scholarly journals Outcomes of gastrointestinal fistulas: Results from a multi-continent, multi-national, multi-center cohort

2021 ◽  
Author(s):  
Humberto Arenas Márquez ◽  
María Isabel Turcios Correia ◽  
Juan Francisco García ◽  
Roberto Anaya Prado ◽  
Arturo Vergara ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Elective Surgery ◽  
Spontaneous Closure ◽  
The Other ◽  
Calf Circumference ◽  
Cross Sectional ◽  
Nutritional Characteristics ◽  
Prospective Longitudinal ◽  
Type Of Surgery ◽  
Prospective Longitudinal Cohort

SUMMARYRationaleGastrointestinal fistulas (GIF) represent a severe and potentially lethal complication of the hospital surgical activity. However, evidences are lacking about prognosis and outcomes of GIF in Latin America (LATAM) hospitals.ObjectiveTo describe the prognosis and outcomes GIF in LATAM hospitals.Study designProspective, longitudinal, cohort-type study. The cohort fostered three cross-sectional examinations: First examination: On admission of the patient in the study; Second examination: Thirty days later; and Third (and last) examination: Sixty days after patient’s admission.Study serieOne hundred seventy-seven patients (Males: 58.2 %; Average age: 51.0 ± 16.7 years; Ages ≥ 60 years: 36.2 %) diagnosed with, and assisted for, GIF (ECF: Enterocutaneous: 64.9 % vs. EAF: Enteroathmospheric: 35.1 %) in 76 LATAM hospitals (13 countries) and Europe (4).MethodsCondition (Alive vs. Deceased) and hospital status (Hospitalized vs. Discharged) of the patient, and the GFI patency (Closed vs. Non closed) were recorded in each of the cohort’s examination. Indicators of GFI prognosis thus constructed were correlated demographical, sanitary, surgical and nutritional characteristics of the patientsResultsOn conclusion of the study indicators of GIF prognosis behaved as follows: Mortality:14.7 %; Prolonged hospitalization: 47.4 %; Spontaneous closure of GIF: 36.2 %. Type of GIF influenced upon patient’s survival: ECF: 87.0 % vs. EAF: 82.3 % (Δ = +4.7 %; χ2 = 6.787; p < 0.05). In each examination of the cohort, the number of surviving subjects was always greater among those with ECF: After 30 days: ECF: 92.1 % vs. EAF: 83.9 % (Δ = +8.2 %); After 60 days: ECF: 98.1 % vs. EAF: 90.4 % (Δ = +7.7 %; χ2 = 13.764; p < 0.05). On the other hand, hospital stay was prolonged in the subjects of elective surgery (Elective surgery: 61.4 % vs. Emergency surgery: 38.3 % (Δ = +23.1 %; χ2 = 9.064; p < 0.05) and those with a reduced calf circumference (χ2 = 12.655; p < 0.05). Location of the fistula also influenced upon prolongation of hospital stay (χ2 = 7.817; p < 0.05).ConclusionsType of GIF influences upon survival of the patient. On the hand, hospital stay was dependent upon type of surgery previously performed, location of the fistula, and calf circumference value on admission in the study serie.

scholarly journals Prognostic factors of intraoperative awakening

2021 ◽  
Vol 13 (1) ◽  
pp. 62-67
Author(s):  
Mg. Yacnira L Martínez-Bazán ◽  
Dr. Alberto Rodríguez- Carballo ◽  
Yurisnel Ortiz- Sánchez ◽  
Est. Sandra Blanco- Martínez ◽  
Mg. Bernardo Blanco- Zamora
Keyword(s):  
Risk Factors ◽  
General Anesthesia ◽  
Elective Surgery ◽  
Inclusion Criteria ◽  
Physical Status ◽  
Surgical Risk ◽  
Provincial Hospital ◽  
Relative Risks ◽  
Prospective Longitudinal ◽  
Prospective Longitudinal Cohort

A prospective longitudinal cohort study was carried out in patients announced for major elective surgery, with orotracheal general anesthesia, at the “Carlos Manuel de Céspedes de Bayamo Provincial Hospital, from the Cauto region during the period from January 1, 2016 until December 31, 2018; with the objective of identifying the risk factors hypothetically related to the prognosis of intraoperative awakening. The exposed cohort consisted of two patients who experienced intraoperative awakening in the study period, and met the inclusion criteria. The magnitude of the associations was estimated by calculating the relative risks (RR). Age equal to or greater than 65 years, difficult intubation, patients with ASA III and IV physical status, and chronic alcohol ingestion, were the surgical risk factors depending on the patient, associated with the prognosis of awakening. Intraoperative in patients announced for major elective surgery, under general orotracheal anesthesia, although not significantly; while the female sex did not present an association. The time of surgery equal to or greater than four hours, was constituted in the surgical risk factor depending on the surgery, related to the prognosis of appearance of intraoperative awakening in patients announced for major elective surgery, with orotracheal general anesthesia.

scholarly journals Nutritional screening in surgical patients of a teaching hospital from Southern Brazil: the impact of nutritional risk in clinical outcomes

2013 ◽  
Vol 11 (2) ◽  
pp. 147-152 ◽  
Author(s):  
Rosane Scussel Garcia ◽  
Léa Regina da Cunha Tavares ◽  
Carla Alberici Pastore
Keyword(s):  
Hospital Stay ◽  
Clinical Outcomes ◽  
Teaching Hospital ◽  
Screening Tool ◽  
Elective Surgery ◽  
Nutritional Risk ◽  
Surgical Patients ◽  
Nutritional Screening ◽  
Cross Sectional ◽  
The Impact

OBJECTIVE: To assess the prevalence of nutritional risk in surgical patients of a teaching hospital and its associated factors. METHODS: A cross-sectional study with secondary data of surgical ward patients of the Hospital Escola da Universidade Federal de Pelotas, from April to October, 2010. Patients were evaluated up to 36 hours after admission using the Malnutrition Screening Tool. RESULTS: The study included 565 patients, with a mean age of 52.8±15.6 years, and the majority (51%) was female. More than 30% of the patients presented with an average or high nutritional risk, and 7% of them were at high risk. Associated with the greater risk were aging, cancer surgery, and mortality. The length of hospital stay showed a linear increase according to nutritional risk. CONCLUSION: The Malnutrition Screening Tool is a simple and effective tool for nutritional screening that does not require anthropometric measurements. In this study, average or high nutritional risk was prevalent in one third of the sample, and was related to increased mortality, hospital stay, cancer, and aging. Nutritional care outpatients´ protocols could be used prior to elective surgery to reduce the nutritional risk of these patients, improving clinical outcomes and reducing length and costs of hospital stay.

scholarly journals Analysis of Preoperative Test Screening in Patients Undergoing Elective Surgery at the Gynecology Department of the “Rafael Ángel Calderón Guardia” Hospital during 2009

2011 ◽  
Vol 52 (3) ◽  
Author(s):  
Manrique Leal Mateos ◽  
Juan B Madrigal Solis
Keyword(s):  
Medical Records ◽  
Analytical Study ◽  
Elective Surgery ◽  
Cross Sectional ◽  
Preoperative Test ◽  
The Mean ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Type Of Surgery ◽  
Abnormal Results

Aim: To evaluate the use of preoperative tests in patients undergoing an elective surgery at the Dr. Rafael Ángel Calderón Guardia Hospital during 2009. Methods: A cross-sectional observational analytical study was conducted. Two hundred and seventy two clinical histories, from patients who underwent surgery between 1 January 2009 and 3 June 2009, were analyzed. The analyzed variables were: age, coexisting morbidity prior to surgery, number and type of preoperative tests performed, missing and additional, and type of surgery performed. The number and type of preoperative tests required for each patient, depending on their morbidity, was decided according to the 2002 Guidelines of the American Society of Anesthesiologists (ASA). Results: The mean of preoperative tests performed for each patient was 4.3 (SD + 2.1). According to morbidity, the tests prescribed by ASA were fully conducted in only 44.9% (CI: 95% 38.8-51.0) of the patients. The mean of missed preoperative tests per patient was 1.7 (SD + 1.1). Ninety three percent (CI: 95% 89.3-95.7) of patients underwent a mean of 2.5 (SD+1.6) additional preoperative tests. Of the additional preoperative tests performed, 9.5% showed abnormal results. Only 7.6% (CI: 95% 2.5-16.8) of the medical records with abnormal results, recorded actions towards correcting these abnormalities and surgery was cancelled only for 3% (CI: 95% 0.4-10.5) of these patients. Conclusion: This study evidenced the inadequate use of preoperative tests, not only because they were not fully conducted in approximately 50% of patients, but also because a majority of them were requested a considerable amount of unjustified tests. 

HISTOPATHOLOGY OF THE PIGMENTED TUMORAL-LIKE LESIONS OF THE SKIN AT HUE HOSPITAL OF MEDICINE AND PHARMACY UNIVERSITY

2018 ◽  
Vol 8 (4) ◽  
pp. 65-69
Author(s):  
Mao Nguyen Van ◽  
Dong Tran Nam
Keyword(s):  
Key Words ◽  
Definitive Diagnosis ◽  
The Other ◽  
Cell Tumour ◽  
Cross Sectional ◽  
Skin Tumour ◽  
Clinical Appearance ◽  
The Face ◽  
The Common ◽  
Difficult Cases

Background: Pigmented tumour of the skin is one of the common tumour in human including the benign pigmented tumours (more common) called Nevi tumours and the malignant one called melanoma which was less frequent but the most poor in prognosis. In addition, the others not belonging to these group had the same clinical appearance, so the application of histopathology and immunohistochemistry for the definitive diagnosis was indespensible. Objectives: 1. To describe the macroscopic features of the pigmented tumoral-like lesions; 2. To classify the histopathologic types of the pigmented cell tumours and the other pigmented tumours of the skin. Materials and Method: Cross-sectional research on 55 patients diagnosed as pigmented tumoral lesions by clinician, then all definitively diagnosed by histopathology combining the immunohistochemistry in difficult cases. Results: There was no difference in gender, the disease was discovered most common in adult, especially with the age over 51 years old (58.1%). the most region located was in the face accounting for 60%, following the trunk and limbs (14.6%, 12.8% respectively). All 3 malignant melanomas happened in foot. The most common color of the lesions was black (65.4%), the other ones were rose, grey and blue. Histopathology and immunohisthochemistry showed that the true pigmented cell tumours were 52.6% encompassing benign ones (Nevi tumour) (41.8%), melanoma (5.4%) and lentigo (5.4%). 47.4% was not the true pigmented cell tumour including pigmented basocellular carcinoma (36.4%) and the others less common as histiofibromas, acanthoma and papilloma. Conclusion: the pigmented tumoral-like lesions of the skin could be the true pigmented cell tumours and the others, so the application of the histopathology and the immunohistochemistry after the clinical discovery helps to determine and classify the disease definitely and for the best orientation of treatment as well. Key words: skin tumour, benign pigmented tumour (Nevi), malignant pigmented tumour (melanoma), pigmented basocellular carcinoma

EXPRESSION OF SOME IMMUNOLOGIC MARKERS FOR THE DIAGNOSIS OF SUSPECTED LYMPHOID LESIONS OF LYMPHOMA

2018 ◽  
Vol 8 (4) ◽  
pp. 28-33
Author(s):  
Mao Nguyen Van ◽  
Thao Le Thi Thu
Keyword(s):  
Correct Diagnosis ◽  
Tumour Cells ◽  
The Body ◽  
The Other ◽  
Cervical Region ◽  
Cross Sectional ◽  
Immunologic Markers ◽  
Microscopic Features ◽  
Poor Differentiation ◽  
Benign Tumours

Background: In practice it was difficult or impossible to have a correct diagnosis for the lymphoid proliferation lesions based on only H.E standard histopathology. In addition to histopathology, the application of immunohistochemistry was indispensable for the definitive diagnosis of the malignant or benign tumours and the origin of the tumour cells as well. Objectives: 1. To describe the gross and microscopic features of the suspected lesions of lymphoma; 2. To asses the expression of some immunologic markers for the diagnosis and classification of the suspected lesions of lymphoma. Materials and Method: Cross-sectional research on 81 patients diagnosed by histopathology as lymphomas or suspected lesions of lymphoma, following with immunohistopathology staining of 6 main markers including LCA, CD3, CD20, Bcl2, CD30 and AE1/3. Results: The most site was lymph node 58.1% which appeared at cervical region 72.3%, then the stomach 14.9% and small intestine 12.4%. The other sites in the body were met with lower frequency. Histopathologically, the most type of the lesions was atypical hyperplasia of the lymphoid tissue suspecting the lymphomas 49.4%, lymphomas 34.5%, the other diagnoses were lower including inflammation, poor differentiation carcinoam not excluding the lymphomas, lymphomas differentiating with poor differentiation carcinomas. Immunohistochemistry showed that, LCA, CD3, CD20, Bcl2, CD30 and AE1/3 were all positive depending on such type of tumours. The real lymphomas were 48/81 cases (59.3%), benign ones 35.8% and poor differentiated carcinomas 4.9%. Conclusion: Immunohistochemistry with 6 markers could help to diagnose correctly as benign or malignant lesions, classify and determine the origin of the tumour cells as lymphocytes or epithelial cells diagnosed by histopathology as lymphomas or suspected lesions of lymphomas. Key words: histopathology, immunohistochemistry, lymphomas, poor differentiated carcinomas, hyperplasia, atypicality

A study on the design of a wardrobe, for patients bed-ridden with cancer, applying the knowledge of anonymous design

Impact ◽  
2020 ◽  
Vol 2020 (7) ◽  
pp. 45-47
Author(s):  
Naoko Fujii
Keyword(s):  
Hospital Stay ◽  
Nursing Care ◽  
Healthcare Professionals ◽  
The Other ◽  
Human Beings ◽  
Prolonged Hospital Stay ◽  
Hospital Patients ◽  
Hospital Gowns ◽  
Hospital Stays ◽  
Prolonged Hospital

The majority of human beings will be admitted to hospital at some point over the course of their lives. For the more fortunate among us, these hospital stays will be brief and will barely register as a significant experience. However, for others, being admitted for weeks or months at a time will be necessary in order to combat and recover from whatever it was that made admittance to hospital necessary. While it is easy to think of many reasons why a prolonged hospital stay might be undesirable, one that may escape our attention is the clothes that are worn by patients during their stay. Once a patient has been assigned a bed, they are often given a gown which they put on without thought and then lie down. The gowns that are given to patients are generally designed with healthcare professionals in mind. For example, in Japan pyjamas and yukata (bathrobes) are used as hospital gowns because they have a front opening that is easy to use during treatment and nursing care. In addition, the other gowns can be opened from the ankle to the crotch using the zip. Dr Naoko Fujii has focused her career on designing clothes for hospital patients and believes that there is a way to satisfy the practical needs of a hospital and the care it gives at the same time as satisfying the requirements of patients. She is now focusing her attention on this challenge.

Human density, economic level and frequency of canine helminths in Buenos Aires

2021 ◽  
Vol 95 ◽  
Author(s):  
D. Rubel ◽  
N. Flaibani
Keyword(s):  
Linear Models ◽  
Buenos Aires ◽  
Toxocara Canis ◽  
The Other ◽  
Green Spaces ◽  
Cross Sectional ◽  
Independent Variables ◽  
Economic Level ◽  
Faecal Samples ◽  
Human Density

Abstract The aim of this study was to explore through cross-sectional study the variation in the prevalence of parasitic helminths in canine faeces collected from green spaces of Buenos Aires according to the human density (HD) and economic level (EL) in the surroundings. HD and EL were considered as independent variables with three categories each. Twenty public squares (one hectare of surface) were randomly selected for each existing combination of the two independent variables. Ten random samples of fresh canine faeces were obtained in each square and analysed for helminths by the sedimentation and flotation techniques. The prevalence for each of the species was analysed using generalized linear models (GLM). The prevalence was modelled with a binomial error distribution and a logit link function. Helminth eggs were detected in 45 out of the 200 (22.5%) faecal samples collected and in 18 of the 20 green spaces sampled. The species observed were Ancylostoma caninum (13% of samples), Trichuris vulpis (8%) and Toxocara canis (4.5%). The GLM indicated that the prevalence of A. caninum in the slum areas (very high HD and very low EL) was higher than that in the other areas studied. However, the HD seemed to contribute more than the EL to the variations in the prevalence of A. caninum in faecal samples. The GLM showed no differences in the prevalence of the other parasite species for the different levels of the independent variables.

scholarly journals Quality of Life of Brazilian Vegetarians Measured by the WHOQOL-BREF: Influence of Type of Diet, Motivation and Sociodemographic Data

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2648
Author(s):  
Shila Minari Hargreaves ◽  
Eduardo Yoshio Nakano ◽  
Heesup Han ◽  
António Raposo ◽  
Antonio Ariza-Montes ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Online Survey ◽  
Well Being ◽  
Vegetarian Diet ◽  
The Other ◽  
Average Score ◽  
Cross Sectional ◽  
Domain 3 ◽  
Domain 4

This study aimed to evaluate the general quality of life (QoL) of Brazilian vegetarians. A cross-sectional study was conducted with Brazilian vegetarian adults (18 years old and above). Individuals were recruited to participate in a nationwide online survey that comprised the WHOQOL-BREF as well as sociodemographic and characterization questions related to vegetarianism. The WHOQOL-BREF is composed of 24 items which are divided into four domains (domain 1: physical health; domain 2: psychological well-being; domain 3: social relationships; and domain 4: environment), plus two general items which were analyzed separately, totaling 26 items. The answers from the questionnaire were converted into scores with a 0–100 scale range, with separate analyses for each domain. Results were compared among groups based on the different characteristics of the vegetarian population. A total of 4375 individuals completed the survey. General average score results were 74.67 (domain 1), 66.71 (domain 2), 63.66 (domain 3) and 65.76 (domain 4). Vegans showed better scores when compared to the other vegetarians, except in domain four, where the statistical difference was observed only for semi-vegetarians (lower score). Individuals adopting a vegetarian diet for longer (>1 year) showed better results for domains one and two, with no difference for the other domains. Having close people also adopting a vegetarian diet positively influenced the results for all domains. On the other hand, it was not possible to distinguish any clear influence of the motivation for adopting a vegetarian diet on the scores’ results. Adopting a vegetarian diet does not have detrimental effects on one’s QoL. In fact, the more plant-based the diet, and the longer it was adopted, the better the results were.

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