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Eduarda Barreira André Novo Josiana A. Vaz Ana M.G. Pereira 《Atencion primaria / Sociedad Espa?ola de Medicina de Familia y Comunitaria》2018,50(10):590-610
Objectives
Evaluate the effectiveness of the implementation of independently or combined dietary and physical activity programs on the blood glucose values and lipid profile in patients with type 2 diabetes, including participants aged 60 years and over.Design
Systematic review.Data source
PubMed/Medline database, with language restrictions. Papers published between 2010 and 2016 were included.Study selection
A total of 30 randomised controlled trials were included that focused on physical activity and dietary interventions in patients with type 2 diabetes mellitus and include participants aged 60 years and over.Results
The selected articles have shown that the implementation of physical activity programs (aerobic, resistance, flexibility and combined exercises), and programs based on a higher intake of vegetables, grains, legumes, fruits, unsaturated fatty acids, as well as consumption of foods with low glycaemic index, calorie restriction, intake of probiotics, vitamin D supplementation and educational sessions about diabetes improves blood glucose levels, as well as the lipid profile, in patients with type 2 diabetes.Conclusions
Physical activity and dietary programs are fundamental in the treatment and metabolic control of type 2 diabetes mellitus. 相似文献3.
Objectives
Trimethoprim has been recently included in the French guidelines for the treatment of urinary tract infections, but no epidemiological data supports its use. We aimed to determine the trimethoprim susceptibility of Escherichia coli isolates responsible for community-acquired urinary tract infections in women of childbearing age.Materials and methods
We conducted a national prospective survey. A total of 350 strains of E. coli isolated from urines in 35 laboratories were included. Antibiotic susceptibility testing was performed in each laboratory.Results
We reported a susceptibility rate of 78%, and a similar clinical categorization between trimethoprim and cotrimoxazole for 97.4% of isolates. We pointed out an association between resistance to trimethoprim and other antibiotic classes.Conclusion
The results support trimethoprim as a second-line therapy based on antibiotic susceptibility testing results. We confirm that trimethoprim and cotrimoxazole susceptibility rates are very close. 相似文献4.
Alba Llop-Gironés Montse Vergara-Duarte Josep Anton Sánchez Gemma Tarafa Joan Benach 《Gaceta sanitaria / S.E.S.P.A.S》2018,32(4):369-372
Objective
To measure time trends in major day surgery rates according to hospital ownership and other hospital characteristics among the providers of the public healthcare network of Catalonia, Spain.Method
Data from the Statistics of Health Establishments providing Inpatient Care. A generalized linear mixed model with Gaussian response and random intercept and random slopes.Results
The greatest growth in the rate of major day surgery was observed among private for-profit hospitals: 42.9 (SD: 22.5) in 2009 versus 2.7 (SD: 6.7) in 1996. These hospitals exhibited a significant increase in major day surgery compared to public hospitals (coefficient 2; p-value <0.01)Conclusions
The comparative evaluation of hospital performance is a decisive tool to ensure that public resources are used as rationally and efficiently as possible. 相似文献5.
A. Grateau M. Le Maréchal H. Labussière-Wallet S. Ducastelle-Leprêtre F.-E. Nicolini X. Thomas S. Morisset M. Michallet F. Ader 《Médecine et maladies infectieuses》2018,48(3):202-206
Objectives
To study the management of chronic disseminated candidiasis (CDC) in patients presenting with acute leukemia.Patients and methods
Single-center retrospective study of acute leukemia patients (2006–2015) to investigate three aspects of CDC: its impact on the time interval between diagnosis and hematopoietic stem cell transplantation, when required (non-parametric Wilcoxon-Mann-Whitney test); its impact on overall survival (Cox proportional hazard regression model); antifungal therapeutic strategies implemented.Results
A total of 639 patients presenting with acute leukemia were included; 144 were transplanted and 29 developed CDC. CDC did not significantly increase the time interval between diagnosis and transplantation, nor did it impact the overall survival of recipients. An improved overall survival was observed in non-transplanted acute leukemia patients presenting with CDC.Conclusion
CDC should not postpone transplantation if antifungal treatment is optimized. 相似文献6.
D. Vandroux N. Allou J. Jabot G. Li Pat Yuen E. Brottet B. Roquebert O. Martinet 《Médecine et maladies infectieuses》2018,48(2):141-144
Background
Coronavirus OC43 infection causes severe pneumonia in patients presenting with comorbidities, but clinical signs alone do not allow for viral identification.Objectives
To analyze acute manifestations of Coronavirus OC43 infections and outcomes of patients admitted to an intensive care unit (ICU).Patients and methods
Retrospective and monocentric study performed during a Coronavirus OC43 outbreak. We used multiplex PCR to detect an OC43 outbreak in Reunion Island during the 2016 Southern Hemisphere's winter: seven admissions to the ICU.Results
Mean age of patients was 71 [67;76] years, SAPS II was 42 [28;53], pneumonia severity index 159 [139;182] vs 73 [40.5;107] for patients in medical wards, and 43% required mechanical ventilation. Comorbidities were diabetes mellitus (87%), chronic respiratory failure (57%), and chronic renal failure (29%). One patient died from Haemophilus influenzae co-infection.Conclusion
As for MERS Co-V infections, underlying comorbidities impacted the clinical outcomes of OC43 infections. 相似文献7.
Objectives
Although regularly looked for in blood donors, HTLV infections are very rare in Reunion. We aimed to describe HTLV infections locally.Patients and methods
HTLV infections were identified from the database of the Reunion University Hospital administrative database (PMSI) between 2000 and 2016. Diagnosis was performed with HTLV 1/2 enzyme immunoassay test and confirmed by Western blot.Results
We reported three asymptomatic and four symptomatic HTLV infections, including two tropical spastic paraparesis/HTLV-1 associated myelopathies (TSP/HAM) and two adult T-cell leukemia/lymphoma (ATLL), diagnosed between 2000 and 2016.Conclusion
Reunion is a low HTLV prevalence area, which could be explained by its settlement history. The present report underlines the local circulation of HTLV and symptomatic infections. 相似文献8.
A. Bouaziz I. Uçkay S. Lustig A. Boibieux D. Lew P. Hoffmeyer P. Neyret C. Chidiac T. Ferry 《Médecine et maladies infectieuses》2018,48(3):207-211
Objective
The long-term impact of treatment strategies proposed by the IDSA guidelines for patients presenting with methicillin-susceptible S. aureus (MSSA) prosthetic joint infection (PJI) is not well-known.Patients and methods
Retrospective (2000–2010) cohort study including patients presenting with MSSA hip or knee PJI. A univariate Cox analysis was performed to determine if the non-compliance with IDSA surgical guidelines was a risk factor for treatment failure.Results
Eighty-nine patients with a mean follow-up of 2.8 years were included. Non-compliance with IDSA surgical guidelines was associated with treatment failure (hazard ratio 2.157; 95% CI [1.022–4.7]). The American Society of Anesthesiologists score, inadequate antimicrobial therapy, and a rifampicin-based regimen did not significantly influence patient outcome.Conclusion
Based on the IDSA guidelines, if a patient presenting with MSSA PJI is not eligible for implant retention, complete implant removal is needed to limit treatment failure. 相似文献9.
N. Masdoua L. Boublenza H. Hassaine J. Ngou A. Nahet M. Segondy F. Razik D. Regagba N. Sadouki D. Mouhammedi 《Médecine et maladies infectieuses》2017,47(1):38-41
Objectives
We aimed to characterize HPV infections and cervical lesions in Western Algeria.Patients and methods
A total of 96 cervical samples obtained from women at risk of HPV infection (HIV-1-infected or presenting with a gynecological disease) were analyzed to characterize this infection and search for cytological abnormalities.Results
A total of 60% of women at risk had an HPV infection. The rate of high-risk HPV (HR-HPV) infection among these women was 84.5% and that of intraepithelial lesions was 29.3%. The frequency of HPV infection was significantly higher among HIV-1-infected patients. An association between the presence of HR-HPV and the polygamy of the partner was observed. An association between cytological abnormalities and the use of oral contraceptives was observed among HIV-1-infected women.Conclusion
Given the high frequency of HPV infection in this at risk population, close monitoring and regular gynecological screening are essential. 相似文献10.
Lena Gunvor Larsson Siv Bäck-Pettersson Sven Kylén Bertil Marklund Eric Carlström 《Health policy (Amsterdam, Netherlands)》2017,121(1):58-65
Objectives
The aim of this study was to investigate primary care managers’ perceptions of their capability in providing care planning to patients with complex needs. Care planning is defined as a process where the patient, family and health professionals engage in dialogue about the patient’s care needs and plan care interventions together.Methods
Semi-structured interviews with 18 primary care managers in western Sweden were conducted using Westrin’s theoretical cooperation model. Data were analysed using a qualitative deductive method.Main findings
Results reveal that the managers’ approach to care planning was dominated by non-cooperation and separation. The managers were permeated by uncertainty about the meaning of the task of care planning as such. They did not seem to be familiar with the national legislation stipulating that every healthcare provider must meet patients’ need for care interventions and participate in the care planning.Implications for practice
To accomplish care planning, the process needs to cross – and overcome – both professional and organisational boundaries. There is also a need for incentives to develop working methods that promote local cooperation in order to facilitate optimal care for patients with complex needs. 相似文献11.
G. Hoarau S. Picot J. Lemant J. Peytral P. Poubeau P. Zunic C. Mohr X. Coueffe P. Gerardin E. Antok 《Médecine et maladies infectieuses》2018,48(6):414-418
Objectives
We aimed to describe the epidemiology of Candida bloodstream infection in an intensive care unit (ICU) in Reunion Island.Methods
We performed a retrospective cohort study and evaluated 63 candidemia episodes, which occurred between January 2004 and December 2015 in the ICU of a University Hospital in St-Pierre.Results
The incidence rate of candidemia in the ICU was estimated at 7.6%. Candida albicans was the most common yeast pathogen species recovered (54%), followed by Candida glabrata (17%), Candida tropicalis (12%) and Candida parapsilosis (10%). Between 2012 and 2015, we also observed a modification of antifungal use.Conclusion
The epidemiology of candidemia in Reunion Island is characterized by the predominance of Candida albicans and by the relative importance of Candida tropicalis. This pattern corresponds to a model of epidemiological transition between the one usually observed in tropical areas and the one observed in temperate countries. 相似文献12.
A. Bleibtreu N. Grall J.-P. Laissy C. Rioux A. Strukov S. Lariven P. Yeni Y. Yazdanpanah V. Joly 《Médecine et maladies infectieuses》2018,48(8):533-539
Background
Miliary tuberculosis (miliary TB) is characterized by a hematogenous spread of Mycobacterium tuberculosis. Cerebral lesions associated with miliary TB have been reported with diverse frequencies.Methods
We retrospectively analyzed brain imaging in 34 patients presenting with proven miliary TB hospitalized in our teaching hospital between 2008 and 2014.Results
Neurological symptoms were present at admission in 15 patients, emerged during treatment in six, and were never reported in 13. Twenty-one of 34 patients had cerebral involvement, of which five patients did not present with any neurological symptoms. The most common brain lesions on MRI were tuberculomas. Cerebrospinal fluid (CSF) analysis showed elevated cell count in eight patients who all had abnormal MRI results. Nine patients with normal CSF had abnormal MRI results. CSF cultures were positive in only eight patients. Paradoxical clinical worsening during TB and corticosteroid treatment was observed in six patients.Conclusion
Among patients presenting with miliary TB who underwent brain imaging, more than 60% demonstrated cerebral involvement. Abnormal imaging could occur without any clinical nor CSF impairment. Systematically performing brain imaging in miliary TB patients could therefore be informative. 相似文献13.
Moriah E. Ellen Ulysses Panisset Islene Araujo de Carvalho James Goodwin John Beard 《Health policy (Amsterdam, Netherlands)》2017,121(3):282-291
Background
The world’s population aged 60 and over will more than triple from 600 million to 2 billion between the years 2000 to 2050. This demographic change has significant impact on health, social, and economic sectors. The need to ensure that research into older peoples’ health is effectively translated to policy is immediate.Objective
The purpose of this paper is to present a proposed framework to support evidence informed policymaking in ageing and health.Methods
We undertook a two stage process to develop the framework. We (a) conducted a review of the literature, and (b) convened an expert panel to provide feedback.Results
Numerous frameworks have been proposed yet the majority do not address all the barriers. The Lavis et al., framework addresses a majority of the obstacles associated with evidence-informed policymaking and this framework was modified to include sub-elements important to ageing and health and to reflect the order of importance of the elements. The main elements are: a climate and/or context for research use, linkage and exchange efforts, creation of new knowledge, push efforts, facilitating pull efforts, pull efforts, and evaluation. A four-step implementation process is proposed.Discussion
This paper offers an approach to Knowledge Translation within the field of ageing and health. The framework and proposed implementation could be used to conceptualize and implement evidence-informed policymaking. 相似文献14.
María Julia Ajejas Bazán María Isab Jiménez Trujillo Julia Wärnberg Silvia Domínguez Fernández Ana López de Andrés Napoleón Pérez Farinós 《Gaceta sanitaria / S.E.S.P.A.S》2018,32(5):477-480
Objective
To examine relevant differences in the prevalence of overweight and obesity in children aged 2-15 years according to different sets of criteria (Orbegozo Foundation, International Obesity Task Force and World Health Organization), and how their use affects the trends in obesity recorded for both sexes between 1995 and 2011 in Spain.Method
Cross-sectional study, a population between 2 and 15 years. Three diagnosis criteria of overweight and obesity were be used.Results
The boys according to the three criteria, showed higher values of overweight and obesity compared to the girls. The lowest levels of overweight and obesity were observed using the Orbegozo tables.Discussion
The prevalence of overweight and obesity varies significantly according to the criteria used to define overweight and obesity. The percentiles of the Foundation Orbegozo gave the lowest estimates and the standards of growth of the World Health Organization were higher. 相似文献15.
Xavier Continente Anna Pérez Albert Espelt Carles Ariza María José López 《Gaceta sanitaria / S.E.S.P.A.S》2017,31(4):332-335
Objective
We aimed to analyse the prevalence of having multiple lifestyle risk behaviours (LRB) and the potential relationship between excess weight (including overweight and obesity) and cumulative multiple LRB among adolescents in Barcelona, Spain.Methods
A cross-sectional study was performed among a representative sample of 3,114 secondary school students in Barcelona. Height and weight were objectively measured and excess weight was defined in accordance with World Health Organization criteria. Information on screen time, breakfast, physical activity and sleep duration was obtained through a self-administered questionnaire.Results
More than 80% of the students had at least two LRBs. In compulsory schooling, the adjusted prevalence ratio (aPR) of excess weight increased with a higher number of reported LRBs (four LRBs: aPR = 1.56; 95% confidence interval: 1.19-2.05).Conclusions
These results highlight the importance of a multiple-behaviour approach in preventive programmes aimed at reducing adolescent obesity. 相似文献16.
Eleonora Feletto Sara J. Schonfeld Evgeny V. Kovalevskiy Igor V. Bukhtiyarov Sergey V. Kashanskiy Monika Moissonnier Kurt Straif Joachim Schüz Hans Kromhout 《International journal of hygiene and environmental health》2017,220(5):857-868
Introduction
Historic dust concentrations are available in a large-scale cohort study of workers in a chrysotile mine and processing factories in Asbest, Russian Federation. Parallel dust (gravimetric) and fibre (phase-contrast optical microscopy) concentrations collected in 1995, 2007 and 2013/14 were used to determine if dust to fibre conversion factors can be estimated.Materials/subjects and methods
Daily medians of multiple parallel dust and fibre concentrations by sampling points were used to derive fibre to dust ratios. Applying linear mixed models, we estimated best linear unbiased predictions for the fibre to dust ratios.Results and discussion
A total of 620 daily median fibre to dust ratios were derived. In the factories, modelled ratios varied by unit, increasing along the stages of asbestos enrichment as expected. In the mine, ratios were higher in winter compared to summer. Overall, the ratios showed a strong negative dependency on dust concentration.Conclusions
Our study shows that dust to fibre conversion is possible by unit but extrapolations are needed. The patterns for exposure by dust and fibre will be similar but estimated fibre levels will show less contrast due to the conversion factor being smaller at higher dust concentrations. 相似文献17.
Frédérique Papin-Lefebvre Elodie Guillaume Grégoire Moutel Guy Launoy Célia Berchi 《Health policy (Amsterdam, Netherlands)》2017,121(10):1079-1084
Objective
French health authorities put general practitioners at the heart of the colorectal cancer screening. This position raises organisational issues and poses medico-legal problems for the professionals and institutions involved in these campaigns, related to the key concepts of medical decisions and suitability of standards. The objective of our study is to reveal the preferences of general practitioners related to colorectal cancer screening organisation with regard to the medico-legal riskMethods
A discrete choice questionnaire presenting hypothetical screening scenarios was mailed to 2114 physicians from 20 French different areas. The preferences of 358 general practitioners were analysed using logistic regression models.Results
The factors that have significant impact on the preferences of general practitioners are the capacity of the primary care professional in the procedure, the manner in which pre-screening information is given to patients, the manner in which screening results are given to patients, the number of reminders sent to patients who test positive and who do not undergo a colonoscopy and the remuneration of the attending physician.Conclusions
Our results reveals that current colorectal cancer screening organisation is not adapted to general practitioners preferences. This work offers the public authorities avenues for reflection on possible developments in order to optimize the involvement of general practitioners in the promotion of cancer screening programme. 相似文献18.
H. Coignard-Biehler C. Rapp J.M. Chapplain B. Hoen D. Che P. Berthelot F. Cazenave-Roblot C. Rabaud P. Brouqui C. Leport 《Médecine et maladies infectieuses》2018,48(2):95-102
Context
In 2012, the French Infectious Diseases Society (French acronym SPILF) initiated the “Coordination of epidemic and biological risk” (SPILF-COREB - Emergences [SCE]) group to support the readiness and response of healthcare workers (HCWs) to new alerts.Objective
To present the SCE group, its functioning, and the main support it provided for frontline HCWs.Methods
A multidisciplinary group of heads of infectious disease departments from reference hospitals was created to build a network of clinical expertise for care, training, and research in the field of epidemic and biological risk (EBR). The network developed a set of standardized operational procedures (SOPs) to guide interventions to manage EBR-suspect patients.Results
A working group created the SOP aimed at frontline HCWs taking care of patients. Priority was given to the development of a generic procedure, which was then adapted according to the current alert. Five key steps were identified and hierarchized: detecting, protecting, caring for, alerting, and referring the EBR patient. The interaction between clinicians and those responsible for the protection of the community was crucial. The SOPs validated by the SPILF and its affiliates were disseminated to a wide range of key stakeholders through various media including workshops and the SPILF's website.Conclusion
SPILF can easily adapt and timely mobilize the EBR expertise in case of an alert. The present work suggests that sharing and discussing this experience, initiated at the European level, can generate a new collective expertise and needs to be further developed and strengthened. 相似文献19.
Marcelo Leiva-Bianchi Felipe Cornejo Andrés Fresno Carolina Rojas Camila Serrano 《Gaceta sanitaria / S.E.S.P.A.S》2018,32(3):291-296
Objective
This is the first time that the effectiveness of cognitive-behavioural therapy for post-disaster stress (CBT-PD) in symptoms of posttraumatic stress disorder (PTSD) has been tested outside the United States of America.Design
Quasi-experiment with three groups. In the quasi-control group, complete CBT-PD was applied even though its members did not have PTSD; in quasi-experimental conditions, participants received complete treatment because they had this diagnosis; and in the third group, participants with PTSD received an abbreviated treatment (double sessions) due to organisational requirements.Location
Primary health care workers in Constitución (Chile), city exposed to earthquake and tsunami; public department workers in Talca (city exposed only to earthquake) and teachers from a school (Constitución).Participants
A total of 13 of the 91 people diagnosed with PTSD participated. In addition, 16 people without diagnosis voluntarily participated. The treatment was completed by 29 participants. There were no dropouts. Only 1 of the 9 participants in the quasi-experimental group did not respond to treatment.Interventions
CBT-PD is a group therapy (10-12 sessions) that includes psychoeducation, breathing retraining, behavioural activation and cognitive restructuring. CBT-PD (complete and abbreviated) was applied between September and December 2010.Measurements
Short Posttraumatic Stress Disorder Rating Interview (SPRINT-E) was used to measure PTSD symptoms before and after treatment.Results
The group that received the complete treatment and was diagnosed with PTSD showed a significant decrease in the total symptoms to below dangerous levels (IGAAB: 31.556; p < 0.01; 95%CI: 0.21-2.01]; η2 = 0.709).Discussion
The effectiveness and benefits of incorporating CBT-PD in the health network after events like disasters were discussed. 相似文献20.
E. Laurent G. Gras J. Druon P. Rosset S. Baron A. Le-Louarn E. Rusch L. Bernard L. Grammatico-Guillon 《Médecine et maladies infectieuses》2018,48(4):256-262