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2.
Pneumologie ; 74(1): 24-34, 2020 Jan.
Artículo en Alemán | MEDLINE | ID: mdl-31863422

RESUMEN

Sarcoidosis is a multisystemic granulomatous disorder which affects the respiratory system in the majority of the cases. Symptomatic cardiac manifestations are found in less than 10 % of the affected cohorts and show a large heterogeneity based on the ethnic background. Cardiac sarcoidosis is not only found in patients with rhythmogenic heart disease, such as atrial and ventricular fibrillation but also in all phenotypes of cardiomyopathy. The overall morbidity and mortality caused by cardiac sarcoidosis in Germany remains unclear and large prospective international observational studies.underline the importance of this disease entity. This consensus paper on diagnostic and therapeutic algorithms for cardiac sarcoidosis is based on a current literature search and forms an expert opinion statement under the auspices of the German Respiratory Society and the German Cardiac Society. The rationale of this statement is to provide algorithms to facilitate clinical decision-making based on the individual case situation.


Asunto(s)
Cardiología/normas , Guías de Práctica Clínica como Asunto , Sarcoidosis Pulmonar/diagnóstico , Sarcoidosis Pulmonar/terapia , Cardiomiopatías , Consenso , Alemania/epidemiología , Humanos , Comunicación Interdisciplinaria , Neumología/normas , Sociedades Médicas
3.
Medicine (Baltimore) ; 98(51): e18149, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31860962

RESUMEN

RATIONALE: Retroperitoneal schwannomas are very rare and may grow very close to major abdominal vessels. Since the surgical approach to the retroperitoneal space may be complex due to surrounding vital organs, including major vessels, laparoscopic surgery is challenging and has only been recently adopted. Here, we report a case of laparoscopic resection of a large retroperitoneal schwannoma attached to large vital vessels. PATIENT CONCERNS: A 62-year-old woman presented with a chief complaint of pain in the lower right limb with consequent claudication, which had lasted for approximately 1 year. DIAGNOSES: Magnetic resonance imaging revealed a solid oval mass measuring 45 × 32 × 39 mm, located medially to the right iliopsoas muscle at the level of the intersomatic space between the 5th lumbar vertebra and the 1st sacral vertebra. This mass was inhomogeneously hypointense in T2 due to the presence of cystic areas, with intense and inhomogeneous contrast enhancement, compatible with the diagnosis of a schwannoma. The mass compressed the inferior caval vein near its bifurcation and the right common iliac vein, anteriorly dislocating the ipsilateral iliac arterial axis. INTERVENTIONS: A multidisciplinary team skilled in vascular and pelvic laparoscopy was involved. The patient underwent laparoscopic surgery via an anterior transperitoneal approach with right adnexectomy and radical excision of the tumor. The surgery lasted 120 minutes without intraoperative complications. Blood loss was less than 100 mL. The histologic diagnosis was a benign Schwannoma; grade I according to World Health Organization classification. OUTCOMES: The postoperative course was uneventful. At the 10-month follow-up, the patient had no recurrences and was asymptomatic. LESSONS: Laparoscopic removal of large retroperitoneal schwannomas, even if attached to major vital vessels, is feasible and safe when performed by experienced surgeons.


Asunto(s)
Laparoscopía/métodos , Neurilemoma/diagnóstico , Neurilemoma/cirugía , Neoplasias Retroperitoneales/diagnóstico , Neoplasias Retroperitoneales/cirugía , Vena Cava Inferior/patología , Anciano , Biopsia con Aguja , Femenino , Estudios de Seguimiento , Humanos , Inmunohistoquímica , Comunicación Interdisciplinaria , Extremidad Inferior , Dolor Musculoesquelético/diagnóstico , Dolor Musculoesquelético/etiología , Invasividad Neoplásica/patología , Estadificación de Neoplasias , Neurilemoma/diagnóstico por imagen , Enfermedades Raras , Neoplasias Retroperitoneales/diagnóstico por imagen , Medición de Riesgo , Resultado del Tratamiento
4.
RECIIS (Online) ; 13(4): 887-895, out.-dez. 2019. ilus
Artículo en Portugués | LILACS | ID: biblio-1047673

RESUMEN

Este relato objetiva apresentar o processo de desenvolvimento de um material escrito e ilustrado voltado para o dentista atuante em Unidades de Terapia intensiva, bem como os motivos e justificativas que levaram à decisão de sua necessidade. O cirurgião-dentista tem ampliado sua área de atuação e, por isso, necessita de materiais didáticos que forneçam uma base para essa nova forma de pensar a Odontologia, com um caráter integral e multiprofissional. Por não haver contato dos cirurgiões-dentistas com o ambiente hospitalar durante a graduação, salvo raras exceções, o material didático nesta área foi planejado para abranger desde os conhecimentos básicos até situações que envolvem maior conhecimento para a tomada de decisão. A metodologia utilizada foi o levantamento bibliográfico e a montagem de material escrito na forma de manual, além da produção e tratamento de fotografias ilustrativas, obtidas em um Hospital Universitário durante o processo de cuidado odontológico de pacientes críticos.


This report aims to present the process of developing a written and illustrated material for the dentist in intensive care units, as well as the reasons and justifications that led to the decision of their need. The dental surgeon has expanded his area of practice and, therefore, needs didactic materials that provide a basis for this new way of thinking about Dentistry, with an integral and multiprofessional character. Due to the lack of contact between dental surgeons and the hospital environment during graduation, with few exceptions, the teaching material in this area was designed to cover everything from basic knowledge to situations involving greater knowledge for decision making. The methodology used was the bibliographical survey and the assembly of written material in manual form, as well as the production and treatment of illustrative photographs obtained at a University Hospital during the dental care process of critical patients.


Este relato tiene como objetivo presentar el proceso de desarrollo de un material escrito e ilustrado orientado hacia el dentista actuante en Unidades de Terapia intensiva, así como los motivos y justificaciones que llevaron a la decisión de su necesidad. El cirujano-dentista ha ampliado su área de actuación y, por eso, necesita materiales didácticos que proveen una base para esa nueva forma de pensar la Odontología, con un carácter integral y multiprofesional. Por no haber contacto de los cirujanos-dentistas con el ambiente hospitalario durante la graduación, salvo raras excepciones, el material didáctico en esta área fue planeado para abarcar desde los conocimientos básicos hasta situaciones que involucran mayor conocimiento para la toma de decisión. La metodología utilizada fue el levantamiento bibliográfico y el montaje de material escrito en la forma de manual, además de la producción y tratamiento de fotografías ilustrativas, obtenidas en un Hospital Universitario durante el proceso de cuidado odontológico de pacientes críticos.


Asunto(s)
Humanos , Materiales de Enseñanza , Desarrollo de Personal , Comunicación Interdisciplinaria , Personal de Odontología en Hospital , Diccionarios Odontológicos como Asunto , Atención Odontológica , Contención de Riesgos Biológicos , Servicios de Salud Dental , Odontólogos , Fotografía , Unidades de Cuidados Intensivos
7.
J Cardiovasc Med (Hagerstown) ; 20(7): 414-418, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31593558

RESUMEN

: The 2015 European Society of Cardiology (ESC) guidelines for the management of infective endocarditis recommend the use of a multidisciplinary team in the care of patients with infective endocarditis. A standardized collaborative approach should be implemented in centres with immediate access to different imaging techniques, cardiac surgery and health professionals from several specialties. This position paper has been produced by the Task Force for Management of Infective Endocarditis of Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI) with the aim of providing recommendations for the implementation of the Endocarditis Team within the Italian hospital network. On the basis of the Italian hospital network with many cardiology facilities encompassing a total of 405 intensive cardiac care units (ICCUs) across the country, 224 (3.68 per million inhabitants) of which have on-site 24-h PCI capability, but with relatively few centres equipped with cardiac surgery and nuclear medicine, in the present article, the SIECVI Task Force for Management of Infective Endocarditis develops the idea of a network where 'functional' reference centres act as a link with the periphery and with 'structural' reference centres. A number of minimum characteristics are provided for these 'functional' reference centres. Outcome and cost analysis of implementing an Endocarditis Team with functional referral is expected to be derived from ongoing Italian and European registries.


Asunto(s)
Técnicas de Imagen Cardíaca/normas , Servicio de Cardiología en Hospital/normas , Prestación Integrada de Atención de Salud/normas , Endocarditis/diagnóstico por imagen , Endocarditis/terapia , Grupo de Atención al Paciente/normas , Regionalización/normas , Consenso , Humanos , Comunicación Interdisciplinaria , Valor Predictivo de las Pruebas , Resultado del Tratamiento
8.
J Cardiovasc Surg (Torino) ; 60(6): 662-671, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31603291

RESUMEN

BACKGROUND: Recent studies showed no reduction in major amputation rates after introduction of a multidisciplinary team (MDT) approach for the treatment of diabetic foot ulcer. The efficacy of MDTs in the current standard of care is being questioned. This retrospective single-center study evaluated the efficacy of an outpatient MDT approach on limb salvage and ulcer healing in treating diabetic foot ulcers. METHODS: Patients with a diabetic foot ulcer treated before (2015) and after (2017) implementation of an MDT in a single center were compared. The MDT met weekly and consisted of a vascular surgeon, physiatrist, internist, shoe technician, wound care nurse, nurse practitioner, cast technician, and podiatrist. The primary outcome was limb salvage at 1 year. Secondary outcomes were ulcer healing, amputation-free survival, freedom from any amputation, and overall survival. Multivariable Cox regression models were used to assess predictors for major amputation. RESULTS: A vascular surgeon treated 104 patients with 148 ulcers in 2015, and the multidisciplinary team treated 133 patients with 188 ulcers in 2017. Limb salvage (90.9% vs. 95.5%, P=0.050), freedom from any amputation (56.5% vs. 78.0%, P<0.001), and ulcer healing (48.3% vs. 69.2%, P<0.001) were significantly lower in the non-MDT group than in the MDT group. Amputation-free survival and overall survival did not differ significantly between the groups. Predictors for major amputation were University of Texas Wound Classification 3D (hazard ratio, 2.8; 95% confidence interval, 1.17-6.45) and being treated in the non-MDT group (hazard ratio, 3.7; 95% confidence interval, 1.25-11.08). CONCLUSIONS: This retrospective study found an MDT dedicated to diabetic foot care was highly effective in increasing limb salvage and ulcer healing. We advise that such an MDT is an integrated part of the patient's chain-based care.


Asunto(s)
Atención Ambulatoria/organización & administración , Prestación Integrada de Atención de Salud/organización & administración , Pie Diabético/terapia , Grupo de Atención al Paciente/organización & administración , Cicatrización de Heridas , Anciano , Anciano de 80 o más Años , Amputación , Conducta Cooperativa , Pie Diabético/diagnóstico , Femenino , Humanos , Comunicación Interdisciplinaria , Recuperación del Miembro , Masculino , Persona de Mediana Edad , Países Bajos , Supervivencia sin Progresión , Estudios Retrospectivos , Factores de Riesgo , Factores de Tiempo
9.
Tech Vasc Interv Radiol ; 22(3): 125-126, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31623751

RESUMEN

While the tools and techniques employed by interventional radiologists on a day-to-day basis translate well to learning the skills required to perform basic endoscopic interventions, collaboration with other specialties is crucial to the success of an interventional radiology endoscopy program. As in any field in medicine, the paramount goal is to improve patient care. Adding the ability to directly visualize structures through an endoscope to certain interventional radiologic procedures may greatly augment the efficacy, safety, and success of interventional radiology procedures. Colleagues in urology, gastroenterology, and surgery should be involved in decision-making and treatment planning to ensure that a shared vision for optimal patient care is achieved.


Asunto(s)
Endoscopía , Comunicación Interdisciplinaria , Grupo de Atención al Paciente/organización & administración , Administración de la Práctica Médica/organización & administración , Radiografía Intervencional , Conducta Cooperativa , Ahorro de Costo , Endoscopía/economía , Gastroenterólogos/organización & administración , Costos de la Atención en Salud , Humanos , Grupo de Atención al Paciente/economía , Administración de la Práctica Médica/economía , Radiografía Intervencional/economía , Radiólogos/organización & administración , Urólogos/organización & administración
11.
Rev Sci Tech ; 38(1): 261-270, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-31564724

RESUMEN

The convergence of humans, animals and our shared environment results in a dynamic in which the health of each group is inextricably linked. Taking into account the fact that the majority of emerging pathogens (e.g. highly pathogenic avian influenza [HPAI], severe acute respiratory syndrome coronavirus, Nipah virus, Middle East respiratory syndrome coronavirus) are zoonotic diseases, Egypt has established a national One Health coordination mechanism. The primary purpose of this mechanism is to provide a comprehensive, strategic approach to concurrent and future health challenges that are facing public and animal heath, including environmental impacts. In this way, the public health, animal health and environment sectors can improve disease mitigation measures, develop stronger and more stable public and animal health services, promote effective national communication strategies and improve One Health collaboration among all relevant sectors. In Egypt, the Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO) currently assist in hosting the country's Four-Way Linking Task Force with the participation of the convening Ministries (Ministry of Health and Population, Ministry of Environment, and Ministry of Agriculture and Land Reclamation [MOALR] - through the General Organisation for Veterinary Services and the MOALR's laboratories). In the context of the Emerging Pandemic Threats 2 Program, funded by the United States Agency for International Development (USAID), FAO plans to assist Egypt in establishing a robust, multidisciplinary and multisectoral One Health system. This system is based on the solid foundation of the Four-Way Linking Platform, which combines information from four functional streams - epidemiology, laboratories, and animal and human health. Egypt's platform will involve all sectors concerned with HPAI control and combine all stakeholders in an integrated, holistic approach to improve the detection of, response to and control of any threats at the human- animal-environment interface in Egypt.


Asunto(s)
Control de Enfermedades Transmisibles , Colaboración Intersectorial , Salud Única , Animales , Control de Enfermedades Transmisibles/tendencias , Egipto , Humanos , Comunicación Interdisciplinaria , Naciones Unidas , Zoonosis/prevención & control
15.
Recurso Educacional Abierto en Español | CVSP - Paraguay | ID: oer-3856

RESUMEN

Material visual de 41 páginas, desarrollado en formato ppt que desarrolla el tipo de comunicación que debe utilizarse en las informaciones de los recursos humanos en salud sobre el estado de salud de los pacientes, a fin de mantener una apropiada relación profesional.


Asunto(s)
Comunicación Interdisciplinaria
17.
Urologiia ; (4 ()): 36-38, 2019 Sep.
Artículo en Ruso | MEDLINE | ID: mdl-31535796

RESUMEN

Currently, thorough understanding of multidisciplinary approach is required in all areas of healthcare, including education, science and practice. This article is dedicated to the actual problem of interdisciplinary communications in current educational process in the Medical University.


Asunto(s)
Comunicación Interdisciplinaria , Urología/educación , Curriculum , Prestación de Atención de Salud , Educación Médica , Evaluación Educacional , Humanos
19.
Adv Parasitol ; 105: 95-110, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31530397

RESUMEN

In 2005, the network decided to increase its number of target diseases to include other helminthic zoonoses such as fascioliasis, clonorchiasis, opisthorchiasis, paragonimiasis and cysticercosis and in the process expanding membership to include South Korea, Vietnam, Thailand and Japan. NTDs were eventually included as awareness is heightened on these diseases affecting poor and developing countries. Researches on clonorchiasis and opisthorchiasis unravel the mechanism by which these diseases eventually predispose to cholangiocarcinoma. The liver cancer associated with these liver fluke infections necessitate the need to clarify the global burden of disease of these infections. The magnitude of these liver fluke diseases in endemic countries like China, Vietnam, Laos, Cambodia and Thailand is described. Success in elimination of lymphatic filariasis in PR China and Cambodia is highlighted to show how intensified multisectoral collaboration and strong political become strong ingredients in elimination of parasitic diseases like LF. New advances are presented that clarify species and strain differences in Fasciola spp., Paragonimus spp., Taenia spp. and Echinococcocus spp. Conventional diagnostic techniques are compared with new serologic techniques that are being developed. New control strategies such as the Lawa model are presented.


Asunto(s)
Erradicación de la Enfermedad , Helmintiasis/prevención & control , Comunicación Interdisciplinaria , Animales , Asia , Redes Comunitarias/tendencias , Humanos
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