Pneumonia is the most common reason for hospitalization

2008 ◽  
Keyword(s):  
Common Reason

Ground-Based Medical Services for In-Flight Emergencies

2020 ◽  
Vol 91 (4) ◽  
pp. 348-351
Author(s):  
Jung Ha Kim ◽  
Smi Choi-Kwon
Keyword(s):  
Common Reason ◽  
Medical Services ◽  
Prescription Medications ◽  
Team Leaders ◽  
Cabin Crew ◽  
Medication Prescription ◽  
South Korean ◽  
Cardiac Symptoms ◽  
Actual Use ◽  
Specific Symptoms

BACKGROUND: The aim of this study was to evaluate the use of ground-based medical services (GBMS) by the cabin crew of a major South Korean airline for in-flight medical incidents involving passengers.METHODS: We conducted a survey of cabin crew to identify the anticipated use of GBMS in 2017. We compared the anticipated use to actual use as reported in cabin crew records submitted to the GBMS team and cabin crew logs from May 2013 to April 2016.RESULTS: Among 766 team leaders and assistant leaders, 211 individuals answered the questionnaire. A total of 915 instances of GBMS use were reported during the study period. There were no significant differences between anticipated and actual use in terms of the reasons for needing GBMS, with medication prescription being the most common reason. However, there were significant differences in the specific symptoms that triggered contact with GBMS. Pediatric and digestive symptoms were under-predicted, while neuropsychiatric and cardiac symptoms were over-predicted.DISCUSSION: Cabin crew tended to require GBMS to assist with pediatric and digestive conditions more often than anticipated. Furthermore, digestive and pediatric symptoms often require prescription medications.Kim JH, Choi-Kwon S. Ground-based medical services for in-flight emergencies. Aerosp Med Hum Perform. 2020; 91(4):348–351.

389 General Surgery Operative Cancellations Within Aberdeen Royal Infirmary 2019

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S McIntosh ◽  
R Jardine ◽  
M Ghazanfar
Keyword(s):  
Median Time ◽  
General Surgery ◽  
Retrospective Review ◽  
Common Reason ◽  
Patient Treatment ◽  
Royal Infirmary ◽  
Emergency Operations ◽  
Elective Operation ◽  
Theatre Management ◽  
Aberdeen Royal Infirmary

Abstract Introduction Operative cancellation rates can be up to 17.6%, resulting in delays to patient treatment and management. This audit was conducted to assess underlying reasons for operative cancellations with the aim to minimise cancellations in the future. Method A retrospective review of General surgery operative cancellations during 2019 at Aberdeen Royal Infirmary was undertaken. Data was obtained from Theatre Management. Results 28548 operations were performed across all surgical specialities during 2019 with 2664 operations cancelled. Within General Surgery, 447 were cancelled (182 emergency (40.7%), 265 electives (59.3%)). The most common reason was lack of theatre time for elective cases and procedure no longer needed for emergency cases. For cancelled elective surgeries, there was a median time of 29 days before being operated. Conclusions We highlight that both elective and emergency operations are susceptible to cancellation. There are clear differences in the reason of cancellation between elective and emergency. Going forward, it is worth discussing booking emergency operations with the on-call consultant to ensure they are necessary. Regarding elective operation cancellations due to lack of theatre time it would be imperative to assess the exact cause of this as to minimise operative cancellations. We plan re-audit once a departmental discussion has been made.

Utilization of P16 in Head and Neck Cytology and Surgical Specimens After the Release of CAP Guidelines

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S22-S22
Author(s):  
H Laharwani ◽  
V Manucha ◽  
G Jefferson ◽  
L Jackson
Keyword(s):  
Head And Neck ◽  
Squamous Cell ◽  
Squamous Cell Carcinomas ◽  
Common Reason ◽  
Unknown Primary ◽  
Hpv Testing ◽  
Neck Masses ◽  
P16 Immunohistochemistry ◽  
Hpv Status ◽  
Wrong Site

Abstract Introduction/Objective HPV-positive oropharyngeal squamous cell carcinoma is biologically and clinically unique and has a survival advantage over other head and neck squamous cell carcinomas. In December 2017 College of American Pathologist published guidelines for testing HPV status in head and neck cancer. It was recommended that pathologists perform HR-HPV testing on head and neck squamous cell carcinomas from all patients with known oropharyngeal SCC not previously tested for HR-HPV, with suspected oropharyngeal SCC, or with metastatic SCC of unknown primary. The aim of this study was to determine the compliance of pathologists following the CAP guidelines. Methods Cases that underwent HPV testing using p16 immunohistochemistry for the years 2017 and 2019 were retrieved. Based on the guidelines, p16 testing was designated as “indicated” or “not indicated”. Results There were 196 cases in which p16 testing was performed in a period of 3 consecutive years. Of these, 175 were FNA/ biopsies and 21 were surgical resections. In 69 cases (56 FNAs and 13 biopsies) the biopsy was performed on neck masses with unknown primary. The compliance for p16 testing in OPC and Lymph nodes with metastatic SCC of unknown primary was 100%. In 34 (17.3%) cases p16 testing was not indicated, the most common reason being wrong site (85%) including the larynx, oral tongue, the floor of the mouth, buccal mucosa, and nasal mass. Of the unindicated p16s, 20 (58%) were received in consultation for continuity of care. Conclusion Not being clear about the site of the tumor is the most common reason for unindicated p16 testing. A clear designation of biopsy site and proper communication between pathologist and surgeon can improve utilization of p16 testing in head and neck carcinomas.

scholarly journals 114. Implementation of an Empiric Organism Specific Guidelines for Gram-negative Bacteremia in conjunction with Rapid Diagnostic Testing

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S71-S71
Author(s):  
Fidelia Bernice ◽  
Edina Avdic ◽  
Kathryn Dzintars ◽  
Aliyah Cruz
Keyword(s):  
Clinical Status ◽  
Compliance Rate ◽  
Diagnostic Testing ◽  
Specific Treatment ◽  
Resistance Mechanisms ◽  
Primary Objective ◽  
Blood Cultures ◽  
Common Reason ◽  
Empiric Antibiotic Therapy ◽  
Gram Negative

Abstract Background The objective of this study was to confirm the validity of institution specific treatment recommendations targeting organisms identified by GenMark Dx® ePlex® blood cultures identification (BCID) Gram-negative panel prior to susceptibility results. Methods We developed and implemented institution specific guidelines for empiric antibiotic therapy for Gram-negative organisms targeted by GenMark Dx® ePlex® BCID. We utilized blood culture antibiograms, existing evidence for the most optimal agent for each pathogen, probable resistance mechanisms and patient clinical status to create these guidelines. From December 16, 2019 through May 31, 2020, infectious diseases pharmacists reviewed all positive blood cultures; assessed compliance with guidelines and intervened as needed. The primary objective was to determine how frequently guideline recommend agents would be ineffective against targeted pathogens based on susceptibilities. Secondary objectives were compliance with guidelines and frequency of therapy escalation or de-escalation. Results GenMark® testing was completed on 222 cultures positive for Gram-negative rods with target organisms identification in 195 (88%) blood cultures. Two hundred and five organisms were identified; most commonly E. coli (40%) and K. pneumoniae (21%).Resistance markers were detected in 30 aerobic blood cultures; 28 CTX-M, and 2 KPC. Our institutional guideline provided appropriate empiric coverage in 93% of bacteremia episodes. The most common reason for ineffective therapy was the presence of resistance mechanisms not detected by GenMark® test (e.g. non-CTX-M extended spectrum beta-lactamases). The compliance rate with the guidelines was 55%; the most common reason for non-compliance was the use of an anti-pseudmonal beta-lactams in neutropenic patients.. The system failed to identify panel organisms in only 5 (2%) of blood cultures. Conclusion The institution-specific guidelines providing empiric coverage for each organism identified by rapid diagnostic tests can aid antimicrobial stewardship efforts to de-escalate therapy while still providing effective coverage in >90% of cases. Disclosures All Authors: No reported disclosures.

scholarly journals The Reported Use of Tongue-Ties and Nosebands in Thoroughbred and Standardbred Horse Racing—A Pilot Study

Animals ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 622
Author(s):  
Dominic Weller ◽  
Samantha Franklin ◽  
Peter White ◽  
Glenn Shea ◽  
Kate Fenner ◽  
...  
Keyword(s):  
Risk Factor ◽  
Pilot Study ◽  
Airway Obstruction ◽  
Positive Association ◽  
Common Reason ◽  
Horse Racing ◽  
Equal Importance ◽  
Potential Risks ◽  
Equine Industry ◽  
Insight Into

This article reports on the results of a survey of racehorse trainers (n = 112) outlining the reasons for tongue-tie (TT) and noseband (NB) use by Thoroughbred trainers (TBTs) (n = 72) and Standardbred trainers (SBTs) (n = 40). The study also investigated the reported effectiveness of TTs and possible complications arising from their use. Tongue-tie use was reported by 62.5% (n = 70) of racehorse trainers. The reasons for TT use varied between TBTs and SBTs. For TBTs, the most common reason for TT use was to prevent or reduce airway obstruction (72.3%, n = 34), followed closely by to prevent or reduce airway noise (55.3%, n = 16). Standardbred trainers assigned equal importance for TT use [to prevent or reduce airway obstruction (69.6%, n = 16) and to prevent the horse from moving its tongue over the bit (69.6%, n = 16)]. Tongue-ties were considered significantly less effective at improving performance than at reducing airway obstruction and preventing the tongue from moving over the bit (t = −2.700, p = 0.0007). For respondents who used both TTs and NBs, there was a mild to moderate positive association between the reasons for using TTs and NBs. Of the 70 TT-using respondents, 51.4% (n = 36) recorded having encountered either a physical or behavioural complication due to TT use, with redness/bruising of the tongue (20.0%, n = 14) being the most common physical complication reported. Duration of use influenced the risk of observing complications. The likelihood of a respondent reporting a behavioural complication due to TT use increased with every minute of reported application and a nine-minute increment in application period doubled the odds of a respondent reporting a complication. Tightness was a risk factor for physical complications: Checking TT tightness by noting the tongue as not moving was associated with increased reporting of physical complications (OR = 6.59; CI 1.1–67.5). This pilot study provides some insight into how and why TTs are applied by some racehorse trainers, and the potential risks associated with their use. A further study of a larger cohort is recommended because these results are valid for only the 112 trainers who responded and cannot be generalized to the equine industry.

Foundation trainees and changes in career intentions

2017 ◽  
Vol 26 (1) ◽  
pp. 98-101
Author(s):  
Adam B Joiner ◽  
Shamsa Mahmood ◽  
Samuel P Dearman ◽  
Sarah Maddicott
Keyword(s):  
Medical School ◽  
Positive Attitude ◽  
Good Practice ◽  
School Experience ◽  
Common Reason ◽  
Career Intentions ◽  
Positive Intention ◽  
Foundation Programme ◽  
Experiential Design

Objectives: To understand whether foundation trainees change their career intentions during psychiatry placements and explore what factors influence such changes. Methods: Over a two-year period, foundation trainees completed questionnaires at the beginning, middle and end of their four-month placement. There were two questions, the first as to how likely they were to pursue a career in psychiatry and the second openly asked them to elaborate on their reasons. Results: Twenty-one out of 41 eligible trainees returned all three questionnaires. The number of trainees ‘highly likely’ to choose psychiatry increased over the four-month period, from 4.5% to 19%. The number of trainees ‘highly unlikely’ to choose psychiatry decreased, from 27.3% to 9.5%. An increasingly positive intention towards a psychiatry career appeared to relate to enjoyment of the placement and the quality of supervision. The most common reason for not choosing psychiatry was a pre-existing interest in another specialty. Conclusions: Undertaking a psychiatry placement during the foundation programme continues to increase the likelihood of a positive attitude towards psychiatry as a career. The findings of our study suggest good practice in providing foundation placements in psychiatry includes identifying medical school experience, enjoyment, quality weekly supervision and mindful experiential design of placements.

Children in Self-Care: A New Priority for Pediatricians

PEDIATRICS ◽  
1986 ◽  
Vol 77 (4) ◽  
pp. 548-549
Author(s):  
PATRICIA FOSARELLI
Keyword(s):  
Preschool Children ◽  
Extended Family ◽  
Self Care ◽  
Divorce Rate ◽  
Common Reason ◽  
After School ◽  
Alternative Care ◽  
School Aged Children ◽  
Common Time ◽  
World Report

Everyday in this country, approximately 2 to 5 million 6- to 13-year-old children are in their own care1,2 (US News and World Report, Sept 14, 1981, pp 42, 47). In addition, at least 20,000 children younger than 6 years care for themselves.1 These figures are estimates because many parents do not like to admit to the practice of leaving their children alone. The most common time children are in selfcare is after school, and the most common reason is because their parents work and alternative care arrangements might be unavailable or unaffordable. Currently, 47% of mothers of preschool children and 64% of mothers of school-aged children work outside of the home.3 This situation, coupled with the increasing number of families headed by women, the staggering 50% divorce rate in this country, and the disappearance of the extended family, creates a situation in which certain children must care for themselves.

Isolated tibial insert exchange in revision total knee arthroplasty

2021 ◽  
Vol 103-B (6) ◽  
pp. 1103-1110
Author(s):  
Matthew W. Tetreault ◽  
Jeremy T. Hines ◽  
Daniel J. Berry ◽  
Mark W. Pagnano ◽  
Robert T. Trousdale ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Polyethylene Wear ◽  
Revision Total Knee Arthroplasty ◽  
Common Reason ◽  
Original Diagnosis ◽  
Tibial Insert ◽  
Total Knee ◽  
Component Loosening ◽  
Revision Tka

Aims This study aimed to determine outcomes of isolated tibial insert exchange (ITIE) during revision total knee arthroplasty (TKA). Methods From 1985 to 2016, 270 ITIEs were performed at one institution for instability (55%, n = 148), polyethylene wear (39%, n = 105), insert fracture/dissociation (5%, n = 14), or stiffness (1%, n = 3). Patients with component loosening, implant malposition, infection, and extensor mechanism problems were excluded. Results Survivorship free of any re-revision was 68% at ten years. For the indication of insert wear, survivorship free of any re-revision at ten years was 74%. Re-revisions were more frequent for index diagnoses other than wear (hazard ratio (HR) 1.9; p = 0.013), with ten-year survivorships of 69% for instability and 37% for insert fracture/dissociation. Following ITIE for wear, the most common reason for re-revision was aseptic loosening (33%, n = 7). For other indications, the most common reason for re-revision was recurrence of the original diagnosis. Mean Knee Society Scores improved from 54 (0 to 94) preoperatively to 77 (38 to 94) at ten years. Conclusion After ITIE, the risk and reasons for re-revision correlated with preoperative indications. The best results were for polyethylene wear. For other diagnoses, the re-revision rate was higher and the failure mode was most commonly recurrence of the original indication for the revision TKA. Cite this article: Bone Joint J 2021;103-B(6):1103–1110.

scholarly journals Knowledge attitude practice and acceptance of postpartum intrauterine devices among postpartal women in a tertiary care center

2017 ◽  
Vol 6 (4) ◽  
pp. 1507 ◽  
Author(s):  
Sumitra Yadav ◽  
Ruchi Joshi ◽  
Monica Solanki
Keyword(s):  
Family Planning ◽  
Retention Rate ◽  
Low Cost ◽  
Care Center ◽  
Tertiary Care ◽  
School Level ◽  
World Health ◽  
Common Reason ◽  
Eligibility Criteria ◽  
Expulsion Rate

Background: PPIUCDs are the only method for couples requesting a highly effective and reversible, yet long acting, family planning method that can be initiated during the immediate postpartum phase. World Health Organization (WHO) medical eligibility criteria state that it is generally safe for postpartum lactating women to use a PPIUCD, with the advantages outweighing the disadvantages. PPIUCDs are cost-effective and they are low-cost intervention that reduces maternal, infant, and under-five Child mortality.Methods: After approval from the ethical committee and consent from the patients, the study was performed on 1000 postpartum women within 10 min. of delivery and up to 6 weeks of delivery at Labour Room of, M.Y. Hospital, Indore.Results: Majority of acceptor (72.5%) belong to age group of 18-25 years and 53% belonged to urban area. Acceptance was more in those who completed their secondary school level education (33%). Working women (55.5%) accepted PPIUCD more than the non-working. Out of 1000 women counselled only 10% agreed for PPIUVD insertion. During the study of 1 year duration (3.5%) of non-acceptors become pregnant and none of the acceptors conceived. Most common reason stated for accepting PPIUCD among acceptors, was that it is a reversible method (66%). Most common reason for not accepting PPIUCD among non-acceptors, because they are interested in Other Method of Family Planning (60%).Conclusions: Verbal acceptance is more than actual insertion of PPIUCD because of adoption of other method of family planning, family pressure, nonacceptance by partner, lack of awareness, fear of complication. Proper counselling can help to generate awareness and compliance for PPIUCD use in postpartum mother who have institutional delivery. Inserting CuT 380A within 10 min after placental delivery is safe and effective, has high retention rate. The expulsion rate was not high, and further can be reduced with practice could not be predicted.

scholarly journals Infectious Disease Hospitalizations Among American Indian/Alaska Native and Non–American Indian/Alaska Native Persons in Alaska, 2010-2011

2016 ◽  
Vol 132 (1) ◽  
pp. 65-75 ◽  
Author(s):  
Prabhu P. Gounder ◽  
Robert C. Holman ◽  
Sara M. Seeman ◽  
Alice J. Rarig ◽  
Mary McEwen ◽  
...  
Keyword(s):  
Infectious Disease ◽  
American Indian ◽  
Alaska Native ◽  
Rate Ratio ◽  
Common Reason ◽  
Data Set ◽  
Discharge Data ◽  
Public Health Programs ◽  
Hospitalization Rates ◽  
Population Rate

Objective: Reports about infectious disease (ID) hospitalization rates among American Indian/Alaska Native (AI/AN) persons have been constrained by data limited to the tribal health care system and by comparisons with the general US population. We used a merged state database to determine ID hospitalization rates in Alaska. Methods: We combined 2010 and 2011 hospital discharge data from the Indian Health Service and the Alaska State Inpatient Database. We used the merged data set to calculate average annual age-adjusted and age-specific ID hospitalization rates for AI/AN and non-AI/AN persons in Alaska. We stratified the ID hospitalization rates by sex, age, and ID diagnosis. Results: ID diagnoses accounted for 19% (6501 of 34 160) of AI/AN hospitalizations, compared with 12% (7397 of 62 059) of non-AI/AN hospitalizations. The average annual age-adjusted hospitalization rate was >3 times higher for AI/AN persons (2697 per 100 000 population) than for non-AI/AN persons (730 per 100 000 population; rate ratio = 3.7, P < .001). Lower respiratory tract infection (LRTI), which occurred in 38% (2486 of 6501) of AI/AN persons, was the most common reason for ID hospitalization. AI/AN persons were significantly more likely than non-AI/AN persons to be hospitalized for LRTI (rate ratio = 5.2, P < .001). Conclusions: A substantial disparity in ID hospitalization rates exists between AI/AN and non-AI/AN persons, and the most common reason for ID hospitalization among AI/AN persons was LRTI. Public health programs and policies that address the risk factors for LRTI are likely to benefit AI/AN persons.

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