Background: The Minorities' Diminished Returns (MDRs) theory suggests that the health effect of educational attainment is considerably smaller for members of racial and ethnic minority groups than for Whites.
Objective: The current study explored the racial and ethnic differences in the association between educational attainment and breast physical exam (BPE) among women in the U.S.
Methods: The National Health Interview Survey (NHIS 2015) included 12 510 women who were Hispanic or non-Hispanic Black or White people. The independent variable was the level of educational attainment. The dependent variable was lifetime BPE. Age, region, marital status, and employment were the covariates. Race and ethnicity were the focal moderators. Logistic regressions were used for data analysis.
Results: Overall, higher educational attainment was associated with higher odds of BPE, net of all confounders (odds ratio [OR] = 1.11, 95% CI = 1.09-1.13). Ethnicity showed a significant statistical interaction with educational attainment on BPE (OR = 0.96, 95% CI = 0.93-1.00), which was suggestive of a smaller effect of high education attainment on BPE for Hispanic than non-Hispanic women. The same interaction could not be found for the comparison of White and Black women (OR = 0.98, 95% CI =0.94-1.02).
Conclusion: In line with other domains, non-Hispanic White women show a larger amount of health gain from their educational attainment than Hispanic women. It is not ethnicity or class but ethnicity and class that shapes how people engage in pro-health behaviors. This result may help hospitals and healthcare systems to better reduce health disparities in their target populations.
背景:少数族裔收益递减理论表明，受教育程度对种族和民族少数群体成员的健康影响要比白人小得多。目的:本研究探讨美国女性受教育程度与乳房体检(BPE)之间的种族和民族差异。方法:全国健康访谈调查(NHIS 2015)包括12510名西班牙裔或非西班牙裔黑人或白人女性。自变量是受教育程度。因变量为终身BPE。协变量为年龄、地区、婚姻状况和就业情况。种族和民族是主要的调节因素。采用Logistic回归进行数据分析。结果:总体而言，综合所有混杂因素，较高的教育程度与较高的BPE发生率相关(优势比[OR] = 1.11, 95% CI = 1.09-1.13)。种族与受教育程度对BPE的影响有显著的交互作用(OR = 0.96, 95% CI = 0.93-1.00)，这表明西班牙裔女性受教育程度对BPE的影响小于非西班牙裔女性。在白人和黑人妇女的比较中没有发现同样的相互作用(OR = 0.98, 95% CI =0.94-1.02)。结论:与其他领域一样，非西班牙裔白人妇女比西班牙裔妇女从教育程度中获得的健康收益更大。不是种族或阶级，而是种族和阶级决定了人们如何从事有利于健康的行为。这一结果可能有助于医院和卫生保健系统更好地减少其目标人群的健康差距。
{"title":"Educational Attainment Better Increases the Chance of Breast Physical Exam for Non-Hispanic Than Hispanic American Women: National Health Interview Survey.","authors":"Shervin Assari, Mohsen Bazargan","doi":"10.15171/HPR.2019.25","DOIUrl":"https://doi.org/10.15171/HPR.2019.25","url":null,"abstract":"<p><strong>Background: </strong>The Minorities' Diminished Returns (MDRs) theory suggests that the health effect of educational attainment is considerably smaller for members of racial and ethnic minority groups than for Whites.</p><p><strong>Objective: </strong>The current study explored the racial and ethnic differences in the association between educational attainment and breast physical exam (BPE) among women in the U.S.</p><p><strong>Methods: </strong>The National Health Interview Survey (NHIS 2015) included 12 510 women who were Hispanic or non-Hispanic Black or White people. The independent variable was the level of educational attainment. The dependent variable was lifetime BPE. Age, region, marital status, and employment were the covariates. Race and ethnicity were the focal moderators. Logistic regressions were used for data analysis.</p><p><strong>Results: </strong>Overall, higher educational attainment was associated with higher odds of BPE, net of all confounders (odds ratio [OR] = 1.11, 95% CI = 1.09-1.13). Ethnicity showed a significant statistical interaction with educational attainment on BPE (OR = 0.96, 95% CI = 0.93-1.00), which was suggestive of a smaller effect of high education attainment on BPE for Hispanic than non-Hispanic women. The same interaction could not be found for the comparison of White and Black women (OR = 0.98, 95% CI =0.94-1.02).</p><p><strong>Conclusion: </strong>In line with other domains, non-Hispanic White women show a larger amount of health gain from their educational attainment than Hispanic women. It is not ethnicity or class but ethnicity and class that shapes how people engage in pro-health behaviors. This result may help hospitals and healthcare systems to better reduce health disparities in their target populations.</p>","PeriodicalId":32113,"journal":{"name":"Hospital Practices and Research","volume":"4 4","pages":"122-127"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37753032","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: Complementary medicine claims that biofeedback affects the reduction of blood glycemia. Objective: The current study aimed to determine the effects of biofeedback on decreasing blood glucose levels and tension and increasing the quality of life in diabetic patients. Methods: The current retrospective evidence-based study used pretest-posttest accidental sampling to select a group of 30 diabetic patients admitted to Glenview Clinic in the Aghdasiyeh region, Tehran, Iran, as the sample. Participants were divided into two 15-membered groups, the experiment and the control groups, matched by age and gender. Data gathering tools included the Quality of Life questionnaire in diabetic patients by Thomas et al, the Perceived Tension Index by Cohen et al, a glucometer, and the fasting blood glucose test. Data was analyzed using analysis of covariance (ANCOVA). Results: The results showed that biofeedback training was effective in decreasing blood glucose levels in diabetic patients. Conclusion: Biofeedback can reduce tension and improve the quality of life of diabetic patients; thus, it could be used as a complementary service in healthcare centers.
{"title":"The Impact of Biofeedback on Diabetic Patients’ Glycemia","authors":"Fariba Aaraji, Masoud Nosratabadi, Mohammadjavad Hoseinpourfard","doi":"10.15171/HPR.2019.03","DOIUrl":"https://doi.org/10.15171/HPR.2019.03","url":null,"abstract":"Background: Complementary medicine claims that biofeedback affects the reduction of blood glycemia. Objective: The current study aimed to determine the effects of biofeedback on decreasing blood glucose levels and tension and increasing the quality of life in diabetic patients. Methods: The current retrospective evidence-based study used pretest-posttest accidental sampling to select a group of 30 diabetic patients admitted to Glenview Clinic in the Aghdasiyeh region, Tehran, Iran, as the sample. Participants were divided into two 15-membered groups, the experiment and the control groups, matched by age and gender. Data gathering tools included the Quality of Life questionnaire in diabetic patients by Thomas et al, the Perceived Tension Index by Cohen et al, a glucometer, and the fasting blood glucose test. Data was analyzed using analysis of covariance (ANCOVA). Results: The results showed that biofeedback training was effective in decreasing blood glucose levels in diabetic patients. Conclusion: Biofeedback can reduce tension and improve the quality of life of diabetic patients; thus, it could be used as a complementary service in healthcare centers.","PeriodicalId":32113,"journal":{"name":"Hospital Practices and Research","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76309733","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}
Z. Keshavarz, L. Moezzi, R. Ranjbaran, A. Behzad-Behbahani, M. Abdullahi, M. Mahmoodi, S. Sharifzadeh
Background: Quantification of fetal red blood cells (RBCs) in maternal blood is of great importance to calculate appropriate dose of post-deliver anti D immunoglobulin in a rhesus D (RhD)-negative woman. Objective: The aim of this study is to evaluate a direct immunofluorescence flow cytometry technique in artificial and clinical samples and compared it to the Kleihauer-Betke test (KBT). Methods: This study was a prospective cohort design. Blood samples from 26 pregnant women who gave birth to RhD positive babies were tested using direct immunofluorescence flow cytometry and KBT techniques to determine the amount of FMH in the maternal circulation. The zone of D-positive cells was identified employing artificial samples including 0.3%, 0.6%, 1%, 1.5%, 2%, 5%, 10%, and 50% of D-positive fetal cells in D-negative maternal cells. Results: Analysis of 26 clinical samples for FMH showed consistent quantification with the flow cytometry and Kleihauer techniques. Although a good correlation was found between the KBT and flow cytometry results, in artificial samples containing more than 2% of fetal RhD positive cells, the flow cytometry results were closer to theoretical percentages. In a patient with FMH >4 mL, the FMH and consequently the required vial of Ig were overestimated using KBT. Conclusion: Most of the FMH calculated could have been neutralized by doses less than 625 IU, whereas the routine dose in Iran is more than double that amount (1500 IU). This achievement demonstrates that adjusting between the RhD immune globulin (RhDIg) dose and FMH size is inevitable.
{"title":"Evaluation of Flow Cytometry and Kleihauer Techniques for Quantification of Fetomaternal Hemorrhage: A Prospective Cohort Study in Southwestern Iran","authors":"Z. Keshavarz, L. Moezzi, R. Ranjbaran, A. Behzad-Behbahani, M. Abdullahi, M. Mahmoodi, S. Sharifzadeh","doi":"10.15171/HPR.2018.26","DOIUrl":"https://doi.org/10.15171/HPR.2018.26","url":null,"abstract":"Background: Quantification of fetal red blood cells (RBCs) in maternal blood is of great importance to calculate appropriate dose of post-deliver anti D immunoglobulin in a rhesus D (RhD)-negative woman. Objective: The aim of this study is to evaluate a direct immunofluorescence flow cytometry technique in artificial and clinical samples and compared it to the Kleihauer-Betke test (KBT). Methods: This study was a prospective cohort design. Blood samples from 26 pregnant women who gave birth to RhD positive babies were tested using direct immunofluorescence flow cytometry and KBT techniques to determine the amount of FMH in the maternal circulation. The zone of D-positive cells was identified employing artificial samples including 0.3%, 0.6%, 1%, 1.5%, 2%, 5%, 10%, and 50% of D-positive fetal cells in D-negative maternal cells. Results: Analysis of 26 clinical samples for FMH showed consistent quantification with the flow cytometry and Kleihauer techniques. Although a good correlation was found between the KBT and flow cytometry results, in artificial samples containing more than 2% of fetal RhD positive cells, the flow cytometry results were closer to theoretical percentages. In a patient with FMH >4 mL, the FMH and consequently the required vial of Ig were overestimated using KBT. Conclusion: Most of the FMH calculated could have been neutralized by doses less than 625 IU, whereas the routine dose in Iran is more than double that amount (1500 IU). This achievement demonstrates that adjusting between the RhD immune globulin (RhDIg) dose and FMH size is inevitable.","PeriodicalId":32113,"journal":{"name":"Hospital Practices and Research","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88351180","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 treatment and hospitalization of psychiatric patients has been a dilemma for many years. Many countries have different specific legislations regarding the hospitalization and treatment of mental patients. Objective: In the current study, 4100 voluntary/involuntary psychiatric admissions and readmissions to a university hospital in Turkey were investigated, and patient groups were compared in terms of demographic variables and psychiatric diagnoses based on DSM IV-TR. Methods: The records of patients who had been hospitalized approximately 4–6 weeks were reviewed by two psychiatrists, and the patients were then divided into groups on the basis of single/multiple admissions and voluntary/involuntary admissions. The groups were compared based on psychiatric diagnoses. Results: Schizophrenia was the most common diagnosis in 71.5% (n = 865) of patients with multiple admissions. The second most common diagnosis was bipolar affective disorder with 13.1% (n = 159). The rate of schizophrenia in both voluntary and involuntary hospitalizations was significant (34.5% and 54.6%, respectively). However, depression, the second most common diagnosis requiring hospitalization with a rate of 23.2% of voluntary hospitalizations, accounted for only 3.7% of involuntary hospitalizations. Conclusion: Males constituted almost 75% of the single admission group. This difference may result from the socioeconomic and cultural profile of Turkey, as mental disorders make marriage impossible and are hidden in females suffering from them. Different findings from different cultures on single/multiple admissions and voluntary/involuntary admissions of patients lead to the conclusion that specific legislation covering treatment or hospitalization for mental disorders is needed in every country.
{"title":"Voluntary/Involuntary Admissions/Readmissions of Psychiatric Patients in a University Hospital in Turkey From 2008 to 2016","authors":"B. Geniş, B. Coşar, S. Candansayar, N. Gürhan","doi":"10.15171/HPR.2018.27","DOIUrl":"https://doi.org/10.15171/HPR.2018.27","url":null,"abstract":"Background: The treatment and hospitalization of psychiatric patients has been a dilemma for many years. Many countries have different specific legislations regarding the hospitalization and treatment of mental patients. Objective: In the current study, 4100 voluntary/involuntary psychiatric admissions and readmissions to a university hospital in Turkey were investigated, and patient groups were compared in terms of demographic variables and psychiatric diagnoses based on DSM IV-TR. Methods: The records of patients who had been hospitalized approximately 4–6 weeks were reviewed by two psychiatrists, and the patients were then divided into groups on the basis of single/multiple admissions and voluntary/involuntary admissions. The groups were compared based on psychiatric diagnoses. Results: Schizophrenia was the most common diagnosis in 71.5% (n = 865) of patients with multiple admissions. The second most common diagnosis was bipolar affective disorder with 13.1% (n = 159). The rate of schizophrenia in both voluntary and involuntary hospitalizations was significant (34.5% and 54.6%, respectively). However, depression, the second most common diagnosis requiring hospitalization with a rate of 23.2% of voluntary hospitalizations, accounted for only 3.7% of involuntary hospitalizations. Conclusion: Males constituted almost 75% of the single admission group. This difference may result from the socioeconomic and cultural profile of Turkey, as mental disorders make marriage impossible and are hidden in females suffering from them. Different findings from different cultures on single/multiple admissions and voluntary/involuntary admissions of patients lead to the conclusion that specific legislation covering treatment or hospitalization for mental disorders is needed in every country.","PeriodicalId":32113,"journal":{"name":"Hospital Practices and Research","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85192773","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}
R. Safdari, L. Shahmoradi, A. Garavand, Nasim Aslani, A. Valipour, Hassan Bostan
Background: With regard to the particularly high prevalence, cost, and number of disabilities associated with diabetes, increasing patients’ knowledge and skills for managing the disease can help minimize the risks of complications. Objective: The present study aimed to design and evaluate a mobile-based application with which patients with type 2 diabetes can increase their knowledge of and skills for managing their disease. Methods: The current developmental-applied study was conducted in 2016 in a library and used a 2-step sectional format. The research population comprised 15 physicians and endocrinologists working in medical centers associated with Tehran University of Medical Sciences and 20 physicians and patients. Based on the library study, a checklist was designed and then distributed among participants. Their responses were analyzed using SPSS software version 20. Results: The data was divided into 4 main sections: identity information (patient demographics), clinical information, education curriculum related to diabetes management, and program requirements for diabetes management, which consisted of 52 subsets. The evaluation of the system by doctors and patients showed that the system has high capabilities. Conclusion: Mobile-based programs can help diabetics control blood glucose levels, reduce diabetes complications, and promote overall health.
{"title":"Design and Evaluation of a Mobile-Based Application for Patients With Type 2 Diabetes: Case Study of Shariati Hospital in Tehran, Iran","authors":"R. Safdari, L. Shahmoradi, A. Garavand, Nasim Aslani, A. Valipour, Hassan Bostan","doi":"10.15171/HPR.2018.28","DOIUrl":"https://doi.org/10.15171/HPR.2018.28","url":null,"abstract":"Background: With regard to the particularly high prevalence, cost, and number of disabilities associated with diabetes, increasing patients’ knowledge and skills for managing the disease can help minimize the risks of complications. Objective: The present study aimed to design and evaluate a mobile-based application with which patients with type 2 diabetes can increase their knowledge of and skills for managing their disease. Methods: The current developmental-applied study was conducted in 2016 in a library and used a 2-step sectional format. The research population comprised 15 physicians and endocrinologists working in medical centers associated with Tehran University of Medical Sciences and 20 physicians and patients. Based on the library study, a checklist was designed and then distributed among participants. Their responses were analyzed using SPSS software version 20. Results: The data was divided into 4 main sections: identity information (patient demographics), clinical information, education curriculum related to diabetes management, and program requirements for diabetes management, which consisted of 52 subsets. The evaluation of the system by doctors and patients showed that the system has high capabilities. Conclusion: Mobile-based programs can help diabetics control blood glucose levels, reduce diabetes complications, and promote overall health.","PeriodicalId":32113,"journal":{"name":"Hospital Practices and Research","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73211855","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}
M. Menacho-Román, Gilberto Pérez-López, José Manuel del Rey-Sánchez, D. Ly-Pen, Antonio Becerra-Fernández
Background: Hospital malnutrition, usually secondary to various diseases and their treatments, is an important problem in our clinical practice. For its proper assessment, it is crucial to use a nutritional alert system, such as the CONUT (COntrol NUTrition) program; this tool uses 3 analytical parameters: serum albumin, total cholesterol, and total lymphocyte count. Objective: The current study assessed the results of the implementation of this program in the University Hospital Ramón y Cajal. Methods: The CONUT program has been used in the University Hospital Ramón y Cajal since 2013. This retrospective study, throughout 2016, was conducted in the Central Laboratory of Chemical Biochemistry at the University Hospital Ramón y Cajal. All blood tests with serum albumin, total cholesterol, and total lymphocyte count were studied. The degree of malnutrition was assessed using the scale of normal (=0), mild (=4), moderate (=8), and severe (=12). Results: In 2016, there were 405406 analytics performed in the laboratory of University Hospital Ramón y Cajal. The CONUT tool was applied to 3.64% of them (14741 analytics). In the outpatient setting, the highest malnutrition index comprised patients from the liver transplant consultation department, followed by the cardiology, rheumatology, and oncology departments. With inpatients, the hematology, cardiology, and endocrinology departments showed the most severe malnutrition index. Conclusion: The CONUT system seemed to provide useful information about the cohort of the studied hospital. The results showed that 94% of the patients were not classified with malnutrition, there was no gender predilection, and they were younger than the rest. Patients with more severe malnutrition were usually older and male.
背景:医院营养不良是我国临床实践中的一个重要问题，通常继发于各种疾病及其治疗。为了进行适当的评估，使用营养警报系统是至关重要的，例如CONUT(控制营养)计划;该工具使用3个分析参数:血清白蛋白，总胆固醇和总淋巴细胞计数。目的:本研究评估了该方案在Ramón y Cajal大学医院实施的结果。方法:CONUT程序自2013年起在Ramón y Cajal大学医院使用。这项回顾性研究于2016年全年在University Hospital Ramón y Cajal的化学生物化学中心实验室进行。研究了所有血液检查，包括血清白蛋白、总胆固醇和总淋巴细胞计数。营养不良程度分为正常(=0)、轻度(=4)、中度(=8)、重度(=12)。结果:2016年在卡哈尔大学医院Ramón实验室进行了405406次分析。CONUT工具应用于其中的3.64%(14741个分析)。在门诊情况下，营养不良指数最高的患者来自肝移植会诊科，其次是心脏病科、风湿病科和肿瘤科。住院患者中，血液科、心脏科和内分泌科的营养不良指数最严重。结论:CONUT系统似乎提供了有关所研究医院队列的有用信息。结果显示，94%的患者未被划分为营养不良，无性别偏好，且年龄偏小。营养不良较严重的患者多为老年男性。
{"title":"CONUT: A Useful Alarm of Malnutrition in the Centralized Laboratory of a Spanish Hospital","authors":"M. Menacho-Román, Gilberto Pérez-López, José Manuel del Rey-Sánchez, D. Ly-Pen, Antonio Becerra-Fernández","doi":"10.15171/HPR.2018.25","DOIUrl":"https://doi.org/10.15171/HPR.2018.25","url":null,"abstract":"Background: Hospital malnutrition, usually secondary to various diseases and their treatments, is an important problem in our clinical practice. For its proper assessment, it is crucial to use a nutritional alert system, such as the CONUT (COntrol NUTrition) program; this tool uses 3 analytical parameters: serum albumin, total cholesterol, and total lymphocyte count. Objective: The current study assessed the results of the implementation of this program in the University Hospital Ramón y Cajal. Methods: The CONUT program has been used in the University Hospital Ramón y Cajal since 2013. This retrospective study, throughout 2016, was conducted in the Central Laboratory of Chemical Biochemistry at the University Hospital Ramón y Cajal. All blood tests with serum albumin, total cholesterol, and total lymphocyte count were studied. The degree of malnutrition was assessed using the scale of normal (=0), mild (=4), moderate (=8), and severe (=12). Results: In 2016, there were 405406 analytics performed in the laboratory of University Hospital Ramón y Cajal. The CONUT tool was applied to 3.64% of them (14741 analytics). In the outpatient setting, the highest malnutrition index comprised patients from the liver transplant consultation department, followed by the cardiology, rheumatology, and oncology departments. With inpatients, the hematology, cardiology, and endocrinology departments showed the most severe malnutrition index. Conclusion: The CONUT system seemed to provide useful information about the cohort of the studied hospital. The results showed that 94% of the patients were not classified with malnutrition, there was no gender predilection, and they were younger than the rest. Patients with more severe malnutrition were usually older and male.","PeriodicalId":32113,"journal":{"name":"Hospital Practices and Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82750243","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}
Introduction: It is well known that the tendency toward thrombosis is increased in cancer patients. The increase in cancer procoagulant and tissue factor levels, endothelial damage, and stasis due to compression are among the most accused causes of thrombosis in cancer patients. Hypereosinophilia is a rare condition that causes endothelial damage leading to thrombosis. Case Presentation: We present a 64-year-old male patient with cardiac involvement of hypereosinophilia which developed in the T-cell lymphoma ground resulting in a fatal cardioembolic stroke. Despite normal left ventricular (LV) contractions, almost half of the ventricular volume was full of thrombus in this case. Conclusion: Hypereosinophilia is a rare cause of thrombus formation in the left ventricle in patients with preserved ejection fraction. However, hypereosinophilic cardiac involvement can lead to rapid, progressive, life-threatening complications.
{"title":"Hypereosinophilic Cardiac Involvement Presenting With Left Ventricular Massive Thrombus and Cardioembolic Stroke: A Case Report","authors":"M. Gürdoğan, U. Ozkan, S. Altay, F. Puyan","doi":"10.15171/HPR.2018.29","DOIUrl":"https://doi.org/10.15171/HPR.2018.29","url":null,"abstract":"Introduction: It is well known that the tendency toward thrombosis is increased in cancer patients. The increase in cancer procoagulant and tissue factor levels, endothelial damage, and stasis due to compression are among the most accused causes of thrombosis in cancer patients. Hypereosinophilia is a rare condition that causes endothelial damage leading to thrombosis. Case Presentation: We present a 64-year-old male patient with cardiac involvement of hypereosinophilia which developed in the T-cell lymphoma ground resulting in a fatal cardioembolic stroke. Despite normal left ventricular (LV) contractions, almost half of the ventricular volume was full of thrombus in this case. Conclusion: Hypereosinophilia is a rare cause of thrombus formation in the left ventricle in patients with preserved ejection fraction. However, hypereosinophilic cardiac involvement can lead to rapid, progressive, life-threatening complications.","PeriodicalId":32113,"journal":{"name":"Hospital Practices and Research","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74845451","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}
{"title":"Observance of Architectural Principles in Hospital Construction; A Step Towards Energy Consumption Optimization","authors":"Z. Mohseni","doi":"10.15171/HPR.2018.30","DOIUrl":"https://doi.org/10.15171/HPR.2018.30","url":null,"abstract":"<jats:p>??\u0000 </jats:p>","PeriodicalId":32113,"journal":{"name":"Hospital Practices and Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79245064","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}
Derya Yalçın, D. Arı, C. Köksal, C. Akin, Sinan Karaca, Ö. Karakuş
Background: Opioids added to local anesthetics for peripheral nerve blocks may intensify analgesia and prolong analgesic and sensorial block duration. These agents may also cause potentiation and prolongation of motor block. Objective: This study compared the postoperative effects of 30 mL of 0.25% bupivacaine +50 mcg fentanyl and 30 mL of 0.25% bupivacaine + 100 mcg fentanyl solutions for the ultrasound-guided infraclavicular block in patients undergoing elbow and forearm surgery. Methods: In this randomized double-blind study, thirty-six patients with risk of ASA class I-III were randomly allocated into 2 randomized groups. Ultrasound-guided infraclavicular blocks with 30 mL of 0.25% bupivacaine + 50 mcg fentanyl for group 1 and 30 mL of 0.25% bupivacaine + 100 mcg fentanyl for group 2 were performed before patients emerged from general anesthesia. After surgery, pain levels at rest and during movement were evaluated using the 10-cm visual analog scale (VAS) at recovery room admission, at the 15th and 30th minutes in the recovery room, and at the 2nd, 6th, 12th and 24th hours postoperatively. Both morphine and rescue analgesic requirements were recorded. Sensorial and motor block durations, patient satisfaction, and complications related to the infraclavicular block were recorded. Results: In both groups, no significant difference in VAS pain scores, total morphine and total rescue analgesic requirements, duration of sensorial and motor block, or patient satisfaction were observed. None of the patients experienced any complications. Conclusion: The mixtures of 0.25% bupivacaine + 50 mcg fentanyl and 0.25% bupivacaine + 100 mcg fentanyl showed similar postoperative effects.
背景:阿片类药物加入局麻药用于周围神经阻滞可增强镇痛，延长镇痛和感觉阻滞持续时间。这些药物也可引起运动阻滞的增强和延长。目的:比较30 mL 0.25%布比卡因+50 mcg芬太尼溶液与30 mL 0.25%布比卡因+ 100 mcg芬太尼溶液用于超声引导下肘部和前臂手术患者锁骨下阻滞的术后效果。方法:采用随机双盲研究方法，将36例ASA I-III级高危患者随机分为2个随机组。超声引导下锁骨下阻滞，1组为30 mL 0.25%布比卡因+ 50 mcg芬太尼，2组为30 mL 0.25%布比卡因+ 100 mcg芬太尼，在患者全麻恢复前进行。术后恢复室入院时、恢复室15分钟、30分钟及术后2、6、12、24小时采用10 cm视觉模拟评分(VAS)评估休息和运动时疼痛水平。记录吗啡和抢救镇痛需求。记录感觉和运动阻滞持续时间、患者满意度和锁骨下阻滞相关的并发症。结果:两组在VAS疼痛评分、总吗啡和总抢救镇痛需求、感觉和运动阻滞持续时间、患者满意度等方面均无显著差异。所有患者均未出现任何并发症。结论:0.25%布比卡因+ 50 mcg芬太尼与0.25%布比卡因+ 100 mcg芬太尼的配伍术后效果相近。
{"title":"Ultrasound Guided Infraclavicular Block for Pain Control After Upper Extremity Surgery","authors":"Derya Yalçın, D. Arı, C. Köksal, C. Akin, Sinan Karaca, Ö. Karakuş","doi":"10.15171/HPR.2018.24","DOIUrl":"https://doi.org/10.15171/HPR.2018.24","url":null,"abstract":"Background: Opioids added to local anesthetics for peripheral nerve blocks may intensify analgesia and prolong analgesic and sensorial block duration. These agents may also cause potentiation and prolongation of motor block. Objective: This study compared the postoperative effects of 30 mL of 0.25% bupivacaine +50 mcg fentanyl and 30 mL of 0.25% bupivacaine + 100 mcg fentanyl solutions for the ultrasound-guided infraclavicular block in patients undergoing elbow and forearm surgery. Methods: In this randomized double-blind study, thirty-six patients with risk of ASA class I-III were randomly allocated into 2 randomized groups. Ultrasound-guided infraclavicular blocks with 30 mL of 0.25% bupivacaine + 50 mcg fentanyl for group 1 and 30 mL of 0.25% bupivacaine + 100 mcg fentanyl for group 2 were performed before patients emerged from general anesthesia. After surgery, pain levels at rest and during movement were evaluated using the 10-cm visual analog scale (VAS) at recovery room admission, at the 15th and 30th minutes in the recovery room, and at the 2nd, 6th, 12th and 24th hours postoperatively. Both morphine and rescue analgesic requirements were recorded. Sensorial and motor block durations, patient satisfaction, and complications related to the infraclavicular block were recorded. Results: In both groups, no significant difference in VAS pain scores, total morphine and total rescue analgesic requirements, duration of sensorial and motor block, or patient satisfaction were observed. None of the patients experienced any complications. Conclusion: The mixtures of 0.25% bupivacaine + 50 mcg fentanyl and 0.25% bupivacaine + 100 mcg fentanyl showed similar postoperative effects.","PeriodicalId":32113,"journal":{"name":"Hospital Practices and Research","volume":"137 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81754334","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: In providing optimum medical and health services, great pressure is put on the physical and mental health of family physicians. Job burnout is damaging to the health of family physicians and medical treatment personnel. It leads to reduced job productivity, increased absenteeism, increased healthcare costs, elevated turnover rates, a reduced level of service provided to patients, and ultimately, patient dissatisfaction. Objective: The current research investigated job burnout among family physicians in rural areas of Isfahan province during the years 2017-2018. Methods: This cross-sectional study was carried out in Isfahan province during the years 2017-2018. The research population included all family physicians working in Isfahan province, and 155 of whom met the inclusion criteria and participated in this research. Questionnaires were used as the data collection tool. Data was analyzed using SPSS software, and the analytical variables were analyzed using the independent t test and Pearson correlation coefficient. Results: A total of 45 men (29%) and 110 women (71%) comprised the research population. Participants’ mean age and mean duration of work experience were 35.3±8.1 and 7.5 years, respectively. The scores for overall job burnout, emotional exhaustion, depersonalization, and lack of personal accomplishment dimensions were low among the family physicians in Isfahan. The results showed no significant difference between male and female, single and married participants in any of the dimensions. The results also revealed a direct relationship between years of work experience and the overall job burnout and lack of personal accomplishment scores. Conclusion: According to the findings of the present research and considering the stressful nature of a family physician’s job, healthcare authorities need to pay special attention to job burnout and implement measures to prevent it or at least reduce its subsequent adverse effects.
{"title":"Job Burnout Among Family Physicians in Rural Areas of Isfahan Province","authors":"Neda Moein, Gholamhossein Ahmadzadeh, Alireza Safaeeyan","doi":"10.15171/HPR.2018.21","DOIUrl":"https://doi.org/10.15171/HPR.2018.21","url":null,"abstract":"Background: In providing optimum medical and health services, great pressure is put on the physical and mental health of family physicians. Job burnout is damaging to the health of family physicians and medical treatment personnel. It leads to reduced job productivity, increased absenteeism, increased healthcare costs, elevated turnover rates, a reduced level of service provided to patients, and ultimately, patient dissatisfaction. Objective: The current research investigated job burnout among family physicians in rural areas of Isfahan province during the years 2017-2018. Methods: This cross-sectional study was carried out in Isfahan province during the years 2017-2018. The research population included all family physicians working in Isfahan province, and 155 of whom met the inclusion criteria and participated in this research. Questionnaires were used as the data collection tool. Data was analyzed using SPSS software, and the analytical variables were analyzed using the independent t test and Pearson correlation coefficient. Results: A total of 45 men (29%) and 110 women (71%) comprised the research population. Participants’ mean age and mean duration of work experience were 35.3±8.1 and 7.5 years, respectively. The scores for overall job burnout, emotional exhaustion, depersonalization, and lack of personal accomplishment dimensions were low among the family physicians in Isfahan. The results showed no significant difference between male and female, single and married participants in any of the dimensions. The results also revealed a direct relationship between years of work experience and the overall job burnout and lack of personal accomplishment scores. Conclusion: According to the findings of the present research and considering the stressful nature of a family physician’s job, healthcare authorities need to pay special attention to job burnout and implement measures to prevent it or at least reduce its subsequent adverse effects.","PeriodicalId":32113,"journal":{"name":"Hospital Practices and Research","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84680314","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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