The learning of trichogram and assesment of trichogram results among healthy volunteers

Aim. To evaluate the effectiveness of microscopic (Trichogram) learning course and reliability assessment among healthy volunteer students (VS). Objectives. 1. To evaluate effectiveness of prepared Trichogram learning course among VS. 2. To assess hair growth’s phase distribution on the strength of Trichogram results among VS. 3. To compare Trichogram’s assessment of congruence according to experience of the assessors. Methods. A cross-sectional study was preformed from February of 2015 till February of 2016. 21 VS of Medicine faculty, Medical academy of Lithuanian University of Health Sciences (LUHS MA MF) and one experienced investigator (IE) of Dermatovenerology resident doctor who acquired Trichology course participated in the study. After literature review the Basic Trichology Learning Material (BTLM) was prepared which VS learned and preformed it to each other. On the next stage the Trichogram knowledge of VS was evaluated by test. Afterwards VS analysed Trichogram pictures and prepared digital Phototrichogram which was assessed by IE to match results of VS. Results. Using BTLM two thirds of VS gained good enough knowledge to perform Trichogram successfully. Less than half of VS had slightly lower number of hair in anagen phase, two thirds – excessive number in catogen phase. Normal anagen and telogen parameters value ratio according to the 1st and 2nd assessors were just for 8 VS, while for 13 VS – abnormal. Only 3 investigatives had normal trichogram parameter values. Most results of VS and IE had similar values analyzing dystrophic, damaged hair. However the results didn’t match measuring hair of anagen phase. Conclusions. The prepared BTLM is effective because for two thirds of VS gained good knowledge and skills that require to perform Trichogram. We found aberrant Trichogram parameters comparing to normal value for the bulk of VS. As a result, we have to pay more attention to the skin and hair timely care and information measures. The most assessment values of EI and VS coincided. However it takes 5 times longer for VS to perform and assess Trichogram comparing to EI. Moreover, VS assess more of dystrophic hair and less hair of anagen and catogen phase. To sum up, only a well-trained medical personnel can assess and perform Trichogram properly

Student‘s health literacy – a well-balanced lifestyle

Tyrimo tikslas – įvertinti studentų sveikatos raštingumo žinias. Tyrimo metodika. Momentinis prospektyvusis tyrimas atliktas anketinės apklausos metodu. 2016 m. vasario – balandžio mėn. apklausti 382 LSMU ir VDU studentai. Apklausai naudotas klausimynas sudarytas SMLPC. Statistinių duomenų analizė aplikta SPSS 21.0 programa. Vidurkių reikšmės pateiktos procentais. Duomenys statistiškai reikšmingi, kai p<0,05. Rezultatai. Pagrindiniai studentų sveikatos informacijos šaltiniai: internetas (84,6 proc.), gydytojai (72,3 proc.), spauda (49 proc.). 68,3 proc. respondentų paprasta suprasti televizijos ir radijo sveikatos laidas, kartais sudėtinga – 16,2 proc. 72,3 proc. respondentų paprasta suprasti sveikatos priežiūros įstaigų platinamus leidinius, kartais sudėtinga – 24,1 proc. 74,9 proc. studentų supranta vaistų vartojimo instrukcijas. 66,5 proc. studentų nesudėtinga pildyti medicininius dokumentus. Gauta informacija apie sveikatą teigiamai paveikė pusę respondentų: pradėjo profilaktiškai lankytis pas gydytojus, sportuoti, sveikiau maitintis. 46,9 proc. studentų pas šeimos medicinos gydytoją lankosi vieną kartą per metus. Išvados. Studentų pagrindinis informacijos šaltinis apie sveikatą – internetas. Daugiau nei pusė respondentų lengvai supranta televizijos ir radijo laidų transliuojamą informaciją, sveikatos priežiūros įstaigų platinamus leidinius, vaistų vartojimo instrukcijas, sveikatos priežiūros specialistų patarimus sveikatos tema. Dalis studentų, kurie nesupranta televizijoje ir radijo laidose, sveikatos informaciniuose leidiniuose pateikiamos sveikatos priežiūros informacijos, pažymi, kad nesupranta pateikiamo turinio. Pusė respondentų nurodė, kad gauta sveikatos informacija teigiamai paveikė jų sveikatą. Dauguma studentų savo sveikatą įvertino kaip gerąThe aim of the study. To assess health literacy of the students of Vytautas Magnus university and Lithuanian Health Sciences university. The methods of the study. A prospective cross–sectional study was performed using anonymous questionnaire provided by center for health education and disease prevention of Health ministry of Lithuania. From February till April of 2016 a total of 382 questionnaires were answered of the students of Vytautas Magnus University and Lithuanian Health Sciences University. Descriptive and comparative statistical data analysis was processed with SPSS 21.0. The mean values were given in proportions (percentage, %). Results with values of p < 0.05 were considered statistically significant. The results of the study. The main sources of health information for students are – internet (84.6%), doctors (72.3%) and media (49%). More than two–third of the respondents (68.3%) stated that they understand television and radio shows about health easily while for 16.2% of the students sometimes it is difficult. Nearly three–quarters of respondents (72.3%) read and understand booklets and journals published by health care institutions simple, however for one quarter it is difficult. Three–quarters of students (74.9%) claimed to understand instruction of medications. In addition to this, two–third of respondents (66.5%) can fill medical documents without any difficulties. The information about health care and a well-balanced lifestyle impacted positively half of the respondents. These students started to visit their family doctors for prophylactic reasons, to have more physical activity and eat more healthy food. Almost half of students (46.9%) visit family doctor once a year. Conclusions. The main source of health care information is internet. [...]Lietuvos sveikatos mokslų universitetas. Medicinos akademijaSporto centrasVytauto Didžiojo universiteta

Student‘s health literacy – a well-balanced lifestyle

The aim of the study. To assess health literacy of the students of Vytautas Magnus university and Lithuanian Health Sciences university. The methods of the study. A prospective cross–sectional study was performed using anonymous questionnaire provided by center for health education and disease prevention of Health ministry of Lithuania. From February till April of 2016 a total of 382 questionnaires were answered of the students of Vytautas Magnus University and Lithuanian Health Sciences University. Descriptive and comparative statistical data analysis was processed with SPSS 21.0. The mean values were given in proportions (percentage, %). Results with values of p &lt; 0.05 were considered statistically significant. The results of the study. The main sources of health information for students are – internet (84.6%), doctors (72.3%) and media (49%). More than two–third of the respondents (68.3%) stated that they understand television and radio shows about health easily while for 16.2% of the students sometimes it is difficult. Nearly three–quarters of respondents (72.3%) read and understand booklets and journals published by health care institutions simple, however for one quarter it is difficult. Three–quarters of students (74.9%) claimed to understand instruction of medications. In addition to this, two–third of respondents (66.5%) can fill medical documents without any difficulties. The information about health care and a well-balanced lifestyle impacted positively half of the respondents. These students started to visit their family doctors for prophylactic reasons, to have more physical activity and eat more healthy food. Almost half of students (46.9%) visit family doctor once a year. Conclusions. The main source of health care information is internet. [...].Tyrimo tikslas – įvertinti studentų sveikatos raštingumo žinias. Tyrimo metodika. Momentinis prospektyvusis tyrimas atliktas anketinės apklausos metodu. 2016 m. vasario – balandžio mėn. apklausti 382 LSMU ir VDU studentai. Apklausai naudotas klausimynas sudarytas SMLPC. Statistinių duomenų analizė aplikta SPSS 21.0 programa. Vidurkių reikšmės pateiktos procentais. Duomenys statistiškai reikšmingi, kai p&lt;0,05. Rezultatai. Pagrindiniai studentų sveikatos informacijos šaltiniai: internetas (84,6 proc.), gydytojai (72,3 proc.), spauda (49 proc.). 68,3 proc. respondentų paprasta suprasti televizijos ir radijo sveikatos laidas, kartais sudėtinga – 16,2 proc. 72,3 proc. respondentų paprasta suprasti sveikatos priežiūros įstaigų platinamus leidinius, kartais sudėtinga – 24,1 proc. 74,9 proc. studentų supranta vaistų vartojimo instrukcijas. 66,5 proc. studentų nesudėtinga pildyti medicininius dokumentus. Gauta informacija apie sveikatą teigiamai paveikė pusę respondentų: pradėjo profilaktiškai lankytis pas gydytojus, sportuoti, sveikiau maitintis. 46,9 proc. studentų pas šeimos medicinos gydytoją lankosi vieną kartą per metus. Išvados. Studentų pagrindinis informacijos šaltinis apie sveikatą – internetas. Daugiau nei pusė respondentų lengvai supranta televizijos ir radijo laidų transliuojamą informaciją, sveikatos priežiūros įstaigų platinamus leidinius, vaistų vartojimo instrukcijas, sveikatos priežiūros specialistų patarimus sveikatos tema. Dalis studentų, kurie nesupranta televizijoje ir radijo laidose, sveikatos informaciniuose leidiniuose pateikiamos sveikatos priežiūros informacijos, pažymi, kad nesupranta pateikiamo turinio. Pusė respondentų nurodė, kad gauta sveikatos informacija teigiamai paveikė jų sveikatą. Dauguma studentų savo sveikatą įvertino kaip gerą.Studentų reikalų departamentas / Student Affairs DepartmentSporto centras / Sports CentreVytauto Didžiojo universitetas / Vytautas Magnus Universit

Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.Peer reviewe

Exploring the cost-effectiveness of high versus low perioperative fraction of inspired oxygen in the prevention of surgical site infections among abdominal surgery patients in three low- and middle-income countries

Background: This study assessed the potential cost-effectiveness of high (80–100%) vs low (21–35%) fraction of inspired oxygen (FiO2) at preventing surgical site infections (SSIs) after abdominal surgery in Nigeria, India, and South Africa. Methods: Decision-analytic models were constructed using best available evidence sourced from unbundled data of an ongoing pilot trial assessing the effectiveness of high FiO2, published literature, and a cost survey in Nigeria, India, and South Africa. Effectiveness was measured as percentage of SSIs at 30 days after surgery, a healthcare perspective was adopted, and costs were reported in US dollars ($). Results: High FiO2 may be cost-effective (cheaper and effective). In Nigeria, the average cost for high FiO2 was$216 compared with $222 for low FiO2 leading to a −$6 (95% confidence interval [CI]: −$13 to −$1) difference in costs. In India, the average cost for high FiO2 was $184 compared with$195 for low FiO2 leading to a −$11 (95$15 to −$6) difference in costs. In South Africa, the average cost for high FiO2 was$1164 compared with $1257 for low FiO2 leading to a −$93 (95% CI: −$132 to −$65) difference in costs. The high FiO2 arm had few SSIs, 7.33% compared with 8.38% for low FiO2, leading to a −1.05 (95% CI: −1.14 to −0.90) percentage point reduction in SSIs. Conclusion: High FiO2 could be cost-effective at preventing SSIs in the three countries but further data from large clinical trials are required to confirm this

Use of Telemedicine for Post-discharge Assessment of the Surgical Wound: International Cohort Study, and Systematic Review with Meta-analysis

Objective: This study aimed to determine whether remote wound reviews using telemedicine can be safely upscaled, and if standardised assessment tools are needed. Summary background data: Surgical site infection is the most common complication of surgery worldwide, and frequently occurs after hospital discharge. Evidence to support implementation of telemedicine during postoperative recovery will be an essential component of pandemic recovery. Methods: The primary outcome of this study was surgical site infection reported up to 30-days after surgery (SSI), comparing rates reported using telemedicine (telephone and/or video assessment) to those with in-person review. The first part of this study analysed primary data from an international cohort study of adult patients undergoing abdominal surgery who were discharged from hospital before 30-days after surgery. The second part combined this data with the results of a systematic review to perform a meta-analysis of all available data conducted in accordance with PRIMSA guidelines (PROSPERO:192596). Results: The cohort study included 15,358 patients from 66 countries (8069 high, 4448 middle, 1744 low income). Of these, 6907 (45.0%) were followed up using telemedicine. The SSI rate reported using telemedicine was slightly lower than with in-person follow-up (13.4% vs. 11.1%, P&lt;0.001), which persisted after risk adjustment in a mixed-effects model (adjusted odds ratio: 0.73, 95% confidence interval 0.63-0.84, P&lt;0.001). This association was consistent across sensitivity and subgroup analyses, including a propensity-score matched model. In nine eligible non-randomised studies identified, a pooled mean of 64% of patients underwent telemedicine follow-up. Upon meta-analysis, the SSI rate reported was lower with telemedicine (odds ratio: 0.67, 0.47-0.94) than in-person (reference) follow-up (I2=0.45, P=0.12), although there a high risk of bias in included studies. Conclusions: Use of telemedicine to assess the surgical wound post-discharge is feasible, but risks underreporting of SSI. Standardised tools for remote assessment of SSI must be evaluated and adopted as telemedicine is upscaled globally

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58\ub75%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31\ub72%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10\ub72%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12\ub73%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9\ub74%] of 7339 patients), middle (549 [14\ub70%] of 3918 patients), and low (298 [23\ub72%] of 1282) HDI (p&lt;0\ub7001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17\ub78%] of 574 patients in high-HDI countries; 74 [31\ub74%] of 236 patients in middle-HDI countries; 72 [39\ub78%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1\ub760, 95% credible interval 1\ub705\u20132\ub737; p=0\ub7030). 132 (21\ub76%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16\ub76%) of 295 patients in high-HDI countries, in 37 (19\ub78%) of 187 patients in middle-HDI countries, and in 46 (35\ub79%) of 128 patients in low-HDI countries (p&lt;0\ub7001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication. Funding: DFID-MRC-Wellcome Trust Joint Global Health Trial Development Grant, National Institute of Health Research Global Health Research Unit Grant