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Cathy Harrison

Abstract

An integrated model of specialised-delivered care is widely accepted as the standard of care for people with haemophilia in the UK. Assessment of available evidence on patient outcomes confirms this approach. But leading the specialist care for this group of patients does not require a medical qualification. Specialist nursing is well established within the haemophilia service and offers perhaps the greatest resource as health services cope with cost constraints on the specialist provision of services.

Open access

Yuwares Sittichanbuncha, Chalermpon Chairat and Kittisak Sawanyawisuth

Abstract

Background: Animal bites are one of the leading causes of visits to an emergency room (ER) in Thailand. Rabies is an almost invariably fatal disease.

Objectives: We evaluated the appropriateness of rabies vaccination in clinical practice following the World Health Organization (WHO) guidelines.

Methods: All patients who visited the ER at Ramathibodi Hospital of Mahidol University because of mammal bites and received rabies vaccination by the WHO rabies postexposure regimen were enrolled. Data were retrieved from medical records. Wound categories were classified by WHO guidelines both in real practice and by the investigators on subsequent investigation.

Results: The agreement between clinical practice and the WHO guidelines was calculated and reported as kappa statistics. There were 372 eligible patients. The mean age was 36 years and 172 patients were male. The agreement between clinical practice and the WHO guidelines was a disturbing 26.9% with a kappa statistic of -0.02, P = 0.56.

Conclusion: Even in a referral and teaching hospital, rabies postexposure vaccination in Thailand was not appropriate according to WHO guidelines.

Open access

Chi Chiu Mok

Abstract

Rheumatoid arthritis (RA) is the most common rheumatic disease being managed by the rheumatologists. With the emergence of the biologic and targeted synthetic disease modifying anti-rheumatic drugs (b/tsDMARDs), the prognosis of RA has improved substantially. However, these novel agents are associated with high cost and untoward effects. International consensus statements for the drug management of RA have been published to guide the practice of rheumatologists. In this article, updates from the 2016 EULAR management recommendations for RA are reviewed and discussed within the context of our local situation in Hong Kong.

Open access

Goce Spasovski, Pierre Cochat, Frans Hj Claas, Uwe Heemann, Julio Pascual, Chris Dudley, Paul Harden, Marivonne Hourmant, Umberto Maggiore, Maurizio Salvadori, Jean-Paul Squifflet, Jurg Steiger, Armando Torres, Ondrej Viklicky, Martin Zeier, Raymond Vanholder, Wim Van Biesen, Evi Nagler and Daniel Abramowicz

Abstract

The Clinical Practice Guideline on evaluation of the kidney donor and transplant recipient was developed following a rigorous methodological approach aiming to provide information and aid decision-making to the transplant professionals. Thus, this document should help caregivers to improve the quality of care they deliver to patients with no intention it is defined as a standard of care.

In this short version of the guidelines we present 112 statements about the evaluation of the kidney transplant candidate as well as the potential deceased and living donor, the immunological work-up of kidney donors and recipients and the perioperative recipient care.

The extended version of the guidelines with methods, rationale and references is published in Nephrol Dial Transplant (2013) 28: i1-i71; doi: 10.1093/ndt/gft218 and can be downloaded freely from http://www.oxfordjournals.org/our_journals/ndt/era_edta.html.