scholarly journals ANTIGLAUCOMA WORK IN PERM: PROBLEMS AND WAYS OF DECISION

2018 ◽  
Vol 35 (1) ◽  
pp. 75-81
Author(s):  
L I Soloviyeva ◽  
T V Gavrilova ◽  
N A Sobyanin
Keyword(s):  
Early Detection ◽  
Medical Care ◽  
Retrospective Analysis ◽  
Medical Staff ◽  
Adult Population ◽  
Population Prevalence ◽  
Morbidity Index ◽  
Centralized System

Aim. To analyze the state of antiglaucoma work in Perm and determine the necessary organizational measures, permitting to improve early detection of glaucoma and quality of patients’ follow-up observation. Materials and methods. Retrospective analysis of reports of ophthalmologists from 15 treatment-and-prophylactic institutions of Perm and statistical reports of Medicosocial Examination Bureau for 7 years (2010-2016) was carried out. Results. Morbidity index in Perm during 2010-2016 does not reveal an evident dynamics and ranges 0.69 to 0.7 per 1000 of the adult population. Prevalence of glaucoma is 10.95-11.8 per 1000 of the adult population. The share of patients with first-diagnosed degree I-II glaucomas ranged from 81.1 % to 86.4 %. Conclusions. The centralized system of rendering qualified medical care permits to develop and observe specialized standards of antiglaucoma activity, to introduce the recent scientific designs, to train medical staff for management of patients.

scholarly journals Quality of follow-up monitoring of the adult population with grade 1-3 hypertension, with the exception of resistant hypertension, by primary care physicians in different Russian regions

2021 ◽  
Vol 26 (4) ◽  
pp. 4332
Author(s):  
O. M. Drapkina ◽  
R. N. Shepel ◽  
L. Yu. Drozdova ◽  
A. M. Kalinina ◽  
E. S. Bulgakova ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Care ◽  
Resistant Hypertension ◽  
Clinical Guidelines ◽  
Primary Care Physicians ◽  
Adult Population ◽  
Russian Regions ◽  
Target Values

In view of the high prevalence of hypertension (HTN) among Russian population, it becomes extremely important to meet the criteria for the medical care quality within the periodic examinations for this group of patients.Aim.  To assess the quality of follow-up monitoring of the adult population with grade 1-3 hypertension, with the exception of resistant hypertension (RH), by primary care physicians in different Russian regions.Materials and methods. As part of working visits of the expert group from the National Medical Research Center for Therapy and Preventive Medicine in 38 Russian regions in the period from February 1, 2020 to December 15, 2020, an analysis of ambulatory records of patients with grade 1-3 hypertension was carried out. A total of 3614 ambulatory medical records (AMRs) were analyzed, of which the grade 1-3 hypertension, with the exception of RH, was revealed in 764 ones. The analysis of records was carried out using an original checklist. Statistical processing was carried out using the software package IBM SPSS Statistics 20 (USA) and Microsoft Office Excel 2016 (USA).Results. An analysis of 764 AMRs was performed. The mean age of patients was 63,9-11,2 (women, 64,7-11,3 years; men, 62,7-10,9 years). The majority (58,9%) of participants were women. Follow-up monitoring was established in a timely manner in 450 people (58,9%) of patients, of which there were 189 men (42%) and 261 women (58%). In 87,9% (n=672) of cases, the diagnosis formulation met the established clinical guidelines criteria. In 36 cases (4,7%), there was no evidence in favor of hypertension according to the current clinical guidelines. In 21,1% (n=161) of cases, the minimum recommended periodicity of visits was not observed. In last visits of 323 patients, the blood pressure did not reach the target values. AMRs did not contain information on low-density lipoprotein cholesterol (LDL-C) in 91б4% of cases (n=698). Among patients with a known level of LDL-C, the target values were achieved only in 15,2% of cases (n=10).Conclusion. Our analysis revealed the insufficient quality of outpatient medical care to hypertensive patients within the periodic examinations. Proposals are created for monitoring and measures to improve the quality of care for this category of patients.

Evaluation of medical care for Diabetic and Hypertensive patients in primary care in Mexico: Observational retrospective study (Preprint)

2020 ◽  
Author(s):  
Agustin Lara-Esqueda ◽  
Sergio A Zaizar-Fregoso ◽  
Violeta M Madrigal-Perez ◽  
Mario Ramirez-Flores ◽  
Daniel A Montes-Galindo ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Medical Care ◽  
Serum Lipids ◽  
Quality Care ◽  
Premature Death ◽  
Current Standard ◽  
Anonymized Data ◽  
Quality Of Medical Care

BACKGROUND Diabetes Mellitus is a worldwide health problem and the leading cause of premature death with increasing prevalence over time. Usually, along with it, Hypertension presents and acts as another risk factor that increases mortality risk. Both diseases impact the country's health while also producing an economic burden for society, causing billions of dollars to be invested in their management. OBJECTIVE The present study evaluated the quality of medical care for patients diagnosed with diabetes mellitus (DM), hypertension (HBP), and both pathologies (DM+HBP) within a public health system in Mexico, according to the official Mexican standard for each pathology. METHODS 45,498 patients were included from 2012 to 2015. All information was taken from the electronic medical records database, exported as anonymized data for research purposes. Each patient record was compared against the standard to test the quality of medical care. RESULTS Glycemia with hypertension goals reached 29.6% in DM+HBP, 48.6% in DM, and 53.2% in HBP. The goals of serum lipids were reached by 3% in DM+HBP, 5% in DM, and 0.2% in HBP. Glycemia, hypertension, and LDL cholesterol reached 0.04%. 15% of patients had an undiagnosed disease of diabetes or hypertension. Clinical follow-up examinations reached 20% for foot examination and clinical eye examination in the whole population. Specialty referral reached 1% in angiology or cardiology in the whole population. CONCLUSIONS Goals for glycemic and hypertension reached 50% in the overall population, while serum lipids, clinical follow-up examinations, and referral to a specialist were deficient. Patients who had both diseases had more consultations, better control for hypertension and lipids, but inferior glycemic control. Overall, quality care for DM and/or HBP has not been met according to the standards. While patients with DM and HBP do not have a current standard to evaluate their own needs.

Online Reviews of Credence Service Providers: What Do Consumers Evaluate, Do Other Consumers Believe the Reviews, and Are Interventions Needed?

2020 ◽  
Vol 40 (1) ◽  
pp. 27-44
Author(s):  
Shannon Lantzy ◽  
Rebecca W. Hamilton ◽  
Yu-Jen Chen ◽  
Katherine Stewart
Keyword(s):  
Medical Care ◽  
Service Providers ◽  
Online Reviews ◽  
Economics Of Information ◽  
Policy Interventions ◽  
Credence Attributes ◽  
Made In ◽  
Other Consumers

Consumer-generated online reviews of credence service providers, such as doctors, have become common on platforms such as Yelp and RateMDs. Yet doctors have challenged the legitimacy of these platforms on the grounds that consumers do not have the expertise required to evaluate the quality of the medical care they receive. This challenge is supported by the economics of information literature, which has characterized doctors as a credence service, meaning that consumers cannot evaluate quality even after consumption. Are interventions needed to ensure that consumers are not misled by these reviews? Data from real online reviews shows that many of the claims made in real reviews of credence service providers focus on experience attributes, such as promptness, which consumers can typically evaluate, rather than credence attributes, such as knowledge. Follow-up experiments show that consumers are more likely to believe experience claims (vs. credence claims) made by other consumers, claims that are supported by data, and longer reviews even if they are not more informative. The authors discuss implications for consumers and credence service providers and possible policy interventions.

scholarly journals Factors predicting overall success: a review of 747 microsurgical vasovasostomies

2013 ◽  
Vol 1 (4) ◽  
pp. 388 ◽  
Author(s):  
Stéphane Bolduc ◽  
Marc Anthony Fischer ◽  
Genevieve Deceuninck ◽  
Michel Thabet
Keyword(s):  
Retrospective Analysis ◽  
Semen Analysis ◽  
Surgical Techniques ◽  
Successful Outcome ◽  
Partner Status ◽  
Kaplan Meier ◽  
Predicting Success ◽  
Preoperative Factors

Objectives: Advances in surgical techniques have improved the outcome of microsurgical vasovasostomy (VV). We performed a retrospective analysis of surgical procedures to determine outcomes and predictors of VV success, to develop Kaplan–Meier Curves for predicting VV outcomes and to evaluate the use of α-glucosidase (AG) to predict outcomes.Patients and Methods: We undertook a retrospective analysis of 747 modified 1-layer microsurgical VV procedures performed between 1984 and 2000. Obstructive interval, partner status, social status preoperatively and method of vasal obstruction, vasal fluid quality and sperm granuloma intraoperatively were compared with outcome results. Parameters evaluated at follow-up included semen analysis, AG concentration in ejaculate fluid and pregnancy rates.Results: The overall patency rate was 86% and pregnancy rates were 33% and 53% at 1 and 2 years after primary VV, respectively. Preoperative factors associated with successful outcome and pregnancy included shorter obstructive interval and same female partner (p < 0.05). Intraoperative factors predicting success included the use of surgical clips instead of suture at vasectomy, the presence of a sperm granuloma, the presence and quality of vasal fluid, and the presence and quality of sperm in vasal fluid. Further, increased AG in the postoperative semen predicted improved patency and pregnancy outcomes.Conclusion: This study confirms the effectiveness of VV for vasectomized men who wish to father children. It also demonstrates that preoperative and intraoperative factors are predictive of the VV outcome. Postoperative AG is also a useful marker of patency and it appears to predict pregnancy outcome.

scholarly journals Markers of vulnerability for cervical cancer in HIV-infected women

2011 ◽  
Vol 19 (3) ◽  
pp. 500-507 ◽  
Author(s):  
Daniele Mary Silva de Brito ◽  
Marli Teresinha Gimeniz Galvão ◽  
Maria Lúcia Duarte Pereira
Keyword(s):  
Health Care ◽  
Cervical Cancer ◽  
Early Detection ◽  
Social Dimensions ◽  
Structured Interviews ◽  
Preventive Actions ◽  
Quality Of Health Services ◽  
Supply Information

This study identifies the dimensions and markers of vulnerability among women infected with HIV regarding the development of cervical cancer. A total of 76 HIV-infected women cared for in Fortaleza, CE, Brazil from October 2007 to June 2008 participated in the study. Semi-structured interviews were used to collect socio-demographic, clinical, and sexual data, as well as situations related to health care follow-up and the prevention of cervical cancer. Identified situations were grouped according to the dimensions and markers of vulnerability. HIV-infected women experience different situations linked to individual, programmatic and social dimensions that leave them vulnerable to the development of cervical cancer. The conclusion is that this population is vulnerable to cervical cancer and specific preventive actions are necessary to supply information associated with early detection, improve knowledge, encourage self-care, and improve the quality of health services directed to this population.

scholarly journals 0807 NREM Parasomnias: Retrospective Analysis Of Treatment And Outcomes

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A307-A307
Author(s):  
N Limbekar ◽  
J Pham ◽  
H Yusuf ◽  
R Budhiraja ◽  
S Javaheri ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Retrospective Chart Review ◽  
Depression And Anxiety ◽  
Comorbid Conditions ◽  
Osa Treatment ◽  
Negative Impacts ◽  
Lost To Follow Up ◽  
Diagnosis Date

Abstract Introduction NREM parasomnias are relatively common among children and sometimes persist in adulthood. These behaviors may result in injury or have negative impacts on functioning and quality of life thus necessitating treatment. The treatment is challenging given the lack of evidence for frequently used medications such as benzodiazepines (BDZ) or tricyclic antidepressants (TCA). The aim of this retrospective analysis is to determine the most frequently prescribed medications for treatment of NREM parasomnias and evaluate reported outcomes. Methods We performed a retrospective chart review of all patients with NREM parasomnia diagnosed within BWH clinics examining the date of diagnosis, date of starting therapy, comorbidities, type of medication prescribed, and the reported change in symptoms or side effects at the individual’s follow-up visits. Results From 2012 to 2019, 123 patients (64 females, 59 male) at BWH clinics received the diagnosis of NREM parasomnia, including sleepwalking and night terrors. Mean age was 44. Comorbidities included depression=16, anxiety=32, seizures=6, RLS=9, epilepsy=5, insomnia=29, and OSA=57. Initial treatment included safety counseling (72), BDZ (7), TCA (4), and treatment of comorbidity (23). Treatment of OSA only (n=15) was effective in 66% (n=10) and 33% were lost to follow up. Of those with OSA treatment plus BDZ (n=6), treatment was effective in 50% (n=3). Of those receiving BDZ only (n=7), treatment was effective in 43%. Of those receiving Melatonin (8),treatment was effective among 62.5% (n=5). TCAS (n=4) were effective in 3 patients (75%). Treatment of comorbid conditions without pharmacotherapy (23) was effective in 35% (n=8) while the remaining 65% (n=15) were lost to follow up. Conclusion Treating comorbid conditions such as OSA, insomnia, RLS, depression, and anxiety is a frequent treatment strategy. Additional pharmacologic treatment most commonly includes melatonin, BDZs, and TCAs. Support None

scholarly journals Health status, quality of life and medical care in adult women with Turner syndrome

2018 ◽  
Vol 7 (4) ◽  
pp. 534-543 ◽  
Author(s):  
Diana-Alexandra Ertl ◽  
Andreas Gleiss ◽  
Katharina Schubert ◽  
Caroline Culen ◽  
Peer Hauck ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Medical Care ◽  
Turner Syndrome ◽  
Reference Population ◽  
Care Quality ◽  
Study Cohort ◽  
Adult Women ◽  
Adult Care

Background Previous studies have shown that only a minority of patients with Turner syndrome (TS) have adequate medical care after transfer to adult care. Aim of this study To assess the status of medical follow-up and quality of life (QoL) in adult women diagnosed with TS and followed up until transfer. To compare the subjective and objective view of the medical care quality and initiate improvements based on patients’ experiences and current recommendations. Methods 39 adult women with TS out of 64 patients contacted were seen for a clinical and laboratory check, cardiac ultrasound, standardized and structured questionnaires (SF-36v2 and Beck depression inventory). Results 7/39 of the patients were not being followed medically at all. Only 2/39 consulted all the specialists recommended. Comorbidities were newly diagnosed in 27/39 patients; of these, 11 related to the cardiovascular system. Patients in our cohort scored as high as the mean reference population for SF-36v2 in both mental and physical compartments. Obese participants had lower scores in the physical function section, whereas higher education was related to higher physical QoL scores. Adult height slightly correlated positively with physical health. Conclusion Medical follow-up was inadequate in our study cohort of adults with TS. Even though their medical follow-up was insufficient, these women felt adequately treated, leaving them vulnerable for premature illness. Initiatives in health autonomy and a structured transfer process as well as closer collaborations within specialities are urgently needed.

Long-term Quality of Life and Safety in Remote Monitoring of Patients with Pacemakers

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Lopez-Villegas ◽  
R Lopez-Liria ◽  
C Leal-Costa ◽  
S Peiro ◽  
E Robles-Musso ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Early Detection ◽  
Functional Capacity ◽  
Remote Monitoring ◽  
Pacemaker Implantation ◽  
Euroqol 5D ◽  
Hospital Visits

Abstract Introduction Health-related quality of life (HRQoL) and functional capacity values immediately after pacemaker implantation have been well established; however, not much has been known about its long-term effects. The present study compared the long-term effectiveness and safety of remote monitoring (RM) plus a clinic visit versus clinic visits alone during follow-up of adults implanted with PMs. Methods This study was a single-centre, controlled, non-randomised, non-blinded clinical trial. Data were collected pre-implantation and after 60 months. The patients in the PONIENTE study were assigned to two different groups: RM and conventional monitoring (CM). The EuroQol-5D (EQ-5D) questionnaire was used to assess HRQoL and Duke Activity Status Index was used for the functional capacity. Results After five years, 55 patients completed the study (RM = 21; CM = 34). EuroQol-5D and functional capacity values were improved; however, significant differences were observed only in the EQ5D visual analogue scale (p &lt; 0.001). Conclusions Remote monitoring was equally feasible, reliable, safe, and clinically useful as CM. The frequencies of rehospitalisations and emergency visits did not differ between the groups. RM was found to be safe and effective in early detection and treatment of medical- and device-related events and in reducing hospital visits. Improved HRQoL was described not only immediately after PM implantation but also extended over a long time. Key messages Remote monitoring of patients with pacemakers was found to be safe and effective in early detection and treatment of medical- and device-related events and in reducing hospital visits. Patients included in both groups of follow-up were equally feasible, reliable, safe, and clinically useful.

scholarly journals Polysomnography Applied to Patients with Tinnitus: A Review

2017 ◽  
Vol 22 (02) ◽  
pp. 177-180
Author(s):  
Liane Teixeira ◽  
Ronaldo Granjeiro ◽  
Carlos Oliveira ◽  
Fayez Bahamad Júnior
Keyword(s):  
Sleep Disorders ◽  
Sleep Disturbances ◽  
Adult Population ◽  
Acoustic Stimulation ◽  
Control Group ◽  
Data Synthesis ◽  
Psychiatric Disturbances ◽  
Initial Appointment

Introduction Tinnitus has been defined as an “auditory phantom perception,” meaning that tinnitus results from an abnormal activity within the nervous system, in the absence of any internal or external acoustic stimulation. About 10 to 15% of the adult population is affected by tinnitus, and a relevant percentage of tinnitus sufferers experience symptoms severe enough to significantly affect quality of life, including sleep disturbances, work impairment, and, in some cases, psychiatric distress. The self-rated complaints about tinnitus focus on emotional distress, auditory perceptual difficulties, and sleep disturbances. Objectives To evaluate the works that show sleep disorders in patients with tinnitus, and sleep disorders assessed by polysomnography. Data Synthesis We found four studies with polysomnography to assess sleep disorders in patients with tinnitus. The first study evaluated 80 patients who were military personnel without major psychiatric disturbances, and their tinnitus was associated with noise-induced permanent hearing. The second study was a prospective, case-control, nonrandomized study of 18 patients affected by chronic tinnitus who were compared with a homogeneous control group consisting of 15 healthy subjects. The last work evaluated questionnaires mailed to patients before their initial appointment at the Oregon Health Sciences University Tinnitus Clinic between 1994 and 1997. These questionnaires requested information pertaining to insomnia, tinnitus severity, and loudness. Follow-up questionnaires were mailed to 350 patients 1 to 4 years (mean 5 ± 2.3 years) after their initial appointment at the clinic. Conclusion There are few studies with polysomnography for the evaluation of patients with sleep disorders caused by tinnitus. This shows the need for more studies on this subject.

scholarly journals The analytic hierarchy process as a holistic model for the assessment of dialysis centres

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M B Kaziuk ◽  
W Kosiba
Keyword(s):  
Analytic Hierarchy Process ◽  
Medical Care ◽  
Nursing Care ◽  
Medical Staff ◽  
Therapeutic Process ◽  
Ahp Method ◽  
Analytic Hierarchy ◽  
The Analytic Hierarchy Process ◽  
Hierarchy Process

Abstract Introduction Haemodialysis is one of the methods of renal replacement therapy which is most frequently used in Poland and in the world in patients with chronic and acute renal failure. Purpose: An attempt was made to have patients undergoing regular haemodialysis assess the results of activity of dialysis centres. Methods 64 patients (30 women, 34 men, age: 50.2 +/- 11.9 years) undergoing dialysis therapy in three selected dialysis centres in Poland were included in the study. A questionnaire correlated with the analytic hierarchy process (AHP) was employed for the assessment. The dialysis centres were assessed by the patients in the context of availability of services, communication between the medical staff and the patient and the treatment used. Two sub-criteria were connected with each criterion, for which significance (priorities) indicating a dependent impact on the assessment of the quality of dialysis centres was calculated. Results From amongst four domains of the assessment of dialysis centres, the patients rated medical care and nursing care the highest (w = 0.386), where medical care had significance equal to 0.455, and nursing care had significance equal to = 0.545. The next important part of the assessment of dialysis centres was communication between the medical staff and the patient (w = 0.321) and the treatment used (haemodialysis) (w = 0.155). Availability of services had the lowest significance (w = 0.138), including performance of examinations for kidney transplant and medical transport for haemodialysis. Conclusions The assessment of dialysis centres using the AHP method should be part of the therapeutic process where one needs to emphasise the role of the patient in chronic nephrological care which translates into the quality of services provided by dialysis centres. Key messages The assessment of dialysis centres using the AHP method should be part of the therapeutic process. The patient’s role and its good assessment in the treatment process is very important.

Sign in / Sign up

Export Citation Format

Share Document