scholarly journals Closed tracheal suctioning systems in the era of COVID-19: is it time to consider them as a gold standard?

2020 ◽  
pp. 175717742096377
Author(s):  
Guglielmo Imbriaco ◽  
Alessandro Monesi
Keyword(s):  
Cost Effective ◽  
World Health ◽  
Artificial Airway ◽  
Surrounding Environment ◽  
Number Of Patients ◽  
Increased Risk ◽  
Massive Number ◽  
Tracheal Suctioning ◽  
Critical Patients ◽  
Health Organization

Tracheal suctioning is one of the most common activities performed in intensive care units (ICU) and is recognised as a high-risk procedure by the World Health Organization (WHO) and Centers for Disease Control (CDC). Aerosol-generating procedures on critical patients with COVID-19 present an increased risk of contamination for medical workers. In the time of the Sars-Cov-2 pandemic, with a massive number of patients with COVID-19 admitted to the ICU, the open tracheal suction technique (OTST) represents a serious threat for medical workers, even if they are wearing full personal protective equipment. Closed tracheal suction systems (CTSS) allow the removal of tracheobronchial secretions without disconnecting ventilatory circuits, preventing alveolar derecruitment, gas exchange deterioration and hypoxia. CTSS reduce the risk of pathogens entering the respiratory circuit and appear to be a cost-effective solution. CTSS should be considered mandatory for patients in the ICU with an artificial airway, in order to reduce bioaerosol exposure risk for medical workers and contamination of the surrounding environment.

Infectious Disease Frequency Among Evacuees at Shelters After the Great Eastern Japan Earthquake and Tsunami: A Retrospective Study

2014 ◽  
Vol 8 (1) ◽  
pp. 58-64 ◽  
Author(s):  
Takahisa Kawano ◽  
Kohei Hasegawa ◽  
Hiroko Watase ◽  
Hiroshi Morita ◽  
Osamu Yamamura
Keyword(s):  
Infectious Disease ◽  
Acute Gastroenteritis ◽  
Disease Transmission ◽  
Cumulative Incidence ◽  
Median Number ◽  
World Health ◽  
Number Of Patients ◽  
Increased Risk ◽  
Health Organization ◽  
Eastern Japan

AbstractObjectiveAfter the Great Eastern Japan Earthquake and tsunami, the World Health Organization cautioned that evacuees at shelters would be at increased risk of infectious disease transmission; however, the frequency that occurred in this population was not known.MethodsWe reviewed medical charts of evacuees who visited medical clinics at 6 shelters from March 19, to April 8, 2011. Excluded were patients who did not reside within the shelters or whose medical records lacked a name or date. We investigated the frequency of and cumulative incidences of acute respiratory infection [ARI], acute gastroenteritis, acute jaundice syndrome, scabies, measles, pertussis, and tetanus.ResultsOf 1364 patients who visited 6 shelter clinics, 1167 patients (86.1%) were eligible for the study. The median total number of evacuees was 2545 (interquartile range [IQR], 2277-3009). ARI was the most common infectious disease; the median number of patients with ARI was 168.8 per week per 1000 evacuees (IQR, 64.5-186.1). Acute gastroenteritis was the second most common; the median number of patients was 23.7 per week per 1000 evacuees (IQR, 5.1-24.3). No other infectious diseases were observed. The median cumulative incidence of ARI per 1000 evacuees in each shelter was 13.1 person-days (IQR, 8.5–18.8). The median cumulative incidence of gastroenteritis was 1.6 person-days (IQR, 0.3–3.4).ConclusionAfter the Great Eastern Japan Earthquake and tsunami, outbreaks of ARI and acute gastroenteritis occurred in evacuation shelters. (Disaster Med Public Health Preparedness. 2014;0:1-7)

Antidiabetics: Structural Diversity of Molecules with a Common Aim

2018 ◽  
Vol 25 (18) ◽  
pp. 2140-2165 ◽  
Author(s):  
Jelena B. Popovic-Djordjevic ◽  
Ivana I. Jevtic ◽  
Tatjana P. Stanojkovic
Keyword(s):  
Structural Diversity ◽  
World Health ◽  
Common Disease ◽  
Peroxisome Proliferator ◽  
Epidemic Disease ◽  
Peroxisome Proliferator Activated Receptor ◽  
Increased Risk ◽  
Dipeptidyl Peptidase Iv Inhibitors ◽  
Glucagon Like Peptide 1 ◽  
Health Organization

Background: Diabetes mellitus type 2 (DMT2) is an endocrine disease of global proportions which is currently affecting 1 in 12 adults in the world, with still increasing prevalence. World Health Organization (WHO) declared this worldwide health problem, as an epidemic disease, to be the only non-infectious disease with such categorization. People with DMT2 are at increased risk of various complications and have shorter life expectancy. The main classes of oral antidiabetic drugs accessible today for DMT2 vary in their chemical composition, modes of action, safety profiles and tolerability. Methods: A systematic search of peer-reviewed scientific literature and public databases has been conducted. We included the most recent relevant research papers and data in respect to the focus of the present review. The quality of retrieved papers was assessed using standard tools. Results: The review highlights the chemical structural diversity of the molecules that have the common target-DMT2. So-called traditional antidiabetics as well as the newest and the least explored drugs include polypeptides and amino acid derivatives (insulin, glucagon-like peptide 1, dipeptidyl peptidase-IV inhibitors, amylin), sulfonylurea derivatives, benzylthiazolidine- 2,4-diones (peroxisome proliferator activated receptor-γ agonists/glitazones), condensed guanido core (metformin) and sugar-like molecules (α-glucosidase and sodium/ glucose co-transporter 2 inhibitors). Conclusion: As diabetes becomes a more common disease, interest in new pharmacological targets is on the rise.

scholarly journals Newborns at risk of Covid-19 ― lessons from the last year

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Malika D. Shah ◽  
Ola Didrik Saugstad
Keyword(s):  
Horizontal Transmission ◽  
Mode Of Delivery ◽  
Newborn Infants ◽  
World Health ◽  
Premature Delivery ◽  
Mortality And Morbidity ◽  
Skin Contact ◽  
Cord Clamping ◽  
Increased Risk ◽  
Health Organization

Abstract After more than 1 year of the SARS-CoV-2 pandemic, a great deal of knowledge on how this virus affects pregnant women, the fetus and the newborn has accumulated. The gap between different guidelines how to handle newborn infants during this pandemic has been minimized, and the American Academy of Pediatrics (AAP)’s recommendations are now more in accordance with those of the World Health Organization (WHO). In this article we summarize present knowledge regarding transmission from mother to the fetus/newborn. Although both vertical and horizontal transmission are rare, SARS-CoV-2 positivity is associated with an increased risk of premature delivery and higher neonatal mortality and morbidity. Mode of delivery and cord clamping routines should not be affected by the mother’s SARS-CoV-2 status. Skin to skin contact, rooming in and breastfeeding are recommended with necessary hygiene precautions. Antibodies of infected or vaccinated women seem to cross both the placenta and into breast milk and likely provide protection for the newborn.

Patterns of skull base meningioma progression after failed radiosurgery

2007 ◽  
Vol 106 (1) ◽  
pp. 30-35 ◽  
Author(s):  
William T. Couldwell ◽  
Chad D. Cole ◽  
Ossama Al-Mefty
Keyword(s):  
Skull Base ◽  
Stereotactic Radiosurgery ◽  
Growth Patterns ◽  
World Health ◽  
Benign Tumors ◽  
Subtotal Resection ◽  
Surgical Removal ◽  
Skull Base Meningioma ◽  
Number Of Patients ◽  
Health Organization

Object Stereotactic radiosurgery has been reported to be an effective alternative to surgical removal of small to medium benign meningiomas as well as an adjuvant treatment modality to reduce the risk of tumor progression after subtotal resection. Its efficacy has been proved by excellent short-term radiosurgically demonstrated control rates, which have been reported to approach or exceed 90% in many contemporary studies involving the use of either linear accelerator–based systems or the Gamma Knife. Little is known, however, regarding the growth patterns of meningiomas that fail to stabilize after radiosurgery. Methods The authors report 13 cases of benign skull base meningiomas (World Health Organization Grade I) that demonstrated progression after radiosurgical treatment as a primary or an adjuvant therapy. Several tumors demonstrated rapid growth immediately after radiosurgical treatment, whereas other lesions progressed in a very delayed manner in some patients (up to 14 years after treatment). Regardless of the interval after which it occurs, tumor growth can be quite aggressive once it has begun. Conclusions Skull base meningioma growth can be aggressive after failed radiosurgery in some patients, and treatment failure can occur at long intervals following treatment. Special attention must be devoted to such significant occurrences given the increasing number of patients undergoing stereotactic radiosurgery for benign tumors, and careful extended (> 10 years) follow up must be undertaken in all patients after radiosurgery.

scholarly journals Improving the Role and Contribution of Pharmacokinetic Analyses in Antimalarial Drug Clinical Trials

2014 ◽  
Vol 58 (10) ◽  
pp. 5643-5649 ◽  
Author(s):  
Katherine Kay ◽  
Eva Maria Hodel ◽  
Ian M. Hastings
Keyword(s):  
Antimalarial Drug ◽  
Theoretical Data ◽  
Drug Efficacy ◽  
Cost Effective ◽  
Field Studies ◽  
World Health ◽  
Efficacy Trials ◽  
Drug Concentrations ◽  
Health Organization ◽  
Study Designs

ABSTRACTIt is now World Health Organization (WHO) policy that drug concentrations on day 7 be measured as part of routine assessment in antimalarial drug efficacy trials. The rationale is that this single pharmacological measure serves as a simple and practical predictor of treatment outcome for antimalarial drugs with long half-lives. Herein we review theoretical data and field studies and conclude that the day 7 drug concentration (d7c) actually appears to be a poor predictor of therapeutic outcome. This poor predictive capability combined with the fact that many routine antimalarial trials will have few or no failures means that there appears to be little justification for this WHO recommendation. Pharmacological studies have a huge potential to improve antimalarial dosing, and we propose study designs that use more-focused, sophisticated, and cost-effective ways of generating these data than the mass collection of single d7c concentrations.

scholarly journals An IoT Architecture for Assessing Road Safety in Smart Cities

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Abd-Elhamid M. Taha
Keyword(s):  
Road Safety ◽  
Markov Models ◽  
Smart Cities ◽  
Dynamic Assessment ◽  
Route Planning ◽  
Cost Effective ◽  
World Health ◽  
Road Users ◽  
Health Organization ◽  
The Impact

The Safe System (SS) approach to road safety emphasizes safety-by-design through ensuring safe vehicles, road networks, and road users. With a strong motivation from the World Health Organization (WHO), this approach is increasingly adopted worldwide. Considerations in SS, however, are made for the medium-to-long term. Our interest in this work is to complement the approach with a short-to-medium term dynamic assessment of road safety. Toward this end, we introduce a novel, cost-effective Internet of Things (IoT) architecture that facilitates the realization of a robust and dynamic computational core in assessing the safety of a road network and its elements. In doing so, we introduce a new, meaningful, and scalable metric for assessing road safety. We also showcase the use of machine learning in the design of the metric computation core through a novel application of Hidden Markov Models (HMMs). Finally, the impact of the proposed architecture is demonstrated through an application to safety-based route planning.

scholarly journals Motion – Screening and Surveillance of Barrett’s Epithelium Is Practical and Cost Effective: Arguments against the Motion

2002 ◽  
Vol 16 (8) ◽  
pp. 541-545 ◽  
Author(s):  
Naoki Chiba
Keyword(s):  
Cost Effective ◽  
World Health ◽  
Endoscopic Screening ◽  
Effective Screening ◽  
Screening And Surveillance ◽  
Screening Protocol ◽  
Surveillance Programs ◽  
Prolongation Of Life ◽  
Health Organization ◽  
Very High

The issue of whether to screen individuals for Barrett’s esophagus (BE) to prevent esophageal adenocarcinoma (EAC) is highly controversial. Important considerations are that BE is not highly prevalent in the general population and that not many patients with BE develop or die from EAC. Studies that suggest an improved prognosis from surveillance programs are susceptible to lead-time bias. Most of the principles for effective screening, as outlined by the World Health Organization, are not met by endoscopic screening and surveillance protocols. The diagnosis of BE (and dysplasia) is often unclear. Most patients with BE are not identified by screening, and few deaths would be prevented by surveillance. A decision analysis found that the most cost effective screening protocol would be every five years, but the costs associated with prolongation of life are very high, even if a group at high risk for EAC could be identified.

scholarly journals Covid-19 and Acute Kidney Injury: Recent Updates

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Salman Tahir Shafi
Keyword(s):  
Acute Kidney Injury ◽  
Severe Acute Respiratory Syndrome ◽  
World Health Organization ◽  
Recent Literature ◽  
Kidney Injury ◽  
World Health ◽  
Related Disease ◽  
Increased Risk ◽  
The World ◽  
Health Organization

In January 2020, the pathogen was identified and named by the World Health Organization as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2). The consequent SARS-CoV-2-related disease was defined as coronavirus disease 2019 (COVID-19). As data emerged about characteristics of the disease, it was found to be associated with increased risk of acute kidney injury (AKI). We explore the recent literature and reports emerging from the epicenters of the pandemic to help our viewers understand the nature of AKI among these patients. 

scholarly journals A PIECEWISE GROWTH MODEL FOR MODELING THE ACCUMULATED NUMBER OF COVID-19 CASES IN THE CITY OF CAMPO GRANDE

2021 ◽  
Vol 39 (1) ◽  
pp. 240
Author(s):  
Erlandson Ferreira SARAIVA ◽  
Leandro SAUER ◽  
Basílio De Bragança PEREIRA ◽  
Carlos Alberto de Bragança PEREIRA
Keyword(s):  
Growth Model ◽  
Health Department ◽  
World Health ◽  
Mathematical Study ◽  
Number Of Patients ◽  
Technical Report ◽  
The World ◽  
The Government ◽  
Health Organization ◽  
The City

In December of 2019, a new coronavirus was discovered in the city of Wuhan, China. The World Health Organization officially named this coronavirus as COVID-19. Since its discovery, the virus has spread rapidly around the world and is currently one of the main health problems, causing an enormous social and economic burden. Due to this, there is a great interest in mathematical models capable of projecting the evolution of the disease in countries, states and/or cities. This interest is mainly due to the fact that the projections may help the government agents in making decisions in relation to the prevention of the disease. By using this argument, the health department of the city (HDC) of Campo Grande asked the UFMS for the development of a mathematical study to project the evolution of the disease in the city. In this paper, we describe a modeling procedure used to fit a piecewise growth model for the accumulated number of cases recorded in the city. From the fitted model, we estimate the date in which the pandemic peak is reached and project the number of patients who will need treatment in intensive care units. Weekly, was sent to HDC a technical report describing the main results.

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