Management and Surgical Outcome of Non Missile Penetrating Head Injuries at Assiut University Hospital: One Year Study

Abstract Background: The consequences of fall-related injuries are becoming more significant due to ageing societies worldwide. This study aims to provide information on medications prescribed to older adults within one year before they experienced fall-related injury in Ontario, Canada. Methods: A population-based descriptive study of older adults (66 years and older) who experienced fall-related injury was conducted using administrative secondary health care data of Ontario. The percentages of patients prescribed each Anatomical Therapeutic Chemical 4th level medication class and fall-risk increasing drugs one year before their fall-related injuries was summarized. Results: From 2010 to 2014, 288,251 older adults (63.2% females) were admitted to Emergency Department due to fall-related injury, 39.9% were fall-related fractures, 12.6% were head injuries. One year prior to their injury, 48.46% of older adults were prescribed with statins; 35.23% were prescribed with diuretics; 26.84% were prescribed with antidepressants; 25.90% were prescribed with opioids and 16.61% were prescribed with anxiolytics. A higher percentage of females were prescribed with diuretics, antidepressants, and anxiolytics than males. 85 years and older people had higher percentage of prescription of diuretics, antidepressants and antipsychotics than other age group. Discussion: In general, older adults diagnosed with fall-related injuries were prescribed with more opioids, benzodiazepines and antidepressants than other general older adults. There were distinct patterns of prescription medication within each sex and age group (66-74 group, 75-84 group and 85 years and older group). Further association between medications and fall-related injuries need to be established using well-defined cohort studies.

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A Minimally-Invasive, Simple, Rapid, and Effective Surgical Technique for the Treatment of Ingrown Toenails: A Reminder of the Original Winograd Procedure

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18010278 ◽

2021 ◽

Vol 18 (1) ◽

pp. 278

Author(s):

Jahyung Kim ◽

Sanghyeon Lee ◽

Jeong Seok Lee ◽

Sung Hun Won ◽

Dong Il Chun ◽

...

Keyword(s):

Patient Outcomes ◽

Simple Procedure ◽

Wedge Resection ◽

Operation Time ◽

University Hospital ◽

Wound Infections ◽

Germinal Matrix ◽

One Year ◽

Ingrown Toenails

(1) Background: Ingrown toenail is a common disorder of the toe that induces severe toe pain and limits daily activities. The Winograd method, the most widely used operative modality for ingrown toenails, has been modified over years to include wedge resection of the nail fold and complete ablation of the germinal matrix. We evaluated the outcomes of original Winograd procedure without wedge resection with electrocautery-aided matrixectomy. (2) Methods: We retrospectively analyzed the outcomes of patients who underwent surgery for ingrown toenails at a university hospital for two years from November 2015 to October 2017. Surgery was performed in 76 feet with a mean operation time of 9.34 min. (3) Results: The minimal interval from surgery to return to regular activities was 13.26 (range 7 to 22) days. Recurrence and postoperative wound infections were found in 3 (3.95%) and 2 (2.63%) patients, respectively. Evaluation of patient satisfaction at one-year follow-up showed that 40 (52.63%) patients were very satisfied, 33 (43.42%) were satisfied, 3 (3.95%) were dissatisfied, and none of them were very dissatisfied. The average follow-up duration was 14.66 (range 12 to 25) months. (4) Conclusions: Therefore, it is believed that this less-invasive and simple procedure could be easily performed by clinicians, with satisfactory patient outcomes.

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Use of an optical surface scanner in assessment of outcome following rhinoplasty surgery

The Journal of Laryngology & Otology ◽

10.1017/s0022215108002302 ◽

2008 ◽

Vol 122 (9) ◽

pp. 972-977 ◽

Cited By ~ 2

Author(s):

H Chau ◽

R Dasgupta ◽

V Sauret ◽

G Kenyon

Keyword(s):

Surgical Intervention ◽

University Hospital ◽

Facial Features ◽

Optical Surface ◽

Case Study Analysis ◽

The Future ◽

University College London ◽

One Year ◽

The Right

AbstractObjective:To demonstrate the use of an optical surface scanner, with associated software, in the assessment of rhinoplasty patients, and to discuss the possible clinical applications of this technology in the future.Design:Case study analysis of pre- and post-operative scans of a patient undergoing septorhinoplasty at Whipps Cross University Hospital, London, UK.Subject:A 21-year-old man undergoing septorhinoplasty underwent pre-operative optical surface scanning of his face. The scans were repeated at one week and one year post-operatively. Software developed at University College London was then used to analyse the scans.Results:The scans clearly showed that the man's dorsal hump had been well reduced and the nose straightened, with a resulting 1600 mm3 gain on the right side and a 1000 mm3 loss on the left side of the nose. Tip projection had also been achieved.Conclusion:This technique allowed objective quantification of facial features and analysis of change. It may well prove useful in the future in predicting change following surgical intervention.

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Humanization and Macroergonomics: An Analysis in the Billing Sector of a University Hospital in Paraná

Advances in Transdisciplinary Engineering - Transdisciplinary Engineering for Complex Socio-technical Systems – Real-life Applications ◽

10.3233/atde200078 ◽

2020 ◽

Author(s):

Larissa de Oliveira Matia Leite ◽

Alexandre Minoru Sasaki ◽

Rosimeire Sedrez Bitencourt ◽

Maria Lucia Miyake Okumura ◽

Osiris Canciglieri Junior

Keyword(s):

Health Workers ◽

Work Organization ◽

University Hospital ◽

Participatory Ergonomics ◽

Sociotechnical System ◽

Work System ◽

Organizational Constructs ◽

Sociotechnical Analysis ◽

Machine Systems ◽

One Year

The humanization of organizations is a trend in companies that have a vision of the future aligned with the needs of the market. In the health area, this humanization should not be limited to its users, but include the employees involved in the work system. The human aspect and its relations with the work system is a focus of studying ergonomics, which in its macroergomic approach aims at integrating organization-man-machine systems into a sociotechnical and participatory context. This study aims to apply the macroergonomic approach with health workers in order to propose and implement improvements; evidencing the importance of their involvement in better acceptance of the proposed improvements generating greater satisfaction. To this end, a study was conducted in the Billing sector of a Brazilian Hospital. Ergonomic demands were identified in a participatory way through the Macroergonomic Analysis of Work (MAW) method, proposed in [1]. The results were tabulated and divided into constructs: Environment, Biomechanical, Cognitive, Work Organization, Risk, Company and Discomfort/Pain. After one year, a new macroergonomic evaluation was carried out and the improvements implemented included the concept of the sociotechnical system, which were: i) acquisition of new computers; ii) implementation of a new computational system and; iii) implementation of changes in the form of sector management. The results showed an increase of up to 40% in satisfaction with the improvements implemented in the Biomechanical and Organizational constructs, indicating that the application of participatory ergonomics and macroergonomics was fundamental for the changes made to increase satisfaction in aspects of the work performed by them. Finally, this research highlights the importance of employee involvement in sociotechnical analysis for the humanization of organizations and it is suggested for future studies the proposition of improvements related to the Environment and Cognitive constructs and pain/discomforts.

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Implementation of an automated cluster alert system into the routine work of infection control and hospital epidemiology: experiences from a tertiary care university hospital

BMC Infectious Diseases ◽

10.1186/s12879-021-06771-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Seven Johannes Sam Aghdassi ◽

Britta Kohlmorgen ◽

Christin Schröder ◽

Luis Alberto Peña Diaz ◽

Norbert Thoma ◽

...

Keyword(s):

Tertiary Care ◽

Median Number ◽

Multidrug Resistant ◽

University Hospital ◽

Infection Prevention And Control ◽

Alert System ◽

Related Data ◽

Healthcare Settings ◽

Care Systems ◽

One Year

Abstract Background Early detection of clusters of pathogens is crucial for infection prevention and control (IPC) in hospitals. Conventional manual cluster detection is usually restricted to certain areas of the hospital and multidrug resistant organisms. Automation can increase the comprehensiveness of cluster surveillance without depleting human resources. We aimed to describe the application of an automated cluster alert system (CLAR) in the routine IPC work in a hospital. Additionally, we aimed to provide information on the clusters detected and their properties. Methods CLAR was continuously utilized during the year 2019 at Charité university hospital. CLAR analyzed microbiological and patient-related data to calculate a pathogen-baseline for every ward. Daily, this baseline was compared to data of the previous 14 days. If the baseline was exceeded, a cluster alert was generated and sent to the IPC team. From July 2019 onwards, alerts were systematically categorized as relevant or non-relevant at the discretion of the IPC physician in charge. Results In one year, CLAR detected 1,714 clusters. The median number of isolates per cluster was two. The most common cluster pathogens were Enterococcus faecium (n = 326, 19 %), Escherichia coli (n = 274, 16 %) and Enterococcus faecalis (n = 250, 15 %). The majority of clusters (n = 1,360, 79 %) comprised of susceptible organisms. For 906 alerts relevance assessment was performed, with 317 (35 %) alerts being classified as relevant. Conclusions CLAR demonstrated the capability of detecting small clusters and clusters of susceptible organisms. Future improvements must aim to reduce the number of non-relevant alerts without impeding detection of relevant clusters. Digital solutions to IPC represent a considerable potential for improved patient care. Systems such as CLAR could be adapted to other hospitals and healthcare settings, and thereby serve as a means to fulfill these potentials.

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Retenção da aprendizagem após treinamento em Suporte Básico de Vida com uso de simulação de baixa fidelidade em uma unidade hospitalar odontológica

Scientia Medica ◽

10.15448/1980-6108.2018.1.29410 ◽

2018 ◽

Vol 28 (1) ◽

pp. 29410

Author(s):

Marcelo Nunes de Lima ◽

Fernanda Drummond Ruas Gaspar ◽

Túlio Gomes da Silva Mauro ◽

Márcia Apoliano Mesquita Arruda ◽

Gardênia da Silva Abbad

Keyword(s):

Basic Life Support ◽

Life Support ◽

University Hospital ◽

Theoretical Knowledge ◽

Learning Retention ◽

Or Practice ◽

Post Test ◽

Quasi Experimental ◽

Research Interviews ◽

One Year

AIMS: To evaluate the learning retention of participants of a Basic Life Support course in a dental unit of a university hospital.METHODS: This study combined quantitative and qualitative methods in a quasi-experimental design, in which the same subjects were compared before and at two moments after an intervention, which consisted of a training course in Basic Life Support. The participants were employees of the Oral Health Unit of the University Hospital of Brasília. Three evaluations were performed: pre-test, post-test and late post-test, in order to assess participants' learning retention. In a second stage of the research, interviews were conducted with the participants approved in the retention learning test.RESULTS: At all, 66 professionals participated in the course and carried out the theoretical pre-test and the theoretical and practical post-test. One year and five months after the course, 10 participants were submitted to the late post-test, also theoretical and practical. Regarding the theoretical knowledge, the mean was 6.3±2.31 points in the pre-test, 8.3±1.25 points in the post-test and 5.1±1.44 points in the late post-test. Late post-test results revealed also that 70% of participants met the minimum theoretical knowledge requirement for approval (5 of 10 points) but only 20% passed the practical retention assessment. The two participants who passed the practical evaluation had repeated the training after the initial course.CONCLUSIONS: Basic Life Support training based on simulation resulted in practical and theoretical learning in cardiopulmonary resuscitation. However, the effect did not persist after one year and five months, except for participants who repeated the training during this period, indicating that the long term retention of this learning requires more opportunities for training or practice. Further studies are needed to investigate the ideal workload, the number of repetitions required during training and the appropriate frequency of training, as well as to obtain information about the influence of prior knowledge of the participants and the practice after training in retention of skills.

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

Revista da Escola de Enfermagem da USP ◽

10.1590/s0080-623420160000200017 ◽

2016 ◽

Vol 50 (2) ◽

pp. 302-308 ◽

Cited By ~ 6

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.

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The development of echoencephalography in Sweden

Ultrasound in Clinical Diagnosis ◽

10.1093/oso/9780199602070.003.0010 ◽

2011 ◽

Author(s):

Leif G. Salford

Keyword(s):

Head Injuries ◽

Nobel Laureate ◽

The United States ◽

University Hospital ◽

Neurosurgical Department ◽

Karolinska Institute ◽

Creative Mind ◽

Harvey Cushing ◽

Acute Patient ◽

Winter War

Although neurosurgery has a long history it was thanks to brave pioneering neurosurgeons such as Harvey Cushing in the United States — and in Sweden Herbert Olivecrona — that the speciality made huge progress during the first half of the 20th century. However, around 1950, the possibility to reveal pathological processes taking place inside the closed skull, was still very restricted. The only available rapid procedure was the neurological examination of the patient. X-ray of the skull is of restricted value, pneumo-encephalography was much too complicated and time-consuming for acute situations, and angiography was still in its infancy. Thus the neurosurgeon, receiving an acute patient with a suspected intracranial haematoma, had to make a qualified guess about where to start placing his trephine on the skull in order to save the life of the patient — often within minutes in the case of a bleeding between the skull bone and the dura. The mortality in those days was 40 % , often because the diagnosis was made too late. Thanks to an ingenious Swedish neurosurgeon, Lars Leksell, working at Lund University Hospital, a new approach to reveal the secrets inside the skull was introduced in clinical praxis — echoencephalography. Lars Leksell graduated from the Karolinska Institute (KI) and received his neurosurgical training in Herbert Olivecrona’s department from 1935. He volunteered as a neurosurgeon in the Finnish winter war in 1940 in Karelia. His team could operate on 24 head injuries per 24 hours and already by this point, Leksell showed his creative mind in constructing the double-action rongeur for more efficient removal of shell-splinters from the vicinity of the spinal cord. In 1941 he joined Professor Ragnar Granit (1967 Nobel laureate in Medicine) at the Institute of Neurophysiology where he presented his thesis on gamma nerve fibres in 1945. In 1946 he became the chief of the new neurosurgical unit in Lund and in 1958 he was appointed the first Professor of Neurosurgery at Lund University. In 1960 he succeeded Olivecrona as Professor and Chairman of the Neurosurgical Department at the Karolinska Institute/Hospital.

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