WorldWideScience

Sample records for university hospital patients

  1. Universal isolation precautions for patients at an academic hospital

    Maziero,Vanessa Gomes; Vannuchi,Marli Terezinha Oliveira; Vituri,Dagmar Willamourius; Haddad,Maria do Carmo Lourenço; Tada,Cristiane Nakaya

    2012-01-01

    OBJECTIVE: To apply universal isolation precautions for patients at an academic hospital by a nursing team. METHODS: This descriptive and prospective study used data from advice service of quality control and nursing care that were gathered in observational reports of universal isolation precautions for patients admitted in two surgical inpatient units during 2008 and 2010. RESULTS: The mean general classification for both units was between desirable and adequate in the observational analysis...

  2. Review of thromboembolic prophylaxis in patients attending Cork University Hospital.

    Byrne, Stephen; Weaver, Daniel Timothy

    2013-06-01

    Although preventable, venous thromboembolism remains a common cause of hospital acquired morbidity and mortality. Guidelines, such as the one produced by the American College of Chest Physicians (ACCP), are aimed at reducing hospital associated venous thromboemboli. Unfortunately the majority of studies have revealed inadequate adherence to these guidelines. The objective of this study was to evaluate the use of venous thromboembolism prophylaxis at Cork University Hospital. Cork University Hospital, Wilton, Cork, Ireland. Data from the patient's chart, drug kardex and laboratory results were recorded during April 2010. A Caprini score, a venous thromboembolism risk factor assessment tool, was subsequently calculated for each patient based on data collected. Appropriate prophylaxis was determined after examining data collected, Caprini score and prophylactic regime according to the ACCP 8th edition guidelines. Primary outcome was to analyse adherence to VTE prophylaxis guidelines. A total of 394 patients met the inclusion criteria and were reviewed, of which, 60% (n = 236) were medical and 37% (n = 146) were surgical patients. In total 63% of patients received some form of venous thromboembolism prophylaxis. Furthermore, 54% of medical and 76% of surgical patients received prophylaxis. However only 37% of the patients studied received appropriate thromboprophylaxis according to the ACCP 8th edition guidelines (Geerts et al. in chest 133(6 Suppl):381S-453S, 2008). Additionally 51% of surgical and 27% of medical patients received appropriate prophylaxis. Data collected from Cork University Hospital revealed poor adherence to international venous thromboembolism prophylaxis guidelines. As stated in the ACCP 8th edition guidelines, every hospital should develop a formal strategy for venous thromboembolism prevention (Geerts et al. in chest 133(6 Suppl):381S-453S, 2008). In order to improve adherence to guidelines, Cork University Hospital should develop, implement and

  3. A survey on postanesthetic patient satisfaction in a university hospital

    Adel Ali Alshehri

    2015-01-01

    Full Text Available Background and Objectives: Patient satisfaction after anesthesia is an important outcome of hospital care. The aim is to evaluate the postoperative patient satisfaction during the patient stay at King Khalid University Hospital in Riyadh, Saudi Arabia. Patients and Methods: Three hundred and fifty-three patients who underwent surgery under general/regional anesthesia were surveyed. They were interviewed face to face on the first postoperative day. We recorded pain and pain controls in addition to some common complication of anesthesia like nausea and vomiting (postoperative nausea and vomiting as a parameter to assess the rate of patient′s satisfaction. Results: The overall level of satisfaction was high (95.2%; 17 (4.8% patients were dissatisfied with their anesthetic care. There was a strong relation between patient dissatisfaction and: (i Patients with poor postoperative pain control 13 (12.4%, (ii patients with moderate nausea 8 (11.1% and (iii patients with static and dynamic severe pain 6 (21.4. Several factors were associated with dissatisfaction can be prevented, or better treated. Conclusion: We concluded that the patient satisfaction was high. Postoperative visit should be routinely performed in order to assess the quality and severity of postoperative pain, nausea and vomiting and the other side-effects postoperatively.

  4. The role of expectations in patients' hospital assessments: a Turkish university hospital example.

    Bakar, Coskun; Akgün, H Seval; Al Assaf, A F

    2008-01-01

    This paper aims to conduct a preliminary assessment of patient attitudes regarding important aspects of service dimensions using SERVQUAL. The SERVQUAL scale is routinely used at the Baskent University Hospitals Network, Turkey. The study consisted of 550 randomly chosen patients who presented to any member of the hospital network during January and February 2006 and received treatment as inpatients or outpatients at those healthcare facilities. The patients' perceived scores were higher than expected for an ordinary hospital but lower than expected for a high-quality hospital. Young patients had a high-expected service score gap and a low adequate service score difference. Highly educated patients had a high-expected service score difference. Uninsured patients had a low adequate service score difference. Baskent University multidisciplinary healthcare teams have performed periodic patient satisfaction surveys in order to identify strengths and problem areas, formulate the quality improvement objectives and monitor progress towards achieving these objectives. However, patient satisfaction survey results are often highly positive. In these cases, improving care is not easy because measures are not sensitive enough to changes. Therefore a more sensitive measurement tool based on the SERVQUAL scale was developed. The authors believe that patient opinions are extremely important because they provide information that is not necessarily emphasized by managers or health care professionals, resulting in a more complete assessment of past performance and a clearer road map for future action.

  5. [Screening for malnutrition among hospitalized patients in a Colombian University Hospital].

    Cruz, Viviana; Bernal, Laura; Buitrago, Giancarlo; Ruiz, Álvaro J

    2017-04-01

    On admission, 30 to 50% of hospitalized patients have some degree of malnutrition, which is associated with longer length of stay, higher rates of complications, mortality and greater costs. To determine the frequency of screening for risk of malnutrition in medical records and assess the usefulness of the Malnutrition Screening Tool (MST). In a cross-sectional study, we searched for malnutrition screening in medical records, and we applied the MST tool to hospitalized patients at the Internal Medicine Wards of San Ignacio University Hospital. Of 295 patients included, none had been screened for malnutrition since hospital admission. Sixty one percent were at nutritional risk, with a higher prevalence among patients with HIV (85.7%), cancer (77.5%) and pneumonia. A positive MST result was associated with a 3.2 days increase in length of hospital stay (p = 0.024). The prevalence of malnutrition risk in hospitalized patients is high, but its screening is inadequate and it is underdiagnosed. The MST tool is simple, fast, low-cost, and has a good diagnostic performance.

  6. Assessment of Patient Safety Friendly Hospital Initiative in Three Hospitals Affiliated to Tehran University of Medical Sciences

    Firoozeh Bairami

    2016-01-01

    Full Text Available Introduction: The aim of this study was to assess the status of patient safety in three hospitals, affiliated to Tehran University of Medical Sciences, based on the critical standards of Patient Safety Friendly Hospital Initiative (PSFHI. Materials and Methods:In this cross-sectional study, conducted in 2014, we used PSFHI assessment tool to evaluate the status of patient safety in three hospitals, affiliated to Tehran University of Medical Sciences; these general referral hospitals were selected purposefully. PSFHI assessment tool is comprised of 140 patient safety standards in five domains, categorized in 24 sub-domains. The five major domains include leadership and management, patient and public involvement, safe evidence-based clinical practices, safe environment, and lifelong learning. Results: All three hospitals met more than 70% of the critical standards. The highest score in critical standards (> 80% was related to the domain of leadership and management in all hospitals. The average score in the domain of safe evidence-based clinical practices was 70% in the studied hospitals. Finally, all the hospitals met 50% of the critical standards in the domains of patient and public involvement and safe environment. Conclusion: Based on the findings, PSFHI is a suitable program for meeting patient safety goals. The selected hospitals in this survey all had a high managerial commitment to patient safety; therefore, they could obtain high scores on critical standards.

  7. Sepsis in a university hospital: a prospective study for the cost analysis of patients' hospitalization.

    Barreto, Maynara Fernanda Carvalho; Dellaroza, Mara Solange Gomes; Kerbauy, Gilselena; Grion, Cintia Magalhães Carvalho

    2016-04-01

    To estimate the cost of hospitalization of patients with severe sepsis or septic shock admitted or diagnosed in the Urgent and Emergency sector at a university hospital and followed until the clinical outcome. An epidemiological, prospective, observational study conducted in a public hospital in southern Brazil for the period of one year (August 2013 to August 2014). Sepsis notification forms, medical records and data of the cost sector were used for the collection of clinical and epidemiological data. The sample comprised 95 patients, resulting in a total high cost of hospitalization (R$ 3,692,421.00), and an average of R$ 38,867.60 per patient. Over half of the total value of the treatment of sepsis (R$ 2,215,773.50) was assigned to patients who progressed to death (59.0%). The higher costs were related to discharge, diagnosis of severe sepsis, the pulmonary focus of infection and the age group of up to 59 years. The high cost of the treatment of sepsis justifies investments in training actions and institution of protocols that can direct preventive actions, and optimize diagnosis and treatment in infected and septic patients. Estimar o custo da internação de pacientes com sepse grave ou choque séptico admitidos ou diagnosticados no setor de Urgências e Emergências de um hospital universitário e seguidos até o desfecho clínico. Estudo epidemiológico, prospectivo e observacional, realizado em um hospital público do sul do Brasil, no período de 1 ano (agosto de 2013 a agosto de 2014). A coleta dos dados clínico-epidemiológicos utilizou fichas de notificação de sepse, prontuários e dados do setor de custos. Foi realizada análise de tendência central, dispersão e quartis dos custos das internações. Amostra composta por 95 pacientes que totalizaram elevado custo da internação (R$ 3.692.421,00), com média de R$ 38.867,60 por paciente. Mais da metade do valor total do tratamento da sepse (R$ 2.215.773,50) destinou-se a pacientes que evoluíram a

  8. Costs of the Patients Hospitalized with Acute Exacerbations of Chronic Obstructive Pulmonary Disease in a University Hospital

    Fatma Yıldırım

    2015-12-01

    Full Text Available Objective: Chronic obstructive pulmonary disease (COPD, although a preventable and treatable disease continues to be a major health problem. Acute exacerbations of COPD is a major cause of hospitalization of patients and it constitutes a significant portion of COPD-related health care costs. In this study, we aimed to determine the cost of patients hospitalized with acute exacerbations of COPD in a university hospital. Methods: Data of the patients that were hospitalized due to COPD exacerbation between 1 September 2013-1 September 2014 in Hospital of Gazi University Medical Faculty were retrospectively analyzed. Cost data were gathered from data processing department. Costs were identified for drugs, laboratory tests, bed costs and other materials. Results: A total of 790 patients were hospitalized during twelve months. Among these patients 181 (23.0% patients had COPD and 99 (12.5% were hospitalized due to acute exacerbation of COPD. Of these 99 patients 77 (77.8% were male and 22 (22.2% were female. Forty-nine (49.5% patients were hospitalized from the emergency department, 50 (50.5% patients were from the outpatient clinic. The median age was 70 (64-77 years old and median length of hospital stay was 8 (6-13 days. Ninety-one (91.9% of them were discharged from the service. Eight (8.1% patients were transfered to the intensive care unit (ICU due to respiratory failure, and 7 of these patients (7.4% hospitalized back to the service after treatment at ICU, 2 (2.1% patients died. The median cost per patient was 1.064 (726-1.866 Turkish Lira (TL. Drug costs accounted the largest portion (36.0% of the median cost, followed by bed cost (26.0%. Two (2.1% of patients died in hospital. Although the number of patients without antibiotic usage is less (17.2% vs 82.8%; the median cost per patient in the antibiotic using group was higher than that were without antibiotic using (median 643 vs 1.162 TL p=0.001. Presence of a comorbidity, hypoxemia

  9. Patient information regarding medical radiation exposure is inadequate: Patients' experience in a university hospital

    Ukkola, L.; Oikarinen, H.; Henner, A.; Haapea, M.; Tervonen, O.

    2017-01-01

    Introduction: It is suspected that little or no information is provided to patients regarding radiological examinations. The purpose was to evaluate the coverage, content and source of this information in a university hospital. Methods: Altogether 147 patients (18–85 years) were interviewed after different examinations using a questionnaire. The patients had undergone 35 low (<1 mSv), 66 medium (1–10), and 46 high (>10) dose examinations. They were asked if they were informed about radiation use, the course or indication of the examination, the consequences of not having the examination, other options, the dose and risks of radiation, the source for the information and if any consent was enquired. Results: 52 (35%) patients did not receive any information while 95 (65%) obtained some information. Fifty-six (38%) patients received an information letter, and 75 (51%) obtained oral information, mainly from the referrer or the radiographer. The information was mostly about indication, course or radiation use, very seldom about radiation risks and the other areas. Those with a nuclear medicine examination received information more often than those with other medium- or high-dose examinations (p = 0.004). The patients scored the received information as 2.2 (mean, SD 1.3) on a Likert scale from 1 (poor) to 5 (good). Conclusion: Patients obtained inadequate information regarding radiological examinations in a university hospital. The information was provided non-systematically from various sources. The results help to set up practical guidelines for systematic information and to follow up their efficiency. The mode of operation might be helpful elsewhere in the future. - Highlights: • Patients obtained inadequate information regarding medical radiation exposure. • The information was provided non-systematically from various sources. • Patients with nuclear examinations were informed better than with other modalities. • In addition to general guidelines

  10. Factors Associated with Readmission of Patients with Congenital Heart Disease in a Swiss University Hospital.

    Chave, Morgane; Marques-Vidal, Pedro

    2017-04-01

    Congenital heart defects (CHD) lead to extensive use of healthcare resources. Still, there is little information available regarding readmission rates or associated factors. We sought to evaluate readmission rates and their determinants among patients with CHD hospitalized in a Swiss university hospital. We conducted a retrospective study using data from all non-adult (readmissions, 83 (86.5%) were related to the CHD. Median time to readmission was 10 days (interquartile range 6-20) and median length of readmission was 12 days (interquartile range 6-20). After multivariate adjustment, foreign nationality, greater distance to hospital and length of index hospitalization readmission. Patients who underwent surgery were less likely to be readmitted (8.7%). We conclude that readmissions were frequent, almost 1 in 10 patients, and associated with several socio-clinical factors. Providing patients who live far from hospital with specialized care closer to home may help reduce the rate of readmission.

  11. A "Prepaid Package" for Obstetrics: Effect on Teaching and Patient Care in a University Hospital

    Young, Philip E.

    1976-01-01

    The changing social milieu has removed the charity patient but not the need for a teaching population. The University Hospital's program is described, in which patients prepaid a fixed, single fee for all obstetrics-related care through the third post partum day. (LBH)

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

    Fethiye Gülden Turgut

    2013-12-01

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

  13. (ANC) patients at the Lagos state university teaching hospital

    STORAGESEVER

    2009-08-04

    Aug 4, 2009 ... Pearson's correlation matrices and student t-test of data were generated and P < 0.05 was considered statistically significant. RESULT. Results were compared for parity, age of patient, ges- tational age of pregnancy, booking weight, blood group and genotype, and haemoglobin status. In this study, the.

  14. Mortality Rates of Traumatic Traffic Accident Patients at the University Hospital

    Atilla Senih MAYDA

    2014-05-01

    Full Text Available The aim of the study is to estimate hospitalization and mortality rates in patients admitted to the University Hospital due to traffic accidents, and to determine the mean cost of the applicants in the hospital due to traffic accident. In this retrospective study data were obtained from the records of a university research and practice hospital. There were 802 patients admitted to emergency and other outpatient clinics of the University Hospital because of traffic accidents throughout the year 2012. Out of these patients, 166 (20.7% were hospitalized, and the annual mortality rate was 0.87%. The total cost was 322,545.2 euro and 402.2 euro per patient. Road traffic accident detection reports covered only the numbers of fatal injuries and injuries that happened at the scene of accidents. Determination of the number of the dead and wounded with overall mortality rate would be supposed to reveal the magnitude of public health problem caused by traffic accidents.

  15. The role of expectations in patient assessments of hospital care: an example from a university hospital network, Turkey.

    Bakar, Coskun; Akgün, H Seval; Al Assaf, A F

    2008-01-01

    The aim of this paper is to document a study, in which the SERVQUAL scale was used to evaluate hospital services, conducting a preliminary assessment of patient attitudes regarding the important aspects of service dimensions. The SERVQUAL scale was implemented into routine use at the Baskent University Hospitals Network in Baskent, Turkey. The study consisted of 550 randomly chosen patients who presented to any member hospital in that network during January and February 2006 and received treatment as inpatients or outpatients at those healthcare facilities. The SERVQUAL scale was utilised to evaluate hospital services. A questionnaire was completed by a total of 472 (86.0 per cent) patients. The perceived scores of the patients were higher than expected for an ordinary hospital but lower than expected for a high-quality hospital. The highest difference between the perceived service score and the expected service score was found at the Alanya Application and Research Center in Alanya, Turkey. The paper demonstrates the use of the SERVQUAL scale in measuring the functional quality of the hospitals assessed.

  16. Prevalence of malnutrition and associated factors among hospitalized elderly patients in King Abdulaziz University Hospital, Jeddah, Saudi Arabia.

    Alzahrani, Sami H; Alamri, Sultan H

    2017-07-03

    Malnutrition is a nutritional disorder that adversely affects the body from a functional or clinical perspective. It is very often observed in the elderly population. This study aimed to estimate the prevalence of malnutrition among hospitalized elderly patients and its associated factors and outcomes in terms of length of stay and mortality in King Abdulaziz University Hospital, Jeddah, Saudi Arabia. In a cross-sectional study, we evaluated the nutritional status of hospitalized elderly patients using the most recent version of the short form of Mini Nutritional Assessment (MNA-SF). A total of 248 hospitalized patients were included (70.0 ± 7.7 years; 60% female). According to the MNA-SF, a total of 76.6% patients were either malnourished or at risk of malnutrition. Malnourished patients had significantly lower levels of serum albumin (28.2 ± 7.7), hemoglobin (10.5 ± 1.8), and lymphocyte (1.7 ± 0.91). They had increased tendency to stay in the hospital for longer durations (IQR, 5-11 days; median = 7 days) and had a mortality rate of 6.9%. Malnutrition was highly prevalent among hospitalized elderly and was associated with increased length of stay and mortality.

  17. Treatment cost of patients with maxillofacial fractures at the University Hospital in Mostar 2002-2006.

    Jurić, Mario; Novakovic, Josip; Carapina, Mirela; Kneiević, Ervin

    2010-03-01

    The aim of this study was to establish the costs structure of medical treatment for the patients with maxillofacial fractures, to perform a treatment cost evaluation, describe the factors which considerably influence the costs and discover the ways of achieving financial savings in treated patients. The study group consisted of patients with maxillofacial fractures who were admitted and treated at the Department of Maxillofacial Surgery of the University Hospital Mostar in the period from January 2002 until December 2006. Data for the study were collected from the patients' databases, case histories and data obtained on the basis of individual payments for the treatment that was collected by Finance Department of the University Hospital of Mostar Most patients in this study were men (83%), of average age 34 +/- 19 years. Zygomatic bone fracture was the commonest injury. Open surgical procedure was performed in 84.7% of treated cases. The costs for the open procedure were considerably higher than conservative treatment. Medication cost made up a total of 37.9% and cost of hospital accommodation 27.3% out of total hospital charge. Cost reduction in treated patients with maxillofacial fractures should be achieved through protocols of urgent treatment of maxillofacial trauma patients immediately after sustaining an injury and with earlier discharge of the patients when postoperative complications are not expected.

  18. Clinical outcome of protein-energy malnourished patients in a Brazilian university hospital

    Pasquini, T.A.S. [Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG (Brazil); Neder, H.D. [Instituto de Economia, Universidade Federal de Uberlândia, Uberlândia, MG (Brazil); Araújo-Junqueira, L. [Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG (Brazil); De-Souza, D.A. [Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG (Brazil); Departamento de Clínica Médica e Curso de Nutrição, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG (Brazil)

    2012-12-17

    Protein-energy malnutrition (PEM) is a treatable disease with high prevalence among hospitalized patients. It can cause significant increases in the duration of hospitalization and costs. PEM is especially important for health systems since malnourished patients present higher morbidity and mortality. The objective of the present study was to assess the evolution of nutritional status (NS) and the effect of malnutrition on clinical outcome of patients at a public university hospital of high complexity in Brazil. Patients hospitalized in internal medicine (n = 54), oncology (n = 43), and infectious diseases (n = 12) wards were included. NS was evaluated using subjective global assessment up to 48 h after admission, and thereafter at intervals of 4-6 days. On admission, patients (n = 109) were classified as well-nourished (n = 73), moderately malnourished or at risk of malnutrition (n = 28), and severely malnourished (n = 8). During hospitalization, malnutrition developed or worsened in 11 patients. Malnutrition was included in the clinical diagnosis of only 5/36 records (13.9% of the cases, P = 0.000). Nutritional therapy was administered to only 22/36 of the malnourished patients; however, unexpectedly, 6/73 well-nourished patients also received commercial enteral diets. Complications were diagnosed in 28/36 malnourished and 9/73 well-nourished patients (P = 0.000). Death occurred in 12/36 malnourished and 3/73 well-nourished patients (P = 0.001). A total of 24/36 malnourished patients were discharged regardless of NS. In summary, malnutrition remains a real problem, often unrecognized, unappreciated, and only sporadically treated, even though its effects can be detrimental to the clinical course and prognosis of patients. The amount of public and private funds unnecessarily dispersed because of hospital malnutrition is significant.

  19. Clinical outcome of protein-energy malnourished patients in a Brazilian university hospital

    Pasquini, T.A.S.; Neder, H.D.; Araújo-Junqueira, L.; De-Souza, D.A.

    2012-01-01

    Protein-energy malnutrition (PEM) is a treatable disease with high prevalence among hospitalized patients. It can cause significant increases in the duration of hospitalization and costs. PEM is especially important for health systems since malnourished patients present higher morbidity and mortality. The objective of the present study was to assess the evolution of nutritional status (NS) and the effect of malnutrition on clinical outcome of patients at a public university hospital of high complexity in Brazil. Patients hospitalized in internal medicine (n = 54), oncology (n = 43), and infectious diseases (n = 12) wards were included. NS was evaluated using subjective global assessment up to 48 h after admission, and thereafter at intervals of 4-6 days. On admission, patients (n = 109) were classified as well-nourished (n = 73), moderately malnourished or at risk of malnutrition (n = 28), and severely malnourished (n = 8). During hospitalization, malnutrition developed or worsened in 11 patients. Malnutrition was included in the clinical diagnosis of only 5/36 records (13.9% of the cases, P = 0.000). Nutritional therapy was administered to only 22/36 of the malnourished patients; however, unexpectedly, 6/73 well-nourished patients also received commercial enteral diets. Complications were diagnosed in 28/36 malnourished and 9/73 well-nourished patients (P = 0.000). Death occurred in 12/36 malnourished and 3/73 well-nourished patients (P = 0.001). A total of 24/36 malnourished patients were discharged regardless of NS. In summary, malnutrition remains a real problem, often unrecognized, unappreciated, and only sporadically treated, even though its effects can be detrimental to the clinical course and prognosis of patients. The amount of public and private funds unnecessarily dispersed because of hospital malnutrition is significant

  20. Inpatient Management of Diabetes Mellitus among Noncritically Ill Patients at University Hospital of Puerto Rico.

    Allende-Vigo, Myriam Zaydee; González-Rosario, Rafael A; González, Loida; Sánchez, Viviana; Vega, Mónica A; Alvarado, Milliette; Ramón, Raul O

    2014-05-01

    To describe the state of glycemic control in noncritically ill diabetic patients admitted to the Puerto Rico University Hospital and adherence to current standard of care guidelines for the treatment of diabetes. This was a retrospective study of patients admitted to a general medicine ward with diabetes mellitus as a secondary diagnosis. Clinical data for the first 5 days and the last 24 hours of hospitalization were analyzed. A total of 147 noncritically ill diabetic patients were evaluated. The rates of hyperglycemia (blood glucose ≥180 mg/dL) and hypoglycemia (blood glucose diabetic patients is suboptimal, probably due to clinical inertia, manifested by absence of appropriate modification of insulin regimen and intensification of dose in uncontrolled diabetic patients. A comprehensive educational diabetes management program, along with standardized insulin orders, should be implemented to improve the care of these patients.

  1. Opportunistic infection manifestation of HIV-AIDS patients in Airlangga university hospital Surabaya

    Asmarawati, T. P.; Putranti, A.; Rachman, B. E.; Hadi, U.; Nasronudin

    2018-03-01

    Opportunistic infections are common in HIV-infected patients especially those who progress to acquired immunodeficiency syndrome. There are many factors involved in the prevalence of opportunistic infections. We investigated the patterns of opportunistic infection in HIV-infected patients admitted to Airlangga University Hospital Surabaya. This study was an observational study, conducted in adults patients with HIV infection from January 2016 to September 2017. Data collected from the medical records of the patients. The number of samples in this study was 58. The mean age was 42.9 years, mostly male. Most patients admitted were in clinical stadium III or IV. Heterosexual transmission is a common risk factor in patients. The most prevalent opportunistic infections found in patients were oral candidiasis (58.6%), followed by pulmonary tuberculosis (41.4%) and pneumonia/PCP (41.4%). Other infections found were toxoplasmosis, chronic diarrhea, cytomegalovirus, meningitis TB, hepatitis C, amoebiasis, and cerebritis. Opportunistic infections occurred more often in age≥40 years and increased as clinical stadium get worse. From the results, we conclude that oral candidiasis and pulmonary tuberculosis were the most common opportunistic infections found in Airlangga University Hospital. The pattern of opportunistic infections in this study could help the hospital to set priorities related to the management of patients.

  2. Patient education process in teaching hospitals of Tehran University of Medical Sciences.

    Seyedin, Hesam; Goharinezhad, Salime; Vatankhah, Soodabeh; Azmal, Mohammad

    2015-01-01

    Patient education is widely recognized as a core component of nursing. Patient education can lead to quality outcomes including adherence, quality of life, patients' knowledge of their illness and self-management. This study aimed to clarify patient education process in teaching hospitals affiliated to Tehran University of Medical Sciences (TUMS) in Iran. This cross-sectional study was conducted in 2013. In this descriptive quantitative study, the sample covered 187 head nurses selected from ten teaching hospitals through convenience sampling. Data were collected with a questionnaire developed specifically for this study. The questionnaire measured patient education process in four dimensions: need assessment, planning, implementing and evaluating. The overall mean score of patient education was 3.326±0.0524. Among the four dimensions of the patient education process, planning was in the highest level (3.570±0.0591) and the lowest score belonged to the evaluation of patient education (2.840 ±0.0628). Clarifying patient education steps, developing standardized framework and providing easily understandable tool-kit of the patient education program will improve the ability of nurses in delivering effective patient education in general and specialized hospitals.

  3. Patients' perception of the ambulance services at Hospital Universiti Sains Malaysia.

    Anisah, A; Chew, K S; Mohd Shaharuddin Shah, C H; Nik Hisamuddin, N A R

    2008-08-01

    Little is known regarding public opinion of prehospital care in Malaysia. This study was conducted to find out the public's perception and expectations of the ambulance services in one of the university hospitals in Malaysia. A six-month prospective cross-sectional study to look at patients' perception of Hospital Universiti Sains Malaysia's (HUSM) ambulance service was conducted from February 2006 to July 2006. Upon arrival at the hospital, patients or their relatives (who used our hospital's ambulances) were interviewed with a set of questions regarding their perception of the ambulance services and were asked to rate the perception on a Likert Scale from 1 to 10. A convenient sampling method was applied. A total of 87 samples were obtained. Despite the many problems faced by the ambulance service in HUSM, the mean score for each of the questions on patient's perception ranged from 9.33 to 9.70 out of 10. The questions with the highest mean score, which were both 9.70 each, were related to staff attentiveness and staff gentleness. Patients' perceptions can be very subjective, but until further similar studies could be carried out in other parts of Malaysia, this set of data merely represents a numerical measure of public perception of the ambulance services from HUSM.

  4. Review of Application Development and the Patient Encounter Concept within the University of Iowa Hospital Information System

    Wagner, James R.; Wood, David E.

    1982-01-01

    The logical structure of the patient data base supporting the University of Iowa Hospital Information System has produced significant management reporting capabilities. A technique is discussed for grouping information concerning the services provided by the hospital during each Patient Encounter that allows subsequent analysis by Medical Episode and Financial Account. The implementation of this data organization structure is discussed in the context of the 13 major health care applications implemented at the University of Iowa Hospitals and Clinics.

  5. Effect of Surgical Safety Checklist on Mortality of Surgical Patients in the α University Hospitals

    R. Mohebbifar

    2014-01-01

    Full Text Available Background & Aims: Patient safety is one of the indicators of risk management in clinical governance system. Surgical care is one of the most sophisticated medical care in the hospitals. So it is not surprising that nearly half of the adverse events, 66% were related to surgery. Pre-flight aircraft Inspection model is starting point for designing surgical safety checklist that use for audit procedure. The aim of this study is to evaluate the effect of the use of surgical safety checklist on surgical patients mortality and complications. Materials and Methods: This is a prospective descriptive study. This study was conducted in 2012 in the North West of Iran. The population consisted of patients who had undergoing surgery in α university of medical science`s hospital which have surgical department. In this study, 1125 patients underwent surgery within 3 months were studied. Data collection tool was designed based on WHO model and Surgcical Care and Outcomes Assessment Program(SCOAP. Data analysis was performed using the SPSS-20 statistical software and logistic regression analysis was used to calculate P values for each comparison. Results: No significant differences between patients in the two periods (before and after There was. All complications rate reduced from 11 percent to 4 percent after the intervention by checklist (p<0.001. In the all hospitals mortality rate was decreased from 3.44% to 1.3% (p <0.003. Overall rate of surgical site infection and unplanned return to the operating room was reduced (p<0.001 and p<0.046. Conclusion: Many people every year due to lack of safety in hospitals, lose their lives. Despite the risks, such as leaving surgery sets in patient body and wrong surgery is due to lack of proper safety programs during surgery. By using safety checklist in all hospitals mortality rate and complications was reduced but this reduction was extremely in α3 hospital (from 5.2% to 1.48%.

  6. Oral candidiasis as clinical manifestation of HIV/AIDS infection in Airlangga University hospital patients

    Putranti, A.; Asmarawati, T. P.; Rachman, B. E.; Hadi, U.; Nasronudin

    2018-03-01

    The purpose of this study was to determine the characteristics of HIV/AIDS patients with oral candidiasis as its clinical manifestation at Airlangga University Hospital Surabaya. This is a descriptive analytic research with cross-sectional design using Chi-Square statistic test. Samples of this study consist of 34 patients using total sampling methods. Those patients were all HIV/AIDS infected patients with oral candidiasis clinical manifestations, who were admitted to Airlangga University Hospital Surabaya from January 2016 to September 2017. Results showed that mostly HIV/AIDS patients with oral candidiasis are male (79.4%), old age (40-75years) total amounted to 58.8%, heterosexual as main risk factor (70%), clinical stadium mostly in stage IV (61.8%), 26% of patients with chronic diarrhea and 56% with pulmonary TB, clinical stages of patients have a significant relation to the incidence of oral candidiasis infection (p=0.024). The most common oral lesions found in people with HIV are Candidiasis. The best management is through routine dental examination and dental precautions to maintain health and achieve a better quality of life.

  7. Prevalence of anaemia among patients with heart failure at the Brazzaville University Hospital.

    Ikama, Méo Stéphane; Nsitou, Bernice Mesmer; Kocko, Innocent; Mongo, Ngamami Solange; Kimbally-Kaky, Gisèle; Nkoua, Jean Louis

    2015-01-01

    Heart failure (HF) is a frequent cause of ospitalisation in cardiology. Its prognosis depends on several risk factors, one of which is anaemia. We aimed to determine the prevalence of anaemia in patients with heart failure, and evaluate its impact on their prognosis. This article describes a cross-sectional study with prospective collection of data, carried out from 1 January to 31 December 2010 in the Department of Cardiology at Brazzaville University Hospital, Congo. Patients admitted for heart failure were included. Anaemia was defined as a haemoglobin level failure, and it had a negative effect on the prognosis.

  8. Evaluation of Patients Visiting the Dermatology Emergency Unit of a University Dermatology Hospital in Tehran, Iran.

    Abedini, Robabeh; Matinfar, Amin; Sasani, Pardis; Salehi, Anahita; Daneshpazhooh, Maryam

    2017-11-01

    Published studies on dermatological emergencies are limited in the literature. To our knowledge, no study has previously explored this subject in Iran. Our aim was to ascertain the characteristics of patients visiting the dermatologic emergency (DE) unit of a university skin hospital in Tehran, Iran. We studied the files of all the patients seen in the DE unit over a 3-month period, collecting data on age, sex, referral mode, duration of consultation, status (true emergency or non-emergency), and diagnosis. A total of 2539 patients were evaluated; 53% of them were female. Infection and infestation (41.9%), urticaria (16.7%), and dermatitis (13.2%) were the most prevalent entities. Almost 1% of the patients were referred by another physician and psoriasis was their most frequent diagnosis. Almost 2.6% of the patients were hospitalized; psoriasis was once again the most frequent cause. The hospitalization rate was significantly higher in referred patients (Pdermatologic disorders. This data could also help in tailoring the educational curriculum for medical students more appropriately in order to increase their knowledge of the most prevalent skin disorders.

  9. Two Belgian University Hospitals

    M. Huylebrouck

    2012-01-01

    Full Text Available Background. Bevacizumab (BEV, a humanized immunoglobulin G1 monoclonal antibody that inhibits VEGF has demonstrated activity against recurrent high-grade gliomas (HGG in phase II clinical trials. Patients and Methods. Data were collected from patients with recurrent HGG who initiated treatment with BEV outside a clinical trial protocol at two Belgian university hospitals. Results. 19 patients (11 M/8 F were administered a total of 138 cycles of BEV (median 4, range 1–31. Tumor response assessment by MRI was available for 15 patients; 2 complete responses and 3 partial responses for an objective response rate of 26% for the intent to treat population were observed on gadolinium-enhanced T1-weighted images; significant regressions on T2/FLAIR were documented in 10 out of 15 patients (67%. A reduced uptake on PET was documented in 3 out of 4 evaluable patients. The six-month progression-free survival was 21% (95% CI 2.7–39.5. Two patients had an ongoing tumor response and remained free from progression after 12 months of BEV treatment. Conclusions. The activity and tolerability of BEV were comparable to results from previous prospective phase II trials. Reduced uptake on PET suggests a metabolic response in addition to an antiangiogenic effect in some cases with favorable clinical outcome.

  10. Clinical profile of patients with myasthenia gravis followed at the University Hospital, Federal University of Minas Gerais

    Aline Mansueto Mourão

    2015-04-01

    Full Text Available Summary Objective: to determine the clinical profile of patients with myasthenia gravis (MG; followed at the Neuromuscular Diseases Clinic of the University Hospital, Federal University of Minas Gerais, Brazil, and to compare it with other Brazilian case series. Methods: sociodemographic and clinical data were collected from patients, and a systematic literature review performed, focusing on national studies on the clinical profile of MG patients. Results: sixty nine patients were enrolled in the study. Fifty five (91% subjects were female and the mean age (SD was 37.6 (±11.4 years. The mean disease duration was 14.1 years. Regarding treatment, prednisone was the most used strategy (64%, followed by the use of azathioprine (43%. There was no difference between thymectomized (42 and non-thymectomized (27 patients regarding disease severity and medication use. Conclusion: clinical and socio-demographic features of this MG sample from a University-based clinic resemble those reported in other Brazilian series and in the international literature.

  11. Depression in diabetic patients attending University of Gondar Hospital Diabetic Clinic, Northwest Ethiopia

    Birhanu AM

    2016-05-01

    Full Text Available Anteneh Messele Birhanu,1 Fekadu Mazengia Alemu,2 Tesfaye Demeke Ashenafie,3 Shitaye Alemu Balcha,4 Berihun Assefa Dachew5 1School of Medicine, College of Medicine and Health Sciences, Wollo University, Dessie, 2Department of Midwifery, 3Department of Nursing, 4Department of Internal Medicine, College of Medicine and Health Sciences, 5Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia Background: Diabetes mellitus, frequently associated with comorbid depression, contributes to the double burden of individual patients and community. Depression remains undiagnosed in as many as 50%–75% of diabetes cases. This study aimed to determine the prevalence and associated factors of depression among diabetic patients attending the University of Gondar Hospital Diabetic Clinic, Northwest Ethiopia. Methods: An institution-based cross-sectional study was conducted from March to May 2014 among 422 sampled diabetic patients attending the University of Gondar Hospital Diabetic Clinic. The participants were selected using systematic random sampling. Data were collected by face-to-face interview using a standardized and pretested questionnaire linked with patient record review. Depression was assessed using the Patient Health Questionnaire-9. Data were entered to EPI INFO version 7 and analyzed by SPSS version 20 software. Binary logistic regression analysis was performed to identify factors associated with depression. Results: A total of 415 diabetic patients participated in the study with a response rate of 98.3%. The prevalence of depression among diabetic patients was found to be 15.4% (95% confidence interval (CI: 11.7–19.2. Only religion (adjusted odds ratio [AOR] =2.65 and 95% CI: 1.1–6.0 and duration of diabetes (AOR =0.27 and 95% CI: 0.07–0.92 were the factors associated with depression among diabetic patients. Conclusion: The prevalence of depression was low as compared to other

  12. Factors affecting satisfaction of patients after orthognathic surgery at a University Hospital

    Al-Ahmad, Hazem T.; Al-Omari, Iyad K.; Eldurini, Laila N.; Suleiman, Ahmad A.

    2008-01-01

    The objective was to analyze factors that influence patient's satisfaction with orthognathic treatment and evaluate patient's perception of changes in physical and psychosocial aspects. In a retrospective clinical study conducted at Jordan University Hospital, Amman, Jordan between December 2006 and December 2007, we examined 38 patients who had orthognathic surgery after an average follow-up of 20 months. Examination included evaluation of nerve function and temporomandibular function with Helkimo index. Patients filled out a questionnaire on treatment satisfaction and perception of physical and psychosocial changes after treatment. Patients were generally satisfied with the result, 82% agreed they would undergo treatment again. They were divided into very satisfied n=25 and less satisfied n=13 groups according to satisfaction score, with statistically significant differences found between them concerning diagnosis and follow-up period, with all vertical maxillary excess patients very satisfied and 75% of asymmetrical deformities patients less satisfied, and less satisfaction by patients more than one year postoperatively, p=0.006. Patients perceived improvement oral function, general health, appearance and interpersonal skills. Lower rates of joint and muscular pain and increased mobility of lower jaw correlated with better patient's perception of health and appearance. Although patient's report high satisfaction levels, several factors such as the temporomandibular joint function could affect patient's psychosocial adjustment after treatment. Sufficient information for patient on the treatment course is required to improve satisfaction. Controlling these factors could improve patient's quality of life. (author)

  13. A Study of Rate and Predictors of Fall Among Elderly Patients in a University Hospital.

    al Tehewy, Mahi Mahmoud; Amin, Ghada Essam; Nassar, Nahla Wassem

    2015-12-01

    Falls represent a serious problem facing hospital-admitted patients, and the severity of fall-related complications rises steadily after the age of 65 years. The aims of this study were (a) to calculate the rate of falls among elderly patients in the internal medicine departments in Ain Shams University Hospital, (b) to identify different predictors and characteristics of falls, and (c) to assess clinical consequences and hospitalization outcomes of falls. An observational longitudinal study has been conducted in Ain Shams University Hospital, where 411 elderly patients admitted to the internal medicine departments were included. Upon admission, the patients were assessed for their risk for falling using the Morse Fall Scale (MFS). Information about their medical condition and drugs administered was obtained. Functional assessment of the patients regarding their ability to perform different daily activities was also performed. The patients were followed up during their stay, and once a fall event occurred, complete details regarding the circumstances and consequences of that event were obtained. The incidence rate of falls was found to be 16.9 per 1000 patient days. The fallers had a significantly high risk for falling according to the MFS (P = 0.02). The MFS was able to predict patients at risk for falling and identified correctly 82.6% of the fallers. The most common medical conditions associated with falls were diabetes (48.7%), hypertension (58.7%), and visual impairment (41.3%). Anemia (P = 0.05) and osteoporosis (P = 0.02) showed a statistically significant difference between the fallers and the nonfallers. Presence of a history of a fall and increased length of hospital stay were highly significant (P = 0.01) factors that predisposed to falls. Logistic regression analysis showed that anemia, osteoporosis, and history of a fall were independent predictors of falls. Most falls had no serious consequences, approximately 18% had contusions, 2% had subdural

  14. Oral care for patients with head and neck cancer in Hokkaido University Hospital

    Hata, Hironobu; Yamazaki, Yutaka; Imamachi, Kenji

    2011-01-01

    We have been providing oral care for patients with head and neck cancer in Hokkaido University Hospital since 2007. In this paper, we report clinical statistics of the 254 head and neck cancer patients who received oral care. About 80 percent of these patients were treated with radiation therapy, so it is important to cope with adverse events related to such therapy. Oral care is helpful for cancer patients when it is started as soon as possible (at least 1 week before radiation therapy is started). The percentage of patients who could start oral care 4 days before radiation therapy gradually increased to about 60 percent by fiscal 2009. In fiscal 2010, the percentage decreased to its lowest level of 37.9 percent. To start oral care for all patients 7 days before irradiation, we are going to change our system and start oral care in the outpatient period. In their hometowns, oral care was continued for only 19 (27.0 percent) of the 74 patients who could not visit our hospital. An important task for our project is to establish a medical cooperation system for discharged patients treated for head and neck cancer. (author)

  15. Median Survival Time of Endometrial Cancer Patients with Lymphovascular Invasion at the Hospital Universiti Sains Malaysia.

    Asyikeen, Wan Adnan Wan Nor; Siti-Azrin, Ab Hamid; Jalil, Nur Asyilla Che; Zin, Anani Aila Mat; Othman, Nor Hayati

    2016-11-01

    Endometrial cancer is the most common gynaecologic malignancy among females worldwide. The purpose of this study was to determine the median survival time of endometrial cancer patients at the Hospital Universiti Sains Malaysia (USM). A list of 121 endometrial cancer cases registered at Hospital USM between 2000 until 2011 was retrospectively reviewed. The survival time of the endometrial cancer patients was estimated by Kaplan-Meier survival analysis. Log-rank tests were performed to compare the survival of the patients based on socio-demographics and clinical presentation. Only 108 patients, 87.0%, were included who were of Malay ethnicity. Previous history included menopause in 67.6% of patients and diabetes mellitus in 39.8% of patients; additionally, 63.4% of patients were nulliparous. Tumour staging was as follows: 24.5% stage I, 10.8% stage II, 26.5% stage III and 38.2% stage IV. The overall median survival time of the endometrial cancer patients was 70.20 months (95% confidence interval (CI): 51.79, 88.61). The significant factors were age, the presence of lymphovascular invasion and treatment received. The overall survival of endometrial cancer was low. A prospective study needs to be carried out to discover more effective and accurate tests for the early detection of endometrial cancer.

  16. Cryptococcal meningitis in HIV-infected patients at Chiang Mai University Hospital: a retrospective study.

    Chaiwarith, Romanee; Vongsanim, Surachet; Supparatpinyo, Khuanchai

    2014-05-01

    Cryptococcal meningitis (CM) is a common central nervous system infection in HIV-infected patients. This study aimed to determine treatment outcomes among HIV-infected patients who had cryptococcal meningitis and to determine predictors of death. We conducted a retrospective cohort study among HIV-infected patients receiving care at Chiang Mai University Hospital from January 1, 2005 to December 31, 2010. We studied 79 patients; 45 (57.0%) were male and the mean age was 35.1 +/- 7.2 years. Eleven patients (13.9%) had previous opportunistic infection. The most common presenting symptoms were headache (63 patients, 79.8%), fever (49 patients, 62.0%), and altered consciousness (21 patients, 26.6%). The median CD4+ cell count was 20 cells/mm3 [Interquartile range (IQR) 10, 53]. The in-hospital, 90-day, and 1-year mortality rates were 24.1%, 32.4%, and 52.2%, respectively. The CM attributable in-hospital, 90-day and 1-year mortality rates were 13.9%, 20.3%, and 23.2%, respectively. Predictors associated with a 1-year mortality were a high cerebrospinal (CSF) cryptococcal antigen titer (> 1:10,000) [Odds Ratio (OR) =7.08, 95% confidence interval (CI): 1.62-31.00, p = 0.009], and altered consciousness at presentation (OR = 5.27; 95% CI: 1.16-24.05; p = 0.032). Cryptococcal meningitis is an important cause of death in HIV-infected patients. HIV-infected patients with a low CD4+ cell count, a headache, fever and altered consciousness should be investigated for CM and those with a high CSF cryptococcal antigen titer are at high risk for mortality.

  17. What Do Patients Want? Survey of Patient Desires for Education in an Urban University Hospital

    Thomas Seibert

    2014-11-01

    Full Text Available Introduction: This study examines the emergency department (ED waiting room (WR population’s knowledge about the ED process and hospital function and explores the types of educational materials that might appeal to patients and their companions in an ED waiting room. Our goal was to identify potential high-impact opportunities for patient education. Methods: A 32-question survey about demographics, usage of primary care physicians (PCP, understanding of the ED and triage process, desire to know about delays, health education and understanding of teaching hospitals was offered to all qualified individuals. Results: Five hundred and forty-four surveys were returned. Fifty-five percent reported having a PCP, of which 53% (29% of all WR patients called a PCP prior to coming to the ED. It was found that 51.2% can define triage; 51% as an acuity assessment and 17% as a vital signs check. Sixty-nine percent knew why patients were seen according to triage priority. Seventy-two percent wanted to know about delays, yet only 25% wanted to know others’ wait times. People wanted updates every 41 minutes and only three percent wanted a physician to do this. Forty-one percent wanted information on how the ED functions, 60% via handouts and 43% via video. Information on updates and common medical emergencies is significantly more important than material on common illnesses, finding a PCP, or ED function (p<0.05. Median estimated time for medical workup ranged from 35 minutes for radiographs, to one hour for lab results, computed tomography, specialist consult, and admission. Sixty-nine percent knew the definition of a teaching hospital and of those, 87% knew they were at a teaching hospital. Subgroup analysis between racial groups showed significantly reduced knowledge of the definitions of triage and teaching hospitals and significantly increased desire for information on ED function in minority groups (p<0.05. Conclusion: The major findings in this study

  18. Osteoporosis among hospitalized patients with proximal femoral fractures in Assiut University Trauma Unit, Egypt.

    Farouk, Osama; Mahran, Dalia G; Said, Hatem G; Alaa, Mohamed M; Eisa, Amr; Imam, Hisham; Said, G Z

    2017-12-01

    The study was done to investigate osteoporosis prevalence in 275 hip fracture admissions at the Trauma Unit of Assiut University Hospitals and associated factors, which are understudied in our locality. Prevalence was 74.9%. Female sex, older age, low body mass index, and fall on the ground were associated with osteoporosis. This study aims to identify osteoporosis prevalence in hip fracture admissions at the Trauma Unit of Assiut University Hospitals and to study the independent correlates of osteoporosis-related fracture. A prospective cross-sectional study was carried out in 275 hip fracture patients admitted to the Trauma Unit of Assiut University Hospitals from January through December 2014 of both sexes aged 50 years and older. Exclusion criteria were polytrauma, major accidents, and history of chronic conditions and long-term medication associated with osteoporosis risk increase and bilateral hip fractures. For every patient, weight, height, and bone mineral density by dual-energy x-ray absorptiometry (DEXA) were recorded. Tests of significance for non-parametric data were used. The questionnaire included sociodemographic characteristics, dietary habits, lifestyle factors such as smoking and physical activity, and female obstetric and gynecological factors. Mean age was 70.82 ± 11.02 SD; 51.6% were males and 8.4% were obese. Fall on ground was in 81.1% of fractures. Osteoporosis (femoral neck T score ≤ -2.5 SD) prevalence was 74.9%. By univariable analysis, significant correlates were female gender, older age, normal BMI, and fall on the ground. Milk and cheese daily intake was significantly associated with lower prevalence of osteoporosis. In a multivariable logistic regression model, female sex, older age, low BMI, and fall on the ground were associated with osteoporosis. Osteoporosis prevalence is high among hip fracture patients and associated with female sex, increase in age, low BMI, and fall on ground. Strategies to prevent osteoporosis are

  19. Pediatric chronic patients at outpatient clinics: a study in a Latin American University Hospital.

    Alveno, Renata A; Miranda, Caroline V; Passone, Caroline G; Waetge, Aurora R; Hojo, Elza S; Farhat, Sylvia C L; Odone-Filho, Vicente; Tannuri, Uenis; Carvalho, Werther B; Carneiro-Sampaio, Magda; Silva, Clovis A

    2017-10-02

    To describe the characteristics of children and adolescentes with chronic diseases of outpatient clinics at a tertiary university hospital. A cross-sectional study was performed with 16,237 patients with chronic diseases followed-up in one year. The data were collected through the electronic system, according to the number of physician appointments in 23 pediatric specialties. Patients were divided in two groups: children (0-9 years) and adolescents (10-19 years). Early (10-14 years) and late (15-19 years) adolescent groups were also analyzed. Of the total sample, 56% were children and 46% were adolescents. The frequencies of following pediatric specialties were significantly higher in adolescents when compared with children: cardiology, endocrinology, hematology, nephrology/renal transplantation, neurology, nutrology, oncology, palliative and pain care, psychiatry, and rheumatology (p<0.05). The frequencies of emergency service visits (30% vs. 17%, p<0.001), hospitalizations (23% vs. 11%, p<0.001), intensive care unit admissions (6% vs. 2%, p<0.001), and deaths (1% vs. 0.6%, p=0.002) were significantly lower in adolescents than in children. However, the number of physician appointments (≥13) per patient was also higher in the adolescent group (5% vs. 6%, p=0.018). Further analysis comparison between early and late adolescents revealed that the first group had significantly more physician appointments (35% vs. 32%, p=0.025), and required more than two pediatric specialties (22% vs. 21%, p=0.047). Likewise, the frequencies of emergency service visits (19% vs. 14%, p<0.001) and hospitalizations (12% vs. 10%, p=0.035) were higher in early adolescents. This study evaluated a large population in a Latin American hospital and suggested that early adolescents with chronic diseases required many appointments, multiple specialties and hospital admissions. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  20. TEMPOROMANDIBULAR PAIN DYSFUNCTION SYNDROME IN PATIENTS ATTENDING LAGOS UNIVERSITY TEACHING HOSPITAL, LAGOS, NIGERIA.

    Eweka, O M; Ogundana, O M; Agbelusi, G A

    2016-01-01

    Temporomandibular joint pain dysfunction syndrome (TMJPDS) is the most common temporomandibular disorder. This condition presents with symptoms of pain, restricted jaw movement and joint noise. Other symptoms include otalgia, headache, neck pain and trismus. To determine the pattern of Temporomandibular joint pain dysfunction syndrome patients managed at the Lagos University Teaching Hospital, Lagos, Nigeria. A descriptive study of patients with signs and symptoms of Temporomandibular joint pain dysfunction syndrome attending the Oral Medicine Clinic of Lagos University Teaching Hospital. Twenty-one patients with Temporomandibular joint pain dysfunction syndrome were enrolled into the study, out of which 10(48%) were females and 11(52%) were males. The age range was 23-81years with a mean of 45.2 ± 18.9 years. Majority of the patients 20(95.2%) complained of pain around the joint, in the pre-auricular region, in the muscles of mastication and the ear. While 7(35%) complained of clicking sounds, 10(47.6%) complained of pain on mouth opening and during mastication only. In all 5(23.8%) had impaired movement of the jaws, mouth opening was normal in 18(85.7%) but reduced in 3(14.3%) patients. Over half of patients 12(57%) experienced clicking sounds, there was tenderness around the temporomandibular joint in 16(76.2%) cases, pain in the ear of 7(33.3%) patients and 13(61.9%) people presented with tenderness of the muscles of mastication. Conservative management of all the cases resulted in resolution of the symptoms. Temporomandibular joint pain dysfunction syndrome has diverse clinical presentation and though distressing, it responds to prompt and effective conservative management.

  1. Depression and anxiety in patients on chronic hemodialysis in University Clinical Hospital Mostar.

    Klarić, Miro; Letica, Ivona; Petrov, Bozo; Tomić, Monika; Klarić, Branka; Letica, Ludvig; Francisković, Tanja

    2009-12-01

    Depression and anxiety are prevailing mental problem in patients on chronic hemodialysis and they have great influence on outcome of illness. Additionally, these disorders are rarely identified in that population of patients and they are insufficiently treated. The aim of this study was to assess the prevalence of depression and anxiety in patients on chronic hemodialysis in University Clinical Hospital Mostar and to examine the correlation between the demographic variables and the time spent on dialysis with depression and anxiety levels. The experimental group consisted of 56 patients on chronic hemodialysis in Mostar Clinical Hospital. The control group 1 consisted of 53 patients diagnosed with a chronic illness and treated for at least a year, while the control group 2 consisted of 51 persons who were not diagnosed with any chronic somatic or mental illness. Demographic data were collected using the constructed questionnaire. The Beck Depression Inventory-BDI was used to determine depression, while the Spielberger State-Trait Anxiety Inventory-STAI was used to determine anxiety. We recorded significantly higher prevalence of depression in patients on chronic dialysis (51.8%) than in patients with a chronic illness (41.5%) and persons without chronic illnesses (9.8%; p < 0.001). Trait anxiety level was significantly higher in hemodialysed patients compared to the other two groups (p = 0.006) but there were no significant differences in state anxiety level. The study has not shown any significant difference in the prevalence of depression and anxiety level regarding the differences in sex, gender and education level, apart from a higher level of state anxiety in patients with a lower education level (p = 0.032). These results indicate that patients on hemodialysis have a significantly higher level of depression and a higher level of trait anxiety compared to patients with chronic illnesses and especially compared to general population.

  2. Leech management before application on patient: a nationwide survey of practices in French university hospitals

    Delphine Grau

    2018-02-01

    Full Text Available Abstract Background Leech therapy in plastic/reconstructive microsurgery significantly improves a successful outcome of flap salvage but the drawback is a risk of severe infection that results in a drop of the salvage rates from 70-80% to below 30%. We report the results of a national survey conducted in all the French university hospitals to assess the current extent of use of leech for medical practices in the hospital and to investigate maintenance, delivery practices and prevention of the risk of infection. Methods Data concerning conditions of storage, leech external decontamination, microbiological controls, mode of delivery and antibiotic prophylaxis were collected from all the French university hospitals in practicing leech therapy, on the basis of a standardized questionnaire. Results Twenty-eight of the 32 centers contacted filled the questionnaire, among which 23 practiced leech therapy, mostly with a centralized storage in the pharmacy; 39.1% of the centers declared to perform leech external decontamination and only 2 centers recurrent microbiological controls of the water storage. Leech delivery was mostly nominally performed (56.5%, but traceability of the leech batch number was achieved in only 39.1% of the cases. Only 5 centers declared that a protocol of antibiotic prophylaxis was systematically administered during leech therapy: either quinolone (2, sulfamethoxazole/trimethoprim (2 or amoxicillin/clavulanic acid (1. Conclusions Measures to prevent infectious complications before application to patient have to be better applied and guidelines of good practices are necessary.

  3. Metabolic syndrome and associated factors among psychiatric patients in Jimma University Specialized Hospital, South West Ethiopia.

    Asaye, Sintayehu; Bekele, Shiferaw; Tolessa, Daniel; Cheneke, Waqtola

    2018-04-24

    Metabolic syndrome is a multisystem disorder which coined to describe the recognized clustering of metabolic and cardiovascular abnormalities including obesity, hypertension, dyslipidemia, and abnormalities of glucose homeostasis. To assess the prevalence and associated factors of metabolic syndrome among psychiatric patients in Jimma University Specialized Hospital. This study was conducted at Jimma University Specialized hospital psychiatric ward from May 15 to July 16, 2015. A cross-sectional study design and consecutive sampling technique were used. A single population proportion formula was used to include a total of 360 psychiatric patients. An interview administered structured questionnaire was used to collect socio-demographic and some clinical data. Anthropometric data were collected based on standard guild line for anthropometric measurement. Five milliliter of venous blood was collected from ante-cubital fossa after overnight fasting for 8 h. Semi-automated clinical chemistry analyzer (Temis Linear) was used for biochemical laboratory analysis. Data analysis was performed by using SPSS version-20 software. Binary and multiple logistic regressions were used to identify the association between dependent and independent variables. P value less than 0.05 was taken as statistically significant association. The prevalence of metabolic syndrome among psychiatric patients was 28.9%. Age greater than 30 years old (AOR: 5.2, CI: 2.3, 11.8, P. value metabolic syndrome among diabetic patients in the study area. The other independent variables such as family history of hypertension, chewing chat, Psychotropic drugs, duration of treatment, regularly eating fruits and vegetables had no statistically significant association with metabolic syndrome (P. value > 0.05). There was high prevalence of metabolic syndrome among the psychiatric patients. Therefore; close assessment, management and treatment of metabolic syndrome among patients with psychiatry problem is

  4. Inpatient Management Of Diabetes Mellitus Among Noncritically Ill Patients At The University Hospital Of Puerto Rico

    Allende-Vigo, Myriam Zaydee; González-Rosario, Rafael A.; González, Loida; Sánchez, Viviana; Vega, Mónica A.; Alvarado, Milliette; Ramón, Raul O.

    2014-01-01

    OBJECTIVE To describe the state of glycemic control in non-critically ill diabetic patients admitted to the PR University Hospital, and the adherence to current standard of care guidelines for the treatment of diabetes. METHODS This was a retrospective study of patients admitted to a General Medicine ward with Diabetes Mellitus as a secondary diagnosis. Clinical data was analyzed for the first 5 days and the last 24 hours of admission. RESULTS One hundred and forty-seven (147) non-critically ill diabetic patients were evaluated. The rate of hyperglycemia and hypoglycemia was 56.7% and 2.8%, respectively. Nearly 60% of patients were hyperglycemic during the first 24 hrs of admission and 54.2% during the last 24 hrs. Mean last glucose value before discharge was 189.6 ± 73 mg/dL. Most patients were treated with subcutaneous insulin with basal insulin alone used as the most common regimen. The proportion of patients classified as uncontrolled receiving basal-bolus therapy increased from 54.3% on day 1 to 60.0% on day 5, with still 40.0% receiving only basal insulin. Most of the uncontrolled patients had their insulin dose increased (70.1%), however, a substantial portion had no change (23.7%) or even had a decrease (6.2%) in their insulin dose. CONCLUSIONS Even though there are areas of improvement in the management of hospitalized diabetic patients, it is still suboptimal, probably due to clinical inertia. A comprehensive educational diabetes management program, along with standardized insulin orders should be implemented to improve the care of these patients. PMID:24325996

  5. Potentially avoidable inpatient nights among warfarin receiving patients; an audit of a single university teaching hospital.

    Forde, Dónall

    2009-01-01

    BACKGROUND: Warfarin is an oral anticoagulant (OAT) that needs active management to ensure therapeutic range. Initial management is often carried out as an inpatient, though not requiring inpatient facilities. This mismatch results in financial costs which could be directed more efficaciously. The extent of this has previously been unknown. Here we aim to calculate the potential number of bed nights which may be saved among those being dose optimized as inpatients and examine associated factors. METHODS: A 6 week prospective audit of inpatients receiving OAT, at Cork University Hospital, was carried out. The study period was from 11th June 2007 to 20th July 2007. Data was collected from patient\\'s medications prescription charts, medical record files, and computerised haematology laboratory records. The indications for OAT, the patient laboratory coagulation results and therapeutic intervals along with patient demographics were analysed. The level of potentially avoidable inpatient nights in those receiving OAT in hospital was calculated and the potential cost savings quantified. Potential avoidable bed nights were defined as patients remaining in hospital for the purpose of optimizing OAT dosage, while receiving subtherapeutic or therapeutic OAT (being titred up to therapeutic levels) and co-administered covering low molecular weight heparin, and requiring no other active care. The average cost of euro638 was taken as the per night hospital stay cost for a non-Intensive Care bed. Ethical approval was granted from the Ethical Committee of the Cork Teaching Hospitals, Cork, Ireland. RESULTS: A total of 158 patients were included in the audit. There was 94 men (59.4%) and 64 women (40.6%). The mean age was 67.8 years, with a median age of 70 years.Atrial Fibrillation (43%, n = 70), followed by aortic valve replacement (15%, n = 23) and pulmonary emboli (11%, n = 18) were the commonest reasons for prescribing OAT. 54% had previously been prescribed OAT prior to

  6. Pattern and outcome of patients discharged from chest ward of a university hospital

    Ruchi Sachdeva

    2013-01-01

    Full Text Available Aim: To describe morbidity and mortality profile of patients discharged from chest ward of a university hospital. Materials and Methods: Prospectively selected information (age, gender, residence, length of stay, outcome and primary diagnosis of all consecutive in-patients was recorded for six month reference period. Results: Out of 967 patients, mean age was 50.64 years (±15.71; M:F = 3.5:1; 81.3% were from rural area. Primary diagnosis was tuberculosis/sequel among 528 (54.60% and non-TB among 439 (45.4% patients (chronic obstructive pulmonary diseases [COPD] - 20.3%; pneumonia - 15.8%; lung cancer - 5.0%; asthma - 1.6%; bronchiectasis - 0.9%, lung abscess - 0.8%, miscellaneous - 1.0%. Total deaths observed was 142 (14.7% of all discharges and 54.25% of deaths occurred within 48 hours of admission suggesting criticality/late presentation; time distribution of death was similar considering 8-hourly period of 24-h cycle. Average length of stay for all patients was 6.91 (±5.14 days while it was 7.38 (±4.98 days for discharge live and 4.19 (±5.21 days for expired patients. Conclusion: Study provides a snapshot of patients discharged from chest ward that may aid in decision making, improving quality of care and initiation of educational activities at primary level.

  7. Breast reconstruction rate and profile in a Singapore patient population: a National University Hospital experience.

    Sim, Nadia; Soh, Sharon; Ang, Chuan Han; Hing, Chor Hoong; Lee, Han Jing; Nallathamby, Vigneswaran; Yap, Yan Lin; Ong, Wei Chen; Lim, Thiam Chye; Lim, Jane

    2017-05-15

    Breast reconstruction is an integral part of breast cancer management, with the aim of restoring a breast to its natural form. There is increasing awareness among women that it is a safe procedure and its benefits extend beyond aesthetics. Our aim was to establish the rate of breast reconstruction and provide an overview of the patients who underwent breast reconstruction at National University Hospital (NUH), Singapore. We evaluated factors, such as ethnicity, age, time and type of implant, for their impact on a patient's decision to proceed with breast reconstruction. We retrospectively reviewed the medical records of women who had breast cancer and underwent breast surgery at NUH between 2001 and 2010. The breast reconstruction rate in this study was 24.3%. There were 241 patients who underwent breast reconstruction surgeries (including delayed and immediate procedures) among 993 patients for whom mastectomies were done for breast cancer. Chinese patients were the largest ethnic group who underwent breast reconstruction after mastectomy (74.3%). Within a single ethnic patient group, Malay women had the largest proportion of women undergoing breast reconstruction (60.0%). The youngest woman in whom cancer was detected in our study was aged 20 years. Malay women showed the greatest preference for autologous tissue breast reconstruction (92.3%). The median age at cancer diagnosis of our cohort was 46 years. We noted increases in the age of patients undergoing breast reconstruction and the proportion of breast reconstruction cases over the ten-year study period.

  8. Exploring the impact of staff absenteeism on patient satisfaction using routine databases in a university hospital.

    Duclay, E; Hardouin, J B; Sébille, V; Anthoine, E; Moret, L

    2015-10-01

    To explore the influence of staff absenteeism on patient satisfaction using the indicators available in management reports. Among factors explaining patient satisfaction, human resource indicators have been studied widely in terms of burnout or job satisfaction, but there have not been many studies related to absenteeism indicators. A multilevel analysis was conducted using two routinely compiled databases from 2010 in the clinical departments of a university hospital (France). The staff database monitored absenteeism for short-term medical reasons (5 days or less), non-medical reasons and absences starting at the weekend. The patient satisfaction database was established at the time of discharge. Patient satisfaction related to relationships with staff was significantly and negatively correlated with nurse absenteeism for non-medical reasons (P absenteeism starting at weekends (P absenteeism for short-term medical reasons (P absenteeism and should lead to a better understanding of the impact of human resources on patient satisfaction. To enhance patient satisfaction, managers need to find a way to reduce staff absenteeism, in order to avoid burnout and to improve the atmosphere in the workplace. © 2014 John Wiley & Sons Ltd.

  9. Focused development of advanced practice nurse roles for specific patient groups in a Swiss university hospital

    Spichiger, Elisabeth; Zumstein-Shaha, Maya; Schubert, Maria; Herrmann, Luzia

    2018-02-01

    Background: To cover future health care needs of the population, new care models are necessary. The development of advanced nursing practice (ANP) offers the opportunity to meet these challenges with novel services. At the Inselspital, Bern University Hospital, ANP services and corresponding advanced practice nurse (APN) roles have been developed since 2011. Purpose: The aim is to develop innovative and evidence based ANP services to supplement health care for specific patient groups and their family members with the goal to improve safety and achieve better outcomes. Methods: Project-based ANP services are developed in close collaboration of clinical departments and the Nursing Development Unit (NDU) of the Directorate of Nursing. Structure, process and outcome data are collected for evaluation. Findings: Currently, five ANP services are established and running, eight more are in the developmental phase. Most services address the long term care of patients with chronic illnesses and their family members. Ten APNs work between 10 % and 80 %, three are leading an ANP-team. APNs work over 50 % in direct clinical practice, primarily in counselling. An ANP network connects APNs and NDU, promoting synergy and exchange. Conclusions: The available resources often constitute a challenge for the development of ANP services. Vital for the long-term success are an adequate extent of the position, the support by department directorate, the conceptual framework that is implemented across the whole hospital, and the development within project structures.

  10. Urinary tract infection among obstetric fistula patients at Gondar University Hospital, northwest Ethiopia.

    Wondimeneh, Yitayih; Muluye, Dagnachew; Alemu, Abebe; Atinafu, Asmamaw; Yitayew, Gashaw; Gebrecherkos, Teklay; Alemu, Agersew; Damtie, Demekech; Ferede, Getachew

    2014-01-17

    Many women die from complications related to pregnancy and childbirth. In developing countries particularly in sub-Saharan Africa and Asia, where access to emergency obstetrical care is often limited, obstetric fistula usually occurs as a result of prolonged obstructed labour. Obstetric fistula patients have many social and health related problems like urinary tract infections (UTIs). Despite this reality there was limited data on prevalence UTIs on those patients in Ethiopia. Therefore, the aim of this study was to determine the prevalence, drug susceptibility pattern and associated risk factors of UTI among obstetric fistula patients at Gondar University Hospital, Northwest Ethiopia. A cross sectional study was conducted from January to May, 2013 at Gondar University Hospital. From each post repair obstetric fistula patients, socio-demographic and UTIs associated risk factors were collected by using a structured questionnaire. After the removal of their catheters, the mid-stream urine was collected and cultured on CLED. After overnight incubation, significant bacteriuria was sub-cultured on Blood Agar Plate (BAP) and MacConkey (MAC). The bacterial species were identified by series of biochemical tests. Antibiotic susceptibility test was done by disc diffusion method. Data was entered and analyzed by using SPSS version 20. A total of 53 post repair obstetric fistula patients were included for the determination of bacterial isolate and 28 (52.8%) of them had significant bacteriuria. Majority of the bacterial isolates, 26 (92.9%), were gram negative bacteria and the predominant ones were Citrobacter 13 (24.5%) and E. coli 6 (11.3%). Enterobacter, E.coli and Proteus mirabilis were 100% resistant to tetracycline. Enterobacter, Proteus mirabilis, Klebsella pneumonia, Klebsella ozenae and Staphylococcus aureus were also 100% resistant to ceftriaxone. The prevalence of bacterial isolates in obstetric fistula patients was high and majority of the isolates were gram

  11. Survival of cutaneous malignant melanoma patients at University of Iowa Hospitals: 1950--1974.

    Griffel, M

    1981-01-01

    Survival of 387 patients treated for cutaneous malignant melanoma at University of Iowa Hospitals during the period 1950--1974 was analyzed. For the entire period, the observed five-year survivals were 57% for women and 33% for men; the corresponding ten-year survivals were 43 and 23%. For both men and women, there was an impressive improvement in outcome between the earliest and the latest periods, so that for 1970--1974, the five-year observed survival was 68% for women and 49% for men. Data are presented on mean age at diagnosis, distribution by stage, site, and sex, and survival by site and sex. The question is raised whether the biologic nature of malignant melanoma is variable, so that increased incidence is associated with better prognosis.

  12. Risk factors for laryngeal and pharyngeal cancer in patients treated at Liaquat University Hospital, Jamshoro, Pakistan

    Amur, S.A.; Channa, N.A.; Mugheri, M.H.; Khuhro, Q.

    2017-01-01

    To assess the environmental as well as dietary risk factors for the laryngeal and pharyngeal cancer (LPC) in patients treated at Liaquat University Hospital, Jamshoro. Methodology: Total 395 LPC patients and 550 healthy persons were interviewed through a standard questionnaire specially designed to study the risk factors for LPC disease. Significance level (p<0.05) was assessed with chi-squared test (95% confidence interval) and odds ratios were measured for associations of factors with LPC by logistic regression analysis. Results: The age range was 37.6 to 56.6 years with majority of males as compared to females. Majority of LPC patients were married, underweight and labor workers. Use of non-branded oil, smoking and illiteracy and sun exposure 1 hour were significantly positively associated with LPC. Mainpuri was observed at highest significant positive risk factor for LPC. Less vegetables, less fruit and less meat consumption as well as, deep fried/fried foods and more tea intake were found significantly positively associated with LPC disease. Conclusion: Labor work, Illiteracy, smoking, use of non-branded cooking oil, sun exposure 1 hour, manipuri, consumption of less vegetables, less fruit and less meat, deep fried/fried foods and more tea intake were found significantly positively associated risk factors of LPC. (author)

  13. [Prospective assessment of medication errors in critically ill patients in a university hospital].

    Salazar L, Nicole; Jirón A, Marcela; Escobar O, Leslie; Tobar, Eduardo; Romero, Carlos

    2011-11-01

    Critically ill patients are especially vulnerable to medication errors (ME) due to their severe clinical situation and the complexities of their management. To determine the frequency and characteristics of ME and identify shortcomings in the processes of medication management in an Intensive Care Unit. During a 3 months period, an observational prospective and randomized study was carried out in the ICU of a university hospital. Every step of patient's medication management (prescription, transcription, dispensation, preparation and administration) was evaluated by an external trained professional. Steps with higher frequency of ME and their therapeutic groups involved were identified. Medications errors were classified according to the National Coordinating Council for Medication Error Reporting and Prevention. In 52 of 124 patients evaluated, 66 ME were found in 194 drugs prescribed. In 34% of prescribed drugs, there was at least 1 ME during its use. Half of ME occurred during medication administration, mainly due to problems in infusion rates and schedule times. Antibacterial drugs had the highest rate of ME. We found a 34% rate of ME per drug prescribed, which is in concordance with international reports. The identification of those steps more prone to ME in the ICU, will allow the implementation of an intervention program to improve the quality and security of medication management.

  14. A comprehensive database of Duchenne and Becker muscular dystrophy patients in Children's Hospital of Fudan University

    Xi-hua LI

    2015-05-01

    Full Text Available Background China is one of the countries that have the largest number of patients suffering from Duchenne and Becker muscular dystrophy (DMD/BMD. Although the building of international DMD/BMD databases has laid a foundation for clinical drug development and clinical trials, it has not yet been carried out in China. In this study, a modified registry form of Remudy was applied to 229 DMD/BMD patients in order to establish a comprehensive database, which will lay the groundwork for international cooperation.  Methods A total of 229 DMD/BMD patients diagnosed by genetic testing or muscle biopsy admitted in Children's Hospital of Fudan University (CHFU during the period of August 2011 to December 2013 were enrolled in this study. The data included sex, age, age at diagnosis, geographic distribution of patients, DMD gene mutation types, family history, walking capability, cardiac and respiratory function, steroid treatment and rehabilitation intervention.  Results There were 194 DMD and 35 BMD male patients who were diagnosed at the age of 0-18 years, and among them, most patients were diagnosed at the age of > 3-4 (16.59%, 38/229 and > 7-8 (14.85%, 34/229 years. Exon deletion was the most frequent genetic mutations for DMD/BMD [65.46% (127/194 and 74.29% (26/35], respectively. Patients with a family history accounted for 23.14% (53/229. The rate of DMD registrants losing walking capability was 17.53% (34/194, and all the BMD registrants were able to walk. Cardiac functions were examined in 46.29% (106/229 DMD/BMD boys and respiratory functions were examined in 17.90% (41/229 DMD/BMD boys. The proportion of DMD patients receiving prednisone with dosage of 0.75 mg/(kg·d was 26.29% (51/194.  Conclusions This database describes in detail the genotype, clinical manifestation, diagnosis and treatment and rehabilitation status of 229 DMD/BMD patients in China. The database not only provides comprehensive information for DMD/BMD patient management

  15. Social and hospital costs of patients admitted to a university hospital in Brazil due to motorcycle crashes.

    Dos Anjos, Katia Campos; de Rezende, Marcelo Rosa; Mattar, Rames

    2017-08-18

    This study aimed to investigate the social and hospital costs of patients treated at a public hospital who were motorcycle crash victims. This prospective study was on 68 motorcycle riders (drivers or passengers), who were followed up from hospital admission to 6 months after the crash. A questionnaire covering quantitative and qualitative questions was administered. Motorcycle crash victims were responsible for 12% of the institution's hospital admissions; 54.4% were young (18-28 years of age); 92.6% were the drivers; 91.2% were male; and 50% used their motorcycles as daily means of transportation. Six months afterward, 94.1% needed help from someone; 83.8% had changed their family dynamics; and 73.5% had not returned to their professional activities. Among the injuries, 94.7% had some type of fracture, of which 53.5% were exposed fractures; 35.3% presented temporary sequelae; and 32.4% presented permanent sequelae. They used the surgical center 2.53 times on average, with a mean hospital stay of 18 days. The per capita hospital cost of these victims' treatment was US$17,481.50. The social and hospital costs were high, relative to the characteristics of a public institution. Temporary or permanent disability caused changes to family dynamics, as shown by the high numbers of patients who were still away from their professional activities more than 6 months afterward.

  16. Characterization of colonizing Staphylococcus aureus isolated from surgical wards' patients in a Nigerian university hospital.

    Deboye O Kolawole

    Full Text Available In contrast to developed countries, only limited data on the prevalence, resistance and clonal structure of Staphylococcus aureus are available for African countries. Since S. aureus carriage is a risk factor for postoperative wound infection, patients who had been hospitalized in surgical wards in a Nigerian University Teaching Hospital were screened for S. aureus carriage. All S. aureus isolates were genotyped (spa, agr and assigned to multilocus sequence types (MLST. Species affiliation, methicillin-resistance, and the possession of pyrogenic toxin superantigens (PTSAg, exfoliative toxins (ETs and Panton-Valentine Leukocidin (PVL were analyzed. Of 192 patients screened, the S. aureus carrier rate was 31.8 % (n = 61. Of these isolates, 7 (11.5% were methicillin-resistant (MRSA. The isolates comprised 24 spa types. The most frequent spa types were t064, t084, t311, and t1931, while the most prevalent MLST clonal complexes were CC5 and CC15. The most frequent PTSAg genes detected were seg/sei (41.0% followed by seb (29.5%, sea (19.7%, seh (14.7% and sec (11.5. The difference between the possession of classical and newly described PTSAg genes was not significant (63.9% versus 59.0% respectively; P = 0.602. PVL encoding genes were found in 39.3% isolates. All MRSA isolates were PVL negative, SCCmec types I and VI in MLST CC 5 and CC 30, respectively. Typing of the accessory gene regulator (agr showed the following distribution: agr group 1 (n = 20, group II (n = 17, group III (n = 14 and group IV (n = 10. Compared to European data, enterotoxin gene seb and PVL-encoding genes were more prevalent in Nigerian methicillin-susceptible S. aureus isolates, which may therefore act as potential reservoir for PVL and PTSAg genes.

  17. Perceived Obstacles Faced by Diabetes Patients Attending University of Gondar Hospital, Northwest Ethiopia

    Akshaya Srikanth Bhagavathula

    2018-03-01

    Full Text Available BackgroundDiabetes mellitus (DM is a non-communicable, chronic, and progressive disease that can lead to serious complications and even to premature death. A closer understanding of the DM patients’ specific obstacles will provide a greater clarity of the factors influencing their disease-related quality of life and coping with daily life. The study aimed to evaluate the obstacles of DM patients attending ambulatory clinic of the University of Gondar Hospital (UOGH, Northwest Ethiopia.MethodsA cross-sectional study was conducted from February to April 2017 at ambulatory clinic of the UOGH. A validated short version of the diabetic obstacle questionnaire was used. The internal reliability of the questionnaire was checked using Cronbach’s alpha and was found to be 92.5%. To determine any association between each of the nine sections of the questionnaire and age, sex, residence, educational status, and DM type, a binary logistic regression was performed.ResultsThe mean age of respondents was 38.69 ± 15.39 years. Compared with patients with type 1 DM, patients with type 2 DM reported poorer relationships with medical professionals (adjusted odds ratio (AOR: 2.191, p-value = 0.027 and less support from families and friends (AOR: 1.913, p-value = 0.049. Patients coming from rural areas (AOR: 2.947, p = 0.002 and having no formal education (AOR: 2.078, p = 0.029 also received less support from families and friends.ConclusionDM patients in UOGH reported several obstacles related to patients’ relationship with health professionals, lack of support from their friends, lack of knowledge about DM, and lack of motivation to exercise. Effective efforts should be initiated to improve healthier environment to educate, care and preventive services for people with DM.

  18. Clinical profile of newly presenting diabetic patients at the University of Uyo Teaching Hospital, Nigeria

    Unadike, B.C.; Akpan, N.A.; Essien, I.O.

    2010-01-01

    Diabetes Mellitus is emerging as a major health challenge with the incidence and prevalence of the disease on the increase. It also contributes to overall morbidity and mortality with complications like cardiovascular disease, neuropathy, nephropathy, retinopathy and lower extremity amputation. There are few local studies on the clinical characteristics of the disease in our wet up and this study therefore set out to characterize the clinical profile of newly presenting diabetic patients in a health facility in Nigeria. It is a cross sectional, descriptive study carried out at the diabetes clinic of the University of Uyo Teaching Hospital between January 2007 and September 2008. Data obtained included age, sex, anthropometric indices, symptomatology, co-morbidities, complications and treatment of diabetes. Data was analyzed using SPSS version 10. A total of two hundred and seventy patients were studied (120 males, 150 females). About 89.2% were Type 2 DM patients and majority of the study subjects were overweight. Diabetic neuropathy was the commonest complication present in 38.8% of the subjects. Polyuria was the commonest symptom and hypertension the commonest comorbidity. Majority of the subjects were on oral hypolgycaemic agents for the management of their disease with the sulphonyureas and biguanides being the most common medication that was taken by them. A few of the patients were also taking herbal medication for treatment of their disease. Majority of the patients presenting in our facility have Type 2 diabetes, were hypertensive and overweight. Hypertension was the commonest co-morbidity and diabetic neuropathy the commonest complication. Adequate health education, subsidies on medications and proper funding of the health sector is necessary to stem the tide of the burden attributable to the disease. (author)

  19. Prehospital management and fluid resuscitation in hypotensive trauma patients admitted to Karolinska University Hospital in Stockholm.

    Talving, Peep; Pålstedt, Joakim; Riddez, Louis

    2005-01-01

    Few previous studies have been conducted on the prehospital management of hypotensive trauma patients in Stockholm County. The aim of this study was to describe the prehospital management of hypotensive trauma patients admitted to the largest trauma center in Sweden, and to assess whether prehospital trauma life support (PHTLS) guidelines have been implemented regarding prehospital time intervals and fluid therapy. In addition, the effects of the age, type of injury, injury severity, prehospital time interval, blood pressure, and fluid therapy on outcome were investigated. This is a retrospective, descriptive study on consecutive, hypotensive trauma patients (systolic blood pressure Karolinska University Hospital in Stockholm, Sweden, during 2001-2003. The reported values are medians with interquartile ranges. Basic demographics, prehospital time intervals and interventions, injury severity scores (ISS), type and volumes of prehospital fluid resuscitation, and 30-day mortality were abstracted. The effects of the patient's age, gender, prehospital time interval, type of injury, injury severity, on-scene and emergency department blood pressure, and resuscitation fluid volumes on mortality were analyzed using the exact logistic regression model. In 102 (71 male) adult patients (age > or = 15 years) recruited, the median age was 35.5 years (range: 27-55 years) and 77 patients (75%) had suffered blunt injury. The predominant trauma mechanisms were falls between levels (24%) and motor vehicle crashes (22%) with an ISS of 28.5 (range: 16-50). The on-scene time interval was 19 minutes (range: 12-24 minutes). Fluid therapy was initiated at the scene of injury in the majority of patients (73%) regardless of the type of injury (77 blunt [75%] / 25 penetrating [25%]) or injury severity (ISS: 0-20; 21-40; 41-75). Age (odds ratio (OR) = 1.04), male gender (OR = 3.2), ISS 21-40 (OR = 13.6), and ISS >40 (OR = 43.6) were the significant factors affecting outcome in the exact

  20. Distal sensory polyneuropathy among HIV-infected patients at Parakou University Hospital, Benin, 2011.

    Adoukonou, T A; Kouna-Ndouongo, P; Kpangon, A; Gnonlonfoun, D; Kpacha, B; Dovonou, A; Houinato, D

    2017-06-01

    Distal sensory polyneuropathy (DSP) is the most frequent neurological complication among HIV patients, and its risk increases with use of highly active antiretroviral therapy (HAART). We aimed to assess the prevalence of DSP and the factors associated with it among HIV-infected outpatients treated at Parakou University Hospital. This cross-sectional study took place from April 15 to July 15, 2011, and included 262 patients. All patients underwent a neurological examination by two neurologists with training and clinical experience in these examinations and in the Brief Peripheral Neuropathy Screening (BPNS), which was the primary tool used here. Data from nutritional status (body mass index: BMI), social and demographic information, HAART status, and CD4 count were recorded. The factors associated with DSP were studied with multivariate analysis, using a logistic regression model and a significance level of 0.05. The study included 60 men (22.9 %). Patients' ages ranged from 16 to 74 years and averaged 36.8±10 years. All patients but one patient were infected by HIV type 1 only; that one was coinfected by types 1 and 2. The mean BMI was 22.5+/-4.2 kg/m 2 . In all, 213 (81.3 %) received HAART, and the mean CD4 count was 355.0 cells/mm 3 +/-236.1. The prevalence of DSP was 42.4 %. The factors associated with it on univariate analysis were age, marital status, HAART status, duration of HIV infection, and duration of HAART. Only advanced age (OR 1.8, 95 % CI 1.1-5.3) and HAART use (OR 2.3, 95 % CI 1.5-4.9) were associated with DSP in the multivariate analysis. The main symptoms were paresthesia (numbness:75.7%; burning: 39.6%; pins and needles sensation 32.4 %) and pain (23.4 %). Vibration perception at the toes was missing or reduced for 84.4 %. According to the sensory symptoms grade, 93.7 % of patients were classified in Grades 2 or 3. This study showed that the prevalence of DSP is high and that it is associated with age and HAART.

  1. Hotel-based ambulatory care for complex cancer patients: a review of the University College London Hospital experience.

    Sive, Jonathan; Ardeshna, Kirit M; Cheesman, Simon; le Grange, Franel; Morris, Stephen; Nicholas, Claire; Peggs, Karl; Statham, Paula; Goldstone, Anthony H

    2012-12-01

    Since 2005, University College London Hospital (UCLH) has operated a hotel-based Ambulatory Care Unit (ACU) for hematology and oncology patients requiring intensive chemotherapy regimens and hematopoietic stem cell transplants. Between January 2005 and 2011 there were 1443 patient episodes, totaling 9126 patient days, with increasing use over the 6-year period. These were predominantly for hematological malignancy (82%) and sarcoma (17%). Median length of stay was 5 days (range 1-42), varying according to treatment. Clinical review and treatment was provided in the ACU, with patients staying in a local hotel at the hospital's expense. Admission to the inpatient ward was arranged as required, and there was close liaison with the inpatient team to preempt emergency admissions. Of the 523 unscheduled admissions, 87% occurred during working hours. An ACU/hotel-based treatment model can be safely used for a wide variety of cancers and treatments, expanding hospital treatment capacity, and freeing up inpatient beds for those patients requiring them.

  2. Social support for patients undergoing liver transplantation in a Public University Hospital.

    Garcia, Clerison Stelvio; Lima, Agnaldo Soares; La-Rotta, Ehideé Isabel Gómez; Boin, Ilka de Fátima Santana Ferreira

    2018-02-17

    Several diseases may lead to the need for liver transplantation due to progressive organ damage until the onset of cirrhosis, resulting in changes in interpersonal relationships. Social Support for transplant candidates is an important variable, providing them with psychological and social well-being. This study aims to assess social support in chronic hepatic patients, waiting for liver transplantation. A cross-sectional study was conducted with 119 patients, for convenience sampling, from the liver transplant waiting list at a Brazilian University Hospital Outpatients. The information was collected through semistructured questionnaires, in four stages: 1) socioeconomic and demographic information 2) clinical aspects 3) feelings 4) Social Support Network Inventory (SSNI), to Brazilian Portuguese. The statistical analysis was conducted using ANOVA and multivariate linear regression analysis to evaluate the relationship between the scales of social support and the collected co-variables. Average age was 50.2 ± 11.6, and 87 (73.1%) were men. Patients with alcohol and virus liver disease etiology had the same frequency of 28%. The MELD, without extrapoints, was 16.7 ± 4.9. Global social support family score was 3.72 ± 0.39, and Cronbach's alpha = 0.79. The multivariate analysis presented the following associations, age = [- 0.010 (95% CI = - 0.010 - -0.010); P = 0.001], etiology of hepatic disease = [- 0.212 (95% CI = - 0.37 - -0.05); P = 0.009], happiness = [- 0.214(95% CI = - 0.33 - -0.09) P = 0.001) and aggressiveness = [0.172 (95% CI = 0.040-0.030); P = 0.010). The social support was greater when the patients were younger (18 to 30 years). Patients with alcoholic cirrhosis, regardless of whether or not they were associated with virus, had less social support. As for feelings, the absence of happiness and the presence of aggressiveness showed a negative effect on social support.

  3. A personalized mobile patient guide system for a patient-centered smart hospital: Lessons learned from a usability test and satisfaction survey in a tertiary university hospital.

    Yoo, Sooyoung; Jung, Se Young; Kim, Seok; Kim, Eunhye; Lee, Kee-Hyuck; Chung, Eunja; Hwang, Hee

    2016-07-01

    The present study focused on the design, implementation, and evaluation of a personalized mobile patient guide system that utilizes smart phones, indoor navigation technology and a hospital information system (HIS) to address the difficulties that outpatients face in finding hospital facilities, recognizing their daily treatment schedule, and accessing personalized medical and administrative information. The present study was conducted in a fully digitized tertiary university hospital in South Korea. We developed a real-time location-based outpatient guide system that consists of Bluetooth access points (APs) for indoor navigation, an Android-based guide application, a guide server, and interfaces with the HIS. A total of 33 subjects and 43 outpatients participated in the usability test (UT) and the satisfaction survey, respectively. We confirmed that the indoor navigation feature can be applied to outpatient departments with precision using a position error test. The participants in the UT completed each scenario with an average success rate of 67.4%. According to the results, we addressed the problems and made improvements to the user interface by providing users with context-based guidance information. The satisfaction rating of the system was high, with an average score of 4.0 out of 5.0, showing its utility as a patient-centered hospital service. The innovative mobile patient guide system for outpatients is feasible and can be successfully implemented to provide personalized information with high satisfaction. Additionally, the issues identified and lessons learned from our experiences regarding task scheduling, indoor navigation, and usability should be considered when developing the system. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. Radiology Online Patient Education Materials Provided by Major University Hospitals: Do They Conform to NIH and AMA Guidelines?

    Prabhu, Arpan V; Donovan, Ashley L; Crihalmeanu, Tudor; Hansberry, David R; Agarwal, Nitin; Beriwal, Sushil; Kale, Hrishikesh; Heller, Matthew

    The internet creates opportunities for Americans to access medical information about imaging tests and modalities to guide them in their medical decision-making. Owing to health literacy variations in the general population, the American Medical Association and National Institutes of Health recommend patient education resources to be written between the third and seventh grade levels. Our purpose is to quantitatively assess the readability levels of online radiology educational materials, written for the public, in 20 major university hospitals. In September and October 2016, we identified 20 major university hospitals with radiology residency-affiliated hospital systems. On each hospital׳s website, we downloaded all radiology-related articles written for patient use. A total of 375 articles were analyzed for readability level using 9 quantitative readability scales that are well validated in the medical literature. The 375 articles from 20 hospital systems were collectively written at an 11.4 ± 3.0 grade level (range: 8.4-17.1). Only 11 (2.9%) articles were written at the recommended third to seventh grade levels. Overall, 126 (33.6%) were written above a full high-school reading level. University of Washington Medical Center׳s articles were the most readable with a reading level corresponding to 7.9 ± 0.9. The vast majority of websites at major academic hospitals with radiology residencies designed to provide patients with information about imaging were written above the nationally recommended health literacy guidelines to meet the needs of the average American. This may limit the benefit that patients can derive from these educational materials. Copyright © 2018 Elsevier Inc. All rights reserved.

  5. [Therapy costs of adult patients admitting to emergency unit of a university hospital with asthma acute attack].

    Serinken, Mustafa; Dursunoğlu, Neşe; Cimrin, Arif H

    2009-01-01

    In the present study, hospital costs of patients who admitted to the emergency department with asthma attack and several variables that could effect this cost were analyzed and data were collected in order to reduce economical burden of that disease was aimed. Between September 2005 and February 2007 patients with acute asthma attack, admitted to Pamukkale University Hospital Emergency Department were retrospectively evaluated. Totally 108 patients who met the inclusion criteria admitted to the emergency department with asthma acute attack. Of those 97 were women (89.8%). Forty mild, 51 moderate, 15 severe and 2 life-threatening attacks were detected. Severe and life-threatening attacks were more frequent in patients graduated from primary school compared with the other groups. Mean therapy costs of the patients who were hospitalized and treated in the emergency department were 836.60 +/- 324.30 TL (Turkish Lira) and 170.66 +/- 86.71 TL respectively. Treatment procedures consisted of 45.8% of and 38.5% hospital costs for patients treated in the emergency department and for patients hospitalized respectively. There was a statistically significant difference in the comparison of costs according to the attack severity (p= 0.0001). Education level of the patients had a significant effect on hospital costs (p= 0.025). Comorbidities were found a significant increasing factor of treatment costs (p= 0.017). There were no effects of sex, age, medical insurance or duration of asthma disease on the hospital costs. The relation between low-education level, living in the rural area and admissions with severe attacks of asthma to emergency department show the importance of treatment success with patient compliance. Positive and negative factors effecting disease control should be detected by evaluating larger populations to reduce economical burden of asthma.

  6. Patient blood management knowledge and practice among clinicians from seven European university hospitals

    Manzini, P. M.; Dall'Omo, A. M.; D'Antico, S.

    2018-01-01

    Background and Objectives: The aim of this survey was to evaluate the knowledge about Patient Blood Management (PBM) principles and practices amongst clinicians working in seven European hospitals participating in a European Blood Alliance (EBA) project. Materials and Methods: A web...

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

    Gottlieb, Magnus; Marså, Kristoffer; Andreassen, Helle

    2014-01-01

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

  8. Sickness absence among depressed patients attending the General Out Patients Department of the Jos University Teaching Hospital, Jos, Nigeria.

    Goar, G S; Moses, D A; Micheal, T A

    2013-01-01

    Depression has been associated with low productivity and long absence from work. This has a serious consequence for the individuals, the employer and the society. The objectives of this study were to determine sickness absence from work among depressed patients attending General Out Patients Department (GOPD) in the preceding 12 months, to assess socio-demographic correlates of sickness absence in these patients and lastly, to determine the effect of depression on perception of work performance. This was a cross-sectional descriptive study among 200 consecutive patients attending the General Out Patients Department of the Jos University Teaching Hospital from November 2006 to March 2007. A semi-structured questionnaire designed by the authors was used to collect socio-demographic variables, self-reported perception of work and sickness absence days in the 12 months prior to the study. Depression was assessed using Structured clinical Interview for DSM- IV (SCID) axis 1 disorder. A total of 51(25.4%) of the 200 patients met the DSM IV diagnostic criteria for major depression. The depressed respondents significantly had higher mean and cumulative days of sickness absence compared to the non-depressed (p marital status (p = 0.867) were associated with sickness absence. Older age (P = 0.001) was associated with sickness absence in the non-depressed while gender (p = 0.117), and marital status (p = 0.752) were not. Having a diagnosis of depression was associated with poor work performance compared with the non-depressed (p productivity and toprevent long spells of sickness absence.

  9. Strategic management for university hospitals

    Martha Isabel Riaño-Casallas

    2016-10-01

    Full Text Available Introduction: There are several approaches and schools that support strategic management processes. University hospitals require the implementation of a strategic approach to their management, since they are a particular type of organization with the triple mission of providing health care, education and research. Objective: To propose a strategic profile for a university hospital. Materials and methods: The theoretical framework of strategic management was analyzed and some particular components of hospital management were studied; based on these criteria, the strategic management process in three high complexity hospitals of Bogotá, D.C. was examined and a profile of both the objectives and the functional strategies for the hospital was proposed. Results: The main strategic thinking schools are presented; the processes and components of strategic management are described, and a strategic management profile for a university hospital is proposed. Conclusion: The strategic orientation of management for an institution with the characteristics of a university hospital facilitates achieving organizational objectives.

  10. Comparison of Patient Costs in Internal Medicine and Anaesthesiology Intensive Care Units in a Tertiary University Hospital.

    Kara, İskender; Yıldırım, Fatma; Başak, Dilek Yumuş; Küçük, Hamit; Türkoğlu, Melda; Aygencel, Gülbin; Katı, İsmail; Karabıyık, Lale

    2015-06-01

    The allocation of the Gross Domestic Product (GDP) to health is limited, therefore it has made a need for professional management of health business. Hospital managers as well as employees are required to have sufficient knowledge about the hospital costs. Hospital facilities like intensive care units that require specialization and advanced technology have an important part in costs. For this purpose, cost analysis studies should be done in the general health business and special units separately. In this study we aimed to compare the costs of anaesthesiology and internal medicine intensive care units (ICU) roughly. After approval of this study by Gazi University Faculty of Medicine Ethics Committee, the costs of 855 patients that were hospitalized, examined and treated for at least 24 hours in internal medicine and anaesthesiology ICUs between January 2012-August 2013 (20 months period) were taken and analyzed from chief staff of the Department of Information Technology, Gazi University Hospital. At the end of the study, we observed clear differences between internal medicine and anaesthesiology ICUs arising from transactions and patient characteristics of units. We stated that these differences should be considered by Social Security Institution (SSI) for the reimbursement of the services. Further, we revealed that SSI payments do not meet the intensive care expenditure.

  11. Patient journey in decompensated heart failure: An analysis in departments of cardiology and geriatrics in the Greater Paris University Hospitals.

    Laveau, Florent; Hammoudi, Nadjib; Berthelot, Emmanuelle; Belmin, Joël; Assayag, Patrick; Cohen, Ariel; Damy, Thibaud; Duboc, Denis; Dubourg, Olivier; Hagege, Albert; Hanon, Olivier; Isnard, Richard; Jondeau, Guillaume; Labouree, Florian; Logeart, Damien; Mansencal, Nicolas; Meune, Christophe; Pautas, Eric; Wolmark, Yves; Komajda, Michel

    2017-01-01

    Hospitalization for worsening/acute heart failure is increasing in France, and limited data are available on referral/discharge modalities. To evaluate patients' journeys before and after hospitalization for this condition. On 1 day per week, between October 2014 and February 2015, this observational study enrolled 260 consecutive patients with acute/worsening heart failure in all 10 departments of cardiology and four of the departments of geriatrics in the Greater Paris University Hospitals. First medical contact was an emergency unit in 45% of cases, a general practitioner in 16% of cases, an emergency medical ambulance in 13% of cases and a cardiologist in 13% of cases; 78% of patients were admitted directly after first medical contact. In-hospital stay was 13.2±11.3 days; intensive care unit stay (38% of the population) was 6.4±5 days. In-hospital mortality was 2.7%. Overall, 63% of patients were discharged home, whereas 21% were transferred to rehabilitation units. A post-discharge outpatient visit was made by only 72% of patients within 3 months (after a mean of 45±28 days). Only 53% of outpatient appointments were with a cardiologist. Emergency departments, ambulances and general practitioners are the main points of entry before hospitalization for acute/worsening heart failure. Home discharge occurs in two of three cases. Time to first patient post-discharge visit is delayed. Therefore, actions to improve the patient journey should target primary care physicians and emergency structures, and efforts should be made to reduce the time to the first visit after discharge. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  12. Positive predictive value and impact of misdiagnosis of a heart failure diagnosis in administrative registers among patients admitted to a University Hospital cardiac care unit

    Mard, Shan; Nielsen, Finn Erland

    2010-01-01

    To evaluate the positive predictive value (PPV) of a diagnosis of heart failure (HF) in the Danish National Registry of Patients (NRP) among patients admitted to a University Hospital cardiac care unit, and to evaluate the impact of misdiagnosing HF.......To evaluate the positive predictive value (PPV) of a diagnosis of heart failure (HF) in the Danish National Registry of Patients (NRP) among patients admitted to a University Hospital cardiac care unit, and to evaluate the impact of misdiagnosing HF....

  13. Four minutes for a patient, twenty seconds for a relative - an observational study at a university hospital

    Xander Carola J

    2010-04-01

    Full Text Available Abstract Background In the modern hospital environment, increasing possibilities in medical examination techniques and increasing documentation tasks claim the physicians' energy and encroach on their time spent with patients. This study aimed to investigate how much time physicians at hospital wards spend on communication with patients and their families and how much time they spend on other specific work tasks. Methods A non-participatory, observational study was conducted in thirty-six wards at the University Medical Center Freiburg, a 1700-bed academic hospital in Germany. All wards belonging to the clinics of internal medicine, surgery, radiology, neurology, and to the clinic for gynaecology took part in the study. Thirty-four ward doctors from fifteen different medical departments were observed during a randomly chosen complete work day. The Physicians' time for communication with patients and relatives and time spent on different working tasks during one day of work were assessed. Results 374 working hours were analysed. On average, a physician's workday on a university hospital ward added up to 658.91 minutes (10 hrs 58 min; range 490 - 848 min. Looking at single items of time consumption on the evaluation sheet, discussions with colleagues ranked first with 150 minutes on average. Documentation and administrative requirements took an average time of 148 minutes per day and ranked second. Total time for communication with patients and their relatives was 85 minutes per physician and day. Consequently, the available time for communication was 4 minutes and 17 seconds for each patient on the ward and 20 seconds for his or her relatives. Physicians assessed themselves to communicate twice as long with patients and sevenfold with relatives than they did according to this study. Conclusions Workload and time pressure for physicians working on hospital wards are high. To offer excellent medical treatment combined with patient centred care and

  14. [Acute ethanol intoxication among children and adolescents. A retrospective analysis of 173 patients admitted to a university children hospital].

    Schöberl, S; Nickel, P; Schmutzer, G; Siekmeyer, W; Kiess, W

    2008-01-01

    In the last time the alcohol consumption among children and adolescents is a big theme in all kind of media. The ethanol consumption among children and adolescents has risen during the last years, but also new hazardous drinking patterns like "binge-drinking" are increasing. These drinking episodes are responsible for many hospital presentations of children and adolescents with acute ethanol intoxication. This study is a retrospective analysis of 173 patients admitted to the university children hospital of Leipzig due to acute ethanol intoxication during the period 1998-2004. Investigated parameters were: socio-demographic factors, clinical presentation and management as well as quantity and type of alcohol. During the years 1998-2004 the rate of alcohol intoxicated patients in this study increased, from 1998-2003 at about 171.4%. Totally 173 patients with an average age of 14.5 years were admitted to the university children hospital. There were significantly more boys than girls. The mean blood alcohol concentration of these patients was 1.77%. Some of the patients had severe symptoms. 62 were unconscious, 2 were in coma and at least 3 patients had to be ventilated. A difference between socioeconomic groups could be observed by comparing the different school types. 44.8% of the patients went to the middle school. Furthermore 17 patients of this study had mental disorders or psychosocial problems and were therefore in psychological or psychiatric treatment. In this study a significant influence of social classes or psychosocial problems on alcohol consumption such as binge-drinking leading to acute ethanol intoxication could not be found. Alarming is the increasing number of ethanol intoxicated patients, the young age, the high measured blood ethanol concentrations and the severe symptoms of these patients. This is the reason why early and intensive prevention strategies are required.

  15. Influenza vaccine effectiveness among adult patients in a University of Lyon hospital (2004-2009).

    Amour, Sélilah; Voirin, Nicolas; Regis, Corinne; Bouscambert-Duchamp, Maude; Comte, Brigitte; Coppéré, Brigitte; Pires-Cronenberger, Silene; Lina, Bruno; Vanhems, Philippe

    2012-01-20

    The aim of this study was to estimate influenza vaccine effectiveness (IVE) against laboratory-confirmed influenza among hospitalized patients. A case-control investigation was based on the prospective surveillance of influenza-like illness (ILI) during five flu seasons. We compared influenza-positive cases and influenza-negative controls. Unadjusted overall IVE was 62% (95% confidence interval 24% to 81%). We found that IVE was lower during the 2004-05 flu season (11%; 95% CI -232% to 76%) when the vaccine and circulating viruses were mismatched. Expansion of the study to other hospitals could provide IVE estimates earlier in the season, for different age groups and emerging virus strains. Copyright © 2011 Elsevier Ltd. All rights reserved.

  16. Care of cancer patients at the end of life in a German university hospital: A retrospective observational study from 2014.

    Burkhard Dasch

    Full Text Available Cancer care including aggressive treatment procedures during the last phase of life in patients with incurable cancer has increasingly come under scrutiny, while integrating specialist palliative care at an early stage is regarded as indication for high quality end-of-life patient care.To describe the demographic and clinical characteristics and the medical care provided at the end of life of cancer patients who died in a German university hospital.Retrospective cross-sectional study on the basis of anonymized hospital data for cancer patients who died in the Munich University Hospital in 2014. Descriptive analysis and multivariate logistic regression analyses for factors influencing the administration of aggressive treatment procedures at the end of life.Overall, 532 cancer patients died. Mean age was 66.8 years, 58.5% were men. 110/532 (20.7% decedents had hematologic malignancies and 422/532 (79.3% a solid tumor. Patients underwent the following medical interventions in the last 7/30 days: chemotherapy (7.7%/38.3%, radiotherapy (2.6%/6.4%, resuscitation (8.5%/10.5%, surgery (15.2%/31.0%, renal replacement therapy (12.0%/16.9%, blood transfusions (21.2%/39.5%, CT scan (33.8%/60.9%. In comparison to patients with solid tumors, patients with hematologic malignancies were more likely to die in intensive care (25.4% vs. 49.1%; p = 0.001, and were also more likely to receive blood transfusions (OR 2.21; 95% CI, 1.36 to 3.58; p = 0.001 and renal replacement therapy (OR 2.65; 95% CI, 1.49 to 4.70; p = 0.001 in the last 7 days of life. Contact with the hospital palliative care team had been initiated in 161/532 patients (30.3%. In 87/161 cases (54.0%, the contact was initiated within the last week of the patient's life.Overambitious treatments are still reality at the end of life in cancer patients in hospital but patients with solid tumors and hematologic malignancies have to be differentiated. More efforts are necessary for the timely inclusion of

  17. PROGNOSTIC FACTORS IN PATIENTS WITH PRESSURE SORES IN A UNIVERSITY HOSPITAL IN SOUTHERN BRAZIL.

    Walter, Gustavo Palmeiro; Seidel, William; Giustina, Renata Della; Bins-Ely, Jorge; Maurici, Rosemeri; Narciso-Schiavon, Janaína Luz

    2017-01-01

    Despite advances in medical care, patients who are hospitalized or have spinal cord injuries often develop pressure sores. The objective of this study was to describe the epidemiological characteristics of pressure sores and evaluate factors associated with recurrence and cure. In this historical cohort study, clinical and laboratory data were collected from medical records between 1997 and 2016. Sixty individuals with pressure ulcers were included; mean patient age was 38.1±16.5 (37.0) years, 83.3% were men, and 86.8% identified as white. Most patients (85.1%) had paraplegia, amputation, or trauma of the lower limbs with motor sequelae; the remainder (14.9%) were quadriplegic. Most (78.3%) underwent surgery, and the mean follow-up time was 1.8±2.5 years. The lesions were cured in 25 patients; they recurred in 25% of the patients, and recurrence was seen to be associated with the location of the lesions. Patients with recurrent lesions had more medical consultations and a longer treatment time. Individuals whose ulcers had healed had fewer lesions, higher body mass index (BMI), and a higher proportion of these patients underwent surgery. BMI and location and number of lesions are prognostic factors. Level of Evidence IV, Case Series.

  18. Epidemiological profile of patients seen in the pre-anesthetic assessment clinic of a university hospital

    Monica Loureiro Santos

    Full Text Available Abstract Objective Assess the demographic and clinical characteristics of surgical patients seen in the Pre-anesthetic Assessment Clinic of the Hospital Universitário Gaffrée e Guinle (APA/HUGG, in order to assist in the pursuit for quality, effectiveness, and resource rationalization of hospital management. Method Cross-sectional descriptive study with 491 patients undergoing elective surgery, treated at APA/HUGG Clinic from March to December 2014. The following variables were assessed: sex, age, BMI, smoking status, associated diseases, classification of MET's and ASA, presence of decompensated disease, medical associated appointments interconsultation, specialty and surgical risk, history of prior anesthetic-surgical procedure, and complications. Results There was a predominance of female (64.8% and overweight patients (55.9%, aged 18-59 years. The prevalence of associated diseases was high (71.3%, with hypertension pressure prevailing (50.1%. Most patients had clinically compensated morbidity (96.3% and long-term use of medication (77.4%. Regarding the surgical characteristics, the most frequent specialty was general and medium risk surgeries. The analysis of the characteristics by age showed that the elderly have more associated diseases and long-term use of medication, in addition to predominance of ASA II-III. Conclusion The epidemiological profile of surgical patients seen at the APA/HUGG was female, age 18-59 years, overweight, with associated diseases, long-term use of medication, without clinical decompensation, ASA II and MET's ≥4. Knowledge of the clinical characteristics of surgical patients is critical to schedule the perioperative care, allowing the improvement of quality and safety in anesthesia and surgery.

  19. Analysis of clinical records of dental patients attending Jordan University Hospital: Documentation of drug prescriptions and local anesthetic injections

    Najla Dar-Odeh

    2008-08-01

    Full Text Available Najla Dar-Odeh1, Soukaina Ryalat1, Mohammad Shayyab1, Osama Abu-Hammad21Department of Oral and Maxillofacial Surgery Oral Medicine and Periodontics, Faculty of Dentistry, University of Jordan, Jordan; 2Department of Prosthetic Dentistry, Faculty of Dentistry, University of Jordan, JordanObjectives: The aim of this study was to analyze clinical records of dental patients attending the Dental Department at the University of Jordan Hospital: a teaching hospital in Jordan. Analysis aimed at determining whether dental specialists properly documented the drug prescriptions and local anesthetic injections given to their patients.Methods: Dental records of the Dental Department at the Jordan University Hospital were reviewed during the period from April 3rd until April 26th 2007 along with the issued prescriptions during that period.Results: A total of 1000 records were reviewed with a total of 53 prescriptions issued during that period. Thirty records documented the prescription by stating the category of the prescribed drug. Only 13 records stated the generic or the trade names of the prescribed drugs. Of these, 5 records contained the full elements of a prescription. As for local anesthetic injections, the term “LA used” was found in 22 records while the names and quantities of the local anesthetics used were documented in only 13 records. Only 5 records documented the full elements of a local anesthetic injection.Conclusion: The essential data of drug prescriptions and local anesthetic injections were poorly documented by the investigated group of dental specialists. It is recommended that the administration of the hospital and the dental department implement clear and firm guidelines for dental practitioners in particular to do the required documentation procedure.Keywords: dental records, documentation, prescriptions, local anesthesia

  20. Universal isolation precautions for patients at an academic hospital Precauciones universales en el aislamiento de pacientes en un hospital universitario Precauções universais em isolamentos de pacientes em hospital universitário

    Vanessa Gomes Maziero; Marli Terezinha Oliveira Vannuchi; Dagmar Willamourius Vituri; Maria do Carmo Lourenço Haddad; Cristiane Nakaya Tada

    2012-01-01

    OBJECTIVE: To apply universal isolation precautions for patients at an academic hospital by a nursing team. METHODS: This descriptive and prospective study used data from advice service of quality control and nursing care that were gathered in observational reports of universal isolation precautions for patients admitted in two surgical inpatient units during 2008 and 2010. RESULTS: The mean general classification for both units was between desirable and adequate in the observational analysis...

  1. The Diatek Arkive "Organizer" patient information management system: experience at a university hospital.

    Block, F E; Reynolds, K M; McDonald, J S

    1998-02-01

    To install and successfully use early commercial automatic anesthesia recordkeepers, the Diatek Arkive "Organizer" units, in the operating rooms at a major university medical center. Because of the history of previous academic attempts at automatic anesthesia recordkeeping, the units were installed on a "surprise" basis, with hardly any discussion of the devices beforehand. The devices themselves had a number of minor difficulties at the start, most of which were promptly corrected. Eventually the units were in use in all non-cardiac general operating rooms. At one point, usage reached over 90% of possible cases. Continued opposition to the device on the part of certain individuals, coupled with the obsolescence of the present devices in light of new technology, led to the eventual abandonment of the system and removal of the devices from service. Total resistance to the new devices on the part of a few vocal faculty members was a major factor in the ultimate downfall of the system. The method of introduction, and especially the lack of involvement of faculty, residents, surgeons, operating room personnel, hospital computer personnel, and the hospital administration in the installation also played a role in the failure of the system. Lack of a workable training mechanism for new residents prevented that user group from rapidly gaining comfort with the systems.

  2. Nutritional issues and self-care measures adopted by cancer patients attending a university hospital in Turkey

    Sevgisun Kapucu

    2016-01-01

    Full Text Available Objective: This study aimed to assess the nutritional status of cancer patients and the self-care measures they adopted as a response to nutritional problems. Methods: This descriptive study included seventy cancer patients staying in the oncology and internal disease clinics of a university hospital in Turkey. Data were collected using a questionnaire with 29 questions. Results: The mean age of participants was 40.2 ΁ 1.82 years. Approximately, 62.9% of the patients ate only half of the meals offered to them, 65.7% experienced weight loss, and 45.7% had difficulty eating their meals on their own. Moreover, 47.1% of the patients received nutritional support and nutritional problems were observed in 71.4% of the patients; 80% were unable to eat hospital food, 54.3% had an eating disorder related to a special diet, 30% suffered from loss of appetite, 27% had nausea, and 14.3% had difficulty swallowing. Furthermore, 48.5% of patients responded that they ate home-cooked food or ordered food from outside when questioned about the self-care measures taken to avoid the aforementioned nutritional problems. Conclusions: Most of the cancer patients had serious nutritional problems and ate home-cooked food and used nutritional supplements to overcome these problems. Oncology nurses are responsible for evaluating the nutritional status of cancer patients and eliminating nutritional problems.

  3. Patient Blood Management in Europe: surveys on top indications for red blood cell use and Patient Blood Management organization and activities in seven European university hospitals.

    Bruun, M T; Pendry, K; Georgsen, J; Manzini, P; Lorenzi, M; Wikman, A; Borg-Aquilina, D; van Pampus, E; van Kraaij, M; Fischer, D; Meybohm, P; Zacharowski, K; Geisen, C; Seifried, E; Liumbruno, G M; Folléa, G; Grant-Casey, J; Babra, P; Murphy, M F

    2016-11-01

    Patient Blood Management (PBM) in Europe is a working group of the European Blood Alliance with the initial objective to identify the starting position of the participating hospitals regarding PBM for benchmarking purposes, and to derive good practices in PBM from the experience and expertise in the participating teams with the further aim of implementing and strengthening these practices in the participating hospitals. We conducted two surveys in seven university hospitals in Europe: Survey on top indications for red blood cell use regarding usage of red blood cells during 1 week and Survey on PBM organization and activities. A total of 3320 units of red blood cells were transfused in 1 week at the seven hospitals. Overall, 61% of red cell units were transfused to medical patients and 36% to surgical patients, although there was much variation between hospitals. The organization and activities of PBM in the seven hospitals were variable, but there was a common focus on optimizing the treatment of bleeding patients, monitoring the use of blood components and treatment of preoperative anaemia. Although the seven hospitals provide a similar range of clinical services, there was variation in transfusion rates between them. Further, there was variable implementation of PBM activities and monitoring of transfusion practice. These findings provide a baseline to develop joint action plans to further implement and strengthen PBM across a number of hospitals in Europe. © 2016 International Society of Blood Transfusion.

  4. The effect on patient loyalty of service quality, patient visit experience and perceived switching costs: lessons from one Taiwan university hospital.

    Wang, Hsiu-Ling; Huang, Jun-Ying; Howng, Shen-Long

    2011-02-01

    The reimbursement system changed from fee-for-service to fixed prospective payments in Taiwan, the effect on the physician-patient's relationship is worth being studied. We examined the relationship between patient visit experience, cost perceptions and the two important aspects of quality of care, curing and interpersonal performance, and patients' loyalty to the hospital physicians. A total of 404 patients from an acute care hospital in Taiwan, Kaohsiung Medical University Hospital (KMUH), were investigated using a self-administered mailing survey. All measures including patient loyalty (PL), curing service quality (CSQ), interpersonal service quality (ISQ), visit experience (VE) and perceived switching costs (PSC), were adapted and modified from existing scales. Our results showed that the physician's CSQ and ISQ positively affected patients' loyalty to KMUH. The interaction between the main effects of service quality, patients' VE and three types of switching visit costs, yielded additional insights into the importance of service quality for patient retention. The CSQ of physicians becomes a more important determinant of loyalty than ISQ as patients' VE increases. The importance of CSQ and ISQ increases in relation to PL as the perceived procedural and relational costs of changing care providers increases. Neither CSQ nor ISQ has a reduced relationship with PL as the perceived financial costs of switching hospitals increase. Our study indicates that the impact of CSQ and ISQ on loyalty varies according to the perceived visit costs of changing hospitals and the patients' VE.

  5. Drug abuse in hospitalized trauma patients in a university trauma care center: an explorative study

    A.R. Soroush

    2006-08-01

    Full Text Available Background: Drug abuse has been known as a growing contributing factor to all types of trauma in the world. The goal of this article is to provide insight into demographic and substance use factors associated with trauma and to determine the prevalence of drug abuse in trauma patients. Methods: Evidence of substance abuse was assessed in trauma patients presenting to Sina trauma hospital over a 3-month period. They were interviewed and provided urine samples to detect the presence of drug/metabolites of opium, morphine, cannabis and heroin by “Morphine Check” kits. Demographic data, mechanisms of injury, history of smoking and drug abuse were recorded. Results: A total of 358 patients with a mean age of 28.4 years were studied. The Patients were predominantly male (94.7%. There was a history of smoking in 136 cases (38%. 58 cases (16.2% reported to abuse drugs (91.5% opium. The commonest route of administration was smoke inhalation (37.2%. Screening by Morphine Check test revealed 95 samples to be positive (26.5%. The preponderance of test-positive cases was among young people (of 20-30 years of age with a history of smoking. Victims of violence and those with penetrating injuries also showed a higher percentage of positive screens (P=0.038 and P<0.001, respectively. Conclusion: These results suggest that drug abuse is a contributing factor to trauma especially in violent injuries and among the young. Regarding the considerable prevalence of drug abuse among trauma patients, it’s highly recommended that all trauma patients be screened for illicit drugs

  6. Overspecialized and undertrained? Patient diversity encountered by medical students during their internal medicine clerkship at a university hospital.

    Melderis, Simon; Gutowski, Jan-Philipp; Harendza, Sigrid

    2015-03-31

    During the four-month internal medicine clerkship in their final year, undergraduate medical students are closely involved in patient care. Little is known about what constitutes their typical learning experiences with respect to patient diversity within the different subspecialties of internal medicine and during on call hours. 25 final year medical students (16 female, 9 male) on their internal medicine clerkship participated in this observational single-center study. To detail the patient diversity encountered by medical students at a university hospital during their 16-week internal medicine clerkship, all participants self-reported their patient contacts in the different subspecialties and during on call hours on patient encounter cards. Patients' chief complaint, suspected main diagnosis, planned diagnostic investigations, and therapy in seven different internal medicine subspecialties and the on call medicine service were documented. 496 PECs were analysed in total. The greatest diversity of chief complaints (CC) and suspected main diagnoses (SMD) was observed in patients encountered on call, with the combined frequencies of the three most common CCs or SMDs accounting for only 23% and 25%, respectively. Combined, the three most commonly encountered CC/SMD accounted for high percentages (82%/63%), i.e. less diversity, in oncology and low percentages (37%/32%), i.e. high diversity, in nephrology. The percentage of all diagnostic investigations and therapies that were classified as "basic" differed between the subspecialties from 82%/94% (on call) to 37%/50% (pulmonology/oncology). The only subspecialty with no significant difference compared with on call was nephrology for diagnostic investigations. With respect to therapy, nephrology and infectious diseases showed no significant differences compared with on call. Internal medicine clerkships at a university hospital provide students with a very limited patient diversity in most internal medicine

  7. Invasive fungal sinusitis in patients with hematological malignancy: 15 years experience in a single university hospital in Taiwan

    Huang Shang-Yi

    2011-09-01

    Full Text Available Abstract Background Risk factors and outcomes in hematological patients who acquire invasive fungal sinusitis (IFS are infrequently reported in the modern medical era. Method A retrospective study of hospitalized patients with hematological disease was conducted at National Taiwan University Hospital between January 1995 and December 2009. Results Clinical characteristics and outcomes with their associated radiographic and microbiological findings were analyzed. Forty-six patients with IFS and 64 patients with chronic non-invasive sinusitis were enrolled as comparsion. IFS developed more commonly in patients with acute myeloid leukemia (AML and with prolonged neutropenia (absolute neutrophil count less than 500/mm3 for more than 10 days (p Aspergillus flavus was the most common pathogen isolated (44%. Serum Aspergillus galactomannan antigen was elevated in seven of eleven patients (64% with IFS caused by aspergillosis but negative for all three patients with mucormycosis. Bony erosion and extra-sinus infiltration was found in 15 of 46 (33% patients on imaging. Overall, 19 of 46 patients (41.3% died within 6 weeks. Patients with disease subtype of AML (p = 0.044; Odds Ratio [OR], 5.84; 95% confidence interval [95% CI], 1.02-30.56 and refractory leukemia status (p = 0.05; OR, 4.27; 95% CI, 1.003-18.15 had worse prognosis. Multivariate analysis identified surgical debridement as an independent good prognostic factor (p = 0.047 in patients with IFS. Conclusions Patients of AML with prolonged neutropenia (> 10 days had significantly higher risk of IFS. Early introduction of anti-fungal agent and aggressive surgical debridement potentially decrease morbidity and mortality in high risk patients with IFS.

  8. Quality of life in vitiligo patients: a report from Razi referral University Hospital in Tehran

    Feizy V

    2007-08-01

    Full Text Available Background: This study aimed to assess the quality of life in vitiligo sufferers and its relationship with a number of variables such as age, gender, educational level, place of residence, marital status, disease duration, disease extension, visibility of lesions and skin phototype (SPT. Methods: In this study we evaluate the quality of life in patients with vitiligo attending Razi Hospital in July and August 2005. Permission from Professor Finlay was obtained to use the DLQI (Dermatology Life Quality Index questionnaire to evaluate the quality of life. One hundred patients with at least one vitiligo patch (age range= 14–57 answered the question-naire. Other survey questions about mentioned variables were also answered. Scoring was done according to Finlay`s guidelines. The higher the score, the greater the impairment of quality of life. Results: The mean DLQI score in our study was 8.16 (sd=5.423 with a minimum of 0 and a maximum of 28. There were statistically significant relationships between DLQI scores and marital status, skin phototype and disease extension independently, but not between DLQI scores and other variables. The mean DLQI score was significantly higher in married compared to single patients. In fact this difference was significant in women. Married women had a statistically higher score than single women while single and married men had no significant difference. Patients with Skin Phototype IV showed a higher DLQI score than other SPTs, which was statistically notable (p=0.000. The patients with more disease extension had higher score that was statistically significant (p=0.000. Conclusions: This study shows that vitiligo has a major impact on the quality of life and indicates specific groups that are most affected by the disease. Hence, dermatologists should pay attention to the psychologic effects of this cosmetic disease and try to decrease its extension and disfiguring effects by various treatment modalities.

  9. Prevalence of invasive fungal disease in hematological patients at a tertiary university hospital in Singapore

    Koh Liang-Piu

    2011-02-01

    Full Text Available Abstract Background The use of newer azoles as prophylaxis in hematological patients undergoing stem cell transplantation or immunosuppressive chemotherapy has been shown to decrease the risk of developing invasive fungal disease (IFD. However, the cost-effectiveness of such a strategy is dependent on the local epidemiology of IFD. We conducted an audit of hematological patients with IFD in our institution in order to derive the prevalence and types of IFD that occur locally. Findings We conducted a retrospective chart review of all hematological patients who developed possible, probable or definite IFD according to EORTC/MSG criteria in the period from Oct 2007 to Apr 2010. The prevalence of IFD was determined via correlation with institutional database records of all hematological patients treated at our institution over the same time period. There were 39 cases of IFD diagnosed during the study period, with 8 (20.5% possible, 19 (48.7% probable and 12 (30.8% definite cases of IFD. Aspergillus spp. accounted for 83.9% of all probable and definite infections. There was 1 case each of Rhinocladelia spp., Coprinopsis cinerea, Exserohilum spp. sinusitis and Rhizopus spp. sinusitis. IFD occurred in 12 of 124 (9.7% AML and 4 of 103 (3.9% ALL patients treated at our institution respectively. There were 10 (16.1% infections among 62 allogeneic HSCT recipients, six of whom were having concurrent graft-versus-host disease (GVHD. Five other cases occurred after allogeneic HSCT failure, following salvage chemotherapy for disease relapse. The prevalence of IFD during induction chemotherapy was 8.9% (11 of 124 cases for AML and 1.0% (1 of 103 cases for ALL. Fluconazole prophylaxis had been provided for 28 out of the 39 (71.8% cases, while 4 (10.3% were on itraconazole prophylaxis. The in-hospital mortality was 28.2% (11 of 39 cases, of which 5 (12.8% deaths were attributed to IFD. Conclusions The burden of IFD is high in our institution, especially in

  10. Evaluation of Drug Use Attitudes of Patient and Its Relatives Attending to Cukurova University Medical Faculty Balcali Hospital

    Yusuf Karatas

    2012-02-01

    Full Text Available Objective: Irrational drug usage is one of the important public health problems in all countries. Also in our country irrational drug usage patterns is a serious problem and it increases the drug’s share of public health care costs. The aim of our study was evaluate the drug use patterns of patients and relatives of patients in Cukurova University Medical Faculty Balcali Hospital. Material and Methods: Face-to-face interviews (using a questionnaire about Rational Drug Use Survey with 209 patients and patients relatives, admitted to Cukurova University Medical Faculty Balcali Hospital clinics. Results: 209 people participated in this study and 58 % (124 of these are women. The mean age of women was 41,39±13,76 and the mean age of the man was 44,67±13,55. If we decompose the participants to their educational attainment; primary school (34,4 %, secondary school (18,7 %, high school (26,3 % and university (20,6 %. 11,0 % of the participants have no social security. 5,7 % of the participants have acute disease, 54,5 % of them have chronic disease and 39,7 % of them have no medical problems. 53,1 % of the participants said that they do not use drugs without consulting a medical doctor, 11,0 % of the participants said that they sometimes use drugs, 30,6 % of the participants said that they rarely use drugs and 5,3 % of the participants said that they often use drugs without consulting a medical doctor. 14,8 % of the participants said that they use drugs with advise of their relatives, friends and neighbors, 17,2 % of the participants said that they advise the drugs to their relatives, friends and neighbors when they were sick. 16,7 % of the participants said that they often use antibiotics and 77,5 % of the participants said that they sometimes use antibiotics without consulting a doctor when they had common cold or flu. 40,2 % of the participants said that they do not use herbal medicine in treatment. Patients with canser 2,4 %, patients with

  11. Identification of hospitalized elderly patients at risk for adverse in-hospital outcomes in a university orthopedics and trauma surgery environment.

    Janine Gronewold

    Full Text Available As a consequence of demographic changes, hospitals are confronted with increasing numbers of elderly patients, who are at high risk of adverse events during hospitalization. Geriatric risk screening followed by comprehensive geriatric assessment (CGA and treatment has been requested by geriatric societies and task forces to identify patients at risk. Since empirical evidence on factors predisposing to adverse hospital events is scarce, we now prospectively evaluated implications of geriatric risk screening followed by CGA in a university hospital department of orthopedics and trauma surgery.Three hundred and eighty-one patients ≥75 years admitted to the Department of Orthopedics and Trauma Surgery of the University Hospital Essen received Identification of Seniors at Risk (ISAR Screening followed by CGA via a geriatric liaison service in case of positive screening results. Associations between ISAR, CGA, comorbid risk factors and diseases, length of hospital stay, number of nursing and physiotherapy hours, and falls during hospital stay were analyzed.Of 381 ISAR screenings, 327 (85.8% were positive, confirming a high percentage of patients at risk of adverse events. Of these, 300 CGAs revealed 82.7% abnormal results, indicating activities of daily living impairment combined with cognitive, emotional or mobility disturbances. Abnormal CGA resulted in a longer hospital stay (14.0±10.3 days in ISAR+/CGA abnormal compared with 7.6±7.0 days in ISAR+/CGA normal and 8.1±5.4 days in ISAR-, both p<0.001, increased nursing hours (3.4±1.1 hours/day in ISAR+/CGA abnormal compared with 2.5±1.0 hours/day in ISAR+/CGA normal and 2.2±0.8 hours/day in ISAR-, both p<0.001, and increased falls (7.3% in ISAR+/CGA abnormal, 0% in ISAR+/CGA normal, 1.9% in ISAR-. Physiotherapy hours were only significantly increased in ISAR+/CGA abnormal (3.0±2.7 hours compared with in ISAR+/CGA normal (1.6±1.4 hours, p<0.001 whereas the comparison with ISAR- (2.4±2

  12. Acute myeloid leukemia: survival analysisof patients at a university hospital of Paraná

    Sergio Lunardon Padilha

    2015-02-01

    Full Text Available Objective: The aim of this study was to analyze the prognostic factors correlated with survival of patients with acute myeloid leukemia at the Hospital de Clínicas, Universidade Federal do Paraná between 2003 and 2009, as well as to investigate the clinical and epidemiological profile. Methods: The overall survival and disease-free survival were statistically evaluated using the Kaplan-Meier method, the log-rank test and multivariate evaluation by Cox regression analysis. Results: The study population was predominantly younger than 60 years old (81,6%, had intermediate cytogenetic risk (40.8%, in first complete remission after induction chemotherapy (46.9%, with a white blood count at diagnosis of less than 30 × 109 /L (57.1% and de novo acute myeloid leukemia (62.2%. Survival curves showed that better prognosis was related to age below 60 years (median:12,4 months; p-value = 0,2227; Odds Ratio = 0,6676, good pro- gnostic cytogenetic markers (median: 97.7 months; p-value = 0.0037; Odds Ratio = 0.4239 and white blood cell count at diagnosis of less than 30 × 109 /L (median survival: 23.6 months; p- value = 0.0001; Odds Ratio = 0.3651. Regarding the French-American-British subgroups, the median overall survival was 23.5 months for M0, M1 and M2, 97.7 months for M3 and 7.4 months for M4, M5, M6, and M7 (p-value = 0.0288. Conclusion: Prognostic factors strongly influenced patient survival, as well as guided treat- ment. Moreover, these factors were consistent with the available literature adjusted for the population in question.

  13. Brain stem tumors in children - therapeutic results in patients of the University Children's Hospital of Cracow in Poland

    Korab-Chrzanowska, E.; Bartoszewska, J.; Kwiatkowski, S.

    2005-01-01

    To analyse the treatment results achieved in children treated for brain stem tumours at one institution between the years 1990 and 2004. Material. 20 patients (10 girls, 10 boys) aged 2.8-15.6 years were treated for brain stem tumors at the University Children's Hospital of Cracow (UCHC) in the years 1990-2004. The tumour type was defined basing on imaging studies (CT, MRI), and, in the case of 7 patients, additionally basing on histopathological results. In the collected material the predominant tumor type was benign glioma, detected in 17 patients. Malignant gliomas were diagnosed in 3 children. 7 children were treated by radiotherapy only. Surgical procedures and adjuvant radiotherapy were employed in 3 patients. 6 children underwent radiotherapy and chemotherapy. Combined surgical treatment followed by radiotherapy and chemotherapy was employed in 4 patients. Of the 20 patients 6 have died (30%). The surviving group (70%) includes 1 patient with tumor progression (5%), 5 - with stable tumors (25%), and 8 (40%) - with tumor regression. The probability of three-year overall survival for the entire group as calculated by the Kaplan-Meier method was 70% while the probability of three-year progression-free survival was 65%. Conclusions. Diffuse brain stem tumors, mostly those involving the pons, and malignant gliomas have poor prognosis. In the presented material we achieved the best treatment results in patients with exophytic or focal tumors, treated surgically with adjuvant therapy. (author)

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

    Abebe T

    2015-01-01

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

  15. Etiological pattern and early outcome of patients presenting with obstructive jaundice at isra university hospital, hyderabad, pakistan

    Bhanbhro, R.J.; Maheshwari, T.; Jarwar, M.

    2017-01-01

    Objective: To determine the etiological pattern and early outcome of patients presenting with obstructive jaundice. Methodology: This prospective case series was conducted on 82 patients through convenient sampling for one year from July 2010 to June 2011 at Isra University Hospital, Hyderabad, Pakistan. All patients with obstructive jaundice were included in this study. After making final diagnosis, depending upon the etiology and stage of disease, the patient was offered the appropriate treatment. SPSS version 16.0 was used to for data analysis. Results: Mean age of the participants was 54.16+-11.50. Males were predominant as compare to females, 57.3% and 42.7%. Gallstones were the most common cause; seen in 74 (90.2%) patients. Seventy (96.3%) were managed conservatively as compare to those patients in which surgery performed (1 case, 1.2%). 97.6% improved and were discharged where as 2(1.64%) did not improve. Conclusion: Gallstones were the predominant cause of obstructive jaundice in our setup. Most of the patients did not require surgical treatment, and outcome was very good with conservative treatment. (author)

  16. Treatment outcomes of patients co-infected with tuberculosis and HIV at Chiang Mai University Hospital, Thailand.

    Limmahakhun, S; Chaiwarith, R; Nuntachit, N; Sirisanthana, T; Supparatpinyo, K

    2012-06-01

    Thailand has been greatly affected by the tuberculosis (TB) and HIV syndemic. This study aimed to determine treatment outcomes among HIV/TB co-infected patients. A retrospective cohort study was conducted at Chiang Mai University Hospital from 1 January 2000 to 31 December 2009. Of 171 patients, 100 patients were male (58.5%) and the mean age was 36.8 ± 8.0 years. Seventy-two patients (42.1%) had pulmonary tuberculosis. Median CD4+ count before TB treatment was 69 cells/mm(3) (interquartile range [IQR] 33, 151). The overall mortality was 3.5% (6 patients). Immune reconstitution inflammatory syndrome (IRIS) occurred in eight patients (6.0%). Disseminated TB infections increased risk of death (odds ratio [OR] = 2.55, 95% confidence interval [CI] 1.25, 5.18) and IRIS (OR = 9.16, 95% CI 1.67, 50.07). Initiating combination antiretroviral therapy (cART) within two months after TB treatment increased risk of IRIS (OR = 6.57, 95% CI 1.61-26.86) and physicians caring for HIV/TB co-infected patients should be aware of this condition.

  17. Malnutrition and associated factors among heart failure patients on follow up at Jimma university specialized hospital, Ethiopia.

    Amare, Hiwot; Hamza, Leja; Asefa, Henok

    2015-10-15

    Malnutrition and cachexia are serious consequences of numerous chronic diseases. Severe heart failure patients could be related with marked weight loss. Malnutrition is associated with poor prognosis among heart failure patients. Despite its implication, factors associated with malnutrition among heart failure patients in Africa and Ethiopia was not addressed. Hence, in this study we tried to determine factors associated with malnutrition among heart failure patients on follow up at Jimma University specialized hospital, Ethiopia. A cross-sectional study was done on 284 randomly selected heart failure patients. The nutritional status of the patients was assessed based on their serum albumin level (normal value 4-5 mg/dl) and triceps skin fold thickness. The data was analyzed using SPSS version 20.0. Multivariable logistic regression was used to identify factors associated with malnutrition among heart failure patients using SPSS 20.0. Based on serum albumin and triceps skin fold thickness, 77.8 % of patients were malnourished. Mean age of the patients was 48.3 ± 15.9 years. The commonest cause of heart failure was ischemic heart disease (34.9 %). Hypertension (36 %) was the commonest co morbid disease. Forty four percent of patients had New York heart association functional class II heart failure. Serum hemoglobin (AOR = 0.77, 95 % CI: 0.67-0.92) was found to be significantly associated with nutritional status of heart failure patients. As serum hemoglobin increases by 1gm/dl, the risk of malnutrition decreased by 15 % (P value = 0.03). The majority of patients were malnourished. A higher hemoglobin concentration was associated with reduced odds of being malnourished.

  18. Identification and antifungal susceptibility of Candida species isolated from the urine of patients in a university hospital in Brazil

    Gláucia Moreira Espíndola Lima

    2017-12-01

    Full Text Available ABSTRACT The aim of this study was to identify Candida spp. isolated from candiduria episodes at a tertiary hospital in the Midwest region of Brazil, and to determine their susceptibility profiles to antifungal compounds. From May 2011 to April 2012, Candida spp. isolated from 106 adult patients with candiduria admitted to the University Hospital of the Federal University of Mato Grosso do Sul were evaluated. Both, species identification and susceptibility testing with fluconazole-FLC, voriconazole-VRC, and amphotericin B-AmB were carried out using the Vitek 2. To discriminate species of the C. parapsilosis complex, a RAPD-PCR technique using the RPO2 primer was performed. From the total of 106 isolates, 42 (39.6% C. albicans and 64 (60.4% Candida non-albicans (CNA - 33 C. tropicalis, 18 C. glabrata, 5 C. krusei, 4 C. parapsilosis sensu stricto, 2 C. kefyr, 1 C. lusitaniae, and 1 C. guilliermondii were identified. All isolates were susceptible to AmB and VRC, whereas all C. glabrata isolates presented either resistance (5.6% or dose-dependent susceptibility (94.4% to FLC. The study of Candida spp. and their resistance profiles may help in tailoring more efficient therapeutic strategies for candiduria.

  19. Patient outcome of emergency laparotomy improved with increasing "number of surgeons on-call" in a university hospital: Audit loop.

    Hussain, Anwar; Mahmood, Fahad; Teng, Chui; Jafferbhoy, Sadaf; Luke, David; Tsiamis, Achilleas

    2017-11-01

    Emergency laparotomy is a commonly performed high-mortality surgical procedure. The National Emergency Laparotomy Network (NELA) published an average mortality rate of 11.1% and a median length of stay equivalent to 16.3 days in patients undergoing emergency laparotomy. This study presents a completed audit loop after implementing the change of increasing the number of on-call surgeons in the general surgery rota of a university hospital. The aim of this study was to evaluate the outcomes of emergency laparotomy in a single UK tertiary centre after addition of one more consultant in the daily on-call rota. This is a retrospective study involving patients who underwent emergency laparotomy between March to May 2013 (first audit) and June to August 2015 (second audit). The study parameters stayed the same. The adult patients undergoing emergency laparotomy under the general surgical take were included. Appendicectomy, cholecystectomy and simple inguinal hernia repair patients were excluded. Data was collected on patient demographics, ASA, morbidity, 30-day mortality and length of hospital stay. Statistical analysis including logistic regression was performed using SPSS. During the second 3-month period, 123 patients underwent laparotomy compared to 84 in the first audit. Median age was 65(23-93) years. 56.01% cases were ASA III or above in the re-audit compared to 41.9% in the initial audit. 38% patients had bowel anastomosis compared to 35.7% in the re-audit with 4.2% leak rate in the re-audit compared to 16.6% in the first audit. 30-day mortality was 10.50% in the re-audit compared to 21% and median length of hospital stay 11 days in the re-audit compared to 16 days. The lower ASA grade was significantly associated with increased likelihood of being alive, as was being female, younger age and not requiring ITU admission post-operatively. However, having a second on-call consultant was 2.231 times more likely to increase the chances of patients not dying (p = 0

  20. [Proper use of fluoroquinolones in hospitalized elderly patients: Realisation of a clinical audit in geriatric hospitals of Lyon University Hospital].

    Papailhau, C; Gaujard, S; Girard, R; Bourguignon, L; Mouchoux, C

    2018-05-18

    Fluoroquinolones (FQ) are widely used because of their broad spectrum and their ease of use, especially in the elderly. Nevertheless, their misuse is behind the development and the emergence of bacterial resistances. The objective of this study was to evaluate the compliance of FQ prescriptions in the elderly hospitalized, before and after pharmaceutical interventions (PI). A prospective clinical audit was conducted for three months in three geriatric hospitals. A pharmacist carried out the evaluation of the prescription's conformity with the help of referent geriatric doctor in infectiology according to the criteria defined by SPILF recommendations (2015). The PIs and their future have been collected and codified. A total of 100 patients were included (mean age: 85.3 years; male female ratio: 1,17). The medical-pharmaceutical collaboration helped to increase the overall compliance rate from 56 to 80%. FQ were used for urinary (72%) or respiratory (20%) infections, first-line (57%), documented (60%) and monotherapy (63%). Our results show that FQ misuse is a not inconsiderable case since in 28% they should not have been prescribed. Thirty-three PI were performed and accepted in 72% cases. Actions to promote the FQ proper use have therefore been put in place: communication of the audit results, dissemination of a summary of SPILF recommendations and creation of a tool to assist in the analysis of prescriptions FQ for pharmacists. Copyright © 2018. Published by Elsevier SAS.

  1. The Relationship between Nursing Care Quality and Patients Satisfaction among Hospitals affiliated to Zahedan University of Medical Sciences in 2014

    Mahnaz Gholjeh

    2015-07-01

    Full Text Available Background and Objective: Obtaining the means of promoting nursing care quality have been always considered by nursing managers. The present study was conducted to determine the relationship between nursing care quality and patients satisfaction in the hospitals affiliated to Zahedan University of Medical Sciences in 2014. Methods: The present cross-sectional study was accomplished on 68 employed nurses and 204 patients during a 4 month random sampling time interval. Three patients per nurse who had utilized at least 72 hours of nursing cares and were about to discharge at the time of research were chosen. Data collection tolls were the standardized questionnaires including nursing care quality measurement tool (Quality patient care scale: QUALPAC and Patient Satisfaction Instrument (PSI. The data were analyzed using Chi-square, One-Way ANOVA and Pearson correlation coefficient tests. Results: The average age of the nurses and patients were respectively 30.8±4.9 and 37.9±10.7. The average score for QUALPAC was 61.3±12.5 and the quality of care was desirable in 55% of cases. Moreover, the average score for the satisfaction of patients was 71.8±10.9 and the patients expressed an intermediate satisfaction in 61 percent of cases. There was a positive significant correlation between the nursing care and patient satisfaction (P=0001. Conclusion: It seems as if the health care system can provide the satisfaction of patients by enhancing nursing care quality or to employing more skilled nurses.

  2. Kaposi Sarcoma among HIV Infected Patients in Lagos University Teaching Hospital, Nigeria: A 14-Year Retrospective Clinicopathological Study

    Olakanmi Akinde

    2016-01-01

    Full Text Available Background. Despite the increased incidence of Kaposi sarcoma (KS resulting from the Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS pandemic, there is still significant underreporting of KS in this environment. Objectives. This study was aimed at determining the incidence and clinicopathologic patterns of KS among HIV infected patients in Lagos University Teaching Hospital (LUTH, Nigeria, over a 14-year period: January 2000 to December 2013. Methodology. The materials for this study included patients’ hospital clinical files, duplicate copies of histopathologic reports, and tissue blocks and corresponding archival slides in the Anatomic and Molecular Pathology Department and the HIV/AIDS unit of the Department of Haematology. Results. Within the study period, 182 cases of KS were diagnosed, accounting for 1.2% of all patients managed for HIV/AIDS and 2.99% of solid malignant tumours. The male-to-female ratio and modal age group were 1 : 1.3 and 5th decade, respectively. Most cases (90% had purely mucocutaneous involvement with the lower limb being the commonest site (65.8%. The majority of lesions were plaques (65.8%. Vascular formation was the predominant histologic type seen (43.5%. Conclusion. KS in Lagos followed the same epidemiologic trend as other centers in Nigeria, with an increasing incidence in this era of HIV/AIDS.

  3. Resident physicians' attitudes and confidence in communicating with patients: a pilot study at a Japanese university hospital.

    Ishikawa, Hirono; Eto, Masato; Kitamura, Kiyoshi; Kiuchi, Takahiro

    2014-09-01

    This study aimed to explore the relationships among physicians' confidence in conducting medical interviews, their attitudes toward the patient-physician relationship, and undergraduate training in communication skills among resident physicians in Japan. Participants were 63 first-year resident physicians at a university hospital in Tokyo. The Physician Confidence in the Medical Interview scale (PCMI) was constructed based on the framework of the Calgary-Cambridge Guide. Additionally, participants' attitudes toward the patient-physician relationship (Patient-Practitioner Orientation Scale; PPOS), undergraduate experience of communication skills training, and demographic characteristics were assessed through a self-reported questionnaire. The internal consistency of the PCMI and PPOS scales were adequate. As expected from the undergraduate curriculum for medical interviews in Japan, residents had relatively higher confidence in their communication skills with respect to gathering information and building the relationship, whereas less confident about sharing information and planning treatment. The PCMI was associated with a more patient-centered attitude as measured by the PPOS. These scales could be useful tools to measure physicians' confidence and attitudes in communicating with patients and to explore their changes through medical education. Residency programs should consider including systematic training and assessment in communication skills related to sharing information and planning treatment. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  4. Prevalence of depression and its associated factors among elderly patients in outpatient clinic of Universiti Sains Malaysia Hospital.

    Imran, A; Azidah, A K; Asrenee, A R; Rosediani, M

    2009-06-01

    Depression among elderly primary care patients is a serious problem with significant morbidity and mortality. This is a cross sectional study to determine the prevalence of depression and its associated factors among the elderly patients attending the outpatient clinic, Universiti Sains Malaysia Hospital. This study utilized Malay version Geriatric Depression Scale 14 (M-GDS 14) to screen for elderly depression among Malaysian population. It also looked into associated risk factors for elderly depression using sociodemographic, family dynamics, and medically related questionnaires. Out of 244 subjects, 34 or 13.9% were found to have depression. Three variables were found to be significantly associated with depression. Elderly patient with any illness that limits the patient's activity or mobility has more risk of developing depression (OR 2.68 CI 1.15 - 6.24). Elderly patients who were satisfied with their personal incomes (OR 0.29 CI 0.10 - 0.85), and who had children or son/daughter-in-law to take care of them when they are sick (OR 0.10 CI 0.01 - 0.83) have a lower chance of having depression. Screening the elderly for depression, would help in diagnosing the elderly depression better and offer them the treatment needed.

  5. Evaluation of antioxidant status of female diabetic patients in Nnamdi Azikiwe University Teaching Hospital, Anambra State, Nigeria.

    Okuonghae, E O P; Onyenekwe, C C; Ahaneku, J E; Ukibe, N R; Nwani, P O; Asomugha, A L; Osakue, N O; Aidomeh, F; Awalu, C C

    2015-01-01

    Diabetes mellitus has become an onerous disease to developing countries such as Nigeria. Rapid acceptance of urbanisation and sedentary life styles pose an encumbrance to its prevention and management. Increased oxidative stress in diabetes mellitus has been implicated as a culprit in perpetuating antioxidant depletion and diabetic complications in diabetes mellitus individuals. This study aims to evaluate the level of antioxidant status in type 2 diabetes mellitus (DM) female participants visiting the out-patient diabetic clinic of Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Anambra State, Nigeria. A total of 86 participants aged 51±10 years were recruited for this study. The test group consists of 43 already confirmed type 2 diabetes mellitus females, while the control group consists of 43 apparently healthy females. The test subjects were further subgrouped into good and poor glycaemic control groups, using a cut-off of 0.05). This study concludes that there is antioxidant depletion in females with type 2 diabetes.

  6. Positive predictive value and impact of misdiagnosis of a heart failure diagnosis in administrative registers among patients admitted to a University Hospital cardiac care unit

    Mard, Shan; Nielsen, Finn Erland

    2010-01-01

    OBJECTIVE: To evaluate the positive predictive value (PPV) of a diagnosis of heart failure (HF) in the Danish National Registry of Patients (NRP) among patients admitted to a University Hospital cardiac care unit, and to evaluate the impact of misdiagnosing HF. DESIGN: The NRP was used to identify...

  7. Patients' satisfaction towards radiological service and associated factors in Hawassa University Teaching and referral hospital, Southern Ethiopia.

    Mulisa, Teshome; Tessema, Fasil; Merga, Hailu

    2017-06-26

    Patient satisfaction, one of the main components of quality of care, is a crucial phenomenon for the overall health care delivery system. Even though a number of studies have been conducted about patient satisfaction in different health services, studies in radiology services are flimsy in Ethiopia. This study aimed at assessing patient satisfaction towards radiological service and associated factors in Hawassa University Teaching and Referral hospital. An institution based cross-sectional study was conducted among 321 adult patients presented for radiological service in the study area using stratified sampling technique. Patient satisfaction was measured using SERVQUAL (Service Quality) tool that consisted of seven items: accessibility, quality of radiological service, courtesy of radiology staff, existence of good communication with service provider and desk worker, physical environment and privacy technique. Exit interviews of patients were conducted using a structured and pretested questionnaire. Data was collected by three grade ten completed trained data collectors from May 12 to May 28, 2016. Multiple logistic regressions were used to identify independent factors associated with patient satisfaction on radiological services using SPSS version 21. The overall patient satisfaction towards radiological service was 71.6%. Satisfaction to accessibility of the service was 84.5% while it was 80.6% to courtesy of the staff. Similarly, 81.6% reported satisfied with quality of the service and 59.4% and 71% of reported satisfied with physical environment and radiological service provider respectively. On the other hand, 99.7% of the respondents were dissatisfied with privacy of the service. The study revealed that patients who attended primary school (AOR = 0.317, 95% CI: 0.11-0.88), unemployed patients (AOR = 0.067, 95% CI: 0.007-0.622) and patients who had short waiting time to enter into examination room less than one hour (AOR = 4.12, 95% CI: 1.4-11.62) were

  8. Anemia management among hemodyalisis patients at the University Hospital in Puerto Rico.

    Ocasio, Heana E; Diaz, Hector; Cangiano, José L; Báez, Rafael; Suárez, Erick

    2014-01-01

    End-stage renal disease is frequently complicated with anemia. Iron deficiency anemia occurs in most hemodialysis patients secondary to increased iron demand driven by the accelerated erythropoiesis that occurs when stimulating agents are administered as treatment of the anemia. The purpose of this study was to determine the prevalence of anemia and iron stores in patients undergoing hemodialysis at our unit; identify their treatment and effectiveness. Medical records of fifty-three patients undergoing ambulatory hemodialysis were evaluated for three months. Patient's hemoglobin, ferritin, iron, total iron binding capacity and percent transferrin saturation were recorded. 91% patients had arterial hypertension and 62% were diabetic. The prevalence of anemia was 34%, 57% and 47% during the three-month period respectively. Only 21% of the population had transferrin saturation less than 20% and none had ferritin below 200 ng/ml. Throughout the study, the majority of patients were managed with combination of iron and erythropoietin stimulating agents (ESAs). The prevalence of anemia remained elevated despite treatment with iron and ESAs. However, 56% of anemic patients throughout the three months showed an increase in hemoglobin levels by the end of the observation period. 53% of patients were treated with iron alone or with ESAs for the three consecutive month periods and only two had transferrin saturation less than 20%. In our population, ESAs low responsiveness is not related to iron deficiency but to the morbidity of their disease.

  9. Impulsive behaviors in female patients with eating disorders in a university hospital in northern Taiwan

    Kuei-Yu Liang

    2011-09-01

    Full Text Available Eating disorders (EDs are often associated with various impulsive behaviors. This study investigated the prevalence of impulsive behaviors in ED patients in Taiwan. Three hundred sixteen female outpatients with ED and 142 psychiatric controls were recruited. All participants completed self-administered questionnaires assessing lifetime presence of impulsive behaviors, including suicide, self-injury, stealing, alcohol use, illicit drug use, excessive spending, sexual promiscuity, and general psychopathology. More than 60% of the ED patients had at least one impulsive behavior. The most common impulsive behaviors among ED patients were excessive spending (34.9%, deliberate self-harm (32.7%, and stealing (26.3%. However, there were no significant differences in prevalences of any impulsive behaviors between ED patients and psychiatric controls. Clinicians should routinely assess and treat impulsive behaviors in female psychiatric patients with negative affectivity, regardless of the presence of ED, to help prevent potential adverse outcomes related to impulsive behaviors.

  10. Risk management of QTc-prolongation in patients receiving haloperidol: an epidemiological study in a University hospital in Belgium.

    Vandael, Eline; Vandenberk, Bert; Vandenberghe, Joris; Spriet, Isabel; Willems, Rik; Foulon, Veerle

    2016-04-01

    Many drugs, including haloperidol, are linked with a risk of QTc-prolongation, which can lead to Torsade de Pointes and sudden cardiac death. To investigate the prevalence of concomitant risk factors for QTc-prolongation in patients treated with haloperidol, and the use of safety measures to minimize this risk. University Hospitals of Leuven, Belgium. Methods A retrospective epidemiological study was performed. On 15 consecutive Mondays, all patients with a prescription for haloperidol were included. A risk score for QTc-prolongation, inspired by the pro-QTc score of Haugaa et al., was calculated based on gender, comorbidities, lab results and concomitant QTc-prolonging drugs (each factor counting for one point). Available electrocardiograms before and during the treatment of haloperidol were registered. Management of the risk of QTc-prolongation. Two hundred twenty-two patients were included (59.0 % men, median age 77 years) of whom 26.6 % had a risk score of ≥4 (known to significantly increase the mortality). Overall, 24.3 % received haloperidol in combination with other drugs with a known risk of Torsade de Pointes. Half of the patients had an electrocardiogram in the week before the start of haloperidol; only in one-third a follow-up electrocardiogram during haloperidol treatment was performed. Of the patients with a moderately (n = 41) or severely (n = 14) prolonged QTc-interval before haloperidol, 48.8 % and 42.9 % respectively had a follow-up electrocardiogram. In patients with a risk score ≥4, significantly more electrocardiograms were taken before starting haloperidol (p = 0.020). Although many patients had risk factors for QTc-prolongation (including the use of other QTc-prolonging drugs) or had a prolonged QTc on a baseline electrocardiogram, follow-up safety measures were limited. Persistent efforts should be taken to develop decision support systems to manage this risk.

  11. [Patient satisfaction survey and the place of users in the Oran university hospital quality project].

    Chougrani, Saada; Ouhadj, Salah

    2014-01-01

    Quality of care is a strategic priority of any management approach in order to meet users' expectations of health care systems. This study tried to define the role of patient satisfaction surveys and the place of user in the quality of care project. The results of patient satisfaction surveys conducted between 2010 and 2012 and the draft quality of care project were analysed. Patient satisfaction surveys from 2010 to 2012 focused on logistic shortcomings. No comment was formulated about health care. Comments and suggestions did not provide any contribution in terms of patient involvement in the health care process. The multiple perspectives of quality of care include clinical care and other social objectives of respect for the individual and attention to the patient. User satisfaction as assessed by patient satisfaction surveys or patients' experiences only reflect the health professionals' representation. However, the objective is to measure what the user perceives and feels and his/her representation of the attention provided. These approaches, conducted outside of the quality of care strategic plan, only provide a basis for actions with limited or no effectiveness.

  12. Mortality Analysis of Patients with Paraquat Poisoning Treated at Two University Hospitals in Shiraz, Iran

    Fazel Goudarzi

    2014-12-01

    Conlcusion: PQ poisoning is associated with high mortality requiring an immediate assessment of patients and prediction of prognosis. Renal and hepatic failure in addition to respiratory distress can be the strongest risk factors for poor prognosis in acute PQ poisoning.

  13. The outcome of agitation in poisoned patients in an Iranian tertiary care university hospital.

    Sabzghabaee, Ali Mohammad; Yaraghi, Ahmad; Khalilidehkordi, Elham; Mirhosseini, Seyyed Mohammad Mahdy; Beheshtian, Elham; Eizadi-Mood, Nastaran

    2014-01-01

    Introduction. This study was conducted to evaluate and document the frequency and causes of agitation, the symptoms accompanying this condition in intoxications, relationship between agitation score on admission and different variables, and the outcome of therapy in a tertiary care referral poisoning center in Iran. Methods. In this prospective observational study which was done in 2012, 3010 patients were screened for agitation at the time of admission using the Richmond Agitation Sedation Scale. Demographic data including age, gender, and the drug ingested were also recorded. The patients' outcome was categorized as recovery without complications, recovery with complications (hyperthermia, renal failure, and other causes), and death. Results. Agitation was observed in 56 patients (males, n = 41), mostly aged 19-40 years (n = 38) and more frequently in illegal substance (stimulants, opioids and also alcohol) abusers. Agitation score was not significantly related to the age, gender, and previous history of psychiatric disorders. Forty nine patients had recovery without any complication. The need for mechanical ventilation was the most frequent complication. None of the patients died. Conclusion. Drug abuse seems to be a must-to-consider etiology for patients presenting with acute agitation and its morbidity and mortality could be low in agitated poisoning cases if prompt supportive care is performed.

  14. Prevalence of Intestinal Parasites and Associated Factors among Pulmonary Tuberculosis Suspected Patients Attending University of Gondar Hospital, Gondar, Northwest Ethiopia.

    Tegegne, Yalewayker; Wondmagegn, Tadelo; Worku, Ligabaw; Jejaw Zeleke, Ayalew

    2018-01-01

    Intestinal parasitic infections are among the major public health problems in developing countries. Hence, it is significant to explore coinfection with intestinal parasites and pulmonary tuberculosis because coinfection increases the complexity of control and prevention of pulmonary tuberculosis and parasitic diseases. To assess the prevalence of intestinal parasites among pulmonary tuberculosis suspected patients. Institutional based cross-sectional study was conducted at University of Gondar Hospital from March to May, 2017. Stool samples were taken from each participant and examined by direct microscopy and concentration technique. Descriptive statistics was performed and chi-square test was used to show the association between variables. P values of Intestinal parasites were detected in 50 (19.6%) among a total of 256 pulmonary tuberculosis suspected patients who were included in the study, whereas the prevalence of pulmonary tuberculosis was 16.8% (43/256). Pulmonary tuberculosis and intestinal parasite coinfection was detected in 5 (2.0%) of the participants. The most prevalent intestinal parasites infection in this study was Ascaris lumbricoides, 15 (5.85%), followed by Entamoeba histolytica/dispar, 14 (5.46%), and Hookworm, 13 (5.1%). The prevalence of intestinal parasites and their coinfection rate with pulmonary tuberculosis among pulmonary tuberculosis suspected patients were considerable.

  15. Prevalence of Intestinal Parasites and Associated Factors among Pulmonary Tuberculosis Suspected Patients Attending University of Gondar Hospital, Gondar, Northwest Ethiopia

    Yalewayker Tegegne

    2018-01-01

    Full Text Available Introduction. Intestinal parasitic infections are among the major public health problems in developing countries. Hence, it is significant to explore coinfection with intestinal parasites and pulmonary tuberculosis because coinfection increases the complexity of control and prevention of pulmonary tuberculosis and parasitic diseases. Objective. To assess the prevalence of intestinal parasites among pulmonary tuberculosis suspected patients. Method. Institutional based cross-sectional study was conducted at University of Gondar Hospital from March to May, 2017. Stool samples were taken from each participant and examined by direct microscopy and concentration technique. Descriptive statistics was performed and chi-square test was used to show the association between variables. P values of <0.05 were considered statistically significant. Results. Intestinal parasites were detected in 50 (19.6% among a total of 256 pulmonary tuberculosis suspected patients who were included in the study, whereas the prevalence of pulmonary tuberculosis was 16.8% (43/256. Pulmonary tuberculosis and intestinal parasite coinfection was detected in 5 (2.0% of the participants. The most prevalent intestinal parasites infection in this study was Ascaris lumbricoides, 15 (5.85%, followed by Entamoeba histolytica/dispar, 14 (5.46%, and Hookworm, 13 (5.1%. Conclusion. The prevalence of intestinal parasites and their coinfection rate with pulmonary tuberculosis among pulmonary tuberculosis suspected patients were considerable.

  16. Electronic health record in the internal medicine clinic of a Brazilian university hospital: Expectations and satisfaction of physicians and patients.

    Duarte, Jurandir Godoy; Azevedo, Raymundo Soares

    2017-06-01

    To evaluate the satisfaction and expectations of patients and physicians before and after the implementation of an electronic health record (EHR) in the outpatient clinic of a university hospital. We conducted 389 interviews with patients and 151 with physicians before and after the implementation of a commercial EHR at the internal medicine clinic of Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo (HC-FMUSP), Brazil. The physicians were identified by their connection to the outpatient clinic and categorized by their years since graduation: residents and preceptors (with 10 years or less of graduation) or assistants (with more than 10 years of graduation). The answers to the questionnaire given by the physicians were classified as favorable or against the use of EHR, before and after the implementation of this system in this clinic, receiving 1 or 0 points, respectively. The sum of these points generated a multiple regression score to determine which factors contribute to the acceptance of EHR by physicians. We also did a third survey, after the EHR was routinely established in the outpatient clinic. The degree of patient satisfaction was the same before and after implementation, with more than 90% positive evaluations. They noted the use of the computer during the consultation and valued such use. Resident (younger) physicians had more positive expectations than assistants (older physicians) before EHR implementation. This optimism was reduced after implementation. In the third evaluation the use of EHR was higher among resident physicians. Resident physicians perceived and valued the EHR more and used it more. In 28 of the 57 questions on performance of clinical tasks, resident physicians found it easier to use EHR than assistant physicians with significant differences (pclinical setting should be preceded by careful planning to improve physician's adherence to the use of EHR. Patients do not seem to notice much difference to the

  17. High prevalence of pain among adult HIV-infected patients at University of Gondar Hospital, Northwest Ethiopia

    Azagew AW

    2017-10-01

    Full Text Available Abere Woretaw Azagew,1 Hiwot Kassa Woreta,1 Ambaye Dejen Tilahun,2 Degefaye Zelalem Anlay3 1Department of Medical Nursing, 2Emergency and Critical Nurse Unit, 3Community Health Unit, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia Background: HIV/AIDS are pressing global health problems. Pain is a common symptom reported by patients living with HIV/AIDS. The exact cause of pain in HIV patients has not been thoroughly described, but it may, due to a symptom of HIV itself, result from opportunistic infections, as a side effect of antiretroviral drugs, concurrent neoplasia or other causes. In addition, pain perception of HIV-infected patients is highly variable and may vary based on cultural context and patient demographics. In Ethiopia, there is insufficient evidence on the prevalence and factors associated with HIV-related pain.Methods: A cross-sectional study was conducted among 422 adult HIV-infected patients at Gondar University Hospital antiretroviral care clinic from March 1 to May 1, 2016. Systematic random sampling was used to select study participants. A pretested interviewer-administered questionnaire and a standardized medical record data abstraction tool were used to collect data. A short form brief pain inventory tool was used to measure the outcome. Bivariate and multivariate logistic regression models were fitted to identify factors associated with pain among adult HIV patients.Results: The prevalence of pain was found to be 51.2% (95% CI: 46.4%–55.9%. Headache (17.9%, abdominal pain (15.6%, and backache (13.3% were the most common symptoms of study participants. Being female (adjusted odds ratio [aOR]=1.8, 95% CI: 1.1–2.9; regular alcohol intake (aOR=3.3, 95% CI: 1.5–7.2; baseline World Health Organization clinical disease stage: II (aOR=2.5, 95% CI: 1.2–4.9, III (aOR=2, 95%, CI: 1.1–3.6, and IV (aOR=2.4, 95% CI: 1.1–5.3; and the presence of a chronic comorbid condition (aOR=5.9, 95% CI

  18. [Blood transfusion assessment to 112 homozygous sickle-cell disease patients in university hospital of Brazzaville].

    Dokekias, A Elira; Ossini, L Ngolet; Tsiba, F O Atipo; Malanda, F; Koko, I; De Montalembert, M

    2009-01-01

    Homozygous, sickle-cell disease (SCD) is responsible for acute complication, especially anaemic crisis and special situation such as acute chest syndrome, stroke and acute priapism. Pregnancy sickle-cell disease presents high risk for the mother and the fetus. In these indications, blood transfusion is the main therapy aiming to reduce anaemia in order to restore hemoglobin's rate or to increase normal Hb proportion. This study aims to assess the short-term efficiency of the red cell transfusion in SCD homozygous form. One hundred and twelve homozygous sickle-cell patients were enrolled in this prospective study: 59 females and 53 males, median age is 21,8 years (extremes: 2 and 45 years). These patients are mostly with very low income. Two groups of patients are included in this study. In the first group, patients present acute anemia crisis caused by infections disease (malaria, bacterial infections). In the second group (20 cases), SCD patients have particularly situations: pregnancy (10 cases); stroke (six cases); cardiac failure (two cases) and priapism (two cases). Transfusion treatment in first group is simple regimen. Transfusion of EC increased median Hb level at 2,9 g/dl (extremes: 1,1 and 4,7). In the second group of patients, 16 cases were transfused by manual partial exchange (1-3) and four patients received simple regimen of transfusion. Median Hb level was 3,1g/dl (extremes: 2,4-4,9 g/dl). HbS percentage reduction was after PTE between -30 and -66,8% (median: -52,6%). According to our diagnostic possibilities (blood serologic test), we have not found any contamination by HIV, HBV and HCV (virus).

  19. Inappropriate use of urinary catheters in patients admitted to medical wards in a university hospital.

    Fernández-Ruiz, Mario; Calvo, Beatriz; Vara, Rebeca; Villar, Rocío N; Aguado, José María

    2013-10-01

    The prevalence and predisposing factors were determined for inappropriate urinary catheterization (UC) among inpatients in medical wards. A cross-sectional study was conducted including all patients aged ≥ 18 years admitted to medical wards in a 1300-bed tertiary-care centre, and who had a urinary catheter in place on the day of the survey. Of 380 patients observed, 46 (12.1%) had a urinary catheter in place. Twelve of them (26.1%) were inappropriately catheterized. The most common indication for inappropriate UC was urine output monitoring in a cooperative, non-critically ill patient. Inappropriateness was associated with increased age, poor functional status, urinary incontinence, dementia, and admission from a long-term care facility. Further educational efforts should be focused on improving catheterization prescribing practices by physicians. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  20. Developing marketing strategies for university teaching hospitals.

    Fink, D J

    1980-07-01

    University teaching hospitals face increasing competition from community hospitals, expanding regulation of health care, a rising tide of consumerism, and in many cases a declining urban population base. These problems, which may threaten the teaching hospital's ability to continue tertiary care, teaching, and research functions, may be solved with the aid of new marketing strategies. In developing its marketing strategy, a hospital must assess its strengths and weaknesses, specify its goals in measurable terms, implement tactics to achieve these goals, and evaluate its marketing program. The strategies should be directed toward achieving better relationships with institutions, practitioners, and surrounding communities and increasing patient, visitor, and employee satisfaction. A wide variety of programs can be used to reach these goals and to help teaching hospitals meet the competitive challenges of this decade.

  1. Cow’s milk allergy: a cohort of patients from a university hospital

    Reynolds, A

    2016-03-01

    Our aim was to establish the feeding history, presentation, management and rate of resolution for an Irish cohort of children with cow’s milk protein allergy (CMPA) attending a hospital-based outpatient service. This was a cohort study consisting of two parts: a retrospective chart review and a follow-up questionnaire. Fifty-one infants (male: 61%, n=31) were enrolled. Twenty-one (41%) had IgE-mediated allergy. Twenty-nine (57%) had non-IgE mediated allergy. Twenty-two (49%) had tried ≥3 different formulas prior to diagnosis. Of the children who had reached two years, the overall rate of tolerance was 53% (IgE: 35%, non-IgE: 67%). Mild cases of CMPA can be managed in the community. Potential severe complications include faltering growth and anaphylaxis. CMPA should be managed using a multi-disciplinary approach. Increased awareness of CMPA may speed diagnosis and decrease the use of inappropriate formulas.

  2. Strategies of Daily Living Rehabilitative Activities for Post Stroke Patients at Minia University Hospital

    Zaky, Hend Elham Mohamed; EL-Lateef Mohammad, Zienab Abd; EL-Labban, Abdou Saad Taha; Ahmed, Gahen

    2015-01-01

    Background: Stroke is a leading cause of disability. Rehabilitation aims to hasten and maximize recovery from stroke by treating the disabilities caused by the stroke. Therefore, the aim of this study determine the post stroke patients' knowledge and practices in relation to disease and activities of daily living before the implementation of…

  3. Use of complementary and alternative medicine by cancer patients at the University of Nigeria Teaching Hospital, Enugu, Nigeria

    Anarado Agnes N

    2007-09-01

    Full Text Available Abstract Background The use of Complementary and Alternative Medicine (CAM by cancer patients is very common and varies between populations. The referenced English literature has no local study from Africa on this subject. This study was conducted to define the prevalence, pattern of use, and factors influencing the use of CAM by cancer patients at the University of Nigeria Teaching Hospital Enugu (UNTH-E, Nigeria Method Face-to-face interviews using semi-structured questionnaire were used to determine the use of CAM by cancer patients. All consenting cancer patients were interviewed as they presented at the core surgical units of the UNTH- E, from June 2003 to September 2005. Results 160 patients were interviewed; 68 (42.5% were males and 94 (57.5% were females. Ages ranged from 13–86 years. Breast, urogenital system, gastrointestinal system, and soft tissue cancers predominated. One hundred and four patients (65.0% have used CAM at some time during their current cancer illness; 56 (35.0% patients have not used any form of CAM. There were more females than males among the non-CAM users. The use of CAM was not affected by age, marital status, level of education, religious affiliation, or socioeconomic status. The most frequently used CAMs were herbs (51.9%, faith/prayer healing (49.4%, aloe vera (23.1%, Forever Living Products (16.3%, medicinal tea (14.4%, and Blackstone (12.5%. Over 23% of those who used CAM were satisfied, but 68.3% were disappointed. Most users (67.3% did not see any benefit from the CAM, but 25% could describe some specific benefits. More than 21% of users reported various unwanted effects. While 86.5% of CAM users will use orthodox medicine instead of CAM in the future, 9.6% will use the two together to help each other. Most users (79.8% will not repeat CAM or recommend its use for cancer. The majority of patients (55.8% did not mention their use of CAM to their doctors – mostly because the doctor did not ask

  4. Seroprevalence of parvovirus B19 infection in patients with beta thalassemia major in Fayoum University Hospital

    Mohamed E. Al Ghwass

    2016-09-01

    Conclusion: Parvovirus B19 infection is detected in high rates among children with beta thalassemia major. Measures to avoid iatrogenic and nosocomial transmission have to be implemented including screening of donated blood for B19 especially blood given to patients with hematological disorders. Also data from this study support the need for introduction of an approved B19 vaccine that primarily protects children with thalassemia major against that infection.

  5. Spoligotyping of Mycobacterium tuberculosis isolates from tuberculosis diagnosed patients at Dilla University Referral Hospital and other private clinics, Southern Ethiopia

    Gebremedhin Gebrezgabiher

    2015-04-01

    Full Text Available Objective: To assess Mycobacterium tuberculosis (M. tuberculosis strains exsisting in Gedeo zone and the surrounding areas of the Southern Ethiopia using spoligotyping. Methods: A cross sectional study was carried out from February, 2012 to June, 2013 and 97 (76 sputum and 21 fine needle aspirate samples were taken from tuberculosis diagnosed patients at Dilla University Referral Hospital and other private clinics. Culturing, region of difference (RD9 deletion typing and spoligotyping techniques were employed to isolate M. tuberculosis strains. Results: Growth of mycobacteria was observed in 35.1% (34/97. Speciation of isolates showed that 91.2% (31/34 of the isolates were M. tuberculosis. Further characterization led to the identification of 23 different spoligotype patterns of M. tuberculosis of which 61% and 39% displayed unique and cluster patterns, respectively. The most dominant shared type was spoligotype international type 53. Of the 23 strains, 12 have not been registered in the international spoligotyping database (SpolDB4. Seventy one percent of the strains belonged to the Euro-American lineage. Conclusions: This study revealed the existence of both genetically diverse and clustered M. tuberculosis strains from tuberculosis patients in the area, suggesting reactivation of infection and recent transmission, respectively. Molecular epidemiology of M. tuberculosis should be done nationwide in order to set appropriate control measures.

  6. Alfabetización en salud en pacientes que asisten a un hospital universitario Health literacy in patients attending a University Hospital

    Jonatan Konfino

    2009-12-01

    hospitalization rates, less frequent screening for cancer, poor control of diabetes, and disproportionately high rates of disease and mortality. Despite the importance of health literacy in medicine, there is no information about its prevalence in Latin America. The aim of this study was to assess the prevalence of inadequate health literacy in a random sample of patients, at a University Hospital where a descriptive study was performed during 2007. Health literacy was assessed through the Short Assessment of Health Literacy for Spanish-speaking Adults. Participants were randomly selected from the ambulatory clinic and from the medical inpatient ward during 2007.There were a total of 2345 patients potentially eligible during the time of the study, 234 were approached after random selection and 229 patients were interviewed (98% response; 54.6% of respondents were women and 62% were recruited from the ambulatory clinic. The respondents had a median age of 56 years. The prevalence of inadequate health literacy was 30.1% (69 patients. Patients with ≤ 7 years of formal education had more risk of having inadequate health literacy compared with those with > 12 years of education OR = 45.1 (IC 9.6-211.6. We found a high prevalence of inadequate health literacy, being strongly associated with the level of formal education. It is important that health care providers know the implications of health literacy and its consequences.

  7. Evaluation of Drug Use Attitudes of Patient and Its Relatives Attending to Cukurova University Medical Faculty Balcali Hospital

    Yusuf Karatas

    2012-03-01

    Conclusion: Information of rational drug usage pattern is sufficient for the patients who visit Balcali Hospital and this condition is related to their gender, educational level and social security level. [Cukurova Med J 2012; 37(1: 1-8

  8. Knowledge, attitudes and practices towards patients with HIV/AIDS in staff nurses in one university hospital in Sicily

    Marina Marranzano

    2013-03-01

    Full Text Available Background: nurses’ knowledge, attitudes and practices towards patients with HIV/AIDS are of ongoing interest, especially in developing countries. Nothing or very little is known about Italian nurses.Methods: HIV/AIDS knowledge, attitudes and behaviours of the nurses (n=107 from one university hospital inCatania,Sicily, were documented. Comparisons among nurses belonging to different Operative Units (O.U. were conducted by the chi-square test (P<0.05.Results: although HIV was nurses’ main concern in regard to contracting infections in the workplace (54%, the vast majority of them (98% had never refused an HIV/AIDS patient care assignment. Moreover, despite their concern of being more at risk of contracting HIV than the general population (41%, a not negligible percentage of nurses did not use gloves routinely (21% and only a few treated all patients as potentially HIV-positive (9%. The vast majority of the respondents knew the meaning of AIDS (87% and of a positive serological test (78%. On the contrary, a relatively low percentage of them knew what is the ‘window period’ (62% and were acquainted with HIV pathophysiology (65%. No statistically significant differences in terms of risk perception were found between nurses who had previously attended an HIV/AIDS workshop, lecture or specific course (43% and nurses who did not (57%. Level of knowledge was positively associated to age (P=0.000 and to education (P=0.016, and it was found higher in nurses working in a O.U. of Infectious Diseases.Conclusions: data from our study show that also in developed countries, such as Italy, nurses could have some misconceptions and concerns about HIV/AIDS. The importance of examining the impact of continuing education on nurses’ preparedness to care for patients with HIV/AIDS and to prevent the risks of occupational HIV transmission is discussed. 

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

    Nathálie Crestani

    2011-12-01

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

  10. High prevalence of pain among adult HIV-infected patients at University of Gondar Hospital, Northwest Ethiopia.

    Azagew, Abere Woretaw; Woreta, Hiwot Kassa; Tilahun, Ambaye Dejen; Anlay, Degefaye Zelalem

    2017-01-01

    HIV/AIDS are pressing global health problems. Pain is a common symptom reported by patients living with HIV/AIDS. The exact cause of pain in HIV patients has not been thoroughly described, but it may, due to a symptom of HIV itself, result from opportunistic infections, as a side effect of antiretroviral drugs, concurrent neoplasia or other causes. In addition, pain perception of HIV-infected patients is highly variable and may vary based on cultural context and patient demographics. In Ethiopia, there is insufficient evidence on the prevalence and factors associated with HIV-related pain. A cross-sectional study was conducted among 422 adult HIV-infected patients at Gondar University Hospital antiretroviral care clinic from March 1 to May 1, 2016. Systematic random sampling was used to select study participants. A pretested interviewer-administered questionnaire and a standardized medical record data abstraction tool were used to collect data. A short form brief pain inventory tool was used to measure the outcome. Bivariate and multivariate logistic regression models were fitted to identify factors associated with pain among adult HIV patients. The prevalence of pain was found to be 51.2% (95% CI: 46.4%-55.9%). Headache (17.9%), abdominal pain (15.6%), and backache (13.3%) were the most common symptoms of study participants. Being female (adjusted odds ratio [aOR]=1.8, 95% CI: 1.1-2.9); regular alcohol intake (aOR=3.3, 95% CI: 1.5-7.2); baseline World Health Organization clinical disease stage: II (aOR=2.5, 95% CI: 1.2-4.9), III (aOR=2, 95%, CI: 1.1-3.6), and IV (aOR=2.4, 95% CI: 1.1-5.3); and the presence of a chronic comorbid condition (aOR=5.9, 95% CI: 2.1-16.7) were significantly associated with pain. Adult HIV patients in this sample reported a high level of chronic pain. Healthcare providers should better implement a routine pain assessment among HIV-positive patients to alleviate their suffering.

  11. Occupational Accidents among Clinical Staff of Tabriz University Hospitals

    Leila Sahebi; Rana Gholamzadeh nikjoo; Majid Khalili

    2015-01-01

    ​Background and Objectives : Occupational health and safety is one of the most important issues in the workplace. The purpose of this study was to explore the one –year prevalence of occupational accidents in Tabriz University hospitals. Materials and Methods : A cross-sectional study was conducted on 400 patients of seven university hospitals using researcher made questionnaire. The hospitals were selected based on their specialty of the service. Then, one hospital was selected from each s...

  12. Implementation of a rapid HIT immunoassay at a university hospital - Retrospective analysis of HIT laboratory orders in patients with thrombocytopenia.

    Black, Anne; Heimerl, Susanne; Oertli, Linnéa; Wilczek, Wolf; Greinacher, Andreas; Spannagl, Michael; Herr, Wolfgang; Hart, Christina

    2017-10-01

    Heparin-induced thrombocytopenia (HIT) is a rare cause of thrombocytopenia and a potentially life-threatening adverse drug reaction. Clinical overdiagnosis of HIT results in costly laboratory tests and anticoagulation. Criteria and algorithms for diagnosis are established, but their translation into clinical practice is still challenging. In a retrospective approach we studied all HIT related laboratory test requests within four years and evaluated data before (1st period, 24month) and after (2nd period, 24month) replacing particle gel immunoassay (PaGIA) and enzyme-linked immunosorbent assay (ELISA) by a chemiluminescent immunoassay (CLIA). HIT was confirmed by heparin-induced platelet activation (HIPA) test. Clinical pretest probability for HIT using an implemented simplified 4Ts score and platelet count were evaluated. Costs for laboratory tests and alternative anticoagulation were calculated. In 1850 patients with suspected HIT, 2327 laboratory orders were performed. In 87.2% of these orders an intermediate/high simplified 4Ts score was found. Thrombocytopenia was present in 87.1%. After replacing PaGIA and ELISA by CLIA the number of immunological and functional laboratory tests was reduced by 38.2%. The number of positive HIT immunoassays declined from 22.6% to 6.0%, while the number of positive HIPA tests among positive immunological tests increased by 19%. Altogether, acute HIT was confirmed in 59 patients. A decline in the use of alternative anticoagulants was observed in the 2nd period. Our study shows that in a university hospital setting HIT is well-known, but diagnosis requires a precise laboratory confirmation. Replacing PaGIA and ELISA by CLIA did not influence laboratory order behavior but results in reduced overall costs for laboratory diagnostics and alternative anticoagulation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Perceptions of burden of caregiving by informal caregivers of cancer patients attending University of Calabar Teaching Hospital, Calabar, Nigeria

    Akpan-Idiok, Paulina Ackley; Anarado, Agnes Nonye

    2014-01-01

    Introduction Cancer care is devastating to families. This research studied the informal caregivers’ perceptions of burden of caregiving to cancer patients attending University of Calabar Teaching Hospital, Calabar. Methods The research adopted a cross-sectioned descriptive design and 210 caregivers providing care to advanced cancer patients were purposively selected. Data were collected using a researcher developed questionnaire and standardized Zarit Burden Interview scale (ZBIS). Data collected were analysed using descriptive and chi-square statistics with the help of SPSS 18.0 and PAS 19.0 softwares. Results The results indicated that the caregivers were in their youthful and active economic age, dominated by females, Christians, spouses, partners and parents. The burden levels experienced by the caregivers were as follows: severe (46.2%), moderate (36.2%) and trivial of no burden (17.6%). The forms of burden experienced were physical (43.4%), psychological (43.3%), financial (41.1%) and social (46.7%), quite frequently and nearly always. Psychological and social forms of burden had the highest weighted score of 228 in terms of magnitude of burden. The result further showed that there was a significant (P = 0.001) and inverse association between caregivers’ burden and the care receivers’ functional ability. The level of burden also increased significantly (P = 0.000) with the duration of care, while there was also a significant (P = 0.01) relationship between caregivers’ experience of burden and their desire to continue caregiving. Conclusion Caregiving role can be enhanced by provision of interventions such as formal education programme on cancer caregiving, oncology, home services along side with transmural care. PMID:25419297

  14. Bacteriospermia and Sperm Quality in Infertile Male Patient at University of Benin Teaching Hospital, Benin City, Nigeria

    Ibadin, O. K.; Ibeh, I. N.

    2008-01-01

    Male Urogenital tract infection plays an important role in men infertility. Asymptomtic bacteriospermia has been regarded as of the contributing factor to male infertility. In this study, 87 semen samples of infertile men attending the Human Reproduction Research Programme and Invitrofertilization unit (HRRP/IVF) of University Benin Teaching Hospital were evaluated Bacteriologically using standard Bacterial culture method. Standard semen analysis was performed according to WHO guidelines. Amo...

  15. Statistical Observations of The Patients With Vertigo in The Oto-Rhino-Laryngological Department of The Ryukyu University Hospital in 1980

    勢理客, 友子; 名嘉嶺, 苗子; 喜友名, 千佳子; 又吉, 重光; 野田, 寛; Serikyaku, Tomoko; Nakamine, Naeko; Kiyuna, Chikako; Matayoshi, Shigemitsu; Noda, Yutaka; 琉球大学医学部附属病院耳鼻咽喉科

    1982-01-01

    Statistical analyses were presented, regarding to the 69 patients with vertigo in the Oto-Rhino-Laryngological Department of the Ryukyus University Hospital, and the following features were observed : 1. We had monthly 7.7 patients with vertigo on an average, which were increased in comparison with average 4.9 patients a month in 1979. 2. Many of the patients were presented in the third to the fifth decade of age in both sex, and the female patients were 2.5 times more than the male. 3. The p...

  16. Seroprevalence of Toxoplasma gondii IgG antibody in HIV-infected patients at the Lagos University Teaching Hospital

    Osunkalu VO

    2011-09-01

    Full Text Available Vincent O Osunkalu1, Sulaimon A Akanmu1, Nkolika J Ofomah1, Igwebuike V Onyiaorah2, Adewumi A Adediran1, Ralph O Akinde3, Ifeanyi A Onwuezobe41Department of Haematology and Blood Transfusion, College of Medicine Idi-Araba, Lagos, Nigeria; 2Department of Histopathology, Nnamdi Azikiwe University, Nnewi Campus, Lagos, Nigeria; 3Department of Morbid Anatomy, College of Medicine Idi-Araba, Lagos, Nigeria; 4Department of Microbiology, University of Calabar, NigeriaBackground: Toxoplasmosis is caused by infection with a ubiquitous intracellular protozoan parasite, Toxoplasma gondii. With the advent of the HIV pandemic in Nigeria, toxoplasmic encephalitis has become one of the more frequent opportunistic infections and the most commonly implicated cause of focal brain lesions complicating the course of AIDS.Objectives: This study was conducted to compare the pattern of seroprevalence of T. gondii (Toxo-IgG antibodies among HIV-infected persons presenting with neurological complications and those without.Materials and methods: Plasma specimens collected from 380 subjects were tested for Toxo-IgG antibodies by enzyme immunoassay technique and CD4 estimation by flow cytometry. Close-ended questionnaires were applied to all respondents to collect relevant data, with ethical approval from the hospital ethical committee. Plasma was obtained from two study groups comprising 300 HIV-positive respondents without neurological presentations, and 80 HIV-positive respondents with neurological complications.Results: Seroprevalence of Toxo-IgG antibodies was 58% in the HIV-positive study group without neurological complications (of these, 79.2% were males and 38.5% were females and 40% in the study group with neurological complications (46.2% of these were males and 28.6% were females. The overall seroprevalence of Toxo-IgG antibodies among the HIV-positive respondents (with and without neurological complications was 54.2% (206 of 380. Seroprevalence of Toxo

  17. Hospital enterprise Architecture Framework (Study of Iranian University Hospital Organization).

    Haghighathoseini, Atefehsadat; Bobarshad, Hossein; Saghafi, Fatehmeh; Rezaei, Mohammad Sadegh; Bagherzadeh, Nader

    2018-06-01

    Nowadays developing smart and fast services for patients and transforming hospitals to modern hospitals is considered a necessity. Living in the world inundated with information systems, designing services based on information technology entails a suitable architecture framework. This paper aims to present a localized enterprise architecture framework for the Iranian university hospital. Using two dimensions of implementation and having appropriate characteristics, the best 17 enterprises frameworks were chosen. As part of this effort, five criteria were selected according to experts' inputs. According to these criteria, five frameworks which had the highest rank were chosen. Then 44 general characteristics were extracted from the existing 17 frameworks after careful studying. Then a questionnaire was written accordingly to distinguish the necessity of those characteristics using expert's opinions and Delphi method. The result showed eight important criteria. In the next step, using AHP method, TOGAF was chosen regarding having appropriate characteristics and the ability to be implemented among reference formats. In the next step, enterprise architecture framework was designed by TOGAF in a conceptual model and its layers. For determining architecture framework parts, a questionnaire with 145 questions was written based on literature review and expert's opinions. The results showed during localization of TOGAF for Iran, 111 of 145 parts were chosen and certified to be used in the hospital. The results showed that TOGAF could be suitable for use in the hospital. So, a localized Hospital Enterprise Architecture Modelling is developed by customizing TOGAF for an Iranian hospital at eight levels and 11 parts. This new model could be used to be performed in other Iranian hospitals. Copyright © 2018 Elsevier B.V. All rights reserved.

  18. Ambliopia por estrabismo: estudo retrospectivo de pacientes em hospital universitário Strabismic amblyopia: a retrospective study on patients from a university hospital

    Deborah Salerno Costa

    2006-04-01

    Full Text Available OBJETIVO: Avaliar a influência da adesão ao tratamento, da gravidade da ambliopia e da idade de início do tratamento em pacientes com ambliopia por estrabismo submetidos à terapia oclusiva. MÉTODOS: Analisaram-se 569 prontuários de pacientes com ambliopia por estrabismo atendidos no Hospital das Clínicas da Faculdade de Medicina da USP no período de 1983 a 2000. Os critérios de exclusão foram: perda de seguimento, idade maior que 12 anos, presença de nistagmo e outras doenças oculares. Todos foram submetidos a exame oftalmológico completo com avaliação da motilidade ocular, divididos por faixas etárias e classificados quanto ao tipo de estrabismo, gravidade da ambliopia e adesão ao tratamento. Os dados foram analisados estatisticamente pelo método de Fisher. RESULTADOS: Foram incluídos 198 pacientes (34,8%. Não houve diferença de adesão nos diversos grupos etários. A taxa de sucesso foi maior nos pacientes com boa adesão independente da gravidade da ambliopia. Porém a adesão ao tratamento foi menor no grupo com ambliopia grave, que foi o mais freqüente e obteve menor taxa de sucesso em nossa amostra. Não houve relação entre idade e sucesso terapêutico. CONCLUSÕES: O estudo demonstrou que a adesão ao tratamento oclusivo desempenha papel fundamental na eficácia terapêutica. Com isto, idade de início do tratamento isoladamente não teve influência no sucesso terapêutico, uma vez que foi possível obter boa adesão a despeito da idade. Além disto, os resultados foram piores nos casos de ambliopia grave, nos quais a adesão foi menor.PURPOSE: To evaluate the influence of compliance with treatment, severity of amblyopia and age at the beginning of treatment in patients with strabismic amblyopia submitted to patching. METHODS: The data were selected from medical records of 569 patients seen at the Department of Ophthalmology, University of São Paulo during the period of 1983 to 2000. Exclusion criteria: loss of

  19. Patient life in hospital

    Ludvigsen, Mette Spliid

    Patient life in hospital.A qualitative study of informal relationships between hospitalised patients Introduction Within a patientology framework, this PhD dissertation is about an empirical study on patient life that provides insight into the nature of informal relationships between patients...... are created through stories about three roughly framed aspects of hospitalisation: A. Being together with fellow patients entails a constant dilemma, B. Relationships between patients are restricted and extended and C. Shifting perspectives in solidarity. Conclusion Patients' hospitalisation is strongly...

  20. Patient Motivators for Emergency Department Utilization: A Pilot Cross-Sectional Survey of Uninsured Admitted Patients at a University Teaching Hospital.

    Lozano, Karla; Ogbu, Uzor C; Amin, Alpesh; Chakravarthy, Bharath; Anderson, Craig L; Lotfipour, Shahram

    2015-08-01

    During the past several decades, emergency department (ED) increasing volume has proven to be a difficult challenge to address. With the advent of the Affordable Care Act, there is much speculation on the impact that health care coverage expansion will have on ED usage across the country. It is currently unclear what the effects of Medicaid expansion and a decreased number of uninsured patients will have on ED usage. We sought to identify the motivators behind ED use in patients who were admitted to a university teaching hospital in order to project the possible impact of health care reform on ED utilization. We surveyed a convenience sample of uninsured patients who presented to the ED and were subsequently admitted to the inpatient setting. Our respondents sought care in the ED primarily because they perceived their condition to be a medical emergency. Their lack of insurance and associated costs of care resulted in delays in seeking care, in reduced access, and a limited ability to manage chronic health conditions. Thus, contributing to their admission. Affordability will reduce financial barriers to health care insurance coverage. However, efficient and timely access to primary care is a stronger determinant of ED usage in our sample. Health insurance coverage does not guarantee improved health care access. Patients may continue to experience significant challenges in managing chronic health conditions. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Frequency and risk factors associated with emergency medical readmissions in Galway University Hospitals.

    Gorman, J

    2010-06-01

    Unplanned readmissions of medical hospital patients have been increasing in recent years. We examined the frequency and associates of emergency medical readmissions to Galway University Hospitals (GUH).

  2. Popularity and Harms of Aural Foreign Bodies: A Descriptive Study of Patients in Baqiyatallah University Hospital, Tehran, Iran.

    Taheri, Abolfazl; Mehmandari, Sina Navaei; Shahidi, Mojtaba; Mehdizadeh, Hamidreza; Mirlohi, Seyyed Mohammad Javad; Aref, Nasrin Mohammadi; Avanaki, Mahsa Alborzi; Khosravi, Mohammad Hossein

    2017-12-01

    To evaluate the prevalence of external ear complications among Iranian aural foreign body users attending to otolaryngology clinic of our hospital. In this cross-sectional study patients attending to Otolaryngology clinics of Baqiyatallah hospital were enrolled regardless of their age, gender and reason of attending. Patients between 15 and 60 years of age were included in the present study. Those with positive history of chronic ear diseases, ear surgery, congenital ear disorders, trauma to ear or head and neck region or shock wave trauma were excluded from the study. Demographic information as well as data on chief complaint, educational level, frequency and type of used foreign body and findings of physical examination and Otoscopy by a single otolaryngologist were recorded in a predesigned checklist. Eventually 362 patients (232 male and 130 female) with a mean age of 40.32 ± 16.90 years underwent analysis. Of all patients 244 (67.2%) were using a kind of aural foreign body frequently and Cotton bud was the most popular (63.5%) used foreign body among patients. Drying ear canal was the most common (54.9%) reason of using AFBs among study individuals followed by itching (29.5%) and pyorrhea (11.06%). Also 11 (4.5%) patients were using AFBs as a habit with no specific reason. Itching was the most prevalent symptom reported by both aural foreign body users (78%) and non-users (45.5%); however it was significantly higher among AFB users (p = 0.026). Also hearing loss was significantly more reported by AFB users (p = 0.033). A majority of patients had normal physical examination in both AFB users and non-users group. Inflammation of ear canal was significantly more detected in AFB users (p = 0.004). In addition, rate of right ear wax impaction was higher among AFB users (p = 0.016). In conclusion we realized that 67.2% of patients attending to Otolaryngology clinic of our hospital were using a kind of aural foreign bodies and itching was the most common chief

  3. Ten-year Survival and Its Associated Factors in the Patients Undergoing Pacemaker Implantation in Hospitals Affiliated to Shiraz University of Medical Sciences During 2002 - 2012

    Rajaeefard, Abdolreza; Ghorbani, Mohammad; Babaee Baigi, Mohammad Ali; Tabatabae, Hamidreza

    2015-01-01

    Background: Heart failure is a prevalent disease affecting about 4.9 million people in the U.S. and more than 22 million individuals worldwide. Using electric pacemaker is the most common treatment for the patients with heart conduction problems. The present study aimed to determine the factors affecting survival in the patients undergoing pacemaker implantation in the hospitals affiliated to Shiraz University of Medical Sciences. Objectives: The aim of the present study was to identify the factors affecting the survival of the patients suffering from arrhythmia. Patients and Methods: This retrospective survival analysis was conducted on all 1207 patients with heart failure who had undergone permanent pacemaker implantation in the hospitals affiliated to Shiraz University of Medical Sciences from 2002 to 2012. The data were analyzed using non-parametric methods such as Kaplan-Meier method, life table, and Cox regression model. The risk factors of mortality were determined using multivariate Cox proportional hazards method. Results: Survival data were available for 1030 (80%) patients (median age = 71 years [5th to 95th percentile range: 26 - 86 years]) and follow-up was completed for 84.28% of them. According to the results, 56% of the patients had received dual-chamber systems, while 44% had been implanted by single-chamber ventricular systems. Moreover, sick sinus syndrome and pacemaker mode were independent predictors of increased mortality. Conclusions: In this study, sick sinus syndrome and pacemaker mode followed by syncope were independently associated with increased mortality. PMID:26734484

  4. Body Mass Index and Western Ontario & McMaster Universities Osteoarthritis Index in Patients with Knee Osteoarthritis in Dr. Hasan Sadikin General Hospital, Bandung in November 2012

    Ainna Binti Mohamad Dat

    2015-09-01

    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.

  5. COPD is frequent in conditions of comorbidity in patients treated with various diseases in a university hospital

    Akira Yamasaki

    2010-09-01

    Full Text Available Akira Yamasaki, Kiyoshi Hashimoto, Yasuyuki Hasegawa, Ryota Okazaki, Miki Yamamura, Tomoya Harada, Shizuka Ito, Soichiro Ishikawa, Hiroki Takami, Masanari Watanabe, Tadashi Igishi, Yuji Kawasaki, Eiji ShimizuDivision of Medical Oncology and Molecular Respirology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, JapanBackground: Chronic obstructive pulmonary disease (COPD is one of the leading causes of death and loss of disability-adjusted life-years. However, many COPD patients are not diagnosed because of underrecognition or underdiagnosis of this disease among many patients and physicians. One possible reason is underrecognition of spirometry. In this study, we examined the prevalence of airflow limitation and underlying disease in patients with airflow limitation.Methodology: From April 2006 to March 2008, patients who had spirometry performed were examined. The original disease of patients, pulmonary function tests, smoking status, and respiratory symptoms were surveyed from their medical records.Results: Of all patients who had spirometry performed, 15.8% showed airflow limitation (FEV1/FVC < 0.7. A variety of diseases were observed in patients with airflow limitation. Among all diseases, cardiovascular disease was the highest and gastrointestinal malignant disease had the second highest prevalence in patients with airflow limitation.Conclusion: COPD might be frequent in conditions of comorbidity in patients treated for various diseases. Attention should be paid to the possibility of co-existence of COPD and the influence of COPD on these patients.Keywords: airflow limitation, chronic obstructive pulmonary disease, comorbidity, spirometry, prevalence

  6. Bacteriospermia and Sperm Quality in Infertile Male Patient at University of Benin Teaching Hospital, Benin City, Nigeria

    Ibadin, O. K.

    2008-01-01

    Full Text Available Male Urogenital tract infection plays an important role in men infertility. Asymptomtic bacteriospermia has been regarded as of the contributing factor to male infertility. In this study, 87 semen samples of infertile men attending the Human Reproduction Research Programme and Invitrofertilization unit (HRRP/IVF of University Benin Teaching Hospital were evaluated Bacteriologically using standard Bacterial culture method. Standard semen analysis was performed according to WHO guidelines. Among the total cases, 36 (41.4% showed at least one pathogen. Staphylococcus aureus (16.1%, Staphylococcus Saprophyticus (9.1%, Escherichia Coli (6.9% Proteus mirabilis (3.4% Klebsiella spp (2.3% Pseudomonas aerouginosa (1.1% and Proteus vulgaris (2.3%. There was a significant relation between bacteriospermia and the rate of number of total motility and morphologically abnormal sperms (p 0.05. It seems that leukocytopermia is not a good maker to predict bacteriospermia.

  7. Clinical characteristics of adult patients with inborn errors of metabolism in Spain: A review of 500 cases from university hospitals

    J. Pérez-López

    2017-03-01

    Full Text Available Patients with inborn errors of metabolism (IEMs have become an emerging and challenging group in the adult healthcare system whose needs should be known in order to implement appropriate policies and to adapt adult clinical departments. We aimed to analyze the clinical characteristics of adult patients with IEMs who attend the most important Spanish hospitals caring for these conditions. A cohort study was conducted in 500 patients, categorized by metabolic subtype according to pathophysiological classification. The most prevalent group of IEMs was amino acid disorders, with 108 (21.6% patients diagnosed with phenylketonuria. Lysosomal storage disorders were the second group, in which 32 (6.4% and 25 (5% patients had Fabry disease and Gaucher disease respectively. The great clinical heterogeneity, the significant delay in diagnosis after symptom onset, the existence of some degree of physical dependence in a great number of patients, the need for a multidisciplinary and coordinated approach, and the lack of specific drug treatment are common features in this group of conditions.

  8. Patient satisfaction with the perioperative surgical services and associated factors at a University Referral and Teaching Hospital, 2014: a cross-sectional study.

    Gebremedhn, Endale Gebreegziabher; Lemma, Girmay Fitiwi

    2017-01-01

    Globally, increasing consideration has been given to the assessment of patient satisfaction as a method of monitor of the quality of health care provision in the health institutions. Perioperative patient satisfaction has been contemplated to be related with the level of postoperative pain intensity, patients' expectation of the outcome, patient health provider relationship, inpatient services, hospital facilities, access to care, waiting time, cost and helpfulness of treatments received. The study aimed to assess the level of patient satisfaction with perioperative surgical services and associated factors. Hospital based quantitative cross-sectional study was conducted in University of Gondar teaching hospital from April1-30, 2014. Structured Amharic version questionnaire and checklist used for data collection. All patients who operated upon during the study period were included. Both bivariate and multivariate logistic regression model used to identify the variables which had association with the dependent variable. P-values patient satisfaction with perioperative surgical services was 98.1%. The variables that had association with the outcome variable from the multivariate analysis were patient admission status (AOR=0.073, CI=0.007-0.765, P=0.029), information about the disease and operation (AOR=0.010, CI=0.001-0.140, P=0.001) and operation theatre staff attention to the patients complains (AOR=0.028, CI=0.002-0.390, P=0.008) respectively. The level of patient satisfaction with perioperative surgical services was high compared with previous studies conducted in the country and other countries in the world. Health professionals need to give emphasis for information on care provision processes, patients' health progress and patients' complaints.

  9. Universal isolation precautions for patients at an academic hospital Precauciones universales en el aislamiento de pacientes en un hospital universitario Precauções universais em isolamentos de pacientes em hospital universitário

    Vanessa Gomes Maziero

    2012-01-01

    Full Text Available OBJECTIVE: To apply universal isolation precautions for patients at an academic hospital by a nursing team. METHODS: This descriptive and prospective study used data from advice service of quality control and nursing care that were gathered in observational reports of universal isolation precautions for patients admitted in two surgical inpatient units during 2008 and 2010. RESULTS: The mean general classification for both units was between desirable and adequate in the observational analysis of universal precaution. A borderline effect was observed only in November 2008 at the Men's Surgical Unit. The units assessed had compromised biosecurity, however, as time advanced data showed an improvement on their performance. CONCLUSION: The effective involvement of nurses in the unit is critical to prevent and control nosocomial infections.OBJETIVO: Utilización de las precauciones universales por el equipo de Enfermería en el aislamiento de pacientes en un Hospital Universitario. MÉTODOS: Estudio descriptivo, prospectivo. Fueron utilizados datos de la Asesoría de Control de Calidad de la Asistencia de Enfermería, correspondientes a los informes de las observaciones respecto a las precauciones universales en el aislamiento de pacientes en dos unidades de internamiento Médico - Quirúrgico, en el período comprendido entre 2008 y 2010. RESULTADOS: Las dos unidades de la institución presentaron un promedio general de clasificación, del análisis observacional de precaución universal, entre deseable y adecuada, siendo limítrofe apenas en noviembre del 2008 en la unidad Médico-Quirúrgica Masculina. Las unidades evaluadas, respecto a la adhesión a las precauciones universales, presentaron compromiso con la bioseguridad, y los datos exhibidos se mostraron mejores en cada año descrito. CONCLUSIÓN: La participación activa del enfermero responsable por la unidad es importante en la prevención y control de infecciones hospitalarias

  10. Patient safety incident reports related to traditional Japanese Kampo medicines: medication errors and adverse drug events in a university hospital for a ten-year period.

    Shimada, Yutaka; Fujimoto, Makoto; Nogami, Tatsuya; Watari, Hidetoshi; Kitahara, Hideyuki; Misawa, Hiroki; Kimbara, Yoshiyuki

    2017-12-21

    Kampo medicine is traditional Japanese medicine, which originated in ancient traditional Chinese medicine, but was introduced and developed uniquely in Japan. Today, Kampo medicines are integrated into the Japanese national health care system. Incident reporting systems are currently being widely used to collect information about patient safety incidents that occur in hospitals. However, no investigations have been conducted regarding patient safety incident reports related to Kampo medicines. The aim of this study was to survey and analyse incident reports related to Kampo medicines in a Japanese university hospital to improve future patient safety. We selected incident reports related to Kampo medicines filed in Toyama University Hospital from May 2007 to April 2017, and investigated them in terms of medication errors and adverse drug events. Out of 21,324 total incident reports filed in the 10-year survey period, we discovered 108 Kampo medicine-related incident reports. However, five cases were redundantly reported; thus, the number of actual incidents was 103. Of those, 99 incidents were classified as medication errors (77 administration errors, 15 dispensing errors, and 7 prescribing errors), and four were adverse drug events, namely Kampo medicine-induced interstitial pneumonia. The Kampo medicine (crude drug) that was thought to induce interstitial pneumonia in all four cases was Scutellariae Radix, which is consistent with past reports. According to the incident severity classification system recommended by the National University Hospital Council of Japan, of the 99 medication errors, 10 incidents were classified as level 0 (an error occurred, but the patient was not affected) and 89 incidents were level 1 (an error occurred that affected the patient, but did not cause harm). Of the four adverse drug events, two incidents were classified as level 2 (patient was transiently harmed, but required no treatment), and two incidents were level 3b (patient was

  11. Suspected acute appendicitis in female patients: Trends in diagnosis in emergency department in a University Hospital in Western region of Saudi Arabia

    Althoubaity, Fatima K.

    2006-01-01

    Objective was to determine the negative appendectomy rate; utilization, accuracy of Alvarado scale, ultrasound (US), computed tomography (CT) in diagnosis of acute appendicitis. Hospital records of 124 female patients admitted for suspicious of acute appendicitis from January 2003-January 2004 to the Emergency Department (ED) at King Abdul-Aziz University Hospital Jeddah, Saudi Arabia were reviewed retrospectively. We reviewed the age of patients, clinical presentation, Alvarado scale, US, CT, histopathalogical diagnosis of appendicular specimen. A total of 124 female patients aged 6-64 years were presented to ED with right iliac fossa pain. Of the total, 103 patients have appendectomies (83.1%), 21 (16.9%) patients underwent conservative treatment. Prevalence of advanced appendicitis was 13.7% and negative appendectomy rate was 27.2%. Accuracy rate of appendicitis with Alvarado scale 67.7%, US was 57.9% CT was 66.7%. Postoperative correlation was found between advanced cases and Alvarado scale (r=0.338), and hospital stay duration (r=0.250, p<0.01). Clinical findings and experiments remain of major importance in appendicitis-diagnosis. When appendicitis appears with atypical presentations, it remains a clinical challenge. In such cases, laboratory and imaging investigation may be useful in establishing a correct diagnosis. Alvarado scoring system is easy, simple and cheap complementary aid for supporting the diagnosis of acute appendicitis especially for junior surgeons. (author)

  12. Type of dyslipidemia and achievement of the LDL-cholesterol goal in chronic kidney disease patients at the University Hospital.

    Sangsawang, Tamon; Sriwijitkamol, Apiradee

    2015-01-01

    Chronic kidney disease (CKD) has been defined as a coronary artery disease risk equivalent. Therefore, the current guideline has been recommended for CKD patients to reach and maintain a low-density lipoprotein-cholesterol (LDL-C) goal of less than 100 mg/dL. However, the data regarding the achievement of LDL-C goal in these patients is lacking. This study was conducted to evaluate the types of dyslipidemia affecting patients with CKD stages 3 and 4 and to determine whether these patients achieved LDL-C goal. We performed a retrospective chart review of patients with CKD stage 3 or 4 and dyslipidemia who were followed-up at Siriraj Hospital between October 2011 and September 2012. In total, 150 patients with CKD stage 3 or 4 and dyslipidemia were recruited. The mean age was 72±10 years, and the body mass index was 25.6±4 kg/m(2); 60% had CKD stage 3 with an estimated glomerular filtration rate of 34±12 mL/min/1.73 m(2), and 54% had type 2 diabetes. The percentage of patients with hypercholesterolemia was 78%, hypertriglyceridemia 54%, and low high-density lipoprotein-C 36%. Of these, 52% had mixed hyperlipidemia. Statin treatment was prescribed to 87% of the patients, of which only 31.3% achieved the LDL-C goal according to the National Cholesterol Education Program and the European Society of Cardiology/European Atherosclerosis Society recommendations. Patients who did not achieve the LDL-C goal had a higher cholesterol level at diagnosis and higher prevalence of type 2 diabetes and stroke than those who achieved it. Two-thirds of CKD patients with hyperlipidemia had mixed hyperlipidemia. Despite the high frequency of statin treatment, only one-third of patients with CKD achieved the LDL-C goal. Thus, a developmental plan for the management of dyslipidemia in patients with CKD should be implemented to increase their achievement of the LDL-C goal.

  13. Inpatient satisfaction and usage patterns of personalized smart bedside station system for patient-centered service at a tertiary university hospital.

    Ryu, Borim; Kim, Seok; Lee, Kee-Hyuck; Hwang, Hee; Yoo, Sooyoung

    2016-11-01

    Bedside stations, also known as bedside terminals, are in place to enhance the quality and experience of a hospital's healthcare service delivery. The purpose of this study was to identify information needs and overall satisfaction with the personalized patient bedside system, called Smart Bedside Station (SBS) system, embedded in a tertiary general university hospital. End-user responses on the satisfaction survey and system usage logs of the SBS system were collected and analyzed. For the user opinion survey, 156 nurses and 1914 patients, their family members, or caregivers participated during the evaluation period of 2013 to 2014 in this study. All working nurses in the SBS-installed ward were answered the paper-based evaluation, for complete enumeration survey. Inpatients were voluntary participated to deliver the online questionnaire on the SBS menu. We also explored system log data including page calls and usage time from December 2013 to 2015. Regarding the relationship of overall satisfaction of the SBS with patient's characteristics, patient's education status and degree of familiarity with the smart device were statistically significant. From the analysis of system logs, Personalized My Menu(28.0%) was the most frequently used menu item (except for TV and Internet entertainment service use of 62.7%),it provides individual health information, such as laboratory test results, hospital fee check, message logs, daily medication information, and meal information. Next frequently used menus were information support(4.9%) which deliver hospital guide and health information and convenience service ordering(4.4%) such as meal order, bed sheet change. Satisfaction survey results and log data results show that the personalized service enhances the user satisfaction during hospital admission. Our post-implementation experience and subsequent assessment of SBS system is capable of providing insights into improving the hospital information system and service contents

  14. Primary hyperparathyroidism: King Khalid University Hospital experience

    Fouda, Mona A.

    1999-01-01

    This study was conducted to examine the prevalence, mode of presentationand management of primary hyperparathyroidism in one of the major hospitalsin Saudi Arabia. This was a retrospective analysis of 24 cases of primaryhyperparathyroidism comprising of 21 females and three males, who were seenat King Khalid University Hospital over a period of 16 years from 1982 untilDecember 1997. The prevalence of disease was estimated to be estimated to be11.34 per 100,000 hospital population. The majority of patients presentedwith musculoskeletal complaints (62%-67%) and/or renal complications were(58%). Hyperclacemia was seen in 92% of the cases. Serum PTH was availablefor 21 patients and 20 had significantly elevated levels. Fifty percent ofthe patients had features of hyperparathyroid bone disease on plane x-ray,while 79% showed osteopenia of the femoral neck and dual x-rayabsorptiometry, and almost all the patients had lumbar osteopenia. Fiftypercent of the patients had features of metabolic bone disease on bone scan.Thallium -technetium subtraction studies proved to be the most reliable tool,with 83% sensitivity of 55%. CT scan of the neck was attempted in only inseven patients (29%), with a sensitivity of 86%. Twenty-one patients (87.5%)underwent surgical exploration and removal of the parathyroid adenoma. Singleparathyroid adenoma was identified in 85% of the cases, 5% had multipleadenomas and 5% had hyperplasia of the parathyroid gland. Our results showedthat primary hyperparathyroidism is not rare disease in Saudi Arabia. It hastendency for late presentation with complications. We believe that routinescreening for calcium, and early identification of such cases, are warrantedto reduce the morbidity of this easily treatable disorder. (author)

  15. [Diet of neutropenic patients in pediatric oncology service; the experience of the university hospital of Strasbourg (HUS)].

    Mutel, T; Foeglé, J; Belotti, L; Sery, V; Bourneton, O; Hernandez, C; Lutz, P; Lavigne, T

    2012-12-01

    This article clarifies the choices made by the HUS concerning the ways of preparing food reserved to neutropenic children hospitalized in pediatric oncology service. We will describe the results of microbiological analysis of food realized from 2002 to 2007. A specific team prepares this food which is canned and treated by "appertisation" (autoclaving). Each dish portion produced is provided to the service only if the microbiological results are conform, that is to say free of organisms. Three thousand and seventy-eight dishes were analysed: 82.9% of the analysed packs were conform. The contamination ratio decreased significantly (Pfood which is the most frequently "nonconform" is the dry food with a contamination rate of 37.9%. The identified concentrations remain mainly lower than 50 colony-forming units per millilitre (CFU/mL): 66.2% for the bacteria and 97.2% for the fungi. Considering the lack of consensus on the acceptable microbiological thresholds and on the food protection level, the HUS make it a rule to have a maximal precautionary principle. Currently, this principle appears to us to be a safety option required for the patients hospitalized in pediatric oncology service. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  16. Patient blood management knowledge and practice among clinicians from seven European university hospitals: a multicentre survey.

    Manzini, P M; Dall'Omo, A M; D'Antico, S; Valfrè, A; Pendry, K; Wikman, A; Fischer, D; Borg-Aquilina, D; Laspina, S; van Pampus, E C M; van Kraaij, M; Bruun, M T; Georgsen, J; Grant-Casey, J; Babra, P S; Murphy, M F; Folléa, G; Aranko, K

    2018-01-01

    The aim of this survey was to evaluate the knowledge about Patient Blood Management (PBM) principles and practices amongst clinicians working in seven European hospitals participating in a European Blood Alliance (EBA) project. A web-based questionnaire was sent to 4952 clinicians working in medical, surgery and anaesthesiology disciplines. The responses were analysed, and the overall results as well as a comparison between hospitals are presented. A total of 788 responses (16%) were obtained. About 24% of respondents were not aware of a correlation between preoperative anaemia (POA) and perioperative morbidity and mortality. For 22%, treatment of POA was unlikely to favourably influence morbidity and mortality even before surgery with expected blood loss. More than half of clinicians did not routinely treat POA. 29%, when asked which is the best way to treat deficiency anaemia preoperatively, answered that they did not have sufficient knowledge and 5% chose to 'do nothing'. Amongst those who treated POA, 38% proposed red cell transfusion prior to surgery as treatment. Restrictive haemoglobin triggers for red blood cell transfusion, single unit policy and reduction of number and volumes of blood samples for diagnostic purposes were only marginally implemented. Overall, the responses indicated poor knowledge about PBM. Processes to diagnose and treat POA were not generally and homogeneously implemented. This survey should provide further impetus to implement programmes to improve knowledge and practice of PBM. © 2017 International Society of Blood Transfusion.

  17. [Introduction of computerized anesthesia-recording systems and construction of comprehensive medical information network for patients undergoing surgery in the University of Tokyo Hospital].

    Kitamura, Takayuki; Hoshimoto, Hiroyuki; Yamada, Yoshitsugu

    2009-10-01

    The computerized anesthesia-recording systems are expensive and the introduction of the systems takes time and requires huge effort. Generally speaking, the efficacy of the computerized anesthesia-recording systems on the anesthetic managements is focused on the ability to automatically input data from the monitors to the anesthetic records, and tends to be underestimated. However, once the computerized anesthesia-recording systems are integrated into the medical information network, several features, which definitely contribute to improve the quality of the anesthetic management, can be developed; for example, to prevent misidentification of patients, to prevent mistakes related to blood transfusion, and to protect patients' personal information. Here we describe our experiences of the introduction of the computerized anesthesia-recording systems and the construction of the comprehensive medical information network for patients undergoing surgery in The University of Tokyo Hospital. We also discuss possible efficacy of the comprehensive medical information network for patients during surgery under anesthetic managements.

  18. Retrospective assessment of occupational asbestos exposure among 220 patients with respiratory cancer hospitalized at Vilnius University Institute of Oncology

    Petrauskaite Everatt, R.; Jankauskas, R.; Tossavainen, A.; Cicenas, S.; Smolianskiene, G.

    2005-01-01

    No cases of lung cancer or mesothelioma have ever been diagnosed or compensated as asbestos-related in Lithuania. This paper attempts to estimate the proportion of those occupationally exposed to asbestos among respiratory cancer patients. Occupational exposure to asbestos was assessed retrospectively for 218 lung cancer and 2 mesothelioma patients admitted to Institute of Oncology, Vilnius University. The evaluation was based on personal interview data using an internationally established questionnaire. Cumulative exposure to asbestos at work was evaluated in fibre-years. A cumulative asbestos exposure of ≥25 fibre-years was found for 7 patients (3.2%), in further 135 (61.2%) a cumulative exposure from 0.01 to 24.99 fibre-years was assessed. The most common occupations among heavily (≥25 fibre-years) exposed patients were smith, welder or insulator in foundries, construction, shipyard as well as asbestos cement and glass industry. Preliminary findings indicate that a fraction (3.2%) of the respiratory cancer cases could be attributed to occupational exposure to asbestos. Since 1560 or more cases of lung cancer are registered every year in Lithuania, about 50 cases per year could be predicted to be asbestos-related. (author)

  19. Investigating the relationship between fatty liver and diabetes in patients admitted to hospitals affiliated to Tehran Shahid Beheshti University of Medical Sciences

    Marzieh Salehi

    2016-07-01

    Full Text Available Fatty liver is the most common chronic liver disease in Western industrialized countries. However, there is evidence on correlation between management of fatty liver risk and diabetes. In this regard, the current study was conducted to find the relationship between fatty liver and diabetes in patients admitted to hospitals affiliated to Tehran Shahid Beheshti University of Medical Sciences . This descriptive correlational study was conducted on 180 patients admitted to the hospitals of Shahid Beheshti University of Medical Sciences in Tehran. The instruments used in this study included demographic and clinical characteristics of patients such as serum levels of cholesterol, LDL, HDL, triglycerides, hemoglobin and liver horns. Results were analyzed using t-test and chi-square tests . According to ANOVA tests, significant difference was found among indicators of LDL, triglycerides, cholesterol and ALT so that with an increase in triglycerides, HbA1c level also increased (05/0> P. On the other hand, by reducing HDL, the indicator of HbA1c increased. In addition, significant relationship was found between indicators of ALP and triglycerides so that with an increase in triglyceride and ALP, FBS level also increases (P<0.05. Due to the great impact of obesity and type 2 diabetes at an increased risk of non-alcoholic fatty liver disease, regular exercise and physical activities appropriate with age, low-fat diet, weight loss and different treatments to control diabetes and hypertension are recommended to reduce nonalcoholic fatty liver disease.

  20. Generalized psychological distress among HIV-infected patients enrolled in antiretroviral treatment in Dilla University Hospital, Gedeo zone, Ethiopia

    Solomon H. Tesfaye

    2014-05-01

    Full Text Available Background: Psychological disorders like depression and anxiety are potentially dangerous conditions. In the context of HIV/AIDS, this can influence health-seeking behavior or uptake of diagnosis and treatment for HIV/AIDS, add to the burden of disease for HIV patients, create difficulty in adherence to treatment, and increase the risk of mortality and morbidity. The objective of this study was to assess the prevalence and correlates of generalized psychological distress among HIV-infected subjects on antiretroviral treatment (ART. Design: An institution-based cross-sectional study was conducted. Interviews were conducted with 500 patients initiating ART at Dilla Referral Hospital. Generalized psychological distress was measured using the Hospital Anxiety and Depression Scale (HADS. A cutoff score ≥19 was used to identify possible cases of patients with generalized psychological distress. Multivariable logistic regression analysis using SPSS Version 20 was performed to identify factors associated with psychological distress. Results: The prevalence of generalized psychological distress among the population of this study was 11.2% (HADS≥19. Factors independently associated with generalized psychological distress were moderate stress (OR=6.87, 95% CI 2.27–20.81, low social support (OR=10.17, 95% CI 2.85–36.29, number of negative life events of six and above (OR=3.99, 95% CI 1.77–8.99, not disclosing HIV status (OR=5.24, 95% CI 1.33–20.62, and CD4 cell count of <200 cells/mm3 (OR=1.98, 95% CI 0.45–0.83 and 200–499 cells/mm3 (OR=3.53, 95% CI 1.62–7.73. Conclusions: This study provides prevalence of psychological distress lower than the prevalence of common mental disorders in Ethiopia and comparable to some other studies in sub-Saharan Africa. The findings are important in terms of their relevance to identifying high-risk groups for generalized psychological distress and preventing distress through integrating mental health

  1. Weekend versus weekday hospital deaths: Analysis of in‑patient ...

    2013-02-15

    patients of a tertiary hospital in Nigeria. Materials and Methods: This is a 10‑year retrospective survey conducted at the Nnamdi Azikiwe University Teaching. Hospital in which the death records of the hospital were accessed from ...

  2. Current practices in the management of patients with ureteral calculi in the emergency room of a university hospital

    Oliver Rojas Claros

    2012-01-01

    Full Text Available OBJECTIVE: Urinary lithiasis is a common disease. The aim of the present study is to assess the knowledge regarding the diagnosis, treatment and recommendations given to patients with ureteral colic by professionals of an academic hospital. MATERIALS AND METHODS: Sixty-five physicians were interviewed about previous experience with guidelines regarding ureteral colic and how they manage patients with ureteral colic in regards to diagnosis, treatment and the information provided to the patients. RESULTS: Thirty-six percent of the interviewed physicians were surgeons, and 64% were clinicians. Forty-one percent of the physicians reported experience with ureterolithiasis guidelines. Seventy-two percent indicated that they use noncontrast CT scans for the diagnosis of lithiasis. All of the respondents prescribe hydration, primarily for the improvement of stone elimination (39.3%. The average number of drugs used was 3.5. The combination of nonsteroidal anti-inflammatory drugs and opioids was reported by 54% of the physicians (i.e., 59% of surgeons and 25.6% of clinicians used this combination of drugs (p = 0.014. Only 21.3% prescribe alpha blockers. CONCLUSION: Reported experience with guidelines had little impact on several habitual practices. For example, only 21.3% of the respondents indicated that they prescribed alpha blockers; however, alpha blockers may increase stone elimination by up to 54%. Furthermore, although a meta-analysis demonstrated that hydration had no effect on the transit time of the stone or on the pain, the majority of the physicians reported that they prescribed more than 500 ml of fluid. Dipyrone, hyoscine, nonsteroidal anti-inflammatory drugs, and opioids were identified as the most frequently prescribed drug combination. The information regarding the time for the passage of urinary stones was inconsistent. The development of continuing education programs regarding ureteral colic in the emergency room is necessary.

  3. Etiology of chronic prostatitis syndrome in patients treated at the university hospital for infectious diseases "Dr. Fran Mihaljević" from 2003 to 2005.

    Skerk, Vianja; Cajić, Vjeran; Markovinović, Leo; Roglić, Srdan; Zekan, Sime; Skerk, Vedrana; Radosević, Velena; Tambić Andragević, Arijana

    2006-12-01

    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.

  4. Demographic characteristics and clinical predictors of patients discharged from university hospital-affiliated pain clinic due to breach in narcotic use contract.

    Chakrabortty, Shushovan; Gupta, Deepak; Rustom, David; Berry, Hussein; Rai, Ajit

    2014-01-01

    The current retrospective study was completed with the aim to identify demographic characteristics and clinical predictors (if any) of the patients discharged from our pain clinic due to breach in narcotic use contract (BNUC). Retrospective patient charts' review and data audit. University hospital-affiliated pain clinic in the United States. All patient charts in our pain clinic for a 2-year period (2011-2012). The patients with BNUC were delineated from the patients who had not been discharged from our pain clinic. Pain characteristics, pain management, and substance abuse status were compared in each patient with BNUC between the time of admission and the time of discharge. The patients with BNUC discharges showed significant variability for the discharging factors among the pain physicians within a single pain clinic model with this variability being dependent on their years of experience and their proactive interventional pain management. The patients with BNUC in our pain clinic setting were primarily middle-aged, obese, unmarried males with nondocumented stable occupational history who were receiving only noninterventional pain management. Substance abuse, doctor shopping, and potential diversion were the top three documented reasons for BNUC discharges. In 2011-2012, our pain clinic discharged 1-in-16 patients due to breach in narcotic use contract.

  5. Smart information system for gachon university gil hospital.

    Park, Dong Kyun; Jung, Eun Young; Jeong, Byung Hui; Moon, Byung Chan; Kang, Hyung Wook; Tchah, Hann; Han, Gi Seong; Cheng, Woo Sung; Lee, Young Ho

    2012-03-01

    In this research, the hospital information system of Gachon University Gil hospital is introduced and a future strategy for hospital information systems is proposed. This research introduces the development conditions of hospital information system at Gachon University Gil hospital, information about the development of the enterprise resource planning (ERP), a medical service process improvement system, and the personal health record (PHR) system. The medical service process and work efficiency were improved through the medical service process improvement system, which is the most common hospital information system at Gachon University Gil hospital and which includes an emergency medical service system, an online evaluation system and a round support system. Gachon University Gil hospital developed medical service improvement systems to increase work efficiency of medical team and optimized the systems to prove the availability of high-quality medical services for patients and their families. The PHR-based personalized health care solution is under development and will provide higher quality medical service for more patients in the future.

  6. Medicare Hospital Spending Per Patient - Hospital

    U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...

  7. Two dimensional and Doppler echocardiographic evaluation of patients presenting at Obafemi Awolowo University Teaching Hospitals Complex Ile Ife Nigeria a prospective study of 2501 subjects

    Adebayo RA

    2013-07-01

    Full Text Available Rasaaq Ayodele Adebayo,1 Patience Olayinka Akinwusi,2 Michael Olabode Balogun,1 Anthony Olubunmi Akintomide,1 Victor Oladeji Adeyeye,1 Olugbenga Olusola Abiodun,1 Luqman Adeleke Bisiriyu,3 Suraj Adefabi Ogunyemi,1 Ebenezer Adekunle Ajayi,4 Olufemi Eyitayo Ajayi,1 Adebayo Tolulope Oyedeji5 1Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, 2Cardiology Unit, Department of Medicine, Osun State University, Osogbo, Osun State, 3Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Osun State, 4Cardiology Unit, Department of Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, 5Cardiology Unit, Department of Medicine, LAUTECH Teaching Hospital, Osogbo, Osun State, Nigeria Background: Echocardiography remains a key noninvasive cardiac investigative tool in the management of patients, especially in a developing economy like Nigeria. In this study, we investigated the indications for transthoracic echocardiography and spectrum of cardiac disease found in patients referred to our cardiac unit for echocardiography. Methods: A prospective two-dimensional, pulsed, continuous, and color-flow Doppler echocardiographic evaluation was done using the transthoracic approach in 2501 patients over an eight-year period. Univariate data analysis was performed for mean age, gender, clinical indications, and diagnoses. Results: The subject age range was less than 12 months to 97 years (mean 52.39 years. There were 1352 (54.06% males and 1149 (45.94% females. The most common indication for echocardiography was hypertension (52.1% followed by congestive cardiac failure (13.9%. Others were for screening (6.1%, arrhythmias (5%, cerebrovascular disease (5%, chest pain (3.3%, chronic kidney disease (3.2%, congenital heart disease (2.6%, cardiomyopathy (1.8%, rheumatic heart disease (1.7%, diabetes mellitus (1.3%, thyrocardiac disease (1.2%, ischemic heart

  8. Evaluation of dizziness at Jordan University Hospital

    Abdul-Baqi, Khader J.; Moamed, Faisal I.; Shubair, Kandil S.; Sarhan, Yusuf S.; Tawalbeh, Mohmed I.

    2004-01-01

    This study was performed prospectively to the dizzy patients in the Neurotology Outpatient Clinic at Jordan University Hospital, Amman, Jordan during the period 1993-2000 and to discuss the prevalence and and etiology of dizziness. Data were collected from 108 patients (52 male and 56 female) with a mean age of 45.6-years. diagnosis was made on the basis of history, physical, otolarygological and neurological examination and confirmed by relevant investigation including laboratory, radiological and audio vestibular tests. Secure diagnosis was made in 98% of patients (14% had one cause alone and 84% had multiple causes). Cardivascular disorders accounted for 31.5% of primary and 49% of secondary causes, perpheral vestibular disorders, 25% of primary and 3% of secondary causes, central vestibular disorders 17% of primary and 9% of secondary causes, metabolic endocrine 13% of primary and 38% of secondary causes and psychogenic 4.6% of primary and 6.5% of secondary causes.Our findings demonstrate that vertigo is most common subtype of dizziness (50%). Multiple causes are more prevalent in older age and single cause is more prevalent in younger age. Cardiovascular was the most common cause of dizziness followed by vestibular disorders, metabolic and cervical osteoarthritis. Vestibular disorders are primary causes and non vestibular are predominantly secondary causes of dizziness. Hyperlipidemia, diabetes and cervical causes are major secondary contributionsto dizziness. We recommend a a multi disciplinary setting and application of a comprehensive diagnostic and treatment approach without unnecessary protracted investigative schemeand installment of rehabilitatioon facilities. (author)

  9. Expectation and satisfaction of HIV/AIDS patients toward the pharmaceutical care provided at Gondar University Referral Hospital, Northwestern Ethiopia: a cross-sectional study

    Abebe TB

    2016-10-01

    Full Text Available Tamrat Befekadu Abebe,1 Daniel Asfaw Erku,2 Begashaw Melaku Gebresillassie,1 Kaleab Taye Haile,3 Abebe Basazn Mekuria4 1Department of Clinical Pharmacy, 2Department of Pharmaceutical Chemistry, 3Department of Pharmaceutics, 4Department of Pharmacology, School of Pharmacy, University of Gondar, Gondar, Ethiopia Purpose: Measurements of patient satisfaction help to assess the performance of health service provision and predict treatment adherence and outcomes. This study aimed to assess human HIV/AIDS patients’ expectation of and satisfaction with the pharmaceutical service delivered at Gondar University Referral Hospital, Ethiopia. Patients and methods: An institution-based cross-sectional study was performed from May 11 to 25, 2015. A total of 291 patients living with HIV/AIDS were included using a simple random sampling method. Data were collected using structured questionnaires measuring expectation and satisfaction of respondents using a Likert scale of 1–5 through face-to-face interviews. The data collected were entered into and analyzed using Statistical Packages for Social Sciences. Comparison was made between those respondents who lived in and outside the town. Results: The overall mean expectation and satisfaction of respondents toward pharmacy setting and services were 3.62 and 3.13, respectively. More than half (56.1% of the participants were dissatisfied with the comfort and convenience of waiting area and private counseling room. Similarly, 69.3% of the respondents claimed that pharmacy professionals did not give information about side effects and drug–drug and drug–food interactions of antiretroviral medications. There was a statistically significant difference between respondents who live in and outside Gondar town in overall expectation (t=3.415, P=0.001 with the pharmacy setting and services. Conclusion: In this study, the overall satisfaction level of respondents with pharmaceutical service (pharmacy setting and services

  10. Comparison of Risk Factors of Stroke and Myocardial Infarction in Patients 15 to 45 Years in Affiliated Hospitals of Babol University of Medical Sciences

    Alijan Ahmadi Ahangar

    2016-12-01

    Full Text Available Background Myocardial infarction (MI and stroke are the second and third leading causes of death in the world. By identifying the risk factors we can take the necessary measures to prevent the occurrence of these diseases. Methods In this retrospective study, 90 MI patients and 90 stroke patients 15 - 45 year admitted to hospitals of Babol University of Medical Sciences that randomly arranged by the time of hospitalization conducted. Demographics, laboratory test and risk factors were collected using check list. The data analyzed with McNemar and Npar tests by using SPSS 21 version software. Results The most common risk factor in young patient was a history of cerebrovascular disease that in stroke was 31 cases (34% And in MI was 33 cases (37%. History of cerebrovascular disease with MI was significant 33 (37%, 57(63%, P = 0.047. A history of cardiovascular disease with stroke was significant (20 (22%, 70 (68, P = 0.001. A history of addiction with MI was significant (23 (26%, 67 (74%, P < 0.001. In stroke patients 52 cases (% 57 low-density lipoprotein (LDL was high and in 66 cases (73.1% high-density lipoprotein (HDL was low. In patients with MI in 46 patients (51% LDL was high and the 66 patients (73% HDL was low. Conclusions Young peoples with a history of cerebrovascular, cardiovascular disease and addictions should be considering as target society. Primary health care system must identify high-risk individuals, and policy barriers that prevent implementation of programs to lower death rate.

  11. Prevalence of iodine- and thyroglobulin-negative findings in differentiated thyroid cancer. A retrospective analysis of patients treated from 1961 to 1998 in a university hospital

    Klutmann, S.; Jenicke, L.; Geiss-Toenshoff, M.; Bohuslavizki, K.H.; Mester, J.; Clausen, M.

    2001-01-01

    Aim: The prevalence of iodine- and thyroglobulin-negative findings was evaluated in all patients with differentiated thyroid cancer (DTC) treated from 1961 until 1998 at the Department of Nuclear Medicine, University Hospital Hamburg-Eppendorf. Methods: A total of 490 patients with papillary thyroid cancer (PCA) and 242 patients with follicular thyroid cancer (FCA) were analyzed retrospectively. Patients were divided into four groups: 1: no recurrence, 2: recurrent disease, 3: primary metastatic/progressive disease and 4: inconclusive follow-up. Results of iodine scan, serum-TG, and additional imaging modalities as well as histology were compared in all patients. Results: 21/490 (4,3%) of patients with PCA and 16/242 (6,6%) with FCA suffered from recurrent disease. 62/490 (12,7%) of patients with PCA and 59/242 (24,4%) with FCA had primary metastatic/progressive disease. 12/21 patients with PCA and 12/16 with FCA showing up with recurrent disease had a negative iodinescan. 11/21 of patients with PCA and 4/16 with FCA and tumor recurrence had negative serum-TG levels. 14/62 patients with PCA and 14/59 with FCA presenting with primary metastatic/progressive disease had negative iodinescan. 14/62 patients with PCA and 6/59 with FCA had negative serum-TG. Conclusion: The prevalence of iodine-negative recurrent/metastatic disease is in accordance to the literature, whereas the prevalence of TG-negative recurrent/metastatic was noted higher than reported previously. Thus, the commonly used follow-up scheme of DTC is confirmed. However, iodine scan should be regularly performed in patients with high risk of recurrence. (orig.) [de

  12. [Prevalence of pressure sores in a university hospital in 2003].

    Daideri, G; Berthier, F; Brocker, P; Darmon, M-J; Mignolet, F; Quaranta, J-F; Staccini, P

    2006-12-01

    To determine the prevalence of pressure sores in a university hospital and to assess the risk of developing a pressure sore. A one-day survey was performed in all hospitalized patients, day hospital excepted. The Garches scale was used to assess the severity of pressure sores and the Braden scale was used to measure the patient's risk for the development of pressure ulcers. One thousand six hundred and eleven patients were included, mean age was 62+/-23 years and 53.3% were over 65 years old. In hospitalized patients, 64% were in acute care, 29% in intermediate medicine and long-term care and 7% in intensive care units. We have found 675 pressure sores in 268 patients, mean age of 76 years; 263 decubitus ulcers were acquired during hospitalization. The most frequent sites were heels (46%) and sacrum (26%). Stage 1 pressure ulcers showed 33% of the total. The total prevalence was 16.6%, 95% CI (14.9-18.6), the hospital acquired pressure sores prevalence was 7.5%, all stages included. A Braden score less than or equal to 15 was found in 29.1% of hospitalized patients. Standard mattresses were used in 37% of patients with pressure sores. Multivariate analysis showed that age and a Braden score less than or equal to 15 were significantly associated with pressure sores. Pressure sores are still an important problem in hospital; occurrence must be considered as an iatrogenic event and management requires a multidisciplinary approach.

  13. Bone mineral density status and frequency of osteoporosis and clinical fractures in 155 patients with psoriatic arthritis followed in a university hospital.

    Busquets, Noemi; Vaquero, Carmen Gómez; Moreno, Jesús Rodríguez; Vilaseca, Daniel Roig; Narváez, Javier; Carmona, Loreto; Nolla, Joan M

    2014-01-01

    To assess the bone mineral density (BMD) and the frequency of osteoporosis and clinical fractures in a large group of Spanish patients with psoriatic arthritis (PsA). BMD was determined by DXA in all the patients who were willing to participate and had peripheral PsA regularly evaluated in a tertiary university hospital. All patients underwent a physical examination and general laboratory analysis. We gathered demographic and clinical variables related with BMD and risk of fractures. We also recorded the history of clinical low impact fractures. The population of reference to calculate T-score and Z-score came from a Spanish database. One hundred and fifty-five patients were included (64 postmenopausal women, 26 premenopausal women and 65 men). The clinical forms of PsA were: 46% oligoarticular and 54% polyarticular. Mean disease duration was 13.7±9.4 years and mean ESR was 21.8±13.9mm/h; 66% of patients had received glucocorticoid treatment. We found no differences in BMD status between the patients and the Spanish general population, neither in the whole series nor in each defined subgroup. Frequency of osteoporosis was 16%; it was higher in postmenopausal women (28%) than in men (9%) or premenopausal women (4%). Frequency of clinical fractures was 13%; it accounted specially in postmenopausal women. The magnitude of the problem of osteoporosis in PsA seems to be mild. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  14. Uncontrolled hypertension and associated factors among adult hypertensive patients on follow-up at Jimma University Teaching and Specialized Hospital: cross-sectional study

    Tesfaye B

    2017-03-01

    Full Text Available Bekele Tesfaye,1 Dessalegn Haile,1 Benalfew Lake,1 Tefera Belachew,2 Temamen Tesfaye,3 Habtamu Abera4 1Department of Nursing, College of Health Science, Debre Markos University, Debre Markos, 2Department of Population and Family Health, 3Department of Nursing and Midwifery, College of Health Science, Jimma University, Jimma, 4Department of Nursing and Midwifery, College of Health Sciences, School of Allied Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia Introduction: Hypertension, including poorly controlled blood pressure, is the major global health problem that affects one billion people worldwide. Limited studies have been conducted on prevalence of uncontrolled hypertension and associated factors among adult hypertensive patients in Ethiopia.Objective: The aim of this study was to determine the prevalence of uncontrolled hypertension and associated factors among adult hypertensive patients at Jimma University Teaching and Specialized Hospital.Methods: Institution-based cross-sectional study was conducted at the chronic illness clinic of Jimma University Specialized and Teaching hospital from March 09 to April 13, 2016. A total of 345 hypertensive patients were selected using systematic sampling technique. Data were collected using structured questionnaire through face-to-face exit interview and chart review. Data were analyzed using Statistical Package for the Social Sciences (SPSS version 20.0 software. The bivariate and multivariable analysis was done to identify factors of uncontrolled hypertension.Results: More than half, 52.7%, of the patients had uncontrolled hypertension. Lack of awareness of hypertension-related complications (adjusted odds ratio [AOR]=2.140, 95% confidence interval [CI]=1.272–3.600, p=0.004, nonadherent to smoking abstinence (AOR=3.935, 95% CI=1.065–14.535, p=0.004, nonadherent to alcohol abstinence (AOR=2.477, 95% CI=1.074–5.711, p=033, Khat (Catha edulis chewing (AOR=2.518, 95% CI=1.250–5

  15. Analysis of patients with atypical hemolytic uremic syndrome treated at the Mie University Hospital: concentration of C3 p.I1157T mutation.

    Matsumoto, Takeshi; Fan, Xinping; Ishikawa, Eiji; Ito, Masaaki; Amano, Keishirou; Toyoda, Hidemi; Komada, Yoshihiro; Ohishi, Kohshi; Katayama, Naoyuki; Yoshida, Yoko; Matsumoto, Masanori; Fujimura, Yoshihiro; Ikejiri, Makoto; Wada, Hideo; Miyata, Toshiyuki

    2014-11-01

    Atypical hemolytic uremic syndrome (aHUS) is caused by abnormalities of the complement system and has a significantly poor prognosis. The clinical phenotypes of 12 patients in nine families with aHUS with familial or recurrent onset and ADAMTS13 activity of ≥20 % treated at the Mie University Hospital were examined. In seven of the patients, the first episode of aHUS occurred during childhood and ten patients experienced a relapse. All patients had renal dysfunction and three had been treated with hemodialysis. Seven patients experienced probable triggering events including common cold, influenza, bacterial infection and/or vaccination for influenza. All patients had entered remission, and renal function was improved in 11 patients. DNA sequencing of six candidate genes, identified a C3 p.I1157T missense mutation in all eight patients in six families examined and this mutation was causative for aHUS. A causative mutation THBD p.D486Y was also identified in an aHUS patient. Four missense mutations, CFH p.V837I, p.Y1058H, p.V1060L and THBD p.R403K may predispose to aHUS manifestation; the remaining seven missense mutations were likely neutral. In conclusion, the clinical phenotypes of aHUS are various, and there are often trigger factors. The C3 p.I1157T mutation was identified as the causative mutation for aHUS in all patients examined, and may be geographically concentrated in or around the Mie prefecture in central Japan.

  16. [Visits of patients with exertional rhabdomyolysis to the Emergency Department at Landspítali, The National University Hospital of Iceland in the years 2008-2012].

    Halldorsson, Arnljotur Bjorn; Benedikz, Elisabet; Olafsson, Isleifur; Mogensen, Brynjolfur

    2016-03-01

    Overexertion and too much training are among the -multiple etiologies of rhabdomyolysis. Creatine kinase (CK) and myo-globine, released from skeletal muscle cells, are useful for diagnosis and follow-up. Acute kidney injury is a serious complication of myoglobinemia. Literature on exertional rhabdomyolysis in the general population is scarce. The aim of this study was to investigate the epidemiology of exertional rhabdomyolysis among patients diagnosed at Landspítali The National University Hospital of Iceland in 2008-2012. The study was retrospective and observational. All patients presenting with muscle pain after exertion and elevated creatine kinase >1000 IU/L, during the period from 1 January 2008 to 31 December 2012, were included. Patients with CK elevations secondary to causes other than exertion were excluded. Variables included: patient number and gender, CK-levels, date of hospital admission, cause of rhabdomyolysis, location of injured muscle groups, length of hospital stay, complications and means of fluid replacement. Population figures of the capital region were gathered from Statistics Iceland and information on sport practice in the capital region from The National Olympic and Sports Association of Iceland. Exertional rhabdomyolysis was diagnosed in 54 patients, 18 females (33,3%) and 36 males (66,7%), or 8,3% of rhabdomyolysis cases from all causes in the study period (648 cases). Incidence in the capital region was 5,0/100.000 inhabitants per year in the study period. Median age was 28 years and median CK-level was 24.132 IU/L. CK-levels were higher among females but the difference between genders was not significant. Muscle groups of the upper and lower extremities were most frequently affected (89%). Thirty patients received intravenous fluids. They had significantly higher CK values than other patients. One patient developed acute kidney injury. Information on sport practice and physical training in the capital region was not available

  17. Significant spread of extensively drug-resistant Acinetobacter baumannii genotypes of clonal complex 92 among intensive care unit patients in a university hospital in southern Iran.

    Saffari, Fereshteh; Monsen, Tor; Karmostaji, Afsaneh; Azimabad, Fahimeh Bahadori; Widerström, Micael

    2017-11-01

    Infections associated with Acinetobacter baumannii represent an increasing threat in healthcare settings. Therefore, we investigated the epidemiological relationship between clinical isolates of A. baumannii obtained from patients in a university hospital in Bandar Abbas in southern Iran. Sixty-four consecutive non-duplicate clinical isolates collected during 2014-2015 were subjected to susceptibility testing, clonal relationship analysis using PFGE, multilocus variable-number tandem-repeat analysis (MLVA) and multilocus sequence typing (MLST), and examined for the presence of carbapenemases and integrons. Almost all A. baumannii isolates were extensively drug-resistant (XDR; 98 %) and carried an OXA carbapenemase gene (blaOXA-23-like; 98 %) and class 1 integrons (48 %). PFGE and MLST analysis identified three major genotypes, all belonging to clonal complex 92 (CC92): sequence type 848 (ST848) (n=23), ST451 (n=16) and ST195 (n=8). CC92 has previously been documented in the hospital setting in northern Iran, and ST195 has been reported in Arab States of the Persian Gulf. These data suggest national and global transmission of A. baumannii CC92. This report demonstrates the occurrence and potential spread of closely related XDR genotypes of A. baumannii CC92 within a university hospital in southern Iran. These genotypes were found in the majority of the investigated isolates, showed high prevalence of blaOXA-23 and integron class 1, and were associated with stay in the intensive care unit. Very few treatment options remain for healthcare-adapted XDR A. baumannii, and hence effective measures are desperately needed to reduce the spread of these strains and resultant infections in the healthcare setting.

  18. [Pain therapy in in-patients with cancer. Effects of a manual-based approach as guideline for pain-consulting service at a university hospital].

    Brinkers, M; Pfau, Gernot; Lux, A; Pfau, Giselher; Schneemilch, C; Meyer, F; Grond, S

    2016-03-01

    Appropriate medication is an important and substantial part in the therapy of tumor-induced pain. The objective of this study was to investigate the efficiency of anaesthesiology-based consultant service characterizing the quality of this type of treatment in daily clinical practice of a university hospital, i. e., in the patient profile of a tertiary center (study design: systematic clinical, unicenter observational study reflecting clinical practice and study-based control of therapeutic care quality). In the course of consulting function with regard to pain care on the single wards a considerable portion of cancer patients are recieving drugs. For most patients such care comprises several consultations and subsequently initiated treatment modifications. The consulting function ends if the patients feel free of pain or report a substantial improvement. From 1/1/2010 to 12/31/2012 detailed information on the drug therapy applied prior to, during and after the consultation was prospectively documented.This data was retrospectively evaluated as "pre-vs.-post" comparison (Chi-squared test, Fisher's exact test and McNemar's test), in particular, focussing on the quality of pain medication using the WHO index as well as pain intensity obtained by means of the visual analogue scale (VAS). In total, 375 in-patients were treated. The modified pain medication by the anesthesiological consultant service led to a significant increase (p therapy for cancer-related pain. © Georg Thieme Verlag KG Stuttgart · New York.

  19. Assessment of quality of care given to diabetic patients at Jimma University Specialized Hospital diabetes follow-up clinic, Jimma, Ethiopia

    Gudina Esayas K

    2011-12-01

    Full Text Available Abstract Background Sub-Saharan Africa is currently enduring the heaviest global burden of diabetes and diabetes care in such resource poor countries is far below standards. This study aims to describe the gaps in the care of Ethiopian diabetic patients at Jimma University Specialized Hospital. Methods 329 diabetic patients were selected as participants in the study, aged 15 years or greater, who have been active in follow-up for their diabetes for more than 1 year at the hospital. They were interviewed for their demographic characters and relevant clinical profiles. Their charts were simultaneously reviewed for characters related to diabetes and related morbidities. Descriptive statistics was used for most variables and Chi-square test, where necessary, was used to test the association among various variables. P-value of Results Blood glucose determination was done for 98.5% of patients at each of the last three visits, but none ever had glycosylated haemoglobin results. The mean fasting blood sugar (FBS level was 171.7 ± 63.6 mg/dl and 73.1% of patients had mean FBS levels above 130 mg/dl. Over 44% of patients have already been diagnosed to be hypertensive and 64.1% had mean systolic BP of > 130 and/or diastolic > 80 mmHg over the last three visits. Diabetes eye and neurologic evaluations were ever done for 42.9% and 9.4% of patients respectively. About 66% had urine test for albumin, but only 28.2% had renal function testing over the last 5 years. The rates for lipid test, electrocardiography, echocardiography, or ultrasound of the kidneys during the same time were Conclusions The overall aspects of diabetes care at the hospital were far below any recommended standards. Hence, urgent action to improve care for patients with diabetes is mandatory. Future studies examining patterns and prevalence of chronic complications using appropriate parameters is strongly recommended to see the true burden of diabetes.

  20. Prevalence and phenotypic characterization of Enterococcus species isolated from clinical samples of pediatric patients in Jimma University Specialized Hospital, south west Ethiopia.

    Toru, Milkiyas; Beyene, Getnet; Kassa, Tesfaye; Gizachew, Zeleke; Howe, Rawleigh; Yeshitila, Biruk

    2018-05-08

    This study was done to determine the prevalence and phenotypic characterization of Enterococcus species isolated from clinical samples of pediatric patients in Jimma University Specialized Hospital, Southwest Ethiopia. The overall prevalence of Enterococci species was 5.5% (22/403). Five (22.7%) of Enterococci species were vancomycin resistant. Haemolysin, gelatinase and biofilm production was seen among 45.5, 68.2 and 77.3% of isolates respectively. The overall rate of antibiotic resistance was 95.5% (21/22). High resistance was observed against norfloxacin (87.5%), and tetracycline (77.3%). Whereas, low resistance (36.5%) was observed against ciprofloxacin and eighteen (80.8%) of the isolates were multi-drug resistant.

  1. Treatment outcome and predictors of better response to thyroxin in hypothyroid patients with sleep apnea syndrome in Zagazig University hospital

    Mohamed El-Shabrawy

    2017-04-01

    Conclusions: Some hypothyroidism patients with OSA will improve on hormonal therapy alone but other will continue to need CPAP. Neck circumference, free T4 and TSH levels may help us in predicting the response of these patients.

  2. Evaluation of patients diagnosed with fascioliasis: A six-year experience at a university hospital in Turkey.

    Boşnak, Vuslat Keçik; Karaoğlan, İlkay; Sahin, Handan Haydaroğlu; Namiduru, Mustafa; Pehlivan, Mustafa; Okan, Vahap; Mete, Ayşe Özlem

    2016-04-28

    In this study, clinical, laboratory, radiological, and serological examinations of fascioliasis patients were analyzed, and data with a significant impact on differential diagnosis were evaluated. Clinical, radiological, and laboratory findings and treatment responses of a total of 22 fascioliasis patients, treated between October 2009 and September 2014, were evaluated. Nineteen patients were diagnosed with fascioliasis at the invasive phase and three patients at the chronic phase. Patients were followed up for clinical, laboratory, and radiology findings for a period of three months to one year after treatment. The most frequent complaints in both groups were abdominal pain, and the most common physical examination finding was epigastric tenderness. In the performed examination, an eosinophil elevation in whole blood count was detected in 19 patients (100%) in the hepatic phase, and in 2 patients (66.6%) in the biliary phase. The results of the Fasciola hepatica indirect hemagglutination assay (IHA) test ordered in the diagnosis were positive in all patients. Treatment with 10 mg/kg/day triclabendazole for two consecutive days was effective. Live parasites were extracted from patients in the biliary phase with endoscopic retrograde cholangiopancreatography. In the follow-ups, remission in IHA titer and clinical and radiological improvement was achieved in all patients. If hypereosinophilia is detected by peripheral smear in patients who are admitted with complaints such as abdominal pain, weakness, nausea, myalgia, and weight loss, radiological evaluation and serological tests should be performed and fascioliasis should be considered in the differential diagnosis.

  3. Evaluation of dizziness at Jordan University Hospital.

    Abdul-Baqi, Khader J; Mohammed, Faisal I; Shubair, Kandil S; Sarhan, Yusef S; Tawalbeh, Mohamed I

    2004-05-01

    This study was performed prospectively to evaluate the dizzy patients in the Neurotology Outpatient clinic at Jordan University Hospital, Amman, Jordan during the period 1993-2000 and to discuss the prevalence and etiology of dizziness. Data were collected from 108 patients (52 males and 56 females) with a mean age of 45.6-years. Diagnosis was made on the basis of history, physical, otolaryngological and neurological examination and confirmed by relevant investigation including laboratory, radiological and audio vestibular tests. Secure diagnosis were made in 98% of patients (14% had one cause alone and 84% had multiple causes). Cardiovascular disorders accounted for 31.5% of primary and 49% of secondary causes, peripheral vestibular disorders, 25% of primary and 3% of secondary causes, central vestibular disorders 17% of primary and 9% of secondary causes, metabolic endocrine 13% of primary and 38% of secondary causes, cervical osteoarthritis 5.5% of primary and 28% of secondary causes and psychogenic 4.6% of primary and 6.5% of secondary causes. Our findings demonstrate that vertigo is the most common subtype of dizziness (50%). Multiple causes are more prevalent in older age and the single cause is more prevalent in younger age. Cardiovascular was the most common cause of dizziness followed by vestibular disorders, metabolic and cervical osteoarthritis. Vestibular disorders are primary causes and non vestibular are predominantly secondary causes of dizziness. Hyperlipidemia, diabetes and cervical causes are major secondary contributors to dizziness. We recommend a multi disciplinary setting and application of a comprehensive diagnostic and treatment approach without unnecessary protracted investigative scheme and installment of rehabilitation facilities.

  4. The importance of superficial basal cell carcinoma in a retrospective study of 139 patients who underwent Mohs micrographic surgery in a Brazilian university hospital

    Luciana Takata Pontes

    2015-11-01

    Full Text Available OBJECTIVE: Mohs micrographic surgery is a specialized surgical procedure used to treat skin cancer. The purpose of this study was to better understand the profile of the patients who underwent the procedure and to determine how histology might be related to complications and the number of stages required for complete removal. METHODS: The records of patients who underwent Mohs micrographic surgery from October 2008 to November 2013 at the Dermatology Division of the Hospital of the Campinas University were assessed. The variables included were gender, age, anatomical location, histology, number of stages required and complications. RESULTS: Contingency tables were used to compare the number of stages with the histological diagnosis. The analysis showed that patients with superficial basal cell carcinoma were 9.03 times more likely to require more than one stage. A comparison between complications and histological diagnosis showed that patients with superficial basal cell carcinoma were 6.5 times more likely to experience complications. CONCLUSION: Although superficial basal cell carcinoma is typically thought to represent a less-aggressive variant of these tumors, its propensity for demonstrating “skip areas” and clinically indistinct borders make it a challenge to treat. Its particular nature may result in the higher number of surgery stages required, which may, as a consequence, result in more complications, including recurrence. Recurrence likely occurs due to the inadequate excision of the tumors despite their clear margins. Further research on this subtype of basal cell carcinoma is needed to optimize treatments and decrease morbidity.

  5. First-line antiretroviral treatment failure and associated factors in HIV patients at the University of Gondar Teaching Hospital, Gondar, Northwest Ethiopia.

    Ayalew, Mohammed Biset; Kumilachew, Dawit; Belay, Assefa; Getu, Samson; Teju, Derso; Endale, Desalegn; Tsegaye, Yemisirach; Wale, Zebiba

    2016-01-01

    Antiretroviral therapy (ART) restores immune function and reduces HIV-related adverse outcomes. But treatment failure erodes this advantage and leads to an increased morbidity and compromised quality of life in HIV patients. The aim of this study was to determine the prevalence and factors associated with first-line ART failure in HIV patients at the University of Gondar Teaching Hospital. A retrospective study was conducted on 340 adults who had started ART during the period of September 2011 to May 2015. Data regarding patients' sociodemographics, baseline characteristics, and treatment-related information were collected through review of their medical charts. Data were analyzed using SPSS version 21. Descriptive statistics, cross-tabs, and binary and multiple logistic regressions were utilized. Pfailure. The median duration of treatment failure from initiation of treatment was 17.5 months (8-36 months). Poor adherence to treatment and low baseline CD4 cell count were found to be significant predictors of treatment failure. The prevalence of first-line ART failure was 4.1%. Treatment failure was most likely to occur for the patients who had poor drug adherence and those who were delayed to start ART till their CD4 cell count became very low (<100 cells/mm(3)).

  6. Determinants of virological failure among patients on highly active antiretroviral therapy in University of Gondar Referral Hospital, Northwest Ethiopia: a case-control study.

    Bayu, Belete; Tariku, Amare; Bulti, Abera Balcha; Habitu, Yohannes Ayanaw; Derso, Terefe; Teshome, Destaw Fetene

    2017-01-01

    Viral load monitoring is used as an important biomarker for diagnosing treatment failure in patients with HIV infection/AIDS. Ethiopia has started targeted viral load monitoring. However, factors leading to virological failure are not well understood and studied. Thus, the aim of this study was to identify the determinants of virological failure among HIV-infected patients on highly active antiretroviral therapy at the University of Gondar Referral Hospital, Northwest Ethiopia. A case-control study was conducted from May to June 2015. Cases were subjects who had already experienced virological failure; controls were those without virological failure. Data were extracted from 153 cases and 153 controls through chart review. A multivariate logistic regression analysis was carried out to identify factors associated with virological failure, and variables with a p -value failure was observed among patients aged failure. Therefore, evidence-based intervention should be implemented to improve adherence to ART, which in turn helps to boost immunity (CD4) and suppresses viral replication and load. Moreover, attention should be given to younger patients who have had ART for longer periods.

  7. Quality of health care: patient satisfaction in a university hospital Qualidade da assistência à saúde: satisfação de pacientes em um hospital universitário

    Denise Fornazari de Oliveira

    2006-10-01

    Full Text Available OBJECTIVE: To evaluate patient characteristics and satisfaction in an outpatient service at a university hospital, aiming at obtaining subsidies for standardization of a quality assessment program. METHOD: Patient-representative sample was selected. It consisted of users of the Ophthalmology Outpatient Service at the Hospital das Clínicas, Universidade Estadual de Campinas (UNICAMP. A structured questionnaire was applied through interview, including the following variables: personal characteristics (gender, age, literacy, job, type of appointment (new patient, follow-up, waiting time for the first appointment, opinion regarding ease of access to the hospital, assistance at the front desk, time spent in the waiting room on the appointed day, quality of care, degree of satisfaction with the consultation and general evaluation of the assistance. RESULTS: The sample was characterized by patients with low literacy and socioeconomic level; 21.7% had a steady income. The majority of them think that it is easy to obtain an appointment. According to patients, the mean waiting time for the appointment was 94.6 minutes and 45.3% of them received no orientation after the appointment. Final evaluation of the quality of assistance was positive and patients were satisfied with the provided assistance. CONCLUSION: Although a high level of satisfaction regarding the provided service was observed, when the various factors that can affect patient satisfaction are considered, users reported limitations as concerns quality. Evaluation allowed a better knowledge about the provided service in a university hospital and pointed to the possibility of implantation of quality assessment routines.OBJETIVO: Avaliar características e satisfação de pacientes do ambulatório de oftalmologia de um hospital universitário, com vistas a obter subsídios para a padronização de um sistema de avaliação de qualidade. MÉTODO: Realizou-se estudo transversal analítico. Foi

  8. Pattern of chemotherapy-related adverse effects among adult cancer patients treated at Gondar University Referral Hospital, Ethiopia: a cross-sectional study

    Belachew SA

    2016-12-01

    Full Text Available Sewunet Admasu Belachew,1 Daniel Asfaw Erku,2 Abebe Basazn Mekuria,3 Begashaw Melaku Gebresillassie1 1Department of Clinical Pharmacy, 2Department of Pharmaceutical Sciences, 3Department of Pharmacology, School of Pharmacy, University of Gondar, Gondar, Ethiopia Background: Adverse drug reactions (ADRs are a global problem and constitute a major clinical problem in terms of human suffering. The high toxicity and narrow therapeutic index of chemotherapeutic agents makes oncology pharmacovigilance essential. The objective of the present study was to assess the pattern of ADRs occurring in cancer patients treated with chemotherapy in a tertiary care teaching hospital in Ethiopia.Methods: A cross-sectional study over a 2-year period from September 2013 to August 2015 was conducted on cancer patients undergoing chemotherapy at Gondar University Referral Hospital Oncology Center. Data were collected directly from patients and their medical case files. The reported ADRs were assessed for causality using the World Health Organization’s causality assessment scale and Naranjo’s algorithm. The severities of the reported reactions were also assessed using National Cancer Institute Common Terminology CTCAE version 4.0. The Pearson’s chi-square test was employed to examine the association between two categorical variables.Results: A total of 815 ADRs were identified per 203 patients included in the study. The most commonly occurring ADRs were nausea and vomiting (18.9%, infections (16.7%, neutropenia (14.7%, fever and/or chills (11.3%, and anemia (9.3%. Platinum compounds (31.4% were the most common group of drugs causing ADRs. Of the reported ADRs, 65.8% were grades 3–4 (severe level, 29.9% were grades 1–2 (mild level, and 4.3% were grade 5 (toxic level. Significant association was found between age, number of chemotherapeutic agents, as well as dose of chemotherapy with the occurrence of grades 3–5 toxicity.Conclusion: The high incidence of

  9. Incidence and risk factors of antiretroviral treatment failure in treatment-naïve HIV-infected patients at Chiang Mai University Hospital, Thailand

    2011-01-01

    Background The use of combination antiretroviral therapy (cART) has become a standard of care for the treatment of HIV infection. However, cost and resistance to cART are major obstacles for access to treatment especially in resource-limited settings. In this study, we aimed to determine the incidence and risk factors of treatment failure in a cohort of treatment-naïve Thai HIV-infected patients. Methods A retrospective cohort study was conducted among HIV-infected patients initiating their first cART at Chiang Mai University Hospital, Thailand. Results From January 2002 to December 2008, 788 patients were enrolled; 365 were male (46.3%), and the mean age was 37.9 ± 8.6 years. The median baseline CD4 count was 57.7 cells/mm3 (IQR 22, 127). GPO-VIR® (a fixed-dose combination of lamivudine, stavudine, and nevirapine) was the most common prescribed cART (657 patients, 83.4%). Seventy-six patients developed virological failure given the cumulative incidence of 9.6%. The incidence of virological failure was 2.79 (95% CI 2.47, 3.14) cases per 100 person years. Poor adherence was the strongest predictor for virological failure. Of 535 immunologically evaluable patients, 179 (33.5%) patients developed immunological failure. A low CD4 cell count at baseline (< 100 cells/mm3) and the increment of CD4 cell count of < 50 cell/mm3 after 6 months of cART were the predictors for immunological failure (p < 0.001). Conclusions This study demonstrated that even in resource-limited settings, the high rate of success could be expected in the cohort with good and sustainable drug adherence. Poor adherence, older age, and low baseline CD4 cell count are the predictors for unfavorable outcome of cART. PMID:22060823

  10. Urinary tract infections at aga Khan University hospital nairobi - a ...

    2013-06-11

    Jun 11, 2013 ... (Uti) are normally treated empirically and urine culture is usual ordered for as a last ... symptomatic Uti in patients at aga Khan University hospital by looking at the trends of Uti ... in the context of pyelonephritis in pregnancy(9).

  11. Preventing hospital malnutrition: a survey on nutritional policies in an Italian University Hospital.

    Annetta, M G; Pittiruti, M; De Rosa, S; Franchi, P; Pintaudi, G; Caricato, A; Antonelli, M

    2015-11-01

    A proper strategy for fighting hospital malnutrition should include nutritional screening of all hospitalized patients, adequate utilization of the Hospital facilities - such as Clinical Nutrition Services or Nutrition Teams - and an adequate algorithm for the adoption of proper nutrition support (oral, enteral or parenteral) with proper timing. The main aim of the present study was to investigate the current policies of different non-intensive wards of our institution (a 1100 beds University Hospital) in terms of prevention of hospital malnutrition. We conducted a one-day survey to verify the current policies of nutritional screening and the indication to nutritional support in adult patients, interviewing nurses and physicians of our non-intensive hospital wards. A total of 29 wards were considered, which sum up to 755 hospitalized patients. We found that nutritional screening at admission is routinely assessed only in 41% of wards and that oral nutrient intake is controlled regularly only in 72%. Indication to clinical nutrition support and specifically to artificial nutrition is not consistent with the current international guidelines. Only 14% of patients were receiving artificial nutrition at the moment of the survey and the majority of them were given parenteral nutrition rather than enteral feeding. Our survey confirmed that in large hospitals the main barriers to the fight against hospital malnutrition are the lack of knowledge and/or commitment by nurses and physicians as well as the lack of well-defined hospital policies on early nutritional screening, surveillance of nutritional status and indication to nutrition support.

  12. Clinico-statistical study on the patients who were applied preoperative CT imaging for dental implant treatment in Iwate Medical University Hospital

    Shoji, Satoru; Izumisawa, Mitsuru; Satoh, Hitoshi; Hoshino, Masayuki; Takahashi, Noriaki; Shozushima, Masanori; Nakasato, Tatsuhiko

    2007-01-01

    The diagnosis of jaw bones using X-ray computed tomography (CT) is important to determine placement of dental implants. A Clinico-statistical study were made on 490 cases which applied preoperative dental mutiplannar reconstructing CT (dental MPR) imaging for dental implant treatment in Iwate Medical University Hospital, during a five-year period from 2002 to 2006. The following results were obtained: The 490 cases consisted of 179 males and 311 females. They ranged in age from 16 to 80 years, the average age was 53.6 years old. The largest number of cases were in their 50's and, in most generations, there were more female cases than male. Similar cases have been increasing every year. Most patients were referred from other clinics to our hospital. Of the cases that underwent CT scanning more were mandible than maxilla. Implantation prearranged region revealed a predominance of mandible in anterior teeth, and maxilla in molar teeth. The cases that were using diagnostic surgical stents increased in the first three years, but were constant afterwards. (author)

  13. Five-year experience of critical incidents associated with patient-controlled analgesia in an Irish University Hospital.

    Ahmad, I

    2012-02-01

    BACKGROUND: Patient-controlled analgesia (PCA) is a common and effective means of managing post-operative pain. We sought to identify factors that may lead to critical incidents (CIs) in patient safety when using PCA in our institution. METHODS: An observational study of prospectively collected data of patients who received PCA from 2002 to 2006 was performed. All CIs were documented and analysed by staff members of the acute pain service (APS). Cause analysis of CIs was undertaken to determine if measures can be instituted to prevent recurrence of similar events. RESULTS: Over eight thousand patients (8,240) received PCA. Twenty-seven CIs were identified. Eighteen were due to programming errors. Other CIs included co-administration of opioids and oversedation. CONCLUSION: In our institution, the largest contributory factor to CIs with PCAs was programming error. Strategies to minimize this problem include better education and surveillance.

  14. Unused Medications Disposal Practice: The case of Patients Visiting University of Gondar Specialized Teaching Hospital, Gondar, Ethiopia

    Tadele Atinafu; Abayneh Takele; Adeladlew Kassie; Adane Yehualaw; Getu Tesfaw; Tesfanesh Desseno; Tadesse Mekonnen; Mulugeta Fentie

    2014-01-01

    Background: The disposal of unwanted medications has been a concern in many countries, as pharmaceutical waste enters the ecosystem, ultimately having an effect on human health and environment. The main objective of this study was to assess unused medications disposal practice of patients Method: Institution based cross sectional study was used. Patients were systematically selected and interviewed using structured questionnaires. The Data was analyzed using SPSS version 20. Result: Out of...

  15. The influence of socioeconomic status on the hemoglobin level and anthropometry of sickle cell anemia patients in steady state at the Lagos University Teaching Hospital.

    Animasahun, B A; Temiye, E O; Ogunkunle, O O; Izuora, A N; Njokanma, O F

    2011-01-01

    Sickle cell anemia (SCA) has multisystemic manifestations and is associated with severe morbidity and high mortality. It commonly affects growth leading to wasting and stunting. This study aimed to determine the influence of socioeconomic status on the nutritional status using anthropometric measurements and steady-state hemoglobin, of children with homozygous SCA, aged 1 year to 10 years in steady state at the Lagos University Teaching Hospital. This is a cross-sectional study involving 100 children with SCA and 100 age-, sex-, and social class-matched controls that fulfilled the inclusion criteria. Social class was assessed using educational attainment and occupation of parents. Hemoglobin concentration was determined using the oxy-hemoglobin method. This study demonstrated a significantly lower mean weight and weight-for-height in the SCA patients than those of controls (P hemoglobin concentration were observed from social class 1 to 4; this was statistically significant in controls (P = 0.00) but not in subjects (P > 0.1). However, SCA patients had significantly lower values than controls in each of the social classes. Poor socioeconomic status has an adverse effect on the nutritional status and hemoglobin of SCA patients.

  16. Performance Based Supplementary Payment System at University Hospitals in Turkey

    Vahit YÝÐÝT

    2017-06-01

    Results: The result of the analysis has revealed that PBSP system encourage physicians who would like to receive financial incentives. PBSP system supports the individual performance, reduces waiting times in patients, increases revenues and decreases expenditures and increases in efficiency of department. However, this payment system increases work load, number of examinations and provokes the conflict among personals. Conclusions: University hospitals are academic institutions that perform important missions such as research, medical education and health services provision. Therefore, PBSP system should be revised so as to encourage performing these missions at university hospitals. There is also shortage of financial resources at the university hospitals. This situation leads to less additional payments to physicians. [J Contemp Med 2017; 7(2.000: 126-131

  17. Predictors of Survival among Adult Ethiopian Patients in the National ART Program at Seven University Teaching Hospitals: A Prospective Cohort Study.

    Fekade, Daniel; Weldegebreal, Teklu; Teklu, Alula M; Damen, Melake; Abdella, Saro; Baraki, Nega; Belayhun, Bekele; Berhan, Eyoel; Kebede, Amha; Assefa, Yibeltal

    2017-02-01

    In Ethiopia, the publicly funded antiretroviral treatment (ART) program was started in 2005. Two hundred seventy-five thousand patients were enrolled in the national ART program by 2012. However, there is limited data on mortality and predictors of death among adult patients in the ART program. The study aimed to estimate mortality and risk factors for death among adult, ART-naïve patients, started in the national ART program from January 2009 to July 2013. Multi-site, prospective, observational cohort study of adult, age > 18 years, ART-naïve patients, started in the national ART program at seven university-affiliated hospitals from January 2009 - July 2013. Kaplan-Meier and Cox regression analyses were used to estimate survival and determine risk factors for death. A total of 976 patients, 594 females (60.9 %), were enrolled into the study. Median age of the cohort was 33years. The median CD4 count at start of ART was 144 cells/µl (interquartile range (IQR) 78-205), and 34.2% (330/965) had CD4 ART. Cox regression analyses showed that the following measures independently predicted mortality: age >51 years, (Adjusted Hazard Ratio (AHR) 4.01, P=0.003), WHO stages III&IV, (AHR 1.76, p = 0.025), CD4 count, 5 log copies /ml (CHR 1.71, p = 0.037). There is high early on- ART mortality in patients presenting with advanced immunodeficiency. Detecting cases and initiating ART before onset of advanced immunodeficiency might improve survival.

  18. [Problems in the admission to in-hospital oral surgical care from the patient's viewpoint--results of patient interviews in the hospital for dental and maxillo-facial surgery of the Karl Marx University, Leipzig].

    Erpenbeck, F; Birnbaum, K; Langanke, B; Niemand, B; Thomzyk, I

    1979-06-01

    The author deals with the results from the interviewing of oral surgery patients on their problems concerning the sending and the admission to the hospital, with special attention to the problems of waiting for admission, the familiarization with the clinical environment and the improvement suggestions of the patients. The conclusions concern tasks arising from the medical and dental care for inpatients as well as for outpatients.

  19. The Prevalence of HIV in Cancer Patients at the Surgical Oncology Unit of Donka University Hospital of Conakry (Guinea).

    Traore, Bangaly; Bah, Thierno Souleymane; Traore, Fode Amara; Sow, Mamadou Saliou; Diane, Solomana; Keita, Mamady; Cisse, Mohamed; Koulibaly, Moussa; Camara, Naby Daouda

    2015-01-01

    Aim. To determine the prevalence of HIV infection among patients seen at the surgical oncology unit of Donka (Conakry, Guinea). Method. We conducted a retrospective and descriptive study of HIV infection in cancer patients from May 2007 to December 2012. Social characteristics (age, gender, marital status, and education) and immune status (HIV type, CD4 count) were reviewed. Results. Out of 2598 cancer patients, 54 (2.1%) tested positive for HIV. There were 11 (20.4%) defining AIDS and 43 (79.6%) nondefining AIDS cancers. The most frequent cancers were breast (14) (26.0%), non-Hodgkin lymphoma (6) (11.1%), liver (6) (11.1%), eye and annexes (6) (11.1%), and cervical cancer (5) (9.3%). These patients were female in 34 (63.0%) and had a median age of 39 years and body mass index was 20,3 Kg/m(2). They were unschooled in 40 (74.1%) and married in 35 (64.8%). CD4 count showed a median of 317 cells/mL. Antiretroviral treatment was performed in 40 (74.1%). Conclusion. HIV prevalence is higher in patients in our unit of surgical oncology. Breast cancer was the most common in this association. A national survey of a large sample is needed to determine the true prevalence and impact of HIV on cancer prognosis.

  20. The Prevalence of HIV in Cancer Patients at the Surgical Oncology Unit of Donka University Hospital of Conakry (Guinea

    Bangaly Traore

    2015-01-01

    Full Text Available Aim. To determine the prevalence of HIV infection among patients seen at the surgical oncology unit of Donka (Conakry, Guinea. Method. We conducted a retrospective and descriptive study of HIV infection in cancer patients from May 2007 to December 2012. Social characteristics (age, gender, marital status, and education and immune status (HIV type, CD4 count were reviewed. Results. Out of 2598 cancer patients, 54 (2.1% tested positive for HIV. There were 11 (20.4% defining AIDS and 43 (79.6% nondefining AIDS cancers. The most frequent cancers were breast (14 (26.0%, non-Hodgkin lymphoma (6 (11.1%, liver (6 (11.1%, eye and annexes (6 (11.1%, and cervical cancer (5 (9.3%. These patients were female in 34 (63.0% and had a median age of 39 years and body mass index was 20,3 Kg/m2. They were unschooled in 40 (74.1% and married in 35 (64.8%. CD4 count showed a median of 317 cells/mL. Antiretroviral treatment was performed in 40 (74.1%. Conclusion. HIV prevalence is higher in patients in our unit of surgical oncology. Breast cancer was the most common in this association. A national survey of a large sample is needed to determine the true prevalence and impact of HIV on cancer prognosis.

  1. The Prevalence of HIV in Cancer Patients at the Surgical Oncology Unit of Donka University Hospital of Conakry (Guinea)

    Traore, B.; Diane, S.; Keita, M. S.; Bah, T. S.; Sow, M. S.; Cisse, M.; Koulibaly, M.; Camara, N. D.

    2015-01-01

    To determine the prevalence of HIV infection among patients seen at the surgical oncology unit of Donka (Conakry, Guinea). Method. We conducted a retrospective and descriptive study of HIV infection in cancer patients from May 2007 to December 2012. Social characteristics (age, gender, marital status, and education) and immune status (HIV type, CD4 count) were reviewed. Results. Out of 2598 cancer patients, 54 (2.1%) tested positive for HIV. There were 11 (20.4%) defining AIDS and 43 (79.6%) non defining AIDS cancers. The most frequent cancers were breast (14) (26.0%), non-Hodgkin lymphoma (6) (11.1%), liver (6) (11.1%), eye and annexes (6) (11.1%), and cervical cancer (5) (9.3%). These patients were female in 34 (63.0%) and had a median age of 39 years and body mass index was 20,3 Kg/m 2 . They were unschooled in 40 (74.1%) and married in 35 (64.8%). CD4 count showed a median of 317 cells/mL. Antiretroviral treatment was performed in 40 (74.1%). Conclusion. HIV prevalence is higher in patients in our unit of surgical oncology. Breast cancer was the most common in this association. A national survey of a large sample is needed to determine the true prevalence and impact of HIV on cancer prognosis

  2. Study of cardiovascular diseases in hospitalized AECOPD patients

    Mohamed El-Shabrawy

    2017-01-01

    Conclusions: The prevalence of cardiovascular diseases (CVD in patients hospitalized for COPD in Zagazig University Hospital was high. Age, sex and CVD trends, as well as life style changes, should be considered when prevention and control strategies are formulated.

  3. Perfil socioeconômico e epidemiológico dos pacientes submetidos à cirurgia de catarata em um hospital universitário Socioeconomic and epidemiologic profile of patients submitted to cataract surgery at a university hospital

    Beatriz de Abreu Fiuza Gomes

    2008-10-01

    Full Text Available OBJETIVO: Determinar as características sócioeconômicas dos pacientes operados de catarata em hospital universitário, avaliar o acesso à unidade terciária e determinar o tempo de espera até o tratamento cirúrgico. MÉTODOS: Estudo transversal, realizado através da revisão de prontuários de 148 pacientes operados de catarata escolhidos aleatoriamente durante o primeiro semestre de 2007. RESULTADOS: Os pacientes apresentaram idade mediana de 70,5 anos, com maior prevalência de mulheres (60,1%, da raça branca (48,0%, com baixo grau de instrução (ensino fundamental incompleto, 50,7%, acuidade visual igual ou pior a 20/200 (57,4% e diagnóstico realizado em consulta regular no hospital universitário (47,8%. Apenas 9,4% dos pacientes operados foram diagnosticados na campanha de catarata. O tempo médio entre o diagnóstico e a cirurgia foi 3,5 meses e relacionou-se principalmente à realização dos exames oftalmológicos e clínicos pré-operatórios. CONCLUSÃO: Os pacientes com baixa renda familiar são os principais usuários do Sistema Único de Saúde (SUS e o acesso ao tratamento cirúrgico é demorado, resultando em visão subnormal incapacitante. Ressalta-se a importância da campanha de catarata no ingresso de pacientes carentes ao hospital de alta complexidade.PURPOSE: To determine the socio-economic characteristics of the patients who were submitted to cataract surgery in a university hospital, to evaluate the accessibility to the tertiary health service and to determine the waiting time for cataract surgery. METHODS: A cross-sectional study of medical charts from 148 random patients who underwent cataract surgery during the first semester of 2007. RESULTS: The patients in this study had median of age of 70.5 years, and the major prevalence was of female (60.1%, caucasian (48.0%, with low educational level (incomplete fundamental study, 50.7%, best corrected visual acuity 20/200 or worst; the diagnosis of cataract was done

  4. Prevalence of Intestinal Parasites and Associated Factors among Pulmonary Tuberculosis Suspected Patients Attending University of Gondar Hospital, Gondar, Northwest Ethiopia

    Tegegne, Yalewayker; Wondmagegn, Tadelo; Worku, Ligabaw; Jejaw Zeleke, Ayalew

    2018-01-01

    Introduction. Intestinal parasitic infections are among the major public health problems in developing countries. Hence, it is significant to explore coinfection with intestinal parasites and pulmonary tuberculosis because coinfection increases the complexity of control and prevention of pulmonary tuberculosis and parasitic diseases. Objective. To assess the prevalence of intestinal parasites among pulmonary tuberculosis suspected patients. Method. Institutional based cross-sectional study wa...

  5. Antifungal susceptibility testing of Candida species isolated from the immunocompromised patients admitted to ten university hospitals in Iran

    Badiee, P.; Badali, H.; Boekhout, T.; Diba, K.; Moghadam, A.G.; Hossaini Nasab, A.; Jafarian, H.; Mohammadi, R.; Mirhendi, H.; Najafzadeh, M.J.; Shamsizadeh, A.; Soltani, J.

    2017-01-01

    Background Antifungal susceptibility testing is a subject of interest in the field of medical mycology. The aim of the present study were the distributions and antifungal susceptibility patterns of various Candida species isolated from colonized and infected immunocompromised patients admitted to

  6. Perioperative nursing in public university hospitals

    Sørensen, Erik Elgaard; Olsen, Ida Østrup; Tewes, Marianne

    2014-01-01

    BACKGROUND: In recent years, perioperative nursing has received ongoing attention as part of an interprofessional collaboration. Perioperative nursing is constantly faced with new challenges and opportunities that necessitate continual updates of nursing knowledge and technical skills. In light...... of the longstanding relationship between nursing and technology, it is interesting that few studies with this focus have been performed. Therefore, our research question was: What is the content of perioperative nursing and how do nurses facilitate the interaction between nursing care and technology in highly...... specialized operating rooms in public university hospitals? METHODS: An ethnography involving participant observations and interviews was conducted during a 9-month study period. The participants comprised 24 nurses from 9 different operating wards at 2 university hospitals in different regions of Denmark...

  7. Results of high-risk neutropenia therapy of hematology-oncology patients in a university hospital in Uruguay

    Matilde Boada Burutaran

    2015-02-01

    Full Text Available Background: Febrile neutropenia is an important cause of mortality and morbidity in hematology-oncology patients undergoing chemotherapy. The management of febrile neutropenia is typically algorithm-driven. The aim of this study was to assess the results of a standardized protocol for the treatment of febrile neutropenia. Methods: A retrospective cohort study (2011-2012 was conducted of patients with high-risk neutropenia in a hematology-oncology service. Results: Forty-four episodes of 17 patients with a median age of 48 years (range: 18-78 years were included. The incidence of febrile neutropenia was 61.4%. The presence of febrile neutropenia was associated with both the duration and severity of neutropenia. Microbiological agents were isolated from different sources in 59.3% of the episodes with bacteremia iso- lated from blood being the most prevalent (81.3%. Multiple drug-resistant gram-negative bacilli were isolated in 62.5% of all microbiologically documented infections. Treatment of 63% of the episodes in which the initial treatment was piperacillin/tazobactam needed to be escalated to meropenem. The mortality rate due to febrile neutropenia episodes was 18.5%. Conclusion: The high rate of gram-negative bacilli resistant to piperacillin/tazobactam (frontline antibiotics in our protocol and the early need to escalate to carbapenems raises the question as to whether it is necessary to change the current protocol.

  8. Cross-infection and infection control in dentistry: Knowledge, attitude and practice of patients attended dental clinics in King Abdulaziz University Hospital, Jeddah, Saudi Arabia

    Nahla K. Ibrahim

    2017-07-01

    Full Text Available The objective of the study was to determine the level of Knowledge, Attitude and Practice (KAP of patients attended dental clinics at King Abdulaziz University Hospital (KAUH regarding cross infections and infection control in dentistry. A cross-sectional study was conducted among 225 patients who attended the dental clinics of KAUH, Jeddah, Saudi Arabia, 2014. A standardized, confidential, anonymous, interviewing questionnaire was used. Knowledge about dental infections was assessed by 12 MCQs. The attitudes were assessed through answering seven statements on a three- point Likert scale. Patients’ self reported practices were also evaluated. Descriptive and inferential statistics were done.Results of the study revealed that 39.5%, 38.7% and 21.8% of the participants obtained poor, fair and satisfactory level of knowledge about infections and infection control in dentistry, respectively. Social media was the commonest source of information about dental infection. Participant's educational level was significantly associated with the level of knowledge about dental infection. Patients had positive attitudes towards infection control in dentistry. Regarding self-reported practice, only few participants would ask dentists about sterilization of dental instruments (9.3%, wearing face mask (13.3% and gloves (16.4% if they don’t do so. In conclusion, our participants had good attitudes towards infection control in dentistry. However, their knowledge and practice need improvements. Conduction of educational programs is needed through social media, mass media, schools and public places. These programs involve both patients and providers. Keywords: Patient safety, Cross infection, Dental infection, Infection control, Emerging diseases, KAP

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

    Crestani, Nathálie

    2011-01-01

    Full Text Available Objetivo: Identificar o perfil nutricional de pacientes adultos e idosos admitidos em um hospital universitário. Materiais e Métodos: Trata-se de um estudo transversal, retrospectivo e descritivo. Foram utilizados para avaliação nutricional o Índice de Massa Corporal (IMC e a Avaliação Subjetiva Global (ASG, que classifica o paciente em três categorias: bem nutrido (A, moderadamente ou suspeita de ser desnutrido (B ou gravemente desnutrido (C. Os dados (ASG, IMC e condição primária foram coletados a partir de informações dos formulários de avaliação nutricional preenchidos na rotina assistencial, aplicados em até setenta e duas horas após a interação do paciente. Esse estudo foi aprovado pela Comissão Científica e pelo Comitê de Ética em Pesquisa da PUCRS. Resultados: O estudo incluiu 32 adultos e 36 idosos (n=68. Em relação à ASG, 46,9% dos adultos foram classificados na categoria A e 53,1% na categoria B. Entre os idosos, 25% foram classificados na categoria A e 75% na categoria B. O IMC apontou 37,5% dos adultos como eutróficos e 62,5% como sobrepeso e/ou obesidade; os idosos apresentaram 50% de eutrofia, 36,1% de sobrepeso e 13,9% de baixo peso. Conclusão: O perfil nutricional dos pacientes estudados foi caracterizado pela alta prevalência de risco nutricional e sobrepeso/obesidade concomitantes nos dois grupos estudados. Esta realidade parece traduzir, em nível hospitalar, a situação de transição nutricional vivida em nosso país na atualidade. Os resultados evidenciam a importância da utilização de mais de um método de triagem nutricional em pacientes internados em unidades hospitalares, para obter-se maior precisão na avaliação

  10. [Pressure sores in a university hospital].

    Barbut, Frédéric; Parzybut, Bérengère; Boëlle, Pierre-Yves; Neyme, Denis; Farid, Rachida; Kosmann, Marie-Jeanne; Luquel, Laurence

    2006-05-01

    To determine the prevalence of pressure sores, their risk factors, and the responsible microbial agents in an acute-care hospital and to evaluate their management. A prevalence survey was conducted from 5 July through 9 July 2004. Investigators completed a standardized questionnaire for each hospitalized patient, including demographic data (age, sex, previous hospitalizations, etc.) and Braden scale risk factors (sensory perception, humidity, activity, mobility, nutrition, and friction and shear). Two experts in skin care detected pressure sores by physical examination of the patients. Each pressure sore was swabbed and inoculated on selective media. Management was evaluated by reviewing the clinical charts of each patient with a pressure sore. The study included 535 adult patients (aged 59 +/- 19 years): 75 ulcer sores were observed in 37 patients (prevalence=6.9%). Stage I sores accounted for 24% of the total, stage II for 29%, stage III 31%, and stage IV 16%. The most frequent site was the heel (41%), followed by the sacrum (20%), elbow (11%), back (7%) and ischial tuberosities (7%). Sixty (80%) were acquired while hospitalized. Age-adjusted multivariate analyses found that the risk factors significantly associated with pressure sores were Braden scorepressure sores (OR=5.0 95% CI: 2.2-11.6, psores (24.5%), mostly stage III and IV, were colonized by multiple-drug-resistant bacteria (i.e., methicillin resistant Staphylococcus aureus, extended spectrum beta-lactamase Enterobacteriaceae). Seven (9.3%) of the 75 ulcers were diagnosed only during the survey, by the experts; of the 68 diagnosed before the survey, 57 (83.8%) had been under treatment. Treatment was considered inappropriate according to French guidelines in 31.6% of the cases. This prospective prevalence study resulted in better awareness of the patients at risk for pressure sores. It also made the recently created mobile geriatrics unit better known within the hospital.

  11. A retrospective non-comparative analysis of the quality of care for osteoarthritis at the general out-patient department of Jos University Teaching Hospital, Nigeria

    Festus E Osajie

    2015-01-01

    Full Text Available Background: Osteoarthritis is a common condition in primary care and is often associated with disability and limitation of function requiring holistic care. Aim: The aim of this audit was to assess the quality of care provided by family physicians in the management of osteoarthritis at the General Out-patient Department (GOPD of Jos University Teaching Hospital (JUTH as well as ascertain if such care was in line with evidence-based medicine. Methods: This was a retrospective noncomparative study. The recommendations of the Nigerian Standard Treatment Guidelines 2008 and the National Institute for Health and Care Excellence 2014 guidelines were used to form standard targets for each of the structural, process and outcome components of the care process. Each of the consultation rooms was inspected for the structure components of the care process. For the process and outcome components of care, the medical records of all patients being managed for osteoarthritis at the GOPD of JUTH over a 1-year period were retrieved and studied. Results: For one aspect of the structural component (i.e. availability of weighing scale for each consultation room, 80% of the standard target was met which was below the standard target of 100%. The highest performance under the process component was for the documentation of risk associated with the use of nonsteroidal anti-inflammatory drugs (NSAIDs and documentation for NSAID/cyclooxygenase-2 inhibitors use with a gastro-protective agent. For both of these, 22.4% of the standard target was met; less than the standard target of 100% and 80% respectively. None of the standard targets for the outcome component were met. Conclusion: The quality of care for patients with osteoarthritis in this practice setting was sub-optimal. More can be done by family physicians with regards provision of comprehensive care for patients suffering from osteoarthritis.

  12. Impact of patients' professional and educational status on perception of an antibiotic policy campaign: a pilot study at a university hospital.

    Giannitsioti, Efthymia; Athanasia, Sofia; Plachouras, Diamantis; Kanellaki, Stavroula; Bobota, Fani; Tzepetzi, Georgia; Giamarellou, Helen

    2016-09-01

    Antibiotics are overused in many European countries, particularly Greece, leading to emerging antimicrobial resistance with sustained high mortality among hospitalised patients. Limited data are available regarding factors influencing people's knowledge and the impact of public campaigns on antibiotic misuse. Patients' beliefs regarding antibiotics were investigated in the outpatient clinic of a university hospital in Athens, Greece. A questionnaire-based survey was conducted to examine patients' opinions on antibiotic use in the waiting room of the outpatient clinic. All participants read an illustrated pocket-sized leaflet endorsed by official authorities on the European Antibiotic Awareness Day (EAAD). Volunteers then completed a questionnaire containing information on demographics, knowledge on antibiotic use and overuse, and remarks on the quality of the leaflet's content. In a logistic regression analysis including age, sex, educational level and professional status of 605 eligible participants, women were more aware [odds ratio (OR)=3.2, 95% confidence interval (CI) 1.8-5.8; Peducation were less aware (OR=0.4, 95% CI 0.1-0.9; P=0.04) of antimicrobial misuse. Workers were also more aware than retired or unemployed people (P=0.007). However, only 16.0% of participants knew about the EAAD. All participants agreed on antibiotic misuse in Greece, mentioning patient accountability as the main cause (26.8%), an opinion more pronounced in highly educated individuals. In conclusion, targeted interventions taking into account variations in educational level and employee status should be considered in future scheduled educative campaigns on antibiotic overconsumption in highly prescribing antibiotic countries. Copyright © 2016 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.

  13. The prevalence and bacteriology of asymptomatic bacteriuria among antenatal patients in Nnamdi Azikiwe University Teaching Hospital Nnewi; South Eastern Nigeria.

    Oli, A N; Okafor, C I; Ibezim, E C; Akujiobi, C N; Onwunzo, M C

    2010-12-01

    Urinary tract infection in pregnancy leads to poor pregnancy outcome. Diagnosis and treatment of asymptomatic bacteriuria markedly improves pregnancy outcome as well as reduce the incidence of acute pyelonephritis. To determine the prevalence and bacteriology of asymptomatic bacteriuria among Antenatal patients in our centre, and to know if routine screening will be justifiable. This was a prospective study carried out between April and August 2008. Sample size was statistically determined. Women who consented were interviewed and mid stream urine samples were collected and processed in the microbiology laboratory, using standard microbiological methods. Out of 357 women studied, 65(18.21%) had significant bacteriuria. Escherichia coli was the commonest isolate (25.6%), while proteus mirabilis was the least frequent isolate (3.66%). Women in third trimester had the highest prevalence (25.68%) while those in the first trimester had the least (15.79%). Women that had only primary education had the highest prevalence (27.50%) while those that had tertiary education had the least prevalence (21.10%). The prevalence of significant asymptomatic bacteriuria among the women studied was high. Screening of all the pregnant women and treatment will reduce the incidence and complications of overt urinary tract infection in pregnancy among these women.

  14. [Distribution of hepatitis C virus genotypes among patients with chronic hepatitis C infection in Akdeniz University Hospital, Antalya, Turkey: a five-year evaluation].

    Sağlik, İmran; Mutlu, Derya; Öngut, Gözde; İnan, Dilara; Öğünç, Dilara; Can Sarinoğlu, Rabia; Özhak Baysan, Betil; Gültekin, Meral; Çolak, Dilek

    2014-07-01

    Hepatitis C virus (HCV) is one of the major causes of chronic hepatitis. It is important to know the genotypes of HCV in the decision of the HCV related chronic hepatitis therapy. The aim of this study was to evaluate the HCV genotypes determined at the Microbiology Laboratory of Akdeniz University Hospital, and to evaluate the changes in the distribution of the genotypes within the last five years. A total of 422 blood samples from HCV-RNA positive chronic hepatitis C patients (219 male, 203 female; age range: 8-79 yrs, mean age 46.3 ± 15.5 yrs) which were sent to our laboratory for genotyping between 2009-2013 period, were analyzed retrospectively. HCV-RNA extractions were performed in an automated system (EZ1 Virus Mini Kit v2.0, Qiagen, Germany), and a commercial reverse hybridization line probe-based assay (LIPA; GEN-C RT-PCR, Italy) was carried out for genotyping, For viral load determinations, a real-time PCR method (Cobas TaqMan HCV, Roche Diagnostics, Germany) was used. Demographic data of the patients were obtained from the hospital information systems and electronic patients' files. Out of the 422 patients, genotype 1b was detected in 63.3% (n= 267), genotype 1a in 14.7% (n= 62), genotype 3a in 11.1% (n= 47), genotype 2b in 0.9% (n= 4), genotype 4e in 0.2% (n= 1). The subtypes couldn't be determined for 5.4% (n= 23), 2.6% (n= 11) and 1.4% (n= 6) of the patients infected with genotype 1, 2 and 4, respectively. One (0.2%) patient, was coinfected with genotype 1 and 4. Of the patients, 40 were foreign-born (16 cases from Russia; 4 of each from Ukraine and Georgia; 3 of each from Turkmenistan, Kyrgyzstan, and Germany; one of each from Tajikistan, Azerbaijan, Uzbekistan, Chechnya, Moldova, Switzerland and Romania) and among these patients genotype 3a (19/40; 47.5%) was the most common genotype followed by genotype 1b (17/40; 42.5%). Median values of HCV viral load were 668.500 IU/ml (range: 2.000-9.630.000) in the whole group; while it was 732.000 IU

  15. Brief hospitalizations of elderly patients

    Strømgaard, Sofie; Rasmussen, Søren Wistisen; Schmidt, Thomas Andersen

    2014-01-01

    BACKGROUND: Crowded departments are a common problem in Danish hospitals, especially in departments of internal medicine, where a large proportion of the patients are elderly. We therefore chose to investigate the number and character of hospitalizations of elderly patients with a duration of less...

  16. [Effects of self-adapting G-DRG system 2004 to 2006 on in-patient services payment in pediatric hematology and oncology patients of a university hospital].

    Christaras, A; Schaper, J; Strelow, H; Laws, H-J; Göbel, U

    2006-01-01

    Reimbursement of inpatient treatment by daily constant charges is replaced by diagnosis- and procedure-related group system (G-DRG) in German acute care hospitals excerpt for psychiatry since 2004. Re-designs of G-DRG system were undertaken in 2005 and 2006. Parallel to implementation requirement- and resource-based self-adjustment of this new reimbursement system has been established by law. Adjustments performed in 2005 and 2006 are examined with respect to their effect on reimbursements in treatments of children with oncological, hematological, and immunological diseases. An unchanged population of 349 patients associated with 1,731 inpatient stays of a Clinic of Pediatric Oncology, Hematology, and Immunology in 2004 was analyzed by methods and means of G-DRG systems 2004, 2005, and 2006. DRGs and additional payments for drugs and procedures eligible for all and/or individual hospitals were calculated. G-DRG system 2005 resulted in overall reimbursement loss of 3.77 % compared to G-DRG 2004. G-DRG 2006 leads to slightly improved overall reimbursements compared to G-DRG 2005 by increasing DRG-based revenues. G-DRG 2006 effects 2.40 % reduction in overall reimbursement compared to G-DRG 2004. This loss includes ameliorating effects of additional payments for drugs and blood products already. Despite introduction of additional payments especially designed for children and teenagers in 2006, additional payment volume is decreased by 21.71 % from 2005 to 2006. G-DRG 2006 yields over-all reimbursement losses of 1.45 % in comparison to G-DRG 2004. Overall reimbursements include introduced additional payments for drugs and blood products. (Reimbursements resulting out of DRG payment alone drop by 14.73 % from 2004 to 2005, and increase by 3.26 % from 2005 to 2006 (2004 vs. 2006 11.95 %). Introduction of additional payments for drugs and blood products on a Germany-wide basis introduced in 2005 dampens DRG-based reimbursement losses. Despite introduction of dosage

  17. Avaliação do estado nutricional de pacientes internados em um hospital universitário Evaluation of nutritional status of hospitalized patients from an university hospital

    Poliana Coelho Cabral

    1998-12-01

    Full Text Available O objetivo deste trabalho foi avaliar o estado nutricional de pacientes internados no Hospital das Clínicas da Universidade Federal de Pernambuco, na faixa etária de 15 a 89 anos. A amostra escolhida ao acaso, foi composta por 154 indivíduos de ambos os sexos (74 homens e 80 mulheres. Durante o estudo foram coletados os dados antropométricos, os hábitos alimentares e as causas do internamento. As análises mostraram uma grande instabilidade nutricional, com elevadas prevalências tanto de baixo peso como de excesso de peso. Com relação aos hábitos alimentares foi observada pobreza e monotonia nos cardápios. Dos pacientes entrevistados, a maioria mencionou apenas seis tipos de alimentos comuns como sendo seus favoritos (arroz e feijão, carne bovina, galinha, macarrão e pão. Por outro lado, esse estudo também deixou claro a alta freqüência de tabus alimentares, o que pode limitar o consumo de vários nutrientes. Em termos de admissões ás clínicas médica e cirúrgica, a proporção para ambos o grupos foi muito similar.The purpose of this research was to evaluate the nutritional status of hospitalized patients, aged 15 to 89 years old, from the Hospital das Clínicas - Universidade Federal de Pernambuco - Brazil. The sample, chosen at random, consisted of 154 individuals of both sexes (74 males and 80 females. Anthropometric data, food habits and reasons for hospitalization were recorded during the assessment. The analysis showed a great nutritional instability, with high prevalences of underweight and overweight. Regarding food habits, it was observed a poor and monotonous menu, resulted from a lack of variety. Of the patients interviewed, the majority mentioned only six kinds of common foods as their favourites (rice and beans, beef, chicken, macaroni and bread. On the other hand, this study also made clear the high frequency of food taboos, which might limit the consumption of various nutrients. In terms of admissions to the

  18. Acute intoxications in two university hospitals in Burkina Faso ...

    Acute intoxications in two university hospitals in Burkina Faso. ... admitted to the emergency services of the two sole University Hospitals of Ouagadougou from July 1, ... followed by chemicals, animals' toxins, food, alcohol and addictive drugs.

  19. Management of chronic orofacial pain: a survey of general dentists in german university hospitals

    Wirz, Stefan; Ellerkmann, Richard K.; Buecheler, Marcus; Putensen, Christian; Nadstawek, Joachim; Wartenberg, Hans-Christian

    2010-01-01

    AIM: This survey assessed procedures performed by general dentists in German university hospitals treating patients with chronic orofacial pain (COP). METHODS: A standardized questionnaire was sent to dentists at all 42 German universities. Doctors were asked to describe demographics, diagnoses,

  20. Outpatient admissions and hospital costs of Syrian refugees in a Turkish university hospital.

    Tahirbegolli, Bernard; Çavdar, Sabanur; Çetinkaya Sümer, Esin; Akdeniz, Sıdıka I; Vehid, Suphi

    2016-07-01

    To examine the most frequent admitted polyclinics, diagnoses, and the costs of Syrian refugee patient in a Turkish university hospital in the metropolitan city of Istanbul, Western part of Turkey.  Research methodology consist of analyzing outpatient admissions to the Hospital Polyclinics of Faculty of Medicine, Istanbul University, Cerrahpasa, Istanbul, Turkey from January-June 2014. We carried out diagnosis groups as classified in the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification, and analyzed the hospital cost of first admission through records based in the hospital information system.  Median age of 251 Syrian refugee patients is 19 years, inter quartile rate 7-34 years. Patients aged 65 and older compared with those until 18 years and 19 to 64 years aged groups have made statistically significant (p less than 0.001) less hospital admissions. The Most frequented clinic was the emergency clinic. On June there have been significantly (p less than 0.001) more admissions compared with other months. The most common diagnoses were diseases of the respiratory system. The costs of per admission was estimated nearly 48 US Dollar/per patient and the total amount of hospital admissions was 12,031.93 US Dollar.  On the specified dates, the clinics were mostly frequented from Syrian refugees until 18 years group. The most common presenting symptoms are respiratory diseases and most frequented clinic is emergency.

  1. Antifungal susceptibility testing of Candida species isolated from the immunocompromised patients admitted to ten university hospitals in Iran: comparison of colonizing and infecting isolates

    Parisa Badiee

    2017-11-01

    Full Text Available Abstract Background Antifungal susceptibility testing is a subject of interest in the field of medical mycology. The aim of the present study were the distributions and antifungal susceptibility patterns of various Candida species isolated from colonized and infected immunocompromised patients admitted to ten university hospitals in Iran. Methods In totally, 846 Candida species were isolated from more than 4000 clinical samples and identified by the API 20 C AUX system. Antifungal susceptibility testing was performed by broth microdilution method according to CLSI. Results The most frequent Candida species isolated from all patients was Candida albicans (510/846. The epidemiological cutoff value and percentage of wild-type species for amphotericin B and fluconazole in Candida albicans, Candida tropicalis, Candida glabrata and Candida krusei were 0.5 μg/ml (95% and 4 μg/ml (96%; 1 μg/ml (95% and 8 μg/ml (95%; 0.5 μg/ml (99% and 19 μg/ml (98%; and 4 μg/ml (95% and 64 μg/ml (95%, respectively. The MIC90 and epidemiological cutoff values to posaconazole in Candida krusei were 0.5 μg/ml. There were significant differences between infecting and colonizing isolates of Candida tropicalis in MIC 90 values of amphotericin B, and isolates of Candida glabrata in values of amphotericin B, caspofungin, and voriconazole (P < 0.05. Conclusions Our findings suggest that the susceptibility patterns of Candida species (colonizing and infecting isolates in immunocompromised patients are not the same and acquired resistance was seen in some species.

  2. Antifungal susceptibility testing of Candida species isolated from the immunocompromised patients admitted to ten university hospitals in Iran: comparison of colonizing and infecting isolates.

    Badiee, Parisa; Badali, Hamid; Boekhout, Teun; Diba, Kambiz; Moghadam, Abdolkarim Ghadimi; Hossaini Nasab, Ali; Jafarian, Hadis; Mohammadi, Rasoul; Mirhendi, Hossein; Najafzadeh, Mohammad Javad; Shamsizadeh, Ahmad; Soltani, Jafar

    2017-11-21

    Antifungal susceptibility testing is a subject of interest in the field of medical mycology. The aim of the present study were the distributions and antifungal susceptibility patterns of various Candida species isolated from colonized and infected immunocompromised patients admitted to ten university hospitals in Iran. In totally, 846 Candida species were isolated from more than 4000 clinical samples and identified by the API 20 C AUX system. Antifungal susceptibility testing was performed by broth microdilution method according to CLSI. The most frequent Candida species isolated from all patients was Candida albicans (510/846). The epidemiological cutoff value and percentage of wild-type species for amphotericin B and fluconazole in Candida albicans, Candida tropicalis, Candida glabrata and Candida krusei were 0.5 μg/ml (95%) and 4 μg/ml (96%); 1 μg/ml (95%) and 8 μg/ml (95%); 0.5 μg/ml (99%) and 19 μg/ml (98%); and 4 μg/ml (95%) and 64 μg/ml (95%), respectively. The MIC90 and epidemiological cutoff values to posaconazole in Candida krusei were 0.5 μg/ml. There were significant differences between infecting and colonizing isolates of Candida tropicalis in MIC 90 values of amphotericin B, and isolates of Candida glabrata in values of amphotericin B, caspofungin, and voriconazole (P Candida species (colonizing and infecting isolates) in immunocompromised patients are not the same and acquired resistance was seen in some species.

  3. [Impact of driving cessation on daily transportation utility in elderly people with cognitive decline: a survey of patients in the memory clinic of an urban university hospital].

    Kawano, Naoko; Makino, Taeko; Suzuki, Yusuke; Umegaki, Hiroyuki

    2009-09-01

    In the present study our goal was to explore the impact of driving cessation on daily transportation utility in older people with cognitive decline. A total of 101 older persons participated in our survey of responding of a questionnaire about driving and other methods for traveling, administered at the memory clinic of the geriatric outpatient unit of Nagoya University Hospital. Of this total, 48 (47.5%) still had driving licenses, 16 (15.8%) had licenses that had expired, and 37 (36.6%) had no driving experience. The majority of license holders (77.1%) were active drivers, and we found that license holders tend to utilize public transport loss than older people without driving experience. Furthermore, among those who had ceased driving, there was a contrast in daily transportation utility between those with dementia and those without dementia, with the former accessing public transport less frequently. When clinicians advise drivers with dementia to cease driving, these patients need special attention to assist them in providing alternative ways of transportation.

  4. Characteristics, complications and outcome of patients treated with automated peritoneal dialysis at the Peritoneal Dialysis Unit, University Hospital of the West Indies.

    Lawal, C O; Soyibo, A K; Frankson, A; Barton, E N

    2010-06-01

    To characterize and evaluate complications and outcomes of the patients treated with automated peritoneal dialysis (PD) at the University Hospital of the West Indies (UHWI), Jamaica. Retrospective data were collected from peritoneal dialysis patients' case files retrieved from the medical records department of UHWI. Demographic data (age, gender address, marital status), year of dialysis commencement, cause of end stage renal disease (ESRD), haemoglobin, serum electrolytes, serology, blood pressure readings, medications used, blood transfusion and erythropoietin use were collated. Complications such as infections (pneumonia, catheter-related infections), cardiac related disorders (congestive cardiac failure, acute coronary syndrome, pericarditis/pericardial effusion), cerebrovascular diseases, renal osteodystrophy, complications of the procedure and of end stage renal disease (ESRD), outcome and cause of death were retrieved from patients' case files for analysis. There were 202 patients receiving peritoneal dialysis between September, 1999 and December 2008. Data on 190 were analysed. The case files of 12 patients were not included because of incomplete data. The ages of the studied PD patients ranged between 33 and 65 years. The mean haemoglobin was 7.4 g/dL, serum calcium of 2.1 mmol/L, serum phosphate of 1.9 mmol/L and calcium/phosphate product of 4.1mmol2/L2. The serum albumin was 32 g/L and serum total cholesterol/HDL ratio of 5.3. Most patients were from Kingston and St Andrew (56.8%), St Catherine (18.9%) and Clarendon (7.4%). Hypertension (27.9%), chronic glomerulonephritis (17.9%) and diabetes mellitus (17.4%) were the commonest causes of ESRD. There were 70.5% unmarried persons and 81.6% of patients were unemployed. HIV, Hepatitis B and Hepatitis C seropositivity were discovered in 4.1%, 1.1 and 0.5% of patients respectively. Only 20% of the patients used erythropoietin and of this 92% used it less than 50% of the prescribed frequency. Infections (43

  5. ["Should the staff's attitude towards the patients remain unchanged, I will not guarantee anything." Protest masculinity and coping of "rebellious patients" at the Heidelberg University Psychiatric Hospital on the eve of deinstitutionalization].

    Schwamm, Christoph

    2015-01-01

    This article analyses the illness experiences of male patients from the Heidelberg University Psychiatric Hospital during the protests against Psychiatry in the year 1973. Protest is one of the most important expressions of masculinity in socially disadvantaged men, such as men with mental disorders. The analysis of 100 medical records shows that some patients tried to construct themselves as men in a way that was explicitly motivated by antipsychiatric ideas: They questioned psychiatric authority, behaved "sexually inappropriate", or used drugs. On the eve of psychiatric reform in West Germany those patients were well aware that the alternative--complying with the treatment--would put them at considerable risk. In addition to the usual inference of hegemonic or normative masculinities as risk-factors, the behavior of those ,,rebellious patients" has to be interpreted as individual coping strategies.

  6. Syntax Score and Major Adverse Cardiac Events in Patients with Suspected Coronary Artery Disease: Results from a Cohort Study in a University-Affiliated Hospital in Southern Brazil.

    Fuchs, Felipe C; Ribeiro, Jorge P; Fuchs, Flávio D; Wainstein, Marco V; Bergoli, Luis C; Wainstein, Rodrigo V; Zen, Vanessa; Kerkhoff, Alessandra C; Moreira, Leila B; Fuchs, Sandra C

    2016-09-01

    The importance of coronary anatomy in predicting cardiovascular events is well known. The use of traditional anatomical scores in routine angiography, however, has not been incorporated to clinical practice. SYNTAX score (SXscore) is a scoring system that estimates the anatomical extent of coronary artery disease (CAD). Its ability to predict outcomes based on a baseline diagnostic angiography has not been tested to date. To evaluate the performance of the SXscore in predicting major adverse cardiac events (MACE) in patients referred for diagnostic angiography. Prospective cohort of 895 patients with suspected CAD referred for elective diagnostic coronary angiography from 2008 to 2011, at a university-affiliated hospital in Brazil. They had their SXscores calculated and were stratified in three categories: no significant CAD (n = 495), SXscoreLOW-INTERMEDIATE: prospectiva de 895 pacientes com suspeita de DAC encaminhados para cineangiocoronariografia diagnóstica eletiva de 2008 a 2011, em hospital universitário no Brasil. Os pacientes tiveram seus SXescores calculados e foram estratificados em três categorias: 'sem DAC significativa' (n = 495); SXescoreBAIXO-INTERMEDIÁRIO: < 23 (n = 346); e SXescoreALTO: ≥ 23 (n = 54). O desfecho primário foi composto de morte cardíaca, infarto do miocárdio e revascularização tardia. Os desfechos secundários foram MACE e morte por todas as causas. Em média, os pacientes foram acompanhados por 1,8 ± 1,4 anos. Desfecho primário ocorreu em 2,2%, 15,3% e 20,4% nos grupos 'sem DAC significativa', SXescoreBAIXO-INTERMEDIÁRIO e SXescoreALTO, respectivamente (p < 0,001). Morte por todas as causas foi significativamente mais frequente no grupo de SXescoreALTO comparado ao grupo 'sem DAC significativa', 16,7% e 3,8% (p < 0,001), respectivamente. Após ajuste para fatores de confusão, todos os desfechos permaneceram associados com o SXescore. O SXescore prediz independentemente MACE em pacientes submetidos a

  7. ELECTROCONVULSIVE THERAPY EXPERIENCES AT NARA MEDICAL UNIVERSITY HOSPITAL

    Kishimoto, Toshifumi; Ueda, Atsushi; Noriyama, Yoshinobu; Nagai, Toshiya; Hirayama, Tomohide; Kirita, Ikuhiro; Hata, Kazuya; Ikawa, Genro

    1995-01-01

    We surveyed the clinical electroconvulsive therapy (ECT) treatment expe- riences between 1987 and 1992 at Nara Medical University Hospital. ECT is restrictedly applied to severely ill patients who have no response to other somatic therapies. For 5 years, 43 cases were treated with ECT, of which 27 suffered from depressive disorders, 3 from schizophrenia, 3 from somatoform disorders, and 10 from anxiety disorders. ECT was selected by psychiatrists for severe depressive states after failure of ...

  8. Image quality control in radiodiagnostic in an University Hospital

    Almeida, Claudio Domingues de; Mota, Helvecio C.; Almeida, Carlos Eduardo de

    1996-01-01

    The image quality criteria proposed for European Union (UE) has been used to evaluate the chest x-ray examinations in a typical Department of Radiology of an University Hospital in Rio de Janeiro. The study includes information on x-ray beam parameters, film-screen combination, doses to the patients, film processing and image quality. Lateral and PA chest examinations of 63 patients were investigated. Only 10% of the patients presented entrance doses greater than the reference level proposed for UE and adopted by International Atomic Energy Agency and World Health Organization. The image quality has been approved for 87% of the examinations. (author)

  9. Opportunistic infections in patients with aids admitted to an university hospital of the Southeast of Brazil Infecções oportunistas em pacientes com aids internados em um hospital universitário do sudeste do Brasil

    Vandack Nobre

    2003-04-01

    Full Text Available Opportunistic diseases in HIV-infected patients have changed since the introduction of highly active anti-retroviral therapy (HAART. This study aims at evaluating the frequency of associated diseases in patients with AIDS admitted to an university hospital of Brazil, before and after HAART. The medical records of 342 HIV-infected patients were reviewed and divided into two groups: group 1 comprised 247 patients before HAART and, group 2, 95 patients after HAART. The male-to-female rate dropped from 5:1 to 2:1for HIV infection. There was an increase in the prevalence of tuberculosis and toxoplasmosis, with a decrease in Kaposi's sarcoma, histoplasmosis and cryptococcosis. A reduction of in-hospital mortality (42.0% vs. 16.9%; p = 0.00002 has also occurred. An agreement between the main clinical diagnoses and autopsy findings was observed in 10 out of 20 cases (50%. Two patients with disseminated schistosomiasis and 2 with paracoccidioidomycosis are reported. Overall, except for cerebral toxoplasmosis, it has been noticed a smaller proportion of opportunistic conditions related to severe immunosuppression in the post HAART group. There was also a significant reduction in the in-hospital mortality, possibly reflecting improvement in the treatment of the HIV infection.O espectro das doenças oportunistas em pacientes com aids vem se modificando desde a introdução da terapia antiretroviral altamente eficaz (HAART. O objetivo deste estudo é o de avaliar o perfil das afecções oportunistas em pacientes com aids internados em um hospital universitário do Brasil, comparando os períodos pré e pós-utilização da terapia HAART. Para tanto, revisaram-se os prontuários médicos de 342 pacientes infectados pelo HIV, dividindo-os em dois grupos: grupo 1, composto de 247 pacientes pré-HAART e grupo 2, composto de 95 pacientes pós-HAART. A relação homem-mulher caiu de 5:1 para 2:1. Houve aumento da prevalência da tuberculose e da toxoplasmose, com

  10. Urgent consultations at the dermatology department of Basel University Hospital, Switzerland: characterisation of patients and setting - a 12-month study with 2,222 patients data and review of the literature.

    Ruzza, N; Itin, P H; Beltraminelli, H

    2014-01-01

    Urgent consultations for skin disorders are commonly done in different settings. Scarce data exist about the characteristics of these patients. The aim of this study was to analyse specific characteristics of patients receiving an urgent consultation at a dermatology department in a university hospital. We prospectively recorded the data of all patients having had an urgent consultation during a period of 12 months. We registered 2,222 urgent consultations. The most frequent diagnoses were eczemas (24.8%), dermatomycoses (5.1%) and dermatitis not otherwise specified (4.8%). The most frequent treatments were topical steroids, emollients, topical antibiotics, systemic antihistamines, antibiotics and virostatics. 2.2% of patients were hospitalized, 78.8% asked for a consultation for a disease lasting less than 4 weeks, and 6.9% presented the same day as the skin disease appeared. This study shows the characteristics of patients receiving an urgent dermatologic consultation. It underlines the need for collaboration between dermatologists, other physicians, general practitioners and nurses. © 2014 S. Karger AG, Basel.

  11. Latex allergies - for hospital patients

    ... ency/patientinstructions/000499.htm Latex allergies - for hospital patients To use the sharing features on this page, ... ADAM Health Solutions. About MedlinePlus Site Map FAQs Customer Support Get email updates Subscribe to RSS Follow ...

  12. Perfil social de los cuidadores familiares de pacientes dependientes ingresados en el Hospital General Universitario de Elche Social profile of the family caregiver of dependant patients in the University General Hospital of Elche

    Pablo López-Casanova

    2009-12-01

    Full Text Available El objetivo de este estudio es describir el perfil social de los cuidadores familiares en el Hospital General Universitario de Elche y conocer el tipo de necesidades que cubren. Metodología: Investigación de tipo descriptivo y transversal, mediante 32 encuestas realizadas entre enero y febrero de 2008, en el Servicio de Medicina Interna. Se efectuó un análisis descriptivo y las variables fueron edad, sexo, ingresos económicos, vivienda, trabajo, parentesco del cuidador y permanencia en el centro hospitalario. Resultados: El perfil del cuidador informal corresponde a una mujer, con una media de edad de 54 años y que permanece todo el día en el hospital. Las necesidades que el cuidador distingue como más importantes estuvieron relacionadas con la compañía, la vigilancia y las necesidades básicas. Conclusiones: El perfil del cuidador familiar es de cónyuges o madres. La realización de las tareas de cuidador supone un gasto de tiempo, dinero, desgaste físico, psicológico y social. Parte de las necesidades del paciente son cubiertas por los cuidadores informales, que reciben poca información y asesoramiento del personal de enfermería sobre cómo realizarlas. Por tanto, ampliar la mirada enfermera es una exigencia y demanda de nuestra sociedad.The aim of this study is to describe the social profile of the family caregivers in the University General Hospital of Elche, and to know the sort of needs that they cater for. Methodology: This is a descriptive and transversal piece of research, performed by means of 32 surveys done between January and February 2008 in the Internal Medicine service. A descriptive analysis was carried out; such analysis bore in mind the following variables: the caregivers´ age, sex, income, dwelling, employment, their kinship with the patient and the lenght of stay at the hospital. Results: The profile of the average informal caregiver corresponds to a woman of approximately 54 years old who stays all day in

  13. Stenotrophomonas maltophilia isolated from patients exposed to invasive devices in a university hospital in Argentina: molecular typing, susceptibility and detection of potential virulence factors.

    Alcaraz, Eliana; Garcia, Carlos; Papalia, Mariana; Vay, Carlos; Friedman, Laura; Passerini de Rossi, Beatriz

    2018-05-25

    The aim of this work was to investigate the presence of selected potential virulence factors, susceptibility and clonal relatedness among 63 Stenotrophomonas maltophilia isolates recovered from patients exposed to invasive devices in a university hospital in Argentina between January 2004 and August 2012. Genetic relatedness was assessed by enterobacterial repetitive intergenic consensus PCR (ERIC-PCR) and pulsed-field gel electrophoresis (PFGE). Isolates were characterized by antimicrobial resistance, the presence and/or expression of potential virulence determinants, and virulence in the Galleria mellonella model.Results/Key findings. ERIC-PCR generated 52 fingerprints, and PFGE added another pattern. Resistance to trimethoprim-sulfamethoxazole (6.35 %), levofloxacin (9.52 %) and ciprofloxacin (23.80 %) was detected. All isolates were susceptible to minocycline. All isolates were lipase, protease and siderophore producers, while all but Sm61 formed biofilms. However, 11/63 isolates did not amplify the major extracellular protease-coding gene (stmPr1). Sm61 is an stmPr1-negative isolate, and showed (as did Sm13 and the reference strain K279a) strong proteolysis and siderophore production, and high resistance to hydrogen peroxide. The three isolates were virulent in the G. mellonella model, while Sm10, a low-resistance hydrogen peroxide stmPr1-negative isolate, and weak proteolysis and siderophore producer, was not virulent. This is the first epidemiological study of the clonal relatedness of S. maltophilia clinical isolates in Argentina. Great genomic diversity was observed, and only two small clusters of related S. maltophilia types were found. Minocycline and trimethoprim-sulfamethoxazole were the most active agents. S. maltophilia virulence in the G. mellonella model is multifactorial, and further studies are needed to elucidate the role of each potential virulence factor.

  14. Class 1 integrons and plasmid-mediated multiple resistance genes of the Campylobacter species from pediatric patient of a university hospital in Taiwan.

    Chang, Yi-Chih; Tien, Ni; Yang, Jai-Sing; Lu, Chi-Cheng; Tsai, Fuu-Jen; Huang, Tsurng-Juhn; Wang, I-Kuan

    2017-01-01

    The Campylobacter species usually causes infection between humans and livestock interaction via livestock breeding. The studies of the Campylobacter species thus far in all clinical isolates were to show the many kinds of antibiotic phenomenon that were produced. Their integrons cause the induction of antibiotic resistance between bacterial species in the Campylobacter species. The bacterial strains from the diarrhea of pediatric patient which isolated by China Medical University Hospital storage bank. These isolates were identified by MALDI-TOF mass spectrometry. The anti-microbial susceptibility test showed that Campylobacter species resistant to cefepime, streptomycin, tobramycin and trimethoprim/sulfamethoxazole (all C. jejuni and C. coli isolates), ampicillin (89% of C. jejuni ; 75% of C. coli ), cefotaxime (78% of C. jejuni ; 100% of C. coli ), nalidixic acid (78% of C. jejuni ; 100% of C. coli ), tetracycline (89% of C. jejuni ; 25% C. coli ), ciprofloxacin (67% of C. jejuni ; 50% C. coli ), kanamycin (33% of C. jejuni ; 75% C. coli ) and the C. fetus isolate resisted to ampicillin, cefotaxime, nalidixic acid, tetracycline, ciprofloxacin, kanamycin by disc-diffusion method. The effect for ciprofloxacin and tetracycline of the Campylobacter species was tested using an E-test. The tet, erm , and integron genes were detected by PCR assay. According to the sequencing analysis (type I: dfr12 - gcuF - aadA2 genes and type II: dfrA7 gene), the cassette type was identified. The most common gene cassette type (type I: 9 C. jejuni and 2 C. coli isolates; type II: 1 C. coli isolates) was found in 12 class I integrase-positive isolates. Our results suggested an important information in the latency of Campylobacter species with resistance genes, and irrational antimicrobial use should be concerned.

  15. [Nutritional assessment for hospitalized patients].

    Henríquez Martínez, T; Armero Fuster, M

    1991-01-01

    A review of the following points was performed: Factors favouring the development and presence of malnutrition among hospitalized patients. Useful parameters in nutritional evaluation. Types of malnutrition. The Chang nutritional evaluation protocol is used in our Hospital, which is simple, inexpensive, reliable, specific and easily reproduced. This is based on five variables (three anthropometric and two biochemical), randomized and based on reference tables and values. A study was made on data corresponding to 70 patients, in whom a prevalence of malnutrition was observed in critical patients. The patients were classified based on three different definitive possibilities (Marasmo, Kwashiorkor and combined), and three grades of malnutrition (slight, moderate and severe).

  16. University/Hospital fetal dose policy experiences

    Wilson, B.M.; Vinson, W.R.; Deforest, W.W.; Washburn, D.B.

    1991-01-01

    Since at least 1981, an informal policy has existed at the authors research university and teaching hospital institution to interview, inform and assure appropriate personnel monitoring for pregnant radiation workers. Events, such as popular and technical publications (NCRP 87) and the maturation of NRC's proposed changes in 10 CFR 20 (NRC 88), brought increased attention to the subject of fetal radiation dose. The need for a formal approach to the subject became evident. By 1987, a concerted effort to promulgate a formal policy was launched. A draft policy statement was presented to each institutional radiation safety committee for review and action. There was immediate strong interest. A thorough, multilevel review, comment and redraft process developed. Well tested policy statements were then approved in 1988

  17. Experiences with MBSR at a university hospital

    Fjorback, Lone; Piet, Jacob; Pallesen, Karen Johanne

    Collaboration across disciplinary boundaries, i.e. between practitioners, clinicians, researchers, and scholars, is needed to effectively run an MBSR research clinic and professional training institute. The establishment of such collaboration poses specific challenges. In this session, we...... will present some general reflections and concrete examples of the ways in which we work to realize our common vision of an MBRS research clinic and professional training institute. Our group has expertise in MBSR clinical intervention, clinical research, brain research, MBSR delivered to the community...... and integrated in these processes. In practice, we take particular interest in the application and transmission of MBSR at a university hospital and in the broader society. As we hope to show, recognizing the reality of different individual, institutional and disciplinary agendas is as important an element...

  18. Maternal Mortality in Ribat University Hospital, Khartoum, Sudan ...

    Background: Maternal death is a tragedy that leaves an enormous negative impact on the family. The objectives of the study were to determine the rate and causes of maternal mortality in Ribat University Hospital Methods: This was a descriptive, hospital-based study conducted in Ribat University Hospital, Khartoum, Sudan ...

  19. Clinical profiles of patients colonized or infected with extended-spectrum beta-lactamase producing Enterobacteriaceae isolates: a 20 month retrospective study at a Belgian University Hospital

    Jamart Jacques

    2011-01-01

    Full Text Available Abstract Background Description of the clinical pictures of patients colonized or infected by ESBL-producing Enterobacteriaceae isolates and admitted to hospital are rather scarce in Europe. However, a better delineation of the clinical patterns associated with the carriage of ESBL-producing isolates may allow healthcare providers to identify more rapidly at risk patients. This matter is of particular concern because of the growing proportion of ESBL-producing Enterobacteriaceae species isolates worldwide. Methods We undertook a descriptive analysis of 114 consecutive patients in whom ESBL-producing Enterobacteriaceae isolates were collected from clinical specimens over a 20-month period. Clinical data were obtained through retrospective analysis of medical record charts. Microbiological cultures were carried out by standard laboratory methods. Results The proportion of ESBL-producing Enterobacteriaceae strains after exclusion of duplicate isolates was 4.5% and the incidence rate was 4.3 cases/1000 patients admitted. Healthcare-associated acquisition was important (n = 104 while community-acquisition was less frequently found (n = 10. Among the former group, two-thirds of the patients were aged over 65 years and 24% of these were living in nursing homes. Sixty-eight (65% of the patients with healthcare-associated ESBL, were considered clinically infected. In this group, the number and severity of co-morbidities was high, particularly including diabetes mellitus and chronic renal insufficiency. Other known risk factors for ESBL colonization or infection such as prior antibiotic exposure, urinary catheter or previous hospitalisation were also often found. The four main diagnostic categories were: urinary tract infections, lower respiratory tract infections, septicaemia and intra-abdominal infections. For hospitalized patients, the median hospital length of stay was 23 days and the average mortality rate during hospitalization was 13% (Confidence

  20. Sound and Music Interventions in Psychiatry at Aalborg University Hospital

    Lund, Helle Nystrup; Bertelsen, Lars Rye; Bonde, Lars Ole

    2016-01-01

    to their needs here-and-now. In the study, we focus on how self-selected music may lead to decrease of anxiety and pain or improved relaxation/sleep. The article describes and discusses the theory-driven development of the sound/music milieu, relevant empirical studies, the novel method of data collection......This article reports on the ongoing project development and research study called “A New Sound and Music Milieu at Aalborg University Hospital”. Based on a number of pilot studies in AUH Psychiatry, investigating how special playlists and sound equipment (“sound pillows” and portable players) can...... be used by hospital patients and administered by hospital staff supervised by music therapists, the new project aims to prepare the ground for a systematic application of sound and music in the hospital environment. A number of playlists have been developed, based on theoretical and empirical research...

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

    P Thomas

    2015-03-01

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

  2. Compliance with carbapenem guidelines in a university hospital.

    Van Hollebeke, M; Chapuis, C; Bernard, S; Foroni, L; Stahl, J P; Bedouch, P; Pavese, P

    2016-03-01

    We aimed to evaluate carbapenem prescription compliance with guidelines for nosocomial and community-acquired infections. We conducted a prospective study over a four-month period at our university hospital. We included all adult and pediatric hospitalized patients who had received at least one dose of carbapenem. Data was collected from patients' medical records (hard copy and computerized data; CristalLink software). Compliance with guidelines was assessed by two infectious disease specialists. Assessment criteria included indication, antibiotic choice, dosage, and treatment duration. We included 152 patients in the study (65.4% of men). Carbapenem prescription was appropriate for 76.3% of prescriptions. The use of carbapenems was considered appropriate for 73.9% of empirical prescriptions and for 77.8% of documented prescriptions. Non-compliance with guidelines was mainly due to prescriptions for community-acquired infections. Antibiotic de-escalation could not be initiated in 40.3% of patients and was only initiated in 51.7% of patients for whom it could be considered. Although the average treatment duration was 7.5 days, 23.7% of patients received carbapenems for more than 10 days. These results highlight the need for a strong carbapenem stewardship program in our hospital. Copyright © 2016. Published by Elsevier SAS.

  3. Stapled hemorrhoidopexy: The Aga Khan University Hospital Experience

    Athar, Ali; Chawla, Tabish; Turab, Pishori

    2009-01-01

    Stapled hemorrhoidopexy for prolapsing hemorrhoids is conceptually different from excision hemorrhoidectomy. It does not accompany the pain that usually occurs after resection of the sensitive anoderm. This study was carried out to evaluate the clinical outcome of stapled hemorrhoidopexy at The Aga Khan University Hospital. A sample of 140 patients with symptomatic second-, third-, and fourth-degree hemorrhoids and circumferential mucosal prolapse underwent stapled hemorrhoidopexy from July 2002 to July 2007. They were evaluated for postoperative morbidity, analgesic requirement, and recurrence. Seventy-eight percent were males and the mean age was 45 (range 16-90) years. The mean operative time was 35 (15-78) min. The mean parenteral analgesic doses during the first 24 h were 2.1. All patients received oral analgesics alone after 24 h. No significant postoperative morbidity was observed. The mean in-patient hospital stay was 1.3 (0-5) days. Patients were followed-up for 24 (range, 2-48) months. Minor local recurrence of hemorrhoids was seen in four patients and was managed by band ligation. Stapled hemorrhoidopexy procedure was found safe, well tolerated by patients with minimal parenteral analgesic use and early discharge from the hospital. (author)

  4. Considerações sobre analgesia controlada pelo paciente em hospital universitário Consideraciones sobre analgesia controlada por el paciente en hospital universitario Patient controlled analgesia in a university hospital

    Guilherme Antônio Moreira de Barros

    2003-02-01

    ás utilizado (54,2%, siendo la vía peridural la que tiene preferencia (49,5%. La escala numérica verbal media fue de 0,8 (0-10. Los efectos colaterales ocurrieron en 22,4% de los enfermos tratados. CONCLUSIONES: Los resultados fueron considerados excelentes en lo que se refiere a la calidad de la analgesia, no obstante con ocurrencia de efectos colaterales indeseables, siendo que hubo buena aceptación de la técnica de analgesia por las clínicas atendidas.BACKGROUND AND OBJECTIVES: The rapid development seen in recent years in surgical and anesthetic techniques allowed for an increased indication of invasive procedures. At the same time, with the aging of the population, the postoperative recovery period became the focus of major concern for the healthcare team. For such, new analgesic techniques were developed, among them, Patient Controlled Analgesia (PCA. In Brazil, the Acute Pain Service (SEDA of the Anesthesiology Department, Botucatu Medical School - UNESP, has been using PCA for many years. Aiming at verifying the quality of the service provided, this research has evaluated the efficacy and safety of the technique, in addition to identifying and characterizing patients submitted to PCA. METHODS: Participated in this retrospective study 679 patients treated by SEDA with the PCA method only, during a 3-year period. Patients were randomly included in the study with no restrictions concerning age, gender and type of surgery, considering only the possibility of PCA. The following parameters were evaluated: gender, age, type of surgery, pain score, treatment duration, analgesic drugs used, administration route, side effects and complications. RESULTS: The PCA technique was used in 3.96% of patients submitted to surgical procedures and in 1.64% of all hospitalized patients. Thoracic surgeries were the most frequent procedures and accounted for 25% of patients. Morphine was the most commonly used analgesics (54.2% and the epidural route was the most frequent route of

  5. Workplace violence against nursing staff in a Saudi university hospital.

    Alkorashy, Hanan A Ezzat; Al Moalad, Fawziah Bakheet

    2016-06-01

    Violence against nurses is a major challenge for healthcare administrators. It is gaining more attention because it has a negative impact on nurses, the quality of health care and health organization. Common types of violence include physical harassment, sexual abuse, aggression, mobbing and bullying. Patients, their relatives and co-workers are considered the main perpetrators. To determine the prevalence rate of workplace violence against nursing professionals in a university hospital in Riyadh, Saudi Arabia, most frequent type and perpetrators as well as the contributing factors. This quantitative cross-sectional study adapted a survey questionnaire from the Massachusetts Nurses Association Survey on Workplace Violence/Abuse to collect data from a quota sample of 370 nursing personnel. Almost half of the participants had experienced violence in the professional setting during the 12 months prior to the study. The majority of subjects perceived workplace violence as verbal abuse. Nearly all nursing professionals identified patients as the leading cause. Slightly more than half mentioned understaffing, misunderstandings, long waits for service and lack of staff training and policies for preventing crisis as contributing factors. The prevalence rate is extremely high among nurses in the targeted Saudi university hospital. Saudi health as well as university hospitals' administration and policy makers should adopt and introduce a 'zero tolerance policy', set standards and develop practical measures for preventing the incidence and for controlling the prevalence of violence against nurses. Besides, healthcare organizations, particularly hospitals, can fulfil their obligations to provide both staff and patients with more secure environment. Further research on the topic is needed. © 2016 International Council of Nurses.

  6. Hospital information systems: experience at the fully digitized Seoul National University Bundang Hospital.

    Yoo, Sooyoung; Hwang, Hee; Jheon, Sanghoon

    2016-08-01

    The different levels of health information technology (IT) adoption and its integration into hospital workflow can affect the maximization of the benefits of using of health IT. We aimed at sharing our experiences and the journey to the successful adoption of health IT over 13 years at a tertiary university hospital in South Korea. The integrated system of comprehensive applications for direct care, support care, and smart care has been implemented with the latest IT and a rich user information platform, achieving the fully digitized hospital. The users experience design methodology, barcode and radio-frequency identification (RFID) technologies, smartphone and mobile technologies, and data analytics were integrated into hospital workflow. Applications for user-centered electronic medical record (EMR) and clinical decision support (CDS), closed loop medication administration (CLMA), mobile EMR and dashboard system for care coordination, clinical data warehouse (CDW) system, and patient engagement solutions were designed and developed to improve quality of care, work efficiency, and patient safety. We believe that comprehensive electronic health record systems and patient-centered smart hospital applications will go a long way in ensuring seamless patient care and experience.

  7. Incidence of falls and preventive actions in a University Hospital.

    Luzia, Melissa de Freitas; Cassola, Talita Portela; Suzuki, Lyliam Midori; Dias, Vera Lucia Mendes; Pinho, Leandro Barbosa de; Lucena, Amália de Fátima

    2018-01-01

    Objective Describing the incidence of falls and its relation with preventive actions developed in a Brazilian university hospital. Method A retrospective longitudinal study. Hospitalized adult patients in the clinical, surgical, psychiatric and emergency units who suffered a fall in the institution, and who had the event notified in the period from January 2011 to December 2015 were included in the study. The data were collected from the institution's management information system and analyzed in the SPSS statistical program. Results There were 2,296 falls, with a mean incidence of 1.70 falls/1,000 patients per day. An increase in the incidence of falls was observed in the period from 2011 (1.61) to 2012 (2.03). In the following years, the incidence of falls decreased from 1.83 falls/1,000 patients per day in 2013 to 1.42 falls/1,000 patients per day in 2015. The incidence of falls accompanied an implementation of preventive actions, suggesting the impact of such interventions in reducing the event occurrence. Conclusion The findings demonstrate the importance of implementing preventive interventions in reducing the incidence of falls in hospitalized patients.

  8. Risk of malnutrition of hospitalized children in a university public hospital.

    Muñoz-Esparza, Nelly Carolina; Vásquez-Garibay, Edgar Manuel; Romero-Velarde, Enrique; Troyo-Sanromán, Rogelio

    2017-02-01

    The study aimed to demonstrate that the duration of hospitalization has a significant effect on the nutritional status of children treated in a university hospital. A longitudinal study was conducted during 2014, with a non-random sampling site concentration in children from birth to 19 years who were admitted to the hospital in the past 24 hours and who met the inclusion criteria and had signed informed consent. Upon entering, at 7 days, and at discharge, anthropometric indices, including weight/age, height/age, weight/height, BMI/age, head circumference/age, triceps and subscapular skin folds, and fat percentage, were obtained. Student's t-test, U Mann-Whitney, ANOVA, chi square, Wilcoxon, and odds ratios were used to analyze the data. In total, 206 patients were included: 40% infants, 25% preschoolers, 15% schoolchildren, and 20% teenagers. Infants had a significant improvement from admission to discharge in the indices weight/length (p = 0.042) and BMI (p = 0.002); adolescents showed decreased BMI from admission to discharge from the hospital (p = 0.05). Patients with longer hospitalization (more than 10 days) had an increased deficit in anthropometric indices at admission (p malnutrition and require greater monitoring of nutritional status during hospitalization.

  9. A survey of the radiographic cassettes disinfection of university hospitals in seoul

    Kweon, Dae Cheol; Park, Peom; Kim, Moon Sun; Kim, Dong Sung

    2001-01-01

    The purpose of this study is to prevent nosocomial infection in patients through contact of radiographic cassettes. Data were collected from radiographers working in 29 university hospitals in Seoul in February and March 2001. Radiographic cassettes were disinfected daily in 5 hospitals, weekly in 4 hospitals, monthly in 5 hospitals, bimonthly in 1 hospital and once every three months in another hospital. 12 other hospitals do not practice regular disinfections of radiographic cassettes. Gauze soaked in disinfectant solution is used in 7 hospitals while 11 hospitals used cotton and cloth soaked in disinfectant solution to clean the radiographic cassettes. 26 hospitals used 99% alcohol based disinfectant solutions while 3 hospitals used 75% alcohol based disinfectant, 26 hospitals use of intercourse cassettes outpatients and in patients. In 26 hospitals, all patients shared the same set of radiographic cassettes used in the hospitals, or in 26 hospitals, separate sets of radiographic cassettes are used for outpatients and inpatients. Separate sets of cassettes are used for ICU and inpatients in 6 others hospitals. 23 hospitals used the same sets of radiographic cassettes for all their patients. radiographic cassettes are cleaned in wash area in the study room of the radiographic department in 17 hospitals. 12 other hospitals do not have designated cleaning areas for the cassettes. All radiographers practiced hands washing with soap. All 29 hospitals surveyed have infection control committee. However, only 9 out of the 29 hospitals surveyed provided Infection · disinfections control education to radiographers. Only 3 hospitals have radiographers sitting in the infection control committee. Infection management education is conducted in 63 hospitals annually, twice a year in 1 hospital and once every 3 months in 2 hospitals

  10. Violence experienced by nurses at six university hospitals in Turkey.

    Ünsal Atan, S; Baysan Arabaci, L; Sirin, A; Isler, A; Donmez, S; Unsal Guler, M; Oflaz, U; Yalcinkaya Ozdemir, G; Yazar Tasbasi, F

    2013-12-01

    This research was conducted to analyse the violence experienced by nurses employed at six university hospitals. A descriptive and cross-sectional study was conducted. The research sample consisted of 441 nurses who worked in the emergency, intensive care and psychiatry units of six university hospitals in Turkey between June 2008 and June 2009 and who voluntarily agreed to participate. It was found that 60.8% of the nurses were subjected to verbal violence and/or physical violence from patients, visitors or health staff. Of the nurses who were subjected to workplace violence, 42.9% stated that their experience of verbal and/or physical violence had a negative impact on their physical and/or psychological health, and 42.9% stated that their work performance was negatively affected. Of these nurses, 1.8% stated that they received professional help, 13.6% stated that a report was made and 9.5% stated that they contacted the hospital police in some way. According to the findings of this research, similar to the situation worldwide, nurses in Turkey are subjected to verbal and/or physical violence from patients, visitors and health staff. © 2012 John Wiley & Sons Ltd.

  11. Evaluation of the Implementation of an educational intervention nurse in patients treated at the Heart Failure Unit at the University Hospital Puerta de Hierro

    Aurora Hernández Rivas

    2012-11-01

    Full Text Available Objective: To evaluate the effectiveness of the implementation of a nurse educational intervention in patients with heart failure in relation to the level of knowledge about their disease, level of self-care, treatment adherence, perceived satisfaction, fewer hospital readmissions and improved quality of life. Methods: Quasi-experimental study with two groups: control group (consisting of patients treated according to standard practice and experimental group (consisting of patients who will apply the nursing educational intervention proposal. It included all patients (= 18 years, good cognitive, literacy, sign informed consent with a diagnosis of heart failure (HF of recent (3-6 months or new onset, coming first in the Heart Failure Unit of Hospital Universitario Puerta de Hierro from May 2008. Sample: 68 patients per group. Nurse educational intervention will consist of four teaching sessions of 20 minutes before discharge, will be given a boost educational DVD, complete with brochures and explanatory guide, it will reinforce the information a month by telephone. Monitoring: baseline visit (inclusion and follow-up after 15 days, at 3 and 6 months. Outcomes/Instruments: demographic and clinical/exploration and medical history; quality of life, knowledge, self-care and medication adherence/validated questionnaires. Analysis: measures of central tendency and dispersion. Analysis by treatment assignment.

  12. Reasons for delay in decision making and reaching health facility among obstetric fistula and pelvic organ prolapse patients in Gondar University hospital, Northwest Ethiopia.

    Adefris, Mulat; Abebe, Solomon Mekonnen; Terefe, Kiros; Gelagay, Abebaw Addis; Adigo, Azmeraw; Amare, Selamawit; Lazaro, Dorothy; Berhe, Aster; Baye, Chernet

    2017-08-22

    Obstetric fistula and pelvic organ prolapse remain highly prevalent in sub-Saharan Africa, where women have poor access to modern health care. Women having these problems tend to stay at home for years before getting treatment. However, information regarding the reasons contributing to late presentation to treatment is scarce, especially at the study area. The objective of this study was to assess the reasons whywomen with obstetric fistula and pelvic organ prolapse at Gondar University Hospital delay treatment. A hospital based cross-sectional study was conducted among 384 women. Delay was evaluated by calculating symptom onset and time of arrival to get treatment at Gondar University Hospital. Regression analysis was conducted to elicit predictors of delay for treatment. Of the total 384 participants, 311 (80.9%) had pelvic organ prolapse and 73(19.1%) obstetric fistula. The proportion of women who delayed treatment of pelvic organ prolapse was 82.9% and that of obstetric fistula 60.9%. Fear of disclosing illness due to social stigma (AOR = 2; 1.03, 3.9) and lack of money (AOR = 1.97; 1.01, 3.86) were associated with the delay of treatment for pelvic organ prolapse,while increasing age (AOR =1.12; 1.01, 1.24) and divorce (AOR = 16.9; 1.75, 165.5) were were responsible for delaying treatment forobstetric fistula. A large numberof women with pelvic organ prolapse and obstetric fistula delayed treatment. Fear of disclosure due to social stigma and lack of moneywere the major factors that contributed to thedelay to seek treatment for pelvic organ prolapse,while increasing age and divorce were the predictors for delaying treatment for obstetric fistula.

  13. Benign breast diseases: experience at isra university hospital, hyderabad, pakistan

    Memon, W.; Mannan, A.; Gilani, R.

    2017-01-01

    To determine the frequency of Benign Breast Disease (BBD) in Isra University Hospital Hyderabad. Methodology: This prospective, descriptive study was carried out at Isra University Hospital Hyderabad, Pakistan from January 2014 and January 2016. Data including age, presenting complaints, clinical examination, histopathological examination and treatment given were all collected from patients presenting in surgery department with breast complaints and recorded. All patients with breast malignancy and trauma of breast were excluded from the study. Data were analyzed using SPSS v. 17. Results: A total of 105 patients with benign breast disease admitted during the study period. Mean age of patients was 30 years (range 13-65). Fibroadenoma was the most common diagnosis in 45(42%), followed by fibrocystic disease 25(23%), breast abscesses 15(14%), sebaceous cyst 10(9.5%), duct ectasia 4(3.8%) and Phylloides 2(1.9%) cases. Conclusion: Fibroadenoma was the most common BBD followed by fibrocystic disease with presentation of either discrete mass or mastalgia. (author)

  14. Duration of hospital stay following orthognathic surgery at the jordan university hospital.

    Jarab, Fadi; Omar, Esam; Bhayat, Ahmed; Mansuri, Samir; Ahmed, Sami

    2012-09-01

    Major oral and maxillofacial surgery procedures have been routinely performed on an inpatient basis in order to manage both, the recovery from anesthesia and any unpredictable morbidity that may be associated with the surgery. The use of inpatient beds is extremely expensive and if the surgical procedures could be done on an outpatient setting, it would reduce the costs and the need for inpatient care. The aim was to determine the length of hospital stay (LHS) and the factors which influence the LHS following orthognathic surgery at the Jordan University Hospital over 5 years (2005-2009). This was a retrospective record review of patients who underwent orthognathic surgery at Jordan University Hospital between 2005 and 2009. The variables were recorded on a data capture form which was adapted and developed from previous studies. Descriptive and analytical statistical methods were used to correlate these variables to the LHS. Ninety two patients were included in the study and 74% of them were females. The mean age was 23.7 years and the mean LHS was 4 days. The complexity of the procedure, length of operation time, intensive care unit (ICU) stay and year of operation were significantly correlated with a positive LHS (P LHS over the progressing years and this could be due to an increase in experience and knowledge of the operators and an improvement in the hospital facilities.

  15. Frequency of CT studies performed in pediatric patients in the Canary University Hospital in the period 2005-2010; Frecuencia de los estudios de tomografia computerizada a pacientes pediatricos realizados en el hospital universitario de canarias en el periodo 2005-2010

    Hdez Armas, O.; Glez Martin, A.; Bethencourt Pana, A.; Catalan Acosta, A.; Hdez Armas, J.

    2011-07-01

    This paper provides data for the number and diversity of computerized tomography scans performed on pediatric patients (<15 years) at the University Hospital of Tenerife (UHT), Canary Islands. The analysis of the frequency and trends of these medical procedures will make comparisons with the medical use of CT in other parts of Spain and the world.

  16. Reference levels at diagnosis (NRD) for explorations in TC of the university Hospital Donostia

    Iriondo Igerabide, U.; Puertolas Hernandez, J. R.; Masso Odriozola, A.; Alonso Espinaco, M. t.; Pino Leon, C.; Lozano Flores, F. J.; Larretxea Etxarri, R.

    2013-01-01

    The objective of this work is the establishment of diagnostic reference levels in TC, for the anatomical regions, in the University Hospital Donostia, in order to reduce the dose to patients and without prejudice to the required diagnosis. (Author)

  17. The Use of Operational Excellence Principles in a University Hospital.

    Edelman, Eric R; Hamaekers, Ankie E W; Buhre, Wolfgang F; van Merode, Godefridus G

    2017-01-01

    The introduction of Operational Excellence in the Maastricht University Medical Center (MUMC+) has been the first of its kind and scale for a university hospital. The policy makers of the MUMC+ have combined different elements from various other business, management, and healthcare philosophies and frameworks into a unique mix. This paper summarizes the journey of developing this system and its most important aspects. Special attention is paid to the role of the operating rooms and the improvements that have taken place there, because of their central role in the working of the hospital. The MUMC+ is the leading tertiary healthcare center for the South-East region of The Netherlands and beyond. Regional, national, and international developments encouraged the MUMC+ to start significantly reorganizing its care processes from 2009 onward. First experiments with Lean Six Sigma and Business Modeling were combined with lessons learned from other centers around the world to form the MUMC+'s own type of Operational Excellence. At the time of writing, many improvement projects of different types have been successfully completed. Every single department in the hospital now uses Operational Excellence and design thinking in general as a method to develop new models of care. An evaluation in 2014 revealed several opportunities for improvement. A large number of projects were in progress, but 75% of all projects had not been completed, despite the first projects being initiated back in 2012. This led to a number of policy changes, mainly focusing on more intensive monitoring of projects and trying to do more improvement projects directly under the responsibility of the line manager. Focusing on patient value, continuous improvement, and the reduction of waste have proven to be very fitting principles for healthcare in general and specifically for application in a university hospital. Approaching improvement at a systems level while directly involving the people on the work

  18. The Use of Operational Excellence Principles in a University Hospital

    Eric R. Edelman

    2017-07-01

    Full Text Available The introduction of Operational Excellence in the Maastricht University Medical Center (MUMC+ has been the first of its kind and scale for a university hospital. The policy makers of the MUMC+ have combined different elements from various other business, management, and healthcare philosophies and frameworks into a unique mix. This paper summarizes the journey of developing this system and its most important aspects. Special attention is paid to the role of the operating rooms and the improvements that have taken place there, because of their central role in the working of the hospital. The MUMC+ is the leading tertiary healthcare center for the South-East region of The Netherlands and beyond. Regional, national, and international developments encouraged the MUMC+ to start significantly reorganizing its care processes from 2009 onward. First experiments with Lean Six Sigma and Business Modeling were combined with lessons learned from other centers around the world to form the MUMC+’s own type of Operational Excellence. At the time of writing, many improvement projects of different types have been successfully completed. Every single department in the hospital now uses Operational Excellence and design thinking in general as a method to develop new models of care. An evaluation in 2014 revealed several opportunities for improvement. A large number of projects were in progress, but 75% of all projects had not been completed, despite the first projects being initiated back in 2012. This led to a number of policy changes, mainly focusing on more intensive monitoring of projects and trying to do more improvement projects directly under the responsibility of the line manager. Focusing on patient value, continuous improvement, and the reduction of waste have proven to be very fitting principles for healthcare in general and specifically for application in a university hospital. Approaching improvement at a systems level while directly involving the

  19. Second hip fractures at Chiang Mai University Hospital.

    Wongtriratanachai, Prasit; Chiewchantanakit, Siripong; Vaseenon, Tanawat; Rojanasthien, Sattaya; Leerapun, Taninnit

    2015-02-01

    Hip fractures are a major public health problem. Patients who have suffered a hip fracture have an increased risk of a subsequent hip fracture. This study examines the incidence ofsecondhip fractures and attempts to identify underlying risk factors. To examine the incidence ofsecond hip fractures in osteoporotic patients at Chiang Mai University Hospital and to identify risk factors related to second hip fractures. A retrospective review was conducted of all low-energy mechanism hip fracture patients admitted during 2008 and 2009. Analysis of second hip fractures was conducted using survival analysis and logistic regression analysis. A total of 191 patients were observed for 391.68 person-years (mean 2.05 person-years per patient). Among that group, nine second hip fractures were identified, an overall incidence rate of 0.023 second fractures per person-year. Second hip fractures tended to occur within the first year following an initial hip fracture. There were no significant differences related to either gender or comorbid medical conditions. Logistic regression analysis revealed that increased risk of a second hip fracture was associated with age (highest between 80 to 89 years) and patients who were not treated for osteoporosis following their initial fracture. The incidence of second hip fractures at Chiang Mai University Hospital was 0.023 per person-year Careful follow-up of older patients, especially those over 80, and treatment ofosteoporosis with bisphosphonate plus vitamin D and calcium supplements was correlated with a reduction in the incidence of second hip fractures.

  20. Hospitality Major Vocational High School Students' Expectations on University Education

    Chung, Ya-Ting; Yang, Cheng-Cheng

    2013-01-01

    Hospitality is not a new industry in Asia, but high quality hospitality industry has become more and more important in the trend of questing service-based economy and the increasing number of tourists in Asia. Thus there are more universities opened hospitality degree programs in Asia, Taiwan is no exception. In this context, why high school…

  1. [Respect of patient's dignity in the hospital].

    Duguet, A-M

    2010-12-01

    Every code of ethics of health professionals in France considers the respect of dignity as a fundamental duty. The French 2002 Law on patient rights says that the person has the right to respect of dignity and of private life. After a presentation of the articles of ethics codes regarding dignity, this paper presents recommendations to deliver medical care in situations where dignity might be endangered such as for patients hospitalized in psychiatric services without consent, or for medical examination of prisoners or medical care to vulnerable patients unable to express their will, especially in palliative care or at the end of life. Respect of dignity after death is illustrated by the reflection conducted by the Espace Ethique de l'AP-HP (Paris area hospitals) and in the Chart of the mortuary yard. A survey of the patients' letters of complaint received by the emergency service of the Toulouse University Hospital showed that, in five years, there were 188 letters and 18 pointed out infringements to the dignity of the person. The health professional team is now aware of this obligation, and in the accreditation of the hospitals, the respect of dignity is one of the indicators of the quality of medical care.

  2. Skin cancer patients profile at faculty of medicine university of North Sumatera pathology anatomy laboratory and Haji Adam Malik general hospital in the year of 2012-2015

    Sembiring, E. K.; Delyuzar; Soekimin

    2018-03-01

    The most common types of skin cancer found worldwide are basal cell carcinoma, squamous cell carcinoma, and malignant melanoma. In America, about 800,000 people suffer from skin cancer every year and 75% are basal cell carcinoma. According to WHO, around 160,000 people suffer from malignant melanoma every year and 48,000 deaths were reported every year. In Jakarta, in 2000-2009, dr. CiptoMangunkusumo Hospital (RSCM) reported 261 cases of basal cell carcinoma, followed by 69 cases of squamous cell carcinoma and 22 cases of malignant melanoma.This study was descriptive study with retrospective design and consecutive sampling method. Data consisted of age, gender, tumor location, occupation and histopathology subtype which were taken from skin cancer patients’ medical record at Faculty of Medicine University of North Sumatera Pathology Anatomy Laboratory and Haji Adam Malik General Hospital Medan in 2012-2015. Data were analyzed using SPSS program and classified based on WHO. From 92 study subjects, squamous cell carcinoma is the most common form of skin cancer which is 59 cases (64.13%), found in 48 women (52.2%), and often found between 45-47 years old (30.4%).

  3. KAMEDO report No. 93-the power failure at Karolinska University Hospital, Huddinge, 07 April 2007.

    Angantyr, Lars-Göran; Häggström, Eskil; Kulling, Per

    2009-01-01

    A sudden and extensive power failure occurred at Karolinska University Hospital in Huddinge on Easter Saturday, 07 April 2007. The power failure lasted one hour and 22 minutes, but it took a longer time for activities to return to normal. It put many patients at great risk, particularly in the intensive care unit and other departments with critically ill patients. This report details the conditions and response at Karolinska University Hospital during the power failure and provides lessons learned for future events.

  4. Prevalence of depression and anxiety disorders in hospitalized patients at the dermatology clinical ward of a university hospital Prevalência de depressão e ansiedade em pacientes hospitalizados na enfermaria da clínica de dermatologia de um hospital universitário

    Maria Rita Polo Gascón

    2012-06-01

    Full Text Available BACKGROUND: The objective of this study was to estimate the prevalence of depression and anxiety disorders in hospitalized patients at the dermatology ward at a university hospital in São Paulo, Brazil. OBJECTIVE: To assess the prevalence of mood and anxiety disorders in hospitalized patients at the dermatology ward at a university hospital in São Paulo. METHOD: A total of 75 patients, men and women, aged between 18 and 76 years, took part in the research. The study employed a descriptive, cross sectional and correlational method. The data was collected by means of a social demographic questionnaire and the PRIME-MD. RESULTS: It was found that 45.3 percent of the subjects presented with depressive symptoms, and 52 percent presented with symptoms of anxiety and that this survey showed moderate and high significant correlations (pFUNDAMENTOS: O presente estudo teve como objetivo verificar a freqüência de depressão e ansiedade em pacientes internados na Divisão da Clínica de Dermatologia de um hospital universitário de São Paulo. OBJETIVO: Avaliar a prevalência de depressão e ansiedade em pacientes hospitalizados na enfermaria da clínica de dermatologia de um hospital universitário em São Paulo. MÉTODO: Participaram da pesquisa 75 sujeitos, homens e mulheres, entre 18 e 76 anos. O delineamento do estudo foi transversal e descritivo. Os instrumentos utilizados foram Entrevista Sócio Demográfica e PRIME-MD. RESULTADOS: Identificou-se a presença de depressão em 45,3% e de ansiedade em 52% dos pacientes avaliados. CONCLUSÃO: Verificou-se correlação moderada e altamente significativa (p<0,01; r =0,616 para os índices de depressão e ansiedade, que pode evidenciar a relação entre adoecimento físico e psíquico muito encontrada na literatura.

  5. Knowledge about diabetes mellitus of patients treated at interdisciplinary ambulatory program of a public university hospital Conhecimento sobre diabetes mellitus de pacientes atendidos em programa ambulatorial interdisciplinar de um hospital universitário público

    Maria Helena D. Menezes Guariente

    2008-10-01

    Full Text Available As diabetes mellitus (DM is a disease that needs changes that last a life time, an educational action is necessary to instruct and make the diabetic aware of the importance of his/her knowledge about the disease as an integral part of the care. The purpose of this research is to evaluate the knowledge acquired by the diabetic treated at an interdisciplinary ambulatory about themes related to DM and compare these results with those obtained in a study with the same purpose carried out in 1995 when discouraging results were obtained, leading to a methodological alteration of the educational activity. This is a descriptive study in the qualitative approach carried out with patients treated at an interdisciplinary ambulatory of a public university hospital. The subjects that took part in this study were ten diabetic selected by asystematic sampling. Data were obtained by means of an audio-taped semi-structured interview. The interview questions consisted of themes concerning knowledge acquired about the DM, medication therapy, nutrition, self-monitoring, physical activity and body care. The interviewees showed good knowledge of diabetes mellitus, medication therapy, nutrition and the importance of physical activity. Self-monitoring was mentioned as necessary for the glycemic control and insulin scheme readjustment. Feet care was the most mentioned activity regarding body care. Knowledge about the questioned theme was greater than that of the study carried out previously. It was concluded that, after the educational activity alteration, patients became more aware about their disease, highlighting the importance of health education for the DM control. Como o diabetes mellitus (DM é uma doença que necessita de mudanças que duram para toda a vida, torna-se necessária uma ação educativa para instruir e conscientizar o diabético da importância do seu conhecimento sobre a doença como parte integral do cuidado. Tem-se como objetivo nesta pesquisa

  6. Profundization of acetabular cup uncemented in total substitution of hip in-patient with acetabular dysplasia - Experience university hospital - Clinica San Rafael

    Dimian Mayorga, Omar David; Sandoval Daza, Alejandro; Vargas Turriago, Marcela; Perez Torres, Javier

    2005-01-01

    14 patients with acetabular dysplasia were treated at Hospital Universitario Clinica San Rafael with total hip arthroplasty with uncemented cup internization. According to Crowe classification, one was type 1, eight were type 2 and five were type 3. The average follow up was twenty-four months. The Harris hip score was used for the clinical evaluation with a pre operative average of 35 points and 37 points post operative. The average cup internization was four millimeters, with an average cup protrutio of 47% and an average of cup coverage of 81%. The average internization of the femoral head's center was 26mm. screws for cup fixation were used in 3 patients. We did not have complications nor implant revision at the time of follow up

  7. [Retrospective study of neuromeningeal cryptococcosis in patients infected with HIV in the infectious diseases unit of university hospital of Casablanca, Morocco].

    Dollo, I; Marih, L; El Fane, M; Es-Sebbani, M; Sodqi, M; Oulad Lahsen, A; Chakib, A; El Kadioui, F; Hamdani, A; El Mabrouki, M J; Soussi Abdallaoui, M; Karima, Z; Hassoune, S; Maaroufi, A; Marhoum El Filali, K

    2016-12-01

    To report the cases of neuromeningeal cryptococcosis and to describe the clinical, paraclinical, therapeutic and outcomes of patients. Retrospective study of 43 patients infected with HIV admitted from January first 2010 to June 30th 2015 in the infectious disease unit of UHC Ibn Rochd, for neuromeningeal cryptococcus. The mean frequency of neuromeningeal cryptococcosis in patients infected with HIV was 1.4%. The mean age was 39 years and a sex ratio of 1.38. The mean CD4 count was 70 cells/mm 3 . The diagnosis of HIV was revealed by neuromeningeal cryptococcus in 77% of cases. Fifteen days interval was reported between the first symptom and hospital admission. Headache (77%) was the most represented clinical sign. The cerebrospinal fluid analysis showed hypoglycorachy (67%), hyperproteinorachy (65%) and lymphocytosis (63%). Chinese ink direct examination for Cryptococcus neoformans in CSF was positive in 86% of cases and all cases were positive after culture on Sabouraud's medium. Patients were treated with monotherapy amphotericin B (42%) or fluconazole (28%) and bitherapy amphotéricine B/fluconazole (28%). Fatal evolution was observed in 60% of cases. Neuromeningeal cryptococcosis remains a severe opportunistic infection in HIV patients with a heavy mortality rate. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  8. The Prevalence of Hepatitis C Virus (HCV) among Lichen Planus Patients and Its Clinical Pattern at the University of Abuja Teaching Hospital (U.A.T.H), Gwagwalada, Abuja, Nigeria

    Bob, Ukonu Agwu; Augustine, Uhunmwangho

    2012-01-01

    Objective: The relationship between hepatitis C virus and Lichen Planus have been widely reported in the literature; although there are wide geographical variations in the reported prevalence of hepatitis C virus infection in patients with lichen planus. This study seeks to determine the prevalence of hepatitis C virus among lichen planus patients and its clinical morphological type in the University of Abuja Teaching Hospital, Gwagwalada Abuja, Nigeria. Materials/Methods: This study was conducted between January 2010 and December, 2011 at the out patients Dermatological unit of the department of medicine at the University of Abuja Teaching Hospital Gwagwalada Abuja, Nigeria. Consecutive patients who had body eruptions suspected to be lichen planus were recruited and histology done for confirmation. The control group included patients’ relations and some dermatology patients known to have low risk of hepatitis C virus infection and liver function tests done for both subjects and control after obtaining oral consent from them to participate in the study. Result: Anti- HCV antibodies were detected in nine cases (21.4%) and one case (3.3%) in the control group. This was statistically significant difference between the HCV antibody among the subject and control group (Plichen planus was the most frequent clinical type. Liver function test was not statistically significant among the subject and control group. Conclusion: Lichen planus and Hepatitis C virus appear to have a relationship and the prevalence rate was higher among the subject as compared to the control group in our environment. PMID:22980383

  9. Profile of patients submitted to gastroplasty in the university hospital of Maringá - Paraná State during 2008-2009 - doi: 10.4025/actascihealthsci.v35i2.12019

    Kazuyuki Hashimoto

    2013-06-01

    Full Text Available This study evaluated the profile of patients submitted to gastroplasty in the University Hospital of Maringá during 2008-2009. Clinical charts were analyzed to obtain clinical and laboratory data of all patients with morbid obesity submitted to gastroplasty. During the study period, 28 surgeries were performed, 57% of the patients lived in Maringá, 82% female, 40 years average age, with mean body mass index (BMI of 46.7kg m-2. It was verified that 39% of the patients maintained an usual non-hypocaloric diet, 25% had quoted dietary reeducation, 36% were sedentary, and 29% practiced some physical activity, and remaining 1/3 of patients presented no data about lifestyle. Regarding associated pathologies, 79% were hypertensive, and 71% of patients presented fasting glucose above 100 mg dL-1, but only 12 of them had diagnosis of Type 2 diabetes mellitus. The hospital stay length was 4 days for 89% of the patients, and 11% had surgery complications. In this group of subjects, there was a clear preponderance of females and high prevalence of other pathologies. Identifying the profile of obese patients contributes to more effective decision-making and emphasizes the crucial role of multidisciplinary approach to health promotion and prevention of early and late complications of morbid obesity and gastroplasty.

  10. The prevalence and severity of non-carious cervical lesions in a group of patients attending a university hospital in Trinidad.

    Smith, W A J; Marchan, S; Rafeek, R N

    2008-02-01

    Non-carious cervical lesions (NCCLs) are often encountered in clinical practice and their aetiology attributed to toothbrush abrasion, erosion and tooth flexure. This paper aims to determine the prevalence and severity of NCCLs in a sample of patients attending a university clinic in Trinidad and to investigate the relationship with medical and dental histories, oral hygiene practices, dietary habits and occlusion. Data were collected via a questionnaire and clinical examination. Odds ratios were used to determine the association of the presence of lesions and the factors examined. One hundred and fifty-six patients with a mean age of 40.6 years were examined of whom 62.2% had one or more NCCLs. Forty five per cent of the lesions were sensitive to compressed air. Younger age groups had a significantly lower correlation with the presence of NCCLs than older age groups. Other significant factors included patients who reported heartburn, gastric reflux, headaches, bruxism, sensitive teeth and swimming or had a history of broken restorations in the last year. There was also significant correlation of NCCLs in patients who brushed more than once a day or used a medium or hard toothbrush. Patients with vegetarian diets and those who reported consuming citrus fruits, soft drinks, alcohol, yoghurt and vitamin C drinks were associated with the presence of lesions. Significant associations were also found in patients with group function, faceting, clicking joints or those who wore occlusal splints.

  11. Financial Analysis of National University Hospitals in Korea.

    Lee, Munjae

    2015-10-01

    This paper provides information for decision making of the managers and the staff of national university hospitals. In order to conduct a financial analysis of national university hospitals, this study uses reports on the final accounts of 10 university hospitals from 2008 to 2011. The results of comparing 2008 and 2011 showed that there was a general decrease in total assets, an increase in liabilities, and a decrease in total medical revenues, with a continuous deficit in many hospitals. Moreover, as national university hospitals have low debt dependence, their management conditions generally seem satisfactory. However, some individual hospitals suffer severe financial difficulties and thus depend on short-term debts, which generally aggravate the profit and loss structure. Various indicators show that the financial state and business performance of national university hospitals have been deteriorating. These research findings will be used as important basic data for managers who make direct decisions in this uncertain business environment or by researchers who analyze the medical industry to enable informed decision-making and optimized execution. Furthermore, this study is expected to contribute to raising government awareness of the need to foster and support the national university hospital industry.

  12. Sexual harassment against nursing staff in Tanta University Hospitals, Egypt.

    Abo Ali, Ehab A; Saied, Shimaa M; Elsabagh, Hala M; Zayed, Hanaa A

    2015-09-01

    Sexual harassment against nurses is a major workplace problem causing adverse psychological effects and may affect the occupational performance of the nurses. This study aimed to assess the magnitude of this problem, and its characteristics and consequences among the nursing staff in Tanta University Hospitals, Gharbeia Governorate, Egypt. A descriptive cross-sectional study was carried out on 430 nurses at Tanta University Hospitals using a semistructured, self-administered questionnaire to collect the data concerning the exposure and characteristics of harassment situations. A representative sample of the nurses was taken randomly from the emergency, medical and surgical departments. Overall, 70.2% of the studied nurses were ever exposed to sexual harassment at the workplace; 43.7% of the harassed nurses were working in both day and night shifts. Staring in a suggestive manner emerged as the most common form of harassment, followed by hearing sexual words and comments or jokes (70.9, 58.6 and 57.3%, respectively). The relatives of the patients were the most common perpetrators, followed by the hospital staff other than the doctors (61.9, 45.4%, respectively). During the harassment situation, astonishment and shock were the most frequent responses in 65.2% of the harassed nurses, while after its occurrence 38.4% ignored the situation. About 95% of the harassed nurses were left with psychological effects, mostly in the form of disappointment and depression (76.5 and 67.9%, respectively). The prevalence of sexual harassment among nurses at the workplace was high with relation to certain occupational factors, and it led to marked psychological effects on the victims. Hence, protective legislations and measures should be taken by the hospital management for prevention of this problem in the future.

  13. Occupational Accidents among Clinical Staff of Tabriz University Hospitals

    Leila Sahebi

    2015-07-01

    Full Text Available ​Background and Objectives : Occupational health and safety is one of the most important issues in the workplace. The purpose of this study was to explore the one –year prevalence of occupational accidents in Tabriz University hospitals. Materials and Methods : A cross-sectional study was conducted on 400 patients of seven university hospitals using researcher made questionnaire. The hospitals were selected based on their specialty of the service. Then, one hospital was selected from each specialty using random selection method. Univariate and multiple regression analyses were employed. The SPSS version 19 was used for data analysis. Results : The one-year prevalence of workplace accident was %21. Women were encountered in workplace accidents more than men (%31.1 vs. % 26.8. The youngest age group (20-30 years experienced the most workplace accidents (%41.5. Carelessness was the main cause of the workplace accidents (%49.3. Reporting rate of the occupational accidents was% 48.3 and the most common cause for not reporting was the fear of being recognized as a less competent individual. Sick leaves due to the severity of the accident was reported %23 (median: 5 days. Over %90 of the accident victims had experienced severe stress and job pressure within the previous year. In multiple regression models, the young staff (20-30 years with severe stress, job pressure and verbal violence victim had more chance of workplace accident.   Conclusion : In addition to the high prevalence of workplace accidents, intensity and consequences of workplace accidents should be considered as well. Providing appropriate methods including prevention of accidents and education of safety along with the assistance of technical staff, managers and attendants would be helpful.

  14. Patient referral patterns and the spread of hospital-acquired infections through national health care networks.

    Tjibbe Donker

    2010-03-01

    Full Text Available Rates of hospital-acquired infections, such as methicillin-resistant Staphylococcus aureus (MRSA, are increasingly used as quality indicators for hospital hygiene. Alternatively, these rates may vary between hospitals, because hospitals differ in admission and referral of potentially colonized patients. We assessed if different referral patterns between hospitals in health care networks can influence rates of hospital-acquired infections like MRSA. We used the Dutch medical registration of 2004 to measure the connectedness between hospitals. This allowed us to reconstruct the network of hospitals in the Netherlands. We used mathematical models to assess the effect of different patient referral patterns on the potential spread of hospital-acquired infections between hospitals, and between categories of hospitals (University medical centers, top clinical hospitals and general hospitals. University hospitals have a higher number of shared patients than teaching or general hospitals, and are therefore more likely to be among the first to receive colonized patients. Moreover, as the network is directional towards university hospitals, they have a higher prevalence, even when infection control measures are equally effective in all hospitals. Patient referral patterns have a profound effect on the spread of health care-associated infections like hospital-acquired MRSA. The MRSA prevalence therefore differs between hospitals with the position of each hospital within the health care network. Any comparison of MRSA rates between hospitals, as a benchmark for hospital hygiene, should therefore take the position of a hospital within the network into account.

  15. Prospective Audit of Colonoscopy Practice in a Lebanese University Hospital

    Rita Slim

    2008-01-01

    Full Text Available Background Colonoscopy has a great impact on diagnosis and management of the diseases of the colon. In general it's a safe and accurate procedure. No evaluation has been done of any endoscopic practices in a country where the practice of medicine is totally private. Objectives Prospective audit of technical success and complication rates of both therapeutic and diagnostic colonoscopy. Setting One endoscopy unit of a Lebanese university hospital. Patients and design 407 consecutive colonoscopies were evaluated over a 6-month period. Data were recorded for age and sex of the patients, indication of the colonoscopy, presence of comorbidities, patients risk stratification, administrated dose of anesthetic drugs. Data concerning the procedure itself were also monitored. Intervention Completion rate as well as complications reported during or post colonoscopy. All patients were called back by phone 48 hours and 1 month later to identify any related post-procedural complication. Results 407 patients underwent colonoscopy. All patients were sedated with midazolam, propofol and fentanyl. The overall caecal intubation rate was 99.99%. 70 snare polypectomies and 29 cold forceps excision were performed as well as 5 coagulations with Argon Plasma Coagulation. The most important post-procedural complication was chemical colitis in 2 cases. Limitations Patients and endoscopists satisfaction was not evaluated. It's an audit of a single tertiary French affiliated hospital. It does not necessarily reflect what's really happening on a national level. Conclusion This audit enabled us to change some of our practices; i.e. rinsing method of endoscopes. It stimulated the team to keep a high performance level without neglecting the risk of potential complications.

  16. Paroxysmal nocturnal haemoglobinuria at Oslo University Hospital 2000-2010.

    Nissen-Meyer, Lise Sofie H; Tjønnfjord, Geir E; Golebiowska, Elzbieta; Kjeldsen-Kragh, Jens; Akkök, Çiğdem Akalın

    2015-06-16

    Paroxysmal nocturnal haemoglobinuria (PNH) is a rare haematological disease characterised by chronic haemolysis, pancytopenia and venous thrombosis. The condition is attributable to a lack of control of complement attack on erythrocytes, thrombocytes and leukocytes, and can be diagnosed by means of flow cytometry. In this quality assurance study, we have reviewed information from the medical records of all patients tested for PNH using flow cytometry at our laboratory over a ten-year period. In the period 2000-2010 a total of 28 patients were tested for PNH using flow cytometry at the Department of Immunology and Transfusion Medicine, Oslo University Hospital. We have reviewed the results of these examinations retrospectively together with information from medical records and transfusion data for the patients concerned. Flow cytometry identified 22 patients with PNH: four with classic disease and 18 with PNH secondary to another bone marrow disease. Five patients had atypical thrombosis. Seventeen patients received antithymocyte globulin or drug treatment; of these, six recovered from their bone marrow disease, while six died and five had a need for long-term transfusion. Five patients with life-threatening bone marrow disease underwent allogeneic stem cell transplantation, three of whom died. Six of 22 patients received eculizumab; the need for transfusion has been reduced or eliminated in three patients treated with eculizumab over a longer period. Flow cytometry identified PNH in a majority of patients from whom we obtained samples. Most patients had a PNH clone secondary to bone marrow failure. Atypical thrombosis should be borne in mind as an indication for the test. Treatment with eculizumab is relevant for selected patients with PNH.

  17. [MEOPA use practices in a university hospital: Which conformity?

    Victorri-Vigneau, Caroline; Paille, Cécile; Joyau, Caroline; Veyrac, Gwenaëlle; Cosset, Claire; Le Pelletier, Aline; Jolliet, Pascale; Nizard, Julien; Kuhn, Emmanuelle

    2017-12-01

    MEOPA (equimolar mixture of oxygen and nitrous oxide) is used for its analgesic and anxiolytic properties in order to obtain conscious sedation of the patient when performing painful care. It is subject to an enhanced pharmacovigilance and addictovigilance monitoring. In this context, it is important to dispose of hospital utilization data. This work aims to assess the compliance of the use of nitrous oxide regarding the recommendations of the summary of product characteristics, in a French university hospital (Nantes) and consider possible improvements. Transversal descriptive study, conducted in 2014 with all health professionals using MEOPA. Two thousand thirty-four health professionals answered the questionnaire ; durations of administrations are in conformity and the premises are generally appropriate but almost 60% of professionals have the feeling of inhaling the drug. The systematization of the prescription (always or almost always prescribed for 67% of professionals) and traceability of use (always or almost always in the patient's file for 71% of professionals) are potential source of improvement, particularly since 18% of professional health reported "abuse demands" from patients. The formation and information of health professionals are major issues of good use of nitrous oxide. Copyright © 2017 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

  18. Bioethics and University: The University Hospital, Private or Public Institution?

    José Nel Carreño R., MD, esp.

    2007-12-01

    Full Text Available In order to acquire a real and useful knowledgeof medicine, the practice in the hospital setting is indispensable. Public, former charity hospitals have been the scenary for student practice. In a paternalistic model of medicine this was understandable.Nevertheless now that the model has changed to a more respectful of autonomy and justice this discrimination appears as unethical. There are no real reasons to discriminate educationin such a way. Medical education should happen in both the public and private sector.

  19. [Satisfaction of hospitalized patients in a hospital in Apurimac, Peru].

    Sihuin-Tapia, Elsa Yudy; Gómez-Quispe, Oscar Elisban; Ibáñez-Quispe, Vladimiro

    2015-01-01

    In order to determine the satisfaction of hospitalized patients in the Sub-regional Hospital of Andahuaylas, 175 patients were surveyed using the Servqual multidimensional model. The estimate of variables associated with the satisfaction of the hospitalized patients was performed by using bivariate and multivariate logistic regression analysis. We found 25.0% satisfaction. Lower levels of satisfaction were associated with having a secondary level education (aOR: 0.05; 95% CI: 0.01 to 0.64) and with having been hospitalized in the surgery department (aOR 0.14, CI: 95%: 0.04 to 0.53). It was concluded that there was a low level of satisfaction with the quality of care received by hospitalized patients and this was associated with the level of education and type of hospital department.

  20. [Drug supply chain safety in hospitals: current data and experience of the Grenoble university hospital].

    Bedouch, P; Baudrant, M; Detavernier, M; Rey, C; Brudieu, E; Foroni, L; Allenet, B; Calop, J

    2009-01-01

    Drug supply chain safety has become a priority for public health which implies a collective process. This process associates all health professionals including the pharmacist who plays a major role. The objective of this present paper is to describe the several approaches proven effective in the reduction of drug-related problem in hospital, illustrated by the Grenoble University Hospital experience. The pharmacist gets involved first in the general strategy of hospital drug supply chain, second by his direct implication in clinical activities. The general strategy of drug supply chain combines risk management, coordination of the Pharmacy and Therapeutics Committee, selection and purchase of drugs and organisation of drug supply chain. Computer management of drug supply chain is a major evolution. Nominative drug delivering has to be a prior objective and its implementation modalities have to be defined: centralized or decentralized in wards, manual or automated. Also, new technologies allow the automation of overall drug distribution from central pharmacy and the implementation of automated drug dispensing systems into wards. The development of centralised drug preparation allows a safe compounding of high risk drugs, like cytotoxic drugs. The pharmacist should develop his clinical activities with patients and other health care professionals in order to optimise clinical decisions (medication review, drug order analysis) and patients follow-up (therapeutic monitoring, patient education, discharge consultation).

  1. Risk factors for recurrent hospital-acquired Clostridium difficile infection in a Japanese university hospital

    Hikone M

    2015-07-01

    Full Text Available Mayu Hikone,1 Yusuke Ainoda,1,2 Sayaka Tago,2 Takahiro Fujita,2 Yuji Hirai,2 Kaori Takeuchi,2 Kyoichi Totsuka31Department of Infectious Diseases, Tokyo Metropolitan Bokutoh General Hospital, 2Department of Infectious Diseases, Tokyo Women's Medical University, 3Department of Internal Medicine, Kitatama Hospital, Tokyo, JapanBackground: Clostridium difficile infection (CDI is a highly prevalent hospital-associated infection. Although most patients respond well to discontinuation of antibiotics, 20%–30% of patients relapse. To initiate early therapeutic measures, the risk factors for recurrent CDI must be identified, although very few Japanese studies have used standard surveillance definitions to identify these risk factors.Methods: We retrospectively reviewed the medical records of patients with health care facility-onset CDI between August 2011 and September 2013. Patients with diarrhea who were positive for Clostridium difficile (via an enzyme immunoassay were defined as having CDI. Clinical data (eg, demographics, comorbidities, medication, laboratory results, and clinical outcomes were evaluated, and multivariate analysis was used to identify risk factors that were associated with recurrent CDI.Results: Seventy-six health care facility-onset CDI cases were identified, with an incidence rate of 0.8 cases per 10,000 patient-days. Fourteen cases (18.4% were recurrent, with 13 patients having experienced a single recurrent episode and one patient having experienced three recurrent episodes. The 30-day and 90-day mortality rates were 7.9% and 14.5%, respectively. Multivariate analysis revealed that recurrent patients were more likely to have underlying malignant disease (odds ratio: 7.98; 95% confidence interval: 1.22–52.2; P=0.03 and a history of intensive care unit hospitalization (odds ratio: 49.9; 95% confidence interval: 1.01–2,470; P=0.049.Conclusion: Intensive care unit hospitalization and malignancy are risk factors for recurrent

  2. Identifying patient risks during hospitalization

    Lucélia Ferreira Lima

    2008-12-01

    Full Text Available Objective: To identify the risks reported at a public institution andto know the main patient risks from the nursing staff point of view.Methods: A retrospective, descriptive and exploratory study. Thesurvey was developed at a hospital in the city of Taboão da Serra, SãoPaulo, Brazil. The study included all nurses working in care areas whoagreed to participate in the study. At the same time, sentinel eventsoccurring in the period from July 2006 to July 2007 were identified.Results: There were 440 sentinel events reported, and the main risksincluded patient falls, medication errors and pressure ulcers. Sixty-fivenurses were interviewed. They also reported patient falls, medicationerrors and pressure ulcers as the main risks. Conclusions: Riskassessment and implementation of effective preventive actions arenecessary to ensure patient’s safety. Involvement of a multidisciplinaryteam is one of the steps for a successful process.

  3. Pelvic Organ Prolapse in Jimma University Specialized Hospital ...

    Pelvic Organ Prolapse in Jimma University Specialized Hospital, Southwest Ethiopia. ... and there was a significant association between prolapse and residence area. ... Awareness creation on risk factors of pelvic organ prolapse and use of ...

  4. Use of seatbelts by vehicle occupants in University College Hospital ...

    Use of seatbelts by vehicle occupants in University College Hospital, Ibadan, Nigeria. AO Sangowawa, SEU Ekanem, BT Alagh, IP Ebong, B Faseru, O Uchendu, BJ Adekunle, VHS Shaahu, A Fajola, GI Ogbole ...

  5. Childhood pneumonia at the University of Ilorin Teaching Hospital ...

    owner

    2013-01-09

    Jan 9, 2013 ... which was significantly higher ... University of Ilorin Teaching Hospital between 1st July ..... two organisms formed more than 40% of the isolates. ... Educational Services; 2007:425-. 41. 3. ... Brazilian children in a metropoli-.

  6. Abdominal Injuries in University of Port Harcourt Teaching Hospital

    operative findings, postoperative complications, and outcome of management. Data analysis was performed using the Statistical Package for Social Sciences version 16. Abdominal Injuries in University of Port Harcourt. Teaching Hospital. Amabra ...

  7. Potential and limits of mammography (Statistical and casuistic investigation of clinically positive, mammographically negative cases among the patients of Goettingen Radiological University Hospital)

    Pforte, A.

    1978-01-01

    In the radiological clinic of the Goettingen University, 23,945 patients were mammographed from 1971 to 1977. For 612 patients with existing clinical findings, a negative radiological finding was established; as for the 202 patients who are dealt with in this paper, in 192 of these cases a histological or cytological clarification was carried out; 10 other cases were observed over a longer period. The average age of the patients examined was 39.7 years. The maximum frequency with regard to the age lies in the 5th life decade with 26.2%. Corresponding to the Goettingen model, the patients examined were assigned to 4 main groups in accordance to their parenchymal structure. In relation to the mamma structure, the clinical finding in 53.9% is hardening and in 46.1% nodes. As for the nodes, most have the size of cherry or plum (21.3%), this is followed by those with the size of beans (13,8%) and lenses (10.9%). A coherence between age and size of the clinical finding cannot be manifested definitely. In nearly half of the cases, the histological or cytological examination revealed a mastopathy (48.9%). In 10.4% a fibroadenoma was found and in 2.1% a carcinoma. In the remaining 32,8% the finding referred to lipomas, mastitis, atypical cells or negative cytological results. Related to the age, mastopathy is dominant in women between 20 and 60 years of age. In women below 20 years, fibroadenomas are dominant, in women in their 7th decade other benign diagnoses which in the 8th decade are of the same frequency as carcinomas. With increasing age, the number of fibroadenomas decreases.

  8. Perspectives of Patients, Doctors and Medical Students at a Public University Hospital in Rio de Janeiro Regarding Tuberculosis and Therapeutic Adherence.

    Elizabeth da Trindade de Andrade

    Full Text Available The World Health Organization (WHO identifies 8.7 million new cases of tuberculosis (TB annually around the world. The unfavorable outcomes of TB treatment prevent the achievement of the WHO's cure target.To evaluate existing intersections in the conceptions relative to the knowledge of TB, the experience of the illness and the treatment.Doctors, medical students and patients were selected from a public university in Rio de Janeiro, Brazil, from 2011 to 2013. The data were obtained by semi-structured individual and focus group interviews, participant observation and a field journal. The inclusion of patients was interrupted due to saturation, and the inclusion of doctors and medical students stopped due to exhaustion. The theoretical background included symbolic Interactionism, and the analysis used rounded Theory. The analysis prioritized the actions/interactions axis.Twenty-three patients with pulmonary TB, seven doctors and 15 medical students were included. In the interviews, themes such as stigma, self-segregation, and difficulties in assistance emerged, in addition to defense mechanisms such as denial, rationalization, isolation and other mental mechanisms, including guilt, accountability and concealment of the disease. Aspects related to the assistance strategy, the social support network, bonding with the healthcare staff and the doctor-patient relationship were highlighted as adherence enablers. Doctors and students recommended an expansion of the theoretical and practical instruction on TB during medical students' education. The existence of health programs and policies was mentioned as a potential enabler of adherence.The main concepts identified were the stigma, self-segregation, guilt, responsibility, concealment and emotional repercussions. In relation to the facilitation of therapeutic adherence, the concepts identified were the bonds with healthcare staff, the doctor-patient relationship, assistance and educational health

  9. Perspectives of Patients, Doctors and Medical Students at a Public University Hospital in Rio de Janeiro Regarding Tuberculosis and Therapeutic Adherence

    de Andrade, Elizabeth da Trindade; Hennington, Élida Azevedo; de Siqueira, Hélio Ribeiro; Rolla, Valeria Cavalcanti; Mannarino, Celina

    2015-01-01

    Introduction The World Health Organization (WHO) identifies 8.7 million new cases of tuberculosis (TB) annually around the world. The unfavorable outcomes of TB treatment prevent the achievement of the WHO’s cure target. Goal To evaluate existing intersections in the conceptions relative to the knowledge of TB, the experience of the illness and the treatment. Methods Doctors, medical students and patients were selected from a public university in Rio de Janeiro, Brazil, from 2011 to 2013. The data were obtained by semi-structured individual and focus group interviews, participant observation and a field journal. The inclusion of patients was interrupted due to saturation, and the inclusion of doctors and medical students stopped due to exhaustion. The theoretical background included symbolic Interactionism, and the analysis used rounded Theory. The analysis prioritized the actions/interactions axis. Results Twenty-three patients with pulmonary TB, seven doctors and 15 medical students were included. In the interviews, themes such as stigma, self-segregation, and difficulties in assistance emerged, in addition to defense mechanisms such as denial, rationalization, isolation and other mental mechanisms, including guilt, accountability and concealment of the disease. Aspects related to the assistance strategy, the social support network, bonding with the healthcare staff and the doctor-patient relationship were highlighted as adherence enablers. Doctors and students recommended an expansion of the theoretical and practical instruction on TB during medical students’ education. The existence of health programs and policies was mentioned as a potential enabler of adherence. Conclusion The main concepts identified were the stigma, self-segregation, guilt, responsibility, concealment and emotional repercussions. In relation to the facilitation of therapeutic adherence, the concepts identified were the bonds with healthcare staff, the doctor-patient relationship

  10. Perspectives of Patients, Doctors and Medical Students at a Public University Hospital in Rio de Janeiro Regarding Tuberculosis and Therapeutic Adherence.

    de Andrade, Elizabeth da Trindade; Hennington, Élida Azevedo; Siqueira, Hélio Ribeiro de; Rolla, Valeria Cavalcanti; Mannarino, Celina

    2015-01-01

    The World Health Organization (WHO) identifies 8.7 million new cases of tuberculosis (TB) annually around the world. The unfavorable outcomes of TB treatment prevent the achievement of the WHO's cure target. To evaluate existing intersections in the conceptions relative to the knowledge of TB, the experience of the illness and the treatment. Doctors, medical students and patients were selected from a public university in Rio de Janeiro, Brazil, from 2011 to 2013. The data were obtained by semi-structured individual and focus group interviews, participant observation and a field journal. The inclusion of patients was interrupted due to saturation, and the inclusion of doctors and medical students stopped due to exhaustion. The theoretical background included symbolic Interactionism, and the analysis used rounded Theory. The analysis prioritized the actions/interactions axis. Twenty-three patients with pulmonary TB, seven doctors and 15 medical students were included. In the interviews, themes such as stigma, self-segregation, and difficulties in assistance emerged, in addition to defense mechanisms such as denial, rationalization, isolation and other mental mechanisms, including guilt, accountability and concealment of the disease. Aspects related to the assistance strategy, the social support network, bonding with the healthcare staff and the doctor-patient relationship were highlighted as adherence enablers. Doctors and students recommended an expansion of the theoretical and practical instruction on TB during medical students' education. The existence of health programs and policies was mentioned as a potential enabler of adherence. The main concepts identified were the stigma, self-segregation, guilt, responsibility, concealment and emotional repercussions. In relation to the facilitation of therapeutic adherence, the concepts identified were the bonds with healthcare staff, the doctor-patient relationship, assistance and educational health strategies.

  11. [Issues related to national university medical schools: focusing on the low wages of university hospital physicians].

    Takamuku, Masatoshi

    2015-01-01

    University hospitals, bringing together the three divisions of education, research, and clinical medicine, could be said to represent the pinnacle of medicine. However, when compared with physicians working at public and private hospitals, physicians working at university hospitals and medical schools face extremely poor conditions. This is because physicians at national university hospitals are considered to be "educators." Meanwhile, even after the privatization of national hospitals, physicians working for these institutions continue to be perceived as "medical practitioners." A situation may arise in which physicians working at university hospitals-performing top-level medical work while also being involved with university and postgraduate education, as well as research-might leave their posts because they are unable to live on their current salaries, especially in comparison with physicians working at national hospitals, who focus solely on medical care. This situation would be a great loss for Japan. This potential loss can be prevented by amending the classification of physicians at national university hospitals from "educators" to "medical practitioners." In order to accomplish this, the Japan Medical Association, upon increasing its membership and achieving growth, should act as a mediator in negotiations between national university hospitals, medical schools, and the government.

  12. Implementation of a radiology information system in an University Hospital

    Marques, Paulo Mazzoncini de Azevedo; Santos, Antonio Carlos; Elias Junior, Jorge; Trad, Clovis Simao; Goes, Wilson Moraes; Castro, Carlos Roberto de

    2000-01-01

    This paper describes a radiology information system (RIS) developed and in the process of implementation in an University Hospital (Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto - Universidade de Sao Paulo) which integrates a plan for a 'filmless' radiology facility. (author)

  13. Interior design criteria for successful hospital patient rooms

    Bilir, Seda

    1997-01-01

    Ankara : The Department of Interior Architecture and Environmental Design and Institute of Fine Arts of Bilkent University, 1997. Thesis (Master's) -- Bilkent University, 1997. Includes bibliographical references leaves 94-99 In this study, the design requirements of hospital acute-care patient rooms, which support the recovery and well-being of the patients, are examined. Patients' psycho-spatial needs which may be complementary to the healing effects of the medical treatme...

  14. [Hypertensive emergencies at the University Hospital Center in Brazzaville, Congo].

    Ellenga, Mbolla B F; Gombet, T R; Mahoungou, Guimbi K C; Otiobanda, G F; Ossou, Nguiet P M; Ikama, M S; Kimbally-Kaky, G; Etitiele, F

    2011-02-01

    The purpose of this retrospective study conducted in the emergency department of the University Hospital Center in Brazzaville, Congo was to determine the prevalence and clinical characteristics of hypertensive emergencies. With a total of 76 patients admitted during the study period, the prevalence of hypertensive emergency was 4%. The sex ratio was 1 and mean patient age was 57.3 years (range, 30 to 80 years). Risk factors included obesity in 62 cases (81.6%), history of hypertension in 65 (85.5%) and low socioeconomic level in 58 (76.3%). Mean delay for consultation was 50 hours (range, 1 to 240 hours). The disease underlying the hypertensive emergency was stroke with 38 cases (50%), heart failure in 20 (26.3%), hypertensive encephalopathy in 11 (14.4%), malignant hypertension in 9 (11.8%), and renal failure in 10 (13.1%). The mean length of emergency treatment was 14.7 hours (range, 5 to 48 hours). Eight deaths (10.5%) occurred during hospitalization in the emergency department.

  15. [The impact of UV radiation B and C in vitro on different of bacteria strains isolated from patients hospitalized in the Warsaw Medical University Clinics].

    Rongies, Witold; Wultańska, Dorota; Kot, Katarzyna; Bogusz, Aleksandra; Rongies, Magdalena; Świercz, Paweł; Swierszcz, Paweł; Lewandowska, Monika; Cholewińska, Grazyna; Meisel-Mikołajczyk, Felicja

    2011-01-01

    Infections in human body caused by various microbes are a significant problem in modern medicine. Special attention is put to infections of wounds, which are a significant threat to the life of patients. Attempts to treat these wounds base mainly on the application of various chemical preparations (locally) and systematic antibiotic treatment. UV radiation, because of its anti-bacterial activity, appear a complementary issue in therapy. AIM OF THE SURVEY: The aim of this study was an examination of the sensitivity of bacteria strains isolated from patients hospitalised in the Warsaw Medical University clinics, and prove that antibiotics and operation of UV B and C radiation with Endolamp 474 may become a complementary or alternative method of treatment. The study used 65 strains grown aerobically (15 strains of Escherichia coli, 20 strains of Pseudomonas aeruginosa, 15 strains of Staphylococcus aureus, 15 strains of Streptococcus and Enterococcus sp). The same strains were planted on different excipients and were subjected to UV radiation using Endolamp 474. Correctly prepared strains were radiated from a 25 cm distance in various durations (from 5 seconds to 105 seconds). As a result of UV irradiation of microorganisms studied B and C using 474 Endolampy received varied, but the great sensitivity to the effects of this radiation, in all tested bacterial strains. UV radiation on microorganisms requires further study, also in vivo.

  16. Health workers' ICT literacy in a Nigerian University Teaching Hospital

    This study investigated the ICT literacy among the health workers of Igbinedion University Teaching Hospital. The emergence of Internet for Telemedicine and health information revolution necessitates that issue of computer and other communication technology literacy among the health workers of Igbinedion University ...

  17. in bingham university teaching hospital, jos

    FOBUR

    neuropore. Two of the paternal cousins of the patient had cleft lip which supports a genetic predisposition. Patient had a multidisciplinary care by the obstetrician, Neonatologist, anesthesiologist and the plastic surgery team who scheduled a soft tissue repair of the upper lip defect, columella and anterior nasal septal defect.

  18. Dental interventions in patients taking anti-resorptive medication for the treatment of osteoporosis and other bone disease: an audit of current practice in the Dublin Dental University Hospital

    Henry, Cian

    2017-11-01

    Medication-related osteonecrosis of the jaws (MRONJ) is a well-established complication of anti-resorptive and, more recently, anti-angiogenic therapy. The dental profession has a pivotal role to play in the prevention and management of this debilitating condition, and all dentists have a responsibility to remain cognisant of national and international best practice guidelines in the prevention of this disease process. The management of patients in the Dublin Dental University Hospital at risk of MRONJ when carrying out dental interventions was audited against nationally- and internationally-published guidelines. The results of the audit showed compliance with the national and international guidance in 5% and 0% of cases, respectively. The most common measures implemented in the management of patients at risk of MRONJ were: preoperative antibiotics in 49% of cases; preoperative chlorhexidine mouthwash in 76%; plain local anaesthetic in 51%; and, post-operative antibiotics in 80%.

  19. Tabagismo entre pacientes internados em um hospital universitário no sul do Brasil: prevalência, grau de dependência e estágio motivacional Smoking among patients hospitalized at a university hospital in the south of Brazil: prevalence, degree of nicotine dependence, and motivational stage of change

    Rafael Balsini Barreto

    2012-02-01

    Full Text Available OBJETIVO: Avaliar a prevalência e o perfil do tabagismo em pacientes internados em um hospital universitário no sul do Brasil. MÉTODOS: Estudo descritivo transversal com pacientes maiores de 18 anos hospitalizados há mais de 24 h no Hospital Universitário da Universidade de Santa Catarina em Florianópolis. Os pacientes foram entrevistados em duas ocasiões distintas. Dados demográficos, socioeconômicos e ligados ao tabagismo foram coletados. RESULTADOS: Foram entrevistados 235 pacientes: 44 (18,7% eram tabagistas; 77 (32,8% eram ex-tabagistas; 114 (48,5% eram não tabagistas e 109 (46,7% eram tabagistas passivos. A média de idade dos fumantes foi de 45,7 ± 15,2 anos, e 29 (65,9% eram do sexo masculino. Entre os fumantes, a mediana da idade de início do tabagismo foi de 15 anos; a carga tabágica média foi de 32 ± 30,2 anos-maço; 36 (81,9% tinham consumo diário de até 20 cigarros; 20 (45,4% tinham grau de dependência à nicotina elevada ou muito elevada; 32 (72,7% já haviam tentado cessar, 39 (88,6% gostariam de cessar, 32 (72,7% aceitariam receber tratamento, 13 (29,5% fumaram durante a internação, e 13 (29,5% apresentaram síndrome de abstinência. Houve um aumento no número de pacientes nos estágios motivacionais de preparação e ação durante a internação (de 31,8% para 54,8%. CONCLUSÕES: A prevalência de tabagismo no estudo foi semelhante à encontrada em outros estudos no Brasil. Os resultados sugerem que nossa amostra foi significativa em relação à população de fumantes hospitalizados, que se encontra motivada à cessação do hábito tabágico durante a hospitalização, necessitando de uma abordagem sistematizada para a cessação.OBJECTIVE: To determine the prevalence and profile of smoking among hospitalized patients at a university hospital in the south of Brazil. METHODS: This was a descriptive cross-sectional study involving patients over 18 years of age hospitalized for over 24 h at the Federal

  20. Sexuality after hysterectomy at University of Jordan Hospital: a teaching hospital experience.

    Fram, Kamil Mosa; Saleh, Shawqi S; Sumrein, Issa A

    2013-04-01

    This research concentrates on evaluating the sexual activity of the patients after having hysterectomy for benign disorders. This analysis took place at the University of Jordan hospital. The retrospective record was reviewed for over 2 years (from January 2008 to January 2010). The sample of study included a total number of 124 patients with benign disorders who underwent hysterectomy. The sexual life parameters indicate that 93 patients (75 %) felt general improvement in their performance, while 14 patients (11.3 %) complained of having suffered bad performance, 6 patients (4.8 %) noticed no changes, and 11 patients (8.9 %) did not provide any comment. As for the partner's sexual function (as relayed by the patients themselves), 69 patients (55.6 %) felt improvements in their performance and 23 (18.5 %) commented that their partners had bad performance, while 18 patients (14.5 %) noticed no changes and 14 (11.3 %) did not provide any comment. Patients were interviewed by the operating physician each of whom was subjected to an average of half an hour verbal interview after obtaining the prior written consent of the patient. Questionnaire forms were used to record the answers given by each patient. The interview data recorded in the questionnaires were analyzed. The result of these analyses significantly indicated that sexual function is a major cause of women's concern for scheduled hysterectomy. That is because they were influenced by both physiological and psychological factors. Even though the analysis results implied that there was a sizeable minority who evidently suffered a considerably worse outcome, it was recognized that hysterectomy leads to improvement in sexual function and health for the majority of women. Therefore, it is important to spread awareness among women and let them know that most probably they will neither lose their sexual desire after hysterectomy, nor they will lose their feminine shape or style.

  1. Myocardial Revascularization in Dyalitic Patients: In-Hospital Period Evaluation

    Miranda, Matheus; Hossne, Nelson Américo Jr.; Branco, João Nelson Rodrigues; Vargas, Guilherme Flora; Fonseca, José Honório de Almeida Palma da; Pestana, José Osmar Medina de Abreu; Juliano, Yara; Buffolo, Enio

    2014-01-01

    Coronary artery bypass grafting currently is the best treatment for dialytic patients with multivessel coronary disease, but hospital morbidity and mortality related to procedure is still high. Evaluate results and in-hospital outcomes of coronary artery bypass grafting in dialytic patients. Retrospective unicentric study including 50 consecutive and not selected dialytic patients, who underwent coronary artery bypass grafting in a tertiary university hospital from 2007 to 2012. High prevalence of cardiovascular risk factors was observed (100% hypertensive, 68% diabetic and 40% dyslipidemic). There was no intra-operative death and 60% of the procedures were performed off-pump. There were seven (14%) in-hospital deaths. Postoperative infection, previous heart failure, cardiopulmonary bypass, abnormal ventricular function and surgical re-exploration were associated with increased mortality. Coronary artery bypass grafting is feasible to dialytic patients although high in-hospital morbidity and mortality. It is necessary better understanding about metabolic aspects to plan adequate interventions

  2. Myocardial Revascularization in Dyalitic Patients: In-Hospital Period Evaluation

    Miranda, Matheus, E-mail: matheus10miranda@gmail.com; Hossne, Nelson Américo Jr.; Branco, João Nelson Rodrigues; Vargas, Guilherme Flora; Fonseca, José Honório de Almeida Palma da; Pestana, José Osmar Medina de Abreu [Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp), São Paulo, SP (Brazil); Juliano, Yara [Universidade de Santo Amaro, São Paulo, SP (Brazil); Buffolo, Enio [Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp), São Paulo, SP (Brazil)

    2014-02-15

    Coronary artery bypass grafting currently is the best treatment for dialytic patients with multivessel coronary disease, but hospital morbidity and mortality related to procedure is still high. Evaluate results and in-hospital outcomes of coronary artery bypass grafting in dialytic patients. Retrospective unicentric study including 50 consecutive and not selected dialytic patients, who underwent coronary artery bypass grafting in a tertiary university hospital from 2007 to 2012. High prevalence of cardiovascular risk factors was observed (100% hypertensive, 68% diabetic and 40% dyslipidemic). There was no intra-operative death and 60% of the procedures were performed off-pump. There were seven (14%) in-hospital deaths. Postoperative infection, previous heart failure, cardiopulmonary bypass, abnormal ventricular function and surgical re-exploration were associated with increased mortality. Coronary artery bypass grafting is feasible to dialytic patients although high in-hospital morbidity and mortality. It is necessary better understanding about metabolic aspects to plan adequate interventions.

  3. Pelvic organ prolapse in jimma university specialized hospital, southwest ethiopia.

    Akmel, Menur; Segni, Hailemariam

    2012-07-01

    Pelvic organ prolapse is the down ward descent of female organs including the bladder, small and large bowel resulting in protrusion of the vagina, uterus or both. It is a disorder exclusive to women and one of the most common indications for gynecologic surgery. This hospital based retrospective descriptive study was conducted to assess the magnitude of pelvic organ prolapse and risk factors for it. All cases of pelvic organ prolapse admitted and treated in Jimma University Specialized Hospital from July 1, 2008 to June 30, 2011 were included. The collected data were analyzed using SPSS computer software version 16.0. Chi-square test was used and was considered to be significant when presidence area. Farmers accounted for 68.2% of the patients and there was a significant association between prolapse and occupation (p creation on risk factors of pelvic organ prolapse and use of contraception to reduce parity is recommended. Health institution delivery should be advocated to minimize the rate of home deliveries and hence of prolonged labor.

  4. Using business process redesign to reduce wait times at a university hospital in the Netherlands

    Elkhuizen, Sylvia G.; Burger, Matthe P. M.; Jonkers, Rene E.; Limburg, Martien; Klazinga, Niek; Bakker, Piet J. M.

    2007-01-01

    BACKGROUND: Business process redesign (BPR) has been applied to implement more customer-focused and cost-effective care. In 2002, two pilot projects to improve patient care processes for two specific patient groups were conducted at the Academic Medical Center, a 1,000-bed university hospital in

  5. A Computerized Hospital Patient Information Management System

    Wig, Eldon D.

    1982-01-01

    The information processing needs of a hospital are many, with varying degrees of complexity. The prime concern in providing an integrated hospital information management system lies in the ability to process the data relating to the single entity for which every hospital functions - the patient. This paper examines the PRIMIS computer system developed to accommodate hospital needs with respect to a central patient registry, inpatients (i.e., Admission/Transfer/Discharge), and out-patients. Finally, the potential for expansion to permit the incorporation of more hospital functions within PRIMIS is examined.

  6. Patients with worsening chronic heart failure who present to a hospital emergency department require hospital care

    Shafazand Masoud

    2012-03-01

    Full Text Available Abstract Background Chronic heart failure (CHF is a major public health problem characterised by progressive deterioration with disabling symptoms and frequent hospital admissions. To influence hospitalisation rates it is crucial to identify precipitating factors. To characterise patients with CHF who seek an emergency department (ED because of worsening symptoms and signs and to explore the reasons why they are admitted to hospital. Method Patients (n = 2,648 seeking care for dyspnoea were identified at the ED, Sahlgrenska University Hospital/Östra. Out of 2,648 patients, 1,127 had a previous diagnosis of CHF, and of these, 786 were included in the present study with at least one sign and one symptom of worsening CHF. Results Although several of the patients wanted to go home after acute treatment in the ED, only 2% could be sent home. These patients were enrolled in an interventional study, which evaluated the acute care at home compared to the conventional, in hospital care. The remaining patients were admitted to hospital because of serious condition, including pneumonia/respiratory disease, myocardial infarction, pulmonary oedema, anaemia, the need to monitor cardiac rhythm, pathological blood chemistry and difficulties to communicate. Conclusion The vast majority of patients with worsening CHF seeking the ED required hospital care, predominantly because of co-morbidities. Patients with CHF with symptomatic deterioration may be admitted to hospital without additional emergency room investigations.

  7. Auditing the frequency and the clinical and economic impact of testing for Fabry disease in patients under the age of 70 with a stroke admitted to Saint Vincent's University Hospital over a 6-month period.

    Lambe, J; Noone, I; Lonergan, R; Tubridy, N

    2018-02-01

    Fabry disease is an X-linked recessive lysosomal storage disorder that provokes multi-organ morbidity, including early-onset stroke. Worldwide prevalence may be greater than previously estimated, with many experiencing first stroke prior to diagnosis of Fabry disease. The aim of this study is to screen a cohort of stroke patients under 70 years of age, evaluating the clinical and economic efficacy of such a broad screening programme for Fabry disease. All stroke patients under 70 years of age who were entered into the Saint Vincent's University Hospital stroke database over a 6-month period underwent enzyme analysis and/or genetic testing as appropriate for Fabry disease. Patients' past medical histories were analysed for clinical signs suggestive of Fabry disease. Cost-effectiveness analysis of testing was performed and compared to overall economic impact of young stroke in Ireland. Of 22 patients tested for Fabry disease, no new cases were detected. Few clinical indicators of Fabry disease were identified at the time of testing. Broad screening programmes for Fabry disease are highly unlikely to offset the cost of testing. The efficacy of future screening programmes will depend on careful selection of an appropriate patient cohort of young stroke patients with multi-organ morbidity and a positive family history.

  8. Teleradiology and PACS - strategy of the Innsbruck University Hospital

    Vogl, R.

    2005-01-01

    Systems for management of digital imaging data are very important and widespread at the Innsbruck University Hospital and constitute a central component of the IT strategies followed by the hospital operating company TILAK (Tyrolean public hospitals). The particular goal is to integrate all imaging data into the electronic medical records and make these available online to each of the approx. 2500 clinic workstations and ensure electronic data exchange with other healthcare services. Teleradiology connections have been established at the University Clinic for Radiology since 1995; these have been continually expanded and linked to the central PACS. An eHealth web portal was recently established to facilitate transfer of images and findings from TILAK hospitals to other healthcare organizations. Registered users can be cleared for a limited time to access all radiological imaging data via this web portal. (orig.) [de

  9. Implementing Patient Safety Initiatives in Rural Hospitals

    Klingner, Jill; Moscovice, Ira; Tupper, Judith; Coburn, Andrew; Wakefield, Mary

    2009-01-01

    Implementation of patient safety initiatives can be costly in time and energy. Because of small volumes and limited resources, rural hospitals often are not included in nationally driven patient safety initiatives. This article describes the Tennessee Rural Hospital Patient Safety Demonstration project, whose goal was to strengthen capacity for…

  10. Patients who fall in hospital - Contributing factors

    M.I. Bright

    1983-09-01

    Full Text Available This is a retrospective study of the factors which contributed to accidental injuries sustained by those patients who fell in a White provincial hospital in die period 1 January to 30 June 1982. The research study was undertaken by Diploma in Nursing Administration students during their 3-week hospital practice at a White provincial hospital.

  11. Investigation of health promotion status in specialized hospitals associated with Hamadan University of Medical Sciences: health-promoting hospitals.

    Hamidi, Yadollah; Hazavehei, Seyed Mohammad Mahdi; Karimi-Shahanjarini, Akram; SeifRabiei, Mohamad Ali; Farhadian, Maryam; Alimohamadi, Shohreh; Kharghani Moghadam, Seyedeh Melika

    2017-12-01

    The prophecy of health promoting hospitals (HPH) is bringing about a change and transition from treatment-oriented to health-oriented attitudes. In Iran, hospitals usually play the traditional roles. The present study was aimed at the evaluation of the health promotion status in specialized hospitals associated with Hamadan University of Medical Sciences (HUMS). This applied study was conducted in two Hamadan specialized hospitals in the Hamadan city. The health promotion status was evaluated using a self-assessment checklist designed by the World Health Organization's HPH. The evaluation was done in five standards including management policy, patient assessment, patient information and intervention, promotion of a healthy workplace and continuity and cooperation. The results showed that both the hospitals studied had a poor status in terms of promoting a healthy workplace (average = 31.24%) and management policy standards (average = 35.29%) in comparison with the other relevant standards: patient assessment (53.12%), patient information and intervention (62.5%), continuity and cooperation (65.78%)). The results of the standards and sub-standards status displayed better performance in the cardiovascular hospital (53.67%) compared to the women and parturition hospital (42.64%). The findings indicated that HPH standards are very low in the studied hospitals. The reason behind this wide gap might be due to the fact that hospitals in Iran are more treatment-oriented and patient-oriented and they do not play an active part in health promoting. It was found that management policy and promoting healthy workplace standards had the worst status and must be improved.

  12. Hospital simulated patient programme: a guide.

    Barrett, Jenny; Hodgson, Jan

    2011-12-01

    Many university courses employ simulated patients to work with students in the development of communication skills. Our challenge was to build a sustainable programme that could be adapted for medical, nursing and allied health staff, and groups of students, on our hospital campus. In recognition of the need to provide practice opportunities for junior medical staff to hone their capacity to communicate effectively with parents, we employed professional actors who are also qualified teachers. Junior doctors have multiple opportunities over their training time to work one-to-one with an actor-tutor in the role of simulated parent. The simulated parents are skilled in helping the trainees reflect on the conversation, and the trainees are given a recording of their sessions for further reflection and feedback from a colleague. This model has been adapted to meet the 'topic' needs and scheduling requirements of other staff and hospital-based student groups. In adapting the original medical staff programme, we came to appreciate not only the logistical but also the ethical considerations inherent in a simulated parent/patient programme. Our guide highlights the importance of safeguarding the educational integrity of the design, maintaining the fidelity of the simulations and ensuring the safety of all involved. © Blackwell Publishing Ltd 2011.

  13. The prevalence of suspected and challenge-verified penicillin allergy in a university hospital population

    Borch, Jacob Eli; Andersen, Klaus Ejner; Bindslev-Jensen, Carsten

    2006-01-01

    patterns and public economy as a consequence. We performed a cross-sectional case-control study with two visits to all clinical departments of a large university hospital in order to find in-patients with medical files labelled "penicillin allergy" or who reported penicillin allergy upon admission. Patient....... In a cohort of 3642 patients, 96 fulfilled the inclusion criteria giving a point-prevalence of alleged penicillin allergy of 5% in a hospital in-patient population. Mean time elapsed since the alleged first reaction to penicillin was 20 years. The skin was the most frequently affected organ (82.2%), maculo...

  14. Multi-modal intervention improved oral intake in hospitalized patients

    Holst, M; Beermann, T; Mortensen, M N

    2015-01-01

    BACKGROUND: Good nutritional practice (GNP) includes screening, nutrition plan and monitoring, and is mandatory for targeted treatment of malnourished patients in hospital. AIMS: To optimize energy- and protein-intake in patients at nutritional risk and to improve GNP in a hospital setting. METHODS......: A 12-months observational multi-modal intervention study was done, using the top-down and bottom-up principle. All hospitalized patients (>3 days) were included. Setting: A university hospital with 758 beds and all specialities. Measurements: Record audit of GNP, energy- and protein-intake by 24-h...... recall, patient interviews and staff questionnaire before and after the intervention. Interventions: Based on pre-measurements, nutrition support teams in each department made targeted action plans, supervised by an expert team. Education, diagnose-specific nutrition plans, improved menus and eating...

  15. Nurses' perceptions of patient safety culture in Jordanian hospitals.

    Khater, W A; Akhu-Zaheya, L M; Al-Mahasneh, S I; Khater, R

    2015-03-01

    Patients' safety culture is a key aspect in determining healthcare organizations' ability to address and reduce risks of patients. Nurses play a major role in patients' safety because they are accountable for direct and continuous patient care. There is little known information about patients' safety culture in Jordanian hospitals, particularly from the perspective of healthcare providers. The study aimed to assess patient safety culture in Jordanian hospitals from nurses' perspective. A cross-sectional, descriptive design was utilized. A total number of 658 nurses participated in the current study. Data were collected using an Arabic version of the hospital survey of patients' safety culture. Teamwork within unit dimensions had a high positive response, and was perceived by nurses to be the only strong suit in Jordanian hospitals. Areas that required improvement, as perceived by nurses, are as follows: communication openness, staffing, handoff and transition, non-punitive responses to errors, and teamwork across units. Regression analysis revealed factors, from nurses' perspectives, that influenced patients' safety culture in Jordanian hospital. Factors included age, total years of experience, working in university hospitals, utilizing evidence-based practice and working in hospitals that consider patient safety to be a priority. Participants in this study were limited to nurses. Therefore, there is a need to assess patient safety culture from other healthcare providers' perspectives. Moreover, the use of a self-reported questionnaire introduced the social desirability biases. The current study provides insight into how nurses perceive patient safety culture. Results of this study have revealed that there is a need to replace the traditional culture of shame/blame with a non-punitive culture. Study results implied that improving patient safety culture requires a fundamental transformation of nurses' work environment. New policies to improve collaboration between

  16. Burkholderia cepacia infection at A university Teaching Hospital in ...

    Twenty five isolates of B. cepacia, representing 1.4% of all isolates, were obtained at the Microbiology Laboratory of a University Teaching Hospital in Lagos between January 1996 and December 1997. Identification of isolates was done using analytical profile index systems (Biomerieux, France) and sensitivity testing was ...

  17. Forceps delivery at the University College Hospital, Ibadan, Nigeria ...

    Forceps delivery at the University College Hospital, Ibadan, Nigeria. ... Ibadan, Nigeria. CO Aimakhu, O Olayemi, OO Enabor, FA Oluyemi, VE Aimakhu ... Methodology: A retrospective analysis of all forceps delivery done at this centre between the 1st of January 1997 and 31st December 2001, a 5-year period was done.

  18. Obstructed Labour at the University of Ilorin Teaching Hospital. Ilorin ...

    Obstructed Labour at the University of Ilorin Teaching Hospital. Ilorin. AAG Jimoh, OR Balogun, Abubakar Danladi. Abstract. During a five-year period between 1st January 1995 to 31st December 1999, three hundred and twenty eight cases of obstructed labour were encountered out of a total of 12,614 deliveries managed ...

  19. Cardiac arrest during anesthesia at a University Hospital in Nigeria ...

    Background: We assessed the incidence and outcomes of cardiac arrest during anesthesia in the operating room at our university hospital. A previous study on intraoperative cardiac arrests covered a period from 1994-1998 and since then; anesthetic personnel, equipment, and workload have increased remarkably.

  20. Ectopic Pregnancy in Lagos State University Teaching Hospital ...

    We set out to determine the socio-demographic factors,pattern of presentation and management of ectopic pregnancy in a University Teaching Hospital in Lagos, Nigeria. A retrospective descriptive analysis of all cases of ectopic pregnancy over a 2-year period was carried out. The case notes were retrieved from the ...

  1. Triple Gestations in Two University Teaching Hospitals in Yaounde ...

    3Department of Obstetrics & Gynecology, Central Hospital Yaounde/Faculty of Medicine and Biomedical Sciences,. University of Yaounde I, BP 337, Yaounde, Cameroon. Address correspondence to E. Nkwabong, enkwabong@yahoo.fr. Received 27 November 2010; Accepted 19 January 2011. Abstract The frequency of ...

  2. Anaemia in Pregnancy in Abia State University Teaching Hospital, Aba

    A prospective study of incidence of anaemia in pregnancy at Abia state University Teaching Hospital, Aba was conducted over a six-month period spanning from 31st January 2000 to 31st July 2000. The incidence of anaemia in pregnancy was 29%. The vast majority (97.6%) had mild anaemia. The result showed that most ...

  3. Overviewof Contraceptive Use In Jos University Teaching Hospital ...

    Background: Modern contraceptive methods accepted by 17,846 new clients in Jos University Teaching Hospital, a tertiary health institution, over two decades are presented. Methods: This was a review of the contraceptive trend in new clients who used the various methods of contraception over an 18-year period, ...

  4. New compliance management system of the University Hospital Frankfurt, Germany

    Irmscher, Bettina

    2016-01-01

    The meaning of Corporate Governance is all values and principles guiding or regulating good and responsible business management. Clearly defined roles and responsibilities for managing compliance, risks and checks is the prerequisite for the latter. For that reason, a compliance management system was set up at the University Hospital Frankfurt in 2015.

  5. Vacuum Delivery in Jos University Teaching Hospital, Jos, Nigeria ...

    Obstetric practice continues to change, particularly assisted vaginal delivery. Vacuum delivery is a mode of delivery technique in Jos University Teaching Hospital (JUTH) in the maternity unit. The objective of the study was to determine the rate of ventouse delivery, its indications, and maternal and fetal morbidity in our ...

  6. Outpatient waiting time in Jos University Teaching Hospital ...

    Problem Long waiting time for services has been identified as a reason people avoid presenting to for care in African countries. Design Examination of causes for long outpatient waiting time and the effect of measures to reduce waiting time. Setting Outpatient department of the Jos University Teaching Hospital.

  7. Management of patient with hepatocellular carcinomas by in situ injection of iodine-131 labelled lipiodol solution (Lipiocis) in the Biophysics and Timone APHM University Hospital Central Service

    Sigrist, S.

    2008-01-01

    The aim of this work was to determine what are the prognosis factors in term of global expectation of life at patient receiving a treatment by Lipiocis, to estimate the tolerance at this treatment in order to choose patient which will be the best candidates to this treatment and to define more precisely the criteria of patient inclusion and follow-up. A study including 35 patient having received one or several Lipiocis injections between May 2003 and May 2007 has been carried out. The results of this study are given. Lipiocis seems to be a well tolerated treatment which has proved its efficiency. (O.M.)

  8. Malnutrition in hospitalized patients: results from La Rioja.

    Martín Palmero, Ángela; Serrano Pérez, Andra; Chinchetru Ranedo, Mª José; Cámara Balda, Alejandro; Martínez de Salinas Santamarí, Mª Ángeles; Villar García, Gonzalo; Marín Lizárraga, Mª Del Mar

    2017-03-30

    There is a high malnutrition prevalence in hospitalized patients. To determine the malnutrition prevalence in hospitalized patients of La Rioja Community (Spain) when evaluated with different screening/ evaluation tools and its relationship with hospital stay and mortality. Cross sectional observational study of hospitalized adult patients (age > 18 years old) from medical and surgical departments that underwent within 72 h of their admission a nutritional screening with Malnutrition Universal Screening Tool (MUST), Nutritional Risk Screening (NRS) 2002, Controlling Nutritional Status (CONUT) y Subjective Global Assessment (SGA). 384 patients (273 medical and 111 surgical) were evaluated. Almost fifty percent of them were considered malnourished independently of the screening/assessment tool used. High concordance was found between SGA and NRS-2002 (k = 0.758). Malnourished patients had a longer hospital stay than those well-nourished (9.29 vs. 7.10 days; p = 0.002), used a greater number of medicines (9.2 vs. 7.4; p = 0.001) and underwent a higher number of diagnostic tests (16.4 vs. 12.5; p = 0,002). Half of the hospitalized patients in the medical and surgical department of La Rioja are malnourished. This is associated with a longer hospital stay, higher use of medicines, diagnostics tests and greater mortality. Malnutrition could be detected with easy screening tools to treat it appropriately.

  9. Hospital waste management status in Iran: a case study in the teaching hospitals of Iran University of Medical Sciences.

    Farzadkia, Mahdi; Moradi, Arash; Mohammadi, Mojtaba Shah; Jorfi, Sahand

    2009-06-01

    Hospital waste materials pose a wide variety of health and safety hazards for patients and healthcare workers. Many of hospitals in Iran have neither a satisfactory waste disposal system nor a waste management and disposal policy. The main objective of this research was to investigate the solid waste management in the eight teaching hospitals of Iran University of Medical Sciences. In this cross-sectional study, the main stages of hospital waste management including generation, separation, collection, storage, and disposal of waste materials were assessed in these hospitals, located in Tehran city. The measurement was conducted through a questionnaire and direct observation by researchers. The data obtained was converted to a quantitative measure to evaluate the different management components. The results showed that the waste generation rate was 2.5 to 3.01 kg bed(-1) day(-1), which included 85 to 90% of domestic waste and 10 to 15% of infectious waste. The lack of separation between hazardous and non-hazardous waste, an absence of the necessary rules and regulations applying to the collection of waste from hospital wards and on-site transport to a temporary storage location, a lack of proper waste treatment, and disposal of hospital waste along with municipal garbage, were the main findings. In order to improve the existing conditions, some extensive research to assess the present situation in the hospitals of Iran, the compilation of rules and establishment of standards and effective training for the personnel are actions that are recommended.

  10. Vitamin D deficiency and its relationship with cardiac iron and function in patients with transfusion-dependent thalassemia at Chiang Mai University Hospital.

    Dejkhamron, Prapai; Wejaphikul, Karn; Mahatumarat, Tuanjit; Silvilairat, Suchaya; Charoenkwan, Pimlak; Saekho, Suwit; Unachak, Kevalee

    2018-02-01

    Vitamin D deficiency is common in patients with thalassemia. Vitamin D deficiency could be related to cardiac dysfunction. Increased parathyroid hormone (PTH) is also known to be associated with heart failure. To determine the prevalence of Vitamin D deficiency and to explore the impact of Vitamin D deficiency on cardiac iron and function in patients with transfusion-dependent thalassemia. A cross-sectional study in patients with Transfusion-dependent thalassemia was conducted. Patients with liver disease, renal disease, type 1 diabetes, malabsorption, hypercortisolism, malignancy, and contraindication for MRI were excluded. Calcium, phosphate, PTH, vitamin D-25OH were measured. CardiacT2 * and liver iron concentration (LIC) and left ventricular ejection fraction (LVEF) were determined. Results Sixty-one (33M/28F) patients with Transfusion-dependent thalassemia were enrolled. The prevalence of Vitamin D deficiency was 50.8%. Patients with cardiac siderosis had tendency for lower D-25OH than those without siderosis (15.9 (11.7-20.0) vs. 20.2 (15.85-22.3) ng/mL); p = 0.06). Serum calcium, phosphate, PTH, LIC, cardiac T2 * , and LVEF were not different between the groups with or without Vitamin D deficiency. Patients with Vitamin D deficiency had significantly lower hemoglobin levels compared to those without Vitamin D deficiency (7.5 (6.93-8.33) vs. 8.1 (7.30-8.50) g/dL; p = 0.04). The median hemoglobin in the last 12 months was significantly correlated with D-25OH. Cardiac T2 * had significant correlation with PTH. Vitamin D deficiency is prevalent in patients with Transfusion-dependent thalassemia. Vitamin D level is correlated with hemoglobin level. Vitamin D status should be routinely assessed in these patients. Low PTH is correlated with increased cardiac iron. This study did not demonstrate an association between Vitamin D deficiency and cardiac iron or function in patients with Transfusion-dependent thalassemia.

  11. Malnutrition upon Hospital Admission in Geriatric Patients: Why Assess It?

    Paolo Orlandoni

    2017-10-01

    Full Text Available ObjectiveTo assess the prevalence of malnutrition according to the new ESPEN definition in a population of geriatric hospital patients and to determine how malnutrition affects the length of hospital stay (LOS and hospital mortality.DesignA retrospective analysis of data gathered during nutritional screening surveys carried out three consecutive years, from 2012 to 2014, in an Italian geriatric research hospital (INRCA, Ancona was performed. On the day of the study, demographic data, data on clinical conditions and the nutritional status of newly admitted patients were collected. Patients were screened for malnutrition risk using the Malnutrition Universal Screening Tool (MUST. Subsequently, malnutrition was diagnosed, for subjects at high risk, following the criteria suggested by the European Association for Clinical Nutrition and Metabolism [body mass index (BMI < 18.5 kg/m2 or different combinations of unintentional weight loss over time and BMI values]. Sensitivity, specificity, positive and negative predictive value of MUST compared to ESPEN criteria were assessed. The characteristics of patients with a diagnosis of malnutrition were compared to those of non-malnourished patients. The impact of malnutrition on LOS and hospital mortality was investigated through logistic and linear regression models.SettingThe study was performed in an Italian geriatric research hospital (INRCA, Ancona.SubjectsTwo hundred eighty-four newly hospitalized geriatric patients from acute care wards (mean age 82.8 ± 8.7 years, who gave their written consent to participate in the study, were enrolled.ResultsAccording to the MUST, high risk of malnutrition at hospitalization was found in 28.2% of patients. Malnutrition was diagnosed in 24.6% of subjects. The malnutrition was an independent predictor of both the LOS and hospital mortality. The multivariate analyses—linear and logistic regression—were performed considering different potential

  12. Anaerobic bacteria in 118 patients with deep-space head and neck infections from the University Hospital of Maxillofacial Surgery, Sofia, Bulgaria.

    Boyanova, Lyudmila; Kolarov, Rossen; Gergova, Galina; Deliverska, Elitsa; Madjarov, Jivko; Marinov, Milen; Mitov, Ivan

    2006-09-01

    The aim of this study was to assess the incidence and susceptibility to antibacterial agents of anaerobic strains in 118 patients with head and neck abscesses (31) and cellulitis (87). Odontogenic infection was the most common identified source, occurring in 73 (77.7%) of 94 patients. The incidence of anaerobes in abscesses and cellulitis was 71 and 75.9%, respectively, and that in patients before (31 patients) and after (87) the start of empirical treatment was 80.6 and 72.4%, respectively. The detection rates of anaerobes in patients with odontogenic and other sources of infection were 82.2 and 71.4%, respectively. In total, 174 anaerobic strains were found. The predominant bacteria were Prevotella (49 strains), Fusobacterium species (22), Actinomyces spp. (21), anaerobic cocci (20) and Eubacterium spp. (18). Bacteroides fragilis strains were isolated from 7 (5.9%) specimens. The detection rate of Fusobacterium strains from non-treated patients (32.2%) was higher than that from treated patients (13.8%). Resistance rates to clindamycin and metronidazole of Gram-negative anaerobes were 5.4 and 2.5%, respectively, and those of Gram-positive species were 4.5 and 58.3%, respectively. One Prevotella strain was intermediately susceptible to ampicillin/sulbactam. In conclusion, the start of empirical treatment could influence the frequency or rate of isolation of Fusobacterium species. The involvement of the Bacteroides fragilis group in some head and neck infections should be considered.

  13. Candiduria in hospitalized patients in teaching hospitals of Ahvaz.

    Zarei-Mahmoudabadi, A; Zarrin, M; Ghanatir, F; Vazirianzadeh, B

    2012-12-01

    Nosocomial infections are usually acquired during hospitalization. Fungal infection of the urinary tract is increasing due to predisposing factors such as; antibacterial agents, indwelling urinary catheters, diabetes mellitus, long hospitalization, immunosuppressive agents, use of IV catheters, radiation therapy, malignancy. The aim of our study was to determine the prevalence of candiduria and urinary tract infection in patients admitted in Golestan and Emam Khomeini hospitals of Ahvaz, Iran. During 14 months, a total of 744 urine samples were collected and transferred to medical mycology laboratory immediately. Ten µl of uncentrifuged sample was cultured on CHROM agar Candida plates and incubated at 37°C for 24-48h aerobically. Candida species were identified based on colony morphology on CHROM agar Candida, germ tube production and micro-morphology on corn meal agar including 1% Tween 80. In the present study, 744 hospitalized patients were sampled (49.5%, female; 50.5%, male). The prevalence of candiduria in subjects was 16.5% that included 65.1% female and 34.9% male. The most common isolates were C. albicans (53.3%), followed by C. glabrata (24.4%), C. tropicalis (3.7%), C. krusei (2.2%), and Geotrichum spp. (0.7%) Urine cultures yielded more than 10,000 yeast colonies in 34.1% of cases, and the major predisposing factor associated with candiduria was antibiotic therapy (69.1%). Candiduria is relatively common in hospitalized patients in educational hospitals of Ahvaz. In addition, there is a strong correlation between the incidence of candiduria in hospitalized patients and broad-spectrum antibiotics therapy.

  14. Queueing network model for obstetric patient flow in a hospital.

    Takagi, Hideaki; Kanai, Yuta; Misue, Kazuo

    2016-03-03

    A queueing network is used to model the flow of patients in a hospital using the observed admission rate of patients and the histogram for the length of stay for patients in each ward. A complete log of orders for every movement of all patients from room to room covering two years was provided to us by the Medical Information Department of the University of Tsukuba Hospital in Japan. We focused on obstetric patients, who are generally hospitalized at random times throughout the year, and we analyzed the patient flow probabilistically. On admission, each obstetric patient is assigned to a bed in one of the two wards: one for normal delivery and the other for high-risk delivery. Then, the patient may be transferred between the two wards before discharge. We confirm Little's law of queueing theory for the patient flow in each ward. Next, we propose a new network model of M/G/ ∞ and M/M/ m queues to represent the flow of these patients, which is used to predict the probability distribution for the number of patients staying in each ward at the nightly census time. Although our model is a very rough and simplistic approximation of the real patient flow, the predicted probability distribution shows good agreement with the observed data. The proposed method can be used for capacity planning of hospital wards to predict future patient load in each ward.

  15. Prevalence of Helicobacter pylori prevalence and upper gastrointestinal endoscopy in HIV/AIDS patients with gastrointestinal symptoms in the University Teaching Hospitals in Cameroon.

    Andoulo, F A; Kowo, M; Ngatcha, G; Ndam, A N; Awouoyiegnigni, B; Sida, M B; Tzeuton, C; Ndjitoyap Ndam, E C

    2016-08-01

    To determine the prevalence of Helicobacter pylori (H. pylori) infection and of various upper gastrointestinal (GI) lesions in HIV + patients with GI symptoms and the relation of H. pylori infection to CD4 cell counts. In all, 56 HIV + patients and 56 age- and sex-matched HIV - controls, all with upper GI symptoms, were evaluated by an upper endoscopy examination and gastric biopsy. H. pylori status was assessed with a urease test and histology. HIV was diagnosed with the rapid test and enzyme-linked immunosorbent assay (ELISA). The prevalence of H. pylori was 50% (28/56 [95%CI 36.3-63.7]) in HIV + subjects and 55% (31/56 [95%CI 41.5-68.7]) in HIV - controls (p = 0.57). H. pylori infection rates did not differ significantly in HIV + patients between those with a CD4 count ≥200/mm 3 (52%) and those with a CD4 count HIV + patients and controls were compared: esophageal candidiasis (61%, 34/56 vs. 7%; pHIV + and HIV - subjects. Prevalence of H. pylori was also lower, although not significantly, among HIV + patients with CD4 T-cell counts below 200/mm 3 . On endoscopy, esophageal candidiasis was the most common finding in HIV + patients, discovered by dysphagia.

  16. Quality assessment of the wound dressing procedure in patients at a university hospital Evaluación de la calidad de los procedimientos curativos en pacientes internados en un hospital universitario Avaliação da qualidade do procedimento curativo em pacientes internados em um hospital universitário

    Eleine Aparecida Penha Martins Nonino

    2008-02-01

    Full Text Available This observational and sectional study analyzed the quality of the wound dressing procedure performed on hospitalized patients at a medical surgical unit of a University Hospital, based on their classification according to the degree of care dependency and activity performance phases. Using a check list, 168 wound dressings were observed between October and December 2005. Procedure quality was analyzed based on the Positivity Index (IP and values >70% were considered satisfactory.For the preparation, the IP was 68%, 63%, 73% and 75% for patients with degrees I, II, III and IV, respectively; for execution, 70%, 69%, 71% and 75% and, for unit organization, it was >70% for all degrees. However, the items: validity time frame checking, respect for aseptic principles and maintenance of logical sequence of procedures were compromised. Rigorous execution of procedures allows for risk decrease and assures benefic results for patients, conferring quality to nursing actions.Estudio observacional y seccional analizó la calidad del procedimiento curativo, realizado en pacientes internados en una unidad medico-quirúrgica de un Hospital Universitario, de acuerdo con el grado de dependencia asistencial y las fases de realización de la actividad. Con la utilización de un instrumento tipo check list fueran observados 168 curativos, entre octubre y diciembre 2005. La cualidad de los procedimientos fue analizada basada en el Índice de Positividad (IP y fueron considerados satisfactorios aquellos que alcanzaron valores >70%. En la preparación, el IP fue de 68%, 73% y 75% para pacientes en grados I, II, III y IV, respectivamente; en la ejecución, fueran de 70%, 69%, 71% y 75% y en la de organización de la unidad, en todos los grados fue >70%. Entre tanto, los ítems: conferencia del plazo de validez de los materiales, respeto a los principios de asepsia y manutención de la secuencia lógica muestrearon se comprometidos. La ejecución rigorosa de un

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

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

    2006-01-01

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

  18. Adesão a diretrizes e impacto nos desfechos em pacientes hospitalizados por pneumonia adquirida na comunidade em um hospital universitário Adherence to guidelines and its impact on outcomes in patients hospitalized with community-acquired pneumonia at a university hospital

    Carla Discacciati Silveira

    2012-04-01

    evaluate the agreement between the criteria used for hospitalization of patients with community-acquired pneumonia (CAP and those of the Brazilian Thoracic Association guidelines, and to evaluate the association of that agreement with 30-day mortality. Secondarily, to evaluate the agreement between the treatment given and that recommended in the guidelines with length of hospital stay, microbiological profile, 12-month mortality, complications, ICU admission, mechanical ventilation, and 30-day mortality. METHODS: This was a retrospective study involving adult patients hospitalized between 2005 and 2007 at the Federal University of Minas Gerais Hospital das Clínicas, located in Belo Horizonte, Brazil. Medical charts and chest X-rays were reviewed. RESULTS: Among the 112 patients included in the study, admission and treatment criteria were in accordance with the guidelines in 82 (73.2% and 66 (58.9%, respectively. The 30-day and 12-month mortality rates were 12.3% and 19.4%, respectively. The 30-day mortality rate was lower for patients in whom the CRB-65 (mental Confusion, Respiratory rate, Blood pressure, and age > 65 years score was 1-2 and the antibiotic therapy was in accordance with the guidelines (p = 0.01. Cerebrovascular disease and appropriate antibiotic therapy showed independent associations with 30-day mortality. There was a trend toward an association between guideline-concordant antibiotic therapy and shorter hospital stay. CONCLUSIONS: In the population studied, admission and treatment criteria that were in accordance with the guidelines were associated with favorable outcomes in hospitalized patients with CAP. Cerebrovascular disease, as a risk factor, and guideline-concordant antibiotic therapy, as a protective factor, were associated with 30-day mortality.

  19. Occurrence of yeast bloodstream infections between 1987 and 1995 in five Dutch university hospitals

    A. Voss (Andreas); J.A.J.W. Kluytmans (Jan); J.G. Koeleman; L. Spanjaard (Lodewijk); C.M.J.E. Vandenbroucke-Grauls (Christina); H.A. Verbrugh (Henri); M.C. Vos (Margreet); A.Y.L. Weersink (A. Y L); J.A.A. Hoogkamp-Korstanje (J. A A); J.F. Meis

    1996-01-01

    textabstractThe aim of this study was to identify retrospectively trends in fungal bloodstream infections in The Netherlands in the period from 1987 to 1995. Results of over 395,000 blood cultures from five Dutch university hospitals were evaluated. Overall, there were more than 12 million patient

  20. Hydatidiform mole in university of Calabar teaching hospital, Nigeria ...

    Suction evacuation was done in all the cases. About 63% of patients had 1-3 months follow up, while 2.9% continued beyond 1 year. The case fatality was 1.47%. However. 12 patients never came back to the hospital after evacuation. Conclusion : Molar pregnancy is a common cause of first trimester miscarriages and ...

  1. Steering patients to safer hospitals? The effect of a tiered hospital network on hospital admissions.

    Scanlon, Dennis P; Lindrooth, Richard C; Christianson, Jon B

    2008-10-01

    To determine if a tiered hospital benefit and safety incentive shifted the distribution of admissions toward safer hospitals. A large manufacturing company instituted the hospital safety incentive (HSI) for union employees. The HSI gave union patients a financial incentive to choose hospitals that met the Leapfrog Group's three patient safety "leaps." The analysis merges data from four sources: claims and enrollment data from the company, the American Hospital Association, the AHRQ HCUP-SID, and a state Office of the Insurance Commissioner. Changes in hospital admissions' patterns for union and nonunion employees using a difference-in-difference design. We estimate the probability of choosing a specific hospital from a set of available alternatives using conditional logistic regression. Patients affiliated with the engineers' union and admitted for a medical diagnosis were 2.92 times more likely to select a hospital designated as safer in the postperiod than in the preperiod, while salaried nonunion (SNU) patients (not subject to the financial incentive) were 0.64 times as likely to choose a compliant hospital in the post- versus preperiod. The difference-in-difference estimate, which is based on the predictions of the conditional logit model, is 0.20. However, the machinists' union was also exposed to the incentive and they were no more likely to choose a safer hospital than the SNU patients. The incentive did not have an effect on patients admitted for a surgical diagnosis, regardless of union status. All patients were averse to travel time, but those union patients selecting an incentive hospital were less averse to travel time. Patient price incentives and quality/safety information may influence hospital selection decisions, particularly for medical admissions, though the optimal incentive level for financial return to the plan sponsor is not clear.

  2. [Consumer surveys among hospitalized patients with lung disease].

    Humborstad, O T; Omenaas, E; Gulsvik, A

    2001-03-30

    The aim of our survey was to record the experiences of hospitalised patients with respiratory diseases in order to create a more patient-friendly department. Our study included 609 patients (response rate 70%) with a median age of 64 years (range 13-91) who were discharged from the Department of Thoracic Medicine, Haukeland University Hospital in October 1991, 1992, 1994, 1995 and 1996. 268 patients had obstructive lung disease, 82 had lung cancer. They answered a questionnaire with 24 questions. Patient reception to the ward and staff knowledge of the patients' illnesses, were for the physicians rated as good or better by 92% and 79% and for the nurses by 94% and 70% respectively. 16% of the patients experienced insecurity, 17% anxiety, 12% helplessness, 9% loneliness and 12% little say in the decision making process. Trend factors for these emotional experiences were female sex, old age, obstructive lung disease and long stay in hospital. Patients aged 50 to 69 years and patients with lung cancer had the lowest rate of negative emotional experiences. Despite staff awareness of the prevalence and of the patients' emotional experiences and the risk factors involved, there was no clear reduction of negative experiences in the later surveys compared to the first survey. Patients in a university hospital with respiratory diseases showed unchanged experiences of health care and personal emotions in repeated surveys over a period of five years.

  3. Effect of Cognitive Rehabilitation on Improving Cognitive Function and Activities of Daily Living among Elderly Patients with Stroke at Assiut University Hospital

    Abd-Elaziz, Saieda Abd-Elhameed; Khedr, Eman M.; Ahmed, Hanaa Abd Elhakiem; Ibrahim, Hoda Diab Fahmy

    2015-01-01

    Cognitive impairment is a frequent consequence of stroke. The study aimed to measure the effect of cognitive rehabilitation of elderly patients with stroke on their cognitive function and activities of daily living. Quasi experimental research design were used in this study. This study was conducted at neuropsychiatric, physical medicine and…

  4. Antifungal susceptibility testing of Candida species isolated from the immunocompromised patients admitted to ten university hospitals in Iran : comparison of colonizing and infecting isolates

    Badiee, Parisa; Badali, Hamid; Boekhout, Teun; Diba, Kambiz; Moghadam, Abdolkarim Ghadimi; Hossaini Nasab, Ali; Jafarian, Hadis; Mohammadi, Rasoul; Mirhendi, Hossein; Najafzadeh, Mohammad Javad; Shamsizadeh, Ahmad; Soltani, Jafar

    2017-01-01

    BACKGROUND: Antifungal susceptibility testing is a subject of interest in the field of medical mycology. The aim of the present study were the distributions and antifungal susceptibility patterns of various Candida species isolated from colonized and infected immunocompromised patients admitted to

  5. Prognostic Factors Predicting the Surgical Outcomes of Bilateral Lateral Rectus Recession for Patients with Concomitant Exotropia in Chiang Mai University Hospital.

    Trakanwitthayarak, Supaporn; Patikulsila, Prapatsorn

    2017-01-01

    To determine the preoperative variables affecting early and late favorable outcomes of bilateral lateral rectus recession surgery for concomitant exotropia. A retrospective study of 65 patients with concomitant exotropia (constant and intermittent) who had bilateral lateral rectus recession was conducted. The follow-up period was more than 1 year in all patients. Preoperative parameters were obtained and evaluated using univariate analysis. Sixty-five patients with concomitant exotropia who underwent bilateral lateral rectus recession were included. In the early and late postoperative outcome, 78% and 82% of the patients were in the success group, respectively. Meanwhile, 22% and 18% were in the failure group, respectively. There was no association between postoperative outcome and preoperative variables i.e. age at onset (p = 0.841, 0.591), age at surgery (p = 0.564, 0.634), interval between onset and surgery (p = 0.506, 0.753), preoperative deviation (p = 0.278, 0.211), refractive error (p = 0.217, 0.136), anisometropia (p = 0.946, 0.946), phase of exotropia (p = 0.741, 0.013), A-V pattern (p = 1.000, 1.000), stereopsis (p = 0.841, 0.268) and amblyopia (p = 0.569, 0.567). Preoperative variables could not be used to predict the early and late postoperative outcome.

  6. Current status of diagnostic imaging in dental university hospitals in Japan

    Sasaki, Takehito; Fujita, Minoru; Katoh, Tsuguhisa; Kobayashi, Kaoru; Okano, Tomohiro; Sato, Kenji; Wada, Shinichi

    2004-01-01

    The diagnostic imaging examinations in all 29 dental university hospitals in Japan were analyzed during a 1-year period from April 1999 to March 2000. The total number of patients examined was 790859, which corresponded to 27271 patients per hospital on average, with a range from 7872 to 62904. Relative to the total number of patients, intraoral radiography was found to have been most frequently performed, 59% on average, with a range from 40% to 80%, depending on the hospital. Extraoral radiography, mostly panoramic radiography, was 36% on average with the range from 18% to 56%. A significant inverse correlation was observed between the percentages of intraoral and extraoral radiography, relative to the total number of all types of imaging examinations. Computed tomography (CT) examinations were performed with their own apparatuses in 27 hospitals with a frequency of 2.9% of patients in all imaging examinations on average and 9.1% at maximum. The scanning parameter of milliampere seconds (mAs) for individual types of routinely performed CT examinations varied widely, and thus the patient dose can be expected to be considerably reduced, without reducing the amount of diagnostic information to be obtained. Other imaging examinations performed were magnetic resonance imaging in 11 hospitals, X-ray fluoroscopy in 8 hospitals, ultrasonography in 20, nuclear medicine in 5, and bone densitometry in 1 hospital. (author)

  7. Awareness, attitudes, need and demand on replacement of missing teeth among a group of partially dentate patients attending a University Dental Hospital.

    Jayasinghe, Rasika Manori; Perera, Janana; Jayasinghe, Vajira; Thilakumara, Indika P; Rasnayaka, Sumudu; Shiraz, Muhammad Hanafi Muhammad; Ranabahu, Indra; Kularatna, Sanjeewa

    2017-07-27

    Our objective was to assess awareness, attitudes, need and demand on replacement of missing teeth according to edentulous space, age, gender, ethnicity, educational level and socio-economical status of the patient. 76.2% of the study group was opined that the missing teeth should be replaced by prosthetic means. Majority were keen in getting them replaced mainly for the comfort in mastication. Although 77.9 and 32.9% were aware of the removable prostheses and implants respectively, only 25.2% knew about tooth supported bridges as an option of replacement of missing teeth. Participants' awareness on tooth and implant supported prostheses is at a higher level. Participants' opinion on need of regular dental visit was statistically significant when gender, ethnicity and education level were considered. The highest demand for replacement of missing teeth was observed in Kennedy class I and II situations in both upper and lower arches. Demand for fixed prostheses was significantly highest in Kennedy class II in upper and lower arches. In conclusion, although removable prosthodontic options are known to most of the patients, their awareness on tooth and implant supported prostheses is also at a higher level. The highest demand for replacement of missing teeth is by patients with Kennedy class I and II situations whereas Kennedy class II being the category with highest demand for fixed prostheses. We recommend that the location of missing teeth to be considered as a priority when educating patients on the most appropriate prosthetic treatment options. Dentists' involvement in educating patients on prosthetic options needs to be improved.

  8. Hip fracture in hospitalized medical patients

    Zapatero Antonio

    2013-01-01

    Full Text Available Abstract Background The aim of the present study is to analyze the incidence of hip fracture as a complication of admissions to internal medicine units in Spain. Methods We analyzed the clinical data of 2,134,363 adults who had been admitted to internal medicine wards. The main outcome was a diagnosis of hip fracture during hospitalization. Outcome measures included rates of in-hospital fractures, length of stay and cost. Results A total of 1127 (0.057% admittances were coded with an in-hospital hip fracture. In hospital mortality rate was 27.9% vs 9.4%; p  Conclusions In-hospital hip fracture notably increased mortality during hospitalization, doubling the mean length of stay and mean cost of admission. These are reasons enough to stress the importance of designing and applying multidisciplinary plans focused on reducing the incidence of hip fractures in hospitalized patients.

  9. Antibiotic Susceptibility Pattern of Gram-positive Cocci Cultured from Patients in Three University Hospitals in Tehran, Iran during 2001-2005

    Aligholi Marzieh

    2009-10-01

    Full Text Available Bacterial resistance to antibiotics is a serious problem and is increasing in prevalence world-wide at an alarming rate. The antimicrobial susceptibility patterns of 1897 gram-positive bacterial Isolates were evaluated. The minimum inhibitory concentration (MIC of isolates which comprised Staphylococcus aureus (927 isolates, coagulase-negative staphylococci (CNS; 425 isolates, Enterococcus faecalis (320 isolates, Enterococcus faecium (157 isolates, and pneumococci (50 isolates collected from 3 teaching hospitals in Tehran were determined by agar dilution method according to Clinical and Laboratory Standards Institute (CLSI guidelines. The presence of mecA gene was investigated in methicillin-resistant staphylococci by PCR method and vanA and vanB genes were targeted in enterococcal isolates by Multiplex PCR method. The resistance rate to methicillin among S. aureus and CNS isolates were 33% and 49%, respectively. All S. aureus isolates were susceptible to vancomycin .The lowest rate of resistance in all S. aureus isolates was found for rifampicin (<4%. The vancomycin resistance rate in enterococci isolates was 11% which was more frequent among E. faecium (19% than E. faecalis (4%, all resistant isolates carrying vanA. High-level resistance to gentamicin and streptomycin, were detected in 47% and 87% of enterococcal isolates respectively. The rate of penicillin resistance in pneumococci was 3% and about 27% of isolates had reduced susceptibility to penicillin. The prevalence of erythromycin resistant among pneumococci was 58%. All pneumococcal isolates were susceptible to ceftriaxone, rifampicin and vancomycin. Our data highlight the importance of access to updated bacterial susceptibility data regarding commonly prescribed agents for clinicians in Iran.

  10. Adalimumab (Humira) restores clinical response in patients with secondary loss of efficacy from infliximab (Remicade) or etanercept (Enbrel): results from the STURE registry at Karolinska University Hospital.

    Wick, M C; Ernestam, S; Lindblad, S; Bratt, J; Klareskog, L; van Vollenhoven, R F

    2005-01-01

    To determine whether the tumour necrosis factor-alpha (TNF-alpha) antagonist adalimumab (Humira) can be efficacious after secondary loss of efficacy (i.e. loss of clinical response in patients who had initially demonstrated clinical response) to infliximab (Remicade) or etanercept (Enbrel). We studied 36 patients from the Stockholm TNF-alpha follow-up registry (STURE) who received adalimumab after secondary loss of efficacy to infliximab (group A, n = 27) or etanercept (group B, n = 9), and 26 patients who were started on adalimumab as the first TNF-alpha antagonist (group C). In group A, the baseline disease activity score 28 (DAS28) at infliximab institution was 5.5+/-0.2. During infliximab treatment, the mean best DAS28 was 3.7+/-0.2 (p<0.001), but increased to 5.2+/-0.3 when infliximab was stopped. After 3 months on adalimumab, the mean DAS28 decreased to 4.5+/-0.3 (p<0.003), and then to 4.2+/-0.2 at 6 months (p<0.001). In group B, the baseline DAS28 at etanercept institution was 6.6+/-0.5. During etanercept treatment, the mean best DAS28 was 4.6+/-0.5 (p<0.01), but increased to 5.7+/-0.4 by the time etanercept was stopped. After 3 months on adalimumab, the mean DAS28 decreased to 4.8+/-0.3 (p<0.005), and to 4.1+/-0.2 at 6 months (p<0.001). In group C, the mean baseline DAS28 was 5.6+/-0.3. After 6 months of adalimumab therapy, the DAS28 decreased to 3.5+/-0.4 (p<0.001). ACR20 responses with adalimumab in groups A, B, and C were similar (70-78%). For patients with secondary loss of efficacy from infliximab or etanercept, switching to adalimumab can restore a good clinical response.

  11. Knowledge and attitude of donating and using cord blood for transfusion among patients attending Nnamdi Azikiwe University Teaching Hospital, Nnewi, South East Nigeria

    Chide E Okocha; Nkiru N Ezeama; John C Aneke; Chinyere U Onubogu; Charles I Okafor; Chijioke G Egbunike

    2017-01-01

    Background: Allogeneic blood for transfusion is in short supply in most parts of the developing world. Cord blood for transfusion can be a significant source of blood supply to our health institutions. Aims: This study aims to investigate the knowledge and attitude to the donation and use of umbilical cord blood (UCB) for transfusion among the patients receiving services in a tertiary health institution in South-East Nigeria. Materials and Methods: This was a cross-sectional study; an a...

  12. Are medical students accepted by patients in teaching hospitals?

    Yousef Marwan

    2012-04-01

    Full Text Available Background: Worldwide, patients are the cornerstone of bedside teaching of medical students. In this study, the authors aimed to assess patients’ acceptability toward medical students in teaching hospitals of the Faculty of Medicine of Kuwait University. Methods: Ninehundred and ninety five patients were approached in 14 teaching hospitals; 932 patients agreed to participate (refusal rate is 6.3%. A self-administered questionnaire was used to collect data. Results: In general, higher acceptance of students by patients was found when there is no direct contact between the patient and the student (e.g., reading patients’ files, presenting in outpatient clinic, observing doctors performing examination or procedures compared to other situations (e.g., performing physical examination or procedures. Pediatrics patients showed higher acceptance of students compared to patients in other specialties, while Obstetrics/Gynecology patients showed the highest refusal of students. Gender of patients (especially females and students appeared to affect the degree of acceptance of medical students by patients. Majority of the patients (436; 46.8% believed that the presence of medical students in hospitals improves the quality of health care. Conclusion: Patients are an important factor of bedside teaching. Clinical tutors must take advantage of patients who accept medical students. Clinical tutors and medical students should master essential communication skills to convince patients in accepting students, thus improving bedside teaching. Also, using simulation and standardization should be considered to address scenarios that most patients are unwilling to allow students to participate.

  13. QUALITY OF WORKING LIFE IN COMMODITIZED HOSPITALS AND UNIVERSITIES

    Josep M. Blanch

    2014-01-01

    Full Text Available New Public Management (NPM turns public hospital and university services into market enterprises. The aim of the paper is to analyze and describe the impact of this metamorphosis on the labor subjectivity of the staff employed in such services. Empirical studies in Spanish and Latin American hospitals and universities uncover a paradoxical experience: relative manifest satisfaction with material and technical conditions allowing them to work harder and better, but also latent discomfort with the task overload, and professional and ethical dilemmas posed by new organizational demands, in the face of which staff develop ways of coping ranging from manifest obedience to latent resistance. This supports the reasons for the redesign of these services based on a better balance between commercial and social demands, managerial and professional values, and between business efficiency and quality of working life.

  14. Comparing the organisational structure of the preoperative assessment clinic at eight university hospitals.

    Edward, G M; Biervliet, J D; Hollmann, M W; Schlack, W S; Preckel, B

    2008-01-01

    The preoperative assessment clinic (PAC) has been implemented in most major hospitals. However, there is no uniformity in the way PACs are organised. We compared the organisational structure of the PACs from all eight university hospitals in The Netherlands, looking at the following variables: number of patients visiting the PAC, staffing of the PAC, opening hours, scheduling, and additional preoperative diagnostic testing. The number of patients seen yearly varies from 7.000 to 13.500. In all clinics, the preoperative assessment was performed by anaesthetists and residents. In five PACs, preoperative assessment was also performed by physician assistants or nurse practitioners. Opening hours varied. Consultations are by appointment, 'walk-in', or a combination of these two. In four clinics additional testing is performed at the PAC itself. This study shows that the organisational structure of the PAC at similar university hospitals varies greatly; this can have important implications when designing a benchmarking process.

  15. Experience with an end-of-life practice at a university hospital.

    Campbell, M L; Frank, R R

    1997-01-01

    To describe a 10-yr experience with an end-of-life practice in a hospital. A nonexperimental, prospective, descriptive design was used to record variables from a convenience sample of patients transferred to the Comprehensive Supportive Care Team. Detroit Receiving Hospital is an urban, university-affiliated, Level I trauma/emergency hospital. Patients who are not expected to survive hospitalization, and for whom a decision has been made to focus care on palliative interventions, are candidates for care by this practice. None. Patient demographics, including the following information: age, gender; diagnoses; illness severity; mortality rate; and disposition. Measures of resource utilization included: referral sources; Therapeutic intervention Scoring System values; bed costs; and length of hospital stay. Satisfactory patient/family care with a measurable reeducation in the use of resources can be achieved in the hospital setting. A hands-on approach to the care of dying patients by this specialty, palliative care service has provided patients, families, and clinicians with the type of support needed for satisfactory end-of-life care. A summary of our experience may be useful to others.

  16. The challenge of tobacco control at a university hospital

    Natália Ferreira Cruz

    Full Text Available Objective: To identify the actions taken by the Commission of Tobacco Control (CTC to control smoking in the hospital environment.Methods: Descriptive and exploratory retrospective documentary research conducted at a university hospital in southern Brazil, in 2014. The content of the minutes of CTC meetings was used to create a database, and the rounds reports were descriptively analyzed. We sought to identify the most relevant actions from 2005 to 2014.Results: The CTC implemented the Tobacco-Free Environment programme restricted cigarette smoking to designated areas and subsequently deactivated these areas. The only remaining outdoor smoking area in 2014 was deactivated.Conclusion: CTC actions have contributed to tobacco control in the hospital environment. This study will hopefully serve as a model to encourage other institutions to implement similar actions.

  17. Combined PACS and intranet information system in a University Hospital

    Heiss, D.; Pfluger, T.; Pfeifer, K.J.; Hahn, K.; Koenig, A.; Endres, S.

    2000-01-01

    Purpose: The Department of Radiology at the University Hospital Innenstadt Munich provides all clinical departments of a large university hospital with several radiology units at different locations. During the last four years all units have been fully digitalized with a stepwise installation of a PACS. The PACS also processes images from the Nuclear Medicine Department. Methods: As image modalities, archive systems and review workstations, we use devices from multiple vendors, which are integrated into a consistent system using the DICOM standard. The hospital has developed its own RIS and an intranet information system, which provides access to all reports and images from radiology for all clinical departments inside the hospital. Additionally, other clinical information such as laboratory results or ECG examinations are available through the system. Results: After one year of operation, the system succeeded in the clinical routine work as the primary source for radiological reports and images as well as for laboratory values. Conclusion: The advantages of digitalization were, besides reduction of film cost, especially optimizations of work flow with access to digital images from every where at any time. (orig.) [de

  18. [The role of university hospital executive board members].

    Debatin, J F; Rehr, J

    2009-09-01

    Demographic changes and medical progress in combination with vastly altered regulatory and economic environments have forced considerable change in the structure of German university hospitals in recent years. These changes have affected medical care as well as research and medical school training. To allow for more flexibility and a higher level of reactivity to the changing environment German university hospitals were transferred from state agencies to independent corporate structures. All but one remains wholly owned by the respective state governments. The governing structure of these independent medical hospitals consists of an executive board, generally made up of a medical director, a financial director, a director for nursing, and the dean of the medical faculty. In most hospitals, the medical director serves as chief executive officer. The regulations governing the composition and responsibility of the members of the executive board differ from state to state. These differences do affect to some degree the interactive effectiveness of the members of the executive boards. Modalities that stress the overall responsibility for all board members seem to work better than those that define clear portfolio limits. Even more than organizational and regulatory differences, the effectiveness of the work of the executive boards is influenced by the personality of the board members themselves. Success appears to be a clear function of the willingness of all members to work together.

  19. Patient (customer) expectations in hospitals.

    Bostan, Sedat; Acuner, Taner; Yilmaz, Gökhan

    2007-06-01

    The expectations of patient are one of the determining factors of healthcare service. The purpose of this study is to measure the Patients' Expectations, based on Patient's Rights. This study was done with Likert-Survey in Trabzon population. The analyses showed that the level of the expectations of the patient was high on the factor of receiving information and at an acceptable level on the other factors. Statistical meaningfulness was determined between age, sex, education, health insurance, and the income of the family and the expectations of the patients (pstudy, the current legal regulations have higher standards than the expectations of the patients. The reason that the satisfaction of the patients high level is interpreted due to the fact that the level of the expectation is low. It is suggested that the educational and public awareness studies on the patients' rights must be done in order to increase the expectations of the patients.

  20. Ocular related emergencies in Zagreb University Hospital Centre--ten month analysis.

    Skegro, Ivan; Kordić, Rajko; Kuzman, Tomislav; Perić, Sanja; Kutija, Marija Barisić; Jandroković, Sonja; Jukić, Tomislav

    2013-04-01

    To determine number, demographic characteristics and presenting symptoms of patients admitted to Emergency ophthalmologic department of Zagreb University hospital centre. Prospective analysis of data of 743 patients admitted to Emergency ophthalmologic department of University hospital centre Zagreb during period of 10 month. Main presenting symptoms at admission were red eye, pain and foreign body sensation. 64% of all patients admitted to emergency unit were male. Almost 40% of them were between 20 and 40 years of age. In female population majority is between 50 and 60 years old (19.33%). The study shows that the most frequent reason for admission in emergency ophthalmic unit is red eye, pain and foreign body sensation. These symptoms were present most frequently in young male patients. Considering fact of their working ability, data can suggest that they don't comply with occupational safety measures. Further research in this direction is needed.

  1. Histopathological diagnosis of eyelid tumors in Chiang Mai University Hospital.

    Nithithanaphat, Chanut; Ausayakhun, Sakarin; Wiwatwongwana, Damrong; Mahanupab, Pongsak

    2014-10-01

    To report the histopathological diagnosis ofeyelid tumors and to study the prevalence of eyelid tumors in Chiang Mai University Hospital Chiang Mai, Thailand. A retrospective review of medical and pathological records ofpatients diagnosed as eyelid tumor that underwent histopathological biopsy between January 2007 and December 2013 in Chiang Mai University Hospital was done. Three hundred sixteen cases of eyelid tumors were reviewed. The mean age at diagnosis was 54.2 +/- 19.6 years (range 1 month-99 years), women were 59.5% (n = 188) and men 40.5% (n = 128). The tumor sites were left lower eyelid (27.5%), right upper eyelid (24.4%), right lower eyelid (21.2%), and left upper eyelid (18.7%). There were 204 (64.6%) benign tumors and 112 (35.4%) malignant tumors. Nevi were the most common in benign group (16.4%) and basal cell carcinoma was the most common eyelid malignancy (18.0%). The most common histopathological diagnosis for benign eyelid tumor was nevus, while the most common malignant eyelid tumor was basal cell carcinoma at Chiang Mai University Hospital.

  2. [Description of current hypnosis practice in French university hospitals].

    Chabridon, G; Nekrouf, N; Bioy, A

    2017-10-01

    Hypnosis is very fashionable as an entertainment through TV shows searching for new sensational experiences. What about its practice in the medical world? The aim of this article is to answer to this question. Therefore, we contacted every French University Hospital of each region to find out if hypnosis was practiced for the care of pain (hypnoanalgesia), for chirurgical procedures (hypnosedation) and in adult psychiatry care units (hypnotherapy). For this last practice, we also questioned the type of indications. All 30 of the French University Hospitals had replied by November 2015. Hypnoanalgesia is practiced by all and two-thirds offer hypnosedation. Hypnotherapy is practiced by 40 % of the University Hospitals, 91,7 % for anxiety disorders, 66,7 % for psychotraumatic care and 25 % for mood disorders. Therefore, hypnosis seems to have found its place in the care of pain and as an anesthetic to replace standard procedures. However, the use of hypnotherapy in psychiatry is less frequent, indications for its use being variable and not very consensual. Copyright © 2016 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

  3. Healthcare professionals' work engagement in Finnish university hospitals.

    Lepistö, Sari; Alanen, Seija; Aalto, Pirjo; Järvinen, Päivi; Leino, Kaija; Mattila, Elina; Kaunonen, Marja

    2017-10-10

    Concerns about the sufficiency and dedication of the healthcare workforce have arisen as the baby boomer generation is retiring and the generation Y might have different working environment demands. To describe the association between work engagement of healthcare professionals' and its background factors at five Finnish university hospitals. Survey data were collected from nurses, physicians and administrative staff (n = 561) at all five university hospitals in Finland. Data were collected using an electronic questionnaire that comprised the Utrecht Work Engagement Scale (9 items) and 13 questions regarding the respondents' backgrounds. Descriptive and correlational analyses were used to examine the data. Most respondents were female (85%) and nursing staff (72%). Baby boomers (49%) were the largest generational cohort. The work engagement composite mean for the total sample was 5.0, indicating high work engagement. Significant differences in work engagement existed only among sex and age groups. The highest work engagement scores were among administrative staff. Work engagement among healthcare professionals in Finnish university hospitals is high. High work engagement might be explained by suitable job resources and challenges, as well as opportunities provided by a frontline care environment. Attention should especially be paid to meeting the needs of young people entering the workforce to strengthen their dedication and absorption. © 2017 Nordic College of Caring Science.

  4. Knowledge and attitude of donating and using cord blood for transfusion among patients attending Nnamdi Azikiwe University Teaching Hospital, Nnewi, South East Nigeria.

    Okocha, Chide E; Ezeama, Nkiru N; Aneke, John C; Onubogu, Chinyere U; Okafor, Charles I; Egbunike, Chijioke G

    2017-01-01

    Allogeneic blood for transfusion is in short supply in most parts of the developing world. Cord blood for transfusion can be a significant source of blood supply to our health institutions. This study aims to investigate the knowledge and attitude to the donation and use of umbilical cord blood (UCB) for transfusion among the patients receiving services in a tertiary health institution in South-East Nigeria. This was a cross-sectional study; an anonymous structured questionnaire was used. A total of 549 consenting patients randomly selected from the antenatal, postnatal, sickle cell clinics, and wards were the subjects. Statistical analysis of the data was done using SPSS version 20.0. The mean age of the participants was 31.9 ± 9.5 years. The majority were females (77.2%), married (86.4%). About 26.2% of the respondents were willing to accept UCB for transfusion to them or their child. Following counseling, the acceptance rate increased to 71.5%. Most of the respondents (80.0%) were willing to donate the UCB of their baby; or be tested for HIV (93.3%), if necessary. Educational level was significantly associated with knowledge of UCB. After logistic regression, occupation, and gender were significantly associated with acceptance of UCB for transfusion. Up to 52% belonged to low income family background, approximately 150 US dollars monthly family income (50,000 naira). The knowledge and acceptance of UCB for transfusion are low in our environment. However, proper counseling and public enlightenment could change this attitude.

  5. The HOSPITAL score and LACE index as predictors of 30 day readmission in a retrospective study at a university-affiliated community hospital

    Robert Robinson

    2017-03-01

    Full Text Available Introduction Hospital readmissions are common, expensive, and a key target of the Medicare Value Based Purchasing (VBP program. Validated risk assessment tools such as the HOSPITAL score and LACE index have been developed to identify patients at high risk of hospital readmission so they can be targeted for interventions aimed at reducing the rate of readmission. This study aims to evaluate the utility of HOSPITAL score and LACE index for predicting hospital readmission within 30 days in a moderate-sized university affiliated hospital in the midwestern United States. Materials and Methods All adult medical patients who underwent one or more ICD-10 defined procedures discharged from the SIU-SOM Hospitalist service from Memorial Medical Center (MMC from October 15, 2015 to March 16, 2016, were studied retrospectively to determine if the HOSPITAL score and LACE index were a significant predictors of hospital readmission within 30 days. Results During the study period, 463 discharges were recorded for the hospitalist service. The analysis includes data for the 432 discharges. Patients who died during the hospital stay, were transferred to another hospital, or left against medical advice were excluded. Of these patients, 35 (8% were readmitted to the same hospital within 30 days. A receiver operating characteristic evaluation of the HOSPITAL score for this patient population shows a C statistic of 0.75 (95% CI [0.67–0.83], indicating good discrimination for hospital readmission. The Brier score for the HOSPITAL score in this setting was 0.069, indicating good overall performance. The Hosmer–Lemeshow goodness of fit test shows a χ2 value of 3.71 with a p value of 0.59. A receiver operating characteristic evaluation of the LACE index for this patient population shows a C statistic of 0.58 (95% CI [0.48–0.68], indicating poor discrimination for hospital readmission. The Brier score for the LACE index in this setting was 0.082, indicating good

  6. Medicare Hospital Spending Per Patient - State

    U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...

  7. Medicare Hospital Spending Per Patient - National

    U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...

  8. Variation in Annual Volume at a University Hospital Does Not Predict Mortality for Pancreatic Resections

    Rita A. Mukhtar

    2008-01-01

    Full Text Available Annual volume of pancreatic resections has been shown to affect mortality rates, prompting recommendations to regionalize these procedures to high-volume hospitals. Implementation has been difficult, given the paucity of high-volume centers and the logistical hardships facing patients. Some studies have shown that low-volume hospitals achieve good outcomes as well, suggesting that other factors are involved. We sought to determine whether variations in annual volume affected patient outcomes in 511 patients who underwent pancreatic resections at the University of California, San Francisco between 1990 and 2005. We compared postoperative mortality and complication rates between low, medium, or high volume years, designated by the number of resections performed, adjusting for patient characteristics. Postoperative mortality rates did not differ between high volume years and medium/low volume years. As annual hospital volume of pancreatic resections may not predict outcome, identification of actual predictive factors may allow low-volume centers to achieve excellent outcomes.

  9. EVALUATION OF MALE SEX HORMONES AND TRACE ELEMENTS IN MALE TYPE 2 DIABETIC PATIENTS ATTENDING NNAMDI AZIKIWE UNIVERSITY TEACHING HOSPITAL DIABETIC CLINICS.

    Ubajaka, C F; Meludu, S C; Dioka, C E; Onah, C E; Osuji, C U; Modebe, I A; Ifeadike, G C; Okwara, J E; Amah, U K; Nnebue, C C

    2015-01-01

    There is accumulating evidence that the metabolism of male sex hormones and several trace elements are altered in type 2 diabetic mellitus and may have specific role in the pathogenesis and progression of the disease. To assess the levels of male sex hormones and trace elements in type 2 diabetic patients and to ascertain an association between male sex hormones and trace elements among diabetic subjects. A descriptive cross sectional study was conducted among 125 diabetic and 50 non diabetic subjects. Venous blood samples were collected from all respondents and estimated for fasting blood glucose, male sex hormones and trace elements. The results were subjected to statistical analysis and comparison using Students' test and Pearson correlation analysis. The mean testosterone level was significantly lower in diabetics than in controls (3.9 ± 1.9ng/ml) in comparison with (5.1 ± 1.7ng/ml; P < 0.05). The mean value of Zinc, Manganese, Selenium and Chromium were significantly lower among the diabetics when compared with the controls (Zn;898.7 ± 131.0 μg/l; Mn:0.30 ± 0.06 μg/l;Se:51.3 ± 11.1 μg/l; Cr: 0.04 ± 0.03 μg/I) in comparison with (Zn: 1007.3 ± 85.2 μg/l; Mn: 0.05 ± 0.07μg/l; Se: 62.1 ± 11.1 μg/l; Cr: 0.06 ± 0.01 μg/l; P < 0.05).The mean Fasting Blood Glucose in diabetic subjects was significantly higher when compared with the controls (7.9 ± 3.7 mmol/l) in comparison with (4.6 ± 0.4 mmol/l; P < 0.05).The trace elements showed a positive correlation with testosterone in diabetic subjects (Zn r = 0.359, Ser = 0.443, Mn r = 0.350, P < 0.05). This study observed decreased levels of testosterone and trace elements in type 2 diabetics and a positive correlation between low testosterone and low trace elements levels in diabetic subjects. These trace elements are antioxidants and their low levels in diabetic patients may further increase the severity of the disease.

  10. [Analysis of HIV antibody positive cases in Peking University Hospital of Stomatology during 9 years].

    Ding, Jian-fen; Qiu, Juan; Shen, Shu-ming

    2016-02-01

    To investigate the prevalence and characteristics of HIV patients found in Peking University Hospital of Stomatology during 9 years, and provide management strategy for early diagnosis and control of HIV in Stomatology Hospital. A retrospective study of the HIV positive patients diagnosed by HIV antibody screening was carried out. The related information about these patients found in Peking University School of Stomatology during 2005-2013 was obtained from China Disease Control Information System. 68,562 patients accepted HIV antibody screening in Peking University Hospital of Stomatology during 2005-2013. Thirty one patients were found HIV antibody positive. The ratio of HIV antibody positive was about 0.045%, which was composed of 25 males and 6 females. 61.29% patients aged between 20-40 years, and their career was mainly commercial service with a education level of junior high school. The proportion of sexual route of transmission was about 74.91%, and 34.78% of them were male homosexuality. Most of the patients with HIV antibody positive were found in the out-patient clinic, especially in the department of oral mucosal diseases, accounting for 70.97%. HIV antibody positive rate in Peking University School of Stomatology was slightly lower than that in general hospitals. Medical staff should increase their awareness of AIDS prevention and control, for higher HIV risk departments, such as oral mucosal diseases and periodontal disease, efforts should be made to increase HIV screening, expand the scope of screening, and promote provider-initiated HIV testing and counseling.

  11. Inadequate Nutritional Status of Hospitalized Cancer Patients

    Ali Alkan

    2017-03-01

    Full Text Available Objective: In oncology practice, nutrition and also metabolic activity are essential to support the nutritional status and prevent malignant cachexia. It is important to evaluate the patients and plan the maneuvers at the start of the therapy. The primary objective of the study is to define the nutritional status of hospitalized patients and the factors affecting it in order to define the most susceptible patients and maneuvers for better nutritional support. Methods: Patients hospitalized in oncology clinic for therapy were evaluated for food intake and nutritional status through structured interviews. The clinical properties, medical therapies, elements of nutritional support were noted and predictors of inadequate nutritional status (INS were analyzed. Results: Four hundred twenty three patients, between 16-82 years old (median: 52 were evaluated. Nearly half of the patients (185, 43% reported a better appetite at home than in hospital and declared that hospitalization is an important cause of loss of appetite (140/185, 75.6%. Presence of nausea/vomiting (N/V, depression, age less than 65 and use of non-steroidal anti-inflammatory drugs (NSAIDs were associated with increased risk of INS in hospitalized cancer patients. On the contrary, steroid medication showed a positive impact on nutritional status of cancer patients. Conclusion: N/V, younger age, presence of depression and NSAIDs medication were associated with INS in hospitalized cancer patients. Clinicians should pay more attention to this group of patients. In addition, unnecessary hospitalizations and medications that may disturb oral intake must be avoided. Corticosteroids are important tools for managing anorexia and INS.

  12. Oncology patients hospitalized in the Clinicas Hospital Dr. Manuel Quintela

    Arostegui, M.; Borba, M.; Caldarelli, D.; Eguiia, A.; Fernandez, E.; Peleteiro, M.; Pereira, C.; Vico, M.

    2004-01-01

    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

  13. Diagnostic procedures, treatments, and outcomes in stroke patients admitted to different types of hospitals.

    Asplund, Kjell; Sukhova, Maria; Wester, Per; Stegmayr, Birgitta

    2015-03-01

    In many countries, including Sweden, initiatives have been taken to reduce between-hospital differences in the quality of stroke services. We have explored to what extent hospital type (university, specialized nonuniversity, or community hospital) influences hospital performance. Riksstroke collects clinical data during hospital stay (national coverage 94%). Follow-up data at 3 months were collected using administrative registers and a questionnaire completed by surviving patients (response rate 88%). Structural data were collected from a questionnaire completed by hospital staff (response rate 100%). Multivariate analyses with adjustment for clustering were used to test differences between types of hospitals. The proportion of patients admitted directly to a stroke unit was highest in community hospitals and lowest in university hospitals. Magnetic resonance, carotid imaging, and thrombectomy were more frequently performed in university hospitals, and the door-to-needle time for thrombolysis was shorter. Secondary prevention with antihypertensive drugs was used less often, and outpatient follow-up was less frequent in university hospitals. Fewer patients in community hospitals were dissatisfied with their rehabilitation. After adjusting for possible confounders, poor outcome (dead or activities of daily living dependency 3 months after stroke) was not significantly different between the 3 types of hospital. In a setting with national stroke guidelines, stroke units in all hospitals, and measurement of hospital performance and benchmarking, outcome (after case-mix adjustment) is similar in university, specialized nonuniversity, and community hospitals. There seems to be fewer barriers to organizing well-functioning stroke services in community hospitals compared with university hospitals. © 2015 American Heart Association, Inc.

  14. Knowledge of the mothers of hospitalized children in a university hospital regarding diarrhea

    Ana Paula do Rego

    2014-04-01

    Full Text Available This qualitative research aimed at identifying the knowledge of the mothers regarding diarrhea. It was conducted with eight mothers of hospitalized children in a university hospital located in Santa Cruz, Rio Grande do Norte, Brazil, in 2012. Data were collected through open interviews and the analysis was based on Bardin. The categories emerging from the analysis were: understanding diarrhea and preventing/treating diarrhea. Regarding the understanding of diarrhea, mothers conceptualize and understand it from the symptoms, habits/eating mistakes and/or cultural beliefs. Concerning the prevention and treatment of the disease, the mothers highlight hygiene and home cleaning as preventive measures, as well the importance of home and hospital care measures. The interviewees have basic knowledge of pathology, further studies are necessary in order to define the current gap between the knowledge of mothers and recurrence of diarrhea cases, resulting in hospitalization and expenses with unnecessary treatment.

  15. 15 Pattern of bladder cancer at University Teaching Hospital, Lusaka,

    Esem

    bladder cancer who presented to the hospital during this period were recruited .... malignant tissues. Table 2: Distribution of variables among patients. Gender number. Percentage .... cancer of the cervix, cancer of the eye, breast cancer,. Kaposi's sarcoma .... as a result of national wide roll out of anti retroviral treatment in ...

  16. Hospitalized Patients' Responses to Offers of Prayer.

    McMillan, Kathy; Taylor, Elizabeth Johnston

    2018-02-01

    Most Americans pray; many pray about their health. When they are hospitalized, however, do patients want an offer of prayer from a healthcare provider? This project allowed for the measurement of hospitalized patient's responses to massage therapists' offers of a colloquial prayer after a massage. After the intervention, 78 patients completed questionnaires that elicited quantitative data that were analyzed using uni- and bivariate statistical analyses. In this sample, 88% accepted the offer of prayer, 85% found it helpful, and 51% wanted prayer daily. Patients may welcome prayer, as long as the clinician shows "genuine kindness and respect."

  17. In vitro activity of colistin mono- and combination therapy against colistin-resistant Acinetobacter baumannii, mechanism of resistance, and clinical outcomes of patients infected with colistin-resistant A. baumannii at a Thai university hospital

    Lertsrisatit Y

    2017-11-01

    Full Text Available Yongyut Lertsrisatit,1 Wichai Santimaleeworagun,2,3 Sudaluck Thunyaharn,4 Jantima Traipattanakul5 1College of Pharmacotherapy Thailand, Nonthaburi, Thailand; 2Department of Pharmacy, Faculty of Pharmacy, Silpakorn University, Nakorn Pathom, Thailand; 3Pharmaceutical Initiative for Resistant Bacteria and Infectious Diseases Working Group (PIRBIG Faculty of Pharmacy, Silpakorn University, Nakorn Pathom, Thailand; 4Faculty of Medical Technology, Nakhonratchasima College, Nakhonratchasima, Thailand; 5Division of Infectious Disease, Department of Medicine, Phramongkutklao Hospital, Bangkok, Thailand Purpose: Colistin is a drug of last resort for treating multidrug-resistant Acinetobacter baumannii infections. Unfortunately, colistin-resistant A. baumannii (CoR-AB has been reported. Here, we examined the in vitro effect of mono- and combined antimicrobials against CoR-AB strains and their resistance mechanism, and evaluated the clinical outcomes of CoR-AB-infected patients.Patients and methods: Seventeen clinical CoR-AB strains were isolated from patients at Phramongkutklao hospital, 2011–2015. The mono- and synergistic activities of colistin, tigecycline, sulbactam, imipenem, meropenem, amikacin, fosfomycin, and cotrimoxazole were examined by minimum inhibitory concentration (MIC and fractional inhibitory concentration index. Clonal relationship and resistance genes were determined by repetitive extragenic palindromic polymerase chain reaction with specific primers. The effect of carbonyl cyanide 3-chlorophenylhydrazone combined with colistin was used to test efflux pump involvement. Patient treatment outcomes were also reported.Results: The most prevalent infection in CoR-AB patients was pneumonia (35.3%, and all patients were administered colistin combined with another agent. The 30-day mortality was 70.6%, and the colistin MIC range and MIC50 was 16–512 µg/mL and 64 µg/mL, respectively. All CoR-AB strains were sensitive to tigecycline

  18. Bacterial Isolates from Blood Samples of Patients in University of ...

    Bacterial Isolates from Blood Samples of Patients in University of Benin Teaching Hospital Benin City, Edo State, Nigeria. ... The thioglychollate broth was sub cultured onto blood agar plate for anaerobic incubation, while the brain heart infusion broth was sub cultured onto chocolate, blood agar and McConkey agar for ...

  19. Organizing integrated care in a university hospital: application of a conceptual framework

    Axelsson, Runo; Axelsson, Susanna Bihari; Gustafsson, Jeppe; Seemann, Janne

    2014-01-01

    Background and aim As a result of New Public Management, a number of industrial models of quality management have been implemented in health care, mainly in hospitals. At the same time, the concept of integrated care has been developed within other parts of the health sector. The aim of the article is to discuss the relevance of integrated care for hospitals. Theory and methods The discussion is based on application of a conceptual framework outlining a number of organizational models of integrated care. These models are illustrated in a case study of a Danish university hospital implementing a new organization for improving the patient flows of the hospital. The study of the reorganization is based mainly on qualitative data from individual and focus group interviews. Results The new organization of the university hospital can be regarded as a matrix structure combining a vertical integration of clinical departments with a horizontal integration of patient flows. This structure has elements of both interprofessional and interorganizational integration. A strong focus on teamwork, meetings and information exchange is combined with elements of case management and co-location. Conclusions It seems that integrated care can be a relevant concept for a hospital. Although the organizational models may challenge established professional boundaries and financial control systems, this concept can be a more promising way to improve the quality of care than the industrial models that have been imported into health care. This application of the concept may also contribute to widen the field of integrated care. PMID:24966806

  20. Organizing integrated care in a university hospital: application of a conceptual framework.

    Axelsson, Runo; Axelsson, Susanna Bihari; Gustafsson, Jeppe; Seemann, Janne

    2014-04-01

    As a result of New Public Management, a number of industrial models of quality management have been implemented in health care, mainly in hospitals. At the same time, the concept of integrated care has been developed within other parts of the health sector. The aim of the article is to discuss the relevance of integrated care for hospitals. The discussion is based on application of a conceptual framework outlining a number of organizational models of integrated care. These models are illustrated in a case study of a Danish university hospital implementing a new organization for improving the patient flows of the hospital. The study of the reorganization is based mainly on qualitative data from individual and focus group interviews. The new organization of the university hospital can be regarded as a matrix structure combining a vertical integration of clinical departments with a horizontal integration of patient flows. This structure has elements of both interprofessional and interorganizational integration. A strong focus on teamwork, meetings and information exchange is combined with elements of case management and co-location. It seems that integrated care can be a relevant concept for a hospital. Although the organizational models may challenge established professional boundaries and financial control systems, this concept can be a more promising way to improve the quality of care than the industrial models that have been imported into health care. This application of the concept may also contribute to widen the field of integrated care.

  1. A qualitative study of DRG coding practice in hospitals under the Thai Universal Coverage Scheme

    Winch Peter J

    2011-04-01

    Full Text Available Abstract Background In the Thai Universal Coverage health insurance scheme, hospital providers are paid for their inpatient care using Diagnosis Related Group-based retrospective payment, for which quality of the diagnosis and procedure codes is crucial. However, there has been limited understandings on which health care professions are involved and how the diagnosis and procedure coding is actually done within hospital settings. The objective of this study is to detail hospital coding structure and process, and to describe the roles of key hospital staff, and other related internal dynamics in Thai hospitals that affect quality of data submitted for inpatient care reimbursement. Methods Research involved qualitative semi-structured interview with 43 participants at 10 hospitals chosen to represent a range of hospital sizes (small/medium/large, location (urban/rural, and type (public/private. Results Hospital Coding Practice has structural and process components. While the structural component includes human resources, hospital committee, and information technology infrastructure, the process component comprises all activities from patient discharge to submission of the diagnosis and procedure codes. At least eight health care professional disciplines are involved in the coding process which comprises seven major steps, each of which involves different hospital staff: 1 Discharge Summarization, 2 Completeness Checking, 3 Diagnosis and Procedure Coding, 4 Code Checking, 5 Relative Weight Challenging, 6 Coding Report, and 7 Internal Audit. The hospital coding practice can be affected by at least five main factors: 1 Internal Dynamics, 2 Management Context, 3 Financial Dependency, 4 Resource and Capacity, and 5 External Factors. Conclusions Hospital coding practice comprises both structural and process components, involves many health care professional disciplines, and is greatly varied across hospitals as a result of five main factors.

  2. A qualitative study of DRG coding practice in hospitals under the Thai Universal Coverage scheme.

    Pongpirul, Krit; Walker, Damian G; Winch, Peter J; Robinson, Courtland

    2011-04-08

    In the Thai Universal Coverage health insurance scheme, hospital providers are paid for their inpatient care using Diagnosis Related Group-based retrospective payment, for which quality of the diagnosis and procedure codes is crucial. However, there has been limited understandings on which health care professions are involved and how the diagnosis and procedure coding is actually done within hospital settings. The objective of this study is to detail hospital coding structure and process, and to describe the roles of key hospital staff, and other related internal dynamics in Thai hospitals that affect quality of data submitted for inpatient care reimbursement. Research involved qualitative semi-structured interview with 43 participants at 10 hospitals chosen to represent a range of hospital sizes (small/medium/large), location (urban/rural), and type (public/private). Hospital Coding Practice has structural and process components. While the structural component includes human resources, hospital committee, and information technology infrastructure, the process component comprises all activities from patient discharge to submission of the diagnosis and procedure codes. At least eight health care professional disciplines are involved in the coding process which comprises seven major steps, each of which involves different hospital staff: 1) Discharge Summarization, 2) Completeness Checking, 3) Diagnosis and Procedure Coding, 4) Code Checking, 5) Relative Weight Challenging, 6) Coding Report, and 7) Internal Audit. The hospital coding practice can be affected by at least five main factors: 1) Internal Dynamics, 2) Management Context, 3) Financial Dependency, 4) Resource and Capacity, and 5) External Factors. Hospital coding practice comprises both structural and process components, involves many health care professional disciplines, and is greatly varied across hospitals as a result of five main factors.

  3. Hospital costs fell as numbers of LVADs were increasing: experiences from Oslo University Hospital

    Mishra Vinod

    2012-08-01

    Full Text Available Abstract Background The current study was undertaken to examine total hospital costs per patient of a consecutive implantation series of two 3rd generation Left Ventricle Assist Devices (LVAD. Further we analyzed if increased clinical experience would reduce total hospital costs and the gap between costs and the diagnosis related grouped (DRG-reimbursement. Method Cost data of 20 LVAD implantations (VentrAssist™ from 2005-2009 (period 1 were analyzed together with costs from nine patients using another LVAD (HeartWare™ from 2009-June 2011 (period 2. For each patient, total costs were calculated for three phases - the pre-LVAD implantation phase, the LVAD implantation phase and the post LVAD implant phase. Patient specific costs were obtained prospectively from patient records and included personnel resources, medication, blood products, blood chemistry and microbiology, imaging and procedure costs including operating room costs. Overhead costs were registered retrospectively and allocated to the specific patient by predefined allocation keys. Finally, patient specific costs and overhead costs were aggregated into total hospital costs for each patient. All costs were calculated in 2011-prices. We used regression analyses to analyze cost variations over time and between the different devices. Results The average total hospital cost per patient for the pre-LVAD, LVAD and post-LVAD for period 1 was $ 585, 513 (range 132, 640- 1 247, 299, and the corresponding DRG- reimbursement (2009 was $ 143, 192 . The mean LOS was 54 days (range 12- 127. For period 2 the total hospital cost per patient was $ 413, 185 (range 314, 540- 622, 664 and the corresponding DRG- reimbursement (2010 was $ 136, 963. The mean LOS was 49 days (range 31- 93. The estimates from the regression analysis showed that the total hospital costs, excluding device costs, per patient were falling as the number of treated patients increased. The estimate from the trend variable was -14

  4. Daily antibiotic cost of nosocomial infections in a Turkish university hospital

    Yalcin Ata

    2005-01-01

    Full Text Available Abstract Background Many studies associated nosocomial infections with increased hospital costs due to extra days in hospital, staff time, extra investigations and drug treatment. The cost of antibiotic treatment for these infections represents a significant part of hospital expenditure. This prospective observational study was designed to determine the daily antibiotic cost of nosocomial infections per infected adult patient in Akdeniz University Hospital. Methods All adult patients admitted to the ICUs between January 1, 2000, and June 30, 2003 who had only one nosocomial infection during their stay were included in the study. Infection sites and pathogens, antimicrobial treatment of patient and it's cost were recorded. Daily antibiotic costs were calculated per infected patient. Results Among the 8460 study patients, 817 (16.6% developed 1407 episodes of nosocomial infection. Two hundred thirty three (2.7% presented with only one nosocomial infection. Mean daily antibiotic cost was $89.64. Daily antibiotic cost was $99.02 for pneumonia, $94.32 for bloodstream infection, $94.31 for surgical site infection, $52.37 for urinary tract infection, and $162.35 for the other infections per patient. The treatment of Pseudomonas aeruginosa infections was the most expensive infection treated. Piperacillin-tazobactam and amikacin were the most prescribed antibiotics, and meropenem was the most expensive drug for treatment of the nosocomial infections in the ICU. Conclusions Daily antibiotic cost of nosocomial infections is an important part of extra costs that should be reduced providing rational antibiotic usage in hospitals.

  5. Patient choice modelling: how do patients choose their hospitals?

    Smith, Honora; Currie, Christine; Chaiwuttisak, Pornpimol; Kyprianou, Andreas

    2018-06-01

    As an aid to predicting future hospital admissions, we compare use of the Multinomial Logit and the Utility Maximising Nested Logit models to describe how patients choose their hospitals. The models are fitted to real data from Derbyshire, United Kingdom, which lists the postcodes of more than 200,000 admissions to six different local hospitals. Both elective and emergency admissions are analysed for this mixed urban/rural area. For characteristics that may affect a patient's choice of hospital, we consider the distance of the patient from the hospital, the number of beds at the hospital and the number of car parking spaces available at the hospital, as well as several statistics publicly available on National Health Service (NHS) websites: an average waiting time, the patient survey score for ward cleanliness, the patient safety score and the inpatient survey score for overall care. The Multinomial Logit model is successfully fitted to the data. Results obtained with the Utility Maximising Nested Logit model show that nesting according to city or town may be invalid for these data; in other words, the choice of hospital does not appear to be preceded by choice of city. In all of the analysis carried out, distance appears to be one of the main influences on a patient's choice of hospital rather than statistics available on the Internet.

  6. Presbycusis in Nigerians at the University College Hospital, Ibadan.

    Ogunleye, A O A; Labaran, A O

    2005-09-01

    Presbycusis refers to sensori-neural hearing impairment in elderly individuals resulting from the degenerative changes of aging. Characteristically, it involves bilateral sensorineural hearing loss, worse at high frequencies, which is associated with difficulty in speech discrimination and central auditory processing of information. The aim of this study is to present our observations on presbycusis as seen in Nigerians. A 41/2-year prospective study of 67 patients that presented with features of presbycusis in the Ear, Nose and Throat Department of the University College Hospital, Ibadan, Nigeria between January 2000 and June 2004 was done. The diagnosis of presbycusis in each subject was based on history, clinical findings, and pure tone audiometry. 67 patients with features of presbycusis were seen and treated over the studied period with 37 males (55.2%), 30 females (44.8%) (M:F 1.2:1) and with an average age of 69.3 years (age range 46-90 years). Presbycusis constituted 2.4% of the 2817 otological cases seen during the studied period. Majority (64.1%) of the cases were of 6th to 8th decades of life. The symptoms were mainly of hearing loss 34 (50.7%), tinnitus 19 (28.4%), hearing loss and tinnitus together in 14 (20.9%) cases. Stria (metabolic) presbycusis 20 (29.9%) constituted the most common type of presbycusis seen in this study followed by mechanical presbycusis 15 (22.4%), neural presbycusis 14 (20.9%) and sensory presbycusis 7 (10.4%) respectively. Presbycusis has been found in this study to affect both males and females subjects almost equally, has an insidious onset as from fourth decades of life in our environment, of stria (metabolic) type mostly, presents with moderate to severe sensori-neural hearing loss (SNHL), and constitute an important problem in the society as it occurs in an elderly population that relies on their special senses (especially auditory) to compensate for other age-associated disabilities.

  7. The effect of incident tuberculosis on immunological response of HIV patients on highly active anti-retroviral therapy at the university of Gondar hospital, northwest Ethiopia: a retrospective follow-up study.

    Assefa, Abate; Gelaw, Baye; Getnet, Gebeyaw; Yitayew, Gashaw

    2014-08-27

    Human immunodeficiency virus (HIV) infection is usually complicated by high rates of tuberculosis (TB) co-infection. Impaired immune response has been reported during HIV/TB co-infection and may have significant effect on anti-retroviral therapy (ART). TB/HIV co - infection is a major public health problem in Ethiopia. Therefore, the aim of the study was to assess the effect of TB incidence on immunological response of HIV patients during ART. A retrospective follow-up study was conducted among adult HIV patients who started ART at the University of Gondar Hospital. Changes in CD4+ T - lymphocyte count and incident TB episodes occurring during 42 months of follow up on ART were assessed. Life table was used to estimate the cumulative immunologic failure. Kaplan-Meier curve was used to compare survival curves between the different categories. Cox-proportional hazard model was employed to examine predictors of immunological failure. Among 400 HIV patients, 89(22.2%) were found to have immunological failure with a rate of 8.5 per 100 person-years (PY) of follow-up. Incident TB developed in 26(6.5%) of patients, with an incidence rate of 2.2 cases per 100 PY. The immunological failure rate was high (20.1/100PY) at the first year of treatment. At multivariate analysis, Cox regression analysis showed that baseline CD4+ T - cell count immunological failure. There was borderline significant association with incident TB (AHR 2.2; 95%CI: 0.94 - 5.09, p = 0.06). The risk of immunological failure was significantly higher (38.5%) among those with incident TB compared with TB - free (21.1%) (Log rank p = 0.036). High incidence of immunological failure occurred within the first year of initiating ART. The proportions of patients with impaired immune restoration were higher among patients with incident TB. Lower baseline CD4+ T - cells count of immunological failure. The result highlighted the beneficial effects of earlier initiation of ART on CD4+ T - cell count recovery.

  8. Experience with the Implementation of Clinical Pharmacy Services and Processes in a University Hospital in Belgium.

    Somers, Annemie; Claus, Barbara; Vandewoude, Koen; Petrovic, Mirko

    2016-03-01

    This article summarizes the experience with the development of clinical pharmacy services in the Ghent University Hospital in Belgium. Implementation of clinical pharmacy services in Belgian hospitals has not been evident because these activities were initially not structurally financed. The aim is to describe the strengths and weaknesses of the clinical pharmacy development process, and the milestones that enhanced the progress. Furthermore, the organisation of clinical pharmacy in the Ghent University Hospital is explained, including back- and front-office activities, seamless pharmaceutical care and medication safety improvement. Some working methods, procedures and tools are explained for different clinical pharmacy services. In particular, the clinical pharmacy projects for geriatric patients as well as the preparation of clinical pharmacy services for the accreditation process are explained. We also reflect on the organisation model and the future development of clinical pharmacy, taking into consideration facilitators and potential barriers.

  9. Perfil nutricional e alimentar de portadores de HIV-1/AIDS internados em um hospital universitário = Nutritional and alimentary profile of HIV-1/AIDS patients admitted in a university hospital

    Kauffmann, Luanny Kaísa de Oliveira

    2017-01-01

    Full Text Available Objetivo: Avaliar o perfil nutricional e alimentar de portadores de HIV-1, internados em um hospital universitário. Materiais e Métodos: Tratou-se de um estudo transversal, descritivo, no qual a população de estudo foi composta por 54 pacientes internados, de ambos os sexos, adultos, com faixa etária de 20 a 59 anos, acompanhados durante o período de Abril a Outubro de 2014, na Clínica de Doenças Infecciosas e Parasitárias (DIP, do Hospital Universitário João de Barros Barreto (HUJBB/UFPA. Foi utilizado formulário próprio para o levantamento das características demográficas, socioeconômicas, antropométricas e dietéticas (QFA. Para verificar a as diferenças de médias foi realizada a análise de variância (ANOVA e o grau de associação entre as variáveis foi medido pela correlação de Pearson, estabeleceu-se como significância valor de p<0,05. Resultados: Prevalência do sexo masculino, os pacientes pertencem a um nível econômico baixo, apresentando também uma baixa escolaridade. O perfil nutricional encontrado nos pacientes, de acordo com os métodos de avaliação antropométrica (índice de massa corporal, prega cutânea tricipital, circunferência do braço e circunferência muscular do braço, apresentou predominância de desnutrição (55,5; 92,6; 79,6 e 55,5%; respectivamente, evidenciando déficit de massa magra e gordura corporal. Encontrou-se ainda significativa correlação linear do índice de massa corpórea com as outras medidas antropométricas compartimentadas. Quanto à ingestão dietética, verificou-se expressivo consumo de alimentos energéticos, significativo consumo de alimentos construtores e baixa ingestão de alimentos reguladores quando comparados ao recomendado. Conclusão: Observou-se que a maioria dos pacientes apresentou estado nutricional de desnutrição e o perfil alimentar, de modo geral, se caracterizou por prevalência de hábitos alimentares saudáveis

  10. Assessment of nurses' work climate at Alexandria Main University Hospital.

    Emam, Sanaa Abdel-aziz; Nabawy, Zeinab Mohamed; Mohamed, Azzaa Hassan; Sbeira, Walaa Hashem

    2005-01-01

    Work climate is indicative of how well the organization is realizing its full potential. An accurate assessment of work climate can identify the unnecessary obstacles to nurses interfering with their best performance. The present study aims to assess nurses' work climate at Alexandria Main University Hospital. The study sample included all nurses (N=400) who were working in inpatient medical and surgical units at the Alexandria Main University Hospital who were available at the time of data collection. A structured questionnaire was developed to assess nurses' perceptions regarding the dimensions of work climate. Data was collected by individual interview using the structured questionnaire. Results indicated that the highest percentages of nurses in medical and surgical units perceived that their work climate is characterized by good way of performance management, feeling of responsibility, warmth and supportive relationships, quality of communication, morale, organizational clarity and feeling of identity and belongness to the hospital. Nurses perceived that they are lacking work climate conducive to conflict resolution, participation in decision making, opportunity for training and development, fair rewards and recognition, calculated risks, sufficient resources, effective leadership and teamwork. There were no significant difference between nurses perceptions in medical and surgical units regarding all dimensions of work climate. The highest percentage of nurses in all units were satisfied only with the feeling of responsibility, way of performance management, and quality of communication. Conflict and identity were perceived as the most important areas that need improvement in the hospital. Based on the results recommendations were given to enhance work climate through designing compensation and recognition systems, and negotiate their requirements and accomplishment based on established standards and outcomes measures. Also, encouragement of and planning for

  11. Private finance initiative hospital architecture: towards a political economy of the Royal Liverpool University Hospital.

    Jones, Paul

    2018-02-01

    Sociological analysis has done much to illuminate the architectural contexts in which social life takes place. Research on care environments suggests that the built environment should not be understood as a passive backdrop to healthcare, but rather that care is conditioned by the architecture in which it happens. This article argues for the importance of going beyond the hospital walls to include the politics that underwrite the design and construction of hospital buildings. The article assesses the case of the yet-to-be-realised Liverpool Royal University Hospital, and the private finance initiative (PFI) funding that underpins the scheme, which is suggested as a salient 'external' context for understanding architecture's role in the provision of healthcare of many kinds for many years to come. PFI has major implications for democratic accountability and local economy, as well as for the architecture of the hospital as a site of care. Critical studies can illuminate these paradoxically visible-but-opaque hospital spaces by going beyond that which is immediately empirically evident, so as to reveal the ways in which hospital architecture is conditioned by political and economic forces. © 2018 Foundation for the Sociology of Health & Illness.

  12. Estudo comparativo das indicações de cesariana entre um hospital público-universitário e um hospital privado Comparative study of cesarean section indications between a public university hospital and a private hospital

    Renato Humberto Fabri

    2002-04-01

    Full Text Available OBJETIVOS: analisar a incidência e as indicações de cesariana realizadas no Hospital Escola da Falculdade de Medicina do Triângulo Mineiro e um hospital privado, ambos localizados em Uberaba, Minas Gerais, Brasil. MÉTODOS: trata-se de estudo transversal desenvolvido a partir da coleta nos prontuários dos hospitais, consistindo da idade, procedência, situação conjugal, escolaridade, paridade e indicações de cesariana. RESULTADOS: a incidência de cesariana foi de 24,3% no Hospital Escola contra 89,2% no hospital privado. As indicações mais freqüentes de cesariana no Hospital Escola foram a cesárea iterativa (26,7%, distócia (22,4% e o sofrimento fetal agudo (18,2%, e no hospital privado foram cesárea iterativa (36% e distócia (36%. As pacientes do hospital privado tinham maior escolaridade. CONCLUSÕES: os dados sugerem que o aumento de cesarianas no hospital privado foi decorrente de iteratividade, distócia e a escolaridade mais elevada das pacientes.OBJECTIVES: to analyse the incidence and the indications of cesarean section performed in the University Hospital of the "Triângulo Mineiro Faculty of Medicine " and a private hospital in Uberaba, Minas Gerais, Brazil. METHODS: a cross sectional study was carried out by using the data source of the medical files from both hospitals consisting of patient age, place of origin, marital status, education level, parity and cesarean sections indications. RESULTS: the cesarean sections rate was 24,3 % (325 of 1.441 births at the university hospital against 89,2% (100 of 112 births of the private hospital. The most frequent indications in the University Hospital were previous cesarean sections (26,7%, dystocia (22,4% and acute fetal distress (18,2%. In the private hospital, indications were previous cesarean section (36% and dystocia (36%. The private hospital's patients had higher education levels. CONCLUSIONS: the higher rate of cesarean sections observed in the private hospital

  13. Reducing Hospital Toxicity: Impact on Patient Outcomes.

    Milani, Richard V; Bober, Robert M; Lavie, Carl J; Wilt, Jonathan K; Milani, Alexander R; White, Christopher J

    2018-05-02

    Circadian rhythms are endogenous 24-hour oscillations in biologic processes that drive nearly all physiologic and behavioral functions. Disruption in circadian rhythms can adversely impact short and long-term health outcomes. Routine hospital care often causes significant disruption in sleep-wake patterns that is further compounded by loss of personal control of health information and health decisions. We wished to evaluate measures directed at improving circadian rhythm and access to daily health information on hospital outcomes. We evaluated 3,425 consecutive patients admitted to a medical-surgical unit comprised of an intervention wing (n=1,185) or standard control wing (n=2,240) over a 2.5-year period. Intervention patients received measures to improve sleep that included reduction of nighttime noise, delay of routine morning phlebotomy, passive vital sign monitoring, and use of red-enriched lighting after sunset, as well as access to daily health information utilizing an inpatient portal. Intervention patients accessed the inpatient portal frequently during hospitalization seeking personal health and care team information. Measures impacting the quality and quantity of sleep were significantly improved. LOS was 8.6 hours less (p=0.04), 30 and 90-day readmission rates were 16% and 12% lower, respectively (both p≤ 0.02), and self-rated emotional/mental health was higher (69.2% vs. 52.4%; p=0.03) in the intervention group compared to controls. Modest changes in routine hospital care can improve the hospital environment impacting sleep and access to health knowledge, leading to improvements in hospital outcomes. Sleep-wake patterns of hospitalized patients represent a potential avenue for further enhancing hospital quality and safety. Copyright © 2018. Published by Elsevier Inc.

  14. Hip fracture in hospitalized medical patients.

    Zapatero, Antonio; Barba, Raquel; Canora, Jesús; Losa, Juan E; Plaza, Susana; San Roman, Jesús; Marco, Javier

    2013-01-08

    The aim of the present study is to analyze the incidence of hip fracture as a complication of admissions to internal medicine units in Spain. We analyzed the clinical data of 2,134,363 adults who had been admitted to internal medicine wards. The main outcome was a diagnosis of hip fracture during hospitalization.Outcome measures included rates of in-hospital fractures, length of stay and cost. A total of 1127 (0.057%) admittances were coded with an in-hospital hip fracture. In hospital mortality rate was 27.9% vs 9.4%; p patients with a hip fracture (20.7 days vs 9.8 days; p hip-fracture patients (6927€ per hospitalization vs 3730€ in non fracture patients). Risk factors related to fracture were: increasing age by 10 years increments (OR 2.32 95% CI 2.11-2.56), female gender (OR 1.22 95% CI 1.08-1.37), admission from nursing home (OR 1.65 95% CI 1.27-2.12), dementia (1.55 OR 95% CI1.30-1.84), malnutrition (OR 2.50 95% CI 1.88-3.32), delirium (OR 1.57 95% CI 1.16-2.14), and anemia (OR 1.30 95%CI 1.12-1.49). In-hospital hip fracture notably increased mortality during hospitalization, doubling the mean length of stay and mean cost of admission. These are reasons enough to stress the importance of designing and applying multidisciplinary plans focused on reducing the incidence of hip fractures in hospitalized patients.

  15. Characteristics of patients assisted at an ambulatory of dementia from a university hospital Perfil dos pacientes atendidos no ambulatório de demência de um hospital universitário

    Lyssandra dos Santos Tascone

    2008-01-01

    Full Text Available OBJECTIVE: To present socio-demographic characteristics, mean scores of tests and scales applied to patients with dementia and discuss the relationship between test scores, clinical diagnoses and the severity of dementia. METHOD: Patients (n=113 were diagnosed according to the DSM-IV criteria, and the diagnostic work-up included physical and neurological examination, auxiliary exams, cognitive and functional tests, and the evaluation of neuropsychiatric symptoms. RESULTS: Mean age was 74.0 years. Alzheimer's disease (AD was diagnosed in 62.8% of the patients, AD and vascular dementia in 8.8%, other dementias in 14.2%, and mild cognitive impairment in 2.7%. At least one neuropsychiatric symptom was diagnosed in 96.9% of the sample. There were significant differences on cognitive and functional performance between the groups classified according to dementia severity. CONCLUSION: Neuropsychiatric symptoms were quite common in patients with dementia, being more frequent as severity increased, and those symptoms were associated with functional impairment in the patients.OBJETIVO: Apresentar características demográficas, escores médios de testes e escalas aplicadas aos pacientes com demência e discutir a relação dos escores dos testes com os diagnósticos clínicos e a gravidade da demência. MÉTODO: Pacientes (n=113 foram diagnosticados segundo os critérios para demência do DSM-IV, avaliados com história clínica, exame físico, exames complementares e aplicação de testes cognitivos, funcionais e neuropsiquiátricos. RESULTADOS: A idade média foi 74,0 anos. A doença de Alzheimer (DA foi diagnosticada em 62,8% dos casos, DA e demência vascular em 8,8%, outras demências em 14,2%, e comprometimento cognitivo leve em 2,7%, Ao menos um sintoma neuropsiquiátrico foi diagnosticado em 96,9% da amostra. Houve diferenças significativas nos escores dos testes cognitivos e escalas funcionais entre os grupos classificados segundo a gravidade de

  16. Process of care and prescription in pneumonia acquired in the community in university hospitals in Colombia

    Martinez, Carlos Eli; Jaimes, Fabian A; Montufar, Franco E; Hincapie, Gustavo A; Morales, Alvaro; Acero, Rafael; Muneton, David; Gomez, Sujey; Cuenca, Diana Maria; Salinas, Juan Carlos; Zabaleta Joel E

    2003-01-01

    The objective is to describe the process of care and prescription practices for CAP patients in four university hospitals in Colombia. Patients older than 15 years with a diagnosis of CAP during the two years study period. Collection of demographic and clinical status data and management during the first day of consult, classification in severity groups according to fine's prediction rule. Evaluation of the frequency of use of ancillary diagnostic tests antimicrobials prescription and agreement with ATS guidelines according to severity group and hospital. 734 patients were included, mean age 56 years old, 50.5% males, mean length of stay 8.6 days, 39% fine's classes IV to V. Frequency of sputum sampling (overall cohort between hospitals rank) was 46% (10 - 67%), chest x-ray 95% (57-100%), blood cultures 34% (0 -63%) and arterial blood gas analysis 71% (10-88%). the use of ancillary diagnostic test had wide variation between hospitals and severity classes, specially for sputum and blood gases. At least 45 different antimicrobial protocols were used in the cohort. Overall agreement between actual prescription and guidelines recommendations was variable (mean 44%, range 22 to 72%) between groups and hospitals, but without significant impact on mortality. There are many differences between actual clinical practice and guidelines for the management of CAP and wide variations between hospitals, but the precise effect of the lack of guideline-adherence on mortality is unclear

  17. [Susceptibility of yeasts to antifungal agents in Kaunas University of Medicine Hospital].

    Skrodeniene, Erika; Dambrauskiene, Asta; Vitkauskiene, Astra

    2006-01-01

    The aim of this study was to determine the species of yeast and their susceptibility to antifungal agents isolated from clinical specimens of patients treated in Kaunas University of Medicine Hospital. A total of 142 yeasts isolated from various clinical specimens of patients hospitalized in Kaunas University of Medicine Hospital were included in this study. All yeasts were cultivated on Sabouraud dextrose agar and identified using either CHROM agar or API 20C AUX system. The minimum inhibitory concentrations of fluconazole, itraconazole, and amphotericin B were determined by the ATB FUNGUS 2 agar microdilution test. In all clinical specimens except blood, Candida albicans was the most frequently isolated yeast (65.5%, pyeast strains showed resistance to fluconazole. Nearly one-fourth of Candida albicans strains (24.7%) and 23.2% of all isolated yeast strains showed resistance to itraconazole. Almost all of fluconazole-resistant (93.3%) and 12.6% of fluconazole-susceptible yeast were found to be resistant to itraconazole (pyeast strains were susceptible to amphotericin B. Candida albicans strains were significantly frequently resistant to fluconazole than non-albicans Candida species (15.1% and 4.1%, respectively, pyeast isolated in Kaunas University of Medicine Hospital. There was determined that yeasts resistant to fluconazole were commonly resistant to itraconazole too. All isolated yeast strains were susceptible to amphotericin B.

  18. Potentially inappropriate prescriptions in patients admitted to a psychiatric hospital

    Soerensen, Ann Lykkegaard; Nielsen, Lars Peter; Poulsen, Birgitte Klindt

    2016-01-01

    university hospital during a 3-month period (September 2013–November 2013). Patients medication lists (n = 207) were reviewed at the time of admission and all identified PIPs were assessed for potential consequences by clinical pharmacologists. Results There were 349 PIP identified in 1291 prescriptions...... with the probability of PIP. Improving the quality of prescribing might benefit from an interprofessional approach and thus better training of physicians and nurses is needed in order to minimize PIP....

  19. Qualities of Inpatient Hospital Rooms: Patients' Perspectives.

    Devlin, Ann Sloan; Andrade, Cláudia Campos; Carvalho, Diana

    2016-04-01

    The aim of this qualitative study was to investigate what design features of hospital rooms are valued by inpatients. Little research has explored how patients evaluate the physical environment of their hospital rooms. Most responses are captured by the Hospital Consumer Assessment of Healthcare Providers and Systems survey, which includes only two questions about the physical environment. Two hundred thirty-six orthopedic patients (78 in the United States and 158 in Portugal) listed three features of their hospital room that influenced their level of satisfaction with their hospital stay, indicating whether the feature was positive or negative. The comments were more positive (71.4%) than negative (28.6%). Using the framework of supportive design from Ulrich, over half the comments (64.31%) could be categorized in one of the three dimensions: 33.2% (positive distraction), 22.4% (perceived control), and 6.0% (social support). This total includes Internet (2.7%), which could be categorized as either social support or positive distraction. Comments called "other aspects" focused on overall environmental appraisals, cleanliness, and functionality and maintenance. The majority of comments could be accommodated by Ulrich's theory, but it is noteworthy that other aspects emerge from patients' comments and affect their experience. Cross-cultural differences pointed to the greater role of light and sun for Portuguese patients and health status whiteboard for U.S. Qualitative research can add significantly to our understanding of the healthcare experience and may inform design decisions. © The Author(s) 2015.

  20. Fatores relacionados à fidelidade ao tratamento do glaucoma: opiniões de pacientes de um hospital universitário Factors related to glaucoma treatment compliance: patients' opinions from a University Hospital

    Lucas Ravagnani Silva

    2010-04-01

    disease in lifestyle. METHODS: Interviews, with application of a semi-structured questionnaire, of 50 patients with primary open-angle glaucoma. The analysis was performed using Lefèvre's technique (Collective Subject Speech - CSS, qualitative/quantitative research. RESULTS: Thirty-eight percent of patients did not consider themselves well informed about glaucoma. The percentage of patients that reported noncompliance was 20%. The main causes of noncompliance are: side effects of antiglaucomatous drugs (24%; lack of information about the disease (22%; difficulty in understanding information and communication problems with the physician (14%; difficulties in administering the eye drops (14%; poverty, with impossibility to pay for the eye drops (10%; patients´ attitudes and beliefs (10%. Eighteen percent of the participants informed that the disease affected their life quality. CONCLUSION: In the studied population, most of the problems related to noncompliance to glaucoma treatment pointed out different factors that may decrease with education about POAG, interventions on attitudes and behavior, improvement of doctor-patient relationship and anti-glaucoma drugs supply.

  1. Cumulative radiation dose of multiple trauma patients during their hospitalization

    Wang Zhikang; Sun Jianzhong; Zhao Zudan

    2012-01-01

    Objective: To study the cumulative radiation dose of multiple trauma patients during their hospitalization and to analyze the dose influence factors. Methods: The DLP for CT and DR were retrospectively collected from the patients during June, 2009 and April, 2011 at a university affiliated hospital. The cumulative radiation doses were calculated by summing typical effective doses of the anatomic regions scanned. Results: The cumulative radiation doses of 113 patients were collected. The maximum,minimum and the mean values of cumulative effective doses were 153.3, 16.48 mSv and (52.3 ± 26.6) mSv. Conclusions: Multiple trauma patients have high cumulative radiation exposure. Therefore, the management of cumulative radiation doses should be enhanced. To establish the individualized radiation exposure archives will be helpful for the clinicians and technicians to make decision whether to image again and how to select the imaging parameters. (authors)

  2. [Nutritional status recording in hospitalized patient notes].

    Matos, L; Teixeira, M A; Henriques, A; Tavares, M M; Alvares, L; Antunes, A; Amaral, Teresa F

    2007-01-01

    The prevalence of disease-related malnutrition (DRM) is described to be of 30-60% on admission to hospital, and of 10% in the community. It has been associated with worse clinical outcomes, namely higher morbidity and mortality as well as higher frequency of health care and its associated costs. The lack of screening and monitoring of nutritional status have been said to be risk factors for the increased prevalence of DRM during hospital stay. The aims of this study were to evaluate the importance given by health care professionals to certain aspects related with nutritional status (weight, food intake) of hospital patients and to see if there were any differences between the under and non undernourished ones. A systematic sample of patients from six hospitals was collected. Pregnancy, paediatric age and critical illness were exclusion criteria as well as incapacity to fulfil nutritional risk screening protocol and length-of-stay less than 24h. Socio-demographic, anthropometric data and clinical notes (e.g. weight, food/nutrient intake) from medical records were collected and Nutritional Risk Screening 2002 protocol was applied. A total of 1152 patients were included in this study. The prevalence of nutritional risk varied between 28.5% and 47.3% while undernutrition classified by anthropometrical parameters was considerably lower (6.3% to 14.9%). Two thirds of the patients had their food intake monitored and registered in medical records but only one third were weighted. Undernourished patients had their food intake more frequently monitored but their weight was less frequently measured, than the well-nourished ones. DRM prevalence amongst hospital patients on admission is significantly high. Clinical notes regarding nutritional status is rather infrequent on medical records. This study showed that urges the need to empower health care providers of the importance of the screening and monitoring of weight and food intake, on admission and during hospital stay.

  3. Muddy puddles - the microbiology of puddles located outside tertiary university teaching hospitals.

    Furukawa, M; McCaughan, J; Stirling, J; Millar, B C; Bell, J; Goldsmith, C E; Reid, A; Misawa, N; Moore, J E

    2018-04-01

    In the British Isles, the frequency of rain results in the formation of puddles on footpaths and roads in/around hospitals. No data are available demonstrating the microbiological composition of such puddles and therefore a study was undertaken to examine the microbiology of puddles in the grounds of two tertiary university-teaching hospitals (18 sites) and compared with control puddles from non-hospital rural environments (eight sites), estimating (i) total viable count; (ii) identification of organisms in puddles; (iii) enumeration of Escherichia coli: (iv) detection of Extended Spectrum β-Lactamase producing organisms and (v) direct antimicrobial susceptibility testing. A mean count of 2·3 × 10 3  CFU per ml and 1·0 × 10 9  CFU per ml was obtained for hospital and non-hospital puddles respectively. Isolates (n = 77; 54 hospital and 23 non-hospital) were isolated comprising of 23 species among 17 genera (hospital sites), where the majority (10/16; 62·5%) of genera identified were Gram-negative approximately, a fifth (20·6%) were shared by hospital and non-hospital rural samples. Escherichia coli was detected in half of the hospital puddles and under-half (37·5%) of the rural puddles extended spectrum β-lactamase organisms were not detected in any samples examined. Rainwater puddles from the hospital and non-hospital environments contain a diverse range of bacteria, which are capable of causing infections. This study demonstrated the presence of a wide diversity of bacterial taxa associated with rainwater puddles around hospitals, many of which are capable of causing human disease. Of clinical significance is the presence of Pseudomonas aeruginosa isolated from a hospital puddle, particularly for patients with cystic fibrosis. The presence of potentially disease-causing bacteria in puddles in and around hospitals identifies a new potential environmental reservoir of bacteria. Furthermore work is now needed to define their potential of entering or

  4. Report of the unannounced monitoring assessment at University Hospital Limerick

    Maher, M M

    2012-02-03

    We aimed to assess management by interventional radiology techniques of patients with urinary diversion procedures (UD) complicated by urinary obstruction (UO). A 12-year electronic database of interventional cases was searched for urinary access in patients with UD. Patients\\' records were assessed for aetiology of obstruction, indication for procedure, types of interventional radiology, complications and outcome. Management issues included frequency of visits for catheter care, type of catheter placement and technical problems associated with catheter maintenance. Three hundred and seventy eight procedures were carried out in 25 patients (mean age 70 years; Male : Female ratio 13:12). Indications for UD were malignancy (n = 22) and neuropathic bladder (n = 3). UD included ileal conduits (n = 17), cutaneous ureterostomy (n = 3 (2 patients)) and sigmoid colon urinary conduit (n = 6). In most patients, catheters were placed antegradely through nephrostomy tract, but subsequent access was through the UD. Twenty of 25 patients had unilateral stents where as 5 had bilateral stents (8-10- Fr pigtail catheters (20-45 cm in length)). The mean number of procedures including catheter changes was 15 +\\/- 4 per patient and 331 of 378 procedures (87 %) were carried out as outpatients. Since catheter placement, 11 patients required hospital admission on 22 occasions for catheter-related complications. Ureteric strictures in patients with UD can be successfully managed by interventional radiology.

  5. Assessment of jaundice in the hospitalized patient.

    Kathpalia, Priya; Ahn, Joseph

    2015-02-01

    Jaundice in the hospitalized patient is not an uncommon consultation for the general gastroenterologist. It is essential to explore the underlying cause of jaundice because management is largely aimed at addressing these causes rather than the jaundice itself. Although the diagnostic evaluation for jaundice can be broad, clinical judgment must be used to prioritize between various laboratory tests and imaging studies. Most importantly, clinicians must understand which conditions are emergent and/or require evaluation for liver transplantation. Further studies need to be performed to better understand the outcomes of hospitalized patients who develop jaundice. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Hand injuries in foreign labour workers in an Irish university hospital.

    Sattler, Thorsten

    2009-01-01

    The present study reports on a new, rapidly growing patient subpopulation presenting with hand injuries to the Department of Plastic Surgery in Cork University Hospital (Ireland). The impact of the 10 new European Union accession states on the trauma workload is examined. The associated growth in expenditure on interpreter services is also examined. Potential risk factors in the foreign workers\\' new working environment is explored.

  7. Pattern of cardiovascular admissions at Nnamdi Azikiwe University Teaching Hospital Nnewi, South East Nigeria

    Osuji, Charles Ukachukwu; Onwubuya, Emmanuel Ikechukwu; Ahaneku, Gladys Ifesinachi; Omejua, Emeka Godwin

    2014-01-01

    Introduction Cardiovascular disease (CVD) is one of the top killer diseases in the world sparing neither developed or developing countries. The study was carried out to determine the pattern of cardiovascular admissions at Nnamdi Azikiwe University Teaching Hospital Nnewi South East Nigeria. Methods The study was a retrospective study covering the period January 2007 to December 2009. SPSS version 13 software was used to analyze data. Results 537 (15%) patients were admitted into the study ou...

  8. [Perceived quality assessment in the University Hospital Authority in Sassary, Italy].

    Virdis, A; Licheri, N; Cagnina, N; Sassu, A; Tanda, E; Soddu, M D

    2010-01-01

    In line with the health legislation that introduced a system to monitor and review the quality, the Hospital Authority of University of Sassari has placed among its main objectives the satisfaction of patients/clients and has made an initial assessment of customer satisfaction for users hospitalized in their facilities with the methodology of the questionnaire. It was drawn up a questionnaire to closed questions, with default value scales, divided into 4 areas: 1) Hospitality, 2) Hotel treatment, 3) Professionalism of staff-information related pathology, informed consent, 4) personal opinion of the patient upon discharge. The questionnaire was administered the day of discharge, to users hospitalized of six UO of Hospital Authority in the months of September and October 2009, and patients discharged within 2 months were given a total of 514, of them have completed the testing 290 (54% of discharged patients). The questionnaires were analyzed in the results of both the individual UO involved in both the overall result, persons responsible for each facility was sent a report with the results of its own. The survey results are satisfactory with regard to both positive aspects, that is the overall grade average of 86.23% which to criticism, to which they are planning initiatives for their solution.

  9. Does progressive resistance strength training as additional training have any measured effect on functional outcomes in older hospitalized patients?

    Tibaek, Sigrid; Andersen, Christina W.; Pedersen, Sigrid F

    2014-01-01

    OBJECTIVE: To evaluate the effect of progressive resistance strength training as additional training measured on functional outcomes in older hospitalized patients. DESIGN: A single-blinded randomized controlled trial. SETTING: Department of Geriatric Rehabilitation in university hospital...

  10. Constipation in the acutely hospitalized older patients.

    Cardin, Fabrizio; Minicuci, Nadia; Droghi, Annapaola Teggia; Inelmen, Emine Meral; Sergi, Giuseppe; Terranova, Oreste

    2010-01-01

    The aim of this work was to establish the factors that determine the onset of constipation in acutely hospitalized older patients with a view to contributing towards an evidence-based identification of which patients warrant early, specific preventive measures. To evade the problem posed by the definition of constipation, we have considered parameters that are part of the daily routine in the hospital ward, such as the prescription of laxatives, also paying attention to how the co-operative older person subjectively interpret this condition. One thirds of the 192 hospitalized older patients needed a laxative at least once every 3 days. Multivariate analysis identified the use of laxatives at home as the only risk factor for objective constipation while in hospital (odds ratio (OR)=3.0). A significant risk of being dissatisfied with their bowel emptying emerged among patients who were bedridden for more than 2 weeks (OR=6.0), and in those who experienced cerebrovascular events (OR=3.1). The use of laxatives at home and awareness that satisfaction with bowel movements drops in patients obliged to stay in bed for lengthy periods of time and in those who have suffered cerebrovascular damage, should provide the grounds for a screening program to establish rational guidelines on bowel movement therapy. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

  11. Patient evaluation of the hotel function of hospitals.

    Oz, M C; Zikria, J; Mutrie, C; Slater, J P; Scott, C; Lehman, S; Connolly, M W; Asher, D T; Ting, W; Namerow, P B

    2001-01-01

    A means of measuring patient satisfaction is essential in the effort to improve the quality of health care delivered in our nation's hospitals. Accurate feedback allows employers to better meet patients' needs and allows hospital administrators to improve service delivery. Patients are empowered by having a voice in the manner in which their health care is delivered. Moreover, improving the efficiency of the health care delivery system decreases health care costs. Hospital comparisons can be made readily available to a large audience through the Internet, resulting in empowerment of the patient and a universal improvement in hospital care. This is the first multi-institutional analysis of patient satisfaction among New York City and northern New Jersey area tertiary care hospitals. In this study, we evaluated the patient-assessed hotel function of hospitals in a single geographic region to determine whether clinically and statistically significant differences would be revealed that could provide beneficial information to stakeholders in the healthcare system. Patients (n = 261) who had spent a night during the past year in one of eleven hospitals within 60 miles of New York City were chosen at random from doctors' waiting rooms. On average, 24 patients from each hospital were surveyed. They were asked to complete a questionnaire that rated the various departments in the hospital on qualities such as courtesy, promptness, and cleanliness. The questionnaire also rated important characteristics of the patient experience, such as the ease of parking and the taste of the food. Each item on the survey was coded on a scale of 1 to 10 with 10 being the most positive response. The 26 specific questions were divided into 14 domains. Averages in each domain were compared by gender, age, and hospital identity, attractiveness, and setting. All statistical calculations were performed using SPSS/PC, and means were compared using t-tests. Analysis designed to evaluate outcomes

  12. Model construction of nursing service satisfaction in hospitalized tumor patients.

    Chen, Yongyi; Liu, Jingshi; Xiao, Shuiyuan; Liu, Xiangyu; Tang, Xinhui; Zhou, Yujuan

    2014-01-01

    This study aims to construct a satisfaction model on nursing service in hospitalized tumor patients. Using questionnaires, data about hospitalized tumor patients' expectation, quality perception and satisfaction of hospital nursing service were obtained. A satisfaction model of nursing service in hospitalized tumor patients was established through empirical study and by structural equation method. This model was suitable for tumor specialized hospital, with reliability and validity. Patient satisfaction was significantly affected by quality perception and patient expectation. Patient satisfaction and patient loyalty was also affected by disease pressure. Hospital brand was positively correlated with patient satisfaction and patient loyalty, negatively correlated with patient complaint. Patient satisfaction was positively correlated with patient loyalty, patient complaints, and quality perception, and negatively correlated with disease pressure and patient expectation. The satisfaction model on nursing service in hospitalized tumor patients fits well. By this model, the quality of hospital nursing care may be improved.

  13. A Descriptive Study Of The Burden Of Animal-Related Trauma At Cork University Hospital.

    Sheehan, M

    2018-01-01

    Farming is the most dangerous occupation in Ireland1 and the incidence of farm accidents is rising. This study examines major farm animal-related trauma treated at Cork University Hospital over a 5 year period. There were 54 patients admitted to Cork University Hospital (C.U.H.) with major farm animal-related trauma. The median age was 56 years, 85% were male and the median hospital length of stay was four days. Older patients had longer lengths of stay; 5.5 vs 4 days (p=0.026). Tibia\\/fibula fractures were the most common injuries (N=13, 24%); head injury occurred in six patients (11%). There were 32 (59%) patients who required surgery, the majority for orthopaedic injuries. There were nine patients (16.7%) admitted to the intensive care unit; their median ICU stay was four days. Injury prevention and treatment strategies require that the age profile, mechanism of injury and injury patterns of farmers sustaining animal-related trauma is recognised.

  14. Patient Survey (PCH - HCAHPS) PPS-exempt Cancer Hospital - Hospital

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

  15. Prevalence of Diabetic Foot Ulcer and Associated Factors among Adult Diabetic Patients Who Attend the Diabetic Follow-Up Clinic at the University of Gondar Referral Hospital, North West Ethiopia, 2016: Institutional-Based Cross-Sectional Study

    Mariam, Tesfamichael G.; Alemayehu, Abebaw; Tesfaye, Eleni; Mequannt, Worku; Temesgen, Kiber; Yetwale, Fisseha

    2017-01-01

    Diabetes mellitus is a metabolic disorder which is characterized by multiple long-term complications that affect almost every system in the body. Foot ulcers are one of the main complications of diabetes mellitus. However, there is limited evidence on the occurrence of foot ulcer and influencing factors in Ethiopia. An institutional-based cross-sectional study was conducted in Gondar University Hospital, Ethiopia, to investigate foot ulcer occurrence in diabetic patients. Systematic random sampling was used to select 279 study participants. Bivariate and multivariable logistic regression model was fitted to identify factors associated with diabetic foot ulcer. Odds ratio with 95% confidence interval was computed to determine the level of significance. Diabetic foot ulcer was found to be 13.6%. Rural residence [AOR = 2.57; 95% CI: 1.42, 5.93], type II diabetes mellitus [AOR = 2.58; 95% CI: 1.22, 6.45], overweight [AOR = 2.12; 95% CI: 1.15, 3.10], obesity [AOR = 2.65; 95% CI: 1.25, 5.83], poor foot self-care practice [AOR = 2.52; 95% CI: 1.21, 6.53], and neuropathy [AOR = 21.76; 95% CI: 8.43, 57.47] were factors associated with diabetic foot ulcer. Diabetic foot ulcer was found to be high. Provision of special emphasis for rural residence, decreasing excessive weight gain, managing neuropathy, and promoting foot self-care practice would decrease diabetic foot ulcer. PMID:28791310

  16. Prevalence of Diabetic Foot Ulcer and Associated Factors among Adult Diabetic Patients Who Attend the Diabetic Follow-Up Clinic at the University of Gondar Referral Hospital, North West Ethiopia, 2016: Institutional-Based Cross-Sectional Study

    Tesfamichael G. Mariam

    2017-01-01

    Full Text Available Diabetes mellitus is a metabolic disorder which is characterized by multiple long-term complications that affect almost every system in the body. Foot ulcers are one of the main complications of diabetes mellitus. However, there is limited evidence on the occurrence of foot ulcer and influencing factors in Ethiopia. An institutional-based cross-sectional study was conducted in Gondar University Hospital, Ethiopia, to investigate foot ulcer occurrence in diabetic patients. Systematic random sampling was used to select 279 study participants. Bivariate and multivariable logistic regression model was fitted to identify factors associated with diabetic foot ulcer. Odds ratio with 95% confidence interval was computed to determine the level of significance. Diabetic foot ulcer was found to be 13.6%. Rural residence [AOR = 2.57; 95% CI: 1.42, 5.93], type II diabetes mellitus [AOR = 2.58; 95% CI: 1.22, 6.45], overweight [AOR = 2.12; 95% CI: 1.15, 3.10], obesity [AOR = 2.65; 95% CI: 1.25, 5.83], poor foot self-care practice [AOR = 2.52; 95% CI: 1.21, 6.53], and neuropathy [AOR = 21.76; 95% CI: 8.43, 57.47] were factors associated with diabetic foot ulcer. Diabetic foot ulcer was found to be high. Provision of special emphasis for rural residence, decreasing excessive weight gain, managing neuropathy, and promoting foot self-care practice would decrease diabetic foot ulcer.

  17. Hospital services quality assessment: hospitals of Kerman University of Medical Sciences, as a tangible example of a developing country.

    Nekoei-Moghadam, Mahmood; Amiresmaili, Mohammadreza

    2011-01-01

    Although quality orientation is one of the main priorities of any progressive organization, quality evaluation in organizations providing services such as hospitals is one of the key challenges, because in this sector quality is determined by many intangible factors. Applying the service quality gap model is one of the common tools for quality evaluation in the service sector. This paper seeks to evaluate this issue. The present descriptive study was carried out through a cross-sectional method in 2008. The participants of this study were patients who had been referred to Kerman University of Medical Sciences hospitals. The sample comprised 385 patients, the data were collected by SERVQUAL as a standard questionnaire, and data analysis was carried out on 385 completed questionnaires. In all five dimensions of quality, a gap was observed between patients' perceptions and expectations as follows: Assurance: -1.28, Empathy: -1.36, Responsiveness: -1.80, Tangibles: -1.86 and Reliability: -1.69. A paired T-test showed that the differences between quality perceptions and expectations are significant (p value SERVQUAL approach to hospital services of a developing country.

  18. Grimstone v Epsom and St Helier University Hospitals NHS Trust: (It's Not) Hip To Be Square.

    Austin, Louise V

    2017-11-24

    In Montgomery v Lanarkshire Health Board [2015] UKSC 11 the Supreme Court redefined the standard of disclosure in informed consent to medical treatment, rejecting the application of the doctor-focused Bolam standard in favour of one focused on what was significant to patients. In Grimstone v Epsom and St Helier University Hospitals NHS Trust [2015] EWHC 3756 (QB), despite acknowledging a new standard now applied, McGowan J nevertheless used the Bolam test to determine liability for non-disclosure. This illustrates ongoing judicial deference to the medical profession and this case commentary explores that decision and its implications. © The Author 2017. Published by Oxford University Press.

  19. [Patient safety culture in hospitals: experiences in planning, organising and conducting a survey among hospital staff].

    van Vegten, Amanda; Pfeiffer, Yvonne; Giuliani, Francesca; Manser, Tanja

    2011-01-01

    This article presents the first hospital-wide survey on patient safety climate, involving all staff (medical and non-medical), in the German-speaking area. Its aim is to share our experiences with planning, organising and conducting this survey. The study was performed at the university hospital in Zurich and had a response rate of 46.8% (2,897 valid questionnaires). The survey instrument ("Patientensicherheitsklimainventar") was based on the Hospital Survey on Patient Safety Culture (AHRQ). Primarily it allowed for assessing the current patient safety climate as well as identifying specific areas for improvement and creating a hospital-wide awareness and acceptance for patient safety issues and interventions (e.g., the introduction of a Critical Incident Reporting System [CIRS]). We discuss the basic principles and the feedback concept guiding the organisation of the overall project. Critical to the success of this project were the guaranteed anonymity of the respondents, adequate communication through well-established channels within the organisation and the commitment of the management across all project phases. Copyright © 2011. Published by Elsevier GmbH.

  20. Hospital dental practice in special patients

    Silvestre-Rangil, Javier; Espín-Gálvez, Fernando

    2014-01-01

    Dental patients with special needs are people with different systemic diseases, multiple disorders or severe physical and/or mental disabilities. A Medline search was made, yielding a total of 29 articles that served as the basis for this study, which offers a brief description of the dental intervention protocols in medically compromised patients. Dental treatment in patients with special needs, whether presenting medical problems or disabilities, is sometimes complex. For this reason the hospital should be regarded as the ideal setting for the care of these individuals. Before starting any dental intervention, a correct patient evaluation is needed, based on a correct anamnesis, medical records and interconsultation reports, and with due assessment of the medical risks involved. The hospital setting offers the advantage of access to electronic medical records and to data referred to any complementary tests that may have been made, and we moreover have the possibility of performing treatments under general anesthesia. In this context, ambulatory major surgery is the best approach when considering general anesthesia in patients of this kind. Key words:Hospital dentistry, special patients, medically compromised patients. PMID:24121921

  1. Assessing the Social Responsibility of Tabriz University Educational Hospitals from Managers’ Perspective, 2012

    Massumeh gholizadeh

    2015-08-01

    Full Text Available Background and objectives: Social responsibility is one of the most important parts of an organization’s existence. The aim of this study was assessing the social responsibility of Tabriz University educational hospitals from managers’ perspective. Material and Methods: This cross-sectional descriptive study was conducted in 2012. 40 managers of educational hospitals have been selected through census sampling method. Data were collected through Ministry of Health and Medical education (MOHME valid and reliable questionnaire and analyzed by spss software package and descriptive statistics. Results : From the managers’ perspective, patients are the most effective group on hospital activities (48.5 percent, international standards are the most important motivation for hospitals (27.5 percent, the implementation of the organization’s legal obligations is the most important definition of social responsibility (27.5 percent. To be ensured a fair and ethical behavior, hospitals have benefited greatly from the workplace and employees (30 percent. Managers (90 percent emphasized that corporate social responsibility activities have a positive effect on hospital financial performance. Conclusion: The findings indicated that managers have no unique definition of social responsibility and it is difficult for them to understand the concept of social responsibility and there is no special policy or process in hospitals to understand this concept. They have introduced social responsibility as compliance with obligations of the organization. ​

  2. Consultation clinics for complementary and alternative medicine at Japanese university hospitals: An analysis at Tokushima University Hospital

    YANAGAWA, HIROAKI; TERAO, JUNJI; TAKEDA, EIJI; TAKAISHI, YOSHIHISA; KASHIWADA, YOSHIKI; KAWAZOE, KAZUYOSHI; FUSHITANI, SHUJI; TSUCHIYA, KOICHIRO; YAMAUCHI, AIKO; SATO, CHIHO; IRAHARA, MINORU

    2010-01-01

    Here, we report on a Consultation Clinic for Complementary and Alternative Medicine (CAM) which we established at Tokushima University Hospital in July of 2007 with the aim of providing person-to-person information on CAM, though not CAM therapy itself. In December of 2008, we received 55 applications for consultation, 37% concerning health foods, 37% Japanese herbal medicine (Kampo), and 26% various other topics. The consultants (nutritionists and pharmacists) communicated individually with 38 applicants; malignancies (26%) and cardiovascular disease (24%) were the main underlying concerns. To promote the quality of consultation, data was collected by means of focus group interviews concerning the perspective of the consultants. Safe and effective use of CAM requires a network of communication linking individuals, consultation teams, physicians, primary care institutions and university hospitals. To advance this goal, we plan to broaden the efforts described herein. Our findings indicate that the specific role of the consultation clinic in promoting the scientific use of CAM merits further study. PMID:22993564

  3. Universal versus tailored solutions for alleviating disruptive behavior in hospitals.

    Berman-Kishony, Talia; Shvarts, Shifra

    2015-01-01

    Disruptive behavior among hospital staff can negatively affect quality of care. Motivated by a standard on disruptive behavior issued by The Joint Commission (LD 3.10), as well as the desire to improve patient care, minimize liability, and improve staff retention, hospitals are setting policies to prevent and resolve disruptive behaviors. However, it is unknown whether uniform conflict management tools are equally effective among different hospital settings. We surveyed residents and nurses to identify similarities and differences among hospital departments in the antecedents, characteristics, and outcomes of disruptive behaviors, and in the effectiveness of conflict management tools. We used a quantitative questionnaire-based assessment to examine conflict perceptions in eight different hospital departments at Rambam Medical Center in Haifa, Israel. Most participants (89 %) reported witnessing disruptive behavior either directly or in other parties; the most significant causes were identified as intense work, miscommunication, and problematic personalities. The forms of these behaviors, however, varied significantly between departments, with some more prone to expressed conflicts, while others were characterized by hidden disruptive behaviors. These outcomes were correlated by the antecedents to disruptive behavior, which in turn affected the effectiveness of alleviating strategies and tools. Some tools, such as processes for evaluating complaints, teamwork and conflict management courses, and introducing a behavioral mission statement, are effective across many antecedents. Other tools, however, are antecedent-specific, falling into two principal categories: tools directly removing a specific problem and tools that offer a way to circumvent the problem. Conflict resolution tools and strategies, based on residents and nurse perceptions, may be more effective if tailored to the specific situation, rather than using a "one-size-fits-all" approach.

  4. Psychological symptoms and quality of life of dermatology outpatients and hospitalized dermatology patients

    Zachariae, R.; Zachariae, C.; Ibsen, H.H.

    2004-01-01

    The aim of the investigation was to compare psychological symptoms and health-related quality of life of dermatology patients and healthy controls. The sample consisted of 333 consecutively recruited patients from four dermatology outpatient clinics, 172 hospitalized dermatological patients from...... two university hospitals and 293 matched healthy controls. All patients and controls completed Beck's Depression Inventory, the Brief Symptom Inventory and the Dermatology Life Quality Index. Hospitalized patients were more distressed than outpatients and healthy controls and reported greater...... of dermatology patients, especially among patients with atopic dermatitis and psoriasis....

  5. Avaliação epidemiológica dos pacientes vítimas de queimadura ocular pelo agente químico cal no Serviço de Oftalmologia do Hospital Universitário Evangélico de Curitiba Epidemiological assessment at the Ophthalmology Departament of the Evangelic University Hospital of Curitiba of patients victims of ocular lime burns

    Alessandra Guerra Daros Castellano

    2002-06-01

    Full Text Available Objetivo: Avaliar o perfil epidemiológico dos pacientes vítimas de queimadura ocular pelo agente químico cal, no Serviço de Oftalmologia do Hospital Universitário Evangélico de Curitiba, enfatizando-se os casos de queimaduras oculares pela "Bomba de Cal". Métodos: Estudo prospectivo de 88 pacientes com queimadura ocular pela cal (cal sem explosão ou bomba de cal, que procuraram o serviço de Pronto Atendimento do referido hospital no período de setembro de 1999 a setembro de 2000. Resultados: Dos 88 pacientes avaliados 73 (82,95% foram vítimas de queimadura ocular pela cal no ambiente de trabalho e 15 (17,24% foram vítimas da "Bomba de Cal" (brincadeira regional. A maioria dos pacientes examinados foi do sexo masculino, com faixa etária entre 20 e 40 anos, com predomínio de queimadura ocular unilateral e grau I quando vítimas de acidente de trabalho e bilateral e grau IV quando a queimadura foi resultante da "Bomba de Cal". Conclusão: Comparando-se os grupos estudados observou-se que o grupo vítima de queimadura ocular pela "Bomba de Cal" apresentou maior agravo à saúde ocular demonstrado, neste estudo, pela bilateralidade, gravidade das lesões e idade mais precoce de acometimento dos pacientes.Purpose: The assessment of the epidemiological profile of patients victims of lime ocular burns, by the Ophthalmology Department of the Evangelic University Hospital of Curitiba, with emphasis on "Lime Bomb" burn cases. Methods: A study on 88 ocular lime burn patients (lime bomb or not, who came to the HUEC Emergency Service from September 1999 to September 2000. Results: Of 88 patients that were evaluated, 73 (82.95% had suffered ocular lime burn in their working place and 15 (17.24% had suffered it due to the `Lime Bomb" itself (local custom. Most of the patients that were examined were males, aged 20-40 years, with predominance of unilateral ocular burn and degree I in case of accident at the workplace, and bilateral and degree IV in

  6. Hypokalaemia and subsequent hyperkalaemia in hospitalized patients

    M.J. Crop (Meindert); E.J. Hoorn (Ewout); J. Lindemans (Jan); R. Zietse (Bob)

    2007-01-01

    textabstractBackground. The objective was to study the epidemiology of hypokalaemia [serum potassium concentration (SK) <3.5 mmol/l] in a general hospital population, specifically focusing on how often and why patients develop subsequent hyperkalaemia (SK<5.0 mmol/l). Methods. In a 3-month

  7. Hospital patient loyalty: causes and correlates.

    MacStravic, R S

    1994-01-01

    This study was designed to test whether factors associated with customer and employee loyalty are linked to hospital loyalty, and to measure the relative strength of the associations between traditional patient satisfaction factors and loyalty as compared to non-traditional factors.

  8. Urine Creatinine Concentrations in Drug Monitoring Participants and Hospitalized Patients.

    Love, Sara A; Seegmiller, Jesse C; Kloss, Julie; Apple, Fred S

    2016-10-01

    Urine drug testing is commonly performed in both clinical and forensic arenas for screening, monitoring and compliance purposes. We sought to determine if urine creatinine concentrations in monitoring program participants were significantly different from hospital in-patients and out-patients undergoing urine drug testing. We retrospectively reviewed urine creatinine submitted in June through December 2015 for all specimens undergoing urine drug testing. The 20,479 creatinine results were categorized as hospitalized patients (H) and monitoring/compliance groups for pain management (P), legal (L) or recovery (R). Median creatinine concentrations (interquartile range, mg/dL) were significantly different (P creatinine concentrations were significantly lower in the R vs. L group (Pcreatinine concentration and may indicate participants' attempts to tamper with their drug test results through dilution means. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Prevalência e prognóstico dos pacientes com pneumonia associada à ventilação mecânica em um hospital universitário Prevalence of ventilator-associated pneumonia in a university hospital and prognosis for the patients affected

    Márcio Martins de Queiroz Guimarães

    2006-08-01

    Full Text Available OBJETIVO: Determinar prevalência de pneumonia associada à ventilação mecânica em unidade de terapia intensiva, fatores associados e evolução. MÉTODOS: Foram avaliados 278 pacientes sob ventilação mecânica por mais de 24 horas prospectivamente em hospital universitário. RESULTADOS: Desenvolveram a doença 38,1% dos pacientes, 35,7 casos/1.000 dias de ventilação mecânica: 45,3% por bacilos gram negativos, Pseudomonas aeruginosa (22% o mais comum e 43,4% por germes multi-resistentes. O grupo com pneumonia associada à ventilação mecânica teve maiores tempos de ventilação mecânica, desmame, permanência no hospital e na unidade de terapia intensiva (p 10 dias (7,7; 4,1 - 14,2, imunodepressão (4,3; 1,3 - 14,3, síndrome do desconforto respiratório agudo (3,5; 1,4 - 9,0, atelectasia (3,0; 1,2 - 7,3, parada cardiorrespiratória (0,18; 0,05 - 0,66 e hemorragia digestiva alta (0,07; 0,009 - 0,62]. Fatores associados ao óbito hospitalar: insuficiência renal crônica (26,1; 1,9 - 350,7, admissão prévia na unidade de terapia intensiva (15,6; 1,6 - 152,0, simplified acute physiologic score II > 50 pontos (11,9; 3,4 - 42,0 e idade > 55 anos (4,4; 1,6 - 12,3. CONCLUSÃO: A pneumonia associada à ventilação mecânica aumentou tempos de ventilação mecânica, permanência na unidade de terapia intensiva e no hospital, número de complicações, mas não a letalidade.OBJECTIVE: To determine the prevalence of ventilator-associated pneumonia in an intensive care unit, as well as to identify related factors and characterize patient evolution. METHODS: This study evaluated 278 patients on mechanical ventilation for more than 24 hours in a university hospital. RESULTS: Ventilator-associated pneumonia developed in 38.1% of the patients, translating to 35.7 cases/1000 ventilator-days: 45.3% were caused by gram-negative agents (Pseudomonas aeruginosa accounting for 22%; and multidrug resistant organisms were identified in 43.4%. In the

  10. Prognostic Indices of Poor Nutritional Status and Their Impact on Prolonged Hospital Stay in a Greek University Hospital

    Georgia Tsaousi

    2014-01-01

    Full Text Available Background. To ascertain the potential contributors to nutritional risk manifestation and to disclose the factors exerting a negative impact on hospital length of stay (LOS, by means of poor nutritional status, in a nonselected hospitalized population. Materials and Methods. NutritionDay project questionnaires were applied to 295 adult patients. Study parameters included anthropometric data, demographics, medical history, dietary-related factors, and self-perception of health status. Body Mass Index (BMI and Malnutrition Universal Screening Tool (MUST were calculated for each participant. MUST score was applied for malnutrition assessment, while hospital LOS constituted the outcome of interest. Results. Of the total cohort, 42.3% were at nutritional risk and 21.4% malnourished. Age, gender, BMI, MUST score, autonomy, health quality, appetite, quantity of food intake, weight loss, arm or calf perimeter (P7 days. Conclusion. Nutritional status and nutrition-related parameters such as weight loss, quantity of food intake, appetite, arm circumference, dietary type, and extent of dependence confer considerable prognostic value regarding hospital LOS in acute care setting.

  11. Performance management of nuclear medical apparatuses in Osaka University Hospital

    Ikehara, Katsuhiro; Kusumi, Yoshimi; Hayashi, Makoto; Miharu, Tomoyoshi; Masuda, Kazutaka

    1975-01-01

    Nuclear medical out side-body measuring equipments in Osaka University Hospital consist of scinticamera, scintiscanner and movement-measuring equipment as measuring equipments, and central processing equipment, CRT attached with Polaroid camera, data typewriter, X-Y recorder, and high speed tape reader as data processing equipments. Daily and monthly management items are set up to maintain the best function of these equipments. The data processing room is air-conditioned to keep temperature at 25 0 C and humidity at 60% constantly, and they are confirmed with a temperature and humidity self-recorder. Computer system is used for the homogeneity control and the correction to counting failure of the scinticamera. As the repair of nuclear medical apparatuses needs long period and because of the special circumstances of radioactive drugs, very close cooperation among technicians, doctors and equipment makers is required. (Kobatake, H.)

  12. Radiation doses in angiography in the University Hospital of Caracas

    Diaz Aponte, Angel R.

    2001-01-01

    In the present work is evaluated, in angiography procedures carried out in the Radiology Department of the University Hospital of Caracas, the radiation dose received by the exposed professional when they carry out these explorations invasive and the followed norms of radiological protection during the exploration. The measurement was carried out on the exposed professional conformed by a medical interventionist, a medical assistant (resident), a nurse and a technical radiologist. Dosimeters TL was placed in the inter-orbital line at level of the crystalline lens, on thyroid, on the hands, thorax, breast, and on the gonads. The maximum values of dose (in mGy) that were measured: 1,84 at level of the crystalline lens; 1,24 on thyroid; 9,04 on the right hand; 65,04 on hand left; 0,07 on thorax; 0,07 on Breast; 0,07 for ovaries; and smaller than 0,04 for testicle. (author)

  13. Comparative Assessment of Patients’ Rights Observance in the Hospitalization Wards of Shahid Beheshti University of Medical Sciences’ Hospitals

    M. Sharifi

    2017-06-01

    Full Text Available Background: Patients are one of the most vulnerable social groups. Respecting patients’ rights will lead in advantages like “decrease in hospitalization time” and “increase in patients’ satisfaction”. This study is performed to assess the patients' rights observance in the hospitalization wards of educational hospitals of Shahid Beheshti University of Medical Sciences. Methods: In this descriptive-cross sectional study 137 medical student (intern were selected by convenience sampling method. We used a questionnaire with 12 questions. Reliability of questionnaire was confirmed by experts of the field and validity was confirmed by Cronbach’s Alpha coefficient (81%. The obtained data were analyzed by SPSS (v21 using descriptive statistics, analysis of variance and Tukey test. Findings: In this study the observance rate of patients’ rights was at a good level in 41.6% of cases, at an average level in 55.5% of cases and at a low level in 2.9% of cases. There was a significant difference between several hospitalization wards in the observance rate of patients’ rights. (p = 0.001. The observance rate of patients’ rights in infectious disease ward and gynecology ward was at a lower level in comparison with other wards. Conclusion: The observance rate of patients’ rights was at an average to good level in most of hospitalization ward. However this observance rate is at a low level in some wards. More studies about the causes of these differences can help us in planning about improvement of patients’ rights observance.

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

    Amilton dos Santos Jr.

    2013-01-01

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

  15. Aspectos ergonômicos na transferência de pacientes: um estudo realizado com trabalhadores de uma central de transportes de um hospital universitário Aspectos ergonómicos en la transferencia de enfermos: un estudio hecho com trabajadores de una central de transportes de un hospital universitário The transfer of patients and its ergonomic aspects: a study conducted at a university hospital lifting center

    Cristiane Gonzales Rossi

    2001-09-01

    Full Text Available Com o objetivo de avaliar aspectos ergonômicos na transferência de pacientes com a utilização de maca e cadeira de rodas, observou-se 249 transferências realizadas por trabalhadores da Seção de Escolta de um Hospital Universitário. Os resultados sugerem que a existência dessa equipe é uma iniciativa que deve ser estimulada mas que esses trabalhadores precisam de treinamento específico sobre movimentação e transporte de pacientes e de terem à disposição materiais auxiliares e equipamentos mecânicos.Com el objetivo de avaliar aspectos ergonómicos de transferencia de enfermos com utilización de maca y silla de ruedas, observarán se 249 transferencias realizadas por trabajadores de la Sección de Escolta (Acompañamiento de un Hospital Universitário. Los resultados sugerem que la existencia desse equipo es una iniciativa que debrá ser estimulada. Pero esos trabajadores necessitan entrenamiento especifico sobre mobilizacion y transporte de enfermos e necessitam tener a disposicion materiales auxiliares y equipamentos mecânicos.The purpose of this study was to evaluate ergonomic aspects involved in using a stretcher and a wheel chair to transfer patients. 249 transfers carried out by the workers of a university hospital lifting sector were observed. The observations showed that the idea of having a team to transfer patients has to be stimulated but the members of the team require specific training in handling and transferring patients. Mechanical equipment and other devices should also be available.

  16. The use of cimetidine in hospitalized patients.

    Kopala, L

    1984-01-01

    Cimetidine is the most commonly prescribed drug in North America. A clinical review was conducted to identify physicians' prescribing habits. From September 1, 1981 to March 31, 1982, the charts were reviewed of 50 patients receiving cimetidine in an isolated coastal community hospital in British Columbia. It was discovered that physicians prescribed the drug for reasons approved by the Food and Drug Administration (FDA) only 14% of the time. The FDA guidelines approve cimetidine for duodenal ulcer, Zollinger-Ellison syndrome, and other hypersecretory states. A literature review was conducted, and guidelines on prescribing cimetidine were given to all members of the hospital's medical staff.

  17. Patient Satisfaction At The Muhimbili National Hospital In Dar Es ...

    Patient Satisfaction At The Muhimbili National Hospital In Dar Es Salaam, Tanzania. ... staffpatient relationship ethos, in which the patient is a viewed as a customer. Keywords: patient satisfaction, reform, Muhimbili National Hospital, referral ...

  18. Environmental qualities and patient wellbeing in hospital settings

    Frandsen, Anne Kathrine

    2013-01-01

    undertaken by Architecture and Design and the Danish Building Research Institute (Aalborg University) set out in 2008 to review research on the impact of the environmental qualities of health-care facilities on patients and staff. The objective of the review team was to develop a tool that would allow......Within the last decades the impacts of the physical environments of hospitals on healing and health-care outcomes have been subject to ample research. The amount of documentation linking the design of physical environments to patient and staff outcomes is increasing. A Danish research project...

  19. Laryngopharyngeal abnormalities in hospitalized patients with dysphagia.

    Postma, Gregory N; McGuirt, W Frederick; Butler, Susan G; Rees, Catherine J; Crandall, Heather L; Tansavatdi, Kristina

    2007-10-01

    To determine the prevalence of laryngopharyngeal (LP) abnormalities in hospitalized patients with dysphagia referred for flexible endoscopic evaluation of swallowing (FEES). Retrospective, blinded review by two otolaryngologists of 100 consecutive FEES studies performed and video-recorded by a speech-language pathologist (SLP). Two otolaryngologists reviewed videos of 100 consecutive FEES studies on hospitalized patients with dysphagia for the presence of abnormal LP findings. Sixty-one male and 38 female patients comprised the hospital dysphagia cohort. The mean age was 62. One subject could not be evaluated because of the severity of the retained secretions, leaving 99 subjects in the cohort. Seventy-six percent had been previously intubated, with a mean intubation duration of 13 days. The overall prevalence of abnormal LP findings was 79%. Forty-five percent of the patients presented with two or more findings, which included arytenoid edema (33%), granuloma (31%), vocal fold paresis (24%), mucosal lesions (17%), vocal fold bowing (14%), diffuse edema (11%), airway stenosis (3%), and ulcer (6%). There was a significant difference in LP findings between those individuals who had or had not been intubated. Hospitalized patients with dysphagia are at high risk for LP abnormalities, particularly if they have been intubated, and may benefit from either 1) an initial joint examination by the SLP and otolaryngologist or 2) an otolaryngologist's review of the recorded examination conducted by the SLP. Such otolaryngology involvement could identify airway stenosis patients at an earlier stage, initiate granuloma treatment sooner, enable earlier biopsy of unexpected lesions, and allow follow-up of mucosal and neuromuscular findings that do not respond to medical management.

  20. Occupational Radiation Dose for Medical Workers at a University Hospital

    M.H. Nassef

    2017-11-01

    Full Text Available Occupational radiation doses for medical workers from the departments of diagnostic radiology, nuclear medicine, and radiotherapy at the university hospital of King Abdul-Aziz University (KAU were measured and analysed. A total of 100 medical radiation workers were monitored to determine the status of their average annual effective dose. The analysis and the calibration procedures of this study were carried out at the Center for Radiation Protection and Training-KAU. The monitored workers were classified into subgroups, namely, medical staff/supervisors, technicians, and nurses, according to their responsibilities and specialties. The doses were measured using thermo luminescence dosimeters (TLD-100 (LiF:Mg,Ti placed over the lead apron at the chest level in all types of workers except for those in the cath lab, for whom the TLD was placed at the thyroid protective collar. For nuclear medicine, a hand dosimeter was used to measure the hand dose distribution. The annual average effective doses for diagnostic radiology, nuclear medicine, and radiotherapy workers were found to be 0.66, 1.56, and 0.28 mSv, respectively. The results of the measured annual dose were well below the international recommended dose limit of 20 mSv. Keywords: Occupational radiation dose, radiation workers, TLD, radiation protection

  1. Predictors of in-hospital mortality among older patients

    Thiago J. A. Silva

    2009-01-01

    Full Text Available OBJECTIVE: The objective of this study was to determine predictors of in-hospital mortality among older patients admitted to a geriatric care unit. INTRODUCTION: The growing number of older individuals among hospitalized patients demands a thorough investigation of the factors that contribute to their mortality. METHODS: This was a prospective observational study implemented from February 2004 to October 2007 in a tertiary university hospital. A consecutive sample of 922 patients was evaluated for possible inclusion in this study. Patients hospitalized for palliative care, those who declined to participate, and those with incomplete data were excluded, resulting in a group of 856 patients aged 60 to 104 years. Bivariate and multivariate analyses were performed to determine associations between in-patient mortality and gender, age, length of stay, number of prescribed medications and diagnoses at admission, history of heart failure, neoplastic disease, immobility syndrome, delirium, infectious disease, and laboratory tests at admission (serum albumin and creatinine. RESULTS: The overall mortality rate was 16.4%. The following factors were associated with higher in-hospital mortality: delirium (OR=4.13, CI=2.65-6.44, P1.3mg/dL (OR=2.39, CI=1.53-3.72, P<.001, history of heart failure (OR=1.97, CI=1.20-3.22, P=.007, immobility (OR=1.84, CI=1.16-2.92, P =.009, and advanced age (OR=1.03, CI=1.01-1.06, P=.019. CONCLUSIONS: This study strengthens the perception of delirium as a mortality predictor among older inpatients. Cancer, immobility, low albumin levels, elevated creatinine levels, history of heart failure and advanced age were also related to higher mortality rates in this population.

  2. Organizing integrated care in a university hospital: application of a conceptual framework

    Runo Axelsson

    2014-06-01

    Full Text Available Background and aim: As a result of New Public Management, a number of industrial models of quality management have been implemented in health care, mainly in hospitals. At the same time, the concept of integrated care has been developed within other parts of the health sector. The aim of the article is to discuss the relevance of integrated care for hospitals.Theory and methods: The discussion is based on application of a conceptual framework outlining a number of organizational models of integrated care. These models are illustrated in a case study of a Danish university hospital implementing a new organization for improving the patient flows of the hospital. The study of the reorganization is based mainly on qualitative data from individual and focus group interviews.Results: The new organization of the university hospital can be regarded as a matrix structure combining a vertical integration of clinical departments with a horizontal integration of patient flows. This structure has elements of both interprofessional and interorganizational integration. A strong focus on teamwork, meetings and information exchange is combined with elements of case management and co-location.Conclusions: It seems that integrated care can be a relevant concept for a hospital. Although the organizational models may challenge established professional boundaries and financial control systems, this concept can be a more promising way to improve the quality of care than the industrial models that have been imported into health care. This application of the concept may also contribute to widen the field of integrated care.

  3. Organizing integrated care in a university hospital: application of a conceptual framework

    Runo Axelsson

    2014-06-01

    Full Text Available Background and aim: As a result of New Public Management, a number of industrial models of quality management have been implemented in health care, mainly in hospitals. At the same time, the concept of integrated care has been developed within other parts of the health sector. The aim of the article is to discuss the relevance of integrated care for hospitals. Theory and methods: The discussion is based on application of a conceptual framework outlining a number of organizational models of integrated care. These models are illustrated in a case study of a Danish university hospital implementing a new organization for improving the patient flows of the hospital. The study of the reorganization is based mainly on qualitative data from individual and focus group interviews. Results: The new organization of the university hospital can be regarded as a matrix structure combining a vertical integration of clinical departments with a horizontal integration of patient flows. This structure has elements of both interprofessional and interorganizational integration. A strong focus on teamwork, meetings and information exchange is combined with elements of case management and co-location. Conclusions: It seems that integrated care can be a relevant concept for a hospital. Although the organizational models may challenge established professional boundaries and financial control systems, this concept can be a more promising way to improve the quality of care than the industrial models that have been imported into health care. This application of the concept may also contribute to widen the field of integrated care.

  4. The role of university hospitals as centers of excellence for shared health-care-delivery of in- and outpatients

    Adelhard, K.; Matzko, M.; Bruening, R.; Holzknecht, N.; Stark, V.; Reiser, M.

    2002-01-01

    Problem. Health care delivery in Germany has to face severe challenges that will lead to a closer integration of services for in- and out-patients. University hospitals play an important role due to their activities in research, education and health care delivery. They are requested to promote and evaluate new means and ways for health care delivery. Methods. The Institute of Clinical Radiology at the University Hospital of the Ludwig-Maximilians-University started teleradiological services for hospitals and general practices in January 1999 in the framework of the ''Imaging services - teleradiological center of excellence''. Legal, technical and organizational prerequisites were analyzed. Results. Networks between university hospitals and general practices are not likely to solve all future problems. They will, however, increase the availability of the knowledge of experts even in rural areas and contribute to a quality ensured health care at the patients home. Future developments may lead to international co-operations and such services may be available to patients abroad. Conclusion. Legal, technical and organizational obstacles have to be overcome to create a framework for high quality telemedical applications. University hospitals will play an important role in promoting and evaluating teleradiological services. (orig.) [de

  5. Service quality of hospital outpatient departments: patients' perspective.

    Zarei, Ehsan

    2015-01-01

    Assessment of patient perceptions of health service quality as an important element in quality assessments has attracted much attention in recent years. The purpose of this paper is to assess the service quality of hospital outpatient departments affiliated to Shahid Beheshti University of Medical Sciences from the patients' perspective. This cross-sectional study was conducted in 2014 in Tehran, Iran. The study samples included 500 patients who were selected by multi-stage random sampling from four hospitals. The data collection instrument was a questionnaire consisting of 50 items, and the validity and reliability of the questionnaire were confirmed. For data analysis, exploratory and confirmatory factor analysis, Friedman test, and descriptive statistics were used through LISREL 8.54 and SPSS 18 applications. Eight significant factors were extracted for outpatient service quality, which explained about 67 per cent of the total variance. Physician consultation, information provided to the patient, and the physical environment of the clinic were the three determining factors of the quality of outpatient services. The highest and lowest perceptions were related to physician consultation and perceived waiting time dimension, respectively. The mean score of patients' perception of outpatient service quality was 3.89 (±0.60). About 59.5 per cent of patients assessed the quality of outpatient services as good, 38.2 per cent as moderate, and 2.3 per cent as poor. Practical implications - The instrument developed for this study is valid and reliable, and it can help hospital managers to identify the areas needing improvement and correction. According to the findings of this study, the majority of patients had a positive experience with outpatient departments of teaching hospitals, and the services provided in these centres were of adequate quality, based on patient assessments.

  6. Acute Hospitalization of the Older Patient

    Bodilsen, Ann Christine; Pedersen, Mette Merete; Petersen, Janne

    2013-01-01

    OBJECTIVE: Acute hospitalization of older patients may be associated with loss of muscle strength and functional performance. The aim of this study was to investigate the effect of acute hospitalization as a result of medical disease on muscle strength and functional performance in older medical...... patients. DESIGN: Isometric knee-extension strength; handgrip strength; and functional performance, that is, the Timed Up and Go test, were assessed at admission, at discharge, and 30 days after discharge. Twenty-four-hour mobility was measured during hospitalization. RESULTS: The mean (SD) age was 82.7 (8...... hospitalization, from 17.3 secs at admission to 13.3 secs at discharge (P = 0.003), but with no improvement at the 30-day follow-up (12.4 secs, P = 0.064). The median times spent in lying, sitting, and standing/walking were 17.4 hrs per day, 4.8 hrs per day, and 0.8 hrs per day, respectively. CONCLUSIONS: Muscle...

  7. O megaesôfago tratado cirurgicamente: perfil epidemiológico dos pacientes operados no Hospital de Clínicas da Universidade Estadual de Campinas entre 1989 e 2005 Surgically treated megaesophagus: epidemiological profile of patients operated in the Clinical Hospital of the State University of Campinas between 1989 and 2005

    Gustavo Carvalho de Oliveira

    2008-04-01

    Full Text Available O megaesôfago é uma das manifestações da doença de Chagas, cujo tratamento cirúrgico ó o que apresenta melhores resultados. Neste estudo retrospectivo, avaliou-se o perfil epidemiológico dos pacientes operados no Hospital de Clínicas da Universidade de Campinas entre 1989 e 2005, quanto a: naturalidade e procedência, provável local de contágio, idade, grau do megaesôfago, etiologia, duração da disfagia e sua evolução, outras doenças associadas e modalidade cirúrgica adotada. O método foi a análise de 390 prontuários desses doentes, junto ao Serviço de Arquivo Médico do Hospital de Clínicas da Universidade de Campinas. Os resultados permitiram estabelecer: as regiões endêmicas dos pacientes chagásicos atendidos nesse Serviço, a naturalidade/procedência e a caracterização do grupo. Após análise detalhada, foram obtidas a média de idade = 47 anos, e a duração média da disfagia = 9,47 anos. Observa-se que: a em 84,4% dos pacientes a disfagia instalou-se progressivamente; b 306 (78,5% pacientes apresentaram etiologia chagásica; c em 48% deles, houve prevalência do grau 2 (48%; d 89,8% dos pacientes foram submetidos à cardiomiotomia; e houve associações freqüentes a gastrites, esofagites, megacólon, hipertensão arterial e cardiopatias.Megaesophagus is one of the manifestations of Chagas disease and surgical treatment is the approach that presents the best results. In this retrospective study, the epidemiological profile of patients operated in the Clinical Hospital of University of Campinas between 1989 and 2005 was evaluated with regard to: place of birth, place of residence, probable place of infection, age, degree of megaesophagus, etiology, duration and evolution of dysphagia, other diseases in association and the type of surgery chosen. The method used was to analyze the 390 medical files of these patients, at the hospital's medical archive service. The results made it possible to establish the

  8. Audit of colonoscopy practice in Lagos University Teaching Hospital

    Adedapo Osinowo

    2016-01-01

    Full Text Available Introduction: Recent procurement of new endoscopies and accessories led to the reactivation of diagnostic and therapeutic colonoscopy services at our center. A preliminary audit is deemed necessary after a 2-year period of open access colonoscopy. Objective: To assess the pattern of indications, diagnostic yield, and selected key performance indicators in the practice of colonoscopy at our tertiary hospital. Patients and Methods: The endoscopy reports of all patients that underwent colonoscopy from January 2012 to April 2014 were reviewed. The demographic data, indications, and endoscopic findings were recorded. Information on cecal intubation, colonoscopy withdrawal time, polyp detection, adverse events, and bowel preparation quality were also extracted and analyzed. Results: Colonoscopy was performed in 149 patients. They were 81 males and 68 females, aged between 18 and 101 years with a mean of 46.9 ± 22.7 years. 126 (84.5% patients had a colonoscopy for symptomatic conditions while 5 (4% were for screening. Bowel preparation was assessed to be excellent in 81 (54.4%, adequate in 42 (28.2%, and inadequate in 26 (17.4% patients, respectively. The cecal intubation rate (CIR was 80.2%, polyp detection rate 7.4%, average colonoscopy withdrawal time was 6 min 53 s, overall diagnostic yield 55.9% and there were no adverse events. Tumors were seen in 19 patients (10.1%; 13 were located in the rectum, three in the sigmoid and three in the descending colon. Conclusion: The audit revealed that our CIR could be improved by a more effective bowel preparation, increased expertise, and procedure volume of endoscopists. Tumors of the colorectum were detected in 10.1% of patients.

  9. Buerger’s Disease in Tehran University of Medical Sciences Hospitals: A Fifteen Years Study

    Salimi Javad

    2009-10-01

    Full Text Available Buerger's disease is an occlusive inflammatory disease of the small and medium-sized arteries and accounts for a variable proportion of patients with peripheral vascular disease throughout the world. The aim of this study was to review the records of Buerger's disease patients admitted to surgery wards of our university hospitals. 277 patients with Buerger's disease were surgically treated between 1987 and 2002, in affiliated hospitals of Tehran University of Medical Sciences, in Iran. Two hundred and seventy three (98.6% of the patients were male, aged 41.5 ± 11 years (mean ± SD; 99.6% of which were smokers with an average of 22.9 pack/years tobacco use. The major complaints included: ischemic ulcers in 203 (73.3%, CI 95%: 0.68-0.77 patients, rest pain in 201 (72.6%, CI 95%: 0.64-0.73, paresthesia in 143 (51.3%, CI 95%: 0.48- 0.58. Vascular bypass, sympathectomy and amputation were performed in 9.7% (CI 95%: 0.08-0.14 and 69.3% (CI 95%: 0.51-0.60 and 59.6% (CI 95%: 0.65-0.73 of the patients, respectively. Lumbar sympathectomy was carried out in 177 (63.9% patients, while 15 (5.4% patients underwent thoracic sympathectomy. In our study, afflicted patients were mostly young males, inveterate tobacco smokers. Patients presented frequently with ischemic ulcers or severe rest pain; thrombophlebitis and Raynaud's phenomenon were infrequent. Vascular reconstruction was rarely possible due to distal and segmental involvement; therefore sympathectomy and amputation were inevitable in a large group of patients in this study.

  10. Adesão de pacientes com AIDS ao tratamento com antiretrovirais: dificuldades relatadas e proposição de medidas atenuantes em um hospital escola Adhesión del paciente con SIDA al tratamiento con antiretrovirales: dificultades relatadas y propuesta de medidas atenuantes en un hospital escuela Adherence of AIDS patients to treatment with antiretroviral drugs in a university hospital: difficulties observed and suggestions of interventions

    Rosely Moralez de Figueiredo

    2001-01-01

    Full Text Available Com finalidade de propor medidas que facilitem a adesão do paciente com AIDS ao tratamento, este trabalho teve como objetivo caracterizar os erros e as principais dificuldades relatadas por 61 pacientes com AIDS atendidos junto ao Hospital de Clínicas da UNICAMP. Os erros mais freqüentes foram referentes às combinações entre as drogas e falta de jejum; as dificuldades relatadas foram: quantidade de medicamentos e reações adversas. As autoras propuseram, a partir destes dados, a utilização de um roteiro ilustrado para realização de orientações relativas aos medicamentos. Espera-se assim que a orientação individualizada possa contribuir para minimizar as falhas da adesão à terapêutica.Con la finalidad de proponer medidas que faciliten la adhesión del paciente con SIDA al tratamiento, este trabajo tuvo como objetivo caracterizar los errores y las principales dificultades relatadas por 61 pacientes con SIDA atendidos en el Hospital Clínicas de la UNICAMP. Los errores más frecuentes estuvieron relacionados con las combinaciones entre las drogas y la falta de ayuno; las dificultades relatadas fueron: Cantidad de medicamentos y reacciones adversas. Las autoras propusieron, a partir de estos datos, la utilización de una guía ilustrada para dar orientaciones relacionadas con los medicamentos. Se espera que la orientación individualizada pueda contribuir para disminuir las fallas en la adhesión al tratamiento.This study aimed at identifying the incidence of drug intake errors and the main therapy-related difficulties among AIDS patients as well as at proposing measures to increase patients' adherence to treatment. Sixty-one patients with AIDS assisted by the University Hospital of São Paulo State University at Campinas were interviewed. The most frequent errors concerned the combinations of drugs and the length of fasting. The difficulties reported were adverse effects and the variety of drugs. Based on these data, the authors

  11. Pattern of sudden death at Ladoke Akintola University of Technology Teaching Hospital, Osogbo, South West Nigeria

    Akinwusi PO

    2013-06-01

    Full Text Available Patience Olayinka Akinwusi,1,2 Akinwumi Oluwole Komolafe,3 Olanrewaju Olayinka Olayemi,2 Adeleye Abiodun Adeomi41Department of Medicine, College of Health Sciences, Osun State University, 2Department of Medicine, LAUTECH Teaching Hospital, Osogbo, 3Department of Morbid Anatomy, Obafemi Awolowo University Teaching, Hospitals Complex, Ile-Ife, Osun State, 4Department of Community Medicine, LAUTECH Teaching Hospital, Ogbomoso, Oyo State, NigeriaBackground: The purpose of this study was to determine the etiology and epidemiologic characteristics of sudden death at Ladoke Akintola University of Technology (LAUTECH Teaching Hospital, South West Nigeria.Methods: This was a retrospective descriptive study of all cases of natural unexpected death, either occurring out of hospital or less than 24 hours after admission to LAUTECH Teaching Hospital, over a nine-year period from January 2003 to December 2011. Data were generated from information in the case notes and autopsy reports for these cases.Results: Sudden death accounted for 29 (4.0% of 718 adult medical deaths and 1.0% of all adult medical admissions. Out-of-hospital deaths occurred in 72.4% of cases. The mean age of the patients was 46.8 ± 11.5 (range 25–74 years. The male to female ratio was 6.25:1. Cardiovascular disease were the most common cause of death (51.7%, followed by respiratory disease (20.7%, pulmonary thromboembolism (10.4%, central nervous system disease (13.8%, gastrointestinal disorders (13.8%, severe chemical/drug poisoning (13.8%, and combined cardiovascular and central nervous system disease (13.8%. Hypertension-related causes were responsible for 14/29 (48.3% of the sudden deaths. Hypertensive heart disease accounted for 86.7% of the cardiovascular deaths, hypertensive heart failure accounted for 73.3%, whilst all heart failure cases accounted for 80.0%. Left ventricular hypertrophy was present in 69.2% of the patients with hypertensive heart disease. Moderate to severe