scholarly journals Carbapenems Utilization Evaluation in Neutropenic Patients of a Teaching Hospital

2020 ◽  
Author(s):  
Lida Bahador ◽  
Afsaneh Vazin ◽  
Mohammad Ali Davarpanah ◽  
Peyman Arfa
Keyword(s):  
Patient Outcomes ◽  
Length Of Hospital Stay ◽  
Marrow Transplant ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Prolonged Length ◽  
Poor Patient ◽  
Correct Dose ◽  
Empirical Antibacterial Therapy ◽  
Neutropenic Patients

Background: Carbapenems is frequently prescribed for treatment or prophylaxis in neutropenic patients. It is cleared that antimicrobial misuse can cause poor patient outcomes, through raise of antibiotic resistance, increased adverse events, and prolonged length of hospital stay. To evaluate the rational use of Imipenem- Cilastatin and Meropenem for empirical antibacterial therapy in neutropenic patients based on IDSA guideline. Methods: Through this cross-sectional study, we assessed the appropriateness of administration of Carbapenems in neutropenic patients admitted in hematology–oncology and bone marrow transplant wards in Namazee hospital, Shiraz, Iran, from March 2012 to May 2013. Results: Total of 90 patients was enrolled. Drug therapy duration was appropriate in 69.6% of Imipenem-Cilastatin and 75% of Meropenem groups. Sampling time of culture was appropriated in 59.1% of Imipenem-Cilastatin and 78.3% of Meropenem group, interval of drug administration was correct in 74.5% at initiation and 79.4% during therapy in Imipenem-Cilastatin group. For dosing these values were 74.5% and 72.2%, respectively. These values were evaluated in patients who received Meropenem too, interval was correct in 89.5% at initiation and 90.3% during therapy, dosing was correct in 12.3% both at initiation and during therapy. Conclusion: These finding suggest that attention to correct dose, correct interval, renal dose adjustment, logical indication for administration of Carbapenem should be considered by health care system. J Pharm Care 2019; 7(4): 106-111.

scholarly journals Hypertension and chronic cor pulmonale were the independent risk factors for a prolonged length of hospital stay in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients: a multicenter cross-sectional study

2021 ◽  
Author(s):  
Hong Wang ◽  
TAO YANG ◽  
Zhihong Chen ◽  
Yajuan Ran ◽  
Jiajia Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Length Of Hospital Stay ◽  
Cross Sectional Study ◽  
Cor Pulmonale ◽  
Sectional Study ◽  
Cross Sectional ◽  
Prolonged Length ◽  
Logistics Regression ◽  
Independent Risk Factors ◽  
Chronic Cor Pulmonale

Background: AECOPD is a severe status of COPD. The prolonged length of hospital stay (LHS) was associated with poor prognosis and higher medical costs in AECOPD patients. Identification of the risk factors for prolonged LHS will help physicians provide targeted and personalized interventions, reduce LHS, and avoid unnecessary health services in COPD patients. This study aimed to explore the risk factors for prolonged LHS in hospitalized AECOPD patients. Methods: In this multicenter cross-sectional study, 598 AECOPD patients were screened. In the end, the LHS of 111 were <7 days (Normal LHS, N-LHS), 218 were 7-10 days (Mild Prolonged LHS, MP-LHS), and 100 were≥11 days (Severe Prolonged LHS, SP-LHS). Demographic data, underlying diseases, symptoms, and laboratory findings were collected. Multiple logistics regression was performed to investigate the independent risk factors for prolonged LHS in AECOPD patients. Results: The significant differences in 11 variables were found by univariate analysis. Since significant collinearities among white blood cells (WBC), neutrophils (NS), and NS% were observed, WBC and NS% were excluded. Therefore, 9 factors were included in multiple logistics regression. Subsequently, our results identified that the rates of hypertension and chronic cor pulmonale (CCP) were independently associated with prolonged LHS in AECOPD patients. Conclusions: Collectively, our results suggested that complications of hypertension and CCP were at a higher risk of prolonged LHS in AECOPD patients. It also indicated that AECOPD combined with hypertension and/or CCP probably more severe. Then, more extensive management should be initially administrated.

The utility of strain imaging in the cardiac surveillance of bone marrow transplant patients

Heart ◽  
2021 ◽  
pp. heartjnl-2021-319359
Author(s):  
Tejas Deshmukh ◽  
Peter Emerson ◽  
Paul Geenty ◽  
Shehane Mahendran ◽  
Luke Stefani ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Global Longitudinal Strain ◽  
Group Versus ◽  
Marrow Transplant ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Right Ventricular Free Wall ◽  
Cross Sectional ◽  
Allogenic Bone ◽  
Transplant Patients

ObjectiveTo evaluate the utility of two-dimensional multiplanar speckle tracking strain to assess for cardiotoxicity post allogenic bone marrow transplantation (BMT) for haematological conditions.MethodsCross-sectional study of 120 consecutive patients post-BMT (80 pretreated with anthracyclines (BMT+AC), 40 BMT alone) recruited from a late effects haematology clinic, compared with 80 healthy controls, as part of a long-term cardiotoxicity surveillance study (mean duration from BMT to transthoracic echocardiogram 6±6 years). Left ventricular global longitudinal strain (LV GLS), global circumferential strain (LV GCS) and right ventricular free wall strain (RV FWS) were compared with traditionl parameters of function including LV ejection fraction (LVEF) and RV fractional area change.ResultsLV GLS (−17.7±3.0% vs −20.2±1.9%), LV GCS (−14.7±3.5% vs −20.4±2.1%) and RV FWS (−22.6±4.7% vs −28.0±3.8%) were all significantly (p=0.001) reduced in BMT+AC versus controls, while only LV GCS (−15.9±3.5% vs −20.4±2.1%) and RV FWS (−23.9±3.5% vs −28.0±3.8%) were significantly (p=0.001) reduced in BMT group versus controls. Even in patients with LVEF >53%, ~75% of patients in both BMT groups demonstrated a reduction in GCS.ConclusionMultiplanar strain identifies a greater number of BMT patients with subclinical LV dysfunction rather than by GLS alone, and should be evaluated as part of post-BMT patient surveillence. Reduction in GCS is possibly due to effects of preconditioning, and is not fully explained by AC exposure.

scholarly journals Prevalence and costs of hospitalizations for poisoning and accidental intoxication in Brazilian elderly

2013 ◽  
Vol 49 (4) ◽  
pp. 679-687
Author(s):  
Marcelle Silva de Abreu ◽  
Silvandro Diego de Albuquerque Ferreira ◽  
Larissa Pelágia de Lima Ferreira ◽  
José Ferreira Toneo Júnior ◽  
Wamberto Vieira Maciel ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Secondary Data ◽  
Mortality Rates ◽  
Cross Sectional Study ◽  
Microsoft Excel ◽  
Cross Sectional ◽  
Alcohol And Drugs ◽  
Elderly Males

A cross-sectional study of secondary data/information obtained from the Hospital Information System (HIS) spanning the years 2008 - 2009 was performed. The distribution of the main hospital admissions by gender, age, color/race, region and federal unit of residence, average expenditure and average length of hospital stay, year of hospitalization and mortality rates (MR) were studied. The data collected were tabulated by TabNet and keyed into Microsoft Excel 2007. It was verified that elderly males (54.3%), from 60 to 69 years old (50.6%), nonwhites (36.3%) and residents of Southeast and North regions of the country had the highest rates of hospitalization. Seniors were hospitalized for an average of 4.8 days, and the major causes were exposure to alcohol (43.7%) and to drugs (33.9%). Expenses related to hospital admissions were, on average, R$ 529,817.70. The highest mortality rates were recorded among females (MR = 4.34), in elderly, 80 years or older (MR = 10.16) and Caucasians (MR = 3.95), where pharmacological substances with action on the Autonomic Nervous System were the leading cause of death. There are demographic differences in morbi-mortality of these elderly since, although men and younger elderly were the main victims, women and elderly of advanced age have greater mortality. The leading causes of hospitalization were alcohol and drugs.

scholarly journals Factors Related To Outcome of Traumatic Brain Injury Patients at M Djamil Padang Hospital

2021 ◽  
Vol 5 (8) ◽  
pp. 811-817
Author(s):  
Nora Fitri ◽  
Syarif Indra ◽  
Hendra Permana
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Patient Outcomes ◽  
Significant Relationship ◽  
Traffic Accidents ◽  
Cross Sectional Study ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
Major Threat

Background: Traumatic brain injury is still a major threat because it can cause global morbidity and mortality. Many factors can affect the outcome of a traumatic brain injury. Some conditions that can exacerbate traumatic brain injury include GCS conditions, blood pressure variability, and pupillary reflexes.Methods: The research was conducted in M. Djamil Padang Hospital from October 2020 to March 2021. The study design was a cross-sectional study in traumatic brain injury patients with ≤ 48 hours of onset and the aged between 18-60 years. The subjects in this study consisted of 66 subjects. At 6 weeks after onset, a GOS assessment was performed to assess patient outcomes. Statistical analysis was performed computerized with SPSS 22.0. P-value <0.05 was considered statistically significant. Results: Most of the patients were male (71.2%) with an average age of 36.41 ± 14,275 years, and the most common injury mechanism was traffic accidents (95.5%). There was a significant relationship between onset of incidence, hypotension, pupillary reflexes, and Rotterdam score with the outcome of traumatic brain injury patients (p<0.05) and there was no significant relationship between age, gender, and mechanism of injury with the outcome patients with traumatic brain injury. Conclution: The onset of events, hypotension, pupillary reflexes, and Rotterdam scores significantly affect the outcome patients of traumatic brain injury.

scholarly journals Peripartum hysterectomy and its risk factors

2019 ◽  
Vol 9 (1) ◽  
pp. 27-31
Author(s):  
Renuka Tamrakar ◽  
Upendra Pandit ◽  
Sabita Shrestha ◽  
Basant Sharma ◽  
Rakshya Joshi
Keyword(s):  
Placenta Accreta ◽  
Length Of Hospital Stay ◽  
Cross Sectional Study ◽  
Morbidity Rate ◽  
Sectional Study ◽  
Cross Sectional ◽  
Peripartum Hysterectomy ◽  
Estimated Blood Loss ◽  
Severe Hemorrhage ◽  
Emergency Peripartum Hysterectomy

Background: Emergency Peripartum Hysterectomy (EPH) is an important lifesaving surgical procedure considered in cases of severe hemorrhage unresponsive to medical and conservative management. The objective is to review incidence, identification, intervention and impact of emergency peripartum hysterectomy. Methods: The retrospective, cross-sectional study designed was to used. EPH data were collected from January 2014 to December 2018.Descriptive statistics was used to analyzed data and presented in tables and charts. Results: Incidence of Emergency Peripartum Hysterectomies was 2.3% out of 252(2.6%) cases of obstetrical emergencies and 0.06% that is 1 in 1600 deliveries. Most common indications for EPH were uterine rupture (33.3%); placenta accreta (33.3%) followed by retained placenta (16.6%) and endometritis with pyometritis (16.6%). Estimated blood loss 1916 ml., timeliness from delivery to hysterectomy was 140 minutes; most common post-operative complication was surgical site infection (33.3%) and length of hospital stay 11.7 days. Maternal morbidity rate was 33.3%. There was no maternal mortality recorded. Conclusions: The timely intervention improves the outcome in Peripar­tum Hysterectomy, which is frequently associated with abnormal placen­tation as a consequence of increasing caesarean deliveries rate.

scholarly journals Emergency general surgery in Rwandan district hospitals: a cross-sectional study of spectrum, management, and patient outcomes

BMC Surgery ◽  
2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Christophe Mpirimbanyi ◽  
Alexandre Nyirimodoka ◽  
Yihan Lin ◽  
Bethany L. Hedt-Gauthier ◽  
Jackline Odhiambo ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
General Surgery ◽  
Cross Sectional Study ◽  
Spectrum Management ◽  
Sectional Study ◽  
Emergency General Surgery ◽  
Cross Sectional ◽  
District Hospitals

Additional cytogenetic abnormalities in chronic myeloid leukemia; an experience from Pakistan

2020 ◽  
pp. 1-8
Author(s):  
Nida Anwar ◽  
Muhammad Nadeem ◽  
Sana Khurram ◽  
Naveena Fatima ◽  
Tahir Shamsi ◽  
...  
Keyword(s):  
Bone Marrow ◽  
International System ◽  
Marrow Transplant ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Female Ratio ◽  
Cytogenetic Abnormalities ◽  
Human Cytogenetic ◽  
Bone Marrow Cultures ◽  
Male To Female

Abstract Objectives: To evaluate the presence and characteristics of additional karyotype abnormalities in chronic myeloid leukaemia cases. Method: The cross-sectional study was conducted at the Department of Cytogenetics and Molecular Pathology, National Institute of Blood Diseases and Bone Marrow Transplant, Karachi, from May 2010 to September 2016 and comprised diagnosed chronic myeloid leukaemiapatients regardless of age and gender.Baseline cytogenetic evaluation was done on overnight, 24-hrs un-stimulated and 72-hrs stimulated bone marrow cultures, and karyotypes were defined according to the International System for Human Cytogenetic Nomenclature2013. Data was analysed using SPSS 23. Results: There were 222 cases with a median age of 38 years (range: 12-84 years). The male-to-female ratio was 1.8:1. Chronic myeloid leukaemiawas detected in 18(8.1%) patients havingadditional cytogenetic abnormalities. Among the patients found positive, cytogenetic type was minor in 10(55.55%), major 3(16.66%), complex 3(16.66%), and variant 2(11.11%). . Conclusion: Additional cytogenetic abnormalitieswere found in 8% of the sample. Key Words: Additional cytogenetic abnormalities, Chronic myelogenous leukaemia, Bone marrow, Cytogenetics.

scholarly journals Adesão ao protocolo de prevenção de infecção do trato urinário

2018 ◽  
Vol 12 (10) ◽  
pp. 2675
Author(s):  
Thelma Helena Anghinoni ◽  
Ligia Marcia Contrin ◽  
Isabela Shumaher Frutuoso ◽  
Alexandre Lins Werneck ◽  
Ana Maria Rodrigues Da Silveira ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Length Of Hospital Stay ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Nursing Team ◽  
High Adherence ◽  
Student’S T ◽  
High Level ◽  
Student’S T Test

RESUMOObjetivo: identificar a adesão ao protocolo de prevenção de infecção do trato urinário de acordo com as condições de higiene, identificação, fixação e localização da sonda vesical de demora. Método: trata-se de estudo quantitativo, de campo, analítico, explicativo e transversal, com dados coletados por meio de checklist à beira do leito em seis UTIs. Analisaram-se os resultados pelo Teste Estatístico de Regressão Linear Múltipla e teste t de Student, apresentados em tabelas. Resultados: identificaram-se que das 945 checagens, 403 homens e 346 mulheres necessitaram de SVD. Encontraram-se resultados estatisticamente significantes ao cruzar SVD fixada com tempo de internação e com o sexo; SVD/sujidade com o tempo de internação e com o sexo; SVD identificada com tempo de internação. Consideram-se o principal motivo da infecção o uso de SVD e o microrganismo mais prevalente, a Escherichia Coli. Conclusão: verificou-se alta adesão da equipe de enfermagem ao protocolo de prevenção de infecção do trato urinário, com baixo índice de infecção e alto nível de conformidades em relação à higiene, identificação, fixação e localização da SVD. Descritores: Equipe de Enfermagem; Infecção; Trato Urinário; Protocolos; Segurança Do Paciente; Unidades de Terapia Intensiva.ABSTRACT Objective: to identify the adherence to the protocol of prevention of infection of the urinary tract according to the conditions of hygiene, identification, fixation and location of the bladder catheter of delay. Method: this is a quantitative, field-based, analytical, and cross-sectional study with data collected through the bedside checklist at six ICUs. The results were analyzed by the Multiple Linear Regression Statistical Test and Student's t test, presented in tables. Results: it was identified that of the 945 checks, 403 men and 346 women required SVD. Statistically significant results were found when crossing SVD fixed with hospitalization time and with sex; SVD / soil with time of hospitalization and with sex; SVD identified with length of hospital stay. The main reason for the infection is the use of SVD and the most prevalent microorganism, Escherichia coli. Conclusion: there was a high adherence of the nursing team to the protocol for the prevention of urinary tract infection, with a low infection rate and a high level of compliance regarding hygiene, identification, fixation and location of SVD. Descriptors: Nursing Team; Infection; Urinary Tract; Protocols; Patient Safety; Intensive Care Units.RESUMEN Objetivo: identificar la adhesión al protocolo de prevención de infección del tracto urinario de acuerdo con las condiciones de higiene, identificación, fijación y localización de la sonda vesical de demora. Método: se trata de estudio cuantitativo, de campo, analítico, -explicativo y transversal, con datos recogidos por medio de checklist al borde del lecho en seis UTIs. Se analizaron los resultados por el Test Estadístico de Regresión Lineal Múltiple y test t de Student, presentados en tablas. Resultados:  se identificaron que de las 945 chequeos, 403 hombres y 346 mujeres necesitaron SVD. Se encontraron resultados estadísticamente significantes al cruzar SVD fijada con tiempo de internación y con el sexo; SVD / suciedad con el tiempo de internación y con el sexo; SVD identificada con tiempo de internación. Se considera el principal motivo de la infección el uso de SVD y el microorganismo más prevalente, la Escherichia Coli. Conclusión: se verificó alta adhesión del equipo de enfermería al protocolo de prevención de infección del tracto urinario, con bajo índice de infección y alto nivel de conformidades en relación a la higiene, identificación, fijación y localización de la SVD. Descriptores: Grupo de Enfermería; Infección; Sistema Urinario; Protocolos; Seguridad del Paciente; Unidades de Cuidados Intensivos.

scholarly journals Do Patients Know Their Physicians' Names and Their Specialties? Results from King Abdulaziz Medical City, Riyadh, Saudi Arabia

2014 ◽  
Vol 4 (1) ◽  
pp. 9-13
Author(s):  
Salih Binsalih ◽  
Omar Al Harthi ◽  
Mohammad Qahtani ◽  
Abdullah Al Sayyari
Keyword(s):  
Emergency Department ◽  
Saudi Arabia ◽  
Length Of Hospital Stay ◽  
Female Gender ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Medical City ◽  
Arabic And English ◽  
Medical Wards

Objective: To determine if inpatients in medical wards are aware who their most responsible physician (MRP) is and what is the nature of his/her specialty and if this awareness is influenced by age, sex, method of admission and the length of hospital stay. Methods: A cross-sectional study conducted at King Abdulaziz Medical City, Riyadh. Results: One hundred patients completed the survey from 7 different wards. 66% were male and two-thirds of the patients were over the age of 60 years, and 55% were inpatients for more than 10 days. Overall respondents, 43% knew the name of their MRP whereas 57% did not. Conclusion: Reduced awareness was more often observed in female gender, older age and being admitted through Emergency Department. It's recommended that MRPs' names on signboards be written in Arabic and English in all wards.

scholarly journals Influence of maternal age and hospital characteristics on the mode of delivery

2020 ◽  
Vol 73 (suppl 4) ◽  
Author(s):  
Thales Philipe Rodrigues da Silva ◽  
Bruna Luiza Soares Pinheiro ◽  
Karolina Yukari Kitagawa ◽  
Renato Camargo Couto ◽  
Tânia Moreira Grillo Pedrosa ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Maternal Age ◽  
Diagnosis Related Groups ◽  
Mode Of Delivery ◽  
Length Of Hospital Stay ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Public And Private ◽  
Public Care ◽  
Vaginal Deliveries

ABSTRACT Objectives: to analyze the relationship between maternal age and the source of healthcare payment with mode of delivery in public and private national hospitals between the years 2012 to 2017, and the length of hospital stay. Methods: cross-sectional study of 91,894 women who had children in public and private hospitals between 2012 and 2017. Data were collected from the Diagnosis-Related Groups Brazil system and a comparative analysis was performed between patients in public care and those in supplementary healthcare. Results: in public care, the majority were vaginal deliveries and the reverse occurred in supplementary health. The proportion of cesarean sections was higher in the age group 31 to 40 years old in both services. The hospital stay was longer among women who underwent a cesarean section. Conclusions: high maternal age and the source of healthcare payment influence the mode of delivery, which interfere with the length of hospital stay.

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