Swiss medical weekly
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Swiss medical weekly · Jan 2009
ReviewThe emotional impact of medical error involvement on physicians: a call for leadership and organisational accountability.
Involvement in errors often results in serious health effects, emotional distress, as well as performance and work-related consequences in staff members, in particular physicians. The aim of this systematic review was to evaluate current evidence on a) the impact of involvement in medical errors on physicians, b) needs and experiences in coping with the experience of error, and c) interventions to support physicians involved in errors. ⋯ Many professionals respond to error with serious emotional distress, and these emotions can imprint a permanent emotional scar. Given the significant burden on physicians' health, well-being and performance associated with medical errors, health care institutions and clinical leaders have to take accountability and provide staff with formal and informal systems of support.
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Swiss medical weekly · Jan 2009
ReviewThe emotional impact of medical error involvement on physicians: a call for leadership and organisational accountability.
Involvement in errors often results in serious health effects, emotional distress, as well as performance and work-related consequences in staff members, in particular physicians. The aim of this systematic review was to evaluate current evidence on a) the impact of involvement in medical errors on physicians, b) needs and experiences in coping with the experience of error, and c) interventions to support physicians involved in errors. ⋯ Many professionals respond to error with serious emotional distress, and these emotions can imprint a permanent emotional scar. Given the significant burden on physicians' health, well-being and performance associated with medical errors, health care institutions and clinical leaders have to take accountability and provide staff with formal and informal systems of support.
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Sepsis, the systemic inflammatory response to an infection, is an increasingly common condition. It represents a major healthcare problem as affected patients have a high morbidity and mortality leading to high direct and indirect costs. This article describes the progression from a simple infection to septic shock and multi-organ failure, with a special emphasis on the body's response at the cellular level. ⋯ This underlines the assumption that organ dysfunction during sepsis is predominantly a functional problem which appears to relate to the creation of a new balance between energy generation and expenditure. Hence, organ dysfunction could be viewed as a protective mechanism for the patient and may represent a state analogous to hibernation, which can be reversed once the infection is overcome and inflammation has abated. More research is needed to develop better directed and timed therapeutic interventions that can reduce the high morbidity and mortality of this common condition.
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Severe alpha1-antitrypsin (AAT) deficiency is the best characterised genetic risk factor for the development of emphysema. AAT has a wide spectrum of antiprotease activity and its primary function is inhibition of neutrophil elastase in the lung. ⋯ Intravenous administration of human AAT is well tolerated and has been shown to increase the levels of AAT in the alveolar lining fluid of individuals with this deficiency. In contrast to the proof of the biochemical effectiveness of augmentation treatment, the favourable clinical effect of AAT on pulmonary function, emphysema progression, morbidity and survival has not been persuasively demonstrated by prospective controlled clinical trials and remains controversial.
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Swiss medical weekly · Nov 2007
ReviewAdvanced chronic lung disease: need for an active interdisciplinary approach.
Modern treatment of patients with advanced lung disease includes not only pulmonary therapy but also integrative treatment of co-morbidities directly or indirectly linked to the underlying lung disease. Moreover, impairment of heath related quality of life is frequent in these patients and influences their physical and psychological "well-being". ⋯ Referral to the intensive care unit is not generally contraindicated and mortality depends on the underlying lung disease and co-morbidities. Nowadays, lung transplantation is a valuable therapeutic option in advanced lung disease and should be considered early especially in IPF patients.