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1.
Ann Surg ; 275(3): e575-e585, 2022 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-32649454

RESUMO

OBJECTIVE: To create the first structured surgical report form for NBL with international consensus, to permit standardized documentation of all NBL-related surgical procedures and their outcomes. SUMMARY OF BACKGROUND DATA: NBL, the most common extracranial solid malignant tumor in children, covers a wide spectrum of tumors with significant differences in anatomical localization, organ or vessel involvement, and tumor biology. Complete surgical resection of the primary tumor is an important part of NBL treatment, but maybe hazardous, prone to complications and its role in high-risk disease remains debated. Various surgical guidelines exist within the protocols of the different cooperative groups, although there is no standardized operative report form to document the surgical treatment of NBL. METHODS: After analyzing the treatment protocols of the SIOP Europe International Neuroblastoma Study Group, Children's Oncology Group, and Gesellschaft fuer Paediatrische Onkologie und Haematologie - German Association of Pediatric Oncology and Haematology pediatric cooperative groups, important variables were defined to completely describe surgical biopsy and resection of NBL and their outcomes. All variables were discussed within the Surgical Committees of SIOP Europe International Neuroblastoma Study Group, Children's Oncology Group, and Gesellschaft fuer Paediatrische Onkologie und Haematologie - German Association of Pediatric Oncology and Haematology. Thereafter, joint meetings were organized to obtain intercontinental consensus. RESULTS: The "International Neuroblastoma Surgical Report Form" provides a structured reporting tool for all NBL surgery, in every anatomical region, documenting all Image Defined Risk Factors and structures involved, with obligatory reporting of intraoperative and 30 day-postoperative complications. CONCLUSION: The International Neuroblastoma Surgical Report Form is the first universal form for the structured and uniform reporting of NBL-related surgical procedures and their outcomes, aiming to facilitate the postoperative communication, treatment planning and analysis of surgical treatment of NBL.


Assuntos
Formulários como Assunto , Neuroblastoma/cirurgia , Projetos de Pesquisa/normas , Oncologia Cirúrgica/normas , Criança , Humanos , Cooperação Internacional
2.
Pan Afr Med J ; 40: 49, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34795829

RESUMO

INTRODUCTION: despite the adoption of mental disorders act in 1972, the use of required mental health care act (MHCA) forms during admission of patients with mental illnesses remained below the legal expectation in the Maun District Hospital. This study audited Letsholathebe II Memorial Hospital (LIIMH) professionals´ usage of MHCA forms. METHODS: this was a quasi-experimental study that audited files of patients admitted with mental illnesses, before, three and six months after a continuing medical education (CME). Cochran Q, McNemar symmetry Chi-square were used for comparison of performance. RESULTS: of the 239 eligible files, we accessed 235 (98.3%). About two in ten (n=36/235, 15.3%) MHCA forms were not used in combination with required forms. The quasi-majority of MHCA forms set used, aligned with involuntary admission (n=134/137, 97.8%). Required admission MHCA forms significantly increased from nil before continuing medical education (CME-0), to 64.6% (n=51/79) at CME-3 and 77% (n=59/77) at CME-6 (p<0.001). However, there was no statistical difference between the last two periods (64.6% vs 77%, p=0.164). Voluntary admission remained below 13% (n=10/79). Only six types of MHCA forms were used during this study. CONCLUSION: there was no adequate use of required MHCA forms at LIIMH before CME. Thereafter, the proportion of adequate use increased from period CME-0 to the periods CME-3 and CME-6. However, there was no difference in proportion between the last two periods. We recommend an effective and regular CME twice a year for health professionals on selected MHCA forms.


Assuntos
Educação Continuada/métodos , Transtornos Mentais/terapia , Admissão do Paciente/normas , Atenção Primária à Saúde/métodos , Adolescente , Adulto , Botsuana , Feminino , Formulários como Assunto , Pessoal de Saúde/educação , Pessoal de Saúde/normas , Hospitais/normas , Humanos , Masculino , Auditoria Médica , Admissão do Paciente/legislação & jurisprudência , Atenção Primária à Saúde/legislação & jurisprudência , Adulto Jovem
4.
Cancer Res Treat ; 53(4): 926-934, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34082493

RESUMO

PURPOSE: Six forms relating to decisions on life-sustaining treatment (LST) for patients at the end-of-life (EOL) in hospital are required by the "Act on Decision of LST for Patients at the EOL." We investigated the preparation and creation status of these documents from the database of the National Agency for Management of LST. MATERIALS AND METHODS: We analyzed the contents and details of each document necessary for decisions on LST, and the creation status of forms. We defined patients completing form 1 as "self-determined" of LST, and those whose family members had completed form 11/12 as "family decision" of LST. According to the determination subject, we compared the four items of LST on form 13 (the paper of implementation of LST) and the documentation time interval between forms. RESULTS: The six forms require information about the patient, doctor, specialized doctor, family members, institution, decision for LST, and intention to use hospice services. Of 44,381 who had completed at least one document, 36,693 patients had form 13. Among them, 11,531, 10,976, and 12,551 people completed forms 1, 11, and 12, respectively. The documentation time interval from forms 1, 11, or 12 to form 13 was 8.6±13.6 days, 1.0±9.5 days, and 1.5±9.7 days, respectively. CONCLUSION: The self-determination rate of LST was 31% and the mean time interval from self-determination to implementation of LST was 8.6 days. The creation of these forms still takes place when the patients are close to death.


Assuntos
Doença/psicologia , Família/psicologia , Formulários como Assunto , Hospitais/tendências , Médicos/psicologia , Padrões de Prática Médica/estatística & dados numéricos , Assistência Terminal/psicologia , Suspensão de Tratamento/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Tomada de Decisões , Doença/etiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , República da Coreia , Taxa de Sobrevida , Assistência Terminal/legislação & jurisprudência , Suspensão de Tratamento/ética , Suspensão de Tratamento/legislação & jurisprudência
5.
Arch Pathol Lab Med ; 145(7): 864-870, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-33112959

RESUMO

CONTEXT.­: Tumor reporting constitutes a significant daily task of pathologists. An efficient tumor-reporting methodology is thus vitally important. The Web dynamic form (WbDF) method offers a multitude of advantages over the prevailing transcription-mediated reporting method based on static-text checklists. However, its adaptation has been severely hampered for 2 decades by its costly needs to maintain a complex back-end system and to change the system for frequent updates of reporting content. OBJECTIVE.­: To overcome these 2 obstacles with a serverless Web platform that enables users to create, customize, use, and download WbDFs as synoptic templates for structured tumor reporting. DESIGN.­: Deploy ReactJS as a Web platform. Create form components in JavaScript Object Notation files. Use JavaScript Object Notation files to make WbDFs on the Web platform. Use the WbDFs to generate final pathology reports. RESULTS.­: Ordinary users (pathologists) can create/customize reporting templates as WbDFs on the Web platform. The WbDF can be used to make a pathology report and stored/shared like ordinary document files. There is no back-end system to change, nor a requirement for computer programming skills. CONCLUSIONS.­: This strategy eliminates the need for a complex back-end system and the associated cost when updating tumor-reporting standards, making it possible to adopt the WbDF method without the technological drawbacks associated with content updates. It also opens a new field of how the tumor-reporting system should be organized, updated, and implemented.


Assuntos
Registros Eletrônicos de Saúde , Controle de Formulários e Registros , Formulários como Assunto , Internet , Neoplasias/patologia , Patologistas , Design de Software , Biópsia , Eficiência , Humanos , Valor Preditivo dos Testes , Fatores de Tempo , Simplificação do Trabalho , Fluxo de Trabalho
6.
World J Urol ; 39(7): 2447-2452, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33079251

RESUMO

PURPOSE: The goal of the current study was to evaluate the effect of a standardized prostate mpMRI reporting template on urologists' understanding and confidence in counselling a patient on the results of the MRI. To do this we performed a survey study to assess the understanding and confidence of urologists reviewing reports prior to (pre) and after (post) adoption of a standardized mpMRI template. METHODS: Six urologists reviewed ten pre- and post- mpMRI templated reports and completed a survey to assess the clarity of key elements and the confidence in counseling the patient. The urologists were blinded to the study objective. Nonparametric constrained permutation test for significance was performed to compare the results prior to and after implementation of the template. RESULTS: 29 pre- and 30 post-template mpMRI reports were reviewed. The average score for the post-template reports was significantly higher (10.7 ± 0.6 vs 7.5 ± 2.7 [ p< 0.001]) regardless of the reviewer. Urologists were also overall more confident in counselling patients when the standardized mpMRI reporting template had been used. CONCLUSION: Implementation of a standardized template for reporting of prostate mpMRI findings resulted in improved clarity and confidence in counselling patients. Radiologists should consider implementing a standardized reporting template to improve clinicians' understanding and confidence of the report.


Assuntos
Formulários como Assunto , Imageamento por Ressonância Magnética Multiparamétrica , Próstata/diagnóstico por imagem , Projetos de Pesquisa/normas , Humanos , Masculino , Melhoria de Qualidade
7.
Rev Salud Publica (Bogota) ; 20(6): 745-751, 2020 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-33206900

RESUMO

OBJECTIVE: To evaluate the case report forms and times elapsed between the surveillance steps for dengue virus (DENV) infection in a large Colombian city before the emergence of other arbovirus epidemics. MATERIALS AND METHODS: The descriptive epidemiology of DENV infection cases was analyzed from 2009 to 2013. The completeness of the case report forms filed at the Primary Units of Data Generation (PUDG) were evaluated, as well as the accuracy and suitability of the tests (PPV: positive predictive value). The average time-lags between each step were then calculated. RESULTS: There were 7.3, 12.38, 4.66, 6.25 and 29.9 annual cases of dengue infection per 10 000 inhabitants in 2009 to 2013, respectively. In this study, only 57.76% of the cases were classified correctly by the physicians and 26.32% of them were questioned about their home conditions and whether their family/friends had similar symptoms. Patients visited a clinic/hospital on average 4.76 days after developing symptoms and the health system was notified on average 1.75 days later, while 70.6% of them were reported within the one-day target period. There were only minor changes in case reporting times even during a DENV epidemic. Some (12.85%) of the case forms were later modified (average 16.7 days). In the period 2009-2013, the IgM confirmed PPV was 58.60%, while 20 mandatory criteria were absent on more than 25% of the forms. CONCLUSIONS: The system was accurate, simple, flexible, stable and acceptable, but a number of ways are suggested to improve this case detection and reporting system.


Assuntos
Dengue/epidemiologia , Notificação de Doenças/métodos , Formulários como Assunto , Vigilância da População , Anticorpos Antivirais/sangue , Colômbia/epidemiologia , Busca de Comunicante , Diagnóstico Tardio , Dengue/diagnóstico , Vírus da Dengue/imunologia , Gerenciamento Clínico , Doenças Endêmicas , Habitação , Humanos , Imunoglobulina M/sangue , Padrões de Prática Médica , Valor Preditivo dos Testes , Tamanho da Amostra , Inquéritos e Questionários
8.
Isr Med Assoc J ; 11(22): 700-703, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33249791

RESUMO

BACKGROUND: Burn injuries are an extreme form of traumatic injury and are a global health issue. The Israeli National Burn Unit at the Sheba Medical Center, a tertiary level 1 trauma center and hence the national referral center, treats burn patients admitted both directly and referred from other medical centers. The transfer and handover of patients is a critical step in patient care. In Israel, to date, there is no standardized and accepted transfer request form for burn patients from one medical facility to another. OBJECTIVES: To construct a transfer request form to be used in all future burn patient referrals. METHODS: After reviewing publicly available international transfer forms and comparing them to the admission checklist used at our unit, a structured transfer request form was constructed. RESULTS: After a pilot study period, testing the form in various scenarios and adapting it, the first standardized transfer form for burn patients in Israel in both English and Hebrew was implemented beginning May 2020. CONCLUSIONS: Implementation of a standardized transfer process will improve communication between healthcare professionals to help maintain a continuum of care. We believe that implementation of a burn transfer form in all future referrals can standardize and assure better care for burn patients, thus improving overall patient care.


Assuntos
Unidades de Queimados/organização & administração , Formulários como Assunto , Transferência da Responsabilidade pelo Paciente/organização & administração , Transferência de Pacientes/organização & administração , Encaminhamento e Consulta/organização & administração , Lista de Checagem , Humanos , Israel , Transferência da Responsabilidade pelo Paciente/normas , Transferência de Pacientes/normas , Projetos Piloto , Encaminhamento e Consulta/normas
9.
Ann Ital Chir ; 91: 345-351, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33055390

RESUMO

INTRODUCTION: The recent Sars-CoV2 pandemic has dramatically slowed patients' access to our clinic for vascular pathology when the contagion curve peaked. The need to restore the assistance activity has led us to adopt new individual prophylaxis and hygiene measures. METHODS: Doctors and staff must wear dedicated clothes. Mask and gloves are mandatory for patients. A visit is scheduled every 60 minutes to allow the sanitation of the rooms. The day before the visit patients are contacted by telephone for the Covid-19 risk triage. In the presence of symptoms the visit is postponed. In the presence of other risk factors a IgG/IgM Rapid Test for Covid-19 is performed on admission to the clinic. In the presence of fever, if an extraordinary rapid test cannot be performed, the visit must be postponed. Rapid test positive patients cannot be visited: they are placed in solitary confinement at their home waiting for a nasopharyngeal swab for Covid-19. When the rapid test is positive, immediate room sanitation also occurs. The rooms dedicated to the outpatient clinic as well as medical and not medical instruments are disinfected. CONCLUSION: The one adopted can be a useful management model for any type of care activity in order to guarantee the safety of patients and all the staff. KEY WORDS: COVID-19, Management, vascular, Outpatient clinic.


Assuntos
Betacoronavirus , Cardiologia/organização & administração , Técnicas de Laboratório Clínico , Infecções por Coronavirus/prevenção & controle , Controle de Infecções/métodos , Ambulatório Hospitalar/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Anticorpos Antivirais/sangue , Agendamento de Consultas , Betacoronavirus/imunologia , Betacoronavirus/isolamento & purificação , COVID-19 , Teste para COVID-19 , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Desinfecção , Formulários como Assunto , Hospitais Universitários/organização & administração , Humanos , Higiene/normas , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Controle de Infecções/organização & administração , Controle de Infecções/normas , Itália/epidemiologia , Nasofaringe/virologia , Equipamento de Proteção Individual , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Guias de Prática Clínica como Assunto , SARS-CoV-2 , Avaliação de Sintomas , Termometria , Triagem/organização & administração
10.
Neurocrit Care ; 33(3): 793-828, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32948987

RESUMO

Since its original report in January 2020, the coronavirus disease 2019 (COVID-19) due to Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) infection has rapidly become one of the deadliest global pandemics. Early reports indicate possible neurological manifestations associated with COVID-19, with symptoms ranging from mild to severe, highly variable prevalence rates, and uncertainty regarding causal or coincidental occurrence of symptoms. As neurological involvement of any systemic disease is frequently associated with adverse effects on morbidity and mortality, obtaining accurate and consistent global data on the extent to which COVID-19 may impact the nervous system is urgently needed. To address this need, investigators from the Neurocritical Care Society launched the Global Consortium Study of Neurological Dysfunction in COVID-19 (GCS-NeuroCOVID). The GCS-NeuroCOVID consortium rapidly implemented a Tier 1, pragmatic study to establish phenotypes and prevalence of neurological manifestations of COVID-19. A key component of this global collaboration is development and application of common data elements (CDEs) and definitions to facilitate rigorous and systematic data collection across resource settings. Integration of these elements is critical to reduce heterogeneity of data and allow for future high-quality meta-analyses. The GCS-NeuroCOVID consortium specifically designed these elements to be feasible for clinician investigators during a global pandemic when healthcare systems are likely overwhelmed and resources for research may be limited. Elements include pediatric components and translated versions to facilitate collaboration and data capture in Latin America, one of the epicenters of this global outbreak. In this manuscript, we share the specific data elements, definitions, and rationale for the adult and pediatric CDEs for Tier 1 of the GCS-NeuroCOVID consortium, as well as the translated versions adapted for use in Latin America. Global efforts are underway to further harmonize CDEs with other large consortia studying neurological and general aspects of COVID-19 infections. Ultimately, the GCS-NeuroCOVID consortium network provides a critical infrastructure to systematically capture data in current and future unanticipated disasters and disease outbreaks.


Assuntos
COVID-19/fisiopatologia , Elementos de Dados Comuns , Formulários como Assunto , Doenças do Sistema Nervoso/fisiopatologia , COVID-19/complicações , Coleta de Dados , Documentação , Humanos , Internacionalidade , Doenças do Sistema Nervoso/etiologia , SARS-CoV-2
11.
Am J Obstet Gynecol ; 223(5): B12-B15, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32861688

RESUMO

When performing a maternal transport between two facilities, numerous pieces of information must be communicated between physicians, nurses, and transport personnel, including the health status of 2 patients (mother and fetus), availability of bed space and personnel in 2 units at the receiving facility (labor and delivery unit and neonatal intensive care unit), arrangements for transportation, and inpatient and outpatient records. The amount and complexity of information creates a risk of medical error due to communication lapses. A cognitive aid such as a standardized form can help the team prepare for a transfer and provide a consistent framework for a handoff briefing among healthcare professionals. SMFM presents a sample briefing form to ensure that key elements are communicated for every maternal transport. Practical suggestions are given to help facilities customize the form and implement it on their units.


Assuntos
Lista de Checagem , Formulários como Assunto , Transferência da Responsabilidade pelo Paciente , Transferência de Pacientes/métodos , Transporte de Pacientes/métodos , Salas de Parto , Feminino , Ruptura Prematura de Membranas Fetais , Humanos , Unidades de Terapia Intensiva Neonatal , Erros Médicos/prevenção & controle , Trabalho de Parto Prematuro , Gravidez
12.
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. Impr.) ; 46(supl.1): 111-117, ago. 2020. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-192609

RESUMO

OBJETIVO: En Euskadi, dos casos de COVID-19 fueron diagnosticados el 28 de febrero de 2020. El 14 de marzo el Gobierno español estableció el estado de alarma. La única información acerca del número de casos de COVID-19 eran los confirmados por RT-PCR. Lanzamos una herramienta de vigilancia basada en la web para estimar el número mínimo de casos sintomáticos de COVID-19 y generar información útil para la toma de decisiones en salud pública. MATERIAL Y MÉTODOS: Implementamos un cuestionario web anónimo y lo difundimos a través de redes sociales. Recopilamos información epidemiológica sobre variables de «tiempo» (fecha de inicio de los síntomas), «lugar» (código postal) y «persona» (género, edad). Comparamos los casos positivos detectados mediante RT-PCR con los casos estimados según la definición de caso del Ministerio de Sanidad Consumo y Bienestar Social. Calculamos la tasa de respuesta al cuestionario y la incidencia acumulada a 14días. RESULTADOS: Entre el 19 y 26 de marzo de 2020 el cuestionario fue contestado por 128.182 personas (5,5% de la población vasca). De ellas, 27.599 cumplieron la definición de caso. Los casos estimados fueron seis veces más que los RT-PCR positivos para COVID-19. La incidencia acumulada a 14días fue de 463,3 por 100.000 habitantes, mientras que la de los casos positivos por RT-PCR fue de 139,6 por 100.000 habitantes. CONCLUSIONES: Esta herramienta mostró su utilidad para estimar el mínimo número de casos sintomáticos en Euskadi, lo cual podría apoyar acciones de salud pública


OBJECTIVE: In the Basque Country, two cases of COVID-19 were diagnosed on February 28 2020. On March 14, the Spanish Government established a state of alarm. Only cases confirmed by molecular biology (reverse-transcriptase polymerase chain reaction [RT-PCR]) were known. We launched a web-based surveillance tool to estimate the number of symptomatic cases of COVID-19 to contribute to Public Health decision-making. MATERIAL AND METHODS: We implemented an anonymous web questionnaire and disseminated it through online social media social. We collected epidemiological information about «time» (date of onset of symptoms), «place» (zip code), and «person» (gender, age). We compared cases detected by RT-PCR with the estimated cases, according to the case definition of the Ministry of Health. We calculated the questionnaire response rate and the cumulative incidence at 14days. RESULTS: Between March 19 and 26, 128,009 people answered the questionnaire (5.5% of the Basque population). Of these, 26,375 met the case definition (symptom prevalence of 21.4%). The estimated cases were almost six times more than COVID-19 positive RT-PCR. The estimated 14-day cumulative incidence was 578.3 per 100,000 population compared to RT-PCR positive cases, which was 139.6 per 100,000 population. CONCLUSIONS: This tool was useful in estimating the minimum number of symptomatic cases in the Basque Country, which could support Public Health actions


Assuntos
Humanos , Infecções por Coronavirus/epidemiologia , Vírus da SARS/patogenicidade , Síndrome Respiratória Aguda Grave/epidemiologia , Administração de Caso/estatística & dados numéricos , Controle de Doenças Transmissíveis/estatística & dados numéricos , Formulários como Assunto , Rede Social
14.
Semergen ; 46 Suppl 1: 55-64, 2020 Aug.
Artigo em Espanhol | MEDLINE | ID: mdl-32571677

RESUMO

The aim of this study was to promote the rapid identification of the contacts of patients infected with SARS-CoV-2 and therefore the control of the pandemic. Different methodologies and recommendations on contact tracing for Primary Health Care (PHC) and Public Health Services (PHS), like articles in Pubmed about COVID-19 and contact tracing, official contact definitions, the classic contact tracing model in tuberculosis (TB), information about apps for contact tracing and the role of the diagnostic tests, were reviewed. To establish efficient prevention and control measures, it is always necessary to implement contact tracing based on clinical suspicion, early diagnosis and isolation of cases and contacts and their follow-up. The classic contact tracing model in TB can be applied to this new infection, but accelerating the process given its acute nature and its potential severity. Good coordination between PHC and PHS and having sufficient resources is essential.


Assuntos
Busca de Comunicante/métodos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Atenção Primária à Saúde , Saúde Pública , COVID-19 , Formulários como Assunto , Humanos
16.
Ann Ist Super Sanita ; 56(1): 48-58, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32242535

RESUMO

BACKGROUND: Syringomyelia and Chiari Syndrome are classified as rare diseases, but current known occurrence in Europe is missing. The increased ability to diagnose these pathologies by magnetic resonance imaging and its widespread availability has led to an increase of reported cases, often asymptomatic, with the need to standardize definitions, diagnostic criteria and treatments. AIMS: We present shared Interregional Recommendations developed with the primary aim to estimate Syringomyelia and Chiari Syndrome prevalence and incidence in North Western Italy, with special reference to symptomatic forms. METHODS: An agreement for the standardization of definitions, classifications, diagnostic criteria and surgical Recommendations was reached by the multidisciplinary Interregional Piemonte and Valle d'Aosta Chiari-Syringomyelia Consortium (Delphi method); next, in 2011 a census for Syringomyelia and Chiari Malformation was performed through the Interregional Piemonte and Valle d'Aosta Rare Disease Registry, integrated by a dedicated form in order to estimate prevalence and incidence. RESULTS: 436 patients, 292 females, met shared interregional diagnostic criteria. Syringomyelia prevalence was estimated in 4.84:100 000; Chiari Malformation prevalence was 7.74:100 000; incidence was 0.82:100 000 and 3.08:100 000 respectively. Demographics, neuroradiological parameters and aetiology were reported (in symptomatic and asymptomatic forms). Finally, symptoms and signs, familiar and natural history were analyzed. CONCLUSIONS: First Italian epidemiological data (prevalence, incidence) on Chiari and syringomyelia was collected, according to shared diagnostic Recommendations. Future perspectives include the adoption of these Recommendations at national level to standardize the access to diagnosis and care process and promote multicenter clinical trials.


Assuntos
Malformação de Arnold-Chiari/epidemiologia , Doenças Raras/epidemiologia , Sistema de Registros , Siringomielia/epidemiologia , Adolescente , Adulto , Malformação de Arnold-Chiari/classificação , Malformação de Arnold-Chiari/diagnóstico por imagem , Malformação de Arnold-Chiari/cirurgia , Doenças Assintomáticas , Criança , Pré-Escolar , Descompressão Cirúrgica , Progressão da Doença , Encefalocele/epidemiologia , Encefalocele/etiologia , Feminino , Formulários como Assunto , Humanos , Incidência , Itália/epidemiologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Fenótipo , Guias de Prática Clínica como Assunto , Gravidez , Complicações na Gravidez/epidemiologia , Prevalência , Sistema de Registros/estatística & dados numéricos , Siringomielia/diagnóstico por imagem , Siringomielia/cirurgia , Adulto Jovem
17.
J Pak Med Assoc ; 70(4): 694-698, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32296217

RESUMO

OBJECTIVE: To assess the compliance of healthcare personnel with regard to sending completely filled transfusion requisition forms. METHODS: The audit was conducted at Aga Khan University Hospital, Karachi, and comprised requisition slips received at the hospital blood bank from September 2014 to February 2015. The British Committee for Standards in Haematology guidelines was used as the standard. Percentage of each variable on the proforma was analsyed. Rating <50% for each form was defined as "needs improvement", 51-99% as "good compliance" and 100% as "excellent compliance". After implementing strategies to increase awareness and the launching of an online transfusion requisition form, a re-audit of physician compliance was done from February to April 2016 and the results were compared with the initial audit.. Data was analysed using SPSS 21. RESULTS: The audit and the re-audit both comprised 1000 transfusion requisition forms each. In the audit, The sum of total scores of all the transfusion requisition forms was 4911, indicating a compliance rate of 46.9%, while the corresponding numbers in the re-audit were 10000 and 100%. CONCLUSIONS: The implementation of online blood transfusion requisition system had a positive impact on compliance rate.


Assuntos
Transfusão de Sangue , Documentação/normas , Escrita Manual , Sistemas de Registro de Ordens Médicas , Médicos , Auditoria Clínica , Formulários como Assunto , Humanos
19.
Headache ; 60(3): 576-588, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31943195

RESUMO

OBJECTIVE: We explore factors that may have contributed to differences in treatment-emergent adverse events in the phase 2 and phase 3 lasmiditan clinical trials. BACKGROUND: Phase 2 and phase 3 trials showed that the centrally penetrant 5-HT1F agonist, lasmiditan, was effective; higher frequency and severity of adverse events (AEs) were seen in phase 2. METHODS: This work represents a hybrid of a review of primary documents and study reports with additional post hoc analyses. Protocols, informed consents, data collection forms, and methodologies were reviewed. This information was supplemented by results from the clinical study reports and post hoc analyses of individual patient data from each trial. RESULTS: For lasmiditan 100 and 200 mg, in phase 2, the incidence of ≥1 AE was 72-86% (26% severe), while in phase 3 was 36-43% (2% severe). The most common AEs in all studies were CNS-related. The phase 2 consent form was more descriptive of AEs than phase 3. In phase 2, patients recorded AEs and severity in a paper diary that warned about drowsiness and dizziness. In phase 3, patients recorded in electronic diaries whether they experienced unusual feelings after dosing with lasmiditan that they had not felt with a migraine before, and were contacted to determine if an AE had occurred. In phase 2, the AE Schwindel was variably translated from German as "vertigo" or "dizziness," while phase 3 vertigo cases were queried to ensure there was a sensation of rotation or movement. History of recurrent dizziness and/or vertigo was exclusionary in phase 3. CONCLUSIONS: This work illustrates how informed consent wording, AE collection methods, translation, exclusion criteria, and other factors may be important determinants for reporting of the frequency and severity of AEs in clinical trials.


Assuntos
Benzamidas/farmacologia , Ensaios Clínicos Fase II como Assunto , Ensaios Clínicos Fase III como Assunto , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Formulários como Assunto , Consentimento Livre e Esclarecido , Transtornos de Enxaqueca/tratamento farmacológico , Medidas de Resultados Relatados pelo Paciente , Piperidinas/farmacologia , Piridinas/farmacologia , Agonistas do Receptor de Serotonina/farmacologia , Adulto , Benzamidas/administração & dosagem , Benzamidas/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Piperidinas/administração & dosagem , Piperidinas/efeitos adversos , Piridinas/administração & dosagem , Piridinas/efeitos adversos , Agonistas do Receptor de Serotonina/administração & dosagem , Agonistas do Receptor de Serotonina/efeitos adversos , Tradução
20.
J Am Acad Orthop Surg ; 28(19): 814-822, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31868837

RESUMO

INTRODUCTION: A standardized letter of recommendation (SLOR) form for orthopaedic surgery residency programs has recently been adopted for use, but it has not been scientifically evaluated. The purpose of this study is to investigate the usefulness of the SLOR form in the selection process. METHODS: All SLOR forms submitted to our institution over a single application cycle were extracted and analyzed. The United States Medical Licensing Examination Step 1 scores, grades in clinical rotations, Alpha Omega Alpha status, and the number of publications were recorded for each applicant. Correlations were calculated with Spearman rho, and inter-rater reliability was evaluated by calculating intraclass correlation coefficients. RESULTS: One thousand one hundred thirty-seven SLOR forms were analyzed for 513 applicants. There was substantial rank inflation with the SLOR form; the majority (92%) of applicants were rated as either ranked to match or in the top one-third of their rank list. Objective applicant factors such as grades and Step 1 scores demonstrated a very weak to nonexistent correlation with the summative rank (rho 0.07 to 0.13, P ≤ 0.012). Poor inter-rater reliability was observed with the intraclass correlation coefficient ranging from 0.22 to 0.33 (P < 0.001). CONCLUSIONS: The usefulness of the SLOR form is limited by the very high ratings observed for all questions, and in particular, the final summative rank. Measures to reduce rank inflation must be implemented to improve the discriminant ability of the SLOR form, and if this cannot be accomplished, perhaps the form should be abandoned. LEVEL OF EVIDENCE: Level III Retrospective.


Assuntos
Correspondência como Assunto , Avaliação Educacional/métodos , Avaliação Educacional/normas , Formulários como Assunto , Internato e Residência , Candidatura a Emprego , Ortopedia/educação , Seleção de Pessoal/métodos , Seleção de Pessoal/normas , Humanos , Estados Unidos
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