scholarly journals Management reorganization of a Radiology ward during the Covid-19 pandemic in a University Hospital structured inpavilions.

2020 ◽  
Author(s):  
Guido Marzocchi ◽  
Mattia Gentilini ◽  
Alice Gianstefani ◽  
Fabrizio Giostra ◽  
Giuliano Orazio Grassi ◽  
...  
Keyword(s):  
Radiology Information System ◽  
University Hospital ◽  
Protective Equipment ◽  
Rational Analysis ◽  
Serological Screening ◽  
Effective Response ◽  
Critical Problems ◽  
Picture Archiving And Communication ◽  
Staff Recruitment

Abstract Objective: The aim of the recent management reorganization of the Emergency Room and Radiology ward was to face the recent Coronavirus pandemic in the most rational way possible, to preserve the essential role of these Units in the complex context of a pavillions structured Hospital. Methods: The most challenging management criticalities posed by the recent Coronavirus pandemic were individually analyzed and dealt with. The pavilions structure of our Hospital, biohazard management, shortage of personnel and shortage or temporary inadequacy of personal protective equipment were addressed as the most urgent and important problems.Results: A strategic use of the Radiology Information System and Picture Archiving And Communication System (RIS-PACS), dedicated ambulances with specific disinfection procedures, the institution of dedicated pavilions, wards, checkpoints and different paths for COVID-19 (Coronavirs Disease 2019) and non COVID-19 patients, frequent sanification procedures, serological screening for employees and emergency dedicated staff recruitment were put to place as a result of said analysis.Nevertheless, all of these goals couldn’t have been achieved without a constant sense of responsibility of the employees involved.Conclusions: A rational analysis of the most critical problems associated with a pandemic is vital to provide a fast and effective response, and represents a valuable wealth of experience in case of future pandemics.

Putting the Madhyamaka Trick in Context: A Contextualist Reading of Huntington’s Interpretation of Madhyamaka

2014 ◽  
Vol 31 (1) ◽  
pp. 91-124
Author(s):  
Michael Dorfman
Keyword(s):  
Fifteenth Century ◽  
Common Ground ◽  
Correspondence Theory ◽  
The Body ◽  
Rational Analysis ◽  
At Command ◽  
Rational Argumentation ◽  
Logical Fallacies ◽  
Key Terms

In a series of works published over a period of twenty five years, C.W. Huntington, Jr. has developed a provocative and radical reading of Madhyamaka (particularly Early Indian Madhyamaka) inspired by ‘the insights of post- Wittgensteinian pragmatism and deconstruction’ (1993, 9). This article examines the body of Huntington’s work through the filter of his seminal 2007 publication, ‘The Nature of the M?dhyamika Trick’, a polemic aimed at a quartet of other recent commentators on Madhyamaka (Robinson, Hayes, Tillemans and Garfield) who attempt ‘to read N?g?rjuna through the lens of modern symbolic logic’ (2007, 103), a project which is the ‘end result of a long and complex scholastic enterprise … [which] can be traced backwards from contemporary academic discourse to fifteenth century Tibet, and from there into India’ (2007, 111) and which Huntington sees as distorting the Madhyamaka project which was not aimed at ‘command[ing] assent to a set of rationally grounded doctrines, tenets, or true conclusions’ (2007, 129). This article begins by explicating some disparate strands found in Huntington’s work, which I connect under a radicalized notion of ‘context’. These strands consist of a contextualist/pragmatic theory of truth (as opposed to a correspondence theory of truth), a contextualist epistemology (as opposed to one relying on foundationalist epistemic warrants), and a contextualist ontology where entities are viewed as necessarily relational (as opposed to possessing a context-independent essence.) I then use these linked theories to find fault with Huntington’s own readings of Candrak?rti and N?g?rjuna, arguing that Huntington misreads the semantic context of certain key terms (tarka, d???i, pak?a and pratijñ?) and fails to follow the implications of N?g?rjuna and Candrak?rti’s reliance on the role of the pram??as in constituting conventional reality. Thus, I find that Huntington’s imputation of a rejection of logic and rational argumentation to N?g?rjuna and Candrak?rti is unwarranted. Finally, I offer alternate readings of the four contemporary commentators selected by Huntington, using the conceptual apparatus developed earlier to dismiss Robinson’s and Hayes’s view of N?g?rjuna as a charlatan relying on logical fallacies, and to find common ground between Huntington’s project and the view of N?g?rjuna developed by Tillemans and Garfield as a thinker committed using reason to reach, through rational analysis, ‘the limits of thought.’

Neurological consultations and diagnoses in a large, dedicated COVID-19 university hospital

2020 ◽  
Vol 78 (8) ◽  
pp. 494-500 ◽  
Author(s):  
Adalberto STUDART-NETO ◽  
Bruno Fukelmann GUEDES ◽  
Raphael de Luca e TUMA ◽  
Antonio Edvan CAMELO FILHO ◽  
Gabriel Taricani KUBOTA ◽  
...  
Keyword(s):  
Neurological Diseases ◽  
Neuromuscular Disorders ◽  
Neurological Symptoms ◽  
University Hospital ◽  
Special Treatment ◽  
Nasal Swabs ◽  
Neurological Exam ◽  
Neurological Conditions ◽  
De Medicina

ABSTRACT Background: More than one-third of COVID-19 patients present neurological symptoms ranging from anosmia to stroke and encephalopathy. Furthermore, pre-existing neurological conditions may require special treatment and may be associated with worse outcomes. Notwithstanding, the role of neurologists in COVID-19 is probably underrecognized. Objective: The aim of this study was to report the reasons for requesting neurological consultations by internists and intensivists in a COVID-19-dedicated hospital. Methods: This retrospective study was carried out at Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil, a 900-bed COVID-19 dedicated center (including 300 intensive care unit beds). COVID-19 diagnosis was confirmed by SARS-CoV-2-RT-PCR in nasal swabs. All inpatient neurology consultations between March 23rd and May 23rd, 2020 were analyzed. Neurologists performed the neurological exam, assessed all available data to diagnose the neurological condition, and requested additional tests deemed necessary. Difficult diagnoses were established in consensus meetings. After diagnosis, neurologists were involved in the treatment. Results: Neurological consultations were requested for 89 out of 1,208 (7.4%) inpatient COVID admissions during that period. Main neurological diagnoses included: encephalopathy (44.4%), stroke (16.7%), previous neurological diseases (9.0%), seizures (9.0%), neuromuscular disorders (5.6%), other acute brain lesions (3.4%), and other mild nonspecific symptoms (11.2%). Conclusions: Most neurological consultations in a COVID-19-dedicated hospital were requested for severe conditions that could have an impact on the outcome. First-line doctors should be able to recognize neurological symptoms; neurologists are important members of the medical team in COVID-19 hospital care.

The role of blood inflammatory markers in the diagnosis of appendicitis in children: a prospective study from a University Hospital in Greece

2020 ◽  
Vol 178 (11) ◽  
Author(s):  
George Sakellaris ◽  
Dimitra Dimopoulou ◽  
Maria Niniraki ◽  
Anastasia Dimopoulou ◽  
Athanasios Alegakis ◽  
...  
Keyword(s):  
Prospective Study ◽  
Inflammatory Markers ◽  
University Hospital ◽  
A Prospective Study

A Clinico-pathological Study of Transvaginal Endometrial Thickness Measurement in Asymptomatic Postmenopausal Patients and Patients with Postmenopausal Bleeding

2019 ◽  
pp. 1
Author(s):  
Ayse Filiz Gokmen Karasu ◽  
Seda Ates ◽  
Tugba Gurbuz ◽  
Nurhan Sahin ◽  
Taha Takmaz ◽  
...  
Keyword(s):  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Thickness Measurement ◽  
University Hospital ◽  
Postmenopausal Bleeding ◽  
Pathological Study ◽  
Endometrial Polyps ◽  
Endometrial Sampling ◽  
Proliferative Endometrium

<p><strong>Objective:</strong> We aimed to determine the frequency of endometrial pathologies of patients who presented to our outpatient clinic with postmenopausal bleeding (PMB) and asymptomatic menopausal patients with a finding of thickened endometrium on transvaginal ultrasonography.</p><p><strong>Study Design:</strong> This study was performed at Bezmialem University Hospital. Women who presented to our clinic from January 2015 to January 2017 were analyzed. Patients were divided to two groups. All patients underwent transvaginal ultrasound with a 7.5 MHz probe. Endometrial sampling was performed by either blind D&amp;C (dilatation &amp; curettage) or pipelle sampling. We excluded patient specimens that were obtained by hysteroscopy.</p><p><strong>Results:</strong> Electronic records of a total of 368 patients in menopause were inspected. Out of these patients; 287 (78%) underwent endometrium sampling indicated by bleeding. Eighty-one patients (22%) were asymptomatic; however, a thickened endometrium echo on TVUSG examination (≥ 5 mm) was suspected. The median age was 57 (42-85). In both groups the two leading causes of endometrial pathology was; endometrial polyps followed by proliferative endometrium. The frequency of endometrial cancer was 9.4 % for the PMB group and 1.2 % in the asymptomatic patient group</p><p><strong>Conclusion:</strong> Evaluation of PMB as soon as possible is essential for diagnosing endometrial pathologies. Role of endometrial thickness is decisive in detecting patients at high risk for malignancy especially with comorbid conditions. Histopathological evaluation is mandatory for ruling out malignancy.</p>

scholarly journals Contagion Management at the Méditerranée Infection University Hospital Institute

2021 ◽  
Vol 10 (12) ◽  
pp. 2627
Author(s):  
Pierre-Edouard Fournier ◽  
Sophie Edouard ◽  
Nathalie Wurtz ◽  
Justine Raclot ◽  
Marion Bechet ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Early Diagnosis ◽  
Personal Protective Equipment ◽  
Early Stage ◽  
Point Of Care ◽  
University Hospital ◽  
Protective Equipment ◽  
Monitoring Point ◽  
Epidemiological Monitoring ◽  
Wide Range

The Méditerranée Infection University Hospital Institute (IHU) is located in a recent building, which includes experts on a wide range of infectious disease. The IHU strategy is to develop innovative tools, including epidemiological monitoring, point-of-care laboratories, and the ability to mass screen the population. In this study, we review the strategy and guidelines proposed by the IHU and its application to the COVID-19 pandemic and summarise the various challenges it raises. Early diagnosis enables contagious patients to be isolated and treatment to be initiated at an early stage to reduce the microbial load and contagiousness. In the context of the COVID-19 pandemic, we had to deal with a shortage of personal protective equipment and reagents and a massive influx of patients. Between 27 January 2020 and 5 January 2021, 434,925 nasopharyngeal samples were tested for the presence of SARS-CoV-2. Of them, 12,055 patients with COVID-19 were followed up in our out-patient clinic, and 1888 patients were hospitalised in the Institute. By constantly adapting our strategy to the ongoing situation, the IHU has succeeded in expanding and upgrading its equipment and improving circuits and flows to better manage infected patients.

scholarly journals Coagulopathy and its effect on treatment and mortality in patients with traumatic intracranial hemorrhage

2021 ◽  
Author(s):  
Janne Kinnunen ◽  
Jarno Satopää ◽  
Mika Niemelä ◽  
Jukka Putaala
Keyword(s):  
Intracranial Hemorrhage ◽  
Multivariable Analysis ◽  
International Normalized Ratio ◽  
University Hospital ◽  
Lower Mortality ◽  
Traumatic Intracranial Hemorrhage ◽  
Hemorrhage Volume ◽  
Anticoagulant Medication ◽  
Admission Glasgow Coma Scale

Abstract Background The role of coagulopathy in patients with traumatic brain injury has remained elusive. In the present study, we aim to assess the prevalence of coagulopathy in patients with traumatic intracranial hemorrhage, their clinical features, and the effect of coagulopathy on treatment and mortality. Methods An observational, retrospective single-center cohort of consecutive patients with traumatic intracranial hemorrhage treated at Helsinki University Hospital between 01 January and 31 December 2010. We compared clinical and radiological parameters in patients with and without coagulopathy defined as drug- or disease-induced, i.e., antiplatelet or anticoagulant medication at a therapeutic dose, thrombocytopenia (platelet count < 100 E9/L), international normalized ratio > 1.2, or thromboplastin time < 60%. Primary outcome was 30-day all-cause mortality. Logistic regression analysis allowed to assess for factors associated with coagulopathy and mortality. Results Of our 505 patients (median age 61 years, 65.5% male), 206 (40.8%) had coagulopathy. Compared to non-coagulopathy patients, coagulopathy patients had larger hemorrhage volumes (mean 140.0 mL vs. 98.4 mL, p < 0.001) and higher 30-day mortality (18.9% vs. 9.7%, p = 0.003). In multivariable analysis, older age, lower admission Glasgow Coma Scale score, larger hemorrhage volume, and conservative treatment were independently associated with mortality. Surgical treatment was associated with lower mortality in both patients with and without coagulopathy. Conclusions Coagulopathy was more frequent in patients with traumatic intracranial hemorrhage presenting larger hemorrhage volumes compared to non-coagulopathy patients but was not independently associated with higher 30-day mortality. Hematoma evacuation, in turn, was associated with lower mortality irrespective of coagulopathy.

scholarly journals The Prognostic Role of LRIG Proteins in Endometrial Cancer

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1361
Author(s):  
Zoia Razumova ◽  
Husam Oda ◽  
Igor Govorov ◽  
Eva Lundin ◽  
Ellinor Östensson ◽  
...  
Keyword(s):  
Overall Survival ◽  
Endometrial Cancer ◽  
Prognostic Factor ◽  
Confidence Interval ◽  
Initial Study ◽  
Surface Proteins ◽  
University Hospital ◽  
Study Cohort ◽  
Risk Of Death

Endometrial cancer (EC) is the most common gynecologic malignancy in Sweden and it has various prognostic factors. The LRIG family is a group of three integral surface proteins with a similar domain organization. The study aimed to explore LRIG family as prognostic factor proteins in EC. The initial study cohort included 100 women with EC who were treated at the Department of Women’s and Children’s Health, Karolinska University Hospital Solna, between 2007 and 2012. We assessed the associations between LRIG protein expression and type, grade, and stage of EC, as well as progression-free and overall survival. Immunohistochemistry results revealed that most women in the analytical sample had >50% LRIG1-, LRIG2- and LRIG3-positive cells. A statistically significant association was observed between having a high number of LRIG3-positive cells and superior overall survival (incidence rate ratio = 0.977; 95% confidence interval: 0.958–0.996, p = 0.019). Moreover, positive LRIG3 staining of the cell membrane was associated with reducing in the risk of death (hazard ratio = 0.23; 95% confidence interval: 0.09–0.57). Our results show that LRIG3 expression might be a prognostic factor in EC. The role of LRIG1 and LRIG2 expression remains to be further investigated.

scholarly journals Adherence to personal protective equipment use among healthcare workers caring for confirmed COVID-19 and alleged non-COVID-19 patients

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Meike M. Neuwirth ◽  
Frauke Mattner ◽  
Robin Otchwemah
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
University Hospital ◽  
Protective Equipment ◽  
Care Workers

AbstractAdherence observations of health care workers (HCW) revealed deficiencies in the use of recommended personal protective equipment (PPE) among HCW caring in COVID-19 and non-COVID-19 wards during the first period of the SARS-CoV-2 pandemic in a university hospital in Germany. The adherence to wearing surgical face or FFP2-masks and disinfecting hands prior to donning and after doffing the PPE was significantly higher in COVID-19 wards However, there was no total adherence of 100% in COVID-19 wards.

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