Клинические и патоморфологические аспекты эффективности лечения беременных с хронической плацентарной недостаточностью Диавитолом и Диаспленом

БЕРЕМЕННОСТИ ОСЛОЖНЕНИЯ /ЛЕК ТЕРПЛАЦЕНТАРНАЯ НЕДОСТАТОЧНОСТЬ /ЛЕК ТЕРПЛАЦЕНТЫ БОЛЕЗНИДИАВИТОЛДИАСПЛЕ

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

When the crisis strikes : A qualitative study of how the refugee crisis has affected the everyday operations of a Swedish municipality, how the crisis has been managed and the co-workers perception of the crisis management

Studiens syfte är att undersöka vilka konsekvenser en nationell kris kan få på organisationsnivå, vilka strategier som använts för att hantera krisen, samt medarbetarnas uppfattning av krishanteringen. Studien har utformats som en fallstudie där kvalitativa intervjuer genomförts i en kommunal verksamhet, med inriktning på integration, mitt under en pågående flyktingkris. Intervjuerna har omfattat medarbetare, föreståndare samt chefer och HR på strategisk nivå. Resultatet visar att den nationella flyktingkrisen fått stora konsekvenser för verksamheten. Bildandet av en händelsegrupp, med uppgift att söka lösningar på strategisk nivå, användandet av HR som expertroll samt ledningens agerande har varit de mest framträdande strategierna. Ledningens agerande har präglats av tillgänglighet, förtroende och acceptans. De har även visat mod och flexibilitet genom att förändra rekryteringsprocessen samt låtit medarbetare utvecklas genom ökat ansvar och mandat. Bland tidigare forskningsbidrag fokuserar endast ett fåtal på medarbetarnas upplevelse av krishanteringen. Vår studie lyfter fram medarbetarnas uppfattningar och visar att delaktighet, stöd och feedback varit avgörande för krishanteringen. The purpose of this study is to examine what consequences a national crisis can have on organizational level, what strategies has been used to manage it, and the co-workers perception of the crisis management. The study has been designed as a case study within a Swedish municipality during an ongoing refugee crisis. Qualitative interviews were conducted on three levels of the organization covering the perception of co-workers, head of the units along with managers and HR on a strategic level. The result shows that the national refugee crisis has had a large impact on the municipality and their everyday operations. Establishing a crisis management team, using HR as an expert resource and the actions taken by leaders were the most salient strategies. The leadership expressed by the management was characterized by availability, trust and acceptance. They showed courage and flexibility by changing the recruitment process and letting the co-workers develop through enhanced responsibility and by giving clear mandates. Previously, there has only been limited research focusing on the co-workers perception of crisis management strategies, a gap that this study aims to reduce. From this perspective the result shows that participation, support and feedback has been prominent for the co-workers perception of the crisis management

Tonsillar colonisation of Fusobacterium necrophorum in patients subjected to tonsillectomy.

Fusobacterium necrophorum is a well-known cause of Lemirre's disease and accumulating evidence support its pathogenic role in peritonsillar abscess while its role in recurrent and chronic tonsillitis is uncertain. The objective of this study was to assess the prevalence of oropharyngeal colonisation with F. necrophorum and Beta-haemolytic streptococci in a cohort of patients scheduled for tonsillectomy due to recurrent or persistent throat pain, and to evaluate the dynamics of colonisation with repeated sampling during a follow-up time of 6 to 8 months