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  1. Article ; Online: Treatment of Anorectal Malformations in German Hospitals: Analysis of National Hospital Discharge Data from 2016 to 2021.

    Wilms, Miriam / Jenetzky, Ekkehart / Märzheuser, Stefanie / Busse, Reinhard / Nimptsch, Ulrike

    European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie

    2024  

    Abstract: Background:  Anorectal malformations (ARMs) are complex congenital anomalies. The corrective operation is demanding and schedulable. Based on complete national data, patterns of care have not been analyzed in Germany yet.: Methods:  All cases with ... ...

    Abstract Background:  Anorectal malformations (ARMs) are complex congenital anomalies. The corrective operation is demanding and schedulable. Based on complete national data, patterns of care have not been analyzed in Germany yet.
    Methods:  All cases with ARM were analyzed (1) at the time of birth and (2) during the hospital stay for the corrective operation, based on the national hospital discharge data (DRG statistics). Patient's comorbidities, treatment characteristics, hospital structures, and the outcome of corrective operations were analyzed with respect to the hospitals' caseload.
    Results:  From 2016 to 2021, 1,726 newborns with ARM were treated at the time of birth in 388 hospitals. Of these hospitals, 19% had neither a pediatric nor a pediatric surgical department. At least one additional congenital anomaly was present in 49% of cases and 7% of the newborns had a birthweight below 1,500 g.In all, 2,060 corrective operations for ARM were performed in 113 hospitals in the same time period. In 24.5% of cases, at least one major complication was documented. One-third of the operations were performed in 56 hospitals, one-third in 20 hospitals, and one-third in 10 hospitals with median annual case numbers of 2, 5, and 10, respectively.Hospitals with the highest caseload operated cloacal defects more often than hospitals with the lowest caseload (7 vs. 2%) and had more early complications than hospitals with the lowest caseload (30 vs. 21%). This difference was not statistically significant after risk adjustment.
    Conclusions:  Children with ARM are multimorbid. Early complications after corrective surgery are common. Considering the large number of hospitals with a very low caseload, centralization of care for the complex and elective corrective surgery for ARM remains a key issue for quality of care.
    Language English
    Publishing date 2024-02-29
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1065043-x
    ISSN 1439-359X ; 0939-7248 ; 0939-6764 ; 0930-7249
    ISSN (online) 1439-359X
    ISSN 0939-7248 ; 0939-6764 ; 0930-7249
    DOI 10.1055/a-2260-5124
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 3140: Show issues Location:
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  2. Article: Treatment of Anorectal Malformations in German Hospitals: Analysis of National Hospital Discharge Data from 2016 to 2021

    Wilms, Miriam / Jenetzky, Ekkehart / Märzheuser, Stefanie / Busse, Reinhard / Nimptsch, Ulrike

    European Journal of Pediatric Surgery

    2024  

    Abstract: Background: Anorectal malformations (ARMs) are complex congenital anomalies. The corrective operation is demanding and schedulable. Based on complete national data, patterns of care have not been analyzed in Germany yet.: Methods: All cases with ARM ... ...

    Abstract Background: Anorectal malformations (ARMs) are complex congenital anomalies. The corrective operation is demanding and schedulable. Based on complete national data, patterns of care have not been analyzed in Germany yet.
    Methods: All cases with ARM were analyzed (1) at the time of birth and (2) during the hospital stay for the corrective operation, based on the national hospital discharge data (DRG statistics). Patient's comorbidities, treatment characteristics, hospital structures, and the outcome of corrective operations were analyzed with respect to the hospitals' caseload.
    Results: From 2016 to 2021, 1,726 newborns with ARM were treated at the time of birth in 388 hospitals. Of these hospitals, 19% had neither a pediatric nor a pediatric surgical department. At least one additional congenital anomaly was present in 49% of cases and 7% of the newborns had a birthweight below 1,500 g. In all, 2,060 corrective operations for ARM were performed in 113 hospitals in the same time period. In 24.5% of cases, at least one major complication was documented. One-third of the operations were performed in 56 hospitals, one-third in 20 hospitals, and one-third in 10 hospitals with median annual case numbers of 2, 5, and 10, respectively. Hospitals with the highest caseload operated cloacal defects more often than hospitals with the lowest caseload (7 vs. 2%) and had more early complications than hospitals with the lowest caseload (30 vs. 21%). This difference was not statistically significant after risk adjustment.
    Conclusions: Children with ARM are multimorbid. Early complications after corrective surgery are common. Considering the large number of hospitals with a very low caseload, centralization of care for the complex and elective corrective surgery for ARM remains a key issue for quality of care.
    Keywords anorectal malformation ; volume–outcome relationship ; quality of care
    Language English
    Publishing date 2024-02-02
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 1065043-x
    ISSN 1439-359X ; 0939-7248 ; 0939-6764 ; 0930-7249
    ISSN (online) 1439-359X
    ISSN 0939-7248 ; 0939-6764 ; 0930-7249
    DOI 10.1055/a-2260-5124
    Database Thieme publisher's database

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  3. Book: Innere Medizin

    Crysandt, Martina / Hempfing, Berit / Wilms, Miriam / Vogeler, Friederike

    [leitlinienbasierend ; evidenzgesicherte Fakten ; mit ICD-10-Schlüssel ; inklusive Online-Version ; Berücksichtigung des Gegenstandskatalogs für die ärztliche Prüfung]

    (Facts)

    2010  

    Title variant Facts Innere Medizin
    Author's details M. Crysandt ; B. Hempfing ; M. Wilms. Hrsg. von F. Vogeler
    Series title Facts
    Keywords Innere Krankheit
    Subject Innere Erkrankung
    Subject code 616
    Language German
    Size XV, 836 S. : Ill., graph. Darst., 19 cm
    Edition 1. Aufl.
    Publisher KVM, der Medizinverl
    Publishing place Marburg
    Publishing country Germany
    Document type Book
    Note Literaturangaben
    Accompanying material Zeitlich befristeter Zugang zur Internetausgabe über Code
    HBZ-ID HT016267069
    ISBN 978-3-940698-27-8 ; 3-940698-27-X
    Database Catalogue ZB MED Medicine, Health

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    Shelf markLoan statusLocation
    2009 A 6958 order for loan Magazin
    Zeitlich befristeter Zugang zur Internetausgabe über Code aus lizenzrechtlichen Gründen nicht verfügbar
    2010 A 1641 order for loan Magazin
    Zeitlich befristeter Zugang zur Internetausgabe über Code aus lizenzrechtlichen Gründen nicht verfügbar

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  4. Article ; Online: Avoiding scrotal haematoma after repair of extensive scrotal hernias by postoperative scrotal compression through scrotal suspension by scrotal-abdominal skin suture.

    Wilms, Miriam C / Hellmold, Peter

    Tropical doctor

    2012  Volume 42, Issue 2, Page(s) 86–87

    Abstract: Scrotal haematoma and oedema are the most frequent complications of scrotal surgery and are associated with high morbidity. Through early postoperative compression on the scrotal sac these complications can be avoided. Compression can be assured by the ... ...

    Abstract Scrotal haematoma and oedema are the most frequent complications of scrotal surgery and are associated with high morbidity. Through early postoperative compression on the scrotal sac these complications can be avoided. Compression can be assured by the following simple surgical method independent of the quality of the postoperative care: extending the scrotal sac over the abdominal wall and fixing it with skin sutures under tension at the lower abdominal wall over a pile of gauzes. This method was shown to be effective after hernia repair of scrotal hernias but also seems promising for other scrotal surgery.
    MeSH term(s) Hematoma/etiology ; Hematoma/prevention & control ; Hernia, Inguinal/surgery ; Herniorrhaphy/adverse effects ; Hospitals, District ; Humans ; Male ; Postoperative Complications/prevention & control ; Scrotum/pathology ; Scrotum/surgery ; Skin ; Surgical Mesh ; Suture Techniques ; Tanzania
    Language English
    Publishing date 2012-04
    Publishing country England
    Document type Evaluation Studies ; Journal Article
    ZDB-ID 193169-6
    ISSN 1758-1133 ; 0049-4755
    ISSN (online) 1758-1133
    ISSN 0049-4755
    DOI 10.1258/td.2011.110300
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1056: Show issues Location:
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  5. Article ; Online: An in-depth, exploratory assessment of the implementation of the National Health Information System at a district level hospital in Tanzania.

    Wilms, Miriam C / Mbembela, Osman / Prytherch, Helen / Hellmold, Peter / Kuelker, Rainer

    BMC health services research

    2014  Volume 14, Page(s) 91

    Abstract: Background: A well functioning Health Information System (HIS) is crucial for effective and efficient health service delivery. In Tanzania there is a national HIS called Mfumo wa Taarifa za Uendeshaji Huduma za Afya (MTUHA). It comprises a guideline/ ... ...

    Abstract Background: A well functioning Health Information System (HIS) is crucial for effective and efficient health service delivery. In Tanzania there is a national HIS called Mfumo wa Taarifa za Uendeshaji Huduma za Afya (MTUHA). It comprises a guideline/manual, a series of registers for primary data collection and secondary data books where information from the registers is totalled or used for calculations.
    Methods: A mix of qualitative methods were used. These included key informant interviews; staff interviews; participant observations; and a retrospective analysis of the hospital's 2010 MTUHA reporting documents and the hospital's development plan.
    Results: All staff members acknowledged data collection as part of their job responsibilities. However, all had concerns about the accuracy of MTUHA data. Access to training was limited, mathematical capabilities often low, dissemination of MTUHA knowledge within the hospital poor, and a broad understanding of the HIS's full capabilities lacking.Whilst data collection for routine services functioned reasonably well, filling of the secondary data tools was unsatisfactory. Internal inconsistencies between the different types of data tools were found. These included duplications, and the collection of data that was not further used. Sixteen of the total 72 forms (22.2%) that make up one of the key secondary data books (Hospital data/MTUHA book 2) could not be completed with the information collected in the primary data books.Moreover, the hospital made no use of any of the secondary data. The hospital's main planning document was its development plan. Only 3 of the 22 indicators in this plan were the same as indicators in MTUHA, the information for 9 more was collected by the MTUHA system but figures had to be extracted and recalculated to fit, while for the remaining 10 indicators no use could be made of MTUHA at all.
    Conclusion: The HIS in Tanzania is very extensive and it could be advisable to simplify it to the core business of data collection for routine services. Alternatively, the more comprehensive, managerial aspects could be sharpened for each type of facility, with a focus upon the hospital level. In particular, hospital planning documents need to be more closely aligned with MTUHA indicators.
    MeSH term(s) Health Information Systems/organization & administration ; Health Information Systems/standards ; Hospitals, District/organization & administration ; Humans ; Interviews as Topic ; Personnel, Hospital ; Program Development ; Program Evaluation ; Qualitative Research ; Registries ; Tanzania
    Language English
    Publishing date 2014-02-26
    Publishing country England
    Document type Journal Article
    ISSN 1472-6963
    ISSN (online) 1472-6963
    DOI 10.1186/1472-6963-14-91
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Effects of preincubation temperature on the detection of fastidious organisms in delayed-entry samples in the BacT/ALERT 3D blood culture system.

    Wilms, Miriam C / Stanzel, Sven / Reinert, Ralf R / Burckhardt, Irene

    Journal of microbiological methods

    2009  Volume 79, Issue 2, Page(s) 194–198

    Abstract: This study evaluates the effect of preincubation on delayed-entry samples for fastidious organisms including the HACEK group, Streptococcus species, Neisseria meningitidis, Haemophilus species and Corynebacterium species for the BacT/ALERT 3D System ( ... ...

    Abstract This study evaluates the effect of preincubation on delayed-entry samples for fastidious organisms including the HACEK group, Streptococcus species, Neisseria meningitidis, Haemophilus species and Corynebacterium species for the BacT/ALERT 3D System (bioMérieux) using the FA (aerobic) medium. Bottles were inoculated with two different concentrations (0.5 McFarland and a 1:100,000 dilution) of each organism and either loaded into the system immediately or stored at 4 degrees C, room temperature (RT) or 37 degrees C for 24 hours (h) prior to loading. The detection rate (DR) was 92.5% for bottles loaded immediately for both concentrations with a mean time to detection (TTD) of 26.7 h (standard deviation (SD): 14.7 h) for the low concentration and 9.21 h (SD: 5.3 h) for the high concentration. Preincubation at 4 degrees C did not affect the DR for either of the two concentrations in comparison to no preincubation. The DR at RT was 90.0% for the low concentration and 83.6% for the high concentration. At 37 degrees C the DR was 76.3% and 66.3% for the low and the high concentrations respectively. The average TTD was inversely correlated with the preincubation temperature. An incubation of four days was sufficient, with the exception of Eikenella corrodens and Gemella sanguinis. The serotype of Streptococcus pneumoniae or Neisseria meningitidis did not influence the TTD. Kingella kingae remained undetected. For the retrieval of the above mentioned bacteria we recommend storage of bottles at room temperature. In case of erroneous storage at 37 degrees C subcultivation is advisable. All cases with a negative result on day four should be reevaluated and eventually new material for alternative diagnostic procedures should be retrieved.
    MeSH term(s) Bacteremia/diagnosis ; Bacteria/isolation & purification ; Bacteriological Techniques/methods ; Blood/microbiology ; Colony Count, Microbial ; Humans ; Sensitivity and Specificity ; Specimen Handling/methods ; Temperature ; Time Factors
    Language English
    Publishing date 2009-11
    Publishing country Netherlands
    Document type Evaluation Studies ; Journal Article
    ZDB-ID 604916-3
    ISSN 1872-8359 ; 0167-7012
    ISSN (online) 1872-8359
    ISSN 0167-7012
    DOI 10.1016/j.mimet.2009.08.015
    Database MEDical Literature Analysis and Retrieval System OnLINE

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