scholarly journals Peripheral polyneuropathy from electrodiagnostic tests: a 10-year etiology and neurophysiology overview

2021 ◽  
Author(s):  
Renata Dal-Prá Ducci ◽  
Camila Lorenzini Tessaro ◽  
Cláudia Suemi Kamoi Kay ◽  
Otto Jesus Hernandez Fustes ◽  
Lineu Cesar Werneck ◽  
...  
Keyword(s):  
Medical Records ◽  
Neuromuscular Disorders ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Etiological Diagnosis ◽  
Sensorimotor Polyneuropathy ◽  
Multiple Risk Factors ◽  
Peripheral Polyneuropathy ◽  
Etiological Heterogeneity

ABSTRACT Background: Polyneuropathies are characterized by a symmetrical impairment of the peripheral nervous system, resulting in sensory, motor and/or autonomic deficits. Due to the heterogeneity of causes, an etiological diagnosis for polyneuropathy is challenging. Objective: The aim of this study was to determine the main causes of polyneuropathy confirmed by electrodiagnostic (EDX) tests in a tertiary service and its neurophysiological aspects. Methods: This observational cross-sectional study from a neuromuscular disorders center included individuals whose electrodiagnostic tests performed between 2008 and 2017 confirmed a diagnosis of polyneuropathy. Through analysis of medical records, polyneuropathies were classified according to etiology and neurophysiological aspect. Results: Of the 380 included patients, 59.5% were male, with a median age of 43 years. The main etiologies were: inflammatory (23.7%), hereditary (18.9%), idiopathic (13.7%), multifactorial (11.1%), and diabetes (10.8%). The main electrophysiological patterns were axonal sensorimotor polyneuropathy (36.1%) and “demyelinating and axonal” sensorimotor polyneuropathy (27.9%). Axonal patterns showed greater etiological heterogeneity, with a predominance of idiopathic and multifactorial polyneuropathy, while demyelinating and “demyelinating and axonal” polyneuropathies had a significantly fewer etiologies, with a predominance of hereditary and inflammatory polyneuropathies. Conclusion: The main causes of polyneuropathy confirmed by EDX test in this study were those that presented a severe, atypical and/or rapidly progressing pattern. Other causes were hereditary and those that defy clinical reasoning, such as multiple risk factors; some polyneuropathies did not have a specific etiology. EDX tests are useful for etiological diagnosis of rare polyneuropathies, because neurophysiological patterns are correlated with specific etiologies.

scholarly journals Inadequate Gestational Weight Gain and Exposure to Second-Hand Smoke during Pregnancy Increase the Risk of Low Birth Weight: A Cross-Sectional Study among Full-Term Infants

2021 ◽  
Vol 18 (3) ◽  
pp. 1068
Author(s):  
Muliana Edi ◽  
Yit Chin ◽  
Fui Woon ◽  
Geeta Appannah ◽  
Poh Lim ◽  
...  
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Pregnant Women ◽  
Medical Records ◽  
Cross Sectional Study ◽  
Second Hand Smoke ◽  
Sectional Study ◽  
Cross Sectional ◽  
Shs Exposure ◽  
At Home

Despite the advancement of the healthcare system, low birth weight (LBW) remains as one of the leading causes of under-five mortality. This cross-sectional study aimed to determine the prevalence of LBW and its associated factors among 483 third trimester pregnant women recruited from six selected public health clinics in the Federal Territory of Kuala Lumpur and the state of Selangor, Malaysia. Pregnant women were interviewed for information on socio-demographic characteristics, smoking behaviour, and second-hand smoke (SHS) exposure at home and in the workplace. Information on the obstetrical history and prenatal care visits history were retrieved from the maternal medical records, while infant’s birth outcomes were retrieved from infant medical records. The prevalence of LBW (<2.5 kg) in infants was 10.4%, with a mean birth weight of 3.0 [standard deviation (SD) 0.4] kg. Results from the multivariable logistic regression model showed that inadequate weight gained during pregnancy [odds ratio (OR) = 2.41, 95% confidence interval (CI) = 1.18–4.90] and exposure to SHS at home (OR = 1.92, 95% CI = 1.03–3.55) were significantly associated with LBW. In conclusion, pregnant women should monitor their rate of weight gain throughout pregnancy and avoid SHS exposure at home to reduce the risk of delivering LBW infants.

Ophthalmologists and WhatsApp: Teleophthalmology is already here

2021 ◽  
pp. 112067212110026
Author(s):  
Edward Barayev ◽  
Ofri Vorobichik Berar ◽  
Gad Dotan ◽  
Alon Skaat ◽  
Orly Gal-Or ◽  
...  
Keyword(s):  
Medical Records ◽  
Cross Sectional Study ◽  
Work Hours ◽  
Clinical Settings ◽  
Sectional Study ◽  
Cross Sectional ◽  
Policy Makers ◽  
Media Messages ◽  
Rapid Responses ◽  
Wide Availability

Purpose: To estimate the extent of WhatsApp utilization using text and media messages for inter-physician consultations among ophthalmologists (residents and specialists) at various clinical settings and its perceived benefits for ophthalmologists and their patients. We also aimed to detect obstacles that concern ophthalmologists when using WhatsApp as a consultation platform. Methods: This was a cross-sectional study using a self-administered survey through Google Forms, which was sent to 660 practicing ophthalmologists during April to May 2020. Results: One hundred and ninety-two ophthalmologists completed the questionnaire, 151 of which (78.6%) were specialists and 41 (21.4%) were residents. Most ophthalmologists reported using WhatsApp at least once a day for both personal and professional use. Residents reported lower rates of contacting patients using WhatsApp than specialists (1.51 ± 0.98 vs 2.72 ± 1.32, p < 0.001). Respondents reported WhatsApp consultations frequently replaced referrals of patients to other physicians, with a median of once a week. 97.8% of residents and 91.4% of specialists reported the ability to share media is a major advantage of WhatsApp over other medias, followed by rapid responses for consultations. Conclusion: Many ophthalmologists already use WhatsApp as a tool for professional consultations with other providers, mainly thanks to its simplicity and wide availability. Residents use it more frequently than specialists, and ranked it higher when asked how much WhatsApp has improved the clinical setting. Policy makers should address concerns brought up by physicians, such as documentation in medical records and proper compensation for consulting ophthalmologists during and after work hours.

scholarly journals Chronic stress, work-related daily challenges and medicolegal investigations: a cross-sectional study among German general practitioners

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Christine Kersting ◽  
Lena Zimmer ◽  
Anika Thielmann ◽  
Birgitta Weltermann
Keyword(s):  
Regression Model ◽  
General Practitioners ◽  
Chronic Stress ◽  
Medical Records ◽  
High Strain ◽  
Well Being ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Work Related

Abstract Background The prevalence of chronic stress among German general practitioners (GPs) was shown to be twice as high as in the general population. Because chronic stress negatively influences well-being and poor physician well-being is associated with poor patient outcomes, targeted strategies are needed. This analysis focuses on work-related factors associated with high chronic stress in GPs. Methods This cross-sectional study measured chronic stress among German GPs using the validated and standardized Trier Inventory for the Assessment of Chronic Stress (TICS-SSCS). Based on the TICS, GPs were categorized as either having low strain (≤ 25th percentile) or high strain (≥ 75th percentile) due to chronic stress. Questions on work-related challenges assessed the frequency and the subjectively perceived strain of single challenges. For exploratory analyses, these items were combined to dichotomous variables reflecting challenges that are common and that cause high strain. Variables significant in bivariate analyses were included in a multivariate logistic regression model analyzing their association with high chronic stress. Results Data of 109 GPs categorized as having low strain (n = 53) or high strain (n = 56) due to chronic stress were analyzed. Based on bivariate analyses, challenges regarding personnel matters, practice software, complexity of patients, difficult patients, care facilities, scheduling of appointments, keeping medical records up-to-date, fee structures, and expectations versus reality of care were included in the regression model. Keeping medical records up-to-date had the strongest association with high chronic stress (odds ratio 4.95, 95% confidence interval 1.29–19.06). A non-significant trend showed that medicolegal investigations were more common among GPs with high chronic stress. Conclusions This exploratory research shows that chronic stress is predominantly associated with administrative challenges. Treatment documentation, which represents a legal safeguard and is closely linked to existential concerns, has the strongest influence.

scholarly journals Profile of medicines used via oral and gastrointestinal catheter in a Walk-in Service

2018 ◽  
Vol 52 (0) ◽  
Author(s):  
Moara Avila de Jesus Moreira ◽  
Paula Pereira de Figueiredo ◽  
Rosemary Silva da Silveira ◽  
Valdecir Zavarese da Costa ◽  
Eliana Cardia de Pinho ◽  
...  
Keyword(s):  
Medical Records ◽  
Drug Class ◽  
Cross Sectional Study ◽  
Oral Route ◽  
Descriptive Statistics ◽  
University Hospital ◽  
Care Practice ◽  
Sectional Study ◽  
Cross Sectional ◽  
Pharmaceutical Form

ABSTRACT Objective: To identify the profile of drugs prescribed via oral and gastrointestinal catheter in a Walk-in Service of a University Hospital. Method: Quantitative cross-sectional study in which data were collected from the medical records of hospitalized patients using medication via oral or gastrointestinal catheter at least once a day between April and October 2015. The analysis was performed through descriptive statistics. Results: Out of 568 prescriptions (total), there were 143 different medications. The pharmaceutical form with the greatest number of prescriptions was solid (95.8%), of which 46.1% were simple tablets. The oral route had the highest number of administrations (97.3%). The most prescribed drug class was of anti-infectives (25.9%), but the Omeprazole drug was the most prescribed in the study (40%). Conclusion: There are indications that enable rethinking the care practice and establishing criteria and norms for contributing to the safety and efficacy of services provided in healthcare, especially regarding the preparation and administration of medications via gastrointestinal catheter.

scholarly journals Prevalensi Infeksi Clostridium difficile Pada Pasien Neutropenia dengan Kanker

Medicinus ◽  
2018 ◽  
Vol 5 (2) ◽  
Author(s):  
Andree Kurniawan
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Cancer Patients ◽  
Immunocompromised Patient ◽  
Hematologic Malignancy ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Multiple Risk Factors ◽  
Secondary Referral Hospital

<p><em>Clostridium difficile</em> (<em>C. difficile</em>) infection mostly found in immunocompromised patient. Most of the patients with neutropenia had hematologic malignancy and come with multiple risk factors for <em>C. difficile</em> infection. The aim of this study is to know the prevalence and characteristic of <em>C. difficile</em> infections in cancer neutropenia patients. This cross-sectional study was done in secondary referral hospital in suburban Karawaci, Tangerang, Banten, Indonesia from June 2014 until Mei 2015. Adult cancer patients hospitalized with neutrophil count less than 1500 10<sup>6</sup> cell/L were included. All patients were checked for antigen and toxin <em>C. difficile</em> in faeces. From 25 patients were evaluated for <em>C. difficile</em> infection in neutropenia. <em>C. difficile</em> antigen only found in one patient or 4% sample.</p><p><strong>Key words: <em>C. difficile</em>, cancer, neutropenia</strong></p>

scholarly journals Potential Incompatibility Problem of Intravenous Drugs’ Administration among Intensive Care Unit (ICU) Patients at PKU Muhammadiyah Yogyakarta Hospital

2019 ◽  
Vol 9 (4) ◽  
pp. 238
Author(s):  
Ardhanarishwari Umi Salamah ◽  
Fita Rahmawati ◽  
Fivy Kurniawati
Keyword(s):  
Medical Records ◽  
Dosage Form ◽  
Electrolyte Solutions ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Icu Patients ◽  
Injectable Drugs ◽  
Intravenous Drugs

Drugs’ administration among hospitalized patients in ICU commonly is given intravenously. Mixing the intravenous drugs may result in incompatibility problem that might affect the drugs’ stability and bioavailability. The aim of the study was to investigate the potential incompatibility problem of  intravenous mixing drugs’ administration among ICU patients at PKU Muhammadiyah Yogyakarta Hospital. This study was a cross-sectional study in which design and data was obtained from ICU patients’ medical record retrospectively with purposive sampling in order to observe the pattern of intravenous drug’s combination. The potential incompatibility problem was analyzed using Handbook on Injectable Drugs. There were 79 out of 119 medical records which fulfilled sample inclusion criteria taken in this study. Parenteral dosage form was commonly used rather than non parenteral (62.06%) among ICUs’ patients. The potential incompatibility pattern consisted of incompatibility of intravenous drugs, electrolyte solutions/parenteral nutritions in mixture form, and the electrolyte solutions/parenteral nutritions, which are administrated simultaneously. Potential incompatibility of intravenous dosage was found in 50 events out of 79 patients (0.63 events per patients), which consisted of 8 events (8.51%) in using of drugs administrated simultaneously, 10 events (19.23%) in using of electrolyte solutions/parenteral nutritions in mixture form, and 32 events (11.72%) in using of electrolyte solutions/parenteral nutritions administrated simultaneously. Common potential incompatibilities types were precipitation of drugs and drug’s adsorption to packaging materials.

scholarly journals Assessment of the differentiated aspiration process of palivizumab

2014 ◽  
Vol 27 (1) ◽  
pp. 69-75
Author(s):  
Rosemeire Sartori de Albuquerque ◽  
Corintio Mariani Neto ◽  
Gisleine Aparecida de Castro Arone ◽  
Ana Aparecida Sanches Bersusa ◽  
Vanessa Peres Leandro
Keyword(s):  
Medical Records ◽  
Care Management ◽  
Planning Process ◽  
Secondary Data ◽  
Cross Sectional Study ◽  
Team Work ◽  
Public Expenditures ◽  
Sectional Study ◽  
Cross Sectional ◽  
Management Planning

OBJECTIVE: Assess the differentiated aspiration process of palivizumab, from planning to administration, and from the patient's profile to obtained savings as a result of the optimization of doses.METHODS: Cross-sectional study carried out by means of secondary data obtained from the medical records of 858 children. Variables of the study were as follows: information on the profile of cared children, amount of acquired and administered doses, vaccination procedure, and optimized doses. Data were extracted from care management reports.RESULTS: The innovative technique and the vaccination planning allowed for 98 children to be favored by leftovers of the medication, implying savings of R$ 1.144.347,52 in 2012 and 2013.CONCLUSION: The employment of the differentiated aspiration process favored the availability of the medication to 54 children other than those previously programmed, and the application of 78 leftovers. The establishment of a previous management planning process of programmed contents to be administered to children, in compliance with their profile, especially their body weight, favored the inclusion of other admitted newborns. The systematization process of the team work toward the administration of palivizumab implied the reduction of public expenditures.

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