DOZ047.116: Reducing complications for tracheostomy patients

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
T Valika ◽  
D M Thompson ◽  
J Ida
Keyword(s):  
Wound Care ◽  
Healthcare Providers ◽  
Retrospective Chart Review ◽  
Emergency Situations ◽  
Wound Breakdown ◽  
Digital Format ◽  
Time Period ◽  
Postoperative Time ◽  
The Difference

Abstract Objective The objective of this study was to review the utilization of a standardized tracheostomy handoff sheet to reduce tracheostomy-related complications. Methods A retrospective chart review was carried out of patients who underwent tracheostomy and had a dedicated tracheostomy handoff sheet utilized in the postoperative period. The handoff sheet contains trach size, backup trach size, airway findings, suction depth, location of maturation suture, location of stay sutures, and photograph of the wound bed on postoperative day 0. An anonymous survey of healthcare providers participating in the patient's care was undertaken regarding the utility of the dedicated trach handoff sheet. Results There were a total of 18 completed questionnaires. The majority of respondents felt the trach handoff sheet was helpful and provided vital information (4.61, scale 1–5). Hundred percent of respondents referenced the handoff sheet at some point during the hospital stay; 83% of respondents (15/18) felt the handoff sheet was more productive than a verbal handoff and 67% of respondents (12/18) preferred the sheet be available bedside rather than a digital format for reference in the electronic medical record. 89% of respondents (16/18) utilized the handoff sheet for wound care. Conclusion There are numerous aspects to proper tracheostomy care. From the immediate postoperative time period to several years out, proper care can make the difference for quality of life, respiratory standpoint, and airway safety. With a daily nursing handoff that at times can become redundant, utilization of a standardized tracheostomy handoff can lead to improve outcomes. These handoff sheets provide information deemed essential to optimal patient care and are always available bedside for review. Standardization and utilization of these tracheostomy sheets have led to decreased airway complications in emergency situations, reduced wound breakdown, and increased safety and efficiency in handoffs.

Lamotrigine Augmentation Strategy for Patients with Treatment-Resistant Depression

CNS Spectrums ◽  
2005 ◽  
Vol 10 (10) ◽  
pp. 800-805 ◽  
Author(s):  
Rosben L. Gutierrez ◽  
Ruth McKercher ◽  
Jason Galea ◽  
Katrina L. Jamison
Keyword(s):  
Retrospective Chart Review ◽  
Common Side Effect ◽  
Symptom Improvement ◽  
Treatment Resistant Depression ◽  
Medication Regimen ◽  
Treatment Resistant ◽  
Time Period ◽  
Augmentation Strategy ◽  
Resistant Depression ◽  
The Difference

AbstractObjective:To investigate if lamotrigine added to an antidepressant regimen reduces the symptoms of major depression in treatment-resistant patients.Introduction:Charts were retrospectively reviewed for 34 patients (36–63 years of age) with major depressive disorder who received lamotrigine augmentation to the antidepressant regimen for treatment-resistant depression (TRD). Data collection occurred at baseline and at an average of 30 (Time 2), 78 (Time 3), 167 (Time 6), and 356 days (Time 12), thereafter, using a “Medication Visit by MD” scale for collection of target symptom data at each timepoint.Results:Following the addition of lamotrigine to the antidepressant regimen (mean dose of 43, 63, and 113 mg/day for Time 3, Time 6, and Time 12, respectively), a statistically significant reduction of scores was shown as early as Time 2 for target symptoms of depressed mood, loss of interest, anxiety, irritability, (low) energy, and cognitive impairment. The difference from baseline remained statistically significant at Time 3, Time 6, and Time 12 (with the exception of irritability, which was not statistically significant at Time 6). “Patient's response” also reflected statistically significant improvement at each time period compared with baseline. The most common side effect reported and reason for discontinuation was tiredness.Discussion:Because TRD is a clinical condition that can present with severe and disabling symptoms, many clinicians are faced with an urgent need to find relief for their patients. Trying to achieve symptom improvement in a timely manner during a medication change can be challenging and difficult. This can be managed by an augmentation strategy using a psychotropic add-on to an existing medication regimen. Our results show the benefits of lamotrigine augmentation to an antidepressant regimen. Prospective, controlled clinical trials with larger sample size are needed to confirm our results.Conclusion:In this retrospective chart review, augmentation with lamotrigine was a tolerable and efficacious strategy for treating patients with TRD.

Quality-of-life (QOL) evaluation for advanced non-small cell lung cancer (NSCLC): Comparison between vinorelbine and gemcitabine followed by docetaxel (VGD), and paclitaxel and carboplatin (PC) regimen on protocol JMTO LC00–03 (BRI LC03- 01)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 18043-18043
Author(s):  
H. Tada ◽  
A. Tokoro ◽  
R. Ishiwata ◽  
S. Teramukai ◽  
M. Fukushima ◽  
...  
Keyword(s):  
Longitudinal Analysis ◽  
Advanced Nsclc ◽  
Progression Free Survival ◽  
Free Survival ◽  
Treatment Groups ◽  
Time Period ◽  
Significant Difference ◽  
The Difference ◽  
Asco 2006

18043 Background: JMTO LC00–03, a randomized trial of VGD versus PC in patients with advanced NSCLC, showed differences between the two treatment groups in response rate (25 vs 37.1%) and regimens’ specific toxicities including taxane-related toxicities such as numbness (0 vs 16.2%) and neuropathy (0.5 vs 9.6%), but not in overall survival (MST, 13.6 vs 14.1 mos) and progression-free survival (MST, 5.5 vs 5.8 mos). (Kawahara et al, # 7013, ASCO, 2006). Methods: Patients with advanced NSCLC were randomly assigned to VGD or PC. The patients were assessed with Functional Assessment of Cancer Therapy- FACT-L and FACT-Taxane score in baseline, and at 6-, 12-, 18-weeks after the treatment. The longitudinal analysis was used to compare mean changes of the QOL score over the two treatment groups. Results: Sixty-eight patients from the trial (VGD: 34, PC: 34) who submitted both baseline questionnaire and at least one questionnaire over the course of the treatment were subjects of the study. The table presents the estimated changes in mean scores in treatment arms over the time period. The longitudinal analysis showed significant difference in FACT-Taxane (p<0.001) in the treatment over time, but no significant difference in the FACT-L score (p=0.261). The analysis assuming non-random missing mechanism resulted in slightly larger differences in the mean change. Conclusions: There was no statistically significant difference in FACT-L between the two groups, but VGD group was numerically better than PC group at any point from baseline. The significant difference in FACT-Taxane score favoring VGD would be due to the difference in frequency of neuropathy with docetaxel than with paclitaxel. [Table: see text] [Table: see text]

scholarly journals Effect of Using Personal Protective Equipment during the COVID-19 Pandemic on the Quality Indicators of Screening Colonoscopies

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Subin Chirayath ◽  
Janak Bahirwani ◽  
Parampreet Kaur ◽  
Noel Martins ◽  
Ronak Modi
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
Cecal Intubation ◽  
Withdrawal Time ◽  
Time Period ◽  
Adenoma Detection ◽  
Cecal Intubation Time ◽  
Practice Of Medicine ◽  
Cecal Intubation Rate

Background. Coronavirus Disease 2019 (COVID-19) has affected many facets of the practice of medicine including screening colonoscopies. Aims. Our study looks to observe if there has been an effect on the quality of colonoscopies, as indicated by quality measures such as the cecal intubation rate (CIR), cecal intubation time (CIT), scope withdrawal time (SWT), and adenoma detection rate (ADR) with the adoption of standard COVID-19 precautions. Methods. We conducted a retrospective chart review to analyze the effects of the COVID-19 pandemic on screening colonoscopies. The study utilized data on CIR, CIT, SWT, and ADR from outpatient, nonemergent procedures conducted at 3 endoscopy suites of St. Luke’s University Health Network. All inpatient and emergent procedures were excluded. Results. Our study demonstrated that the total number of screening colonoscopies was decreased between 2019 and 2020 (318 in 2019 vs. 157 in 2020, p = 0.005 ). CIT ( 320 ± 105 seconds in 2019 vs. 392 ± 107 seconds in 2020, p = 0.001 ) and SWT ( 706 ± 232 seconds in 2019 vs. 830 ± 241 seconds in 2020, p = 0.001 ) were increased while CIR (98.2% in 2019 vs. 96.6% in 2020, p = 0.04 ) was decreased between 2019 and 2020 likely due to PPE introduction. ADR was similar between the two groups (38.23 (12.50-66.66) in 2019 vs. 38.18 (16.66-66.00) in 2020, p = 0.8 ). Conclusion. Our study showed that quality indices for screening colonoscopies like CIR, CIT, and SWT were negatively impacted during the COVID-19 time period. ADR, however, was similar. Thus, the efficiency of the procedures was affected by the use of PPE but it did not affect the colonoscopy’s clinical benefit.

scholarly journals Method for the numerical evaluation of the color rendering quality of matrix photodetectors

2021 ◽  
pp. 39-44
Author(s):  
Oleksandr Kupko ◽  
Olena Liashenko ◽  
Pavel Neyezhmakov ◽  
Yevhen Tymofeiev ◽  
Eduard Diumin ◽  
...  
Keyword(s):  
Color Image ◽  
Spectral Characteristics ◽  
Light Sources ◽  
Color Coordinates ◽  
Visual Impression ◽  
Digital Format ◽  
The Difference ◽  
Angular Coordinates ◽  
Color Rendering

To objectively evaluate the color image of an architectural object when changing its spectral quality and luminance in lighting, it is necessary to ensure its accurate fixation. The measurement of the color coordinates of an object provides the fully capture of its appearance, but this does not allow to get an adequate evaluation of the visual impression without visualizing the lighting scene. This requires a thorough procedure of reproducing the same color coordinates for each point of the image and the object with the same angular coordinates. In this work, an attempt is made to develop a numerical criterion for evaluating the quality of color rendering of the camera as a fixer of color visual impression of the selected scene. The development of a numerical detailed method for evaluation of the quality of color rendering of cameras will allow capturing more reliably such a subjective concept as the correspondence of the visual impression of the real scene and the image file of this scene. The digital format, which contains information about the object, avoids the problems associated with aging of the image. The proposed method of developing ways to numerically evaluate color distortion in photography is considered on the example of digital cameras Nikon D300s, Sony DSC-H5. The described approach for the case of known spectral characteristics allows to unambiguously link the calculated reaction of the camera with the chromaticity coordinates of spectrally pure colors. Modern methods of evaluating the quality of light sources (IES TM-30-15) allow evaluation of the direction of the shift. The proposed indicator – graph E (λi) numerically characterizes the difference between the reaction of the camera and the reaction of the human eye and does not give an idea in which direction there is a difference, conditionally red or blue image compared to the natural scene, but is the simplest and most understandable to the untrained user. It is shown that with an accuracy of measuring spectral characteristics of 1% for the considered example with Nikon D300s, this indicator at different wavelengths is calculated with an uncertainty of not more than 0.002.

scholarly journals Involvement of Gastroenterology Fellows in Colonoscopy Improves the Adenoma Detection Rate: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Wissam Kiwan ◽  
Suhag Patel ◽  
Stephanie Judd ◽  
Hala Nas ◽  
Sachin Goyal ◽  
...  
Keyword(s):  
Detection Rate ◽  
Healthcare Providers ◽  
Inverse Correlation ◽  
Retrospective Chart Review ◽  
Adenoma Detection Rate ◽  
Polyp Detection ◽  
Adenoma Detection ◽  
Inadequate Bowel Preparation ◽  
The Impact

Abstract Background: The quality of colonoscopy is sometimes questioned by the patient, the family and even the endoscopist when a trainee is involved in the procedure. The adenoma detection rate (ADR) has emerged as the main quality measure for colonoscopy due to its inverse correlation with colorectal cancer (CRC) incidence. Few studies have evaluated the impact of involvement of trainees on the quality of colonoscopy, with conflicting results.Aims: We aimed to evaluate the effect of fellow involvement on ADR and polyp detection.Methods: A retrospective chart review was conducted for outpatient colonoscopies (December 2013 to April 2015) done for patients 40-85 years old which were complete and were performed by academic gastroenterologists. Colonoscopies with inadequate bowel preparation were excluded.Results: 1100 patients were included. Indication was screening or surveillance in 60%. Most were males (93%), and 50% were African American. Mean age was 62.1 years. A gastroenterology fellow participated in 54.7% of the procedures.Fellow involvement resulted in a significant increase in the ADR (55.2% to 64.6%, P=0.001). There was also a substantial increase in mean number of polyps (2.59 to 3.27; P < 0.001), adenoma per patient (1.56 to 2.06; P = 0.001) as well as detection of at least three adenomas (21.7% to 29.2%; P = 0.004). Conclusions: Participation of trainees in colonoscopy is associated with a higher ADR and a higher number of polyps per patient, providing reassurance to patients and healthcare providers about the quality of the colonoscopy.

Letter to the Editor: The Continuing Challenge of Evaluating RSD Impairment and Disability

1998 ◽  
Vol 3 (5) ◽  
pp. 8-10
Author(s):  
Robert L. Knobler ◽  
Charles N. Brooks ◽  
Leon H. Ensalada ◽  
James B. Talmage ◽  
Christopher R. Brigham
Keyword(s):  
Disability Evaluation ◽  
Body Part ◽  
Loss Of Function ◽  
Regulatory Requirements ◽  
Major Cardiac Event ◽  
Clinical Scenarios ◽  
Impairment Score ◽  
Occupational Activities ◽  
The Difference

Abstract The author of the two-part article about evaluating reflex sympathetic dystrophy (RSD) responds to criticisms that a percentage impairment score may not adequately reflect the disability of an individual with RSD. The author highlights the importance of recognizing the difference between impairment and disability in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides): impairment is the loss, loss of use, or derangement of any body part, system, or function; disability is a decrease in or the loss or absence of the capacity to meet personal, social, or occupational demands or to meet statutory or regulatory requirements because of an impairment. The disparity between impairment and disability can be encountered in diverse clinical scenarios. For example, a person's ability to resume occupational activities following a major cardiac event depends on medical, social, and psychological factors, but nonmedical factors appear to present the greatest impediment and many persons do not resume work despite significant improvements in functional capacity. A key requirement according to the AMA Guides is objective documentation, and the author agrees that when physicians consider the disability evaluation of people, more issues than those relating to the percentage loss of function should be considered. More study of the relationships among impairment, disability, and quality of life in patients with RSD are required.

COMBINATORIAL POLYNOMIALLY COMPUTABLE CHARACTERISTICS OF SUBSTITUTIONS AND THEIR PROPERTIES

2020 ◽  
Vol 7 (2) ◽  
pp. 34-41
Author(s):  
VLADIMIR NIKONOV ◽  
◽  
ANTON ZOBOV ◽  
Keyword(s):  
Mathematical Expectation ◽  
Point Of View ◽  
Small Range ◽  
Computational Point ◽  
Wide Range ◽  
Bijective Function ◽  
The Difference ◽  
Element Base ◽  
Selection Of

The construction and selection of a suitable bijective function, that is, substitution, is now becoming an important applied task, particularly for building block encryption systems. Many articles have suggested using different approaches to determining the quality of substitution, but most of them are highly computationally complex. The solution of this problem will significantly expand the range of methods for constructing and analyzing scheme in information protection systems. The purpose of research is to find easily measurable characteristics of substitutions, allowing to evaluate their quality, and also measures of the proximity of a particular substitutions to a random one, or its distance from it. For this purpose, several characteristics were proposed in this work: difference and polynomial, and their mathematical expectation was found, as well as variance for the difference characteristic. This allows us to make a conclusion about its quality by comparing the result of calculating the characteristic for a particular substitution with the calculated mathematical expectation. From a computational point of view, the thesises of the article are of exceptional interest due to the simplicity of the algorithm for quantifying the quality of bijective function substitutions. By its nature, the operation of calculating the difference characteristic carries out a simple summation of integer terms in a fixed and small range. Such an operation, both in the modern and in the prospective element base, is embedded in the logic of a wide range of functional elements, especially when implementing computational actions in the optical range, or on other carriers related to the field of nanotechnology.

THE INFLUENCE OF TILLAGE SYSTEMS ON THE GROWTH, DEVELOPMENT AND YIELD OF LONG-FLAX

2020 ◽  
Author(s):  
V. Dumych ◽  
Keyword(s):  
Growth And Development ◽  
Field Experiments ◽  
Conservation Tillage ◽  
Mineral Fertilizers ◽  
Tillage Systems ◽  
Yield And Quality ◽  
Tillage System ◽  
The Difference ◽  
Flax Seeds

The purpose of research: to improve the technology of growing flax in the Western region of Ukraine on the basis of the introduction of systems for minimizing tillage, which will increase the yield of trusts and seeds. Research methods: field, laboratory, visual and comparative calculation method. Research results: Field experiments included the study of three tillage systems (traditional, canning and mulching) and determining their impact on growth and development and yields of trusts and flax seeds. The traditional tillage system included the following operations: plowing with a reversible plow to a depth of 27 cm, cultivation with simultaneous harrowing and pre-sowing tillage. The conservation system is based on deep shelfless loosening of the soil and provided for chiseling to a depth of 40 cm, disking to a depth of 15 cm, cultivation with simultaneous harrowing, pre-sowing tillage. During the implementation of the mulching system, disking to a depth of 15 cm, cultivation with simultaneous harrowing and pre-sowing tillage with a combined unit was carried out. Tillage implements and machines were used to perform tillage operations: disc harrow BDVP-3,6, reversible plow PON-5/4, chisel PCh-3, cultivator KPSP-4, pre-sowing tillage unit LK-4. The SZ-3,6 ASTPA grain seeder was used for sowing long flax of the Kamenyar variety. Simultaneously with the sowing of flax seeds, local application of mineral fertilizers (nitroammophoska 2 c/ha) was carried out. The application of conservation tillage allows to obtain the yield of flax trust at the level of 3,5 t/ha, which is 0,4 t/ha (12.9 %) more than from the area of traditional tillage and 0,7 t/ha (25 %) in comparison with mulching. In the area with canning treatment, the seed yield was the highest and amounted to 0,64 t/ha. The difference between this option and traditional and mulching tillage reaches 0,06 t/ha (10,3 %) and 0.10 t/ha (18.5 %), respectively. Conclusions. Preservation tillage, which is based on shelf-free tillage to a depth of 40 cm and disking to a depth of 15 cm has a positive effect on plant growth and development, yield and quality of flax.

Pengaruh ovaprim, aromatase inhibitor, dan hipofisa terhadap kualitas telur ikan Lele Dumbo (Clarias gariepinus)

2017 ◽  
Vol 5 (1) ◽  
Author(s):  
Erwin A. Aziz ◽  
Ockstan Kalesaran
Keyword(s):  
Survival Rate ◽  
Experimental Design ◽  
Aromatase Inhibitor ◽  
Fish Larvae ◽  
Clarias Gariepinus ◽  
Randomized Design ◽  
Completely Randomized Design ◽  
The Difference ◽  
Hatching Eggs

This study aimed to determine the effect of ovaprim hormone, aromatase inhibitor and pituitary on the quality of the catfish eggs (Clarias gariepinus). Experimental Design used was Completely Randomized Design (CRD) with four treatments, each with three replications. Treatment A: ovaprim; treatment B: Aromatase inhibitors, treatment C: hypophysis and treatment D: Control. The results showed that the difference in treatment gave highly significant effect on fertilization and hatching eggs but no significant effect on the survival rate of larvae. Aromatase inhibitor hormone was the best because it provided highly significant effect on fertilization (92.66%), hatchability of eggs (95%), and surviva rate (81.33%) of fish larvae.   Keywords : Clarias gariepinus. Ovaprim, Aromatase Inhibitor, Hypophysis, egg, larvae

Multivariate micropollutants analysis in marine waters

1995 ◽  
Vol 32 (9-10) ◽  
pp. 341-348
Author(s):  
V. Librando ◽  
G. Magazzù ◽  
A. Puglisi
Keyword(s):  
Multivariate Data Analysis ◽  
Partial Least Squares Regression ◽  
Environmental Chemistry ◽  
Sampling Site ◽  
Principal Component ◽  
Least Squares Regression ◽  
Organic Micropollutants ◽  
Suspended Material ◽  
The Difference

The monitoring of water quality today provides a great quantity of data consisting of the values of the parameters measured as a function of time. In the marine environment, and especially in the suspended material, increasing importance is being given to the presence of organic micropollutants, particularly since some are known to be carcinogenic. As the number of measured parameters increases examining the data and their consequent interpretation becomes more difficult. To overcome such difficulties, numerous chemometric techniques have been introduced in environmental chemistry, such as Multivariate Data Analysis (MVDA), Principal Component Analysis (PCA) and Partial Least Squares Regression (PLSR). The use of the first technique in this work has been applied to the interpretation of the quality of Augusta bay, by measuring the concentration of numerous organic micropollutants, together with the classical water pollution parameters, in different sites and at different times. The MVDA has highlighted the difference between various sampling sites whose data were initially thought to be similar. Furthermore, it has allowed a choice of more significant parameters for future monitoring and more suitable sampling site locations.

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