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case-based scenario

Katsiaryna Holl, Christophe Sauboin, Emanuele Amodio, Paolo Bonanni, Giovanni Gabutti
BACKGROUND: Varicella is a highly infectious disease with a significant public health and economic burden, which can be prevented with childhood routine varicella vaccination. Vaccination strategies differ by country. Some factors are known to play an important role (number of doses, coverage, dosing interval, efficacy and catch-up programmes), however, their relative impact on the reduction of varicella in the population remains unclear. This paper aims to help policy makers prioritise the critical factors to achieve the most successful vaccination programme with the available budget...
October 21, 2016: BMC Public Health
Ashleigh A McGirr, Kevin L Schwartz, Upton Allen, Melinda Solomon, Beate Sander
Background Children with cystic fibrosis (CF) are at higher risk of severe respiratory syncytial virus (RSV) infection, which can lead to a decline in lung function. A monoclonal antibody, palivizumab (PMB), effectively prevents RSV hospitalizations; however, the high cost of PMB, approximately C$10,000 per patient per RSV season, limits its widespread use. We assess the cost-effectiveness of PMB prophylaxis in CF children less than 2 years of age from the Canadian healthcare payer's perspective. Methods In 2014, a Markov cohort model of CF disease and infant RSV infections in the Canadian setting was developed based on literature data...
October 21, 2016: Human Vaccines & Immunotherapeutics
Janine Naß, Mita Banerjee, Thomas Efferth, Anita Wohlmann
Illness is a disruptive experience that requires high-quality care. The best evidence-based medical treatment risks losing some of its efficacy, however, when patients feel misunderstood when faced with the complexity of their experiences. They might stop treatment, refuse to disclose relevant information or seek unsound alternatives. A narrative-based approach to health care understands the patient's case history as a narrative that can be read or analyzed like a story. In other words, this approach honors individual illness experiences through the stories that patients tell...
October 20, 2016: International Journal of Clinical Pharmacy
Michele Antonio De Riggi, Nicola Rocco, Giulio Gherardini, Emanuela Esposito, Massimiliano D'Aiuto
INTRODUCTION: One-stage implant-based breast reconstruction using titanium-coated polypropylene mesh is a novel approach widely used in Europe. Complication rates in breast reconstruction with the use of titanium-coated meshes seem to be comparable to those in patients with implant-based breast reconstruction alone. However, the use of synthetic meshes in implant-based breast reconstructive surgery leads to new clinical scenarios with the need for the breast surgeon to face new complications...
October 20, 2016: Aesthetic Plastic Surgery
Damian Hoy, Salanieta T Saketa, Roy Roger Maraka, Alison Sio, Ian Wanyeki, Pascal Frison, Divi Ogaoga, Dennie Iniakawala, Cynthia Joshua, Sala Duituturaga, Christelle Lepers, Adam Roth, Paul White, Yvan Souares
Mass gatherings pose public health challenges to host countries, as they can cause or exacerbate disease outbreaks within the host location or elsewhere. In July 2012, the 11th Festival of Pacific Arts (FOPA), a mass gathering event involving 22 Pacific island states and territories, was hosted by Solomon Islands. An enhanced syndromic surveillance (ESS) system was implemented for the event. Throughout the capital city, Honiara, 15 sentinel sites were established and successfully took part in the ESS system, which commenced one week before the FOPA (25 June) and concluded eight days after the event (22 July)...
July 2016: Western Pacific Surveillance and Response Journal: WPSAR
M Corvaro, S Gehen, K Andrews, R Chatfield, C Arasti, J Mehta
Acute systemic (oral, dermal, inhalation) toxicity testing of agrochemical formulations (end-use products) is mainly needed for Classification and Labelling (C&L) and definition of personal protection equipment (PPE). A retrospective analysis of 225 formulations with available in vivo data showed that: A) LD50/LC50 values were above limit doses in <20.2% via oral route but only in <1% and <2.4% of cases via dermal and inhalation route, respectively; B) for each formulation the acute oral toxicity is always equal or greater than the Acute Toxicity Estimate (ATE) via the other two routes; C) the GHS (Global Harmonised System) computational method based on ATE, currently of limited acceptance, has very high accuracy and specificity for prediction of agrochemical mixture toxicity according to the internationally established classification thresholds...
October 17, 2016: Regulatory Toxicology and Pharmacology: RTP
Lauren Beswick, Bei Ye, Daniel R van Langenberg
INTRODUCTION: Concurrent cytomegalovirus (CMV) in inflammatory bowel disease-related colitis is an important yet complex clinical scenario associated with high rates of colectomy and other morbidity. This review aimed to examine the literature to produce a comprehensive diagnostic and treatment algorithm for the management of CMV in patients with colitis. METHODS: A systematic literature review was conducted via PubMed/Medline databases until August 31, 2015, using multiple keywords in English language and where original data only presented...
October 18, 2016: Inflammatory Bowel Diseases
Ronald E Domen, Kristen Johnson, Richard Michael Conran, Robert D Hoffman, Miriam D Post, Jacob J Steinberg, Mark D Brissette, Dita A Gratzinger, Cindy B McCloskey, Patricia M Raciti, Cory Anthony Roberts, Amyn M Rojiani, Suzanne Zein-Eldin Powell
CONTEXT: -Professionalism issues in residency training can be difficult to assess and manage. Generational or role-based differences may also exist between faculty and residents as to what constitutes unprofessional behavior and how to manage it. OBJECTIVE: -To examine and compare how faculty and residents would approach the same 5 case scenarios detailing various aspects of unprofessional behavior. DESIGN: -Five case scenarios highlighting various unprofessional behaviors were presented in a workshop at an annual meeting of pathology department chairs, residency program directors, and undergraduate pathology medical educators (ie, pathologists involved in medical student pathology education)...
October 20, 2016: Archives of Pathology & Laboratory Medicine
Anna L Funk, Flavie Luce Goutard, Eve Miguel, Mathieu Bourgarel, Veronique Chevalier, Bernard Faye, J S Malik Peiris, Maria D Van Kerkhove, Francois Louis Roger
Nearly 4 years after the first report of the emergence of Middle-East respiratory syndrome Coronavirus (MERS-CoV) and nearly 1800 human cases later, the ecology of MERS-CoV, its epidemiology, and more than risk factors of MERS-CoV transmission between camels are poorly understood. Knowledge about the pathways and mechanisms of transmission from animals to humans is limited; as of yet, transmission risks have not been quantified. Moreover the divergent sanitary situations and exposures to animals among populations in the Arabian Peninsula, where human primary cases appear to dominate, vs...
2016: Frontiers in Veterinary Science
Andrew Keller, Christian Gericke, Jennifer A Whitty, John Yaxley, Boon Kua, Geoff Coughlin, Troy Gianduzzo
BACKGROUND AND OBJECTIVES: The Göteborg randomised population-based prostate cancer screening trial demonstrated that prostate-specific antigen (PSA)-based screening reduces prostate cancer deaths compared with an age-matched control group. Utilising the prostate cancer detection rates from this study, we investigated the clinical and cost effectiveness of a similar PSA-based screening strategy for an Australian population of men aged 50-69 years. METHODS: A decision model that incorporated Markov processes was developed from a health system perspective...
October 18, 2016: Applied Health Economics and Health Policy
Matthew H Holden, Stephen P Ellner
Despite major advances in quantitative approaches to natural resource management, there has been resistance to using these tools in the actual practice of managing ecological populations. Given a managed system and a set of assumptions, translated into a model, optimization methods can be used to solve for the most cost-effective management actions. However, when the underlying assumptions are not met, such methods can potentially lead to decisions that harm the environment and economy. Managers who develop decisions based on past experience and judgment, without the aid of mathematical models, can potentially learn about the system and develop flexible management strategies...
July 2016: Ecological Applications: a Publication of the Ecological Society of America
Scott Creel, Jassiel M'soka, Egil Dröge, Eli Rosenblatt, Matthew S Becker, Wigganson Matandiko, Twakundine Simpamba
While trophy hunting provides revenue for conservation, it must be carefully managed to avoid negative population impacts, particularly for long-lived species with low natural mortality rates. Trophy hunting has had negative effects on lion populations throughout Africa, and the species serves as an important case study to consider the balance of costs and benefits, and to consider the effectiveness of alternative strategies to conserve exploited species. Age-restricted harvesting is widely recommended to mitigate negative effects of lion hunting, but this recommendation was based on a population model parameterized with data from a well-protected and growing lion population...
October 2016: Ecological Applications: a Publication of the Ecological Society of America
Christine H Stortini, Denis Chabot, Nancy L Shackell
We have learned much about the impacts of warming on the productivity and distribution of marine organisms, but less about the impact of warming combined with other environmental stressors, including oxygen depletion. Also, the combined impact of multiple environmental stressors requires evaluation at the scales most relevant to resource managers. We use the Gulf of St. Lawrence, Canada, characterized by a large permanently hypoxic zone, as a case study. Species Distribution Models were used to predict the impact of multiple scenarios of warming and oxygen depletion on the local density of three commercially and ecologically important species...
October 18, 2016: Global Change Biology
Antonino Carbone, Annunziata Gloghini, Arnaldo Caruso, Paolo De Paoli, Riccardo Dolcetti
The pathogenesis of classical Hodgkin lymphoma (cHL) is still enigmatic, largely because its tumor cells, the so-called Hodgkin and Reed-Stenberg (HRS) cells, invariably reside in a prominent reactive microenvironment, are rare and therefore difficult to analyze. On the other hand, the broadly investigated cHL-derived cell lines are not unequivocally considered as suitable and representative models for this puzzling disease. Based on current knowledge, it appears that the cross talk between the tumour cells and the reactive infiltrate of the microenvironment is complex and that multiple mechanisms occur, making cHL a very heterogeneous disease...
October 17, 2016: International Journal of Cancer. Journal International du Cancer
Tauheed A Farooqui, Marguerite A Renouf, Steven J Kenway
Urban areas will need to pursue new water servicing options to ensure local supply security. Decisions about how best to employ them are not straightforward due to multiple considerations and the potential for problem shifting among them. We hypothesise that urban water metabolism evaluation based a water mass balance can help address this, and explore the utility of this perspective and the new insights it provides about water servicing options. Using a water mass balance evaluation framework, which considers direct urban water flows (both 'natural' hydrological and 'anthropogenic' flows), as well as water-related energy, we evaluated how the use of alternative water sources (stormwater/rainwater harvesting, wastewater/greywater recycling) at different scales influences the 'local water metabolism' of a case study urban development...
October 6, 2016: Water Research
Jason K Hou, Christoph Gasche, Noam Z Drazin, Sarah Alandra Weaver, Orna G Ehrlich, Ridhima Oberai, Sophie Zapala, Corey A Siegel, Gil Melmed
BACKGROUND: Anemia is a common complication among patients with inflammatory bowel diseases (IBD) and is associated with high rates of IBD-related complications, resource utilization, and impaired quality of life. Despite practice guidelines for anemia in patients with IBD, gaps remain in the perceptions of anemia among health care providers. The aims of this study were to identify gaps in care and to develop a care pathway for anemia in patients with IBD. METHODS: The Crohn's & Colitis Foundation of America anemia care pathway was developed by a committee using principles of cognitive task analysis...
September 30, 2016: Inflammatory Bowel Diseases
Brett K Beaulieu-Jones, Casey S Greene
Patient interactions with health care providers result in entries to electronic health records (EHRs). EHRs were built for clinical and billing purposes but contain many data points about an individual. Mining these records provides opportunities to extract electronic phenotypes, which can be paired with genetic data to identify genes underlying common human diseases. This task remains challenging: high quality phenotyping is costly and requires physician review; many fields in the records are sparsely filled; and our definitions of diseases are continuing to improve over time...
October 12, 2016: Journal of Biomedical Informatics
Sylvie Deuffic-Burban, Jérôme Boursier, Vincent Leroy, Yazdan Yazdanpanah, Laurent Castera, Philippe Mathurin
BACKGROUND AND AIMS: This study quantifies the impact of different rules for access to treatment, ranging from targeted therapy in patients with ⩾F3 in Italy, ⩾ severe F2 in France, and universal therapy in UK, using noninvasive diagnostic tests of fibrosis to determine targeted therapy. METHODS: A country-specific Markov model predicts outcomes with targeted and universal interferon-free therapy vs. no treatment in the three countries. Targeted therapy was initiated in patients ⩾F2 (F2-scenario) or ⩾F3 (F3-scenario) evaluated by noninvasive diagnostic tests according to the real stage of fibrosis...
October 12, 2016: Journal of Hepatology
Sarkis Kiramijyan, Romain Didier, Edward Koifman, Smita I Negi
BACKGROUND: It has become challenging for cardiovascular fellows-in-training (FIT) to determine which national cardiovascular conference (NCC) to attend given the broad range of meetings and the breadth of information offered. The aim of this study was to report our own experiences of the utility and individual strengths of the NCCs and to further understand the interventional cardiology (IC) FITs' viewpoint regarding the benefits of the individual NCCs. METHODS: A survey was formulated with questions and scenarios regarding topics deemed to be of highest importance for an IC-FIT...
October 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Yohannes Yihdego, Len Drury
The efficient use of water resources in arid region has become highly relevant in the evaluation and mining planning, since the exploration phase to closure. The objective of the numerical groundwater model was to assess the potential for groundwater extraction to meet mine water demand from one of the driest area in the world. Numerical groundwater models were used to assess groundwater resource. Modelling was undertaken using MODFLOW-SURFACT code, an advanced MODFLOW based code, within the framework of Visual MODFLOW version 4...
November 2016: Environmental Monitoring and Assessment
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