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AIMS: The aim of this study was to enhance the effectiveness of an integrated treatment model for patients with severe multiple injuries in China. METHODS: In this study, we conducted a retrospective analysis of data from 110 patients with multiple severe injuries. These patients were divided into two groups based on the treatment model they received. The first group, called the MDTM group, received the integrated treatment model, which involved a multidisciplinary team-based approach. The second group, designated the TSM group, received the traditional specialist-based treatment model. The primary outcome measure was the survival rate of patients after treatment. Secondary outcomes included the time spent on hospital emergency treatment, the length of hospital stay, the mortality rate, and family satisfaction. RESULTS: The survival rate of patients after treatment in the MDTM group (83.93%) was significantly greater than that in the TSM group (70.37%). Consequently, the mortality of patients after treatment in the MDTM group (16.07%) was significantly lower than that in the TSM group (29.63%). Furthermore, the MDTM group demonstrated significantly shorter durations of rescue efforts and shorter hospital stays. Additionally, family satisfaction was significantly greater in the MDTM group. CONCLUSION: The integrated treatment model shows potential for optimizing outcomes for patients with multiple severe injuries and generating higher levels of family satisfaction. This model holds practical applicability in the context of China and may help alleviate the strained relationship between physicians and patients.
Subject(s)
Multiple Trauma , Adult , Aged , Female , Humans , Male , Middle Aged , China , East Asian People , Length of Stay/statistics & numerical data , Multiple Trauma/therapy , Multiple Trauma/mortality , Retrospective StudiesABSTRACT
We provided the palliative care of a multiple disciplinary team care mode to a patient diagnosed with advanced head and neck cancer and her caregivers.People-centered integrated health services were provided according to the specific needs and preferences of individuals.The team-based palliative care relieved the suffering and improved the quality of life of the patient and that of her family who were facing challenges associated with life-threatening illness.
Subject(s)
Head and Neck Neoplasms , Palliative Care , Humans , Female , Quality of Life , Head and Neck Neoplasms/therapyABSTRACT
We provided the palliative care of a multiple disciplinary team care mode to a patient diagnosed with advanced head and neck cancer and her caregivers.People-centered integrated health services were provided according to the specific needs and preferences of individuals.The team-based palliative care relieved the suffering and improved the quality of life of the patient and that of her family who were facing challenges associated with life-threatening illness.
Subject(s)
Humans , Female , Palliative Care , Quality of Life , Head and Neck Neoplasms/therapyABSTRACT
BACKGROUND: Malignant splenic tumors are rare but fatal, presenting a challenge in diagnosis and management involving hematology, oncology, and general surgery. By contrast, diagnosing and treating other common malignant tumors (such as lung and gastrointestinal cancer) offers multiple strategies for chemotherapy, radiotherapy, targeted therapy, and immunotherapy with the prospect of a cure. With various specialists involved in clinical multiple disciplinary team (MDT) discussion, personal bias can be minimized. It can also ignite important discussion which can benefit not only one patient but many patients. CASE SUMMARY: Here, we report on the MDT diagnosis and management of the malignant splenic tumors littoral cell angiosarcoma and histiocytic sarcoma. Although only two cases of rare primary splenic malignancy are presented, MDT is a novel means of rare disease treatment. CONCLUSION: To benefit patients, imaging analysis, safe operation, precise pathology examination, and individualized therapeutic treatment strategies are required. The involvement of various specialists in a clinical MDT discussion minimizes personal bias and can create important ideas to benefit all patients.
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BACKGROUND: Uterine myoma is the most common benign tumor among women and is often accompanied by anemia. Here, we report the case of a patient with a very large leiomyoma but with a hemoglobin level as high as 197 g/L. After undergoing hysterectomy, all her hematological parameters returned to normal. Immunohistochemical staining of her myoma for erythropoietin showed strong positivity, which suggested that erythropoietin may be the cause of her erythrocytosis. A multidisciplinary team played a significant role in treating the disease. CASE SUMMARY: A 47-year-old woman visited our department complaining that her abdomen had been continuously growing for the past 2 years. After careful examinations, she was suspected of having a very large leiomyoma. She was also diagnosed with erythrocytosis because her RBC count was 6.49 × 1012/L, hemoglobin was 197 g/L. Following a multidisciplinary team consultation, bilateral ureteral stents were placed, and 800 mL blood was removed by phlebotomy. The patient then underwent hysterectomy and bilateral salpingectomy. She recovered well from the operation, and her hemoglobin level decreased sharply following the surgery. Low-molecular-weight heparin was administered daily to prevent postoperative thrombosis. She was discharged from the hospital on the fourth postoperative day. Two months later, all her hematological parameters returned to normal. Pathological analysis of the myoma revealed that it was a benign leiomyoma, with partial hyalinization, and strong positivity for erythropoietin in immunohistochemical staining suggested that erythropoietin may be responsible for the erythrocytosis. CONCLUSION: Erythropoietin ectopically produced from the myoma was responsible for the erythrocytosis in this patient. A multidisciplinary team is strongly recommended.
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Pancreatic surgery is an important specialty in the field of general surgery. As the anatomical location of pancreas is deeply and complex, and the diseases of pancreatic surgery is various kinds of and serious with high difficulty in surgery, the development of pancreatic surgery is slowly in the past. In the recent 20 years, with the deepening of basic and clinical researches in related fields, researchers' cognition of pancreatic diseases has gradually deepened. A series of new con-cepts and techniques have been applied to pancreatic surgery, making pancreatic surgery enter a rapid development stage. At the same time, researchers also recognize that the existing medical concepts and technical means are not sufficient to solve all clinical problems. Therefore, the cancer of pancreatic surgery in China can be alive and flourishing by grasping the opportunities, making continuous exploration and innovation.
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In order to improve the overall treatment level of pancreatic cancer in China, Study Group of Pancreatic Surgery in China Society of Surgery of Chinese Medical Association and Pancreatic Disease Committee of China Research Hospital Association have formulated the guideline for neoadjuvant therapy of pancreatic cancer in China (2020 edition). Based on the GRADE system, the guideline has conducted a discussion on the indication, regimen selection, therapeutic effect evaluation, pathological diagnosis and surgery strategy, etc. This guideline has quantified the evidence level of the current clinical researches and provided recommendations for the clinical practice in the neoadjuvant therapy of pancreatic cancer. The guideline has highlighted the role of multiple disciplinary team and represented the conversion of treatment concept in pancreatic cancer. Neoadjuvant therapy has prolonged the survival of the part of pancreatic cancer patients. However, more high-quality clinical researches are in urgent need to improve the level of evidence, optimize the clinical practice and improve the survival of patients.
Subject(s)
Neoadjuvant Therapy , Pancreatic Neoplasms/therapy , China , HumansABSTRACT
In order to improve the overall treatment level of pancreatic cancer in China, Study Group of Pancreatic Surgery in China Society of Surgery of Chinese Medical Association and Pancreatic Disease Committee of China Research Hospital Association have formulated the guideline for neoadjuvant therapy of pancreatic cancer in China (2020 edition). Based on the GRADE system, the guideline has conducted a discussion on the indication, regimen selection, therapeutic effect evaluation, pathological diagnosis and surgery strategy, etc. This guideline has quantified the evidence level of the current clinical researches and provided recommendations for the clinical practice in the neoadjuvant therapy of pancreatic cancer. The guideline has highlighted the role of multiple disciplinary team and represented the conversion of treatment concept in pancreatic cancer. Neoadjuvant therapy has prolonged the survival of the part of pancreatic cancer patients. However, more high-quality clinical researches are in urgent need to improve the level of evidence, optimize the clinical practice and improve the survival of patients.
Subject(s)
Humans , China , Neoadjuvant Therapy , Pancreatic Neoplasms , TherapeuticsABSTRACT
The incidence of thyroid cancer in China is increasing. The treatment methods are considerably arbitrary and non-normative in the cancer treatment process, resulting in high proportion of over-treatment in benign thyroid nodules. Multiple-disciplinary(MDT)team has become a standard mode and direction of cancer therapy. Shanghai Thyroid Research Center was founded to improve MDT mode in thyroid disease treatment. This article summarized the practice experiences of our clinical process, and provide reference for the promotion of the MDT mode and standard treatment.
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Acute pancreatitis (AP) is a common clinical acute abdominal disease.To further improve its overall cure rate,severe acute pancreatitis (SAP) should be paid more attention.In early inflammatory reaction period of SAP,comprehensive treatment in ICU should be strengthened,including adequate fluid resuscitation,early viscera function protection,effective nutritional support and dealing with abdominal compartment syndrome.Surgeons should be responsible in the treatment of infection period of SAP,and seize the timing of surgical intervention correctly.Pluralistic debridement model should be set up,which is mainly based on "step-up" strategy and combined with minimally invasive and multi-disciplinary.In addition,late complications of SAP should be prevented and treated with caution when they occur.The whole SAP treatment system should be based on the multi-disciplinary team (MDT),which requires fully cooperation of each department.Moreover,medical unions at different levels should be established to realize prompt network consultation or referral.In this way,case fatality rate of SAP can be reduced and overall cure rate of AP can be improved,thus benefiting the patients to the maximum extent.
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Objective To explore the value of applying multiple disciplinary team (MDT) in the clinical practice teaching of lymphoma. Methods 5-year program clinical medicine undergraduate students of 2012 were divided into experimental and control group randomly, with 30 cases in each group. The ex-perimental group received MDT in clinical teaching through MDT conference and cases analysis. The control group received conventional teaching mainly by smal class presentation and ward round . The effect of teaching was evaluated by examination and questionnaire. The data were analyzed through t-test and chi-square test by SPSS 20.0 software. Results The results showed the students' scores of the theory knowledge test of two groups were similar to each other, but the scores of discussional topic and clinical cases analysis were higher in experimental group than control group and statistically difference [(16.5 ±2.3)vs. (10.5 ±1.8);(37.5±2.5) vs.(27.5±1.8)], (P=0.000), and the final score of two groups showed statistically difference (93.5± 5.2 vs. 76.0 ±6.2) (P=0.000). Meanwhile, questionnaire survey of satisfaction showed that 27 students of experimental group (90.0%) were interested in this new teaching model, 29 students (96.7%) believed it im-proved understanding and memory to the process of lymphoma diagnosis and treatment, 25 students (83.3%) believed it could improved the ablility to diagnose and differential diagnose lymphoma and expanded their clinical view. 28 students (93.3%) had consolidated clinical thinking, and 26 students (86.7%) improved negotiation with patients. All issues were significantly better than control group (P<0.05). Conclusions The clinical teaching model innovation based on MDT could help medical students use the cross-discipinary interviewing and make optimal treatment plan for patients. It is conducive to the cultivation of their diagnosis, differential diagnosis and clinical thinking ability, which is worthy of promotion in hematological clinical teaching.
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Anaplastic lymphoma kinase (ALK)-positive diffuse large B-cell lymphoma (DLBCL) is a rare and distinct variant of DLBCL. It is classified as a unique subtype of DLBCL in the 2008 WHO classification of lymphomas. No standard and effective therapeutic regi-men is available for ALK+DLBCL because it shows a more aggressive clinical course and frequent relapse. Therefore, a standardized and individualized treatment is needed to benefit more patients diagnosed with ALK+DLBCL through a multiple disciplinary team. This arti-cle presents a case of an ALK+DLBCL patient who relapsed after transplantation and was successfully treated with the ALK kinase inhibi-tor Crizotinib.
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Olfactory neuroblastoma is a rare malignant tumor. Although multiple therapeutic modalities including surgery, radio-therapy, or chemotherapy could be used in patients with olfactory neuroblastoma, no standardized treatment has been achieved. This re-view introduces a case of adult olfactory neuroblastoma treated by a multiple disciplinary team in Tianjin Medical University Cancer In-stitute and Hospital. This review also aims to explore a complete set of diagnostic and treatment practices for the benefit of future pa-tients.
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Solitary brain metastasis in non-small cell lung cancer (NSCLC) patients was previously considered as Stage IV. Gen-erally, only chemotherapy or radiotherapy rather than surgery was considered the treatment for these patients;hence, achieving the de-sired effect was difficult. In recent years, the treatment benefit for these patients significantly increased. Several patients were even pro-vided the chance of being cured through standardized and individualized treatment by a multiple disciplinary team (MDT). This article introduces two solitary brain metastasis patients with NSCLC who were treated by MDT in Tianjin Medical University Cancer Institute and Hospital. This article aims to explore a complete set of diagnostic and treatment practices for the benefit of more patients.
