ABSTRACT
UNLABELLED: Pilot study to validate a Computerized Decision Support Systems (CDS) (HTE-DLP) for improving treatment of hyperlipidemia. METHODS: HTE-DLP was programmed to offer automatic specific reminders for lipid treatment. Seventy-seven patients with high cardiovascular risk were randomized. 10 expert physicians in cardiovascular-risk management were recruited. We assessed number of patients at LDL <70 mg/dl after 12 weeks of treatment. RESULTS: A greater proportion of intervention group reached the LDL-C <70 mg/ml [55.0% vs 12.5%, p = 0.003; OR: 3.26 IC (1.16-9.15)]. "High potency statins" and combined therapy were used more frequently in the intervention group than the control group (p = 0.001). Seven adverse effects were documented in the intervention group and two in the control group. An acceptable relationship was observed with regard to costeffectiveness in the intervention group. Physicians expressed good agreement with HTE-DLP (86.1%) and comfortable ease-of-use (85%). CONCLUSIONS: Use of a CDSS in high-risk cardiovascular patients resulted in a significant reduction in LDL-C levels.
Subject(s)
Decision Support Systems, Clinical/economics , Dyslipidemias/therapy , Aged , Atherosclerosis/economics , Atherosclerosis/therapy , Cardiology/methods , Cardiology/standards , Cholesterol, LDL/blood , Cost-Benefit Analysis , Dyslipidemias/economics , Female , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/economics , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Male , Middle Aged , Pilot Projects , Treatment Outcome , Triglycerides/blood , User-Computer InterfaceABSTRACT
In this paper, we review the etiological, clinical and evolutive aspects of patients with fever of unknown origin (FUO) whose hepatic biopsy showed the presence of granulomas (GH). This is retrospective study covering a period of 10 years (1982-1991). The clinical records of all the patients hospitalized due to FUO (n = 71) and of all those in whose hepatic biopsy the presence of GH (n = 70) was documentated, were reviewed. Thirty patients fulfilled both criteria: FUO + GH. In our environment, Q Fever is the most frequent cause of FUO and GH in patients without infection by the HIV. On the contrary, in patients infected by HIV, the most frequent etiology is tuberculosis.
