ABSTRACT
End-stage renal disease (ESRD) patients undergoing outpatient hemodialysis (HD) and home peritoneal dialysis (PD) are high risk population of severe and critical types caused by SARS-CoV-2 infection. In order to improve the quality of diagnosis and treatment in dialysis patients with SARS-CoV-2 infection, we wrote this recommendation for primary care clinicians. During the epidemic period of SARS-CoV-2 infection, all patients should be instructed to strengthen self-management. Once the SARS-CoV-2 infection was found in dialysis patients, early stratified management should be carried out within 72 hours after the first positive nucleic acid or antigen test results, which includes early antiviral therapy, early recognition, and transferring severe patients from community or primary hospital to a referral hospital promptly. Guidance for dietary and sports rehabilitation after SARS-CoV-2 infection should also be started as soon as possible.
ABSTRACT
@#Diabetes remains as the 6th leading cause of death in the Philippines, with more than 33,000 deaths in 2016. Given this alarming prevalence, it is imperative that this public health concern be prioritized in the country and to answer such concern, a group of cardiologists and endocrinologists who are in active clinical practice and research, formed a technical working group composed of five members. Their primary objective was to develop an evidence-based consensus document for Filipino healthcare practitioners and people in the academe that would serve as a guideline on the approach to lower the CV risk of individuals with T2DM. The TWG agreed on focusing with the pharmacological approach to treatment of lowering CV risk for T2DM patients using the ADAPTE model which is a more systematic approach to guideline adaptation. The recommendations were developed using the ADAPTE framework appraising all international practice guidelines and recommendations through to 2013. The technical working group’s overall objective of guideline adaptation is to take advantage of the existing guidelines to enhance the efficient production and use of high-quality adapted guidelines specially in the local Philippine setting. Each of these articles was then assessed using the AGREE instrument. Based on the key questions that the technical working group had identified regarding the approach to lower the risk of individuals with type 2 diabetes, 9 recommendations concerning the antidiabetic drug of choice for persons with type 2 diabetes with or without established ASCVD and management of type 2 diabetes mellitus patients with hypertension and dyslipidemia were drafted and are presented in this report.
Subject(s)
Diabetes Mellitus, Type 2 , Heart Disease Risk FactorsABSTRACT
To assess the adherence of physicians involved in the management of diabetes mellitus with or without co-morbidities with reference to Clinical Practice Guideline 2009 given by Ministry of Health Malaysia in the tertiary care hospital, Pinang General Hospital Malaysia. Cross-sectional study was done at tertiary care hospital, Penang, Malaysia. The total 51 physicians and 1020 patient’s prescriptions written by same physicians were taken from the record of the Penang General Hospital (20 prescriptions for each enrolled physician). All 1020 patients were suffering from diabetes mellitus with or without co-morbidities. These patients were recruited from the different wards of the Penang General Hospital. Depending on the recommendations of CPG 2009 the prescriptions of patients were divided into adherent and non-adherent prescriptions. The overall good level of physician adherence was seen with respect to the recommendations of CPG 2009 in all prescriptions. A statistically significant negative association (Ф= 0.094, p-value=0.003) was observed between diabetes mellitus control and co-morbidities. CPG adherent had statistically weak negative association (Ф= -0.081, p-value=0.010) with patients having co-morbidities. No statistically significant association was observed between CPG adherence and any other co-morbidity. The study explored the several features of prescription pattern of physicians involved in the management of diabetes mellitus with or without co-morbidities and recognized the need for improvement in their prescription pattern for treating the diabetes mellitus.
ABSTRACT
To assess the adherence of physicians involved in the management of diabetes mellitus with or without co-morbidities with reference to Clinical Practice Guideline 2009given by Ministry of Health Malaysia in the tertiary care hospital, Pinang General Hospital Malaysia. Cross-sectional study was done at tertiary care hospital, Penang, Malaysia. The total 51physicians and 1020 patient’s prescriptions written by same physicians were taken from the record of the Penang General Hospital (20 prescriptions for each enrolled physician). All 1020 patients were suffering from diabetes mellitus with or without co-morbidities. These patients were recruited from the different wards of the Penang General Hospital. Depending on the recommendations of CPG 2009 the prescrip-tions of patients were divided into adherent and non-adherent prescriptions. The overall good level of physician adherence was seen with respect to the recommendations of CPG2009 in all prescriptions. A statistically significant negative association (Ф= 0.094, p-value=0.003) was observed between diabetes mellitus control and co-morbidities. CPG adherent had statistically weak negative association (Ф= - 0.081, p-value=0.010) with patients having co-morbidities. No statistically significant association was observed between CPG adherence and any other co-morbidity. The study explored the several features of prescription pattern of physicians involved in the management of diabetes mellitus with or without co-morbidities and recognized the need for improvement in their prescription pattern for treating the diabetes mellitus.
ABSTRACT
Morphea is a rare fibrosing disorder of the skin. Evidence-based treatment strategies in morphea are lacking. This review summarizes the available data on morphea treatment and provides therapeutic strategies based on morphea subtypes. The Cochrane Library, Medline and Embase from inception until May of 2011 were searched using the key words "morphea" and "morphea treatment." Reference lists of the resultant articles, as well as relevant reviews, were also searched. This review focuses on randomized controlled trials, prospective interventional trials without controls and retrospective reviews with greater than five subjects.
ABSTRACT
Summary: Cerebrovascular disease is one of the leading causes of death in Chile. Its main manifestation, CVA, is most frequent in elderly subjects. Approximately 70 percent of CVA recognize an ischemic origin, the rest corresponds to intracerebral bleeding episodes. In several studies the prior use of statins has been proven to reduce the incidence of CVA as well as improving their prognosis, in spite of a lack of significant correlation with statin's effects on serum cholesterol. Statin effects have been related to their pleiotropic properties, to reductions in Protein C levels and to activation of endothelial stem cells. American Stroke Association Guidelines (2011) recommend statins for CVA in subjects with high cardiovascular risk. Triglycerides have not been clearly shown to be a risk factor for CVA and no other lipid lowering agents are recommended in this setting.