EFFICACY OF A NOVEL DEVICE TO DETECT, ALERT AND RESOLVE NEONATAL APNEA - PILOT STUDY

2019 ◽  
Vol 9 (9) ◽  
pp. 608-613
Author(s):  
Dr. Swapna Lingaldinna,Dr. Himabindu Singh,Mona Sharma*
Keyword(s):  
Newborn Care ◽  
Standard Of Care ◽  
The Novel ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
Care Community ◽  
Novel Device ◽  
Sick Newborn ◽  
Central Apneas ◽  
Neonatal Apnea

Objective: To measure the accuracy of a novel device in detecting Bradycardia andDesaturation (B&D) events and to determine its efficacy in resolving apneas innewborns with comparison to standard monitor (which only detects B&D eventsand alerts).Design: This was a prospective observational study.Setting: Sick Newborn Care Unit of a large tertiary referral hospital in Hyderabad,India.Methods: 31 newborns were provided with a novel device, which monitored oxygensaturation and pulse rate and alarmed when values dropped below a set thresholdwhich is referred as an event, henceforth. The novel device also provided footstimulation in response to above-mentioned events. When the monitor alarmed, anurse attended to the baby to confirm whether the baby was breathing and whetherthe event had been resolved by the device. If the event had not resolved, appropriateaction as per the standard-of-care was performed.Results: The novel device “ApneBootTM” positively detected B&D events 94.03% oftimes as compared to the standard reference monitor. 56 of 67 observed B&D eventswere visually confirmed to be apneas, indicating that 83.6% of B&D eventscoincided with apneas. Of the 56 apneic events, 50 were central apneas, of which 35were resolved by the novel device, making the device’s efficacy of apnea resolution70%.Conclusion: The results of the study indicate that this novel device “ApneBootTM”is very effective in detecting and alarming B&D events, which coincides with theapnea, and resolving it by providing foot stimulation.Keywords: Novel Device, Neonatal Apnea, Low Birth Weight, Body Temperature,Kangaroo Mother Care, Community Health,

scholarly journals Unlocking of the Orthopedic Department in the Largest Tertiary Referral Hospital of Iran: Our Experience during Coronavirus Disease 2019 Pandemic

2020 ◽  
Author(s):  
Seyed Hadi Kalantar ◽  
Seyed Mohammad Javad Mortazavi ◽  
Mohammadreza Razzaghof ◽  
Alireza Moharrami ◽  
Mohammad Zarei ◽  
...  
Keyword(s):  
Referral Hospital ◽  
The Novel ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
Microsoft Excel ◽  
Orthopedic Department ◽  
Healthcare Crisis ◽  
The Mean ◽  
The Government ◽  
Second Wave

Background: The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused the largest global healthcare crisis of the last century since its emergence in December 2019. As more of the condition’s chronicity became evident and the government policies changed, the unlocking of the orthopedic wards seemed necessary. In this study, we decided to share our experience regarding the unlocking of our orthopedic ward in the largest tertiary referral hospital of Iran and to explain its negative and positive consequences. Methods: This observational study was done in Imam Khomeini Hospital Complex, Tehran, Iran, from April to August 2020. We extracted the data regarding the number of elective/trauma operations, emergency patients, and morning report sessions attendance from our registry database. The data were analyzed and plotted using Microsoft Excel 365. Results: The mean weekly number of orthopedic operations decreased from 50 for elective and 30 for trauma operations in January 2020 to almost zero for both in late March and early April 2020 [the first coronavirus disease 2019 (COVID-19) peak]. Following the department unlocking, the mean weekly elective and trauma operations returned to 50 and 20 by mid-June, respectively. The mean weekly orthopedic emergency visits followed the same order with decrease from 50 to almost zero in late March and increase to 70 in mid-June. However, by the beginning of the second wave, it decreased to almost 38 in early July and further to 28 in late July by the end of the second wave. Conclusion: The unlocking of the orthopedic department in a tertiary referral hospital during the COVID-19 pandemic is possible, provided that there is a set of protocols for patient care in the ward, emergency room (ER), operating room (OR), and clinic during the pandemic.

Measuring Earwax Cortisol Concentration Using a Non-Stressful Method (Preprint)

2020 ◽  
Author(s):  
Andrés Herane-Vives
Keyword(s):  
Cortisol Level ◽  
Local Stress ◽  
Extraction Methods ◽  
Cortisol Concentration ◽  
The Novel ◽  
Sampling Device ◽  
Related Factors ◽  
Novel Device ◽  
Cortisol Levels ◽  
The Right

BACKGROUND “Short-term” samples are not the most appropriate for reflecting Chronic Cortisol Concentration (CCC). Although hair is used for reflecting the systemic cortisol level over “long-term”, its use appears clinically problematic. Local stress and non-stress related factors may release a circumscribed cortisol secretion that is accumulated in hair. Non-stressful earwax extraction methods may provide a more accurate specimen to measure CCC. OBJECTIVE Correlate cortisol levels using hair, serum and earwax samples METHODS Earwax from both ears of 37 controls were extracted using a clinical procedure commonly associated with local pain. One month later, earwax from the left ear side was extracted using the same procedure, and earwax from the right ear side was comfortably extracted, using an earwax self-sampling device. Participants also provided one centimetre of hair that represented the retrospective month of cortisol output, and one serum sample that reflected the effect of systemic stressors on cortisol levels. Earwax (ECC), Hair (HCC) and Serum (SCC) Cortisol Concentration were correlated and compared. Confounders´ effect on cortisol levels were studied. RESULTS Serum showed the largest and hair the lowest cortisol concentration (p<0.01). Left-ECC was larger than Right-ECC (p=0.03). Right-ECC was the only sample unaffected by confounders (all p>0.05). Right-ECC and HCC showed the only significant association (r=0.39; p=0.03). CONCLUSIONS The self-sampling device did not represent a local stressor for the ceruminous glands. It provided the cortisol level with the least likely to be affected by confounding factors over the previous month. ECC using the novel device may constitute another accurate, but more suitable and affordable specimen for measuring CCC.

scholarly journals Wrapping the pancreas with a polyglycolic acid sheet before stapling reduces the risk of fluid collection on the pancreatic stump after distal pancreatectomy

2021 ◽  
Author(s):  
Ji Su Kim ◽  
Seoung Yoon Rho ◽  
Dong Min Shin ◽  
Munseok Choi ◽  
Chang Moo Kang ◽  
...  
Keyword(s):  
Pancreatic Fistula ◽  
Distal Pancreatectomy ◽  
Fluid Collection ◽  
International Study ◽  
Polyglycolic Acid ◽  
Previous Method ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
Pancreatic Stump ◽  
Resection Line

Abstract Background Postoperative pancreatic fistula (POPF) and postoperative fluid collection (POFC) are common complications after distal pancreatectomy (DP). The previous method of reducing the risk of POPF was the application of a polyglycolic acid (PGA) sheet to the pancreatic stump after cutting the pancreas with a stapler (After-stapling); the new method involves wrapping the pancreatic resection line with a PGA sheet before stapling (Before-stapling). The study aimed to compare the incidence of POPF and POFC between two methods. Methods Data of patients who underwent open or laparoscopic DPs by a single surgeon from October 2010 to February 2020 in a tertiary referral hospital were retrospectively analyzed. POPF was defined according to the updated International Study Group of Pancreatic Fistula criteria. POFC was measured by postoperative computed tomography (CT). Results Altogether, 182 patients were enrolled (After-stapling group, n = 138; Before-stapling group, n = 44). Clinicopathologic and intraoperative findings between the two groups were similar. Clinically relevant POPF rates were similar between both groups (4.3% vs. 4.5%, p = 0.989). POFC was significantly lesser in the Before-stapling group on postoperative day 7 (p < 0.001). Conclusions Wrapping the pancreas with PGA sheet before stapling was a simple and effective way to reduce POFC.

scholarly journals Direct antivirals working against the novel coronavirus: azithromycin (DAWn-AZITHRO), a randomized, multicenter, open-label, adaptive, proof-of-concept clinical trial of new antivirals working against SARS-CoV-2—azithromycin trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Iwein Gyselinck ◽  
◽  
Laurens Liesenborghs ◽  
Ewout Landeloos ◽  
Ann Belmans ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Standard Of Care ◽  
Ordinal Scale ◽  
Cytokine Signaling ◽  
Nasopharyngeal Swab ◽  
The Novel ◽  
Proof Of Concept ◽  
Open Label ◽  
Novel Coronavirus

Abstract Background The rapid emergence and the high disease burden of the novel coronavirus SARS-CoV-2 have created a medical need for readily available drugs that can decrease viral replication or blunt the hyperinflammatory state leading to severe COVID-19 disease. Azithromycin is a macrolide antibiotic, known for its immunomodulatory properties. It has shown antiviral effect specifically against SARS-CoV-2 in vitro and acts on cytokine signaling pathways that have been implicated in COVID-19. Methods DAWn-AZITHRO is a randomized, open-label, phase 2 proof-of-concept, multicenter clinical trial, evaluating the safety and efficacy of azithromycin for treating hospitalized patients with COVID-19. It is part of a series of trials testing promising interventions for COVID-19, running in parallel and grouped under the name DAWn-studies. Patients hospitalized on dedicated COVID wards are eligible for study inclusion when they are symptomatic (i.e., clinical or radiological signs) and have been diagnosed with COVID-19 within the last 72 h through PCR (nasopharyngeal swab or bronchoalveolar lavage) or chest CT scan showing typical features of COVID-19 and without alternate diagnosis. Patients are block-randomized (9 patients) with a 2:1 allocation to receive azithromycin plus standard of care versus standard of care alone. Standard of care is mostly supportive, but may comprise hydroxychloroquine, up to the treating physician’s discretion and depending on local policy and national health regulations. The treatment group receives azithromycin qd 500 mg during the first 5 consecutive days after inclusion. The trial will include 284 patients and recruits from 15 centers across Belgium. The primary outcome is time from admission (day 0) to life discharge or to sustained clinical improvement, defined as an improvement of two points on the WHO 7-category ordinal scale sustained for at least 3 days. Discussion The trial investigates the urgent and still unmet global need for drugs that may impact the disease course of COVID-19. It will either provide support or else justify the discouragement of the current widespread, uncontrolled use of azithromycin in patients with COVID-19. The analogous design of other parallel trials of the DAWN consortium will amplify the chance of identifying successful treatment strategies and allow comparison of treatment effects within an identical clinical context. Trial registration EU Clinical trials register EudraCT Nb 2020-001614-38. Registered on 22 April 2020

Micafungin use in a UK tertiary referral hospital

2018 ◽  
Vol 15 ◽  
pp. 82-87 ◽  
Author(s):  
David A. Enoch ◽  
Michael E. Murphy ◽  
Christianne Micallef ◽  
Huina Yang ◽  
Nicholas M. Brown ◽  
...  
Keyword(s):  
Referral Hospital ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital

scholarly journals Mortality in children with COVID-19: Lessons learned from a tertiary referral hospital in Indonesia

2021 ◽  
Author(s):  
Rismala Dewi ◽  
Nastiti Kaswandani ◽  
Mulya Rahma Karyanti ◽  
Darmawan Budi Setyant ◽  
Antonius Hocky Pudjiadi ◽  
...  
Keyword(s):  
Lessons Learned ◽  
Referral Hospital ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital

scholarly journals Carbapenemase screening in an Irish tertiary referral hospital: Best practice, or can we do better?

2020 ◽  
Vol 2 (4) ◽  
pp. 100100
Author(s):  
S. Fahy ◽  
J.A. O'Connor ◽  
D. O'Brien ◽  
L. Fitzpatrick ◽  
M. O'Connor ◽  
...  
Keyword(s):  
Best Practice ◽  
Referral Hospital ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital
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