scholarly journals The Effects of Diagnosis-Related Group Payment on Diagnostic Cerebral Angiograms through a Transradial and Transfemoral Approach: A Comparative Observational Study

2022 ◽  
Vol 2022 ◽  
pp. 1-8
Author(s):  
Wei Chen ◽  
Xi-Fang Song ◽  
Min Wan ◽  
Li Liu ◽  
Wei-Hua Jia
Keyword(s):  
Success Rate ◽  
Radial Artery ◽  
Femoral Artery ◽  
Cerebral Angiography ◽  
Diagnosis Related Group ◽  
X Ray ◽  
Significant Difference ◽  
Related Group ◽  
Medical Process

Background. Cerebral angiography is an X-ray examination technique widely used in hospitals. At present, it is mainly divided into two kinds of angiography examination: transfemoral artery and transradial artery puncture. The diagnosis-related group (DRG) system is a new type of payment standard recognized internationally, but its impact on medical care and health outcomes is currently controversial. Aim. In this study, we conducted a comparative study on two invasive approaches, transradial artery and transfemoral artery puncture and observed whether DRG had an impact on the quality of the medical process. Methods. We compared and analyzed patients undergoing cerebral angiography via the femoral artery and radial artery puncture by recording the relevant parameters and comfort scale scores (GCQ) during the operation, as well as postoperative complications. At the same time, we observed the proportion of different puncture routes and the success rate of cerebral angiography before and after the implementation of a DRG payment simulation. Results. The results of the comparative analysis of patients’ transradial artery and transfemoral artery puncture angiography showed that the puncture success rate (99.1% vs. 97.2%, P > 0.05 ), angiography success rate (97.3% vs. 95.1%, P > 0.05 ), and X-ray radiation time (4.82 vs. 5.15 min, P > 0.05 ) demonstrated no significant difference. The ambulation time (1.52 vs. 12.06 h, P < 0.05 ), puncture time (22.42 vs. 31.02 min, P < 0.05 ), and complications (3.57% vs. 9.03%, P < 0.05 ) of the radial artery group were significantly lower than those of the femoral artery group. In contrast, the GCQ score of the radial artery group at each stage after angiography was significantly higher than that of the femoral artery group ( P < 0.05 ). Compared with before the DRG simulation, the proportion of cerebral angiography with transradial artery puncture increased significantly after its implementation. Conclusion. Compared with transfemoral cerebrovascular angiography, transradial cerebrovascular angiography has many advantages, such as less local damage, less pain, less postoperative bed-rest time, significantly lower incidence of total complications, and a lower cost. Following the implementation of the DRG payment method, the quality of the angiography medical process improved.

scholarly journals Bilateral Simultaneous Endoscopic Dacryocystorhinostomy: Outcome and Impact on the Quality of Life of the Patients

2019 ◽  
Vol 23 (02) ◽  
pp. 191-195
Author(s):  
Islam R. Herzallah ◽  
Osama A. Marglani ◽  
Ameen Z. Alherabi ◽  
Nuha S. Faraj ◽  
Deemah H. Bukhari
Keyword(s):  
Quality Of Life ◽  
Success Rate ◽  
Symptom Score ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Safe Procedure ◽  
Duct Obstruction ◽  
Endoscopic Dacryocystorhinostomy ◽  
Significant Difference

Introduction Bilateral simultaneous endoscopic dacryocystorhinostomy (endo-DCR) has received little attention in the literature, thus many surgeons continue to address bilateral nasolacrimal duct obstruction at two stages, rather than in the same setting. Objective To evaluate the feasibility and the outcome of simultaneous bilateral Endo-DCR and its impact on the quality of life of the patients. Methods We have conducted a retrospective analysis of patients who underwent bilateral simultaneous endo-DCR between March 2013 and February 2017 at our tertiary care institution. The reviewed data included clinical presentation; operative details; success rate; pre and postoperative evaluation of the symptoms of the patients, using the Nasolacrimal Duct Obstruction Symptom Score Questionnaire; satisfaction of the patients, and improvement in the quality of life, assessed by the Glasgow Benefit Inventory (GBI) questionnaire. Results Out of 128 cases in which endo-DCRs were performed, 13 were bilateral (26 sides). Postoperative success was documented in 24 of the 26 sides (92.3%), with a mean follow-up duration of 16.2 months. The two failed sides were reported in the same case. The preoperative symptom score ranged between 12 and 80 (mean ± standard deviation [SD]: 38.23 ± 15.7). The postoperative symptom score was significantly lower (mean ± SD: 5.4 ± 12.9). The success rates in unilateral and bilateral cases were comparable, with no statistically significant difference. A notable improvement in the quality of life of the patients was also reported, with a mean GBI score of 81.38 ± 12.37. Conclusion Our results support that a simultaneous bilateral endo-DCR is a safe procedure that offers a high success rate, spares the patient from the stress of a second surgery, provides the patient with a bilateral resolution of the symptoms, and confers an immediate improvement in the quality of life of the patients.

TRIACCESS study: randomized comparison between radial, femoral and transpedal access for for percutanous supertfitial femoral artery angioplasty

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Z Ruzsa ◽  
A Csavajda ◽  
M Deak ◽  
P Sotonyi ◽  
O.F Bertrand ◽  
...  
Keyword(s):  
Success Rate ◽  
Femoral Artery ◽  
Complication Rate ◽  
Randomized Study ◽  
Technical Success ◽  
Access Site ◽  
Femoral Access ◽  
X Ray ◽  
Technical Success Rate ◽  
Access Site Complication

Abstract Background Traditional access for the treatment of femoral artery lesions is the femoral artery (FA) approach, but radial (RA) and pedal access (PA) is an alternative access site. The aim of the study was to compare the success rate, complication rate of different access sites for the treatment of superfitial artery stenosis in a randomized study Methods 180 consecutive patients were randomized in a prospective study to treat symptomatic superficial femoral stenosis, via RA, FA and PA. Primary endpoint: technical success, rate of major and minor access site complications. Secondary endpoints: major adverse events (MAE), procedural factors, cross-over rate, and duration of hospitalization. Results Technical success was achieved in 96.6%, 100% and 100% patients in RA, FA and PA group (p=ns). Secondary access site was used in 30%, 3.3% and 30% in the RA, FA and PA access group (p&lt;0.01). Stent implantation was done in the femoral artery in 26.6%, 58.3% and 71.6% cases in RA, FA and PA group (p&lt;0.01). CTO recanalization was performed in 34/36 (100%), 30/30 (100%) and 45/45 (100%) cases successfully in RA, FA and PA group (p=ns). Contrast consumption, fluoroscopy and procedure time was not statistically different, but the X Ray dose was significantly lower in PA than in the RA and FA access group (63.1 vs 162 vs 153 Dyn). The cumulative rate of access site complications in the RA, FA and PA group was 3.3% (0% major and 3.3% minor), 15% (3.3% major and 11.6% minor) and 3.3% (0% major and 3.3% minor) (p&lt;0.01), respectively. The cumulative incidence of MAE's at 6 months in the RA, FA and PA group was 8.3% vs 13.3% and 18.3%. (p&lt;0.05) Conclusion Femoral artery intervention can be safely and effectively performed using radial, femoral and pedal access, but radial and pedal access is associated with less access site complication rate. Pedal access is associated with less X Ray dose than radial and femoral access. Funding Acknowledgement Type of funding source: None

scholarly journals Renal Arteriography via Radial Artery Access with a 125 cm Long Angiographic Catheter

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Ji-Xuan Liu ◽  
Zhi-Jun Sun ◽  
Jin-Da Wang
Keyword(s):  
Success Rate ◽  
Radial Artery ◽  
Femoral Artery ◽  
Differential Analysis ◽  
Renal Arteriography

A 125 cm long catheter makes it possible to perform renal arteriography via radial artery, but its feasibility and safety remain unclear. Our study recruited 1,323 patients grouped by two different vascular accesses to renal arteriography, i.e., femoral artery access and radial artery access. The success rate of angiography was 100% in both groups. Differential analysis showed that the overall complication incidence of radial artery access group was significantly lower (2.5% for radial artery access vs. 4.8% for femoral artery access, p = 0.03 ). From this study, we suggest that using the 125 cm angiographic catheter to perform renal arteriography via radial artery access is feasible and safe.

scholarly journals Microscopic Versus Endoscopic Stapes Surgery: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
JIANNIS HAJIIOANNOU ◽  
Eleni Gkrinia ◽  
Konstantinos Tzimkas-Dakis ◽  
Effrosyni Palla ◽  
Alexandros Brotis ◽  
...  
Keyword(s):  
Success Rate ◽  
Meta Analysis ◽  
Operation Time ◽  
Stapes Surgery ◽  
Cochrane Library ◽  
Efficacy And Safety ◽  
Quality Of Evidence ◽  
Randomized Controlled Studies ◽  
Significant Difference

Objectives Endoscopic approaches constitute a newly introduced and promising technique in the field of stapes surgery, presenting favorable outcomes, so far. This study aims to compare endoscopic and microscopic stapes surgery based on current literature evidence, in terms of their efficacy and safety characteristics. Design We conducted a systematic literature search of three medical databases (Pubmed, Cochrane Library, and Scopus). We focused on randomized controlled studies or observational studies comparing microscopic to endoscopic stapes surgery. Data related to the efficacy and safety of each technique were extracted. Outcome data were summarized using the pooled mean differences or pooled odds ratio along with their 95% confidence intervals, according to the available data. The quality of evidence was assessed according to the GRADE recommendations. Results Thirteen studies with 705 patients were included in the meta-analysis. Success rate was evaluated by estimating air-bone gap improvement, resulting in comparable outcomes for the two techniques (mean difference: -0.20; 95% CI: -0.53, 0.14). No statistically significant difference was detected concerning postoperative complications, except for dysgeusia that was in favor of the endoscopic approach (OR: -1.46; 95% CI: -2.45, -.047). The overall quality of evidence was assessed to range from “Low” to “Very Low”. Conclusion Endoscopic stapes surgery is an innovative alternative to the microscopic technique, resulting in commensurate outcomes in terms of success rate and complications. Further high-quality studies are needed, to adequately compare the two approaches, particularly in terms of operation time, learning curve, cost-effectiveness, and otology surgical skills acquisition.

Casemix and Affective Disorders: A Comparison of Private and Public Psychiatric Systems

1996 ◽  
Vol 30 (4) ◽  
pp. 511-515 ◽  
Author(s):  
Robert D. Goldney ◽  
Penny Kent ◽  
Robert H. Elzinga
Keyword(s):  
Length Of Stay ◽  
Affective Disorders ◽  
Average Length ◽  
South Australia ◽  
Psychiatric Hospitals ◽  
Diagnosis Related Group ◽  
Average Length Of Stay ◽  
Significant Difference ◽  
Private And Public ◽  
Related Group

Objective: To determine whether there is a difference in length of stay for patients with affective disorders between private and public psychiatric hospitals. Method: The casemix Australian national diagnosis-related group (AN-DRG) diagnoses of all inpatient separations from private and public psychiatric hospitals in South Australia for 1 year were abstracted from records. The average length of stay for patients with affective disorders was calculated. Results: There was no significant difference in the average length of stay for patients with affective disorders treated in private and public psychiatric hospitals. Conclusions: These results should allay fears that the treatment of patients with affective disorders in any particular treatment setting will be compromised by the introduction of casemix.

scholarly journals Sustainable, Proficient Fodder Influenced By Bio Diversity in Mineral Composition of Shrub Leaves of Quetta District

2020 ◽  
Vol 1 (1) ◽  
pp. 01-08
Author(s):  
Anam Iqbal
Keyword(s):  
Seasonal Changes ◽  
Small Ruminants ◽  
Critical Value ◽  
X Ray ◽  
Elemental Concentrations ◽  
Significant Difference ◽  
Nomadic People ◽  
Perovskia Abrotanoides ◽  
Animal Grazing

The vegetation of Balochistan is of critical value to the quality of life for the local nomadic people. Many important dominant species used for animal grazing were selected to evaluate their value as fodder during 2016-2017. These plants including Amylgdalus brahuica Boiss, Prunus eburnea Aitch, Caragana ambigua Stocks, Sophora mollis Royle, Perovskia abrotanoides Karel, and Berberis baluchistanica Ahrendt, (as because Sophora mollis were not found in Zarghoon] were collected seasonally from Hazarganji, Karkhasa and Zarghoon area of Quetta district. These were analyzed for macro and micro elemental composition such as P, Ca, Na, K, S, Fe, Zn, Sr, Al and Mn by using atomic absorption, flame photometer and X-ray florescence spectrophotometer. The elemental concentrations were compared with standard feed table of Pakistan Agriculture Research Council. P. eburnea and B. baluchistanica showed good amount of nutrients in their foliage, these two plants were palatable and preferred by the small ruminants, while A. brahuica and C. ambigua showed medium amounts of minerals and fulfill the requirements of the animal as fodder. The animals did not prefer to eat P. abrotanoides may due to its strong smell while S. mollishad deposition of cutin and suberin on their leaves. It was observed that there was no significant difference (P > 0.05] in the concentration of different elements of the forage due to seasonal changes.

scholarly journals The Appropriate Dose of Remimazolam Combined with Remifentanil in Anesthesia for Gastroscopy

2021 ◽  
Author(s):  
Jianyou Zhang ◽  
Maohua Wang ◽  
Fengxia Liu ◽  
Miao Guo ◽  
Yue Zhu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Success Rate ◽  
Heart Rate Recovery ◽  
Ideal Body Weight ◽  
Control Group ◽  
Significant Difference ◽  
Ideal Body ◽  
Diachronic Changes

Abstract Background: The appropriate doses of remimazolam combined with remifentanil were investigated in anesthesia gastroscopy by observing the effect of two methods of administration in fixed doses and dosed by ideal weight on success rate and recover effect in painless gastroscopy. Methods: A total of 400 patients underwent the anesthesia of gastroscopy were randomized to divide into five groups (W1, W2, F1, F2 and C Group) in endoscopy center, with 80 cases in each group. All patients were given 0.25ug/kg of remifentanil before gastroscopy. The success rate, the quality of anesthesia resuscitation, heart rate, blood pressure, Pulse oxygen saturation, perioperative adverse events and Modified observer’ s assessment of alert/sedation (MOAA/S) diachronic changes were recorded. Results: In terms of anesthetic effects of the first dose of the drug(P<0.05), the patients in F1 group showed be lack of sedation obviously. The success rate of induction in F2 group was higher than that in F1 group. The success rate of sedation in W2 groups was highest (96%). The control group was second to W2 Group. Blood pressure in W2 Group was lower than W1 Group after first administration(P<0.05). There was no significant difference in next several minutes. There was no difference in blood pressure between W2 Group and C Group at T1(P>0.05). There was no difference in the changes of heart rate, recovery time and discharge time(P>0.05). The incidence of cough in F1 and W1 is high(P<0.05). Conclusions: Remimazolam combined with remifentanil used were safe, and 0.3mg/kg of remimazolam combined with 0.25ug/kg of remifentanil by ideal body weight is better in painless gastroscopy.Trial registration: The trial was registered on ClinicalTrials.gov: ChiCTR2100041759, registered 4 January 2021.

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