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[PMID]:29040329
[Au] Autor:Abrahams N; Mathews S; Lombard C; Martin LJ; Jewkes R
[Ad] Endereço:Gender & Health Research Unit, South African Medical Research Council, Cape Town & Pretoria, South Africa.
[Ti] Título:Sexual homicides in South Africa: A national cross-sectional epidemiological study of adult women and children.
[So] Source:PLoS One;12(10):e0186432, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:METHODS: We conducted a retrospective national mortuary based study to identify all adult female homicides (18 years and older) and all child homicides (boys and girls < 18 years) in 2009 in a randomly selected, proportionate sample of mortuaries. Victim, perpetrator and crime data were collected in three processes: from the mortuary register, the autopsy report and from police with the identification of sexual homicides validated across the data collection processes. FINDINGS: Among the 2670 (95% CI: 2311-2979) adult women killed in 2009, 494 (95% CI: 406-574) were identified as sexual homicides which was 19.8% (95% CI: 17.6-22.0) of all adult female homicides and among 1277 (95% CI: 1091-1462) children killed in SA, sexual homicides were found in 104 (95% CI: 77-132) of the child homicides which was 8.7% (95% CI: 10.9-11.2%) of these murders. Strangulation was the most common cause of death for both children and adult females. A distinct age and sex pattern was found among children with only 1% boy child death identified as a sexual homicide and 92% of all the child sexual homicides were among girls. Strangulation was the most common manner of death among children (35.5%) and perpetrators were seldom strangers. However, no difference in the proportion of convictions between the sexual homicides and non-sexual homicides were found for both adult females and children. CONCLUSION: Rape homicide is not a rare event in South Africa, with one in five female homicides and nearly one in ten child homicides identified with an associated sexual crime. These high prevalences are amongst the highest levels reported in the literature with our study among the few reporting on the epidemiology of child sexual homicide. Reducing mortality is an important policy goal for South Africa and for the rest of the world and the prevention of female and child homicide is an important part of attaining this goal.
[Mh] Termos MeSH primário: Asfixia/epidemiologia
Abuso Sexual na Infância/estatística & dados numéricos
Homicídio/estatística & dados numéricos
Estupro/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Distribuição por Idade
Asfixia/mortalidade
Autopsia/estatística & dados numéricos
Criança
Estudos Transversais
Feminino
Seres Humanos
Masculino
Necrotério/estatística & dados numéricos
Prevalência
Estudos Retrospectivos
Distribuição por Sexo
África do Sul/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171018
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0186432


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[PMID]:28711011
[Au] Autor:Obenson K; Enow Orock G
[Ad] Endereço:Department of Laboratory Medicine Saint John Regional Hospital, 400 University Avenue, Saint John New Brunswick, E2L 4L2, Canada; Dalhousie University, Faculty of Medicine, Halifax B3H 4R2, Nova Scotia, Canada. Electronic address: kenneth.obenson@horizonnb.ca.
[Ti] Título:An overview of the challenges facing death investigation systems in certain resource limited countries.
[So] Source:J Forensic Leg Med;50:58-62, 2017 Aug.
[Is] ISSN:1878-7487
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:A properly operated death investigation system (DIS) serves multiple stakeholders. Law enforcement, public health departments and members of the public, benefit in various ways from the information that it provides. This information must be collected systematically and efficiently. The system must also be flexible enough to respond to pressures on its resources such as occurs during mass disasters. These obligations on a DIS require an investment of public money. However even in affluent Western countries the recent world economic crisis has led to a cut in spending on public services that affect both the healthcare system and services associated with death investigation. Although pathologists and other stake holders (judiciary, police, families) would like to see death investigations conducted to international standards, the fact is that policy makers in resource limited countries face additional population health and sociopolitical pressures which generally result in very little funding for the service. The purpose of this paper is to review some of the challenges that impede the proper functioning of a death investigation system in resource limited countries in Sub-Saharan Africa and the Caribbean. Possible solutions are discussed.
[Mh] Termos MeSH primário: Países em Desenvolvimento
Ciências Forenses/organização & administração
[Mh] Termos MeSH secundário: África ao Sul do Saara
Educação Médica Continuada
Equipamentos e Provisões/provisão & distribuição
Arquitetura de Instituições de Saúde
Ciências Forenses/legislação & jurisprudência
Seres Humanos
Necrotério/organização & administração
Médicos/provisão & distribuição
Política
Competência Profissional
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171018
[Lr] Data última revisão:
171018
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170716
[St] Status:MEDLINE


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[PMID]:28221185
[Au] Autor:Drewry AM; Ablordeppey EA; Murray ET; Stoll CRT; Izadi SR; Dalton CM; Hardi AC; Fowler SA; Fuller BM; Colditz GA
[Ad] Endereço:1Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO. 2Departments of Emergency Medicine and Anesthesiology, Washington University School of Medicine, St. Louis, MO. 3University of Missouri-Columbia School of Medicine, Columbia, MO. 4Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO. 5Bernard Becker Medical Library, Washington University School of Medicine, St. Louis, MO.
[Ti] Título:Antipyretic Therapy in Critically Ill Septic Patients: A Systematic Review and Meta-Analysis.
[So] Source:Crit Care Med;45(5):806-813, 2017 May.
[Is] ISSN:1530-0293
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: This meta-analysis aimed to examine the impact of antipyretic therapy on mortality in critically ill septic adults. DATA SOURCES: Literature searches were implemented in Ovid Medline, Embase, Scopus, Cumulative Index of Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, NHS Economic Evaluation Database, and ClinicalTrials.gov through February 2016. STUDY SELECTION: Inclusion criteria were observational or randomized studies of septic patients, evaluation of antipyretic treatment, mortality reported, and English-language version available. Studies were excluded if they enrolled pediatric patients, patients with neurologic injury, or healthy volunteers. Criteria were applied by two independent reviewers. DATA EXTRACTION: Two reviewers independently extracted data and evaluated methodologic quality. Outcomes included mortality, frequency of shock reversal, acquisition of nosocomial infections, and changes in body temperature, heart rate, and minute ventilation. Randomized and observational studies were analyzed separately. DATA SYNTHESIS: Eight randomized studies (1,507 patients) and eight observational studies (17,432 patients) were analyzed. Antipyretic therapy did not reduce 28-day/hospital mortality in the randomized studies (relative risk, 0.93; 95% CI, 0.77-1.13; I = 0.0%) or observational studies (odds ratio, 0.90; 95% CI, 0.54-1.51; I = 76.1%). Shock reversal (relative risk, 1.13; 95% CI, 0.68-1.90; I = 51.6%) and acquisition of nosocomial infections (relative risk, 1.13; 95% CI, 0.61-2.09; I = 61.0%) were also unchanged. Antipyretic therapy decreased body temperature (mean difference, -0.38°C; 95% CI, -0.63 to -0.13; I = 84.0%), but not heart rate or minute ventilation. CONCLUSIONS: Antipyretic treatment does not significantly improve 28-day/hospital mortality in adult patients with sepsis.
[Mh] Termos MeSH primário: Estado Terminal/mortalidade
Unidades de Terapia Intensiva/estatística & dados numéricos
Sepse/tratamento farmacológico
Sepse/mortalidade
[Mh] Termos MeSH secundário: Temperatura Corporal/efeitos dos fármacos
Infecção Hospitalar/epidemiologia
Mortalidade Hospitalar
Seres Humanos
Necrotério
Estudos Observacionais como Assunto
Ensaios Clínicos Controlados Aleatórios como Assunto
Sepse/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170509
[Lr] Data última revisão:
170509
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170222
[St] Status:MEDLINE
[do] DOI:10.1097/CCM.0000000000002285


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[PMID]:28101750
[Au] Autor:Anderson M; Leditschke J; Bassed R; Cordner SM; Drummer OH
[Ad] Endereço:Department of Forensic Medicine, Monash University, Melbourne, Australia.
[Ti] Título:Mortuary operations following mass fatality natural disasters: a review.
[So] Source:Forensic Sci Med Pathol;13(1):67-77, 2017 Mar.
[Is] ISSN:1556-2891
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This is a critical review to discuss the best practice approaches to mortuary operations in preparation for and the response to natural, mass fatality, disaster events, as identified by a review of published articles. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) Statement guided the identification of potential articles to use in this critical review. Subsequent searches were also conducted to identify articles relating to heat wave, and flood mortality. All identified peer-reviewed studies published in English which discussed the preparation and response of mortuaries to mass fatality natural disasters occurring in developed countries were included. Using the PRISMA-P method of identifying articles, 18 articles were selected for inclusion in this review. Although there are numerous articles which describe the mortuary response to mass fatality incidents, few articles analyzed the response, or discussed the roles which supported and enabled the organization to undertake the task of identifying disaster victims. It is thus difficult to determine objectively if the actions and activities outlined in the articles represent best-practice.
[Mh] Termos MeSH primário: Desastres
Incidentes com Feridos em Massa
Práticas Mortuárias/organização & administração
[Mh] Termos MeSH secundário: Atitude do Pessoal de Saúde
Comunicação
Pessoal de Saúde/educação
Seres Humanos
Necrotério
Medidas de Segurança
Transportes
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1703
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170120
[St] Status:MEDLINE
[do] DOI:10.1007/s12024-016-9836-3


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[PMID]:27762003
[Au] Autor:Chen JY; Chan GS; Tsang JP; Tsang GK
[Ad] Endereço:juliechen@hku.hk.
[Ti] Título:The hospital mortuary: learning about death… and life.
[So] Source:Med Educ;50(11):1145-1146, 2016 Nov.
[Is] ISSN:1365-2923
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Morte
Hospitais
Necrotério
Inquéritos e Questionários/normas
[Mh] Termos MeSH secundário: Luto
Educação Médica
Hong Kong
Seres Humanos
Aprendizagem
Estudantes de Medicina/psicologia
Redação
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161021
[St] Status:MEDLINE
[do] DOI:10.1111/medu.13201


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[PMID]:27404619
[Au] Autor:Keyes CA; Hill L; Gordon GM
[Ad] Endereço:Division of Forensic Medicine and Pathology, School of Clinical Medicine, University of the Witwatersrand, 25A Hospital Street, Braamfontein, 2195, Johannesburg, Gauteng, South Africa.
[Ti] Título:An Appraisal of Decomposition Cases Received at the Johannesburg Forensic Pathology Service Medico-legal Mortuary During 2010-2011.
[So] Source:J Forensic Sci;61(2):452-457, 2016 Mar.
[Is] ISSN:1556-4029
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Decomposed bodies pose many questions for researchers regarding environmental effects, cause of death, and patterns. This study aimed to observe the factors associated with decomposed bodies autopsied at the Johannesburg Forensic Pathology Service Medico-legal Mortuary. A total of 4876 autopsies were conducted from 2010 to 2011, of which 109 were decomposed. Black individuals made up the largest proportion (67%) followed by White (26%). Males comprised 86.2%, while 12.8% were female. The mean age was 42.78 years. Most cases were in the early stages of decomposition (49.5%), with 32.1% bloated, 11.9% in active decay, 2.8% in advanced decay, and 3.7% were skeletal. Insect activity was identified in 25.7% of decomposition cases. Cause of death was determined in 48.6% of cases. Of all the cases, 64% were found indoors and 23% outdoors, while 23% had insufficient information regarding the location. Of considerable interest was the number of cases from hospitals and clinics.
[Mh] Termos MeSH primário: Necrotério
Mudanças Depois da Morte
[Mh] Termos MeSH secundário: Adulto
Grupo com Ancestrais do Continente Africano/estatística & dados numéricos
Distribuição por Idade
Idoso
Animais
Meio Ambiente
Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos
Comportamento Alimentar
Feminino
Patologia Legal
Seres Humanos
Insetos
Masculino
Meia-Idade
Estudos Retrospectivos
Distribuição por Sexo
África do Sul
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1701
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160713
[St] Status:MEDLINE
[do] DOI:10.1111/1556-4029.13005


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[PMID]:26936041
[Au] Autor:Ortaç Ersoy E; Durusu Tanriover M; Öcal S; Gulsun Akpinar M; Topeli A
[Ad] Endereço:Hacettepe University Faculty of Medicine, Department of Internal Medicine, Medical Intensive Care Unit, Ankara, Turkey. Electronic address: nebruortac@mynet.com.
[Ti] Título:Measurement of pulmonary artery to aorta ratio in computed tomography is correlated with pulmonary artery pressure in critically ill chronic obstructive pulmonary disease patients.
[So] Source:J Crit Care;33:42-6, 2016 Jun.
[Is] ISSN:1557-8615
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:AIM: Chronic obstructive pulmonary disease (COPD) is one of the leading chronic diseases and a common cause of death. Identification of COPD patients at high risk for complications and mortality is of utmost importance. Computed tomography (CT) can be used to measure the ratio of the diameter of the pulmonary artery (PA) to the diameter of the aorta (A), and PA/A ratio was shown to be correlated with PA pressure (PAP). However, the prognostic value of PA size remains unclear in patients with COPD. We hypothesized that PA enlargement, as shown by a PA/A ratio greater than 1, could be associated with a higher risk of mortality in COPD patients admitted to the intensive care unit. METHODS: Data of patients admitted to a medical intensive care unit of a university hospital were retrospectively reviewed between January 2008 and December 2012. Patients who were identified to have a diagnosis of acute exacerbation of COPD and who had an echocardiogram and CT scan were included. Pulmonary artery to aorta ratio was calculated and patients were grouped as PA/A ≤1 and PA/A >1. Comparisons were made between the groups and between patients who died and survived. Correlation analysis, survival analysis, and logistic regression analysis were done, where appropriate. RESULTS: One hundred six COPD patients were enrolled. There were 40 (37.4%) patients who had a PA/A >1. Echocardiography measured PAP was higher in the group with PA/A >1 than in those with PA/A ≤1 (62.1 ± 23.2 mm Hg vs 45.3 ± 17.9 mm Hg, P = .002). Mortality rate of patients with PA/A >1 was higher (50%) than of those patients with PA/A ≤1 (36.4%), although the difference did not reach a statistical significance (P = .17). Correlation was found between vmeasured PA diameter and PAP (r = 0.51, P = .001) as well as between the Acute Physiology and Chronic Health Evaluation II values and PAP (r = 0.25, P = .025). CONCLUSION: The PA/A ratio is an easily measured method that can be performed on thorax CT scans. Although, we failed to demonstrate a statistically significant association between higher PA/A and increased mortality, PA/A can be used as a surrogate marker to predict the pulmonary hypertension.
[Mh] Termos MeSH primário: Aorta/diagnóstico por imagem
Hipertensão Pulmonar/diagnóstico por imagem
Artéria Pulmonar/diagnóstico por imagem
Doença Pulmonar Obstrutiva Crônica/diagnóstico por imagem
Pressão Propulsora Pulmonar
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Estado Terminal
Ecocardiografia
Feminino
Hospitalização
Seres Humanos
Hipertensão Pulmonar/complicações
Unidades de Terapia Intensiva
Masculino
Meia-Idade
Necrotério
Prognóstico
Doença Pulmonar Obstrutiva Crônica/complicações
Estudos Retrospectivos
Análise de Sobrevida
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170912
[Lr] Data última revisão:
170912
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160304
[St] Status:MEDLINE


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[PMID]:26851799
[Au] Autor:Bafadhel M; Greening NJ; Harvey-Dunstan TC; Williams JE; Morgan MD; Brightling CE; Hussain SF; Pavord ID; Singh SJ; Steiner MC
[Ad] Endereço:Respiratory Medicine Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK. Electronic address: mona.bafadhel@ndm.ox.ac.uk.
[Ti] Título:Blood Eosinophils and Outcomes in Severe Hospitalized Exacerbations of COPD.
[So] Source:Chest;150(2):320-8, 2016 Aug.
[Is] ISSN:1931-3543
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Patients with moderate exacerbations of COPD and the eosinophilic phenotype have better outcomes with prednisolone. Whether this outcome is similar in patients hospitalized with a severe exacerbation of COPD is unclear. We investigated the rate of recovery of eosinophilic and noneosinophilic exacerbations in patients participating in a multicenter randomized controlled trial assessing health outcomes in hospitalized exacerbations. METHODS: Patients were recruited at presentation to the hospital with an exacerbation of COPD. They were stratified into groups according to eosinophilic exacerbations if the peripheral blood eosinophil count on admission was ≥ 200 cells/µL and/or ≥ 2% of the total leukocyte count. Admission details, serum C-reactive protein levels, length of stay, and subsequent rehospitalization data were compared between groups. RESULTS: A total of 243 patients with COPD (117 men) with a mean age of 71 years (range, 45-93 years) were recruited. The inpatient mortality rate was 3% (median time to death, 12 days; range, 9-16 days). The median absolute eosinophil count was 100 cells/µL (range, 10-1,500 cells/µL), and 25% met our criteria for an eosinophilic exacerbation; in this population, the mean length of stay (in days) was shorter than in patients with noneosinophilic exacerbations (5.0 [range, 1-19] vs 6.5 [range, 1-33]; P = .015) following treatment with oral corticosteroids and independent of treatment prior to admission. Readmission rates at 12 months were similar between groups. CONCLUSIONS: The study patients presenting to the hospital with a severe eosinophilic exacerbation of COPD had a shorter length of stay. The exacerbations were usually not associated with elevated C-reactive protein levels, suggesting that better treatment stratification of exacerbations can be used. TRIAL REGISTRY: http://www.isrctn.com/ISRCTN05557928.
[Mh] Termos MeSH primário: Eosinofilia/imunologia
Eosinófilos/imunologia
Tempo de Internação/estatística & dados numéricos
Doença Pulmonar Obstrutiva Crônica/imunologia
Recuperação de Função Fisiológica
[Mh] Termos MeSH secundário: Corticosteroides/uso terapêutico
Idoso
Idoso de 80 Anos ou mais
Proteína C-Reativa/imunologia
Progressão da Doença
Eosinofilia/epidemiologia
Feminino
Volume Expiratório Forçado
Hospitalização
Seres Humanos
Contagem de Leucócitos
Masculino
Meia-Idade
Necrotério
Readmissão do Paciente
Prognóstico
Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico
Doença Pulmonar Obstrutiva Crônica/mortalidade
Doença Pulmonar Obstrutiva Crônica/fisiopatologia
Ensaios Clínicos Controlados Aleatórios como Assunto
Índice de Gravidade de Doença
Capacidade Vital
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Adrenal Cortex Hormones); 9007-41-4 (C-Reactive Protein)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160207
[St] Status:MEDLINE


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[PMID]:26762620
[Au] Autor:Queiroz LF; Anami EH; Zampar EF; Tanita MT; Cardoso LT; Grion CM
[Ad] Endereço:Londrina State University, Hospital Universitário - Universidade Estadual de Londrina, Rua Robert Koch 60, Vila Operária, Londrina, Paraná 86038-440, Brazil.
[Ti] Título:Epidemiology and outcome analysis of burn patients admitted to an Intensive Care Unit in a University Hospital.
[So] Source:Burns;42(3):655-62, 2016 May.
[Is] ISSN:1879-1409
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To describe the epidemiologic aspects of burn victims who were hospitalized in the Intensive Care Unit (ICU) at the Burn Center in the University Hospital of the State University of Londrina (UEL). METHODS: A longitudinal retrospective study was conducted, involving patients admitted to the Intensive Care Unit of the Burn Center from January 2010 to December 2012. Demographic and diagnostic data including the diagnosis of the extent and causes of the burns, complications resulting from the burns and the need for specific surgical interventions were collected, together with data for the calculation of the Acute Physiology and Chronic Health Evaluation (APACHE II), Sequential Organ Failure Assessment (SOFA), Therapeutic Intervention Scoring System (TISS-28) and Abbreviated Burn Severity Index (ABSI). Data were collected at admission and daily until discharge from the burn Intensive Care Unit. Risk factors for death and the prognostic performance of scores to predict mortality were analyzed. The level of significance was set at 5%. RESULTS: Two hundred ninety-three patients were analyzed in the study; 68.30% were men, with a median age of 38 years (interquartile range: 28-52). The mean total body surface area burned was 26.60±18.05%. Home incidents were the most frequent cause, occurring in 53.90% of the cases. Fire was the most common cause, found in 77.10% of patients. Liquid alcohol was the most common agent and was associated with 51.50% of the cases. The ABSI presented a median of 7, and the area under the ROC curve was 0.890. In multivariate analysis, age (p<0.001), female gender (p=0.02), total body surface area burned (p<0.001), mechanical ventilation (p<0.001) and acute renal failure (p<0.001) were all associated with mortality. ICU mortality was 32.80%, and hospital mortality was 34.10%. CONCLUSION: Burns most often occurred in young adult men in our study. The most common cause was a direct flame. Liquid alcohol was the most frequent accelerating agent. Patients were considered to be severely burned. Most of the samples had a high mean total body surface area burned. The ABSI score showed the best performance in discriminating non-survivors. Hospital mortality rate was high.
[Mh] Termos MeSH primário: Lesão Renal Aguda/epidemiologia
Queimaduras/epidemiologia
Hospitais Universitários
Unidades de Terapia Intensiva
Respiração Artificial/utilização
[Mh] Termos MeSH secundário: APACHE
Acidentes Domésticos/estatística & dados numéricos
Acidentes de Trabalho/estatística & dados numéricos
Adolescente
Adulto
Distribuição por Idade
Idoso
Idoso de 80 Anos ou mais
Álcoois
Superfície Corporal
Brasil/epidemiologia
Queimaduras/mortalidade
Criança
Pré-Escolar
Feminino
Fogo/estatística & dados numéricos
Hospitalização
Seres Humanos
Lactente
Recém-Nascido
Estudos Longitudinais
Masculino
Meia-Idade
Necrotério
Análise Multivariada
Prognóstico
Curva ROC
Estudos Retrospectivos
Fatores de Risco
Distribuição por Sexo
Fatores Sexuais
Índices de Gravidade do Trauma
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Alcohols)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160115
[St] Status:MEDLINE


  10 / 10 MEDLINE  
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[PMID]:25851550
[Au] Autor:Kao SH; Lu DK; Lin YL; Hsieh HM; Lin TH; Chiu HC
[Ad] Endereço:Bureau of National Health Insurance, Department of Health, Executive Yuan, Taiwan.
[Ti] Título:Association of Physician Certification Policy and Quality of Care: Evidence of percutaneous coronary intervention certification program in Taiwan.
[So] Source:Health Policy;119(8):1031-8, 2015 Aug.
[Is] ISSN:1872-6054
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: The aim of this study was to compare procedural, short-term and two-year outcomes of percutaneous coronary intervention (PCI) between board-certified and non-board certified interventional cardiologists in Taiwan. BACKGROUND: Most studies of associations between quality and certification have analyzed populations in the Western developed countries. METHODS: This retrospective population-based study analyzed 2057 patients who had received PCI in 11 hospitals in 2007. The outcome measures were procedural, 30-day, and 2-year adverse events. RESULTS: Sixty certified physicians performed 1771 PCI procedures whereas 84 non-certified physicians performed 286 procedures. Patients treated by non-certified physicians had significantly higher rates of in-hospital mortality (6.99% vs. 2.82%, respectively; p ≤ 0.001) and same-stay CABG (1.40% vs. 0.06%, respectively; p ≤ 0.001). The results of multilevel logistic regression and Cox multivariate regression indicated that patients treated by non-certified physicians also had higher probabilities of in-hospital death (OR=2.92, 95% CI: 1.20-7.08) and two-year death (hazard ratio, 1.63; 95% confidence interval, 1.18-2.24). CONCLUSIONS: This is the first study in Asia in investigating the association between board certification policy and surgical outcomes, and the results confirmed that the board certification policy is also effective for Asian population. The policy implications of these findings are discussed.
[Mh] Termos MeSH primário: Certificação/organização & administração
Política de Saúde
Intervenção Coronária Percutânea/normas
Qualidade da Assistência à Saúde/organização & administração
[Mh] Termos MeSH secundário: Idoso
Feminino
Seres Humanos
Masculino
Meia-Idade
Necrotério
Intervenção Coronária Percutânea/mortalidade
Médicos/organização & administração
Médicos/normas
Qualidade da Assistência à Saúde/normas
Taiwan
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1612
[Cu] Atualização por classe:161230
[Lr] Data última revisão:
161230
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:150409
[St] Status:MEDLINE



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