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John Masenga - One of the best experts on this subject based on the ideXlab platform.
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skin diseases among elderly patients attending skin clinic at the regional dermatology Training Centre northern tanzania a cross sectional study
BMC Research Notes, 2016Co-Authors: Kelvin Mponda, John MasengaAbstract:Background As global population of the elderly continues to rise, a critical need to provide it with health services, including dermatology, will be significant, especially in developing countries like Tanzania. To adequately meet their dermatologic needs, knowledge of local patterns of skin conditions is vital. This study was aimed to describe the spectrum of skin diseases among elderly patients attending skin clinic at the Regional Dermatology Training Centre (RDTC) in Northern Tanzania.
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Skin diseases among elderly patients attending skin clinic at the Regional Dermatology Training Centre, Northern Tanzania: a cross-sectional study
BMC Research Notes, 2016Co-Authors: Kelvin Mponda, John MasengaAbstract:Background As global population of the elderly continues to rise, a critical need to provide it with health services, including dermatology, will be significant, especially in developing countries like Tanzania. To adequately meet their dermatologic needs, knowledge of local patterns of skin conditions is vital. This study was aimed to describe the spectrum of skin diseases among elderly patients attending skin clinic at the Regional Dermatology Training Centre (RDTC) in Northern Tanzania. Methods A descriptive hospital based cross-sectional study was conducted between January 2013 and April 2013 at RDTC and included all patients aged 55 years and above who consented to be examined. Diagnoses were clinical, diagnostic tests being done only when necessary. Ethical clearance to conduct the study was granted. Results A total of 142 patients, age ranges 55–99 years, median age of 67.5 years were seen. Eczemas were the leading disease group (43.7 %), with unclassified eczemas (33.9 %) predominating. Papulosquamous disorders (15.4 %) were second with psoriasis (50 %) being the leading disease. Infections (11.3 % with fungal infections the leading group representing 5.6 % of all diseases), tumours (9.8 %: Kaposi’s sarcoma 4.2 %), vascular disorders 9.1 % (lymphedema 4.9 %), autoimmune disorders 7.7 % (connective tissue diseases 4.9 %), vitiligo 4.2 %, nutritional diseases 2.1 % (pellagra 0.7 %), urticaria 0.7 % and drug reactions 0.7 %. Conclusions Eczemas are the most common group of disorders among elderly patients presenting at RDTC.
Paul Dieppe - One of the best experts on this subject based on the ideXlab platform.
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the effects of surgical volumes and Training Centre status on outcomes following total joint replacement analysis of the hospital episode statistics for england
Journal of Public Health, 2006Co-Authors: Andrew Judge, Jiri Chard, Ian D. Learmonth, Paul DieppeAbstract:Objective Previous work from other countries has shown a significant inverse relationship between the number of some surgical procedures undertaken in a hospital and in an adverse outcomes. In the light of the changing nature of the provision of joint replacements in the United Kingdom, we have examined the effects of surgical volumes and the presence/absence of Training Centre status, on outcomes following total joint replacement (TJR) in England. Methods Analysis of the Hospital Episode Statistics (HES) on all hip/knee joint replacements in English National Health Service (NHS) trusts between financial years 1997 and 2002. Exposures explored were the volume of hip/knee replacements per annum in an NHS trust, Training Centre status and whether the admission was routine or emergency. Four surrogate measures of adverse outcome were assessed: 30-day in-hospital mortality, length of stay in hospital, readmission within a year and surgical revision within 5 years. Age and sex were controlled for as potential confounders. Results Data from a total of 281 360 hip replacements and 211 099 knee replacements were examined. HES data show that the numbers of TJRs performed in low volume trusts are small and decreasing. Adverse outcomes were also uncommon. Nevertheless, significant associations between adverse outcomes and low volume units, and better outcomes in Training Centres, were detected. For example, the odds ratio (OR) for in-hospital death within 30 days of hip replacement in trusts doing <50 hip/replacements per annum is 1.98 [95% confidence interval (95% CI) = 1.13–3.47] compared with trusts doing 251–500 operations/annum. Similarly, surgery in non-Training Centres is more likely to result in mortality than that in Training Centres (OR = 1.25, 95% CI = 1.05–1.48). The examination of surgical revision indicated adverse outcomes in higher volume units; this may be due to case-mix. Conclusion In England, there are fewer adverse events following TJR in high volume Centres and in orthopaedic Training Centres. Standardization of procedures may account for this finding. The data have implications for private practice in the United Kingdom and for the current move to undertake TJRs in Independent Sector Treatment Centres.
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The effects of surgical volumes and Training Centre status on outcomes following total joint replacement: analysis of the Hospital Episode Statistics for England
Journal of public health (Oxford England), 2006Co-Authors: Andrew Judge, Jiri Chard, Ian D. Learmonth, Paul DieppeAbstract:Objective Previous work from other countries has shown a significant inverse relationship between the number of some surgical procedures undertaken in a hospital and in an adverse outcomes. In the light of the changing nature of the provision of joint replacements in the United Kingdom, we have examined the effects of surgical volumes and the presence/absence of Training Centre status, on outcomes following total joint replacement (TJR) in England. Methods Analysis of the Hospital Episode Statistics (HES) on all hip/knee joint replacements in English National Health Service (NHS) trusts between financial years 1997 and 2002. Exposures explored were the volume of hip/knee replacements per annum in an NHS trust, Training Centre status and whether the admission was routine or emergency. Four surrogate measures of adverse outcome were assessed: 30-day in-hospital mortality, length of stay in hospital, readmission within a year and surgical revision within 5 years. Age and sex were controlled for as potential confounders. Results Data from a total of 281 360 hip replacements and 211 099 knee replacements were examined. HES data show that the numbers of TJRs performed in low volume trusts are small and decreasing. Adverse outcomes were also uncommon. Nevertheless, significant associations between adverse outcomes and low volume units, and better outcomes in Training Centres, were detected. For example, the odds ratio (OR) for in-hospital death within 30 days of hip replacement in trusts doing
Kelvin Mponda - One of the best experts on this subject based on the ideXlab platform.
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skin diseases among elderly patients attending skin clinic at the regional dermatology Training Centre northern tanzania a cross sectional study
BMC Research Notes, 2016Co-Authors: Kelvin Mponda, John MasengaAbstract:Background As global population of the elderly continues to rise, a critical need to provide it with health services, including dermatology, will be significant, especially in developing countries like Tanzania. To adequately meet their dermatologic needs, knowledge of local patterns of skin conditions is vital. This study was aimed to describe the spectrum of skin diseases among elderly patients attending skin clinic at the Regional Dermatology Training Centre (RDTC) in Northern Tanzania.
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Skin diseases among elderly patients attending skin clinic at the Regional Dermatology Training Centre, Northern Tanzania: a cross-sectional study
BMC Research Notes, 2016Co-Authors: Kelvin Mponda, John MasengaAbstract:Background As global population of the elderly continues to rise, a critical need to provide it with health services, including dermatology, will be significant, especially in developing countries like Tanzania. To adequately meet their dermatologic needs, knowledge of local patterns of skin conditions is vital. This study was aimed to describe the spectrum of skin diseases among elderly patients attending skin clinic at the Regional Dermatology Training Centre (RDTC) in Northern Tanzania. Methods A descriptive hospital based cross-sectional study was conducted between January 2013 and April 2013 at RDTC and included all patients aged 55 years and above who consented to be examined. Diagnoses were clinical, diagnostic tests being done only when necessary. Ethical clearance to conduct the study was granted. Results A total of 142 patients, age ranges 55–99 years, median age of 67.5 years were seen. Eczemas were the leading disease group (43.7 %), with unclassified eczemas (33.9 %) predominating. Papulosquamous disorders (15.4 %) were second with psoriasis (50 %) being the leading disease. Infections (11.3 % with fungal infections the leading group representing 5.6 % of all diseases), tumours (9.8 %: Kaposi’s sarcoma 4.2 %), vascular disorders 9.1 % (lymphedema 4.9 %), autoimmune disorders 7.7 % (connective tissue diseases 4.9 %), vitiligo 4.2 %, nutritional diseases 2.1 % (pellagra 0.7 %), urticaria 0.7 % and drug reactions 0.7 %. Conclusions Eczemas are the most common group of disorders among elderly patients presenting at RDTC.
Andrew Judge - One of the best experts on this subject based on the ideXlab platform.
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the effects of surgical volumes and Training Centre status on outcomes following total joint replacement analysis of the hospital episode statistics for england
Journal of Public Health, 2006Co-Authors: Andrew Judge, Jiri Chard, Ian D. Learmonth, Paul DieppeAbstract:Objective Previous work from other countries has shown a significant inverse relationship between the number of some surgical procedures undertaken in a hospital and in an adverse outcomes. In the light of the changing nature of the provision of joint replacements in the United Kingdom, we have examined the effects of surgical volumes and the presence/absence of Training Centre status, on outcomes following total joint replacement (TJR) in England. Methods Analysis of the Hospital Episode Statistics (HES) on all hip/knee joint replacements in English National Health Service (NHS) trusts between financial years 1997 and 2002. Exposures explored were the volume of hip/knee replacements per annum in an NHS trust, Training Centre status and whether the admission was routine or emergency. Four surrogate measures of adverse outcome were assessed: 30-day in-hospital mortality, length of stay in hospital, readmission within a year and surgical revision within 5 years. Age and sex were controlled for as potential confounders. Results Data from a total of 281 360 hip replacements and 211 099 knee replacements were examined. HES data show that the numbers of TJRs performed in low volume trusts are small and decreasing. Adverse outcomes were also uncommon. Nevertheless, significant associations between adverse outcomes and low volume units, and better outcomes in Training Centres, were detected. For example, the odds ratio (OR) for in-hospital death within 30 days of hip replacement in trusts doing <50 hip/replacements per annum is 1.98 [95% confidence interval (95% CI) = 1.13–3.47] compared with trusts doing 251–500 operations/annum. Similarly, surgery in non-Training Centres is more likely to result in mortality than that in Training Centres (OR = 1.25, 95% CI = 1.05–1.48). The examination of surgical revision indicated adverse outcomes in higher volume units; this may be due to case-mix. Conclusion In England, there are fewer adverse events following TJR in high volume Centres and in orthopaedic Training Centres. Standardization of procedures may account for this finding. The data have implications for private practice in the United Kingdom and for the current move to undertake TJRs in Independent Sector Treatment Centres.
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The effects of surgical volumes and Training Centre status on outcomes following total joint replacement: analysis of the Hospital Episode Statistics for England
Journal of public health (Oxford England), 2006Co-Authors: Andrew Judge, Jiri Chard, Ian D. Learmonth, Paul DieppeAbstract:Objective Previous work from other countries has shown a significant inverse relationship between the number of some surgical procedures undertaken in a hospital and in an adverse outcomes. In the light of the changing nature of the provision of joint replacements in the United Kingdom, we have examined the effects of surgical volumes and the presence/absence of Training Centre status, on outcomes following total joint replacement (TJR) in England. Methods Analysis of the Hospital Episode Statistics (HES) on all hip/knee joint replacements in English National Health Service (NHS) trusts between financial years 1997 and 2002. Exposures explored were the volume of hip/knee replacements per annum in an NHS trust, Training Centre status and whether the admission was routine or emergency. Four surrogate measures of adverse outcome were assessed: 30-day in-hospital mortality, length of stay in hospital, readmission within a year and surgical revision within 5 years. Age and sex were controlled for as potential confounders. Results Data from a total of 281 360 hip replacements and 211 099 knee replacements were examined. HES data show that the numbers of TJRs performed in low volume trusts are small and decreasing. Adverse outcomes were also uncommon. Nevertheless, significant associations between adverse outcomes and low volume units, and better outcomes in Training Centres, were detected. For example, the odds ratio (OR) for in-hospital death within 30 days of hip replacement in trusts doing
Ian D. Learmonth - One of the best experts on this subject based on the ideXlab platform.
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the effects of surgical volumes and Training Centre status on outcomes following total joint replacement analysis of the hospital episode statistics for england
Journal of Public Health, 2006Co-Authors: Andrew Judge, Jiri Chard, Ian D. Learmonth, Paul DieppeAbstract:Objective Previous work from other countries has shown a significant inverse relationship between the number of some surgical procedures undertaken in a hospital and in an adverse outcomes. In the light of the changing nature of the provision of joint replacements in the United Kingdom, we have examined the effects of surgical volumes and the presence/absence of Training Centre status, on outcomes following total joint replacement (TJR) in England. Methods Analysis of the Hospital Episode Statistics (HES) on all hip/knee joint replacements in English National Health Service (NHS) trusts between financial years 1997 and 2002. Exposures explored were the volume of hip/knee replacements per annum in an NHS trust, Training Centre status and whether the admission was routine or emergency. Four surrogate measures of adverse outcome were assessed: 30-day in-hospital mortality, length of stay in hospital, readmission within a year and surgical revision within 5 years. Age and sex were controlled for as potential confounders. Results Data from a total of 281 360 hip replacements and 211 099 knee replacements were examined. HES data show that the numbers of TJRs performed in low volume trusts are small and decreasing. Adverse outcomes were also uncommon. Nevertheless, significant associations between adverse outcomes and low volume units, and better outcomes in Training Centres, were detected. For example, the odds ratio (OR) for in-hospital death within 30 days of hip replacement in trusts doing <50 hip/replacements per annum is 1.98 [95% confidence interval (95% CI) = 1.13–3.47] compared with trusts doing 251–500 operations/annum. Similarly, surgery in non-Training Centres is more likely to result in mortality than that in Training Centres (OR = 1.25, 95% CI = 1.05–1.48). The examination of surgical revision indicated adverse outcomes in higher volume units; this may be due to case-mix. Conclusion In England, there are fewer adverse events following TJR in high volume Centres and in orthopaedic Training Centres. Standardization of procedures may account for this finding. The data have implications for private practice in the United Kingdom and for the current move to undertake TJRs in Independent Sector Treatment Centres.
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The effects of surgical volumes and Training Centre status on outcomes following total joint replacement: analysis of the Hospital Episode Statistics for England
Journal of public health (Oxford England), 2006Co-Authors: Andrew Judge, Jiri Chard, Ian D. Learmonth, Paul DieppeAbstract:Objective Previous work from other countries has shown a significant inverse relationship between the number of some surgical procedures undertaken in a hospital and in an adverse outcomes. In the light of the changing nature of the provision of joint replacements in the United Kingdom, we have examined the effects of surgical volumes and the presence/absence of Training Centre status, on outcomes following total joint replacement (TJR) in England. Methods Analysis of the Hospital Episode Statistics (HES) on all hip/knee joint replacements in English National Health Service (NHS) trusts between financial years 1997 and 2002. Exposures explored were the volume of hip/knee replacements per annum in an NHS trust, Training Centre status and whether the admission was routine or emergency. Four surrogate measures of adverse outcome were assessed: 30-day in-hospital mortality, length of stay in hospital, readmission within a year and surgical revision within 5 years. Age and sex were controlled for as potential confounders. Results Data from a total of 281 360 hip replacements and 211 099 knee replacements were examined. HES data show that the numbers of TJRs performed in low volume trusts are small and decreasing. Adverse outcomes were also uncommon. Nevertheless, significant associations between adverse outcomes and low volume units, and better outcomes in Training Centres, were detected. For example, the odds ratio (OR) for in-hospital death within 30 days of hip replacement in trusts doing
