scholarly journals Sepsis in a university hospital: a prospective study for the cost analysis of patients' hospitalization

2016 ◽  
Vol 50 (2) ◽  
pp. 302-308 ◽  
Author(s):  
Maynara Fernanda Carvalho Barreto ◽  
Mara Solange Gomes Dellaroza ◽  
Gilselena Kerbauy ◽  
Cintia Magalhães Carvalho Grion
Keyword(s):  
Severe Sepsis ◽  
Public Hospital ◽  
Epidemiological Data ◽  
University Hospital ◽  
Preventive Actions ◽  
Focus Of Infection ◽  
One Year ◽  
A Prospective Study ◽  
The Cost ◽  
Pulmonary Focus

Abstract OBJECTIVE To estimate the cost of hospitalization of patients with severe sepsis or septic shock admitted or diagnosed in the Urgent and Emergency sector at a university hospital and followed until the clinical outcome. METHOD An epidemiological, prospective, observational study conducted in a public hospital in southern Brazil for the period of one year (August 2013 to August 2014). Sepsis notification forms, medical records and data of the cost sector were used for the collection of clinical and epidemiological data. RESULTS The sample comprised 95 patients, resulting in a total high cost of hospitalization (R$ 3,692,421.00), and an average of R$ 38,867.60 per patient. Over half of the total value of the treatment of sepsis (R$ 2,215,773.50) was assigned to patients who progressed to death (59.0%). The higher costs were related to discharge, diagnosis of severe sepsis, the pulmonary focus of infection and the age group of up to 59 years. CONCLUSION The high cost of the treatment of sepsis justifies investments in training actions and institution of protocols that can direct preventive actions, and optimize diagnosis and treatment in infected and septic patients.

Ultra-resistant schizophrenia and potentiation strategies

2017 ◽  
Vol 41 (S1) ◽  
pp. s834-s834 ◽  
Author(s):  
S. Khouadja ◽  
R. Ben Soussia ◽  
S. Younes ◽  
A. Bouallagui ◽  
I. Marrag ◽  
...  
Keyword(s):  
Treatment Resistance ◽  
Cost Benefit ◽  
Clinical Excellence ◽  
University Hospital ◽  
Dsm Iv ◽  
Competing Interest ◽  
A Prospective Study ◽  
Psychiatric Department ◽  
The Cost ◽  
The University

IntroductionTreatment resistance to clozapine is estimated at 40–70% of the treated population. Several clozapine potentiation strategies have come into clinical practice although often without evidence-based support.ObjectiveThe aim of our work was to identify the potentiation strategies in ultra-resistant schizophrenia depending on the subtype of schizophrenia.MethodologyThis is a prospective study conducted on patients with the diagnosis of schizophrenia, based on DSM-IV-TR criteria, and hospitalized in the psychiatric department of the university hospital in Mahdia, Tunisia. The study sample consisted of patients meeting the resistant schizophrenia criteria as defined by national institute for clinical excellence (NICE), and the prescription of clozapine for 6 to 8 weeks was shown without significant improvement.Resultswe have collected 10 patients. The mean serum level of clozapine was 462.25 mg/L. The potentiation strategies were different depending on the subtype of schizophrenia. For the undifferentiated schizophrenia, we have chosen ECT sessions. For the disorganized schizophrenia, we opted for amisulpiride and aripiprazole. For the paranoid forms, we have chosen the association of risperidone and ECT. A psychometric improvement was noted in BPRS ranging from 34 to 40%.ConclusionEvery potentiation strategy entails a cost, whether it is an additional monetary cost, adverse effects or greater stress to caregivers. The cost/benefit equation should be thoroughly evaluated and discussed before commencing a strategy.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Aetiology, antimicrobial therapy and outcome of patients with community acquired severe sepsis: a prospective study in a Norwegian university hospital

2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Siri Tandberg Nygård ◽  
Nina Langeland ◽  
Hans K Flaatten ◽  
Rune Fanebust ◽  
Oddbjørn Haugen ◽  
...  
Keyword(s):  
Severe Sepsis ◽  
Prospective Study ◽  
Antimicrobial Therapy ◽  
University Hospital ◽  
A Prospective Study

scholarly journals A one-year survey of nosocomial bacteraemia at a Danish university hospital

1986 ◽  
Vol 97 (3) ◽  
pp. 471-478 ◽  
Author(s):  
K. Eliasen ◽  
P. B. Nielsen ◽  
F. Espersen
Keyword(s):  
Staphylococcus Epidermidis ◽  
Foreign Bodies ◽  
University Hospital ◽  
Focus Of Infection ◽  
One Year ◽  
Tract Infections ◽  
Catheter Infections ◽  
Hospital Acquired ◽  
Intravenous Catheters ◽  
Overall Mortality

SUMMARYA 1-year prospective study of nosocomial bacteraemia was performed at Hvidovre Hospital with special reference to frequency, focus of infection and prognosis. All patients were examined clinically in order to confirm the bacteraemia. In total, 98 hospital-acquired bacteraemias were observed, giving an incidence rate of 0·28%. Bacteraemia due to Escherichia coli, Staphylococcus aureus and Staphylococcus epidermidis predominated. The overall mortality was 38%; 65% of the patients with S. aureus bacteraemia died, 25% due to the bacteraemia. The most common types of infection were urinary tract infections and intravenous catheter infections. Fifty-five of the bacteraemias were caused by foreign bodies, mostly urinary catheters and intravenous catheters, and in 14 cases the focus was unknown. The patient population was severely ill patients. We conclude that nosocomial bacteraemia occurs specially in severely ill patients often preceded by indwelling urinary or intravenous catheters. The patients seldom die due to the bacteraemia, but they die with concomitant bacteraemia.

scholarly journals What to expect? Injury patterns of Electric-Scooter accidents over a period of one year - A prospective monocentric study at a Level 1 Trauma Center

2021 ◽  
Author(s):  
Andreas Harbrecht ◽  
Michael Hackl ◽  
Tim Leschinger ◽  
Stephan Uschok ◽  
Kilian Wegmann ◽  
...  
Keyword(s):  
Trauma Center ◽  
Epidemiological Data ◽  
University Hospital ◽  
Maximum Speed ◽  
Injury Patterns ◽  
New Type ◽  
Level 1 ◽  
One Year ◽  
Intensive Education ◽  
Level 1 Trauma Center

Abstract Purpose E-scooters are a new type of urban transportation utilized in Germany since June 2019, primarily in larger cities in the context of sharing offers. Such electrically operated standing scooters can be driven at a maximum speed of 20 km/h. A helmet is not mandatory. The aim of this prospective study is to document the injury patterns over the period of 1 year and compare our findings with already available data. Methods Over a period of 1 year (July 2019–July 2020), data on E-scooter-related accidents treated at a level 1 trauma center of a major German city were prospectively documented. Injury patterns were analyzed, and epidemiological data evaluated. Results Fifty-nine (35 female, 24 male) accidents were included in the observation period. Mean age of accident victims was 30.03 years (± 9.32). Alcohol influence at the time of accident was detected in 9 cases (15.25%). Many of the accident victims suffered multiple injuries. Most of the injuries were upper (50.84%) and lower extremity (47.45%) as well as craniofacial injuries (62.71%). A helmet was not worn in any of the cases. Conclusion In the year following their introduction, E-scooter-related accidents have led to an additional burden on the emergency capacities of the involved University Hospital, especially in the summer months of 2019. Protective equipment is de facto not worn. Injuries to the extremities, head, and face were most common. None of the accident victims died. This coincides with results from other major cities in national and international comparison. A more intensive education about injury consequences of unprotected E-scooter use and the discussion of a possible obligation to wear a helmet and further protection equipment for the extremities should take place.

scholarly journals A prospective study on causality, severity and preventability assessment of adverse drug reactions in a tertiary care hospital in India

2018 ◽  
Vol 8 (1) ◽  
pp. 104
Author(s):  
Mahesh N. Belhekar ◽  
Sweta B. Tondare ◽  
Prasad R. Pandit ◽  
Kiran A. Bhave ◽  
Tejal C. Patel
Keyword(s):  
Tertiary Care ◽  
World Health ◽  
Care Hospital ◽  
Antimicrobial Drugs ◽  
Related Information ◽  
Cutaneous Reactions ◽  
One Year ◽  
Health Organization ◽  
A Prospective Study ◽  
The Cost

Background: The present study was undertaken to evaluate the incidence and pattern of adverse drug reaction (ADRs), causality, severity and preventability of ADRs.Methods: Data was collected and analyzed with the information such as patients’ demographic details, associated co-morbid conditions and detailed drug related information gathered from ADR reporting forms. World Health Organization (WHO) scale was used for assessing causality, modified Hartwig scale was used for assessing severity and modified Schumock and Thorntons scale were used for assessing preventability of ADRs. Data was analyzed using descriptive statistics.Results: Total 154 ADRs were reported in a period of one year (August 2016- July 2017). Out of 154 ADRs analyzed, 120 (77.9%) were in adults, 33 (21.4%) pediatric and 01 (0.7%) in geriatric patients. The most common ADR recorded was cutaneous reactions (43.5%) and the most common causative class of drugs for the same was found to be antimicrobials (46.7%) followed by non-steroidal anti-inflammatory drugs (15.6%). Causality assessment scale indicated 68.8% ADRs possible and 24% ADRs as probable. Severity assessment revealed that 45.5 % were mild, 50.6% moderate and 3.9% ADRs severe. Preventability assessment showed 84.4% of the cases were probably non-preventable.Conclusions: In this study it was found that, most of the ADRs were of possible category with mild to moderate severity and majority being non-preventable. Antimicrobial drugs being the most common offending drug class causing ADRs. Strategies targeting appropriate and cautious use of this class of drugs may benefit in reducing the number of ADRs and therefore the cost involved in the treatment.

scholarly journals Efficacy of topical 5% fluorouracil (5%- FU) needling in vitiligo: فعالية الحقن الموضعي بالإبر الدقيقة لـ fluorouracil  5% في علاج البهاق

2021 ◽  
Vol 5 (4) ◽  
pp. 34-28
Author(s):  
Mai Abdulkhaliq Ibrahiem, Mohammed Adel Ismaiel Mai Abdulkhaliq Ibrahiem, Mohammed Adel Ismaiel
Keyword(s):  
Side Effects ◽  
Prospective Study ◽  
The Body ◽  
University Hospital ◽  
Safe Method ◽  
Study Results ◽  
One Year ◽  
A Prospective Study ◽  
Treatment Improvement

Objective: The aim of this study is to assess the efficacy of topical 5- fluorouracil (5%- FU) with micro needling in treating stable vitiligo. In addition to, assessment the side effects of the treatment. Patients and Methods: A Prospective study (Before& After) conducted for the period one year (April 2019- April2020)at Tishreen University Hospital in Lattakia- Syria, 31 patients with stable vitiligo who received treatment with micro needling and topical 5- fluorouracil (5%- FU) were included in this study. Results : The median age was 36 years, 67.70% of patients were female. Focal type was found in 61.3%, and most common sites of vitiligo involvement were hand and feet (33.7%), followed by trunk (24.8%)and extremities (24.8%). After 6 months of treatment, improvement was excellent in 63.4%, and very good in 23.8%. The lesions of neck and trunk were responded better to treatment than those in other parts of the body. Regarding of side effects, pain, erythema, and itching were reported in 100% followed by ulceration in (16.1%). Conclusion: Topical 5%- fluorouracil (5%- FU) with needling appears to be an effective and safe method in treating stable vitiligo. Except of pain, erythema, and itching after procedure, significant complications not occurred in most patients.

scholarly journals A hospital qPCR-based survey of 10 gastrointestinal parasites in routine diagnostic screening, Marseille, France

2019 ◽  
Vol 147 ◽  
Author(s):  
E. Menu ◽  
C. Mary ◽  
I. Toga ◽  
D. Raoult ◽  
S. Ranque ◽  
...  
Keyword(s):  
Simultaneous Detection ◽  
Epidemiological Data ◽  
Gastrointestinal Parasites ◽  
University Hospital ◽  
Parasitic Infections ◽  
Automated Method ◽  
Enteric Parasites ◽  
Blastocystis Sp ◽  
Conventional Microscopy ◽  
A Prospective Study

AbstractThere is a scarcity of recent epidemiological data on intestinal parasitic infections in France. We conducted a prospective study aimed at estimating the prevalence of 10 enteric parasites in Marseille, France, using real-time polymerase chain reaction (PCR)-based diagnosis. A total of 643 faeces from 488 patients referred to the Parasitology-Mycology Laboratory of the University Hospital of Marseille over a 6 months period were included. DNA was extracted using a semi-automated method. Parasites of interest were detected using singleplex quantitative PCRs (qPCRs). For positive samples, theBlastocystissubtype was determined by sequence analysis. During the study, the overall prevalence of enteric parasites was 17%.Blastocystis sp.was the most frequent species (10.5%), followed byDientamoeba fragilis(2.3%) andGiardia intestinalis(2.3%). The prevalence of other parasites was <1% each. The ST3Blastocystissubtype was predominant (43.6%) and the other subtypes identified were ST1, ST2, ST4 and ST6. This is the first time that a qPCR-based diagnosis has been used to survey the prevalence of 10 enteric parasites in a French University Hospital. This study confirms that fast, specific, sensitive and simultaneous detection in a single stool sample by qPCR clearly outperforms conventional microscopy-based diagnosis. Furthermore, qPCR is particularly well suited to surveying gastroenteritis agents.

scholarly journals N-terminal brain natriuretic propeptide levels correlate with procalcitonin and C-reactive protein levels in septic patients

2007 ◽  
Vol 12 (2) ◽  
Author(s):  
Mariusz Piechota ◽  
Maciej Banach ◽  
Robert Irzmański ◽  
Małgorzata Misztal ◽  
Jacek Rysz ◽  
...  
Keyword(s):  
Severe Sepsis ◽  
Plasma Concentrations ◽  
University Hospital ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein ◽  
The Mean ◽  
A Prospective Study ◽  
Medical University ◽  
The Relationship

AbstractThe aim of this study was to find the relationship between N-terminal brain natriuretic propeptide (NT-proBNP), procalcitonin (PCT) and C-reactive protein (CRP) plasma concentrations in septic patients. This was a prospective study, performed at Medical University Hospital No. 5 in łódź. Twenty patients with sepsis and severe sepsis were included in the study. N-terminal brain natriuretic propeptide, procalcitonin and C-reactive protein concentrations, and survival were evaluated. In the whole studied group (128 measurements), the mean NT-proBNP, procalcitonin and C-reactive protein concentrations were, respectively: 140.80±84.65 pg/ml, 22.32±97.41 ng/ml, 128.51±79.05 mg/l. The correlations for the NT-proBNP level and procalcitonin and C-reactive protein levels were 0.3273 (p<0.001) and 0.4134 (p<0.001), respectively. NT-proBNP levels correlate with PCT and CRP levels in septic patients. In the survivor subgroup, the mean NT-proBNP plasma concentrations were significantly lower than in the non-survivor subgroup.

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