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Ti3C2Tx MXene sensing unit pertaining to speedy Hg2+ analysis within large salinity setting.
Introduction Hip fracture is a major cause of morbidity and mortality in older adults. Intertrochanteric hip fractures often are treated surgically using cephalomedullary nails (CMN), in either a short or long length. Their outcomes are documented in the literature; however, outcomes of the intermediate-length CMN have not been well described. Methods A retrospective review was conducted of older adults with intertrochanteric hip fractures that were treated with cephalomedullary nail fixation using an intermediate-length (235 mm Synthes Trochanteric Fixation® nail or 240 mm Stryker Gamma 3®) nail. Outcome data were collected during the inpatient stay and 16 months post-operatively. Results Seventy-seven patients met inclusion criteria and were reviewed during inpatient stay; however, only 42 had documented post-operative outcomes. Of those, two patients died post-discharge and were not included in the 16-month follow-up. Comparison of results to published literature suggested that intermediate-length nails ard over a longer period of time to confirm our findings.Introduction The purpose of this study was to identify additional injuries commonly seen with proximal humerus fractures experienced by patients 65 years or older and to evaluate discrepancies in the management of these patients with regard to provider type. Methods A retrospective review was conducted of all patients 65 years or older who sustained a proximal humerus fracture. Patient data collected included demographics, injury details, hospital course, and discharge destination. Results Patients with a concomitant fracture (45.5%, n = 65) had a slightly higher Injury Severity Score (ISS; 8.3 ± 3.0 vs. 6.4 ± 3.0, p less then 0.001) and experienced one additional death than those with an isolated fracture (54.5%, n = 78). Slightly more patients were managed by a trauma provider (51.7%, n = 74) than by a non-trauma provider (48.3%, n = 69). Those managed by a trauma provider sustained the most pelvic fractures (12.2% vs. 2.9%, p = 0.038), were more likely to be injured in a motor vehicle collision (8.1% vs. 0%, p = 0.005), had a higher ISS (8.0 ± 3.3 vs. 6.4 ± 2.8, p = 0.003), and had more imaging performed than those treated by a non-trauma provider. There was, however, no difference in operative rates, concomitant injuries, length of stay, or discharge disposition regarding provider type. Conclusion It is important to recognize proximal humerus fractures as a sign of fragility and to optimize hospital management of these patients.Introduction This is the 2018 Annual Report of the Kansas Poison Control Center at The University of Kansas Health System (KSPCC). The KSPCC serves the state of Kansas 24-hours per day, 365 days a year with certified specialists in poison information and clinical and medical toxicologists. Methods All encounters reported to the KSPCC from January 1, 2018 through December 31, 2018 were analyzed. Data recorded for each exposure included caller location, age, weight, gender, exposure substance, nature of exposure, route of exposure, interventions, medical outcome, disposition, and location of care. Results There were 21,072 total encounters, including 20,031 human exposure cases. Calls were received from every county and hospital in Kansas. Most of the exposures involved females (51.5%, n = 10,320) and a child less than 19 year of age (64%, n = 12,865). Medical outcomes were 24.5% (n = 4,912) no effect, 17.7% (n = 3,542) minor effect, 9.1% (n = 1,830) moderate effect, and 2.4% (n = 476) major effect. Seven deaths were reported in 2018. The number of exposure calls from healthcare facilities and severity of medical outcomes increased in 2018 compared to 2017. Conclusion The 2018 KSPCC annual report demonstrated that the center receives calls from the entire state of Kansas totaling over 20,000 human exposures. While pediatric exposures remain the most common encounter, a trend continued of an increasing number of calls from healthcare facilities and for cases with serious outcomes. This report supported the continued value of the KSPCC to both public and acute health care in the state of Kansas.Introduction Difficulties with the electronic health record (EHR) are known to be associated with high physician burnout. Usability studies can evaluate and identify usability issues with the EHR at the end user level. This study was conducted to determine physician perspectives and usability issues of local EHR systems. Methods Survey and focus group methodology were employed. Participants were resident physicians who were members of a resident council in the Midwest. Survey data collected included demographics and perceptions. Focus group data included participants identification of usability principle violations and potential impact to end user. Selleckchem ADH-1 Results There were 15 survey respondents (across 11 residency programs) who reported use of three different EHR systems Cerner®, Meditech, and Computerized Patient Record System (CPRS). Satisfaction was greatest with Cerner® as well as most reported level of experience. Focus group respondents reported a variety of usability violations which lead to provider confusion, increased time, alert fatigue, and potential patient safety issues. Conclusion Violations of usability principles can result in disruption of physician workflow processes and lead to increased documentation time as well as fatigue. These issues have been associated with increased provider burnout. Continuous usability assessments should be conducted at the end user level to promote the development of more effective and efficient EHR interface designs.Medical practice usually involves different activities which if not professionally handled, may give rise to liabilities on the part of the medical practitioner. These liabilities may arise in tortious claims and in some other cases, may go beyond the realm of civil liabilities to criminal liabilities. This review focuses on liabilities that amount to negligence both under the civil and criminal laws in Nigeria, other instances of malpractices which may not amount to negligence but may suffice to give rise to a successful cause of action in other branches of substantive law including claims for breach of fundamental human rights; contract; and fiduciary relationship. The review concludes by emphasizing the need for caution and the need to ensure that justice is seen to be done not only to the victims but also to the medical practitioners who deserve all legal protection in the exercise of their professional duties.Introduction Several studies have shown that older people have a higher risk of exposure to viral hepatitis B and C than younger people. This study aimed to determine the seroprevalence of hepatitis B and C and their associated factors in people aged 45+ years old in Burera, a rural district of Rwanda. Methods A cross sectional study was conducted from July to December 2017 during a mass campaign of hepatitis B (HBV) and hepatitis C (HCV) screening and vaccination of eligible populations against HBV in Burera District. Blood samples were collected and hepatitis B surface antigen (HBsAg) and an antibody against hepatitis C (Anti-HCV) were detected using an Enzyme-Linked Immuno-Sorbent Assay (ELISA). The associated factors were identified using a structured questionnaire and the data was analyzed using SPSS software. Results Of the 374 people included in this study, 53.2% were females. The median age was 56 years old with an interquartile range (IQR) of 50 - 63 years old. The prevalence of HBV and HCV infection was 6.4% and 9.4%, respectively, with 0.3% co-infection rate. Age, social economic level, history of blood transfusion, history of never using a condom, as well as a history of injury with a used sharp material were significantly associated with HCV infection. Conclusion The study showed a high seroprevalence of both HBV and HCV in Burera's elderly population aged 45+ years. Several factors associated with HBV and HCV in this study could be prevented through education and improved hygiene.Introduction The World Health Organization (WHO) recommends that in malaria endemic areas with moderate to high transmission rates, pregnant women presenting for antenatal clinic (ANC) should receive at least three doses of intermittent preventive treatment in pregnancy (IPTp) for malaria between the 16th and 36th weeks of pregnancy at intervals of 4 weeks between doses. Several challenges remain in effective implementation of IPTp policy making the targeted coverage (80%) of the third doses of IPTp far from being achieved. The main objective of this study was to assess factors associated with the uptake of IPTp among pregnant women attending ANCs in the Bamenda Health District. Methods To reach our objectives, we carried out a cross-sectional study following informed consent with thirty-nine (39) healthcare workers (HCW) and four hundred (400) pregnant women who were either in the third trimester of pregnancy or had recently given birth in any of thirty-six (36) health facilities (HF) within the Bamenda Healver, 35.9% reported not receiving any training on IPTp. Among the health providers, 28.2% did not know when to start IPTp and 43.59% did not know when to stop IPTp. Out of all the health care providers, 30.77% complained of medication (sulfadoxine-Pyrimethamine) stock out and 84.62% practiced the policy of direct observed therapy. Conclusion The uptake of the third dose of IPTp is poor in the Bamenda Health District and this may be attributed to medication stock out and inadequacy of routine trainings for the health providers. The good practice observed was that of direct observed therapy by HCWs. Patient knowledge about IPTp in our study was associated with better uptake of IPTp. Encouraging education of pregnant women on the importance of IPTp, providing routine training to HCWs and promoting direct observation of therapy may improve on IPTp uptake during pregnancy.Pulmonary artery (PA) sarcoma is an extremely rare malignant tumor of pulmonary artery. It is often misdiagnosed as pulmonary thromboembolism (PTE) because of its clinical and imaging features which are quite similar to PTE. Multimodality diagnostic imaging and recognition of specific imaging characteristics with appropriate clinical suspicion are required to make correct diagnosis. In this report, we present a case of PA sarcoma with imaging and clinical features as well as emphasize significance of using multimodality imaging.Introduction Obesity is a serious public health problem having a direct impact on physical and psychological health of individuals. The purpose of this study was to determine the prevalence of obesity and overweight in a child population attending urban and rural schools in the oasis of Tafilalet. Methods We conducted a cross-sectional descriptive study within the urban and rural public schools in of the oasis of Tafilalet. We recruited a representative sample of 3,684 children attending 39 public primary schools. Results The average age of patients was 9.81 ± 2.13 years. The total sample was divided into 1,794 boys (48.70%) and 1,890 girls (51.30%). Two thousand three hundred and nine lived in an urban area (62.70%) and 1,375 in a rural area (37.30%). According to the World Health Organization References, our study showed a rate of obesity of 1.9% and of 10.8% for overweight. Overweight and obesity were not significantly associated with children sex. Conclusion The prevalence of obesity in the oasis of Tafilalet is less than the national and international values; lifestyle and dietary habits of this population appear to be a protective factor against overweight and obesity.
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