scholarly journals OPTIMIZATION OF DIAGNOSIS AND TREATMENT FOR PERIPROSTHETIC KNEE INFECTION

2017 ◽  
pp. 14-19
Author(s):  
S. P. Shpinyak ◽  
A. P. Barabash ◽  
Yu. A. Barabash
Keyword(s):  
Public Health ◽  
Periprosthetic Infection ◽  
Public Health System ◽  
Diagnosis And Treatment ◽  
Surgical Interventions ◽  
Knee Infection ◽  
Long Period ◽  
Periprosthetic Knee Infection

Purpose of study: to analyze the modern approaches to classification of large joints periprosthetic infection (PPI) and evaluate the results of revision surgical interventions in patients with deep PPI of the knee. Patients and methods. One hundred fifty three patients, 51 men and 102 women (mean age 57.3±12.4 years), with deep PPI were operated on. Treatment tactics was determined by the term after primary operation. In early PPI (n=31) sanitation interventions with implant preservation and in late PPI (n=122) – two step interventions with long period between the operations (over 4 weeks) were performed. Results. Follow up made up from 2 to 5 years. Sanitation interventions with implant preservation were successful in71% of patients. In group of patients with late PPI satisfactory results were achieved in 89.6% of cases. On the basis of the obtained data the variants of diagnosis and treatment tactics optimization as well as its adaptation to domestic public health system were proposed.

scholarly journals Optimization of Diagnosis and Treatment for Periprosthetic Knee Infection

2017 ◽  
Vol 24 (3) ◽  
pp. 14-19
Author(s):  
Sergey P. Shpinyak ◽  
A. P Barabash ◽  
Yu. A Barabash
Keyword(s):  
Public Health ◽  
Periprosthetic Infection ◽  
Public Health System ◽  
Diagnosis And Treatment ◽  
Surgical Interventions ◽  
Knee Infection ◽  
Long Period ◽  
Periprosthetic Knee Infection

Purpose of study: to analyze the modern approaches to classification of large joints periprosthetic infection (PPI) and evaluate the results of revision surgical interventions in patients with deep PPI of the knee. Patients and methods. One hundred fifty three patients, 51 men and 102 women (mean age 57.3±12.4 years), with deep PPI were operated on. Treatment tactics was determined by the term after primary operation. In early PPI (n=31) sanitation interventions with implant preservation and in late PPI (n=122) - two step interventions with long period between the operations (over 4 weeks) were performed. Results. Follow up made up from 2 to 5 years. Sanitation interventions with implant preservation were successful in71% of patients. In group of patients with late PPI satisfactory results were achieved in 89.6% of cases. On the basis of the obtained data the variants of diagnosis and treatment tactics optimization as well as its adaptation to domestic public health system were proposed.

scholarly journals Preoperative multidisciplinary program for bariatric surgery: a proposal for the Brazilian Public Health System

2017 ◽  
Vol 54 (1) ◽  
pp. 70-74 ◽  
Author(s):  
Elinton Adami CHAIM ◽  
José Carlos PAREJA ◽  
Martinho Antonio GESTIC ◽  
Murillo Pimentel UTRINI ◽  
Everton CAZZO
Keyword(s):  
Public Health ◽  
Bariatric Surgery ◽  
Health System ◽  
Public Health System ◽  
Wound Dehiscence ◽  
Pulmonary Complications ◽  
Multidisciplinary Program ◽  
The Impact ◽  
Access To Surgery

ABSTRACT BACKGROUND Bariatric surgery has become the gold standard treatment for morbid obesity, but access to surgery remains difficult and low compliance to postoperative follow-up is common. To improve outcomes, enable access and optimize follow-up, we developed a multidisciplinary preoperative approach for bariatric surgery. OBJECTIVE To determine the impact of this program in the outcomes of bariatric surgery in the Brazilian public health system. METHODS A prospective evaluation of the individuals who underwent a preoperative multidisciplinary program for bariatric surgery and comparison of their surgical outcomes with those observed in the prospectively collected historical database of the individuals who underwent surgery before the beginning of the program. RESULTS There were 176 individuals who underwent the multidisciplinary program and 226 who did not. Individuals who underwent the program had significantly lower occurrence of the following variables: hospital stay; wound dehiscence; wound infection; pulmonary complications; anastomotic leaks; pulmonary thromboembolism; sepsis; incisional hernias; eventrations; reoperations; and mortality. Both loss of follow-up and weight loss failure were also significantly lower in the program group. CONCLUSION The adoption of a comprehensive preoperative multidisciplinary approach led to significant improvements in the postoperative outcomes and also in the compliance to the postoperative follow-up. It represents a reproducible and potentially beneficial approach within the context of the Brazilian public health system.

Leg Varices Originating from the Pelvis: Diagnosis and Treatment

Vascular ◽  
2007 ◽  
Vol 15 (2) ◽  
pp. 70-78 ◽  
Author(s):  
Milka Greiner ◽  
Geoffrey L. Gilling-Smith
Keyword(s):  
Effective Treatment ◽  
Lower Limb ◽  
Varicose Veins ◽  
Diagnosis And Treatment ◽  
Repeat Surgery ◽  
Recurrent Reflux ◽  
Venous Circulation ◽  
Platinum Coils

This article reports the investigation and treatment of 24 women presenting with recurrent lower limb varicosities secondary to reflux within the pelvic venous circulation. Diagnosis based on selective retrograde pelvic phlebography enabled precise identification and classification of sites of incompetence. A total of 74 veins were treated by embolization with platinum coils and glue prior to repeat surgery to the lower limb veins. At 4-year follow-up, signs of stasis had disappeared in all patients. Repeat phlebography revealed no evidence of recurrent reflux at the sites of treatment. One patient developed recurrent varices due to incomplete embolization of incompetent pelvic veins. Endovascular occlusion of incompetent pelvic veins is an effective treatment for varicose veins secondary to pelvic venous incompetence.

A sustainable community based model of non-communicable disease risk factor surveillance: “SHRADDHA-JAGRITHI project” (Preprint)

2021 ◽  
Author(s):  
Jaideep Menon ◽  
Mathews Numpeli ◽  
Sajeev.P. Kunjan ◽  
Beena.V. Karimbuvayilil ◽  
Aswathy Sreedevi ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Public Health System ◽  
Health Workers ◽  
Communicable Disease ◽  
Community Based ◽  
Frontline Health Workers ◽  
The Individual ◽  
Non Communicable Disease

UNSTRUCTURED Abstract: India has a massive non-communicable disease (NCD) burden at an enormous cost to the individual, family, society and health system at large, in spite of which prevention and surveillance is relatively neglected. Risk factors for atherosclerotic cardiovascular disease if diagnosed early and treated adequately would help decrease the mortality and morbidity burden. India is in a stage of rapid epidemiological transition with the state of Kerala being at the forefront, pointing us towards likely disease burden and outcomes for the rest of the country, in the future. A previous study done by the same investigators, in a population of >100,000, revealed poor awareness and treatment of NCDs and also poor adherence to medicines in individuals with CVD. The investigators are looking at a sustainable, community based model of surveillance for NCDs with corporate support wherein frontline health workers check all individuals in the target group ( > age 30 years) with further follow up and treatment planned in a “spoke and hub” model using the public health system of primary health centres (PHCs) as spokes to the hubs of Taluk or District hospitals. All data entry done by frontline health workers would be on a Tab PC ensuring rapid acquisition and transfer of participant health details to PHCs for further follow up and treatment. The model will be evaluated based on the utilisation rate of various services offered at all tier levels. The proportions of the target population screened, eligible individuals who reached the spoke or hub centres for risk stratification and care and community level control for hypertension and diabetes in annual surveys will be used as indicator variables. The model ensures diagnosis and follow up treatment at no cost to the individual entirely through the tiered public health system of the state and country.

scholarly journals Undergraduate paramedic students’ experience of paramedic tutors teaching public health

2021 ◽  
Vol 18 ◽  
Author(s):  
Marguerite Claire Sendall ◽  
Athena Ng ◽  
Laura McCosker
Keyword(s):  
Public Health ◽  
Public Health System ◽  
Learning Experience ◽  
Teaching Style ◽  
The Public ◽  
The Subject ◽  
Second Year ◽  
The Relationship ◽  
Positive Effect

Introduction Previous studies have shown teaching public health in medical courses improves students’ analytical, problem-solving and communication skills. However, little research to date has shown if public health teaching is helpful to paramedic students. The aim of this study was to examine if having paramedic tutors teach public health had a positive effect on students’ learning and interest in public health. Methods 184 second-year paramedic students at an Australian university completed a printed survey and provided feedback about their learning experience. Students answered multiple choice and open-ended questions about whether their understanding of a public health subject was improved by having a paramedic tutor, and if having different tutors each week affected students’ learning. Results Most students reported their understanding of public health improved when the subject was taught by a paramedic tutor and when paramedic scenario examples were included in teaching. Nearly half felt having different tutors each week made learning difficult. The following themes emerged from student narratives: the relevance of public health to their career; an improved understanding of public health; a realisation about the importance of public health; difficulties presented by an inconsistent teaching style; and poor follow-up and conflicting advice. Conclusion Teaching public health from a paramedic perspective enabled students to understand the relevance of paramedic practice and the role paramedics play in the public health system. Having the same paramedic tutor teaching each week helped students understand the relationship between public health and paramedic practice.

scholarly journals The Age at Which a Woman Becomes a Mother and Her Satisfaction with the Process of Pregnancy, Childbirth and the Puerperium

Healthcare ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 82
Author(s):  
Leticia Molina-García ◽  
Manuel Hidalgo-Ruiz ◽  
Alberto Gálvez-Toro ◽  
Silvia Cristina Aguilar-Puerta ◽  
Miguel Delgado-Rodríguez ◽  
...  
Keyword(s):  
Public Health ◽  
Maternal Age ◽  
Public Health System ◽  
Maternal Satisfaction ◽  
Degree Of Satisfaction ◽  
The Mean ◽  
Mother’S Age ◽  
Mean Differences ◽  
Primiparous Women

This study assessed the effect of maternal age on satisfaction at each stage of pregnancy, childbirth and puerperium, and globally. An observational study was carried out in five hospitals of the Andalusian public health system with older primiparous women, from May 2016 to May 2018. Using a pre-piloted questionnaire, information was collected on pregnancy, childbirth, puerperium, newborn variables and degree of satisfaction with the care received. Crude and adjusted mean differences and the standard error of the mean were calculated. A total of 373 women participated. In total, 43.0% of the sample were very satisfied with the care received during pregnancy, and 74.2% with the care received during childbirth. During the puerperium, the highest percentage (60.4%) was found among the women who reported being quite satisfied, although the results were not significant in any of these stages (p > 0.05). No significant differences were established between women’s different age strata and maternal satisfaction. However, the average given by women regarding their satisfaction with the process, on a scale from 0 to 4, was: 3.5 ± 0.5 in general, 3.2 ± 0.8 regarding pregnancy, 3.7 ± 0.5 in childbirth and 3.1 ± 0.6 in the postpartum period. The woman’s satisfaction with the follow up and health care received during pregnancy, childbirth and puerperium is independent of the mother’s age.

scholarly journals Access to colposcopy in the State of São Paulo, Brazil: probabilistic linkage study of administrative data

2022 ◽  
Vol 38 (1) ◽  
Author(s):  
Lewis Fletcher Buss ◽  
Lise Cury ◽  
Caroline Madalena Ribeiro ◽  
Gulnar Azevedo e Silva ◽  
José Eluf Neto
Keyword(s):  
Public Health ◽  
Cervical Cancer ◽  
Health System ◽  
Public Health System ◽  
Sao Paulo ◽  
The State ◽  
São Paulo ◽  
The Public ◽  
Reference Cohort

Cervical cancer screening is a multistage process, therefore access to both the primary test and subsequent diagnostic procedures is essential. Considering women undergoing screening on the public health system in the State of São Paulo, Brazil, we aimed to estimate the proportion of women accessing colposcopy within six months of an abnormal smear result. We retrieved records from two administrative databases, the Information System on Uterine Cervical Cancer (SISCOLO) that contains smear results and the Outpatient Information System of the Brazilian Unified National Health System (SIA/SUS) that records colposcopies. A reference cohort consisted of women, aged 25 years or older, with an abnormal smear result between May 1, 2014, and June 30, 2014. We excluded prevalent cases. We linked the reference cohort and records in the SIA/SUS extending to December 31, 2014. After excluding prevalent cases, 1,761 women with abnormal cytology results were left. A total of 700 (39.8%) women were linked to a colposcopy record within the follow-up period; this dropped to 671 (38.1%) women when follow-up was censored at six months. We could notice a slightly higher attendance in women living in the metropolitan region of São Paulo compared with residents of the rest of the state. We found no association between colposcopy attendance and age or cytology class. These results emphasize that access to colposcopy in the public health system in São Paulo is limited. This compromises the quality of screening, and the issue needs to be prioritized in service planning.

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