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THE WHITE PLAN AND HOSPITAL RESILIENCE - TWO FACES OF THE CAPABILITY OF THE HOSPITAL TO RESPOND TO MASS CASUALTY TRAUMATIC INCIDENTS
Get PDFBackground- Resilience defines the reserve capacity of the system in the disasters or mass casualty incidents, which requires far superior or different resources to those current, on extended periods, in order to resolve the crisis. Cost efficiency designate the term of tangible benefits produced by money spent to build and maintain the system in action.
Purpose of the paper- is to highlight the benefits and usefulness of hospitals in general and specially ED resilience as critical facilities for large-scale events intervention, to identify the main practical issues that limit their ability of specific intervention in emergency situations and to identify their vulnerability and risk elements of in these situations which, if you are promptly fined, can improve overall system performance.
The method of study - several mass casualty s events analysis involving the hospitals over the past 13 years and parallel analysis of hospitals resources from 3 different Romanian’s regions.Conclusion- Resiliency and cost efficiency in emergency systems preplanning must reside in a dynamic balance system. Hospital medical network is top of the medical pyramid system, but in terms of reaction to crises, has specific needs of planning, command and control that can becomes vulnerabilities throughout the chain of emergency response in case of disaster. The system flexibility consist of both in the ability to prompt expand capacity and intervention specialization, to ensure sustainability of the primary benefits of the intervention and the ability to develop functional relationships with similar foreign systems
COMPARISON OF THE EFFECT OF REFLEXOLOGIC MASSAGE WITH STROKE MASSAGE ON BLOOD OXYGEN SATURATIONOF MYOCARDIAL INFARCTION PATIENTS
Get PDFIntroduction: Today, in many countries, the massage is used as a complementary therapy to reduce stress. In this study we evaluate the effect of reflexologic massage in comparison with stroke massage on physiological parameters of myocardial infarction patients.
Materials and Methods: This clinical trial was performed in 2012 on 105 patients who were randomly divided into three groups: reflexologic massage, stroke massage and control groups (each group with 35 patients). In the intervention groups each patient took massages for 15 minutes in morning and afternoon in one day. Vital signs and arterial O2 saturation were measured before and after the massage by blood pressure cuff, thermometer, and pulse oxymeter. Paired T test and χ2 test were used to analyze data
Results: in stroke massage group, significant differentiation evaluated in oxygen saturation and with (p =0.002) in morning and afternoon in a day. No significant differences in blood oxygen saturation were seen in both reflexive massage group and control group.
Conclusion: stroke massages is effective on blood oxygen saturation and it’s so helpful for this patients
COGNITIVE FUNCTIONING AND BEHAVIOUR IN CHILDREN WITH ACQUIRED CEREBELLAR LESIONS
Get PDFThis study describes the cognitive and behavioral disorders identified in children with cerebellar tumors removed at the University Hospital Center "Mother Teresa", Tirana (UHC), 2004-2008.
Objective: To evaluate the speech skills and executive functions of children who underwent surgery for extirpation of cerebellar tumors. Design: Clinical follow up study.
Setting: University Hospital Center, Neurology-Neurosurgery Division and community Mental Health Center. Participants: Children, 18 in total, who received surgery for cerebellar astrocytomas and medulloblastoma of the vermis.
Main outcome measures: Identifying the changes in cognitive functions and behavior during a period of 24 months after surgery and/or radio or chemotherapy;the importance of differences identified in functioning of children according to the type of tumor.
Results: The average age of the children with astrocytoma was 10.2 years (from 7- 12.6), of whom six averaging 9.8 years (6.11- 13.4) had an involvement of the right hemisphere, and four averaging 10.6 years (7.2- 13.1) saw an involvement of the left hemisphere. Average "Z" scores for left and right lesions resulted: subjects with right cerebellar lesions showed a slight, insignificant decline in their verbal performance -1.4 z- score. Children with left cerebellar lesions showed a decline in non-verbal performance -1.3 z-score. Most of the children with medulloblastomas of the cerebellar cermis (MCV) resulted in mutism without behavioralchanges.
Conclusion: The alteration of cognitive and social profiles associated with cerebellar tumors means that these lesions contribute in those deficits. These findings also support Schmahmann’s hypothesis on functional topography inside the cerebellum and suggests that this topography begins to operate from an early stage
AN ANATOMICAL VARIATION IN THE ORIGIN OF BICEPS BRACHII MUSCLE
Get PDFThe biceps brachii muscle is the muscle situated in the flexor compartment of the arm. It is known to show variations in the number of heads of its origin. This study was performed to evaluate the variations in the origin of the biceps brachii muscle
CHANGES OF BLOOD PLASMA PROTEINS DURING SELECTED CARDIOVASCULAR DISEASES
Get PDFCardiovascular diseases are one of the most dangerous diseases in the world and that is why it is necessary constantly research and try to study these diseases not only with traditional methods but also with new techniques. This study describes laboratory methods that are applicable for the rapid early screening of cardiovascular diseases. Blood plasma of patients with thoracic aortic aneurysm, aortic valve stenosis and aortic valve regurgitation was subjected to experimental biochemical analysis by fluorescence analysis and atomic force microscopy. The structural and metabolic changes have been studied in blood plasma of patients with a thoracic aneurysm in comparison with the samples of healthy individuals. The results of fluorescence analysis showed a significant decrease of autofluorescence in blood plasma of patients in comparison with healthy subjects. Atomic force microscopy confirmed structural changes in the blood of patients in comparison with the blood of healthy subjects. The results of using new experimental laboratory methods in future could contribute to the improvement of diagnosis of selected cardiovascular diseases
ABDOMINAL TRAUMA AND BRAIN INJURY– DIFFICULT CONDITION, FREQUENT ASSOCIATION, SPECIFIC CONSEQUENCES FOR EMERGENCY MEDICAL PREHOSPITAL TEAM
Get PDFBackground: Brain injury provides a significant percentage of, preventable deaths \u27\u27 in trauma, makes threaten in the highest degree the survival chance leads to definitive impairment of the brain functions, generates traumatic disability and concomitant lesion associations.
Purpose of the paper is to highlight specific diagnosis but also management and evolution medical issues that each of the two lesion types generates and which can lead to misdiagnosis symptoms and signs. We focused on the specific ways trough abdominal and brain injury interacts each other to produce a traumatic complex evolving and adding secondary traumatic effects In the same time we aimed to distinguish very particular emergency approach standards to minimize the risks of worsening evolution
The method of study: We analyzed 398 patients assisted by the prehospital teams related to ED County Hospital Craiova (2009 – 2012) with different association of multiple trauma lesions but significant abdominal and brain trauma association
Conclusions:1. Clinical examination data are difficult to analyze in the presence of altered mental status and paraclinically resources must be widespread or systematic used.2. Cervical spine lesions or spinal shock hide most significantly clinical abdominal signs.3. Neurogenic shock can create confusion in the hemorrhagic shock interpretation.4. Secondary brain injury is maintained or worsening by the presence of shock, but overcorrection of those to.5. General anesthesia should be early considered in tactics, techniques and means custom, which has undeniable benefits in combating shock and brain protection6. Temperature control should be considere
STUDY OF THE CLINICAL PROFILE OF PATIENTS WITH CT PROVEN ACUTE PYELONEPHRITIS IN A TERTIARY CARE HOSPITAL
Get PDFBackground- Acute pyelonephritis is a common renal infection that causes considerable morbidity.
Materials and methodology- This was a prospective study of a cohort of patients who presented to Sri Ramachandra University, Chennai, India between 2011 and 2013 with a CT proven diagnosis of acute pyelonephritis Data was collected and the patients were followed up till discharge or death. This was then analyzed.
Results- Out of the 100 patients, 52 were male. Most patients were in the 51-60 year age, diabetes was the most common risk factor present in 73% of the patients. Fever was the dominant symptom.18 had emphysematous pyelonephritis. 29 needed ICU care while 3 succumbed.
Conclusions- Acute pyelonephritis is a common infection, typical triad of symptoms are not very common, high index of suspicion is needed in diabetics. CT is very useful in diagnosis and early treatment results in good outcomes
GIANT CELL REPARATIVE GRANULOMA: CYTOMORPHOLOGICAL DIAGNOSIS
Get PDFGiant cell reparative granuloma is not a true neoplasm, rather a reactive process. It can behave aggressively if left untreated and can mimic malignant process. Hence, early intervention is essential. Herein, we present a similar case, where a simple diagnostic modality led to an early diagnosis of giant cell reparative granuloma, thereby preventing any further complications like facial disfigurement. The patient was treated conservatively and kept on follow up
PREOPERATIVE Ac ANTI-THYROGLOBULIN COULD BE A POTENTIAL RISK FACTOR FOR DIFFERENTATED THYROID CANCER
Get PDFHashimoto thyroiditis (HT) is an autoimmune disease and the most common cause of hypothyroidism. It is characterized by the presence of thyroid antibodies (Tg Ab and TPO Ab ).
Material and Methods: In a retrospective study we analyzed the date of 201 patients, who underwent total thyroidectomy during a period from January 2013 until February 2016. Tg Abs was measured in all patients before surgery.
Results: Females were 84.5%; males 15.4%; 57.7% with benign pathology and 42.2% with malignant pathology. Papillary thyroid cancer (PTC) accounted for the vast majority of the differentiated thyroid cancer (DTC) diagnoses (95.1%, n=79). There was no difference in the sex ratio between patients with benign tumors or DTC (p=0.66). Patients with DTC were relatively younger (43.2 ± 14.9 versus 48.4 ± 13.6 yr; p=0.760) and had higher preoperative median TSH levels (2.42 mIU/L versus 1.38 mIU/L; p<0.028) than those with benign nodule. Solitary nodules were more common in patients with DTC (40.4%) compared to patients with benign nodules (19.4%; p<0.001). Patients with TgAb concentration more than 115 IU/mL were more common in DTC group than in benign nodule group (28.2% versus 13%, p<0.007), suggesting that elevated Tg Ab may associate DTC. The prevalence of DTC was significantly associated with TgAb ≥ 115 IU/mL (OR=2.8), compared with TgAb < 115 IU/mL group.
Conclusions. Elevated serum TgAb level was associated with an increased risk of TC in patients with TN. We can conclude that high serumTgAb levels may serve as a predictive marker for DTC
CLINICAL VARIABLES ASSOCIATED WITH THE REHABILITATION OF A HEMIMANDIBULECTOMY PATIENT
Get PDFThe mandible is perhaps one of rarest bones that could be hypothetically termed as an organ because not only it helps in mastication and deglutition it plays a major role in species survival. Humans exceptionally have refined and mastered its use in communication also. The bone is unique in the body since it is a single bone that is attached by two separate joints that are capable of functioning independently. Its attachment with the remaining skull besides temperomandibular joint also includes an attachment through muscles, ligaments, disk, occlusion, and skin. Any breach in the continuity of the mandible through disease or trauma results in a pattern of mandibular movement that is more complex and dynamic in nature. Hemimandibulectomy is one such clinical condition that results after the removal of any portion of the mandible and poses clinical challenges to prosthodontic rehabilitationists. This article presents a case of hemimandibulectomy who was successfully rehabilitated by using a dynamic occlusal ramp in the maxillary complete denture