International journal of clinical practice
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To analyse the accuracy of commonly used risk scores (PSI and CURB-65) in predicting mortality and need for ICU admission in Covid-19. ⋯ Prognosis scores routinely used for CAP (PSI and CURB-65) were good predictors for mortality in patients with Covid-19 CAP but not for need of hospitalisation or ICU admission. In the evaluation of Covid-19 pneumonia, we need scores that allow to decide the appropriate level of care.
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Int. J. Clin. Pract. · Sep 2020
ReviewImpact of food and drinks on urine production: a systematic review.
The impact of food and drinks on body fluid metabolism is of direct clinical relevance but current evidence remains fragmented. ⋯ Current evidence suggests that although several types of food and drinks may impact body fluid metabolism, the quality of the data is variable. Urine production appears to be influenced by multiple factors including composition (ie, moisture, macronutrients, and electrolytes), metabolite load, and the presence of specific diuresis-promoting substances (eg, caffeine, alcohol) and other bioactive phytochemicals. Future research is needed to support current evidence and the physiologic mechanisms underlying these findings.
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Int. J. Clin. Pract. · Sep 2020
Randomized Controlled TrialOnabotulinumtoxin Type A reconstitution with preserved versus preservative-free saline in chronic migraine (B-RECON). A randomized, double-blind trial.
Onabotulinumtoxin type A (BoNTA) is manufactured as powder that requires reconstitution with normal saline prior to injection. Previous literature has suggested that preserved saline (PS) exerts a local anaesthetic effect, and reduces the procedure discomfort when used in reconstitution in lieu of preservative-free saline (PFS). However, this was mainly studied in the aesthetics indications of BoNTA, and never in its use for the treatment of chronic migraine. The distinction is important as chronic migraine population suffers high incidence of scalp allodynia which makes it more prone to injection site pain. In addition, the pain of the procedure itself may be related to the spike of migraine frequency in the immediate postprocedural period which can occur in up to 5% of patients receiving the treatment. Our trial aimed to study the difference in procedural pain scale, and postprocedural headache rating with the use of PS vs PFS in constitution of BoNTA when used as a treatment for chronic migraine. ⋯ This study supports the use of PS (bacteriostatic) over PFS for reconstitution of BoNTA in chronic migraine as it reduces the discomfort of the injection sites.
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Int. J. Clin. Pract. · Sep 2020
The treatment rate of erectile dysfunction (ED) in younger men with Type 2 Diabetes is up to 4 times higher than the equivalent non-diabetes population.
Erectile dysfunction (ED) is common in older age and in diabetes mellitus (DM). Phosphodiesterase type 5-inhibitors (PDE5-is) are the first-line for ED. We investigated how the type of diabetes and age of males affect the PDE5-i use in the primary care setting. ⋯ There is a wide variation in the use of PDE5-is. With only 14% variance capture, other factors including wide variation in patient awareness, prescribing rules of local health providers, and recognition of the importance of male sexual health by GP prescribers might have a significant impact.
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Int. J. Clin. Pract. · Sep 2020
Factors Affecting Health-related Quality of Life Among Hypertensive Patients Using the EQ-5D Tool.
Hypertension (HTN) is a major risk factor for cardiovascular disease, it is an epidemic health problem with 1 billion people affected worldwide. Limited studies have examined the impact of HTN on physical, psychological and social functioning of HTN patients. Furthermore, little is known about factors that impair these domains among these patients. Thus, the aim of the present study is to assess health-related quality of life (HRQoL) and to explore predictors of poor HRQoL in patients with HTN in Jordan. ⋯ The current study highlights factors that negatively impact HRQoL in patients with HTN. Such findings should provide useful information for future pharmaceutical care intervention programmes aimed at improving HRQoL and other health outcomes in patients with HTN.