Tag: nevin manimala

Eur Rev Med Pharmacol Sci. 2023 May;27(9):3887-3891. doi: 10.26355/eurrev_202305_32294.

ABSTRACT

OBJECTIVE: The aim of the present study is to evaluate the success rate and safety of both auto-grafts and collagen-based semi-synthetic grafts in patients with dura defects.

PATIENTS AND METHODS: A prospective comparative study was conducted at the neurosurgery departments of different hospitals in Peshawar and Faisalabad. Patients were divided into two groups: A (autologous graft) and B (semi-synthetic graft). Dura graft autologous was applied in one group of patients with supratentorial brain surgery. Fascia lata was used, harvested from the lateral thigh, 3 to 5 cm long incision at the junction of the upper and middle one-third of the upper leg. A bone flap was implanted in the subcutaneous region in the abdominal part. Perioperative antibiotics were given to all the patients, and surgical drains placed intraoperatively were removed after 24 hours of surgery. In the second group, semi-synthetic dura grafts of 2.5×2.5 cm and 5×5 cm 7.5×7.5 cm sizes were used. Statistical analysis was performed using SPSS version v.20. Student’s t-test was performed for the two groups to compare categorical variables, and the data were considered statistically significant at p > 0.05.

RESULTS: In this study, 72 patients of both genders were recruited. We observed that the Semi-synthetic collagen matrix had less surgical time. The mean difference in surgical duration was observed as 40 minutes. However, both groups reported statistically significant differences in terms of surgical duration (< 0.001). No case of infection was reported in both groups. The overall mortality ratio was 12%. Two male deaths were recorded due to cardiovascular disorders, while one death of a 42-year male was also recorded.

CONCLUSIONS: Based on the above findings, it may be concluded that using a semi-synthetic collagen substitute for dura repair is a simple, safe, and effective alternative to the autologous graft for dura repair in dura defects.

PMID:37203812 | DOI:10.26355/eurrev_202305_32294

Eur Rev Med Pharmacol Sci. 2023 May;27(9):3823-3832. doi: 10.26355/eurrev_202305_32287.

ABSTRACT

OBJECTIVE: This study aimed to assess the effect of radial shock wave and ultrasound therapy combined with traditional physical therapy on foot function and range of motion in chronic plantar fasciitis.

PATIENTS AND METHODS: Sixty-nine participants with chronic plantar fasciitis (25-56 years) were allocated randomly into three groups. Group (A) received ultrasound (US) therapy plus conventional physical therapy exercises (in the form of stretching, strengthening exercise, and deep friction massage), Group (B) received a radial shock wave (RSW) therapy plus conventional physical therapy exercises, and Group (C) received a combination of both RSW and US therapy in addition to conventional physical therapy exercises, with 3 sessions per week for US therapy and one session for RSW therapy, in addition to 45 minutes of exercises for all groups for 4 consecutive weeks. Foot function was assessed using the foot function index (FFI), and ankle dorsiflexion range of motion was measured using the Baseline® bubble inclinometer at baseline and 4 weeks following treatment.

RESULTS: ANOVA revealed significant differences (p<0.05) in the measured outcomes among the groups after treatment. Tukey’s honest significant difference post-hoc test demonstrated a highly statistically significant (p<0.001) improvement in the assessed outcomes of group C in the post-intervention settings when compared to the other groups. After 4 weeks of intervention, the mean (SD) of FFI in groups A, B, and C were (64.54±4.91, 61.93±4.17, and 45.16±4.57) respectively, and the active range of motion (ROM) of the ankle dorsiflexion were (35.27±3.22, 36.59±2.91, and 41.85±3.04) respectively.

CONCLUSIONS: The addition of RSW to US with the conventional physical therapy program improved foot function and ankle dorsiflexion range of motion significantly for patients with chronic plantar fasciitis.

PMID:37203806 | DOI:10.26355/eurrev_202305_32287

Eur Rev Med Pharmacol Sci. 2023 May;27(9):3799-3808. doi: 10.26355/eurrev_202305_32285.

ABSTRACT

OBJECTIVE: The clinical work of ICU doctors is characterized by high intensity and medical risks, which lead to a highly stressful state for a long time and the occurrence of resignation due to long-term burnout. This study analyzes the correlation between the personal life, hospital work, social opinion, and psychological assessment of ICU physicians and their resignation intention.

SUBJECTS AND METHODS: This study is a multicenter questionnaire on the factors influencing resignation intention among ICU physicians. The study was completed through Critical Care E Institute (CCEI) and China Calm Therapy Research Group Academic Organization (CNCSG) by contacting critical care physicians in 3-A hospitals in 34 provinces in China. The questionnaire was in electronic format, and the results were filled in using the WeChat scan code. The survey included 22 indicators which included basic information about physicians (including gender, marriage, children, and income, etc.), hospital work (weekly working hours, on night duty, hospital environment, the evaluation of hospital’s emphasis on medical staff, etc.), and SCL-90 psychological assessment.

RESULTS: A total of 1,749 ICU physicians completed the questionnaire. The results showed that 1,208 physicians (69.1%) intended to resign. There were statistical differences between the group’s resignation intention and without resignation intention on 13 indicators. These indicators include professional title, night shift every few days, hospital hours/week, income satisfaction, work environment satisfaction, career prospect, and SCL-90 score, etc. (all p<0.05, respectively). The remaining nine indicators were not statistically different between the two groups (all p>0.05, respectively). Logistics analysis showed that working years, hospital hours (h/week), income satisfaction, work environment satisfaction, pride in hospital work, career prospects, and total SCL-90 score were all independent influences on physicians’ choice of resignation intention (all p<0.05, respectively). The ROC curves’ results showed that all seven indicators’ predictive diagnostic value was low, with AUC areas ranging from 0.567 to 0.660. However, the combined diagnostic model of seven indicators has moderate diagnostic value. The AUC area of the model was 0.740 (95% CI: 0.718-0.760), with a sensitivity of 75.99% and specificity of 60.07%.

CONCLUSIONS: Physicians’ income, working years, work environment satisfaction, career prospects, and psychological well-being can influence the choice of physicians’ resignation intention in Chinese intensive care units. Government administration and hospitals can develop appropriate policies to enhance doctors working in hospital, thus reducing physicians’ resignation choices.

PMID:37203804 | DOI:10.26355/eurrev_202305_32285

Paediatr Anaesth. 2023 May 19. doi: 10.1111/pan.14695. Online ahead of print.

ABSTRACT

BACKGROUND: Inhalational anesthetic agents are potent greenhouse gases with global warming potential that far exceed that of carbon dioxide. Traditionally, pediatric inhalation inductions are achieved with a volatile anesthetic delivered to the patient in oxygen and nitrous oxide at high fresh gas flows. While contemporary volatile anesthetics and anesthesia machines allow for a more environmentally conscious induction, practice has not changed. We aimed to reduce the environmental impact of our inhalation inductions by decreasing the use of nitrous oxide and fresh gas flows.

METHODS: Through a series of four plan-do-study-act cycles, the improvement team used content experts to demonstrate the environmental impact of the current inductions and to provide practical ways to reduce this, by focusing on nitrous oxide use and fresh gas flows, with visual reminders introduced at point of delivery. The primary measures were the percentage of inhalation inductions that used nitrous oxide and the maximum fresh gas flows/kg during the induction period. Statistical process control charts were used to measure improvement over time.

RESULTS: 33 285 inhalation inductions were included over a 20-month period. nitrous oxide use decreased from 80% to <20% and maximum fresh gas flows/kg decreased from a rate of 0.53 L/min/kg to 0.38 L/min/kg, an overall reduction of 28%. Reduction in fresh gas flows was greatest in the lightest weight groups. Induction times and behaviors remained unchanged over the duration of this project.

CONCLUSIONS: Our quality improvement group decreased the environmental impact of inhalation inductions and created cultural change within our department to sustain change and foster the pursuit of future environmental efforts.

PMID:37203788 | DOI:10.1111/pan.14695

Stud Health Technol Inform. 2023 May 18;302:541-545. doi: 10.3233/SHTI230201.

ABSTRACT

The use and shareability of Clinical Quality Language (CQL) artefacts is an important aspect in enabling the exchange and interoperability of clinical data to support both clinical decisions and research in the medical informatics field. This paper, while basing on use cases and synthetic data, developed purposeful CQL reusable libraries to showcase the possibilities of multidisciplinary teams and how CQLs could be best used to support clinical decision making.

PMID:37203744 | DOI:10.3233/SHTI230201

Stud Health Technol Inform. 2023 May 18;302:490-491. doi: 10.3233/SHTI230185.

ABSTRACT

In 2013 using a Public Procurement of Innovation procedure the Region of Galicia developed a patient portal called “E-Saúde”, that went live in 2015. COVID situation in 2019 produced a high demand of e-health services, scaling by 10x the number of users in 2021.

OBJECTIVE: In this study a quantitative description of patient portal usage from 2018 to 2022 is made to show the behaviour of usage trends of a patient portal before, during and after COVID pandemic.

METHODS: Two main data sets were obtained from patient portal logs to obtain: 1) Enrolment of new users and number of sessions opened in the portal. 2) Detailed usage of relevant functionalities. Descriptive statistical methods were applied to show the usage of the portal in a biannual time series description.

RESULTS: Prior to the pandemic, the portal was gradually being introduced to citizens. During pandemics, more than 1 million users were registered and a peak of 15x usage could be observed. After COVID, the level of usage of portal services decreased, but kept a sustained trend five times higher than in Pre-COVID situation.

CONCLUSION: There is limited information available on metrics, functionalities and acceptability for general purpose patient portals, but the analysis performed on usage levels shows that after a high peak reached during COVID period, explained by the need of direct access to clinical information, the level of usage of the patient portal remains five times higher than in pre-pandemic situation for all functionalities of the patient portal.

PMID:37203729 | DOI:10.3233/SHTI230185

Stud Health Technol Inform. 2023 May 18;302:484-485. doi: 10.3233/SHTI230182.

ABSTRACT

The German Association for Medical Informatics, Biometry and Epidemiology (GMDS) aims to develop subject-specific methods, which are then to be applied in collaboration with various medical domains. Furthermore, the support of young scientists is an essential field of activity of the GMDS, since the need for junior staff has increased due to the acceleration in medical digitization. A specially established Presidential Commission strives to promote young talents and scientists in the above-mentioned disciplines. For this purpose, various strategies and concepts are elaborated in regular meetings and finally implemented. These include online formats such as a lecture series on research-related topics, as well as events such as summer schools and PhD symposia.

PMID:37203726 | DOI:10.3233/SHTI230182

Stud Health Technol Inform. 2023 May 18;302:458-462. doi: 10.3233/SHTI230172.

ABSTRACT

One of the major barriers to joining pulmonary rehabilitation (PR) programs is a lack of awareness about its benefits, combined with overall skepticism about regular exercise among COPD patients. Empowering COPD patients with foundational knowledge about PR may potentially facilitate their decision to join a PR program. A virtual reality (VR) app may serve as an engaging and interactive means to deliver PR education; however, the feasibility of this approach in COPD patients is unknown. The goal of this project was to assess the feasibility of VR-based PR education in COPD patients. Using mixed methods design, the feasibility of the VR app was assessed by evaluating its usability, patient acceptance, and its impact on patient knowledge about PR. The results of the usability assessment showed high user acceptance of the VR system and the ability to successfully operate the VR appliances. The use of the VR education app resulted in a statistically significant increase in patient understanding of the main concepts of pulmonary rehabilitation. Further development and evaluation of VR-based systems for patient engagement and empowerment are warranted.

PMID:37203716 | DOI:10.3233/SHTI230172

Stud Health Technol Inform. 2023 May 18;302:356-357. doi: 10.3233/SHTI230138.

ABSTRACT

Patient-Accessible Electronic Health Records (PAEHR) are particularly disputed in mental healthcare. We aim to explore if there is any association between patients having a mental health condition and someone unwanted seeing their PAEHR. A chi-square test showed a statistically significant association between group belonging and experiences of someone unwanted seeing their PAEHR.

PMID:37203682 | DOI:10.3233/SHTI230138

Stud Health Technol Inform. 2023 May 18;302:272-276. doi: 10.3233/SHTI230117.

ABSTRACT

The German Medical Informatics Initiative makes clinical routine data available for biomedical research. In total, 37 university hospitals have set up so-called data integration centers to facilitate this data reuse. A standardized set of HL7 FHIR profiles (“MII Core Data Set”) defines the common data model across all centers. Regular Projectathons ensure continuous evaluation of the implemented data sharing processes on artificial and real-world clinical use cases. In this context, FHIR continues to rise in popularity for exchanging patient care data. As reusing data from patient care in clinical research requires high trust in the data, data quality assessments are a key point of concern in the data sharing process. To support the setup of data quality assessments within data integration centers, we suggest a process for finding elements of interest from FHIR profiles. We focus on the specific data quality measures defined by Kahn et al.

PMID:37203661 | DOI:10.3233/SHTI230117