International journal of clinical practice
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Int. J. Clin. Pract. · Sep 2021
Liver Stiffness is Associated with Disease Severity and Worse Clinical Scenarios in Coronavirus Disease 2019: A Prospective Transient Elastography Study.
Pre-existing chronic liver disease is currently considered a poor prognostic factor for coronavirus disease 2019 (COVID-19). The present study aimed to investigate the association of liver stiffness measurement (LSM) with disease severity and clinical course of COVID-19. ⋯ Initial VCTE application might help physicians identify patients who are more likely to have severe illness or worse clinical outcomes, in addition to other well-established clinical and laboratory factors. Further multicentre prospective studies are warranted to validate our results.
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Int. J. Clin. Pract. · Sep 2021
Deprescribing practice in a resource-limited setting: Healthcare providers' insights in Ethiopia.
Inappropriate polypharmacy poses risks of adverse drug events, high healthcare costs and mortality. Deprescribing could minimise inappropriate polypharmacy and the consequences thereof. The aim of this study was to evaluate healthcare providers' (HCPs') attitudes toward and experiences with deprescribing practice in Ethiopia. ⋯ HCPs' decision to discontinue a medication could be multifactorial. Physicians could be influenced by physical health condition and clinical endpoints for deprescribing decision. Future studies should emphasise on barriers and facilitators to deprescribing practice specific to the context in Ethiopia.
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Int. J. Clin. Pract. · Sep 2021
Outcomes of transesophageal echocardiogram guided electrical cardioversion in patients with atrial fibrillation greater than 48 hours treated in the emergency department versus the cardiology ward: A retrospective comparison study.
The current emergency medicine literature on cardioversion for atrial fibrillation (AF) describes its performance on those who are hemodynamically unstable, present within 48 hours of the onset of the arrhythmia, or are on long-term anticoagulants. For patients who are not anticoagulated and present with atrial fibrillation for more than 48 hours, one option is to perform a transesophageal echocardiogram and then synchronized cardioversion in the absence of atrial clot. The objective of this study is to compare outcomes of patients presenting to the emergency department (ED) with atrial fibrillation (AF) of more than 48 hours who underwent a transesophageal echocardiogram (TEE) and subsequent cardioversion in the ED versus the cardiology ward. ⋯ Patients who present in atrial fibrillation for more than 48 hours and then have a TEE undergo electrical cardioversion faster in the ED compared with the cardiology ward. This clinical pathway also results in a shorter length of hospital stay without having more side effects.
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Int. J. Clin. Pract. · Sep 2021
The Knowledge, Attitudes and Practices of Healthcare Workers on Drug Hypersensitivity Reactions in Children: A Tertiary Center Experience from Turkey.
Adverse drug reactions are an important public health concern that affects doctor and dentist prescriptions and healthcare workers' practice. We planned to evaluate the knowledge, attitudes and practices of healthcare workers in our country about drug hypersensitivity reactions in paediatric patients and to determine the risk factors that may affect them. ⋯ Our results suggest that advanced training programmes must be provided for healthcare workers in learning drug hypersensitivity reactions, particularly in paediatric patients.
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Int. J. Clin. Pract. · Sep 2021
Is it necessary to have a guidewire down through the ureter during mini percutaneous nephrolithotomy? Single-centre experience with 1052 cases.
In this study, it is aimed to identify the rate of successful placement of a guidewire down through the ureter during PNL and to compare the outcomes of different locations of guidewires in the collecting system following renal puncture in terms of success and complications rates. ⋯ Placement of guidewire down through the ureter could not be established in more than 60% of the cases. Location of guidewire prior to dilation did not affect the outcomes. Therefore, we suggest to proceed with tract creation even when the guidewire coils within the punctured calyx.