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1.
Rev. Esc. Enferm. USP ; 53: e03486, Jan.-Dez. 2019. tab
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1020393

RESUMO

RESUMO Objetivo Avaliar o impacto das Infecções Relacionadas à Assistência à Saúde no custo da hospitalização de crianças. Método Estudo de coorte, prospectivo, quantitativo, envolvendo crianças admitidas nas Unidades de Internação e de Terapia Intensiva Pediátrica de um hospital universitário público. Os dados foram analisados por meio do software SPSS por distribuição de frequências, medidas de tendência central e dispersão. Para todas as análises foi considerado o nível de significância estatística de p<0,05. Resultados A amostra foi composta de 173 crianças, destas, 18,5% desenvolveram infecção relacionada à assistência à saúde, que aumentou em 4,2 vezes (p<0,001) o custo da hospitalização. Maior impacto de custo foi observado entre pacientes com dois ou mais sítios infecciosos (R$ 81.037,57, p=0,010) e sepse (R$ 46.315,63 p<0,001). Crianças colonizadas por microrganismos multirresistentes, com prevalência de E. coli e A. baumannii ESBL, geraram custos maiores, R$ 35.206,15 e R$ 30.692,52, respectivamente. Conclusão As infecções relacionadas à assistência à saúde aumentaram significativamente os custos da hospitalização de crianças, em especial entre aquelas com mais de dois sítios infecciosos, que desenvolveram sepse e colonizadas por microrganismos multirresistentes.


RESUMEN Objetivo Evaluar el impacto de las Infecciones Relacionadas con la Asistencia Sanitaria en el costo de la hospitalización de niños. Método Estudio de cohorte, prospectivo, cuantitativo, involucrando a niños ingresados en las Unidades de Hospitalización y de Cuidados Intensivos Pediátricos de un hospital universitario público. Los datos fueron analizados mediante el software SPSS por distribución de frecuencias, medidas de tendencia central y dispersión. Para todos los análisis, se consideró el nivel de significación estadística de p<0,05. Resultado La muestra estuvo compuesta de 173 niños, de estos el 18,5% desarrollaron infección relacionada con la asistencia sanitaria, que aumentó 4,2 veces (p<0,001) el costo de la estancia hospitalaria. Mayor impacto de costo fue observado entre pacientes con dos o más sitios infecciosos (R$ 81.037,57, p=0,010) y sepsis (R$ 46.315,63 p<0,001). Niños colonizados por microorganismos multirresistentes, con prevalencia de E. coli y A. baumannii ESBL, generaron costos mayores, R$ 35.206,15 y R$ 30.692,52, respectivamente. Conclusión Las infecciones relacionadas con la asistencia sanitaria aumentaron significativamente los costos de la hospitalización de niños, en especial entre los con más de dos sitios infecciosos, que desarrollaron sepsis y colonizados por microorganismos multirresistentes.


ABSTRACT Objective To evaluate the impact of Healthcare-Associated Infections on the hospitalization cost of children. Method A prospective, quantitative cohort study involving children admitted to the Inpatient and Pediatric Intensive Care Units of a public university hospital. The data were analyzed through SPSS software by frequency distribution, central tendency measures and dispersion. The level of statistical significance was set at p<0.05 for all analyzes. Results The sample consisted of 173 children, of whom 18.5% developed Healthcare-Associated Infections, which increased the hospitalization costs 4.2 times (p<0.001). A greater cost impact was observed among patients with two or more infectious sites (R$81,037.57; p=0.010) and sepsis (R$46,315.63; p<0.001). Children colonized by multiresistant microorganisms with a prevalence of E. coli and A. baumannii ESBL also generated higher costs of R$35,206.15 and R$30,692.52, respectively. Conclusion Healthcare-Associated Infections significantly increased the hospitalization costs for children, especially among those with more than two infectious sites, who developed sepsis or were colonized by multiresistant microorganisms.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Criança Hospitalizada , Infecção Hospitalar , Custos de Cuidados de Saúde , Resistência Microbiana a Medicamentos , Unidades de Terapia Intensiva Pediátrica , Estudos de Coortes , Hospitais Universitários
2.
Z Gastroenterol ; 57(9): 1124-1130, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31525803

RESUMO

INTRODUCTION: The specific support of medical students is indispensable in gastroenterology. The aim of this study was to identify factors that influenced members of the German Society of Gastroenterology, Digestive and Metabolic Diseases (DGVS) to choose their specialty. METHODS: Using an online survey all members of the DGVS were invited to assess the following factors: earliest time point of the decision to become a gastroenterologist, important role models and mentors, important course contents and teaching methods, the role of the doctoral thesis and other influencing aspects of the specialty gastroenterology. The evaluation included an additional subgroup analysis involving work experience (≤ 8, 9-29, ≥ 30 years) and working place (university hospital, community-based hospital, private practice). RESULTS: 1358 participants representing 24.2 % of the DGVS-members took part in the survey. Physicians with ≤ 8 years of work experience decided in 62.5 % during medical school to become a gastroenterologist compared to 37.1 % of the physicians with a work experience of ≥ 9 years (p < 0.001). Senior physicians were regarded as important role models and mentors by 40.8 % of the participants. Doctoral supervisors were regarded as important mentors that influenced the selection of the specialty by 42.8 % of the participants that completed their doctoral thesis in gastroenterology. Hands-on courses like sonography were regarded as important course contents by 42.2 % of the participants. Interventional medicine in particular endoscopy and the diversity of gastroenterology were rated as important in the selection process for the specialty. CONCLUSION: The decision to become a gastroenterologist is mainly made during medical school. The main influencing role models and mentors are senior physicians. Hands-on training in ultrasound and endoscopy were regarded as important course contents and teaching methods.


Assuntos
Gastroenterologistas/psicologia , Gastroenterologia/educação , Mão de Obra em Saúde , Médicos/psicologia , Hospitais Universitários , Humanos , Medicina , Sociedades Médicas , Inquéritos e Questionários
3.
Pan Afr Med J ; 33: 130, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31558929

RESUMO

Introduction: Cancer is a public health problem that affect women more than men. The aim of the study was to describe the epidemiological and histopathological features of gynecological malignancies in the city of Yaoundé, Cameroon. Methods: This was a descriptive cross-sectional study of histologically proven gynecological cancers over a 10-year period (2008-2017) in the Gynecology and Pathological Anatomy Departments of the University Teaching Hospital of Yaoundé. Results: A total of 682 cancers were identified among which, 342 gynecological cancers, for an overall frequency of 50.1% and an annual frequency of 34.2 cases on average. There was a trend suggesting an increase annual frequency over time. The cervix was the most frequent location with 182 cases (53.2%); followed by breast with 96 cases (28.1%); endometrium with 33 cases (9.7%) and ovaries 15 cases (4.4%). These patients were on average 51.9±13.7 years old, mostly housewives (56.8%), married (60.4%), multiparous (61.3%) and referred (62.6%). Histopathologically, cervical cancer was predominantly squamous cell carcinoma (86.8%), invasive (80.9%) and well differentiated (45.5%). For breast cancers, the majority were ductal carcinomas (78.1%), invasive (92%), and histological grade SBR II (50.6%). The most common histopathological types of endometrial and ovarian cancer were adenocarcinoma (72.2%) and serous cystadenocarcinoma (46.7%), respectively. Conclusion: Gynecological cancers are common. Screening is expected to increase at 30 years for cervical cancer and start at age 40 with mammography for breast cancer.


Assuntos
Neoplasias da Mama/epidemiologia , Neoplasias dos Genitais Femininos/epidemiologia , Programas de Rastreamento/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/patologia , Camarões/epidemiologia , Carcinoma Ductal de Mama/epidemiologia , Carcinoma Ductal de Mama/patologia , Estudos Transversais , Neoplasias do Endométrio/epidemiologia , Neoplasias do Endométrio/patologia , Feminino , Neoplasias dos Genitais Femininos/patologia , Hospitais Universitários , Humanos , Pessoa de Meia-Idade , Neoplasias Ovarianas/epidemiologia , Neoplasias Ovarianas/patologia , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/patologia , Adulto Jovem
4.
J Glob Health ; 9(2): 020403, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31489186

RESUMO

Background: There is a need to develop sustainable emergency health care systems in low-resource settings, but data that analyses emergency health care needs in these settings are scarce. We aimed at assessing presenting complaints (PCs) and post-discharge mortality in a large emergency department population in Nepal. Methods: Characteristics of adult patients who entered the emergency department (ED) in a hospital in Nepal were prospectively recorded in the local emergency registry from September 2013 until December 2016. To assess post-ED mortality, patient households were followed-up by telephone interviews at 90 days. Results: In 21892 included adults, the major PC categories were injuries (29%), abdominal complaints (23%), and infections (16%). Median age was 40 years and sex distribution was balanced. Among 3793 patients followed at 90 days, 8% had died. For respiratory and cardiovascular PCs, 90-day mortality were 25% and 23%. The highest mortality was in individuals with known chronic lung disease, in this group 32% had died by 90 days of ED discharge, regardless of PC. In women, illiteracy compared to literacy (adjusted odds ratio (aOR) = 7.0, 95% confidence interval (CI) = 2.1-23.6) and being both exposed to tobacco-smoking and traditional cooking stove compared to no smoke (aOR = 2.8, 95% CI = 1.6-4.9) were associated with mortality. The mortality was much higher among family-initiated discharged patients (17%, aOR = 5.4, 95% CI = 3.3-8.9) compared to doctor-initiated discharged (3%). Conclusions: Our report suggests that nearly one in ten patients seeking emergency health care died within 90 days. This finding is alarming and novel. Post-discharge studies need to be replicated and appropriate follow-up programs in low-resource settings where primary health care is underdeveloped are urgently needed.


Assuntos
Serviço Hospitalar de Emergência/estatística & dados numéricos , Mortalidade/tendências , Adulto , Idoso , Feminino , Hospitais Universitários , Humanos , Masculino , Pessoa de Meia-Idade , Nepal/epidemiologia , Estudos Prospectivos
5.
Rev Assoc Med Bras (1992) ; 65(8): 1048-1054, 2019 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-31531600

RESUMO

INTRODUCTION: Medical Residency is a recognized form of professional qualification, but there are criticisms regarding the overload of work activities. Given the length of the daily and weekly workdays, residents develop practices that enable them to reconcile the Residency with their personal life. AIM: To describe time management strategies in the daily routine of Internal Medicine Medical Residents of a university hospital in São Paulo, Brasil. METHODS: Eight interviews were conducted with resident physicians of the second year, addressing aspects of personal and family life, theoretical study, practical activities, and work bonds. Content analysis was carried out using the MaxQDA software. RESULTS: Six thematic categories emerged from the reports: work organization at the Medical Residency; learning and/or professional activities; housing, financial planning, and household activities; time for leisure and interpersonal relationship; family planning/children; rest/sleep. DISCUSSION: Several strategies are adopted for time management: residing near the hospital, domestic activities helped by housekeepers, postponement of maternity leave, and social support centered on interacting with other residents. There are paid activities not associated with the Residency, which lead to reduced time for rest, study, and leisure, with a greater loss during work at night shifts. CONCLUSIONS: Residents experience a period of intense learning, which requires a high workload and complex work. The evaluation of the work organization of medical residents should include not only time for rest but also time management strategies for daily activities, which can reduce the negative outcomes associated with long working hours.


Assuntos
Medicina Interna/educação , Internato e Residência/estatística & dados numéricos , Gerenciamento do Tempo , Carga de Trabalho/estatística & dados numéricos , Adulto , Brasil , Feminino , Hospitais Universitários , Humanos , Medicina Interna/estatística & dados numéricos , Entrevistas como Assunto , Masculino , Pesquisa Qualitativa , Carga de Trabalho/psicologia
6.
Rev Med Suisse ; 15(663): 1657-1660, 2019 Sep 18.
Artigo em Francês | MEDLINE | ID: mdl-31532116

RESUMO

Old age with its succession of losses is a vulnerable phase in life for developing or exacerbating mental illnesses. Pragmatically, we can identify three types of senior patients: patients presenting behavioral and psychological symptoms of dementia, patients affected by a chronic mental illness, patients experiencing a first major psychiatric syndrome in later life. The purpose of this article is to describe the specific programs developed by the day care hospital of the Geriatric Psychiatry Service, Geneva University Hospitals, to respond to the need of these groups of patients as well as their relatives. This community psychiatric care intends to provide a better psychological adaption in order to support functional and social recovery.


Assuntos
Hospital Dia , Psiquiatria Geriátrica , Transtornos Mentais , Doença Crônica , Hospital Dia/psicologia , Demência/terapia , Psiquiatria Geriátrica/métodos , Psiquiatria Geriátrica/tendências , Hospitais Universitários , Humanos , Transtornos Mentais/terapia
7.
Medicine (Baltimore) ; 98(37): e17157, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517862

RESUMO

Antimicrobial resistance, a major threat to human health, is mainly driven by the overuse of antimicrobials. The purpose of this study was to further investigate the relationship between antimicrobial use and resistance with a 15-year record in Southwest hospital, one of the largest hospitals in Southwest China and a university affiliated hospital, thus to further predict the antimicrobial resistance in an autoregressive integrated moving average (ARIMA) manner. Kirby-Bauer tests were carried out to figure out the drug sensitivity of Gram-negative bacterial. Antimicrobials (ß-lactamase inhibitor complex, aminoglycosides, quinolones, third and fourth-generation cephalosporins, carbapenems, cephamycins, oxacephems, and sulfonamides) consumption were calculated according to World Health Organization (WHO) anatomical therapeutic chemical classification index and expressed as annual defined daily dose (DDD) or DDD per 1000 out patients. Resistance rates of levofloxacin-resistant Escherichia coli, ceftazidime-resistant Klebsiella pneumoniae, amikacin-resistant Bacterium levans, imipenem-resistant Pseudomonas aeruginosa is positively correlated with the usage of aminoglycosides and quinolones; resistance rates of imipenem-resistant Acinetobacter baumanii is positively correlated with the usage of carbapenemes (P-value between the drug resistance of levofloxacin-resistant E. coli, ceftazidime-resistant K. pneumoniae and the usage of aminoglycosides is under .05, the other P-value are under .01); resistance rates of the drug resistance of levofloxacin-resistant E. coli is positively correlated with the usage of oxacephems (P < .01); resistance rates of imipenem-resistant P. aeruginosa is positively correlated with the usage of oxacephems and sulfonamides (P < .01).The present study presents one of the largest and longest retrospective analyses in China between antimicrobial consumption and antimicrobial resistance. Change of the usage of several antibacterial drugs has great influence on the drug resistance of Gram-negative bacterial. Of particular, ARIMA forecasting revealed that carbapenem related bacterial resistance should be closely watched.


Assuntos
Antibacterianos/uso terapêutico , Farmacorresistência Bacteriana , Uso de Medicamentos , Bactérias Gram-Negativas/efeitos dos fármacos , Aceitação pelo Paciente de Cuidados de Saúde , Monitoramento Epidemiológico , Hospitais Universitários , Humanos , Estudos Retrospectivos
8.
Zhonghua Wei Chang Wai Ke Za Zhi ; 22(8): 719-723, 2019 Aug 25.
Artigo em Chinês | MEDLINE | ID: mdl-31422608

RESUMO

Department of minimally invasive gastrointestinal surgery in Peking University Cancer Hospital (also named as Department of Gastrointestinal Surgery IV) was established on April 7, 2009. Up to now, ten years have passed since its foundation. As the first department built in specialized cancer hospital, which mainly focuses on laparoscopic surgery, its foundation and development has a very important historical and practical significance in the development of surgical oncology in China. Reviewing the rapid growth of the Department of Minimally Invasive Gastrointestinal Surgery over the past decade, on the one hand, it has benefited from the opportunities of the times and the support of leaders in Peking University Cancer Hospital at that time. More importantly, the progress owes to the pioneering Professor Su Xiangqian, who is brave and innovative, with indomitable spirit and advanced management philosophy. With rigorous training, the ability of the team has been steadily enhanced, the competitiveness has been gradually improved, and the development direction which focuses on laparoscopic gastric cancer surgery and laparoscopic colorectal cancer surgery has been established. Now, the Department of Minimally Invasive Gastrointestinal Surgery has become a well-known domestic gastrointestinal tumor center. In the past ten years, under the leadership of Professor Su Xiangqian, the growth of this team is innovative and comprehensive: (1) Introduce the internationally advanced Baldrige medical service management framework, and propose the "management by principle" concept to improve the core competitiveness of the department; (2) Establish an academic brand by laparoscopic standardized surgery training courses for gastrointestinal tumors, promote cooperation and exchange at home and abroad, and participate in international multi-center clinical research projects; (3) Adhere to the "formation of a research-oriented department, conducting clinical and basic research simultaneously" as the development direction; (4) Stick to the core development concept of team building and cultivate professional talents. Looking forward to the future, our team will not forget the beginning of the heart, and move forward! In the next ten years, we will break through ourselves and continue to pursue the higher level!


Assuntos
Procedimentos Cirúrgicos do Sistema Digestório/história , Neoplasias Gastrointestinais/história , Procedimentos Cirúrgicos Minimamente Invasivos/história , Institutos de Câncer/história , Institutos de Câncer/normas , China , Procedimentos Cirúrgicos do Sistema Digestório/educação , Procedimentos Cirúrgicos do Sistema Digestório/normas , Neoplasias Gastrointestinais/cirurgia , História do Século XX , História do Século XXI , Hospitais Universitários/história , Hospitais Universitários/normas , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos/educação , Procedimentos Cirúrgicos Minimamente Invasivos/normas , Desenvolvimento de Programas
9.
West Afr J Med ; 36(2): 138-143, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31385600

RESUMO

BACKGROUND: Holistic ward round (HWR) is a polyadic, multiphasic, holistic model of neurosurgical patient care. It is a multidisciplinary ward round where all healthcare providers involved in patients care, the patients, the relations, as well as clergymen (depending on the patients' faith and need) collectively work to review patient's condition and make decisions in the patient's best interest. OBJECTIVES: The study assessed the effectiveness of the holistic model of care and identified the challenges facing this model of healthcare delivery. METHODS: The study was qualitative in design and In-depth Interviews (IDIs) were conducted with eighteen (18) participants who were purposively selected. They include neurosurgeons, nurses, medical social workers and physiotherapists. The data were thematically content analysed with the help of ATLAS.ti (v.7) software. RESULTS: The study found that patients and relations have immensely benefitted from the model of care through psychosocial support. The major challenges facing HWR were logistic, timing and common problems found in the Nigerian healthcare system. CONCLUSION: It was concluded that for HWR to effectively help spinal cord injured patients further, the healthcare providers, patients and their families require support in different forms from outside the hospital.


Assuntos
Saúde Holística , Equipe de Assistência ao Paciente , Assistência ao Paciente , Assistência Centrada no Paciente/métodos , Adulto , Feminino , Hospitais Universitários , Humanos , Relações Interprofissionais , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Neurocirurgiões , Neurocirurgia , Nigéria , Fisioterapeutas , Pesquisa Qualitativa , Assistentes Sociais
10.
J Forensic Leg Med ; 67: 19-23, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31376649

RESUMO

In cases of death due to burn injury, it may be of great medico-legal importance to determine if the death is caused by fatal burn injury or due to other factors related to treatment. Therefore, this study aimed to investigate early predictors of mortality in patients with thermal burns admitted to Burn Unit, Ain Shams University Hospitals during a period of one year (2011). The study included 152 cases, mortalities represented 20.4% of the included cases (31 cases). Binary logistic regression analysis showed that, total body surface area (TBSA) of the burns and APACHE III score were significant predictors of mortality. This model resulted in accurate classification of 95.9% of the cases. Further multi-centric studies on larger sample sizes are recommended to validate the results of this study. Also, it is important to study the effect of co-morbidities as confounding factors on the prediction of mortality in patients with thermal burns.


Assuntos
Queimaduras/mortalidade , APACHE , Adolescente , Adulto , Superfície Corporal , Unidades de Queimados , Criança , Egito/epidemiologia , Feminino , Hospitais Universitários , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto Jovem
11.
Rev Fac Cien Med Univ Nac Cordoba ; 76(3): 154-158, 2019 08 29.
Artigo em Espanhol | MEDLINE | ID: mdl-31465182

RESUMO

Introduction: Aeromonas is a common cause of gastroenteritis but occasionally it can cause extraintestinal infections. The incidence of bacteremia by this genus is very low and in general the patients have associated base diseases. Materials and methods: Retrospective analysis of episodes of bacteremia by Aeromonas spp. during a period of eight years in the National Hospital of Clinics of the city of Córdoba, emphasizing age, sex, associated comorbidities, clinical presentation, focus, origin of the infection, clinical evolution, species prevalence and antimicrobial sensitivity of the same . Results: 10 episodes of bacteremia were recorded by Aeromonas spp. 60% corresponded to women and 40% to men. The average age was 65 years. In seven patients the origin of the infection was community and in three nosocomial. 70% of the patients presented predisposing base pathologies. The focus of bacteremia was abdominal in two cases. A. hydrophila complex was responsible for 50% of the cases. 80% of bacteremia were monomicrobial. The isolates generally showed high percentages of sensitivity. Conclusion: Bacteremia occurred in elderly patients of both sexes, most of whom had associated comorbidities. The majority of the infections originated in the community. While bacteremia by Aeromonas spp. it is rare, the mortality found in our study was relatively high despite the high percentage of sensitivity to antimicrobials.


Assuntos
Aeromonas/isolamento & purificação , Bacteriemia/microbiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/classificação , Antibacterianos/uso terapêutico , Bacteriemia/tratamento farmacológico , Bacteriemia/epidemiologia , Comorbidade , Resistência a Medicamentos , Feminino , Hospitais Universitários , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
12.
Rev Lat Am Enfermagem ; 27: e3162, 2019 Aug 19.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31432917

RESUMO

OBJECTIVE: to describe the activities developed by the liaison nurses for the continuity of care after hospital discharge. METHOD: descriptive, qualitative study, based on the theoretical reference. Strength Based Care. The sample comprised 23 liaison nurses. The data was collected through a semi-structured questionnaire via Survey Monkey electronic platform and analyzed through the content analysis technique, with pre-defined categories. RESULTS: among the liaison nurses, nine (39.14%), between 35 and 44 years of age; 17 (73.91%) were female; 15 (65.22%) were working eleven years or more nurse and 11 (47.82%), were between six and ten years old as a liaison nurse. The professionals participate in the identification of the patients who need care after hospital discharge, coordinate the planning of the hospital discharge and transfer the patient's information to an extra-hospital service. CONCLUSION: the activities developed by the liaison nurses focus on the needs of the patient and the articulation with the extra-hospital services, and can be adapted to the Brazilian context as a strategy to minimize the discontinuity of care at the time of hospital discharge.


Assuntos
Continuidade da Assistência ao Paciente/normas , Papel do Profissional de Enfermagem , Recursos Humanos de Enfermagem no Hospital/normas , Alta do Paciente/estatística & dados numéricos , Adulto , Brasil , Canadá , Feminino , Hospitais Universitários , Humanos , Masculino , Transferência de Pacientes , Pesquisa Qualitativa , Inquéritos e Questionários
13.
Stud Health Technol Inform ; 264: 1421-1422, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438161

RESUMO

Grenoble Alpes University Hospital (CHUGA) currently deploys a clinical data warehouse PREDIMED to integrate and analyze for research, education and institutional management the data of patients treated at CHUGA. In this poster, we present the methodology used to implement PREDIMED and illustrate its functionality through three first research use cases.


Assuntos
Data Warehousing , Hospitais Universitários , Humanos
14.
Ther Umsch ; 76(2): 77-83, 2019 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-31429396

RESUMO

The Interdisciplinary Stomatology Service at the Department of Oral Surgery and Dental Imaging, University Center for Dental Medicine and the University Hospital Basel, Switzerland - Results from 2003 - 2013 Abstract. Stomatological problems are common, but rarely diagnosed in private dental practice. Even for oral surgeon's diagnosis and therapy of these disorders could be challenging. Stomatological problems can indicate general health problems. Hence, the oral cavity is also known as the «mirror of systemic diseases¼. To tackle this problem, an interdisciplinary stomatological service in a specialized dental clinic was established in 1999 at the Center for Dental Medicine, University of Basel, Switzerland. A board of specialists (Dermatologists, Otorhinolaryngologists, Oral- and Maxillofacial surgeons) was summoned monthly to perform interdisciplinary consultations of selected patients with complex oral and medical disorders. The specific knowledge of each specialist helped to ensure a diagnosis, even of rare systemic disorders and symptoms. Networking with a variety of specialists built the foundation for synoptic therapy approaches. Thus, the center was able to provide appropriate care for patients suffering from severe, chronic and complex stomatological findings. The results presented in this article are part of a dissertation based on the analysis of 154 patients who were seen in the interdisciplinary consultations in 2003 - 2013.


Assuntos
Medicina Bucal , Hospitais Universitários , Humanos , Encaminhamento e Consulta , Suíça
15.
Stud Health Technol Inform ; 264: 969-973, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438068

RESUMO

Since the eighties, case mix evaluation methods based on diagnosis-related groups (DRG) were gradually introduced in developed countries. These methods of assessing the costs of diseases to measure the productivity of the hospital have been introduced in management softwares that are not accessible to low-income countries. In this study, the authors applied these methods to an open source hospital management information system (HMIS) implemented in three university hospitals in Great Lakes Africa. A comparative study of the financial burden of five major diseases, monitored as part of a universal health coverage (UHC) analysis, was carried out. The level of coverage of patients in the hospitals was evaluated and the impact of UHC policies demonstrated. Although the financial protection of patients treated in the three hospitals had improved, HIV and tuberculosis treatments that ought to be free, remained a considerable financial burden for the patient.


Assuntos
Sistemas de Informação Hospitalar , África , Efeitos Psicossociais da Doença , Hospitais Universitários , Humanos , Cobertura Universal do Seguro de Saúde
16.
Stud Health Technol Inform ; 264: 1508-1509, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438205

RESUMO

The Demonstrator study aims to analyse comorbidities and rare diseases among patients from German university hospitals within the German Medical Informatics Initiative. This work aimed to design and determine the feasibility of a model to assess the quality of the claims data used in the study. Several data quality issues were identified affecting small amounts of cases in one of the participating sites. As a next step an extension to all participating sites is planned.


Assuntos
Confiabilidade dos Dados , Informática Médica , Hospitais Universitários , Humanos
17.
Stud Health Technol Inform ; 264: 1580-1581, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438241

RESUMO

Clinical Decision Support Systems (CDSS) are promising to support physicians in finding the right diagnosis of patients with rare diseases (RD). The MIRACUM consortium, which includes ten university hospitals in Germany, will establish a diagnosis support system for RD. This system conducts a similarity analysis on distributed clinical data with the aim to identify similar patient cases at each MIRACUM site to offer the physician a hint to a possible diagnosis.


Assuntos
Sistemas de Apoio a Decisões Clínicas , Alemanha , Hospitais Universitários , Humanos , Médicos
18.
Pan Afr Med J ; 33: 79, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31448041

RESUMO

Introduction: Family planning is a high impact strategy to reduce maternal mortality and to prevent mother-to-child transmission of HIV. This study aims to describe contraceptive practices of HIV-infected women followed upon an ambulatory basis at the Treichville University Hospital. Methods: We conducted a cross-sectional descriptive multicenter survey of people living with HIV in the ambulatory care units of the Treichville University Hospital from 1 April to 30 June 2016. During this period, all HIV positive patients of childbearing age attending the Department of Obstetrics and Gynecology, the Pneumophtisiology Department, the Department of Dermatovenereology and the Department of internal medicine were invited to complete a standardized questionnaire on the sociodemographic, medical characteristics and the contraceptive practices. Results: In total, 283 women agreed to participate in the study, their median age was 36 years with an average parity of 1.7. Patients were nulliparous in only 22.3% of cases and lived with a partner in 54.8% of cases. They had no child with the current partner in 68.2% of cases. The partner was informed about their HIV status in 51.6% of cases. They were under antiretroviral treatment in 92.9% of cases with a median mean CD4 of 382 cells/mL. The majority of patients (62.9%) declared that they were using a modern contraceptive method. They mainly used progestin injectable (45.5%) and contraceptive implant (32.6%). The practice of dual protection was reported by only 17.4% of them. Secondary and higher education (OR=2.23 [1,35-3,69], p=0.01), multiparity (OR=1.84 [1,11-3,06], p=0.002) and revelation of HIV positive status to the partner (OR=1.86 [1,14-3,03], p<0.01) were factors significantly associated with the use of contraception. Conclusion: Based on our experience, contraceptive practices in women infected with HIV are generally discouraging. It is essential to develop strategies to improve the integration of family planning into the management of HIV-infected women.


Assuntos
Fármacos Anti-HIV/administração & dosagem , Comportamento Contraceptivo/estatística & dados numéricos , Anticoncepção/métodos , Infecções por HIV/tratamento farmacológico , Adolescente , Adulto , Contagem de Linfócito CD4 , Anticoncepção/estatística & dados numéricos , Costa do Marfim , Estudos Transversais , Serviços de Planejamento Familiar/estatística & dados numéricos , Feminino , Hospitais Universitários , Humanos , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Pessoa de Meia-Idade , Parceiros Sexuais , Adulto Jovem
19.
Medicine (Baltimore) ; 98(34): e16951, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31441892

RESUMO

Teaching status/academic ranking may play a role in the variations in trauma center (TC) outcomes. Our study aimed to determine the relationship between TC teaching status and injury-adjusted, all-cause mortality in a national sampling.Retrospective review of the National Sample Program (NSP) from the National Trauma Data bank (NTDB). TCs were categorized based on teaching status. Adjusted mortality was determined by observed/expected (O/E) mortality ratios, derived using TRauma Injury Severity Score methodology from the Injury Severity Score and Revised Trauma Score. Chi-square and t test analyses were utilized with a statistical significance defined as P <.05.Of the 94 TCs in the NSP, 46 were university, 38 were community teaching, and 10 were community nonteaching. For the University TCs, 62.8% were American College of Surgeons (ACS) level 1 and 81.2% state level 1. Of the community teaching TCs, 39.0% was ACS level 1 and 35.1% was state level 1. Of the community nonteaching TCs, 0% was ACS level 1 and 11.1% was state level 1. University TCs had a significantly higher O/E mortality rate than community teaching (0.75 vs 0.71; P = .04). There were no differences in O/E between community teaching and nonteaching TCs (0.71 vs 0.70; P = .70).Community teaching and nonteaching TCs have lower injury-adjusted, all-cause mortality rates than University Centers. Future studies should further investigate key differences between University TCs and community teaching TC to evaluate possible quality and performance improvement measures.


Assuntos
Hospitais Comunitários/estatística & dados numéricos , Hospitais Universitários/estatística & dados numéricos , Avaliação de Resultados (Cuidados de Saúde)/estatística & dados numéricos , Centros de Traumatologia/normas , Ferimentos e Lesões/mortalidade , Adulto , Bases de Dados Factuais , Feminino , Humanos , Escala de Gravidade do Ferimento , Masculino , Estudos Retrospectivos , Centros de Traumatologia/classificação , Estados Unidos
20.
Rev. pesqui. cuid. fundam. (Online) ; 11(4): 894-899, jul.-set. 2019. tab
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1005683

RESUMO

Objective: The study's purpose has been to delineate the clinical-epidemiological profile of patients undergoing cardiac catheterization; furthermore, to propose a management technology to create a database with information of epidemiological relevance. Methods: It is a retrospective study with a quantitative approach, which considers the databases and medical records of 1,890 patients who underwent cardiac catheterization at a hemodynamic unit from April 2014 to April 2016. Microsoft Office Excel® software was used to both organize and analyze the data. CAAE No. 55615616.0.0000.5282. Results: The average age was 61.45 years old. The majority of the assisted population is indicated by the National Regulation System (63%) with the following distribution: (52.86%) male and (47.14%) female. It was identified that 79.5% of the users have high blood pressure. It was found that the current strategy for monitoring the assisted users shows information deficiencies


Objetivo: Traçar o perfil clínico-epidemiológico de usuários submetidos ao cateterismo cardíaco; propor uma tecnologia gerencial para criar um banco de dados com informações de interesse epidemiológico. Método: Estudo quantitativo, retrospectivo de bases de dados e prontuários de 1890 usuários submetidos ao procedimento na unidade de hemodinâmica entre abril/2014 e abril/2016. Utilizou-se o software Microsoft Office Excel® para organização e análise dos dados. CAAE:55615616.0.0000.5282 Resultados: A idade média é de 61,45 anos. A maioria da população atendida é encaminhada pelo Sistema de Regulação (63%) e sua distribuição: (52,86%) masculino e (47,14%) feminino. Identificou-se que 79,5% dos usuários são hipertensos. Verificou-se que a atual estratégia para acompanhamento dos usuários atendidos apresenta falhas nas informações. Conclusão: A consulta de enfermagem com a obtenção de informações relevantes e determinantes para as condutas de enfermagem, contribui para a melhoria do Sistema Único de Saúde. Descritores: Cateterismo cardíaco; Enfermagem; Fatores de risco; Hemodinâmica; Perfil epidemiológico


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Cateterismo Cardíaco/enfermagem , Cateterismo Cardíaco/estatística & dados numéricos , Sistemas de Informação em Saúde , Perfil de Saúde , Hospitais Universitários
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