scholarly journals Respiratory Tuberculosis in Those over 70 Years of Age: Specific Course of the Disease and Diagnostic Difficulties

2021 ◽  
Vol 99 (6) ◽  
pp. 39-42
Author(s):  
A. S. Shprykov ◽  
D. A. Sutyaginа ◽  
M. A. Dolgovа
Keyword(s):  
Medical Care ◽  
Medical Records ◽  
Diagnostic Difficulties ◽  
Sputum Conversion

The objective: to study specific features of the course and diagnosis of respiratory tuberculosis in persons aged 70 years and older.Subjects and methods. Medical records of 93 patients aged 70 years and older who were hospitalized due to respiratory tuberculosis in 2000-2019 were retrospectively analyzed. Men made 60.2%, and women – 39.8%.Results. Often tuberculosis was detected late when referring for medical care (68.8%). In 59.4% of patients, tuberculosis was detected later than in 2 months after the onset of the first symptoms. 89.2% had multiple co-morbidities. Destruction was detected in 52.7% of patients, bacterial excretion – in 69.9%, and remaining post-tuberculosis changes – in 34.4%. Sputum conversion was achieved in 81.5% of patients and cavities were healed in 53.1%.

Medical Care for a Mass Gathering: The Suwa Onbashira Festival

2007 ◽  
Vol 22 (5) ◽  
pp. 431-435 ◽  
Author(s):  
Kazuyuki Yazawa ◽  
Yukihiro Kamijo ◽  
Ryuichi Sakai ◽  
Masahiko Ohashi ◽  
Mafumi Owa
Keyword(s):  
Medical Care ◽  
Medical Records ◽  
Medical Service ◽  
Medical Problems ◽  
Medical Care System ◽  
Mass Gatherings ◽  
Emergency Medical ◽  
Cervical Spine Fractures ◽  
First Time ◽  
Care System

AbstractIntroduction:The Suwa Onbashira Festival is held every six years and draws approximately one million spectators from across Japan. Men ride the Onbashira pillars (logs) down steep slopes.At each festival, several people are crushed under the heavy log. During the 2004 festival, for the first time, a medical care system that coordinated a medical team, an emergency medical service, related agencies, and local hospitals was constructed.Objective:The aims of this study were to characterize the spectrum of injuries and illness and to evaluate the medical care system of this festival.Methods:The festival was held 02 April–10 May 2004. The medical records of all of the patients who presented to an on-site medical tent or who were treated at the scene and transported to hospitals over a 12-day period were reviewed.The following items were evaluated: (1) the emergency medical system at the festival; (2) the environmental circumstances; and (3) patient data.Results:All medical usage rates are reported as patients per 10,000 attendees (PPTT). A total 1.8 million spectators attended the festival during the 12-day study period; a total of 237 patients presented to the medical tent (1.32 PPTT), and 63 (27%) were transferred to hospitals (0.35 PPTT). Of the total, 135 (57%) suffered from trauma—two were severely injured with pelvic and cervical spine fractures; and 102 (43%) had medical problems including heat-related illness.Conclusions:Comprehensive medical care is essential for similar mass gatherings. The appropriate triage of patients can lead to efficient medical coverage.

scholarly journals Occult Foreign Body Aspirations in Pediatric Patients: 20-years of Experience

2020 ◽  
Author(s):  
Bo Liu ◽  
Fengxia Ding ◽  
Yong An ◽  
Yonggang Li ◽  
Zhengxia Pan ◽  
...  
Keyword(s):  
Foreign Body ◽  
Medical Records ◽  
Foreign Bodies ◽  
Pediatric Patients ◽  
Previous History ◽  
Rigid Bronchoscopy ◽  
Diagnostic Difficulties ◽  
History Of ◽  
Male Patients ◽  
Symptoms And Signs

Abstract Background: The purpose of our study was to assess the frequency of occult foreign body aspiration (FBA) and to evaluate the diagnostic difficulties and therapeutic methods for these patients. Methods: Between May 2000 and May 2020, 3557 patients with the diagnosis of FBA were treated in our department. Thirty-five patients with occult FBA were included in this study. A retrospective analysis of medical records was performed. Results: Twenty-three male patients (65.7%) and 12 female patients (34.3%) were hospitalized due to occult FBA. The average age was 3.60 years (range 9 months-12 years). Most of the patients were younger than 3 years old (n=25, 71.4%). Coughing (n=35, 100%) and wheezing (n=18, 51.4%) were the main symptoms and signs. All the patients were found to have a FBA under the fiberoptic bronchoscope. The most common organic foreign bodies were peanuts (n=10) and the most common inorganic foreign bodies were pen caps (n=5). The extraction of foreign bodies under rigid bronchoscopy was applied successfully in 34 patients. Only one patient needed a surgical intervention. Conclusions: Occult FBA should always be considered in the differential diagnosis of chronic or recurrent respiratory diseases that are poorly explained, even in the absence of a previous history of aspiration.

Psychological, Social and Technical Factors Influencing Electronic Medical Records Systems Adoption by U.S. Physicians: A Systematic Model

2020 ◽  
Author(s):  
Raghid El-Yafouri ◽  
Leslie Klieb ◽  
Valérie Sabatier
Keyword(s):  
United States ◽  
Health Care ◽  
Medical Care ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Service Providers ◽  
Financial Burden ◽  
The United States ◽  
Care Providers ◽  
Intention To Adopt

Abstract Background: Wide adoption of electronic medical records (EMR) systems in the United States can lead to better quality medical care at a lower cost. Despite the laws and financial subsidies by the U.S. government for service providers and suppliers, the adoption has been slow. Understanding the EMR adoption drivers for physicians and the role of policymaking can translate into increased adoption rate and enhanced information sharing between medical care providers. Methods: Physicians across the United States were surveyed to gather primary data on their psychological, social, and technical perceptions toward EMR systems. This quantitative study builds on the Theory of Planned Behavior, the Technology Acceptance Model, and the Diffusion of Innovation theory to propose, test, and validate an innovation adoption model for the health care industry. 382 responses were collected and data were analyzed via linear regression to uncover the effects of 12 variables on the intention to adopt EMR systems.Results: Regression model testing uncovers that government policymaking or mandates and other social factors have little or negligible effect on physicians’ intention to adopt an innovation. Rather, physicians are directly driven by their attitudes and ability to control, and indirectly motivated by their knowledge of the innovation, the financial ability to acquire the system, the holistic benefits to their industry, and the relative advancement of the system compared to others.Conclusions: A unidirectional mandate from the government is not sufficient for physicians to adopt an innovation. Government, health care associations, and EMR system vendors can benefit from our findings by working toward increasing the physicians’ knowledge of the proposed innovation, socializing how medical care providers and the overall industry can benefit from EMR system adoption, and solving for the financial burden of system implementation and sustainment.

Electronic Medical Records as an Improvement to Comply with Data Protection Rules

2012 ◽  
Vol 1 (3) ◽  
pp. 13-19
Author(s):  
Ángel Igualada Menor ◽  
Teresa Pereyra Caramé
Keyword(s):  
Medical Care ◽  
Electronic Medical Records ◽  
Data Protection ◽  
Medical Records ◽  
Personal Data ◽  
Medical Records Systems ◽  
The Right

The right implementation and design of Electronic Medical Records Systems present an opportunity of improvement, since they provide the owners of personal data, who are under treatment in medical care activities, with the exercise of control over them; avoidance of any change; loss or non-authorised access, as well as availability safeguarding, and use in activities that are not strictly within welfare.

Comparison of Administrative Data and Medical Records to Measure the Quality of Medical Care Provided to Vulnerable Older Patients

Medical Care ◽  
2006 ◽  
Vol 44 (2) ◽  
pp. 141-148 ◽  
Author(s):  
Catherine H. MacLean ◽  
Rachel Louie ◽  
Paul G. Shekelle ◽  
Carol P. Roth ◽  
Debra Saliba ◽  
...  
Keyword(s):  
Medical Care ◽  
Administrative Data ◽  
Medical Records ◽  
Older Patients ◽  
Quality Of Medical Care

scholarly journals Completeness of Prenatal Records in Community Hospital Charts

2018 ◽  
Author(s):  
Nedra W ◽  
Laura B. Strange ◽  
Sara M. Kennedy ◽  
Katrina D. Burson ◽  
Gina L. Kilpatrick
Keyword(s):  
Intensive Care ◽  
Medical Care ◽  
Medical Records ◽  
Laboratory Tests ◽  
Community Hospital ◽  
Medical Condition ◽  
Medical Conditions ◽  
Community Hospitals ◽  
Newborn Intensive Care ◽  
Common Laboratory

We describe the completeness of prenatal data in maternal delivery records and the prevalence of selected medical conditions and complications among patients delivering at community hospitals around Atlanta, Georgia. Medical charts for 199 maternal-infant dyads (99 infants in normal newborn nurseries and 104 infants in newborn intensive care nurseries) were identified by medical records staff at 9 hospitals and abstracted on site. Ninety-eight percent of hospital charts included prenatal records, but over 20 percent were missing results for common laboratory tests and prenatal procedures. Forty-nine percent of women had a pre-existing medical condition, 64 percent had a prenatal complication, and 63 percent had a labor or delivery complication. Missing prenatal information limits the usefulness of these records for research and may result in unnecessary tests or procedures or inappropriate medical care.

scholarly journals SYPHILIS IN EMERGENCY DEPARTMENT: CONDITION OF THE ISSUE AND UNRESOLVED PROBLEMS

2019 ◽  
Vol 25 (4) ◽  
pp. 39-47 ◽  
Author(s):  
I. A. Bagretsova ◽  
A. V. Sukharev ◽  
I. M. Barsukova
Keyword(s):  
Emergency Department ◽  
Medical Care ◽  
Medical Records ◽  
Treatment Process ◽  
Medical Personnel ◽  
Emergency Medical Care ◽  
Serological Reaction ◽  
Diagnostic Measures ◽  
Current State ◽  
Medical Process

Introduction. The development of the system of emergency medical care in emergency department inevitably brings up issues of its availability and quality. Moreover, if the leading pathological syndrome resulting in the hospitalization and threating to the patient’s life deserves priority attention, so the accompanying pathology often remains in the shadow. Thus, venereal diseases, in particular, syphilis is epidemiologically dangerous disease as for the patients having this illness and for the patients surrounding them and the medical personnel carrying out the medical process. The objective of the study was to assess the current state of the problem of medical care for patients with venereal pathology in an emergency department.Material and methods. The material for the study was the data of medical records of patients in multispecialised emergency department of St. Petersburg for 4 years: 1088 – with positive serological reaction and 4500 – without dermatovenereal pathology (DVP).Results. By the results of the research, the diagnosis of syphilis was based only on the enzyme immunoassay test for syphilis and the diagnosis of syphilis remained unspecified; the efforts to prevent the spread of syphilis in emergency department were insufficient, did not allow carrying out appropriate preventive, therapeutic and diagnostic measures.Conclusion. Development of new models and principles of the organization of the diagnostic and treatment process, including the introduction of methods of express diagnosis in emergency department is required. 

scholarly journals TINJAUAN PELAKSANAAN NILAI GUNA REKAM MEDIS BAGI PASIEN DI RUMAH SAKIT UMUM IMELDA PEKERJA INDONESIA (RSU IPI) MEDAN TAHUN 2018

2020 ◽  
Vol 5 (1) ◽  
pp. 80-84
Author(s):  
Johanna Christy ◽  
Afni Efani Putri S
Keyword(s):  
Health Care ◽  
Medical Care ◽  
General Hospital ◽  
Medical Record ◽  
Medical Records ◽  
Health Care Facilities ◽  
Use Value ◽  
Care Facilities ◽  
Conducting Research

ABSTRAK Rekam medis adalah berkas yang berisi catatan dan dokumen tentang identitas pasien, pemeriksaan, pengobatan, tindakan dan pelayanan lain kepada pasien pada sarana pelayanan kesehatan. Tujuan penelitian ini adalah untuk mengetahui bagaimana pelaksanan nilai guna rekam medis bagi pasien. Jenis penelitian ini adalah deskriptif bertujuan menggambarkan secara sistematis fakta dan karakteristik objek dan subjek secara tepat. Waktu penelitian ini dilakukan pada bulan Juli di Rumah Sakit Umum Pekerja Indonesia Medan (RSU IPI) Tahun 2018. Populasi dalam penelitian adalah 440 berkas rekam medis. Dalam melakukan penelitian, peneliti mengambil sampel sebanyak 81 berkas rekam medis. Berdasarkan hasil penelitian yang dilakukan di RSU IPI pelaksanaan nilai guna rekam medis sudah terlaksana dengan baik, dilihat dari tersedianya ringkasan masuk dan keluar, resume, lembar operasi, identifikasi bayi, lembar persetujuan tindakan, lembar kematian pada setiapberkas pasien pulang meninggal, asuhan keperawatan didalam berkas rekam medis. Tetapi dalam pengisian berkas rekam medis petugas rekam medis belum mengimplementasikan nilai guna rekam medis dengan baik. Kesimpulannya pelaksanaan nilai guna rekam medis sudah baik namun dalam pengisian berkas rekam medis lebih di perhatikan sesuai Permenkes 269 Tahun 2008 Tentang rekam Medis sehingga pelaksaaan nilai guna rekam medis dan pengisisan berkas rekam medis berjalan lebih baik.   Kata Kunci: Rekam Medis, Nilai Guna Rekam Medis, Berkas Rekam Medis                                             ABSTRACT   Medical record is a document that contains records and documents about patient identity, examination, treatment, care and other services for patients in health care facilities. The purpose of this study was to study how the implementation of the use of medical records for patients. This type of research is descriptive which addresses the systematic problem and the appropriate characteristics of objects and subjects. When this study was conducted in July at the Medan Indonesian Workers General Hospital (RSU IPI) in 2018. The population in this study was 440 medical record documents. In conducting research, researchers took 81 samples of medical records. Based on the results of research conducted at the IPI General Hospital, the implementation of the use value of medical records has been carried out well, seen from the availability of incoming and outgoing assessments, proceeding, surgery sheets, accessing infants, action approval sheets, consent sheets on each patient's return documents, medical care care. However, in applying medical records, medical record officers have not applied the use value of medical records properly. Conclusion the reclamation of the value of the medical record has been better in the reclamation of the medical record is better with the approval in accordance with Minister of Health Regulation 269 of 2008 About the Medical Record requires the implementation of the value of the medical record and the filling of the medical record better.

scholarly journals Critical Diagnoses in Ophthalmic Pathology: Suspected Important Unanticipated Diagnoses in Surgically Removed Eyes

2019 ◽  
Vol 6 (1) ◽  
pp. 44-49
Author(s):  
Curtis E. Margo
Keyword(s):  
Clinical Practice ◽  
Medical Care ◽  
Medical Records ◽  
Clinical Information ◽  
Critical Values ◽  
Care Providers ◽  
Request Form ◽  
Pathology Laboratory ◽  
Ophthalmic Pathology ◽  
Clinical Diagnoses

Aim: To describe the 5-year profile of anatomic critical diagnoses from an ophthalmic pathology laboratory and raise awareness of the challenges of establishing guidelines for these diagnoses. Methods: Medical records of patients who had consecutively submitted surgically removed globes or eviscerated eyes from 1 October 2009 to 31 October 2014 were examined for a critical diagnosis, as defined by a verbal communication for a serious, unanticipated diagnosis.Important discordant anatomic and clinical diagnoses were reviewed to determine whether the anatomic finding was truly unanticipated. Results: During the study period, 313 eyes were submitted to the laboratory as primary specimens. Twenty (6.4%) had critical (alert) diagnoses. Six of the 20 anatomic diagnoses (30%) were known or suspected prior to surgery but were not communicated on the pathology request form. Five diagnoses (25%) were not clinically suspect before surgery. In 9 cases (45%) medical-care providers were alerted to the critical findings but insufficient clinical information was provided about preoperative conditions. Conclusions: The proportion of critical diagnoses among surgically removed eyes is small, but not inconsequential. Some “critical alerts” would be unnecessary if relevant clinical information was provided when the tissue is submitted to the laboratory. Laboratory guidelines for critical values in surgical pathology should be flexible since they need to anticipate the vicissitudes of clinical practice. Surgeons need to appreciate that relevant clinical information must be provided to pathologists because it can play a role in formulating anatomic diagnoses.

Risk Factors for Unnecessary Antibiotic Therapy: A Major Role for Clinical Management

2018 ◽  
Vol 69 (3) ◽  
pp. 466-472 ◽  
Author(s):  
Pierre-Marie Roger ◽  
Eve Montera ◽  
Diane Lesselingue ◽  
Nathalie Troadec ◽  
Patrick Charlot ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antibiotic Therapy ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Modifiable Risk Factors ◽  
Comorbid Conditions ◽  
Prospective Multicenter Study ◽  
Diagnostic Difficulties ◽  
Microbial Samples ◽  
Diagnosis Of Infection

Abstract Background Assessment of antimicrobial use places an emphasis on therapeutic aspects of infected patients. Our aim was to determine the risk factors for unnecessary antibiotic therapy (UAT). Methods This was a prospective, multicenter study evaluating all curative antibiotic therapies prescribed over 2 consecutive days through the same electronic medical records. Each item that could participate in these prescriptions was collected from the computerized file (reason for hospitalization, comorbid conditions, suspected or definitive diagnosis of infection, microbial analyses). UAT was defined as the recognition of noninfectious sydromes (NIS), nonbacterial infections, use of redundant antimicrobials, and continuation of empirical broad-spectrum antimicrobials. Results Four hundred fifty-three antibiotic therapies were analyzed at 17 institutions. An infectious disease was the reason for hospitalization in 201 cases (44%). An unspecified diagnosis of infection was observed in 104 cases (23%). Microbial samples were taken in 296 cases (65%), allowing isolation of a pathogen in 156 cases (53%). Unspecified diagnosis was associated with the absence of a microbial sample compared to patients with a diagnosis: (56/104 [54%] vs 240/349 [69%]; P = .005). A total of 158 NIS were observed (35%). UAT was observed in 169 cases (37%), due to NIS in 106 cases. In multivariate analysis, the modifiable risk factors for UAT were unspecified diagnosis (adjusted odds ratio [AOR], 1.83; 95% confidence interval [CI], 1.04–3.20) and absence of a blood culture (AOR, 5.26; 95% CI, 2.56–10.00). Conclusions UAT is associated with an unspecified diagnosis and the absence of microbial testing. Antimicrobial stewardship programs should focus on diagnostic difficulties and microbial testing, the latter facilitating antibiotic reassessment and therapeutic interruption.

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