International journal of clinical practice
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Int. J. Clin. Pract. · Mar 2021
Where did all the trauma go? A rapid review of the demands on orthopaedic services at a U.K. Major Trauma Centre during the COVID-19 pandemic.
This retrospective study aims to quantify the early impact of the COVID-19 pandemic on trauma and orthopaedic surgery at a Major Trauma Centre (MTC) in the United Kingdom. We hypothesise that the social restrictions placed on the public by the government will reduce the amount of trauma presentations and operations performed. ⋯ The COVID-19 pandemic has had a profound effect of the provision of trauma and orthopaedic surgery. We report a significant decrease in all orthopaedic referrals during the pandemic, leading to a greatly reduced number of trauma operations performed. This has allowed for reallocation of staff and resources. We must plan for the lifting of social restrictions, which may lead to an increase in patients presenting with trauma requiring operative intervention.
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Int. J. Clin. Pract. · Mar 2021
Gender differences in incidence and in-hospital outcomes of community-acquired, ventilator-associated and nonventilator hospital-acquired pneumonias in Spain.
We aim to compare the incidence and in-hospital outcomes of community-acquired pneumonia (CAP), ventilator-associated pneumonia (VAP) and nonventilator hospital-acquired pneumonia (NV-HAP) according to gender. ⋯ Our findings show a difference between females and males, with females presenting a lower incidence of all types of pneumonia. However, female gender was a risk factor for IHM after VAP.
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Int. J. Clin. Pract. · Mar 2021
The lower the expectations in controlling the symptoms of advanced cancer patients, the better the clinical response.
The aim of this study was to compare patients' global impression (PGI) and the achievement of personalised symptom goal response (PSGR), after a comprehensive palliative care treatment in advanced cancer patients having high (HPSG) and low symptom goals (LPSG). ⋯ Advanced cancer patients with low expectations (HPSG) were more likely to achieve their PSGR after a comprehensive palliative care treatment, reporting also a better PGI for some leading symptoms such as pain, weakness, and poor well-being. More fragile patients seem to have lower expectations and to be more likely to be satisfied.
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Int. J. Clin. Pract. · Mar 2021
Impact of the multidisciplinary antimicrobial stewardship team intervention focusing on carbapenem de-escalation: a single-center and interrupted time series analysis.
As a result of the constant increase in carbapenem resistance amongst gram-negative bacteria in several countries, the inappropriate use of carbapenems must be reduced. Antimicrobial stewardship programmes (ASPs) aim to improve carbapenem usage by implementing interventions, including the promotion of the de-escalation (DE) strategy. Thus, this study aimed to evaluate the impact of this strategy on carbapenem use based on a clear definition of DE. ⋯ The PPRF strategy implemented by the AST could improve the carbapenem usage by increasing the DE rate of carbapenem.
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Post-COVID-19 symptoms and diseases appeared on many survivors from COVID-19 which are similar to that of the post-severe acute respiratory syndrome (SARS) fatigue. Hence, the study aims to investigate and characterise the manifestations which appear after eradication of the coronavirus infection and its relation to disease severity. ⋯ The post-COVID-19 manifestation is largely similar to the post-SARS syndrome. All subjects recovered from COVID-19 should undergo long-term monitoring for evaluation and treatment of symptoms and conditions that might be precipitated with the new coronavirus infection.