Neonatal Macroglossia

2018 ◽  
Vol 55 (8) ◽  
pp. 1122-1129 ◽  
Author(s):  
Jonathan C. Simmonds ◽  
Anju K. Patel ◽  
Nicholas R. Mildenhall ◽  
Nicholas S. Mader ◽  
Andrew R. Scott
Keyword(s):  
Length Of Stay ◽  
Cross Sectional Study ◽  
Demographic Variables ◽  
Cost Of Care ◽  
Cross Sectional ◽  
Birth Prevalence ◽  
Prolonged Length ◽  
Linear Regression Modeling ◽  
The Cost ◽  
Inpatient Database

Objectives: To examine the birth prevalence of congenital macroglossia and identify demographic variables and comorbidities that may influence length of stay and cost of care. Study Design: Retrospective cross-sectional study using the Kids’ Inpatient Database 2003, 2006, 2009, and 2012. Methods: Demographics were analyzed. Linear regression modeling and multivariate analyses were performed. Results: The birth prevalence of congenital macroglossia was 4.63/100 000 births. Patients were classified as isolated (n = 349, 48.1%) or syndromic (n = 377, 51.9%). A higher incidence of isolated macroglossia was seen in females (odds ratio, OR [95% confidence interval, 95% CI]: 1.93 [1.45-2.56] and African Americans (2.02 [1.41-2.88]). Length of stay was higher for syndromic patients than for nonsyndromic patients (22.6 days [18.6-26.6] vs 7.93 days [5.95-9.90], as were inpatient costs ($3619USD [$27 628-$44 754] vs $10 168USD [$6272-$14 064]. After accounting for gender, race, location, and socioeconomic status, the presence of macroglossia alone increased length of stay by 4.07 days (0.42-7.72 days) in nonsyndromic patients and 12.02 days (3.63-20.4 days) in syndromic patients. The cost of care increased by $6207USD ($576-$11 838) among nonsyndromic newborns and $17 205USD ($374-34 035) among syndromic patients. Conclusion: The birth prevalence of congenital isolated macroglossia appears to vary by sex and race. Prolonged length of stay and increased costs are associated with both isolated macroglossia and syndromic macroglossia, even after controlling for other syndromic comorbidities.

scholarly journals Cross-sectional study of prevalence and risk factors, and a cost-effectiveness evaluation of screening and preventive treatment strategies for latent tuberculosis among migrants in Singapore

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e050629
Author(s):  
Vanessa W Lim ◽  
Hwee Lin Wee ◽  
Phoebe Lee ◽  
Yijun Lin ◽  
Yi Roe Tan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cost Effectiveness ◽  
Length Of Stay ◽  
Latent Tuberculosis ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Sectional Study ◽  
Cross Sectional ◽  
Ltbi Prevalence ◽  
The Cost

ObjectivesWHO recommends that low burden countries consider systematic screening and treatment of latent tuberculosis infection (LTBI) in migrants from high incidence countries. We aimed to determine LTBI prevalence and risk factors and evaluate cost-effectiveness of screening and treating LTBI in migrants to Singapore from a government payer perspective.DesignCross-sectional study and cost-effectiveness analysis.SettingMigrants in Singapore.Participants3618 migrants who were between 20 and 50 years old, have not worked in Singapore previously and stayed in Singapore for less than a year were recruited.Primary and secondary outcome measuresCosts, quality-adjusted life-years (QALYs), threshold length of stay, incremental cost-effectiveness ratios (ICERs), cost per active TB case averted.ResultsOf 3584 migrants surveyed, 20.4% had positive interferon-gamma release assay (IGRA) results, with the highest positivity in Filipinos (33.2%). Higher LTBI prevalence was significantly associated with age, marital status and past TB exposure. The cost-effectiveness model projected an ICER of S$57 116 per QALY and S$12 422 per active TB case averted for screening and treating LTBI with 3 months once weekly isoniazid and rifapentine combination regimen treatment compared with no screening over a 50-year time horizon. ICER was most sensitive to the cohort’s length of stay in Singapore, yearly disease progression rates from LTBI to active TB, followed by the cost of IGRA testing.ConclusionsFor LTBI screening and treatment of migrants to be cost-effective, migrants from high burden countries would have to stay in Singapore for ~50 years. Risk-stratified approaches based on projected length of stay and country of origin and/or age group can be considered.

scholarly journals Analisis zat gizi dan biaya sisa makanan pada pasien dengan makanan biasa

2005 ◽  
Vol 1 (3) ◽  
pp. 108
Author(s):  
Mihir Djamaluddin ◽  
Endy Paryanto Prawirohartono ◽  
Ira Paramastri
Keyword(s):  
Length Of Stay ◽  
Food Waste ◽  
Economic Value ◽  
Food Service ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Regular Diet ◽  
The Difference ◽  
The Cost

Background: The quality of food service in a hospital can be assessed from the inpatients’ nutritional status. Food waste is an indicator of food service among inpatients. Besides its therapeutic value, food has a significant economic value. The wasting cost in term of food waste affects the total availability of food costs.Objective: This study analyzes the nutrient quantity and the cost of food waste among inpatients with regular diet at Dr. Sardjito Hospital, Yogyakarta.Method: This was a cross sectional study. The subjects were inpatients aged 17 to 60 years old who got regular diet with length of stay was at least three days, and were willing to take part in this study (n=100). The amount of food waste was measured using the Comstock visual estimation. The cost of food waste was calculated as the proportion of food waste from cost per serving. The quantity of nutrients in food waste was calculated using the Food Processor 2 software. The data were analyzed using Chi-square test.Results: There was a difference of food waste according to gender. Rice waste was found more frequent among female (p<0,005). There was a difference of food waste according to ward class. There were more waste of meat and vegetables among inpatients in class II and the difference was significant (p<0,05). There were more waste of meat and vegetables among patients with length stay of 7 – 14 days and > 15 days (p<0,05). The vegetables and rice waste were more frequent among surgery and cancer inpatients (p<0,05). In average the nutritional value of food waste was 19,85% - 9,33% of a patient’s RDA, while the wasting cost per day was Rp 1265,08 or 10,79% of all food cost per day. The annual wasting cost of food waste was Rp 45.543.120 or 4,4% of the available budget of Rp 1.038.605.333,00.Conclusion: There were differences of food waste according to gender, ward class, length of stay, and kind of disease, especially rice, meat, and vegetables.

scholarly journals Acute respiratory infections in hospitalised infants with congenital heart disease

2020 ◽  
pp. 1-9
Author(s):  
Namrata Ahuja ◽  
Wendy J Mack ◽  
Susan Wu ◽  
John C Wood ◽  
Christopher J Russell
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Length Of Stay ◽  
Congenital Heart ◽  
Respiratory Infections ◽  
Cross Sectional Study ◽  
Acute Respiratory Infections ◽  
Cross Sectional ◽  
Significant Burden ◽  
Inpatient Database

Abstract Objectives: To assess the overall burden and outcomes of acute respiratory infections in paediatric inpatients with congenital heart disease (CHD). Methods: This is a retrospective cross-sectional study of non-neonates <1 year with CHD in the Kid’s Inpatient Database from 2012. We compared demographics, clinical characteristics, cost, length of stay, and mortality rate for those with and without respiratory infections. We also compared those with respiratory infections who had critical CHD versus non-critical CHD. Multi-variable regression analyses were done to look for associations between respiratory infections and mortality, length of stay, and cost. Results: Of the 28,696 infants with CHD in our sample, 26% had respiratory infections. Respiratory infection-associated hospitalisations accounted for $440 million in costs (32%) for all CHD patients. After adjusting for confounders including severity, mortality was higher for those with respiratory infections (OR 1.5, p = 0.003), estimated mean length of stay was longer (14.7 versus 12.2 days, p < 0.001), and estimated mean costs were higher ($53,760 versus $46,526, p < 0.001). Compared to infants with respiratory infections and non-critical CHD, infants with respiratory infections and critical CHD had higher mortality (4.5 versus 2.3%, p < 0.001), longer mean length of stay (20.1 versus 15.5 days, p < 0.001), and higher mean costs ($94,284 versus $52,585, p < 0.001). Conclusion: Acute respiratory infections are a significant burden on infant inpatients with CHD and are associated with higher mortality, costs, and longer length of stay; particularly in those with critical CHD. Future interventions should focus on reducing the burden of respiratory infections in this population.

scholarly journals Effect of the Movement Control Order on the Incidence of Complicated Appendicitis During the COVID-19 Pandemic: A Cross-Sectional Study

2021 ◽  
Vol 28 (5) ◽  
pp. 130-136
Author(s):  
Hamzah Sukiman ◽  
◽  
Abdul Malek Mohamad ◽  
Muhammad Firdaus Nasution Raduan ◽  
Mohd Nur Afiq Mohd Yasim ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Movement Control ◽  
Cross Sectional Study ◽  
Complicated Appendicitis ◽  
Delayed Presentation ◽  
Sectional Study ◽  
Surgical Morbidity ◽  
Cross Sectional ◽  
Prolonged Length ◽  
Control Order

Background: Appendicitis is common and delayed presentation results in complicated appendicitis with increased morbidity. This study investigates the effect of the Movement Control Order (MCO) during the COVID-19 pandemic on the presentation and severity of appendicitis. Methods: A cross-sectional study including 193 patients diagnosed with appendicitis was conducted at four hospitals in Pahang, Malaysia. Those who presented between 1 February 2020 and 17 March 2020 were included in the pre-MCO group and those between 18 March 2020 and 30 April 2020 in the MCO group. The definitions of simple and complicated appendicitis were based on the Sunshine Appendicitis Grading Score. The primary outcome was the incidence of complicated appendicitis, and the secondary outcomes were length of stay, a composite of surgical morbidities and a composite of organ failure. Results: A total of 105 patients in the pre-MCO group and 88 in the MCO group were analysed. The incidence of complicated appendicitis was 33% and it was higher in the MCO than in the pre-MCO group (44% versus 23%, P = 0.002). The MCO period was independently associated with complicated appendicitis in the logistic regression (P = 0.001). It was also associated with prolonged length of stay (3.5 days versus 2.4 days, P < 0.001) and higher overall surgical morbidity (19% versus 5%, P = 0.002). Conclusion: The MCO imposed during the COVID-19 pandemic was associated with a higher incidence of complicated appendicitis and surgical morbidity.

scholarly journals Delayed Discharge for Non-Clinical Reasons in Hip Procedures: Differential Characteristics and Opportunity Cost

2021 ◽  
Vol 18 (17) ◽  
pp. 9407
Author(s):  
Amada Pellico-López ◽  
Ana Fernández-Feito ◽  
David Cantarero ◽  
Manuel Herrero-Montes ◽  
Joaquín Cayón-De Las Cuevas ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Urban Area ◽  
Functional Recovery ◽  
Opportunity Cost ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Prolonged Stay ◽  
Delayed Discharge ◽  
The Mean ◽  
The Cost

Delayed discharge for non-clinical reasons shares common characteristics with hip procedures. We sought to quantify the length of stay and related costs of hip procedures and compare these with other cases of delayed discharge. A cross-sectional study was conducted at a public hospital in Spain (2007–2015) including 306 patients with 6945 days of total stay and 2178 days of prolonged stay. The mean appropriate stay was 15.58 days, and the mean prolonged stay was 7.12 days. The cost of a prolonged stay was €641,002.09. The opportunity cost according to the value of the hospital complexity unit was €922,997.82. The mean diagnostic-related groups’ weight was 3.40. Up to 85.29% of patients resided in an urban area near the hospital (p = 0.001), and 83.33% were referred to a long-stay facility for functional recovery (p = 0.001). The proportion of patients with hip procedures and delayed discharge was lower than previous reports; however, their length of stay was longer. The cost of prolonged stay could account for 21.17% of the total. Compared with the remaining cases of delayed discharge, the appropriate stay was shorter in hip procedures, with a profile of older women living in an urban area close to the hospital and referred to a long-stay center for functional recovery.

Prevalence of Trichomonas Vaginalis and its Correlation with Socio-demographic Variables in Pregnant Women in Al-Diwaniya,Iraq

2018 ◽  
Vol 9 (SPL1) ◽  
Author(s):  
Shiren Ali Al Hamzawi
Keyword(s):  
Pregnant Women ◽  
Rural Areas ◽  
Trichomonas Vaginalis ◽  
Cross Sectional Study ◽  
Demographic Variables ◽  
Transmitted Infection ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
Vaginal Swabs ◽  
Low Education

Estimates of Trichomonas vaginalis prevalence in pregnant women are variable with few studies in Iraq.T. vaginalis is a worldwide prevalent sexually transmitted infection,but fortunately,it is very treatable. Researchers believed that pregnancy is one of the effective factors for T. vaginalis infection in women.A cross-sectional study performed in Obstetrics and Gynecology Department at Maternity and Children Teaching Hospital in Al-Diwaniya city on two hundred female pregnant patients between the ages of 16-45 years. These females had no intercourse for 2–3 days,not using drugs (antibiotics,antiprotozoal or steroids) for the last 15 days. Vaginal discharges of any type with or without itching,burning sensation or both were their main complaints. Vaginal swabs were taken from all participating patients for direct wet mount microscopy and culture for the detection of Trichomonas vaginalis infection. The study showed that twelve out of two hundred examined pregnant women (6%) presented with T. vaginalis infection. The infection was more in those with mothers’ age (26-35) years,housewives,low education,higher parity,and of rural residents. Other maternal variables were not significantly associated with T. vaginalis infection. The study showed a prevalence of (6%) of T. vaginalis infection in pregnant female attendees. Infection was more in those with mothers ’age (26-35) years,housewives,low educational level,higher parity,and living in rural areas.

scholarly journals Assessment of Knowledge, Practice and Attitude about Biomedical Waste Management among Healthcare Professionals during COVID-19 Crises in Al-Ahsa

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 747
Author(s):  
Sahbanathul Missiriya Jalal ◽  
Fahima Akhter ◽  
Amal Ismael Abdelhafez ◽  
Ahmed Mansour Alrajeh
Keyword(s):  
Work Experience ◽  
Healthcare Professionals ◽  
Cross Sectional Study ◽  
Demographic Variables ◽  
Cross Sectional ◽  
Biomedical Waste ◽  
Respiratory Therapists ◽  
Global Pandemic ◽  
Before And After ◽  
Knowledge Practice

Biomedical waste (BMW) management is an essential practice of healthcare professionals (HCPs) for preventing health and also environmental hazards. Coronavirus disease (COVID-19) has become a global pandemic, posing significant challenges for healthcare sectors. A cross-sectional study was performed to assess the knowledge, practice, and attitude on BMW management among HCPs when taking care of patients with COVID-19 and associated with demographic variables. From Al-Ahsa healthcare sectors, 256 HCPs were selected randomly, of which 105 (41%) had excellent knowledge, 87 (34%) had good knowledge, and 64 (25%) had poor knowledge with a mean score of 13.1 ± 3.6. A higher mean score was (14.4 ± 3.2) obtained by physicians, and (13.6 ± 3.8) nurses than the other HCPs. Regarding practice, 72 (28.1%) HCPs used and discarded PPE while handling biomedical wastes. Additionally, 88 (34.4%) followed proper hand hygiene before and after each procedure and whenever needed. Physicians, nurses, and respiratory therapists had a more favorable attitude than other HCPs. There was a statistically significant association found among knowledge level and educational qualification (p < 0.0001), gender (p < 0.001), and work experience (p < 0.05). Emphasis is needed to train all HCPs regarding proper BMW management during this pandemic to prevent infection transmission.

scholarly journals Patients’ Perspectives about Lifestyle Behaviors and Health in the Context of Family Medicine: A Cross-Sectional Study in Portugal

2021 ◽  
Vol 18 (6) ◽  
pp. 2981
Author(s):  
Rosália Páscoa ◽  
Andreia Teixeira ◽  
Micaela Gregório ◽  
Rosa Carvalho ◽  
Carlos Martins
Keyword(s):  
Family Medicine ◽  
Family Doctor ◽  
Cross Sectional Study ◽  
Demographic Variables ◽  
Future Research ◽  
Lifestyle Behaviors ◽  
Sectional Study ◽  
Self Assessment ◽  
Cross Sectional ◽  
The Family

Lifestyle interventions are recognized as essential in the prevention and treatment of non-communicable diseases. Previous studies have shown that Portuguese patients tend to give more importance to diagnostic and laboratory tests than to lifestyle measures, and seem unaware that behavioral risks are the main modifiable risk factors. The study aimed to analyze patients’ perspectives about lifestyle behaviors and health in the context of family medicine in Portugal. A population-based cross-sectional study was carried out in Portugal (the mainland). A total of 900 Portuguese patients aged ≥20 years, representative of the population, were surveyed using face-to-face questionnaires. Participants were selected by the random route method. Descriptive statistics and non-parametric tests were performed to evaluate differences between the personal beliefs and the personal behavior self-assessment, as well as between the level of importance given to the family doctor to address health behaviors and the reported approach implemented by the family doctor, and its association with bio-demographic variables. The results indicate that the vast majority of this Portuguese cohort has informed beliefs regarding lifestyle behaviors, tends to overestimate their own behavior self-assessment, and strongly agrees that it is important that their family doctor asks/advises on these lifestyle behaviors, although the proportion of those who totally agree that their family doctor usually does this is significantly lower. Differences concerning bio-demographic variables were found. Future research directions should focus on the politics, economics, and policy aspects that may have an impact in this area. It will also be important to understand more broadly the relationships between lifestyle behaviors and clinical, physical, and sociodemographic variables.

A Comparison of Falls and Dizziness Handicap by Vestibular Diagnosis

2021 ◽  
pp. 1-10
Author(s):  
Ryan J. Huang ◽  
Sherri L. Smith ◽  
Libor Brezina ◽  
Kristal M. Riska
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Demographic Variables ◽  
Vestibular Migraine ◽  
Cross Sectional ◽  
Positional Vertigo ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Paroxysmal Positional Vertigo

Purpose There is a paucity of data that directly compares the falls rate and dizziness handicap of different vestibular diagnoses. The purpose of this study is to compare the falls rate and dizziness handicap of common vestibular diagnoses encountered among a cohort of vestibular patients at a single institution. Method We conducted a retrospective cross-sectional study of patients evaluated for dizziness at a tertiary care center vestibular clinic between August 1, 2017, and March 19, 2019. Vestibular diagnosis, demographic variables, comorbidities, falls status, and Dizziness Handicap Inventory (DHI) were extracted from the medical record for analysis. Associations between vestibular diagnosis and falls history or DHI were evaluated using multivariate logistic and linear regression, respectively. Results A total of 283 patients met our inclusion criteria with the following diagnoses: benign paroxysmal positional vertigo (BPPV; n = 55), acoustic neuroma ( n = 30), Ménière's disease ( n = 28), multiple vestibular diagnoses ( n = 15), vestibular migraine ( n = 135), or vestibular neuritis ( n = 20). After adjusting for age, sex, race, medications, and comorbidities, the odds of falling was 2.47 times greater (95% CI [1.08, 6.06], p = .039) and the DHI score was 11.66 points higher (95% CI [4.99, 18.33], p < .001) in those with vestibular migraine compared to those with BPPV. Other diagnoses were comparable to BPPV with respect to odds of falling and dizziness handicap. Conclusions Patients with vestibular migraine may suffer an increased risk of falls and dizziness handicap compared to patients with BPPV. Our findings highlight the need for timely evaluation and treatment of all patients with vestibular disease.

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