Analysis of Patients Undergoing Prostate Biopsy Procedure In Outpatient Care

Abstract Currently in the concept of de-hospitalization and consequently an increase in invasive procedures performed in the extra-hospital environment. This work aims to identify the signs and symptoms of an adverse event related to prostate biopsy. This is a cohort and retrospective research through the registration of patient care in electronic medical records after the exam. In the period from 2016 to 2018, 3,570 exams were performed, with 491 patients presenting the criteria for the classification of infection related to the procedure that strictly obeys the criteria established by the Centers Diseases Control (CDC). The inclusion criteria for patients were those who, within 15 days after performing the prostate biopsy, had emergency care due to the presence of signs and symptoms. The exams analyzed were urine culture and blood culture collected at the time of emergency care. The results were that of the 491 patients evaluated, 38 (9%) patients required hospitalization, the average age of the hospitalized patients was 71.5 years and all had at least one associated comorbidity on positive cultures, 13 for E. coli with total sensitivity to aminoglycosides and carbapenems and partial sensitivity to fluoroquinolones, 1 Protein spp sensitive to aminoglycosides and carbapenems and 1 Salmonella spp sensitive to fluoroquinolones and carbapenems. Thus, it is noted the importance of the infection control nurse's activity in the diagnostic medicine units for the elaboration of protocols adapted to the outpatient reality.

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Evaluation of the benefits for the patient arising from an inter-hospital teleradiology network in a French administrative area

Journal of Telemedicine and Telecare ◽

10.1258/1357633054068964 ◽

2005 ◽

Vol 11 (4) ◽

pp. 178-184 ◽

Cited By ~ 3

Author(s):

Valentin Daucourt ◽

Marie-Edith Petitjean ◽

Jean-François Chateil ◽

Philippe Michel

Keyword(s):

Emergency Care ◽

Medical Records ◽

Outcome Measure ◽

Inclusion Criteria ◽

Remote Consultation ◽

Main Outcome Measure ◽

Administrative Area ◽

One Year ◽

A Prospective Study ◽

Remote Consultations

We conducted a prospective study of the teleradiology network which connects 15 hospitals in the Aquitaine area. All transmissions sent over a one-year period were examined (data transmitted at the time of the remote consultation and health outcomes of patients from their medical records). For emergency cases, the main outcome measure of effectiveness was the proportion of avoided transfers. For non-emergency cases, the main outcome measure of effectiveness was the proportion of transfers, hospitalizations and consultations avoided. There were 737 transmissions, of which 664 (90%) met the inclusion criteria. Of these, 562 (85%) were for emergency care and 102 (15%) for non-emergency care. In emergency care, the pathologies most often associated with a remote consultation were cerebral pathologies (88%) and traumatic spinal pathologies (8%); the proportion of avoided transfers was 48%. In non-emergency care, the specialties most often concerned with remote consultations were neurology/neurosurgery (36%), cardiology and pulmonary diseases (17%) and gastroenterology (14%). Transfer was avoided for 37% of the patients and hospitalization for 12%. An additional consultation occurred after remote consultation for 2% of the patients. The results confirm the effectiveness of an inter-hospital teleradiology network.

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Association between Fever during Admission and Outcome of Treatment in Tuberculous Meningitis Patients in Hasan Sadikin General Hospital Bandung

Journal Of Medicine & Health ◽

10.28932/jmh.v2i3.1233 ◽

2019 ◽

Vol 2 (3) ◽

Author(s):

Regita A Kuswanto ◽

Ahmad Rizal ◽

R Raspati C Koesoemadinata

Keyword(s):

Tuberculous Meningitis ◽

Medical Records ◽

Retrospective Cohort ◽

Inflammatory Process ◽

Common Type ◽

Limited Data ◽

Inclusion Criteria ◽

Exclusion Criteria ◽

Factors Associated

Tuberculous meningitis (TBM) is the most common type of meningitis with a highmortality rate (20-41%). There are limited data on factors associated with outcome oftreatment, especially in Indonesia. Fever is a common inflammatory process in meningitispatients. This study aims to investigate the association between fever during admission andoutcome of treatment in TBM patients treated in the In-patient Neurology Department at HasanSadikin Hospital Bandung. This is an observational retrospective cohort study conducted byusing medical records from 2017. The inclusion criteria of this study were all medical recordsof inpatients who were diagnosed as TBM and ?18 years old, while the exclusion criteria wereincomplete medical records. The variables in this study were age, gender, body temperature,classification of TBM, and Glasglow Outcome Scale (GOS). There were 125 medical recordswhich fulfilled the inclusion criteria. Kruskal- Wallis test showed that fever was notsignificantly associated with GOS (p=0.193). In conclusion, fever during admission was notassociated with GOS in TBM patients.Keywords: tuberculous meningitis, fever, Glasglow Outcome Scale, outcome

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Clinical and genetic profile of Brazilian patients with dysferlinopathies – A retrospective study

10.5327/1516-3180.054 ◽

2021 ◽

Author(s):

Igor Braga Farias ◽

Bruno de Mattos Lombardi Badia ◽

Gustavo Carvalho Costa ◽

Roberta Ismael Lacerda Machado ◽

Carolina Maria Marin ◽

...

Keyword(s):

Muscular Dystrophy ◽

Medical Records ◽

Autosomal Recessive ◽

Statistical Difference ◽

Plantar Flexion ◽

Functional Decline ◽

Clinical Manifestations ◽

Genetic Profile ◽

Inclusion Criteria

Introduction: Dysferlinopathies are a group of conditions that are caused by mutations in the dysferlin gene. Objectives: To characterize the clinical phenotypes and genotypic spectrum of dysferlinopathies patients and to estimate the progression of functional and motor decline. Design and setting: Retrospective analysis of the medical records of patients followed up at our institution between 1995 and 2020. Methods: Patients were selected based on the following inclusion criteria:(i) Identification of a mutation defined as pathogenic in homozygosis or compound heterozygosis in the Dysf gene;or (ii)compatible clinical manifestations and decreased expression of dysferlin in immunohistochemistry on muscle biopsy. Classification of the phenotype was based on the first symptoms. Functionality was defined by the Gardner–Medwin & Walton(GMW) scale modified for dysferlinopathy. Results: 23 patients were included in the study. 16 were classified as limb-girdle muscular dystrophy autosomal recessive 2 (LGMDR2), 4 as Miyoshi muscular dystrophy, 2 as proximo-distal onset and 1 as asymptomatic hyperCKemia. Thighs adduction was the most affected movement in the first evaluation (mean strength=3). Plantar flexion was the movement with the greatest decline in strength(mean=-0.10 points on MRC/year;pT, Arg2042Cys and c.2643+1G>A, p.?(splicing), found 3 times each. There was no statistical difference in muscle strength in the first evaluation, motor and functional decline between the phenotypes. Conclusion: While LGMDR2 was the most common phenotype at onset, with the exception of asymptomatic hyperCKemia, there were not a clear difference in the pattern of progression between them.

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P104: Can patients suffering traumatic cardiac arrest be identified using the National Ambulatory Care Reporting System (NACRS) database?

CJEM ◽

10.1017/cem.2019.295 ◽

2019 ◽

Vol 21 (S1) ◽

pp. S101 ◽

Cited By ~ 1

Author(s):

N. Radulovic ◽

A. Kim ◽

C. Evans

Keyword(s):

Cardiac Arrest ◽

Ambulatory Care ◽

Medical Records ◽

Reporting System ◽

Emergency Department Visits ◽

Diagnostic Code ◽

Inclusion Criteria ◽

Traumatic Cardiac Arrest ◽

Icd 10

Introduction: Trauma is a common cause of mortality across all age groups and is projected to become the third greatest contributor to global disease burden. Recent studies have demonstrated that survival from traumatic cardiac arrest (TCA) is more favourable than once believed and further research on this population is being encouraged. Currently, it is unclear whether existing databases, such as the National Ambulatory Care Reporting system (NACRS), which includes all emergency department visits, could be used to identify TCAs for population-based studies. We aimed to determine the accuracy of NACRS administrative codes in identifying TCA patients. Methods: This retrospective validation study used data acquired from NACRS and our institutional Patient Care System. We identified a number of International Classification of Diseases, tenth revision (ICD-10) diagnostic, procedural and cause of injury codes that we hypothesized would be consistent with TCA. NACRS was subsequently searched for patients meeting the diagnostic code criteria (January 1 - December 31, 2015). The following inclusion criteria were: an eligible ICD-10 diagnostic code or a qualifying Canadian Classification of Health Interventions (CCI) procedure code and an eligible ICD-10 external cause of injury code. Electronic medical records for these patients were then reviewed to determine whether true TCAs had occurred. Results: Eighty-five patients met the inclusion criteria and one was excluded from analysis due to inaccessible health records, leaving 84 patients eligible for chart review. Overall, 55% (n = 46) of patients were found to have true TCA, 35% (n = 29) sustained a cardiac arrest of non-traumatic etiology and 11% (n = 9) were considered “unclear” (i.e. could not determine whether it was a true TCA based on the medical records). We found that true TCA patients were most accurately identified using a combination of ICD-10 CA cardiac arrest and external cause of injury codes (Positive predictive value: 70.6%, 95% CI 46.9-86.7). Conclusion: TCA patients were identified with moderate accuracy using the NACRS database. Further efforts to integrate specific data fields for TCA cases within existing population databases and trauma registries is necessary to facilitate future studies focused on this patient population.

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Fever at diagnosis of pediatric acute lymphoblastic leukemia (ALL): Are antibiotics really necessary?

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.9553 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 9553-9553

Author(s):

Monica Khurana ◽

James Henry Feusner ◽

Brian Lee

Keyword(s):

Medical Records ◽

Bacterial Resistance ◽

Lymphoblastic Leukemia ◽

Coagulase Negative Staphylococcus ◽

Inclusion Criteria ◽

E Coli ◽

Pediatric All ◽

Patient’S History ◽

Cancer Network ◽

Related Mortality

9553 Background: Great variability exists in the management of suspected bacteremia in febrile, neutropenic pediatric ALL patients during chemotherapy. The National Comprehensive Cancer Network and Infectious Diseases Society of America encourage immediate, empiric antibiotics in patients with chemotherapy-induced fever and neutropenia to reduce infection-related mortality. No standard recommendation exists for patients with isolated fever at initial presentation of their ALL. This study evaluates bacteremic episodes in this subpopulation of pediatric patients. Methods: We retrospectively analyzed 245 consecutive patients with ALL at Children’s Hospital Oakland from 2000 through 2011. Using electronic medical records, we investigated each patient’s history and outcome. We surveyed bacteremic episodes up to 60 days after presentation per National Healthcare Safety Network’s guidelines. Inclusion criteria were patients with fever at presentation, which prompts a blood culture, and were started on antibiotics. We stratified bacteremic episodes into community-acquired (up to three days from admission) and nosocomial (four to 60 days). Results: Seventy-seven patients met the inclusion criteria, five of whom had positive cultures – four were contaminants (three coagulase-negative Staphylococcus and one non-anthracis Bacillus) and one was a true nosocomial bactermic episode (E coli). There were no infection-related deaths in the first 60 days of diagnosis in this cohort. Conclusions: Given our institution’s rarity of bacteremic episodes, we contemplate a more judicious use of antibiotics, including quicker narrowing of broad-spectrum antibiotics coverage and discontinuing all antibiotics sooner. These modifications may decrease bacterial resistance to antibiotics, reduce costs, and shorten patients’ hospitalization. We encourage other institutions to conduct a similar investigation.

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Surveillance of Antibiotic Resistance Among Enterobacteriaceae Strains Isolated in an Infectious Diseases Hospital from Romania

Revista de Chimie ◽

10.37358/rc.18.5.6298 ◽

2018 ◽

Vol 69 (5) ◽

pp. 1240-1243

Author(s):

Manuela Arbune ◽

Mioara Decusara ◽

Luana Andreea Macovei ◽

Aurelia Romila ◽

Alina Viorica Iancu ◽

...

Keyword(s):

Antibiotic Resistance ◽

Infectious Diseases ◽

Salmonella Spp ◽

Resistance Level ◽

E Coli ◽

Bacterial Genus ◽

Antibiotic Resistance Profile ◽

Carbapenem Resistant ◽

Invasive Infections ◽

Klebsiella Spp

The aim of the present study was to characterize the antibiotic resistance profile of enterobacteriaceae strains isolated in Infectious Diseases Hospital Galati, Romania, during 2016, in order to guide the local antibiotic stewardship strategy. There are 597 biological samples with positive cultures for enterobacteriaceae, related to invasive and non-invasive infections. The main bacterial genus were E. coli 62%, Klebsiella spp 15%, Proteus spp 11% and Salmonella spp 6%. Over a half of isolated strains have one or more antibiotic resistance. The resistance level depends on bacterial genus, with highest level found among the rare isolates: Enterobacter spp, Citrobacter spp, Morganella spp and Serratia spp. The rate of MDR was 17.,6% for E. coli, 40.9% for Klebsiella spp and 50.7% for Proteus spp. while the rate of strains producing Extended Spectrum of Beta Lactamase are 7.2% for E. coli, 28.4% for Klebsiella spp and 12.3% for Proteus spp. The carbapenem resistant strains were found in 1.1% cases.

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The association of triglyceride levels with the incidence of initial and recurrent acute pancreatitis

Lipids in Health and Disease ◽

10.1186/s12944-021-01488-8 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Robert J. Sanchez ◽

Wenzhen Ge ◽

Wenhui Wei ◽

Manish P. Ponda ◽

Robert S. Rosenson

Keyword(s):

Acute Pancreatitis ◽

Medical Records ◽

Adult Population ◽

Baseline Period ◽

Prior History ◽

Inclusion Criteria ◽

Exclusion Criteria ◽

Recurrent Acute Pancreatitis ◽

History Of ◽

Nationally Representative

Abstract Background This retrospective cohort study assessed the annualized incidence rate (IR) of acute pancreatitis (AP) in a nationally representative US adult population, as well as the variation in the risk of AP events across strata of triglyceride (TG) levels. Methods Data were obtained from IQVIA’s US Ambulatory Electronic Medical Records (EMR) database linked with its LRxDx Open Claims database. Inclusion criteria included ≥1 serum TG value during the overlapping study period of the EMR and claims databases, ≥1 claim in the 12-month baseline period, and ≥ 1 claim in the 12 months post index. All TG measurements were assigned to the highest category reached: < 2.26, ≥2.26 to ≤5.65, > 5.65 to ≤9.94, > 9.94, and > 11.29 mmol/L (< 200, ≥200 to ≤500, > 500 to ≤880, > 880, and > 1000 mg/dL, respectively). The outcome of interest was AP, defined as a hospitalization event with AP as the principal diagnosis. Results In total, 7,119,195 patients met the inclusion/exclusion criteria, of whom 4158 (0.058%) had ≥1 AP events in the prior 12 months. Most patients (83%) had TGs < 2.26 mmol/L (< 200 mg/dL), while < 1% had TGs > 9.94 mmol/L (> 880 mg/dL). Overall, the IR of AP was low (0.08%; 95% confidence internal [CI], 0.08–0.08%), but increased with increasing TGs (0.08% in TGs < 2.26 mmol/L [< 200 mg/dL] to 1.21% in TGs > 11.29 mmol/L [> 1000 mg/dL]). In patients with a prior history of AP, the IR of AP increased dramatically; patients with ≥2 AP events at baseline had an IR of 29.98% (95% CI, 25.1–34.9%). Conclusion The risk of AP increases with increasing TG strata; however, the risk increases dramatically among patients with a recent history of AP.

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Mechanistic insights into synergy between nalidixic acid and tetracycline against clinical isolates of Acinetobacter baumannii and Escherichia coli

Communications Biology ◽

10.1038/s42003-021-02074-5 ◽

2021 ◽

Vol 4 (1) ◽

Author(s):

Amit Gaurav ◽

Varsha Gupta ◽

Sandeep K. Shrivastava ◽

Ranjana Pathania

Keyword(s):

Escherichia Coli ◽

Acinetobacter Baumannii ◽

Nalidixic Acid ◽

Bacterial Infections ◽

Clinical Isolates ◽

Hospital Environment ◽

Infection Model ◽

Drug Resistant ◽

E Coli

AbstractThe increasing prevalence of antimicrobial resistance has become a global health problem. Acinetobacter baumannii is an important nosocomial pathogen due to its capacity to persist in the hospital environment. It has a high mortality rate and few treatment options. Antibiotic combinations can help to fight multi-drug resistant (MDR) bacterial infections, but they are rarely used in the clinics and mostly unexplored. The interaction between bacteriostatic and bactericidal antibiotics are mostly reported as antagonism based on the results obtained in the susceptible model laboratory strain Escherichia coli. However, in the present study, we report a synergistic interaction between nalidixic acid and tetracycline against clinical multi-drug resistant A. baumannii and E. coli. Here we provide mechanistic insight into this dichotomy. The synergistic combination was studied by checkerboard assay and time-kill curve analysis. We also elucidate the mechanism behind this synergy using several techniques such as fluorescence spectroscopy, flow cytometry, fluorescence microscopy, morphometric analysis, and real-time polymerase chain reaction. Nalidixic acid and tetracycline combination displayed synergy against most of the MDR clinical isolates of A. baumannii and E. coli but not against susceptible isolates. Finally, we demonstrate that this combination is also effective in vivo in an A. baumannii/Caenorhabditis elegans infection model (p < 0.001)

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Drinking water quality and antibiotic resistance of E. coli and Salmonella spp. from different sources in Gweru urban, Zimbabwe

Environmental Monitoring and Assessment ◽

10.1007/s10661-021-09322-5 ◽

2021 ◽

Vol 193 (8) ◽

Author(s):

Desmond Tichaona Mugadza ◽

Sibusisiwe Isabel Nduku ◽

Edlyn Gweme ◽

Sherpherd Manhokwe ◽

Patience Marume ◽

...

Keyword(s):

Water Quality ◽

Drinking Water ◽

Antibiotic Resistance ◽

Drinking Water Quality ◽

Salmonella Spp ◽

E Coli ◽

Different Sources

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Small Bowel Obstruction

AACN Advanced Critical Care ◽

10.4037/15597768-2010-2009 ◽

2010 ◽

Vol 21 (2) ◽

pp. 187-194

Author(s):

Colleen Trevino

Keyword(s):

Small Bowel ◽

Physical Examination ◽

Surgical Intervention ◽

Signs And Symptoms ◽

Bowel Ischemia ◽

Key Factors ◽

The Past ◽

Factors Influencing ◽

Imaging Response

Strategies for the management of small bowel obstructions have changed significantly over the years. Nonoperative medical management has become the mainstay of treatment of many small bowel obstructions. However, the key to the management of small bowel obstructions is identifying those patients who need surgical intervention. Identification of those at risk for bowel ischemia and bowel death is an art as much as it is a science. Using the current literature and the past knowledge regarding small bowel obstructions, the clinician must carefully identify the signs and symptoms that suggest the need for operative intervention. Classification of the obstruction, history and physical examination, imaging, response to decompression and resuscitation, and resolution or progression of symptoms are the key factors influencing the management of small bowel obstructions.

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