Failure rate of labor epidural: An observational study among different levels of trainee anesthesiologists in a university hospital of a developing country

Rheumatic diseases (RD) and hereditary thrombophilias (HT) can be associated with high-risk pregnancies. This study describes obstetric outcomes after receiving medical care at a multidisciplinary consultation (MC) and compares adverse neonatal outcomes (ANOs) before and after medical care at an MC. This study is a retrospective observational study among pregnant women with RD and HT treated at an MC of a university hospital (southern Spain) from 2012 to 2018. Absolute risk reduction (ARR) and number needed to treat (NNT) were calculated. A total of 198 pregnancies were registered in 143 women (112 with RD, 31 with HT), with 191 (96.5%) pregnancies without ANOs and seven (3.5%) pregnancies with some ANOs (five miscarriages and two foetal deaths). Results previous to the MC showed 60.8% of women had more than one miscarriage, with 4.2% experiencing foetal death. MC reduced the ANO rate by AAR = 60.1% (95%CI: 51.6−68.7%). The NNT to avoid one miscarriage was 1.74 (95%CI: 1.5–2.1) and to avoid one foetal death NNT = 35.75 (95CI%: 15.2–90.9). A total of 84.8% of newborns and 93.2% of women did not experience any complication. As a conclusion, the follow-up of RD or HT pregnant women in the MC drastically reduced the risk of ANOs in this population with a previous high risk.

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P237 Annual incidence and prevalence of ulcerative colitis and Crohn’s disease from 2010 to 2017 in four Nordic countries: Results from the TRINordic study

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz203.366 ◽

2020 ◽

Vol 14 (Supplement_1) ◽

pp. S261-S262

Author(s):

M Lördal ◽

J Burisch ◽

E Langholz ◽

T Knudsen ◽

M Voutilainen ◽

...

Keyword(s):

Ulcerative Colitis ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Observational Study ◽

Nordic Countries ◽

Annual Incidence ◽

University Hospital ◽

Retrospective Observational Study ◽

Western World ◽

The Impact

Abstract Background Incidence and prevalence of inflammatory bowel diseases (IBD) have been increasing for the past decades in the western world, however with an emerging trend of incidence stabilisation in recent years. There is an indication of higher IBD incidence and prevalence in northern Europe, especially in the Nordic region, compared with southern Europe. Methods This retrospective observational study collected data from the National Patient Registries and National Prescription Registries (Sweden [SWE], Norway [NOR], Denmark [DEN]) and one university hospital database (Turku, Finland [FIN]) during 2010–2017 to investigate the annual incidence and prevalence of ulcerative colitis (UC) and Crohn’s disease (CD). Patients with ≥2 ICD-10 diagnosis codes for UC (K51) or CD (K50) from 2010 or later and no K51 or K50 codes prior to 2010 were included; patients were classified according to their last code. The look-back period for SWE was until 2000, for NOR until 2008, for DEN until 1995, and for FIN until 2004. Incidence proportions highlight results through 2016, as 2017 patients had less than 1-year follow-up. Results In total, 69,876 patients were included (SWE n = 27,902, NOR n = 20,761, FIN n = 2,118, DEN n = 19,095), of which 44 367 patients were diagnosed with UC and 25,509 with CD. In 2016, the annual incidence of UC was 28 patients per 100,000 persons in NOR, 32 patients per 100,000 persons in DEN, 25 patients per 100,000 persons in SWE, and 44 patients per 100,000 in FIN. The corresponding results for the annual incidence of CD per 100,000 persons were 22 in NOR, 16 in DEN, 16 in SWE, and 21 in FIN. The prevalence per 100,000 persons of both UC and CD was the highest in DEN, followed by SWE and NOR, and lowest in FIN. Prevalence estimates increased in all four Nordic countries during 2010–2017: for UC, from 409 to 488 patients in SWE, from 256 to 428 in NOR, from 129 to 375 in FIN, and from 577 to 798 in DEN. For CD, it increased from 261 to 313 patients in SWE, from 164 to 258 in NOR, from 54 to 164 in FIN, and from 280 to 400 in DEN. Conclusion This retrospective observational study showed that during 2016, the annual incidence of UC ranged from 25–44 patients per 100,000 persons across the evaluated Nordic countries, whereas the annual incidence of CD was 16–22 patients per 100,000 persons. Prevalence of both UC and CD increased during 2010–2017 in all four countries. Estimates of UC and CD incidence and prevalence in this analysis are greater than reported in the published literature. Additional analyses are underway to further explore the impact of methodological decisions on the estimates of UC and CD annual incidence and prevalence.

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University hospital-based drug information service in a developing country

European Journal of Clinical Pharmacology ◽

10.1007/s002280050343 ◽

1997 ◽

Vol 53 (2) ◽

pp. 89-94 ◽

Cited By ~ 4

Author(s):

M. P. Joshi

Keyword(s):

Developing Country ◽

Drug Information ◽

Information Service ◽

University Hospital ◽

Drug Information Service

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Developing a Professionalism Manual for Nurse Managers to Improve Their Perception Regarding Professionalism and Professional Identity

SAGE Open Nursing ◽

10.1177/23779608211026174 ◽

2021 ◽

Vol 7 ◽

pp. 237796082110261

Author(s):

Marwa H. Ageiz ◽

Hayam A. Elshrief ◽

Huda M. Bakeer

Keyword(s):

Professional Identity ◽

Nurse Managers ◽

Test Phase ◽

University Hospital ◽

Performance Review ◽

Post Test ◽

Quasi Experimental ◽

Different Levels ◽

Assessment Questionnaire

Background Developing a professional identity is rooted in the dimensions of professionalism and professional development. Moreover, the need for teaching professionalism has a mutual relationship with the formation of a desirable professional identity. Aim The current study aimed at developing a professionalism manual for the nurse managers to improve their perception regarding professionalism and professional identity. Design Quasi-experimental research design with pre-test, post-test, and follow-up was used. Setting The study was conducted at two different hospitals; Menoufia University hospital and Al-helal Insurance hospital, Menoufia Governorate, Egypt. Subjects The participants included all nurse managers at different levels from the two different hospitals ( n =100). Tools: tool 1: Professionalism Questionnaire and tool 2: Professional Identity Assessment Questionnaire were used to collect data. Results there was a statistically significant improvement in professionalism perception and professional identity level immediately after administering the professionalism manual and after three months in the follow-up phase than the pre-test phase. Additionally, there was a statistically significant positive correlation between two variables of the study at the post and follow-up phases, but not significant at the pre-test phase. Conclusion the professionalism manual was effective in improving nurse managers’ perceptions regarding professionalism and professional identity. Recommendations: Incorporate the attributes of professionalism that were included in the professionalism manual as a guide for the performance review processes of nurses.

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Telemedicine in Patients With an Ostomy During the COVID-19 Pandemic: A Retrospective Observational Study

Wound Management & Prevention ◽

10.25270/wmp.2021.1.1217 ◽

2021 ◽

Vol 67 (1) ◽

pp. 12-17

Author(s):

Vincenza Dinuzzi ◽

Giuseppe Palomba ◽

Maria Minischetti ◽

Alfonso Amendola ◽

Pierluigi Aprea ◽

...

Keyword(s):

Observational Study ◽

Health Care Services ◽

Irrigation System ◽

Care Center ◽

Mechanical Bowel Preparation ◽

University Hospital ◽

Retrospective Observational Study ◽

Care Services ◽

Group B ◽

Stoma Care

BACKGROUND: Italy instituted a lockdown from March 10 to May 3, 2020, due to the coronavirus disease-19 pandemic. All nonessential businesses were closed during this time, and health care services were reorganized. On March 11, the Stoma Care Center started providing telehealth services for patients with a stoma. PURPOSE: This retrospective observational study describes the experience of the Stoma Care Center of the University Hospital Federico II, Naples, Italy, before and during the lockdown. METHODS: Consultation records from January 1 through April 29 were retrieved, patient demographics and reasons for consultation abstracted, and pre-lockdown (January 1 to February 29) and lockdown (March 1 to April 29) information was compared. Patients who used telehealth services were also asked to rate their satisfaction with these services on a scale of 0 (extremely dissatisfied) to 4 (extremely satisfied). The authors analyzed all consultations provided from January to April 2020 and evaluated the use of telemedicine services for patients with an ostomy. Consultations were divided into 2 groups. Group A included consultations provided from January 1 to February 29. Group B included consultations provided from March 1 to April 29, which included the lockdown period. Group B included both in-person and telemedicine consultations. RESULTS: During the pre-lockdown period, 240 in-person consultations were provided. During the lockdown period, 181 in-person and 99 telemedicine consultations were provided. The number of in-person consultations for mechanical bowel preparation and transanal irrigation system training was lower (12.5% vs 6.6% [P = .046] and 3.3% vs 0% [P = .03]), whereas the number of consults for stoma care follow-up and stoma complications was higher (202 [84.1%] vs 266 [95%]). Of the 65 patients who completed the questionnaire, 82% indicated being extremely satisfied. CONCLUSIONS: The reorganization of stoma care services, including the availability of telemedicine, did not result in a decrease in the number of consultations provided. The results suggest that stoma care services using telemedicine may provide valid support for patients with an ostomy in the future.

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The impact of a patient’s social status on the cost of vaginal deliveries: an observational study in a French university hospital

Journal of Gynecology Obstetrics and Human Reproduction ◽

10.1016/j.jogoh.2018.10.020 ◽

2019 ◽

Vol 48 (1) ◽

pp. 33-38

Author(s):

Thomas Vermeulin ◽

Mélodie Lucas ◽

Loëtizia Froment ◽

Valérie Josset ◽

Pierre Czernichow ◽

...

Keyword(s):

Observational Study ◽

Social Status ◽

University Hospital ◽

Vaginal Deliveries ◽

The Cost ◽

The Impact

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Transmission of ESBL-producing Enterobacteriaceae and their mobile genetic elements—identification of sources by whole genome sequencing: study protocol for an observational study in Switzerland

BMJ Open ◽

10.1136/bmjopen-2018-021823 ◽

2018 ◽

Vol 8 (2) ◽

pp. e021823 ◽

Cited By ~ 12

Author(s):

Tanja Stadler ◽

Dominik Meinel ◽

Lisandra Aguilar-Bultet ◽

Jana S Huisman ◽

Ruth Schindler ◽

...

Keyword(s):

Observational Study ◽

Whole Genome Sequencing ◽

Genome Sequencing ◽

Bacterial Species ◽

Mobile Genetic Elements ◽

University Hospital ◽

Whole Genome ◽

Hospital Acquired Infections ◽

Genetic Elements ◽

Hospital Acquired

IntroductionExtended-spectrum beta-lactamases (ESBL)-producing Enterobacteriaceae were first described in relation with hospital-acquired infections. In the 2000s, the epidemiology of ESBL-producing organisms changed as especially ESBL-producingEscherichia coliwas increasingly described as an important cause of community-acquired infections, supporting the hypothesis that in more recent years ESBL-producing Enterobacteriaceae have probably been imported into hospitals rather than vice versa. Transmission of ESBL-producing Enterobacteriaceae is complicated by ESBL genes being encoded on self-transmissible plasmids, which can be exchanged among the same and different bacterial species. The aim of this research project is to quantify hospital-wide transmission of ESBL-producing Enterobacteriaceae on both the level of bacterial species and the mobile genetic elements and to determine if hospital-acquired infections caused by ESBL producers are related to strains and mobile genetic elements predominantly circulating in the community or in the healthcare setting. This distinction is critical in prevention since the former emphasises the urgent need to establish or reinforce antibiotic stewardship programmes, and the latter would call for more rigorous infection control.Methods and analysisThis protocol presents an observational study that will be performed at the University Hospital Basel and in the city of Basel, Switzerland. ESBL-producing Enterobacteriaceae will be collected from any specimens obtained by routine clinical practice or by active screening in both inpatient and outpatient settings, as well as from wastewater samples and foodstuffs, both collected monthly over a 12-month period for analyses by whole genome sequencing. Bacterial chromosomal, plasmid and ESBL-gene sequences will be compared within the cohort to determine genetic relatedness and migration between humans and their environment.Ethics and disseminationThis study has been approved by the local ethics committee (Ethikkommission Nordwest-und Zentralschweiz) as a quality control project (Project-ID 2017–00100). The results of this study will be published in peer-reviewed medical journals, communicated to participants, the general public and all relevant stakeholders.

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INTRAVENOUS APPLICATION OF HELIXOR® IN GYNECOLOGICAL ONCOLOGY: IS IT SAFE?

International Journal of Research -GRANTHAALAYAH ◽

10.29121/granthaalayah.v5.i10.2017.2306 ◽

2017 ◽

Vol 5 (10) ◽

pp. 307-312

Author(s):

Yong-Il Ji

Keyword(s):

Observational Study ◽

Adverse Drug Reactions ◽

Gynecological Cancer ◽

Viscum Album ◽

University Hospital ◽

Drug Reactions ◽

Gynecological Oncology ◽

Patients With Cancer ◽

Therapeutic Outcomes ◽

Efficacy Studies

Background: Traditional mistletoe (Viscum album L.) therapy has been frequently used in patients with cancer in Europe. The different mistletoe formulations available for oncological use are Iscador®, Iscucin®, AbnovaViscum®, and Lektinol®, as well as Helixor®, which may improve therapeutic outcomes following intravenous (i.v.) administration and therefore, is becoming more commonly used. Method: I conducted an observational study in four different University Hospital Centers and the frequency of adverse drug reactions (ADRs) induced by the i.v. infusion of Helixor® was determined. Result: of the 108 patients with gynecological cancer who received i.v. infusions of Helixor®, 10 (9.3%) reported mild ADRs, and no serious ADRs were reported. Conclusion: Therefore, i.v. infusion of Helixor® was determined to be safe, and prospective efficacy studies are recommended.

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The Incidence, Risk Factors, Predictors, and Prognoses of Cytomegalovirus Reactivation in Immunocompetent Mechanical Ventilation Patients: A Prospective Observational Study

10.21203/rs.3.rs-247841/v1 ◽

2021 ◽

Author(s):

Zhihui Zhang ◽

Xuesong Liu ◽

Ling Sang ◽

Sibei Chen ◽

Zhan Wu ◽

...

Keyword(s):

Risk Factors ◽

Mechanical Ventilation ◽

Observational Study ◽

Prospective Observational Study ◽

Area Under The Curve ◽

University Hospital ◽

Laboratory Findings ◽

Cytomegalovirus Reactivation ◽

Cmv Reactivation ◽

Immunocompetent Patients

Abstract Background: Cytomegalovirus (CMV) reactivation can seriously affect the clinical prognoses of critically ill patients. However, the epidemiology and predictors of CMV in immunocompetent patients with mechanical ventilation are not very clear. Methods: A single-center, prospective observational study (conducted from June 30, 2017 to July 01, 2018) with a follow-up of 90 days (September 29, 2018) that included 71 CMV-seropositive immunocompetent patients with mechanical ventilation at a 37-bed university hospital general intensive care unit (ICU) in China. Routine detection of CMV DNAemia was performed once a week until 28 days (Day1, 7, 14, 21, 28) and serology, laboratory findings, and clinical data were obtained at admission.Results: Among 71 patients, 13 (18.3%) showed CMV reactivation within ICU 28-day admission. The median time to reactivation was 7 days. CMV reactivation was related to various factors, including body weight, body mass index (BMI), sepsis, NT-proBNP, BUN, and Hb levels (P< 0.05). In the multivariate regression model, BMI, Hb level, and sepsis were associated with CMV reactivation patients (P< 0.05). Moreover, the area under the curve (AUC) of BMI, Hb and BMI combined Hb was 0.69, 0.70, 0.76, respectively. The rate of complications, duration of mechanical ventilation, hospitalization expense, length of ICU stay, and 90-day all-cause mortality rate in patients with CMV reactivation was significantly higher than in those without CMV reactivation (P< 0.05).Conclusions: Among immunocompetent patients with mechanical ventilation, the incidence of CMV reactivation was high. CMV reactivation can lead to various adverse prognoses. BMI, Hb, and sepsis were independent risk factors for CMV reactivation. BMI and Hb may predict CMV reactivation.

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