Trauma Patient Outcome in an Army Deployable Medical Systems Environment Compared with a Medical Center

Abstract Arts and Humanities networks harness social capital in the service of older populations creating strength in age. This symposium will feature presentations in aging, arts, education, health and humanities exemplifying enormous and often underutilized resources readily available to engage older people across the spectrum of aging to combat decline and frailty at cognitive and physiological levels. Presenters will describe innovative partnership projects such as Sound Health, an initiative developed by the National Institutes of Health and the John F. Kennedy Center for the Performing Arts to expand knowledge and understanding of how listening, performing, or creating music could be harnessed for health and well-being; hybrid arts and humanities in health programs based within medical systems such as the Center for Performing Arts in Medicine at Texas Medical Center: Houston Methodist promoting research/evaluation of arts inventions to improve overall quality of patient care; and, MedStar Georgetown Lombardi Arts and Humanities Program providing a continuum of support for older patients and their caregivers from diagnoses through treatment processes. A Georgetown University case study will be presented on how arts, ethics and humanities are necessary and ideal components of an interdisciplinary master’s degree program in aging studies to ensure understanding a diverse and inter-generational cohort and student’s cultural value systems. The symposium will conclude with a presentation from the National Endowment of the Arts describing program service infrastructures across the country supporting arts engagement of older people, their families and caregivers focusing on lifelong learning; health and well-being; and age friendly design

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National evaluation program for emergency medical center

Journal of Korean Medical Association ◽

10.5124/jkma.2020.63.4.184 ◽

2020 ◽

Vol 63 (4) ◽

pp. 184-186

Author(s):

Sung Woo Lee

Keyword(s):

Emergency Care ◽

Evaluation System ◽

Medical Center ◽

Medical Systems ◽

Emergency Rooms ◽

Evaluation Program ◽

Emergency Medical ◽

Final Treatment ◽

Medical Person ◽

Emergency Medical Systems

Since 2003, the national evaluation program for emergency medical centers (EMCs) has been managed by the Central Emergency Medical center which is controlled by the Ministry of Health and Welfare. Although the evaluation system for EMC has contributed to the development of the structure of emergency centers and the expansion of emergency resources (emergency medical person and equipment), it has some limitations in terms of quality control for both EMCs and emergency medical systems. One of the purposes of the evaluation program is to assess the performance of EMC in different levels. However, both regional and local emergency centers have same role that is offering of final treatment to severe emergency patients. There is no role for local emergency rooms in the emergency care of patients. In addition, the national evaluation program does not have outcome indicators that assess the performance of the EMC in emergency care. The improvement of the national evaluation system for EMC is required for the appropriate assessment of the performance of EMCs in the future.

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Percutaneous nephrolithotomy assisted by LithoClast master in one-phase treatment for staghorn renal stones with refractory infections

10.21203/rs.3.rs-38642/v1 ◽

2020 ◽

Author(s):

Hai-Xiao Tang ◽

Di Wu ◽

Bo-Wen Shi ◽

Ze-Hao Dai ◽

Yun-Teng Huang

Keyword(s):

Percutaneous Nephrolithotomy ◽

Medical Center ◽

Operation Time ◽

Renal Stones ◽

Efficacy And Safety ◽

Medical Systems ◽

Two Phase ◽

Reactive Protein ◽

Fifth Generation ◽

Grade Ii

Abstract Background: Infectious staghorn renal stones are usually treated with one-phase for percutaneous puncture and drainage, and then two-phase for percutaneous nephrolithotomy (PCNL). The objective of the study was to evaluate the efficacy and safety of PCNL assisted by LithoClast master (the fifth-generation Electro Medical Systems, EMS) in one-phase treatment for staghorn renal stones with refractory infections.Methods: From September 2017 to September 2019, 80 patients with staghorn renal stones who underwent one-phase for PCNL combined with the fifth-generation EMS in our hospital were retrospectively analyzed. According to whether patients with staghorn renal stones were complicated with refractory infections or not before operation, they were divided into A group (48 cases with refractory infections) and B group (32 cases without infections). In A group, refractory infections were properly controlled with sensitive antibiotics before operation. The efficacy and safety of treatment for two groups were compared.Results: Before taking sensitive antibiotics in A group, there was statistical difference in the location of stones between the two groups (P＜0.05), while there were no statistical significances in other general clinical data between the two groups (P＞0.05). Although there were statistical differences in the increase rate of white blood cell count, C-reactive protein, procalcitonin on the first day after operation between the two groups (P＜0.05), there were no statistical differences in operation time, hospitalization time, hemoglobin, stone-free rate, Clavien-Dindo grade I complications, Clavien-Dindo grade II and above complications between the two groups (P＞0.05). Conclusions: For staghorn renal stones with refractory infections, based on the application of sensitive antibiotics before operation to properly control refractory infections, PCNL assisted by the fifth-generation EMS in one-phase can efficiently remove staghorn renal stones, without increasing the risk of postoperative complications. In the medical center with mature technical conditions and rich experience, staghorn renal stones with refractory infections can be selected carefully to carry out one-phase operation.

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