scholarly journals Factors influencing nonadministration of thrombolytic therapy in early arrival strokes in a university hospital in Hyderabad, India

2016 ◽  
Vol 19 (3) ◽  
pp. 351
Author(s):  
Subhash Kaul ◽  
Lalitha Pidaparthi ◽  
Anitha Kotha ◽  
VenkatReddy Aleti ◽  
AbhijeetKumar Kohat ◽  
...  
Keyword(s):  
Thrombolytic Therapy ◽  
University Hospital ◽  
Factors Influencing ◽  
Early Arrival

scholarly journals Can the timing of hospitalization influence the outcomes of childbirth?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Kundisova ◽  
N Nante ◽  
S Bardelli ◽  
C Lorenzini ◽  
L Alaimo
Keyword(s):  
Gestational Age ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Lower Probability ◽  
Cross Sectional ◽  
Medical Interventions ◽  
Physiological Processes ◽  
Early Arrival ◽  
High Possibility ◽  
Initiation Of Breastfeeding

Abstract Background The timing of hospitalization of pregnant females could influence the outcomes of both mother and the baby. The aim of this study was to analyze impact of coming to hospital too early on outcomes of childbirth. Methods A cross-sectional study was conducted in the birth center of Siena University hospital (Italy), all women that gave birth between 2017 and 2019 were included. Examined variables were: age, parity, gestational age: GA(weeks), Bishop score at admission: BS (0-13; >9 high possibility of spontaneous delivery), time to delivery:TTD (min), labor duration:LD (min), n°of interventions (induction, amniorhexis, augmentation):NI, type of birth (vaginal/caesarean section: CS/operational birth: OB), laceration, episiotomy, hematic loss: HL (ml), skin to skin:StS and initiation of breastfeeding: BR (yes/no). The females that came too early were identified if TTD >75° percentile. Analysis was performed with Stata 12. Results A total of 758 females were analyzed (32.0±5.2years), 55.5% multiparous, average GA was 39.6±1weeks, average BS was 7.2±2.5; 63% had BS <9. Average TTD was 376.7±318.5min; 23% came too early (TTD 865.6±244), more likely primiparous (OR 3.9) and those with higher GA (OR 1.2). A negative correlation between BS and TTD was observed (Rho=-0.6), females with BS <9 had higher probability to have prolonged TTD (OR10.8). Ninety-three% had vaginal birth, 6%CS, 1%OB Average LD was 169.1±145 min, average NI was 0.64±0.93, 78% had lacerations, 7.2% episiotomy. Average HL was 299.3±282.7ml. Females with prolonged TTD had higher NI (1.2 ±1 vs 0.4±0.6), higher probability of CS (OR 3), OB (OR4.5) and episiotomy (OR3.6), lower probability of StS and BR (OR 0.9), prolonged LD (299±184 vs. 120±102) and major HL (347.2±301.8 vs 284.9±275.4). Conclusions Our study showed an association between too early arrival to hospital and adverse maternal and fetal outcomes in terms of higher use of medical interventions that can interfere with physiological processes. Key messages The risk of arriving too early in hospital for labor was higher in primiparous and in those with higher gestational age. The too early arrival in hospital for labor was associated within increased use of medical interventions, interfering with physiological processes.

Factors influencing surgical management of acute appendicitis in a large university hospital without a dedicated emergency theatre

2019 ◽  
Vol 189 (2) ◽  
pp. 649-653 ◽  
Author(s):  
Megan Power Foley ◽  
Michael MacLean ◽  
Ciaran Doyle ◽  
Timothy Nugent ◽  
Michael E. Kelly ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Surgical Management ◽  
University Hospital ◽  
Factors Influencing

scholarly journals P1663CLINICAL AND PATHOLOGICAL FACTORS INFLUENCING RESIDUAL RENAL FUNCTION AFTER LIVING DONOR NEPHRECTOMY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Akihiro Okubo ◽  
Hideki Yokoi ◽  
Kaoru Sakai ◽  
Takeshi Matsubara ◽  
Motoko Yanagita
Keyword(s):  
Renal Function ◽  
Kidney Transplantation ◽  
University Hospital ◽  
Kidney Volume ◽  
Nephron Number ◽  
Kidney Donors ◽  
Protocol Biopsy ◽  
Living Kidney Donors ◽  
Post Transplant ◽  
Factors Influencing

Abstract Background and Aims Renal function decreases with aging. Aging is associated with significant changes in structure and function of the kidney. On the macrostructural level, kidney cortical volume decreases, therefore total kidney volume (TKV) also decreases with aging. On the microstructural level, the number of glomerulosclerosis increases, therefore nephron number decreases with aging. Some reports show that the decline of TKV and nephron number is accompanied by a reduction in renal function. However, in the field of living kidney transplantation, TKV and glomerulosclerosis are not fully evaluated as factors influencing the donor’s post-transplant renal function. Living kidney transplantation is an established renal replacement therapy for end-stage renal disease patients. To predict living kidney recipient’s renal function, one-hour protocol biopsy is conducted during the operation. From one-hour protocol biopsy, donor’s pathophysiological findings such as glomerulosclerosis can be evaluated. In this study, we evaluated the correlation of potential influencing factors including TKV and glomerulosclerosis with pre- and post-transplant renal function in living kidney donors. Method This is a retrospective study including all 37 living related kidney donors seen at Kyoto University Hospital from January 2013 to April 2019. Estimated glomerular filtration rate (eGFR) was calculated using equation for Japanese population from serum creatinine levels at pre- and post-transplant. TKV was calculated from the 3D volume-rendered images of enhanced CT (=π/6×length×width×thickness), and adjusted to standard body surface area (BSA) by individual BSA. The ratio of number of non-glomerulosclerosis per that of whole glomeruli (non-GS) was evaluated by protocol renal biopsy at one hour after renal reperfusion. This study protocol was approved by the Ethics Committee on human research of the Graduate School of Medicine, Kyoto University. Results We evaluated 37 living kidney donors (35.1% male, mean age 58.2 ± 12.0 years). Mean pre-transplant eGFR was 75.7 ± 12.1 ml/min/1.73m2, mean post-transplant eGFR; 44.9 ± 7.75 ml/min/1.73m2, adjusted TKV (aTKV); 349.3 ± 58.4 ml, and non-GS; 0.892 ± 0.086. Pre-transplant eGFR was associated with aTKV and aTKV×nonGS (r=0.525, 0.569 respectively, p<0.01). Post-transplant eGFR was associated with age (≧65 years old, p<0.01), aTKV, non-GS, and aTKV×non-GS (r=0.527, 0.344, 0.626 respectively, p<0.05). The rate of eGFR decline was associated with age (≧65 years old, p=0.044), but not with aTKV and non-GS, aTKV×non-GS. Conclusion These results suggest that non-GS and age are correlated with post-transplant renal function but not pre-transplant renal function in living kidney donor, and the decline rate of eGFR are correlated with age.

Factors influencing emotional labor of clinical nurses in a university hospital

2014 ◽  
Vol 12 (3) ◽  
pp. 200-201 ◽  
Author(s):  
E. Choi ◽  
S. Chong ◽  
M. H. Cho ◽  
H. J. Jeon ◽  
E. G. Oh
Keyword(s):  
Emotional Labor ◽  
University Hospital ◽  
Clinical Nurses ◽  
Factors Influencing

Changing Characteristics of Psychiatric Consultation in a University Hospital

1969 ◽  
Vol 14 (3) ◽  
pp. 259-266 ◽  
Author(s):  
Peter C. Whybrow ◽  
Roger F. Spencer
Keyword(s):  
Psychiatric Care ◽  
University Hospital ◽  
Medical Patients ◽  
Psychiatric Consultation ◽  
Psychiatric Disturbance ◽  
Factors Influencing ◽  
The Future ◽  
One Year ◽  
Accuracy Of Prediction

Fifty-seven patients were referred for psychiatric consultation during a two-month period. One year later adequate follow-up data were obtained on 46 persons. The study evaluated the outcome of the original psychiatric disturbance in these patients, the accuracy of prediction by the psychiatric consultants and the factors influencing outcome. The recommendations most frequently followed are noted and the implications of the study for the future psychiatric care of general medical patients are discussed.

scholarly journals Pre-hospital causes for delayed arrival in acute ischemic stroke before and during the COVID-19 pandemic: A study at two stroke centers in Egypt

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254228
Author(s):  
Hany M. Aref ◽  
Hossam Shokri ◽  
Tamer M. Roushdy ◽  
Fatma Fathalla ◽  
Nevine M. El Nahas
Keyword(s):  
Ischemic Stroke ◽  
Thrombolytic Therapy ◽  
Acute Ischemic Stroke ◽  
Medical Staff ◽  
Pronounced Effect ◽  
Previous Experience ◽  
Stroke Outcome ◽  
The Public ◽  
Early Arrival ◽  
To Receive

Background In the current study we investigated the causes of pre-hospital delay as this can compromise the patient’s chance to receive thrombolytic therapy and thus impact stroke outcome. Methods We surveyed 254 patients regarding reasons for delayed and early arrival to hospital after acute ischemic stroke. The survey was performed over five months, spanning a period pre- and during COVID-19 (between December 7, 2019 and May 10, 2020). Results A total of 71.2% of patients arrived beyond four hours of onset of ischemic stroke. The commonest cause for delay pre-Covid-19 was receiving treatment in a non-stroke hospital, while that during COVID-19 was fear of infection and lock down issues. Not realizing the urgency of the condition and stroke during sleep were common in both periods. Early arrival because of the patient’s previous experience with stroke accounted for approximately 25% of cases in both periods. The effect of media was more evident during COVID-19, accounting for 47.7% of cases. Conclusion Pre-hospital delay secondary to misperception of the urgency of stroke and management in a non-stroke hospital reflect the lack of awareness among the public and medical staff. This concept is emphasized by early arrival secondary to previous experience with stroke and the pronounced effect of media in the time of COVID-19.

scholarly journals Impact of onset-to-door time on outcomes and factors associated with late hospital arrival in patients with acute ischemic stroke

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247829
Author(s):  
Eung-Joon Lee ◽  
Seung Jae Kim ◽  
Jeonghoon Bae ◽  
Eun Ji Lee ◽  
Oh Deog Kwon ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Onset Time ◽  
Reperfusion Therapy ◽  
University Hospital ◽  
Hospital Arrival ◽  
Nihss Score ◽  
Late Arrival ◽  
Early Arrival ◽  
Years Of Schooling

Background and purpose Previous studies have reported that early hospital arrival improves clinical outcomes in patients with acute ischemic stroke; however, whether early arrival is associated with favorable outcomes regardless of reperfusion therapy and the type of stroke onset time is unclear. Thus, we investigated the impact of onset-to-door time on outcomes and evaluated the predictors of pre-hospital delay after ischemic stroke. Methods Consecutive acute ischemic stroke patients who arrived at the hospital within five days of onset from September 2019 to May 2020 were selected from the prospective stroke registries of Seoul National University Hospital and Chung-Ang University Hospital of Seoul, Korea. Patients were divided into early (onset-to-door time, ≤4.5 h) and late (>4.5 h) arrivers. Multivariate analyses were performed to assess the effect of early arrival on clinical outcomes and predictors of late arrival. Results Among the 539 patients, 28.4% arrived early and 71.6% arrived late. Early hospital arrival was significantly associated with favorable outcomes (three-month modified Rankin Scale [mRS]: 0−2, adjusted odds ratio [aOR]: 2.03, 95% confidence interval: [CI] 1.04–3.96) regardless of various confounders, including receiving reperfusion therapy and type of stroke onset time. Furthermore, a lower initial National Institute of Health Stroke Scale (NIHSS) score (aOR: 0.94, 95% CI: 0.90–0.97), greater pre-stroke mRS score (aOR: 1.58, 95% CI: 1.18–2.13), female sex (aOR: 1.71, 95% CI: 1.14–2.58), unclear onset time, and ≤6 years of schooling (aOR: 1.76, 95% CI: 1.03–3.00 compared to >12 years of schooling) were independent predictors of late arrival. Conclusions Thus, the onset-to-door time of≤4.5 h is crucial for better clinical outcome, and lower NIHSS score, greater pre-stroke mRS score, female sex, unclear onset times, and ≤6 years of schooling were independent predictors of late arrival. Therefore, educating about the importance of early hospital arrival after acute ischemic stroke should be emphasized. More strategic efforts are needed to reduce the prehospital delay by understanding the predictors of late arrival.

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