scholarly journals Quality indicators of a stroke unit in Curitiba (Paraná)

2021 ◽  
Author(s):  
Camila Lorenzini Tessaro ◽  
Gabriela Ávila Rodbard ◽  
Marianna Yamila Gomes Brassaroto ◽  
Nathália Mitsue Kishi ◽  
Ramon Eduardo Szymczak Conde ◽  
...  
Keyword(s):  
Secondary Prevention ◽  
Quality Indicators ◽  
Stroke Unit ◽  
Intravenous Thrombolysis ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Tertiary Center ◽  
Stroke Center ◽  
Epidemiological Profile

Background: Stroke represents the second leading cause of death and disability in Latin America. Thus, there is a constant need to understand the profile of patients admitted for stroke, as well as to analyze the quality indicators of treatment centers. Objectives: The aim of this study was to analyze the quality indicators of a stroke center in a tertiary service and to determine the epidemiological profile of inpatients. Design and setting: Observational cross- sectional study. Stroke unit from a tertiary center. Methods: The individuals included in the study were those admitted with stroke or TIA in the stroke unit of the Hospital de Clínicas - UFPR from November 2020 to April 2021. The variables and quality indicators were collected through the application of questionnaires in two moments, on admission and hospital discharge. Results: Of the 132 patients included, 53.8% were men, with a mean age of 62.7 years (SD +/- 17.5). Ischemic stroke was the most common type of stroke, accounting for 77.3% of cases. The majority of patients (68.9%) did not receive specific intervention, while 31% underwent intravenous thrombolysis, with a median door-to-needle time of 35 minutes. In 80.4% of the individuals, thrombolysis started in less than 60 minutes. All patients underwent neuroimaging, 87.4% underwent carotid imaging and 77.9% were monitored with Holter. Dysphagia screening was applied in 58.3% of cases. Regarding secondary prevention, 48.1% received antiplatelet drugs and 25.2% received anticoagulants. Conclusions: Intravenous thrombolysis is not performed in most hospitalized patients, however, when performed, it presents an adequate door-to-needle time. Hospitalization in a stroke unit allows a complete etiological investigation and optimization of secondary prevention and rehabilitation.

Perfil Epidemiológico de Pacientes Renais Crônicos em Tratamento Conservador em um Hospital Escola do Sul de Minas/ Epidemiological Profile of Chronic Renal Failure Patients on Conservative Treatment in a Hospital in Southern School of Minas

1970 ◽  
Vol 4 (4) ◽  
pp. 49-60
Author(s):  
Camila Dorilêo Negretti ◽  
Pablo Girardeli Mendonça Mesquita ◽  
Nilo César do Vale Baracho
Keyword(s):  
Diabetes Mellitus ◽  
Conservative Treatment ◽  
Cross Sectional Study ◽  
Age Group ◽  
Sectional Study ◽  
Cross Sectional ◽  
Control Programs ◽  
Keywords Epidemiology ◽  
Epidemiological Profile ◽  
Grade Iii

Objetivo: Determinar o perfil epidemiológico dos pacientes com Doença Renal Crônica em tratamento conservador no ambulatório do Hospital Escola de Itajubá. Materiais e Métodos: Estudo descritivo, de corte transversal, de abordagem quantitativa. Realizado com 171 pacientes atendidos em tratamento conservador no ambulatório de nefrologia no período de janeiro de 2012 a dezembro de 2013. A coleta objetivou caracterizar idade, sexo, raça, estado civil e procedência. Também foram avaliados dados do primeiro atendimento como: valores de ureia e creatinina, o grau de DRC, a etiologia e o número de retorno. Resultados: Dos doentes renais crônicos avaliados, 50,3% eram do sexo masculino, 88% da raça branca, 54,4% casados e a maioria (70,8%) possuía faixa etária prevalente >60 anos. A maioria dos atendidos, 98,5% pertence a microrregião de referência. Quanto a dados de primeira consulta, o diabetes mellitus foi a principal etiologia (38%). Os valores de ureia e creatinina acima da referência preconizada foi observado na maioria dos pacientes e o grau III de DRC em 31% dos casos. O número médio de retornos após a primeira consulta foi de três retornos em 25,13% dos pacientes. Conclusão: A pesquisa permitiu o conhecimento do perfil epidemiológico dos portadores de DRC em tratamento conservador. Os achados reforçam a necessidade de implementação de políticas voltadas para promoção e prevenção à saúde com divulgação de mais programas de controle para minimizar o surgimento de novos casos da DRC. Palavras-chave: Epidemiologia. Doença Renal Crônica. Tratamento. ABSTRACT.Objective: Determine the epidemiological profile of patients with Chronic Kidney Disease (CKD) on conservative treatment at the Hospital Escola de Itajubá. Materials and Methods: A retrospective, descriptive, cross-sectional study of quantitative approach. It was conducted with 171 patients who were treated in conservative treatment at the nephrology clinic from January 2012 to December 2013. The collection aimed to characterize age, sex, race, marital status and origin. We also evaluated data from the first service as: urea and creatinine values, the degree of CKD the etiology and the number of return. Results: Among the chronic renal patients evaluated, 50.3% were male, 88% Caucasian, 54.4% were married and the majority (70.8%) was the most prevalent age group> 60 years. Most of the patients 98.5% belong to micro region of reference. As the first appointment data, diabetes mellitus was the major cause (38%). The urea and creatinine values above the recommended reference was observed in the majority of patients and the DRC grade III in 31% of cases. The average number of returns after the fisrt visit was three return in 25.13% of patients. Conclusion: The research gave us the knowledge of the epidemiological profile of patients with CKD on dialysis. The findings reinforce the need to implement policies for health promotion and prevention with more disclosure of control programs to minimize the appearance of new cases of CKD. Keywords: Epidemiology. Chronic Kidney Disease.Treatment.

scholarly journals The impact of COVID-19 pandemic on training and mental health of residents: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eman Alshdaifat ◽  
Amer Sindiani ◽  
Wasim Khasawneh ◽  
Omar Abu-Azzam ◽  
Aref Qarqash ◽  
...  
Keyword(s):  
Mental Health ◽  
Residency Training ◽  
Training Programs ◽  
Cross Sectional Study ◽  
Protective Equipment ◽  
Sectional Study ◽  
Cross Sectional ◽  
Surgical Residents ◽  
Tertiary Center ◽  
The Impact

Abstract Background Residency programs have been impacted by the Coronavirus disease 2019 (COVID-19) pandemic. In this study we aim to investigate and evaluate the impact of the pandemic on residents as well as residency training programs. Methods This was a cross-sectional study including a survey of 43 questions prepared on Google forms and electronically distributed among a convenience sample of residents training at a tertiary center in North Jordan during the COVID-19 pandemic. Data were collected in the period between October 30th and November 8th of 2020. The survey included questions that addressed the impact of the pandemic on residents’ health as well as training programs. The study participants included residents in training at KAUH in 2020 and were stratified according to the type of residency program (surgical residents (SRs) and non-surgical residents (NSRs)). Statistical methods included descriptive analysis, Chi-square or Fisher’s exact test, Mann Whitney U test, and Cramer’s V and r statistics as measures of effect sizes. Results Of all 430 residents, 255 (59%) responded to the survey. A total of 17 (7%) of residents reported being infected with COVID-19 and a significant difference was reported between SRs and NSRs (10% vs 4%, V = .124 “small effect” (95% CI; .017–.229), p = 0.048). Approximately, 106 (42%) reported a decrease in the number of staff working at the clinic and 164 (64%) reported limited access to personal protective equipment during the pandemic. On a 4-point Likert scale for the feeling of anxiety, the median was 2 (2–3 IQR) in the NSRs group, vs 2 (1–2 IQR) in the SRs groups, with the NSRs being more likely to feel anxious (r = 0.13 “small effect” (95% CI; 0.007–0.249), p = .044). Similarly, the proportion of residents who reported feeling anxious about an inadequacy of protective equipment in the work area was significantly greater in the NSRs group (90.3% vs 75.2%; V = .201 “small effect” (95% CI; .078–.313), p = .001), as well as the proportion of residents who reported feeling increased stress and anxiety between colleagues being also significantly higher in the NSRs group (88.1% vs 76%; V = .158 “small effect” (95% CI; .032–.279), p = .012). Conclusion The burden of the ongoing pandemic on the mental health status of residents is very alarming and so providing residents with psychological counseling and support is needed. Also, critical implications on the flow of residency training programs have been noticed. This necessitates adapting and adopting smart educational techniques to compensate for such limitations.

scholarly journals Pilot epidemiological study of cleft lip and/or palate inh Kota Kinabalu, Sabah

2013 ◽  
Vol 4 (3) ◽  
pp. 86-91
Author(s):  
Chai Siew Cheng ◽  
SKL Jimeno ◽  
R Sasidaran ◽  
A Sergius
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cross Sectional Study ◽  
Queen Elizabeth Hospital ◽  
Sectional Study ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Tertiary Center ◽  
Secondary Palate ◽  
Male Patients

Objective: To identify number of cases and the type of cleft lip and/or palate managed in government tertiary center (Queen Elizabeth Hospital) in Kota Kinabalu; and to analyze the associative factors of cleft lip and/or palate. Methods: A retrospective cross-sectional study carried out in Hospital Queen Elizabeth, Kota Kinabalu, Sabah from January 2011 to December 2012. Data from 162 new cases, which were referred for cleft lip and/or palate, were included in the study. Result: Cleft lip and palate was the most common type. While cleft lip with or without palate had higher preponderance towards male patients, secondary palate however was more common among female patients. These results were statistically significant. Conclusion: Further and larger scale study need to be carried out to identify the incidence of cleft lip and/or palate in Sabah, and its associated genetic and environmental risk factors. Early identification and intervention for cleft lip and palate need to be emphasized. DOI: http://dx.doi.org/10.3126/ajms.v4i3.8170   Asian Journal of Medical Sciences 4(2013) 86-91

Prevalence and Associated Factors of Sarcopenia and Frailty in Parkinson’s Disease: A Cross-Sectional Study

Gerontology ◽  
2018 ◽  
Vol 65 (3) ◽  
pp. 216-228 ◽  
Author(s):  
Marina Peball ◽  
Philipp Mahlknecht ◽  
Mario Werkmann ◽  
Kathrin Marini ◽  
Franziska Murr ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Population Based ◽  
Cross Sectional Study ◽  
Prevalence Rates ◽  
Sectional Study ◽  
Cross Sectional ◽  
Tertiary Center

Background: Sarcopenia and frailty are found in up to one-third of the general elderly population. Both are associated with major adverse health outcomes such as nursing home placement, disability, decreased quality of life, and death. Data on the frequency of both syndromes in Parkinson’s disease (PD), however, are very limited. Objective: We aimed to screen for sarcopenia and frailty in PD patients and to assess potential associations of both geriatric syndromes with demographic and clinical parameters as well as quality of life. Methods: In this observational, cross-sectional study, we included 104 PD patients from a tertiary center and 330 non-PD controls from a population-based cohort aged > 65 years. All groups were screened for sarcopenia using the SARC-F score and for frailty using the Clinical Frailty Scale of the Canadian Study of Health and Aging (CSHA CFS). Prevalence rates of sarcopenia and frailty were also assessed in 18 PD patients from a population-based cohort aged > 65 years. Moreover, PD patients from the tertiary center were evaluated for motor and non-motor symptoms, quality of life, and dependency. Results: The prevalence of sarcopenia was 55.8% (95% CI: 46.2–64.9%) in PD patients from the tertiary center and 8.2% (5.7–11.7%; p < 0.001) in non-PD controls. Frailty was detected in 35.6% (27.0–45.2%) and 5.2% (3.2–8.1%; p < 0.001). Prevalence rates for sarcopenia and frailty were 33.3% (16.1–56.4%; p = 0.004) and 22.2% (8.5–45.8%; p = 0.017) in the community-based PD sample. Both sarcopenia and frailty were significantly associated with longer disease duration, higher motor impairment, higher Hoehn and Yahr stages, decreased quality of life, higher frequency of falls, a higher non-motor symptom burden, institutionalization, and higher care levels in PD patients from a tertiary center compared to not affected PD patients (all p < 0.05). Conclusions: Both frailty and sarcopenia are more common in PD patients than in the general community and are associated with a more adverse course of the disease. Future studies should look into underlying risk factors for the occurrence of sarcopenia and frailty in PD patients and into adequate management to prevent and mitigate them.

scholarly journals Using quality indicators to predict inspection ratings: cross-sectional study of general practices in England

2019 ◽  
Vol 70 (690) ◽  
pp. e55-e63 ◽  
Author(s):  
Thomas Allen ◽  
Kieran Walshe ◽  
Nathan Proudlove ◽  
Matt Sutton
Keyword(s):  
General Practice ◽  
Quality Indicators ◽  
Predictive Power ◽  
Predictive Accuracy ◽  
Cross Sectional Study ◽  
Care Quality ◽  
Sectional Study ◽  
Validity And Reliability ◽  
Cross Sectional ◽  
Logistic Regression Models

BackgroundThe Care Quality Commission regulates, inspects, and rates general practice providers in England. Inspections are costly and infrequent, and are supplemented by a system of routine quality indicators, measuring patient satisfaction and the management of chronic conditions. These indicators can be used to prioritise or target inspections.AimTo determine whether this set of indicators can be used to predict the ratings awarded in subsequent inspections.Design and settingThis cross-sectional study was conducted using a dataset of 6860 general practice providers in England.MethodThe indicators and first-inspection ratings were used to build ordered logistic regression models to predict inspection outcomes on the four-level rating system (‘outstanding’, ‘good’, ‘requires improvement’, and ‘inadequate’) for domain ratings and the ‘overall’ rating. Predictive accuracy was assessed using the percentage of correct predictions and a measure of agreement (weighted κ).ResultsThe model correctly predicted 79.7% of the ‘overall’ practice ratings. However, 78.8% of all practices were rated ‘good’ on ‘overall’, and the weighted κ measure of agreement was very low (0.097); as such, predictions were little more than chance. This lack of predictive power was also found for each of the individual domain ratings.ConclusionThe poor power of performance of these indicators to predict subsequent inspection ratings may call into question the validity and reliability of the indicators, inspection ratings, or both. A number of changes to the way data relating to performance indicators are collected and used are suggested to improve the predictive value of indicators. It is also recommended that assessments of predictive power be undertaken prospectively when sets of indicators are being designed and selected by regulators.

scholarly journals The association between animal flesh foods consumption and semen parameters among infertile Iranian men: a cross-sectional study

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Reza Ghiasvand ◽  
Laleh Dehghan Marvast ◽  
Seyyed Payam Shariatpanahi ◽  
Makan Pourmasoumi ◽  
Cain C. T. Clark ◽  
...  
Keyword(s):  
Quality Indicators ◽  
Semen Quality ◽  
Cross Sectional Study ◽  
Red Meat ◽  
Fish Intake ◽  
Sectional Study ◽  
Cross Sectional ◽  
Fresh Fish ◽  
Infertile Men ◽  
Canned Fish

Abstract Background Previous studies have demonstrated the association between dietary patterns and semen quality indicators, but research on the possible association between animal flesh foods consumption and semen quality is limited. Therefore, this study was conducted to investigate the association between animal flesh foods consumption with semen quality. Methods In this cross-sectional study, 400 newly-identified (< 6 months) infertile men, as diagnosed by an andrologist, were recruited into the study. Dietary intake was assessed by using a semiquantitative Food Frequency Questionnaire. The total meat consumption was defined as the sum of red meat, poultry, fresh fish, canned fish, processed meats, and organ meats in the diet. A linear mixed model was used to assess the relationship between meat consumption and semen quality indicators of participants. Results Consumption of canned fish was inversely related to sperm immotility. Compared with the men in the lowest quartile of canned fish intake, those in the highest quartile had a lower sperm immotility [lowest quartile: 52.5%; (95% CI: 47–57) vs 47.4%; (95% CI: 43–51) P-trend = 0.026]. Similarly, a trend toward an inverse significant association between fresh fish intake and sperm immotility was observed (P-trend = 0.074). In contrast, fresh and canned fish intake was unrelated to other outcomes of sperm quality (P-trend > 0.05). No association was found between consumption of processed red meat, red meat, poultry, and organ meat, and semen quality indicators (P-trend > 0.05). Conclusions We found that consumption of canned fish is associated with a lower percentage of immotile sperm, whilst a high consumption of fresh fish increased the percentage of immotile sperm in Iranian infertile men. Further studies are recommended in this regard.

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