International journal of clinical practice
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Int. J. Clin. Pract. · Dec 2020
A Nurse-led Atrial Fibrillation Clinic: Impact on Anticoagulation Therapy and Clinical Outcomes.
Nurses play a central role in the management of atrial fibrillation (AF) patients. An unresolved question is whether a nurse-led clinic would improve clinical outcomes. Herein, we investigated the impact of a nurse-led clinic on anticoagulation therapy and clinical outcomes in a cohort of naïve AF patients. ⋯ A nurse-led AF clinic may offer a "patient-centered" review and holistic follow-up, and it would be associated with a reduction of ischaemic stroke/TIA, without increasing bleeding complications. Further studies should confirm these results.
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Int. J. Clin. Pract. · Dec 2020
Prognostic machine learning models for COVID-19 to facilitate decision making.
An increasing number of COVID-19 cases worldwide has overwhelmed the healthcare system. Physicians are struggling to allocate resources and to focus their attention on high-risk patients, partly because early identification of high-risk individuals is difficult. ⋯ Implementing such an algorithm to predict high-risk individuals during the early stages of infection would be helpful in decision making for clinicians such that irreversible damage could be prevented. Here, we propose recommendations to develop prognostic machine learning models using electronic health records so that a real-time risk score can be developed for COVID-19.
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Urea is a hygroscopic molecule that, because of its moisturising properties, is topically used for the treatment of skin dryness at concentrations ranging from 2% to 12% in different formulations. Based on existing literature, low-concentration urea-containing products are effective in the treatment and/or prevention of xerosis in some skin disorders such as ichthyosis, atopic dermatitis and psoriasis, or unrelated to specific skin diseases. Generally, urea formulations at low concentration are well-tolerated and suited for the treatment of large skin areas, once or twice daily, even for a long period of time. At low concentrations stinging and burning sensation is rare and transient, whit no reported sensitisation despite its widespread use.
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We aimed to investigate the demographic shifts in emergency service admissions, possible measures and room for improvement in emergency services during the Covid-19 pandemic. ⋯ Measures taken to prevent the spread of Covid-19 infection have caused a significant drop in emergency service admissions. We are of the opinion that this will lead to an increase in deaths occurring at home, and we will soon encounter patients with worse prognosis and overcrowded emergency services. We are in opinion that the public awareness about emergency conditions requiring emergency service admission should be heightened alongside of the "stay home" calls. As: "In order to reduce morbidity and mortality from non-covid-19 conditions, we call for heightened public awareness on other emergency and urgent symptoms, which should prompt urgent attendance to medical services."
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Int. J. Clin. Pract. · Dec 2020
Current and Future Implications of COVID-19 on Gastroenterology Training and Clinical Practice.
The novel coronavirus disease 2019 (COVID-19) pandemic has affected almost every country on the globe, affecting 185 countries with more than 2.6 million cases and 182,000 deaths as of April 22, 2020. The United States (US) has seen an exponential surge in the COVID-19 patients and has become the epicentre with more than 845,000 confirmed cases and 46,000 deaths. The governments and healthcare providers all over the world are racing with time to reduce the rate of increase in active cases by social distancing to flatten the curve of this pandemic. ⋯ Given the imperatives for social and physical distancing, training programmes have to implement innovative educational methods to substitute traditional teaching. Healthcare organisations must synchronise institutional workforce needs with trainee safety, education and well-being. In this perspective, we have discussed the challenges that can be anticipated and implementing strategies to support fellows during the times of the COVID-19 pandemic.