Quality Of Treatment For Patients Research Articles

Development of a new 3-dimensional scintillating detector for patient treatment quality control in pencil beam scanning proton therapy

Development of a new 3-dimensional scintillating detector for patient treatment quality control in pencil beam scanning proton therapy

The National German Transplantation Certification : Interdisciplinary and innovative

The interdisciplinary additional advanced training in transplantation medicine (ZWB) has been passed with the (Model) Advanced Training Regulation 2018 and is now implemented in all federal states. It includes joint interdisciplinary contents that must be mastered by all disciplines and special skills that are specific to the individual disciplines. An organ-specific training is also possible. With its interdisciplinary approach the ZWB transplantation certification is pioneering the structure of modern transplantation centers and will thus further improve the quality of treatment for patients on the waiting lists for organ transplantation and for patients with transplanted organs.

Disease Prevalence Estimation

Nowadays, disease prevalence estimation is a significant concern, with heart disease being one of the most common ailments. Unfortunately, the treatment of such diseases can be costly, often beyond the means of the average individual. However, we can mitigate this issue to some extent by accurately estimating disease prevalence before it reaches dangerous levels, using techniques such as Machine Learning and Data Mining. In the healthcare biomedical field, there's a vast amount of health data available, ranging from text to images. However, much of this data remains unexplored and unmined. Introducing a Disease Prevalence Estimation System could address this gap. Such a system would not only help in reducing costs but also enhance the quality of treatment for patients. Machine Learning and Data Mining techniques can be employed to construct this Disease Prevalence Estimation System. By analyzing patient profiles including factors like blood pressure, age, sex, cholesterol, and blood sugar levels, the system can predict the likelihood of individuals developing various health issues. Furthermore, the system can identify complex problems and make intelligent medical decisions, thereby improving overall healthcare outcomes. Performance evaluation can be done using metrics such as the confusion matrix, allowing for the calculation of accuracy, precision, and recall. In conclusion, a Disease Prevalence Estimation System has the potential to offer high performance and better accuracy, thus significantly contributing to the early detection and management of various diseases

3D Printing – A Revolution in Modern Healthcare: Recent Achievements & Challenges

Abstract: The pharmaceutical industry grows every year keeping public health as a priority, protection, and economic development. The industry is mostly concentrated on the novel drug development process as well as new methods that can help improve the recovery rate of a condition and improve the quality of patient treatment. Pharmaceutical companies have recently experimented with producing medications using 3D printing to increase their quality and improve user health. Later, in 2015, the companies found success by producing the 3D-printed medication Spritam, which had already received US FDA approval. Over the past few years, the medical device industry has adapted to 3D printing technology and creative companies have used it to produce goods with distinctive content, appearance, and customizability. However, these distinctive capabilities of 3D printing have brought forth new legal difficulties and troubling issues with the regulatory agencies' acceptance of these devices. Customizability and distinctive construction procedures of medical devices printed via 3D printing techniques have difficulties in attaining quality assurance and regulatory criteria for manufacturing. Advancement in 3D printing technology has helped in the production of various innovative medical products along with new structures and constituents. The present review discusses distinctive regulatory problems faced by the USFDA as well as by other regulatory authorities in the case of approval of 3D printing products and measures required to develop regulations for the safety, quality, and effectiveness of 3D printing Devices.

Assessing the Impact of Percutaneous Nephrostomy Presence on Neoadjuvant Treatment Quality in Patients With Muscle Invasive Bladder Cancer

IntroductionSymptomatic hydronephrosis associated with muscle invasive bladder cancer (MIBC) necessitates percutaneous nephrostomy (PCN) insertion before neoadjuvant chemotherapy (NAC). This study assesses the impact of PCN presence on standard intended NAC quality, its related complications and outcome after radical cystectomy (RC). Materials and MethodsThe study comprises a retrospective, multicenter cohort of 193 consecutive RCs performed between 2016 and 2019. Eighty (42%) of these patients received NAC and were divided in 2 comparison groups by presence (n = 26; 33%) or absence (n = 54; 67%) of PCN. Endpoints included completion of adequate NAC treatment (cisplatin-based chemotherapy for at least 4 courses), complications during NAC, post-RC complications and hospital stay. ResultsOverall, patients with PCN (45/193; 23%) featured a higher referral rate to NAC (58% vs. 36%, P = .01), worse glomerular filtration rates (P < .001) and more adverse events (P = .04), in comparison to non-PCN patients. In the NAC cohort, PCN patients had less adequate treatment rates (54% vs. 85%, P = .005), and more infections (35% vs, 7%; P = .008) and hospitalizations (58% vs. 13%; P < .001) during chemotherapy. Post-RC outcome was similar for both comparison groups. PCN was an independent risk factor for inadequate NAC (OR = 3.9, P = .04), and infections (OR = 11.3, P = .01) and hospitalizations (OR = 7.5, P = .004) during NAC. ConclusionsPCN in MIBC patients is a significant risk factor for inadequate NAC and adverse events during treatment. This finding may quire the rationale of NAC, potentially leading to consideration of NAC avoidance and upfront RC in PCN patients. Further survival studies with long follow-up are needed for elucidating this issue.

Dementia prevalence among hospitalized older patients: a multicenter study in Iran.

To evaluate the prevalence of dementia and its associated risk factors among older patients admitted to hospitals. The study included older patients (≥ 60 years) admitted to medical departments of a general hospital in three major Iranian cities. Researchers utilized the Activities of Daily Living-Instrumental Activities of Daily Living (ADL-IADL) scale, the Geriatric Depression Scale (GDS), the Mini-Cog test, the 4 A's test (4AT), and the Abbreviated Mental Test Score (AMTS). Among the 420 recruited older inpatients, 228 (54.3%) were female. The mean age of participants was 71.39 years (standard deviation ±7.95), with 30.7% diagnosed with major neurocognitive disorder (dementia). The likelihood of dementia exhibited statistically significant correlations with gender, age, number of children, and occupation. Screening older individuals for cognitive impairment upon hospital admission holds the potential to prevent adverse outcomes and enhance the quality of treatment for patients concurrently dealing with dementia.

Psychometric Proprieties of the Arabic Version of the Perceived Preoperative Nursing Care Competence Scale for Nursing Students (PPreCC-NS)

Background: Enhancing the quality of patient treatment and safety relies heavily on nursing students’ preoperative competence, making it an essential component of their education. The Perceived Preoperative Nursing Care Competence Scale for Nursing Students (PPreCC-NS) has been created in English to assess the preoperative competence of nursing students. Hence, translation and evaluation of the psychometric proprieties of the PPreCC-NS scale in the Arabic context are pivotal. Purpose: To examine the psychometric proprieties of the Arabic version of the Perceived Preoperative Nursing Care Competence Scale for Nursing Students (PPreCC-NS). Methods: A descriptive, crosssectional study was carried out on 202 nursing students using an online questionnaire. The students’ selection was based on the probability simple random sampling technique. The international guidelines were followed in the translation of the PPreCC-NS. The psychometric proprieties and internal consistency were assessed using exploratory factor analysis and reliability tests. Results: Five factors were extracted by the exploratory factor analysis, with 22 final items. The obtained factor structure explained 62.71% of the variance. The Cronbach's alpha coefficients for the five domains ranged between 0.70 and 0.85, whereas the overall Cronbach's alpha coefficient for the scale was greater than 0.7. Conclusion: The translated questionnaire demonstrated valid and reliable psychometric properties when administered to nursing students. The translated preoperative nursing care competence measure for nursing students is thought to be used to assess perceived preoperative nursing students’ competence in the Arab region. Implications for Nursing: The findings could be valuable for nursing educators, nursing managers, and decisionmakers in devising efficient strategies to improve preoperative nursing care. Further research studies are essential to understand factors influencing the level of understanding among nursing students in relation to preoperative nursing care. Keywords: Preoperative care, Competence, Nursing students, Exploratory factor analysis, Psychometric proprieties.

Application of chitosan-based wound dressings in local treatment of parenchymal organ wounds: a preclinical experimental study

Background. Injuries of various origins with damage to parenchymal organs remain one of the urgent issues of emergency surgery, despite all the achievements of medical science of the first quarter of the XXI century. One way to improve the quality of treatment for patients with this pathology consists in developing new wound dressings or modifying the properties of existing ones. Hemostatic efficacy is claimed to be one of the main requirements for such dressings.Objective. To perform a comparative analysis of the efficacy of the developed biodegradable wound dressings based on chitosan in the treatment of experimental wounds of parenchymal organs.Methods. The study involved laboratory animals (male rabbits weighing 2900 ± 150 g) to form experimental wounds of parenchymatous organs. The methodology involved wounding the liver via internal method, with the creation of a tissue defect of a given volume, or forming a linear incised wound with fixed parameters followed by application of a developed wound dressing. In the control group of animals, a collagen hemostatic sponge was used as a wound dressing. The animals used in the experiment were kept in accordance with GOST 33044-2014 “Principles of good laboratory practice”. The experiment involved studying the properties of two samples of wound dressings developed on the basis of modified Chitosan Soft (Ch-S) and Chitosan Hard (Ch-H) chitosan, having different properties due to their different structural parameters. The applied ultrasound control of the experimental wound area, with visualization of the samples of the investigated material in the process of biodegradation, enabled the features of the wound process to be studied in more detail. Statistical processing of the study results was carried out by methods of variational statistics, including the calculation of mean values (M), standard errors of mean values (± m). The criterion of the level of statistical significance considered a value of p &lt;0.05. Histomorphological examination of samples was carried out using classical methods.Results. An experimental study conducted on laboratory animals in the treatment of liver wounds, followed by a comprehensive assessment of the results obtained, revealed high efficacy in the developed wound dressings in comparison with the control. The following parameters predicted in the development of wound dressing samples were confirmed: stable hemostatic and scaffold functions, biodegradability, adhesiveness and stimulating effect on bioreparative processes in the wound area. In addition, the ultrasound control algorithm in vivo was adapted in animals to assess the dynamics of the wound process and biodegradation of the studied wound dressings in wounds of parenchymal organs in the experiment, previously used in studying the dynamics of the wound process in soft tissues.Conclusion. The developed samples of chitosan-based wound dressings proved their efficacy in an experimental model of the wound process in parenchymal organs. The applied ultrasonic method for monitoring the biodegradation of the studied wound dressing, as well as the dynamics of the wound process in the liver tissue, revealed the correspondence between the visualized image and the histomorphological picture of the studied tissues, the structure and properties of the wound dressing.

809 Direct Referral Pilot- Speech and Language Therapy-ENT, Ninewells Hospital

Abstract Aim Ear, nose, and throat (ENT) specialists and speech and language therapists (SALT) work very closely together in management of speech and language disorders. Here at Ninewells Hospital, we have created a pilot project for a direct referral system, where voice referrals which have been vetted are referred directly to SALT, in which patients receive the necessary treatments and are then referred to ENT specialists if required. Method This is a retrospective audit. Patients who were referred directly to SALT were included in this study. A questionnaire was developed to assess patient’s satisfaction with this pathway via telephone. Five questions were asked about their satisfaction with different aspects of this study, including waiting times, concerns addressed, provided with clear explanations, patient involved in plans and overall satisfaction with ratings of between very good, good, fair, poor, very poor and prefer not to answer. Results 41 responses were obtained, out of 67 patients included in this study. Majority of patients responded with very good and good in all aspects of the questionnaire 48.8% had a very good overall satisfaction from this project. 29.3% had a good outcome and 4.9% responded with fair and poor respectively. Conclusions This study highlights that SALT play a significant role in not only improving quality of treatment for patients but also the quality of streamlining to specialist care as and when needed. More work is required to look into this pathway further and to assess its feasibility for implementation in the future and in other hospitals across the UK.

Education and Training in Addiction Medicine and Psychology across Europe: A EUFAS Survey

Introduction: Training in addiction medicine and addiction psychology is essential to ensure the quality of treatment for patients with substance use disorders. Some earlier research has shown varying training between countries, but no comprehensive study of addiction training across Europe has been performed. The present study by the European Federation for Addiction Societies (EUFAS) aimed to fill this gap. Methods: A Delphi process was used to develop a questionnaire on specialist training in addiction treatment in 24 European countries. The final questionnaire consisted of 14 questions on either addiction medicine or addiction psychology, covering the nature and content of the training and institutional approval, the number of academic professorial positions, and the estimated number of specialists in each country. Results: Information was not received from all countries, but six (Belgium, Denmark, Ireland, Italy, Poland, and Romania) reported no specialized addiction medicine training, while 17 countries did. Seven countries (Belgium, France, Ireland, Italy, Russia, Switzerland, and the Netherlands) reported no specialized addiction psychology training, while 14 countries did. Training content and evaluation methods varied. Approval was given either by governments, universities, or professional societies. Eighteen countries reported having professorships in addiction medicine and 12 in addiction psychology. The number of specialists in addiction medicine or psychology varied considerably across the countries. Discussion: The survey revealed a large heterogeneity in training in addiction medicine and addiction psychology across Europe. Several countries lacked formal training, and where formal training was present, there was a large variation in the length of the training. Harmonization of training, as is currently the case for other medical and psychology specializations, is warranted to ensure optimal treatment for this under-served patient group.

Evaluation of morphological changes based on cone beam CT for adaptive radiotherapy

BackgroundDuring radiotherapy treatment, morphological changes can occur in patients (as weight loss). This can lead to significant dosimetric consequences on target volumes and/or organs at risk. The process of adaptive radiotherapy can compensate for these variations. Its deployment in the clinic is slowed by the considerable additional workload for the medical teams. The need for a tool facilitating the detection of patients whose treatment plans need adaptation has been clearly expressed in clinical practice, hence the usefulness of studying the impact of these morphological changes before the decision of adaptive radiotherapy. MethodsWe considered the cases of 26 patients treated for pelvic cancer where CBCT (Cone Beam Computed Tomography) repositioning images were used. These images have undergone pre-processing to improve their quality and obtain a more precise registration using seven algorithms. We compared the results obtained in order to choose the most adequate algorithm allowing the calculation of external morphological differences using similarity metrics, such as DSC, NCC, MI and TC. ResultsIn this study, we showed that the “rigid body” algorithm, based on the rigid registration, gives the best results. The conservation of external contours allowed quantification of the variation in the external volumes of the patients. The obtained variations were on average (6.12±1.69)% and (4.36±1.22)% for rectum and prostate cancers, respectively. ConclusionMorphological changes evaluated in this study may influence the quality of patient treatment; hence the need for adaptive radiotherapy to take these variations into consideration. However, a rigorous evaluation of the dosimetric impact of these morphological variations is necessary to determine decision criteria for treatment plan adaptation.

Two-way referral cooperative hospital selection with uncertain information: A two-sided matching decision-making approach

To better rationalize the allocation of medical resources and improve the efficiency of medical resource utilization, researchers have focused on the problem of two-way referral cooperation among hospitals. The selection of an appropriate referral hospital constitutes a crucial aspect of a two-way referral system, which affects the quality of patient treatment and the financial outcome of hospital operations. Within this context, this study regards the collaborative referral hospital selection problem as a two-sided matching decision-making process. Given the hesitance and bounded rationality of decision-makers, a novel two-sided matching framework is developed that integrates hesitant fuzzy linguistic term sets and regret theory to more accurately reflect real-world conditions. Specifically, evaluation information is converted to hesitant fuzzy linguistic term sets via context-free grammar, and new utility functions are introduced to calculate the utility value, regret utility, and rejoice utility through the hesitant degree and score function. Furthermore, an optimization model for calculating the criteria weight is established based on the Euclidean distance and maximization deviation method. Ultimately, the matching satisfaction degree is determined, and a biobjective programming model that maximizes the overall matching satisfaction degree is formulated and solved. The results from experiments and analysis indicate that the proposed framework produces optimal and stable matching solutions, thereby providing a useful reference for hospitals seeking satisfactory referral partners. Moreover, this model could be extended to address large-scale two-sided matching problems or to refine the referral hospital selection problem by considering individual patient needs.

Home NIV treatment quality in patients with chronic respiratory failure having participated to the French nationwide telemonitoring experimental program (The TELVENT study)

BackgroundThe ETAPES program is a national telemedicine experiment conducted in France between 2018 and 2023 to investigate whether home non-invasive ventilation (NIV) telemonitoring improves healthcare pathways in patients with chronic respiratory failure (CRF) and impacts healthcare organization. The program provides a combination of therapeutic education and NIV telemonitoring with data processed by an algorithm generating alerts. The TELVENT study objective was to analyze the evolution of ventilation quality in patients included in the ETAPES program. MethodsMulticentric cohort study on patients undergoing long-term NIV included in the ETAPES program between September 2018 and December 2020 and who did not refuse the use of their data for this research. Data were obtained from homecare provider databases. The primary endpoint was to attain successful NIV treatment, which was determined by a combination of daily NIV usage for > 4 h per day, low leaks, and a low apnea-hypopnea index (AHI) identified by the NIV device. Respiratory disability was assessed using the DIRECT questionnaire. Results329 patients were included in the study of which 145 had COPD and 83 had started NIV and ETAPES within one-month delay. Approximately 25% of patients did not achieve the criteria for successful NIV at ETAPES entry. The proportion of patients with successful NIV treatment increased to 86.8% at six months (p = 0.003, Cochran-Armitage trend test) regardless of NIV history and continued to increase at 12 months in newly equipped NIV patients (93.8%, at month 12, p = 0.0026 for trend test). Over time, a significant increase in NIV use and compliance was observed, while AHI significantly decreased in the overall population. No significant decrease was observed for non-intentional leaks. Approximately 4.9 alerts were generated per patient per 6 months. Their number and type (low NIV use, high AHI or leaks) differed among patients based on their NIV history. Respiratory disability score decreased over time compared with baseline. ConclusionThe TELVENT study highlights the importance of remote NIV monitoring to rapidly identify patients with unsuccessful ventilation. The combination of remote monitoring and therapeutic education may improve the quality of home NIV, especially in the first months of treatment.

Use the ARIMA and EMG Models to Predict the Confirmed Cases and ICU Bed Occupancy Data of COVID-19 in Massachusetts and Compare the Accuracy of the Two Models

Beginning in 2019, COVID-19 has invaded our lives and continues until now. People are still being effort made to control the spread of the virus and treat patients. Two variables in COVID-19 data are confirmed data and ICU bed occupancy data. Collect the data, use the ARIMA model and EMG model to predict the data, and then compare it with the actual data. Through comparison, it is found that there is a small gap between the ARIMA predicted value and the actual data, which can be used to predict the data of these two variables. In the process of fighting against COVID-19, it is very important to strengthen medical service capabilities, adequate treatment resources, and strengthen the construction of ICU wards. The construction of ICU is very complicated and involves many medical equipment, including ventilator, infusion pump, electrocardiogram machine, extracorporeal membrane oxygenation machine (ECMO), oximeter and so on. Therefore, the accuracy of data prediction is very important. Sufficient ICU beds and medical resources can be prepared according to the forecast. Do a good job of safeguarding the treatment work and medical services to ensure the level and quality of patient treatment and avoid causing panic.

Knowledge graph assisted end-to-end medical dialog generation

Medical dialog systems have the potential to assist e-medicine in improving access to healthcare services, improving patient treatment quality, and lowering medical expenses. In this research, we describe a knowledge-grounded conversation generation model that demonstrates how large-scale medical information in the form of knowledge graphs can aid in language comprehension and generation in medical dialog systems. Generic responses are often produced by existing generative dialog systems, resulting in monotonous and uninteresting conversations. To solve this problem, we combine various pre-trained language models with a medical knowledge base (UMLS) to generate clinically correct and human-like medical conversations using the recently released MedDialog-EN dataset. The medical-specific knowledge graph contains broadly 3 types of medical-related information, including disease, symptom and laboratory test. We perform reasoning over the retrieved knowledge graph by reading the triples in each graph using MedFact attention, which allows us to use semantic information from the graphs for better response generation. In order to preserve medical information, we employ a policy network, which effectively injects relevant entities associated with each dialog into the response. We also study how transfer learning can significantly improve the performance by utilizing a relatively small corpus, created by extending the recently released CovidDialog dataset, containing the dialogs for diseases that are symptoms of Covid-19. Empirical results on the MedDialog corpus and the extended CovidDialog dataset demonstrate that our proposed model significantly outperforms the state-of-the-art methods in terms of both automatic evaluation and human judgment.

Assessment of orthopedic treatment quality in patients with complete absence of teeth

Objective. To evaluate the effectiveness of dental orthopedic treatment in patients with complete absence of teeth using removable plate prostheses applying integral qualitative and evaluative indicators. The relevance of the study is dictated by the need to improve the quality of orthopedic treatment in patients with complete absence of teeth, through the introduction of new composite materials, the use of which provides high strength of prosthetic structures. For an objective assessment of the effectiveness of dental orthopedic treatment of patients using removable plate prostheses, integral approaches based on the calculation of qualitative and evaluative indicators have been modified.&#x0D; Materials and methods. In order to improve the quality of orthopedic treatment of patients with complete absence of teeth, a design of a complete removable plate prosthesis with a combined basis and a method of its manufacture based on the use of digital technologies was developed. In the course of the work, the evaluation of the effectiveness of treatment in patients with complete absence of teeth in the long-term follow-up using integral qualitative and evaluative indicators was carried out.&#x0D; Results. Clinical and laboratory stages of manufacturing a new design combining analog and digital metols were developed and tested. As a result of clinical studies, it was found that the type of construction of a complete removable plate prosthesis does not significantly affect the indicator of the integral assessment of the quality of orthopedic treatment, with the exception of the criterion of the prosthesis integrity.&#x0D; Conclusions. To conclude, it was found that the type of construction of a complete removable plate prosthesis does not significantly affect the integral assessment of the quality of orthopedic treatment, except for the criterion of the integrity of the prosthesis; the introduction of a composite material based on fiberglass into the design of a combined prosthesis allows to improve the strength properties of the prosthesis basis and increase the performance characteristics of the structure. The use of CAD / CAM technologies provides the possibility of using high-strength composite materials, gives sufficient accuracy in the manufacture of the frame of a combined full removable plate prosthesis. Due to satisfactory physical and mechanical properties, the application of the developed design contributes to the predicted increase in the durability of prostheses.

Experience of remote monitoring of treatment quality in patients with arterial hypertension during the current pandemic period

Objective. To conduct a retrospective assessment of the dynamics of blood pressure (BP), the quality of antihypertensive therapy and the frequency of contacts with doctors in conditions of pandemic among patients with hypertension identified during a preventive examination of the population in an organized population of Baku.&#x0D; Materials and methods. Two groups of patients were studied: group 1 patients with hypertension who were aware of their disease before the start of the preventive examination; group 2 patients who were diagnosed hypertension for the first time during the preventive examination. The results of the survey of these patients according to the questionnaire by means of telephone contacts, which includes questions regarding the control of blood pressure (BP), taking antihypertensive drugs, frequency of visiting doctors for 2 years after the initial preventive examination were studied.&#x0D; Results. The results, obtained in group 1, indicate that taking antihypertensive drugs without periodic medical control over the effectiveness of therapy in most cases does not allow achieving the target values of blood pressure. The results, obtained in group 2, demonstrate poor adherence of patients to medical recommendations and justify the need to create a system of active detection and monitoring of persons with hypertension, who do not know about their disease.&#x0D; Conclusions. It is necessary to create such a system of remote monitoring of newly identified and registered patients with hypertension, which based on modern technological advances, would allow patients to contact doctors (including remote ones) with a calculated frequency, and thus would ensure regular monitoring of the quality of treatment and adherence to recommendations regarding the treatment and prevention of cardiovascular diseases.

To Determine the Effect of Prothrombin Time (PT), Activated Partial Thrombopalstin Time (APTT), and International Normalized Ratio (INR) Levels on Gender and Age

Background: Hepatic function, coagulation disorders, and the risk of postoperative bleeding can all be detected with PT assay. When it comes to measuring "extrinsic route" coagulation factors, the PT is the most commonly used test. It is possible to check for a lack of intrinsic or common route factors by measuring the duration to trigger partial thromboplastin (aPTT). A solution to the problem of inconsistent PT measurements among laboratories was the creation of the International Normalized Ratio (INR). Laboratory-specific reference intervals can have a significant impact on the quality of patient treatment by influencing clinical decision-making. Objective: The purpose of this study is to determine if gender and age affect PT, International normalised ratio (INR), and aPTT levels in people without known liver disease or anticoagulant therapy. Method: Between July and December of 2021, patients without a past history of bleeding were admitted to the LUMHS Hyderabad civil hospital for minor surgical procedures (inguinal/umbilical hernia repair, caesarean section, rectal polyp excision, and diagnostic cystoscopy). There were 2274 patients in all, with 766 males and 1508 females. According to their chronological age, patients were separated into three groups. The study sampled 268 men and 22 women aged 0-14, 222 men and 1335 women aged 15-50, and 151 women and 276 men in the third age range (over the age of 50 year). Systemex CA-500 auto analyzer was used to conduct the analyses. Results: Males and females have considerably different PT and INR values. Men and women between the ages of 15 and 50 were more likely to have increased PT, INR, and aPTT readings than those between the ages of 0 and 14. Males and females between the ages of zero and fourteen had the lowest aPTT levels. Between the ages of 15 and 50, women and men had higher PT, INR, and aPTT values than women and men over 50. PT, INR, and aPTT reference values based on a 95% confidence interval for men and women, as well as sexes and ages. Conclusion: In this arena, a dearth of study has established that gender and age have little effect on PT, INR, and aPTT levels. Gender and age disparities in clinically used reference ranges for PT, INR, and aPTT must be taken into account. Keywords: Prothrombin Time, INR, APTT, Outcomes

A robust localization approach for Percutaneous Nephrolithotomy (PCNL): A single-center retrospective study.

Percutaneous Nephrolithotomy (PCNL) represents the gold standard treatment method for cases with large kidney stones. As a critical step in performing PCNL, the procedure of establishing a safe and accurate nephrostomy tract will dramatically impact the treatment quality of patients with large-sized kidney stones. This work attempts to describe a new and improved process of establishing an accurate nephrostomy tract and clinically evaluate the effectiveness and safeness of this proposed methodology. This work represents a retrospective single-center study carried out between August 2013 and November 2019. The collected samples consist of 937 patients who were operated on using PCNL coupled with our proposed procedure. Briefly, a preoperative B-ultrasonography was firstly performed to decide the puncture point in a simulated surgical position where was marked with ureteral catheter segments (2-3 cm). A computed tomography (CT) scan was followed to correct the anchor points in the simulated surgical position. After this, an accurate puncture operation was performed under the real-time guidance of intraoperative B ultrasound. Examining this study, 851 subjects with renal stones and 86 subjects with ureteropelvic junction stones were included for the PCNL operation project. All samples were grouped with Guy's grading system: grade I, II, III, and IV patients there were 0.00%, 42.69%, 51.01%, and 6.30%, respectively. Among these patients, the average age was 48.49 ± 10.80 years old, with a male to female ratio of around 1.73:1. This study showed that our developed method warrants an accurate and safe PCNL operation that involves the process of establishing the nephrostomy tract. Other advantageous attributes of this new PCNL process include negligible radiation exposure, lesser complications, and low failure rates. More importantly, this new localization approach is particularly attractive for hospitals that are new to the field of adopting PCNL considering its safeness, effectiveness, and learnability.

Quality of dental treatments under intravenous sedation among patients with disability: A self-matching study

Background/purposePatients with disabilities usually have difficulties in communication and mobility, and the quality of the dental treatments are often inferior. This study uses the Taiwan National Health Insurance Database to analyze the quality of dental treatment for patients with disabilities who receive intravenous sedation (IVS). Materials and methodsThis study selected patients with disabilities who received dental treatment under IVS. Their oral cavity was divided into three major sections: anterior teeth, upper posterior teeth, and lower posterior teeth. Self-matching of the same section was conducted to observe whether operative dental treatment (OD) with or without IVS affected the occurrence of dental retreatment. This study observed the occurrence of refilling and the duration from the end of treatment until retreatment to compare treatment differences with or without IVS. ResultsAfter self-matching, this study found 158 patients who received dental treatment within the same section with and without IVS. During a follow-up period of 17 years, 75.18% of the patients who received OD treatment required refilling, 10.87% required endodontic treatment, and 5.67% required tooth extraction. After OD treatment with IVS, the risks of refilling, endodontic treatment, and tooth extraction were 0.71 (95% CI: 0.58–0.87, P < 0.001), 0.77 (95% CI: 0.48–1.23, P = 0.28), and 0.64 (95% CI: 0.32–1.27, P = 0.20), respectively. ConclusionFor patients with disabilities, OD treatment with IVS significantly reduces the risk of refilling compared with OD treatment without IVS. IVS can be ideal for people with disabilities who receive dental treatment.