8 research outputs found
Tuberculosis-HIV Co-infection in Kiev City, Ukraine
In 2004, we tested all patients with newly diagnosed tuberculosis (TB) for HIV in Kiev City. The results were compared to information from medical records of 2002, when co-infection prevalence was 6.3%. Of 968 TB patients, 98 (10.1%) were HIV infected. TB-HIV co-infection is increasing, especially in injecting drug users
Management of Children with Disease Caused by New Coronaviral Infection (SARS-CoV-2)
The Ministry of Health of the Russian Federation jointly with professional association and experts in the field of pediatrics, infectious diseases and resuscitation has developed guidelines âClinical Features and Management of the Disease Caused by New Coronaviral Infection (COVID-19) in Childrenâ in order to provide the child population with effective medical care during the pandemic of the new coronaviral infection. The practical experience of specialists from various countries was considered during the development of this document. Special attention should be given to the evidence base of the presented data, as well as to the efficiency and safety issues of medications used in treatment of coronaviral infection and its complications. The authors highlight the problems of prevention, diagnostics and management of pathological conditions caused by COVID-19 in the article according to the presented guidelines. Patientâs management is presented depending on the age and severity of the disease itself. The therapy is considered with regard to etiological, pathogenetic and symptom focus
Clinical Features and Management of the Disease Caused by New Coronaviral Infection (COVID-19) in Children. Version 2
The Ministry of Health of the Russian Federation jointly with professional association and experts in the field of pediatrics, infectious diseases and resuscitation has revised guidelines âClinical Features and Management of the Disease Caused by New Coronaviral Infection (COVID-19) in Childrenâ in order to provide the child population with effective medical care during the pandemic of the new coronaviral infection. The practical experience of specialists from various countries was considered during the development of this document. Special attention should be given to the evidence base of the presented data, as well as to the efficiency and safety issues of medications used in treatment of coronaviral infection and its complications. The authors highlight the problems of prevention, diagnostics and management of pathological conditions caused by COVID-19 in the article according to the presented guidelines. Patientâs management is presented depending on the age and severity of the disease itself. The therapy is considered with regard to etiological, pathogenetic and symptom focus
ĐĐ”ĐŽĐ”ĐœĐžĐ” ĐŽĐ”ŃĐ”Đč Ń Đ·Đ°Đ±ĐŸĐ»Đ”ĐČĐ°ĐœĐžĐ”ĐŒ, ĐČŃĐ·ĐČĐ°ĐœĐœŃĐŒ ĐœĐŸĐČĐŸĐč ĐșĐŸŃĐŸĐœĐ°ĐČĐžŃŃŃĐœĐŸĐč ĐžĐœŃĐ”ĐșŃОДĐč (SARS-CoV-2)
The Ministry of Health of the Russian Federation jointly with professional association and experts in the field of pediatrics, infectious diseases and resuscitation has developed guidelines âClinical Features and Management of the Disease Caused by New Coronaviral Infection (COVID-19) in Childrenâ in order to provide the child population with effective medical care during the pandemic of the new coronaviral infection. The practical experience of specialists from various countries was considered during the development of this document. Special attention should be given to the evidence base of the presented data, as well as to the efficiency and safety issues of medications used in treatment of coronaviral infection and its complications. The authors highlight the problems of prevention, diagnostics and management of pathological conditions caused by COVID-19 in the article according to the presented guidelines. Patientâs management is presented depending on the age and severity of the disease itself. The therapy is considered with regard to etiological, pathogenetic and symptom focus.ĐĄ ŃДлŃŃ ĐŸĐ±Đ”ŃпДŃĐ”ĐœĐžŃ ĐŽĐ”ŃŃĐșĐŸĐłĐŸ ĐœĐ°ŃĐ”Đ»Đ”ĐœĐžŃ ŃŃŃĐ”ĐșŃĐžĐČĐœĐŸĐč ĐŒĐ”ĐŽĐžŃĐžĐœŃĐșĐŸĐč ĐżĐŸĐŒĐŸŃŃŃ ĐČ ŃŃĐ»ĐŸĐČĐžŃŃ
ĐżĐ°ĐœĐŽĐ”ĐŒĐžĐž ĐœĐŸĐČĐŸĐč ĐșĐŸŃĐŸĐœĐ°ĐČĐžŃŃŃĐœĐŸĐč ĐžĐœŃĐ”ĐșŃОО ĐĐžĐœĐ·ĐŽŃĐ°ĐČĐŸĐŒ Đ ĐŸŃŃОО ŃĐŸĐČĐŒĐ”ŃŃĐœĐŸ Ń ĐżŃĐŸŃĐ”ŃŃĐžĐŸĐœĐ°Đ»ŃĐœŃĐŒĐž Đ°ŃŃĐŸŃОаŃĐžŃĐŒĐž Đž ŃĐșŃпДŃŃĐ°ĐŒĐž ĐČ ĐŸĐ±Đ»Đ°ŃŃĐž пДЎОаŃŃОО, ĐžĐœŃĐ”ĐșŃĐžĐŸĐœĐœŃŃ
Đ±ĐŸĐ»Đ”Đ·ĐœĐ”Đč Đž ŃĐ”Đ°ĐœĐžĐŒĐ°ŃОО ŃĐ°Đ·ŃĐ°Đ±ĐŸŃĐ°ĐœŃ ĐŒĐ”ŃĐŸĐŽĐžŃĐ”ŃĐșОД ŃĐ”ĐșĐŸĐŒĐ”ĐœĐŽĐ°ŃОО «ĐŃĐŸĐ±Đ”ĐœĐœĐŸŃŃĐž ĐșĐ»ĐžĐœĐžŃĐ”ŃĐșĐžŃ
ĐżŃĐŸŃĐČĐ»Đ”ĐœĐžĐč Đž лДŃĐ”ĐœĐžŃ Đ·Đ°Đ±ĐŸĐ»Đ”ĐČĐ°ĐœĐžŃ, ĐČŃĐ·ĐČĐ°ĐœĐœĐŸĐłĐŸ ĐœĐŸĐČĐŸĐč ĐșĐŸŃĐŸĐœĐ°ĐČĐžŃŃŃĐœĐŸĐč ĐžĐœŃĐ”ĐșŃОДĐč (COVID-19), Ń ĐŽĐ”ŃĐ”Đč». ĐŃĐž ŃĐ°Đ·ŃĐ°Đ±ĐŸŃĐșĐ” ĐŽĐŸĐșŃĐŒĐ”ĐœŃĐ° бŃĐ» ŃŃŃĐ”Đœ ĐżŃĐ°ĐșŃĐžŃĐ”ŃĐșĐžĐč ĐŸĐżŃŃ ŃпДŃОалОŃŃĐŸĐČ ĐœĐ” ŃĐŸĐ»ŃĐșĐŸ ĐœĐ°ŃĐ”Đč ŃŃŃĐ°ĐœŃ, ĐœĐŸ Đž Đ·Đ°ŃŃĐ±Đ”Đ¶ĐœŃŃ
ĐșĐŸĐ»Đ»Đ”Đł. ĐŃĐŸĐ±ĐŸĐ” ĐČĐœĐžĐŒĐ°ĐœĐžĐ” ŃĐŽĐ”Đ»Đ”ĐœĐŸ ĐŽĐŸĐșĐ°Đ·Đ°ŃДлŃĐœĐŸĐč базД ĐżŃДЎŃŃĐ°ĐČĐ»Đ”ĐœĐœŃŃ
ĐŽĐ°ĐœĐœŃŃ
, Đ° ŃĐ°ĐșжД ĐČĐŸĐżŃĐŸŃĐ°ĐŒ ŃŃŃĐ”ĐșŃĐžĐČĐœĐŸŃŃĐž Đž Đ±Đ”Đ·ĐŸĐżĐ°ŃĐœĐŸŃŃĐž лДĐșĐ°ŃŃŃĐČĐ”ĐœĐœŃŃ
ĐżŃДпаŃĐ°ŃĐŸĐČ, ĐżŃĐžĐŒĐ”ĐœŃĐ”ĐŒŃŃ
ĐżŃĐž лДŃĐ”ĐœĐžĐž ĐŽĐ°ĐœĐœĐŸĐč ĐžĐœŃĐ”ĐșŃОО Đž ДД ĐŸŃĐ»ĐŸĐ¶ĐœĐ”ĐœĐžĐč. Đ ŃŃĐ°ŃŃĐ” ĐœĐ° ĐŸŃĐœĐŸĐČĐ°ĐœĐžĐž ŃĐșĐ°Đ·Đ°ĐœĐœŃŃ
ĐŒĐ”ŃĐŸĐŽĐžŃĐ”ŃĐșĐžŃ
ŃĐ”ĐșĐŸĐŒĐ”ĐœĐŽĐ°ŃОО Đ°ĐČŃĐŸŃŃ ĐŸŃĐČĐ”ŃĐ°ŃŃ ĐČĐŸĐżŃĐŸŃŃ ĐżŃĐŸŃОлаĐșŃĐžĐșĐž, ĐŽĐžĐ°ĐłĐœĐŸŃŃĐžĐșĐž, лДŃĐ”ĐœĐžŃ ĐżĐ°ŃĐŸĐ»ĐŸĐłĐžŃĐ”ŃĐșĐžŃ
ŃĐŸŃŃĐŸŃĐœĐžĐč, ĐŸĐ±ŃŃĐ»ĐŸĐČĐ»Đ”ĐœĐœŃŃ
COVID-19. йаĐșŃĐžĐșĐ° ĐČĐ”ĐŽĐ”ĐœĐžŃ ĐżĐ°ŃĐžĐ”ĐœŃĐ° ĐżŃДЎŃŃĐ°ĐČĐ»Đ”ĐœĐ° ĐČ Đ·Đ°ĐČĐžŃĐžĐŒĐŸŃŃĐž ĐŸŃ ĐČĐŸĐ·ŃĐ°ŃŃĐ° Đž ŃŃĐ”ĐżĐ”ĐœĐž ŃŃжДŃŃĐž ŃĐ”ŃĐ”ĐœĐžŃ Đ±ĐŸĐ»Đ”Đ·ĐœĐž, ŃĐ”ŃĐ°ĐżĐžŃ ŃĐ°ŃŃĐŒĐŸŃŃĐ”ĐœĐ° Ń ĐżĐŸĐ·ĐžŃОО ŃŃĐžĐŸĐ»ĐŸĐłĐžŃĐ”ŃĐșĐŸĐč, паŃĐŸĐłĐ”ĐœĐ”ŃĐžŃĐ”ŃĐșĐŸĐč Đž ŃĐžĐŒĐżŃĐŸĐŒĐ°ŃĐžŃĐ”ŃĐșĐŸĐč ĐœĐ°ĐżŃĐ°ĐČĐ»Đ”ĐœĐœĐŸŃŃĐž
ĐŃĐŸĐ±Đ”ĐœĐœĐŸŃŃĐž ĐșĐ»ĐžĐœĐžŃĐ”ŃĐșĐžŃ ĐżŃĐŸŃĐČĐ»Đ”ĐœĐžĐč Đž лДŃĐ”ĐœĐžŃ Đ·Đ°Đ±ĐŸĐ»Đ”ĐČĐ°ĐœĐžŃ, ĐČŃĐ·ĐČĐ°ĐœĐœĐŸĐłĐŸ ĐœĐŸĐČĐŸĐč ĐșĐŸŃĐŸĐœĐ°ĐČĐžŃŃŃĐœĐŸĐč ĐžĐœŃĐ”ĐșŃОДĐč (COVID-19), Ń ĐŽĐ”ŃĐ”Đč. ĐĐ”ŃŃĐžŃ 2
The Ministry of Health of the Russian Federation jointly with professional association and experts in the field of pediatrics, infectious diseases and resuscitation has revised guidelines âClinical Features and Management of the Disease Caused by New Coronaviral Infection (COVID-19) in Childrenâ in order to provide the child population with effective medical care during the pandemic of the new coronaviral infection. The practical experience of specialists from various countries was considered during the development of this document. Special attention should be given to the evidence base of the presented data, as well as to the efficiency and safety issues of medications used in treatment of coronaviral infection and its complications. The authors highlight the problems of prevention, diagnostics and management of pathological conditions caused by COVID-19 in the article according to the presented guidelines. Patientâs management is presented depending on the age and severity of the disease itself. The therapy is considered with regard to etiological, pathogenetic and symptom focus.ĐĄ ŃДлŃŃ ĐŸĐ±Đ”ŃпДŃĐ”ĐœĐžŃ ĐŽĐ”ŃŃĐșĐŸĐłĐŸ ĐœĐ°ŃĐ”Đ»Đ”ĐœĐžŃ ŃŃŃĐ”ĐșŃĐžĐČĐœĐŸĐč ĐŒĐ”ĐŽĐžŃĐžĐœŃĐșĐŸĐč ĐżĐŸĐŒĐŸŃŃŃ ĐČ ŃŃĐ»ĐŸĐČĐžŃŃ
ĐżĐ°ĐœĐŽĐ”ĐŒĐžĐž ĐœĐŸĐČĐŸĐč ĐșĐŸŃĐŸĐœĐ°ĐČĐžŃŃŃĐœĐŸĐč ĐžĐœŃĐ”ĐșŃОО ĐĐžĐœĐ·ĐŽŃĐ°ĐČĐŸĐŒ Đ ĐŸŃŃОО ŃĐŸĐČĐŒĐ”ŃŃĐœĐŸ Ń ĐżŃĐŸŃĐ”ŃŃĐžĐŸĐœĐ°Đ»ŃĐœŃĐŒĐž Đ°ŃŃĐŸŃОаŃĐžŃĐŒĐž Đž ŃĐșŃпДŃŃĐ°ĐŒĐž ĐČ ĐŸĐ±Đ»Đ°ŃŃĐž пДЎОаŃŃОО, ĐžĐœŃĐ”ĐșŃĐžĐŸĐœĐœŃŃ
Đ±ĐŸĐ»Đ”Đ·ĐœĐ”Đč Đž ŃĐ”Đ°ĐœĐžĐŒĐ°ŃОО бŃлО пДŃĐ”ŃĐ°Đ±ĐŸŃĐ°ĐœŃ ĐŒĐ”ŃĐŸĐŽĐžŃĐ”ŃĐșОД ŃĐ”ĐșĐŸĐŒĐ”ĐœĐŽĐ°ŃОО «ĐŃĐŸĐ±Đ”ĐœĐœĐŸŃŃĐž ĐșĐ»ĐžĐœĐžŃĐ”ŃĐșĐžŃ
ĐżŃĐŸŃĐČĐ»Đ”ĐœĐžĐč Đž лДŃĐ”ĐœĐžŃ Đ·Đ°Đ±ĐŸĐ»Đ”ĐČĐ°ĐœĐžŃ, ĐČŃĐ·ĐČĐ°ĐœĐœĐŸĐłĐŸ ĐœĐŸĐČĐŸĐč ĐșĐŸŃĐŸĐœĐ°ĐČĐžŃŃŃĐœĐŸĐč ĐžĐœŃĐ”ĐșŃОДĐč (COVID-19), Ń ĐŽĐ”ŃĐ”Đč». ĐŃĐž ŃĐ°Đ·ŃĐ°Đ±ĐŸŃĐșĐ” ĐŽĐŸĐșŃĐŒĐ”ĐœŃĐ° бŃĐ» ŃŃŃĐ”Đœ ĐżŃĐ°ĐșŃĐžŃĐ”ŃĐșĐžĐč ĐŸĐżŃŃ ĐœĐ” ŃĐŸĐ»ŃĐșĐŸ ŃпДŃОалОŃŃĐŸĐČ ĐœĐ°ŃĐ”Đč ŃŃŃĐ°ĐœŃ, ĐœĐŸ Đž Đ·Đ°ŃŃĐ±Đ”Đ¶ĐœŃŃ
ĐșĐŸĐ»Đ»Đ”Đł. ĐŃĐŸĐ±ĐŸĐ” ĐČĐœĐžĐŒĐ°ĐœĐžĐ” ŃĐŽĐ”Đ»Đ”ĐœĐŸ ĐŽĐŸĐșĐ°Đ·Đ°ŃДлŃĐœĐŸĐč базД ĐżŃДЎŃŃĐ°ĐČĐ»Đ”ĐœĐœŃŃ
ĐŽĐ°ĐœĐœŃŃ
, Đ° ŃĐ°ĐșжД ĐČĐŸĐżŃĐŸŃĐ°ĐŒ ŃŃŃĐ”ĐșŃĐžĐČĐœĐŸŃŃĐž Đž Đ±Đ”Đ·ĐŸĐżĐ°ŃĐœĐŸŃŃĐž лДĐșĐ°ŃŃŃĐČĐ”ĐœĐœŃŃ
ĐżŃДпаŃĐ°ŃĐŸĐČ, ĐżŃĐžĐŒĐ”ĐœŃĐ”ĐŒŃŃ
ĐżŃĐž лДŃĐ”ĐœĐžĐž ĐŽĐ°ĐœĐœĐŸĐč ĐžĐœŃĐ”ĐșŃОО Đž ДД ĐŸŃĐ»ĐŸĐ¶ĐœĐ”ĐœĐžĐč. Đ ŃŃĐ°ŃŃĐ” ĐœĐ° ĐŸŃĐœĐŸĐČĐ°ĐœĐžĐž ŃĐșĐ°Đ·Đ°ĐœĐœŃŃ
ĐŒĐ”ŃĐŸĐŽĐžŃĐ”ŃĐșĐžŃ
ŃĐ”ĐșĐŸĐŒĐ”ĐœĐŽĐ°ŃĐžĐč Đ°ĐČŃĐŸŃŃ ĐŸŃĐČĐ”ŃĐ°ŃŃ ĐČĐŸĐżŃĐŸŃŃ ĐżŃĐŸŃОлаĐșŃĐžĐșĐž, ĐŽĐžĐ°ĐłĐœĐŸŃŃĐžĐșĐž, лДŃĐ”ĐœĐžŃ ĐżĐ°ŃĐŸĐ»ĐŸĐłĐžŃĐ”ŃĐșĐžŃ
ŃĐŸŃŃĐŸŃĐœĐžĐč, ĐŸĐ±ŃŃĐ»ĐŸĐČĐ»Đ”ĐœĐœŃŃ
COVID-19. йаĐșŃĐžĐșĐ° ĐČĐ”ĐŽĐ”ĐœĐžŃ ĐżĐ°ŃĐžĐ”ĐœŃĐ° ĐżŃДЎŃŃĐ°ĐČĐ»Đ”ĐœĐ° ĐČ Đ·Đ°ĐČĐžŃĐžĐŒĐŸŃŃĐž ĐŸŃ ĐČĐŸĐ·ŃĐ°ŃŃĐ° Đž ŃŃĐ”ĐżĐ”ĐœĐž ŃŃжДŃŃĐž ŃĐ”ŃĐ”ĐœĐžŃ Đ±ĐŸĐ»Đ”Đ·ĐœĐž, ŃĐ”ŃĐ°ĐżĐžŃ ŃĐ°ŃŃĐŒĐŸŃŃĐ”ĐœĐ° Ń ĐżĐŸĐ·ĐžŃĐžĐč ŃŃĐžĐŸĐ»ĐŸĐłĐžŃĐ”ŃĐșĐŸĐč, паŃĐŸĐłĐ”ĐœĐ”ŃĐžŃĐ”ŃĐșĐŸĐč Đž ŃĐžĐŒĐżŃĐŸĐŒĐ°ŃĐžŃĐ”ŃĐșĐŸĐč ĐœĐ°ĐżŃĐ°ĐČĐ»Đ”ĐœĐœĐŸŃŃĐž
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Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries
Background
Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks.
Methods
The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned.
Results
A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31).
Conclusion
Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)