Qvistmorsing8964

The pandemic of coronavirus disease 2019 (Covid-19) caused a large number of non-ventilated hypoxemic patients to require the use of prone position. The aim of this study is to measure the efficiency and tolerance of prone positioning in ward hypoxemic patients treated for Covid-19. This retrospective study included confirmed Covid-19 hypoxemic patients treated by at least one prone position session. Primary outcome was pulse oximetry over inspired oxygen fraction ratio (SpO2/FiO2) before, during, and after prone position. Secondary outcomes were failure, adverse events, and poor tolerance rate. Twenty-seven patients were included. During first, second and third sessions, SpO2/FiO2 ratio was significantly higher during posture than before (p less then 0.0001, p less then 0.01, and p less then 0.001 respectively). Eighteen patients were responders (defined as an improvement of SpO2/FiO2 of more than 50) during the first posture and have a shorter length of hospital stay than non-responder patients. Failure rate was 5%, and poor tolerance and adverse events rates were 8% and 7% respectively. Our study found that prone position in wards improved alveolar exchange during posture and is well tolerated. This technique could be used in any medical ward.

The COVID-19 pandemic has resulted in radical changes in the delivery of healthcare worldwide. Our oncology service (at an Irish national cancer centre) rapidly transitioned to the use of telemedicine or virtual clinics (VC) to minimise potential risk of exposure to COVID-19 amongst an immunosuppressed, high-risk population. Our study aimed to evaluate the use of VC in this setting.

An 18-point questionnaire was designed to investigate the patient experience of VC during the COVID-19 pandemic in Ireland and compliance with guidelines developed in Ireland to conduct VC and the role of VC in the future. Questionnaires were distributed following the receipt of verbal consent from patients during the VC. Descriptive statistics were utilised for data analysis using SPSS®.

One hundred and four patients returned completed surveys (n = 104/164, 63% response rate). Overall satisfaction levels were high with most patients (n = 58/100, 58%; no answer provided (NAP), n = 4) equally satisfied or nearly equally satisfied with VC in comparison to a usual clinic encounter. The majority of patients felt that there should be a role for VC in the future (n = 84/102, 82%; NAP, n = 2). Epacadostat supplier The majority of patients (n = 61/99, 61%; NAP, n = 5) were very relieved to avoid a hospital visit due to perceived risk of potential exposure to COVID-19.

The majority of oncology patients were satisfied with a VC encounter. VC may have a role in the future of medical care in Ireland post the COVID-19 pandemic.

The majority of oncology patients were satisfied with a VC encounter. VC may have a role in the future of medical care in Ireland post the COVID-19 pandemic.

The impact of a change in service delivery in a psychogeriatric service, moving from a consultation model to liaison model of care, was examined in a naturalistic study.

The study period was divided into two phases, defined by the change in service delivery. The impact of the change on (1) referral rate, (2) referrals seen, (3) extent of intervention and (4) clinical characteristics was examined.

While we did not see a dramatic improvement in time waiting for assessment (2.9 vs. 2.4days), the enhanced team provided significantly more clinical input. The number of assessments completed increased by 60% (39 vs. 66). Most significantly, during phase I, more than half of all referrals were not seen (54%), while during phase II only one patient referred was not assessed (1%). The number of reviews undertaken also increased significantly.

The results of the present study suggest improved outcomes for patients and improved satisfaction in the clinical teams. Further clinical effectiveness and cost-effectiveness studies are needed.

The results of the present study suggest improved outcomes for patients and improved satisfaction in the clinical teams. Further clinical effectiveness and cost-effectiveness studies are needed.

The purpose of this study is to compare maternal outcomes in patients with placenta accreta spectrum (PAS) when managed as part of a multi-disciplinary team (MDT) compared to standard care.

Patients in the standard care group were retrospectively identified from pathology records, with patients in the MDT group prospectively collected on an electronic database. Data on maternal demographics, delivery, estimated blood loss (EBL), transfusion requirements, and morbidity were recorded.

Sixty patients were diagnosed with PAS between 2006 and 2019, of whom 32 were part of the standard care group and 28 in the MDT group. Compared to standard care, MDT care was associated with an increase in antenatal diagnosis from 56.3 to 92.9% (p < 0.0001), a significant reduction in EBL (4150 mL (800-19500) vs 1975 (495-8500), p < 0.0001), and transfusion requirements (median 7 (0-30) units of RCC vs 1 (0-13), p < 0.0001).

PAS is associated with significant maternal morbidity and warrants management in an MDT setting with specialist input, which is associated with improved outcomes.

PAS is associated with significant maternal morbidity and warrants management in an MDT setting with specialist input, which is associated with improved outcomes.

The brutal COVID-19 pandemic has majorly impacted populations and health systems, and surgeons have observed dramatic changes in their daily clinical activities. A survey of French digestive surgeons was conducted to assess these changes.

An electronic survey was sent to French digestive and general surgeons in the Societe Francaise de Chirurgie Digestive (SFCD) to assess the surgeons' daily activity during the pandemic and investigate changes in patients' management. The care deviations were classified as delay of management, modification of strategy, or modification of organization, and the impact of these changes on patients was evaluated by the surgeon's estimation of loss of chance.

A major reduction in surgical elective activity was observed in 50 (75%) of the 67 hospitals that responded. Of these, 48 hospitals (71.6%) reported receiving SARS-CoV-2 patients. A deviation from usual care was observed in 10% of patients admitted for emergency general surgery. Among 140 patients presenting a deviation from usual care, 74 (52.