scholarly journals 1552. Clinical Outcomes and Healthcare Costs of Inpatients with Tetanus in Korea in 2011–2019

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S777-S777
Author(s):  
Sohyun Bae ◽  
Hyun-Ha Chang ◽  
Sook In Jung ◽  
Shin-Woo kim ◽  
Yoonjung Kim
Keyword(s):  
Clinical Outcomes ◽  
Medical Cost ◽  
Tetanus Toxoid ◽  
Grave Disease ◽  
Wound Management ◽  
Common Symptom ◽  
University Hospitals ◽  
Entry Site ◽  
United States Dollar ◽  
National University

Abstract Background We aimed to investigate the recent trend of clinical outcomes and medical costs of inpatients with tetanus, which is a rare, vaccine-preventable but extremely grave disease, in Korea, in 2011–2019 for the first time. Methods From January 2011 to October 2019, this study examined 49 patients with tetanus admitted in 2 national university hospitals in Gwangju and Daegu of South Korea. Patients’ medical records were retrospectively reviewed to determine the clinical factors and medical cost for tetanus management. Results The mean age was 65.3 ± 16.1 years and 32 (65.3%) of them were female. All patients (100.0%) had generalized tetanus, and 5 (10.2%) died during admission. The median duration from symptom onset to hospital visit was 4 days. Trismus (85.7%) was the most common symptom, and wound of the lower extremities (24.5%) was the most frequent presumed entry site of toxin. Only 6 (15.0%) patients were operated for wound management. The median hospital stay was 39 (9; 49) days. Furthermore, 32 (65.3%) needed mechanical ventilation, and 20 (40.8%) patients developed aspiration pneumonia. The median total healthcare cost was 21,072 KRW(Korean Republic Won) (17,560 USD(United States Dollar); 1 USD = 1200 KRW) per person. After discharge, 35 (79.5%) patients fully recovered without any disability. Conclusion Tetanus remains a grave disease that requires long duration of admission and huge medical cost in Korea. The completion rate of 3-time tetanus toxoid (Td) or tetanus toxoid, acellular pertussis and diphtheria vaccine (Tdap) vaccination was low; thus, the medical staff needs to establish more medical advice or policies to the general population of Korea Disclosures All Authors: No reported disclosures

scholarly journals Clinical outcomes and healthcare costs of inpatients with tetanus in Korea, 2011–2019

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sohyun Bae ◽  
Minsik Go ◽  
Yoonjung Kim ◽  
Soyoon Hwang ◽  
Shin-Woo Kim ◽  
...  
Keyword(s):  
South Korea ◽  
Clinical Outcomes ◽  
Medical Costs ◽  
Common Symptom ◽  
University Hospitals ◽  
South Korean ◽  
National University ◽  
Hospital Stays ◽  
Serious Disease ◽  
Vaccination Completion

Abstract Background Tetanus is a rare, vaccine-preventable but extremely serious disease. We investigated the recent trend of the clinical outcomes and medical costs for inpatients with tetanus in South Korea over 10 years. Methods We conducted a retrospective review to determine the clinical factors and medical costs associated with tetanus at two national university hospitals in South Korea between January 2011 and October 2019. Results Forty-nine patients were admitted for tetanus (mean age, 67.0 years [range, 53.0–80.0 years]; 32 women [57.1%]). All the patients had generalized tetanus, and 5 (10.2%) died during hospitalization. The median duration from symptom onset to hospital admission was 4 days. Trismus (85.7%) was the most common symptom, and the median hospital stay was 39 days. Thirty-two patients (65.3%) required mechanical ventilation, and 20 (40.8%) developed aspiration pneumonia. The median total healthcare cost per patient was US $18,011. After discharge, 35 patients (71.4%) recovered sufficiently to walk without disability. Conclusions Tetanus requires long hospital stays and high medical expenditures in South Korea; however, the vaccination completion rate is low. Medical staff should therefore promote medical advice and policies on the management of tetanus to the general South Korean population.

Acellular fish skin grafts for the management of wounds in dogs and cats: 17 cases (2019–2021)

2021 ◽  
pp. 1-5
Author(s):  
Elise S. Mauer ◽  
Elizabeth A. Maxwell ◽  
Christina J. Cocca ◽  
Justin Ganjei ◽  
Daniel Spector
Keyword(s):  
Soft Tissue ◽  
Clinical Outcomes ◽  
Medical Records ◽  
Complete Healing ◽  
Wound Management ◽  
Skin Grafts ◽  
Fish Skin ◽  
Secondary Intention ◽  
Management Techniques ◽  
Complex Wounds

Abstract OBJECTIVE To report the clinical outcomes of the use of acellular fish skin grafts (FSGs) for the management of complex soft tissue wounds of various etiologies in dogs and cats. ANIMALS 13 dogs and 4 cats with complex wounds treated with FSGs between February 2019 and March 2021. PROCEDURES Medical records were reviewed for information regarding cause, location, size of the wound, management techniques, complications, and clinical outcomes. RESULTS In dogs, the number of FSG applications ranged from 1 to 4 (median, 2 graft applications). The time between each application ranged from 4 to 21 days (median, 9.5 days). Time to application of the first FSG ranged from 9 to 210 days (median, 19 days). Wounds closed by second-intention healing following the first fish skin application between 26 and 145 days (median, 71 days; n = 12). In cats, 1 or 2 FSGs were used, and the wounds of 3 of 4 cats healed completely by secondary intention. The wounds of 1 dog and 1 cat did not heal. There were no adverse events attributed to the use of the FSGs. CLINICAL RELEVANCE For dogs and cats of the present study, complete healing of most wounds occurred with the use of FSGs, the application of which did not require special training, instruments, or bandage materials.

scholarly journals Ultrasound guided Extracorporeal Shock Wave Lithotripsy (SONO ESWL) versus fluoroscopy guided ESWL in patients with radiopaque renal stones; A comparative randomized study

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A S Hegazy ◽  
D M Abdelfattah ◽  
H N Hassan
Keyword(s):  
Shock Wave ◽  
Urinary Tract ◽  
Clinical Outcomes ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Shock Wave Lithotripsy ◽  
Randomized Study ◽  
Renal Stones ◽  
Ultrasound Guided ◽  
University Hospitals ◽  
Extracorporeal Shock Wave

Abstract Background Radiopaque stones in the upper urinary tract can often be visualized by both ultrasonography (US) and fluoroscopy (FS) during ESWL treatment. This prospective study was performed to compare the results of ESWL when both US and FS are possible and to evaluate efficacy and safety of ultrasound guided ESWL (SONO ESWL) in patients with radiopaque renal stone. The study was limited to renal calculi, since calculi in lower urinary tract may be difficult to visualize with ultrasonography. Objective To investigate whether the localization modality (u/s or fluoroscopy) affects clinical outcomes of ESWL or not. Patients and Methods Our study was conducted on 100 Patients with renal stones planned to have ESWL sessions attending urology outpatient clinic in Ain shams university hospitals and National Institute of Urology and Nephrology from February 2018 to January 2019 and divided into two equal groups; group A (ultrasound guided ESWL) and group B (fluoroscope guided ESWL). Results Our study revealed that the localization modality on ESWL (ultrasound or fluoroscopy) didn’t affect the clinical outcomes of ESWL. Conclusion Even in patients with radiopaque renal stones, ultrasound can be used to guide extracorporeal shock wave lithotripsy as effectively as fluoroscopy, without any risk of radiation.

scholarly journals A pilot survey on the outpatient chemotherapy unit of national university hospitals in Japan for early palliative care

2019 ◽  
Vol 30 ◽  
pp. vi95
Author(s):  
Hidenori Takahashi ◽  
Yuji Satomi ◽  
Takeshi Suzuki ◽  
Shogo Uneoka ◽  
Takeo Ishii ◽  
...  
Keyword(s):  
Palliative Care ◽  
University Hospitals ◽  
Early Palliative Care ◽  
Pilot Survey ◽  
Outpatient Chemotherapy ◽  
National University

scholarly journals Longer Working Hours of Pharmacists in the Ward Resulted in Lower Medication- related Errors—Survey of National University Hospitals in Japan

2011 ◽  
Vol 131 (4) ◽  
pp. 635-641 ◽  
Author(s):  
Kazuo MATSUBARA ◽  
Akira TOYAMA ◽  
Hiroshi SATOH ◽  
Hiroshi SUZUKI ◽  
Toshio AWAYA ◽  
...  
Keyword(s):  
Working Hours ◽  
University Hospitals ◽  
National University

scholarly journals Maximising the opportunity of a self‑administration outpatient parenteral antimicrobial therapy pathway

2021 ◽  
Vol 15 (1) ◽  
pp. 15-23
Keyword(s):  
Clinical Outcomes ◽  
Antimicrobial Therapy ◽  
Patient Questionnaire ◽  
University Hospitals ◽  
Self Administration ◽  
Patient Response ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
Nurse Empowerment ◽  
The University ◽  
The Impact

Background: The University Hospitals of Leicester NHS Trust outpatient parenteral antimicrobial therapy (OPAT) service has expanded rapidly with more nurse-led direction. Aims: A retrospective study between 1 July 2014 and 31 December 2019 was undertaken to assess the impact of OPAT expansion on beds released for further utilisation, clinical outcomes, adverse vascular access device (VAD) outcome, and self- and family-administered parenteral antimicrobial therapy. Method: Data were extracted from the OPAT Patient Management System and from a patient questionnaire survey. Findings: 1084 completed patient episodes were recorded in 958 patients, rising from 39 episodes in 2014 to 265 in 2019. The number of beds released for further utilisation correspondingly rose from 828 in 2014 to 8462 in 2019. The proportion of patients/family members trained to self-administer rose from 25% to 75%, with clinical cure/improvement of infection remaining high at between 84.6% and 92.8% of patients annually. Serious adverse VAD events remained low throughout. The patient response was generally positive. Conclusion: Nurse empowerment within OPAT can lead to significant improvements and patient benefits, while maintaining clinical outcomes.

scholarly journals Status of Institutional Review Board Meetings Conducted Through Web Conference Systems in Japanese National University Hospitals During the COVID-19 Pandemic: Questionnaire Study

10.2196/22302 ◽  
2020 ◽  
Vol 22 (11) ◽  
pp. e22302
Author(s):  
Kenta Yagi ◽  
Kazuki Maeda ◽  
Satoshi Sakaguchi ◽  
Masayuki Chuma ◽  
Yasutaka Sato ◽  
...  
Keyword(s):  
Financial Burden ◽  
Controlled Trial ◽  
Institutional Review Board ◽  
Current Status ◽  
University Hospitals ◽  
State Of Emergency ◽  
Face To Face ◽  
Institutional Review ◽  
National University ◽  
The Cost

Background With the global proliferation of the novel COVID-19 disease, conventionally conducting institutional review board (IRB) meetings has become a difficult task. Amid concerns about the suspension of drug development due to delays within IRBs, it has been suggested that IRB meetings should be temporarily conducted via the internet. Objective This study aimed to elucidate the current status of IRB meetings conducted through web conference systems. Methods A survey on conducting IRB meetings through web conference systems was administered to Japanese national university hospitals. Respondents were in charge of operating IRB offices at different universities. This study was not a randomized controlled trial. Results The survey was performed at 42 facilities between the end of May and early June, 2020, immediately after the state of emergency was lifted in Japan. The survey yielded a response rate of 74% (31/42). Additionally, while 68% (21/31) of facilities introduced web conference systems for IRB meetings, 13% (4/31) of the surveyed facilities postponed IRB meetings. Therefore, we conducted a further survey of 21 facilities that implemented web conference systems for IRB meetings. According to 71% (15/21) of the respondents, there was no financial burden for implementing these systems, as they were free of charge. In 90% (19/21) of the facilities, IRB meetings through web conference systems were already being conducted with personal electronic devices. Furthermore, in 48% (10/21) of facilities, a web conference system was used in conjunction with face-to-face meetings. Conclusions Due to the COVID-19 pandemic, the number of reviews in clinical trial core hospitals has decreased. This suggests that the development of pharmaceuticals has stagnated because of COVID-19. According to 71% (15/21) of the respondents who conducted IRB meetings through web conference systems, the cost of introducing such meetings was US $0, showing a negligible financial burden. Moreover, it was shown that online deliberations could be carried out in the same manner as face-to-face meetings, as 86% (18/21) of facilities stated that the number of comments made by board members did not change. To improve the quality of IRB meetings conducted through web conference systems, it is necessary to further examine camera use and the content displayed on members’ screens during meetings. Further examination of all members who use web conference systems is required. Our measures for addressing the requests and problems identified in our study could potentially be considered protocols for future IRB meetings, when the COVID-19 pandemic has passed and face-to-face meetings are possible again. This study also highlights the importance of developing web conference systems for IRB meetings to respond to future unforeseen pandemics.

scholarly journals Type of sedation and the need for unplanned interventions during ERCP: analysis of the clinical outcomes research initiative national endoscopic database (CORI-NED)

2019 ◽  
Vol 11 (2) ◽  
pp. 104-110
Author(s):  
Zachary L Smith ◽  
Katelin B Nickel ◽  
Margaret A Olsen ◽  
John J Vargo ◽  
Vladimir M Kushnir
Keyword(s):  
Clinical Outcomes ◽  
Outcomes Research ◽  
Population Based ◽  
University Hospitals ◽  
Serious Adverse Events ◽  
Health Maintenance ◽  
Logistic Regression Models ◽  
Research Initiative ◽  
Anaesthesia Care ◽  
The Impact

Background and aimsRecent studies suggest that sedation provided by anaesthesia professionals may be less protective against serious adverse events than previously believed, however, data are lacking regarding endoscopic retrograde cholangiopancreatography (ERCP). Using the clinical outcomes research initiative national endoscopic database (CORI-NED), we aimed to assess whether mode of sedation was associated with rates of unplanned interventions (UIs) during ERCP.Patients and methodsAll subjects from CORI-NED undergoing ERCP from 2004 to 2014 were identified and stratified into three groups based on the initial mode of anaesthesia: endoscopist-directed sedation (EDS), monitored anaesthesia care without an endotracheal tube (MAC-WET) and general endotracheal anaesthesia (GEA). The primary outcome was UIs. To assess the impact of sedation mode on UIs, multivariable logistic regression models were created adjusting for demographic, physician and procedure-level variables.DesignPopulation-based study.Results26 698 ERCPs were analysed (7588 EDS, 8395 MAC-WET, 10 715 GEA). UIs occurred in 320 ERCPs (1.2%). EDS was associated with a higher risk of UIs compared with sedation administered by an anaesthesia professional (OR 1.86, 95% CI 1.44 to 2.42). Additional factors associated with a higher risk of UIs included ASA class IV compared with class II (OR 3.18, 95% CI 2.00 to 5.06) and ERCPs done in community (OR 1.41, 1.04 to 1.91) and health maintenance organisations (OR 3.75, 2.01 to 6.99) hospitals.ConclusionEDS is associated with a higher risk of UIs during ERCP compared with sedation administered by an anaesthesia professional. Higher ASA class and procedures performed in non-university hospitals were also associated with a higher risk of UIs. This study suggests that, when available, sedation using an anaesthesia professional should be utilised for ERCP.

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