Outpatient Clinic Visits Using Telemedicine - For Patients With Type 1 Diabetes Mellitus Treated With Insulin Pumps (Preprint)

2020 ◽  
Author(s):  
Anders Nikolai Ørsted Schultz ◽  
Georg Bollig ◽  
Frans Brandt Kristensen
Keyword(s):  
Diabetes Mellitus ◽  
Outpatient Clinic ◽  
Insulin Pump ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Clinic Visit ◽  
World Health ◽  
Technical Problems ◽  
Digital Revolution ◽  
The World

UNSTRUCTURED Aim: We aim to investigate three different aspects of conducting an outpatient clinic visit remotely using telemedicine. The areas investigated will be: Diabetes regulation, patient and healthcare professionals perspective on video consultation , and economic evaluation. Background: Diabetes Mellitus (DM) has doubled over the last three decades. A meta-analysis of 12 randomized controlled trials including a total of 600 people treated in period of 2,5 – 24 months the authors concluded that insulin pump treatment lead to significantly better glycemia control, measured by Hba1c. Studies suggest that centres with a large volume of insulin pump patients have a lower complication rate and achieve better metabolic control (lower HbA1c levels) than smaller centres. Accordingly, patients will have larger distance to their centre, more traveling time, and more inconvenience. Hence some patients may not even want to start insulin pump treatment due to distance or may not even get the offer by the HCP even if the indications are present. The Longer travel times might lead some patients to opt out of an insulin pump treatment, or make patients wait longer before contacting staff in case of technical problems or medical issues. A solution to overcome distances to centre and make the healthcare service provide even better could be by use of telemedicine. Telemedicine was defined in 1997 by the World Health Organization. Since then the world has experienced a new digital revolution Study design: A randomised controlled trial will be conducted, including DM1 patients treated with insulin pump. Inclusion criteria: Adult patients, diagnosed with DM1 and use of insulin pump for at least 6 months. Exclusion criteria: No internet access or unable to adhere to protocol. Unable to speak or read Danish. Impact: The study will not only provide solid evidence for implementation of telemedicine in the outpatient clinic regarding DM patients living with an Insulin pump, but hopefully also set a standard for future projects aiming to implement telemedicine in daily clinical practice. ClinicalTrials.gov Identifier: NCT04612933

scholarly journals COVID-19 in ophthalmic practice

2020 ◽  
Author(s):  
KhP Takhchidi ◽  
NKh Takhchidi ◽  
MKh Movsesian
Keyword(s):  
Public Health ◽  
Diabetes Mellitus ◽  
Distress Syndrome ◽  
Meta Analysis ◽  
World Health ◽  
The Past ◽  
Ocular Manifestations ◽  
The World ◽  
Coronavirus Infection ◽  
Health Organization

The end of 2019 in China was marked by the breakout of the new Coronavirus Disease (COVID-19) caused by the severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2). Gradually, the infection spread around the world and in March 2020, the World Health Organization (WHO) declared Covid-19 a pandemic. The new coronavirus disease 2019 is highly contagious, causing respiratory distress syndrome and poses a huge threat to public health, especially in patients. with serious concomitant diseases such as diabetes mellitus, bronchial asthma, hypertension, etc. Many scientists have put forward the idea that COVID-19 can be transmitted through the eyes through contact and everyday life. Over the past six months, works on the ocular manifestations of coronavirus infection have begun to appear in the literature. We conducted a systematic review of scientific articles from the PubMed, e-Library, Scopus databases in order to conduct a meta-analysis of the effect of coronavirus infection on the eyes and its ophthalmological manifestations.

Pregnancy planning in women with diabetes mellitus type 2

2021 ◽  
Vol 70 (3) ◽  
pp. 11-19
Author(s):  
Natalya V. Borovik ◽  
Еkaterina V. Musina ◽  
Alyona V. Tiselko ◽  
Svetlana V. Suslova ◽  
Olga B. Glavnova ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Unplanned Pregnancy ◽  
Self Control ◽  
World Health ◽  
Pregnancy Planning ◽  
Planned Pregnancy ◽  
The World

BACKGROUND: The increase in the incidence of type 2 diabetes mellitus worldwide and the improvement in the quality of diabetic and obstetric care lead to an increase in the number of pregnant women with type 2 diabetes mellitus. The incidence of obstetric and perinatal adverse outcomes in women with type 2 diabetes mellitus is often higher than in women with type 1 diabetes. In the world literature, there are few works on the effect of pregnancy planning on the course and outcome of pregnancy in women with type 2 diabetes mellitus. AIM: The aim of this study was to evaluate the role of pregnancy planning in patients with type 2 diabetes mellitus in improvement of pregnancy and birth outcomes. MATERIALS AND METHODS: We retro- and prospectively analyzed the course and outcome of pregnancy in 124 women with type 2 diabetes mellitus, who were observed in the Diabetes Mellitus and Pregnancy Center of the Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott for the period from 2010 to 2019. The study included 34 women with type 2 diabetes mellitus at the stage of pregnancy planning and 90 women during pregnancy. All patients underwent a general clinical examination, carbohydrate metabolism correction, training at the School of Diabetes Mellitus in the principles of rational nutrition, self-control of glycemia and insulin therapy. Diabetes compensation was assessed by the level of glycated hemoglobin, determined using a method certified in accordance with the National Glycogemoglobin Standartization Program and standardized in accordance with the reference values adopted in the Diabetes Control and Complications Trial, as well as by the level of glycemia (self-control at least four times a day). We also assessed the severity of vascular complications of type 2 diabetes mellitus before and during pregnancy, and identified and treated comorbidities. To assess the degree of obesity, the criteria of the World Health Organization and the pregravid body mass index calculated by the Quetelet formula were used. The severity of preeclampsia was assessed in accordance with federal clinical guidelines. Ultrasound examination of the fetus with Doppler blood flow in the vessels of the fetoplacental complex was performed using a Voluson E6 ultrasound system (GE Healthcare, USA). For the timely diagnosis of diabetic fetopathy and fetal cardiomyopathy, dynamic fetometry and echocardiography were conducted. In addition, cardiotocography was performed for antenatal assessment of the fetus from the 30th week of pregnancy. After delivery, a neonatologist assessed the condition of the newborn using the Apgar scale at the first and fifth minutes of life, and then the assessment was carried out in the early neonatal period. RESULTS: In the group of women who received pregravid training, the course and outcomes of pregnancy were significantly better: the frequency of preeclampsia was lower (14.7%) compared to the group of women with an unplanned pregnancy (40.0%); there was no severe preeclampsia compared to the same women (13.3%). The number of preterm births was significantly lower (14.7%) in the group of women with planned pregnancy compared to the group of women without pregravid preparation (37.8%). In addition, in the group of women planning pregnancy, there were no fetal congenital malformations, neonatal hypoglycemic conditions, hypertrophic cardiomyopathy; in the group of women with an unplanned pregnancy, these parameters being found to amount to 6.7%, 24.4% and 6.7%, respectively. There was no perinatal mortality in the group of women with a planned pregnancy; however, this parameter was shown to be 3.3% in the group of women with an unplanned pregnancy. CONCLUSIONS: Pregnancy planning in patients with type 2 diabetes mellitus can significantly improve the course of pregnancy and childbirth outcomes.

scholarly journals Improving Hand Hygiene Compliance in Nursing Homes: Protocol for a Cluster Randomized Controlled Trial (HANDSOME Study)

10.2196/17419 ◽  
2020 ◽  
Vol 9 (5) ◽  
pp. e17419 ◽  
Author(s):  
Gwen R Teesing ◽  
Vicki Erasmus ◽  
Mariska Petrignani ◽  
Marion P G Koopmans ◽  
Miranda de Graaf ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Nursing Homes ◽  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Disease Incidence ◽  
Controlled Trial ◽  
World Health ◽  
The World ◽  
Hygiene Compliance ◽  
Cluster Randomized

Background Hand hygiene compliance is considered the most (cost-)effective measure for preventing health care–associated infections. While hand hygiene interventions have frequently been implemented and assessed in hospitals, there is limited knowledge about hand hygiene compliance in other health care settings and which interventions and implementation methods are effective. Objective This study aims to evaluate the effect of a multimodal intervention to increase hand hygiene compliance of nurses in nursing homes through a cluster randomized controlled trial (HANDSOME study). Methods Nursing homes were randomly allocated to 1 of 3 trial arms: receiving the intervention at a predetermined date, receiving the identical intervention after an infectious disease outbreak, or serving as a control arm. Hand hygiene was evaluated in nursing homes by direct observation at 4 timepoints. We documented compliance with the World Health Organization’s 5 moments of hand hygiene, specifically before touching a patient, before a clean/aseptic procedure, after body fluid exposure risk, after touching a patient, and after touching patient surroundings. The primary outcome is hand hygiene compliance of the nurses to the standards of the World Health Organization. The secondary outcome is infectious disease incidence among residents. Infectious disease incidence was documented by a staff member at each nursing home unit. Outcomes will be compared with the presence of norovirus, rhinovirus, and Escherichia coli on surfaces in the nursing homes, as measured using quantitative polymerase chain reaction. Results The study was funded in September 2015. Data collection started in October 2016 and was completed in October 2017. Data analysis will be completed in 2020. Conclusions HANDSOME studies the effectiveness of a hand hygiene intervention specifically for the nursing home environment. Nurses were taught the World Health Organization’s 5 moments of hand hygiene guidelines using the slogan “Room In, Room Out, Before Clean, After Dirty,” which was developed for nursing staff to better understand and remember the hygiene guidelines. HANDSOME should contribute to improved hand hygiene practice and a reduction in infectious disease rates and related mortality. Trial Registration Netherlands Trial Register (NTR6188) NL6049; https://www.trialregister.nl/trial/6049 International Registered Report Identifier (IRRID) DERR1-10.2196/17419

scholarly journals The efficacy and safety of interferons for the treatment of patients with COVID-19: protocol for systematic review and meta-analysis of controlled trials

2021 ◽  
Author(s):  
Afsaneh Noormandi ◽  
Mohammad Fathalipour ◽  
Reza Daryabeygi-Khotbehsara ◽  
Soheil Hassanipour
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Meta Analysis ◽  
World Health ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Global Pandemic ◽  
The World ◽  
Health Organization ◽  
Time Of Administration

Background and objective: COVID-19 has since been declared a global pandemic by the World Health Organization (WHO), infecting millions worldwide. The use of Interferon (INF) subtypes previously examined in the treatment of SARS and MERS is also being initiated in some clinical trials. Although different clinical trials were evaluated IFNs in the treatment of COVID-19, their efficacy and safety remain unknown. Therefore, this study aims to systematically assess IFNs efficacy and safety in treating patients with COVID-19. Methods: The protocol has been registered in the PROSPERO International Prospective Register (CRD42020200643) on 24 July 2020. This protocol has been arranged according to the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) 2015 checklist. Discussion: Due to lack of approved medication for the covid-19 treatment and also various mutations of this virus, evaluated the efficacy and safety of medications by various studies could help for finding treatments with high effectiveness. IFNs are one of the medications that have been administered in covid-19 infection.  Moreover, the best time of administration and dose of this medication was unknown. Although meta-analysis is a potent source for assessing the accuracy of subjects, heterogeneity of articles is a potent limitation of our work.

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