scholarly journals 1498 A Ten-Year Observational Study of The Use of Two-Way Catheters Post-Transurethral Resection of The Prostate Without the Use of Post-Op Irrigation

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
L Kretzmer ◽  
A Damola ◽  
M Sandher ◽  
W Martin ◽  
S. Ali Ehsanullah ◽  
...  
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Primary Outcome ◽  
Average Duration ◽  
Bladder Irrigation ◽  
Post Operative Period ◽  
Operative Care ◽  
Nice Guidance ◽  
Secondary Outcomes ◽  
The Uk

Abstract Over 15,000 transurethral resections of the prostate (TURP) are performed yearly in the UK. It is therefore vital that peri-operative care is optimised. Our centre favours the use of two-way catheters post-operatively without continuous bladder irrigation (CBI). Aim To evaluate our practice of using two-way catheters without irrigation post-TURP and to determine impact on patient care compared to standard three-way catheterization. Our primary outcome was duration of admission, but multiple secondary outcomes were also analysed. Method This was a prospective observational study. Every patient undergoing TURP at our centre from 2009 to 2019 was included. Prospective patient data were collected pertaining to peri-operative factors. This data was then compared with data published in the NICE guidance pertaining to TURP. Results 687 patients underwent TURP at our centre between 2009-2019. The average age of patients was 71.42 (±7.89). 87.17% (n = 598) had two-way catheters placed post-operatively. Average duration of admission was 1.61 (±1.35) days. TWOC was successful in 93.74% (n = 644). Complication rate was 8.73% (n = 60), reduced in comparison to other units. Furthermore, when compared to other centres, our method reduced lengths of admission and transfusion rates (1.6 days vs. 3.1 days and 0.87% vs. 2.83% respectively). Conclusions Our method preserves patient safety and is associated with reduced length of admission. It also has cost-saving benefits and a reduced post-operative period of catheterisation. We recommend this practice to the wider urological community.

scholarly journals Meeting Calorie and Protein Needs in the Critical Care Unit: A Prospective Observational Pilot Study

2020 ◽  
Vol 13 ◽  
pp. 117863882090599
Author(s):  
Shinobu Yamamoto ◽  
Karen Allen ◽  
Kellie R Jones ◽  
Sarah S Cohen ◽  
Kemuel Reyes ◽  
...  
Keyword(s):  
Critically Ill ◽  
Prospective Observational Study ◽  
Primary Outcome ◽  
Medical Intensive Care Unit ◽  
Mechanical Ventilator ◽  
Macronutrient Composition ◽  
Gastrointestinal Intolerance ◽  
Medical Intensive Care ◽  
Secondary Outcomes ◽  
Enteral Formula

Background: Inadequate calorie and protein intake during critical illness is associated with poor clinical outcomes. Unfortunately, most critically ill patients do not consume adequate levels of these nutrients. An enteral formula with appropriate macronutrient composition may assist patients in meeting nutritional goals. Design: This study was a single center, prospective, observational study of 29 adults in the medical intensive care unit who required enteral nutrition for at least 3 days. Subjects received a calorically dense, enzymatically hydrolyzed 100% whey peptide-based enteral formula for up to 5 days to assess the ability to achieve 50% of caloric goals within the first 3 days (primary outcome), the daily percentage of protein goals attained and gastrointestinal tolerance (secondary outcomes). Result: A total of 29 subjects consented and began the study. Four subjects dropped out before first day and 25 subjects were included in analyses. Subjects were aged 55.5 ± 16.9 years with mean body mass index (BMI) of 27.9 ± 7.5 kg/m2. Most (92%) subjects were on a mechanical ventilator and experienced organ failure. At least 50% of caloric and protein goals were achieved in 78.9% and 73.7% of the subjects, respectively, during the first 3 days. Overall, 75.0 ± 26.3% and 69.3 ± 26.7% of calorie and protein goals were achieved using the study formula. Conclusions: Subjects fed enterally with a calorically dense, enzymatically hydrolyzed 100% whey peptide-based enteral formula exceeded 50% of caloric and protein goals in most critically ill subjects included in this study. Use of study formula did not lead to severe gastrointestinal intolerance.

scholarly journals Safe Elective Surgical Practice During COVID-19 Pandemic – A Prospective Observational Study of 303 Elective Surgeries in the UK

Cureus ◽  
2021 ◽  
Author(s):  
Chiranjit De ◽  
Saumil Shah ◽  
Kusy Suleiman ◽  
Zehong Chen ◽  
Vishal Paringe ◽  
...  
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Surgical Practice ◽  
The Uk

scholarly journals Association between potentially inappropriate medications at discharge and unplanned readmissions among hospitalised elderly patients at a single centre in Japan: a prospective observational study

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e032574 ◽  
Author(s):  
Junpei Komagamine ◽  
Taku Yabuki ◽  
Masaki Kobayashi
Keyword(s):  
Observational Study ◽  
Elderly Patients ◽  
Prospective Observational Study ◽  
Primary Outcome ◽  
Secondary Outcome ◽  
Unplanned Readmission ◽  
Potentially Inappropriate Medications ◽  
Patient Age ◽  
Patient Âgé ◽  
Increased Risk

ObjectiveTo determine the prevalence of potentially inappropriate medication (PIM) use at admission and discharge among hospitalised elderly patients and evaluate the association between PIMs at discharge and unplanned readmission in Japan.DesignA prospective observational study conducted by using electronic medical records.ParticipantsAll consecutive patients aged 65 years or older who were admitted to the internal medicine ward were included. Patients who were electively admitted for diagnostic procedures were excluded.Main outcome measuresThe primary outcome was 30-day unplanned readmissions. The secondary outcome was the prevalence of any PIM use at admission and discharge. PIMs were defined based on the Beers Criteria. The association between any PIM use at discharge and the primary outcome was evaluated by using logistic regression.ResultsSeven hundred thirty-nine eligible patients were included in this study. The median patient age was 82 years (IQR 74–88); 389 (52.6%) were women, and the median Charlson Comorbidity Index was 2 (IQR 0–3). The proportions of patients taking any PIMs at admission and discharge were 47.2% and 32.2%, respectively. Of all the patients, 39 (5.3%) were readmitted within 30 days after discharge for the index hospitalisation. The use of PIMs at discharge was not associated with an increased risk of 30-day readmission (OR 0.93; 95% CI 0.46 to 1.87). This result did not change after adjusting for patient age, sex, number of medications, duration of hospital stay and comorbidities (OR 0.78; 95% CI 0.36 to 1.66).ConclusionThe prevalence of any PIM use at discharge was high among hospitalised elderly patients in a Japanese hospital. Although the use of PIMs at discharge was not associated with an increased risk of unplanned readmission, given a lack of power of this study due to a low event rate, further studies investigating this association are needed.Trial registration numberUMIN000027189.

scholarly journals Comparison of Effects of Propofol and Sevoflurane Used in Maintenance of General Anaesthesia on Post-Operative Nausea and Vomiting - A Prospective Observational Study

2021 ◽  
Vol 10 (20) ◽  
pp. 1515-1518
Author(s):  
Siri Kandavar ◽  
Sampathila Padmanabha
Keyword(s):  
Observational Study ◽  
General Anaesthesia ◽  
Prospective Observational Study ◽  
Nausea And Vomiting ◽  
P Value ◽  
Sevoflurane Group ◽  
Anaesthetic Agents ◽  
Operative Care ◽  
The Difference ◽  
Post Operative Nausea

BACKGROUND Post-operative nausea and vomiting is a complication of general anaesthesia but can also be seen less commonly in regional anaesthesia. The uneasiness and discomfort associated with it can make the post-operative period eventful. We conducted this study to evaluate if sevoflurane and propofol used in maintenance of anaesthesia have any influence on post-operative nausea and vomiting. METHODS We included 64 patients in this prospective observational study who were undergoing elective otorhinolaryngology surgery belonging to American Society of Anaesthesiologist (ASA) PS I and II. After induction of general anaesthesia and endotracheal intubation, Group P received propofol at 100 - 200 mcg / kg / hr and group S received sevoflurane as maintenance anaesthetics agent at 1.5 - 2 %. All the patients were given ondansetron intravenously in the intra-operative period. Anaesthetic agents used for maintenance was stopped at the end of the surgery and patients were extubated and shifted to post-operative care unit. Patients were assessed for any occurrence of post-operative nausea and vomiting after extubation for 24 hours. RESULTS There were 2 (6.25 %) patients in the propofol group and 12 (37.5 %) patients in the sevoflurane group who had post-operative nausea and vomiting in the first hour. The difference in the nausea and vomiting between the groups was statistically significant with (P value of 0.0046) higher incidence in sevoflurane group. All the patients who had nausea and vomiting were treated with dexamethasone. When the patients were reassessed after four hours, five patients had nausea in sevoflurane group after four hours, which was treated with metoclopramide or Ondansetron. After six hours, none of the patients had nausea or vomiting. CONCLUSIONS The incidence of post-operative nausea and vomiting was lesser in the propofol group compared to sevoflurane group. KEY WORDS Post-Operative Nausea and Vomiting, Propofol, Sevoflurane, General Anaesthesia

scholarly journals Post A-H Pyeloplasty Analysis of Renal Function in Unilateral Hydronephrosis Due to Congenital Pelviureteric Junction Obstruction

2014 ◽  
Vol 2 (2) ◽  
pp. 53-55
Author(s):  
Nandan Kumar Majumder ◽  
Md. Ruhul Amin ◽  
Rajib Khastgir ◽  
Mizanur Rahman ◽  
Md. Abu Bakar Akan
Keyword(s):  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Observational Study ◽  
Filtration Rate ◽  
Prospective Observational Study ◽  
Functional Improvement ◽  
Paediatric Surgery ◽  
Gradual Improvement ◽  
Post Operative Period ◽  
Unilateral Hydronephrosis

Background: The objective of this study was to analyze the functional improvement of renal function in terms of split renal function (SRF) & glomerular filtration rate (GFR) by DTPA renogram in early post operative period who underwent A-H pyeloplasty for unilateral hydronephrosis due to congenital pelvi ureteric junction obstruction.Methods: A prospective observational study was conducted to see the post operative renal function improvement in patient with unilateral hydronephrosis due to congenital pelvi ureteric junction obstruction in department of paediatric surgery, BSMMU from July 2007 to October 2008. All the patients were followed up at 4 weeks interval for 12 weeks.Results: Total 13 Patients both male & female were observed with age ranging from 03 months to 15 years. Out of 13, eleven patients showed gradual improvement of renal function in terms of SRF & GFR in three successive DTPA renogram done at 4, 8 & 12 weeks post operatively but two patients showed deterioration of renal function in 1st two renogram but improved at 12th weeks period.Conclusion: DTPA renogram is the best method to see the functional improvement of renal function after A-H pyeloplasty but should be done on 12th post operative day.DOI: http://dx.doi.org/10.3329/jpsb.v2i2.19543

scholarly journals A study of monitoring of early postoperative serum calcium levels in total thyroidectomy and its role in predicting temporary or permanent hypocalcemia: a prospective observational study

2020 ◽  
Vol 7 (3) ◽  
pp. 697
Author(s):  
Suryanarayana Reddy V. ◽  
Ashrith Reddy Cheruku ◽  
Rammohan Cheeti ◽  
Vivek Acha ◽  
Prashanth Gunde
Keyword(s):  
Observational Study ◽  
Total Thyroidectomy ◽  
Serum Calcium ◽  
Prospective Observational Study ◽  
Post Operative Period ◽  
Permanent Hypocalcemia ◽  
Postoperative Serum ◽  
The Mean ◽  
Postoperative Hypocalcaemia

Background: This aim of study was to evaluate the ability of consecutive measurements of serum calcium levels to predict clinically relevant post-thyroidectomy hypocalcaemia and to assess risk factors for post-thyroidectomy hypocalcaemia.Methods: The study design was a prospective observational study, total 65 patients who undergoing completion or total thyroidectomy. Serum calcium level was measured at the time of first follow up (nearly 20th postoperative day) and patient was examined for signs of hypocalcemia.Results: In this study, 65 patients of all age group included from 19 years to 78 years. The mean (±SD) age of the patients was 47.65±12.35 years with range from 19 to 78 years. The mean difference of calcium values after 6 hours, 12 hours, 24 hours and 48 hours post-operative period were statistically significant (p<0.001) between patients with hypocalcaemia and patient with normokalaemia in unpaired t-test.Conclusions: There was no significant increase in morbidity (including postoperative hypocalcaemia) in completion thyroidectomy compared to primary total thyroidectomy.

scholarly journals Higher clinical acuity and 7-day hospital mortality in non-COVID-19 acute medical admissions: prospective observational study

2021 ◽  
Vol 38 (5) ◽  
pp. 366-370
Author(s):  
Marcus J Lyall ◽  
Nazir I Lone
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Kidney Injury ◽  
Severity Of Illness ◽  
Hospital Death ◽  
Hospital Inpatient ◽  
Day Hospital ◽  
Inpatient Mortality ◽  
Increased Risk ◽  
The Uk

ObjectivesTo understand the effect of COVID-19 lockdown measures on severity of illness and mortality in non-COVID-19 acute medical admissions.DesignA prospective observational study.Setting3 large acute medical receiving units in NHS Lothian, Scotland.ParticipantsNon-COVID-19 acute admissions (n=1682) were examined over the first 31 days after the implementation of the COVID-19 lockdown policy in the UK on 23 March 2019. Patients admitted over a matched interval in the previous 5 years were used as a comparator cohort (n=14 954).Main outcome measuresPatient demography, biochemical markers of clinical acuity and 7-day hospital inpatient mortality.ResultsNon-COVID-19 acute medical admissions reduced by 44.9% across all three sites in comparison with the mean of the preceding 5 years (p<0.001). Patients arriving during this period were more likely to be male, of younger age and to arrive by emergency ambulance transport. Non-COVID-19 admissions during lockdown had a greater incidence of acute kidney injury, lactic acidaemia and an increased risk of hospital death within 7 days (4.2% vs 2.5%), which persisted after adjustment for confounders (OR 1.87, 95% CI 1.43 to 2.41, p<0.001).ConclusionsThese data demonstrate a significant reduction in non-COVID-19 acute medical admissions during the early weeks of lockdown. Patients admitted during this period were of higher clinical acuity with a higher incidence of early inpatient mortality.

scholarly journals What Are the Trends in Tonsillectomy Techniques in Wales? A Prospective Observational Study of 19,195 Tonsillectomies over a 10-Year Period

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Hussein Walijee ◽  
Ali Al-Hussaini ◽  
Andrew Harris ◽  
David Owens
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Surgical Instrument ◽  
Bipolar Diathermy ◽  
Intraoperative Bleeding ◽  
Surveillance Programme ◽  
National Guidance ◽  
Secondary Haemorrhage ◽  
The Uk ◽  
Cold Steel Dissection

There are a multitude of techniques to undertake tonsillectomy, with hot techniques such as diathermy and coblation being associated with a higher risk of secondary haemorrhage. The UK National Prospective Tonsillectomy Audit (2004) advocated cold steel dissection and ties to be the gold standard. This prospective observational study investigates the trends in tonsillectomy techniques across Wales in the last decade to establish if surgeons have adhered to this national guidance. Data relating to tonsillectomy were extracted over a 10-year period from 1 January 2003 to 31 December 2012 from the Wales Surgical Instrument Surveillance Programme database. A total of 19,195 patients were included. Time-series analysis using linear regression showed there was an increase in the number of bipolar diathermy tonsillectomies by 84% (Pearson’sr=0.762,p=0.010) and coblation tonsillectomies by 120% (r=0.825,p=0.003). In contrast, there was a fall in the number of cold steel dissection tonsillectomies with ties by 60% (r=-0.939,p<0.001). This observational study suggests that the use of bipolar and coblation techniques for tonsillectomy has increased. This deviation from national guidance may be due to these techniques being faster with less intraoperative bleeding. Further study for the underlying reasons for the increase in these techniques is warranted.

scholarly journals Predictors of post-spinal hypotension in elderly patients; a prospective observational study in the Durban Metropole

2019 ◽  
pp. 13-17
Author(s):  
ZA Malima ◽  
A Torborg ◽  
L Cronjé ◽  
BM Biccard
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Observational Study ◽  
Systolic Blood Pressure ◽  
Spinal Anaesthesia ◽  
Prospective Observational Study ◽  
Primary Outcome ◽  
Baseline Heart Rate ◽  
Female Sex ◽  
Spinal Hypotension

Aims and objective: To evaluate the pre-spinal risk factors for hypotension associated with spinal anaesthesia in elderly surgical patients. Summary of background data: Hypotension is associated with morbidity and mortality following noncardiac surgery. Reducing the incidence of hypotension associated with spinal anaesthesia may be associated with improved postoperative outcomes. Methods: This was a prospective, observational study, using convenience sampling. All patients over 55 years of age scheduled to receive spinal anaesthesia for lower limb surgery were eligible. Exclusion criteria included the need for resuscitation and/or the need for vasopressors prior to anaesthesia and surgery, and patients who declined spinal anaesthesia. The dosage of spinal anaesthesia and the use of intraoperative sedation were left to the attending anaesthesiologist. The primary outcome was hypotension, which was defined as a decrease in the systolic blood pressure by 25% from the baseline, or a systolic blood pressure below 100 mmHg. The following pre-spinal risk factors were assessed in a multivariable logistic regression for their association with spinal hypotension: age, American Society of Anaesthesiologists-Physical September 2019 Status, sex, dose of local anaesthetic, isobaric bupivacaine or bupivacaine with dextrose, baseline blood pressure, baseline heart rate and fluid preloading prior to spinal anaesthesia. Results: Three hundred and eighty-nine patients were recruited. The primary outcome of spinal hypotension was independently associated with female sex (odds ratio [OR] 1.97, 95% confidence interval [CI] 1.19–3.28), increasing dosage of bupivacaine (OR 1.14, CI 1.01–1.29), and the use of isobaric bupivacaine (OR 1.50, CI 0.95–2.36). Conclusion: Spinal hypotension was associated with female sex, increasing dosage of bupivacaine, and the use of isobaric bupivacaine.

Sign in / Sign up

Export Citation Format

Share Document