scholarly journals N06 Patient perspectives on the role of the IBD nurse and telemedicine during COVID-19 pandemic: results from a Belgian tertiary IBD unit

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S610-S611
Author(s):  
G Dewitte ◽  
J Geldof ◽  
M Truyens ◽  
T Lobaton

Abstract Background Many inflammatory bowel disease (IBD) patients experienced additional stress due to the COVID-19 pandemic. Concerns for COVID-19 disease increased the risk of immunomodulatory or biologic treatment discontinuation. Furthermore, lockdown threatened the continuity of chronic care delivery. To guarantee the continuity of care our IBD unit rapidly adapted and developed new ways of remote communication. This included telephonic clinics and telephonic pre-admission screening before every appointment at the dayclinic. In this process the IBD nurse played a pivotal role. The aim was to assess patients’ concerns during the first COVID-19 wave and their acceptance of telemedicine. Methods A cross-sectional study was performed using an anonymous electronic questionnaire (REDCap®) to assess IBD patients’ satisfaction regarding care delivery at the IBD unit of the Ghent University Hospital during the first COVID-19 wave. Results A total of 274 patients participated. Mean age was 47.5 years (SD ± 15.4). According to patients’ answers, 57.2% had Crohn’s disease, 34.5% ulcerative colitis and 8.3% reported ‘other’. During the first wave, 43.6% of patients contacted their IBD nurse; usually questions regarding medication (20.6%), appointments (18.4%) or SARS-CoV2 infection risk (6%). For the majority of patients (96.5%) these contacts were sufficient. In person follow-up consultation was scheduled for 178 patients. From those, 31 considered cancelling their consultation due to the pandemic and 18 effectively cancelled (Fig 1). Half of the population (51.6%) received intravenous therapy at the day clinic. Telephonic pre-admission screening the day before was done for all patients and well received in most of them (98.5%). During the first wave, endoscopy was planned in 31.5% of the responding patients. A minority (11.1%) postponed or cancelled endoscopic appointments. From those, 55.6% reported that the main reason was fear of the coronavirus. Ninety-four (39.2%) of responders had a telephonic consultation during the first wave. Different aspects regarding satisfaction and acceptance of telemedicine were also assessed (Fig 2–3). For further follow-up, 60.2% preferred balanced combination of telephonic and face-to-face consultations. Conclusion Remote ways of care delivery were generally well received during the first wave of the pandemic. Only a minority of patients cancelled appointments without discussion with the medical team. The most frequent patient concerns were about medications and appointments. The challenges in continuity of care during the pandemic created a window for new ways of care delivery in the future.

2017 ◽  
Vol 45 (3) ◽  
Author(s):  
Brynhildur Tinna Birgisdottir ◽  
Malin Holzmann ◽  
Ingela Hulthén Varli ◽  
Sofie Graner ◽  
Sissel Saltvedt ◽  
...  

AbstractObjective:Lactate ProStudy design:A cross-sectional study was conducted at a university hospital in Sweden. A total of 113 laboring women with fetal heart rate abnormalities on cardiotocography (CTG) had FBS carried out. Lactate concentration was measured bedside with both LP1 and LP2 from the same blood sample capillary. A linear regression model was constructed to retrieve a conversion equation to convert LP2 values to LP1 values.Results:LP2 measured higher values than LP1 in all analyses. We found that 4.2 mmol/L with LP1 corresponded to 6.4 mmol/L with LP2. Likewise, 4.8 mmol/L with LP1 corresponded to 7.3 mmol/L with LP2. The correlation between the analyses was excellent (Spearman’s rank correlation, r=0.97).Conclusion:We recommend the following guidelines when interpreting lactate concentration in FBS with LP2: <6.4 mmol/L to be interpreted as normal, 6.4–7.3 mmol/L as preacidemia indicating a follow-up FBS within 20–30 min, and >7.3 mmol/L as acidemia indicating intervention.


Author(s):  
F. Ceccato ◽  
G. Voltan ◽  
C. Sabbadin ◽  
V. Camozzi ◽  
I. Merante Boschin ◽  
...  

Abstract Context The COVID-19 outbreak in Italy is the major concern of Public Health in 2020: measures of containment were progressively expanded, limiting Outpatients’ visit. Objective We have developed and applied an emergency plan, tailored for Outpatients with endocrine diseases. Design Cross-sectional study from March to May 2020. Setting Referral University-Hospital center. Patients 1262 patients in 8 weeks. Interventions The emergency plan is based upon the endocrine triage, the stay-safe procedures and the tele-Endo. During endocrine triage every patient was contacted by phone to assess health status and define if the visit will be performed face-to-face (F2F) or by tele-Medicine (tele-Endo). In case of F2F, targeted stay-safe procedures have been adopted. Tele-Endo, performed by phone and email, is dedicated to COVID-19-infected patients, to elderly or frail people, or to those with a stable disease. Main outcome measure To assess efficacy of the emergency plan to continue the follow-up of Outpatients. Results The number of visits cancelled after endocrine triage (9%) is lower than that cancelled independently by the patients (37%, p < 0.001); the latter reduced from 47 to 19% during the weeks of lockdown (p = 0.032). 86% of patients contacted by endocrine-triage received a clinical response (F2F and tele-Endo visits). F2F visit was offered especially to young patients; tele-Endo was applied to 63% of geriatric patients (p < 0.001), visits’ outcome was similar between young and aged patients. Conclusions The emergency plan respects the WHO recommendations to limit viral spread and is useful to continue follow-up for outpatients with endocrine diseases.


Author(s):  
Doaa K. Mohorjy ◽  
Iman Kamal Ramadan ◽  
Bahaa A. Abalkhail ◽  
Khalid M. Jaamal

Background: Vitamin D is essential for bone physical condition, and vitamin D insufficiency may add to further autoimmune diseases, infections or even cancer. Enzyme-inducing antiepileptic drugs have been predominantly linked with osteoporosis hazard proved their impacts on vitamin D. The study aim was to determine the prevalence of vitamin D insufficiency and deficiency and the covariates associated with it among the adult epileptic patients attending King Fahd neurology outpatient clinics. Subjects and Methods: 297 adult epilepsy patients joined this cross-sectional study at King Fahd Hospital in 2017. Vitamin D level was considered as deficiency (<10ng/ml), insufficiency (<30ng/ml), or normal (≥30ng/ml). Antiepileptic drugs were sorted out according to their enzyme inducing criteria. Results: 87.88% adult epileptic patients were between 18 – 50 years of age, more than half were females, married, and with higher degree of education, less than half received monthly income of less than 5,000 SR, nearly two third were either smokers or ex-smokers. Multiple linear regression model for predictors of vitamin D insufficiency and deficiency declared that; enzyme induced antiepileptic drugs, polytherapy, and smoking were significantly correlated with vitamin deficiency and insufficiency (p < 0.05). Conclusion: Vitamin D insufficiency and deficiency is widespread among adult epileptic patients. Screening of vitamin D level should be taken into consideration as part of the regular follow up of epileptic patients.


2020 ◽  
Vol 26 (1) ◽  
pp. 1-6
Author(s):  
Jolita Badarienė ◽  
Vilma Dženkevičiūtė ◽  
Egidija Rinkūnienė ◽  
Živilė Girkantaitė ◽  
Dovilė Šilinskienė ◽  
...  

SummaryObjectives. To assess the association between education degree and attitude towards the treatment after myocardial infarction (MI).Design and Methods. The participants of this cross-sectional study were 191 (140 men and 51 women) outpatients in a period of 3 months – 5 years after acute MI (mean age 59 ± 9.2 years) from Vilnius University Hospital Santaros Klinikos. All patients were asked to complete two questionnaires: “Quality of Life and Treatment after Myocardial Infarction” and “Cholesterol-lowering Drugs Consumption Peculiarities”. The data was analyzed using the SPSS software.Results. The education degree (a higher (post-secondary education provided by a college or university) vs. a lower (secondary or vocational education) education degree) had similar influence on the patients’ occasional concern (43.2%; n = 35 vs. 52.9%; n = 55, respectively; p = 0.226) and on the frequent concern (25.9%; n =21 vs. 26.9%; n = 28, respectively; p = 0.226) about MI. Patients with a higher education degree were more likely to identify themselves as the main subjects in MI treatment in comparison with patients that had a lower education degree (30.5%; n = 25 vs. 15.2%; n = 16, respectively, p = 0.033). More educated patients found it easier to follow up the doctor’s treatment plan than less educated patients (23.2%; n = 19 vs. 9.5%; n = 10, respectively; p = 0.035).Conclusions. More educated patients are more likely to follow up the doctor’s treatment plan and see it easier than less educated patients. Thus, more attention should be paid to less educated patients in order to increase their own impact on their post-MI treatment.


2014 ◽  
Vol 21 (06) ◽  
pp. 1209-1212
Author(s):  
Sikandar Ali Bhand ◽  
Chetan Das ◽  
Farzana Sheikh ◽  
Muhammad Akber Nizamani ◽  
Muhammad Saeed

Objective: Objective of this study to determine the clinical presentation and frequency of asthma triggers in the children suffering from asthma at Liaquat university of medical and health science. Subjects & Methods: This cross sectional study was carried out at Liaquat University Hospital Hyderabad. All the patients were selected from OPD and pediatric ward of LUMHS. Complete history of allergy was taken from the cases and their parents and all the triggers of asthma were documented on the proforma. Results: Total 100 patients were included in the study. Majority of the cases in the age group of 1- 3years and 2nd most common age group was 4- 7 years with the percentage of 39% and 33% respectively. Majority of the cases 51%, while moderate was present in 35% cases and 14% children were seen with severe asthma condition. Asthma triggers in the children was found as; Smoking, Exercise, Dust, Pets, Ice, Plants, Carpets, Eggs, Corn oil, Allergic rhinitis and Without triggers, with the percentage of 22.%, 55.%, 51.%, 10.%, 34.%, 05.% ,11.%, 12.% , 27.%, 46.% and17.% respectively. Conclusions: In the conclusion of this study we concluded that allergic triggers perform the important role in the severity of asthma disease, these triggers attacks at night and early morning, so to avoid from the smoke, dust, allergens and proper management of asthma with good compliance and regular follow up of the patients.


2018 ◽  
Vol 32 (2) ◽  
pp. 17-21
Author(s):  
Kimberly Mae C. Ong ◽  
Teresa Luisa G. Cruz ◽  
Precious Eunice R. Grullo

Objective: To determine the prevalence rate of follow-up among infants who had a “refer” result on initial newborn hearing screening and to identify reasons for default by parents or guardians.   Method: Study Design:   Cross-sectional study Setting:             Tertiary public university hospital Participants:     79 parents or guardians whose newborns obtained a “refer” result on initial hearing screening were interviewed over the phone.   Results: Among those babies who had a “refer” result on initial hearing screening, 51% followed up for repeat testing. The most common reasons for non-follow up by parents or guardians include being busy, distance from the hospital and baby’s health condition.   Conclusions: The follow-up rate in this study is higher compared to previous figures (27%), but is still below target. The reasons for non-follow-up obtained suggest problems may exist on all levels of the healthcare system. Appropriate solutions to address these problems should be explored.   Keywords: neonatal screening, hearing loss, infant, newborn, hearing tests, otoacoustic emissions


2020 ◽  
Vol 26 (1) ◽  
pp. 31-36
Author(s):  
Md Zakaria Sarkar ◽  
AHM Ferdows Nur ◽  
Utpal Kumar Dutta ◽  
Muhammad Rafiqul Islam ◽  
Debabrota Roy ◽  
...  

Objective: The aim of this study was to evaluate hearing outcome after stapedotomy in patients with Otosclerosis. Methods: This cross sectional study was carried out from July 2017 to January 2019 in National Institute of ENT, Unit V. About 22 patients with Otosclerosis were included in this study. Diagnosis of Otosclerosis was based on the history, medical status with Otoscopy, Tuning fork tests and Audiometric tests. We compiled data on the pre and post operative air-bone gap (ABG) at 0.5, 1, 2 KHZ. The ABG was Calculated using AC and BC thresholds on the same audiogram. Post operative hearing gain was then Calculated from the ABG before the operation minus the ABG of the last follow up examination Results: In this study most of the cases were age group 14-30 years (72.7%), female (54.5%). Most common symptoms was progressive hearing loss, tinnitus (77.8%).The average preoperative hearing loss in this study was (AC) was 48.31±7.68. The average post opt. hearing (AC) at follow up was 28.95±10.30 with an average hearing gain of 15.40±8.53 dB which was significant. The average pre-operative ABG was 28.99 dB ± 8.10. The average post opt. ABG was analyzed at 1 follow up showed ABG 13.18±8.09 dB which was found to be significant. Conclusion: Stapedotomy is an effective surgical procedure for the treatment of otosclerosis which leads to improvement in patient’s quality of life. A favorable hearing outcome can be obtained by the combination of experienced hands with minimal surgical trauma and appropriate surgical technique. Bangladesh J Otorhinolaryngol; April 2020; 26(1): 31-36


2016 ◽  
pp. 59-65 ◽  
Author(s):  
Van Mao Nguyen

Background: Lymphoma is one of the most ten common cancers in the world as well as in Vietnam which has been ever increasing. It was divided into 2 main groups Hodgkin and non – Hodgkin lymphoma in which non-Hodgkin lymphoma appeared more frequency, worse prognosis and different therapy. Objectives: - To describe some common characteristics in patients with non – Hodgkin lymphoma; - To determine the proportion between Hodgkin and non- Hodgkin lymphoma, histopathological classification of classical Hodgkin by modified Rye 1966 and non-Hodgkin lymphoma by Working Formulation (WF) of US national oncology institute 1982. Materials and Method: This cross-sectional study was conducted on 65 patients with Hodgkin and non- Hodgkin lymphoma diagnosed definitely by histopathology at Hue Central Hospital and Hue University Hospital. Results:. The ratio of male/female for the non-Hodgkin lymphoma was 1.14/1, the most frequent range of age was 51-60 accounting for 35%, not common under 40 years. Non - Hodgkin lymphoma appeared at lymph node was the most common (51.7%), at the extranodal site was rather high 48.3%. The non - Hodgkin lymphoma proportion was predominant 92.3% comparing to the Hodgkin lymphoma only 7.7%; The most WF type was WF7 (53.3%), following the WF6 18,3% and WF5 11,7%; The intermediate malignancy grade of non- Hodgkin lymphoma was the highest proportion accouting for 85%, then the low and the high one 8.3% and 6.7% respectively. Conclusion: The histopathological classification and the malignant grade of lymphoma for Hodgkin and non - Hodgkin lymphoma played a practical role for the prognosis and the treatment orientation, also a fundamental one for the modern classification of non - Hodgkin lymphoma nowadays. Key words: lymphoma, Hodgkin lymphoma, non-Hodgkin lymphoma, classication, grade, histopathology, lymph node


2011 ◽  
pp. 122-129
Author(s):  
Quang Di Bui ◽  
Phuoc Lam Nguyen

Objectives: The aim of study is to evaluate the efficacy, tolerability and adverse effects of a standard triple therapy including Rabeprazole, Clarithromycin and Amoxicilline at Sai gon Hoan My hospital in order to consider treatment H.pylori for patients who have not yet eradicated before or need to be undertaked by alternative regimens. Methods: By descriptive cross-sectional study, the authors have examined 116 patients sufferring from peptic ulcer received 10-day therapy including Rabe (20mg b.d) plus Clari(500mg b.d) plus Amoxi(1g b.d). Eradication is confirmed with endoscopy after 4 weeks from completing of treatment. Results and Discussion: 100% of patients were initially included and noboby was dropped out of the follow-up satges. The mean age was 49 in which 62% was male, 73(62,9%) presented duodenal ulcer, 28(24,1%) gastric ulcer and 15(13%) simultaneous gastric and duodenal ulcers. All patients took medications correctly. Per-protocol and intention to treat eradication rates were both 75%(95% CI=73,4-78,3). Additionally, 62(53,4%) patients had at least one risky factor for peptic ulcer disease, smoking being the most common one 44(37,9%).The adverse effects were reported overall in 67% of the patients, mainly including changed taste, very bitter, tired 49%, trouble sleeping 12% and diarrhea 5%. Conclusion: this ten-day standard triple therapy used in this study is ineffective with high adverse effects.The first line eradication with new regimens should be alternative.


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