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International Journal of Clinical Practice

Adrienne Torda, Victor Chan
BACKGROUND: Many patients admitted to hospital have an antibiotic allergy (AAL) documented in their medical record. In many of these, the reaction is not a hypersensitivity reaction or may no longer be relevant. Despite this, the label adversely affects patient care directly in terms of antibiotic selection, and indirectly in terms of patient costs and the development of antimicrobial resistance. AIMS: To estimate the prevalence of AALs in a cohort of hospitalised patients, to investigate the feasibility of de-labelling through re-challenge based solely upon clinical grounds...
January 17, 2018: International Journal of Clinical Practice
Juan José Gorgojo-Martínez, Manuel Angel Gargallo-Fernández, Miguel Brito-Sanfiel, Arturo Lisbona-Catalán
AIMS: To evaluate in a real-world setting the effectiveness of exenatide once-weekly (ExQW) in patients with T2D and to determine predictors of glycaemic and weight response to this drug at 6 months. METHODS: Observational, retrospective, multicenter study in adult patients with T2D and BMI ≥30 kg/m2 from 4 tertiary Spanish hospitals who started ExQW therapy at least 6 months before the inclusion and had not achieved adequate glycaemic control on oral therapies or other GLP-1 receptor agonists...
January 17, 2018: International Journal of Clinical Practice
Marc-Alexander Ohlow, Ahmed Farah, Thomas Kuntze, Bernward Lauer
BACKGROUND: The decision for coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) in patients with multi-vessel coronary artery disease (mCAD) is currently made by a heart-team approach. Patients' preference is less well investigated. METHODS: All consecutive patients with prior CABG and at least 2 PCI procedures were interviewed whether they would elect bypass surgery or staged PCI in case of a hypothetical scenario in which they had mCAD and CABG or PCI will equally improve symptoms and survival...
January 9, 2018: International Journal of Clinical Practice
Nijole Bernaitis, Tony Badrick, Shailendra Anoopkumar-Dukie
BACKGROUND: Warfarin is used to prevent stroke in patients with atrial fibrillation (AF). Ongoing monitoring of International normalised ratio (INR) and time in therapeutic range (TTR) commonly used to assess the quality of warfarin management are required. Anticoagulant clinics have demonstrated improved TTRs, particularly in countries with poorer control in primary care settings. Reported TTR in Australia has been relatively high; so, it is unknown if benefit would be seen from dedicated warfarin clinics in Australia...
January 9, 2018: International Journal of Clinical Practice
Charat Thongprayoon, Wisit Cheungpasitporn, Michael A Mao, Ankit Sakhuja, Stephen B Erickson
BACKGROUND: The risk of acute kidney injury (AKI) development among hospitalised patients with elevated calcium levels on admission remains unclear. The aim of this study was to assess the risk of AKI in hospitalised patients stratified by various admission serum calcium levels. METHODS: This is a single-centre retrospective study conducted at a tertiary referral hospital. All hospitalised adult patients who had admission calcium levels available between 2009 and 2013 were enrolled...
January 5, 2018: International Journal of Clinical Practice
Fotios Sampsonas, Loukas Kakoullis, Dimosthenis Lykouras, Kiriakos Karkoulias, Konstantinos Spiropoulos
The use of endobronchial ultrasound trans-bronchial needle aspiration (EBUS-TBNA) as the initial diagnostic and staging procedure in patients with suspected, non-metastatic lung cancer has gained substantial support, and is now recommended by numerous guidelines. Whereas considerable attention has been pointed to the reductions in costs achieved by EBUS-TBNA, that has not been the case for some of its more significant benefits, namely the reduction of the diagnostic work-up time and its ability to accurately assess and restage lymph nodes, which were previously stated incorrectly by CT or PET scan...
January 3, 2018: International Journal of Clinical Practice
Matteo Beltrami, Alberto Palazzuoli, Luigi Padeletti, Elisabetta Cerbai, Stefano Coiro, Michele Emdin, Rossella Marcucci, Doralisa Morrone, Matteo Cameli, Ketty Savino, Roberto Pedrinelli, Giuseppe Ambrosio
AIM: Functional analysis and measurement of left atrium are an integral part of cardiac evaluation, and they represent a key element during non-invasive analysis of diastolic function in patients with hypertension (HT) and/or heart failure with preserved ejection fraction (HFpEF). However, diastolic dysfunction remains quite elusive regarding classification, and atrial size and function are two key factors for left ventricular (LV) filling evaluation. Chronic left atrial (LA) remodelling is the final step of chronic intra-cavitary pressure overload, and it accompanies increased neurohormonal, proarrhythmic and prothrombotic activities...
December 28, 2017: International Journal of Clinical Practice
Adrian H Heald, Mark Livingston, David Holland, John Robinson, Gabriela Yc Moreno, Gemma Donnahey, Christopher J Duff, Pensee Wu, Anthony A Fryer
INTRODUCTION: Polycystic ovarian syndrome (PCOS) is one of the commonest endocrine disorders affecting women of reproductive age. We examined the specific tests that are done in primary care to lead to the diagnosis of PCOS, and to support the diagnosis once made. METHODS: One thousand seven hundred and ninety-seven women were identified from a pooled GP practice database. The search included all patients defined with PCOS or related terms. Records included demographic information, medical history (diagnoses), blood test results and whether a pelvic ultrasound scan had been performed...
December 22, 2017: International Journal of Clinical Practice
Carla Araújo, Marta Pereira, Olga Laszczyńska, Paula Dias, Ana Azevedo
BACKGROUND: Real-world data from different levels of hospital specialisation would help to understand if differences in management between women and men with acute coronary syndrome (ACS) are still a priority target. We aimed to identify sex inequalities in management of patients with different types of ACS. METHODS: We analysed 1757 patients with a non-ST-elevation ACS (NSTEACS) and 1184 with ST elevation myocardial infarction (STEMI) or left bundle branch block (non-classifiable (NC) ACS (STEMI/NC ACS group), consecutively discharged from ten Portuguese hospitals with different specialisation levels, between 2008 and 2010...
December 22, 2017: International Journal of Clinical Practice
Anastazia Kei, Freideriki Koutsouka, Andromachi Makri, Moses Elisaf
BACKGROUND: Although the relationship of elevated serum uric acid levels and cardiovascular disease has been established in a great number of studies, the causal relevance of this finding remains ambiguous. An approach to evaluate the causal relevance of biomarkers is to exploit the natural randomised allocation of allelic variation in genes affecting their level, also known as Mendelian randomisation. AIM: The aim of this paper is to review the current literature regarding serum uric acid levels and cardiovascular and renal disease risk in Mendelian randomisation studies...
December 18, 2017: International Journal of Clinical Practice
Lior Dar, Shmuel Tiosano, Abdulla Watad, Nicola Luigi Bragazzi, Devi Zisman, Doron Comaneshter, Arnon Cohen, Howard Amital
OBJECTIVES: In recent years, both the prevalence of obesity and the incidence of RA have been rising. Our aim was to assess the association between overweight or obesity and rheumatoid arthritis (RA). DESIGN: Patients who were diagnosed with RA were compared with population-based controls, matched for age and sex (by a ratio of 1:5). Body measurements and smoking status were collected from medical records. Body mass index was classified in WHO categories of underweight, normal, overweight and obese (<18...
December 12, 2017: International Journal of Clinical Practice
Ana Paula Helfer Schneider, Mari Ângela Gaedke, Anderson Garcez, Nêmora Tregnago Barcellos, Vera Maria Vieira Paniz
INTRODUCTION: Cardiovascular medications are effective in prevention of cardiovascular diseases (CVD); however, medication non-adherence contributes to morbidity and mortality. OBJECTIVE: This systematic review and meta-analysis aims to summarise the evidence regarding the relationship between characteristics of drug therapy (pharmacotherapy) and medication non-adherence in the CVD population. METHODS: Systematic searches in PubMed, LILACS, Academic Search and CINAHL databases for observational studies that enrolled adults with CVD were performed, from January 1960 to December 2015...
November 29, 2017: International Journal of Clinical Practice
Yohana Mashalla, Vincent Setlhare, Amos Massele, Enoch Sepako, Celda Tiroyakgosi, Joyce Kgatlwane, Mpo Chuma, Brian Godman
BACKGROUND AND AIMS: Inappropriate drug prescribing has increased especially in developing countries where systems for monitoring medicine use are not well developed. This increases the rate of antimicrobial resistance. The study aim was to assess the prescribing patterns among urban primary health facilities in Botswana to provide future guidance including developing future quality indicators. METHODS: Retrospective data from patients' records between January and December 2013 in 19 clinics were collected in a cross-sectional study...
November 27, 2017: International Journal of Clinical Practice
Gati Dhroove
No abstract text is available yet for this article.
November 22, 2017: International Journal of Clinical Practice
Suresh Durgam, Willie Earley, Kaifeng Lu, György Németh, István Laszlovszky, Stephen Volk, Robert E Litman
INTRODUCTION: Global rating scale measures are useful for assessing the clinical relevance of patient change. Cariprazine, a dopamine D3 and D2 receptor partial agonist, is FDA-approved for the adult treatment of acute manic/mixed episodes of bipolar I disorder and schizophrenia. Post hoc evaluations of Clinical Global Impressions-Severity (CGI-S) scores from the cariprazine pivotal trials in both indications were conducted. METHODS: Data from 3 bipolar mania and 3 schizophrenia trials were pooled by indication (bipolar disorder = 1033; schizophrenia = 1466)...
November 9, 2017: International Journal of Clinical Practice
Luan Koay, Joanne Rose, Ahmed H Abdelhafiz
OBJECTIVES: Parkinson disease (PD) frequently leads to acute hospitalisation resulting in increased cost to health care systems and reduced quality of life for patients. The objective of this review was to identify causes that lead to acute hospitalisation of patients with PD. METHODS: A systematic review of English language literature from 1997 to present. FINDINGS: The incidences of acute general medical or surgical problems that trigger acute hospitalisation in patients with PD are similar to those in the general population...
November 9, 2017: International Journal of Clinical Practice
Carolina de Oliveira Cruz Latorraca, Ana Luiza Cabrera Martimbianco, Daniela Vianna Pachito, Rafael Leite Pacheco, Rachel Riera
BACKGROUND: Nineteen million adults worldwide are in need of palliative care. Of those who have access to it, 80% fail to receive an efficient management of symptoms. OBJECTIVES: To assess the effectiveness and safety of mindfulness meditation for palliative care patients. METHODS: We searched CENTRAL, MEDLINE, Embase, LILACS, PEDro, CINAHL, PsycINFO, Opengrey, and WHO-ICTRP. No restriction of language, status or date of publication was applied...
November 6, 2017: International Journal of Clinical Practice
Lu Yang, Wenbo Peng, Jon Adams, David Sibbritt
BACKGROUND: There is growing acupuncture use amongst people with osteoarthritis, and acupuncture has been shown to have a positive effect on osteoarthritis. The aim of the study is to identify the characteristics of Australian women who consult acupuncturists for osteoarthritis treatment in order to help inform patients, practitioners and policy makers about the range of health care options accessed by older women with osteoarthritis. METHODS: The research reported here involved participants from a sub-study of the Sax Institute's 45 and Up Study in Australia...
November 3, 2017: International Journal of Clinical Practice
Karin Weigel, Christian H Nickel, Alexandra Malinovska, Roland Bingisser
BACKGROUND: The type and number of symptoms in emergency patients differ widely. It remains unclear, if outcomes can be predicted by the number of symptoms. Furthermore, it is unknown, whether clinical practice could be influenced by presenting symptoms. METHODS: Prospective observational study, performed in the emergency department of the University Hospital Basel, a tertiary hospital. A consecutive sample of patients was interviewed at presentation for a predefined set of 35 symptoms...
October 26, 2017: International Journal of Clinical Practice
Paul Valensi, Lise Lotte N Husemoen, James Weatherall, Louis Monnier
No abstract text is available yet for this article.
December 2017: International Journal of Clinical Practice
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