Flexible bronchoscopy in a tertiary healthcare facility: a review of indications and outcomes

Objectives: Flexible Fibreoptic bronchoscopy (FFB) is a major diagnostic and therapeutic tool employed largely in respiratory medicine but its use in our country has been quite limited. We performed a retrospective review of the indications, overall diagnostic yield and safety of FFB at the Korle-Bu Teaching Hospital (KBTH).Study Design: Retrospective studyStudy Setting: Cardiothoracic Unit, Korle-Bu Teaching HospitalStudy Participants: All bronchoscopy records from January 2017 - December 2018Interventions: Eight-five bronchoscopy reports generated over a 2-year period were reviewed. Using a data extraction form, patient’s demographic details, indications for FFB, sedation given, specimen obtained and results of investigation, and complications encountered were recorded and entered into SPSS version 22. Descriptive analysiswas performed and presented as means and percentages.Results: Suspected lung cancer was the predominant indication for bronchoscopy requests (55.3%). Diagnostic yield of endobronchial biopsy was 86.7% increased to 93.3% when biopsy was combined with bronchial washing cytology. Bronchial washing geneXpert was positive in 20.8% of sputum negative cases, and 20.7% of patients with unresolved pneumonia and bronchiectasis had a positive microbial yield. Overall mild complications occurred in 5.9% of patients with no mortality.Conclusion: Flexible bronchoscopy has a significantly high diagnostic yield, particularly in evaluating lung cancers and undiagnosed lung infections with minimal associated complications, hence increasing its availability in the country and widening the diagnostic scope at the cardiothoracic unit of the Korle-Bu Teaching Hospital.

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Impact of surgery timing for craniosynostosis on neurodevelopmental outcomes: a systematic review

Journal of Neurosurgery Pediatrics ◽

10.3171/2018.10.peds18536 ◽

2019 ◽

Vol 23 (4) ◽

pp. 442-454 ◽

Cited By ~ 6

Author(s):

Rachel Mandela ◽

Maggie Bellew ◽

Paul Chumas ◽

Hannah Nash

Keyword(s):

Systematic Review ◽

Beneficial Effect ◽

Data Extraction ◽

Sociodemographic Factors ◽

Future Research ◽

Neurodevelopmental Outcomes ◽

Age At Surgery ◽

Data Extraction Form ◽

Surgery Timing ◽

Anesthetic Exposure

OBJECTIVEThere are currently no guidelines for the optimum age for surgical treatment of craniosynostosis. This systematic review summarizes and assesses evidence on whether there is an optimal age for surgery in terms of neurodevelopmental outcomes.METHODSThe databases MEDLINE, PsycINFO, CINAHL, Embase + Embase Classic, and Web of Science were searched between October and November 2016 and searches were repeated in July 2017. According to PICO (participants, intervention, comparison, outcome) criteria, studies were included that focused on: children diagnosed with nonsyndromic craniosynostosis, aged ≤ 5 years at time of surgery; corrective surgery for nonsyndromic craniosynostosis; comparison of age-at-surgery groups; and tests of cognitive and neurodevelopmental postoperative outcomes. Studies that did not compare age-at-surgery groups (e.g., those employing a correlational design alone) were excluded. Data were double-extracted by 2 authors using a modified version of the Cochrane data extraction form.RESULTSTen studies met the specified criteria; 5 found a beneficial effect of earlier surgery, and 5 did not. No study found a beneficial effect of later surgery. No study collected data on length of anesthetic exposure and only 1 study collected data on sociodemographic factors.CONCLUSIONSIt was difficult to draw firm conclusions from the results due to multiple confounding factors. There is some inconclusive evidence that earlier surgery is beneficial for patients with sagittal synostosis. The picture is even more mixed for other subtypes. There is no evidence that later surgery is beneficial. The authors recommend that future research use agreed-upon parameters for: age-at-surgery cut-offs, follow-up times, and outcome measures.

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Factors Related to Diagnostic Yield of Flexible Bronchoscopy Without Guidance in Bronchoscopically Invisible Peripheral Lung Lesions

CHEST Journal ◽

10.1016/j.chest.2016.08.1118 ◽

2016 ◽

Vol 150 (4) ◽

pp. 1012A

Author(s):

Jongmin Lee ◽

Hye Seon Kang ◽

Wooho Ban ◽

Sung Bae Cho ◽

Myung Sook Kim ◽

...

Keyword(s):

Diagnostic Yield ◽

Flexible Bronchoscopy ◽

Lung Lesions ◽

Peripheral Lung

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Private Rooms in Low Acuity Settings: A Systematic Review of the Literature

HERD Health Environments Research & Design Journal ◽

10.1177/1937586717702597 ◽

2017 ◽

Vol 11 (1) ◽

pp. 57-74 ◽

Cited By ~ 4

Author(s):

Jeffrey Voigt ◽

Michael Mosier ◽

Rabih Darouiche

Keyword(s):

Systematic Review ◽

Data Extraction ◽

Quality Data ◽

Review Of The Literature ◽

Single Patient ◽

Patient Falls ◽

Assessment Development ◽

High Acuity ◽

Data Extraction Form ◽

Quality Evidence

Objectives: Determine if the peer-reviewed evidence supports single-patient ward bedrooms in low-acuity care settings within a hospital. Background: New evidence exists since the 2006 Facility Guideline Institute guideline recommended single-bedded rooms (SBRs) in low-acuity care settings. Additionally, prior studies evaluated high-acuity care settings (e.g., critical care) in their recommendations on SBRs. There is a need to reevaluate the evidence. Methods: A systematic review of the literature was completed including electronic and hand searches of references. A data extraction form was utilized. Two reviewers evaluated the studies independently. Studies that were included examined the effect of single-patient rooms on medical surgical ward beds only. Each study was graded using accepted clinical evidence grading instruments. Results: Over 1,400 records were identified. After excluding studies, a total of 49 records were graded. The highest quality evidence identified (Center for Evidence-Based Medicine [CEBM]: 2a, 2b, and Grading of Recommendations, Assessment, Development, and Evaluation [GRADE] C) did not support the use of single-patient rooms for reducing infections, for minimizing patient falls, for reducing medication errors, or for patient satisfaction. Operational efficiencies were improved with SBRs but only addressed the maternity ward. The lowest quality evidence (CEBM: 4/5 and GRADE D) supported the use of single-patient rooms. Conclusions: Based on CEBM and GRADE assessments, there is a lack of high-quality data supporting the use of low-acuity SBRs throughout the entire hospital. Furthermore, it is recommended that more research be conducted on the effect of SBRs, so higher quality evidence is developed.

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The Diagnostic Yield, Safety, and Impact of Flexible Bronchoscopy in Non-HIV Immunocompromised Critically Ill Patients in the Intensive Care Unit

Lung ◽

10.1007/s00408-018-0169-8 ◽

2018 ◽

Vol 196 (6) ◽

pp. 729-736 ◽

Cited By ~ 2

Author(s):

Mazen O. Al-Qadi ◽

Rodrigo Cartin-Ceba ◽

Rahul Kashyap ◽

Sumanjit Kaur ◽

Steve G. Peters

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Critically Ill ◽

Critically Ill Patients ◽

Diagnostic Yield ◽

Flexible Bronchoscopy

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The effect of including the Nordic Hamstring exercise on sprint and jump performance in athletes: protocol of a systematic review and meta-analyses

10.1101/2020.04.01.20048686 ◽

2020 ◽

Author(s):

Kasper Krommes ◽

Mathias F. Nielsen ◽

Laura Krohn ◽

Birk M. Grønfeldt ◽

Kristian Thorborg ◽

...

Keyword(s):

Systematic Review ◽

High Speed ◽

Data Extraction ◽

Force Production ◽

List Type ◽

Jump Performance ◽

Production Studies ◽

Hamstring Strain ◽

Data Extraction Form ◽

Meta Analyses

AbstractThe Nordic Hamstring exercise reduces hamstring strain injuries in football and other sports, but the exercise is not well adopted in practice. Barriers from practitioners include fear of performance decrements, due to lack of specificity of the exercise with high speed running. However, in theory, increased eccentric hamstring strength could transfer to faster sprinting due to higher horizontal force production. Studies on the effect of the Nordic Hamstring exercise on performance have been conflicting and no synthesis of the evidence exists. We therefore pose the following question: does including the Nordic Hamstring exercise hamper sprint or jump performance in athletes? We will answer this question by performing a systematic review of the literature, critically appraise relevant studies, and GRADE the evidence across key outcomes and perform meta-analyses, meta-regression and subgroup analyses. In this protocol we outline the planned methods and procedures.Progress reportBesides this protocol, our data extraction form and the process of data extraction has been piloted on 3 relevant studies, along with familiarization with the Risk of Bias 2.0 tool. We have also comprised a preliminary search strategy for PubMed.Supplementary filesData Extraction Form (.pdf)Populated PRISMA-P checklist (.pdf)

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Use of flexible bronchoscopy for rapid diagnosis of suspected tubercular cases in rural India

The Journal of Infection in Developing Countries ◽

10.3855/jidc.608 ◽

2009 ◽

Vol 3 (11) ◽

pp. 860-864 ◽

Cited By ~ 3

Author(s):

Sameer Singhal ◽

Abhay M. Gaidhane ◽

Nazli Khatib ◽

Tripti Hrivastava ◽

Sanjay Diwan ◽

...

Keyword(s):

Diagnostic Yield ◽

Correct Diagnosis ◽

Positive Culture ◽

Cross Sectional Study ◽

Flexible Bronchoscopy ◽

Special Importance ◽

Cross Sectional ◽

Tuberculosis Patients ◽

Negative Sputum ◽

Tuberculosis Therapy

Background: Reaching a correct diagnosis is a challenge for physicians treating any of the 30% to 50% of pulmonary tuberculosis patients who have negative sputum cultures or who present with no sputum. Flexible bronchoscopy acquires special importance for these cases for whom empirical anti-tuberculosis therapy is the only option left. In our study we aimed to assess the diagnostic yield of flexible bronchoscopy in patients, suspected to have tuberculosis, whose sputum smears were negative. Methodology: In our hospital-based cross-sectional study, 42 patients were enrolled by consecutive sampling. Flexible bronchoscopy and selective bronchial washings were done in all patients. Results: Bronchoscopy lavage smears were positive for M. tuberculosis in 10 (23.8%) patients. Fifteen (35.7%) patients had positive culture. Conclusion: Flexible bronchoscopy has an important role in the diagnosis of patients suspected to have tuberculosis, whose sputum smears are negative or who can not produce sputum.

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Cancer services during the COVID-19 pandemic: systematic review of patients' and caregivers' experiences

10.1101/2021.03.19.21253949 ◽

2021 ◽

Author(s):

Symran Dhada ◽

Derek Stewart ◽

Ejaz Cheema ◽

Muhammed Abdul Hadi ◽

Vibhu Paudyal

Keyword(s):

Systematic Review ◽

Cancer Screening ◽

Cancer Patients ◽

English Language ◽

Resource Constraints ◽

Data Extraction ◽

Psychological Wellbeing ◽

Cancer Services ◽

Data Extraction Form ◽

The Impact

Background Cancer patients have faced intersecting crises in the face of COVID-19 pandemic. This review aimed to examine patients' and caregivers' experiences of accessing cancer services during the COVID-19 pandemic and perceived impact of the pandemic on their psychological wellbeing. Methods A protocol-led (CRD42020214906) systematic review was conducted by searching six databases including EMBASE, MEDLINE and CINAHL for articles published in English-language between 1/2020-12/2020. Data were extracted using a pilot-tested, structured data extraction form. Thematic synthesis of data was undertaken and reported as per the PRISMA guideline. Results A total of 1110 articles were screened of which 19 studies met the inclusion criteria. Studies originated from 10 different countries including the US, UK, India and China. Several themes were identified which were categorised into seven categories. Postponement and delays in cancer screening and treatment, drug shortages and inadequate nursing care were commonly experienced by patients. Hospital closures, resource constraints, national lockdowns and patient reluctance to use health services because of infection worries contributed to the delay. Financial and social distress, isolation; and spiritual distress due to the uncertainty of rites as well as fulfilment of last wishes were also commonly reported. Caregivers felt anxious about infecting cancer patients with COVID-19. Conclusions Patients and caregivers experienced extensive impact of COVID-19 on cancer screening, treatment and care, and their own psychological wellbeing. Patient and caregiver views and preferences should be incorporated in ensuring resilient cancer services that can minimise the impact of ongoing and future pandemic on cancer care and mitigate patient fears.

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The influence of health insurance scheme on the drug prescribing pattern in a Nigerian tertiary healthcare facility

Nigerian Medical Journal ◽

10.4103/0300-1652.170378 ◽

2015 ◽

Vol 56 (5) ◽

pp. 344 ◽

Cited By ~ 6

Author(s):

JosephOlusesan Fadare ◽

AdekunleOlaitan Adeoti ◽

Felix Aina ◽

OlusojiAbidemi Solomon ◽

JoelOlatunde Ijalana

Keyword(s):

Health Insurance ◽

Healthcare Facility ◽

Health Insurance Scheme ◽

Drug Prescribing ◽

Insurance Scheme ◽

Prescribing Pattern ◽

Tertiary Healthcare

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Diabetes registry and service in Nigerian suburban-based tertiary healthcare facility

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20195862 ◽

2019 ◽

Vol 7 (1) ◽

pp. 250

Author(s):

Fortunatus D. Gbeinbo ◽

Eunice O. Igumbor ◽

Otovwe Agofure ◽

Chinedu O. Obodo ◽

Emmanuel Olu-Ero ◽

...

Keyword(s):

Data Collection ◽

Health Facility ◽

Scale Up ◽

Healthcare Facility ◽

Clinical Tool ◽

Diabetes Registry ◽

Glucose Levels ◽

Hospital Patients ◽

Tertiary Healthcare ◽

Diabetes Register

Background: Diabetes register is a clinical tool necessary for patient management including follow-up and referral procedures. In the Bringing Research in Diabetes to Global Environments and Systems that is in progress in Delta State, Nigeria; part of focus is establishment of diabetes register at a tertiary health facility. This phase of the project aimed to establish a diabetes register and to assess the baseline data.Methods: This was a clinical observational descriptive study at Eku Baptist Government Hospital. The diabetes register developed as in previous report was adopted as a scale-up study. After due clearance from the hospital, patients’ hospital record files were screened for cases of diabetes and 70 files were identified. Data were analyzed descriptively using Microsoft Excel Data Analysis ToolPak 2010.Results: There was a 2/1 female/male ratio, while 6% were below 40 years. 90% of patients had blood glucose levels results that indicated poor diabetes control. There is problem of incomplete data collection, for instance <25% BMI data was available. Capability and opportunity for standard service, e.g. diabetic foot examination, lipid profile, renal and retinal assessment was available at the tertiary health facility to allow management and referral from other hospitals.Conclusions: This report highlights poor adherence to diabetes care practices by stakeholders. It underscores the need for motivation to improve the quality of clinical data collection vis-à-vis documentation that enables assessment of diabetes epidemiology, especially in a facility that has the capacity.

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