International Journal of Medicine and Surgery最新文献_第8页

Using In-Hospital Mortality as an Indicator of Quality Care and Hospital Performance 利用住院死亡率作为优质护理和医院绩效的指标

International Journal of Medicine and Surgery Pub Date : 2016-06-26 DOI: 10.15342/IJMS.V3I1.77

B. Bisbis, A. E. Gamri

{"title":"Using In-Hospital Mortality as an Indicator of Quality Care and Hospital Performance","authors":"B. Bisbis, A. E. Gamri","doi":"10.15342/IJMS.V3I1.77","DOIUrl":"https://doi.org/10.15342/IJMS.V3I1.77","url":null,"abstract":"The in-hospital mortality (MIH) is used as a performance indicator and quality healthcare in hospital. However, the majority of deaths resulted from an inevitable disease process (severity of cases and / or co-morbidity), and not medical errors or changes in the quality of care. This work aims to make a distribution of deaths in the Regional Hospital of Eastern, Al Farabi hospital and to highlight that more studies on the MIH are required consistently with detailed clinical data at the admission. The MIH showed its limitation as a health care indicator. The overall rate of in-hospital deaths within the Al Farabi hospital has averaged 2.4%, with 8.4% in the emergency unit, 28% in intensive care unit, 22% Neonatology unit, 1.6% in pediatric unit. The MIH may depend, firstly, on the condition of patients before hospitalization and secondly, on the conditions of their transfer from one institution to another that supports them as a last resort. Al Farabi hospital supports patients transferred from the provinces of the eastern region. Thus, 6% of patients who died in 2014 come from Berkane, 2% from Nador, 2% from Bouarfa, 4% from Taourirt and 2% from Jerrada. One might question about the procedures and the conditions of such transfers. In conclusion, the overall MIH measured from routine data do not allow proper comparison between hospitals or the assessment of the quality of care and patient safety in the hospital. To do so, we should ideally have detailed clinical data on admission (e.g. type of admission, age of patient, sex, comorbidity, ...). The MIH is however an important indicator to consider as a tool to detect potential problems related to admission procedures and to suspect an area of \"non-quality\" in healthcare . The MIH is interesting for the patient and for the hospital because it serves the improvement of quality healthcare.","PeriodicalId":259657,"journal":{"name":"International Journal of Medicine and Surgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115790552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Three Weekly Irinotecan and Bolus 5-Fluorouracil Combination in the First Line Treatment of Advanced Gastric Cancer - A Single Institution Experience 三周伊立替康联合5-氟尿嘧啶丸一线治疗晚期胃癌-单机构经验

International Journal of Medicine and Surgery Pub Date : 2016-06-26 DOI: 10.15342/IJMS.V3I1.95

Mohamed Mesmoudi, T. Mahfoud, S. Ahid, N. Ismaili, S. Boutayeb, H. Errihani

{"title":"Three Weekly Irinotecan and Bolus 5-Fluorouracil Combination in the First Line Treatment of Advanced Gastric Cancer - A Single Institution Experience","authors":"Mohamed Mesmoudi, T. Mahfoud, S. Ahid, N. Ismaili, S. Boutayeb, H. Errihani","doi":"10.15342/IJMS.V3I1.95","DOIUrl":"https://doi.org/10.15342/IJMS.V3I1.95","url":null,"abstract":"Background: The goal of this study is to determine the efficacy and toxicity of a non-platinum based chemotherapy combination using irinotecan associated to bolus 5-FU as first line treatment in advanced gastric cancer. Materiel and methods: Retrospective analysis of a population of patients treated for metastatic and locally advanced gastric cancer with irinotecan and 5-FU as upfront chemotherapy. Results: Thirteen patients were enrolled. The median age was 56 years. Seven patients were males and six were of females. Ten patients had a metastatic disease and three patients had a locally advanced disease. Patients received a total number of 43 cycles of chemotherapy. Overall response rate was 38,4%, median time to progression (TTP) was 3 months, and median overall survival was 4 months. Three patients (23,1%) presented grade 3 /4 neutropenia complicated with an infectious episode with fever in two cases, three patients (23,1%) required blood transfusion for a grade 4 anemia, and one patient (7,6%) was hospitalized for a severe episode of diarrhea. Conclusion: Three weekly irinotecan and bolus 5-FU is an interesting combination as first line treatment of advanced gastric cancer; designed clinical trials are needed to confirm the activity of this combination.","PeriodicalId":259657,"journal":{"name":"International Journal of Medicine and Surgery","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127896297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Merkel Cell Carcinoma : A Rare Neuroendocrine Neoplasm 默克尔细胞癌:一种罕见的神经内分泌肿瘤

International Journal of Medicine and Surgery Pub Date : 2016-06-26 DOI: 10.15342/IJMS.V3I1.74

H. Atarguine, S. Amal

引用次数: 0

A Chronic Psychogenic Vomiting Case of Dramatic Response to Escitalopram 慢性心因性呕吐1例艾司西酞普兰显著反应

International Journal of Medicine and Surgery Pub Date : 2016-06-26 DOI: 10.15342/IJMS.V3I1.91

O. Öztürk, M. Selcuk

引用次数: 0

Evidence Based Digoxin Therapeutic Monitoring - A Lower and Narrower Therapeutic Range 基于证据的地高辛治疗监测-较低和较窄的治疗范围

International Journal of Medicine and Surgery Pub Date : 2016-06-26 DOI: 10.15342/IJMS.V3I1.87

Amine Benlmouden, E. Billaud

{"title":"Evidence Based Digoxin Therapeutic Monitoring - A Lower and Narrower Therapeutic Range","authors":"Amine Benlmouden, E. Billaud","doi":"10.15342/IJMS.V3I1.87","DOIUrl":"https://doi.org/10.15342/IJMS.V3I1.87","url":null,"abstract":"Cardiac glycosides have been used for congestive heart failure and certain cardiac arrhythmias for more than 200 years. Despite the introduction of a variety of new classes of drugs for the management of heart failure, specifically angiotensin-converting enzyme (ACE) inhibitors, b-adrenergic antagonists (bblockers), and the aldosterone antagonist spironolactone, digoxin continues to have an important role in long-term outpatient management. However, a narrow margin exists between therapeutic and toxic doses of digoxin, resulting in a high incidence of digoxin toxicity in clinical practice. A wide variety of placebo-controlled clinical trials have unequivocally shown that treatment with digoxin can improve symptoms, quality of life, and exercise tolerance in patients with mild, moderate, or severe heart failure. The clinical relevance of digoxin therapeutic monitoring is also proved but the SDC (Serum Digoxin Conentrations) required for optimal clinical efﬁcacy and acceptable toxicity remains controversial. In the last years, international guidelines recommend 1.2 ng/mL as acceptable high level. In this bibliographic synthesis, we aim to collect pertinent informations from MedLine database about exposure-effect relationship in order to assess the evidence level scientific of new digoxin therapeutic monitoring.","PeriodicalId":259657,"journal":{"name":"International Journal of Medicine and Surgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124923612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Importance of Therapeutic Drug Monitoring in the Treatment of Active Tuberculosis - A Retrospective Study of 4 Cases 治疗药物监测在活动性肺结核治疗中的重要性——附4例回顾性分析

International Journal of Medicine and Surgery Pub Date : 2016-06-26 DOI: 10.15342/IJMS.V3I1.92

S. Hammi, Khawla El Ataouna, K. Bouti, O. Elbouazzi, M. Laine, J. Bourkadi

{"title":"Importance of Therapeutic Drug Monitoring in the Treatment of Active Tuberculosis - A Retrospective Study of 4 Cases","authors":"S. Hammi, Khawla El Ataouna, K. Bouti, O. Elbouazzi, M. Laine, J. Bourkadi","doi":"10.15342/IJMS.V3I1.92","DOIUrl":"https://doi.org/10.15342/IJMS.V3I1.92","url":null,"abstract":"Background: In the treatment of active tuberculosis, therapeutic drug monitoring (TDM) is used to optimize dosing that maximizes therapeutic benefit while minimizing toxicity. In Morocco, TDM is not routinely used, yet low levels of anti-TB drugs can be associated with poorer treatment outcomes. Methods: We retrospectively checked our archives for patients with active TB for whom TDM was performed during 2014. Medical records were reviewed to abstract demographic, clinical, radiographic and microbiological data including time until smear and culture conversion. Then, we looked for cases with delay of TB conversion. Results: In total, 24 patients were identified, for whom TDM was performed, they all had low serum drug levels. Among them, 4 patients showed delayed bacteriological conversion. Conclusions: Our study cases are showing the benefit of serum dosage in the follow-up of the patients showing a delay of sputum examination conversion, both direct and culture, during their evolutions. TDM is potentially useful for the treatment of active TB, but is currently underused in Morocco.","PeriodicalId":259657,"journal":{"name":"International Journal of Medicine and Surgery","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130639500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Ashy dermatosis : A case of cinderella 灰色皮肤病:灰姑娘的例子

International Journal of Medicine and Surgery Pub Date : 2015-12-31 DOI: 10.15342/ijms.v0i0.64

H. Zaouri, B. Hassam

{"title":"Ashy dermatosis : A case of cinderella","authors":"H. Zaouri, B. Hassam","doi":"10.15342/ijms.v0i0.64","DOIUrl":"https://doi.org/10.15342/ijms.v0i0.64","url":null,"abstract":"We report the case of a 20-years old female, who presented an asymptomatic grayish macules affecting the neck, trunk and roots of legs (Panel A). Histopathologic examination showed an increased dermal melanophages (Panel B) and a vacuolization of basal cell layer (Panel C), evoking an ashy dermatosis (AD). Paraclinical assessment didn't find any related disease. Multiple therapy was proposed such as corticosteroids and phototherapy. Evolution was marked by the extension of lesions in members at five years of follow-up. AD was first described by Ramirez. He called the patients «Los cenicientos». The Spanish term cenicienta means Cinderella, because of this folklore character's close association with ashes from sitting at home alone by the fireplace. Most cases present gray–brown macules which are commonly found on the face, arms, neck, and trunk. Histopathologic findings are nonspecific and include vacuolization of the basal layer, pigmentary incontinence and perivascular inflammatory infiltrate. The etiology of AD is unknown. Some authors reported associations with ammonium nitrate, whipworm infestation and HIV seroconversions. Many treatments was proposed such as corticosteroids, dapsone, clofazimine and phototherapy, but the results are not satisfactory. Such as basic research on the pathogenesis and treatment of hypermelanosis continuous, we look for more answers to the questions raised by this case.","PeriodicalId":259657,"journal":{"name":"International Journal of Medicine and Surgery","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122481143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Tuberculosis of The Parotid Gland in Children A Report of 4 Cases 儿童腮腺结核附4例报告

International Journal of Medicine and Surgery Pub Date : 2015-12-28 DOI: 10.15342/IJMS.V2I2.78

Rajae Borki, K. Bouti, Jawad Lahma, Noureddine Bouadel, I. Rkain, S. Nitassi, A. El Ayoubi, R. Bencheikh, A. Benbouzid, Leila Essakalli

{"title":"Tuberculosis of The Parotid Gland in Children A Report of 4 Cases","authors":"Rajae Borki, K. Bouti, Jawad Lahma, Noureddine Bouadel, I. Rkain, S. Nitassi, A. El Ayoubi, R. Bencheikh, A. Benbouzid, Leila Essakalli","doi":"10.15342/IJMS.V2I2.78","DOIUrl":"https://doi.org/10.15342/IJMS.V2I2.78","url":null,"abstract":"Tuberculosis is a chronic granulomatous infection caused by Mycobacterium tuberculosis or bovis that can affect all organs. However being located in the salivary glands is rare, affecting mainly adults between 20 and 50 years, although a few cases were described in children. We reported a series of 4 children with parotid TB diagnosed and treated at the ENT department of the hospital of specialties of Rabat. The average age was 9.25 years and sex ratio M/F was 1. All children were admitted for parotid swelling evolving over an average period of 6 months which fistulized afterwards, a child had also facial paralysis. Histological analysis of the fine-needle aspiration or the sample taken from the fistula confirmed the diagnosis of tuberculosis with the presence of giant cell granuloma with caseous necrosis. All children received anti-bacillary treatment during 6 months, and showed good evolution. Although being rare, the parotid TB in children remains a condition to be considered at the occurrence of any chronic parotid swelling, especially in endemic countries.","PeriodicalId":259657,"journal":{"name":"International Journal of Medicine and Surgery","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123487209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Treatment Results Of Diaphyseal Forearm Fractures With Dynamique Compression Plate A Retrospective study of 156 Cases. 动力加压钢板治疗前臂骨干骨折156例回顾性研究。

International Journal of Medicine and Surgery Pub Date : 2015-12-26 DOI: 10.15342/IJMS.V2I2.51

H. Boussakri, Ahmed Bouziane Ouaritini, M. Shimi, M. Elidrissi, A. Elibrahimi, A. Elmrini

{"title":"Treatment Results Of Diaphyseal Forearm Fractures With Dynamique Compression Plate A Retrospective study of 156 Cases.","authors":"H. Boussakri, Ahmed Bouziane Ouaritini, M. Shimi, M. Elidrissi, A. Elibrahimi, A. Elmrini","doi":"10.15342/IJMS.V2I2.51","DOIUrl":"https://doi.org/10.15342/IJMS.V2I2.51","url":null,"abstract":"This retrospective study addresses a series of 156 cases of forearm fractures. These 156 cases were managed in the trauma-orthopedic department (B4) of Fez University Hospital, Morocco, from May 2008 till January 2013. The purpose of this study is to analyze epidemiological and clinical factors of diaphyseal forearm fractures and the results of their treatment with dynamic compression plate (DCP), as well as the complications and therapeutic errors of this surgical technique. The frequency of hospitalization in the trauma-orthopedic department was 3,96%. Ages ranged between 16 and 83, the average age was 32. 132 patients were male (85%). 90% were managed at the day of trauma. Traffic accidents were the most frequent cause in 52% patients. The fracture was in the left forearm in 65% of patients. 53% of fracture lines were in the middle third of the forearm. 38 fractures were open, and 30 were admitted for polytrauma. Osteosynthesis was performed with dynamic compression plate for all patients. In comparison with the literature, our series shows the predominance of young male patients, with traffic accidents being the cause. Osteosynthesis with dynamic compression plate remains the treatment of choice that provides satisfactory results if the accuracy in this technique was respected.","PeriodicalId":259657,"journal":{"name":"International Journal of Medicine and Surgery","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132594034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Fatal Cardiothyreosis Revealed Through A Status Epilepticus And Resulting In A Therapeutic Impasse - A Case Report 通过癫痫持续状态和导致治疗僵局揭示致命的心脏病-一个病例报告

International Journal of Medicine and Surgery Pub Date : 2015-12-26 DOI: 10.15342/IJMS.V2I2.38

A. Ghannam, Zakaria Ouassou, J. Tadili, A. Kettani, M. Faroudy

引用次数: 0