Causes of nasoenteral tube obstruction in tertiary hospital patients

2019 ◽  
Vol 74 (2) ◽  
pp. 261-267
Author(s):  
José L. A. Borges ◽  
Ivens A. O. De Souza ◽  
Michele C. V. Costa ◽  
Fabiana Ruotolo ◽  
Livia M. G. Barbosa ◽  
...  
Keyword(s):  
Tertiary Hospital ◽  
Tube Obstruction ◽  
Hospital Patients

CLINICAL FEATURES, INDICATIONS AND RESULT OF TRACHEOTOMY

2017 ◽  
pp. 50-55
Author(s):  
Duc Luu Ngo ◽  
Tu The Nguyen ◽  
Manh Hung Ho ◽  
Thanh Thai Le
Keyword(s):  
Clinical Features ◽  
University Hospital ◽  
Female Ratio ◽  
Tube Obstruction ◽  
Level Ii ◽  
Study Results ◽  
Male Female Ratio ◽  
Hospital Patients ◽  
Level I

Background: This study aims to survey some clinical features, indications and results of tracheotomy at Hue Central Hospital and Hue University Hospital. Patients and method: Studying on 77 patients who underwent tracheotomy at all of departments and designed as an prospective, descriptive and interventional study. Results: Male-female ratio was 4/1. Mean age was 49 years. Career: farmer 44.2%, worker 27.2%, officials 14.3%, student 7.8%, other jobs 6.5%. Respiratory condition before tracheotomy: underwent intubation 62.3%, didn’t undergo intubation 37.7%. Period of stay of endotracheal tube: 1-5 days 29.2%, 6-14 days 52.1%, >14 days 18.7%. Levels of dyspnea before tracheotomy: level I 41.4%, level II 48.3%, level III 0%, 10.3% of cases didn’t have dyspnea. Twenty cases (26%) were performed as an emergency while fifty seven (74%) as elective produces. Classic indications (37.7%) and modern indications (62.3%). On the bases of the site, we divided tracheostomy into three groups: high (0%), mid (25.3%) and low (74.7%). During follow-up, 44 complications occurred in 29 patients (37.7%). Tracheobronchitis 14.3%, tube obstruction 13%, subcutaneous empysema 10.4%, hemorrhage 5%, diffcult decannulation 5.2%, tube displacement 3.9%, canule watery past 2.6%, wound infection 1.3%. The final result after tracheotomy 3 months: there are 33 patients (42.9%) were successfully decannulated. In the 33 patients who were successfully decannulated: the duration of tracheotomy ranged from 1 day to 90 days, beautiful scar (51.5%), medium scar (36.4%), bad scar (12.1%). Conclusions: In tracheotomy male were more than female, adult were more than children. The main indication was morden indication. Tracheobronchitis and tube obstruction were more common than other complications. Key words: Tracheotomy

scholarly journals The nationwide retrospective cohort study by Health Insurance Review and Assessment Service proves that asthma management decreases the exacerbation risk of asthma

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nam-Eun Kim ◽  
Sanghun Lee ◽  
Bo Yeon Kim ◽  
Ae Gi Hwang ◽  
Ji Hyeon Shin ◽  
...  
Keyword(s):  
Health Insurance ◽  
South Korea ◽  
Asthma Management ◽  
Estimating Equation ◽  
Tertiary Hospital ◽  
Asthma Exacerbations ◽  
Hospital Patients ◽  
Insurance Claims Data ◽  
Health Insurance Claims Data ◽  
Exacerbation Risk

AbstractMedical costs have recently increased in South Korea due to the rising rate of asthma. Primary clinics serve an important role in asthma management, as they are the first stop for patients presenting with symptoms. The Health Insurance Review and Assessment Service (HIRA) in South Korea has assessed asthma-management quality since 2013, but studies are lacking on whether these assessments have been performed properly and contribute toward reducing asthma exacerbations. Therefore, we investigated whether the HIRA’s quality assessments have decreased asthma exacerbations using national health insurance claims data from 2013 to 2017 of 83,375 primary-clinic and 15,931 tertiary-hospital patients with asthma. These patients were classified into four groups based on disease severity according to the monthly prescribed amount of asthma medication using K-means clustering. The associations between HIRA assessments and asthma exacerbation were analyzed using a generalized estimating equation. Our results showed that exacerbation odds gradually decreased as the HIRA assessments progressed, especially in the mild-severity group, and that exacerbation risk among patients with asthma decreased in the order of assessment grades: “Unsatisfactory,” “Satisfactory,” and “Tertiary.” Therefore, we may conclude that asthma exacerbations may decrease with high quality asthma management; appropriate quality assessment could be helpful in reducing asthma exacerbations.

scholarly journals Analysis of genitourinary trauma patients admitted to the emergency department

2021 ◽  
Vol 15 (2) ◽  
pp. 32-37
Author(s):  
İrfan Aydın ◽  
Erdal Yavuz
Keyword(s):  
Emergency Department ◽  
Tertiary Hospital ◽  
Trauma Patients ◽  
Abdominal Organ ◽  
Survivor Group ◽  
Genitourinary Trauma ◽  
Accompanying Injuries ◽  
Hospital Patients ◽  
Time Of Admission

Background and objective: Genitourinary injuries are commonly encountered in the emergency department but may be over looked in case of multi-trauma. Determining the clinical features of genitourinary injuries will help physicians in the management of genitourinary trauma. Methods: The study was conducted in a tertiary hospital. Patients of all ages, admitted in the emergency department, with trauma between 2015 and 2020 were included and analyzed. The cause of genitourinary trauma, affected organs, any accompanying injury, treatments, mortality status, and laboratory tests related to mortality were obtained from the hospital records and analyzed. Results: During the study period, 87 patients admitted to the emergency department with genitourinary trauma were included in the study. The majority of these patients (n=79) were male. Of the patients, 9.2% died. All the patients in the mortality group had additional injuries. The most frequently injured organ was determined as the kidney (51.7%), followed by the scrotum (25.3%) and penis (8.1%). Additional injuries were observed in 81.6% of the patients. Intra-abdominal organ injuries (19.5%) were the most common accompanying injuries. White blood cell count (WBC), aspartate aminotransferase (AST), alanine aminotransferase ( ALT), blood glucose and creatinine values measured at the time of admission to the emergency department were found to be higher in the non-survivor group. The majority of the patients (81%) were discharged with conservative treatment and follow-up. Conclusion: It was determined that genitourinary injuries were frequently seen with additional injuries. Genitourinary injury should be evaluated carefully, especially in the presence of intra-abdominal organ injuries. Ibrahim Med. Coll. J. 2021; 15(2): 32-37

scholarly journals A retrospective observational study to estimate use of biomarkers to predict severity of community acquired pneumonia in children

2021 ◽  
Author(s):  
Anam Bashir ◽  
Raheel Khan ◽  
Stephanie Thompson ◽  
Manuel Caceres
Keyword(s):  
Area Under The Curve ◽  
Retrospective Chart Review ◽  
Tertiary Hospital ◽  
Community Acquired Pneumonia ◽  
Pneumonia Severity ◽  
Neutrophil Lymphocyte Ratio ◽  
Reactive Protein ◽  
Hospital Patients ◽  
Minimal Research

Purpose: Multiple studies have investigated the role of biomarkers in predicting pneumonia severity in adults but minimal research exists for children. The aim of this study was to determine if the following biomarkers: white blood cell count (WBC), platelet count, C-reactive protein (CRP), procalcitonin (PCT), neutrophil-lymphocyte ratio, neutrophil count, or band count predict community associated pneumonia (CAP) severity in children. Methods: A retrospective chart review was conducted on pediatric patients (aged 60 days to 18 years) diagnosed with CAP, admitted to a regional, tertiary hospital. Patients were stratified into two severity cohorts, mild (no ICU care), and moderate /severe (required ICU care). Biomarker values were then compared between the severity cohorts and area under the curve (AUC), cut-off values, performance characteristics were calculated. Results: A total of 108 patients met inclusion criteria. Among the biomarkers examined, elevated levels of CRP (51.7 mg/L in mild vs. 104.8 mg/L in moderate/severe, p = 0.003, PCT (0.29 ng/ml in mild vs. 4.02 ng/ml in moderate/severe, p = 0.001) and band counts (8% in mild vs. 15% moderate/severe, p = 0.009) were associated with increased pneumonia severity. In predicting moderate/severe CAP, PCT had the highest AUC of 0.77 (p = 0.001) followed by bands AUC of 0.69 (p = 0.009) and CRP AUC of 0.67 (p = 0.003). The cut-off for PCT of 0.55ng/ml had a sensitivity of 83% and a specificity of 65%. A cut-off level of 53.1 mg/L for CRP had a sensitivity of 79% and specificity of 52%. A cut off level of 12.5% bands had a sensitivity of 61% and specificity of 71%. Conclusion: Biomarkers, in particular PCT, obtained early in hospitalization appear to perform as predictors for CAP severity in children and may be beneficial in guiding CAP management

Incidence of Drug-induced Liver Injury Among Government Tertiary Hospital Patients on Anti-Koch’s Treatment

2015 ◽  
Vol 13 (7) ◽  
pp. e84
Author(s):  
M.A. Malbog ◽  
M.C. Naval ◽  
F.L. Domingo ◽  
M.V. Chu ◽  
L. Gatchalian ◽  
...  
Keyword(s):  
Liver Injury ◽  
Tertiary Hospital ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Hospital Patients

scholarly journals Relocation and transfer of patients to a new hospital: Practical lessons

2021 ◽  
Vol 10 (1) ◽  
pp. 23
Author(s):  
Ged Williams ◽  
Nawal A. Awad ◽  
Devin Roloff ◽  
Craig E. Daniels
Keyword(s):  
Tertiary Hospital ◽  
Lessons Learned ◽  
Major Disaster ◽  
Patient Resources ◽  
Hospital Patients ◽  
Medical City ◽  
Field Notes ◽  
Additional Support ◽  
General Care ◽  
New Facility

Objective: We describe the practical aspects of planning for and executing the safe movement of patients and care teams from an existing tertiary hospital (Mafraq Hospital) to a new hospital (Sheikh Shakhbout Medical City) in Abu Dhabi, United Arab Emirates.Methods: Field notes and measures taken during the planning and execution of this event were prospectively collated by the authors to inform the final manuscript.Results: A central command structure similar to that used for major disaster management helped to guide the move of all inpatients, staff and support services from one hospital to the other. Five patient tracks (clinical teams) were established to move patients to the new facility concurrently along set and separate routes. Five additional support tracks were established to provide logistical support for the movement of essential non-patient resources. A total of 142 acutely ill general care and critically ill hospital patients were moved during a five-hour period with zero patient harm events.Conclusions: The tools, processes used, and lessons learned in this exercise are shared in the hope that others who are required to move hospitals can learn from and use our experience.

scholarly journals Determination of Antimicrobial Resistance Patterns in Bloodstream Infections-Isolated Bacteria From a University Tertiary Hospital Patients

2019 ◽  
Vol 7 (2) ◽  
pp. 49-54
Author(s):  
Alka Hasani ◽  
Nasim Asadi Faezi ◽  
Mohammad Ahangarzadeh Rezaee ◽  
Elham Sheykhsaran ◽  
Narges Darabi ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Antimicrobial Agents ◽  
Bloodstream Infections ◽  
Tertiary Hospital ◽  
Resistance Rate ◽  
High Morbidity ◽  
Hospital Patients ◽  
Resistance Patterns ◽  
Susceptibility Patterns

Background: Bloodstream infections are considered a significant medical concern associated with high morbidity and mortality rates. Therefore, physicians should be guided to use antimicrobial susceptibility patterns in order to select appropriate empiric antimicrobial agents to treat the patients who suffer from bacteremia. Objective: The present study aimed to determine antimicrobial resistance and susceptibility patterns in isolates collected from bloodstream infections. Materials and Methods: To achieve this, a total of 710 bacterial blood culture isolates were collected from Sina hospital, and then susceptibility patterns to a number of antibiotics were analyzed according to Clinical and Laboratory Standards Institute guidelines. Results: The identified isolates included Staphylococcus aureus 14 (20.6%), Escherichia coli 14 (20.6%), Acinetobacter baumannii 12 (17.6%), Pseudomonas aeruginosa 11 (16.2%), Coagulasenegative Staphylococcus 8 (11.8%), Klebsiella pneumoniae 6 (8.8%), and Enterobacter spp. 3 (4.4%). The total resistance rate to co-trimoxazole, ceftriaxone, ceftazidime, cefotaxime, ofloxacin, gentamicin, ciprofloxacin, levofloxacin, amikacin, and imipenem was 44 (64.7%), 42 (61.8%), 39 (57.4%), 38 (55.9%), 35 (51.51%), 32 (47.1%), 31 (45.6%), 25 (36.8%), and 27 (39.7%), respectively. Finally, the susceptibility rate to amikacin and imipenem was 43 (63.2%) and 41 (60.3%), respectively. Conclusion: In general, A. baumannii strains isolated from blood cultures were resistant to most antibiotics and the greatest sensitivity was observed to gentamicin (58.3%) compared to other antibiotics. Therefore, gentamicin was found as the most effective antibiotic for treating bloodstream infections caused by A. baumannii.

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