Rheumatologic aspects of the COVID-19 pandemic: a practical resource for physicians in Kuwait and the Gulf region based on recommendations by the Kuwait Association of Rheumatology (KAR)

2021 ◽  
Vol 17 ◽  
Author(s):  
Baron F ◽  
Alhajeri H ◽  
Abutiban F ◽  
Almutairi M ◽  
Alawadhi A ◽  
...  
Keyword(s):  
Scientific Evidence ◽  
World Health ◽  
Gulf Region ◽  
National Medical ◽  
The United Kingdom ◽  
Medical Library ◽  
Clinical Scenarios ◽  
Evidence Collection ◽  
Health Organization ◽  
Optimum Management

: The Kuwait Association of Rheumatology members met three times in April 2020 to quickly address and support the local practitioners treating rheumatic disease in Kuwait and the Gulf region during the COVID-19 pandemic. As patients with rheumatic and musculoskeletal disease (RMD) may need modifications to their therapy during the COVID-19 pandemic, we voted online for general guidance that local practitioners needed. In this review, we have addressed the vulnerability of rheumatic patients and issues surrounding their optimum management. We base our recommendations on a synthesis of national/international guidelines and expert consensus among KAR members in the context of the Kuwaiti healthcare system caring for the patient population with RMD. The most recent reports from the World Health Organization, the Center for Disease Control, the National Institutes of Health – National Medical Library, and the COVID-19 educational website of the United Kingdom National Health Service have been incorporated. We discuss the management of RMD in various clinical scenarios: screening protocols in an infusion clinic, medication protocols for stable patients and care for suspected or confirmed COVID infection and whether they are stable, in a disease flare or newly diagnosed. Besides, we also outline the conditions for the hospital admission. This guidance is for the specialist and non-specialist readership and should be regarded as interim as the virus is relatively new and we rely on experience and necessity more than evidence collection. The guidance presented should be supplemented with recent scientific evidence wherever applicable.

Características y especialización de la respuesta inmunitaria en la COVID-19 y posibles tratamientos profilácticos

2020 ◽  
Vol 63 (4) ◽  
pp. 7-18 ◽  
Author(s):  
Anamary Súarez Reyes ◽  
Carlos Agustín Villegas Valverde
Keyword(s):  
Immune Response ◽  
Rna Virus ◽  
Scientific Evidence ◽  
World Health ◽  
Alveolar Level ◽  
Inflammatory Drugs ◽  
Interferon System ◽  
Severity Of The Disease ◽  
Health Organization ◽  
De Medicina

Characteristics and Specialization of the Immune Response in COVID-19 Abstract The outbreak of coronavirus pneumonia in Wuhan, China, became a pandemic on March 11, 2020. It has caused almost 4 million confirmed cases worldwide, with more than 270,000 deaths. Coronavirus is an enveloped RNA virus of the β-coronavirus genus distributed in birds, humans, and other mammals. The World Health Organization has named the new disease COVID-19. The scientific community is look http://doi.org/10.22201/fm.24484865e.2020.63.4.02 8 8 Revista de la Facultad de Medicina de la UNAM | ing for evidence that can lead to a better understanding of the infection and the immune response (IR), prognostic and therapeutic predictors, effective treatments and vaccines. The objective of this review was to compile updated scientific evidence of the IR to COVID-19, in order to guide professionals with solutions that have a clinical impact. The most important elements involve innate immunity with failures in the interferon system in the early stages of the infection and a sustained increase in proinflammatory interleukins. This can end in a potentially fatal cytokine storm. The infiltration of neutrophils and macrophages at the alveolar level, accompanied by neutrophilia, is very characteristic. Lymphopenia is evident at the adaptive immunity level, that, depending on the degree, can indicate the severity of the disease. Understanding the temporal sequence of the IR is crucial for choosing the appropriate and effective therapies, especially when selecting which type of anti-inflammatory drugs can be used and the frequency of the dosage. Due to the fact that it is difficult to determine when they will be clearly beneficial, not harmful to the IR and not too late, due to the irreversibility of the process. Key words: COVID-19; coronavirus; immune response

scholarly journals National Antimicrobial Consumption: Analysis of Central Warehouses Supplies to In-Patient Care Health Facilities from 2017 to 2019 in Uganda

2021 ◽  
Vol 6 (2) ◽  
pp. 83
Author(s):  
Juliet Sanyu Namugambe ◽  
Alexandre Delamou ◽  
Francis Moses ◽  
Engy Ali ◽  
Veerle Hermans ◽  
...  
Keyword(s):  
Inpatient Care ◽  
Health Facilities ◽  
World Health ◽  
Defined Daily Dose ◽  
Antimicrobial Consumption ◽  
National Medical ◽  
The World ◽  
Daily Dose ◽  
Care Health ◽  
Health Organization

Antimicrobial consumption (AMC) surveillance at global and national levels is necessary to inform relevant interventions and policies. This study analyzed central warehouse antimicrobial supplies to health facilities providing inpatient care in Uganda. We collected data on antimicrobials supplied by National Medical Stores (NMS) and Joint Medical Stores (JMS) to 442 health facilities from 2017 to 2019. Data were analyzed using the World Health Organization methodology for AMC surveillance. Total quantity of antimicrobials in defined daily dose (DDD) were determined, classified into Access, Watch, Reserve (AWaRe) and AMC density was calculated. There was an increase in total DDDs distributed by NMS in 2019 by 4,166,572 DDD. In 2019, Amoxicillin (27%), Cotrimoxazole (20%), and Metronidazole (12%) were the most supplied antimicrobials by NMS while Doxycycline (10%), Amoxicillin (19%), and Metronidazole (10%) were the most supplied by JMS. The majority of antimicrobials supplied by NMS (81%) and JMS (66%) were from the Access category. Increasing antimicrobial consumption density (DDD per 100 patient days) was observed from national referral to lower-level health facilities. Except for NMS in 2019, total antimicrobials supplied by NMS and JMS remained the same from 2017 to 2019. This serves as a baseline for future assessments and monitoring of stewardship interventions.

scholarly journals Comprehensive physiotherapy management in covid-19 – a narrative review

2020 ◽  
Vol 30 (1) ◽  
pp. 38030 ◽  
Author(s):  
Deivendran Kalirathinam ◽  
Raj Guruchandran ◽  
Prabhakar Subramani
Keyword(s):  
Narrative Review ◽  
World Health ◽  
Evidence Based ◽  
The United Kingdom ◽  
Global Pandemic ◽  
Related Quality ◽  
Health Related ◽  
Novel Coronavirus ◽  
Health Organization ◽  
The Uk

The 2019 novel coronavirus officially named as coronavirus disease 2019 (COVID-19) pandemic by the World Health Organization, has spread to more than 180 countries. The ongoing global pandemic of severe acute respiratory syndrome coronavirus, which causes COVID-19, spread to the United Kingdom (UK) in January 2020. Transmission within the UK was confirmed in February, leading to an epidemic with a rapid increase in cases in March. As on April 25- 2020, there have been 148,377 confirmed cases of COVID-19 in the UK and 20,319 people with confirmed infection have died. Survival of critically ill patients is frequently associated with significant functional impairment and reduced health-related quality of life. Early physiotherapy and community rehabilitation of COVID-19 patients has recently been identified as an essential therapeutic tool and has become a crucial evidence-based component in the management of these patients. This comprehensive narrative review aims to describe recent progress in the application of physiotherapy management in COVID 19 patients. Assessment and evidence- based treatment of these patients should include prevention, reduction of adverse consequences in immobilization, and long-term impairment sequelae. A variety of techniques and modalities of early physiotherapy in intensive care unit are suggested by clinical research. They should be applied according to the stage of the disease, comorbidities, and patient’s level of cooperation.

scholarly journals An Uncertain Risk: The World Health Organization's Account of H1N1

2014 ◽  
Vol 27 (3) ◽  
pp. 511-529 ◽  
Author(s):  
Sudeepa Abeysinghe
Keyword(s):  
Public Health ◽  
Influenza Pandemic ◽  
Scientific Evidence ◽  
H1n1 Influenza ◽  
World Health ◽  
Scientific Uncertainty ◽  
Global Public Health ◽  
The World ◽  
Public Risk ◽  
Health Organization

ArgumentScientific uncertainty is fundamental to the management of contemporary global risks. In 2009, the World Health Organization (WHO) declared the start of the H1N1 Influenza Pandemic. This declaration signified the risk posed by the spread of the H1N1 virus, and in turn precipitated a range of actions by global public health actors. This article analyzes the WHO's public representation of risk and examines the centrality of scientific uncertainty in the case of H1N1. It argues that the WHO's risk narrative reflected the context of scientific uncertainty in which it was working. The WHO argued that it was attempting to remain faithful to the scientific evidence, and the uncertain nature of the threat. However, as a result, the WHO's public risk narrative was neither consistent nor socially robust, leading to the eventual contestation of the WHO's position by other global public health actors, most notably the Council of Europe. This illustrates both the significance of scientific uncertainty in the investigation of risk, and the difficulty for risk managing institutions in effectively acting in the face of this uncertainty.

scholarly journals Scientific Certainty in a Time of Uncertainty: Predicting Vulnerability of Canada's First Nations to Pandemic H1N1/09

2010 ◽  
Vol 1 (1) ◽  
Author(s):  
Nicholas Spence ◽  
Jerry P. White
Keyword(s):  
World Health Organization ◽  
First Nations ◽  
Influenza Pandemic ◽  
Scientific Evidence ◽  
Indigenous Populations ◽  
World Health ◽  
Director General ◽  
Pandemic H1n1 ◽  
The World ◽  
Health Organization

On June 11, 2009, the Director General of the World Health Organization, Dr. Margaret Chan, announced that the scientific evidence indicated that the criteria for an influenza pandemic had been met: pandemic H1N1/09 virus, the first in nearly 40 years, was officially upon us. The World Health Organization has estimated that as many as 2 billion or between 15 and 45 percent of the population globally will be infected by the H1N1/09 virus. Scientists and governments have been careful to walk a line between causing mass public fear and ensuring people take the risks seriously. The latest information indicates that the majority of individuals infected with the H1N1/09 virus thus far have suffered mild illness, although very severe and fatal illness have been observed in a small number of cases, even in young and healthy people (World Health Organization 2009c). There is no evidence to date that the virus has mutated to a more virulent or lethal form; however, as we enter the second wave of the pandemic, a significant number of people in countries across the world are susceptible to infection. Most importantly, certain subgroups have been categorized as high risk given the clinical evidence to date. One of these subgroups is Indigenous populations (World Health Organization 2009c).

scholarly journals Final orientation for new graduates on the highest attainable standard of health

2019 ◽  
Vol 33 (5) ◽  
pp. 362-365
Author(s):  
Samlee Plianbangchang
Keyword(s):  
Self Care ◽  
Good Health ◽  
Individual Responsibility ◽  
World Health ◽  
Public Health Workforce ◽  
Content Type ◽  
New Graduates ◽  
National Medical ◽  
The Government ◽  
Health Organization

Purpose The purpose of this paper is to discuss the importance of taking responsibility for our own self-care as fundamental to achieving optimum healthcare at all levels: family, community and country. However, for self-care to work at its best, the support of the government and the national medical and public health workforce are required in addition to increased facilities that ensure the development and long-term maintenance of a person’s health status. Moreover, inter-disciplinary government policy, strategy and resource support should be placed as a central part of the national healthcare development system. Design/methodology/approach It is a commentary piece of work from own long experience in working with the World Health Organization. Findings The value of self-care and individual responsibility in achieving one’s own good health ultimately results in improved national and global health standards. Originality/value This commentary explores the ideas and concepts on ways and means of leading people to think and act toward achieving their own optimum health in order to lead a socially and economically productive life and ultimately achieve “the highest attainable standard of health,” a WHO objective.

Meningiomas

2018 ◽  
Author(s):  
K. E. Hovinga ◽  
Y. Esquenazi ◽  
P. H. Gutin
Keyword(s):  
Treatment Strategies ◽  
Brain Structures ◽  
World Health ◽  
Spinal Tumors ◽  
Central Nervous System Tumors ◽  
Clinical Scenarios ◽  
The World ◽  
Specific Factors ◽  
Health Organization ◽  
Slow Growing

Meningiomas are the most common primary central nervous system tumors and account for about one third of all primary brain and spinal tumors. They are classified according to the World Health Organization into 3 groups (I–III). Treatment strategies range from observation, surgery, and/or a radiation therapy. Many meningiomas are slow growing and discovered incidentally. Symptoms can vary widely, depending on the location. Patient’s specific factors and the location of the meningioma in relation to critical brain structures are all important factors in determining the optimal treatment. This chapter presents common clinical scenarios of meningioma. Differential diagnosis, perioperative workup, surgical nuances, and postoperative complications are discussed.

scholarly journals Misinformation, chiropractic, and the COVID-19 pandemic

2020 ◽  
Vol 28 (1) ◽  
Author(s):  
Iben Axén ◽  
Cecilia Bergström ◽  
Marc Bronson ◽  
Pierre Côté ◽  
Casper Glissmann Nim ◽  
...  
Keyword(s):  
Public Health ◽  
Social Media ◽  
Scientific Evidence ◽  
Collective Responsibility ◽  
Economic Consequences ◽  
Best Interests ◽  
World Health ◽  
Chiropractic Treatment ◽  
Health Organization ◽  
The Impact

Abstract Background In March 2020, the World Health Organization elevated the coronavirus disease (COVID-19) epidemic to a pandemic and called for urgent and aggressive action worldwide. Public health experts have communicated clear and emphatic strategies to prevent the spread of COVID-19. Hygiene rules and social distancing practices have been implemented by entire populations, including ‘stay-at-home’ orders in many countries. The long-term health and economic consequences of the COVID-19 pandemic are not yet known. Main text During this time of crisis, some chiropractors made claims on social media that chiropractic treatment can prevent or impact COVID-19. The rationale for these claims is that spinal manipulation can impact the nervous system and thus improve immunity. These beliefs often stem from nineteenth-century chiropractic concepts. We are aware of no clinically relevant scientific evidence to support such statements. We explored the internet and social media to collect examples of misinformation from Europe, North America, Australia and New Zealand regarding the impact of chiropractic treatment on immune function. We discuss the potential harm resulting from these claims and explore the role of chiropractors, teaching institutions, accrediting agencies, and legislative bodies. Conclusions Members of the chiropractic profession share a collective responsibility to act in the best interests of patients and public health. We hope that all chiropractic stakeholders will view the COVID-19 pandemic as a call to action to eliminate the unethical and potentially dangerous claims made by chiropractors who practise outside the boundaries of scientific evidence.

Experience of non-breastfeeding mothers

2014 ◽  
Vol 23 (2) ◽  
pp. 231-241 ◽  
Author(s):  
Jessica Nihlén Fahlquist
Keyword(s):  
Online Survey ◽  
Research Question ◽  
World Health ◽  
The United Kingdom ◽  
Qualitative Survey ◽  
Health Authorities ◽  
Public Health Authorities ◽  
Ethics Guidelines ◽  
Health Organization ◽  
Research Ethics Guidelines

Background: Breastfeeding is currently strongly recommended by midwives and paediatricians, and the recommendations are based on documents provided by the World Health Organization and public health authorities worldwide. Research question: The underlying question is, how are non-breastfeeding mothers affected emotionally when informed that breastfeeding is the safest and healthiest option? Research design: The method used is an anonymous web-based qualitative survey exploring the narratives of non-breastfeeding mothers, published on Thesistools.com . The aim is to achieve qualitative knowledge about the emotions of non-breastfeeding mothers. Participants and research context: Participants were based in Sweden, the United Kingdom and the Netherlands and were selected through a purposeful sample. Ethical considerations: The online survey anonymizes responses automatically, and all respondents had to tick a box agreeing to be quoted anonymously in scientific articles. The study conforms to research ethics guidelines. Findings: Respondents describe how they were affected, and the following themes emerged in studying their descriptions: depression, anxiety and pain, feeling failed as a mother and woman, loss of freedom/feeling trapped, relief and guilt. Discussion: The themes are discussed against the background of the ethics of care and a theory of ethically responsible risk communication. Conclusion: Three conclusions are made. First, the message should become more empathetic. Second, information should be given in an attentive dialogue. Third, information providers should evaluate effects in a more inclusive way.

Community Nurses and Health Promotion: Ethical and Political Perspectives

1996 ◽  
Vol 3 (2) ◽  
pp. 97-107 ◽  
Author(s):  
Jane Thomas ◽  
Paul Wainwright
Keyword(s):  
Health Promotion ◽  
Health Gain ◽  
Individual Responsibility ◽  
World Health ◽  
Department Of Health ◽  
The United Kingdom ◽  
Central Council ◽  
Recent Developments ◽  
The One ◽  
Health Organization

This paper brings together ideas from two perspectives on ethics and health promotion. A discussion of the ethical dimension of the health promotion practice of community nurses is set in the wider context of health policy, with particular reference to health gain and individual responsibility. It is widely held that nurses have a key role to play in health promotion and that this is particularly the case for nurses working in primary health care. This assumption is reinforced by policy documents from the World Health Organization, the Department of Health and statutory bodies such as the United Kingdom Central Council for Nursing, Midwifery and Health Visiting. The approach of many nurses to health promotion has tended on the one hand to be somewhat naive and on the other to be authoritarian and didactic; there has been little discussion in the nursing literature of the ethical aspects of health promotion. However, recent developments in nurse education, such as Project 2000 and the consequent changes to preregistration programmes, have resulted in increased attention to both ethics and health promotion within the curriculum.

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