Care Of Severe Patients Research Articles

Examining medical urgent and patient precedence within the telemedicine landscape with its infrastructure and policies: A comprehensive review

Medical facilities are confronted with grave issues, including a population that is aging and a physician shortage. In an effort to address these issues, telehealth and remote health monitoring systems (RHMS) aim to reduce hospital visits by a small amount. RHMS lessens the workload for primary care patients and enhances inter-unit communication, which lessens the strain on emergency rooms. Due to significant advancements in mobile information transfer and processing of signal technologies, some healthcare researchers have made efforts to employ RHMS in place of hospital visits to provide triage and prioritization for individuals. Prioritization is a strategy for giving people urgent medical care in an attempt to save their lives, while clinical examination determines the severity of a sickness or damage. To emphasize the disadvantages of the present patient screening and prioritization system over the telehealth environment, a crucial inquiry is needed. Based on two crucial axes, an in-depth examination of patient prioritization and medical crisis assessment in a videoconferencing setting was provided in this research. First, a collection, analysis, and classification of earlier research on triage of patients and prioritization in this kind of setting was done. Second, a variety of priorities and standards, as well as various approaches and procedures for prioritization, were provided and examined. The subsequent outcomes were attained: The shortcomings and issues with the current patient prioritization and assessment methods were highlighted. The assessment and priority for individuals who have cardiac conditions were not presented. In the years to come, a structure based on the theory of evidence, as well as the incorporation of a multiple-layer analytical hierarchy approach and method for ranking preference due to resemblance to perfect solutions, can be used to prioritize the care of several patients with ongoing cardiovascular disease by triaging them based on various emergencies dimensions.

Personalizing Care Through Robotic Assistance and Clinical Supervision.

By 2030, the World Health Organization (WHO) foresees a worldwide workforce shortfall of healthcare professionals, with dramatic consequences for patients, economies, and communities. Research in assistive robotics has experienced an increasing attention during the last decade demonstrating its utility in the realization of intelligent robotic solutions for healthcare and social assistance, also to compensate for such workforce shortages. Nevertheless, a challenge for effective assistive robots is dealing with a high variety of situations and contextualizing their interactions according to living contexts and habits (or preferences) of assisted people. This study presents a novel cognitive system for assistive robots that rely on artificial intelligence (AI) representation and reasoning features/services to support decision-making processes of healthcare assistants. We proposed an original integration of AI-based features, that is, knowledge representation and reasoning and automated planning to 1) define a human-in-the-loop continuous assistance procedure that helps clinicians in evaluating and managing patients and; 2) to dynamically adapt robot behaviors to the specific needs and interaction abilities of patients. The system is deployed in a realistic assistive scenario to demonstrate its feasibility to support a clinician taking care of several patients with different conditions and needs.

Forecasting of Oxidant/Antioxidant levels of COVID-19 patients by using Expert models with biomarkers used in the Diagnosis/Prognosis of COVID-19

BackgroundEarly detection of oxidant-antioxidant levels and special care in severe patients are important in combating the COVID-19 epidemic. However, this process is costly and time consuming. Therefore, there is a need for faster, reliable and economical methods. MethodsIn this study, antioxidant/oxidant levels of patients were estimated by Expert-models using biomarkers, which are effective in the diagnosis/prognosis of COVID-19 disease. For this purpose, Expert-models were trained and created between the white-blood-cell-count (WBC), lymphocyte-count (LYM), C-reactive-protein (CRP), D-dimer, ferritin values of 35 patients with COVID-19 and antioxidant/oxidant parameter values of the same patients. Error criteria and R2 ratio were taken into account for the performance of the models. The validity of the all models was checked by the Box-Jenkis-method. ResultsAntioxidant/Oxidant levels were estimated with 95% confidence-coefficient using the values of WBC, LYM, CRP, D-dimer, ferritin of different 500 patients diagnosed with COVID-19 with the trained models. The error rate of all models was low and the coefficients of determination were sufficient. In the first data set, there was no significant difference between measured antioxidant/oxidant levels and predicted antioxidant/oxidant levels. This result showed that the models are accurate and reliable. In determining antioxidant/oxidant levels, LYM and ferritin biomarkers had the most effect on models, while WBC and CRP biomarkers had the least effect. The antioxidant/oxidant parameter estimated with the highest accuracy was Native-Thiol divided by Total-Thiol. ConclusionsThe results showed that the antioxidant/oxidant levels of infected patients can be estimated accurately and reliably with LYM, ferritin, D-dimer, WBC, CRP biomarkers in the COVID-19 outbreak.

Building infrastructure and operating-technological options in post-COVID-19 oral health care

During the COVID-19 pandemic, concerns about the impact of the aerosol generated in dental procedures on the spread of disease led to additional infection control measures that will remain as part of the biosafety routine after the end of the pandemic. This article addresses a little discussed topic that concerns the need to adapt the physical space and operational-technological choices for post-COVID dental care19. The current architecture of spaces for dental care in teaching and public health service units allows the care of several patients simultaneously. However, aerosols are produced routinely during dental procedures, with a real possibility of contamination between different patients. In this way, we present perspectives and suggestions for readjusting these spaces for teaching units and public health services in the short, medium and long term and also for using the resources of Information and Communication Technologies and minimally invasive dentistry.

Early and Critical Care in Severe Patients with COVID-19 in Jiangsu Province, China: A Descriptive Study

Background: Patients with coronavirus disease 2019 (COVID-19) infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which originated in Wuhan

Early and Critical Care in Severe Patients with COVID-19 Infection in Jiangsu Province, China: A Descriptive Study

Early and Critical Care in Severe Patients with COVID-19 Infection in Jiangsu Province, China: A Descriptive Study

The application effect of intensive nursing intervention on the occurrence of fecal incontinence dermatitis in severe patients

Objective To explore the effect of intensive nursing on the occurrence of incontinence dermatitis in patients with fecal incontinence. Methods A total of 62 patients with fecal incontinence in the emergency intensive care unit in our hospital were randomly divided into control group (31 cases) and observation group (31 cases). The control group received routine care for fecal incontinence patients.The observation group was combined with intensive nursing intervention.The incidence of incontinence dermatitis, nursing cost and nursing time were statistically analyzed. Results The incidence of incontinence dermatitis in the observation group was lower than that in the control group, and the nursing time and cost were both short (less)than that in the control group, and the difference was statistically significant(P<0.05). Conclusions The application of intensive care in severe patients can reduce the incidence of incontinence dermatitis.And effective avoid aboveⅡdegrees skin lesions. It can improve the working efficiency of nursing staff and reduce the economic burden of patients, which is better than the traditional nursing method. Key words: Intensive care; Fecal incontinence; Incontinence dermatitis; Critical patients

Limitation of Infarct Size and the Open Artery Hypothesis: A Conversation With Eugene Braunwald, MD.

Eugene Braunwald received an MD from the New York University School of Medicine. He completed an internal medicine residency at Johns Hopkins Hospital and cardiology fellowships at Mount Sinai Hospital, Columbia University, and the National Heart Institute. He served as chief of cardiology and subsequently clinical director of the institute. From 1968 to 1972, he was the founding chair of medicine at the University of California, San Diego. From 1972 to 1996, he served as chair of medicine at the Brigham and Women’s Hospital. In 1975, he was elected to the National Academy of Sciences. He is now the Distinguished Hersey Professor of Medicine at Harvard Medical School and a senior investigator of the TIMI Study Group, which he founded in 1984. Dr Braunwald replies: I became aware of the importance of AMI in 1951 during an elective in cardiology during my senior year at the New York University School of Medicine. At the time, AMI was by far the most common cause of death in adults in the United States. Of the patients who survived to be admitted to hospitals (no one knew how many AMI patients failed to reach hospital emergency departments), about one third died before discharge, either suddenly, presumably from an arrhythmia, or secondary to pump failure. Of the patients who were discharged alive, about one quarter died within a year, most frequently as a consequence of heart failure or recurrent MI. Pathologists had taught that AMI was usually associated with coronary thrombosis. Indeed, during my cardiology elective, Herrick’s classic article describing AMI was required reading. Its title, “Clinical Features of Sudden Obstruction of the Coronary Arteries,” showed how these 2 conditions (coronary occlusion and AMI) were intertwined.1 My direct involvement in the care of several patients who did not survive the acute event left …

Discussion on cultivation of master of intensive nursing specialist and vocational connection

Intensive nursing care, developing rapidly, is a secondary subject of nursing science. The researches mainly focus on rescue and nursing care of severe (critical) patients so as to improve the clinical prognosis of patients. The cultivation of master of intensive nursing specialist is consistent with vocational connection cultivation along with important and realistic significance. We should not only focus on fostering thinking ability of clinical nursing and ability to research but also cultivate operation ability to offer service to patients among graduate students. This article mainly summarized and analyzed the practice of master of intensive nursing specialist and vocational connection to explore how to further improve thoughts and methods. Key words: Intensive nursing; Medical education; Postgraduate education; Professional degree

Emergency Department Interfaces

Emergency Departments ED may be an exceptionally good example of an interface within a hospital. EDs have no patients of their own but pass them over to other institutions, either to specialist departments within the hospital or to primary care providers. Moreover, many doctors, nurses, attendants and institutions take part in the care of emergency department patients, and thus the number of its interfaces is very high. The characteristics of working in an ED, for example shortage of time, high work load, taking care of several patients at the same time and frequently crowding, may compromise the transfer of information via interfaces, sometimes including even vital data. The best way to secure handoff of information may be the formalization and standardization of this process, assuring patient safety and quality of care. Further study is required.

Bioethics Inserted in Oncologic Palliative Care: A Systematic Review

Introduction: Bioethics emerges in oncologic palliative care from the reflctions of that care at the end of life for cancer patients are usually inadequate because the individuals has little relief of symptoms, adverse reactions to treatment, threats of physical, social and psychological destruction and loss of functions.Material and Findings: Systematic review in MEDLINE, IBECS, LILACS and SciELO from 1 st January, 2006 to 10th January. The searchvwas conducted with the descriptors "CuidadosPaliativos" (DeCS);"Oncologia" (DeCS); "Morte e Morrer" (Keyword); and "Bioética" (DeCS) during the month of December 2013. The literature points out that physicians should not accept something as absolute truth; and to help them in their choices at the moment comes to bioethics, which does not provide ready answers, but, with its pluralistic view, makes us exercise the capacity for reflction in choosing the best conduits for the patient. It is necessary to rescue more widely the value of the care that was in the background before the search for the cure of diseases, which in a broader sense, encompasses human, spiritual and social aspects. In Brazil, the practice of euthanasia or assisted suicide are illegal conduct that typify the crime of murder, however, the suspension of therapeutic effort is not prohibited (SET), extensively comment, orthothanasia.Conclusion: Despite the possible philosophical and ideological differences, it is necessary that health professionals to really take care of severe patients, prove conscious and attentive to the rights of the individual, the real meaning of the concepts of health and disease, issues the lack of therapeutic possibilities, extreme old age and death.

Care of Organ Donors

In summary, anesthesiologists play a pivotal role in maintaining adequate organ function in the donor. Anesthesiologists are responsible for integrating the needs of all transplant services involved in donor organ retrieval. In addition, anesthesiologists can play critical roles in expediting preparation of the patient for surgery, and they can lend emotional support to operating room personnel during the surgery. The care of the organ donor is really the care of several patients--the donor and the fortunate recipients of the donated organs--and can afford great personal satisfaction.

SULFANILAMIDE IN THE TREATMENT OF GONORRHEAL VULVOVAGINITIS

Gonorrheal vulvovaginitis in children is a common disease; at the Cook County Hospital alone we treat about 150 patients a year. Brunet and his co-workers 1 estimate that it occurs in from 1 to 5 per cent of the female children of the poor sections of the larger cities. We feel that this estimate is very conservative. In 1930 we were called to an institution to take care of several patients with vaginitis. After taking smears of all the girls, approximately 300, we found that 20 per cent were positive for gonococci. In Chicago there is a high percentage of active cases among the Negro population. The sources of infection are numerous. In institutions the diaper appears to be the chief source of infection. Towels, linen, thermometers, bath tubs, attendants and nurses also may convey the organism from one child to another. About 80 per cent of our patients are