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[PMID]:29283541
[Au] Autor:Thinard-Morel J
[Ti] Título:[In process]
[Ti] Título:Alimentation et soins des maladies de I'Hotel-Dieu de Paris à l'èpoque moderne..
[So] Source:Vesalius;22(2):44-53, 2016 Dec.
[Is] ISSN:1373-4857
[Cp] País de publicação:Belgium
[La] Idioma:fre
[Ab] Resumo:At the end of the Middle Ages, in 1492, the Hôtel-Dieu de Paris was still and establishment of charity intended to receive thepoor which came there to find a shelter and some food. Three centuries later, just before the French Revolution, it became an establishment of care mainly destined to receive the patients, to feed them, take care of them and if possible cure them. This medicalization of the Hôtel-Dieu de Paris is related to the progressive emergence of the medical function, which resulted in the creation and the development of a doctor's and surgeon's profession, but also in the development of the apothecary and its drugs. In this context, the diet plays a central part, because it happens to supplies. It would not be until the eve of the French Revolution that it would be integrated in the doctor's prescription and became a dietetic item.
[Mh] Termos MeSH primário: Hospitais Municipais/história
Médicos/história
[Mh] Termos MeSH secundário: Dieta/história
História do Século XVIII
Seres Humanos
Paris
Preparações Farmacêuticas/história
Farmácia/história
Cirurgiões/história
[Pt] Tipo de publicação:HISTORICAL ARTICLE; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Pharmaceutical Preparations)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180212
[Lr] Data última revisão:
180212
[Sb] Subgrupo de revista:QIS
[Da] Data de entrada para processamento:171229
[St] Status:MEDLINE


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[PMID]:28170457
[Au] Autor:Zuger A
[Ad] Endereço:Department of Medicine, Mount Sinai West and Mount Sinai St Luke's Hospitals, New York, New York.
[Ti] Título:Bellevue Gets Its Biography.
[So] Source:JAMA;317(5):460-461, 2017 Feb 07.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Anedotas como Assunto
Livros
Fechamento de Instituições de Saúde
Hospitais Municipais/história
Medicina nas Artes
[Mh] Termos MeSH secundário: Asilos/história
História do Século XVIII
História do Século XIX
História do Século XX
Serviço Hospitalar de Limpeza
Habitação
Cidade de Nova Iorque
Pobreza
[Pt] Tipo de publicação:HISTORICAL ARTICLE; JOURNAL ARTICLE; PERSONAL NARRATIVES
[Em] Mês de entrada:1703
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170208
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2016.20313


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[PMID]:27865941
[Au] Autor:Ishikawa H; Unno Y; Omoto A; Shozu M
[Ad] Endereço:Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, Japan. Electronic address: ishikawa@chiba-u.jp.
[Ti] Título:Local injection of diluted vasopressin followed by suction curettage for cervical ectopic pregnancy.
[So] Source:Eur J Obstet Gynecol Reprod Biol;207:173-177, 2016 Dec.
[Is] ISSN:1872-7654
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To report the results of local injection of diluted vasopressin followed by suction curettage as a conservative treatment for women with cervical ectopic pregnancy, who wish to preserve their future fertility. STUDY DESIGN: This was a retrospective chart review in a university hospital and a municipal hospital. We injected diluted vasopressin (Pitressin R, total amount of 4-10 units) transvaginally into the cervix surrounding the gestational sac, but not directly into the gestational sac, and/or the lower segment of the uterine body under transvaginal ultrasonographic guidance. After cessation of fetal heartbeats, we aspirated the conceptus by performing suction curettage. We injected additional vasopressin into the gestational sac in cases with a viable fetus after the initial injection. Forced contraction of the cervical smooth muscle facilitated removal of the conceptus with minimal blood loss during curettage. We measured operative time, total blood loss, complications, and the need for additional treatment. RESULTS: We included 11 women. Mean patient age, gestational age, and serum human chorionic gonadotrophin (hCG) at the intervention were 31.2±6.4years, 6.0±0.6 weeks, and 18,370±21,570 IU/L, respectively. Mean size of the gestational sac was 19.6±9.5mm. The uterus was successfully preserved without any complications in all patients. All procedures were completed within 15min except for the first case (range: 5-33min). In 4 cases, the conceptus containing a gestational sac was spontaneously extruded en bloc from the external os after the injection. Additional systematic methotrexate administration was required in one case because of remaining villi at the implantation site with persistence of serum hCG levels after the procedure. CONCLUSION: Local injection of diluted vasopressin and subsequent suction curettage is a feasible conservative treatment for cervical ectopic pregnancy.
[Mh] Termos MeSH primário: Complicações Pós-Operatórias/prevenção & controle
Gravidez Ectópica/tratamento farmacológico
Gravidez Ectópica/cirurgia
Curetagem a Vácuo
Vasoconstritores/uso terapêutico
Vasopressinas/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Perda Sanguínea Cirúrgica/prevenção & controle
Colo do Útero
Gonadotropina Coriônica/análise
Terapia Combinada/efeitos adversos
Estudos de Viabilidade
Feminino
Hospitais Municipais
Hospitais Universitários
Seres Humanos
Injeções Intramusculares
Japão
Duração da Cirurgia
Complicações Pós-Operatórias/etiologia
Gravidez
Gravidez Ectópica/sangue
Gravidez Ectópica/diagnóstico por imagem
Estudos Retrospectivos
Ultrassonografia Doppler em Cores
Curetagem a Vácuo/efeitos adversos
Vasoconstritores/administração & dosagem
Vasoconstritores/efeitos adversos
Vasopressinas/administração & dosagem
Vasopressinas/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Chorionic Gonadotropin); 0 (Vasoconstrictor Agents); 11000-17-2 (Vasopressins)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170414
[Lr] Data última revisão:
170414
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161121
[St] Status:MEDLINE


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[PMID]:27835829
[Au] Autor:Papaleo E; Zaffagnini S; Munaretto M; Vanni VS; Rebonato G; Grisendi V; Di Paola R; La Marca A
[Ad] Endereço:IRCCS San Raffaele Hospital, Centro Scienze della Natalità, Department of Obstetrics and Gynaecology, 20132 Milan, Italy. Electronic address: papaleo.enrico@hsr.it.
[Ti] Título:Clinical application of a nomogram based on age, serum FSH and AMH to select the FSH starting dose in IVF/ICSI cycles: a retrospective two-centres study.
[So] Source:Eur J Obstet Gynecol Reprod Biol;207:94-99, 2016 Dec.
[Is] ISSN:1872-7654
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To externally validate a nomogram based on ovarian reserve markers as a tool to optimize the FSH starting dose in IVF/ICSI cycles. STUDY DESIGN: A two-centres retrospective study including 398 infertile women undergoing their first IVF/ICSI cycle (June 2013-June 2014). IVF data were retrieved from two independent IVF centres in Italy (San Raffaele Hospital, Centre 1; Verona Hospital, Centre 2). A central lab for the routine measurement of AMH and FSH was used for both centres. All women were treated based on physical and hormonal characteristics according to locally adopted protocols. The nomogram was then retrospectively applied to the patients comparing the calculated starting dose to the one actually given. RESULTS: In Centre 1, 64/131 women (48.8%) had an ovarian response below the target. While 45 of these patients were treated with a maximal FSH starting dose (≥225 IU), n=19/131 (14.5%) were treated with a submaximal dose. The vast majority of them (n=17/19) would have received a higher FSH starting dose by using the nomogram. Seventeen patients (n=17/131) had hyper response and about half of them would have been treated with a reduced FSH starting dose according to the nomogram. In Centre 2, 142/267 patients (53.2%) had an ovarian response below the target. While 136 of these were treated with a maximal FSH starting dose (≥225 IU), n=6/267 were treated with a submaximal dose. The majority of them (n=5/6) would have received a higher FSH starting dose. Thirty-two (n=32/267) patients had hyper response and more than half of them would have been treated with a reduced FSH dose. CONCLUSION: In both Centres, applying the nomogram would have resulted in more appropriate FSH starting doses compared to the the ones actually given based on clinicians choices. The use of an objective algorithm based on patient's age, serum FSH and AMH levels may thus be an effective advice on the selection of the tailored FSH starting dose. Hence, the use of this easily available nomogram could increase the proportion of patients achieving the optimal ovarian response.
[Mh] Termos MeSH primário: Hormônio Antimülleriano/sangue
Fármacos para a Fertilidade Feminina/administração & dosagem
Fertilização In Vitro
Hormônio Foliculoestimulante/administração & dosagem
Hormônio Foliculoestimulante/sangue
Infertilidade Feminina/terapia
Indução da Ovulação
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Biomarcadores/sangue
Estudos de Coortes
Cálculos da Dosagem de Medicamento
Feminino
Fármacos para a Fertilidade Feminina/efeitos adversos
Hormônio Foliculoestimulante/efeitos adversos
Hospitais Municipais
Seres Humanos
Infertilidade Feminina/sangue
Itália/epidemiologia
Nomogramas
Ambulatório Hospitalar
Síndrome de Hiperestimulação Ovariana/epidemiologia
Síndrome de Hiperestimulação Ovariana/etiologia
Síndrome de Hiperestimulação Ovariana/prevenção & controle
Indução da Ovulação/efeitos adversos
Proteínas Recombinantes/administração & dosagem
Proteínas Recombinantes/efeitos adversos
Proteínas Recombinantes/uso terapêutico
Estudos Retrospectivos
Risco
Injeções de Esperma Intracitoplásmicas
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; VALIDATION STUDIES
[Nm] Nome de substância:
0 (Biomarkers); 0 (Fertility Agents, Female); 0 (Recombinant Proteins); 80497-65-0 (Anti-Mullerian Hormone); 9002-68-0 (Follicle Stimulating Hormone)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170704
[Lr] Data última revisão:
170704
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161112
[St] Status:MEDLINE


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[PMID]:27662046
[Au] Autor:Riggs SE; Garrett M; Arnold K; Colon E; Feldman EN; Huangthaisong P; Hyacinthe B; Indelicato HA; Lee E
[Ad] Endereço:NYC CBTp, Brooklyn, NY, USA.
[Ti] Título:Can Frontline Clinicians in Public Psychiatry Settings Provide Effective Psychotherapy For Psychosis?
[So] Source:Am J Psychother;70(3):301-328, 2016.
[Is] ISSN:0002-9564
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This report consists of the personal reflections of seven frontline clinicians who participated in a formal training program for the psychotherapy of psychosis implemented in a large public clinic setting. The training was part of a quality improvement initiative, consisting of 12 hours of didactic presentation followed by 30 hours of weekly peer-group supervision. The clinicians comment on ways of working with patients prior to the training, and how their views and techniques changed as a result of the training. The reflections of frontline staff provide proof of the concept that psychotherapy for psychosis techniques can be added to existing clinical skills, and that it is possible to implement a program in psychotherapy for psychosis in a busy public clinic.
[Mh] Termos MeSH primário: Serviços Comunitários de Saúde Mental
Psiquiatria Comunitária
Hospitais Municipais
Transtornos Psicóticos/psicologia
Transtornos Psicóticos/terapia
Prática de Saúde Pública
[Mh] Termos MeSH secundário: Adolescente
Adulto
Criança
Abuso Sexual na Infância/diagnóstico
Abuso Sexual na Infância/psicologia
Abuso Sexual na Infância/terapia
Pré-Escolar
Terapia Cognitiva/educação
Terapia Cognitiva/métodos
Psiquiatria Comunitária/educação
Comparação Transcultural
Currículo
Hospitalização
Seres Humanos
Acontecimentos que Mudam a Vida
Masculino
Terapia Ambiental/educação
Terapia Ambiental/métodos
Relações Médico-Paciente
Unidade Hospitalar de Psiquiatria
Transtornos Psicóticos/diagnóstico
Esquizofrenia/diagnóstico
Esquizofrenia/terapia
Psicologia do Esquizofrênico
Resultado do Tratamento
Reino Unido
Estados Unidos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1701
[Cu] Atualização por classe:170117
[Lr] Data última revisão:
170117
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160924
[St] Status:MEDLINE


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[PMID]:27289381
[Au] Autor:Kurihara Y; Tachibana D; Yokoi N; Nakagawa K; Kitada K; Hayashi M; Yanai S; Katayama H; Hamuro A; Misugi T; Tanaka K; Fukui M; Koyama M
[Ad] Endereço:Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan.
[Ti] Título:Time-interval changes of cardiac cycles in fetal growth restriction.
[So] Source:Eur J Obstet Gynecol Reprod Biol;203:152-5, 2016 Aug.
[Is] ISSN:1872-7654
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The aims of this study were to investigate the time intervals of each component of cardiac flow velocity waveforms (FVWs) in fetuses with fetal growth restriction (FGR) and to compare these with those of normal fetuses using reference ranges. METHODS: The durations of atrioventricular (AV) valve opening (AVVO), AV valve closure (AVVC), total E- (total-E) and A- (total-A) waves, total ejection time (total-ET), acceleration time (acc-E for E-wave, acc-A for A-wave, and acc-ET for ejection time), and deceleration time (dec-E for E-wave, dec-A for A-wave, and dec-ET for ejection time) were measured in fetuses with FGR. All variables were analyzed using z-scores. RESULTS: Measurements of 17 growth-restricted fetuses were obtained. The time intervals between the last Doppler examination and delivery ranged from 0 to 6 days, with a median of 1 day. Significant increases were observed in AVVO, total-E, dec-E, and acc-A of the left heart. acc-E, acc-ET and AVVC of the left heart were significantly decreased. In the right heart, AVVO, total-E and dec-E were significantly increased. CONCLUSION: A prolonged time interval between early ventricular inflow and atrial contraction, as well as increased duration of AV valve opening, may reflect hemodynamic alterations in FGR fetuses.
[Mh] Termos MeSH primário: Arritmias Cardíacas/diagnóstico por imagem
Circulação Coronária
Retardo do Crescimento Fetal/fisiopatologia
Sistema de Condução Cardíaco/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adulto
Arritmias Cardíacas/embriologia
Arritmias Cardíacas/etiologia
Peso ao Nascer
China
Ecocardiografia Doppler
Feminino
Idade Gestacional
Sistema de Condução Cardíaco/embriologia
Sistema de Condução Cardíaco/fisiopatologia
Hospitais Municipais
Hospitais Universitários
Seres Humanos
Recém-Nascido
Masculino
Gravidez
Volume Sistólico
Fatores de Tempo
Ultrassonografia Pré-Natal
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; OBSERVATIONAL STUDY
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170413
[Lr] Data última revisão:
170413
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160613
[St] Status:MEDLINE


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[PMID]:27191517
[Au] Autor:Sacco C; Castiglioni C; Cocco G; Vario M
[Ad] Endereço:Dottore Magistrale in Scienze Infermieristiche e Ostetriche, c.p.s. Infermiere d'area medica ad intensità di cure, Azienda Ospedaliera Sant'Andrea di Roma Correspondence: Carmelosacco81@hotmail.it.
[Ti] Título:[The health care through the critical eyes of the users: a survey].
[Ti] Título:Le criticità dell'assistenza sanitaria attraverso lo sguardo degli utenti: un'indagine conoscitiva..
[So] Source:Prof Inferm;69(1):10-6, 2016 Jan-Mar.
[Is] ISSN:0033-0205
[Cp] País de publicação:Italy
[La] Idioma:ita
[Ab] Resumo:INTRODUCTION: Hospitalization is a condition, in which the individual ceases his daily normal acti- vities to be taken over by a hospital, in order to solve a health problem. The healthcare profes- sionals have the responsibility to make the event "admission" the least traumatic as possible. In this regard the welcome is a crucial moment - like a "business card" for the structure - and it will mostly define the satisfaction of the hospitalization experience. OBJECTIVE: Aim of this study is to explore the experience of hospitalization of the respondents, to outline the main issues that affect the quality of care provided in two hospitals in Rome and to detect the most common critical situations, in relation to the thematic areas identified. METHOD: Data collected through semi-structured questionnaires and following phenomenological approach focused on the analysis of experiences of respondents to extract the meaning themes with inductive technique of Van Kaam. RESULTS: Thanks to the interviews about the users hospitalization experience, there were outlined four key-elements that affect the quality of care provided and the more obvious critical issues detected; therefore it is highlighted a relational and communicative asymmetry between the heal- thcare provider and the user and also a lack of awareness of healthcare professionals on the impor- tance of the "primacy effect", which is a preliminary element to strengthen the subsequent posi- tive perceptions of hospital care. CONCLUSIONS: In the light of the results, that work can provide interesting insights and guidance to all those who, for various reasons, are active in the health professions in addition to contribu- ting to the improvement of the quality of care in our facilities.
[Mh] Termos MeSH primário: Infecção Hospitalar/enfermagem
Assistência à Saúde
Pacientes Internados
Qualidade da Assistência à Saúde
[Mh] Termos MeSH secundário: Adulto
Idoso
Assistência à Saúde/normas
Feminino
Hospitais Municipais
Seres Humanos
Masculino
Meia-Idade
Qualidade da Assistência à Saúde/normas
Cidade de Roma
Inquéritos e Questionários
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170209
[Lr] Data última revisão:
170209
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:160519
[St] Status:MEDLINE
[do] DOI:10.7429/pi.2016.691010


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[PMID]:27033489
[Au] Autor:Logan A; Kemsley R
[Ad] Endereço:Logan Practice, Houldsworth Centre, Wishaw, Honorary Clinical Senior Lecturer, University of Glasgow, and Co-Editor, The Good GP Training Guide. E-mail: aleclogan@dial.pipex.com.
[Ti] Título:Houldsworth Centre, Lanarkshire, Scotland: a new civic facility.
[So] Source:Br J Gen Pract;66(645):200-1, 2016 Apr.
[Is] ISSN:1478-5242
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Arquitetura de Instituições de Saúde
Acesso aos Serviços de Saúde/estatística & dados numéricos
Hospitais Públicos
[Mh] Termos MeSH secundário: Estruturas de Acesso
Arquitetura de Instituições de Saúde/tendências
Hospitais Municipais/recursos humanos
Hospitais Públicos/recursos humanos
Hospitais Públicos/normas
Hospitais Públicos/tendências
Seres Humanos
Escócia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170519
[Lr] Data última revisão:
170519
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160402
[St] Status:MEDLINE
[do] DOI:10.3399/bjgp16X684577


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[PMID]:26489986
[Au] Autor:Cooper H; Tekiteki A; Khanolkar M; Braatvedt G
[Ad] Endereço:Department of General Medicine, Auckland City Hospital, Auckland, New Zealand.
[Ti] Título:Risk factors for recurrent admissions with diabetic ketoacidosis: a case-control observational study.
[So] Source:Diabet Med;33(4):523-8, 2016 Apr.
[Is] ISSN:1464-5491
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIM: To perform a detailed analysis of patients with recurrent diabetic ketoacidosis admissions in order to establish risk factors for readmission. METHODS: The medical records of all adults and young people (> 15 years) with Type 1 diabetes admitted to Auckland City Hospital over a 15-year period from 1997 to 2011 with a primary diagnosis of ketoacidosis were analysed. Patients readmitted with ketoacidosis within 5 years of their index admission were identified and compared with patients without ketoacidosis readmission who were matched for age, gender, ethnicity and duration of diabetes. RESULTS: A total of 268 patients accounted for a total of 412 admissions. In all, 58 patients had more than one admission for diabetic ketoacidosis during this period. Of these, 40 patients readmitted with diabetic ketoacidosis were compared with matched control subjects (n = 40) who had only one admission for diabetic ketoacidosis. The mean ± sd age of the cohort was 31 ± 12 years. The readmission group had more severe diabetic ketoacidosis and poorer glycaemic control. Alcohol abuse was commonly noted in both groups, with insulin dose omission being the main contributor to the development of ketoacidosis. Both groups had high rates of clinic non-attendance. There were no other differences noted between the groups. CONCLUSION: When patients with recurrent diabetic ketoacidosis were matched for age, duration of diabetes, gender and ethnicity with patients who had only one admission for diabetic ketoacidosis, few differences were noted. This makes designing intervention strategies to reduce readmission with diabetic ketoacidosis difficult.
[Mh] Termos MeSH primário: Diabetes Mellitus Tipo 1/fisiopatologia
Cetoacidose Diabética/etiologia
[Mh] Termos MeSH secundário: Adulto
Alcoolismo/complicações
Estudos de Casos e Controles
Estudos de Coortes
Diabetes Mellitus Tipo 1/sangue
Diabetes Mellitus Tipo 1/complicações
Diabetes Mellitus Tipo 1/tratamento farmacológico
Cetoacidose Diabética/epidemiologia
Cetoacidose Diabética/fisiopatologia
Cetoacidose Diabética/terapia
Registros Eletrônicos de Saúde
Feminino
Hospitais Municipais
Seres Humanos
Hipoglicemiantes/uso terapêutico
Insulina/uso terapêutico
Masculino
Adesão à Medicação
Meia-Idade
Nova Zelândia/epidemiologia
Readmissão do Paciente
Recidiva
Estudos Retrospectivos
Fatores de Risco
Índice de Gravidade de Doença
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Hypoglycemic Agents); 0 (Insulin)
[Em] Mês de entrada:1612
[Cu] Atualização por classe:161230
[Lr] Data última revisão:
161230
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:151023
[St] Status:MEDLINE
[do] DOI:10.1111/dme.13004


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[PMID]:26311655
[Au] Autor:Katchanov J; Wöstmann K; Tominski D; Jefferys L; Liedtke A; Schneider A; Slevogt H; Arastéh K; Stocker H
[Ad] Endereço:Department of Infectious Diseases, Vivantes Auguste-Viktoria-Klinikum, Rubensstraße 125, 12157, Berlin, Germany. juri.katchanov@icloud.com.
[Ti] Título:Burden and spectrum of infectious disease in Germany 2009-2014: a multicentre study from Berlin's Municipal Hospitals.
[So] Source:Infection;44(2):187-95, 2016 Apr.
[Is] ISSN:1439-0973
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:PURPOSE: This study aimed at assessing the burden and spectrum of infectious diseases (ID) in a Metropolitan population in Germany. METHODS: A discharge database using ICD-10 codes enabled the identification of hospitalizations with infection-related diagnoses. All hospital admissions between 2009 and 2014 were analysed from 9 municipal hospitals serving approximately one-third of an urban population of 3.5 million people. RESULTS: We identified 114,168 admissions with a primary (first-listed) ID diagnosis and 220,483 admissions with any-listed ID diagnosis, accounting for 8.9 % [95 % confidence interval (CI) 8.9-9.0 %] and 17.2 % (95 % CI 17.1-17.3) of all 1,284,559 admissions, respectively. Annually, 439,837 bed-days (range 413,707-488,520) were occupied by patients with an ID diagnosis, utilizing 22.8 % of total bed capacity. The median length of stay for patients with primary ID diagnosis and secondary ID diagnosis was 6 days (IQR 3-11) and 10 days (IQR 5-19), respectively. The most common diagnosis across all age groups was "pneumonia" (22.8 and 16.2 % of ID admissions as primary and secondary diagnosis, respectively). In-hospital mortality was 6.8 % (95 % CI 6.6-6.9) and 8.9 % (95 % CI 8.7-9.1) for ID as primary and secondary diagnosis, respectively. CONCLUSION: Infectious diseases contribute significantly to the overall burden of disease in a health system caring for an urban German population. In view of the magnitude of ID's contribution, establishing more specialists in ID medicine and adjusting the reimbursements for managing infection-related admissions should be made a public health priority in Germany.
[Mh] Termos MeSH primário: Doenças Transmissíveis/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Berlim/epidemiologia
Criança
Pré-Escolar
Feminino
Serviços de Saúde
Administração de Serviços de Saúde
Hospitais Municipais
Seres Humanos
Lactente
Recém-Nascido
Masculino
Meia-Idade
População Urbana
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1612
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150828
[St] Status:MEDLINE
[do] DOI:10.1007/s15010-015-0834-2



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