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Challenges in the treatment of complicated gallstone disease during the Covid-19 pandemic, group comparison research
No full textMedicīnaVeselības aprūpeMedicineHealth CareKomplicētā žultsakmeņu slimība ir stāvoklis, kas prasa steidzamu ķirurģisku iejaukšanos. Covid-19 pandēmija ir skārusi visas medicīnas nozares tostarp arī ķirurģiju. Šī pētījuma ietvaros tiek aplūkotas Covid-19 pandēmijas ienestās izmaiņas komplicētās žultsakmeņu slimības diagnostikā un ārstēšanā, ka arī vērtētas atšķirības starp pirms pandēmijas un pandēmijas pacientu grupām. Pētījuma mērķis ir izvērtēt komplicētās žultsakmeņu slimības diagnostisko un ārstniecisko taktiku pirms un Covid-19 pandēmijas laikā.
Retrospektīvi tika ievākti dati par komplicētās žultsakmeņu slimības pacientu laboratorisku analīžu, diagnostikas izmeklējumu rezultātiem un operāciju protokolu aprakstiem. Pacienti tika iedalītas divās grupās: pirms Covid-19 pandēmijas grupa un Covid-19 pandēmijas grupa. Pētījumā gaitā tika noskaidrots, ka pandēmijas laikā komplicētās žultsakmeņu slimības pacientu hospitalizācijas ilgums bija lielāks nekā pirms pandēmijas laika. Šiem pacientiem laparoskopiska kopēja žultsvada sanācija tika pielietota biežāk Covid-19 pandēmijas laikā nekā pirms Covid-19 perioda. Savukārt konvencionāla ķirurģiska metode tika retāk pielietota Covid-19 pandēmijas laikā. Asociācija starp komplicētās žultsakmeņu slimības pacientu sarežģījumiem un pandēmiju netika novērota. Letālo iznākumu ziņā starp abām grupām netika novērota atšķirība.
Pētījumā atsevišķi ir aprakstīti komplicētās žultsakmeņu slimības pacienti, kuriem hospitalizācijas laikā tika atklāta SARS-CoV-2 infekcija, ka arī pacienti ar Covid-19 infekciju anamnēze. Pētījumā tika noskaidrots, ka SARS-CoV-2 pozitīvi pacienti ar komplicēto žultsakmeņu slimību ilgāku laiku pavadīja slimnīcā nekā neinficēti pacienti. SARS-CoV-2 pozitīviem pacientiem kopējā un tiešā bilirubīna līmenis bija augstāks nekā pacientiem bez Covid-19 infekcijas.
Covid-19 pandēmija kā ārkārtas situācija sabiedrības veselības jomā ir uzsvērusi veselības sistēmas noturības nozīmi un aktualizējusi jautājumu par veselības speciālistu, veselības aprūpes iestāžu gatavību un spēju efektīvi reaģēt uz krīzēm. Konkrētajā pētījumā tika pieradīts, ka Rīgas Austrumu klīniskās universitātes slimnīcas “Gaiļezers” stacionāra Vispārējās un neatliekamās ķirurģijas klīnika izrādīja gatavību krīzei.Complicated gallstone disease is a condition that requires urgent surgical intervention. The Covid-19 pandemic has affected all medical fields, including surgery field. This study describes the changes the Covid-19 pandemic made in the diagnosis and treatment of complicated gallstone disease, as well as the differences between pre-pandemic and pandemic patient groups. The aim of the study is to evaluate the diagnostic and therapeutic tactics of complicated gallstone disease before and during the Covid-19pandemic.
Data on the results of laboratory tests, diagnostic examinations and descriptions of surgical protocols in patients with complicated gallstones were retrospectively collected. Patients were divided into two groups: the pre-Covid-19 pandemic group and the Covid-19 pandemic group. The study found that the duration of hospitalization in patients with complicated gallstones was longer during the pandemic than before the pandemic. In these patients, laparoscopic common bile duct exploration was performed more frequently during the Covid-19 pandemic than before the Covid-19 period. In contrast, the open common bile duct exploration was less commonly frequently performed during the Covid-19 pandemic. No association was observed between complications of patients with complicated gallstones and pandemics. There was no difference in lethality between the two groups.
Patients with a history of SARS-CoV-2 infection and a history of Covid-19 infection were reported separately from patients with complicated gallstones in the study. The study found that SARS-CoV-2-positive patients with complicated gallstones spent more time in hospital than uninfected patients. Total and direct bilirubin levels were higher in SARS-CoV-2 positive patients than in patients without Covid-19 infection.
Covid-19 pandemic as a public health emergency has highlighted the importance of the sustainability of the health system and raised the question of the preparedness and ability of health professionals, healthcare institutions to respond effectively to crises. In this particular case Riga East Clinical University Hospital, stationary “Gaiļezers” General and Emergency Surgery Clinic showed preparedness for the crisis
Evaluation of risk assessment of surgical site infection in Riga East University Hospital
No full textVeselības vadībaVeselības aprūpeHealth managementHealth CareDarba tēma: Pēcoperācijas ķirurģisko brūču infekciju riska mazināšanas novērtēšana Rīgas Austrumu Klīniskajā Universitātes slimnīcā.
Visā Pasaulē pēcoperācijas ķirurģisko brūču infekciju risks vēlarvien ieņem procentuāli augstāko novērtējumu attiecībā uz stacionāri iegūto infekciju fona. Pēcoperācijas ķirurģiskās brūces infekciju risks ne tikai ietekmē pacienta veselību, bet arī slimnīcas kvalitātes un budžeta rādītājus. Pastāv gadījumi, kad pēcoperācijas ķirurgiskās brūces infekcijas risks izraisa smagas sekas uz pacienta veselību vai pat pacienta nāvi. Pēcoperācijas ķirurģiskās brūces infekcijas riska mazināšanai ir veikti daudz un dažādi pētījumi, kā mazināt šo risku un attiecīgi izstrādātas rekomendācijas, kas palīdz slimnīcām samazināt pēcoperācijas ķirurģiskās brūces infekcijas risku.
Mērķis: Novērtēt pēcoperācijas ķirurģisko brūču infekciju riskus ārstniecības iestādē un izstrādāt priekšlikumus pēcoperācijas ķirurģisko brūču infekciju risku mazināšanai RAKUS.
Darba uzdevumi:
- Izpētīt starptautisko praksi un pieeju pēcoperācijas ķirurģisko brūču infekciju risku mazināšanā;
- Izpētīt RAKUS pieeju un praksi pēcoperācijas ķirurģisko brūču infekciju riska mazināšanā;
- Izstrādāt secinājumus un uz tiem balstītus priekšlikums pēcoperācijas ķirurģisko brūču infekciju riska mazināšanai RAKUS.
Pētījuma jautājumi:
1. Kāda ir ieteicamā starptautiskā prakse pēcoperācijas brūču infekciju riska mazināšanai?
2. Kāda ir RAKUS prakse pēcoperācijas brūču infekciju riska mazināšanai?
3. Cik lielā mērā RAKUS prakse saskan ar starptautiski rekomendētu pieeju pēcoperācijas brūču infekciju riska mazināšanai?
4. Vai RAKUS tiek novērtēts infekcijas risks ķirurģiskajos pakalpojumos?
5. Vai pastāv korelācija starp infekciju riska faktoriem?
6. Kādas atšķirības pastāv risku faktoru bloku novērtēšanā starp respondentu profesijām?
7. Kādi pasākumi veicami pēcoperācijas brūču infekciju riska mazināšanas uzlabošanai RAKUS?
Darbs sastāv no ievada, trīs nodaļām, secinājumiem un priekšlikumiem. Teorētiskajā, darba pirmajā nodaļā, tiek analizēti zinātniskās literatūras avoti un starptautiskā prakses attiecībā uz darba tēmu.
Darba teorētisā nodaļa atspoguļo Pasaules Veselības organizācijas, Amerikas ķirurgu koledžas un CDC (Slimību profilakses un novēršanas Centru) rekomendācijas, kas ārstniecības iestādēm palīdz samazināt pēcoperācijas ķirurģisko brūču infekciju risku. Darba otrajā nodaļā tiek analizēta Latvijas pieeja un prakse pēcoperācijas ķirurģisko brūču infekciju riska mazināšanā. Autore iepazīstas ar normatīvo aktu bāzi. Ņemot vērā pētījuma mērķi, autore iepazīstas arī ar pētījuma bāzes praksi, kādi iekšējie dokumenti ir izstrādāti pēcoperācijas ķirurģisko brūču infekciju riska mazināšanai. Tiek veikta pētījuma bāzes prakses dokumentu analīze. Trešajā nodaļā atspoguļoti kvantitatīvā pētījuma datu analīze un rezultāti, kas noslēdzas ar secinājumiem un uz tiem balstītiem priekšlikumiem.Research topic: Evaluation of risk assessment of surgical site infection in Riga East University Hospital.
Surgical site infection still take a highest place in all hospital infections in all the World. Surgical site infection has significant impact to patient health and hospitals quality and finance indicators. There are cases where the risk of surgical site infection has serious consequences for the patient's health or even the patient's death. To reduce the risk of surgical site infection, many different studies have been conducted. The recommendations have been developed to help hospitals reduce the risk of surgical site infection.
Research aim: Evaluate surgical site infection risks in the Riga East University Hospital and develop proposals for reducing the risk of surgical site infections in hospital.
Research tasks:
- Investigate worldwide practices and approaches to reduce the risk of surgical site infections;
- Investigate Riga East University Hospital practice to reduce surgical site infection risk.;
- Make conclusions and suggestions for system implementation to reduce surgical site infection risk in the Riga East University Hospital.
Research questions:
1. What is the recommended worldwide practice for reducing the risk of surgical site infections?
2. What is Riga East University Hospital practice for reducing the risk of surgical site infections?
3. To what extent does Riga East University Hospital practice be in line with the worldwide recommended approach to reducing the risk of surgical site infections??
4. Does Riga East University Hospital evaluate the risk of surgical site infections?
5. Is there a correlation between infection risk factors?
6. What are the differences in the assessment of risk factor blocks between respondents professions?
7. What should be done for improvement to reduce risk of surgical site infection?
Research has three parts.The theoretical part, chapter 1 and 2, analyzes the literature sources such as PVO, ACS, CDC recommendations to reduce surgical site infections in hospitals and other scientific literature author introduce with research base, analyzes research bases documentation, which helps to reduce SSI. The third part contains statistical analysis about surgical site infection risks in research base.
This research can be used as a base for system implementation to reduce surgical site infection risk in the Riga East University Hospital. The risk assessment tool can be used to evaluate the surgical site infection risks in other Latvian hospitals with aim to reduce surgical site infection in hospital to improve the quality of surgical procedures and patient safety.
Sarapova Digule, Tamara. Evaluation of risk assessment of surgical site infection in Riga East University Hospital. Master thesis./scientific supervisor .prof.Haralds Plaudis, Riga: RSU/RISEBA, 2020. 86 pages.: 23 pictures, 17 tables, 7 attachments, 55 references
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Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
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