Wiener klinische Wochenschrift
-
Wien. Klin. Wochenschr. · Jan 2015
Systematic implementation of clinical risk management in a large university hospital: the impact of risk managers.
For health care systems in recent years, patient safety has increasingly become a priority issue. National and international strategies have been considered to attempt to overcome the most prominent hazards while patients are receiving health care. Thereby, clinical risk management (CRM) plays a dominant role in enabling the identification, analysis, and management of potential risks. CRM implementation into routine procedures within complex hospital organizations is challenging, as in the past, organizational change strategies using a top-down approach have often failed. Therefore, one of our main objectives was to educate a certain number of risk managers in facilitating CRM using a bottom-up approach. ⋯ The CRM approach is unique with respect to its dimension; members of all health care professions were trained to be able to identify potential risks. A network of risk managers supported the centrally coordinated CRM process. There is a strong commitment among management, academia, clinicians, and administration to foster cooperation. The introduction of CRM led to a visible shift with regard to patient safety culture throughout the entire organization. Still, there is a long way to go to keep people engaged in CRM and work on national and international patient safety initiatives to continuously decrease potential hazards.
-
Wien. Klin. Wochenschr. · Jan 2015
Controlled Clinical TrialThe major predictors of amputation and length of stay in diabetic patients with acute foot ulceration.
Diabetic foot infections are associated with substantial morbidity and mortality. Prediction of diabetic foot ulcer outcome may be helpful for optimizing management strategy. This study aimed to determine the major predictors of amputation and length of stay in diabetic patients with acute foot ulceration. ⋯ Baseline levels of acute-phase reactants, especially CRP, WBC, ESR, and increased Wagner grade, appeared to be helpful in predicting amputation and length of stay in diabetic patients with acute foot ulceration. However, duration of diabetes and glucose control seems to have no effect.
-
Wien. Klin. Wochenschr. · Jan 2015
No evidence for desmocollin 3 to serve as a prognostic marker in primary radiotherapy of head and neck cancer.
To investigate the role of desmocollin 3 expression in radiation sensitivity and survival in squamous cell carcinoma of the head and neck. ⋯ In this cohort of squamous cell carcinoma of the head and neck, we found no evidence for a predictive potential of desmocollin 3.
-
Wien. Klin. Wochenschr. · Jan 2015
Randomized Controlled TrialEvaluation of liver perfusion in diabetic patients using 99mTc-sestamibi.
The liver is an important organ for various aspects of glucose metabolism, including glucose uptake, storage, and synthesis. It is a major organ in the metabolic process with perfusion provided by both the portal vein and hepatic artery. In diabetic patients organ perfusion is reduced and this is linked to atherosclerosis, and as a result complications occur. In this study, we aimed to evaluate liver perfusion by scintigraphic methods in diabetic patients. ⋯ This study shows that liver perfusion in diabetic patients is reduced compared with those without diabetes. Prospective studies with larger patient groups are required.