Prescription of Antimicrobial Drugs to Hospitalized Children

1993 ◽  
Vol 27 (7-8) ◽  
pp. 974-977 ◽  
Author(s):  
Josef V. Kolář ◽  
Eva Kadáková
Keyword(s):  
Retrospective Study ◽  
Length Of Stay ◽  
Outcome Measures ◽  
Teaching Hospital ◽  
Medical Records ◽  
Hospitalized Children ◽  
Antimicrobial Drugs ◽  
Pediatric Clinic ◽  
The Mean

OBJECTIVE: To analyze with regard to age, gender, and diagnosis, the profile, frequency of prescribing, and cost of antimicrobial drugs (AMDs) in hospitalized children. DESIGN: Retrospective study of medical records of children hospitalized during 1987 and 1988. SETTING: First Pediatric Clinic, Children's Teaching Hospital, Bratislava, Czechoslovakia (now Slovakia). PATIENTS: One thousand randomly selected hospitalized children. MAIN OUTCOME MEASURES: Patterns of AMD prescribing. Consumption is expressed by the number of drugs and cost per child. RESULTS: AMDs were prescribed to 69.9 percent of the patients (average 1.91 per patient). Ampicillin was the drug most frequently prescribed (20.0 percent), followed by oxacillin (12.8 percent). The mean length of stay was 15.9 days. An average of 3.61 drugs from other pharmacotherapeutic categories were prescribed per patient. Most children who received AMD treatment were in the 1-year group (patients between six months and 1.5 years of age [88.6 percent]). CONCLUSIONS: This study provides an overview of the prescribing of AMDs and other drugs in hospitalized children in Bratislava.

scholarly journals Prevalence of Dermatological Presentations of Canine Leishmaniasis in a Nonendemic Area: A Retrospective Study of 100 Dogs

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Roberta Perego ◽  
Daniela Proverbio ◽  
Giada Bagnagatti De Giorgi ◽  
Eva Spada
Keyword(s):  
Immune System ◽  
Retrospective Study ◽  
Medical Records ◽  
Canine Leishmaniasis ◽  
Inclusion Criteria ◽  
Continuous Stimulation ◽  
Exfoliative Dermatitis ◽  
The Mean ◽  
Endemic Areas ◽  
Stimulation Of

This retrospective study determined the prevalence of dermatological lesions associated with canine leishmaniasis (CanL) in a nonendemic area in Italy. The medical records of 131 dogs with CanL were reviewed and, of these, 115/131 dogs (88%) had dermatological manifestations of which 100/131 dogs (76%) met the inclusion criteria. Sixty-two percent of dogs were male and 38% were female and the mean age was 6.4 years. Thirty-two percent of dogs were mixed breeds; the remainder represented a variety of pure breeds. In 79% of dogs dermatological signs occurred in association with systemic signs of CanL, whilst 21% of dogs had only dermatological manifestations. The most common dermatological manifestation was exfoliative dermatitis (74%), followed by ulcerative (18%) and nodular (11%) lesions. In 51% of dogs the lesions were localized mainly on the pinnae, head, and pressure points; in the remaining 49% lesions were generalized. The only statistically significant association was between Retriever breed and animals with only dermatological signs (P=0.0034, OD 5.97, CI 0.996–37.933). In this study dermatological manifestations of CanL were very commonly reported, and their prevalence is similar to previous studies in endemic areas despite the fact that dogs living in nonendemic areas are not exposed to repeated infectious bites and continuous stimulation of the dermal immune system.

scholarly journals Endoscopic posterior cordotomy for treatment of dyspnea due to vocal fold immobility

2020 ◽  
Vol 15 ◽  
Author(s):  
Narin Nard Carmel Neiderman ◽  
Max Chason ◽  
Anat Wengier ◽  
Oshri Wasserzug ◽  
Oren Cavel ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Respiratory Distress ◽  
Surgical Procedures ◽  
Medical Records ◽  
Vocal Fold ◽  
Surgical Intervention ◽  
Acute Setting ◽  
Vocal Fold Immobility ◽  
The Mean

Introduction: Several surgical procedures have been described for the treatment of respiratory distress secondary to vocal fold immobility (VFI), but the contribution of posterior cordotomy (PC) to tracheostomy weaning or prevention has not been studied in depth, particularly in the acute setting. The objective of this study was to show the effectiveness of PC to relieve dyspnea, prevent the need for tracheostomy, and enable decannulation in patients with VFI. Methods: We conducted a retrospective study and reviewed the medical records of all patients whose dyspnea warranted surgical intervention from January 2013 to January 2018. Data were retrieved on epidemiology, etiology, and duration of VFI, tracheostomy dependence, success in decannulation from tracheostomy or respiratory relief, number of procedures until decannulation, and complications. Results: Twelve suitable patients were identified of whom eleven had bilateral VFI and one had unilateral VFI. Five were tracheostomy-dependent. Ten patients underwent unilateral PC, and two patients underwent bilateral PC. All the patients experienced respiratory relief, eleven after a single PC and one after two PCs. All tracheostomy-dependent patients were decannulated. The mean follow-up after PC was 24.55 months during which none of the patients required a re-tracheostomy and three patients required revision of the PC. There were no surgical complications. Postoperatively, eight patients (67%) experienced a breathy voice and three patients (25%) had dysphagia for fluids. No patient had aspiration pneumonia. Conclusions: We conclude that PC is an easy, safe, and effective procedure for tracheostomy weaning and respiratory relief in patients with VFI. A revision PC may be indicated in some patients. A breathy voice is to be expected, and a few patients will experience dysphagia to fluids that may be addressed by instructing the patient to use a fluid thickener and take small sips.

scholarly journals Limited Mobility to the Bed Reduces the Chances of Discharge and Increases the Chances of Death in the ICU

2021 ◽  
Vol 12 (1) ◽  
pp. 8-16
Author(s):  
Talita Leite dos Santos Moraes ◽  
Joana Monteiro Fraga de Farias ◽  
Brunielly Santana Rezende ◽  
Fernanda Oliveira de Carvalho ◽  
Michael Silveira Santiago ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Retrospective Study ◽  
Medical Records ◽  
High Mobility ◽  
University Hospital ◽  
Limited Mobility ◽  
The Mean ◽  
The University

Background: Progressive mobility in the ICU has been recommended; however, the definitions of low, moderate, and high mobility in the ICU still diverge between studies. Therefore, our objective was to classify the mobility of the sample from verticalization and active withdrawal from the bed, and from that, to analyze the chances of discharge, death, and readmission to the ICU. Materials and methods: This is an observational and retrospective study that consults the medical records of individuals admitted to the ICU of the University Hospital of Sergipe (HU/SE) between August 2017 and August 2018. Mobility level was classified based on the Intensive Care Unit Mobility Scale (IMS). Results: A total of 121 individuals were included. The mean age was 61.45 ± 16.45, being 53.7% female. Of these, 28 (23.1%) had low mobility, 33 (27.3%) had moderate mobility, and 60 (49.6%) had high mobility. Individuals with low mobility were 45 times more likely to die (OR = 45.3; 95% CI = 3.23–636.3) and 88 times less likely to be discharged from the ICU (OR = 0.22; 95% CI = 0.002–0.30). Conclusion: Those who evolved with low mobility had a higher chance of death and a lower chance of discharge from the ICU. Moderate and high mobility were not associated with the investigated outcomes.

scholarly journals A Retrospective Study of Small Animal Poisoning at the Veterinary Medical Teaching Hospital from South Region of Brazil

2018 ◽  
Vol 46 (1) ◽  
pp. 7 ◽  
Author(s):  
Luciana Zang ◽  
Rafaela Scheer Bing ◽  
Ana Cristina Pacheco De Araujo ◽  
Marcio Poletto Ferreira
Keyword(s):  
Retrospective Study ◽  
Teaching Hospital ◽  
Medical Records ◽  
Clinical Signs ◽  
Small Animal ◽  
Medical Teaching ◽  
Specific Patient ◽  
Cleaning Product ◽  
Number Of Patients ◽  
Antiparasitic Drugs

Background: Poisoning cases are a challenge for the veterinary practitioner, since many agents can be involved. The incomplete patient history associated with advanced poisoning stage often leads to death. Since lacking information is common, it is essential to be aware of principal poisoning agents and their associated symptomatology. The aim of this study is to describe the major agents involved in small animal poisoning, the causative agent, poisoning route, time to search veterinary care, clinical signs and ancillary tests of canine and feline patients treated at the Veterinary Medical Teaching Hospital from January 2010 to June 2016.Materials, Methods & Results: Forty-four medical records with poisoning history were found and reviewed, but only 30 medical records had complete data to be evaluated. There were 24 dogs and 6 cats, 17 female and 13 male. Six females were spayed. Poisoning agent identification was possible in 29 cases and was food, molluscicide, cleaning product, ornamental plants, medication, rodenticide and antiparasitic drugs. Fourteen poisonings were caused by the owner and 16 were accidental. There was a higher poisoning incidence in dogs than cats. Most of the patients were young and unneutered/unspayed.Discussion: In this study there was a higher poisoning prevalence in dogs than cats, as occurred in other studies published in Europe, Belgium, France, Greece, Italy, Spain, Austria and other Brazilian regions. Most of the patients were young, which is in agreement with previous studies in which young animals were more affected. Domestic antiparasitic drugs were the most common poisoning agents (33%), as reported in studies from France and Spain. In southern Brazil, the most common poisoning agent was medication, whereas in southeast Brazil, organophosphates were the most prevalent poisoning agent. Considering this, the geographic localisation seems to influence the poisoning agent. It is known that many owners give unprescribed medication to their pets and this also happened in this study, as 46% of the poisoning cases were caused by the owner. The most common clinical signs were gastrointestinal (76%, emesis and anorexia) and neurological (63%, depression). This is in agreement with another study that showed a high number of patients poisoned by medications leading to severe gastrointestinal clinical signs. Despite a history of eating spiced food, our food-poisoned patient did not show clinical signs compatible with pepper poisoning. In fact, clinical signs were more compatible with salt or onion and garlic poisoning, but there was no history to support that our patient had eaten these foods. The patient who ate fern and busy Lizzie (Impatiens walleriana) did not show clinical signs compatible with these agents but showed gastrointestinal clinical signs that could have occurred due to plant indigestion. This fact emphasises the need for more studies in this area. One dog with rodenticide poisoning presented with normal blood test results, but the blood sample was collected a few hours after exposure. This can occur after brodifacoum poisoning, which has a longer half-life than warfarin. In brodifacoum poisoning cases, clinical signs can appear days after exposure. In one dog, it was not possible to indentify the poisoning agent and this specific patient case exemplifies the challenge to diagnose the exact poisoning agent and concomitant diseases when the history is incomplete. This retrospective study shows the heterogeneity of the causative agents and the associated symptomatology, which highlights the need for further studies in this area. In this study, antiparasitic drugs were the most common poisoning agents, especially pyrethroids. Dogs were more affected than cats. Most of the patients were young and unneutered/unsprayed, indicating these characteristics could be a risk factor in this study.

Depilatory Agents intoxication and factors contributing to its mortality: A 9-year review

2011 ◽  
Vol 30 (10) ◽  
pp. 1454-1457
Author(s):  
Esmaeil Farzaneh ◽  
Babak Mostafazadeh ◽  
Nasim Zamani ◽  
Armen Eskandari ◽  
Mohammadali Emamhadi
Keyword(s):  
Retrospective Study ◽  
Mortality Rate ◽  
Medical Records ◽  
Time Of Arrival ◽  
Emergency Ward ◽  
Western Countries ◽  
The Mean ◽  
Mean Time

Poisoning with depilatory agents is a rather uncommon entity in western countries. In this study, we describe poisoning with a corrosive arsenic-based depilatory agent (CABD) and factors related to its mortality in a poisoning center in Tehran. In a retrospective study, the medical records of all patients with CABD intoxication who attended the emergency ward of Loghman-Hakim hospital, the only poisoning center in Tehran, over a 9-year period between 2000 and 2009 were reviewed. The majority of patients were men (78.7%, n = 122 vs. women: 21.3%, n = 33). The mean age was 35.55 ± 16.68 years. Mean time of arrival to hospital was 3.63 hours (SD = 4.07). The mortality rate was 5.8% and increased significantly with higher amounts of ingestion and delay in arrival to hospital. CABD poisoning may be lethal if not treated promptly and correctly. Restriction or, if not practical, reduction of harmful components of this substance should be considered.

scholarly journals Are Only A Few Hours Adequate For Hospitalization Following Mini-Incision Open Appendectomy In Pediatric Patients?

2021 ◽  
Author(s):  
Paiboon Sookpotarom ◽  
Vichack Chakrapan Na Ayudhya ◽  
Vorapatu Tangsirapat
Keyword(s):  
Length Of Stay ◽  
Medical Records ◽  
Pediatric Patients ◽  
Open Appendectomy ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Open Technique ◽  
The Mean ◽  
Surgical Condition ◽  
Mini Incision

Abstract Purpose- A very short hospital length of stay following an open appendectomy in children with acute simple appendicitis has never been mentioned yet in literature. The authors reviewed the outcome of these pediatric patients who were treated with the open technique.Methods -We retrospectively reviewed the medical records of the 115 consecutive patients who underwent open appendectomy from June 2017 to July 2021.Results- There were 84 patients whose appendices were inflammatory or suppurative and appendectomies were done only through McBurney’s point. Of these, the average age was 9.11 ± 2.67 years. The mean length of the incision was 1.95 ± 0.48 centimeters. Nearly one-third (25/85) could be discharged with 3 hours following surgery. Of the remaining cases, 9 patients were discharged within the same day.Conclusion- There were increased percentages of patients who were eligible for our criteria in each year. The confidence of both parents and the therapeutic team on this concept is of paramount importance affecting a shift of paradigm of this treatment of this very common surgical condition.

scholarly journals RERATA VOLUME TROMBOSIT, HITUNG LEUKOSIT DAN TROMBOSIT DI APENDISITIS AKUT

2018 ◽  
Vol 20 (2) ◽  
pp. 103
Author(s):  
Jayadi Festiawan ◽  
Nurhayana Sennang ◽  
Ibrahim Abdul Samad
Keyword(s):  
Platelet Count ◽  
Retrospective Study ◽  
Acute Appendicitis ◽  
Blood Cell ◽  
Medical Records ◽  
Normal Values ◽  
Platelet Volume ◽  
Blood Tests ◽  
Significant Difference ◽  
The Mean

The diagnosis of acute appendicitis and its complications still depends on the radiological examination and laparoscopy techniques.The aim of this study was to know the Mean Platelet Volume (MPV), WBC and platelet value in the diagnosis of acute appendicitis,associated with the incidence of existing complications. This research was carried out by a retrospective study by taking secondary datafrom the medical records, including the results of routine blood tests of acute appendicitis patients with and without complications atthe Dr. Wahidin Sudirohusodo Hospital between May 2011− May 2012. The data obtained in the study were MPV, White Blood Cell(WBC) and platelet count which were then analyzed using independent T test. The results obtained from 44 samples were that MPVvalues showed a significant difference (p=0.02), while WBC (p=0.12) and platelet count (p=0.13) were statistically not significantlydifferent between patients with and without complications. In conclusion, it was found that acute appendicitis with complications hadhigher MPV average values than those without complications and although there were significant differences between them, these werestill within the normal values.

scholarly journals A Five-Year Retrospective Study of Gestational Trophoblastic Disease at University of Maiduguri Teaching Hospital Maiduguri, Nigeria

2021 ◽  
Vol 6 (2) ◽  
pp. 228-234
Author(s):  
Obetta Hillary Ikechukwu ◽  
Hadiza Abdullah Usman ◽  
Nweze Sylvester Onuegunam
Keyword(s):  
Retrospective Study ◽  
Teaching Hospital ◽  
Hydatidiform Mole ◽  
Lower Abdominal Pain ◽  
Gestational Trophoblastic Disease ◽  
Good Prognosis ◽  
Patient Counseling ◽  
Trophoblastic Disease ◽  
The Mean

Background: Gestational trophoblastic disease (GTD) is an uncommon complication of pregnancy. It is of clinical and epidemiological interest partly because of its good prognosis if detected and managed early. Objective: This study was to determine the prevalence, clinical presentation, management outcome and histologic types of GTDs at University of Maiduguri Teaching Hospital, Maiduguri, Nigeria. Methodology: A five-year retrospective study of histologically confirmed cases of GTDs managed in UMTH was undertaken. Folders of patient treated for GTD during the study period served as source of data. Statistical analysis was done using Statistical Package for the Social Sciences. Results: There were a total of 47 (38 molar and 9 choriocarcinoma) cases of GTDs that were diagnosed and managed at UMTH. However, only 40[31(77.5%)] molar and [9(22.5%) choriocarcinoma] case files were retrieved. 55% of the GTDs were complete hydatidiform mole, 22.5% partial hydatidiform mole and 22.5% choriocarcinoma. There was no case of invasive mole or placental site trophoblastic tumour noted. There were 15,426 deliveries in UMTH during this period giving the incidence of GTDs as 3.0 per 1000 deliveries or 1 in 328deliveries. The mean (SD) age of the patients was 30.5 ± 5.6years. Only 3(7.5%) of the patients were below 20 years of age and those who were at least 40 years of age constituted 8(20%). Low parity constituted 62.5% of the patients while 12.5% and 2.5% were nullipara and primipara respectively. The mean gestational age (SD) at presentation was 16.5±6.2 weeks. The common clinical presentations were amenorrhoea (100.0%), abnormal vaginal bleeding (97.5%), lower abdominal pain (90%) and passage of grape-like vesicles (45.0%). Only 6(15.0%) complied with the follow-up protocol for one year, while 25(62.5%) of the patients did not observe the follow-up protocol. Anaemia was the commonest complication observed. Conclusion: Gestational trophoblastic disease is relatively common in our center with an incidence of 3.0 per 1000 deliveries and 1.48% of our gynaecological admissions. Adequate patient counseling and compliance to follow-up are recommend for good outcome. Keywords: Prevalence, gestational trophoblastic disease, Hydatidiform mole, Choriocarcinoma, Maiduguri.

scholarly journals O17 Physiotherapy experience of treating patients with PIMS-TR COVID-19 following stepdown from PICU

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Susan Maillard ◽  
Kim Noar ◽  
Samantha Harris ◽  
Jeremy Hasson ◽  
Kathryn Foy
Keyword(s):  
Case Report ◽  
Young People ◽  
Length Of Stay ◽  
Outcome Measures ◽  
Muscle Weakness ◽  
Respiratory Function ◽  
Joint Involvement ◽  
The Mean

Abstract Case report - Introduction It has been reported by the European Centre for Disease Prevention and Control that by May 2020 there were 230 suspected cases of PIMS-TR COVID-19. At Great Ormond Street Hospital NHS Foundation Trust (GOSH) there were 50 suspected cases. This report summarises the physiotherapy input to these patients outside of PICU. The rheumatology team were allocated the COVID-19positive ward and therefore were able to be involved in the evolving understanding of the clinical presentation and management of this new disease. Case report - Case description 50 children were admitted to GOSH with suspected PIMS-TR COVID-19, of these, 36 were admitted to PICU. The mean length of stay in PICU was 4.6 days and the median 3.5 days (Range 1–16 days). The mean total length of stay in hospital was 11 days (range 2–94 days). 42% were male and 57% female and the age ranged from 5 weeks -17 years, but the mean age was 9 yrs. Most were previously well, but 3 had asthma, 2 diabetes, 1 obese, 1 with liver disease and 2 with sickle cell disease. The physiotherapy provided included assessment and relatively quickly it was recognised that these patients had a specific pattern of muscle weakness (proximal>distal) and so the Manual Muscle Test of 8 muscle groups (MMT8) and the Childhood Myositis Assessment Score (CMAS) were adopted as outcomes. The initial mean MMT8 score was 56/80 (42–79) and mean CMAS score 20/52 (4–51) Assessment of respiratory function, mobility and safety of postural changes including sitting to standing, gait and managing the stairs was also included. The treatment provided included breathing exercises and specific muscle strengthening that was progressed as able. Advice to the nursing and medical staff was provided to ensure that patients were safe while they were regaining strength and stability. Gait re-education and stairs assessment was completed before discharge. The patients have now been placed into a multidisciplinary assessment programme to follow up the long-term outcomes including physiotherapy outcomes. At the 2 months follow up the mean MMT8 was 72/80 and the mean CMAS is 46/52 indicating that there may be a long-term impact upon musculoskeletal function in young people. Case report - Discussion At GOSH the rheumatology physiotherapy team were redeployed to the temporary general paediatrics service. This service was responsible for the patients who were diagnosed with this new and evolving disease and who were transferred from the PICU. The physiotherapy team started to recognise the extent of their illness including postural instability, muscle weakness, severe fatigue, and joint involvement. The children also had impairment in respiratory function and cardiac function. It was recognised that mobility was limited for many reasons and care was required in the intensity and frequency of exercise and level of activity. Initially moving around the bed was exhausting and had to be effective and safe before progressing to weight-bearing and walking. Because the physiotherapy team were musculoskeletal specialists, they were able to consider different outcome measures and quickly decided upon using the MMT8 and the CMAS as well as assessing joint range of movement and muscle length. Respiratory assessments were also completed. It was also recognised that as the hospital had rapidly developed the COVID-19ward (Hedgehog ward) and as the staff were from many different areas of the hospital effective communication between this new team had to be established and within weeks a daily MDT meeting was started that ensured all aspects of each patients care were discussed to enable complete co-ordinated treatment of the patient. This meeting allowed staff to contribute to decisions about treatment as well as ensuring the nursing staff were informed about safety for each child regarding mobility. The meeting also allowed for discharge planning to ensure that every child was safe to be discharged and was able to physically manage at home. A weekly psychosocial meeting was also developed and so the psychological and social factors for each child and their family could also be considered and supported. Case report - Key learning points The hospital planned and prepared for the Pandemic and staff were placed together to work in different ways. Because of the diversity of the skills of the staff it was possible to recognise the many systems that were affected by the disease and to pull together the expertise of the staff to be able to provide a high level and holistic clinical management for each and every child. It has also been possible to explore outcome measures and to be able to work with each other and to learn and discuss treatments moving forwards. The speed in which a completely new service was established was impressive especially as there had been a misunderstanding initially that children would probably not be severely affected by COVID-19. The importance of physiotherapy treatment in order to enable these young people to regain strength, mobility and function was apparent and with the longer term follow up it is demonstrating that several of these patients need longer term care and treatment after discharge. The outcome measures that are being used for the longer term follow up; CMAS, MMT8, 6 min walking test as well as neurological examinations and questionnaires to assess function and psychological well-being and fatigue are able to be used if other patients develop this disease and these measures can be used nationwide in order to enable a cohesive approach to managing PIMS-TR COVID-19.

Clinical improvement at Day 3 as factor influencing length of hospital stay and discharge of patients with schizophrenia

2011 ◽  
Vol 26 (S2) ◽  
pp. 1348-1348
Author(s):  
L. San-Molina ◽  
G. Rubio ◽  
I. Bernardo-Fernández ◽  
S. Miguélez-Fernández
Keyword(s):  
Retrospective Study ◽  
Length Of Stay ◽  
Hospital Stay ◽  
Hospital Discharge ◽  
Clinical Improvement ◽  
Length Of Hospital Stay ◽  
Medical Intervention ◽  
Symptom Improvement ◽  
The Mean ◽  
Symptom Outcome

IntroductionThe type of treatment used for patients with schizophrenia and an improvement at Day 3 can affect the length of stay and symptom outcome.ObjectivesTo determine the influence of improvement at Day 3 in the lenght of hospital stay and hospital discharge in the case of patients with schizophrenia admitted to acute units.MethodsA multicenter, naturalistic, retrospective study evaluating medical intervention in 1346 patients with schizophrenia in acute units in Spain.ResultsThe mean of hospital stay days was 23.3 (range 1–260 days). 49.5% of patients with improvement at Day 3 had a shorter length of hospital stay. 78.7% received treatment with antipsychotics prior to admission. The most common drugs were risperidone, olanzapine and quetiapine. 99.8% and 99.7% were treated during hospital stay and on discharge, respectively. The drugs most commonly used were paliperidone ER, risperidone and olanzapine. 99.8% of patients with improvement measured by GCI at Day 3 and 100% with improvement at Day 5 had improved at discharge. The percentage of patients requiring use of benzodiazepines or physical/mechanical restriction decreased as the days passed.ConclusionsThe three most commonly used drugs during admission were effective, but the action of paliperidone ER is to be noted (its use increased from 4% prior to admission to 43% and 44% during hospital stay and on discharge, respectively). The results of this study appear to confirm that symptom improvement should be obtained as early as the first week of treatment to achieve a shorter hospital stay.

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