Evaluation of shared care for people with HIV.
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Continuity of Patient Care↗
Biomedical subjects
S Smith
Publications and source records attributed to S Smith.
Evaluation of neonatal whole blood versus plasma glucose concentration by ion-selective electrode technology and comparison with two whole blood chromogen test strip methods.
OBJECTIVE: Determination of glucose concentration from whole blood samples in neonates is confounded by variable hematocrit values, sample source, user technique, and test method, which results in poor correlation with glucose values measured from plasma or serum. Recently developed ion-selective electrodes (ISE) allow measurement of glucose in the water phase of both red blood cells and plasma with a small sample size (200 microliters). STUDY DESIGN: The purpose of this study was to compare (1) whole blood and plasma glucose measurements by the ISE method and (2) ISE glucose values with those determined by two chromogen reagent test strip colorimetric methods. Values were determined in 180 different samples obtained from 145 infants. RESULTS: Correlation of whole blood and plasma glucose concentrations determined by the ISE method was excellent (y = 0.99x, R2 = 0.99) and no effect was seen from hematocrit values. The two chromogen test strip methods also revealed good linearity with ISE whole blood and plasma glucose values but had large confidence intervals for individual values. Sensitivity for detecting blood glucose levels < 40 mg/dl by the two test strip methods was 9 of 11 and 9 of 10 with four and one false-positive results, respectively. CONCLUSION: These data indicate that the ISE method provides an excellent correlation of whole blood and plasma glucose measurement results, overcoming technical problems of differing hematocrit values and serum or plasma sample acquisition in neonates. Chromogen test strip methods have limited value in estimating specific glucose values, but can be useful in screening infants for hypoglycemia.
Blood Chemical Analysis↗
Stars of the night.
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Clinical Competence↗
The loneliness of a long-term leader.
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Adaptation, Psychological↗
Nursing abroad. War and peace.
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Bosnia and Herzegovina↗
Early switch from intravenous to oral antibiotics in hospitalized patients with infections: a 6-month prospective study.
We assessed what percentage of hospitalized patients treated with intravenous antibiotics would be candidates for early switch to oral therapy, and evaluated the clinical outcomes of patients after the switch. All hospitalized patients in whom an intravenous antibiotic was prescribed for treatment of an infection were prospectively screened to identify candidates for switch in therapy. Of the 655 patients treated with intravenous antibiotics, 300 (46%) were candidates for a switch, and the change was implemented in 262 (40%). Of the 171 evaluable patients, the switch was associated with clinical cure in 167 (98%) and failure in 4 (2%). In hospitalized patients with infections, the duration of intravenous antibiotic therapy can be minimized with early switch to oral therapy. This practice is associated with good patient outcome.
Administration, Oral↗
When views of care conflict.
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Advance Directives↗
Knowledge and attitudes to prescribed drugs in young and elderly patients.
Increasing patient knowledge of drug therapy is said to improve compliance and may reduce adverse drug reactions. We assessed patient knowledge of prescribed drugs in fifty patients attending a hypertension clinic [outpatients] and in elderly patients on admission to (n = 129) and on discharge from (n = 100) an acute geriatric assessment unit. We found that 88% of outpatients, 40% of elderly admissions, and 41% of elderly discharges knew the indications for their therapy; only 40% of outpatients, 8% of elderly admissions and 12% of elderly discharges could name their medications. Patients said that their information came principally from the prescribing doctor. In a further study we assessed doctor, nurse, young and elderly patients' ability to discriminate between commonly prescribed white tablets. Errors were made by the doctors on 25% occasions, nurses on 40% occasions and patients on 61% occasions. Young patients made errors 67% of the time and elderly patients 55% of the time. These studies indicate that both inpatients and outpatients, both young and elderly have poor knowledge of their medications. In addition, many commonly prescribed drugs are not easily distinguishable by patient, prescriber or drug administrator. We conclude that there is a need to improve knowledge both in patients and in prescribers. We suggest that prescribers should consider the colour and shape of medications prescribed concurrently as many "little white tablets" are difficult to tell apart.
Adult↗
The outer edge of consciousness.
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Consciousness↗
Mental health for the millennium.
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Humans↗
All in a day's work.
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Ambulatory Surgical Procedures↗
Workers' health undermined.
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Coal Mining↗