Cognitive aid in telecommunication information handover - prospective field experimental open-label study.

BACKGROUND: Health care providers are paying more and more attention to clinical handovers. Previous studies have found that poor handovers resulted in adverse effects for patients. This study aims to determine the effectiveness of the standardized pre-notification process, from emergency medical services (EMS) to in-hospital care, with specific cognitive aid based on ATMIST. METHODS: In February 2018, a prospective field test of the effectiveness of a standardized handover tool based on the ATMIST acronym was conducted in 11 Prague hospitals. The Emergency Medical Dispatch Centre used the form to record the information from the Crews (Protocol 1). The hospital dispatch centre (Protocol 2) used the same form to record the information from the EMS Dispatching. Both protocols were then compared and monitored to determine whether the information from the field was correctly transferred to the hospital. Signature items from the ATMIST form in different groups were empirically set to find out if the level of awareness of the personnel differs between groups. RESULTS: Two hundred and sixty-nine Protocols 1 and 2 (37.41% of all pre-notifications) were analysed. There were 7,262 possible pieces of information to be transferred in total. 82.78% (n=6012) of all information was transferred correctly. The group analyses show no differences between the clinical condition of the patient and the awareness of the health care providers. CONCLUSION: This is first study evaluating the use of a standardized handover tool for telecommunication handover. The clinical condition of patients did not play any role in how the information was transferred.

Combined Therapy for Patients after Ischemic Stroke as a Support of Social Adaptability.

THE OBJECTIVE: The main objective of the research was to find out the effectivity of the combined therapy suitable for patients after ischemic stroke (promoting social adaptability). The therapy itself is then focused on robotic, psychomotor and cognitive therapy. The research indicators were divided into three categories of psychological, social and cognitive indicators. PROBAND SAMPLE: We have a 58 probands diagnosed with a stroke participated on the research (ischemic type I60-I69; ICD-10; the 10th revision of the International Statistical Classification of Diseases and Related Health Problem), out of which 49 were male patients ages between 48-55 and women between the age of 45-51. The data collection was then done during 2018. Indicators were evaluated and tested firstly after the initiation of the combined therapy, then after 10 weeks of intensive therapy, which took place 3 times a week 45 minutes for each patient participating in the research. RESULTS: The results of the research point to the fact, that combined therapy of robotic, psychomotor and cognitive can have positive effect on, and be suitable as a treatment for patients after ischemic stroke, regarding their productive age. Positive results have been therefore overt among all tested areas. CONCLUSION: The results of the research point to the fact, that combined therapy of robotic, psychomotor and cognitive can have positive effect on, and be suitable as a treatment for patients after ischemic stroke, regarding their productive age. Positive results have been therefore overt among all tested areas.

Lithium intoxication in the pre-hospital care with stroke symptoms - Case report.

Lithium is widely used in psychiatry to treat bipolar affective disorders since 1970 but little is known about the incidence, clinical course and associated factors of acute lithium intoxication. Moderate and severe cases of lithium intoxication are rare. This case reports a patient with acute lithium intoxication (serum level of 3.7 mmol/L) with neurological symptoms imitating stroke, which affects the differential diagnosis in the pre-hospital and hospital care. Patient was treated with forced diuresis and dismissed 21 days after admission.

Anaphylaxis in Public Health.

The increasing number of patients with anaphylactic reactions is a modern challenge for healthcare professionals in clinical practice and public health professionals. It remains difficult to determine the prevalence or incidence of anaphylaxis in the population due to the long absence of a consensus definition, the fact that analyses are performed on various population groups and the use of different data collection methodologies. In the United States, anaphylaxis mortality ranges from 0.63 to 0.76 cases per million inhabitants, with 58% of these deaths due to drug anaphylaxis. The risk factors for anaphylaxis are ramipril and metoprolol use, which is common in patients with cardiovascular disease. Also, a higher level of gliadin following excess gluten intake is associated with a higher incidence of anaphylaxis. Drugs, food and insect stings have long been known as anaphylaxis inductors. In diagnosis, determination of serum tryptase concentration is used. In patients with normal tryptase concentration, it is appropriate to screen other inflammatory mediators. The authors of this article present new findings on anaphylaxis in the literature and recommended practices of professional societies in the context of public health.

Prostate histoscanning in clinically localized biopsy proven prostate cancer: an accuracy study.

PURPOSE: To assess the accuracy of prostate histoscanning (PHS) for spatial detection and localization of prostate cancer (PCa). PATIENTS AND METHODS: Prospective, single center study from January to September 2012 was conducted. Inclusion criterion was biopsy confirmed PCa in patients scheduled for radical prostatectomy. In total, 98 patients were included in the study. Results of PHS were compared against whole-mount step sectioning by the Stanford technique. A lower limit of 0.1 cm(3) was used for PHS. A dedicated 12-sector form was used for spatial correlation. The urologist and pathologist were blinded for each other's results. Sensitivity, specificity, and receiver operating characteristic curves were calculated with a logistic regression model for covariates. RESULTS: PHS performance for detection of PCa lesions ≥0.1 cm(3) had sensitivity of 60%, specificity of 66%, and area under the curve (AUC) of 0.63. Posterior and anterior sectors achieved sensitivity of 77%, specificity of 39%, and 28% and 84%, respectively. The model containing PHS positivity within a given sector reached sensitivity of 73.4%, specificity of 65.7%, and AUC of 0.75. In a ogistic regression model, the performance of PHS was affected by sector location, rectal distance, index, and total cancer volume (all P<0.0001) and bladder fullness (P=0.02). The best PHS accuracy was present in midposterior sectors. CONCLUSIONS: PHS has a potential for clinical practice, especially if PHS positivity within given sectors is taken into account. A trained operator is important. More studies are necessary to test different detection limits in various clinical settings, such as targeted biopsies and image guided focal therapy.