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Predicting Pharmacist Objective for you to Give rise to COVID-19 Management with the Neighborhood Level: A Cross-Sectional Questionnaire Study.
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A Sepsis Code (CS) is a comprehensive multidisciplinary system which has the aim of optimising the identification and intervention times of patients with sepsis, as well as improving their monitoring and treatment adjustments in order to reduce their mortality.

To present the outcomes of the first year of introducing the CS in the emergency department of a tertiary hospital.

A single-centre retrospective descriptive observational study was conducted on all patients in whom the CS was activated in the emergency department of a tertiary hospital during the first year of implementation. The variables included demographics, CS activation, comorbidities, focus of infection, microbiology, antibiotic treatment, and mortality.

CS was activated in 555 patients, of which 302 (54.4%) had a definitive diagnosis of sepsis or septic shock on discharge from the emergency department. The degree of completion of the protocol variables was variable (41.8-95%).The large majority (86.1%) of the patients received antibiotics in the first hour, and in 76.2% blood cultures were collected prior to the antibiotic. Of the blood cultures performed, 13.3% of the isolated germs were multi-resistant and the level of contamination of blood cultures was 9.1%. All patients received empirical treatment and recommendations were followed in patients with septic shock in 28.3%. During follow-up, 64.4% the antibiotic treatment was targeted, and 39.5% received sequential therapy. In-hospital mortality was 32.2%.

Areas of improvement in the completion of the variables, contamination of blood cultures, and empirical treatment received were detected, with the strong points being the early administration of the antibiotic and the collection of blood cultures.
Areas of improvement in the completion of the variables, contamination of blood cultures, and empirical treatment received were detected, with the strong points being the early administration of the antibiotic and the collection of blood cultures.
Maternal death surveillance in Canada relies on hospitalization data, which lacks information on the underlying cause of death. We developed a method for identifying underlying causes of maternal death, and quantified the frequency of maternal death by cause.

We used data from the Discharge Abstract Database for fiscal years 2013 to 2017 to identify women who died in Canadian hospitals (excluding Quebec) while pregnant or within 1 year of the end of pregnancy. A sequential narrative based on hospital admission(s) during and after pregnancy was constituted and reviewed to assign the underlying cause of death (based on the World Health Organization's framework). Maternal deaths (i.e., while pregnant or within 42 days after the end of pregnancy) and late maternal deaths (i.e., more than 42 days to a year after the end of pregnancy) were examined separately.

We identified 85 maternal deaths. Direct obstetric causes included 8 deaths (9%) related to complications of spontaneous or induced abortion; 9 (11%), to hypertensive disorders of pregnancy; 15 (18%), to obstetric hemorrhage; 11 (13%), to pregnancy-related infection; 16 (19%), to other obstetric complications; and <5 (<6%), to complications of management. There were 21 (25%) maternal deaths with indirect obstetric causes, and <5 (<6%) with undetermined causes. Of 120 late maternal deaths, 16 (13%) had direct obstetric causes, among them, 9 deaths by suicide (56%). One hundred late maternal deaths (83%) had indirect obstetric causes; and <5 (<4%) had undetermined causes.

The majority of maternal deaths in Canada have direct obstetric causes, whereas most late maternal deaths have indirect obstetric causes. Suicide is an important direct cause of late maternal death.
The majority of maternal deaths in Canada have direct obstetric causes, whereas most late maternal deaths have indirect obstetric causes. Suicide is an important direct cause of late maternal death.
Despite increased public awareness and use of opioid agonist therapy (OAT), there is little published data on contraception among women on methadone or buprenorphine/naloxone. This study aimed to characterize patterns of contraception use among this population.

We conducted a cross-sectional survey between May 2014 and October 2015 at 6 medical clinics, pharmacies, and community organizations in British Columbia. Trained surveyors used the Canadian Sexual Health Survey (CSHS) to collect information on contraceptive practices and barriers to health care access. Descriptive analysis was performed on the subset of women on OAT who were at risk for unintended pregnancy.

Of the 133 survey respondents, 80 (60.2%) were at risk for unintended pregnancy. Among the 46 respondents with a recent pregnancy, 44 (95.7%) reported it as unintended. Of those at risk for unintended pregnancy, the most common contraceptive methods used were "no method," male condom, and depo-medroxyprogesterone at 28.8%, 16.3%, and 12.5%, address their patients' concerns about contraception. Incorporating family planning discussions into OAT services may improve understanding and use of effective contraceptive methods. Addressing unmet contraceptive needs may enable women on OAT to achieve their reproductive goals.
To give an overview of patient-reported outcome measures (PROMs) programs in routine cancer care that allow for both major purposes of PROM assessment 1) monitoring of an individual patient's outcome to assist treatment decision making, and 2) use in quality improvement initiatives including the benchmarking of providers. We synthesize information on program elements like the mode of assessment and questionnaire used, as well as information relevant for adaptation following a PDCA scheme.

We carried out a systematic literature research in the databases PubMed and EMBASE using MeSH terms and keywords related to PROM assessment in routine cancer care to identify eligible studies published between January 2003 and November 2018 (PROSPERO reg. no. Selleck CCG-203971 CRD42019141402). We included studies in which PROM assessment programs had been reported as being implemented in clinical practice as well as collected multicentrically with at least one site in Europe and in which PROMs had been collected before and at least once aver, were hardly addressed, among them costs, staff resources and methods of reporting and responding.
Few reports have so far been published on PROM programs that allow for both the monitoring of an individual patient's outcome and use in quality improvement initiatives. The studies revealed relevant information on existing PROM programs and gave valuable insight into issues that need to be considered when setting up such an infrastructure. Some critical issues, however, were hardly addressed, among them costs, staff resources and methods of reporting and responding.
Type 1 diabetes can lead to various long-term complications including macro- and microvascular disorders and osteoporosis. However, published data on the association between type 1 diabetes (T1D) and urinary system and genital tract disorders is limited. The aim of this work was to estimate the prevalence and incidence of urinary system- and genital tract disorders among women with T1D treated in gynecological practices in Germany.

This retrospective cohort study included women aged 16 years or older with T1D diagnosis between January 2015 and December 2018 from 268 gynecological practices in Germany (IMS Disease Analyzer database). T1D patients were matched 15 by age and physician with non-diabetic patients. The main outcome of the study was the prevalence of different urinary system, pelvic organ and genital tract disorders documented between the first documentation of T1D diagnosis and the last outpatient visit. All study disorders were included as dependent variables in multivariate logistic regressioith T1D. Firstly, the focus should not be on diabetes management alone, but also on identifying and handling additional associated comorbidities including urinary system and genital tract disorders. link2 Secondly, the data suggest that patients with T1D should be asked specifically about symptoms they may be experiencing that are related to the associated disorders identified.
To analyze the use of pain medication among community-dwelling people aged 65 years or older with and without type 2 diabetes in primary care.

A total of 187 patients with and 176 patients without diabetes were randomly selected from a primary care sample of 389 patients with diabetes and 604 age- and gender-matched controls. Pain status was defined as no pain, nociceptive pain or neuropathic pain. Pain medication (paracetamol, NSAID, opioids, neuropathic pain medication) use was based on electronic patient records and checked by a physician during a health examination.

Some pain was present in 90 (51%) patients without and in 106 (57%) patients with diabetes (p = 0.55). Of the patients without diabetes, 109 (62%) and with diabetes 123 (66%) used some pain medication (p = 0.45). The respective proportions for the regular use were 13% and 11% and for the as needed use 56% and 61%. Diabetes was not associated with any of the pain medications used. The use of pain-relieving drugs was most common for neuropathic pain.

The present study indicated that community-dwelling people with and without diabetes used pain medication similarly. Pain medication was used mostly as needed instead of being regular.
The present study indicated that community-dwelling people with and without diabetes used pain medication similarly. Pain medication was used mostly as needed instead of being regular.
Although sex- and age-specific differences in coronary plaque features detected by coronary computed tomography angiography (CCTA) are known, insufficient information regarding the long-term prognostic value of these findings exists.

A total of 1615 patients with suspected but not previously diagnosed coronary artery disease (CAD) were examined by CCTA and coronary plaque features were assessed. The median follow-up period was 10.5 (IQR 9.2-11.4) years. Cox proportional-hazards analysis was used for the combined endpoint of cardiac death or nonfatal myocardial infarction.

The endpoint occurred more often in patients older than 65 years (5.66% vs. 2.05%; p=0.00029) but similarly between female (3.34%) and male (3.07%) patients (p=0.76). Both sexes displayed a similar prevalence for noncalcified (female vs. male 0.77±1.38 vs. 0.89±1.41; p=0.098) and low-attenuation (female vs. male 2.6% vs. 4.37%; p=0.096) plaques. link3 As assessed by p for interaction CADRADS (p for interaction=0.013), noncalcified plaques (p for interaction=0.022) and low-attenuation plaques (p for interaction=0.045) had a better primary endpoint association in women than in men. Concerning age, no difference in outcome association was apparent as evaluated by p for interaction.

CCTA demonstrates excellent long-term prognostic value irrespective of sex and age and independent from the higher prevalence of atherosclerotic plaques in men and patients older than 65 years. Although similarly prevalent in both sexes, noncalcified and low-attenuation plaques exhibit a better prognostic value in women.
CCTA demonstrates excellent long-term prognostic value irrespective of sex and age and independent from the higher prevalence of atherosclerotic plaques in men and patients older than 65 years. Although similarly prevalent in both sexes, noncalcified and low-attenuation plaques exhibit a better prognostic value in women.
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