The Experts below are selected from a list of 309 Experts worldwide ranked by ideXlab platform
Michael Einar Roder - One of the best experts on this subject based on the ideXlab platform.
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management of people with type 2 diabetes shared between a specialized Outpatient Clinic and primary health care is noninferior to management in a specialized Outpatient Clinic a randomized noninferiority trial
Diabetic Medicine, 2019Co-Authors: Lene Munch, Birgitte Bocher Bennich, Dorthe Overgaard, Hanne Konradsen, Helle Middelfart, Niels Kaarsberg, Filip K Knop, Tina Vilsboll, Michael Einar RoderAbstract:AIM: To evaluate whether management of people with Type 2 diabetes shared between a specialized Outpatient Clinic and primary health care has noninferior HbA1c outcomes compared with mono-sectorial management in a specialized Outpatient Clinic. METHODS: A randomized controlled, noninferiority study. People with moderate hyperglycaemia, hypertension and/or incipient complications were eligible for the study. All participants had annual comprehensive check-ups at the Outpatient Clinic. Quarterly check-ups were conducted by general practitioners (GPs) for the shared care group and by endocrinologists at the Outpatient Clinic for the control group. The primary outcome was the mean difference in HbA1c from baseline to 12 months of follow-up. The noninferiority margin for HbA1c was 4.4 mmol/mol. RESULTS: A total of 140 people were randomized [age 65.0 ± 0.9 years, HbA1c 52 ± 0.8 mmol/mol (6.9 ± 0.1%), systolic BP 135.6 ± 1.1 mmHg; all mean ± sem]. Peripheral neuropathy was present in 68% of participants and microalbuminuria in 19%; 15% had history of a previous major cardiovascular event. Among study completers (n = 133), HbA1c increased by 2.3 mmol/mol (0.2%) in the shared care group and by 1.0 mmol/mol (0.1%) in the control group, with a between-group difference of 1.3 mmol/mol [90% confidence interval (CI) -1.3, 3.9] (0.1%, 90% CI -0.1, 0.4). Noninferiority was confirmed in both per protocol and intention to treat analyses. CONCLUSION: We found that our shared care programme was noninferior to specialized Outpatient management in maintaining glycaemic control in this group of people with Type 2 diabetes. Shared care should be considered for the future diabetes management of Type 2 diabetes.
Lynn Ramirezavila - One of the best experts on this subject based on the ideXlab platform.
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the acceptability and feasibility of routine pediatric hiv testing in an Outpatient Clinic in durban south africa
Pediatric Infectious Disease Journal, 2013Co-Authors: Lynn Ramirezavila, Farzad Noubary, Janet Giddy, Elena Losina, Rochelle P Walensky, Deirdre Pansegrouw, Siphesihle Sithole, Ingrid V BassettAbstract:BACKGROUND: Limited access to HIV testing of children impedes early diagnosis and access to antiretroviral therapy. Our objective was to evaluate the feasibility and acceptability of routine pediatric HIV testing in an urban fee-for-service Outpatient Clinic in Durban South Africa. METHODS: We assessed the number of patients (0-15 years) who underwent HIV testing upon physician referral during a baseline period. We then established a routine voluntary HIV testing study for pediatric patients regardless of symptoms. Parents/caretakers were offered free rapid fingerstick HIV testing of their child. For patients <18 months the biological mother was offered HIV testing and HIV DNA polymerase chain reaction was used to confirm the infants status. The primary outcome was the HIV testing yield defined as the average number of positive tests per month during the routine compared with the baseline period. RESULTS: Over a 5-month baseline testing period 931 pediatric patients registered for Outpatient care. Of the 124 (13%) patients who underwent testing on physician referral 21 (17% 95% confidence interval: 11-25%) were HIV infected. During a 13-month routine testing period 2790 patients registered for care and 2106 (75%) were approached for participation. Of these 1234 were eligible and 771 (62%) enrolled. Among those eligible 637 (52% 95% confidence interval: 49-54%) accepted testing of their child or themselves (biological mothers of infants <18 months). There was an increase in the average number of HIV tests during the routine compared with the baseline HIV testing periods (49 versus 25 tests/month P = 0.001) but no difference in the HIV testing yield during the testing periods (3 versus 4 positive HIV tests/month P = 0.06). However during the routine testing period HIV prevalence remains extraordinarily high with 39 (6% 95% confidence interval: 4-8%) newly diagnosed HIV-infected children (median 7 years 56% female). CONCLUSIONS: Targeted and symptom-based testing referral identifies an equivalent number of HIV-infected children as routine HIV testing. Routine HIV testing identifies a high burden of HIV and is a feasible and moderately acceptable strategy in an Outpatient Clinic in a high prevalence area.
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routine hiv testing in adolescents and young adults presenting to an Outpatient Clinic in durban south africa
PLOS ONE, 2012Co-Authors: Lynn Ramirezavila, Kristy Nixon, Farzad Noubary, Janet Giddy, Elena Losina, Rochelle P Walensky, Ingrid V BassettAbstract:Objectives Although youth (12–24 years) in Sub-Saharan Africa have a high HIV risk, many have poor access to HIV testing services and are unaware of their status. Our objective was to evaluate the proportion of adolescents (12–17 years) and young adults (18–24 years) who underwent HIV testing and the prevalence among those tested in an urban adult Outpatient Clinic with a routine HIV testing program in Durban, South Africa. Design We conducted a retrospective cross-sectional analysis of adolescent and young adult Outpatient records between February 2008 and December 2009. Methods We determined the number of unique Outpatient visitors, HIV tests, and positive rapid tests among those tested. Results During the study period, 956 adolescents registered in the Outpatient Clinic, of which 527 (55%) were female. Among adolescents, 260/527 (49%, 95% CI 45–54%) females underwent HIV testing compared to 129/429 (30%, 95% CI 26–35%) males (p<0.01). The HIV prevalence among the 389 (41%, 95% CI 38–44%) adolescents who underwent testing was 16% (95% CI 13–20%) and did not vary by gender (p = 0.99). During this period, there were 2,351 young adult registrations, and of these 1,492 (63%) were female. The proportion consenting for HIV testing was similar among females 980/1,492 (66%, 95% CI 63–68%) and males 543/859 (63%, 95% CI 60–66%, p = 0.25). Among the 1,523 (65%, 95% CI 63–67%) young adults who underwent testing, the HIV prevalence was 22% (95% CI 19–24%) in females versus 14% in males (95% CI 11–17%, p<0.01). Conclusions Although the HIV prevalence is high among youth participating in an adult Outpatient Clinic routine HIV program, the uptake of testing is low, especially among 12–17 year old males. There is an urgent need to offer targeted, age-appropriate routine HIV testing to youth presenting to Outpatient Clinics in epidemic settings.
Glenn Haugeberg - One of the best experts on this subject based on the ideXlab platform.
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ten years of change in Clinical disease status and treatment in rheumatoid arthritis results based on standardized monitoring of patients in an ordinary Outpatient Clinic in southern norway
Arthritis Research & Therapy, 2015Co-Authors: Glenn Haugeberg, I J W Hansen, D M Soldal, Tuulikki SokkaAbstract:Introduction In the new millennium, Clinical outcomes in patients with rheumatoid arthritis (RA) have improved. Despite a large number of register data, there is a lack of data reflecting the entire Outpatient RA population, and in particular long-term data. The main aim of this study was to explore changes in Clinical disease status and treatment in an RA Outpatient Clinic population monitored with recommended outcome measures over a 10-year period.
Ingrid V Bassett - One of the best experts on this subject based on the ideXlab platform.
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the acceptability and feasibility of routine pediatric hiv testing in an Outpatient Clinic in durban south africa
Pediatric Infectious Disease Journal, 2013Co-Authors: Lynn Ramirezavila, Farzad Noubary, Janet Giddy, Elena Losina, Rochelle P Walensky, Deirdre Pansegrouw, Siphesihle Sithole, Ingrid V BassettAbstract:BACKGROUND: Limited access to HIV testing of children impedes early diagnosis and access to antiretroviral therapy. Our objective was to evaluate the feasibility and acceptability of routine pediatric HIV testing in an urban fee-for-service Outpatient Clinic in Durban South Africa. METHODS: We assessed the number of patients (0-15 years) who underwent HIV testing upon physician referral during a baseline period. We then established a routine voluntary HIV testing study for pediatric patients regardless of symptoms. Parents/caretakers were offered free rapid fingerstick HIV testing of their child. For patients <18 months the biological mother was offered HIV testing and HIV DNA polymerase chain reaction was used to confirm the infants status. The primary outcome was the HIV testing yield defined as the average number of positive tests per month during the routine compared with the baseline period. RESULTS: Over a 5-month baseline testing period 931 pediatric patients registered for Outpatient care. Of the 124 (13%) patients who underwent testing on physician referral 21 (17% 95% confidence interval: 11-25%) were HIV infected. During a 13-month routine testing period 2790 patients registered for care and 2106 (75%) were approached for participation. Of these 1234 were eligible and 771 (62%) enrolled. Among those eligible 637 (52% 95% confidence interval: 49-54%) accepted testing of their child or themselves (biological mothers of infants <18 months). There was an increase in the average number of HIV tests during the routine compared with the baseline HIV testing periods (49 versus 25 tests/month P = 0.001) but no difference in the HIV testing yield during the testing periods (3 versus 4 positive HIV tests/month P = 0.06). However during the routine testing period HIV prevalence remains extraordinarily high with 39 (6% 95% confidence interval: 4-8%) newly diagnosed HIV-infected children (median 7 years 56% female). CONCLUSIONS: Targeted and symptom-based testing referral identifies an equivalent number of HIV-infected children as routine HIV testing. Routine HIV testing identifies a high burden of HIV and is a feasible and moderately acceptable strategy in an Outpatient Clinic in a high prevalence area.
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routine hiv testing in adolescents and young adults presenting to an Outpatient Clinic in durban south africa
PLOS ONE, 2012Co-Authors: Lynn Ramirezavila, Kristy Nixon, Farzad Noubary, Janet Giddy, Elena Losina, Rochelle P Walensky, Ingrid V BassettAbstract:Objectives Although youth (12–24 years) in Sub-Saharan Africa have a high HIV risk, many have poor access to HIV testing services and are unaware of their status. Our objective was to evaluate the proportion of adolescents (12–17 years) and young adults (18–24 years) who underwent HIV testing and the prevalence among those tested in an urban adult Outpatient Clinic with a routine HIV testing program in Durban, South Africa. Design We conducted a retrospective cross-sectional analysis of adolescent and young adult Outpatient records between February 2008 and December 2009. Methods We determined the number of unique Outpatient visitors, HIV tests, and positive rapid tests among those tested. Results During the study period, 956 adolescents registered in the Outpatient Clinic, of which 527 (55%) were female. Among adolescents, 260/527 (49%, 95% CI 45–54%) females underwent HIV testing compared to 129/429 (30%, 95% CI 26–35%) males (p<0.01). The HIV prevalence among the 389 (41%, 95% CI 38–44%) adolescents who underwent testing was 16% (95% CI 13–20%) and did not vary by gender (p = 0.99). During this period, there were 2,351 young adult registrations, and of these 1,492 (63%) were female. The proportion consenting for HIV testing was similar among females 980/1,492 (66%, 95% CI 63–68%) and males 543/859 (63%, 95% CI 60–66%, p = 0.25). Among the 1,523 (65%, 95% CI 63–67%) young adults who underwent testing, the HIV prevalence was 22% (95% CI 19–24%) in females versus 14% in males (95% CI 11–17%, p<0.01). Conclusions Although the HIV prevalence is high among youth participating in an adult Outpatient Clinic routine HIV program, the uptake of testing is low, especially among 12–17 year old males. There is an urgent need to offer targeted, age-appropriate routine HIV testing to youth presenting to Outpatient Clinics in epidemic settings.
Tuulikki Sokka - One of the best experts on this subject based on the ideXlab platform.
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ten years of change in Clinical disease status and treatment in rheumatoid arthritis results based on standardized monitoring of patients in an ordinary Outpatient Clinic in southern norway
Arthritis Research & Therapy, 2015Co-Authors: Glenn Haugeberg, I J W Hansen, D M Soldal, Tuulikki SokkaAbstract:Introduction In the new millennium, Clinical outcomes in patients with rheumatoid arthritis (RA) have improved. Despite a large number of register data, there is a lack of data reflecting the entire Outpatient RA population, and in particular long-term data. The main aim of this study was to explore changes in Clinical disease status and treatment in an RA Outpatient Clinic population monitored with recommended outcome measures over a 10-year period.
