inaceptablemente altas. Objetivo: identificar la terapia antimicrobiana usada en las meningoencefalitis. Métodos: estudio descriptivo, observacional y retrospectivo. Se estudiaron 150 pacientes con diagnóstico de meningoencefalitis viral o meningoencefalitis bacteriana confirmada por cuadro clínico, estudio citoquímico del líquido cefalorraquídeo o identificación del agente etiológico. Todos se atendieron en el período comprendido entre los años 2004 y primer semestre del 2011, en los servicios de Medicina y Pediatría del Hospital Militar Central "Dr. Luis Díaz Soto". Se empleó el diseño de un estudio de utilización de medicamentos que hace uso de la indicación-prescripción y el esquema terapéutico para este tipo de paciente. Resultados: se utilizó terapia antimicrobiana en el 18,67 % de pacientes con meningoencefalitis viral (23,93 % de 117 y el 22 % con bacteriana (100 % de 33 casos. Las antibioticoterapias más usadas fueron la ceftriaxona (como único antibiótico en la meningoencefalitis viral, y asociada (ceftriaxona más vancomicina en la meningoencefalitis bacteriana. El patógeno más aislado (Streptococcus pneumoniae fue tratado en la mayoría de los casos con ceftriaxona más vancomicina. La generalidad de los tratamientos para la meningoencefalitis bacteriana duró menos de 21 días. Conclusiones: se evidenció el uso de terapia antimicrobiana en pacientes con meningoencefalitis viral y la coincidencia entre la terapia empírica y la específica en la meningoencefalitis bacteriana.
This study analyzes the effect of episode-of-care payment and patient choice on waiting time and the comprehensive quality of hospital care. The study assumes that two hospitals are located in two cities with different population sizes and compete with each other. We find that the comprehensive quality of hospital care as well as waiting time of both hospitals improve with an increase in payment per episode of care. However, we also find that the extent of these improvements differs according to the population size of the cities where the hospitals are located. Under the realistic assumptions that hospitals involve significant labor-intensive work, we find the improvements in comprehensive quality and waiting time in a hospital located in a small city to be greater than those in a hospital located in a large city. The result implies that regional disparity in the quality of hospital care decreases with an increase in payment per episode of care.
Lauterbach, Karl W.
Full Text Available The intended adoption of a global reimbursement system for inpatient care in Germany envisions identical payments for identical treatments at different hospitals. This may lead to losses in some hospitals and may cause problems for the supply with health care facilities in the long run if there a important regional cost differences. Cost and performance data of 1112 hospitals in Germany have been analysed for regional differences in 2001: As regional categorizations we used official classification schemes based on centrality. The investigation does not support the postulation of additional payments for selected regions in Germany accounting for level cost-differences between hospitals. Confounding influence factors like ownership and hospital size seem to be more important. We recommend further investigations to evaluate regional cost-differences on the level of medical wards and using more risk-adjusted data. The examination of the individual case is necessary.
Márquez-Caraveo, Maria Elena; Arroyo-García, Eduardo; Granados-Rojas, Armida; Ángeles-Llerenas, Angélica
The activities concerning mental health care of psychiatric disorders during more than 50 years of service (1966-2016) at the Children's Psychiatric Hospital "Dr. Juan N. Navarro" (HPI), as well as the progressive development of teaching and research, have contributed to its positioning as a leading institution in medical care of high specialization. This has been possible through the training of human resources that focus the quality of care to the children and their families. The hospital has progressed towards diagnostic and therapeutic care of outpatients through the creation of specialized clinics (emotions, behavior, development, adolescence, among others) and the development of more actualized and integral therapeutic programs (behavioral psychotherapy, cognitive behavioral, psychodynamic; individual, group, family, etc.). In the field of education, the hospital has been the most important institution in the training of child psychiatrists in Mexico and its recognition as a research interdisciplinary center has grown.
María Elena Márquez-Caraveo
Full Text Available The activities concerning mental health care of psychiatric disorders during more than 50 years of service (1966-2016 at the Children’s Psychiatric Hospital “Dr. Juan N. Navarro”(HPI, as well as the progressive development of teaching and research, have contributed to its positioning as a leading institution in medical care of high specialization. This has been possible through the training of human resources that focus the quality of care to the children and their families. The hospital has progressed towards diagnostic and therapeutic care of outpatients through the creation of specialized clinics (emotions, behavior, development, adolescence, among others and the development of more actualized and integral therapeutic programs (behavioral psychotherapy, cognitive behavioral, psychodynamic; individual, group, family, etc.. In the field of education, the hospital has been the most important institution in the training of child psychiatrists in Mexico and its recognition as a research interdisciplinary center has grown.
Sánchez Bisonó, J R; Gómez Rosich, A; Amor Gea, J F; García Sánchez, M J; Campoy Domene, L F; Peña Migallón-Sánchez, P
The hospital mortality rate in our centre es 2.34% (264 deaths from a total of 11,336 discharges between 1991 and 1993). The most frequent causes are acute myocardial infarction and cerebrovascular accidents, followed in descending order by pneumonia, chronic bronchitis, congestive heart failure, upper GI haemorrhage, GI tumours, liver cirrhosis, lung tumours and arrhythmias. Our analysis reflects a mortality pattern of a rural population with an age pyramid in which 52% of the patients are older than 45 years. The pattern also reflects the little impact of accidents on our mortality. A 87% of the deaths were older than 65 years with a male to female ratio of 1, 6 and a Swaroop index of 93% and 94% for males and females respectively.
J. Jesús Pérez M.; Noé Alfaro A.; Eusebio Angulo C.; Mireya Robledo A.
Esta publicación muestra la prevalencia de apéndice preauricular y la frecuencia de algunas variables relevantes. Se estudió la de prevalencia en 254 neonatos con apéndice preauricular diagnosticada en el momento del nacimiento, en 129,426 nacimientos consecutivos ocurridos en el Hospital Civil de Guadalajara (México) Dr. Juan I Menchaca durante el período de 1990 a 2003. Con una entrevista directa a las madres se obtuvo información de las variables relevantes. Se midió la prevalenci...
NEUMOCISTOSIS EN EL SERVICIO DE MEDICINA INTERNA, COMPLEJO HOSPITALARIO UNIVERSITARIO “DR. LUIS RAZETTI”, BARCELONA, VENEZUELA, 2011-2012 I PNEUMOCYSTOSIS IN THE INTERNAL MEDICINE SERVICE, UNIVERSITY HOSPITAL COMPLEX “DR. LUIS RAZETTI”, BARCELONA, VENEZUELA, 2011-2012
Full Text Available In Venezuela and in the state Anzoátegui, the pneumocystosis, is little studied. To weigh that it is an infection opportunist caused by Pneumocystis jirovecii, it causes pneumonia of high morbility and mortality. The inmunocompromised patient is those that present bigger risks of acquiring this infection. The objectives of this investigation were to determine the infection frequency for P. jirovecii in patient with breathing symptoms and immunocompromised hospitalized in the Service of Internal Medicine of the Complex Hospital University “Dr. Luis Razetti", and to describe the clinical parameters, of laboratory, radiological and epidemic. To increase the sensibility of the diagnosis etiologic of the pneumocystosis you employment the combination of microscopic methods (Giemsa and direct immunofluorescence technique. 52 samples of spontaneous sputum were studied, which were processed by fluidification -concentration. Results: 8 patients (15.38% they were positive. The most frequent clinical manifestations among the patients with pneumocystosis were the dyspnea (75%, cough (62% and bullous (50% they were the most common signs among those infected, the one infiltrated alveolar (62.5% and the spill pleural (37.5% they prevailed as radiological signs. Was the LDH presented in values 300 UI/L in 5 of the positive patients. Other common discoveries were: moderate anemia and breathing alkalosis. The evaluated epidemic aspects were the gender, occupation, smoking, accumulation and comorbidities, in this last aspect, the diabetes, hypertension and infection for the VIH was opposing comorbidities among these patients. The confirmation of the infection in the state Anzoátegui, demonstrates that in this hospital the agent exists and probably you this underdiagnosticated the pneumocystosis.
Sinorita, Hemi; Saádah; Jazakillah, Setyowati
to recognize the effect of education and diet on glycemic control in patients with type 2 diabetes mellitus at Dr. Sardjito Central General Hospital, Jogjakarta. a cross-sectional study was conducted in 88 patients with type 2 DM who had routine visit to the outpatient clinic in Endocrinology Division of Dr. Sardjito Central General Hospital, Jogjakarta. As inclusion criteria, patients who had routine visit in 3 month continuously with fasting plasma glucose (GDN) 126 mg/dl as poor glycemic control group. Data were recorded which included age, sex, period of DM, daily diet pattern, and education received. we found that glycemic control was not affected by sex (p=0.52) and age (p=0.38), but it was affected by period of DM (p=0.02). Glycemic control in the present study was affected by dietary pattern (p=0.01), but not by education (p=1.00). the present study has found significant correlation between regulation of dietary pattern and glycemic control (p=0.01).
Ainna Binti Mohamad Dat
Full Text Available Background: Osteoarthritis is one of the major disabilities among elderly. One of its well-recognized potent risk factors is obesity. The aim of this study was to identify the body mass index and severity of knee osteoarthritis patients who were treated in Dr. Hasan Sadikin General Hospital Bandung. Methods: A descriptive study was carried out to 9 patients of the Medical Rehabilitation Policlinic at Dr. Hasan Sadikin General Hospital Bandung in November 2012. Patients were diagnosed as having knee Osteoarthritis based on American College of Rheumatology clinical classification. Exclusion criteria were patient having previous trauma in spine and lower limb, having bleeding disorder like hemophilia, incomplete data in medical records and incomplete data in questionnaire. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC was used to measure the intensity of pain, stiffness, and functional difficulty. The weight (kg and height (cm of the patients were measured and the Body Mass Index was calculated by Weight (kg/Height² (m. The data were analyzed using frequency distribution. Results: The patients who came to the Medical Rehabilitation Policlinic had ranged in age from 57 to78 years, mostly female with knee Osteoarthritis bilateral. Out of 9 patients, 5 patients were overweight, followed by normal BMI and obese type I. Patient with obese type 1 had the highest WOMAC score. Conclusions: Most of the patients with knee osteoarthritis bilateral are overweight and the patient with obese type 1 has the highest WOMAC score.
Vaona, L.; Ciroi, S.; Di Mille, F.; Cracco, V.; La Mura, G.; Rafanelli, P.
Although the properties of the narrow-line region (NLR) of active galactic nuclei (AGN) have been deeply studied by many authors in the past three decades, many questions are still open. The main goal of this work is to explore the NLR of Seyfert galaxies by collecting a large statistical spectroscopic sample of Seyfert 2 and Intermediate-type Seyfert galaxies having a high signal-to-noise ratio in order to take advantage of a high number of emission lines to be accurately measured. 2153 Seyfert 2 and 521 Intermediate-type Seyfert spectra were selected from Sloan Digital Sky Survey Data Release 7 (SDSS-DR7) with a diagnostic diagram based on the oxygen emission-line ratios. All the emission lines, broad components included, were measured by means of a self-developed code, after the subtraction of the stellar component. Physical parameters, such as internal reddening, ionization parameter, temperature, density, gas and stellar velocity dispersion were determined for each object. Furthermore, we estimated mass and radius of the NLR, kinetic energy of the ionized gas and black hole accretion rate. From the emission-line analysis and the estimated physical properties, it appears that the NLR is similar in Seyfert 2 and Intermediate-Seyfert galaxies. The only differences, lower extinction, gas kinematics in general not dominated by the host galaxy gravitational potential and higher percentage of [O III]λ5007 blue asymmetries in Intermediate-Seyfert, can be ascribed to an effect of inclination of our line of sight with respect to the torus axis.
Blanco Chaves, Ana Lorely
Cervical cancer is one of the leading causes of death among women worldwide, occupying in Costa Rica the fourth place. The human papillomavirus (HPV) is shown that is linked to at least 99.7% of cases, mainly associated with high risk genotypes. A study was conducted of type descriptive where were implemented molecular techniques such as: PCR, reverse hybridization for the determination of different HPV genotypes, and immunohistochemical detection of cell proliferation marker Ki67 in paraffin-embedded cervical biopsies from patients at the Hospital Dr. Max Peralta in Cartago, during the year 2013. The most frequent genotype that was determined among the study population has been 39, which was presented in 53% of cases. In addition, 65% of biopsies studied have showed mixed infections of HPV. (author) [es
Shaleh, A. S.; Fahrial; Siregar, M. L.; Jamil, K. F.
Human Immunodeficiency Virus (HIV) / Acquired Immune Deficiency Syndrome (AIDS) is a retrovirus that infects the human immune system. Damaged immunity in HIV/AIDS patients is marked by a decline in CD4 cells. Opportunistic infections appear differently, depending on the levels of immunosuppressive degrees, and the frequency of opportunistic infections in the environment. This study aims to describe the CD4 at various clinical stages of HIV/AIDS with tuberculosis and non-tuberculosis opportunistic infections (OI). Descriptive study with a cross-sectional design. This study is secondary data obtained from the medical records of patients with HIV/AIDS in the period of January 2011 - December 2015 at dr. Zainoel Abidin Hospital in Banda Aceh. The samples that met the inclusion criteria were 135 people with 63 cases were tuberculosis OI, 33 cases were non-tuberculosis and 39 cases were without OI. The study showed CD4 tuberculosis OI and 93.9% for non-tuberculosis OI.
Rojas Calderon, Ingoberg
Epidemiology, clinical morbidity and mortality are described in patients with infection by Angiostrongylus costaricensis at the Hospital Nacional de Ninos 'Dr. Carlos Saenz Herrera', of June 2010 - September 2013. 52 patients with diagnosis of infection by Angiostrongylus costaricensis are studied by identification of the parasite, their larvae or eggs, latex agglutination test and/or indirect immunofluorescence. The clinical findings, evolution and laboratory results are determined in the patients with A. costaricensis. The treatment used, conservative and surgical management are identified in the study patients. The latex agglutination has been the serologic method most used, cheaper and with more reliable results. The complications and mortality are determined. Pathologic findings are described in patients infected by A. costaricensis [es
Utomo, H. T.; Nugroho, A.; Harijanto, P. N.
Methicillin-resistant Staphylococcus aureus (MRSA) presents nosocomial infection problemsin hospitals. Identification of risk factors related to MRSA infection is a concern among healthcare provider. A retrospective case-control study was conducted to identify MRSA infection proportion among isolates, also to identify risk factors amonginpatients at Prof. dr.R. D. Kandou General Hospital, Manado. Data were from themedical record, from patient’s culture isolateswith positive Staphylococcus aureus infection from January-December 2015. Case subject isolated cultures of MRSA and control subject isolated cultures of non-MRSA. Bivariate analysis were performed in 10 independent variables (age, length of stay, prior use of antibiotics before cultures, history of HIV infection, prior use of corticosteroid, history of malignancy, history of chronic disease, prior use of medical tools (catheter, ventilator, etc), history of invasive medical procedure, history of hospitalization before). All variables with a p-value<0.05 were into multivariate analysis with forwarding stepwise logistic regression. Mean subjects age were 48.13 ± 2.05 years old and length of stay were 8.65 ± 0.25 days, and only prior antibiotic use-variable were considered statistically significant (p = 0.017; OR 1.889; 95%CI 1.595 – 2.238).
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.
Syahril, Syahril; Andini, Isnani Yuli
Internal accountants has critical leverage to encourage hospitals to be involved in activities such as social or corporate social responsibility.This study aims to examines the role of internal accountants in the implementating of corporate social responsibility at RSUD Moh. Anwar Sumenep District. Research uses descriptive (qualitative) approach to interpret and describe data that obtained from observation, interview and documentation. This research concludes that RSUD Moh. Anwar Sumenep Dis...
Full Text Available Patent ductus arteriosus is treated according to its indications conservatively with medications or by surgical closure; the latter was traditionally performed by an open technique, then later, the percutaneous approach was developed for selected cases and finally, in recent years, it has been done by thoracoscopic surgery with success challenging percutaneous results. However, at our hospital, this had not been tried before. We present the case of a female patient who met the ideal criteria for this procedure to be performed and in whom it was successfully accomplished without complications; hence our report, motivated by the historical importance and as a baseline for future cases.
Data was collected using a pre-tested, coded questionnaire and analyzed using SPSS computer system. A total of 94 geriatric trauma patients constituting 22.7% of all trauma admissions ... Pre-hospital care was recorded in 5.3% of cases. The musculoskeletal (72.3%) and head (66.0%) regions were commonly affected.
Tony Castillo Calzadilla
Full Text Available El objetivo de esta investigación es diagnosticar la gestión de mantenimiento de la red hospitalaria del estado Anzoátegui, a partir de un estudio de caso Hospital "Dr. Luis Razetti", siendo éste el más importante de la región y con ello determinar las causas por las cuales los activos en la red hospitalaria se deterioran tan aceleradamente. El estudio se fundamenta en una investigación "descriptiva" con diseño de campo, recurriéndose a directivos, supervisores y operarios del hospital, quienes respondieron un cuestionario dirigido adaptado de la Norma covenin 2500- 93. Se concluyó que la red hospitalaria del Estado se encuentra en estado grave en cuanto a la Gestión del Mantenimiento para este tipo de instalaciones y que en las mismas se carece de una visión de ingeniería clínica.
Skerk, V; Schönwald, S; Bobinac, E; Bejuk, D; Zrinsćak, J
A total number of 836 episodes of bacteremia and fungemia were examined in 823 hospitalized patients in the University Hospital of Infectious Diseases "Dr Fran Mihaljević" Zagreb from the beginning of 1987 to the end of 1991. Twenty-five percent of them were nosocomial bacteremias and 5% were polymicrobial bacteremias. The most frequently isolated causative agents were Salmonella spp. (26%), Escherichia coli (17%), Streptococcus pneumoniae (11%) and Staphylococcus aureus (8%). There were 34% of gram-positive bacteremias. The increased frequency of nosocomial bacteremias caused by coagulase-negative staphylococci was recorded. The frequency of coagulase-negative staphylococci strains resistant to gentamicin and Klebsiella spp. strains resistant to cefotaxime was increased. Shock was present in 19% of episodes. Relation between septic shock occurrence and causative agent of bacteremia was not proved. Mortality in patients with bacteremia was 13%, and total mortality was 20%. The outcome of the disease was in direct relation with causative agent of bacteremia. The initial empiric antimicrobial therapy was prolonged in 91% of episodes of bacteremia after blood culture results were known.
Moro Alujas, Yassell N.
The extent of the problem on the radiological exposure of anesthesiologists in the operating rooms was identified in the Hospital Rafael Angel Calderon Guardia, San Jose, Costa Rica. It was necessary to establish the risks in the professional disciplines more exposed to ionizing radiations, including Anesthesiology. Provides information on the radiations received by the anesthesia personnel as a risk factor of labor during professional practice. Within the findings were met dose ionizing radiation received by the participating subjects. It was determined that the monthly doses do not reach the limits of permissible dose average. Besides, no relationship was found between the number of procedures that were used ionizing radiations and the values of dosimetric measurements personal; but, if the type of procedure. In this way was showed that in some radiointerventional procedures there is a higher risk of irradiation [es
Protocolo de tratamiento de cicatrices queloides en el pabellón auricular del Hospital General Dr. Manuel Gea González Treatment protocol of auricular keloid scars in the General Hospital Dr. Manuel Gea González
C. Gutiérrez Gómez
Full Text Available Las cicatrices queloideas son una de las patologías de más difícil tratamiento por el alto porcentaje de recidivas que presentan, hasta un 100 % en tratamientos únicos y un 50 % en tratamientos combinados. El pabellón auricular es un blanco frecuente de esta patología. Presentamos el protocolo de tratamiento empleado en nuestro hospital en los últimos 6 años con terapia combinada en 51 pacientes y 64 pabellones auriculares afectados por queloides. Aplicamos de forma preoperatoria 3 dosis de triamcinolona o betametasona intralesional, con diferencia de 4 a 6 semanas entre dosis y 4 semanas después de la última dosis, realizamos resección de la cicatriz dejando piel suficiente para el cierre sin tensión. En los pacientes que presentaban antecedente de resección quirúrgica se añadió al tratamiento el uso de colchicina, comenzando el día de la cirugía y manteniéndolo durante 8 semanas, a dosis de 1 mg. al día, con control de pruebas de función hepática pre y postratamiento. En el 74.5 % de los casos la cicatriz queloide fue unilateral; el 56.8 % de los pacientes fueron mujeres; las edades fluctuaron entre los 8 y los 61 años con una media de 24 años de edad. En el 65 % de los casos el queloide se presentó en el pabellón auricular derecho y en cuanto a su localización dentro del mismo, el 42 % se presentó en el lóbulo. La causa en el 56 % de los casos fue por perforación. El 18.6 % de las cicatrices tratadas cedieron con la infiltración intralesional; de las 48 cicatrices que recibieron tratamiento quirúrgico, hubo recidiva en el 12.5 % (6 cicatrices, con un seguimiento de entre 8 meses a 6 años.Keloid scars are one of the most difficult pathologies to treat because its high rate of recurrence, from 100 % with single treatment to 50 % with combined therapy. The auricle is a frequent localization of keloids. We report our experience in the last 6 years with combined therapy in 51 patients and 64 auricles with keloid
Full Text Available There is still a controversy among the neurologists whether brain CT scan must be performed on the mild head trauma patients. This study was executed to find out the correlation between the brain CT scan image findings and its clinical impairment among the mild head trauma patients with Glasgow coma scale (GCS score of 13 to 15. The study was a retrospective study by analyzing the uniform medical records of the head trauma patients hospitalized at the Neurology ward of Dr. Cipto Mangunkusumo Hospital within the period of 1999 to 2001. During that period 1,663 patients were hospitalized due to head trauma, and 1,166 of them (70.1 % were suffered from mild head trauma patients with GCS score of 13-15. Among those with brain CT scan examinations (N: 271, the neurological abnormalities were found on 144 (53.1% of patients, consisted of cerebral edema (11,4%, intracerebral hemorrhage (5.5%, epidural hemorrhage (16.2%, subdural hemorrhage (18.1%, subarachnoid hemorrhage (5.5%, and combination (13.8%. The further analysis showed that cranial nerves disturbance, amnesia, loss of conciousness for more than 10 minutes, and vomiting are significantly correlated to the brain CT scan abnormality. Combination of the above four clinical signs and symptoms have sensitivity of 90 % in predicting brain insults. This findings may be used as a simple set of clinical criteria for identifying mild head trauma patients who need undergo CT scan examination. (Med J Indones 2004; 13: 156-60 Keywords: mild head injury, brain CT scan
Vera Solórzano, Venus; Sancán Baque, Mercedes
The research work is about the management of hospital waste and its relationship with infectious and contagious diseases, which is exposed to the staff of the hospital of the IESS of Guayaquil, Dr. Teodoro Maldonado Carbo; where is has demonstrated that there are consequences, not only for the health of the human resource that works, but also damages to the environment, by the improper handling of such waste; What is considered to apply biosafety standards, in order to minimize the amount of ...
He had four children Irene Majale,. Prof. Mike Majale (Architect) Victoria Majale Ojiambo and Chris Majale. Dr. Majale died on 21st April 1978. As an orthopaedic Surgeon he worked at Kenyatta. National Hospital (KNH), Kabete Orthopaedic Unit and. Armed Forces Memorial Hospital. He did not do any private practice.
Suárez Iznaga, Rodolfo; Pozo Almaguer, Armando del; Gil Valdés, Doris; Fleitas Anaya, Ricardo
The Nuclear Medicine Service of the University Hospital Surgical Clinic D r. Salvador Allende , located in the municipality of Cerro, began the provision of scintigraphic services in May 2013. A retrospective descriptive and analytical study was carried out from May 2013 to December 2015 from the archived scintigraphic reports. The objective of the study was to present the results of the Nuclear Medicine Service during this period. The data were reflected in percentages, using tables and graphs. To determine the existence of a statistically significant relationship between the variables were used: Chi square test with a level of significance α = 0.05 being positive if p <0.05. Until December 2015, 798 cases had been reported, which included Bone scans (88.34%), renal (10.65%) and thyroid scans for follow-up of cancer patients (1%); (76.82%) and the female sex was the most attended with 446 (55.89%) patients, there were no statistically significant differences between the scintigraphic studies and the sex of the patients. There were statistically significant differences between the scintigraphic studies and the age of the patients. The most frequent diagnoses were: bone scintigraphy, metastasis in 86.52% of patients, renal cyst scintigraphy (48.78%) and dynamic scintigraphy of the kidneys with obstructive functional involvement (63.64%) It was recommended to create the necessary technical and human resources conditions to be able to introduce other scintigraphy studies in the Nuclear Medicine Service such as: breast scintigraphy and lymph node scans, high demand in the medical center. In addition, to use scientifically the criteria of approval of patients in the consultation of classification of the service, with the aim of achieving a better selection of the applicants for scintigraphic studies, which would favor a more rational and efficient use of these studies.
Caminiti, Carolina; Saure, Carola; Bomer, Ilanit; Brea, Mercedes; González Ramos, Javier
Craniopharyngiomas are histologically benign malformations located between the pituitary and hypothalamus that may affect key hormone secretion for endocrine regulation and satiety modulation. Although this is a relatively benign disease, the combination of severe hypothalamic obesity and associated comorbidities results in a reduced quality of life. To assess the nutritional status of patients after craniopharyngioma surgery. Patients younger than 21 years old at the time of the study who required craniopharyngioma surgery at Hospital de Pediatr.a Garrahan and who signed an informed consent. Anthropometric characteristics, body composition by impedance analysis, energy expenditure by indirect calorimetry and energy intake were assessed. Insulin resistance and dyslipemia were estimated. A total of 39 patients were included; 41% had a normal weight and 59% were obese. Overall, 68% of patients had a central fat distribution; 40% had insulin resistance; and 32%, dyslipemia. No significant differences were observed in terms of insulin resistance, dyslipemia, energy expenditure at rest, or energy intake between normal weight and obese patients. Among obese patients, 77% had a low energy expenditure, regardless of their percentage of lean body mass (62 Å} 2.7% versus 61.2 Å} 1.8% of normal versus low energy expenditure at rest; p = 0.8). A total of 59% of the studied population was obese. No significant differences were observed in terms of metabolic complications between normal weight and obese patients. A lower energy expenditure was observed, regardless of the lean body mass percentage and a similar energy intake. Sociedad Argentina de Pediatría
Vega, Elena María; Fontana, Daniela; Iturrieta, Martha; Segovia, Liliana; Rodríguez, Gabriela; Agüero, Sandra
To achieve rational use of antibiotics (ATB), is necessary to know its use and prescription patterns over time, Objective: To describe and analyze the characteristics of the use of ATB in the Guillermo Rawson Hospital (GRH) adult intensive care unit (ICU). Observational, descriptive, longitudinal and retrospective study (2008-2011). Pharmacy and Statistics records were consulted, ATC code was used, the group analyzed was J01, Oral or parenteral DDD were assigned, Data was processed with Excel 2007, Unit of measure: DDD/100 bed-days, for each ATB per year and an average of use. Over 4 years, 48 different medicines were dispensed (33 drugs), The average consumption of ATB was 177,07 DDD/100 bed-days and distribution per year was: 183,10, 165,90, 180,94, 178,34, The DDD/100 bed-days average for treatment groups more used were: penicillin (57.10), other β-lactam antibacterials (48.01), other antibacterials (21.07), trimethoprim and sulfonamides (19,54), quinolones (15,64), macrolides/azalides and lincosamides (6,53), aminoglycosides (5,65) and tetracyclines (3,53), There were changes in consumption without clear pattern of increase or decrease. ATB used in the ICU and its variation in use between 2008-2011 were described, The ATB most used were penicillins and other β-lactams and 2008 was the year that more ATB was dispensed. Understanding these patterns of consumption will be useful to develop a founded antibiotic policy reached by consensus and beneficial to the patients.
Orozco-Valerio, María de Jesús; Celis de la Rosa, Alfredo de Jesús; Méndez-Magaña, Ana Cecilia; Miranda-Altamirano, Rodolfo Ariel
Burns are a public health problem, ranking among the 20 principal causes of morbidity in Mexico. Children are a more vulnerable group to suffer from these injuries. For that reason, we analyzed cases in order to gain a better comprehension and to propose preventive measures for this problem. The aim of the study was to determine the epidemiological profile of those injuries to allow us to plan and implement actions for burn prevention. We conducted a cross-sectional study that included demographic characteristics of the child, the parents and the burn injuries from children treated at this Burn Unit. Statistical analysis was done to calculate amounts, proportions and 95% confidence intervals. The epidemiological profile of the injuries included males (63.4%) <5 years of age (65.2%) with educational level according to their age (56.2%). Parents of the included children were <35 years old with basic educational level. Burns were caused by hot water (56.2%) and occurred between noon and midnight (73.0%). The majority of the burns were shallow and deep second-degree or minor (69.2%) and affected <20% of body surface area (74.5%). This epidemiological profile paved the way for preventive actions beginning with scientific research to guide the actions in a progressive direction along with the cooperative actions of public and private institutions in the development of programs and strategies. The end result would be the establishment of a public policy for accidental injuries. Copyright © 2015 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.
Skerk, Vianja; Cajić, Vjeran; Markovinović, Leo; Roglić, Srdan; Zekan, Sime; Skerk, Vedrana; Radosević, Velena; Tambić Andragević, Arijana
A total of 835 patients with symptoms of chronic prostatitis syndrome and no evidence of structural or functional lower genitourinary tract abnormalities were examined in a three year period at the Outpatient Department for Urogenital Infections, University Hospital for Infectious Diseases "Dr. Fran Mihaljević" Zagreb, Croatia. Disease etiology was determined in 482 (57.72%) patients. Chlamydia trachomatis was proved to be the causative pathogen in 161 patients, Trichomonas vaginalis in 85, Escherichia coli in 68, Enterococcus in 51, Proteus mirabilis in 20, Klebsiella pneumoniae in 9, Streptococcus agalactiae in 15, Ureaplasma urealyticum in 49 patients with chronic prostatitis. Other patients had mixed infection. In 257 (53.32%) of 482 patients, the inflammatory finding (>10 WBCs/hpf) was found in EPS or VB3. Normal WBCs/hpf (<10) was found in 103 (63.98%) of 161 patients with symptoms of chronic prostatitis in whom C. trachomatis was detected in EPS or VB3, in 50 (58.82%) of 85 patients in whom Trichomonas vaginalis was isolated, and in 23 (46.94%) of 49 patients in whom Ureaplasma urealyticum was isolated.
Full Text Available Si bien los efectos teratogénicos del alcohol fueron descritos desde hace más de 40 años, muchas mujeres en el mundo continúan consumiendo alcohol durante el embarazo. Se realizó un análisis de archivo en el Hospital Civil de Guadalajara Dr. Juan I. Menchaca a fin de conocer el porcentaje de mujeres que reportaron consumir alcohol durante el embarazo entre 1991 y 1998, su asociación con el consumo de tabaco y drogas ilícitas, así como variaciones de acuerdo a la edad. Se encontró una prevalencia de 2.42% que se mantiene en los años analizados, el consumo más frecuente es el de alcohol asociado a tabaco y un efecto de la edad en los patrones de consumo donde la asociación alcohol- droga ilícita es más frecuente entre las mujeres más jóvenes.
Yudelkys Clairat Sierra
Full Text Available Se realizó un estudio descriptivo y transversal con vistas a evaluar la calidad de la atención en el Servicio de Neonatología del Hospital General Docente "Dr. Juan Bruno Zayas Alfonso", de septiembre de 2013 a marzo de 2014, para lo cual fue dividida la investigación en 3 dimensiones: estructura, proceso y resultados; y se establecieron diferentes criterios, indicadores y estándares. De forma general, se identificaron deficiencias en la calidad de la atención respecto a la estructura del Servicio, en el que no se contaba con ningún pediatra y de los 12 neonatólogos que debían estar laborando, solo lo hacían 7. En cuanto al equipamiento, se detectó que de las 2 cunas térmicas existentes, una se encontraba en mal estado, para 50,0 %, de manera que este indicador resultó inadecuado; de los 5 perfusores disponibles, 1 de ellos estaba en mal estado y 4 aptos, para 80,0 %, lo cual se consideró como inadecuado. Por su parte, de las 3 pesas convencionales, 2 de ellas estaban en mal estado, para 67,0 % del estándar establecido, de modo que este indicador fue inadecuado. Por último, no se detectaron deficiencias ni en el proceso ni en los resultados, por lo que todo el personal fue evaluado como adecuado
Full Text Available Primary Hyperparathyroidism is a fairly common disease that is much more predominant in females. Treatment is surgery and includes removing the parathyroid adenoma or the hyperplastic parathyroid glands. Considering the difficulty of this operation procedure, localization test are utilized including ultrasound, MRI, CT scan, Thallium-Technesium subtraction scan, MIBI scan and a series of other tests. According to the studies regarding these tests, MIBI scan is superior to all the others. In this survery we have studied 110 primary hyperparathyroidism patients that were operated on in Dr.Shariati Hospital between 1356 and 1376. In order to localize the adenoma ultrasound was used in ten patients, thallium-technesium subtraction scan in 38 patients. MIBI scan in 30 patients and CT scan in 3 patients. The sensitivity of MIBI scan was 86% and its specificity was 100%. In comparison, the sensitivity of thallium-technesium scan was found to be about 65%. Our results show that MIBI scan has had a high degree of sensitivity and specificity in our patients and has shown to be the best localization test. Therefore we suggest this test for the localization of all parathyroid adenomas.
Alejandro Cervantes Palomino
Full Text Available Se realizó un estudio prospectivo longitudinal en el Hospital “Dr. Ernesto Guevara de la Serna”, en el período comprendido de enero a diciembre del 2013, con un universo y muestra de 286 pacientes, que acudieron a la consulta de Medicina Natural y Tradicional de forma voluntaria, o que fueron remitidos por otras especialidades médicas con diagnóstico de obesidad y podían o no estar acompañados de otra patología (asma, diabetes mellitus, gota, hipertensión arterial, etc.. A estos pacientes se les realizó diagnóstico oriental, para posterior tratamiento con catgupuntura, la que se aplicó en los puntos escogidos al efecto. Del total de los pacientes (193 femeninas, 93 masculinos evolucionaron de forma satisfactoria 178 y no así el resto. El grupo de edades que más acudió fue el de 26 a 35 años y este mismo grupo etario fue el que mejor respuesta al tratamiento tuvo, poniéndose de manifiesto la efectividad de la terapia aplicada, a la que se le conjugaron dietoterapia y ejercicios.
James M. Learning
Full Text Available Introduction: Surge capacity for optimization of access to hospital beds is a limiting factor in response to catastrophic events. Medical facilities, communication tools, manpower, and resource reserves exist to respond to these events. However, these factors may not be optimally functioning to generate an effective and efficient surge response. The objective was to improve the function of these factors.Methods: Regional healthcare facilities and supporting local emergency response agencies developed a coalition (the Healthcare Facilities Partnership of South Central Pennsylvania; HCFP¬SCPA to increase regional surge capacity and emergency preparedness for healthcare facilities. The coalition focused on 6 objectives: (1 increase awareness of capabilities and assets, (2 develop and pilot test advanced planning and exercising of plans in the region, (3 augment written medical mutual aid agreements, (4 develop and strengthen partnership relationships, (5 ensure National Incident Management System compliance, and (6 develop and test a plan for effective utilization of volunteer healthcare professionals.Results: In comparison to baseline measurements, the coalition improved existing areas covered under all 6 objectives documented during a 24-month evaluation period. Enhanced communications between the hospital coalition, and real-time exercises, were used to provide evidence of improved preparedness for putative mass casualty incidents.Conclusion: The HCFP-SCPA successfully increased preparedness and surge capacity through a partnership of regional healthcare facilities and emergency response agencies.
Knutson, D; Anderson, L
Feasibility analysis of the co-generation retrofit of the Red Deer Regional Hospital pointed to a reasonable payback of capital cost and increased efficiency in operation of the facility. Budget restrictions nearly stopped the project from proceeding. Innovative construction procedures proposed by the Facility Management Group, in particular, Mr Keith Metcalfe, Director of Maintenance, allowed a worthwhile project to reach successful completion. We feel that this model can perhaps be used by similar facilities in the future to achieve their energy efficiency goals.
Photo 01: L. to r.: Dr. Philippe Bloch, CERN CMS ECAL Deputy Project Manager, Dr. Yu Wang, Dr. Etiennette Auffray, CERN, responsible of the CERN ECAL Regional Centre. Photo 02: L. to r.: Dr. Yu Wang, Dr. Philippe Bloch, Dr. Apollo GO, National Central University, Taiwan, Dr. Etiennette Auffray.
With a mortality estimated at 25% when missed, diaphragmatic injuries due to penetrating thoracoabdominal trauma present a diagnostic challenge for both the radiologist and the surgeon. In the current literature, chest x-ray has a sensitivity of 27-60% for left-sided injuries and only 17% for right-sided injuries while, CT scan has a sensitivity of 14-61% and a specificity of 76-99%. Thoracoscopy using a single lung ventilation is one of the modalities of choice for the diagnosis of these injuries with a specificity of 100% and a sensitivity of 87.5%. This was a prospective study; all stable trauma patients with penetrating thoracoabdominal injury aged 18 years and above admitted to the trauma unit at Dr George Mukhari Academic Hospital during the period of the study were included. All patients with penetrating thoracoabdominal trauma who were unstable, or necessitating prompt management and all paediatric patients were excluded from the study. In theatre, under general anaesthesia, we first performed thoracoscopy without single lung ventilation followed by laparoscopy as control on each patient. Data was collected using a standard proforma by the attending surgeon and was analysed by a statistician using IBM SPSS 22 software. A total of 32 patients met the inclusion criteria of which 4 were female (12.5%) and 28 male (87.5%) with the median age of 29 years. Of the 32 patients, 27 had thoracoabdominal stab wounds (84.3%) and 5 had gunshot wounds (15.6%). Fourteen patients (43.75%) had left sided injury and 18 patients (56.25%) had injury to the right side. The incidence of diaphragmatic injury was 37.5% (n = 12). No injuries were missed on thoracoscopy; there was no mortality or morbidity. Thoracoscopy without single lung ventilation is safe and comparable to thoracoscopy with single lung ventilation as a diagnostic tool for diaphragmatic injuries in stable patients with penetrating thoracoabdominal trauma.
Lázaro Quintana Tápanes
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En el artículo se identifican, evalúan las competencias laborales a nivel organizacional, de procesos clínicos – quirúrgicos y se determina su influencia en la calidad del servicio del Hospital “Dr. Mario Muñoz Monroy”. Se elaboran los perfiles de competencias correspondientes y se calcula el indicador desviación competencial, que permite conocer el comportamiento de las competencias en la comparación entre el estado deseado y actual, en los niveles jerárquicos antes mencionados. Se emplean diferentes métodos y técnicas como: análisis documental, entrevista, cuestionario, pruebas de conocimientos, observación, dinámica de grupo, método delphi, análisis-síntesis, inducción-deducción y el paquete estadístico SPSS versión 12.0. La muestra seleccionada está compuesta por clientes internos (médicos, enfermeros y por clientes externos (pacientes-familiares.
Se identifican las competencias menos desarrolladas y se proponen estrategias a implementar por la entidad que permitan mejorar la calidad a través de las competencias laborales.
Full Text Available Background: Brachial plexus is a network of nerves that controls the upper limb. Unfortunately, it can be injured easily which is called brachial plexus injury (BPI. It can cause disability. Until now, the epidemiology of BPI in Indonesia is still lacking. The aim of this study was to describe the characteristics of patients with BPI in Bandung, in order to increase knowledge and attention of health care provider and community to prevent BPI. Methods: This was a descriptive retrospective study. Data from medical records of patients with BPI who underwent electromyography (EMG in Neurophysiology Laboratory Dr. Hasan Sadikin General Hospital, Bandung from 2003 to 2012 were collected. The data included age, sex, mode of injury, affected side and distribution of paralysis. Collected data were presented as percentages shown in tables. Results: A total of 91 cases were collected during study period, which consisted of 69 males and 22 females (76% vs. 24%. Most of them were in productive age group (11−20 years and 21−30 years. The main cause of brachial plexus injury was traffic accident (76%, followed by birth injury. Distribution of paralysis was mostly in postganglionic area of cervical (C5, C6, C7, C8 and thoracal (T1 (67%. Around two third of the cases involved the right side of upper limb. Conclusions: The study showed that most of patients with BPI are male in their productive ages. Traffic accident is the most common cause, and the most affected side is the right side of upper limb.
Fantappie, Marcelo Rosado; Furtado, Daniel Rodrigues; Rumjanek, Franklin David; LoVerde, Philip T.
The eggs produced by sexually mature female Schistosma mansoni are responsible for the pathogenesis of the disease. The eggshell precursor gene p14 is expressed only in the vitelline cells of sexually mature female worms in response to a yet unidentified male stimulus. Herein, we report the identification of a novel nuclear receptor response element in the upstream region of the p14 gene. This element contains the canonical hexameric DNA core motif, 5'-PuGGTCA, composed of an atypically spaced direct repeat (DR17). Schistosome nuclear receptors SmRXR1 and SmNR1 specifically bound to the p14-DR17 element as a heterodimer. SmRXR1, but not SmNR1, bound to the motif as a monomer. Introduction of mutations in the TCA core sequence completely abolished the binding by SmRXR1/SmNR1 heterodimer. This finding supports our hypothesis that the expression of Schistosoma mansonip14 gene is regulated through the nuclear receptor signaling pathway
PF Castro Brezzo; E Dreyer Arroyo
En el presente estudio descriptivo de incidencia, 604 niños menores de 15 años fueron examinados y atendidos en la Clínica de Odontopediatría del Complejo Asistencial Dr. Sotero del Río, con diagnóstico de Traumatismo Dentoalveolar (TDA), desde Enero a Diciembre del 2010. El propósito de este estudio fue caracterizar los TDA de acuerdo a la clasificación de Andreasen y Andreasen, determinar su frecuencia y distribución estacional, tipo y número de dientes afectados, distribución de género y e...
Alshahrani Bander Sayaf
Saudi Arabia Southern Region hospitals have shortage of health professionals especially doctors. Retention of quality doctors and minimizing staff turnover has, therefore, become a major priority for hospitals. Job satisfaction is recognized as key factor influencing retention of doctors. In our paper special emphasis is put on doctors working is Southern Region hospitals of Saudi Arabia. By conducting correlation analysis we determine the most important factors conducive to job satisfaction....
Macías Carpio, Mireya Martha
La investigación presente, gestión de la bioseguridad hospitalaria en el Servicio de Emergencia del Hospital Dr. Teodoro Maldonado Carbo, tiene como objetivo analizar el cumplimiento de las medidas de bioseguridad del personal de la salud y de limpieza, según la gestión actual de manejo de la bioseguridad del hospital. Para cumplir con el objetivo, se empleó la observación directa del sitio, la entrevista al Comité de Control de Infecciones y las encuestas al personal. Durante el estudi...
CONOCIMIENTO DE LA LEY GENERAL DE SALUD RESPECTO DE LAS TRANSFUSIONES SANGUÍNEAS EN MÉDICOS Y PACIENTES TESTIGOS DE JEHOVÁ DEL HOSPITAL DR. DARÍO CONTRERAS DE REPÚBLICA DOMINICANA CONHECIMENTO DA LEI GERAL DE SAÚDE - RESPEITO ÀS TRANSFUSÕES SANGUÍNEAS EM MÉDICOS E PACIENTES TESTEMUNHAS DE JEOVÁ DO HOSPITAL DR. DARÍO CONTRERAS DA REPÚBLICA DOMINICANA KNOWLEDGE OF GENERAL HEALTH LAW WITH RESPECT TO BLOOD TRANSFUSIONS BY PHYSICIANS AND PATIENTS JEHOVAH WITNESSES IN HOSPITAL DR. DARIO CONTRERAS OF DOMINICAN REPUBLIC
Elsa Díaz Santana
Full Text Available Este estudio evalúa hasta qué grado el cuerpo médico del Hospital Dr. Darío Contreras de República Dominicana conoce, respeta, informa y aplica la Ley General de Salud, con relación al derecho del paciente Testigo de Jehová de negarse a ser transfundido (respeto a su autonomía. También si los Testigos de Jehová conocen la Ley General de Salud y hasta qué grado se han beneficiado con la puesta en marcha de la misma. El estudio reveló que ni médicos ni Testigos de Jehová conocen suficientemente dicha ley.Este estudo avalia quanto o corpo médico do Hospital Dr. Darío Contreras de República Dominicana conhece, respeita, informa e aplica a Lei Geral de Saúde em relação aos direitos do paciente Testemunha de Jeová de negar-se a ser transfundido (respeito a sua autonomia; também se os Testemunhas de Jeová conhecem a Lei Geral de Saúde e até que ponto têm se beneficiado diante dessa proposição. O estudo revelou que nem médicos, nem Testemunhas de Jeová conhecem de fato essa lei.This study evaluates up to which degree physicians of Hospital Dr. Dario Contreras of Dominican Republic know, respect, inform and apply the General Health Law in relation to the right of Jehovah witness patients to refuse being blood transfused (respect to their autonomy. It also evaluates whether Jehovah witnesses know General Health Law and in which degree they have been benefited by putting it into practice. The study reveals that Jehovah Witnesses do not know the law.
Eliene de Souza Porto
Full Text Available The study aimed to analyze the implementation of the Nursing Care System (NCS in the ICU - Neonatal Hospital Regional de Cáceres Dr. Anthony Fontes - HRCAF. This is an exploratory qualitative approach with descriptive profile of the case study. Data were collected through interviews with five nurses from ICU - Neonatal, using as research instrument, a questionnaire containing open and closed questions and analyzing a chart. The results showed that nurses know and realize the importance of NCS as a methodological tool that guides the practice of care and as professional recognition, although not held by all. The analysis of the records showed that there Systematization of Nursing Care at this clinic. Of the 707 days analyzed records there were only 30 (4.25% Nursing Research, none (0.0% record Diagnosis and Planning, 57 (8.26% days with record Deployment, Assessment and 23 record (3.24% in which its registered nursing care, assistance totaling 15.55% recorded in medical records. With the completion of this study, it was noted that the SAE often becomes impossible in practice of nursing because of various difficulties such as lack of time, lack of human resources, work overload, and the generic form organizational structure.
YELMI RENI PUTRI
Full Text Available Relations of pursuance taking drug of HIV patients with the success of Antiretroviral Therapy (ART in Poli Serunai Hospital Dr. Achmad Muchtar Bukittinggi Year 2014 Yelmi Reni Putri, AdrianiProgram Studi Ilmu Keperawatan STIKes Fort De Kock BukittinggiEmail : Yelmi.email@example.com ABSTRACT1st of of December is the day each year is celebrated as a day of HIV / AIDS this year themed "prevent HIV / AIDS, protect workers, families and the nation", this is when the right moment for us health workers give a good contribution to overcome or provide suggestions for improving services to patients with HIV / AIDS. The increasing number of patients with HIV / AIDS today is not only to make our health care workers need to be vigilant, even patients and families also need to work together to overcome this proble.The purpose of this study was to identify the level of compliance of patients taking antiretroviral drugs and HIV-positive people do with the success of antiretroviral therapy, the study sample taken in accident sampling with the number of respondents 40 patients idODHA of the month from May to October 2014. The study design using qualitative and quantitative method Mix , measuring instrument used in this research is a questionnaire that contains the characteristics of patients living with HIV, guided interviews to assess the role of the KPA, manager of HIV RSAM, and people living with HIV patients themselves.The result showed 57.5% of patients did not obey, and as much as 52.5% of patients successfully in HIV treatment, but there is no relationship between adherence with therapy success with value value 0.583 and 0.677 OR it is associated with the patient's anxiety and fear to know the results of which he repeated CD4 CD4 is one measure of the success of therapy. The conclusion of this study is important to know the patients' adherence PLWHA still low this will impact on the occurrence of resistance will even increase mortality, it is recommended
Petgrave-Pérez, Alexander; Padilla, Juan I; Díaz, José; Chacón, Rosarito; Chaves, Carlos; Torres, Héctor; Fernández, Jorge
To determine the epidemiological profile of the patients who suffered traumatic brain injury (TBI) and were treated at the Dr. Rafael A. Calderón Guardia Hospital (HCG) Neurosurgery department, during the period from 2007 to 2012. An observational, descriptive, retrospective and cross section study was performed on all the patients with TBI and who were admitted to the emergency room of the HCG during the period 2007 to 2012. There were a total of 721 cases, of which 566 records were obtained of patients who had the variables established in this study, excluding those with incomplete or inconsistent information. The present study established the epidemiological profile of the TBI in the population seen during the period 2007 to 2012 at the HCG. It was determined that the male sex made up the majority of the cases were male, with mean age of 46 years. The mortality rate was 12.69% (n=69). Car accidents were the most frequent cause of TBI (n=259 persons) in the age group of 25 to 44 years, followed by falls (n=174). It was observed that the majority were farmers, followed by students, and then construction workers. No chronic illnesses were recorded in 71.6% of the medical charts. No alcohol or other drugs were reported in 74.9% of the cases, while there was evidence of the presence of alcohol recorded in 22.8%. The clinical and laboratory parameters that had statistical significance (Paccidents being the main cause of these lesions (45.8%) in combination with alcohol consumption. Also, the consequences of such are aggravated when the victims present with chronic diseases such as, systemic arterial hypertension and mellitus diabetes. As regards the post-traumatic indicators directly related to a poor outcome, it was determined that a GCS score equal to or less than 8, a mean blood pressure less than 60, the prolongation of the coagulation times, the presence of mydriasis, and skull fractures, have a direct association with the negative or fatal outcome for the
Evaluación del espesor corneal central y su influencia en la presión intraocular en pacientes del Hospital "Dr. Miguel Enríquez" Evaluation of the central corneal thickness and its impact on the intraocular pressure of patients in "Dr. Miguel Enriquez" hospital
María Teresa Arrronte Alarcón
Full Text Available Objetivo: evaluar el espesor corneal central en sujetos sanos, hipertensos oculares, sospechosos de glaucoma y glaucomatosos, y su influencia en la presión intraocular. Métodos: se realizó un estudio descriptivo y transversal que incluyó 708 ojos de 356 sujetos que acudieron al servicio de oftalmología del Hospital Universitario "Dr. Miguel Enríquez" entre enero y diciembre de 2010. A los pacientes se les midió el espesor corneal central con paquimetría ultrasónica (paquímetro US 4000. El resto de la información se obtuvo a partir de las historias clínicas de los pacientes. Resultados: Los hipertensos oculares presentaron córneas gruesas (p=0,07; el mayor número de casos que tenían diagnóstico de sospecha de glaucoma y de glaucoma primario de ángulo abierto presentaron un grosor corneal delgado (p=0,62 y p=0,08 respectivamente. Si no se hubiese tenido en cuenta el factor de corrección para evaluar la presión intraocular se encontraría 48,1 % de los glaucomatosos y 31,5 % de los hipertensos oculares con diagnóstico inadecuado (pObjective: to evaluate the central corneal thickness in healthy individuals, in persons with ocular hypertension, and in suspected glaucoma and glaucomatous people, and its influence in intraocular pressure. Methods: a cross-sectional and descriptive study was performed in 708 eyes from 356 people who had been seen at ophthalmology service of “Dr. Miguel Enríquez”, university hospital from January to December, 2010. Their central corneal thickness was measured with ultrasonic pachymetry (pachymeter US 4000. The rest of the information came from the clinical histories of the patients. Results: Most of the ocular hypertensives presented thick corneas (p=0,07; a high number of cases that had diagnosis of glaucoma suspicion and primary open-angle glaucoma showed thin corneas (p=0,62 and (p=0,08 respectively. If the correction factor to evaluate the IOP had not been considered, then 48,1 % of the
Leeuwen, van M.
The idea has gained ground in recent years that, as conflicts in the countries of the Great Lakes Region are strongly interlinked, regional approaches are necessary to resolve them. This interest in regional dimensions of conflict and peacebuilding also gains currency in other parts of the world.
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.
NEUMOCISTOSIS EN EL SERVICIO DE MEDICINA INTERNA, COMPLEJO HOSPITALARIO UNIVERSITARIO “DR. LUIS RAZETTI”, BARCELONA, VENEZUELA, 2011-2012 I PNEUMOCYSTOSIS IN THE INTERNAL MEDICINE SERVICE, UNIVERSITY HOSPITAL COMPLEX “DR. LUIS RAZETTI”, BARCELONA, VENEZUELA, 2011-2012
Fadi Wahab-El-Fatairi; Ignacio Sigona-Giangreco; Isabel Ortiz-Vielma; María Teresa Maniscalchi-Badaoui; Duvric Lemus-Espinoza
In Venezuela and in the state Anzoátegui, the pneumocystosis, is little studied. To weigh that it is an infection opportunist caused by Pneumocystis jirovecii, it causes pneumonia of high morbility and mortality. The inmunocompromised patient is those that present bigger risks of acquiring this infection. The objectives of this investigation were to determine the infection frequency for P. jirovecii in patient with breathing symptoms and immunocompromised hospitalized in the Service of Intern...
Full Text Available Introducción y Objetivo. El síndrome de Parry Romberg se caracteriza por atrofia hemifacial progresiva; afecta piel y tejidos blandos y en ocasiones provoca también atrofia de músculos, cartílago y estructuras óseas subyacentes. Su diagnóstico diferencial incluye: esclerodermia generalizada, morfea y síndrome de CREST. Las alteraciones en piel se asocian con variantes alélicas (polimórficas del sistema HLA (antígeno leucocitario humano. La esclerodermia se ha asociado con HLA DR11, el CREST con DR1 y DR3, en tanto que la morfea no parece asociarse a genes del HLA en población mexicana. El propósito de este trabajo es explorar la posibilidad de asociación del síndrome de Parry Romberg con algún alelo del sistema HLA con el fin de entender el mecanismo fisiopatogénico y el probable papel de la etnicidad en la prevalencia e incidencia de esta enfermedad en individuos mestizos mexicanos. Material y método. Estudiamos 24 pacientes con Parry Romberg, de la consulta externa de Cirugía Plástica y Reconstructiva del Hospital General "Dr. Manuel Gea González" de la Ciudad de México. El diagnóstico se basó en hallazgos clínicos, imagenología e histopatología de las lesiones dérmicas. Establecimos las frecuencias génicas y haplotípicas de los antígenos del sistema HLA en los 24 pacientes (48 haplotipos. El estudio incluyó los loci HLA A, B, DR, DQ. Comparamos los resultados con las frecuencias presentes en un grupo de 99 controles mestizos mexicanos sin antecedentes de enfermedades autoinmunes y/o metabólicas. Analizamos las diferencias en las frecuencias génicas mediante estadística no paramétrica que incluyó prueba de Chi cuadrado y exacta de Fisher, además de determinación de RM (razón de momios e intervalos de confianza de 95%. Resultados. Encontramos en los pacientes con Parry Romberg aumento significativo del HLA DRB1*16 (frecuencia génica: 14% en SPR vs 1% en normales. p=0.002, OR: 6.5, IC 95%: 1.9-21.7 y
Kiliccot, Sila [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)
State of the large customers for demand response integration of solar and wind into electric grid; openADR; CAISO; DR as a pseudo generation; commercial and industrial DR strategies; California regulations
Chen, Hsueh-Fen; Karim, Saleema; Wan, Fei; Nevola, Adrienne; Morris, Michael E; Bird, T Mac; Tilford, J Mick
Previous studies showed that the Hospital Readmissions Reduction Program (HRRP) and the Hospital Value-based Purchasing Program (HVBP) disproportionately penalized hospitals caring for the poor. The Mississippi Delta Region (Delta Region) is among the most socioeconomically disadvantaged areas in the United States. The financial performance of hospitals in the Delta Region under both HRRP and HVBP remains unclear. To compare the differences in financial performance under both HRRP and HVBP between hospitals in the Delta Region (Delta hospitals) and others in the nation (non-Delta hospitals). We used a 7-year panel dataset and applied difference-in-difference models to examine operating and total margin between Delta and non-Delta hospitals in 3 time periods: preperiod (2008-2010); postperiod 1 (2011-2012); and postperiod 2 (2013-2014). The Delta hospitals had a 0.89% and 4.24% reduction in operating margin in postperiods 1 and 2, respectively, whereas the non-Delta hospitals had 1.13% and 1% increases in operating margin in postperiods 1 and 2, respectively. The disparity in total margins also widened as Delta hospitals had a 1.98% increase in postperiod 1, but a 0.30% reduction in postperiod 2, whereas non-Delta hospitals had 1.27% and 2.28% increases in postperiods 1 and 2, respectively. The gap in financial performance between Delta and non-Delta hospitals widened following the implementation of HRRP and HVBP. Policy makers should modify these 2 programs to ensure that resources are not moved from the communities that need them most.
Lenny Carbonell García; Alicia Fernández Chacón; Yadira Rodríguez Ramírez; Maribel Machado
Se realizó un estudio descriptivo de corte transversal, para determinar el comportamiento de los recién nacidos muy bajo peso, ventilados en modalidades convencionales en el Hospital General Docente “Dr. Ernesto Guevara de la Serna”, en el período de enero de 2010 a julio de 2012. El universo estuvo constituido por 104 recién nacidos vivos muy bajo peso, tomándose como muestra a los 66 recién nacidos muy bajo peso que necesitaron apoyo ventilatorio. Las principales variables a estudiar fueron...
Neira Morante, Martha Leticia
Determinar la epidemiología de las lesiones por presión en los pacientes internados en el hospital de niños Dr. Roberto Gilbert E. desde enero de 2013 a junio de 2014. -Objetivos Específicos. ¿ Identificar la causa de las lesiones por presión ¿ Establecer la edad, sexo, tipo y ubicación de la lesión más frecuentes. ¿ Relacionar el estado nutricional de los pacientes y la aparición de lesiones por presión. ¿ Describir la respuesta al tratamiento empleado Método. Estudio pr...
Kim, Sun Chil; Jung, Jae Eun
Currently, many hospital are hastening to introduce digital radiography systems. This is a direct result of the intentions to improve medical services and to digitalized radiology information systems, and is also leading to the improvement of medical imaging technology. Throughout F/S system's long history, many people have researched the image quality and dosage concerning these systems, and as a result, huge improvements in the dosage of patients were possible. Similarly, I believe that DR systems need the same kind of effort. Of course, decreases in dosage that ignore image quality are unthinkable. The results of experiments conducted by five hospitals during a period of 3 months brought to us the conclusions listed below. Based on the comparison and analysis of the exposure control of F/S systems and DR systems, DR systems generally showed higher exposure control for parts of the phantom that became thicker, and the exposure control improved rapidly as the thickness increased. DR systems still proved to be somewhat deficient in resolution measurements compared to existing F/S systems. The image processing part of DR systems contributed much to these result. Under conditions used clinically, the dosage measurements of DR systems were generally higher regardless of region. According to the evaluation of image quality, DR systems showed a higher degree of satisfaction as the thickness of the region became thinner. As mentioned above and based on the mutual relationship experiments between the dosage and image quality of F/S systems and DR systems, research to increase the satisfaction of DR systems must be considered
Perfil dos Pacientes com Câncer Gástrico Atendidos no Hospital Municipal Dr. José de Carvalho Florence no Período de 2007 a 2012 / Profile of Gastric Cancer Patients Treated in Hospital Municipal Dr. José de Carvalho Florence Between the Period from 2007
Rogério Mariotto Bitetti da Silva
Full Text Available Objetivo: Avaliar o perfil dos pacientes com neoplasia maligna de estômago, que receberam atendimento e tratamento no Hospital Municipal Dr. Jose de Carvalho Florence (HMJCF. Métodos: Estudo retrospectivo a partir do levantamento de prontuários. Análises foram feitas com uma amostragem e proporções esperadas desiguais e Quadros de contingência. Para se verificar associação entre as variáveis, utilizado o teste Qui–Quadrado de Pearson, considerando-se p ≤ 0,05, em um grau de confiabilidade de 95%. Resultados: O sexo masculino é o com maior número de casos na proporção de 2:1. A idade média ao diagnóstico é 65,16 anos. A queixa mais comum apresentada por estes pacientes foi a epigastralgia seguido pela inapetência. A maioria dos tumores encontrava-se no antro gástrico. Cinquenta e nove destes pacientes foram submetidos a cirurgia sendo 45 com intuito curativo. A sobrevida média foi de 15 meses e a taxa de sobrevida em 5 anos de apenas 6%. Conclusão: O CG é uma doença muito agressiva e de prognóstico ruim. Suas manifestações iniciais são inespecíficas, o que torna seu diagnóstico em fases iniciais muito difícil. Objective: Evaluate the profile of patients with malignant neoplasia of stomach, receiving care and treatment in Hospital Municipal Dr. Jose de Carvalho Florence (HMJCF. Methods: Retrospective study based on a survey of medical records. Analysis were made with a sampling and unequal expected ratios and contingency tables. To assess the association between variables, will be used the chi-square test, considering p ≤ 0.05, at a reliability level of 95%. Results: The largest number of cases are male, ratio of 2:1. The average age at diagnosis is 65.16 years. Caucasians followed by mulatto were the most frequent with Gastric Cancer. The most common complaint presented by these patients was abdominal pain followed by loss of appetite. Most tumors found in the gastric antrum. Fifty-nine of these patients
Lev, Efraim; Perry, Yaron
At the age of 46, Dr Edward Macgowan, by now a well-established physician, joined the ranks of the London Society for Promoting Christianity among the Jews with the aim of establishing the first modern hospital in Palestine. For the first six months of 1842, Macgowan established his work among the Jerusalem population on a regular basis and managed to establish a close relationship with the Jewish community and some of its leaders in Jerusalem. On 12 December 1844, the Jews' Hospital was opened in Jerusalem and became a source of great pride for the missionaries. Edward Macgowan died in Jerusalem after 18 years of service and was buried in the Protestant cemetery in his beloved city.
Márquez-Caraveo, Maria Elena; Arroyo-García, Eduardo; Granados-Rojas, Armida; Ángeles-Llerenas, Angélica
Resumen: La atención de la salud mental y de los trastornos psiquiátricos de niños y adolescentes a lo largo de 50 años de servicio (1966-2016) en el Hospital Psiquiátrico Infantil Dr. Juan N. Navarro (HPI), y el desarrollo progresivo de la enseñanza y la investigación han contribuido al posicionamiento de éste como institución líder en la atención médica de alta especialidad. El hospital ha evolucionado en la atención diagnóstica y terapéutica de pacientes ambulatorios a través de la creació...
Refractory epilepsy treated by hemispherectomy, experience, retrospective analysis and results on the casuistry of patients treated at the Hospital Nacional de Ninos Dr. Carlos Saenz Herrera, in the period between the years 1993-2014
Murillo Alvarez, Ricardo
A retrospective analysis is realized on the casuistry of patients treated with hemispherectomy in the Hospital Nacional de Ninos Dr. Carlos Saenz Herrera, in the period between the years 1993-2014. The bases of refractory epilepsy and the need of surgery as therapeutic are reviewed in patients treated. The hemispherectomies are quantified in the period between 1993-2014. The results obtained of the work carried at the Unidad de Monitoreo y Cirugia de Epilepsia from Hospital Nacional de Ninos is analyzed in the group of patients. The improvement in quality of life is documented in patients treated with hemispherectomy. Reduction in the amount of drugs used and suppression of subsequent seizures to surgery are determined in patients [es
Noordt, M. van; Zee, J. van der; Groenewegen, P.P.
For the analysis of regional variations in hospital admission rates a model was set up, including both supply and demand indicators. Data were gathered for regions in four health care systems (the Dutch, Belgian, French and German), for 1982, 1979, 1974 (France 1982 only). Hospital bed supply proved
Beasley, Gary S; Murphy, Anne M; Brenner, Joel I; Ravekes, William J
Johns Hopkins has been a leader in paediatric cardiology for over 85 years. In the 1940s, Dr Helen Taussig began training fellows in paediatric cardiology at Johns Hopkins at a time when the diagnosis and treatment of CHD were in the earliest stage. Under her leadership, the fellowship developed a strong foundation that has continued to evolve to meet the current needs of learners and educators. In the current era, the Johns Hopkins programme implements the current theories of adult education and actively engages our fellows in learning as well as teaching. The programme uses techniques such as flipped classroom, structured case-based small-group learning, observed and structured clinical examination, simulations, and innovative educational technology. These strategies combined with our faculty and rich history give our fellows a unique educational experience.
@@ Dr. Shi Hanzhang (施汉章) of Dongzhimen Hospital affiliated to Beijing University of Traditional Chinese Medicine is experienced in both teaching and clinical practice, especially in treating andropathy, such as sexual disorder, infertility, and hyperplasia of the prostate. The author has the honour to follow him for study and really learned a lot from him. A brief introduction to Dr. Shi's way of thinking in treatment is as follows.
The distribution of oesophageal, liver, stomach and colorectal cancers diagnosed per year across the five referral hospitals was ... Conclusion: Oesophageal, liver, stomach and colorectal cancer remain the most common gastrointestinal malignancies and their rate is .... intake, poor dietary patterns such as consumption of a.
Khayat Moghadam S
Full Text Available Objectives: A new and unique tool for survival of organizations among their competitors is the use of organizational intelligence; Organizational intelligence means having a comprehensive knowledge of all the environmental factors that affect on the organization. This research is one of the few studies with the aim of determine the organizational intelligence level of hospitals and ranking of organizational intelligence components to enable administrators to provide more accurate identification of strengths and weaknesses and take more effective steps to improve service delivery. Materials and Methods: This is a descriptive-analytical and applicable study performed in the 2012 at 12 General Hospital related to Mashhad University of Medical Sciences. Data collection was performed by Albrecht organizational intelligence questionnaire. The data gathering tool was the questionnaire Albrecht Organizational Intelligence. The collected Data were analyzed using T-test and Smirnov test with SPSS-16 software. The significance level for all tests was considered 0.05. Results: All components of organizational intelligence were in the optimum status. Component of Shared fate gained the first rank and component of knowledge Deployment gained the last rank. Conclusion: Ranking of organizational intelligence components is different in hospitals of the province and the county; representing different features and conditions. Considering the importance of organizational intelligence role in the promotion of organization, hospital managers can take active steps to improve organizational intelligence based on done rankings.
Shaikh, Sajid A; Robinson, Richard D; Cheeti, Radhika; Rath, Shyamanand; Cowden, Chad D; Rosinia, Frank; Zenarosa, Nestor R; Wang, Hao
Prolonged hospital discharge boarding can impact patient flow resulting in upstream Emergency Department crowding. We aim to determine the risks predicting prolonged hospital discharge boarding and their direct and indirect effects on patient flow. Retrospective review of a single hospital discharge database was conducted. Variables including type of disposition, disposition boarding time, case management consultation, discharge medications prescriptions, severity of illness, and patient homeless status were analyzed in a multivariate logistic regression model. Hospital charges, potential savings of hospital bed hours, and whether detailed discharge instructions provided adequate explanations to patients were also analyzed. A total of 11,527 admissions was entered into final analysis. The median discharge boarding time was approximately 2 h. Adjusted Odds Ratio (AOR) of patients transferring to other hospitals was 7.45 (95% CI 5.35-10.37), to court or law enforcement custody was 2.51 (95% CI 1.84-3.42), and to a skilled nursing facility was 2.48 (95% CI 2.10-2.93). AOR was 0.57 (95% CI 0.47-0.71) if the disposition order was placed during normal office hours (0800-1700). AOR of early case management consultation was 1.52 (95% CI 1.37-1.68) versus 1.73 (95% CI 1.03-2.89) for late consultation. Eighty-eight percent of patients experiencing discharge boarding times within 2 h of disposition expressed positive responses when questioned about the quality of explanations of discharge instructions and follow-up plans based on satisfaction surveys. Similar results (86% positive response) were noted among patients whose discharge boarding times were prolonged (> 2 h, p = 0.44). An average charge of $6/bed/h was noted in all hospital discharges. Maximizing early discharge boarding (≤ 2 h) would have resulted in 16,376 hospital bed hours saved thereby averting $98,256.00 in unnecessary dwell time charges in this study population alone. Type of disposition, case
Rabbani, Fauziah; Hashmani, Farah Naz; Mukhi, Aftab A Ali; Gul, Xaher; Pradhan, Nousheen; Hatcher, Peter; Farag, Mounir; Abbas, Farhat
The WHO Eastern Mediterranean Regional Office has emphasized health system strengthening among the top five strategic priorities. One of the integral elements of health systems are the hospitals. The purpose of this paper is to review the need for formalized training in hospital management to improve the quality of care. Literature review and hands on experience of conducting a regional training in hospital management for Eastern Mediterranean Region (EMR) countries. Majority of patients in EMR bypass Primary Health Care facilities due to inadequate quality of services and prefer seeking specialized care at a tertiary level. There is mounting evidence of mediocre to poor patient satisfaction due to inefficient health care practices in hospitals of EMR. Strengthening the management capacity of the hospitals through a formal training programme is therefore necessary for improving the performance of health care delivery and the overall health system. Hospital management encompasses hospital planning and operational activities including development and implementation of organizational strategies to ensure adequate numbers and quality of trained human resources and effective financial management, disaster management, health management information system utilization, support services, biomedical engineering, transport and waste management. Such training will prepare health care professionals with leadership skills to deliver quality hospital services. This is one of the first papers emphasizing the need for a formal structured regional training in hospital management for the countries of EMR. A modular incremental training approach developing an EMR Credit Transfer and Accumulation system is proposed.
Literature search and review of research involving radioisotopes conducted by Dr. G.E. Burch at Charity Hospital in New Orleans, Louisiana under the auspices of Tulane University during the 1940s,1950s, and 1960s
Brooks, F.; Curtis, E.C.; Forrester, G.; Roth, V.; Spickard, J.; Webster, B.; Engle, J.; Perkins, L.; Powell, S.
This report presents a synopsis of research performed by Dr. G.E. Burch during the 1940s, 1950s, and 1960s at Charity Hospital in New Orleans, Louisiana. Four technical experts have reviewed twenty-seven research published in peer-reviewed research journals and proceedings by Dr. Burch and his colleagues between the years 1946 and 1968. The papers were grouped prior to the review into three categories represented in this report by the following chapter titles: Studies Involving Human Subjects; Isotopic Studies Not Involving Human or Canine Subjects; and Studies Involving Dogs as Test Models. The experts' reviews addressed five areas. What, if Any, Is the Scientific Value of the Research on Which These Studies Are Based?; Did the Research Provide Medicine with New and Useful Information?; What Contributions Did This Research Make to Patient Care or to the Understanding of the Disease Process?; What Was Known Medically about Matters Addressed by This Research at the Time It Was Being Conducted? and Is There Documentation That Shows Informed Consent?
Elected: 2010 Section: General Biology. Galande, Dr Sanjeev Ph.D. (IISc). Date of birth: 20 September 1967. Specialization: Epigenetics, Chromatin Biology, Gene Regulation, Genomics and Proteomics Address: Centre for Excellence in Epigenetics, Indian Institute of Science Education, & Research, Dr Homi Bhabha Road, ...
Medarbejdere vil i fremtiden også kunne arbejde, mens de sover. Virksomheder tilbyder snart deres ansatte interne kurser i ‘lucid dreaming’. Disse giver mulighed for, at man i sine drømme bliver bevidst om, at man drømmer og således kan manipulere dem. Det skal nu udnyttes. Management...
Conclusions: This study demonstrates the precarious living conditions of hospitalised indigenous peoples and the difficulties they face in fighting diseases given their socioeconomic conditions. Recommendations are made to address the way the indigenous peoples are identified in the hospital, on recognising them as a vulnerable population, as well as the need for records of sociodemographic and health information regarding this population in hospital settings, so that it is reliable and comparable and to serve as a strong case for the implementation of local actions which meet national and international standards.
Full Text Available Walelegn Worku Yallew,1 Abera Kumie,2 Feleke Moges Yehuala3 1Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, 2School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, 3Department of Medical Microbiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia Purpose: Hospital-acquired infection (HAI is a major safety issue affecting the quality of care of hundreds of millions of patients every year, in both developed and developing countries, including Ethiopia. In Ethiopia, there is no comprehensive research that presents the whole picture of HAIs in hospitals. The objective of this study was to examine the nature and extent of HAIs in Ethiopia. Methods: A repeated cross-sectional study was conducted in two teaching hospitals. All eligible inpatients admitted for at least 48 hours on the day of the survey were included. The survey was conducted in dry and wet seasons of Ethiopia, that is, in March to April and July 2015. Physicians and nurses collected the data according to the Centers for Disease Control and Prevention definition of HAIs. Coded and cleaned data were transferred to SPSS 21 and STATA 13 for analysis. Univariate and multivariable logistic regression analyses were used to examine the prevalence of HAIs and relationship between explanatory and outcome variables. Results: A total of 908 patients were included in this survey, the median age of the patients was 27 years (interquartile range: 16–40 years. A total of 650 (71.6% patients received antimicrobials during the survey. There were 135 patients with HAI, with a mean prevalence of 14.9% (95% confidence interval 12.7–17.1. Culture results showed that Klebsiella spp. (22.44% and Staphylococcus aureus (20.4% were the most commonly isolated HAI-causing pathogens in these hospitals. The association of patient age and hospital type with the occurrence of HAI was
on stillbirths in developing countries and rural settings, where the majority of such births occur. ... The stillbirth rate at LUWMRH is much higher than that at other regional ... deaths, stillbirths, early and late neonatal deaths, cases of birth.
Söhner, F; V Cranach, M; Fangerau, H; Becker, T
In Bavarian psychiatric hospitals approximately 15,000 people with mental handicaps and mental illnesses were killed after the so-called Action T4. The Heil- und Pflegeanstalt (psychiatric hospital) Günzburg was a so-called Zwischenanstalt (interim institution). The aim of the study was to analyze its role in carrying out "regionalized euthanasia". Based on defined criteria the patient records of deceased patients at the Günzburg Psychiatric Hospital between July 1941 and December 1943 were analyzed to establish whether criteria for "regionalized euthanasia" were fulfilled. During the study period 45 patients at the Günzburg Psychiatric Hospital probably died following actions by direct or indirect intention to kill using malnutrition, neglect, medication overdose or a combination of these actions. The Günzburg Psychiatric Hospital was involved in "regionalized euthanasia".
Utility of the scintigraphy in the diagnosis and monitoring of patients with Hodgkin's disease at the Servicio de Oncologia of the Hospital Nacional de Ninos Dr. Carlos Saenz Herrera from January 2000 to July 2007
Romero Cubero, David
Results obtained of the gammagraphy are described in patients with diagnosis and monitoring of the Hodgkin's disease. The transversal observational study is carried in 48 patients with Hodgkin's disease at the Hospital Nacional de Ninos Dr. Carlos Saenz Herrera, during the period January 2000 to July 2007. Quantitative and qualitative variables are analyzed from the diverse studies carried to patients at sites of tumor apparition and, clinical and pathological findings. The gammagraphy is evaluated as a diagnostic method for Hodgkin's disease according to the different times of evolution from the diagnosis and the diverse clinical or histopathologic manifestations. Computed axial tomography and gammagraphy have proved to be useful in the initial approach of the disease [es
Conclusion: Laparoscopic colectomy for colorectal cancer in a new regional hospital is feasible and safe. It does not need additional time for learning. Laparoscopic sigmoidectomy can be considered as the initial surgery for a trainee.
Neonatal deaths occur due to asphyxia, preterm delivery, sepsis and tetanus. A country's ... The study was conducted at the large regional hospital in Worcester,. SA. Worcester .... 45% very low birth weight and 10% had an extremely low ...
Morán López, Jesús Manuel; Hernández González, Miriam; Peñalver Talavera, David; Peralta Watt, María; Temprano Ferreras, José Luis; Redondo Llorente, Cristina; Rubio Blanco, María Yolanda
Disease-related malnutrition (DRM) is highly prevalent in Spanish hospitals (occurring in 1 out of every 4 patients). The 'Más Nutridos' Alliance has developed an action plan to detect and treat DRM. In Extremadura (Spain), the public health system has included nutritional screening as the only mechanism to fight malnutrition. The results of this strategy are evaluated here. An agreement study was conducted in standard clinical practice. Variables collected included the following rates: nutritional screening at entry, coded nutritional diagnoses, nutritional status assessment, nutritional requirements, successful nutritional therapy, weight and height at entry and discharge, referral to a nutritional support unit (NSU). Standards to comparison based on the results of the Netherland Program to Fight Malnutrition. Nutritional screening rate at entry was 20.5% (95% CI: 18.00-21.00). Coding and nutritional status assessment rate at entry was 13%. Weight and height were both measured in 16.5% of patients at entry and 20% at discharge. Nutritional requirements were estimated in 30% and were poorly monitored (13.3%). Only 15% of patients were referred to a NSU. Significantly lower values were found for all indicators as compared to standards, with kappa values lower than 0.2 in all cases. Data analysis showed poorer results when patients referred to the NSU were excluded. A strategy to fight malnutrition based on nutritional screening alone is highly inefficient in hospitals such as HVP. Copyright © 2018 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.
Wright, Jason D; Tergas, Ana I; Hou, June Y; Burke, William M; Chen, Ling; Hu, Jim C; Neugut, Alfred I; Ananth, Cande V; Hershman, Dawn L
Despite the lack of efficacy data, robotic-assisted surgery has diffused rapidly into practice. Marketing to physicians, hospitals, and patients has been widespread, but how this marketing has contributed to the diffusion of the technology remains unknown. To examine the effect of regional hospital competition and hospital financial status on the use of robotic-assisted surgery for 5 commonly performed procedures. A cohort study of 221 637 patients who underwent radical prostatectomy, total nephrectomy, partial nephrectomy, hysterectomy, or oophorectomy at 1370 hospitals in the United States from January 1, 2010, to December 31, 2011, was conducted. The association between hospital competition, hospital financial status, and performance of robotic-assisted surgery was examined. The association between hospital competition was measured with the Herfindahl-Hirschman Index (HHI), hospital financial status was estimated as operating margin, and performance of robotic-assisted surgery was examined using multivariate mixed-effects regression models. We identified 221 637 patients who underwent one of the procedures of interest. The cohort included 30 345 patients who underwent radical prostatectomy; 20 802, total nephrectomy; 8060, partial nephrectomy; 134 985, hysterectomy; and 27 445, oophorectomy. Robotic-assisted operations were performed for 20 500 (67.6%) radical prostatectomies, 1405 (6.8%) total nephrectomies, 2759 (34.2%) partial nephrectomies, 14 047 (10.4%) hysterectomies, and 1782 (6.5%) oophorectomies. Use of robotic-assisted surgery increased for each procedure from January 2010 through December 2011. For all 5 operations, increased market competition (as measured by the HHI) was associated with increased use of robotic-assisted surgery. For prostatectomy, the risk ratios (95% CIs) for undergoing a robotic-assisted procedure were 2.20 (1.50-3.24) at hospitals in moderately competitive markets and 2.64 (1.84-3.78) for highly competitive markets
This study entitled Potential and Effectiveness of retribution collecting in RSUD Dr. Agoesdjam Ketapang which aims to identify and analyze the potential retribution of RSUD Dr . Agoesdjam and also to investigate and analyze the effectiveness of the retribution collecting in RSUD Dr. Agoesdjam . This study uses secondary data , from 2008 to 2012 that were obtained from the Regional Revenue Office of Ketapang and RSUD Dr. Agoesdjam Ketapang . The method of this study is descriptive. To analyz...
Full Text Available Fourty three patients with chronic renal failure undergoing chronic hemodialysis in Division of Nephrology and Hypertension, Faculty of Medicine, University of Indonesia/Cipto-Mangunkusumo Hospital, Jakarta, since October 2003 until February 2004, were examined for echocardiography (2-D, M-mode, Doppler imaging.Diastolic dysfunction was found in 58.1 % of chronic renal failure patients on hemodialysis. There was no significant difference between left ventricular mass in the group with or without left ventricular diastolic dysfunction. (Med J Indones 2006; 15:105-8Keywords: Left ventricular mass, diastolic function, chronic renal failure, hemodyalisis
Sosa Quesada, Carlos Ivan; Wang Zuniga, Sylvia
Preoperative risk factors and postoperative complications were determined in patients with radical hysterectomy in gynecologic oncology service of Hospital Rafael Angel Calderon Guardia in 2000-2006. Radical hysterectomy Piver type II and III was carried out among women in the gynecology service. The information derived from the qualitative variables were analyzed using frequency distributions and percentages. The most common preoperative comorbidity has been hypertension, the most frequently encountered complication has been urinary incontinence. Postoperative complications have been located in a period less than three months. [es
Elected: 1995 Section: Mathematical Sciences. Thiagarajan, Dr Pazhamaneri Subramaniam Ph.D. (Rice), FNASc. Date of birth: 9 November 1948. Specialization: Distributed Probabilistic Systems, Hybrid Systems and Computational Systems Biology Address: Laboratory of System Pharmacology, Harvard Medical School, ...
Elected: 2009 Section: Medicine. Mishra, Dr A C . Ph.D. (Pune), FNA. Date of birth: 1 July 1950. Specialization: Human Viral Infection & Zoonotic Diseases, Public Health Address: Director, Interactive Research School of Health Affairs, Bharati Vidyapeeth University, ...
Hazarika, Dr Nabajit Ph.D. (Tezpur). Date of birth: 17 January 1986. Specialization: Remote Sensing, GIS Applications, Fluvial Geomorphology, Landuse Landcover Studies Address: Dept. of Environmental Science, Nagaland University, Lumami 798 627, Nagaland Contact: Residence: 94354 81256, 97066 71256
van Leeuwen, F.; de Bruijne, J. H. J.; Arenou, F.; Bakker, J.; Blomme, R.; Busso, G.; Cacciari, C.; Castañeda, J.; Cellino, A.; Clotet, M.; Comoretto, G.; Eyer, L.; González-Núñez, J.; Guy, L.; Hambly, N.; Hobbs, D.; van Leeuwen, M.; Luri, X.; Manteiga, M.; Pourbaix, D.; Roegiers, T.; Salgado, J.; Sartoretti, P.; Tanga, P.; Ulla, A.; Utrilla Molina, E.; Abreu, A.; Altmann, M.; Andrae, R.; Antoja, T.; Audard, M.; Babusiaux, C.; Bailer-Jones, C. A. L.; Barache, C.; Bastian, U.; Beck, M.; Berthier, J.; Bianchi, L.; Biermann, M.; Bombrun, A.; Bossini, D.; Breddels, M.; Brown, A. G. A.; Busonero, D.; Butkevich, A.; Cantat-Gaudin, T.; Carrasco, J. M.; Cheek, N.; Clementini, G.; Creevey, O.; Crowley, C.; David, M.; Davidson, M.; De Angeli, F.; De Ridder, J.; Delbò, M.; Dell'Oro, A.; Diakité, S.; Distefano, E.; Drimmel, R.; Durán, J.; Evans, D. W.; Fabricius, C.; Fabrizio, M.; Fernández-Hernández, J.; Findeisen, K.; Fleitas, J.; Fouesneau, M.; Galluccio, L.; Gracia-Abril, G.; Guerra, R.; Gutiérrez-Sánchez, R.; Helmi, A.; Hernandez, J.; Holl, B.; Hutton, A.; Jean-Antoine-Piccolo, A.; Jevardat de Fombelle, G.; Joliet, E.; Jordi, C.; Juhász, Á.; Klioner, S.; Löffler, W.; Lammers, U.; Lanzafame, A.; Lebzelter, T.; Leclerc, N.; Lecoeur-Taïbi, I.; Lindegren, L.; Marinoni, S.; Marrese, P. M.; Mary, N.; Massari, D.; Messineo, R.; Michalik, D.; Mignard, F.; Molinaro, R.; Molnár, L.; Montegriffo, P.; Mora, A.; Mowlavi, N.; Muinonen, K.; Muraveva, T.; Nienartowicz, K.; Ordenovic, C.; Pancino, E.; Panem, C.; Pauwels, T.; Petit, J.; Plachy, E.; Portell, J.; Racero, E.; Regibo, S.; Reylé, C.; Rimoldini, L.; Ripepi, V.; Riva, A.; Robichon, N.; Robin, A.; Roelens, M.; Romero-Gómez, M.; Sarro, L.; Seabroke, G.; Segovia, J. C.; Siddiqui, H.; Smart, R.; Smith, K.; Sordo, R.; Soria, S.; Spoto, F.; Stephenson, C.; Turon, C.; Vallenari, A.; Veljanoski, J.; Voutsinas, S.
The second Gaia data release, Gaia DR2, encompasses astrometry, photometry, radial velocities, astrophysical parameters (stellar effective temperature, extinction, reddening, radius, and luminosity), and variability information plus astrometry and photometry for a sample of pre-selected bodies in the solar system. The data collected during the first 22 months of the nominal, five-year mission have been processed by the Gaia Data Processing and Analysis Consortium (DPAC), resulting into this second data release. A summary of the release properties is provided in Gaia Collaboration et al. (2018b). The overall scientific validation of the data is described in Arenou et al. (2018). Background information on the mission and the spacecraft can be found in Gaia Collaboration et al. (2016), with a more detailed presentation of the Radial Velocity Spectrometer (RVS) in Cropper et al. (2018). In addition, Gaia DR2 is accompanied by various, dedicated papers that describe the processing and validation of the various data products. Four more Gaia Collaboration papers present a glimpse of the scientific richness of the data. In addition to this set of refereed publications, this documentation provides a detailed, complete overview of the processing and validation of the Gaia DR2 data. Gaia data, from both Gaia DR1 and Gaia DR2, can be retrieved from the Gaia archive, which is accessible from https://archives.esac.esa.int/gaia. The archive also provides various tutorials on data access and data queries plus an integrated data model (i.e., description of the various fields in the data tables). In addition, Luri et al. (2018) provide concrete advice on how to deal with Gaia astrometry, with recommendations on how best to estimate distances from parallaxes. The Gaia archive features an enhanced visualisation service which can be used for quick initial explorations of the entire Gaia DR2 data set. Pre-computed cross matches between Gaia DR2 and a selected set of large surveys are
Full Text Available In this presentation the author explains how the Dr Math service works; how tutors are recruited to act as Dr Math; and how school pupils can reach Dr Math for help with their mathematics homework....
Chou, Li-Ping; Li, Chung-Yi; Hu, Susan C
Objectives To explore the prevalence and associated factors of burnout among five different medical professions in a regional teaching hospital. Design Cross-sectional study. Setting Hospital-based survey. Participants A total of 1329 medical professionals were recruited in a regional hospital with a response rate of 89%. These voluntary participants included 101 physicians, 68 physician assistants, 570 nurses, 216 medical technicians and 374 administrative staff. Primary and secondary outcome measures Demographic data included gender, age, level of education and marital status, and work situations, such as position, work hours and work shifts, were obtained from an electronic questionnaire. Job strain and burnout were measured by two validated questionnaires, the Chinese version of the Job Content Questionnaire and the Copenhagen Burnout Inventory. Results Among the five medical professions, the prevalence of high work-related burnout from highest to lowest was nurses (66%), physician assistants (61.8%), physicians (38.6%), administrative staff (36.1%) and medical technicians (31.9%), respectively. Hierarchical regression analysis indicated that job strain, overcommitment and low social support explained the most variance (32.6%) of burnout. Conclusions Physician assistant is an emerging high burnout group; its severity is similar to that of nurses and far more than that of physicians, administrative staff and medical technicians. These findings may contribute to the development of feasible strategies to reduce the stress which results in the burnout currently plaguing most hospitals in Taiwan. PMID:24568961
Holloway, K L; Yousif, D; Bucki-Smith, G; Hosking, S; Betson, A G; Williams, L J; Brennan-Olsen, S L; Kotowicz, M A; Sepetavc, A; Pasco, J A
We found that lower limb fractures, which were largely the result of minimal trauma, had high levels of hospitalisation, length of stay and surgery. It is therefore important to prevent fractures at all sites to avoid the associated morbidity and mortality. Hip fractures are a major cause of morbidity and mortality, particularly in older women. In comparison, less is known about the epidemiology and burden of other lower limb fractures. The study aimed to investigate the epidemiology and burden of these fractures. Incident fractures of the hip, femur, tibia/fibula, ankle and foot in women (≥ 20 years) managed through the University Hospital Geelong, Australia, were ascertained from 1 Jan. 2014 to 31 Dec. 2014 from radiology reports. Age, cause of fracture, post-fracture hospitalisation, surgery, length of stay and discharge location were ascertained from medical records. We identified 585 fractures of the lower limb (209 hip, 42 femur, 41 tibia/fibula, 162 ankle, 131 foot). Most fractures were sustained by women aged ≥ 50 years. Fractures were largely a result of minimal trauma. Most women with hip or femur fractures were hospitalised; fewer were hospitalised for fractures at other sites. Surgery for fracture followed the same pattern as hospitalisations. Length of stay was the highest for hip and femur fractures and the lowest for foot fractures. Women with hip or femur fractures were discharged to rehabilitation more often than home. Fractures at other sites were most commonly discharged home. Fractures of the lower limb occurred frequently in older women. Hospitalisation and subsequent surgery were common in cases of hip and femur fractures. It is important for prevention strategies to target fractures at a range of skeletal sites to reduce costs, hospitalisations, loss of independence and reduced quality of life.
Full Text Available Background: With the growing trend of unhealthy behaviors in the community, the likelihood of transmission of hepatitis B virus from infected people to society is increasing. So, early detection for preventing disease progression in patients and preventing the spread to the community has an important role. The aim of this study is assessment of risk factors in patients with chronic hepatitis B referred to Labbafi nejad’s Hospital hepatitis Clinic during 2012-2014.Materials and Methods: This cross-sectional study is done on 329 hepatitis B confirmed patients that were admitted to Labbafi nejad’s Hospital hepatitis Clinic 2012-15. Information was collected by interviewing patients by researcher-made questionnaire. Variables are, all risk factors for hepatitis B, respectively. Statistical analysis was performed by SPSS version 21. Average and frequency was used for descriptive and chi-square test was used for analysis.Results: 329 persons (59% males, 41%females with a mean age of 44/83 years. 33/7% of these individuals have been identified through routine screening. The frequency of exposure to risk factors in this study are as follows: Some groups, such as history of dentist visit (62.3%, major surgery (45.5% and hospitalization (54.7% had higher prevalence than other groups. There were no cases of hepatitis B in history of cosmetics and splice joint, common use of blades and razors, HCV disease in patients at the same time, Family history of HIV positive in patients and HIV disease in patients at the same time.Conclusion: It seems to be of great importance to pay more attention to certain jobs, lifestyles and cultural matters in Iran that predispose people to a number of risk factors so as to implement measures to control HBV spread. Also, given the high levels of hepatitis B infection among housewives (in this study, it seems that increased awareness and social - health education in order to avoid unprotected sexual contact with an infected
Zahra Riahi Paghaleh
Full Text Available Emotional display is the management and proper expression of correct emotions consistent with organizational and profession rules. One of the factors affecting the occupational performance is the skills of the managers in control and effective use of excitement. The present study was conducted to determine the relationship between nursing managers' emotional display and the performance of nursing staff. The study population consisted of all managers and nursing staff of Shariati Hospital, Tehran in 2015 who were selected using census method. The instruments were Dindorf et al. emotional display questionnaire and Paterson's job performance questionnaire whose validity and reliability were confirmed. Data were analyzed with Spearman correlation Coefficient, independent t-test, and ANOVA using SPSS software. "Real-emotion display" of nursing managers had a significant correlation with nursing staff performance (P=0.02, r=0.203. But "superficial and deep display of emotions" of the managers did not. There were no significant correlations between emotional display with age and work experience in managers and between job performance with marital status, gender, and age and work experience in nursing staff (P>0.05. The results showed that design and mplementation of training courses about emotional display are necessary in managers in order to improve the job performance of nursing staff.
Full Text Available Background: Membranoproliferative glomerulonephritis is a pattern of glomerular lesion with a variety of causes. It can be classified by using direct immunofluorescence into immune complex-mediated membranoproliferative glomerulonephritis and complement-mediated membranoproliferative glomerulonephritis. Objective: Determine the prevalence of membranoproliferative glomerulonephritis by biopsy (light microscopy, direct immunofluorescence and electron microscopy, categorise them according to the most recent classification, identify possible causes and determine certain epidemiological and clinical characteristics. Material and method: A descriptive, cross-sectional study was carried out, selecting renal biopsies with a membranoproliferative pattern at 5 years at Hospital General de MÃ©xico. Age, gender, clinical syndrome and immunofluorescence and electron microscopy results were obtained. Biopsies lacking immunofluorescence or electron microscopy results were excluded. Results: 133 biopsies diagnosed as membranoproliferative glomerulonephritis were obtained. The average annual rate was 3.37%, while average age was 31.35Â Â±Â 16 years. The disorder affected mostly women (60.15%, nÂ =Â 80. Nephrotic syndrome was the most common clinical presentation (48.12%, nÂ =Â 64, while autoimmune disease was the most common cause (77.77%, nÂ =Â 91. Conclusions: Direct immunofluorescence is indispensable for classifying membranoproliferative glomerulonephritis. Resumen: Antecedentes: La glomerulonefritis membranoproliferativa es un patrÃ³n de lesiÃ³n glomerular con diferentes etiologÃas. Se clasifica por inmunofluorescencia directa en: glomerulonefritis membranoproliferativa mediada por complejos inmunes y glomerulonefritis membranoproliferativa mediada por complemento. Objetivo: Determinar la prevalencia de las glomerulonefritis membranoproliferativas mediante la biopsia (microscopÃa de luz, inmunofluorescencia directa y microscop
Full Text Available BACKGROUND Headache is one of the causes of discomfort to a human being and can be classified as primary or secondary headache. CT scan has proved to be useful when the neurological physical examination is abnormal. The aim of the study is to1. Determine the causes of headache of patients presenting with nontraumatic headache by CT scan at Tripura Medical College and Dr. B.R. Ambedkar Memorial Teaching Hospital, Hapania, Agartala, West Tripura. 2. Correlate the clinical diagnosis and the CT scan findings of patients with nontraumatic headache. MATERIALS AND METHODS A total of 157 patients presented with nontraumatic headache underwent CT scan examination in the Radiodiagnosis Department of Tripura Medical College and Dr. B.R. Ambedkar Memorial Teaching Hospital, Hapania, Agartala, West Tripura and scans were viewed for the presence of any secondary cause of headache and findings were expressed as frequency and percentage. Statistical Analysis- The data were entered in spreadsheet and analysed using SPSS 21 statistical software. Results were expressed as frequency and percentage. RESULTS In our study, female patients (50.96% were slightly more than the male (49.04% patients and majority of the patients were in the age group of >20 to ≤40 years (54.14% followed by >40 to ≤60 years (25.47%.Primary headache (73.89% was found to be more common than secondary headache (26.11%. Sinusitis (73.17% was the commonest cause of secondary headache. Prevalence of positive CT scans of patients presenting with headache was 26.11%. Most of the clinical diagnosis did not correlate (61.78% with the CT scan finding. Patients with clinical diagnosis of migraine correlates mostly with the CT scan finding (69.44%, which is one of commonest cause of primary headache where we got negative findings in CT scan followed by sinusitis (38.77%, CVA/ICH (cerebrovascular accident and intracerebral haemorrhage 32.25% and brain SOL (25%. CONCLUSION CT scan has a role in
Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F.
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)
Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F.
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)
Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F.
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)
Angeles C, A.; Vizuet G, J.; Benitez S, J. A.
Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F.
Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F.
Paull, J D; Morris, G M
On 16 February 1845 the Reverend W. H. Browne, rector of St John's Church in Launceston, Van Diemen's Land, wrote in his journal, "My dear Wife died very suddenly almost immediately after and in consequence of taking a preparation of Hyd. Cyan. Acid prepared & supplied by Dr Pugh". This journal entry raises a number of questions. Was Dr Pugh treating a condition which he thought merited that treatment or was it a ghastly mistake? Was Caroline Browne suffering from pulmonary tuberculosis? Was hydrocyanic acid an accepted treatment at that time? Did Mrs Browne take the wrong dose? Was an incorrect concentration of the drug prepared by Dr Pugh? Did he use the wrong pharmacopoeia in preparing the hydrocyanic acid? Why was there no inquest? Only some of these questions can be answered.
Nowossadeck, Enno; Prütz, Franziska
Population aging and population decline in many regions of the Federal Republic of Germany are key elements of demographic change. In the regions concerned there is a rising number of older people and, simultaneously, a declining population. So far, the consequences of regional shrinkage and growth for inpatient care don't seem to have been analysed very well. This paper analyses the influence of population aging and declining/increasing population (demographic factors) as well as other, non-demographic factors on the number of hospitalizations in Germany and the Federal States since 2000.One result of the analysis is that there are major differences between the Federal States. The analysis shows, for example, an increase of hospitalizations in Berlin while in Saxony-Anhalt the number of hospitalizations declines. The increase in Berlin was the result of population aging and, to a lower extent, an increase in population. In Saxony-Anhalt the declining population resulted in a decreasing number of hospitalizations. Population aging and non-demographic factors were not able to compensate this trend.Overall, the effect of demographic factors on the number of hospitalizations remains constant over time. Short-term changes of hospitalizations are due to non-demographic factors, such as epidemiological trends, (for example trends of incidence or prevalence), or structural changes of health care service (for example patients shifting between different sectors of health care or the introduction of new reimbursement systems).
Ølgaard, Povl Lebeck
state of the reactor and to determine, which radionuclides remain where in the reactor in what amounts. The first part of the reactor to be investigated was the reactor tank. The lids at the reactor top wereremoved, air samples taken and smear test made in the tank. Then the control rods, the magnet....... At the start of the project the activity in DR-2 was about 45-50 GBq. Now it is about 5-10 GBq. Based on the results of the DR-2 project it is believed that the reactor can readily bedismantled and decommissioned....
Bhimo Rizky Samudro; Yogi Pasca Pratama
This study aims to investigate the efficiency level of hospital surgery hospital installation in Special Region of Yogyakarta Province. Research conceptual constructs are based on input and output performance in institutional performance processes. This research approach uses positivist pattern and is derived by quantitative method. This is to explain the efficiency pattern of the installation of hospital and private hospital surgery rooms. The quantitative method chosen is the concept of Dat...
Antonio Roldan Betancur
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Nació en Briceño, Antioquia, el 17 de febrero de 1946; fueron sus padres Angel e Inés, su esposa Gloria y sus hijas Natalia y Daniela. Bachiller del Liceo Antioqueño: 1964. Médico y Cirujano de la Facultad de Medicina de la Universidad de Antioquia: 1971. Medicatura rural en Betulia, Antioquia: 1971-1972. Médico de planta del Hospital Regional de Urabá: 1972. Alcalde y Concejal de Apartadó. Dirigente deportivo. Gerente de Corpurabá. Director de Coldeportes, Antioquia. Gerente de la Fabrica de Licores de Antioquia. Jefe del Servicio Seccional de Salud de Antioquia. Gobernador del Departamento de Antioquia. Falleció el4 de Julio de 1989.
Maria E Cattana
Full Text Available La criptococosis es una infección fúngica causada por levaduras del género Cryptococcus, particularmente las del complejo Cryptococcus neoformans/Cryptococcus gattii. El conocimiento sobre la casuística de la criptococosis en el nordeste argentino es exiguo y no se tiene información sobre los tipos moleculares circulantes. El objetivo de este estudio fue realizar la caracterización genética de los aislamientos pertenecientes al complejo C. neoformans/C. gattii obtenidos en el Hospital «Dr. Julio C. Perrando» de la ciudad de Resistencia (Chaco, Argentina, con el fin de determinar especie, variedad y genotipo. Durante dos años y un mes se estudiaron 26 aislamientos clínicos. Mediante métodos convencionales y moleculares, un aislamiento fue identificado como C. gattii genotipo VGI y los 25 restantes como C. neoformans var.grubii, 23 de los cuales correspondieron al genotipo VNI y dos al genotipo VNII. Estos datos son una contribución al conocimiento de la epidemiología de la criptococosis en la Argentina y el primer informe sobre genotipos del complejo C. neoformans/C. gattii de origen clínico en el nordeste argentino.
Gupta, Dr Chhitar Mal Ph.D. (Agra), FNA, FNASc, FAMS, FTWAS Council Service: 1998-2000. Date of birth: 1 September 1944. Specialization: Membrane Biology, Bio-organic Chemistry and Molecular Biophysics Address: Distinguished Professor and Infosys Chair, Institute of Bioinformatics & Applied Biotechnology, Room ...
Home; Fellowship. Fellow Profile. Elected: 2012 Section: General Biology. Mohanty, Dr Debasisa Ph.D. (IISc), FNASc, FNA. Date of birth: 30 November 1966. Specialization: Bioinformatics, Computational & Structural Biology, Biophysics Address: National Institute of Immunology, Aruna Asaf Ali Marg, New Delhi 110 067, ...
Home; Fellowship. Fellow Profile. Elected: 1943 Section: Animal Sciences. Bal, Dr Dattatreya Vaman Ph.D. (Liverpool). Date of birth: 25 August 1905. Date of death: 1 April 1999. Specialization: Marine Zoology, Oceanography. Fisheries and Aquaculture Last known address: 104, Swaroop Complex, Karve Road, Pune 411 ...
Fellow Profile. Elected: 1990 Section: Engineering & Technology. Banerjee, Dr Srikumar Ph.D. (IIT, Kharagpur), FNA, FNAE, FNASc, FTWAS Council Service: 2007-12; Vice-President: 2010-12. Date of birth: 25 April 1946. Specialization: Materials Science, Physical Metallurgy, Phase Transformations, Nuclear Fuel Cycle, ...
Bogen beskriver i en række intense analyser forbindelsen mellem ydre og indre billeder: altså mellem de moderne mediers billedverden og drømmens og erindringens indre billeder. I fokus for undersøgelsen er desuden kønnet, altså hvordan billeder viser, omformer eller skjuler kønnet, 'det andet', s...
Agrewala, Dr Javed Naim Ph.D. (Agra), FNA, FNASc. Date of birth: 14 May 1961. Specialization: Immunology, Vaccine, Drug Discovery Address: Chief Scientist, Immunology Laboratory, Institute of Microbial Technology, Sector 39A, Chandigarh 160 036, U.T.. Contact: Office: (0172) 666 5261. Residence: (0172) 666 5514
Home; Fellowship. Fellow Profile. Elected: 2015 Section: Earth & Planetary Sciences. Anil, Dr Arga Chandrashekar Ph.D. (Karnatak). Date of birth: 23 January 1959. Specialization: Biological Oceanography, Marine Ecology, Marine Biology Address: Chief Scientist, National Institute of Oceanography, Dona Paula 403 004, ...
Prakash, Dr Vishweshwaraiah Ph.D. (Mysore), FNASc, FNAE, FRSC,FNAAS. Date of birth: 23 November 1951. Specialization: S&T Policy, Physical Biochemistry, Chemistry of Macromolecules, Biophysics of Proteins, Enzymes & Thermodynamics, Food Chemistry, Nutrition, Food Biotechnology and Food Science Address: ...
Fellow Profile. Elected: 2001 Section: General Biology. Salunke, Dr Dinakar Mashnu Ph.D. (IISc), FNASc, FNA, FTWAS. Date of birth: 1 July 1955. Specialization: Structural Biology, Macromolecular Crystallography and Immunology Address: Director, International Centre for Genetic Engineering, & Biotechnology, Aruna Asaf ...
Elected: 1975 Section: Engineering & Technology. Paranjpe, Dr Pramod Anand D.Sc. Tech. (ETH Zurich). Date of birth: 1 April 1934. Specialization: Turbomachinery and Jet Propulsion Systems Address: 'Bahaar', 5, Hindustan Estate, Road No. 13, Kalyaninagar, Pune 411 006, Maharashtra Contact: Residence: (020) 2668 ...
Fellow Profile. Elected: 1986 Section: Physics. Bhawalkar, Dr Dilip Devidas Ph.D. (Southampton), FNA, FNASc. Date of birth: 16 October 1940. Specialization: Lasers and laser Instrumentation Address: 26, Paramanu Nagar, Indore 452 013, M.P.. Contact: Office: (0731) 232 2707. Residence: (0731) 232 0031. Mobile: 93032 ...
Fellow Profile. Elected: 1990 Section: Plant Sciences. Babu, Dr Cherukuri Raghavendra D.Phil. (Calcutta). Date of birth: 30 June 1940. Specialization: Biosystematics, Ecology and Population Genetics Address: Professor Emeritus, CEMDE, School of Environmental Studies, University of Delhi, Delhi 110 007, U.T.. Contact:
Home; Fellowship. Fellow Profile. Elected: 1972 Section: Engineering & Technology. Brahm Prakash, Dr Ph.D. (Panjab), FNA 1974-76. Date of birth: 21 August 1912. Date of death: 3 January 1984. Specialization: Metallurgy. YouTube; Twitter; Facebook; Blog ...
Budhani, Dr Ramesh Chandra Ph.D. (IIT, Delhi), FNASc, FNA. Date of birth: 3 February 1955. Specialization: Renewable Energy, Nanoscale Systems, Experimental Condensed Matter Physics, Superconductivity and Magnetism Address: Department of Physics, Lasers & Photonics, Indian Institute of Technology, Kanpur 208 ...
Home; Fellowship. Fellow Profile. Elected: 2010 Section: Chemistry. Ghosh, Dr Pushpito Kumar Ph.D. (Princeton). Date of birth: 29 May 1954. Specialization: Processes Research, Water Purification, Renewable Energy, R&D Management Address: A-604, Punit Park, Plot No. 182/C, Sector 17, Merol, Navi Mumbai 400 706, ...
Elected: 1972 Section: Chemistry. Varadarajan, Dr Srinivasan Ph.D. (Delhi and Cantab), D.Sc. (h.c.), D.Litt. (h.c.), FNA, FNAE, FTWAS Council Service:1974-88; Vice-President: 1977-79; President: 1980-82. Date of birth: 31 March 1928. Specialization: Organic & Biological Chemistry, Molecular Biology, Engineering Design ...
Elected: 1978 Section: Medicine. Brahmayya Sastry, Dr Podila Ph.D. (McGill). Date of birth: 24 May 1913. Date of death: 28 May 1993. Specialization: Physiology, Neurophysiology and Placental Physiology Last known address: Sitaramanilayam, Plot No. 9, Doctors Co-Operative Housing Colony, Waltair, Visakhapatnam ...
Fellow Profile. Elected: 2014 Section: Animal Sciences. Majumdar, Dr Subeer Suhash Ph.D. (nagpur), FNA, FNASc. Date of birth: 21 May 1961. Specialization: Animal Biotechnology, Transgenic Animals, Endocrinology Address: Director, National Institute of Animal Biotechnology, Gopan Pally, Hyderabad 500 046, A.P.
Sirsat, Dr Satyavati Motiram Ph.D. (Mumbai). Date of birth: 7 October 1925. Date of death: 10 July 2010. Specialization: Medical Research (Cancer) & Ultrastructural Pathology and Hospice Care of the Dying Last known address: Bhagirathi Sadan, 17th Road, Khar, Mumbai 400 052. YouTube · Twitter · Facebook · Blog ...
Home; Fellowship. Fellow Profile. Elected: 2018 Section: General Biology. Nandicoori, Dr Vinay Kumar Ph.D. (IISc), FNASc. Date of birth: 1 March 1969. Specialization: Molecular & Cellular Biology, Cell Signalling, Cell Biology Address: National Institute of Immunology, Aruna Asaf Ali Marg, New Delhi 110 067, U.T.; Contact ...
Fellow Profile. Elected: 2010 Section: General Biology. Mukhopadhyay, Dr Amitabha Ph.D. (Jadavpur), FNASc, FNA. Date of birth: 5 February 1959. Specialization: Cell Biology, Host-Pathogen Interactions, Drug Delivery Address: Staff Scientist VII, National Institute of Immunology, Aruna Asaf Ali Marg, New Delhi 110 067, ...
Gangal, Dr Sharad Vishwanath Ph.D. (Mumbai), FNASc. Date of birth: 2 May 1937. Specialization: Allergy, Immunology and Biochemistry Address: Lakshmi Niwas, Opp. Santoshi Mata Temple (B Cabin), Sane Guruji Path, Naupada, Thane 400 602, Maharashtra Contact: Residence: (022) 2537 6961. Mobile: 93249 24307
Home; Fellowship. Fellow Profile. Elected: 2009 Section: Medicine. Chitnis, Dr Chetan Eknath Ph.D. (UC, Berkeley), FNA. Date of birth: 3 April 1961. Specialization: Molecular Parasitology, Vaccine Development for Malaria and Molecular & Cell Biology Address: Head, Malaria Parasite Biology & Vaccine, Institut Pasteur, 28, ...
Elected: 2013 Section: Medicine. Mukhopadhyay, Dr Sangita Ph.D. (Utkal), FNASc. Date of birth: 1 January 1966. Specialization: Immunology, Cell Signalling, Communicable Diseases Address: Group Leader, Molecular Cell Biology, Centre for DNA Fingerprinting & Diagnostics, Nampally, Hyderabad 500 001, A.P.. Contact ...
Elected: 2015 Section: Medicine. Bhandari, Dr Nita Ph.D. (JNU), FAMS. Date of birth: 9 November 1955. Specialization: Nutrition-Infection Interaction, Child Health, Nutritional Interventions, Clinical Evaluation of Vaccine Address: President & Director, Centre for Health R&D Society for Applied Studies, 45, Kalu Sarai, New ...
Nageswara Rao, Dr Gullapalli M.D. (Opthal.) (AIIMS), FAMS, FACS, FRCS, FNASc. Date of birth: 1 September 1945. Specialization: Cornea, Community Eye Health and Eye Care Policy & Planning Address: Distinguished Chair of Eye Health, LV Prasad Eye Institute, LV Prasad Marg, Banjara Hills, Hyderabad 500 034, A.P.
Fellow Profile. Elected: 1945 Section: Mathematical Sciences. Chandrasekaran, Dr Chidambara Ph.D. (London) 1962-64. Date of birth: 30 October 1911. Date of death: 4 January 2000. Specialization: Statistics, Public Health and Demography Last known address: 'Sri Kripa', 79/3, Benson Cross Road, Bengaluru 560 046.
Fellow Profile. Elected: 2000 Section: Chemistry. Chandrashekar, Dr Tavarekere Kalliah Ph.D. (IISc), FNASc, FNA, FTWAS Council Service: 2013-15. Date of birth: 1 January 1956. Specialization: Bio-inorganic Chemistry, Synthetic Inorganic Chemistry and Catalysis Address: Senior Professor, School of Chemical Sciences, ...
Date of birth: 12 December 1957. Specialization: Wildlife Ecology & Animal Cognition, Evolutionary Biology, Computational Biology and Microbial Diversity Address: Professor, Biology, Indian Institute of Science Education & Research, Dr Homi Bhabha Road, Pashan, Pune 411 008, Maharashtra Contact: Office: (020) 2590 ...
Gangal, Dr Sudha Gajanan Ph.D. (Mumbai), FNA Council Service: 1995-97. Date of birth: 25 August 1934. Specialization: Cancer & Basic Immunology, Cell Biology and Genetic Diseases Address: 4, Mahavishnu Apartments, Dahanukar Colony A, Kothrud, Pune 411 029, Maharashtra Contact: Residence: (020) 2538 4382, ...
Home; Fellowship. Fellow Profile. Elected: 1974 Section: Engineering & Technology. Amarjit Singh, Dr Ph.D. (Harvard). Date of birth: 19 November 1924. Specialization: Millimeter Wave Tubes, Microwave Tubes and Microwave Electronics Address: 12, Auburn Court, Vernon Hills, IL 60061, USA Contact: Residence: ...
Home; Fellowship. Fellow Profile. Elected: 2008 Section: Medicine. Chandy, Dr Mammen MD (Madras), FRACP, FRCPA. Date of birth: 30 August 1949. Specialization: Hematology, Bone Marrow Transplantation and Molecular Genetics of Blood Diseases Address: Director, Tata Memorial Centre, 14, Major Arterial Road, ...
Home; Fellowship. Fellow Profile. Elected: 1991 Section: Earth & Planetary Sciences. Thakur, Dr Vikram Chandra Ph.D. (London). Date of birth: 15 January 1940. Specialization: Structural Geology, Tectonics of Himalayan Geology and Active Tectonics Address: 9/12 (Lane 9), Ashirwad Eclave, Dehra Dun 248 001, ...
Home; Fellowship. Fellow Profile. Elected: 2011 Section: Animal Sciences. Shivaji, Dr Sisinthy Ph.D. (Delhi), FNASc. Date of birth: 17 June 1950. Specialization: Anti-Microbial Resistance, Gut Microbiome, Eye Disease, Conservation Biology, Mammalian Sperm Function, Bacterial Biodiversity of Cold Habitats, Cold ...
Home; Fellowship. Fellow Profile. Elected: 2000 Section: Medicine. Dikshit, Dr Madhu Ph.D. (Kanpur), FNASc, FNA Council Service: 2016. Date of birth: 21 November 1957. Specialization: Redox Biology, Cardiovascular Pharmacology, Molecular Pharmacology, Neutrophiles and Nitric Oxide Synthase Address: Department ...
Home; Fellowship. Fellow Profile. Elected: 1993 Section: Physics. Chaddah, Dr Praveen Ph.D. (Mumbai), FNA, FNASc. Date of birth: 20 December 1951. Specialization: Superconductivity, Low Temperature Physics and Phase Transitions Address: Flat 702, Block 24, Heritage City, MG Road (near Metro Station), Gurgaon ...
Sengupta, Dr Sagar Ph.D. (IISc), FNA, FNASc. Date of birth: 23 June 1968. Specialization: Cancer Biology, Cell Signalling, Mytochondrial Biology Address: National Institute of Immunology, Aruna Asaf Ali Marg, New Delhi 110 067, U.T.. Contact: Office: (011) 2670 3786. Residence: (0124) 422 7107. Mobile: 93131 05470
Home; Fellowship. Fellow Profile. Elected: 1989 Section: Earth & Planetary Sciences. Sharma, Dr Ram Swaroop Ph.D. (Basel), FNA. Date of birth: 10 July 1937. Specialization: Metamorphic Petrology, Mineralogy and Precambrian Geology Address: 70/36, Pratapnagar, Sector 7, Sanganer (RHB), Jaipur 302 033, Rajasthan
Shastry, Dr B Sriram Ph.D. (Mumbai), FNA, FNASc, FTWAS. Date of birth: 26 November 1950. Specialization: Strongly-Correlated Fermi Systems, Quantum Integrable Systems Address: Distinguished Professor, Department of Physics, University of California, Santa Cruz, CA 95064, USA Contact: Office: (+1-831) 459 5849
Elected: 1992 Section: Earth & Planetary Sciences. Shetye, Dr Satish Ramnath Ph.D. (Washington), FNA, FNASc. Council Service: 1998-2003. Date of birth: 25 October 1950. Specialization: Physical Oceanography Address: Vice Chancellor, Goa University, Taleigao Plateau 403 206, Goa Contact: Office: (0832) 651 9001
Home; Fellowship. Fellow Profile. Elected: 1971 Section: Engineering & Technology. Valluri, Dr Sitaram Rao Ph.D. (Caltech). Date of birth: 25 June 1924. Specialization: Metal Fatigue Address: 'Prashanthi', 659, 100 Feet Road, Indiranagar, Bengaluru 560 038, Karnataka Contact: Residence: (080) 2525 8294. YouTube ...
Home; Fellowship. Fellow Profile. Elected: 1948 Section: Medicine. Authikesavalu, Dr Munisamy MBBS (Madras), MS (Minneapolis), FRCS. Date of birth: 16 August 1906. Date of death: 22 September 1973. Specialization: Experimental Surgery, Ophthalmology, Otolaryngology Last known address: 5-C, Lavelle Cross Road, ...
Elected: 2010 Section: Medicine. Sharma, Dr Surendra Kumar Ph.D. (AIIMS), MD (PGIMER, Chandigarh), FNASc, FNA. Date of birth: 22 February 1951. Specialization: Environmental Medicine, Infectious Diseases, Internal Medicine, Pulmonary & Critical Care and Sleep Medicine Address: B-5/3, B Block, Sector 13, RK ...
Jameel, Dr Shahid Ph.D. (Washington State Univ.), FNASc, FNA. Date of birth: 8 August 1957. Specialization: Molecular Biology and Molecular Virology Address: Chief Executive Officer, The Wellcome Trust/DBT India Alliance, 8-2-684/3/K/19, Kaushik Society, Road NO. 12, Banjara Hills, Hyderabad 500 034, A.P.. Contact:
Elected: 1974 Section: Plant Sciences. Santhanam, Dr Vaidyanathaswamy Ph.D. (Madras). Date of birth: 31 July 1925. Specialization: Plant Breeding & Genetics, Research Management and Cotton Development Address: 'Shri Abhirami', 107, Venkataswamy Road West, R S Puram Post, Coimbatore 641 002, T.N.. Contact:
Elected: 1985 Section: Plant Sciences. Shivanna, Dr Kundaranahalli Ramalingaiah Ph.D. (Delhi), FNA, FNAAS, FNASc. Date of birth: 30 June 1940. Specialization: Pollen Biology, Reproductive Ecology and Conservation Biology Address: Odekar Farms, Nandihalli, via Thovinakere, Tumkur 572 138, Karnataka Contact:
Elected: 1987 Section: Physics. Barua, Dr Asok Kumar Ph.D. (Calcutta). Date of birth: 1 July 1936. Specialization: Solid State Materials, Thin Film Technology and Thin Film Solar Cells Address: Honorary Emeritus Professor, Indian Institute of Engineering Science & Technology, Shibpur, Howrah 711 103, W.B.. Contact:
Jena, Dr Prafulla Kumar Ph.D. (Utkal). Date of birth: 27 December 1931. Specialization: Extractive Metallurgy, Mineral Processing, Environmental Engineering and Materials Processing Address: Chairman, Institute of Advance Technology and Environmental Studies, 80A-831A Lewis Road, Bhubaneswar 751 002, Orissa
Home; Fellowship. Fellow Profile. Elected: 1982 Section: Medicine. David, Dr Joy Caesarina M.B.B.S., M.S. (Madras). Date of birth: 3 May 1927. Date of death: 20 April 2004. Specialization: Neuropharmacology Last known address: 292, 4th Main, 1st Block, Koramangala, Bengaluru 560 034. YouTube; Twitter; Facebook ...
Elected: 1961 Section: Medicine. Chandy, Dr Jacob MBBS (Madras), FRCS (c) Council Service: 1962-70. Date of birth: 23 January 1910. Date of death: 23 June 2007. Specialization: Neurology, Neurosurgery and Medical Education Last known address: Paarra, Matteethra, Kottayam 686 004. YouTube; Twitter; Facebook ...
Mishra, Dr Rakesh K Ph.D. (Allahabad), FNASc, FNA. Date of birth: 14 April 1961. Specialization: Genomics, Chromatin, Epigenetics Address: Director, Centre for Cellular & Molecular Biology, Uppal Road, Hyderabad 500 007, A.P.. Contact: Office: (040) 2719 2600. Residence: (040) 2720 6400. Mobile: 94419 02188
Elected: 1991 Section: Chemistry. Ranganathan, Dr Darshan Ph.D. (Delhi), FNA. Date of birth: 4 June 1941. Date of death: 4 June 2001. Specialization: Organic Chemistry, Bio-Organic Chemistry and Supramolecular Chemistry Last known address: Scientist, Indian Institue of Chemical, Technology, Uppal Road, Hyderabad ...
Panda, Dr Subrat Kumar M.B.B.S. (Utkal), M.D. (Path.) (AIIMS), FNA. Date of birth: 18 November 1954. Specialization: Liver Pathology, Viral Hepatitis and Molecular Biology/Virology Address: Professor, Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, U.T.. Contact:
Gurjar, Dr Mukund Keshao Ph.D. (Nagpur and London), FNASc. Date of birth: 28 August 1952. Specialization: Carbohydrate Chemistry and Synthetic Organic Chemistry Address: Director, R&D, Emcure Pharmaceuticals Limited, P2, ITBT Park Phase II, Hinjwadi, Pune 411 057, Maharashtra Contact: Office: (020) 3982 1350, ...
Elected: 1996 Section: Engineering & Technology. Kulkarni, Dr Mohan Gopalkrishna Ph.D. (Mumbai), FNAE. Date of birth: 14 November 1950. Specialization: Polymer Science & Engineering, Intellectual Property Address: Emeritus Scientist, Unit for R&D of Information Products, Tapovan, NCL Campus, Pashan Road, Pune ...
Fellow Profile. Elected: 1986 Section: Plant Sciences. Sethunathan, Dr Nambrattil Ph.D. (Madras), FNA, FNAAS, FNASc. Date of birth: 2 June 1937. Specialization: Environmental Microbiology Address: Flat No. 103, Ushodaya Apartments, Sri Venkateswara Officers' Colony, Ramakrishnapuram, Secunderabad 500 056, A.P.
Elected: 2008 Section: Animal Sciences. Parnaik, Dr Veena Krishnaji Ph.D. (Ohio State), FNA. Date of birth: 22 August 1953. Specialization: Cell Biology, Molecular Biology, Lamins and Nuclear Organisation Address: INSA Senior Scientist, Centre for Cellular & Molecular Biology, Uppal Road, Hyderabad 500 007, A.P.
Fellow Profile. Elected: 2017 Section: General Biology. Sengupta, Dr Sagar Ph.D. (IISc), FNA, FNASc. Date of birth: 23 June 1968. Specialization: Cancer Biology, Cell Signalling, Mytochondrial Biology Address: National Institute of Immunology, Aruna Asaf Ali Marg, New Delhi 110 067, U.T.. Contact: Office: (011) 2670 3786
Fellow Profile. Elected: 1992 Section: General Biology. Basu, Dr Sandip Kumar Ph.D. (Calcutta), FNASc, FNA, FTWAS Council Service: 1995-97. Date of birth: 1 January 1944. Specialization: Cell Biology, Molecular Biology and Microbial Genetics Address: FD-426, Sector 3, Bidhan Nagar, Kolkata 700 106, W.B.. Contact:
Elected: 1999 Section: General Biology. Adhya, Dr Samit Ph.D. (New York), FNA. Date of birth: 29 September 1953. Specialization: Mitochondrial Biology, Molecular Genetics of Parasites, Intracellular RNA Trafficking and DNA Diagnostics Address: CSIR Emeritus Scientist, Indian Inst. of Chemical Biology, 4, Raja S.C. ...
Elected: 2008 Section: General Biology. Apte, Dr Shree Kumar Ph.D. (Gujarat), FNA, FNASc, FNAAS. Date of birth: 18 October 1952. Specialization: Molecular Biology & Biotechnology, Physiology and Stress Biology of Bacteria & Plants Address: Emeritus Professor, Homi Bhabha National Institute, Anushakti Nagar, ...
Elected: 2014 Section: Medicine. Mukerji, Dr Mitali Ph.D. (IISc). Date of birth: 13 November 1967. Specialization: Functional Genomics, Population Genomics, Ayurgenomics Address: Sr Principal Scientist, Genomics & Molecualr Medicine, Institute of Genomics & Integrative Biology, Sukhdev Vihar, Mathura Road, New Delhi ...
Wu, Jingjiong; Zhang, Yanwen; Luo, Xiaochen; Zhang, Qing; Zhu, Jianxin
To explore the modern hospital and regional medical consumable reagents logistics system management. The characteristics of regional logistics, through cooperation between medical institutions within the region, and organize a wide range of special logistics activities, to make reasonable of the regional medical consumable reagents logistics. To set the regional management system, dynamic management systems, supply chain information management system, after-sales service system and assessment system. By the research of existing medical market and medical resources, to establish the regional medical supplies reagents directory and the initial data. The emphasis is centralized dispatch of medical supplies reagents, to introduce qualified logistics company for dispatching, to improve the modern hospital management efficiency, to costs down. Regional medical center and regional community health service centers constitute a regional logistics network, the introduction of medical consumable reagents logistics services, fully embodies integrity level, relevance, purpose, environmental adaptability of characteristics by the medical consumable reagents regional logistics distribution. Modern logistics distribution systems can increase the area of medical consumables reagent management efficiency and reduce costs.
Koch, Evan; Brangman, Goldie
In September 1958 the Rev Dr Martin Luther King Jr was stabbed and nearly assassinated. Surgeons at Harlem Hospital in New York City removed a 17.8-cm (7-in)-long letter opener from Dr King's chest. Certified Registered Nurse Anesthetist Goldie Brangman remembers this event because she participated in Dr King's anesthetic. This article correlates Brangman's memories with published accounts of the event. It also places the event within the context of the modern civil rights movement that Dr King led.
Fjølner, J; Greisen, J; Jørgensen, M R S; Terkelsen, C J; Ilkjaer, L B; Hansen, T M; Eiskjaer, H; Christensen, S; Gjedsted, J
Extracorporeal Cardiopulmonary Resuscitation (ECPR) has emerged as a feasible rescue therapy for refractory, normothermic out-of-hospital cardiac arrest (OHCA). Reported survival rates vary and comparison between studies is hampered by heterogeneous study populations, differences in bystander intervention and in pre-hospital emergency service organisation. We aimed to describe the first experiences, treatment details, complications and outcome with ECPR for OHCA in a Danish health region. Retrospective study of adult patients admitted at Aarhus University Hospital, Denmark between 1 January 2011 and 1 July 2015 with witnessed, refractory, normothermic OHCA treated with ECPR. OHCA was managed with pre-hospital advanced airway management and mechanical chest compression during transport. Relevant pre-hospital and in-hospital data were collected with special focus on low-flow time and ECPR duration. Survival to hospital discharge with Cerebral Performance Category (CPC) of 1 and 2 at hospital discharge was the primary endpoint. Twenty-one patients were included. Median pre-hospital low-flow time was 54 min [range 5-100] and median total low-flow time was 121 min [range 55-192]. Seven patients survived (33%). Survivors had a CPC score of 1 or 2 at hospital discharge. Five survivors had a shockable initial rhythm. In all survivors coronary occlusion was the presumed cause of cardiac arrest. Extracorporeal cardiopulmonary resuscitation is feasible as a rescue therapy in normothermic refractory OHCA in highly selected patients. Low-flow time was longer than previously reported. Survival with favourable neurological outcome is possible despite prolonged low-flow duration. © 2016 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
Full Text Available AIM: To investigate the value of ultrasonography in diabetic retinopathy(DR. METHODS: Totally 103 cases(103 eyesof type 2 diabetes mellitus were selected from May 2015 to May 2017 in our hospital, there were 32 patients 32 eyes with non diabetic retinopathy(NDR, 40 patients 40 eyes with non proliferative diabetic retinopathy(NPDR, and 31 patients 31 eyes with proliferative diabetic retinopathy(PDR, 40 healthy volunteers(40 eyeswere selected as control group, the maximum systolic blood flow velocity(PSV, end diastolic velocity(EDVand resistance index(RIof the central retinal artery(CRA, posterior ciliary artery(PCAand ophthalmic artery(OAwere detected by color Doppler ultrasound. RESULTS: The difference of PSV, EDV and RI of CRA, PCA and OA in each group was statistically significant(PPPPCONCLUSION: Color Doppler ultrasound monitoring the hemodynamic changes of ocular blood vessels in diabetes can provide evidence for early detection of diabetic retinopathy.
Objectives: We describe the demographics, diabetic characteristics, diabetic control and complications in the diabetes service in Edendale Regional Hospital, Pietermaritzburg, in this study. Diabetes mellitus, together with its complications, is increasing at an alarming rate worldwide. Good glycaemic control translates into ...
Monrad, Rikke Nygaard; Hansen, Dennis Schrøder
Three cases of meningitis caused by the fastidious Gram-negative rod Capnocytophaga canimorsus have been observed at a regional hospital in 1 y. The difficulties connected with the correct diagnosis by classical culturing methods in contrast to molecular methods, as well as possible reasons...
Naqi, N.; Ahmed, T.A.; Bashir, M.M.
Objective: To determine frequencies of HLA DR beta 1 alleles in rheumatoid arthritis in Pakistani patients. Study Design: Cross sectional / analytical study. Place and Duration of Study: Department of Immunology, Armed Forces Institute of Pathology, Rawalpindi in collaboration with Rheumatology departments of Military Hospital, Rawalpindi and Fauji Foundation Hospital, Rawalpindi, from January 2009 to January 2010. Methodology: HLA DR beta 1 genotyping of one hundred Pakistani patients, diagnosed as having RA as per American College of Rheumatology revised criteria 1987, was done. HLA DR beta 1 genotyping was carried out at allele group level (DR beta 1*01-DR beta 1*16) by sequence specific primers in RA patients. Comparison of HLA DR beta 1 allele frequencies between patients and control groups was made using Pearson's chi-square test to find possible association of HLA DR?1 alleles with RA in Pakistani rheumatoid patients. Results: HLA DR beta 1*04 was expressed with significantly increased frequency in patients with rheumatoid arthritis (p <0.05). HLA DR?1*11 was expressed statistically significantly more in control group as compared to rheumatoid patients indicating a possible protective effect. There was no statistically significant difference observed in frequencies of HLA DR beta 1 allele *01, DR beta 1 allele *03, DR beta 1 allele *07, DR beta 1 allele *08, DR beta 1 allele *09, DR beta 1 allele *10, DR beta 1 allele *12, DR beta 1 allele *13, DR beta 1 allele *14, DR?1 allele *15 and DR beta 1 allele *16 between patients and control groups. Conclusion: The identification of susceptible HLA DR beta 1 alleles in Pakistani RA patients may help physicians to make early decisions regarding initiation of early intensive therapy with disease modifying anti rheumatic medicines and biological agents decreasing disability in RA patients. (author)
Bhimo Rizky Samudro
Full Text Available This study aims to investigate the efficiency level of hospital surgery hospital installation in Special Region of Yogyakarta Province. Research conceptual constructs are based on input and output performance in institutional performance processes. This research approach uses positivist pattern and is derived by quantitative method. This is to explain the efficiency pattern of the installation of hospital and private hospital surgery rooms. The quantitative method chosen is the concept of Data Envelopment Analysis (DEA. The results showed that 1 the installation of a private hospital surgery room tends to be more efficient than government property; 2 the installation of a special hospital surgical hospital is not absolutely more efficient than a public hospital. As a recommendation, this research provides scenario for setting input usage for efficient performance.
Wilson, A. G.; de Vries, N. [=Niek; Pociot, F.; di Giovine, F. S.; van der Putte, L. B.; Duff, G. W.
The tumor necrosis factor (TNF) alpha gene lies within the class III region of the major histocompatibility complex (MHC), telomeric to the class II and centromeric to the class I region. We have recently described the first polymorphism within the human TNF-alpha locus. This is biallelic and lies
Retrospective study on the epidemiology of the septic arthritis and acute osteomyelitis by Staphylococcus aureus in patients hospitalized at the Hospital Nacional de Ninos Dr. Carlos Saenz Herrera January 2007- September 2013
Sanabria Leiva, Mariana
The general epidemiology and microbiology of acute osteomyelitis and septic arthritis by Staphylococcus aureus (S. aureus) are described in children hospitalized at the Hospital de Ninos between January 2007 and September 2013. 88 patients are included in the study, of which 64% have corresponded to acute osteomyelitis, septic arthritis 21% and 15% both diagnoses. Age groups, joints and bones most affected are identified. Antibiotic sensitivity changes of the S. aureus are determined in the last 5 years. The use of imaging studies and diagnostic tests are specified in patients with acute osteomyelitis and septic arthritis. Complications, mortality and sequelae most common are established in patients. The surgical procedures are described. The clindamycin and TMP-SMX are recommended as drugs of first choice for the treatment of acute osteomyelitis and septic arthritis [es
Sewunet, Tsegaye; Kebede, Wakjira; Wondafrash, Beyene; Workalemau, Bereket; Abebe, Gemeda
Unsafe working practices, working environments, disposable waste products, and chemicals in clinical laboratories contribute to infectious and non-infectious hazards. Staffs, the community, and patients are less safe. Furthermore, such practices compromise the quality of laboratory services. We conducted a study to describe safety practices in public hospital laboratories of Oromia Regional State, Ethiopia. Randomly selected ten public hospital laboratories in Oromia Regional State were studied from Oct 2011- Feb 2012. Self-administered structured questionnaire and observation checklists were used for data collection. The respondents were heads of the laboratories, senior technicians, and safety officers. The questionnaire addressed biosafety label, microbial hazards, chemical hazards, physical/mechanical hazards, personal protective equipment, first aid kits and waste disposal system. The data was analyzed using descriptive analysis with SPSS version16 statistical software. All of the respondents reported none of the hospital laboratories were labeled with the appropriate safety label and safety symbols. These respondents also reported they may contain organisms grouped under risk group IV in the absence of microbiological safety cabinets. Overall, the respondents reported that there were poor safety regulations or standards in their laboratories. There were higher risks of microbial, chemical and physical/mechanical hazards. Laboratory safety in public hospitals of Oromia Regional State is below the standard. The laboratory workers are at high risk of combined physical, chemical and microbial hazards. Prompt recognition of the problem and immediate action is mandatory to ensure safe working environment in health laboratories.
Klutsey, Ellen Eyi; Ankomah, Augustine
Induced abortion rates remained persistently high in the Volta Region of Ghana in the 5 years from 2006 to 2011. Some hospitals, both rural and urban, report induced abortion-related complications as one of the top ten conditions in hospital admissions. This study explored demographic and other factors associated with induced abortion, and also assessed awareness of abortion-related complications among women of reproductive age in the Volta Region. A quantitative, hospital-based, unmatched case-control study was performed. The Volta Region was stratified into two health administration zones, ie, north and south. For each zone, hospitals were stratified into government and private hospitals. Employing simple random sampling, one private and three government hospitals were selected from each zone. This study is therefore based on eight hospitals, ie, six government hospitals and two private hospitals. Marital status, employment status, number of total pregnancies, and knowledge about contraception were found to be associated with induced abortion. Multiple logistic regression showed a 4% reduction in the odds of induced abortion in married women compared with women who were single (odds ratio [OR] 0.11, 95% confidence interval [CI] 0.07-0.22). Unemployed women of reproductive age were found to be 0.35 times less likely to seek induced abortion compared with their employed counterparts (OR 0.35, CI 0.19-0.65). It was also observed that women with their second pregnancies were 3.8 times more likely to seek induced abortion and women with more than two pregnancies were 6.6 times more likely to do so (OR 3.81, CI 1.94-7.49 and OR 6.58, CI 2.58-16.79, respectively). Women with no knowledge of contraceptive methods were 4.6 times likely to seek induced abortion (OR 4.64, CI 1.39-15.4). Compared with women who had not had induced abortion, women with a high number of pregnancies and no contraceptive knowledge were more likely to have induced abortion. It was found that lack
Profile of the geriatric patient treated in the Unidad de Incontinencia Urinaria del Hospital Nacional de Geriatria y Gerontologia 'Dr. Raul Blanco Cervantes' in the period from January 1, 2012 to June 30, 2013
Garita Cordero, Andrea
The elderly adult patient is characterized in the Unidad de Incontinencia Urinaria of the Hospital Nacional de Geriatria 'Dr. Raul Blanco Cervantes', during the period between January 1, 2012 and June 30, 2013. The total revision was 513 clinical records of patients treated for the first time in the Urinary Incontinence Unit in the established period. 228 of the cases were excluded. A final sample of 285 patients aged 76 years on average is studied, the predominance is the female sex and the state is widowhood, schooling is Aged 6 and residing in San Jose. In addition, partial dependent patients BLFA (Basic Life Activities) and IALF (Instrumental Activities of Life) are included, in normal cognitive condition according to schooling by MMSE (Mini Mental State Examination) and with risk of depression. As comorbidity they have presented mainly AHT (Arterial hypertension), DM (Diabetes Mellitus) and depression with associated obesity. The patients studied have consumed at least 2 medications simultaneously and usually have had a previous surgical history. Women who have had gynecological obstetric records of pregnancies and births were found to be unrelated to some type of incontinence. Patients have presented defects of the pelvic floor, such as cystocele and rectocele, in men increased prostate size. The most prevalent urinary incontinence has been the mixed, finding association by gender, in women is given more mixed urinary incontinence, followed by stress urinary incontinence; In men, urgent urinary incontinence and urinary incontinence due to overflow. Patients are sent to treatment with electrostimulation of pelvic floor and completed sessions, have shown an improvement in incontinence and quality of life. A more detailed evaluation of the older adult and to evaluate urinary incontinence could give greater results of the capture of patients with positive repercussion in the patient's quality of life. (author) [es
THE ANTI-TB DRUG SENSITIVITY OF MYCOBACTERIUM TUBERCULOSIS FROM CEREBROSPINAL FLUID AND BONE TISSUE BIOPSY SPECIMENS OF PATIENTS SUSPECTED TUBERCULOUS MENINGITIS AND SPINAL TB IN DR SOETOMO HOSPITAL INDONESIA
Ni Made Mertaniasih
Full Text Available Tuberculous meningitis (TBM is an infection of meningens which potentially life threatening with significant morbidity and mortality. Spinal TB has the same problem with TBM, infection in bone and joint, the delayed diagnosis worsens the prognosis. The rapid and accurate diagnosis plus promt adequate treatment is essential for the good outcome. The aim of this research is to study the first line drug sensitivity of Mycobacterium tuberculosis isolated from specimens of cerebrospinal fluid from suspected tuberculous meningitis patients and bone tissue biopsy from suspected spinal TB patients. The method of this research is TB Laboratory examination in Department of Clinical Microbiology – Dr. Soetomo General Hospital, Indonesia, using the gold standard liquid culture method MGIT 960 System (Becton Dickinson and solid culture method with Lowenstein-Jensen medium. The specimens CSF from 50 TBM patients at January 2013 until May 2014. Positive isolate detection of Mycobacterium tuberculosis complex were 11 isolates (22%, which sensitivity 100% (11/11 isolates to Rifampin (R, Pyrazinamide (Z, Ethambutol (E, and Streptomycin (S; one isolate resistant to Isoniazid, sensitivity to Isoniazid 90,90% (10/11; and received 21 specimens of bone tissue biopsy which positive 5 isolates (23%, all isolates sensitive 100% (5/5 isolates to Rifampin and Pyrazinamide, and 1 isolates resistant to Isoniazid, Ethambutol, and Streptomycin, in which sensitivity 80% (4/5 isolates to Isoniazid, Ethambutol, and Streptomycin. The conclusion of this research is positivity detection 22% of CSF specimens, and 23% of bone tissue biopsy were low. All isolates sensitive 100% to Rifampin and Pyrazinamide, and 80-90% sensitive to Isoniazid.
Full Text Available This study applies the game theory to the discussion and analysis of trans-regional Telemedicine System, builds the game model of the selection strategies of trans-regional hospitals and patients and analyzes evolving paths, equilibrium states and influencing factors of the three parties. It is derived that medical insurance reimbursement proportion of specialized hospitals, government support for general hospitals and medical expenses in specialized hospitals, operating costs of general hospitals are the influential factors in the Telemedicine System. Finally, a numerical stimulation is conducted with Matlapb based on the data from ligChina Health and Family Planning Statistical Yearbook 2015l/ig.
Koenta Adji Koerniawan
Full Text Available This study aims to understand the effect of management perceptions in Regional Public Service Agency BLUD for Hospital in Malang regency Indonesia on the role of the Independent Auditor and their understanding towards Good Governance the General Audit Engagement and its implications for the prevention of corruption. This research is quantitative which placed latent variables General Audit Engagements as intervening variables. Partial Least Square PLS is used to confirm the model created in order to explain the relationship between variables. The results show that the perception of BLUD hospital management on the role of independent auditors and their understanding of good governance to give effect to the implementation of the audit engagement and the implications for the prevention of fraud in BLUDs hospital. This is consistent with the theory of auditing and fraud prevention concepts. JEL Classification M420 K420
Mohammed, A S; Al-Hashemy, A; Addous, A J; Ismail, G
The Southern Region renal transplant program was established in February 1989. The appointment of a transplant co-ordinator and creation of a waiting list for the Southern Region as well as tissue typing of all patients in the region were important early steps. Between February 1989 and December 1995, 155 transplants were performed on 152 patients at the Armed Forces Hospital, Southern Region (AFHSR). Of them, 52 were cadaveric donor transplants and the remaining were from living related donors. The overall five-year actuarial patient and graft survival was 93% and 78% respectively. Of the 152 patients who were transplanted, 79 patients were from other hospitals in the region and 73 were from AFHSR. Maintenance immunosuppression consisted of cyclosporin, azathioprine and prednisolone. Use of the spouse as a donor was an early feature of this program. Our results compare favorably with results published from other centers. To cope with the increasing demand of transplantation in the Southern Region, we have to look into ways of increasing our transplant numbers to match the needs.
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...
Full Text Available Introduction. Globally, depression is one of the three leading causes of disease and it will be the second leading cause of world disability by 2030. The prevalence of depression in Sub-Saharan Africa ranges from 15 to 30%. In Ethiopia, depression was found to be the seventh leading cause of disease burden and its prevalence has been increased in hospital compared to community setting because hospital environment itself is stressful. Yet, no study was done in Eastern Ethiopia, where substance use like Khat is very rampant. Objective. To assess depression and associated factors among adult inpatients at public hospitals of Harari Regional State, Eastern Ethiopia, from February 01 to 28, 2017. Methodology. Hospital based cross-sectional study design was employed on 492 admitted adult patients in Harari region hospitals. Consecutive sampling method was used to include study population. The data were collected by interviewee and analyzed by SPSS version 20.0. Bivariate and multivariate logistic regression analyses were employed. p value of 0.05 or less was considered to be statistically significant. Result. A total of 489 patients were interviewed with response rate of 99.4%. Having duration of 1-2 weeks in the hospital [AOR = 2.02, 95% CI: (1.28, 3.19], being diagnosed with chronic morbidity [AOR = 4.06, 95% CI: (2.23, 7.40], being users of psychoactive drugs [AOR = 2.24, 95% CI: (1.18, 4.24], and having been admitted to surgical ward [AOR = 0.50, 95% CI: (0.31, 0.81] were significantly associated with depression. Conclusion and Recommendation. Prevalence of depression among admitted inpatients was high. Therefore, increasing the awareness of benefits of early diagnosis of patients to prevent major form of depression and strengthening the clinical set-up and establishing good referral linkage with mental health institutions was considered to be cost-effective method to reduce its prevalence.
van Leeuwen, F.; de Bruijne, J. H. J.; Arenou, F.; Comoretto, G.; Eyer, L.; Farras Casas, M.; Hambly, N.; Hobbs, D.; Salgado, J.; Utrilla Molina, E.; Vogt, S.; van Leeuwen, M.; Abreu, A.; Altmann, M.; Andrei, A.; Babusiaux, C.; Bastian, U.; Biermann, M.; Blanco-Cuaresma, S.; Bombrun, A.; Borrachero, R.; Brown, A. G. A.; Busonero, D.; Busso, G.; Butkevich, A.; Cantat-Gaudin, T.; Carrasco, J. M.; Castañeda, J.; Charnas, J.; Cheek, N.; Clementini, G.; Crowley, C.; Cuypers, J.; Davidson, M.; De Angeli, F.; De Ridder, J.; Evans, D.; Fabricius, C.; Findeisen, K.; Fleitas, J. M.; Gracia, G.; Guerra, R.; Guy, L.; Helmi, A.; Hernandez, J.; Holl, B.; Hutton, A.; Klioner, S.; Lammers, U.; Lecoeur-Taïbi, I.; Lindegren, L.; Luri, X.; Marinoni, S.; Marrese, P.; Messineo, R.; Michalik, D.; Mignard, F.; Montegriffo, P.; Mora, A.; Mowlavi, N.; Nienartowicz, K.; Pancino, E.; Panem, C.; Portell, J.; Rimoldini, L.; Riva, A.; Robin, A.; Siddiqui, H.; Smart, R.; Sordo, R.; Soria, S.; Turon, C.; Vallenari, A.; Voss, H.
We present the first Gaia data release, Gaia DR1, consisting of astrometry and photometry for over 1 billion sources brighter than magnitude 20.7 in the white-light photometric band G of Gaia. The Gaia Data Processing and Analysis Consortium (DPAC) processed the raw measurements collected with the Gaia instruments during the first 14 months of the mission, and turned these into an astrometric and photometric catalogue. Gaia DR1 consists of three parts: an astrometric data set which contains the positions, parallaxes, and mean proper motions for about 2 million of the brightest stars in common with the Hipparcos and Tycho-2 catalogues (the primary astrometric data set) and the positions for an additional 1.1 billion sources (the secondary astrometric data set). The primary set forms the realisation of the Tycho-Gaia Astrometric Solution (TGAS). The second part of Gaia DR1 is the photometric data set, which contains the mean G-band magnitudes for all sources. The third part consists of the G-band light curves and the characteristics of 3000 Cepheid and RR Lyrae stars observed at high cadence around the south ecliptic pole. The positions and proper motions in the astrometric data set are given in a reference frame that is aligned with the International Celestial Reference Frame (ICRF) to better than 0.1 mas at epoch J2015.0, and non-rotating with respect to the ICRF to within 0.03 mas yr^-1. For the primary astrometric data set, the typical standard error for the positions and parallaxes is about 0.3 mas, while for the proper motions the typical standard error is about 1 mas yr^-1. Whereas it has been suggested in Gaia Collaboration et al. (2016a) that a systematic component of ∼0.3 mas should be 'added' (in quadrature) to the parallax uncertainties, Brown (2017) clarifies that reported parallax standard errors already include local systematics as a result of the calibration of the TGAS parallax uncertainties by comparison to Hipparcos parallaxes. For the subset of
Kumar, Sandeep; Mitchell, Mark A; Rup, Bonita; Singh, Satish K
Aggregation and unwanted immunogenicity are hurdles to avoid in successful commercial development of antibody-based therapeutics. In this article, the relationship between aggregation-prone regions (APRs), capable of forming cross-β motifs/amyloid fibrils, and major histocompatibility complex class II-restricted human leukocyte antigen (HLA)-DR-binding T-cell immune epitopes (TcIEs) is analyzed using amino acid sequences of 25 therapeutic antibodies, 55 TcIEs recognized by T-regulatory cells (tregitopes), 1000 randomly generated 15-residue-long peptides, 2257 human self-TcIEs (autoantigens), and 11 peptides in HLA-peptide cocrystal structures. Sequence analyses from these diverse sources consistently show a high level of correlation between APRs and TcIEs: approximately one-third of TcIEs contain APRs, but the majority of APRs occur within TcIE regions (TcIERs). Tregitopes also contain APRs. Most APR-containing TcIERs can bind multiple HLA-DR alleles, suggesting that aggregation-driven adverse immune responses could impact a broad segment of patient population. This article has identified common molecular sequence-structure loci that potentially contribute toward both manufacturability and safety profiles of the therapeutic antibodies, thereby laying a foundation for simultaneous optimization of these attributes in novel and follow-on candidates. Incidence of APRs within TcIERs is not special to biotherapeutics, self-TcIEs from human proteins, involved in various diseases, also contain predicted APRs and experimentally proven amyloid-fibril-forming peptide sequence portions. Copyright © 2012 Wiley Periodicals, Inc.
Nilsson, Josefine; Pembe, Andrea B; Urasa, Miriam; Darj, Elisabeth
Unsafe injections and substandard waste management are public health issues exposing healthcare workers and the community to the risk of infections. The objective of this study was to assess the knowledge and practice of safe injections and health care waste management among healthcare workers at a regional hospital in northern Tanzania. This cross sectional descriptive study was conducted in a regional hospital in northern Tanzania. Data was collected through a self-administered questionnaire with additional observations of the incinerator, injections, waste practices, and the availability of medical supplies. Data was analysed in SPSS descriptive statistics and chi-square tests were performed. A total of 223 of 305 (73%) healthcare workers from different cadres were included in the study. The majority of healthcare workers had adequate knowledge and practice of safe injections, but inadequate knowledge about waste management. The majority of the staff reported knowledge of HIV as a risk factor, however, had less knowledge about other blood-borne infections. Guidelines and posters on post exposure prophylaxes and waste management -were present at the hospital, however, the incinerator had no fence or temperature gauge. In conclusion, healthcare workers reported good knowledge and practice of injections, and high knowledge of HIV transmission routes. However, the hospital is in need of a well functioning incinerator and healthcare workers require sufficient medical supplies. There was a need for continual training about health care waste management and avoidance of blood-borne pathogens that may be transmitted through unsafe injections or poor health care waste management.
Srofenyoh, Emmanuel; Ivester, Thomas; Engmann, Cyril; Olufolabi, Adeyemi; Bookman, Laurel; Owen, Medge
To reduce maternal and neonatal death at a large regional hospital through the use of quality improvement methodologies. In 2007, Kybele and the Ghana Health Service formed a partnership to analyze systems and patient care processes at a regional hospital in Accra, Ghana. A model encompassing continuous assessment, implementation, advocacy, outputs, and outcomes was designed. Key areas for improvement were grouped into "bundles" based on personnel, systems management, and service quality. Primary outcomes included maternal and perinatal mortality, and case fatality rates for hemorrhage and hypertensive disorders. Implementation and outcomes were evaluated tri-annually between 2007 and 2009. During the study period, there was a 34% decrease in maternal mortality despite a 36% increase in patient admission. Case fatality rates for pre-eclampsia and hemorrhage decreased from 3.1% to 1.1% (Pcontinuous quality improvement were developed and employed. Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Full Text Available Ellen Eyi Klutsey,1 Augustine Ankomah2 1School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Volta Region, 2Department of Population, Family and Reproductive Health School of Public Health, University of Ghana, Legon, Accra, Ghana Background: Induced abortion rates remained persistently high in the Volta Region of Ghana in the 5 years from 2006 to 2011. Some hospitals, both rural and urban, report induced abortion-related complications as one of the top ten conditions in hospital admissions. This study explored demographic and other factors associated with induced abortion, and also assessed awareness of abortion-related complications among women of reproductive age in the Volta Region. Methods: A quantitative, hospital-based, unmatched case-control study was performed. The Volta Region was stratified into two health administration zones, ie, north and south. For each zone, hospitals were stratified into government and private hospitals. Employing simple random sampling, one private and three government hospitals were selected from each zone. This study is therefore based on eight hospitals, ie, six government hospitals and two private hospitals. Results: Marital status, employment status, number of total pregnancies, and knowledge about contraception were found to be associated with induced abortion. Multiple logistic regression showed a 4% reduction in the odds of induced abortion in married women compared with women who were single (odds ratio [OR] 0.11, 95% confidence interval [CI] 0.07–0.22. Unemployed women of reproductive age were found to be 0.35 times less likely to seek induced abortion compared with their employed counterparts (OR 0.35, CI 0.19–0.65. It was also observed that women with their second pregnancies were 3.8 times more likely to seek induced abortion and women with more than two pregnancies were 6.6 times more likely to do so (OR 3.81, CI 1.94–7.49 and OR 6.58, CI 2.58–16.79, respectively
M Kit Delgado
Full Text Available Introduction: Optimal solutions for reducing diversion without worsening emergency department (ED crowding are unclear. We performed a systematic review of published simulation studies to identify: 1 the tradeoff between ambulance diversion and ED wait times; 2 the predicted impact of patient flow interventions on reducing diversion; and 3 the optimal regional strategy for reducing diversion.Methods: Data Sources: Systematic review of articles using MEDLINE, Inspec, Scopus. Additional studies identified through bibliography review, Google Scholar, and scientific conference proceedings. Study Selection: Only simulations modeling ambulance diversion as a result of ED crowding or inpatient capacity problems were included. Data extraction: Independent extraction by two authors using predefined data fields.Results: We identified 5,116 potentially relevant records; 10 studies met inclusion criteria. In models that quantified the relationship between ED throughput times and diversion, diversion was found to only minimally improve ED waiting room times. Adding holding units for inpatient boarders and ED-based fast tracks, improving lab turnaround times, and smoothing elective surgery caseloads were found to reduce diversion considerably. While two models found a cooperative agreement between hospitals is necessary to prevent defensive diversion behavior by a hospital when a nearby hospital goes on diversion, one model found there may be more optimal solutions for reducing region wide wait times than a regional ban on diversion.Conclusion: Smoothing elective surgery caseloads, adding ED fast tracks as well as holding units for inpatient boarders, improving ED lab turnaround times, and implementing regional cooperative agreements among hospitals. [West J Emerg Med. 2013;14(5:489-498.
Full Text Available Reviews the legal and regulatory basis in the sphere of the guardianship treatment centres in the Russian Empire in the middle of the XIXth century, alleging the establishment of the public supervision over the activities of city, County and provincial hospitals. Contents of the powers of the Trustees, their objectives and main activities. Specific examples in the Danube region proved the thesis that among the Trustees were dominated by representatives of the nobility.
This paper reports the experience of a quality management project leading to an ISO 9001 certification in a Swiss regional hospital. It describes the motivations for the project, the process that was followed and the benefits of the approach. It also shows its limitations, problems encountered as well as costs and resources involved. The emphasis is on practical issues. Choices that were made are discussed and lessons are drawn.
Safavi, Kyan C; Dai, Feng; Gilbertsen, Todd A; Schonberger, Robert B
Objective To determine whether surgical quality measures that Medicare publicly reports provide a basis for patients to choose a hospital from within their geographic region. Data Source The Department of Health and Human Services' public reporting website, Medicare Claims Processing Manual Baltimore, MD CMS http://www.medicare.gov/hospitalcompare. Study Design We identified hospitals (n = 2,953) reporting adherence rates to the quality measures intended to reduce surgical site infections (Surgical Care Improvement Project, 1–3) in 2012. We defined regions within which patients were likely to compare hospitals using the hospital referral regions (HRRs) from the Dartmouth Atlas of Health Care Project. We described distributions of reported SCIP adherence within each HRR, including medians, interquartile ranges (IQRs), skewness, and outliers. Principal Findings Ninety-seven percent of HRRs had median SCIP-1 scores ≥95 percent. In 93 percent of HRRs, half of the hospitals in the HRR were within 5 percent of the median hospital's score. In 62 percent of HRRs, hospitals were skewed toward the higher rates (negative skewness). Seven percent of HRRs demonstrated positive skewness. Only 1 percent had a positive outlier. SCIP-2 and SCIP-3 demonstrated similar distributions. Conclusions Publicly reported quality measures for surgical site infection prevention do not distinguish the majority of hospitals that patients are likely to choose from when selecting a surgical provider. More studies are needed to improve public reporting's ability to positively impact patient decision making. PMID:24611578
Full Text Available Purpose: The library of Henrik Tuma, kept at the Research Station ZRC SAZU (Raziskovalna postaja ZRC SAZU in Nova Gorica, is nowadays considered to be one of the best preserved private libraries arising in the region of Gorica at the turn of the 19th century. The article tries to evaluate and encompass all the richness of the collection thus giving an insight in the reading culture and book production in Gorica and in the wider Slovenia. It also points out to the fact that the library was closely connected to the European cultural and ideological trends as the books were supplied by all important publishing centres in Europe.Methodology/approaach: The article gives an analysis of the library catalogue created in the period 2004-2008 (electronic version was published in 2013. The overview of the major subject areas of the collection defines the place (the Goriška region and time (from the end of the 19th century to the thirties of the 20th century of building the collection.Results: The evaluation of the subject areas and the analysis of the catalogue give an insight in the present state of the collection which differs from Tuma’s inventory of the collection. It is evident that it is one of the best preserved private libraries arising in the region of Gorica at the turn of the 19th century.Research limitation: Many publications (monographs, periodicals inventoried in the old Tuma’s register were excluded from the 2008 catalogue as they were proved to be missing or lost. Thus since 2008 there has been no gap between the catalogue and the actual physical units of the collection.Originality/practical implications: The library of Henrik Tuma, a bourgeois intellectual, politician, lawyer, an alpinist, a local historian, literary critic, an editor, a publicist, psychologist, an educator, economist, a Marxist, husband, father and, last but not least, a librarian, had been systematically built during his life. It represents an important tool for
A. N. Gurov
Full Text Available Rationale: According to prognosis made by World Health Organization experts, by mid-21st century gastrointestinal disorders will be among the leaders, partially due to lifestyle of a modern man (stress, unhealthy diet, lack of physical exercise, unhealthy habits, environmental pollution, genetically modified and low quality foods.Aim: To provide informational support of activities aimed at improvement of organization of medical care to patients with gastrointestinal disorders and at further development of specialized gastroenterological care to the population of the Moscow Region, its better availability and higher efficacy and quality.Materials and methods: We calculated and analyzed gastrointestinal morbidity in 2014 (according to referrals among the main age categories (children, adolescents, adults of the population of the Moscow Region, as well as hospitalization rates and in-hospital mortality. The information was taken from the Federal Statistical Surveillance report forms # 12 and # 14.Results: In 2014, the highest prevalence of gastrointestinal disorders was registered in adolescents, being by 42.7% higher than that in adults and by 11.7% higher than that in children. The leading causes of referrals in all age categories were gastritis and duodenitis, as well as gall bladder and bile tract disorders. The structure of morbidity was characterized by a high proportion of pancreatic disorders, stomach and duodenal ulcers in adults. The rate of hospitalizations due to gastrointestinal disorders was 17.8 cases per 1000 patients, being 17.4‰ in adults and 19.8‰ in children and adolescents. The main reasons for hospitalization in adults were diseases of pancreas (23.9% of all hospitalization due to gastrointestinal disorders, gall bladder and bile tract disorders (16.3%. In children and adolescents, the main reasons for hospitalizations were intestinal disorders (36.4%, gastritis and duodenitis (17.9%. In-hospital mortality from
Carugno, Michele; Consonni, Dario; Randi, Giorgia; Catelan, Dolores; Grisotto, Laura; Bertazzi, Pier Alberto; Biggeri, Annibale; Baccini, Michela
The Lombardy region in northern Italy ranks among the most air polluted areas of Europe. Previous studies showed air pollution short-term effects on all-cause mortality. We examine here the effects of particulate matter with aerodynamic diameter ≤10µm (PM10) and nitrogen dioxide (NO2) exposure on deaths and hospitalizations from specific causes, including cardiac, cerebrovascular and respiratory diseases. We considered air pollution, mortality and hospitalization data for a non-opportunistic sample of 18 highly polluted and most densely populated areas of the region in the years 2003-2006. We obtained area-specific effect estimates for PM10 and NO2 from a Poisson regression model on the daily number of total deaths or cause-specific hospitalizations and then combined them in a Bayesian random-effects meta-analysis. For cause-specific mortality, we applied a case-crossover analysis. Age- and season-specific analyses were also performed. Effect estimates were expressed as percent variation in mortality or hospitalizations associated with a 10µg/m(3) increase in PM10 or NO2 concentration. Natural mortality was positively associated with both pollutants (0.30%, 90% Credibility Interval [CrI]: -0.31; 0.78 for PM10; 0.70%, 90%CrI: 0.10; 1.27 for NO2). Cardiovascular deaths showed a higher percent variation in association with NO2 (1.12%, 90% Confidence Interval [CI]: 0.14; 2.11), while the percent variation for respiratory mortality was highest in association with PM10 (1.64%, 90%CI: 0.35; 2.93). The effect of both pollutants was more evident in the summer season. Air pollution was also associated to hospitalizations, the highest variations being 0.77% (90%CrI: 0.22; 1.43) for PM10 and respiratory diseases, and 1.70% (90%CrI: 0.39; 2.84) for NO2 and cerebrovascular diseases. The effect of PM10 on respiratory hospital admissions appeared to increase with age. For both pollutants, effects on cerebrovascular hospitalizations were more evident in subjects aged less than
Colodey, A G; Salmon, R A; Lim, P G
The marine environment surrounding the Capital Region district (CRD) of British Columbia that includes the City of Victoria has been monitored by municipal, provincial, and federal authorities over the past 20 years to determine the impact of wastewater discharges. This report presents data from limited sampling conducted near the main CRD deep-water outfalls at Clover and Macaulay Points, the Canadian Department of National Defence septic tank outfall off Belmont and Esquimault Lagoon, and reference locations on Constance Bank and Discovery Island. Samples for this study were collected in April and October 1989, and April 1990. Parameters investigated were sediment and biota trace metals, sediment particle size, sediment volatile residues, visual descriptions of sediment, bacterial counts, water conductivity, temperature, salinity, and dissolved oxygen.
Ubeda, Carlos; Galaz, Sergio; Leyton, Fernando; Delgado, Otto; Espinosa, Alfonso; Inzulza, Alonso; Ramirez, Raul; Blanco, Daniel; Oyarzun, Carlos
Full text: International Atomic Energy Agency defined guidance level for medical exposure, for the exams of general radiology, reason why the objective of the present work was to evaluate the evolution of the doses for the radiological exam of thorax posterior/anterior among the years 2005 at 2007. The used design was of traverse, descriptive, analytic and comparative type. The study population corresponded to 2 groups of 50 patients selected at random, of both sexes that attended the imagenology service of the public hospital Dr. Juan Noe Crevanni of the city of Arica, to be carried out a X-ray of thorax posterior/anterior. The first group of patients corresponded the participants in the project ARCAL LXXV (Determination of guidance level for Conventional Radiology and Interventionist) carried out in the year 2005. The second group of patients was those incorporate ones during the year 2007 to the project RLA/9/057 (Radiological Protection of Patient in Medical Exhibitions). Both investigations were sponsored by the International Atomic Energy Agency, The Institute of Health Publishes and the Chilean Commission of Nuclear Energy. The stages of the study were divided in: characterization of the yield of the teams, taking of exams, evaluation image quality, estimate of the dose values and statistical analysis. The mean values from entrance surface air kerma for the radiological exam of thorax posterior/anterior vary of 0,14 mGy (S.D. 0.29) to 0.08 mGy (S.D. 0.31), among the years 2005 and 2007 respectively, being this significant difference (p=0.001). Both values are inferior to the value recommended in the Adenda III of the BSS. As for the proportions of execution of the approaches of image quality this it was of 0.95 for the project ARCAL LXXV and 0.92 for the project RLA/9/057, without being this significant difference. The continuous evaluation of the guidance level for medical exposure, associated to the quality of the images constitutes an estimator on the
Waleed H. BuAli
Full Text Available Purpose: No study had been conducted to assess the hospitals’ environment for learning purposes in multicenter sites in Saudi Arabia. It aims to evaluate the environment of hospitals for learning purposes of pediatric residents. Methods: We applied Postgraduate Hospital Educational Environment Measure (PHEEM to measure the learning environment at six teaching hospitals in the Eastern Region of Saudi Arabia from September to December 2013. Results: The number of respondents was 104 (86.7% out of 120 residents and 37 females and 67 male residents have responded. The residents’ response scored 100 out of 160 maximum score in rating of PHEEM that showed overall learning environment is favorable for training. There were some items in the social support domain suggesting improvements. There was no significant difference between male and female residents. There was a difference among the participant teaching hospitals (p<0.05. Conclusion: The result pointed an overall positive rating. Individual item scores suggested that their social life during residency could be uninspiring. They have the low satisfactory level and they feel racism, and sexual discrimination. Therefore, there is still a room for improvement.
Paulo Affonso Grisolli
Full Text Available Som mangeårig producent af telenovelaer både i Brasilien og Portugal, kender Grisolli alle sider af telenovelaen: Novelaen som de fattiges drøm om rigdom og succes, novelaen som et redskab i TV-kanalernes kamp om seerne, som exportvare, som glansbillede under det brasillianske dik- tatur, som industriprodukt og som politisk igangsætter. I denne artikel be- skriver Grisolli sine erfaringer med gode og dårlige sider af telenovela- fascinationen i Latinamerika og præsenterer en ny genre, som er på vej frem i Brasilien, mini-serien. Artiklen er Grisollis foredrag på Folkekirkens Nødhjælps Konference om TV og Video i Latinamerika, november 1992.
Alla Yu. Baranova
Full Text Available Objective to determine and classify the institutional traps in financing the hospitality industry in Russia. Methods abstractlogical generalization and observation. Results basing on the analysis of statistics and regional program of tourism development in Krasnodar region the challenges and obstacles were identified to the development and improvement of tourist services quality. The research result is the identification and systematization of institutional traps in the financing of tourism expressed in the increased public support of the sector. In particular a significant proportion of touristrecreational sector funding is still taken from the budget though the specific weight of profitable health resort organizations amounted to 60 over the past three years. In the process of research the author formulated a general concept of the institutional structure of the hospitality industry in Russia and the model of the sector financing through a system of incentives and benefits for vacationers forming the tourist clusters and forming a mechanism of dialogue between the authorities and representatives of tourist business. Scientific novelty the institutional traps are defined and systematized which are formed in the system of tourism financing measures to overcome them are proposed. Practical significance the proposed recommendations can be used by the entities of the hospitality industry to enhance business activities and by authorities to implement tasks outlined in the state programs.
Timmons, Suzanne; Manning, Edmund; Barrett, Aoife; Brady, Noeleen M.; Browne, Vanessa; O’Shea, Emma; Molloy, David William; O'Regan, Niamh A.; Trawley, Steven; Cahill, Suzanne; O'Sullivan, Kathleen; Woods, Noel; Meagher, David; Ni Chorcorain, Aoife M.; Linehan, John G.
Background: previous studies have indicated a prevalence of dementia in older admissions of ∼42% in a single London teaching hospital, and 21% in four Queensland hospitals. However, there is a lack of published data from any European country on the prevalence of dementia across hospitals and between patient groups. Objective: to determine the prevalence and associations of dementia in older patients admitted to acute hospitals in Ireland. Methods: six hundred and six patients aged ≥70 years were recruited on admission to six hospitals in Cork County. Screening consisted of Standardised Mini-Mental State Examination (SMMSE); patients with scores dementia; with 29% in public hospitals. Prevalence varied between hospitals (P dementia had a previous diagnosis. Patients with dementia were older and frailer, with higher co-morbidity, malnutrition and lower functional status (P dementia (57%) on admission. Conclusion: dementia is common in older people admitted to acute hospitals, particularly in acute medical admissions, and rural hospitals, where services may be less available. Most dementia is not previously diagnosed, emphasising the necessity for cognitive assessment in older people on presentation to hospital. PMID:26420638
Galván, Pedro; Velázquez, Miguel; Benítez, Gualberto; Ortellado, José; Rivas, Ronald; Barrios, Antonio; Hilario, Enrique
Determine the viability of a remote diagnosis system implemented to provide health care to remote and scattered populations in Paraguay. The study was conducted in all regional and general hospitals in Paraguay, and in the main district hospitals in the country's 18 health regions. Clinical data, tomographic images, sonography, and electrocardiograms (ECGs) of patients who needed a diagnosis by a specialized physician were entered into the system. This information was sent to specialists in diagnostic imaging and in cardiology for remote diagnosis and the report was then forwarded to the hospitals connected to the system. The cost-benefit and impact of the remote diagnosis tool was analyzed from the perspective of the National Health System. Between January 2014 and May 2015, a total of 34 096 remote diagnoses were made in 25 hospitals in the Ministry of Health's telemedicine system. The average unit cost of remote diagnosis was US$2.6 per ECG, tomography, and sonography, while the unit cost of "face-to-face" diagnosis was US$11.8 per ECG, US$68.6 per tomography, and US$21.5 per sonography. As a result of remote diagnosis, unit costs were 4.5 times lower for ECGs; 26.4 times lower for tomography, and 8.3 times lower for sonography. In monetary terms, implementation of the remote diagnosis system during the 16 months of the study led to average savings of US$2 420 037. Paraguay has a remote diagnosis system for electrocardiography, tomography, and sonography, using low-cost information and communications technologies (ICTs) based on free software that is scalable to other types of remote diagnostic studies of interest for public health. Implementation of remote diagnosis helped to strengthen the integrated network of health services and programs, enabling professionals to optimize their time and productivity, while improving quality, increasing access and equity, and reducing costs.
McTiernan, K; McDonald, N
Burnout negatively impacts the delivery of mental health services. Psychiatric nurses face stressors that are distinct from other nursing specialities. The research was conducted in Ireland and captured a relatively large sample of respondents. The results compared the stressors, coping strategies and burnout levels between hospital and community-based psychiatric nurses. Occupational stress can negatively impact on the well-being of psychiatric nurses, which in turn can lead to poor client care. There is a dearth of published research conducted in Ireland that examines stress within the discipline. A between-groups study, undertaken in February 2011, investigated stressors, burnout and coping strategies between hospital and community-based psychiatric nurses in a Dublin region. Sixty-nine participants (8 males and 61 females), aged between 18 to 60 years voluntarily completed the Mental Health Professional Stress Scale, the Maslach Burnout Inventory and the PsychNurse Methods of Coping Scale. The findings revealed that nurses were operating in a moderately stressful environment. Stressors focused on organizational issues as opposed to client issues. The main stressors identified were lack of resources, workload and organizational structures/processes. Both groups reported average levels of emotional exhaustion, low levels of depersonalization and average levels of personal accomplishment. A Mann-Whitney U-test and Independent Samples t-test found significant differences between hospital and community-based nurses regarding depersonalization and personal accomplishment, respectively. Hospital nurses reported higher depersonalization scores, and community nurses had a greater sense of personal accomplishment. The personal accomplishment scores of hospital nurses were below mental health professional norms. No significant differences emerged regarding coping strategies. Avoidant coping strategies were favoured by both groups. It is recommended that interventions
Sánchez-Pérez, Inma; Comes Garcia, Nuri; Romero Piniella, Lola; Prats Martos, Gemma; Arnau Bataller, Gemma; Coderch, Jordi
Hospital emergencies (HE) arising from nursing homes (NH) are on the rise. We analyse the evolution, characteristics and appropriateness of HE of NH residents in a region, as well as resulting hospital admissions. Retrospective descriptive study between 2010 and 2013 of institutionalised residents of 11 NH located in Baix Empordà (704 beds) and Palamós Hospital. Gender, age, morbidity and relative weight according to clinical risk groups (CRG), NH, length of stay, diagnosis of the emergency, appropriateness of HE according to Bermejo's criteria and the HE appropriateness protocol (HEAP), and appropriateness of hospitalisations according to the Appropriateness Evaluation Protocol (AEP). Sample to evaluate appropriateness: 159 HE and 91 hospitalisations. frequency, mean, standard deviation, percentiles, Fisher's exact test and ANOVA, with a confidence interval of 95% and using IBM SPSS Statistics 23. 1,474 people were enrolled, of which 73% were women. Group ≥85 years increased to 60.3% and the mean weight of morbidity was 3.2 to 4.0 (p <0.001). 1,805 HE were generated. The annual rate per 1,000 stays arising from NH increased from 1.64 to 2.05, of which 90.6% were appropriate according to Bermejo's criteria and 93.7% according to the HEAP. Of these, 502 involved hospitalisation. The annual rate per 10 emergencies fell from 2.96 to 2.64 and 98.9% were appropriate according to the AEP. Hospital emergencies and hospitalisations of NH residents are increasing and are appropriate. Increasing age and disease burden could explain this phenomenon. NH and hospitals should react appropriately, considering the specific needs of this population sector. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.
Although the total number of stillbirths worldwide was estimated at 2.6 million in 2009, there is currently a dearth of literature on stillbirths in developing countries and rural settings, where the majority of such births occur. The 'Hands Up' Mortality and Morbidity Extraction Tool (HUMMET), developed at Lower Umfolozi War Memorial Regional Hospital (LUWMRH) in 2010, outlines a systematic approach to summarising individual cases of adverse perinatal outcomes. To depict the HUMMET form by describing the detailed demographic and obstetric profile of patients who delivered a stillborn infant at LUWMRH, as well as risk factors associated with these stillbirths between 1 April 2014 and 31 March 2015. The findings add to a global initiative advanced by the Lancet series on stillbirths, aimed at raising awareness of stillbirth statistics in low- and middle-income countries. A total of 310 detailed stillbirth case summaries of 305 patients were collected during the study period, representing 90% of the total number of stillborn infants delivered at LUWMRH. A retrospective audit of the HUMMET forms was conducted and the cases were further summarised in a Microsoft Excel spreadsheet that allowed for a univariate analysis of the variables. The stillbirth rate at LUWMRH is much higher than that at other regional hospitals owing to the number of at-risk referrals and emergency cases from surrounding clinics and district hospitals. Referrals were from local clinics (49%) and district hospitals (45%), 35% of stillbirths were due to abruptio placentae and a large proportion were associated with gestational hypertension, pre-eclampsia and/or eclampsia. Avoidable factors were predominantly a late patient response to reduced fetal movements and delays in transfer to hospital. Twenty percent of stillbirths were associated with inappropriate monitoring or management of the obstetric condition at the district hospital. The HUMMET form provides a systematic approach to analysing cases
Tindong, Maxime; Palle, John N; Nebongo, Daniel; Aminde, Leopold Ndemnge; Mboue-Djieka, Yannick; Mbarga, Nicole T Fouda; Dehayem, Mesmin Y; Choukem, Siméon-Pierre
This study aimed to determine the prevalence of diabetic foot ulcer and high risk for ulceration, describe the clinical presentation, and identify factors associated with diabetic foot ulcer in the Southwest regional hospitals of Cameroon. In this cross-sectional study, data were collected using a structured questionnaire administered to consecutive patients with diabetes. Findings from detailed foot examination were recorded. Diabetic foot ulcer was diagnosed according to the International Working Group on Diabetic Foot (IWGDF) definition. Data were analyzed with Stata IC version 12. Of the 203 participants included, 63.1% were females. Age ranged from 26 to 96 years. The median duration of diabetes was 4.0 years (interquartile range 1.0-8.0 years). The prevalence of diabetic foot ulcer was 11.8% (24), of whom 29.2% (7) had high grade (grades 2 to 4), and most of the ulcers 58.3% (14) were located at the plantar region. The prevalence of high risk for ulceration was 21.8% (39). Loss of protective sensation (OR = 3.73, 95% CI = 1.43-9.71; P = .007), and peripheral arterial disease (OR = 3.48, 95% CI = 1.14-10.56; P = .028) were independently associated with diabetic foot. Diabetic foot ulcer is a common complication among patients with diabetes attending these regional hospitals. Loss of protective sensation, and peripheral arterial disease increase the odds of having diabetic foot ulcer, and we suggest them as the main target of interest for prevention.
[Integration of district psychiatric hospitals into the development of regional community psychiatry networks--the actual state. Results of a survey among medical directors of Bavarian district hospitals].
Welschehold, Michael; Kraus, Eva
In this study, the medical directors of all Bavarian district psychiatric hospitals evaluated certain aspects of the integration of their hospitals into the development of regional community psychiatry networks ("Gemeindepsychiatrische Verbunde" - GPVs). They were asked to rate the actual quantity of cooperation between their hospitals and diverse community based services and to express their requests concerning the quality of cooperation. An estimation of possible advantages of the hospitals' integration in GPVs and expectations to future perspectives of GPV development were also investigated. The data were collected by a written questionnaire. The results of the survey indicate that a high relevance is attached to GPV: inspite of current heterogenous developments and inspite of existing skepticism concerning the feasibility of a complete GPV structure, medical directors strongly approve of seeing their hospitals actively engaged in the further development of community psychiatry networks.
O. V. Reshetko
Full Text Available Aim. To evaluate the real practice of thrombolytic therapy of patients with ST-elevation myocardial infarction (STEMI at cardiological departments of Saratov and Saratov region hospitals.Material and methods. Retrospective pharmacoepidemiologic study was carried out. Case histories of STEMI patients discharged from cardiologic departments of several central district hospitals (CDH of Saratov region, cardiologic department of one of Saratov general municipal hospitals (MH and urgent cardiology department of Saratov clinical hospital (CH in 2006 were analyzed.Results. In CH all patients received thrombolytic therapy given they did not have contraindications and were admitted to the hospital timely. Few patients received thrombolytic therapy in MH and CDH in 2006.Conclusion. Correlation between hospital type and quality of STEMI management has been revealed.
Chehab, Hussam El; Agard, Emilie; Dot, Corinne
The NATO KAIA Hospital (Kabul International Airport), under French command, provided medical support for NATO forces in the Kabul region from 2009 to 2014. Medical assistance to civilians was an additional mission which included support for children who were war injured. The objective of this study was to analyze characteristics of cephalic injuries in children victims of war trauma. A retrospective study was conducted and commenced with the hospital opening (July 2009) to March 2012 on all children (<15years) with war trauma. We distinguished cephalic lesions in cranial (neuro-surgical), ophthalmological and neck regions. We analyzed mechanism, region, severity score, surgeries and resuscitation efforts. 217 children were operated on with 81 war traumas (mean age 10.2years). 36 children (44.4%) had a cephalic injury. 52.9% of the injured had an ophthalmological injury, 38.2% a cranial region injury and 29.4% a neck lesion. Mortality rate was 5.6% (1 hemorrhagic shock and 1 cerebral wound) in this cephalic lesion group. Ophthalmic injuries were the most common of cephalic injuries; 19 children of which 7 had a bilateral injury (26 eyes). In this group, fragmentary injuries were the most frequent (64% of eyes). In cerebral lesion group, the lesions were linked to a bullet or a shrapnel in 9 of 13 children. This mechanism systematically caused a crania-cerebral wound. Explosion (fragmentary and shrapnel) was the most important in the neck lesions (7 children of 10). The cephalic lesions were the second most common region in children during our experience in Afghanistan. Lack of protection (helmet) in children may explain the frequency of cephalic wounds. Copyright © 2018 Elsevier Ltd. All rights reserved.
Full Text Available This paper seeks to contribute to the debate on the decision-making process for the location of large public facilities, responding to the growing demand for greater rationality in public investment whilst still offering services of quality and addressing the problem of spatial friction. The specific problem analysed in this paper is the need to define the best location for a public hospital in a particular region of Portugal. The singularity of the approach adopted lies above all in the seg- mentation into macro-location and micro-location.
Koll, Brian S; Ruiz, Rafael E; Calfee, David P; Jalon, Hillary S; Stricof, Rachel L; Adams, Audrey; Smith, Barbara A; Shin, Gina; Gase, Kathleen; Woods, Maria K; Sirtalan, Ismail
The incidence, severity, and associated costs of Clostridium difficile (C. difficile) infection (CDI) have dramatically increased in hospitals over the past decade, indicating an urgent need for strategies to prevent transmission of C. difficile. This article describes a multifaceted collaborative approach to reduce hospital-onset CDI rates in 35 acute care hospitals in the New York metropolitan region. Hospitals participated in a comprehensive CDI reduction intervention and formed interdisciplinary teams to coordinate their efforts. Standardized clinical infection prevention and environmental cleaning protocols were implemented and monitored using checklists. Monthly data reports were provided to hospitals for facility-specific performance evaluation and comparison to aggregate data from all participants. Hospitals also participated in monthly teleconferences to review data and highlight successes, challenges, and strategies to reduce CDI. Incidence of hospital-onset CDI per 10,000 patient days was the primary outcome measure. Additionally, the incidence of nonhospital-associated, community-onset, hospital-associated, and recurrent CDIs were measured. The use of a collaborative model to implement a multifaceted infection prevention strategy was temporally associated with a significant reduction in hospital-onset CDI rates in participating New York metropolitan regional hospitals. © 2013 National Association for Healthcare Quality.
Adusi-Poku, Yaw; Antwil, Edward; Osei-Kwakye, Kingsley; Tetteh, Chris; Detoh, Eric Kwame; Antwi, Phyllis
The government of Ghana and key stakeholders have put into place several interventions aimed at reducing maternal deaths. At the institutional level, the conduct of maternal deaths audit has been instituted. This also contributes to reducing maternal deaths as shortcomings that may have contributed to such deaths could be identified to inform best practice and forestall such occurrences in the future. The objective of this study was to review the quality of maternal care in a regional hospital. A review of maternal deaths using Quality of Care Evaluation Form adapted from the Komfo Anokye Teaching Hospital (KATH) Maternal Death Audit Evaluation Committee was used. About fifty-five percent, 18 (55%) of cases were deemed to have received adequate documentation, senior clinicians were involved in 26(85%) of cases. Poor documentation, non-involvement of senior clinicians in the management of cases, laboratory related issues particularly in relation to blood and blood products as well as promptness of care and adequacy of intensive care facilities and specialists in the hospital were contributory factors to maternal deaths . These are common themes contributing to maternal deaths in developing countries which need to be urgently tackled. Maternal death review with emphasis on quality of care, coupled with facility gap assessment, is a useful tool to address the adequacy of emergency obstetric care services to prevent further maternal deaths.
d'Amore, Maurizia; Peroni, Antonia
In 2006, 279 nurses of a Lazio Region Hospital were assessed to verify whether certain Human Resources decisions, such as outsourcing, can negatively influence their working motivation and sense of belonging to a health organization and whether any dissatisfaction can be attributed to poor ethical information within the health service. The research method had a descriptive basis and for data collection a questionnaire with 35 questions was issued. Results showed that nurses felt strongly involved in the study and interesting aspects for management of human resources emerged, depicting an organization lacking in motivation : this confirmed one of the aspects of the study : poor levels of motivation and sense of belonging can be correlated to insufficient ethical information in local health organizations. The main working needs that emerged among the nurses of this hospital regarded economical retribution (90%), security and success (88%) , belonging (86%) and self-satisfaction (77%): the need for power was relatively low (40%). The strong points of the study were : the strong involvement of nurses, the value of the information gathered regarding working motivation, sense of belong to a nursing organization , working needs , ethical information in health environments, organization according to targets. The limits of the study were: limited number of nurses in outsourcing at the time of the study (12%), impossibility of comparing the results with data prior to the outsourcing choices made by the hospital in question.
Full Text Available In 2007, Laurie Butgereit, a researcher at the CSIR Meraka Institute, started to use Mxit as a communication channel to tutor her son in mathematics. Her son and a number of his friends logged in, and Dr Math was born. At the inception of Dr Math...
Bienvenido Ortega Aguaza
Full Text Available The aim of this paper is to analyze the determinants of labour productivity growth in the hospitality industry in Spain using regional data over the period 1996-2004. The results obtained suggest that the increase in the number of 3-star hotels and the reduction process in the stock of physical capital per worker are factors which may have contributed to the fall in productivity growth. However, increased regional tourism intensity has a positive impact on the growth of labour productivity. Nonetheless, changes in demand-related factors, such as average length of stay and the seasonality of demand, have not had a significant aggregate impact on labour productivity growth during this period.
The challenge could be briefly seen in these terms: hospitals as places for treatment where there’s a technology focus and hospitals for healing where there’s a human focus. In the 60s - 70s wave of new hospital building, an emphasis on technology can be seen. It’s time to move from the technology...... focus. It is not enough to consider only the factors of function within architecture, hygiene, economy and logistics. We also need to look at aspects of aesthetics, bringing nature into the building, art, color, acoustics, volume and space as we perceive them. Contemporary methods and advances...... placed, accessible, provided with plenty of greenery, and maximize sensory impressions, providing sounds, smells, sight and the possibility to be touched. This is a very well documented area I can say. Hygiene, in terms of architecture can give attention to hand wash facilities and their positioning...
Heller, A R; Bauer, K R; Eberlein-Gonska, M; Albrecht, D M; Koch, T
The German Social Act V section sign 12 is aimed towards competition, efficiency and quality in healthcare. Because surgical departments are billing standard diagnosis-related group (DRG) case costs to health insurance companies, they claim best value for money for internal services. Thus, anaesthesia concepts are being closely scrutinized. The present analysis was performed to gain economic arguments for the strategic positioning of regional anaesthesia procedures into clinical pathways. Surgical procedures, which in 2005 had a relevant caseload in Germany, were chosen in which regional anaesthesia procedures (alone or in combination with general anaesthesia) could routinely be used. The structure of costs and earnings for hospital services, split by types and centres of cost, as well as by underlying procedures are contained in the annually updated public accessible dataset (DRG browser) of the German Hospital Reimbursement Institute (InEK). For the year 2005 besides own data, national anaesthesia staffing costs are available from the German Society of Anaesthesiology (DGAI). The curve of earnings per DRG can be calculated from the 2005 InEK browser. This curve intersects by the cost curve at the point of national mean length of stay. The cost curve was calculated by process-oriented distribution of cost centres over the length of stay and allows benchmarking within the national competitive environment. For comparison of process times data from our local database were used. While the InEK browser lacks process times, the cost positions 5.1-5.3 (staffing costs anaesthesia) and the national structure adjusted anaesthesia staffing costs 2005 as published by the DGAI, were used to calculate nationwide mean available anaesthesia times which were compared with own process times. Within the portfolio diagram of lengths of stay for each DRG and process times most procedures are located in the economic lower left, in particular those with high case mix (length of stay and
Specialization: Microphysics, Regional Radiative Forcing, Equatorial Aeronomy, Atmospheric Aerosols, Radiation Budget & Climate Science and Climatology Address: Distinguished Visiting Scientist, CAOS, Indian Institute of Science, Bengaluru 560 012, Karnataka Contact: Office: (080) 2293 2505/208. Residence: 94960 ...
Coates, Ralph J.; Pérez, Alejandro; Baer, Atar; Zhou, Hong; English, Roseanne; Coletta, Michael; Dey, Achintya
Objective We examined the representativeness of the nonfederal hospital emergency department (ED) visit data in the National Syndromic Surveillance Program (NSSP). Methods We used the 2012 American Hospital Association Annual Survey Database, other databases, and information from state and local health departments participating in the NSSP about which hospitals submitted data to the NSSP in October 2014. We compared ED visits for hospitals submitting 15 data with all ED visits in all 50 states and Washington, DC. Results Approximately 60.4 million of 134.6 million ED visits nationwide (~45%) were reported to have been submitted to the NSSP. ED visits in 5 of 10 regions and the majority of the states were substantially underrepresented in the NSSP. The NSSP ED visits were similar to national ED visits in terms of many of the characteristics of hospitals and their service areas. However, visits in hospitals with the fewest annual ED visits, in rural trauma centers, and in hospitals serving populations with high percentages of Hispanics and Asians were underrepresented. Conclusions NSSP nonfederal hospital ED visit data were representative for many hospital characteristics and in some geographic areas but were not very representative nationally and in many locations. Representativeness could be improved by increasing participation in more states and among specific types of hospitals. PMID:26883318
Jia, Haimei; Ma, Chao; Lu, Mengting; Fu, Jianping; Rodewald, Lance E; Su, Qiru; Wang, Huaqin; Hao, Lixin
As China approaches the elimination of measles, outbreaks of measles continue to occur. Healthcare workers (HCWs) are known to be at high risk of infection and transmission of measles virus. A measles outbreak occurred in a hospital in Xinjiang Uighur Autonomous Region of the People's Republic of China. We report an investigation of this outbreak and its implications for measles elimination and outbreak preparedness. We conducted a retrospective search for measles cases using hospital records. Information on cases was collected by interview, and was used to determine epidemiological linkages. We surveyed HCWs to determine their demographic characteristics, disease history and vaccination status, and knowledge about measles. We identified 19 cases, ages 18 to 45 years, in Hospital W between December 2015 and January 2016; 14 were laboratory-confirmed, and 5 were epidemiologically linked. The primary case was a 25-year-old neurology department nurse who developed a rash on 22 December 2015 that was reported on 11 January 2016. She continued working and living with her workmates in a dormitory during her measles transmission period. Among the 19 infected HCWs, 2 had received a dose of measles-containing vaccine (MCV) before the outbreak, and 16 had unknown vaccination status. Outbreak response immunization activities were started on 8 January in a non-selective manner by offering vaccine regardless of vaccination history; 605(68%) of 890 HCWs were vaccinated. The HCW survey had a 73% response rate (646/890); 41% of HCWs reported that they had received MCV before outbreak, and 56% exhibited good knowledge of measles symptoms, transmission, complications, and vaccination. Low MCV coverage, low measles knowledge among HCWs, delayed reporting of measles cases, and absence of proper case management were associated with this outbreak. Training and vaccinating HCWs against measles are essential activities to prevent measles virus transmission among HCWs.
Sharma, A S; Pijls, R W M; Weerwind, P W; Delnoij, T S R; de Jong, W C; Gorgels, A P M; Maessen, J G
The current outcome of out-of-hospital cardiac arrest (OHCA) patients in the Maastricht region was analysed with the prospect of implementing extracorporeal cardiopulmonary resuscitation (E-CPR). A retrospective analysis of adult patients who were resuscitated for OHCA during a 24-month period was performed. 195 patients (age 66 [57-75] years, 82 % male) were resuscitated for OHCA by the emergency medical services and survived to admission at the emergency department. Survival to hospital discharge was 46.2 %. Notable differences between non-survivors and survivors were observed and included: age (70 [58-79] years) vs. (63 [55-72] years, p = 0.01), chronic heart failure (18 vs. 7 %, p = 0.02), shockable rhythm (67 vs. 99 %, p < 0.01), and return of spontaneous circulation (ROSC) at departure from the site of the arrest (46 vs. 99 %, p < 0.01) and on arrival to the emergency department (43 vs. 98 %, p < 0.01), respectively. Acute coronary syndrome was diagnosed in 32 % of non-survivors vs. 59 % among survivors, p < 0.01. Therapeutic hypothermia was provided in non-survivors (20 %) vs. survivors (43 %), p < 0.01. Percutaneous coronary intervention (PCI) was performed in 14 % of non-survivors while 52 % of survivors received PCI (p < 0.01). No statistical significance was observed in terms of gender, witnessed arrest, bystander CPR, or automated external defibrillator deployed among the cohort. At hospital discharge, moderately severe neurological disability was present in six survivors. These observations are compatible with the notion that a shockable rhythm, ROSC, and post-arrest care improve survival outcome. Potentially, initiating E-CPR in the resuscitation phase in patients with a shockable rhythm and no ROSC might serve as a bridge to definite treatment and improve survival outcome.
Sharma, Yubaraj; Maibam, Deveshwori; Saxena, Atul; Ram, Priya P.; Walia, Devesh
In this paper, we report our findings on radon survey in indoor environment which consists of around 105 rooms in 8 major hospitals in Shillong region and also present experimental estimates on the associated annual effective doses and life-time fatality risks. The survey has been undertaken using LR-115 Type 2 detectors. Radon activity concentration values were found to range from 65.66 Bq.m -3 to 783.77 Bq.m -3 with an arithmetic mean value of 260.4±138.3 Bq.m -3 and a geometric mean value of 228.4±1.67 Bq.m -3 . Distribution analysis of the radon activity concentration measured at the hospital rooms has been carried out. Of the total rooms surveyed, 60% have radon concentration more than the ICRP prescribed lower limit of 200 Bq.m -3 and about 4% of the rooms higher than the upper limit of 600 Bq.m -3 . Floor-wise study has been done and a decrease in radon concentration with increase in floor-number has been observed. (author)
Montoya Alcoser, Carlos Augusto; Montoya Alcoser, Carlos Augusto
En un Hospital moderno» las Instalaciones y los Equipos por ellas accionado constituye la parte más importante; lo que se puede llamar la parte dinámica» la vida del Hospital. Las Instalaciones deben satisfacer las exigencias de los equipos utilizados en la medicina para el diagnóstico y tratamiento» así como los equipos pertenecientes a los servicios generales y auxiliares. En este caso la presente TESIS tiene como finalidad elaborar y proyectar, dentro de los aspectos técnicos y econó...
Feruglio, G A; Lestuzzi, L; Carminati, D
For a close follow-up of large groups of pacemaker patients and for evaluation of long term pacing on a reliable statistical basis, many pacemaker centers in the world are now using computer systems. A patient data system with structured display records, designed to give complete, comprehensive and surveyable information and which are immediately retrievable 24 hours a day, on display or printed sets, seems to offer an ideal solution. The pacemaker clinic at the Regional Hospital of Udine has adopted this type of system. The clinic in linked to a live, on-line patient data system (G/3, Informatica Friuli-Venezia Giulia). The input and retrieval of information are made through a conventional keyboard. The input formats have fixed headings with coded alternatives and a limited space for comments in free text. The computer edits the coded information to surveyable reviews. Searches can be made on coded information and data of interest.
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.
Department of the Interior — This article is about Dr. Raymond V Pierce who owned St. Vincent Island before it became a refuge. The doctor painted advertisements for his famous “Woman’s Tonic”...
Al-Jawaldeh, Ayoub; Abul-Fadl, Azza
The Baby-Friendly Hospital Initiative (BFHI) is a global program for promoting support and protection for breastfeeding. However, its impact on malnutrition, especially in countries of the Eastern Mediterranean region (EMR) that are facing the turmoil of conflict and emergencies, deserves further investigation. Having said that, this paper aims to discuss the status and challenges to BFHI implementation in the EMR countries. Data on BFHI implementation, breastfeeding practices, and nutritional status were collected from countries through structured questionnaires, personal interviews, and databases. The 22 countries of the EMR were categorized as follows: 8 countries in advanced nutrition transition stage (group I), 5 countries in early nutrition transition stage (group II), 4 countries with significant undernutrition (group III), and 5 countries in complex emergency (group IV). The challenges to BFHI implementation were discussed in relation to malnutrition. BFHI was not implemented in 22.7% of EMR countries. Designated Baby-Friendly hospitals totaled 829 (group I: 78.4%, group II: 9.05%; group III: 7.36%; group: IV5.19%). Countries with advanced nutrition transition had the highest implementation of BFHI but the lowest breastfeeding continuity rates. On the other hand, poor nutritional status and emergency states were linked with low BFHI implementation and low exclusive breastfeeding rates but high continuity rates. Early initiation and longer duration of breastfeeding correlated negatively with overweight and obesity ( p < 0.001). In countries with emergency states, breastfeeding continues to be the main source of nourishment. However, suboptimal breastfeeding practices prevail because of poor BFHI implementation which consequently leads to malnutrition. Political willpower and community-based initiatives are needed to promote breastfeeding and strengthen BFHI in the region.
Full Text Available The Baby-Friendly Hospital Initiative (BFHI is a global program for promoting support and protection for breastfeeding. However, its impact on malnutrition, especially in countries of the Eastern Mediterranean region (EMR that are facing the turmoil of conflict and emergencies, deserves further investigation. Having said that, this paper aims to discuss the status and challenges to BFHI implementation in the EMR countries. Data on BFHI implementation, breastfeeding practices, and nutritional status were collected from countries through structured questionnaires, personal interviews, and databases. The 22 countries of the EMR were categorized as follows: 8 countries in advanced nutrition transition stage (group I, 5 countries in early nutrition transition stage (group II, 4 countries with significant undernutrition (group III, and 5 countries in complex emergency (group IV. The challenges to BFHI implementation were discussed in relation to malnutrition. BFHI was not implemented in 22.7% of EMR countries. Designated Baby-Friendly hospitals totaled 829 (group I: 78.4%, group II: 9.05%; group III: 7.36%; group: IV5.19%. Countries with advanced nutrition transition had the highest implementation of BFHI but the lowest breastfeeding continuity rates. On the other hand, poor nutritional status and emergency states were linked with low BFHI implementation and low exclusive breastfeeding rates but high continuity rates. Early initiation and longer duration of breastfeeding correlated negatively with overweight and obesity (p < 0.001. In countries with emergency states, breastfeeding continues to be the main source of nourishment. However, suboptimal breastfeeding practices prevail because of poor BFHI implementation which consequently leads to malnutrition. Political willpower and community-based initiatives are needed to promote breastfeeding and strengthen BFHI in the region.
Al-Jawaldeh, Ayoub; Abul-Fadl, Azza
The Baby-Friendly Hospital Initiative (BFHI) is a global program for promoting support and protection for breastfeeding. However, its impact on malnutrition, especially in countries of the Eastern Mediterranean region (EMR) that are facing the turmoil of conflict and emergencies, deserves further investigation. Having said that, this paper aims to discuss the status and challenges to BFHI implementation in the EMR countries. Data on BFHI implementation, breastfeeding practices, and nutritional status were collected from countries through structured questionnaires, personal interviews, and databases. The 22 countries of the EMR were categorized as follows: 8 countries in advanced nutrition transition stage (group I), 5 countries in early nutrition transition stage (group II), 4 countries with significant undernutrition (group III), and 5 countries in complex emergency (group IV). The challenges to BFHI implementation were discussed in relation to malnutrition. BFHI was not implemented in 22.7% of EMR countries. Designated Baby-Friendly hospitals totaled 829 (group I: 78.4%, group II: 9.05%; group III: 7.36%; group: IV5.19%). Countries with advanced nutrition transition had the highest implementation of BFHI but the lowest breastfeeding continuity rates. On the other hand, poor nutritional status and emergency states were linked with low BFHI implementation and low exclusive breastfeeding rates but high continuity rates. Early initiation and longer duration of breastfeeding correlated negatively with overweight and obesity (p < 0.001). In countries with emergency states, breastfeeding continues to be the main source of nourishment. However, suboptimal breastfeeding practices prevail because of poor BFHI implementation which consequently leads to malnutrition. Political willpower and community-based initiatives are needed to promote breastfeeding and strengthen BFHI in the region. PMID:29534482
Ferreira, Vera; Teixeira, Margarida Ribau
The management of healthcare wastes is receiving greater attention because of the risks to both human health and the environment caused by inadequate waste management practices. In that context, the objective of this study was to analyse the healthcare waste management practices in hospitals of the Algarve region, Portugal, and in particular to assess the risk perceptions of, and actual risk to, healthcare staff. The study included three of the six hospitals in the region, covering 41% of the bed capacity. Data were collected via surveys, interviews, and on-site observations. The results indicate that waste separation is the main deficiency in healthcare waste practice, with correct separation being positively related to the degree of daily contact with the waste. Risk perceptions of healthcare staff show the highest levels for the environment (4.24) and waste workers (4.08), and the lowest for patients (3.29) and visitors (2.80), again being positively associated with the degree of daily contact. Risk perceptions of healthcare staff are related to the difficulties of the correct separation of wastes and the lack of knowledge concerning the importance of that separation. The risk of infection with needlesticks/sharps is higher during patient care than during waste handling, and the frequency of these injuries is related to the daily tasks of each healthcare group (doctors, nurses, and housekeepers). Furthermore, legislative definitions and classifications of healthcare wastes appear to have conditioned the management practices associated with, and the perceptions of risk concerning, healthcare wastes. Copyright © 2010 Elsevier Ltd. All rights reserved.
Dr Stanislaw Huskowski, Mayor of Wroclaw, Poland visiting the ATLAS magnet assembly hall, building 180. From l to r: Mr Carlo Lamprecht, State Councillor, Dr Stanislaw Huskowski and Dr Peter Jenni, ATLAS Spokesperson
Dr Stanislaw Huskowski, Mayor of Wroclaw, Poland visiting the ATLAS magnet assembly hall, building 180 with Mr Carlo Lamprecht, State Councillor, Dr Stanislaw Huskowski and Dr Peter Jenni, ATLAS Spokesperson
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
Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F
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
Angeles C, A.; Vizuet G, J.; Benitez S, J. A
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
Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F
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
Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F
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
Angeles C, A.; Rodriguez A, F.; Garcia A, J
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)
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
Angeles C, A.; Hernandez C, J.E.; Rodriguez A, F.; Garcia A, J
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)
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
Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F
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
Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F
Dr. Nadine Foreman was interviewed by representatives of the US DOE Office of Human Radiation Experiments (OHRE). Dr. Foreman was selected for interview because of the position she held at the University of California, San Francisco. Following a brief biographical sketch, Dr. Foreman describes her work with Dr. Mayo Soley using I-131 in treatment of hyperthyroidism, selection criteria for patients in the radioiodine project, work with Dr. Earl Miller, work at Highland Hospital, radioiodine treatment of diffuse toxic goiter (myxedema), the radiophosphorus and radioiodine programs with Dr. Bert Low-Beer, and treatment of polycythemia vera
Dr. Nadine Foreman was interviewed by representatives of the US DOE Office of Human Radiation Experiments (OHRE). Dr. Foreman was selected for interview because of the position she held at the University of California, San Francisco. Following a brief biographical sketch, Dr. Foreman describes her work with Dr. Mayo Soley using I-131 in treatment of hyperthyroidism, selection criteria for patients in the radioiodine project, work with Dr. Earl Miller, work at Highland Hospital, radioiodine treatment of diffuse toxic goiter (myxedema), the radiophosphorus and radioiodine programs with Dr. Bert Low-Beer, and treatment of polycythemia vera.
The inter-war years in the UK were notable for debates about the extent to which an extension of state intervention in hospital provision was desirable and necessary, and about the limits to and future of the voluntary hospital system which relied largely on various forms of private charity. These themes were intertwined in the UK's 'Special Areas', locations recognized as having suffered adversely from the inter-war depression, with consequent effects on their ability to finance desirable investments in social infrastructures. Grant aid was offered to hospitals in these locations under the terms of the Special Areas legislation of 1934, but there were extensive debates about the principle and practice of such subsidies to hospital development. This paper reviews these debates and considers whether the measures taken by the Commissioners can be seen as neglected antecedents of the regionalism detected in British hospital policy by several commentators.
Palafox, Damián; Gutiérrez-Gómez, Claudia; Granados, Julio; Barquera, Rodrigo; Ortega-Hernández, Esteban; Hernández-Zaragoza, Diana I.; Pérez-Dosal, Marcia; Pacheco-Ubaldo, Hanna R.; Lona-Sánchez, Abraham
Introducción y Objetivo. El síndrome de Parry Romberg se caracteriza por atrofia hemifacial progresiva; afecta piel y tejidos blandos y en ocasiones provoca también atrofia de músculos, cartílago y estructuras óseas subyacentes. Su diagnóstico diferencial incluye: esclerodermia generalizada, morfea y síndrome de CREST. Las alteraciones en piel se asocian con variantes alélicas (polimórficas) del sistema HLA (antígeno leucocitario humano). La esclerodermia se ha asociado con HLA DR11, el CREST...
Bond, Stuart E; Boutlis, Craig S; Yeo, Wilfred W; Miyakis, Spiros
Community-acquired pneumonia (CAP) is the second commonest indication for antibiotic use in Australian hospitals and is therefore a frequent target for antimicrobial stewardship. A single-centre prospective study was conducted in a regional referral hospital comparing management of adult patients with CAP before and after an educational intervention. We demonstrated a reduction in duration of therapy and reduced inappropriate use of ceftriaxone-based regimens for non-severe CAP. © 2017 Royal Australasian College of Physicians.
Angeles C, A.; Hernandez C, J.E.; Rodriguez A, F.; Garcia A, J.
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)
Angeles C, A.; Rodriguez A, F.; Garcia A, J.
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)
Ji Yongling; Liu Jingjie; Tian Ye; Li Xianming; Zhu Yaqun; Yu De; Du Xianghui
Objective: to explore the changes and the tendency of breast cancer radiotherapy in China within the past decade. Methods: A survey on breast cancer radiotherapy in 1999 and 2006 was conducted in 4 hospitals located within the southeast coastal region of China, including patients' clinical characteristics, the purpose of radiotherapy and its techniques. Results: The percentage of breast conservative treatment (BCT) increased from 3% in 1999 to 13% in 2006. For radiotherapy techniques in 2066 compared with 1999, the growth trend was found in use of breast immobilization devices (80% vs. 46%), treatment planning system (70% vs. 23%), and CT simulation (14% vs. 0). The frequency was increased in the chest wall irradiation after mastectomy (90% vs. 67%), but decreased in internal mammary region (30% vs. 76%) and axilla (37% vs. 69%) treatment. There were no differences in total dose and fractionation prescription. Conclusions: BCT was performed more frequently, but post-mastectomy radiotherapy was still essential option in China at present. Although some advanced techniques were applied frequently in clinical practice. Simulation, treatment planning, and irradiation target design were urgent for improvement and standardization. (authors)
Molet, Lucie; Saloum, Kenda; Marque-Juillet, Stéphanie; Garbarg-Chenon, Antoine; Henquell, Cécile; Schuffenecker, Isabelle; Peigue-Lafeuille, Hélène; Rozenberg, Flore; Mirand, Audrey
The monitoring and genotyping of Enterovirus (EV) infections can help to associate particular or severe clinical manifestations with specific EV types and to identify the aetiology of infectious outbreaks. To describe the epidemiological features of EV infections diagnosed during the year 2013 in the Greater Paris area (Ile de France). During 2013, 2497 samples taken from 470 patients in 33 hospitals of Ile-de France were tested for EV genome by RT-PCR. EV genotyping was performed by the National Reference Centre (NRC) laboratories. EV infections were retrospectively reviewed by retrieving clinical and genotyping data from the NRC database. Of the 2497 samples, 490 (19.6%) was positive for EV genome detection. These EV infections represented 88.7% and 24.1%, respectively, of all reported regional and national infections. Twenty-seven different genotypes were identified. Echovirus 30 (E-30) accounted for 54.1% of all characterized strains and caused a large outbreak. Four severe neonatal infections were reported, of which two were caused by EV-A71. Respiratory infections involving EV-D68 were observed in two adults. One fatal case of Coxsackievirus A2-associated myocarditis was reported. Monitoring EV infections in combination with EV genotyping via the French EV network characterized the epidemiology of EV infections in the Ile de France region in 2013 and documented severe EV infections associated with EV-A71 or CV-A2. Copyright © 2015 Elsevier B.V. All rights reserved.
Márcio Antônio Couto Ferreira
Full Text Available With the objective of evaluating the quality of prenatal and analyse the epidemiological data of their women in the city of Tefé, in the interior of the Amazon, was a study descriptive and quantitative, secondary source documentation, by evaluation of the book of records that contain information about the card of their women who attended prenatal 93 in Tefé Regional Hospital of that city in April 2009. The results showed that the average age of women in labour was 23.3 years, most completed elementary education, and more than 50% have stable relationship, being three the number of children. Regarding prenatal assessment, 55% prenatal began until the fourth month, approximately 46% held six consultations during the prenatal,22.6% had 65.6% have 6 queries, at least 1 time basic examinations and 77% were immunized. The comparison of these results with other studies conducted in different regions of Brazil served as a tool to compare prenatal assessment in several Brazilian States. Is of great value the result of this research for improvement of care, since there are no records of assessment of quality of care provided during prenatal Amazonas State and also to encourage new research in the State.
Chu, Cheng-I; Lee, Ming-Shinn; Hsu, Hsiang-Ming; Chen, I-Chi
Organizational citizenship behaviors (OCB) are deemed indispensable due to their importance in promoting positive relationships among employees and involving employees in the organization's activities. OCB is believed to facilitate attainment of a hospital's goals and enhance a hospital's performance. The aim of this study is to extend the work of previous studies by providing an integrated model of OCB and demonstrate its applicability in a non-Western culture. Questionnaires were completed by 314 non-supervisory hospital nurses, each of whom was given a supervisor rating for their OCB. Exploratory factor analysis was used to assess the convergent and discriminant validity of the variables in the model. Multiple regression analysis was used because it provided estimates of net effects and explanatory power. The results showed that job satisfaction, supervisor support, job involvement, and procedural justices had significant effects on the nurses' citizenship behaviors. Since the study used a non-Western site in one of Taiwan's health care institutions, its overall findings should contribute to further understanding of the cross-cultural aspects of OCB.
Dr Luigi Orlando, Dr Sergio Ceccuzzi, Dr. Armando Sbrana, Europa Metalli, Italy, Dr Albert Scherger, Member of KM Europa Metal AG, Osnabr ck, Germany, Prof. Filippo Menzinger, Scientific Attaché, Permanent Mission of Italy in Geneva
Photo 01: Dr Lyn Evans and Dr Luigi Orlando Photo 04: L. to r.: Dr Lyn Evans, Dr Luigi Orlando, Prof. Luciano Maiani and Prof. Filippo Menzinger Photo 06: L. to r.: Prof. Philippo Menzinger, Dr Armando Sbrana, Prof. Luciano Maiani, Dr Albert Scherger, Dr Lyn Evans, Dr Luigi Orlando, Dr Sergio Ceccuzzi, visiting the LHC superconducting magnet test hall, SM18
"Dr. Vernon W. Hughes, a Yale physicist whose investigation of particles called muons poked holes in standard subatomic theory and provided evidence for the existence of previously undetected matter, died at Yale-New Haven Hospital last Tuesday" (1/2 page).
Márcia Lait Morse
Full Text Available OBJETIVO: Analisar perfil epidemiológico da morbidade materna grave/near miss em uma maternidade pública de referência regional, utilizando diferentes critérios identificadores. MÉTODOS: Trata-se de um estudo descritivo de corte transversal dos casos de morbidade materna grave/near miss realizado em Hospital de referência regional entre junho e outubro de 2009, identificados a partir dos livros de registro de internação da maternidade e análise dos prontuários clínicos. Foram estudadas mulheres que, durante a gestação, parto ou puerpério, apresentaram qualquer quadro clínico compatível com os critérios definidores de morbidade materna grave/near miss de Waterstone et al., Mantel et al. e Organização Mundial de Saúde. RESULTADOS: Entre as 1.544 internações foram identificadas 89 mulheres com morbidade materna grave, considerando os critérios adotados. As razões de morbidade materna grave/near miss variaram entre 81,4 a 9,4 por 1.000 NV, dependendo do critério utilizado. O índice de Mortalidade foi de 3,2%, chegando a 23% no critério da OMS. Das 89 mulheres, apenas 40% fizeram mais de seis consultas de pré-natal e 10% não realizaram qualquer consulta. Os marcadores mais encontrados foram a pré-eclâmpsia grave seguida de hemorragia grave, internação em UTI, Síndrome HELLP e eclâmpsia. Ocorreram três mortes maternas por causas obstétricas com RMM de 280/100.000 NV e uma morte tardia. O critério da OMS se mostrou mais específico, identificando os casos mais graves, enquanto o de Waterstone foi mais sensível. CONCLUSÃO: O estudo da morbidade materna grave/near miss em um hospital de referência regional pode contribuir para o conhecimento da magnitude deste evento, como também identificar suas características e condições clínicas mais frequentes, sendo extremamente importante para o enfrentamento da morbi-mortalidade materna.OBJECTIVE: To investigate severe maternal morbidity/near misses in a tertiary
The purpose of this paper is to identify factors influencing performance of hospital nurses in Riyadh Region, Saudi Arabia. Specific objectives were to estimate self-reported performance, and determine whether differences in employee demographics, job satisfaction, and organizational commitment, influenced performance. In total, 15 hospitals were randomly selected. The questionnaire was sent to all nurses (1,834) in these facilities and 923 nurses responded. Statistical analysis included correlation, t-test, and regression analysis. The study finds that job performance is positively correlated with organizational commitment, job satisfaction and personal and professional variables. Both job satisfaction and organizational commitment are strong predictors of nurses' performance. Job performance is positively related to some personal factors, including years of experience, nationality, gender, and marital status. Level of education is negatively related to performance. The findings of this study have a limited generalisability due to the fact that all measures used are based on self-reports. Future research may be directed to other objective measures of performance. Emphasis should be placed on effective supervision, empowerment, and a better reward system. Cultural diversity is a reality for most health organizations in Saudi Arabia; therefore, they need to adopt effective human resources strategies that aim to improve commitment and retention of qualified workers, and build a high performance organizational culture based on empowerment, open communication, and appreciation of impact of national culture on work attitudes. This study fulfills a research gap in the area of nursing performance, and its relationship with work attitudes in Saudi Arabia. The paper also highlights the impact of national culture on job performance and work attitude among nurses in Saudi Arabia, and other countries facing the issue of multi-national work force.
Jennings, P; Lotito, A; Baysson, H; Pineau-Blondel, E; Berlioz, J
The purpose of the study was to evaluate physician's satisfaction with the clinical pharmacy activities in a French regional hospital. Data were collected by face-to-face interviews carried out by a public health intern with physicians from 14 different departments of medicine and surgery. A specifically designed questionnaire was used for this study. This contained 18 closed-ended questions, 3 open-ended questions and 6 questions relating to the multidisciplinary analysis of prescriptions of elderly patients. The questionnaire was proposed to 78 physicians, of which 62 replied (participation rate of 79%). Thirty-seven percent were interns (23/62), 19% were assistants (12/62) and 44% were senior physicians (27/62). Clinical pharmacy satisfaction levels were generally very high. In regard to clinical skills, 87% of the physicians were satisfied with pharmacists' competencies and 91% by the pertinence of transmitted information. Ninety-five percent of the physicians were also satisfied by the logistical aspect and the relationship with pharmacists (reactivity, availability and communication). Analysis of the open-ended questions showed that physicians were in favour of the increased presence of clinical pharmacists on the wards. This study shows a high level of physician satisfaction in relation to the clinical pharmacy activities in our hospital, and should be viewed as a strong endorsement of the work of the clinical pharmacy. This study highlights some areas of improvement such as increase presence of the clinical pharmacists on the wards. In order to assess periodically our activity, this study must be repeated in the future. Copyright © 2016 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.
Bambi, Stefano; Becattini, Giovanni; Pronti, Fabio; Lumini, Enrico; Rasero, Laura
Lateral hostilities among emergency and critical care nurses. Survey in five hospitals of Tuscany Region. Introduction. Lateral hostilities (LHs) are a kind of workplace violence. They are defined as varieties of cruel, rude, antagonistic interactions between people at the same hierarchical level. Nurses are affected by LH from 5.7% to 65%, leading to reduced work motivation, psycho-physical disorders, and in some cases, drop out of the nursing profession. Objective. To quantify the LHs among nurses in the emergency departments (ED) and intensive care units (ICU) in 5 hospitals of Tuscany (Italy). To show the impact on the quality of their psycho-physical and professional lives. Method. Exploratory-descriptive study, through closed-ended questionnaire. Results. 360/444 nurses (81%); 294 (81.6%) were victims of LHs during the past 12 months. Gossiping, complaints shared with others without discussing with the concerned person, and sarcastic comments were the most reported LHs. LHs occur more in EDs than ICUs (respectively 90% and 77%; p=0.0038). No statistically significant differences were observed for gender, age, or years of experience. The 17.7% of nurses asked to be moved from the ward, and 6.9% left it; 6.9% respondents had thought to leave the nursing profession; 235 (65.2%) experienced at least one LHs related disorder during the last year. Most reported symptoms were low morale, anxiety, and sleep disturbances. Conclusions. The incidence of LH and related disorders is high in EDs and ICUs, determining a low professional and psycho-physical quality of life.
Jocelyn Qi-Min Teo
Full Text Available Abstract Background Candidemia is a common cause of nosocomial bloodstream infections, resulting in high morbidity and mortality. This study was conducted to describe the epidemiology, species distribution, antifungal susceptibility patterns and outcomes of candidemia in a large regional tertiary referral hospital. Methods A retrospective surveillance study of patients with candidemia was conducted at Singapore General Hospital between July 2012 and December 2015. In addition, incidence densities and species distribution of candidemia episodes were analysed from 2008 to 2015. Results In the period of 2012 to 2015, 261 candidemia episodes were identified. The overall incidence was 0.14/1000 inpatient-days. C. glabrata (31.4%, C. tropicalis (29.9%, and C. albicans (23.8% were most commonly isolated. The incidence of C. glabrata significantly increased from 2008 to 2015 (Coefficient 0.004, confidence interval 0–0.007, p = 0.04. Fluconazole resistance was detected primarily in C. tropicalis (16.7% and C. glabrata (7.2%. fks mutations were identified in one C. albicans and one C. tropicalis. Candidemia episodes caused by C. tropicalis were more commonly encountered in patients with haematological malignancies (p = 0.01, neutropenia (p < 0.001 and higher SAPS II scores (p = 0.02, while prior exposure to echinocandins was associated with isolation of C. parapsilosis (p = 0.001. Echinocandins (73.3% were most commonly prescribed as initial treatment. The median (range time to initial treatment was 1 (0–9 days. The 30-day in-hospital mortality rate was 49.8%. High SAPS II score (Odds ratio, OR 1.08; 95% confidence interval, CI 1.05–1.11 and renal replacement therapy (OR 5.54; CI 2.80–10.97 were independent predictors of mortality, while drain placement (OR 0.44; CI 0.19–0.99 was protective. Conclusions Decreasing azole susceptibilities to C. tropicalis and the emergence of echinocandin resistance suggest that susceptibility
Roberto Serpa Flórez
Full Text Available
“Señora Muerte que se va llevando todo lo bueno que en nosotros topa. Solos, en un rincón, vamos quedando los demás… ¡gente mísera de tropa!” ……¿Dónde las almas íntimas, hermanas ¡Señora Muerte se las va llevando!”
La noticia de la muerte de mi muy querido amigo y admirado maestro Humberto Rosselli, que hoy me llega por el correo de la Academia de Medicina, me llena de amargura y profundo pesar.
Humberto Rosselli Quijano nació en Sogamoso en 1923. Médico, psiquiatra, psicoanalista, escritor, historiador, profesor universitario y académico, el doctor Rosselli hizo estudios profesionales en la Facultad de Medicina de la Universidad Nacional y estudios y formación y adiestramiento en psicoanálisis didáctico como psicoanalista. Doctor en Medicina y Cirugía de la Universidad Nacional (1948 y Psicoanalista de la Sociedad Colombiana de Psicoanálisis, Profesor Titular, Honorario y Emérito de Psiquiatría de la Universidad Nacional, Jefe de la Sección de Psiquiatría de la Facultad de Medicina de la Universidad Nacional y Director del Hospital Psiquiátrico de Bogotá. Presidente de la Sociedad Colombiana de Psiquiatría, de la Asociación Psicoanalítica Colombiana, del Instituto Colombiano del Sistema Nervioso, de la Sociedad Colombiana de Historia de la Medicina, de la Asociación Psiquiátrica de América Latina y del Consejo Interamericano de Asociaciones Psiquiátricas; Miembro de la Academia Colombiana de Historia, Miembro de número de la Academia Nacional de Medicina por más de veinte años hasta su elección como Miembro Honorario.
En los últimos años desempeñó los cargos de Profesor y Jefe del Área Psicosocial de la Escuela Colombiana de Medicina El Bosque. Dirigió durante quince años la Revista Colombiana de Psiquiatría. Humberto Rosselli fue autor de dos de los libros más importantes de Historia de la
Bourgois, Jan G; Dumortier, Jasmien; Callewaert, Margot
'A tribute to Dr J. Rogge' aims to systematically review muscle activity and muscle fatigue during sustained submaximal quasi-isometric knee extension exercise (hiking) related to Olympic dinghy sailing as a tribute to Dr Rogge's merits in the world of sports. Dr Jacques Rogge is not only...... of invasive needle electromyography (EMG) during a specific sailing technique (hiking) on a self-constructed sailing ergometer. Hiking is a bilateral and multi-joint submaximal quasi-isometric movement which dinghy sailors use to optimize boat speed and to prevent the boat from capsizing. Large stresses...... are generated in the anterior muscles that cross the knee and hip joint, mainly employing the quadriceps at an intensity of 30-40% maximal voluntary contraction (MVC), sometimes exceeding 100% MVC. Better sailing level is partially determined by a lower rate of neuromuscular fatigue during hiking and for ≈60...
Aksan, Hediye A D; Ergin, Işıl; Ocek, Zeliha
Substantial regional health inequalities have been shown to exist in Turkey for major health indicators. Turkish data on hospitals deserves a closer examination with a special emphasis on the regional differences in the context of the rapid privatization of the secondary or tertiary level health services.This study aims to evaluate the change in capacity and service delivery at public and private hospitals in Turkey between 2001-2006 and to determine the regional differences. Data for this retrospective study was provided from Statistical Almanacs of Inpatient Services (2001-2006). Hospitals in each of the 81 provinces were grouped into two categories: public and private. Provinces were grouped into six regions according to a development index composed by the State Planning Organisation. The number of facilities, hospital beds, outpatient admissions, inpatient admissions (per 100 000), number of deliveries and surgical operations (per 10 000) were calculated for public and private hospitals in each province and region. Regional comparisons were based on calculation of ratios for Region 1(R1) to Region 6(R6). Public facilities had a fundamental role in service delivery. However, private sector grew rapidly in Turkey between 2001-2006 in capacity and service delivery. In public sector, there were 2.3 fold increase in the number of beds in R1 to R6 in 2001. This ratio was 69.9 fold for private sector. The substantial regional inequalities in public and private sector decreased for the private sector enormously while a little decrease was observed for the public sector. In 2001 in R1, big surgical operations were performed six times more than R6 at the public sector whereas the difference was 117.7 fold for the same operations in the same regions for the private sector. These ratios decreased to 3.6 for the public sector and 13.9 for the private sector in 2006. The private health sector has grown enormously between 2001-2006 in Turkey including the less developed
Full Text Available Abstract Background Substantial regional health inequalities have been shown to exist in Turkey for major health indicators. Turkish data on hospitals deserves a closer examination with a special emphasis on the regional differences in the context of the rapid privatization of the secondary or tertiary level health services. This study aims to evaluate the change in capacity and service delivery at public and private hospitals in Turkey between 2001-2006 and to determine the regional differences. Methods Data for this retrospective study was provided from Statistical Almanacs of Inpatient Services (2001-2006. Hospitals in each of the 81 provinces were grouped into two categories: public and private. Provinces were grouped into six regions according to a development index composed by the State Planning Organisation. The number of facilities, hospital beds, outpatient admissions, inpatient admissions (per 100 000, number of deliveries and surgical operations (per 10 000 were calculated for public and private hospitals in each province and region. Regional comparisons were based on calculation of ratios for Region 1(R1 to Region 6(R6. Results Public facilities had a fundamental role in service delivery. However, private sector grew rapidly in Turkey between 2001-2006 in capacity and service delivery. In public sector, there were 2.3 fold increase in the number of beds in R1 to R6 in 2001. This ratio was 69.9 fold for private sector. The substantial regional inequalities in public and private sector decreased for the private sector enormously while a little decrease was observed for the public sector. In 2001 in R1, big surgical operations were performed six times more than R6 at the public sector whereas the difference was 117.7 fold for the same operations in the same regions for the private sector. These ratios decreased to 3.6 for the public sector and 13.9 for the private sector in 2006. Conclusions The private health sector has grown
This article looks at a prescribed academic framework for various criteria that serve as a checklist for marketing performance that can be applied to hospital marketing organizations. These guidelines are drawn from some of Dr. Noel Capon of Columbia University's book Marketing Management in the 21st Century and applied to actual practices of hospital marketing organizations. In many ways this checklist can act as a "marketing" balanced scorecard to verify performance effectiveness and develop opportunities for innovation.
Govender, Sagaren; Gerwel Proches, Cecile N; Kader, Abdulla
Background Four public hospitals in South Africa, which render both specialized and nonspecialized services to thousands of patients, were examined to determine the impact of leadership on health care service delivery. These hospitals were inundated by various problems that were impacting negatively on health care service delivery. Purpose This research study aimed to gain a comprehensive understanding of the challenges, complexities and constraints facing public health care in KwaZulu-Natal (KZN) and to examine leadership as a strategy to enhance healthcare service delivery with a particular focus on four regional hospitals in the KZN Province. Methods The mixed-method research approach was utilized. Purposive sampling and stratified random sampling were employed in the research setting, and in-depth, semistructured interviews and questionnaires were used to collect data. Data were analyzed using the Nvivo computer software package for in-depth interviews and the Statistical Package for the Social Sciences (SPSS) software for the quantitative analysis. Results The research findings showed that the current leadership framework adopted by the health care leaders in regional hospitals in KZN is weak and is contributing to poor health care service delivery. Conclusion This study, therefore, aimed to address the current challenges and weaknesses that are impacting negatively on health care service delivery in regional hospitals in the KZN Province and made recommendations for improvement. PMID:29535529
Govender, Sagaren; Gerwel Proches, Cecile N; Kader, Abdulla
Four public hospitals in South Africa, which render both specialized and nonspecialized services to thousands of patients, were examined to determine the impact of leadership on health care service delivery. These hospitals were inundated by various problems that were impacting negatively on health care service delivery. This research study aimed to gain a comprehensive understanding of the challenges, complexities and constraints facing public health care in KwaZulu-Natal (KZN) and to examine leadership as a strategy to enhance healthcare service delivery with a particular focus on four regional hospitals in the KZN Province. The mixed-method research approach was utilized. Purposive sampling and stratified random sampling were employed in the research setting, and in-depth, semistructured interviews and questionnaires were used to collect data. Data were analyzed using the Nvivo computer software package for in-depth interviews and the Statistical Package for the Social Sciences (SPSS) software for the quantitative analysis. The research findings showed that the current leadership framework adopted by the health care leaders in regional hospitals in KZN is weak and is contributing to poor health care service delivery. This study, therefore, aimed to address the current challenges and weaknesses that are impacting negatively on health care service delivery in regional hospitals in the KZN Province and made recommendations for improvement.
Leal Costa, C; Luján Cebrián, I; Gascón García, J; Ferrer Villalonga, L; Van-der Hofstadt Román, C J
To assess the social skills of health care professionals in the emergency and critical care units of the regional hospital Vega Baja and analyze the association between a series of sociodemographic and professionals variables and social skills. A cross-sectional, descriptive study. Two evaluation tools were used. These included a sociodemographic and professional variables questionnaire, and the Elena Gismero's Social Skills Scale (SSS). A response rate of 82.6% was obtained. Considering the standards made by the author in SSS validation, it can be seen that the sample has obtained a medium-high score in each one of the aspects. Significant differences have been found when considering the sociodemographic variable gender as an independent variable with the complete score of SSS (F=6.555; p=0.013), and with the scale dimensions, self-expression in social situations (F=4.468; p=0.039) and making a demand (F=7.982; p=0.007). In each one of the SSS dimensions, the sample has obtained a slightly higher score than the standard sample and it within the 50-69 percentile. This indicates the existence of a medium-high level of Social Skill. The doctors score higher than the nurses, although these differences are not statistically significant. Copyright © 2010 Elsevier España, S.L. y SEEIUC. All rights reserved.
Regalado C, S.; Benavente A, T.; Celedonio O, E.; Vasquez A, M.
The irradiation doses have been measured in operators, patients and members of public, who attend the diagnostic service of the Hospital Regional Docente in Trujillo, Peru by using TLD-100 and TLD-200. For cranium test, the results are 8,68 x 10 -3 mSv in operators and 7,8 x 10 -4 mSv in members of the public. It means a fatal cancer risk of 3,7 x 10 -7 and 3,9 x 10 -8 , respectively. For patients, the equivalent doses in the examined organs are 0,181 mSv in lung; 4,982 mSv in spine; 6,466 mSv in abdomen; 6,039 mSv in pelvis and 2,174 mSv in cranium. In order to maximize benefits for patients, a quality control program was carried out in x-ray equipment. It consisted in the measurement of an effective, average and maximum kilovoltage, as well as in the determination of the HVL, linearity, exposition time and coincidence between luminous and radiation fields. It was concluded that the measured doses are similar to the international ones reported. In the same way, it is indicated that it is possible to reduce risks in patients and operators by regulating kilo-voltages, adjusting the radiation fields and electronic calibration equipment. (authors). 4 refs., 2 tabs
Lewandowski, A.; Hejjamy, R.; Turek, W.; Gul, E.
Two main groups of malignant lymphomas: Hodgkin's and non-Hodgkin's lymphomas have been presented as a poster. Their epidemiology has been discussed and attention has been called to the frequency of their occurrence in ENT diseases. Special attention has been also called to the significance of congenital and acquired immune deficiency syndromes and infectious factors in malignant lymphomas etiology. Histological classification has been described presenting difficulties in the division of non-Hodgkin's lymphomas and significance of the classification. in finding the appropriate way of treatment. Pathogenesis and diagnostic difficulties have been presented and attention to the significance of histologic diagnosis of lymphonodes taken as a whole from the neck. The aim of that was to avoid non-specific inflammatory changes which often occur in axillary and inguinal nodules described with special emphasis on out of nodules neoplastical changes. 23 cases of malignant lymphomas treated in the ENT Dept. of the Babinski Regional Hospital in Wroclaw in the years 1982-1992 have been presented. Special attention has been called to the correlation between advancement and ways of treatment. Two cases of lymphoma have been shown in the pictures. (author)
Chadli, S; Aghrouch, M; Taqarort, N; Malmoussi, M; Ouagari, Z; Moustaoui, F; Bourouache, M; Oulkheir, S
Neuromeningeal cryptococcosis (NMC) is a severe and fatal opportunistic infection. Lethality is frequent in the absence of treatment, especially in the presence of HIV co-infection. To determine the prevalence, epidemiological, clinical, biological and therapeutic aspects as well as the evolution of NMC for patients infected with HIV. This is a retrospective study of 40 cases of neuromeningeal cryptococcosis diagnosed in HIV-infected patients. Data are collected for 7 years (from January 2010 to December 2016) in the registers of the parasitology laboratory and the infectious diseases department at the regional hospital center in Agadir. A reduction in the prevalence of neuromeningeal cryptococcosis in HIV-infected patients was noted from 2010 to 2016 (3.66% to 0.83%). The overall prevalence of NMC was 1.53%. The mean age was 37±10 years old, with 90% of patients aged less than 45 years. The main clinical symptomatology was headache (75%). The main cytochemical abnormalities of cerebrospinal fluid analysis were hyperproteinorachy (60%), hypoglycorachy (63%) and lymphocytosis (50%). The mean CD4 cell count was 47/mm 3 . Patients were initially treated with amphotericin B, relayed with fluconazole. The overall lethality was 35%. Neuromeningeal cryptococcosis is a serious opportunistic infection in patients HIV-infected, and the lethality rate remains unacceptable. Fighting NMC in HIV+ patients requires early diagnosis, increased access to antiretrovirals, rapid introduction of appropriate treatment and the prescription of effective systemic antifungals. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Full Text Available In 2009, a survey focused on barriers to entrepreneurship among managers and/or owners of companies in the hospitality industry in the South Moravian Region was carried out (Klapalová,2011 at the College of Business and Hotel Management in Brno. Results of this survey revealed that knowledge together with skills and competencies was considered to be the biggest barrier to sustainable successful entrepreneurship of these companies and this perception wasalso confirmed by Spearman’s correlations analysis with statistically significant coefficient at the 0.05 level (Spearman’s rho=0.214, p=0.18, when analyzing the relation to financial performanceof companies. The issue of knowledge was not investigated deeper in the survey but it raised several questions for further research. This paper offers preliminary and partial results of an inquiry done during the autumn and winter 2011 and spring and summer 2012 which takes up the previous survey from 2009 with the aim to explore the types of knowledge, skills and competencies perceived as the most important for company success and as the most missing in nowadays entrepreneurship of inquired companies. Three relationships of knowledge categories were analysed: relation to the age and size of companies and relation to the indicators of financial performance. The findings have several managerial implications, both for business practice and educational organisations.
Suicide is the third most common cause of death among adolescents globally, and poisoning is the leading method of attempted suicide. Survival after self-poisoning or drug overdose (OD) is common, providing an opportunity for secondary prevention. The aim of this study was to highlight pattern of presentations and preceding factors of OD in an adolescent population. We retrospectively evaluated the data of 85 adolescents presenting to a large regional hospital with OD over a 3-year period. The female-to-male ratio was 4.3:1. The median age of adolescents was 15.83 (range: 11.32 – 16.98) years. History of deliberate self-harm (DSH) was documented in 44.7%. Twenty-eight (33%) patients had been under the care of the CAMHS prior to index admission. Acetaminophen was the commonest drug used. Depression was the most common cause of mental illness in the study group. Substance abuse and conduct disorder were significantly commoner in males (p<0.05). Self-poisoning including OD in adolescence is a strong predictor of suicide; understanding the probable triggers can be significant in establishing appropriate prevention strategies.
Tchelougou, D; Karou, D S; Kpotsra, A; Balaka, A; Assih, M; Bamoke, M; Katawa, G; Anani, K; Simpore, J; de Souza, C
The aim of this study was to evaluate the prevalence of the major microorganisms causing vaginal infections in pregnant women consulting at the Regional Hospital of Sokodé and to assess their sensitivity to antibiotics. This prospective study took place from June 2010 through August 2011 and included 302 pregnant women from whom a sample was taken by a vaginal swab. Samples were processed for parasitic, bacterial, and fungal agents, by microscopic examination and culture. We isolated 273 germs, alone or in association in 221 women. These germs were distributed as follows: Gardnerella vaginalis (55.31%), Candida spp (30.77%), Staphylococcus aureus (5.49%), Enterobacteriaceae (4.40%), Trichomonas vaginalis (3.66%) and Mobiluncus spp (0.37%). No Streptococcus strain was isolated during the study. Over 40% of women had bacterial vaginosis and 23.08% of them were coinfected. The occurrence of coinfection was statistically influenced by the stage of pregnancy (P = 0.05). The susceptibility tests revealed that S. aureus developed a strong resistance to aminopenicillins (66.67%) and cephalosporins (>44.44%), while Enterobacteriaceae was resistant to cephalosporins and quinolones. (16.67%). This study showed that pregnant women in Sokode are still exposed to vaginal infection, caused mostly by G. vaginalis and Candida species. These results underline the need for at least one vaginal swab culture for each woman during pregnancy.
María Caridad Corría Santos
Full Text Available Se realizó un trabajo descriptivo de corte transversal sobre la morbimortalidad en la unidad de cuidados intensivos neonatales del Hospital Regional Sunyani de Ghana, en un periodo de seis meses, desde agosto de 2009 hasta enero de 2010, con el objetivo de determinar el comportamiento de la morbimortalidad de 170 neonatos, que necesitaron de estos servicios en el periodo estudiado. Se revisaron las entidades o eventos clínicos definidos y diagnosticados al egreso, así como la cantidad de pacientes que sobrevivieron y los fallecidos. Los datos fueron obtenidos de historias clínicas y el libro de registro del referido servicio. Los resultados se presentaron en tablas y mediante el empleo de la estadística porcentual. La prematuridad estuvo presente en 89 pacientes (52%, seguido de la asfixia, en 51 (30% y de la sepsis neonatal, en 46 (27%. Fallecieron 33 neonatos (19,4% y sobrevivieron 137 (80,6%. Las entidades clínicas más frecuentes en los fallecidos fueron: prematuridad en 21 pacientes (63%, asfixia perinatal en 19 neonatos (57,6% y la sepsis en 9 (27,3%. Un paciente falleció (0,6% con diagnóstico de tétanos neonatal. La letalidad y la sobrevida se comportaron como en la generalidad de los países en vías de desarrollo
Full Text Available Capnocytophaga canimorsus is a commensal bacterium in the oral cavity of dogs and cats and has been isolated from humans with a history of dog or cat bites or scratches. C. canimorsus are capnophilic facultative anaerobic, fastidious gram negative fusiform rods, included in the CDC group DF-2 or dysgonic fermenter 2. The bacterium can cause severe illness in patients at elevated risk i.e. after splenectomy, with alcohol addiction, chronic lung or liver diseases or immunosuppression. In 2010 at the Bolzano Regional Hospital (Northern-Italy C. canimorsus was isolated from blood cultures in two splenectomised patients suffering from septicaemia.The bacterium is difficult to cultivate because of its specific requirements for nutrients as well as to identify with routine automated instruments; therefore we used molecular typing by 16S rDNA sequencing.The true number of C. canimorsus infections is probably underestimated due to the fastidious growth of the organism. However, given the severity of the disease and the poor outcome one should consider this bacterium to apply appropriate diagnostic methods for this etiologic agent.
Brabazon, E D
Rapid notification of infectious diseases is essential for prompt public health action and for monitoring of these diseases in the Irish population at both a local and national level. Anecdotal evidence suggests, however, that the occurrence of notifiable infectious diseases is seriously underestimated. This study aims to assess the level of hospitalization for notifiable infectious diseases for a 6-year period in one health board region in Ireland and to assess whether or not there was any under-reporting during this period. All hospital in-patient admissions from 1997 to 2002 inclusive with a principal diagnosis relating to \\'infectious and parasitic diseases\\' (ICD codes 001-139) of residents from a health board region in Ireland were extracted from the Hospital In-Patient Enquiry System (HIPE). All notifiable infectious diseases were identified based on the 1981 Irish Infectious Disease Regulations and the data were analysed in the statistical package, JMP. These data were compared with the corresponding notification data. Analysis of the hospital in-patient admission data revealed a substantial burden associated with notifiable infectious diseases in this health board region: there were 2758 hospitalizations by 2454 residents, 17,034 bed days and 33 deaths. The statutory notification data comprises both general practitioner and hospital clinician reports of infectious disease. Therefore, only in cases where there are more hospitalizations than notifications can under-reporting be demonstrated. This occurred in nine out of 22 notifiable diseases and amounted to an additional 18% of notifications (or 572 cases) which were \\'missed\\' due to hospital clinician under-reporting. The majority of these under-reported cases were for viral meningitis (45%), infectious mononucleosis (27%), viral hepatitis C unspecified (15%) and acute encephalitis (5.8%). This study has highlighted the extent of under-reporting of hospitalized notifiable infectious diseases, in a
Mochungong, Peter I K; Gulis, Gabriel; Sodemann, Morten
a survey to evaluate hospital workers' awareness of health and environmental impacts of poor clinical waste disposal in Cameroon. We randomly distributed 500 questionnaires to hospital workers in three hospitals in the Northwest Region of Cameroon in April 2008. In addition, we observed collection......Due to the infectious nature of some clinical waste, poor disposal practices have sparked concern regarding the impact on public health and the environment. Lack of sufficient knowledge of the associated risks may be a strong factor contributing to inadequate disposal practices. We conducted......, segregation, transportation, and disposal of clinical waste at the three hospitals. Of 475 total respondents, most lacked sufficient awareness of any environmental or public health impacts of poor clinical waste disposal and had never heard of any policy--national or international--on safe clinical waste...
McAuliffe, Gary N; Taylor, Susan L; Drinković, Dragana; Roberts, Sally A; Wilson, Elizabeth M; Best, Emma J
In July 2014, New Zealand introduced universal infant vaccination with RotaTeq (Merk & Co.) administered as 3 doses at 6 weeks, 3 and 5 months of age. We sought to assess the impact of rotavirus vaccination on gastroenteritis (GE) hospitalizations in the greater Auckland region and analyze changes in rotavirus testing in the period around vaccine introduction. Hospitalizations, laboratory testing rates and methods were compared between the pre-vaccine period (2009-2013), post-vaccine period (January 2015 to December 2015) and year of vaccine introduction (2014). There was a 68% decline in rotavirus hospitalizations of children Auckland region. However, continued rotavirus testing at pre-vaccine rates risks generating false positive results. Laboratories and clinicians should consider reviewing their testing algorithms before vaccine introduction.
Curtis L. Baysinger
Full Text Available Many low- and middle-income countries (LMICs report low rates of regional anesthesia (RA use for cesarean delivery (CD, despite its association with lower maternal major morbidity and mortality. Also, the prevalence of neuraxial analgesia for labor (NAL is often low in LMICs. We report on the results of a collaboration in clinical education over a multi-year period between Kybele Inc., an international non-profit organization, and Klinicki Centar Vojvodine (CCV, a teaching hospital in Novi Sad, Serbia, to increase RA use for CD and NAL at CCV. From late 2011 through 2015, teams from Kybele participated in annual to biannual didactic conferences and week-long bedside teaching efforts involving obstetric and anesthesia staff from CCV and surrounding hospitals. Ongoing contact occurred at least weekly between Kybele and the host to discuss progress. De-identified quality improvement data on total deliveries, numbers of elective and non-elective CDs, number of vaginal deliveries, type of anesthesia for CD, and the number of NALs were collected. RA use for CD increased to 25% in year 2015 versus 14% in base year 2011 [odds ratio (OR: 2.05; 95% confidence interval (CI: 1.73,2.42; p < 0.001]. NAL increased to 10.5% of laboring women in 2015 versus 1.2% in 2011 (OR: 9.6; 95% CI: 7.2, 12.8; p < 0.001. Greater increases for RA use during non-elective CD were observed between 2011 and 2015 (1.4 versus 7.5% of total CD; OR: 5.52; 95% CI: 2.63, 8.41; p < 0.001 relative to elective CD (12.5 versus 17.5% of total CD; OR: 1.48; 95% CI: 1.23, 1.77; p < 0.001. Overall, RA for CD increased during the 4 year collaboration but was not as great as reported in other countries with similar health-care demographics utilizing a similar program. Detailed descriptions of program interventions and barriers to change at CCV are presented.
Baysinger, Curtis L; Pujic, Borislava; Velickovic, Ivan; Owen, Medge D; Serafin, Joanna; Shotwell, Matthew S; Braveman, Ferne
Many low- and middle-income countries (LMICs) report low rates of regional anesthesia (RA) use for cesarean delivery (CD), despite its association with lower maternal major morbidity and mortality. Also, the prevalence of neuraxial analgesia for labor (NAL) is often low in LMICs. We report on the results of a collaboration in clinical education over a multi-year period between Kybele Inc., an international non-profit organization, and Klinicki Centar Vojvodine (CCV), a teaching hospital in Novi Sad, Serbia, to increase RA use for CD and NAL at CCV. From late 2011 through 2015, teams from Kybele participated in annual to biannual didactic conferences and week-long bedside teaching efforts involving obstetric and anesthesia staff from CCV and surrounding hospitals. Ongoing contact occurred at least weekly between Kybele and the host to discuss progress. De-identified quality improvement data on total deliveries, numbers of elective and non-elective CDs, number of vaginal deliveries, type of anesthesia for CD, and the number of NALs were collected. RA use for CD increased to 25% in year 2015 versus 14% in base year 2011 [odds ratio (OR): 2.05; 95% confidence interval (CI): 1.73,2.42; p < 0.001]. NAL increased to 10.5% of laboring women in 2015 versus 1.2% in 2011 (OR: 9.6; 95% CI: 7.2, 12.8; p < 0.001). Greater increases for RA use during non-elective CD were observed between 2011 and 2015 (1.4 versus 7.5% of total CD; OR: 5.52; 95% CI: 2.63, 8.41; p < 0.001) relative to elective CD (12.5 versus 17.5% of total CD; OR: 1.48; 95% CI: 1.23, 1.77; p < 0.001). Overall, RA for CD increased during the 4 year collaboration but was not as great as reported in other countries with similar health-care demographics utilizing a similar program. Detailed descriptions of program interventions and barriers to change at CCV are presented.
Full Text Available Trauma is a leading cause of morbidity and mortality worldwide. Data characterizing the burden of trauma in Cameroon is limited. Regular, prospective injury surveillance can address the shortcomings of existing hospital administrative logs and medical records. This study aims to characterize trauma as seen at the emergency department (ED of Limbe Regional Hospital (LRH and assess the completeness of data obtained by a trauma registry.From January 2008 to October 2013, we prospectively captured data on injured patients using a strategically designed, context-relevant trauma registry instrument. Indicators around patient demographics, injury characteristics, delays in accessing care, and treatment outcomes were recorded. Descriptive, bivariate, and multivariate statistical analyses were conducted. About 5,617 patients, aged from 0.5-95years (median age of 26 years, visited the LRH ED with an injury; 67% were male. Students (27% were the most affected occupation category. Road traffic injuries (RTIs (56%, assault (22%, and domestic injuries (13% were the leading causes of injury. Two-thirds of RTIs were motorcycle-related. Working in transportation (AOR 4.42, p<0.001 and law enforcement (AOR 1.73, p = 0.004 were significant predictors of having a RTI. The trauma registry showed a significant improvement in completeness of all data (p<0.001 and it improved over time compared with previous administrative records. However, proportions of missing data still ranged from 0.5% to 8.2% and involved respiratory rate or Glasgow Coma scale.Implementation of a context-appropriate trauma registry in resource-constrained settings is feasible. Providing valuable, high-quality data, the trauma registry can inform trauma care quality improvement efforts and policy development. Study findings indicate the need for injury prevention interventions and policies that will prioritize high-risks groups, such as those aged 20-29 years, and those in occupations requiring
... Section: Animal Sciences. Ali, Dr Moizuddin Abdul Salim D.Sc. (Andhra), D.Sc. (h.c.), FNA. Date of birth: 12 November 1896. Date of death: 20 June 1987. Specialization: Ecology, Zoogeography, Nature Conservation, Ornithology Last known address: No. 46, Pali Hill, Bombay 400 050. YouTube; Twitter; Facebook; Blog ...
Elected: 2002 Section: Engineering & Technology. Murty, Dr Thutupalli Gopala Krishna Ph.D. (Adelaide). Date of birth: 11 February 1944. Specialization: Optical Engineering, Thin Film Technology, Electro-Optical Instrumentation and Atmospheric Science Technologies Address: 848, 8th B Main, 17th Cross, ISRO Layout, ...
Dr. John Marburger, Director of the United States Office of Science and Technology Policy, visited the research center DESY in Hamburg. The American physicist wanted to inform himself about the status of the TESLA X-ray laser and the TESLA linear collider as well as the international collaboration at DESY (1/2 page).
von Strauss und Torney, Marco; Güller, Ulrich; Rezaeian, Farid; Brosi, Philippe; Terracciano, Luigi; Zuber, Markus
Vital tissue provided by fresh frozen tissue banking is often required for genetic tumor profiling and tailored therapies. However, the potential patient benefits of fresh frozen tissue banking are currently limited to university hospitals. The objective of the present pilot study--the first one in the literature--was to evaluate whether fresh frozen tissue banking is feasible in a regional hospital without an integrated institute of pathology. Patients with resectable breast and colon cancer were included in this prospective study. Both malignant and healthy tissue were sampled using isopentan-based snap-freezing 1 h after tumor resection and stored at -80 °C before transfer to the main tissue bank of a University institute of pathology. The initial costs to set up tissue banking were 35,662 US$. Furthermore, the running costs are 1,250 US$ yearly. During the first 13 months, 43 samples (nine samples of breast cancer and 34 samples of colon cancer) were collected from 41 patients. Based on the pathology reports, there was no interference with standard histopathologic analyses due to the sample collection. This is the first report in the literature providing evidence that tissue banking in a regional hospital without an integrated institute of pathology is feasible. The interesting findings of the present pilot study must be confirmed by larger investigations.
Full Text Available Background: The rates of cesarean deliveries have been increasing steadily in several European countries in recent decades, with Italy having the second-highest rate (38% in 2010, causing concern and debate about the appropriateness of many interventions. Moreover, some recent studies suggest that rates of common obstetric interventions are not homogeneous across hospitals, maybe not only because of patient case mix but also possibly because of different hospital practices and cultures. Thus, it is important to investigate whether the variation in rates of cesarean sections can be traced back to patient characteristics or whether it depends upon context variables at the hospital level. Objective and method: Using official hospital abstracts on deliveries that occurred in Sardinia over a two-year period, we implement multilevel logistic regression models in order to assess whether the observed differences in cesarean rates across hospitals can be justified by case-mix differences across hospitals. Results: The between-hospital variation in rates of cesarean delivery is estimated to be 0.388 in the model with only the intercept and 0.382 in the model controlling for the mother’s clinical and sociodemographic characteristics. Conclusions: The results show that taking into account the individual characteristics of delivered mothers is not enough to justify the observed variation across hospital rates, suggesting the important role of unobserved variables at the hospital level in determining cesarean section rates.
Full Text Available This paper aims to provide an efficiency evaluation of selected hospital bed care providers during years 2010 -2012 with respect to selected factors: The size of the hospital establishment according to number of beds, number of hospitalized patients, the average length of stay per a patient in care, total staff cost calculated per bed, total revenues calculated per bed, and total costs calculated per bed. For this purpose, hospitals providing primarily acute bed care were chosen. From the legal point of view, they are allowance organizations of a particular region. The evaluation concerns both allocative efficiency and technical efficiency. The allocative efficiency is treated from the proper algorithm point of view and it compares total costs calculated per bed with total revenues calculated per bed. A method denominated Data Envelopment Analysis was applied for the calculation of the technical efficiency of units. To be more specific, it was input-oriented model with constant returns to scale (CCR. The input parameters involve the number of beds, the average length of stay and costs per day of stay. Output parameters were as follows: Bed occupancy in days and the number of hospitalized patients. The data published by the Institute of Health Information and Statistic of the Czech Republic and by ÚFIS system (the Data Base of Ministry of Finance of the Czech Republic were used as the source of data. The evaluation implies that only three hospitals were economically-effective: Silesian Hospital in Opava, Hospital Jihlava, and TGM Hospital Hodonín. The most significant factor influencing the efficiency was determined - the average length of stay.
Ansari, A A; Freidhoff, L R; Meyers, D A; Bias, W B; Marsh, D G
A well-characterized allergen of Lolium perenne (perennial rye grass) pollen, Lol p III, has been used as a model antigen to study the genetic control of the human immune response. Associations between HLA type and IgE or IgG antibody (Ab) responsiveness to Lol p III were studied in two groups of skin-test-positive Caucasoid adults (N = 135 and 67). We found by nonparametric and parametric analyses that immune responsiveness to Lol p III was significantly associated with HLA-DR3 and DR5. No association was found between any DQ type and immune responsiveness to Lol p III. Geometric mean IgE or IgG Ab levels to Lol p III were not different between B8+, DR3+ subjects and B8-, DR3+ subjects, showing that HLA-B8 had no influence on the association. Lol p III IgG Ab data obtained on subjects after grass antigen immunotherapy showed that 100% of DR3 subjects and 100% of DR5 subjects were Ab+. A comparison of all the available protein sequences of DRB gene products showed that the first hypervariable region of DR3 and DR5 (and DRw6), and no other region, contains the sequence Glu9-Tyr-Ser-Thr-Ser13. Our observations are consistent with the possibility that immune responsiveness to the allergen Lol p III is associated with this amino acid sequence in the first hypervariable region of the DR beta 1 polypeptide chain.
Heskestad, Ben; Baardsen, Roald; Helseth, Eirik
it with previous Norwegian studies. METHODS: All head injured patients referred to Stavanger University Hospital during a one-year period (2003) were registered in a partly prospective and partly retrospective study. The catchment area for the hospital is strictly defined to a local population of 283...
Hopkins, C J
Reporting of antibiotic consumption in hospitals is a crucial component of antibiotic stewardship, but data from Australasian secondary hospitals are scarce. The hypothesis of this audit is that antibiotic consumption in secondary hospitals would be lower than in tertiary centres. The study aims to present the first published audit of antibiotic consumption from a secondary hospital in New Zealand compared with two tertiary centres. Hospital population-level data were retrospectively accessed to identify all systemic antibiotics dispensed to adult inpatients at Taranaki District Health Board during 2011. Consumption was calculated in defined daily doses per 100 inpatient-days and per 100 admissions, stratified by drug class. Comparison was against published data from two tertiary centres. Total consumption was lower, but that of high-risk antibiotic classes was higher than both tertiary centres. The relative consumption of lincosamides was 4.0 and 2.6 times higher than the two tertiary centres, with an associated 14% incidence of Clostridium difficile associated diarrhoea within 3 months. Our secondary hospital appears to consume the wrong types of antibiotic rather than too much. Data from all Australasian hospitals, stratified by clinical service area and hospital level, are required for clinically relevant benchmarking. © 2014 The Author; Internal Medicine Journal © 2014 Royal Australasian College of Physicians.
Long, D Adam; Sheehan, Paula
This article reviews the population health improvement initiative of a Midwest regional hospital employer. Services included health risk assessments, health education, and motivational health coaching conducted telephonically. Outcomes categories for this program evaluation comprised participation rates, participant satisfaction, health status and behavior change, productivity change, health care claims savings, and return on investment. Participation rates varied widely with incentive structure, although retention of participants in coaching programs averaged 89%. The participant satisfaction rate for the last 14 months of interventions was 96%. Four years of population health status and behavior trending showed significant improvements in smoking status, dietary fat and fiber intake, exercise, mental health (ie, stress, effects depressive symptoms in the past year, life satisfaction), readiness to change (ie, diet, exercise, stress, smoking, body weight), perceptions of overall health, an index of good health habits, sum of lifestyle health risks, and sum of risks and chronic conditions. Body mass index showed nonsignificant improvements during the years of greatest participation (years 2 to 4). Indicators of productivity demonstrated improvements as well. These gains were noted for employees across all health risk statuses, which suggests population health improvement strategies can influence productivity even for healthy employees. Program year 3 was evaluated for health care claims savings using a 2-stage multivariate regression approach. Stage 1 was a computation of propensity-to-participate scores. Stage 2 was an estimation of per member per month (PMPM) claims savings for participant cohorts using a propensity score-weighted linear regression analysis. Participants averaged $40.65 PMPM savings over the control population. Program return on investment, including incentive costs and vendor fees, was 2.87:1.
Yaita, Kenichiro; Sakai, Yoshiro; Iwahashi, Jun; Masunaga, Kenji; Hamada, Nobuyuki; Watanabe, Hiroshi
To clarify the characteristics of post-travel consultation services in Japan, particularly in the provinces, we analyzed our post-travel patients in the travel clinic of Kurume University Hospital located in Kurume City (a regional hub City in southwestern Japan). Sixty post-travel patients visited our clinic between April 2008 and October 2014 and participated in this study: 55 were Japanese and five were foreign. We summarized and compared the characteristics of the patients after dividing the Japanese participants into long-term travelers (>14 days) and short-term travelers (≤14 days). The foreign travelers were described in a separate analysis. Of the 55 Japanese travelers, the mean age (± standard deviation) was 37.3 ± 16.3 years, and 36 patients (65%) were men. Southeast Asia was the major destination (30/55, 55%), and business was stated as the major reason for travel (16/55, 29%). Post-exposure rabies prophylaxis (16/55, 29%) was the most common purpose for the consultations. There were 34 participants (62%) who were classified as short-term travelers. Fewer of the short-term travelers stated receiving pre-travel consultations compared with long-term travelers (11% vs. 79%, p=0.0002). The five foreign travelers included one dengue fever patient and two malaria patients. Most post-travel Japanese patients visited our clinic were short-term travelers who had not received any pre-travel consultation. One of the most common complaints, post-exposure rabies prophylaxis, could have been avoided to some extent by appropriate pre-travel consultations. The results of this study suggest that pre-travel consultations should therefore be encouraged for both long- and short-term travelers.
Full Text Available Objective: To determine the type and frequency of predominant enteropathogens in acute diarrhea and their associated characteristics in children treated at Hospital Regional Lambayeque (HRL - Peru. Materials and methods: A cross-sectional analytical study was carried out in 70 fecal samples between March and May 2015. These samples were studied by coproculture and immunochromatography for the detection of enteropathogenic bacteria and viruses, respectively, while enteroparasites were sought by direct microscopic examination, Kinyoun staining method and ELISA for the detection of coproantigens (Entamoeba histolytica, Giardia lamblia and Cryptosporidium spp. Leukocyte count and chemical tests (Benedict, Thevenon and Sudan III were also performed for the functional study of the diarrheal disease. Results: In 48.6% of the samples, the infectious etiology of diarrhea was detected, prevailing the parasitic cause (25.8%, followed by the bacterial (17.1% and viral (5.8% ones. The most common enteropathogens were G. lamblia (18.6% and Salmonella enteritidis (10.0%. An association between greater than 100 fecal leukocytes per field and the bacterial etiology (p=0.027 was observed, while less than 10 fecal leukocytes per field (p=0.002 and a positive Sudam III test (p=0.003 were associated with the parasitic etiology. Conclusions: In more than half of the samples (51.4% the infectious etiology of diarrhea could not be proven, whereas Giardia lamblia was the most frequent cause of diarrhea in the studied population. However, it is necessary to implement more sensitive and specific techniques for the detection of a greater range of enteropathogens with which to improve the diagnosis and treatment of the disease
Lal, Sonal Tina; Banipal, Raja Paramjeet Singh; Bhatti, Deepak John; Yadav, Hanuman Prasad
Skin cancer constitutes a small but significant proportion of patients with cancer. Although the presence of eumelanin in dark skin is protective against the development of skin cancer, it is increasingly being diagnosed in the Indian population. To study the profile of skin cancer patients presenting to a tertiary hospital in Malwa area of Punjab, India. Retrospective study was done to analyse the profile of skin cancer patients who attended the institution over one year from 1(st) December 2013 to 30(th) November 2014. A comprehensive review of aetiology and related risk factors was done to correlate the environmental factors with high skin cancer prevalence in this region. Skin cancer constituted (3.18%) 84 out of 2638 patients registered with cancer of all types. The age of the patients was 62±14.2 years and ranged from 27 to 92 yrs. Basal cell carcinoma (BCC) was the most common histological type(46/84, 54.76%) followed by squamous cell carcinoma (SCC) (31/84, 36.91%) and malignant melanoma (MM) (7/84, 8.33%). Male: female ratio was found to be 0.79:1. BCC showed higher female preponderance (phistory of prolonged exposure to sunlight. Skin cancer constitutes a small but significant proportion of patients with cancers. This study highlights a paradoxically increasing trend of BCC and female preponderance. Head and neck is the most common site involved. Exposure to Ultra Violet B (UVB) radiation and higher levels of arsenic in drinking water has been reported to be associated with skin cancers. Limited studies show that levels of arsenic and pesticides were higher in the samples of drinking water in Malwa area of Punjab. Therefore a multipronged strategy to provide safe drinking water supply and discouraging the indiscriminate use of pesticides is recommended.
This study was an analysis of the effect of strategic planning on procurement of medicals in Uganda’s regional referral hospitals (RRH’s). Medicals were defined as essential medicines, medical devices and medical equipment. The Ministry of Health (MOH) has been carrying out strategic planning for the last 15 years via the Health Sector Strategic Plans. Their assumption was that strategic planning would translate to strategic procurement and consequently, availability of medicals in the RRH’s. However, despite the existence of these plans, there have been many complaints about expired drugs and shortages in RRH’s. For this purpose, a third variable was important because it served the role of mediation. A questionnaire was used to obtain information on perceptions of 206 respondents who were selected using simple random sampling. 8 key informant interviews were held, 2 in each RRH. 4 Focus Group Discussions were held, 1 for each RRH, and between 5 and 8 staff took part as discussants for approximately three hours. The findings suggested that strategic planning was affected by funding to approximately 34% while the relationship between funding and procurement was 35%. The direct relationship between strategic planning and procurement was 18%. However when the total causal effect was computed it turned out that strategic planning and the related variable of funding contributed 77% to procurement of medicals under the current hierarchical model where MOH is charged with development of strategic plans for the entire health sector. Since even with this contribution there were complaints, the study proposed a new model called CALF which according to a simulation, if adopted by MOH, strategic planning would contribute 87% to effectiveness in procurement of medicals. PMID:28299158
Masembe, Ishak Kamaradi
This study was an analysis of the effect of strategic planning on procurement of medicals in Uganda's regional referral hospitals (RRH's). Medicals were defined as essential medicines, medical devices and medical equipment. The Ministry of Health (MOH) has been carrying out strategic planning for the last 15 years via the Health Sector Strategic Plans. Their assumption was that strategic planning would translate to strategic procurement and consequently, availability of medicals in the RRH's. However, despite the existence of these plans, there have been many complaints about expired drugs and shortages in RRH's. For this purpose, a third variable was important because it served the role of mediation. A questionnaire was used to obtain information on perceptions of 206 respondents who were selected using simple random sampling. 8 key informant interviews were held, 2 in each RRH. 4 Focus Group Discussions were held, 1 for each RRH, and between 5 and 8 staff took part as discussants for approximately three hours. The findings suggested that strategic planning was affected by funding to approximately 34% while the relationship between funding and procurement was 35%. The direct relationship between strategic planning and procurement was 18%. However when the total causal effect was computed it turned out that strategic planning and the related variable of funding contributed 77% to procurement of medicals under the current hierarchical model where MOH is charged with development of strategic plans for the entire health sector. Since even with this contribution there were complaints, the study proposed a new model called CALF which according to a simulation, if adopted by MOH, strategic planning would contribute 87% to effectiveness in procurement of medicals.
Becerra, C; Gonzales, G F; Villena, A; de la Cruz, D; Florián, A
Population based health surveys in Peru show that the general fertility rates, proportion of pregnant adolescents, and maternal and child morbidity are higher in the jungle regions than in other parts of the country. Endemic intestinal parasitic diseases increase the risk of anemia in pregnant women already suffering from iron, folic acid, and other nutritional deficiencies. This is the most common complication of pregnancy in many Latin American countries and is often associated with premature labor, low birthweight, and perinatal mortality. There are very few studies on this subject based on jungle populations and no reliable estimates of the prevalence of anemia in local pregnant women. The present study was designed to determine the prevalence of anemia in pregnant women attending the Regional Hospital in Pucallpa, located in the Peruvian jungle, from January 1993 to June 1995. This cross-sectional study, which was based on the registries of prenatal and childbirth services encompassing 1,015 pregnant women, looked into the potential association between anemia and such variables as the mother's chronological age, schooling, previous pregnancies, and weight at the beginning of pregnancy. Maternal hemoglobin levels were compared with the newborns' weight at birth. The prevalence of anemia in this population sample was 70.1%. This value was not modified when adjusted for maternal age, schooling, or interval between births. Anemia prevalence was directly related to the number of previous pregnancies and inversely related to weight gain during pregnancy. The perinatal mortality rate was 37.7 per 1,000 births. Neither this rate nor the birthweights were associated with the mother's degree of anemia. A multivariate regression analysis showed that maternal body weight at the start of pregnancy (P = 0.0001), weight gain during pregnancy (P = 0.0001), and the number of pregnancies (P = 0.008) are predictors of birthweight. Results showed that the high prevalence of
Sihotang, Bona Boy Pandapotan
The number of patients admitted in the emergency room at dr. Djasamen Saragih General Hospital Pematangsiantar every day it is high, but the number of nurses who treat patients are not balanced so that the conditions that affect the number of deaths of patient in the emergency room at dr. Djasamen Saragih General Hospital Pematangsiantar which in 2008 an average of 35%. The purpose of this survey study with explanatory approach was to analyze the influence of quantitative and qualitative w...
Carbonelli Tuiro, Carbonelli Tuiro, Noemi Noemi
Objetivo: Determinar el manejo de los residuos sólidos hospitalarios en el servicio de enfermería del Hospital Regional Hermilio Valdizan de Huánuco, 2015. Metodología: El presente Plan adopta la metodología descriptiva, prospectiva de corte transversal. Conclusiones: La cantidad de residuos hospitalarios según el área en el servicio de enfermería del Hospital Hermilio Valdizan fue mayor en el área de Emergencia con un promedio de residuos sólidos Biocontaminados al día de 11.56 kg; Res...
Propuesta para mejoras en el nivel de servicio a los usuarios de Farmacia del Hospital Dr. Tony Facio Castro (HTFC), utilizando herramientas de medición y análisis de los factores que inciden en la satisfacción de dichos usuarios
Quesada Bolaños, Yorleny
Tesis de maestría -- Universidad de Costa Rica. Posgrado en Administración y Dirección de Empresas. Maestría Profesional en Administración y Dirección de Empresas, 2015 El objetivo general del trabajo es “Proponer una metodología de mejoras continua de los procesos en el servicio de farmacia del Hospital Dr. Tony Facio Castro (HTFC), basado en la utilización de herramientas para la recolección de información y medición de la satisfacción, para lograr calidad en el servicio y la percepción ...
Hung, Jui-Tai; Lin, Ching-Wen; Wen, Wei-Chun; Lin, Esther Ching-Lan
The nursing practice environment has been shown to wield significant influence on nursing retention and nursing quality of care. Because a large percentage of Taiwan nurses currently work at regional teaching hospitals, exploring the perception toward the practice environment of nurses working at this type of hospital is important. This study explored the perception of nurses working at a regional teaching hospital in central Taiwan toward their practice environment. A cross-sectional research design with a sample of 474 nurses from a regional hospital in central Taiwan was conducted. Instruments including the demographic data and the Chinese-version Practice Environment Scale-Nursing Work Index (CPES-NWI) were anonymously self-administered. Overall, participants were moderately satisfied with their practice environment, with the greatest dissatisfaction focused on staffing and resource adequacy. Work unit and nursing level, respectively, had significant impacts on perceptions regarding the practice environment. Furthermore, discriminant analysis identified two new compound variables: 1) adequate staffing resources and partnership in the workplace and 2) supportive administrative management environment. Participants who worked in medical and surgical units were significantly more dissatisfied with the adequacy of staffing resources and partnership in the workplace than participants who worked in acute/intensive and special units. Participants at the N2 level were significantly more dissatisfied with the supportive nature of the administrative management environment. These findings support that the nursing practice environment of regional hospitals may be improved using several measures, including: modifying the staffing and resource adequacy of nurses, fostering collaborative nurse-physician relationships, and further involving nurses in administrative management and decision-making.
Ferrer, Rizaldy R; Balasuriya, Darshi; Iverson, Ellen; Upperman, Jeffrey S
We describe pediatric-related emergency experiences and responses, disaster preparation and planning, emergency plan execution and evaluation, and hospital pediatric capabilities and vulnerabilities among a disaster response network in a large urban county in the West Coast of the United States. Using semistructured key informant interviews, the authors conducted qualitative research between March and April 2008. Eleven hospitals and a representative from the community clinic association agreed to participate (86 percent response rate) and a total of 22 key informant interviews were completed. Data were analyzed using ATLAS.ti.v.5.0, a qualitative analytical software program. Although hospitals have infrastructure to respond in the event of a large-scale disaster, well-established disaster preparedness plans have not fully accounted for the needs of children. The general hospitals do not anticipate a surge of pediatric victims in the event of a disaster, and they expect that children will be transported to a children's hospital as their conditions become stable. Even hospitals with well-established disaster preparedness plans have not fully accounted for the needs of children during a disaster. Improved communication between disaster network hospitals is necessary as incorrect information still persists.
Al-Shehri, Mohammed Y.
The number of patients with primary hyperparathyroidism (PHP) seen at theAsir Central Hospital (ACH) is remarkably low. This observation has raisedthe question of whether there is a low prevalence of PHP in the Asir region,whether it is underdiagnosed, or perhaps a combination of other both factors.A survey of 15 hospitals in the Asir region was conducted for the cases ofPHP. All case notes of the patients with PHP are seen at ACH were reviewed.Also a sample of patients seen at ACH was chosen randomly. The charts ofthose found to have hypercalcemia were reviewed for the inclusion of PHP inthe diagnostic work-up. Only 13 patients with PHP were discovered. The eightpatients with PHP seen at ACH had advanced bone manifestations and seven ofthem had renal manifestations. Hypercalcemia was found in 39 out of 655patients seen at ACH. None of these had been investigated for PHP. The numberof patients with PHP seen in hospitals in the Asir region is very low.Underdiagnosis seems to be an important factor. Therefore, it is felt thatthere is a need for greater awareness of disease in the region. Furthermore,there is a need for national survey to measure the prevalence of PHP in SaudiArabia. (author)
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
Farø, Ken Joensen
blev tidligere brugt i Danmarks Radio som pausesignal, afspillet på en spilledåse. Ak ja, det var dengang. Gå ind på nettet og lyt til den, hvis du ikke kender melodien. Det er national kulturarv. Mange bevingede ord indeholder en form af ”drøm(me)”, fx Martin Luther Kings ”I have a Dream”. Eller...
Fan, C W
Most patients with acute stroke are admitted to hospital. If stroke services in this country are to be improved, we need accurate and reliable information about the types of stroke patients being admitted, their present management and outcome.
d'Elbée, M; Baumevieille, M; Dumartin, C
In 2009, the French Act "Hospital, Patients, Health and Territories" (loi "Hôpital, Patients, Santé et Territoires") reorganized the outpatient care pathway and defined missions aimed at improving cooperation between pharmaceutical and medical professionals. Five years later, we conducted a survey among community pharmacists in order to assess the appropriation of these missions and the way cooperation was implemented. We also aimed to investigate factors that could hamper or ease the development of these activities in order to identify actions needed to improve pharmacists' involvement. In partnership with the local health authorities "Agence régionale de santé", we conducted a survey via an online questionnaire sent to pharmacy holders in July 2014 in Aquitaine region. Information was collected about the pharmacies, involvement in collaborative activities, and barriers to cooperation. Overall, 20% (249) of pharmacists responded to the survey. They owned predominantly rural pharmacies (46%) or neighborhood pharmacies (41%), with two pharmacists per pharmacy (48%). Regarding collaborative activities, the majority of pharmacists (78%) had conducted interviews with their patients taking vitamin K antagonist therapy and they were willing to continue (87%). The implication was less common concerning other actions such as referent pharmacist for nursing homes (19%) or activities relating to therapeutic educational programs for patients with chronic conditions (34%). The vast majority of respondents (85%) were not aware of opportunities to become a correspondent pharmacist. The main obstacles for engaging in these activities were the lack of time, lack of knowledge about these missions and the lack of remuneration. We identified differences in pharmacists' involvement in collaborative activities depending on selected characteristics of the pharmacies. The findings of this survey underlined pharmacists' acceptance of these missions and suggest that better information
Powell, Adam C; Ludhar, Jasmine K; Ostrovsky, Yuri
To characterize the electronic health record (EHR) systems in use in an affluent region of India in order to understand the state-of-the-art within the Indian market. A survey on EHR features was created by combining an instrument developed by the Organisation for International Cooperation and Development and an instrument developed by an American team of researchers. An interviewer directly administered the survey to leaders from hospitals in greater Chandigarh which possessed electronic health information systems. Summary statistics from the survey are reported. 24 hospitals offering multi-specialty inpatient care were identified in greater Chandigarh. 18 of these hospitals had electronic health information systems, 17 of which were interviewed. Of the hospitals with systems, 17 (100%) could access patient demographic information internally, but 12 (71%) could not access vital sign, allergy, or immunization data internally. 11 (65%) of the systems were capable of sharing patient summaries internally, but 13 (76%) could not send electronic referrals internally. Among organizations which have adopted systems, major barriers tend to have been around financial and staff matters. Concerns over interoperability, privacy, and security were infrequently cited as barriers to adoption. EHRs are ubiquitous in at least one region of India. Systems are more likely to have capabilities for intra-organizational information sharing than for inter-organizational information sharing. The availability of EHR data may foster clinical research. Copyright © 2017 Elsevier B.V. All rights reserved.
Lo, Siu-Fai; Spurgeon, Peter
The Accreditation Council for Graduate Medical Education and European working time directive have restricted residents' workweek to 80 and 48 hours, respectively. Impacts on resident's training and health services are under evaluation in western countries. However, relevant studies are deficient in Hong Kong. Methods: Surgeons in a regional hospital of Hong Kong were recruited. Opinions were collected by semi-structured questionnaire. Results: Response rate was 82%. Most respondents agr...
Mulisya, Olivier; Roberts, Drucilla J.; Sengupta, Elizabeth S.; Agaba, Elly; Laffita, Damaris; Tobias, Tusabe; Mpiima, Derrick Paul; Henry, Lugobe; Augustine, Ssemujju; Abraham, Masinda; Hillary, Twizerimana; Mugisha, Julius
Objective. We sought to determine the prevalence of and factors associated with hydatidiform molar gestations amongst patients undergoing uterine evacuation at Mbarara Regional Referral Hospital (MRRH), Mbarara, Uganda. Methods. This was a cross-sectional study carried out from November 2016 to February 2017. All patients admitted for uterine evacuation for nonviable pregnancy were included. The study registered 181 patients. Data were collected on sociodemographics, medical conditions, obste...
This issue of Journal of Physics: Condensed Matter has been assembled to recognize the valuable contribution of Dr Trevor J Hicks to the field of neutron scattering and magnetism. Trevor began his study of magnetism as a PhD student at Monash University in Melbourne in the early 1960s, working with Professor Jack Smith. From the very beginning magnetism in alloys, and disordered systems in general, became a key aspect of his career. After a postdoctoral position at Harwell working with Dr Graeme Low Trevor returned to Australia and took up a position with Monash. He soon became a key figure in developing the capability for neutron scattering using the HIFAR reactor at the Australian Atomic Energy Commission, now the Australian Nuclear Science and Technology Organisation, ANSTO. The instrumentation was always developed to further his studies of magnetism. The development of polarization analysis measurements of diffuse magnetic scattering, first using iron filters and then his own design of supermirror benders for beam polarization, took place through the 1970s, 1980s and into the 1990s. Throughout this time, Trevor mentored a series of PhD students and postdoctoral fellows, many of whom have contributed to this issue (and, indeed, guest edited it). As befits a scientist and university academic for whom teaching has always been important, Trevor has not only created a strong body of significant research, he has also made a major contribution to preparing several generations of neutron scattering scientists, and this issue reflects that. When I approached Journal of Physics: Condensed Matter with a proposal for an issue in honour of Trevor, the response was immediate and positive. It is with great pleasure that I present the result of that proposal. The great diversity of the content, all centred on neutron scattering and magnetism, reflects the breadth of Trevor's own career and of the scientists with whom he has interacted. Finally, I would like to make some
This podcast reflects on one of the greatest pioneers in virology, Dr. Frank John Fenner. Dr. Frederick Murphy, a member of EID's editorial board and the Institute of Medicine, and professor of Pathology at the University of Texas Medical Branch in Galveston, shares professional and personal stories of Dr. Frank Fenner.
Propuesta de implementación de una guía de procedimientos para mejorar la eficiencia en los procesos de la Central de Esterilización del Hospital "Dr. Teodoro Maldonado Carbo" de la ciudad de Guayaquil.
Payez Freire, Eva Cristina
La presente investigación se desarrolló en la central de esterilización del Hospital Teodoro Maldonado Carbo de la ciudad de Guayaquil, perteneciente al Instituto Ecuatoriano de Seguridad Social, con la finalidad de evaluar el nivel de aplicación de los procedimientos obligatorios de esterilización y su relación con el nivel de eficiencia en los resultados obtenidos. Para el logro de los objetivos planteados se desarrolló una investigación de campo aplicando encuestas y entrevistas al...
Plambeck, R.L.; Menten, K.M.
The BIMA array is used to map the 95-GHz 8(0) to 7 1A(+) transition of methanol and the 98-GHz J = 2-1 transition of CS toward the DR 21(OH) and DR 21 star-forming regions. Several strong methanol masers were found. The positions of the two brightest masers were measured with an accuracy of about + or - 0.3 arcsec. Toward DR 21(OH), the positions, velocities, and line shapes of the 95 GHz masers are in excellent agreement with those of the 84-GHz 5(-1) to 4 () methanol masers previously mapped by Batrla and Menten (1988), demonstrating that maser emission in both transitions originates from the same clumps of gas. The methanol masers are offset from CS emission peaks and from other known infrared and maser sources; they may possibly be clustered along the interface between outflows, traced by shock-excited H2 emission, and dense ambient gas, traced by CS emission. 25 refs
Rolseth, S; Stange, P; Adamou, D; Roald, B; Danki-Sillong, F; Jourdan, P
The knowledge of factors that may influence blood donation in Cameroon is limited. The objectives of this study are to assess the characteristics of previous and potential blood donors by exploring the religious beliefs, and knowledge and understanding of blood donations among individuals present at a district hospital. Forty-nine in-depth, semi-structured interviews were conducted among consenting, randomly selected 18 years or older community members present at a district hospital in the Adamaoua region during October and November 2011. Ninety-eight per cent (48/49) of the individuals present at this district hospital had heard of blood transfusions. Forty-seven per cent (23/49) had not previously been asked to donate blood; however, 94% (44/47) said that they would donate if given the opportunity. Thirty-three per cent (16/49) had previously donated blood to family members or for replacement, and 81% of these said they would repeat donations. The majority of both donors and non-donors were motivated to donate blood for altruistic reasons. The findings suggest that community members present at this district hospital in Cameroon may be recruited for repeat blood donations. Although the altruistic motivation to donate blood suggests that donors could be recruited from a district hospital population, targeted information about blood donations and accessible blood transfusion services need to be put in place. The study may add to the understanding of the preconditions for blood donations and the possibility to establish sustainable blood transfusion services in the Adamaoua region in Cameroon. © 2014 British Blood Transfusion Society.
Lucinea Marcelino Villela
In this interview, which took place in June 2016, Dr Anna Matamala described some details about her long professional experience in Audiovisual Translation, especially in dubbing from English into Catalan, and we talked about many other things like her interest in lexicography, her point of view on some contemporary topics in Audiovisual Translation Studies: the use of technology, the relation between AVT and Accessibility Studies, AVT and Filmmaking fields, the importance of keeping in touch with other countries and even continents outside Europe, and she also gave some advice to the new generation of Translation students.
Lucinea Marcelino Villela
Full Text Available In this interview, which took place in June 2016, Dr Anna Matamala described some details about her long professional experience in Audiovisual Translation, especially in dubbing from English into Catalan, and we talked about many other things like her interest in lexicography, her point of view on some contemporary topics in Audiovisual Translation Studies: the use of technology, the relation between AVT and Accessibility Studies, AVT and Filmmaking fields, the importance of keeping in touch with other countries and even continents outside Europe, and she also gave some advice to the new generation of Translation students.
Full Text Available Las encuestas demográficas de salud y población del Perú indican que las tasas globales de fecundidad, la proporción de adolescentes embarazadas y la mortalidad maternoinfantil son más altas en la selva que en otras zonas del país. Las parasitosis intestinales endémicas agravan el riesgo de anemia ya generalmente presente en las embarazadas por deficiencias de hierro, ácido fólico y otros nutrientes. En muchos países latinoamericanos, esa es la complicación más frecuente del embarazo y está asociada con partos pretérmino, bajo peso al nacer y mortalidad perinatal. Los estudios realizados sobre este tema en la selva peruana son escasos y no se dispone de estimaciones confiables de la prevalencia de anemia durante la gestación. Los autores se propusieron determinar la prevalencia de anemia en mujeres gestantes que acudían al Hospital Regional de Pucallpa, en la selva del Perú, entre enero de 1993 y junio de 1995. El estudio de corte transversal se basó en los registros de control prenatal y de parto de 1 015 embarazadas y permitió estudiar la asociación entre la prevalencia de anemia y variables como edad cronológica, escolaridad, número de gestaciones previas y peso de la madre al inicio del embarazo. También se compararon los valores de la hemoglobina materna con el peso de los recién nacidos. La prevalencia de anemia en la población de gestantes fue de 70,1%, valor que no se modificó por efecto de la edad materna, la escolaridad ni el intervalo intergenésico. La prevalencia de anemia se asoció directamente con el número de gestaciones e inversamente con la ganancia de peso durante el embarazo. La tasa de mortalidad perinatal fue de 37,7 por 1 000 nacidos. Ni esta tasa ni el peso de los recién nacidos resultaron asociados con el grado de anemia de la madre. El análisis de regresión multivariado muestra que el peso de la madre al inicio de la gestación (P = 0,0001, el peso ganado durante la gestación (P = 0
Dillon, J P
Since the opening of a temporary ice-rink in our hospital\\'s catchment area, we have observed an increase in patients requiring in-patient treatment for orthopaedic intervention. The authors performed a prospective analysis of all patients admitted to our unit over a one-month period. Epidemiological data, wearing of protective gear and skater experience were collected. Fracture type, treatment required, average length of hospital stay and number of days missed from work was also recorded. Ice-skating injuries accounted for 7.7% of our total admissions over the study period. There was a significant variation noted in the types of fracture sustained ranging from comminuted fractures of the radial head to spiral fractures of the tibia. The average length of hospital stay was 2.6 days and average time missed from work was 6.1 weeks. This paper highlights the potential serious injuries that can occur in ice-skating and their impact on admissions to our orthopaedic unit.
Mohr, Peter D
Catherine Corbett was the second woman to gain a medical degree from the University of Manchester Medical School in 1905; however, little was known about her life or work, apart from the fact that she was a School Medical Inspector (SMI) and never married. The rediscovery of her Diary in Serbia (1916) has revealed her work for the Scottish Women's Hospitals (SWH) during the First World War in Serbia (1915-1916). Her time alongside her female colleagues was a good experience, however the harsh conditions, especially those she experienced during a further period working in Russia (1916-1917), left her exhausted and psychologically stressed. After the war, her job as a SMI in Burnley and her pursuit of rock climbing helped her adjust to a normal life and allowed her to promote her views on female education.
Elstad, Jon Ivar
The proportion of migrants and refugees increase in many populations. Health planners have to consider how migration will influence demand for health care. This study explores how migrants' geographical origin, reason for migration, and duration of residence are associated with admission rates to somatic hospitals in Norway. Sociodemographic information on all individuals residing in Norway at the start of 2008 was linked to data on all admissions to somatic hospitals during 2008-2011. Migrants, age 30-69, who had come to Norway during 1970-2007 (N = 217,907), were classified into seven world region origins and compared with native Norwegians of the same age (N = 2,181,948). Any somatic hospital stay 2008-2011 and number of hospital admissions 2008-2011 per 1000 personyears for a set of somatic diagnoses were analyzed by age and gender standardized rates, linear probability models, and Poisson regression. In the native Norwegian sample, 28.7 % had at least one admission 2008-2011, and there were 116 admissions per 1000 personyears. Corresponding age and gender adjusted figures for the migrant sample were 27.0 % and 103 admissions. Admission rates varied with migrants' geographical origin, with relatively many admissions among migrants from West and South Asia and relatively few admissions among migrants from Western, East European, and Other Asian countries. Hospitalization varied strongly with reason for migration, with low admission rates for recent work migrants and high admission rates for recent refugees. Admission rates tended to move towards the level among native Norwegians with increasing length of stay. Among longstanding migrants (arrival period 1970-1989), admission rates were close to the levels of native Norwegians for most analyzed migrant categories. Both world region origin, reason for migration, and duration of residence are important sources for variations in migrants' utilization of somatic hospitals. Forecasts about migrants' use of
Brownridge, D J; Zaidi, S T R
Chronic obstructive pulmonary disease (COPD) is associated with significant morbidity and mortality, and frequent exacerbations are associated with an increased risk of death, deterioration in lung function and reduced quality of life. Current Australian guidelines developed by the Lung Foundation of Australia (the COPD-X Plan) recommends the use of a short course of corticosteroids and oral antibiotics (amoxycillin or doxycycline) as part of the treatment of an AECOPD; however, it was noted that clinical practice at the study hospital had deviated from these guidelines. To evaluate the antibiotic prescribing practices in acute exacerbations of chronic obstructive pulmonary disease (AECOPD) patients, and to compare the differences in clinical outcomes (primarily mean length of stay and the rate of unplanned readmissions) between patients who received broad- vs. narrow-spectrum antibiotics in a large regional hospital. Retrospective audit of medical records for patients admitted with uncomplicated AECOPD during January-September, 2014 in a 224 acute bed regional hospital in Victoria, Australia. Fifty-nine per cent of patients received broad-spectrum antibiotics (ceftriaxone), whereas only 10% of prescriptions were concordant with current Australian guideline recommendations. Patients receiving a broad-spectrum regimen were more likely to be older (74·9 vs. 69·9 years; P = 0·009), have a higher COPD severity score (i.e. BAP-65 score, 1·55 vs. 1·06; P = 0·002) and a higher CRP (59·2 vs. 25·5 mg/L; P = 0·003) on admission. The mean LOS was not significantly different between those who received ceftriaxone and those who did not (5·09 vs. 4·55 days; P = 0·47). There was no significant difference between the groups in rates of readmissions. The antibiotic prescribing patterns for AECOPD in rural and regional Australian hospitals have not previously been examined in the current literature. In the study hospital, the majority of patients received broad
Daras, Laura Coots; Ingber, Melvin J; Deutsch, Anne; Hefele, Jennifer Gaudet; Perloff, Jennifer
To examine whether there are differences in inpatient rehabilitation facilities' (IRFs') all-cause 30-day postdischarge hospital readmission rates vary by organizational characteristics and geographic regions. Observational study. IRFs. Medicare fee-for-service beneficiaries discharged from all IRFs nationally in 2013 and 2014 (N = 1166 IRFs). Not applicable. We applied specifications for an existing quality measure adopted by Centers for Medicare & Medicaid Services for public reporting that assesses all-cause unplanned hospital readmission measure for 30 days postdischarge from inpatient rehabilitation. We estimated facility-level observed and risk-standardized readmission rates and then examined variation by several organizational characteristics (facility type, profit status, teaching status, proportion of low-income patients, size) and geographic factors (rural/urban, census division, state). IRFs' mean risk-standardized hospital readmission rate was 13.00%±0.77%. After controlling for organizational characteristics and practice patterns, we found substantial variation in IRFs' readmission rates: for-profit IRFs had significantly higher readmission rates than did not-for-profit IRFs (Preadmission rates than did IRFs in New England that had the lowest rates. Our findings point to variation in quality of care as measured by risk-standardized hospital readmission rates after IRF discharge. Thus, monitoring of readmission outcomes is important to encourage quality improvement in discharge care planning, care transitions, and follow-up. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Hamdy, Nermin A; Alamgir, Mohammad Jawad; Mohammad, El Gamri E; Khedr, Mahmoud H; Fazili, Shafat
Introduction Epilepsy is a diverse set of chronic neurological disorders characterized by seizures. It is one of the most common of the serious neurological disorders. About 3% of people will be diagnosed with epilepsy at some time in their lives. Objectives We aimed to address the commonest types of seizures, their aetiologies, EEG and neuroimaging results and prognosis of patients presented to neurology services of the King Fahad Specialist Hospital- AlQassim (KFSH). Methodology In this retrospective epidemiological study we investigated the medical records of patients with epilepsy, who attended the neurology services of KFSH, during the study period (26/10/2011–26/4/2012). Results The study included 341 patients; 189 (55.4%) males and 152 (44.6%) females. Their ages ranged between 12 and 85 years (mean ± SD = 31±16.9). The majority of patients had Generalised Tonic Clonic Seizures (76.2%), followed by Complex Partial Seizures (7.6%). 73% of our patients had idiopathic epilepsy. The commonest causes for symptomatic epilepsy were Cerebro Vascular Accidents and Head trauma. Hemiplegia, mental retardation and psychiatric illness were the commonest comorbidity. 69.3% of patients had controlled seizures. Patients with idiopathic epilepsy were significantly controlled than patients with symptomatic epilepsy (P=0.01), and those using one Anti Epileptic Drug were significantly controlled compared to patients using polytherapy (P=0.0001) there was no significant relation between controlled seizure and duration of illness or hospitalization or EEG changes. Conclusion Seizure types, aetiology, drug therapy, Comorbidities and outcome in a tertiary care hospital in Saudi Arabia are similar to previous local and international studies. 35.3% of patients were hospitalized, higher rates than previous studies. Seizure control was better in generalized seizures and idiopathic epilepsy compared to complex partial seizures or partial seizures with secondary generalization and
Ugalde-Espiñeira, J; Bilbao-Aguirregomezcorta, J; Sanjuan-López, A Z; Floristán-Imízcoz, C; Elorduy-Otazua, L; Viciola-García, M
Programs for optimizing the use of antibiotics (PROA) or antimicrobial stewardship programs are multidisciplinary programs developed in response to the increase of antibiotic resistant bacteria, the objective of which are to improve clinical results, to minimize adverse events and to reduce costs associated with the use of antimicrobials. The implementation of a PROA program in a 128-bed general hospital and the results obtained at 6 months are here reported. An intervention quasi-experimental study with historical control group was designed with the objective of assessing the impact of a PROA program with a non-restrictive intervention model to help prescription, with a direct and bidirectional intervention. The basis of the program is an optimization audit of the use of antimicrobials with not imposed personalized recommendations and the use of information technologies applied to this setting. The impact on the pharmaceutical consumption and costs, cost per process, mean hospital stay, percentage of readmissions to the hospital are described. A total of 307 audits were performed. In 65.8% of cases, treatment was discontinued between the 7th and the 10th day. The main reasons of treatment discontinuation were completeness of treatment (43.6%) and lack of indication (14.7%). The reduction of pharmaceutical expenditure was 8.59% (P = 0.049) and 5.61% of the consumption in DDD/100 stays (P=0.180). The costs by processes in general surgery showed a 3.14% decrease (p=0.000). The results obtained support the efficiency of these programs in small size hospitals with limited resources.
Sellaeg, Wenche Frogn
Few studies describe and evaluate the use of ambulatory geriatric teams in nursing homes. This article gives an account of a model in which a multidisciplinary group from the local hospital has been visiting 17 communities in Norway twice a year for 11 years. The ambulatory geriatric team includes a geriatrician, a geriatric nurse, a physiotherapist and an occupational therapist. Their aim is to raise the quality of geriatric assessment and care and to enhance the cooperation between the hospital and the nursing homes in the communities. The team members are doing a comprehensive geriatric assessment of some of the patients; they assess cases for further referral, and examine patients with declining functioning with a view to rehabilitation. The team provides instruction in various aspects of geriatrics to community care professionals. Much time is devoted to discussions on problems raised by the staff, such as management of patients with dementia-related behavioural problems, and to provide feedback to staff-members. The team liaise between hospitals, nursing homes and community care services in the communities in order to enhance communication between the professionals involved. An evaluation of the team was done on behalf of the National Institute of Health through a postal questionnaire which was returned by 223 doctors, nurses and allied health care professionals. The results indicate that visits by the ambulatory team improve the knowledge of doctors and allied professionals about diseases in the elderly; 92% reported that they now felt they were doing a better job.
Luis Alberto Beares
Full Text Available Tourism in secluded communities puts different cultures in contact with each other and must be handled carefully not to cause environmental damage as well as cultural loss which might jeopardize the local development and create hostile relationships. The proposal of in sito tourism, considering the local memory and patrimony as a hospitality potential, was observed during technical visitations to three communities located in the Paraty region and surroundings: Guarani, Caiçara (fishermen and Quilombola(African slaves descendants. Through field work involving visitations to communities and interviews with locals, information regarding cultural differences and the importance of the land occupation in the history of each of the communities was assessed. The common link in the history of these peoples is the struggle for the right of land possession. During visits when people shared their territory various forms of hospitality in each community were verified, issued from different cultures and cultural values.
Maira Giseli C. Silva
Full Text Available ABSTRACT Introduction: Candidemia is a bloodstream infection produced by Candida genus yeasts. Objective: The purpose of this study was to characterize the epidemiology and the fluconazole susceptibility in Candida species isolated from patients at a regional hospital in Passo Fundo, RS. Methods: Records from the laboratory were used to identify patients with positive blood cultures for Candida between 2010 and 2011. The in vitro activity of fluconazole was determined using the disk diffusion method. Results: Were analyzed 24 positive blood cultures for Candida and found a 54.16% mortality rate. C. albicans was the most prevalent species, followed by C. parapsilosis and C. krusei. For susceptibility to fluconazole, C. albicans, C. parapsilosis and C. tropicalis showed 100% sensitivity. However, C. krusei was 100% resistant; and C. glabrata, 50% resistant. Conclusion: The high mortality and fluconazole resistance rates emphasize the importance of the diagnosis of candidemia in a hospital environment.
Guilbert, Ariane; Cox, Bianca; Bruffaerts, Nicolas; Hoebeke, Lucie; Packeu, Ann; Hendrickx, Marijke; De Cremer, Koen; Bladt, Sandrine; Brasseur, Olivier; Van Nieuwenhuyse, An
Outdoor pollen grain and fungal spore concentrations have been associated with severe asthma exacerbations at the population level. The specific impact of each taxon and the concomitant effect of air pollution on these symptoms have, however, still to be better characterized. This study aimed to investigate the short-term associations between ambient concentrations of various aeroallergens and hospitalizations related to asthma in the Brussels-Capital Region (Belgium), an area recording especially high rates of admissions. Based on administrative records of asthma hospitalizations and regular monitoring of 11 tree/herbaceous pollen taxa and 2 fungal spore taxa, daily time series analyses covering the 2008-2013 period were performed. Effects up to 6 days after exposure were captured by combining quasi-Poisson regression with distributed lag models, adjusting for seasonal and long-term trends, day of the week, public holidays, mean temperature and relative humidity. Effect modification by age and air pollution (PM, NO 2 , O 3 ) was tested. A significant increase in asthma hospitalizations was observed for an interquartile range increase in grass (5.9%, 95% CI: 0.0, 12.0), birch (3.2%, 95% CI: 1.1, 5.3) and hornbeam (0.7%, 95% CI: 0.2, 1.3) pollen concentrations. For several taxa including grasses, an age modification effect was notable, the hospitalization risk tending to be higher in individuals younger than 60 years. Air pollutants impacted the relationships too: the risk appeared to be stronger for grass and birch pollen concentrations in case of high PM 10 and O 3 concentrations respectively. These findings suggest that airborne grass, birch and hornbeam pollen are associated with severe asthma exacerbations in the Brussels region. These compounds appear to act in synergy with air pollution and to more specifically affect young and intermediate age groups. Most of these life-threatening events could theoretically be prevented with improved disease diagnosis
Silva-Díaz, Heber; Flores-Esqueche, Lorena; Llatas-Cancino, Dunalia; Guevara Vásquez, Génesis; Silva-García, Teresa
To describe the frequency and antiparasitic in vitro susceptibility of Blastocystis hominis in patients admitted to theHospital Regional Lambayeque, Peru. A cross-sectional study was conducted from January to August 2015 at 313 patients of all ages. B. hominis detection was performed on serial fecal samples by direct microscopic examination and microculture in modified Locke solution. The in vitro susceptibility testing against the drug metronidazole, nitazoxanide, trimethoprim-sulfamethoxazole and erythromycin was performed in 24 strains of B. hominis, which grew up (microculture method) in 10 double concentrations of each antimicrobial (from 256 ug/ml to 0.5 ug/mL) plus a control. 46.3% (145/313) of the sample had B. hominis, also the age between 12 to 17 years and 60 years was associated with higher frequency of parasites (OR: 2.93 and 2.62). The minimum inhibitory concentration (MIC) 90 of metronidazole and nitazoxanide was 3.19 ug/mL and 11.19 ug/ml, respectively, whereas the MIC 90 of trimethoprim-sulfamethoxazole and erythromycin were above 256 ug/mL. B. hominis occurs in high frequency in patients admitted to the Hospital Regional in Lambayeque, proving to be an important problem of public health in the region. Also B. hominis isolated from these patients were shown to be susceptible in vitro to low concentrations of metronidazole and nitazoxanide so they could be chosen for treatment of this parasite.
Full Text Available Background: Cranium-cerebral traumas in today’s era are a serious public health problem with bothsocial and economic dimensions. They are characterized as an ‘epidemic’, due to the increase in car accidents and they particularly affect the productive population.The objective of this study was to investigate the occurrence and allocation of Cranium-cerebral traumas among the population in the Prefecture of Laconia, in order to determine the explanatory factors or risk factors, the record of how they are managed (diagnosis, therapy, and outcome and their correlation with demographics and other factors.Methodology: This study was conducted with the collection of data from hospital archives and Emergency Department logbooks from the General Hospital of Sparta. Specifically designed record forms were used which included patient demographics, means of arrival to the hospital, the clinical pictures, the gravity of the injury, possible accompanying injuries, diagnostic tests, treatment and outcome, as well as evidence related to the causes of the injury.Results: 2352 cases of children and adults with Cranium-cerebral traumas were included in this study who came to the Emergency Department from 1st of January 2005 to 31st of December 2010. The cause of Cranium-cerebral traumas in adults is affected by gender, nationality and place of residence, while in children it is affected by place of residence and the means of arrival to the Emergency Department. Respectively, the outcome of Cranium–cerebral traumas in adults is affected by place of residence and their means of arrival to the hospital while in children it is affected by nationality and place of residence.Conclusions: This study has revealed the magnitude of the problem and the epidemiological characteristics of Cranium-cerebral traumas in the Prefecture of Laconia, with the ultimate need for intervention at a level of prevention. Proposals regard the improvement in road networks, informative
Nuemi, G; Afonso, F; Roussot, A; Billard, L; Cottenet, J; Combier, E; Diday, E; Quantin, C
The evaluation of national cancer plans is an important aspect of their implementation. For this evaluation, the principal actors in the field (doctors, nurses, etc.) as well as decision-makers must have access to information that is reliable, synthetic and easy to interpret, and which reflects the implementation process in the field. We propose here a methodology to make this type of information available in the context of reducing inequalities with regard to access to healthcare for patients with lung cancer in the region of Burgundy. We used the national medico-administrative DRG-type database, which gathers together all hospital stays. By using this database, it was possible to identify and reconstruct the care management history of these patients. That is, by linking together all attended hospitals, sorted chronologically. Eligible patients were at least 18 years old, whatever the gender and had undergone surgery for their lung cancer. They had to be residents of Burgundy at the time of the first operation between 2006 and 2008. Patient's pathway was defined as the sequence of all attended hospitals (hospital stays) during the year of follow up linked together using an anonymised patient identifier. We then constructed a pathway typology of pathway using an unsupervised clustering method, and conducted a spatial analysis of this typology. Between 2006 and 2008, we selected 495 patients in the 4 administrative departments of the Burgundy region. They accounted for a total of 3821 stays during the year of follow-up. There were 393 men (79%) and the mean age was 64 (95% confidence interval: 63-65) years. We reconstructed 94 pathways (about five per patient). Here, neighbourhood's cares accounted for 41% of them, while 44% included a surgical intervention outside the region of Burgundy. We constructed a pathway typology with five classes. Spatial analysis showed that the vast majority of initial surgeries took place in the major regional centres. The construction
Burden, D J
This retrospective study assessed the outcome of orthodontic treatment of 264 patients with Class II division 1 malocclusion (overjet greater than 6 mm). The sample comprised patients who had completed their fixed appliance orthodontic treatment at a regional hospital orthodontic unit in the Republic of Ireland. The PAR Index (Peer Assessment Rating) was used to evaluate treatment outcome using before and after treatment study casts. The results revealed that treatment for this particular type of malocclusion was highly effective with a very few patients failing to benefit from their orthodontic treatment.
Jessica Riveros; Gloria Echagüe; Santiago Evers; Laura Mendoza
La anemia es un problema de salud pública a nivel mundial. En Paraguay, existen datos limitados sobre la frecuencia de anemia en mujeres en edad reproductiva no gestantes. Este estudio piloto descriptivo de corte transverso tuvo como objetivo determinar la frecuencia de anemia y deficiencia de hierro, el estado nutricional, hábitos alimentarios y tóxicos en 99 mujeres no gestantes en edad reproductiva de 18 a 48 años que acudieron al Hospital Regional de Villa Hayes en Octubre del 2.014. La a...
Núñez Manayay, Tania Mercedes; Universidad Señor de Sipán; Vera Ñañez, Huendy Jame; Universidad Señor de Sipán
La presente investigación cualitativa titulada Experiencias psicosexuales de pacientes histerectomizadas del servicio de Ginecología del Hospital Regional Docente las Mercedes – Chiclayo 2013 tuvo como objetivo describir las experiencias psicosexuales de pacientes histerectomizadas. Con diseño estudio de caso; la muestra conformada por siete pacientes post histerectomizadas de seis meses a un año; en la recolección de datos se utilizó la observación y la entrevista semiestructurada, las que ...
Full Text Available Application of home mechanical ventilators represents the future in the treatment of children with chronic respiratory insufficiency. In this way patients are treated in the home environment, they have full support from their families, they are protected against nosocomial infections and their condition is monitored by medical staff. The role of regional centers is very important in the future development of the home mechanical ventilation network. Doctors in these centers under the full support of the University Children's Hospital physicians can assist and monitor the treatment of children on the household respirators.
Solís Sánchez, G; Pérez González, C; García López, E; Costa Romero, M; Arias Llorente, R P; Suárez Rodríguez, M; Fernández Colomer, B; Coto Cotallo, G D
To determine the preterm viability between 22 and 25 gestational weeks in our hospital in last 10 years. A descriptive retrospective study was conducted on preterms between 22-25 gestational weeks born between 1-1-2002 and 12-31-2011. There were 121 newborns, 45 (37%) stillbirths and 76 (63%) live births (16 died in delivery room, and 60 admitted to neonatal intensive unit). Among the 60 admitted, 34 died before hospital discharge, and 26 survived (21% of total, 34% of live births and 43% of those admitted to neonatal intensive unit). The causes of death were: 16 therapeutic effort limitation in delivery room, 8 therapeutic effort limitation in neonatal ward, 7 nosocomial sepsis, 7 NEC, 4 respiratory problems, and 8 of unknown cause. There were no survivors below 24 gestational weeks. Of the 26 survivors, 4 had major neurological disorders, and 11 with a normal neurological outcome. No significant statistical differences were found in the mortality between the two five-year periods analysed. The peri-viability has important clinical and ethical problems for neonatologist. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.
This podcast reflects on one of the greatest pioneers in virology, Dr. Frank John Fenner. Dr. Frederick Murphy, a member of EID's editorial board and the Institute of Medicine, and professor of Pathology at the University of Texas Medical Branch in Galveston, shares professional and personal stories of Dr. Frank Fenner. Created: 4/22/2011 by National Center for Emerging Zoonotic and Infectious Diseases (NCEZID). Date Released: 4/26/2011.
Dr. von Braun began his association with Walt Disney in the 1950s when the rocket scientist appeared in three Disney television productions related to the exploration of space. Years later, Dr. von Braun invited Disney and his associates to tour the Marshall Space Flight Center (MSFC) in Huntsville, Alabama. This photograph is dated April 13, 1965. From left are R.J. Schwinghamer from the MSFC, Disney, B.J. Bernight, and Dr. von Braun.
Effectiveness of Self Instructional Module on Knowledge and Skills Regarding Use of Glasgow Coma Scale in Neurological Assessment of Patients among Nurses Working in Critical Care Units of KLE Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum
Full Text Available Background: The brain is the central unit that controls all the functions of our body. The brain cannot function all by its self without the neurons. The proper functioning of the brain and its relationship with the world is known as consciousness. The level of consciousness is the sensitive and reliable indicator of the patients neurological status. The alteration in the consciousness helps to determine if there is any damage in the nervous system that can occur even without visible damage to the head. There are numerous tools used to determine level of consciousness. The most common tool used to determine level of consciousness is the Glasgow Coma Scale (GCS. It was used with ease and helped to standardize clinical observations of the patients with impaired consciousness. A proper neurological assessment using the Glasgow Coma Scale is the essential part of nursing care. It is very essential for the nurse to have knowledge and skills about neurological assessment and the Glasgow Coma Scale.Hence the present study to evaluate the effectiveness of Self Instructional Module (SIM on knowledge and skill regarding Glasgow Coma Scale was undertaken. Aim and Objectives: 1]To assess the knowledge and skills regarding the use of Glasgow Coma Scale in neurological assessment of patients among the staff nurses. 2] To determine the effectiveness of the Self Instructional Module on knowledge and skills regarding the GCS in neurological assessment of patients. 3] To find association between the pre test knowledge and skills scores and demographic variables. 4] To find the correlation between the knowledge score sand the skills scores regarding the GCS in neurological assessment of patients. Material and Methods: The study was evaluative in nature. A purposive sampling technique was used for the study. A total of 55 staff nurses working in Critical Care Units of KLES Hospital and MRC,Belgaum were selected for the study. A structured questionnaire and an
Shaker, N Z; Hasan, S S; Ismail, Z A
This study aimed to assess the impact of the Baby-Friendly Hospital Initiative on WHO-defined breastfeeding indicators in Shaqlawa district in Kurdistan region of Iraq. A household survey was carried out on a purposive non-probability sample of 200 mothers with a child aged < 30 months. Mothers were interviewed using a structured form to determine demographic data and feeding practices of the most recent child. The rate of early initiation of breastfeeding was 38.1%, exclusive breastfeeding was 15.4% and continued breastfeeding was 61.0% and 39.5% at 1 and 2 years of age respectively. A significant relationship was found between delivery at the Baby- Friendly accredited hospital and early initiation of breastfeeding but not with exclusive or continued breastfeeding. While continued breastfeeding at 1 year and 2 year was good, early initiation and exclusive breastfeeding indicators were not at an acceptable level, which indicates an ineffective role for the Baby-Friendly Hospital Initiative.
Ueki, Shigeharu; Kayaba, Hiroyuki; Tomita, Noriko; Kobayashi, Noriko; Takahashi, Tomoe; Obara, Toshikage; Takeda, Masahide; Moritoki, Yuki; Itoga, Masamichi; Ito, Wataru; Ohsaga, Atsushi; Kondoh, Katsuyuki; Chihara, Junichi
The active involvement of hospital laboratory in surveillance is crucial to the success of nosocomial infection control. The recent dramatic increase of antimicrobial-resistant organisms and their spread into the community suggest that the infection control strategy of independent medical institutions is insufficient. To share the clinical data and surveillance in our local medical region, we developed a microbiology data warehouse for networking hospital laboratories in Akita prefecture. This system, named Akita-ReNICS, is an easy-to-use information management system designed to compare, track, and report the occurrence of antimicrobial-resistant organisms. Participating laboratories routinely transfer their coded and formatted microbiology data to ReNICS server located at Akita University Hospital from their health care system's clinical computer applications over the internet. We established the system to automate the statistical processes, so that the participants can access the server to monitor graphical data in the manner they prefer, using their own computer's browser. Furthermore, our system also provides the documents server, microbiology and antimicrobiotic database, and space for long-term storage of microbiological samples. Akita-ReNICS could be a next generation network for quality improvement of infection control.
Full Text Available Qualitative assessment of diagnostics and treatment of patients with community-acquired pneumonia (CAP was carried out in ten therapeutic departments of urban and district hospitals of Saratov region, using quality indicators (Qls. Each case of CAP was assessed in expert health care quality (HCQ card according to the diagnostic and treatment quality federal standards and the basic Ql. The application of Ql in CAP patients allowed revealing the following: low CAP agent isolation rate; late hospitalization of CAP patients; low frequency of sputum bacteriological and bacterioscopic investigations prior to antibiotic therapy; insufficient frequency of step-by-step introduction of antibiotics. Recommendations on CAP patients dispenserization were not properly prescribed; recommendations on vaccination were absent. The basic measures of HCQ improvement are as follows: organizing for each CAP patient therapeutic and diagnostic quality control according to Ql; quick administrative decisions; using of HCQ expertise during the first 2-3 days of treatment to correct diagnosis and treatment; optimizing hospital diagnostic resources (laboratory and instrumental and rational pharmacotherapy
@@ I. Professional Background Dr. Alyce Su specializes in investment managemeng, managing portfolios consisted of investment opportunities originated from China's growth and internationalization, both'outbound and inbound.
Full Text Available Anemia is a global public health problem that has affected a significant number of pregnant mothers worldwide. The World Health Organization has estimated the prevalence of anemia in pregnant women at 18% and 56% in developed and developing countries, respectively. This study aimed to identify factors associated with severe anemia among laboring women in Mekelle city public hospitals, Tigray, Ethiopia.This unmatched case-control study involved 264 (88 = cases and 176 = controls pregnant women who were recruited when they came for delivery service in Mekelle city public hospitals. The data was collected from July to August, 2016. In this study, a systematic sampling technique was used inselecting controls, but the cases were enrolled until the required sample size was reached. Bivariate and multivariate analyses were conducted to find predictors of severe anemia. Statistically significant predictors of severe anemia were identified at P-value <0.05 and 95% confidence interval.A total of 264 pregnant women who came for delivery services were enrolled in this study. The major predicting variables for the occurrence of severe anemia among laboring women were residency (AOR = 3.28, 95% CI: 1.26-8.48, number of pregnancies (AOR = 2.46, 95% CI: 1.14-5.29, iron folate supplementation (AOR = 3.29, 95% CI: 1.27-8.49, dietary diversification score (AOR = 3.23, 95% CI: 1.19-8.71 and duration of menstrual cycle (AOR = 2.37, 95% CI: 1.10-5.10. The variable 'blood loss during pregnancy' (AOR = 6.63 95% CI: 2.96-14.86 was identified as a strong predictor of the outcome variable, severe anemia.This study identified determinants of severe anemia among laboring women in Mekelle city public hospitals, Northern Ethiopia. To reduce anemia, strengthening health education provision related to the importance of birth spacing and consuming diversified and iron-enriched food should be considered. Moreover, screening of pregnant women for state of anemia during their
Sandra Hernández García
Full Text Available El paludismo grave es el causado por el Plasmodium falciparum, que cada año cobra millones de vidas en los países del tercer mundo, siendo los niños los más afectados, por este motivo se realizó estudio prospectivo, descriptivo transversal de los pacientes pediátricos que ingresaron con gota gruesa positiva a plasmodium falciparum, del mes de enero a julio del año 2003 en el hospital regional de Bata en Guinea Ecuatorial. Se encontró que el 49% de los ingresos correspondieron a los niños de 1-4 años, siguiendoles los menores de un año con 34,5% de casos. Se encontró que el 24% de los niños solo permanecieron un día en el hospital y el 67% de 2-5 días. Presentaron complicaciones 35,5% de los ingresados, la anemia severa fue la complicación que más se presentó (17,3%, los trastornos hidroelectrolíticos le siguieron con un 10%. Fallecieron 16 niños, de ellos con anemia severa 10 para (62,5%, con estadía de menos de un día fallecieron 7 pacientes y de 2-5 días otros 7 niños y entre los 6-13 días hubo 2 muertes. La principal recomendación fue que los niños con sospecha de paludismo deben ser atendidos inmediatamente para evitar las graves complicaciones de ésta enfermedad.Severe malaria is caused by Plasmodium falciparum taken millions of lives in Third World countries every year and being children the most affected. A descriptive, prospective, cross "sectional and correlational-casual study was carried out with pediatric patients who were admitted at Bata Regional Hospital in Equatorial Guinea after practicing a thick" film method test with positive results of plasmodium falciparum from January to July 2003, aimed at establishing clinical features of children affected by plasmodium falciparum determining the number of admissions, stay in hospital, complications and mortality, scientific methods used were empiric; analyzing documents and verbal interviews, statistic methods were: parametric samples and percentage
Sorensen, Bjarke Lund; Elsass, Peter; Nielsen, Brigitte Bruun
for major substandard care. Hospital based maternal deaths between 2006 and 2008 (35 months) were included. Of 68 registered maternal deaths sufficient information for reviewing was retrieved for 62 cases (91%). As a supplement, in-depth interviews with staff about the underlying causes of substandard care...... in 46 (74%) of the 62 cases reviewed. During the same time period MDA identified substandard care in 18 cases. Staff perceived poor organization of work and lack of training as important causes for substandard care. Local MDA was considered useful although time-consuming and sometimes threatening......, and staff dedication to the process was questioned. CONCLUSION: Quality assurance of emergency obstetric care might be strengthened by supplementing internal MDA with external CE....
Kaar, T K
A prospective study of the pattern of responses to requests for autopsy in a general surgical unit was performed. Information on the characteristics of the deceased, of the requestee and of the requester was documented in the case of 66 patients who died while in hospital. Permission to perform autopsy was not requested in 39 out of 66 cases and this was the most frequent contributory factor to the low rate of autopsy. Once a decision to grant or refuse autopsy is made by relatives of the deceased, the decision is unlikely to be reversed. Permission to perform autopsy was more likely to be sought when the deceased was male than when deceased was female. The relatives of patients who had recently undergone surgery were more likely to refuse permission for autopsy than were those of patients who had not had recent surgery.
Fegan, Greg; Shavadia, Jay; Denje, Douglas; Mandaliya, Kishor; Bates, Imelda; Maitland, Kathryn; Hassall, Oliver W.
BACKGROUND Severe anemia in children is a major public health problem in sub‐Saharan Africa. In this study we describe clinical and operational aspects of blood transfusion in children admitted to Coast Provincial General Hospital, Kenya. STUDY DESIGN AND METHODS This was an observational study where over a 2‐year period, demographic and laboratory data were collected on all children for whom the hospital blood bank received a transfusion request. Clinical data were obtained by retrospective review of case notes over the first year. RESULTS There were 2789 requests for blood for children (median age, 1.8 years; interquartile range [IQR], 0.6‐6.6 years); 70% (1950) of the samples were crossmatched with 85% (1663/1950) issued. Ninety percent (1505/1663) were presumed transfused. Median time from laboratory receipt of request to collection of blood was 3.6 hours (IQR, 1.4‐12.8 hr). Case notes of 590 children were reviewed and median pretransfusion hemoglobin level was 6.0 g/dL (IQR, 4.2‐9.1 g/dL). Ninety‐four percent (186) were transfused “appropriately” while 52% (120) were transfused “inappropriately.” There was significant disagreement between the clinical and laboratory diagnosis of severe anemia (exact McNemar's test; p blood transfusions but only 41% (106) of these had a positive blood film. CONCLUSION In this setting, clinicians often order blood based on the clinical impression of “severe anemia.” This has implications for laboratory workload and the blood supply itself. However, the majority of children with severe anemia were appropriately transfused. The use of antimalarials with blood transfusions irrespective of blood film results is common practice. PMID:27611471
Marchal, Bruno; Dedzo, McDamien; Kegels, Guy
Realist evaluation offers an interesting approach to evaluation of interventions in complex settings, but has been little applied in health care. We report on a realist case study of a well performing hospital in Ghana and show how such a realist evaluation design can help to overcome the limited external validity of a traditional case study. We developed a realist evaluation framework for hypothesis formulation, data collection, data analysis and synthesis of the findings. Focusing on the role of human resource management in hospital performance, we formulated our hypothesis around the high commitment management concept. Mixed methods were used in data collection, including individual and group interviews, observations and document reviews. We found that the human resource management approach (the actual intervention) included induction of new staff, training and personal development, good communication and information sharing, and decentralised decision-making. We identified 3 additional practices: ensuring optimal physical working conditions, access to top managers and managers' involvement on the work floor. Teamwork, recognition and trust emerged as key elements of the organisational climate. Interviewees reported high levels of organisational commitment. The analysis unearthed perceived organisational support and reciprocity as underlying mechanisms that link the management practices with commitment. Methodologically, we found that realist evaluation can be fruitfully used to develop detailed case studies that analyse how management interventions work and in which conditions. Analysing the links between intervention, mechanism and outcome increases the explaining power, while identification of essential context elements improves the usefulness of the findings for decision-makers in other settings (external validity). We also identified a number of practical difficulties and priorities for further methodological development. This case suggests that a well
Nabwera, Helen M; Fegan, Greg; Shavadia, Jay; Denje, Douglas; Mandaliya, Kishor; Bates, Imelda; Maitland, Kathryn; Hassall, Oliver W
Severe anemia in children is a major public health problem in sub-Saharan Africa. In this study we describe clinical and operational aspects of blood transfusion in children admitted to Coast Provincial General Hospital, Kenya. This was an observational study where over a 2-year period, demographic and laboratory data were collected on all children for whom the hospital blood bank received a transfusion request. Clinical data were obtained by retrospective review of case notes over the first year. There were 2789 requests for blood for children (median age, 1.8 years; interquartile range [IQR], 0.6-6.6 years); 70% (1950) of the samples were crossmatched with 85% (1663/1950) issued. Ninety percent (1505/1663) were presumed transfused. Median time from laboratory receipt of request to collection of blood was 3.6 hours (IQR, 1.4-12.8 hr). Case notes of 590 children were reviewed and median pretransfusion hemoglobin level was 6.0 g/dL (IQR, 4.2-9.1 g/dL). Ninety-four percent (186) were transfused "appropriately" while 52% (120) were transfused "inappropriately." There was significant disagreement between the clinical and laboratory diagnosis of severe anemia (exact McNemar's test; p blood transfusions but only 41% (106) of these had a positive blood film. In this setting, clinicians often order blood based on the clinical impression of "severe anemia." This has implications for laboratory workload and the blood supply itself. However, the majority of children with severe anemia were appropriately transfused. The use of antimalarials with blood transfusions irrespective of blood film results is common practice. © 2016 The Authors. Transfusion published by Wiley Periodicals, Inc. on behalf of AABB.
Full Text Available Introduction. Patient safety and the avoidance of inhospital adverse events is a key focus of clinical practice and medical audit. A large of proportion of medical errors affect surgical patients in the peri-operative setting. Safety checklists have been adopted by the medical profession from the aviation industry as a cheap and reliable method of avoiding errors which arise from complex or stressful situations. Current evidence suggests that the use of periooperative checklists has led to a decrease in surgical morbidity and hospital costs. Aim. To assess the quality of implementation of a modified patient safety checklist in a UK district general hospital. Methods. An observational tool was designed to assess in real time the peri-operative performance of the surgical safety checklist in patients undergoing general surgical, urological or orthopaedic procedures. Initiation of the checklist, duration of performance and staff participation were audited in real time. Results. 338 cases were monitored. Nurses were most active in initiating the safety checklist. The checklist was performed successfully in less than a minute in most cases. 11-24% of staff (according to professional group present in the operating room did not participate in the checklist. Critical safety checks (patient identity and procedure name were performed in all cases across all specialties. Variations were noted in checking other categories, such as deep vein thrombosis (DVT prophylaxis or patient warming. Conclusions. There is still a potential for improving the practice and culture of surgical patient safety activities. Staff training and designation of patient safety leadership roles is needed in increasing compliance and implementation of patient safety mechanism, such as peri-operative checklists. There is significant data to advocate the need to implement patient safety surgical checklists internationally
Full Text Available Abstract Background Realist evaluation offers an interesting approach to evaluation of interventions in complex settings, but has been little applied in health care. We report on a realist case study of a well performing hospital in Ghana and show how such a realist evaluation design can help to overcome the limited external validity of a traditional case study. Methods We developed a realist evaluation framework for hypothesis formulation, data collection, data analysis and synthesis of the findings. Focusing on the role of human resource management in hospital performance, we formulated our hypothesis around the high commitment management concept. Mixed methods were used in data collection, including individual and group interviews, observations and document reviews. Results We found that the human resource management approach (the actual intervention included induction of new staff, training and personal development, good communication and information sharing, and decentralised decision-making. We identified 3 additional practices: ensuring optimal physical working conditions, access to top managers and managers' involvement on the work floor. Teamwork, recognition and trust emerged as key elements of the organisational climate. Interviewees reported high levels of organisational commitment. The analysis unearthed perceived organisational support and reciprocity as underlying mechanisms that link the management practices with commitment. Methodologically, we found that realist evaluation can be fruitfully used to develop detailed case studies that analyse how management interventions work and in which conditions. Analysing the links between intervention, mechanism and outcome increases the explaining power, while identification of essential context elements improves the usefulness of the findings for decision-makers in other settings (external validity. We also identified a number of practical difficulties and priorities for further
Chen, Yung-Liang; Yeh, Ming-Yang; Huang, Shau-Yen; Liu, Chi-Ming; Sun, Chi-Chen; Lu, Hsu-Feng; Chiu, Tsan-Hung; Hsia, Te-Chun; Chung, Jing-Gung
Epidemic prevention policies in hospitals address issues such as, indoor air quality control, cleanliness of medical staff clothing and employee hand-washing procedures. Our hospital employed Bio-Kil to treat air-conditioning filters and nursing staff uniforms. We also assessed the efficacy of different detergents. Using Bio-Kil technology, the mean bacterial count in the air was reduced from 108.8 CFU/h/plate (n=420) to 68.6 CFU/h/plate (n=630). On the lower hems of the Bio-Kil-treated gowns, the mean bacterial count was 1,201 CFU/100 cm(2), markedly lower than the bacterial count of 7,753 CFU/100 cm(2), found on the parts of the gowns not treated with Bio-Kil (p=0.0401). On the cuffs of sleeves treated with Bio-Kil, the mean count was 1,165 CFU/100 cm(2), markedly lower than that of 2,131 CFU/100 cm(2), found on the cuffs not treated with Bio-Kil (p=0.0073). With regard to the mean bacterial eradication rates of antimicrobial solutions, Steridal Solution, 75% alcohol and Bio-Kil (3rd generation) were shown to be the most effective, with rates exceeding 80%. Hibiscrub with paper towels and Fresh Protect Skin were the second most effective. Bio-Kil (1st generation), tap water with paper towels, liquid hand soap with paper towels and ozone water were the least effective. One important observation was that hand-washing without the use of paper towels increased the bacterial count by as much as 84% . Bio-Kil is effective in reducing bacterial counts in the air, on nursing staff uniforms and is an effective detergent.
Pre-hospital care, emergency department and critical care medicine are the key components of emergency medical service system. Two investigations about the pediatric critical care medicine in China mainland showed great progress. In recent years, most hospitals in China mainland have established emergency department, hardware configuration and staff status were gradually standardized. But most of the emergency departments mainly provide service to adult patients and pediatric emergency medicine lags behind. The purpose of this investigation was to understand the current situation and main problems of pediatric emergency in China mainland. A questionnaire developed by the Subspecialty Group of Pediatrics, Chinese Society of Emergency Medicine and the Subspecialty Group of Emergency Medicine, Chinese Society of Pediatrics was e-mailed to the members of the above-mentioned two subspecialty groups. The contents of the questionnaire included 46 items which were divided into 5 categories: the general situation of the hospital, the pediatric emergency setting and composition, key equipments and techniques, staff status, training program and running data from 2011 to 2012. Sixty-three questionnaires were delivered and 27 (42.9%) hospitals responded which located in 15 different provinces, municipalities and autonomous regions. Among the 27 hospitals, 10 (37.0%) had no pediatric resuscitation room; 25 (92.6%) had no equipments for cardiac output monitor and gastric lavage; 13 (48.1%) had no bedside fibrolaryngoscope or fiberbronchoscope; 5 (18.5%) had no blood gas analyzer; 4 (14.8%) without respirator, defibrillator, bedside radiography or ultrasonic equipment; 2 (7.4%) had no neonatal incubator; 9 (33.3%) could not do intraossous infusion. The average ratio of professional emergency pediatricians to all physicians was 43.5%. Twenty hospitals incompletely filled in the pediatric emergency running data. The main problems existing in pediatric emergency include: imperfect
Full Text Available Background. Worldwide, cataract is a major cause of blindness. The paper aims to evaluate factors associated with borderline and poor outcomes of cataract surgery at an Eastern Regional Health Authority (ERHA hospital in Trinidad and Tobago.Materials and Methods. A hospital-based, retrospective study was done on 401 patients who had undergone cataract surgery (unilateral and bilateral at an ERHA Hospital between March 2009 and September 2014. Data was collected on variables concerning demographic, medical history, surgical history, ocular findings and visual acuity (VA. The outcome variable of interest was Snellen’s post-operative (presenting VA which was transformed into a dichotomous variable with borderline and poor outcomes as one and good outcomes as the other. Data were analysed using univariate and multivariate logistic regression analyses.Results. Good outcome (presenting VA 6/18 or better was seen in 350 (67% eyes. The fitted model consisted of ocular co-morbidity (OR =2.133; 95% CI [1.346–3.380], hypertension (OR = 0.520; 95% CI [0.381–0.928], surgical procedure (OR = 1.56; 95% CI [1.004–2.425], good preoperative VA (OR = 0.388, 95% CI [0.211–0.714], borderline preoperative VA (OR = 0.485; 95% CI = [0.278–0.843] and year of first visit to clinic (OR = 2.243; 95% CI [1.215–4.141].Conclusion. There is a need for community-based outreach to increase awareness of eye health and diseases. It is recommended that the general population is encouraged to take responsibility for personal management. The facilities at the Hospital should also be enhanced.
recordings of scoliosis today are carried out on CR systems even though most radiological departments have DR systems available. Theoretically speaking the two modalities are similar regarding dose and image quality. In this project consequently, the focus will be to obtain images of equal dose and quality...... at a DR system when using different receptors during the exam. This is a completely new opportunity, as it has earlier been difficult to compare distinct scintilators connected to the receptors due to unlike processing of the image. Given that Canon have released a receptor with CsI scintilator we...... in which theory is used as a background for the test setup and later audit appraisal. Two tests are carried out on two different hospitals with each their receptor, and afterwards the results are compared. To guarantee comparable tests the results are verified through status checks and statistical t...
The red light from the Light Emitting Diode (LED) probe shines through the fingers of Dr. Harry Whelan, a pediatric neurologist at the Children's Hospital of Wisconsin in Milwaukee. Dr. Whelan uses the long waves of light from the LED surgical probe to activate special drugs that kill brain tumors. Laser light previously has been used for this type of surgery, but the LED light illuminates through all nearby tissues, reaching parts of tumors that shorter wavelengths of laser light carnot. The new probe is safer because the longer wavelengths of light are cooler than the shorter wavelengths of laser light, making the LED less likely to injure normal brain tissue near the tumor. Also, it can be used for hours at a time while still remaining cool to the touch. The probe was developed for photodynamic cancer therapy under a NASA Small Business Innovative Research Program grant. The program is part of NASA's Technology Transfer Department at the Marshall Space Flight Center.
Bakola, Helen; Zyga, Sofia; Stergioulas, Apostolos; Kipreos, George; Panoutsopoulos, George
The surgery unit is a particularly labor-intensive environment in the hospital. Studies reflect the correlation of labor risk factors for musculoskeletal injuries among nurses but few have investigated the relationship to perioperative nurses. The purpose of this study is the identification and definition of ergonomic risk factors in the operating room and their connection with musculoskeletal disorders in perioperative nurses in regional hospitals in Greece. Forty four Greek perioperative nurses working in regional hospitals in southern Peloponnese participated. Anonymous self-administered questionnaire was used to collect the data, which consisted of three parts (investigating musculoskeletal symptoms, description of work, psychometric evaluation). The analysis was done with the statistical program SPSS.19. Symptoms of musculoskeletal problems emerged. Specifically, 54.4% in the lumbar, 47.7% in the neck, 45.5% in the shoulder, followed by smaller percentages of the hip, knee, elbow and ankle. 6.8% of participants indicated no musculoskeletal symptoms in the last year while 74.9% of those who had symptoms presented them in two or more areas. Activities rated as a major problem among others were the manual handling, tools with weight and vibration etc. 100% of respondents agreed that the work in the surgery unit is demanding and has anxiety. The lack of support from the government (81.8%), combined with the low perioperative nurses (6.8%) having the opportunity to participate in administrative decisions concerning them were related to problems in the organization and management of work. Apart from engineers target factors, a main aim should be the organization of work within the framework of a national policy based on European directives on the protection and promotion of the health and safety of workers.
Delgado, M. Kit; Meng, Lesley J.; Mercer, Mary P.; Pines, Jesse M.; Owens, Douglas K.; Zaric, Gregory S.
Introduction: Optimal solutions for reducing diversion without worsening emergency department (ED) crowding are unclear. We performed a systematic review of published simulation studies to identify: 1) the tradeoff between ambulance diversion and ED wait times; 2) the predicted impact of patient flow interventions on reducing diversion; and 3) the optimal regional strategy for reducing diversion. Methods: Data Sources: Systematic review of articles using MEDLINE, Inspec, Scopus. Additional st...
Labh, R K; Adhikari, P R; Karki, P; Singh, S K; Sitoula, R P
Low vision is an important public health problem. To study the profile of low vision patients in a hospital of Nepal. Information related to the patients' profile, visual status, ocular disease and, low vision devices prescribed were obtained retrospectively from the records of 1,860 visually- impaired patients, regardless of the cause, presenting to the low vision department of the Biratnagar Eye Hospital, Biratnagar, Nepal, over a period of four years. These patients, after a comprehensive ocular examination, underwent low vision examination by an ophthalmologist and a low vision specialist. Of 1,860 patients, males comprised 1298 (70 %), while 562 (30 %) patients were female. Six hundred and one (32.3%) patients were of less than 20 years while 398(21.4%) were more than 60 years of age. Agriculture (500, 27 %), household work (341, 18 %) and students (308, 17 %) were the common occupations. Retinal diseases were the commonest cause of low vision. They were: macular disorders 408 (22 %), retinitis pigmentosa 226 (12.1 %) and other retinal causes 361 (19.4 %) (diabetic retinopathy, choroidal coloboma, post laser for retinal vasculitis and central retinal/branch retinal vein occlusion, healed macular chorioretinal scar secondary to retinochroiditis and choroiditis). Refractive error 215 (11.5 %), amblyopia 49 (2.6 %), optic atrophy 144 (7.8 %) and microphthalmos 105 (5.6 %) were the other causes. Uncorrected distance visual acuity was between 6/24 and 6/60 in 509 (27.4 %) and between 5/60 and PL in 1,327 (71.3 %) patients. Similarly, near visual acuity with vision better than 2.50 M (N 20) and worse than 2.50 M (N20) was present in 643(34.5%) and 1,217(65.5%) patients. About 67% and 54.5% of the patients had some improvement in their distance and near visual acuity with glasses and low vision aids. Distance spectacles 909 (49 %), near spectacles 106 (5.7 %), hand held magnifiers 78 (4 %) and telescopes 18 (1 %) were the optical devices prescribed. The prevalence of
Nkokone S Z Tema
Full Text Available Background. Psychiatrists are often called upon to evaluate patients with a medical condition and psychiatric symptoms, either as a complication thereof or initial presenting symptoms. There are often grey areas with regard to neuropsychiatric disorders in which psychiatrists and specialists from other clinical disciplines would need to co-manage or share ideas on the comprehensive treatment of a presenting patient. Objectives. This study was undertaken to provide a demographic and clinical profile of all patients consulted by the consultation-liaison psychiatry (CLP service at the Helen Joseph Hospital (HJH in Johannesburg, and to describe the clinical management of patients admitted with a diagnosis of a mental disorder associated with a comorbid medical condition, including delirium, dementia and a mood or psychotic disorder due to a general medical condition. Methods. A retrospective record review of all patients referred to the HJH CLP team over a 6-month period. Results. A total of 884 routine and emergency consultations were done for 662 patients (males n=305; females n=357 between the ages of 13 and 90 years who were referred from various other clinical departments. The most common documented reason for referral was a request for assessment (n=182; 27.5%, which consisted of mental state assessment, reconsultation and assessing capacity. A total of 63 patients (10.0% of cases consulted were admitted to either the medical or psychiatric wards with a confirmed diagnosis of delirium, dementia and/or a mood or psychotic disorder due to a general medical condition (although admission wards were identified in 55 files only. The medical wards admitted the majority (n=37; 67.3% mostly for delirium (n=28; 50.9%. HIV was identified as the most common systemic aetiological factor (n=23; 67.7%. Conclusion. In this study, a female patient between 31 and 45 years of age was slightly more likely to be referred to the HJH CLP service for assessment, and
Fabbian, Fabio; Gallerani, Massimo; Pala, Marco; De Giorgi, Alfredo; Salmi, Raffaella; Dentali, Francesco; Ageno, Walter; Manfredini, Roberto
Using a regional Italian database, we evaluated the relationship between renal dysfunction and in-hospital mortality (IHM) in patients with acute stroke (ischemic/hemorrhagic). Patients were classified on the basis of renal damage: without renal dysfunction, with chronic kidney disease (CKD), and with end-stage renal disease (ESRD). Of a total of 186,219 patients with a first episode of stroke, 1626 (0.9%) had CKD and 819 (0.4%) had ESRD. Stroke-related IHM (total cases) was independently associated with CKD, ESRD, atrial fibrillation (AF), age, and Charlson comorbidity index (CCI). In patients with ischemic stroke (n=154,026), IHM remained independently associated with CKD, ESRD, AF, and CCI. In patients with hemorrhagic stroke (n=32,189), variables that were independently associated with IHM were CKD, ESRD, and AF. Renal dysfunction is associated with IHM related to stroke, both ischemic and hemorrhagic, with even higher odds ratios than those of other established risk factors, such as age, comorbidities, and AF. © The Author(s) 2013.
In this essay Dr Valter Rukavina (Rijeka 1896-1972), excellent specialist in infectious diseases and professor of the Rijeka University School of Medicine, is presented as successful amateur painter. He had been refining his talent through relentless practice since the school days, complementing it with skills and advice from established painters he associated with. He favoured figurative, realistic and somewhat romantic expression for his themes such as coastal landscapes, marinas, Quarnero sceneries, still life in tempera or oil, and drawings in ink or sepia. Despite partial colour blindness, he successfully used colour. He featured in a number of group exhibitions such as that of amateur painters of Rijeka in 1950, of painters physicians of Yugoslavia (Zagreb, 1956), in the Second International Exhibition of Contemporary Art (Florence, 1964), exhibition of the Rijeka branch of the Croatian Association of Visual Artists (Belgrade, 1966), and the 1969 exhibition in Opatija. His native city hosted two one-man exhibitions, the first retrospective in 1971, while he was still alive, and the second posthumous in 2007, with a good selection of his life's work.
Riaz, N.; Warriach, R.A.
The oro-facial region including the oral cavity, the maxilla and mandible and related tissues can be the site of a multitude of neoplastic conditions. These tumours have a predilection for the entire facial region; however, odontogenic tumours tend to affect the mandible more than the maxilla. We report results from a retrospective study spanning five years on the frequency, clinical presentation, sites and character of orofacial tumors seen in the main referral hospital of Pakistan. Patients and Methods: Records of consecutive patients of all age and sex seen by the author's team at the Department of Oral and Maxillofacial Surgery, Mayo Hospital with tumours affecting the oro-facial region from January 2005 to December 2009 were retrieved, coded and entered into a database. The data were then analyzed by age, sex, presenting signs and symptoms, site of lesion, and their histology. Results: A total of 237 patients with oro-facial swellings were retrieved from the registry. The complete data set was obtained for 189 patients, comprising 108 (57.9%) males and 81 (42%) females. The most common clinical presenting features were mandibular facial swelling (63%), intra-oral swelling (55%), and ulceration (29%). The tumors were found in the mandible 67 (35%), buccal mucosa 33 (17%), floor of the mouth 22 (11%) and tongue 29 (15%). The remainder making up almost 20% was found in the palate, submandibular region, pre auricular region and lips. Ninety three (49.2%) of the patients presented with lesions that were classified as malignant of which 64 (69%) were diagnosed as squamous cell carcinoma (SCC). seventy (37.0%) had benign odontogenic tumors and twenty six (13.7%) had non-odontogenic tumor - like lesions. Sixty - four (69%) of malignant tumors were squamous cell carcinoma; sixty four (86.4%) of the benign odontogenic tumors were classified as ameloblastoma. The mean age at presentation of all lesions was 40.4 years with over 50% of benign lesions in patients aged
Quispe, Antonio M; Pozo, Edwar; Guerrero, Edith; Durand, Salomón; Baldeviano, G Christian; Edgel, Kimberly A; Graf, Paul C F; Lescano, Andres G
Severe malaria caused by Plasmodium vivax is no longer considered rare. To describe its clinical features, we performed a retrospective case control study in the subregion of Luciano Castillo Colonna, Piura, Peru, an area with nearly exclusive vivax malaria transmission. Severe cases and the subset of critically ill cases were compared with a random set of uncomplicated malaria cases (1:4). Between 2008 and 2009, 6,502 malaria cases were reported, including 106 hospitalized cases, 81 of which fit the World Health Organization definition for severe malaria. Of these 81 individuals, 28 individuals were critically ill (0.4%, 95% confidence interval = 0.2-0.6%) with severe anemia (57%), shock (25%), lung injury (21%), acute renal failure (14%), or cerebral malaria (11%). Two potentially malaria-related deaths occurred. Compared with uncomplicated cases, individuals critically ill were older (38 versus 26 years old, P < 0.001), but similar in other regards. Severe vivax malaria monoinfection with critical illness is more common than previously thought. © The American Society of Tropical Medicine and Hygiene.
Xin Zou; Nong Xiao; Bei Xu
OBJECTIVE: To investigate the changing trends of nervous system diseases among hospitalized children and the risk factors of death. METHOD: The disease was statistically classified according to the International Statistical Classification of Disease and Health Problem (ICD10). The retrospective investigation includes demographic characteristics, as well as categories and fatality rates for nervous system diseases. All data was statistically analyzed. RESULTS: The percentage of nervous system diseases among inpatients in all wards was 2.4% (2 537/ 107 250) between January 1993 and December 1999, and 3.6% (6 082/170 619) between January 2000 and December 2006. The first ten patterns of various etiologic forms of nervous system diseases were identical-epilepsies and seizures, infections of the central nervous system, autoimmune and demyelination disorders, cerebral palsy, motor unit disorders, hypoxic-ischemic encephalopathy, hydrocephalus, extra-pyramidal disorders, congenital abnormalities of nervous system, and headache. Epilepsies and seizures took first place in both year groups, with 29.4% and 35%, respectively. Bacterial infections were responsible for the majority of cranial infections in both year groups, with 78.9% and 63.6% respectively. The death rate in the year group January 2000 to December 2006 was significantly less than in the year group January 1993 to December 1999 (X2= 27.832, P<0.01). CONCLUSION: Among all nervous system diseases, epilepsies and seizures were among the most common, with the lowest fatality rate.
Siyem C. Nkwawir
Objectives: To evaluate the results of SLMTA implementation at BRHL and discuss lessons learned. Method: In 2010, the SLMTA programme was rolled out in Cameroon to improve laboratory quality management systems in five laboratories, including BRHL. Three workshops were conducted (the first centralised, the remaining two on-site at each laboratory and improvement projects were implemented after each workshop with the assistance of mentors. Audits were used in order to evaluate performance and to identify areas for further improvement. Results: BRHL had the lowest score (18% amongst the cohort at the baseline audit and the highest (81% at the official Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA audit conducted in August 2013 by the African Society for Laboratory Medicine. Improvements were observed in each of the 12 Quality System Essentials; improvement was especially noteworthy in the areas of facilities and safety, and purchasing and inventory. Staff investment and pride in the quality of laboratory services increased. Conclusion: BRHL’s remarkable improvement was achieved with a combination of SLMTA training activities, intensive on-site mentorship and the collective focus of all laboratory staff. The experience at Bamenda Hospital illustrates what can be achieved when a laboratory successfully harnesses the energy of its staff and implements changes to improve the quality of services in a transformation taking them from grass to grace.
Gillikin, P; Price, L; Lee, S; Sprinkle, M D; Leist, J C
To meet the informational needs of health care practitioners and trainees in a four-county rural area of northwestern North Carolina, the eleven-member UNIFOUR Consortium was founded as a two-year experimental project from 1978 to 1980. The consortium has several unique features: (1) it is an organization of institutions, not libraries; (2) it employs its own professional librarian who manages a central library, coordinates consortium programs, and makes regular circuit visits to all affiliated institutions; (3) the central library, where the circuit is based, is a developing community hospital library, not an established academic medical center library; and (4) it is ultimately tied to the Northwest Area Health Education Center and that organization's emerging learning resources network, which includes the Bowman Gray School of Medicine, Library, two other subregional libraries, and the libraries of all member institutions. At the end of the experimental period in 1980, member institutions voted unanimously to continue the program and assume their share of the costs.
Niimura, Junko; Nakanishi, Miharu; Yamasaki, Syudo; Nishida, Atsushi
Several clinical trials have demonstrated that linkage to an outreach service can prevent prolonged length of stay of patients at psychiatric hospitals. However, there has been no investigation of the association between length of stay in psychiatric hospital and regional supply of outreach services using national case mix data. The aim of this study was to clarify the relationship between length of stay in psychiatric hospital and regional supply of outreach services. We used data from the National Patient Survey in Japan, a nationally representative cross-sectional survey of inpatient care conducted every three years from 1996 to 2014. Data from 42,268 patients with schizophrenia who had been admitted to psychiatric hospitals were analyzed. After controlling for patient and regional characteristics, patients in regions with fewer number of visits for psychiatric nursing care at home had significantly longer length of stay in psychiatric hospitals. This finding implies that enhancement of the regional supply of outreach services would prevent prolonged length of stay in psychiatric hospitals. Copyright © 2017 Elsevier B.V. All rights reserved.
Principal Contact. Dr Sjoerd A Gehrels Editor-in-Chief Stenden Hotel Management School, Academy of International Hospitality Research, Leeuwarden, The Netherlands Email: firstname.lastname@example.org ...
Alamgir, Mohammad Jawad; Ali, Syed Abrar; Hamdy, Nermin Aly; Khan, Moin Zafar; Mohammad, Elgamri E
Optic neuritis (ON) can occur in isolation or association with multiple sclerosis (MS) or neuromyelitis optica. ON, is seen more commonly in Caucasians and interaction is found to exist between ethnic origin and the latitude at which the patient grows up. At present limited information is available about the profile of ON in Saudi patients. We aimed to analyze the records of ON patients, in regard to their presentation, natural history, treatment outcome, and risk and association with MS. Whether, ON in Saudi patients behaves differently from the Western and Asian patients? In this retrospective observational study; we retrieved the data from the medical records of the patients with ON, who attended the ophthalmology and neurology services of King Fahad Specialist Hospital Buraidah, Al Qassim, Saudi Arabia, from period 2006 to 2012. We recorded data of 60 patients of ON; 38 females (63.3%) and 22 males (36.7%). Color vision was affected in 66.7% of cases. Vision in the affected eye was 20/200 or worse in 74.97 % of our cases. Magnetic resonance imaging (MRI) brain revealed multiple lesions in 55% of cases; most of them developed MS on follow-up. Only 48.3% of patients had received systemic steroids. Vision improved in 85% of our cases. Most of our patients had idiopathic ON, and almost 85% had good visual recovery, in this regard our study is comparable with such studies done in other Asian countries. On the other hand, 55% of our patients had multiple MRI brain lesions, a high risk and association of MS, almost similar to the Western Europe and North American ON patients.
Naor, Michael; Heyman, Samuel N; Bader, Tarif; Merin, Ofer
The Israeli Defense Force (IDF) Medical Corps developed a model of airborne field hospital. This model was structured to deal with disaster settings, requiring self-sufficiency, innovation and flexible operative mode in the setup of large margins of uncertainty regarding the disaster environment. The current study is aimed to critically analyze the experience, gathered in ten such missions worldwide. Interviews with physicians who actively participated in the missions from 1988 until 2015 as chief medical officers combined with literature review of principal medical and auxiliary publications in order to assess and integrate information about the assembly of these missions. A body of knowledge was accumulated over the years by the IDF Medical Corps from deploying numerous relief missions to both natural (earthquake, typhoon, and tsunami), and man-made disasters, occurring in nine countries (Armenia, Rwanda, Kosovo, Turkey, India, Haiti, Japan, Philippines, and Nepal). This study shows an evolutionary pattern with improvements implemented from one mission to the other, with special adaptations (creativity and improvisation) to accommodate logistics barriers. The principals and operative function for deploying medical relief system, proposed over 20 years ago, were challenged and validated in the subsequent missions of IDF outlined in the current study. These principals, with the advantage of the military infrastructure and the expertise of drafted civilian medical professionals enable the rapid assembly and allocation of highly competent medical facilities in disaster settings. This structure model is to large extent self-sufficient with a substantial operative flexibility that permits early deployment upon request while the disaster assessment and definition of needs are preliminary.
Indah Kemala Hasibuan
Full Text Available The research is titled "The Role of Public Relations as a Management Support Hospital General Dr. Pirngadi Medan City "and discusses the role of public relations in order to improve the image of the hospital which describes the public relations image of the hospital to maintain (maintenance of image and restore the image of the hospital (recovery of image when carrying out its role as a supporter of management. This study aims to answer the problems that have been formulated. The detailed objectives of this study was to determine achievable extent of successful public relations duties to support the management to minimize patient complaints about inpatient services Jamkesmas participants in improving the image of the hospital in General Hospital Dr. Pirngadi Medan. The study population was inpatients General Hospital Dr. Pirngadi Jamkesmas Medan which is a participant during the month of January 2009 and aged 17 to 50 years. While the number of samples used to determine the Taro Yamane and using proportional random sampling technique. To answer the problems that have been formulated, used descriptive method with quantitative approach. From the analysis found the success rate of maintaining public relations image of the hospital by providing the best services at 65.12%, and restore the image of the hospital by providing the right solution for 62.79% proving that the role of public relations as a management support works.
Full Text Available Abstract Background Health insurance claims data are increasingly used for health services research in Germany. Hospital diagnoses in these data are coded according to the International Classification of Diseases, German modification (ICD-10-GM. Due to the historical division into West and East Germany, different coding practices might persist in both former parts. Additionally, the introduction of Diagnosis Related Groups (DRGs in Germany in 2003/2004 might have changed the coding. The aim of this study was to investigate regional and temporal variations in coding of hospitalisation diagnoses in Germany. Methods We analysed hospitalisation diagnoses for oesophageal bleeding (OB and upper gastrointestinal bleeding (UGIB from the official German Hospital Statistics provided by the Federal Statistical Office. Bleeding diagnoses were classified as "specific" (origin of bleeding provided or "unspecific" (origin of bleeding not provided coding. We studied regional (former East versus West Germany differences in incidence of hospitalisations with specific or unspecific coding for OB and UGIB and temporal variations between 2000 and 2005. For each year, incidence ratios of hospitalisations for former East versus West Germany were estimated with log-linear regression models adjusting for age, gender and population density. Results Significant differences in specific and unspecific coding between East and West Germany and over time were found for both, OB and UGIB hospitalisation diagnoses, respectively. For example in 2002, incidence ratios of hospitalisations for East versus West Germany were 1.24 (95% CI 1.16-1.32 for specific and 0.67 (95% CI 0.60-0.74 for unspecific OB diagnoses and 1.43 (95% CI 1.36-1.51 for specific and 0.83 (95% CI 0.80-0.87 for unspecific UGIB. Regional differences nearly disappeared and time trends were less marked when using combined specific and unspecific diagnoses of OB or UGIB, respectively. Conclusions During the study
Photo 01 : Prof. Roger Cashmore, director for Collider Programmes and Dr Vito Domenici, Member of the Abruzzo Regional Government Photo 02 : Prof. Roger Cashmore and Dr. Vito Domenici Photo 03 : Prof. Roger Cashmore, Dr. Vito Domenici and Dr Chiara Mariotti, DELPHI physicist
Vanoye, C; Lacroix, G; Le Gonidec, E; Couret, A; Benois, A; Peigne, V
Stingray injuries are very painful. Systemic analgesics are ineffective, and the use of local-regional anesthesia has been reported. This retrospective descriptive study reviewed all cases of stingray injuries seen at the emergency department of the Bouffard Hospital (Djbouti, Africa) between 2011 and 2014. The study included 35 patients. Most of the injuries (n= 31, 89%) concerned the lower limbs. Median pain intensity was 6 [5-8] on a visual analog scale of 0 (no pain) to 10. The following systemic medications were administered: acetaminophen to 13 (27%) patients, morphine to 8 (23%), and tramadol to 6 (17%). In all, 25 (71%) patients received local-regional anesthesia, 15 (60%) by injections at the ankle. All procedures were successful, and no adverse event was reported. This study reports clinical data about stingray injuries in the Red Sea area and highlights the interest of local-regional anesthesia in their management. Most of the procedures were distal and could be performed by trained emergency physicians.
Rongère-Casteigt, Julie; Pinon, Elodie; Domecq, Sandrine; Hoppe, Stéphanie; Bousser, Véronique; Vimard, Edwige; Saillour-Glenisson, Florence
An announcement procedure is mandatory to obtain accreditation to treat cancer patients. Health care professionals in the Aquitaine region evaluated the organization of this announcement procedure in their institutions and the patients' perception, in order to initiate actions to improve the structure and traceability of this procedure. Self-assessment approach based on a retrospective study plan comprising three concomitant steps: organizational audit, medical records audit and patient experience survey. 29 institutions participated in the study. Heterogeneous organizations were observed, although progress had been made in the deployment of the announcement procedure in terms of personnel training,formal organization and the resources devoted to this procedure, but there remains considerable room for improvement in terms of traceability, coordination between doctors and nursing staff, and referral of patients to supportive care. This evaluation triggered active mobilization of hospital teams concerning the announcement procedure in the Aquitaine region and a better awareness of the patient's perception. The regional dynamic allowed exchanges between institutions, facilitating the implementation of improvement actions.
Increasing numbers of oncology\\/haematology patients attending Midland Regional Hospital Tullamore (MRHT) has increased the workload of the Regional Oncology Haematology Pharmacy (ROHP) compounding unit. Staff restrictions require optimisation of current workflow practices. This audit (November 2010 and June 2011) focused on workflow in the aseptic compounding unit.\\r\
To report a study that explored the experiences of night-shift nurses, focusing on employee interrelationships and work satisfaction. Night-shift nurses are a critical component in hospital care making it essential to understand the experiences that give meaning to their work and understand how these nurses and the organization can benefit from their contribution to hospital care. A literature review revealed minimal research in this area. Qualitative case study. A qualitative case study using semi-structured interviews and self-completed diaries was conducted in 2010 in regional public hospitals in Australia. Participants were 14 nurses working nights half or more of their shifts in medical or surgical wards. Thematic analysis identified four major areas of concern: work relationships, work environment, work practices and lifestyle impact. Notably, work relationships were most meaningful for nurses on the same shift; night-shift nurses experienced working conditions inferior to their daytime counterparts including a perception of minimal leadership. Despite limited education opportunities, night shift provided opportunity for professional growth for some nurses with a slippage in skills for others; night shift provided flexibility for family and social activities, yet impeded these same activities, primarily due to pervasive fatigue. Night-shift nurses considered their role critical, yet believed that they were poorly regarded. The strong interpersonal relationships developed between night-shift workers need to be capitalized on whilst developing a more effective leadership model, improved work environment, more equitable professional development, and genuine recognition of the critical role of night nurses. © 2013 Blackwell Publishing Ltd.
López-Cima, María Felicitas; García-Pérez, Javier; Pérez-Gómez, Beatriz; Aragonés, Nuria; López-Abente, Gonzalo; Tardón, Adonina; Pollán, Marina
Asturias, an Autonomous Region in Northern Spain with a large industrial area, registers high lung cancer incidence and mortality. While this excess risk of lung cancer might be partially attributable to smoking habit and occupational exposure, the role of industrial and urban pollution also needs to be assessed. The objective was to ascertain the possible effect of air pollution, both urban and industrial, on lung cancer risk in Asturias. This was a hospital-based case-control study covering 626 lung cancer patients and 626 controls recruited in Asturias and matched by ethnicity, hospital, age, and sex. Distances from the respective participants' residential locations to industrial facilities and city centers were computed. Using logistic regression, odds ratios (ORs) and 95% confidence intervals (95%CIs) for categories of distance to urban and industrial pollution sources were calculated, with adjustment for sex, age, hospital area, tobacco consumption, family history of cancer, and occupation. Whereas individuals living near industries displayed an excess risk of lung cancer (OR = 1.49; 95%CI = 0.93-2.39), which attained statistical significance for small cell carcinomas (OR = 2.23; 95%CI = 1.01-4.92), residents in urban areas showed a statistically significant increased risk for adenocarcinoma (OR = 1.92; 95%CI = 1.09-3.38). In the Gijon health area, residents in the urban area registered a statistically significant increased risk of lung cancer (OR = 2.17; 95%CI = 1.25-3.76), whereas in the Aviles health area, no differences in risk were found by area of exposure. This study provides further evidence that air pollution is a moderate risk factor for lung cancer.
Full Text Available OBJETIVO: Aislar e identificar hongos en diferentes especímenes de pacientes inmunocomprometidos, atendidos en un hospital de la Ciudad de México, y determinar su asociación con micosis. MATERIAL Y MÉTODOS: Se realizó un estudio de tipo observacional transversal en pacientes del Hospital Regional General Ignacio Zaragoza, de junio de 1999 a mayo de 2000. De 108 pacientes se procesaron 268 especímenes para estudio micológico que incluyó examen directo, frotis, cultivos y microcultivos en medios específicos además de pruebas bioquímicas. La mayoría de pacientes tenía diagnóstico clínico de tuberculosis pulmonar y de síndrome de inmunodeficiencia adquirida. RESULTADOS: Se obtuvieron 183 aislamientos de levaduras y 66 de hongos filamentosos. Se diagnosticaron 45 micosis que en su mayoría correspondieron a candidosis pulmonar (32 casos. Las especies de Candida más frecuentes asociadas a patología fueron Candida albicans y C parapsilosis. Se obtuvieron cinco aislamientos de Cryptococcus neoformans variedad neoformans, uno de C albidus, tres de Histoplasma capsulatum y uno de Geotrichum candidum, asociados a infección micótica. CONCLUSIONES: El 41.6% de los pacientes estudiados presentaron una micosis asociada principalmente a síndrome de inmunodeficiencia adquirida y a tuberculosis pulmonar.
T. S.M. Aritonang
Full Text Available In performance-based design, the level of performance of hospital buildings is generally operational, where the buildings are expected to continue to function after the occurrence of the earthquake and do not undergo significant damage. This research evaluates the level of performance suitability of the Emergency Care Installation Buildings of Dr. Sardjito Hospital (hereinafter referred to as IRD RSUP Dr. Sardjito building for the effects of earthquakes. First evaluation is done by Rapid Visual Screening by FEMA 154 (2002, then continued with more detailed evaluation based on FEMA 310 (1998. The building structure is modeled by SAP2000 and created in 2 models, i.e. the Models with wall and the Models without wall. The earthquake loads refers to SNI 1726-2002. The strength of structural elements is calculated with SNI 2847-2002 and Response-2000. For evaluation of structure performance levels, a pushover analysis used for nonlinear procedures, where the analysis used to the Seismicity region 3 and 4. Performance point is determined by Capacity Spectrum Method based on ATC-40 (1996, which has built-in in the SAP2000 Program. The performance level of the building is determined by drift ratio criteria required by FEMA 356 (2000 as well as ATC-40 (1996. From the research results, it is obtained that the natural period for the Model with wall is 0.592 seconds and 1.687 Hz frequency, and natural period for Model without wall is 1.291 seconds and 0.774 Hz frequency. Therefore, the level of structure performances for earthquake return period of 500 years is immediate occupancy.
Bustamante-Ubilla, Miguel Alejandro; del Río-Rivero, María Carolina; Lobos-Andrade, Germán Enrique; Villarreal-Navarrete, Patricia Isabel
In this work, a questionnaire was designed and perceptions of motivation and demotivation of middle managers in three hospitals in the Region del Maule, Chile were measured. The fieldwork was carried out between September and October, 2006. A questionnaire that included 57 statements to measure attitude was administered and qualified according to a five-point Likert-type scale. The population studied included l25 professionals that supervise roughly 3 800 employees. Ten variables were identified, 5 motivational and 5 demotivational. Notable among the motivational variables are vocation and service-oriented spirit; among the demotivational variables are lack of recognition and commitment. It is affirmed that both motivational variables as well as demotivational variables are essentially qualitative and that economic and salary variables are less relevant and less hierarchical.
Sorensen, Bjarke Lund; Rasch, Vibeke; Massawe, Siriel
OBJECTIVE: To evaluate the management of prolonged labor and neonatal care before and after Advanced Life Support in Obstetrics (ALSO) training. METHODS: Staff involved in childbirth at Kagera Regional Hospital, Tanzania, attended a 2-day ALSO provider course. In this prospective intervention study...... conducted between July and November 2008, the management and outcomes of 558 deliveries before and 550 after the training were observed. RESULTS: There was no significant difference in the rate of cesarean deliveries owing to prolonged labor, and vacuum delivery was not practiced after the intervention...... 5.6% to 71.5% (RR 12.71; 95% CI, 9.04-17.88). There was a significant decrease from 6 to 0 neonatal deaths before discharge among those born with an Apgar score after 1minute of 4 or more (P=0.03). CONCLUSION: ALSO training had no effect on the management of prolonged labor. Early contact between...
Pasquali, Sara; Capitoni, Enrica; Tiraboschi, Giuseppina; Alborghetti, Adriana; De Luca, Giuseppe; Di Mauro, Stefania
Eleven medical care units of nine Lombardy Region hospitals organized by levels of care model or by the traditional departmental model have been analyzed, in order to evaluate if methods for complexity of patient-care evaluation represent an index factor of nursing organizational effectiveness. Survey with nine Nurses in managerial position was conducted between Nov. 2013-Jan. 2014. The following factors have been described: context and nursing care model, staffing, complexity evaluation, patient satisfaction, staff well-being. Data were processed through Microsoft Excel. Among Units analysed ,all Units in levels of care and one organized by the departmental model systematically evaluate nursing complexity. Registered Nurses (RN) and Health Care Assistants (HCA) are on average numerically higher in Units that measure complexity (0.55/ 0.49 RN, 0.38/0.23 HCA - ratio per bed). Adopted measures in relation to changes in complexity are:rewarding systems, supporting interventions, such as moving personnel within different Units or additional required working hours; reduction in number of beds is adopted when no other solution is available. Patient satisfaction is evaluated through Customer Satisfaction questionnaires. Turnover, stress and rate of absenteeism data are not available in all Units. Complexity evaluation through appropriate methods is carried out in all hospitals organized in levels of care with personalized nursing care models, though complexity is detected with different methods. No significant differences in applied managerial strategies are present. Patient's satisfaction is evaluated everywhere. Data on staffing wellbeing is scarcely available. Coordinated regional actions are recommended in order to gather comparable data for research, improve decision making and effectiveness of Nursing care.
Bell, Teresa M; Gilyan, Dannielle; Moore, Brian A; Martin, Joel; Ogbemudia, Blessing; McLaughlin, Briana E; Moore, Reilin; Simons, Clark J; Zarzaur, Ben L
Hospital-based violence intervention programs (HVIP) aim to reduce violent-injury recidivism by providing intensive case management services to high-risk patients who were violently injured. Although HVIP have been found effective at reducing recidivism, few studies have sought to identity how long their effects last. Additionally, prior studies have been limited by the fact that HVIP typically rely on self-report or data within their own healthcare system to identify new injuries. Our aim was to quantify the long-term recidivism rate of participants in an HVIP program using more objective and comprehensive data from a regional health information exchange. The study included 328 patients enrolled in Prescription for Hope (RxH), an HVIP, between January 2009 and August 2016. We obtained RxH participants' emergency department (ED) encounter data from a regional health information exchange database from the date of hospital discharge to February 2017. Our primary outcome was violent-injury recidivism rate of the RxH program. We also examined reasons for ED visits that were unrelated to violent injury. We calculated a 4.4% recidivism rate based on 8 years of statewide data, containing 1,575 unique encounters. More than 96% of participants were matched in the state database. Of the 15 patients who recidivated, only five were admitted for their injury. More than half of new violence-related injuries were treated outside of the HVIP-affiliated trauma center. The most common reasons for ED visits were pain (718 encounters), followed by suspected complications or needing additional postoperative care (181 encounters). Substance abuse, unintentional injuries, and suicidal ideation were also frequent reasons for ED visits. The low, long-term recidivism rate for RxH indicates that HVIPs have enduring positive effects on the majority of participants. Our results suggest that HVIP may further benefit patients by partnering with organizations that work to prevent suicide
Munford, Veridiana; Gilio, Alfredo Elias; de Souza, Eloisa Correa; Cardoso, Debora Morais; Cardoso, Divina das Dores de Paula; Borges, Ana Maria Tavares; Costa, Paulo Sergio Sucasas da; Melgaço, Irene Angela Melo; Rosa, Humberto; Carvalho, Paulo Roberto Antonacci; Goldani, Marcelo Zubaran; Moreira, Edson Duarte; Santana, Ciria; El Khoury, Antoine; Ikedo, Fabio; Rácz, Maria Lucia
Rotavirus is a major cause of gastroenteritis in children. Knowledge of rotavirus genotypes is important for vaccination strategies. During 2005-2006, rotavirus surveillance studies were conducted in São Paulo, Salvador, Goiânia, and Porto Alegre, Brazil. Stool samples were collected from children <5 years of age who had diarrhea and were screened by the Rotaclone Enzyme Immunoassay for the presence of rotavirus. Confirmed rotavirus-positive samples were characterized for P and G genotypes by reverse-transcriptase polymerase chain reaction. A total of 510 stool samples were collected. Of these, 221 (43.3%) were positive for rotavirus. Overall, G9 was the predominant G type, followed by G2, and G1; P and P were the predominant P types. The most frequent G/P genotype combination detected was G2P, followed by G9P, G9P, and G1P. G2P was the predominant type in Goiânia and Salvador; G9P and G1P were predominant in São Paulo and Porto Alegre, respectively. The prevalence, seasonality, and genotype distribution of rotavirus infection varied in different regions in Brazil. With immunization programs, continuous monitoring of rotavirus types is important to detect novel and emerging strains.
Vyas Kumar Rathaur
Full Text Available Introduction: There is paucity of studies on infant feeding practices from the rural areas of garhwal Himalayas of the state of uttarakhand. The present study was designed to assess the infant feeding practices in Garhwal region. Infant feeding practices have significant implications on a child's health. Early nutritional status especially during the first year of life has been shown to have a significant effect on child health and development. Optimal infant feeding practices are crucial for nutritional status, growth, development, health, and ultimately the survival of infants and young children. The study of infant feeding practices is essential before formulation of any interventional programme. Settings and Design: A study was conducted in HNB Base Hospital and Teaching Institute with the aim to assess the infant feeding practices and the prevalence of malnutrition in the study population reporting at the hospital in garhwal region of uttarakhand. Methods and Material: This is an observational cross sectional study. 275 infants were included in the study. After taking informed consent, case study forms were filled by interviewing the infants' mothers. Weight, length and head circumference of each infant was also measured. The information thus obtained was compiled, tabulated and analysed statistically. Results: The study findings revealed that 46.4% infants in the age group 0-5 months were breastfed within 1 hour of birth. 52.8% infants aged 0-5 months of were exclusively breastfed. 33.6% infants in age group 0-5 months received prelacteal feeds. 53.12% infants in age group 6-8 months received solid, semi-solid or soft food, in addition to breast milk. 53.33% infants were partially or fully bottle fed. Age appropriate feeding was found in 56% infants. The percentage of wasting, stunting and underweight in 0-5 months was 33.6%,30.4% and 36.8% respectively . The percentage of wasting, stunting and underweight in 6-11 months was 28%, 26.5% and
Eyer, L.; Guy, L.; Distefano, E.; Clementini, G.; Mowlavi, N.; Rimoldini, L.; Roelens, M.; Audard, M.; Holl, B.; Lanzafame, A.; Lebzelter, T.; Lecoeur-Taïbi, I.; Molnár, L.; Ripepi, V.; Sarro, L.; Jevardat de Fombelle, G.; Nienartowicz, K.; De Ridder, J.; Juhász, Á.; Molinaro, R.; Plachy, E.; Regibo, S.
This chapter of the Gaia DR2 documentation describes the models and methods used on the 22 months of data to produce the Gaia variable star results for Gaia DR2. The variability processing and analysis was based mostly on the calibrated G and integrated BP and RP photometry. The variability analysis approach to the Gaia data has been described in Eyer et al. (2017), and the Gaia DR2 results are presented in Holl et al. (2018). Detailed methods on specific topics will be published in a number of separate articles. Variability behaviour in the colour magnitude diagram is presented in Gaia Collaboration et al. (2018c).
Full Text Available In this issue of the English version of Social Medicine we are publishing the first of several pamphlets loaned to us by the US Health Activism History Collection. To introduce this collection we travelled to Philadelphia on June 18, 2008 to interview Dr. Walter J. Lear. Dr Lear, born in 1923, is the person responsible for the collection. In a wide-ranging interview in his home Dr. Lear discussed his personal background, the origins and purpose of the collection, the impact of the McCarthy period on the US health left, as well as his vision for the future.
Full Text Available OBJETIVO: Aislar e identificar hongos en diferentes especímenes de pacientes inmunocomprometidos, atendidos en un hospital de la Ciudad de México, y determinar su asociación con micosis. MATERIAL Y MÉTODOS: Se realizó un estudio de tipo observacional transversal en pacientes del Hospital Regional General Ignacio Zaragoza, de junio de 1999 a mayo de 2000. De 108 pacientes se procesaron 268 especímenes para estudio micológico que incluyó examen directo, frotis, cultivos y microcultivos en medios específicos además de pruebas bioquímicas. La mayoría de pacientes tenía diagnóstico clínico de tuberculosis pulmonar y de síndrome de inmunodeficiencia adquirida. RESULTADOS: Se obtuvieron 183 aislamientos de levaduras y 66 de hongos filamentosos. Se diagnosticaron 45 micosis que en su mayoría correspondieron a candidosis pulmonar (32 casos. Las especies de Candida más frecuentes asociadas a patología fueron Candida albicans y C parapsilosis. Se obtuvieron cinco aislamientos de Cryptococcus neoformans variedad neoformans, uno de C albidus, tres de Histoplasma capsulatum y uno de Geotrichum candidum, asociados a infección micótica. CONCLUSIONES: El 41.6% de los pacientes estudiados presentaron una micosis asociada principalmente a síndrome de inmunodeficiencia adquirida y a tuberculosis pulmonar.OBJECTIVE: To isolate and identify the fungi in specimens collected from immunocompromised patients seen in Mexico City hospital, and to assess their association with mycosis. MATERIAL AND METHODS: A total of 268 specimens from 108 patients were processed for mycological study, including direct examination, smears, cultures, and microcultures in specific media, in addition to biochemical tests. Most of the patients had been diagnosed with pulmonary tuberculosis and Acquired Immunodeficiency Syndrome (AIDS. RESULTS: One hundred and eighty-three yeasts and 66 mycelial fungi were isolated. Forty-five mycoses were diagnosed; the most frequent
Abd-Allah, Dr. Adel-Gamil. Vol 12, No 4 (2000) - Articles CORRELATION BETWEEN UTERINE ARTERY FLOW VELOCITY WAVEFORMS AND ENDOMETRIAL HISTOPATHOLOGY IN WOMEN WITH PERIMENOPAUSAL AND POSTMENOPAUSAL BLEEDING. Details. ISSN: 1110-5607. AJOL African Journals Online.
Elected: 2014 Section: Engineering & Technology. Raghavarao, Dr Karumanchi Srisaila Mallikarjuna S Ph.D. (Mumbai), FNAE, FNAAS. Specialization: Food Engineering, Biotechnology Address: Chief Scientist, Department of Food Engineering, Central Food Technological Research Institute, Mysore 570 020, Karnataka
Ramos, Pedro Palma; Leitão, António Menezes
The Python programming language is becoming increasingly popular in a variety of areas, most notably among novice programmers. On the other hand, Racket and other Scheme dialects are considered excellent vehicles for introducing Computer Science concepts. This paper presents an implementation of Python for Racket and the DrRacket IDE. This allows Python programmers to use Racket libraries and vice versa, as well as using DrRacket's pedagogic features. In particular, it allows architects and d...
Straney, Lahn D; Bray, Janet E; Beck, Ben; Finn, Judith; Bernard, Stephen; Dyson, Kylie; Lijovic, Marijana; Smith, Karen
Out-of-hospital cardiac arrest (OHCA) remains a major public health issue and research has shown that large regional variation in outcomes exists. Of the interventions associated with survival, the provision of bystander CPR is one of the most important modifiable factors. The aim of this study is to identify census areas with high incidence of OHCA and low rates of bystander CPR in Victoria, Australia. We conducted an observational study using prospectively collected population-based OHCA data from the state of Victoria in Australia. Using ArcGIS (ArcMap 10.0), we linked the location of the arrest using the dispatch coordinates (longitude and latitude) to Victorian Local Government Areas (LGAs). We used Bayesian hierarchical models with random effects on each LGA to provide shrunken estimates of the rates of bystander CPR and the incidence rates. Over the study period there were 31,019 adult OHCA attended, of which 21,436 (69.1%) cases were of presumed cardiac etiology. Significant variation in the incidence of OHCA among LGAs was observed. There was a 3 fold difference in the incidence rate between the lowest and highest LGAs, ranging from 38.5 to 115.1 cases per 100,000 person-years. The overall rate of bystander CPR for bystander witnessed OHCAs was 62.4%, with the rate increasing from 56.4% in 2008-2010 to 68.6% in 2010-2013. There was a 25.1% absolute difference in bystander CPR rates between the highest and lowest LGAs. Significant regional variation in OHCA incidence and bystander CPR rates exists throughout Victoria. Regions with high incidence and low bystander CPR participation can be identified and would make suitable targets for interventions to improve CPR participation rates.
Bewket Tadesse Tiruneh
Full Text Available Background: Childhood unintentional injuries cause nearly 875,000 deaths each year. The aim of this study was to assess the prevalence and factors associated with unintentional injury of children presenting to the hospitals of Amhara Regional State, Ethiopia. Methods: In a hospital-based, cross-sectional study undertaken in one month, from April 1 to 30th 2016, 893 children less than 18Â years of age were included. Data were collected using an interviewer-administered questionnaire. Training was given to all data collectors and supervisors. Data was entered into EPI info version 7 and then exported to SPSS version 20, for further analysis. Results: Unintentional injury caused 62% (554 of all injuries in attending children. Several factors affected the likelihood of injuries, namely the age of the child, age of the parents or guardians, sex of the child, and whether the child lived with the parents. Modifiable factors were the childâs behaviour, awareness of danger, the childâs level of educational, if the childâs parent had received adequate injury counselling, and whether a child was left in the care of another child. The source of light in the house, and house floor material were also significant factors at pÂ <Â 0.05. Conclusion: The prevalence of unintentional injury was high. Many of the factors associated with injuries are modifiable and safety issues for children need urgent attention. Keywords: Unintentional injury, Paediatric, Ethiopia, Low resource
Del Valle-Mendoza, Juana; Casabona-Oré, Veronica; Petrozzi-Helasvuo, Veronica; Cornejo-Tapia, Angela; Weilg, Pablo; Pons, Maria J; Cieza-Mora, Erico; Bazán-Mayra, Jorge; Cornejo-Pacherres, Hernan; Ruiz, Joaquin
Bordetella pertussis is an important human pathogen that causes whooping cough (pertussis), an endemic illness responsible of significant morbidity and mortality, especially in infants and children. Worldwide, there are an estimated of 16 million cases of pertussis, resulting in about 195,000 child deaths per year. In Peru, pertussis is a major health problem that has been on the increase despite immunization efforts. The objective of this study was to determine the prevalence of B. pertussis among children under five years of age suspected to have whopping cough in Cajamarca, Peru. Children diagnosed with whooping cough admitted to the Hospital Regional de Cajamarca from August 2010 to July 2013 were included. Nasopharyngeal samples were obtained for B. pertussis culture and polymerase chain reaction (PCR) detection. In 133 children, the pertussis toxin and IS481 gene were detected in 38.35% (51/133) of the cases by PCR, while only 9.02% (12/133) of the Bordetella cultures were positive. The most frequent symptoms in patients with positive B. pertussis were paroxysm of coughing 68.63% (35/51), cyanosis 56.86% (29/51), respiratory distress 43.14% (22/51), and fever 39.22% (20/51). Pneumonia and acute bronchial obstructive syndrome were present in 17.65% (9/51) and 13.72% (7/51) of the cases, respectively. B. pertussis is responsible for an important proportion of whooping cough in hospitalized children in Cajamarca. Epidemiologic surveillance programs for B. pertussis are essential in Peru, especially in children who could most benefit from the vaccine.
Kljaić, Leposava; Borota, Radoslav
Dr Milenko Petrović was one of the very distinguished physicians in the history of Sombor city, who significantly contributed to the development of health care in Voivodina. His father Dimitrije was a professor in the High Teacher-training School in Sombor, recognized writer and politician of his epoch. He was born in Sombor in 1884, where he was educated and finished grammar school. For medical studies he moved to Budapest as a boarder of the famous Tekelianum, and graduated in 1908. He started specialisation in surgery, but being a great patriot he voluntarily recruited in the Serbian army to fight in Balkan liberation wars against Turkey. For his excellent work as a war surgeon he obtained many recognitions. After completing specialization in surgery in Debrecin, he returned to his native city Sombor, where he intended to practice as a physician, but because af the outbreak of the first world he was mobilized and sent to the front in Galicia. After the war he again returned to Sombor where he was immediatelly nominated for the main county physician and then begins his fruitful many year's work on the establishment and promotion of the health care in Sombor and broader territory. As the main county phsician he initiated the foundation and construction of the hospital in Sombor, because of high mortality rate among children, and spreading of contagious diseases like tuberculosis and trachoma. The construction of the hospital was completed in 1925 and Dr. Petrović was appointed its first director and this duty he performed for many years till the World War 2 in 1941. Under his management the hospital in Sombor became one of the best quality hospitals in the country and gave a big contribution to the promotion of health of the inhabitants of Voivodina. In spite of his extensive duties in the hospital. Dr. Milenko Petrović was very much engaged in social work, as the president of library "Laza Kosti ć". in the Soko association, Fire brigade, Rotary club, and he
Campos-Navarro, Roberto; Ruiz-Llanos, Adriana
Albert Schweitzer (1875-1965) was a young and promising German who at age 29 decided to undertake the profession of Medical Doctor at the University of Strassburg after finishing a career in musical studies in Paris (1899) and obtaining in Berlin a doctoral degree in Philosophy and Theology. Surprisingly, Albert Schweitzer, despite his comfortable life in Europe, decided in 1913 to practice his medical career in a remote and small Equatorial African country. He devoted nearly 50 years of his life caring for the Black population at Lamaberene, where he built a hospital. In this paper, we attempt to develop some theoretical aspects related with interculturality in the medical practice of Dr. Albert Schweitzer. We begin by considering certain sociocultural variables in hospitals that give care to patients with cultural characteristics that are substantially different from those of the health care personnel who organize, administer, and execute medical functions.
Oliva Ramos, Pamela; Universidad Señor de Sipán
El presente estudio Nivel de Satisfacción del Paciente Adulto Postoperado Respecto al Cuidado de Enfermería en Servicio de Cirugía del Hospital Regional de Lambayeque Chiclayo 2013, tuvo como objetivo: Determinar el nivel de satisfacción en el paciente adulto postoperado respecto al cuidado de enfermería en servicio de cirugía del Hospital Regional de Lambayeque Chiclayo 2013. El diseño metodológico fue de tipo cuantitativo descriptivo simple, se utilizó como instrumento el cuestionario tipo...
Jurke, A; Kock, R; Becker, K; Thole, S; Hendrix, R; Rossen, J; Daniels-Haardt, I; Friedrich, AW
Meticillin-resistant Staphylococcus aureus (MRSA) disseminates between hospitals serving one patient catchment area. Successful prevention and control requires concerted efforts and regional surveillance. Forty hospitals located in the German EUREGIO have established a network for combating MRSA. In
Geelen, Caroline MM van; Pennarun, Bodvael; Le, Phuong TK; Vries, Elisabeth GE de; Jong, Steven de
rhTRAIL is a therapeutic agent, derived from the TRAIL cytokine, which induces apoptosis in cancer cells by activating the membrane death receptors 4 and 5 (DR4 and DR5). Here, we investigated each receptor's contribution to rhTRAIL sensitivity and rhTRAIL resistance. We assessed whether agonistic DR4 or DR5 antibodies could be used to circumvent rhTRAIL resistance, alone or in combination with various chemotherapies. Our study was performed in an isogenic model comprised of the SW948 human colon carcinoma cell line and its rhTRAIL resistant sub-line SW948-TR. Effects of rhTRAIL and agonistic DR4/DR5 antibodies on cell viability were measured using MTT assays and identification of morphological changes characteristic of apoptosis, after acridine orange staining. Sensitivity to the different death receptor ligands was stimulated using pretreatment with the cytokine IFN-gamma and the proteasome inhibitor MG-132. To investigate the mechanisms underlying the changes in rhTRAIL sensitivity, alterations in expression levels of targets of interest were measured by Western blot analysis. Co-immunoprecipitation was used to determine the composition of the death-inducing signalling complex at the cell membrane. SW948 cells were sensitive to all three of the DR-targeting agents tested, although the agonistic DR5 antibody induced only weak caspase 8 cleavage and limited apoptosis. Surprisingly, agonistic DR4 and DR5 antibodies induced equivalent DISC formation and caspase 8 cleavage at the level of their individual receptors, suggesting impairment of further caspase 8 processing upon DR5 stimulation. SW948-TR cells were cross-resistant to all DR-targeting agents as a result of decreased caspase 8 expression levels. Caspase 8 protein expression was restored by MG-132 and IFN-gamma pretreatment, which also re-established sensitivity to rhTRAIL and agonistic DR4 antibody in SW948-TR. Surprisingly, MG-132 but not IFN-gamma could also increase DR5-mediated apoptosis in SW948
de Vries Elisabeth GE
Full Text Available Abstract Background rhTRAIL is a therapeutic agent, derived from the TRAIL cytokine, which induces apoptosis in cancer cells by activating the membrane death receptors 4 and 5 (DR4 and DR5. Here, we investigated each receptor's contribution to rhTRAIL sensitivity and rhTRAIL resistance. We assessed whether agonistic DR4 or DR5 antibodies could be used to circumvent rhTRAIL resistance, alone or in combination with various chemotherapies. Methods Our study was performed in an isogenic model comprised of the SW948 human colon carcinoma cell line and its rhTRAIL resistant sub-line SW948-TR. Effects of rhTRAIL and agonistic DR4/DR5 antibodies on cell viability were measured using MTT assays and identification of morphological changes characteristic of apoptosis, after acridine orange staining. Sensitivity to the different death receptor ligands was stimulated using pretreatment with the cytokine IFN-gamma and the proteasome inhibitor MG-132. To investigate the mechanisms underlying the changes in rhTRAIL sensitivity, alterations in expression levels of targets of interest were measured by Western blot analysis. Co-immunoprecipitation was used to determine the composition of the death-inducing signalling complex at the cell membrane. Results SW948 cells were sensitive to all three of the DR-targeting agents tested, although the agonistic DR5 antibody induced only weak caspase 8 cleavage and limited apoptosis. Surprisingly, agonistic DR4 and DR5 antibodies induced equivalent DISC formation and caspase 8 cleavage at the level of their individual receptors, suggesting impairment of further caspase 8 processing upon DR5 stimulation. SW948-TR cells were cross-resistant to all DR-targeting agents as a result of decreased caspase 8 expression levels. Caspase 8 protein expression was restored by MG-132 and IFN-gamma pretreatment, which also re-established sensitivity to rhTRAIL and agonistic DR4 antibody in SW948-TR. Surprisingly, MG-132 but not IFN
Determination of respiratory virus by RT-PCR in people with acute respiratory infection of the Area de Salud Pavas, Area de Salud Paraiso and Hospital Nacional de Ninos 'Dr. Carlos Saenz Herrera', in the period January 2012 to September 2012
Montero Bonilla, Andrei
Respiratory viruses are diagnosed through reverse transcriptase polymerase chain reaction (RT-PCR) in people with acute respiratory disease of the Area de Salud Pavas, Area de Salud Paraiso and Hospital Nacional de Ninos. The frequency of respiratory viruses are determined in the samples analyzed in the study population. The presence of viral coinfections is identified in the samples analyzed. The frequency of patients with respiratory viruses is categorized according to age in the study population. The frequency of respiratory viruses is examined between the studied geographic regions (Pavas and Paraiso). The results found by RT-PCR are compared with the frequency data reported with the direct immunofluorescence technique [es
and YouTube are apparently not that popular. Social Media accounts are not used at their full capacity and from the total number identified on each segment, not all have a direct reference from their own site, for in case of Facebook 31 out of 48, Twitter 7 out of 10 and YouTube 7 out of 10. The most important limitation is considered to be the consistency of the sample we used. We only investigated the hotels (rated 3 to 5 stars from the North-East region of Romania. A sample including all the hotels from Romania would have given a more realistic view of the use of Social Media in the hospitality industry. Another possible study limitation can be that the Social Media accounts may have been missed as it did not feature in the first three pages search results. The worst part is that the same mistake would be made by the potential customers searching for that hotel that is why we considered this error an acceptable one. As we made only a qualitative research, the results must be validated in a future research. The results of this research can be used by hotel managers and also by those who manage Internet websites. Business people who intend to enter on hospitality market might also be interested in this information. For the North-East region of Romania, during our documentation stage for this article, there was no study identified, similar to the one we realized. Also Romania, as a country where tourism industry it is in early stages of development, needs to benefit from this kind of research, for creating new strategies and implement best practices in the field.
require ICU level of care. S Afr J Crit Care 2017;33(1):12-14. ... at Dr George Mukhari Academic Hospital (DGMAH), Ga-Rankuwa,. SA. DGMAH is a ... day. The median length of ICU stay was 24 hours (range 1 - 17 days). Eighty-seven percent ...
Montgomery, Judy K.
This article is an interview with Dr. Pam Enderby--a speech language therapist and professor at the Institute of General Practice and Primary Care at the University of Sheffield, Community Sciences Centre, Northern General Hospital, in the United Kingdom--conducted by Judy Montgomery, Editor in Chief, of "Communication Disorders…
This article summarizes a seminar presented at a CIRDAP regional workshop in February 1998, on gender equity, poverty, rights, and participation. This seminar discussed India's experience with banks and financial policies. The recent East Asian crisis has shown that poverty eradication and sustainable development are not possible without an effective and transparent state that can play a catalytic, facilitating role and can increase and complement the activities of private businesses and individuals. The economy grows faster with a well diversified, efficient financial sector for promoting investment. Well developed, market oriented financial systems contribute to greater economic growth than weak and stringently regulated ones. Formal banks play a key role in meeting the growing needs of the economy and pursuing a social agenda. India, in 1991, reformed its banks which became more competitive and responsive to emerging challenges of a fast growing economy. India has an anti-poverty agenda that for the last 50 years promoted economic growth, offered wage assurance and self employment schemes, and provided a safety net for the poor. These schemes have met with varying success. For example, some operational constraints to credit in rural non-farm schemes were: the bank's perception that rural businesses were high risk and less profitable; poor infrastructure; and a slow process of credit delivery changes and skill upgrades for visible results. The author touches on other issues, such as the changing labor market, collateral substitutes, self-help concepts, venture capital, and integration of rural development programs within banking systems.
Triyanto, Endang; Kamaluddin, Ridlwan
Nurse activity can be seen at nursing documentation result. It's consist anamneses study, diagnose, planning, implementation and evaluation. Therefore nurse activity is one of quality service in hospital. This matter still need attention for nurse. The aim of this research was to know data motivate nurse to do nursing documentation in Prof. Dr. Margono Soekardjo Hospital of Purwokerto.Research study is survey with sectional cross. Research population is nurse take care of to lodge in RSUD Pro...
Utami, Ayu Rizki
One of the necessary for increasing the quality of health services in the hospital is the availability of good medical records implementation system. Achievement of the purpose of medical record implementation related to how the medical records are implemented. This research aimed to know the description of medical records implementation system in Dr. F. L. Tobing Public Hospital, Sibolga. Type of research was descriptive survey. Data retrieval was done in January 2011. T...
Wu, Lin-Chu; Maa, Suh-Hwa; Chung, Tieh-Chi; Huang, Kuei-Hsiang; Hsieh, Ming-Chu; Chen, Chiung-Hua
Professional autonomy often causes confusion in nursing staffs that limit their ability to perform to the best of their professional capabilities. Moreover, heavy and busy workloads reduce the energy available for work resulting in lower working efficiency and lower job satisfaction. This study explores the status and factors related to professional autonomy and job satisfaction in nurses. A cross-sectional design was used to target the nurses employed at a regional hospital in southern Taiwan. Data on locus of control, professional autonomy, and job satisfaction were collected for analysis. Data were collected from 207 nurses, with 196 valid responses (response rate: 94.69%). One hundred and forty-six subjects (74.5%) were found to have an internal locus of control personality type. Scores for both professional autonomy and job satisfaction were above the "moderate" level (averages: 3.37 and 3.32, respectively, on a maximum scale of 5). Social demographic differences contributed to the variance in professional autonomy and job satisfaction among participants. Professional autonomy was found to be positively associated with job satisfaction. The findings of this study indicate that nurses with an internal locus of control personality exhibit higher professional autonomy and job satisfaction and that higher professional autonomy is associated with higher job satisfaction.
Paxton, Mark; Heal, Clare F; Drobetz, Herwig
Cervical spine radiography may be over-utilised in an emergency department setting. The Canadian C-Spine Rule has been developed to reduce unnecessary radiography. Our aim was to retrospectively determine the proportion of cervical spine radiographs requested through the emergency department for trauma patients that were clinically indicated, according to the Canadian C-Spine Rule. This was a cross-sectional survey conducted at a regional centre in Northern Queensland, Australia. All cervical spine radiographs for trauma, performed at the Mackay Base Hospital from 1 January 2009 to the 31 December 2009, were reviewed. The relevant patient charts were audited for evidence of indications for radiography. Of 406 patients in the study, 155 patients (38%) (95% confidence interval 33.3%, 42.7%) had cervical spine imaging performed that was not indicated according to the Canadian C-Spine Rule. None of these patients had a significant cervical spine injury on radiography. Applying the Canadian C-Spine Rule would have safely reduced the incidence of cervical spine radiography by 38%. This would also reduce costs, patient morbidity and radiation exposure. © 2012 The Authors. Journal of Medical Imaging and Radiation Oncology © 2012 The Royal Australian and New Zealand College of Radiologists.
Nanteza, Martina; Tusiime, Jayne B; Kalyango, Joan; Kasangaki, Arabat
The aim of this study was to determine the prevalence of Human Immune Virus (HIV) related oral lesions and their association with Cluster of Differentiation 4 (CD4+) count among treatment naïve HIV positive patients. This was a descriptive and analytical cross sectional study. Participants were 346 treatment naïve HIV positive adult patients. These were consecutively recruited from Hoima Regional Referral hospital between March and April 2012. Data collection involved interviews, oral examinations and laboratory analysis. A total of 168(48.6%) participants had oral lesions. The four commonest lesions were oral candidiasis (24.9%, CI = 20.6-29.7%), melanotic hyperpigmentation (17.3%, CI = 13.7-21.7%), kaposi sarcoma (9.3%, CI = 6.6-12.8%) and Oral Hairy Leukoplakia (OHL) (5.5%, CI = 3.5-8.4%). There was significant association between oral candidiasis and immunosuppression measured as CD4+ less than 350 cells/mm3 (OR = 2.69, CI = 1.608-4.502, p Oral candidiasis was the only oral lesion significantly predictive of immunosuppression (OR = 2.56, CI = 1.52-4.30, p Oral candidiasis can be considered as a marker for immunesuppression, making routine oral examinations essential in the management of HIV positive patients.
Full Text Available Objectives: Rabies is one of the highest mortality ratesinfectious disease. The aim was the evaluation of the patientswho admitted to The Batman Regional State HospitalEmergency Service with suspect of rabies in the datesbetween June 2011 and November 2011.Materials and methods: Totally, 166 cases who admittedto our center was recorded according to the followingdata: place of residence (rural/urban, contact type andwound information, time after the contact, whether vaccineor immunoglobulin is applied or not and also the species,breed and being owned of suspected animal.Results: Our study population consisted of a total of 166cases including 38 women (23%, 128 men (77% withthe mean age of 22.01 ± 17.90 years. Of all subjects, 105(63% lived in urban and 61 (37% lived in rural areas.Eighty-five percent of suspicious animals (51% had anowner, while 81 animals were unattended.Conclusions: Our results showed that all admitted patientswere vaccinated and the ones contacted with petsor had a surface wound were vaccinated with 3 doses.Moreover, since the 49% of our cases were contactedwith animals which cannot be follow-up, our study obviouslyreveals that in our country deficiencies in the controlof waifs still is a public health problem and increases thecost of vaccination. J Clin Exp Invest 2012; 3 (3: 383-386Key words: Rabies, suspected bite, rabies prophylaxis
Gani, Linsey; Reddy, Saripalli K; Alsuwaigh, Rayan; Khoo, Joan; King, Thomas F J
This study aims at assessing the gap in secondary fracture prevention at a regional general hospital setting in Singapore. Male patients have significantly lower rate of being investigated and treated for osteoporosis than their female counterparts. Vitamin D deficiency is prevalent in our population. Secondary fracture prevention services are not routine in Singapore; we seek to assess the treatment gap that exists in the lack of diagnosis and treatment of osteoporosis in fragility fracture patients. We performed a retrospective analysis of all admissions for fragility fractures between December 2013 and December 2014. Demographic data, rates of BMD performance, serum vitamin D investigation and calcium and vitamin D supplementation as well as antiresorptive initiation 1 year post admission were analysed. There were 125 fragility fractures in patients below 65 and 615 fractures in older patients. There was a slightly higher proportion of males in the younger population, whereas females predominated in the older population. Median vitamin D levels were low in both younger (19.1 μg/L) and older (22.0 μg/L) groups, but supplementation was lower in younger patients (4.8 versus 16.6%, p = 0.003). Rate of BMD performance was lower in younger patients (34.4 versus 64.6%, p Singapore. Male osteoporosis remains inadequately investigated and treated in both age groups.
Lo, Siu-Fai; Spurgeon, Peter
The Accreditation Council for Graduate Medical Education and European working time directive have restricted residents' workweek to 80 and 48 hours, respectively. Impacts on resident's training and health services are under evaluation in western countries. However, relevant studies are deficient in Hong Kong. Surgeons in a regional hospital of Hong Kong were recruited. Opinions were collected by semi-structured questionnaire. Response rate was 82%. Most respondents agreed that residents' work hours should be limited. Seventy-two percent thought that the addition of physician assistants, nurse practitioners and ancillary staff could help decrease the workload of residents. More than 60% thought that residents should have post-call afternoon off. Seventy-two percent worried that the number of operations residents performed would decrease. Only half agreed that long work hours was part of resident training and 56.3% agreed that the training period should be lengthened because of limiting work hours. Ninety-four percent agreed that sleep-deprived residents would create more medical errors; 72% thought that long work hours would impair quality of care. Surprisingly, only 28% thought that limiting work hours would compromise continued patient care. Most respondents opine that resident work hours should be regulated and welcome minor rescheduling of residents' workflow. The impacts on residents' training and patient care require further evaluation.
De Jesus, M.; Trujillo-Zamudio, F. E.
A building project of Radiotherapy and Nuclear Medicine services (diagnostic and therapy), within an Integral Oncology Center (IOC), requires interdisciplinary participation of architects, biomedical engineers, radiation oncologists and medical physicists. This report focus on the medical physicist role in designing, building and commissioning stages, for the final clinical use of an IOC at the Oaxaca High Specialization Regional Hospital (HRAEO). As a first step, during design stage, the medical physicist participates in discussions about radiation safety and regulatory requirements for the National Regulatory Agency (called CNSNS in Mexico). Medical physicists propose solutions to clinical needs and take decisions about installing medical equipment, in order to fulfill technical and medical requirements. As a second step, during the construction stage, medical physicists keep an eye on building materials and structural specifications. Meanwhile, regulatory documentation must be sent to CNSNS. This documentation compiles information about medical equipment, radioactivity facility, radiation workers and nuclear material data, in order to obtain the license for the linear accelerator, brachytherapy and nuclear medicine facilities. As a final step, after equipment installation, the commissioning stage takes place. As the conclusion, we show that medical physicists are essentials in order to fulfill with Mexican regulatory requirements in medical facilities.
Gandiya, Tariro; Dua, Anahita; King, Gerry; Mazzocco, Thomas; Hussain, Amir; Leslie, Stephen J
This study assessed the perceived usage of, and attitudes toward, communication technologies (mobile phone and texting, e-mail, and the World Wide Web) in patients attending a cardiology clinic with a view to guiding future health service redesign. This was performed in a remote regional hospital serving both urban and rural populations. A self-completion questionnaire was completed by a convenience sample of 221 patients attending a general cardiology clinic. The questions asked about patients' access to and use of technology at home. Data collected also included age, gender, travel time to the clinic, mode of travel, and whether the respondent was accompanied to the clinic. Appropriate statistical tests were used with significance taken at the 0.05 level. Age was the strongest predictor of use of communication technologies, with younger patients more likely to use e-mail, Web, mobile phone, and texting. However, frequency of use of e-mail was not related to age. It is encouraging that over 99% of patients used at least one communication technology. This study has highlighted that there may be several potential barriers to the widespread implementation of communication technologies in general cardiology patients. Cognizance should be taken of these findings when attempting service redesign.
Pérez Albacete, Mariano
With the celebration of the centenary of the birth of Dr. Luis Cifuentes Delatte, due to his great scientific personality, we want to emphasize two features that, taken from his works and memories, we consider have not been emphasized enough: his role as historian of urology, both for the histories he narrated of his life experiences and the historical exposition of several pathologies, and also his teaching as professor of several generations of urologists, with the objective of trying to get to know his great human quality as he demonstrated over his life and showed in his writings. We review his books and works, lectures and published papers, in addition the news about his person we have collected from the media, and after analysis, mainly of his memories, we extract data reflecting his personality, and they way he thought and behaved. Since he was young he went with his father to the international urology meetings where he met a great number of personalities in the World of Urology; he extended his training with them, and later on they got to have a great relationship. He travelled around Europe and United States before and after Second World War, respectively, with stays in the most prestigious centers, which he described meticulously. He also reported his activity during the first two years he directed the Department of Urology at the Hospital La Princesa in Madrid and cited the series of collaborators he had. In his research works he made an ample description of historical development as introduction to the various pathologies he analyzed in depth. The reading of the narration of his trips, that he did in the convulse International time he lived, offers details which enable us to know firsthand the situation of urology and the human side of the actors he had relation with, and the social life they had, in addition to data about their families and daily life. As a researcher in transcendental chapters in urological pathology we emphasize his historical
Mazeyra Guillén, Alvaro Augusto
El presente estudio tuvo como objetivos determinar el estrés laboral en los médicos residentes del Hospital “Carlos Alberto Seguín Escobedo” de EsSalud (HNCASE). y del Hospital Regional “Honorio Delgado Espinosa” (HRHDE) y establecer las semejanzas y diferencias del estrés laboral de los médicos residentes de ambos hospitales. La población estuvo conformada por 220 médicos residentes de primero, segundo y tercer año de residencia. Se aplicó el muestreo al azar estratifica...
van Geelen, Caroline M. M.; Pennarun, Bodvael; Le, Phuong T. K.; de Vries, Elisabeth G. E.; de Jong, Steven
Background: rhTRAIL is a therapeutic agent, derived from the TRAIL cytokine, which induces apoptosis in cancer cells by activating the membrane death receptors 4 and 5 (DR4 and DR5). Here, we investigated each receptor's contribution to rhTRAIL sensitivity and rhTRAIL resistance. We assessed whether
The members of the Peenemuende team and their family members were awarded the United States citizenship on April 14, 1955. Pictured here is Dr. Ernst Stuhlinger (middle) and Dr. Wernher von Braun signing U.S. citizenship certificates. Martin Schilling is at left.
Blogindlæg om Machiavelliske følelser i HBO tv-serien Game of Thrones: "Dræb, dræb, dræb! Nej ... liiiige et øjeblik: De machiavelliske følelser i Game of Thrones"......Blogindlæg om Machiavelliske følelser i HBO tv-serien Game of Thrones: "Dræb, dræb, dræb! Nej ... liiiige et øjeblik: De machiavelliske følelser i Game of Thrones"...
Jovananović, Svetlana; Milovanović, Srdjan; Zagradjanin, Danica; Milovanović, Nebojša; Puzović, Dragana
This paper describes the life and work of Dr. Atanasije Puljo (1878-1944). He was a volunteer in the Balkan wars, an active participant in the First World War; he was the first who noted the importance of team-work of a dentist and a surgeon in the care of jaw and facial injuries. He established primacy in this field, as he came up with this brilliant idea three years before other colleagues. His method of treatment of the upper jaw neglected fractures, called the Balkan method, was recognized worldwide. Dr. Puljo is the pioneer of dental radiology in Serbia, founder of the Odontology Clinic of the Medical Faculty and main supporter of the establishment of the School of Dentistry. Merits of Dr. Atanasije Puljo, medical practitioner with a broad knowledge in different fields, remain within the academic institution that was founded by this pioneer of dentistry in Serbia.
Full Text Available Dr. Willy Lens, born on December 10th, 1943, passed away on August 29th, 2014. With his passing, the motivation community has lost a seminal member, a mentor, and a friend. Dr. Lens – a Fellow of the Association for Psychological Science and Founding Fellow of the American Educational Research Association – made fundamental contributions to the study of motivation both through his own work and through his caring and thoughtful mentorship of a large community of scholars. With this tribute, we want to honor Dr. Willy Lens’ significance to psychology and education as well as his positive influence, both personally and professionally, on the lives of dozens of scholars. With his contagious enthusiasm and caring mentorship, Willy was an example for our academic community and with this tribute we express our gratitude for the privilege to have collaborated with him.
Photo 01: Dr. David Syz (left) with Professor Roger Cashmore, Research Director for Collider Programmes.Photo 02: Dr. David Syz signing the VIP visitors' book, with Prof. Roger Cashmore.Photo 03: Dr. David Syz signing the VIP visitors' book.Photo 04: Handshake between Dr. David Syz (left) and Prof. Roger Cashmore.
In 2002-2003, the practice of doctors lending their names to appear as "staff" of hospitals became known. Problems regarding funds from public hospitals were also revealed. Tohoku University asked regional societies how to improve the medical situation, and redefined its responsibilities. The Educational Development Center for Local Medicine and Department of Local Medical Service System were set up (2005-2008). A severe shortage of medical doctors prevails in Japan: the number of doctors per population is at the 4th lowest among OECD countries, and the number per hospital bed is the lowest. We have no nursing homes whose beds are not counted as hospital beds. The number of faculty staff in Japanese medical schools is 1/3 to those of Western countries. The reported number of doctors working in hospitals and offices surpasses that by census for medical doctors by >40,000. Japanese doctors work for >60 hours per week. I propose essential plans to improve Japanese situation for medical service: 1. Immediately increase the number of doctors by at least 50%. Based on our calculation, we need 450,000 doctors. 2. When the shortage of doctors is severe, establish a magnet hospital with c.a. 500 beds for every 200,000 population, capable of treating highly emergency patients and attracting doctors who need medical training. Hospitals should not belong to each city or town. 3. Establish a comprehensive organization to nurture doctors on a long-term basis. It should consist of a medical school, hospitals, and the prefectural government. It should help doctors to move between hospitals, and be responsible both for designing doctors' career paths and for allocating them appropriately.
Ronald J. Ajcalon
Full Text Available La insuficiencia renal aguda, es una condición común en la Unidad de Cuidados Intensivos de Adultos (UCIA y probablemente una consecuencia de la enfermedad crítica que se asocia a resultados clínicos adversos, altos costos y una mortalidad de más del 50%, sobre todo si se requiere tratamiento de reemplazo renal. El objetivo fue determinar la incidencia de insuficiencia renal aguda en pacientes ingresados a la UCIA. El estudio fue prospectivo, longitudinal, observacional, en 101 pacientes ingresados en la UCIA del Hospital Regional de Cuilapa. Se diagnosticaron 101 pacientes durante el periodo de estudio con insuficiencia renal aguda represento el 27.4% del total de pacientes internados (368 en el servicio en un año. La incidencia de mortalidad en pacientes que requieren terapia de reemplazo renal y se encuentran en ventilación mecánica es del 100%. Del total de pacientes estudiados, según la escala Akin, se encontró que el 49.5% de los pacientes correspondían a grado II, aunque el grado I también fue frecuente (29%, y que el 22 % de los pacientes correspondían a grado III. La patología que mayormente se asoció al desarrollo de insuficiencia renal aguda fue sepsis grave con un 31%, seguido de pacientes sometidos a cirugía mayor e hipovolemia con el 21 y 18% respectivamente. Se halló una incidencia aumentada de insuficiencia renal aguda comparado con estadísticas internacionales, cuya etiología fue mayormente causada por procesos sépticos.
Haynes, Emma; Hohnen, Harry; Katzenellenbogen, Judith M; Scalley, Benjamin D; Thompson, Sandra C
Translation of evidence into practice by health systems can be slow and incomplete and may disproportionately impact disadvantaged populations. Coronary heart disease is the leading cause of death among Aboriginal Australians. Timely access to effective medical care for acute coronary syndrome substantially improves survival. A quality-of-care audit conducted at a regional Western Australian hospital in 2011-2012 compared the Emergency Department management of Aboriginal and non-Aboriginal acute coronary syndrome patients. This audit is used as a case study of translating knowledge processes in order to identify the factors that support equity-oriented knowledge translation. In-depth interviews were conducted with a purposive sample of the audit team and further key stakeholders with interest/experience in knowledge translation in the context of Aboriginal health. Interviews were analysed for alignment of the knowledge translation process with the thematic steps outlined in Tugwell's cascade for equity-oriented knowledge translation framework. In preparing the audit, groundwork helped shape management support to ensure receptivity to targeting Aboriginal cardiovascular outcomes. Reporting of audit findings and resulting advocacy were undertaken by the audit team with awareness of the institutional hierarchy, appropriate timing, personal relationships and recognising the importance of tailoring messages to specific audiences. These strategies were also acknowledged as important in the key stakeholder interviews. A follow-up audit documented a general improvement in treatment guideline adherence and a reduction in treatment inequalities for Aboriginal presentations. As well as identifying outcomes such as practice changes, a useful evaluation increases understanding of why and how an intervention worked. Case studies such as this enrich our understanding of the complex human factors, including individual attributes, experiences and relationships and systemic factors
Bentubo, Henri Donnarumma Levy; Mantovani, Ariane; Yamashita, Jane Tomimori; Gambale, Walderez; Fischman, Olga
The knowledge of the diversity of yeasts that make up the skin microbiota of human beings is essential for the efficient monitoring of infections to which a person may be predisposed. This study identified yeasts comprising the genital skin microbiota of patients attending the Dermatology Service at the Hospital São Paulo-UNIFESP, Brazil. Samples were collected from the genital region of each patient and cultured on Sabouraud dextrose agar. Individual colonies were carefully transferred to tubes daily. Yeasts were identified based on classical methodologies and confirmed using a commercial kit. Eighty-three patients were included in the study. Approximately 80% were women and 20% were men. The average age was 55 years. Hypertension, diabetes, kidney transplant and AIDS were the main underlying diseases reported by the patients. The most prevalent yeasts were Candida parapsilosis (36.1%), Rhodotorula mucilaginosa (9.2%), Rhodotorula glutinis (8.3%), Candida tropicalis (5.5%) and Trichosporon inkin (1.8%). Approximately 78% of the isolates were obtained in pure cultures. Trichosporon inkin was isolated only from women, in contrast to literature describing a high prevalence in males. Our results suggest that Candida albicans is not the main yeast found on genital skin as previously thought, and opportunistic pathogens such as C. parapsilosis, C. tropicalis, Rhodotorula spp. and T. inkin make up the genital skin microbiota, representing a risk for infection in immunocompromised subjects. These results also indicate that women are carriers of T. inkin, the etiological agent of white piedra and trichosporonosis. Copyright © 2013 Revista Iberoamericana de Micología. Published by Elsevier Espana. All rights reserved.
J. Jhonnel Alarco
Full Text Available Objetivo, Determinar algunas características epidemiológicas de la enfermedad cerebro vascular (ECV, describir las características de la población estudiada según sexo, edad, procedencia, raza, forma de inicio, ubicación, tipos y subtipos, síntomas, antecedentes patológicos y mortalidad intrahospitalaria. Materiales y métodos, estudio descriptivo. Lugar, Hospital Regional Docente de Ica. Criterios de inclusión, pacientes ingresados con diagnóstico de accidente cerebrovascular. Intervenciones, revisión de historias clínicas de archivo entre los años 2003 y 2006 Principales medidas de resultados, análisis estadístico, porcentajes y medidas de tendencia central, tabuladas en una base de datos con ayuda del programa Microsoft Excel 2003 para Windows®. Resultados, de 152 pacientes ingresados al servicio de Medicina 119 fueron casos de ECV isquémico, 33 casos fueron ECV hemorrágico. El principal antecedente patológico fue la hipertensión arterial con un 75.0 %. El síntoma más frecuente fue el trastorno motor con 80.3% seguido por alteraciones del lenguaje con 55.9%. El mayor número fue encontrado entre la séptima y octava décadas de la vida. La edad mínima fue de 17 y máxima de 102 años. La mortalidad global fue de 18 casos obteniéndose una tasa de letalidad específica para el ECV isquémico de 0,8% y de 51,5% para el ECV hemorrágico. Conclusiones: Se distingue a la HTA como el principal antecedente modificable, cuya prevención reduciría notablemente su mortalidad.
Full Text Available Objective: Translation of evidence into practice by health systems can be slow and incomplete and may disproportionately impact disadvantaged populations. Coronary heart disease is the leading cause of death among Aboriginal Australians. Timely access to effective medical care for acute coronary syndrome substantially improves survival. A quality-of-care audit conducted at a regional Western Australian hospital in 2011–2012 compared the Emergency Department management of Aboriginal and non-Aboriginal acute coronary syndrome patients. This audit is used as a case study of translating knowledge processes in order to identify the factors that support equity-oriented knowledge translation. Methods: In-depth interviews were conducted with a purposive sample of the audit team and further key stakeholders with interest/experience in knowledge translation in the context of Aboriginal health. Interviews were analysed for alignment of the knowledge translation process with the thematic steps outlined in Tugwell’s cascade for equity-oriented knowledge translation framework. Results: In preparing the audit, groundwork helped shape management support to ensure receptivity to targeting Aboriginal cardiovascular outcomes. Reporting of audit findings and resulting advocacy were undertaken by the audit team with awareness of the institutional hierarchy, appropriate timing, personal relationships and recognising the importance of tailoring messages to specific audiences. These strategies were also acknowledged as important in the key stakeholder interviews. A follow-up audit documented a general improvement in treatment guideline adherence and a reduction in treatment inequalities for Aboriginal presentations. Conclusion: As well as identifying outcomes such as practice changes, a useful evaluation increases understanding of why and how an intervention worked. Case studies such as this enrich our understanding of the complex human factors, including
Floyd, Liz; Bryce, Fiona; Ramaswamy, Rohit; Olufolabi, Adeyemi; Srofenyoh, Emmanuel; Goodman, David; Pearson, Nancy; Morgan, Kerry; Tetteh, Cecilia; Ahwireng, Victoria; Owen, Medge
to introduce and embed a midwife-led obstetric triage system in a busy labour ward in Accra, Ghana to improve the quality of care and to reduce delay. the study utilized a participatory action research design. Local staff participated in baseline data collection, the triage training course design and delivery, and post-training monitoring and evaluation. a regional referral hospital in Accra, Ghana undertaking 11,032 deliveries in 2012. all midwives and medical staff. measurements included maternal health outcomes, observations of labour ward activity, structured assessments of midwife actions during admission, waiting times, focus group discussions, and learning needs assessments which informed the course content. During training, two quality improvement tools were developed; coloured risk acuity wristbands and a one page triage assessment form. Participants measured compliance and accuracy in the use of these tools following course completion. initially, no formal triage system was in place. The environment was chaotic with poor compliance to existing protocols. Sixty-two midwives received triage training between 2013 and 2014. Two Triage Champions became responsible for triage implementation, monitoring and further training. Following training, the 'in-charge' midwives recorded a cumulative average of 83.4% of women wearing coloured wristbands. A separate audit by the Triage Champions found that 495/535 (93%) of the wristbands were correctly applied based on the diagnosis. Quarterly monitoring of the triage assessment forms by Kybele trainers, showed that 92% recorded the risk acuity colour, 85% a 'working diagnosis' and 82% a 'plan.' Median (interquartile range) waiting times were reduced from 40 (15-100) to 29 (11-60) minutes (p = 007). Twenty of 25 of the staff reported that the wristbands were helpful. an interactive triage training course led to the development of a triage assessment form and the use of coloured patient wristbands which resulted in delay
Full Text Available La anemia es un problema de salud pública a nivel mundial. En Paraguay, existen datos limitados sobre la frecuencia de anemia en mujeres en edad reproductiva no gestantes. Este estudio piloto descriptivo de corte transverso tuvo como objetivo determinar la frecuencia de anemia y deficiencia de hierro, el estado nutricional, hábitos alimentarios y tóxicos en 99 mujeres no gestantes en edad reproductiva de 18 a 48 años que acudieron al Hospital Regional de Villa Hayes en Octubre del 2.014. La anemia se determinó tomando como punto de corte una concentración de hemoglobina <12 g/dL. La deficiencia de hierro se evaluó según la saturación de la transferrina. Además, se evaluó el índice de masa corporal (IMC y los hábitos nutricionales a través de una encuesta. La frecuencia de anemia fue de 15,1% (IC95% 8,7-23,8%, de éste el 33,3% (IC95% 12,8-61,6% correspondió a anemia ferropénica. Se observó asociación entre la presencia de anemia y los niveles disminuidos tanto del hematocrito (<38% como del número de glóbulos rojos (<4,2x 106/uL. Todas las mujeres con anemia ferropénica tenían peso <64 kg e IMC <24,5 kg/m2. Además, se detectó una alta frecuencia de sobrepeso y obesidad (45,4%, alto consumo de grasas, y bajo consumo de legumbres, frutas y verduras. A partir de estos resultados, se sugiere mantener la vigilancia e implementar programas que incluyan a estas mujeres, tanto para evitar deficiencias nutricionales como excesos.
Else Toft Würtz
Full Text Available Abstract Background In recent years, livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA multi locus sequence type CC398 has spread widely in the livestock production in Europe. The rates of LA-MRSA in hospitals have been found to be largely determined by contact to and density of livestock in the area. Methods This is a cross sectional study of the prevalence of LA-MRSA among hospital staff in a Danish hospital situated in a livestock production region. We analysed nasal swabs, air and dust samples for the presence of MRSA using PCR and mass spectrometry. Results Of 1745 employees, 545 (31% contributed nasal swabs. MRSA was not detected in any participant, nor was it detected in air or dust at the hospital or in houses of employees living on farms. Four percent of the participants had contact to pigs either directly or through household members. LA-MRSA was detected in two of 26 samples from animal sheds, both of them from pig farms. The participation rate was relatively low, but participants were representative for the source population with regards to animal contact and job titles. Conclusions The study suggests a low point prevalence of LA-MRSA carriage in Danish hospital staff even in regions where livestock production is dense. Should more studies confirm our findings we see no need for additional hospital precautions towards LA-MRSA in Denmark at the moment. We think that our data might reduce potential stigmatization of hospital workers with contact to LA-MRSA positive farms at their work places and in their communities.
Nakanishi, Miharu; Niimura, Junko; Yamasaki, Syudo; Nishida, Atsushi
Japan designates psychiatric inpatient care for behavior management of individuals with dementia and for helping dementia patients discharge to home. However, there has been no examination of the effectiveness of this strategy. The present study investigated the association between dementia and the discharge destination of patients in psychiatric hospitals. Data from the National Patient Survey, which is a nationally representative cross-sectional survey of inpatient care, were used. The 96,420 patients with dementia or other mental illness who were discharged from psychiatric hospitals in September of every 3 years from 1996 to 2014 were included in analyses. Of the 96,420 discharged patients, 13,823 had dementia as the primary disease. Of the 13,823 dementia patients, 3,865 (28.0%) were discharged to home, 3,870 (28.0%) were admitted to a facility or other care settings, 3,574 (25.9%) were admitted to another hospital, and 2,514 (18.2%) died. Patients were more likely to die in psychiatric hospital if their primary disease was dementia, and they had resided in a region that provided fewer home visits for psychiatric nursing care or had available a larger number of psychiatric hospital beds per capita. Psychiatric inpatient care may be ineffective as a treatment for the challenging behaviors of dementia. A community mental health system for behavior management should be constructed in parallel with a reduction in the number of hospital beds allotted for psychiatric care.