Listeriosis invasiva en un hospital general: rasgos diferenciales de los pacientes con cáncer

Aquest estudi es va dissenyar amb l’objectiu de comparar les característiques dels malalts amb càncer respecte als malalts sense càncer, amb listeriosis invasiva. No es van detectar diferencies en les característiques basals dels malalts. La forma de presentació més freqüent en els malalts oncològics va ser la bacterièmia, i en els malalts no oncològics, la infecció del sistema nerviós central. El grup de malalts amb càncer va tenir un mortalitat superior. Cap de les diferencies va ser estadísticament significativa, probablement pel baix nombre de malalts, però les dades coincideixen amb la literatura.

Evaluation of pilot initiatives undertaken in the North Eastern and South Eastern Health Boards on the provision of General Practitioner out-of-hours services in those areas

To assess the efficiency and effectiveness of the management, administrative and support structures for the General Practitioner out-of-hours pilot projects in the North Eastern and South Eastern Health Boards having regard to value for money and service enhancement considerations Download the Report here

Methadone maintenance treatment (MMT) in general practice or in specialized centers: profile of patients in the Swiss Canton of Vaud.

We studied profile of patients (n=1782) treated in specialized centers and general practice (GP) enrolled in methadone maintenance treatment (MMT) programs during 2001 in the Swiss Canton of Vaud. We found that GPs treated the majority of patients (76%). Specialized centers treated a higher proportion of patients with uncontrolled intravenous use of cocaine and heroin, and prescribed neuroleptics as concomitant medication three times more frequently than GPs. Patients treated in specialized centers were more likely to undergo screening for HIV, HBV, HCV, and receive complete HBV immunization. In conclusion, specialized centers are more likely to treat severely addicted patients and patients with a poor global assessment (physical, psychiatric, and social).

Review of governance and accountability mechanisms in the General Medical Services schemes

Click here to download PDF

Comparison of the clientele of an anonymous HIV test centre and persons tested in the general population.

This study compares the clientele of a Swiss anonymous test centre with the general population tested. Information was obtained through similar questionnaires submitted to two samples of HIV-tested people aged from 17 to 45 years: the first administered in the context of a general population telephone survey (n = 245) and the second completed during face-to-face interviews of the clientele of an anonymous test centre (n = 250). The test centre sample has higher proportions of younger and single people. Attenders for anonymous testing were more likely to have acquired a new regular partner during the year preceding the interview (48.0% versus 14.4%). These differences remain when controlling for age and gender. Decision to test comes mostly from the respondent's own initiative, but suggestion from a doctor is more frequent in the general population (23.8% versus 0.8%), whereas suggestion from partner or friends is more frequent in the anonymous centre (44.4% versus 3.0%). The anonymous test centre clientele is not different from the general population tested except for the relational situation and origin of decision for testing. The test centre has become a place where the general population finds a response to a situation-specific need for HIV testing.

¿Qué ocurre con el déficit de vitamina d en la población general mayor de 65 años después del verano?

Estudi d’una cohort de persones majors de 64 anys ateses en 5 Àrees Bàsiques de Salut del Vallès Occidental, a les que es van determinar els nivells de vitamina D desprès de l’estiu, per analitzar la possible existència d’una variació estacional en el seu estat vitamínic, i els factors associats. Es van comparar els resultats amb les dades obtingudes en un estudi previ realitzat desprès de l’hivern. Es manté una elevada prevalença d’hipovitaminosi D en aquesta població desprès de l’estiu. Els factors associats amb la deficiència vitamínica van ser els nivells basals previs de 25(OH)D3 i la menor exposició solar.

Clinical presentation and survival of smear-positive pulmonary tuberculosis patients of a University General Hospital in a developing country

From January 1995 to August 1997 we evaluated prospectively the clinical presentation, laboratory findings and short-term survival of smear-positive pulmonary tuberculosis (TB) patients who sought care at our hospital. After providing informed, written consent, the patients were interviewed and laboratory tests were performed. Information about survivorship and death was collected through September 1998. Eighty-six smear-positive pulmonary TB patients were enrolled; 26.7% were HIV-seropositive. Seventeen HIV-seronegative pulmonary TB patients (19.8%) presented chronic diseases in addition to TB. In the multiple logistic regression analysis a CD4+ cell count <= 200 cell/mm³ was independently associated with HIV seropositivity. In the Cox regression model, fitted to all patients, HIV seropositivity and age > or = 50 years were independently associated with decreased survival. Among HIV-seronegative persons, the presence of an additional disease increased the risk of death of almost six-fold. Use of antiretroviral drugs was associated with a lower risk of death among HIV-seropositive smear-positive pulmonary TB patients (RH = 0.32, 95% CI 0.10-0.92). In our study smear-positive pulmonary TB patients had a low short-term survival rate that was strongly associated with HIV infection, age and co-morbidities. Therapy with antiretroviral drugs reduced the short-term risk of death among HIV-seropositive patients after TB diagnosis.

Associació entre la malaltia renal crònica i la malaltia cardiovascular a la població general mediterrània

La malaltia renal crònica (MRC) inicial s’ha definit com un marcador de risc cardiovascular susceptible d’intervenció terapèutica preventiva. Aquesta relació ha estat poc estudiada al nostre entorn. Objectius: Determinar si la MRC s’associa a un increment de risc de morbiditat i mortalitat al nostre entorn. Disseny: Estudi observacional prospectiu d’una cohort poblacional de Girona de 31.612 individus de 35-74 anys. Resultats: La MRC estadi 3 sense albuminúria no incrementa el risc de malaltia cardiovascular en població general de baix risc cardiovascular. L’albuminúria&20mg/L i els estadis 4-5 de MRC s’associen a un increment de risc de morbiditat cardiovascular i mortalitat global.

Medical Card for Over 70s: Fees payable to General Practitioners (Sullivan Report)

Medical Card for Over 70s: Fees payable to General Practitioners (Sullivan Report) In the context of the Government decision to end the arrangements whereby medical cards are issued automatically, without a means test, to all those aged 70 and over, a new income threshold was set and the Government decided to introduce a new single capitation rate payable in respect of patients aged 70 and over. I was asked to recommend a new rate for consideration by the Minister for Health & Children and the Government. Click here to download PDF 58kb

Opening statement by Mr Michael Scanlan, Secretary General of the Department of Health & Children at the meeting of the DÃil Committee of Public Accounts on 7th May 2009

Opening statement by Mr Michael Scanlan, Secretary General of the Department of Health & Children at the meeting of the Dáil Committee of Public Accounts on 7th May 2009 Click here to download PDF 37kb

Report to Secretary General on: Travel associated with Management - Union Partnership Activities, and in which Department officials participated, and Funding for Management -Union Partnership activities other than SKILL

Report to Secretary General on: Travel associated with Management – Union Partnership Activities, and in which Department officials participated, and Funding for Management -Union Partnership activities other than SKILL Download this document as a PDF 58KB Also… Subsistence Allowances PDF 1.19MB Extracts from the Health Service National Partnership Forum’s Financial Statements for the year ended 31 December 2000 PDF 338KB Foreign Travel claims relating to Skills & Partnership PDF 13KB Details of Funding Provided to Nursing Unions from 12/6/2000 – 5/11/2004 PDF 360KB Partnership Investigation PDF 428KB

General Scheme of the Public Health (Standardised Packaging of Tobacco) Bill

The purposes of this Act are to : (a) reduce the appeal of tobacco and tobacco products, (b) increase the effectiveness of health warnings on tobacco products, and (c)reduce the ability of the packaging of tobacco and tobacco products to mislead consumers about the harmful effects of smoking in the public interest,by providing for the standardisation of the labelling and physical features of retailpackaging of tobacco products and the requirements for the appearance of cigarettes. Click here to download PDF 125KB Read the Reports of the Joint Committee on Health and Children – General Scheme of the Public Health (Standardised Packaging of Tobacco) Bill 2013 here  

Reliability and validity of the Alcohol Use Disorders Identification Test (AUDIT) imbedded within a general health risk screening questionnaire: results of a survey in 332 primary care patients.

BACKGROUND: Self-administered, general health risk screening questionnaires that are administered while patients wait in the doctor's office may be a reasonable and timesaving approach to address the requirements of preventive medicine in a typical 10-min medical visit. The psychometric characteristics of the Alcohol Use Disorders Identification Test (AUDIT) incorporated within a health questionnaire (H-AUDIT) have not been examined. METHODS: The reliability and validity of the self-administered AUDIT were compared between the H-AUDIT and the AUDIT used as a single scale (S-AUDIT) in 332 primary care patients. RESULTS: No major demographic or alcohol use characteristics were found between the 166 subjects who completed the H-AUDIT and the 166 individuals who completed the S-AUDIT. The test-retest reliability of the 166 subjects who completed the H-AUDIT [estimated by Spearman correlation coefficient at a 6-week interval (0.88), internal consistency (total correlation coefficients for all items ranged from 0.38 to 0.69; Cronbach alpha index 0.85), and the sensitivity and specificity of the H-AUDIT were used to identify at-risk drinkers' areas under receiver operating characteristic (0.77) and alcohol-dependent subjects' areas under receiver operating characteristic (0.89)] was similar to the same measurements obtained with the 166 individuals who completed the S-AUDIT. CONCLUSIONS: The AUDIT incorporated in a health risk screening questionnaire is a reliable and valid self-administered instrument to identify at-risk drinkers and alcohol-dependent individuals in primary care settings.