Establishing an optimal diagnostic policy for patients with respiratory tract infections, at the emergency department (ED) of a university hospital in The Netherlands. Adult patients were sampled at admission, during the respiratory season (2014-2015). The FilmArray-RP was implemented at the clinical virology laboratory. Diagnostics were provided from 8 am to 10 pm, weekends included. 436/492 (89%) results were available while patients were still at the ED. Median TAT from admission to test result was 165 min (IQR: 138-214). No antibiotics were prescribed in 94/207 (45%) patients who tested positive for a virus. 185/330 (56%) hospitalized patients did not need admission with isolation measures. The value-based measure, expressed in euro-hour (€h), increased to tenfold compared with previous policy. An optimal policy is essential for patient management, by providing timely, reliable diagnostics.
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http://dx.doi.org/10.2217/fmb-2019-0119 | DOI Listing |
Background: Outpatient training for resident physicians has been attracting attention in recent years. However, to our knowledge, there have only been a few surveys on outpatient training, particularly in Japan. This study evaluates outpatient care among Japanese resident physicians by determining how the volume of outpatient encounters and length of outpatient training correlate with residents' clinical competence.
View Article and Find Full Text PDFJ Thromb Haemost
January 2025
ICES, Toronto, Ontario, Canada; Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Background: There are limited data regarding the association between cancer and ischemic stroke, particularly among individuals with previous stroke. Our objective was to measure and compare the risk of ischemic stroke in individuals with and without cancer.
Methods: Population-based matched cohort study in Ontario, Canada.
Microb Pathog
January 2025
Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka 72388, Saudi Arabia. Electronic address:
Antimicrobial resistance (AMR) in Escherichia coli strains, particularly those producing Extended-Spectrum Beta-Lactamase (ESBL) and Carbapenemase (CR-Ec), represents a serious global health threat. These resistant strains have been associated with increased morbidity, mortality, and healthcare costs, as they limit the effectiveness of standard antibiotic therapies. The prevalence of ESBL- and CR-Ec-producing strains continues to rise, driven by the overuse and misuse of antibiotics in healthcare and agricultural settings, and facilitated by global interconnectedness through international travel, trade, and food distribution.
View Article and Find Full Text PDFLancet Child Adolesc Health
January 2025
Department of Infectious Diseases, Alder Hey Children's NHS Foundation Trust, Liverpool, UK; Department of Clinical Infection, Microbiology, and Immunology, Institute of Infection, Veterinary, and Ecological Sciences, University of Liverpool, Liverpool, UK. Electronic address:
Background: Procalcitonin is a rapid response biomarker specific for bacterial infection, which is not routinely used in the UK National Health Service. We aimed to assess whether using a procalcitonin-guided algorithm would safely reduce the duration of antibiotic therapy compared with usual care, in which C-reactive protein is the commonly used biomarker.
Methods: The BATCH trial was a pragmatic, multicentre, open-label, parallel, two-arm, individually randomised, controlled trial conducted in 15 hospitals in England and Wales.
Midwifery
January 2025
School of Health, Education, Policing and Sciences, University of Staffordshire, UK.
Problem: Tongue tie is an added complication when breastfeeding, but little is known about the role tongue tie might play when breastfeeding twins.
Background: Twins are much less likely to be breastfed than singleton babies due to added complications regarding pregnancy, birth and ongoing care. Tongue tie can cause breastfeeding barriers including poor latch, inefficient milk transfer and nipple pain.
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