scholarly journals Predicting Japanese Kampo formulas by analyzing database of medical records: a preliminary observational study

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Tetsuhiro Yoshino ◽  
Kotoe Katayama ◽  
Yuko Horiba ◽  
Kaori Munakata ◽  
Rui Yamaguchi ◽  
...  
Keyword(s):  
Observational Study ◽  
Medical Records

scholarly journals Long-term postoperative opioid prescription after cholecystectomy or gastric by-pass surgery: a retrospective observational study

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Viktoria Larsson ◽  
Cecilia Nordenson ◽  
Pontus Karling
Keyword(s):  
Observational Study ◽  
Postoperative Period ◽  
Medical Records ◽  
Early Postoperative Period ◽  
Retrospective Observational Study ◽  
Opioid Use ◽  
Opioid Prescription ◽  
Post Surgery ◽  
Gastric By Pass

Abstract Objectives Opioids are commonly prescribed post-surgery. We investigated the proportion of patients who were prescribed any opioids 6–12 months after two common surgeries – laparoscopic cholecystectomy and gastric by-pass (GBP) surgery. A secondary aim was to examine risk factors prior to surgery associated with the prescription of any opioids after surgery. Methods We performed a retrospective observational study on data from medical records from patients who underwent cholecystectomy (n=297) or GBP (n=93) in 2018 in the Region of Västerbotten, Sweden. Data on prescriptions for opioids and other drugs were collected from the patients` medical records. Results There were 109 patients (28%) who were prescribed opioids after discharge from surgery but only 20 patients (5%) who still received opioid prescriptions 6–12 months after surgery. All 20 of these patients had also been prescribed opioids within three months before surgery, most commonly for back and joint pain. Only 1 out of 56 patients who were prescribed opioids preoperatively due to gallbladder pain still received prescriptions for opioids 6–12 months after surgery. Although opioid use in the early postoperative period was more common among patients who underwent cholecystectomy, the patients who underwent GBP were more prone to be “long-term” users of opioids. In the patients who were prescribed opioids within three months prior to surgery, 8 out of 13 patients who underwent GBP and 12 of the 96 patients who underwent cholecystectomy were still prescribed opioids 6–12 months after surgery (OR 11.2; 95% CI 3.1–39.9, p=0,0002). Affective disorders were common among “long-term” users of opioids and prior benzodiazepine and amitriptyline use were significantly associated with “long-term” opioid use. Conclusions The proportion of patients that used opioids 6–12 months after cholecystectomy or GBP was low. Patients with preoperative opioid-use experienced a significantly higher risk of “long-term” opioid use when undergoing GBP compared to cholecystectomy. The indication for being prescribed opioids in the “long-term” were mostly unrelated to surgery. No patient who was naïve to opioids prior surgery was prescribed opioids 6–12 months after surgery. Although opioids are commonly prescribed in the preoperative and in the early postoperative period to patients with gallbladder disease, there is a low risk that these prescriptions will lead to long-term opioid use. The reasons for being prescribed opioids in the long-term are often due to causes not related to surgery.

scholarly journals Associations between double-checking and medication administration errors: a direct observational study of paediatric inpatients

2020 ◽  
pp. bmjqs-2020-011473
Author(s):  
Johanna I Westbrook ◽  
Ling Li ◽  
Magdalena Z Raban ◽  
Amanda Woods ◽  
Alain K Koyama ◽  
...  
Keyword(s):  
Observational Study ◽  
Medical Records ◽  
Medication Administration ◽  
Clinical Settings ◽  
Paediatric Hospital ◽  
Factors Associated ◽  
Medication Administration Errors ◽  
Multivariable Regression ◽  
Very High ◽  
Considerable Resource

BackgroundDouble-checking the administration of medications has been standard practice in paediatric hospitals around the world for decades. While the practice is widespread, evidence of its effectiveness in reducing errors or harm is scarce.ObjectivesTo measure the association between double-checking, and the occurrence and potential severity of medication administration errors (MAEs); check duration; and factors associated with double-checking adherence.MethodsDirect observational study of 298 nurses, administering 5140 medication doses to 1523 patients, across nine wards, in a paediatric hospital. Independent observers recorded details of administrations and double-checking (independent; primed—one nurse shares information which may influence the checking nurse; incomplete; or none) in real time during weekdays and weekends between 07:00 and 22:00. Observational medication data were compared with patients’ medical records by a reviewer (blinded to checking-status), to identify MAEs. MAEs were rated for potential severity. Observations included administrations where double-checking was mandated, or optional. Multivariable regression examined the association between double-checking, MAEs and potential severity; and factors associated with policy adherence.ResultsFor 3563 administrations double-checking was mandated. Of these, 36 (1·0%) received independent double-checks, 3296 (92·5%) primed and 231 (6·5%) no/incomplete double-checks. For 1577 administrations double-checking was not mandatory, but in 26·3% (n=416) nurses chose to double-check. Where double-checking was mandated there was no significant association between double-checking and MAEs (OR 0·89 (0·65–1·21); p=0·44), or potential MAE severity (OR 0·86 (0·65–1·15); p=0·31). Where double-checking was not mandated, but performed, MAEs were less likely to occur (OR 0·71 (0·54–0·95); p=0·02) and had lower potential severity (OR 0·75 (0·57–0·99); p=0·04). Each double-check took an average of 6·4 min (107 hours/1000 administrations).ConclusionsCompliance with mandated double-checking was very high, but rarely independent. Primed double-checking was highly prevalent but compared with single-checking conferred no benefit in terms of reduced errors or severity. Our findings raise questions about if, when and how double-checking policies deliver safety benefits and warrant the considerable resource investments required in modern clinical settings.

scholarly journals Prevalence of toddler, child and adolescent overweight and obesity derived from primary care electronic medical records: an observational study

CMAJ Open ◽  
2016 ◽  
Vol 4 (3) ◽  
pp. E538-E544 ◽  
Author(s):  
Suzanne Biro ◽  
Dave Barber ◽  
Tyler Williamson ◽  
Rachael Morkem ◽  
Shahriar Khan ◽  
...  
Keyword(s):  
Primary Care ◽  
Observational Study ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Child And Adolescent ◽  
Overweight And Obesity ◽  
Adolescent Overweight

scholarly journals Ocular related emergencies in Spain during the COVID-19 pandemic, a multicenter study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Martín Puzo ◽  
Jorge Sánchez-Monroy ◽  
Carmen A. Porcar-Plana ◽  
Francisco de Asís Bartol-Puyal ◽  
Marina Dotti-Boada ◽  
...  
Keyword(s):  
Observational Study ◽  
Electronic Medical Records ◽  
Multicenter Study ◽  
Medical Records ◽  
Retrospective Observational Study ◽  
Publication Data ◽  
Tertiary Hospitals ◽  
First Cause ◽  
Acute Conjunctivitis ◽  
Punctate Keratitis

Abstract Purpose To evaluate ophthalmological emergencies (OE) during the COVID-19 pandemic comparing them with the same period of the previous year. Methods Retrospective observational study of all OE visits in four tertiary hospitals in Spain comparing data from March 16th to April 30th, 2020 (COVID-19 period) and the same period of 2019 (pre-COVID-19 period). Severity of the conditions was assessed following Channa et al. publication. Data on demographics, diagnosis and treatments were collected from Electronic Medical Records. Results During lockdown, OE significantly declined by 75.18%, from 7,730 registered in the pre-COVID-19 period to 1,928 attended during the COVID-19 period (p < 0.001). In 2019, 23.86% of visits were classified as emergent, 59.50% as non-emergent, and 16.65% could not be determined. In 2020, the percentage of emergent visits increased up to 29.77%, non-emergent visits significantly decreased to 52.92% (p < 0.001), and 17.31% of the visits were classified as “could not determine”. During the pandemic, people aged between 45 and 65 years old represented the largest attending group (37.89%), compared to 2019, where patients over 65 years were the majority (39.80%). In 2019, most frequent diagnosis was unspecified acute conjunctivitis (11.59%), followed by vitreous degeneration (6.47%), and punctate keratitis (5.86%). During the COVID-19 period, vitreous degeneration was the first cause for consultation (9.28%), followed by unspecified acute conjunctivitis (5.63%) and punctate keratitis (5.85%). Conclusions OE visits dropped significantly during the pandemic in Spain (75.18%), although more than half were classified as non-urgent conditions, indicating a lack of understanding of the really emergent ocular pathologies among population.

scholarly journals Outcomes in rheumatoid arthritis patients treated with abatacept: a UK multi-centre observational study

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Ernest Choy ◽  
Lara Groves ◽  
Daniel Sugrue ◽  
Michael Hurst ◽  
John Houghton ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Observational Study ◽  
Medical Records ◽  
Functional Disability ◽  
Joint Destruction ◽  
Treatment Patterns ◽  
Chronic Synovitis ◽  
Line Of Therapy ◽  
The Uk ◽  
Inflammatory Autoimmune Disease

Abstract Background Rheumatoid arthritis (RA) is an inflammatory autoimmune disease that causes chronic synovitis, resulting in progressive joint destruction and functional disability and affects approximately 400,000 people in the UK. This real-world study aimed to describe the characteristics, treatment patterns and clinical outcomes of patients who received abatacept in UK clinical practice. Methods This was a multi-centre, retrospective, observational study of patients with RA treated with abatacept at four UK centres between 01 January 2013 and 31 December 2017. Data were collected from medical records of each patient from the index date (date of first bDMARD initiation) until the most recent visit, death or end of study (31 December 2017). Results In total, 213 patients were included in the study. Patients received up to eight lines of therapy (LOTs). Treatment with abatacept, or any other bDMARD, was associated with reductions in DAS28-ESR and DAS28-CRP scores at 6 and 12 months. The distribution of EULAR responses (good/moderate/no response) tended to be more favourable for patients when receiving abatacept than when receiving other bDMARDs (22.8%/41.3%/35.9% versus 16.6%/41.4%/42.1% at 6 months, and 27.9%/36.1%/36.1% versus 21.2%/34.5%/44.2% at 12 months). Patients receiving abatacept at LOT1 (n = 68) spent significantly longer on treatment compared with patients receiving other bDMARDs (53.4 vs. 17.4 months; p< 0.01); a similar trend was observed for LOT2. Among patients who discontinued after 6 months, a greater proportion experienced infection requiring antibiotics when receiving other bDMARDs compared to those receiving abatacept. Conclusions RA patients who received bDMARDs, including abatacept, experienced reduced disease activity. When receiving abatacept as first or second line of therapy, patients persisted with treatment significantly longer than those receiving other bDMARDs.

scholarly journals P625 Characteristics of SARS-CoV-2 infection in IBD patients in the second and third wave compared with the first wave and with the data of general population

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S563-S564
Author(s):  
I Guerra Marina ◽  
A Algaba ◽  
S Castro ◽  
L Jiménez ◽  
D Garza ◽  
...  
Keyword(s):  
General Population ◽  
Observational Study ◽  
Clinical Features ◽  
Medical Records ◽  
Telephone Interview ◽  
Demographic Characteristics ◽  
Third Wave ◽  
Autonomous Community ◽  
Severity Of Disease ◽  
Biological Treatments

Abstract Background Our aims were: 1.) to compare the characteristics of SARS-CoV-2 infection in IBD patients in the second and third wave with respect to the results published in our site in the first wave (I. Guerra et al. Inflamm Bowel Dis. 2021 Jan 1;27(1):25–33) and 2.) to compare the date of the second and third wave with data of general population from the Autonomous Community of Madrid Methods Cohort, observational study in IBD patients followed in our IBD Unit with SARS-CoV-2 infection between March 2020 and May 2020 (first wave) and between July 2020 to March 2021 (second-third wave). All data were collected by telephone interview and reviewing the electronical medical records Results The demographic characteristics of the patients included are shown in Table 1. Regarding clinical features of SARS-CoV-2 infection in both group of patients are represented in Table 2. The severity of disease was not related to immunomodulators and/or biological treatments in both cohorts. The number of COVID-19 cases by date in our IBD Unit in comparison with the cases in the Community of Madrid are shown in the Figure 1. Conclusion The patients diagnosed in the first wave were older and more symptomatic. Although the number of severe cases was higher in the first wave, influenced by the limited availability of tests in that period, no difference was found in mortality or in the percentage of ICU admissions.Severity of SARS-CoV-2 infection was not related to immunosuppression and in the second-third wave the IBD treatment was maintained more frequently.The distribution of cases in our series was in concordance with the data obtained in the general population.

scholarly journals Patient Safety and Unplanned Extubation in a Pediatric Intensive Care Unit: A Analytical Observational Study

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Elaine Rossi Ribeiro
Keyword(s):  
Observational Study ◽  
Medical Records ◽  
Unknown Origin ◽  
Female Gender ◽  
Unplanned Extubation ◽  
Large Hospital ◽  
Unplanned Extubations ◽  
Surgical Icu ◽  
Protocol Evaluation ◽  
Domain 3

Introduction: Unplanned extubation (UE) is characterized by the removal or displacement of the endotracheal tube (ETT). Objectives: To analyze the incidence of unplanned extubation, characterize the most prevalent cases of unplanned extubation and analyze an extubation protocol. Methodology: This study is characterized as an analytical observational study design, performed in two stages: field research to collect and analyze data from medical records and analysis of the NPE protocol used by a large hospital. Results: In the collected medical records, rates of 7.75 UE/100 days of MV for general and surgical ICU and 4.68 UE/100 days of MV for cardiopediatric ICU were found. The female gender was predominant in the group of patients evaluated and the cause of unknown origin was the most prevalent. We identified 19 unplanned extubations in the general and surgical ICU, and 9 episodes of unplanned extubation in the cardiopediatric ICU, 28 occurrences. For the protocol evaluation the AGREE II instrument was used and the following scores were obtained: domain 1 with 85.19%; domain 2 with 72.22%; domain 3 with 35.42%; domain 4 with 96.30%; domain 5 with 76.39% and domain 6 with 100%. The general score of the protocol evaluation was grade four. Conclusion: The data presented can be of great benefit for prevention, identification and early intervention of UE episodes in pediatric patients with higher risk factors.

scholarly journals Hubungan Kadar Kreatinin Serum Dengan Kadar Mineral Pada Pasien Chronic Kidney Disease

2020 ◽  
Vol 7 (2) ◽  
pp. 393-397
Author(s):  
Diah Ayu Kusuma ◽  
Indranila Kustarini Samsuria
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Observational Study ◽  
Serum Creatinine ◽  
Kidney Function ◽  
Medical Records ◽  
Retrospective Observational Study ◽  
Metabolic Processes ◽  
Cross Sectional ◽  
Positive Correlation

Pendahuluan : Chronic Kidney Disease (CKD) merupakan gangguan fungsi ginjal yang irreversible, yaitu kemampuan tubuh gagal untuk mempertahankan metabolisme dan keseimbangan cairan dan elektrolit dan juga mineral. Sebagian besar proses metabolisme memerlukan dan dipengaruhi oleh elektrolit. Konsentrasi elektrolit mineral yang tidak normal dapat menyebabkan banyak gangguan .  Saat fungsi ginjal semakin memburuk menjadi Stadium CKD 4 dan 5, ekskresinya cenderung berkurang dan tidak dapat dikompensasi. Tujuan penelitian ini adalah melihat pengaruh CKD pada mineral yaitu magnesium dan calcium. Metode : Penelitian ini adalah penelitian observasional retrospektif dengan pendekatan belah lintang (cross sectional) dengan melihat rekam medik pada senter tunggal di RSUP Dr. Kariadi Semarang selama periode 1 Januari 2017 – 31 Desember 2018 untuk kemudian dilihat hubungan pengaruh kadar kreatinin serum dengan magnesium dan calcium pada pasien CKD dengan terapi hemodialisis. Hasil dan pembahasan: Terdapat hubungan signifikan positif lemah antara kreatinin serum dengan magnesium (p=0,032, r= 0,327).  Tidak terdapat hubungan antara kreatinin serum dengan kadar kalsium. Simpulan : Dari hasil penelitian dapat disimpulkan bahwa secara statistik terdapat hubungan yang bermakna antara kadar kreatinin serum dengan magnesium pada pasien Chronic Kidney Disease (CKD) dengan terapi hemodialisis. Kata Kunci Kreatinin, mineral, magnesium Chronic Kidney Disease, hemodialisis.   ABSTRACT Introduction: Chronic Kidney Disease (CKD) is an irreversible kidney function disorder, which is the body's ability to fail to maintain metabolism and balance fluid and electrolytes and minerals. Most metabolic processes require and are influenced by electrolytes. Abnormal mineral electrolyte concentrations can cause many disturbances. When kidney function getting worse to stages CKD 4 and 5, the excretion tends to decrease and cannot be compensated. The purpose of this study is to look at the effect of CKD on minerals namely magnesium and calcium. Method: This study was a retrospective observational study with a cross sectional approach by looking at medical records at RSUP Dr. Kariadi Semarang during the period of 1 January 2017 - 31 December 2018 to see the correlation of  influence of serum creatinine levels with magnesium and calcium in CKD patients with hemodialysis therapy. Results and discussion: There was a significantly weak positive correlation between serum creatinine and magnesium (p = 0.032, r = 0.327). There is no correlation between serum creatinine and calcium levels. Conclusion: The results of the study it can be concluded that there is a statistically significant correlation between serum creatinine levels with magnesium in Chronic Kidney Disease (CKD) patients with hemodialysis therapy. Keywords Creatinine, minerals, magnesium Chronic Kidney Disease, hemodialysis.

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