Organization of Hospital for Extrahospital Emergencies

1985 ◽  
Vol 1 (3) ◽  
pp. 284-285
Author(s):  
E. Tresalti ◽  
G. Rossi ◽  
P. Contegiacomo
Keyword(s):  
Clinical Care ◽  
University Hospital ◽  
Treatment Center ◽  
Second Phase ◽  
Transfusion Center ◽  
Technological Level ◽  
Subsequent Phase ◽  
Set Up ◽  
The University ◽  
Gastro Intestinal Tract

In the last few years various departments of the University Hospital “A. Gemelli” have been engaged in dealing with disasters of different kinds: the earthquakes of Belice, Friuli and Irpinia, the fire of the Todi antique exhibition, and various terrorist attacks. In these events the organization of the care of the survivors took the following four aspects into account: 1) Type and kind of lesions related to the nature of the event. 2) Criteria and collection areas of the injured, casualty clearing and treatments. 3) Distance of the disaster from the treatment center. 4) New structures to be set up for improving efficiency in the future.1) The most frequent clinical problems encountered burns and crushing injuries, and those affecting the musculoskeletal, cardiorespiratory and neuro-muscular systems. In a second phase, together with the possible lack of water, food, clothing, shelter and toilet facilities, infectious diseases of the respiratory and gastro-intestinal tract appear, particularly in old people and children. The treatment of the injured in the emergency phase requires a series of interventions at a very high technological level. In the subsequent phase, which may last for months, the treatment needed comes under normal preventive and clinical care.2) In the emergency period, which in our experience does not generally last longer than ten days, the medical and surgical departments of our hospital mostly concerned were the intensive care units (18 beds), the orthopedics and traumatology sections (122 beds), the surgical wards (309 beds), the transfusion center and the hemodialysis service.

scholarly journals Treat Iron-Related Childhood-Onset Neurodegeneration (TIRCON)—An International Network on Care and Research for Patients With Neurodegeneration With Brain Iron Accumulation (NBIA)

2021 ◽  
Vol 12 ◽  
Author(s):  
Ivan Karin ◽  
Boriana Büchner ◽  
Florence Gauzy ◽  
Angelika Klucken ◽  
Thomas Klopstock
Keyword(s):  
Clinical Care ◽  
Iron Accumulation ◽  
University Hospital ◽  
The European Union ◽  
Brain Iron ◽  
Childhood Onset ◽  
Double Blind ◽  
Patient Organizations ◽  
Research Activities ◽  
Set Up

In order to improve clinical care, coordinate research activities and raise awareness for the ultra-orphan Neurodegeneration with Brain Iron Accumulation (NBIA) disorders, a group of NBIA clinicians and researchers, industry partners and patient advocacies from six European countries, Canada and the US joined forces in 2010 to set-up the collaborative initiative TIRCON (Treat Iron-Related Childhood-Onset Neurodegeneration). As a research project, TIRCON received funding in the 7th Framework Programme (FP7) of the European Union (EU) from 2011 to 2015. After successful and timely completion of the initial FP7 project, funding and donations from industry and patient organizations have sustained the further development of TIRCON's dedicated clinical research infrastructure and its governance architecture, as well as the ongoing efforts undertaken in the NBIA community to establish a network of care. From the beginning, the University Hospital of the Ludwig-Maximilians-University in Munich, Germany has been coordinating the TIRCON initiative. It consists of 8 work packages, of which the first double-blind, placebo-controlled, randomized, multi-site clinical trial in NBIA (deferiprone in PKAN, completed) and a global patient registry and biobank, currently comprising baseline and follow-up data of > 400 NBIA patients have gained particular importance. Here we describe TIRCON's history with all the challenges and achievements in diagnosing and treating NBIA. Today, TIRCON lays the ground for future clinical care and research. In these times, it may also serve as a good example of well-directed governmental funding and fruitful international scientific collaboration.

External validation of a suggested extension of the ESC 0/1h-algorithm for early rule out of myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
P Lopez Ayala ◽  
T Nestelberger ◽  
I Strebel ◽  
P.D Ratmann ◽  
J Boeddinghaus ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Troponin T ◽  
Clinical Care ◽  
External Validation ◽  
High Sensitivity ◽  
University Hospital ◽  
Funding Source ◽  
Absolute Change ◽  
The University ◽  
Rule Out

Abstract Background The European Society of Cardiology (ESC) high sensitivity cardiac troponin T 0/1h-algorithm has substantially improved the management of patients with suspected acute myocardial infarction (AMI) by triaging about 75% of patients to rapid rule-out and/or rapid rule-in. However, about 25% of patients remain in the “observe-zone”, and the optimal management of these patients is unknown. Recently, a pilot single center study with a low prevalence of AMI suggested that an absolute change of less than 7ng/L between the 0h and 3h hs-cTnT concentration would allow to help in the evaluation of patients in the observe-zone and allow triage towards rule-out with very high negative predictive value [NPV]. Purpose To externally validate this suggested modification of the ESC 0/1h-algorithm for early rule out of AMI. Methods In an ongoing multicentre international study, we prospectively enrolled unselected patients presenting to the emergency department with symptoms suggestive of MI. Final diagnoses were centrally adjudicated by two independent cardiologists using all available medical records obtained during clinical care including 90 day follow-up information and cardiac imaging. High sensitivity-cTnT (Elecsys) concentrations were measured at presentation and after 1 and 3 hours. The primary outcome was safety, quantified by the sensitivity and NPV for early rule out of NSTEMI. Results Among 1633 enrolled patients with available 0, 1 and 3h hs-cTnT concentrations, NSTEMI was the adjudicated final diagnosis in 337 (20.6%) patients. The ESC 0/1h-algorithm ruled out 918 (56.2%) patients, with a sensitivity of 98.8% (95% confidence interval [CI], 97.0–99.5) and a NPV of 99.6% (95% CI, 98.9–99.8). A total of 428 patients (26.2%) remained in the observe zone. After applying the suggested 0–3 hour absolute change cut-off criteria of 7ng/L, 393 (92.0%) additional patients from the observe zone were triaged towards ruled out. However, the safety of this triage step was poor with 62 patients with NSTEMI missed, resulting in a sensitivity of 33.3% and a NPV of 84.2% for rule-out. Conclusions The suggested 0/3h absolute change cut-off of 7ng/L for patients remaining in the observe zone of the ESC 0/1h-algorithm does NOT allow safe rule-out of AMI and should therefore NOT be implemented into routine clinical care. Figure 1 Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): Swiss National Science Foundation, the Swiss Heart Foundation, the Stiftung für kardiovaskuläre Forschung Basel, the University of Basel and the University Hospital Basel

scholarly journals Psychosis Research at Maastricht University, The Netherlands

2003 ◽  
Vol 183 (06) ◽  
pp. 559-560 ◽  
Author(s):  
Jim van Os ◽  
Philippe Delespaul
Keyword(s):  
Mental Health ◽  
Central Government ◽  
University Hospital ◽  
Source Population ◽  
Health Institutions ◽  
Mental Health Institutions ◽  
Set Up ◽  
Government Grant ◽  
The University ◽  
Academic Personnel

The academic department of psychiatry at Maastricht University is situated not only in the university hospital, but crucially also in nearly all the affiliated mental health institutions in a region with a source population of 650 000. This set-up is funded by a central government grant, allowing academic personnel to work in affiliated mental health institutions. Research projects are carried out on the basis of 4-year PhD contracts, or, in the case of doctors with specialist training, through research psychiatrist appointments in the regional academic psychiatric network. Strong links exist with the Institute of Psychiatry in London.

A Working Model for Augmented Technology Transfer

1997 ◽  
Vol 11 (3) ◽  
pp. 137-144
Author(s):  
Carol Dempster ◽  
Homer Goldberg
Keyword(s):  
Wastewater Treatment ◽  
Organ Preservation ◽  
Cold Spring Harbor ◽  
University Hospital ◽  
Technology Commercialization ◽  
North Shore ◽  
Cold Spring ◽  
Institutional Funding ◽  
Set Up ◽  
The University

The Long Island Research Institute was set up in 1992 to create and nurture enterprises based on technologies derived from its sponsoring institutions: the University at Stony Brook, Brookhaven and Cold Spring Harbor Laboratories, and North Shore University Hospital. An account of the organization's conception is followed by descriptions of its comprehensive approach to technology commercialization in three projects: a gene-finding methodology, an organ preservation device, and a wastewater treatment system. These experiences suggest that success for such an organization requires managers combining technical and business expertise, extensive contacts with local business and research communities, variable and ongoing company assistance, access to venture capital, knowledge of company needs, an entrepreneurial champion for each project, and, fundamentally, public and institutional funding.

scholarly journals Evaluation of the Time Spent by Anesthetist on Clinical Tasks in the Operating Room

2022 ◽  
Vol 8 ◽  
Author(s):  
Compère Vincent ◽  
Besnier Emmanuel ◽  
Clavier Thomas ◽  
Byhet Nicolas ◽  
Lefranc Florent ◽  
...  
Keyword(s):  
Operating Room ◽  
Clinical Care ◽  
Public Hospitals ◽  
University Hospital ◽  
External Observer ◽  
Private Hospitals ◽  
General Hospitals ◽  
Public And Private ◽  
Public And Private Hospitals ◽  
The University

BackgroundChanges in the health system in Western countries have increased the scope of the daily tasks assigned to physicians', anesthetists included. As already shown in other specialties, increased non-clinical burden reduces the clinical time spent with patients.MethodsThis was a multicenter, prospective, observational study conducted in 6 public and private hospitals in France. The primary endpoint was the evaluation by an external observer of the time spent per day (in minutes) by anesthetists on clinical tasks in the operating room. Secondary endpoints were the time spent per day (in minutes) on non-clinical organizational tasks and the number of task interruptions per hour of work.ResultsBetween October 2017 and April 2018, 54 anesthetists from six hospitals (1 public university hospital, two public general hospitals and three private hospitals) were included. They were followed for 96 days corresponding to 550 hours of work. The proportion of overall clinical time was 62% (58% 95%CI [53; 63] for direct care. The proportion of organizational time was higher in public hospitals (11% in the university hospital (p < 0.001) and 4% in general hospitals (p < 0.01)) compared to private hospitals (1%). The number of task interruptions (1.5/h ± 1.4 in all hospitals) was 4 times higher in the university hospital (2.2/h ± 1.6) compared to private hospitals (0.5/h ± 0.3) (p < 0.05).ConclusionsMost time in the operating room was spent on clinical care with a significant contrast between public and private hospitals for organizational time.

Set-up of a Real-time Broad-Range 16S PCR in the University Hospital of Strasbourg, France.

2014 ◽  
Vol 142 (suppl_1) ◽  
pp. A164-A164
Author(s):  
Mariam Meddeb ◽  
Frédéric Schramm ◽  
Benoit Jaulhac ◽  
Christelle Koebel
Keyword(s):  
Real Time ◽  
University Hospital ◽  
Set Up ◽  
The University

scholarly journals Psychosis Research at Maastricht University, The Netherlands

2003 ◽  
Vol 183 (6) ◽  
pp. 559-560
Author(s):  
Jim van Os ◽  
Philippe Delespaul
Keyword(s):  
Mental Health ◽  
Central Government ◽  
University Hospital ◽  
Source Population ◽  
Health Institutions ◽  
Mental Health Institutions ◽  
Set Up ◽  
Government Grant ◽  
The University ◽  
Academic Personnel

The academic department of psychiatry at Maastricht University is situated not only in the university hospital, but crucially also in nearly all the affiliated mental health institutions in a region with a source population of 650 000. This set-up is funded by a central government grant, allowing academic personnel to work in affiliated mental health institutions. Research projects are carried out on the basis of 4-year PhD contracts, or, in the case of doctors with specialist training, through research psychiatrist appointments in the regional academic psychiatric network. Strong links exist with the Institute of Psychiatry in London.

scholarly journals Contribution to the Assessment of the Quality of the Pre-Analytical Phase of Medical Biology Tests at the Ibn Sina University Hospital in Rabat

2021 ◽  
Vol 8 ◽  
Author(s):  
Abdelhak Jnah
Keyword(s):  
University Hospital ◽  
Pneumatic Cylinder ◽  
Structured Interviews ◽  
Ibn Sina ◽  
Laboratory Errors ◽  
Transportation Equipment ◽  
Analytical Phase ◽  
Set Up ◽  
Sampling Procedures ◽  
The University

The study of the nonconformities (NC) literatures in medical biology report that between 60-85% of laboratory errors are produced during the pre-analytical phase, which are often external and escapes the biologist's control. The objective of our study was to identify the factors at the origin of non-conformities during this phase at the University Hospital of Rabat. A mixed analytical descriptive study realized between August 2019 and August 2020 based on a non-compliance form, a self-questionnaire, an observation grid, focus groups and semi-structured interviews. We also set up the Deming wheel PDCA as well as the work tools (BRAINSTORMIN, 5M, ISHIKAWA). Our results show that 22 % of the prescriptions of biologic tests are drafted by nurses and not doctors this in the absence of an updated list of biological exams. The samples are taken at 88,1% by unqualified personnel and 95 % without any guide or manual.  For the traceability aspect, the name of the sampler is never placed on the sheet of examination, age, sex of the patient; time and nature of the sample are often not mentioned in the label vials of samples.  Transportation is made by pneumatic cylinder system and sometimes by unqualified staff in absence of procedures for packaging and transportation equipment without traceability. The reception of samples is carried out by untrained staff on the error management of the pre-analytical phase. They result at first from a major defect of coordination between the laboratory and the services, then by the lack of continuing education and the weak competence of the staff involved in this process and finally compounded by the lack of manual sampling, procedures for packaging, transport, reception and triage.

Clofarabine As the Element of Conditioning Regimen in Matched Related Allogeneic Transplantation – Single Center Experience

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4516-4516
Author(s):  
Patrycja Mensah-Glanowska ◽  
Beata Piatkowska-Jakubas ◽  
Aleksander Skotnicki
Keyword(s):  
Conflicts Of Interest ◽  
Therapeutic Option ◽  
Conditioning Regimen ◽  
Allogeneic Transplantation ◽  
University Hospital ◽  
Second Phase ◽  
Single Center Experience ◽  
Two Phases ◽  
The University ◽  
Refractory Aml

Abstract Abstract 4516 Since June 2010 to July 2012 since in Department of Hematology of the University Hospital in Krakow five patients with advanced hematological malignancies have been subjected to allogeneic transplantation from matched related donors with clofarabine as a part of conditioning regimen. Indications for transplantation were relapsed/refractory acute myeloid leukemia in four patients and CML lymphoblastic crisis in relapse after RIC alloPBSCT in one patient. In a case of three patients conditioning regimen consisted of two phases. First phase: cytoreduction with clofarabine 20mg/m2/day + ARA-C 2000 mg/day for 4 days in 2 patients with refractory AML and Clofarabine 20mg/m2/day + Cyclophosphamide 400mg/day for 4 days in one (CML lymphoblastic crisis). Second phase: Busilvex + Fludarabine (Bu4Flu). Two later patients were treated without cytoreduction. One patient with extramedullary AML in second CR was treated with Clofarabine 30mg/m2 for 4 days + TBI. Last patient with early AML relapse was conditioned with Clofarabine30mg/m2 for 5 days+ Busilvex (BuClo). G-CSF mobilized peripheral blood was used as a source of stem cells in all the patients. Results: One patient died during conditioning regimen after cytoreduction (Clofarabine + Cyclophosphamide). It was the patient with CML lymphoblastic crisis relapse after RIC allogeneic transplantation. The other patients treatment toxicity was moderate (mucositis garde I-III). Aplastic period was complicated in one patient with septic infection. One patient relapsed 5 months after transplantation. He was diagnosed with AML secondary to MDN/MPD with very high cytogenetics (t(3;3) with 7 monosomy) Three of patient series remain in complete remission. All of them were diagnosed with relapse/refractory AML with CR duration 6 months to 26 months. Conclusions: Use of clofarabine as a part of conditioning regimen is valuable therapeutic option especially in the group of patients with relapsed/refractory AML. Disclosures: No relevant conflicts of interest to declare.

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