scholarly journals An Osteopathic Perspective on COVID-19: Is There a Missing Link to Treatment?

2020 ◽  
Vol 30 (3) ◽  
pp. 7-14
Author(s):  
Richard Chmielewski
Keyword(s):  
Lymphatic System ◽  
Health Care Systems ◽  
Developed Countries ◽  
Modern Medicine ◽  
Pulmonary Complications ◽  
Missing Link ◽  
The Public ◽  
Technological Interventions ◽  
Care Facilities ◽  
Care Systems

Abstract As the COVID-19 pandemic progressed across the globe, clinical reports and autopsies on patient deaths proved that the pulmonary complications were the result of an acute respiratory distress syndrome caused by an excessive inflammatory response; a cytokine storm. Through literature research and review it has become apparent to the author that the lymphatic system is a vital, somewhat overlooked, missing link in the treatment of COVID-19 pulmonary infection. The major challenges the whole world is facing now have been a shortage of supplies such as PPE, or personal protective equipment, and intensive care facilities to treat the overwhelming numbers of COVID-19 cases, in under-developed countries as well as developed countries. Osteopathic manipulative medicine (OMM) and osteopathic manipulative treatment (OMT) have been proven, for over a century, to be very effective in the treatment of pulmonary diseases and previous pandemics. Osteopathic professionals must challenge the present paradigm of modern medicine which, only too often, relies less on the body’s own capacity to regulate itself, to compensate, and to heal, and more on outside intervention such as medications and vaccinations. Osteopathic physicians are needed to step forward and discuss, explain, teach and train the importance of the lymphatic system as a major component of the circulatory as well as the immune system which plays a vital, pivotal, role in fighting diseases such as the COVID-19 coronavirus. A “viral infection protocol” (VIP), as discussed in this article, needs to be promoted as a mainstream adjunct, along with all of the other modalities of modern medicine, to health professionals and the public, in the event that the health care systems are overwhelmed. The VIP treatment is easy to train and to certify practitioners, with proven results in other pulmonary infections and epidemics. It may prove invaluable in preventing clinical deterioration of masses of patients, who then would require more expensive, less available, and more dangerous technological interventions.

The Challenges of Treating Neovascular Age-Related Macular Degeneration

2021 ◽  
Author(s):  
Marlene Hollaus ◽  
Wolf Bühl ◽  
Ursula Schmidt-Erfurth ◽  
Stefan Sacu
Keyword(s):  
Health Care ◽  
Macular Degeneration ◽  
Vision Loss ◽  
Health Care Systems ◽  
Developed Countries ◽  
Modern Medicine ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
Effective Form ◽  
Care Systems

AbstractAge-related macular degeneration (AMD) is one of the main causes of visual impairment and blindness in patients over 60 years in developed countries. Whilst no effective form of therapy is available for the dry form of AMD, intravitreal application of anti-VEGF substances is able to prevent the progression of neovascular AMD (nAMD) in most cases. Aside from the drugs ranibizumab, aflibercept and brolucizumab, other agents such as bevacizumab are often used off-label in order to save expense. The treatment intervals have also been refined, so as to reduce the burden on patients and health care systems. After fixed injection intervals, the pro re nata-regimen has been developed. Each month, it is decided whether the patient receives intravitreal injections based on fixed criteria. In the treat and extend-protocol, patients receive injections on each visit, but the intervals between injections vary due to the clinical outcomes. The observe-and-plan regime allows scheduling of the injection intervals in blocks, for three consecutive injections at a time. However, results of real-world studies were not able to reproduce those obtained in the pivotal studies. A high number of visits and fear of the injection procedure impose a burden on patients, that is mostly accepted due to fear of vision loss. Caregivers also complain of loss of productivity and income from having to provide regular support to patients. Health care systems worldwide are affected by increasing treatment numbers and the costs involved. The treatment of nAMD constitutes an achievement for modern medicine. However, despite the challenges, it must be evaluated and reviewed repeatedly in order to provide the best therapy for patients.

Modernization, Globalization, Trends, and Convergence in Health Expenditure in Latin America and the Caribbean

2015 ◽  
Vol 1 (2) ◽  
pp. 321-346 ◽  
Author(s):  
Shiri Noy ◽  
Patricia A. McManus
Keyword(s):  
Health Care ◽  
Latin America ◽  
Health Care Systems ◽  
Health Care Financing ◽  
Health Spending ◽  
Modernization Theory ◽  
The Public ◽  
National Differences ◽  
Care Systems ◽  
Public Private Mix

Are health care systems converging in developing nations? We use the case of health care financing in Latin America between 1995 and 2009 to assess the predictions of modernization theory, competing strands of globalization theory, and accounts of persistent cross-national differences. As predicted by modernization theory, we find convergence in overall health spending. The public share of health spending increased over this time period, with no convergence in the public-private mix. The findings indicate robust heterogeneity of national health care systems and suggest that globalization fosters human investment health policies rather than neoliberal, “race to the bottom” cutbacks in public health expenditures.

Health Care

2018 ◽  
Author(s):  
Pierre Pestieau ◽  
Mathieu Lefebvre
Keyword(s):  
Health Care ◽  
Technological Progress ◽  
Health Care Systems ◽  
Third Party ◽  
Medical Expenditure ◽  
Public Health Care ◽  
The Public ◽  
Common Features ◽  
Care Systems

This chapter reviews the public health care systems as well as their challenges. It first shows how expenditure on health care has evolved in previous decades and deals with the reasons for the growth observed in almost every European country. It emphasizes the role of technological progress as a main explanatory factor of the increase in medical expenditure but also points to the challenges facing cost-containment policies. Especially, the main common features of health care systems in Europe, such as third-party payment, single provider approach and cost-based reimbursement are discussed. Finally the chapter shows that although inequalities in health exist in the population, health care systems are redistributive. Reforms are thus needed but the trade-off between budgetary efficiency and equity is difficult.

scholarly journals COVID-19, psychosocial issues, politics, and public mental health care

2021 ◽  
Vol 51 (2) ◽  
pp. 293-303
Author(s):  
Anthony L Pillay ◽  
Anne L Kramers-Olen
Keyword(s):  
Mental Health ◽  
South Africa ◽  
Health Care ◽  
Mental Health Care ◽  
Health Care Systems ◽  
Mental Health Policy ◽  
Public Mental Health ◽  
The Public ◽  
Care Systems ◽  
Public Mental Health Care

The COVID-19 pandemic heralded challenges that were both significant and unfamiliar, placing inordinate burdens on health care systems, economies, and the collective psyche of citizens. The pandemic underscored the tenuous intersections between public mental health care, politics, economics, and psychosocial capital. In South Africa, the inadequacies of the public health system have been laid bare, and the disproportionate privileges of the private health care system exposed. This article critically considers government responses to the COVID-19 pandemic, the psychosocial correlates of lockdown, politics, corruption, and public mental health policy in South Africa.

Accountability for Rationing — Theory into Practice

2005 ◽  
Vol 33 (4) ◽  
pp. 660-668 ◽  
Author(s):  
Christopher Newdick
Keyword(s):  
Health Care ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Health Care Systems ◽  
The Public ◽  
Modern Health Care ◽  
Concept Of Health ◽  
Care Systems ◽  
Health Need

Most now recognize the inevitability of rationing in modern health care systems. The elastic nature of the concept of “health need,” our natural human sympathy for those in distress, the increased range of conditions for which treatment is available, the “greying” of the population; all expand demand for care in ways that exceed the supply of resources to provide it. UK governments, however, have found this truth difficult to present and have not encouraged open and candid public debate about choices in health care. Indeed, successive governments have presented the opposite view, that “if you are ill or injured there will be a national health service there to help; and access to it will be based on need and need alone.” And they have been rightly criticized for misleading the public and then blaming clinical and managerial staffin the National Health Service (NHS) when expectations have been disappointed.

scholarly journals The Super-Wicked Problem of Antimicrobial Resistance

2020 ◽  
pp. 421-443
Author(s):  
Jasper Littmann ◽  
A. M. Viens ◽  
Diego S. Silva
Keyword(s):  
Antimicrobial Resistance ◽  
Global Economy ◽  
Bacterial Infections ◽  
Health Care Systems ◽  
Modern Medicine ◽  
Social Consequences ◽  
Wicked Problem ◽  
Lost Productivity ◽  
Care Systems ◽  
To Come

Abstract Antimicrobial resistance (AMR) – the progressive process by which microbes, such as bacteria, through evolutionary, environmental and social factors develop the ability to become resistant to drugs that were once effective at treating them – is a threat from which no one can escape. It is one of the largest threats to clinical and global health in the twenty-first century – inflicting monumental health, economic and social consequences. All persons locally and globally, and even all future persons yet to come into existence, all suffer the shared, interdependent vulnerability to this threat that will have a substantial impact on all aspects of our lives. For example, while reliable data are hard to find, the European Centre for Disease Prevention and Control (ECDC) has conservatively estimated that, in Europe alone, AMR causes additional annual cost to health care systems of at least €1.5 billion, and is responsible for around 25,000 deaths per year. Furthermore, AMR significantly increases the cost of treating bacterial infections with an increase in length of hospital stays and average number of re-consultations, as well as the resultant lost productivity from increased morbidity. With a combined cost of up to $100 trillion to the global economy – pushing a further 28 million people into extreme poverty – this is one of the most pressing challenges facing the world. Most troublingly, if we do not succeed in diminishing the progression of AMR, there is the very real potential for it to threaten common procedures and treatments of modern medicine, including the safety and efficacy of surgical procedures and immunosuppressing chemotherapy. Some experts are warning that we may soon be ushering in a post-antibiotic area.

scholarly journals Back to the Future: Principles on Resuming Outpatient Services in the COVID-19 Era

2020 ◽  
Vol 163 (4) ◽  
pp. 705-706 ◽  
Author(s):  
Taher S. Valika ◽  
Kathleen R. Billings
Keyword(s):  
Health Care ◽  
Outpatient Care ◽  
Health Care Systems ◽  
Lessons Learned ◽  
Outpatient Services ◽  
Drastic Reduction ◽  
The Public ◽  
Outpatient Visits ◽  
The Future ◽  
Care Systems

The rapidly changing health care climate related to coronavirus disease 2019 (COVID-19) has resulted in numerous changes to health care systems and in practices that protect both the public and the workers who serve in hospitals around the country. As a result, these past few months have seen a drastic reduction in outpatient visits. With phased reopening and appropriate guidance, health care systems are attempting to return to normal. The experiences and lessons learned are described, and we provide guiding principles to allow for a safe and effective return to outpatient care.

scholarly journals Újraélesztést követő koszorúér-angiográfia és katéteres intervenció

2019 ◽  
Vol 160 (46) ◽  
pp. 1826-1831
Author(s):  
László Rudas ◽  
Endre Zima
Keyword(s):  
Coronary Angiography ◽  
Large Scale ◽  
Health Care Systems ◽  
Coronary Intervention ◽  
Developed Countries ◽  
Public Access ◽  
Temperature Management ◽  
Prehospital Management ◽  
Care Systems ◽  
St Elevation

Abstract: Out-of-hospital cardiac arrest (OHCA) presents a great challenge for the health care systems even in the highly developed countries. For several decades, our greatest efforts have been directed toward the improvement of the prehospital management, including promotion of lay resuscitation and deployment of public access automated defibrillators. Recently, the importance of the hospital phase of the OHCA-management has been also emphasized. Attention has been paid to targeted temperature management and also to early coronary intervention. For those patients who present with ST-elevation on their post-resuscitation ECG, our approach is straightforward: urgent coronary angiography is indicated. The optimal management of those survivors of OHCA who present without ST-elevation is, however, still debated. Although up to 30% of these subjects also suffer from acute occlusive epicardial coronary disease, the clear benefit of urgent coronary angiography for the whole group is yet to be documented. Several large-scale randomized studies are under way to resolve this question. In our present review we detail the above controversies and outline the future directions. Orv Hetil. 2019; 160(46): 1826–1831.

scholarly journals Return to Normalcy? Principles on Resuming Surgical Services in the COVID-19 Era

OTO Open ◽  
2020 ◽  
Vol 4 (2) ◽  
pp. 2473974X2093665
Author(s):  
Taher S. Valika ◽  
Kathleen R. Billings
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care Systems ◽  
Lessons Learned ◽  
Drastic Reduction ◽  
The Public ◽  
Surgical Services ◽  
Outpatient Visits ◽  
Care Systems ◽  
Full Capacity

The rapidly changing health care climate related to coronavirus disease 2019 (COVID-19) has resulted in numerous changes to health care systems and in practices that protect both the public and the workers who serve in hospitals around the country. As a result, these past few months have seen a drastic reduction in outpatient visits and surgical volumes. With phased reopening and appropriate guidance, health care systems are attempting to return to normal. Our institution has had the unique opportunity to already return operations back to full capacity. The experiences and lessons learned are described, and we provide guiding principles to allow for a safe and effective return to patient care.

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