Patients In General Hospital Research Articles

The reliability, validity and screening effect of the happiness index scale among inpatients in a general hospital

BackgroundThe Happiness Index Scale (HIS) is a newly developed scale by our group to screen for common psychological illnesses among general hospital inpatients. This study aimed to analyze the reliability, validity and screening effect of the HIS and to explore its clinical application.MethodsFrom April 1, 2021, to December 31, 2021, a total of 8405 continuous inpatients were enrolled from different departments of a large tertiary general hospital with 1385 inpatient beds in Guangzhou, Guangdong Province, China. Using a cross-sectional survey design, each participant was assessed with the Patient Health Questionnaire 9(PHQ-9), Generalized Anxiety Disorder 7 items(GAD-7), Athens Insomnia Scale (AIS), Columbia Suicide Severity Rating Scale (C-SSRS) and HIS within 24 h of admission. McDonald's ω coefficient, the Guttman split-half coefficient and the test–retest reliability coefficient were used to evaluate the reliability of the HIS and the construct validity and criterion validity of the validity tests. Scores on the PHQ-9, GAD-7, AIS, and C-SSRS were used as the gold standard tools to analyze the screening effect of the HIS.ResultsThe HIS exhibited very good reliability, with a McDonald's ω coefficient of 0.825, a Guttman split-half coefficient of 0.920 and a test–retest reliability coefficient of 0.745 (P < 0.05). Confirmatory factor analysis showed a satisfactory model fitting index with a χ2/df = 2.602, a root mean squared error of approximation (RMSEA) of 0.014, a standardized root mean square residual (SRMR) of 0.010, a comparative fit index (CFI) of 0.992, and a Tucker–Lewis index (TLI) of 0.983. The correlation coefficient between the total score of each dimension of the scale and the corresponding criterion was 0.854 ~ 0.949 (P < 0.001). The HIS showed a very good distinguishing effect. The average HIS score of inpatients who screened positive for psychological problems was significantly higher than that of inpatients who screened negative for psychological problems (t = 3790.619, P < 0.001). The effect size was very large (Cohens d = 2.695, 95% CI = 2.630 ~ 2.761). Approximately 90.2% of the positive and negative screening results of the HIS were matched with the gold standard tools, with a kappa value of 0.747 (P < 0.001). The screening effect test showed a sensitivity (true positive rate) of 92.9% and a specificity (true negative rate) of 89.5%.ConclusionThe HIS exhibited satisfactory reliability and validity and a clinically meaningful screening effect with a much shorter version compared to the commonly used screening scales. Thus, it could potentially be useful as the first screening step to rule out psychological conditions for inpatients in general hospitals or to remind medical teams of further psychological concerns.

The Role of Sex and Age in Moderating the Outcome of In-Person and Computer-Based Brief Alcohol Interventions at General Hospitals: Reanalysis of a Brief Intervention Study

Introduction: The aim of this study was to test whether brief alcohol interventions at general hospitals work equally well for males and females and across age-groups. Methods: The current study includes a reanalysis of data reported in the PECO study (testing delivery channels of individualized motivationally tailored alcohol interventions among general hospital patients: in PErson vs. COmputer-based) and is therefore of exploratory nature. At-risk drinking general hospital patients aged 18–64 years (N = 961) were randomized to in-person counseling, computer-generated individualized feedback letters, or assessment only. Both interventions were delivered on the ward and 1 and 3 months later. Follow-ups were conducted at months 6, 12, 18, and 24. The outcome was grams of alcohol/day. Study group × sex and study group × age interactions were tested as predictors of change in grams of alcohol/day over 24 months in latent growth models. If rescaled likelihood ratio tests indicated improved model fit due to the inclusion of interactions, moderator level-specific net changes were calculated. Results: Model fit was not significantly improved due to the inclusion of interaction terms between study group and sex (χ²[6] = 5.9, p = 0.439) or age (χ²[6] = 5.5, p = 0.485). Discussion: Both in-person counseling and computer-generated feedback letters may work equally well among males and females as well as among different age-groups. Therefore, widespread delivery of brief alcohol interventions at general hospitals may be unlikely to widen sex and age inequalities in alcohol-related harm.

Proactive automatised lifestyle intervention (PAL) in general hospital patients: study protocol of a single-group trial

IntroductionThe co-occurrence of health risk behaviours (HRBs, ie, tobacco smoking, at-risk alcohol use, insufficient physical activity and unhealthy diet) increases the risks of cancer, other chronic diseases and mortality more...

Adherence to Antipsychotic Drugs by Medication Possession Ratio for Schizophrenia and Similar Psychotic Disorders in the Republic of Korea: A Retrospective Cohort Study.

ObjectivePharmacotherapy is considered as an essential element in the treatment of psychotic disorders including schizophrenia. Discontinuation of antipsychotic drugs increases medical use and economic burden. Therefore, maintenance of medication is essential to reduce the social burden caused by schizophrenia and schizophrenia similar psychosis (SSP), and hence, it is important to investigate the rate at which pharmacotherapy is maintained. Therefore, this study aimed to examine the current status of drug compliance using national health insurance data.MethodsThis was a retrospective cohort study, which analyzed data from the nationwide insurance claims database. A total of 343,134 patients who were newly diagnosed with schizophrenia and SSP during 2011−2015. The adherence to antipsychotic drugs was assessed by medication possession ratio (MPR) and the risk factors of poor adherence were defined as MPR < 40%.ResultsThe average of the MPRs was 45.8%, and the proportion of patients with less than 40% of MPR was 50.8%. It was found that female patients, the experience of “general hospital outpatient,” “psychiatric hospital admission,” “general hospital admission,” and patients receiving “health insurance” showed high risk of having statistically significant low MPR (< 40%).ConclusionIn this study, the drug adherence of schizophrenia and SSP patients currently under treatment, as estimated by MPR, was very low. However, it was also found that the MPR was high among patients receiving medical aid, with less medical expenses. Thus, it is possible to consider an institutional mechanism in which schizophrenia and SSP patients can be treated with less economic burden.

TU2.9 Under-investigation of iron deficiency anaemia in QFIT-negative suspected colorectal cancer patients

Abstract Introduction QFIT (Quantitative faecal immunochemical testing) has become the first-line screening tool for suspected colorectal cancer due to a lower risk profile, higher sensitivity and specificity than routine colonoscopy and faecal occult blood testing. Patients with QFIT measurements &amp;lt;10micrograms/ml are considered unlikely to have colorectal cancer and may be discharged from the 2-week wait (2WW) pathway without further investigations, in the absence of other concerning features including iron deficiency anaemia (IDA). We present our findings on the under-investigation of IDA in a cohort of QFIT-negative patients. Method We collected data on 100 patients in a district general hospital, referred via the 2WW suspected colorectal cancer pathway with QFIT measured as &amp;lt;10 micrograms/ml, over a 2-month period. Our data-points included whether iron, ferritin and haemoglobin were measured in the 6months preceding QFIT measurement. Results Our patients included 67 females and 33 males, with a median age of 67.5. 32 out of 100 patients underwent neither iron nor ferritin blood tests; 21 of which did not have their haemoglobin measured either. 25 out of 100 patients underwent iron, ferritin and haemoglobin blood tests in the specified time period. Discussion Failure to investigate IDA in QFIT-negative suspected colorectal cancer patients increases the risk of missed pathology. Studies have found patients with right sided colon cancer sometimes have false negative QFIT results but often present with IDA. We propose that mandatory investigation of IDA is incorporated into existing 2WW suspected colorectal cancer pathways, alongside QFIT measurement, to mitigate this risk.

Evaluation of the Antibiotic Resistance Rate of Helicobacter pylori in Peptic Ulcer Patients in Tien Giang Central General Hospital, Tien Giang Province, Vietnam

BACKGROUND: Peptic ulcer (PU), trauma on the lining of the stomach and/or small intestine, is among the top five reasons for hospitalization in Tien Giang, a province in the South of Vietnam. Since Helicobacter pylori (HP) is one of the main causes of PU, its features, especially the antibiotic-resistant status, have critical significance in PU treatment. AIM: This study evaluates the HP infection prevalence, HP antibiotic resistance rate, and its associations with the patients’ sociodemographic characteristics. MATERIALS AND METHODS: A cross-sectional study was conducted on PU patients in Tien Giang province, Vietnam, from June 2020 to June 2021. The volunteers were tested for HP infection and antibiotic resistance using three methods, where appropriate, including Gram staining, CLO (urease) test, and bacterial culture method. RESULTS: Among 368 samples, 31.5% had infected with antibiotic-resistant HP. The resistance rates to five antibiotics commonly used in HP treatment, including metronidazole, clarithromycin, tetracycline, levofloxacin, and amoxicillin, were 96.6%, 94.8%, 70.7%, 61.2%, and 53.4%, respectively. The rates of tetracycline and clarithromycin resistance were related to alcohol consumption (t-test, p &lt; 0.05). The HP treatment history was significantly associated with the levofloxacin resistance (t-test, p &lt; 0.05). CONCLUSIONS: The emergence of antibiotic-resistant HP is a major public health concern in Tien Giang, Vietnam. This issue should be tackled at the national level to avoid the further spread of these multi-drug resistant HP strains.

Impact of peptic ulcer disease on the quality of life: A Cross Sectional Study

Background: Peptic ulcer disease (PUD) is a serious chronic medical condition. It is considered one of the most common illnesses worldwide. PUD has its own impact on the patients’ quality of life (QOL). Objectives: This study aimed to assess the QOL in patients with peptic ulcer disease in Mosul city, Iraq. Methods: A cross sectional study was carried out among 385 patients in a public general hospital and 5 local pharmacies in Mosul city during the period from 10th May to 5th August 2021. Data collection was performed using a face-validated SF-12v2 questionnaire assessing the patients’ physical, mental, and overall health. All the data were subjected to descriptive and inferential analyses. Results: Overall, only 8.6% of the participants reported that their general health is poor. The majority (40.8% and 38.4%) stated that peptic ulcer disease has no or little impact on their moderate daily physical activity. Significant differences were found in the physical, mental and overall QOL scores with socio-demographic characteristics. Conclusion: Quality of life assessment indicated that there are some negative impacts in the patients’ daily life caused either by the patients’ environmental aspects or peptic ulcer related symptoms.

The microeconomic impact of out-of-pocket medical expenditure on the households of cardiovascular disease patients in general and specialized heart hospitals in Ibadan, Nigeria.

Cardiovascular diseases (CVDs) present a huge threat to population health and in addition impose severe economic burden on individuals and their households. Despite this, there is no research evidence on the microeconomic impact of CVDs in Nigeria. Therefore, this study estimated the incidence and intensity of catastrophic health expenditures (CHE), poverty headcount due to out-of-pocket (OOP) medical spending and the associated factors among the households of a cohort of CVDs patients who accessed healthcare services in public and specialized heart hospitals in Ibadan, Nigeria. This study adopts a descriptive cross-sectional study design. A standardized data collection questionnaire developed by the Initiative for Cardiovascular Health Research in Developing Countries was adapted to electronically collect data from all the 744 CVDs patients who accessed healthcare services in public and specialized heart hospitals in Ibadan between 4th November 2019 to the 31st January 2020. A sensitivity analysis, using rank-dependent thresholds of CHE which ranged from 5%-40% of household total expenditures was carried out. The international poverty line of $1.90/day recommended by the World Bank was utilized to ascertain poverty headcounts pre-and post OOP payments for healthcare services. Categorical variables like household socio-demographic and clinical characteristics, CHE and poverty headcounts, were presented using percentages and proportions. Unadjusted and adjusted logistic regression models were used to assess the factors associated with CHE and poverty. Data were analyzed using STATA version 15 and estimates were validated at 5% level of significance. Catastrophic OOP payment ranged between 3.9%-54.6% and catastrophic overshoot ranged from 1.8% to 12.6%. Health expenditures doubled poverty headcount among households, from 8.13% to 16.4%. Having tertiary education (AOR: 0.49, CI: 0.26-0.93, p = 0.03) and household size (AOR: 0.40, CI: 0.24-0.67, p = 0.001) were significantly associated with CHE. Being female (AOR: 0.41, CI: 0.18-0.92, p = 0.03), household economic status (AOR: 0.003, CI: 0.0003-0.25, p = <0.001) and having 3-4 household members (AOR: 0.30, CI: 0.15-0.61, p = 0.001) were significantly associated with household poverty status post payment for medical services. OOP medical spending due to CVDs imposed enormous strain on household resources and increased the poverty rates among households. Policies and interventions that supports universal health coverage are highly recommended.

Psychiatric Consultation to Hospitalized Patients: Current Status and Psychiatric Diagnoses

Background: The benefits of addressing behavioral health issues in inpatients have been well documented. However, these problems are not frequently recognized by physicians during the hospitalization of patients in general hospitals. Objectives: This study described the current status and medical diagnoses made in psychiatric consultations to inpatients admitted to general hospitals affiliated to Babol University of Medical Sciences, North of Iran. Methods: This cross-sectional observational research was carried out at Babol University of Medical Sciences from 2019 to 2020. All psychiatric consultations for patients hospitalized in different departments of two general hospitals affiliated to this university for 6 months were included. The mental disorders diagnosed for patients were recorded by a psychiatrist according to the diagnostic and statistical manual of mental disorders (DSM-5) criteria. Results: A total of 266 patients with a mean age of 51.21 ± 16.95 years were examined. Most of the consults were requested by the departments of cardiology (39.5%) and neurology (16.2%). According to the psychiatric visits, 32.3%, 51.1%, and 15.4% of the patients had no, one, and two concomitant psychiatric disorders, respectively. Mental disorders were found to have a significant association with gender (P &lt; 0.001), admission department (P &lt; 0.001), comorbid malignancies (P = 0.011), cardiovascular disorders (P &lt; 0.001), need for surgical intervention (P = 0.018), a history of substance use (P = 0.001), and reasons for consult request (P &lt; 0.001). Conclusions: Mental disorders, especially mood and anxiety disorders, were identified in approximately 70% of consultations. Therefore, requesting a timely psychiatric consultation can lead to better managing hospitalized patients.

Sistem Pakar Deteksi Awal Covid-19 Menggunakan Metode Certainty Factor

Data on the development of Covid-19 cases globally and in Indonesia and predictions of an increase in the number of cases, of course, it is necessary to take several steps in dealing with Covid-19, the community must implement physical distancing and maintain personal hygiene and the surrounding environment as preventive measures to suppress the spread of Covid-19. This is in accordance with WHO's appeal regarding strategic steps in dealing with the global Covid-19 pandemic. As in other countries, suspect Corona (people who show symptoms of being infected with COVID-19 and are suspected of having had contact with positive COVID-19 patients) are increasing in Indonesia so that requests for specimen tests at laboratories that have been appointed by the government have also increased. For this reason, another way is needed to detect COVID-19 that is more practical and faster by analyzing data using the Certainty Factor method. With the Covid-19 Early Detection expert system, so that it can provide convenience for Aek Kanopan Regional General Hospital (RSUD) doctors and patients in carrying out the Covid-19 Early Detection process in the database. Can help the Regional General Hospital Doctor (RSUD) Aek Kanopan and provide services to patients in terms of the existing Covid-19 Early Detection and successfully conclude the early symptoms of covid-19 and their handling solutions

964 MOUTHCARE MATTERS: QI PROJECT TO IMPROVE ORAL HEALTH IN ELDERLY HOSPITAL INPATIENTS

Abstract Background A quality improvement (QI) project completed over four months on an elderly-care ward comprising 34 inpatients in a UK district general hospital. The QI team comprised the ward Foundation Year 1 (FY1) and Consultant, with Nursing staff consultation. Introduction There is evidence that oral-health in elderly people deteriorates with hospitalisation (Terezakis et al. J Clin Periodontol. 2011;38(7):628–636). Poor oral-health is associated with increased incidence of hospital-acquired infections and reduced oral intake (Kaneoka et al. Infect Control Hosp Epidemiol. 2015;36(8):899–906; Poisson et al. Gerodontology. 2016;33(2):61–168). We had no data on oral-health among our hospital inpatients, nor on nursing measures to maintain or improve it. We aimed to collect baseline data and implement ward-based improvements to oral-health assessment and care. Method Interventions were identified using a ‘drivers-for-change’ flow-diagram: main interventions were introduction of a mouthcare proforma (for nurse-led assessment of patient oral-health and documentation of mouthcare given), ensuring availability of mouthcare products and providing relevant ward-staff education. Two ‘Plan-Do-Study-Act’ cycles were completed; intervention implementation was staggered two-monthly, following evaluation of preceding changes’ impact. Data to measure impact of changes was collected two-monthly by the FY1 on patient oral-health (subjectively scored with assessment tool), rate of proforma completion and patient-reported completion of routine mouthcare. Results Over the four-month period, there were significant improvements to rates of oral-health assessment (proforma completion increased by 86%), completion of routine mouthcare (increased by 32%), and overall patient oral-health: proportion of ‘good’ or ‘excellent’ oral-health scores increased from 21% to 66%. We aim to deliver further ward-based education to maintain progress. Conclusion These interventions are simple, low-cost and could be implemented across many elderly-care wards. Wider adoption would improve mouthcare across larger patient-numbers, with potential benefit to both patient experience and morbidity. Ongoing education and integration of the proforma into existing ward ‘patient-care-bundles’ will promote sustained improvement.

An Audit to Assess the Quality of Ward Referrals Sent to City Hospital Liaison Psychiatry Team From Inpatients Wards D15, D17and D27, Between July 2021 to September 2021

AimsLiaison psychiatry provides psychiatric care to medical patients. Patients include those attending emergency departments, general hospital inpatients and outpatients. Liaison teams work hand in hand with several general hospital teams to offer advice, review and manage these patients. Over the last few months, the Liaison service in City Hospital have been receiving many inappropriate referrals. Inappropriate referrals are defined as patients who are referred to services, with one of the following reasons: 1.Insufficient presenting complaint2.No documented Past psychiatric history3.Insufficient Mental state Examination (MSE)4.No risk assessment5.No documented Drug/alcohol history6.Patients having not consented to referral.7.If one or more of the above criteria is not metOur aim was to evaluate the appropriateness of the referrals received from D15, D17, D27 inpatients wards in City Hospital over a 3-month period from July to September 2021. These wards were chosen as they commonly refer patients to liaison services.MethodsWe collated data retrospectively on the nature of all referrals from D15, D17 and D27 ward over a 3-month period. The patient referral portal was used, and referral content of each patient was analysed. An audit tool was devised to assess whether the referrals followed the liaison referral pathway and guidelines set by NHS England for referral structure to liaison services.Results18 patients were referred to the Liaison psychiatry from the three wards over the three-month period. We observed 77.8% (n = 14) of the referrals having insufficient information for the presenting complaints, whilst 22.2% (n = 4) of them did not state past psychiatric history. Approximately 94.4%(n = 17) did not state sufficient details of MSE. In 83.3% (n = 15) of referrals appropriate detailed risk assessment was not done, 27.8% (n = 5) of them did not have alcohol/ drug use stated and 22.2% (n = 4) of patients referred did not consent to the referral being made.ConclusionThe results demonstrated that ward referrals lack quality and contain inadequate information to allow for safe screening of patients and for the implementation of appropriate actions by the liaison team. A possible reason for inappropriate referrals may be due an existing knowledge gap and lack of confidence taking detailed psychiatric histories, assessing risk, and performing MSE in non-psychiatric trainees making referrals to liaison services.

Inpatient psychiatric care of COVID-19 infected patients in a Hungarian general hospital

Introductionduring the study period (08/02/2021 – 11/05/2021) the Centre of Psychiatry in the Jahn Ferenc South-pest Hospital (CP-JFSH) was one of the two psychiatric wards in Budapest, specialized for the treatment of COVID-19 infected psychiatric patients.Objectivesthe aim of the study was to survey the characteristics and evaluate the outcome of the COVID-19 infected psychiatric patients treated in the CP-JFSH.Methodsretrospective analysis of the files of COVID-19 infected psychiatric patients admitted to the CP-JFSH in a 3 month period. In addition to demographic data, diagnostic distribution, co-morbidities, date of infection, method of detection of the virus, presence of pneumonia, severity of infection, outcome, treatment, vaccination data were evaluated.Resultsin the study period 124 COVID-19 infected psychiaric patients were admitted to the CP-JFSH. The gender distribution was aproximately equal, the mean age of the patients was 62.8+/-15.7 years. Majority of the patients suffered from major neurocognitive disorder followed by schizophrenia spectrum disorder. Most common co-morbidities were cardiovascular diseases and diabetes. Pneumonia was present in 41% of the patients. Majority of the patients were already infected at the time of admission, detected with the first PCR examination and haven’t been vaccinated yet. Thirty-one percent of the patients suffered from moderate to severe COVID-19 illness. COVID-19 specific therapy (favipiravir, remdesivir, fluvoxamin) was introduced in 57%. Mortality was 12% while the relaps rate 4%.Conclusionscomparing with inpatient mortality rate published in the literature, mortality rate was higher among psychiatric patients, underlining the need for special attention of this population.DisclosureNo significant relationships.

Dialysis Access Created Using Double-horseshoe versus Continuous Circular Polypropylene Suture

&lt;p&gt;Background: Although haemodialysis with an arteriovenous fistula (AVF) is a common treatment for chronic renal failure, the most common causes of early failure can be attributed to the anastomosis site. This study compared the safety, efficacy, and failure rates of anastomoses created using traditional continuous circular polypropylene suture versus double-horseshoe suture. Methods: This retrospective clinical study used data from general district hospital patients who received either continuous circular polypropylene suture (n = 72; age: 62.6 &amp;plusmn; 13.2 years) or double-horseshoe polypropylene suture (n= 185; age: 62.5 &amp;plusmn; 12.2 years) between January 2010 and December 2015. Results: Preoperatively, more patients in the double-horseshoe suture group had poor (i.e. &lt; 3 mm) vein quality(circular group 5.6% vs. double-horseshoe group 33%) and poor (i.e., calcification, atheroma formation) artery quality (circular group 1.4% vs. double-horseshoe group 11.4%). The reintervention rates for outflow vein stenosis were 62.5% and 100% in the circular and double-horseshoe groups, respectively. The double-horseshoe group did not require percutaneous transluminal angioplasty (PTA) at the anastomosis site. Conclusions: Switching from circular to double-horseshoe anastomosis resulted in a PTA rate of 0%. Thus, although patients in the double-horseshoe group had no stenosis over the anastomosis site, poor vein quality, and poor artery quality, it was still possible to use a native vessel to create an AVF without increasing PTA rates.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Psychiatry engagement in the management of delirium in general hospital patients

Background: Delirium is a common and serious problem in patients with medical illness. The overall prevalence rate of delirium was 10~31% in hospital general medical in-patient settings. The purpose of this study is to examine the characteristics of patients with delirium encountered during the consultation of psychiatric departments in other departments of general hospitals, the benefit of consultation. Methods: We reviewed the medical records to collect relevant information. The Confusion Assessment Method-Short (CAM-Short) scale was used to evaluate the severities. Results: Twenty patients were recruited. The average age was 73.9-year-old. All the participants presented with hyperactive delirium. The average initial CAM score was 4.5 and then decreased to 2 after the follow-up. Almost all teams applying for consultation arranged treatment (19 in 20) or examinations (18 in 20) as the suggestion.. Conclusion: In our study, the psychiatric department's consultation services have specific assistance to patients with delirium. The consulting physician should still track the follow-up status of the case and discuss the treatment of delirium with other physicians at an appropriate time. Keywords: Delirium, psychiatric consultation, CAM-S

Clinical Application Evaluation of Elecsys® HIV Duo Assay in Southwest China.

BackgroundHIV/AIDS continues to be a serious health concern of morbidity and mortality globally, and novel HIV testing is still an important component of diagnosing HIV earlier and reducing the spread of HIV. The Elecsys® HIV Duo assay is a 4th generation assay that can detect both HIV-1 p24 antigen (Ag) and HIV-1/2 antibody (Ab) in parallel and show the subresults for the Ab and Ab units.ObjectivesTo evaluate the clinical performance of the Elecsys® HIV Duo assay on the new cobas E 801 analyzer using a large number of clinical samples from a population in southwest China.MethodsWe collected testing results and information from all patients in a large general hospital. All eligible clinical specimens were first analyzed using the Elecsys® HIV Duo assay. The test results are given either as reactive or nonreactive as well as in the form of a cutoff index (COI). All initially reactive specimens were retested in duplicate with a 3rd-generation kit. Supplementary tests were divided into Ab confirmation tests and HIV-1 nucleic acid tests. GraphPad Prism and Python were used for plotting, and SPSS 21.0 software was used for statistical analysis.ResultsA total of 186391 specimens were received, and 436 patients were confirmed to be positive for HIV. Among the 86 cases with contact history available, there were more males than females, and heterosexual transmission was the most common route of HIV infection. The Elecsys® HIV Duo assay displayed 99.94%, 99.93% and 99.98% specificity for inpatient, outpatient and physical examination patients, respectively. The median COI ratios of the false-positive group were significantly lower than those of the true-positive group.ConclusionsThe Elecsys® HIV Duo test (Cobase801 analyzer) differentiates the detection of HIV-1 p24 Ag and HIV-1/2 Ab with high specificity and facilitates the diagnosis of patients with early HIV infection. Therefore, the Elecsys®HIV Duo test is used for differentiation of antigen and antibody reactivity, making it suitable for routine clinical diagnosis.

Clinical Characteristic of Bloody Diarrhea in Under- Five Pediatric Inpatients

Background: Diarrhea is the most common cause of death in under-five children. Bloody diarrhea comprises around 10% of all cases of diarrhea and may lead to severe complications until death. This study examined the characteristics of bloody diarrhea in children under five years old in Dr. Soetomo General Hospital Surabaya from 2013 to 2017.&#x0D; Material and Methods: A retrospective, cross-sectional study was conducted using secondary data from Dr. Soetomo General Hospital's inpatients with bloody diarrhea from 2013 to 2017. Gender, age, nutritional status, clinical symptoms, degree of dehydration, and laboratory results were assessed, and the data were presented in percentage (%)&#x0D; Results: Fifty-six samples were included in this study. The main demographics were male (58,9%), aged 7-24 months (44,6%), and normal nutritional status (66,1%). Meanwhile, the most notable manifestations were stool mucous (55,3%), mild to moderate degree of dehydration (60,7%), and leukocytosis (62%). Eleven patients (39,2%) had temperatures ≥380C. Leukocytes were positive in 93.7% of the stools. Furthermore, amoeba was found in 46,8% of samples. The serum electrolyte result showed hyponatremia (18%) and hypokalaemia (15%).&#x0D; Conclusion: The primary demographics of bloody diarrhea in under-five children admitted to Dr. Soetomo General Hospital were males, 7-24 months of age, and with normal nutritional status. The most frequent manifestations were mucous in stool, mild to moderate dehydration, leucocytosis, as well as positive leucocytes and amoeba in the stool.

The Role of Tobacco Smoking in the Efficacy of Brief Alcohol Intervention: Results from a Randomized Controlled Trial.

This study investigated whether tobacco smoking affected outcomes of brief alcohol interventions (BAIs) in at-risk alcohol-drinking general hospital patients. Between 2011 and 2012 among patients aged 18–64 years, 961 patients were allocated to in-person counseling (PE), computer-based BAI containing computer-generated individual feedback letters (CO), and assessment only. PE and CO included contacts at baseline, 1, and 3 months. After 6, 12, 18, and 24 months, self-reported reduction of alcohol use per day was assessed as an outcome. By using latent growth curve models, self-reported smoking status, and number of cigarettes per day were tested as moderators. In PE and CO, alcohol use was reduced independently of smoking status (IRRs ≤ 0.61, ps < 0.005). At month 24, neither smoking status nor number of cigarettes per day moderated the efficacy of PE (IRR = 0.69, ps > 0.05) and CO (IRR = 0.85, ps > 0.05). Up to month 12, among persons smoking ≤ 19 cigarettes per day, the efficacy of CO increased with an increasing number of cigarettes (ps < 0.05). After 24 months, the efficacy of PE and CO that have been shown to reduce drinking did not differ by smoking status or number of cigarettes per day. Findings indicate that efficacy may differ by the number of cigarettes in the short term.

Behavioral Health Risk Factors and Motivation to Change among Cardiovascular General Hospital Patients Aged 50 to 79 Years.

Little is known about the (co-)occurrence of smoking, alcohol at-risk drinking, physical inactivity and overweight, and the motivation to change these behavioral health risk factors (HRFs) in older general hospital patients with cardiovascular disease. Between October and December 2016, all consecutively admitted patients aged 50 to 79 years were proactively recruited on 3 cardiology wards and asked to participate in a survey on HRFs and behavior change motivation. Of the eligible patients, 80.4% participated in the survey (n = 328). The mean age was 66.5 years (standard deviation 9.0), and 65.5% were male. At least 1 HRF was present in 91.8% (n = 280), at least 2 HRFs in 54.4% (n = 166), and 3 or 4 HRFs in 12.1% (n = 37) of participants. The proportion of older adults who contemplated or were changing or planning to change their behavior to meet health behavior recommendations ranged between 66.0% (smoking) and 93.2% (alcohol consumption). The results indicate a notable co-occurrence of behavioral HRFs in older patients with cardiovascular disease. The majority of older adults were at least considering changing the respective behavior. To prevent and treat diseases efficiently, hospitalization may be a suitable moment for systematic multiple HRF screening and intervention.

Magnetically controlled capsule endoscopy in one-time gastro-small intestinal joint examination: a two-centre experience

BackgroundThe lesions of certain diseases are widely distributed in both stomach and small intestine, while the step-by-step strategy of gastroscopy followed by enteroscopy can be burdensome and costly. We aimed to determine if magnetically controlled capsule endoscopy (MCE) could be used in one-time gastro-small intestine (GSI) joint examination.MethodsIn this study, data of patients in Chinese PLA General Hospital and Changhai Hospital who underwent MCE GSI examination from January 2020 to August 2021 were retrospectively analysed. The primary outcome of this study was the success rate of one-time GSI joint examination, and secondary outcomes included visualization and cleanliness of gastrointestinal tract, gastrointestinal transit times, diagnostic yield and safety of MCE examination.ResultsA total of 768 patients were included. The success rate of one-time GSI joint examination was 92.58%. There were 94.92% MCEs observed > 90% gastric mucosa in the 6 anatomic landmarks. The rate of complete small bowel examination was 97.40%. The median gastric examination time, gastric transit time and small intestine transit time were 8.18 min, 63.89 min and 4.89 h, respectively. Magnetic steering of MCE significantly decreased gastric transit time (8.92 min vs. 79.68 min, P = 0.001) and increased duodenal lesion detection rate (13.47% vs. 6.26%, P = 0.001) when compared with non-magnetic steering group. Two capsules were retained and were removed by enteroscopy or spontaneously excreted.ConclusionsMCE is feasible to complete GSI joint examination and the detection of both gastric and small intestinal diseases can be achieved simultaneously.Trial registration Clinical Trial Registration ClinicalTrials.gov, ID: NCT05069233.