scholarly journals Geriatric Intensive Care Unit Admission Protocol

2020 ◽  
Vol 3 ◽  
Author(s):  
Tom Byvoets ◽  
Brian Brewer
Keyword(s):  
Hospital Stay ◽  
Rib Fractures ◽  
Control Group ◽  
Supporting Evidence ◽  
Exact Test ◽  
Icu Admission ◽  
Icu Length Of Stay ◽  
Potential Impact ◽  
Discharge Criteria ◽  
Experimental Group

Background and Hypothesis:   The Society of Critical Care Medicine has recommended protocolized admission and discharge criteria for the ICU, but there is little supporting evidence for these guidelines. Our goal is to find predictors supported by data that can consistently triage patients appropriately on admission and decrease the need to upgrade the level of care during the same hospital stay. We hypothesized that applying a protocol would reduce the number of unplanned ICU admissions in our institution.    Methods:   We retrospectively applied our protocol to patients sixty-five years or older from the trauma registry at Methodist Hospital admitted between January 1 and December 31, 2019. Patients who did not have an unplanned ICU admission during hospital stay were used as the control group, while those who had an unplanned ICU admission event were considered the experimental group. After this, we used crosstabulation and Fisher’s exact test to analyze the data.    Results:   We reviewed one thousand one hundred forty-six (1146) subjects with 1088 in the control group and 58 in the experimental group. Subjects in the experimental group were statistically more likely to have COPD (OR: 2.646, p=0.001), been transfused > two units of PRBC in the first 24 hours (OR: 5.303, p=0.000), or to have greater than two rib fractures (OR: 2.469, p=0.002).     Conclusion and Potential Impact:   This study demonstrates that applying this protocol can capture elderly patients who will likely require ICU level care during their hospitalization. COPD, > two rib fractures, and transfusion of > two units PRBC during the first 24 hours appear to be significant predictors of clinical deterioration. Unplanned ICU admissions are associated with increased hospital and ICU length of stay. We must develop evidence-based protocols to decrease morbidity and cost associated with unplanned ICU admissions.  

The use of biofeedback intervention in the improvement of depression levels: a randomised trial

2021 ◽  
pp. 1-8
Author(s):  
Willams Henrique da Costa Maynart ◽  
Maria Cicera dos Santos de Albuquerque ◽  
Regina Célia Sales Santos ◽  
Patrícia de Albuquerque Sarmento ◽  
Jadelson Júnior da Silva ◽  
...  
Keyword(s):  
Multinomial Logistic Regression ◽  
Randomised Trial ◽  
Severe Depression ◽  
Randomised Clinical Trial ◽  
Control Group ◽  
Main Hypothesis ◽  
Exact Test ◽  
Post Test ◽  
Group Sex ◽  
Experimental Group

Abstract Objective: To evaluate the use of biofeedback intervention in the levels of depression. The main hypothesis tested if the use of biofeedback improves depression levels compared to the control group. Methods: A randomised clinical trial. The final sample was composed of 36 participants (18 in the experimental group, receiving 6 training, once a week, with biofeedback; and 18 in the control group, who received conventional treatment in the service).Outcome measures were assessed in two stages: pre-test and post-test. The research used the following instruments: demographic survey data, Mini International Neuropsychiatric Interview 5.0.0 and Beck Depression Inventory (BDI). The factors and variables were presented in terms of descriptive and inferential statistics. Fisher’s exact test (p < 0.05) was used to verify the existence of an association between the counting variables. The multinomial logistic regression model was adopted, and the Logit link function was used, as the software RStudio version 3.6.2. Results: The factors that remained in the final model were group, sex, partner, atypical antidepressant, benzodiazepines, mood stabiliser, antiepileptic and antihistamine, according to the levels of depression based on the BDI. The group that did not receive biofeedback intervention had 16 times more chances of increasing the depression levels compared to participants in the experimental group. Conclusion: The use of biofeedback reduces depression, thus, representing a complementary alternative for the treatment of moderate and severe depression, and dysthymia.

scholarly journals Optimization of Esophageal Ultrasound under Artificial Fish Swarm Algorithm and Its Adoption in Treatment of Ventricular Septal Defect

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Zhi Li ◽  
Guihe Chen ◽  
Feng Wang
Keyword(s):  
Ventricular Septal Defect ◽  
Hospital Stay ◽  
Septal Defect ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Control Group ◽  
Artificial Fish Swarm Algorithm ◽  
Artificial Fish Swarm ◽  
Swarm Algorithm ◽  
Experimental Group

This work was aimed at exploring the adoption value of the optimized and upgraded esophageal ultrasound in the treatment of patients with ventricular septal defect (VSD) by artificial fish swarm algorithm. A model was built based on artificial fish swarm algorithm. A random ultrasonic optical signal in the database was decomposed several times and sparsity was optimized to complete partial optimization, which was then extended to global optimization. A total of 100 patients with ventricular septal defect were divided into control group who underwent cardiopulmonary bypass under the guidance of three-dimensional thoracic ultrasound and experimental group of ventricular septal defect occlusion under the guidance of esophageal ultrasound based on artificial fish swarm algorithm. The results showed that the number of successful cases in the experimental group was 12 cases of perimembranous type, 10 cases of septal type, 7 cases of simple membranous type, 13 cases of muscular type, 4 cases of subdry type, and 2 cases of ridge type. The average length of operation after surgery was 70.65 minutes, the average length of ventilator ventilation was 125.8 minutes, and the average length of intensive care unit was 377.9 minutes. The average length of hospital stay after surgery was 5.6 days, and the average total length of hospital stay was 8.2 days, which were better than the control group in many aspects, with statistical significance ( P < 0.05 ). In short, the artificial fish swarm algorithm for esophageal ultrasound-guided ventricular septal defect closure had short operation time and good postoperative effect, which was of high application value in the clinical treatment of patients with ventricular septal defect.

14 ENHANCEMENT OF THE EARLY RECOVERY OF OVARY AND UTERUS FUNCTIONS BY TREATMENT OF eCG AND POVIDONE-IODINE IN POSTPARTUM JAPANESE BLACK CATTLE

2017 ◽  
Vol 29 (1) ◽  
pp. 114
Author(s):  
H. Matsuda ◽  
T. Yamanouchi ◽  
Y. Goto ◽  
M. Ohtake ◽  
Y. Hashiyada
Keyword(s):  
Povidone Iodine ◽  
Early Stage ◽  
Beef Cows ◽  
Innovative Technology ◽  
Control Group ◽  
Japanese Black Cattle ◽  
Early Recovery ◽  
Exact Test ◽  
Animal Reproduction ◽  
Experimental Group

The aim of this study was to evaluate the effect of administration of eCG and intrauterine infusion of povidone-iodine to promote the early recovery of ovary and uterus functions in early stage after delivery on postpartum beef cows. Thirty-three postpartum Japanese Black cows without retention of placenta were used for this investigation. After delivery, cows nursed colostrums to calves for several hours in a pen, and then were separated from calves and returned into a barn managed in a group. In experimental group (n = 14), on Day 10 (Day 0 = day of parturition), an intramuscular administration of 500 IU of eCG and infusion of 30 mL of 2% povidone-iodine into the uterus body were conducted. The untreated cows delivered in the same period were compared as a control group (n = 19). Cows were inseminated artificially using commercial Japanese Black frozen–thawed semen when standing oestrus was detected until Day 90. Pregnancy diagnosis was performed 30 days after insemination by ultrasonography. For all of the experimental group and 8 cows in the control group, the diameter of follicles >8 mm and the diameter of cross-section between endometrium in uterus of the implanted side at the point of ~2 cm from bifurcation of the uterus were measured using an ultrasound scanning machine connected to a 7.5-MHz convex probe. This monitoring was carried out every 10 days from Day 10 until the day of first oestrus (= insemination) or until Day 80 for non-returned oestrus cows. Data were analysed using Fisher’s exact test and ANOVA. The ratio of returned oestrus by Day 90 was 100% (14/14) in experimental group and 89.5% (17/19) in control group. The first oestrus day postpartum in the experimental group and the control group was the almost same: 52.9 ± 12.1 (24–88) days and 57.2 ± 19.9 (29–78) days, respectively. The conception rate until Day 90 tended to be higher (P = 0.07) in the experimental group (78.6%, 11/14) than in the control group (47.4%, 9/19). The days inseminated to cows that were conceived, was almost same between the experimental group (57.5 ± 18.6, 24–87 d) and the control group (55.4 ± 12.9, 36–78 d). The ratio of cows observed follicles more than 8 mm, was higher in the experimental group than control group on Day 50 (90.9% v. 50.0%; P = 0.09) and Day 60 (66.7% v. 0%; P < 0.05), respectively. The diameter of uterus tended to be lesser in the experimental group than in the control group on Day 30 (16.9 ± 2.8 mm v. 19.2 ± 2.8 mm; P = 0.09), and that regressed linearly to Day 30 in the experimental group however that was prolonged until Day 40 (16.4 ± 1.7 mm) in the control group. These results indicate that administration of eCG and uterus infusion of povidone-iodine at an early stage postpartum may promote the early recovery of ovary and uterus functions in beef cows. This research was supported by a grant from the Research Program of MAFF, (REP1004) Development of Innovative Technology for Animal Reproduction.

Analysis of Clinical Efficiency and Safety of Laparoscopic Anus-Conserving Operation for Ultralow Rectal Cancer

2019 ◽  
Vol 85 (5) ◽  
pp. 539-548
Author(s):  
Zhongkun Zuo ◽  
Ke Ding ◽  
Tenglong Tang ◽  
Leiyi Zhang ◽  
Weihui Peng ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Postoperative Complications ◽  
Hospital Stay ◽  
Incidence Rate ◽  
Anal Sphincter ◽  
Resection Margin ◽  
Survival Rates ◽  
Incidence Rates ◽  
Control Group ◽  
Experimental Group

To explore the efficiency and safety of laparoscopic anus-conserving operation for ultralow rectal cancer, we retrospectively reviewed 236 patients with ultralow rectal cancer who underwent laparoscopic anus-conserving operation (experimental group, n = 124) or conventional open surgery (control group, n = 112). Operation-related indexes, pathological results of mesentery, incidence rates of postoperative complications, anus preservation rates, anal sphincter controllability after surgery, and survival rates of the first, second, and third years after operation were compared between the two groups. The amount of intraoperative bleeding, first postoperative exhaust time, abdominal drainage, pain score, and hospital stay in the experimental group were significantly less than those in the control group ( P < 0.05). There were no significant differences in the postoperative circumferential resection margin, distal resection margin, number of dissected lymph nodes, successful resection rate, and quality of mesorectum between the two groups ( P > 0.05). The total incidence rate of postoperative complications, anal sphincter controllability, and survival rates after surgery were similar between the two groups ( P > 0.05). The anus preservation rate of the experimental group (84.7%) was significantly higher than that of the control group (69.6%) ( P < 0.05). Laparoscopic anus-conserving operation is effective and safe in treatment of patients with ultralow rectal cancer, which has advantages such as small trauma, less intra-operative bleeding, short hospital stay, rapid recovery, a low incidence rate of postoperative complications, and a high anus-preserving rate, so it is worthy of clinical application.

Impact of Psychotherapeutic Support for Patients With Gastrointestinal Cancer Undergoing Surgery: 10-Year Survival Results of a Randomized Trial

2007 ◽  
Vol 25 (19) ◽  
pp. 2702-2708 ◽  
Author(s):  
Thomas Küchler ◽  
Beate Bestmann ◽  
Stefanie Rappat ◽  
Doris Henne-Bruns ◽  
Sharon Wood-Dauphinee
Keyword(s):  
Colorectal Cancer ◽  
Hospital Stay ◽  
Gastrointestinal Cancer ◽  
Cox Regression ◽  
Medical Psychology ◽  
Control Group ◽  
Term Survival ◽  
Formal Program ◽  
The Impact ◽  
Experimental Group

Purpose The impact of psychotherapeutic support on survival for patients with gastrointestinal cancer undergoing surgery was studied. Patients and Methods A randomized controlled trial was conducted in cooperation with the Departments of General Surgery and Medical Psychology, University Hospital of Hamburg, Germany, from January 1991 to January 1993. Consenting patients (N = 271) with a preliminary diagnosis of cancer of the esophagus, stomach, liver/gallbladder, pancreas, or colon/rectum were stratified by sex and randomly assigned to a control group that received standard care as provided on the surgical wards, or to an experimental group that received formal psychotherapeutic support in addition to routine care during the hospital stay. From June 2003 to December 2003, the 10-year follow-up was conducted. Survival status for all patients was determined from our own records and from three external sources: the Hamburg cancer registry, family doctors, and the general citizen registration offices. Results Kaplan-Meier survival curves demonstrated better survival for the experimental group than the control group. The unadjusted significance level for group differences was P = .0006 for survival to 10 years. Cox regression models that took TNM staging or the residual tumor classification and tumor site into account also found significant differences at 10 years. Secondary analyses found that differences in favor of the experimental group occurred in patients with stomach, pancreatic, primary liver, or colorectal cancer. Conclusion The results of this study indicate that patients with gastrointestinal cancer, who undergo surgery for stomach, pancreatic, primary liver, or colorectal cancer, benefit from a formal program of psychotherapeutic support during the inpatient hospital stay in terms of long-term survival.

scholarly journals Preliminary Study of Transforaminal Endoscope in the Treatment of Spinal Metastasis

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Daiqi Guo ◽  
Tenghui Zeng
Keyword(s):  
Hospital Stay ◽  
Spinal Metastases ◽  
Length Of Hospital Stay ◽  
Control Group ◽  
Activity Time ◽  
Incision Length ◽  
Drainage Volume ◽  
Surgical Methods ◽  
Postoperative Drainage ◽  
Experimental Group

Objective: To investigate the therapeutic effect of transforaminal endoscope in patients with spinal metastases. Methods: Clinical data of 28 patients with spinal metastases admitted to our hospital from May 2015 to May 2019 were retrospectively collected. According to different surgical methods, they were divided into control group (20 cases) and experimental group (8 cases), among which control group was treated with traditional open palliative decompression, while the experimental group was treated with transforaminal endoscopic decompression. The surgery and recovery indicators were compared between the two groups, including surgery time, incision length, postoperative drainage volume, out of bed activity time, length of hospital stay, the Japanese Orthopaedic Association (JOA) scores of 7 days after surgery, pain degree, complications (wound infection, transient reduction of muscle strength, hypoproteinemia with wound drainage and delayed healing), and activity of daily living. Results: The surgery time, incision length, postoperative drainage volume, out of bed activity time, and postoperative length of hospital stay of the experimental group were all less than those of the control group, and the JOA score of 7 days after surgery was higher than that of the control group, showing statistically significant differences (P < 0.05). VAS scores of the experimental group on the day 1 and day 7 after surgery were lower than those of the control group, with statistically significant differences (P < 0.05). The incidence of complications in the experimental group was slightly lower than that in the control group, but the difference was not significant (P > 0.05). Conclusions: Transforaminal endoscope used in suitable patients with spinal metastases can greatly reduce the incision length, soft tissue and bone tissue damages, and postoperative drainage, promote early mobilization and early discharge, and reduce a series of complications due to hemorrhage and hypoproteinemia, which has a better early clinical effect in comparison with the traditional open palliative decompression.

scholarly journals The Psychological Effect of Forming WeChat Groups Between Medical Staff and Patients With COVID-19

2021 ◽  
Vol 9 ◽  
Author(s):  
Li-Ping Yuan ◽  
Zheng-Hao Yu ◽  
Xian-Cui Zhang ◽  
Wei Zhang ◽  
Ling-Li Jin ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Medical Staff ◽  
Psychological Intervention ◽  
Depression Scale ◽  
Basic Unit ◽  
Control Group ◽  
Self Evaluation ◽  
The Difference ◽  
And Control ◽  
Experimental Group

Background: This study was conducted in order to explore the effect of psychological intervention based on the use of WeChat with coronavirus disease 2019 (COVID-19) patients.Methods: A total of 65 patients with COVID-19, from two wards, were divided into an experimental group and a control group with the ward as the basic unit. Communication concerning routine treatment and nursing was established between the medical staff and patients in the experimental group via WeChat groups. Within 48 h of admission, at 7 days, and on discharge, all 65 patients completed two self-evaluation questionnaires: the Positive and Negative Affect Schedule (PANAS) and the Hospital Anxiety and Depression Scale (HADS). Hospital stay statistics and a satisfaction survey on discharge were also collated for both groups of patients.Results: The PANAS scores of the experimental group were 26.61 ± 7.99 points on admission, 20.81 ± 5.48 points at 7 days, and 19.58 ± 6.61 points on discharge (P &lt; 0.05). The scores of HADS in the experimental group were 27.74 ± 9.35 points on admission, 12.19 ± 1.92 points at 7 days, and 11.71 ± 3.64 points on discharge (P &lt; 0.05). The differences in the PANS and HADS scores between the experimental and control groups at 7 days and on discharge were statistically significant. The discharge satisfaction ratings of the two groups of patients were 99.87 ± 0.34 and 98.68 ± 1.09 points, the difference being statistically significant (t = 5.827, P &lt; 0.05).Conclusion: Establishing WeChat groups between medical staff and patients with COVID-19 and building a bridge for better communication improved patients' positive mentality and their compliance with doctors, shortened their hospital stay, and promoted their recovery.

scholarly journals Support Vector Machine-Based Backprojection Algorithm for Detection of Gastric Cancer Lesions with Abdominal Endoscope Using Magnetic Resonance Imaging Images

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Huajia Dai ◽  
Yuhao Bian ◽  
Libin Wang ◽  
Junfeng Yang
Keyword(s):  
Magnetic Resonance Imaging ◽  
Gastric Cancer ◽  
Support Vector Machine ◽  
Magnetic Resonance ◽  
Hospital Stay ◽  
Radical Resection ◽  
Support Vector ◽  
Control Group ◽  
Resonance Imaging ◽  
Experimental Group

This study was to analyze the diagnostic value of magnetic resonance imaging (MRI) for gastric cancer (GC) lesions and the treatment effect of complete laparoscopic radical resection (CLSRR). A malignant tumor recognition algorithm was constructed in this study based on the backprojection (BP) and support vector machine (SVM), which was named BPS. 78 GC patients were divided into an experimental group (received CLSRR) and a control group (received assisted laparoscopic radical resection (ALSRR)), with 39 cases in each group. It was found that the BPS algorithm showed lower relative mean square error (MSE) in axle x (OMSE, x) and axle y (OMSE, x), but the classification accuracy (CA) was the opposite ( P < 0.05 ). The postoperative hospital stay, analgesia duration, first exhaust time (FET), and first off-bed activity time (FOBA) for patients in the experimental group were less ( P < 0.05 ). The operation time of the experimental group (270.56 ± 90.55 min) was significantly longer than that of the control group (228.07 ± 75.26 min) ( P < 0.05 ). There were 3 cases of anastomotic fistula, 1 case of acute peritonitis, and 2 cases of lung infections in the experimental group, which were greatly less than those in the control group (7 cases, 4 cases, and 3 cases) ( P < 0.05 ). In short, the BPS algorithm was superior in processing MRI images and could improve the diagnostic effect of MRI images. The CLSRR could reduce the length of hospital stay and the probability of complications in GC patients, so it could be used as a surgical plan for the clinical treatment of advanced GC.

scholarly journals The rationale for the joint use of osteopathic correction and kinesiotherapy in the humeroscapular periarthrosis syndrome (humeroscapular periarthropathy) treatment

2020 ◽  
pp. 99-110
Author(s):  
E. B. Lebedev ◽  
D. B. Miroshnichenko
Keyword(s):  
Shoulder Joint ◽  
Local Level ◽  
T Test ◽  
Control Group ◽  
Test Statistics ◽  
Exact Test ◽  
Detection Frequency ◽  
High Prevalence ◽  
Experimental Group ◽  
Joint State

Introduction. The humeroscapular periarthrosis syndrome (humeroscapular periarthropathy) is characterized by a high prevalence — shoulder pain is observed in 7–26 % of the population, such patients account for up to 18 % of paid sick leave. The term «humeroscapular periarthrosis» combines lesions of both the muscles and the joint capsule itself. To date, the scientific literature notes that in most cases the conservative therapy is effective in the form of pharmacotherapy and non-drug methods, including manual therapy, osteopathy and kinesiotaping. It should be noted that today there are no studies aimed to study the combination of osteopathic correction and kinesiotaping method, each of which is individually recognized as sufficiently effective in the treatment of the humeroscapular periarthrosis syndrome (humeroscapular periarthropathy).The goal of research — is to substantiate the feasibility of combining osteopathic correction and kinesiotaping in the treatment of the humeroscapular periarthrosis (humeroscapular periarthropathy).Materials and methods. The study was conducted in the period from February 1, 2018 to January 1, 2019 in the Neurological Department of the Rehabilitation Center Tula Regional Clinical Hospital. The study involved 43 patients with the syndrome of humeroscapular periarthrosis, duration of the disease — 1–5 months. By simple randomization the patients were divided into two groups: experimental — 22 patients receiving osteopathic correction in combination with kinesiotaping; control — 21 patients receiving only osteopathic correction. In both groups, at the beginning and at the end of the study, an osteopathic examination was performed with the formation of an osteopathic conclusion, the severity of pain on a visual-analog scale, and the shoulder joint state was assessed by the Swanson scale. The obtained data were processed using parametric (student′s t-test for independent groups and student′s paired t-test) and nonparametric (McNemar′s criterion and Fisher′s exact test) statistics.Results. Both osteopathic correction and combination of osteopathic correction and kinesiotaping are accompanied by a statistically significant (p<0,05) decrease in the detection frequency of some dysfunctions at the regional and local level, a decrease in the pain intensity, and an improvement in the shoulder joint state. The combination of osteopathic correction and kinesiotaping is accompanied by a statistically significant (p<0,05) more pronounced improvement in the shoulder joint state.Conclusion. Statistically significantly more pronounced improvement in the shoulder joint state of the experimental group patients compared with the control group patients suggests that the combination of osteopathic correction with kinesiotaping could be more effective in the treatment of the humeroscapular periarthrosis syndrome (humeroscapular periarthropathy).

scholarly journals Motivational Media and Academic Success

2015 ◽  
Vol 4 (1) ◽  
pp. 160-163
Author(s):  
Nicolle Grant
Keyword(s):  
Academic Performance ◽  
Academic Success ◽  
Positive Emotions ◽  
Academic Motivation ◽  
College Graduates ◽  
Male Students ◽  
Control Group ◽  
Psychology Courses ◽  
Potential Impact ◽  
Experimental Group

Motivating students to do well in courses that fail to interest them can be challenging. The current study was designed to assess the potential impact of priming motivational media on academic performance. Students in six sections of introductory psychology courses (n = 128) completed a quiz after watching a 4 minute inspirational video (experimental group, n = 63), or without watching the video (control group, n = 65). The video selected showed scenes of individuals pushing their limits in all aspects of life and a commentary of a motivational commencement speech by Arnold Schwarzenegger given to college graduates. After completing the quiz participants were given a survey with questions pertaining to their motivation, positive and negative emotions, demographics, and their reactions to the video. Students who were primed by the video reported greater academic motivation and planned to study more for the next quiz than students who did not watch the video. Females reported lower GPA and lower positive emotions in the experimental condition. While there was not an overall effect of the video on quiz scores, male students who watched the video performed 10% better on the quiz than males in the control condition. Implications of these findings suggest that motivational information may be beneficial in inspiring academic performance in certain circumstances.

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