scholarly journals Implementing TeamSTEPPS in a Shanghai COVID-19 Quarantine Center for Medical Observation to Enhance Interprofessional Attitude and Skills Regarding Teamwork

2021 ◽  
Vol 6 (3) ◽  
pp. 85
Author(s):  
Tang Baoxin ◽  
Yu Haiping ◽  
Gu Yanfen ◽  
Sun Xiaoliang ◽  
Kang Baoli ◽  
...  
Keyword(s):  
Neurosurgery ◽  
2003 ◽  
Vol 52 (3) ◽  
pp. 534-544 ◽  
Author(s):  
Scott W. Soleau ◽  
Richard Schmidt ◽  
Steve Stevens ◽  
Anne Osborn ◽  
Joel D. MacDonald

Abstract OBJECTIVE Dural sinus thrombosis (DST) is an uncommon cause of stroke. The safest and most effective therapy for DST has not been conclusively identified. METHODS A retrospective chart review of data for 31 patients who were treated for DST at our institution between 1992 and 2001 was performed. Four treatment strategies were identified, i.e., 1) medical observation only, 2) systemic anticoagulation (AC) therapy with heparin, 3) endovascular chemical thrombolysis with urokinase or tissue plasminogen activator and concurrent systemic AC therapy, and 4) mechanical endovascular clot thrombolysis with concurrent systemic AC therapy. Complications and clinical outcomes were assessed for each group. RESULTS Patients treated solely with medical observation fared the worst; four of five patients experienced intracranial hemorrhagic complications, and only two of five exhibited clinical improvement. Patients who received systemic AC therapy experienced no hemorrhagic complications, even when pretreatment hemorrhage was present; 75% (six of eight patients) exhibited improvement with AC therapy alone. Chemical thrombolysis was very effective in restoring sinus patency (90% of patients); however, 30% of patients (3 of 10 patients) experienced hemorrhagic complications. Sixty percent of patients (6 of 10 patients) who underwent chemical thrombolysis exhibited clinical improvement. Patients who underwent mechanical thrombectomies demonstrated a low hemorrhagic complication rate, and most (88%) made good recoveries. CONCLUSION Therapy directed at the underlying clot in DST must begin without delay. Our results suggest that supportive medical management of DST, without therapy directed at the clot or clotting process, is not effective. Systemic AC therapy, even in the presence of intracerebral hemorrhage, seems to be safe. Heparin can be safely titrated to yield partial thromboplastin times of 60 to 70 seconds. Chemical clot thrombolysis is efficacious in opening occluded sinuses but may cause intracranial hemorrhage. We currently recommend either systemic AC therapy or systemic AC therapy in conjunction with mechanical clot thrombectomy as a safe effective treatment for DST.


1901 ◽  
Vol IX (3) ◽  
Author(s):  
B. I. Vorotynsky

Medicine, as a science that studies a healthy and sick human organism, together with the rapidly advancing development of our knowledge in the field of natural sciences, begins to gradually expand the circle of its observations and studies. Along with this, the connection between medicine and such important branches of knowledge as criminal anthropology, sociology and psychology is becoming closer and closer and closer; Many provisions of these sciences are still based on data borrowed from the field of medical observation or obtained with the help of natural scientific methods of research.


2021 ◽  
Vol 20 (1) ◽  
pp. 18-24
Author(s):  
Rasmus Søgaard Hansen ◽  
◽  
Jesper Revsholm ◽  
Daniel Pilsgaard Henriksen ◽  
Lars Christian Lund Lund ◽  
...  

Aim: To explore, which differential diagnoses to consider in individuals with elevated troponins without acute myocardial infarction (AMI), and the mortality for those individuals. Methods: Retrospective, register-based study on a representative sample of the Danish population with the following inclusion criteria: High-sensitive troponin I (hs-TnI) ≥25 ng/L, age ≥18 years, and exclusion of AMI. Results: 3067 individuals without AMI but increased hs-TnI were included. Most frequent discharge diagnoses: Pneumonia (12.8%), Aortic valve disorder (11.3%), Medical observation (10.9%) and Heart failure (8.9%). The 30-days and one-year mortality was 15.8% and 32.0%, respectively. Conclusions: A selected number of alternative diagnoses must be considered in individuals with increased hs-TnI. Due to high mortality it is crucial to carefully evaluate these individuals despite the absence of AMI.


2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Xiaowei Gong ◽  
Boyun Yuan ◽  
Yadong Yuan ◽  
Fengju Li

Coronavirus disease 2019 (COVID-19) has become a global pandemic. Community and close contact exposures continue to drive the COVID-19 pandemic. There is no confirmed effective treatment for suspected cases and close contacts. Lianhuaqingwen (LH) capsules, a repurposed Chinese herbal product that is currently on the market, have proven effective for influenza and COVID-19. To determine the safety and efficacy of LH capsules for the prevention of COVID-19, we conducted a prospective open-label controlled trial of LH capsules on subjects who had close contact with people infected with COVID-19. Subjects received LH capsules (4 capsules, three times daily) or the usual medical observation for 14 days. The primary endpoint was the rate of positive nucleic acid tests of nasal and pharyngeal swabs during the quarantine medical observation period. We included 1976 patients, including 1101 in the treatment group and 875 in the control group. The rate of positive nucleic acid tests in the treatment group was significantly lower than that in the control group (0.27% vs. 1.14%, respectively; mean difference: −0.87%; 95% CI: −1.83 to −0.13; p = 0.0174 ) during the quarantine medical observation period (14 days). Among subjects with different close contact states, there was no significant difference in the rate of positive nucleic acid test results among close contacts in the treatment group and the control group (6.45% vs. 11.43%, respectively; p = 0.6762 ). Among secondary close contacts, the rate of positive nucleic acid tests in the treatment group was significantly lower than that in the control group (0.09% vs. 0.71%, respectively; p = 0.0485 ). No serious adverse events were reported. Taken together, and in light of the safety and effectiveness profiles, these results show that LH capsules can be considered to prevent the progression of COVID-19 after close contact with an infected person. This trial is registered with ChiCTR2100043012.


1997 ◽  
Vol 7 (3) ◽  
pp. 331-333
Author(s):  
Wei Li ◽  
Jane Somerville

AbstractA patient with aortitis presented in infancy with dermatitis gangrenosa. Coarctation of the aorta was subsequently produced by granulomatous tissue. We report 30 years of medical observation.


1921 ◽  
Vol 67 (279) ◽  
pp. 475-482
Author(s):  
G. A. Auden

When our President invited me to contribute a paper for this meeting, I understood that it was to be of the nature of a presentation of the case of the school medical officer in relation to a unification of those medical services which deal with the various aspects of mental defect. This I have attempted to do in the belief that if real constructive work is to be done, the foundations must be laid by examining the problem as it is manifested in childhood and early youth. This is comparatively easy, because not only does a very large proportion of children and young persons now come under continuous medical observation, but there is in addition the important testimony which their educational progress affords as to their mental make-up. Further, I believe that the practical solution of the question of mental deficiency from the point of view of the community at large will depend for its completeness upon early diagnosis, and upon the measures which are taken to deal with the subjects before they reach adult life. In one of his addresses, Dr. Oliver Wendell Holmes urges that in these days of specialisation we must not neglect the older theories which have yielded place to new. “The débris of broken systems and exploded dogmas form a great mound, a Monte Testaccio of shards and remnants of old vessels which once held human beliefs. If you take the trouble to climb to the top of it, you will widen your horizon.” To none is this advice more needful than to those of us who are brought into contact with mental defect and all its attendant problems. There is still so much confusion of thought, the result of changing points of view, that we do not always see clearly the end to which our efforts should be directed. This is of practical importance, because upon the standpoint from which we view the problem will depend, not only the range of our activities, but also the particular members of the community whom we hope to include therein.


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