Financial Affect of an Automatic Oncology DoseRounding Gumption OneYear Analysis

03). Serotypes 14, 18C, 9V and 6B, which were identified before vaccination, never colonized afterwards. Number of siblings and having sibling with older age of five were determined to be significant effective factors for SP colonization presence after vaccination and antibiotic use was negatively associated with pneumococcal carriage but associated with penicillin non-susceptibility. CONCLUSIONS Nasopharyngeal carriage rate of S. pneumoniae dropped after PCV7 vaccination, and replacement by NVT pneumococci were also observed. Risk factors for nasopharyngeal carriage included household crowding and having a sibling age five years or older. Penicillin non-susceptibility increased in both VT and NVT strains. Copyright (c) 2019 Basak Kaya Gursoy, Ufuk Beyazova, Melahat Melek Oguz, Filiz Demirel, Secil Ozkan, Nedim Sultan, Selin Nar Otgun.INTRODUCTION Diagnosis and management of urinary tract infection (UTI) are complex, and do not always follow guidelines. The aim of this study was to determine adherence to the 2014 Malaysian Ministry of Health guidelines for managing suspected UTI in a Malaysian primary care setting. METHODOLOGY We retrospectively reviewed computerized medical records of adults with suspected UTI between July-December 2016. Excluded were consultations misclassified by the search engine, duplicated records of the same patient, consultations for follow-up of suspected UTI, patients who were pregnant, catheterised, or who had a renal transplant. Records were reviewed by two primary care physicians and a clinical microbiologist. RESULTS From 852 records, 366 consultations were a fresh episode of possible UTI. Most subjects were female (78.2%) with median age of 61.5 years. The major co-morbidities were hypertension (37.1%), prostatic enlargement in males (35.5%) and impaired renal function (31.1%). Symptoms were reported in 349 (95.4%) consultations. Antibiotics were prescribed in 307 (83.9%) consultations, which was appropriate in 227/307 (73.9%), where the subject had at least one symptom, and leucocytes were raised in urine full examination and microscopic examination (UFEME). In 73 (23.8%) consultations antibiotics were prescribed inappropriately, as the subjects were asymptomatic (14,4.6%), urine was clear (17,5.5%), or UFEME did not show raised leucocytes (42,13.7%). In 7 (2.3%) consultations appropriateness of antibiotics could not be determined as UFEME was not available. CONCLUSION Several pitfalls contributed to suboptimal adherence to guidelines for diagnosis and management of suspected UTI. This illustrates the complexity of managing suspected UTI in older subjects with multiple co-morbidities. Copyright (c) 2019 Sajaratulnisah Othman, Alison A Jackson, Aqtab Mazhar Alias, Pauline Siew Mei Lai, Nadia Atiya, Siti Nurkamilla Ramdzan, Tun Firzara Abdul Malik, Fadzilah Hanum Mohd Mydin, Haireen Abd Hadi.INTRODUCTION Surgical site infections (SSI) continue to be a major problem for thoracic surgery patients. We aimed to determine incidence rate (IR) and risk factors for SSI in patients with thoracic surgical procedures. METHODOLOGY During 12 years of hospital surveillance of patients with thoracic surgical procedures, we prospectively identified SSI. see more Patients with SSI were compared with patients without SSI. RESULTS We operated 3,370 patients and 205 (6.1%) developed SSI postoperatively. We detected 190 SSI among open thoracic surgical procedures (IR 7.1%) and 15 SSI after video-assisted thoracic surgery (IR 2.1%). Five independent risk factors for SSI were identified wound contamination (p = 0.013; relative risk (RR) 2.496; 95%, confidence interval (CI) 1.208-5.156), American Society of Anesthesiologist (ASA) score (p = 0.012; RR 1.795; 95% CI 1.136-2.834), duration of drainage (p less then 0.001; RR 1.117; 95% CI 1.085-1.150), age (p = 0.036; RR 1.018; 95% CI 1.001-1.035) and duration of operation (p less then 0.001; RR1.005; 95% CI1.002-1.008). CONCLUSION The results are valuable in documenting risk factors for SSI in patients undergoing thoracic surgery. The knowledge and prevention of controllable risk factors is necessary in order to reduce the incidence of SSI. Copyright (c) 2019 Vlado Cvijanovic, Aleksandar Ristanović, Nebojsa Maric, Natasa Vesovic, Vanja Kostovski, Ljubinko Djenic, Dejan Stojkovic, Aleksandar Nikolic, Dragan Djordevic, Vesna Suljagic.INTRODUCTION The incidence of diabetes mellitus is increasing rapidly in India. In addition to well-known complications, diabetes increases the risk for hospitalization and death from severe acute respiratory infection (SARI) and influenza. Here we examined the impact of SARI and influenza in Indian adults with diabetes. METHODOLOGY This was a single-center, active surveillance study conducted in Jammu and Kashmir State, India, during the 2015-2016 and 2016-2017 influenza seasons. Adults hospitalized for SARI and receiving at least one diabetes medication were included. Demographics, health care use, and direct costs were collected from medical records and interviews of patients or caregivers. Indirect costs were estimated based on lost earnings and WHO-CHOICE estimates for hospital costs. RESULTS The study included 192 patients with type 2 diabetes. Median age was 66 years, median body mass index was 26.6 kg/m2, and most patients had comorbidities, especially hypertension and cardiovascular disease (83.9%). Only 32.2% regularly monitored blood glucose or hemoglobin A1C, and median values at admission indicated poor glycemic control for most. Influenza was detected in 8.9% of cases. The median hospital stay for SARI was 8 days, and 22 patients (11.4%) died. Median total costs associated with hospitalization were US$710 (interquartile range, $539-$1067) for SARI patients and US$716 ($556-$1078) for influenza patients, mostly (~75%) from indirect costs. CONCLUSIONS Adults with diabetes in India hospitalized with SARI or influenza are generally older, in poor health, and suffer from poor glycemic control. The costs for their hospitalization and care are substantial. Copyright (c) 2019 Parvaiz A Koul, Amit Bhavsar, Hyder Mir, Mark Simmerman, Hemant Khanna.