Importance of the human cadaveric dissection for learning anatomy by the first year MBBS students – An observational study

ObjectiveTo explore the hypothesis that earlier administration of acute gabapentinoids is beneficial to motor recovery after spinal cord injury in humans.MethodsThis is an observational study using a cohort from the European Multi-Centre Study about Spinal Cord Injury. Patient charts were reviewed to extract information regarding the administration and timing of gabapentinoid anticonvulsants. The primary outcome measure was motor scores, as measured by the International Standards for Neurological Classification of Spinal Cord Injury, collected longitudinally in the first year after injury. Sensory scores (light touch and pinprick) and functional measures (Spinal Cord Independence Measure) were secondary outcomes. Linear mixed effects regression models included a drug-by-time interaction to determine whether exposure to gabapentinoids altered recovery of muscle strength in the first year after injury.ResultsA total of 201 participants were included in the study and had a median age of 46 and baseline motor score of 50. Participants were mostly men (85%) with sensory and motor complete injuries (50%). Seventy individuals (35%) were administered gabapentinoids within the first 30 days after injury, and presented with similar demographics. In the longitudinal model, the administration of gabapentinoids within 30 days after injury was associated with improved motor recovery when compared to those who did not receive gabapentinoids during this time (3.69 additional motor points from 4 to 48 weeks after injury; p = 0.03). This effect size increased as administration occurred earlier after injury (i.e., a benefit of 4.68 points when administered within 5 days).ConclusionsThis retrospective, observational study provided evidence of the beneficial effect of gabapentinoid anticonvulsants on motor recovery after spinal cord injury. More critically, it highlighted a potential time dependence, suggesting that earlier intervention is associated with better outcomes.Classification of evidence:This study provides Class IV evidence that gabapentinoids improve motor recovery for individuals with acute spinal cord injury.

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Development of an Interdisciplinary Electronic Consultation Platform in the Netherlands: a mixed methodes observational study. (Preprint)

10.2196/preprints.33630 ◽

2021 ◽

Author(s):

Sanne Sanavro ◽

Henk van der Worp ◽

Danielle Jansen ◽

Paul Koning ◽

Marco H Blanker

Keyword(s):

Observational Study ◽

Secondary Care ◽

Knowledge Exchange ◽

Interdisciplinary Approach ◽

First Year ◽

Patient Centered ◽

Interactive Communication ◽

Mean Response Time ◽

Questions And Answers ◽

To Receive

BACKGROUND Consultation between General Practitioners (GPs) and hospital specialists can be challenging due to mutual unavailability and lack of interactive communication tools. By contrast, team-based case collaboration on a patient-centered network of healthcare professionals could facilitate communication and knowledge transfer. A digital interactive platform was developed to support this new way of collaboration. OBJECTIVE Purpose. To describe the development of the digital consultation platform (PRISMA) to connect general GPs with hospital specialists via the Siilo application and to evaluate the first year of use, including consultations, topic diversity, and number of participating physicians. METHODS Methods. We conducted a mixed-methods observational study, analyzing qualitative and quantitative data for cases posted on the platform between June 2018 and May 2020. Any GP can post questions to an interdisciplinary group of secondary care specialists, with the platform designed to facilitate discussion and knowledge exchange for all users. RESULTS Results. In total, 3674 cases were posted by 424 GPs across 16 specialisms. Most questions and answers concerned diagnosis, non-medical treatment, and medication. Mean response time was 76 minutes (range, 44–252). An average of three users engaged with each case (up to seven specialists). Almost half of the internal medicine cases received responses from at least two specialisms in secondary care, contrasting with about one-fifth for dermatology. Of note, the growth in consultations was steepest for dermatology. CONCLUSIONS Conclusions. Digital consultations offer the possibility for GPs to receive quick responses when seeking advice. The interdisciplinary approach of PRISMA creates opportunities for digital patient-centered networking. CLINICALTRIAL none

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