Application of Magnetic Resonance Imaging of Patients with Concussion in Clinical Emergency

Concussion syndrome is a common disease in neurosurgery, and its incidence ranks first among all traumatic brain injuries. Cognitive dysfunction is one of the most common functional impairments in concussion syndrome. Neuroimaging and content assessments on concussion patients and healthy control subjects are used in this study, which uses MRI technology to evaluate brain pictures of concussion patients. Moreover, this paper separately evaluates the scores of the concussion syndrome group and the healthy control group in multiple functional aspects and performs independent sample t -test after statistics of the two scores. In addition, this paper uses resting-state fMRI to study the changes in the functional connectivity of the medial prefrontal lobe in patients with PCS, which has certain significance in revealing cognitive dysfunction after concussion and has a certain effect on improving the clinical emergency diagnosis and treatment of concussion.

Drone versus ambulance for blood products transportation: an economic evaluation study

Background Medical transportation is an essential step in health care services, and includes ground, air and water transportation. Among the important uses of medical transportation is the delivery of blood products in the event of a clinical emergency. Drone technology is the latest technological advancement that may revolutionize medical transportation globally. Nonetheless, its economic evaluation is scant and insufficient, whilst its cost-effectiveness remains controversial. The aim of this study was to compare the cost-effectiveness of drone transportation versus the ambulance. Methods The setting of the study was within a developing nation. An economic evaluation study of drone versus ambulance for emergency blood products transportation between the Sabah Women and Children Hospital (SWACH) and the Queen Elizabeth II Hospital (QEH2) on Borneo Island was conducted using the Cost-Effectiveness Analysis (CEA) technique. The total cost of each mode of transportation was calculated using the Activity Based Costing (ABC) method. Travel time was used as a denominator to estimate the Incremental Cost Effectiveness Ratio (ICER). Results For one clinical emergency in SWACH, a round trip of blood products transportation from SWACH to QEH2 costs RM1,266.02 (USD307.09) when using the ambulance, while the drone costs RM1,313.28 (USD319.36). The travel time for the drone was much shorter (18 min) compared to the ambulance (34 min). The Cost-Effectiveness Ratio (CER) of ambulance transportation was RM37.23 (USD9.05) per minute whilst the CER of drone transportation was RM72.96 (USD17.74) per minute. The ICER of drone versus ambulance was − 2.95, implying an increase of RM2.95 in cost for every minute saved using a drone instead of an ambulance. Conclusion Although drone transportation of blood products costs more per minute compared to the ambulance, the significantly shorter transport time of the drone offset its cost. Thus, we believe there is good economic potential for drone usage for blood products transportation in developing nations particularly if the drone price decreases and its operational lifespan increases. Our limitation of a non-clinical denominator used in this study leads to the recommendation for use of clinical outcomes in future studies.

Cerebral and spinal neurological complications in patients with COVID-19: authors’ clinical experience and literature review

Objective ‒ to highlight the high probability and features of neurological complications in patients with COVID-19 pneumonia.Materials and methods. A retrospective cohort study was done of 57 patients with COVID-19 pneumonia who were treated at the COVID-location of the Department of Vascular and Minimally Invasive Neurosurgery and Neurology of the Clinical Emergency Hospital of Lviv in the period from June 29 to September 28, 2020 (91 day).Results. Out of the 57 patients 14 (24.6 %) were selected by prospective analysis that had a clear association between COVID-19 pneumonia and neurological complications. Neurological complications of COVID-19 were manifested as ischemic stroke in 57.1 % of patients, encephalopathy with convulsions and without seizures ‒ in 35.7 %, polyneuropathy with tetraparesis, secondary purulent-inflammatory lesions of the spine ‒ in 7.2 %. Neurological complications occurred on average (20. 4 ± 6.1) days after the onset of the disease.Conclusions. Lesions of the spine and structures in the spinal canal after coronavirus infection had a significant spread along the axis of the spine and severe course. The largest (57.1 %) was the proportion of ischemic stroke in the structure of neurological complications of COVID-19, which indicated the severity of the coronavirus infection and its aggressive effect on the nervous system. The effectiveness of treatment of COVID-19 neurological complications depends on the urgency of hospitalization of patients, as evidenced by the correlation between favorable treatment outcomes and the time from disease onst to admission to either therapeutic (r = + 0.37) or neurological department (r = +0.32).

Obstetrics and Gynecology Acute Abdomen Clinical Diagnosis and Differential Value of Ultrasonography

Acute abdomen in obstetrics and gynecology is a common disease in clinical emergency, most of the patients have the characteristics of complex condition and rapid progress, and need to be treated through clinical diagnosis. There are many traditional diagnosis methods, but the accuracy is not ideal. Ultrasound is a widely used imaging technique in recent years, which has the characteristics of simple operation and high accuracy, so it is favored by doctors and patients in obstetrics and gynecology. In this study, 200 patients with acute abdomen in obstetrics and gynecology were selected, and the results of pathological examination were taken as the gold standard to evaluate the clinical value of ultrasound examination. As a result, the misdiagnosed ultrasound group was significantly lower after the diagnosis than in the normal group, the difference was significant (P > 0.05). Therefore, the use of ultrasound imaging, the clinical diagnosis of acute abdominal diseases in gynecology and obstetrics achieves a clear diagnostic effect, improves the diagnostic accuracy of patients with acute abdominal disease in the clinical. It is very important for the development of targeted therapeutic programmes.

ANALYSIS OF THE OBSTETRIC AND GYNECOLOGICAL SERVICE BUDGET HEALTHCARE INSTITUTION OF THE VORONEZH REGION "VORONEZH STATE CLINICAL EMERGENCY HOSPITAL Nо. 8" FOR 2015-2020

Важное медико-социальное значение, как для современного этапа развития общества, так и для будущего страны, имеет охрана здоровья женщин и детей. Здоровье ребенка находится в прямой зависимости от состояния здоровья матери, ее физической и нравственной готовности к рождению ребенка. Поэтому защита материнства и детства стала одной из основных задач государственной политики, важной составляющей здравоохранения, имеющей особое значение в формировании здоровья нации. Охрана репродуктивного здоровья населения, создание условий для рождения здоровых детей, предупреждение инвалидности, сокращение младенческой, детской и материнской смертности в стране имеют особую общественную значимость и стали критериями эффективности деятельности органов управления и организаций здравоохранения. Акушерско-гинекологическая служба в Российской Федерации находится в постоянном развитии. Внедряются новые методы и подходы к ведению беременности, родов и послеродового периода. С каждым годом снижаются материнская, младенческая, перинатальная смертности. Государство определило одним из приоритетов улучшение демографической политики в стране и делает все возможное для достижения результата. В статье приводится характеристика акушерско-гинекологической службы Воронежской государственной клинической больницы скорой медицинской помощи №8. Проведен анализ показателей, характеризующих организацию работы гинекологического отделения и дневного стационара. Выявлены проблемы в работе службы и предложены варианты их решения The protection of the health of women and children is of great medical and social importance, both for the current stage of development of society and for the future of the country. The health of the child is directly dependent on the state of health of the mother, her physical and moral readiness for the birth of the child. Therefore, the protection of mothers and children has become one of the main tasks of state policy, an important component of health care, which is of particular importance in shaping the health of the nation. The protection of the reproductive health of the population, the creation of conditions for the birth of healthy children, the prevention of disability, the reduction of infant, child and maternal mortality in the country are of particular public importance and have become criteria for the effectiveness of the activities of governing bodies and healthcare organizations. The obstetric and gynecological service in the Russian Federation is in constant development. New methods and approaches are being introduced to the management of pregnancy, childbirth and the postpartum period. Maternal, infant and perinatal mortality rates are decreasing every year. The state has identified improvement of the demographic policy in the country as one of its priorities and is doing everything possible to achieve the result. The article describes the characteristics of the obstetric and gynecological service of the Voronezh State Clinical Emergency Hospital No.8. The analysis of indicators characterizing the organization of work of the gynecological department and day hospital was carried out. Problems in the work of the service were identified and options for their solution were proposed

Features of the psychoemotional state of doctors providing medical care in the context of the COVID-19 pandemic

Due to the difficult working conditions, the lack of effective treatment methods, and the high mortality rate, the work of doctors with a new coronavirus infection significantly affects their mental and emotional state.Objective. To study the features of the psychoemotional state of doctors, providing medical care in the context of a pandemic of a new coronavirus infection in Smolensk.Material and methods. A questionnaire was developed to study the psychoemotional state of health professionals. 110 doctors working with COVID-19 patients were interviewed at the bases of the Smolensk Regional Emergency Hospital, the Clinical Emergency Hospital, and the Clinical Hospital No. 1 in Smolensk. The results of the responses were statistically analyzed and revised.Results. There was an increased level of anxiety (average score 8.427) and depression (average score 7.518). 26.4% of the respondents were found to have a gross sleep disorder. 76.4% of doctors indicated a deterioration in their condition since starting work with COVID-19 patients. For the majority of medical professionals, the main factors that help to maintain normal psychoemotional state are the support of relatives and colleagues (93.6%) and the provision of PPE (74.5%).Conclusions. According to the results of the study, increased anxiety, depression and deterioration of the general condition of doctors working in «red zones» were found. An extremely low organization and availability of psychological support for doctors struggling with a new coronavirus infection was revealed.