International journal of clinical practice
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Int. J. Clin. Pract. · Apr 2020
A consultant-led anticoagulation review of all patients in one clinical commissioning group to prevent atrial fibrillation related stroke.
Ensuring patients with Atrial fibrillation (AF) are appropriately anticoagulated across NHS Bedfordshire Clinical Commissioning Group (BCCG) with the primary goal of reducing AF-related strokes. ⋯ Through comprehensive audit, BCCG have been able to ensure that patients with AF are appropriately anticoagulated in 80% of their catchment population. This has improved anticoagulation to prevent AF-related stroke.
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Int. J. Clin. Pract. · Apr 2020
Association between serum uric acid levels and metabolic markers in patients with type 2 diabetes from a community with high diabetes prevalence.
The importance of uric acid has been increasingly appreciated because of its association with the development of diabetes mellitus and related diseases. ⋯ SUA level was positively associated with incidence of cardiovascular diseases CVD in patients with abnormal eGFR. HbA1c correlated significantly with SUA level in patients with normal eGFR. Incidence of metabolic syndrome did not show any association with SUA level. Incidence of hypertension, waist circumference and serum triglycerides were significantly higher and serum high-density lipoprotein level was lower in patients with higher SUA level.
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Int. J. Clin. Pract. · Apr 2020
Multicenter StudyDiabetes in day case general and vascular surgery: A multicentre regional audit.
People with Diabetes Mellitus (DM) are at increased risk of postoperative complications if their HbA1C readings are not well controlled. In the UK, there are clear national guidelines requiring all people with DM to have HbA1C blood testing within 6months before undergoing surgery and that these readings should be below 69 mmol/mol if this is safe to achieve. The aim of this study was to determine whether hospitals in the region were compliant with the guidelines. ⋯ A significant proportion of people with diabetes undergoing elective day case procedures in our region do not have HbA1C testing within 6 months of their procedure as recommended by the national guidelines. In patients who do have a high HbA1C, the majority still undergo surgery without adequate control of their DM. Greater awareness amongst healthcare workers and robust pathways are required for this vulnerable group of patients if we are to reduce the risk of developing postoperative complication rates.
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Int. J. Clin. Pract. · Apr 2020
Implementation of a standardised pharmacist check of medical orders prior to preparation of anticancer drugs to reduce drug wastage.
The increasing cost of anticancer drugs is now being recognised as a global problem, and measures against drug wastage are among the most important cost containment strategies for anticancer drugs. ⋯ Pharmacists' checks of the eligibility, start of treatment, dose reduction and discontinuation criteria for anticancer drugs based on the present protocol prior to preparation of injectable anticancer drugs was useful for reducing drug wastage after preparation.
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Int. J. Clin. Pract. · Apr 2020
Admission serum phosphate levels and the risk of respiratory failure.
The objective of this study was to evaluate the relationship between admission serum phosphate and in-hospital respiratory failure requiring mechanical ventilation in hospitalised patients. ⋯ Our study revealed the J-shaped association between serum phosphate level at admission and risk of respiratory failure requiring mechanical ventilation in unselected hospitalised patients.