scholarly journals Factors influencing length of survival in ambulatory palliative care - a cross sectional study based on secondary data

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Johannes Just ◽  
Marie-Therese Schmitz ◽  
Ulrich Grabenhorst ◽  
Thomas Joist ◽  
Kirsten Horn ◽  
...  
Keyword(s):  
Palliative Care ◽  
Survival Time ◽  
Performance Status ◽  
Secondary Data ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Karnofsky Score ◽  
Cross Sectional ◽  
And Performance ◽  
Clinical Records

Abstract Background Quality of life and patient self-determination are key elements in successful palliative care. To achieve these goals, a robust prediction of the remaining survival time is useful as it can provide patients and their relatives with information for individual goal setting including appropriate priorities. The Aim of our study was to assess factors that influence survival after enrollment into ambulatory palliative care. Methods In this cross-sectional, multicenter study (n = 14 study centers) clinical records of all palliative care patients who were treated in 2017 were extracted and underwent statistical analysis. The main outcome criterion was the association of survival time with clinical characteristics such as age, type of disease, symptoms and performance status. Results A total of 6282 cases were evaluated. Median time of survival was 26 days (95 % CI: 25–27 days). The strongest association for an increased hazard ratio was found for the following characteristics: moderate/severe weakness (aHR: 1.91; 95 % CI: 1.27–2.86) Karnofsky score 10–30 (aHR: 1.80; 95 % CI: 1.67–1.95), and age > 85 (aHR: 1.50; 95 % CI: 1.37–1.64). Surprisingly, type of disease (cancer vs. non-cancer) was not associated with a change in survival time (aHR: 1.03; 95 % CI: 0.96–1.10). Conclusions In this cross-sectional study, the most relevant predictor for a short survival time in specialized ambulatory palliative care was the performance status while type of disease was irrelevant to survival.

scholarly journals Thyroid cancer overdiagnosis and overtreatment: a cross- sectional study at a thyroid cancer referral center in Ecuador

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Paola Solis-Pazmino ◽  
Jorge Salazar-Vega ◽  
Eddy Lincango-Naranjo ◽  
Cristhian Garcia ◽  
Gabriela Jaramillo Koupermann ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Cancer Mortality ◽  
Incidental Finding ◽  
Cross Sectional Study ◽  
Anaplastic Carcinoma ◽  
Treatment Modalities ◽  
Sectional Study ◽  
Cross Sectional ◽  
Referral Center ◽  
Clinical Records

Abstract Background In contrast to the rapid increase in thyroid cancer incidence, the mortality has remained low and stable over the last decades. In Ecuador, however, thyroid cancer mortality has increased. The objective of this study is to determine possible drivers of high rates of thyroid cancer mortality, through a cross-sectional analysis of all patients attending a thyroid cancer referral center in Ecuador. Methods From June 2014 to December 2017, a cross-sectional study was conducted at the Hospital de Especialidades Eugenio Espejo, a regional reference public hospital for endocrine neoplasia in adults in Quito, Ecuador. We identified the mechanism of detection, histopathology and treatment modalities from a patient interview and review of clinical records. Results Among 452 patients, 74.8% were young adults and 94.2% (426) were female. 13.7% had a family history of thyroid cancer, and patients’ median tumor size was 2 cm. The incidental finding was 54.2% whereas 45.8% was non-incidental. Thyroid cancer histology reported that 93.3% had papillary thyroid cancer (PTC), 2.7% follicular, 1.5% Hurtle cells, 1.6% medullary, 0.7% poor differentiated, and 0.2% anaplastic carcinoma. The mean MACIS (metastasis, age, completeness, invasion, and size) score was 4.95 (CI 4.15–5.95) with 76.2% of the thyroid cancer patients having MACIS score less than or equal to 6. The very low and low risk of recurrence was 18.1% (79) and 62% (271) respectively. An analysis of 319 patients with non-metastatic thyroid cancer showed that 10.7% (34) of patients had surgical complications. Moreover, around 62.5% (80 from 128 patients with thyroglobulin laboratory results) of TC patients had a stimulated-thyroglobulin value equal or higher than 2 ng/ml. Overall, a poor surgical outcome was present in 35.1% (112) patients. Out of 436 patients with differentiated thyroid carcinoma, 86% (375) received radioactive iodine. Conclusion Thyroid cancer histological characteristics and method of diagnosis are like those described in other reports without any evidence of the high frequency of aggressive thyroid cancer histology. However, we observed evidence of overtreatment and poor surgical outcomes that demand additional studies to understand their association with thyroid cancer mortality in Ecuador.

scholarly journals Identifying missing people: the contribution of forensic dentistry and DNA

2017 ◽  
Vol 46 (6) ◽  
pp. 313-318
Author(s):  
Luciene Menrique CORRADI ◽  
Denise Vieira TRAVASSOS ◽  
Sylvia Cury COSTE ◽  
Rosa Núbia Vieira de MOURA ◽  
Efigênia Ferreira e FERREIRA
Keyword(s):  
Forensic Anthropology ◽  
Dna Analysis ◽  
Secondary Data ◽  
Human Identification ◽  
Cross Sectional Study ◽  
Medical Institute ◽  
Forensic Dentistry ◽  
Sectional Study ◽  
Cross Sectional ◽  
Dental Examination

Abstract Introduction Human identification is considered one of the major steps concerning missing people. The Forensic Anthropology Sector of Legal Medical Institutes identifies corpses. Forensic dentistry and DNA tests stand out among the existing standard tests. Objective This article aimed to evaluate human identification effectiveness through forensic dental examination performed in the forensic anthropology sector in a Forensic Medical Institute, comparing them with DNA analyses. Methodology This is a cross-sectional study using secondary data available in the department´s database, from 2008 to 2014, concerning identification procedures using forensic dentistry and DNA techniques. Result The analysis of the examinations eligible to this study (241) showed that DNA analysis was the method used for identification in 79.3% of the cases and forensic dental examinations were used in 20.7% of the cases. As for the type of biological material used during these examinations, unidentified corpses corresponded to 131 cases (53.9%), skeleton structures corresponded to 109 cases (44.9%) and there were 3 cases of body segments (1.2%). When analyzing the time spent to complete the tests, dental examinations were faster than DNA tests. The time spent for forensic dental examination does not depend on the type of dental documentation evaluated. Conclusion The analysis of the results in this study showed that human identification through forensic dentistry is effective, rapid and less costly, contributing to greater agility in solving issues related to locating missing people.

scholarly journals Prevalence and Factors Associated with Undernutrition on Cancer Patients at Tikur Anbessa Specialized Hospital, Ethiopia: A cross-sectional study

2021 ◽  
Author(s):  
Eyerusalem Worku ◽  
Hayat Aragaw ◽  
Damitie Kebede
Keyword(s):  
Cancer Patients ◽  
Addis Ababa ◽  
Performance Status ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Under Nutrition ◽  
Specialized Hospital ◽  
Tikur Anbessa Specialized Hospital

Abstract Background Cancer is one of the leading causes of death in the world and it is considered that every fourth person dies of it. Under-nutrition is most commonly seen in cancer patients with some types of solid tumors, various chronic diseases, as well as in older persons and young children. This can result in longer hospital stay, reduced response to therapies, increased complications to therapy and surgery proceedings, poor survival and higher care costs. This study aimed to assess the prevalence and factors associated with under-nutrition on cancer patients attending Tikur Anbessa Specialized Hospital, Ethiopia.Methods Cross-sectional study was conducted from September to October 2018 among 347 cancer patients in Tikur Anbessa Specialized hospital Addis Ababa, Ethiopia. All cancer patients 18–65 years of age who were on the 2nd cycle and above treatment phase were included. Quantitative data was collected using questionnaires and the Patient Generated-Subjective Global Assessment (PG-SGA) score. Data was entered into Epi-Info version 7 and exported and analyzed by SPSS version 20. Both bivariate and multivariate logistic regression analyses were employed to identify the associated factors. Variables with 𝑃 value of less than 0.05 were considered as significant predictors.Results The prevalence of under-nutrition according to PG-SGA score result 202 (63.1%) and 88(27.5%) of the participants were moderately and severely undernourished, respectively. BMI of the participants also showed that 206 (64.4%) and 89 (27.8%) were normal and underweight, respectively. Two hundred seventy-six (86.3%) of the patients needed critical nutrition intervention. Performance status of ≥ 2 [AOR = 7.9, 95% CI (3.05, 20.48)] and cancer stage II, III & IV [AOR = 3.47, 95% CI (1.25, 9.58)], [AOR = 3.81, 95% CI (1.17, 12.31)] and [AOR = 6.11, 95% CI (1.48, 25.14)] were significantly associated with malnutrition on cancer patients at a P-value < 0.05.Conclusion The prevalence of under-nutrition is prevalent in the study area. Performance status of ≥ 2 and cancer stages were important factors associated with malnutrition in cancer patients. Screening and evaluation of nutritional status of the patients and planning nutritional therapy such as dietary supplements or enteral nutrition to counteract malnutrition on cancer patients should be implemented.

scholarly journals Profil Primigravida Muda dan Luaran Persalinan di Rumah Sakit Dr.Oen Surakarta

2018 ◽  
Vol 5 (1) ◽  
pp. 39
Author(s):  
Supanji Raharja ◽  
Ova Emilia ◽  
Poedji Rochjati
Keyword(s):  
Secondary Data ◽  
Cross Sectional Study ◽  
Young Age ◽  
Reproductive Age ◽  
Perinatal Morbidity ◽  
Sectional Study ◽  
Cross Sectional ◽  
Level Of Education ◽  
Adolescent Women ◽  
Important Health

Background: Pregnancy at a young age has become an important health problem both in developed and developing countries. Pregnancy at a young age increases the risk of maternal and perinatal morbidity and mortality. This is because adolescent women who are not ready both physically and psychologically to get pregnant.Obsjective: This study aims to identify and analyze labor in young primigravida (<20 years) with pathological labor in hospital Dr.Oen Surakarta.Method: This was an observational analytic study without intervention in the form of comparative cross sectional study conducted in young primigravida group age <20 years and primigravida group age 20 to 34 years old, who underwent labor in hospital delivery room. Dr.Oen Surakarta. This study used secondary data from the medical record of pregnant women who gave birth at RS.Dr.Oen Surakarta from January 1, 2011 to December 31, 201. A comparison between young primigravids (<20 years) in which pathologic pathways were performed with primigravida of reproductive age (20-34 years) experienced pathological labor were conducted.Result and Discussion: The number of deliveries in young primigravida (<20 years) was 61 people (6.65%) whereas in primigravida (21-35 years) there were 856 people (93.34%). Younger primigravids have lower levels of education than the primigravida age of reproductive age (p 0.00, CI 3.557 - 11.227). The younger primigravida has a tendency to give birth outside its residence area compared to primigravida of reproductive age (p 0.00; CI 0.050,178). Unmarried status in the young primigravida is greater than that of primigravida of reproductive age (p 0.00, CI 0.011 - 0,229) .An Antenatal Care on Primigravida reproductive age is more regular than young primigravida (p 0.03; CI 0.255 - 0.97) . Young primigravida tended to have anemia (p = 0.00, OR 8.4 CI 3.22 - 21.93) The risk of prematurity was higher in young primigravids than in the reproductive age primigravida (p 0.01, OR 2.9 CI 1, 16 - 7.25). Younger primigravids have a higher risk for pathologic delivery compared to primigravida of reproductive age (p 0.05 OR 0.56 CI 0.315 - 1.01).Conclusions: There are differences in terms, level of education, marital status, residence, regularity of ANC between young primigravida and prmigravida of reproductive age. The study found that young primigravids have a higher risk of occurrence of anemia, prematurity and pathologic delivery compared with healthy reproductive age primigravids.Keywords: young primigravida, primigravida healthy reproductive age, risk factors

scholarly journals Costs of reusable and disposable aprons in a public teaching hospital

2014 ◽  
Vol 48 (5) ◽  
pp. 915-921
Author(s):  
Paloma de Souza Cavalcante Pissinati ◽  
Maria do Carmo Lourenço Haddad ◽  
Mariana Ângela Rossaneis ◽  
Roseli Broggi Gil ◽  
Renata Aparecida Belei
Keyword(s):  
Direct Cost ◽  
Teaching Hospital ◽  
Average Cost ◽  
Secondary Data ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Hospital Managers ◽  
Study Population ◽  
The Cost

Objective To analyze the direct cost of reusable and disposable aprons in a public teaching hospital. Method Cross-sectional study of quantitative approach, focusing on the direct cost of reusable and disposable aprons at a teaching hospital in northern Paraná. The study population consisted of secondary data collected in reports of the cost of services, laundry, materials and supplies division of the institution for the year 2012 Results We identified a lower average cost of using disposable apron when compared to the reusable apron. The direct cost of reusable apron was R$ 3.06, and the steps of preparation and washing were mainly responsible for the high cost, and disposable apron cost was R$ 0.94. Conclusion The results presented are important for hospital managers properly allocate resources and manage costs in hospitals
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Change in foot strike patterns and performance in recreational runners during a road race: A cross-sectional study

2020 ◽  
Vol 23 (6) ◽  
pp. 621-624 ◽  
Author(s):  
Stephen P. Bovalino ◽  
Neil J. Cunningham ◽  
Rachel D. Zordan ◽  
Samuel M. Harkin ◽  
Heidi H.G. Thies ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Foot Strike ◽  
Road Race ◽  
Recreational Runners ◽  
And Performance

scholarly journals Characteristics of prescriptions and costs for acute upper respiratory tract infections in Chinese outpatient pediatric patients: a nationwide cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Shan Wang ◽  
Lihua Liu ◽  
Jianchao Liu ◽  
Likun Miao ◽  
Qian Zhuang ◽  
...  
Keyword(s):  
Outpatient Care ◽  
Pediatric Patients ◽  
Cross Sectional Study ◽  
Upper Respiratory Tract ◽  
Sectional Study ◽  
Cross Sectional ◽  
Short Supply ◽  
Upper Respiratory ◽  
Tract Infections ◽  
Clinical Records

Abstract Background To understand the characteristics of prescriptions and costs in pediatric patients with acute upper respiratory infections (AURI) is important for the regulation of outpatient care and reimbursement policy. This study aims to provide evidence on these issues that was in short supply. Methods We conducted a retrospective cross-sectional study based on data from National Engineering Laboratory of Application Technology in Medical Big Data. All outpatient pediatric patients aged 0–14 years with an uncomplicated AURI from 1 January 2015 to 31 December 2017 in 138 hospitals across the country were included. We reported characteristics of patients, the average number of medications prescribed per encounter, the categories of medication used and their percentages, the cost per visit and prescription costs of drugs. For these measurements, discrepancies among diverse groups of age, regions, insurance types, and AURI categories were compared. Kruskal-Wallis nonparametric test and Student-Newman-Keuls test were performed to identify differences among subgroups. A multinomial logistic regression was conducted to examine the independent effects of those factors on the prescribing behavior. Results A total of 1,002,687 clinical records with 2,682,118 prescriptions were collected and analyzed. The average number of drugs prescribed per encounter was 2.8. The most frequently prescribed medication was Chinese traditional patent medicines (CTPM) (36.5% of overall prescriptions) followed by antibiotics (18.1%). It showed a preference of CPTM over conventional medicines. The median cost per visit was 17.91 USD. The median drug cost per visit was 13.84 USD. The expenditures of antibiotics and CTPM per visit (6.05 USD and 5.87 USD) were among the three highest categories of drugs. The percentage of out-of-pocket patients reached 65.9%. Disparities were showed among subgroups of different ages, regions, and insurance types. Conclusions The high volume of CPTM usage is the typical feature in outpatient care of AURI pediatric patients in China. The rational and cost-effective use of CPTM and antibiotics still faces challenges. The reimbursement for child AURI cases needs to be enhanced.

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