the services of psychiatry of breath

Already mobilized in the previous events, the staff of the hospital departments of psychiatry expect to be again heard, this Tuesday, June 16, at the new national day of action, organized at the call of a coalition of unions and collective hospital. Because each one, in hospitals, is expecting a massive arrival of patients in the weeks to come.

→ TO READ. Hospital : the trade unions of health care workers called the strike on 16 June

“Since the end of the confinement, there is an increase in emergency admissions and, says dr. Antoine Pelissolo, head of the department of psychiatry at the hospital Henri-Mondor in Créteil, and a member of the Inter-Hospitals. Containment has been a factor of stress and anxiety important, some chronic patients have stopped taking their treatment and follow-up were not able to take place. “

On-occupied

But the capacity of the patients is not sufficient. “It is already three patients in rooms of two, we can’t go further. Sometimes they spend two, three days in the emergency room, alert Antoine Pelissolo. The teams can not watch over them, while looking for an available bed. “

According to Eurostat, France has lost a little over 7 psychiatric beds per 100 000 inhabitants between 2006 and 2017, from 91,44 beds 83,77. In comparison, over the same period in Germany, whose capacity was already higher in 2006, has opened nearly 20 additional beds.

Few expectations regarding ” I health “

Valérie (1), healthcare assistant at psychiatric hospital of Vinatier in Bron, near Lyon, has the feeling of being “wrung out, especially psychologically “. “I depend on a unit of long evolution, in which the support of the patients is longer and also heavier, she says. We are in demand too, but we’re still to colleagues and patients “, further stresses the health care aide is said “angry “ but can not go to show on Tuesday : “I’m requisitioned, it is stack-coat the minimum number that day. “

During the containment, the staff of the Vinatier has initiated a standoff with the management. Several units of the hospital were threatened with closure. “When we can accommodate them, our patients do not report anything, they cost us money because they stay with us long, then it returns to the field structure, and finally, if they exist “, critical Valérie.

→ FORUM. Reform the hospital, beyond the emotion

The ” Ségur health “, which must lead to a plan for the hospitals this summer, will bring to the caregivers means that they are waiting for ? “My colleagues who participate in it, tell me that these are discussions and not projections in the concrete, and regrets dr Antoine Pelissolo. The announcements that have been made previously have been followed by disappointments, it does not bode well. “

An average of two months of hospitalization for psychiatric patients

In 2015, 417, 000 patients have been supported in psychiatry in France and remained hospitalized for two months on average, according to the Directorate-general of the offer of care (DGOS). “The question of new structures to home, to make more ambulatory care and less hospitalization, long is on the table, accurate Antoine Pelissolo. We are not opposed to this thinking, but there is an urgency to invest in the places that already exist. We ask a 5% increase in the budget of the psychiatry. “

The feeling of being considered will also drop by a salary adjustment for these caregivers. “It’s been years that I survive. The months where I don’t work on Sunday, I win 1 700 € net per month, while I have 25 years of career “, confides Valerie.

→ MAINTENANCE. Containment : “The level of anxiety of the French rose “

Like other health care providers in psychiatry also undermine the pricing in the act and the weight of administrative tasks. “ Perhaps even more than in other hospital services, psychiatry requires a lot of availability of personal, ensures Françoise Chalons, social worker in psychiatry at retired and militant CGT. When a problem occurs with a patient, the emergency is not of the record administratively, but to take the time to reassure him and sit a few minutes with him. “

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The caregivers in the street

– A national day of action is organized on Tuesday, 16 June the call of a coalition of unions (CGT, FO, SUD, Unsa,…) and multi-hospital (Inter-Hospital and Inter-Emergencies), to claim more resources for the hospital.

– Several dozens of rallies are planned across France, primarily to health institutions or the prefectures.

– In Paris, the event must be held in the early after-noon, in front of the ministry of health, according to the CGT. It could be followed by a procession in the direction of the Invalides, if the prefecture of police gives his consent to the event.

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it affects not only the lungs, but the whole body

The first 10 days after the onset of symptoms of the disease, the 38-year-old American was feeling quite well. He was not at risk; he had no chronic diseases.

– The man was examined, the disease was mild. The patient had a slight cough. Therefore, he was sent home for treatment, ”says the head of the Department of Vascular Surgery at Westchester Medical Center Sean Wengerter.

And then the incredible happened.

One morning, a man woke up with icy and numb legs. The body was constrained by terrible weakness; there was not even the strength to get out of bed.

The examination showed that the patient had aortic occlusion – a large blood clot formed in the main artery at the place where the artery diverged in two directions – to the right and left leg. Because of this clot, blood enriched with oxygen did not enter the iliac arteries.

“This is extremely dangerous.” From this can die from 20% to 50% of patients, – notes Vangerter. – But such things are not typical for 38-year-olds.

An emergency operation to remove a blood clot could save the patient’s life. But doctors working with patients with COVID-19 are everywhere faced with rather strange and frightening phenomena in infected patients. For example, the formation of blood clots (actually blood clots) of various sizes throughout the body, renal failure, inflammation of the heart muscle and malfunctions of the immune system.

“Coronavirus occurs in each patient in its own way,” notes Scott Brackenridge, associate professor of emergency surgery at the College of Medicine at the University of Florida. – In some cases, the patient has a problem with breathing, in others, the internal organs begin to fail. In children, the immune system as a whole begins to rebel.

Coronavirus is not just a respiratory diseasePhoto: Ivan MAKEEV

MYSTERIOUS STROKES

A new type of coronavirus is considered to be a respiratory virus, although it is already becoming obvious – the infection affects the entire human body. The most common symptoms are fever, pneumonia, and acute respiratory distress syndrome.

In this case, the virus attacks some organs directly. First of all, the mucous membrane of blood vessels, which entails unnatural coagulation of blood.

– COVID-19 provokes a local inflammatory reaction that leads to the formation of blood clots, – explains Wengerter. – This is due to the direct effect of the virus on the arteries.

A number of doctors recorded strokes in young patients with coronavirus, as well as the formation of blood clots in the lungs. Blood clots were found even in the smallest vessels.

“Since each organ feeds on blood vessels, and the virus attacks them first and foremost, we end up with damage to internal organs,” adds Dr. Scott Brackenridge.

Another serious symptom that is observed in some patients who become ill with the new coronavirus is the “co-fingers.” The infected toes swell, becoming red or purple. It is possible that the reason for this is blockage of blood vessels. But doctors say that usually this does not have serious consequences.

Kawasaki Syndrome

One of the most alarming reactions to COVID-19 is observed in children. It has already been named as a children’s multisystem inflammatory syndrome. In newYork Doctors have identified more than 100 cases.

This syndrome is characterized by a rather long fever, inflammatory process, malfunction of one or more internal organs, as well as the general condition, which is usually observed with shock. Pediatricians also compare these symptoms with the syndrome. Kawasaki.

Kawasaki syndrome is a rare disease that affects children aged 3 to 10 years. It is characterized by damage to the medium and small arteries, thrombosis, the formation of aneurysms and rupture of the vascular wall. Cases of infection are rare. However, recently, doctors have noted an increase in the number of patients with this syndrome.

Both childhood multisystem inflammatory syndrome and Kawasaki syndrome lead to an overly aggressive immune system response to coronavirus. This may be accompanied by inflammation of the blood vessels and heart muscle.

KILLER CELLS

However, scientists note that coronavirus is not able to cause a strong immune response, but, on the contrary, suppress the entire immune system. And this can allow the infection to freely attack the internal organs.

Partly this theory was confirmed by Chinese experts, led by Dr. Zhang Zhang. Scientists analyzed samples of immune cells taken from the lungs of 9 patients infected with coronavirus. The results of the study showed an abnormally high level of leukocytes – macrophages and neutrophils responsible for the destruction of harmful pathogen – in severe patients. At the same time, these patients had a rather low level of CD8 T cells, which are called killer cells. They are responsible for killing virus-infected cells.

But doctors are reassuring, noting that they have drugs that can thin the blood, and also help the work of white blood cells that resist infection.

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In Ferrara shops open from 11 May – Ultima Ora

(ANSA) – FERRARA, MAY 5 – Non-food stores in Ferrara
they can be opened from 11 May, in advance of one
week compared to the rest of Italy. An ordinance provides for this
who will sign the mayor Alan Fabbri (Lega). “We want to give
trust the Ferrarese – he said – and breathe in the many realities
commercials that are likely to come out on their knees from this
lockdown. We are sure that the people of Ferrara will know how to manage in
best way this opportunity. “The ordinance will allow
all stores to resume selling, respecting the rules of
health security provided for commercial establishments already
open. Only one member of the family can enter,
you can stay in the shop for the time strictly
necessary to purchase and measures must be taken that
ensure the quota of the entrances, with the strict
compliance with the distance of one meter and the prohibition of each
gathering inside and outside. Immediately, the shopkeepers
they will have access to the premises for cleaning and sanitization.

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