Bohdana Semeniuk, MD

Stroke Unit, Kolomiya Central Regional Hospital

Kolomiya, Ukraine

Visit to Perugia Hospital Stroke Unit, Perugia, Italy from 21 June – 13 July

In recent years Ukrainian medicine has been passing through a medical reform (since 2017), and we were moving towards improving and developing the medical healthcare system.

Since 24 February, our lives have changed. All medical community members, including our foreign colleagues, face the war’s inevitable consequences.

Given the circumstances, to improve international cooperation and acquire European medical experience, we were kindly invited to Perugia S. Maria Della Misericordia Hospital.

Due to the enormous support of ESO and such devoted professionals as Prof. Valeria Caso, Prof. Francesca Romana Pezzella, Prof. Yuriy Flomin, and Prof. Iryna Sadovyak, we had the opportunity to visit Italy and the Perugia Hospital. As it was our first visit to the stroke department abroad, we had a lot of questions about the pathway of stroke patients, the network of hospitals, and details about acute stroke treatment and primary and secondary stroke prevention.

Special gratitude goes to Valeria Caso; she is deliberate, intelligent, engaged in improving the healthcare system, and strongly gender orientated. She acquainted us with the healthcare system of Italy, introduced us to many talented doctors, and emphasized the necessity of broad-mindedness in all aspects of life.

We had an incredible opportunity to observe the work of a Stroke Centre in Perugia Hospital.

Deeply impressed by the level of high qualification of medical workers, modern and accurate technologies such as endovascular interventions, widespread usage of telemedicine, level of the preventive measures, and its modern approach.

We were also impressed by the diagnostic department of Perugia Hospital, which provides 1.5 T and 3T imaging for pediatric and adult populations with the necessary anesthesiology support.

As the Perugia Stroke unit specializes in detecting atrial fibrillation as a cause of stroke, we had a chance to discuss the nuances of administering anticoagulants in different cases. The most interesting case was a 76 -year old female with an embolic stroke after orthopedic surgery, deep venous thrombosis, pulmonary embolism, and patent foramen ovale. The Perugia Stroke unit is also a center where many RCTs are performed. We could assist with patient randomization in the ELAN trial, and the results of the asundexian AF trial were discussed during the journal club.

Deeply impressed by the level of preventive medicine, especially concerning cardiovascular diseases, which definitely results in better outcomes and prognoses in stroke patients.

The international atmosphere inside the hospital and the cordiality of all department members are very inspiring.

We were sincerely astonished by the eagerness of all the department members to cooperate with foreign doctors.

Prof. Caso kindly organized a visit to Gemelli Hospital in Rome. While there, we followed a  patient pathway who was first thrombolysed in a stroke  center and treated by thrombectomy in the Gemelli Hospital.

We admired the overwhelming power of teambuilding in Perugia Stroke Unit. Prof. Caso organized a female leadership course at her country house, where we discussed with the residents, young female consultants, and nurses the importance of gender equality in medicine and how to support and create a female network.

In conclusion, this observership was a great opportunity to better understand how a stroke unit should function and gave us new insights into improving our hospital’s stroke center.