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Nicole M Revie, Kali R Iyer, Nicole Robbins, Leah E Cowen
Microorganisms have a remarkable capacity to evolve resistance to antimicrobial agents, threatening the efficacy of the limited arsenal of antimicrobials and becoming a dire public health crisis. This is of particular concern for fungal pathogens, which cause devastating invasive infections with treatment options limited to only three major classes of antifungal drugs. The paucity of antifungals with clinical utility is in part due to close evolutionary relationships between these eukaryotic pathogens and their human hosts, which limits the unique targets to be exploited therapeutically...
March 12, 2018: Current Opinion in Microbiology
Fauzia A Khan, Alan F Merry
The safety of anesthesia characteristic of high-income countries today is not matched in low-resource settings with poor infrastructure, shortages of anesthesia providers, essential drugs, equipment, and supplies. Health care is delivered through complex systems. Achieving sustainable widespread improvement globally will require an understanding of how to influence such systems. Health outcomes depend not only on a country's income, but also on how resources are allocated, and both vary substantially, between and within countries...
April 2018: Anesthesia and Analgesia
Søren Kudsk-Iversen, Naomi Shamambo, M Dylan Bould
The majority of the world's population lacks access to safe, timely, and affordable surgical care. Although there is a health workforce crisis across the board in the poorest countries in the world, anesthesia is disproportionally affected. This article explores some of the key issues that must be tackled to strengthen the anesthesia workforce in low- and lower-middle-income countries. First, we need to increase the overall number of safe anesthesia providers to match a huge burden of disease, particularly in the poorest countries in the world and in remote and rural areas...
April 2018: Anesthesia and Analgesia
P Stefan, M Pfandler, P Wucherer, S Habert, J Fürmetz, S Weidert, E Euler, U Eck, M Lazarovici, M Weigl, N Navab
Surgical simulators are being increasingly used as an attractive alternative to clinical training in addition to conventional animal models and human specimens. Typically, surgical simulation technology is designed for the purpose of teaching technical surgical skills (so-called task trainers). Simulator training in surgery is therefore in general limited to the individual training of the surgeon and disregards the participation of the rest of the surgical team. The objective of the project Assessment and Training of Medical Experts based on Objective Standards (ATMEOS) is to develop an immersive simulated operating room environment that enables the training and assessment of multidisciplinary surgical teams under various conditions...
March 15, 2018: Der Unfallchirurg
Gesine Meyer, Klaus Badenhoop
An adrenal crisis (Addisonian crisis) is an acute life-threatening complication of adrenal insufficiency. It occurs when hydrocortisone demand is not met by supplementation in the context of an infection - often gastrointestinal, fever, trauma, acute psychological or physical stress. Symptoms of weakness, nausea, muscle/joint pain and drowsiness may develop out of robust health within few hours. If overlooked, treated too late, with insufficient dose or route of application, there exists a considerable risk of mortality...
March 2018: Deutsche Medizinische Wochenschrift
Christina Schumann, Michael Faust
BACKGROUND:  Diabetic ketoacidosis and the hyperosmolar hyperglycemic state are the most serious diabetic emergencies. Before the discovery of insulin in 1921 by Banting and Best the diagnosis of type 1 diabetes was fatal ending in diabetic ketoacidosis equivalent to a torturous death. Today, mortality from diabetic ketoacidosis is low at approximately 2 %. But each death from these two acute metabolic complications of diabetes is potentially avoidable by improved patient and healthcare professional education...
March 2018: Deutsche Medizinische Wochenschrift
Chi-Yuan Lee, Shih-Chun Li, Chia-Hung Chen, Yen-Ting Huang, Yu-Syuan Wang
Looking for alternative energy sources has been an inevitable trend since the oil crisis, and close attentioned has been paid to hydrogen energy. The proton exchange membrane (PEM) water electrolyzer is characterized by high energy efficiency, high yield, simple system and low operating temperature. The electrolyzer generates hydrogen from water free of any carbon sources (provided the electrons come from renewable sources such as solar and wind), so it is very clean and completely satisfies the environmental requirement...
March 15, 2018: Sensors
Jacqueline H Wolf
In the late 19th-century United States and Europe, infants died at high rates from diarrhea. Physicians and social justice advocates responded to the public health crisis with attempts to clean up the water and cows' milk supplies, as well as social welfare legislation and assorted educational efforts to help mothers better care for their children. Most visible among the educational efforts were breastfeeding campaigns. A century later in developing countries, physicians and activists were confronted with a similar problem-infants dying from diarrhea due to the unethical advertising and marketing practices of formula companies...
March 1, 2018: Journal of Human Lactation: Official Journal of International Lactation Consultant Association
Kristin M Mills, Scott Sadler, Karen Peterson, Lorrin Pang
BACKGROUND: Falls in the elderly represent a public health crisis. Effective prevention programs need to conduct economic analyses. The Move With Balance program showed a 65% reduction in falls in institutionalized elderly. METHODS: We evaluated the return on investment (ROI) of Move With Balance. We calculated the ROI for 2 situations: first, using data from the current study (N = 27); second, extrapolating the data to an "intended" annual program (N = 45) where training costs can be spread over 6 years...
March 15, 2018: Journal of Physical Activity & Health
Amy G Bryant, Jonas J Swartz
Crisis pregnancy centers are organizations that seek to intercept women with unintended pregnancies who might be considering abortion. Their mission is to prevent abortions by persuading women that adoption or parenting is a better option. They strive to give the impression that they are clinical centers, offering legitimate medical services and advice, yet they are exempt from regulatory, licensure, and credentialing oversight that apply to health care facilities. Because the religious ideology of these centers' owners and employees takes priority over the health and well-being of the women seeking care at these centers, women do not receive comprehensive, accurate, evidence-based clinical information about all available options...
March 1, 2018: AMA Journal of Ethics
Karl Kim, Pradip Pant, Eric Yamashita
A recent lava flow in Puna, Hawaii, threatened to close one of the major highways serving the region. This article provides background information on the volcanic hazards and describes events, responses, and challenges associated with managing a complex, long-duration disaster. In addition to the need to better understand geologic hazards and threats, there is a need for timely information and effective response and recovery of transportation infrastructure. This requires coordination and sharing of information between scientists, emergency managers, transportation planners, government agencies, and community organizations...
January 2018: Journal of Emergency Management: JEM
Ali Bin Nadeem, Ysa Chandna
The majority of the Pakistani public has known little of the unmanned aerial vehicles, also known for their onomatopoeically inspired name "drones," except the fact that it regularly rains Hellfire missiles in Pakistan, claiming the lives of many innocent Pakistanis settled in the western provinces. In actuality, in addition to their destructive capacities, these remotely piloted vehicles have been used since the turn of the century in a variety of live-saving and risk-reducing roles. This research article primarily addresses the third stage of Emergency management-response, with Pakistan being the primary region of research...
January 2018: Journal of Emergency Management: JEM
Angel Lopez-Candales, Dagmar F Hernandez-Suarez, Anthony D Osterman-Pla, José G Conde-Santiago
On September 20, 2017, Hurricane Maria hit Puerto Rico, causing an unprecedented humanitarian crisis on a level that none of us have experienced before. The following editorial intends to show a physician's perspective of the impact of this storm on healthcare, particularly in triggering cardiovascular events.
January 8, 2018: Curēus
Qian Li, Xiao-Ji Lin, Hui Chen, Jian Gong, Zhen Li, Xiang-Nan Chen
More than 90% of patients with chronic myeloid leukemia (CML) have the chromosomal translocation t(9;22)(q34;q11), while 5-8% of patients have complex variant translocations that have previously been thought not to affect the efficacy of imatinib therapy. The present study reports a patient with CML in B-lymphoid blast crisis who had a rare three-way Philadelphia (Ph) variant t(3;9;22)(p21;q34;q11), in addition to isodicentric Ph chromosomes. The patient was initially treated with imatinib for >2 months with a very poor response...
April 2018: Oncology Letters
Ji-Hyun Bae, Gaeun Kim
One of the typical symptoms of a psychological crisis is depression, an increasing concern in the elderly population. Although omega-3-polyunsaturated fatty acids (PUFAs) are reported to be promising nutrients for treating depression, currently, there are no systematic reviews or meta-analyses of randomized control trials that provide critical evidence regarding the potential benefits of omega-3 fatty acids in elderly patients with depression. This analysis was conducted to provide evidence for the clinical application of omega-3 fatty acids in the treatment of depressive symptoms of elderly subjects older than 65 years...
February 2018: Nutrition Research
N D B Ehelepola, A N Abayagunawardana, T N Sudusinghe
BACKGROUND: Hemolysis can occur in people with G6PD deficiency under oxidative stress. Acalypha indica is a tropical plant used as a medicinal plant as well as a vegetable. There are a few reported cases of Acalypha indica ingestion induced hemolysis in G6PD deficient people. All except one of them are from Sri Lanka. The information available at present (2017) about G6PD deficiency prevalence and variants of the G6PD gene among Sri Lankans is very sparse. There are no past reports on hemolytic crisis in a G6PD deficient person presenting mimicking leptospirosis...
March 14, 2018: BMC Research Notes
Scott Schlossberg, Michael J Chase, Curtice R Griffin
With populations of African savannah elephants (Loxodonta africana) declining across the continent, assessing the status of individual elephant populations is important for conservation. Angola's elephant population represents a key linkage between the larger populations of Namibia and Botswana. Elephants in Angola were decimated during the 1975-2002 Angolan civil war, but a 2005 survey showed that populations were recolonizing former habitats. Between 2005 and 2015, no research was permitted on elephants in Angola, but elsewhere in Africa many elephant populations experienced a poaching crisis...
2018: PloS One
Jing Li, Xiaoli Fan, Qin Wang
RATIONALE: Glycyrrhizin is the main active component of licorice. Licorice and glycyrrhizin induced hypertension has been widely reported, yet licorice and glycyrrhizin induced hypertensive crisis has been rarely known. PATIENT CONCERNS: The case of this report was a 47-year-old woman, who took 225 mg of glycyrrhizin daily for 3 years due to primary biliary cholangitis. She was found to have a dramatically elevated blood pressure of about 230/110 mmHg without a history of hypertension and was referred to the emergency department...
March 2018: Medicine (Baltimore)
Nicholas Alipui, Nicole Gerke
We are currently facing one of the largest and most complex refugee crises in modern times. Conflict and natural disasters have resulted in 22.5 million refugees worldwide, more than half are children. As the world struggles to respond to this massive displacement of people, how is this affecting child refugees' development and what is being done about it? In this commentary, we explore answers to these central questions. First, we review the situation of child refugees in numbers, exploring their geographic concentration...
March 2018: New Directions for Child and Adolescent Development
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