scholarly journals Risk Factors of Enterostomy Infection Caused by Bacterial Infection through Mathematical Modelling-Based Information Data Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Jing Li ◽  
Xiaoyu Liu ◽  
Jun Chen
Keyword(s):  
Risk Factors ◽  
Data Analysis ◽  
Mathematical Modelling ◽  
Length Of Hospital Stay ◽  
Normal Group ◽  
Infection Group ◽  
Single Lumen ◽  
Before And After ◽  
Anastomotic Fistula ◽  
Group 5

Objective. The study aimed to explore the risk factors of infections after enterostomy through the information data analysis method based on a mathematical model. Methods. 156 cases of enterostomy patients admitted to the hospital were retrospectively selected as the study subjects and were divided into the infection group (17 cases) and normal group (139 cases) according to whether they were complicated with infections. Then, the factors of infection and related indexes before and after surgery were analyzed, and the data of the whole hospital were estimated by mathematical modelling. Results. The length of hospital stay in the infection group was 21 ± 11.2 days, which is longer than 10.1 ± 7.1 days in the normal group ( P  < 0.05). The incidence of anastomotic fistula in the infection group was 14%, which is higher than 2% in the normal group. The mortality rate of infection group (44%) was higher than that of normal group (5%). In the infection group, the incidence of single-cavity stoma (69%) was higher than that of double-cavity stoma (31%), the nosocomial infection rate (11%) was significantly higher compared with out of hospital (2%), and there were significant differences ( P  < 0.05). Conclusions. Patients with malnutrition and hypoproteinemia before enterostomy, the use of gastric tube and ventilator in the treatment, single lumen stomy in the operation, and the occurrence of anastomotic fistula were more likely to have concurrent infections.

scholarly journals Premammillary Artery Infarction after Microsurgical Clipping of Unruptured Posterior Communicating Artery Aneurysm: Risk Factors, Surgical, and Anatomical Considerations

2021 ◽  
Author(s):  
JONG MIN LEE ◽  
Joon Ho Byun ◽  
Seungjoo Lee ◽  
Eun Suk Park ◽  
Jung Cheol Park ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Logistic Regression Analysis ◽  
Length Of Hospital Stay ◽  
Artery Aneurysm ◽  
Normal Group ◽  
Posterior Communicating Artery ◽  
Microsurgical Clipping ◽  
Posterior Communicating Artery Aneurysm ◽  
Independent Risk Factors ◽  
The Mean

Abstract Purpose Posterior communicating artery (PCoA) aneurysm is common and sometimes requires microsurgery; however, as data on premammillary artery (PMA) infarction after clipping is scarce, we retrospectively reviewed cases of post-clipping PMA infarction to analyze incidence, independent risk factors of infarction, and anatomical considerations. Methods Data from 569 consecutive patients who underwent microsurgical clipping for unruptured PCoA aneurysm between January 2008 and December 2020 were included. Patients were categorized into the normal or the PMA infarction group. Statistical analyses and comparisons between the two groups were used to determine the influence of various factors. Results The normal group included 515 patients while the PMA infarction group had 31. The mean length of hospital stay was significantly longer in the PMA infarction group (10.3 ± 9.1 days) than in the normal group (6.5 ± 6.4 days; p < 0.0001). The distribution of Glasgow Outcome Scale (GOS) at discharge was significantly different between the two groups (p ≤ 0.0001) but was not so at 6 months after discharge (p = 0.0568). Multivariate-logistic-regression analysis identified aneurysm size (odds ratio [OR], 1.194; 95% confidence interval [CI], 1.08–1.32; p = 0.0005) and medial direction of aneurysm (OR, 4.615; 95% CI, 1.224–17.406; p = 0.0239) as independent risk factors of post-clipping PMA infarction. Conclusions Surgeons must beware of PMA infarction after clipping of large aneurysms that are medial in direction. Intraoperative verification of the patency of the PCoA and the PMA from various angles using various intraoperative methods can reduce morbidity due to PMA infarction.

scholarly journals The timing of oesophageal dilatations in anastomotic stenosis after one-stage anastomosis for congenital oesophageal atresia

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Xue-Jie Gao ◽  
Jin-Xi Huang ◽  
Qiang Chen ◽  
Song-Ming Hong ◽  
Jun-Jie Hong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Data Analysis ◽  
Oesophageal Atresia ◽  
Anastomotic Stenosis ◽  
Retrospective Data ◽  
One Stage ◽  
Oesophageal Dilatation ◽  
Retrospective Data Analysis ◽  
Anastomotic Fistula ◽  
Dilatation Group

Abstract Background In infants with congenital oesophageal atresia, anastomotic stenosis easily occurs after one-stage oesophageal anastomosis, leading to dysphagia. In severe cases, oesophageal dilatation is required. In this paper, the timing of oesophageal dilatation in infants with anastomotic stenosis was investigated through retrospective data analysis. Methods The clinical data of 107 infants with oesophageal atresia who underwent one-stage anastomosis in our hospital from January 2015 to December 2018 were retrospectively analysed. Data such as the timing and frequency of oesophageal dilatation under gastroscopy after surgery were collected to analyse the timing of oesophageal dilatation in infants with different risk factors. Results For infants with refractory stenosis, the average number of dilatations in the early dilatation group (the first dilatation was performed within 6 months after the surgery) was 5.75 ± 0.5, which was higher than the average of 7.40 ± 1.35 times in the normal dilatation group (the first dilatation was performed 6 months after the surgery), P = 0.038. For the infants with anastomotic fistula and anastomotic stenosis, the number of oesophageal dilatations in the early dilatation group was 2.58 ± 2.02 times, which was less than the 6.38 ± 2.06 times in the normal dilatation group, P = 0.001. For infants with non-anastomotic fistula stenosis, early oesophageal dilatation could not reduce the total number of oesophageal dilatations. Conclusion Starting to perform oesophageal dilatation within 6 months after one-stage anastomosis for congenital oesophageal atresia can reduce the required number of dilatations in infants with postoperative anastomotic fistula and refractory anastomotic stenosis.

The Timing of Oesophageal Dilatations in Anastomotic Stenosis After One-Stage Anastomosis for Congenital Oesophageal Atresia

2020 ◽  
Author(s):  
Hong Ye ◽  
qiang chen ◽  
Jinxi Huang ◽  
Junjie Hong ◽  
songming hong
Keyword(s):  
Risk Factors ◽  
Data Analysis ◽  
Oesophageal Atresia ◽  
Anastomotic Stenosis ◽  
Retrospective Data ◽  
One Stage ◽  
Oesophageal Dilatation ◽  
Retrospective Data Analysis ◽  
Anastomotic Fistula ◽  
Dilatation Group

Abstract Background: In infants with congenital oesophageal atresia, anastomotic stenosis easily occurs after one-stage oesophageal anastomosis, leading to dysphagia. In severe cases, oesophageal dilatation is required. In this paper, the timing of oesophageal dilatation in infants with anastomotic stenosis was investigated through retrospective data analysis.Methods: The clinical data of 107 infants with oesophageal atresia who underwent one-stage anastomosis in our hospital from January 2015 to December 2018 were retrospectively analysed. Data such as the timing and frequency of oesophageal dilatation under gastroscopy after surgery were collected to analyse the timing of oesophageal dilatation in infants with different risk factors.Results: For infants with refractory stenosis, the average number of dilatations in the early dilatation group (the first dilatation was performed within 6 months after the surgery) was 5.75±0.5, which was higher than the average of 7.40±1.35 times in the normal dilatation group (the first dilatation was performed 6 months after the surgery), P=0.038. For the infants with anastomotic fistula and anastomotic stenosis, the number of oesophageal dilatations in the early dilatation group was 2.58±2.02 times, which was less than the 6.38±2.06 times in the normal dilatation group, P=0.001. For infants with non-anastomotic fistula stenosis, early oesophageal dilatation could not reduce the total number of oesophageal dilatations.Conclusion: Starting to perform oesophageal dilatation within 6 months after one-stage anastomosis for congenital oesophageal atresia can reduce the required number of dilatations in infants with postoperative anastomotic fistula and refractory anastomotic stenosis.

scholarly journals Nursing-led ultrasound to aid in trans-radial access in cardiac catheterisation: a feasibility study

2020 ◽  
Vol 25 (2) ◽  
pp. 159-172
Author(s):  
Trent Williams ◽  
Jeremy Condon ◽  
Allan Davies ◽  
Jennifer Brown ◽  
Lucinda Matheson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Radial Artery ◽  
Length Of Hospital Stay ◽  
Artery Occlusion ◽  
Cardiac Catheterisation ◽  
Bleeding Complications ◽  
Radial Access ◽  
Before And After ◽  
Cohort Study Design ◽  
Specialist Nurses

Background Trans-radial access is increasingly common for cardiac catheterisation. Benefits include reduced bleeding complications, length of hospital stay and costs. Aims To determine the feasibility of implementing a nurse-led ultrasound programme to measure radial artery diameter before and after cardiac catheterisation; to determine radial artery occlusion (RAO) rates, risk factors for RAO and predictors of radial artery (RA) diameter. Method A prospective observational cohort study design for 100 consecutive patients undergoing cardiac catheterisation, using RA access. Pre- and post-procedural RA diameter were measured using ultrasound, by specialist nurses trained to do so. Logistic regression analyses were performed to determine risk factors for RAO and predictors of RA diameter with results reported as odds ratios (OR) and 95% confidence intervals (CI). Results There were no adverse events, supporting the feasibility of nurse led ultrasound programmes. A 4% ( n = 4) rate of occlusion was observed. Haemostasis device application time of greater than 190 min was a predictor of RAO (OR 3.12, 95% CI 0.31–31). Male gender and height were predictors for a RA diameter of >2.2 mm. Conclusions Nurses can lead the assessment of RA occlusion using ultrasound to enhance planning and care, including monitoring compression times to reduce RAO.

PENGARUH TERAPI TERTAWA TERHADAP PENURUNAN TEKANAN DARAH LANSIA DI UPT PANTI WREDHA BUDHI DHARMA YOGYAKARTA

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Niken Setyaningrum ◽  
Andri Setyorini ◽  
Fachruddin Tri Fitrianta
Keyword(s):  
Blood Pressure ◽  
Data Analysis ◽  
The Elderly ◽  
Control Group ◽  
Group Comparison ◽  
Control Blood Pressure ◽  
Men And Women ◽  
Treatment Of Hypertension ◽  
Before And After ◽  
The Difference

ABSTRACTBackground: Hypertension is one of the most common diseases, because this disease is suffered byboth men and women, as well as adults and young people. Treatment of hypertension does not onlyrely on medications from the doctor or regulate diet alone, but it is also important to make our bodyalways relaxed. Laughter can help to control blood pressure by reducing endocrine stress andcreating a relaxed condition to deal with relaxation.Objective: The general objective of the study was to determine the effect of laughter therapy ondecreasing elderly blood pressure in UPT Panti Wredha Budhi Dharma Yogyakarta.Methods: The design used in this study is a pre-experimental design study with one group pre-posttestresearch design where there is no control group (comparison). The population in this study wereelderly aged over> 60 years at 55 UPT Panti Wredha Budhi Dharma Yogyakarta. The method oftaking in this study uses total sampling. The sample in this study were 55 elderly. Data analysis wasused to determine the difference in blood pressure before and after laughing therapy with a ratio datascale that was using Pairs T-TestResult: There is an effect of laughing therapy on blood pressure in the elderly at UPT Panti WredhaBudhi Dharma Yogyakarta marked with a significant value of 0.000 (P <0.05)

Indications and practice of enteral nutrition

2014 ◽  
Vol 155 (51) ◽  
pp. 2028-2033 ◽  
Author(s):  
Judit Hallay ◽  
Dániel Nagy ◽  
Béla Fülesdi
Keyword(s):  
Risk Factors ◽  
Treatment Outcome ◽  
Enteral Nutrition ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Nutrition Therapy ◽  
Present Review ◽  
Hospitalised Patients ◽  
Impact On Treatment ◽  
Efficacy Of Treatment

Malnutrition in hospitalised patients has a significant and disadvantageous impact on treatment outcome. If possible, enteral nutrition with an energy/protein-balanced nutrient should be preferred depending on the patient’s condition, type of illness and risk factors. The aim of the nutrition therapy is to increase the efficacy of treatment and shorten the length of hospital stay in order to ensure rapid rehabilitation. In the present review the authors summarize the most important clinical and practical aspects of enteral nutrition therapy. Orv. Hetil., 2014, 155(51), 2028–2033.

Comparison of Risk Factors of Falling for Psychiatric Inpatients and General Ward Inpatients Who Had Fallen

2021 ◽  
pp. 107839032110330
Author(s):  
Wen P. Chang ◽  
Hsiu J. Jen
Keyword(s):  
Risk Factors ◽  
Multinomial Logistic Regression ◽  
Psychiatric Patients ◽  
Length Of Hospital Stay ◽  
Psychiatric Inpatients ◽  
General Ward ◽  
Prevention Measures ◽  
Risk Of Falling ◽  
Multinomial Logistic Regression Analysis ◽  
Risk Factors For Falling

BACKGROUND: For psychiatric patients, the issue of falling is complex. OBJECTIVE: The objective of this study was to compare the risk factors for falling in psychiatric inpatients and general ward inpatients who had fallen. METHODS: The researchers first derived official fall records for 122 psychiatric inpatients and then selected 122 psychiatric inpatients who had not fallen as well as 122 general ward patients who had fallen, matched for gender, age, and length of hospital stay at the time of the fall incident. RESULTS: After controlling other variables, multinomial logistic regression analysis revealed that psychiatric inpatients who had fallen and had dizziness (odds ratio [OR] = 7.11, p < .001), had an unsteady gait (OR = 1.97, p = .030), or were not using aids (OR = 0.42, p = .042) were at greater risk of falling than those who had not fallen. The researchers also found that general ward inpatients who had fallen and had higher Charlson Comorbidity Index scores (OR = 1.77, p < .001), were clear-headed (OR = 27.15, p = .001), had dizziness (OR = 11.55, p < .001), were unable to walk (OR = 64.28, p < .001), or were using aids (OR = 3.86, p = .001) were at greater risk of falling than those who had not fallen before. CONCLUSIONS: The causes of falling among psychiatric inpatients and general ward inpatients are different. Medical personnel should understand the medications and attributes of patients for an accurate assessment of their risk factors for falling and thus implement fall prevention measures and health education to reduce falls.

scholarly journals Rupture Risk of Intracranial Aneurysm and Prediction of Hemorrhagic Stroke after Liver Transplant

2021 ◽  
Vol 11 (4) ◽  
pp. 445
Author(s):  
Hye-Mee Kwon ◽  
In-Gu Jun ◽  
Kyoung-Sun Kim ◽  
Young-Jin Moon ◽  
In Young Huh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intracranial Aneurysm ◽  
Hemorrhagic Stroke ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Hazard Analysis ◽  
Related Data ◽  
Incidence And Mortality ◽  
Before And After ◽  
History Of ◽  
Cirrhotic Patients

Postoperative hemorrhagic stroke (HS) is a rare yet devastating complication after liver transplantation (LT). Unruptured intracranial aneurysm (UIA) may contribute to HS; however, related data are limited. We investigated UIA prevalence and aneurysmal subarachnoid hemorrhage (SAH) and HS incidence post-LT. We identified risk factors for 1-year HS and constructed a prediction model. This study included 3544 patients who underwent LT from January 2008 to February 2019. Primary outcomes were incidence of SAH, HS, and mortality within 1-year post-LT. Propensity score matching (PSM) analysis and Cox proportional hazard analysis were performed. The prevalence of UIAs was 4.63% (n = 164; 95% confidence interval (CI), 3.95–5.39%). The 1-year SAH incidence was 0.68% (95% CI, 0.02–3.79%) in patients with UIA. SAH and HS incidence and mortality were not different between those with and without UIA before and after PSM. Cirrhosis severity, thrombocytopenia, inflammation, and history of SAH were identified as risk factors for 1-year HS. UIA presence was not a risk factor for SAH, HS, or mortality in cirrhotic patients post-LT. Given the fatal impact of HS, a simple scoring system was constructed to predict 1-year HS risk. These results enable clinical risk stratification of LT recipients with UIA and help assess perioperative HS risk before LT.

scholarly journals Prevalence and risk factors of delirium and subsyndromal delirium in older adults

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Maha Hosam El-Din Ibrahim ◽  
Manal Elmasry ◽  
Fady Nagy ◽  
Ahmed Abdelghani
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Functional Ability ◽  
Cognitive Assessment ◽  
Length Of Hospital Stay ◽  
Assessment Method ◽  
Assessment Tools ◽  
Subsyndromal Delirium ◽  
Confusion Assessment ◽  
Definition Of

Abstract Background Delirium is a common geriatric problem associated with poor outcomes. Subsyndromal delirium (SSD) is characterized by the presence of certain symptoms of delirium yet, not satisfying the definition of full-blown delirium, defined by categorical elements, and is usually referred to as the presence of one or more symptoms in the confusion assessment method (CAM). This study aimed to investigate the prevalence and risk factors of delirium and SSD in older adults admitted to the hospital. Five hundred eighty-eight elderly (above 65 years) Egyptian patients were recruited from January 2019 to February 2020. After explaining the purpose of the study and assuring the confidentiality of all participants, an informed consent was obtained from the participant or a responsible care giver for those who were not able to give consent. All patients were subjected ‘on admission’ to thorough history taking, clinical examination, and comprehensive geriatric assessment including confusion assessment tools, mini-mental state examination, and functional assessment using Barthel index score. Results The current study showed that 19.6% of patients had delirium and 14.1% of patients had SSD with combined prevalence of 33.7%. Most common causes included metabolic, infection, organic brain syndrome, and dehydration. The current study reported significant proportionate relation between cognitive assessment and functional ability, so patients with a score of 23 MMSE had good functional ability, while cognitive assessment using mini-mental score shows inversed relation to delirium and SSD using CAM score. Conclusion Delirium is independently associated with adverse short-term and long-term outcomes, including an increase in mortality, length of hospital stay, discharge to an institution, and functional decline on discharge. Subsyndromal delirium (SSD) is characterized by the presence of certain symptoms of delirium, not yet satisfying the definition of full-blown delirium but it can identify patients with early cognitive and functional disabilities, and because of high prevalence of delirium and SSD. Efforts to prevent or early detection may identify patients who warrant clinical attention.

Spironolactone-Induced Agranulocytosis

1997 ◽  
Vol 31 (5) ◽  
pp. 582-585 ◽  
Author(s):  
Anna M Whitling ◽  
Pablo E Pérgola ◽  
John Lee Sang ◽  
Robert L Talbert
Keyword(s):  
Risk Factors ◽  
Adverse Effect ◽  
Bone Marrow ◽  
Leukocyte Count ◽  
Laboratory Data ◽  
University Hospital ◽  
Drug Induced ◽  
Bone Marrow Biopsies ◽  
Case Summary ◽  
Before And After

OBJECTIVE: TO report a case of agranulocytosis secondary to spironolactone in a patient with cryptogenic liver disease. CASE SUMMARY: A 58-year-old Hispanic woman with cryptogenic cirrhosis was admitted to University Hospital on October 31, 1995. Laboratory data revealed a leukocyte count of 1.0 × 103/mm3 and an absolute neutrophil count (ANC) of 10 cells/mm3. Prior to treatment with spironolactone, the leukocyte count was 10.2 × 103/mm3 and ANC 8400 cells/mm3. Agranulocytosis resolved 5 days following the discontinuation of spironolactone. Results from the bone marrow biopsies before and after treatment with spironolactone suggested that agranulocytosis was caused by the drug's toxic effect on the bone marrow. DISCUSSION: Drug-induced agranulocytosis is a serious adverse effect, occurring at a rate of approximately 6.2 cases per million persons each year. In addition to the case reported here, three other reports of agranulocytosis secondary to spironolactone have been published in the literature. Several factors have been identified that may increase a patient's risk for developing agranulocytosis, including increased age, hepatic or renal impairment, drag dosage and duration, and concurrent medications. CONCLUSIONS: Agranulocytosis secondary to spironolactone is a serious potential adverse effect. Patients with risk factors for developing this adverse effect should be closely monitored since early detection and discontinuation of spironolactone can improve prognosis.

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