- 著者
- Rubuna Sato Masahiro Ishikane Noriko Kinoshita Tetsuya Suzuki Takato Nakamoto Kayoko Hayakawa Norifumi Bekki Hisao Hara Norio Ohmagari
- 出版者
- National Center for Global Health and Medicine
- 雑誌
- Global Health & Medicine (ISSN:24349186)
- 巻号頁・発行日
- vol.2, no.3, pp.190-192, 2020-06-30 (Released:2020-07-04)
- 参考文献数
- 13
- 被引用文献数
- 1 14
Hypercoagulation and anticoagulation treatment have become new challenges in coronavirus disease 2019 (COVID-19) patients during the COVID-19 pandemic. We herein suggest an algorithm for an anticoagulation treatment with unfractionated heparin in moderate to severe COVID-19 cases in Japan, and report a case of COVID-19 pneumonia with anticoagulation treatment. Although several promising drugs for COVID-19 are being tested in clinical trials, definitive treatments have not yet been established. In this report, we demaonstrate that anticoagulation treatment with unfractionated heparin has the possibility of becoming at least a supportive treatment for COVID-19 patients.
- 著者
- Norihiro Kokudo Haruhito Sugiyama
- 出版者
- National Center for Global Health and Medicine
- 雑誌
- Global Health & Medicine (ISSN:24349186)
- 巻号頁・発行日
- vol.3, no.2, pp.56-59, 2021-04-30 (Released:2021-05-08)
- 参考文献数
- 8
- 被引用文献数
- 29
The rapid global spread of the COVID-19 pandemic has posed a significant challenge to various countries in terms of the capacity of hospitals to admit and care for patients during the crisis. To estimate hospital capacity during the COVID-19 pandemic, clinicians working in tertiary hospitals around the world were surveyed regarding available COVID-19 hospital statistics. Data were obtained from 8 tertiary centers in 8 countries including the United States, United Kingdom, Switzerland, Turkey, Singapore, India, Pakistan, and Japan. The correlation between the number of patients with COVID-19 per 1 million population vs. the maximum number of inpatients with COVID-19 in a representative tertiary hospital in each country was determined, as was the correlation between COVID-19 deaths per 1 million population vs. the maximum number of patients with COVID-19 in the intensive care unit (ICU). What was noteworthy was that none of the 8 hospitals reduced emergency room (ER) activity even at the peak of the pandemic although treatment of patients without COVID-19 decreased by 0-70% depending on the extent of the epidemic. Although various measures are being actively implemented to slow the spread of the virus and reduce the strain on the health care system, the reality is that there are still a significant number of hospitals at risk of being overloaded in the event of a future surge in cases.
- 著者
- Shigeko Yashiro Takashi Ueta Satoshi Kutsuna Tatsuya Okamoto Miyuki Nagahara Norio Ohmagari
- 出版者
- National Center for Global Health and Medicine
- 雑誌
- Global Health & Medicine (ISSN:24349186)
- 巻号頁・発行日
- pp.2020.01091, (Released:2020-12-14)
- 参考文献数
- 10
- 被引用文献数
- 3
Ocular complications of coronavirus disease 2019 (COVID-19) do not essentially cause serious visual loss. However, due to the characteristics of this disease, delays in diagnosis and treatment in hospitalized patients may leave them with serious visual impairment. If conjunctivitis is suspected, ophthalmological follow-up is needless because it is expected spontaneous healing. Diplopia is often complicated for extra-ocular neurological findings and need neurological consults. Ophthalmologists should be consulted for ocular surface disease, high intraocular pressure, and ocular inflammation that may cause visual loss if patients complain of blurred vision, visual loss, and ocular pain. The problem is unconscious patients with risk of developing high intraocular pressure or keratitis. An ophthalmologist should be consulted as soon as possible if eye redness or pupil abnormalities appear in these patients. We developed a flowchart for ophthalmic consultations in hospitalized patients with COVID-19, for facilities where an ophthalmologist is not always present, and for third or fourth waves or, a pandemic of another infectious disease.
- 著者
- Eloisa Franchi Matteo Donadon Guido Torzilli
- 出版者
- National Center for Global Health and Medicine
- 雑誌
- Global Health & Medicine (ISSN:24349186)
- 巻号頁・発行日
- pp.2020.01013, (Released:2020-09-04)
- 参考文献数
- 59
- 被引用文献数
- 9
The positive relationship between volume and outcome in hepatobiliary surgery has been demonstrated for many years. As for other complex surgical procedures, both improved short- and long-term outcomes have been associated with a higher volume of procedures. However, whether the centralization of complex hepatobiliary procedures makes full sense because it should be associated with higher quality of care, as reported in the literature, precise criteria on what to centralize, where to centralize, and who should be entitled to perform complex procedures are still missing. Indeed, despite the generalized consensus on centralization in hepatobiliary surgery, this topic remains very complex because many determinants are involved in such a centralization process, of which some of them cannot be easily controlled. In the context of different health systems worldwide, such as national health systems and private insurance, there are different stakeholders that demand different needs: politicians, patients, surgeons, institutions and medical associations do not always have the same needs. Starting from a review of the literature on centralization in hepatobiliary surgery, we will propose some guidelines that, while not data-driven due to low evidence in the literature, will be based on good clinical practice.
- 著者
- Guido Torzilli Jacopo Galvanin Luca Viganò Matteo Donadon Marco Montorsi
- 出版者
- National Center for Global Health and Medicine
- 雑誌
- Global Health & Medicine (ISSN:24349186)
- 巻号頁・発行日
- pp.2020.01039, (Released:2020-05-28)
- 参考文献数
- 13
- 被引用文献数
- 4
After the initial description of COVID-19 in Wuhan, China, Italy was hit first in Europe and the impact has been rapidly enlarging. In early April 2020, at the epidemic peak, there were more than 33,000 patients hospitalized including more than 4,000 in Intensive Care Units (ICU). On May 15, the confirmed cases in Italy approached 224,000 patients (5th highest number worldwide), with more than 31,000 deaths (3rd highest number worldwide). Non-urgent, non-cancer procedures were stopped to reallocate nurses and anesthetists to face the COVID-19 emergency. The timeline of the progressive involvement by COVID-19 patients of 36 hospitals referrals for surgical oncology in Italy was shown in this article. Only emergency, and elective oncological procedures were allowed with obvious limitations in terms of numbers of operable cases. Criteria for prioritizing oncologic patients waiting for surgery were released by each region, mainly issuing main factors for decision making, biological aggressiveness or symptomatic disease, the interval from the latest treatment, and the risk of un-resectability if delayed. However, the lack of facilities mostly influenced the decision or not to proceed. The risk of operating on oncological patients with ongoing SARS-CoV-2 syndrome is real, and a preoperative flowchart for ruling out this occurrence has been promoted. In our center, the day before surgery, chest CT and swab testing have been introduced, and a similar behavior has been recommended prior to patients' discharge. The care of patients addressed for surgical oncology should be featured by dedicated paths to secure proper and prompt disease management.