scholarly journals When Scarcity Meets Disparity: “Resources Allocation and COVID-19 Patients with Diabetes”

2021 ◽  
pp. 193229682199111
Author(s):  
Jacob M. Appel
Keyword(s):  
Risk Factors ◽  
Resource Allocation ◽  
Life Expectancy ◽  
Ethical Challenge ◽  
Severe Illness ◽  
Resources Allocation ◽  
Economic Disparity ◽  
Patients With Diabetes ◽  
Current Stage

The COVID-19 pandemic raised distinct challenges in the field of scarce resource allocation, a long-standing area of inquiry in the field of bioethics. Policymakers and states developed crisis guidelines for ventilator triage that incorporated such factors as immediate prognosis, long-term life expectancy, and current stage of life. Often these depend upon existing risk factors for severe illness, including diabetes. However, these algorithms generally failed to account for the underlying structural biases, including systematic racism and economic disparity, that rendered some patients more vulnerable to these conditions. This paper discusses this unique ethical challenge in resource allocation through the lens of care for patients with severe COVID-19 and diabetes.

scholarly journals Vaping and subsequent comorbidities potentially associated with increased mortality and more severe illness in COVID-19: a narrative review

2021 ◽  
Keyword(s):  
Risk Factors ◽  
Cigarette Smoking ◽  
Health Risks ◽  
Older Patients ◽  
Significant Risk ◽  
Self Report ◽  
Severe Illness ◽  
Protective Effects ◽  
Cigarette Use

Introduction: COVID-19 (or COVID) is a highly virulent viral disease which more frequently presents severe infection in specific populations, such as the elderly, patients with hypertension, patients with respiratory disease, and patients who smoke. The effects vaping (i.e., an electronic cigarette or JUUL device) has on COVID progression remains unclear, because there is an information paucity correlating e-cigarette use and COVID. This review sought to identify links between vape use and COVID severity via literature review. Additionally, because there is more widespread information about cigarette smoking than about vaping, this review sought to illustrate commonalities between smoking and vaping. If smoking and vaping are deemed near-identical practices, then it is possible the effects of smoking on human health and on COVID disease could be comparable in vaping. Methods: Several searches were performed on PubMed with MeSH headings and JSTOR between 17 December 2020 and 22 December 2020. Search results were excluded if they were not trials or controlled clinical trials, if the articles were not about COVID, if the articles were about smoking behaviors or habits, or if the articles were not related to vaping or smoking. Key findings were summarized and tabled based on relevance, substantiability, and applicability to COVID. Results: Multiple sources viewed smoking and vaping as equal risk factors for COVID disease, whereas other sources viewed the two as unique risk factors. Because of this controversy, it is challenging to view the two practices as similar enough to pose equivalent risks for COVID. Both practices pose significant health risks to its users, but these health risks are unique to each practice. Discussion: There are several limitations which exacerbate ambiguity—(1) it is unclear how harmful smoking is for COVID patients, because several publications found smoking may have protective effects; (2) few older patients vape, but yet most severe COVID cases occur in older populations; (3) older patients and impoverished patients show a statistically significant risk for severe COVID disease independent of other factors; (4) vaping is a relatively new practice, and there are few patients who self-report long-term e-cigarette use or long-term adverse effects as a result thereof. Conclusion: Although vaping may present serious health risks, clinically, it is uncertain how significantly vaping affects COVID disease, especially when compared against cigarette smoking. More research is needed on both the effects of vaping on COVID and the likeness of vaping versus smoking.

scholarly journals In-hospital delirium risk assessment, diagnosis and management; medications to avoid

2013 ◽  
pp. 98-102
Author(s):  
Andrew Clegg ◽  
John Young
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
At Risk ◽  
Medication Review ◽  
Adverse Outcomes ◽  
Severe Illness ◽  
Term Care ◽  
Prevention Interventions ◽  
Delirium Prevention

Background: Delirium is a common, but potentially preventable complication of acute illness that is associated with important adverse outcomes including increased length of hospital admission, risk of dementia and admission to long-term care. In-hospital risk assessment and diagnosis: Age over 65, severe illness, current hip fracture and presence of cognitive impairment or dementia are important risk factors for delirium. Assess people with any of these risk factors for recent changes or fluctuations in behaviour that might indicate delirium. If any indicators are present, complete a full cognitive assessment to confirm the diagnosis of delirium. In-hospital risk management: Multicomponent delirium prevention interventions can reduce the incidence of delirium in hospital by around one third and should be provided to people with any of the important risk factors that do not have delirium at admission. A medication review that considers both the number and type of prescribed medications is an important part of the multicomponent delirium prevention intervention. Which medications to avoid in people at risk of delirium: For people at risk of delirium, avoid new prescriptions of benzodiazepines or consider reducing or stopping these medications where possible. Opioids should be prescribed with caution in people at risk of delirium but this should be tempered by the observation that untreated severe pain can itself trigger delirium. Caution is also required when prescribing dihydropyridines and antihistamine H1 antagonists for people at risk of delirium and considered individual patient assessment is advocated. Conclusion: Delirium is common, distressing to patients, relatives and carers and is associated with important adverse outcomes. Multicomponent delirium prevention interventions can reduce the incidence of delirium by approximately one third and usually incorporate a medication review. Identification of which medications to avoid in people at risk of delirium will help guide evidence-based decision making.

scholarly journals Adhesive capsulitis of the shoulder joint (?frozen shoulder?) in patients with diabetes mellitus

2014 ◽  
Vol 17 (4) ◽  
pp. 16-24
Author(s):  
Nadezhda Viktorovna Maximova ◽  
Maria Vadimovna Amosova ◽  
Evdokiya Sergeevna Tsvetkova ◽  
Natalya Alexandrovna Chubrova ◽  
Galina Afanas'evna Mel’nichenko
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Risk Factors ◽  
Adhesive Capsulitis ◽  
Frozen Shoulder ◽  
Diabetic Patients ◽  
Patients With Diabetes ◽  
Loss Of Motion

Adhesive capsulitis (АС) has an incidence of 20% in diabetic patients. The tightening of the shoulder capsule ("freezing") can cause gradually increasing limitation in active and passive range of motion (ROM) of shoulder. Consequences of the increasing limitations are reduced quality of life and patient disability. It is thought that AC is a self-limiting disorder that resolves in 1?2.5 years in most cases. However, new clinical data indicate both long-term persistent pain and residual loss of motion in 10% of patients without diabetes and in 85% of patients with diabetes. In this review, we summarize the results from different clinical trials in which risk factors and pathogenesis of AC in diabetic patients as well as the diagnosis and efficacy of various methods for the treatment of AC were examined.

THE RISK FACTORS FOR CARDIOVASCULAR COMPLICATIONS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

2020 ◽  
Vol 2 (1) ◽  
pp. 62-65
Author(s):  
M.R. Rahmetova ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cardiovascular Complications ◽  
Term Therapy ◽  
Patients With Diabetes ◽  
Long Term Therapy

Purpose: to study the influence of risk factors on the development of cardiovascular complications in patients with diabetes mellitus and to evaluate the effectiveness of treatment depending on the effect of certain factors. Materials and methods. Westudied 23 patients with type 2 diabetes mellitus with chronic cardiovascular complications, who were prescribed long-term therapy for diabetes and cardiovascular complications. Patients were offered questionnaires with questions about the prescribed treatment, the actual treatment received and the reasons for the violation of the recommendations.

Predicting attrition in long-term residential substance use disorder treatment: A modifiable risk factors perspective.

2020 ◽  
Vol 17 (4) ◽  
pp. 472-482
Author(s):  
Danielle E. Baker ◽  
Keith A. Edmonds ◽  
Maegan L. Calvert ◽  
Sarah M. Sanders ◽  
Ana J. Bridges ◽  
...  
Keyword(s):  
Risk Factors ◽  
Substance Use ◽  
Substance Use Disorder ◽  
Modifiable Risk Factors ◽  
Substance Use Disorder Treatment ◽  
Disorder Treatment

Risk Factors for Hypoglycemia in Patients with Diabetes Mellitus

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 2271-PUB
Author(s):  
ASAKO MIZOGUCHI
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Patients With Diabetes
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