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J Simo

Publications and source records attributed to J Simo.

11 recordsLinked to original sources
PubMed2001

Strategy-making capability and performance of Slovak acute hospitals.

BACKGROUND: Research of strategic management issues in the environment of Slovak Health Care System generally and in the environment of secondary health care providers partially is a relatively new approach of last decade. In continuity with research of western authors this pilot study approaches a specific area of strategic management that is strategy-making capability and its relationship to performance of hospitals. AIM: Main goal of authors was to apply framework developed by Hart and test relationship of strategy making capability and performance in Slovak Acute Hospitals. Two hypotheses were developed for that purpose. METHODS: To conduct a test of both hypotheses a combination of three instruments was used. First was a set of 17 questionnaire items to tap the five strategy-making modes. Second was another set of 8 questionnaire items to tap the four perceived performance dimensions. Third was a current classification of Slovak acute hospitals and their levels. In summary data on twenty-five questionnaire--items were mailed to Chief Executive Officers (CEO) of 81 Slovakian acute hospitals within a larger survey co-ordinated by Ministry of Health. Data were collected via a questionnaire survey of top managers from selected acute Slovak hospitals within December 1999--February 2000. The sample was chosen from the list of acute care hospitals in the 1999 Report of the Slovak Institute for Health Care Information and Statistics. RESULTS: Being aware of certain limitations in such a construct results indicate that hospitals with higher level of strategy-making capabilities might outperform those with lower level of this capability. (Tab. 5, Ref. 21.).

Data Collection↗
PubMed2000

[The "open abdomen" as one of the possible therapeutic alternatives in postoperative complications].

The authors discuss the important problem of healing, infection of surgical wounds and causes of healing per secundam. Despite efforts on the part of surgeons to close the surgical wound, in particular in old people with polymorbidity, hypoproteinaemia and anaemia, disintegration of the surgical wound may occur which cannot be closed and healing must proceed while the abdomen is open.

Abdomen↗
PubMed2000

[Gastroduodenal hemorrhage].

Haemorrhage is a serious complication of peptic ulcer disease. It is an indication for urgent diagnostic and therapeutic endoscopy, which is at present the method of first choice. All patients with gastroduodenal peptic ulcer bleeding, who underwent endoscopy in Ist Department of Surgery in Bratislava between January 1995 and December 1999, were considered for retrospective study. A total of 291 patients (195 male and 96 female) underwent urgent endoscopy with a finding in 34.7% of patients with gastric ulcer and in 65.3% patients duodenal ulcer. The finding was Forrest I in 23%, Forrest II in 25.7% and Forrest III in 51.3% patients. Endoscopic hemostasis was used in 12.37% of patients. A first haemorrhage was found in 82.9% patients, a recurrent one in 17.1% patients. 41.5% of patients had positive peptic ulcer history. Surgical treatment was indicated in cases, when bleeding was not controlled by endoscopic means, or in cases of recurrent bleeding within 48 hours in 19 patients (6.52%).

Female↗
PubMed2000

[Surgical treatment of acute diverticulitis of the large intestine].

The authors analyze in this paper covering a ten-year period (1990-1999) a group of patients with acute perforated diverticulitis. The patients were classified according to Hinchey's classification. During this period 35 patients were operated with a high preoperative morbidity. With regard to the low number of complications of acute diverticulitis the authors do not prefer early preventive resections of non-complicated diverticulitis, but they tend to extend indications, first of all in cases of repeated recurrences, haemorrhage and in case of stenosis. In the IIIrd and IVth stage according to Hinchey's classification dominates Hartmann's operative procedure. But the authors agree with the trend to perform resection with primary anastomosis in the IIIrd stage, especially in cases of a good status of the patient and short duration of the disease. In cases of acute perforated diverticulitis operated in the first 24-hour interval the mortality rate was 23.1%.

Acute Disease↗
PubMed1999

[Diagnosis of colorectal carcinoma].

The authors analyzed a group of 207 patients operated on for colorectal carcinoma at the 1st Department of Surgery, Medical Faculty of Comenius University, in the years 1994-1998. They detected a high number of patients in stages C and D according to Dukes' classification--53.1% and a high percentage of patients with liver metastases (42%). The number of urgent operations in this five year follow-up increases gradually, which signalizes no improvement in early diagnostics of colorectal carcinoma. The first symptom of this disease was in 37% of cases bowel obstruction (ileus) or another complication of the underlying disease. It is clear from this analysis, that the early diagnostics of colorectal carcinoma is not improving. The authors also analyse the possibilities of improving this situation and the new possibilities of early diagnostics of colorectal carcinoma. (Tab. 2, Ref. 13.)

Adult↗
PubMed1999

[True aneurysms of the popliteal artery--surgical treatment].

The authors discuss the history of treatment of popliteal aneurysm, causes of its development and its surgical treatment. They recommend surgery of an asymptomatic aneurysm with a diameter greater than 2 cm because of possible development of thrombosis with subsequent embolization into the periphery and development of gangrene of the extremity which may end by amputation. Early thrombolysis of a thrombotized aneurysm can be successful and combined with subsequent surgery can save the extremity. When a peripheral aneurysm is detected thorough surgical examination is necessary using ultrasonography, computed tomography and magnetic resonance resp. to detect aneurysms at other sites.

Aneurysm↗
PubMed1999

[Antibiotic prophylaxis in surgery].

Infection remains a serious complication after surgical produces. The main risk factors for developing infection are: 1. endogenous-host related, 2. exogenous-produce related, 4. environmental-related ones. Systemic antibiotic prophylaxis significantly reduces the incidence of potentially serious infective complications. It is indicated in procedures with incidence of infective complications more as 5%, in clean contaminated wounds and also in produces, in which infection has fatal consequences (vascular surgery, heart surgery, traumatology). The decision to use antibiotic prophylaxis depends upon the operation to be performed, the findings at operations, the general health of the patient and pharmacological and antibacterial properties of the agent. Timing of the first dose (administration not more as 1 hour preoperatively) and duration not more as 24 hours are very important. We use the second generations of cephalosporins (cefuroxim and after antibiotic rotation cefamandol) in antibiotic prophylaxis obligatory in vascular surgery, pacemaker implantation, traumatology and in colorectal surgery (there in combination with metronidasol) with mean infection rate in clean surgical procedures from 0.5 to 1.5%. Complications after antibiotic prophylaxis are very rare. However antibiotic prophylaxis can not compensate the correction of medical problems preoperatively and the meticulous surgical technique.

Antibiotic Prophylaxis↗