Using Patient-Reported Outcome Measures to Evaluate Care for Patients With Inflammatory Chronic Rheumatic Disease

Objectives: Few countries integrate patient-reported outcome measures (PROMs) in routine performance assessment and those that do focus on elective surgery. This study addresses the challenges of using PROMs to evaluate care in chronic conditions. We set out a modeling strategy to assess the extent to which changes over time in self-reported health status by patients with inflammatory chronic rheumatic disease are related to their biological drug therapy and rheumatology center primarily responsible for their care. Methods: Using data from the Portuguese Register of Rheumatic Diseases, we assess health status using the Health Assessment Questionnaire-Disability Index for rheumatic patients receiving biological drugs between 2000 and 2017. We specify a fixed-effects model using the least squares dummy variables estimator. Results: Patients receiving infliximab or rituximab report lower health status than those on etanercept (the most common therapy) and patients in 4 of the 26 rheumatology centers report higher health status than those at other centers. Conclusions: PROMs can be used for those with chronic conditions to provide the patient's perspective about the impact on their health status of the choice of drug therapy and care provider. Care for chronic patients might be improved if healthcare organizations monitor PROMs and engage in performance assessment initiatives on a routine basis.info:eu-repo/semantics/publishedVersio

Using patient-reported outcome measures to evaluate care for patients with inflammatory chronic rheumatic disease

Objectives: Few countries integrate Patient-Reported Outcome Measures (PROMs) in routine performance assessment, and those that do focus on elective surgery. This study addresses the challenges of using PROMs to evaluate care in chronic conditions. We set out a modelling strategy to assess the extent to which changes over time in self-reported health status by patients with inflammatory chronic rheumatic disease are related to their biological drug therapy and Rheumatology centre primarily responsible for their care. Methods: Using data from the Portuguese Register of Rheumatic Diseases, we assess the health status using the Health Assessment Questionnaire-Disability Index (HAQ-DI) for rheumatic patients receiving biological drugs between 2000 and 2017. We employ a fixed effects model using the Least Squares Dummy Variables estimator. Results: Patients receiving infliximab or rituximab report lower health status than those on etanercept (the most common therapy) and patients in 4 of the 26 Rheumatology centres report higher health status than those at other centres. Conclusions: PROMs can be used for those with chronic conditions to provide the patient’s perspective about the impact on their health status of the choice of drug therapy and care provider. Care for chronic patients might be improved if healthcare organisations monitor PROMs and engage in performance assessment initiatives on a routine basis

Bis[glycinium(0.5+)] perrhenate

All the residues of the title compound, (C2H5.5NO2)2[ReO4], are located in general crystallographic positions. The glycine mol­ecules have usual conformations [Rodrigues Matos Beja et al. (2006 ▶). Acta Cryst. C62, o71–o72] with the H atom of the carboxylate group half-occupied, thus bearing a formal half-positive charge per molecule. The perrhenate anion has nearly ideal tetra­hedral geometry. A large number of strong hydrogen bonds give rise to the overall three-dimensional network. A two-dimensional network, parallel to (100), is made up of strong O—H⋯O hydrogen bonds with a donor acceptor distance of 2.445 (2) Å. A large number of weaker O—H⋯O and N—H⋯O hydrogen bonds consolidates the structure into an overall three-dimensional network

Leriche syndrome: accidental CT diagnosis

A 41 years old male patient underwent a staging abdominal CT because of a pulmonary cancer

Petit's lumbar triangle hernia: CT findings

A 45 years old male patient complaining of a lump in the left flank, associated with a dull, heavy, pulling feeling, underwent an abdominal CT

Optimal control strategies for tuberculosis treatment: a case study in Angola

We apply optimal control theory to a tuberculosis model given by a system of ordinary differential equations. Optimal control strategies are proposed to minimize the cost of interventions. Numerical simulations are given using data from Angola.Comment: This is a preprint of a paper whose final and definite form will appear in the international journal Numerical Algebra, Control and Optimization (NACO). Paper accepted for publication 15-March-201

l-Tryptophan 4-nitro­phenol tris­olvate

The title compound, C11H12N2O2·3C6H5NO3, comprises a zwitterionic amino acid formed by two nearly planar groups: (i) the indole ring and Cβ, and (ii) the carboxyl group, Cα, as well as the amine N atom, with r.m.s. deviations of 0.0084 and 0.0038 Å, respectively. The angle between these idealized planes is 39.47 (9)°. The amine group of the amino acid is in a syn (−sc) arrangement relative to the ring system. The overall crystal structure results from the packing of sheets parallel to the (001) planes. These sheets are formed by a pair of screw axis related parallel networks bound by hydrogen-bond and π–π stacking interactions. The intermolecular cohesion of all organic residues in each of the latter two-dimensional networks is achieved via strong hydrogen bonding, nitro–π and π–π stacking interactions

Research project SerpaFlora: valorization of native microbiota of the Serpa cheese

info:eu-repo/semantics/publishedVersio

Relativistic scalar Aharonov-Bohm scattering

We discuss the scattering of relativistic spin zero particles by an infinitely long and arbitrarily thin solenoid. The exact solution of the first-quantized problem can be obtained as a mimic of the nonrelativistic case, either in the original Aharonov-Bohm way or by using the Berry's magnetization scheme. The perturbative treatment is developed in the Feshbach-Villars two-component formalism for the Klein-Gordon equation and it is shown that it also requires renormalization as in the Schrodinger counterpart. The results are compared with those of the field theoretical approach which corresponds to the two-body sector of the scalar Chern-Simons theory.Comment: 15 pages, Revte

Endocardite Aguda Bi-Valvular Esquerda por Estafilococo Aureus Meticilino-Resistente com Complicações Cardíaca, Cerebral, Renal e Sepsis

Infective endocarditis (IE) is now rare in developed countries, but its prevalence is higher in elderly patients with prosthetic valves, diabetes, renal impairment, or heart failure. An increase in health-care associated IE (HCAIE) has been observed due to invasive maneuvers (30% of cases). Methicillin-resistant Staphylococcus aureus (MRSA) and Enterococcus are the most common agents in HCAIE, causing high mortality and morbidity. We review complications of IE and its therapy, based on a patient with acute bivalvular left-sided MRSA IE and a prosthetic aortic valve, aggravated by congestive heart failure, stroke, acute immune complex glomerulonephritis, Candida parapsilosis fungémia and death probably due to Serratia marcescens sepsis. The HCAIE was assumed to be related to three temporally associated in-hospital interventions considered as possible initial etiological mechanisms: overcrowding in the hospital environment,iv quinolone therapy and red blood cell transfusion. Later in the clinical course,C. parapsilosis and S. marcescens septicemia were considered to be possible secondary etiological mechanisms of HCAIE