The Effects of Diagnosis-Related Group Payment on Diagnostic Cerebral Angiograms through a Transradial and Transfemoral Approach: A Comparative Observational Study

Background. Cerebral angiography is an X-ray examination technique widely used in hospitals. At present, it is mainly divided into two kinds of angiography examination: transfemoral artery and transradial artery puncture. The diagnosis-related group (DRG) system is a new type of payment standard recognized internationally, but its impact on medical care and health outcomes is currently controversial. Aim. In this study, we conducted a comparative study on two invasive approaches, transradial artery and transfemoral artery puncture and observed whether DRG had an impact on the quality of the medical process. Methods. We compared and analyzed patients undergoing cerebral angiography via the femoral artery and radial artery puncture by recording the relevant parameters and comfort scale scores (GCQ) during the operation, as well as postoperative complications. At the same time, we observed the proportion of different puncture routes and the success rate of cerebral angiography before and after the implementation of a DRG payment simulation. Results. The results of the comparative analysis of patients’ transradial artery and transfemoral artery puncture angiography showed that the puncture success rate (99.1% vs. 97.2%, P > 0.05 ), angiography success rate (97.3% vs. 95.1%, P > 0.05 ), and X-ray radiation time (4.82 vs. 5.15 min, P > 0.05 ) demonstrated no significant difference. The ambulation time (1.52 vs. 12.06 h, P < 0.05 ), puncture time (22.42 vs. 31.02 min, P < 0.05 ), and complications (3.57% vs. 9.03%, P < 0.05 ) of the radial artery group were significantly lower than those of the femoral artery group. In contrast, the GCQ score of the radial artery group at each stage after angiography was significantly higher than that of the femoral artery group ( P < 0.05 ). Compared with before the DRG simulation, the proportion of cerebral angiography with transradial artery puncture increased significantly after its implementation. Conclusion. Compared with transfemoral cerebrovascular angiography, transradial cerebrovascular angiography has many advantages, such as less local damage, less pain, less postoperative bed-rest time, significantly lower incidence of total complications, and a lower cost. Following the implementation of the DRG payment method, the quality of the angiography medical process improved.

7P pediatrics — Medicine of Development and Health Programming

The transition to personalized, predictive, preventive and participatory medicine, due, among other things, to the achievements of fundamental science, digitalization and the development of information and communication technologies, naturally demanded changes in childrens health care. New organizational, methodological and technological changes that have taken place to ensure a highly dynamic, adapted, and, at the same time, permanent provision of the medical process anywhere and at any time, have led to the need for specialists of a new formation a pluriexpert team ready to work in new conditions: how to participate in research in fundamental science, and to the introduction of innovative methods in clinical practice, medical and social support and the educational process. In these conditions, the strategic goal set for pediatrics to analyze absolutely all aspects of health: somatic, neuropsychic, emotional and psycho-social, in the process of growth and development of a child from conception/birth to adolescence / adulthood was implemented in a new direction of clinical and fundamental medicine developmental pediatrics and child health programming. 7P-pediatrics: Programming the development and health of the child, Preventive, Predictive, Personalized, Participatory, Polyprofessional (Pluriexpert), Progressive medicine for children, in which the results of scientific work based on fundamental data and ideas of neurosciences about progressive development and modern methodology of educational support of the entire medical process are fully translated into a clinical practice.

Automatic Verbal Autopsy Classification Using Multinomial Logistic Regression Classifier by Using Recursive Feature Elimination

Verbal autopsy is one of the finest medical process to identify automatically the cause of a death afore medical ascendant entities will certify it. Identifying the exact cause is intricate and fuzzy in nature. The dataset with an exact cause of death is a paramount implement for every country to make the presage about the life style and medical facilities available to the people. Multinomial logistic regression was utilized in our study to relegate the exact cause of death. We used standard datasets like PHMRC and Matlab which were potentially accepted in medical field. The reason to utilize the Multinomial logistic Regression is that most of the dataset is consisting of 0 and 1 values which betoken the presence and absence of value in the attribute. We used three standard metrics like the sensitivity, Chance Corrected Concordance (CCC) and Cause-specific mortality fraction (CSMF) for a comparison of our model with precedent models like Insilico VA, Tariff and InterVA-4. Computed results show that proposed model is better than the precedent models.

Formulation of Legal Provisions Concerning Gender Change

Sex change that is carried out through a medical process or commonly called sex change surgery, invites pros and cons in the community. The purpose of this study is to formulate regulations regarding the formulation of legal provisions regarding sex change that can reflect justice, benefit, and legal certainty as well as support the welfare of Transgender and Ambiguous Genitalia sufferers. This research is a normative legal research with philosophical, legislative, conceptual,case and comparative approaches. The analysis technique uses descriptive, comparative, evaluative and argumentative techniques. The results of the study indicate that the formulation of legal provisions regarding gender change is the use of the phrase the right to live in physical and spiritual prosperity in the formulation of legal norms as a large group that can reach various things, and the prohibition against plastic surgery to change identity, except for patients who have received court decision.

Fergus Shanahan: The language of illness

Abstract"The language of illness" is a wide ranging exploration of the therapeutic medical process - where it goes right and where is misfires. Communication and empathy are core values explored in the detail exemplifying the art of medicine along side the science. There is a deep seated wisdom and sympathetic philosophy within its pages which is very valuable for the healing and caring professions.

ОБЗОР СОВРЕМЕННЫХ МЕТОДОВ ПРОИЗВОДСТВА ИМПРЕГНИРОВАННЫХ ШОВНЫХ МАТЕРИАЛОВ

The modern medical process poses new challenges, classical suture materials have ceased to satisfy surgeons with both their sanogenetic properties and physical properties. These properties are capable of giving threads the production methods described in the article. Among these methods, there are two fundamental differences: an active pharmacological substance is applied in the process of creating a thread, and a substance is applied to an already finished thread, which fundamentally affects the physical and biological parameters.

Enhancing vigilance for cerebral air embolism after pneumonectomy: a case report

Background Vascular air embolism (VAE) is a rare but important complication that has not been paid enough attention to in the medical process such as surgery and anesthesia. Case presentation We report for the first time that a 54-year-old male patient with central lung cancer developed severe complications of CAE after right pneumonectomy. After targeted first-aid measures such as assisted breathing, mannitol dehydration and antibiotic treatment, the patient gradually improved. The patient became conscious at discharge after 25 days of treatment but left limb was left with nerve injury symptoms. Conclusion We analyzed the possible causes of CAE in this case, and the findings from this report would be highly useful as a reference to clinicians.

Research and Survey on the Status of Hospital Graded Care System and its Related Industries

The graded treatment system refers to the gradation of diseases according to their priority and ease of treatment, with medical institutions at different levels undertaking the treatment of different diseases and gradually realizing the medical process from general practice to specialization. Since the “new medical reform”, China has been committed to promoting “primary care”, “two-way referral”, “separation of acute and slow treatment” The “new health care reform” has been implemented in China since the beginning of the reform. However, in the process of implementation, the effectiveness of the system has always been controversial due to the inadequate construction of primary medical institutions and the weak awareness of graded treatment among residents.

EXPERIENCE IN USING INFORMATION AND COMMUNICATION TECHNOLOGIES IN CLINICAL PRACTICE AND EDUCATIONAL PROCESS

The article pays attention to modern information technologies that allow distance learning among students in higher educational institutions. Describes the role of modern technologies, information and communication, in the education system and the practice of a doctor. The ex-perience of introducing telecommunication technologies for holding meetings with participants in the educational and medical process is described.