International Medical Publisher Journals (iMedPub)
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The political economy of ebola virus disease (EVD) in West African countries
Get PDFAbstract:The Ebola virus disease (EVD) was first reported to have been identified in Africa in 1976 when it occurred in south Sudan and Zaire (now Democratic Republic of Congo). Its first occurrence in West Africa was in a 1994 lone infection of an ethnologist in Côte d’Ivoire but in 2014, there was an outbreak in West Africa stemming from an index case in Guinea. The outbreak is still ongoing. The EVD is one of the filoviral hemorrhagic fevers. This paper examined the political economies in West African nations in relation to the management of their natural resources and to the resultant susceptibility to an infectious disease outbreak. It reviewed the African Development Bank Reports from 2007 to 2011 and also searched Google Scholar database using conflict and natural resource as search terms. The findings from this study showed that abundant natural resources did not translate to improved economic opportunities but usually a downturn in economic resources and poor governance riddled by civil conflicts over the regions of natural resources. The foundational issues in the current outbreak lie in the political economies of the West African countries. The numerous conflicts have left the West African nations susceptible to preventable diseases like EVD. The findings also suggest that changes in climatic conditions around the West African country of Guinea enabled the Ebola virus to come in contact with humans. Further, the author suggests that governments of West African nations should develop a transborder framework for regions around natural resources and those governments should be more transparent with the people they rule. In addition, individuals and communities should take ownership in the prevention and control of EVD.Key words: Ebola Virus Disease (EVD); filoviral hemorrhagic fevers; outbreak; West Africa; natural resource, Political Economy; civil conflicts; ownership; Governance; Guinea
Hepatic Function in Obese Adolescents and the relationship with hepatic steatosis.
Get PDFIntroduction: The prevalence of obesity has increased at an impressive rate over the past years, especially among children and adolescents. Many are the alterations that may be found in obese individuals; hepatic steatosis is one of them. The aim of this study was to analyze biochemical and radiographic parameters in overweight and obese adolescents and relate these parameters to anthropometric data so that the hepatic dysfunction could be characterized. Methods: Anthropometric and laboratory data, as well as the nutritional status of the patients, were evaluated. Besides laboratory exams, a liver ultrasound scan was performed to confirm hepatic alterations. Results: A total of 41 patients were recruited and 6 out of that total were excluded due to the fact they were eutrophic. The remaining group was compared with a control group of 12 patients. The overweight/obese group had higher values of AST and ALT in relation to the control group. There were no alterations associated with biochemical parameters regarding anthropometric variables. A significant difference between the BMI of patients with and without steatosis could be observed. Conclusions: There was a predominance of hepatic steatosis in the overweight/obese group, which was associated with the increase in GGT and ALT levels
Cultural case: sexual orientation as bias in health care practices
No full textBackgorund. The objective was to identify the perception of Lesbian, Gay, Bisexual, and Transgender people about the implications of non-heterosexual sexual orientation in health care practices. Methods. We adopted a qualitative research by conducting interviews with 30 gay and bisexual individuals recruited in the municipality of Juazeiro do Norte, Brazil, from the snowball technique in 2013. The data was categorized and analyzed based on the Theory of Diversity and Universality of Cultural Care. Findings. It was found that sexual minorities have encountered prejudiced and discriminatory professional practices in health care as a result of heteronormative cultural representations, which reflect difficulties in accessibility to the services. The exclusionary cultural care results in poor self-care and linked to sexually transmitted diseases, low attendance and distance of health services for gay and bisexual men. Conclusion. It is believed that the influence of heteronormative cultural conceptions in services imply deficit of self-care by the group
The changing microbiological and antimicrobial susceptibility profile of cerebrospinal fluid organism isolates in a teaching hospital, Tangerang, Indonesia
Get PDFCentral nervous system (CNS) infections have become serious problems that contribute to morbidity and mortality in developing countries. In the recent years, antimicrobial resistance has arisen parallel with the changing trend of infectious pathogens, which resulted in the unavailability of an ideal antimicrobial agent. This study was designed to evaluate the central nervous system pathogens and their susceptibility profile using routine microbiological data. The data of CSF culture and susceptibility testing were collected from January 2010 to August 2015. The majority of eligible sample 68/99 (68.7%) had history of neurosurgical procedures. The most common pathogens isolated were coagulase negative staphylococci (CoNS) 39/99 (39.4%) followed by Acinetobacter baumanii 10/99 (10.1%), Pseudomonas aeruginosa 7/99 (7.1%), Sphingomonas paucimobilis 5/99 (5.0%), and Aeromonas salmonocida 4/99 (4.0%). Almost of all Gram positive cocci were susceptible to tigecycline, linezolide, vancomycin, and trimethoprim/sulfamethoxazole. Most Gram negative bacilli (GNB) in this study were multi-drug resistant with high susceptibility level to amikacin, tigecycline, and trimethoprim/sulfamethoxazole. The overall susceptibility testing to cephalosporins was low, ranging 34.2% to 58.5%. The susceptibility to several antifungal remained high for Candida spp. and Cryptococcus neoformans. The present study notifies the changing pathogens trend of CNS infections along with their antimicrobial susceptibility level in our hospital. There is a need of local antimicrobial recommendation and surveillance system to control the usage of antimicrobial and selection of empirical antimicrobial therapy
Neuropsychiatric symptoms and associated caregiver stress in geriatric patients with Parkinson’s disease
Get PDFObjectives: In Parkinson´s disease, researchers are becoming increasingly aware of the need to include the assessment of behavioural and psychological symptoms as important outcome measures in clinical trials. Besides, clinicians are starting to recognise the need to identify and manage these symptoms in addition to the motor ones. Our objective is to explore the presence of neuropsychiatric symptoms in geriatric patients with Parkinson and the associated distress in their caregivers. Methods: 100 patients with PD ageing 75 years old or more (50 PD without dementia and 50 PD Dementia (PDD) were assessed using the 10-item Neuropsychiatric Inventory-questionnaire (NPI-Q), and the NPI Caregiver Distress Scale (NPI-D). Results: The mean total NPI score was 12.9. At least one neuropsychiatric symptom was present in more than 80% of participants. Within PDD patients about 89% suffered at least one NPI symptom, 70% suffered at least 2 symptoms and one of those symptoms had an intensity scoring 4 of higher in more than 50%. Numbers in PD patients without dementia were significantly lower, though more than 50% of patients had at least 2 symptoms. The most frequent symptom was depression, followed by apathy, anxiety, depression and hallucinations. Antiparkinsonian agents can exacerbate psychotic symptoms. Nearly 60% of caregivers reported suffering a moderate to severe level of stress due to these symptoms. Symptoms causing more stress were agitation/aggression followed by hallucinations and irritability/lability. Conclusions: Neuropsychiatric symptoms are frequent in geriatric patients with PD –specially in patients with PDD– and lead to moderate to severe caregiver distress
Rabdomiolisis secundaria al uso de electroestimulación muscular
Get PDFPresentamos el caso de una mujer joven que desarrolló una rabdomiolisis tras someterse a electroestimulación con fines estéticos. La rabdomiolisis es una condición infrecuente en personas jóvenes y no se han descrito más que un caso secundario al uso prolongado de este tipo de dispositivos de electroestimulación
Role of advanced simulation in undergraduate and postgraduate medical education
Get PDFMedical simulations are effective education complements for medical training, demonstrating effective learning, level of participation, and improvement in knowledge, skills and attitudes. In undergraduate medical education, simulation provides the potential for valid, cost-benefit teaching and assessment of clinical skills, especially clinical reasoning skills, bridging the gap between theory and practice. Simulation as a training tool in postgraduate medical training is a practical method to provide a kind of educational realistic significance for practicing specialty in order to improve quality of care and patient safety. In particular, simulation is an excellent opportunity to implement reports of security which can be considered a true strategy in order to minimize clinical risk and ensure appropriate levels of quality in daily clinical practice
Characterisation of Clinical Epidemiological Profie of Patients with Facial Lipoatrophy, Living with Aids, Submitted to Facial Filling with Polymethylmethacrylate
No full textBackground : Patients living with AIDS and on Antiretroviral Therapy are likely to develop Lipodystrophy syndrome. Soft tissue filler with Polymethylmethacrylate is an option to treat Facial Lipoatrophy. It is a small procedure performed on an outpatient basis. Aimet to characterise the clinical and epidemiological profile of patients living with AIDS, who developed Facial Lipoatrophy and who underwent facial filler with Polymethylmethacrylate.Methods: A descriptive, observational study with 63 patients with AIDS, Facial Lipoatrophy, submitted to facial filling with Polymethylmethacrylate. As sources for data collection, data were analysed from records, and the Protocol Lipodystrophy Clinic of the Municipal STD/AIDS and Viral Hepatitis of São Bernardo do Campo, in São Paulo, Brazil, of patients treated between January and July 2009.Results: On average, HIV was diagnosed for 11.5 years, mean duration of antiretroviral therapy for 10 years and mean duration of 3.8 years for Facial Lipoatrophy. Most made use of Stavudine and/or Efavirenz. At the beginning of treatment, the mean dosage of CD4 was 284 cells/mm ³ and at the time of filling the average was 709 cells/mm³. Cholesterol levels were elevated in 44.4%, and the triglycerides were elevated in 66.7%. here were practically no adverse effects from the filling.Conclusion: On average, HIV was diagnosed for 11.5 years, mean duration of antiretroviral therapy for 10 years and mean duration of 3.8 years for Facial Lipoatrophy.Â
Combined auditory and visual cueing provided by eyeglasses influence gait performance in Parkinson Disease patients submitted to deep brain stimulation: a pilot study
Get PDFBackground: Auditory-visual cueing using portable cueing devices has been effective for gait training in rehabilitation programs with Parkinson patients. However, it is possible that some gait problems arise due to interference from chronic high frequency stimulation with the gait and balance neural networks in patients with Parkinson Disease. Thus, it should be useful to test whether advanced Parkinson Disease patients experiencing gait problems (despite the treatment with medication and high frequency deep brain stimulation) would benefit from therapy using cueing. Methods: Eyeglasses combining auditory-visual cueing were used with 18 patients with advanced Parkinson Disease and treated with medication and deep brain stimulation. Patients were assessed using the Dynamic Gait Index, Timed Up and Go and Six-Minute Walking Test and performance was measured with and without the cueing (with and without eyeglasses on). Results: One way ANOVA on the performance measures indicated that Dynamic Gait Index and Six-Minute Walking Test significantly improved in the cued condition. Since cueing was task specific, and Timed Up and Go includes subtasks such sitting and standing, the combined auditory-visual cueing did not improve performance on such tasks. Conversely, the combined cueing may have worked as distractors during these subtasks. Conclusion: Combined auditory-visual cueing provided by this wearable technology may have practical applicability in rehabilitation therapy. It provided additional benefits on gait in patients with advanced Parkinson Disease with deep brain stimulation in the subthalamic nucleus
Ebola: an international public health emergency
Get PDFThe outbreak of Ebola in West Africa could become one of the worst infectious-disease-driven humanitarian crises of recent times. With more than 3000 deaths since the first case was confirmed in March 2014, the international community has recognized Ebola as a public health emergency of international concern and a clear threat to global health security. The complexity of dealing with this Ebola outbreak has highlighted the need for traditional actors, such as WHO and the CDC, to embrace the wider health and humanitarian community. The epidemic reinforces the need for nations to investment in health infrastructure and disease surveillance to keep pace with other developments in Africa. If Ebola arrives in high-income and middleincome nations, it should be contained quickly. The crisis shows the importance of sufficient levels of multilateral funding for WHO. The world needs a strong WHO, with the financing and political influence to fulfil its historic mission