scholarly journals Managing hospitalized patients with a COPD exacerbation: the role of hospitalists and the multidisciplinary team

Author(s):  
Alpesh N. Amin ◽  
Sharon Cornelison ◽  
J. Andrew Woods ◽  
Nicola A. Hanania
Medic ro ◽  
2020 ◽  
Vol 6 (1) ◽  
pp. 8-13
Author(s):  
Roxana Marcela Sânpălean ◽  
Dorina Nastasia Petra

Heart failure (HF) is a burden for the healthcare system. The incidence will increase significantly due to the aging of po­pu­la­tion, which is associated with multiple comorbidities. Ane­mia and iron deficiency are common in patients with HF, their etiology being often multifactorial. The screening for anemia and iron deficiency is recommended as soon as pos­si­ble. There are often no targeted investigations, therefore a significant proportion of cases are underdiagnosed. The ma­nagement of patients may focus on identifying and correcting the cause. Anemia can occur due to nutritional deficiencies, infla­m­mation, renal failure, bone marrow dysfunction, neuro­hor­mo­nal activity, treatment and hemodilution. The appropriate the­ra­py for the patients with anemia and HF will contribute to the improvement of life quality. The only recommended iron product is ferric carboxymalose administered by in­tra­venous infusion. Under the appropriate treatment, the pa­tients showed an increase in effort tolerance, with an im­prove­ment in symptomatology and a lower number of hos­pi­ta­li­za­tion days. The management of these cases is handled by a multidisciplinary team consisting of a general prac­ti­tio­ner, a cardiologist and other specialists if the patient has other comorbidities. The role of the general practitioner is essential, as he can perform proper screening, prevention and management, developed by a multidisciplinary team, in order to reduce the cardiac morbidity and mortality.  


QJM ◽  
2021 ◽  
Author(s):  
K Shah ◽  
D Saxena ◽  
D Mavalankar

Abstract Objective: Current meta-analysis aims to understand the effect of oral supplementation of vitamin D on intensive care unit (ICU) requirement and mortality in hospitalized COVID-19 patients. Methods: Databases PubMed, preprint servers, and google scholar were searched from December 2019 to December 2020. Authors searched for the articles assessing role of vitamin D supplementation on COVID-19. Cochrane RevMan tool was used for quantitative assessment of the data, where heterogeneity was assessed using I2 and Q statistics and data was expressed using odds ratio with 95% confidence interval. Results: Final meta-analysis involved pooled data of 532 hospitalized patients (189 on vitamin D supplementation and 343 on usual care/placebo) of COVID-19 from three studies (Two randomized controlled trials, one retrospective case-control study). Statistically (p<0.0001) lower ICU requirement was observed in patients with vitamin D supplementation as compared to patients without supplementations (odds ratio: 0.36; 95% CI: 0.210-0.626). However, it suffered from significant heterogeneity, which reduced after sensitivity analysis. In case of mortality, vitamin D supplements has comparable findings with placebo treatment/usual care (odds ratio: 0.93; 95% CI: 0.413-2.113; p=0.87). The studies did not show any publication bias and had fair quality score. Subgroup analysis could not be performed due to limited number of studies and hence dose and duration dependent effect of vitamin D could not be evaluated. Conclusions: Although the current meta-analysis findings indicate potential role of vitamin D in improving COVID-19 severity in hospitalized patients, more robust data from randomized controlled trials are needed to substantiate its effects on mortality.


2012 ◽  
Vol 6 (2) ◽  
pp. 173-185 ◽  
Author(s):  
Robert G Gish ◽  
Riccardo Lencioni ◽  
Adrian M Di Bisceglie ◽  
Jean-Luc Raoul ◽  
Vincenzo Mazzaferro

2012 ◽  
Vol 9 (3) ◽  
pp. 243-250 ◽  
Author(s):  
Carlos Martinez-Rivera ◽  
Karina Portillo ◽  
Aida Muñoz-Ferrer ◽  
María Luisa Martínez-Ortiz ◽  
Elena Molins ◽  
...  

2021 ◽  
Vol 14 (8) ◽  
pp. e244463
Author(s):  
Charisse Anne F Aquino ◽  
Maria Jesusa B Banal-Silao

Trauma has emerged as the leading cause of death during pregnancy. Penetrating abdominal trauma in pregnancy requires a rigorous clinical evaluation to establish a complete assessment of obstetric and non-obstetric lesions. In the case of major trauma, treatment is essentially carried out in a trauma centre with a multidisciplinary team to improve maternal and fetal prognosis. This is a case of a 20-year-old primigravid woman, 33 weeks and 4 days age of gestation, who was admitted for impaled foreign body. She was brought to the emergency department for a penetrating wound of the chest and abdomen after being accidentally impaled by a metre-long, inch-thick steel rod. Emergency laparotomy, caesarean section and thoracotomy were performed. The aim of this report is to discuss the assessment, management and role of the multidisciplinary team in the management of a pregnant trauma patient.


2014 ◽  
Vol 83 (4) ◽  
pp. 282-287
Author(s):  
Sofiya Prokip ◽  
Iga Pawłowska ◽  
Bohdan Hromovyk ◽  
Leszek Pawłowski

Introduction. The efficient pharmacotherapy is an important part of palliative and hospice care, and requires a multidisciplinary approach to the patients. The pharmacist, as the member of the multidisciplinary therapeutic team, is responsible for performing pharmaceutical care, which provides safe and efficient treatment. The aim of the research was to conduct a comparative research about the status of palliative and hospice care and role of the pharmacist (clinical pharmacist) in Ukraine and Poland.Material and methods. It was a questionnaire survey conducted in Ukraine, as well as analysis of information sources associated with this subject. The questionnaire was developed on the basis of similar study conducted in Poland. It consisted of 15 multiple-choice questions addressed to head physicians and doctors in Ukraine. The obtained results were compared to the results of the mentioned above Polish study. Results. Eight head physicians and 22 doctors (30 questionnaires) from 13 palliative and hospice care institutions in Ukraine responded to the survey. It has been found that almost half in Ukraine (43%) believed that the pharmacist should be a mandatory member of a multidisciplinary team, because of his/her significant role in drug management in hospice. Conclusion. A multidisciplinary approach to satisfying of patients' needs in palliative and hospice care has a great significance. Results of the study testify to the importance of including the pharmacists into the multidisciplinary team.


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