Caracterização das lesões por pressão em adultos portadores de germes multirresistentes

Objetivo: Describir las características de las lesiones por presión en pacientes adultos con gérmenes multirresistentes.Método: Este es un estudio transversal realizado con pacientes hospitalizados en la unidad de pacientes hospitalizados por gérmenes resistentes a múltiples fármacos de un hospital público en el sur de Brasil. Se seleccionaron pacientes con lesión por presión del estadio II. Los datos se recopilaron en 2017 de una muestra de 110 lesiones en 36 pacientes utilizando la Herramienta de evaluación de heridas Bates-Jensen (BWAT). Los datos se analizaron mediante estadísticas descriptivas y analíticas. Resultados: La edad promedio de los individuos fue de 45.4 (± 21.3) años y el 89.1% había sido hospitalizado con una lesión por presión, que ocurrió en el hogar o en otras instituciones de salud. El valor medio de BWAT fue de 35.5 ± 8.9 puntos y hubo una correlación positiva débil (r = 0.228 p = 0.017) con el tamaño de la lesión, correlación positiva moderada con el estadio de la lesión (r = 540 p <0.001). y con el resultado de la escala de Braden (r = 0.44 p = 0.651).Conclusión: Los resultados muestran la enfermedad de pacientes jóvenes. Los pacientes con gérmenes multirresistentes presentaron lesiones por presión con una mayor participación de las estructuras, lo que sugiere la necesidad de apoyo en el hogar. Objective: To describe the characteristics of the pressure lesions in adult patients with multiresistant germs.Method: This is a cross-sectional study conducted with patients admitted to the inpatient unit for multidrug resistant germs in a public hospital in Brazil. Patients with pressure lesions from stage II were selected. Data collection took place in 2017, in a sample of 110 injuries, in patients, through the Pressure Ulcer State Assessment Instrument (Bates-Jensen Wound Assessment Tool - BWAT). Results: The average age of the individuals was 45.4 (± 21.3) years old and 89.1% had already suffered pressure lesions, such as those that occurred at home or in other health institutions. The mean BWAT value was 35.5 ± 8.9 points and there was a weak positive correlation (r = 0.228 p = 0.017) with lesion size, moderate positive correlation with lesion stage (r = 540 p <0.001), and with the result of the Braden scale (r = 0.44 p = 0.651).Conclusion: The results indicated the illness of young patients. Patients with multiresistant germs suffered pressure lesions with greater involvement of structures, which suggests the need for home support.

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Adolescent Humour and Its Relationship with Psychological Adjustment

National Journal of Professional Social Work ◽

10.51333/njpsw.2020.v21.i1.246 ◽

2020 ◽

Vol 21 (1) ◽

pp. 40

Author(s):

Abhijeet Singh ◽

Arif Ali ◽

Maria Choudhary ◽

Rini Gogoi ◽

Nilesh Maruti Gujar

Keyword(s):

Psychological Adjustment ◽

Psychosocial Adjustment ◽

Social Behaviour ◽

Significant Positive Correlation ◽

Significant Negative Correlation ◽

Cross Sectional Study ◽

Assessment Instrument ◽

Cross Sectional ◽

Positive Correlation ◽

Difficulty Score

Background: Adolescence is a transition phase towards adulthood. There is a correlation between humour and psychosocial adjustment. Aim: To assess the level of humour among adolescents and to see its relationships with their general psychological adjustment. Methods and Materials: The present study is a cross-sectional study. Convenience sampling was used to select the school and total enumeration method was used for the selection of the respondents (school-going adolescent). School going adolescents between the ages of 13-17 years were included. They were assessed with their consent using a Socio-demographic Datasheet, Richmond Humour Assessment Instrument, Beck Depression Inventory, Interaction Anxiousness Scale, Strength and Difficulty Questionnaire, Academic Expectation Stress Inventory and Rosenberg self-esteem scale. Results: Humour has a significant negative correlation with the emotional problems and significant positive correlation with pro-social behaviour and total difficulty score. Moreover, it was found that humour has a significant positive correlation with self-efficacy. In regression analysis, it was found that conduct problems and pro-social behaviour contribute significantly to the prediction of humour among adolescents; though, accounting only for 1.08% variance. Remaining 98.9% was attributed to a variable not included in the study. Conclusion: Humour can lead to an improvement in psychological adjustment among adolescent.

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Can Cytokines be used as an Activation Marker in Rheumatoid Arthritis?

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530320666201019115030 ◽

2020 ◽

Vol 20 ◽

Author(s):

Fatih Öner Kaya ◽

Yeşim Ceylaner ◽

Belkız Öngen İpek ◽

Zeynep Güneş Özünal ◽

Gülbüz Sezgin ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Healthy Volunteers ◽

Venous Blood ◽

Cross Sectional Study ◽

Joint Disease ◽

Control Group ◽

Cross Sectional ◽

Positive Correlation ◽

Das 28 ◽

Tnf Α

Aims: The etiopathogenesis of Rheumatoid Arthritis (RA) is not clearly understood. However, the role of the cytokines takes an important part in this mechanism. We aimed to bring a new approach to the concept of 'remission' in patients with RA. Background: RA is a chronic, autoimmune, inflammatory disease that involves small joints in the form of symmetrical polyarthritis and progresses with exacerbations and remissions. Pain, swelling, tenderness and morning stiffness are typical of the joints involved. Although it is approached as a primary joint disease, a wide variety of extra-articular involvements may also occur. It is an interesting pathophysiological process, the exact cause of which is still unknown, with many environmental, genetic and potentially undiscovered possible factors in a chaotic manner. Objective: In this cross-sectional study, sedimentation rate (ESR), C- Reactive protein (CRP), Tumor necrosis factor (TNF)-α, soluble-TNF-α receptor (TNF-R), Interleukin (IL)-1B and IL-10 were measured in three groups which were healthy volunteers, patients with RA in the active period, and patients with RA in remission. Disease activity score-28 (DAS-28) was calculated in active RA and RA in remission. Methods: This study included 20 healthy volunteers, 20 remission patients with RA and 20 active RA patients. Venous blood samples were collected from patients in both healthy and RA groups. Results: RA group consisted 43 (71.6%) female and 17 (28.4%) male. Control group consisted 11 (55%) female and 9 (45%) male. TNF-R was significantly high only in the active group according to the healthy group (p=0.002). IL-10 was significantly high in active RA according to RA in remission (p=0.03). DAS-28 was significantly high in active RA according to RA in remission (p=0.001). In the active RA group, ESR and TNF-R had a positive correlation (r:0.442; p=0.048). In the active RA group, there was also a positive correlation between TNF-R and CRP (r:0.621; p=0,003). Both healthy and active RA group had significant positive correlation between ESR and CRP (r: 0.481; p=0.032 and r: 0,697; p=0,001 respectively). Conclusion: TNF-R can be the main pathophysiological factor and a marker showing activation. TNF-R can be very important in revealing the effect of TNF on the disease and the value of this effect in the treatment and ensuring the follow-up of the disease with CRP instead of ESR in activation.

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Desigualdade social em doentes renais crônicos/ Social inequality in chronic renal patients

REVISTA CIÊNCIAS EM SAÚDE ◽

10.21876/rcsfmit.v1i1.16 ◽

1970 ◽

Vol 1 (1) ◽

pp. 44-49

Author(s):

Beatriz Bertolaccini Martínez ◽

Fernanda Marcelino Da Silva ◽

Vinícius Tavares Veiga ◽

Rodrigo Pereira Custódio ◽

José Vítor Da Silva

Keyword(s):

Social Inequality ◽

Access To Health Care ◽

Young Patients ◽

Cross Sectional Study ◽

Access To Health Services ◽

Access To Treatment ◽

Cross Sectional ◽

Economic Class ◽

Access To Health ◽

Clinical Background

Introdução: A pobreza influencia na evolução dos pacientes com doenças crônicas, porque contribui para o seu agravamento e dificulta o acesso à assistência médica. O objetivo deste trabalho foi avaliar os aspectos relacionados à desigualdade social de pacientes em hemodiálise. Métodos: Estudo transversal com 123 pacientes em hemodiálise no Hospital Samuel Libânio – Pouso Alegre, MG, divididos, de acordo com a classe econômica, em 3 grupos: AB (n=23), C (n=60) e DE (n=40),. Foram coletados dados sociodemográficos e econômicos, antecedentes clínicos e informações sobre o acesso a serviços de saúde. Para a análise dos resultados, foi utilizada estatística analítica e descritiva. Adotou-se p £ 0,05. Resultados: O grupo AB apresentou um menor número de pacientes jovens (4,3% em AB vs 40% em C e 25% em DE, p < 0,05), um maior número de indivíduos com mais anos de escolaridade (65,3% em AB vs 18,3% em C e 2,5% em DE; p < 0,05), predomínio de pacientes com menos de um ano em tratamento de hemodiálise (65,2% em AB vs 10% em C e 5% em DE, p < 0,05), menor número de usuários do SUS (40% em C e 25% em DE vs 4,3% em AB; p < 0,05) e maior acesso ao tratamento com nefrologista (73,9% em AB vs 46,7% em C e 52,5 em DE; p < 0,05). Conclusão: Classes economicamente desfavorecidas agregam indivíduos mais jovens, com menor escolaridade, usuários do SUS, com maior tempo em hemodiálise e pior acesso ao tratamento com nefrologista.Introduction: The poverty influence on the evolution of patients with chronic diseases because it contributes to your aggravation and hinders access to health care. Our goal was to evaluate the aspects related to social inequality on hemodialysis patients. Methods: cross-sectional study with 123 patients on hemodialysis in Samuel Libânio Hospital – Pouso Alegre, MG, divided according to the economic class, into 3 groups: AB (n = 23), C (n = 60) and DE (n = 40). Were collected socio-demographic and economic data, clinical background and information about access to health services. For analysis of the results has been used statistical analytical and descriptive. We take p £ 0,05. Results: The AB group has fewer young patients (4,3% in AB vs 40% in C and 25% in DE, p< 0,05), a greater number of individuals with more years of schooling (65,3% in AB vs 18,3% in C and 2,5% in DE; p< 0,05), predominance of patients with less than a year on haemodialysis treatment (65,2% in AB vs 10% in C and 5% in DE, p< 0,05), smaller number of users of SUS (40% in C and 25% in DE vs 4,3% in AB; p< 0,05), greater access to treatment with nephrologist (73,9% in AB vs 46,7% in C and 52,5% in DE; p< 0,05). Conclusion: Economically disadvantaged classes bring younger patients, with less schooling, users of SUS, patients with greater time on hemodialysis and worse access to treatment with nephrologist.

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Prevalence of Enterobacteriaceae spp. and its multidrug-resistant rates in clinical isolates: A two-center cross-sectional study

Molecular Biology Reports ◽

10.1007/s11033-020-06114-x ◽

2021 ◽

Author(s):

Bahman Mirzaei ◽

Ryhane Babaei ◽

Zahra Norouzi Bazgir ◽

Hamid Reza Goli ◽

Shima Keshavarzi ◽

...

Keyword(s):

Multidrug Resistant ◽

Cross Sectional Study ◽

Clinical Isolates ◽

Sectional Study ◽

Cross Sectional

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Frequent neurocognitive deficits after recovery from mild COVID-19

Brain Communications ◽

10.1093/braincomms/fcaa205 ◽

2020 ◽

Vol 2 (2) ◽

Author(s):

Marcel S Woo ◽

Jakob Malsy ◽

Jana Pöttgen ◽

Susan Seddiq Zai ◽

Friederike Ufer ◽

...

Keyword(s):

Short Term Memory ◽

Telephone Interview ◽

Acute Infection ◽

Young Patients ◽

Cross Sectional Study ◽

Cognitive Status ◽

Neurocognitive Deficits ◽

Cross Sectional ◽

Neuropsychiatric Complications ◽

Moderate Disease

Abstract Neuropsychiatric complications associated with coronavirus disease 2019 caused by the Coronavirus SARS-CoV-2 (COVID-19) are increasingly appreciated. While most studies have focussed on severely affected individuals during acute infection, it remains unclear whether mild COVID-19 results in neurocognitive deficits in young patients. Here, we established a screening approach to detect cognitive deficiencies in post-COVID-19 patients. In this cross-sectional study, we recruited 18 mostly young patients 20–105 days (median, 85 days) after recovery from mild to moderate disease who visited our outpatient clinic for post-COVID-19 care. Notably, 14 (78%) patients reported sustained mild cognitive deficits and performed worse in the Modified Telephone Interview for Cognitive Status screening test for mild cognitive impairment compared to 10 age-matched healthy controls. While short-term memory, attention and concentration were particularly affected by COVID-19, screening results did not correlate with hospitalization, treatment, viremia or acute inflammation. Additionally, Modified Telephone Interview for Cognitive Status scores did not correlate with depressed mood or fatigue. In two severely affected patients, we excluded structural or other inflammatory causes by magnetic resonance imaging, serum and cerebrospinal fluid analyses. Together, our results demonstrate that sustained sub-clinical cognitive impairments might be a common complication after recovery from COVID-19 in young adults, regardless of clinical course that were unmasked by our diagnostic approach.

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Beijing Friendship Hospital Osteoporosis Self-Assessment Tool for Elderly Male (BFH-OSTM) vs Fracture Risk Assessment Tool (FRAX) for identifying painful new osteoporotic vertebral fractures in older Chinese men: a cross-sectional study

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04476-2 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Ning An ◽

Ji Sheng Lin ◽

Qi Fei

Keyword(s):

Assessment Tool ◽

Roc Curves ◽

Cross Sectional Study ◽

Self Assessment ◽

Cross Sectional ◽

Fracture Group ◽

Friendship Hospital ◽

Fracture Risk Assessment Tool ◽

Older Chinese ◽

Sensitivity Specificity

Abstract Background To compare the validation of four tools for identifying painful new osteoporotic vertebral compression fractures (PNOVCFs) in older Chinese men: bone mineral density (BMD), Asian osteoporosis self-assessment tool (OSTA), World Health Organization fracture risk assessment tool (FRAX) (without BMD) and Beijing Friendship Hospital Osteoporosis Self-Assessment Tool (BFH-OSTM). Methods A cross sectional study was conducted from 2013 to 2019. A total of 846 men aged ≥50 were included and were divided into two groups: Fracture Group (patients with PNOVCFs underwent percutaneous vertebroplasty surgery) and Non-Fracture Group (community dwelled subjects for healthy examination). All subjects accepted a dual-energy X-ray BMD test and a structured questionnaire. The results of BMD, OSTA, FRAX and BFH-OSTM scores were assessed and receiver-operating characteristic (ROC) curves were generated to compare the validity of four tools for identifying PNOVCFs. Optimal cutoff points, sensitivity, specificity, and areas under the ROC curves (AUCs) were determined. Results There were significant differences including BMD T score (femoral neck, total hip and L1-L4), OSTA, FRAX and BFH-OSTM scores between Fracture group and Non-fracture group. Compared to BMD and OSTA, BFH-OSTM and FRAX had better predictive value, the sensitivity, specificity and AUC value are 0.841, 81.29%, 70.67% and 0.796, 74.85%, 78.52%, respectively. Compared with FRAX, the BFH-OSTM has a better AUC value. Conclusions Both BFH-OSTM and FRAX can be used to identify POVCFs, However, BFH-OSTM model may be a more simple and effective tool to identify the risk of POVCFs in Chinese elderly men.

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Influence ofABCC2andABCC4Polymorphisms on Tenofovir Plasma Concentrations in Thai HIV-Infected Patients

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.04930-14 ◽

2015 ◽

Vol 59 (6) ◽

pp. 3240-3245 ◽

Cited By ~ 26

Author(s):

Kanokrat Rungtivasuwan ◽

Anchalee Avihingsanon ◽

Narukjaporn Thammajaruk ◽

Siwaporn Mitruk ◽

David M. Burger ◽

...

Keyword(s):

Body Weight ◽

Multivariate Analysis ◽

Plasma Concentration ◽

Protease Inhibitors ◽

Demographic Data ◽

Plasma Concentrations ◽

Multidrug Resistant ◽

Cross Sectional Study ◽

Cross Sectional ◽

The Mean

ABSTRACTTenofovir (TFV) is eliminated by renal excretion, which is mediated through multidrug-resistant protein 2 (MRP2) and MRP4, encoded byABCC2andABCC4, respectively. Genetic polymorphisms of these transporters may affect the plasma concentrations of tenofovir. Therefore, the aim of this study was to investigate the influence of genetic and nongenetic factors on tenofovir plasma concentrations. A cross-sectional study was performed in Thai HIV-infected patients aged ≥18 years who had been receiving tenofovir disoproxil fumarate at 300 mg once daily for at least 6 months. A middose tenofovir plasma concentration was obtained. Multivariate analysis was performed to investigate whether there was an association between tenofovir plasma concentrations and demographic data, including age, sex, body weight, estimated glomerular filtration rate (eGFR), hepatitis B virus coinfection, hepatitis C virus coinfection, duration of tenofovir treatment, concomitant use of ritonavir-boosted protease inhibitors, and polymorphisms ofABCC2andABCC4. A total of 150 Thai HIV-infected patients were included. The mean age of the patients was 43.9 ± 7.2 years. The mean tenofovir plasma concentration was 100.3 ± 52.7 ng/ml. In multivariate analysis, a low body weight, a low eGFR, the concomitant use of ritonavir-boosted protease inhibitors, and theABCC44131T → G variation (genotype TG or GG) were independently associated with higher tenofovir plasma concentrations. After adjusting for weight, eGFR, and the concomitant use of ritonavir-boosted protease inhibitors, a 30% increase in the mean tenofovir plasma concentration was observed in patients having theABCC44131 TG or GG genotype. Both genetic and nongenetic factors affect tenofovir plasma concentrations. These factors should be considered when adjusting tenofovir dosage regimens to ensure the efficacy and safety of a drug. (This study has been registered at ClinicalTrials.gov under registration no. NCT01138241.)

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The importance of dysphagia screening and nutritional assessment in hospitalized patients

Einstein (São Paulo) ◽

10.1590/s1679-45082018ao4189 ◽

2018 ◽

Vol 16 (2) ◽

Cited By ~ 5

Author(s):

Patrícia Amaro Andrade ◽

Carolina Araújo dos Santos ◽

Heloísa Helena Firmino ◽

Carla de Oliveira Barbosa Rosa

Keyword(s):

Nutritional Status ◽

Global Assessment ◽

Assessment Tool ◽

Nutritional Assessment ◽

Cross Sectional Study ◽

Hospitalized Patients ◽

The Body ◽

Subjective Global Assessment ◽

Cross Sectional ◽

Knee Height

ABSTRACT Objective: To determine frequency of dysphagia risk and associated factors in hospitalized patients as well as to evaluate nutritional status by using different methods and correlate the status with scores of the Eating Assessment Tool (EAT-10). Methods: This was a cross-sectional study including 909 inpatients of a philanthropic hospital. For the diagnosis of dysphagia we used an adapted and validated Brazilian version of the Eating Assessment Tool (EAT-10). The nutritional status was evaluated through the subjective global assessment, and anthropometric measurements included weight, calf and arm circumference, and knee height. The Mann-Whitney test, associations using the Pearson’s χ2 and Spearman’s correlation were used to verify differences between the groups. Results: The prevalence of dysphagia risk was 10.5%, and aging was the associated factor with this condition. Patients at risk presented lower values of arm and calf circumference, variables that correlated inversely with the Eating Assessment Tool (EAT-10) score. Malnutrition was observed in 13.2% of patients based on the subjective global assessment and in 15.2% based on the Body Mass Index. Conclusion: Screening for dysphagia and malnutrition should be introduced in hospitals routine to avoid or minimize damages caused by dysphagia or malnutrition, especially among older people.

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OSCE: An Effective Tool of Assessment for Medical Students

10.53350/pjmhs211582235 ◽

2021 ◽

Vol 15 (8) ◽

pp. 2235-2239

Author(s):

Farrukh Sarfraz ◽

Fahad Sarfraz ◽

Imran Jawad ◽

Mohammad Zia-Ul-Miraj ◽

Rizwan Zafar Ahmad ◽

...

Keyword(s):

Medical Students ◽

Time Allocation ◽

Assessment Tool ◽

Clinical Skills ◽

Cross Sectional Study ◽

Cross Sectional ◽

Clinical Competencies ◽

Medical College ◽

Data Collection Procedure

Background: To assess the competency of a student different tools are used. Since its introduction in 1975 by Dr. Harden and his team, OSCE has gained tremendous strides to assess the clinical competencies. Since 1975 onward OSCE has been very successfully used to assess the clinical competencies of medical student globally. OSCE is an assessment tool in which student is observed for performance of different tasks at specified stations. In the current study perception of medical students about OSCE examination was done which shall give room for positive criticism and further improvement of the system where ever required. Objective: To expedite view of final year MBBS students of Azra Naheed College about OSCE Material and Method Study design: Quantitative, cross sectional study. Settings: Azra Naheed College, Lahore. Duration: Six months i.e. 1st July2020 to 31st December 2020 Data Collection procedure: After an informed consent and appropriate briefing, the questionnaire was distributed among the final year medical students of Azra Naheed Medical College. Questionnaire developed by Russell et al was used. Results: Out of 148 students who participated in the study, 66(45%) students were females and 82(55%) were male. Majority of the students were satisfied with the quality of the exam. Consensus about the quality of exam was that, 29.7% were aware about the nature of the exam, 52.7% were satisfied that the syllabus taught was asked in the exam, 58.1% were satisfied about the time allocation for each station. Majority i.e. 60% considered OSCE an exam of practical nature which is not biased by gender or ethnicity. More than 50% of the students were satisfied with the standard of the exam. At the same time more than 50% students considered essay exam the easiest format of assessment. However, OSCE was considered to be fairest form of assessment 73%. 68.9% perceived that learning is enhanced by MCQs rather than other formats of assessment. Conclusion: To conclude this study, it is very much clear that the perception of students about OSCE as an assessment tool was very encouraging, as it not only provided them the opportunity to highlight their weaknesses but also helped them to perform well in the exam, manage time during exam and to overcome them stress which influenced their results. Key words: OSCE, Objective, Examinations, Clinical skills, qualitative analysis

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Effect of family practice contract services on the quality of primary care in Guangzhou, China: a cross-sectional study using PCAT-AE

BMJ Open ◽

10.1136/bmjopen-2017-021317 ◽

2018 ◽

Vol 8 (11) ◽

pp. e021317 ◽

Cited By ~ 8

Author(s):

Lina Li ◽

Chenwen Zhong ◽

Jie Mei ◽

Yuan Liang ◽

Li Li ◽

...

Keyword(s):

Primary Care ◽

Family Practice ◽

Assessment Tool ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Quality Of Primary Care ◽

Care Assessment ◽

First Contact

ObjectiveCurrent healthcare reform in China has an overall goal of strengthening primary care and establishing a family practice system based on contract services. The objective of this study was to determine whether contracting a general practitioner (GP) could improve quality of primary care.DesignA cross-sectional study using two-stage sampling conducted from June to September 2014. Propensity score matching (PSM) was employed to control for confounding between patients with and without contracted GP.SettingThree community health centres in Guangzhou, China.Participants698 patients aged 18–89 years.Main outcome measuresThe quality of primary care was measured using a validated Chinese version of primary care assessment tool (PCAT). Eight domains are included (first contact utilisation, accessibility, continuity, comprehensiveness, coordination, family-centredness, community orientation and cultural competence from patient’s perceptions).ResultsA total of 692 effective samples were included for data analysis. After PSM, 94 pairs of patients were matched between the patients with and without contracted GPs. The total PCAT score, continuity (3.12 vs 2.68, p<0.01), comprehensiveness (2.31 vs 2.04, p<0.01) and family-centredness (2.11 vs 1.79, p<0.01) were higher in patients who contracted GPs than those did not. However, the domains of first contact utilisation (2.74 vs 2.87, p=0.14) and coordination (1.76 vs 1.93, p<0.05) were lower among patients contracted with GPs than in those who did not.ConclusionOur findings demonstrated that patients who had a contracted GP tend to experience higher quality of primary care. Our study provided evidence for health policies aiming to promote the implementation of family practice contract services. Our results also highlight further emphases on the features of primary care, first contact services and coordination services in particular.

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