Northern California's Experience

PEDIATRICS ◽  
1989 ◽  
Vol 83 (5) ◽  
pp. 868-871
Author(s):  
Deborah Hurst
Keyword(s):  
Sickle Cell ◽  
Health Care Professionals ◽  
Public Information ◽  
Prenatal Testing ◽  
Early Years ◽  
Educational Outreach ◽  
Screening Programs ◽  
Optimal Screening ◽  
The Difference

Future plans involve continued expansion of cord blood screening in the Bay Area until no babies with hemoglobin diseases are missed. Modification of screening and trait follow-up procedures will continue as necessary to allow screening of increased numbers despite limitations in funding. To reduce the need for intensive trait follow-up by the center, we will continue to develop community resources. There must be more general public information about hemoglobin traits, more well-run prenatal testing and counseling programs, and continued education of health care professionals. It is also essential to assess the effect of hemoglobin trait notification on the involved families. A definitive trait follow-up study could help state public health departments design optimal screening programs that provide satisfactory trait follow-up without detrimental psychologic effects or prohibitive expense. Historical studies of the effects of trait screening at other times or in other ethnic groups for different diseases may not be applicable to our population. For example, in trait follow-up today, initial parental anxiety when notified of an abnormal blood test in the baby more often involves fear of acquired immunodeficiency syndrome than fear of sickle cell disease. Most people now can be reassured about the difference between trait and disease and about the fact that their baby with trait is healthy. Clearly, the level of public knowledge has increased since the early years of screening because of the sickle cell center's educational outreach as well as general exposure to information on television and in public school curricula. These impressions should be documented by studies to assess the levels of understanding and anxiety in families before and after counseling. In addition, information concerning the 17% of individuals who make appointments but never appear for counseling and the 28% who are not contacted by either telephone or mail would be useful. There is no way of knowing how many of these people simply do not need or want counseling, how many never receive the information, and how many avoid further contact because of inappropriate anxiety. Tracking these individuals would be a major undertaking, beyond the scope of current staffing, but an important future study.

Acute Splenic Sequestration in a 2-Month-Old Infant With Sickle Cell Anemia

PEDIATRICS ◽  
1989 ◽  
Vol 84 (3) ◽  
pp. 578-579
Author(s):  
ALBERTO PAPPO ◽  
GEORGE R. BUCHANAN
Keyword(s):  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Parental Education ◽  
Early Years ◽  
Splenic Sequestration ◽  
Screening Programs ◽  
Splenic Enlargement ◽  
Clinically Significant ◽  
Overall Mortality

Acute splenic sequestration crisis is a potentially fatal complication of sickle cell anemia. It is characterized by acute splenic enlargement, with trapping of erythrocytes, causing increasing anemia and the potential for circulatory failure. The development of newborn screening programs aimed at identifying children with clinically significant hemoglobinopathies, combined with early parental education and careful follow-up, has decreased the overall mortality due to acute splenic sequestration crisis and other complications during the early years of life. The purpose of this paper is to report the case of an 8-week-old infant with sickle cell anemia and acute splenic sequestration crisis.

scholarly journals Difference between Bibliometric and Grey Data. Transdisciplinary Bioeconomy Research

2020 ◽  
Vol 24 (2) ◽  
pp. 103-114
Author(s):  
Indra Muizniece ◽  
Anna Kubule ◽  
Lauma Zihare ◽  
Dagnija Blumberga
Keyword(s):  
Public Opinion ◽  
Bibliometric Analysis ◽  
Public Information ◽  
Information Space ◽  
Analysis Method ◽  
Key Factors ◽  
The Public ◽  
The Difference ◽  
The One

AbstractThis study is a follow-up to previous research on the use of a transdisciplinary approach in the analysis of factors that influence bioeconomy development and interactions between them. It is very important to consider the significance of public opinion while performing transdisciplinary research. This study integrates public opinion in the bibliometric analysis method by using grey data from information available in the public information space: mass media and social networks. The network of factors influencing the development of bioeconomy, created with the help of social network analysis method, was compared with the one obtained from bibliometric analysis of SCOPUS database in order to find out the difference between scientific tendencies and the overall atmosphere in the information space. Although the structure of these networks varies, there is a common tendency in literature to identify the following factors as the key factors in the development of the bioeconomy: research and innovations; technology; energy and energy consumption.

scholarly journals Newborn Screening for Sickle Cell Disease: Indian Experience

2018 ◽  
Vol 4 (4) ◽  
pp. 31 ◽  
Author(s):  
Roshan Colah ◽  
Pallavi Mehta ◽  
Malay Mukherjee
Keyword(s):  
Sickle Cell Disease ◽  
Newborn Screening ◽  
Sickle Cell ◽  
Screening Program ◽  
Clinical Manifestations ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Cell Disease ◽  
Screening Programs

Sickle cell disease (SCD) is a major public health problem in India with the highest prevalence amongst the tribal and some non-tribal ethnic groups. The clinical manifestations are extremely variable ranging from a severe to mild or asymptomatic condition. Early diagnosis and providing care is critical in SCD because of the possibility of lethal complications in early infancy in pre-symptomatic children. Since 2010, neonatal screening programs for SCD have been initiated in a few states of India. A total of 18,003 babies have been screened by automated HPLC using either cord blood samples or heel prick dried blood spots and 2944 and 300 babies were diagnosed as sickle cell carriers and SCD respectively. A follow up of the SCD babies showed considerable variation in the clinical presentation in different population groups, the disease being more severe among non-tribal babies. Around 30% of babies developed serious complications within the first 2 to 2.6 years of life. These pilot studies have demonstrated the feasibility of undertaking newborn screening programs for SCD even in rural areas. A longer follow up of these babies is required and it is important to establish a national newborn screening program for SCD in all of the states where the frequency of the sickle cell gene is very high followed by the development of comprehensive care centers along with counselling and treatment facilities. This comprehensive data will ultimately help us to understand the natural history of SCD in India and also help the Government to formulate strategies for the management and prevention of sickle cell disease in India.

scholarly journals Interet D’une Supplementation En Spiruline Chez Les Enfants Drepanocytaires Homozygotes A L’hopital National De Niamey. (Essai Clinique Randomise En Double Aveugle A Propos De 53 Cas)

2017 ◽  
Vol 13 (21) ◽  
pp. 208
Author(s):  
Malam-Abdou B. ◽  
Brah S. ◽  
Andia A. ◽  
Mahamane Sani MA ◽  
Chefou M. ◽  
...  
Keyword(s):  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
The Body ◽  
National Hospital ◽  
Double Blind ◽  
Blind Test ◽  
Essai Clinique ◽  
Essai Clinique Randomisé ◽  
The Difference

Spirulina is a micro algae used for thousands of years due to its healing properties. We supplemented children suffering from sickle cell anemia in order to appreciate its impact on the anthropometrical and clinical parameters. It consisted of a randomized clinical double blind test which was carried during a period of 9 months. The study concerned 53 homozygotes children suffering from sickle cell anemia aged 6 months to 15 years. Also, they were visiting the National Hospital of Niamey for follow up. One group (28 children) received 5 g of spirulina daily, and the other group (25 children) received placebo. The aspects studied were: the number of hospitalizations and transfusions, the vaso-occlusive crisis, the body mass index, and the splenomegalia. We found that 84.90% of patients were hospitalized at least once and 45.3% of them have already been transfused. The average number of crisis has greatly decreased in the spirulina group from 2.75 before the study to 1.18 at the end of the study. This, thus, was observed when compared to 2.44 to 1.6 in the placebo group. We also noticed a decrease of the number of hospitalizations and the number of transfusions which is less important in the group supplemented with spirulina. In conclusion, this study showed that supplementation in spirulina had a significant impact on children suffering from sickle cell anemia. This is even despite the fact that the difference between the two groups is not significant in some cases.

Assessing Sexual Dysfunction, Part 1: Male Sexual Dysfunction

2016 ◽  
Vol 21 (2) ◽  
pp. 3-8
Author(s):  
Seth D. Cohen ◽  
Steven Mandel ◽  
David B. Samadi
Keyword(s):  
Sexual Dysfunction ◽  
Health Care Professionals ◽  
Laboratory Testing ◽  
Aging Male ◽  
Testosterone Deficiency ◽  
Subjective Complaint ◽  
Validated Questionnaire ◽  
Male Sexual Dysfunction ◽  
Multiple Health

Abstract To properly assess men and women with sexual dysfunction, evaluators should take a biopsychosocial approach that may require consultation with multiple health care professionals from various fields in order to get to the root of the sexual dysfunction; this multidisciplinary methodology offers the best chance of successful treatment. For males, this article focuses on erectile dysfunction (ED) and hypogonadism. The initial evaluation of ED involves a thorough case history, preferably taken from the patient and partner, physical examination, and proper laboratory and diagnostic tests, including an acknowledgment of the subjective complaint. The diagnosis is established on the basis of an individual's report of the consistent inability to attain and maintain an erection sufficient to permit satisfactory sexual intercourse. Initial workups for ED should entail a detailed history that can be obtained from a validated questionnaire such as the International Index of Erectile Function and the Sexual Health Inventory for Men. Hypogonadism is evaluated using the validated Androgen Deficiency in the Aging Male questionnaire and laboratory testing for testosterone deficiency. Treatments logically can begin with the least invasive and then progress to more invasive strategies after appropriate counseling. The last and most important treatment component when caring for men with sexual dysfunction—and, arguably, the least practiced—is close follow-up.

Re-Increased Male Suicide Rates in the Recovery Phase Following the Great East Japan Earthquake

Crisis ◽  
2020 ◽  
Vol 41 (6) ◽  
pp. 422-428 ◽  
Author(s):  
Masatsugu Orui
Keyword(s):  
Social Connectedness ◽  
Recovery Phase ◽  
Great East Japan Earthquake ◽  
Temporary Housing ◽  
Period Analysis ◽  
Suicide Rates ◽  
Male Suicide ◽  
The Social ◽  
The Difference

Abstract. Background: Monitoring of suicide rates in the recovery phase following a devastating disaster has been limited. Aim: We report on a 7-year follow-up of the suicide rates in the area affected by the Great East Japan Earthquake, which occurred in March 2011. Method: This descriptive study covered the period from March 2009 to February 2018. Period analysis was used to divide the 108-month study period into nine segments, in which suicide rates were compared with national averages using Poisson distribution. Results: Male suicide rates in the affected area from March 2013 to February 2014 increased to a level higher than the national average. After subsequently dropping, the male rates from March 2016 to February 2018 re-increased and showed a greater difference compared with the national averages. The difference became significant in the period from March 2017 to February 2018 ( p = .047). Limitations: Specific reasons for increasing the rates in the recovery phase were not determined. Conclusion: The termination of the provision of free temporary housing might be influential in this context. Provision of temporary housing was terminated from 2016, which increased economic hardship among needy evacuees. Furthermore, disruption of the social connectedness in the temporary housing may have had an influence. Our findings suggest the necessity of suicide rate monitoring even in the recovery phase.

scholarly journals Perception and Use of Economic Thresholds Among Farmers and Agricultural Professionals: A Case Study on Soybean Aphid in Minnesota

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Natalie Hoidal ◽  
Robert L Koch
Keyword(s):  
Soybean Aphid ◽  
Educational Outreach ◽  
Economic Injury Level ◽  
Economic Thresholds ◽  
Foundational Principle ◽  
Economic Injury ◽  
Fundamental Misunderstanding ◽  
The Difference ◽  
Commercial Pesticide ◽  
Agricultural Professionals

Abstract Economic thresholds (ETs) are a foundational principle of integrated pest management but are not always widely accepted by farmers and agricultural professionals. This article reports on a survey of Minnesota farmer and agricultural professional perceptions of the ET for soybean aphid, Aphis glycines Matsumura (Hempitera: Aphididae). We discuss insights for Extension programs on how to frame the importance of thresholds and teach stakeholders to use them effectively. Key takeaways include farmers and agricultural professionals often worry about combined effects of insect, disease, and physiological pressures, whereas effects of interactions with these other stressors are seldom discussed in educational outreach. Across groups, there is a fundamental misunderstanding about the difference between ETs and economic injury level. Many survey participants reported believing in the ET but lacked the time and capacity to fully implement it. Sales agronomists and farmers were the least likely groups to trust the university-determined soybean aphid ET, whereas commercial pesticide applicators and independent consultants were the most likely groups to trust it. Based on these results, we recommend adapting communication about ETs based on the target audience to address common misconceptions and barriers to ET use that are unique to each group.

scholarly journals Variability of Prognostic Results Based on Biological Parameters in Sickle Cell Disease Cohort Studies in Children: What Should Clinicians Know?

Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 143
Author(s):  
Julie Sommet ◽  
Enora Le Roux ◽  
Bérengère Koehl ◽  
Zinedine Haouari ◽  
Damir Mohamed ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Sickle Cell Disease ◽  
Cohort Studies ◽  
Statistical Methods ◽  
Sickle Cell ◽  
Biological Parameters ◽  
Analysis Method ◽  
Cell Disease ◽  
Statistical Analysis Method

Background: Many pediatric studies describe the association between biological parameters (BP) and severity of sickle cell disease (SCD) using different methods to collect or to analyze BP. This article assesses the methods used for collection and subsequent statistical analysis of BP, and how these impact prognostic results in SCD children cohort studies. Methods: Firstly, we identified the collection and statistical methods used in published SCD cohort studies. Secondly, these methods were applied to our cohort of 375 SCD children, to evaluate the association of BP with cerebral vasculopathy (CV). Results: In 16 cohort studies, BP were collected either once or several times during follow-up. The identified methods in the statistical analysis were: (1) one baseline value per patient (2) last known value; (3) mean of all values; (4) modelling of all values in a two-stage approach. Applying these four different statistical methods to our cohort, the results and interpretation of the association between BP and CV were different depending on the method used. Conclusion: The BP prognostic value depends on the chosen statistical analysis method. Appropriate statistical analyses of prognostic factors in cohort studies should be considered and should enable valuable and reproducible conclusions.

scholarly journals POS0208 GENDER DIFFERENCES IN RESPONSE TO BIOLOGICALS. WOMEN FARE WORSE ACROSS INFLAMMATORY ARTHRITIS DISEASES - DATA FROM THE BIOREG

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 320.1-321
Author(s):  
E. Loibner ◽  
V. Ritschl ◽  
B. Leeb ◽  
P. Spellitz ◽  
G. Eichbauer-Sturm ◽  
...  
Keyword(s):  
Gender Differences ◽  
Psoriatic Arthritis ◽  
Gender Difference ◽  
Disease Activity ◽  
Inflammatory Arthritis ◽  
Tnf Inhibitors ◽  
Significant Difference ◽  
The Difference ◽  
All Diseases

Background:Gender differences in prevalence and disease course are known in various rheumatic diseases; however, investigations of gender difference concerning therapeutical response have yielded variable results.Objectives:The aim of this retrospective study was to investigate, whether a gender difference in response rate to biological disease-modifying antirheumatic drugs (bDMARDs) and apremilast in bDMARD-naïve patients could be observed across the three most prevalent inflammatory arthritis diseases: rheumatoid arthritis (RA), spondylarthritis (SpA) and psoriatic arthritis (PsA). Additionally, a response to individual TNF blockers was investigated in this respect.Methods:Data from bDMARD-naïve RA-, SpA- and PsA-patients from Bioreg, the Austrian registry for biological DMARDs in rheumatic diseases, were used. Patients with a baseline (Visit 1=V1) and follow-up visits at 6 months (Visit 2=V2) and 12 months (Visit 3=V3) were included and response to therapy with TNF-inhibitors (TNFi), furthermore to therapy with rituximab, tocilizumab and apremilast was analyzed according to gender. The remaining bDMARDs were not analyzed due to small numbers. Key response-parameter for RA was disease activity score (DAS28), whereas for PsoA the Stockerau Activity Score for Psoriatic Arthritis (SASPA) and for SpA the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) were employed; in addition, the Health assessment Questionnaire (HAQ) was used. Data were analyzed in R Statistic stratified by gender using Kruskal-Wallis and Wilcoxon tests.Results:354 women and 123 men with RA (n=477), 81 women and 69 men with PsA (n=150), 121 women and 191 men with SpA (n=312) were included. No significant differences in biometrics was seen between female and male patients at baseline in all diseases.In RA patients overall DAS28 decreased from baseline (V1) to V2 and V3 (DAS28: V1: male: 4.38 [3.66, 5.11], female: 4.30 [3.68, 5.03], p(m/f) = 0.905; V2: male: 2.66 [1.73, 3.63], female: 3.10 [2.17, 3.98], p(m/f) = 0.015; V3: male: 2.25 [1.39, 3.36], female: 3.01 [1.87, 3.87], p(m/f) = 0.002). For TNF inhibitors (n=311), there was a significant difference between genders at V2 (Fig.1a). Patients receiving Rituximab (n=41) displayed a significantly higher DAS28 at baseline in females, which diminished in the follow up: V1: (p(m/f) p=0.002; V2: p=0.019; V3: p=0.13); response to tocilizumab (n=63) did not show any gender differences.In PsA patients overall SASPA decreased from baseline (V1) to V2 and V3 (SASPA: V1: male: 4.00 [2.80, 5.20], female: 4.40 [2.80, 5.80], p(m/f) = 0.399; V2: male: 2.20 [1.20, 3.50], female: 3.40 [2.00, 5.00], p(m/f) = 0.071; V3: male: 1.80 [0.80, 2.70], female: 3.01 [2.35, 4.80], p(m/f) = 0.001). For TNF inhibitors (n=79), there was a significant difference between genders at V3 (Fig 1a). For Apremilast (n=39), there was a significant difference between genders at V2 (Fig.1c).In SpA patients overall BASDAI decreased from baseline (V1) to V2 and V3 (BASDAI: V1: male: 4.70 [2.88, 6.18], female: 4.80 [3.30, 6.20], p(m/f) = 0.463; V2: male: 3.05 [2.00, 4.60], female: 3.64 [2.62, 5.41], p(m/f) = 0.039; V3: male: 3.02 [1.67, 4.20], female: 3.65 [2.18, 5.47], p(m/f) = 0.016). In V3 a differential BASDAI in response to TNFi (n=299) was observed (Fig.1a).Possible differences of response to individual TNFi (etanercept, infliximab, other TNFi) measured by HAQ were investigated in all diseases together. The difference between male and females was significant at baseline for all 3 TNFi; whereas with the use of ETA the significant difference was carried through to V2 and V3, it was lost with the use of IFX and was variable with the other TNFi (Fig.1b)Figure 1.Conclusion:Female patients showed a statistically lower response to TNFi in all three disease entities (RA, SpA and PsoA) to a variable degree in our homogenous central european population. Interestingly, the difference was not uniform across individual TNFi when measured by HAQ. Gender differences were also seen in response to Apremilast.Disclosure of Interests:Elisabeth Loibner: None declared, Valentin Ritschl: None declared, Burkhard Leeb Speakers bureau: AbbVie, Roche, MSD, Pfizer, Actiopharm, Boehringer-Ingelheim, Kwizda, Celgene, Sandoz, Grünenthal, Eli-Lilly, Grant/research support from: TRB, Roche, Consultancies: AbbVie, Amgen, Roche, MSD, Pfizer, Celgene, Grünenthal, Kwizda, Eli-Lilly, Novartis, Sandoz;, Peter Spellitz: None declared, Gabriela Eichbauer-Sturm: None declared, Jochen Zwerina: None declared, Manfred Herold: None declared, Miriam Stetter: None declared, Rudolf Puchner Speakers bureau: AbbVie, BMS, Janssen, Kwizda, MSD, Pfizer, Celgene, Grünenthal, Eli-Lilly, Consultant of: AbbVie, Amgen, Pfizer, Celgene, Grünenthal, Eli-Lilly, Franz Singer: None declared, Ruth Fritsch-Stork: None declared

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