Kenya and Guinea: Preventive Strategies in R2P

BackgroundAlthough AKI lacks effective therapeutic approaches, preventive strategies using preconditioning protocols, including caloric restriction and hypoxic preconditioning, have been shown to prevent injury in animal models. A better understanding of the molecular mechanisms that underlie the enhanced resistance to AKI conferred by such approaches is needed to facilitate clinical use. We hypothesized that these preconditioning strategies use similar pathways to augment cellular stress resistance.MethodsTo identify genes and pathways shared by caloric restriction and hypoxic preconditioning, we used RNA-sequencing transcriptome profiling to compare the transcriptional response with both modes of preconditioning in mice before and after renal ischemia-reperfusion injury.ResultsThe gene expression signatures induced by both preconditioning strategies involve distinct common genes and pathways that overlap significantly with the transcriptional changes observed after ischemia-reperfusion injury. These changes primarily affect oxidation-reduction processes and have a major effect on mitochondrial processes. We found that 16 of the genes differentially regulated by both modes of preconditioning were strongly correlated with clinical outcome; most of these genes had not previously been directly linked to AKI.ConclusionsThis comparative analysis of the gene expression signatures in preconditioning strategies shows overlapping patterns in caloric restriction and hypoxic preconditioning, pointing toward common molecular mechanisms. Our analysis identified a limited set of target genes not previously known to be associated with AKI; further study of their potential to provide the basis for novel preventive strategies is warranted. To allow for optimal interactive usability of the data by the kidney research community, we provide an online interface for user-defined interrogation of the gene expression datasets (http://shiny.cecad.uni-koeln.de:3838/IRaP/).

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The Role of New Technologies to Prevent Suicide in Adolescence: A Systematic Review of the Literature

Medicina ◽

10.3390/medicina57020109 ◽

2021 ◽

Vol 57 (2) ◽

pp. 109

Author(s):

Alberto Forte ◽

Giuseppe Sarli ◽

Lorenzo Polidori ◽

David Lester ◽

Maurizio Pompili

Keyword(s):

Suicide Prevention ◽

Mobile Applications ◽

English Language ◽

New Technologies ◽

Cross Sectional Study ◽

Text Messages ◽

Health Concern ◽

Preventive Strategies ◽

Open Label ◽

Cross Sectional

Background and objectives: Suicide in adolescents represents a major public health concern. To date, a growing number of suicide preventive strategies based on the use of new technologies are emerging. We aimed to provide an overview of the present literature on the use of new technologies in adolescent suicide prevention. Materials and methods: An electronic search was run using the following keywords: Technology OR Technologies OR APP OR Application OR mobile application) AND (Adolescent OR youth OR puberty) AND (Suicid* OR Self-harm OR self-destruction). Inclusion criteria were: English language, published in a peer-reviewed journal, suicide prevention with the use of new technologies among adolescents. Results: Our search strategy yielded a total of 12 studies on the use of telemedicine, 7 on mobile applications, and 3 on language detection. We also found heterogeneity regarding the study design: 3 are randomized controlled trials (RCT), 13 are open-label single group trials, 2 are randomized studies, and 1 is a cross-sectional study. Telemedicine was the most adopted tool, especially web-based approaches. Mobile applications mostly focused on screening of depressive symptoms and suicidal ideation, and for clinical monitoring through the use of text messages. Although telepsychiatry and mobile applications can provide a fast and safe tool, supporting and preceding a face-to-face clinical assessment, only a few studies demonstrated efficacy in preventing suicide among adolescents through the use of these interventions. Some studies suggested algorithms able to recognize people at risk of suicide from the exploration of the language on social media posts. Conclusions: New technologies were found to be well accepted and tolerated supports for suicide prevention in adolescents. However, to date, few data support the use of such interventions in clinical practice and preventive strategies. Further studies are needed to test their efficacy in suicide prevention among adolescents and young adults.

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Effectiveness of Epidemic Preventive Policies and Hospital Strategies in Combating COVID-19 Outbreak in Taiwan

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18073456 ◽

2021 ◽

Vol 18 (7) ◽

pp. 3456

Author(s):

Ting Wan Tan ◽

Han Ling Tan ◽

Man Na Chang ◽

Wen Shu Lin ◽

Chih Ming Chang

Keyword(s):

Mortality Rate ◽

Incidence Rate ◽

Risk Ratio ◽

Early Stage ◽

Control Measures ◽

Polymerase Chain Reaction Test ◽

Effective Control ◽

Nasopharyngeal Swab ◽

Preventive Strategies ◽

Epidemic Control

(1) Background: The implementation of effective control measures in a timely fashion is crucial to control the epidemic outbreak of COVID-19. In this study, we aimed to analyze the control measures implemented during the COVID-19 outbreak, as well as evaluating the responses and outcomes at different phases for epidemic control in Taiwan. (2) Methods: This case study reviewed responses to COVID-19 and the effectiveness of a range of control measures implemented for epidemic control in Taiwan and assessed all laboratory-confirmed cases between 11 January until 20 December 2020, inclusive of these dates. The confirmation of COVID-19 infection was defined as the positive result of a reverse-transcriptase–polymerase-chain-reaction test taken from a nasopharyngeal swab. Test results were reported by the Taiwan Centers for Disease Control. The incidence rate, mortality rate, and testing rate were compiled, and the risk ratio was provided to gain insights into the effectiveness of prevention measures. (3) Results and Discussion: This study presents retrospective data on the COVID-19 incidence rate in Taiwan, combined with the vital preventive control measures, in a timeline of the early stage of the epidemic that occurred in Taiwan. The implementation of multiple strategy control measures and the assistance of technologies to control the COVID-19 epidemic in Taiwan led to a relatively slower trend in the outbreak compared to the neighboring countries. In Taiwan, 766 confirmed patients were included, comprised of 88.1% imported cases and 7.2% local transmission cases, within the studied period. The incidence rate of COVID-19 in Taiwan during the studied period was 32 per million people, with a mortality rate of 0.3 per million people. Our analysis showed a significantly raised incidence risk ratio in the countries of interest in comparison to Taiwan during the study period; in the range of 1.9 to 947.5. The outbreak was brought under control through epidemic policies and hospital strategies implemented by the Taiwan Government. (4) Conclusion: Taiwan’s preventive strategies resulted in a drastically lower risk for Taiwan nationals of contracting COVID-19 when new pharmaceutical drug or vaccines were not yet available. The preventive strategies employed by Taiwan could serve as a guide and reference for future epidemic control strategies.

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Why Do Patients Leave against Medical Advice? Reasons, Consequences, Prevention, and Interventions

Healthcare ◽

10.3390/healthcare9020111 ◽

2021 ◽

Vol 9 (2) ◽

pp. 111

Author(s):

Asseel Albayati ◽

Steven Douedi ◽

Abbas Alshami ◽

Mohammad A. Hossain ◽

Shuvendu Sen ◽

...

Keyword(s):

Hospital Admissions ◽

Medical Advice ◽

Preventive Strategies ◽

Against Medical Advice ◽

Cause Analysis ◽

Persistent Problem ◽

Root Cause ◽

Discharge Against Medical Advice ◽

Leaving Against Medical Advice

Background: A patient decides to leave the hospital against medical advice. Is this an erratic eccentric behavior of the patient, or a gap in the quality of care provided by the hospital? With a significant and increasing prevalence of up to 1–2% of all hospital admissions, leaving against medical advice affects both the patient and the healthcare provider. We hereby explore this persistent problem in the healthcare system. We searched Medline and PubMed within the last 10 years, using the keywords “discharge against medical advice,” “DAMA,” “leave against medical advice,” and “AMA.” We retrospectively reviewed 49 articles in our project. Ishikawa fishbone root cause analysis (RCA) was employed to explore reasons for leaving against medical advice (AMA). This report presents the results of the RCA and highlights the consequences of discharge against medical advice (DAMA). In addition, the article explores preventive strategies, as well as interventions to ameliorate leaving AMA.

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Analysis and outcomes of wrong site thyroid surgery

BMC Surgery ◽

10.1186/s12893-021-01247-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Gianlorenzo Dionigi ◽

Marco Raffaelli ◽

Rocco Bellantone ◽

Carmela De Crea ◽

Carlo Enrico Ambrosini ◽

...

Keyword(s):

Thyroid Surgery ◽

Rare Event ◽

Lymph Node Excision ◽

Legal Action ◽

Preventive Strategies ◽

Case Presentation ◽

Wrong Site Surgery ◽

Wrong Side ◽

Low Volume ◽

Wrong Site

Abstract Background In thyroid surgery, wrong-site surgery (WSS) is considered a rare event and seldom reported in the literature. Case presentation This report presents 5 WSS cases following thyroid surgery in a 20-year period. We stratified the subtypes of WSS in wrong target, wrong side, wrong procedure and wrong patient. Only planned and elective thyroid surgeries present WSS cases. The interventions were performed in low-volume hospitals, and subsequently, the patients were referred to our centres. Four cases of wrong-target procedures (thymectomies [n = 3] and lymph node excision [n = 1] performed instead of thyroidectomies) and one case of wrong-side procedure were observed in this study. Two wrong target cases resulting additionally in wrong procedure were noted. Wrong patient cases were not detected in the review. Patients experienced benign, malignant, or suspicious pathology and underwent traditional surgery (no endoscopic or robotic surgery). 40% of WSS led to legal action against the surgeon or a monetary settlement. Conclusion WSS is also observed in thyroid surgery. Considering that reports regarding the serious complications of WSS are not yet available, these complications should be discussed with the surgical community. Etiologic causes, outcomes, preventive strategies of WSS and expert opinion are presented.

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Sudden death in schizophrenia: pay special attention and develop preventive strategies

Current Medical Research and Opinion ◽

10.1080/03007995.2021.1937089 ◽

2021 ◽

pp. 1-1

Author(s):

Fulvio A. Scorza ◽

Antonio-Carlos G. de Almeida ◽

Carla A. Scorza ◽

Roberta M. Cysneiros ◽

Josef Finsterer

Keyword(s):

Sudden Death ◽

Preventive Strategies

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