Exchange Of Medicine Research Articles

National expert consensus on the application of negative pressure wound therapy in the treatment of diabetic foot wounds (2021 version)

Diabetic foot has a high rate of disability and mortality. Negative pressure wound therapy (NPWT) is one of the effective techniques in treating diabetic foot wounds, but the non-standard use of it often leads to infections, bleeding, necrosis and other complications, which seriously affects the outcome. In 2020, Tissue Repair of Burns and Trauma Committee, Cross-Straits Medicine Exchange Association organized experts from department of burns, department of orthopedics, department of vascular surgery, department of endocrinology, department of wound repair, and other departments engaged in the treatment of diabetic foot to discuss and write the "expert consensus on the application of negative pressure wound therapy in the treatment of diabetic foot wounds". This consensus is based on evidence-based medicine and combined with the latest clinical research progress, aiming to form a standardized plan for the treatment of diabetic foot wounds with NPWT, which can be used as a reference for clinicians, so as to promote the improvement of clinical diagnosis and treatment of diabetic foot.

The scope of hospital medicine practice at night: a national survey of night shift hospitalists

ABSTRACT Introduction: Although in-person hospitalist presence, increasingly staffed by dedicated nocturnists, has become the norm overnight in the hospital, the scope of nocturnist practice and typical workload has not been defined. This study examines the clinical responsibilities and patient safety perceptions of hospitalists who work night shifts in the United States. Methods: In the fall of 2019, a cross-sectional, web-based survey was administered to physician and nurse practitioner/physician assistant (NP/PA) hospitalists who work night shifts. The questionnaire assessed night staffing structure, typical responsibilities, patient volume, perceptions of safety overnight, as well as demographic information. The survey was posted on the Society of Hospital Medicine (SHM) Hospital Medicine Exchange (HMX) Online Discussion Forum. Additionally, the survey was distributed by ‘snowball method’ by respondents to other night hospitalists. Responses were collected anonymously. Results: Of the 167 respondents, 157 reported working night shifts. There was at least one respondent from 32 different states. In addition to performing admissions to medicine services and covering inpatients, night hospitalists cover ICU patients, participate in RRT/Code teams and procedure teams, perform consults, participate in medical education, and take outpatient calls. Across institutions, there was a large distribution in numbers of patients covered in a night shift; however, patient volume fell into typical ranges: 5–10 admissions for physicians, 0–6 admissions for NP/PAs, and 25–75 patient cross-coverage census. When physicians perform more than five admissions per night, hospitalists were less likely to agree that they could provide safe care (88% vs. 63%, p = 0.0006). Conclusions: This is the first national study to examine the clinical responsibilities of hospitalists working overnight. Overnight responsibilities are heterogeneous across institutions. As hospitals are increasingly employing nocturnists, more research is needed to guide night staffing and optimize patient safety.

A historical overview on medical exchanges between China and Vietnam

This article reviews the history of transmission and exchange of medicine between China and Vietnam. Systematic textual research found medical activities such as doctor visits, epidemics transmission, exchanges of therapies, import of local herbal, and drug specialties occurred in both countries. Vietnamese traditional medicine was once a truly large-scale system and one of the biggest branches of Chinese medicine abroad in history.

A Comprehensive Compression and Encryption Scheme for Secured Medical Images Communication

Background/Objectives: Among a gamut of evolving domains in medicine exchange of medicinal data and images amid multiple entities constitutes a pivotal aspect for telemedicine. An effective bandwidth allocation and management scheme is essential to accomplish the telemedicine communication requirements. This necessitates the requisite to develop and implement a compression and encryption scheme for medical images. Methods: This paper recapitulates the diverse transformation techniques employed in compression and identifies the constraints associated with the techniques. This paper summarizes the comparison of encryption methods such as Rivest Cipher 4(RC4), Rivest Cipher 2(RC2) and Data Encryption Standard (DES) in terms of time consumed to complete encryption and decryption operations. Findings: This paper considers Peak Signal-to-Noise Ratio (PSNR) and Compression Ratio (CR) as performance measures and establishes the proposed algorithms's effectiveness over Set Partitioning Hierarchical Trees (SPIHT). Application: This algorithm can be utilized for medical image compression, transfer and archiving operations.

A household survey on the extent of home medication storage. A cross-sectional study from rural Crete, Greece

Background: Patients often have multiple chronic diseases, use multiple prescriptions and over the counter medications resulting in polypharmacy. Many of them store these medications for future use in their homes, rather than take them as directed by their physician, resulting in a waste of health care resources, and potentially dangerous misuse.Objectives: This study aimed to investigate the magnitude of medication home hoarding, the exchange of medication with family/friends, families’ beliefs about the medication use, source of medication, pharmaceutical class, cost of stored medicine and conditions of storage.Methods: A structured questionnaire was administered within the homes in two rural areas in Crete.Results: Forty families participated in the study including 85 individual household members (36 men, and 49 women with an average age of 56.5 ± 24.3 mean ± SD). There were a total of 557 medications recorded, with 324 different medications representing a total value of €8954. The mean quantity of medication boxes stored in each home was 8.5 ± 5.8. Cardiovascular medications accounted for 56% of medications for current use; whereas analgesics (24%), and antibiotics (17%), were the most medications being stored for future use. Exchange of medicine was very common (95%). Beliefs that ‘more expensive medication is more effective’, and that ‘over the counter medications are safe because they were easily available’ were expressed.Conclusions: Medications are being stored in large quantities in these rural areas, with a large percentage of them being wasted or misused.

Parallel and divergent landscapes: cultural encounters in the ethnographic space of Tuareg medicine.

This essay explores the dialogue between the local quest for healing and the anthropological quest for healing knowledge, and local assessments of knowledge-power relationships in these processes. The context is medical discourse among the Tuareg of Niger Republic, West Africa, and my research experiences among these people. I examine local medical specialists and their traditional and changing practice in terms of how they perceive and respond to wider knowledge and power systems that impinge on local health care. Paramount in these systems are central state policies and medical anthropological research on healing, as these intersect in a postcolonial and post-separatist/rebellion setting. The essay analyzes parallels between the exchange of medicine and the exchange of knowledge and reflects upon how anthropological knowledge of African healing systems is constructed in an environment highly charged with power and danger--of political violence and economic crisis. The broader issue addressed here is how to give greater empowerment to local residents' voices in their "indigenous critique" of the medical anthropological project.