Retrospective analysis of the incidence of toxocarosis

Целью данной работы явился ретроспективный анализ заболеваемости населения Астраханской области токсокарозом за 2012-2019 гг. Проанализированы 48 эпидемиологических карт лиц, инвазированных токсокарами. Диагноз «токсокароз» подтверждался данными клинического осмотра, жалобами пациентов, эпидемиологическим анамнезом и результатами иммуноферментного анализа с применением тест-систем для выявления антител к антигенам токсокар класса G. Случаи токсокароза отмечались у лиц от 3 до 75 лет, из которых дети составили 18,8% (n = 9). По результатам эпидемиологического анамнеза выяснилось, что большая часть инвазированных – 91,7% (n = 44) не соблюдала правила личной гигиены (употребляла грязные немытые фрукты и овощи – 89,6% (n = 43), не мыла руки перед едой – 16,7% (n = 8), контактировала с недегельминтизированными животными – 58,4% (n = 28): собаками – 43,8% (n = 21), в т. ч. домашними – 90,5% (n = 19), кошками – 14,6% (n = 7), в т. ч. домашними – 85,7% (n = 6). Склонность к геофагии (привычка есть почву) отмечалась у 68,8% (n = 33) инвазированных. А привычка грызть ногти на руках и ногах (онихофагия) отмечалась у 18,8% (n = 9) детей. После установления окончательного диагноза все пациенты проходили курс химиотерапии препаратом албендазол. Таким образом, высокие цифры зараженности лиц, проживавших в Ленинском и Трусовском районах г. Астрахани, связаны с тем, что данные районы являются густонаселенными с большим числом домовладений частного сектора, в котором находятся домашние животные (кошки и собаки). Основные причины заражения токсокарами – несоблюдение правил личной гигиены, употребление в пищу плохо вымытых фруктов и овощей, контакт с животными и геофагия. Титр антител к антигенам токсокар выше разведения 1:800 свидетельствует о наличии висцерального токсокароза у обследуемого лица. The purpose of this work was a retrospective analysis of the incidence of toxocars in the population of the Astrakhan region for 2012-2019. 48 epidemiological maps of persons infected with toxocars were analyzed. The clinical diagnosis of «Toxocarosis» was confirmed by clinical examination data, patient complaints, collected epidemiological history, and data from the enzyme immunoassay method using test systems to detect antibodies to toxocar class G antigens. Cases of toxocarosis were observed in persons aged 3 to 75 years, of which children accounted for 18,8% (n = 9). An epidemiological history was collected, as a result of which it was found that most of the infected – 91,7% (n = 44) did not follow the rules of personal hygiene (this category of patients had such bad habits as: eating dirty unwashed fruits and vegetables – 89,6% (n = 43), unwashed dirty hands before eating – 16,7% (n = 8), contact with non – dehelminthized animals – 58,4% (n = 28): dogs – 43,8% (n = 21), including domestic – 90,5% (n = 19), cats – 14,6% (n = 7), including domestic-85,7% (n = 6). The tendency to geophagy (the habit of eating the soil) was observed in 68,8% (n = 33) of the infected. And the habit of biting the nails on the hands and feet (onychophagia) was observed in 18,8% (n = 9) of children. After the final diagnosis, all patients underwent a course of chemotherapy with albandazole. Thus, the high infection rates of people who lived in the Leninsky and Trusovsky districts of Astrakhan are associated with the fact that these areas are densely populated with a large number of private sector, in which there are domestic animals (cats and dogs). Presumably, one of the main causes of human infection with toxocars was not following the rules of personal hygiene, eating poorly washed fruits and vegetables, contact with animals and geophagy. The presence of a titer of antibodies to toxocar antigens above a dilution of 1: 800 indicates the presence of the disease «Visceral toxocarosis» in the examined person.

Reporting violations of European Charter of Patients’ Rights: analysis of patient complaints in Croatia

Background The European Charter of Patients' Rights (ECPR) presents basic patients' rights in health care. We analysed the characteristics of patients' complaints about their rights submitted through the official complaints system and to a non-governmental organization in Croatia. Methods The official system for patients’complaints in Croatia does not have a common pathway but offers different modes for addressing patient complaints. In this cross-sectional study, we analysed the reports about patients’ complaints from the official regional committees sent to the Ministry of Health. We also analysed the complaints received by the Croatian Association for the Protection of Patient’s Rights (CAPR) and mapped them to the ECPR. Results The aggregated official data from the Ministry of Health in 2017 and 2018 covered only 289 individual complaints from 10 out of 21 counties. Complaints were most frequently related to secondary and tertiary healthcare institutions and details were not provided. CAPR received a total of 440 letters, out of which 207 contained 301 complaints about violations of patients’ rights in 2017–2018. The most common complaint was the Right of Access to health care (35.3%) from the ECPR, followed by the Right to Information (29.9%) and the Right to Safety (21.7%). The fewest complaints were about the Right to Complain (1.9%), Right to Innovation (1.4%), Right to Compensation (1.4%), and Right to Preventive Measures (1.0%). Conclusions Reporting and dealing with patients’ complaints about violations of their patients’ rights does not appear to be effective in a system with parallel but uncoordinated complaints pathways. Mapping patient's complaints to the ECPR is a useful tool to assess the perception of patients’ rights and to plan actions to improve the complaints system for effective health care.

Patient complaints in the postoperative period following spine surgery

OBJECTIVE Patient complaints are associated with a number of surgical and medical outcomes. Despite high rates of patient complaints regarding spine surgeons and efforts to study patient complaints across medicine and surgery, few studies have analyzed the complaints of patients undergoing spinal surgery. The authors present a retrospective analysis that, to their knowledge, is the first study to directly investigate the complaints of spine surgery patients in the postoperative period. METHODS Institutional records were reviewed over a 5-year period (2015–2019) to identify patients who underwent spine surgery and submitted a complaint to the institution’s ombudsman’s office within 1 year of their surgery. A control group, comprising patients who underwent spine surgery without filing a complaint, was matched to the group that filed complaints by admission diagnosis and procedure codes through propensity score matching. Patient demographic and clinical data were obtained by medical record review and compared between the two groups. Patient complaints were reviewed and categorized using a previously established taxonomy. RESULTS A total of 52 patients were identified who submitted a complaint after their spine surgery. There were 56 total complaints identified (4 patients submitted 2 each) that reported on 82 specific issues. Patient complaints were most often related to the quality of care received and communication breakdown between the healthcare team and the patient. Patients who submitted complaints were more likely to be Black or African American, have worse baseline health status, and have had prior spine surgery. After their surgery, these patients were also more likely to have longer hospital stays, experience postoperative complications, and require reoperation. CONCLUSIONS Complaints were most often related to the quality of care received and communication breakdown. A number of patient-level demographic and clinical characteristics were associated with an increased likelihood of a complaint being filed after spine surgery, and patients who filed complaints were more likely to experience postoperative complications. Improving communication with patients could play a key role in working to address and reduce postoperative complaints. Further study is needed to better understand patient complaints after spine surgery and investigate ways to optimize the care of patients with risks for postoperative complaints.

Jugular Vein Aneurysm, When We Have to Do Surgery?

Introduction: The most common lesions of jugular vein dilatation are aneurysms and ectasia. A jugular vein aneurysm is less common compare to an arterial aneurysm in adults. Because of the rare incidence, treatment guidelines primarily associated with the timing of surgery are not clearly established. Proper treatment can reduce patient complaints without excessive intervention. Case report: A 54 years old woman complained of swelling in the right neck that started three years ago and cephalgia for two years. From CT angiography, we obtained a jugular vein dilatation of 2.3 cm. During periodic evaluation from ultrasonography doppler, there is no increase in the size of the jugular vein. Conclusion: Jugular vein aneurysm presenting in adults is an infrequent phenomenon. It is a benign condition, and conservative observation is advised. It should be operated only if symptomatic or progressive enlarging. A periodic examination must be done to evaluate the size of the jugular vein before a surgical decision

Remote monitoring of patients with chronic heart failure using blood pressure telemonitoring and ECG

Introduction. Remote monitoring of patients with chronic heart failure seems to be very promising in connection with a possible decrease in mortality as a result of the use of telemedicine technologies in the treatment of chronic heart failure (CHF). Materials and methods. Remote monitoring of the health of 997 patients with confirmed diagnoses of circulatory diseases complicated by CHF, aged 18 to 74, inclusive, living in rural areas, mainly in remote and hard-to-reach settlements of Uvatsky, Vagaysky, Nizhnetavdinsky, Tobolsky and Yarkovsky, was carried out. districts of the Tyumen region. Results. We studied the results of remote monitoring of blood pressure and ECG in 997 patients with chronic heart failure in rural areas for 24 months using various models of telemedicine support. In the «home» monitoring group (n = 316), patients independently recorded and broadcast blood pressure and ECG data; in the «office» monitoring group (n = 681), the same studies were performed by medical workers. Additionally, the presence or absence of patient complaints about the state of health at the time of the research was recorded. Conclusions. The organization and conduct of remote monitoring of the health status of patients with CHF using teleAP and teleECG in the «home» self-registration mode has an advantage over the implementation of such monitoring in a medical organization, which is reflected in a statistically significant decrease in the need for hospitalizations.

Jugular Vein Aneurysm, When We Have to Do Surgery?

Introduction: The most common lesions of jugular vein dilatation are aneurysms and ectasia. A jugular vein aneurysm is less common compare to an arterial aneurysm in adults. Because of the rare incidence, treatment guidelines primarily associated with the timing of surgery are not clearly established. Proper treatment can reduce patient complaints without excessive intervention. Case report: A 54 years old woman complained of swelling in the right neck that started three years ago and cephalgia for two years. From CT angiography, we obtained a jugular vein dilatation of 2.3 cm. During periodic evaluation from ultrasonography doppler, there is no increase in the size of the jugular vein. Conclusion: Jugular vein aneurysm presenting in adults is an infrequent phenomenon. It is a benign condition, and conservative observation is advised. It should be operated only if symptomatic or progressive enlarging. A periodic examination must be done to evaluate the size of the jugular vein before a surgical decision