scholarly journals Inulin-Type Fructan Supplementation of 3- to 6-Year-Old Children Is Associated with Higher FecalBifidobacteriumConcentrations and Fewer Febrile Episodes Requiring Medical Attention

2018 ◽  
Vol 148 (8) ◽  
pp. 1300-1308 ◽  
Author(s):  
Szimonetta Lohner ◽  
Viktória Jakobik ◽  
Krisztina Mihályi ◽  
Sara Soldi ◽  
Sotirios Vasileiadis ◽  
...  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Alejandro Garcia-Ruiz de Morales ◽  
Covadonga Morcate ◽  
Elena Isaba-Ares ◽  
Ramon Perez-Tanoira ◽  
Jose A. Perez-Molina

Abstract Background The study aimed to analyse the likelihood of imported malaria in people with a suggestive clinical picture and its distinctive characteristics in a hospital in the south of Madrid, Spain. Methods Observational retrospective study that consisted of a review of all medical files of patients with any malaria test registered at Móstoles University Hospital between April 2013 and April 2018. All suspected malaria cases were confirmed by Plasmodium spp. polymerase chain reaction (PCR). Results Of the 328 patients with suspected malaria (53.7% migrant-travellers; 38.7% visitors; 7.6% travellers), 108 cases were confirmed (101 by Plasmodium falciparum), accounting for a 33% positive sample rate. Sixteen cases were diagnosed only by PCR. Patients with malaria, compared to those without, presented predominantly with fever (84% vs. 65%), were older (34 vs. 24 years), sought medical attention earlier (17d vs. 32d), had a greater number of previous malaria episodes (74% vs. 60%), lower levels of platelets (110,500µL vs. 250,000µL), and higher of bilirubin (0.6 mg/dL vs. 0.5 mg/dL). Severe malaria was present in 13 cases; no deaths were recorded. Malaria diagnosis showed a bimodal distribution with two peaks: June to September and November to January. Conclusions Malaria is still a common diagnosis among febrile patients coming from the tropics specially among migrant travellers. Fever, thrombocytopenia, and/or high bilirubin levels should raise suspicion for this parasitic infection. Prompt diagnosis is crucial to avoid severe cases and deaths.


2021 ◽  
Author(s):  
Alejandro Garcia-Ruiz de Morales ◽  
Covadonga Morcate ◽  
Elena Isaba-Ares ◽  
Ramon Perez-Tanoira ◽  
Jose A. Perez-Molina

Abstract Objectives: We aimed to analyse the likelihood of imported malaria in people with a suggestive clinical picture and its distinctive characteristics in a hospital in the south of Madrid, Spain.Methods: This retrospective study consisted of a review of all medical files of patients with any malaria test registered at Móstoles University Hospital between April 2013 and April 2018. All suspected malaria cases were confirmed by Plasmodium spp. polymerase chain reaction (PCR).Results: Of the 328 patients with suspected malaria (53.7% migrant-travellers; 38.7% visitors; 7.6% travellers), 108 cases were confirmed (101 by P. falciparum), accounting for a 33% positive sample rate. Sixteen cases were diagnosed only by PCR. Patients with malaria, compared to those without, presented predominantly with fever (84% vs 65%), were older (34 vs 24 years), sought medical attention earlier (17d vs 32d), had a greater number of previous malaria episodes (74% vs 60%), lower levels of platelets (110,500µL vs 250,000µL), and higher of bilirubin (0.6mg/dL vs 0.5mg/dL). Severe malaria was present in 13 cases; no deaths were recorded. Malaria diagnosis showed a bimodal distribution with two peaks: June to September and November to January. Conclusion: Malaria is still a common diagnosis among febrile patients coming from the tropics specially among migrant travellers. Fever, thrombocytopenia, and/or high bilirubin levels should raise suspicion for this parasitosis. Prompt diagnosis is crucial to avoid severe cases and deaths. We suggest a proportion around 30% of positive samples as a potential adequate index of suspicion for malaria diagnosis.


2019 ◽  
Vol 4 (6) ◽  
pp. 1507-1515
Author(s):  
Lauren L. Madhoun ◽  
Robert Dempster

Purpose Feeding challenges are common for infants in the neonatal intensive care unit (NICU). While sufficient oral feeding is typically a goal during NICU admission, this can be a long and complicated process for both the infant and the family. Many of the stressors related to feeding persist long after hospital discharge, which results in the parents taking the primary role of navigating the infant's course to ensure continued feeding success. This is in addition to dealing with the psychological impact of having a child requiring increased medical attention and the need to continue to fulfill the demands at home. In this clinical focus article, we examine 3 main areas that impact psychosocial stress among parents with infants in the NICU and following discharge: parenting, feeding, and supports. Implications for speech-language pathologists working with these infants and their families are discussed. A case example is also included to describe the treatment course of an infant and her parents in the NICU and after graduation to demonstrate these points further. Conclusion Speech-language pathologists working with infants in the NICU and following hospital discharge must realize the family context and psychosocial considerations that impact feeding progression. Understanding these factors may improve parental engagement to more effectively tailor treatment approaches to meet the needs of the child and family.


2019 ◽  
Vol 101 (4) ◽  
pp. 357-395 ◽  
Author(s):  
Saty Satya-Murti ◽  
Jennifer Gutierrez

The Los Angeles Plaza Community Center (PCC), an early twentieth-century Los Angeles community center and clinic, published El Mexicano, a quarterly newsletter, from 1913 to 1925. The newsletter’s reports reveal how the PCC combined walk-in medical visits with broader efforts to address the overall wellness of its attendees. Available records, some with occasional clinical details, reveal the general spectrum of illnesses treated over a twelve-year span. Placed in today’s context, the medical care given at this center was simple and minimal. The social support it provided, however, was multifaceted. The center’s caring extended beyond providing medical attention to helping with education, nutrition, employment, transportation, and moral support. Thus, the social determinants of health (SDH), a prominent concern of present-day public health, was a concept already realized and practiced by these early twentieth-century Los Angeles Plaza community leaders. Such practices, although not yet nominally identified as SDH, had their beginnings in the late nineteenth- and early twentieth-century social activism movement aiming to mitigate the social ills and inequities of emerging industrial nations. The PCC was one of the pioneers in this effort. Its concerns and successes in this area were sophisticated enough to be comparable to our current intentions and aspirations.


2020 ◽  
Vol 10 (1) ◽  
pp. 14-17
Author(s):  
Ramachandran K ◽  
Rajesh Yadav ◽  
Sumitra Devkota

Febuxostat used for the treatment of patients with arthritis littered with Hyperuricemia and is utilized in its Chronic Management. a number of the internal organ adverse effects have diode to the employment of febuxostat replaced with with allopurinol drug. Febuxostat, associate degree compound accelerator matter, achieves its therapeutic result by decreasing humour acid. At therapeutic concentrations it is not expected that Febuxostat will inhibit different enzymes which are involved in purine and pyrimidine synthesis and their metabolism. Metabolism of Febuxostat is done by conjugation via uridine diphosphate glucuronosyltransferase (UGT) enzymes and also by UGT1A1, UGT1A3, UGT1A9, and UGT2B7 and reaction via hemoprotein P450 (CYP) enzymes as well as CYP1A2, 2C8 and 2C9 and non-P450 enzymes. Febuxostat is eliminated primarily through each viscus and excretory organ pathways. Febuxostat could cause heart issues that may result in coronary failure, could cause issues within the blood vessels that visit your brain. this could conjointly result in stroke, urarthritis flare-ups and Liver injury. Some facet effects of febuxostat could occur that sometimes don't would like medical attention. We conclude from our review, vessel Death urarthritis patients with established vessel (CV) illness treated with febuxostat had a better rate of CV death compared to those treated with allopurinol drug in a very CV outcomes study.


2018 ◽  
Vol 69 (7) ◽  
pp. 1687-1691
Author(s):  
Razan Al Namat ◽  
Mihai Constantin ◽  
Ionela Larisa Miftode ◽  
Andrei Manta ◽  
Antoniu Petris ◽  
...  

Repetitive or recurrent hospitalizations are a general major health issue in patients with chronic disease. Congestive heart failure, is associated with a high incidence and presence of early rehospitalization, but variables in order to identify patients at increased risk and also an analysis of potentially remediable factors contributing to readmission have not been previously reported and it remains still a difficult problem. We retrospectively assessed 100 patients aged between 48-85 years old, of which 75% were men, who had been hospitalized with documentation of congestive heart failure in St. Spiridon County Emergency Hospital. They were hospitalized between 2010-2017. Even if recurrent heart failure was the most common cause for readmission or rehospitalization, other cardiac disorders and noncardiac illnesses were also accounted for readmission. Predictive factors of an increased probability of readmission included prior patient�s medical heart failure history, heart failure decompensation precipitated or accelerated by an ischaemic episode, atrial fibrillation or uncontrolled hypertension. Factors contributing to preventable readmissions included noncompliance with medications or diet, inadequate discharge planning or follow-up, failure of both social support system and the seek of a promp medical attention when symptoms reappeared. We also identified an inappropriate colaboration with family doctors especially for the patients from rural areas. Patients were more likely to cite side effects of prescribed medications rather than nonadherence as a precipitating factor for readmission. Thus, we can appreciate that early rehospitalization in patients with congestive heart failure may be avoidable in up to 50% of cases. Identification of high risk patients is possible and also necessary shortly after admission in order to identify nonpharmacological interventions designed to decrease readmission frequency.


Author(s):  
Daisy Fancourt

Emergency medicine involves the care of patients who require immediate medical attention. The specialty encompasses a broad range of medical disciplines, including anaesthesia, cardiology (a field related to the heart), neurology (a field related to the brain), plastic surgery, orthopaedic surgery (surgery relating to the bones or muscles), and cardiothoracic surgery (surgery relating to the heart, chest, or lungs). There are also a number of subspecialties including extreme environment medicine, disaster medicine and sports medicine. Related to emergency medicine is the specialty of critical care medicine, which is concerned with the care of patients with life-threatening conditions often treated in intensive care settings....


Author(s):  
J. Donald Boudreau ◽  
Eric Cassell ◽  
Abraham Fuks

This book reimagines medical education and reconstructs its design. It originates from a reappraisal of the goals of medicine and the nature of the relationship between doctor and patient. The educational blueprint outlined is called the “Physicianship Curriculum” and rests on two linchpins. First is a new definition of sickness: Patients know themselves to be ill when they cannot pursue their purposes and goals in life because of impairments in functioning. This perspective represents a bulwark against medical attention shifting from patients to diseases. The curriculum teaches about patients as functional persons, from their anatomy to their social selves, starting in the first days of the educational program and continuing throughout. Their teaching also rests on the rock-solid grounding of medicine in the sciences and scientific understandings of disease and function. The illness definition and knowledge base together create a foundation for authentic patient-centeredness. Second, the training of physicians depends on and culminates in development of a unique professional identity. This is grounded in the historical evolution of the profession, reaching back to Hippocrates. It leads to reformulation of the educational process as clinical apprenticeships and moral mentorships. “Rebirth” in the title suggests that critical ingredients of medical education have previously been articulated. The book argues that the apprenticeship model, as experienced, enriched, taught, and exemplified by William Osler, constitutes a time-honored foundation. Osler’s “natural method of teaching the subject of medicine” is a precursor to the Physicianship Curriculum.


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