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[PMID]:28902377
[Au] Autor:Marahrens L; Röck D; Ziemssen T; Kern R; Ziemssen F; Fritsche A
[Ad] Endereço:Universitäts-Augenklinik Tübingen, Eberhard Karls Universität, Tübingen.
[Ti] Título:[Implementation of the National Guidelines for the treatment of Diabetes mellitus type 2 in secondary diabetes centers].
[Ti] Título:Umsetzung der Nationalen VersorgungsLeitlinie (NVL) zur Therapie des Diabetes mellitus Typ 2 in diabetologischen Schwerpunktpraxen..
[So] Source:Dtsch Med Wochenschr;142(18):e131-e139, 2017 Sep.
[Is] ISSN:1439-4413
[Cp] País de publicação:Germany
[La] Idioma:ger
[Ab] Resumo:The German National Disease Management Guideline (NVL) on treatment of Type 2 Diabetes recommends lowering of blood glucose in four therapy steps. There is little evidence, how NVL is implemented for the individual patients. 810 patients in secondary diabetes centers were examined within the DiabCheck trial. Data about the patient's health status (electronic medical record) were classified according to the NVL treatment steps. The degree of implementation was assessed for every person with diabetes type 2 (NCT02 311 504). Related to the levels of treatment, 81 % of patients received metformin in level 2, 48 % the dual combination of metformin with DPP4-Inhibitors (level 3) and 41 % an intensified insulin therapy in combination with metformin (level 4). The overall percentage for metformin was 67 %, for DPP4-Inhibitors 20 % and 10 % for sulfonylureas.The duration of diabetes significantly increased with higher NVL level. After 3 years of diabetes 55 % received more than one antihyperglycemic drug. Half of the patients were treated with complex insulin strategies after 9 years, however almost all after 25 years. The therapy in secondary care centers met national guidelines to a large extent. Similar proof of implementation would be important for primary care by general practitioners. As the factual information of the therapy level strongly correlated with the duration of disease, it might be used for structured communication (risk profile).
[Mh] Termos MeSH primário: Diabetes Mellitus Tipo 2/tratamento farmacológico
Diabetes Mellitus Tipo 2/epidemiologia
Hipoglicemiantes/uso terapêutico
Centros de Cuidados de Saúde Secundários/estatística & dados numéricos
[Mh] Termos MeSH secundário: Glicemia
Inibidores da Dipeptidil Peptidase IV/uso terapêutico
Alemanha/epidemiologia
Seres Humanos
Insulina/uso terapêutico
Metformina/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Blood Glucose); 0 (Dipeptidyl-Peptidase IV Inhibitors); 0 (Hypoglycemic Agents); 0 (Insulin); 9100L32L2N (Metformin)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170927
[Lr] Data última revisão:
170927
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170914
[St] Status:MEDLINE
[do] DOI:10.1055/s-0043-111388


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[PMID]:28364525
[Au] Autor:Klein HJ; Simic D; Fuchs N; Schweizer R; Mehra T; Giovanoli P; Plock JA
[Ad] Endereço:University Hospital Zurich, Zurich, Switzerland.
[Ti] Título:Complications After Cosmetic Surgery Tourism.
[So] Source:Aesthet Surg J;37(4):474-482, 2017 04 01.
[Is] ISSN:1527-330X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Background: Cosmetic surgery tourism characterizes a phenomenon of people traveling abroad for aesthetic surgery treatment. Problems arise when patients return with complications or need of follow-up care. Objectives: To investigate the complications of cosmetic surgery tourism treated at our hospital as well as to analyze arising costs for the health system. Methods: Between 2010 and 2014, we retrospectively included all patients presenting with complications arising from cosmetic surgery abroad. We reviewed medical records for patients' characteristics including performed operations, complications, and treatment. Associated cost expenditure and Diagnose Related Groups (DRG)-related reimbursement were analyzed. Results: In total 109 patients were identified. All patients were female with a mean age of 38.5 ± 11.3 years. Most procedures were performed in South America (43%) and Southeast (29.4%) or central Europe (24.8%), respectively. Favored procedures were breast augmentation (39.4%), abdominoplasty (11%), and breast reduction (7.3%). Median time between the initial procedure abroad and presentation was 15 days (interquartile range [IQR], 9) for early, 81.5 days (IQR, 69.5) for midterm, and 4.9 years (IQR, 9.4) for late complications. Main complications were infections (25.7%), wound breakdown (19.3%), and pain/discomfort (14.7%). The majority of patients (63.3%) were treated conservatively; 34.8% became inpatients with a mean hospital stay of 5.2 ± 3.8 days. Overall DRG-related reimbursement premiums approximately covered the total costs. Conclusions: Despite warnings regarding associated risks, cosmetic surgery tourism has become increasingly popular. Efficient patients' referral to secondary/tertiary care centers with standardized evaluation and treatment can limit arising costs without imposing a too large burden on the social healthcare system. Level of Evidence: 4.
[Mh] Termos MeSH primário: Assistência à Saúde/economia
Custos de Cuidados de Saúde/estatística & dados numéricos
Tempo de Internação/economia
Turismo Médico
Complicações Pós-Operatórias/economia
Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Feminino
Seres Humanos
Reembolso de Seguro de Saúde/economia
Meia-Idade
Procedimentos Cirúrgicos Reconstrutivos/economia
Encaminhamento e Consulta/economia
Estudos Retrospectivos
Centros de Cuidados de Saúde Secundários/normas
Suíça
Centros de Atenção Terciária/normas
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170825
[Lr] Data última revisão:
170825
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170402
[St] Status:MEDLINE
[do] DOI:10.1093/asj/sjw198


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[PMID]:28245242
[Au] Autor:Addison NO; Pfau S; Koka E; Aboagye SY; Kpeli G; Pluschke G; Yeboah-Manu D; Junghanss T
[Ad] Endereço:Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.
[Ti] Título:Assessing and managing wounds of Buruli ulcer patients at the primary and secondary health care levels in Ghana.
[So] Source:PLoS Negl Trop Dis;11(2):e0005331, 2017 Feb.
[Is] ISSN:1935-2735
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Beyond Mycobacterium ulcerans-specific therapy, sound general wound management is required for successful management of Buruli ulcer (BU) patients which places them among the large and diverse group of patients in poor countries with a broken skin barrier. METHODS: Clinically BU suspicious patients were enrolled between October 2013 and August 2015 at a primary health care (PHC) center and a municipal hospital, secondary health care (SHC) center in Ghana. All patients were IS2404 PCR tested and divided into IS2404 PCR positive and negative groups. The course of wound healing was prospectively investigated including predictors of wound closure and assessment of infrastructure, supply and health staff performance. RESULTS: 53 IS2404 PCR positive patients-31 at the PHC center and 22 at the SHC center were enrolled-and additionally, 80 clinically BU suspicious, IS2404 PCR negative patients at the PHC center. The majority of the skin ulcers at the PHC center closed, without the need for surgical intervention (86.7%) compared to 40% at the SHC center, where the majority required split-skin grafting (75%) or excision (12.5%). Only 9% of wounds at the PHC center, but 50% at the SHC center were complicated by bacterial infection. The majority of patients, 54.8% at the PHC center and 68.4% at the SHC center, experienced wound pain, mostly severe and associated with wound dressing. Failure of ulcers to heal was reliably predicted by wound area reduction between week 2 and 4 after initiation of treatment in 75% at the PHC center, and 90% at the SHC center. Obvious reasons for arrested wound healing or deterioration of wound were missed additional severe pathology; at the PHC center (chronic osteomyelitis, chronic lymphedema, squamous cell carcinoma) and at the SHC center (malignant ulceration, chronic lymphedema) in addition to hygiene and wound care deficiencies. When clinically suspicious, but IS2404 PCR negative patients were recaptured in the community, 76/77 (98.7%) of analyzed wounds were either completely closed (85.7%) or almost closed (13%). Five percent were found to have important missed severe pathology (chronic osteomyelitis, ossified fibroma and suspected malignancy). CONCLUSION: The wounds of most BU patients attending the primary health care level can be adequately managed. Additionally, the patients are closer to their families and means of livelihood. Non-healing wounds can be predicted by wound area reduction between 2 to 4 weeks after initiation of treatment. Patients with clinically BU suspicious, but PCR negative ulcers need to be followed up to capture missed diagnoses.
[Mh] Termos MeSH primário: Úlcera de Buruli/terapia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Úlcera de Buruli/microbiologia
Úlcera de Buruli/fisiopatologia
Criança
Pré-Escolar
Feminino
Gana
Seres Humanos
Lactente
Masculino
Meia-Idade
Mycobacterium ulcerans/genética
Mycobacterium ulcerans/isolamento & purificação
Mycobacterium ulcerans/fisiologia
Atenção Primária à Saúde/estatística & dados numéricos
Estudos Prospectivos
Centros de Cuidados de Saúde Secundários/estatística & dados numéricos
Cicatrização
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170714
[Lr] Data última revisão:
170714
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170301
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pntd.0005331


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[PMID]:28224769
[Au] Autor:Kim D; Ahn JY; Lee CH; Jang SJ; Lee H; Yong D; Jeong SH; Lee K
[Ad] Endereço:Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea.
[Ti] Título:Increasing Resistance to Extended-Spectrum Cephalosporins, Fluoroquinolone, and Carbapenem in Gram-Negative Bacilli and the Emergence of Carbapenem Non-Susceptibility in Klebsiella pneumoniae: Analysis of Korean Antimicrobial Resistance Monitoring System (KARMS) Data From 2013 to 2015.
[So] Source:Ann Lab Med;37(3):231-239, 2017 May.
[Is] ISSN:2234-3814
[Cp] País de publicação:Korea (South)
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: National surveillance of antimicrobial resistance becomes more important for the control of antimicrobial resistance and determination of treatment guidelines. We analyzed Korean Antimicrobial Resistance Monitoring System (KARMS) data collected from 2013 to 2015. METHODS: Of the KARMS participants, 16 secondary or tertiary hospitals consecutively reported antimicrobial resistance rates from 2013 to 2015. Data from duplicate isolates and institutions with fewer than 20 isolates were excluded. To determine the long-term trends, previous KARMS data from 2004 to 2012 were also considered. RESULTS: The prevalence of methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus faecium from 2013 to 2015 was 66-72% and 29-31%, respectively. The resistance rates of Escherichia coli to cefotaxime and cefepime gradually increased to 35% and 31%, respectively, and fluoroquinolone resistance reached 48% in 2015. The resistance rates of Klebsiella pneumoniae to cefotaxime, cefepime, and carbapenem were 38-41%, 33-41%, and <0.1-2%, respectively, from 2013 to 2015. The carbapenem susceptibility rates of E. coli and K. pneumoniae decreased from 100% and 99.3% in 2011 to 99.0% and 97.0% in 2015, respectively. The resistance rate of Pseudomonas aeruginosa to carbapenem increased to 35% and the prevalence of carbapenem-resistant Acinetobacter baumannii increased from 77% in 2013 to 85% in 2015. CONCLUSIONS: Between 2013 and 2015, the resistance rates of E. coli to third- and fourth-generation cephalosporins increased continuously, while carbapenem-susceptibility gradually decreased, particularly in K. pneumoniae. The prevalence of carbapenem-resistant P. aeruginosa and A. baumannii increased significantly; therefore, few treatment options remain for these resistant strains.
[Mh] Termos MeSH primário: Antibacterianos/farmacologia
Farmacorresistência Bacteriana
Bactérias Gram-Negativas/efeitos dos fármacos
Klebsiella pneumoniae/efeitos dos fármacos
[Mh] Termos MeSH secundário: Grupo com Ancestrais do Continente Asiático
Carbapenêmicos/farmacologia
Cefalosporinas/farmacologia
Bases de Dados Factuais
Fluoroquinolonas/farmacologia
Bactérias Gram-Negativas/isolamento & purificação
Bactérias Gram-Positivas/efeitos dos fármacos
Bactérias Gram-Positivas/isolamento & purificação
Seres Humanos
Klebsiella pneumoniae/isolamento & purificação
Testes de Sensibilidade Microbiana
República da Coreia
Centros de Cuidados de Saúde Secundários
Centros de Atenção Terciária
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Carbapenems); 0 (Cephalosporins); 0 (Fluoroquinolones)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170501
[Lr] Data última revisão:
170501
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170223
[St] Status:MEDLINE
[do] DOI:10.3343/alm.2017.37.3.231


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[PMID]:28092247
[Au] Autor:López-Ocaña LR; Hernández-Pineda NA; Cruz-Cruz PR; Ramiro-H M; Pérez Del Valle-Ibarra VO
[Ad] Endereço:Coordinación de Atención Integral en Segundo Nivel, Instituto Mexicano del Seguro Social, Ciudad de México, México. pol_roc@hotmail.com.
[Ti] Título:[Emergency obstetric causes and Immediate Response Team in a secondary hospital].
[Ti] Título:Causas de emergencia obstétrica y Equipo de Respuesta Inmediata en un hospital de segundo nivel..
[So] Source:Rev Med Inst Mex Seguro Soc;55(1):48-51, 2017 Jan-Feb.
[Is] ISSN:0443-5117
[Cp] País de publicação:Mexico
[La] Idioma:spa
[Ab] Resumo:BACKGROUND: The aim of this work is to describe the causes of the obstetric emergency, which motivates the activation of the Immediate Response Team at a second level hospital of the Instituto Mexicano del Seguro Social, which has not an Intensive Care Unit for Adult Patients. METHODS: Retrospective observational study of the causes of obstetric emergency that occurred in the domains of Admission, Hospitalization, Labor, Delivery Room, Operating Room and Recovery of the Hospital General de Zona 53 of the IMSS, during the years 2014 and 2015. RESULTS: In 2014, were attended 3915 women due to obstetric cause; of them, 75 cases were of obstetric emergency and 3276 live births. In 2015, were 4390 women with 3842 live births and 80 cases of obstetric emergency. The main domains where performed the Immediate Response Team were: Labor, Admission and Recovery. In 2014, preeclampsia-eclampsia-Hellp ranked first as a cause of obstetric emergency: 42 cases, also in 2015: 36 cases; followed by obstetric hemorrhage with 28 and 34 cases, respectively. In 2014, there was a maternal death from severe preeclampsia and extensive liver rupture. CONCLUSIONS: Consolidation of Immediate Response Team at a hospital, according to the healthcare environment, it is essential, above all, within the meaning given by staff members.
[Mh] Termos MeSH primário: Serviços Médicos de Emergência
Complicações do Trabalho de Parto/etiologia
Complicações do Trabalho de Parto/terapia
Centros de Cuidados de Saúde Secundários
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
México
Complicações do Trabalho de Parto/diagnóstico
Gravidez
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170809
[Lr] Data última revisão:
170809
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170117
[St] Status:MEDLINE


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[PMID]:28066962
[Au] Autor:Melaku Z; Lulseged S; Wang C; Lamb MR; Gutema Y; Teasdale CA; Ahmed S; Gadisa T; Habtamu Z; Bedri A; Fayorsey R; Abrams EJ
[Ad] Endereço:ICAP in Ethiopia, Addis Ababa, Ethiopia.
[Ti] Título:Outcomes among HIV-infected children initiating HIV care and antiretroviral treatment in Ethiopia.
[So] Source:Trop Med Int Health;22(4):474-484, 2017 Apr.
[Is] ISSN:1365-3156
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To describe pediatric ART scale-up in Ethiopia, one of the 21 global priority countries for elimination of pediatric HIV infection. METHODS: A descriptive analysis of routinely collected HIV care and treatment data on HIV-infected children (<15 years) enrolled at 70 health facilities in four regions in Ethiopia, January 2006-September 2013. Characteristics at enrollment and ART initiation are described along with outcomes at 1 year after enrollment. Among children who initiated ART, cumulative incidence of death and loss to follow-up (LTF) were estimated using survival analysis. RESULTS: 11 695 children 0-14 years were enrolled in HIV care and 6815 (58.3%) initiated ART. At enrollment, 31.2% were WHO stage III and 6.3% stage IV. The majority (87.9%) were enrolled in secondary or tertiary facilities. At 1 year after enrollment, 17.9% of children were LTF prior to ART initiation. Among children initiating ART, cumulative incidence of death was 3.4%, 4.1% and 4.8%, and cumulative incidence of LTF was 7.7%, 11.8% and 16.6% at 6, 12 and 24 months, respectively. Children <2 years had higher risk of LTF and death than older children (P < 0.0001). Children with more advanced disease and those enrolled in rural settings were more likely to die. Children enrolled in more recent years were less likely to die but more likely to be LTF. CONCLUSIONS: Over the last decade large numbers of HIV-infected children have been successfully enrolled in HIV care and initiated on ART in Ethiopia. Retention prior to and after ART initiation remains a major challenge.
[Mh] Termos MeSH primário: Fármacos Anti-HIV/uso terapêutico
Infecções por HIV
Perda de Seguimento
[Mh] Termos MeSH secundário: Adolescente
Antirretrovirais
Criança
Pré-Escolar
Etiópia
Feminino
Seguimentos
Infecções por HIV/tratamento farmacológico
Infecções por HIV/mortalidade
Seres Humanos
Lactente
Recém-Nascido
Masculino
Fatores de Risco
População Rural
Centros de Cuidados de Saúde Secundários
Índice de Gravidade de Doença
Centros de Atenção Terciária
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-HIV Agents); 0 (Anti-Retroviral Agents)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170705
[Lr] Data última revisão:
170705
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170110
[St] Status:MEDLINE
[do] DOI:10.1111/tmi.12834


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[PMID]:27861707
[Au] Autor:McGoldrick EL; Brown JA; Groom KM; Crowther CA
[Ad] Endereço:Liggins Institute, The University of Auckland, Auckland, New Zealand.
[Ti] Título:Investigating antenatal corticosteroid clinical guideline practice at an organisational level.
[So] Source:Aust N Z J Obstet Gynaecol;57(1):25-32, 2017 Feb.
[Is] ISSN:1479-828X
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: High-quality, evidence-based guidelines can improve the quality of health care and facilitate standardisation of practice within and across healthcare organisations. Limited information is known regarding existing antenatal corticosteroid (ACS) guideline practices within organisations across Australia and New Zealand. AIMS: To assess existing ACS clinical practice guidelines (CPG). To describe current organisational practice related to the production, implementation and renewal of CPG. DESIGN: A cross-sectional survey of hospital practice using an online questionnaire. METHODS: Clinical Managers at 27 secondary and 25 tertiary maternity hospitals, that contribute data to the Australia and New Zealand Neonatal Network, were approached from May to September 2015 and completed the questionnaire on behalf of their organisation. RESULTS: Of the hospitals surveyed, 93% reported having a CPG or protocol. Of these, 89% of CPG included recommendations on a single course of ACS, 37% on the use of repeat course/s and 41% on use prior to elective caesarean section at term. Variation in the recommendations provided existed between countries and depending on the level of neonatal care provided. A guideline development group existed in 85% of hospitals. The preferred tools to facilitate implementation of a CPG include: email with a link to the hospital intranet, education sessions and an opinion leader. Only 28% of respondents reported auditing the use of ACS administration. CONCLUSIONS: There is significant variation in the recommendations provided by current ACS CPGs. Utilisation of a single ACS CPG reflective of the current available evidence base may limit this variation.
[Mh] Termos MeSH primário: Corticosteroides/uso terapêutico
Maternidades/normas
Guias de Prática Clínica como Assunto
Cuidado Pré-Natal/normas
[Mh] Termos MeSH secundário: Austrália
Protocolos Clínicos
Estudos Transversais
Feminino
Maternidades/organização & administração
Seres Humanos
Nova Zelândia
Política Organizacional
Gravidez
Desenvolvimento de Programas
Centros de Cuidados de Saúde Secundários/normas
Inquéritos e Questionários
Centros de Atenção Terciária/normas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Adrenal Cortex Hormones)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170324
[Lr] Data última revisão:
170324
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161119
[St] Status:MEDLINE
[do] DOI:10.1111/ajo.12564


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[PMID]:27988235
[Au] Autor:Gado AS; Ebeid BA; Axon AT
[Ad] Endereço:Department of Medicine, Bolak Eldakror Hospital, Giza, Egypt. Electronic address: agado1954@yahoo.com.
[Ti] Título:Quality assurance in gastrointestinal endoscopy: An Egyptian experience.
[So] Source:Arab J Gastroenterol;17(4):153-158, 2016 Dec.
[Is] ISSN:2090-2387
[Cp] País de publicação:Egypt
[La] Idioma:eng
[Ab] Resumo:Over the last four decades, gastrointestinal endoscopy has become of paramount importance to diagnose, treat and prevent diseases of the digestive tract. Practice variation, however, is likely to have an important effect on the effectiveness of endoscopy and can impair the delivery of high-quality endoscopic procedures. There have been increasing demands to assess the quality of service and track and improve patient outcomes. Quality assurance has paved its way into professional guidelines for physicians. Developing a modern endoscopy unit demands the institution of a quality assurance programme, continuous training and monitoring of service delivery. This article describes our experience in implementing a quality assurance programme in endoscopy in a secondary care government hospital in Egypt. The implementation of quality assurance and improvement programme can lead to dramatic improvements in the quality of endoscopic care and patient outcomes. Quality assurance and continual improvement can be applied in developing countries.
[Mh] Termos MeSH primário: Endoscopia Gastrointestinal/normas
Unidades Hospitalares/normas
Garantia da Qualidade dos Cuidados de Saúde/métodos
Melhoria de Qualidade
[Mh] Termos MeSH secundário: Egito
Endoscopia Gastrointestinal/educação
Unidades Hospitalares/organização & administração
Seres Humanos
Desenvolvimento de Programas
Indicadores de Qualidade em Assistência à Saúde
Centros de Cuidados de Saúde Secundários
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170217
[Lr] Data última revisão:
170217
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161219
[St] Status:MEDLINE


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[PMID]:27933580
[Au] Autor:Schramm S; Uluduz D; Gouveia RG; Jensen R; Siva A; Uygunoglu U; Gvantsa G; Mania M; Braschinsky M; Filatova E; Latysheva N; Osipova V; Skorobogatykh K; Azimova J; Straube A; Eren OE; Martelletti P; De Angelis V; Negro A; Linde M; Hagen K; Radojicic A; Zidverc-Trajkovic J; Podgorac A; Paemeleire K; De Pue A; Lampl C; Steiner TJ; Katsarava Z
[Ad] Endereço:Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Duisburg-Essen, Hufelandstr, 55, 45122, Essen, Germany. sara.schramm@uk-essen.de.
[Ti] Título:Headache service quality: evaluation of quality indicators in 14 specialist-care centres.
[So] Source:J Headache Pain;17(1):111, 2016 Dec.
[Is] ISSN:1129-2377
[Cp] País de publicação:Italy
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The study was a collaboration between Lifting The Burden (LTB) and the European Headache Federation (EHF). Its aim was to evaluate the implementation of quality indicators for headache care Europe-wide in specialist headache centres (level-3 according to the EHF/LTB standard). METHODS: Employing previously-developed instruments in 14 such centres, we made enquiries, in each, of health-care providers (doctors, nurses, psychologists, physiotherapists) and 50 patients, and analysed the medical records of 50 other patients. Enquiries were in 9 domains: diagnostic accuracy, individualized management, referral pathways, patient's education and reassurance, convenience and comfort, patient's satisfaction, equity and efficiency of the headache care, outcome assessment and safety. RESULTS: Our study showed that highly experienced headache centres treated their patients in general very well. The centres were content with their work and their patients were content with their treatment. Including disability and quality-of-life evaluations in clinical assessments, and protocols regarding safety, proved problematic: better standards for these are needed. Some centres had problems with follow-up: many specialised centres operated in one-touch systems, without possibility of controlling long-term management or the success of treatments dependent on this. CONCLUSIONS: This first Europe-wide quality study showed that the quality indicators were workable in specialist care. They demonstrated common trends, producing evidence of what is majority practice. They also uncovered deficits that might be remedied in order to improve quality. They offer the means of setting benchmarks against which service quality may be judged. The next step is to take the evaluation process into non-specialist care (EHF/LTB levels 1 and 2).
[Mh] Termos MeSH primário: Cefaleia/terapia
Pessoal de Saúde/normas
Indicadores de Qualidade em Assistência à Saúde/normas
Centros de Cuidados de Saúde Secundários/normas
Especialização/normas
Centros de Atenção Terciária/normas
[Mh] Termos MeSH secundário: Adulto
Europa (Continente)/epidemiologia
Feminino
Cefaleia/diagnóstico
Cefaleia/epidemiologia
Seres Humanos
Masculino
Avaliação de Resultados (Cuidados de Saúde)/métodos
Avaliação de Resultados (Cuidados de Saúde)/normas
Satisfação do Paciente
Estudos Prospectivos
Encaminhamento e Consulta
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161210
[St] Status:MEDLINE


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[PMID]:27817172
[Au] Autor:Abou-Shaaban M; Ali AA; Rao PG; Majid A
[Ad] Endereço:Department of Clinical Pharmacy and Pharmacology, RAK Medical and Health Sciences University, Ras Al Khaimah, UAE.
[Ti] Título:Drug utilization review of cephalosporins in a secondary care hospital in United Arab Emirates.
[So] Source:Int J Clin Pharm;38(6):1367-1371, 2016 Dec.
[Is] ISSN:2210-7711
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Background Cephalosporins are one of the most commonly used antibiotics in United Arab Emirates (UAE). Few studies have been carried out to evaluate the antibiotic utilization pattern in UAE in spite of the obvious increase in cephalosporins resistance during the past decade. Objective To assess the prescriptions pattern of cephalosporins among physicians at a secondary care hospital in Ras Al Khaimah, UAE. Method This observational prospective study was carried out during October 2013 to April 2014. The data of in patients were documented in the predesigned patient profile form and was analyzed for patient's, drug's and drug's therapy related parameters. Results The 3rd generation cephalosporins constituted 83.6 % of the prescriptions, with ceftriaxone being the most commonly used one (81.1 %). They were mainly prescribed for the treatment of the lower respiratory tract infections (60.2 %). Seven (3.5 %) different ADRs linked to cephalosporin use were observed ranging from oral thrush to clostridium difficile infection. A total of 1039 antimicrobial and nonantimicrobial medications were prescribed concomitantly with cephalosporins. Conclusion The 3rd generation cephalosporins were commonly prescribed by parenteral route. Thus, there is a strong need for rationalizing their use to preserve their efficacy and prevent the development of resistance in the region.
[Mh] Termos MeSH primário: Antibacterianos
Cefalosporinas
Revisão de Uso de Medicamentos/métodos
Centros de Cuidados de Saúde Secundários/tendências
Atenção Secundária à Saúde/tendências
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Prospectivos
Atenção Secundária à Saúde/normas
Centros de Cuidados de Saúde Secundários/normas
Emirados Árabes Unidos/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Cephalosporins)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161107
[St] Status:MEDLINE



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