scholarly journals Frequency of polypharmacy and drug interactions in inpatients in the emergency department, Southwest of Iran

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Mobina Tahmasebivand ◽  
Hassan Barzegari ◽  
Mandana Izadpanah
Keyword(s):  
Emergency Department ◽  
Standard Deviation ◽  
Drug Interactions ◽  
Medical Records ◽  
Study Data ◽  
Study Population ◽  
The Mean ◽  
Southwest Of Iran ◽  
Drug Therapy Problems ◽  
Length Of Hospitalization

This study aimed to evaluate the polypharmacy extent and the frequency and severity of drug interactions by evaluating inpatients in the emergency department. In this epidemiologicaldescriptive study, data were collected retrospectively by reviewing medical records of 92 hospitalized patients in the emergency department with a stay over 48 hours. Out of the study population, 54.3% and 45.7% were respectively male and female, with a mean age of 59.09. In terms of hospitalization, 27.2% and 16.3% were hospitalized due to heart problems and trauma, respectively and the mean length of hospitalization was 3.91 with a standard deviation of 2.57 days. The mean drug received was 8.48, with a standard deviation of 4.48. Of the patients, 81.5% received more than 5 drugs; in addition, the observed amounts of drug interactions of A, B, C, D, and X were 2.5%, 17%, 59.3%, 19.5%, and 1.9%, respectively. The drug interaction prevalence in inpatients in the emergency department was high. The presence of a pharmacist is necessary to identify drug interactions and reduce drug-therapy problems to provide quality services.

scholarly journals Results of Classification of Korean Triage And Acute Scale of Patients Visiting The Emergency Department

2021 ◽  
Author(s):  
Kyeongmin Jang ◽  
Sung Hwan Kim
Keyword(s):  
Emergency Department ◽  
Medical Records ◽  
Research Study ◽  
Emergency Department Visits ◽  
Descriptive Research ◽  
High Severity ◽  
Emergency Department Stay ◽  
Scale Levels ◽  
The Mean

Abstract BackgroundNot much is known about the results of the severity classification according to the time of visit to the emergency department and the appropriateness of using a public ambulance when visiting the emergency department.MethodsThis descriptive research study retrospectively reviewed and analyzed the medical records of patients who visited the emergency department of the B general hospital in Seoul from January to December 2019.ResultsA total of 54,297 patients were included in the analysis. Of the total, 34,629 (63.8%) patients visited directly while 14,065 (25.9%) visited through public ambulances, and 10,328 (73.4%) of patients using public ambulances were discharged home. The numbers of daytime and nighttime patients were 24,891 (45.8%) and 29,406 (54.2%), respectively. The mean length of emergency department stay (LoS) of patients classified as emergency was 326 minutes, while that of non-emergency patients was 159 minutes. In addition, the mean LoS of patients classified as Korean triage and acuity scale levels 1 and 2 was 427 min and 430 min, respectively, which was longer than the total of 236 minutes.ConclusionWe confirmed that patients who visited the emergency department using public ambulances accounted for about 25% of all emergency department visits, and of which 70% were discharged home. In addition, patients with high severity showed a longer mean LoS, and daytime showed higher severity and more patients than nighttime.

scholarly journals Economic analysis of strategic control program (5, 8, 11) for gastrointestinal nematodes in grazing beef cattle during the growing phase in Central Brazil

2019 ◽  
Vol 40 (5Supl1) ◽  
pp. 2309 ◽  
Author(s):  
Mário Henrique Conde ◽  
Rafael Pereira Heckler ◽  
Dyego Gonçalves Lino Borges ◽  
Valter Joost Van Onselen ◽  
Ricardo Carneiro Brumatti ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Beef Cattle ◽  
Control Program ◽  
Gastrointestinal Nematodes ◽  
Study Data ◽  
Strategic Control ◽  
Stock Valuation ◽  
Central Brazil ◽  
Operational Result ◽  
The Mean

This study aimed to analyze economically different control protocols for beef cattle gastrointestinal nematodes in Brazil. Field study data previously published was used to compare three groups: 1) non-dosed; 2) current deworming program with two doses - May and November; and 3) alternative strategic control program with three doses - May, August, and November. An economic sensitivity analysis was performed based on beef carcass price (BCP) variation, thus creating three economic scenarios: 1) more probable (M) using the mean BCP in the studied region; 2) optimistic (O) using the mean BCP plus standard deviation; and 3) pessimistic (P) using the mean BCP minus standard deviation. Stock valuation (SV), operational result (OP), and treatment differential (TD) were calculated for each scenario. Average BCP was US$ 2.93 kg-1 carcass (± US$ 0.27 kg-1 carcass). The mean annual cost of deworming per animal was US$ 5.43 and US$ 7.97 for protocols with two and three doses, respectively. The cost of anthelmintic treatment represented 0.63% and 0.74% of operating results, both in M scenario. TD ranged from 9.5% to 27.6% for the assessed protocols. Regardless of the scenario, the protocol with three annual dosages presented the highest SV and OP, which economically justifies its implementation in strategic control of gastrointestinal nematodes in grazing beef cattle in Central Brazil. These results also demonstrate the relevance of strategic anthelmintic treatments in weaned stocker calves in tropical and humid subtropical areas.

scholarly journals An unresolved issue: The relationship between spot urine protein-to-creatinine ratio and 24-hour proteinuria

2019 ◽  
Vol 47 (3) ◽  
pp. 1179-1184 ◽  
Author(s):  
Davut Akin ◽  
Sehmus Ozmen
Keyword(s):  
Medical Records ◽  
Urine Protein ◽  
Entire Study ◽  
Spot Urine ◽  
Protein Excretion ◽  
Ratio Data ◽  
Study Population ◽  
The Mean ◽  
The Relationship ◽  
H Protein

Objective To investigate the relationship between spot urine protein-to-creatinine (sP/Cr) ratio and 24-h protein excretion in patients with different diagnoses. Methods This retrospective study analysed data from the medical records of patients admitted for24-h proteinuria determination who also had sP/Cr ratio data for the same day. Results A total of 1222 urine samples obtained from 694 adult outpatients were analysed. The mean ± SD age of the patients was 53.6 ± 15.9 years. The mean ± SD 24-h proteinuria and sP/Cr were 1.7 ± 2.4 g/day and 1.8 ± 2.4, respectively. The correlation between the sP/Cr and 24-h protein excretion was high (R2 = 0.89). The sP/Cr ratio accounted for 72% of the variability in 24-h proteinuria in the entire study population. Areas under the curve for 24-h proteinuria at 0.3 g/day, 1.0 g/day and 3.0 g/day were 0.940, 0.966, and 0.949, respectively. The mean + 2SD limits of agreement were between +2.99 and –2.73 g/day according to the Bland Altman analysis. Conclusion This current study found a clinically unacceptable deviation between 24-h proteinuria and sP/Cr ratio. Therefore, the sP/Cr ratio cannot replace 24-h proteinuria. A new method using spot urine protein and creatinine values that is able to minimize under or over estimation is still warranted.

scholarly journals STUDY OF POTENTIAL DRUG INTERACTIONS AMONG EIGHT MAJOR DEPARTMENTS-GENERAL MEDICINE, ORTHOPEDICS, GYNECOLOGY, PULMONOLOGY, GENERAL SURGERY, PSYCHIATRY, OTOLARYNGOLOGY AND DERMATOLOGY OF A TERTIARY CARE TEACHING HOSPITAL IN SOUTHERN INDIA

2020 ◽  
pp. 59-67
Author(s):  
TALHA JABEEN ◽  
MOHD ABDUL KHADER ◽  
A. V. KISHORE BABU ◽  
A. SRINIVASA RAO
Keyword(s):  
Drug Interactions ◽  
Teaching Hospital ◽  
General Surgery ◽  
Tertiary Care ◽  
General Medicine ◽  
Potential Drug ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
Study Population ◽  
The Mean

Objective: To identify frequency, type, severity and predictors of potential drug-drug interactions(pDDIs), potential drug-food interactions(pDFIs), potential drug-alcohol interactions(pDAIs) and potential drug-tobacco interactions(pDTIs) and most frequently interacting drug combination pairs in hospitalized patients from departments(depts) of General Medicine(GM), Orthopedic(Ortho), Gynecology(OBG), Pulmonology(Pulmo), General Surgery (GS), Psychiatry (Psych), Otolaryngology(ENT) and Dermatology (Derm) of study population. Methods: A Prospective Observational Study was conducted in eight major dept's of a tertiary care teaching hospital for a period of 6 mo. A sample size of 650 prescriptions reflecting admission no's for each department were used. Results: A total of 650 patients were included in the study. Among them, 282(43.4%) were males and 368(56.6%) were females. The mean age of the study population was 39.67±15.23. A total of 487 pDDIs, 734 pDFIs, 586 pDAIs and 159 pDTIs were found out of 650 hospitalized episodes. OBG showed the highest pDDIs and pDAIs. Highest pDFIs and pDTIs were seen in Pulmo. The majority of DDIs were minor, DFIs and DAIs were moderate and DTIs were of major in severity. Pharmacokinetic types of interactions were seen in the majority of the depts. Logistic regression analysis showed that Polypharmacy was associated with the occurrence of DIs. Most of the DIs repeated several times in particular depts and a list of these combinations was prepared. Conclusion: With the high occurrence of overall DIs and characteristic patterns of DIs combination pairs among different departments of the hospital, the presence of clinical pharmacists in hospitals can play a great role, especially in developing nations like India where their role in hospitalized settings is always controversial.

The prevalence of potentially beneficial and harmful drug-drug interactions in intensive care units

2019 ◽  
Vol 34 (1) ◽  
Author(s):  
Hossein Ali Mehralian ◽  
Jafar Moghaddasi ◽  
Hossein Rafiei
Keyword(s):  
Intensive Care ◽  
Drug Interaction ◽  
Drug Interactions ◽  
Intensive Care Units ◽  
Medical Records ◽  
Potential Ddis ◽  
Cross Sectional ◽  
Text Book ◽  
The Mean ◽  
Potential Interactions

Abstract Background The present study was conducted with the aim of investigating the prevalence of potentially beneficial and harmful drug-drug interactions (DDIs) in intensive care units (ICUs). Methods The present cross-sectional prospective study was conducted in two ICUs in Shahr-e Kord city, Iran. The study sample was consisted of 300 patients. The Drug Interaction Facts reference text book [Tatro DS. Drug interaction facts. St Louis, MO: Walters Kluwer Health, 2010.] was used to determine the type and the frequency of the DDIs. Results The participants consisted of 189 patients men and 111 women. The mean age of patients was 44.2 ± 24.6 years. Totally, 60.5% of patients had at least one drug-drug interaction in their profile. The total number of DDIs found was 663 (the mean of the total number of drug-drug interactions was 2.4 interactions per patient). Of all the 663 interactions, 574 were harmful and others were beneficial. In terms of starting time, 98 of the potential interactions were rapid and 565 of them were delayed. In terms of severity, 511 of the potential interactions were moderate. Some of the drugs in the patients’ medical records including phenytoin, dopamine, ranitidine, corticosteroid, dopamine, heparin, midazolam, aspirin, magnesium, calcium gluconate, and antibiotics, the type of ventilation, the type of nutrition and the duration of hospital stay were among the factors that were associated with high risk of potential DDIs (p < 0.05). Conclusions The prevalence of potentially beneficial and harmful DDIs, especially harmful drug-drug interactions, is high in ICUs and it is necessary to reduce these interactions by implementing appropriate programs and interventions.

scholarly journals La incorporación de tecnologías emergentes en la formación de alumnos del área económico-administrativo

2019 ◽  
pp. 6-15
Author(s):  
Anabelem Soberanes-Martín ◽  
José Luis Castillo-Mendoza ◽  
Esperanza Cotera-Regalado ◽  
Magally Martínez-Reyes
Keyword(s):  
Standard Deviation ◽  
Mobile Phones ◽  
Emerging Technologies ◽  
Bachelor's Degree ◽  
University Center ◽  
Bachelor's Degrees ◽  
Study Population ◽  
Administrative Area ◽  
The Mean ◽  
Convenience Sampling

The present work is focused on proposing the incorporation of Emerging Technologies (ET) in the Economic-Administrative area (EAA), specifically for students of the Bachelor's Degree in Accounting (LCN, Spanish acronym) and the Bachelor's Degree in Administrative Informatics (LIA, Spanish acronym), of the Chalco Valley University Center of the UAEMex, because they are focused on the development and creation of businesses, starting with the use of mobile phones, augmented reality and virtual supports. An instrument with a Likert scale elaborated, applied to a sample of 238 students of LIA and LCN, taking the total of students as population (408) and a convenience sampling was carried out. Also, there was an interview with 12 professors of both bachelor's degrees. The focus considered in the research was qualitative, transversal, and field. The questionnaire validated with Cronbach's alpha (0.81) and its score applying the mean and standard deviation, coding each of the items according to the characteristics of the study population. Among the results, teachers agreed to incorporate emerging technologies and to design how they will implement them in the classroom so that the proposed strategies contribute to the learning of students in the economic-administrative area.

scholarly journals Gambaran kadar hemoglobin pasien pra dan pasca operasi seksio sesarea yang tidak mendapat transfusi darah

e-CliniC ◽  
2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Herry Y. Tia ◽  
Lucky T. Kumaat ◽  
Diana Ch. Lalenoh
Keyword(s):  
Caesarean Section ◽  
Blood Transfusion ◽  
Medical Records ◽  
Mean Value ◽  
Age Group ◽  
Mean Values ◽  
Life Threatening ◽  
The Mean ◽  
Using Data ◽  
Length Of Hospitalization

Abstract: The occurence of increased or decreased levels of hemoglobin of post-caesarean patients depends on the intake of nutrients during pregnancy, bleeding, and anemia. In case of massive and life-threatening bleeding during the caesarean section, blood transfusion has to be administered to revive the patient in critical condition. This study was aimed to obtain the patients’ levels of hemoglobin in either pre- and post-operative caesarean section without blood transfusion. This was a retrospective descriptive study using data of medical records at the Installation of Medical Record Department of Prof. Dr. R. D. Kandou Hospital Manado from September 2015 to August 2016. There were 32 patients in this study. The result showed that the mean values of pre-operative Hb was 12.4 g/dL and of post-operative Hb was 11.5 g/dL with a difference of 0.9 g/dL. Decreased levels of hemoglobin occured in 28 patients. It is discerned that the mean value of pre-operative Hb was 12.4 g/dL while of post-operative Hb was 11.3 g/dL with a difference of 1.1 g/dL. Furthermore, increased levels of hemoglobin occured in 4 patients, showing that the mean value of pre-operative Hb was 12.1 g/dLwhereas of post-operative Hb was 12.5 g/dL with a difference of 0.4 g/dL. Based on the characteristics of pregnant women, 23 cases (71.9%), were in the age group of 20-35 years; 18 cases (56.3%) of hemorrhage of 500-1000 ml; and 25 cases (78.1%) of 6-10 days length of hospitalization. Conclusion: In this study, there was increased as well as decreased hemoglobin levels in caesarean patients who were not administered blood transfusion during surgery.Keywords: hemoglobin, caesarean section, blood transfusion Abstrak: Terjadinya peningkatan maupun penurunan kadar hemoglobin pada operasi seksio sesarea tergantung pada asupan zat-zat nutrisi saat kehamilan, perdarahan, dan anemia. Jika terjadi perdarahan hebat selama operasi seksio sesarea berlangsung yang mengakibatkan penurunan kadar hemoglobin mendekati batasan untuk dilakukan transfusi darah, maka transfusi darah diberikan untuk menolong pasien pada kondisi kritis. Penelitian ini bertujuan untuk mengetahui gambaran kadar hemoglobin pasien pra dan pasca operasi seksio sesarea yang tidak mendapat transfusi darah. Jenis penelitian ialah deskriptif retrospektif menggunakan data rekam medik pasien seksio sesarea di Instalasi Rekam Medik RSUP Prof. Dr. R. D. Kandou Manado periode September 2015 sampai Agustus 2016. Hasil penelitian memperlihatkan 32 pasien yang memenuhi kriteria inklusi. Nilai mean kadar Hb pra 12,4 g/dL dan kadar Hb pasca 11,5 g/dL dengan selisih 0,9 g/dL. Penurunan kadar hemoglobin terdapat pada 28 pasien dengan nilai mean kadar Hb pra 12,4 g/dL dan kadar Hb pasca 11,3 g/dL (selisih 1,1 g/dL). Peningkatan kadar hemoglobin terdapat pada 4 pasien dengan nilai mean kadar Hb pra 12,1 g/dL dan kadar Hb pasca 12,5 g/dL (selisih 0,4 g/dL). Karakteristik ibu hamil didapatkan terbanyak kelompok usia 20-35 tahun berjumlah 23 kasus (71,9%), perdarahan 500-1000 cc berjumlah 18 kasus (56,3%), dan lama rawat inap 6-10 hari berjumlah 25 kasus (78,1%). Simpulan: Pada pasien operasi seksio sesarea yang tidak mendapat transfusi darah dapat terjadi penurunan maupun peningkatan kadar hemoglobin. Kata kunci: hemoglobin, seksio sesarea, transfusi darah

scholarly journals Push scooter-related injuries in adults: an underestimated threat? Two decades analysed by an emergency department in the capital of Switzerland

2018 ◽  
Vol 4 (1) ◽  
pp. e000428
Author(s):  
Rhea Viola Mebert ◽  
Jolanta Klukowska-Roetzler ◽  
Stephan Ziegenhorn ◽  
Aristomenis Konstantinos Exadaktylos
Keyword(s):  
Emergency Department ◽  
Patient Population ◽  
Emergency Room Visit ◽  
Study Data ◽  
University Hospital ◽  
Reporting Systems ◽  
Life Threatening ◽  
The Mean ◽  
Current Impact ◽  
Interim Period

BackgroundThe number of people conducting cycling and skating sports in Switzerland is rising; likewise, we notice an increase in patients visiting our emergency department for adults due to push scooter accidents. In 2001, our emergency department published the first article worldwide on push scooter-related injuries. Nearly two decades later, we want to review the interim period—collect data, compare it with other studies and evaluate the current impact of push scooter accidents in our adult patient population.ObjectiveTo investigate data on the incidence, severity, treatment and approximate costs of push scooter-related injuries in adults who presented to our emergency department from 2000 to 2017.Materials and methodsFor this descriptive retrospective study, data were collected in the Department of Emergency Medicine at Inselspital (University Hospital), Berne, Switzerland, from October 2000 to September 2017. We used two clinical reporting systems during that period: Qualicare from 2000 to April 2012 and Ecare from May 2012 to 2017.Results165 patients were included, aged 16–80 years. The accidents were mainly classified as unspecified falls in 139 cases (84.24%). 21 patients (12.73%) were wearing a helmet at the time of the accident, while the remaining 144 (87.27%) were not. The most common injuries suffered were fractures in 73 patients (44.24%). 92 patients (55.76%) sustained an impact to the head. The most common treatment was surgery in the operating theatre (59 patients, 35.76%). The mean total cost per case was SFr7566.65 (emergency room visit, hospital stay and outpatient controls for the initial case).ConclusionThe incidence of push scooter-related injuries in adults in our patient population is small but rising. Nevertheless, the resulting injuries are potentially life-threatening and can lead to persistent medical impairment.

scholarly journals Outcomes of Wound Dehiscence after Penetrating Keratoplasty and Lamellar Keratoplasty

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Xin Wang ◽  
Ting Liu ◽  
Sai Zhang ◽  
Xiaolin Qi ◽  
Suxia Li ◽  
...  
Keyword(s):  
Medical Records ◽  
Penetrating Keratoplasty ◽  
Wound Dehiscence ◽  
Lamellar Keratoplasty ◽  
Wound Treatment ◽  
Light Perception ◽  
Occurrence Time ◽  
Study Population ◽  
The Mean ◽  
Mean Time

Objective. To investigate the incidence, causes, occurrence time, and range of wound and outcomes of wound dehiscence in patients treated by penetrating keratoplasty (PK) or lamellar keratoplasty (LK). Methods. We retrospectively reviewed medical records of keratoplasty in Shandong Eye Hospital from January 2006 to June 2017. Thirty-one eyes of 30 patients had sustained wound dehiscence (WD) after surgical treatment. The surgical type, causes, occurrence time, extent of the wound, treatment, and outcomes were recorded. Results. The study population consisted of 26 men and 4 women. The mean age at the occurrence of WD was 44.6 years old (range: 12–78 years), and the mean time from keratoplasty to WD was 45.9 months (range: 1–204 months). WD occurred in 23 eyes (23/1385, 1.66%) after PK and 8 eyes (8/1632, 0.49%) after LK (p<0.05). Twenty-seven eyes (27/31, 87.0%) had trauma-induced dehiscence. The mean range of dehiscence was 5.5 o’clock. The vision ranged from 20/50 to light perception after wound suture. The eyes receiving LK had fewer serious complications than PK. Conclusions. Compared with LK, PK seems to be more prone to result in wound dehiscence. The WD after LK may be less severe. The visual acuity after treatment of WD can be worse in the eyes with PK than LK.

Prediction of Spontaneous Puberty in Turner Syndrome Based on Mid-Childhood Gonadotropin Concentrations, Karyotype, and Ovary Visualization: A Longitudinal Study

2017 ◽  
Vol 89 (2) ◽  
pp. 90-97 ◽  
Author(s):  
Magdalena Hankus ◽  
Kamil Soltysik ◽  
Kamila Szeliga ◽  
Aleksandra Antosz ◽  
Agnieszka Drosdzol-Cop ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Standard Deviation ◽  
Luteinizing Hormone ◽  
Turner Syndrome ◽  
Follicle Stimulating Hormone ◽  
Tanner Stage ◽  
Biochemical Data ◽  
Study Population ◽  
The Mean

Aims: To investigate whether karyotype, mid-childhood (6–10 years) follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels, and ultrasound ovary visualization results can be used as indicators of spontaneous puberty in Turner syndrome (TS). Methods: The analysis was based on clinical and biochemical data from 110 TS girls aged >13 years at the end of the study (1,140 visits between 1996 and 2015). The study population was divided according to karyotype: 45,X and non-45,X. Results: The mean age ± standard deviation at diagnosis was 10.7 ± 4.0 years, and the follow-up duration was 5.9 ± 3.3 years. Spontaneous puberty was confirmed in 48% and menarche in 20% of the subjects, less frequently in 45,X girls. The mean age at Tanner stage B2 was 13.7 ± 2.4 years and that at menarche 14.2 ± 1.7 years, regardless of the karyotype. The median FSH level at 6–10 years was 8.16 IU/L, which was significantly lower than <6 years and >10 years. The median LH level at 6–10 years was 0.35 IU/L, which was lower than >10 years. The chance of spontaneous menarche was decreased in girls with FSH ≥6.7 IU/L between 6 and 10 years. Conclusions: Although spontaneous puberty and menarche occur more frequently in non-45,X girls, the karyotype cannot be used to predict them. However, the chance of spontaneous menarche can be predicted based on gonadotropin cut-off values. There was no correlation between ultrasound ovary visualization results and spontaneous puberty.

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