International journal of clinical practice
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Int. J. Clin. Pract. · Mar 2021
The Use of Computed Tomography as the First Imaging Modality in Patients with Renal Colic and Microscopic Hematuria.
We aimed to evaluate the use of computed tomography (CT) as the first imaging modality in patients with renal colic and microscopic haematuria. ⋯ Because of its high sensitivity and specificity values in the diagnosis of stone disease, easy applicability and fast results, CT can be safely used as the first imaging modality for the diagnosis of renal colic and microscopic haematuria.
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Int. J. Clin. Pract. · Mar 2021
ReviewAn overview of antiviral strategies for coronavirus 2 (SARS-CoV-2) infection with special reference to antimalarial drugs chloroquine and hydroxychloroquine.
At present, neither specific antiviral drugs, nor vaccine is recommended for coronavirus disease 2019 (COVID-19) treatment. In this review we discuss the drugs suggested as therapy for COVID-19 infection, with a focus on chloroquine and hydroxychloroquine. The list of drugs used for COVID-19 treatment includes a combination of lopinavir and ritonavir, remdesivir, favipiravir, alpha-interferon, ribavirin, atazanavir, umifenovir, and tocilizumab. ⋯ The results from the double-blind, randomised clinical trials, including large number of participants, will add better insight into the role of these two drugs as already available and affordable, antimalarial therapy. The ethical issue on emergency use of chloroquine and hydroxychloroquine in the settings of COVID-19 should be carefully managed, with adherence to the "monitored emergency use of unregistered and experimental interventions" (MEURI) framework or be ethically approved as a trial, as stated by the WHO. Potential shortage of chloroquine/hydroxychloroquine on the market can be overbridged with regular prescriptions by medical doctors and national drug agency should ensure sufficient quantities of these drugs for standard indications.
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Int. J. Clin. Pract. · Mar 2021
Impact of Incorporating Echocardiographic Screening into a Clinical Prediction Model to Optimize Utilization of Echocardiography in Primary Care.
Access to public subspecialty healthcare is limited in underserved areas of Brazil, including echocardiography (echo). Long waiting lines and lack of a prioritisation system lead to diagnostic lag and may contribute to poor outcomes. We developed a prioritisation tool for use in primary care, aimed at improving resource utilisation, by predicting those at highest risk of having an abnormal echo, and thus in highest need of referral. ⋯ The addition of screening echo to clinical variables significantly improves the performance of a score to predict major HD.
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Int. J. Clin. Pract. · Mar 2021
Adherence to antihypertensive medication after referral to secondary health care: a prospective cohort study.
Nonadherence (NAd) to antihypertensive medication is associated with lack of blood pressure control and worsened long-term outcomes. Increased access to a programme for high-risk cardiovascular patients has the potential to reduce NAd and improve clinical outcomes. We evaluated implementation NAd prevalence and risk factors among severely hypertensive patients after 12-month-long access to secondary healthcare centres. ⋯ Greater access to health services is associated with a reduction in NAd to antihypertensive medication and better blood pressure control. NAd was correlated with modifiable variables such as treatment complexity and, for the first time, team satisfaction, suggesting that implementation of similar programmes may limit NAd in similar patient groups.
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Int. J. Clin. Pract. · Mar 2021
In-vitro and in-vivo performance modeling and optimization of different dry powder inhalers: a complementary study of neural networks, genetic algorithms, and decision trees.
Aerosol delivery from DPIs could be affected by different factors. This study aimed to evaluate and predict the effects of different factors on drug delivery from DPIs. ⋯ Modelling of the input data showed a good differentiating and prediction power for both in vitro and in vivo models. The results of the modelling refer to the high efficacy of Diskus followed by Turbohaler for delivering aerosol. With two inhalations, the three DPIs showed an increase in the percent of drug excreted at slow inhalations.