RESUMEN
BACKGROUND: As a response to the acute strain placed on the National Health Service during the first wave of coronavirus disease 2019 in the UK, a number of junior doctors including ENT trainees were redeployed to other clinical specialties. This presented these trainees with novel challenges and opportunities. METHODS: A qualitative study was performed to explore these experiences, undertaking semi-structured interviews with ENT trainees between 17th and 30th July. Participants were recruited through purposeful sampling. Interview transcripts underwent thematic analysis using Dedoose software. RESULTS: Seven ENT trainees were interviewed, ranging from specialty trainee years four to eight ('ST4' to 'ST8') in grade. Six core themes were identified: organisation of redeployment, utilisation of skill set, emotional impact of redeployment, redeployed team dynamics, concerns about safety and impact on training. CONCLUSION: The ENT trainees' experiences of redeployment described highlight some important lessons and considerations for future redeployments.
Asunto(s)
COVID-19/psicología , Fuerza Laboral en Salud/estadística & datos numéricos , Otorrinolaringólogos/provisión & distribución , Medicina Estatal/estadística & datos numéricos , Adulto , COVID-19/diagnóstico , COVID-19/epidemiología , COVID-19/virología , Competencia Clínica/estadística & datos numéricos , Toma de Decisiones/fisiología , Femenino , Humanos , Entrevistas como Asunto , Masculino , Otorrinolaringólogos/educación , Otorrinolaringólogos/psicología , Investigación Cualitativa , SARS-CoV-2/genética , Medicina Estatal/organización & administración , Apoyo a la Formación Profesional/estadística & datos numéricos , Reino Unido/epidemiologíaRESUMEN
Results obtained in 22 patients with Parkinson's disease in whom treatment with standard Madopar was replaced by Madopar HBS, a CR formulation of the same product, are presented. All the patients presented with dyskinesia and akinesia phenomena related in part to the L-dopa treatment and in part to the disease itself. In 20 patients replacement of the standard agent by HBS led to a distinct improvement in the clinical condition and a significant reduction of the 'on-off' phenomenon. However, with the new formulation the dosage had to be increased by 86% on average as compared with standard Madopar. In 6 of the 22 patients treatment with the HBS formulation has continued for over 6 months and is still giving very good results.
Asunto(s)
Benserazida/uso terapéutico , Hidrazinas/uso terapéutico , Levodopa/uso terapéutico , Enfermedad de Parkinson/tratamiento farmacológico , Adulto , Anciano , Benserazida/farmacocinética , Ensayos Clínicos como Asunto , Preparaciones de Acción Retardada , Relación Dosis-Respuesta a Droga , Combinación de Medicamentos/farmacocinética , Combinación de Medicamentos/uso terapéutico , Femenino , Humanos , Levodopa/administración & dosificación , Levodopa/farmacocinética , Masculino , Persona de Mediana Edad , Trastornos del Movimiento/tratamiento farmacológico , Trastornos del Movimiento/etiología , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/fisiopatologíaRESUMEN
Os autores apresentam quatro casos em que foi realizado retalho de lingua, sendo tres para fechamento de fistulas palatinas e um caso para correcao de atrofia de labio superior pos-irradiacao. Discutem a indicacao desta tecnica e a sua vantagem em relacao a outros metodos de tratamento destas patologias. O retalho e confeccionado na regiao dorsal mediana da lingua, com base anterior. O segundo tempo e realizado apos 15 dias, para liberacao do pediculo e modelagem do retalho, com os retoques necessarios para o completo fechamento da area a ser preenchida pelo retalho. Os autores acreditam que a imobilizacao da lingua com sua fixacao tanto a arcada dentaria como ao labio inferior sao necessarios somente quando nao houver compreensao por parte do paciente ou se este apresentar baixa idade. Finalmente apresentam e discutem os resultados obtidos com o metodo empregado
Asunto(s)
Preescolar , Niño , Adulto , Humanos , Masculino , Fisura del Paladar , Colgajos Quirúrgicos , LenguaRESUMEN
Flunitrazepam, a derivative of benzodiazepine was used for induction and maintenance of anaesthesia in 933 patients. The induction dose was from 1,786 to 2,053 mg. The total dose of 2-2.66 mg was sufficient for maintenance of hypnosis for about 2 hours. The undesirable side effects were very rare. The average time of hypnosis after a single dose of flunitrazepam was 50.1 sec. The sedative action of the drug lasted for some time after regaining of consciousness. In most patients there was no need for administration of analgetics during first 24 hours after the operation. The authors believe that surgical anaesthesia will greatly benefit from this drug.