Objective To institutionalize an evidence-based policy/protocol adapted from the Agency for Healthcare Research and Quality (AHRQ) national medication standards for managing telephone medication orders (TMO) and to determine the impact of the policy/protocol on the number of telephone medication errors (TME) on two medical units of a small private hospital in Jamaica. Methods Kotter's Eight-step Change Model was used to facilitate organizational change among nurses and physicians by teaching and implementing the TMO policy/protocol adapted from AHRQ standards and collecting pre-policy and post-policy frequency of TMEs. A convenience sample of 80 nurses and physicians participated in training about the policy/protocol, took post-instructional tests and participated in the implementation of the policy/protocol. Chart audits over six weeks monitored adherence to the policy/protocol. The annual monthly mean of TMEs for the prior year was compared with the number of TMEs just prior to implementation of policy/protocol and at the end of the first six weeks of implementation. Results One hundred per cent of the convenience sample of 80 nurses and doctors passed the post-instructional test; the workforce adhered fully to the protocol during six weeks of implementation, and there was a 100% reduction in TMEs between the prior year and six weeks after policy/protocol implementation. Conclusions Kotter's eight-step framework of organizational change was a successful strategy in institutionalizing and sustaining adherence to the TMO policy/protocol, reducing the number of TMEs and positively influencing the organizational culture.
{"title":"Establishing a Telephone Medication Order Policy and Protocol for a Small Private Hospital in Jamaica.","authors":"M. Grant-Coke, D. Powell, J. Lyttle, H. Hewitt","doi":"10.7727/wimj.2014.214","DOIUrl":"https://doi.org/10.7727/wimj.2014.214","url":null,"abstract":"Objective\u0000To institutionalize an evidence-based policy/protocol adapted from the Agency for Healthcare Research and Quality (AHRQ) national medication standards for managing telephone medication orders (TMO) and to determine the impact of the policy/protocol on the number of telephone medication errors (TME) on two medical units of a small private hospital in Jamaica.\u0000\u0000\u0000Methods\u0000Kotter's Eight-step Change Model was used to facilitate organizational change among nurses and physicians by teaching and implementing the TMO policy/protocol adapted from AHRQ standards and collecting pre-policy and post-policy frequency of TMEs. A convenience sample of 80 nurses and physicians participated in training about the policy/protocol, took post-instructional tests and participated in the implementation of the policy/protocol. Chart audits over six weeks monitored adherence to the policy/protocol. The annual monthly mean of TMEs for the prior year was compared with the number of TMEs just prior to implementation of policy/protocol and at the end of the first six weeks of implementation.\u0000\u0000\u0000Results\u0000One hundred per cent of the convenience sample of 80 nurses and doctors passed the post-instructional test; the workforce adhered fully to the protocol during six weeks of implementation, and there was a 100% reduction in TMEs between the prior year and six weeks after policy/protocol implementation.\u0000\u0000\u0000Conclusions\u0000Kotter's eight-step framework of organizational change was a successful strategy in institutionalizing and sustaining adherence to the TMO policy/protocol, reducing the number of TMEs and positively influencing the organizational culture.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121680513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In the present article, we want to share our experience with usage of ProSeal laryngeal mask airway (LMA) with 45 cm H2O cuff pressure in twelve adult patients undergoing inguinal hernia surgery under general anaesthesia. Laryngeal mask airway and developed models has been used as an alternative to endotracheal tube for many years in anaesthesia practice. Several studies indicated that LMA devices, including LMA ProSeal, caused lower haemodynamic responses during intubation and lower postoperative side effects compared to endotracheal tubes (1). Many studies indicate that reduction and monitorization of LMA intracuff pressure may lower the incidence of postoperative pharyngolaryngeal complications (2). We used Proseal LMA (Number 5) with lower cuff pressure (45 cm H2O) than recommended (60 cm H2O) for twelve male adult patients. Patient characteristics are specified in the Table.
在这篇文章中，我们想分享我们的经验，使用ProSeal喉罩气道(LMA) 45厘米水袖压在12例成人腹股沟疝手术在全身麻醉下。多年来，在麻醉实践中，喉罩气道和开发模型已被用作气管内插管的替代方法。几项研究表明，与气管内插管相比，LMA器械，包括LMA ProSeal，在插管过程中引起的血流动力学反应更低，术后副作用也更低(1)。许多研究表明，降低和监测LMA的袖带压力可能会降低术后咽部并发症的发生率(2)。我们使用ProSeal LMA(5号)，袖带压力(45 cm H2O)低于推荐的(60 cm H2O)。患者特征列于表中。
{"title":"Usage of ProSeal Laryngeal Mask Airway with Low Cuff Pressure.","authors":"A. Ali, N. Turgut, I. O. Akinci","doi":"10.7727/wimj.2014.199","DOIUrl":"https://doi.org/10.7727/wimj.2014.199","url":null,"abstract":"In the present article, we want to share our experience with usage of ProSeal laryngeal mask airway (LMA) with 45 cm H2O cuff pressure in twelve adult patients undergoing inguinal hernia surgery under general anaesthesia. Laryngeal mask airway and developed models has been used as an alternative to endotracheal tube for many years in anaesthesia practice. Several studies indicated that LMA devices, including LMA ProSeal, caused lower haemodynamic responses during intubation and lower postoperative side effects compared to endotracheal tubes (1). Many studies indicate that reduction and monitorization of LMA intracuff pressure may lower the incidence of postoperative pharyngolaryngeal complications (2). We used Proseal LMA (Number 5) with lower cuff pressure (45 cm H2O) than recommended (60 cm H2O) for twelve male adult patients. Patient characteristics are specified in the Table.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121777357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cytomegalovirus (CMV) infection has been associated with ulcerative colitis (UC). The prevalence of CMV infection in UC patients ranges from 10% to 16%. It is particularly high in the patients with steroidrefractory UC and those treated with immunosuppressants. However, synchronous onset of CMV colitis and UC in an immunocompetent patient is rare. It was originally described in 1990 and since then sixteen cases have been reported, as far as we are aware. Here, we present a case of CMV colitis and UC synchronously developing in an elderly immunocompetent woman. She was diagnosed through tissue immunohistochemistry and successfully treated with intravenous ganciclovir. This case demonstrates that in patients with severe active UC, even with new onset of the disease, CMV infection needs to be ruled out before initiating an aggressive immunosuppressive therapy.
{"title":"Synchronous Onset of Cytomegalovirus Colitis and Ulcerative Colitis in an Immunocompetent Patient: A Case Report.","authors":"S. Yangzhen, K. Liu, T. Xu, Y. Yang, Y. Zhang","doi":"10.7727/wimj.2015.307","DOIUrl":"https://doi.org/10.7727/wimj.2015.307","url":null,"abstract":"Cytomegalovirus (CMV) infection has been associated with ulcerative colitis (UC). The prevalence of CMV infection in UC patients ranges from 10% to 16%. It is particularly high in the patients with steroidrefractory UC and those treated with immunosuppressants. However, synchronous onset of CMV colitis and UC in an immunocompetent patient is rare. It was originally described in 1990 and since then sixteen cases have been reported, as far as we are aware. Here, we present a case of CMV colitis and UC synchronously developing in an elderly immunocompetent woman. She was diagnosed through tissue immunohistochemistry and successfully treated with intravenous ganciclovir. This case demonstrates that in patients with severe active UC, even with new onset of the disease, CMV infection needs to be ruled out before initiating an aggressive immunosuppressive therapy.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115105437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background The male:female ratio at birth (M/F: male births divided by total births) is anticipated to approximate 0.515. The M/F in Micronesia in the Pacific Ocean has been noted to be higher than anticipated. This study analysed M/F in island populations available from a World Health Organization dataset. Methods The following islands were identified from the dataset as being sufficiently complete for analysis: Bahamas, Barbados, Puerto Rico, Trinidad and Tobago, and Mauritius. Results There were 540 8629 live births available for analysis over the period 1960-2009 with an overall M/F of 0.5106 (95% CL 0.5101, 0.5110). There were no secular trends in M/F. Conclusion The M/F in these equatorial islands is lower than anticipated, and the reason for this is unknown.
{"title":"Reduced Male:Female Ratio at Birth in Small Islands.","authors":"V. Grech","doi":"10.7727/wimj.2014.195","DOIUrl":"https://doi.org/10.7727/wimj.2014.195","url":null,"abstract":"Background\u0000The male:female ratio at birth (M/F: male births divided by total births) is anticipated to approximate 0.515. The M/F in Micronesia in the Pacific Ocean has been noted to be higher than anticipated. This study analysed M/F in island populations available from a World Health Organization dataset.\u0000\u0000\u0000Methods\u0000The following islands were identified from the dataset as being sufficiently complete for analysis: Bahamas, Barbados, Puerto Rico, Trinidad and Tobago, and Mauritius.\u0000\u0000\u0000Results\u0000There were 540 8629 live births available for analysis over the period 1960-2009 with an overall M/F of 0.5106 (95% CL 0.5101, 0.5110). There were no secular trends in M/F.\u0000\u0000\u0000Conclusion\u0000The M/F in these equatorial islands is lower than anticipated, and the reason for this is unknown.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128325746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Hao, H. Lv, X. Geng, X. Wang, X. Li, J. Shen, Z. Zhang
Objective We aimed to investigate whether Yi Fu Kang oral liquid (YFK) could reduce the gastrointestinal side effects caused by chemotherapy. Methods We randomized 40 animals into four groups for treatment: Control (0.8 mL 0.9% saline solution /100 g body weight/day), Ou Li shu (0.8 mL/100 g body weight/day), YFK (1 mL/100 g body weight/day) and YFK groups [2 mL/100 g body weight/day] (n = 10 in each group). The latency time to first emesis and the total number of emetic behaviours were recorded. The gastrointestinal function of YFK was assessed by observing gastric remnant rate of methyl orange and charcoal powder propelling test of small intestine. Gross mucosal damage was assessed in a blind manner by calculation of a lesion index. Results Different dosages of Yi Fu Kang oral liquid can obviously promote the gastric emptying ( p< 0.01) and the promotion of small intestine function ( p< 0.01). Yi Fu Kang oral liquid can also protect the gastric mucosa and reduce the emetic response. Conclusion Yi Fu Kang oral liquid can enhance the function of gastrointestinal of animals by reducing the number of emetic responses, protecting the gastric mucosa and propelling movement of small intestine.
{"title":"Effect of Yi Fu Kang Oral Liquid on Gastrointestinal Side Effects Caused by Chemotherapy.","authors":"S. Hao, H. Lv, X. Geng, X. Wang, X. Li, J. Shen, Z. Zhang","doi":"10.7727/wimj.2015.076","DOIUrl":"https://doi.org/10.7727/wimj.2015.076","url":null,"abstract":"Objective\u0000We aimed to investigate whether Yi Fu Kang oral liquid (YFK) could reduce the gastrointestinal side effects caused by chemotherapy.\u0000\u0000\u0000Methods\u0000We randomized 40 animals into four groups for treatment: Control (0.8 mL 0.9% saline solution /100 g body weight/day), Ou Li shu (0.8 mL/100 g body weight/day), YFK (1 mL/100 g body weight/day) and YFK groups [2 mL/100 g body weight/day] (n = 10 in each group). The latency time to first emesis and the total number of emetic behaviours were recorded. The gastrointestinal function of YFK was assessed by observing gastric remnant rate of methyl orange and charcoal powder propelling test of small intestine. Gross mucosal damage was assessed in a blind manner by calculation of a lesion index.\u0000\u0000\u0000Results\u0000Different dosages of Yi Fu Kang oral liquid can obviously promote the gastric emptying ( p< 0.01) and the promotion of small intestine function ( p< 0.01). Yi Fu Kang oral liquid can also protect the gastric mucosa and reduce the emetic response.\u0000\u0000\u0000Conclusion\u0000Yi Fu Kang oral liquid can enhance the function of gastrointestinal of animals by reducing the number of emetic responses, protecting the gastric mucosa and propelling movement of small intestine.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"88 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122045155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective This paper aimed to evaluate a modified posture for PICC (peripherally inserted central catheter) placement by comparing it with traditional posture in terms of procedure-related complications and catheter heterotopia. Method From December 2006 to December 2008, 519 patients were recruited into control group. These patients received PICC insertion by holding the traditional posture, ie, horizontal position, arm abduced about 90°, and when the needle successfully entered vein, patients were required to turn their heads to the procedure side and touch their chins to clavicle until the catheter reached the expected position. From January 2009 to June 2010, 508 patients who were to receive PICC insertion were recruited to the experiment group by holding a modified posture, in which the patients hold horizontal position, arm abduces about 90° with no other specific requirement during the insertion procedure. Results No significant differences were found between the traditional and the modified posture group in the incidence of catheter heterotopia and other procedure-related complications. Conclusion Modified posture makes patients more comfortable and relaxed during the PICC procedure. And it is especially more applicable for non-cooperative patients.
{"title":"A Modified Patients' Posture for PICC Catheter Placement makes Patients more Comfortable and Relaxed.","authors":"T. Li, Y. Yan, D. Wei, F. Bilong","doi":"10.7727/wimj.2015.080","DOIUrl":"https://doi.org/10.7727/wimj.2015.080","url":null,"abstract":"Objective\u0000This paper aimed to evaluate a modified posture for PICC (peripherally inserted central catheter) placement by comparing it with traditional posture in terms of procedure-related complications and catheter heterotopia.\u0000\u0000\u0000Method\u0000From December 2006 to December 2008, 519 patients were recruited into control group. These patients received PICC insertion by holding the traditional posture, ie, horizontal position, arm abduced about 90°, and when the needle successfully entered vein, patients were required to turn their heads to the procedure side and touch their chins to clavicle until the catheter reached the expected position. From January 2009 to June 2010, 508 patients who were to receive PICC insertion were recruited to the experiment group by holding a modified posture, in which the patients hold horizontal position, arm abduces about 90° with no other specific requirement during the insertion procedure.\u0000\u0000\u0000Results\u0000No significant differences were found between the traditional and the modified posture group in the incidence of catheter heterotopia and other procedure-related complications.\u0000\u0000\u0000Conclusion\u0000Modified posture makes patients more comfortable and relaxed during the PICC procedure. And it is especially more applicable for non-cooperative patients.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"95 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133537322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives To evaluate the performance of a traditional Chinese medicine pancreas-cleansing, clog-removing (Qiyi Huaji, QYHJ) formula in prolonging survival of pancreatic cancer (PC), stabilizing tumor growth, and inhibiting tumour cell proliferation. Methods A subcutaneous mouse xenograft model was established by using human PC cell line SW1990, from which tumour masses were collected after they were euthanasized. Nude mice with tumours were inoculated in situ and randomly divided into two batches. Each batch consists of three groups: The survival, maximum tumour diameter and transverse diameter of the mice were recorded. After 24, 48 and 72 hours of drug interventions, the optical densities at 490 nm were measured. Results The QYHJ group had significantly longer survival and higher proliferation inhibition rates than those of the Gem and control groups (P < 0.01), but the QYHJ group and Gem group had similar tumour volume and weight (P > 0.05). Conclusion QYHJ formula effectively prolonged the survival of PC and inhibited the proliferation of tumor cells, thus being worthy of promotion in clinical practice.
{"title":"Survival-Prolonging Effects of a Traditional Chinese Medicine Pancreas-Cleansing, Clog-Removing (Qiyi Huaji) Formula on Pancreatic Cancer and Mechanism Study.","authors":"Yi Xu, S. Xu, Y. Cai, L. Liu","doi":"10.7727/wimj.2015.134","DOIUrl":"https://doi.org/10.7727/wimj.2015.134","url":null,"abstract":"Objectives\u0000To evaluate the performance of a traditional Chinese medicine pancreas-cleansing, clog-removing (Qiyi Huaji, QYHJ) formula in prolonging survival of pancreatic cancer (PC), stabilizing tumor growth, and inhibiting tumour cell proliferation.\u0000\u0000\u0000Methods\u0000A subcutaneous mouse xenograft model was established by using human PC cell line SW1990, from which tumour masses were collected after they were euthanasized. Nude mice with tumours were inoculated in situ and randomly divided into two batches. Each batch consists of three groups: The survival, maximum tumour diameter and transverse diameter of the mice were recorded. After 24, 48 and 72 hours of drug interventions, the optical densities at 490 nm were measured.\u0000\u0000\u0000Results\u0000The QYHJ group had significantly longer survival and higher proliferation inhibition rates than those of the Gem and control groups (P < 0.01), but the QYHJ group and Gem group had similar tumour volume and weight (P > 0.05).\u0000\u0000\u0000Conclusion\u0000QYHJ formula effectively prolonged the survival of PC and inhibited the proliferation of tumor cells, thus being worthy of promotion in clinical practice.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120891876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective The aim of this study was to explore the application values of Cystatin C (cys-C) in the early diagnosis of contrast-induced nephropathy (CIN). Methods Three hundred patients who performed the percutaneous coronary intervention (PCI) with non-ionotropic or iso-osmotic contrast agent, were selected. The levels of Cys C and serum creatinine (Scr) at the 4 time points: before PCI, 24, 48 and 72 hours after PCI were detected. Acording to the occurrence of CIN within 72 hours of opacification, the patients were divided into the CIN group and non-CIN group, and the changes of Cys C and Scr at different time points between the two groups were compared and the Roc curve was used to compare the early diagnostic values of the two indicators towards CIN. Results Among the 300 patients, 35 cases related to CIN, with the incidence rate at 11.67%. The postoperative 24 h Cys C level of the CIN group significantly increased more than the non-CIN group, while the Scr level increased at the postoperative 48 hour. The area under the ROC curve of postoperative 24 hour Cys C was bigger than that of Scr (0.898 vs 0.885, p = 0.001). The sensitivity of cys-C as the CIN diagnostic standard was 85.7%, with the specificity at 82.4%. Conclusions The post-opacification 24 hour serum Cys C concentration exhibited certain significance towards the early diagnosis of CIN, and worthy of clinical generalization.
目的探讨Cystatin C (cys-C)在造影剂肾病(CIN)早期诊断中的应用价值。方法选择行非离子型或等渗透造影剂经皮冠状动脉介入治疗(PCI)的患者300例。检测PCI前、PCI后24、48、72 h 4个时间点Cys C和血清肌酐(Scr)水平。根据混浊后72小时内CIN的发生情况，将患者分为CIN组和非CIN组，比较两组患者不同时间点Cys C和Scr的变化，并采用Roc曲线比较两项指标对CIN的早期诊断价值。结果300例患者中，35例与CIN有关，发生率为11.67%。CIN组术后24 h Cys C水平明显高于非CIN组，而Scr水平在术后48 h升高。术后24小时Cys C的ROC曲线下面积大于Scr (0.898 vs 0.885, p = 0.001)。cys-C作为CIN诊断标准的敏感性为85.7%，特异性为82.4%。结论术后24小时血清Cys C浓度对CIN的早期诊断有一定意义，值得临床推广。
{"title":"Use of Cystatin C in the Early Diagnosis of Contrast-Induced Nephropathy.","authors":"Y. Liu, N. Fu, S. Yang, Y. Li, Ying Qiao","doi":"10.7727/wimj.2015.074","DOIUrl":"https://doi.org/10.7727/wimj.2015.074","url":null,"abstract":"Objective\u0000The aim of this study was to explore the application values of Cystatin C (cys-C) in the early diagnosis of contrast-induced nephropathy (CIN).\u0000\u0000\u0000Methods\u0000Three hundred patients who performed the percutaneous coronary intervention (PCI) with non-ionotropic or iso-osmotic contrast agent, were selected. The levels of Cys C and serum creatinine (Scr) at the 4 time points: before PCI, 24, 48 and 72 hours after PCI were detected. Acording to the occurrence of CIN within 72 hours of opacification, the patients were divided into the CIN group and non-CIN group, and the changes of Cys C and Scr at different time points between the two groups were compared and the Roc curve was used to compare the early diagnostic values of the two indicators towards CIN.\u0000\u0000\u0000Results\u0000Among the 300 patients, 35 cases related to CIN, with the incidence rate at 11.67%. The postoperative 24 h Cys C level of the CIN group significantly increased more than the non-CIN group, while the Scr level increased at the postoperative 48 hour. The area under the ROC curve of postoperative 24 hour Cys C was bigger than that of Scr (0.898 vs 0.885, p = 0.001). The sensitivity of cys-C as the CIN diagnostic standard was 85.7%, with the specificity at 82.4%.\u0000\u0000\u0000Conclusions\u0000The post-opacification 24 hour serum Cys C concentration exhibited certain significance towards the early diagnosis of CIN, and worthy of clinical generalization.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125711712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To determine the outcome of macrosomic infants at the University Hospital of the West Indies over a three year period. Methods A retrospective, descriptive, case controlled study was carried out. Data were extracted from the maternal and neonatal medical records of 316 macrosomic infants (weighing ≥ 4000 grams) and 316 controls (weighing 2500 - 3999 grams) delivered at the University Hospital of the West Indies. Descriptive analyses were performed comparing maternal and neonatal characteristics and outcomes between the two groups. Results The incidence of macrosomia at the University Hospital of the West Indies for the study period was 43.5 per 1000 deliveries. Foetal macrosomia was associated with an increased risk of an operative delivery, shoulder dystocia and maternal postpartum haemorrhage p < 0.05. Macrosomic babies were more likely to be male, experience respiratory distress at birth and require admission to the neonatal unit p < 0.05. Conclusion Macrosomia contributes significantly to maternal and neonatal morbidity. There needs to be targeted, coordinated perinatal and neonatal measures if these morbidities are to be reduced.
{"title":"Outcome of Macrosomic Infants at the University Hospital of the West Indies.","authors":"C. Richardson, H. Trotman","doi":"10.7727/wimj.2015.050","DOIUrl":"https://doi.org/10.7727/wimj.2015.050","url":null,"abstract":"Objective\u0000To determine the outcome of macrosomic infants at the University Hospital of the West Indies over a three year period.\u0000\u0000\u0000Methods\u0000A retrospective, descriptive, case controlled study was carried out. Data were extracted from the maternal and neonatal medical records of 316 macrosomic infants (weighing ≥ 4000 grams) and 316 controls (weighing 2500 - 3999 grams) delivered at the University Hospital of the West Indies. Descriptive analyses were performed comparing maternal and neonatal characteristics and outcomes between the two groups.\u0000\u0000\u0000Results\u0000The incidence of macrosomia at the University Hospital of the West Indies for the study period was 43.5 per 1000 deliveries. Foetal macrosomia was associated with an increased risk of an operative delivery, shoulder dystocia and maternal postpartum haemorrhage p < 0.05. Macrosomic babies were more likely to be male, experience respiratory distress at birth and require admission to the neonatal unit p < 0.05.\u0000\u0000\u0000Conclusion\u0000Macrosomia contributes significantly to maternal and neonatal morbidity. There needs to be targeted, coordinated perinatal and neonatal measures if these morbidities are to be reduced.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116205672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Although vitamin D insufficiency is a very common health problem in the world, its prevalence and predictors in adolescents are controversial. We planned to evaluate prevalence and predictors of vitamin D insufficiency in adolescents living at an intermediate altitude. We also want to give optimal serum 25(OH) vitamin D levels in relation to serum PTH levels. The study population comprised 343 primary and high school children living in Erzurum city centre whose ages ranged between 13 to 17 years. These children were selected using stratified random sampling in the spring (April-May), and were invited to our department for participation in this research study. Of 343 children, 246 could be evaluated again in the autumn (September-October). Subjects with vitamin D level < 10 ng/ml were considered as being vitamin D deficient, and with 10 - 20 ng/ml as being vitamin D insufficient and those with vitamin D level > 20 ng/ml are considered to have adequate. In spring, vitamin D deficiency was detected in 17.7% of the subjects while vitamin D insufficiency was detected in 72%. At the end of summer these rates were 1.6 % and 41.1 % respectively. Serum 25 (OH) vitamin D levels at which plasma PTH concentrations begin to form a plateau is 22 ng/mL. Values below estimated lower normal level (22 ng/mL) were detected in 94.2 % of subjects. We believe that vitamin D prophylaxis could be given to all adolescents as well as for the regulation of lifestyles. Our results will increase awareness for vitamin D deficiency and insufficiency in adolescents and inform future public health preventative strategies.
{"title":"Prevalence and Predictors of Vitamin D Insufficiency in Adolescents Living at an Intermediate Altitude.","authors":"M. Konak, H. Alp, Z. Orbak, B. Ozkan","doi":"10.7727/wimj.2015.060","DOIUrl":"https://doi.org/10.7727/wimj.2015.060","url":null,"abstract":"Although vitamin D insufficiency is a very common health problem in the world, its prevalence and predictors in adolescents are controversial. We planned to evaluate prevalence and predictors of vitamin D insufficiency in adolescents living at an intermediate altitude. We also want to give optimal serum 25(OH) vitamin D levels in relation to serum PTH levels. The study population comprised 343 primary and high school children living in Erzurum city centre whose ages ranged between 13 to 17 years. These children were selected using stratified random sampling in the spring (April-May), and were invited to our department for participation in this research study. Of 343 children, 246 could be evaluated again in the autumn (September-October). Subjects with vitamin D level < 10 ng/ml were considered as being vitamin D deficient, and with 10 - 20 ng/ml as being vitamin D insufficient and those with vitamin D level > 20 ng/ml are considered to have adequate. In spring, vitamin D deficiency was detected in 17.7% of the subjects while vitamin D insufficiency was detected in 72%. At the end of summer these rates were 1.6 % and 41.1 % respectively. Serum 25 (OH) vitamin D levels at which plasma PTH concentrations begin to form a plateau is 22 ng/mL. Values below estimated lower normal level (22 ng/mL) were detected in 94.2 % of subjects. We believe that vitamin D prophylaxis could be given to all adolescents as well as for the regulation of lifestyles. Our results will increase awareness for vitamin D deficiency and insufficiency in adolescents and inform future public health preventative strategies.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122451858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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