scholarly journals The impact of the COVID-19 pandemic on non-COVID induced sepsis survival

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Matthias Unterberg ◽  
Tim Rahmel ◽  
Katharina Rump ◽  
Alexander Wolf ◽  
Helge Haberl ◽  
...  
Keyword(s):  
Health Care Systems ◽  
Mortality Rates ◽  
Post Hoc Analysis ◽  
Severity Of Disease ◽  
Significant Difference ◽  
Care Systems ◽  
Sepsis Survival ◽  
Post Hoc ◽  
The Impact

Abstract Background The COVID-19 pandemic has taken a toll on health care systems worldwide, which has led to increased mortality of different diseases like myocardial infarction. This is most likely due to three factors. First, an increased workload per nurse ratio, a factor associated with mortality. Second, patients presenting with COVID-19-like symptoms are isolated, which also decreases survival in cases of emergency. And third, patients hesitate to see a doctor or present themselves at a hospital. To assess if this is also true for sepsis patients, we asked whether non-COVID-19 sepsis patients had an increased 30-day mortality during the COVID-19 pandemic. Methods This is a post hoc analysis of the SepsisDataNet.NRW study, a multicentric, prospective study that includes septic patients fulfilling the SEPSIS-3 criteria. Within this study, we compared the 30-day mortality and disease severity of patients recruited pre-pandemic (recruited from March 2018 until February 2020) with non-COVID-19 septic patients recruited during the pandemic (recruited from March 2020 till December 2020). Results Comparing septic patients recruited before the pandemic to those recruited during the pandemic, we found an increased raw 30-day mortality in sepsis-patients recruited during the pandemic (33% vs. 52%, p = 0.004). We also found a significant difference in the severity of disease at recruitment (SOFA score pre-pandemic: 8 (5 - 11) vs. pandemic: 10 (8 - 13); p < 0.001). When adjusted for this, the 30-day mortality rates were not significantly different between the two groups (52% vs. 52% pre-pandemic and pandemic, p = 0.798). Conclusions This led us to believe that the higher mortality of non-COVID19 sepsis patients during the pandemic might be attributed to a more severe septic disease at the time of recruitment. We note that patients may experience a delayed admission, as indicated by elevated SOFA scores. This could explain the higher mortality during the pandemic and we found no evidence for a diminished quality of care for critically ill sepsis patients in German intensive care units.

PENGARUH PENDIDIKAN KESEHATAN CUCI TANGAN TERHADAP PERILAKU CUCI TANGAN DI TK AISYIYAH BUSTANUL ATHFAL BALONGUMBULHARJO CANGKRINGAN SLEMAN YOGYAKARTA

2020 ◽  
Vol 9 (2) ◽  
Author(s):  
Widuri Widuri ◽  
Atik Badi’ah ◽  
Tomi Darmawan
Keyword(s):  
Health Education ◽  
Health Behavior ◽  
Health Care Systems ◽  
Hand Washing ◽  
Paired Samples ◽  
Children Health ◽  
Significant Difference ◽  
Care Systems ◽  
Child Health Behavior

Background: Improving the quality of life of children one of which isdetermined by plantingearly child health behavior. Behavior of school children are very varied. If not recognized early, these health problems will affect the learning achievements and future children. Health behavior is a person's response to stimuli or objects associated with illness and disease, health care systems, food, drinks and the environment. Many children do not wash their hands before eating, so it can result in bacteria that is in the hand will be brought in with the food through the mouth and throat to the digestive tract so that the occurrence of gastrointestinal disease.Objective: Knowing the effect of health education hand washing behavior of hand washing in TK Aisyiyah Bustanul Athfal Balong umbulharjo Cangkringan Sleman Yogyakarta.Research methods: This type  of research is one group pretest posttest.Research has been conducted kindergarten Aisyiyah Bustanul Athfal BalongUmbulharjo Cangkringan Sleman Yogyakarta for 2 days commencing on 26 April to 28 April 2014.Results: The results of paired samples correlation calculations indicate thatthere is significant influence effect of health education hand washing behavior of hand washing with sig. (Tailed).000Conclusion: A  significant difference between the effect of health educationhand washingbehavior of hand washing in TK Aisyiyah Bustanul Athfal Balong Umbulharjo Cangkringan Sleman Yogyakarta.

scholarly journals Post hoc study to investigate the potential causes of poor quality of cardiovascular medicines collected in sub-Saharan countries

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e039252
Author(s):  
Philippe-Henri Secretan ◽  
Marie Antignac ◽  
Najet Yagoubi ◽  
Mélisande Bernard ◽  
Marie Cécile Perier ◽  
...  
Keyword(s):  
Democratic Republic ◽  
Poor Quality ◽  
African Countries ◽  
Post Hoc Analysis ◽  
Significant Difference ◽  
Lack Of Control ◽  
Republic Of The Congo ◽  
Sub Saharan ◽  
Post Hoc

ObjectivesThe incidence of cardiovascular diseases is increasing and there is a growing need to provide access to quality cardio drugs in Africa. In the SEVEN study, we analysed 1530 cardiovascular drug samples randomly collected from 10 African countries. By that time, of the seven drugs products analysed, only those containing amlodipine and captopril had very low assay values with active substance contents that could be less than 75% of those expected. In this article we investigate complementary aspects of the amlodipine and captopril samples so to explain the previously observed low assays for these two drugs.DesignPost hoc analysis of the captopril and amlodipine drugs samples and their packages collected in the context of the SEVEN study.Setting10 countries were concerned: Benin, Burkina Faso, Congo, Democratic Republic of the Congo, Guinea, Côte d’Ivoire, Mauritania, Niger, Senegal and Togo.ParticipantsLocal scientists and hospital practitioners collected the drug samples in the 10 African countries.Outcome measuresThe drug amount and the relative amounts of drug impurities, as well as the main compounds of the drugs packaging, were analysed.ResultsIdentification of the blister packaging of the samples led to separate both amlodipine and captopril drug samples in two groups. Mann Whitney’s bilateral test showed a significant difference (p<0.0001) between the median value of the captopril dosage when tablets are packaged in blisters providing higher protection to humidity (n=105) as opposed to the tablets packaged in blisters providing lower humidity protection (n=130).ConclusionBased on these results, particular attention should be paid to the materials and types of packaging used in order to minimise the lack of control over the exposures and drug circuits present in these different countries.

Increasing Competition Between Providers in Health Care Markets: The Economic Evidence

2011 ◽  
pp. 670-687 ◽  
Author(s):  
Carol Propper ◽  
George Leckie
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
Empirical Literature ◽  
Health Care Markets ◽  
Economic Evidence ◽  
Care Systems ◽  
Fixed Prices ◽  
The Impact

This article scrutinizes the empirical literature on competition between providers and finds that the outcomes are highly varied, and that competition generates winners and losers among patients as well as providers. It examines the theoretical and empirical economic evidence on the effect of greater competition between providers in health care markets. Most of the evidence focuses on a narrow set of outcomes, primarily the effect of competition on prices and quality of health care, sometimes with a focus on winners and losers. It discusses the impact of centrally fixed prices on competition and examines the role of information in increasing competition is also discussed. It examines the effects of using centrally set prices. This article concludes raising some issues that seem to be pertinent for policymakers interested in increasing competition in their health care systems.

scholarly journals Quality of Life in Danish Patients with Multiple Myeloma during the COVID-19 Pandemic

COVID ◽  
2021 ◽  
Vol 1 (1) ◽  
pp. 303-314
Author(s):  
Louise Redder ◽  
Sören Möller ◽  
Anna Thit Johnsen ◽  
Mary Jarden ◽  
Christen Lykkegaard Andersen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Myeloma ◽  
Health Care Systems ◽  
Viral Spread ◽  
Health Authorities ◽  
Increased Risk ◽  
Care Systems ◽  
Fatal Course ◽  
The Impact

In general, governments and health authorities have taken precautions during the COVID-19 pandemic to reduce the viral spread and protect vulnerable citizens. Patients with multiple myeloma (MM) have an increased risk of being infected with COVID-19 and developing a fatal course due to the related immunodeficiency. We investigated how Danish patients with MM reported their quality of life (QoL) pre-COVID and during COVID, in an ongoing longitudinal QoL survey. The responses given during the first and second wave of the COVID-19 pandemic were pooled, analyzed and compared to the same period the year before. We hypothesized that locking down the society would have caused deteriorated QoL and that patients living alone and those under the age of 65 would be particularly affected by the situation. Surprisingly, our study showed the opposite. Statistically significant and clinically relevant differences were primarily found during the first lock down and represented reduced fatigue, improved role functioning, decreased insomnia and improved physical health summaries in patients below 65 years of age. These results indicate that Danish patients with MM might have felt protected and safe by COVID restrictions. Otherwise, the questionaries used in QoL-MM survey may not have been able to capture the impact of the COVID-19 pandemic. Importantly, this indicates that QoL survey data obtained in clinical studies, in countries with highly developed health-care systems using standard questionnaires during the pandemic, allow room for interpretation without being adjusted for the impacts of the pandemic.

scholarly journals The determinants of Covid-19 mortality rates across Europe

REGION ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. 199-219
Author(s):  
Yannis Psycharis ◽  
Cleon Tsimbos ◽  
Georgia Verropoulou ◽  
Leonidas Doukissas
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
Mortality Rates ◽  
Policy Implications ◽  
Economic Conditions ◽  
Demographic Structure ◽  
Death Rates ◽  
Level Of Economic Development ◽  
Care Systems ◽  
The Impact

The aim of this paper is to examine empirically the impact of the demographic structure and socio-economic environment on the Covid-19 mortality rate across 29 European countries. The analysis is based on empirical data recorded cumulatively from the start of the Covid-19 disease until 26th May 2020 covering ‘the first wave of the pandemic’. Results indicate that, although countries with a higher degree of ageing structure are anticipated to be more vulnerable to Covid-19, this study provides evidence that population ageing contributes only marginally to Covid-19 death rates across Europe. Urbanization, the level of economic development and health care systems, seem to better explain patterns of interstate mortality rates. The analysis provides important policy implications since it underlines the importance of urbanization and socio-economic conditions in the accelerating incidence of casualties and signifies the importance of health care systems for the protection of people and places from the pandemic.    

scholarly journals Comparing the Impact of Serum GPER-1 and Oxidant/Antioxidant Levels on Retinopathy in Diabetic Patients and Healthy Individuals: A Pilot Study

2021 ◽  
Author(s):  
Abdullah Beyoğlu ◽  
Ergül Belge Kurutaş ◽  
Yalçın Karaküçük ◽  
Ayşegül Çömez ◽  
Ali Meşen
Keyword(s):  
Neuronal Damage ◽  
Diabetic Patients ◽  
Healthy Individuals ◽  
Serum Progesterone ◽  
Post Hoc Analysis ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Post Hoc ◽  
The Impact

Abstract Aims This research sought to determine the impact of serum G receptor-mediated protein-1 (GPER-1) levels on the development of retinopathy in diabetic patients, comparing them to healthy individuals. Methods Forty patients with diabetic retinopathy (DR) (Group 1), 40 patients without DR (NDR) (Group 2) and 40 healthy individuals (Group 3) were included in this study. Serum progesterone, GPER-1, oestradiol, oxidant/antioxidant and thyroid-releasing hormone (TSH) levels were analysed and compared among the groups. Post hoc analysis was performed to compare the sub-groups in which statistically significant differences were found. Results A significant difference was found among all groups in terms of GPER-1, oxidant/antioxidant and oestradiol levels (p < 0.01), but no significant difference was found in terms of TSH or progesterone (p = 0.496, p = 0.220, respectively). In the post hoc analysis of the groups with statistically significant differences, another significant difference was found among all groups for GPER-1 and oxidant/antioxidant levels (p < 0.05). GPER-1 and oxidant levels were positively correlated, while GPER-1 and antioxidant levels were negatively correlated (r = 0.622/p < 0.01, r = 0.453/p < 0.01, r = 0.460/p < 0.01, respectively). The multiple regression analysis showed that increased GPER-1 may help prevent DR. Conclusions GPER-1 levels, which were highest in the DR group, increased as the oxidant/antioxidant balance changed in favour of oxidative stress. This seems to be a defence mechanism for preventing neuronal damage.

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