Download or read book valuation de la prise en charge d un premier acc s de fibrillation auriculaire chez les patients admis aux urgences adultes written by Fleur Clanet and published by . This book was released on 2021 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction : la fibrillation atriale (FA) est le trouble du rythme le plus fréquemment rencontré en médecine d'urgence, elle est un facteur de risque indépendant d'AVC, d'insuffisance cardiaque et de mortalité globale. Sa prévalence est de l'ordre de 3%dans la population mondiale et est en constante augmentation du fait du vieillissement de la population. Objectif : nous avons voulu comparer la pris en charge actuelle de la fibrillation atriale aux urgences avec les dernières recommandations afin de faciliter et d'améliorer sa prise en charge dans le but de pouvoir créer un protocole de prise en charge adapté aux urgences de l'hôpital de la Timone et de Nord. Matériel et méthode : cette étude observationnelle et rétrospective a été menée le Centre Hospitalier de la Timone et de Nord. Sur l'année 2018 441 dossiers ont été analysés pour inclure 194 patients qui avaient présentés un premier épisode de FA aux urgences. Nous avons étudié les différentes caractéristiques de cette population, la prise en charge thérapeutique aux urgences (anticoagulants, antiarythmiques et bradycardisants), le devenir du patient et les prescriptions de sortie. Ensuite nous avons comparé les pratiques réalisées aux dernières recommandations en date. Résultats : 194 dossiers ont pu être inclus dans notre étude comme étant des premiers accès de FA aux urgences. 162 patients (83.51%) ont eu un avis cardiologique.159 patients (82.47%) ont reçu un traitement anticoagulant aux urgences, 147 patients (75.77%) ont eu des AOD, nous avons remarqué 11 patients (5.67%) qui étaient sous dosés, 6 patients (3.09%) qui auraient dû être anticoagulés et 23 patients (11.86%) qui ont été anticoagulés malgré un score CHA2DS2VASc dans les normes par rapport au genre.103 patients (53.09%) ont eu des bétabloquants, 11 patients ont eu de l'Amiodarone (5.67%) et 15 patients (7.73%) ont eu de la Digoxine. 70 patients (35.57%)ont été hospitalisés suites à leur passage aux urgences. Le temps passé aux urgences est de 6.2±2.7heures en moyenne et est similaire entre les 2 de sites. Conclusion : cette étude nous aura permis de cibler certains axes à améliorer dans la prise en charge aux urgences d'un premier accès de FA et d'élaborer un protocole pour les services d'urgences.
Download or read book Fibrillation auriculaire aux urgences dans l Interr gion Est written by Chloé Kollmann and published by . This book was released on 2019 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: La Fibrillation Atriale (FA) est le trouble du rythme cardiaque le plus fréquent, en particulier chez l'adulte âgé et il représente 1% des consultations aux urgences. Alors que le diagnostic est rapidement obtenu par la lecture du tracé ECG, sa prise en charge, tant en termes de stratégie thérapeutique, que de choix de filière de soins, est complexe, ceci malgré des recommandations spécifiques éditées par la Société Française de Médecine d'Urgence en 2015 et par la Société Européenne de Cardiologie en 2016. Les stratégies à mettre en oeuvre au SAU en France doivent être précisées. L'objectif de l'étude était de décrire la prise en charge diagnostique et thérapeutique de la FA chez les patients admis aux urgences dans l'interrégion Est, en quantifiant à 3 mois de leur passage au SAU l'incidence : de la FA, des accidents hémorragiques, des évènements cardiovasculaires, ainsi que de la mortalité. Pour cette thèse, une étude observationnelle, descriptive, transversale et multicentrique(33 centres) a été menée du 1er octobre 2018 au 30 novembre 2018. Au total, 1297 patients ont été inclus dans l'étude ACFA, elle-même divisée en deux cohortes : une cohorte « interrégion Est » (149 personnes) versus une cohorte « hors interrégion Est » (1148 personnes). Si les caractéristiques socio-démographiques des patients entre les deux cohortes ne divergent pas outre mesure, la mortalité à 3 mois, quant à elle, semble plus élevée dans l'interrégion Est (27.50% VS 20.86% hors interrégion Est avec p=0.1227). Un retour en rythme sinusal à 3 mois a été constaté pour seulement 22.50% des patients de l'interrégion Est (VS 31.50% hors interrégion Est (p =0.0563)). Le nombre d'évènements hémorragiques à 3 mois était sensiblement le même (1.67% pour l'interrégion Est VS 1.21% hors interrégion Est). Quant aux accidents cardiovasculaires à 3 mois, ils représentaient 2.94% des évènements indésirables pour l'interrégion Est (VS 3.52% hors interrégion Est (p=1)). Seulement 52.50% des patients de l'interrégion Est étaient sous anticoagulants à 3 mois. Les décisions en matière de contrôle du rythme et de la fréquence cardiaques dans l'interrégion Est semblent être en accord avec les recommandations actuelles (69.23% des patients ont reçu au SAU un traitement ralentisseur cardiaque et 46.15% une cardioversion médicamenteuse). Ces différentes observations sous-entendent que des progrès sont encore à effectuer dans la prise en charge de la FA en France et notamment dans l'interrégion Est. En outre, d'après la littérature, il paraitrait faisable et sûr, pour une sélection de patients, d'accéder à une prise en charge ambulatoire de la FA au SAU (avec plus de 90% de réussite initiale de retour en rythme sinusal, dont seulement 3 à 17% de récidive) ; ceci pouvant potentiellement réduire de manière considérable les hospitalisations et accélérer les soins des Structures d'Urgences.
Download or read book valuation de la premi re ann e de mise en place exp rimentale d un r seau ville h pital de prise en charge ambulatoire de la fibrillation auriculaire written by Sarah Ait Abdesselam and published by . This book was released on 2023 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: En 2020 le service d’urgences de l’hôpital Lariboisière a mis en place un programme expérimental de prise en charge ambulatoire des patients présentant une fibrillation auriculaire. Ce dispositif comportait un suivi avec une infirmière hospitalière, coordonné avec le suivi du médecin traitant et du cardiologue de ville. L’objectif de cette étude était d’évaluer la première année de fonctionnement expérimental de ce dispositif. L’évaluation s’est faite selon une approche mixte (quantitative et qualitative), à partir des données de dossiers médicaux et d’une enquête par questionnaires sur la satisfaction des patients inclus et de leurs médecins traitants. Par ailleurs une enquête qualitative auprès du personnel hospitalier ayant participé au dispositif a été réalisée par entretiens semi-directifs. L’étude a porté sur les patients entrés dans le dispositif aux urgences hospitalières de novembre 2020 à décembre 2021. Seulement 13 patients (sur 114) ont été inclus dans le dispositif au cours de la première année de fonctionnement. La majorité des médecinstraitants ont approuvé le programme, avec cependant la mention d’un défaut de communication avec l’hôpital. Les patients étaient globalement satisfaits du programme, notamment de l’observance facilitée par le suivi organisé. Par ailleurs, 2 entretiens semi-directifs ont été réalisés auprès de deux infirmières ayant participé au programme. Celles-ci ont rapporté de nombreuses difficultés essentiellement d’ordre organisationnel, avec un défaut de coordination et de coopération entre les différents acteurs et l’absence de formation des infirmières. Cette expérimentation qui s’est arrêtée au bout de la première année de fonctionnement, malgré la satisfaction relative des patients et de leurs médecins traitants, a rencontré de nombreux obstacles essentiellement d’ordre organisationnel et probablement de mobilisation des médecins urgentistes du service hospitalier.
Download or read book The Globalization of Managerial Innovation in Health Care written by John Kimberly and published by Cambridge University Press. This book was released on 2008-12-18 with total page 395 pages. Available in PDF, EPUB and Kindle. Book excerpt: An examination of patient classification systems in fifteen different countries throughout the world.
Download or read book Management of Patients with Stroke Or TIA written by Scottish Intercollegiate Guidelines Network and published by . This book was released on 2008 with total page 101 pages. Available in PDF, EPUB and Kindle. Book excerpt: This guideline provides recommendations based on current evidence for best practice in the management of patients with stroke or TIA. The guideline follows the patient pathway from the onset of a suspected stroke.
Download or read book Office Emergencies written by Marjorie A. Bowman and published by . This book was released on 2003 with total page 420 pages. Available in PDF, EPUB and Kindle. Book excerpt: Inside, you'll find practical information on how to handle the most common emergencies that present in primary care offices and urgent care centers -- whether in person or over the telephone.
Download or read book Stroke in Childhood written by Paediatric Stroke Working Group and published by Royal College of Physicians. This book was released on 2004 with total page 82 pages. Available in PDF, EPUB and Kindle. Book excerpt: Stroke occuring in childhood although less common, presents serious challenges. This guideline is based on the expertise of a multidisciplinary working group and include the views of patients, parents and families.
Download or read book Public Health Response to Biological and Chemical Weapons written by World Health Organization and published by World Health Organization. This book was released on 2004-01-21 with total page 365 pages. Available in PDF, EPUB and Kindle. Book excerpt: This is the second edition of this publication which focuses on the public health aspects of the possible deliberate use of biological or chemical agents. Issues discussed include: the key principles for public health planning, risk assessment, hazard identification and evaluation, risk management strategies, and response planning as part of existing national emergency plans, disease surveillance and early warning systems, the national and international legal framework, and international sources of assistance. Technical annexes cover a range of issues including chemical agents, toxins, biological agents, principles of protection, precautions against the sabotage of drinking water, food and other products, information resources and the affiliation of WHO Member States to the international treaties on biological and chemical weapons.
Download or read book Thickening Fat written by May Friedman and published by Routledge. This book was released on 2019-08-30 with total page 264 pages. Available in PDF, EPUB and Kindle. Book excerpt: Thickening Fat: Fat Bodies, Intersectionality, and Social Justice seeks to explore the multiple, variable, and embodied experiences of fat oppression and fat activisms. Moving beyond an analysis of fat oppression as singular, this book will aim to unpack the volatility of fat—the mutability of fat embodiments as they correlate with other embodied subjectivities, and the threshold where fat begins to be reviled, celebrated, or amended. In addition, Thickening Fat explores the full range of intersectional and liminal analyses that push beyond the simple addition of two or more subjectivities, looking instead at the complex alchemy of layered and unstable markers of difference and privilege. Cognizant that the concept of intersectionality has been filled out in a plurality of ways, Thickening Fat poses critical questions around how to render analysis of fatness intersectional and to thicken up intersectionality, where intersectionality is attenuated to the shifting and composite and material dimensions to identity, rather than reduced to an “add difference and stir” approach. The chapters in this collection ask what happens when we operationalize intersectionality in fat scholarship and politics, and we position difference at the centre and start of inquiry.
Download or read book Color Atlas of Equine Pathology written by Claus D. Buergelt and published by John Wiley & Sons. This book was released on 2014-01-28 with total page 565 pages. Available in PDF, EPUB and Kindle. Book excerpt: Color Atlas of Equine Pathology offers a practical guide to identifying equine diseases, presenting a single resource with more than 1000 images showing predominantly gross pathology. Organized by body systems, the book allows for picture matching during or after an equine necropsy. In this user-friendly atlas, each chapter takes a common format, presenting the disease process as well as congenital, degenerative, inflammatory, and neoplastic sequences, with text boxes offering quick reference to key information. The book begins with an introductory chapter summarizing the principles of the equine field necropsy, and subsequent organ-based chapters depict gross features of disease, focusing on macroscopic digital images supplemented by histology and immunohistochemistry when necessary. Some clinical information for correlation with pathology is included. Color Atlas of Equine Pathology is an essential resource for diagnostic veterinary pathologists and pathology residents, as well as for equine practitioners performing necropsies in the field.
Download or read book Interprofessional Capability Framework written by HIpE and published by . This book was released on 2011 with total page 16 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Diuretics in Heart Failure written by Lawrence E. Ramsey and published by . This book was released on 1985 with total page 108 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Paediatric Asthma written by Kai-Håkon Carlsen and published by European Respiratory Society. This book was released on 2012-06-01 with total page 246 pages. Available in PDF, EPUB and Kindle. Book excerpt: Asthma is a disease of many faces and is frequently seen in children. This Monograph covers all aspects of paediatric asthma, across all ages, from birth through to the start of adulthood. It considers diagnostic problems in relation to the many phenotypes of asthma, covers the treatment of both mild-to-moderate and severe asthma, and discusses asthma exacerbations as well as exercise-induced asthma. The issue also provides an update on the pathophysiology of asthma, the role of bacterial and viral infections, and the impact of environmental factors, allergy, genetics and epigenetics. Finally,
Download or read book Intrapartum Obstetrics written by John T. Repke and published by . This book was released on 1996 with total page 600 pages. Available in PDF, EPUB and Kindle. Book excerpt: The scope is not simply labor and delivery, but integrated management of patient care in labor and delivery units as they are utilized today. Thirty-four contributed chapters give an overview, followed by discussion of normal labor and delivery management (induction, multiple gestations, malpresentations); labor and delivery as an intensive care unit (tocolysis, preterm labor, asthma, sickle cell disease); controversies (e.g. electronic fetal monitoring, delivery of the very-low-birth-weight infant); and social obstetrics (e.g. medicolegal issues, conflicts between maternal and fetal well-being, perinatal loss). Annotation copyright by Book News, Inc., Portland, OR
Download or read book National Clinical Guidelines for Stroke written by and published by . This book was released on 2012 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This 4th edition of the stroke guideline, prepared by the Intercollegiate Stroke Working Party, provides comprehensive guidance on stroke care pathway, from acute care through rehabilitation and secondary prevention on to long-term support and terminal care. The guideline also contains profession-specific guidelines for nurses, dieticians, occupational therapists, physiotherapists, speech and language therapists, psychologists and those working in primary care.
Download or read book Magnetic Nanoparticles in Human Health and Medicine written by Costica Caizer and published by John Wiley & Sons. This book was released on 2021-09-08 with total page 512 pages. Available in PDF, EPUB and Kindle. Book excerpt: Magnetic Nanoparticles in Human Health and Medicine Explores the application of magnetic nanoparticles in drug delivery, magnetic resonance imaging, and alternative cancer therapy Magnetic Nanoparticles in Human Health and Medicine addresses recent progress in improving diagnosis by magnetic resonance imaging (MRI) and using non-invasive and non-toxic magnetic nanoparticles for targeted drug delivery and magnetic hyperthermia. Focusing on cancer diagnosis and alternative therapy, the book covers both fundamental principles and advanced theoretical and experimental research on the magnetic properties, biocompatibilization, biofunctionalization, and application of magnetic nanoparticles in nanobiotechnology and nanomedicine. Chapters written by a panel of international specialists in the field of magnetic nanoparticles and their applications in biomedicine cover magnetic hyperthermia (MHT), MRI contrast agents, biomedical imaging, modeling and simulation, nanobiotechnology, toxicity issues, and more. Readers are provided with accurate information on the use of magnetic nanoparticles in diagnosis, drug delivery, and alternative cancer therapeutics—featuring discussion of current problems, proposed solutions, and future research directions. Topics include current applications of magnetic iron oxide nanoparticles in nanomedicine and alternative cancer therapy: drug delivery, magnetic resonance imaging, superparamagnetic hyperthermia as alternative cancer therapy, magnetic hyperthermia in clinical trials, and simulating the physics of magnetic particle heating for cancer therapy. This comprehensive volume: Covers both general research on magnetic nanoparticles in medicine and specific applications in cancer therapeutics Discusses the use of magnetic nanoparticles in alternative cancer therapy by magnetic and superparamagnetic hyperthermia Explores targeted medication delivery using magnetic nanoparticles as a future replacement of conventional techniques Reviews the use of MRI with magnetic nanoparticles to increase the diagnostic accuracy of medical imaging Magnetic Nanoparticles in Human Health and Medicine is a valuable resource for researchers in the fields of nanomagnetism, magnetic nanoparticles, nanobiomaterials, nanobioengineering, biopharmaceuticals nanobiotechnologies, nanomedicine, and biopharmaceuticals, particularly those focused on alternative cancer diagnosis and therapeutics.
Download or read book The Explicitation Interview written by Pierre Vermersch and published by Explicitation Interview. This book was released on 2007-07 with total page 170 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book was first published in French in 1994. It has been a training support to numerous researchers as well as practitioners, such as teachers, health workers, personal or sport trainers. Since then, it has constantly been republished and a glossary has been added in 1998. This version is the first complete edition of the book in English. The main idea of this new interview technique is to help a teacher, a supervisor or a researcher to guide the student, the practitioner or the subject to give a fine retrospective description of an action. As it is only the subject that has access to this mental or physical action, the goal is to help the subject with the verbalization, putting the implicit knowledge of this action in words. Yet, to achieve this verbalization, we need guidance, because we don't know how to give such a description ourselves. If we leave the interviewee without guidance, he risks remaining in the implicit, speaking in a general way, or in an incomplete or imprecise way, commenting instead of describing. The explicit and precise description we aim is the opposite of the implicit, meaning a fine, detailed and complete way of putting the action in words. The final aim is to elucidate what the subject did to seek his goal
