scholarly journals Újraélesztést követő koszorúér-angiográfia és katéteres intervenció

2019 ◽  
Vol 160 (46) ◽  
pp. 1826-1831
Author(s):  
László Rudas ◽  
Endre Zima
Keyword(s):  
Coronary Angiography ◽  
Large Scale ◽  
Health Care Systems ◽  
Coronary Intervention ◽  
Developed Countries ◽  
Public Access ◽  
Temperature Management ◽  
Prehospital Management ◽  
Care Systems ◽  
St Elevation

Abstract: Out-of-hospital cardiac arrest (OHCA) presents a great challenge for the health care systems even in the highly developed countries. For several decades, our greatest efforts have been directed toward the improvement of the prehospital management, including promotion of lay resuscitation and deployment of public access automated defibrillators. Recently, the importance of the hospital phase of the OHCA-management has been also emphasized. Attention has been paid to targeted temperature management and also to early coronary intervention. For those patients who present with ST-elevation on their post-resuscitation ECG, our approach is straightforward: urgent coronary angiography is indicated. The optimal management of those survivors of OHCA who present without ST-elevation is, however, still debated. Although up to 30% of these subjects also suffer from acute occlusive epicardial coronary disease, the clear benefit of urgent coronary angiography for the whole group is yet to be documented. Several large-scale randomized studies are under way to resolve this question. In our present review we detail the above controversies and outline the future directions. Orv Hetil. 2019; 160(46): 1826–1831.

scholarly journals Data work: A condition for integrations in health care

2019 ◽  
Vol 25 (3) ◽  
pp. 526-535 ◽  
Author(s):  
Camilla Bjørnstad ◽  
Gunnar Ellingsen
Keyword(s):  
Health Care ◽  
Large Scale ◽  
Health Care Systems ◽  
Medication Management ◽  
Articulation Work ◽  
Efficient Treatment ◽  
Daily Work ◽  
Local Actors ◽  
Care Systems ◽  
Information And Communication

Integration and interoperability between different information and communication technology (ICT) systems are crucial for efficient treatment and care in hospitals. In this article, we are particularly interested in the daily local work conducted by health-care personnel to maintain integrations. A principal aim of our article is, therefore, to contribute to a sociotechnical understanding of the “data work” that is embedded in the integration of health-care systems. Theoretically, we draw on the concepts of “information infrastructures” and “articulation work,” and we discuss how social status may influence the invisible articulation work. Furthermore, we show how historical decisions and existing systems both nationally and regionally have impacts on the daily work of local actors. Empirically, we have studied the formative stages of a large-scale electronic medication management system project in the Northern Norway Regional Health Authority.

Feasibility and Safety of an Early Discharge Strategy after Low-Risk Acute Myocardial Infarction Treated with Primary Percutaneous Coronary Intervention: The EDAMI Pilot Trial

Cardiology ◽  
2015 ◽  
Vol 130 (2) ◽  
pp. 120-129 ◽  
Author(s):  
Lorenzo Azzalini ◽  
Eduard Solé ◽  
Jordi Sans ◽  
Montserrat Vila ◽  
Albert Durán ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Health Care Systems ◽  
Pilot Trial ◽  
Coronary Intervention ◽  
Early Discharge ◽  
Primary Angioplasty ◽  
Low Risk ◽  
Ischemic Time ◽  
Percutaneous Coronary ◽  
Care Systems

Objectives: This pilot trial evaluated the feasibility and safety of an early discharge strategy (EDS: ≤72 h, followed by outpatient lifestyle interventions), in comparison with a conventional discharge strategy (CDS) for low-risk (Zwolle risk score ≤3) ST-elevation myocardial infarction (STEMI) patients treated with primary angioplasty. Methods: One hundred patients were randomized to an EDS (n = 54) or a CDS (n = 46). The primary end point was the feasibility of the EDS: (1) ≥70% of EDS patients discharged ≤72 h, (2) ≥70% visited by a nurse ≤7 days after discharge, (3) ≥70% with ≥3 visits by the nurse and (4) ≥70% visited by a cardiologist ≤3 months. Results: The mean age was 59.2 ± 12.2 years and ejection fraction 54.0 ± 7.1%. Eighty-six percent were male (12% diabetics). Vascular access was radial in 91%. Ischemic time was ≤4 h in 75%. Length of stay was shorter in EDS as compared with CDS (70.1 ± 8.1 vs. 111.8 ± 28.3 h, p < 0.001). EDS feasibility was: (1) 72.2%; (2) 81.5%; (3) 76.9%; (4) 72.2%. There were no adverse events or differences in intervention goals and quality of life between groups. Conclusions: An EDS in low-risk STEMI patients is feasible and seems to be safe. A shorter hospital stay could benefit patients and health care systems.

scholarly journals A minimalist technique for insertion of intrauterine devices

2015 ◽  
Vol 3 (1) ◽  
Author(s):  
Norman David Goldstuck
Keyword(s):  
Large Scale ◽  
Health Care Systems ◽  
Intrauterine Device ◽  
General Rule ◽  
Cost Effective ◽  
The United States ◽  
Efficacy Rate ◽  
Pelvic Infection ◽  
Care Systems ◽  
Long Acting

The world’s population is approaching 7 billion. As a general rule, the countries with the highest population have the least available healthcare resources, the most notable exception being the United States of America (USA). Most of these countries have an urgent need to reduce their populations. The intrauterine device (IUD) is used by the largest number of contraceptives world-wide and it has a proven record in reducing unwanted pregnancies. Its efficacy rate as a long-acting reversible contraceptive is matched only by subdermal implants which are not as cost effective. Although the rates of pelvic infection are elevated in many countries with low-resource health care systems, we now know that pelvic infection rates are independent of IUD usage. This is therefore no longer a contraindication for using IUDs on a large scale in family planning programs. The technique of IUD insertion as described in most textbooks and journals is unnecessarily complex and based on ritual rather than good clinical evidence. This is particularly interesting in that at a time where we prefer evidence based medicine there are still so many clinical practice sacred cows. This article advocates a simplification of the technique for inserting IUDs. The scientific rationale for simplifying the technique is presented, as well as evidence that it is as safe if not safer than the currently suggested methods, if used for the correct type of IUD acceptors.

scholarly journals Information Platforms and the Global Network Economy

2021 ◽  
Vol 92 ◽  
pp. 04007
Author(s):  
Elmira Gojayeva ◽  
Shahla Huseynova ◽  
Saida Babayeva ◽  
Ulker Sadigova ◽  
Reyhan Azizova
Keyword(s):  
Higher Education ◽  
Human Capital ◽  
Information And Communication Technologies ◽  
Knowledge Economy ◽  
Large Scale ◽  
Health Care Systems ◽  
Value Added ◽  
Global Network ◽  
Social Infrastructure ◽  
Care Systems

Research background: The research investigates the formation of the intellectual elite; a radical modernization of the education system is necessary with the use of IT technologies and the introduction of innovations created on the basis of scientific achievements. The development of human capital is crucial for the transition from a traditional economy to a knowledge economy. Purpose of the article: The aim of the article is to show how human capital plays a very important role in the country’s economy, the knowledge that is concentrated in it, allows you to develop a knowledge economy - a type of economy based on the use of this capital. The formation of human capital is associated with investment and high-quality modern education. Modernization of higher education is closely related to the use of information and communication technologies and the introduction of innovations. Distance education can be the beginning of a new stage of higher education. Methods: The method of observation, concretization and abstraction, comparative analysis, abstract-logical, economic-statistical, theoretical and practical assessment were used in the study of various aspects of the research. Findings & Value added: Large-scale reforms carried out in the state have led to an improvement in the standard of living of our society, and it has become possible to improve social infrastructure: housing, its construction, social and cultural facilities, health care systems, education, sports and fitness facilities, etc.

scholarly journals An Osteopathic Perspective on COVID-19: Is There a Missing Link to Treatment?

2020 ◽  
Vol 30 (3) ◽  
pp. 7-14
Author(s):  
Richard Chmielewski
Keyword(s):  
Lymphatic System ◽  
Health Care Systems ◽  
Developed Countries ◽  
Modern Medicine ◽  
Pulmonary Complications ◽  
Missing Link ◽  
The Public ◽  
Technological Interventions ◽  
Care Facilities ◽  
Care Systems

Abstract As the COVID-19 pandemic progressed across the globe, clinical reports and autopsies on patient deaths proved that the pulmonary complications were the result of an acute respiratory distress syndrome caused by an excessive inflammatory response; a cytokine storm. Through literature research and review it has become apparent to the author that the lymphatic system is a vital, somewhat overlooked, missing link in the treatment of COVID-19 pulmonary infection. The major challenges the whole world is facing now have been a shortage of supplies such as PPE, or personal protective equipment, and intensive care facilities to treat the overwhelming numbers of COVID-19 cases, in under-developed countries as well as developed countries. Osteopathic manipulative medicine (OMM) and osteopathic manipulative treatment (OMT) have been proven, for over a century, to be very effective in the treatment of pulmonary diseases and previous pandemics. Osteopathic professionals must challenge the present paradigm of modern medicine which, only too often, relies less on the body’s own capacity to regulate itself, to compensate, and to heal, and more on outside intervention such as medications and vaccinations. Osteopathic physicians are needed to step forward and discuss, explain, teach and train the importance of the lymphatic system as a major component of the circulatory as well as the immune system which plays a vital, pivotal, role in fighting diseases such as the COVID-19 coronavirus. A “viral infection protocol” (VIP), as discussed in this article, needs to be promoted as a mainstream adjunct, along with all of the other modalities of modern medicine, to health professionals and the public, in the event that the health care systems are overwhelmed. The VIP treatment is easy to train and to certify practitioners, with proven results in other pulmonary infections and epidemics. It may prove invaluable in preventing clinical deterioration of masses of patients, who then would require more expensive, less available, and more dangerous technological interventions.

scholarly journals NGOs, partnerships, and public-private discontent in Nepal’s health care sector

2018 ◽  
Vol 5 (2) ◽  
Author(s):  
Agya Mahat ◽  
David Citrin ◽  
Hima Bista
Keyword(s):  
Health Care ◽  
Global Health ◽  
Health Care Services ◽  
Large Scale ◽  
Health Care Systems ◽  
Nongovernmental Organization ◽  
Care Services ◽  
Care Systems ◽  
Public Sector Health ◽  
Blind Spots

Public-private partnerships (PPPs) have become increasingly popular models of collaboration in the global health arena to deliver, scale, and evaluate health care services. While many of these initiatives are multicountry, large-scale partnerships, smaller NGOs play increasingly central roles in new forms of privatization. This article draws on our collective experiences working in a PPP between the nongovernmental organization Possible and the Ministry of Health in Nepal to ethnographically examine the fragile and contested nature of these arrangements in the Nepali context, amidst an increasingly privatized health care landscape that is resulting in widespread discontent and distrust throughout the country, as well as financial hardship. We discuss the Possible PPP as one approach that simultaneously seeks to strengthen public-sector health care systems, yet still taps into some of the promises, anxieties, and blind spots – such as the broader social determinants of health – inherent in new forms of public-private global health work.

scholarly journals Contemporary Management of Out-of-hospital Cardiac Arrest in the Cardiac Catheterisation Laboratory: Current Status and Future Directions

2019 ◽  
Vol 14 (3) ◽  
pp. 113-123 ◽  
Author(s):  
Nilesh Pareek ◽  
Peter Kordis ◽  
Ian Webb ◽  
Marko Noc ◽  
Philip MacCarthy ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Coronary Angiography ◽  
Mechanical Circulatory Support ◽  
Developed Countries ◽  
Cardiac Catheterisation ◽  
Temperature Management ◽  
Current Status ◽  
Circulatory Support ◽  
Hospital Cardiac Arrest ◽  
Catheterisation Laboratory

Out-of-hospital cardiac arrest (OHCA) is an important cause of mortality and morbidity in developed countries and remains an important public health burden. A primary cardiac aetiology is common in OHCA patients, and so patients are increasingly brought to specialist cardiac centres for consideration of coronary angiography, percutaneous coronary intervention and mechanical circulatory support. This article focuses on the management of OHCA in the cardiac catheterisation laboratory. In particular, it addresses conveyance of the OHCA patient direct to a specialist centre, the role of targeted temperature management, pharmacological considerations, provision of early coronary angiography and mechanical circulatory support.

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