Particularities of Surgical Treatment for the Neuropathic Diabetic Foot

Diabetic neuropathy is one of the chronic complications of diabetes and along with other complications causes a pathology called diabetic foot. The present study analyzed a group of 164 patients admitted to the surgery department of the Clinical Hospital “Doctor Ioan Cantacuzino” Bucharest, between September and December 2019. The results of the study highlight the potential for contamination of neuropathic lesions and the need for curative surgery, most conservative. The conclusion of the analysis emphasizes that the imbalance of the underlying disease changes, in a negative sense, the prognosis of any complication of it.

Analysis of the Influence of an Interpersonal Communication Doctors Specialist on Patient Satisfaction in Investigation

The effective communication that occurs between doctors and patients will create a sense of comfort for the patient with medical therapy given by the doctor when examining the inpatient room of the Royal Prima Hospital, Medan. This paper analyzes the influence of interpersonal communication of specialist doctors on patient satisfaction at Royal Prima Medan Hospital. This type of research is quantitative with a study-descriptive research design. The population in this study were all inpatients at the Royal Prima Medan Hospital. The research sample was 80 hospitalized patients. The analysis of research data was univariate, bivariate, and multivariate analysis. The results of the study with the Fisher Exact test explained that there was a relationship between interpersonal communication of specialist doctors and patient satisfaction with a value of p = 0.002. In this study, it can be concluded that there is an influence between the doctor's interpersonal communication on patient satisfaction in the inpatient room of Royal Prima Medan Hospital. It is recommended for the hospital to improve the quality of health services, especially in terms of interpersonal communication between doctors and patients in the inpatient room. Keywords: interpersonal communication, patient satisfaction, hospital, doctor.

Duration of Hospital Stay and Influence on the Period between Hospitalizations of Patients

The purpose of the study. The article presents and substantiates the possibilities of reducing the risk of rehospitalization on the basis of a specially developed econometric model of behavior of the hospital doctor in conditions of different workload of patients using the schedule according to Slutsky. Materials and methods. The effects of the model showed that the growth of the competitive environment leads to: a) a decrease in the number of services provided by the hospital doctor; b) switching to perform functions that help improve the quality of the treatment process; c) an increase in the average duration of treatment. Modern tendencies are shown: a) reduction of the number of doctors of inpatient departments; b) increasing the workload of the hospital doctor with patients and bed-days; c) reducing the average length of stay in the hospital. Results and discussion. The economic mechanisms of reducing the risk of re-hospitalizations are substantiated, namely: a) compensation of the turn of the profit curve through compensatory mechanisms of payment for the quality of work of the hospital doctor; b) increasing the price elasticity of consumer demand for stationary services. That is, we chose the length of the period between regular hospitalizations of patients as a criterion for the quality of inpatient treatment. This criterion is essentially equivalent to the risk of re-hospitalization, in which hospitalization in a department of the same profile, which confirms the failure of the previous treatment. Thus, a link is expected between a longer stay of the patient in the hospital and a lower risk of re-hospitalization, provided that a longer stay will provide additional quality of treatment. Therefore, the discovery of such a connection is a confirmation of the hypothesis, which is based on the theoretical econometric model of physician behavior and relates to the reorientation to the additional quality of inpatient care in a competitive environment. That is, due to the increased load, the doctor reduces the length of the patient's stay in the hospital and therefore the quality of care deteriorates. Due to the fact that the discharge of the patient involves achieving a stable condition, doctors are sometimes forced to give an objective assessment of the condition at the time of discharge. The timeliness of evaluating effectiveness is the possibility of temporary relief when in fact the case of treatment is not over. It should be noted that in countries with a private health care system, reimbursement of hospital care costs is related to the number of bed-days spent by the patient in the hospital, where "day" is defined as the period from one midnight to the next, medical staff can manipulate the time of hospital discharge, as patients who are kept until midnight will have an additional day to reimburse. Conclusion. It follows from the research results that a reduction in the length of hospital stay in the existing situation significantly worsens the prognosis, increasing the risks of an uncontrolled course of the disease and, accordingly, subsequent hospitalizations

Pelaksanaan Kolaborasi Komunikasi antara Dokter-Pasien di Rumah Sakit Kota Padang

Patient care in the hospital consists of 4 pillars of health professionals who play a role, namely clinicians, pharmacists, nurses and nutritionists. To realize good service to patients, it is necessary to have good communication between health workers and patients. Various patient complaints related to communication with doctors. This study was conducted on patients who had been treated at the Padang City hospital, aimed to analyze the collaboration of communication between doctors and patients at the Padang City hospital. The sample criteria were patients who were willing to be interviewed and could communicate well, were over 18 years old and had been hospitalized for ± 1 week. The results of the research carried out are the form of expectations from patients related to communication with patient doctors who hope that the doctor has time to provide repeated explanations related to the results of the diagnosis and the doctor can listen and communicate with patients and the patient's family longer, and patients hope for a form of attention. given by the doctor, causing more satisfaction to the patient. Collaborative communication between doctors and patients generally follows the procedures established by the hospital. However, the results of the study show that some patients are still not satisfied because there are patient complaints about the limited time to visit the doctor and the doctor's short communication in explaining the patient's illness. Keywords: communication; hospital; doctor; patient ABSTRAK Pelayanan pasien di rumah sakit terdiri dari 4 pilar tenaga kesehatan profesional yang sangat berperan, yaitu klinis (dokter), farmasis, perawat dan ahli gizi. Untuk mewujudkan pelayanan yang baik kepada pasien maka perlu adanya komunikasi yang baik antara tenaga kesehatan dengan pasien. Berbagai keluhan pasien terkait dengan komunikasi dengan dokter. Penelitian ini dilakukan pada pasien yang pernah berobat di rumah sakit Kota Padang, bertujuan untuk menganalisis kolaborasi komunikasi antara dokter dengan pasien di rumah sakit Kota Padang. Kriteria sampel yaitu pasien yang bersedia diwawancarai dan bisa berkomunikasi dengan baik, berusia di atas 18 tahun dan pernah dirawat inap ± 1 minggu. Hasil dari penelitian yang dilakukan yaitu bentuk harapan dari pasien terkait dengan komunikasi dengan dokter yaitu pasien berharap dokter punya waktu untuk memberikan penjelasan secara berulang terkait hasil diagnosa dan dokter bisa lebih lama mendengarkan dan berkomunikasi dengan pasien maupun keluarga pasien, serta pasien berharap adanya bentuk perhatian yang diberikan dokter, sehingga menimbulkan kepuasan lebih pada pasien. Kolaborasi komunikasi antara dokter dengan pasien secara umum sudah mengikuti prosedur yang ditetapkan rumah sakit. Namun hasil penelitian bahwa, beberapa pasien masih merasa kurang puas karena ada keluhan pasien terhadap waktu kunjung dokter yang terbatas dan komunikasi dokter yang singkat dalam menjelaskan penyakit pasien. Kata kunci: komunikasi; rumah sakit; dokter; pasien

Chronicle and mix

Senior physician of the Odessa psychiatric hospital, doctor of medicine B.I. Vorotynskiy was elected as a medical faculty in Odessa as a privat-docent in the department of nervous and mental illnesses.

RESPUESTA AL ARIPIPRAZOL INYECTABLE DE LIBERACIÓN PROLONGADA EN PACIENTES DUALES Y NO DUALES.

INTRODUCCIÓN Y OBJETIVOS: El consumo de drogas en los pacientes con otros trastornos mentales ensombrece el curso y el pronóstico, dificulta el tratamiento y el abordaje psicofarmacológico. El objetivo de este estudio es evaluar como el consumo de sustancias influye en la respuesta al tratamiento con aripiprazol inyectable de liberación prolongada (ILP). MATERIAL Y METODOS: Revisión retrospectiva de historias clínicas en busca de pacientes a los que se les trató con Aripiprazol ILP, pertenecientes al Departamento Hospital Doctor Peset (Valencia). Se realiza un estudio en espejo, comparando el número y los días de ingreso, así como las visitas a urgencias durante el año previo y posterior al inicio del tratamiento con aripiprazol ILP. Se estratificaron los resultados en pacientes consumidores de drogas frente a los no consumidores, sin tener en cuenta el tabaquismo. RESULTADOS Y CONCLUSIONES: Se incluyeron 59 casos (50,8% mujeres). La mayoría (50,8%) diagnosticados de esquizofrenia, seguidos de trastorno bipolar (20,3%). El 29,8% consumían drogas. Los pacientes con patología dual presentan mayor número de ingresos, días de ingreso y visitas a urgencias, tanto antes como después del tratamiento, respecto a los no consumidores, aunque no siempre de forma estadísticamente significativa. El tratamiento reduce de forma estadísticamente significativa el número de ingresos (PRE=0,89 vs POST=0,42; p=0,00), días de ingreso (13,6 vs 7,95; p=0,004) y urgencias (1,7 vs 1,19; p=0,012) de forma global. No obstante, al estratificar en función del consumo de sustancias, en el grupo de consumidores, la comparación, aunque también eficaz, pierde la significación estadística en el numero de ingresos y en las visitas a urgencias.

Cannabis sintético: un nuevo paradigma. Serie de casos.

El uso de cannabis sintético (CS) es un problema de salud pública emergente en nuestra sociedad. En los últimos años se ha descrito un importante aumento en su consumo, principalmente en población joven, siendo numerosos los nombres coloquiales con los que se conoce a sus diferentes presentaciones: ‘’pescao’’, ‘’hardcore”, ‘’spice’’... El consumo de CS, ya sea agudo o crónico, ha demostrado tener efectos nocivos sobre la salud física como psicológica de quienes la consumen y puede suponer un motivo para recibir atención médica urgente. Objetivos 1- Describir, mediante una serie de casos clínicos, los motivos de atención urgente y las características clínicas y sociodemográficas de pacientes atendidos por problemas derivados del consumo de CS. Material y métodos Mediante la introducción de palabras clave relacionadas con el CS en el explotador de datos del sistema informático de historias clínicas se identificaron a todos aquellos pacientes consumidores de CS atendidos en urgencias por el servicio de psiquiatría del Hospital Doctor Peset de Valencia entre septiembre de 2019 y febrero de 2020. La recogida de datos se realizó a partir de las historias clínicas informatizadas mediante el empleo de una plantilla diseñada ad hoc para incluir las variables clínicas y sociodemográficas a estudio. Resultados Se identificaron 6 pacientes, 4 hombres y 2 mujeres, con edades comprendidas entre 17 y 22 años. El motivo principal de atención fue por agitación, alteraciones del comportamiento y psicosis. Todos ellos presentaban consumo comórbido de otras drogas así como diferentes comorbilidades psiquiátricas. Conclusión El consumo de CS es un problema que afecta cada día a más jóvenes y puede asociar problemas de salud notorios, incluso en consumos puntuales. La dificultad para su detección en pruebas habituales y la gravedad de las alteraciones psicopatológicas que asocia supone, actualmente, un reto en la atención de estos pacientes en urgencias.