Building human resources capability in health care: a global analysis of best practice--Part I.

This paper is one of a series of three, covering very comprehensively human resource practices in a global and generic context. The series of papers presents practices which are directly of relevance to the health-care context, and which are based on proven, effective and pioneering approaches. The first paper covers practices based on British and European experiences, gathered from world-class organisations that have either been finalists or went on to win prestigious quality awards such as the British and European Quality Awards. The benchmarking analysis presented in this paper is based on the sub-criteria prescribed by the European Quality Awards Model, which include: how people resources are planned and improved; how the skills and capabilities of people are preserved and developed through recruitment, training and career progression; how people and teams agree targets and continuously review performance; how the involvement of everyone in continuous improvement is prompted and people empowered to take appropriate action; how effective top-down and bottom-up communication is achieved.     

Pyogenic granuloma of the oral cavity: comparative study of its clinicopathological and immunohistochemical features

There are two histological types of pyogenic granuloma (PG) of the oral cavity: the lobular capillary hemangioma (LCH) and non-LCH type. The aim of the present study was to examine and compare the clinical features, etiological factors, diameter of vascular elements and immunohistochemical features of LCH and non-LCH histological types of PG to determine whether they are two distinct entities. Thirty cases of LCH and 26 cases of non-LCH PG were retrieved and retrospectively studied. Clinically, LCH PG occurred more frequently (66.4%) as sessile lesion whereas non-LCH PG occurred as pedunculated (77%). Non-LCH PG was associated more frequently (86.4%) with etiological factors. The lobular area of the LCH PG contained a greater number of blood vessels with small luminal diameter than did the central area of non-LCH PG. In the central area of non-LCH PG a significantly greater number of vessels with perivascular mesenchymal cells non-reactive for alpha-smooth muscle actin and muscle-specific actin was present than in the lobular area of LCH PG. The differences found in the present study suggest that the two histological types of PG represent distinct entities.     

Curcumin-conjugated nanoliposomes with high affinity for Aβ deposits: Possible applications to Alzheimer disease

Accumulation of amyloid peptide (Aβ) in senile plaques is a hallmark lesion of Alzheimer disease (AD). The design of molecules able to target the amyloid pathology in tissue is receiving increasing attention, both for diagnostic and for therapeutic purposes. Curcumin is a fluorescent molecule with high affinity for the Aβ peptide but its low solubility limits its clinical use. Curcumin-conjugated nanoliposomes, with curcumin exposed at the surface, were designed. They appeared to be monodisperse and stable. They were non-toxic in vitro, down-regulated the secretion of amyloid peptide and partially prevented Aβ-induced toxicity. They strongly labeled Aβ deposits in post-mortem brain tissue of AD patients and APPxPS1 mice. Injection in the hippocampus and in the neocortex of these mice showed that curcumin-conjugated nanoliposomes were able to specifically stain the Aβ deposits in vivo. Curcumin-conjugated nanoliposomes could find application in the diagnosis and targeted drug delivery in AD.From the Clinical EditorIn this preclinical study, curcumin-conjugated nanoliposomes were investigated as possible diagnostics and targeted drug delivery system in Alzheimer’s disease, demonstrating strong labeling of Aβ deposits both in human tissue and in mice, and in vitro downregulation of amyloid peptide secretion and prevention of Aβ-induced toxicity.     

Managing human resources in healthcare: learning from world class practices--Part I.

This paper, which is presented in two parts, is intended to demonstrate that practices related to the area of human resources management, adopted by model organisations that have dominated their markets consistently, can lend themselves very well to the healthcare sector, which is primarily a "people-oriented" sector. As change in a modern business context is set to continue in an unrelenting way, most organisations will be presented with the challenge of developing the necessary skills and areas of expertise to enable them to cope with the demands on them, master technological opportunities at their disposal, learn how to exploit modern management concepts and optimise value to all the stakeholders they intend to serve. This paper draws from best practices using the experiences of quality recognised organisations and many admired names through pioneering human resource policies and practices and through clear demonstrations on the benefits of relying on people as the major "asset". Part I of this article addresses the importance of human resources as revealed through models of management for organisational excellence. In particular, the paper refers to the criteria for excellence in relation to people management using the following prestigious and integrative management models: Deming Prize (Japan); European Quality Award Model (Europe); and Malcolm Baldrige National Quality Award (USA). In addition, this paper illustrates several case studies using organisations known for their pioneering approaches to people management and which led them to win very prestigious quality awards and various international accolades. The paper concludes by reinforcing the point that human resource management in a healthcare context has to be viewed as an integrated set of processes and practices which need to be adhered to from an integrated perspective in order to optimise individuals' performance levels and so that the human potential can be exploited fully.     

French Spine Surgery Society guidelines for management of spinal surgeries during COVID-19 pandemic

Since the outbreak of coronavirus disease 2019 (COVID-19) in December 2019 in China, various measures have been adopted in order to attenuate the impact of the virus on the population. With regard to spine surgery, French physicians are devoted to take place in the national plan against COVID-19, the French Spine Surgery Society therefore decided to elaborate specific guidelines for management of spinal disorders during COVID-19 pandemic in order to prioritize management of patients. A three levels stratification was elaborated with Level I: Urgent surgical indications, Level II: Surgical indications associated to a potential loss of chance for the patient and Level III: Non-urgent surgical indications. We also report French experience in a COVID-19 cluster region illustrated by two clinical cases. We hope that the guidelines formulated by the French Spine Surgery Society and the experience of spine surgeons from a cluster region will be helpful in order optimizing the management of patients with urgent spinal conditions during the pandemic.     

Treatment of painful bony metastases with Samarium 153-EDTMP in prostate carcinoma

THE OBJECTIVE of this work is to evaluate a new therapy, the metabolic radiotherapy to the 153Samarium-EDTMP, of recent introduction in Tunisia, in the painful bony metastasis treatment observed at the patients affected of cancer of the prostate. METHODS: It is about a retrospective survey with a receding of 40 months, achieved through 45 files of patients having benefited all of this new treatment for painful bony metastases in relation with a prostatic adenocarcinoma and collected by three centers of Nuclear Medicine of the capital: the institute Salah Azaiez (state-controlled), the Center CERU (deprives) and the Military hospital (HMPIT). RESULTS: We tried to appreciate essentially four parameters: the therapeutic efficiency, the factors influencing the answer in the treatment, the toxicity of the treatment and the sources of failure. We observed a positive answer in 92,1% of the cases, this answer was complete in 36,5% of the cases. The results gotten after multiple administrations show that the cures could be repeated with results comparable to those of the first cure. The therapeutic efficiency is at least equivalent to those of the other therapeutic means, with nearly non-existent secondary effects. The only toxicity is of hematological order; it is the most often moderate and reversible with a complete recuperation at the end of 8 weeks. Besides, the effect on the pain came with an improvement of the quality of life of the patients treaties. CONCLUSION: Its precocious introduction in the taken in charge of the metastatic patients, would allow them to benefit better from its efficiency, simplicity and weak toxicity and therefore to enjoy a better quality of life.     

Early cardiac migration of distal shunt catheter

Unusual complications of peritoneal shunts are a well-known occurrence. The authors report a rare case of intra-cardiac migration of a distal shunt catheter, which occurred during the initial post-operative days. The physiopathology of this complication and its management are reported.