scholarly journals Tinjauan Literatur Malnutrisi Didapat di Rumah Sakit: Karakteristik Anak dan Alat Skrining yang Digunakan

Author(s):  
Yuni Maria Olviani Ndede ◽  
Dessie Wanda

This article aimed of child’s characteristic of hospital acquired malnutrition (HAMs) that need to used screening tool to early detect of that risk. This review articles sourced from online database with the keywords child, pediatric, malnutrition, malnourished, hospital or hospital acquire and screening tool were taken from 2014 to 2019.This review discussed 3 subtopics were: (1) Hospital acquired malnutrition, (2) The characteristics of child with hospital acquired malnutrition, and (3) Instrument of malnutrition assessment in hospitals. Based on 3 subtopics, several factors are found that can make increased of hospital acquired malnutrition in child and a few screening tools that used. Screening tools that are appropriate to the hospital environment and the characteristics of children to be able to assess the nutritional malnutrition properly. Keywords: hospital acquired malnutrition; hospitalization; child; screening tool ABSTRAK Artikel ini membahas tentang karakteristik anak terhadap malnutrisi didapat di rumah sakit (MddRS) yang perlu menggunakan alat skrining baku untuk deteksi awal risiko tersebut. Telaah artikel ini berdasarkan sumber dari online database dengan menggunakan kata kunci digunakan child, pediatric, malnutrition, malnourished, hospital or hospital acquire dan screening tool yang diterbitkan tahun 2014 hingga 2019. Dari hasil telaah artikel, didapatkan subtopik pembahasan diantaranya: 1) Malnutrisi didapat di rumah sakit, 2) Karakteristik malnutrisi didapat di rumah sakit, dan 3) Instrumen penilaian malnutrisi di rumah sakit. Simpulan: Berdasarkan tiga subtopik yang menjelaskan tentang malnutrisi didapat di rumah sakit, didapat beberapa faktor penyebab yang mendasari peningkatan kejadian MddRS dan beberapa alat skrining yang digunakan. Perlu alat yang sesuai dengan lingkungan rumah sakit dan karakteristik pasien untuk dapat menilai kejadian malnutrisi dengan baik dan tepat. Kata kunci: malnutrisi didapat di rumah sakit; hospitalisasi; anak; alat skrining

2021 ◽  
Vol 43 (s1) ◽  
Author(s):  
Yuni Maria Olviani Ndede ◽  
Dessie Wanda ◽  
Efa Apriyanti

Detecting the risks for hospital-acquired malnutrition in children can be performed by using nutritional screening tools. One of the screening tools that has been created is Alarm Malnutrition. This study aimed to test the sensitivity and specificity of Alarm Malnutrition in detecting the risks for hospitalacquired malnutrition in comparison to Screening Tool for the Risk on Nutritional status and Growth (STRONGkids). This study employed cross sectional design and involved 168 hospitalized children (1 month to 18 years) at pediatric ward. The data were analyzed using diagnostic approach which resulted in sensitivity and specificity values. The statistical tests showed that the sensitivity and specificity values of Alarm Malnutrition and STRONGKids were 32,2% and 81,6% respectively. These results indicated that this screening tool was not better than STRONGkids which has been previously used in Indonesia. Alarm Malnutrition needs to be developed and improved in order to achieve better performance in detecting the risks for hospital-acquired malnutrition.


CNS Spectrums ◽  
2021 ◽  
Vol 26 (2) ◽  
pp. 181-183
Author(s):  
Michael E. Thase ◽  
Stephen M. Stahl ◽  
Roger S. McIntyre ◽  
Tina Matthews-Hayes ◽  
Mehul Patel ◽  
...  

AbstractIntroductionAlthough mania is the hallmark symptom of bipolar I disorder (BD-I), most patients initially present for treatment with depressive symptoms. Misdiagnosis of BD-I as major depressive disorder (MDD) is common, potentially resulting in poor outcomes and inappropriate antidepressant monotherapy treatment. Screening patients with depressive symptoms is a practical strategy to help healthcare providers (HCPs) identify when additional assessment for BD-I is warranted. The new 6-item Rapid Mood Screener (RMS) is a pragmatic patient-reported BD-I screening tool that relies on easily understood terminology to screen for manic symptoms and other BD-I features in <2 minutes. The RMS was validated in an observational study in patients with clinically confirmed BD-I (n=67) or MDD (n=72). When 4 or more items were endorsed (“yes”), the sensitivity of the RMS for identifying patients with BP-I was 0.88 and specificity was 0.80; positive and negative predictive values were 0.80 and 0.88, respectively. To more thoroughly understand screening tool use among HCPs, a 10-minute survey was conducted.MethodsA nationwide sample of HCPs (N=200) was selected using multiple HCP panels; HCPs were asked to describe their opinions/current use of screening tools, assess the RMS, and evaluate the RMS versus the widely recognized Mood Disorder Questionnaire (MDQ). Results were reported by grouped specialties (primary care physicians, general nurse practitioners [NPs]/physician assistants [PAs], psychiatrists, and psychiatric NPs/PAs). Included HCPs were in practice <30 years, spent at least 75% of their time in clinical practice, saw at least 10 patients with depression per month, and diagnosed MDD or BD in at least 1 patient per month. Findings were reported using descriptive statistics; statistical significance was reported at the 95% confidence interval.ResultsAmong HCPs, 82% used a tool to screen for MDD, while 32% used a tool for BD. Screening tool attributes considered to be of the greatest value included sensitivity (68%), easy to answer questions (66%), specificity (65%), confidence in results (64%), and practicality (62%). Of HCPs familiar with screening tools, 70% thought the RMS was at least somewhat better than other screening tools. Most HCPs were aware of the MDQ (85%), but only 29% reported current use. Most HCPs (81%) preferred the RMS to the MDQ, and the RMS significantly outperformed the MDQ across valued attributes; 76% reported that they were likely to use the RMS to screen new patients with depressive symptoms. A total of 84% said the RMS would have a positive impact on their practice, with 46% saying they would screen more patients for bipolar disorder.DiscussionThe RMS was viewed positively by HCPs who participated in a brief survey. A large percentage of respondents preferred the RMS over the MDQ and indicated that they would use it in their practice. Collectively, responses indicated that the RMS is likely to have a positive impact on screening behavior.FundingAbbVie Inc.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nichtima Chayaopas ◽  
Pornthep Kasemsiri ◽  
Panida Thanawirattananit ◽  
Patorn Piromchai ◽  
Kwanchanok Yimtae

Abstract Background Globally increasing number of elders is concerned. Hearing loss process in older adults cannot be avoided. An effective screening tool for hearing loss is essential for proper diagnosis and rehabilitation, which can improve QOL in older adults. Methods This prospective-diagnostic test study evaluates the diagnostic value of Thai version of the Hearing Handicap Inventory for Elderly Screening (HHIE-ST) and the Thai Single Question (TSQ) surveys in screening hearing disability in 1109 Thai participants aged 60 years and older in communities in four provinces in Thailand. The HHIE-ST consisted of 10 selected questions from the validated HHIE-Thai version. A TSQ survey was developed to have the same meaning as an English Single Question survey. The participants answered both questionnaires, and a standard audiometry test assessed with air conduction from 250 to 8000 Hz was included as a gold standard. Results The prevalence of hearing disability was 38.34%. The HHIE-ST achieved a sensitivity of 88.96% (95% CI 85.77–91.64) and specificity of 52.19% (95% CI 48.24–56.13) for diagnosis hearing disability in Thai older adults, whereas the TSQ yielded a sensitivity of 88.73% and a specificity of 55.93%. A combined test including the HHIE-ST and TSQ achieved better performance with sensitivity of 85.29% and specificity of 60.13%. Conclusions Either the HHIE-ST or the TSQ is a sensitive and useful tool for screening hearing disability in Thai older adults. Using the HHIE-ST together with the TSQ resulted in a better screening tool for detecting moderate hearing loss older adults who will benefit and recommended for hearing rehabilitation. Trial registration The study is registered with the following number in the Thai Clinical Trials Registry: TCTR20151015003. Date of registration October 14, 2015.


Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 905
Author(s):  
Ahmed Elwali ◽  
Zahra Moussavi

Background: The apnea/hypopnea index (AHI) is the primary outcome of a polysomnography assessment (PSG) for determining obstructive sleep apnea (OSA) severity. However, other OSA severity parameters (i.e., total arousal index, mean oxygen saturation (SpO2%), etc.) are crucial for a full diagnosis of OSA and deciding on a treatment option. PSG assessments and home sleep tests measure these parameters, but there is no screening tool to estimate or predict the OSA severity parameters other than the AHI. In this study, we investigated whether a combination of breathing sounds recorded during wakefulness and anthropometric features could be predictive of PSG parameters. Methods: Anthropometric information and five tracheal breathing sound cycles were recorded during wakefulness from 145 individuals referred to an overnight PSG study. The dataset was divided into training, validation, and blind testing datasets. Spectral and bispectral features of the sounds were evaluated to run correlation and classification analyses with the PSG parameters collected from the PSG sleep reports. Results: Many sound and anthropometric features had significant correlations (up to 0.56) with PSG parameters. Using combinations of sound and anthropometric features in a bilinear model for each PSG parameter resulted in correlation coefficients up to 0.84. Using the evaluated models for classification with a two-class random-forest classifier resulted in a blind testing classification accuracy up to 88.8% for predicting the key PSG parameters such as arousal index. Conclusions: These results add new value to the current OSA screening tools and provide a new promising possibility for predicting PSG parameters using only a few seconds of breathing sounds recorded during wakefulness without conducting an overnight PSG study.


Rheumatology ◽  
2018 ◽  
Vol 58 (4) ◽  
pp. 692-707 ◽  
Author(s):  
Nicolas Iragorri ◽  
Glen Hazlewood ◽  
Braden Manns ◽  
Vishva Danthurebandara ◽  
Eldon Spackman

Abstract Objective To systematically review the accuracy and characteristics of different questionnaire-based PsA screening tools. Methods A systematic review of MEDLINE, Excerpta Medical Database, Cochrane Central Register of Controlled Trials and Web of Science was conducted to identify studies that evaluated the accuracy of self-administered PsA screening tools for patients with psoriasis. A bivariate meta-analysis was used to pool screening tool-specific accuracy estimates (sensitivity and specificity). Heterogeneity of the diagnostic odds ratio was evaluated through meta-regression. All full-text records were assessed for risk of bias with the QUADAS 2 tool. Results A total of 2280 references were identified and 130 records were assessed for full-text review, of which 42 were included for synthesis. Of these, 27 were included in quantitative syntheses. Of the records, 37% had an overall low risk of bias. Fourteen different screening tools and 104 separate accuracy estimates were identified. Pooled sensitivity and specificity estimates were calculated for the Psoriatic Arthritis Screening and Evaluation (cut-off = 44), Psoriatic Arthritis Screening and Evaluation (47), Toronto Psoriatic Arthritis Screening (8), Psoriasis Epidemiology Screening Tool (3) and Early Psoriatic Arthritis Screening Questionnaire (3). The Early Psoriatic Arthritis Screening Questionnaire reported the highest sensitivity and specificity (0.85 each). The I2 for the diagnostic odds ratios varied between 76 and 90.1%. Meta-regressions were conducted, in which the age, risk of bias for patient selection and the screening tool accounted for some of the observed heterogeneity. Conclusions Questionnaire-based tools have moderate accuracy to identify PsA among psoriasis patients. The Early Psoriatic Arthritis Screening Questionnaire appears to have slightly better accuracy compared with the Toronto Psoriatic Arthritis Screening, Psoriasis Epidemiology Screening Tool and Psoriatic Arthritis Screening and Evaluation. An economic evaluation could model the uncertainty and estimate the cost-effectiveness of PsA screening programs that use different tools.


Author(s):  
Anania Arjuna ◽  
Dinobandhu Nandi

ABSTRACTObjective: Nosocomial infections or Hospital acquired infection (HAI) are one of the major threats to hospitalized patients as well as for the hospitalassociated personnel. In last few years there is a gross change in causative agents, new organisms have come out with great threat to hospitals as theypossess antibiotic resistance property e.g. production of biofilm, production of enzymes such as β- lactamases. Among many organisms, Acinetobacterbaumannii has emerged as a potent nosocomial pathogen. Our objective of this study was to find the burden of Acinetobacter baumannii infectionswhich are associated as nosocomial infections and to determine the drug of choice for an effective treatment.Methods: Clinical specimens were collected from patients of different unit of the hospital by maintaining universal precautions and standardmicrobiological protocols. All the respective specimens were cultured in respective culture medium i.e. MacConkey agar, blood agar, chocolate agar,cysteine lactose electrolyte deficient (CLED) agar and, fluid thioglycolate (TG) medium at 37˚C for 24-48 hours. After incubation of 24-48 hours cultureplates were examined for bacterial growth and identification and antibiotic sensitivity test was made by Vitek2 compact.Result: The study was conducted at the department of microbiology from January 2016 to April 2016. A total of 2582 specimens were collected andprocessed for identification and sensitivity testing. Specimens of all age group (2 days- 93 years) and both sexes were processed for identificationof A. baumannii and antibiotic sensitivity testing. A total of 119 isolates (4.60%) of A. baumannii were obtained from 2582 clinical specimens. Themost common infection A. baumannii was found as lower respiratory tract infection (89.07%) followed by abscess (6.72%), septicaemia (2.52%),urinary tract infections (0.84%), and soft tissue infections (0.84%). The maximum sensitivity of A. baumannii isolates were seen to Colistin (CL) (119,100%), followed by Tigecycline (TGC) (63, 52.94%) and Minocycline (MIN) (27, 22.69%). The maximum resistant was observed for Imipenem (IMI),Aztreonam (AZT) and Ticarcillin- clavulanic acid (TIC) (119, 100%).Conclusion: The Gram- negative coccobacillus, Acinetobacter baumannii poses a formidable threat to patients. It has emerged as a superbug inhospital environment particularly in ICU units. The chances of A. baumannii infections increase in the presence of iatrogenic factors like inadequatelong- term antibiotic therapy and new interventions in a medical facility. To control the burden of Acinetobacter infections new therapies suchas combine therapy must be obtained and followed with proper dose as recommend by physicians; along with awareness of the importance ofthis infection should be implicated. Proper sanitation, good housekeeping, sterilization of equipment, hand hygiene, water purification, isolationprocedures and maintaining of the hospital environment, use of infection control practices are some of the measures to control the transmission ofAcinetobacter spp. among hospital personnel.Keywords: Acinetobacter baumannii, Biofilm, β-lactamases, Hospital acquired infection.


2010 ◽  
Vol 34 (6) ◽  
pp. 226-230 ◽  
Author(s):  
Nicholas Holdsworth ◽  
Hugh Griffiths ◽  
David Crawford

Aims and methodAlthough alcohol is reported as commonly associated with self-harm, there is nothing in the literature that bases the association on validated screening tools. We sought to discern the different types of alcohol use as discriminated by the Alcohol Use Disorders Identification Test (AUDIT). Completed AUDITs from a 2-year period were analysed, all relating to people who had presented to a district general hospital in Northumberland following self-harm.ResultsThe proportion of dependent, harmful and hazardous drinkers identified using AUDIT was many times higher than previously estimated in similar studies that had not used a validated alcohol screening tool.Clinical implicationsThe routine use of an alcohol screening tool should be part of any standard psychosocial assessment of self-harm, to guide appropriate interventions for problematic alcohol use that might otherwise be overlooked.


2019 ◽  
Vol 2 (1) ◽  
pp. 28-36
Author(s):  
Sonia Elena Popovici ◽  
Ovidiu Horea Bedreag ◽  
Dorel Sandesc

AbstractThe emergence of multi-drug resistantAcinetobacter sppinvolved in hospital-acquired infections, once considered an easily treatable pathogen, is troublesome and an immense burden for the modern medical systems worldwide. In the last 20 years the medical community recorded an increase in the incidence and severity of these infections as therapeutic means tend to be less and less effective on these strains. The ability of these bacteria to rapidly develop resistance to antimicrobial agents by continuously changing and adapting their mechanisms, their ability to survive for long periods of time in the hospital environment and the multitude of transmission possibilities raises serious issues regarding the management of these complex infections. The future lies in developing new and targeted methods for the early diagnosis ofA. baumannii, as well as in the judicious use of antimicrobial drugs. This review details the evolution of the pathogenicity of this microorganism, together with the changes that appeared in resistance mechanisms and the advancements in molecular testing for the early detection of infection.


2021 ◽  
Vol 8 ◽  
Author(s):  
Michiel Delesie ◽  
Lieselotte Knaepen ◽  
Johan Verbraecken ◽  
Karolien Weytjens ◽  
Paul Dendale ◽  
...  

Background: Obstructive sleep apnea (OSA) is a modifiable risk factor of atrial fibrillation (AF) but is underdiagnosed in these patients due to absence of good OSA screening pathways. Polysomnography (PSG) is the gold standard for diagnosing OSA but too resource-intensive as a screening tool. We explored whether cardiorespiratory polygraphy (PG) devices using an automated algorithm for Apnea-Hypopnea Index (AHI) determination can meet the requirements of a good screening tool in AF patients.Methods: This prospective study validated the performance of three PGs [ApneaLink Air (ALA), SOMNOtouch RESP (STR) and SpiderSAS (SpS)] in consecutive AF patients who were referred for PSG evaluation. Patients wore one of the three PGs simultaneously with PSG, and a different PG during each of three consecutive nights at home. Severity of OSA was classified according to the AHI during PSG (&lt;5 = no OSA, 5–14 = mild, 15–30 = moderate, &gt;30 = severe).Results: Of the 100 included AF patients, PSG diagnosed at least moderate in 69% and severe OSA in 33%. Successful PG execution at home was obtained in 79.1, 80.2 and 86.8% of patients with the ALA, STR and SpS, respectively. For the detection of clinically relevant OSA (AHI ≥ 15), an area under the curve of 0.802, 0.772 and 0.803 was calculated for the ALA, STR and SpS, respectively.Conclusions: This study indicates that home-worn PGs with an automated AHI algorithm can be used as OSA screening tools in AF patients. Based on an appropriate AHI cut-off value for each PG, the device can guide referral for definite PSG diagnosis.


2019 ◽  
Vol 45 (3) ◽  
pp. 640-660 ◽  
Author(s):  
Johanna T. Dwyer ◽  
Jaime J. Gahche ◽  
Mary Weiler ◽  
Mary Beth Arensberg

Abstract Protein-energy malnutrition (PEM)/undernutrition and frailty are prevalent, overlapping conditions impacting on functional and health outcomes of older adults, but are frequently unidentified and untreated in community settings in the United States. Using the World Health Organization criteria for effective screening programs, we reviewed validity, reliability, and feasibility of data-driven screening tools for identifying PEM and frailty risk among community-dwelling older adults. The SCREEN II is recommended for PEM screening and the FRAIL scale is recommended as the most promising frailty screening tool, based on test characteristics, cost, and ease of use, but more research on both tools is needed, particularly on predictive validity of favorable outcomes after nutritional/physical activity interventions. The Malnutrition Screening Tool (MST) has been recommended by one expert group as a screening tool for all adults, regardless of age/care setting. However, it has not been tested in US community settings, likely yields large numbers of false positives (particularly in community settings), and its predictive validity of favorable outcomes after nutritional interventions is unknown. Community subgroups at highest priority for screening are those at increased risk due to prior illness, certain demographics and/or domiciliary characteristics, and those with BMI < 20 kg/m2 or < 22 if > 70 years or recent unintentional weight loss > 10% (who are likely already malnourished). Community-based health professionals can better support healthy aging by increasing their awareness/use of PEM and frailty screening tools, prioritizing high-risk populations for systematic screening, following screening with more definitive diagnoses and appropriate interventions, and re-evaluating and revising screening protocols and measures as more data become available.


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