scholarly journals A Comparison of In-flight and Ground-Based Emergency Medical Events on the Clinical Demand for Outreach Medical Services at Taoyuan International Airport, Taiwan

2021 ◽  
Vol 9 ◽  
Author(s):  
Chin-Hsiang Lo ◽  
Yu-Feng Shiao ◽  
Shih-Tien Hsu
Keyword(s):  
Gastrointestinal Symptoms ◽  
Limited Information ◽  
International Airport ◽  
Medical Supplies ◽  
Emergency Medical ◽  
Outreach Services ◽  
Significant Difference ◽  
Chief Complaints ◽  
Hospital Deaths

Background: Limited information is available covering all medical events managed by the airport-based outreach medical service. This study explores the clinical demand for emergency medical outreach services at Taoyuan International Airport (TIA), Taiwan.Methods: Electronic medical records collected from TIA medical outreach services from 2017 to 2018, included passengers' profiles, flight information, events location, chief complaints, diagnosis (using ICD-9 -CM codes), and management outcomes. Medical events distribution was stratified by location and ages, and were compared statistically.Results: Among 1,501 eligible records, there were 81.8% ground-based emergency medical events (GBME), 16.9% in-flight medical events (IFME) managed after scheduled landing, and 1.3% IFME leading to unscheduled diversion or re-entry to TIA. The top three GBME diagnoses were associated with neurological (23.3%), gastrointestinal (21.2%), and trauma-related (19.3%) conditions. The top three IFME diagnosis that prompted unscheduled landings via flight diversion or re-entry were neurological (47.4%), psychological (15.8%), and cardiovascular (10.5%). The chief complaints that prompted unscheduled landings were mostly related to neurological (42.1%), cardiovascular (26.3%), and out-of-hospital cardiac arrest (OHCA) (10.5%) symptoms. A higher frequency of IFME events due to dermatologic causes in patients aged ≤ 18 years compared with adults and older adults (19 vs. 1.5% and 0, respectively); and a higher frequency of IFME due to cardiovascular causes in adults ≥ 65 years compared with patients aged ≤ 65 (15.1 vs. 9%). Among all IFME patients, six out-of-hospital deaths occurred among passengers from scheduled landings and two deaths occurred among 18 IFME passengers who were transferred to local hospitals from flight diversion or re-entry. A statistically significant difference in outcomes and short-term follow-up status was found between patients with IFME and those with GBME (p < 0.001).Conclusion: Ground-based emergency medical events exceeded in-flight medical events at TIA. The most frequent events were related to neurological, gastrointestinal symptoms, or trauma. Results of this study may provide useful information for training medical outreach staff and preparing medical supplies to meet the clinical demand for airport medical outreach services.

scholarly journals Comparison of the efficacy of artemether-lumefantrine vs. artesunate plus sulfadoxine-pyrimethamine in children with uncomplicated falciparum malaria

2010 ◽  
Vol 50 (2) ◽  
pp. 113 ◽  
Author(s):  
Rachmawati Rachmawati ◽  
Novie H Rampengan ◽  
Suryadi N N Tatura ◽  
Tonny H Rampengan
Keyword(s):  
Parasite Clearance ◽  
World Health ◽  
Drug Resistant ◽  
Limited Information ◽  
Clearance Time ◽  
Cure Rate ◽  
Fever Clearance Time ◽  
Significant Difference ◽  
Health Organization

Background World Health Organization (WHO) has recommendedthat countries with drug resistant malaria problem usecombination therapies, especially artemisinin-based combinationtherapy (ACT). However, there is limited information on theefficacy of ACT in North Sulawesi.Objective To compare the efficacy of artemether-lumefanttine andartesunate plus sulfadoxine-pyrimethamine (SP).Methods This was a randomized experimental study, conducted inProf. Dr. R. D. Kandou General Hospital, Manado from Januaryuntil July 2009. There were 42 patients aged less than 13 yearstreated with artemether-lumefanttine and artesunate plus SP. Bodytemperature, parasite and gametocyte count were recorded everyday until day 7 and follow-up reviews were done on day 14 and28.Results Fever clearance time showed a significant differencebetween artemether-lumefanttine group (median 27 hours) andartesunate plus SP group (median 18 hours), P<0.05). There wasno significant difference in parasite clearance time (P>0.05) andgame tocyte clearance time (P > 0. 05) . The 28 day cure rate were100% in the two groups. No side effect was found.Conclusion Both artemether-lumefanttine and artesunate plus SPcombination are effective and safe for the treatment of falciparummalaria in children.

Left Ventricular Mass Regression after Two Alternative Sutureless Aortic Bioprostheses

2015 ◽  
Vol 10 (2) ◽  
pp. 114-119
Author(s):  
Giovanni Concistrè ◽  
Francesca Chiaramonti ◽  
Giuseppe Santarpino ◽  
Steffen Pfeiffer ◽  
Federica Marchi ◽  
...  
Keyword(s):  
Patient Characteristics ◽  
Left Ventricular ◽  
Cardiac Morbidity ◽  
Lv Mass ◽  
Significant Difference ◽  
Significant Clinical Improvement ◽  
Hospital Deaths ◽  
Significant Regression ◽  
Sutureless Bioprostheses

Objective Left ventricular (LV) hypertrophy in aortic stenosis (AS) constitutes a risk factor for cardiac morbidity and mortality. The aim of this study was to investigate the degree of LV mass regression after aortic valve replacement (AVR) with two alternative sutureless self-expanding strategies: Perceval S (Sorin Group, Saluggia, Italy) (P) and 3f Enable (Medtronic, ATS Medical, Minneapolis, MN USA) (e) aortic bioprostheses. Methods Between March 2010 and December 2011, 129 patients with symptomatic AS underwent AVR with the Perceval S or 3f Enable bioprostheses in two cardiac surgery departments (Massa, Italy; Nuremberg, Germany). We analyzed 45 patients in group P and 19 in group E undergoing isolated AVR with a 6-month follow-up. The LV mass was calculated using the Devereux formula and was indexed to body surface area. Results Baseline patient characteristics showed no significant differences between the two groups. There were no in-hospital deaths. Two patients in group P died at follow-up versus zero in group E ( P = 0.49). Mean LV mass index decreased from 146.6 (78) g/m2 at baseline to 123.3 (63) g/m2 at follow-up ( P < 0.001) in group P and from 146.1 (47.6) g/m2 to 118.1 (39.8) g/m2 ( P = 0.003) in group E, with no significant difference between the two groups ( P = 0.315). This effect was accompanied by significant clinical improvement. Conclusions: In isolated AS, AVR with sutureless bioprostheses is associated with a significant regression in LV mass at 6-month follow-up. No significant differences were present between the two alternative sutureless strategies. However, regression needs an evaluation with long-term echocardiographic examinations.

scholarly journals Clinical features and outcome of fecal retention in infancy

2020 ◽  
Author(s):  
Lu Ren ◽  
Lan-Lan Geng ◽  
hong-li Wang ◽  
si-tang Gong ◽  
Jing Xie ◽  
...  
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Clinical Features ◽  
Clinical Symptoms ◽  
Gastrointestinal Symptoms ◽  
Treatment Rate ◽  
Record System ◽  
Significant Difference ◽  
Normal Defecation

Abstract 1) Background: To understand the clinical features and outcome of fecal retention in infancy(FRI), so as to guide the focus and intervention methods of such infants.2) Methods: The electronic medical record system(EMRS)was used to collect and screen out cases diagnosed as fecal retention from June 2018 to June 2019 in outpatient clinic of our hospital. The age, feeding method, frequency and traits of stool, and accompanying symptoms were recorded. The changes of clinical symptoms, medical examinations and drug treatment by the age of 1 year were investigated by means of electronic medical record review and telephone follow-up.3) Results: A total of 286 infants were enrolled, 7 were lost to follow-up, and 279 were effectively followed up. There were 157 males and 129 females, with an age of 3.6 ± 1.5 months. The average stool frequency was 5.9 ± 1.8 days. 63.3% of the infants were breast-fed, 16.8% were formula-fed, and the rest were mixed-fed,all without supplementary food. 9.1% of the infants showed corresponding gastrointestinal symptoms, such as bloating, increased crying, decreased milk intake, and laborious defecation. 87.1% of the infants received medical treatment, including glycerin enema, probiotics, and Chinese herbal preparations, with an effective treatment rate of 7.8%. 38.7% of infants have undergone medical examination, including abdominal ultrasound, X-ray film / barium enema, blood test, etc, the positive rate is 14.8%. The duration of fecal retention in 53% of infants was ≤ 2 months, 22.6% between 2–3 months, 24.4% ≥ 3 months, with an average of 2.6 ± 1.1 months. At the age of followed up to 1 year, 16.8% of infants developed functional constipation(FC). Compared with other infants with normal defecation, there was no significant difference in age, frequency of stool, the proportion of breast milk feeding and receiving treatment, and there was a significant difference in the duration of fecal retention. The duration of FC group was longer than normal defecation group by which was 3.49 ± 0.83 months.4) Conclusions: Infants with fecal retention are more likely to develop FC at age 1 than general population, and may be positively related to the duration of fecal retention.

scholarly journals Magnitude of Anemia and Associated Factors among HIV-Infected Children Receiving Antiretroviral Therapy in Pastoral Community, Ethiopia: A Retrospective Cross-Sectional Study

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Getahun Fentaw Mulaw ◽  
Fatima Ahmed Yesuf ◽  
Haftom Temesgen Abebe
Keyword(s):  
Antiretroviral Therapy ◽  
Statistical Significance ◽  
Clinical Stage ◽  
Hemoglobin Level ◽  
Limited Information ◽  
Cross Sectional ◽  
Factors Associated ◽  
Afar Region ◽  
Significant Difference

Background. The two major comrbidities (anemia and poor nutrition) are common manifestations of HIV-infected children, which threaten their lives. In Ethiopia, there is limited information on the magnitude and factors associated with anemia among HIV-infected children. Thus, this study was aimed to determine the magnitude and factors associated with anemia among HIV-infected children receiving antiretroviral therapy in the Afar region, Ethiopia. Methods. A cross-sectional retrospective record review was conducted on a sample size of 102 HIV-infected children aged 6 months to < 15 years in selected ART sites of the Afar region from May 1 to 25, 2018. Patient cards from 2009 to 2017 with the required information were considered. A paired sample t-test was used to assess whether there is a significant difference in the hemoglobin level before and after the HAART regimen. Multivariable logistic regression was used to determine predictors of anemia. Statistical significance was determined atp value < 0.05. Result. At baseline, 53.9% of study participants were anemic, from which 8.7%, 36.3%, and 9.8% were mild, moderate, and severe, respectively. There was a statistically significant improvement of hemoglobin level following the one-year course of ART treatment from 10.67 ± 1.82 to 11.5 ± 1.5 (p value ≤ 0.001): an improvement of 0.83 ± 1.74. Children who were moderately and severely stunted were more than five (AOR = 5.16, 95% CI (1.71, 15.56)) and more than twelve (AOR = 12.45, 95% CI (2.62, 59.21)) times more likely to be anemic than children who were not stunted, respectively. Children whose mothers had not attended ANC follow-up were more than three (AOR = 3.68, 95% CI (1.38, 9.81)) times more likely to be anemic than children whose mothers attended ANC. Children who were in clinical stages 3 and 4 were more than five (AOR = 5.07, 95% CI (1.79, 14.37)) times more likely to be anemic than children who were in clinical stage 1 and 2. Conclusion. The magnitude of anemia among HIV-infected children was found to be high, which is 53.9%. Nutritional status (stunting), WHO clinical stage, and history of ANC follow-up were the predictors significantly associated with childhood anemia. Thus, interventions for HIV-infected children should consider those factors.

scholarly journals Expanded Indication for Magnetic Sphincter Augmentation: Outcomes in Weakly Acidic Reflux Compared to Standard GERD Patients

2021 ◽  
Author(s):  
Milena Nikolic ◽  
Aleksa Matic ◽  
Joy Feka ◽  
Lisa Gensthaler ◽  
Ivan Kristo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Postoperative Morbidity ◽  
Gastrointestinal Symptoms ◽  
Postoperative Outcome ◽  
Magnetic Sphincter Augmentation ◽  
Comparable Group ◽  
Significant Difference ◽  
Related Quality

Abstract Background Magnetic sphincter augmentation (MSA) is a modern surgical anti-reflux technique with proven efficacy and low postoperative morbidity in patients with acidic reflux. The aim of this retrospective review study was to evaluate the symptomatic outcome of MSA in patients with weakly acidic reflux. Methods From a prospectively collected clinical database, comprising all 327 patients that underwent MSA at our institution, a total of 67 patients with preoperative weakly acidic reflux measured in the 24-h impedance-pH-metry were identified. Postoperative gastrointestinal symptoms, proton pump inhibitor intake (PPI), GERD Health-Related Quality-of-Life (GERD-HRQL), alimentary satisfaction (AS), and patients’ overall satisfaction were evaluated within highly standardized follow-up appointments. Furthermore, outcome of these patients was compared to the postoperative outcome of a comparable group of patients with a preoperative acidic reflux. Results At a median follow-up of 24 months, none of the patients with weakly acidic reflux presented with persistent dysphagia, or underwent endoscopic dilatation or reoperation. The postoperative GERD-HRQL score was significantly reduced (2 vs. 20; p = 0.001) and the median AS was 9/10. Preoperative daily heartburn, regurgitations, and respiratory complaints were improved in 95%, 95%, and 96% of patients, respectively. A total of 10% of the patients continued to use PPIs postoperatively. No significant difference was observed in terms of postoperative outcome or quality of life when comparing weakly acidic reflux patients with those diagnosed with preoperative acidic reflux. Conclusion Magnetic sphincter augmentation significantly improves GERD-related symptoms and quality of life in patients with weakly acidic reflux with very low postoperative morbidity.

scholarly journals The Protective Effect of Teprenone on Aspirin-Related Gastric Mucosal Injuries

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Jing Zhao ◽  
Yihong Fan ◽  
Wu Ye ◽  
Wen Feng ◽  
Yue Hu ◽  
...  
Keyword(s):  
Protective Effect ◽  
Incidence Rate ◽  
Low Dose ◽  
Gastrointestinal Symptoms ◽  
Dose Aspirin ◽  
Increased Risk ◽  
Low Dose Aspirin ◽  
Significant Difference ◽  
Aspirin Group

Objective. Aspirin usage is associated with increased risk of gastrointestinal bleeding. The present study explored the potential of teprenone, an antiulcerative, in preventing aspirin-related gastric mucosal injuries. Methods. 280 patients with coronary diseases, naïve to aspirin medication, were admitted between 2011 and 2013 at the First Affiliated Hospital of Zhejiang Chinese Medical University and randomized into two groups (n=140). The aspirin group received aspirin enteric-coated tablets 100 mg/day, while the aspirin+teprenone group received teprenone 50 mg 3 times/day along with aspirin. The patients were recorded for gastrointestinal symptoms and gastric mucosal injuries during a follow-up period of 12 months with 3-month intervals. Results. During the 3-month follow-up, no significant difference was observed in the incidence rate of gastrointestinal symptoms between the two groups (P=0.498). However, the incidence rate of gastrointestinal symptoms was significantly lower in the aspirin+teprenone group than in the aspirin group during the follow-ups at 6 months (P=0.036) and 12 months (P=0.036). The incidence rate of gastric mucosal injuries in the aspirin group was significantly increased at 12 months compared to that at 3 months (P=0.016). The incidence rates at 12 months and cumulative for the entire follow-up period in the aspirin+teprenone group were both significantly lower than those of the aspirin group (P=0.049 and P=0.001, respectively). Conclusion. Long-term use of low-dose aspirin causes varying degrees of gastric mucosal damages and gastrointestinal symptoms; the severity will increase within a certain range with the extension of medication duration. Teprenone mitigates the gastrointestinal symptoms caused by low-dose aspirin, lowering both the incidence and severity of gastric mucosal injuries and exerting a positive protective effect.

Preliminary Report on Comparative Study of Side Effects of Progestin-Only Contraceptive Methods between Thai Women Using DMPA and a Single-Rod Sub-Dermal Implant at Siriraj Hospital, Bangkok, Thailand

2020 ◽  
Vol 103 (7) ◽  
Keyword(s):  
Side Effects ◽  
Adverse Events ◽  
Comparative Study ◽  
Gastrointestinal Symptoms ◽  
Contraceptive Methods ◽  
Bleeding Events ◽  
Thai Women ◽  
Significant Difference ◽  
Siriraj Hospital

Objective: To compare the side effects or specific adverse events except bleeding pattern reported between women using depo-medroxy progesterone acetate (DMPA) and a single-rod sub-dermal etonogestrel implant (Implanon). Materials and Methods: This comparative study assessed women returning for follow-up visit at the Unit of Family planning, Siriraj Hospital between January and December 2019. Women aged 18 to 45 years old who used one of the progestin-only contraceptive methods, either DMPA or Implanon, as a birth control for six months were invited in the present study. Any adverse effects were recorded and analyzed. Results: Fifty-nine women were in the Implanon group and 52 women were in the DMPA group. More women in the DMPA group were older [34.5 (27.5 to 38) versus 25 (22 to 31) years] and less single (26.9% versus 61.0%), p=0.001. The reported side effects in both groups were similar in degree and extent with no statistical significant difference except the symptom of flushing where more women in the Implanon group observed this event, p=0.004. There was borderline significance that women using Implanon had higher incidence of headache, gastrointestinal symptoms, and depression. Conclusion: Both groups of women observed comparable adverse events except bleeding events. Flushing, headache, gastrointestinal symptoms, and depression were more reported by women using Implanon. Close method counseling during the course of use is essential to prolong continuing use to meet their contraceptive goal. Keywords: DMPA, Implanon, Side effects, Thai women

Relationship between Thyroglobulin and Tumor Detectabilily with Thallium-201 in Differentiated Thyroid Cancer

2000 ◽  
Vol 39 (01) ◽  
pp. 10-15 ◽  
Author(s):  
S. P. Müller ◽  
Ch. Reiners ◽  
A. Bockisch ◽  
Katja Brandt-Mainz
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Roc Analysis ◽  
Tsh Suppression ◽  
Significant Difference ◽  
Test Specificity ◽  
The Relationship ◽  
Tumor Scintigraphy ◽  
Tsh Stimulation

Summary Aim: Tumor scintigraphy with 201-TICI is an established diagnostic method in the follow-up of differentiated thyroid cancer. We investigated the relationship between thyroglobulin (Tg) level and tumor detectability. Subject and methods: We analyzed the scans of 122 patients (66 patients with proven tumor). The patient population was divided into groups with Tg above (N = 33) and below (N = 33) 5 ng/ml under TSH suppression or above (N = 33) and below (N = 33) 50 ng/ml under TSH stimulation. Tumor detectability was compared by ROC-analysis (True-Positive-Fraction test, specificity 90%). Results: There was no significant difference (sensitivity 75% versus 64%; p = 0.55) for patients above and below 5 ng/ml under TSH suppression and a just significant difference (sensitivity 80% versus 58%; p = 0.04) for patients above and below 50 ng/ml under TSH stimulation. In 18 patients from our sample with tumor, Tg under TSH suppression was negative, but 201-TICI-scan was able to detect tumor in 12 patients. Conclusion: Our results demonstrate only a moderate dependence of tumor detectability on Tg level, probably without significant clinical relevance. Even in patients with slight Tg elevation 201-TICI scintigraphy is justified.

Melatih Kepemimpinan Perangkat Desa Kebonharjo Kulonprogo: Membangun Sikap Anti Korupsi

2018 ◽  
Vol 1 ◽  
pp. 107
Author(s):  
Adi Heryadi ◽  
Evianawati Evianawati
Keyword(s):  
Transformational Leadership ◽  
Data Collection ◽  
Paired Samples ◽  
Significant Difference ◽  
Before And After ◽  
Post Test ◽  
Sample Test ◽  
Corruption Perception ◽  
Measuring Tool

This study aims to prove whether transformational leadership training is effective for building anti-corruption attitudes of villages in Kebonharjo village, subdistrict Samigaluh Kulonprogo. This research is an experimental research with one group pre and posttest design.Subject design is 17 people from village of 21 candidates registered. Measuring tool used in this research is the scale of anti-corruption perception made by the researcher referring to the 9 anti-corruption values with the value of reliability coefficient of 0.871. The module used as an intervention made by the researcher refers to the transformational leadership dimension (Bass, 1990). The data collected is analyzed by statistical analysis of different test Paired Sample Test. Initial data collection results obtained sign value of 0.770 which means> 0.05 or no significant difference between anti-corruption perception score between before and after training. After a period of less than 1 (one) month then conducted again the measurement of follow-up of the study subjects in the measurement again using the scale of anti-corruption perception. The results of the second data collection were analysed with Paired Samples Test and obtained the value of 0.623 sign meaning p> 0.05 or no significant difference between post test data with follow-up data so that the hypothesis of this study was rejected.

SUBLINGUAL VITAMIN D3 DRUG THERAPY IN VITAMIN D DEFICIENCY PATIENTS AT PRAVARA RURAL HOSPITAL

2019 ◽  
pp. 18-20
Author(s):  
Sanjeeva Kumar Goud T ◽  
Rahul Kunkulol
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Vitamin D3 ◽  
Serum Vitamin ◽  
Cross Sectional ◽  
Serum Vitamin D ◽  
Significant Difference ◽  
Before And After

The present study was aimed to study the effect of Sublingual Vitamin D3 on Serum Vitamin D level in Vitamin D deficiency patients. This was a cross-sectional and interventional study. All the Vitamin D deficiency patients of age 18-60years and either gender, willing to participate in the study were included. Patients who had greater than 20 ng/ml were excluded from the study. The total number of participants in our study was 200, out of these 111 males and 89 females, the mean age in our study was 51.07 ± 7.39Yrs. All volunteers were given sublingual vitamin D3 (60,000IU) in six doses every fifteen days of follow up for 3 months. The subject’s serum 25(OH)D levels were estimated before and after the treatment of sublingual vitamin D3. There was a statistically significant difference in serum vitamin D3 level before 16.61±6.71 ng/ml and after 35.80±7.80 ng/ml after treatment with Sublingual Vitamin D3. Six doses of 60,000IU of Vitamin D3 sublingual route having improved the role of serum 25(OH)D levels in the treatment of Vitamin D3 deficiency patients.Keywords: Vitamin D3; Sublingual route

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