Lessons learned from first case of Cesarean delivery in a COVID-19 positive parturient in Greek region

Abstract OBJECTIVE AND IMPORTANCE: Acute ischemic stroke is the third leading cause of death in the United States. For patients with NIHSS scores >10 and evaluated within 6 hours, intra-arterial thrombolysis is the treatment of choice. The Merci retriever (Concentric Medical Inc., Mountain View, CA) and IV TPA are currently the only FDA-approved treatments for acute ischemic stroke. For patients who do not meet the criteria for TPA administration and/or in whom the Merci device fails, options are limited. Intracranial stenting for acute ischemic stroke after failed thrombolysis is now possible because of improved delivery systems and appropriately sized stents. CLINICAL PRESENTATION: A 26-year-old woman presented with an NIHSS score of 11 (right-sided hemiparesis and mixed aphasia) 4 hours from the time of symptom onset. CT perfusion demonstrated increased time to peak in the entire left hemisphere; conventional angiography demonstrated a left M1 occlusion. INTERVENTION: After crossing the occlusion with a microcatheter, reteplase (2 units) was administered into the clot. Mechanical thrombolysis was then attempted, without restoration of flow. Two 3 × 12-mm coronary stents were placed from the M1 into the superior and inferior divisions, respectively, with complete restoration of flow (TIMI 3). Within 72 hours, the patient had an NIHSS score of 1, with a small infarction in the external capsule. CONCLUSION: Novel stroke interventions need to be developed for patients with acute ischemic stroke in whom traditional interventions fail. We present (to our knowledge) the first case of successful revascularization of an acute M1 occlusion accomplished with placement of two coronary stents.

Download Full-text

Emergency bedside cesarean delivery: lessons learned in teamwork and patient safety

BMC Research Notes ◽

10.1186/1756-0500-5-412 ◽

2012 ◽

Vol 5 (1) ◽

Cited By ~ 19

Author(s):

Michelle A O Kinney ◽

Carl H Rose ◽

Kyle D Traynor ◽

Eric Deutsch ◽

Hafsa U Memon ◽

...

Keyword(s):

Patient Safety ◽

Cesarean Delivery ◽

Lessons Learned

Download Full-text

Organizational innovation and integrated care: lessons from Buurtzorg

Journal of Integrated Care ◽

10.1108/jica-06-2014-0024 ◽

2014 ◽

Vol 22 (4) ◽

pp. 174-184 ◽

Cited By ~ 11

Author(s):

Sharda Nandram ◽

Nicole Koster

Keyword(s):

Integrated Care ◽

Management Practice ◽

Good Practice ◽

Integrated Approach ◽

Lessons Learned ◽

Secondary Process ◽

Community Based ◽

Content Type ◽

First Case

Purpose – The purpose of this paper is to describe the case of Buurtzorg Nederland as a good practice example of integrated care, focussing in particular on the organizational aspects of its innovation. As the field of integrated care is still in many ways in its infancy, it is hoped that lessons learned could help other agencies and other systems seeking to reform community-based care. Design/methodology/approach – Drawing on a grounded approach, this case study is based on individual interviews with 38 respondents comprising staff, founder, co-founders, coaches, nurses, clients and a trainer and analysis of internal company reports. Findings – Based on the case study the authors suggest an integrated approach as the main explanation of the good practice at Buurtzorg rather than a focus on one single concept such as management structure, information and communication technology, community-based care or a patient focus. Next to the multi-level approach it furthermore shows a multi-dimensional approach as explanation for its success. In this perspective the primary process is the leading process but fully supported by the secondary process containing support facilities from a head office of the organization. Practical implications – Buurtzorg Nederland has been awarded with several prizes for its good management practice in integrated care and attention internationally is growing. Originality/value – This paper provides the first case study write-up of the Buurtzorg model for an international audience, based on extensive research to be published in an international book.

Download Full-text

Lessons Learned to Control COVID-19 to Prevent a Crisis: The Case of Iran

The Open Public Health Journal ◽

10.2174/1874944502013010529 ◽

2020 ◽

Vol 13 (1) ◽

pp. 529-530

Author(s):

Javad Nazari ◽

Saeed Amini ◽

Mohammadreza Amiresmaili

Keyword(s):

Patient Care ◽

Prevention And Control ◽

Lessons Learned ◽

Central Province ◽

Medical Sciences ◽

Unique Role ◽

First Case ◽

Medical University ◽

Improving Patient Care ◽

And Control

Following the detection of the first case of infection due to COVID-19 in Iran central province (named Markazi) on 18 Feb 2020, a serious alert was announced at Arak University of Medical Sciences (the main medical university in Markazi province) to prevent a disaster. The performed measures played a unique role in improving patient care and prevention and control of the disease. Previously, it was expected that Markazi province, due to being situated on the junction of the national highways and placing in the center of Iran, was faced with huge health and social crisis. However, fortunately, the disease morbidity and mortality have been placed in a stabilized status after 7 weeks of the epidemic.

Download Full-text

Use of Absorbable Poly (D,L) Lactic Acid Plates in Cranial-Vault Remodeling: Presentation of the First Case and Lessons Learned about Its Use

The Cleft Palate-Craniofacial Journal ◽

10.1597/03-071.1 ◽

2005 ◽

Vol 42 (4) ◽

pp. 333-339 ◽

Cited By ~ 17

Author(s):

Humberto L. Acosta ◽

Eric J. Stelnicki ◽

Luis Rodriguez ◽

Lisa A. Slingbaum

Keyword(s):

Lactic Acid ◽

Phenotypic Expression ◽

The United States ◽

Lessons Learned ◽

Cranial Vault ◽

Sagittal Craniosynostosis ◽

First Case ◽

Cranial Index ◽

American Case ◽

Cranial Vault Remodeling

Objective To present the first clinical use of a new bioabsorbable material, poly (D,L) lactic acid (PDLLA), in pediatric cranial-vault remodeling procedures. This discussion will highlight the benefits and detriments of PDLLA in comparison with currently used absorbable plating systems. Design This was a case study documenting the first North American case in which PDLLA was used to treat craniosynostosis. Materials and Methods Evaluation of pure PDLLA, a copolymer product of the mixture of poly L-lactic acid and its D-isomer, was used in an 8-month-old boy with a severe phenotypic expression of sagittal craniosynostosis. No signs of elevated intracranial pressure were present, and the neurological examination did not show impairments. Total cranial-vault remodeling with the “hung-span” technique was performed. The Resorb X system, containing 2.2-mm screws and 0.6- to 1-mm-thick plates, was used to stabilize the reconstructed cranial vault. Results No surgical complications occurred. The preoperative cranial index measured 62. The scaphocephalic appearance of the skull was eliminated, and the cranial index was normalized to 77. The screws and plates were less palpable than other plating systems. Twelve months postoperatively, none of the plates and screws were identifiable by external palpation. Conclusion Resorb X has been successfully used in the treatment of sagittal craniosynostosis. Its rapid rate of resorption and lower profile make it an advantageous system for pediatric skull reconstruction. This represents the first use of this product in the United States for any pathology.

Download Full-text

The First City Organizational LCA Case Study: Feasibility and Lessons Learned from Vienna

Sustainability ◽

10.3390/su13095062 ◽

2021 ◽

Vol 13 (9) ◽

pp. 5062

Author(s):

Alexander Cremer ◽

Markus Berger ◽

Katrin Müller ◽

Matthias Finkbeiner

Keyword(s):

Greenhouse Gases ◽

Public Service ◽

Service Provision ◽

Lessons Learned ◽

Mitigation Measures ◽

City Managers ◽

First Case ◽

Public Service Provision ◽

Organizational Lca

Cities are recognized as a major contributor to environmental pressures. Recently, organizational LCA (OLCA) has been found to align well with requirements for city-scale environmental decision support and a novel city-OLCA framework was introduced. City-OLCA combines two relevant aspects: It covers activities beyond public service provision (multi-stakeholder) and emissions beyond greenhouse gases (multi-impact). Its unique approach of acknowledging responsibility levels should help both city-managers and academia in performance tracking and to prioritize mitigation measures. The goal of this work is to test city-OLCA’s feasibility in a first case study with real city data from Vienna. The feasibility was confirmed, and results for 12 impact categories were obtained. As an example, Vienna’s global warming potential, ozone depletion potential, and marine eutrophication potential for 2016 were 14,686 kt CO2 eq., 6796 kg CFC-11 eq., and 310 t N eq., respectively. Our results indicate that current accounting practices may underestimate greenhouse gas emissions of the entire city by up to a factor of 3. This is mainly due to additional activities not covered by conventional standards (food and goods consumption). While the city itself only accounts for 25% of greenhouse gases, 75% are caused by activities beyond public service provision or beyond governmental responsibilities. Based on our results, we encourage city managers to include an organizational based LCA approach in defining reduction strategies. This will reveal environmental blind spots and avoids underestimating environmental burdens, which might lead to setting the wrong focus for mitigation.

Download Full-text

Pre-operative Assessment of Pediatric Congenital Heart Disease Patients in the COVID-19 Era: Lessons Learned

Cardiology in the Young ◽

10.1017/s1047951121002754 ◽

2021 ◽

pp. 1-18

Author(s):

Nour K. Younis ◽

Rana O. Zareef ◽

Marwa A. Diab ◽

Omar El Sedawi ◽

Issam M. El-Rassi ◽

...

Keyword(s):

Healthcare Workers ◽

Pediatric Patients ◽

Care Center ◽

Tertiary Care ◽

Lessons Learned ◽

Open Heart ◽

Assessment Protocol ◽

First Case ◽

Almost All ◽

Operative Assessment

Abstract Background: Equal to COVID-19 patients, non-COVID-19 patients are affected by the medical and social drawbacks of the COVID-19 pandemic. A significant reduction in elective life-changing surgeries has been witnessed in almost all affected countries. This study discusses an applicable and effective pre-operative assessment protocol that can be applied during the COVID-19 era. Methods: Our study is a descriptive retrospective observational study that involves pediatric patients with CHD requiring open heart surgeries at our tertiary care center between March and November 2020. We reviewed the charts of eligible patients aged 18 years and below. We identified the total numbers of scheduled, performed, and postponed surgeries, respectively. A thorough description of the clinical and physical presentation of the postponed cases, who tested positive for SARS-CoV-2, is provided. Results: 68 open heart surgeries were scheduled at our center between March and November 2020. Three surgeries (4%) were postponed due to COVID-19. The three patients were asymptomatic COVID-19 cases detected on routine SARS-CoV-2 PCR testing. No symptoms of cough, chest pain, dyspnea, rhinorrhea, diarrhea, abdominal pain, anosmia, and ageusia were reported by our patients. All patients were afebrile and hemodynamically stable. Owing to the pre-operative assessment protocol that was implemented after the first case was detected, only three healthcare workers were at risk of COVID-19 transmission and were imposed to infectious evaluation and home quarantine. Conclusion: Adopting our discussed preoperative COVID-19 assessment protocol for CHD patients is an effective method to detect COVID-19 infections, optimize patient care, and ensure healthcare workers’ safety.

Download Full-text

After Action Review Qualitative research on Yellow Fever outbreak Coordination, Surveillance & Reponses in Wolaita Zone of SNNPR Region, Ethiopia

10.21203/rs.2.22265/v1 ◽

2020 ◽

Author(s):

Yonas Assefa Tufa ◽

Yaregal Fufa ◽

Diriba Gemechu ◽

Melaku Abebe ◽

Shambel Habebe ◽

...

Keyword(s):

Qualitative Research ◽

Yellow Fever ◽

Surveillance System ◽

Lessons Learned ◽

Research Approach ◽

Outbreak Response ◽

Preparedness Plan ◽

Roles And Responsibilities ◽

After Action Review ◽

First Case

Abstract Background: Coordinating outbreak investigations requires effective interagency communication. Important tasks include making the initial notifications, establishing roles and responsibilities for each jurisdiction, providing updates on the progress of the investigations, revising priorities for the investigation, and establishing the next steps. The major goal of surveillance activities is to identify and eliminate preventable causes of morbidity and mortality. Outbreak response basically entails preparedness which helps to establish arrangements in advance to enable timely, effective and appropriate responses to specific potential hazardous events or emerging disaster situations that might threaten society/environment Objective: To review lessons learned from the October 2018 Wolayta Zone yellow fever outbreak management in SNNPR, Ethiopia. Methods: Qualitative research approach, with Thematic Analysis. Purposive sampling method was used. Data were collected through FGDs, in-depth interviews, observation and document reviews Results : Among the main findings of the review is the weakness of the surveillance to detect case; the surveillance system was not that much effective for early detection of viral hemorrhagic fevers and there was knowledge gap to detect in the existing. The Review found out further that preparedness plan was weak, failing to consider the outbreak for VRAM. However, it is worth-noting that the Review showed that despite late detection, a rapid response team was set up and was able to save the lives of many during the outbreak. The findings further showed there was good coordination among various stakeholders at different levels and with satisfying sharing of roles and responsibilities. Conclusion: Based on the major findings, it may be concluded that the surveillance system was weak to detect yellow fever outbreak occurrence in Wolaita Zone. A major gap is therefore the inability to include the case to the IDSR weekly report. Once the case was confirmed, the response to the crisis was fairly commendable. Even though there was a confusion on identifying the first case, after the confirmation of the first case, the case management went as per the standard guideline and SOPs, helping save so many lives through availing the service free of charge Key terms: After Action Review; Outbreak Response; Yellow Fever, Surveillance, Coordination,

Download Full-text

COVID-19: public health management of the first two confirmed cases identified in the UK

Epidemiology and Infection ◽

10.1017/s0950268820001922 ◽

2020 ◽

Vol 148 ◽

Author(s):

B. Holden ◽

A. Quinney ◽

S. Padfield ◽

W. Morton ◽

S. Coles ◽

...

Keyword(s):

Public Health ◽

Fast Moving ◽

Health Management ◽

Lessons Learned ◽

Contact Tracing ◽

The Public ◽

First Case ◽

The Uk ◽

Public Health Management

Abstract We report key learning from the public health management of the first two confirmed cases of COVID-19 identified in the UK. The first case imported, and the second associated with probable person-to-person transmission within the UK. Contact tracing was complex and fast-moving. Potential exposures for both cases were reviewed, and 52 contacts were identified. No further confirmed COVID-19 cases have been linked epidemiologically to these two cases. As steps are made to enhance contact tracing across the UK, the lessons learned from earlier contact tracing during the country's containment phase are particularly important and timely.

Download Full-text