scholarly journals EFFECT OF TRAHEOSTOMY ON THE INPATIENT TREATMENT OF PATIENTS WITH CONTACT MEDIASTINITES

2019 ◽  
Vol 26 (1) ◽  
pp. 94-100
Author(s):  
Alexander L. Gromov ◽  
Mikhail A. Gubin ◽  
Sergei V. Ivanov ◽  
Denis S. Tishkov
Keyword(s):  
Conflict Of Interest ◽  
Inpatient Treatment ◽  
Surgical Intervention ◽  
Maxillofacial Surgery ◽  
Total Duration ◽  
Treatment Results ◽  
Microbiological Characteristics ◽  
Duration Of Hospitalization ◽  
Bed Days ◽  
The Impact

The aimwas to assess the impact of emergency and planned tracheostomy on the main indicators of inpatient treatment in patients with contact mediastinitis.Materials and methods.This work was performed on the basis of the Department of Maxillofacial Surgery of the Kursk Regional Clinical Hospital. In order to conduct a comparative assessment of the treatment results, the patients with contact mediastinitis (46 people, surveyed period 2008–2017) were divided into 2 subgroups: control (25 people, 7 women, 18 men), who were treated without a tracheostomy; and the main group (21 people: 9 women, 12 men), with tracheostomy performed. The etiological and microbiological characteristics of the disease, the total duration of inpatient treatment, the length of stay in the resuscitation and intensive care units (bed-days), the dependence of the disease outcome (death, recovery) on the form of surgical intervention (tracheostomy) were evaluated.Results.A statistically significant effect of tracheostomy on the total duration of hospitalization and mortality rate was established (p0.05). Consequently, at present this issue cannot be resolved unambiguously and requires further research and mathematical analysis.Conclusion.The implementation of tracheostomy significantly increases the duration of inpatient treatment of patients with contact odontogenic mediastinites (p0.05).Conflict of interest: the authors declare no conflict of interest.

scholarly journals Influence of the Covid-19 pandemic on hospital stay after knee and hip arthroplasty

2021 ◽  
Vol 27 (5) ◽  
pp. 570-577
Author(s):  
A.G. Aliev ◽  
◽  
A. Riakhi ◽  
A.P. Sereda ◽  
E.V. Veber ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Hip Arthroplasty ◽  
Total Duration ◽  
Length Of Hospital Stay ◽  
Significant Difference ◽  
Revision Tha ◽  
Duration Of Hospitalization ◽  
Bed Days ◽  
Knee And Hip Arthroplasty ◽  
The Impact

Abstract. Introduction The Covid-19 pandemic has led to quite significant changes in the length of hospital stay of orthopedic patients. Meanwhile, there has been a tendency for early discharge after arthroplasty for quite some time due to the increasing burden on health care systems that became possible due to the implementation of accelerated rehabilitation protocols. This study is dedicated to the effect of discharge terms on the incidence of postoperative complications. Material and methods A retrospective study of 1,837 patients who underwent primary/revision THA and TKA at our center in 2020 was carried out. The impact of the pandemic was assessed by comparing the duration of hospitalization, the incidence of complications and functional status in patients operated on before and after the introduction of epidemiological restrictions. Purpose of the study To assess the impact of the Covid-19 pandemic on the length of patients’ hospital stay after knee and hip arthroplasty. Results The total duration of hospitalization after primary THA was reduced by 35 % (from 11.8 ± 3.3 to 7.7 ± 2.6 bed-days), and by 38 % (from 19.9 ± 7.5 to 12.8 ± 6.3 bed-days) after revision THA. The overall readmission rate (for surgical and nonsurgical complications) after primary THA was 4.1 % before the pandemic and 4.3 % during the pandemic; for primary TKA it was 2.1 % and 5.1 %, respectively; for revision THA – 13.9 % and 4.5 %, revision TKA – 4.4 % and 9.8 %, respectively. Comparative assessment for each diagnosis separately did not show significant difference. Evaluation of the questionnaire survey using the Oxford hip/knee score also showed the absence of a statistically significant relationship between the time of discharge and the functional state of the operated joint. The interviewing of patients regarding the infection with coronavirus yielded positive answers in 22 % (n = 419). The onset of symptoms during hospitalization or within 14 days after discharge was noted by 4 % of respondents (n = 75). Conclusion The incidence of complications and unfavorable outcomes did not depend on the length of hospital stay after THA and TKA.

scholarly journals Multi-center randomized trial on the impact of “CONFIDENCE” communication program aimed at evaluating therapy adherence of patients with registered myocardial infarction who underwent successful revascularization by stenting or thrombolysis after discharg

2017 ◽  
Vol 21 (1) ◽  
pp. 31 ◽  
Author(s):  
A. R. Tarkova ◽  
V. D. Anisimova ◽  
I. O. Grazhdankin ◽  
V. I. Baystrukov ◽  
D. D. Zubarev ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Coronary Arteries ◽  
Conflict Of Interest ◽  
Total Duration ◽  
Therapy Adherence ◽  
Communication Program ◽  
Parallel Group ◽  
The Impact

<p><strong>Aim.</strong> The article looks at the effect of the program "Confidence" to increase the proportion of patients’ therapy in patients with coronary heart disease for two years after successful revascularization using thrombolytic or stenting of the coronary arteries on the myocardial infarction.<br /><strong>Methods.</strong> This is a prospective, randomized, controlled, parallel-group trial including 4.000 patients. They will be divided into two groups: patients receiving standard outpatient observation (n=2000) and those enrolled for the program "Confidence" (n=2000). The total duration is 24 months. The trial will take place in two stages. In the first stage (0-12 months) the impact of the program "Confidence" on therapy adherence and outcomes of cardiovascular diseases will be assessed. In the second stage (after the change of groups in 12 months, 12-24 months) the effect of changing the way to remind patients of therapy adherence will be evaluated.<br /><strong>Conclusion.</strong> The trial was designed in such a way as to show that the proposed program "Confidence" increases the proportion of patients who adhere to therapy in the cohort of those with coronary heart disease for two years after successful revascularization by using thrombolytic or stenting of the coronary arteries against the background of myocardial infarction.</p><p>Received 13 February 2017. Accepted 9 March 2017.</p><p><strong>Financing:</strong> KRKA company’s grant. Sponsorship had no effect on data acquisition, analysis and interpretation.</p><p><strong>Conflict of interest:</strong> Kretov E.I. served as executive editor of “Endovascular surgery” section. All other authors declare no conflict of interest.</p><p><strong>Author contributions</strong><br />Study conception and design: Kretov E.I., Grazhdankin I.O., Baystrukov V.I., Zubarev D.D. <br />Statistical data processing: Krestyaninov O.V., Kozyr K.V., Obedinskiy A.A., Prokhorikhin A.A.<br />Drafting the article: Tarkova A.R., Anisimova V.D.<br />Critical revision: Tarkova A.R., Anisimova V.D., Kretov E.I.</p>

scholarly journals Comprehensive treatment of tuberculous spondylitis with short course pre-operative anti-tuberculosis therapy

2021 ◽  
Vol 99 (3) ◽  
pp. 46-52
Author(s):  
G. G. Golkа ◽  
V. V. Vesnin ◽  
V. V. Burlаkа ◽  
O. G. Fаdeev ◽  
A. A. Oleynik
Keyword(s):  
Surgical Intervention ◽  
Radical Surgery ◽  
Patient Treatment ◽  
Comprehensive Treatment ◽  
Treatment Results ◽  
Tuberculous Spondylitis ◽  
Short Course ◽  
Bed Days ◽  
Tuberculosis Therapy ◽  
Titanium Cages

The objective: to increase the effectiveness of treatment of patients with tuberculous spondylitis by using short course pre-operative anti-tuberculosis therapy.Subjects and methods. Experimental and clinical studies have been performed. The experiment was carried out on 40 guinea pigs by making a model of tuberculous spondylitis in 30 of them. In the clinic, the effectiveness of short course pre-operative anti-tuberculosis therapy with second line drugs, radical decompression plastic interventions using a sliding titanium cage was studied in 30 patients with tuberculous spondylitis versus 30 patients in whom classical methods of preparation and surgical intervention were used.Results. The created model of experimental tuberculous spondylitis made it possible to study parameters of the clinical and morphological course of the disease. The results obtained substantiated the effectiveness of short course pre-operative anti-tuberculosis therapy without the risk of generalization of the disease after radical surgery.The method of surgical treatment of tuberculous spondylitis used in patients and utilizing telescopic titanium cages against the background of short course pre-operative anti-tuberculosis therapy, taking into account the drug resistance of Mycobacterium tuberculosis and therapy continuation after surgery, significantly improved the frequency of excellent treatment results (up to 54.0% versus 32%). At the same time, the period of preparation for radical surgery was significantly reduced, the frequency of complications went down to 13.3% versus 33.3%, the period of in-patient treatment decreased to 96 ± 12 bed-days versus 190 ± 21 (p < 0.01), and the chances of social rehabilitation of operated patients improved.

scholarly journals Microbiological Characteristics and Surgical Management of Animal-Bite-Related Oral & Maxillofacial Injuries: A Single Center’s Experience

Antibiotics ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 998
Author(s):  
Johannes Spille ◽  
Juliane Schulz ◽  
Dorothee Cäcilia Spille ◽  
Hendrik Naujokat ◽  
Henning Wieker ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Maxillofacial Surgery ◽  
Lower Eyelid ◽  
Wound Management ◽  
Oral And Maxillofacial Surgery ◽  
Microbiological Characteristics ◽  
Information Status ◽  
Antibiotic Management ◽  
Duration Of Hospitalization ◽  
Bite Wounds

The objective of the current study is to retrospectively evaluate animal-bite injuries and to gain insight into the epidemiology, accident consequences and treatment concept of these accidents in oral and maxillofacial surgery. Data of patients, who were admitted January 2015 and April 2021, were retrospectively evaluated regarding the patients’ characteristics (age, gender), facial distribution of substance defects/partial amputations, duration of hospitalization, operation treatments and antibiotic treatments. Data of 75 patients were included. Patients were bitten by dogs (n = 69.92%), cats (n = 4) and horses (n = 2). Lower eyelid/cheek complex was the most affected region (n = 37, 32.74%). Most of the patients between 0 and 3 years had to be operated on under general anesthesia (p = 0.011), while most of the adults could be operated on under local anesthesia (p = 0.007). In the age group 0–12 years, 30 patients (68%) were operated on under general anesthesia. Ampicillin/Sulbactam (48%) was the antibiotic most used. Antibiotics were adjusted after wound swabs in case of wound infections or critical wound conditions. This means that resistant antibiotics were stopped, and sensitive antibiotics were used. Structured surgical and antibiotic management of animal-bite wounds in the maxillofacial region is the most important factor for medical care to avoid long-term aesthetic consequences. Public health actions and policies under the leadership of an interdisciplinary committee could improve primary wound management, healing outcome and information status in the general population.

Motivating Compliance: Firm Response to Mandatory Disclosure Policies

2018 ◽  
Vol 32 (2) ◽  
pp. 103-119
Author(s):  
Colleen M. Boland ◽  
Chris E. Hogan ◽  
Marilyn F. Johnson
Keyword(s):  
Conflict Of Interest ◽  
Low Cost ◽  
Cost Effective ◽  
Data Availability ◽  
Policy Adoption ◽  
Future Research ◽  
Regulated Firms ◽  
Firm Response ◽  
Disclosure Rules ◽  
The Impact

SYNOPSIS Mandatory existence disclosure rules require an organization to disclose a policy's existence, but not its content. We examine policy adoption frequencies in the year immediately after the IRS required mandatory existence disclosure by nonprofits of various governance policies. We also examine adoption frequencies in the year of the subsequent change from mandatory existence disclosure to a disclose-and-explain regime that required supplemental disclosures about the content and implementation of conflict of interest policies. Our results suggest that in areas where there is unclear regulatory authority, mandatory existence disclosure is an effective and low cost regulatory device for encouraging the adoption of policies desired by regulators, provided those policies are cost-effective for regulated firms to implement. In addition, we find that disclose-and-explain regulatory regimes provide stronger incentives for policy adoption than do mandatory existence disclosure regimes and also discourage “check the box” behavior. Future research should examine the impact of mandatory existence disclosure rules in the year that the regulation is implemented. Data Availability: Data are available from sources cited in the text.

scholarly journals Antimicrobial Consumption among 66 Acute Care Hospitals in Catalonia: Impact of the COVID-19 Pandemic

Antibiotics ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 943
Author(s):  
Santiago Grau ◽  
Sergi Hernández ◽  
Daniel Echeverría-Esnal ◽  
Alexander Almendral ◽  
Ricard Ferrer ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Acute Care ◽  
Antimicrobial Consumption ◽  
Trend Pattern ◽  
Defined Daily Doses ◽  
Bed Days ◽  
Antifungal Consumption ◽  
Antibacterial And Antifungal ◽  
Antifungal Use ◽  
The Impact

Background: Antimicrobials have been widely used during the COVID-19 pandemic. This study aimed to analyze the impact of the COVID-19 pandemic on the antimicrobial consumption of 66 hospitals in Catalonia. Methods: Adult antibacterial and antimycotic consumption was calculated as defined daily doses (DDD)/100 bed-days and DDD/100 discharges. Firstly, overall and ICU consumption in 2019 and 2020 were compared. Secondly, observed ICU 2020 consumptions were compared with non-COVID-19 2020 estimated consumptions (based on the trend from 2008–2019). Results: Overall, antibacterial consumption increased by 2.31% and 4.15% DDD/100 bed-days and DDD/100 discharges, respectively. Azithromycin (105.4% and 109.08% DDD/100 bed-days and DDD/100 discharges, respectively) and ceftriaxone (25.72% and 27.97% DDD/100 bed-days and DDD/100 discharges, respectively) mainly accounted for this finding. Likewise, antifungal consumption increased by 10.25% DDD/100 bed-days and 12.22% DDD/100 discharges, mainly due to echinocandins or amphotericin B. ICU antibacterial and antimycotic consumption decreased by 1.28% and 4.35% DDD/100 bed-days, respectively. On the contrary, antibacterial and antifungal use, expressed in DDD/100 discharges, increased by 23.42% and 19.58%. Azithromycin (275.09%), ceftriaxone (55.11%), cefepime (106.35%), vancomycin (29.81%), linezolid (31.28%), amphotericin B (87.98%), and voriconazole (96.17%) use changed the most. Observed consumption of amphotericin B, azithromycin, caspofungin, ceftriaxone, vancomycin, and voriconazole were higher than estimated values. Conclusions: The consumption indicators for most antimicrobials deviated from the expected trend pattern. A worrisome increase in antibacterial and antifungal consumption was observed in ICUs in Catalonia.

scholarly journals Change in Functional Impairment, Disability, and Quality of Life Following Operative Treatment for Degenerative Cervical Myelopathy: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 7 (3_suppl) ◽  
pp. 53S-69S ◽  
Author(s):  
Michael G. Fehlings ◽  
Lindsay A. Tetreault ◽  
Shekar Kurpad ◽  
Darrel S. Brodke ◽  
Jefferson R. Wilson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Operative Treatment ◽  
Functional Impairment ◽  
Cervical Myelopathy ◽  
Surgical Intervention ◽  
Japanese Orthopaedic Association ◽  
Duration Of Symptoms ◽  
Degenerative Cervical Myelopathy ◽  
The Impact

Study Design: Systematic review. Objectives: The primary objective of this systematic review was to define the change in impairment, disability, and pain following surgical intervention in patients with degenerative cervical myelopathy (DCM). Secondary objectives included to assess the impact of preoperative disease severity and duration of symptoms on outcomes and to summarize complications associated with surgery. Methods: A systematic literature search was conducted to identify prospective studies evaluating the effectiveness and safety of operative treatment in patients with DCM. Outcomes of interest were functional status, disability, pain, and complications. The quality of each study was evaluated using the Newcastle-Ottawa Scale, and the strength of the overall body of evidence was rated using guidelines outlined by the Grading of Recommendation Assessment, Development and Evaluation (GRADE) Working Group. Results: Of the 385 retrieved citations, 32 met inclusion criteria and are summarized in this review. Based on our results, pooled standard mean differences showed a large effect for improvement in Japanese Orthopaedic Association or modified Japanese Orthopaedic Association score from baseline at short-, medium-, and long-term follow-up: 6 to 12 months (1.92; 95% confidence interval [CI] = 1.41 to 2.43), 13 to 36 months (1.40; 95% CI = 1.12 to 1.67), and ≥36 months (1.92; 95% CI = 1.14 to 2.69) (moderate evidence). Surgery also resulted in significant improvements in Nurick, Neck Disability Index, and Visual Analogue Scale scores (low to very low evidence). The cumulative incidence of complications was low (14.1%; 95% CI = 10.1% to 18.2%). Conclusion: Surgical intervention for DCM results in significant improvements in functional impairment, disability, and pain and is associated with an acceptably low rate of complications.

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