Is diabetes management in primary care improving clinical outcomes? A study in Qatar.

There has been little research into the effectiveness of primary-care diabetes clinics in the Middle East. This study in Qatar compared patient outcomes at a primary-care facility with a dedicated diabetes clinic and one without. Using a cross-sectional method, data on demographics, diabetes status and 6 clinical outcomes of diabetes care were collected from the records of patients who visited the clinics during 2012. Diabetes management in both facilities improved clinical outcomes over the 1-year observation period. The mean total cholesterol of patients attending the special clinic (n = 102) decreased significantly from 4.66 to 4.27 mmol/dL and LDL cholesterol from 3.42 to 3.22 mmol/dL. The LDL cholesterol of patients receiving standard care (n = 108) reduced significantly from 3.41 to 3.22 mmol/dL and HDL cholesterol increased from 0.83 to 0.87 mmol/dL. Inter-provider comparisons indicated that the outcomes in the facility with a diabetes clinic were not superior to those in the facility with standard care.

Is diabetes management in primary care improving clinical outcomes? A study in Qatar

لا يوجد إلا القليل من البحوث عن فاعلية عيادات الرعاية الأولية الخاصة بمرضى السكّري في الرق الأوسط. وقد قامت هذه الدراسة في قَطَر بمقارنة نتائج العاج في أحد مرافق الرعاية الأولية الذي يوجد به عيادة مخصصة للسكّري مع تلك التي في مرفق ليس به عيادة مخصصة. فتم - باستخدام طريقة مقطعية - جمع بيانات سكانية وعن حالة السكّري وعن 6 نتائج سريرية لرعاية السكّري من سجلات المرضى الذين زاروا العيادتن خال عام 2012 . فوجد أن عاج السكّري في كلا المرفقن قد حسّن النتائج السريرية خال فرة المراقبة التي استمرت لمدة سنة. فانخفض متوسط الكوليسرول الكلي لدى المرضى الذين يراجعون العيادة الخاصة ع = 102 من 3.42 إلى 3.22 مليمول/دل. LDL بشكل ملحوظ من 4.66 إلى 4.27 مليمول/دل، وكوليسرول البروتن الشحمي منخفض الكثافة لدى المرضى الذين يتلقون رعاية معيارية ع = 108 بشكل ملحوظ من 3.41 إلى 3.22 مليمول/دل، وارتفع LDL وانخفض كوليسرول من 0.83 إلى 0.87 مليمول/دل. لقد أشارت المقارنات بن مقدمَي الرعاية إلى أن HDL لديهم كولسرول البروتن الشحمي مرتفع الكثافة النتائج في المرفق الذي يوجد به عيادة سكّري لم تكن أفضل من تلك التي في المرفق الذي يقدم الرعاية العادية.

There has been little research into the effectiveness of primary-care diabetes clinics in the Middle East. This study in Qatar compared patient outcomes at a primary-care facility with a dedicated diabetes clinic and one without. Using a cross-sectional method, data on demographics, diabetes status and 6 clinical outcomesof diabetes care were collected from the records of patients who visited the clinics during 2012. Diabetes management in both facilities improved clinical outcomes over the 1-year observation period. The mean total cholesterol of patients attending the special clinic (n = 102) decreased significantly from 4.66 to 4.27 mmol/dLand LDL cholesterol from 3.42 to 3.22 mmol/dL. The LDL cholesterol of patients receiving standard care (n = 108) reduced significantly from 3.41 to 3.22 mmol/dL and HDL cholesterol increased from 0.83 to 0.87 mmol/dL. Inter-provider comparisons indicated that the outcomes in the facility with a diabetes clinic were not superior to those in the facility with standard care.

Très peu de recherches ont été menées sur l'efficacité des cliniques du diabète intégrées à des établissements de soins de santé primaires au Moyen-Orient. La présente étude menée au Qatar a comparé les résultats pour les patients d'un établissement de soins de santé primaires doté d'une clinique dédiée au diabèteet d'un établissement ne disposant pas de service de ce genre. En recourant à une méthode transversale, des données démographiques, des informations concernant le statut diabétique des patients et six résultats cliniques liés aux soins du diabète ont été collectés à partir des dossiers des patients ayant consulté dans ces établissements en 2012 La prise en charge du diabète dans les deux types d'établissements avait amélioré les résultats cliniques sur la période d'observation d'un an. Le taux moyen de cholestérol total des patients consultant dans la cliniquespécialisée (n =102) avait nettement diminué – de 4,66 à 4,27 mmol/dL – tandis que le cholestérol LDL était passé de 3,42 à 3,22 mmol/dL. Le cholestérol LDL des patients ayant reçu des soins généraux (n =108) avait nettement diminué – de 3,41 à 3,22 mmol/dL – tandis que le cholestérol HDL avait augmenté, passant de 0,83 à 0,87 mmol/dL. Les comparaisons entre les prestataires de soins ont montré que les résultats de l'établissement doté de la clinique spécialisée dans le diabète n'étaient pas supérieurs à ceux du service de soins généraux.

Assessment of the 10-year risk of coronary heart disease events for Qatar Petroleum's firefighters and non-firefighter staff in Qatar.

Coronary heart disease is a major public health problem worldwide and firefighters may be at particular occupational risk. In a cross-sectional study in Ras Laffan Industrial City, Qatar, we assessed the 10-year risk of coronary heart disease events for 369 Qatar Petroleum staff at their periodic medical examination. The subjects of the study (all males) were divided into firefighters and non-firefighters groups. Based on the Framingham risk score calculations, 69.9% of the subjects were categorized as low risk, 27.1% as intermediate risk and 2.9% as high risk. None of the firefighters was categorized as high risk, 15.5% were intermediate and the rest were low risk. In the whole group, low high-density lipoprotein cholesterol was the most prevalent risk factor (68.8%), followed by hypertension (32.0%) and smoking (15.4%). The mean risk of developing coronary heart disease in firefighters [6.5% (SD 3.7%)] was significantly lower than in non-firefighters 19.5% (SD 6.5%)].

Assessment of the 10-year risk of coronary heart disease events for Qatar petroleum's firefighters and non-firefighter staff in Qatar

Coronary heart disease is a major public health problem worldwide and firefighters may be at particular occupational risk. In a cross-sectional study in Ras Laffan Industrial City, Qatar, we assessed the 10- year risk of coronary heart disease events for 369 Qatar Petroleum staff at their periodic medical examination. The subjects of the study [all males] were divided into firefighters and non-firefighters groups. Based on the Framingham risk score calculations, 69.9% of the subjects were categorized as low risk, 27.1% as intermediate risk and 2.9% as high risk. None of the firefighters was categorized as high risk, 15.5% were intermediate and the rest were low risk. In the whole group, low high-density lipoprotein cholesterol was the most prevalent risk factor [68.8%], followed by hypertension [32.0%] and smoking [15.4%]. The mean risk of developing coronary heart disease in firefighters [6.5% [SD 3.7%]] was significantly lower than in non-firefighters [9.5% [SD 6.5%]]

Isolation and partial characterization of human factor V.

Factor V was isolated from human citrate plasma by very mild purification steps. Cryoprecipitation, fractionation with polyethylene glycol 6000, gel filtration of AcA 44 and adsorption of haptoglobin to immobilized hemoglobin were applied successively, resulting in factor V preparations with a specific activity of 14.5 unit/mg. The yield was 28 percent. A molecular weight of 296 000 was determined by gel filtration and the apparent sedimentation constant found by ultracentrifugation in a sucrose gradient was 7.8 S. Parallel experiments with citrate plasma resulted in the same molecular weight and sedimentation constant. Polyacrylamide gel electrophoresis of factor V in the presence or absence of sodium dodecyl sulfate showed a single protein band. Incubation with human thrombin resulted in an 8-fold activation of the purified factor V.