Search results for "Referral"

showing 10 items of 152 documents

Characterization and referral patterns of ST-elevation myocardial infarction patients admitted to chest pain units rather than directly to catherizat…

2017

Abstract Background Direct transfer to the catheterization laboratory for primary percutaneous coronary intervention (PCI) is standard of care for patients with ST-segment elevation myocardial infarction (STEMI). Nevertheless, a significant number of STEMI-patients are initially treated in chest pain units (CPUs) of admitting hospitals. Thus, it is important to characterize these patients and to define why an important deviation from recommended clinical pathways occurs and in particular to quantify the impact of deviation on critical time intervals. Methods and results 1679 STEMI patients admitted to a CPU in the period from 2010 to 2015 were enrolled in the German CPU registry (8.5% of 19…

MaleCardiac CatheterizationChest Painmedicine.medical_specialtyReferralmedicine.medical_treatmentMedizin030204 cardiovascular system & hematologyDirect transferCoronary AngiographyChest painLower riskTime-to-TreatmentElectrocardiography03 medical and health sciences0302 clinical medicineSt elevation myocardial infarctionGermanymedicineHumansRegistriescardiovascular diseases030212 general & internal medicineMyocardial infarctionReferral and Consultationbusiness.industryIncidenceCoronary Care UnitsPercutaneous coronary interventionMiddle AgedLaboratories Hospitalmedicine.diseaseSurvival RateEmergency medicineConventional PCIST Elevation Myocardial InfarctionFemalemedicine.symptomCardiology and Cardiovascular Medicinebusiness
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One-step diagnosis strategy together with multidisciplinary telematics referral perform an effective approach for identifying and treating patients w…

2021

Abstract Introduction and objectives Implementation of a one-step strategy for diagnosis of active Hepatitis C virus (HCV) infection would encourage the early diagnosis and reduce the time to access antiviral treatments. The aim of this study was to evaluate the impact of a HCV one-step diagnosis compared to the traditional two-step protocol in terms of the time required for patients to be seen by specialists and the time taken to start antiviral treatment. Material and methods A comparative study was carried out to assess two diagnostic algorithms (one-step and two-step) for active HCV infection. Serological markers were quantified using the same serum sample to determine both anti-HCV ant…

MaleCare processmedicine.medical_specialtyReferralHepatitis C virusSpecialties of internal medicineViremiaHepacivirusmedicine.disease_causeAntiviral AgentsSerologyMultidisciplinary approachInterquartile rangeInternal medicineHCV-cAgmedicineTelematics referralHumansOne-stepViremiaActive hepatitisHepatologyHepatitis C virusbusiness.industryTwo-stepGeneral MedicineHepatitis C Antibodiesmedicine.diseaseHepatitis CTelemedicineRC581-951FemaleHepatitis C AntigensbusinessAnnals of hepatology
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Clinicopathological profile of gastrointestinal tuberculosis: a multinational ID-IRI study

2020

Data are relatively scarce on gastro-intestinal tuberculosis (GITB). Most studies are old and from single centers, or did not include immunosuppressed patients. Thus, we aimed to determine the clinical, radiological, and laboratory profiles of GITB. We included adults with proven GITB treated between 2000 and 2018. Patients were enrolled from 21 referral centers in 8 countries (Belgium, Egypt, France, Italy, Kazakhstan, Saudi Arabia, UK, and Turkey). One hundred four patients were included. Terminal ileum (n = 46, 44.2%), small intestines except terminal ileum (n = 36, 34.6%), colon (n = 29, 27.8%), stomach (n = 6, 5.7%), and perianal (one patient) were the sites of GITB. One-third of all p…

MaleCirrhosismedicine.medical_treatmentretrospective studylaparoscopyColonoscopymultimodal imagingComorbidityGastroenterologyprotionamide0302 clinical medicineLaparotomyAscitesamikacinMedicinebedaquilinePathologie maladies infectieusesintestine biopsyadultsteroidclinical trialGeneral MedicinerifabutinMicrobiologie et protistologie [entomologiephytoparasitolog.]priority journaldiabetes mellitushistopathologybiological productMicrobiology (medical)Microbiologie et protistologie [parasitologie hum. et anim.]medicine.medical_specialtyTuberculosis030106 microbiologymalignant neoplasmArticle03 medical and health scienceslaparotomyHuman immunodeficiency virus infectionmolecular diagnosisHumansTuberculosisGastro-intestinalhumanRetrospective Studiescolondisease predispositionmicrobiologyTuberculosis; Immune-suppression; Gastro-intestinal; Endoscopy;anusmedicine.diseasemajor clinical studymulticenter studyaminosalicylic acidcyclophosphamide0301 basic medicineBiopsyAntitubercular Agentsethambutolrifampicinterminal ileumcolonoscopyofloxacin030212 general & internal medicineLaparoscopyazathioprinemedicine.diagnostic_testIncidence (epidemiology)gastrointestinal tuberculosisDisease Managementchronic kidney failurecycloserineInfectious DiseasesfemaleTreatment OutcomeMolecular Diagnostic Techniquesdiagnostic testDisease Susceptibilitymedicine.symptommoxifloxacinSymptom AssessmentImmune-suppressionstomachisoniazidpyrazinamidestreptomycinliver cirrhosispatient referrallinezolidInternal medicineBiopsybusiness.industryEndoscopyMycobacterium tuberculosishuman tissueclinical featureTreatmentTuberculosis Gastrointestinaltuberculostatic agentbusinessMicrobiologie et protistologie [bacteriol.virolog.mycolog.]
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Cardiac rehabilitation and 5-year mortality after acute coronary syndromes: The 2005 French FAST-MI study.

2016

IF 2.271; International audience; Background. - Clinical studies have shown a beneficial effect of cardiac rehabilitation (CR) on mortality.Objective. - To study the effect of CR prescription at discharge on 5-year mortality in patients with acute myocardial infarction (AMI).Methods. - Participants, from the 2005 French FAST-MI hospital registry, were 2894 survivors at discharge, divided according to AMI type: ST-segment elevation myocardial infarction (STEMI; n=1523) and non-STEMI (NSTEMI; n=1371). The effect of CR prescription on mortality was analysed using a Cox proportional hazards model.Results. - At discharge, 22.1% of patients had a CR prescription. Patients referred to CR were youn…

MaleMESH: Chi-Square Distributionmedicine.medical_treatmentMESH : Acute Coronary SyndromeMyocardial InfarctionMESH : AgedMESH : Prospective StudiesCardiac rehabilitationMESH: Risk Assessment0302 clinical medicineMyocardial infarctionProspective StudiesReferral and ConsultationMESH: Treatment OutcomeRehabilitationMESH: Middle AgedGeneral MedicineMESH: Follow-Up Studies3. Good healthMESH: Myocardial InfarctionMESH : Patient DischargeCardiology and Cardiovascular Medicinemedicine.medical_specialtyAcute myocardial infarctionMortalitéRisk Assessment03 medical and health sciences[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular systemHumansMESH : Middle AgedAcute Coronary SyndromeMESH: Kaplan-Meier EstimateAgedChi-Square DistributionMESH: HumansMESH : Chi-Square DistributionProportional hazards modelMESH: Patient DischargeMESH : HumansPatient survivalMESH : Follow-Up Studiesmedicine.diseaseMESH : Proportional Hazards ModelsMESH: Acute Coronary SyndromeST-segment elevation myocardial infarctionMESH: FemaleTime FactorsMESH: RegistriesKaplan-Meier Estimate030204 cardiovascular system & hematologyMESH : Referral and ConsultationMESH: Proportional Hazards ModelsOlder patientsRisk FactorsMESH: Risk FactorsMESH : Female030212 general & internal medicineRegistriesMESH : Risk AssessmentMESH: AgedEjection fractionNon–ST-segment elevation myocardial infarctionMiddle Aged[ SDV.MHEP.CSC ] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular systemMESH : Risk FactorsPatient DischargeTreatment OutcomeFemaleFranceMESH : Time FactorsMESH : MaleMESH : Treatment OutcomeMESH: Multivariate AnalysisMESH : Kaplan-Meier EstimateMESH: Referral and ConsultationInternal medicineInfarctus du myocarde sans sus-décalage du segment STmedicineIn patientcardiovascular diseasesMedical prescriptionMortalityRéadaptation cardiaqueMESH : FranceProportional Hazards Modelsbusiness.industryInfarctus du myocarde avec sus-décalage du segment STMESH: Time FactorsMESH : Multivariate AnalysisMESH: MaleMESH: Prospective StudiesSurgeryMESH: FranceInfarctus du myocarde aiguMultivariate AnalysisMESH : Myocardial InfarctionbusinessMESH : RegistriesFollow-Up Studies
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Predictors of emergency department referral in patients using out-of-hours primary care services

2016

Background Out of hours (OOH) doctors could manage many cases limiting the inappropriate accesses to ED. However the possible determinants of referral to ED by OOH doctors are poorly studied. We aimed to characterize patients referred from the OOH to ED service in order to explore the gate-keeping role of OOH service for hospital emergency care and to facilitate future research in improving its cost-effectiveness. Methods A retrospective study was made through data collection of 5217 contacts in a local OOH service in the North-East of Italy (from 10/01/2012 to 03/31/2013). Results Only 8.7% (=454 people) of the total contacts were referred to ED. In the multivariate analysis, the significa…

MaleMultivariate analysisReferralPopulationContext (language use)Emergency department; Gate-keeping; Out-of-hours primary careHealth Services AccessibilityOut-of-hours primary care03 medical and health sciences0302 clinical medicineAfter-Hours CareGate-keepingHumansMedicine030212 general & internal medicineeducationReferral and ConsultationRetrospective Studieseducation.field_of_studyPrimary Health Carebusiness.industryEmergency department030503 health policy & servicesHealth PolicyAge FactorsRetrospective cohort studyOvercrowdingEmergency departmentOdds ratioMiddle Agedmedicine.diseaseNursing HomesItalyFemaleMedical emergencyEmergency Service Hospital0305 other medical sciencebusiness
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Validation of clinical scoring systems ART and ABCR after transarterial chemoembolization of hepatocellular carcinoma.

2016

Abstract Purpose To perform an external validation of the Assessment for Retreatment with Transarterial Chemoembolization (ART) and α-fetoprotein (AFP), Barcelona Clinic Liver Cancer (BCLC), Child–Pugh, and response (ABCR) scores and to compare them in terms of prognostic power. Materials and Methods From 2000 to 2015, 871 patients with hepatocellular carcinoma underwent transarterial chemoembolization at a tertiary referral hospital, and 176 met all inclusion and exclusion criteria for both scores and were analyzed. Nineteen percent (n = 34) had BCLC stage A disease and 81% had stage B disease. Thirty-nine patients (22%) presented with elevated AFP levels. Overall survival was calculated. …

MaleOncologyCancer ResearchMultivariate analysisKaplan-Meier EstimateGastroenterologyTertiary Care Centers0302 clinical medicineRisk FactorsMedicineStage (cooking)Aged 80 and overLiver NeoplasmsMiddle AgedTreatment OutcomeOncologyBrier score030220 oncology & carcinogenesisPredictive value of testsHepatocellular carcinomaRetreatmentInclusion and exclusion criteriaFemale030211 gastroenterology & hepatologyalpha-FetoproteinsCardiology and Cardiovascular MedicineAlpha-fetoproteinLiver cancerAdultmedicine.medical_specialtyTreatment responseCarcinoma HepatocellularClinical Decision-MakingTertiary referral hospitalRisk AssessmentDecision Support TechniquesYoung Adult03 medical and health sciencesPredictive Value of TestsInternal medicineHumansRadiology Nuclear Medicine and imagingAspartate AminotransferasesChemoembolization TherapeuticAgedNeoplasm StagingRetrospective StudiesHepatologybusiness.industryPatient SelectionExternal validationReproducibility of ResultsRetrospective cohort studymedicine.diseaseConfidence intervalBCLC Stagedigestive system diseasesSurgerybusinessJournal of Clinical Oncology
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Carpal tunnel release surgery: small-area variation and impact of ambulatory surgery in the autonomous region of Valencia, Spain

2013

Objective: This study aimed to analyze variability in rates of carpal tunnel release surgery among the healthcare areas of the autonomous region of Valencia, and to evaluate the contribution of ambulatory surgery and referrals to private hospitals to the variability found. Methods: We carried out a cross-sectional, population-based study, describing the rates of carpal tunnel release surgery, standardized by age and sex, among areas in the region of Valencia in 2006. The observed variation was then analyzed using small-area analysis methods. Data from hospital admissions, referrals to private hospitals, population statistics and hospital resources were used to construct standardized rates, …

MaleOperating Roomsmedicine.medical_specialtyOutpatient Clinics HospitalCross-sectional studySíndrome del túnel carpiano/cirugíaPopulationHospitals PrivateCarpal tunnel syndrome/surgerymedicineColaboración público-privadaHumansOutpatient cliniceducationReferral and ConsultationSmall-Area AnalysisSmall-area variation analysisBed Occupancyeducation.field_of_studyHospitals Publicbusiness.industryPublic Health Environmental and Occupational HealthLength of StayDecompression SurgicalAnálisis de áreas pequeñasCarpal Tunnel SyndromeSurgeryCross-Sectional StudiesOrthopedicsAmbulatory Surgical ProceduresSpainSmall-Area AnalysisPublic hospitalAmbulatoryOrthopedic surgeryClinical practice variationWorkforceFemalePublic-private partnershipsStandardized rateVariabilidad en la práctica médicabusinessGaceta Sanitaria
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Recommendation for ophthalmic care in German preschool health examination and its adherence: Results of the prospective cohort study ikidS.

2018

BackgroundEach child in Germany undergoes a preschool health examination including vision screening and recommendations for further ophthalmic care. This study investigated the frequency of and adherence to these recommendations.MethodsA population-based prospective cohort study was performed in the area of Mainz-Bingen (Rhineland-Palatinate, Germany). All preschoolers were examined at the statutory preschool health examination, which includes vision testing (Rodenstock vision screener) with available correction in the last preschool year. Based on the results, recommendations for further ophthalmic care were given to the parents. Six weeks prior to school entry, parents were surveyed conce…

MaleParentsProgram evaluationHealth ScreeningVisionOffice VisitsVisual AcuitySocial SciencesGeographical locationsCohort StudiesFamilies0302 clinical medicineSociologyGermanySurveys and QuestionnairesHealth careMedicine and Health SciencesPsychologyMedicinePublic and Occupational HealthProspective Studies030212 general & internal medicineChildProspective cohort studyChildrenReferral and ConsultationTransients and Migrantseducation.field_of_studySchoolsMultidisciplinaryQREuropeResearch DesignChild PreschoolMedicineSensory PerceptionFemaleAnatomyResearch ArticleCohort studymedicine.medical_specialtySciencePopulationMEDLINESubgroup analysisResearch and Analysis MethodsEducation03 medical and health sciencesVision ScreeningOcular SystemHumansEuropean Unioneducationbusiness.industryBiology and Life SciencesOdds ratioAge GroupsFamily medicinePeople and Places030221 ophthalmology & optometryEyesPatient CompliancePopulation GroupingsbusinessHeadNeuroscienceFollow-Up StudiesProgram EvaluationPLoS ONE
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Analysis of the diagnostic pathway and delay in patients with amyotrophic lateral sclerosis in the Valencian Community

2021

Introduction: Amyotrophic lateral sclerosis (ALS) is an insidious, clinically heterogeneous neurodegenerative disease associated with a diagnostic delay of approximately 12 months. No study conducted to date has analysed the diagnostic pathway in Spain. Methods: We gathered data on variables related to the diagnostic pathway and delay for patients diagnosed with ALS between October 2013 and July 2017. Results: The study included 143 patients with ALS (57% men; 68% spinal onset). Patients were diagnosed in public centres in 86% of cases and in private centres in 14%. The mean diagnostic delay was 13.1 months (median 11.7). Patients were examined by neurologists a mean time of 7.9 months afte…

MalePediatricsmedicine.medical_specialtyDelayed DiagnosisDiseaseValencian communityTrayecto diagnósticomedicineHumansIn patientSymptom onsetNeurologistsAmyotrophic lateral sclerosisRC346-429Referral and Consultationbusiness.industryAmyotrophic lateral sclerosis Diagnostic delay Diagnostic pathway Electrophysiological study Esclerosis lateral amiotrófica Estudio electrofisiológico Retraso diagnóstico Trayecto diagnósticoAmyotrophic Lateral SclerosisNeurodegenerative Diseasesmedicine.diseaseRetraso diagnósticoEstudio electrofisiológicoPrivate healthcareFemaleEsclerosis lateral amiotróficaNeurology. Diseases of the nervous systembusinessHealthcare systemEarly referralNeurología (English Edition)
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On the threshold of effective well infant nursery hearing screening in Western Sicily.

2012

Abstract Objective To determine the feasibility and effectiveness of well-infant nursery hearing screening programme for the early identification of hearing impairment, based on transient evoked otoacoustic emission (TEOAE) with a high “screen sensitivity” reducing the number of more expensive secondary level exams. Methods The newborns were screened by non-specialist health workers in well babies nursery at the twentieth day of life for 6 years consecutive. Based on PASS/FAIL criteria and presence/absence of audiological risk factors the newborns were divided into four groups each one with its personal step programme: G1 – PASS without risk factor, free to go home; G2 – PASS with risk fact…

MalePediatricsmedicine.medical_specialtyReferralHearing lossOtoacoustic Emissions SpontaneousOtoacoustic emissionAudiologyHearing screeningScreening programmeCohort StudiesNeonatal ScreeningClinical ProtocolsPredictive Value of TestsRisk FactorsWell-infant nurseryMedicineHumansRisk factorHearing LossSicilybusiness.industryIncidence (epidemiology)Infant NewbornInfantGeneral Medicinemedicine.diseaseSettore MED/32 - AudiologiaAudiometry Evoked ResponseNeonatal screening; Well-infant nursery; Sensorineural hearing loss; Otoacoustic emission;Settore MED/31 - OtorinolaringoiatriaOtorhinolaryngologySensorineural hearing loPediatrics Perinatology and Child HealthFeasibility StudiesOtoacoustic emissionSensorineural hearing lossFemalemedicine.symptombusinessInternational journal of pediatric otorhinolaryngology
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