Tuberculous meningitis in Turkish children: an evaluation of 38 cases

2005 ◽  
Vol 35 (3) ◽  
pp. 183-184 ◽  
Author(s):  
V Ertekin ◽  
H Alp ◽  
S Altinkaynak ◽  
M A Selimogğlu
Keyword(s):  
Public Health ◽  
Tuberculous Meningitis ◽  
Public Health Problem ◽  
Signs And Symptoms ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Laboratory Findings ◽  
Turkish Children ◽  
The Past ◽  
Meningitis In Children

Thirty-eight cases of tuberculous meningitis in children were studied. Mortality was 28.9%; most of these presented with stage III disease. Tuberculous meningitis (TBM) still ranks as one of the most important communicable diseases in terms of morbidity and mortality. It is universally fatal if not treated and has high morbidity and mortality, if not recognized early. According to WHO's data, 1.3 million new TB cases under 15 year olds were reported. In Turkey, the TB prevalence is 0.4 %. According to data from the Turkish Ministry of Health, the number of admissions to hospitals dropped from 108 per 100,000 in 1971 to 51 per 10,000 in 1988. Early diagnosis and treatment of TBM are essential in order to prevent late sequelas and death. The diagnosis of TBM may be delayed because many patients initially have vague, seemingly minor, signs and symptoms. In this study, the clinical and laboratory findings of 38 patients with the diagnosis of TBM in our hospital were reviewed, retrospectively, during the past five years. Our purpose was to stress the importance of TBM as a public health problem in Turkey, particularly in the Eastern of Turkey.

Driving and Public Health

2021 ◽  
Keyword(s):  
Public Health ◽  
United States ◽  
Health Problem ◽  
Cell Phone ◽  
Motor Vehicle ◽  
Electronic Device ◽  
Public Health Problem ◽  
The United States ◽  
Distracted Driving ◽  
The Past

Distracted driving is defined in the Oxford English Dictionary as “the practice of driving a motor vehicle while engaged in another activity, typically one that involves the use of a mobile phone or other electronic device.” However, other distractions not involving the use of a cell phone or texting are important as well, contributing to this burgeoning public health problem in the United States. Examples include talking to other passengers, adjusting the radio or other controls in the car, and daydreaming. Distracted driving has been linked to increased risk of motor vehicle crashes (MVCs) in the United States, representing one of the most preventable leading causes of death for youth ages 16 to 24 years. Undoubtedly, the proliferation of cell phone, global positioning system (GPS), and other in-vehicle and personal electronic device use while driving has led to this rise in distracted driving prevalence. This behavior has impacted society—including individual and commercial drivers, passengers, pedestrians—in countless numbers of ways, ranging from increased MVCs and deaths to the enactment of new driving laws. In 2016, for example, 20 percent of all US pediatric deaths (nearly 4,000 children and adolescents) were due to fatal MVCs. It has been estimated that at any given time, more than 650,000 drivers are using cell phones or manipulating electronic devices while driving. In the United States, efforts are underway to reduce this driving behavior. In the past two decades, state and federal laws have specifically targeted cell phone use and texting while driving as priority areas for legal intervention. Distracted driving laws have become “strategies of choice” for tackling this public health problem, though their enforcement has emerged as a major challenge and varies by jurisdiction and location. Multimodal interventions using models such as the “three Es” framework—Enactment of a law, Education of the public about the law and safety practices, and Enforcement of the law—have become accepted practice or viewed as necessary steps to successfully change this behavior caused by distractions while driving. This Oxford Bibliographies review introduces these and other aspects (including psychological influences and road conditions) of distracted driving through a presentation of annotated resources from peer- and non-peer-reviewed literature. This selective review aims to provide policymakers, program implementers, and researchers with a reliable source of information on the past and current state of American laws, policies, and priorities for distracted driving.

The Grammar of Leprosy: Temporal Politics and the Impossible Subject

2021 ◽  
Vol 8 (3) ◽  
pp. 1-26
Author(s):  
Laura A. Meek
Keyword(s):  
Public Health ◽  
Public Health Problem ◽  
Unintended Consequences ◽  
World Health ◽  
Test Results ◽  
Temporal Framing ◽  
The Past ◽  
Research Article ◽  
The World ◽  
Potential Problems

This research article critically interrogates the implications and unintended consequences of the World Health Organization’s purported elimination of leprosy as a public health problem. I explore how leprosy has been portrayed (for nearly a century) as something from the past, recalcitrantly lingering on into the present, but surely about to be gone—a temporal framing I call the ‘grammar of leprosy’. I recount the experiences of Daniel, my interlocutor in Tanzania, whose existence became a problem for his doctors. This problem they ultimately resolved by fabricating negative test results in order to record what they already knew: leprosy had been eliminated. I also analyse how researchers working for Novartis (the supplier of leprosy’s cure) continue to push for an always imminent ‘elimination’, while field researchers repeatedly caution about the potential problems of this approach. Finally, I reveal how the grammar of leprosy operates through a complex set of temporal politics, pulling into its orbit and being enabled by multiple interwoven temporalities. I conclude that—due to this grammar, the impossible subjects it produces, and the temporal politics through which it operates—leprosy elimination campaigns may have dire consequences for the lives of people with leprosy today, impeding rather than enabling treatment.

scholarly journals Entamoeba histolytica Neglected Tropical Diseases (NTDs) Agents that Infect Humans and Some Other Mammals: A Review

2020 ◽  
Vol 151 ◽  
pp. 01019
Author(s):  
Junaidi Junaidi ◽  
Umi Cahyaningsih ◽  
Trioso Purnawarman ◽  
Hadri Latif ◽  
Etih Sudarnika ◽  
...  
Keyword(s):  
Public Health ◽  
Entamoeba Histolytica ◽  
Search Engines ◽  
Neglected Tropical Diseases ◽  
Morbidity And Mortality ◽  
Google Scholar ◽  
Intestinal Lumen ◽  
High Morbidity ◽  
Tropical Diseases

Amoebiasis caused by Entamoeba histolytica is an important issue in world public health because it is associated with high morbidity and mortality. Entamoeba histolytica is the only species of its genus that commonly causes mild irritation, injury, to inflammation of the walls of the colon and cecum. In some cases, parasites also invade other organs, especially the liver, lungs, kidneys, and brain. Methods: Our article search uses the help of four search engines namely Google Scholar, PubMed, Science Direct, and Springer. Results: Entamoeba histolytica is not easily transmitted from animals to humans, due to the fact that this parasite rarely encysts in the intestinal lumen of animals which is an important factor in the transmission of this parasite. And conversely, subclinical amebiasis in humans acts as the dominant host for transmission of this parasite either from human to human or from human to animal.

scholarly journals Sodium-glucose cotransporter 2 inhibitors for diabetic kidney disease: a primer for deprescribing

2019 ◽  
Vol 12 (5) ◽  
pp. 620-628 ◽  
Author(s):  
Jiahua Li ◽  
Christopher O Fagbote ◽  
Min Zhuo ◽  
Chelsea E Hawley ◽  
Julie M Paik
Keyword(s):  
Kidney Disease ◽  
Adverse Effects ◽  
Public Health Problem ◽  
Volume Overload ◽  
Health Care Expenditures ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Global Public Health ◽  
Renal Protection ◽  
Sodium Glucose Cotransporter

Abstract Chronic kidney disease (CKD) is a critical global public health problem associated with high morbidity and mortality, poorer quality of life and increased health care expenditures. CKD and its associated comorbidities are one of the most complex clinical constellations to manage. Treatments for CKD and its comorbidities lead to polypharmacy, which exponentiates the morbidity and mortality. Sodium-glucose cotransporter 2 inhibitors (SGLT2is) have shown remarkable benefits in cardiovascular and renal protection in patients with type 2 diabetes mellitus (T2DM). The pleiotropic effects of SGLT2is beyond glycosuria suggest a promising role in reducing polypharmacy in diabetic CKD, but the potential adverse effects of SGLT2is should also be considered. In this review, we present a typical case of a patient with multiple comorbidities seen in a CKD clinic, highlighting the polypharmacy and complexity in the management of proteinuria, hyperkalemia, volume overload, hyperuricemia, hypoglycemia and obesity. We review the cardiovascular and renal protection effects of SGLT2is in the context of clinical trials and current guidelines. We then discuss the roles of SGLT2is in the management of associated comorbidities and review the adverse effects and controversies of SGLT2is. We conclude with a proposal for deprescribing principles when initiating SGLT2is in patients with diabetic CKD.

scholarly journals OC 8277 IDENTIFICATION OF NEW CEREBROSPINAL FLUID AND BLOOD-BASED BIOMARKERS FOR THE DIAGNOSIS OF TUBERCULOUS MENINGITIS IN CHILDREN

2019 ◽  
Vol 4 (Suppl 3) ◽  
pp. A3.2-A3
Author(s):  
Masilo Charles Manyelo ◽  
Regan S Solomons ◽  
Gerhard Walzl ◽  
Novel N Chegou
Keyword(s):  
Cerebrospinal Fluid ◽  
Tuberculous Meningitis ◽  
Point Of Care ◽  
Extrapulmonary Tuberculosis ◽  
Diagnostic Delay ◽  
Severe Form ◽  
High Morbidity ◽  
Serum Samples ◽  
Meningitis In Children ◽  
Study Participants

BackgroundTuberculous meningitis (TBM) is the most severe form of extrapulmonary tuberculosis (TB). It mostly affects young children and results in high morbidity and mortality, mainly due to diagnostic delay. There is an urgent need for new tests for the earlier and accurate diagnosis of the disease. We previously identified a 3-marker cerebrospinal fluid (CSF) biosignature (VEGF, IL-13, and LL-37) with potential to diagnose TBM. In the present study, we show that CSF and blood-based biosignatures may be useful in the diagnosis of TBM.MethodsCSF and serum samples were consecutively collected from 47 children that were admitted to the Tygerberg Academic Hospital in Cape Town, South Africa, on suspicion of having TBM. Using a multiplex platform, the concentrations of 69 host markers were evaluated in the CSF and serum samples from all the study participants, followed by statistical analysis to ascertain the usefulness of these biomarkers as diagnostic candidates for TBM disease.ResultsOut of the 47 study participants, 23 (48.9%) were finally diagnosed with TBM and 6 (12.8%) were infected with HIV. Several CSF and serum biomarkers showed potential individually as diagnostic candidates for TBM as ascertained by area under the receiver operator characteristics curve (AUC). However, the main findings of our study were the identification of a four-marker CSF biosignature which diagnosed TBM with an AUC of 0.97 (95% CI, 0.92–1.00), and a 3-marker serum biosignature which diagnosed TBM with an AUC of 0.84 (95% CI, 0.73–0.96). We also validated a previously identified 3-marker CSF biosignature (VEGF, IL13 and LL37) in the study.ConclusionCSF and serum biosignatures may be useful in the diagnosis of TBM in children. Our findings require further validation in larger, multi-site studies after which the biosignatures may be incorporated into point-of-care diagnostic tests for TBM.

scholarly journals Research Funding for Pain in Canada

2009 ◽  
Vol 14 (2) ◽  
pp. 113-115 ◽  
Author(s):  
Mary E Lynch ◽  
Donald Schopflocher ◽  
Paul Taenzer ◽  
Caitlin Sinclair
Keyword(s):  
Public Health ◽  
Chronic Pain ◽  
Health Problem ◽  
Health Research ◽  
Research Funding ◽  
Public Health Problem ◽  
Current Level ◽  
The Past ◽  
Appropriate Treatment

Chronic pain is an escalating public health problem. There are inadequate resources to assist patients suffering with pain in Canada. Therefore, it is important that research examining novel and appropriate treatment for chronic pain is conducted. To determine the current level of research funding for pain in Canada, the Canadian Pain Society conducted a survey. Of 79 active researchers performing pain-related studies, 65 received funding in the past five years amounting to a total of approximately $80.9 million. This is less than 1% of the total funding from the Canadian Institutes of Health Research and 0.25% of the total funding for health research.

scholarly journals General Molecular Strategy for Development of Arenavirus Live-Attenuated Vaccines

2015 ◽  
Vol 89 (23) ◽  
pp. 12166-12177 ◽  
Author(s):  
Masaharu Iwasaki ◽  
Nhi Ngo ◽  
Beatrice Cubitt ◽  
John R. Teijaro ◽  
Juan C. de la Torre
Keyword(s):  
Public Health ◽  
Rapid Development ◽  
Hemorrhagic Fever ◽  
Health Problems ◽  
Genome Segment ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Major Step ◽  
Live Attenuated Vaccines ◽  
Important Public Health

ABSTRACTHemorrhagic fever arenaviruses (HFA) pose important public health problems in regions where they are endemic. Thus, Lassa virus (LASV) infects several hundred thousand individuals yearly in West Africa, causing a large number of Lassa fever cases associated with high morbidity and mortality. Concerns about human-pathogenic arenaviruses are exacerbated because of the lack of FDA-licensed arenavirus vaccines and because current antiarenaviral therapy is limited to an off-label use of ribavirin that is only partially effective. The Mopeia virus (MOPV)/LASV reassortant (ML29) is a LASV candidate live-attenuated vaccine (LAV) that has shown promising results in animal models. Nevertheless, the mechanism of ML29 attenuation remains unknown, which raises concerns about the phenotypic stability of ML29 in response to additional mutations. Development of LAVs based on well-defined molecular mechanisms of attenuation will represent a major step in combatting HFA. We used the prototypic arenavirus lymphocytic choriomeningitis virus (LCMV) to develop a general molecular strategy for arenavirus attenuation. Our approach involved replacement of the noncoding intergenic region (IGR) of the L genome segment with the IGR of the S genome segment to generate a recombinant LCMV, rLCMV(IGR/S-S), that was highly attenuatedin vivobut induced protection against a lethal challenge with wild-type LCMV. Attenuation of rLCMV(IGR/S-S) was associated with a stable reorganization of the control of viral gene expression. This strategy can facilitate the rapid development of LAVs with the antigenic composition of the parental HFA and a mechanism of attenuation that minimizes concerns about increased virulence that could be caused by genetic changes in the LAV.IMPORTANCEHemorrhagic fever arenaviruses (HFA) cause high morbidity and mortality, and pose important public health problems in the regions where they are endemic. Implementation of live-attenuated vaccines (LAV) will represent a major step in combatting HFA. Here we have used the prototypic arenavirus LCMV to document a general molecular strategy for arenavirus attenuation that can facilitate the rapid development of safe and effective, as well as stable, LAV to combat HFA.

scholarly journals O enfermeiro na assistência à mulher com câncer de colo uterino

2015 ◽  
pp. 19
Author(s):  
Carla Monteiro Santos ◽  
Doralice De Almeida Nascimento Silva ◽  
Gleise Gonçalves Passos da Silva ◽  
Tatiana Santana de Oliveira ◽  
Luiz Faustino dos Santos Maia
Keyword(s):  
Public Health ◽  
Health Care ◽  
Cervical Cancer ◽  
Health Problem ◽  
Public Health Problem ◽  
Morbidity And Mortality ◽  
Major Public Health Problem ◽  
Care Practices ◽  
Multiple Health

O Câncer de Colo Uterino apresenta nos dias atuais um grande problema de saúde pública no Brasil, necessitando cada vez mais de profissionais capacitados para o combate a essa doença maligna, minimizando sua morbimortalidade. Neste âmbito podemos destacar o Papel do enfermeiro como fundamental na transformação dessa realidade que vivemos hoje. O enfermeiro atua tanto no sentido de assistir, coordenar as práticas de cuidado, quanto no sentido de educar, promover, proteger, reabilitar essas mulheres, de forma autônoma, criativa e ativa nos múltiplos níveis de atenção à saúde, através do levantamento de hipóteses analíticas e intervenções sistematizadas de rotinas de cuidados, subsidiando falhas e promovendo continuidade e resolutividade do cuidado em saúde.Descritores: Câncer de Colo Uterino, Mulher, Enfermagem. Nurses in care woman with cervical cancerAbstract: The Cancer Cervical presents nowadays a major public health problem in Brazil, requiring more and more trained professionals to combat this evil disease, minimizing morbidity and mortality. In this context we can highlight the nurse's role as fundamental in transforming this reality we live in today. The nurse acts both to assist coordinate care practices, as to educate, promote, protect, rehabilitate these women in an autonomous, creative and active in multiple health care levels, through the lifting of analytical assumptions systematized and interventions care routines, subsidizing failure and promoting continuity and resolution of health care. Descriptors: Cervical Cancer, Women, Nursing. Enfermero en la atención la mujer con cáncer de cuello uterinoResumen: Los regalos del cáncer de cuello uterino hoy en día un importante problema de salud pública en Brasil, lo que requiere cada vez más capacitados profesionales para combatir esta enfermedad mal, lo que minimiza la morbilidad y la mortalidad. En este contexto cabe destacar el papel de la enfermera tan fundamental en la transformación de esta realidad que vivimos hoy. La enfermera actúa tanto para ayudar, coordinar las prácticas de atención, como para educar, promover, proteger, rehabilitar a estas mujeres en un autónomas, creativas y activas en múltiples niveles de atención de salud, a través de la elevación de supuestos analíticos rutinas sistematizados y las intervenciones de atención, subsidiando el fracaso y la promoción de la continuidad y de la resolución de la atención sanitaria. Descriptores: Cáncer de Cuello Uterino, Mujer, Enfermería.

scholarly journals Outcomes of tuberculous meningitis in children: a case review study

2011 ◽  
Vol 51 (5) ◽  
pp. 288 ◽  
Author(s):  
Yazid Dimyati ◽  
Anna Tjandradjani ◽  
Irawan Mangunatmadja ◽  
Dwi Putro Widodo ◽  
Hardiono D. Pusponegoro
Keyword(s):  
Tuberculous Meningitis ◽  
Young Age ◽  
Stage Ii ◽  
High Morbidity ◽  
Case Review ◽  
Diagnostic Characteristics ◽  
Review Study ◽  
Meningitis In Children ◽  
The Relationship ◽  
Univariate Analyses

Background Tuberculous meningitis is a severe extrapulmonary complication of tuberculosis, with high morbidity and mortality rates.Objective To assess the relationship between presenting clinical characteristics and outcomes of pediatric tuberculous meningitis.Methods We present a case review study of all children diagnosed with tuberculous meningitis in Cipto Mangunkusumo Hospital, Jakarta between January 1998 and December 2004. We compared demographic, clinical, and diagnostic characteristics to clinical outcomes.Results We included 43 patients. Common characteristics on admission were young age (mean 3.2 years), stage II and III tuberculous meningitis (91%), and neurological symptoms existing for more than 1 week, including convulsions (52%), unconsciousness (23%), meningeal irritation (56%), and cranial nerve palsy (67%). A common feature of tuberculous meningitis on computed tomography scan of the brain was hydrocephalus in 19/24 cases. Clinical outcomes were neurological sequelae (88%) and death (12%). Factors associated with poor outcome in univariate analyses were young age, as well as stage II and III tuberculous meningitis.Conclusions Tuberculous meningitis starts with nonspecific symptoms and is often only diagnosed when brain damage has already occurred. Outcome is directly associated with age and the stage of tuberculous meningitis. Earlier diagnosis may significantly improve outcomes. [Paediatr Indones. 2011;51:288-93].

scholarly journals Public Health Aspects of Human Brucellosis in the Republic of Macedonia

2013 ◽  
Vol 1 (1) ◽  
pp. 108-111
Author(s):  
Milka Zdravkovska ◽  
Zharko Stojmanovski ◽  
Vaso Taleski ◽  
Svetlana Jovevska ◽  
Velo Markovski
Keyword(s):  
Public Health ◽  
Public Health Problem ◽  
Annual Reports ◽  
Human Brucellosis ◽  
High Morbidity ◽  
Infected People ◽  
Republic Of Macedonia ◽  
The Republic ◽  
Development Tendency ◽  
Epidemiological Characteristics

Background: The Republic of Macedonia is an endemic area where brucellosis is a dominant zoonosis with high morbidity and enormous economic loss.Aim: To determine the incidence rate, prevalence rate and development tendency of infected people with brucellosis in R. Macedonia in the period from 01.01.1999 to 31.12.2009, to register and analyse the epidemiological characteristics of the infected with brucellosis according to gender, age and regional distribution.Materials and methods: The data about the infected people with brucellosis were taken from the register of individual cases as well as monthly and annual reports for infectious diseases prepared by the Institute for Public Health of Republic of Macedonia.Results:  According to the survey the highest number of incidence of human brucellosis in R. Macedonia was found in 2008, 23.94/100,000 people, and the lowest number of infected people was in 2009, about 13.99/100,000 people. Human brucellosis has a decreasing tendency.Conclusion: Human brucellosis remains a public health problem in Republic of Macedonia.

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