Abstract:
BACKGROUND:Upper gastrointestinal (UGI) haemorrhage is a frequent cause of hospital admission. Scoring systems have been devised to identify those at risk of adverse outcomes. We evaluated the Glasgow Blatchford score's (GBS) ability to identify the need for clinical and endoscopic intervention in patients with UGI haemorrhage. METHODS:A retrospective observational study was performed in all patients who attended the A&E department with UGI haemorrhage during a 12-month period. Patients were separated into low and high risk categories. High risk encompassed patients who required blood transfusions, operative or endoscopic interventions, management on high dependency or intensive care units, and those who re-bled, represented with further bleeding, or who died. RESULTS:A total of 174 patients were seen with UGI bleeding. Eight of them self-discharged and were excluded. Of the remaining 166, 94 had a 'low risk' bleed, and 72 'high risk'. The GBS was significantly higher in the high risk (median = 10) than in the low risk group (median 1, p < 0.001). To assess the validity of the GBS at separating low and high risk groups, receiver-operator characteristic (ROC) curves were plotted. The GBS had an area under ROC curve of 0.96 (95% CI 0.95-1.00). When a cut-off value of > or = 3 was used, sensitivity and specificity of GBS for identifying high risk bleeds was 100% and 68%. Thus at a cut-off value of < or = 2 the GBS is useful for distinguishing those patients with a low risk UGI bleed. CONCLUSIONS:The GBS accurately identifies low risk patients who could be managed safely as outpatients.
journal_name
Int J Clin Practjournal_title
International journal of clinical practiceauthors
Srirajaskanthan R,Conn R,Bulwer C,Irving Pdoi
10.1111/j.1742-1241.2009.02267.xsubject
Has Abstractpub_date
2010-06-01 00:00:00pages
868-74issue
7eissn
1368-5031issn
1742-1241pii
IJCP2267journal_volume
64pub_type
杂志文章abstract::As a result of incessant genetic discoveries and remarkable technological advancements, the availability and the consequent consumer's request for genetic testing are growing exponentially, leading to the development of a 'parallel' market, i.e. the direct-to-consumer (DTC) testing, also known as 'direct access testin...
journal_title:International journal of clinical practice
pub_type: 杂志文章,评审
doi:10.1111/j.1742-1241.2011.02774.x
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:Studies have demonstrated the beneficial effect of normal and high body mass index (BMI) upon risk of osteoporosis (OP). No study has investigated the prevalence of OP in an older population with a very high BMI (higher than 40 kg/m(2) ). METHODS:Data of patients aged over 50 years that attended for a dual ...
journal_title:International journal of clinical practice
pub_type: 杂志文章
doi:10.1111/ijcp.12371
更新日期:2014-06-01 00:00:00
abstract::This randomised, crossover study compared the efficacy, safety, acceptability and patient preference of two multidose powder inhalers (MDPIs)--beclomethasone dipropionate Easyhaler (BDP-EH) and budesonide Turbohaler (BUD-TH)--in 79 stable asthmatics who used inhaled steroids but had no experience of MDPIs. After eight...
journal_title:International journal of clinical practice
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:
更新日期:2000-07-01 00:00:00
abstract::Over the past years, there has been an explosive increase in the prevalence of type 2 diabetes (T2DM) and this is expected to continue, entailing associated morbidity and mortality. An increasing number of studies explore the different ways T2DM could be prevented. On-going lifestyle modifications need to be addressed...
journal_title:International journal of clinical practice
pub_type: 杂志文章,评审
doi:10.1111/j.1368-5031.2006.00929.x
更新日期:2006-05-01 00:00:00
abstract:OBJECTIVE:To investigate the effect of healthcare provider (HCP) type (primary vs. specialist) on glycaemic control and other treatment parameters. RESEARCH DESIGN AND METHODS:Study of Once-Daily Levemir (SOLVE(™) ) is an international, 24-week, observational study of insulin initiation in people with type 2 diabetes....
journal_title:International journal of clinical practice
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1111/ijcp.12776
更新日期:2016-03-01 00:00:00
abstract::Fluid in the pleural space is a common sequela of a wide range of diseases which may be pulmonary, pleural or extrapulmonary. As the differential diagnosis is wide, a systematic approach to investigation and diagnosis is recommended. This review highlights the important features and recommendations for the investigati...
journal_title:International journal of clinical practice
pub_type: 杂志文章,评审
doi:10.1111/j.1742-1241.2009.02068.x
更新日期:2009-11-01 00:00:00
abstract:INTRODUCTION:Erectile dysfunction (ED) is common in older age and in diabetes mellitus (DM). Phosphodiesterase type 5-inhibitors (PDE5-is) are the first-line for ED. We investigated how the type of diabetes and age of males affect the PDE5-i use in the primary care setting. METHODS:From 2018 to 2019, the general pract...
journal_title:International journal of clinical practice
pub_type: 杂志文章
doi:10.1111/ijcp.13538
更新日期:2020-09-01 00:00:00
abstract:AIM:The aim of this study was to investigate how patients' expectations about and experiences with insulin therapy contribute to diabetes treatment satisfaction. METHODS:The Expectations about Insulin Therapy (EAITQ) and the Experience with Insulin Therapy Questionnaires (EWITQ) were administered at baseline and end-p...
journal_title:International journal of clinical practice
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1742-1241.2010.02363.x
更新日期:2010-06-01 00:00:00
abstract::Nitrates are useful drugs in cardiovascular medicine. They have a presumed vasovagal effect, which is a rare but often under-recognised complication that is partly caused by central inhibition of the sympathetic nervous system. However, no consistent variable associated with the presumed vasovagal effects following ni...
journal_title:International journal of clinical practice
pub_type: 杂志文章,评审
doi:
更新日期:1998-09-01 00:00:00
abstract::Osteoporosis results from a decrease in bone strength yielding increased susceptibility to fractures. Hip and spine fractures are a major cause of morbidity and mortality in the elderly population. With an increasingly ageing world population, early prevention of bone loss is essential for adequate control of this con...
journal_title:International journal of clinical practice
pub_type: 杂志文章,评审
doi:10.1111/j.1742-1241.2006.01249.x
更新日期:2007-02-01 00:00:00
abstract::It is important for primary care physicians to recognise rheumatoid arthritis and systemic lupus erythematosus patients as high-risk groups for atherosclerosis, requiring aggressive risk-factor modification. Recent studies suggest that this increased risk is not explained by an excess of traditional risk factors, but ...
journal_title:International journal of clinical practice
pub_type: 杂志文章,评审
doi:10.1111/j.1742-1241.2005.00489.x
更新日期:2005-07-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to explore the feasibility of using low dose radiation and low concentration contrast media in enhanced CT examinations in children with congenital heart disease. MATERIALS AND METHODS:Ninety patients with congenital heart disease were randomly divided into three groups of 30 patien...
journal_title:International journal of clinical practice
pub_type: 杂志文章,随机对照试验
doi:10.1111/ijcp.12857
更新日期:2016-09-01 00:00:00
abstract::Cigarette smoking induces a significant oxidant effect related to variety of free radical-related diseases often affecting the upper respiratory tract, unless it is effectively compensated by the antioxidant barriers of the humans. In the present study, the evaluation of the antioxidant compensatory mechanisms, by est...
journal_title:International journal of clinical practice
pub_type: 杂志文章
doi:10.1111/j.1742-1241.2004.00340.x
更新日期:2005-01-01 00:00:00
abstract::To evaluate the results of post-operative chemoirradiation for gastric carcinoma. The records of 58 patients who underwent resection for gastric carcinoma were retrospectively reviewed. Forty-six patients had complete resection without any residual disease but with high-risk factors of relapse. Twelve patients had mic...
journal_title:International journal of clinical practice
pub_type: 杂志文章
doi:10.1111/j.1368-5031.2004.00024.x
更新日期:2004-05-01 00:00:00
abstract::Buprenorphine is a semi-synthetic opioid derived from thebaine. The transdermal formulation of buprenorphine has been available in Belgium for 3 years, during which time the Pain Clinic of the St Elisabeth of Verviers Hospital has gained experience in the use of transdermal buprenorphine for the treatment of moderate-...
journal_title:International journal of clinical practice
pub_type: 杂志文章
doi:10.1111/j.1742-1241.2006.01109.x
更新日期:2006-10-01 00:00:00
abstract::Using the head-up tilt test (HUTT) we evaluated 986 consecutive patients affected by unexplained syncope. In 266 patients the test induced bradycardia and/or hypotension resulting in syncope or presyncope, thus allowing a diagnosis of neurally mediated syncope. In three other patients (0.3% of the entire population an...
journal_title:International journal of clinical practice
pub_type: 杂志文章
doi:
更新日期:2003-06-01 00:00:00
abstract::We present one of the rarer causes of pregnancy-associated jaundice in the immediate puerperium. A 30-year-old multipara with pyruvate kinase deficiency became jaundiced within a few hours of delivery, following an uneventful pregnancy and labour at term. She responded to conservative management, the jaundice clearing...
journal_title:International journal of clinical practice
pub_type: 杂志文章
doi:
更新日期:1998-07-01 00:00:00
abstract::Patients presenting to the emergency department with chest pain are evaluated by emergency physicians in hospitals without cardiology cover 24 h a day. The purpose of this study is to determine the consistency of electrocardiography (ECG) interpretation and chest pain likelihood classification between emergency physic...
journal_title:International journal of clinical practice
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1742-1241.2005.00788.x
更新日期:2006-10-01 00:00:00
abstract::In this journal, Cummins et al reported an experiment that examined clinicians' predictions of causes of death from subjects' pre-morbid photographs. They found that clinicians performed at chance. The validity of two of their other conclusions are challenged. First, that clinicians routinely form impressions of how a...
journal_title:International journal of clinical practice
pub_type: 评论,杂志文章
doi:
更新日期:2000-03-01 00:00:00
abstract::Prostate cancer remains a most intriguing condition, which poses unique challenges. On reviewing recent literature on localised disease (confined within the capsule T1 or T2, N0, M0), it would seem that it is over treated, resulting in significant morbidity. We now have strong evidence, however, that there can be mort...
journal_title:International journal of clinical practice
pub_type: 杂志文章,评审
doi:10.1111/j.1742-1241.2006.01013.x
更新日期:2007-02-01 00:00:00
abstract:BACKGROUND/AIMS:Simple compound of Helicobacter pylori eradication therapy may improve drug compliance of patients. The aims of this study were to compare the efficacy and tolerability of a simple combination containing levofloxacin 7-day once-daily with standard twice-daily triple therapy. PATIENTS AND METHODS:This w...
journal_title:International journal of clinical practice
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1742-1241.2010.02482.x
更新日期:2010-10-01 00:00:00
abstract::Riedel's thyroiditis (RT) is an extremely rare form of chronic thyroiditis, characterised by a fibroinflammatory process which partially destroys the thyroid, often involving surrounding tissues. We describe an unusual case of RT in a 38-year-old woman, and discuss its typical clinical, pathological, ultrasound, radio...
journal_title:International journal of clinical practice
pub_type: 杂志文章
doi:
更新日期:2002-01-01 00:00:00
abstract:AIM:We analysed the effectiveness and safety of outpatient parenteral antibiotic therapy (OPAT) in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in patients admitted to home hospitalisation units (HHU). METHODS:Retrospective multicentre study of patients with AECOPD included in the Spanish OPAT ...
journal_title:International journal of clinical practice
pub_type: 杂志文章,多中心研究
doi:10.1111/ijcp.13022
更新日期:2017-12-01 00:00:00
abstract:AIMS:Arterial hypertension is a well-established factor for increased risk of cardiovascular diseases, but low admission blood pressure has also been suggested as predictor for increased mortality. We hypothesised that in patients with acute myocardial infarction admission blood pressure at the Emergency Department pre...
journal_title:International journal of clinical practice
pub_type: 杂志文章
doi:10.1111/ijcp.12588
更新日期:2015-08-01 00:00:00
abstract::High plasminogen activator inhibitor-1 (PAI-1) levels are potential risk factors for cardiovascular disease. The risk profile of white coat hypertension (WCHT) has not yet been completely clear. In this study, we aimed to determine the plasma levels of PAI-1, markers of fibrinolysis and increased cardiovascular diseas...
journal_title:International journal of clinical practice
pub_type: 杂志文章
doi:10.1111/j.1368-5031.2004.00119.x
更新日期:2004-06-01 00:00:00
abstract::Marijuana is the most commonly used illicit drug while its abuse and dependence has an increasing prevalence among the young population. Marijuana smoking affects the circulatory system triggering various cardiovascular events. Of note, recent case reports indicate a possible association with atrial fibrillation (AF)....
journal_title:International journal of clinical practice
pub_type: 杂志文章,评审
doi:10.1111/j.1742-1241.2007.01505.x
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:There has been a dramatic increase in the incidence of immediate breast reconstruction after mastectomy for breast cancer over the past few decades and autologous tissue flaps are being used with increasing frequency. Concern has been expressed that these complex procedures may lead to a delay in the deliver...
journal_title:International journal of clinical practice
pub_type: 杂志文章,评审
doi:10.1111/j.1742-1241.2009.02199.x
更新日期:2009-11-01 00:00:00
abstract:AIMS:Studies on macrovascular consequences of glucose control in elderly patients (>75 years) with type 2 diabetes mellitus (T2DM) are lacking. The present study aimed to investigate the relationship between HbA(1c) and mortality in this specific population. METHODS:Between 1998 and 1999, 374 primary care patients wit...
journal_title:International journal of clinical practice
pub_type: 杂志文章
doi:10.1111/j.1742-1241.2010.02596.x
更新日期:2011-04-01 00:00:00
abstract::The rationale for medical therapy for otospongiosis is to slow down and eventually stop the phase of bone resorption. There is some increase in the incidence of stapedial otospongiosis in a low-fluoride area compared with a high-fluoride area. Sodium fluoride treatment has a role to play in preventing the onset and pr...
journal_title:International journal of clinical practice
pub_type: 杂志文章,评审
doi:10.1111/j.1742-1241.2009.02046.x
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVES:A significant proportion of COVID-19 patients may have cardiac involvement including arrhythmias. Although arrhythmia characterization and possible predictors were previously reported, there are conflicting data regarding the exact prevalence of arrhythmias. Clinically applicable algorithms to classify COVID...
journal_title:International journal of clinical practice
pub_type: 杂志文章
doi:10.1111/ijcp.13788
更新日期:2020-10-30 00:00:00