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48 Care and follow-up of non-insulin treated diabetics in metropolitan France in 1998 Weill A. Ricordeau P. Vallier N. Bourrel R. Fender P. Allemand H. Diabetes and Metabolism (2000) 26:SUPPL. 6 (39-48). Date of Publication: 2000 The statistical analysis of French HealthCare's database allows a retrospective evaluation of the overall clinical care given to diabetics in the light of the guidelines (RBPC) promulgated by the National Agency of Health Accreditation and Evaluation (ANAES). This database contains no information on the stage of the disease process, the completeness of the clinical evaluation (neurological or foot examination) or the results of significant blood tests. We studied the follow-up care given to diabetics whom we were able to identify by isolating reimbursements for hypoglycemic agents using their corresponding drug codes. Considering the time needed for this new drug-coding system to become fully operational, the results can be extrapolated to the entire population of non-insulin treated diabetics. In 1998, almost all follow-up care was provided by general practitioners since only 5.5 % of the patients consulted an endocrinologist during the year studied. Blood sugar was generally monitored with fasting blood sugars rather than HbA1c which was only prescribed in 41.3 % of the patients during the final six months of the period under consideration. Screening and follow-up for degenerative complications were insufficient. Fewer than 40 % of the patients had received reimbursement for an ophtalmological consultation during the preceeding year and fewer than 30 % had an ambulatory resting EKG over the same time period. A certain number of factors were studied in order to determine if they were correlated to better clinical follow-up. The best follow-up was encountered in patients who had a consultation with an endocrinologist at least once during the year, those who were exonerated from co-payments (ALD 30) and finally, those aged between 40 and 59 years (at least with respect to appropriate laboratory tests). 49 Modalities of follow-up on non-insulin treated diabetics treated in metropolitan France in 1998 Weill A. Ricordeau P. Vallier N. Bourrel R. Fender P. Allemand H. Diabetes & metabolism (2000) 26 Suppl 6 (39-48) The statistical analysis of French HealthCare's database allows a retrospective evaluation of the overall clinical care given to diabetics in the light of the guidelines (RBPC) promulgated by the National Agency of Health Accreditation and Evaluation (ANAES). This database contains no information on the stage of the disease process, the completeness of the clinical evaluation (neurological or foot examination) or the results of significant blood tests. We studied the follow-up care given to diabetics whom we were able to identify by isolating reimbursements for hypoglycemic agents using their corresponding drug codes. Considering the time needed for this new drug-coding system to become fully operational, the results can be extrapolated to the entire population of non-insulin treated diabetics. In 1998, almost all follow-up care was provided by general practitioners since only 5.5 % of the patients consulted an endocrinologist during the year studied. Blood sugar was generally monitored with fasting blood sugars rather than HbA1c which was only prescribed in 41.3 % of the patients during the final six months of the period under consideration. Screening and follow-up for degenerative complications were insufficient. Fewer than 40 % of the patients had received reimbursement for an ophtalmological consultation during the preceeding year and fewer than 30 % had an ambulatory resting EKG over the same time period. A certain number of factors were studied in order to determine if they were correlated to better clinical follow-up. The best follow-up was encountered in patients who had a consultation with an endocrinologist at least once during the year, those who were exonerated from co-payments (ALD 30) and finally, those aged between 40 and 59 years (at least with respect to appropriate laboratory tests). 50 Clinical evaluation methods for new antimicrobial agents to treat respiratory infections: Report of the Committee for the Respiratory System, Japan Society of Chemotherapy Saito A. Miki F. Oizumi K. Rikitomi N. Watanabe A. Koga H. Niki Y. Kusano N. Journal of Infection and Chemotherapy (1999) 5:2 (110-123). Date of Publication: Jun 1999 The present report constitutes an attempt to improve and modify the existing clinical evaluation method for new antimicrobial agents to treat respiratory infections. One year ago, a general guideline on the clinical evaluation of antimicrobial agents to treat respiratory infections was drafted in Japanese, leaving scope for critical discussion, and this has been translated into English, as there were no major changes. In this report, respiratory infections have been discussed under the headings 'acute respiratory tract infection' and pneumonia and acute exacerbation of chronic pulmonary diseases. Standardized criteria were set for the assessment of severity of infection and effectiveness of the antimicrobial agent in question. Severity was evaluated on the basis of a combined assessment of the severity of infection and severity of the clinical condition of the patients. Clinical effectiveness of the antimicrobial agent used was evaluated on the basis of clinical outcome as well as micro- biological outcome of the trial. Body temperature, local pain, cough, change in sputum quality, peripheral white blood cell count, C-reactive protein level, and chest radiograph were used as the parameters for the evaluation. To maintain the quality of specimens to be examined, Geckler's classification of specimens was used. This report was constructed based on the analysis of large amounts of material collected over the years, incorporating internal and external factors concerning the present evaluation methods. The newly suggested standardized criteria for clinical evaluation of the new antimicrobial drugs are expected to be practiced properly hereupon and subjected to further improvement if necessary. |
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cam967
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2楼2010-05-29 17:37:21
noleg
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zyfdxmc(金币+15, 翻译EPI+1):谢谢！ 2010-06-01 20:14:26
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48 1998年法国大城市中非胰岛素治疗的糖尿病人的护理及复诊/随访 Weill A. Ricordeau P. Vallier N. Bourrel R. Fender P. Allemand H. 糖尿病和新陈代谢 (2006) 26:SUPPL. 6(39-48). Date of Publication:2000 对法国健康护理中心数据库的统计分析，使得我们可以对按照国家健康鉴定和评估署(ANAES)所颁布的指南(RBPC)对糖尿病患者的总体临床护理进行追溯性评估。该数据库并不包含有关疾病治疗的阶段、临床评估(神经学或足部检查)的完整性、或者重要的血液检查结果等方面的数据。我们研究了对糖尿病患者的后续护理。这些患者身份是通过甄别使用相应药物代码的低血糖药物报销单据来确认的。考虑到该新型药物编码系统完全运行的时间，本研究结果可被外推至所有接受非胰岛素治疗的糖尿病患者。在所研究的1998年度，几乎所有后续护理都是由全科医师实施的，而仅有5.5%的患者向内分泌专家进行咨询。血糖主要通过禁食（空腹）血糖跟踪监测而非HbA1c，只是在所考虑周期的最后6个月中，也仅有41.3%的患者按医嘱进行HbA1c监测。对退行性并发症的甄别和随访不充分。上一年度少于40%的患者报销了眼科咨询费，而在同一时期少于30%做了非卧床静止心电图检查。对一些因素进行了研究，以便确定它们是否与更佳的临床复诊相关。碰上最佳复诊的是那些该 年度中至少一次咨询过内分泌专家的患者，那些幸免于支付共付医疗费(ALD 30)的患者，最后还有那些年龄在40至59年的患者（至少对于适宜的实验室试验是如此）。 |
3楼2010-05-30 23:59:02
