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Background Many patients may be tempted to use non-pharmacological home remedies (NPHRs) to relieve various complaints. To the best of our knowledge, there is little data on the characteristics of patients using NPHRs. In this cross-sectional study carried out between March 2020 and July 2021, we examined the socio-demographic factors underlying their use in patient populations in Switzerland and France. Methods Using official registries, we randomly selected 50 primary care physicians (PCPs) in Geneva (Switzerland) and Lyon/Grenoble (France). Seven research assistants consecutively recruited patients from PCP waiting rooms (20–25 patients per practice). Patients completed a paper-based questionnaire assessing the use [yes/no] of 304 NPHRs for 79 medical conditions. The NPHR list was developed by our team with input from 97 patients. We used univariable and multivariable logistic regressions, adjusting for intra-cluster correlations, to examine associations between NPHR use and patient characteristics (gender, age, practice location, nationality, education level, and self-rated health). Results Of the 1198 eligible patients, 1012 agreed to participate (85%). Overall, 635 patients (63%) reported using at least one of the remedies tested in the study. In multivariable analysis, women (OR = 1.7 [95%CI = 1.3–2.3], P -value < 0.001), younger patients (< 40 years: OR = 2.1 [95%CI = 1.6–2.9], P -value < 0.001), and French patients (OR = 1.6 [95%CI = 1.1–2.3], P -value < 0.001) tended to use NPHRs more often than other patients. Conclusions Many patients, particularly women, young people, and French patients, reported using NPHRs. This survey's findings hold the potential to inform healthcare providers, policymakers, and researchers about the diverse preferences that shape patients' healthcare choices. [ABSTRACT FROM AUTHOR]

Abstract Background Traditional medicine (TM) is commonly used as a treatment in Indonesia. This raises the need for an analysis of its potential development and irrational use. Therefore, we analyze the proportion of TM users among chronic disease patients and its associated characteristics to optimize the use of TM in Indonesia. Methods A cross-sectional study of treated adult chronic disease patients was conducted using the fifth Indonesian Family Life Survey (IFLS-5) database. Descriptive analysis was used to identify the proportion of TM users, while a multivariate logistic regression was used to analyze their characteristics. Results This study included 4901 subjects and identified 27.1% as TM users. The highest TM use was in subjects with cancer (43.9%), liver issues (38.3%), cholesterol issues (34.3%), diabetes (33.6%), and stroke (31.7%). Characteristics associated with TM users were a perception of one's current health as unhealthy (OR 2.59, 95% CI 1.76–3.81), low medication adherence (OR 2.49, 95% CI 2.17–2.85), age above 65 years (OR 2.17, 95% CI 1.63–2.90), having higher education (OR 1.64, 95% CI 1.17–2.29), and residence outside of Java (OR 1.27, 95% CI 1.11–1.45). Conclusions Low medication adherence among TM users highlights the potentially irrational use of treatment in chronic diseases. Nevertheless, the longstanding use of TM users indicates the potential for its development. Further studies and interventions are needed to optimize TM use in Indonesia.

Background: Traditional medicine (TM) is commonly used as a treatment in Indonesia. This raises the need for an analysis of its potential development and irrational use. Therefore, we analyze the proportion of TM users among chronic disease patients and its associated characteristics to optimize the use of TM in Indonesia. Methods: A cross-sectional study of treated adult chronic disease patients was conducted using the fifth Indonesian Family Life Survey (IFLS-5) database. Descriptive analysis was used to identify the proportion of TM users, while a multivariate logistic regression was used to analyze their characteristics. Results: This study included 4901 subjects and identified 27.1% as TM users. The highest TM use was in subjects with cancer (43.9%), liver issues (38.3%), cholesterol issues (34.3%), diabetes (33.6%), and stroke (31.7%). Characteristics associated with TM users were a perception of one's current health as unhealthy (OR 2.59, 95% CI 1.76–3.81), low medication adherence (OR 2.49, 95% CI 2.17–2.85), age above 65 years (OR 2.17, 95% CI 1.63–2.90), having higher education (OR 1.64, 95% CI 1.17–2.29), and residence outside of Java (OR 1.27, 95% CI 1.11–1.45). Conclusions: Low medication adherence among TM users highlights the potentially irrational use of treatment in chronic diseases. Nevertheless, the longstanding use of TM users indicates the potential for its development. Further studies and interventions are needed to optimize TM use in Indonesia. [ABSTRACT FROM AUTHOR]

This study explored the patient characteristics and outcomes in relation to guardianship in a large-scale sub-acute Australian hospital. Fifteen patients who appointed a guardian at The Kingston Center, Monash Health, participated through exploratory data collection and analysis utilizing a de-identifiable template. The findings revealed both diverse and complex patient characteristics, and ethical dilemmas in patient outcomes for social workers. Patient outcomes post-guardianship appointment and discharge highlighted a negative impact from long length of stay and the iatrogenic impact on patient wellbeing in hospital. The study reflected a disparity between patients' discharge goals and their outcomes indicating significant ethical dilemmas and complexities for social workers in ensuring rights to autonomy and responsibility for safety are balanced. [ABSTRACT FROM AUTHOR]

Objectives: The etiology of subclavian artery stenosis can be very different, but typically the most common form is due to atherosclerotic disease. Interventional treatment is generally indicated for upper limb ischemia, vertebrobasilar symptoms, subclavian steal syndrome, and coronary steal syndrome. Endovascular stenting is preferred over surgery because of its high success rate, less invasive nature, and minimal complication rate. In this study, the characteristics of patients treated endovascularly due to subclavian artery stenosis in our center and their procedural details will be examined. Materials and Methods: We retrospectively analyzed patients with subclavian artery stenosis treated by endovascular techniques in our center between January 2019 and January 2021. Results: Twelve (80%) of 15 patients with stenotic subclavian arteries were successfully treated with endovascular techniques. In 3 patients, the procedure was terminated with failure. The mean age of the patients was 64.66 years and 3 (20%) of the patients were female. All of the patients were receiving antihypertensive treatment with the diagnosis of hypertension, and 4 (26.66%) patients had diabetes mellitus, 13 (86.66%) patients had hyperlipidemia, and 13 (86.66%) patients had coronary artery disease. In 2 patients, the lesion was diagnosed in the right subclavian artery. In 7 patients, the procedure was performed with the telescopic method from a transfemoral approach. In 5 patients, the transradial approach was used. In 3 patients, the procedure was performed directly over the transbrachial approach. Balloon expandable stent implantation was performed in 10 (66.66%) patients at the end of the procedure, and selfexpandable stent implantation was performed in 1 patient. Conclusion: In conclusion, signs and symptoms can be managed effectively with endovascular techniques in patients with significant subclavian artery disease. In this study, we shared our real-life data on subclavian artery endovascular treatment. [ABSTRACT FROM AUTHOR]

Background: The Multi Drug Resistance Tuberculosis (MDR-TB) prevalence rate is by 6900 in which there are 1.9% of new cases and 12 % of cases fail. Indonesia ranks eighth out of 27 countries in the world. This study is aimed to investigate the characteristics of the new MDR TB patient demographic data, treatment, and side effects. Method: This research was analyzed retrospective data of the Medical Record (MR). Data were analyzed qualitatively. Results: The number of new patients are 82 people consisting of 41 men and 41 women. About 35 patients came from Surabaya and 47 were from outside Surabaya. Among those, 28 patients are 51–60 years old. Patients in the intensive phase (0–8 month) were 47 patient and 35 patients were in the continue phase 9–24 month. The main cause is the highest MDR-TB relapse 33 patients. Cycloserin and ethionamide prescribed to all of the subject followed by levofloxacin which is prescribed to 68 patients. The other medication were kanamycin, capreomycon, moxifloxacin and Para Amino Salicylat (PAS) which administered to 27,14,7 patient consecutively. Nausea is the one of the Adverse Drug reaction (ADR) that is preverly emerged. There were 30 patients complary this ADR and treatment which Omeprazole and Ranitidin. Conclusion: Characteristics of patients greatly differed between patients categories. In Soetomo hospital effort should be made to improve management case, drug and prevent or eliminate adverse drug reaction.

Background: Brachial plexus is a network of nerves that controls the upper limb. Unfortunately, it can be injured easily which is called brachial plexus injury (BPI). It can cause disability. Until now, the epidemiology of BPI in Indonesia is still lacking. The aim of this study was to describe the characteristics of patients with BPI in Bandung, in order to increase knowledge and attention of health care provider and community to prevent BPI. Methods: This was a descriptive retrospective study. Data from medical records of patients with BPI who underwent electromyography (EMG) in Neurophysiology Laboratory Dr. Hasan Sadikin General Hospital, Bandung from 2003 to 2012 were collected. The data included age, sex, mode of injury, affected side and distribution of paralysis. Collected data were presented as percentages shown in tables. Results: A total of 91 cases were collected during study period, which consisted of 69 males and 22 females (76% vs. 24%). Most of them were in productive age group (11−20 years and 21−30 years). The main cause of brachial plexus injury was traffic accident (76%), followed by birth injury. Distribution of paralysis was mostly in postganglionic area of cervical (C)5, C6, C7, C8 and thoracal (T)1 (67%). Around two third of the cases involved the right side of upper limb. Conclusions: The study showed that most of patients with BPI are male in their productive ages. Traffic accident is the most common cause, and the most affected side is the right side of upper limb.

Introduction: The most effective use of trauma center resources helps reduce morbidity and mortality, while saving costs. Identifying critical infrastructure characteristics, patient characteristics and staffing components of a trauma center associated with the proportion of patients needing major trauma care will help planners create better systems for patient care. Methods: We used the 2009 National Trauma Data Bank-Research Dataset to determine the proportion of critically injured patients requiring the resources of a trauma center within each Level I-IV trauma center (n=443). The outcome variable was defined as the portion of treated patients who were critically injured. We defined the need for critical trauma resources and interventions (“trauma center need”) as death prior to hospital discharge, admission to the intensive care unit, or admission to the operating room from the emergency department as a result of acute traumatic injury. Generalized Linear Modeling (GLM) was used to determine how hospital infrastructure, staffing Levels, and patient characteristics contributed to trauma center need. Results: Nonprofit Level I and II trauma centers were significantly associated with higher levels of trauma center need. Trauma centers that had a higher percentage of transferred patients or a lower percentage of insured patients were associated with a higher proportion of trauma center need. Hospital infrastructure characteristics, such as bed capacity and intensive care unit capacity, were not associated with trauma center need. A GLM for Level III and IV trauma centers showed that the number of trauma surgeons on staff was associated with trauma center need. Conclusion: Because the proportion of trauma center need is predominantly influenced by hospital type, transfer frequency, and insurance status, it is important for administrators to consider patient population characteristics of the catchment area when planning the construction of new trauma centers or when coordinating care within state or regional trauma systems. [West J Emerg Med. 2015;16(1):98–106.]

The objective of this article was to study characteristics of pressure ulcer patients and their ulcers, pressure ulcer preventive and treatment measures in four Indonesian general hospitals. A multicentre cross-sectional design was applied to assess pressure ulcers and pressure ulcer care in adult patients in medical, surgical, specialised and intensive care units. Ninety-one of the 1132 patients had a total of 142 ulcers. Half (44·0%) already had pressure ulcers before admission. The overall prevalence of category I- IV pressure ulcers was 8·0% (95% CI 6·4-9·6), and the overall nosocomial pressure ulcer prevalence was 4·5% (95% CI 3·3-5·7). Most pressure ulcer patients had friction and shear problems, were bedfast, had diabetes and had more bedridden days. Most ulcers (42·3%) were category III and IV. One third of the patients had both pressure ulcers and moisture lesions (36·3%) and suffered from pain (45·1%). The most frequently used prevention measures were repositioning (61·5%), skin moisturising (47·3%), patient education (36·3%) and massage (35·2%). Most pressure ulcer dressings involved saline-impregnated or antimicrobial gauzes. This study shows the complexities of pressure ulcers in Indonesian general hospitals and reveals that the quality of pressure ulcer care (prevention and treatment) could be improved by implementing the recent evidence-based international guideline. [ABSTRACT FROM AUTHOR]

The term 'patient centered,' 'patient centric,' or 'patient centricity' is increasingly used in the scientific literature in a wide variety of contexts. Generally, patient centric medicines are recognized as an essential contributor to healthy aging and the overall patient's quality of life and life expectancy. Besides the selection of the appropriate type of drug substance and strength for a particular indication in a particular patient, due attention must be paid that the pharmaceutical drug product design is also adequately addressing the particular patient's needs, i.e., assuring adequate patient adherence and the anticipate drug safety and effectiveness. Relevant pharmaceutical design aspects may e.g., involve the selection of the route of administration, the tablet size and shape, the ease of opening the package, the ability to read the user instruction, or the ability to follow the recommended (in-use) storage conditions. Currently, a harmonized definition on patient centric drug development/design has not yet been established. To stimulate scientific research and discussions and the consistent interpretation of test results, it is essential that such a definition is established. We have developed a first draft definition through various rounds of discussions within an interdisciplinary AAPS focus group of experts. This publication summarizes the outcomes and is intended to stimulate further discussions with all stakeholders towards a common definition of patient centric pharmaceutical drug product design that is useable across all disciplines involved. [ABSTRACT FROM AUTHOR]

Background: Implementation of evidence-based care for pressure ulcer prevention is lacking. As the hospital organization is complex, more knowledge is needed to understand how nursing care in this area can be improved. Objectives: The present study investigated the associations between variables on different levels in the healthcare setting (patient, unit, hospital) and the documentation of (1) risk assessment and (2) skin assessment within 24 h of admission, the use of (3) pressure- reducing mattresses and (4) planned repositioning in bed. Design: A cross-sectional study. Design: A cross-sectional study. Participants: Geriatric (n = 8), medical (n = 24) and surgical (n = 19) units. All adult patients (>17 years), in total 825, were included. Methods: A one-day prevalence study was conducted using the methodology specified by the European Pressure Ulcer Advisory Panel, together with the established methods used by the Collaborative Alliance for Nursing Outcomes. Independent variables were patient characteristics, hospital type, unit type, nurse staffing and workload. Dependent variables were documented risk and skin assessment within 24 h of admission, pressure-reducing mattresses and planned repositioning in bed. The data were analysed with Logistic regression using the Generalized Estimating Equation (GEE) approach. Results: Patients at risk of developing pressure ulcers (Braden < 17) had higher odds of having risk assessment documented, and of receiving pressure-reducing mattresses and planned repositioning. Patients at the general hospital were less likely to have risk and skin assessment documented and to receive pressure-reducing mattresses. On the other hand, planned repositioning was more likely to be used at the general hospital. When total hours of nursing care was lower, patients had higher odds of having pressure-reducing mattresses but were less likely to have planned repositioning. Conclusion: Patient characteristics (high age and risk score) and hospital type were associated with pressure ulcer prevention. Surprisingly, nurse staffing played only a minor role. Leaders in healthcare organizations should establish routines on different levels that support evidence-based pressure ulcer prevention, and registered nurses need to assume responsibility for bedside care. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: Pancreatic cancer (PC) is associated with a dismal prognosis. Few studies have examined characteristics and outcome in an unselected population-based cohort of PC patients. Therefore, we investigated patient baseline characteristics, therapy choices and survival in a complete cohort of patients with PC. Methods: All cases diagnosed with PC between 2007 and 2009 in the Region of Southern Denmark (pop: 1,200,000) were prospectively registered. Patient characteristics including performance status, information about haematology, liver function and therapy were retrieved from patient charts, and used to compare differently treated and untreated groups. Results: Six-hundred-eighteen cases were registered as PC; 25 of which did not have adenocarcinomas. Patients were divided in 3 clinical groups based on initial therapy; group 1: resection (n =64), group 2: chemotherapy or chemo-radiotherapy (n =191), group 3: no tumour directed therapy (n =324). Median survival (mOS) (95% confidence interval (CI)) in the three groups was 25.7months (18–30), 8.1months (7.0–9.5) and 1.1months (1.0–1.3) respectively. Three percent of patients participated in clinical trials. An evaluation of baseline factors prognostic value suggested that treated patients differed significantly from non-treated patients. Conclusion: This study reports survival in treated groups comparable to results obtained from clinical trials with highly selected patients. However the majority of patients with PC do not receive cancer directed therapy. This group was significantly different in several baseline factors, which could suggest a different biology. Improving the outcome of PC patients calls for research into the large group of untreated patients, as only a minority of patients receive cancer directed therapy. [Copyright &y& Elsevier]

The hospice philosophy with focus on the patient's autonomy and the ideal of a good death are the overall objectives of palliative care. Often-raised questions, when discussing hospice, are for which of the incurable ill inpatient hospice is the most optimal care alternative together with who are making use of hospice. The aim of the present study was to describe patient characteristics such as age, marital status, diagnosis, referral source and length of stay (LoS) in relation to gender, during the first decade at an inpatient hospice ward (1992–2001). Data, obtained from medical register, were analysed by using descriptive statistics and the chi-square test. The number of patients was 666 women and 555 men, and most of them were elderly. In some respects significant differences were observed between women and men. More women than men were single, had cancer with relatively rapid trajectory and were referred from the oncology department. Men, more often than women, were diagnosed with cancers with a somewhat longer trajectory. Despite the longer trajectory, the LoS was shorter for men (median =13 days) than for women (median = 17 days). The most frequent referral source was hospital, though men, younger men in particular, were more often referred from home-based hospice care than women. During the last 3 years self-referrals were documented. Self-referrals can be seen as one distinct expression from a standpoint of one's own active choice compared with other referrals. Altogether, self-referrals were less frequent among women than men but in relation to age, self-referrals were more common among the youngest (<60 years) and the oldest women (>85 years) than men in the same age groups. Further studies illuminating a gender perspective can broaden the understanding of what these differences may imply for women and men. [ABSTRACT FROM AUTHOR]

Acupuncture has been proved to be effective for chronic diarrhea. However, it is still unclear what types of patients with chronic diarrhea will benefit more from acupuncture treatment. This study aims to identify the characteristics and baseline measurements related to acupuncture response when treating chronic diarrhea. This is a secondary analysis of a previous published trial in which 448 patients were randomly allocated into 3 electroacupuncture groups and a medication group (control). The primary outcome was the change from baseline in weekly stool frequency at the end of 4-weeks of treatment. Responders were defined as patients who had a ≥ 30 % reduction in primary outcome. We screened potential factors by performing a univariate analysis and then applied a multivariable logistic regression model to explore the factors related to the acupuncture outcomes. We analyzed a total of 325 acupuncture treated participants and found that 49.2 % (160) had a reduction of over 30 % in weekly stool frequency. At baseline patients with higher weekly stool frequencies (P < 0.001), higher bodily pain scores of the MOS 36-item short form health survey (SF-36) (P = 0.004) at baseline, and receiving acupuncture treatment at the He acupoints (P = 0.030) reported better outcomes. Chronic diarrhea patients with higher weekly stool frequencies, less abdominal pain and receiving acupuncture treatment at He acupoints may be more likely to respond to acupuncture treatment. Our findings can contribute to the clinical prognosis for the acupuncture treatment to patient with chronic diarrhea. [ABSTRACT FROM AUTHOR]

Background and Objetive: The incidence of infectious spondylodiscitis has been shown to rise with age; however, they had not been extensively investigated in the very elderly., Material and Methods: This retrospective, monocentric study included patients hospitalized in our department of rheumatology for primary infectious spondylodiscitis between 2000 and 2015, and compared over 75-year-olds with younger patients., Results: Of the 152 patients, 51 (33.6%) were≥75 years old, 59 were 61-74, and 42 were≤60. Patients≥75 years old were more often institutionalized (7.8 vs. 0; P=.02), were less often subject to infection risk factors (27.5 vs. 54.5%; P=.02), but did not differ from the others as regards the frequency of diabetes and cancer. Time to diagnosis was shorter for the under 60-year-olds (23 vs. 30 vs. 30 day for each age group, respectively; P<.05). There were no differences among the age groups in terms of spondylodiscitis localization, frequency of neurological symptoms and fever, frequency or intensity of inflammatory syndrome, imaging use, frequency of microorganism identification, blood culture positivity, or use and efficacy of disco-vertebral biopsy. Microorganism distribution was comparable among the groups, except for Gram-negative bacilli, with Escherichia coli more common in over 75-year-olds (7/8 vs. 4/14; P=.02). Duration of antibiotherapy and hospitalization was comparable across the age groups. Five patients died, all over 75 years old (5/51 vs. 0/101; P=.001)., Conclusion: Age is a risk factor for primary spondylodiscitis, associated with significant mortality in over 75-year-olds (10%). For these elderly patients, spondylodiscitis does not bear any other distinguishing features., (Copyright © 2017 Elsevier España, S.L.U. All rights reserved.)

Abstract: Context: The difficulties in defining a palliative care patient accentuate the need to provide stringent descriptions of the patient population in palliative care research. Objectives: To conduct a systematic literature review with the aim of identifying which key variables have been used to describe adult palliative care cancer populations in randomized controlled trials (RCTs). Methods: The data sources used were MEDLINE (1950 to January 25, 2010) and Embase (1980 to January 25, 2010), limited to RCTs in adult cancer patients with incurable disease. Forty-three variables were systematically extracted from the eligible articles. Results: The review includes 336 articles reporting RCTs in palliative care cancer patients. Age (98%), gender (90%), cancer diagnosis (89%), performance status (45%), and survival (45%) were the most frequently reported variables. A large number of other variables were much less frequently reported. Conclusion: A substantial variation exists in how palliative care cancer populations are described in RCTs. Few variables are consistently registered and reported. There is a clear need to standardize the reporting. The results from this work will serve as the basis for an international Delphi process with the aim of reaching consensus on a minimum set of descriptors to characterize a palliative care cancer population. [Copyright &y& Elsevier]