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World class health care

Jacqueline Dinnes, Jonathan J Deeks, Naomi Chuchu, Lavinia Ferrante di Ruffano, Rubeta N Matin, David R Thomson, Kai Yuen Wong, Roger Benjamin Aldridge, Rachel Abbott, Monica Fawzy, Susan E Bayliss, Matthew J Grainge, Yemisi Takwoingi, Clare Davenport, Kathie Godfrey, Fiona M Walter, Hywel C Williams
BACKGROUND: Melanoma has one of the fastest rising incidence rates of any cancer. It accounts for a small percentage of skin cancer cases but is responsible for the majority of skin cancer deaths. Although history-taking and visual inspection of a suspicious lesion by a clinician are usually the first in a series of 'tests' to diagnose skin cancer, dermoscopy has become an important tool to assist diagnosis by specialist clinicians and is increasingly used in primary care settings. Dermoscopy is a magnification technique using visible light that allows more detailed examination of the skin compared to examination by the naked eye alone...
December 3, 2018: Cochrane Database of Systematic Reviews
M A C Koole, D Kauw, M M Winter, D A J Dohmen, I I Tulevski, R de Haan, G A Somsen, M P Schijven, D Robbers-Visser, B J M Mulder, B J Bouma, M J Schuuring
BACKGROUND: Arrhythmias and heart failure are common and invalidating sequelae in adult patients with congenital heart disease (CHD). Mobile health (m-Health) enables daily monitoring and a timely response that might prevent deterioration. We present an observational prospective registry to evaluate feasibility of an m‑Health telemonitoring program for managing arrhythmia, heart failure and blood pressure in symptomatic adults with CHD. METHODS: Symptomatic adult patients with CHD are enrolled in an m‑Health telemonitoring program, which evaluates single-lead ECG, blood pressure and weight measurements...
November 28, 2018: Netherlands Heart Journal
Vincent J Willey, Sheldon Kong, Bingcao Wu, Amit Raval, Todd Hobbs, Andrea Windsheimer, Gaurav Deshpande, Ozgur Tunceli, Brian Sakurada, Jonathan R Bouchard
Background: Diabetes is associated with substantial clinical and economic burdens on patients and on the US healthcare system. Treatment options for patients with type 1 or type 2 diabetes have increased significantly, from only 3 drug classes in 1995 to more than 12 distinct classes today. Although several of the newer treatments are reported to have improved efficacy and safety profiles, they are often substantially more costly than older medications. Consequently, as drug options increase, the cost of diabetes management continues to grow...
September 2018: American Health & Drug Benefits
Benjamin Chimukangara, Ayesha Bm Kharsany, Richard J Lessells, Kogieleum Naidoo, Soo-Yon Rhee, Justen Manasa, Tiago Gräf, Lara Lewis, Cherie Cawood, David Khanyile, Karidia Diallo, Kassahun A Ayalew, Robert Shafer, Gillian Hunt, Deenan Pillay, Salim Karim Abdool, Tulio de Oliveira
INTRODUCTION: There is evidence of increasing levels of pre-treatment HIV drug resistance (PDR) in Southern Africa. We used data from two large population-based HIV surveillance studies to estimate prevalence of PDR in KwaZulu-Natal, the province with the highest HIV prevalence in South Africa. METHODS: Sanger sequencing was performed on samples obtained from a longitudinal HIV surveillance programme (study A, 2013-2014) and the HIV Incidence Provincial Surveillance System (study B, 2014-2015)...
November 15, 2018: AIDS Research and Human Retroviruses
C T Yeam, S Chia, H C C Tan, Y H Kwan, W Fong, J J B Seng
The aim of this review was to identify factors that influence patients' adherence to anti-osteoporotic therapy. Factors identified that were associated with poorer medication adherence included polypharmacy, older age, and misconceptions about osteoporosis. Physicians need to be aware of these factors so as to optimize therapeutic outcomes for patients. INTRODUCTION: To identify factors that influence patients' adherence to anti-osteoporotic therapy. METHODS: A systematic review of literature was performed for articles published up till January 2018 using PubMed®, PsychINFO®, Embase®, and CINAHL®...
December 2018: Osteoporosis International
Samuel R Nyman, Christopher Hayward, Wendy Ingram, Peter Thomas, Sarah Thomas, Michael Vassallo, James Raftery, Helen Allen, Yolanda Barrado-Martín
BACKGROUND: Falls are a public health issue for the older adult population and more so for people with dementia (PWD). Compared with their cognitively intact peers, PWD are at higher risk of falls and injurious falls. This randomised controlled trial aims to test the clinical and cost effectiveness of Tai Chi to improve postural balance among community-dwelling PWD and to assess the feasibility of conducting a larger definitive trial to reduce the incidence of falls among PWD. METHODS: A 3-centre parallel group randomised controlled trial with embedded process evaluation...
November 3, 2018: BMC Geriatrics
Abolanle Saheed Adekunle, John Adekunle Oyedele Oyekunle, Ibitomilola Janet Ola, Olaoluwa Ruth Obisesan, Nobanathi Wendy Maxakato
The study was carried out to determine the presence and concentration of polycyclic aromatic hydrocarbons (PAHs) and organochlorine pesticides (OCPs) in some personal care products in Nigeria. Commonly used consumer care products grouped into four classes, namely: plastics, cosmetics, disinfectants and washing products, were purchased from some supermarkets in Ile-Ife, Nigeria. The solid samples were pulverized and the PAHs and OCPs were extracted with n-hexane and dichloromethane, respectively using Soxhlet extraction method, while the liquid samples were extracted using liquid-liquid extraction method...
2018: Toxicology Reports
Giuseppe Di Tano, Andrea Di Lenarda, Domenico Gabrielli, Nadia Aspromonte, Renata De Maria, Maria Frigerio, Massimo Iacoviello, Andrea Mortara, Adriano Murrone, Federico Nardi, Fabrizio Oliva, Roberto Pontremoli, Marino Scherillo, Michele Senni, Stefano Urbinati, Michele Massimo Gulizia
Sacubitril/valsartan, the first-in-class angiotensin receptor neprilysin inhibitor (ARNI), is the first medication to demonstrate a mortality benefit in patients with chronic heart failure and reduced ejection fraction (HFrEF) since the early 2000s. Sacubitril/valsartan simultaneously suppresses renin-angiotensin-aldosterone system activation through blockade of angiotensin II type 1 receptors and enhances the activity of vasoactive peptides including natriuretic peptides, through inhibition of neprilysin, the enzyme responsible for their degradation...
October 2018: Giornale Italiano di Cardiologia
Karin E Thompson, Ramesh M Ray, Shanta Alli, Wenbo Ge, Alyssa Boler, W Shannon McCool, Avtar S Meena, Pradeep K Shukla, Radakrishna Rao, Leonard R Johnson, Mark A Miller, Gabor J Tigyi
Diarrheal disease is a severe global health problem. It is estimated that secretory diarrhea causes 2.5 million deaths annually among children under the age of five in the developing world. A critical barrier in treating diarrheal disease is lack of easy-to-use effective treatments. While antibiotics may shorten the length and severity of diarrhea, oral rehydration remains the primary approach in managing secretory diarrhea. Existing treatments mostly depend on reconstituting medicines with water that is often contaminated which can be an unresolved problem in the developing world...
September 25, 2018: Experimental Biology and Medicine
Özal Yıldırım, Paweł Pławiak, Ru-San Tan, U Rajendra Acharya
This article presents a new deep learning approach for cardiac arrhythmia (17 classes) detection based on long-duration electrocardiography (ECG) signal analysis. Cardiovascular disease prevention is one of the most important tasks of any health care system as about 50 million people are at risk of heart disease in the world. Although automatic analysis of ECG signal is very popular, current methods are not satisfactory. The goal of our research was to design a new method based on deep learning to efficiently and quickly classify cardiac arrhythmias...
September 15, 2018: Computers in Biology and Medicine
Jon B Christensen
The North Atlantic Treaty Organization (NATO) Special Operations Combat Medic (NSOCM) course is specifically designed to train 24 highly selected Special Operations Forces (SOF) members to treat trauma and nontrauma patients who have life-threatening diseases and/or injuries. The NSOCM course is held at the International Special Training Centre (ISTC) in Pfullendorf, Germany, and exemplifies ISTC's mission to build interoperability and strengthening alliances between multinational partners. The 24-week NSOCM course is taught by subject matter experts and SOF members from around the globe...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Régis Vaillancourt, Mike P Zender, Laurie Coulon, Annie Pouliot
Background: A panel of medication management experts previously identified 9 key medication safety issues and high-alert drug classes as representing the most pressing medication-handling issues in health care. Objective: To develop medication safety pictograms depicting medication safety issues and high-alert drug classes that represent medication-handling risks for health care personnel. Methods: An iterative design process, including activities such as semiotic analysis, design/redesign, and evaluation, was used to develop medication safety pictograms...
July 2018: Canadian Journal of Hospital Pharmacy
Mikashmi Kohli, Ian Schiller, Nandini Dendukuri, Keertan Dheda, Claudia M Denkinger, Samuel G Schumacher, Karen R Steingart
BACKGROUND: Tuberculosis (TB) is the world's leading infectious cause of death. Extrapulmonary TB accounts for 15% of TB cases, but the proportion is increasing, and over half a million people were newly diagnosed with rifampicin-resistant TB in 2016. Xpert® MTB/RIF (Xpert) is a World Health Organization (WHO)-recommended, rapid, automated, nucleic acid amplification assay that is used widely for simultaneous detection of Mycobacterium tuberculosis complex and rifampicin resistance in sputum specimens...
August 27, 2018: Cochrane Database of Systematic Reviews
Antje Fuss, Humphrey Deogratias Mazigo, Dennis Tappe, Christa Kasang, Andreas Mueller
BACKGROUND: Schistosomiasis remains one of the most prevalent parasitic infections in the world and has significant economic and public health consequences, particularly in poor communities. Reliable and accurate diagnosis plays a key role in surveillance, prevention and control of schistosomiasis. Currently, the microscopic Kato Katz (KK) stool thick smear technique is the most commonly used method to diagnose Schistosoma mansoni infections in epidemiological surveys. It is well-known that the sensitivity of this parasitological method decreases when infection intensities are moderate to low, however...
2018: PloS One
Bo Liu, Shen-Gen Zhang, Chein-Chi Chang
Emerging pollutants (EPs) are a class of chemical pollutants that have potential or substantial threats to human health and ecological environment. EPs mainly include pharmaceuticals and personal care products, endocrine disrupting chemicals, antibiotics, persistent organic pollutants, disinfection by-products and other industrial chemicals, etc. In recent years, with the improvement of environmental analysis level, these substances have been detected frequently in urban sewage, surface water and drinking water all over the world...
October 1, 2018: Water Environment Research: a Research Publication of the Water Environment Federation
Isabelle Nogueira Leroux, Ana Paula Sacone da Silva Ferreira, Fernanda Pollo Paniz, Tatiana Pedron, Fernanda Junqueira Salles, Fábio Ferreira da Silva, Heloisa França Maltez, Bruno Lemos Batista, Kelly Polido Kaneshiro Olympio
Lead, known as a metal with high neurotoxicity to children, cadmium, which is a carcinogenic and bioaccumulative contaminant, and arsenic, a class 1 carcinogenic according to the International Agency for Research on Cancer, are toxic elements (TEs) whose relevant route of exposure may be diet. We determined the bio-accessible fraction of lead, cadmium, and arsenic from the diet of preschool children from two day care centers (DCC). A cross-sectional study was conducted with 64 one⁻four-year-old children from two DCCs where the 24-h duplicate diet samples were collected...
August 18, 2018: International Journal of Environmental Research and Public Health
Michael J Reagin, Michael V Gentry
Cybersecurity is no longer an option or an afterthought-it is a strategic asset that every organization must address, especially in healthcare. The impact of modern cyberattacks extends well beyond privacy breaches and damage to brand or reputation; it can also affect the safe delivery of care. In 2017, a global security incident affected National Health Service hospitals in England and Scotland, preventing them from providing services to patients and causing thousands of appointments to be canceled. Such serious cyberattacks are becoming more prevalent, and their impact has dramatically changed from impeding back-office operations to threatening patient safety and the financial viability of healthcare organizations...
2018: Frontiers of Health Services Management
Colin D Sperling, Leilei Xia, Ian B Berger, Michael H Shin, Marshall C Strother, Thomas J Guzzo
OBJECTIVE: To evaluate the association between obesity and postoperative outcomes following minimally invasive partial nephrectomy (MIPN) and minimally invasive radical nephrectomy (MIRN). METHODS: Using the National Surgical Quality Improvement Project database, we identified adult patients who underwent either MIPN or MIRN from 2012 to 2016. Patients were stratified by body mass index (BMI) according the World Health Organization classification of obesity (non-obese [BMI 18...
August 16, 2018: Urology
Rima Kaddoura, Jocelyn DeJong, Huda Zurayk, Tamar Kabakian, Christine Abbyad, Fadi G Mirza
PROBLEM: There is lack of data on the rate of episiotomy in Lebanon and the study's hospital. BACKGROUND: Only a few studies have addressed episiotomy practice in Lebanon and the Middle East and they show varying rates. AIM: To identify the rate, and change in rate, of episiotomy practice over the years at a teaching hospital in Lebanon and to assess whether maternal age, parity, fetal weight, woman's hospital admission class, and physician's gender were associated with episiotomy...
July 26, 2018: Women and Birth: Journal of the Australian College of Midwives
Saúl Levy-Blitchtein, Ignasi Roca, Stefany Plasencia-Rebata, William Vicente-Taboada, Jorge Velásquez-Pomar, Laura Muñoz, Javier Moreno-Morales, Maria J Pons, Juana Del Valle-Mendoza, Jordi Vila
Carbapenem-resistant Acinetobacter baumannii is the top-ranked pathogen in the World Health Organization priority list of antibiotic-resistant bacteria. It emerged as a global pathogen due to the successful expansion of a few epidemic lineages, or international clones (ICs), producing acquired class D carbapenemases (OXA-type). During the past decade, however, reports regarding IC-I isolates in Latin America are scarce and are non-existent for IC-II and IC-III isolates. This study evaluates the molecular mechanisms of carbapenem resistance and the epidemiology of 80 non-duplicate clinical samples of A...
July 4, 2018: Emerging Microbes & Infections
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