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Results for “HOSPITALS, CONVALESCENT”

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At least 847 records · Page 47Linked to original sources
PubMed1993

The inappropriate use of acute hospital beds in an inner London District Health Authority.

The requirement for District Health Authorities to assess the health care needs of their population implies that they must consider how well acute hospital care meets these identified needs. This study, which was conducted in an inner London health district, identified that 123 (14.6%) patients were perceived by medical and/or nursing staff to be inappropriately located in an acute bed. This group was dominated by patients aged 65 years or above, those in general and geriatric medicine, those with a length of stay of 30 days or more, and those with high levels of physical and mental dependency. The main reasons for patients being labelled as 'inappropriate' were the need for non-acute health services (eg rehabilitation, terminal care etc), a need for nursing home places or because of social or housing problems. Five months after identification, the notes of 100 of the 123 inappropriate patients were traced. Retrospective classification of these notes using the more 'objective' Oxford Bed Study Instrument showed that 97 patients were still defined as inappropriate. Details of the length of inappropriate stay were available for 74 patients who accrued 7,519 inappropriate bed days at a cost of 836,547 pounds. These patients are an illustration of the potential failings of current health and social care systems and highlight the need for imaginative care solutions which bridge this divide.

Adult↗
PubMed2003

Laparoscopic and robotic surgical training in urology.

The most important change in urology during the past decade was the development of minimally invasive surgery, particularly laparoscopy. However, the main drawback of laparoscopy is a steep learning curve, which results from the significant changes in the surgical environment. Although laparoscopy can provide important advantages for the patient, including decreased length of hospitalization, decreased analgesic requirement, and a shortened postoperative convalescence, one concern has been whether laparoscopic techniques should be learned solely in the operating room. For example, sports, music, and aviation are practiced before an actual performance is ever undertaken. In this review, the advantages and limitations of all available training modalities in minimally invasive surgery are described. Testing basic laparoscopic skills on inanimate models, becoming familiar with the principles of dissection and hemostasis on living animals, and studying surgical anatomy on cadavers should be considered as indispensable and complementary elements for laparoscopic training in the future. In addition, telementoring with the help of modern image processing and virtual reality eventually may become the basis of tomorrow's surgical instruction.

Clinical Competence↗
PubMed1990

Anti-HBs response in seroconverting chronic HBV carriers following alpha-interferon treatment.

The antibody response to hepatitis B surface antigen (anti-HBs) was studied in 15 chronic hepatitis B virus (HBV)-infected patients who seroconverted following treatment with alpha interferon. The levels of anti-HBs (IU/l) attained were significantly lower than those recorded in patients with convalescent symptomatic or asymptomatic acute infection and in hospital personnel who received a plasma derived HBV vaccine.

Adolescent↗
PubMed2001

Hand assisted laparoscopic donor nephrectomy: a comparison with the open approach.

PURPOSE: Hand assisted laparoscopy combines aspects of open and laparoscopic surgery. A hand in the abdomen may facilitate laparoscopic live donor nephrectomy, allowing more urologists to participate. We report and compare our initial series of hand assisted laparoscopy donor nephrectomy with nephrectomy performed by standard open methods. MATERIALS AND METHODS: In the last 18 months 60 patients at 2 institutions underwent hand assisted laparoscopy donor nephrectomy. This cohort was compared to a contemporary group of 31 patients who underwent open donor nephrectomy via a flank incision at our 2 institutions. Demographic and outcome data were compared retrospectively in a nonrandomized fashion in the 2 groups. RESULTS: Demographic data on patient age, male-to-female ratio and body mass index were similar in the 2 groups. Operative time, transfusion rate, time to oral intake and complications were also similar. However, estimated blood loss, change in hematocrit preoperatively to postoperatively, hospitalization, parenteral and oral narcotic requirement, and donor convalescence were significantly less in the hand assisted laparoscopy versus open groups. In terms of allograft function, nadir creatinine, time to nadir creatinine, creatinine clearance at 6, 12, and 18 months, delayed graft function, episodes of acute rejection and ureteral stricture were similar in the groups. CONCLUSIONS: Hand assisted laparoscopy is safe, efficacious and reproducible for living related donor nephrectomy. Compared with the open technique hand assisted laparoscopy provides the donor with significantly decreased postoperative morbidity, while enabling excellent allograft function. Further randomized prospective studies are warranted.

Adult↗
PubMed1988

Severe illness in older patients: the association between depressive disorders and functional dependency during the recovery phase.

An association between depression and physical dependency arising from a recent illness has been generally accepted. To clarify this relationship over time, 30 medical rehabilitation patients aged 54 to 94 years were assessed 1 week after admission and at discharge to quantify symptoms of depression, physical dependency, and cognitive functioning using the Hamilton Depression Scale (HAM-D), the Geriatric Depression Scale (GDS), the Barthel Index for physical function, and the Mini-Mental State Examination (MMSE). Significant depressive symptomatology was found by HAM-D in 25 patients on admission and 14 on discharge. No significant associations were present between either admission or discharge depression scores and all other variables. The HAM-D change score was significantly correlated with the Barthel change score (r = 0.57, P less than 0.001) and with the MMSE change score (r = 0.48, P = 0.01). All patients whose mood improved also improved in physical functioning, whereas 75% of those whose mood did not improve failed to make headway in physical functioning. This implies that it is not the degree of physical incapacity but rather the failure to regain prior abilities which is strongly associated with persisting depression following a catastrophic illness. Furthermore, characteristics found commonly in the group whose mood did not improve included physicians' failure to diagnose and treat depression or a setback from a significant medical or surgical complication.

Aged↗
PubMed1987

Staghorn calculi: endourologic management in 120 patients.

Symptomatic staghorn renal calculi were removed from 106 of 124 kidneys (85%) with percutaneous ultrasonic lithotripsy. All remaining fragments were less than 5 mm in greatest diameter, small enough to pass spontaneously. Use of two or more access routes was necessary in 91 kidneys (73%), and 29 patients (24%) required multistage nephrolithotripsy for complete stone removal. The total operative time averaged 162 minutes per patient. The average hospitalization period was 12.5 days, and the average convalescence time after discharge was 15 days. The most common adverse effect was bleeding necessitating transfusion (57%). Infection occurred in 27% of patients and may be intrinsic to removal of these infected stones. There was one death in the study group: a patient with multiple medical problems died of myocardial infarction. Successful stone extraction requires a clear understanding of renal anatomic features, properly placed access routes, and radiologic-urologic expertise. It is concluded that staghorn calculi can be safely and effectively treated with the use of percutaneous techniques.

Adult↗
PubMed2002

Intermediate care. Halfway home.

A pilot scheme involving 30 nursing home places provided intermediate care for 118 elderly people over four months last winter. The average length of stay was 21 days. Two-thirds of patients were discharged to their own home. Patients rated the nursing care highly. Concerns were raised about the availability of therapists.

Aged↗
PubMedDate not supplied

The role of viruses and Mycoplasma pneumoniae in lower respiratory tract infections in childhood.

Acute lower respiratory tract infections are one of the major causes of childhood morbidity and mortality in developing countries. This study was undertaken at Hacettepe University Children's Hospital to determine the role of viruses and Mycoplasma pneumoniae in respiratory tract infections in children. Eighty-three patients with lower respiratory tract infections were selected at random from among the children admitted to the hospital for evaluation of respiratory symptoms. Acute and convalescent serum samples were collected from all patients for the complement-fixation test and the following antigens were used: respiratory syncytial virus (RSV), adenovirus, parainfluenza virus Type 1, influenza viruses A and B, and Mycoplasma pneumoniae. The test was positive in 39 of 83 patients (47%), and RSV was the most frequent agent detected serologically (15.7%).

Acute Disease↗
PubMed2004

Recovery of Finnish short-stay surgery patients.

In order to counsel the surgical patient, the nurse needs to have a clear picture of home recovery based on the patient's biophysiologic health problems. The purpose of this study was to examine short-stay surgery patients' experiences of pain, nausea, vomiting, fatigue, and problems with elimination and wound healing during a 1-week recovery phase at home.

Ambulatory Surgical Procedures↗
PubMedDate not supplied

[Pulmonary tuberculosis convalescents (group IV D) at the outpatient tuberculosis and lung disease clinics in Poland 1967-1986].

An analysis of risk rates of tuberculosis incidence in convalescents registered in tuberculosis dispensaries in Poland in the years 1967-1986 was made. In Poland they are registered in group IVD. Since 1978 this group is steadily decreasing although in 1986 it made up 1.27% of the whole country's population, and was the highest risk group. In 1986 the risk of a tuberculosis infection was six fold higher in this group, and eight fold higher confirmed bacteriologically. Out of this group 8.3% of new infections are derived, and 11.1% of freshly diagnosed cases of bacteriologically confirmed tuberculosis. Heterogeneity of this group suggests different proceedings.

Convalescence↗
PubMed1984

[Endoscopic methods in gastroenterology and gynecology. Completion of diagnostic pelviscopy by endoscopic abdominal surgery].

Diseases affecting the female reproductive organs often raise differential-diagnostic problems in the field of gastroenterology. Diagnostic pelviscopy represents the most reliable means for the diagnostic clarification of alterations of the adnexa, appendicitis irritable colon, genital endometriosis etc. Today, 10 years after its development this technique, which usefully supplements the x-ray and ultrasonic examination, has advanced so far that immediately after the diagnostic procedure, surgical therapy follows in a high percentage of cases during the same procedure. Thus in Kiel surgical pelviscopy replaces today till 50% of the classic laparotomies (e.g. adhaesiolysis, adnexectomy, myoma-enucleation, coagulation of endometriotic spots, appendectomy, fimbrioplasty, salpingostomy etc.). As a result not only is the duration of ectopic diseases considerably shortened but also the hospitalization time and in particular the time of convalescence is also reduced to a minimum.

Appendectomy↗