Tumour markers in internal medicine: a low-cost test or an unnecessary expense? A retrospective study based on appropriateness

2007 ◽  
Vol 2 (2) ◽  
pp. 88-94 ◽  
Author(s):  
D. Arioli ◽  
M. Pipino ◽  
E. Boldrini ◽  
E. Amateis ◽  
A. Cristani ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Retrospective Study ◽  
Low Cost ◽  
Tumour Markers

scholarly journals I’m No Superman: fostering physician resilience through guided group discussion of Scrubs

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Arthur Holtzclaw ◽  
Jack Ellis ◽  
Christopher Colombo
Keyword(s):  
Internal Medicine ◽  
Training Programs ◽  
Low Cost ◽  
Group Discussion ◽  
Well Being ◽  
Internal Medicine Residency ◽  
Resiliency Training ◽  
High Satisfaction ◽  
Burn Out

Abstract Background Almost half of trainees experience burnout during their career. Despite the Accreditation Council on Graduate Medical Education (ACGME) recommendation that training programs enact well-being curricula, there is no proven method of addressing this difficult topic. Methods We created a curriculum addressing physician resiliency and well-being, designed for an Internal Medicine Residency Program. This curriculum utilized episodes from a medical television series, Scrubs, to facilitate a monthly, 1-h faculty guided discussion group. We collected informal feedback and abbreviated Maslach Burnout Inventories (aMBI) monthly and conducted a formal focus group after 6 months to gauge its effectiveness. Results The curriculum was successfully conducted for 12 months with each session averaging 18–20 residents. Residents reported high satisfaction, stating it was more enjoyable and helpful than traditional resiliency training. 19 of 24 residents (79 %) completed a baseline aMBI, and 17 of 20 residents (85 %) who attended the most recent session completed the 6-month follow-up, showing a non-significant 1-point improvement in all subsets of the aMBI. Conclusions This novel, low-cost, easily implemented curriculum addressed resiliency and burn-out in an Internal Medicine Residency. It was extremely well received and can easily be expanded to other training programs or to providers outside of training.

scholarly journals COST-EFFICIENCY ANALYSIS OF A MULTI-PAVILION HOSPITAL IN CLUJ COUNTY

2016 ◽  
Vol 89 (1) ◽  
pp. 110-116
Author(s):  
Mihai Mleșnițe ◽  
Ioan Stelian Bocșan
Keyword(s):  
Internal Medicine ◽  
Retrospective Study ◽  
Cost Efficiency ◽  
Time Frame ◽  
Healthcare Systems ◽  
Efficiency Analysis ◽  
Financial Indicators ◽  
Target Groups ◽  
Hospital Administrators ◽  
Clinical Hospital

Background and aim: Multi-hospital health systems have become the most popular administrative structure in healthcare, leading to both opportunities and challenges for hospital administrators. In government-funded healthcare systems, there is a balance between costs and the provision of health services.The aim of the present study is to assess the efficiency in terms of costs of a multi-pavilion hospital from Cluj County, Romania.Methods: The institution analyzed in this article is the Adults’ Clinical Hospital in Cluj-Napoca. A descriptive retrospective study collected data from January 2004 to December 2010. A set of indicators were compiled, divided into three main categories: personnel, statistics, and financial.Results: Twenty-one financial indicators were investigated. Heterogeneity between different years was observed for the continuous hospitalization indicator and the wage budget indicator. The highest variability was observed between the budget and expenses indicators, while a smaller variability was observed at the average costs per patient. The costs per patient have increased at all pavilions in the studied time frame, the higher costs being at the Internal Medicine and Surgery pavilions: 10,203 RON in 2010 (1 euro ~ 4.4 RON)Conclusion: The pavilions included in the Adults’ Clinical Hospital Cluj-Napoca have different expenses patterns, as each pavilion is focused on different specialties. Each pavilion serves different target groups, requiring different procedures. This in turn results in different expense patterns across each pavilion.

scholarly journals Analysis of Medication-Related Deaths in Denmark

2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
Lars Dahlgaard Hove ◽  
Johannes Bock ◽  
Jens Krogh Christoffersen
Keyword(s):  
Internal Medicine ◽  
Adverse Event ◽  
Patient Safety ◽  
Retrospective Study ◽  
Orthopaedic Surgery ◽  
Safety Measures ◽  
Danish Patient ◽  
Wrong Drug ◽  
Closed Claims ◽  
Future Patient

Objective. To investigate the circumstances associated with medication-related deaths. Design and Setting. This retrospective study investigated closed claims concerning medication-related deaths from 1996 to 2008 registered by the Danish Patient Insurance Association (DPIA). Results. A total of 80 were patients registered as having died because of an adverse event or error associated with a medication, and 37 of these cases were considered to have been preventable. The circumstances of the 37 deaths are described in detail in this report. Orthopaedic surgery, anaesthesiology, and internal medicine were the specialties involved in the majority of the deaths. Incorrect dosing was the cause of 17 deaths, and the use of the wrong drug caused 11 deaths. The administration of a drug despite a known allergy/intolerance or contraindication caused 6 deaths. Other 5 deaths were caused by anticoagulation medications. Methotrexate given daily by mistake caused 2 deaths. Conclusion. This study describes the circumstances of 37 preventable deaths caused by medication. Drug administration despite a known allergy, opioids, sedative, anticonvulsive medicine, and incorrect dosing and incorrect use of anticoagulants are the most important areas to be addressed in the development of future patient safety measures to reduce patient deaths caused by or related to medications.

scholarly journals Cardiovascular Safety of Clonidine and Dexmedetomidine in Critically Ill Patients after Cardiac Surgery

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Angelina Grest ◽  
Judith Kurmann ◽  
Markus Müller ◽  
Victor Jeger ◽  
Bernard Krüger ◽  
...  
Keyword(s):  
Heart Rate ◽  
Cardiac Surgery ◽  
Retrospective Study ◽  
Mean Arterial Pressure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Low Cost ◽  
Cardiovascular Safety ◽  
Drug Infusion ◽  
Saps Ii

Purpose. The aim of this retrospective study was to assess the haemodynamic adverse effects of clonidine and dexmedetomidine in critically ill patients after cardiac surgery. Methods. 2769 patients were screened during the 30-month study period. Heart rate (HR), mean arterial pressure (MAP), and norepinephrine requirements were assessed 3-hourly during the first 12 hours of the continuous drug infusion. Results are given as median (interquartile range) or numbers (percentages). Results. Patients receiving clonidine (n = 193) were younger (66 (57–73) vs 70 (63–77) years, p=0.003) and had a lower SAPS II (35 (27–48) vs 41 (31–54), p=0.008) compared with patients receiving dexmedetomidine (n = 141). At the start of the drug infusion, HR (90 (75–100) vs 90 (80–105) bpm, p=0.028), MAP (70 (65–80) vs 70 (65–75) mmHg, p=0.093), and norepinephrine (0.05 (0.00–0.11) vs 0.12 (0.03–0.19) mcg/kg/min, p<0.001) were recorded in patients with clonidine and dexmedetomidine. Bradycardia (HR < 60 bpm) developed in 7.8% with clonidine and 5.7% with dexmedetomidine (p=0.51). Between baseline and 12 hours, norepinephrine remained stable in the clonidine group (0.00 (−0.04–0.02) mcg/kg/min) and decreased in the dexmedetomidine group (−0.03 (−0.10–0.02) mcg/kg/min, p=0.007). Conclusions. Dexmedetomidine and the low-cost drug clonidine can both be used safely in selected patients after cardiac surgery.

PROGNOSTIC FACTORS OF NON-HODGKIN LYMPHOMA: RETROSPECTIVE STUDY IN UNIT BLOOD SERVICE OF THE INTERNAL MEDICINE DANTEC IN DAKAR (SENEGAL)

2015 ◽  
Vol 6 ◽  
pp. 1
Author(s):  
Fatou Samba Diago Ndiaye ◽  
Seynabou Fall ◽  
Atoumane Faye ◽  
Nafissatou Diagne ◽  
Awa Cheikh Ndaw ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Prognostic Factors ◽  
Retrospective Study ◽  
Hodgkin Lymphoma ◽  
Non Hodgkin Lymphoma

scholarly journals The correct setting to improve the quality of health care process: a retrospective study in Internal Medicine Department

2018 ◽  
Vol 12 (4) ◽  
pp. 285-295
Author(s):  
Filomena Pietrantonio ◽  
Paola Aperti ◽  
Luca Tonoli ◽  
Elaine Tyndall ◽  
Orietta Meneghetti
Keyword(s):  
Internal Medicine ◽  
Health Care ◽  
Retrospective Study ◽  
Hospital Stay ◽  
Medical Records ◽  
Clinical Severity ◽  
Early Warning Score ◽  
Care Process ◽  
Technical Equipment

The definition of the role of hospitals and communities in terms of the response to patients’ health care needs is essential in the Lombardy region health-care reform development (LR. 23/2015). The stratification of patients according to clinical severity and care complexity for adequate clinical health care, is achieved by delineating care settings, staff standards, required technical equipment and crucial aspects of clinical pathways. An observational and retrospective study at Manerbio Hospital Internal Medicine Unit (IMU) was carried out to define: i) characteristics of IMU patients; ii) role of IMU physician in management of poly-pathological patients; iii) alternative organizational models. After a Literature review, clinical severity was defined by modifying early warning score, complexity and co-morbidities by cumulative illness rating scale (CIRS) and by intensity of care through care intensity index (IIA). All medical records of patients admitted in the first quarter of 2016 were analyzed. A total of 393 medical records were examined: 199 M/194 F, median age 81 years. Critical patients (requiring continuous monitoring using advanced equipment): 27% of the sample (10% with intensive care transfer criteria). Co-morbidity: between 5 and 6 active diseases for most of the sample; 53% with CIRS between 7 and 12. Elevated care intensity (IIA) was found in 46% of the sample, remaining constant throughout hospital stay. Medium stay: 9.35 days. 27% of IMU patients needs subintensive care. About a quarter of patients has unresolved social problems contributing to acute presentations in the emergency room. Agreement on appropriate links between hospital and community care structures is advisable to reduce hospital stay, adequately responding to patients’ needs.

scholarly journals Differences in Bacteriological and Antibiotic Sensitivity Patterns in UTI among Hospitalized Diabetic and Nondiabetic Patients

1970 ◽  
Vol 8 (1) ◽  
pp. 10-13
Author(s):  
Mohammed Kamrul Hasan ◽  
Khwaja Nazimuddin ◽  
AKM Shaheen Ahmed ◽  
Rene Suzan Claude Sarker ◽  
Muzammel Haque ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Diabetes Mellitus ◽  
Retrospective Study ◽  
Urine Culture ◽  
Antibiotic Sensitivity ◽  
High Sensitivity ◽  
Generation Cephalosporin ◽  
Third Generation ◽  
Highly Sensitive

Aim of this study was to determine bacteriological pattern and there antibiotic sensitivity in UTI. The retrospective study carried out in department of internal medicine of BIRDEM on 300 consecutive patients with or without Diabetes Mellitus and whose urine culture shows growth of >105 organism/ml of urine, during the period from January 2006 to July 2007.A total of 300 patients were included in the study. The highest number of isolates was E.coli (62%,184) followed by Klebsiella (17%,50),Pseudomonas(6%,19), Enterococcus(8%, 23), Staphylococcus (3%, 10), Proteus (1%, 4) respectively in patient with DM(N-261) or without DM(N-39).All of these isolates were highly sensitive to Imipenem(96%) while some were high to moderate sensitive to other antibiotics. E.coli isolates showed high sensitivity to Aminoglycosides (72%, 133), Nitrofurantoin (70%, 129), and third generation Cephalosporin (61%, 112). Klebsiella was observed highly sensitive to third generation Cephalosporin (29%, 58) AND Nitrofurantoin (30%, 60).   DOI = 10.3329/jom.v8i1.1373 J MEDICINE 2007; 8 : 10-13

Parapneumonic pleural effusion prognosis – retrospective study in an Internal Medicine Service

2021 ◽  
Author(s):  
Chantal Cortesão ◽  
Patrícia Carvalho ◽  
Pedro Silva Santos ◽  
Joana Pacheco ◽  
Armando Carvalho
Keyword(s):  
Internal Medicine ◽  
Retrospective Study ◽  
Pleural Effusion ◽  
Medicine Service ◽  
Parapneumonic Pleural Effusion
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