Search results for " Emergency"

Which Future for Traumatology in Europe?

2010

AbstractThe last decades have been characterized by rapid changes in society, medicine and surgery. There is a distinct evolution towards specialization and super-specialization. Trauma surgery also evolves towards a specialty, focused on the care of the injured. To optimize the quality of care and meet the needs of patients and care providers, a well-structured trauma surgery training program as well as the regionalization of trauma care with the implementation of Level I trauma centers are needed. The core competence of the European trauma surgeon is the coordination of the early management of the severely injured and the treatment of muskuloskeletal trauma, which represent the most commo…

A survey on the thermal conditions experienced by a surgical team

2007

The complex environment of the operating theatre is shared by a group of people having highly different needs: on one side, there is a surgical team whose work may last many hours and, on the other, an anaesthetized patient often subject to liquid infusion. Up to now, little consideration has been given to the different needs of the surgical team who may be affected according to their positions with respect to the scialytic lamp and their particular task. Clothing influences the comfort of the surgical team to a considerable degree: in fact, in some surgery (orthopaedics, neurosurgery and so on), surgeons and assistants must wear paper overalls beneath non-breathable plastic overalls and p…

Case Management for Patients with Complex Multimorbidity: Development and Validation of a Coordinated Intervention between Primary and Hospital Care

2017

In the past few years, healthcare systems have been facing a growing demand related to the high prevalence of chronic diseases. Case management programs have emerged as an integrated care approach for the management of chronic disease. Nevertheless, there is little scientific evidence on the impact of using a case management program for patients with complex multimorbidity regarding hospital resource utilisation. We evaluated an integrated case management intervention set up by community-based care at outpatient clinics with nurse case managers from a telemedicine unit. The hypothesis to be tested was whether improved continuity of care resulting from the integration of community-based and …

Telemedicine during Covid-19 pandemic: Advantage or critical issue?

2020

Telemedicine offers a support to traditional medicine, delivering clinical services when distance is a critical factor. Although this tool does not replace a medical examination, during Covid-19 pandemic, it reduces the spread of infection and avoids the need for a patient’s visit. It is useful in the management of chronic disorders or for patients undergoing palliative treatment. The University Hospital of Palermo has applied this in cases of chronic illness caring for patients who cannot stop their treatment, such as Department of Onco-Haematology, Internal Medicine, Dermatology, etc. The Department of Legal Medicine of Palermo, in particular, is also using telemedicine to manage medico-…

Organisation of care and initial management of severe head injury in Spain: Results of a national survey

2016

Abstract Objective The main objective of the study is to obtain knowledge about the organisation of care for severe head trauma as well as the initial management of these patients in Neurosurgical Departments in Spain. Material and method A 22-item questionnaire was designed and sent to 59 Neurosurgical Departments. The aim of the questionnaire was to collect data regarding the general profile of the patients with a severe head injury, the general characteristics of the hospitals, the initial care of these patients, the monitoring techniques used, and the measures used to control Intracranial pressure (ICP). Results Of the 59 Neurosurgical Departments identified, 29 (49.2%) completed the qu…

Cost Of Multimorbidity: The Influence Of Ambulatory Pharmaceutical And Hospital Expenditure.

2015

Algoritmo diagnóstico-terapéutico de las microangiopatías trombóticas. A propósito de 2 casos

2022

Thrombotic microangiopathies (TMA) are a group of clinical syndromes associated with haemolytic anaemia, thrombocytopenia and organ dysfunction, mainly renal or neurological. They are associated with significant morbidity and mortality, so early diagnosis and treatment are essential. In this article we report two cases of TMA; a patient with thrombotic thrombocytopenic purpura (TTP) and a patient with atypical haemolytic uraemic syndrome (aHUS).

D-dimer testing: advantages and limitations in emergency medicine for managing acute venous thromboembolism

2007

Patients with suspected deep vein thrombosis (DVT) or pulmonary embolism (PE) are frequently admitted to an Emergency Department (ED) for initial evaluation. However, management of patients with suspicion of acute venous thromboembolism (VTE) in this clinical setting can be difficult; in fact symptoms and signs of DVT are non-specific and can be found in a broad spectrum of non-thrombotic disorders. An accurate and timely objective diagnosis is necessary for immediate and correct identification of patients with acute VTE, while avoiding the bleeding risk associated with unnecessary anticoagulant therapy in patients where DVT or PE have been ruled out. The diagnostic approach to patients wit…

US Food and Drug Administration's Risk Evaluation and Mitigation Strategy for Extended-Release and Long-Acting Opioids Pros and Cons, and a European …

2012

Prescriptions for opioid analgesics to manage moderate-to-severe chronic non-cancer pain have increased markedly over the last decade. An unintentional consequence of greater prescription opioid utilization has been the parallel increase in misuse, abuse and overdose, which are serious risks associated with all opioid analgesics. In response to disturbing rises in prescription opioid abuse, the US Food and Drug Administration (FDA) has proposed the implementation of aggressive Risk Evaluation and Mitigation Strategies (REMS). While REMS could dramatically change the development, release, marketing and prescription of extended-release opioids, questions remain on how these programmes may inf…

Are we really seeing the total costs of surgical site infections? A Spanish study.

2007

To identify overall costs generated by surgical site infections (SSI) patients, including indirect costs. A prospective study of case series of patients who have undergone major surgical treatment was undertaken. Patients who suffered SSI were compared with controls (nested case-control design). Centers for Disease Control and Prevention definitions were followed and SSI established. Overall costs and indirect related morbidity/mortality costs were estimated. The study was performed in a general, tertiary hospital (Valencia, Spain) for 4.5 years. Surgical site infections patients were 9.02% of the total people who underwent surgery. Their stays were prolonging by 14 days, and resources were…