scholarly journals Intervenção percutânea por via radial e tempo de permanência hospitalar

2018 ◽  
Vol 12 (6) ◽  
pp. 1665
Author(s):  
Denise Viana Rodrigues de Oliveira ◽  
João Pimenta ◽  
George Ximenes ◽  
Agueda Maria Ruiz Zimmer Cavalcante
Keyword(s):  
Health System ◽  
Hospital Stay ◽  
Pearson Correlation ◽  
Length Of Hospital Stay ◽  
Coronary Intervention ◽  
Study Data ◽  
Significance Level ◽  
Coronary Syndrome ◽  
Unified Health System ◽  
Factores De Riesgo

RESUMOObjetivo: analisar os fatores de risco relacionados ao procedimento percutâneo por via radial e o tempo de permanência hospitalar. Método: estudo quantitativo, longitudinal, prospectivo, descritivo e unicêntrico. A coleta de dados foi realizada por meio de questionário, com 100 pacientes, em três fases (pré-procedimento, transprocedimento e pós-procedimento), em 24h e após sete dias. Para as variáveis quantitativas, foram utilizados os testes Mann-Whitnney ou t de Student; para as qualitativas, o teste exato de Fisher. Para a associação entre duas variáveis quantitativas, foi utilizado o coeficiente de correlação de Pearson com nível de significância ≤5%. Resultados: 100 pacientes realizaram o procedimento com média de internação de 6,6 dias. Após a associação entre o tempo de permanência e as variáveis clínicas, o p não mostrou valor significante. Conclusão: os resultados aproximam-se mais da realidade dos hospitais do Sistema Único de Saúde; não houve linearidade no tempo de permanência hospitalar quando associado a diferentes fatores relacionados à intervenção percutânea. Descritores: Intervenção Coronária Percutânea; Tempo de Internação; Artéria Radial; Sistema Único de Saúde; Síndrome Coronária Aguda; Fatores de Risco.ABSTRACTObjective: to analyze the risk factors related to the percutaneous radial procedure and length of hospital stay. Method: quantitative, longitudinal, prospective, descriptive and unicentric study. Data was collected through a questionnaire, with 100 patients, in three phases (pre-procedure, transprocedure and post-procedure), in 24 hours and after seven days. For the quantitative variables, the Mann-Whitnney or Student's t tests were used; for the qualitative, Fisher's exact test. For the association between two quantitative variables, the Pearson correlation coefficient was used with significance level ≤5%. Results: 100 patients had the procedure with mean hospitalization of 6.6 days. After the association between the length of stay and clinical variables, p did not show significant value. Conclusion: the results are closer to the reality of the hospitals of the Unified Health System; there was no linearity in the length of hospital stay when associated with different factors related to the percutaneous intervention. Descriptors: Percutaneous Coronary Intervention; Length of hospitalization; Radial Artery; Unified Health System; Acute Coronary Syndrome; Risk Factors.RESUMEN Objetivo: analizar los factores de riesgo relacionados con el procedimiento percutáneo por vía radial y el tiempo de permanencia hospitalaria. Método: Estudio cuantitativo, longitudinal, prospectivo, descriptivo y unicéntrico. La recolección de datos fue realizada por medio de un cuestionario, con 100 pacientes, en tres fases: (pre-procedimiento, transprocedimiento y post-procedimiento), en 24h y después de siete días. Para las variables cuantitativas, se utilizaron las pruebas Mann-Whitnney o t de Student; para las cualitativas, la prueba exacta de Fisher. Para la asociación entre dos variables cuantitativas, se utilizó el coeficiente de correlación de Pearson con nivel de significancia ≤5 %%. Resultados: 100 pacientes realizaron el procedimiento, con promedio de internación de 6,6 días. Después de la asociación entre el tiempo de permanencia y las variables clínicas, el p no mostró valor significativo. Conclusión: los resultados se acercaron más a la realidad de los hospitales del Sistema Único de Salud; no hubo linealidad en el tiempo de permanencia hospitalaria, cuando asociado a diferentes factores relacionados a la intervención percutánea. Descriptores: Intervención Coronaria Percutánea; Tiempo de Internación; Arteria Radial; Sistema Único de Salud; Síndrome Coronária Aguda; Factores de Riesgo.

Visual and quantitative assessment of COVID-19 pneumonia on chest CT: The relationship with disease severity and clinical findings

2021 ◽  
Vol 17 ◽  
Author(s):  
Furkan Kaya ◽  
Petek Şarlak Konya ◽  
Emin Demirel ◽  
Neşe Demirtürk ◽  
Semiha Orhan ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Disease Severity ◽  
Pearson Correlation ◽  
Laboratory Data ◽  
Length Of Hospital Stay ◽  
Chest Ct ◽  
Laboratory Findings ◽  
Pneumonia Severity ◽  
High Attenuation ◽  
The Relationship

Background: Lungs are the primary organ of involvement of COVID-19, and the severity of pneumonia in COVID-19 patients is an important cause of morbidity and mortality. Aim: We aimed to evaluate the visual and quantitative pneumonia severity on chest computed tomography (CT) in patients with coronavirus disease 2019 (COVID-19) and compare the CT findings with clinical and laboratory findings. Methods: We retrospectively evaluated adult COVID-19 patients who underwent chest CT, clinical scores, laboratory findings, and length of hospital stay. Two independent radiologists visually evaluated the pneumonia severity on chest CT (VSQS). Quantitative CT (QCT) assessment was performed using a free DICOM viewer, and the percentage of the well-aerated lung (%WAL), high-attenuation areas (%HAA) at different threshold values, and mean lung attenuation (MLA) values were calculated. The relationship between CT scores and the clinical, laboratory data, and length of hospital stay were evaluated in this cross-sectional study. The student's t-test and chi-square test were used to analyze the differences between variables. The Pearson correlation test analyzed the correlation between variables. The diagnostic performance of the variables was assessed using receiver operating characteristic (ROC) analysis was used. Results: The VSQS and QCT scores were significantly correlated with procalcitonin, d-dimer, ferritin, and C-reactive protein levels. Both VSQ and QCT scores were significantly correlated with disease severity (p<0.001). Among the QCT parameters, the %HAA-600 value showed the best correlation with the VSQS (r=730,p<0.001). VSQS and QCT scores had high sensitivity and specificity in distinguishing disease severity and predicting prolonged hospitalization. Conclusion: The VSQS and QCT scores can help manage the COVID-19 and predict the duration of hospitalization.

scholarly journals Use of generic medicines by the Brazilian population: an evaluation of PNAUM 2014

2016 ◽  
Vol 50 (suppl 2) ◽  
Author(s):  
Andréa Dâmaso Bertoldi ◽  
Paulo Sergio Dourado Arrais ◽  
Noemia Urruth Leão Tavares ◽  
Luiz Roberto Ramos ◽  
Vera Lucia Luiza ◽  
...  
Keyword(s):  
Health System ◽  
Statistical Significance ◽  
Population Based ◽  
Cross Sectional Study ◽  
Education Level ◽  
Generic Medicines ◽  
Cross Sectional ◽  
Significance Level ◽  
Economic Class ◽  
Unified Health System

ABSTRACT OBJECTIVE To analyze the existence of differences in the use of generic medicines in Brazil according to demographic and socioeconomic variables and acquisition sources of the medicines. METHODS Population-based cross-sectional study, conducted with data from the Pesquisa Nacional de Acesso, Utilização e Promoção do Uso Racional de Medicamentos (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines). Data collection took place between September, 2013 and February, 2014 in homes of Brazilian cities (urban area). The use of medicines has been investigated in relation to the treatment of chronic diseases and, in the case of acute events, regarding use over the previous 15 days. Generics were identified by visualization of packaging presented by the users of the medicines. The independent variables used were sex, age, education level, economic class, and region of the Country. The statistical significance of differences between the groups was evaluated by Pearson’s Chi-squared test, considering a 5% significance level. RESULTS The prevalence of generic medicines use was 45.5% (95%CI 43.7–47.3). There was no difference considering education level. The prevalence was higher in females (47.0%; 95%CI 44.9–49.0) than in males (43.1%; 95%CI 40.5–45.8), and were higher with increasing age. Generic medicines were more used in the economic class C (47.0%; 95%CI 44.9–49.1) and in the South (50.6%; 95%CI 46.6–54.6) and Southeast (49.9%; 95%CI 46.8–53.0) regions. Generics accounted for 37.3% of the medicines provided by the Brazilian Unified Health System. CONCLUSIONS Currently, there is a choice of purchase or free provision by the Brazilian Unified Health System, characterized by quality assurance and reduced price regarding branded medicines considered as reference. In the private market, a considerable part of the population is choosing generic medicines thanks to the availability of this option for virtually all medicines most used by the population.

Economic and Operational Implications of a Standardized Approach to Hemodynamic Support Therapy Using Percutaneous Cardiac Assist Devices

2014 ◽  
Vol 9 (1) ◽  
pp. 38-42 ◽  
Author(s):  
David Wohns ◽  
Purushothaman Muthusamy ◽  
Alan T. Davis ◽  
Mohsin Khan ◽  
Joseph K. Postma ◽  
...  
Keyword(s):  
High Risk ◽  
Hospital Stay ◽  
Resource Use ◽  
Length Of Hospital Stay ◽  
Coronary Intervention ◽  
Resource Consumption ◽  
Cardiac Assist ◽  
Hemodynamic Support ◽  
Episode Of Care ◽  
Cardiac Assist Devices

Objective Impella 2.5 has been shown to reduce major adverse events for patients undergoing elective high-risk percutaneous coronary intervention. We performed a single-center retrospective study to compare the costs and resource use of Impella 2.5 and intra-aortic balloon pump (IABP) support. Methods All high-risk patients who received Impella 2.5 (n = 35) and IABP (n = 295) support from December 2008 to July 2011 were included. Propensity score matching identified a balanced 1:1 matched cohort (35 Impella vs 35 IABP) based on indications for implantation, preimplantation hemodynamics, and age. Diagnostic, procedural, financial, and resource use data were collected. Results As compared with IABP, Impella offered a more predictable course of treatment/resource consumption and was not associated with any extreme cost outliers (17.1% vs 0.0%, respectively; P = 0.025). The mean admission and 90-day episode of care total costs for Impella were 5.5% ($67,681 vs $71,608, P = 0.79) and 4.2% ($70,680 vs $73,476, P = 0.85) lesser than that for IABP, respectively. Although not statistically significant, Impella patients had a trend toward lower rehospitalization rates (11.4% vs 20%), lesser mean index length of hospital stay (11.2 vs 13.7), and 90-day (11.7 vs 14.2) episode of care length of hospital stay. Conclusions Impella support was associated with consistent course of treatment/resource consumption with significantly fewer 90-day extreme cost outliers than was IABP. The lower index and 90-day follow-up cost trends observed for Impella were driven by shorter length of hospital stay and fewer rehospitalizations. As providers strive to improve quality of care by reducing variability, these findings have implications for the development of hemodynamic support algorithms.

scholarly journals Potential drug-drug interactions among elderly in-patients with cardiac illness at a tertiary care centre

2020 ◽  
Vol 9 (3) ◽  
pp. 470
Author(s):  
Akanksha Mathur ◽  
Nidhi Jain ◽  
Achal Sharma ◽  
Prashant C. Shah
Keyword(s):  
Risk Factors ◽  
Drug Interactions ◽  
Hospital Stay ◽  
Pearson Correlation ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Hospitalized Patients ◽  
Close Monitoring ◽  
Potential Drug ◽  
Cardiac Illness

Background: Drug interactions are major cause of concern in hospitalized patients with cardiac illness especially in elderly population. Therefore, the study was conducted to determine the prevalence and pattern of potential drug-drug interactions (pDDI) and risk factors, if any.Methods: It was a prospective observational study involving 75 elderly in-patients with cardiac diseases. IHEC approval was taken before commencement of study and written informed consent was taken from all the study participants. Data was collected using structured data collection tool. pDDI were analyzed using MEDSCAPE databse. Data was analyzed using SPSS 20.0 in terms of descriptive statistics. Pearson correlation coefficient was used to find the association between the risk factors and potential DDIs. P value of ≤0.05 was considered statistically significant.Results: The prevalence of pDDI was found to be 100%. Total 593 pDDI and 33 interacting drug pairs were observed in the study. The common drug interacting pairs were aspirin and furosemide 140 (23.61%), followed by aspirin+ enalapril 98 (16.53%) and heparin and clopidogrel 56 (9.44%). Majority of pDDI 480 (81%) were found to be of moderate severity. A significant association was documented between length of hospital stay (p=0.041) and occurrence of pDDI. A statistically significant correlation (r =0.621; p<0.01) was noted between number of drugs prescribed and total number of pDDIs.Conclusions: A high prevalence of pDDI was observed. The prevalence rate is directly related to number of drugs prescribed and length of hospital stay. Therefore, close monitoring of hospitalized patients is recommended.

scholarly journals Costs Related To Immunopreventable Diseases: Brazil And Its Geographic Areas (Immunopreventable Diseases’ Costs In Brazil)

2021 ◽  
Author(s):  
Elide Sbardellotto Mariano da Costa ◽  
Adriano Hyeda ◽  
Eliane M Cesario Periera Maluf
Keyword(s):  
Retrospective Study ◽  
Health System ◽  
Hospital Stay ◽  
Yellow Fever ◽  
Whooping Cough ◽  
Direct Costs ◽  
Unified Health System

Abstract Introduction: the occurrence of the immunopreventable diseases in a population global reality.Objective: to discriminate the direct costs of the hospitalizations from the immunopreventable diseases in the Unified Health System (SUS), in Brazil and their areas, between 2008 and 2018.Methods: A population, observational, descriptive and retrospective study, with data from the information supplied by the DATASUS website, these data were collected during the 2019.Results: It was identified 457,479 hospitalizations in the period; with a total of 2,450,870 days of hospital stay, with total costs of R$389,243,264.85. Only the disease mumps presented a growing tendency in whole areas; the chickenpox was decreasing; the illness whooping cough, yellow fever and tetanus were stationary in this period. Conclusions: The costs related to immunopreventable diseases were relevant in all the Brazil areas, with tendencies different between the geographic areas and between the several illnesses analyZed.

scholarly journals Adenoidectomy and adenotonsillotomy in patients treated in the Department of Paediatric Otorhinolaryngology of the Medical University of Warsaw in 2018 – a retrospective analysis

New Medicine ◽  
2019 ◽  
Vol 23 (2) ◽  
Author(s):  
Tomasz Lis ◽  
Lidia Zawadzka-Głos
Keyword(s):  
Hospital Stay ◽  
Otitis Media ◽  
Length Of Hospital Stay ◽  
Study Data ◽  
Upper Respiratory Tract ◽  
Common Procedure ◽  
Sleep Related Breathing Disorders ◽  
Middle Ear Ventilation ◽  
Tract Infections ◽  
Medical University

Introduction. Adenoidectomy and adenotonsillotomy are among the most common surgical procedures worldwide. Sleep-related breathing disorders and recurrent upper respiratory tract infections are two primary categories of indications for adenoidectomy and adenotonsillotomy. Aim. The aim of this study was to analyse selected adenoidectomy and adenotonsillotomy procedures performed in the Department of Paediatric Otorhinolaryngology of the Medical University of Warsaw in 2018. Material and methods. A total of 474 patients aged between 11 months and 18 years, who underwent adenoidectomy and adenotonsillotomy in the Department of Paediatric Otorhinolaryngology of the Medical University of Warsaw in 2018, were included in the study. Data on age, gender, length of hospital stay, as well as additional diagnoses in adenoid hypertrophy or adenoid and palatine tonsil hypertrophy were collected. Minor surgeries performed in addition to tonsillectomy were also evaluated. Results. A total of 472 patients underwent adenoidectomy and adenotonsillotomy in 2018. Adenotonsillotomy was almost twice more common. Tonsillar hypertrophy was accompanied by exudative otitis media in almost 1/3 of children, and ear ventilation tubes were needed in almost 1/5 of children. Mean hospital stay equaled 4.19 ± 1.44 days. Conclusions. We have shown that adenotonsillotomy was the most common procedure in the Department of Paediatric Otorhinolaryngology. Exudative otitis media was the most common concomitant diagnosis, and middle ear ventilation was the most common additional procedure. Hospital stay usually lasted 3 days.

scholarly journals Results of treatment of fifty children with persistent cloaca in one center

2021 ◽  
Vol 11 (3) ◽  
pp. 315-324
Author(s):  
Olga G. Mokrushina ◽  
Vasiliy S. Shumikhin ◽  
Marina V. Levitskaya ◽  
Madina A. Chundokova ◽  
Rashid V. Halafov ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Study Data ◽  
Vaginal Reconstruction ◽  
Anorectal Anomaly ◽  
Persistent Cloaca ◽  
Results Of Treatment ◽  
Individual Planning ◽  
Abdominal Reconstruction ◽  
Radical Reconstruction

BACKGROUND: The preserved cloaca is a particular type of anorectal anomaly. The combination of urological, genital, and rectal abnormalities makes radical reconstruction difficult. MATERIALS AND METHODS: This study examined operations performed in 50 patients with persistent cloaca treated from 2010 to 2021. Two groups are presented: the first with 35 children and a short canal (3 cm), and the second with 15 children and a long canal (3 cm). We examined the prognosis for bowel control, the type of operation, the need for vaginal reconstruction, complications after surgery, and the days of hospital stay. RESULTS: Anomalies of the Mllerian ducts in the second group (94%) were higher than in the first (36%) (p 0.001). The sacral index and myelodysplasia did not differ in both groups. The sacral index in the first group was 0.62 0.14, and in the second group, it was 0.58 0.14 (p = 0.520). Myelodysplasia in the first group was 33%, and in the second group, it was 38% (p = 0.744). Total urogenital mobilization (51%) was used in the first group, and abdominal reconstruction (54%) was used in the second group. Vaginal reconstruction was required in 28% of patients in the first group and 60% in the second group. Complications were 3.5 times more likely in the first group (60% versus 17% in the second) (p = 0.003). The length of hospital stay in patients in the second group was longer than that of patients in the first group. CONCLUSION: Our study data demonstrate that the reconstruction of a persistent cloaca requires individual planning of the operation, considering the length of the canal and the state of all structures forming the cloaca.

scholarly journals Perception on Oral Health and Recommendations for Improvement of Public Service Dental

2019 ◽  
Vol 21 (1) ◽  
pp. 65
Author(s):  
Suzely Adas Saliba Moimaz ◽  
Carlos Ayach ◽  
Léa Lofego ◽  
Cléa Adas Saliba Garbin ◽  
Orlando Saliba
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Health System ◽  
The Self ◽  
Service Improvement ◽  
Health Evaluation ◽  
Self Assessment ◽  
Cross Sectional ◽  
Significance Level ◽  
Unified Health System

A participação social é uma importante ferramenta para o aprimoramento do Sistema Único de Saúde (SUS), fortalece a instituição de processos de avaliação do desempenho e contribui para a ampliação do acesso e qualidade dos serviços prestados. O objetivo foi avaliar a percepção dos usuários sobre a saúde bucal e as recomendações para melhoria do serviço público odontológico. Trata-se de um estudo transversal, tipo inquérito, com 390 usuários do SUS. As variáveis analisadas foram: autoavaliação da saúde bucal; avaliação da equipe e do serviço odontológico prestado. Realizou-se análise qualitativa das questões discursivas e teste estatístico de associação Qui-Quadrado ou Teste G, ao nível de significância de 5%. A autoavaliação da saúde bucal foi categorizada em muito boa/boa, regular, ruim/muito ruim e os motivos identificados da classificação foram: presença de doença, cuidado com a saúde, dor, educação em saúde, negligência com a saúde, tempo e medo. Quanto à avaliação da equipe e do serviço foram feitas sugestões para a melhoria, relacionadas à: infraestrutura, acesso, humanização e educação em saúde. Constatou-se associação significativa entre o cuidado com a saúde e a percepção positiva da saúde bucal. A presença de doença, negligência, tempo e medo influenciaram negativamente na autoavaliação. Como recomendações para melhoria do atendimento, 15,4% dos entrevistados apontou a infraestrutura; 8,2% o acesso; 6,9% a humanização e 1% a educação em saúde. Conclui-se que o cuidado com a saúde foi o fator mais relacionado a uma boa saúde bucal. Houve poucas recomendações para o aprimoramento da qualidade e resolutividade do serviço prestado. Palavras-chave: Avaliação em Saúde. Autoavaliação. Saúde Bucal. Abstract Social participation is an important tool for the improvement of the Brazilian Unified Health System, strengthens the institution of performance evaluation processes and contributes to the expansion of access and quality of services provided. This study evaluated user’s perceptions on oral health and recommendations for improvement of public dental services. This is a cross-sectional study, type inquiry, with 390 users of the Brazilian Unified Health System. The analyzed variables were self-assessment of oral health, evaluation of the team and the dental service provided. A qualitative analysis of the discursive questions was performed and Chi-square or G-test statistical association test, at a significance level of 5%. The self-assessment of oral health was categorized as very good/good, regular, bad/very bad and the identified reasons for the classification were: presence of disease, health care, pain, health education, negligence in health, time and fear. As for team and service evaluation, suggestions for improvement concerning infrastructure, access, humanization and education in health were made. It was found a significant association between health care and positive perception of oral health. The presence of disease, neglect, time and fear  affected negatively the  self-assessment. The recommendations for service improvement, 15.4% interviewed users pointed to infrastructure; 8.2% access; 6.9% humanization and 1% education in health. It is concluded that healthcare was the most frequent factor associated with good oral health. There were few recommendations for quality improvement and outcome of service provided.Keywords: Health Evaluation. Self-Assessment. Oral Health.

Abstract MP093: Clinical Features, Treatment Practices, and Short-term Outcomes of Patients < 55 Years of Age Hospitalized with an Acute Coronary Syndrome: The Global Registry of Acute Coronary Events

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Hamza Awad ◽  
Frederick A Anderson ◽  
Gordon FitzGerald ◽  
Joel Gore ◽  
Robert Goldberg
Keyword(s):  
Acute Coronary Syndrome ◽  
Hospital Stay ◽  
Clinical Features ◽  
Young Patients ◽  
Length Of Hospital Stay ◽  
Hospital Death ◽  
Odds Ratios ◽  
Short Term ◽  
Treatment Practices ◽  
Coronary Syndrome

Limited data are available describing the magnitude, clinical features, treatment practices, and short-term outcomes of comparatively young adults hospitalized with acute coronary syndromes (ACS). The objectives of this large multinational observational study, using data from the GRACE Registry, were to describe nearly decade long trends in these endpoints among adults < 55 years old who were hospitalized with an ACS between 1999 and 2007. The overall proportion of young adult patients in our study population was 23% (n=15,052 of 65,119) and this proportion remained relatively constant over the study years. Baseline demographic and clinical characteristics of our study sample did not change significantly, whereas, the length of hospital stay declined by more than 1 day, on average, during the years under study. The overall in-hospital and 30-day multivariable adjusted case-fatality rates (CFRs) declined by approximately one-third (table) between 1999 and 2007 (crude 30-day CFR= 2.4% in 1999 and 1.7% in 2007). The use of evidence-based cardiac therapies demonstrated to improve outcomes of patients with an ACS increased significantly over time. In conclusion, improving trends in short-term outcomes of comparatively young patients hospitalized with an ACS during the nearly decade long period under study likely reflect enhanced primary and secondary prevention and treatment efforts. Odds of Dying in Younger Patients Hospitalized with an Acute Coronary Syndrome Study Period Crude Odds Ratios of In-Hospital Death Multivariable Adjusted Odds Ratios of In-Hospital Death * Crude Odds Ratios of 30-day Death Multivariable Adjusted Odds Ratios of 30-day Death * 1999-2001º 1.0 1.0 1.0 1.0 2002-2004 0.89 (0.82-0.97) 0.83 (0.76-0.91) 0.93 (0.86-1.0) 0.83 (0.76-0.90) 2005-2007 0.74 (0.67-0.81) 0.66 (0.60-0.74) 0.74 (0.68-0.81) 0.62 (0.57-0.69) * Adjusted for age, sex, length of hospital stay, and medical history ºreferent period

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