Bed blockers: A study on the elderly patients in a teaching hospital in India

A cross-sectional study of in-patients over the age of 60 years was conducted at district McGann Hospital, Shimoga on patients who were classified as bed blockers. Level of dependency and cognitive function of these patients were assessed using Barthel scale and Abbreviated mental test (AMT) respectively. Median age of the study population was 67 years; majority of them were men. Most of them were admitted in the medical ward and the median time to be labeled as bed blocker was 32 days. These bed blockers were a weak group of patients with an average 3.1 pathology per case. Majority of them suffered from neurological disorders and cardiovascular disease. High level of dependence was noted with a mean Barthel score of 29.68 (Range 0 -100). Low levels of cognitive function was also noted among these patients with a mean AMT of 4.76 (Range 0 -10).These findings demonstrate that the bed blockers in McGann hospital suffer not only from genuine health problems but also have a high dependency level in activities of daily living which hamper their discharge to the community. Community based rehabilitation using an intersectoral approach may help at least the less dependent to return home

Social cases?

This was a cross-sectional descriptive study of in-patients over the age of 60 years at St. Luke's hospital who were deemed to be social cases (SC). The majority (58.4%) were female and the mean age was 80 years (range 60-92, SD: 6.7 years). Most (80%) were found in medical wards. The mean length of stay was 22.5 days (range 1-290 days, SD: 36.4 days). Social cases were a frail group with a mean number of co-morbidities of 2.8 (range 0-6, SD:1.5). Dependency level was also high with a mean Barthel score of 6.8 (range 0-20, SD: 7.4). A diagnosis of dementia was documented on the patient's medical record in only 12%. However significant low Abbreviated Mental Test scores were found in 64% (mean AMT 5.0, range 0-9, SD: 2.8). These findings illustrate that most social cases at St. Luke's Hospital are not only there for `social' reasons but also have other factors involved, including a high dependency level in activities of daily living which hamper their discharge to the community. Rehabilitation using an interdisciplinary approach may help the less dependent return to the community.peer-reviewe

Many-core applications to online track reconstruction in HEP experiments

Interest in parallel architectures applied to real time selections is growing in High Energy Physics (HEP) experiments. In this paper we describe performance measurements of Graphic Processing Units (GPUs) and Intel Many Integrated Core architecture (MIC) when applied to a typical HEP online task: the selection of events based on the trajectories of charged particles. We use as benchmark a scaled-up version of the algorithm used at CDF experiment at Tevatron for online track reconstruction - the SVT algorithm - as a realistic test-case for low-latency trigger systems using new computing architectures for LHC experiment. We examine the complexity/performance trade-off in porting existing serial algorithms to many-core devices. Measurements of both data processing and data transfer latency are shown, considering different I/O strategies to/from the parallel devices.Comment: Proceedings for the 20th International Conference on Computing in High Energy and Nuclear Physics (CHEP); missing acks adde

Mean temperature and humidity variations, along with patient age, predict the number of visits for renal colic in a large urban Emergency Department: Results of a 9-year survey

Background: A marked geographic variability has been reported in stone disease, partially attributed to the Mean Annual Temperature (MAT), as well as to the seasonal fluctuations of climatic conditions. Accordingly, peaks in Emergency Department (ED) visits for renal colic are commonplace during the summer. Materials and methods: The aim of this study was to assess the influence of day-by-day climate changes on the number of visits as a result of renal colic in the ED (City of Parma, northern Italy, temperate continental climate). A total of 10,802 colic episodes were retrieved from the database during a period of 3286 days (January 2002 to December 2010). Results: The analysis of the data confirms a peak of renal colic cases during the summer, especially in July (maximum number of 4.1 cases of renal colic per day), and a winter nadir (minimum number of 2.7 cases of renal colic per day, in February). The linear regression analysis shows a high and significant correlation between the mean number of cases of renal colic per day and both the mean daily temperature (positive association, R = 0.93; p 70 years of age. Conclusion: The combined data suggest that the hot and dry climate would favor an acceleration of the process of stone formation, which seems more pronounced in the older population

A Specific Urinary Amino Acid Profile Characterizes People with Kidney Stones

Background. Urolithiasis is the process of stone formation in the urinary tract. Its etiology is only partly known, and efficient therapeutic approaches are currently lacking. Metabolomics is increasingly used in biomarkers discovery for its ability to identify mediators of relevant (patho)physiological processes. Amino acids may be involved in kidney stone formation. The aim of the present study was to investigate the presence of an amino acid signature in stone former urine through a targeted metabolomic approach. Methods. A panel of 35 amino acids and derivatives was assessed in urines from 15 stone former patients and 12 healthy subjects by UPLC-MS. Partial Least Squares Discriminant Analysis (PLS-DA) was used to define amino acid profiles of cases and controls. Results and Discussion. Our approach led to the definition of a specific amino acid fingerprint in people with kidney stones. A urinary amino acid profile of stone formers was characterized by lower levels of \u3b1-aminobutyric acid, asparagine, ethanolamine, isoleucine, methionine, phenylalanine, serine, tryptophan, and valine. Metabolomic analysis may lend insights into the pathophysiology of urolithiasis and allow tracking this prevalent condition over time

Recurrent pain in a child with cerebral palsy: Answers

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Metabolic Evaluation in Pediatric Urolithiasis: Our Experience

Introduction: Pediatric urolithiasis is a morbid condition that is often associated with underlying metabolic disorders. It is essential to diagnose and manage the underlying metabolic disorder along with management of urolithiasis to prevent stone recurrence and decrease the morbidity.Materials and Methods: This retrospective observational study was conducted in 50 patients below 15 years of age with urolithiasis. Urine collection was done for 24 hours in toilet-trained children and spot samples were taken from younger children. The urinary parameters that were evaluated included calcium, oxalate, citrate, uric acid, and total urine volume. The serum levels of calcium, phosphorus, creatinine, uric acid, electrolytes, parathormone, and albumin were also measured. Stone analysis was done whenever possible.Results: There were 32 males and 18 females. Sixty-two percent of the patients had a low calcium intake and 70% of the children had a history of low water intake and had a low urine volume over 24 hours. Half of the children had serum metabolic abnormalities, including hypocalcaemia (n=19,38%), hypocalcaemia with hyperphosphatemia (n=2, 4%), hypercalcemia (n=2, 4%), and hyperuricemia (n=2,4%). Urinary abnormalities were detected in 42% of the children (n=21). These abnormalities included hypocitraturia in 11 patients (50%), hypercalciuria in 7 patients (30%), hyperoxaluria in 1 patient (6%), and hyperuricosuria in 2 patients (12%). Stone analysis was done in 18 patients. Fifteen patients (30%) had calcium oxalate stones, two patients (4%) had uric acid stones, and one patient had a mixed stone.Conclusions: It is important to maintain an optimal blood calcium level and increase fluid intake to prevent stone formation in children.Keywords: Urolithiasis; Pediatric; Metabolic Disorders

Overweight and Obesity: Risk Factors in Calcium Oxalate Stone Disease?

Introduction. Several studies showed an association of overweight and obesity with calcium oxalate stone disease (CaOx). However, there are no sufficient data on the influence of body weight on the course of the disease and the recurrence rate. Patients and Methods. N = 100 consecutive stone formers with pure CaOx were studied. Different parameters were investigated. According to the BMI, patients were divided into three groups: (1) BMI ≤ 25; (2) BMI 25.1–30; (3) BMI > 30. Results. N = 32 patients showed a BMI ≤ 25, n = 42 patients showed a BMI of 25.1–30 and n = 26 patients showed a BMI ≥ 30. The groups differed significantly concerning BMI (by definition), urine pH, and urine citrate. The recurrence rate was not significantly different. Discussion. Our study demonstrated that body weight negatively influences single risk factors in CaOx, but obesity is not a predictor for the risk of recurrence in CaOx