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Multidisciplinary team

Kateřina Rusinová, Markéta Červenková, Zuzana Čepelíková, Ondřej Kopecký
Palliative care is an important constituent of widely accepted quality care standard in seriously ill patients. The needs of these patients in perioperative setting or in intensive care are considerable for attending teams. Principal issues discussed include excellent communication skills during decision making before a high-risk surgery, and risk-benefit weighting in order to respect patients values and preferences. This article, based on examples of interventions in both perioperative care and in intensive care units, aims to demonstrate a complex integrated palliative approach...
2018: Casopís Lékar̆ů C̆eských
Martin Gřiva, Jiří Šťastný, Marie Lazárová, Helena Krejčíková
Chronic heart failure is a progressive disease with an increasing prevalence. In spite of all medical progress (or thanks to it), it is finally one of the most common causes of death. Palliative care is an approach aimed to improve the quality of life of patients and their families in cases of life-threatening illness. Therefore, the use of palliative care in cardiology is entirely relevant. Estimating the course and prognosis of a patient with chronic heart failure is difficult despite many prognostic tools...
2018: Casopís Lékar̆ů C̆eských
Irena Závadová
In the Czech Republic, around 70 % of deceased people die in hospital settings every year. On the other hand, surveys showed that almost 78% Czech wish to die at home. General practitioners take care of most of dying at their homes. Unfortunately, hours of attendance and visiting hours are not always sufficient when complications develop and health status rapidly deteriorates and the goal is to die at home. Significant proportion of patients is then transferred to acute hospital settings and lots of them dies there during so called terminal hospitalization...
2018: Casopís Lékar̆ů C̆eských
Andrew R Summers, Travis Philipp, Jacob D Mikula, Kenneth R Gundle
Metastatic bone disease affects approximately 300,000 people in the United States, and the burden is rising. These patients experience significant morbidity and decreased survival. The management of these patients requires coordinated care among a multidisciplinary team of physicians, including orthopaedic surgeons. This article reviews the role of radiation therapy after orthopaedic stabilization of impending or realized pathologic extremity fractures. Orthopaedic surgeons have an opportunity to benefit patients with metastatic bone disease by referring them for consideration of post-operative radiation therapy...
December 14, 2017: Orthopedic Reviews
Débora Cristina Martins Barbosa, Gabriela Ramos Furman, Aliny de Lima Santos, Carlos Alexandre Molena-Fernandes
OBJECTIVE: To estimate the prevalence of depression and to identify the main risk factors associated with depression in wives of convicted men. METHOD: Descriptive, cross - sectional, quantitative approach. The data were collected with 349 female partners of convicted patients in three penitentiaries in the state of Paraná, with a semistructured research, between January and June of 2016, being compiled in a database and analyzed using SPSS® 20.0 software. RESULTS: It was possible to identify vulnerability to depression among wives of convicted men, most were young and 42...
2018: Revista Brasileira de Enfermagem
Peter G Bittar, Anna R Carlson, Ann Mabie-DeRuyter, Jeffrey R Marcus, Alexander C Allori
OBJECTIVE: Our objective is to describe the process of adapting a conceptual framework into a practical toolkit for one cleft team. DESIGN: This is a single-arm implementation study in a single institution. SETTING: Implementation took place at a mid-sized multidisciplinary clinic for patients with cleft lip and/or palate (CL/P) from urban/suburban and rural areas across North Carolina and neighboring states. PARTICIPANTS: Eligible participants were patients with CL/P from English-speaking families...
January 1, 2018: Cleft Palate-craniofacial Journal
Styliani Mantziari, Céline Duvoisin, Nicolas Demartines, Lucie Favre, Michel Suter
Bariatric and metabolic surgery (BMS) is currently the cornerstone of treatment for severe obesity. It produces significant and lasting weight loss in the vast majority of cases, which depends on the procedure performed, in any case much greater than that observed with non-surgical treatments. This weight loss along with direct metabolic effects of BMS, result in a substantial and lasting improvement in many obesity-related comorbidities, notably metabolic ones, sometimes with complete remission. This leads to a reduction in cardiovascular risk and mortality...
March 21, 2018: Revue Médicale Suisse
E V Beliaeva, L V Lapshina, E V Shaposhnikova, A A Molgachev
Dandy-Walker malformation is a rare disease of the central nervous system pathology (congenital malformations of the fossa cranii posterior). The key features of this syndrome are an enlargement of the fourth ventricle; complete absence of the cerebellar vermis, the posterior midline area of cerebellar cortex responsible for coordination of the axial musculature; and cyst formation near the internal base of the skull. Pregnant patients with Dandy-Walker malformation are at high risk and are managed by multidisciplinary teams including neurologists and obstetricians...
2018: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Marie-Therese I Valovska, Vernon M Pais
Urolithiasis is the most common nonobstetric complication in the gravid patient. The experience can provoke undue stress for the mother, fetus, and management team. The physiologic changes of pregnancy render the physical exam and imaging studies less reliable than in the typical patient. Diagnosis is further complicated by the need for careful selection of imaging modality in order to maximize diagnostic utility and minimize obstetric risk to the mother and ionizing radiation exposure to the fetus. Ultrasound remains the first-line diagnostic imaging modality in this group, but other options are available if results are inconclusive...
April 2018: Therapeutic Advances in Urology
Jamie Heimroth, Eric Chen, Erica Sutton
There are very few clinical studies that highlight a definitive and comprehensive guideline for the management of enterocutaneous fistulas. Most accepted guidelines are found in textbooks and are taken from expert advice and case reports. The goal of this review is to highlight advancements relevant to the management of enterocutaneous fistulas from the recent two to three years. Although strong evidence-based guidelines are lacking, the consensus is that a multidisciplinary team working with a clear treatment plan targeting multiple aspects of management can maximize patient outcomes...
March 1, 2018: American Surgeon
Anas Boulemden, Gemma L Malin, Suzanne V F Wallace, Amr Mahmoud, William H T Smith, Adam A Szafranek
We report the case of a 44-year-old pregnant woman who was diagnosed with symptomatic severe mitral stenosis that did not respond to optimal medical therapy and balloon valvuloplasty. After a multidisciplinary team discussion on the timing and risks of interventions and postoperative optimization of peripartum anticoagulation, the patient underwent mechanical mitral valve replacement during the 2nd trimester of pregnancy. The outcome was excellent for the mother and the infant. This case emphasizes the importance of a multidisciplinary approach in managing unusual cases...
February 2018: Texas Heart Institute Journal
Mohammed B Sarhan, Rula Ghandour, Niveen M E Abu Rmeileh
BACKGROUND: The burden of type 2 diabetes is increasing rapidly in the occupied Palestinian territory. Different counselling interventions have been applied worldwide to reduce HbA1c concentrations in patients with type 2 diabetes. Achieving good glycaemic control is important for prevention of complications of type 2 diabetes. The aim of this modelling study was to assess the effectiveness of different counselling interventions in improving glycaemic control in patients with type 2 diabetes...
February 21, 2018: Lancet
Mohammed N Alkhatib, Tamer Abd-Alghafoor, AlaaEldeen Elmassry, Loai Albarqouni, Bettina Böttcher, Maha Alfaqawi
BACKGROUND: Stroke is a leading cause of morbidity and mortality worldwide. The aim of this study was to assess the standard of care for patients with acute ischaemic stroke at the internal medicine department of Nasser Hospital, Gaza Strip. METHODS: For this retrospective clinical audit, we selected a random sample of 100 medical records for patients with stroke who were admitted to Nasser Hospital between January and August, 2016. Clinical practice was compared with the recommendations in the 2013 American Heart Association and American Stroke Association guidelines...
February 21, 2018: Lancet
Luisa Flohr, Shaylene Beaudry, K Taneille Johnson, Nicholas West, Catherine M Burns, J Mark Ansermino, Guy A Dumont, David Wensley, Peter Skippen, Matthias Gorges
The pediatric intensive care unit (ICU) is a complex environment, in which a multidisciplinary team of clinicians (registered nurses, respiratory therapists, and physicians) continually observe and evaluate patient information. Data are provided by multiple, and often physically separated sources, cognitive workload is high, and team communication can be challenging. Our aim is to combine information from multiple monitoring and therapeutic devices in a mobile application, the VitalPAD , to improve the efficiency of clinical decision-making, communication, and thereby patient safety...
2018: IEEE Journal of Translational Engineering in Health and Medicine
Kordo Saeed, Christina Petridou, Hazel Gray, Matthew Dryden, Karen Davis-Blues, Sheryl Lucero, Natalie Parker, Taryn Keyser, Tanya Matthews, Nick Cortes, Stephen Kidd, Claire Thomas, Heather Peacock, Joanna Hornzee, Bruce Wake
Background: In Hampshire Hospitals NHS Foundation Trust, in addition to an on-the-spot investigation into hospital-onset Clostridium difficile infection (CDI) by the infection prevention team, a multidisciplinary team root cause analysis (MDT-RCA) forum has been developed. The MDT-RCA aims to deliver a more thorough investigation into individual cases and the recommendation of cases to the clinical commissioning groups (CCG) appeals panel against potential financial penalties (£10,000 per breached case)...
March 2018: Journal of Infection Prevention
Signe S Risom, Johanne Lind, Pamela J McCabe, Selina Kikkenborg Berg
Purpose: The CopenHeartRFA trial was designed and conducted to explore the effects of rehabilitation on patients treated with ablation for atrial fibrillation (AF). It included a cardiac rehabilitation program consisting of physical exercise and psychoeducational consultations over 6 months. As part of the evaluation of the CopenHeartRFA trial, both quantitative and qualitative data were collected. The intervention was delivered by a multidisciplinary team. Aim: This study aimed to understand the experience of patients treated for AF with ablation who participated in the CopenHeartRFA cardiac rehabilitation program...
2018: Journal of Multidisciplinary Healthcare
Andres X Samayoa, Thai Vu, Tanya Olszewski, Michael Bova, Qi Yan, Orlando Kirton
INTRODUCTION: Managing trauma in the elderly is challenging and requires a multidisciplinary team approach. The aim of this study is to characterize and compare outcomes in patients 90 years and older in the last two decades. METHODS: Retrospective review of trauma patients 90 years and older admitted from 1996 to 2015. The patients were divided into two groups: Early Decade (ED) and Late Decade (LD). RESULTS: A total of 1697 patients were recorded, 551 (ED) and 1146 (LD)...
March 9, 2018: American Journal of Surgery
Margaret B Menzel, Anne K Lawrence, Eva I Rubio, Dorothy I Bulas
Fetal medicine programs within children's hospitals have been developed to ensure access to pediatric specialists across multiple disciplines. The cases that present to these programs are usually complex and require involvement of a multidisciplinary care team. Although some providers on the team limit their focus to their pediatric specialty when counseling patients, the radiologist and genetic counselor have a distinct perspective allowing them to take the larger picture into account in the evaluation of the fetus...
April 2018: Pediatric Radiology
Daniel S Magnus, Margrid B Schindler, Robin D Marlow, James I Fraser
OBJECTIVE: To describe a novel approach to hospital mortality meetings to elucidate understanding of contributory factors to child death and inform practice in the National Health Service. DESIGN: All child deaths were separately reviewed at a meeting attended by professionals across the healthcare pathway, and an assessment was made of contributory factors to death across domains intrinsic to the child, family and environment, parenting capacity and service delivery...
March 16, 2018: BMJ Open
Sherine Ismail, Mohamed Osman, Rayf Abulezz, Hani Alhamdan, K H Mujtaba Quadri
Pharmacists possess pivotal competencies and expertise in developing clinical pathways (CPs). We present a tertiary care facility experience of pharmacists vis-a-vis interprofessional collaboration for designing and implementing CPs. We participated in the development of CPs as leading members of a collaborative team of healthcare professionals. We reviewed literature, aligning it with hospital formulary and institutional standards, and participated in weekly team meetings for six months. Several tools and services were adapted to guide prescribing and standardization of care through time-bound order sets...
March 16, 2018: Pharmacy (Basel, Switzerland)
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