scholarly journals Crusted Scabies as a Suitable Disease for Teledermatology: A Study of 2 Cases (Preprint)

2021 ◽  
Author(s):  
César Bimbi ◽  
Daiane Flores Dalla Lana ◽  
Piotr Brzezinski ◽  
Georgia Kyriakou
Keyword(s):  
Health Services ◽  
Clinical Picture ◽  
Neurological Diseases ◽  
Medical Personnel ◽  
Clinical Analysis ◽  
Clinical Suspicion ◽  
Local Health ◽  
Older Woman ◽  
Remote Communities ◽  
Crusted Scabies

BACKGROUND Teledermatology has been available for several years now, but the COVID-19 pandemic has highlighted its importance, especially in remote communities. Crusted scabies (CS) presents a unique clinical picture that favors telediagnosis. Patients with neurological diseases, as well as homeless, HIV-infected patients and people with impaired immunological function, are at risk. Clusters of CS have been reported in French Guyana, and these were associated with human T-lymphotropic virus infections. CS has also been reported in Aboriginal Australian communities. OBJECTIVE Teledermatology is especially useful in cases of CS, as it is a disease that affects areas that are in need of medical services. At the same time, CS presents a unique clinical picture. The objective of this presentation is to fuel the clinical suspicion and detection of patients with this debilitating condition. METHODS Relatives of patient 1 contacted our clinic for teledermatology appointments. General practitioners from health services sent images of the second patient. RESULTS Case 1 involved an older woman living in a nursing home with Alzheimer disease, which was severe enough to constrain her to bed. We recommended that her relatives (who had sent images) collect skin scrapings in a container. These scrapings were sent to a clinical analysis laboratory where microscopic potassium hydroxide preparation revealed the presence of <i>Sarcoptes</i> mites. Treatment with oral ivermectin and topical permethrin resulted in the complete resolution of the lesions. Case 2 involved a homeless, HIV-positive, 42-year-old male. The images were sent by clinicians from local health services. This patient was also treated with oral ivermectin and permethrin lotion. We recognize that this case would need further diagnostic workup, but it is highly indicative of CS. CONCLUSIONS CS is one of the most suited diseases for the practice of teledermatology for widespread, large, hyperkeratotic fissured plaques covered with abundant, silvery scales for which the expression “once seen, never forgotten” is highly applicable. These cases are gratifyingly simple to treat, and patients benefit from rapid clinical improvement. Prompt diagnoses prevent outbreaks of scabies for relatives and medical personnel, since these skin crusts contain large numbers of scabies mites. CS has been increasingly reported but poorly recognized, and it has often been misdiagnosed as psoriasis. Images, such as those shown in this presentation, are unique and are enough to raise strong clinical suspicion.

scholarly journals Crusted Scabies as a Suitable Disease for Teledermatology: A Study of 2 Cases

Iproceedings ◽  
10.2196/35429 ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. e35429
Author(s):  
César Bimbi ◽  
Daiane Flores Dalla Lana ◽  
Piotr Brzezinski ◽  
Georgia Kyriakou
Keyword(s):  
Health Services ◽  
Clinical Picture ◽  
Conflicts Of Interest ◽  
Neurological Diseases ◽  
Medical Personnel ◽  
Clinical Analysis ◽  
Clinical Suspicion ◽  
Local Health ◽  
Older Woman ◽  
Crusted Scabies

Background Teledermatology has been available for several years now, but the COVID-19 pandemic has highlighted its importance, especially in remote communities. Crusted scabies (CS) presents a unique clinical picture that favors telediagnosis. Patients with neurological diseases, as well as homeless, HIV-infected patients and people with impaired immunological function, are at risk. Clusters of CS have been reported in French Guyana, and these were associated with human T-lymphotropic virus infections. CS has also been reported in Aboriginal Australian communities. Objective Teledermatology is especially useful in cases of CS, as it is a disease that affects areas that are in need of medical services. At the same time, CS presents a unique clinical picture. The objective of this presentation is to fuel the clinical suspicion and detection of patients with this debilitating condition. Methods Relatives of patient 1 contacted our clinic for teledermatology appointments. General practitioners from health services sent images of the second patient. Results Case 1 involved an older woman living in a nursing home with Alzheimer disease, which was severe enough to constrain her to bed. We recommended that her relatives (who had sent images) collect skin scrapings in a container. These scrapings were sent to a clinical analysis laboratory where microscopic potassium hydroxide preparation revealed the presence of Sarcoptes mites. Treatment with oral ivermectin and topical permethrin resulted in the complete resolution of the lesions. Case 2 involved a homeless, HIV-positive, 42-year-old male. The images were sent by clinicians from local health services. This patient was also treated with oral ivermectin and permethrin lotion. We recognize that this case would need further diagnostic workup, but it is highly indicative of CS. Conclusions CS is one of the most suited diseases for the practice of teledermatology for widespread, large, hyperkeratotic fissured plaques covered with abundant, silvery scales for which the expression “once seen, never forgotten” is highly applicable. These cases are gratifyingly simple to treat, and patients benefit from rapid clinical improvement. Prompt diagnoses prevent outbreaks of scabies for relatives and medical personnel, since these skin crusts contain large numbers of scabies mites. CS has been increasingly reported but poorly recognized, and it has often been misdiagnosed as psoriasis. Images, such as those shown in this presentation, are unique and are enough to raise strong clinical suspicion. Conflicts of Interest None declared.

scholarly journals Public Health Center (Puskesmas) Efficiency Level In Semarang Regency Year 2014

2018 ◽  
Vol 6 (3) ◽  
pp. 306-312
Author(s):  
Eko Setiawan ◽  
Y. Titik Haryati
Keyword(s):  
Public Health ◽  
Health Services ◽  
Community Health ◽  
Health Center ◽  
Community Health Centers ◽  
Medical Personnel ◽  
Health Department ◽  
Health Centers ◽  
Local Health Department ◽  
Local Health

Public health centers is a technical implementation unit of Local Health Department which is responsible for conducting health efforts forh the whole society and as a first-rate health services that directly reach the whole community to achieve a healthy and prosperous society.The purpose of this study is to determine the ability of Community Health Center in managing the resources and how wide the coverage range of the Community Health Centre in district of Semarang.This study using vaariable input and output.The input which is used is consisting of four variables, they are: the number of medical personnel, the number of non-medical personnel, financing sourced from regional government budget and the number of integrated service post.. While the outputvariables are the health services towards toddlers, the immunization coverage, the number of outpatient visits and coverage of births assisted by health personnel The data used was secondary data obtained from Local Health Department in district of Semarang, Central Bureau of Statistics and other sources.From the calculation of DEA, the results are, in 18 Community Health Centers are technically efficient and 8 Community Health Centers are technically inefficient.Unit public health centers that have efficient will be comparison for puskesmas that not efficient. For public health centers inefficient technically can improve efficiency value by raising output based on the calculation on DEA. Suggested the results of the efficiency with the dea can be used as an alternative to assess the efficiency of public health centers in kabupaten semarang regularly and as one input to assess, monitor and improved performance public health centers.

scholarly journals Why has COVID-19 not hit the countries like Nepal yet?

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Krishna Prasad Pathak ◽  
Tara Gaire ◽  
Mu-Hsing Ho ◽  
Hui chen (Rita) Chang
Keyword(s):  
Health Services ◽  
Social Distance ◽  
Scientific Evidence ◽  
Local Health ◽  
First Case ◽  
Populations At Risk ◽  
Test Kit ◽  
Health Services Need ◽  
The Government ◽  
Google Search

AbstractNoble CORONA Virus (COVID-19) is an infectious disease similar form of pneumonia/ SARS-CoV-2- impacting globally. The fear of coronavirus looks pandemic, but its severity is uncertain. Nepal was one of the first nine countries outside of China to report a COVID-19 case. Also, its unpredictability of mode or range of surface, the lifespan of the virus, objects of transmission (a distance of air/air currents, living duration in air, humidity, duration on objects, surface). The first case was found in Wuhan in December 2019 in China. The purpose is to summarize the current information about COVID-19 and to explore in terms of why Nepal is not hitting severely, while other countries are on death toll? We summarized the published articles form the web sources and news, Academic Journals, Ministry of health and population Nepal, WHO/CDC update reports/guidelines, Google search engine. Thematic analysis is made to explore the situation. Although, Nepal has a lack of health services, testing kits, advance lab and protecting equipment (PPE), why COVID-19 does not hit Nepal than China, Europe and North America, it still tremendous uncertainty. Is lockdown, isolation, social distance and quarantine the best ways of prevention? The hypothesis is floating globally – do BCG vaccinated countries are safer than non-user OR due to not having enough kits to screen populations at risk for the virus – while lack of testing a big cause for missing case OR Nepalese have better immune systems? It has attracted global attention. We believe that the COVID-19 is still evolving and it is too early to predict of an outbreak in Nepal. The government needs to increase funding for local health departments, begin planning for future epidemics and be prepared to bolster the economy by supporting consumer spending the midst of a serious outbreak. COVID-19 is a serious health challenge for Nepal, but so far the number of death has been lower than was foretell. It is, therefore essential to carry out more scientific evidence to explore results. Nepalese health services need to maintain up than today and follow lockdown, isolation, social distance and an advance screening test kit through the country.

scholarly journals TeleNeurological evaluation and Support for the Emergency Department (TeleNS-ED): protocol for an open-label clinical trial

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e048293
Author(s):  
Jessica Mandrioli ◽  
Mario Santangelo ◽  
Antonio Luciani ◽  
Stefano Toscani ◽  
Elisabetta Zucchi ◽  
...  
Keyword(s):  
Emergency Department ◽  
Clinical Investigation ◽  
Neurological Diseases ◽  
Medical Personnel ◽  
Primary Objective ◽  
Control Group ◽  
National Guidelines ◽  
Open Label ◽  
Time Saving ◽  
Hospital Networks

IntroductionThe COVID-19 pandemic compelled health systems to protect patients and medical personnel during transit in hospitals by minimising transfers, prompting the use of telehealth systems. In the field of neurology, telemedicine has been used in emergency settings for acute stroke management between spoke and hub hospital networks, where good outcomes have been achieved. However, data on the use of telemedicine in non-stroke acute neurological conditions accessing the emergency department (ED) are currently missing.Methods and analysesThis is an interventional, open-label trial on the use of teleconsultation in the ED for neurological diseases other than stroke. The study aims to develop a remote consultancy system (TeleNeurological Evaluation and Support, TeleNS) for patients with acute neurological symptoms referred to hospital facilities without a 24-hour availability of a neurologist consultant (spoke hospitals). The study population will include 100 ED patients referred to two spoke hospitals in 6 months, who will be asked to perform teleconsultation instead of inperson visits. As a control group, retrospectively available data from patients admitted to the ED of spoke hospitals during the same time period over the last 2 years will be evaluated. The primary objective is to assess whether a TeleNS for the ED guarantees a faster but qualitatively non-inferior diagnostic/therapeutic work-up if compared with inperson examination, assuring the availability of all the necessary examinations and treatments with consistent time-saving.Ethics and disseminationThe trial was designed following the national guidelines on clinical investigation on telemedicine provided by the Italian Ministry of Health and according to the Standard Protocol Items for Randomized Trials statement guidelines. This research protocol was approved by Comitato Etico Area Vasta Emilia Nord in September 2020 (number/identification: 942/2020/DISP/AOUMO SIRER ID 805) and was written without patient involvement. Patients’ associations will be involved in the dissemination of study design and results. The results of the study will be presented during scientific symposia or published in scientific journals.Trial registration numberNCT04611295.

Health Care for South Lebanon's Civilian Population Following the June 1982 War

1985 ◽  
Vol 1 (1) ◽  
pp. 50-54
Author(s):  
T.H. Tulchinsky ◽  
Yakov Adler
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Services ◽  
Child Nutrition ◽  
Renal Dialysis ◽  
Nutrition Status ◽  
Local Health ◽  
Dialysis Unit ◽  
Medical Needs ◽  
South Lebanon

AbstractFollowing the June 1982 war in South Lebanon, the Israel Ministry of Health sent a medical team to assess health conditions in the area, to assist in the restoration of local health services, and to provide additional medical assistance as needed in public health and specialized medical services. For the approximately 600,000 population of the area, public health sanitary conditions were restored by local authorities, with some external assistance. Sanitation and housing for the refugee camp populations were difficult to solve because of extensive damage in the camps; but United Nations activities, supported by international and Israeli sources, were effective. Epidemic conditions did not occur. Monitoring for specific infectious diseases showed increases not exceeding usual summer conditions. Child nutrition status was satisfactory. Medical needs for specialty services, not available in South Lebanon, were arranged through screening and referral to Israeli hospitals. Renal dialysis needs were met by establishing a dialysis unit using local personnel in a damaged and non-functioning government hospital. Private medical and hospital services, the bulk of health care in the area, functioned except for minor dislocations throughout the war and post-war period. Israeli medical aid, managed by a small multidisciplinary team, was designed to assist and, where necessary, augment rather than replace local health services.

scholarly journals Neurological Diseases, Disorders and Injuries in Canada: Highlights of a National Study

2016 ◽  
Vol 43 (1) ◽  
pp. 5-14 ◽  
Author(s):  
Garth M. Bray ◽  
Deanna L. Huggett
Keyword(s):  
Health Services ◽  
Neurological Diseases ◽  
Health Study ◽  
National Study ◽  
Economic Costs ◽  
Neurological Conditions ◽  
The Government ◽  
Government Of Canada ◽  
Synthesis Report ◽  
The Impact

AbstractThe National Population Health Study of Neurological Conditions, a partnership between Neurological Health Charities Canada and the Government of Canada, was the largest study of neurological diseases, disorders, and injuries ever conducted in Canada. Undertaken between 2009 and 2013, the expansive program of research addressed the epidemiology, impacts, health services, and risk factors of 18 neurological conditions and estimated the health outcomes and costs of these conditions in Canada through 2031. This review summarizes highlights from the component projects of the study as presented in the synthesis report, Mapping Connections: An Understanding of Neurological Conditions in Canada. The key findings included new prevalence and incidence estimates, documentation of the diverse and often debilitating effects of neurological conditions, and identification of the utilization, economic costs, and current limitations of related health services. The study findings will support health charities, governments, and other stakeholders to reduce the impact of neurological conditions in Canada.

Malaria, Agriculture, and Development: Lessons from Past Campaigns

1987 ◽  
Vol 17 (2) ◽  
pp. 295-326 ◽  
Author(s):  
Uriel Kitron
Keyword(s):  
Health Services ◽  
Malaria Control ◽  
Socioeconomic Development ◽  
Agricultural Development ◽  
Agricultural Practices ◽  
The United States ◽  
World Health ◽  
Local Health ◽  
Single Measure ◽  
Relative Contribution

The author presents in this article a historical-epidemiological evaluation of several anti-malaria campaigns and of the relative contribution of various direct measures employed and indirect factors operating during these campaigns. Approaches and factors that may be essential or at least useful for successful malaria control are identified. The malaria story in Palestine/Israel and the experience of the Tennessee Valley Authority are analyzed in some detail. In both cases, direct anti-malaria measures were versatile and based mostly on reduction of mosquito breeding and elimination of Anopheles larvae. Efficient organization and coordination of anti-malaria efforts, strenuous research and understanding of the vector biology, and accompanying socioeconomic and agricultural development contributed to successful campaigns. Malaria control in other parts of the United States and in Italy is also considered. The World Health Organization global anti-malaria campaign is discussed in the light of these earlier experiences. The study concludes that no single measure is sufficient to control malaria and that future anti-malaria campaigns need to adopt strategies that are flexible, incorporated into local health services, and interrelated with agricultural practices. Moreover, a certain threshold of socioeconomic development, health services infrastructure, and educational level may have to be reached for the successful application and maintenance of direct anti-malaria measures.

scholarly journals Equitable access to health services for children aged 5 to 9 in a medium city of northeasth of Brazil: a result of Family Health Strategy

2014 ◽  
Vol 17 (suppl 2) ◽  
pp. 39-52 ◽  
Author(s):  
Adriana Xavier de Santiago ◽  
Ivana Cristina de Holanda Cunha Barreto ◽  
Ana Cecília Silveira Lins Sucupira ◽  
José Wellington de Oliveira Lima ◽  
Luiz Odorico Monteiro de Andrade
Keyword(s):  
Health Services ◽  
Health System ◽  
Family Health ◽  
Northeastern Brazil ◽  
Local Health ◽  
Access To Health Services ◽  
Care Services ◽  
Health Strategy ◽  
Access To Health ◽  
Family Health Strategy

INTRODUCTION: The Brazilian National Health System may reduce inequalities in access to health services through strategies that can reach those most in need with no access to care services. OBJECTIVE: To identify factors associated with the use of health service by children aged 5 to 9 years in the city of Sobral, Ceará, northeastern Brazil. RESULTS: Only 558 (17.0%) children used health care services in the 30 days preceding this survey. Children with any health condition (OR = 3.90) who were frequent attenders of primary care strategy of organization (the Family Health Strategy, FHS) (OR = 1.81) and living in the city's urban area (OR = 1.51) were more likely to use health services. Almost 80% of children used FHS as their referral care service. Children from poorer families and with easier access to services were more likely to be FHS users. CONCLUSION: The study showed that access to health services has been relatively equitable through the FHS, a point of entry to the local health system.

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