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https://www.readbyqxmd.com/read/28220745/is-it-possible-to-differentiate-tuberculous-and-cryptococcal-meningitis-in-hiv-infected-patients-using-only-clinical-and-basic-cerebrospinal-fluid-characteristics
#1
J E Vidal, E J F Peixoto de Miranda, J Gerhardt, M Croda, D R Boulware
BACKGROUND: Tuberculous and cryptococcal meningitis (TBM and CM) are the most common causes of opportunistic meningitis in HIVinfected patients from resource-limited settings, and the differential diagnosis is challenging. OBJECTIVE: To compare clinical and basic cerebrospinal fluid (CSF) characteristics between TBM and CM in HIV-infected patients. METHODS: A retrospective analysis was conducted of clinical, radiological and laboratory records of 108 and 98 HIV-infected patients with culture-proven diagnosis of TBM and CM, respectively...
January 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28220740/the-spectrum-and-outcome-of-surgical-sepsis-in-pietermaritzburg-south-africa
#2
S Green, V Y Kong, D L Clarke, B Sartorius, J Odendaal, J L Bruce, G L Laing, P Brysiewicz, W Bekker, E Harknett
BACKGROUND: Sepsis is a leading cause of morbidity and mortality worldwide, and the incidence appears to be increasing. In the resource-limited environment in low- and middle-income countries, the management of surgical sepsis (SS) continues to represent a significant portion of the workload for most general surgeons. OBJECTIVE: To describe the spectrum of SS seen at a busy emergency department, and categorise the outcomes. METHODS: The Pietermaritzburg Metropolitan Trauma Service (PMTS) and Pietermaritzburg Metropolitan Surgical Service (PMSS) in KwaZulu-Natal Province, South Africa (SA), maintain a prospective electronic registry...
January 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28218949/the-triglyceride-and-glucose-index-is-useful-for-recognising-insulin-resistance-in-children
#3
M Rodríguez-Morán, L E Simental-Mendía, F Guerrero-Romero
AIM: Although recognising insulin resistance in children is particularly important, the gold standard test used to diagnose it, the euglyceamic glucose clamp, is costly, invasive and is not routinely available in our clinical settings in Mexico. This study evaluated whether the triglyceride-glucose (TyG) index would provide a useful alternative. METHODS: A total of 2,779 school children aged 7-17 years, from Durango, Mexico, were enrolled during 2015-2016. The gold standard euglyceamic-hyperinsulinemic clamp test was performed in a randomly selected subsample of 125 children and diagnostic concordance between the TyG index and the homeostasis model assessment of IR was evaluated in all of the 2,779 enrolled children...
February 20, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28217219/clinical-outcomes-of-tenofovir-versus-zidovudine-based-regimens-among-people-living-with-hiv-aids-a-two-years-retrospective-cohort-study
#4
Teshale Ayele, Habtemu Jarso, Girma Mamo
BACKGROUND: Tenofovir (TDF) based regimen is one of the first line agents that has been utilized routinely since 2013 in Ethiopia. Unfortunately, there is limited information regarding the Clinical outcomes and associated risk factors in this setting, where patients generally present late, have high rates of TB and other infectious conditions. METHODS: A two year retrospective cohort study was conducted from February 10/2015 to March 10/2015 at Jimma University Specialized Hospital...
2017: Open AIDS Journal
https://www.readbyqxmd.com/read/28212349/household-dengue-prevention-interventions-expenditures-and-barriers-to-aedes-aegypti-control-in-machala-ecuador
#5
Naveed Heydari, David A Larsen, Marco Neira, Efraín Beltrán Ayala, Prissila Fernandez, Jefferson Adrian, Rosemary Rochford, Anna M Stewart-Ibarra
The Aedes aegypti mosquito is an efficient vector for the transmission of Zika, chikungunya, and dengue viruses, causing major epidemics and a significant social and economic burden throughout the tropics and subtropics. The primary means of preventing these diseases is household-level mosquito control. However, relatively little is known about the economic burden of Ae. aegypti control in resource-limited communities. We surveyed residents from 40 households in a high-risk community at the urban periphery in the city of Machala, Ecuador, on dengue perceptions, vector control interventions, household expenditures, and factors influencing purchasing decisions...
February 16, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28211003/an-easy-to-build-low-budget-point-of-care-ultrasound-simulator-from-linux-to-a-web-based-solution
#6
Domagoj Damjanovic, Ulrich Goebel, Benedikt Fischer, Martin Huth, Hartmut Breger, Hartmut Buerkle, Axel Schmutz
BACKGROUND: Hands-on training in point-of-care ultrasound (POC-US) should ideally comprise bedside teaching, as well as simulated clinical scenarios. High-fidelity phantoms and portable ultrasound simulation systems are commercially available, however, at considerable costs. This limits their suitability for medical schools. A Linux-based software for Emergency Department Ultrasound Simulation (edus2TM) was developed by Kulyk and Olszynski in 2011. Its feasibility for POC-US education has been well-documented, and shows good acceptance...
December 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28209414/barriers-and-facilitators-to-the-implementation-of-evidence-based-practice-by-pediatric-surgeons
#7
Katrina J Sullivan, Carolyn Wayne, Andrea M Patey, Ahmed Nasr
BACKGROUND/PURPOSE: Evidence-based practice (EBP) has been identified as a foundation of mainstream medical practice, yet pediatric surgery has been slow in the acceptance and implementation of EBP. METHODS: Semi-structured interviews of 14 pediatric surgeons were conducted to determine barriers and facilitators to EBP. Resulting data were analyzed using a systematic 3-step approached of coding, generation of specific beliefs, and identification of domains relevant to practice change...
February 8, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28207807/how-much-is-a-child-worth-providers-and-patients-views-and-responses-concerning-ethical-and-policy-challenges-in-paying-for-art
#8
Robert Klitzman
Infertility treatments remain expensive and in many countries are covered by little, if any, insurance, raising critical questions concerning how patients and providers view and make decisions regarding these challenges. In-depth semi-structured interviews of approximately 1 hour were conducted with 37 IVF providers and 10 patients (17 physicians, 10 other providers and 10 patients), and were systematically analyzed. These data suggest current insurance policies and legislation pose critical ethical and logistical challenges for both patients and providers...
2017: PloS One
https://www.readbyqxmd.com/read/28199360/systematic-review-of-statistically-derived-models-of-immunological-response-in-hiv-infected-adults-on-antiretroviral-therapy-in-sub-saharan-africa
#9
Joseph B Sempa, Eva L Ujeneza, Martin Nieuwoudt
INTRODUCTION: In Sub-Saharan African (SSA) resource limited settings, Cluster of Differentiation 4 (CD4) counts continue to be used for clinical decision making in antiretroviral therapy (ART). Here, HIV-infected people often remain with CD4 counts <350 cells/μL even after 5 years of viral load suppression. Ongoing immunological monitoring is necessary. Due to varying statistical modeling methods comparing immune response to ART across different cohorts is difficult. We systematically review such models and detail the similarities, differences and problems...
2017: PloS One
https://www.readbyqxmd.com/read/28198789/sustained-responses-to-measles-revaccination-at-24-months-in-hiv-infected-children-on-antiretroviral-therapy-in-kenya
#10
Laura P Newman, Anne Njoroge, Amalia Magaret, Bhavna H Chohan, Veronicah W Gitomea, Anna Wald, Jonathan Gorstein, Julie Overbaugh, Dalton Wamalwa, Elizabeth Maleche-Obimbo, Ruth Nduati, Carey Farquhar
BACKGROUND: There are limited data on whether HIV-infected children in resource-limited countries who are receiving antiretroviral therapy (ART) are able to produce sustained, protective levels of measles antibody after multiple measles vaccinations. METHODS: We administered an additional measles vaccine to HIV-infected children 15 months to 12 years of age receiving ART in Nairobi, Kenya. Measles antibody concentrations were determined by enzyme-linked immunosorbent assay (ELISA) at enrollment, one month, 12 months, and 24 months post revaccination...
February 13, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28196105/adaptive-geostatistical-sampling-enables-efficient-identification-of-malaria-hotspots-in-repeated-cross-sectional-surveys-in-rural-malawi
#11
Alinune N Kabaghe, Michael G Chipeta, Robert S McCann, Kamija S Phiri, Michèle van Vugt, Willem Takken, Peter Diggle, Anja D Terlouw
INTRODUCTION: In the context of malaria elimination, interventions will need to target high burden areas to further reduce transmission. Current tools to monitor and report disease burden lack the capacity to continuously detect fine-scale spatial and temporal variations of disease distribution exhibited by malaria. These tools use random sampling techniques that are inefficient for capturing underlying heterogeneity while health facility data in resource-limited settings are inaccurate...
2017: PloS One
https://www.readbyqxmd.com/read/28195649/validity-and-utility-of-the-patient-health-questionnaire-phq-2-and-phq-9-for-screening-and-diagnosis-of-depression-in-rural-chiapas-mexico-a-cross-sectional-study
#12
Jafet Arrieta, Mercedes Aguerrebere, Giuseppe Raviola, Hugo Flores, Patrick Elliott, Azucena Espinosa, Andrea Reyes, Eduardo Ortiz-Panozo, Elena G Rodriguez-Gutierrez, Joia Mukherjee, Daniel Palazuelos, Molly F Franke
BACKGROUND: Depressive disorders are frequently under diagnosed in resource-limited settings because of lack of access to mental health care or the inability of healthcare providers to recognize them. The Patient Health Questionnaire (PHQ)-2 and the PHQ-9 have been widely used for screening and diagnosis of depression in primary care settings; however, the validity of their use in rural, Spanish-speaking populations is unknown. METHOD: We used a cross-sectional design to assess the psychometric properties of the PHQ-9 for depression diagnosis and estimated the sensitivity and specificity of the PHQ-2 for depression screening...
February 13, 2017: Journal of Clinical Psychology
https://www.readbyqxmd.com/read/28194378/surgical-treatment-of-intraarticular-fractures-of-the-calcaneus-comparison-between-flat-plate-and-calcaneal-plate
#13
Luiz Carlos Almeida da Silva, João Mendonça de Lima Heck, Marcelo Teodoro Ezequiel Guerra
OBJECTIVE: To evaluate the clinical results of surgical treatment of intraarticular fractures of the calcaneus, comparing the use of calcaneal plate and flat plate. METHODS: This was a retrospective study assessing the postoperative results of 25 patients between 2013 and 2015. Patients undergoing surgical treatment of intraarticular fractures of the calcaneus without concomitant surgical lesions were included. Patients who did not complete appropriate follow-up after surgery were excluded from the study...
January 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28193439/simulation-in-neonatal-transport-medicine
#14
REVIEW
Douglas M Campbell, Rita Dadiz
The safe transport of infants in critical condition requires highly reliable inter-professional transport teams that are equipped with the expertise to provide neonatal care in unfamiliar and resource-limited environments. Increasingly, transport teams are comprised of health professionals from various disciplines. Providing didactic and experiential learning alone is insufficient to fully prepare teams that have limited exposure to rare events. Simulation-based training supplements and reinforces knowledge, skills, and the experiences of team members...
November 2016: Seminars in Perinatology
https://www.readbyqxmd.com/read/28187144/a-mathematical-model-of-clostridium-difficile-transmission-in-medical-wards-and-a-cost-effectiveness-analysis-comparing-different-strategies-for-laboratory-diagnosis-and-patient-isolation
#15
Vered Schechner, Yehuda Carmeli, Moshe Leshno
BACKGROUND: Clostridium difficile infection (CDI) is a common and potentially fatal healthcare-associated infection. Improving diagnostic tests and infection control measures may prevent transmission. We aimed to determine, in resource-limited settings, whether it is more effective and cost-effective to allocate resources to isolation or to diagnostics. METHODS: We constructed a mathematical model of CDI transmission based on hospital data (9 medical wards, 350 beds) between March 2010 and February 2013...
2017: PloS One
https://www.readbyqxmd.com/read/28187086/brief-report-flow-rate-of-cerebrospinal-fluid-through-a-spinal-needle-can-accurately-predict-intracranial-pressure-in-cryptococcal-meningitis
#16
Tom H Boyles, Elizabeth Gatley, Sean Wasserman, Graeme Meintjes
BACKGROUND: Patients with HIV-associated cryptococcal meningitis (CM) commonly present with raised intracranial pressure (ICP). Aggressive management of raised ICP reduces mortality but requires manometers, which are unavailable in most resource-limited settings. The law of Poiseuille states that the rate of flow of liquid through a tube is directly proportional to the difference in pressure between each end, and it may be possible to indirectly determine ICP by measuring flow of CSF through a spinal needle rather than using a manometer...
March 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28183335/efficacy-of-vitamin-d3-supplementation-in-reducing-incidence-of-pulmonary-tuberculosis-and-mortality-among-hiv-infected-tanzanian-adults-initiating-antiretroviral-therapy-study-protocol-for-a-randomized-controlled-trial
#17
Christopher R Sudfeld, Ferdinand Mugusi, Said Aboud, Tumaini J Nagu, Molin Wang, Wafaie W Fawzi
BACKGROUND: HIV-infected adults initiating antiretroviral therapy (ART) in sub-Saharan Africa continue to experience high rates of morbidity and mortality during the initial months of treatment. Observational studies in high-income and resource-limited settings indicate that HIV-infected adults with low vitamin D levels may be at increased risk of mortality, HIV disease progression, and incidence of pulmonary tuberculosis (TB). As a result, vitamin D3 supplementation may improve survival and treatment outcomes for HIV-infected adults initiating ART...
February 10, 2017: Trials
https://www.readbyqxmd.com/read/28182618/the-evolving-landscape-of-hiv-drug-resistance-diagnostics-for-expanding-testing-in-resource-limited-settings
#18
Seth C Inzaule, Raph L Hamers, Roger Paredes, Chunfu Yang, Rob Schuurman, Tobias F Rinke de Wit
Global scale-up of antiretroviral treatment (ART) has dramatically changed the prospects of HIV/AIDS disease rendering life-long chronic care and treatment a reality for millions of HIV-infected patients. Affordable technologies to monitor ART are needed to ensure long-term durability of limited available drug regimens. HIV drug resistance tests can complement existing strategies in optimizing clinical decision-making for patients with treatment failure, in addition to facilitating population-based surveillance of HIV drug resistance...
February 9, 2017: AIDS Reviews
https://www.readbyqxmd.com/read/28182124/extended-spectrum-beta-lactamase-and-carbapenemase-producing-enterobacteriaceae-among-ethiopian-children
#19
Melese Hailu Legese, Gebru Mulugeta Weldearegay, Daniel Asrat
BACKGROUND: Infections by extended-spectrum beta-lactamase- (ESBL) and carbapenem-resistant Enterobacteriaceae (CRE) are an emerging problem in children nowadays. Hence, the aim of this study was to determine the prevalence of ESBL- and carbapenemase-producing Enterobacteriaceae among children suspected of septicemia and urinary tract infections (UTIs). METHODS: A cross-sectional study was conducted from January to March 2014. A total of 322 study participants suspected of septicemia and UTIs were recruited...
2017: Infection and Drug Resistance
https://www.readbyqxmd.com/read/28181847/international-service-learning-and-interprofessional-education-in-ecuador-findings-from-a-phenomenology-study-with-students-from-four-professions
#20
Audrey M Johnson, Dana M Howell
Combined international service learning (ISL) and interprofessional education (IPE) experiences can move health professional student learning beyond the traditional confines of the classroom and outside uniprofessional ethos. The purpose of this transcendental phenomenological study was to describe the shared experience of health professional students participating in an ISL trip to a small community in Ecuador. The study focused on the learning and collaboration that occurred among students from multiple health professions during the trip and the cross-cultural exchange between the students and the patients in Ecuador...
March 2017: Journal of Interprofessional Care
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