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At least 1,009 records · Page 56Linked to original sources
PubMed1999

[Management of mycobacteriosis in general hospital without isolation ward for tuberculosis patients. 2. The problems of management of the patients diagnosed pulmonary tuberculosis after admission to the respiratory ward of university hospital having no an isolation ward for the tuberculous patients].

The management of 28 patients, diagnosed pulmonary tuberculosis by bacteriological or pathologic findings after the administration to the Koshigaya Hospital of Dokkyo university school of Medicine from January 1994 through September 1997, which had no an isolation ward for tuberculosis patients was analyzed. The mean age of the patients was 50.6 +/- 16.7 (18-85), and the number of male and female patients was 22 and 6 respectively. The underlying diseases found in 10 patients were gastric cancer, breast cancer, osteochondrosarcoma, collagen disease, diabetes mellitus, liver cirrhosis, pneumoconiosis, and bronchial asthma. Two patients were complicated by a lung cancer. Six of 28 patients showed smear-positive and culture-positive specimens and 22 of 28 patients showed smear-negative and culture-positive specimens. The detection of mycobacterial DNA in the samples after amplification by the polymerase chain reaction (PCR) used in 15 patients and was positive for 7 of 15 patients. The pathological study of the specimens obtained by Transbronchial lung biopsy was performed for 14 patients. The pathological findings were compatible with tuberculosis in 7 of 14 patients. The chief complaints of the 11 patients admitted to the hospital with in 3 days after first visit, were fever in all patients and in 5 patients with pleural effusion. A few patients showed smear-negative and PCR positive specimens and complicated by lung cancer or other malignancy, were treated in non isolation ward in the particular case of emergency evacuation before admission, careful examination such as a tuberculin test, bacterial examination, and PCR of sputum should be performed in the patients suspected of having pulmonary tuberculosis. The patients isolating tubercule bacilli after administration should be transferred to the hospital with isolated ward for tuberculosis or isolated room in general hospital in the particular case of emergency evacuation with the greatest care.

Adolescent↗
PubMed1999

[Management of mycobacteriosis in general hospital without isolation ward for tuberculosis patients. 4. Actual status of the management of tuberculosis patients in a university hospital without isolation wards for infectious diseases].

We retrospectively evaluated clinical findings and the actual status of management of 69 tuberculosis patients admitted to the Fujita Health University Hospital, a hospital without isolation wards for infectious diseases, between 1991 and 1994. Forty-nine patients were smear-positive and 22 patients were smear-negative and culture-positive. Twenty-five cases (36.2%) were classified as type II (cavitary) and 29 cases (42.0%) as type III (non-cavitary) according to the GAKKAI classification of findings on chest X-ray films for pulmonary tuberculosis. Physicians in charge did not diagnose twenty-four patients (34.8%) as tuberculosis on admission. Physicians in charge tended not to suspect smear-negative patients of tuberculosis. Most of the patients with cavities on their chest X-ray films were strongly suspected of tuberculosis on admission, but in some of them, tuberculosis was not considered at all. Smear-positive patients with strongly suspected tuberculosis were diagnosed with the disease within three hospital days, while it took about three weeks in patients who were not considered as tuberculosis on admission to be diagnosed as tuberculosis. In the case of smear-negative patients, it took about one month and two months respectively to diagnose the case as tuberculosis. About half (51.1%) of the smear-positive patients were admitted and treated in single-bed rooms while 44.7% were attended in multiple-bed rooms for 11 days before they were transferred to single-bed rooms. When acid-fast bacilli were detected, 57.4% of the smear-positive patients were transferred to hospitals with isolation wards for infectious diseases, while the remaining smear-positive patients were treated in single-bed rooms at the university hospital. About one-third (31.7%) of the smear-negative patients had already left the hospital when specimens were found to be culture positive for tubercle bacilli. In conclusion, it is utmost important for physicians to suspect to tuberculosis for the early diagnosis of the disease.

Adult↗
PubMed1999

[Management of mycobacteriosis in general hospital without isolation ward for tuberculosis patients. 5. The management of the patients excreting tubercle bacilli in a university hospital without isolation ward for tuberculosis].

The Japanese low ruled that the patients excreting tubercle bacilli should be treated in the isolated ward for tuberculosis. However, it is often difficult to transfer a patient with serious illness to the isolated ward with insufficient medical facilities. We investigated retrospectively the manner of the management of patients excreting tubercle bacilli in the Aichi Medical University Hospital without the isolation ward for tuberculosis. Materials were 166 patients (0.17%) out of 97,275 in-patients during 11 years since 1986 to 1996. Respiratory symptoms were observed in 114 patients (68.7% of 166 patients) on admission. The initial bacteriological examination was ordered by the attendant doctor within a week in 93 patients (81.6%) of 114 patients with respiratory symptoms. On the other hand, a half of the 52 patients without respiratory symptoms on admission were not examined for sputum bacteriology beyond a week. Anti-tuberculous treatment was started within a week after positive bacteriological results in 129 patients (77.7% of the whole 166 patients), while the treatment was not carried out or delayed in 21 patients (12.6%) because of the communication failure of the bacteriological report to the physicians. Some complications were observed in 101 patients: 21 diabetes mellitus, 20 cancers, 15 hematological disorders, 9 collagen diseases, 6 renal failures on dialysis. Serious illnesses were observed in 33 patients (20.6% of the 166 patients). Twenty-four patients (73% of the seriously ill patients) were died of renal failure, pancytopenia, cancer or respiratory failure. We considered that an isolated room for infectious tuberculosis with independent air conditioning system in a general hospital or a educational hospital was very convenient not only to the treatment of the patients with serious complications, but also to the education and training on tuberculosis for the medical student or medical stuffs.

Adult↗
PubMed1976

Hospital managers need management information systems.

A new hospital director seeking to bring his institution to the brink of solvency found himself with ten pounds of data but no "information"--at least, not the kind of information he could use as a basis for management decisions. What he needed was a system that would not only present data, but the meaning of the data. Such a system is the integrated MIS.

Computers↗
PubMed1976

Management of maple syrup urine disease in Canada. Committee for improvement of Hereditary Disease Management.

Nine patients with classic maple syrup urine disease (MSUD) and four with variant forms are under care at five treatment centres in the network affiliated with the National Food Distribution Centre for the Treatment of Hereditary Metabolic Diseases (the "Food Bank"). Diagnosis was made by clinicians and not from mass screening programs. MSUD requires complex emergency treatment to prevent severe neurologic damage, but effective management is compatible with normal growth and development. Long-term treatment requires continuous monitoring of the response to diets restricted in branched-chain amino acids; semisynthetic diet products free of branched-chain amino acids, provided by the Food Bank, are essential. Centralized treatment programs reduce the cost of treatment and maximize the potential benefits. The leucine requirement for adequate somatic growth during infancy in MSUD was found to be 200 to 600 mg/d; this range is lower than that estimated for infants with an intact leucine catabolic outflow pathway. The requirements for isoleucine and valine in infancy were also found to be lower than published values for normal infants.

Canada↗
PubMed1999

Temperature management in trauma patients across the continuum of care: the TEMP Group. Temperature Evaluation and Management Project.

Hypothermia is a potentially preventable consequence of injury in the trauma patient. The physiologic aftermath of hypothermia is such that it is regarded as one of the three components in the trauma triad of death. A multidisciplinary group at a Level I trauma center was formed to originate an innovative team approach to managing temperature in trauma patients. This article describes this unique project to combat a preventable cause of significant morbidity and mortality.

Acute Disease↗
PubMed1999

Recruitment of participants in the childhood Asthma Management Program (CAMP). I. Description of methods: Childhood Asthma Management Program Research Group.

The Childhood Asthma Management Program (CAMP), a multicenter clinical trial sponsored by the Division of Lung Diseases of the National Heart, Lung, and Blood Institute (NHLBI), is the largest outcome study of mild to moderate asthma in children to be undertaken, with eight clinical centers in the United States and Canada participating. The initial recruitment goal was 960 children within an 18-month recruitment period. Recruitment was extended to 23 months, with 1041 children randomized from late December, 1993, to early September, 1995. In this time interval each of the eight centers met the recruitment goal of 120 using a variety of self-selected recruitment strategies. The goal for minority recruiting was 33%, or 320 of the planned 960 children to be recruited. CAMP achieved the overall goal for the number of minorities, with 330 patients. Three centers recruited at or above the expected rate from the beginning. The other five centers had significant delays in recruitment. Examination of the recruitment experiences of the centers with and without delays did not indicate any single recruitment strategy that was certain to be successful. The most commonly cited factors for success were a cohesive staff, endorsement of participation by the child's primary care provider, and ability of the staff to be flexible and honest in assessing progress and the value of recruiting methods being used.

Asthma↗
PubMed1999

[Gerontopsychiatric treatment in comparison between integrated management at a university and separated management at a district hospital. 1: Patient characteristics].

OBJECTIVE: We wanted to study differences between geriatric psychiatric patients and their management in an integrated (with other adult age groups) care in the University Psychiatric Hospital (PUK) compared to those in a separated (only according to age) care in the Psychiatric State Hospital (LKH), which together treat all psychiatric inpatients in Goettingen, Germany. METHOD: We performed standardized chart reviews of randomly selected groups of patients, who had been treated in the PUK (n = 151) and the LKH (n = 145) in the years 1991 and 1992. RESULTS: The LKH patients were significantly older (74.8 +/- 8.7 y versus 70.3 +/- 8.3 y), more often living alone and/or without children. 31.9% of them were living in a nursing home compared to 6.5% of the PUK patients. Psychic disorders had not shown up before old age in 55.7% of all cases. 50.4% of the patients were in a psychiatric hospital for the first time. The majority of the patients (65.6%) had not been investigated by a psychiatrist before admission. CONCLUSIONS: More socially handicapped patients were treated in the LKH. For most cases, the hospital treatment had been the first psychiatric treatment at all.

Adult↗
PubMed1999

[Gerontopsychiatric treatment in comparison between integrated management at a university and separated management at a district hospital. 2: Diagnoses and treatment].

OBJECTIVE: We wanted to study differences between geriatric psychiatric patients and their management in an integrated (with other adult age groups) care in the University Psychiatric Hospital (PUK) compared to those in a separated (only according to age) care in the Psychiatric State Hospital (LKH), which together treat all psychiatric inpatients in Goettingen, Germany. METHOD: We performed standardized chart reviews of randomly selected groups of patients, who had been treated in the PUK (n = 151) and the LKH (n = 145) in the years 1991 and 1992. RESULTS: Most patients of the LKH suffered from organic brain diseases/dementia (63.4%; PUK: 29.1%). In the PUK, depression was the most frequent diagnosis (57.6%; LKH: 21.1%). A part of about 25% of the patients showed neurological deficits. Specialised diagnostics were performed mostly in the PUK. Both institutions treated the wide majority of patients with CNS drugs. Antidementia drugs were given significantly more often in the LKH. About one third of the patients were released into changed living environments. CONCLUSIONS: Patients with further progressed dementias were treated mainly in the LKH. This has consequences for diagnostics, treatment duration and side effect rate.

Adult↗
PubMed2000

Contemporary management of angina: part II. Medical management of chronic stable angina.

Except for a small subset of patients with angina whose survival is improved with coronary artery bypass surgery, chronic stable angina can be appropriately managed with medical therapy in the vast majority of patients. Drug therapy includes aspirin, beta-adrenergic blockers, cholesterol-lowering agents and other anti-ischemic drugs that can ameliorate angina and improve the patient's quality of life. Understanding how and when to use these medicines involves knowledge of the mechanisms of these drugs as well as familiarity with the literature supporting their efficacy in various patient populations.

Adrenergic beta-Antagonists↗
PubMed2000

ACOG practice bulletin. Management of herpes in pregnancy. Number 8 October 1999. Clinical management guidelines for obstetrician-gynecologists.

Genital herpes simplex virus (HSV) infection during pregnancy poses a significant risk to the developing fetus and newborn. In the United States, the incidence of this sexually transmitted disease (STD) has increased significantly since 1970 (1). Because many women of childbearing age are infected or are becoming infected, the risk of maternal transmission of this virus to the fetus or newborn is a major health concern. The purpose of this document is to define the stages of herpetic infection, outline the spectrum of maternal and neonatal infection, including rates of transmission and risks, and provide management guidelines that have been validated by appropriately conducted outcome-based research. Additional guidelines based on consensus and expert opinion also are presented to permit a review of most clinical aspects of HSV.

Breast Feeding↗
PubMed2000

[Proper disposal(management) of medical wastes--infection prevention and waste management(Clean Hospital Project) at Hiroshima City, Asa Hospital].

Hospitals are socially obligated to maintain a clean environment and to dispose of medical waste, in order to prevent pollution and infection within and near the hospital. Since its establishment, Hiroshima City, Asa Hospital has been implementing a "Clean Hospital Project", which has two goals: infection prevention and waste management. The nosocomial infection prevention committee and medical waste treatment and disposal examination committee lead these efforts.

Containment of Biohazards↗
PubMed1999

Sociodemographic determinants of management behaviour of diabetic patients. Part I. Behaviour of patients in relation to management of their disease.

We studied 300 randomly chosen diabetic patients to assess their behaviours in relation to management of their disease. The majority had very good compliance with regular periodic check-ups (97.0%), urine and blood screening for sugar (94.3% and 96.0% respectively), adherence to the prescribed medicines (78.3%) and foot-care practices (75.0%). However, 35.3% and 39.0% had poor compliance with regard to checking their blood pressure and weight monitoring. Among smokers, 30.2% stopped smoking and 42.2% decreased the amount smoked after being diagnosed with the disease. Dietary compliance was either satisfactory or very good for most patients.

Adult↗
PubMed1999

Sociodemographic determinants of management behaviour of diabetic patients. Part II. Diabetics' knowledge of the disease and their management behaviour.

We aimed to: describe the level of knowledge of diabetic patients about the disease, show the relationship between demographic variables (age, sex and education) and level of knowledge and reveal the relationship between knowledge and management-related behaviour of diabetics. We found that a majority of diabetic patients (90.0%) had poor knowledge about the disease, 83.7% had poor knowledge about the complications associated with diabetes and 96.3% had poor awareness of how to control the disease. The poor level of knowledge that diabetics have about their disease suggests that health care providers need to be trained in the areas of information, education and communication.

Age Factors↗
PubMed2001

Surgical management of peptic ulcer disease in the Helicobacter era--management of bleeding peptic ulcer.

Bleeding continues to be a significant cause of morbidity and mortality for patients with peptic ulcer disease. Recent advances have changed the management of this disease. Upper endoscopy with or without endoscopic therapy is the preferred procedure during the initial evaluation of upper gastrointestinal bleeding. With its excellent success rates, many patients are being cured with endoscopic therapy followed by eradication of Helicobacter pylori. H. pylori is now thought to have an important role in the pathogenesis of a majority of gastric and duodenal ulcers. This finding has led to the recommendation that patients with peptic ulcer disease be treated with regimens effective against this organism. Currently, patients who are older and who have more severe underlying medical conditions present a challenge. This review will address the options for treatment of peptic ulcer bleeding. In addition, knowledge gained regarding H. pylori infection and use of nonsteroidal anti-inflammatory drugs will be discussed.

Endoscopy, Gastrointestinal↗
PubMed2001

A randomized clinical trial of care for women with preterm labour: home management versus hospital management.

BACKGROUND: Preterm labour occurs in about 10% of all pregnancies and is the most important cause of premature birth. Women with preterm labour are admitted to hospital to have the contractions stopped. Thereafter, many women remain in hospital until delivery. We conducted a randomized clinical trial to compare hospital care with home care of women who had been admitted to hospital for preterm labour. METHODS: After they had received treatment for an acute episode of premature labour, women at 2 regional perinatal centres associated with teaching hospitals were randomly assigned to home care or hospital care. Eligible women (n = 250) were aged 18 years or older, lived within 50 km of the hospital, had a gestational age between 20 and 35 weeks, had no prior preterm delivery and were experiencing their first episode of preterm labour and first admission to hospital for preterm labour. Analysis was by intention to treat. RESULTS: There were no significant differences between the 2 groups in mean gestational age at delivery (home: 37.52 weeks, hospital: 37.50 weeks) or in mean birth weight (home: 2974 g, hospital: 3020 g). There were no significant differences between the 2 groups with respect to the proportions of babies born before term or the mean duration of neonatal hospital stay, neonatal intensive care unit stay and intermediate care nursery stay. The mean duration of the first stay in hospital for the women in the home group (3.8 days) was significantly shorter than the mean duration for women in the hospital group (6.1 days). In addition, the mean duration of all maternal stays in hospital was significantly shorter for the women in the home group (3.7 days) than in the hospital group (5.0 days). INTERPRETATION: Home care management is an efficient and acceptable alternative to hospital care for women experiencing preterm labour.

Adolescent↗
PubMed2001

[Management of cardiovascular diseases is characterized by male perspective. Women are subjected to incorrect management, diagnosis and treatment].

In women as well as in men cardiovascular disease is common, and almost as many women as men suffer from myocardial infarction every year in Sweden. In spite of this, studies on female cardiovascular disease are few in number. Knowledge about differences in risk factors, prevention, treatment and management is not common. Female cardiovascular disease starts approximately ten years later than in men and consequently most women are excluded from studies because of low age limits for inclusion. Primary preventive effects of e.g. acetylsalicylic acid, lipid-lowering drugs, vitamins and exercise have only been studied in healthy men, but the conclusions have been applied on women as well. The effects of reducing triglyceride levels or abdominal obesity in women--important risk factors for cardiovascular disease--have not been studied in controlled randomized studies. In women, angina is a non-specific symptom, and false positive ECG's are much more frequent than in men. The fact that a woman has to present as a man in order to be treated professionally (the Yentl syndrome) is still at hand. There is a great need for spreading current knowledge regarding gender differences among colleagues and medical students.

Cardiovascular Diseases↗
PubMed1975

[Metabolism and hematology studies of intensively raised fattened lambs under various feeding and management conditions. 2. The effect of various management methods on the blood picture, serum mineral and bilirubin concentration and vitamin A concentration in the liver].

Calcium, phosphorus, magnesium and bilirubin content, blood picture and liver vitamin A were studied in four groups of intensively fattened lambs kept under different conditions of management, in comparison with a control group. Results are shown in graphs and tables, Group-specific differences were found in some of the parameters examined: - Ca, P, erythrocytes, leucocytes, vitamin A.

Animal Feed↗