PROFILE OF PATIENTS WITH URINARY INCONTINENCE IN A UNIVERSITY HOSPITAL OUTPATIENT CLINIC

Objective: to know the sociodemographic and clinical profile of people with urinary incontinence in an outpatient clinic of a University Hospital. Methods: cross-sectional study, using a semi-structured form with 63 women whowere awaiting care at the gynecology and urology outpatient clinics, between the months of July and August 2019. The data were processed in the software Statistical Package for the Social Sciences – SPSS 20.0. Results: interviews were carried out with women aged between 19 and 77 years. Of these, 55.6% maintained an active sex life; 85.7% had pre-existing disease; 69.8% presented urinary loss when coughing, sneezing, smiling, putting on weight and/or making efforts; 12.7% need to urinate as soon as they feel like it; and 17.5% had loss of urine in both situations. About 35% sought consultation due to low bladder and/or loss of urine; 27% had 4 to 5 pregnancies. Among the risk factors associated with urinary incontinence, 28.6% had diabetes mellitus, 61.9% had arterial hypertension, 82.5% used continuous medication, 11.1% was obese, 34.9% reported constipation problems and 74.6% underwent pelvic surgery. Conclusion: it was concluded that all women in the study had more than one risk factor for developing urinary incontinence, reinforcing their multifactoriality, as well as the importance of a holistic and multiprofessional treatment.

Effectiveness of A 24-h Access Outpatient Clinic for Patients with Chronic Conditions in Hospital Outpatient Follow-Up: A Registry-Based Controlled Cohort Study of Healthcare Utilisation and Mortality

Background: In 2015, Regional Hospital Silkeborg in Denmark introduced a 24-h telephone access hospital outpatient clinic (24-h access clinic). The 24-h access clinic allowed patients to call the hospital outpatient clinic in case of an exacerbation of symptoms. The aim of this study was to evaluate the effectiveness of a 24-h access clinic in terms of healthcare utilisation and mortality in patients with chronic conditions.Methods: This study was designed as a registry-based controlled cohort study. The 24-h access clinic was established at Silkeborg Regional Hospital in Central Denmark Region, and the five other regional hospitals served as comparison hospitals. We included patients in hospital outpatient follow-up with chronic obstructive pulmonary disease, congestive heart failure, atrial fibrillation/flutter, inflammatory bowel disease and chronic liver disease. Outcomes were hospital admissions, length of stay (LOS), intensive care unit assistance and outpatient visits, contacts to general practice, municipal home nursing and all-cause mortality. Follow-up was 18 months.Results: The study included 992 24-h access patients and 3,878 usual care patients. For the five conditions combined, the 24-h access patients had fewer all-cause admissions (incidence rate ratio (IRR) = .81, 95% confidence interval (Cl) = .71 to .92), general practice out-of-hours contacts (IRR = .81, CI = .71 to .92) and shorter LOS (IRR = .71, CI = .57 to .88), but the rate of all-cause outpatient visits was higher (IRR = 1.07, CI = .99 to 1.15). General practice daytime contacts were similar between the groups, and there was no significant difference in mortality.Conclusions: A 24-h access clinic reduced acute admissions and LOS compared to usual outpatient care. Planned outpatient visits increased and substituted unplanned acute care, thus enhancing integration of care by allowing for access to the correct level of care and ensuring continuity of care.

Psychotropic Drug Use in Children with Autism Spectrum Disorder Admitted to a Training and Research Hospital Outpatient Clinic: A Retrospective Cross-Sectional Study

This study aimed to examine demographic and clinical variables, psychiatric comorbidities, the prevalence of psychotropic drug use, relationships between drug use, demographic and clinical variables, and predictors of drug use in children with autism spectrum disorder (ASD) admitted to a training and research hospital outpatient clinic. Four hundred and eleven children with ASD admitted to the Department of Child and Adolescent Psychiatry, Dr. Sami Ulus Maternity and Children's Health and Diseases Training and Research Hospital, between October 1, 2019 and December 31, 2019, were retrospectively reviewed. Demographic and clinical variables, psychiatric comorbidities, and characteristics of drug use for the cases were recorded. Psychotropic drug use was found in 34.3% (n = 141) of the cases. Our results revealed male sex and psychiatric comorbidity as predictors of psychotropic drug use. Antipsychotics were the most prescribed drugs, and the most common psychiatric comorbidity was conduct disorder. Also, children with ASD who had been toilet-trained, and could express sentences but were illiterate, were using psychotropic drugs more often than others. Future multicentered, large clinic-based studies from training and research hospitals should focus on trends of treatment in psychiatric comorbidities accompanying ASD, and constitute a systematic approach for the psychopharmacological treatment of these cases.

Internalized stigma, disclosure and self-esteem among psychiatric patients in a general hospital outpatient clinic

Objective: Psychiatric patients often experience internalized stigma. This occurs when persons accept the negative attitudes of others towards them, then internalize and apply these beliefs to themselves. We assess the effects of internalized stigma on illness disclosure and on self-esteem in psychiatric outpatients, hypothesizing that internalized stigma is more pronounced in psychiatric patients than in medical patient controls and that internalized stigma is associated with avoidance of disclosure, as well as reduced self-esteem. Methods: Psychiatric and medical outpatients were randomly selected to participate in the study, conducted at a general hospital specialist outpatient clinic. Results: Psychiatric patients demonstrated significantly lower self-esteem than controls. Internalized stigma was the highest for singles, and the lowest among married and older patients. Among psychiatric patients, a higher internalized stigma was significantly associated with experienced discrimination and with lower levels of self-esteem. Those who avoided disclosure had significantly higher internalized stigma than those who self-disclosed. Conclusion: The results confirmed our study hypotheses. Marriage and older age seemed to confer a protective effect on self-esteem.

Usability of a Smartphone Application for Pre-operative Facial Analysis for Rhinoplasty among ENT Surgeons

Objective: To determine the usability of a smartphone application (ImageMeter) by ENT surgeons for pre-operative photographic analysis of facial angles for rhinoplasty using the USE questionnaire. Methods: Design: Post-Test Only Non-Experimental Evaluation Setting: Tertiary Private Training Hospital Outpatient Clinic Participants: Twenty-five (25) ENT residents and consultants Results: Of forty-five ENT surgeons invited, twenty-five ENT residents and consultants (16 males, 9 females) aged 28 to 52-years-old (mean age 36-years-old) trialed the use of the Image Meter application in measuring the naso-facial, naso-frontal, and naso-labial angles of pre-selected lateral images of 10 volunteers and completed our survey. The usability of the application was measured using the USE questionnaire, through usefulness (Cronbach

Occurrence of patients compared in a pediatric practice and pediatric hospital outpatient clinic

The frequency of consultations and the waiting times in pediatric hospital outpatient clinics are steadily increasing. The aim of this study was to compare the occurrence of patients in a large pediatric group practice and a hospital-based general pediatric outpatient clinic. Primary parameters were the most common reasons for consultation, the waiting times and the reasons for selecting a certain institution. Most frequent diagnoses in the pediatric practice were upper respiratory tract infections (22.7% ( n = 141/621)), otitis media (5.2% ( n = 32/621)), and viral pharyngitis (3.9% ( n = 24/621)). Most common reasons for consultation in the hospital outpatient clinic were upper respiratory tract infections (18.4% ( n = 121/658)) and bacterial pharyngitis (17.9% ( n = 118/658)). In the pediatric practice, bacterial pharyngitis was only diagnosed in 3.1% ( n = 19/621) of the cases. Only slight differences exist between the two institutions regarding the observed entities, which mainly comprise mild to moderate acute illnesses. It can be concluded from this that the majority of patients might as well be treated in the nonhospital setting. Facilitating the communication and coordination between practices and hospitals might allow a better utilization of capacities. Thereby, waiting times, unnecessary reexaminations, and costs in the health-care system could be reduced.