Periodontal therapy for hopeless mandibular anterior teeth: a retrospective case report with a multidisciplinary approach and a 20-year follow-up

Introduction: This case report presents the intentional periodontal maintenance of two periodontal hopeless lower central incisors with a multidisciplinary approach and 20-year follow-up. Case presentation: A 36-year-old male, in 2001, was diagnosed with aggressive periodontitis, gingival swelling, bleeding, and mandibular central incisors with mobility and poor prognosis. Following periodontal therapy (phase I), root canal treatment, and occlusal adjustment, #31 and #41 were gently extracted to remove the granulation tissues, calculus, and infected cementum from the root surface. Then, tetracycline-HCl was applied for 5 minutes on the root surfaces. The teeth were repositioned into the sockets and splinted with a lingual bar. At 3 months, the bar was removed, and a free gingival autogenous graft was done to improve the local keratinized tissue width. Mobility scores, pocket depths, and clinical attachment levels were recorded, and radiographs were taken at 1, 5, and 20 years. The 5-year follow-up showed that the teeth were clinically and radiographically in function. There was a reduction in probing depth and a gain in clinical attachment and radiographic alveolar bone levels. After 20 years, #41 was stable, but #31 had external root resorption, leading to a new treatment plan (dental implants) and extraction. Conclusion: The clinical result of this case was satisfactory for 20 years. Intentional periodontal maintenance of the teeth may be an alternative treatment, even considering the high level of complexity.

Fibromialgia: puesta al día y revisión de literatura / Fibromyalgia: update and literature review

Fibromyalgia is a chronic disease characterized by widespread musculoskeletal pain, sleep disorders, and fatigue, all of which are associated with increased central sensitivity. Its global prevalence is estimated to be between 2% and 4%, with a rate of 2.6% in cases of non-cancer-related pain in Chile. Diagnosis is primarily based on clinical evaluation, with additional tests considered according to specific differential diagnoses. Although the etiology and pathogenesis of the disease are not yet fully understood, predisposing factors such as genetics, stress, nociplastic alterations, and cognitive-emotional changes have been identified. Treatment should be individualized and focus on four key pillars: patient education, lifestyle modifications, psychotherapy, and pharmacotherapy as a last resort. This literature review aims to address the approach that physicians, especially those in primary care, should adopt, as evidence suggests improved prognosis when care is provided in a comprehensive and multidisciplinary setting. Therefore, it is crucial that healthcare professionals are adequately prepared to ensure timely diagnosis and appropriate management in each case.

La fibromialgia es una enfermedad crónica caracterizada por dolor musculoesquelético generalizado, trastornos del sueño y fatiga, todos ellos asociados a una sensibilidad central aumentada. Se estima que su prevalencia global es del 2% al 4%, con una tasa del 2,6% en casos de dolor no relacionado con cáncer en Chile. El diagnóstico se basa principalmente en la evaluación clínica, con pruebas adicionales que deben considerarse según los diagnósticos diferenciales específicos. Aunque la etiología y patogénesis de la enfermedad aún no se comprenden completamente, se han identificado factores predisponentes como la genética, el estrés, las alteraciones nociplásticas y los cambios cognitivo-emocionales. El tratamiento debe ser individualizado y centrarse en cuatro pilares clave: educación del paciente, modificaciones en el estilo de vida, psicoterapia y farmacoterapia como último recurso. Esta revisión de la literatura tiene como objetivo abordar el enfoque que los médicos, especialmente aquellos en atención primaria, deben adoptar, ya que la evidencia sugiere una mejora en el pronóstico cuando se brinda atención en un entorno integral y multidisciplinario. Por lo tanto, es fundamental que los profesionales de la salud estén adecuadamente preparados para garantizar un diagnóstico oportuno y un manejo adecuado en cada caso.

Cystocele management in multisurgical patients: a comprehensive case report emphasizing advanced diagnostic and surgical precision

Pelvic organ prolapses (POP), particularly cystocele, presents significant challenges in postmenopausal women, exacerbated in those with multiple caesarean sections (LSCS) and comorbidities like diabetes mellitus. This case report details the successful management of a 62-year-old woman with a large cystocele, three LSCS, and diabetes mellitus. Thorough preoperative evaluation, including ultrasound and diagnostic laparoscopy, guided surgical planning. Anterior colporrhaphy restored support to the anterior vaginal wall. Perioperative care included strict glycemic control and antibiotic prophylaxis. Multidisciplinary collaboration ensured comprehensive management. This case highlights the importance of advanced diagnostics, meticulous surgical planning, and multidisciplinary care in complex cystocele cases.

Unveiling the elusive: a case of missed hydrops fetalis

Hydrops fetalis, characterized by abnormal fluid accumulation in fetal tissues, poses diagnostic challenges often leading to adverse outcomes. We present a case of a 26-year-old multigravida diagnosed with hydrops fetalis at 26 weeks, despite unremarkable antenatal visits. Detailed ultrasound revealed characteristic signs, prompting urgent intervention. Despite aggressive measures, the neonate succumbed shortly after birth. This case highlights the complexities of diagnosing and managing hydrops fetalis, emphasizing the need for heightened clinical awareness. Diagnostic steps, including fetal ultrasound and genetic testing, are pivotal for confirming diagnosis and guiding management, underlining the critical role of comprehensive prenatal care in improving outcomes.

Rare case of immune mediated cutaneous leucoclastic vasculitis with pancytopenia in a rheumatoid arthritis patient with chronic cytomegalovirus infection

Acute febrile illnesses with systemic involvement can present significant diagnostic and therapeutic challenges, particularly in patients with multiple comorbidities. This case report highlights a complex presentation of acute febrile illness with pancytopenia and immune-mediated cutaneous vasculitis in a patient with type II diabetes mellitus. A 52-year-old male with a known history of type II diabetes mellitus presented with fever, decreased oral intake, loose stools, oral ulcers, dysphagia, and rashes over the trunk and abdomen for four days. Upon admission to the ICU, extensive diagnostic evaluations were performed, revealing significant hematological, biochemical, and serological abnormalities. Imaging studies and histopathological examinations were conducted to further investigate the underlying etiology. Laboratory findings indicated pancytopenia, acute kidney injury, and hyperkalemia. Infectious disease workup was largely negative, except for a positive CMV IgG. Imaging studies revealed medical renal disease, and a skin punch biopsy confirmed cutaneous leukocytoclastic vasculitis. Bone marrow biopsy suggested bone marrow suppression. Multidisciplinary management, including dialysis, IV fluids, antibiotics, blood transfusions, steroids, and Ganciclovir, led to the patient抯 gradual improvement and stabilization. The comprehensive diagnostic and therapeutic approach in this case underscores the importance of considering immune-mediated etiologies in patients with atypical presentations. Multidisciplinary collaboration was crucial in managing the multifaceted clinical condition of the patient. Early recognition and prompt multidisciplinary management are essential in similar cases. Extensive diagnostic evaluations should be performed to identify the underlying causes, and immune-mediated etiologies should be considered in complex presentations. Further research is recommended to explore optimal management strategies for such multifaceted conditions.

Percepções dos profissionais da atenção básica em saúde sobre a responsabilidade no cuidado integral às pessoas com transtornos mentais / Perceptions of primary care professionals about responsibility for comprehensive health care for people with mental disorders

A Reforma Psiquiátrica Brasileira possibilitou a reinserção das pessoas com transtornos mentais na sociedade. Isso acarretou a necessidade de implementar outras formas de olhar e acompanhar essa população, instigando a construção do cuidado em liberdade. Assim, objetivou-se identificar as percepções dos profissionais da atenção básica em saúde sobre a responsabilidade no cuidado integral à pessoa com transtorno mental e/ou sofrimento mental. Trata-se de um estudo descritivo, de abordagem qualitativa, realizado com sete profisionais de uma equipe de Saúde da Família, na região metropolitana de Porto Alegre, Sul do Brasil. Os dados foram coletados por meio de entrevistas individuais e analisados conforme análise de conteúdo. Evidenciou-se que existe o movimento de tomada de responsabilidade por parte dos profissionais entrevistados, a partir da construção de cuidado e acompanhamento em saúde mental. Influenciam esse movimento aspectos como: a escuta, a construção do vínculo, o estigma como modificador da percepção e os fluxos/encaminhamentos para outros serviços. A enfermagem demonstrou ter um papel fundamental na tomada de responsabilidade na atenção básica, em que o profissional enfermeiro é visto como referência na realização dos cuidados e capacitação da equipe.

The Brazilian Psychiatric Reform enabled the reintegration of people with mental disorders into society. This led to the need to implement other ways of looking at and supporting this population, encouraging the construction of care in freedom. Thus, the aim was to identify the perceptions of primary health care professionals regarding responsibility for comprehensive care for people with mental disorders and/or mental distress. This is a descriptive study with a qualitative approach, conducted with seven professionals from a Family Health Team in the metropolitan region of Porto Alegre, Southern Brazil. Data were collected through individual interviews and analyzed using content analysis. It was evident that there is a movement towards taking responsibility on the part of the interviewed professionals, through the construction of mental health care and monitoring. Aspects influencing this movement include: listening; building rapport; stigma as a modifier of perception; and referrals to other services. Nursing demonstrated a fundamental role in taking responsibility in primary care, where the nurse professional is seen as a reference in providing care and training the team.

The one health approach: combating the persistent Visceral Leishmaniasis (Kala-azar) outbreaks in Isiolo County, Kenya

Background: Visceral leishmaniasis has remained a public health problem in Kenya despite Ministry of Health’s numerous efforts. This is associated with absence of a multidisciplinary response to outbreaks. We intended to analyze community’s prioritization of causes of Visceral leishmaniasis as well as community awareness on the disease prevention and control. Methods: This was a descriptive cross-sectional study design conducted between September 2023 to December 2023. 433 households’ heads, 23 community leaders and health workers were study informants. Results: Study findings showed clear proximity of human settlements and socioeconomic activities to the vector sandfly breeding sites. Environmental factors augmented by effects of climate change including flooding and high temperatures have sustained transmission including emergence of the disease in new foci. Low socio-economic status, environmental factors and climate change effects showed highly significant correlations with the disease and interplay with one another. Study results show lack of strategies and policies that promote effective prevention and control of Kala-azar. Stakeholders’ analysis revealed limited community awareness regarding roles played by different individuals in Kala-azar prevention, control, and elimination. Conclusions: There is a major gap in cooperation of partners in human, animal, and environmental health for achievements in public health strategies, therefore One Health approach should be adopted for integrated prevention, control, and elimination. The approach will sustainably improve and promote health while addressing the entire spectrum of disease control, including detection, preparedness, response, and management in addition to disease prevention averting this terrible disease from resurfacing in the future.

O trabalho da Educação Física no núcleo ampliado de Saúde da Família: revisão de literatura / The work of Physical Education in the expanded Family Health core: literature review / El trabajo de la Educación Física en el núcleo ampliado de Salud Familiar: revisión de la literatura

Objetivamos analisar a produção científica relacionada à Educação Física e aos Núcleos Ampliados de Saúde da Família no período de 2010 a 2021, considerando os princípios da política desse serviço fundamental da Saúde Pública brasileira. Foram incluídos 16 artigos. A produção demonstra que há centralidade do trabalho na concepção curativa, mecanicista e biomédica e, por isso, existem lacunas para a efetivação da interdisciplinaridade, do apoio matricial, da clínica ampliada e do projeto terapêutico, especialmente porque o trabalho multiprofissional exige não apenas tenacidade e força de vontade dos profissionais da saúde, mas, também, planejamento e organização com vistas a considerar as necessidades de saúde dos usuários e a diversidade de contextos dos territórios.

We aimed to analyze the scientific production related to Physical Education and the Expanded Family Health Centers from 2010 to 2021, considering the policy principles of this fundamental service of Brazilian Public Health. 16 articles were included. The production demonstrates that work is central to the curative, mechanistic and biomedical conception and, therefore, there are gaps in the implementation of interdisciplinarity, matrix support, the expanded clinic and the therapeutic project, especially because multidisciplinary work requires not only tenacity and willpower of health professionals, but also planning and organization with a view to considering the health needs of users and the diversity of contexts in the territories.

Nuestro objetivo fue analizar la producción científica relacionada con la Educación Física y los Núcleos Ampliados de Salud de la Familia de 2010 a 2021, considerando los principios de política de este servicio fundamental de la Salud Pública brasileña. Se incluyeron 16 artículos. La producción demuestra que el trabajo es central en la concepción curativa, mecanicista y biomédica y, por tanto, existen vacíos en la implementación de la interdisciplinariedad, el apoyo matricial, la clínica ampliada y el proyecto terapéutico, sobre todo porque el trabajo multidisciplinario requiere no sólo tenacidad y voluntad de profesionales de la salud, pero también planificación y organización con miras a considerar las necesidades de salud de los usuarios y la diversidad de contextos en los territorios

Demanda de cuidado nutricional de crianças com transtorno do espectro autista em uma região de acesso remoto / Demandas de atención nutricional de niños con trastorno del espectro autista en una región de acceso remoto / Nutritional care demands of children with autism spectrum disorder in a remote access region

Introdução: O transtorno do espectro autista é uma condição neuropsiquiátrica que demanda atenção interdisciplinar e multiprofissional. A abordagem nutricional é necessária frente aos possíveis sintomas associados, como seletividade alimentar e alterações do hábito intestinal. Famílias residentes em locais de acesso limitado à serviços de saúde podem possuir dificuldades para o adequado acompanhamento. Objetivo: Relatar a experiência de atendimentos em nutrição realizados pela Liga Acadêmica de Nutrição e Saúde Coletiva a crianças com transtorno do espectro autista explorando as principais demandas identificadas e enfrentadas em uma região de acesso remoto. Metodologia: Abordagem descritiva, do tipo relato de experiência, de atendimentos realizados no município de Coari, interior do Amazonas. Os encontros foram realizados com vista a identificar demandas e refletir sobre a melhor maneira de auxiliar as crianças com essas comorbidades. Resultados: Foram atendidas 9 crianças, nem todas com o diagnóstico fechado. Seletividade alimentar, distúrbios gastrointestinais e excesso de peso foram desafios recorrentes. Nota-se a carência da percepção da importância do acompanhamento nutricional, em um cenário de relatos importantes sobre as dificuldades no acesso a medicações, por falta no município ou por ausência de recursos para aquisição, assim como terapias especializadas. Aspectos que se tornam ainda mais desafiadores frente à distância geográfica e carência de profissionais especializados e que realizem uma atenção multiprofissional. Conclusões: O acompanhamento nutricional adequado é essencial para atender às necessidades específicas e melhorar a qualidade de vida dessas crianças. Diante das limitações identificadas na região, são necessários esforços contínuos para desenvolver soluções que garantam uma assistência inclusiva e eficaz às crianças com transtorno do espectro autista no interior do Amazonas. A colaboração entre instituições, a conscientização da comunidade e o fortalecimento da rede de saúde local são cruciais para promover uma abordagem abrangente e de alta qualidade para essas crianças e suas famílias (AU).

Introduction: Autism spectrum disorder is a neuropsychiatric condition that demands interdisciplinary and multidisciplinary attention. Nutritional intervention is necessary in the face of possible associated symptoms, such as food selectivity and changes in bowel habits. Families living in places with limited access to health services may have difficulties in obtaining adequate support and follow-up.Objective: Reporting the experience of nutrition services provided by the Academic League of Nutrition and Public Health to children with autism spectrum disorder, exploring the main identified demands and challengesfaced in a remote access region. Methodology:Descriptive approach, experience of an report, of services provided in the municipality of Coari, in the interiorof Amazonas. The meetings were held with the aim identifying demands and reflecting on the best way to assistchildren with these comorbidities. Results: Ninechildren attended to, not all with a confirmed diagnosis. Food selectivity, gastrointestinal disorders and overweight were recurring challenges. There is a lack of perception of the importance of nutritional monitoring, in a scenario where there areimportant reportsofdifficulties in accessing medications, either due to lack of availability in the municipality or lack of resources for acquisition, as well as specialized therapies. Theseaspects become even more challenging given the geographical distance and scarcity of specialized professionals whocanprovide multidisciplinary care. Conclusions: Adequate nutritional monitoring is essential to meet the specific needs and improve the quality of life of these children. Given the limitations identified in the region, continuous efforts are needed to develop solutions that guarantee inclusive and effective assistance for children with autism spectrum disorder in the interior of Amazonas. Collaboration between institutions, community awareness, and strengthening the local health network are crucial to promoting a comprehensive, high-quality approach for these children and their families (AU).

Introducción: El trastorno del espectro autista es una condiciónneuropsiquiátrica que requiere atención interdisciplinaria y multidisciplinaria. El enfoque nutricionales frente a losposibles síntomas, como selectividad alimentaria y alteraciones delhábitosintestinales. Las familias que viven en lugares con accesolimitado a los servicios de salud pueden tener dificultades para recibir un seguimiento adecuado. Objetivo: Reportar la experiencia de los servicios de nutrición brindados por la Liga Académica de Nutrición y Salud Pública a niños con trastorno del espectro autista, explorando las principales demandas identificadas y enfrentadas en una región de acceso remoto.Metodología: Enfoque descriptivo, relato de experiencia, de los servicios prestados en Coari, en el interior de Amazonas. Los encuentros se realizaron con el objetivo de identificar demandas y reflexionar sobre la mejor manera de ayudar. Resultados:Se atendieron 9 niños, no todos con diagnóstico confirmado. Selectividad alimentaria, trastornos gastrointestinales y exceso de peso fueron desafíos recurrentes. Se observa una falta percepción de la importancia del seguimiento nutricional, en un escenario de informes importantes sobre las dificultades en el acceso a medicamentos, debido a lafaltade suministro en el municipio o a la falta de recursos para su adquisición, así como terapias especializadas. Estosaspectos que se vuelven aún más desafiantes dada la distancia geográfica y falta de profesionales especializados que brinden una atención multidisciplinaria.Conclusiones: Un adecuado seguimiento nutricional es fundamental para satisfacerlas necesidades específicas y mejorar la calidad de vida de estos niños. Antelas limitaciones identificadas, se necesitan esfuerzos continuos para desarrollar soluciones que garanticen una atención inclusiva y efectiva estosniños en el interior de Amazonas. Colaboración entre instituciones, concientización comunitaria y fortalecimiento de la red de salud local son cruciales para promover un enfoque integral y de alta calidad para estos niños com trastorno del espectro autista y sus familias (AU).

Barriers to comprehensive nutrition care for cancer patients: a review

This comprehensive review studies the multifaceted barriers that delay cancer patients from accessing adequate nutrition throughout their cancer journey. Addressing these barriers is paramount, considering their profound implications on treatment efficacy, patient well-being, and overall outcomes. The analysis encompasses a range of obstacles comprises physiological, psychological, economic, social, and healthcare system factors, highlighting their intricate impact on nutritional intake and patient care. The exploration of nutritional barriers reveals a landscape encompassing challenges such as malnutrition, treatment-related side effects, psychological distress, physical limitations, lack of knowledge, cultural influences, financial constraints, and limited access to specialised nutritional support. These hurdles, if left unaddressed, can lead to adverse consequences including malnutrition, weakened immunity, impaired treatment response, decreased quality of life, and ultimately, poorer prognosis. The intricate interplay between inadequate nutrition and cancer outcomes is underscored, emphasising the pivotal role of proper nutrition in boosting the immune system, supporting treatment effectiveness, and hastening recovery. Strategies to overcome these barriers emerge through multidisciplinary approaches integrating medical and nutritional needs, personalised dietary plans, psychosocial support, and the integration of yoga and wellness practices to foster mindful eating and holistic well-being. This review provides valuable insights into the complexities of nutritional barriers in cancer care and emphasizes the critical need for comprehensive strategies to ensure cancer patients receive the vital nutritional support necessary for optimizing their journey through treatment and recovery.

Definition, epidemiology and characterization of sepsis

Sepsis is a condition that occurs when the body's response to infection becomes unbalanced and potentially life-threatening. In this study, there is a focus on understanding and addressing sepsis. This detailed review explores how sepsis is defined in its prevalence in populations and how it is present clinically. The development of sepsis involves a series of events triggered by infections resulting in inflammation and dysfunction in organs. The symptoms of sepsis can range from signs like fever and changes in state to more severe complications such as septic shock. Early recognition of these symptoms using criteria like Systemic inflammatory response syndrome (SIRS) is crucial for intervention, which can greatly impact patient outcomes. Various diagnostic markers, imaging techniques and a deeper understanding of the pathophysiology behind sepsis have contributed to identification and targeted treatment approaches. Managing sepsis involves a combination of therapy, support for blood circulation, respiratory interventions and careful use of agents that modulate the system. It's important to emphasize the efforts among healthcare professionals from disciplines when it comes to managing sepsis effectively. Providing follow up care is essential for survivors as they may experience long term consequences such as sepsis syndrome. Due to its impact on health ongoing research is necessary to explore therapeutic options and refine existing strategies for managing sepsis effectively. The field continues to evolve with advancements, in precision medicine host directed therapies and interdisciplinary collaboration playing roles. This review seeks to grasp the concept of sepsis, providing insights into its various aspects, including the difficulties, in diagnosis and the ever-evolving treatment strategies.

Application of multi-disciplinary team mode in prevention and control of multidrug resistant organism infection in lung transplant recipients / 器官移植

<b>Objective</b> To evaluate the effectiveness of multi-disciplinary team (MDT) mode in the prevention and control of multidrug resistant organism (MDRO) infection in lung transplant recipients. <b>Methods</b> Lung transplant recipients admitted to the hospital from 2019 to 2022 were enrolled. MDT expert group was established in January, 2020. A series of prevention and control measures were conducted. The implementation rate of MDRO prevention and control measures and the detection rate of MDRO on the environmental surface from 2020 to 2022, and the detection rate of MDRO in lung transplant recipients from 2019 to 2022 were analyzed. <b>Results</b> The overall implementation rate of MDRO prevention and control measures for medical staff was increased from 64.9% in 2020 to 91.6% in 2022, showing an increasing trend year by year (<i>P</i><0.05). The detection rate of MDRO on the environmental surface was decreased from 28% in 2020 to 9% in 2022, showing a downward trend year by year (<i>P</i><0.05). The detection rate of MDRO in lung transplant recipients was decreased from 66.7% in 2019 to 44.3% in 2022, showing a decreasing trend year by year (<i>P</i><0.001). <b>Conclusions</b> MDT mode management may enhance the implementation of MDRO prevention and control measures for medical staff, effectively reduce the infection rate of MDRO in lung transplant recipients and the detection rate of MDRO on the environmental surface, which is worthy of widespread application.

Effects of nurse-led multidisciplinary cooperative nutrition intervention on nutritional indicator of patients with stroke / 重庆医学

Objective To explore the impact of nurse-led multidisciplinary collaborative nutrition inter-vention on the nutritional indicators in the patients with stroke.Methods A total of 100 patients with stroke admitted in this hospital from January to December 2020 were selected as the study subjects and divided into the observation group and control group by the propensity score matching,50 cases in each group.The control group was given the traditional nutrition intervention,and the observation group was given the nurse-led mul-tidisciplinary cooperative nutrition intervention.The blood,nutritional and biochemical indicators,physique monitoring indicators and nutritional risk indicators were compared between the two groups.Results The levels of total protein(TP),albumin(ALB),hemoglobin(Hb),prealbumin(PAB),body mass index(BMI),upper arm muscle circumference(AMC)and triceps skin fold thickness(TSF)on 21 d after admission in both groups were increased compared with those on 2,15 d after admission,and which on 15 d after admission were higher than those on 2 d after admission(P＜0.05),moreover the above indicators levels on 15,21 d after ad-mission in the observation group were higher than those in the control group,and the differences were statisti-cally significant(P＜0.05).Body mass index(BMI),upper arm circumference(AMC)and triceps skinfold thickness(TSF)in both groups on 21 d of admission were higher than those on 2,15 d of admission(P＜0.05).The nutritional risk screening 2002(NRS2002)score on 21 d after admission in the two groups were decreased compared with those on 2,15 d after admission,while which on 15 d after admission was decreased compared with that on 2 d after admission,moreover the NRS2002 score on 15,21 d after admission in the ob-servation group were lower than those in the control group,and the differences were statistically significant(P＜0.05).Conclusion Giving the nurse-led multidisciplinary cooperative nutrition intervention could im-prove the blood nutritional and biochemical indicators and physique monitoring indicators,and reduce the nu-tritional risk of the patients with stroke.

Effect Evaluation of Multidisciplinary Collaborative Diagnosis and Treatment Model for Children with Brain Injury / 昆明医科大学学报

Objective To summarize the experience of multi-disciplinary team(MDT)in the pediatric department of Qujing Maternal and Child Health Hospital,and to evaluate the effectiveness of MDT on neonatal brain injury.Methods The clinical data of children with brain injury and treated in the pediatrics department of Qujing Maternal and Child Health Hospital from November 2019 to April 2023 were collected.The children with brain injury and treated from October 2019 to June 2020 were regarded as the non-MDT group,and the children with brain injury and treated from July 2020 to April 2023 were regarded as the MDT group for comparative analysis.Chi-square test/t-test was used to compare and analyze the clinical data of the two groups.Results Among the 890 cases of pediatric brain injury,there were 519 males and 371 females.The median and quartiles of the age distribution for the two groups were as follows:MDT group 2.00(0.82,5.00)years and non-MDT group 1.00(1.00,4.00)years.Craniocerebral injury was the main type of brain injury in both groups,in addition,among children with craniocerebral injury and intracranial hemorrhage,the cure rate of MDT group was higher than that of non-MDT group,and the difference was statistically significant(P<0.05).Among the 405 children in MDT group,154(38.0%)underwent the surgery,while among the 485 children in non-MDT group,121(24.9%)underwent the surgery.The difference was statistically significant(P<0.05).23.2% of children in MDT group were in critical condition during the hospitalization,which was significantly lower than that in non-MDT group(30.5%),and the difference was statistically significant(P<0.05).The unhealed rate of MDT group(2.0%)was also significantly lower than that of non-MDT group(5.6%),the cure rate of MDT group(40.5%)was significantly higher than that of non-MDT group(34.4%),and there was a statistically significant difference(P<0.05).The expense of treatment,medicine and sanitary materials in MDT group were lower than those in non-MDT group,and the differences were statistically significant(P<0.05).The multivariate Logistic regression model analysis of the cure rate of children with brain injury showed that the MDT model could effectively improve the cure rate of children with brain injury(RR = 1.513,95% CI = 1.134-2.020).The results of multiple linear regression model analysis showed that there was no statistical difference in the effect of MDT on the actual hospitalization days of children(P>0.05).Conclusion Using MDT model to diagnose and treat children with brain injury is helpful to improve the cure rate,reduce the risk of children's disease aggravation,and achieve the significant therapeutic effects in children with brain injury.MDT model is worth popularizing and applying in children with brain injury.

All-round and full-cycle management of primary hyperparathyroidism / 中华内分泌外科杂志

Primary hyperparathyroidism is a disease with a large potential population. Some cases of primary hyperparathyroidism are non-primary, preventable and curable at early stage, requiring long-term follow-up after surgery. Therefore, all-round and full-cycle management are necessary for primary hyperparathyroidism, which involves an enhancing focus on etiological prevention, early detection, prompt diagnosis, timely intervention, multi-disciplinary standardized diagnosis and treatment, and postoperative scientific management. Meanwhile, implementing a "12+5+1" multidisciplinary joint diagnosis and treatment model, along with a two-way referral model, to achieve the transition from a disease-oriented diagnostic and treatment model to a patient-oriented, all-round and full-cycle interdisciplinary management model. This management can reduce the incidence and recurrence rate of primary hyperparathyroidism, and related osteoporosis or osteopenia, fractures, nephrolithiasis, metastatic vascular calcification, and systemic abnormal migratory calcium deposits, improve the overall quality of life and prognosis of patients.

Achievements of thyroid surgery in China in recent ten years / 西安交通大学学报(医学版)

In the past decade,thyroid surgery in China has developed rapidly.With the improvement of thyroid diagnosis technology,the standardization of thyroid surgery,the clinical application of systematic therapy,and the progress in fundamental research,thyroid surgery has achieved all-round development.Patients with thyroid disease have benefited significantly from safer,more standardized,more effective,and more diverse treatments,which results in the remarkable increase in the 5-year survival rate.Moreover,Chinese experts have published a number of guidelines and expert consensus related to thyroid surgery,which promotes the standardization of the diagnosis and treatment of thyroid disease.Additionally,the specialized multidisciplinary teams in cancer centers allow patients to receive more standardized diagnosis and treatment of complex thyroid diseases.In the present article,we summarize the important developments of China's thyroid surgery in the past decade,including preoperative diagnosis technology,surgical methods,operation safety,application of minimally invasive techniques,diagnosis and treatment of special thyroid cancers,multidisciplinary diagnosis and treatment models,and standardized postoperative managements.We expect to popularize the concept of standardized diagnosis and treatment of thyroid diseases,and improve the level of standardized diagnosis and treatment in thyroid surgery.

Exploration of multi-disciplinary treatment of functional departments to improve medical quality:a case studay of Children's Hospital,Zhejiang University School of Medicine / 现代医院

Medical quality and safety are the foundation for the high-quality development of public hospitals.The concept of Multi-disciplinary Treatment(MDT)is of great value for functional departments of hospitals to collaborate in carrying out medi-cal quality management practices.Children's Hospital,Zhejiang University School of Medicine explored a new quality manage-ment model,constructed the MDT practice path for medical quality in administration,and formed a closed-loop management process where clinical departments actively initiate consultations,various administrative functional departments collaborate and in-teract in a two-way manner,accurately identify and solve clinical problems,and continuously track and feedback outcomes.After the inception of this path,the overall level of medical quality and safety in the hospital has been comprehensively improved,mainly manifested in the enhancement of quality control capabilities of clinical departments,optimization of core performance e-valuation indicators,and remarkable improvement in patient satisfaction,thereby holding profound significance for high-quality development of the hospital.

Multi-disciplinary cooperative management promotes proper clinical application of antibiotics against the background of performance appraisal in public hospitals / 现代医院

The proper clinical application of antibiotics is of great significance to guarantee medical quality and safety.However,with the widespread clinical use,the phenomenon of non-standard use is becoming increasingly obvious,and the bacteri-al drug resistance caused by it has seriously jeopardized human health.Based on the performance appraisal in a Class A tertiary public hospitals,this paper analyzed the current clinical application of antibiotics in a cancer hospital,and suggested multi-discipli-nary cooperative management be adpoted and multi =measures be taken simultaneously to significantly improve proper drug use.

Current situation and quality control of multidisciplinary clinic——a case study of a tertiary hospital in Guangxi / 现代医院

The Multi-disciplinary diagnosis and treatment(MDT)outpatient service is widely used in the diagnosis and treatment of patients with tumors,difficult critical and complex diseases and multiple diseases.The purpose of this paper is to study the one-stop treatment mode of MDT outpatient service in tertiary hospitals and the closed-loop management after diagnosis,which plays an important role in integrating medical resources,optimizing medical treatment process,improving patient medical experience,and ensuring medical quality and safety.In view of the weak links and difficulties in quality control in MDT outpa-tient management,such as insufficient attention from functional departments,low enthusiasm of clinicians,low initiative of pa-tients,imperfect information construction of MDT outpatient service,poor quality improvement effect,etc.,Effective manage-ment methods such as core members'guidance,supporting incentive and assessment mechanism,regular reporting of quality,im-proving information construction,extending service scope,and increasing publicity efforts have been adopted for continuous im-provement,and remarkable results have been achieved in increasing the number of cases and diseases,expanding brand influ-ence,and improving the quality of consultation.

Thepath of medical social work participating in multidisciplinary treatment of mental health / 现代医院

With the transformation of the concept and model of mental health service in China,the participation of social work in multidisciplinary team cooperation in mental health has become an important development trend.In order to explore the mode and path of multidisciplinary treatment involving social work in mental health,this study selected two typical wards of Shanghai Mental Health Center as typical cases through the double-case study method,and conducted in-depth interviews and participatory observation of the medical teams in the wards.The results show that medical social workers can participate in multi-disciplinary comprehensive treatment through the path of"service embedding-relationship embedding-system embedding".In this process,the"resource-demand"response mode,power acquisition,daily interaction,discourse integration,and service mecha-nism reconstruction are important action strategies to achieve the service embeddedness of social workers.Different strategies de-termine the final different service modes.In the future,the participation of medical social work in multidisciplinary comprehen-sive treatment mode should not only strengthen micro-practice,but also form macro-institutional guarantee.