PubMed Health⌕ Search

Biomedical subjects

P Del Fante

Publications and source records attributed to P Del Fante.

5 recordsLinked to original sources
PubMed1999

The effect of a respiratory home nurse intervention in patients with chronic obstructive pulmonary disease (COPD).

BACKGROUND: Chronic obstructive pulmomary disease (COPD) is associated with substantial mortality, morbidity, and costs to the health care system. With the increasing interest in outreach care programmes it is important to evaluate their impact upon patients and health services, for conditions such as COPD. AIM: To determine the effectiveness of an outreach respiratory nurse in a shared care approach, with collaboration between general practitioners and hospital services, in the management of patients with severe COPD. METHODS: Patients with severe COPD attending The Queen Elizabeth Hospital, Adelaide participated in a randomised controlled trial of a home based nursing intervention (HBNI) over 12 months with outcome measures including mortality rate, hospital service utilisation, FEV1 and health related quality of life (HRQL) using a modified Dartmouth Primary Care Co-operative Quality of Life questionnaire. RESULTS: There were 48 subjects in each study arm, with no differences in mortality rate (eight deaths in the HBNI group and seven in the control group), hospital admissions, length of stay, number of outpatient and Emergency Service visits. The study had inadequate follow-up of FEV1 and HRQL within the control group. Within the HBNI group, a small improvement in HRQL (in three of ten indices measured) was demonstrated, despite a deterioration in FEV1 (11% reduction, p=0.04) compared to baseline. Quality of life of HBNI subjects' carers did not change. CONCLUSION: An increased level of care given by an outreach respiratory nurse in a shared care approach for patients with severe COPD produced small improvements in HRQL but did not result in the prevention of deaths or reduced health care utilisation.

Aged↗
PubMed1994

Travel vaccinations and immunisations.

Health advice and choosing the right vaccinations for the traveller is becoming more complex. If there are any doubts about which vaccinations to offer a traveller don't hesitate to seek advice from travel medicine experts. Where a patient cannot recall their vaccination details, it is better to re-vaccinate rather than risk infection. Finally, it is important to remind the traveller that the commonest diseases acquired overseas (for example, traveller's diarrhoea, malaria, injuries) are not preventable by vaccines.

Drug Administration Routes↗
PubMed1994

Staying healthy while travelling.

By ensuring that the issues raised in this article are appropriately discussed with each traveller at the pre-travel consultation, the chance of staying healthy while travelling is considerably enhanced. If all else fails, the traveller should be well equipped with a first aid medical kit (Table 2) and instructions on how and when to take medications. They should know how to treat travellers diarrhoea, recognise signs and symptoms of malaria and the difference between a bacterial infection and viral infection. Bon voyage!

Accident Prevention↗
PubMed1993

HIV, breast-feeding and under-5 mortality: modelling the impact of policy decisions for or against breast-feeding.

A computer model was developed to assess the impact on under-5 child mortality of breast-feeding practices in developing countries in the context of HIV infection. The model was used to estimate the effect on mortality of cessation of breast-feeding among mothers HIV-positive and mothers HIV-negative at birth, for both urban and rural settings. Using parameter values for a hypothetical East African country, cessation of breast-feeding in urban areas was predicted to result in increases in under-5 mortality of 108% for children of mothers HIV-negative at birth, and 27% for those HIV-positive at birth, with slightly larger increases in rural areas, suggesting that breast-feeding should continue to be promoted. A sensitivity analysis was conducted to identify critical values of key variables for which a review of policies encouraging breast-feeding is indicated. This showed that, even under extreme assumptions, cessation of breast-feeding among mothers HIV-negative at birth (but at risk of acquiring HIV during the lactation period) would increase under-5 mortality. For mothers HIV-positive at birth, the key variables are the additional risk of vertical transmission attributable to breast-feeding, the under-5 mortality rate (U5MR) in breast-fed children, and the relative risk of mortality in non-breast-fed compared to breast-fed children. Depending on the values of these key variables, there may be some urban populations with low U5MR in which the positive and negative effects on under-5 mortality of a policy change are finely balanced. However, no change in policy should be made in these areas until more precise information is available on the key variables, and the many adverse consequences of such a change have been fully explored.

Breast Feeding↗