scholarly journals Tuberculous Meningitis in Children: Reducing the Burden of Death and Disability

Pathogens ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 38
Author(s):  
Julie Huynh ◽  
Yara-Natalie Abo ◽  
Karen du Preez ◽  
Regan Solomons ◽  
Kelly E Dooley ◽  
...  
Keyword(s):  
Drug Therapy ◽  
Tuberculous Meningitis ◽  
Rapid Diagnostics ◽  
Targeted Intervention ◽  
Neurodevelopmental Outcomes ◽  
New Host ◽  
Mortality And Morbidity ◽  
Research Questions ◽  
Meningitis In Children

Tuberculous meningitis disproportionately affects young children. As the most devastating form of tuberculosis, it is associated with unacceptably high rates of mortality and morbidity even if treated. Challenging to diagnose and treat, tuberculous meningitis commonly causes long-term neurodisability in those who do survive. There remains an urgent need for strengthened surveillance, improved rapid diagnostics technology, optimised anti-tuberculosis drug therapy, investigation of new host-directed therapy, and further research on long-term functional and neurodevelopmental outcomes to allow targeted intervention. This review focuses on the neglected field of paediatric tuberculous meningitis and bridges current clinical gaps with research questions to improve outcomes from this crippling disease.

scholarly journals Evidence-based Neonatal Care

2019 ◽  
Author(s):  
Anucha Thatrimontrichai
Keyword(s):  
Neonatal Care ◽  
Evidence Based ◽  
Limited Information ◽  
Long Term Outcomes ◽  
Crucial Issue ◽  
Neurodevelopmental Outcomes ◽  
Mortality And Morbidity ◽  
Randomized Controlled ◽  
Aging Societies

Aging societies are developing around the world while the number of newborns is decreasing. The best neonatal care is a crucial issue since prematurity is surging along with high mortality and morbidity in developing countries. However, the basic areas of evidence-based practice in neonatal care still have limited information because both the shortand long-term outcomes of this fragile population need to be considered. Sophisticated neonatal care is a new topic for improvement of survival and long-term neurodevelopmental outcomes. Randomized controlled trials and metaanalyses in neonatal care were reviewed and the local epidemiology was integrated to implement evidence-based neonatal care.

CURRENT ASPECTS OF CORONARY HEART DISEASE DIAGNOSIS AND TREATMENT

2020 ◽  
pp. 5-10
Author(s):  
O. M. Korzh
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Drug Therapy ◽  
Coronary Arteries ◽  
Artery Bypass ◽  
Myocardial Revascularization ◽  
Disease Diagnosis ◽  
Percutaneous Coronary Angioplasty ◽  
Mortality And Morbidity ◽  
Intravascular Thrombosis

Among the cardiovascular diseases associated with atherosclerosis, chronic coronary heart disease, including angina, is the most common form. It is the myocardium lesion that develops as a result of an imbalance between the coronary circulation and metabolic needs of heart muscle. The presence of angina symptoms often indicates a pronounced narrowing of one or more coronary arteries, but also occurs in non−obstructive arterial impairment and even in normal coronary arteries. Factors of functional damage to the coronary arteries are spasm, temporary platelet aggregation and intravascular thrombosis. Today there are opportunities not only to use the therapy with proven effectiveness, aimed at reducing the risk of complications, including fatal, but also to treat angina (ischemia), which improves the patient's life quality. The drug protocol includes the ones with a proven positive effect on this disease prognosis, which are mandatory if there are no direct contraindications to use, as well as a large group of antianginal or anti−ischemic drugs. The choice of a particular drug or its combinations with other drugs is carried out in accordance with generally accepted recommendations: taking into account the individual approach, the severity of angina, hemodynamic parameters (heart rate and blood pressure, presence of comorbid conditions). If drug therapy is ineffective, the option of coronary myocardial revascularization (percutaneous coronary angioplasty or coronary artery bypass grafting) is considered. Due to the high mortality and morbidity rates of coronary heart disease worldwide, one of the priorities of practical health care is the prevention of diseases caused by atherosclerosis. Key words: coronary heart disease, angina, family physician, prognosis, drug therapy.

scholarly journals Defence Medical Rehabilitation Centre (DMRC) COVID-19 Recovery Service

2021 ◽  
pp. e001681
Author(s):  
Oliver O'Sullivan ◽  
R Barker-Davies ◽  
R Chamley ◽  
E Sellon ◽  
D Jenkins ◽  
...  
Keyword(s):  
Occupational Medicine ◽  
Armed Forces ◽  
Acute Illness ◽  
Medical Rehabilitation ◽  
Rehabilitation Centre ◽  
Operational Effectiveness ◽  
Mortality And Morbidity ◽  
Recovery Service ◽  
Significant Mortality

Coronavirus disease 2019 (COVID-19) causes significant mortality and morbidity, with an unknown impact in the medium to long term. Evidence from previous coronavirus epidemics indicates that there is likely to be a substantial burden of disease, potentially even in those with a mild acute illness. The clinical and occupational effects of COVID-19 are likely to impact on the operational effectiveness of the Armed Forces. Collaboration between Defence Primary Healthcare, Defence Secondary Healthcare, Defence Rehabilitation and Defence Occupational Medicine resulted in the Defence Medical Rehabilitation Centre COVID-19 Recovery Service (DCRS). This integrated clinical and occupational pathway uses cardiopulmonary assessment as a cornerstone to identify, diagnose and manage post-COVID-19 pathology.

Short- and long-term outcomes of preterm spontaneous twin anemia-polycythemia sequence

2020 ◽  
Vol 48 (4) ◽  
pp. 329-334
Author(s):  
Soo Jin Han ◽  
Seung Mi Lee ◽  
Sohee Oh ◽  
Subeen Hong ◽  
Jeong Won Oh ◽  
...  
Keyword(s):  
Cord Blood ◽  
Neonatal Morbidity ◽  
Adverse Outcomes ◽  
Control Group ◽  
Long Term Outcomes ◽  
Neurodevelopmental Outcomes ◽  
Monochorionic Twin ◽  
Increased Risk ◽  
Study Population

AbstractBackgroundIn monochorionic twin pregnancy, placental anastomosis and inter-twin blood transfusion can result in specific complications, such as twin-twin transfusion syndrome (TTTS) and twin anemia-polycythemia sequence (TAPS). It is well established that adverse outcomes are increased in TTTS, but reports on the neonatal and long-term outcomes of TAPS are lacking. The objective of this study was to evaluate the neonatal and neurodevelopmental outcomes in spontaneous TAPS.MethodsThe study population consisted of monochorionic twin pregnancies with preterm birth (24–37 weeks of gestation) between November 2003 and December 2016 and in which cord blood was taken at the time of delivery. According to the result of hemoglobin in cord blood, the study population was divided into two groups: a spontaneous TAPS group and a control group. Neonatal and neurodevelopmental outcomes were compared between the two groups.ResultsDuring the study period, 11 cases were diagnosed as spontaneous TAPS (6.4%). The TAPS group had lower gestational age at delivery and had a higher risk for cesarean delivery. However, neonates with TAPS were not at an increased risk for neonatal mortality and significant neonatal morbidity. In addition, the frequency of severe cerebral lesion during the neonatal period and the risk of cerebral palsy at 2 years of age were not different between the two groups.ConclusionThe spontaneous TAPS diagnosed by postnatal diagnostic criteria was not associated with the increased risk of adverse neonatal and neurodevelopmental outcomes. Further studies are needed to evaluate the morbidity of antenatally diagnosed TAPS.

Tetralogy of Fallot: stent palliation or neonatal repair?

2021 ◽  
pp. 1-9
Author(s):  
Adeolu Banjoko ◽  
Golnoush Seyedzenouzi ◽  
James Ashton ◽  
Fatemeh Hedayat ◽  
Natalia N. Smith ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricular ◽  
Tetralogy Of Fallot ◽  
Surgical Repair ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Hospital Length Of Stay ◽  
Mortality And Morbidity

Abstract Surgical repair of Tetralogy of Fallot has excellent outcomes, with over 90% of patients alive at 30 years. The ideal time for surgical repair is between 3 and 11 months of age. However, the symptomatic neonate with Tetralogy of Fallot may require earlier intervention: either a palliative intervention (right ventricular outflow tract stent, ductal stent, balloon pulmonary valvuloplasty, or Blalock-Taussig shunt) followed by a surgical repair later on, or a complete surgical repair in the neonatal period. Indications for palliation include prematurity, complex anatomy, small pulmonary artery size, and comorbidities. Given that outcomes after right ventricular outflow tract stent palliation are particularly promising – there is low mortality and morbidity, and consistently increased oxygen saturations and increased pulmonary artery z-scores – it is now considered the first-line palliative option. Disadvantages of right ventricular outflow tract stenting include increased cardiopulmonary bypass time at later repair and the stent preventing pulmonary valve preservation. However, neonatal surgical repair is associated with increased short-term complications and hospital length of stay compared to staged repair. Both staged repair and primary repair appear to have similar long-term mortality and morbidity, but more evidence is needed assessing long-term outcomes for right ventricular outflow tract stent palliation patients.

Drug therapy team review in a long-term care facility

1987 ◽  
Vol 21 (7-8) ◽  
pp. 660-660 ◽  
Author(s):  
Kathryn M. Andolsek ◽  
Joseph T. Hanlon ◽  
Robert K. Lyons ◽  
Valerie S. Proffitt
Keyword(s):  
Drug Therapy ◽  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Therapy Team

Long-term Neurodevelopmental Outcomes of Children with Congenital Heart Defects

2021 ◽  
Author(s):  
Neil Derridj ◽  
Romain Guedj ◽  
Johanna Calderon ◽  
Lucile Houyel ◽  
Nathalie Lelong ◽  
...  
Keyword(s):  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Heart Defects ◽  
Neurodevelopmental Outcomes

Surgery Combined With Peritonectomy Procedures and Intraperitoneal Chemohyperthermia in Abdominal Cancers With Peritoneal Carcinomatosis: A Phase II Study

2003 ◽  
Vol 21 (5) ◽  
pp. 799-806 ◽  
Author(s):  
O. Glehen ◽  
F. Mithieux ◽  
D. Osinsky ◽  
A.C. Beaujard ◽  
G. Freyer ◽  
...  
Keyword(s):  
Peritoneal Carcinomatosis ◽  
Phase Ii ◽  
Phase Ii Study ◽  
Complete Resection ◽  
Morbidity Rate ◽  
Term Survival ◽  
Mortality And Morbidity ◽  
Peritonectomy Procedures ◽  
Experienced Team

Purpose: To evaluate the tolerance of peritonectomy procedures (PP) combined with intraperitoneal chemohyperthermia (IPCH) in patients with peritoneal carcinomatosis (PC), a phase II study was carried out from January 1998 to September 2001. Patients and Methods: Fifty-six patients (35 females, mean age 49.3) were included for PC from colorectal cancer (26 patients), ovarian cancer (seven patients), gastric cancer (six patients), peritoneal mesothelioma (five patients), pseudomyxoma peritonei (seven patients), and miscellaneous reasons (five patients). Surgeries were performed mainly on advanced patients (40 patients stages 3 and 4 and 16 patients stages 2 and 1) and were synchronous in 36 patients. All patients underwent surgical resection of their primary tumor with PP and IPCH (with mitomycin C, cisplatinum, or both) with a closed sterile circuit and inflow temperatures ranging from 46° to 48°C. Three patients were included twice. Results: A macroscopic complete resection was performed in 27 cases. The mortality and morbidity rates were one of 56 and 16 of 56, respectively. The 2-year survival rate was 79.0% for patients with macroscopic complete resection and 44.7% for patients without macroscopic complete resection (P = .001). For the patients included twice, two are alive without evidence of disease, 54 and 47 months after the first procedure. Conclusion: IPCH and PP are able to achieve unexpected long-term survival in patients with bulky PC. However, one must be careful when selecting the patients for such an aggressive treatment, as morbidity rate remains high even for an experienced team.

scholarly journals Endoscopic Evaluation of Symptomatic Patients following Bariatric Surgery: A Literature Review

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Miral Subhani ◽  
Kaleem Rizvon ◽  
Paul Mustacchia
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Abdominal Pain ◽  
Drug Therapy ◽  
Upper Gastrointestinal Bleeding ◽  
Comorbid Conditions ◽  
Endoscopic Evaluation ◽  
Number Of Patients ◽  
Upper Gastrointestinal

Obesity is an epidemic in our society, and rates continue to rise, along with comorbid conditions associated with obesity. Unfortunately, obesity remains refractory to behavioral and drug therapy but has shown response to bariatric surgery. Not only can long-term weight loss be achieved, but a majority of patients have also shown improvement of the comorbid conditions associated with obesity. A rise in the use of surgical therapy for management of obesity presents a challenge with an increased number of patients with problems after bariatric surgery. It is important to be familiar with symptoms following bariatric surgery, such as nausea/vomiting, abdominal pain, dysphagia, and upper gastrointestinal bleeding and to utilize appropriate available tests for upper gastrointestinal tract pathology in the postoperative period.

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