scholarly journals Antibiotics Prescription Over Three Years in a French Benchmarking Network of 23 Level 3 Neonatal Wards

2021 ◽  
Vol 11 ◽  
Author(s):  
Séverine Martin-Mons ◽  
Simon Lorrain ◽  
Silvia Iacobelli ◽  
Béatrice Gouyon ◽  
Jean-Bernard Gouyon ◽  
...  
Keyword(s):  
Gestational Age ◽  
System Analysis ◽  
Neonatal Infection ◽  
Steering Committee ◽  
Large Network ◽  
Age Group ◽  
Antibiotic Exposure ◽  
Computerized Order Entry ◽  
Level 3 ◽  
Internal Benchmarking

Introduction: Prescribing antibiotics to newborns is challenging, as excess antibiotics are a risk factor for increased morbidity and mortality. The objective of this study was to describe the evolution of antibiotic exposure over three years in a large network of level 3 neonatal wards where each center is informed yearly of its own results and the results of other centers and has full autonomy to improve its performance.Patients and Methods: This is a prospective, observational study of antibiotics prescriptions over the 2017–2019 period in a network of 23 French level 3 neonatal wards. The network relied on an internal benchmarking program based on a computerized prescription ordering system. Among others, antibiotics exposure, treatment duration, and antibiotics spectrum index were analyzed.Results: The population consisted of 39,971 neonates (51.5% preterm), 44.3% of which were treated with antibiotics. Of the treated patients, 78.5% started their first antibiotic treatment in the first three days of life. Antibiotic exposure rate significantly declined from 2017 to 2019 (from 46.8% to 42.8%, p < 0.0001); this decline was significant in groups with gestational age >26 weeks, but not in the group with extremely low gestational age <27 weeks. Gentamicin, cefotaxime, amoxicillin (ampicillin), vancomycin, and amikacin were the antibiotics most prescribed. The lower the gestational age, the higher the exposure for cefotaxime, vancomycin, and amikacin. Compared to 2017, cefotaxime exposure in 2019 declined by 12.6%, but the change was only significant in the gestational age group of 32–36 weeks (17.4%) and at term (20.3%). The triple combination of antibiotics in the first three days decreased by 28.8% from 2017 to 2019, and this was significant in each gestational age group. During the study, the delayed ending of antibiotics in unconfirmed early-onset neonatal infection increased from 9.6% to 11.9%.Conclusion: This study showed that a strategy characterized by the collection of information via a computerized order-entry system, analysis of the results by a steering committee representative of all neonatal wards, and complete autonomy of neonatal wards in the choice of prescription modalities, is associated with a significant reduction in the use of antibiotics in newborns with gestational age greater than 26 weeks.

scholarly journals IMPLEMENTASI KAJIAN KELAYAKAN FINANSIAL UNTUK MENINGKATKAN TINGKAT KEMATANGAN MANAJEMEN INVESTASI TEKNOLOGI INFORMASI

2012 ◽  
Vol 6 (2) ◽  
pp. 126
Author(s):  
Benny Ranti ◽  
Johan Tambotoh
Keyword(s):  
It Governance ◽  
Steering Committee ◽  
Successful Implementation ◽  
Investment Management ◽  
Maturity Level ◽  
It Investment ◽  
Business Values ◽  
Level 3 ◽  
Level 1 ◽  
Owned Company

Salah satu pilar utama atau domain dari pengelolaan teknologi informasi (TI) adalah investasi TI. Oleh karena itu, strategi untuk mengelola investasi TI sangat penting untuk mendukung keberhasilan pelaksanaan pengelolaan TI (IT Governance). Perusahaan perlu mengetahui tingkat kematangan dari manajemen investasi TI yang dapat membantu mengelola investasi TI dengan benar. Penelitian ini melakukan pengukuran terhadap peningkatan level kematangan manajemen investasi TI pada perusahaan BUMN setelah mengaplikasikan studi kelayakan finansial berdasarkan Generic IS/IT Business Values oleh Ranti, pada setiap tahap investasi TI serta meningkatkan struktur organisasi TI dengan membentuk IT steering committee. Hasil dari penelitian ini menunjukkan bahwa level kematangan manajemen investasi TI meningkat dari level 1 menjadi level 3. One of the key pillars or domains of Information Technology (IT) Governance is IT investment. Therefore, the strategy to manage IT investment is essential to support the successful implementation of IT Governance. Companies need to know the maturity level of IT investment management that can help them managing the IT investment properly. This research measures the increase of IT investment management maturity level of a state-owned company in Indonesia (BUMN) after applying the Financial Feasibility Study based on Ranti's Generic IS/IT Business Values in each IT investment stage as well as improving IT organization structure by forming IT Steering Committee. The result of this study indicates that the level of IT investment management maturity has increased from level 1 to level 3.

scholarly journals The Dynamics of Cullin-1 Expression in Preeclamptic Placenta and its Association with Pregnancy Termination Time

2020 ◽  
Vol 8 (B) ◽  
pp. 210-215
Author(s):  
Makbruri Makbruri ◽  
Isabella Kurnia Liem ◽  
Ahmad Aulia Jusuf ◽  
Tantri Hellyanti
Keyword(s):  
Gestational Age ◽  
Pregnancy Termination ◽  
Age Groups ◽  
Trophoblast Invasion ◽  
Age Group ◽  
Placental Development ◽  
Very Preterm ◽  
Significant Difference ◽  
Cellular Factors ◽  
Termination Time

BACKGROUND: Preeclampsia is a systemic syndrome occurring in 3–5% of pregnancies, caused by disorders of cellular factors resulting in the disruption of trophoblast differentiation and invasion which is important for the placental development and maintaining pregnancy. Cullin-1 is a protein that plays a role in the process of maintaining pregnancy, development, and trophoblast invasion in the placenta. Until now, there have been no studies linking the expression of cullin-1 in preeclamptic patients with the timing of pregnancy termination. AIM: This study analyzed cullin-1 expression in preeclamptic patients and their relationship to the timing of pregnancy termination was carried out. METHODS: Placental samples were taken from preeclampsia patients consisting of three gestational age groups, then immunohistochemical staining was performed to see the dynamics of expression and distribution in each age group of pregnancy and to find out their relationship with the timing of pregnancy termination. RESULTS: Cullin-1 was expressed in syncytiotrophoblasts and cytotrophoblasts. The lowest cullin-1 level was obtained in the very preterm age group, and the highest was found in the moderate preterm gestational age group. There was a significant difference between cullin-1 optical density (OD) expression and termination time of pregnancy, and there was a significant difference (OD) in cullin-1 preeclamptic patients with very preterm gestational age with moderate preterm gestational age. CONCLUSION: Cullin-1 was expressed both in syncytiotrophoblasts and cytotrophoblasts and was associated with the timing of pregnancy termination.

CONSANGUINITY AND MATERNAL AGE;

2017 ◽  
Vol 24 (04) ◽  
pp. 511-515
Author(s):  
Nayyab Zehra ◽  
Ahmed Hassaan Malik ◽  
Zahabia Khalid ◽  
Misha Sabir ◽  
Simra Tanvir ◽  
...  
Keyword(s):  
Family History ◽  
Gestational Age ◽  
Maternal Age ◽  
Sampling Technique ◽  
Reproductive Age ◽  
Military Hospital ◽  
Age Group ◽  
Spontaneous Abortions ◽  
Cross Sectional ◽  
History Of

Objectives: To determine the frequency of risk factors i.e. consanguinity andmaternal age associated with spontaneous abortions in Pakistan and to propose ways toreduce them. Study design: Cross sectional descriptive study. Place of study: Gynecologydepartment of Military Hospital and Combined Military Hospital, Rawalpindi. Duration ofstudy: 6 months (September 2015 to February 2016). Sampling technique: Non probabilityconvenient sampling. Methodology: 150 married female patients in reproductive age group(15-49 years), who were confirmed cases of pregnancy and presented with abortions, wereinterviewed and responses were filled in a structured questionnaire after written consent.The collected data was then entered and analyzed by SPSS 20.0. Results: The major bulkof spontaneous abortions occurred in the maternal age group of 25-35 years (55.3%). A totalof 53.3% of abortions occurred in the gestational age of less than 12 weeks. Around 54.7% offemales had family history of spontaneous abortions and 65.3% had consanguineous marriage.Conclusion: Spontaneous abortions occur more frequently in the females of 25-35 yearsage group and among the fetuses with gestational age less than 12 weeks (1st trimester ofpregnancy). Family history of spontaneous abortions and consanguinity are associated withspontaneous abortions.

OUTCOME OF SECOND BABY OF TWIN IN A RURAL TEACHING HOSPITAL OF WEST BENGAL, INDIA

2021 ◽  
pp. 4-7
Author(s):  
Kajal Kumar Patra ◽  
Anirban Mandal ◽  
Thyadi Himabindu
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Perinatal Outcome ◽  
West Bengal ◽  
Mode Of Delivery ◽  
Reproductive Technologies ◽  
Time Interval ◽  
Age Group ◽  
Multiple Pregnancies ◽  
Second Twin

Background: Multiple pregnancies are a high-risk situation because of its inherent risks to mother and the fetus. Twin or multiple pregnancies are gaining importance worldwide because of the attributable rise in treatment of infertility including assisted reproductive technologies. Twin pregnancies are associated with increased fetal loss, prematurity, structural abnormalities, and fetal growth restriction. Complications associated with twin pregnancy. The conduct of a twin delivery remains one of the most challenging events in the current obstetric practice. This Methods: study was an Hospital-based cross-sectional descriptive study conducted in the Department of Obstetrics & Gynaecology of Bankura Sammilani Medical College and Hospital, Bankura, West Bengal from January 2020 to December 2020. 238 patients were included in the study after informed consent from the patient about being a part of this study. Template was generated in MS excel sheet and analysis was done on SPSS software. Results: Majority 154 (64.7%) of women belonged to age group 21-30 years. Gestational age of 159 (66.8%) mothers were < 37 weeks. Perinatal outcome of second twin was highest in the maternal age group 20 years. Perinatal outcome of second twin was highest in the birth weight of the 2nd twin < 2500 grams. Delivery time interval between the babies was maximum 175 (73.5%) is < 10 minutes. Gestational age, Conclusions: presentation, mode of delivery, and birth weight are the signicant determinants of perinatal outcome of the second twin. The second twin is at higher risk of perinatal morbidity and mortality than the rst twin. Frequent antenatal care should be advised to the mothers.

ICT Skills among Library Professionals

2015 ◽  
pp. 1-20 ◽  
Author(s):  
S. Thanuskodi
Keyword(s):  
System Analysis ◽  
Educational Institutions ◽  
Age Group ◽  
Higher Educational Institutions ◽  
Ict Skills ◽  
Analysis And Design ◽  
Technical Staff ◽  
The Third ◽  
Ict Tools ◽  
Teaching Learning

ICT has changed the traditional methods of library activities and services providing new dimensions for teaching, learning and research in higher educational institutions. With the help of ICT tools, it is possible to store, retrieve, disseminate and organize information by creating websites and databases. Information is now published both electronically and by print making it accessible to users according to their demands. The study shows that that out of the total 172 respondents, 53.48 per cent of them belong to the age group of 30-40 years and 20.93per cent of them come under the age group of below 30 years. In this study, 22.58 per cent of the respondents have above 4 hours of access to internet. Majority of the respondents (37.03%) in the age group 40-50 years have above 4 hours of access to internet. The study reveals that librarian take the first position in their overall expertise in system analysis and design, assistant librarian the second, deputy librarian the third, technical staff the fourth and ministerial staff the last.

Severity of Cerebral Palsy—The Impact of Associated Impairments

2020 ◽  
Vol 51 (02) ◽  
pp. 120-128 ◽  
Author(s):  
Veronka Horber ◽  
Asma Fares ◽  
Mary Jane Platt ◽  
Catherine Arnaud ◽  
Ingeborg Krägeloh-Mann ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Birth Weight ◽  
Gestational Age ◽  
Age Groups ◽  
Walking Ability ◽  
Age Group ◽  
Intellectual Impairment ◽  
Weight Group ◽  
Birth Weight Group ◽  
The Impact

Abstract Objective This article describes associated impairments in children with cerebral palsy (CP) and its subtypes. Method Children born between 1990 and 2006 recorded in the Surveillance of Cerebral Palsy in Europe common database were studied. An “impairment index” characterized severity of impairments and their combinations. Results Amongst the 11,015 children analyzed, 56% (n = 5,968) could walk unaided, 54% (4,972) had normal or near-normal intellect (intelligence quotient ≥ 70). Except for ataxic CP, associated impairments were less frequent when walking ability was preserved. The impairment index was low (walking unaided and normal or near-normal intellect) in 30% of cases; 54% (n = 1,637) in unilateral spastic, 24% (n = 79) in ataxic, 18% (n = 913) in bilateral spastic, and 7% (n = 50) in dyskinetic CP. Around 40% had a high impairment index (inability to walk and/or severe intellectual impairment ± additional impairments)—highest in dyskinetic (77%, n = 549) and bilateral spastic CP (54%, n = 2,680). The impairment index varied little in birth weight and gestational age groups. However, significantly fewer cases in the birth weight group ≤ 1,000 g or gestational age group ≤ 27 weeks had a low impairment index compared to the other birth weight and gestational age groups (23 and 24% vs. between 27 and 32%). Conclusion Thirty percent of the children with CP had a low impairment index (they were able to walk unaided and had a normal or near-normal intellect). Severity in CP was strongly associated to subtype, whereas the association was weak with birth weight or gestational age.

Circulating renin–angiotensin system and catecholamines in childhood: is there a role for birthweight?

2008 ◽  
Vol 114 (5) ◽  
pp. 375-380 ◽  
Author(s):  
Maria C. P. Franco ◽  
Dulce E. Casarini ◽  
Marcela S. Carneiro-Ramos ◽  
Ana L. Sawaya ◽  
Maria L. M. Barreto-Chaves ◽  
...  
Keyword(s):  
Angiotensin Ii ◽  
Gestational Age ◽  
Low Birthweight ◽  
Renin Angiotensin System ◽  
Age Group ◽  
Renin Angiotensin ◽  
Appropriate For Gestational Age ◽  
Study Population ◽  
Ace Activity ◽  
Underlying Mechanisms

There have been only a few reports on the sympathoadrenal and renin–angiotensin systems in children of small gestational age. The purpose of the present study was to investigate plasma levels of ACE (angiotensin-converting enzyme) activity, angiotensin and catecholamines in 8- to 13-year-old children and to determine whether there are correlations between the components of these systems with both birthweight and BP (blood pressure) levels. This clinical study included 66 children (35 boys and 31 girls) in two groups: those born at term with an appropriate birthweight [AGA (appropriate-for-gestational age) group, n=31] and those born at term but with a small birthweight for gestational age [SGA (small-for-gestational age) group, n=35]. Concentrations of angiotensin, catecholamines and ACE activity were determined in plasma. Circulating noradrenaline levels were significantly elevated in SGA girls compared with AGA girls (P=0.036). In addition, angiotensin II and ACE activity were higher in SGA boys (P=0.024 and P=0.050 respectively). There was a significant association of the circulating levels of both angiotensin II and ACE activity with BP levels in our study population. Although the underlying mechanisms that link restricted fetal growth with later cardiovascular events are not fully understood, the findings in the present study support the link between low birthweight and overactivity of both sympathoadrenal and renin–angiotensin systems into later childhood.

Time domain parameters of heart rate variability in children born as small-for-gestational age

2016 ◽  
Vol 27 (4) ◽  
pp. 663-670 ◽  
Author(s):  
Agata Zamecznik ◽  
Jerzy Stańczyk ◽  
Agnieszka Wosiak ◽  
Katarzyna Niewiadomska-Jarosik
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Nervous System ◽  
Gestational Age ◽  
Time Domain ◽  
Small For Gestational Age ◽  
Age Group ◽  
Lower Heart Rate ◽  
Appropriate For Gestational Age ◽  
The Time Domain

AbstractAccording to metabolic programming theory, small-for-gestational age patients are at high risk of cardiovascular diseases also because of the possible malfunction of the autonomic nervous system. Autonomic disorders can be assessed by heart rate variability. The aims of this study were to compare time domain parameters of heart rate variability in children born as small-for-gestational age and appropriate-for-gestational age and to assess the correlation of the postnatal and current somatic parameters with the time domain parameters. The small-for-gestational age group consisted of 68 children aged 5–10 years who were born with birth weight below the 10th percentile. The appropriate-for-gestational age group consisted of 30 healthy peers, matched in terms of gender and age. On the basis of Holter monitoring, slightly higher average heart rate was observed in the small-for-gestational age group than in the appropriate-for-gestational age group. It was found that all the time domain parameters (SDNN, SDNNi, SDANNi, rMSSD, pNN50) were lower in the small-for-gestational age group than in the appropriate-for-gestational age group. In the small-for-gestational age group, girls had lower heart rate and some of the heart rate variability parameters (SDNN, SDNNi, SDANNi) in comparison with boys.Children born as small-for-gestational age have impaired function of the autonomic nervous system. Moreover, in the small-for-gestational age group, autonomic balance moved towards the sympathetic component, which was evidenced by higher heart rate. Children with faster heart rate and lower heart rate variability parameters may be at risk of cardiovascular disease.

scholarly journals The Effects of Gestation Dating on the Calculation of Patient-Specific Risks in Down's Syndrome Screening: Multivariate Case

1997 ◽  
Vol 34 (1) ◽  
pp. 55-60 ◽  
Author(s):  
J C Bishop ◽  
F D J Dunstan ◽  
A B J Nix
Keyword(s):  
Gestational Age ◽  
False Positive Rate ◽  
Down's Syndrome ◽  
Mixture Distribution ◽  
Down’S Syndrome ◽  
Patient Specific ◽  
Age Group ◽  
Data Set ◽  
Single Marker ◽  
Positive Rate

When screening for Down's syndrome using biochemical markers, the measurements are adjusted for the gestational age of the fetus because the concentrations of the markers are known to change with gestational age. This adjustment is performed by referring each marker measurement to the population median for that marker for the appropriate estimated gestational age group. The measurement of gestational age is subject to error, whichever method is used, and so the population median used is usually the median of a mixture of distributions for different true gestational ages. Most screening programmes aim for a specific number of weeks and this produces a concentrated distribution of true gestational ages. This fact, combined with dating errors, leads to an asymmetric mixture for each gestational age group and hence to bias in the estimates of the medians. In a previous communication we have shown how the proportions in this mixture distribution can be estimated and how the true medians corresponding to a true gestational age can be estimated. The calculations presented were performed using a single marker, and the details of our method were restricted to this situation. This paper extends the method to the multimarker situation and, as expected, leads to a gain in the detection rate for a specified false positive rate. The true patient-specific risk estimates are again markedly different from the quoted nominal value obtained by ignoring the dating errors. The data set on which the method is illustrated uses two markers, although the technique generalises in an obvious way to more than two.

scholarly journals KARAKTERISTIK PERSALINAN PREMATUR DI RSUP PROF. DR. R. D. KANDOU MANADO

e-CliniC ◽  
2015 ◽  
Vol 3 (2) ◽  
Author(s):  
Siva Oroh ◽  
Eddy Suparman ◽  
Hermie M. M. Tendean
Keyword(s):  
High School ◽  
General Hospital ◽  
Gestational Age ◽  
Premature Birth ◽  
Preterm Labor ◽  
Neonatal Morbidity ◽  
Descriptive Study ◽  
High School Education ◽  
Age Group ◽  
History Of

Abstract: Preterm labor is labor that occurs at 20 - <37 weeks gestational age calculated from the first day of the last menstrual period. Preterm labor is one cause of neonatal morbidity and mortality, which is 60-80% worldwide. This was a retrospective and descriptive study using the medical record of the Department of Obstetrics & Gynecology/Prof. Dr. R.D. Kandou General Hospital Manado period of January 1st to December 31st 2013. There were 151 premature labors during that period. The most frequent characteristics were age group 21-34 years, high school education, and house wife. Based on the parity status, the highest number was P0. History of abortion was found only in a small part of samples. The highest number of diseases/complications was rupture of membrane. The most frequent type of labor was spontaneous labor with back of the head position.Keywords: premature birth, premature babyAbstrak: Persalinan prematur adalah persalinan yang berlangsung pada usia kehamilan 20 - <37 minggu dihitung dari hari pertama haid terakhir. Persalinan prematur merupakan salah satu penyebab utama morbiditas dan mortalitas neonatal, yaitu 60-80% di seluruh dunia. Penelitian ini bersifat deskriptif retrospektif dengan memanfaatkan data sekunder berupa catatan medik di Bagian Obstetri Ginekologi/BLU RSUP Prof. Dr. R. D. Kandou Manado periode 1 Januari-31 Desember 2013. Hasil penelitian mendapatkan 151 sampel kasus persalinan prematur. Karakteristik berdasarkan usia ibu terbanyak pada usia 21-34 tahun, pendidikan ibu terbanyak SMA, dan pekerjaan IRT. Berdasarkan paritas didapatkan jumlah tertinggi pada P0, riwayat abortus hanya sebagian kecil ibu, penyakit/penyulit tersering ialah ketuban pecah dini, dan jenis persalinan tersering ialah spontan letak belakang kepala.Kata kunci: persalinan prematur, bayi prematur

Sign in / Sign up

Export Citation Format

Share Document