Abstract. aep
•Download as DOC, PDF•
1 like•490 views
1) The study assessed the appropriateness of 174 patient admissions to an internal medicine ward in Portugal using the prospective Appropriateness Evaluation Protocol (AEP). 2) They found that 17.7% of admissions were inappropriate, similar to other studies in the Iberian Peninsula. The most common reason for appropriateness was intravenous therapy. 3) Patients admitted on weekends had significantly longer hospital stays than those admitted on weekdays, possibly due to lack of elective care on weekends.
Report
Share
Report
Share
Recommended
Content server (10)A randomized, controlled, double-blind prospective trial w...
A randomized, controlled, double-blind prospective trial
with a Lipido-Colloid Technology-Nano-OligoSaccharide
Factor wound dressing in the local management of
venous leg ulcers
Frequency and management of respiratory incidents in invasive home ventilation
This study analyzed respiratory incidents in 17 patients receiving invasive home ventilation living in a nursing home attached to a weaning center over a 2-month period. The patients had been ventilated at home for an average of 490 days. During the study period, 8 of the 17 patients (47%) experienced a total of 95 respiratory incidents. The most common incidents were desaturation, dyspnea, and reduced general condition. The most common interventions by nursing staff were use of an Ambu bag and replacement of the tracheal cannula. While most incidents were managed by nursing staff, a doctor was called in 13% of cases. Respiratory incidents were common in long-term invasive home ventilation patients.
Abstract Infections on Internal medicne
This study aimed to understand the magnitude and characteristics of infectious diseases among patients admitted to the internal medicine ward of a Portuguese hospital over one month. A total of 25 out of 73 patients admitted during the study period had infectious diseases, representing 41 infectious episodes. The most common infections were urinary tract infections (44%) and pneumonia (29%). The majority (83%) of cultures grew pathogens, most commonly E. coli (21%), Pseudomonas aeruginosa (11%), and fungi (11%). Infections increased patient mortality by 10% and length of stay by 3.5 days compared to other patients. Pressure ulcers accounted for 12% of infections and were all hospital-acquired. Empiric antibiotic therapy was ineffective in
perioperative management
This chapter discusses perioperative nursing care. It defines the perioperative period as including pre-, intra-, and postoperative phases of a patient's surgical experience. The chapter outlines the roles and responsibilities of nurses in preparing patients both physically and psychologically for surgery. It also describes how nurses provide holistic care to meet patients' individual needs throughout the perioperative period, which can be an anxious time for many. The chapter emphasizes the importance of effective communication between the perioperative team and patients.
Otol HNS Better to be Young-2000-Lacy-Merritt
This study compared outcomes for head and neck cancer patients based on age. Younger patients (≤40 years old) had significantly better 5-year survival rates (65%) than middle-aged (41-64 years old, 52%) or older patients (≥65 years old, 38%). Younger patients also developed fewer recurrent tumors or new primary tumors. However, the reasons for the differences in outcomes based on age are unclear. The study aimed to analyze outcomes while controlling for other factors like smoking history, tumor stage, and treatment received to better understand the independent impact of age.
Ochsner Sherren regimen Vs Appendectomy in Adults with Acute Appendicitis.
ABSTRACT: The main Objective of this study is to examine whether Ochsner Sherren regimen in adult patients with acute appendicitis is safe by correlating the interval from onset of symptoms to operation (total interval) with the degree of pathology and incidence of postoperative complications. Prompt appendectomy has long been the standard of care for acute appendicitis because of the risk of progression to advanced pathology. This time-honored practice has been recently challenged by studies in pediatric patients, which suggested that acute appendicitis can be managed in an elective manner once antibiotic therapy is initiated. No such data are available in adult patients with acute appendicitis. A retrospective review of 480 patients who underwent an appendectomy for acute appendicitis between November2012 and October 2015 was conducted. The following parameters were monitored and correlated: demographics, time from onset of symptoms to arrival at the emergency room (patient interval) and from arrival to the emergency room to the operating room (hospital interval), physical, computed tomography (CT scan) and pathologic findings, complications, length of stay, and length of antibiotic treatment. Pathologic state was graded 1 (G1) for acute appendicitis, 2 (G2) for gangrenous acute appendicitis, 3 (G3) for perforation or phlegmon, and 4 (G4) for a periappendicular abscess. The risk of advanced pathology, defined as a higher pathology grade, increased with the total interval. When this interval was <12>71 hours group compared with total interval<12 hours. Although both prolonged patient and hospital intervals were associated with advanced pathology, prehospital delays were more profoundly related to worsening pathology compared with in-hospital delays . Advanced pathology was associated with tenderness to palpation beyond the right lower quadrant , guarding , rebound , and CT scan findings of peritoneal fluid , fecalith , dilation of the appendix , and perforation . Increased length of hospital stay and antibiotic treatment as well as postoperative complications also correlated with progressive pathology. In adult patients with acute appendicitis, the risk of developing advanced pathology and postoperative complications increases with time; therefore, delayed appendectomy is unsafe. As delays in seeking medical help are difficult to control, prompt appendectomy is mandatory. Because these conclusions are derived from retrospective data, a prospective study is required to confirm their validity
Letter: Is the Stupp Protocol an expensive and unsustainable standard of care...
Glioblastoma multiforme (GBM) is the most common and aggressive primary adult brain neoplasm with an age-adjusted incidence rate of 3.22 per 100 000 individuals and a 5-yr survival rate of 6.8%.1 In 2005, Stupp and colleagues proposed maximal safe resection, concomitant temozolomide (TMZ) with radiotherapy, and adjuvant TMZ as the optimal treatment. Implementation of the Stupp protocol in high-income countries (HICs) has resulted in increased survival compared to previous regimens. With little-to-no literature on the management and outcomes of patients with GBM in low- and middle-income countries (LMICs), it is unclear whether the Stupp protocol is being adopted or whether it is, or ever can be, the optimal strategy in LMICs...
Pattern and Outcome of Paediatric Admissions in a Tertiary Hospital in The N...
Pattern and Outcome of Paediatric Admissions in a Tertiary Hospital in The N...Earthjournal Publisher
- The study analyzed 770 pediatric admissions over 2 years at a hospital in Nigeria.
- The most common causes of admission were respiratory illnesses like bronchopneumonia (21.7% of admissions) and central nervous system diseases like febrile convulsions (20.1%).
- The overall mortality rate was 6.6%. Mortality was highest for diseases classified as "others" and lowest for oncology cases, though oncology had the highest case fatality ratio.Recommended
Content server (10)A randomized, controlled, double-blind prospective trial w...
A randomized, controlled, double-blind prospective trial
with a Lipido-Colloid Technology-Nano-OligoSaccharide
Factor wound dressing in the local management of
venous leg ulcers
Frequency and management of respiratory incidents in invasive home ventilation
This study analyzed respiratory incidents in 17 patients receiving invasive home ventilation living in a nursing home attached to a weaning center over a 2-month period. The patients had been ventilated at home for an average of 490 days. During the study period, 8 of the 17 patients (47%) experienced a total of 95 respiratory incidents. The most common incidents were desaturation, dyspnea, and reduced general condition. The most common interventions by nursing staff were use of an Ambu bag and replacement of the tracheal cannula. While most incidents were managed by nursing staff, a doctor was called in 13% of cases. Respiratory incidents were common in long-term invasive home ventilation patients.
Abstract Infections on Internal medicne
This study aimed to understand the magnitude and characteristics of infectious diseases among patients admitted to the internal medicine ward of a Portuguese hospital over one month. A total of 25 out of 73 patients admitted during the study period had infectious diseases, representing 41 infectious episodes. The most common infections were urinary tract infections (44%) and pneumonia (29%). The majority (83%) of cultures grew pathogens, most commonly E. coli (21%), Pseudomonas aeruginosa (11%), and fungi (11%). Infections increased patient mortality by 10% and length of stay by 3.5 days compared to other patients. Pressure ulcers accounted for 12% of infections and were all hospital-acquired. Empiric antibiotic therapy was ineffective in
perioperative management
This chapter discusses perioperative nursing care. It defines the perioperative period as including pre-, intra-, and postoperative phases of a patient's surgical experience. The chapter outlines the roles and responsibilities of nurses in preparing patients both physically and psychologically for surgery. It also describes how nurses provide holistic care to meet patients' individual needs throughout the perioperative period, which can be an anxious time for many. The chapter emphasizes the importance of effective communication between the perioperative team and patients.
Otol HNS Better to be Young-2000-Lacy-Merritt
This study compared outcomes for head and neck cancer patients based on age. Younger patients (≤40 years old) had significantly better 5-year survival rates (65%) than middle-aged (41-64 years old, 52%) or older patients (≥65 years old, 38%). Younger patients also developed fewer recurrent tumors or new primary tumors. However, the reasons for the differences in outcomes based on age are unclear. The study aimed to analyze outcomes while controlling for other factors like smoking history, tumor stage, and treatment received to better understand the independent impact of age.
Ochsner Sherren regimen Vs Appendectomy in Adults with Acute Appendicitis.
ABSTRACT: The main Objective of this study is to examine whether Ochsner Sherren regimen in adult patients with acute appendicitis is safe by correlating the interval from onset of symptoms to operation (total interval) with the degree of pathology and incidence of postoperative complications. Prompt appendectomy has long been the standard of care for acute appendicitis because of the risk of progression to advanced pathology. This time-honored practice has been recently challenged by studies in pediatric patients, which suggested that acute appendicitis can be managed in an elective manner once antibiotic therapy is initiated. No such data are available in adult patients with acute appendicitis. A retrospective review of 480 patients who underwent an appendectomy for acute appendicitis between November2012 and October 2015 was conducted. The following parameters were monitored and correlated: demographics, time from onset of symptoms to arrival at the emergency room (patient interval) and from arrival to the emergency room to the operating room (hospital interval), physical, computed tomography (CT scan) and pathologic findings, complications, length of stay, and length of antibiotic treatment. Pathologic state was graded 1 (G1) for acute appendicitis, 2 (G2) for gangrenous acute appendicitis, 3 (G3) for perforation or phlegmon, and 4 (G4) for a periappendicular abscess. The risk of advanced pathology, defined as a higher pathology grade, increased with the total interval. When this interval was <12>71 hours group compared with total interval<12 hours. Although both prolonged patient and hospital intervals were associated with advanced pathology, prehospital delays were more profoundly related to worsening pathology compared with in-hospital delays . Advanced pathology was associated with tenderness to palpation beyond the right lower quadrant , guarding , rebound , and CT scan findings of peritoneal fluid , fecalith , dilation of the appendix , and perforation . Increased length of hospital stay and antibiotic treatment as well as postoperative complications also correlated with progressive pathology. In adult patients with acute appendicitis, the risk of developing advanced pathology and postoperative complications increases with time; therefore, delayed appendectomy is unsafe. As delays in seeking medical help are difficult to control, prompt appendectomy is mandatory. Because these conclusions are derived from retrospective data, a prospective study is required to confirm their validity
Letter: Is the Stupp Protocol an expensive and unsustainable standard of care...
Glioblastoma multiforme (GBM) is the most common and aggressive primary adult brain neoplasm with an age-adjusted incidence rate of 3.22 per 100 000 individuals and a 5-yr survival rate of 6.8%.1 In 2005, Stupp and colleagues proposed maximal safe resection, concomitant temozolomide (TMZ) with radiotherapy, and adjuvant TMZ as the optimal treatment. Implementation of the Stupp protocol in high-income countries (HICs) has resulted in increased survival compared to previous regimens. With little-to-no literature on the management and outcomes of patients with GBM in low- and middle-income countries (LMICs), it is unclear whether the Stupp protocol is being adopted or whether it is, or ever can be, the optimal strategy in LMICs...
Pattern and Outcome of Paediatric Admissions in a Tertiary Hospital in The N...
Pattern and Outcome of Paediatric Admissions in a Tertiary Hospital in The N...Earthjournal Publisher
- The study analyzed 770 pediatric admissions over 2 years at a hospital in Nigeria.
- The most common causes of admission were respiratory illnesses like bronchopneumonia (21.7% of admissions) and central nervous system diseases like febrile convulsions (20.1%).
- The overall mortality rate was 6.6%. Mortality was highest for diseases classified as "others" and lowest for oncology cases, though oncology had the highest case fatality ratio.Open Journal of Surgery
This study compared central venous catheters (CVCs) and peripherally inserted central venous catheters (PICCs) in 149 patients who required central venous access. The patients were either randomized to receive a CVC or PICC, or were evaluated based on the total number who received each type of catheter. The study found no significant differences between CVCs and PICCs in terms of complications, function, or risk of treatment interruptions. While CVC patients received antibiotics more frequently, both catheter types were used for similar durations and had comparable complication rates. The study concluded that among patients with serious gastrointestinal disorders, CVCs and PICCs did not differ in safety or function for providing central venous access.
2012 vancomicina uci2012
This study analyzed data from a multicenter observational study to investigate the incidence of nephrotoxicity and associated risk factors in intensive care unit patients receiving vancomycin for the treatment of hospital-acquired, ventilator-associated, or healthcare-associated pneumonia. The study found that nephrotoxicity occurred in 15.4% of vancomycin-treated patients. Initial vancomycin trough levels ≥15 mg/L, concomitant aminoglycoside use, and longer duration of vancomycin therapy were independently associated with an increased risk of nephrotoxicity. The incidence of nephrotoxicity rose with higher initial vancomycin trough levels. This highlights
Sinopsis
This document provides details of a 4th year core course (Module Anesthesiology) at the National University of Malaysia. The 2 credit, 80 hour course aims to familiarize students with anesthesia techniques, drugs, airway equipment and management of perioperative patients. Students will maintain airways, perform basic life support, and communicate with patients and medical teams. The 2-week posting exposes students to principles of general and regional anesthesia, airway skills, basic life support, and management of critically ill patients. Teaching methods include lectures, skills labs, tutorials, operating room procedures and assessments.
Analytical Study on Deep Neck Space Infections
This study was performed Department of Otor hinolaryngology, Jubilee Mission Medical College, thrissur, Kerala for a period of 2 years commencing from December 2012 to November 2014. To review our experience with deep neck space infections and to study changing trends. The objectives were to study clinical presentation, etiology, associated systemic diseases, bacteriology, radiology, management and outcome of deep neck space infections.40 Patients coming from both urban and rural areas irrespective of age and sex admitted in department of ENT with deep neck space infections which was confirmed either clinically or radiologically. Superficial skin abscesses and abscesses due to infections of external neck injuries were excluded from the study \r\n.
Epidemiology of wound_infection_in_a_surgical_ward_of_a_tertiary_care_hospita...
This study examined the prevalence and risk factors of wound infections at a tertiary hospital in Northern Ghana. The researchers reviewed medical records from 1096 patients admitted to the surgical ward in 2012. They found that 32.3% of patients had wound infections, with 60.2% acquired in the community and 39.8% acquired in the hospital. Males had a higher prevalence of infections than females. Significant risk factors for wound infection included female gender, living in a rural area, and having diabetes. The study concluded that wound infections were relatively common, with nearly 40% contracted in the hospital setting, and identified several demographic and clinical factors that influenced the risk of infection.
Ebola virus disease
This document discusses infection prevention procedures for Ebola virus disease outbreaks. It provides objectives of recognizing epidemiological features of EVD and the role of infection control. It summarizes the causative agents of EVD, including the five species and the 2014 West African outbreak being caused by the Zaire species. It also discusses transmission occurring through contact with bodily fluids, with human-to-human transmission driving the 2014 outbreak. The document outlines safety precautions for health care settings, including strict standard precautions, personal protective equipment, and patient placement in isolation rooms.
Different types of_triage
This document discusses different types of triage. It begins by defining triage as a dynamic decision-making process that prioritizes patients' need for medical care when arriving at emergency departments. The document then discusses the history and origins of triage, developing from battlefield use to current emergency department applications. It describes key principles of triage in emergency settings and identifies several types of triage used in different contexts, including disaster triage, military triage, emergency department triage, ICU triage, and telephone triage.
Meningitis
Dexamethasone is a corticosteroid that has shown promise in improving outcomes for patients with bacterial meningitis. However, previous studies have found conflicting results on whether it benefits all patients or only certain subgroups. This study conducted a meta-analysis of individual patient data from 5 randomized controlled trials involving 2029 patients to identify which patients are most likely to benefit from dexamethasone treatment. The analysis found that dexamethasone did not significantly reduce death rates or neurological disability overall. It also did not provide significant benefits within any prespecified subgroups based on factors like causative organism, pre-treatment with antibiotics, HIV status, or age. The only benefit seen was a reduction in hearing loss among survivors.
Cohort study
Cohort studies observe groups of people (cohorts) over time to determine the effects of exposures. They are prospective in nature. Key features include identifying cohorts prior to disease appearance and observing them over time to measure disease frequency. Cohort studies are useful when there is evidence of an exposure-disease association, exposures are rare but diseases common among exposed groups, and follow-up is possible. They involve selecting cohorts, obtaining exposure data, choosing comparison groups, follow-up, and analysis of incidence rates and risk estimates.
Idiopathic Subglottic and Tracheal Stenosis - A Survey of the Patient Experience
This document describes a survey of 160 patients with either acquired subglottic stenosis (AS, n=28) or idiopathic subglottic and tracheal stenosis (ISTS, n=132). The key findings were:
1) ISTS patients experienced longer delays in diagnosis compared to AS patients, with 58% of ISTS patients not receiving a diagnosis for over 18 months.
2) The most common treatments for both groups were balloon dilation and laser dilation, while tracheal resection was performed in 36% of both groups.
3) Patient satisfaction was significantly higher after tracheal resection (76% satisfaction) compared to other treatment modalities (39% satisfaction).
Doctors’ Diaries - A PBS Documentary
Dr. Elliott Bennett-Guerrero graduated from Harvard Medical School and was selected to participate in Doctors' Diaries, a PBS documentary that followed seven doctors from Harvard Medical School for over 20 years as they pursued their medical degrees and careers. Supported by the NOVA science series, Doctors' Diaries provided a rare longitudinal perspective on the lives of doctors from medical school through their professional lives.
Lect10 Human Subjects: History
The document discusses the history of human subjects research, including unethical experiments conducted by Nazi Germany scientists and the Tuskegee Syphilis Experiment conducted by the U.S. Public Health Service from 1932 to 1972. The Nazi experiments violated subjects' rights and caused extreme harm. The Tuskegee study intended to observe untreated syphilis in black men but became unscientific when subjects received some treatment and contributed no useful medical knowledge. It was later deemed unethical by modern standards for failing to obtain informed consent and exposing subjects to harm without benefit.
Casemix, management, and mortality of patients receiving emergency neurosurge...
This study characterized differences in casemix, management, and mortality of patients receiving emergency neurosurgery for traumatic brain injury (TBI) across countries with different levels of human development. The study included 1635 patients from 159 hospitals in 57 countries. Patients' ages, injury mechanisms, and procedures varied significantly between countries. Younger patients in lower HDI countries typically had mild TBI from assaults, while older patients in very high HDI countries usually had moderate or severe TBI from falls. Overall mortality was 18%, and after adjusting for casemix, mortality was higher in medium and high HDI countries compared to very high HDI countries. Significant between-hospital variation in mortality was also observed. This large, global study provides valuable
!7 cy312 unit -ii -mmb
This document outlines the key topics to be covered in Unit II of a medical microbiology course, including the etiology, general characteristics, pathogenesis, symptoms, epidemiology, laboratory diagnosis, prevention, and control measures of several viruses. The viruses to be discussed are Pox, HSV, HBV, Ebola, Marburg, Dengue virus, Adeno virus, Rabies virus, Zika, Swine flu, HIV, prion diseases like Kuru, and scrapie. For each topic, brief descriptions and definitions are provided.
Preoperative leukocytosis as predictor of intraabdominal injury in penetratin...
Preoperative leukocytosis as predictor of intraabdominal injury in penetratin...Juan de Dios Díaz Rosales
This document summarizes a study on using preoperative leukocytosis as a predictor of intraabdominal injury in patients with penetrating abdominal trauma. The study included 231 patients who underwent exploratory laparotomy for abdominal trauma. Patients were divided into two groups: those with therapeutic laparotomy who had intraabdominal injuries (Group I), and those with non-therapeutic laparotomy who did not have intraabdominal injuries (Group II). The study found that 74.2% of patients in Group I had leukocytosis levels over 12,500/mm3, compared to only 27.7% of patients in Group II, indicating leukocytosis over 12,500/mm3 may help predict which patients have intraCohort
This document summarizes a presentation on cohort studies. It defines a cohort study as a type of analytical study that observes groups over time to determine if there is an association between an exposure and disease. It provides details on the types of cohort studies, their elements, strengths, weaknesses and how they are analyzed. Relative risk and attributable risk are discussed as measures to analyze cohort study results. An example schematic of a cohort study on artificial insemination and bovine brucellosis is also included.
In research involving human participants as trial subjects or tissue
The document discusses the importance of protecting human participants in medical research. It notes that while research with human subjects is sometimes necessary, guidelines like the Declaration of Helsinki are needed to ensure participants are not exploited and their welfare and autonomy are prioritized. Certain groups like children, the mentally ill, and the elderly are especially vulnerable to exploitation without such protections in place. Consent is also crucial for research even after a person's death to maintain public trust.
Ethical Considerations around Urgent Hip Hemiarthroplasty during COVID-19: A ...
Ethical discussion surrounding management of hip fractures in the elderly has always been challenging, but the recent coronavirus disease-19 (COVID-19) pandemic has superimposed additional difficulties that have to be addressed by clinicians. We present a case report of elderly gentleman with a history of moderate to advanced dementia, who was diagnosed with an intertrochanteric femoral fracture after a fall, and was incidentally found to be COVID-19 positive. After a lengthy discussion with next of kin, he had operative management of his hip fracture, followed by a brief convalescence, and eventual discharge to his nursing facility where he passed away.
complex neonates CITY
This document describes a study conducted at a children's heart center examining alternative surgical strategies for high-risk neonates and infants with congenital heart defects and significant co-morbidities. The study analyzed 442 cardiac surgeries performed between 2010-2013. It found that alternative bi-ventricular and uni-ventricular strategies minimized mortality but were associated with prolonged intubation, ICU stay, and hospitalization compared to standard strategies. Major pre-operative risk factors and lower weight significantly correlated with worse outcomes. The study concludes that flexible surgical approaches allowed survival of high-risk patients, though at the cost of increased resource utilization.
06 cohort studies
This document describes a cohort study conducted by the Atherosclerosis Risk in Communities (ARIC) Study. The ARIC study recruited over 16,000 participants aged 45-64 from four US communities and followed them prospectively to investigate risk factors for cardiovascular disease. Participants underwent home interviews and clinical exams at baseline and follow-up to collect data on health behaviors and biomarkers. The study assessed the development of cardiovascular outcomes over time and the association with risk factors like hypertension, diabetes and smoking.
Abstract. legibilidad
This study analyzed the legibility of epicrisis reports for 108 deceased patients in the department of internal medicine at a hospital in Portugal in 2002. The reports were written by 13 different doctors, with only 6 being typewritten and fully legible. 30 reports (27.77%) had some degree of illegibility, though only 1 was fully unclear. No reports were completely illegible. Legibility defects were slightly higher for patients with shorter average stays of 5 days or less before death. The study concludes that introducing electronic epicrisis reports could help address legibility issues, and that staffing levels on weekends did not influence mortality or report quality.
More Related Content
What's hot
Open Journal of Surgery
This study compared central venous catheters (CVCs) and peripherally inserted central venous catheters (PICCs) in 149 patients who required central venous access. The patients were either randomized to receive a CVC or PICC, or were evaluated based on the total number who received each type of catheter. The study found no significant differences between CVCs and PICCs in terms of complications, function, or risk of treatment interruptions. While CVC patients received antibiotics more frequently, both catheter types were used for similar durations and had comparable complication rates. The study concluded that among patients with serious gastrointestinal disorders, CVCs and PICCs did not differ in safety or function for providing central venous access.
2012 vancomicina uci2012
This study analyzed data from a multicenter observational study to investigate the incidence of nephrotoxicity and associated risk factors in intensive care unit patients receiving vancomycin for the treatment of hospital-acquired, ventilator-associated, or healthcare-associated pneumonia. The study found that nephrotoxicity occurred in 15.4% of vancomycin-treated patients. Initial vancomycin trough levels ≥15 mg/L, concomitant aminoglycoside use, and longer duration of vancomycin therapy were independently associated with an increased risk of nephrotoxicity. The incidence of nephrotoxicity rose with higher initial vancomycin trough levels. This highlights
Sinopsis
This document provides details of a 4th year core course (Module Anesthesiology) at the National University of Malaysia. The 2 credit, 80 hour course aims to familiarize students with anesthesia techniques, drugs, airway equipment and management of perioperative patients. Students will maintain airways, perform basic life support, and communicate with patients and medical teams. The 2-week posting exposes students to principles of general and regional anesthesia, airway skills, basic life support, and management of critically ill patients. Teaching methods include lectures, skills labs, tutorials, operating room procedures and assessments.
Analytical Study on Deep Neck Space Infections
This study was performed Department of Otor hinolaryngology, Jubilee Mission Medical College, thrissur, Kerala for a period of 2 years commencing from December 2012 to November 2014. To review our experience with deep neck space infections and to study changing trends. The objectives were to study clinical presentation, etiology, associated systemic diseases, bacteriology, radiology, management and outcome of deep neck space infections.40 Patients coming from both urban and rural areas irrespective of age and sex admitted in department of ENT with deep neck space infections which was confirmed either clinically or radiologically. Superficial skin abscesses and abscesses due to infections of external neck injuries were excluded from the study \r\n.
Epidemiology of wound_infection_in_a_surgical_ward_of_a_tertiary_care_hospita...
This study examined the prevalence and risk factors of wound infections at a tertiary hospital in Northern Ghana. The researchers reviewed medical records from 1096 patients admitted to the surgical ward in 2012. They found that 32.3% of patients had wound infections, with 60.2% acquired in the community and 39.8% acquired in the hospital. Males had a higher prevalence of infections than females. Significant risk factors for wound infection included female gender, living in a rural area, and having diabetes. The study concluded that wound infections were relatively common, with nearly 40% contracted in the hospital setting, and identified several demographic and clinical factors that influenced the risk of infection.
Ebola virus disease
This document discusses infection prevention procedures for Ebola virus disease outbreaks. It provides objectives of recognizing epidemiological features of EVD and the role of infection control. It summarizes the causative agents of EVD, including the five species and the 2014 West African outbreak being caused by the Zaire species. It also discusses transmission occurring through contact with bodily fluids, with human-to-human transmission driving the 2014 outbreak. The document outlines safety precautions for health care settings, including strict standard precautions, personal protective equipment, and patient placement in isolation rooms.
Different types of_triage
This document discusses different types of triage. It begins by defining triage as a dynamic decision-making process that prioritizes patients' need for medical care when arriving at emergency departments. The document then discusses the history and origins of triage, developing from battlefield use to current emergency department applications. It describes key principles of triage in emergency settings and identifies several types of triage used in different contexts, including disaster triage, military triage, emergency department triage, ICU triage, and telephone triage.
Meningitis
Dexamethasone is a corticosteroid that has shown promise in improving outcomes for patients with bacterial meningitis. However, previous studies have found conflicting results on whether it benefits all patients or only certain subgroups. This study conducted a meta-analysis of individual patient data from 5 randomized controlled trials involving 2029 patients to identify which patients are most likely to benefit from dexamethasone treatment. The analysis found that dexamethasone did not significantly reduce death rates or neurological disability overall. It also did not provide significant benefits within any prespecified subgroups based on factors like causative organism, pre-treatment with antibiotics, HIV status, or age. The only benefit seen was a reduction in hearing loss among survivors.
Cohort study
Cohort studies observe groups of people (cohorts) over time to determine the effects of exposures. They are prospective in nature. Key features include identifying cohorts prior to disease appearance and observing them over time to measure disease frequency. Cohort studies are useful when there is evidence of an exposure-disease association, exposures are rare but diseases common among exposed groups, and follow-up is possible. They involve selecting cohorts, obtaining exposure data, choosing comparison groups, follow-up, and analysis of incidence rates and risk estimates.
Idiopathic Subglottic and Tracheal Stenosis - A Survey of the Patient Experience
This document describes a survey of 160 patients with either acquired subglottic stenosis (AS, n=28) or idiopathic subglottic and tracheal stenosis (ISTS, n=132). The key findings were:
1) ISTS patients experienced longer delays in diagnosis compared to AS patients, with 58% of ISTS patients not receiving a diagnosis for over 18 months.
2) The most common treatments for both groups were balloon dilation and laser dilation, while tracheal resection was performed in 36% of both groups.
3) Patient satisfaction was significantly higher after tracheal resection (76% satisfaction) compared to other treatment modalities (39% satisfaction).
Doctors’ Diaries - A PBS Documentary
Dr. Elliott Bennett-Guerrero graduated from Harvard Medical School and was selected to participate in Doctors' Diaries, a PBS documentary that followed seven doctors from Harvard Medical School for over 20 years as they pursued their medical degrees and careers. Supported by the NOVA science series, Doctors' Diaries provided a rare longitudinal perspective on the lives of doctors from medical school through their professional lives.
Lect10 Human Subjects: History
The document discusses the history of human subjects research, including unethical experiments conducted by Nazi Germany scientists and the Tuskegee Syphilis Experiment conducted by the U.S. Public Health Service from 1932 to 1972. The Nazi experiments violated subjects' rights and caused extreme harm. The Tuskegee study intended to observe untreated syphilis in black men but became unscientific when subjects received some treatment and contributed no useful medical knowledge. It was later deemed unethical by modern standards for failing to obtain informed consent and exposing subjects to harm without benefit.
Casemix, management, and mortality of patients receiving emergency neurosurge...
This study characterized differences in casemix, management, and mortality of patients receiving emergency neurosurgery for traumatic brain injury (TBI) across countries with different levels of human development. The study included 1635 patients from 159 hospitals in 57 countries. Patients' ages, injury mechanisms, and procedures varied significantly between countries. Younger patients in lower HDI countries typically had mild TBI from assaults, while older patients in very high HDI countries usually had moderate or severe TBI from falls. Overall mortality was 18%, and after adjusting for casemix, mortality was higher in medium and high HDI countries compared to very high HDI countries. Significant between-hospital variation in mortality was also observed. This large, global study provides valuable
!7 cy312 unit -ii -mmb
This document outlines the key topics to be covered in Unit II of a medical microbiology course, including the etiology, general characteristics, pathogenesis, symptoms, epidemiology, laboratory diagnosis, prevention, and control measures of several viruses. The viruses to be discussed are Pox, HSV, HBV, Ebola, Marburg, Dengue virus, Adeno virus, Rabies virus, Zika, Swine flu, HIV, prion diseases like Kuru, and scrapie. For each topic, brief descriptions and definitions are provided.
Preoperative leukocytosis as predictor of intraabdominal injury in penetratin...
Preoperative leukocytosis as predictor of intraabdominal injury in penetratin...Juan de Dios Díaz Rosales
This document summarizes a study on using preoperative leukocytosis as a predictor of intraabdominal injury in patients with penetrating abdominal trauma. The study included 231 patients who underwent exploratory laparotomy for abdominal trauma. Patients were divided into two groups: those with therapeutic laparotomy who had intraabdominal injuries (Group I), and those with non-therapeutic laparotomy who did not have intraabdominal injuries (Group II). The study found that 74.2% of patients in Group I had leukocytosis levels over 12,500/mm3, compared to only 27.7% of patients in Group II, indicating leukocytosis over 12,500/mm3 may help predict which patients have intraCohort
This document summarizes a presentation on cohort studies. It defines a cohort study as a type of analytical study that observes groups over time to determine if there is an association between an exposure and disease. It provides details on the types of cohort studies, their elements, strengths, weaknesses and how they are analyzed. Relative risk and attributable risk are discussed as measures to analyze cohort study results. An example schematic of a cohort study on artificial insemination and bovine brucellosis is also included.
In research involving human participants as trial subjects or tissue
The document discusses the importance of protecting human participants in medical research. It notes that while research with human subjects is sometimes necessary, guidelines like the Declaration of Helsinki are needed to ensure participants are not exploited and their welfare and autonomy are prioritized. Certain groups like children, the mentally ill, and the elderly are especially vulnerable to exploitation without such protections in place. Consent is also crucial for research even after a person's death to maintain public trust.
Ethical Considerations around Urgent Hip Hemiarthroplasty during COVID-19: A ...
Ethical discussion surrounding management of hip fractures in the elderly has always been challenging, but the recent coronavirus disease-19 (COVID-19) pandemic has superimposed additional difficulties that have to be addressed by clinicians. We present a case report of elderly gentleman with a history of moderate to advanced dementia, who was diagnosed with an intertrochanteric femoral fracture after a fall, and was incidentally found to be COVID-19 positive. After a lengthy discussion with next of kin, he had operative management of his hip fracture, followed by a brief convalescence, and eventual discharge to his nursing facility where he passed away.
complex neonates CITY
This document describes a study conducted at a children's heart center examining alternative surgical strategies for high-risk neonates and infants with congenital heart defects and significant co-morbidities. The study analyzed 442 cardiac surgeries performed between 2010-2013. It found that alternative bi-ventricular and uni-ventricular strategies minimized mortality but were associated with prolonged intubation, ICU stay, and hospitalization compared to standard strategies. Major pre-operative risk factors and lower weight significantly correlated with worse outcomes. The study concludes that flexible surgical approaches allowed survival of high-risk patients, though at the cost of increased resource utilization.
06 cohort studies
This document describes a cohort study conducted by the Atherosclerosis Risk in Communities (ARIC) Study. The ARIC study recruited over 16,000 participants aged 45-64 from four US communities and followed them prospectively to investigate risk factors for cardiovascular disease. Participants underwent home interviews and clinical exams at baseline and follow-up to collect data on health behaviors and biomarkers. The study assessed the development of cardiovascular outcomes over time and the association with risk factors like hypertension, diabetes and smoking.
What's hot (20)
Epidemiology of wound_infection_in_a_surgical_ward_of_a_tertiary_care_hospita...
Epidemiology of wound_infection_in_a_surgical_ward_of_a_tertiary_care_hospita...
Idiopathic Subglottic and Tracheal Stenosis - A Survey of the Patient Experience
Idiopathic Subglottic and Tracheal Stenosis - A Survey of the Patient Experience
Casemix, management, and mortality of patients receiving emergency neurosurge...
Casemix, management, and mortality of patients receiving emergency neurosurge...
Preoperative leukocytosis as predictor of intraabdominal injury in penetratin...
Preoperative leukocytosis as predictor of intraabdominal injury in penetratin...
In research involving human participants as trial subjects or tissue
In research involving human participants as trial subjects or tissue
Ethical Considerations around Urgent Hip Hemiarthroplasty during COVID-19: A ...
Ethical Considerations around Urgent Hip Hemiarthroplasty during COVID-19: A ...
Viewers also liked
Abstract. legibilidad
This study analyzed the legibility of epicrisis reports for 108 deceased patients in the department of internal medicine at a hospital in Portugal in 2002. The reports were written by 13 different doctors, with only 6 being typewritten and fully legible. 30 reports (27.77%) had some degree of illegibility, though only 1 was fully unclear. No reports were completely illegible. Legibility defects were slightly higher for patients with shorter average stays of 5 days or less before death. The study concludes that introducing electronic epicrisis reports could help address legibility issues, and that staffing levels on weekends did not influence mortality or report quality.
CME credits
This document is a CME tracker for Javier Rodriguez Vera listing the CME activities he has completed from January 2012 through December 2012. It shows that he earned a total of 52.25 credits. The activities covered topics such as glucose-lowering therapy in chronic kidney disease, assessing treatment response in PAH, biomarker-guided heart failure therapy, management of joint bleeding in hemophilia, incorporating new approaches to hyponatremia management, and more. Each activity is listed with its title, provider, date participated, and credits earned.
Clinical trials
1) The document summarizes key aspects of evaluating clinical trials, including types of trials and potential biases.
2) Clinical trials aim to test interventions in a controlled manner to determine safety and effectiveness. Randomized controlled trials (RCTs) are considered the gold standard for limiting biases.
3) However, biases can still influence trials in many ways, such as through selection of participants, administration of interventions, measurement of outcomes, and reporting/publication of results. It is important to critically appraise trials to assess risk of biases.
Viewers also liked (6)
Similar to Abstract. aep
Candida Score-2.pptx
This study aimed to determine the epidemiology of candidemia and evaluate risk factors for mortality in patients with candidemia admitted to an Indian medical ICU. The study analyzed medical records of over 3,000 ICU admissions and identified 56 patients with candidemia. Majority of candidemia patients had central lines and were using antibiotics prior to infection. Factors associated with increased mortality included older age, higher illness severity scores, previous antifungal use, and a Candida score over 3. The Candida score integrates risk factors to predict risk of invasive candidiasis. This study found the Candida score and previous antifungal use were independent predictors of mortality for ICU patients with candidemia.
Peritonitis in children experience in a tertiary hospital in enugu, nigeria
Peritonitis in children experience in a tertiary hospital in enugu, nigeriaClinical Surgery Research Communications
This study evaluated 52 cases of pediatric peritonitis treated via laparotomy over 5 years at a hospital in Nigeria. The most common cause of peritonitis was found to be typhoid intestinal perforation (48% of cases). Other common causes included ruptured appendix (17.3% of cases) and perforated intussusception (15.4% of cases). Post-operative complications occurred in 46.2% of patients, with surgical site infection being most common (23.1% of cases). The mortality rate was 13.5%. The study concludes that typhoid intestinal perforation is a major cause of peritonitis in children in this setting.Guidelines for the management of hospital-adquired pneumonia ERJ 2017.pdf
This document provides guidelines from the European Respiratory Society (ERS) and other groups for the management of hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP). It summarizes recent studies on the epidemiology, diagnosis, treatment and prevention of HAP/VAP. An international panel of experts was convened to develop evidence-based recommendations using the GRADE methodology. The resulting guidelines address the diagnosis, treatment and prevention of HAP/VAP to improve patient outcomes and reduce healthcare costs.
Medeiros LNB de, Silva DR da, Guedes CDFS et al. .docx
Medeiros LNB de, Silva DR da, Guedes CDFS et al. Prevalence of pressure ulcers in intensive...
English/Portuguese
J Nurs UFPE on line., Recife, 11(7):2697-703, July., 2017 2697
ISSN: 1981-8963 ISSN: 1981-8963 DOI: 10.5205/reuol.10939-97553-1-RV.1107201707
PREVALENCE OF PRESSURE ULCERS IN INTENSIVE CARE UNITS
PREVALÊNCIA DE ÚLCERAS POR PRESSÃO EM UNIDADES DE TERAPIA INTENSIVA
PREVALENCIA DE ÚLCERAS POR PRESIÓN EN UNIDADES DE TERAPIA INTENSIVA
Luan Nogueira Bezerra de Medeiros1, Deyvisson Ribeiro da Silva2, Cintia Danielle Faustino da Silva Guedes3,
Thuanne Karla Carvalho de Souza4, Belisana Pinto de Abreu Araújo Neta5
ABSTRACT
Objective: to detect the prevalence of Pressure Ulcers (PUs) in patients admitted to Intensive Care Units
(ICUs). Method: cross-sectional, quantitative study, developed in an emergency and trauma reference
hospital in the State of Rio Grande do Norte located in the eastern sanitary district of Natal (RN), Brazil.
Results: the prevalence found of PUs was 69% in the four ICUs. Individually, the Cardiac ICU had an incidence
of 44.4%; the Bernadete ICU, 85.7%; the General ICU, 60%; and the Emergency ICU, 87.5%. Conclusion: It is
necessary to focus on a strategic planning for prevention and treatment measures to reduce the PU indexes in
the institution. Descriptors: Nursing; Pressure Ulcer; Intensive Care Units; Prevalence.
RESUMO
Objetivo: detectar a prevalência de Úlceras por Pressão (UPs) em pacientes internados em Unidades de
Terapia Intensiva (UTIs). Método: estudo transversal, de abordagem quantitativa, desenvolvido em um
hospital de referência para o estado do Rio Grande do Norte em urgência e trauma, situado no distrito
sanitário leste do município de Natal (RN), Brasil. Resultados: a prevalência encontrada de UPs foi de 69% nas
quatro UTIs. Individualmente, a UTI Cardiológica apresentou 44,4%; UTI Bernadete, 85,7%; UTI Geral, 60%; e
UTI do Pronto-Socorro, 87,5% de prevalência de UPs. Conclusão: é necessário nortear um planejamento
estratégico para medidas de prevenção e tratamento para redução dos índices de UPs na instituição.
Descritores: Enfermagem; Úlcera por Pressão; Unidades de Terapia Intensiva; Prevalência.
RESUMEN
Objetivo: detectar la prevalencia de Úlceras por Presión (UPs) en pacientes internados en Unidades de
Terapia Intensiva (UTIs). Método: estudio transversal, de enfoque cuantitativo, desarrollado en un hospital de
referencia para el estado de Rio Grande do Norte en urgencia y trauma, situado en el distrito sanitario este
del municipio de Natal (RN), Brasil. Resultados: la prevalencia encontrada de UPs fue de 69% en las cuatro
UTIs. Individualmente, la UTI Cardiológica presentó 44,4%; UTI Bernadete, 85,7%; UTI General, 60%; y UTI de
Pronto-Socorro, 87,5% de prevalencia de UPs. Conclusión: es necesario guiar un planeamiento estrategico
para medidas de prevención y tratamiento para reducción de los índices de U.
Patient Recruitment simplified
Genelife Clinical Research conducts disease surveillance reports to help with patient recruitment for clinical trials. It surveys investigators across India to understand disease prevalence and the number of patients available for different therapeutic areas. Genelife uses this information to select suitable investigators and sites for clinical trials based on the disease area and ability to recruit patients. The surveys also aim to educate investigators about clinical research and help identify new sites interested in clinical trials. Genelife has surveyed over 800 investigators across India in various therapeutic areas to better match trials with eligible patient populations and recruit patients more efficiently.
15. article audit icu ccu
The study aimed to analyze patient demographics and disease patterns among those admitted to the intensive care unit (ICU) and coronary care unit (CCU) of BP Koirala Institute of Health Sciences, Nepal over one year. A total of 601 patients were admitted, with 269 in the ICU and 346 in the CCU. Most patients were aged 20-60 years and from surrounding districts. Common ICU admissions were for exploratory laparotomy complications, organophosphorus poisoning, and encephalitis. Acute coronary syndrome, myocardial infarction, and shock were leading CCU admissions. Outcomes could be improved as many patients were referred or left against medical advice, suggesting further investigation is needed.
The Difficult to Wean Patients2 2015
This document discusses factors that contribute to prolonged mechanical ventilation support. It notes that difficult to wean patients requiring more than 7 days of weaning attempts represent up to 14% of ICU patients on mechanical ventilation. Prolonged mechanical ventilation is defined as needing ventilation for over 21 consecutive days and over 6 hours per day, with evidence that 3-7% of patients meet this definition. The document outlines various predictors of prolonged mechanical ventilation support as well as outcomes like increased mortality, lower quality of life in survivors, and increased healthcare costs. It also discusses mechanisms that can lead to ventilator dependence and factors that can influence patient weaning.
Time between decision to admit and icu arrival of patients from emergency dep...
This is a short audit which was done to see what factors delay admission of a patient from ER to ICU and how can these be prevented.
2018 Effect of Bag-Mask Ventilation vs Endotracheal Intubation During Cardiop...
Bag-mask ventilation (BMV) is a less complex technique than endotracheal
intubation (ETI) for airway management during the advanced cardiac life support phase of
cardiopulmonary resuscitation of patients with out-of-hospital cardiorespiratory arrest.
It has been reported as superior in terms of survival.
orme2014.pdf
This randomized trial compared quality of life (QOL) outcomes between inpatient and outpatient intravenous antibiotic management of pediatric oncology patients with low risk febrile neutropenia (LRFN). 81 patients presented with 159 fever episodes, of which 37 presentations involving 27 patients were randomized to inpatient (18) or outpatient (19) groups. Patients received intravenous cefepime for at least 48 hours until fever resolution for 24 hours. QOL questionnaires completed daily by parents and patients showed higher combined and domain-specific scores for outpatients, indicating benefits to parents and patients across several QOL measures. Length of fever and adverse events were equivalent between groups, demonstrating outpatient management was both feasible and safe.
PROCALCITONINA
This study evaluated the validity of procalcitonin (PCT) for diagnosing bacterial infections in elderly patients aged 75 years or older. 161 patients were included in the study and divided into two groups: 95 patients with probable bacterial infections and 66 patients without infections. PCT levels above 0.5 ng/mL were found in 72% of patients with probable bacterial infections and 8% of patients without infections. The study found that PCT has a sensitivity of 72% and specificity of 92% for diagnosing bacterial infections in elderly patients using a cutoff of 0.5 ng/mL. The researchers concluded that PCT can be reliably used to diagnose bacterial infections in elderly patients due to its good sensitivity and high specificity.
Nebulisation therapy in COVID 19 era.pptx
This document discusses nebulization therapy during the COVID-19 pandemic. It notes that nebulization can generate fugitive aerosols that remain airborne for hours and may transmit SARS-CoV-2. For nebulization of patients with COVID-19, the document recommends using negative pressure rooms with at least 6 air changes per hour, and for healthcare workers to use N-95 respirators, eye protection, gowns and gloves. Precautions are needed during nebulization to prevent the airborne transmission of COVID-19 in hospital settings.
Ventilator Associated Pneumonia (VAP) or Hospital Acquired Pneumonia (HAP)
Ventilator Associated Pneumonia (VAP) or Hospital Acquired Pneumonia (HAP)Philippine Hospital Infection Contol Nurses Associaton (PHICNA) Inc.
This document discusses definitions, pathophysiology, risk factors, and prevention strategies for hospital-acquired infections (HAIs) like hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP). It focuses on prevention bundles, which group multiple interventions together to potentially increase their effectiveness by exploiting synergies. Effective bundle elements include proper hand hygiene, oral care with chlorhexidine, maintaining endotracheal tube cuff pressure, and early mobility. Bundles provide a practical way to enhance care and reduce infection rates.Prospective Study of Acute Appendicitis with its Clinical, Radiological Profi...
Acute appendicitis is the most common condition encountered in general surgical practice. Alvarado and Modified Alvarado Scores (MASS) are the commonly used scoring
systems for its diagnosis, but its performance has been found to
be poor in certain populations. Hence, we compared the RIPASA
score with MASS, to find out which is a better diagnostic tool for
acute appendicitis in the Indian population.
Ventilator associated pneumonia (1).pptx
This document discusses ventilator-associated pneumonia (VAP). Some key points:
- VAP affects 5-10% of ventilated patients and increases ICU and hospital length of stay. Mortality ranges from 0-50% depending on patient factors.
- Common causative pathogens are gram-negative organisms like Pseudomonas, E. coli, and Acinetobacter. Early-onset VAP is associated with community-like pathogens while late-onset involves more nosocomial pathogens.
- Risk factors for developing multi-drug resistant pathogens should take precedence over early vs. late onset distinction in treatment.
- Diagnosis is based on clinical, radiological and microbiological criteria. The Clinical
Goal directed resuscitation for patients
In this randomized controlled trial conducted across 51 centers, 792 patients with early septic shock who were randomized to receive early goal-directed therapy (EGDT) were compared to 796 patients receiving usual care. The primary outcome of all-cause mortality at 90 days was 18.6% in the EGDT group and 18.8% in the usual care group, showing no significant difference between the groups. Secondary and tertiary outcomes also showed no differences. The findings suggest that EGDT does not offer a survival advantage over usual care for patients presenting with early septic shock.
Csq arb2012-sec3
This document summarizes guidelines for oxygen therapy in post-operative care. It recommends that oxygen therapy is an important part of recovery and can reduce post-operative complications. The summary outlines standards for best practice, such as all patients in recovery receiving oxygen according to local guidelines, and all high-risk patients who could benefit from post-operative oxygen being prescribed it and using it correctly. Audit indicators are proposed to measure adherence to these standards.
Epcm l16 outbreak investigations
This lecture was given as a part of the Introduction to Epidemiology & Community Medicine Course given for third-year medical students.
Predictors of Outcome in Acute Respiratory Distress Syndrome with Acute febri...
Predictors of Outcome in Acute Respiratory Distress Syndrome in Acute Febrile Illness in Medical Intensive Care Unit
This study assessed 130 patients with acute febrile illness complicated by acute respiratory distress syndrome admitted to the medical intensive care unit over 18 months. The overall mortality rate was 25.4%. Sequential Organ Failure Assessment (SOFA) scores on admission and at 48 hours, as well as the change in SOFA score, were significant predictors of patient outcome. The ratio of partial pressure of oxygen to fractional inspired oxygen both on admission and at 48 hours also predicted outcomes. Certain laboratory values such as blood urea nitrogen, creatinine, bicarbonate, and albumin levels correlated with survival
Similar to Abstract. aep (20)
Peritonitis in children experience in a tertiary hospital in enugu, nigeria
Peritonitis in children experience in a tertiary hospital in enugu, nigeria
Guidelines for the management of hospital-adquired pneumonia ERJ 2017.pdf
Guidelines for the management of hospital-adquired pneumonia ERJ 2017.pdf
Medeiros LNB de, Silva DR da, Guedes CDFS et al. .docx
Medeiros LNB de, Silva DR da, Guedes CDFS et al. .docx
Time between decision to admit and icu arrival of patients from emergency dep...
Time between decision to admit and icu arrival of patients from emergency dep...
2018 Effect of Bag-Mask Ventilation vs Endotracheal Intubation During Cardiop...
2018 Effect of Bag-Mask Ventilation vs Endotracheal Intubation During Cardiop...
Caring to the End - Launch Slides.ppt.............................
Caring to the End - Launch Slides.ppt.............................
Ventilator Associated Pneumonia (VAP) or Hospital Acquired Pneumonia (HAP)
Ventilator Associated Pneumonia (VAP) or Hospital Acquired Pneumonia (HAP)
Prospective Study of Acute Appendicitis with its Clinical, Radiological Profi...
Prospective Study of Acute Appendicitis with its Clinical, Radiological Profi...
Predictors of Outcome in Acute Respiratory Distress Syndrome with Acute febri...
Predictors of Outcome in Acute Respiratory Distress Syndrome with Acute febri...
More from Javier Rodriguez-Vera
Abstract. rickettsiosis
This study analyzed 30 patients admitted to a hospital in southern Portugal between 1998-2003 with spotted fever. Spotted fever is endemic to the Mediterranean region and transmitted by ticks. The average age was 43 years and 70% were male. Most cases occurred between June-August. Rural environments and contact with dogs were identified as risk factors. The most common symptoms were fever (100%) and rash (90%). Half of patients developed hepatitis and 40% thrombocytopenia. Doxycycline treatment was started early in 93% of patients and all patients recovered well with an average hospital stay of 5.9 days. The study concludes that spotted fever is common in the region likely due to rural areas, treatment with doxycy
Aep 2004 portugal
Este estudo avaliou a adequação de 72 admissões hospitalares num serviço de medicina interna em Portugal utilizando o Protocolo de Avaliação da Apropriação (AEP). 20,8% das admissões foram consideradas inadequadas, principalmente para exames ou tratamentos que poderiam ter sido realizados em ambulatório. O AEP é uma ferramenta útil para avaliar a utilização de recursos e melhorar a eficiência dos hospitais.
Adequaçao do Internamento num Serviço de Medicina INterna Utilizando o AEP. A...
Adequaçao do Internamento num Serviço de Medicina INterna Utilizando o AEP. A...Javier Rodriguez-Vera
Este artigo avalia a adequação das admissões e estadias hospitalares de pacientes internados em uma enfermaria de medicina interna utilizando a versão concorrente do Appropriateness Evaluation Protocol (AEP). Os resultados mostraram que todas as admissões foram consideradas adequadas, com a necessidade de terapia endovenosa sendo o critério mais comum. No entanto, 27,3% das estadias foram consideradas inadequadas de acordo com o AEP.AEP en ingresos y estancias
El estudio evaluó la adecuación de ingresos y estancias en un servicio de medicina interna utilizando la versión concurrente del AEP. Se encontró que un 15.3% de los ingresos y un 33% de las estancias fueron inadecuados, siendo las causas más frecuentes agilizar estudios ambulatorios e esperar resultados de pruebas, respectivamente. El estudio proporciona información sobre el uso de recursos que puede ayudar a mejorar la eficiencia.
Reingreso hospitalario como indicador de la calidad asistencial
RODRIGUEZ-VERA, F. J.; ALCOUCER DIAZ, M. R.; MARIN FERNANDEZ, Y. y PUJOL DE LA LLAVE, E. An. Med. Interna (Madrid). 2002, vol.19, n.5, pp. 66-67. ISSN 0212-7199.
Inadecuación de ingresos y estancias hospitalarias en una seción de digestivo
Este estudio evaluó la inadecuación de ingresos y estancias en la sección de digestivo de un hospital durante enero y febrero de 2000 utilizando el protocolo de evaluación de adecuación. El 15.7% de los pacientes no cumplían criterios de ingreso y la causa más común fue la necesidad de realizar estudios de forma rápida. La estancia media fue de 6.11 días y el 28.57% de las estancias inadecuadas se debió a procedimientos que podrían haberse realizado de forma externa. El estudio conclu
Lo que nunca se ve: resúmenes de estudios enviados para presentación en Congr...
Lo que nunca se ve: resúmenes de estudios enviados para presentación en Congr...Javier Rodriguez-Vera
Not all the studies sent for presentation to a Congress are accepted. Although less selective than a journal, an abstract has to comply with criteria of quality and scientific interest. As higher the number of abstracts sent, more rigurous the selection becomes.SADEMI 2001: Comorbidity and Hospital admission
Este documento estudia la relación entre la comorbilidad crónica de los pacientes y la duración de sus estancias hospitalarias. Analizó los registros médicos de 117 pacientes y calculó su índice de comorbilidad de Charlson. Encontró que los pacientes con mayor comorbilidad tuvieron estancias más largas, especialmente debido a más días de estancia adecuados, probablemente para estabilizar sus condiciones. Además, detectó que el 11% de las estancias fueron inadecuadas, una tasa menor que otros estudios simil
SADEMI 2001 (Abstract of non accepted study): Factores estructurales que dete...
SADEMI 2001 (Abstract of non accepted study): Factores estructurales que dete...Javier Rodriguez-Vera
This is the case: I found interesting to analyze if there were another factors not related with the requirements of acute care causing innappropriateness. Results showed facts, from my perspective, not appropriate to be changed. SADEMI 2001: Escritura Médica (Abstract submitted)
This abstract was accepted, the Director Medicine making despective comments about importance, pertinence and Interest of the study. During the Congress, it was a study calling the attention of many assistens. My boss (Director of Medicine and friend), mantained his position: it´s a "cute" study to be presented on a regional meeting, but that´s all. the study was published as an original article on the Journal of the Royal Society of Medicine, presenting a high individual impact factor. Chiefs can also be wrong.
Congreso 2001 cara a)
Este documento contiene información personal de Francisco Javier Rodríguez-Vera, incluyendo su nombre, lugar de trabajo en el Hospital Juan Ramón Jiménez de Huelva como médico interno, dirección, códigos postales y correo electrónico.
2001 aep concurrente
Este documento evalúa el uso de la versión concurrente del Protocolo de Evaluación de la Adecuación (AEP) en un servicio de medicina interna para evaluar la adecuación de ingresos y estancias. El estudio encontró que el 15.3% de los ingresos y el 25.97% de las estancias fueron inadecuados, principalmente debido a la espera de resultados de pruebas e interconsultas. La conclusión es que el AEP puede identificar la sobreutilización de recursos y que agilizar pruebas y colaboración entre especial
Congreso 2001 cara a concurrente
Este documento evalúa el uso de la versión concurrente del Protocolo de Evaluación de la Adecuación (AEP) en un servicio de medicina interna para evaluar la adecuación de ingresos y estancias. El estudio encontró que el 15.3% de los ingresos y el 25.97% de las estancias fueron inadecuados, principalmente debido a la espera de resultados de pruebas e interconsultas. La conclusión es que el AEP puede identificar la sobreutilización de recursos y que agilizar pruebas y colaboración entre especial
Protocolo de estudio de pluripatología
Este documento contiene un protocolo de estudio de pluripatología para un paciente. Recopila datos personales del paciente como nombre, edad, sexo y número de historia clínica. También incluye información sobre ingresos hospitalarios previos, categorías de patologías crónicas, comorbilidades según la escala de Charlson y detalles sobre la continuidad asistencial tras el último alta hospitalaria.
El paciente pluripatológico en los Servicios de Medicina Interna
This study was carried out as a part of a multicenter-based, global study to find out the real weight of patients with high comorbidity admitted to the wards of Internal Medicine, thus making possible developing strategies to improve delivery of care and acesibility to health care to avoid progression of any intercurrent condition that, utreated, alter the fragile balance of the clinical status of the affected, requirring an admission on an acute care unit.
The first concurrent AEP 2001
The Appropriateness Evaluation protocol (AEP) presents as a limiting factor, the need to do long, time-sparing, studies, which provides information of past events. As we had obtained a very good feedback from this tool, a one-day-study was done, with patients inward at the time and compared results with the other versions (preospective and restrospective AEP). Although data were not useful for stattistic study, they do presented a view of inappropriateness and its causes with a minimum investment in terms of time, thus favouring rapid and synchronic interventions to correct this parameter.
Hyperthyroidism presenting as a diarrheic syndrome
One of the first persons I attended as an independent Physician on my third year of Internship. I found the clinical feature extremely vague, since data collected before the admission were focused on diarrhea, weight loss, anemia, and blood tests suggesting a mild liver dysfunction with an INR of 5 at admission. All these data, together with the fact of the patient being 56yo, made me think in an intestinal neosplasm. results of Thyroid function tests were avalaible after an important part of the workup had been done.
The case, besides presenting clinical interest, is the startpoint of a polemic about the need of considering delay of the resultsof tests when a diagnostic process is going to be initiated.
Sd ateroembólico secundário a fibrinólisis
El documento presenta el caso de un paciente de 60 años que sufrió un infarto de miocardio y recibió tratamiento con estreptoquinasa. Cuatro días después desarrolló síntomas vasculares periféricos y livedo reticularis en las extremidades inferiores, lo que sugirió una enfermedad ateroembólica. Se realizaron biopsias de piel que confirmaron la presencia de cristales de colesterol, y el paciente se recuperó con tratamiento sintomático a pesar de requerir la amputación de un
Book of presentations Argentina 2008
This document provides information about the 29th World Congress of Internal Medicine being held in Buenos Aires, Argentina in 2008. It discusses the long candidacy and organization process for the Congress. It highlights that over 800 participants from 47 countries will participate in the scientific program through 119 sessions and around 900 poster presentations. The Congress aims to define the role of internal medicine, analyze changes in major diseases over the next 30 years, update advances in internal medicine, and update subspecialties from an internist perspective. It also pays tribute to the doctors who organized the 8th World Congress of Internal Medicine in Buenos Aires in 1964.
Insulin theraphy on DM type 2: What´s the evidence?
Este documento discute evidências sobre o uso de insulina no tratamento de diabetes mellitus tipo 2. Apresenta estudos que mostram que o controle glicêmico estrito com insulina ou sulfonilureias reduz o risco de complicações microvasculares. Também mostra que a adição de insulina quando a terapia máxima com sulfonilureias é inadequada pode melhorar o controle glicêmico sem aumentar o risco de hipoglicemia ou ganho de peso. Além disso, a combinação de insulina com sulfonilureias
More from Javier Rodriguez-Vera (20)
Adequaçao do Internamento num Serviço de Medicina INterna Utilizando o AEP. A...
Adequaçao do Internamento num Serviço de Medicina INterna Utilizando o AEP. A...
Reingreso hospitalario como indicador de la calidad asistencial
Reingreso hospitalario como indicador de la calidad asistencial
Inadecuación de ingresos y estancias hospitalarias en una seción de digestivo
Inadecuación de ingresos y estancias hospitalarias en una seción de digestivo
Lo que nunca se ve: resúmenes de estudios enviados para presentación en Congr...
Lo que nunca se ve: resúmenes de estudios enviados para presentación en Congr...
SADEMI 2001 (Abstract of non accepted study): Factores estructurales que dete...
SADEMI 2001 (Abstract of non accepted study): Factores estructurales que dete...
SADEMI 2001: Escritura Médica (Abstract submitted)
SADEMI 2001: Escritura Médica (Abstract submitted)
El paciente pluripatológico en los Servicios de Medicina Interna
El paciente pluripatológico en los Servicios de Medicina Interna
Hyperthyroidism presenting as a diarrheic syndrome
Hyperthyroidism presenting as a diarrheic syndrome
Insulin theraphy on DM type 2: What´s the evidence?
Insulin theraphy on DM type 2: What´s the evidence?
Abstract. aep
- 1. ID: 0454 THE PROSPECTIVE VERSION OF THE APPROPRIATENESS Title: EVALUATION PROTOCOL (AEP) IN PORTUGAL: OUR FIRST EXPERIENCE Authors: F.J.Rodríguez-Vera, N. Vieira, L. Arez, R. Tomé Institution: Department of Internal Medicine. Sector I. Hospital do Barlavento Algarvio City/Country: Portimão.Portugal. EU Categories: Epidemiology Presentation: Oral Abstract: Introduction The prospective version of the Appropriateness Evaluation Protocol (AEP) gives a view of the inappropriateness accumulated until the time of the study. In Portugal no studies with this tool have been carried out. Objective To know the magnitude and causes of inappropriateness of the admissions in a ward of Internal Medicine using the prospective version of the AEP. Material and Method Inclusion criteria: patients admitted to the beds 9, 22, 23, 24 of our ward during 2003. Exclusion criteria: transfer from other bed of the same Department. Parameters assessed: demographical (age, gender), clinical (multiadmission, mortality), appropriateness of the admissions according the AEP, and managemental (average stay, admissions during the weekend, department of procedence and time from the arrival to Hospital to the admission to our ward). Results 174 patients fulfilled the inclusion criteria. The average age was 72,37 years, with a 67,4% were male. 33,1% had criteria of multiadmission. Mortality was 11,4%. 17,7% of the admissions were inappropriate. The most common criteria of appropriateness was utilization of intravenous therapy (96,5%). The average stay was 8,44 days (SD 6,73). 9,7% were
- 2. admitted during the weekend and had a significatively longer stay than those who were admitted during the rest of the week. 5,15% of admissions came from Departments different to the Emergency. 30% had a stay longer than 72 hours before being transferred to Internal Medicine. Conclusions 1. The inappropriateness of the admissions was 17,7%, result similar to those of other studies carried out in the Iberian Peninsule. 2. The most common criterium for appropriateness was utilization of intravenous therapy. A careful consideration of the need of parenteral medication might eventually make the patients tributary of other level of care than Hospitalary 3. The longer stay of the people admitted during the weekend might be due to the inexistence of elective medical care during that period. An specifical program of assistence to the ward on weekends might improve this parameter. Granada, June 3rd, 2004 Dear colleague: It is a pleasure for the Evaluation Committee to let you know that your abstract ´ THE PROSPECTIVE VERSION OF THE APPROPRIATENESS EVALUATION PROTOCOL (AEP) IN PORTUGAL: OUR FIRST EXPERIENCE ¡ has been accepted to be presented in the 27th World Congress of Internal Medicine that will be held in Granada in September 26th to October 1st as an orally presentation. You will expose your abstract on Thursday, September 30th at 14,30-16,30 p.m. in the Room Picasso . Please, formalize your registration form and send it to the Organizing Secretariat as soon as possible. The deadline is June 15th and the registration fee for member are 540€ and no members 600€. Yours sincerely, Blas Gil Extremera President 27th World Congress of Internal Medicine