EFFICACY OF EXTRAPLEURAL PLOMBAGE WITH SILICONE PLUG IN DESTRUCTIVE PULMONARY TUBERCULOSIS PATIENTS AND ITS IMPACT ON PULMONARY FUNCTIONS AND BLOOD GASES

The objective of the study: to analyze the efficacy of extrapleural plombage with silicone plug (EPSP) in those suffering from destructive pulmonary tuberculosis with multiple/extensive drug resistance (M/XDR) and to assess EPSP impact on pulmonary functions and blood gases. Subjects and methods. 34 patients with chronic persistent destructive pulmonary tuberculosis who underwent EPSP were enrolled in the study. 23 were men and 11 were women at the age from 18 to 54 years old (the median age made 36.29± 10.2 years). MDR was diagnosed in 31/34 (91.2%) patients, and of them, 22/31 (70.0%) had XDR. A high profile life long breast implants with texturized coating causing no rejection by the host were used for extrapleural plombage. Results. 18 patients who underwent EPSP as a single surgery had their cavities healed in the operated lung in 100% of cases (95% CI 96.3-100%). There were no lethal outcomes. 1/18 (5.6%) patient suffered from a late complication (empyema) related to EPSP. Postponed outcomes of tuberculosis treatment (effective course of treatment after EPSP) were favorable in 13/16 (81.3%; 95% CI 57.0-93.4%) patients. In 11 patients with disseminated destructive tuberculosis who had EPSP combined with resection or collapse surgery, 12/12 (100%; 95% CI 75.8-100%) had their cavities healed in the operated lung; 2/12 patients needed additional bronchial valve block. Surgeries for EPSP resulted in no lethal outcomes or complications. In 5 patients with destructive tuberculosis relapse in the only lung, EPSP was used to stop the progress of the disease due to poor efficacy of chemotherapy. The impact on cavities healing in the operated lung was achieved in 4/5 (80.0%; 95% CI (37.6-96.3%) patients. The complication after EPSP was observed in у 1/5 (20.0%) patient and resulted in the lethal outcome. 3/5 patients had favorable postponed outcomes. After EPSP, ventilation and gas exchange functions deteriorated in 32% of patients, while in 28% of patients, they improved. The intensity of change was moderate or significant. The most dynamic and informative indicators were the vital capacity of the lungs and the partial tension of oxygen in oxygenated blood (PaO2).

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Evaluation of the effect of the capitation compensation mechanism among pulmonary tuberculosis patients with a full period of treatment

Infectious Diseases of Poverty ◽

10.1186/s40249-021-00861-0 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Xing-Yu Hu ◽

Guang-Ying Gao

Keyword(s):

Pulmonary Tuberculosis ◽

Patient Compliance ◽

Quantitative Data ◽

Financial Burden ◽

Descriptive Analysis ◽

Compensation Mechanism ◽

Medication Costs ◽

Implementation Time ◽

Full Period ◽

The Impact

Abstract Background PTB is an infectious disease, which not only seriously affects people’s health, but also causes a heavier disease economic burden on patients. At present, reform of the medical insurance payment can be an effective method to control medical expenses. Therefore, our study is to explore the compensation mechanism for pulmonary tuberculosis (PTB) patients with a full period of treatment, to alleviate the financial burden of PTB patients and provide a reference and basis for the reform of PTB payment methods in other regions and countries. Methods The quantitative data of PTB patients was collected from the first half of 2015 to the first half of 2018 in Dehui Tuberculosis Hospital in Jilin Province, and medical records of PTB patients registered in the first half of 2018 (n = 100) from the hospital was randomly selected. Descriptive analysis of these quantitative data summarized the number, cost, medication and compliance. Semi-structured in depth interviews with policymakers and physicians were conducted to understand the impact of interventions and its causes. Results After implementation of the compensation mechanism, the number of PTB patient visits in 2018 was increased by 14.2%, average medical costs for outpatients and inpatients were significantly reduced by 31.8% and 47.0%, respectively, and the auxiliary medication costs was reduced by 36.5%. Moreover, the hospital carried out standardized management of tuberculosis, and the patient compliance was very high, reaching almost 90%. Conclusions The capitation compensation mechanism with a full period of treatment was a suitable payment method for PTB, and it is worthy of promotion and experimentation. In addition, the model improved patient compliance and reduced the possibility of drug-resistant PTB. However, due to the short implementation time of the model in the pilot areas, the effect remains to be further observed and demonstrated.

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Elimination of nasal obstruction improves pulmonary functions and oxygenation

Egyptian Journal of Bronchology ◽

10.1186/s43168-021-00079-6 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Eman Sobh ◽

Fatma Elhussieny ◽

Taghreed Ismail

Keyword(s):

Nasal Obstruction ◽

Blood Gases ◽

Medical Problem ◽

Forced Expiratory Volume ◽

Nasal Packing ◽

Nasal Pack ◽

Arterial Blood ◽

Study Population ◽

The Mean ◽

The Impact

Abstract Background Nasal obstruction is a significant medical problem. This study aimed to examine the effect of nasal obstruction and nasal packing on arterial blood gases and pulmonary function indices, and the impact of the elimination of nasal obstruction on preoperative values. Results The mean age of the study population was 26.6 ± 10.1 years, males represented 50.8%. Spirometric indices showed statistically significant improvement (preoperative forced expiratory volume in 1st second 66.9 ± 13.9 vs 79.6 ± 14.9 postoperative and preoperative forced vital capacity 65.5 ± 12.7 vs 80.4 ± 13.8 postoperative). Oxygen saturation was significantly lower during nasal packing (95.6 ± 1.6 preoperative vs 94.7 ± 2.8 with nasal pack), and significant improvement (97.2 ± 1.4) was observed after removal of the nasal pack. Nasal obstruction scores significantly improved. Conclusion The results of this study indicate that either simple nasal obstruction or nasal packing may cause hypoxemia and abnormalities in lung function tests. Hypoxemia was more evident with nasal packing.

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The Impact of Nontuberculous Myobacteria on Management of Presumed Pulmonary Tuberculosis

Infection ◽

10.1007/s15010-001-0101-6 ◽

2001 ◽

Vol 29 (2) ◽

pp. 59-63 ◽

Cited By ~ 16

Author(s):

R. van Crevel ◽

W.C.M. de Lange ◽

N.A. Vanderpuye ◽

D. van Soolingen ◽

J.A.A. Hoogkamp-Korstanje ◽

...

Keyword(s):

Pulmonary Tuberculosis ◽

The Impact

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Antiracist Curriculum and Digital Platforms: Evidence from Black Lives Matter

Management Science ◽

10.1287/mnsc.2021.4281 ◽

2022 ◽

Author(s):

Saharsh Agarwal ◽

Ananya Sen

Keyword(s):

Public Schools ◽

The United States ◽

Control Group ◽

Public School Teachers ◽

School Teachers ◽

Digital Platforms ◽

Marginalized Communities ◽

High Profile ◽

Null Effect ◽

The Impact

In this paper, we examine the impact of racially charged events on the demand for antiracist classroom resources in U.S. public schools. We use book requests made by teachers on DonorsChoose, the largest crowdfunding platform for public school teachers, as a measure of intent to address race-related topics in the classroom. We use the precise timing of high-profile police brutality and other racially charged events in the United States (2010–2020) to identify their effect on antiracism requests relative to a control group. We find a significant increase in antiracism requests following the killing of George Floyd in 2020 and a null effect for all other events in the decade. We also find an increase in requests for books featuring Latinx, Asian, Muslim, and Jewish cultures, suggesting that a focus on equality for one group can spill over and yield culturally aware dialogues for other groups as well. Event studies suggest that local protests played a role in motivating some of the teachers to post these requests. In just four months following George Floyd’s death, $3.4 million worth of books featuring authors and characters from marginalized communities were successfully funded, reaching more than half a million students. Text analysis of impact notes posted by teachers suggests that hundreds of thousands of young students are being engaged in discussions about positive affirmation and cross-cultural acceptance. This paper was accepted by D.J. Wu, information systems.

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Analysis of Radiation Dose to the Shoulder by Treatment Technique and Correlation With Patient Reported Outcomes in Patients Receiving Regional Nodal Irradiation

Frontiers in Oncology ◽

10.3389/fonc.2021.617926 ◽

2021 ◽

Vol 11 ◽

Author(s):

Jose G. Bazan ◽

Dominic DiCostanzo ◽

Karen Hock ◽

Sachin Jhawar ◽

Karla Kuhn ◽

...

Keyword(s):

Breast Cancer ◽

Radiation Therapy ◽

Radiation Dose ◽

Patient Reported Outcomes ◽

Late Complication ◽

Treatment Technique ◽

Regional Nodal Irradiation ◽

Patient Reported ◽

The Impact ◽

Dash Questionnaire

Background/PurposeShoulder/arm morbidity is a late complication of breast cancer treatment with surgery and regional nodal irradiation (RNI). We set to analyze the impact of radiation technique [intensity modulated radiation therapy (IMRT) or 3D conformal radiation therapy (3DCRT)] on radiation dose to the shoulder with a hypothesis that IMRT use results in smaller volume of shoulder receiving radiation. We explored the relationship of treatment technique on long-term patient-reported outcomes using the quick disabilities of the arm, shoulder, and hand (q-DASH) questionnaire.Materials/MethodsWe identified patients treated with adjuvant RNI (50 Gy/25 fractions) from 2013 to 2018. We retrospectively contoured the shoulder organ-at-risk (OAR) from 2 cm above the ipsilateral supraclavicular (SCL) planning target volume (PTV) to the inferior SCL PTV slice and calculated the absolute volume of shoulder OAR receiving 5–50 Gy (V5–V50). We identified patients that completed a q-DASH questionnaire ≥6 months from the end of RNI.ResultsWe included 410 RNI patients: 54% stage III, 72% mastectomy, 35% treated with IMRT. IMRT resulted in significant reductions in the shoulder OAR volume receiving 20–50 Gy vs. 3DCRT. In total, 82 patients completed the q-DASH. The mean (SD) q-DASH=25.4 (19.1) and tended to be lower with IMRT vs. 3DCRT: 19.6 (16.4) vs. 27.8 (19.8), p=0.078.ConclusionWe found that IMRT reduces radiation dose to the shoulder and is associated with a trend toward reduced q-DASH scores ≥6 months post-RNI in a subset of our cohort. These results support prospective evaluation of IMRT as a technique to reduce shoulder morbidity in breast cancer patients receiving RNI.

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Commentary on: Clinical Trial Outcomes of High- and Extra High–Profile Breast Implants

Aesthetic Surgery Journal ◽

10.1177/1090820x13484147 ◽

2013 ◽

Vol 33 (4) ◽

pp. 540-543 ◽

Cited By ~ 4

Author(s):

William P. Adams

Keyword(s):

Clinical Trial ◽

Breast Implants ◽

High Profile ◽

Trial Outcomes

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The Impact of Treatment on the Serum Concentration of Interleukin-1 Beta in Pulmonary Tuberculosis

American Journal of Therapeutics ◽

10.1097/mjt.0000000000000360 ◽

2017 ◽

Vol 24 (3) ◽

pp. e329-e332 ◽

Cited By ~ 2

Author(s):

Chikere A. Anusiem ◽

Paul O. Okonkwo

Keyword(s):

Serum Concentration ◽

Pulmonary Tuberculosis ◽

Interleukin 1 ◽

Interleukin 1 Beta ◽

The Impact

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31. Parliament and Freedom of Information

Exploring Parliament ◽

10.1093/hepl/9780198788430.003.0031 ◽

2018 ◽

Author(s):

Ben Worthy

Keyword(s):

Freedom Of Information ◽

House Of Commons ◽

High Profile ◽

House Of Lords ◽

The Law ◽

The Uk ◽

The Impact

This chapter considers the impact of the Freedom of Information (FOI) Act 2000 on the UK Parliament. Since 2005, FOI 2000 has helped make both the House of Commons and the House of Lords more open and accountable. The most high-profile effect of the law came in 2009, when it played a part in exposing the abuse of the expense allowance system. Despite the scandal, it is not clear whether FOI has transformed the culture of the two Houses. Nevertheless, the law has indirectly sparked a series of other reforms, so that FOI now sits alongside a whole range of instruments intended to make Parliament more open and accessible. The chapter first provides an overview of what FOIs consist of, their application to legislatures and Westminster specifically, before analysing the extent of the impact of FOI 2000 on the UK Parliament.

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