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Essencial: Afegint valor a la pràctica clínica [Essencial: Adding value to the clinical practice]

Essencial Salut

In patients with community-acquired pneumonia, routine hospital admission is not recommended without having assessed the patient's condition using validated prognostic scales for severe illness. Mild cases without additional complications do not require hospitalization and adequate outpatient care is sufficient to properly care for the person. On the other hand, severe cases with complications, associated diseases or previous therapeutic failure may require hospitalization. To help make the ...

Otros artículos/Other articles on this topic

evidenceaid

The authors searched for randomized controlled trials of interventions to increase influenza vaccination uptake among community-dwelling people aged 60 years and older. Reminders and callbacks will increase community demand for vaccines, as will patient education. by nurses and pharmacists. Outreach by teachers, nurses, medical students and retired receptionists was also effective. Home visits, group clinic visits, and free vaccinations improved access to vaccines. Physician payments, physician ...

NICE

NICE

In the absence of evidence, the committee used their own expertise and experience to recommend that people should be tested for vitamin B12 deficiency if they present with at least 1 risk factor and at least 1 symptom or sign. Risk factors, symptoms and signs are not always a clear indication of a vitamin B12 deficiency, but the committee agreed that the presence of at least 1 risk factor and 1 symptom or sign increases its likelihood.

NICE

NICE

The committee noted that there is currently no 'gold standard' test for diagnosing vitamin B12 deficiency. This means that, while tests can be a diagnostic aid, they cannot be relied on completely to confirm or rule out deficiency. The committee did acknowledge that active B12 is a more reliable test during pregnancy, when total B12 concentrations in the body fall even when there is no deficiency, so they recommended active B12 as the initial test for this group based on expert witness advice.

NICE

NICE

There was no evidence on the most effective ongoing care and follow-up strategies for people with vitamin B12 deficiency, so the committee made recommendations based on their expertise and experience. For most people who have started treatment, a follow up at 3 months would give enough time to ensure it is working. However, some people with severe symptoms may need an earlier appointment so that treatment can be switched or adjusted if needed. Anyone who is pregnant or breastfeeding should also ...