A nomogram for predicting the risk of pulmonary embolism in neurology department suspected PE patients: A 10-year retrospective analysis.

Objective: The purpose of this retrospective study was to establish a numerical model for predicting the risk of pulmonary embolism (PE) in neurology department patients. Methods: A total of 1,578 subjects with suspected PE at the neurology department from January 2012 to December 2021 were considered for enrollment in our retrospective study. The patients were randomly divided into the training cohort and the validation cohort in the ratio of 7:3. The least absolute shrinkage and selection operator regression were used to select the optimal predictive features. Multivariate logistic regression was used to establish the numerical model, and this model was visualized by a nomogram. The model performance was assessed and validated by discrimination, calibration, and clinical utility. Results: Our predictive model indicated that eight variables, namely, age, pulse, systolic pressure, hemoglobin, neutrophil count, low-density lipoprotein, D-dimer, and partial pressure of oxygen, were associated with PE. The area under the receiver operating characteristic curve of the model was 0.750 [95% confidence interval (CI): 0.721-0.783] in the training cohort and 0.742 (95% CI: 0.689-0.787) in the validation cohort, indicating that the model showed a good differential performance. A good consistency between the prediction and the real observation was presented in the training and validation cohorts. The decision curve analysis in the training and validation cohorts showed that the numerical model had a good net clinical benefit. Conclusion: We established a novel numerical model to predict the risk factors for PE in neurology department suspected PE patients. Our findings may help doctors to develop individualized treatment plans and PE prevention strategies.

Training practice of clinical thinking ability of clinical interns in neurology department / 中华医学教育探索杂志

Objective:To explore the methods of improving the clinical thinking ability of clinical medical interns in neurology department.Methods:Clinical medical interns from 2017 to 2018 were selected as the research subjects. The clinical medical interns in 2018 and in 2017 were set as the experimental group (98 people) and the control group (95 people). In the clinical practice of the neurology department, the experimental group was trained in clinical thinking ability, and the control group was trained by the traditional methods. Before the end of the internship, the self-made Clinical Medical Interns Clinical Thinking Ability Questionnaire was used to evaluate the teaching effect. SPSS 14.0 was used for t-test and Chi-square test. Results:The experimental group and the control group had the problems of one-sidedness, appearance, fixedness, passivity, laziness, simplification, confusion of clinical thinking. The clinical thinking problems in the experimental group were significantly improved than those in the control group ( P<0.001). There were significant differences in clinical thinking between the experimental group and the control group in terms of one-sidedness, appearance, fixedness, passivity and laziness ( P<0.05). In addition to language communication and expression ability, the self-assessment score of clinical thinking ability in the experimental group was statistically different from that in the control group ( P<0.05). Compared with the control group, there were also significant differences in the examination results of the experimental group ( P< 0.05). Conclusion:The implementation of clinical thinking training in neurology practice is conducive to cultivating students' clinical thinking ability and improving the quality of personnel training.

Practice and reflection on continuing education and training of clinical pharmacists in the neurology department / 中国药房

OBJECTIVE To provide a reference for continuing education and training of clinical pharmacists. METHODS The revision of the syllabus and the improvement of training methods of practical skills training class for clinical pharmacists in the neurology department held by Xuanwu Hospital of Capital Medical University from 2007 to 2022 was sorted to summarize its advantages and characteristics. RESULTS Training programs were developed to benefit clinical pharmacists at different levels， and the training contents were adjusted according to the training programs and the needs of trainees. Teachers with teaching experience were selected to participate in the teaching. Theory teaching was combined with practice teaching in the teaching process， and case teaching and question-based teaching methods were adopted to benefit both senior clinical pharmacists and new clinical pharmacists. In addition， the influence of the training class was expanded through online teaching， so that doctors and pharmacists could communicate and learn together on the platform of the training class. For example， when designing the training program， we replaced one common neurological disease every two years， and carried rollover study on its new progress and new ideas； clinical pharmacist skill course was reduced， drug history writing， information retrieval and test index interpretation were compressed into clinical pharmacy skill course. CONCLUSIONS The continuing education platform is established for clinical pharmacists； new knowledge and concepts that clinical pharmacists of this specialty need to be familiar with are compiled into the teaching syllabus， and the experts who are familiar with the training of clinical pharmacists are selected to explain to the students so that the students could follow the platform to constantly update their knowledge and improve the ability of clinical pharmacists to participate in the clinic work.

[Dawn of a new Day - A brief History of Stroke Treatment in Iceland].

Here we will briefly review the main influential factors and milestones in the history of stroke care in Iceland. Over the last few decades the treatment of ischemic stroke has revolutionized in many ways and so has the general mindset of those providing it. This review article is partly based upon interviews with Icelandic doctors that partook in the development. Looking back at this history it is clear that, in many ways, the medical care in Iceland was at the forefront in implementing those emerging new treatments in stroke care. This is mainly on account of ambitious and hard working individuals that were not easily dissuaded but firmly believed in the possibility of better outcomes for their stroke patients.

Peripherally inserted central venous catheter in upper extremities leads to an increase in D-dimer and deep vein thrombosis in lower extremities.

BACKGROUND: The purpose of this study is to elucidate the association between peripherally inserted central venous catheter (PICC) in upper extremities and lower extremity deep venous thrombosis (LEDVT) by observing the changes in D-dimer. METHODS: This was a retrospective cohort study with 3452 patients (104 inserted with PICCs and 3348 without PICC) enrolled at the neurology department from April 1, 2017 to April 1, 2020. The patients underwent color Doppler ultrasound (CDU) and D-dimer examinations. LEDVT-related factors and D-dimer value were analyzed before and after PICC insertion. The predictive value of D-dimer for LEDVT was also evaluated. RESULTS: Univariate logistic regression analysis showed that PICC insertion increased the risk of LEDVT by 9 times and promoted the increase of D-dimer by 5 times. After risk adjustment, multivariate logistic regression analysis showed that PICC insertion increased the risk of LEDVT by 4 times and tripled the risk of D-dimer increase. The concentration of D-dimer was significantly increased after PICC insertion. D-dimer was unsuitable for excluding venous thrombosis in patients inserted with PICCs. CONCLUSIONS: PICC insertion increases the level of D-dimer and the risk of LEDVT. The risks of venous thrombosis need to be assessed in patients inserted with PICCs to ensure the expected clinical outcomes.

Clinical activity changes in the neurology department of Wenzhou during the COVID-19 pandemic: an observational analysis.

OBJECTIVE: To explore the activity changes in neurology clinical practice that have occurred in tertiary public hospitals during the COVID-19 pandemic. METHODS: Outpatient and inpatient data from the neurology department were extracted from the electronic medical record system of three tertiary Grade A hospitals in Wenzhou. Data were analyzed across 5 months following the beginning of the pandemic (from January 13 to May 17) and compared with the same period in 2019. Data on reperfusion therapy for acute infarction stroke were extracted monthly from January to April. RESULTS: The number of outpatients declined from 102,300 in 2019 to 75,154 in 2020 (26.54%), while the number of inpatients in the three tertiary Grade A hospitals decreased from 4641 to 3437 (25.94%). The latter trend showed a significant drop from the 3rd week to the 7th week. The number of patients in these hospitals decreased significantly, and a significant drop was seen in the neurology department. As usual, stroke was the most common disease observed; however, anxiety/depression and insomnia increased dramatically in the outpatient consultation department. CONCLUSIONS: The results of our study revealed the effects of the COVID-19 pandemic in the clinical practice of neurology in Wenzhou during the outbreak. Understanding the pandemic's trends and impact on neurological patients and health systems will allow for better preparation of neurologists in the future.

Standardized neurology teaching ward-round combined with PBL teaching method and standardized patients in the clinical practice of international students / 中华医学教育探索杂志

Objective:To explore the application effect of standardized neurology teaching ward-round combined with problem-based learning (PBL) teaching method and standardized patients (SP) in the production practice of international students.Methods:A total of 60 foreign students who participated in the neurology department of The 2nd Affiliated Hospital of Harbin Medical University from June 20, 2019 to December 20, 2019 were selected as the study subjects, and were divided into experimental group and control group, with 30 ones in each group. The control group used traditional teaching ward-round methods, the experimental group used the standardized teaching ward-round combined with PBL teaching method and standardized patients for learning. And at the end of the training, the assessment of the first course of disease record writing and questionnaire survey were conducted. SPSS 20.0 was used for t test and chi-square test. Results:The results of writing medical records in the experimental group were significantly outstanding, with statistical difference ( P<0.05). More than 80% of foreign students in the experimental group agreed that standardized teaching ward-round and standardized patient teaching model had significant effectiveness. Conclusion:In the production practice education of international students in department of neurology, the standardized teaching ward-round combined with PBL teaching method and standardized patient have achieved remarkable results.

Will neurological care change over the next 5 years due to the COVID-19 pandemic? Key informant consensus survey. / ¿Va a cambiar la neurología tras la pandemia de COVID-19 en los próximos 5 años? Estudio de enfoque mediante informadores clave.

INTRODUCTION: The COVID-19 pandemic will give rise to long-term changes in neurological care, which are not easily predictable. MATERIAL AND METHODS: A key informant survey was used to enquire about the changes expected in the specialty over the next 5 years. The survey was completed by heads of neurology departments with broad knowledge of the situation, having been active during the pandemic. RESULTS: Despite a low level of consensus between participants, there was strong (85%) and moderate consensus (70%) about certain subjects, mainly the increase in precautions to be taken, the use of telemedicine and teleconsultations, the reduction of care provided in in-person consultations to avoid the presence of large numbers of people in waiting rooms, the development of remote training solutions, and the changes in monitoring visits during clinical trials. There was consensus that there would be no changes to the indication of complementary testing or neurological examination. CONCLUSION: The key informant survey identified the foreseeable changes in neurological care after the pandemic.

Management of neurological care during the COVID-19 pandemic. / La gestión de la asistencia neurológica en tiempos de la pandemia de Covid-19.

INTRODUCTION: The COVID-19 epidemic has led to the need for unprecedented decisions to be made to maintain the provision of neurological care. This article addresses operational decision-making during the epidemic. DEVELOPMENT: We report the measures taken, including the preparation of a functional reorganisation plan, strategies for hospitalisation and emergency management, the use of telephone consultations to maintain neurological care, provision of care at a unit outside the hospital for priority patients, decisions about complementary testing and periodic in-hospital treatments, and the use of a specific telephone service to prioritise patients with epileptic seizures. CONCLUSION: Despite the situation of confinement, neurology departments must continue to provide patient care through different means of operation. Like all elements of management, these must be evaluated.

Effect of improvement activity of nursing projects in rate of nasogastric tube unscheduled extubation / 现代临床护理

Objective To reduce the rate of unscheduled nasogastric extubation for the patients in neurology department.Methods A nursing care team was set up for a thematic activity to reduce the rate of nasogastric tube unscheduled extubation.The team analysed the situations of 164 patients with nasogastric intubation in the neurology department,specifying the problems,deciding their aims and working out the strategies.Result The rate of unscheduled nasogastric extubation decreased from 19.63％ to 2.12％ and the rate of nursing omission decreased from 9.93％ to 2.59％ (P＜0.05).Conclusion The improvement activity of nursing projects can effectively reduce the rate of unscheduled nasogastric extubation and improve the quality of nursing care.

Discussion of stroke unit management in nursing based upon international standards in neurology department / 中国实用护理杂志

Objective To discuss the practice of nursing management model of stroke unit based upon the international standards implemented in the neurological unit.Methods The experiences of the stroke unit management were summarized and applied to instruct the clinical practice.Results After the implementation,the average hospitalization days,the proportion of drugs,medical cost,and mortality rate decreased.The satisfactory degree of patients with the stroke unit increased.Conclusions The nursing management model of stroke unit not only improved the quality of nursing service to stroke patients,but also decreases the mortality and disability rate,shortened the length of hospital stay,and enhanced the satisfaction degree of patients and their family members.

Morbilidad por trastornos del movimiento en la consulta de Neurología / Morbidity due to movement disorders in the Neurology Department

Se realizó un estudio observacional, descriptivo y transversal de 175 pacientes con trastornos del movimiento que asistieron a la Consulta de Neurología del Hospital General Docente "Dr. Juan Bruno Zayas Alfonso" desde el 2007 hasta el 2010, con vistas a describir la morbilidad en estos. Dichas afecciones iniciaron durante la quinta y sexta décadas de la vida en la mayoría de los integrantes de la casuística, con una frecuencia superior de la enfermedad de Parkinson, el temblor esencial y las distonías, y prevalencia del sexo masculino y el color de la piel mestizo. La electromiografía de los músculos agonistas y antagonistas evidenció el predominio del temblor de reposo y la disfunción en la inhibición recíproca, sobre todo en la enfermedad de Parkinson.

An observational, descriptive and cross-sectional study of 175 patients with movement disorders who attended the Neurology Department in "Dr. Juan Bruno Zayas Alfonso" Teaching General Hospital was carried out from 2007 to 2010, aimed at describing the morbidity in them. These disorders began during the fifth and sixth decades of life in most of the members of the case material, with a higher frequency of Parkinson disease, the essential tremor and dystonias, and prevalence of the male sex and half-bred skin. The electromyography of the agonistic and antagonistic muscles evidenced the prevalence of the rest tremor and the disorder in the reciprocal inhibition, mainly in the Parkinson disease.

Effect evaluation of nursing intervention on preventing leakage of urine in patients with indwelling catheter in neurology department / 中国实用护理杂志

Objective To investigate the effect of nursing intervention on preventing leakage of urine in patients with indwelling catheter in neurology department.Methods A total of 76 patients with indwelling catheter in neurology department were randomly assigned into the observation group and the control group with 38 cases in each group.The control group received routine care,the observation group received systemic nursing intervention on the basis of routine care.The incidence of leakage of urine and patients satisfaction degree with nursing service was observed between two groups.Results The incidence of leakage of urine in the control group was 21.1％,higher than 2.6％ of the observation group.he score of satisfaction degree of the observation group was (4.66±0.62),higher than(3.26±0.42) of the control group.Conclusions Nursing intervention can effectively reduce the incidence of leakage of urine and improve the satisfaction degree of patients with indwelling catheter in neurology department,it is worthy of clinical application.

Analysis of Drugs Utilization of Inpatients in Neurology Department of Our Hospital / 中国药房

OBJECTIVE:To evaluate drug utilization of inpatients in neurology department of our hospital.METHODS:Category of drugs,consumption amount,consumption sum and administration time for each person of 853 cases in neurology department of our hospital in 2008 were analyzed retrospectively.RESULTS:Of total 853 inpatients,patients with stroke accounted for 82.8%.The first 3 drugs in the list of consumption amount were Nao'an capsule,folium ginkgo tablet and Shuxuetong injection.The first 3 drugs in the list of consumption sum were Shuxuetong injection,Monosialoganglioside injection and Cobamamide for injection.Aspirin tablet,Nao'an capsule and Cobamamide for injection took up the first 3 places in the list of DDDs.CONCLUSION:Inpatients in neurology department mainly suffer from cerebrovascular disease and are treated with TCM for activating blood and eliminating stasis and nervous system agents,They are also treated various complications such as infection,constipation,hypertension,diabetes and so on.Drug use in the clinic is rational.

Application of evidence-based medicine in the department of neurology / 中华医院管理杂志

Objective To explore ways of enhancing the therapeutic level of the neurology department and reducing the economic burdens of patients. Methods Relevant materials were collected by means of evidence based medicine to optimize therapeutic schedules, with cerebral infarction being the pitching in point. Results Prior to the adoption of evidence based medicine, the average length of stay, the effective rate of treatment and the expenses for single entity diseases were respectively 17.83?13.44, 89.91% and 4 550.70 yuan, whereas after the adoption of evidence based medicine, they were respectively 15.38?11.37, 94.16% and 3 942.88 yuan. Conclusion Evidence based management is a means of scientific management. Its application in the department of neurology has produced a marked effect and it is worthy to be spread.

Risk Factors of Lower Respiratory Tract Infection in Neurology Department / 中华医院感染学杂志

OBJECTIVE To find out some risk factors of lower respiratory tract infection in neurology(department) and provide controlling measures.METHODS Totally 883 inpatient cases of neurology(department) in 2005 were retrospectively surveyed and statistically analyzed.RESULTS From them 98 cases were with nosocomial(infection).The infection rate was 11.1%.Among the 98 cases,54 cases were with respiratory tract infection(55%).Lower respiratory tract is the popular part of nosocomial infection in(neurology) department.(CONCLUSIONS) The(treatment) and recovery of the patients are heavily influenced by the infection of lower(respiratory) tract.It is(necessary) to control and prevent main risk factors in order to avoid nosocomial infection.