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Chen CG, Wang JW, Li JF, Li CH, Gao BL. Factors affecting resolution of oculomotor nerve palsy following endovascular embolization of posterior communicating artery aneurysms. Neurologia 2024; 39:315-320. [PMID: 38616058 DOI: 10.1016/j.nrleng.2021.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 07/13/2021] [Indexed: 04/16/2024] Open
Abstract
PURPOSE To investigate the effect of endovascular embolization of posterior communicating artery (Pcom) aneurysms on concomitant oculomotor nerve palsy (OMNP) and factors affecting the effect of treatment. MATERIALS AND METHODS Patients with the Pcom aneurysms concomitant with OMNP were retrospectively enrolled for endovascular treatment of the aneurysms. All patients had the endovascular management. The clinical effect, degree of OMNP, size of the aneurysm, type of treatment, subarachnoid hemorrhage (SAH), and time from onset to treatment were analyzed on the resolution of OMNP. RESULTS Ninety-six patients with 99 Pcom aneurysms were enrolled and treated endovascularly, with the success rate of 100%. Immediately after endovascular treatment, 75 aneurysms (75.75%) got complete occlusion, and 24 (24.24%) nearly complete occlusion. Followed up for 3-18 (mean 8.52±0.56) months, complete resolution of the OMNP was achieved in 63 patients (65.63%), partial resolution in 21 (21.88%), and non-recovery in the other 12 (12.50%). The degree of OMNP at onset, SAH, and time from onset to treatment were significantly (P<0.05) correlated with the resolution of OMNP. Univariate analysis revealed that younger age of the patient, degree of OMNP at onset, presence of subarachnoid hemorrhage, and time from disease onset to treatment were significantly (P<0.05) associated with the recovery of OMNP. Multivariate analysis revealed that the younger age, degree of OMNP at onset, and time from disease onset to treatment were significantly (P<0.05) associated with the recovery of OMNP. CONCLUSION Endovascular embolization of Pcom aneurysms concomitant with OMNP can effectively improve the OMNP symptoms, especially for patients with moderate and a shorter history of OMNP. Younger age, degree of oculomotor nerve palsy at onset, and time from onset to treatment may significantly affect recovery of oculomotor nerve palsy.
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Affiliation(s)
- C G Chen
- Department of Neurosurgery, Liaoyang City Central Hospital, Liaoyang City 111200, Liaoning Province, China
| | - J W Wang
- Department of Neurosurgery, The First Hospital of Hebei Medical University, China
| | - J F Li
- Department of Neurosurgery, The First Hospital of Hebei Medical University, China
| | - C H Li
- Department of Neurosurgery, The First Hospital of Hebei Medical University, China.
| | - B L Gao
- Department of Neurosurgery, The First Hospital of Hebei Medical University, China
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Romera-Liebana L, Urbina-Juez A, Micó-Pérez RM, Mediavilla Bravo JJ, Marco Martinez A, Gómez-Peralta F, Cubo-Romano P, Formiga F. Assessment of frailty in the person with type 2 diabetes mellitus: Expert analysis. Rev Clin Esp 2023; 223:552-561. [PMID: 37722562 DOI: 10.1016/j.rceng.2023.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 08/18/2023] [Indexed: 09/20/2023]
Abstract
INTRODUCTION People with type 2 diabetes mellitus (DM2) have a higher prevalence of frailty compared to those without DM2. However, there is a lack of consensus on the diagnosis and clinical management of frail individuals with DM2. OBJECTIVES This study aims to identify limitations and current needs in the use of the frailty concept in PCDM2 (people with DM2), as well as define and evaluate the dimensions that should be included in its routine clinical assessment. METHODS A multidisciplinary team of eight health professionals from different hospitals in Spain participated in a process based on the nominal group technique. RESULTS The study identified eight limitations in the assessment of frailty in PCDM2, categorized by importance, and 10 unmet needs related to the diagnosis and follow-up of the disease. Additionally, seven dimensions were identified that should be included in the definition of frail individuals with DM2, prioritized by importance and novelty. CONCLUSIONS This article aims to increase knowledge and usage of the frailty concept in individuals with DM2 within the medical community. It also suggests the potential for future projects to develop a consensus definition of frailty tailored to this specific group.
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Affiliation(s)
- L Romera-Liebana
- Unidad Homecare, Atención Domiciliaria de Cuidados Paliativos y Atención a la Cronicidad, Teladoc Health, Barcelona, Spain
| | - A Urbina-Juez
- Unidad Atención Primaria de Sopela, Organización Sanitaria Integrada de Uribe, Sopela, Spain
| | - R M Micó-Pérez
- Departamento de Salud Xátiva-Ontinyent, Centro Fontanars dels Alforins, Valencia, Spain
| | | | - A Marco Martinez
- Servicio de Endocrinología y Nutrición, Hospital Universitario de Toledo, Toledo, Spain
| | - F Gómez-Peralta
- Unidad de Endocrinología y Nutrición, Hospital General de Segovia, Segovia, Spain
| | - P Cubo-Romano
- Servicio de Medicina Interna, Hospital Universitario Infanta Cristina, Parla, Spain
| | - F Formiga
- Unidad de Geriatría, Servicio de Medicina Interna, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Spain.
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Vrotsou K, Orive-Calzada M, González N, Vergara I, Pascual-Fernández N, Guerra-López C, García-Montes R, Ortiz-Ribes J, Onaindia-Ecenarro MJ, Regalado-de Los Cobos J, Millet-Sampedro M. [Factors associated with the hospital at home workload: A Delphi consensus study]. J Healthc Qual Res 2022:S2603-6479(22)00075-6. [PMID: 36272932 DOI: 10.1016/j.jhqr.2022.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/20/2022] [Accepted: 09/06/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES To identify and prioritize a list of factors that contribute to the workload of the hospital at home (HaH) professionals. MATERIAL AND METHODS A qualitative methodology study performed between January and December 2019 in the 10 HAH units of the Basque Country. The data were obtained in 4phases: 1. Systematic literature search and review; 2. Expert group meeting; 3. Consensus method: Delphi technique (2 survey rounds) and nominal group meeting; 4. Meeting of the research team. RESULTS In the systematic literature search and review 85 factors were initially identified. These were reduced to 38 after the 8-person expert group meeting, in which 10 new factors were added. After the 2 Delphi rounds (106 and 57 professionals, respectively), 17 factors were maintained and 12 remained in doubt. The latter were evaluated at the nominal group meeting, consisting of 13 professionals who decided to eliminate 5 factors, include 3, and keep 3 as doubt. After the 8-person research team meeting, 14 potential factors were finally selected. They are related to the place of residence, the health state and social situation of the patients, as well as the health care provided at home. CONCLUSIONS The identified factors could serve for improving the organization and optimize the daily word of the HaH professionals.
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Affiliation(s)
- K Vrotsou
- Instituto de Investigación Sanitaria Biodonostia, Grupo de Atención Primaria, San Sebastián, Guipúzcoa, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC); Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), España.
| | - M Orive-Calzada
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC); Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), España; Departamento de Psicología Social, Universidad del País Vasco UPV/EHU, Vitoria-Gasteiz, Araba, España
| | - N González
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC); Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), España; Instituto de Investigación en Servicios de Salud Kronikgune, Barakaldo, Bizkaia, España; Osakidetza, Unidad de Investigación, Hospital Galdakao-Usansolo, Galdakao, Bizkaia, España
| | - I Vergara
- Instituto de Investigación Sanitaria Biodonostia, Grupo de Atención Primaria, San Sebastián, Guipúzcoa, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC); Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), España
| | - N Pascual-Fernández
- Osakidetza, Unidad de Hospitalización a Domicilio, Hospital Bidasoa, Hondarribia, Gipuzkoa, España
| | - C Guerra-López
- Osakidetza, Unidad de Hospitalización a Domicilio, Hospital Bidasoa, Hondarribia, Gipuzkoa, España
| | - R García-Montes
- Osakidetza, Unidad de Hospitalización a Domicilio, Hospital Universitario Donostia, San Sebastián, Gipuzkoa, España
| | - J Ortiz-Ribes
- Osakidetza, Unidad de Hospitalización a Domicilio, Hospital Universitario Donostia, San Sebastián, Gipuzkoa, España
| | - M J Onaindia-Ecenarro
- Osakidetza, Unidad de Hospitalización a Domicilio, Hospital de Galdakao-Usansolo, Galdakao, Bizkaia, España
| | - J Regalado-de Los Cobos
- Osakidetza, Unidad de Hospitalización a Domicilio, Hospital Universitario de Araba, Vitoria-Gasteiz, Araba, España
| | - M Millet-Sampedro
- Osakidetza, Unidad de Hospitalización a Domicilio, Hospital Bidasoa, Hondarribia, Gipuzkoa, España
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Chen CG, Wang JW, Li JF, Li CH, Gao BL. Factors affecting resolution of oculomotor nerve palsy following endovascular embolization of posterior communicating artery aneurysms. Neurologia 2021:S0213-4853(21)00125-0. [PMID: 34511274 DOI: 10.1016/j.nrl.2021.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 07/11/2021] [Accepted: 07/13/2021] [Indexed: 10/20/2022] Open
Abstract
PURPOSE To investigate the effect of endovascular embolization of posterior communicating artery (Pcom) aneurysms on concomitant oculomotor nerve palsy (OMNP) and factors affecting the effect of treatment. MATERIALS AND METHODS Patients with the Pcom aneurysms concomitant with OMNP were retrospectively enrolled for endovascular treatment of the aneurysms. All patients had the endovascular management. The clinical effect, degree of OMNP, size of the aneurysm, type of treatment, subarachnoid hemorrhage (SAH), and time from onset to treatment were analyzed on the resolution of OMNP. RESULTS Ninety-six patients with 99 Pcom aneurysms were enrolled and treated endovascularly, with the success rate of 100%. Immediately after endovascular treatment, 75 aneurysms (75.75%) got complete occlusion, and 24 (24.24%) nearly complete occlusion. Followed up for 3-18 (mean 8.52±0.56) months, complete resolution of the OMNP was achieved in 63 patients (65.63%), partial resolution in 21 (21.88%), and non-recovery in the other 12 (12.50%). The degree of OMNP at onset, SAH, and time from onset to treatment were significantly (P<0.05) correlated with the resolution of OMNP. Univariate analysis revealed that younger age of the patient, degree of OMNP at onset, presence of subarachnoid hemorrhage, and time from disease onset to treatment were significantly (P<0.05) associated with the recovery of OMNP. Multivariate analysis revealed that the younger age, degree of OMNP at onset, and time from disease onset to treatment were significantly (P<0.05) associated with the recovery of OMNP. CONCLUSION Endovascular embolization of Pcom aneurysms concomitant with OMNP can effectively improve the OMNP symptoms, especially for patients with moderate and a shorter history of OMNP. Younger age, degree of oculomotor nerve palsy at onset, and time from onset to treatment may significantly affect recovery of oculomotor nerve palsy.
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Affiliation(s)
- C G Chen
- Department of Neurosurgery, Liaoyang City Central Hospital, Liaoyang City 111200, Liaoning Province, China
| | - J W Wang
- Department of Neurosurgery, The First Hospital of Hebei Medical University, China
| | - J F Li
- Department of Neurosurgery, The First Hospital of Hebei Medical University, China
| | - C H Li
- Department of Neurosurgery, The First Hospital of Hebei Medical University, China.
| | - B L Gao
- Department of Neurosurgery, The First Hospital of Hebei Medical University, China
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Pérez-Segura P, Paz-Cabezas M, Núñez-Gil IJ, Arroyo-Espliguero R, Maroun Eid C, Romero R, Fernández Rozas I, Uribarri A, Becerra-Muñoz VM, García Aguado M, Huang J, Rondano E, Cerrato E, Rodríguez EA, Ortega-Armas ME, Raposeiras Roubin S, Pepe M, Feltes G, Gonzalez A, Cortese B, Buzón L, El-Battrawy I, Estrada V. Prognostic factors at admission on patients with cancer COVID-19: Analysis of hope registry data. Med Clin (Barc) 2021; 157:318-324. [PMID: 34154809 PMCID: PMC8101784 DOI: 10.1016/j.medcli.2021.02.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 02/23/2021] [Accepted: 02/24/2021] [Indexed: 02/08/2023]
Abstract
Background Previous works seem to agree in the higher mortality of cancer patients with COVID-19. Identifying potential prognostic factors upon admission could help identify patients with a poor prognosis. Methods We aimed to explore the characteristics and evolution of COVID-19 cancer patients admitted to hospital in a multicenter international registry (HOPE COVID-19). Our primary objective is to define those characteristics that allow us to identify cancer patients with a worse prognosis (mortality within 30 days after the diagnosis of COVID-19). Results 5838 patients have been collected in this registry, of whom 770 had cancer among their antecedents. In hospital mortality reached 258 patients (33.51%). The median was 75 years (65–82). Regarding the distribution by sex, 34.55% of the patients (266/770) were women. The distribution by type of cancer: genitourinary 238/745 (31.95%), digestive 124/745 (16.54%), hematologic 95/745 (12.75%). In multivariate regression analysis, factors that are independently associated with mortality at admission are: renal impairment (OR 3.45, CI 97.5% 1.85–6.58), heart disease (2.32, 1.47–3.66), liver disease (4.69, 1.94–11.62), partial dependence (2.41, 1.34–4.33), total dependence (7.21, 2.60–21.82), fatigue (1.84, 1.16–2.93), arthromialgias (0.45, 0.26–0.78), SatO2 < 92% (4.58, 2.97–7.17), elevated LDH (2.61, 1.51–4.69) and abnormal decreased Blood Pressure (3.57, 1.81–7.15). Analitical parameters are also significant altered. Conclusion In patients with cancer from the HOPE registry, 30-day mortality from any cause is high and is associated with easily identifiable clinical factors upon arrival at the hospital. Identifying these patients can help initiate more intensive treatments from the start and evaluate the prognosis of these patients.
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Affiliation(s)
| | - M Paz-Cabezas
- Medical Oncology Dpt. Hospital Clinico San Carlos, Madrid, Spain
| | | | | | - C Maroun Eid
- Hospital Universitario La Paz. Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - R Romero
- Hospital Universitario Getafe, Madrid, Spain
| | | | - A Uribarri
- Hospital Clinico Universitario de Valladolid, Valladolid, Spain
| | | | - M García Aguado
- Hospital Puerta de Hierro de Majadahonda. Majadahonda, Madrid, Spain
| | - J Huang
- The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - E Rondano
- Sant'Andrea Hospital, Vercelli, Italy
| | - E Cerrato
- San Luigi Gonzaga University Hospital, Orbassano and Rivoli Infermi Hospital, Rivoli, Turin, Italy
| | | | - M E Ortega-Armas
- Hospital General del Norte de Guayaquil IESS Los Ceibos, Guayaquil, Ecuador
| | | | - M Pepe
- Azienda ospedaliero-universitaria consorziale policlinico di Bari, Bari, Italy
| | - G Feltes
- Nuestra Señora de América, Madrid, Spain
| | - A Gonzalez
- Hospital Universitario Infanta Sofia. San Sebastian de los Reyes, Madrid, Spain
| | | | - L Buzón
- Hospital Universitario de Burgos, Burgos, Spain
| | - I El-Battrawy
- First Department of Medicine, Medical Faculty Mannheim, University Heidelberg, Mannheim, 68167, Germany, DZHK (German Center for Cardiovascular Research), Partner Site, Heidelberg-Mannheim, Mannheim, Germany
| | - V Estrada
- Hospital Clinico San Carlos, Madrid, Spain
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Díaz-Pérez A, Vega-Ochoa A, Dominguez-Lozano B, Carrillo-González S, González-Puertas J. Factors attributable to the cancellation of programmed surgeries. CIR CIR 2020; 88:489-499. [PMID: 32567596 DOI: 10.24875/ciru.20001008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective To analyze the factors attributable to the cancellation of surgeries of a third level health institution in the city of Valledupar, Cesar / Colombia (2017-2018). Material and methods Descriptive, retrospective, cross-sectional study. Data from the hospital surgical unit adverse case file were collected for 6 surgical specialties. Results They showed that in 2017 there was a surgical suspension of 4% of the total of scheduled surgeries that were (3339), for 2018 the rate was 3% with a total of scheduled surgeries (1733). The reason for the suspension for both periods was the factor related to the patient's adverse conditions with 45.9 and 38.5% respectively. The specialty most affected for these cases was the specialty of general surgery with the same percentage value in both periods of 4%. Conclusion The results give us an idea of the factors present for the cancellation of scheduled surgeries and the need to apply measures to guarantee patient safety.
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Affiliation(s)
- Anderson Díaz-Pérez
- Departamento de Ciencias Sociales y Humanas, Universidad Simón Bolívar, Barranquilla. Colombia.,Facultad de Química y Farmacia, Universidad del Atlántico, Barranquilla. Colombia
| | - Arley Vega-Ochoa
- Facultad de Ciencias de la Salud Universidad Popular del Cesar, Valledupar. Colombia
| | - Brayan Dominguez-Lozano
- Departamento de Ciencias Sociales y Humanas, Universidad Simón Bolívar, Barranquilla. Colombia
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Nair SS, Thomas KA. Relationship between leadership support and operational excellence in health care sector: A study of Indian health care managers. J Healthc Qual Res 2020; 35:117-122. [PMID: 32229102 DOI: 10.1016/j.jhqr.2020.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 02/10/2020] [Accepted: 02/25/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND AND OBJECTIVE Leadership communicates purpose and innovative ways to thrive for performance. Leadership support influences and impacts operational excellence in the health sector as a patient-centered operation, with effective management, excellence framework, challenges and constraints, teamwork and value stream mapping. It is hypothesized that: (1) perceived leadership support will positively correlate with perceived operational excellence (Patient-centered Operations, Effective Resource Management, Excellence framework, Eliminating Challenges or Constraints, Team Work, Value Stream Mapping) and (2) the correlation would be highest with Patient-centered Operations. The aim of this study was to examine the relationship between leadership support and operational excellence in the health care sector among a selected group of healthcare managers. MATERIALS AND METHOD A correlation study between leadership support and operational excellence was designed for a group of health care managers (n=80) from eight hospitals in Kerala, South India. The selection of executives was from NABH accredited hospitals from districts with a minimum of four NABH accredited hospital. A survey was sent to a selected study sample. The respondents were cooperative and provided responses on perceived leadership support for operational excellence. RESULTS Factors of leadership support correlated to operational excellence. CONCLUSION In the health care sector, leadership support for patient-centered operations helps achieve operational excellence.
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Affiliation(s)
- S S Nair
- CHRIST (Deemed to be University), Hosur Road, Bengaluru 560029, Karnataka, India(1).
| | - K A Thomas
- CEDBEC CHRIST (Deemed to be University), Hosur Road, Bengaluru, Karnataka 560029, India
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