Characteristics and treatment of patients with epistaxis over the last 5 years in Guangzhou

Background: Epistaxis is one of the most common emergencies in the department of otolaryngology, which gives a burden to the health care system. Objectives: This study aimed to investigate the patients’ characteristics of hospital admission with epistaxis and provide an optimized protocol. Methods: This study was a retrospective analysis of patients with epistaxis admitted to The Third Affiliated Hospital of Sun Yat-sen University in Guangzhou, China. The data were analyzed in terms of gender, age, seasonal differences, length and expenses of hospitalization, pathogenesis of epistaxis, primary medical management before hospital admission, bleeding sites, and treatment. Results: A total of 387 patients were included, which consisted of 270 males and 117 females with an average of 43 years. Most patients could be identified with underlying diseases, and the most commonly observed bleeding site was Little area (n = 164). Most patients received electrocauterization as a precision medical treatment (n = 288). The duration of hospitalization length ranged from a mean of 5.17–4.48 days, and the expenses of hospitalization ranged from a mean of RMB 4881–4951 yuan over the last 5 years. Conclusion: Most patients with epistaxis could be treated as outpatients by endoscopic electrocauterization, and hospitalization is indicated when patients need improvement of poor general condition, posterior packing, embolization, or surgery. This study enables to provide an optimized protocol for patient with epistaxis.

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Quality Assessment of Ethics in Health Care: The Accountability Revolution

American Journal of Law & Medicine ◽

10.1017/s0098858800006456 ◽

1994 ◽

Vol 20 (1-2) ◽

pp. 105-128

Author(s):

Susan M. Wolf

Keyword(s):

Health Care ◽

World War Ii ◽

Quality Assessment ◽

Central Place ◽

World War ◽

New Era ◽

The Third ◽

Cost Cutting ◽

Global Budgeting

Writing in 1988, Arnold Relman heralded the dawning of the “third revolution“ in medical care. The first revolution, at the end of World War II, had inaugurated an Era of Expansion, with an explosion of hospitals, physicians, and research. Medicare and Medicaid were passed, and medicine experienced a golden age of growth. Inevitably, according to Relman, this yielded to an Era of Cost Containment starting in the 1970s. The federal government and private employers revolted against soaring costs, brandishing the weapons of prospective payment, managed care, and global budgeting. Yet these blunt instruments of cost-cutting eventually produced concern over how to evaluate the quality of health care, to promote the good while trimming the bad. Thus Relman announced the arrival of the Era of Assessment and Accountability.This chronology helps explain the current importance of quality. Quality assessment and more recently, quality improvement techniques, occupy a central place in this new era.

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Hyperprogressive disease after radiotherapy combined with anti-PD-1 therapy in renal cell carcinoma: a case report and review of the literature

BMC Urology ◽

10.1186/s12894-021-00813-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Chao Liu ◽

Jingjing Piao ◽

Zhiyang Shang

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

General Condition ◽

Renal Cell ◽

Checkpoint Inhibitors ◽

Lung Metastases ◽

Left Lung ◽

The Third ◽

Bidirectional Regulation ◽

Hyperprogressive Disease

Abstract Background Studies have shown that immune checkpoint inhibitors (ICIs) have limited efficacy and can even increase tumour burden in short time periods. This is usually called hyperprogressive disease (HPD). To date, there are few reports regarding HPD; fewer have analysed the relationship between HPD and radiotherapy combined with ICIs, and their conclusions are controversial. Case presentation A 42-year-old woman was diagnosed with stage IV renal clear cell carcinoma. The patient had previously received sorafenib and pazopanib as first- and second-line therapies, respectively. She received radiotherapy combined with nivolumab. Eighteen days after administration of the third dose of nivolumab, the patient’s general condition deteriorated; this was associated with immune-related adverse events. Computed tomography showed that the diameter of left lung metastases had sharply increased. A biopsy of the lung metastasis showed no infiltration of lymphocytes. The patient’s general condition worsened and she died of the disease on the 70th day after administration of the third dose of nivolumab. Conclusions This report describes the development of HPD following the administration of radiotherapy combined with ICIs in a case of advanced renal cell carcinoma. The case indicates that radiotherapy may show bidirectional regulation effects on anti-tumour immune response. If the immunosuppressive function of radiotherapy is dominant, combined with ICIs, it could result in HPD.

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Mosquito Species breeding in “Test” Water Containers in West Africa

Bulletin of Entomological Research ◽

10.1017/s0007485300035446 ◽

1933 ◽

Vol 24 (4) ◽

pp. 483-491 ◽

Cited By ~ 8

Author(s):

Cornelius B. Philip

Keyword(s):

Mosquito Species ◽

Weather Conditions ◽

Dense Population ◽

Seasonal Differences ◽

The Third ◽

Several Variables ◽

Test Water ◽

Aedes Africanus ◽

Optimum Type ◽

Mango Leaves

Observations additional to those made by Dunn (1927) of Culicine mosquitos breeding in “ test ” water containers about a Compound in Southern Nigeria, near Lagos, are here reported for a period of the year (June to December) not covered in Dunn's study. Only the optimum type of container mentioned in Dunn's report (bamboo joints containing water and mango leaves) was employed, and these were placed in the same ten representative environmental situations. The numerical rank of infesting species differed significantly in the two studies only in the case of Culex decens, which dropped from third to last place, and of Aëdes africanus, which rose from tenth to sixth place. The total numbers of infestations in the former study were greater, but this is explainable on the basis of one or several variables, i.e., seasonal differences, elapse of time between studies, or less probably the fact that there were four containers instead of one at each station. The number of infestations at any one station has little relation to the number of resultant adults; there is a wide variation in these numbers.An analysis of the occurrence of A. aegypti in containers and a discussion of certain bionomical information together with relative weather conditions are included. Brief data are also presented of the incidence of species at three additional stations, one in a centre of dense population (Lagos), one in a suburb (Ebute Metta), and the third isolated in dense “ bush.”

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Fraud and Abuse: United States ex rel Merena v. SmithKline Beecham Corp.; United States ex rel Spear v. SmithKline Beecham Clinical Lab.; United States ex rel Grossenbacher v. SmithKline Beecham Clinical Lab.

The Journal of Law Medicine & Ethics ◽

10.1111/j.1748-720x.2000.tb00013.x ◽

2000 ◽

Vol 28 (2) ◽

pp. 191-193 ◽

Cited By ~ 6

Author(s):

Allyson Behm

Keyword(s):

United States ◽

Health Care ◽

Health Care Providers ◽

Laboratory Tests ◽

The United States ◽

Care Providers ◽

Individual Analysis ◽

Court Of Appeals ◽

The Third ◽

The Government

The United States Court of Appeals for the Third Circuit held that when quitam relators file a multi-claim complaint under the Fraudulent Claims Act (FCA), their share of the proceeds must be based on an individual analysis of each claim. More importantly, the court held that relators are not entitled to any portion of the settlement of a specific claim if that claim was subject to dismissal under section 3730(e)(4) Relator Merena filed a quitam suit against his employer, SmithKline Beecham (SKB), claiming, among other things, that SKB defrauded the government by billing for laboratory tests that were not performed, paying illegal kickbacks to health care providers, and participating in an “automated chemistry” scheme. Soon thereafter, additional relators filed suit.

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The political and administrative context of primary health care in the third world

Social Science & Medicine ◽

10.1016/0277-9536(84)90298-3 ◽

1984 ◽

Vol 18 (8) ◽

pp. 693-702 ◽

Cited By ~ 12

Author(s):

Thomas J. Bossert ◽

David A. Parker

Keyword(s):

Health Care ◽

Primary Health Care ◽

Third World ◽

The Political ◽

The Third ◽

Primary Health ◽

The Third World

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STRATEGI PENGENDALIAN TUBERKULOSIS DI PUSKESMAS PEKANBARU KOTA, TENAYAN RAYA DAN SIMPANG TIGA KOTA PEKANBARU The Strategies Of Tb Control In Primary Health Care Pekanbaru City, Tenayan Raya and Simpang Tiga Pekanbaru City

Jurnal Ilmu Lingkungan ◽

10.31258/jil.15.2.p.168-177 ◽

2021 ◽

Vol 15 (2) ◽

pp. 168

Author(s):

Meimi Laillah ◽

Ridwan Manda Putra ◽

Suyanto Suyanto

Keyword(s):

Health Care ◽

Primary Health Care ◽

Government Policy ◽

Sampling Method ◽

Causes Of Death ◽

Tb Control ◽

The Third ◽

Primary Health ◽

The Government ◽

India And China

TTuberculosis (TB) is a chronic infectious disease caused by the Mycobacterium tuberculosis (MTB) which affects the lungs and other organ., Indonesia is the third highest after India and China and Indonesia’s top ten causes of death in Indonesia. The purposeofthis study wastodeterminestrategycontrolof the TB Program in Pekanbaru City. Thisstudyisresearchwith SWOT analysisandsurveyanddirectinterviews in thefield,and the studyisgoing onJanuary-February 2021 at Pekanbaru City Primary Health Care, Tenayan Raya and Simpang Tiga PrimaryHealth Care.interview and survey with a total sampling method of 84 samples. The study’s resultsfrom the government policy involved that supporting the TB program in Pekanbaru cityisrespectable. At thesametime, fromthecommunity in thefield, there are stillpeoplewhodo not understand TB disease, forexample, theincidenceof TB disease, mode oftransmission, andthedurationoftreatmentandprevention. Suggested in controllingthe program TB disease, it is necessary to provide education and explanation to sufferers and the surrounding community

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Virtual health care for community management of patients with COVID-19. (Preprint)

10.2196/preprints.21064 ◽

2020 ◽

Author(s):

Owen Hutchings ◽

Cassandra Dearing ◽

Dianna Jagers ◽

Miranda Shaw ◽

Freya Raffan ◽

...

Keyword(s):

Health Care ◽

Health Service ◽

Hospital Admission ◽

Information Technologies ◽

Care Program ◽

Community Management ◽

Inpatient Setting ◽

Healthcare Associated Infection ◽

Health Information Technologies ◽

Health Care Program

BACKGROUND Virtual health care is emerging as a central strategy to manage large numbers of patients affected by the COVID-19 pandemic, as this can maximise the use of limited clinical resources, reduce pressure on acute facilities and reduce the potential for healthcare-associated infection OBJECTIVE To describe the implementation and early experience of virtual health care for community management of patients with COVID-19. METHODS Design: observational cohort study. Setting: large Australian metropolitan health service with established virtual health care program and remote patient monitoring capability. Participants: patients with COVID-19 living within the health service who can self-isolate safely, do not require immediate admission to an inpatient setting, have no major active comorbid illness and can be managed at home or other suitable accommodation. Main outcome measures: care escalation rates, including hospital admission. RESULTS between 11-29 March 2020, 162/173 (93.6%) locally diagnosed patients with COVID-19 were accepted to the virtual health care program, median age 38y (range 11-79). For the 62 patients discharged during this period the median length of stay was 8 days (range 1-17). The peak of 100 prevalent patients equated to approximately 25 patients per Registered Nurse per shift. Patients were contacted a median of 16 times (range 1-30) during this period, with video consultations used 66.3% of the time; 132/162 (81.5%) patients were monitored remotely. Care escalation rates were low: ambulance attendance, 5 (3%); ED attendance, 4 (2.5%); hospital admission, 3 (1.9%). There were no deaths. CONCLUSIONS Community-based virtual health care is feasible for managing most patients with COVID-19 and can be rapidly implemented in an urban Australian context for pandemic management. Health services implementing virtual health care should anticipate challenges with rapid technology deployments and provide adequate support to resolve them including strategies supporting consumer use of health information technologies.

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Hospitals, field hospitals, community isolation centers, and finally home isolation

The ASEAN Journal of Radiology ◽

10.46475/aseanjr.v22i2.148 ◽

2021 ◽

Vol 22 (2) ◽

pp. 03-04

Author(s):

Wiwatana Tanomkiat

Keyword(s):

Health Care ◽

Royal College ◽

Chest Radiographs ◽

Third Wave ◽

The Third

Unlike the first and second waves of COVID-19 pandemic in Thailand which were limited among certain populations in certain areas, the third wave starting in April 2021 spread nationwide. It was from less than 10 new cases a day in 2020, to be around 2,000 a day in June and then more than 20,000 new cases a day in August 2021. Among four doctors who were killed by COVID-19 during this third wave in Thailand, the Royal College of Radiologists of Thailand lost a very active and warm member, Associated Professor Wilaiwan Bhothisuwan. When hospitals and field hospitals were full, now COVID-19 infected patients were cared in community isolation centers. Home isolation, the last and probably the final form of health care, was set in this August. The Royal College of Radiologists of Thailand had launched a project “RadioVolunteer” to interpret and report chest radiographs of COVID-19 patients in prisons, field hospitals where there were shortage of radiologists, some community isolation centers, and radiographic units for patients with home isolation.

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