Rheumatology Rapid Access and Treatment Service – Improving Patient Care Holistically
Issue:
Volume 1, Issue 1, December 2012
Pages:
1-3
Published:
30 December 2012
Abstract: Objective: Various rheumatological conditions can present with different degrees of severity at any point in their course. It is extremely important for such patients to be monitored regularly and to feel reassured that they are able to access the specialist services for flare ups and concerns. The aim of this project was to evaluate the outcome of the Rapid Access and Treatment Service for Rheumatology patients in our institution, over a period of 1 month. Method: We studied the patient records for all patients who were seen in the Rapid Access and Treatment Service in the Rheumatology Department, in the month of January. The referral process and the management offered at the clinic were reviewed. Re-attendances were also recorded. Results: 51 patients were seen over 18 days in the month of January. 11 New patients with 40 follow up/ known rheumatological diagnosis patients were reviewed. 1 patient needed admission into the hospital, while 8 needed IM Depo injections. 3 needed IV Methyl prednisolone infusions and the remaining needed either their steroid dose reviewing or other procedures. Conclusion: The efficacy of this service was proven with patient satisfaction and reduction in hospital admission rates. This system works very well in our Department and establishing such a system throughout the NHS, might enhance patient care, reduce worsening of flare ups, thus reducing hospital admissions and allow patients to experience a personalised specialty service. Key messages: 1. Reduced hospital admission rates due to prompt treatment of acute rheumatological problems. 2. Improved patient satisfaction and reduction in worsening of flare ups. 3. Improved doctor – patient relationship with effective holistic care.
Abstract: Objective: Various rheumatological conditions can present with different degrees of severity at any point in their course. It is extremely important for such patients to be monitored regularly and to feel reassured that they are able to access the specialist services for flare ups and concerns. The aim of this project was to evaluate the outcome of...
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Recombinant Insulin in Type 2 Diabetes Treatment: Where Are We Now?
Giuseppina T. Russo,
Provvidenza Villari,
Elisabetta L Romeo,
Annalisa Giandalia,
Domenico Cucinotta
Issue:
Volume 1, Issue 1, December 2012
Pages:
4-9
Published:
30 December 2012
Abstract: Several insulin formulations are currently available for clinical use, including human regular and protaminated insulins, rapid- and long- acting analogs and premixed combinations, which can be used in different regimens. However, there is no consensus on which are the insulin formulation and the insulin regimen of choice, especially in type 2 diabetes. Overall, insulin analogs are preferred for their better pharmacological properties with a minor hypoglycaemic risk, whereas their superiority in reducing HbA1c levels is still debated. Despite the impressive steps undertaken so far, insulin therapy is still too complex and burdensome, and even with an intensified regimen, only a modest percentage of subjects reaches HbA1c goals. New insulin formulations and devices are currently awaited to better fulfill the still unmet needs of insulin therapy.
Abstract: Several insulin formulations are currently available for clinical use, including human regular and protaminated insulins, rapid- and long- acting analogs and premixed combinations, which can be used in different regimens. However, there is no consensus on which are the insulin formulation and the insulin regimen of choice, especially in type 2 diab...
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Laparoscopic Intraperitoneal Onlay Repair of Abdominal Incisional and Ventral Hernias wth Polyvinylidene Fluoride-Coated Polypropylene Mesh; A Retrospective Study with Short to Medium Term Results
Issue:
Volume 1, Issue 1, December 2012
Pages:
10-14
Published:
30 December 2012
Abstract: Laparoscopic repair of incisional and ventral hernias has increased in popularity due to reduced pain, shorter length of stay and earlier return to work. Dynamesh Intraperitoneal onlay mesh (IPOM), a composite of polyvinylidene fluoride (PVDF) coated polypropylene (PP) was designed to utilize the properties of both materials. This retrospective study reports a single surgeon experience with laparoscopic IPOM using Dynamesh , to ascertain any short to medium term complications. Forty consecutive patients underwent intraperitoneal onlay mesh repair with Dynamesh in a District General hospital (DGH) over a 33 month period. Data was collected retrospectively from medical notes, clinical assessment and telephone interviews. Short term complications include development of seromas post operatively in three patients which were successfully drained. One patient was readmitted with small bowel obstruction that was successfully managed conservatively. Medium term results showed two further seromas. Our recurrence rate is 13% after a mean follow up of 15 months. On submission of this manuscript, none of the patients have had to undergo surgical re-intervention for Dynamesh related complications. We have not noticed any significant short to medium term complications with Dynamesh in our experience. The debate about the best composite mesh continues; only a randomised control trial between the different meshes, with long term follow up can determine the true incidence of complications.
Abstract: Laparoscopic repair of incisional and ventral hernias has increased in popularity due to reduced pain, shorter length of stay and earlier return to work. Dynamesh Intraperitoneal onlay mesh (IPOM), a composite of polyvinylidene fluoride (PVDF) coated polypropylene (PP) was designed to utilize the properties of both materials. This retrospective st...
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