scholarly journals The Health Experts onLine at Portsmouth (HELP) system: One-year review of adult and Pediatric Asynchronous Telehealth Consultations

2016 ◽  
Vol 4 ◽  
pp. 205031211562643 ◽  
Author(s):  
Andrew H Lin ◽  
Jacob H Cole ◽  
John C Chin ◽  
Chirstopher Becket Mahnke
Keyword(s):  
Medical Center ◽  
First Year ◽  
Time Interval ◽  
Health Providers ◽  
East Region ◽  
Treatment Facilities ◽  
Access And Quality ◽  
One Year ◽  
Navy Medicine ◽  
Health Experts

Introduction: The Health Experts onLine at Portsmouth teleconsultation system is designed to connect health providers in the Navy Medicine East Region to specialists at Naval Medical Center Portsmouth. Methods: A review of the first year of the Health Experts onLine at Portsmouth system was performed. Data on each teleconsultation were extracted from the Health Experts onLine at Portsmouth system database and analyzed. Results: From June 2014 to May 2015 there have been 585 teleconsultations. Providers stationed on 36 ships/submarines and at 28 remote military treatment facilities have utilized the Health Experts onLine at Portsmouth system. Over 280 specialists in 34 different specialties were consulted. The median time to first response from a specialist was 6 h and 8 min, with 75% of all consults being addressed within 24 h. Eighteen medevacs were recommended. Thirty-nine potential medevacs were prevented, and 100 potential civilian network deferrals were prevented, resulting in an estimated savings of over US$580,000. Discussion: Based on the 1-year metrics, Health Experts onLine at Portsmouth has provided improved access and quality of care to service members and their families throughout the Navy Medicine East Region. It has helped avoid over US$580,000 in unnecessary cost burden. Further review at the 2-year time interval will demonstrate the continued growth and effectiveness of the Health Experts onLine at Portsmouth system.

scholarly journals Outcome of Closed Reduction of Developmental Dysplasia of Hip Before First Year of Age, A Retrospective Cohort Study, Saudi Arabia

2020 ◽  
Author(s):  
Fahad AlShayhan ◽  
Abdulmonem Alsiddiky ◽  
Raghad Barri
Keyword(s):  
Closed Reduction ◽  
Open Reduction ◽  
Medical Center ◽  
Developmental Dysplasia ◽  
First Year ◽  
Developmental Dysplasia Of Hip ◽  
Class 1 ◽  
One Year ◽  
Skin Traction

Abstract Background: Developmental dysplasia of hip (DDH) management is challenging hence there is no fixed rules or radiographic criteria to assess and manage DDH. There are many treating modalities including closed reduction, open reduction, skin traction, hip Spica and many others. This study is to assess the outcome of closed reduction in patients below 12 months of ages.Method: A retrospective study among patients with DDH who underwent closed reduction before the first year of age in a major referral medical center. The study included 100 patients and 168 hips. Average of follow up period was 5.97 years (±3.01). Couple of variables were measured in AP x ray of pelvis to assess the outcome of closed reduction. Results: Most of the hips were grade 1 and 2 according to the IHDI (International hip dysplasia institution) classification. Significant improvement in the acetabular index post closed reduction. In addition to the normalizing of CE angel's values. Also, majority of hips were severin's class 1 and 2 which were associated with good outcome.Conclusion: Safe closed reduction in patients with DDH below one year of age had a great outcome, less AVN, less growth complications and decrease the need of future open reduction.

scholarly journals Time interval between (chemo)radiotherapy and subsequent laryngectomy is not prognostic for post operative complications and survival

2020 ◽  
Author(s):  
Thomas F. Pézier ◽  
Johannes A. Rijken ◽  
Bernard M. Tijink ◽  
W. Weibel Braunius ◽  
Remco de Bree
Keyword(s):  
Overall Survival ◽  
Total Laryngectomy ◽  
Medical Center ◽  
Time Interval ◽  
Pharyngocutaneous Fistula ◽  
Retrospective Case ◽  
Rate Risk ◽  
Swallowing Difficulties ◽  
One Year ◽  
The Impact

Abstract Purpose Pharyngocutaneous fistula (PCF) formation and swallowing difficulties are common and troublesome complications following total laryngectomy (TL). Prior (chemo)radiotherapy ((C)RT) is thought to be a risk factor for these complications, but there is conflicting evidence as to whether the time interval between (C)RT and TL is important. The impact of time interval on these complications and also its impact on overall survival are investigated. Methods This is a retrospective case note review of all patients undergoing TL at the University Medical Center, Utrecht, The Netherlands over the 10-year period from January 2008 to December 2017. The cohort was split into those who underwent TL within a year of finishing (C)RT and those longer than 1 year. Results One hundred and twenty-six patients (108 males, 18 females), with a mean age of 66 underwent total laryngectomy after prior (C)RT in the study period. Overall 5-year survival was 35% with a median follow-up of 30 months. Fifty-four patients underwent laryngectomy within a year of their (C)RT versus 72 patients who had a time interval of more than one year. No differences in PCF rate, risk of dilatation or overall survival could be found between the two groups. Conclusions In this modern cohort, time interval between (C)RT and surgery did not impact PCF rate, risk of dilatation or overall survival.

Teleradiology in a military training area

2001 ◽  
Vol 7 (6) ◽  
pp. 348-352 ◽  
Author(s):  
M R Brumage ◽  
S Chinn ◽  
K Cho
Keyword(s):  
Medical Service ◽  
Service Providers ◽  
Medical Center ◽  
Military Training ◽  
Weather Conditions ◽  
First Year ◽  
Army Medical ◽  
One Year ◽  
The Cost ◽  
Training Area

A pilot teleradiology project was established for the medical service providers at the Pohakuloa Training Area (PTA) in Hawaii. It connected them with radiologists at Tripler Army Medical Center (TAMC) on the island of Oahu, approximately 400 km away. This involved changing the standard practice of sending soldiers from the PTA to a civilian hospital in Hilo for radiographs. These emergency trips to Hilo, 55 km away, were expensive, manpower intensive, and dangerous due to road and weather conditions. During 51 days of a training exercise involving 2600 personnel, 29 evacuations were avoided, which would have cost $36,569 in total. The expected savings during one year of training were $176,540. The cost of teleradiology during the first year, including the cost of the equipment, was $167,203. Over five years, the costs and savings were estimated to be $349,940 and $882,700, respectively.

P1711RENAL RESISTIVE INDEX (RRI) OF KIDNEY ALLOGRAFT. OMEN OF THE OUTCOME OF TRANSPLANTION?

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Maria Smyrli ◽  
Glykeria Tsouka ◽  
Theodora Oikonomaki ◽  
Vasileios Vougas ◽  
Theofanis Apostolou ◽  
...  
Keyword(s):  
Renal Function ◽  
Medical Center ◽  
Graft Function ◽  
Resistive Index ◽  
Renal Resistive Index ◽  
First Year ◽  
Kidney Allograft ◽  
The Third ◽  
Reduced Frequency ◽  
One Year

Abstract Background and Aims Renal resistive index (RRI) of ultrasonography is a useful and potent tool for assessment and evaluation of renal hyperfiltration status of the transplanted patients. The aim of this study was to evaluate the association of RRI with renal function one year after transplant. Method We evaluated retrospectively 98 kidney allograft recipients. Data were collected from transplantations performed in our medical center between 01/2014 and 09/2018. Patients with acute loss of the renal function and renal survival less than a year were excluded from the study. We compared longitudinally the RRI at the first week after transplant and the third month, with glomerular filtration rate (eGFR, by CKD-EPI) at the end of the first year of transplantation. RRI was measured on the interlobular artery level, in each of the aforementioned time periods, and results were classified into 2 groups, RRI <0,8 or>0,8. In addition, age, gender and delayed graft function (DGF) were also determined in all patients. Results Sixty seven (67) of the recipients were males and 31 females with a mean age of 48±12years. The corresponding demographics for the donors were 46 males and 52 females with a mean age of 53 ±14. No correlations were found between RRI of the first week with gender and age, of both donors and recipients (p>0.05). Similarly, RRI of the first week was not correlated with DGF and one-year eGFR after transplant (p>0.05). On the contrary, RRI performed at the third month was strongly correlated to DGF and eGFR at the end of the first year. In other words, allograft recipients with a resistive index less than 0.80, had a higher eGFR and reduced frequency of DGF (p=0.01 and 0.03 respectively). Last but not least, higher recipient age and not gender was the main determinant of an increase of resistive index in the third month after transplant (P=0.02). Conclusion RRI offers interesting and helpful data on kidney allograft function. RRI of the third month less than 0.8 was related to better renal function at the end of the first year after transplant mainly and a lower incidence of DGF.

Time Interval Between Traumatic Brain Injury And Post Traumatic Epilepsy

2013 ◽  
Vol 21 (2) ◽  
pp. 222-228
Author(s):  
Daniel Garbin Di Luca ◽  
Glenda Corrêa Borges de Lacerda
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
First Year ◽  
Time Interval ◽  
Partial Seizures ◽  
Complex Partial Seizures ◽  
Post Traumatic ◽  
Faster Development ◽  
Post Traumatic Epilepsy ◽  
Traumatic Epilepsy

Introduction. The estimated time interval in which an individual can develop Post Traumatic Epilepsy (PTE) after a traumatic brain injury (TBI) is not clear. Objective. To assess the possible influence of the clinical features in the time interval between TBI and PTE develop­ment. Method. We analyzed retrospectively 400 medical records from a tertiary Brazilian hospital. We selected and reevaluated 50 patients and data was confronted with the time between TBI and PTE devel­opment by a Kaplan-Meier survival analysis. A Cox-hazard regression was also conducted to define the characteristics that could be involved in the latent period of the PTE development. Results. Patients devel­oped PTE especially in the first year (56%). We found a tendency of a faster development of PTE in patients older than 24 years (P<0.0001) and in men (P=0.03). Complex partial seizures evolving to generalized seizures were predominant in patients after moderate (37.7%) and severe (48.8%) TBIs, and simple partial seizures evolving to general­ized seizures in mild TBIs (45.5%). Conclusions. Our data suggest that the first year after a TBI is the most critical period for PTE de­velopment and those males older than 24 years could have a faster development of PTE.

scholarly journals Cardiovascular risk factors associated with acute myocardial infarction and stroke in the MADIABETES cohort

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
M. A. Salinero-Fort ◽  
F. J. San Andrés-Rebollo ◽  
J. Cárdenas-Valladolid ◽  
M. Méndez-Bailón ◽  
R. M. Chico-Moraleja ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Antihypertensive Drugs ◽  
Hdl Cholesterol ◽  
First Year ◽  
Backward Elimination ◽  
One Year ◽  
Time Varying Covariates

AbstractWe aimed to develop two models to estimate first AMI and stroke/TIA, respectively, in type 2 diabetes mellitus patients, by applying backward elimination to the following variables: age, sex, duration of diabetes, smoking, BMI, and use of antihyperglycemic drugs, statins, and aspirin. As time-varying covariates, we analyzed blood pressure, albuminuria, lipid profile, HbA1c, retinopathy, neuropathy, and atrial fibrillation (only in stroke/TIA model). Both models were stratified by antihypertensive drugs. We evaluated 2980 patients (52.8% women; 67.3 ± 11.2 years) with 24,159 person-years of follow-up. We recorded 114 cases of AMI and 185 cases of stroke/TIA. The factors that were independently associated with first AMI were age (≥ 75 years vs. < 75 years) (p = 0.019), higher HbA1c (> 64 mmol/mol vs. < 53 mmol/mol) (p = 0.003), HDL-cholesterol (0.90–1.81 mmol/L vs. < 0.90 mmol/L) (p = 0.002), and diastolic blood pressure (65–85 mmHg vs. < 65 mmHg) (p < 0.001). The factors that were independently associated with first stroke/TIA were age (≥ 75 years vs. < 60 years) (p < 0.001), atrial fibrillation (first year after the diagnosis vs. more than one year) (p = 0.001), glomerular filtration rate (per each 15 mL/min/1.73 m2 decrease) (p < 0.001), total cholesterol (3.88–6.46 mmol/L vs. < 3.88 mmol/L) (p < 0.001), triglycerides (per each increment of 1.13 mmol/L) (p = 0.031), albuminuria (p < 0.001), neuropathy (p = 0.01), and retinopathy (p = 0.023).

scholarly journals Mortality in older adults following a fragility fracture: real-world retrospective matched-cohort study in Ontario

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jacques P. Brown ◽  
Jonathan D. Adachi ◽  
Emil Schemitsch ◽  
Jean-Eric Tarride ◽  
Vivien Brown ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hip Fracture ◽  
Fragility Fracture ◽  
Mortality Risk ◽  
Real World ◽  
First Year ◽  
Matched Cohort ◽  
Matched Cohort Study ◽  
Fracture Cohort ◽  
One Year

Abstract Background Recent studies are lacking reports on mortality after non-hip fractures in adults aged > 65. Methods This retrospective, matched-cohort study used de-identified health services data from the publicly funded healthcare system in Ontario, Canada, contained in the ICES Data Repository. Patients aged 66 years and older with an index fragility fracture occurring at any osteoporotic site between 2011 and 2015 were identified from acute hospital admissions, emergency and ambulatory care using International Classification of Diseases (ICD)-10 codes and data were analyzed until 2017. Thus, follow-up ranged from 2 years to 6 years. Patients were excluded if they presented with an index fracture occurring at a non-osteoporotic fracture site, their index fracture was associated with a trauma code, or they experienced a previous fracture within 5 years prior to their index fracture. This fracture cohort was matched 1:1 to controls within a non-fracture cohort by date, sex, age, geography and comorbidities. All-cause mortality risk was assessed. Results The survival probability for up to 6 years post-fracture was significantly reduced for the fracture cohort vs matched non-fracture controls (p < 0.0001; n = 101,773 per cohort), with the sharpest decline occurring within the first-year post-fracture. Crude relative risk of mortality (95% confidence interval) within 1-year post-fracture was 2.47 (2.38–2.56) in women and 3.22 (3.06–3.40) in men. In the fracture vs non-fracture cohort, the absolute mortality risk within one year after a fragility fracture occurring at any site was 12.5% vs 5.1% in women and 19.5% vs 6.0% in men. The absolute mortality risk within one year after a fragility fracture occurring at a non-hip vs hip site was 9.4% vs 21.5% in women and 14.4% vs 32.3% in men. Conclusions In this real-world cohort aged > 65 years, a fragility fracture occurring at any site was associated with reduced survival for up to 6 years post-fracture. The greatest reduction in survival occurred within the first-year post-fracture, where mortality risk more than doubled and deaths were observed in 1 in 11 women and 1 in 7 men following a non-hip fracture and in 1 in 5 women and 1 in 3 men following a hip fracture.

scholarly journals Across the COVID-19 Waves; Assessing Temporal Fluctuations in Perceived Stress, Post-Traumatic Symptoms, Worry, Anxiety and Civic Moral Disengagement over One Year of Pandemic

2021 ◽  
Vol 18 (11) ◽  
pp. 5651
Author(s):  
Alessio Gori ◽  
Eleonora Topino
Keyword(s):  
Perceived Stress ◽  
State Anxiety ◽  
Moral Disengagement ◽  
Online Survey ◽  
Well Being ◽  
First Year ◽  
Effective Interventions ◽  
Post Traumatic ◽  
One Year ◽  
Traumatic Symptoms

This study aimed at investigating the psychological effect of the COVID-19 pandemic in Italy by analysing the trends of perceived stress, post-traumatic symptoms, state anxiety, worry, and civic moral disengagement in four different moments from March 2020 to March 2021. The study involved a total of 1827 Italian participants (30% men and 70% women; Mage = 34.72; SD = 12.40) divided into four groups to which an online survey was administered. The first group completed the survey in March 2020, the second one in August 2020, the third one in November 2020, and the fourth one in March 2021. Results highlighted significant decreases in post-traumatic symptoms and a significant increase in civic moral disengagement over the first year of the COVID-19 pandemic. The levels of perceived stress, worry, and state anxiety remained constant. The correlations between the variables at different times were also explored, as well as gender differences over the year. The COVID-19 emergency has had significant effects on the mental state of the population, with important repercussions for individual and collective well-being during but probably also after the pandemic. This study offers a clear snapshot of the psychological outcomes over one COVID-19 pandemic year, providing important information that may contribute to tailor more effective interventions for mental health.

Teething Symptoms in the First Year of Life and Associated Factors: A Cohort Study

2010 ◽  
Vol 34 (3) ◽  
pp. 201-206 ◽  
Author(s):  
Carlos Alberto Feldens ◽  
Italo Medeiros Faraco Junior ◽  
Andréia Bertani Ottoni ◽  
Eliane Gerson Feldens ◽  
Márcia Regina Vítolo
Keyword(s):  
Associated Factors ◽  
Primary Outcome ◽  
First Year ◽  
Structured Interviews ◽  
Self Medication ◽  
Nuclear Families ◽  
Dental Examination ◽  
Pediatric Dentists ◽  
One Year ◽  
First Year Of Life

Objective: To investigate the occurrence and management of teething symptoms during the first year of life and associated factors. Study design: 500 children were recruited at birth. Research assessments including structured interviews, anthropometric measurements and dental examination were carried out after birth, at 6 months and at one-year of age. The primary outcome of this study was defined as the occurrence of one or more teething symptoms within the first year of life, as reported by the mother. Results: Teething symptoms were reported in 73% of the children analyzed (273/375). The symptoms most frequently reported were irritability (40.5%), fever (38.9%), diarrhoea (36.0%) and itching (33.6%). Dentists had little influence on the management of symptoms and self-medication to relieve them was a common practice. The risk of reporting teething symptoms was higher for children from nuclear families (p=0.040) and for children from families with higher income (p=0.040). Conclusions: Teething symptoms were highly reported in this population. Pediatric dentists should be accessible and provide adequate orientation when symptoms can be managed at home or immediate referral to health services when more serious diseases are suspected.

Partnership in Post-Adoption Services Evaluating the First Year of a Complementary Contract

1997 ◽  
Vol 21 (3) ◽  
pp. 50-56 ◽  
Author(s):  
Alan Burnell ◽  
Adrian Briggs
Keyword(s):  
Social Services ◽  
Comprehensive Assessment ◽  
First Year ◽  
Service Users ◽  
Adoptive Families ◽  
Treatment Services ◽  
Assessment And Treatment ◽  
One Year ◽  
Families With Children ◽  
Consultation Services

In the autumn 1995 edition of Adoption & Fostering, Alan Burnell and Adrian Briggs described the origins and objectives of a novel complementary contract between East Sussex Social Services and the Post-Adoption Centre (PAC), aimed at providing post-adoption counselling and consultation services to all those involved in adoption in the county. The same authors now evaluate the operation of the contract, one year on. After filling in some background they assess its achievements so far, with particular regard to the extra support to service users and staff, and reducing the risk of disruption. The article concludes that the first year of the contract has demonstrated the need for comprehensive assessment and treatment services for adoptive families with children experiencing attachment difficulties.

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