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研修感悟

13

Apr

0

研修感悟-柯医生3

May,27th , 2019 cloudy

Perfect prevention of nosocomial infection:

Standard infection control precautions including personal protective equipment and waste management, can help avoid transmission, but central to standard infection control precautions is HAND HYGIENE. Learning how to perform hand hygiene and making sure you wash your hands ‘as you should, when you should’ are the most important things you can do to combat HAI.

But what surprised me most was the strict sterilization of the B-mode ultrasound machine, sterilization of B-mode ultrasound probes/wires for three times before performing ultrasound on each patient with different disinfectants.


May,28th , 2019 cloudy

Today, Alice took us to a typical private hospital in the UK for an observation, this is a hospital with convenient facilities, humanized services and perfect environment, which can only be described as luxury.

“Patients expect the very best when they come to Bupa Cromwell Hospital, and our

ability to invest in world-leading diagnostic and treatment technologies is essential in 

delivering that ‘gold standard’ care.”

What sets us apart from other hospitals is that our care and attention isn’t restricted to medical matters. We have created an environment where people feel safe, secure and comfortable; where Their wellbeing is where privacy is always respected. From the moment our guests walk through the door, they can expect a truly outstanding service. —Philip Luce, CEO.


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May,29th , 2019 sunny

Egg freezing-A summary of the recent UK(HFEA) guidelines.

Why do women want to freeze their eggs?

There are 2 main reasons why women in the UK freeze their eggs.

Social-to delay their child bearing whilst they find the right partner(46% of those who freeze their eggs are single), to pursue their career or because they are not ready to have children.

Medical-they are having treatment for cancer which is likely to affect their fertility or they have other medical problems like severe endometriosis.

How is egg freezing treatment performed?

Egg freezing involves the following steps.

Ovarian stimulation-hormonal injections are administered to stimulate the ovaries to produce eggs.

Egg collection-eggs are retrieved under ultrasound guidance via the vagins.

When do most women in the UK freeze their eggs?

As per the HFEA data, most women who froze their eggs in 2016 were over 35. The most common age to freeze eggs was 38. However, the most common age women came back for fertility treatment to use their cryopreserved eggs was 40.


May,30th , 2019 cloudy

90% of cycles in the UK are privately funded. The average cost of a complete egg freezing cycle rages , from 7000-8000 Pounds. This is made up of the cost of egg freezing, storage and using frozen eggs in treatment. NHS funding is available for those who freeze their eggs for medical reasons. Risks associated with the treatment.

The most important factor that affects the success rates of egg freezing is the age of the women at the time of freezing. The age of thawing the eggs does not seem to significantly influence the outcome. Birth rates from frozen own eggs are increasing but remain below fresh IVF treatment cycles at 18% per treatment cycle.


May,31th , 2019 cloudy

As of 2017, centers receiving sperm donation could distribute sperm to no more families than the number specified by the donor, and the donor could not specify more than ten.

In October and November 2007, the HFEA decided on a policy to reduce multiple births from treatment. This forms part of a wider national strategy to reduce the risk of multiple births from fertility treatment involving professional bodies, patient groups and NHS-funding bodies.

In 2007 the Authority agreed to allow women to be able to donate their eggs to research project, provided that there are strong safeguards in place to ensure the women are properly informed of the risks of the procedure and are properly protected from coercion.

In 2006, the HFEA approved in principle the screening of embryos for genes that may lead to certain cancers in middle age.

In 2005, the HFEA granted a licence to treat mitochondrial diseases by allowing researchers to attempt to create an embryo with two genetic mothers.

In 2004, the HFEA granted British scientists a licence to produce cloned human cells, making it only the second country in the world to permit such a procedure.


June,3rd , 2019 cloudy

Donor anonymity

In 2004, the HFEA enabled donor-conceived children to access the identity of their sperm, egg or embryo donor upon reaching the age of 18.

The regulations were implemented on 1 April 2005 and any donor who donated sperm, eggs or embryos from that date onwards is, by law, identifiable. Since that date, any person born as a result of donation is entitled to request and receive the donor’s name and last known address, once they reach the age of 18.


June,4th , 2019 cloudy

The working environment here is very relaxed and the colleagues are very friendly. Operating rooms will also be equipped with radios. 


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June,5th , 2019 fine

Something about consent form in UK

What a consent form is for:

This form documents the patient’s agreement to go ahead with the investigation or treatment you have proposed. It is not a legal waiver- if patients, for example, do not receive enough information on which to base their decision, then the consent may not be valid, even though the form has been signed. Patients are also entitled to change their mind after signing the form, if they retain capacity to do so. The form should act as an aide-memoire to health professionals and patients, by providing check-list of the kind of information patients should be offered, and by enabling the patient to have a written record of the main points discussed. In no way, however, should the written information provided for the patient be regarded as a substitute for face-to-face discussions with the patient.

Who can give consent:

Everyone aged 16 or more is presumed to be competent to give consent for themselves, unless the opposite is demonstrated. If a child under the age of 16 has “sufficient understanding and intelligence to enable him or her to understand fully what is proposed”, then he or she will be competent to give consent for himself or herself. Young people aged 16 and 17, and legally competent younger children, may therefore sign this form for themselves, but may like a parent to counter sign as well. If the child is not able to give consent for him or herself, some-one with parental responsibility may do so on their behalf and a separate form is available for this purpose. 

When NOT to use this form:

 If the patient is 18 or over and is not legally competent to give consent you should use the special form(form for adults who are unable to consent to investigation or treatment) instead of this form. A patient will not be legally competent to give consent if :

They are unable to comprehend and retain information material to the decision and or / they are unable to weigh and use this information in coming to a decision.


June,6th , 2019 fine

Acupuncture in London & UK

Acupuncture is a practice that originated from China, but more popular in UK. Despite being incorporated into modern medicine, It is surrounded by a miasma of misunderstanding and myth. In truth, acupuncture has undergone many changes in the course of becoming part of modern healthcare, even in IVF.

How, when, where, and why acupuncture is used here in the UK varies immensely based on individual practices and their effectiveness. Generally speaking, acupuncture is largely used in the UK as a treatment for pain, muscle tightness, arthritis, and the pretreatment of IVF

Acupuncture is available from a variety of different sources, including some registered medical health professionals like physiotherapists who can pursue qualifications in the field. That being said, most acupuncturists in the UK will be alternative medicine practitioners, and so care must be taken when using these providers to ensure your own safety. 


June,7th , 2019 fine

Today, I saw a controversial endometrial scraping technique in an outpatient clinic. Endometrial scratching, or disruption of the endometrium resulting in an immunologic response, inflammation, and repair, has been hypothesized to enhance pregnancy rate after the embryo transfer. Some study showed an increase in the rate of live birth or ongoing pregnancy rate. However, some scholar report the results of a large, randomized clinical trial of endometrial scratching that showed no benefit to the outcome of IVF.


June,10th , 2019 fine

Babylon Artificial Intelligence Company

With the rapid commercialization process of machine learning and big data, AI has been in the leading position in the fields of health care and life sciences, and will change the way of medical diagnosis and disease treatment. It may take a traditional doctor 10 minutes to understand the patient's symptoms. Now an AI robot may only need a few minutes to understand the patient's past medical history, living environment and climate, and analyze the symptoms through billions of data behind it. Babylon Artificial Intelligence Doctor is a remote diagnostic and therapeutic APP launched by Babylon Health, a British digital medical 

company. It aims to provide all medical consultation services for users through AI technology. Whenever and wherever, users can see a doctor through App. For example, medical advice can be obtained from online doctors by chatting with AI robots or by video or text. In addition, APP also includes health tracking and drug distribution services.


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