scholarly journals Morbid Anatomy of Patients with Mycobacterial Infections, a Cross Sectional Autopsy Study at a Tertiary Hospital in a High Disease Burden Setting

2020 ◽  
Author(s):  
Dan Wamala ◽  
Gunilla Källenius ◽  
Moses Joloba
Keyword(s):  
Disease Burden ◽  
Tertiary Hospital ◽  
Autopsy Study ◽  
Cross Sectional ◽  
Mycobacterial Infections ◽  
Morbid Anatomy ◽  
High Disease Burden

scholarly journals Morbid anatomy of patients with mycobacterial infections, a cross sectional autopsy study at a tertiary Hospital in a high disease burden setting

2019 ◽  
Author(s):  
Dan Wamala ◽  
Gunilla Kallenius ◽  
Moses Joloba
Keyword(s):  
Tertiary Hospital ◽  
Pathological Features ◽  
Pleural Effusions ◽  
Autopsy Study ◽  
Cross Sectional ◽  
Therapeutic Implications ◽  
Pulmonary Pathology ◽  
Autopsy Specimens ◽  
High Disease Burden ◽  
Culture Positive

Abstract Background Tuberculosis is a major cause of morbidity and mortality globally. Infections caused by different mycobacteria can be clinically indistinguishable but the differences in their pathological features and mortality are unclear. Methods To evaluate the contribution of different mycobacterial pathogens to lethal mycobacterial disease and assess subsequent pathological features, we performed autopsies of 49 patients with suspected TB. Autopsy specimens were examined histologically and cultured for mycobacteria. We identified Mycobacterium tuberculosis (Mtb) isolates and non-tuberculous mycobacteria (NTM), and further genotyped the Mtb isolates. Results Mtb isolates were found in 37 patients and NTM in 12 patients. All patients had signs of caseous pneumonia and 42 patients (86%) had disease involving more than half of the lungs. Two-thirds of the patients with TB or NTM had extrapulmonary engagement in addition to pulmonary pathology. Gross pathology and histopathology were similar in TB patients and patients with NTM, except that patients with NTM had a significantly reduced tendency to cause pleural effusions. Of the Mtb isolates 55% were of the Uganda genotype, which is the predominant Mtb genotype in Uganda. This genotype was significantly more frequent in the younger patients. Conclusion In this autopsy study of patients with presumptive TB a majority of culture positive cases were caused by Mtb. In 25% of patients NTM were identified, and histopathology was similar in TB and NTM patients, although NTM patients had significantly less pleural effusions. These results suggest that NTM contribute to mortality, and that their identification is important because of the special clinical and therapeutic implications associated with NTM infections.

scholarly journals The presence and spectrum of bacteria colonising mobile phones of staff and caregivers in high disease burden paediatric and neonatal wards in an urban teaching hospital in Durban, South Africa

2017 ◽  
Vol 32 (1) ◽  
pp. 9-11
Author(s):  
Raziya Bobat ◽  
Moherndran Archary ◽  
Melissa Lawler ◽  
Sajeeda Mawlana ◽  
Kimesh L. Naidoo ◽  
...  
Keyword(s):  
Mobile Phones ◽  
Nursing Staff ◽  
Disease Burden ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
General Wards ◽  
Staphylococcus Spp ◽  
Hospital Acquired ◽  
High Disease Burden

Background: Hospital acquired infections are on the increase worldwide. A possible source for transmission is the presence of microorganisms on mobile phones which are carried by increasing numbers of medical and nursing staff, students, and caregivers.Methods: A cross-sectional study was performed. Samples were obtained from medical and nursing staff, students, and caregivers from the paediatric wards (85 beds), and the neonatal unit (40 beds) at King Edward VIII Hospital (KEH), Durban. Mobile phones of participants were sampled, with sterile swabs, without prior warning. The swabs were transported promptly to the laboratory and cultured onto colistin, nalidixic acid agar and MacConkey agar plates. All positive cultures were identified using standard laboratory tests.Results: Of the 100 mobile phones sampled, 30 were contaminated with bacteria. Gram-positive microorganisms were more frequently cultured than Gram-negative microorganisms (29 vs. 7). Significantly more caregivers had contaminated phones (54.17% vs. 22.37%, p value = 0.003). Caregivers’ phones were predominantly contaminated with Staphylococcus spp. (41.67%). More phones in the general wards (37.5%) and nursery (32.5%) were contaminated compared to the gastroenteritis ward (10%).Conclusions: Our results indicate that one third of the mobile phones carried in the paediatric wards are contaminated. Caregivers had the highest likelihood of carrying mobile phones that were contaminated, with the lowest rate among the nursing staff. Caregivers’ phones were also more likely to have multiple microorganisms. The lowest rate of contamination was found in the gastroenteritis ward, possibly due to a heightened awareness of the need for handwashing.

scholarly journals Morbilidade em Idosos Dependentes ao Cuidado das Equipas Domiciliárias da Rede Nacional de Cuidados Continuados Integrados na Região de Lisboa e Vale do Tejo: Estudo Transversal Observacional

2017 ◽  
Vol 30 (7-8) ◽  
pp. 546
Author(s):  
Paula Broeiro-Gonçalves
Keyword(s):  
Disease Burden ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Social Needs ◽  
Charlson Index ◽  
Continuing Care ◽  
Cross Sectional ◽  
National Network ◽  
Degree Level ◽  
High Disease Burden

Introduction: In Portugal, the National Network of Continuing Integrated Care’s mission is to take care of new health and social needs. The aim of the study was to know the disease burden and disability of the elderly (75 and over) cared by the integrated continuing care teams.Material and Methods: A cross-sectional study carried out in a sample of 230 participants, from 25 teams randomly selected in the region of Lisbon and Tagus Valley. Data were collected at the patient’s home trough caregiver’s interviewing. The variables studied were: socio-demographic; disability determinants; degree (Barthel’s scale) and duration of disability; morbidity (diagnoses, number and Charlson index).Results: The study population had: on average 84 years; low or no scholar degree level (88.7%); on average 9.5 problems per person and a Charlson index of 8.48; disability over 42 months (severe in 65.2%). The most frequent disability-determinants were: dementia, stroke and femur fracture. The most frequent diagnoses were: osteoarthritis, hypertension and dementia.Discussion: The results revealed a high disease burden (Charlson of 8.48) and disability. Although the diagnoses were those expected and comparable with the literature, their coexistence was universal, averaging 9.5 per person, affecting different organs/systems. Multimorbidity, coupled with severe disability, leads to clinical and organizational-care challenges, as well as the need for other population base studies.Conclusion: The population cared by the integrated continuing care teams is at risk: elderly, with low scholar degree level, with a high disease-burden and disability.

scholarly journals Prioritizing the healthcare access concerns of Canadians with MS

2021 ◽  
Vol 7 (3) ◽  
pp. 205521732110296
Author(s):  
Julie Pétrin ◽  
Mary Ann McColl ◽  
Catherine Donnelly ◽  
Simon French ◽  
Marcia Finlayson
Keyword(s):  
Disease Burden ◽  
Online Survey ◽  
Unmet Needs ◽  
Healthcare Access ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Cross Sectional ◽  
Barriers To Healthcare ◽  
High Disease Burden

Background Canadians with MS are high users of healthcare services, yet they report multiple unmet needs, high disease burden, and low satisfaction with care. Engaging patients in healthcare planning can lead to improvements in access and care. There is currently limited evidence that has harnessed the perspectives of Canadians with MS. Objective To identify and prioritize the healthcare access concerns of Canadians with MS. Methods A cross-sectional online survey informed by the Concerns Report Methodology was used to address the objective. Participants were recruited through multiple methods. Descriptive statistics were used to identify the main barriers to healthcare providers, and concerns report methods were used to calculate needs indexes to prioritize concerns of participants. Results 324 Canadians with MS participated in the study between November 18, 2019 and March 27, 2020. The most pressing healthcare access concerns of Canadians with MS were related to availability of healthcare providers with MS knowledge and affordability of services that aim to improve wellness. Conclusion These findings provide healthcare planners with prioritized access concerns of Canadians with MS, which can be used to guide strategic planning to improve the quality of life of these individuals.

Evaluation of Drug Utilization Pattern Using WHO Prescribing Indicators in Endodontic Department at a Tertiary Hospital in Eastern Nepal

2020 ◽  
Vol 5 (3) ◽  
pp. 1191-1195
Author(s):  
Sushmita Shrestha ◽  
Navin Agrawal ◽  
Deependra Prasad Sarraf
Keyword(s):  
Drug Utilization ◽  
Inappropriate Prescribing ◽  
Systemic Infection ◽  
Tertiary Hospital ◽  
World Health ◽  
Utilization Pattern ◽  
Cross Sectional ◽  
Prescribing Indicators ◽  
Essential Drug List ◽  
Dental Practitioners

Introduction: Irrational or inappropriate prescribing practice is common in developing countries that can lead to ineffective treatment, prolonged hospitalization, harm to the patient, increased treatment cost and development of drug-resistant organisms. The prescription of antibiotics and other drugs in endodontics is limited to patients with progressive and diffuse swelling and with systemic infection. However, antibiotics continue to be over-prescribed by more than 66% dentists without a rational justification.Therefore, the periodic assessment of drug utilization pattern is important to know the existing pattern of drug use, decrease adverse effects and provide feedback to the prescribers. Objective: To evaluate the drug utilization pattern in endodontics using the World Health Organization prescribing indicators. Methodology: A cross-sectional prospective study was conducted among the patients visiting the outpatient department of Conservative Dentistry and Endodontics. After obtaining the informed consent, the relevant data were collected on a self-designed proforma by reviewing the health cards of the patients. The WHO prescribing indicators were calculated. Descriptive statistics were calculated using SPSS version 11.0. Results: Out of 187 patients, 101 (54%) were female. Mean age was 38.9±16.6 years. Majority of the patients suffered from acute apical periodontitis (30.5%). A total of 281 drugs were prescribed to 187 patients. Paracetamol+Ibuprofen (44.1%) was the most frequently prescribed drugs. Most of the patients were prescribed one drug (78.6%).  Average drug per prescription was 1.5. Majority of the drugs (89.0%) were prescribed from Essential drug list of Nepal. Conclusions: Analgesics were the most frequently prescribed drug. The prescription practice was rational. There is need to increase the number of medicine prescribed from National List of Essential medicines.Educational initiatives should be undertaken to further strengthen the rational prescription among dental practitioners.

Comparison of Non-radiographic Axial Spondyloarthritis and Ankylosing Spondyltis from a Single Rheumatology Hospital in Morocco

2020 ◽  
Vol 16 (3) ◽  
pp. 240-244 ◽  
Author(s):  
Nessrine Akasbi ◽  
Siar Nihad ◽  
Zoukal Sofia ◽  
El Kohen Khadija ◽  
Harzy Taoufik
Keyword(s):  
Disease Burden ◽  
Axial Spondyloarthritis ◽  
Univariate Analysis ◽  
Cross Sectional Study ◽  
Low Back ◽  
New Classification ◽  
Cross Sectional ◽  
Asas Criteria ◽  
History Of ◽  
High Level

Background: According to the new classification criteria developed by The Assessment of SpondyloArthritis International Society, patients with axial spondyloarthritis (axSpA) can be classified in 2 subgroups: Patients with radiographic axial spondyloarthritis: ankylosing spondylitis patients (AS) and those with non-radiographic axial spondyloarthritis (nr-axSpA). Objective: The aim of the present study is to describe and discuss the differences and similarities between the two subgroups. Patients and Methods: A cross-sectional study was conducted in a single rheumatology hospital in Morocco. These included patients diagnosed as having axial spondyloarthritis according to ASAS criteria 2010, during a period of 6 years. The AS and the nr-axSpA subgroups were compared for the various axSpA-related variables. Results: Of the 277 patients with a diagnosis of axial SpA who were included in this study, 160 had AS and 117 had nr-axSpA. AS and nr-ax-SpA shared a similar age at diagnosis, similar prevalence of low back pain, lumbar stiffness, extra-articular manifestations, BASDAI and BASFI. In the multivariate analysis, AS patients were mainly male with cervical stiffness, enthesitis, coxitis and high level of ESR (erythrocyte sedimentation rate). The females generally had a family history of SpA and arthritis and were associated to the nr-axSpA form in the univariate analysis. Conclusion: This was the first study to characterise patients with AS and nr-axSpA in Morocco. Consistent with other studies published, this study showed that patients with nr-axSpA and patients with AS shared a comparable degree of disease burden.

scholarly journals Patients and relatives as auditors of safe practices in oncology and hematology day hospitals

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Isabel Rodrigo Rincón ◽  
Isabel Irigoyen Aristorena ◽  
Belén Tirapu León ◽  
Nicolás Zaballos Barcala ◽  
Maite Sarobe Carricas ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Tertiary Hospital ◽  
Patient Identification ◽  
Healthcare Organizations ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Younger Age ◽  
Day Hospitals ◽  
Cross Sectional Design ◽  
Safe Practices

Abstract Background When there is a gap in professionals’ adherence to safe practices during cancer treatment, the consequences can be serious. Identifying these gaps in order to enable improvements in patient safety can be a challenge. This study aimed to assess if cancer patients and their relatives can be given the skills to audit reliably four safe practices, and to explore whether they are willing to play this new role. Methods We recruited 136 participants in 2018, from the oncology and haematology day hospital of a tertiary hospital in Spain. Patient identification, hand hygiene, blood or chemotherapy identification, and side effects related to transfusion and chemotherapy, were the safe practices selected for evaluation. The study comprised two parts: an interventional educational program and a cross-sectional design to collect data and assess to what degree participants are able and willing to be auditors depending on their characteristics using multivariate logistic regression models. A participant’s auditing skill were assessed pre and post the educational intervention. Results The model was seeking predictors of being a good auditor. 63 participants (46.3%) were classified as good auditors after the training. To have younger age, higher educational level and to have had an experience of an adverse event were associated with a higher probability of being a good auditor. Additionally, 106 (77.9%) participants said that they would like to audit anonymously the professionals’ compliance of at least three of four safe practices. The willingness to audit safe practices differed depending on the safe practice but these differences did not reach statistical significance. Conclusions The data gathered by patients and relatives acting as auditors can provide healthcare organizations with valuable information about safety and quality of care that is not accessible otherwise. This new role provides an innovative way to engage patients and their families’ in healthcare safety where other methods have not had success. The paper sets out the methods that healthcare organizations need to undertake to enrol and train patients and relatives in an auditor role.

scholarly journals AB0564 RHEUMATOLOGISTS’ VIEWS AND EXPERIENCES IN MANAGING PsA PATIENTS BASED ON TREATING TO TARGET STRATEGY: A CROSS-SECTIONAL STUDY IN CHINA

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1318.2-1319
Author(s):  
L. Xu ◽  
Z. Wang ◽  
J. Xue ◽  
M. Bai ◽  
H. Zhong ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Psoriatic Arthritis ◽  
Disease Activity ◽  
Western Medicine ◽  
Work Experience ◽  
Tertiary Hospital ◽  
Treat To Target ◽  
Cross Sectional ◽  
Activity Assessment ◽  
High Level

Background:Psoriatic arthritis (PsA) is a chronic inflammatory arthritis with progressive, erosive destruction associated with functional impairment. Principles of treat-to-target (T2T) have been widely used in rheumatoid arthritis, which has powerfully improved patient outcomes. In 2017, the concept of T2T has proposed to apply in PsA patients. However, the awareness and implementation of evidence-based T2T treatment guidelines varies across different geographical regions of China, hospital grades, professional status and specialities.Objectives:The study aimed to investigate Rheumatologists’ views and experiences in managing PsA patients with T2T strategy in china.Methods:A cross-sectional questionnaire survey of Rheumatologists in China from 5 August to 15 August 2020 was conducted for this study. Rheumatologists were contacted by WeChat (a Chinese cell/web app) and asked to complete a web-based questionnaire anonymously. The electronic questionnaire was sent out by the internet platform of WenJuanXing via WeChat (https://www.wjx.cn/). The questionnaire was designed to collect: (a) demographic information; (b) patient management in clinical practice for Rheumatologists; (c) familiarity and application of T2T strategy in Rheumatologists. P values ≤0.05 were considered significant.Results:(1) A total of 823 rheumatologists (69.87% female, 30.13% male) provided valid answers to the questionnaire. 71.09% of the participants major in Modern Western Medicine, 28.91% major in traditional chinese medicine. A total of 75.94% worked in Grade-A Tertiary Hospital. A total of 52.73% had more than 10 years of work experience and 63.55% had High-level title. (2) More than half of the patients were followed up by 69% Rheumatologists in their daily practice. The proportion of follow-up patients increased powerfully in the group of Rheumatologists who major in Modern Western Medicine (P=0.014), work in Grade-A Tertiary Hospital (P<0.001), have more than 10 years of work experience (P<0.001) and High-level title (P<0.001). (3) 36.45% Rheumatologist thought the frequency for patient disease activity assessment was every 1 month and 53.1% was every 3 months. And 41.7% Rheumatologist prefer to use PASDAS for disease activity criteria, and only 3.6% choose MDA. (4) A total of 62.43% thought they were familiar with T2T strategy, and 83.6% Rheumatologists applied T2T strategy in clinical practice. Among 135 Rheumatologists who did not apply T2T strategy, 62.2% of Rheumatologists thought that the main barrier to T2T application was that they did not fully understand the strategy. The frequency of application of T2T strategy in clinical practice was significantly different between Rheumatologists who major in Modern Western Medicine (60.75%) and traditional chinese medicine (22.84%) (P=0.023).Conclusion:In china, the management of PsA patients need to be standardized to improve patient outcomes. And the promotion of T2T strategy in PsA need to be further strengthened.References:[1]Smolen JS, Schöls M, Braun J,et al. Treating axial spondyloarthritis and peripheral spondyloarthritis, especially psoriatic arthritis, to target: 2017 update of recommendations by an international task force. Ann Rheum Dis. 2018 Jan;77(1):3-17.[2]Tucker LJ, Ye W, Coates LC. Novel Concepts in Psoriatic Arthritis Management: Can We Treat to Target? Curr Rheumatol Rep. 2018 Sep 18;20(11):71.[3]Coates LC, Helliwell PS. Treating to target in psoriatic arthritis: how to implement in clinical practice. Ann Rheum Dis. 2016;75(4):640-643.Figure 1A. Rheumatologist priority of frequency for patient follow-up in different disease status. B. Rheumatologist priority of frequency for patient disease activity assessment in clinical practice. C. Rheumatologist priority of disease activity criteria for PsA patients.Disclosure of Interests:None declared.

scholarly journals Risk Factors for Fall-Related Serious Injury among Korean Adults: A Cross-Sectional Retrospective Analysis

2021 ◽  
Vol 18 (3) ◽  
pp. 1239
Author(s):  
Moon-Sook Kim ◽  
Hyun-Myung Jung ◽  
Hyo-Yeon Lee ◽  
Jinhyun Kim
Keyword(s):  
Risk Factors ◽  
Fall Prevention ◽  
Medical Records ◽  
Brain Injuries ◽  
Tertiary Hospital ◽  
Antiplatelet Drugs ◽  
Cross Sectional ◽  
Complete Survey ◽  
Serious Injury ◽  
Serious Injuries

The purpose of this study was to identify the risk factors of serious fall-related injuries by analyzing the differences between two fall groups: one with serious fall-related injuries and one without such injuries. Applying a retrospective, descriptive investigation study design, we analyzed the degree of fall-related injury and the risk factors related to serious falls by conducting a complete survey of the medical records of fall patients reported throughout one full year, 2017, at a tertiary hospital in Seoul, Korea. Among the patients with reported falls, 188 sustained no injury (63.1%), 72 sustained minor injury (24.2%), and 38 patients sustained serious injury (12.8%). The serious fall-related injuries included eight lacerations requiring suture (2.7%), 23 fractures (7.7%), five brain injuries (1.7%), and two deaths (0.7%). Analysis results indicated that taking anticoagulants/antiplatelet drugs (p = 0.016) and having a fall history (p = 0.038) were statistically significant in the differences between the group with serious injury related to falls and the group without serious injury. Logistic regression revealed that taking anticoagulant/antiplatelet drugs was the factor most significantly correlated with serious injuries related to falls (OR = 2.299, p = 0.022). Results show that it is necessary to develop a patient-tailored fall prevention activity program.

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