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https://www.readbyqxmd.com/read/28931399/principles-practices-and-knowledge-of-clinicians-when-assessing-febrile-children-a-qualitative-study-in-kenya
#1
Anneka M Hooft, Kelsey Ripp, Bryson Ndenga, Francis Mutuku, David Vu, Kimberly Baltzell, Linnet N Masese, John Vulule, Dunstan Mukoko, A Desiree LaBeaud
BACKGROUND: Clinicians in low resource settings in malaria endemic regions face many challenges in diagnosing and treating febrile illnesses in children. Given the change in WHO guidelines in 2010 that recommend malaria testing prior to treatment, clinicians are now required to expand the differential when malaria testing is negative. Prior studies have indicated that resource availability, need for additional training in differentiating non-malarial illnesses, and lack of understanding within the community of when to seek care play a role in effective diagnosis and treatment...
September 20, 2017: Malaria Journal
https://www.readbyqxmd.com/read/28930183/substituting-sodium-hydrosulfite-with-sodium-metabisulfite-improves-long-term-stability-of-a-distributable-paper-based-test-kit-for-point-of-care-screening-for-sickle-cell-anemia
#2
Kian Torabian, Dalia Lezzar, Nathaniel Z Piety, Alex George, Sergey S Shevkoplyas
Sickle cell anemia (SCA) is a genetic blood disorder that is particularly lethal in early childhood. Universal newborn screening programs and subsequent early treatment are known to drastically reduce under-five SCA mortality. However, in resource-limited settings, cost and infrastructure constraints limit the effectiveness of laboratory-based SCA screening programs. To address this limitation our laboratory previously developed a low-cost, equipment-free, point-of-care, paper-based SCA test. Here, we improved the stability and performance of the test by replacing sodium hydrosulfite (HS), a key reducing agent in the hemoglobin solubility buffer which is not stable in aqueous solutions, with sodium metabisulfite (MS)...
September 20, 2017: Biosensors
https://www.readbyqxmd.com/read/28927676/a-pilot-study-to-expand-treatment-of-chronic-hepatitis-c-in-resource-limited-settings
#3
REVIEW
Poonam Mathur, Emily Comstock, Edward McSweegan, Natalia Mercer, Nongthombam Suraj Kumar, Shyamasundaran Kottilil
The past five years have seen a revolution in the treatment of chronic hepatitis C, as short duration oral regimens of direct-acting antiviral drugs (DAAs), with nearly 100% cure rates for all genotypes, have replaced longer courses of ribavirin and injected interferon. Although initially very expensive, these DAAs are now becoming available in generic equivalents in countries with large numbers of chronically infected people, such as India. However, a number of obstacles may hinder the delivery of these drugs in resource-limited settings, including lack of access to diagnostic testing and the restriction of treatment to a small number of medical specialists...
September 16, 2017: Antiviral Research
https://www.readbyqxmd.com/read/28924602/factors-defining-expertise-in-screening-colonoscopy
#4
Kinesh Patel, Anna Pinto, Omar Faiz, Matt Rutter, Siwan Thomas-Gibson
BACKGROUND AND STUDY AIMS:  There is very little literature defining characteristics of expert endoscopists. It is hypothesised that previously undetermined human factors may correlate with high performance in screening colonoscopists. The aim of this study was to determine factors contributing towards expertise in screening colonoscopy. MATERIALS AND METHODS:  A focus group was used to hypothesise skills considered to be relevant to high performance in colonoscopy...
September 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28919246/filtered-sunlight-solar-powered-phototherapy-and-other-strategies-for-managing-neonatal-jaundice-in-low-resource-settings
#5
Tina M Slusher, Louise Tina Day, Tolulope Ogundele, Nick Woolfield, Joseph Aderinsola Owa
Challenges in treating severe neonatal jaundice in low and middle-income country settings still exist at many levels. These include: a lack of awareness of causes and prevention by families, communities and even sometimes health care professionals; insufficient, ineffective, high quality affordable diagnostic and therapeutic options; limited availability of rehabilitation provision for kernicterus. Collectively these challenges lead to an unacceptably high global morbidity and mortality from severe neonatal jaundice...
September 15, 2017: Early Human Development
https://www.readbyqxmd.com/read/28916508/development-of-a-whole-slide-imaging-system-on-smartphones-and-evaluation-with-frozen-section-samples
#6
Hong Yu, Feng Gao, Liren Jiang, Shuoxin Ma
BACKGROUND: The aim was to develop scalable Whole Slide Imaging (sWSI), a WSI system based on mainstream smartphones coupled with regular optical microscopes. This ultra-low-cost solution should offer diagnostic-ready imaging quality on par with standalone scanners, supporting both oil and dry objective lenses of different magnifications, and reasonably high throughput. These performance metrics should be evaluated by expert pathologists and match those of high-end scanners. OBJECTIVE: The aim was to develop scalable Whole Slide Imaging (sWSI), a whole slide imaging system based on smartphones coupled with optical microscopes...
September 15, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28912165/holistic-care-of-complicated-tuberculosis-in-healthcare-settings-with-limited-resources
#7
Trevor Duke, Sharon Kasa Tom, Harry Poka, Henry Welch
In recent years, most of the focus on improving the quality of paediatric care in low-income countries has been on improving primary care using the Integrated Management of Childhood Illness, and improving triage and emergency treatment in hospitals aimed at reducing deaths in the first 24 hours. There has been little attention paid to improving the quality of care for children with chronic or complex diseases. Children with complicated forms of tuberculosis (TB), including central nervous system and chronic pulmonary TB, provide examples of acute and chronic multisystem paediatric illnesses that commonly present to district-level and second-level referral hospitals in low-income countries...
September 14, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28910284/caretakers-perspectives-of-paediatric-tb-and-implications-for-care-seeking-behaviours-in-southern-mozambique
#8
Carolina Mindu, Elisa López-Varela, Yara Alonso-Menendez, Yolanda Mausse, Orvalho Joaquim Augusto, Kizito Gondo, Jose Múñoz, Jahit Sacarlal, Alberto L García-Basteiro, Pedro L Alonso, Khátia Munguambe
BACKGROUND: Tuberculosis (TB) remains an important public health concern, especially in poorly resourced settings. TB diagnosis is challenging, particularly for children, who are the most vulnerable to its' impacts. Lack of knowledge and awareness of the disease compromises prompt diagnosis and treatment compliance. OBJECTIVE: To gain insights regarding caretakers' knowledge of the aetiology and prevention of paediatric TB in southern Mozambique, to describe their care-seeking behaviours and to assess the acceptability of diagnostic procedures...
2017: PloS One
https://www.readbyqxmd.com/read/28904186/stool-culture-for-the-diagnosis-of-pulmonary-tuberculosis-in-children
#9
Elisabetta Walters, Anne-Marie Demers, Marieke M van der Zalm, Andrew Whitelaw, Megan Palmer, Corné Bosch, Heather R Draper, Robert P Gie, Anneke C Hesseling
Bacteriological confirmation of Mycobacterium tuberculosis is achieved in the minority of young children with tuberculosis (TB), as specimen collection is resource-intensive and respiratory secretions are mostly paucibacillary, leading to limited sensitivity of available diagnostic tests. Although molecular tests are increasingly available globally, mycobacterial culture remains the gold standard for diagnosis and determination of drug susceptibility and is more sensitive than molecular methods for paucibacillary TB...
September 13, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28901887/microcytosis-is-associated-with-low-cognitive-outcomes-in-healthy-2-year-olds-in-a-high-resource-setting
#10
Elaine K McCarthy, Mairead E Kiely, Geraldine Hannon, Caroline Ahearne, Louise C Kenny, Jonathan O'B Hourihane, Alan D Irvine, Deirdre M Murray
Fe deficiency in early childhood is associated with long-term consequences for cognitive, motor and behavioural development; however explorations in healthy children from low risk, high-resource settings have been limited. We aimed to explore associations between Fe status and neurodevelopmental outcomes in low risk, healthy 2-year-olds. This study was a secondary analysis of a nested case-control subgroup from the prospective, maternal-infant Cork Babies after Screening for Pregnancy Endpoints: Evaluating the Longitudinal Impact using Neurological and Nutritional Endpoints (BASELINE) Birth Cohort Study...
September 2017: British Journal of Nutrition
https://www.readbyqxmd.com/read/28898390/comprehensive-geriatric-assessment-for-older-adults-admitted-to-hospital
#11
REVIEW
Graham Ellis, Mike Gardner, Apostolos Tsiachristas, Peter Langhorne, Orlaith Burke, Rowan H Harwood, Simon P Conroy, Tilo Kircher, Dominique Somme, Ingvild Saltvedt, Heidi Wald, Desmond O'Neill, David Robinson, Sasha Shepperd
BACKGROUND: Comprehensive geriatric assessment (CGA) is a multi-dimensional, multi-disciplinary diagnostic and therapeutic process conducted to determine the medical, mental, and functional problems of older people with frailty so that a co-ordinated and integrated plan for treatment and follow-up can be developed. This is an update of a previously published Cochrane review. OBJECTIVES: We sought to critically appraise and summarise current evidence on the effectiveness and resource use of CGA for older adults admitted to hospital, and to use these data to estimate its cost-effectiveness...
September 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28895526/molecular-testing-for-lynch-syndrome-in-people-with-colorectal-cancer-systematic-reviews-and-economic-evaluation
#12
Tristan Snowsill, Helen Coelho, Nicola Huxley, Tracey Jones-Hughes, Simon Briscoe, Ian M Frayling, Chris Hyde
BACKGROUND: Inherited mutations in deoxyribonucleic acid (DNA) mismatch repair (MMR) genes lead to an increased risk of colorectal cancer (CRC), gynaecological cancers and other cancers, known as Lynch syndrome (LS). Risk-reducing interventions can be offered to individuals with known LS-causing mutations. The mutations can be identified by comprehensive testing of the MMR genes, but this would be prohibitively expensive in the general population. Tumour-based tests - microsatellite instability (MSI) and MMR immunohistochemistry (IHC) - are used in CRC patients to identify individuals at high risk of LS for genetic testing...
September 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28895298/two-decades-of-dendrimers-as-versatile-mri-agents-a-tale-with-and-without-metals
#13
REVIEW
Michael T McMahon, Jeff W M Bulte
Dendrimers or dendritic polymers are a class of compounds with great potential for nanomedical use. Some of their properties, including their rigidity, low polydispersity and the ease with which their surfaces can be modified make them particularly well suited for use as MRI diagnostic or theranostic agents. For the past 20 years, researchers have recognized this potential and refined dendrimer formulations to optimize these nanocarriers for a host of MRI applications, including blood pool imaging agents, lymph node imaging agents, tumor-targeted theranostic agents and cell tracking agents...
September 11, 2017: Wiley Interdisciplinary Reviews. Nanomedicine and Nanobiotechnology
https://www.readbyqxmd.com/read/28888387/scurvy-at-the-agricultural-transition-in-the-atacama-desert-ca-3600-3200-bp-nutritional-stress-at-the-maternal-foetal-interface
#14
Anne Marie E Snoddy, Siân E Halcrow, Hallie R Buckley, Vivien G Standen, Bernardo T Arriaza
Studies of contemporary populations have demonstrated an association between decreased dietary diversity due to resource scarcity or underutilization and an increase in diseases related to poor micronutrient intake. With a reduction of dietary diversity, it is often the women and children in a population who are the first to suffer the effects of poor micronutrient status. Scurvy, a disease of prolonged vitamin C deficiency, is a micronutrient malnutrition disorder associated with resource scarcity, low dietary diversity, and/or dependence on high carbohydrate staple-foods...
September 2017: International Journal of Paleopathology
https://www.readbyqxmd.com/read/28881605/low-pca3-expression-is-a-marker-of-poor-differentiation-in-localized-prostate-tumors-exploratory-analysis-from-12-076-patients
#15
Mohammed Alshalalfa, Gerald W Verhaegh, Ewan A Gibb, Maria Santiago-Jiménez, Nicholas Erho, Jennifer Jordan, Kasra Yousefi, Lucia L C Lam, Tyler Kolisnik, Jijumon Chelissery, Roland Seiler, Ashley E Ross, R Jeffrey Karnes, Edward M Schaeffer, Tamara T Lotan, Robert B Den, Stephen J Freedland, Elai Davicioni, Eric A Klein, Jack A Schalken
BACKGROUND: Prostate cancer antigen 3 (PCA3) is a prostate cancer diagnostic biomarker that has been clinically validated. The limitations of the diagnostic role of PCA3 in initial biopsy and the prognostic role are not well established. Here, we elucidate the limitations of tissue PCA3 to predict high grade tumors in initial biopsy. RESULTS: PCA3 has a bimodal distribution in both biopsy and radical prostatectomy (RP) tissues, where low PCA3 expression was significantly associated with high grade disease (p<0...
August 1, 2017: Oncotarget
https://www.readbyqxmd.com/read/28879175/computer-vision-malaria-diagnostic-systems-progress-and-prospects
#16
REVIEW
Joseph Joel Pollak, Arnon Houri-Yafin, Seth J Salpeter
Accurate malaria diagnosis is critical to prevent malaria fatalities, curb overuse of antimalarial drugs, and promote appropriate management of other causes of fever. While several diagnostic tests exist, the need for a rapid and highly accurate malaria assay remains. Microscopy and rapid diagnostic tests are the main diagnostic modalities available, yet they can demonstrate poor performance and accuracy. Automated microscopy platforms have the potential to significantly improve and standardize malaria diagnosis...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28879161/implementation-of-quality-management-systems-and-progress-towards-accreditation-of-national-tuberculosis-reference-laboratories-in-africa
#17
Heidi Albert, Jean de Dieu Iragena, Kekeletso Kao, Donatelle Erni, Teferi Mekonen, Philip C Onyebujoh
BACKGROUND: Laboratory services are essential at all stages of the tuberculosis care cascade, from diagnosis and drug resistance testing to monitoring response to treatment. Enabling access to quality services is a challenge in low-resource settings. Implementation of a strong quality management system (QMS) and laboratory accreditation are key to improving patient care. OBJECTIVES: The study objective was to determine the status of QMS implementation and progress towards accreditation of National Tuberculosis Reference Laboratories (NTRLs) in the African Region...
2017: African Journal of Laboratory Medicine
https://www.readbyqxmd.com/read/28875696/surface-enhanced-raman-spectroscopy-based-sandwich-immunoassays-for-multiplexed-detection-of-zika-and-dengue-viral-biomarkers
#18
Maria Sánchez-Purrà, Marc Carré-Camps, Helena de Puig, Irene Bosch, Lee Gehrke, Kimberly Hamad-Schifferli
Zika and dengue are mosquito-borne diseases that present similar nonspecific symptoms but possess dramatically different outcomes. The first line of defense in epidemic outbreaks are rapid point-of-care diagnostics. Because many outbreaks occur in areas that are resource poor, assays that are easy to use, inexpensive, and require no power have become invaluable in patient treatment, quarantining, and surveillance. Paper-based sandwich immunoassays such as lateral flow assays (LFAs) are attractive as point-of-care solutions as they have the potential for wider deployability than lab-based assays such as PCR...
September 6, 2017: ACS Infectious Diseases
https://www.readbyqxmd.com/read/28855233/a-mobile-based-community-health-management-information-system-for-community-health-workers-and-their-supervisors-in-2-districts-of-zambia
#19
Godfrey Biemba, Boniface Chiluba, Kojo Yeboah-Antwi, Vichaels Silavwe, Karsten Lunze, Rodgers K Mwale, Scott Russpatrick, Davidson H Hamer
INTRODUCTION: Effective community health management information systems (C-HMIS) are important in low-resource countries that rely heavily on community-based health care providers. Zambia currently lacks a functioning C-HMIS to provide real-time, community-based health information from community health workers (CHWs) to health center staff and higher levels of the health system. PROGRAM DESCRIPTION: We developed a C-HMIS mobile platform for use by CHWs providing integrated community case management (iCCM) services and their supervisors to address challenges of frequent stock-outs and inadequate supportive supervision of iCCM-trained CHWs...
August 30, 2017: Global Health, Science and Practice
https://www.readbyqxmd.com/read/28852868/prevalence-and-predictors-of-anxiety-disorders-amongst-low-income-pregnant-women-in-urban-south-africa-a-cross-sectional-study
#20
Thandi van Heyningen, Simone Honikman, Landon Myer, Michael N Onah, Sally Field, Mark Tomlinson
Anxiety is highly prevalent in many populations; however, the burden of anxiety disorders amongst pregnant women in low-resource settings is not well documented. We investigated the prevalence and predictors of antenatal anxiety disorders amongst low-income women living with psychosocial adversity. Pregnant women were recruited from an urban, primary level clinic in Cape Town, South Africa. The Mini-International Neuropsychiatric Interview diagnostic interview assessed prevalence of anxiety disorders. Four self-report questionnaires measured psychosocial characteristics...
August 29, 2017: Archives of Women's Mental Health
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