scholarly journals ANALYSIS OF TUBERCULOSIS/HIV CO-INFECTION TRENDS IN UKRAINE IN 2008-2017

2019 ◽  
Vol 72 (5) ◽  
pp. 903-907
Author(s):  
Tetiana V. Stepanova ◽  
Olga P. Nedospasova ◽  
Mykhailo V. Golubchykov
Keyword(s):  
Epidemiological Study ◽  
Clinical Characteristics ◽  
Healthcare Delivery ◽  
Absolute Number ◽  
Comprehensive Analysis ◽  
Active Tuberculosis ◽  
Southern Region ◽  
Urban Residents ◽  
Newly Diagnosed ◽  
Health Statistics

Introduction: According to WHO estimates for the European Region in 2017, Ukraine had the highest proportion of active tuberculosis cases co-infected with HIV – 21.6%, with an average of 12% in the Region, and the absolute number of tuberculosis/HIV co-infection cases in Ukraine was estimated at the level of 8,000. The aim: carry out a comprehensive analysis of the epidemical situation regarding tuberculosis/HIV co-infection in Ukraine according to selected epidemiological and clinical characteristics. Materials and methods: The retrospective epidemiological study was based on the data from national reporting forms “Annual Active TB Report”, which was being collected by the Center for Health Statistics of the Ministry of Health of Ukraine for period 2008-2017. Review: The incidence of newly diagnosed active tuberculosis associated with HIV in Ukraine increased by 89,4% – from 6,1 per 100,000 population in 2008 to 11,6 per 100,000 population in 2017, against the backdrop of a gradual decrease in the incidence of active tuberculosis by 36.5% over the same period. The rates of comorbidity TB/HIV increased by 2.8 times from 7.9% to 20.3%. The highest rates of incidence tuberculosis/HIV co-infection are observed in person aged 25-44, males, urban residents, and in the southern region of Ukraine. Conclusions: The revealed tendency to increase the rate of the incidence and comorbidity of tuberculosis/HIV causes necessitates reviewing the organizational approaches to healthcare delivery for tuberculosis/HIV co-infection patients.

Clinical Characteristics and Early Treatment Patterns of Newly Diagnosed Cystic Fibrosis–Related Diabetes in Two Tertiary Centers

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 2374-PUB
Author(s):  
ERIN MCCORRY ◽  
HIBA BASHEER ◽  
JORGE E. LASCANO ◽  
JOHN YOON ◽  
JULIO A. LEEY
Keyword(s):  
Cystic Fibrosis ◽  
Early Treatment ◽  
Clinical Characteristics ◽  
Treatment Patterns ◽  
Newly Diagnosed

The Issue of Sustainability in Third World Food Production (The Distinguishedl Lecture)

1992 ◽  
Vol 31 (4I) ◽  
pp. 511-534
Author(s):  
Winfried Von Urff
Keyword(s):  
Developing Countries ◽  
Population Growth ◽  
Food Production ◽  
Third World ◽  
Total Population ◽  
Absolute Number ◽  
Comprehensive Analysis ◽  
World Food ◽  
The Absolute ◽  
The Difference

In spite of the fact that food production in developing countries doubled over the last 25 years undernutrition is still widely spread. At the beginning of the eighties, according to FAO, 335 to 494 million people in developing countries suffered from serious undernutrition the difference being due to different concepts to determine undernutrition on which scientist were unable to find a consensus.) Unfortunately there is no recent comprehensive analysis of the food situation comparable to those of previous World Food Surveys but it can be taken for sure that the absolute number of undernourished has increased. According to unofficial FAO sources a figure of 870 million was estimated for 1990 (22 percent of the total population in developing countries) using the same concept that led to the figure of 494 million in 1979-81 (23 percent of the total population in developing countries) which means that most probably the number of undernourished increased at a rate slightly less than population growth.

Abstract MP77: Patient, Provider, and Insurance Predictors of Oral Anticoagulation Initiation and Dosing in Atrial Fibrillation

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Inmaculada Hernandez ◽  
Yuting Zhang ◽  
Samir Saba
Keyword(s):  
Atrial Fibrillation ◽  
Oral Anticoagulation ◽  
Clinical Characteristics ◽  
Low Dose ◽  
Antiplatelet Agents ◽  
High Dose ◽  
Strong Impact ◽  
Newly Diagnosed ◽  
Cost Index ◽  
Logistic Regression Models

Background: Recent research has shown strong provider-level variation in oral anticoagulation (OAC) use in atrial fibrillation (AF). The objective of the present study was to examine predictors of prescribing OAC to newly diagnosed AF patients, with special attention to prescribing low-dose direct oral anticoagulant agents (DOACs) to patients with no diagnosis of chronic kidney disease (CKD). Methods: Using 2013-2014 Medicare claims data, we identified patients newly diagnosed with AF who had CHA2DS2-VASc score≥2. Our sample included 19,390 patients who did not initiate OAC, and 22,299 OAC initiators, among whom 12,786 initiated warfarin, 5,984 high-dose DOACs and 3,529 low-dose DOACs. We constructed logistic regression models to estimate the effect of patient demographics, clinical characteristics, provider specialty, and insurance factors on OAC initiation and likelihood of prescribing low dose DOAC in patients with no CKD. Results: As shown in the table, age, gender, heart failure, and a history of bleeding affected the initiation of OAC as well as DOAC dosing. White patients were more likely to initiate OAC, but race did not affect DOAC dosing. Use of antiplatelet agents decreased the odds of OAC initiation by 27% (95%CI, 23%-31%), but did not impact DOAC dosing. The odds of OAC initiation decreased by 10% (95%CI, 6%-15%) for each point increase in the Geographic Practice Cost Index for malpractice. The odds of initiating low-dose DOACs were 30% (95%CI, 11%-38%) lower for patients seen by cardiologists than for those seen by internists or family practitioners. Conclusions: In addition to demographics and clinical characteristics, provider and insurance factors have a strong impact on initiation and dosing of OAC.

scholarly journals Seabather's eruption: a clinical and epidemiological study of 38 cases in Santa Catarina State, Brazil

2009 ◽  
Vol 51 (3) ◽  
pp. 169-175 ◽  
Author(s):  
André Luiz Rossetto ◽  
Gerson Dellatorre ◽  
Fábio Lang da Silveira ◽  
Vidal Haddad Júnior
Keyword(s):  
Gulf Of Mexico ◽  
Epidemiological Study ◽  
Etiologic Agent ◽  
The State ◽  
The Body ◽  
Southern Region ◽  
Marine Water ◽  
Santa Catarina ◽  
Santa Catarina State

Seabather's eruption (SBE) is an intensely itchy, papule-erythematous dermatitis that occurs predominantly in regions of the body covered by bathing costumes, after exposure to marine water. The planulae larvae of Linuche unguiculata scyphomedusae (thimble jellyfish) are the etiologic agent of the dermatitis, which is frequent in waters of Caribbean, Gulf of Mexico and Florida. The authors report 38 cases of SBE in the State of Santa Catarina (Southern region of Brazil), with emphasis on their clinical and epidemiological aspects, such as profile of victim, topography of the papules and conditions predisposing to the accident.

scholarly journals Comparison of endoscopic activity before and during the covid pandemic at a tertiary care hospital in South Punjab

2021 ◽  
Author(s):  
Farooq Mohyud Din ◽  
Muhammad Asif Gul ◽  
Nouman Hameed ◽  
Rizwan Hameed ◽  
Yasir Zaidi ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Tertiary Care ◽  
Healthcare Delivery ◽  
Absolute Number ◽  
Care Hospital ◽  
Common Indication ◽  
Endoscopic Procedures ◽  
Significant Difference ◽  
Internal Hemorrhoids ◽  
One Year

Introduction: Coronavirus disease 2019 (COVID-19) has resulted in dramatic changes to healthcare delivery. Endoscopic activity has had frequent disruptions during this pandemic. The objective of the study was to see the influence of pandemic over the endoscopic activity. Methods: This retrospective analysis of endoscopic activity was undertaken at Nishtar Hospital Multan. Procedural analysis was done in the three months immediately after covid lockdown (1st April till 30th June 2020) and was compared to a similar period one year back. Results: Five hundred and fifty-four (68.5%) patients underwent endoscopic procedures during the three months of pre-COVID era, while this number reduced to half (n=255, 31.5%) patients during the covid pandemic. Even though the absolute number of Esophagogastroduodenoscopies (EGDs) reduced during the pandemic, patients were more likely to undergo EGDs during the COVID pandemic in contrast to the era before the pandemic (79% versus 66%, p = 0.002). The most common indication for EGD was upper gastrointestinal bleeding (UGIB). The percentage of EGDs done for UGIB rose from almost 60% to 80% during the covid pandemic (p < 0.001). The most common findings were esophageal varices and portal gastropathy (non-significant difference during and before the pandemic). Percentage of ERCPs done for obstructive jaundice doubled during the COVID pandemic (33% versus 65%, p = 0.002).The most common indication for sigmoidoscopy or colonoscopy was lower gastrointestinal bleeding. However, no significant difference was found before and during the covid pandemic (41.7% and 45.8% respectively, p=0.72). Internal hemorrhoids were the most common endoscopic finding. Colon cancer diagnosis reduced from 10% to undetected during the pandemic period. Conclusion: COVID pandemic resulted in a considerable reduction in all types of endoscopic procedures. The majority of procedures were done for emergency indications like gastrointestinal bleeding. Rates of cancer detection were significantly reduced. MeSH: Endoscopy, COVID-19, Gastroenterology

scholarly journals Clinical Characteristics and Risk of Diabetic Complications in Data-Driven Clusters Among Type 2 Diabetes

2021 ◽  
Vol 12 ◽  
Author(s):  
Lin Xing ◽  
Fangyu Peng ◽  
Qian Liang ◽  
Xiaoshuang Dai ◽  
Junli Ren ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Complications ◽  
Clinical Characteristics ◽  
Chinese Patients ◽  
Newly Diagnosed ◽  
Medication Treatment ◽  
Dipeptidyl Peptidase 4 ◽  
Age Related

BackgroundThis study aimed to cluster newly diagnosed patients and patients with long-term diabetes and to explore the clinical characteristics, risk of diabetes complications, and medication treatment related to each cluster.Research Design and MethodsK-means clustering analysis was performed on 1,060 Chinese patients with type 2 diabetes based on five variables (HbA1c, age at diagnosis, BMI, HOMA2-IR, and HOMA2-B). The clinical features, risk of diabetic complications, and the utilization of elven types of medications agents related to each cluster were evaluated with the chi-square test and the Tukey–Kramer method.ResultsFour replicable clusters were identified, severe insulin-resistant diabetes (SIRD), severe insulin-deficient diabetes (SIDD), mild obesity-related diabetes (MOD), and mild age-related diabetes (MARD). In terms of clinical characteristics, there were significant differences in blood pressure, renal function, and lipids among clusters. Furthermore, individuals in SIRD had the highest prevalence of stages 2 and 3 chronic kidney disease (CKD) (57%) and diabetic peripheral neuropathy (DPN) (67%), while individuals in SIDD had the highest risk of diabetic retinopathy (32%), albuminuria (31%) and lower extremity arterial disease (LEAD) (13%). Additionally, the difference in medication treatment of clusters were observed in metformin (p = 0.012), α-glucosidase inhibitor (AGI) (p = 0.006), dipeptidyl peptidase 4 inhibitor (DPP-4) (p = 0.017), glucagon-like peptide-1 (GLP-1) (p &lt;0.001), insulin (p &lt;0.001), and statins (p = 0.006).ConclusionsThe newly diagnosed patients and patients with long-term diabetes can be consistently clustered into featured clusters. Each cluster had significantly different patient characteristics, risk of diabetic complications, and medication treatment.

Disruptions to U.S. medical oncology care during the COVID-19 Pandemic: CancerLinQ Discovery (CLQD) analysis.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 6547-6547
Author(s):  
Abdul-Rahman Jazieh ◽  
Mark Riffon ◽  
Jennifer C. King ◽  
Gabrielle Betty Rocque ◽  
Electra D. Paskett ◽  
...  
Keyword(s):  
Medical Oncology ◽  
Cohort Analysis ◽  
Healthcare Delivery ◽  
Absolute Number ◽  
Retrospective Cohort Analysis ◽  
Hispanic Patients ◽  
Oncology Care ◽  
Oncology Practice ◽  
The Impact

6547 Background: The COVID-19 pandemic disrupted all facets of healthcare delivery including cancer care. This study evaluates the disruptions to US medical oncology practice during the pandemic in terms of number and type of patients (pts) encounters to determine the impact on continuity of patient care. Methods: We conducted a retrospective cohort analysis using the CLQD electronic health record database, containing data from 2+ million pts from all 50 states. We assessed changes in the monthly proportions of visit encounter types (in-person outpatient [IPOP] and telehealth [TE]) for new and established patients (NP and EP) with an invasive malignancy, benign or in situ neoplasm, or benign hematology diagnosis having an encounter between 1/1/2018 and 9/30/2020. Results: 781,945 pts were studied. Median age on 1/1/2018 was 64 years (IQR: 53-73), 38% were female, and 58% had an invasive malignancy. From 12/2019 to 9/2020, total monthly encounters dropped from 157,964 to 90,662. Monthly IPOP visits for NP dropped from 11.2% to 7.9%, an absolute drop of 3.3% and a relative drop of 30%; TE for NP increased by 1.1% (Table). Monthly IPOP visits for EP, as a percentage of all visits, dropped from 94.4% to 86.6% from 12/2019 to 6/2020 but rebounded to 90.4% by 9/2020. Fraction of TE increased substantially during the pandemic period reaching a peak in 6/2020 (13.8% for EP and 1.6% for NP) and decreased in 9/2020 to 9.6% and 1.1% for EP and NP, respectively. Compared to non-Hispanic patients, Hispanic patients had a larger reduction in IPOP and more TE during the study period. Percentage of monthly encounters, by type, from baseline*. Conclusions: We observed a reduction in the absolute number and monthly percentage of IPOP encounters during the COVID-19 pandemic. For EP, increases in TE does not fully compensate for reductions in IPOP. The reduction in IPOP NP encounters is particularly concerning since it was not accompanied by a compensatory increase in TE. The reduction in NP is consistent with reported pandemic-associated reductions in cancer screening and suggest a notable delay in cancer diagnoses during the pandemic. Reduction in Hispanic IPOP encounters warrants further evaluation.[Table: see text]

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