Abstract 56: Acute Stroke Reperfusion Treatment Rates at NIH StrokeNET Hospitals

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Opeolu Adeoye ◽  
Dawn Kleindorfer
Keyword(s):  
Clinical Trials ◽  
High Volume ◽  
The United States ◽  
Primary Diagnosis ◽  
Categorical Variables ◽  
Phase 3 ◽  
Chi Square ◽  
Successful Recruitment ◽  
Chi Square Test ◽  
Reperfusion Phase

Background: In 2013, the NIH Stroke Trials Network (StrokeNET) was established to maximize efficiencies in stroke clinical trials. Successful recruitment in future trials was required for participating sites. A high volume of cases treated is a surrogate for the potential to recruit. Among Medicare-eligible acute ischemic stroke (AIS) cases, we estimated the IV rt-PA and endovascular embolectomy treatment rates at StrokeNET Regional Coordinating Centers and their partner hospitals compared with non-StrokeNET hospitals in the United States (US). Methods: We used demographics and IV rt-PA and embolectomy rates in the 2013 Medicare Provider and Analysis Review (MEDPAR) dataset. ICD-9 codes 433.xx, 434.xx and 436 identified AIS cases. ICD-9 code 99.10 defined rt-PA treatment and ICD-9 code 39.74 defined embolectomy. Demographics and treatment rates at StrokeNET and non-StrokeNET sites were compared using t-test for proportions and Chi-square test for categorical variables as appropriate. Results: Of 386,157 AIS primary diagnosis discharges, 5.1% received IV rt-PA and 0.8% had embolectomy (Table). By June 6, 2014, StrokeNET comprised 247 acute care hospitals that discharged 48,946 (13%) out of 386,157 AIS cases. rt-PA (7.4% vs 4.8%) and embolectomy (1.9% vs 0.6%) treatment rates were higher at StrokeNET hospitals. In 2013, 36% of StrokeNET hospitals treated more than 20 AIS cases with rt-PA or embolectomy compared with 6% of non-StrokeNET hospitals (P<0.0001).Conclusions StrokeNET hospitals treat more AIS cases with acute reperfusion therapies. Thus, StrokeNET could successfully recruit in acute reperfusion clinical trials depending on study size, capture of eligible patients and the number of competing trials. We likely underestimated treatment rates due to not accounting for drip-and-ship and non-Medicare cases. To further enhance enrollments in large acute reperfusion phase 3 trials, partnership with high volume non-StrokeNET hospitals may be warranted.

scholarly journals 350. Neurocysticercosis – Gender Differences in Clinical Presentations

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S244-S244
Author(s):  
Bharath Pendyala ◽  
Prasanth Lingamaneni ◽  
Patricia DeMarais ◽  
Lakshmi Warrior ◽  
Gregory Huhn
Keyword(s):  
Gender Differences ◽  
Categorical Variables ◽  
Public Health Issue ◽  
Diagnostic Code ◽  
Continuous Variables ◽  
Chi Square ◽  
Generalized Seizures ◽  
Icd 10 ◽  
Chi Square Test ◽  
Reported Data

Abstract Background Neurocysticercosis is a Neglected Tropical Disease and an important public health issue. Our goal was to collect and analyze data regarding clinically significant gender differences among our Neurocysticercosis patients. Methods A retrospective chart search with ICD 9/ ICD 10 diagnostic code for Neurocysticercosis and neuroimaging suggestive of Neurocysticercosis was performed for clinical encounters in the hospital or affiliated clinics between years 2013–2018. After a careful chart review, patients who were clinically diagnosed with Neurocysticercosis were included in the study. T-test was used to compare means of continuous variables and chi-square test to compare proportions of categorical variables. Results Among 90 total patients included, male (49.4%) and female (50.6%) distribution were nearly identical. The mean age in females was found to be higher than males (52.5 vs 42.0, P &lt; 0.0001). Almost an equal number of males and females presented with either seizures (63.6% vs 57.8%, P= 0.85), headaches (25.0% vs 28.9%, p= 0.85), or other symptoms (11.4% vs 13.3%, p= 0.85). Males had more generalized seizures compared to females (60% vs 38%, P= 0.37), although this result was not statistically significant. Females were more likely to present with &gt; 1 lesion (82.2% vs 56.8%, P= 0.01). Males were more likely to have cystic lesions (64.7% vs 27.9%, P &lt; 0.001) compared to females who had more calcified lesions on presentation (65.1% vs 20.6%, P &lt; 0.001). Male patients were more likely to have contrast enhancement or edema surrounding the lesions (61.4% vs 33.3%, P= 0.01) and were more likely to require treatment with Albendazole/Praziquantel (75.8% vs 31.7%, P &lt; 0.001). Conclusion Although previously reported data is limited, there is a suggestion that there are gender differences in host immune response and that inflammation surrounding parenchymal lesions is more intense in females. This study suggests that men either present early in the disease phase or have different immune responses than women and require anti-parasitic therapy more frequently. More research in this aspect is needed. Disclosures All Authors: No reported disclosures

Abstract 177: Credentials of Staff Performing Echocardiography in the United States: Insights from the Intersocietal Accreditation Commission

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
Matthew W Parker ◽  
Diana Sobieraj ◽  
Mary Beth Farrell ◽  
Craig I Coleman
Keyword(s):  
United States ◽  
Cardiovascular Diseases ◽  
The United States ◽  
Chi Square ◽  
Volume Number ◽  
National Board ◽  
Formal Level ◽  
Chi Square Test ◽  
Level 3 ◽  
Medical Directors

Background: Little has been published on the practice of echocardiography (echo) in the United States. We used the Intersocietal Accreditation Commission-Echocardiography (IAC-Echo) applications database to describe the personnel in echo laboratories seeking accreditation. Methods: We used de-identified data provided on IAC-Echo applications to characterize facilities by hospital association, census region, annual volume, number of sites, previous accreditation, and numbers of physicians and sonographers as well as National Board of Echocardiography (NBE) testamur status of physicians and registered credential status of sonographers. We categorized Medical Directors by board certification in cardiovascular diseases, internal medicine, other specialty, or none. Medical Director echo training could be formal Level 2 or 3 or experiential by ≥3 years of practice. Frequencies, means, and medians were compared between groups using the chi-square test, t-test, or Mann Whitney test, respectively. Results: From 2011 to 2013, 1926 echo labs representing 10618 physicians and 6870 sonographers applied for IAC-Echo accreditation or re-accreditation. The majority of medical directors were board certified in cardiovascular diseases and 34.1% of medical directors and 27.2% of staff physicians held NBE testamur status; 79.5% of sonographers held registered credentials. Most echo labs were in the Northeast or South census regions, have an average of 1.75 sites, and are based outside of hospitals (Table). Compared to nonhospital echo labs, medical directors of hospital-based echo labs were more likely to be Level 3 trained (19.8% versus 30.8%, p<0.01) and be NBE testamurs (28.9% versus 45.6%, p<0.01). Markers of echo lab size, region, previous accreditation, and credentialed sonographers were associated with accreditation versus delay decisions; there was a trend toward accreditation among facilities with NBE medical directors. Conclusion: Among facilities seeking IAC-Echo accreditation, the minority of echo physicians hold NBE testamur status. Hospital and nonhospital facilities are different in the credentials of their personnel.

scholarly journals Relationship Between Undernutrition and Periodontal Diseases Among Yemen Population: a Cross-sectional Study

2020 ◽  
Author(s):  
Milad Al-kalisi ◽  
Manal Al-Hajri ◽  
Sarah Al-Rai
Keyword(s):  
Periodontal Diseases ◽  
Cross Sectional Study ◽  
Categorical Variables ◽  
Fisher Exact Test ◽  
Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Mean Values ◽  
Khat Chewing ◽  
Chi Square Test

Abstract Background: Undernutrition is an inadequate supply of energy and nutrients. Periodontal diseases (PDs) defined as a broad form of chronic inflammatory diseases of the gingiva, bone and ligaments supporting the teeth. This study aimed to reveal the effect of undernutrition, using body mass index (BMI) and serum albumin level (Alb) on PDs and other risk factors as age, smoking and khat chewing. Methods: This was a cross-sectional study conducted at the faculty of dentistry, Sana’a University. Of 1920 patients attended to clinics, only 229 matched the study criteria. Oral examination was performed to assess the periodontal clinical parameters measurements. BMI and Alb was measured. Statistical analysis was used to present the association between categorical variables was assessed using Chi square test and Fisher-Exact test. ANOVA was used to assess the differences in the mean values of the quantitative outcomes. Chi square test was used to evaluate the association between BMI and age, gender, occupation, education level, smoking, khat chewing as well as BMI with PDs. Results: Most of participants (58.5%) were males and most of the study sample (91.3%) was at the age group of (18-35). Among all subjects, (81.2%) of cases were diagnosed with gingivitis. (60.7%) of study participants were mildly undernourished according to BMI. (93%) of participants showed normal Alb level. Regarding to habits, only (18.2%) of patients were smokers and more than half of participants (59.4%) were khat chewers. Conclusion: There was a relationship between PDs and undernutrition which was obviously seen between gingivitis and mild undernutrition.

scholarly journals An audit of US FDA warning letters issued to sponsors, institutional review boards and investigators over a six-year period

2021 ◽  
pp. 01-06
Author(s):  
Unnati Saxena ◽  
Debdipta Bose ◽  
Shruti Saha ◽  
Nithya J Gogtay ◽  
Urmila M Thatte
Keyword(s):  
Adverse Drug Events ◽  
The United States ◽  
Institutional Review Boards ◽  
Chi Square ◽  
Institutional Review ◽  
United States Food ◽  
Post Marketing ◽  
Chi Square Test ◽  
Us Fda ◽  
Review Boards

The present audit was carried out with the objective of evaluating warning letters (WLs) issued to trial sponsors, clinical investigators and institutional review boards (IRBs) by the United States Food and Drug Administration during a six-year period and compare it with two similar earlier audits. WLs were reviewed and classified as per stakeholders and further categorised as per predefined violation themes. The chi-square test was performed for trend analysis of WLs. A total of 62 WLs were issued to the three stakeholders. The maximum number of WLs were issued to the clinical investigators (36/62, 58.06%), followed by sponsors (19/62, 30.64%), and least to the IRBs (7/62, 11.29%). Among sponsors, lack of standard operating procedures for the monitoring, receipt, evaluation and reporting of post-marketing adverse drug events was the most common violation theme (8/19, 42.1%). Among clinical investigators, deviation from investigational plan was the most common violation theme (31/36, 86.11%.). For IRBs, inadequate documentation was the most common violation theme (6/7, 85.71%). We saw an overall reduction in the number of WLs issued to the stakeholders. Thus, we identified multiple areas on which each stakeholder should work for improvement.

scholarly journals Vulnerabilidade social e a cárie dentária na primeira infância

2021 ◽  
Vol 2 (6) ◽  
pp. 1550-1562
Author(s):  
Amanda Albuquerque Diniz ◽  
Isabelle Monteiro Da Silva Lima ◽  
Karyne Barreto Gonçalves Marques ◽  
Luiz Carlos Costa Madeira Alves ◽  
Ingrid Cordeiro Monte ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Early Childhood ◽  
Social Vulnerability ◽  
Descriptive Statistics ◽  
Categorical Variables ◽  
Chi Square ◽  
Cross Sectional ◽  
The Social ◽  
Chi Square Test

Objetivo: Estimar a prevalência da cárie em crianças na primeira infância sob vulnerabilidade social. Métodos: Pesquisa do tipo transversal realizada no Instituto da Primeira Infância - Iprede, com crianças sob vulnerabilidade social em Fortaleza, Ceará. A coleta de dados foi realizada, em dezembro de 2018 a abril de 2019, com 363 crianças aleatoriamente, por meio de exame bucal e questionário. Os dados foram analisados através de estatística descritiva e do teste qui-quadrado para variáveis categóricas. Resultados: Observou-se uma prevalência de cárie de 35,6%, e que de 1 a 4 lesões representavam a maior porcentagem (23,7%). Elevado percentual de crianças nunca foi ao dentista (81,3%); semelhante percentual nunca sentiu dor de dente (82,3%). Conclusão: Apesar da vulnerabilidade social, a prevalência de cárie foi baixa, e sugere-se realização de ações para minimizar os efeitos da doença na qualidade de vida e desenvolvimento infantil.   Objective: To estimate the prevalence of caries in children in early childhood under social vulnerability. Methods: Cross-sectional research conducted at the Instituto da Primeira Infância - Iprede, with children under social vulnerability in Fortaleza, Ceará. Data collection was carried out, from December 2018 to April 2019, with 363 children randomly, through oral examination and questionnaire. The data were analyzed using descriptive statistics and the chi-square test for categorical variables. Results: There was a prevalence of caries of 35,6%, with 1 to 4 caries representing the highest percentage (23,7%). A high percentage of children never went to the dentist (81,3%); a similar percentage never experienced toothache (82,3%). Conclusion: Despite the social vulnerability, the prevalence of caries was low, and actions to minimize the effects of the disease on quality of life and child development are suggested.

scholarly journals Non-Prescription Antibiotic Use For People Aged 15 Years Or Older For Cough In China: A Community-Based Survey

2021 ◽  
Author(s):  
Yan Luo ◽  
Xuewen Tang ◽  
Lingling Ding ◽  
Zhujun Shao ◽  
Jianxing Yu ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Univariate Analysis ◽  
Antibiotic Use ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Chi Square ◽  
Main Driver ◽  
Antibiotics Use ◽  
Chi Square Test ◽  
Use Behavior

Abstract Background Non-prescription antibiotic use at community is a main driver of antimicrobial resistance. Cough is a common condition and prevalent in all communities, including China. This study aims to investigate the non-prescription antibiotic use for cough in China and explore to which extent antibiotic use knowledge was correctly instructed in communities.Methods A probability-proportionate-to-size (PPS) sampling method was adopted to survey from all 14 communities in Yiwu city, China. All participants were investigated by face-to-face interview on Portable Android Devices (PADs). The continuous variables were presented by mean and standard deviation (SD) or medium and inter-quartile range (IQR). The categorical variables were presented using percentage or constituent ratio. Chi-square test for univariate analysis and logistic regression for multivariate analysis were conducted to assess the odds ratios (ORs) and 95% confidence intervals (CIs), respectively.Results A total of 3034 respondents across the 14 communities and the 50 natural villages/streets completed all key items of the questionnaire. Of 2400 (79.10%) respondents stated that they experienced cough in the past 12 months with the medium age of 36.5 (IQR: 26-49) and 12.21% (293/2400) respondents had the non-prescription antibiotic use behavior. Among those 293 respondents, the proportion of non-prescription antibiotic use for cough peaked at around 16% among people aged 30-39 years old. The major sources of antibiotics were pharmacy (77.70%) and/or family storage (43.92%). As for antibiotic knowledge in 3034 participants, 61.8% participants had minimal knowledge on broad-spectrum antibiotic and 53.76% were not familiar about the effects of joint use.Conclusions Non-prescription antibiotics use for cough is prevalent in the community, especially among people in their thirties. Strengthened drug purchase regulation and well-trained professional pharmacists would be promising alternatives to ameliorate AMR. Moreover, penetrating antibiotics knowledge to common citizens and is an urgent task to alleviate antimicrobial resistance. Therefore, proactive policies and regulations should be made to improve current situations.

scholarly journals Evaluation of the Risk of Clinical Deterioration among Inpatients with COVID-19

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Víctor O. Costa ◽  
Eveline M. Nicolini ◽  
Bruna M. A. da Costa ◽  
Fabrício M. Teixeira ◽  
Júlia P. Ferreira ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Lung Parenchyma ◽  
Clinical Deterioration ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Chi Square ◽  
Exact Test ◽  
Laboratory Confirmation ◽  
Chi Square Test ◽  
Imaging Markers

This study aims to assess the risk of severe forms of COVID-19, based on clinical, laboratory, and imaging markers in patients initially admitted to the ward. This is a retrospective observational study, with data from electronic medical records of inpatients, with laboratory confirmation of COVID-19, between March and September 2020, in a hospital from Juiz de Fora-MG, Brazil. Participants (n = 74) were separated into two groups by clinical evolution: those who remained in the ward and those who progressed to the ICU. Mann–Whitney U test was taken for continuous variables and the chi-square test or Fisher’s exact test for categorical variables. Comparing the proposed groups, lower values of lymphocytes ( p  = <0.001) and increases in serum creatinine ( p  = 0.009), LDH ( p  = 0.057), troponin ( p  = 0.018), IL-6 ( p  = 0.053), complement C4 ( p  = 0.040), and CRP ( p  = 0.053) showed significant differences or statistical tendency for clinical deterioration. The average age of the groups was 47.9 ± 16.5 and 66.5 ± 7.3 years ( p  = 0.001). Hypertension ( p  = 0.064), heart disease ( p  = 0.048), and COPD ( p  = 0.039) were more linked to ICU admission, as well as the presence of tachypnea on admission ( p  = 0.051). Ground-glass involvement >25% of the lung parenchyma or pleural effusion on chest CT showed association with evolution to ICU ( p  = 0.027), as well as bilateral opacifications ( p  = 0.030) when compared to unilateral ones. Laboratory, clinical, and imaging markers may have significant relation with worse outcomes and the need for intensive treatment, being helpful as predictive factors.

scholarly journals Impact of Donor Inflow in COVID 19 Pandemic: A Tertiary Care Hospitals Blood Service Experience

2021 ◽  
Vol 33 (1) ◽  
pp. 70-75
Author(s):  
Md Abdul Quader ◽  
Quazi Tarikul Islam
Keyword(s):  
Tertiary Care ◽  
Hospital Setting ◽  
Police Department ◽  
Distribution Patterns ◽  
Categorical Variables ◽  
Time Interval ◽  
Continuous Variables ◽  
Chi Square ◽  
Travel Restrictions ◽  
Chi Square Test

Background: The severe acute respiratory syndrome (SARS) causing the COVID 19 pandemic infection has affected one and all across the world and halting mosthuman activities. During the disease outbreak and country lockdown, Blood Transfusion Services faced numerous challenges to maintain the sustainability in service provision. We intend to identify the challenges faced during COVID-19 outbreak and the following imposed national lockdown. Methods: This retrospective study was done during the lockdown period from26/03/2020 to 30/05/2020 comprising 66 days to detect donor inflow declination and to compare the donor inflow with pre lockdown and post lockdown period of same duration. The periods were divided into six equal intervals to compare donor distribution patterns in lockdown, pre lockdown and post lockdown period. Mean and standard deviation was calculated for continuous variables and chi square test was done for categorical variables. Results: The donations collected during the lockdown period and post lockdown period were almost 71.37% and 62.82% less respectively when compared with the pre lockdown collection (211and 274 versus 737).While in interval periods, donor inflow was declined substantially in lockdown period and in post lockdown period, inflow was declined as of lockdown period initially but it increases as time passed. But the increment was not as such of pre lockdown period. Donor inflow in age group and time interval of donation frequency were statistically significant (p <0.00005 and p< 0.0037 respectively). Conclusion: Concerns of being infected through hospital contact, lack of public transport facilities, travel restrictions imposed by the police department, and no availability of medical student donors in the hospital setting were the main attributing factors for donor inflow. Bangladesh J Medicine July 2022; 33(1) : 70-75

CERVICAL CANCER AMONG 39 YEARS OR YOUNGER FEMALES IN SOUTH INDIA; A RETROSPECTIVE STUDY

2021 ◽  
pp. 15-17
Author(s):  
B Ramkumar ◽  
Srigopal Mohanty ◽  
Kiranmayee Narapaneni ◽  
Amit Saklani ◽  
J Kannan
Keyword(s):  
Cervical Cancer ◽  
Retrospective Study ◽  
Older Women ◽  
Young Women ◽  
Clinicopathological Characteristics ◽  
Categorical Variables ◽  
Chi Square ◽  
Younger Women ◽  
Ciency Virus ◽  
Chi Square Test

Background: Cervical cancer in young women is rare and disparity exists in its characteristics in the available reports. The study aimed to determine the disease burden and to compare its clinicopathological characteristics with older women. Materials and methods: Retrospective study was performed by retrieving data from the cancer registry for consecutive 843 cervical cancer patients treated in the center between 2017 and 2020. Patients were divided into younger (<40 years) and older (≥ 40 years) age. Statistical analysis was performed using SPSS software version 23 for windows. Chi square test was used for analyzing the categorical variables and P < 0.05 was considered signicant. Results: Cervical cancer in young women constituted 9.4%, with majority (96.2%) belonged to 30-39 years age. Higher prevalence of human immunodeciency virus (HIV) was found among younger compared to older women (P = 0.000). Younger women commonly presented late compared to older women (patients presented after 4 months are 49.4% vs. 18.8% respectively, P=0.000). Squamous cell carcinoma was commonest histology in both the groups and no difference in histology pattern between the two groups. Younger women had higher rate of bulky tumor (>4cm) compared to older (62.2% vs. 44.4%, P = 0.023). Conclusion: Delayed and advanced stage of presentation of cervical cancer in younger women in this region of India warrants promotion of health education, knowledge translation, regular cervical cancer screening for its prevention and early detection

Predictors of 30-day readmission rate after total gastrectomy in patients with gastric malignancy.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16109-e16109
Author(s):  
Miguel Salazar ◽  
Estefania Gauto ◽  
Shristi Upadhyay Upadhyay Banskota ◽  
Pedro Palacios ◽  
Trilok Shrivastava ◽  
...  
Keyword(s):  
Total Gastrectomy ◽  
Economic Burden ◽  
Readmission Rate ◽  
Hospital Costs ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Chi Square ◽  
Prolonged Length ◽  
Chi Square Test ◽  
Gastric Malignancy

e16109 Background: Total gastrectomy with lymph node dissection is curative for early gastric malignancy which accounts for 1.5% of cancer cases in the U.S. Readmissions are common postoperatively, and are associated with increased morbidity, mortality, hospital costs and decreased quality of life. We hence aim to identify incidence, impact and independent predictors for readmission in patients who underwent total gastrectomy in gastric malignancy. Methods: We conducted a retrospective cohort study of the 2017 National Readmission Database (NRD) of adult patients readmitted within 30 days after an index admission for total gastrectomy with a concomitant diagnosis of gastric malignancy. T-test was used for continuous variables and chi square test was used for categorical variables. Multivariate regression was used to identify predictors for unplanned readmissions. ICD 10 codes were used to identify diagnoses and procedures. Results: A total of 1,779 patients with gastric malignancy underwent total gastrectomy. The 30-day readmission rate was 18.5%. Main causes for readmission were sepsis, ventricular fibrillation, recurrent STEMI. Readmitted patients were more likely to be on chemotherapy. (40.1% vs 27.2%; P<0.01) and more likely to be discharged to a skilled facility (13.5% vs 17.9%; P<0.01). The total health care in-hospital economic burden of readmission was $6.5 million in total charges and $25 million in total costs. Independent predictors of readmission were major bleeding, respiratory failure requiring mechanical ventilation, peripheral parenteral nutrition, history of non-alcoholic hepato-steatosis, and prolonged length of stay. Conclusions: Readmissions after gastrectomy in patients with gastric malignancies are associated with lower in-hospital mortality yet pose a substantial economic burden on healthcare. The lower mortality might be explained by the relatively stable course and lower comorbidities of patients who become eligible for discharge after surgery. Further studies are suggested. Modifiable risk factors like malnutrition and sepsis warrant special attention to decrease readmissions and improve overall outcomes.[Table: see text]

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