Transfer medicine

2014 ◽  
Author(s):  
Jeremy Prout ◽  
Tanya Jones ◽  
Daniel Martin
Keyword(s):  
Spinal Injury ◽  
Legal Aspects ◽  
Patient Transfer ◽  
Specific Patient ◽  
Patient Groups

This chapter on transfer medicine includes transfer indications, decisions, general considerations and complications as well as legal aspects of patient transfer. Considerations for specific patient groups are described for neurosurgical, trauma, spinal injury, burns and obstetric patients. Complications and management are detailed in an ABCDE format. Transfer equipment including ventilators with modes of ventilation are also considered.

scholarly journals Non-medical risk factors associated with postponing elective surgery: a prospective observational study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Julia Becker ◽  
Gerald Huschak ◽  
Hannes-Caspar Petzold ◽  
Volker Thieme ◽  
Sebastian Stehr ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Low Socioeconomic Status ◽  
Elective Surgery ◽  
Nursing Home Residents ◽  
Hospital Staff ◽  
Data Management System ◽  
Electronic Patient Records ◽  
Specific Patient ◽  
Emergency Procedures ◽  
Patient Groups

Abstract Background Operation room (OR) planning is a complex process, especially in large hospitals with high rates of unplanned emergency procedures. Postponing elective surgery in order to provide capacity for emergency operations is inevitable at times. Elderly patients, residents of nursing homes, women, patients with low socioeconomic status and ethnic minorities are at risk for undertreatment in other contexts, as suggested by reports in the medical literature. We hypothesized that specific patient groups could be at higher risk for having their elective surgery rescheduled for non-medical reasons. Methods In this single center, prospective observational trial, we analysed 2519 patients undergoing elective surgery from October 2018 to May 2019. A 14-item questionnaire was handed out to illicit patient details. Additional characteristics were collected using electronic patient records. Information on the timely performance of the scheduled surgery was obtained using the OR’s patient data management system. 6.45% of all planned procedures analysed were postponed. Association of specific variables with postponement rates were analysed using the Mann–Whitney U test and Fisher's exact test/χ2-test. Results Significantly higher rates of postponing elective surgery were found in elderly patients. No significant differences in postponing rates were found for the variables gender, nationality (Germany, EU, non-EU), native language, professional medical background and level of education. Significantly lower rescheduling rates were found in patients with ties to hospital staff and in patients with a private health insurer. Conclusions Elderly patients, retirees and nursing home residents seem to be at higher risk for having their elective surgery rescheduled. However, owing to the study design, causality could not be proven. Our findings raise concern about possible undertreatment of these patient groups and provide data on short-term postponement of elective surgery. Trial registration DRKS00015836. Retrospectively registered.

scholarly journals Predictive Factors in Sacral Neuromodulation: A Systematic Review

2021 ◽  
pp. 1-21
Author(s):  
Ranjana Jairam ◽  
Jamie Drossaerts ◽  
Tom Marcelissen ◽  
Gommert van Koeveringe ◽  
Desiree Vrijens ◽  
...  
Keyword(s):  
Systematic Review ◽  
Predictive Factors ◽  
Sacral Neuromodulation ◽  
Level Of Evidence ◽  
Specific Patient ◽  
Detrusor Contractility ◽  
Affective Symptoms ◽  
Lower Success Rate ◽  
Patient Groups ◽  
Based Medicine

<b><i>Introduction:</i></b> Sacral neuromodulation (SNM) is an effective treatment in patients with overactive bladder syndrome or nonobstructive urinary retention when conservative treatment fails. Several factors that could impact outcome with SNM have been studied. This systematic review investigated these predictive factors and their relevance for clinical practice. <b><i>Methods:</i></b> Systematic review according to the PRISMA guidelines was conducted. This review is registered in the PROSPERO register (CRD42015016256). <b><i>Results:</i></b> Seventy-eight studies (of which 11 abstracts) were included. Females, younger patients, and a tined lead procedure tend to be predictive in successful SNM outcome. Factors that did not influence SNM outcome were prior back surgery, surgery for stress urinary incontinence, affective symptoms, and duration of complaints. Reduced detrusor contractility is associated with a lower success rate. The level of evidence of most studies (graded according to the Centre for Evidence-Based Medicine) was 3b. <b><i>Conclusion:</i></b> Even though this systematic review investigated predictive factors (gender, age, type of procedure, type of lead, and detrusor contractility), no general consensus on predictive factors could be made. Most studies are small, retrospective, and involve a heterogeneous population. Therefore, prospective research in larger specific patient groups remains necessary to find predictors of SNM outcome.

scholarly journals Subgroup analyses to determine cardiovascular risk associated with nonsteroidal antiinflammatory drugs and coxibs in specific patient groups

2008 ◽  
Vol 59 (8) ◽  
pp. 1097-1104 ◽  
Author(s):  
Daniel H. Solomon ◽  
Robert J. Glynn ◽  
Kenneth J. Rothman ◽  
Sebastian Schneeweiss ◽  
Soko Setoguchi ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Antiinflammatory Drugs ◽  
Specific Patient ◽  
Subgroup Analyses ◽  
Patient Groups

scholarly journals Catheter-Based Therapies and Other Management Strategies for Deep Vein Thrombosis and Post-Thrombotic Syndrome

2020 ◽  
Vol 9 (5) ◽  
pp. 1439 ◽  
Author(s):  
Siddhant Thukral ◽  
Suresh Vedantham
Keyword(s):  
Deep Vein Thrombosis ◽  
Management Strategies ◽  
Patient Centered ◽  
Specific Patient ◽  
Vein Thrombosis ◽  
Post Thrombotic Syndrome ◽  
Patient Morbidity ◽  
Patient Groups ◽  
Deep Vein

Acute deep vein thrombosis (DVT) causes substantial short-term and long-term patient morbidity. Medical, lifestyle, and compressive therapies have been investigated for the prevention of pulmonary embolism (PE) and recurrence of venous thromboembolism (VTE). However, patient-centered outcomes such as resolution of presenting DVT symptoms and late occurrence of post-thrombotic syndrome (PTS) have not been prioritized to the same degree. Imaging-guided, catheter-based endovascular therapy has been used in selected patients to alleviate these sequelae, but important questions remain about their optimal use. In this article, we review the available evidence and summarize the rationale for use of catheter-based therapy in specific patient groups.

Optimising the use of virtual and conventional simulation: a clinical and economic analysis

2007 ◽  
Vol 6 (2) ◽  
pp. 83-91 ◽  
Author(s):  
M. McJury ◽  
B. Foran ◽  
J. Conway ◽  
S. Dixon ◽  
K. Wilcock ◽  
...  
Keyword(s):  
Treatment Process ◽  
Virtual Simulation ◽  
Treatment Episode ◽  
Specific Patient ◽  
Registration Data ◽  
Significant Difference ◽  
Patient Groups ◽  
Set Up ◽  
Costing Analysis

AbstractBackground and purpose: Currently, optimal use of virtual simulation for all treatment sites is not entirely clear. This study presents data to identify specific patient groups for whom conventional simulation may be completely eliminated and replaced by virtual simulation.Sampling and method: Two hundred and sixty patients were recruited from four treatment sites (head and neck, breast, pelvis, and thorax). Patients were randomly assigned to be treated using the usual treatment process involving conventional simulation, or a treatment process differing only in the replacement of conventional plan verification with virtual verification. Data were collected on set-up accuracy at verification, and the number of unsatisfactory verifications requiring a return to the conventional simulator. A micro-economic costing analysis was also undertaken, whereby data for each treatment process episode were also collected: number and grade of staff present, and the time for each treatment episode.Results: The study shows no statistically significant difference in the number of returns to the conventional simulator for each site and study arm. Image registration data show similar quality of verification for each study arm. The micro-costing data show no statistical difference between the virtual and conventional simulation processes.Conclusions: At our institution, virtual simulation including virtual verification for the sites investigated presents no disadvantage compared to conventional simulation.

scholarly journals Sentinel laboratory surveillance of hepatitis C antibody testing in England: understanding the epidemiology of HCV infection

2006 ◽  
Vol 135 (3) ◽  
pp. 417-426 ◽  
Author(s):  
L. J. BRANT ◽  
M. HURRELLE ◽  
M. A. BALOGUN ◽  
P. KLAPPER ◽  
F. AHMAD ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Drug Users ◽  
Laboratory Data ◽  
National Surveillance ◽  
Antibody Testing ◽  
Specific Patient ◽  
Laboratory Surveillance ◽  
Patient Groups ◽  
Test Result

This paper describes sentinel laboratory surveillance of hepatitis C antibody testing in England. Demographic and test result data were supplemented by follow-up questionnaires sent to the requesting clinician. Between October 2002 and September 2003 almost 75000 anti-HCV tests were performed in eight sentinel centres. More males were tested than females and over half of those tested were aged 25–44 years. Overall 5·7% (3333/58144, range 2·8–7·7%) individuals tested positive. Follow-up questionnaire data showed that 82% (1043/1277) of the positives had injecting drug use reported as the main risk exposure. The majority of negative individuals were undergoing routine screening as recommended for specific patient groups. Most individuals were asymptomatic. Antibody prevalence was estimated to be 34% in current injecting drug users and 42% in former injectors. Comparing positives to routine national surveillance suggests that only 53% (1782/3333) of diagnosed cases were reported. Sentinel laboratory data can provide valuable supplementary data to national surveillance.

Pharmacological methods of thromboprophylaxis

2006 ◽  
Vol 21 (1_suppl) ◽  
pp. 11-18
Author(s):  
M Thomas ◽  
B J Hunt
Keyword(s):  
Venous Thromboembolism ◽  
Hospitalized Patients ◽  
National Guidelines ◽  
Specific Patient ◽  
Department Of Health ◽  
Patient Groups

The burden of venous thromboembolism (VTE) in hospitalized patients is significant and often underestimated. In this article the rationale for thromboprophylaxis is reviewed and rates of VTE in different patient populations considered. The options for pharmacological methods of prophylaxis are outlined and the evidence for their use in specific patient groups is reviewed. Thromboprophylaxis is effective but currently underused. Strategies are being developed to remedy this situation including the development of national guidelines and intervention by the Department of Health.

scholarly journals Evidence for the use of probiotics and prebiotics in inflammatory bowel disease: a review of clinical trials

2007 ◽  
Vol 66 (3) ◽  
pp. 307-315 ◽  
Author(s):  
Charlotte Hedin ◽  
Kevin Whelan ◽  
James O. Lindsay
Keyword(s):  
Inflammatory Bowel Disease ◽  
Clinical Trials ◽  
Bowel Disease ◽  
Human Subjects ◽  
Specific Patient ◽  
Attractive Therapeutic Target ◽  
Patient Groups ◽  
Inflammatory Bowel ◽  
Mutual Tolerance

Human subjects and their enteric microbiota have evolved together to reach a state of mutual tolerance. Mounting evidence from both animal models and human studies suggests that inflammatory bowel disease (IBD) represents a malfunction of this relationship. The enteric microecology therefore represents an attractive therapeutic target with few side effects. Probiotics and prebiotics have been investigated in clinical trials as treatments for IBD, with conflicting results. The evidence for the use of probiotics in the management of pouchitis is persuasive and several studies indicate their effectiveness in ulcerative colitis. Trials of probiotics and prebiotics in Crohn's disease are less convincing. However, methodologies vary widely and a range of probiotic, prebiotic and combination (synbiotic) treatments have been tested in a variety of patient groups with an assortment of end points. Conclusions about any one treatment in a specific patient group can therefore only be drawn on evidence from relatively small numbers of patients. The present article reviews the role of the intestinal microbiota in the pathogenesis of IBD and addresses the clinical evidence for the therapeutic manipulation of bowel microbiota using probiotics, prebiotics and synbiotics in IBD.

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