Swiss medical weekly
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Swiss medical weekly · Jan 2017
Glycaemic, blood pressure and lipid goal attainment and chronic kidney disease stage of type 2 diabetic patients treated in primary care practices.
The prevalence of chronic kidney disease and diabetes is rising in Europe. These patients are at high cardiovascular and renal risk and need a challenging multifactorial therapeutic approach. ⋯ This cross-sectional study demonstrates that blood pressure and lipid goals are less often achieved than blood glucose control in type 2 diabetic patients followed up by primary care physicians in Switzerland. Goal attainments for HbA1c and LDL-c were not influenced by chronic kidney disease stages, in contrast to blood pressure. Reaching all three goals was rare (2.2%). There is a need for improvement in blood pressure control in advanced chronic kidney disease, whereas HbA1c goals may be loosened in the elderly and in advanced chronic kidney disease.
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Swiss medical weekly · Jan 2017
Informal caregiving, work-privacy conflict and burnout among health professionals in Switzerland - a cross-sectional study.
Health professionals were found to have an elevated burnout risk compared to the general population. Some studies also reported more emotional exhaustion - a component of burnout - for health professionals with informal caregiving responsibilities for children (double-duty child caregivers) or adults (double-duty adult caregivers) or a combination of both (triple-duty caregivers) compared to health professionals without informal caregiving roles (formal caregivers). However, the potential mediating effect of the work-privacy conflict in this relationship as well as differences between occupational groups have not yet been studied in healthcare settings. ⋯ Additional and large-scale studies focusing on the combination of formal and informal caregiving roles are needed to better understand its effect on burnout among healthcare professionals and to evaluate the role of work-privacy conflict.
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Swiss medical weekly · Jan 2017
Oncological patients in the intensive care unit: prognosis, decision-making, therapies and end-of-life care.
The effectiveness of intensive care unit (ICU) care for cancer patients remains controversial. Advances in antitumour and supportive care led to major improvements in outcomes of oncological patients in the ICU. Improved cancer therapies and supportive management of organ dysfunctions have contributed to improved survival rates. ⋯ Establishment of clear goals and approach to admit and treatment for oncological patients in the ICU are however urgently needed. This requires further prospective studies for independent validation in different medical settings and identifying prognostic tools that can aid with decision-making and patient selection for ICU. Cancer should not be seen as an exclusion criterion and priority should be given to assure the quality of life of oncological patients.
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Swiss medical weekly · Jan 2017
Effectiveness of the Bern Ambulatory Interprofessional Rehabilitation (BAI-Reha) programme for patients with chronic musculoskeletal pain: a cohort study.
Chronic pain has a high impact on individuals and society. (Cost-)effective interventions are desperately needed. We evaluated short- and long-term effects of the Bern Ambulatory Interprofessional Rehabilitation (BAI-Reha) for patients with chronic musculoskeletal pain. ⋯ This study confirms earlier data and supports the effectiveness of interprofessional rehabilitation for patients with chronic musculoskeletal pain.
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Swiss medical weekly · Jan 2017
Value of the Pitt Bacteraemia Score to predict short-term mortality in Staphylococcus aureus bloodstream infection: a validation study.
The widely used Pitt Bacteraemia Score (PBS) has repeatedly been described as a risk factor for short-term mortality in Staphylococcus aureus bloodstream infection (BSI), but little is known about its overall predictive performance. We therefore aimed to externally validate the PBS in S. aureus BSIs. ⋯ For short-term mortality, the PBS had a low predictive value in a patient population with methicillin-susceptible S. aureus BSI. There is a need to improve simple clinical scores to better predict mortality, in particular for S. aureus.