Risultati per: Quotidianosanita.it

Question: A previously healthy 43-year-old woman presented with epigastric pain and intermittent postprandial vomiting for 1 year. The patient denied any fever, night sweats, extraintestinal symptoms, and perianal disease. Physical examination was unremarkable. Initial laboratory values were within normal limits except for increased erythrocyte sedimentation rate (46 mm/h) and positive fecal calprotectin. Ileocolonoscopy revealed erosions in the terminal ileum. Biopsy specimens showed unspecific alterations with acute and chronic inflammation.

BackgroundThe COVID-19 Ambulance Response Assessment (CARA) study was a prospective, longitudinal survey of UK ambulance staff during the first wave of the COVID-19 pandemic. CARA aimed to evaluate perceptions of preparedness and wellbeing, and to collect staff suggestions to benefit working practices and conditions.MethodThree online questionnaires were presented, coinciding with the acceleration, peak and deceleration phases of the first COVID-19 wave in 2020. Inductive thematic analysis was employed to represent 14,237 free text responses from 3,717 participants to 18 free-text questions overall. This report focuses on experiences of IPC practices.ResultsMany participants lacked confidence in using PPE because of low familiarity, an inadequate evidence-base and changing policy. Some experienced insufficient supply, items of poor quality and suboptimal fit-testing procedure. PPE use was further influenced by discomfort, urgency, and perceptions of risk. Various suggestions were made to improve IPC practices, including decontamination personnel, staff ‘bubbles’ and limiting exposure through public education and remote triage improvements.ConclusionRepeated poor experiences of implementing IPC practices1 2 demand that lessons are learnt from this pandemic. PPE developed with specific regard for ambulance staff’s unique working environment and for them to receive regular familiarization training in its use would likely benefit performance and confidence. Overall, ambulance staff emphasised the need for IPC policies to be pragmatic, evidence-based and communicated with clarity.ReferencesBillings J, Ching B C F, Gkofa V, Greene T, & Bloomfield M. (2020). Healthcare workers experiences of working on the frontline and views about support during COVID-19 and comparable pandemics: A rapid review and meta-synthesis. MedRxiv. https://www.medrxiv.org/content/10.1101/2020.06.21.20136705v1.full-textHoughton C, Meskell P, Delaney H, Smalle M, Glenton C, Booth A, Chan XHS, Devane D. & Biesty L M. (2020). Barriers and facilitators to healthcare workers’ adherence with infection prevention and control (IPC) guidelines for respiratory infectious diseases: a rapid qualitative evidence synthesis. Cochrane Database of Systematic Reviews, (4).Conflict of interestNone.FundingCollege of Paramedics.

Stroke, Ahead of Print.

All gastroenterologists, most physicians, and many members of the general public are familiar with the discovery of gastric spiral bacteria in Western Australia in the early 1980s and the struggle to convince us that these bacteria, which we now call Helicobacter pylori, were a significant clinical issue. The eventual acceptance of Marshall and Warrren’s ideas resulted in their receiving the Nobel Prize for Medicine or Physiology in 2005. In contrast with the success story of triumph over adversity of these Antipodean pioneers that has been well-disseminated in the medical and lay media, little has been written about why the United States was particularly slow to accept the infectious theory of peptic ulcers.