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Critical care burden

Nancy Innocentia Ebu
Background: The burden of HIV and cervical cancer is concentrated in sub-Saharan Africa. Women with HIV are more likely to have persistent HPV infection leading to cervical abnormalities and cancer. Cervical cancer screening seems to be the single most critical intervention in any efforts to prevent cervical cancer. The purpose of this study was to determine the socio-demographic factors influencing intention to seek cervical cancer screening by HIV-positive women in the Central Region of Ghana...
2018: Gynecologic Oncology Research and Practice
Javed Iqbal, Banzeer Ahsan Abbasi, Riffat Batool, Tariq Mahmood, Barkat Ali, Ali Talha Khalil, Sobia Kanwal, Sayed Afzal Shah, Riaz Ahmad
Breast cancer (BC) is a devastating disease in female around the world causing significant health care burden in both developed and developing countries. In many cases BC has shown resistance to chemotherapy, radiation and hormonal therapy. Development of new, cost effective, affordable treatment method is the need of hour. Chemical compounds isolated from plants are often biologically active and is attracting the attention of scientific community. Different in vitro and in vivo studies have shown a potential role in reducing the risk of cancer metastasis...
March 10, 2018: European Journal of Pharmacology
Lorenzo D Botto, Pierpaolo Mastroiacovo
Preventing neural tube defects (NTDs) easily qualifies as a high-value opportunity to improve childhood survival and health: the unmet need is significant (major preventable burden), the intervention is transformative (providing sufficient folic acid), and delivery strategies (e.g., fortification) are effective in low-resource countries. Yet, NTD prevention is lagging. Can public health surveillance help fix this problem? Critics contend that surveillance is largely unnecessary, that limited resources are best spent on interventions, and that surveillance is unrealistic in developing countries...
February 2018: Annals of the New York Academy of Sciences
Kathleen Oare Lindell, Mehdi Nouraie, Melinda J Klesen, Sara Klein, Kevin F Gibson, Daniel J Kass, Margaret Quinn Rosenzweig
Introduction: Idiopathic pulmonary fibrosis (IPF), a progressive life-limiting lung disease affects approximately 128 000 newly diagnosed individuals in the USA annually. IPF, a disease of ageing associated with intense medical and financial burden, is expected to grow in incidence globally. Median survival from diagnosis is 3.8 years, and many of these patients succumb to a rapid death within 6 months. Despite the fatal prognosis, we have found that patients and caregivers often fail to understand the poor prognosis as the disease relentlessly progresses...
2018: BMJ Open Respiratory Research
Valliappan Muthu, Sahajal Dhooria, Ritesh Agarwal, Kuruswamy Thurai Prasad, Ashutosh N Aggarwal, Digambar Behera, Inderpaul Singh Sehgal
Background: There is a paucity of literature regarding outcome of critically ill patients with tuberculosis (TB) from India. Herein, we describe our experience of patients with active TB admitted to a Respiratory Intensive Care Unit (RICU) of a tertiary care hospital. Methods: This was a retrospective analysis of all the patients admitted with active TB. The baseline clinical, demographic, ICU parameters and mortality were recorded. A multivariate logistic regression analysis was performed to identify factors predicting mortality...
February 2018: Indian Journal of Critical Care Medicine
Brett D Crist, Troy D Pashuck
OBJECTIVES: To determine the reliability of a condensed computer-based condensed patient-centered outcome score system versus multiple standard uncondensed validated outcome scores used in orthopaedic trauma. DESIGN: Prospective SETTING:: Level I trauma centerPatients/Participants: One hundred patients older than 18 years with various orthopaedic injuries were evaluated at a Level I trauma clinic. INTERVENTION: Study participants were randomly assigned to complete the paper-based and computer-based versions of the EQ-5D and Musculoskeletal Functional Assessment (MFA) at different times during the same visit...
February 20, 2018: Journal of Orthopaedic Trauma
Jennifer A Muszynski, Ron W Reeder, Mark W Hall, Robert A Berg, Thomas P Shanley, Christopher J L Newth, Murray M Pollack, David Wessel, Joseph Carcillo, Rick Harrison, Kathleen L Meert, J Michael Dean, Tammara Jenkins, Robert F Tamburro, Heidi J Dalton
OBJECTIVES: To determine RBC transfusion practice and relationships between RBC transfusion volume and mortality in infants and children treated with extracorporeal membrane oxygenation. DESIGN: Secondary analysis of a multicenter prospective observational study. SETTING: Eight pediatric institutions within the Eunice Kennedy Shriver National Institute of Child Health and Human Development's Collaborative Pediatric Critical Care Research Network...
March 6, 2018: Critical Care Medicine
Adobea Y Owusu, Amos Laar
As of December 2015 there were 37 million persons living with HIV/AIDS (PLWHAs), 70% of whom are in sub-Saharan Africa. Ghana, which contributes a relatively small number to Africa's HIV burden, has a generalised HIV epidemic. The current national prevalence is 1.47%. Agormanya, one of the HIV sentinel sites in the county and where this study was conducted, has current prevalence of 11.6%. This makes it critical to explore how persons infected with HIV manage their lives, especially in the midst of entrenched stigma and discrimination...
March 2018: African Journal of AIDS Research: AJAR
Elias Oussedik, Marc Bourcier, Jerry Tan
Rosacea is a common and chronic skin disorder with substantial impact on a patients' quality of life. Its varying phenotypic features and facial localization can adversely affect the mental health and socialization of those affected. Although there are no curative interventions, certain therapies have greater effect in improving patient quality of life. This article summarizes the associated psychosocial implications of rosacea. Several skin disease and rosacea-specific quality-of-life measures and their application in clinical care and research studies are also summarized...
April 2018: Dermatologic Clinics
Timothy Peters-Strickland, Ainslie Hatch, Anke Adenwala, Katie Atkinson, Benjamin Bartfeld
Background: The digital medicine system (DMS), a drug-device combination developed for patients with serious mental illness, integrates adherence measurement with pharmacologic treatment by embedding an ingestible sensor in a pill, allowing for information sharing among patients, health care providers (HCPs), and caregivers via a mobile interface. Studies conducted during the DMS development process aimed to minimize cognitive burden and use-related risks and demonstrated effective use of the technology...
2018: Neuropsychiatric Disease and Treatment
Annelies Wassenaar, Paul Rood, Danielle Boelen, Lisette Schoonhoven, Peter Pickkers, Mark van den Boogaard
BACKGROUND: Delirium occurs frequently in the intensive care unit and is associated with detrimental consequences. Cognitive training is a promising, nonpharmacologic, preventive intervention, but it is unknown whether cognitive training is feasible for patients in intensive care units. OBJECTIVES: To examine the feasibility for both nurses and patients of using cognitive training exercises for intensive care unit patients. METHODS: A pilot study of a set of cognitive training exercises in a large, academic intensive care unit...
March 2018: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
Mike English, Paul Mwaniki, Thomas Julius, Mercy Chepkirui, David Gathara, Paul O Ouma, Peter Cherutich, Emelda A Okiro, Robert W Snow
BACKGROUND: There is increasing focus on the strength of primary health care systems in low and middle-income countries (LMIC). There are important roles for higher quality district hospital care within these systems. These hospitals are also sources of information of considerable importance to health systems, but this role, as with the wider roles of district hospitals, has been neglected. KEY MESSAGES: As we make efforts to develop higher quality health systems in LMIC we highlight the critical importance of district hospitals focusing here on how data on hospital mortality offers value: i) in understanding disease burden; ii) as part of surveillance and impact monitoring; iii) as an entry point to exploring system failures; and iv) as a lens to examine variability in health system performance and possibly as a measure of health system quality in its own right...
March 1, 2018: BMC Medicine
Mihai Mareș, Valentina Ruxandra Moroti-Constantinescu, David W Denning
OBJECTIVE: To estimate for the first time the burden of fungal infections in Romania. METHODS: Data derived from the World Health Organization (WHO), National Institute of Statistics, Romanian public health agencies and non-profit health organizations, and published annual reports on local epidemiology were used in the present study. When no data were available, specific at-risk populations were used to calculate frequencies of serious fungal diseases, using previously published epidemiological parameters...
March 1, 2018: Journal of Fungi (Basel, Switzerland)
Naima B Benelhaj, Ann Hutchinson, Anthony M Maraveyas, Julie D Seymour, Muhammad Waqas Ilyas, Miriam J Johnson
BACKGROUND: Cancer-associated thrombosis is common. Recommended treatment is daily injected low-molecular-weight heparin for 6 months. Most studies focus on prophylaxis and treatment; few have explored the patients' experience. AIMS: To identify and synthesise the available literature concerning patients' experience of cancer-associated thrombosis. DESIGN: Systematic literature review and qualitative thematic synthesis. DATA SOURCE: MEDLINE, Embase, CINAHL, PsycINFO (until 10/2016; limited to English) were searched...
February 1, 2018: Palliative Medicine
Lesley Dunleavy, Catherine Walshe, Anna Oriani, Nancy Preston
BACKGROUND: Effective recruitment to randomised controlled trials is critically important for a robust, trustworthy evidence base in palliative care. Many trials fail to achieve recruitment targets, but the reasons for this are poorly understood. Understanding barriers and facilitators is a critical step in designing optimal recruitment strategies. AIM: To identify, explore and synthesise knowledge about recruitment barriers and facilitators in palliative care trials using the '6 Ps' of the 'Social Marketing Mix Framework'...
February 1, 2018: Palliative Medicine
Jason M Weissler, Brian L Chang, Martin J Carney, David Rengifo, Charles A Messa, David B Sarwer, Ivona Percec
The landscape of gender dysphoria has changed dramatically in recent years secondary to increased societal acceptance, legislative changes, and medical providers' increased awareness of the associated psychosocial burden associated with the diagnosis. National and global advocacy efforts, in conjunction with expanded third-party insurance coverage, have resulted in new health care opportunities for patients suffering from gender dysphoria. Delivering quality, streamlined health care to these patients requires a complex multidisciplinary approach, involving multiple medical and mental health disciplines, including plastic surgeons...
March 2018: Plastic and Reconstructive Surgery
Anna Fernández, Juan M Mendive, Sonia Conejo-Cerón, Patricia Moreno-Peral, Michael King, Irwin Nazareth, Carlos Martín-Pérez, Carmen Fernández-Alonso, Antonina Rodríguez-Bayón, Jose Maria Aiarzaguena, Carmen Montón-Franco, Antoni Serrano-Blanco, Inmaculada Ibañez-Casas, Emiliano Rodríguez-Sánchez, Luis Salvador-Carulla, Paola Bully Garay, María Isabel Ballesta-Rodríguez, Pilar LaFuente, María Del Mar Muñoz-García, Pilar Mínguez-Gonzalo, Luz Araujo, Diego Palao, María Cruz Gómez, Fernando Zubiaga, Desirée Navas-Campaña, Jose Manuel Aranda-Regules, Alberto Rodriguez-Morejón, Juan de Dios Luna, Juan Ángel Bellón
BACKGROUND: Depression is viewed as a major and increasing public health issue, as it causes high distress in the people experiencing it and considerable financial costs to society. Efforts are being made to reduce this burden by preventing depression. A critical component of this strategy is the ability to assess the individual level and profile of risk for the development of major depression. This paper presents the cost-effectiveness of a personalized intervention based on the risk of developing depression carried out in primary care, compared with usual care...
February 23, 2018: BMC Medicine
Kyu-Tae Han, Seung Ju Kim, Sun Jung Kim, Ji Won Yoo, Eun-Cheol Park
BACKGROUND: The South Korean government introduced a policy in 2 phases, in September 2005 and in January 2010, for reducing copayments for patients with critical diseases, including stroke, to prevent excessive medical expenditures and to ease economic barriers. Previous studies of the effect of this policy were focused primarily on cancer. Therefore, we investigated the relationship between this policy and 1-year mortality after surgery among patients with stroke. METHODS: We used data from the Korean National Health Insurance sampling cohort (n = 2173 in 2003-2012) and performed an interrupted time series analysis...
February 19, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Swati Agrawal, Thomas Tapmeier, Nilufer Rahmioglu, Shona Kirtley, Krina Zondervan, Christian Becker
BACKGROUND: Endometriosis is a common disorder of the reproductive age group, characterised by the presence of ectopic endometrial tissue. The disease not only causes enormous suffering to the affected women, but also brings a tremendous medical and economic burden to bear on society. There is a long lag phase between the onset and diagnosis of the disease, mainly due to its non-specific symptoms and the lack of a non-invasive test. Endometriosis can only be diagnosed invasively by laparoscopy...
February 17, 2018: International Journal of Molecular Sciences
Lingsheng Li, Judith E Nelson, Laura C Hanson, Christopher E Cox, Shannon S Carson, Emily J Chai, Kristine L Keller, James A Tulsky, Marion Danis
OBJECTIVES: Family members commonly make medical decision for patients with chronic critical illness. This study examines how family members approach this decision-making role in real time. DESIGN: Qualitative analysis of interviews with family members in the intervention arm of a randomized controlled communication trial. SETTINGS: Medical ICUs at four U.S. hospitals. PARTICIPANTS: Family members of patients with chronic critical illness (adults mechanically ventilated for ≥ 7 d and expected to remain ventilated and survive for ≥ 72 hr) who participated in the active arm of a communication intervention study...
February 16, 2018: Critical Care Medicine
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