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Enrique Cabrera Torres María Aránzazu García Iglesias María Teresa Santos Jiménez Miguel González Hierro María Luisa Diego Domínguez 《Gaceta sanitaria / S.E.S.P.A.S》2019,33(1):32-37
Objective
To analyze the relationship between the type of hospital admission (outlier and non-outlier admissions) and the appearance of clinical complications and the average stay.Methods
From a retrospective epidemiological study of a cohort of patients admitted to the Hospital Complejo Asistencial Universitario de Salamanca (Salamanca, Spain) over a six-month period, outlier and non-outlier patients were identified. This project had access to the admissions department database, the hospital's CMBD (in Spanish, Conjunto Mínimo Básico de Datos) for hospitalisation, the AP-DRG (All Patient-Diagnosis Related Groups) and ALCOR (a clinical-statistics analytics tool). It then proceeded to break down the results by DRG, looking at the five most common DRGs in that period.Results
8.4% of the total 11,842 admissions were medical outliers. In the overall study, the average stay was longer for outlier patients (8. 11 days) than for other patients (7.15 days). The mortality rate was, likewise, higher for outlier patients, although there was a reduced incidence of complications (7.6% for outlier patients as opposed to 8.4% for others). The analysis by DRG corroborated these results in three of the five cases investigated, showing longer average stays but fewer clinical complications in the case of outlier patients.Conclusions
On admission to hospital, a significant proportion of patients were allocated beds on inappropriate wards (outlier patients). It was more common to find medical patients placed on surgical wards than vice versa. The average stay of outlier patients was longer than that of patients admitted to the correct ward. The study found no significant difference between the two group? in terms of clinical complication rates. 相似文献3.
Valladales-Restrepo Luis Fernando Machado-Alba Jorge Enrique 《International ophthalmology》2020,40(4):803-809
International Ophthalmology - Glaucoma is the leading cause for blindness after cataracts worldwide. The aim was to identify anticholinergic drugs prescribed to patients diagnosed with closed-angle... 相似文献
4.
Meghan L. Good Parisa Malekzadeh Isaac R. Kriley Nirali N. Shah David E. Kleiner Katherine Calvo Jonathan M. Hernandez Jeremy L. Davis 《Pediatric transplantation》2020,24(2)
Secondary malignancies are a significant cause of non‐relapse mortality in patients who undergo allogeneic HCT. However, secondary liver cancer is rare, and ICC following HCT has never been reported in the literature. Secondary solid cancers typically have a long latency period, and cholangiocarcinoma is classically a malignancy occurring in older individuals. Here, we report the first case of secondary ICC, which presented just 3 years after HCT in a young adult with a history of childhood ALL. A 26‐year‐old male with history of precursor B‐cell ALL presented with asymptomatic elevated liver function tests 3 years after HCT. Laboratories were indicative of biliary obstruction. ERCP showed focal biliary stricturing of the common and left hepatic ducts. MRCP revealed left intrahepatic duct dilatation, suggestive of intrahepatic obstructing mass. Additional workup lead to a clinical diagnosis of ICC. The patient underwent left hepatectomy with extrahepatic bile duct resection and portal lymphadenectomy. Surgical pathology was consistent with moderately differentiated cholangiocarcinoma. Our case illustrates a rare SMN following HCT for ALL. It is the first case report of ICC occurring as a secondary cancer in this patient population. Although cholangiocarcinoma is characteristically diagnosed in the older population, it must remain on the differential for biliary obstruction in post‐HCT patients. 相似文献
5.
Development of gastrojejunal stricture following Roux-en-Y gastric bypass (RYGB) leads to an increase in morbidity and adverse effects, such as abdominal p 相似文献
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Jaime Feliu Beatriz Jiménez-Munárriz Laura Basterretxea Irene Paredero Elisenda Llabrés Maite Antonio-Rebollo Beatriz Losada Enrique Espinosa Regina Gironés Ana Belén Custodio María del Mar Muñoz Mariana Díaz-Almirón Jeniffer Gómez-Mediavilla Alvaro Pinto María-Dolores Torregrosa Gema Soler Patricia Cruz Oliver Higuera María José Molina-Garrido 《The oncologist》2020,25(10):e1516-e1524
8.
Huinan Zhang Jingru Meng Shimeng Zhou Yunhan Liu Di Qu Ling Wang Xubo Li Ning Wang Xiaoxing Luo Xue Ma 《The AAPS journal》2016,18(2):385-394
Exendin-4 is now considered as a promising drug for the treatment of cerebral ischemia. To determine the neuroprotective effects of intranasal exendin-4, C57BL/6J mice were intranasally administered with exendin-4 daily for 7 days before middle cerebral artery occlusion (MCAO) surgery. Intranasally administered exendin-4 produced higher brain concentrations and lower plasma concentrations when compared to identical doses administered interperitoneally. Neurological deficits and volume of infarcted lesions were analyzed 24 h after ischemia. Intranasal administration of exendin-4 exhibited significant neuroprotection in C57BL/6 mice subjected to MCAO by reducing neurological deficit scores and infarct volume. The neuroprotective effects of exendin-4 were blocked by the knockdown of GLP-1R with shRNA. However, exendin-4 has no impact on glucose and insulin levels which indicated that the neuroprotective effect was mediated by the activation of GLP-1R in the brain. Exendin-4 intranasal administration restored the balance between pro- and anti-apoptotic proteins and decreased the expression of Caspase-3. The anti-apoptotic effect was mediated by the cAMP/PKA and PI3K/Akt pathway. These findings provided evidence that exendin-4 intranasal administration exerted a neuroprotective effect mediated by an anti-apoptotic mechanism in MCAO mice and protected neurons against ischemic injury through the GLP-1R pathway in the brain. Intranasal delivery of exendin-4 might be a promising strategy for the treatment of ischemic stroke. 相似文献
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Luis García de Guadiana-Romualdo Ignacio Español-Morales Pablo Cerezuela-Fuentes Luciano Consuegra-Sánchez Ana Hernando-Holgado Patricia Esteban-Torrella Enrique Jiménez-Santos Monserrat Viqueira-González África de Béjar-Almira María Dolores Albaladejo-Otón 《Supportive care in cancer》2015,23(7):2175-2182