Correlation between clinical outcome in the first 5 Days of treatment and on hospital discharge in patients with schizophrenia

2011 ◽  
Vol 26 (S2) ◽  
pp. 1350-1350
Author(s):  
L. San-Molina ◽  
G. Rubio ◽  
I. Bernardo-Fernández ◽  
S. Miguélez-Fernández
Keyword(s):  
Hospital Stay ◽  
Hospital Discharge ◽  
Clinical Improvement ◽  
Clinical Symptoms ◽  
Short Hospital Stay ◽  
Clinical Prognosis ◽  
The Mean ◽  
Clinically Significant ◽  
Personal Functioning ◽  
Time Of Admission

IntroductionIn patients with acute clinical symptoms, a short hospital stay and prevalent therapeutic objectives aimed at controlling symptoms overcome the clinician's concern for the functionality levels that will be even more significant after discharge.ObjectivesTo establish the clinical condition of patients admitted to acute/short-stay units in the first five days of hospital stay and on hospital discharge.MethodsA multicenter, naturalistic, retrospective, observational study to evaluate clinical assessment (CGI) obtained in patients with schizophrenia after treatment at the time of admission and on hospital discharge.ResultsThe mean score of the CGI questionnaire decreases from 5.3 recorded on admission to 4.3 on Day 5 and 3 on discharge. On Day 5 of hospital stay, symptoms had improved in 57.3% of cases. In 30.9% of cases there were no changes and in 1.7% symptoms had worsened. In 86.3% of patients symptoms had improved at discharge. 100% of patients with clinical improvement at Day 5 had a clinically significant improvement on hospital discharge.ConclusionsClinical improvement in the first five days after hospital admission appears to lead to a better clinical prognosis on hospital discharge. Hospital discharge should be scheduled from admission, so treatment choice should be geared to looking to control symptoms in the first few days and allow for better social and personal functioning after discharge.

Clinical improvement at Day 3 as factor influencing length of hospital stay and discharge of patients with schizophrenia

2011 ◽  
Vol 26 (S2) ◽  
pp. 1348-1348
Author(s):  
L. San-Molina ◽  
G. Rubio ◽  
I. Bernardo-Fernández ◽  
S. Miguélez-Fernández
Keyword(s):  
Retrospective Study ◽  
Length Of Stay ◽  
Hospital Stay ◽  
Hospital Discharge ◽  
Clinical Improvement ◽  
Length Of Hospital Stay ◽  
Medical Intervention ◽  
Symptom Improvement ◽  
The Mean ◽  
Symptom Outcome

IntroductionThe type of treatment used for patients with schizophrenia and an improvement at Day 3 can affect the length of stay and symptom outcome.ObjectivesTo determine the influence of improvement at Day 3 in the lenght of hospital stay and hospital discharge in the case of patients with schizophrenia admitted to acute units.MethodsA multicenter, naturalistic, retrospective study evaluating medical intervention in 1346 patients with schizophrenia in acute units in Spain.ResultsThe mean of hospital stay days was 23.3 (range 1–260 days). 49.5% of patients with improvement at Day 3 had a shorter length of hospital stay. 78.7% received treatment with antipsychotics prior to admission. The most common drugs were risperidone, olanzapine and quetiapine. 99.8% and 99.7% were treated during hospital stay and on discharge, respectively. The drugs most commonly used were paliperidone ER, risperidone and olanzapine. 99.8% of patients with improvement measured by GCI at Day 3 and 100% with improvement at Day 5 had improved at discharge. The percentage of patients requiring use of benzodiazepines or physical/mechanical restriction decreased as the days passed.ConclusionsThe three most commonly used drugs during admission were effective, but the action of paliperidone ER is to be noted (its use increased from 4% prior to admission to 43% and 44% during hospital stay and on discharge, respectively). The results of this study appear to confirm that symptom improvement should be obtained as early as the first week of treatment to achieve a shorter hospital stay.

scholarly journals Laparoscopic cholecystectomy in Jordan

2001 ◽  
Vol 7 (4-5) ◽  
pp. 838-840
Author(s):  
A. Al Raymoony
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Return To Work ◽  
Hospital Stay ◽  
Operative Time ◽  
Safe Procedure ◽  
Short Hospital Stay ◽  
Early Return ◽  
The Mean ◽  
Mean Time

This study was conducted on 100 patients with symptomatic gallbladder stones, aged 22-81 years with a mean of 51.5 years, who underwent cholecystectomy in Zarqa city, Jordan between July 1998 and July 1999. The success rate was 87% and the procedure was completed using the conventional method in 13 patients. The mean operative time was 60 minutes, complication rate was 5% and there were no deaths. The mean hospital stay was 1 day and mean time to return to work was 10 days. This study showed that laparoscopic cholecystectomy is a safe procedure with reasonable operative time, less postoperative pain, a short hospital stay, early return to work, and a low morbidity and mortality rate.

Laparoscopic Dismembered Pyeloplasty for Ureteropelvic Junction Obstruction: Our Preliminary Experience

2020 ◽  
Vol 19 (2) ◽  
pp. 59-63
Author(s):  
Md Mahfuzur Rahman Chowdhury ◽  
AKM Khurshidul Alam ◽  
AKM Anwarul Islam ◽  
Md Sajid Hasan ◽  
Tms Hossain ◽  
...  
Keyword(s):  
Renal Function ◽  
Postoperative Pain ◽  
Hospital Stay ◽  
Operative Time ◽  
Ureteropelvic Junction Obstruction ◽  
Clinical Symptoms ◽  
Ureteropelvic Junction ◽  
Laparoscopic Pyeloplasty ◽  
The Mean ◽  
Urine Leakage

Objective: To evaluate prospectively the results obtained in 16 patients undergoing laparoscopic pyeloplasty through transperitoneal access. Materials and Methods: The study was conducted in the department of urology, BSMMU, Dhaka between the periods of March 2013 and June 2014, sixteen patients between 15 and 48 years old, were treated for ureteropelvic junction obstruction (UPJO) via a transperitoneal laparoscopy. All patients had clinical symptoms of urinary obstruction and hydronephrosis were confirmed by imaging methods. Anderson-Hynes dismembered pyeloplasty was performed in all patients. Patients were clinically and imaging evaluated in the postoperative period at 6 and 12 weeks. Results: Most of the patients were male (68.75%) and female were 31.25%. The mean operative time was 127.37 (±15.67) minutes ranged from 95 to 240 minutes. Pain score in first postoperative day and third postoperative day following pyeloplasty were 20.87 (±6.83) and 4.75 (±3.34) respectively. The mean hospital stay was 4.25 (±1.34) days. Anomalous vessels were identified in 4 patients, intrinsic stenosis in 12 patients. Postoperative urine leakage and UTI were seen 18.75%, 12.50% subject respectively. Split renal function and GFR were significantly improved (p<0.05) and improvement of renal functional outcome was 87.50%. Conclusion: Laparoscopic pyeloplasty had the advantages like less postoperative pain and shorter hospital stay. Bangladesh Journal of Urology, Vol. 19, No. 2, July 2016 p.59-63

scholarly journals Is Viral Load a Prognostic Indicator for Outcome of Covid-19 Patients? A Prospective Cohort Study in Iran

2021 ◽  
Author(s):  
Mohammad Hosein Taziki Balajelini ◽  
Abdolhalim Rajabi ◽  
Masoud Mohammadi ◽  
Alijan Tabarraei ◽  
Seyed Mohammad Hadi Razavi Nikoo ◽  
...  
Keyword(s):  
Cohort Study ◽  
Viral Load ◽  
Clinical Symptoms ◽  
Study Groups ◽  
Prognostic Indicator ◽  
Nasopharyngeal Swab ◽  
Ct Value ◽  
The Mean ◽  
Severity Of The Disease ◽  
Time Of Admission

Abstract Background: Covid-19 has different clinical symptoms and severity. Predicting its progress and results is clinically important. Hence, in this study, we investigated the relationship between virus load and the outcomes in Golestan Province. Methodology: We conducted a retrospective cohort study of COVID-19 diagnosed with RT-PCR testing from May 2020 to December 2020. According to the severity of the disease, the study groups were divided into three groups: outpatient, inpatient, and inpatient with death. SARS-CoV-2 viral load was assessed using cycle threshold (Ct) values from a reverse transcription-polymerase chain reaction assay applied to nasopharyngeal swab samples. Demographic properties, Clinical characteristics, and CT values of the studied patients were compared. Data were analyzed using STATA Version 16.0 software.Results: Of 1318 included subjects, 599 were outpatient, and 719 were hospitalized. Of the hospitalized patients, 487 were recovered and 232 died. The mean age (year) of patients was 48.81±18.40 and 51.9% were female. There were significant differences between the age and the severity of the disease, the mean age of patients who died was higher than other patients (p<0.001). The mean CT value of all patients was 26.80±4.43, which was higher in outpatients than inpatients' cases (p <0.001). We did not find any significant differences for the Ct values between recovered and dead cases (p=0.66). CT value levels were not significantly different between age and sex groups. Conclusions: According to the results of the study, CT value can be used only as a factor to determine the severity of the disease at the time of admission, but the load of the virus is not a factor to predict the outcome.

scholarly journals Early Hospital Discharge and Early Puerperal Complications

2020 ◽  
Vol 35 (4) ◽  
pp. 294-303
Author(s):  
Zahia Saad Elghazal ◽  
Fatma Abdullah Emtawel ◽  
Ekram Ben Sauod
Keyword(s):  
Urinary Tract ◽  
Prenatal Care ◽  
Hospital Stay ◽  
Hospital Discharge ◽  
Early Discharge ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
The Mean ◽  
Tract Infections ◽  
Late Group

 The study aimed to evaluate the association between the time of postpartum discharge and symptoms indicative of complications during the first postpartum week. The cross-sectional study included 753 women with vaginal delivery at Al-Jamhorya teaching public hospital without complications were interviewed before the hospital discharge and seven days after. The time of postpartum discharge was classified as early (≤24hours) or late (>24hours). A total of 753 mothers were enrolled in the study. The majority (94.3%) of the mothers stayed in the hospital ≤24hours, 4.1% >24hours, and 1.6 % were discharged against medical advice. The mean duration of hospital stay was 12.1±6.1 hours, with a minimum hospital stay of 2 hours and a maximum stay of 46 hours. The prenatal care was satisfactory in 91.2%. Prenatal care was satisfactory in 91% of early discharge mothers and 93.5% in the late group. This slight difference was not statistically significant. After delivery, 8.4% had urinary tract infections. Urinary tract infection after delivery occurred in 8.2% of mothers with early discharge and 12.9 % in mothers with late discharge. This difference was not statistically significant. Complications of episiotomy were recorded in 79.9% of mothers with early discharge and 61.3% in late discharge. This difference was statistically significant. The study’s conclusions indicated that late discharge mothers had received anesthesia and performed episiotomy more than early discharge mothers. Complications of episiotomy were recorded more in mothers with early discharge than in late discharged mothers. It is recommended that a randomized clinical trial is best to evaluate the association between the time of discharge postpartum and the presence of complications, also to attain safety and possible benefits of shorter hospital stay.   

scholarly journals 389. Neutrophil-lymphocyte index, platelet-lymphocyte index and systemic inflammation-immunity index in patients with Covid-19 pneumonia in Veracruz, Mexico

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S263-S264
Author(s):  
Luis Del Carpio-Orantes ◽  
Sergio García-Méndez ◽  
Sara Nohemi Hernández-Hernández ◽  
Ada Lili Rosas-Lozano ◽  
Alvaro Efren Munguia-Sereno ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Correlation Analysis ◽  
Hospital Stay ◽  
Clinical Improvement ◽  
Systemic Inflammation ◽  
Severe Pneumonia ◽  
Hematological Indices ◽  
Hospital Outcome ◽  
The Mean ◽  
Immunity Index

Abstract Background Different indices have been devised that attempt to correlate the severity of the symptoms and predict mortality mainly in septic states and inflammation, with important results that validate their usefulness. In the present pandemic, to date, no indices have been used in severe cases of Covid- 19 that can predict the outcome. Result of the measurement of demographic and clinical variables Comparative analysis of the variables studied stratified by hospital outcome Methods It includes a cohort of patients with pneumonia confirmed by Sars Cov 2 PCR-RT, treated at the Veracruz Norte branch of the Instituto Mexicano del Seguro Social from April to May 2020, analyzing the neutrophil-lymphocyte, platelet-lymphocyte and immunity-systemic inflammation indices. Correlation analysis of severity hematological variables with hospital outcome Results We included 100 patients, 54 (54%) women and 46 (46%) men, with a mean age of 49.4 ± 19.3 years. The mean of leukocytes was 10,103.0 ± 4,289.0 cel / mm3, neutrophils 8,509.3 ± 4,216.0 cel / mm3 and lymphocytes of 1,112.7 ± 585.4 cel / mm3; Regarding the hematological indices used to measure severity, we found that the mean of the INL was 10.7 ± 10.9, that of the IPL was 290.1 ± 229.2 and that of the IIIS was 2.6 ± 3.4 x 109. Regarding the type of pneumonia, 54 (54%) had mild pneumonia and 46 (46%) had severe pneumonia. Regarding hospital outcomes, 75 (75%) of the patients were discharged due to clinical improvement and 25 (25%) of the patients died during the hospital stay. The mean age was significantly higher in the group of patients who died during the hospital stay (45.9 ± 18.6 VS 60.0 ± 17.5 years, p = 0.001), the proportion of women who died was higher and tended to be statistically significant. The mean INL was 20.4 ± 16.9 in patients who died VS 7.5 ± 4.9 in patients who improved (p = 0.001). The mean IPL was 417.1 ± 379.7 in patients who died VS 247.7 ± 127.4 in patients who had improvement; p = 0.038. Finally, the mean IIIS was significantly higher in patients who died VS patients who had clinical improvement (4.8 ± 6.1 VS 1.9 ± 1.2; p = 0.030, respectively). In the correlation analysis, high and significant r were found in the three indices. Conclusion Neutrophil-lymphocyte, platelet-lymphocyte and systemic immunity-inflammation indices in patients with Covid-19 pneumonia can be used as predictors of severity and predict hospital outcome. Disclosures All Authors: No reported disclosures

Pneumomediastinum in the Injured Patient: Inconsequential or Predictive?

2009 ◽  
Vol 75 (5) ◽  
pp. 375-377 ◽  
Author(s):  
Jana B. A. Macleod ◽  
Brian M. Tibbs ◽  
Doug J. Freiberger ◽  
Grace S. Rozycki ◽  
Fran Lewis ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Injured Patient ◽  
Radiology Reports ◽  
Thoracic Ct ◽  
Thoracic Computed Tomography ◽  
Free Air ◽  
Significant Pathology ◽  
The Mean ◽  
Clinically Significant ◽  
Injured Patients

Free air in the peritoneum is a portent of significant pathology in the patient with abdominal trauma. The finding of a pneumomediastinum (PM) on a thoracic computed tomography scan (CT) of a trauma patient is, however, not clinically well-defined. The objectives of this study were to evaluate the incidence, pattern, and outcome of CT-diagnosed PM in a cohort of injured patients. The trauma registry and radiology reports were reviewed retrospectively for all injured patients admitted over an 8-year period to determine the incidence of PM. Medical and radiological records of patients with a PM on thoracic CT were then reviewed to determine the pattern and outcome of the injuries. There were 1364 thoracic CTs performed in the study-period. The prevalence of PM was 5.2 per cent (71/1364). For the cohort of patients with a PM, the mean age was 34.8 years, and 14.7 per cent (10/68) had penetrating injuries. Of these 68 patients, 10.3 per cent (7/68) presented with nine clinically significant injuries to the esophagus, trachea, larynx, or bronchus. These injuries were suspected clinically by an associated open wound or significant symptoms, and only 5.8 per cent of (4/68) patients required surgical repair. The remaining 89.7 per cent (61/68) of patients with a PM did not develop any sequelae nor require further directed treatment. A finding of a pneumomediastinum on a thoracic CT in injured patients is rare and clinically nonspecific. Pneumomediastinum alone does not seem to be predictive of severe injury and warrants detailed investigation only when clinical symptoms are present.

Assessment of the Results of Surgical Treatment of Zenker’S Diverticulum in Own Material

2015 ◽  
Vol 87 (3) ◽  
Author(s):  
Adam Bobkiewicz ◽  
Tomasz Banasiewicz ◽  
Łukasz Krokowicz ◽  
Andrzej Dryjas ◽  
Mateusz Wykrętowicz ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Hospital Stay ◽  
Clinical Symptoms ◽  
Perioperative Complications ◽  
Operating Time ◽  
Oral Intake ◽  
Length Of Hospital Stay ◽  
Endoscopic Techniques ◽  
Zenker Diverticulum ◽  
The Mean

AbstractZenker diverticulum (ZD) is the most common type of diverticula of the esophagus. Most often refers to men with a peak incidence in the seventh and eighth decade of life. In the majority diverticula remains asymptomatic and in patients with symptomatic course of the disease symptoms are often nonspecific.Aim of the study was to present the authors’ own experience in surgical treatment of Zenker diverticulum.Material and methods. In this paper we present an analysis of 31 patients with confirmed ZD treated surgically at the Clinic in 2004-2014. Patients were analyzed in terms of age, gender, clinical symptoms, diverticulum size, type of surgery, the time to return to the oral intake, hospital stay and perioperative complications.Results. 22 men and 9 women were enrolled it this study. The mean age of the patients was 64.8 (SD, 10.7; in the range of 28 to 82 years). 29 patients (93.5%) underwent resection of the diverticulum, while diverticulopexy was performed in two patients. In 25 (80.6%) cases stapler device was used, while in 4 (12.9%) resection was performed manually. The average size of resected diverticulum was 4.9 cm (SD, 1.5). Following the surgery in four patients (12.9%) complications were present. The average operating time was 118.7 minutes (SD, 42.2, in the range of 50 to 240 minutes). The mean length of hospital stay was 9.3 (SD, 3.3).Conclusions. Surgical treatment of ZD is associated with high effectiveness and low recurrence rate. Despite the advantages of endoscopic techniques, surgical treatment is characterized by one- stage procedure. The use of mechanical suture (stapler) significantly improves the operation, although on the basis of our own analysis there was no superiority revealed over hand sewn. Unquestionable adventage of classical technique is the opportunity to histopathological evaluation of resected diverticulum what is impossible to achieve in endoscopic techniques.

Pilonidal Sinus: How to Choose Between Excision and Open Granulation Versus Excision and Primary Closure?

Swiss Surgery ◽  
2002 ◽  
Vol 8 (6) ◽  
pp. 255-258 ◽  
Author(s):  
Perruchoud ◽  
Vuilleumier ◽  
Givel
Keyword(s):  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Healing Time ◽  
Incision And Drainage ◽  
The Mean ◽  
Primary Healing

Aims: The purpose of this study was to evaluate excision and open granulation versus excision and primary closure as treatments for pilonidal sinus. Subjects and methods: We evaluated a group of 141 patients operated on for a pilonidal sinus between 1991 and 1995. Ninety patients were treated by excision and open granulation, 34 patients by excision and primary closure and 17 patients by incision and drainage, as a unique treatment of an infected pilonidal sinus. Results: The first group, receiving treatment of excision and open granulation, experienced the following outcomes: average length of hospital stay, four days; average healing time; 72 days; average number of post-operative ambulatory visits, 40; average off-work delay, 38 days; and average follow-up time, 43 months. There were five recurrences (6%) in this group during the follow-up period. For the second group treated by excision and primary closure, the corresponding outcome measurements were as follows: average length of hospital stay, four days; average healing time, 23 days; primary healing failure rate, 9%; average number of post-operative ambulatory visits, 6; average off-work delay, 21 days. The average follow-up time was 34 months, and two recurrences (6%) were observed during the follow-up period. In the third group, seventeen patients benefited from an incision and drainage as unique treatment. The mean follow-up was 37 months. Five recurrences (29%) were noticed, requiring a new operation in all the cases. Discussion and conclusion: This series of 141 patients is too limited to permit final conclusions to be drawn concerning significant advantages of one form of treatment compared to the other. Nevertheless, primary closure offers the advantages of quicker healing time, fewer post-operative visits and shorter time off work. When a primary closure can be carried out, it should be routinely considered for socio-economical and comfort reasons.

Immunologic Assessment of Patients Treated with Bovine Fibrin as a Hemostatic Agent

1996 ◽  
Vol 76 (06) ◽  
pp. 0925-0931 ◽  
Author(s):  
John F Carroll ◽  
Keith A Moskowitz ◽  
Niloo M Edwards ◽  
Thomas J Hickey ◽  
Eric A Rose ◽  
...  
Keyword(s):  
Coagulation Factors ◽  
Allergic Reactions ◽  
Factor V ◽  
Normal Range ◽  
Serum Samples ◽  
Human Fibrinogen ◽  
Bovine Thrombin ◽  
Thrombotic Complications ◽  
The Mean ◽  
Clinically Significant

SummaryTwenty-one cardiothoracic surgical patients have been treated with fibrin as a topical hemostatic/sealing agent, prepared from bovine fibrinogen clotted with bovine thrombin. Serum samples have been collected before treatment with fibrin and postoperatively between 1 and 9 days, 3 and 12 weeks, and 6 and 8 months. The titers of anti-bovine fibrinogen antibodies, measured by ELISA specific for immunoglobulins IgG or IgM, increased to maximal values after about 8 or 6 weeks, respectively. After 8 months, IgG titers were on average 20-fold lower than the mean maximal value, while IgM titers returned to the normal range. IgG was the predominant anti-bovine fibrinogen immunoglobulin as documented by ELISA, affinity chromatography and electrophoresis. Anti-bovine fibrinogen antibodies present in patients reacted readily with bovine fibrinogen, but did not cross-react with human fibrinogen as measured by ELISA or by immunoelectrophoresis. A significant amount of antibodies against bovine thrombin and factor V has been found, many cross-reacting with the human counterparts. No hemorrhagic or thrombotic complications, or clinically significant allergic reactions, occurred in any patient, in spite of antibody presence against some bovine and human coagulation factors. The treatment of patients with bovine fibrin, without induction of immunologic response against human fibrinogen, appeared to be an effective topical hemostatic/sealing measure.

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