Cílem studie bylo zjistit, jakým způsobem se chorvatští zubní lékaři rozhodují o odesílání svých pacientů k endodontistům a zda se toto rozhodnutí liší v závislosti na demografických proměnných týkajících se praktických zubních lékařů a charakteru jejich stomatologické praxe. Metodika: Byl sestaven dotazník zaměřený na demografické údaje týkající se účastníků studie a jejich praxe, typy prováděných endodontických zákroků a faktory ovlivňující jejich rozhodování o odeslání pacienta k endodontistovi. Dotazník byl rozeslán všem praktickým zubním lékařům s adresou ordinace v chorvatské Rijece. K analýze rozdílů ve zkoumaném vzorku byl použit χ2 test na hladině významnosti p < 0,05. Výsledky: Většina respondentů (39 z 94; 41,5 %) byla ve věku 40 až 49 let. Analýza ukázala, že většina respondentů byly ženy (64 z 94; 68,1 %). Významně více mužů (10 z 30) mělo postgraduální vzdělání ve srovnání se ženami (9 z 64; 33,3 % vs. 14,1 %; p < 0,001). Pokud jde o vliv demografických proměnných, měl významný vliv na rozhodování o odeslání pouze počet zubních lékařů zaměstnaných v ordinaci (χ2 = 7,006; p = 0,030). Respondenti, kteří pracovali ve vlastní zubní ordinaci sami, odesílali pacienty významně častěji než respondenti pracující v ordinacích, kde jsou zaměstnáni tři a více zubních lékařů (72,4 % vs. 20 %; p < 0,05). Závěr: V souvislosti se stárnutím evropské populace rostou náklady na zdravotní péči a je třeba sledovat nadužívání a nevyužívání specializované péče, aby byla pro každého pacienta zajištěna řádná léčba. Studenti a zubní lékaři by měli být podporováni v postgraduálním vzdělávání, které zvyšuje jejich odbornou způsobilost.
The aim of the survey was to identify the endodontic referral pattern among a group of Croatian dentists and to explore if the decision to refer a patient to an endodontist varies based on demographic variables of general dental practitioners and the features of their dental practice. Methods: A questionnaire was designed that focused on demographics of the participants and their practice, the pattern of endodontic procedures they perform and the factors influencing their decision to refer. The survey was mailed to all licensed general practicing dentists with a work address in Rijeka, Croatia. Chi-square test was used at a significance level P<0.05 to analyze differences in the study sample. Results: The majority of respondents (39 out of 94; 41.5%) were between 40 and 49 years old. Analysis revealed that the majority of respondents were female (64 out of 94; 68.1%). Significantly more male practitioners (10 out of 30) had postgraduate education compared to female practitioners (9 out of 64; 33.3% vs. 14.1%; P<0.001). Regarding the effect of demographic variables, only the number of dentists employed in a practice had a significant influence on the referral decisions of dentists (χ2=7.006; P=0.030). Respondents who were the only employed dentists referred patients significantly more often than respondents who work in practices where three or more dentists are employed (72.4% vs. 20%; P<0.05). Conclusion: Due to the aging European population, healthcare costs are increasing, and there is a need to monitor the overuse and underuse of specialized care to ensure appropriate treatment for each patient. Students and dentists should be encouraged to pursue postgraduate education, which enhances their professional competence.
- MeSH
- dospělí MeSH
- index potřeby ortodontické léčby * MeSH
- konziliární vyšetření a konzultace MeSH
- lidé středního věku MeSH
- lidé MeSH
- průzkumy a dotazníky MeSH
- senioři MeSH
- stomatologická péče * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH
- Geografické názvy
- Chorvatsko MeSH
- MeSH
- konziliární vyšetření a konzultace MeSH
- lidé MeSH
- paliativní péče * MeSH
- péče v hospici MeSH
- sociální práce * metody trendy MeSH
- umírající MeSH
- Check Tag
- lidé MeSH
- Geografické názvy
- Česká republika MeSH
Článek přináší podrobný popis konziliárních týmů paliativní péče v nemocnicích jako nové zdravotní a sociální služby v českém zdravotním systému určené hospitalizovaným pacientům se závažným onemocněním a primárním týmům, které o ně pečují. Na dvou kazuistikách ilustruje možný přínos této služby pro polymorbidní geriatrické pacienty.
The article provides a detailed description of hospital-based palliative care consultation teams as a new health and social service in the Czech health care system for hospitalised seriously ill patients and their primary care teams. The authors use two case studies to illustrate the potential benefits of this service for polymorbid geriatric patients.
- MeSH
- komorbidita MeSH
- konziliární vyšetření a konzultace * MeSH
- křehký senior MeSH
- lidé MeSH
- nemocnice MeSH
- paliativní péče * MeSH
- senioři nad 80 let MeSH
- Check Tag
- lidé MeSH
- senioři nad 80 let MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
In Uganda, hypertension is a rapidly increasing non-communicable disease with high morbidity and mortality, leading to complications such as renal failure, heart failure, stroke, and myocardial infarctions. This study aimed to determine the factors associated with left ventricular hypertrophy (LVH) among hypertensive patients at Jinja Regional Referral Hospital. A cross-sectional study was conducted among 323 participants using convenience sampling, the study utilized structured questionnaires and data was analyzed using STATA. Results indicated that factors independently associated with LVH included alcohol consumption (aOR 0.26, 95%CI 0.10-0.70, P=0.007), lack of physical exercise (aOR 0.47, 95%CI 0.23-0.94, P=0.033), Low medication adherence (aOR 0.31, 95%CI 0.13-0.71, P=0.006)., female participants who had waist-hip-ratio >0.80 (aOR 3.70, 95%CI 1.18-11.64, P=0.025), diastolic blood pressure of 100 - 109 mmHg (aOR 4.58, 95%CI 1.65-12.74, P=0.004) and diastolic blood pressure of ≤89 mmHg (aOR 3.03, 95%CI 1.03-8.89, P=0.044). The study highlights the need for better management of hypertension and lifestyle modifications to reduce LVH prevalence.
- MeSH
- dospělí MeSH
- hypertenze * epidemiologie MeSH
- hypertrofie levé komory srdeční * epidemiologie MeSH
- konziliární vyšetření a konzultace MeSH
- lidé středního věku MeSH
- lidé MeSH
- prevalence MeSH
- průřezové studie MeSH
- rizikové faktory MeSH
- senioři MeSH
- srdeční arytmie * epidemiologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Geografické názvy
- Uganda MeSH
There are limited data on referral rates and the number of patients with idiopathic pulmonary fibrosis (IPF) who are eligible for lung transplantation. The aim of the present study was to assess adherence to the consensus of the International Society for Heart and Lung Transplantation (ISHLT) for the referral of patients with IPF among Czech interstitial lung disease (ILD) centers. Czech patients who were diagnosed with IPF between 1999 and 2021 (n = 1584) and who were less than 65 years old at the time of diagnosis were retrospectively selected from the Czech Republic of the European Multipartner Idiopathic Pulmonary Fibrosis Registry (EMPIRE). Nonsmokers and ex-smokers with a body mass index (BMI) of <32 kg/m2 (n = 404) were included for further analyses. Patients with a history of cancer <5 years from the time of IPF diagnosis, patients with alcohol abuse, and patients with an accumulation of vascular comorbidities were excluded. The trajectory of individual patients was verified at the relevant ILD center. From the database of transplant patients (1999-12/2021, n = 541), all patients who underwent transplantation for pulmonary fibrosis (n = 186) were selected, and the diagnosis of IPF was subsequently verified from the patient's medical records (n = 67). A total of 304 IPF patients were eligible for lung transplantation. Ninety-six patients were referred to the transplant center, 50% (n = 49) of whom were referred for lung transplantation. Thirty percent of potentially eligible patients not referred to the transplant center were considered to have too many comorbidities by the reporting physician, 19% of IPF patients denied lung transplantation, and 17% were not referred due to age. Among Czech patients with IPF, there may be a larger pool of potential lung transplant candidates than has been reported to the transplant center to date.
- MeSH
- dodržování směrnic statistika a číselné údaje MeSH
- dospělí MeSH
- idiopatická plicní fibróza * chirurgie MeSH
- intersticiální plicní nemoci chirurgie MeSH
- konziliární vyšetření a konzultace * statistika a číselné údaje MeSH
- lidé středního věku MeSH
- lidé MeSH
- registrace MeSH
- retrospektivní studie MeSH
- senioři MeSH
- transplantace plic * statistika a číselné údaje MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
OBJECTIVE: Real-life management of hypertensive patients with chronic kidney disease (CKD) is unclear. METHODS: A survey was conducted in 2023 by the European Society of Hypertension (ESH) to assess management of CKD patients referred to ESH-Hypertension Excellence Centres (ESH-ECs) at first referral visit. The questionnaire contained 64 questions with which ESH-ECs representatives were asked to estimate preexisting CKD management quality. RESULTS: Overall, 88 ESH-ECs from 27 countries participated (fully completed surveys: 66/88 [75.0%]). ESH-ECs reported that 28% (median, interquartile range: 15-50%) had preexisting CKD, with 10% of them (5-30%) previously referred to a nephrologist, while 30% (15-40%) had resistant hypertension. The reported rate of previous recent (<6 months) estimated glomerular filtration rate (eGFR) and urine albumin-creatinine ratio (UACR) testing were 80% (50-95%) and 30% (15-50%), respectively. The reported use of renin-angiotensin system blockers was 80% (70-90%). When a nephrologist was part of the ESH-EC teams the reported rates SGLT2 inhibitors (27.5% [20-40%] vs. 15% [10-25], P = 0.003), GLP1-RA (10% [10-20%] vs. 5% [5-10%], P = 0.003) and mineralocorticoid receptor antagonists (20% [10-30%] vs. 15% [10-20%], P = 0.05) use were greater as compared to ESH-ECs without nephrologist participation. The rate of reported resistant hypertension, recent eGFR and UACR results and management of CKD patients prior to referral varied widely across countries. CONCLUSIONS: Our estimation indicates deficits regarding CKD screening, use of nephroprotective drugs and referral to nephrologists before referral to ESH-ECs but results varied widely across countries. This information can be used to build specific programs to improve care in hypertensives with CKD.
- MeSH
- antihypertenziva terapeutické užití MeSH
- chronická renální insuficience * komplikace patofyziologie MeSH
- hodnoty glomerulární filtrace MeSH
- hypertenze * farmakoterapie komplikace MeSH
- konziliární vyšetření a konzultace MeSH
- lidé středního věku MeSH
- lidé MeSH
- pilotní projekty MeSH
- plošný screening metody MeSH
- průzkumy a dotazníky MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
In Uganda, hypertension is an escalating health issue, but there is limited specific data regarding the prevalence of left ventricular hypertrophy (LVH) among hypertensive patients in eastern Uganda. This study aimed to establish the prevalence of LVH among hypertensive patients at Jinja Regional Referral Hospital. A cross-sectional study conducted at the hospital enrolled 323 participants using convenience sampling. The results revealed a prevalence rate of 19.50 % for LVH, primarily observed in male participants and younger age groups (25-35 years). Furthermore, the study found a low incidence of associated cardiac arrhythmia, with only 1.59 % of participants having atrial fibrillation. These findings indicate a relatively low burden of LVH and arrhythmia in this population, emphasizing the importance of continued efforts in hypertension management and LVH prevention. Further research and interventions are necessary to mitigate the impact of hypertension-related complications in the eastern region of Uganda.
- MeSH
- dospělí MeSH
- hypertenze * epidemiologie MeSH
- hypertrofie levé komory srdeční * epidemiologie MeSH
- incidence MeSH
- konziliární vyšetření a konzultace statistika a číselné údaje MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- prevalence MeSH
- průřezové studie MeSH
- rizikové faktory MeSH
- senioři MeSH
- srdeční arytmie * epidemiologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Geografické názvy
- Uganda MeSH
OBJECTIVES: This project aimed to improve the quality of antenatal and intrapartum care for women with gestational diabetes (GD) by increasing nursing and midwifery care compliance with best practice recommendations. INTRODUCTION: GD is one of the most common diseases that can lead to several important maternal and fetal complications. METHODS: This project was based on JBI's evidence implementation approach and included a baseline audit, the implementation of strategies, and a follow-up audit. The project was conducted in an obstetrics-gynecology department of a hospital in Bucharest, and the sample included 30 pregnant women with GD from that ward. RESULTS: Regarding antenatal care, the baseline audit revealed low compliance (63%-87%) for criterion 2 (specific education), criterion 3 (multidisciplinary team), criterion 4 (individualized care plan), criterion 5 (training on self-monitoring), criterion 8 (dietician consultation), and criterion 10 (physical exercise program). Compliance with criterion 9 (physiotherapist consultation) was nil. Higher compliance (90%-100%) was reported for criterion 1 (screening for GD), criterion 6 (self-monitoring), and criterion 7 (maintenance of glycemic values). The intrapartum care audit criteria regarding maintaining blood glucose levels had compliance rates of 97% (criteria 13 and 14), 73% (criterion 11), and 67% (criterion 12). As a result of implementing the most appropriate strategies, maximum improvement was observed for all 12 audit criteria found to be deficient in the baseline audit. CONCLUSIONS: Strategies were identified and applied to successfully implement the best practices (educational programs and improved procedures). However, specific actions, such as regular targeted audits and continuous monitoring, are needed to maintain long-term results.
- MeSH
- informace pro uživatele zdravotní péče * MeSH
- internetové poradenství MeSH
- lidé MeSH
- zdravotní výchova MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- novinové články MeSH
- zprávy MeSH