scholarly journals Impact of ERAS compliance on the delay between surgery and adjuvant chemotherapy in hepatobiliary and pancreatic malignancies

2020 ◽  
Vol 405 (7) ◽  
pp. 959-966
Author(s):  
Pénélope St-Amour ◽  
Pascal St-Amour ◽  
Gaëtan-Romain Joliat ◽  
Aude Eckert ◽  
Ismail Labgaa ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Enhanced Recovery ◽  
Young Patients ◽  
University Hospital ◽  
Colorectal Metastases ◽  
Liver Malignancies ◽  
Study Population ◽  
Eras Protocol ◽  
The University ◽  
The Impact

Abstract Background Multidisciplinary approach with adjuvant chemotherapy is the key element to provide optimal outcomes in pancreas and liver malignancies. However, post-operative complications may increase the interval between surgery and chemotherapy with negative oncologic effects. Hypothesis and study aim The aim of the study was to analyse whether compliance to Enhanced Recovery After Surgery (ERAS) pathway was associated with decreased interval to adjuvant chemotherapy. Methods Retrospective analysis of all consecutive ERAS patients with surgery for hepatobiliary or pancreatic malignancies at the University Hospital of Lausanne between 2012 and 2016. Multivariate analysis was performed to assess the impact of ERAS compliance on time to chemotherapy. Results A total of 133 patients with adjuvant chemotherapy were included (n = 44 liver and n = 89 pancreatic cancer). Median compliance to ERAS was 61% (IQR 55–67) for the study population, and median delay to chemotherapy was 49 days (IQR 39-61). Overall, compliance ≥ 67% to ERAS induced a significant reduction in the interval between surgery and chemotherapy for young patients (< 65 years old) with or without severe comorbidities (reduction of 22 and 10 days, respectively). High compliance in young ASA3 patients with liver colorectal metastases was associated with an increase of 481 days of DFS. Conclusions ERAS compliance ≥ 67% tends to be associated with a reduction in the delay to adjuvant chemotherapy for young patients with hepatobiliary and pancreatic malignancies. More prospective studies with strict adhesion to the ERAS protocol are needed to confirm these results.

scholarly journals Onychomycosis in Northwestern Greece over a 7-Year Period

Pathogens ◽  
2020 ◽  
Vol 9 (10) ◽  
pp. 851
Author(s):  
Hercules Sakkas ◽  
Christos Kittas ◽  
Georgia Kapnisi ◽  
Efthalia Priavali ◽  
Amalia Kallinteri ◽  
...  
Keyword(s):  
Demographic Data ◽  
Risk Groups ◽  
University Hospital ◽  
History Of ◽  
Study Population ◽  
Etiological Agents ◽  
And Shifts ◽  
The University ◽  
Northwestern Greece ◽  
The Impact

Onychomycosis is considered as one of the major public health problems with a global distribution associated with geographic, demographic and environmental factors, underlying comorbidities and immunodeficiency disorders. This study was conducted to investigate the etiological agents of onychomycosis, in Northwestern Greece during a 7-year period. The study population included 1095 outpatients with clinically suspected onychomycosis that presented to the University Hospital of Ioannina, NW Greece (2011–2017). Samples were examined for causative fungi, and mycological identification was established using standard mycological methods. Demographic data of each patient, comorbidities, localization of infection and history of previous fungal infection were collected. Onychomycosis was diagnosed in 317 of the 1095 suspected cases (28.9%) and the most frequently isolated pathogens were yeasts (50.8%) followed by dermatophytes (36.9%) and non-dermatophyte molds (NDMs) (12.3%). Dermatophytes were mostly involved in toenail onychomycosis (90.6%) and more commonly affected males than females (57.3% vs. 42.7%), while the predominantly isolated pathogen was Τrichophyton rubrum (74.4%) followed by Τrichophyton interdigitale (21.4%). Candida albicans was the most prevalent isolated yeast (82%), whereas among the cases with onychomycosis due to NDMs, Aspergillus spp. were isolated as the principal species (59%). Continuous monitoring should be performed in order to identify possible trends and shifts in species isolation rates and to evaluate the impact of onychomycosis among the general population and high-risk groups.

scholarly journals The impact of enhanced recovery after surgery (ERAS) protocol compliance on morbidity from resection for primary lung cancer

2018 ◽  
Vol 155 (4) ◽  
pp. 1843-1852 ◽  
Author(s):  
Luke J. Rogers ◽  
David Bleetman ◽  
David E. Messenger ◽  
Natasha A. Joshi ◽  
Lesley Wood ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Primary Lung Cancer ◽  
Protocol Compliance ◽  
Eras Protocol ◽  
The Impact

scholarly journals Impact of the COVID-19 pandemic and its related psychological effect on orthopedic surgeries conducted in different types of hospitals in Taiwan

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902199607 ◽  
Author(s):  
Chia-Lung Shih ◽  
Peng-Ju Huang ◽  
Hsuan-Ti Huang ◽  
Chung-Hwan Chen ◽  
Tien-Ching Lee ◽  
...  
Keyword(s):  
Community Hospital ◽  
University Hospital ◽  
Total Knee Arthroplasties ◽  
Peak Period ◽  
Number Of Patients ◽  
Total Knee ◽  
Investigation Period ◽  
Orthopedic Diseases ◽  
The University ◽  
The Impact

Aim: Taiwan’s response to the coronavirus disease 2019 (COVID-19) differed in that it successfully prevented the spread without having to shutdown or overburden medical services. Patients’ fear regarding the pandemic would be the only reason to reduce surgeries, so Taiwan could be the most suitable place for research on the influence of psychological factors. This study aimed to assess the impact of patients’ fear on orthopedic surgeries in Taiwan amid the peak period of the COVID-19 pandemic. Patients and Methods: The investigation period included the COVID-19 pandemic (March 2020 to April 2020) and the corresponding period in the previous year. The following data on patients with orthopedic diseases were collected: outpatient visits, hospital admission, and surgical modalities. Results: The COVID-19 pandemic led to a 22%–29% and 20%–26% reduction in outpatients, 22%–27% and 25%–37% reduction in admissions, and 26%–35% and 18%–34% reduction in surgeries, respectively, at both hospitals. The weekly mean number of patients was significantly smaller during the COVID-19 pandemic for all types of surgery and elective surgeries at the university hospital, and for all types of surgery, elective surgeries, and total knee arthroplasties at the community hospital. Further, patients visiting the community hospital during the pandemic were significantly younger, for all types of surgery, elective surgeries, and total knee arthroplasties. Conclusions: The reduction in orthopedic surgeries in Taiwan’s hospitals during COVID-19 could be attributed to patients’ fear. Even without restriction, the pandemic inevitably led to a reduction of about 20%–30% of the operation volume.

The Impact of an Enhanced Recovery after Surgery (ERAS) Protocol Implementation in a Community-Based Hospital.

2020 ◽  
Vol 27 (7) ◽  
pp. S111
Author(s):  
D.A. Escobar Jimenez ◽  
D. Encalada ◽  
M. Teitz ◽  
E. Hemmings ◽  
C. Salafia ◽  
...  
Keyword(s):  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Community Based ◽  
Protocol Implementation ◽  
Eras Protocol ◽  
The Impact

scholarly journals Quality of Life in Patients with Psoriasis Seen in the Department of Dermatology, Antananarivo, Madagascar

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Fandresena Arilala Sendrasoa ◽  
Naina Harinjara Razanakoto ◽  
Volatantely Ratovonjanahary ◽  
Onivola Raharolahy ◽  
Irina Mamisoa Ranaivo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Negative Impact ◽  
Young Patients ◽  
The Body ◽  
University Hospital ◽  
Medical Decision ◽  
Cross Sectional ◽  
The Difference ◽  
The Impact

Background. Psoriasis is a chronic, inflammatory, and multifactorial dermatosis that impairs quality of life (QoL). Health-related QoL has become an important element in medical decision-making along with the effectiveness and the harmlessness of the treatments. Objective. To assess the impact of psoriasis in the QoL of patients with psoriasis by using the DLQI scales. Methods. A cross-sectional study from January to June 2018 was conducted in the Department of Dermatology of the University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar, including patients more than 18 years old with mild to severe psoriasis. The severity of psoriasis was assessed using the “Psoriasis Area and Severity Index (PASI)”. QoL of patients with psoriasis was evaluated by using the DLQI scales. Results. 80 patients were included, their mean age was 36.5 years, and the male to female was 1.5 : 1. The mean DLQI score was 13.8. Symptoms, feelings, and psychic were the most altered dimensions. QoL was impaired in young patients, single, having medium level education. Even though patients with disease duration more than 5 years had higher DLQI score than other patients, the difference was not statistically significant (p=0.36). Furthermore, the clinical presentation of psoriasis did not influence the patient’s QoL (p=0.73). Patients with nail involvement had QoL impaired but the difference with another localization was not statistically significant (p=0.2). The quality of life was influenced by body area involved. The higher the body surface area involved, the more QoL is impaired (p=0.002). Furthermore, the higher the PASI, the more QoL is altered (p=0.002). Conclusion. Psoriasis has a negative impact in the quality of life in Malagasy patients with psoriasis, especially in younger and single patients. Worse quality of life is correlated to severity of psoriasis.

A cost analysis of the impact of enhanced recovery after surgery (ERAS) protocol in gynecologic oncology surgery

2019 ◽  
Vol 154 ◽  
pp. 211
Author(s):  
Z.L. Gentry ◽  
T.K.L. Boitano ◽  
H.J. Smith ◽  
J. Russell ◽  
D. Eads ◽  
...  
Keyword(s):  
Cost Analysis ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Gynecologic Oncology ◽  
Eras Protocol ◽  
The Impact

scholarly journals Low Adherence To Hand Hygiene: Analysis Of The Impact Factors In Critical Sectors Of A Hospital

2019 ◽  
Author(s):  
Marília Duarte Valim ◽  
Thaissa Blanco Bezerra ◽  
Alvaro Francisco Lopes Sousa ◽  
Denise de Andrade ◽  
Adriano Menis Ferreira ◽  
...  
Keyword(s):  
Patient Safety ◽  
Hand Hygiene ◽  
Safety Climate ◽  
Physical Structure ◽  
University Hospital ◽  
Impact Factors ◽  
Patient Safety Climate ◽  
Study Population ◽  
Nursing Professionals ◽  
The Impact

Abstract Background: We aimed to monitor hand hygiene (HH) of health professionals in three critical sectors of a university hospital, to verify the physical structure of these units for HH, gloves use and perception of professionals regarding the patient's safety climate Methods: An observational, correlational study, conducted in critical sectors of a hospital. The study population consisted of nurses, nursing technicians, physicians, resident physicians and physiotherapists. The data were collected through four questionnaires to evaluate HH, factors related to adherence to it and sociodemographic characteristics. Results: A total of 148 professionals and 3.025 opportunities for HH were observed. Adherence to HH was higher among nurses when compared to nursing professionals (p <0.05), and there was a difference between different sectors (p <0.05). Professionals who previously participated in training had greater adherence (47.79% CI95% 45.38-50.20) to HH than professionals who did not participate (44.62% CI95% 41.95-47.29). There was a statistical difference between the perception of the security climate and the type of employment bond of the professional, as well as the sector in which it operates. Conclusion: Adherence to HH was affected and / or influenced by the physical structure, use of procedure gloves, work regimen and perceived patient safety climate. Keywords: Hand hygiene; Cross Infection; Patient Safety; Safety culture

scholarly journals D-dimer Level and Diabetes in the COVID-19 Infection

2021 ◽  
Vol 27 ◽  
pp. 107602962110459
Author(s):  
Chaymae Miri ◽  
Hajar Charii ◽  
Mohammed-Amine Bouazzaoui ◽  
Falmata Laouan Brem ◽  
Soumia boulouiz ◽  
...  
Keyword(s):  
Characteristic Curve ◽  
Final Analysis ◽  
Receiver Operator Characteristic Curve ◽  
University Hospital ◽  
Diabetic Patients ◽  
Coagulation Abnormalities ◽  
Study Population ◽  
The University ◽  
D Dimer ◽  
Hospital Center

Introduction Diabetes is the most common of comorbidity in patients with SARS-COV-2 pneumonia. Coagulation abnormalities with D-dimer levels are increased in this disease. Objectifs We aimed to compare the levels of D-dimer in diabetic and non-diabetic patients with COVID 19. A link between D-dimer and mortality has also been established. Materials A retrospective study was carried out at the University Hospital Center of Oujda (Morocco) from November 01st to December 01st, 2020. Our study population was divided into two groups: a diabetic group and a second group without diabetes to compare clinical and biological characteristics between the two groups. In addition, the receiver operator characteristic curve was used to assess the optimal D-dimer cut-off point for predicting mortality in diabetics. Results 201 confirmed-COVID-19-patients were included in the final analysis. The median age was 64 (IQR 56-73), and 56% were male. Our study found that D-dimer levels were statistically higher in diabetic patients compared to non-diabetic patients. (1745 vs 845 respectively, P = 0001). D-dimer level > 2885 ng/mL was a significant predictor of mortality in diabetic patients with a sensitivity of 71,4% and a specificity of 70,7%. Conclusion Our study found that diabetics with COVID-19 are likely to develop hypercoagulation with a poor prognosis.

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