Anecdotal evidence suggests that community infection control measures during the COVID-19 outbreak have modified the number and natural history of acute surgical inflammatory processes (ASIP—appendicitis, cholecystitis, diverticulitis and perianal abscesses) admissions. This study aims to evaluate the impact of the COVID-19 pandemic on the presentation and treatment ASIP and quantify the effect of COVID-19 infection on the outcomes of ASIP patients. This was a multicentre, comparative study, whereby ASIP cases from 2019, 2020 and 2021 (March 14th to May 2nd) were analyzed. Data regarding patient and disease characteristics as well as outcomes, were collected from sixteen centres in Madrid, and one in Seville (Spain). The number of patients treated for ASIP in 2019 was 822 compared to 521 in 2020 and 835 in 2021. This 1/3rd reduction occurs mainly in patients with mild cases, while the number of severe cases was similar. Surgical standards suffered a step back during the first wave: Lower laparoscopic approach and longer length of stay. We also found a more conservative approach to the patients this year, non-justified by clinical circumstances. Luckily these standards improved again in 2021. The positive COVID-19 status itself did not have a direct impact on mortality. Strikingly, none of the 33 surgically treated COVID positive patients during both years died postoperatively. This is an interesting finding which, if confirmed through future research with a larger sample size of COVID-19 positive patients, can expedite the recovery phase of acute surgical services.
In the present study, patients with asthma were interviewed with regard to their treatment adherence. It was shown that adherence is significantly influenced by age, occupation, quality of information about the disease and interest of the patient in disease, mode of action and use of the inhalation device. Younger, working patients who do not feel "completely adequately" informed are more likely to be not-adherent. Each aspect should be noted separately.The characterization enables forming target groups for appropriate counselling initiatives in pulmonology practice and allows the effectiveness of the measures to be examined. The results confirm the importance of doctor/patient communication for achieving a high level of adherence and thus therapeutic success.It is suggested that, in addition to questionnaires already in use, asthma patients should be given the following questions in writing during routine monitoring of therapy; based on the results of the survey, the extent of advice necessary can be determined -Do you feel sufficiently informed about your illness? -Do you feel sufficiently informed about the effect of the drug therapy? -Do you feel sufficiently informed about the handling of the inhalation drugs? -Are you satisfied with the handling of your inhalation medication? The following options to answer the questions should be available: completely - mainly - somewhat - not at all. There were significant differences in adherence between patients who were completely satisfied with the handling of their device and those that were not. However, there was no significant difference between the devices. Therefore, the same therapy adherence can be predicted for all devices when the device is suitable for the patient and also provides complete satisfaction in handling. Since it is the subjective perception of patients, the data show significant differences between study centres. These were mirrored in a blind benchmark to stimulate improvements.
OR 0.42 (95% CI 0.26-0.67)], presence of cognitive dysfunction [OR 0.40 (95% CI 0.20-0.79)], and presence of underlying severe disease [OR 0.45 (95% CI 0.30-0.70)]. Conclusion: We found that age, cognitive dysfunction, underlying severe disease, and delay of rehabilitation would were associated with functional recovery after hip fracture operation in the early period. Therefore early rehabilitation is required to acquire functional recovery after hip fracture operation in early period.
To assess the quality of treatment of patients with asthma who were treated jointly by pulmonologists and the family doctor, a data analysis was performed in 13 asthma specialists in 894 asthmatics and a written survey of patients after 3 months of treatment.The data analysis related to the current therapy, the therapy changes and the changes in asthma control test (ACT). One focus of the investigation was placed on the separate analysis of patients with controlled and uncontrolled asthma. Both patient groups show both decrease, as well as increases in the number of points of the ACT. In patients with non-controlled asthma, the proportion of an increase in the number of points in the ACT is above average and indicates an improvement of the disease. This is operated in the patient's subjective assessment. In both patient groups there is a large proportion of patients who report a subjective improvement. An improvement is usually achieved by an improved pharmacotherapy, a deterioration usually occurs due to external influences. The differences for the patient groups are here but less significantly. There is a general satisfaction with both the drug therapy, as well as with the handling. The inhalation drug therapy is performed very stable. In patients with poor asthma control therapy is usually intensified. In oral pharmacotherapy oral steroid therapy has a great dynamic in patients with uncontrolled asthma. In this group, the most frequent increases in the dose of inhaled substances are recorded.
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