Évaluer l’adéquation de nos pratiques avec les recommandations (17e conférence de consensus, SPILF 2008) et identifier les facteurs associés aux délais des principaux temps de prise en charge.
Étude ...rétrospective observationnelle (2009–2011) portant sur les méningites bactériennes aiguës (MBA) de l’adulte. Les données ont été recueillies par questionnaire standardisé à partir des dossiers médicaux et infirmiers.
Sur 31 MBA admises aux urgences, 29 (93,5 %) y ont reçu ceftriaxone ou céfotaxime. Les indications de corticothérapie et d’imagerie étaient conformes dans 71,0 % et 83,9 % des cas. Les délais médians (IQR) ont été : admission/ponction lombaire (PL), 2h43 (1h09–5h57) ; admission/antibiothérapie, 3h21 (1h34–5h11). La mention de suspicion de méningite dans le courrier d’admission était associée à une PL plus précoce (p=0,01), et une tendance à l’instauration plus rapide de l’antibiothérapie (p=0,05).
La mention de suspicion de MBA dans le courrier d’admission est associée à une meilleure prise en charge aux urgences.
We had for aim to check the appropriateness of our practices according to French guidelines (17th consensus conference, SPILF 2008) and to identify variables associated with the delay before appropriate measures were implemented.
Our retrospective observational study (2009–2011) focused on acute bacterial meningitis (ABM) in adults. Data was collected on a standardized questionnaire from medical charts and nurse reports.
We included 31 adults presenting with ABM; 29 (93.5%) received ceftriaxone or cefotaxime in the emergency department. Indications for corticosteroids and brain imaging complied with guidelines in respectively 71.0% and 83.9% of cases. The median delays (IQR) were: admission/lumbar puncture (LP), 2h43 1h09–5h57; admission/antimicrobials, 3h21 1h34–5h11. The indication of suspected ABM in the admission letter was associated with earlier LP (P=0.01), and was almost significantly associated also with faster initiation of adequate antibiotic therapy (P=0.05).
Suspicion of ABM mentioned in the admission letter was associated to a better management in the emergency department.
La sclérose en plaques Perennes, M.; Ollivier, C.; Lorillon, P.
Actualités pharmaceutiques hospitalières,
02/2008, Letnik:
4, Številka:
13
Journal Article
BackgroundThe development and expansion of oral anti-cancer agents provide multiple benefits, including improvement in patients’ quality of life but also create numerous challenges such as ...side-effect management or medication adherence. In January 2018, we implemented pharmaceutical consultations, as part of a multidisciplinary consultation programme for patients receiving oral chemotherapy agents.PurposeThe aim of this study was to evaluate patients’, community pharmacists’ and oncologists’ satisfaction with the pharmaceutical consultations.Material and methodsA paper-based questionnaire (10 questions) was distributed to patients receiving oral anti-cancer drugs at the end of the pharmaceutical consultation.The overall community pharmacists’ and oncologists’ satisfaction was measured using an online survey tool. The surveys consisted of 14 questions divided into five sections.The survey design was based on a 4-point scale, with answers ranging from strongly agree to strongly disagree, and also included yes/no and short answer questions.All the answers to the questionnaires were collected in an anonymous way.ResultsBetween 1 January 2018 and 20 July 2018 a total of 20 patients, nine oncologists and 15 community pharmacists completed the survey. The response rates were respectively 49%, 53% and 35%.Overall, pharmacists, doctors and patients were highly satisfied with the services of the oral anti-cancer therapy programme (100%).Most patients (90%) felt that the majority of their questions and concerns were answered during the consultation. They found the written information useful (85%) and expressed that they had gained new and clarifying information about their medication (70%).Community pharmacists were satisfied to have been informed of the oral cancer drug initiation (93%), most of the time it allowed them to order the treatment before the patient’s arrival (80%).Oncologists felt that pharmaceutical consultations were always (56%) or sometimes (44%) useful for the patients. Most of them (89%) considered there would be sometimes an interest in conducting consultations together with the pharmacist.ConclusionThis study showed that all participants highly appreciated the pharmaceutical consultations. These results are consistent with previous studies showing the key role of the clinical pharmacist in multidisciplinary programmes established for patients taking oral anti-cancer treatment.References and/or acknowledgements1. Ma C. Role of pharmacists in optimizing the use of anticancer drugs in the clinical setting. Integr Pharm Res Pract 2014.No conflict of interest.
We had for aim to check the appropriateness of our practices according to French guidelines (17th consensus conference, SPILF 2008) and to identify variables associated with the delay before ...appropriate measures were implemented.
Our retrospective observational study (2009-2011) focused on acute bacterial meningitis (ABM) in adults. Data was collected on a standardized questionnaire from medical charts and nurse reports.
We included 31 adults presenting with ABM; 29 (93.5%) received ceftriaxone or cefotaxime in the emergency department. Indications for corticosteroids and brain imaging complied with guidelines in respectively 71.0% and 83.9% of cases. The median delays (IQR) were: admission/lumbar puncture (LP), 2h43 1h09-5h57; admission/antimicrobials, 3h21 1h34-5h11. The indication of suspected ABM in the admission letter was associated with earlier LP (P=0.01), and was almost significantly associated also with faster initiation of adequate antibiotic therapy (P=0.05).
Suspicion of ABM mentioned in the admission letter was associated to a better management in the emergency department.
We had for aim to check the appropriateness of our practices according to French guidelines (17th consensus conference, SPILF 2008) and to identify variables associated with the delay before ...appropriate measures were implemented. Our retrospective observational study (2009-2011) focused on acute bacterial meningitis (ABM) in adults. Data was collected on a standardized questionnaire from medical charts and nurse reports. We included 31 adults presenting with ABM; 29 (93.5%) received ceftriaxone or cefotaxime in the emergency department. Indications for corticosteroids and brain imaging complied with guidelines in respectively 71.0% and 83.9% of cases. The median delays (IQR) were: admission/lumbar puncture (LP), 2h43 1h09-5h57; admission/antimicrobials, 3h21 1h34-5h11. The indication of suspected ABM in the admission letter was associated with earlier LP (P=0.01), and was almost significantly associated also with faster initiation of adequate antibiotic therapy (P=0.05). Suspicion of ABM mentioned in the admission letter was associated to a better management in the emergency department.
Resultats d' une analyse economique et technique realisee au Vanuatu sur la competitivite de la filiere cocotier par rapport au coprah d' Indonesie et des Philippines. Les observations plaident en ...faveur d' une politique de soutien au producteur et de l' utilsation des fonds STABEX. La filiere souffre cependant de la situation d' insularite du pays se traduisant par des couts de transport et de main d' oeuvre eleves. Des ameliorations ponctuelles de la filiere sont proposees. La valorisation des produits derives de la noix de coco est a chercher sur le marche interieur sous de certaines importations ou de developpment de produits nouveaux. Des recommandations techniques et des axes de collaborations de recherche sont egalement indiquees.
Ce chapitre etudie en detail les caracteristiques socio-economiques de la cafeiculture mexicaine : taille des exploitations (2% de gros producteurs travaillent 19% de la surface cultivee, 71% de ...minifundistes s' en partagent 36%), modes de tenure (terres ejidales, communales, privees), differenciations regionales (3 sous-ensembles plus ou moins fragmentes). Il analyse les bouleversements lies aux politiques agricoles et aux modes d' encadrement (role de l' INMECAFE), et les consequences de la crise internationale et du retrait de l' Etat dans la restructuration de la filiere.
PDF
