scholarly journals Health Characteristics of the Madeira Riverine Population

2020 ◽  
Vol 185 (7-8) ◽  
pp. e1222-e1228
Author(s):  
Lízia Felix Cotias de Mattos Oliveira ◽  
Robert P Lennon ◽  
John W Roman ◽  
John F Sullivan ◽  
Edmund A Milder
Keyword(s):  
Intestinal Parasites ◽  
Medical Center ◽  
Dental Health ◽  
Large Population ◽  
Medical Personnel ◽  
Urban Centers ◽  
Chi Square ◽  
Brazilian Government ◽  
Institutional Review ◽  
Hospital Ships

Abstract Introduction The Amazon River Basin is the largest and the most complex fluvial system in the world. The Brazilian government provides dental and medical care to the riverine populations in this region in part through medical assistance missions, conducted by four hospital ships. The Brazilian Navy invited U.S. Navy medical personnel to join the February 2019 mission aboard Navio de Assistência Hospitalar (NAsH) Carlos Chagas to provide care along the Madeira River. Materials and Methods In the course of providing primary care services, demographic, health, and dental data of the Madeira Riverine population were collected. Descriptive statistics were used to generate average health and dental data. Chi-square tests were used to compare population prevalence data. Linear regression was used to evaluate dental caries per patient with proximity to nearest large population center and village population. This project was approved by Naval Medical Center Portsmouth Institutional Review Board. Results The Madeira Riverine population has similar dental health to Brazilians living in urban centers. Their prevalence of hypertension and diabetes compared favorably with the U.S. averages (17.7% vs. 34.3% [P < 0.001] and 3% vs. 9.4% [P < 0.001], respectively). Based on the most prevalent ICD-10 code diagnoses, future missions can expect high volumes of patients with intestinal parasites, hypertension, common skin infections, women’s health concerns, and musculoskeletal complaints. Conclusions This study adds to the limited health data currently available on Brazilian Riverine populations. It demonstrates the effectiveness of the Hospital Assistance missions in providing dental care and documents some unique aspects of Riverine health that warrant further study.

Venous Thromboembolism and High Grade Gliomas

1993 ◽  
Vol 70 (03) ◽  
pp. 393-396 ◽  
Author(s):  
Mandeep S Dhami ◽  
Robert D Bona ◽  
John A Calogero ◽  
Richard M Hellman
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Medical Center ◽  
Significant Risk ◽  
Bleeding Complications ◽  
Fisher Exact Test ◽  
High Grade ◽  
Chi Square ◽  
Exact Test ◽  
High Grade Gliomas

SummaryA retrospective study was done to determine the incidence of and the risk factors predisposing to clinical venous thromboembolism (VTE) in patients treated for high grade gliomas. Medical records of 68 consecutive patients diagnosed and treated at Saint Francis Hospital and Medical Center from January 1986 to June 1991 were reviewed. The follow up was to time of death or at least 6 months (up to December 1991). All clinically suspected episodes of VTE were confirmed by objective tests. Sixteen episodes of VTE were detected in 13 patients for an overall episode rate of 23.5%. Administration of chemotherapy (p = 0.027, two tailed Fisher exact test) and presence of paresis (p = 0.031, two tailed Fisher exact test) were statistically significant risk factors for the development of VTE. Thrombotic events were more likely to occur in the paretic limb and this difference was statistically significant (p = 0.00049, chi square test, with Yates correction). No major bleeding complications were seen in the nine episodes treated with long term anticoagulation.We conclude that venous thromboembolic complications are frequently encountered in patients being treated for high grade gliomas and the presence of paresis and the administration of chemotherapy increases the risk of such complications.

Characteristics and risk factors associated with stroke subtypes among adult patients admitted to stroke unit of JUMC

2019 ◽  
Vol 15 ◽  
Author(s):  
Bekalu Getachew Gebreegziabher ◽  
Tesema Etefa Birhanu ◽  
Diriba Dereje Olana ◽  
Behailu Terefe Tesfaye
Keyword(s):  
Risk Factors ◽  
Stroke Unit ◽  
Medical Center ◽  
Data Entry ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Factors Associated ◽  
Stroke Subtypes

Background: Stroke is a great public health problem in Ethiopia. According to reports, in-hospital stroke mortality was estimated to be 14.7% in Ethiopia. Despite this, in this country researches done on factors associated with stroke sub-types were inadequate. Objective: To assess the Characteristics and risk factors associated with stroke sub-types among patients admitted to JUMC. Methods and materials: A retrospective cross sectional study was conducted from May 2017 to May 2018 in stroke unit of Jimma University Medical Center. A total of 106 medical charts of patients diagnosed with stroke were reviewed. Checklist comprising of relevant variables was used to collect data. SPSS version 21 was employed for data entry and analysis. Chi-square test was used to point-out association and difference among stroke sub-types. The data was presented using text, tables and figures. Result: From a total of 106 patients, 67(63.2%) were men. The mean ± SD of age was 52.67±12.46 years, and no significant association was found. Of all the patients, 59(55.6%) had ischemic strokes and 47(44.4%) had hemorrhagic strokes. The most common risk factor in the patients was alcohol use with a prevalence of 69.9%. Of all the risk factors, only sex, cigarettes smoking and dyslipidemia were significantly associated to sub-types of stroke. Conclusion: Ischemic stroke was the most common subtype of stroke. Sex of patient, cigarette smoking and dyslipidemia are significantly associated with the two stroke subtypes.

Comparison of Clinical Outcomes With Drug Coated Balloons Versus Plain Balloon Angioplasty In Chronic Limb-Threatening Ischemia

2021 ◽  
pp. 153857442110225
Author(s):  
Joel Mathew John ◽  
Vimalin Samuel ◽  
Dheepak Selvaraj ◽  
Prabhu Premkumar ◽  
Albert A Kota ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Interventional Procedure ◽  
Tertiary Care ◽  
Arterial Disease ◽  
Multivariable Logistic Regression Analysis ◽  
Tertiary Care Centre ◽  
Chi Square ◽  
Exact Test ◽  
Institutional Review ◽  
Chi Square Test

Objective: The use of drug coated balloon (DCB) for angioplasty has shown superior efficacy against plain balloons for treating complex infrainguinal arterial disease. We report and compare the clinical outcomes following application of DCB(Paclitaxel) and plain angioplasty (POBA) in our tertiary care centre. Methods: A retrospective, single centre analysis of 301 patients with chronic limb-threatening ischemia involving the infrainguinal segment was conducted between September 2014 and September 2018, after approval from the Institutional review board. We analyzed clinical outcomes by measuring postoperative ABI improvement, restenosis requiring reintervention procedure, minor and major amputations at the end of 18 months. . To find the association between the group variables (POBA and DCB) and other risk variables, Chi-square test/Fisher’s exact test was used. Multivariable logistic regression analysis was used. Results: Patients who underwent treatment with plain balloon (POBA) and DCB(Paclitaxel) angioplasty were 246(81.7%) and 55(18.3%) respectively. Our study group was predominantly male (Male: Female = 6.7:1), most patients were more than 50 years of age (n = 251, 83.4%). Smoking (n = 199, 66.1%) and diabetes (n = 210, 69.8%) were the most common atherosclerotic risk factors. Postoperative Ankle Brachial Pressure Index (ABI) improvement were similar in both groups (POBA = 57.7%; DCB = 69.8%; p = 0.103). Minor and major amputations following POBA were 26% and 22%; and DCB were 12.7% and 16.4% respectively. Re-stenosis requiring a re-interventional procedure within 18 months was 15%, (n = 37) following POBA; and 12.7% (n = 7) following DCB (p = 0.661). Conclusions: This retrospective study shows similar clinical limb related outcomes following POBA and DCB at 18 months. However, our comparative analysis between the POBA and DCB groups was totally unadjusted and not adjusted for common confounders such as age and sex. Hence, for one to draw definitive conclusions leading to changes in clinical practice; a randomized, prospective study with a larger patient cohort is needed.

scholarly journals Perceptions of Seasonal Influenza Vaccine Among U.S. Army Civilians and Dependents in the Kaiserslautern Military Community: A Mixed-Methods Survey

2021 ◽  
Author(s):  
Veronica M Burns ◽  
Fritz M Castillo ◽  
Rodney L Coldren ◽  
Trisha Prosser ◽  
Renee L Howell ◽  
...  
Keyword(s):  
Online Survey ◽  
Seasonal Influenza ◽  
Medical Center ◽  
Vaccine Uptake ◽  
Free Text ◽  
Chi Square ◽  
Military Health ◽  
Influenza Outbreak ◽  
Flu Vaccination ◽  
Flu Vaccine

ABSTRACT Introduction Influenza is a globally occurring viral respiratory infection that can lead to hospitalizations and death. An influenza outbreak can interfere with combat readiness in a military setting, as the infection can incapacitate soldiers. Vaccination remains the most effective tool to prevent and mitigate seasonal influenza. Although influenza vaccinations for U.S. Army soldiers can be monitored through military health systems, those systems cannot capture DoD civilians and Army dependents who may not use military health services. This study aims to gauge flu vaccine uptake and perceptions in U.S. Army civilians and dependents. Materials and Methods An online survey was e-mailed to civilian and dependent enrollees of Landstuhl Regional Medical Center. The survey contained 24 questions pertaining to demographics, vaccine history, history of the flu, and beliefs toward vaccines. Chi-square tests, t-tests, and logistic regressions were performed to investigate the association between demographic, behavior, and belief factors with vaccine uptake. Free-text answers were coded and categorized by themes. Results Over 70% of respondents were vaccinated for the flu. There were differences between vaccinated and unvaccinated respondents regarding their perceptions of barriers to vaccination, benefits of the flu vaccine, severity of flu symptoms, and personal risk of getting ill with the flu. After controlling for confounders, flu vaccination in the previous season and healthcare worker status were associated with increased vaccine uptake, while perceived barriers to influenza vaccination were associated with decreased vaccine uptake. Conclusions Flu vaccine uptake may be increased by increasing access to vaccination, promoting vaccination and addressing concerns at the provider level, and engaging positively framed public messaging. Increasing flu vaccine uptake is of particular importance as the flu season approaches during the COVID-19 (Coronavirus disease 2019) pandemic.

A Tale of Two Cities: What’s Driving the Firearm Mortality Difference in Two Large Urban Centers?

2021 ◽  
pp. 000313482094525
Author(s):  
Jessica K. Friedman ◽  
Elizabeth Mytty ◽  
Scott Ninokawa ◽  
Tara Reza ◽  
Elinore Kaufman ◽  
...  
Keyword(s):  
Injury Severity ◽  
Univariate Analysis ◽  
Case Fatality ◽  
Bivariate Analysis ◽  
Continuous Variables ◽  
Urban Centers ◽  
Chi Square ◽  
Police Data ◽  
Lower Blood ◽  
Mortality Difference

Introduction Per police data, the case fatality rate (CFR) of firearm assault in New Orleans (NO) over the last several years ranged between 27% and 35%, compared with 18%-22% in Philadelphia. The reasons for this disparity are unknown, and potentially reflect important system differences with broader implications for the reduction of firearm mortality. Methods A retrospective analysis of police and city-specific trauma databases between 2012 and 2017 was performed. Victims of firearm assaults within city limits were included. Univariate analysis was performed using chi-square for categorical and t-test for continuous variables. Bivariate analysis was conducted using logistic regression. Results Per police data, the CFR of firearm assault was 31% in NO and 20% in Philadelphia. However, per trauma registry data, the CFR of firearm assault was 14% in NO and 25% in Philadelphia. Patients in Philadelphia were older, had higher injury severity score, and lower blood pressure. Patients in NO had higher rates of head injury. 51% of patients in Philadelphia arrived via police compared to <1% in NO. There was no mortality difference between police and emergency medical service (EMS) transport. Longer EMS prehospital times were associated with increased mortality in NO but not Philadelphia. A much larger percentage of patients died on-scene in NO than Philadelphia. Conclusions Our findings suggest that the major driver of increased mortality following firearm assault in NO compared with Philadelphia is death prior to the arrival of first responders. Interventions that shorten prehospital time will likely have the greatest impact on mortality in NO. This should include the consideration of police transport.

Social assessment of children dental health and its determining factors

2021 ◽  
Vol 21 (2) ◽  
pp. 123-131
Author(s):  
T. G. Svetlichnaya ◽  
A. S. Mityagina ◽  
T. M. Burkova ◽  
N. M. Ogorelkova
Keyword(s):  
Risk Factors ◽  
Oral Hygiene ◽  
Primary Teeth ◽  
Dental Health ◽  
Tooth Decay ◽  
Chi Square ◽  
Significance Level ◽  
Pediatric Dentist ◽  
Chi Square Test ◽  
Decay Risk

Relevance. The high prevalence of tooth decay requires investigation of its risk factors. The aim was to study tooth decay risk factors among six-year-old children according to the level of dental health (based on parents’ assessment).Materials and methods. The research evaluated the dental health of six-year-olds and factors defining their oral health; The study surveyed 515 parents of six-year-old children from 7 kindergartens in Arkhangelsk. Pearson chi-square test assessed the differences in the frequency of tooth decay factors among six-year-old children according to the level of dental health. The accepted significance level was 0.05.Results. The Arkhangelsk parents evaluated the dental health of their six-year-olds as relatively favourable: good (41.2%) and satisfactory (46.6%). Only 9.5% of children had poor health. Children generally had good oral hygiene skills: 86.8% liked brushing their teeth; 60.2% squeezed the optimal amount of toothpaste on the toothbrush; 56.7% brushed their teeth twice a day. The dental literacy of parents was satisfactory: 67.0% purchased toothpaste for children; 90.8% considered necessary to treat primary teeth; 69.2% replaced toothbrush every three months; 59.7% visited a pediatric dentist twice a year. The children with poor dental health had insufficient oral hygiene skills: 46.9% did not like teeth cleaning; 51.1% brushed their teeth once a day. Their diet was not healthy: 100.0% did not eat hard food; 65.3% frequently consumed sweets. The parents  of children with poor dental health had low medical literacy and poor oral hygiene: 46.9% did not know that treatment of primary teeth was necessary; 42.9% considered the treatment of primary teeth as unnecessary; 32.6% purchased whatever toothpaste. The general negative trend is to use toothpaste without fluoride (68.1%).Conclusions. The results of the study demonstrated a significantly higher frequency of cariogenic factors in children with poor dental health.

PRACTICAL EPIGRAM OF APGAR SCORE

PEDIATRICS ◽  
1989 ◽  
Vol 84 (5) ◽  
pp. 778-778
Author(s):  
Joseph Butterfield
Keyword(s):  
Apgar Score ◽  
Scoring System ◽  
Medical Center ◽  
Medical Personnel ◽  
Effective Adjunct

Despite the value of the [Apgar] scoring system, experience has shown that it may be difficult to memorize the categories that make up the score and that [some] medical personnel are not familiar with it. The purpose of this communication is to describe an epigram (Figure) which embodies the basic components of the scoring system and implements its application. [SEE TABLE 1 IN SOURCE PDF.] The epigram has not altered the essence of the Apgar scoring system. . . . It does afford a means of remembering it easily. This has been an effective adjunct in expanding the use of the Apgar Score in this medical center, and it may be of value to those physicians who are interested in furthering the employment of this scoring system in their hospitals.

HUBUNGAN SIKAP PASIEN TERHADAP HAK DAN KEWAJIBAN RAWAT INAP DI RUMAH SAKIT PEKANBARU MEDICAL CENTER (PMC)

2021 ◽  
Vol 13 (1) ◽  
pp. 17-25
Author(s):  
Nur Maimun ◽  
Arnawilis ◽  
Cindy Feby Fayza ◽  
Nur Asikin
Keyword(s):  
Patient Safety ◽  
Medical Information ◽  
Medical Center ◽  
Patient Treatment ◽  
Patient Attitudes ◽  
Chi Square ◽  
Cross Sectional ◽  
The Right ◽  
Relationship Of ◽  
The Relationship

Patient as service users have right and obligations to be hospitalized and patients also have the right to medical information in receiving medical practice services. This study aims to determine the relationship between patient attitudes towards the rights and obligations of being hospitalized in the hospital Pekanbaru Medical Center (PMC). This research method using observational analytic method with cross sectional design. The total sample used in this study 107 sample were taken as simpel random sampling. Chi square test is used to determine the relationship between variables. The data were processed using SPSS statistical software and analyzed using univariate and bivariate analyzes. Of the result obtained of the study namely the relationship between patient attitude to the rights and obligations of patient with chi-suare obtained pvalue 0.016 (<0,05), the relationship of attitude patients to the rights and obligations of choosing a doctor and class of patient care with chi-square obtained pvalue 0,070 (<0,05), the relationship of patient attitudes to the right and obligations of confidentiality of disease by inpatient medical staff with chi-square obtained pvalue 0,000 (<0,05), the relationship of patient attitudes to the rights and obligations of consent to the patient treatment with chi-square obtained pvalue 0,000 (<0,05), the relationship of patient attitudes to the right and obligation of patient safety with chi-square obtained pvalue 0,000 (<0,05), the relationship between patient attitudes towards the right and obligations of patient safety with chi-square obtained pvalue 0,000 (<0,05). Suggestions in order to protect what has been achieved in this case is his ability as effort of service is getting better in the future Keyword : Attitudes of patient, Rights and Obligations inpatient, Hospital

scholarly journals The Incidence of Bleeding and the Factors That Influence Its Development among Patients Admitted With Dengue Fever

2017 ◽  
Vol 9 (2) ◽  
pp. 23-28
Author(s):  
Krishna Bahadur Thapa ◽  
Namrata KC ◽  
T Koirala ◽  
A Bhatttarai
Keyword(s):  
Platelet Count ◽  
Dengue Fever ◽  
Medical Center ◽  
Adult Population ◽  
World Health ◽  
Chi Square ◽  
Factors Affecting ◽  
Female Sex ◽  
Unit Increase ◽  
Health Organization

Background: Dengue virus is now classified as a major global health threat by the World Health Organization. Bleeding is a common complication and is one of the most feared. There is an increase incidence in the adult population, hence, the focus of this study.Objectives: To determine the incidence of bleeding and the factors that influence its development among patients admitted with dengue fever at Fatima Medical Center, Phillipines from January 2009 to December 2011.Methods: This is a case control study using chart review. The incidence of bleeding is calculated using risk ratio. Factors affecting bleeding are determined using chi square for qualitative variables and T-test or ANOVA for quantitative variables. Simultaneous determination of factors association with bleeding will be analyzed using multiple logistic regression. Level of significance will be set at alpha = 0.05.Results: The female sex is significantly more prone to develop bleeding (p=0.044). There is no significant increase in bleeding in patients who have co-morbidities (p=0.447). In every one unit increase in WBC (1 x 109) the odds of bleeding decrease by 15%. For every one unit increase in hematocrit the odds of bleeding decreases by 6.8%. For every one unit increase in platelet count the odds of bleeding decreases by 3% that is every 10 unit increase in platelet count the odds of bleeding decrease by 22.9%.Conclusions: Female sex, a low initial WBC and platelet count will increase a patient’s propensity to develop bleeding.Journal of Gandaki Medical College Volume, 09, Number 2, July December  2016, page: 23-28

scholarly journals An audit of US FDA warning letters issued to sponsors, institutional review boards and investigators over a six-year period

2021 ◽  
pp. 01-06
Author(s):  
Unnati Saxena ◽  
Debdipta Bose ◽  
Shruti Saha ◽  
Nithya J Gogtay ◽  
Urmila M Thatte
Keyword(s):  
Adverse Drug Events ◽  
The United States ◽  
Institutional Review Boards ◽  
Chi Square ◽  
Institutional Review ◽  
United States Food ◽  
Post Marketing ◽  
Chi Square Test ◽  
Us Fda ◽  
Review Boards

The present audit was carried out with the objective of evaluating warning letters (WLs) issued to trial sponsors, clinical investigators and institutional review boards (IRBs) by the United States Food and Drug Administration during a six-year period and compare it with two similar earlier audits. WLs were reviewed and classified as per stakeholders and further categorised as per predefined violation themes. The chi-square test was performed for trend analysis of WLs. A total of 62 WLs were issued to the three stakeholders. The maximum number of WLs were issued to the clinical investigators (36/62, 58.06%), followed by sponsors (19/62, 30.64%), and least to the IRBs (7/62, 11.29%). Among sponsors, lack of standard operating procedures for the monitoring, receipt, evaluation and reporting of post-marketing adverse drug events was the most common violation theme (8/19, 42.1%). Among clinical investigators, deviation from investigational plan was the most common violation theme (31/36, 86.11%.). For IRBs, inadequate documentation was the most common violation theme (6/7, 85.71%). We saw an overall reduction in the number of WLs issued to the stakeholders. Thus, we identified multiple areas on which each stakeholder should work for improvement.

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