Mathiassenbech7899
One of the health policy challenges lies in guaranteeing comprehensive emergency care in Germany. Telemedical applications are assumed to be a potential solution to current problems. One of these innovations is the tele-emergency physician system, which changes the workflows of the various actors in prehospital emergency medicine. The aim of the study was to determine how the potentials of the tele-emergency physician system were evaluated by employees of the ambulance control centres in Germany.
In the cross-sectional study, employees of ambulance control centres throughout Germany were interviewed using an online-based questionnaire. The results are illustrated in a sub-group analysis according to the state of knowledge on innovation, either (very) low or (very) high. Correlation analyses were carried out to determine significant differences between the subgroups. Data analysis was performed using Microsoft Excel 2013 and IBM SPSS Version 25.
The response rate was 69.04%. Of those surveyed, 76.23% expparticipants stated that a tele-emergency physician system should be implemented in their own area.
All in all, the tele-emergency physician system is considered useful in prehospital emergency medical service by the staff of the emergency control centres. However, the majority of participants do not assume that there is potential for implementation of this system in their own region.
All in all, the tele-emergency physician system is considered useful in prehospital emergency medical service by the staff of the emergency control centres. However, the majority of participants do not assume that there is potential for implementation of this system in their own region.
The aim of the study was to determine parents' views in regions distant to medical care (dtmc) vs. close to medical care (ctmc) on (1) the assessment of situation in pediatric care and (2) on delegation of medical tasks to qualified members of non-medical health professions.
A self-developed questionnaire was sent to parents in kindergartens, who are either nearby (=close to the medical care provider, ctmc) or more than 20 km away from the nearest pediatric practice and a pediatrics department (=distant to the medical care provider, dtmc). The questions covered socio-demographic, pediatric-care-related aspects and attitudes to delegation of defined medical tasks to non-medical health professionals.
Of the n=407 evaluable questionnaires (response rate 18%), 49% came from parents in ctmc-kindergartens and 51% from parents in dtmc-kindergartens. Significant differences were found in the number of children living in the household (ctmc 21% with 3 or more children vs. dtmc13%; p-value 0,044), years of educats show clear differences between the survey regions. To support pediatric care in regions distant to medical care facilities, innovative care concepts are needed. The positive attitude of the majority of parents on the subject of delegation forms a good basis for the development of concrete concepts and their practical testing in pilot projects.Prevention has become an important issue in health care. With the funding of Health Regionsplus, Bavaria is participating in the establishment of municipal structures that support health promotion through local networking. In this context, the district of Cham has identified an important field of action the mediation of high-quality offers to local citizens by specially trained people, namely health representatives. A training concept was developed, the evaluation of which is reported here. After a first course, the curriculum was modified gearing the content more towards project management and networking. With this modification, the feedback on the activities of the health representatives in their own view as well as from the perspective of event participants, citizens and local politicians showed a consistently positive response.Liver injury can result from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with more than one-third of COVID-19 patients exhibiting elevated liver enzymes. Microvesicular steatosis, inflammation, vascular congestion, and thrombosis in the liver have been described in autopsy samples from COVID-19 patients. Several factors, including direct cytopathic effect of the virus, immune-mediated collateral damage, or an exacerbation of preexisting liver disease may contribute to liver pathology in COVID-19. Due to its immunological functions, the liver is an organ likely to participate in the viral response against SARS-CoV-2 and this may predispose it to injury. A better understanding of the mechanism contributing to liver injury is needed to develop and implement early measures to prevent serious liver damage in patients suffering from COVID-19. This review summarizes current reports of SARS-CoV-2 with an emphasis on how direct infection and subsequent severe inflammatory response may contribute to liver injury in patients with and without preexisting liver disease.
Two types of self-expandable metal stents (SEMS) are available for malignant distal biliary obstruction fully covered SEMS (FCSEMS) and uncovered SEMS. FCSEMS can prevent stent ingrowth, but a major concern is spontaneous migration. This study aimed to determine whether the additional insertion of a double-pigtail plastic stent to anchor the FCSEMS can prevent migration.
68 patients with unresectable, malignant, distal, biliary obstruction were included in this multicenter, randomized, superiority trial. The patients were randomly assigned to receive either the FCSEMS plus an anchoring plastic stent (n = 33) or an FCSEMS alone (n = 35). After placement of the FCSEMS, the anchoring stent was inserted inside the FCSEMS. The primary outcome was the rate of stent migration during the 6-month follow-up. The secondary outcomes were stent-related adverse events, stent patency, and survival rates.
The baseline characteristics were similar between the two groups. The rate of stent migration at 6 months was significantly lower in patients with the FCSEMS plus anchoring stent (15 % vs. selleck chemicals 40 %;
= 0.02). The mean stent patency was significantly longer in the FCSEMS plus anchoring group (237 days [95 % confidence interval [CI] 199 to 275] vs. 173 days [95 %CI 130 to 217];
= 0.048). There were no significant differences in stent-related adverse events and overall survival rates at 6 months between the two groups.
Our data suggest that the additional double-pigtail plastic stent anchored the FCSEMS to prevent migration and prolonged patency without any serious adverse events.
Our data suggest that the additional double-pigtail plastic stent anchored the FCSEMS to prevent migration and prolonged patency without any serious adverse events.
