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- Cavicchi, A., et al.
(författare)
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INFORMEG, a new evaluation system for family medicine trainees : Feasibility in an Italian rural setting
- 2016
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Ingår i: Rural and Remote Health. - 1445-6354. ; 16:3
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: In Italy the course to become a general practitioner (GP) lasts 3 years and includes both theoretical and practical study. Different from the theoretical part, until recently the practical activity has not been assessed at all. The Emilia Romagna Regional Health Authority has developed a special program called INFORMEG (Management of Tutoring during the Triennial Specific Training in General Practice), aimed at assessing primary doctor trainees' practical skills. INFORMEG includes a list of predefined cases of specific diseases, conditions or health problem, a web application and a smartphone app, aimed at assisting trainee self-management and helping the tutor in the assessment of trainee performance. The Emilia Romagna Regional Health Authority divided the pre-defined cases into three categories (A, B and C) according to their relevance to a trainee's education and coded them using the International Classification of Primary Care (ICPC). The aim of this project report is to illustrate the implementation of INFORMEG in a rural setting. Methods: Program evaluation took place from 2 May to 31 October 2013 during GPs' routine clinical activities. The following steps were accomplished during every meeting: (1) consultation recording; (2) identification of the reason for the encounter (RfE); (3) classification of the diagnostic procedure(s) performed (diagnostic/therapeutic/test results/administrative/advice); (4) classification of special procedures called 'practical clinical skills' and (5) elaboration of the final diagnosis after the encounter. Results: The number of cases of specific disease or condition encountered by the trainee were 98 for type A, 57 for type B and 22 for type C. A total of 605 RfEs were collected: 376 for type A cases, 147 for type B cases and 82 for type C cases. A total of 976 procedures were performed during the 6 months: 590 procedures for the type A cases, 271 for type B and 115 for type C. Conclusions: The pre-selected health problems were almost all addressed, thus confirming the good degree of representativeness of these clinical cases even in a rural setting. The ICPC coding helped the trainee in the construction of the case according to the logical process of family medicine. Two things to amend in INFORMEG are the absence of common arrhythmic conditions such as atrial fibrillation and the absence of means to assess the patient-trainee relationship.
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- Rurik, I., et al.
(författare)
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Early and Menopausal Weight Gain and its Relationship with the Development of Diabetes and Hypertension
- 2017
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Ingår i: Experimental and Clinical Endocrinology & Diabetes. - : Georg Thieme Verlag KG. - 0947-7349 .- 1439-3646. ; 125:04, s. 241-250
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Tidskriftsartikel (refereegranskat)abstract
- Background: Previous research has revealed a clear relationship between weight gain of persons and their metabolic diseases developing later. These studies have covered only short periods lasting 4–8 years. Our goal was to collect decades’ old and often life-long anthropometric data and correlate the figures with the presence of hypertension and diabetes or both. Methods: A retrospective international study was planned and organized to compare self-recorded data of lifelong weight gain among 60–70-year-old patients, analyze their correlation with metabolic diseases they developed, with special attention to women’s weight gain around pregnancy, delivery and menopause in primary care settings in Germany, Hungary, Italy, Slovakia and the Ukraine. Results: Of the recruited 815 participants, 319 men and 496 women presented all the required data. Diabetics of both genders had the highest baseline weight at 20 years of age. The weight and BMI of the whole study population increased steadily until their seventies, but to a lesser extent after their fifties. Compared to the control group, changes over decades were the greatest among diabetics and also greater among patients with hypertension. Weight increase in the first decades (20–30-year-old men and 30–40-year-old women) was a significant risk factor for the development of diabetes (OR=1.044; p=0.002; 95% CI: 1.01–1.07). Among patients with diabetes and hypertension, both diagnoses were set up earlier than among those with a single morbidity. Among females, weight increase around pregnancy and menopause correlated significantly with higher odds for the diagnoses of diabetes and/or hypertension, irrespective of the number of children. Conclusions: During their decade-long relationship with their patients, family physicians are expected to identify the higher weight gain of their patients, especially among younger generation and intervene, if necessary.
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- Villa, L, et al.
(författare)
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Effects by silodosin on the partially obstructed rat ureter in vivo and on human and rat isolated ureters
- 2013
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Ingår i: British Journal of Pharmacology. - : Wiley-Blackwell. - 0007-1188 .- 1476-5381. ; 169:1, s. 230-238
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Tidskriftsartikel (refereegranskat)abstract
- Background and Purpose 1-adrenoceptor (-AR) antagonists may facilitate ureter stone passage in humans. We aimed to study effects by the 1A-AR selective antagonist silodosin (compared to tamsulosin and prazosin) on ureter pressures in a rat model of ureter obstruction, and on contractions of human and rat isolated ureters. Experimental Approach After ethical approval, ureters of male rats were cannulated beneath the kidney pelvis for in vivo ureteral intraluminal recording of autonomous peristaltic pressure waves. A partial ureter obstruction was applied to the distal ureter. Mean arterial blood pressure (MAP) was recorded. Approximate clinical and triple clinical doses of the 1-AR antagonists were given intravenously. Effects by the 1-AR antagonists on isolated human and rat ureters were studied in organ baths. Key Results Intravenous silodosin (0.10.3mgkg1) or prazosin (0.030.1mgkg1) reduced obstruction-induced increases in intraluminal ureter pressures by 2137% or 1840% respectively. Corresponding effects by tamsulosin (0.01 or 0.03mgkg1) were 920%. Silodosin, prazosin and tamsulosin reduced MAP by 1012%, 2526% (P andlt; 0.05), or 1825% (P andlt; 0.05) respectively. When effects by the 1A-AR antagonists on obstruction-induced ureter pressures were expressed as a function of MAP, silodosin had six- to eightfold and 2.5- to eightfold better efficacy than tamsulosin or prazosin respectively. Silodosin effectively reduced contractions of both human and rat isolated ureters. Conclusions and Implications Silodosin inhibits contractions of the rat and human isolated ureters and has excellent functional selectivity in vivo to relieve pressure-load of the rat obstructed ureter. Silodosin as pharmacological ureter stone expulsive therapy should be clinically further explored.
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