This document discusses HIV and hepatitis C, and how treatment has improved outcomes. It presents two case studies of patients with advanced HIV presenting with opportunistic infections who were successfully treated. It also summarizes research showing that early antiretroviral therapy improves survival for patients with HIV/AIDS or opportunistic infections like PCP, and that cure of hepatitis C through direct-acting antivirals reduces mortality and complications like liver cancer. While treatment access has increased globally, challenges remain in testing and treating all those in need.
Utility of routine surveillance blood cultures in asymptomatic allogeneic he...Ahmed Abdelhakeem
Utility of routine surveillance blood cultures in asymptomatic allogeneic hematopoietic stem cell transplant recipients with indwelling central venous catheters at a comprehensive cancer center
This document summarizes an audit of the management of ectopic pregnancies at a UK trust between 2009-2011. It found that conservative management often did not follow guidelines to only include cases with initial hCG <1000. Methotrexate management mostly adhered to guidelines but some patients required intervention. Surgery remained the most common treatment. Overall compliance with anti-D prophylaxis was 69% but improvements in documentation were needed. The audit recommended increased use of methotrexate and improved clinical pathways to ensure guideline adherence.
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In this webinar:
In May-June, 2020, the Canadian Cancer Survivor Network (CCSN) commissioned Leger to conduct a national survey to evaluate the impact that COVID-19 has had on cancer patients, survivors, pre-diagnosis patients, and caregivers. The results of our first survey revealed that the pandemic response has triggered another public health crisis - the postponement and cancellation of essential cancer tests, procedures, and treatments.
CCSN commissioned Leger for a second survey in December, 2020 to evaluate the impact that the suspension of cancer services during the first wave is currently having on those who have been affected by cancer.
Join CCSN and Leger as we present the results of the COVID-19 and Cancer Care Disruption in Canada Survey - Wave 2 and hear from members of the cancer community about how the pandemic has directly impacted them.
View the YouTube video: https://youtu.be/qN4Hq7OtBys
Follow CCSN on social media:
Twitter - https://twitter.com/survivornetca
Facebook - https://www.facebook.com/CanadianSurvivorNet
Instagram: https://www.instagram.com/survivornet_ca/
Pinterest - https://www.pinterest.com/survivornetwork
Edward Cachay, MD, MAS
Professor of Medicine
Division of Infectious Diseases & Global Public Health
Department of Medicine
University of California, San Diego
This document discusses HIV and hepatitis C, and how treatment has improved outcomes. It presents two case studies of patients with advanced HIV presenting with opportunistic infections who were successfully treated. It also summarizes research showing that early antiretroviral therapy improves survival for patients with HIV/AIDS or opportunistic infections like PCP, and that cure of hepatitis C through direct-acting antivirals reduces mortality and complications like liver cancer. While treatment access has increased globally, challenges remain in testing and treating all those in need.
Utility of routine surveillance blood cultures in asymptomatic allogeneic he...Ahmed Abdelhakeem
Utility of routine surveillance blood cultures in asymptomatic allogeneic hematopoietic stem cell transplant recipients with indwelling central venous catheters at a comprehensive cancer center
This document summarizes an audit of the management of ectopic pregnancies at a UK trust between 2009-2011. It found that conservative management often did not follow guidelines to only include cases with initial hCG <1000. Methotrexate management mostly adhered to guidelines but some patients required intervention. Surgery remained the most common treatment. Overall compliance with anti-D prophylaxis was 69% but improvements in documentation were needed. The audit recommended increased use of methotrexate and improved clinical pathways to ensure guideline adherence.
Don't miss our upcoming webinars! Subscribe today!
In this webinar:
In May-June, 2020, the Canadian Cancer Survivor Network (CCSN) commissioned Leger to conduct a national survey to evaluate the impact that COVID-19 has had on cancer patients, survivors, pre-diagnosis patients, and caregivers. The results of our first survey revealed that the pandemic response has triggered another public health crisis - the postponement and cancellation of essential cancer tests, procedures, and treatments.
CCSN commissioned Leger for a second survey in December, 2020 to evaluate the impact that the suspension of cancer services during the first wave is currently having on those who have been affected by cancer.
Join CCSN and Leger as we present the results of the COVID-19 and Cancer Care Disruption in Canada Survey - Wave 2 and hear from members of the cancer community about how the pandemic has directly impacted them.
View the YouTube video: https://youtu.be/qN4Hq7OtBys
Follow CCSN on social media:
Twitter - https://twitter.com/survivornetca
Facebook - https://www.facebook.com/CanadianSurvivorNet
Instagram: https://www.instagram.com/survivornet_ca/
Pinterest - https://www.pinterest.com/survivornetwork
Edward Cachay, MD, MAS
Professor of Medicine
Division of Infectious Diseases & Global Public Health
Department of Medicine
University of California, San Diego
The document discusses early treatment for sepsis patients. It summarizes that early and appropriate antimicrobial therapy is key to reducing mortality from sepsis. It then discusses definitions of sepsis that have evolved over time from 1991 to 2016. The Sequential Organ Failure Assessment (SOFA) score and quick SOFA (qSOFA) score are introduced to better predict mortality risk and identify organ dysfunction in sepsis patients compared to the previous systemic inflammatory response syndrome (SIRS) criteria. The SOFA score is shown to have superior predictive validity for in-hospital mortality compared to SIRS criteria or qSOFA score.
Septic shock, updated presentation, including latest guidelines from Intensive care societies and how to approach to the diagnosis with few notes about Early Goal Directed Therapy and role of steroids
The document discusses recent developments in left atrial appendage closure. Key points include:
- Long term results and meta-analyses from randomized trials of warfarin vs. Watchman leading to FDA approval.
- Differences between trial populations and real-world patients.
- Results from studies of patients who cannot take oral anticoagulants.
- Technical advances in devices.
- Role of CT imaging.
2021 lung presentation pro or contra moscouGeorgesNOEL3
1) For operable stage III NSCLC patients with resectable tumors, preoperative chemoradiotherapy followed by surgery may improve survival outcomes compared to surgery or chemoradiotherapy alone.
2) For stage III NSCLC patients with N2 nodal involvement who have undergone complete resection, postoperative radiotherapy does not provide a survival benefit and can increase toxicity.
3) For unresectable locally advanced stage III NSCLC patients, concurrent chemoradiotherapy improves survival compared to radiotherapy alone and should be the standard of care. Adding consolidation immunotherapy after chemoradiotherapy may provide additional benefits.
LAPORAN HARIAN COVID-19 NEGERI KEDAH 11.04.2022.pptxKeirelEdrin
300 new COVID-19 cases were reported in Kedah on 11 April 2022. The majority of new cases were from symptomatic screening (60.67%). Kota Setar had the highest number of new cases at 59. Bed occupancy rates at hospitals and quarantine centers in Kedah remained low. Vaccination rates in Kedah remained high, with over 89.7% of adults receiving two doses and over 98.1% of teenagers receiving two doses. Vaccination rates for boosters remained below 60% across most districts.
This document summarizes a presentation on hepatitis C given by Dr. Alnoor Ramji. It discusses the epidemiology and natural history of HCV, including its worldwide prevalence and genotype distribution. Screening and treatment options are also reviewed, noting the increasing efficacy of newer antiviral regimens. SVR rates with various treatment combinations are presented according to genotype and fibrosis stage. The importance of viral eradication is highlighted, with SVR associated with reduced mortality.
Initial management of septic shock involves following the hour-1 sepsis bundle which includes drawing blood cultures, measuring serum lactate levels, administering appropriate antibiotics within 1 hour of recognition, giving a balanced crystalloid fluid resuscitation, and administering vasopressors if the patient is hypotensive despite fluid resuscitation. A novel early indicator of sepsis called monocyte distribution width (MDW), which can be measured from a routine complete blood count within 30 minutes, may help improve early sepsis detection when used in combination with other clinical factors. Proper recognition and management of sepsis within the first hour can help reduce morbidity and mortality.
1. Chronic HCV infection can lead to increased mortality from both hepatic and extrahepatic diseases such as liver cancer, cardiovascular disease, and kidney disease.
2. HCV infection is associated with a variety of autoimmune manifestations and lymphoproliferative disorders, most notably mixed cryoglobulinemia vasculitis.
3. Treatment of HCV infection with direct-acting antivirals or pegylated interferon/ribavirin can result in remission of extrahepatic manifestations by achieving sustained virological response.
(1) Severe COVID-19 infection can cause a hyperinflammatory response and cytokine release syndrome similar to what is seen with CAR-T therapy. (2) Preliminary evidence from case studies in China and Michigan Medicine's experience show that treating severe COVID-19 patients with IL-6 blockade via drugs like tocilizumab and sarilizumab can improve clinical outcomes by reducing inflammation and oxygen requirements. (3) However, large randomized controlled trials are still needed to determine which patients may benefit most from IL-6 blockade and to fully understand its risks, optimal timing, and effects on viral clearance.
Hospital-acquired bloodstream infections in Intensive Care Units in Hungary, ...Rita Szabó
This document summarizes a study on hospital-acquired bloodstream infections (HABSI) in intensive care units (ICUs) in Hungary between 2005-2013. The study found an overall HABSI incidence rate of 1.0 per 100 patients. The most common pathogens were Staphylococcus aureus, Acinetobacter species, and Klebsiella species. The overall case fatality rate was 24.9%, with coagulase-negative staphylococci and Pseudomonas species most commonly related to death. The conclusion calls for strict application of prevention and control measures to reduce HABSI incidence and mortality.
The document provides new guidelines for the diagnosis and treatment of hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP). It discusses the definitions, epidemiology, risk factors, pathogenesis, diagnosis, and initial antibiotic therapy for HAP and VAP. For diagnosis, it recommends either a clinical approach using criteria like the Clinical Pulmonary Infection Score (CPIS) or a quantitative culture approach using techniques like bronchoscopy. For initial therapy, it stratifies patients into different risk groups and provides treatment recommendations based on the severity of illness and risk of multi-drug resistant pathogens.
This document summarizes the monthly clinical audit activities of the internal medicine department at HFSUH for the month of Sene 2015 E.C. It provides data on outpatient department activities including the regular OPD, MRC, neurology clinic, TB clinic, and ART clinic. It also summarizes inpatient activities in the male/female wards, neurology ward, ICU, and intermediate care ward. Key findings included increased OPD volume, improved chronic case linkage, and decreased number of patients leaving against medical advice. Gaps identified were inadequate equipment and staffing, incomplete documentation, and issues with radiology and laboratory services.
Raynaud phenomenon and digital ulcers are common complications of systemic sclerosis that are caused by abnormal vasoconstriction and underlying vascular damage. Current management strategies focus on avoiding triggers, medications to improve blood flow such as calcium channel blockers and PDE5 inhibitors, wound care for ulcers, and procedures such as botulinum toxin injections and digital sympathectomy. Novel therapies are also being investigated including phosphodiesterase inhibitors, prostanoids, and stem cell treatments, but more research is still needed to determine their efficacy for Raynaud phenomenon and digital ulcers in systemic sclerosis.
This document provides an annual report on Kuwait's newborn screening program for 2018. It includes statistics on the number of samples received and tested, the screening panel used, positive results, confirmed cases, and performance indicators. A total of 59,655 samples were received in 2018 from various hospitals in Kuwait. Of these, 931 screened positive for various conditions. Further testing confirmed 67 cases across different metabolic disorders and endocrine conditions. Key performance metrics like detection rate, false positive rate, and positive predictive value are provided. The report concludes by thanking the newborn screening team and various doctors for their efforts in the program's success.
Avoiding disruption of surgical treatment of genitourinary cancers...Valentina Corona
The document discusses surgical treatment of genitourinary cancers during the COVID-19 pandemic at a high-volume cancer center in Southern Italy. Through careful patient selection, strict safety protocols, and hospital reorganization, the center was able to maintain surgical treatment flow for urological cancers. A multidisciplinary team prioritized 93 cancer surgeries from March-April 2020, performing 40.8% robotically. Outcomes were similar to the prior year. One patient developed postoperative COVID-19 but recovered. The experience shows timely cancer treatment can continue safely during pandemics with appropriate measures.
SARS-CoV-2 is a novel coronavirus that causes COVID-19. It is believed to have originated in bats and potentially spread to humans through an intermediate host. The virus uses the ACE2 receptor to enter human cells. Early studies found COVID-19 has an R0 value similar to SARS and pandemic flu. Symptoms include fever, cough, fatigue and shortness of breath. Chest CT often shows bilateral lung infiltrates. Treatment focuses on supportive care while research investigates antivirals like remdesivir and chloroquine. Prevention strategies aim to slow the spread through social distancing, quarantines and hygiene practices.
it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
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The document discusses early treatment for sepsis patients. It summarizes that early and appropriate antimicrobial therapy is key to reducing mortality from sepsis. It then discusses definitions of sepsis that have evolved over time from 1991 to 2016. The Sequential Organ Failure Assessment (SOFA) score and quick SOFA (qSOFA) score are introduced to better predict mortality risk and identify organ dysfunction in sepsis patients compared to the previous systemic inflammatory response syndrome (SIRS) criteria. The SOFA score is shown to have superior predictive validity for in-hospital mortality compared to SIRS criteria or qSOFA score.
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- Differences between trial populations and real-world patients.
- Results from studies of patients who cannot take oral anticoagulants.
- Technical advances in devices.
- Role of CT imaging.
2021 lung presentation pro or contra moscouGeorgesNOEL3
1) For operable stage III NSCLC patients with resectable tumors, preoperative chemoradiotherapy followed by surgery may improve survival outcomes compared to surgery or chemoradiotherapy alone.
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LAPORAN HARIAN COVID-19 NEGERI KEDAH 11.04.2022.pptxKeirelEdrin
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This document summarizes a presentation on hepatitis C given by Dr. Alnoor Ramji. It discusses the epidemiology and natural history of HCV, including its worldwide prevalence and genotype distribution. Screening and treatment options are also reviewed, noting the increasing efficacy of newer antiviral regimens. SVR rates with various treatment combinations are presented according to genotype and fibrosis stage. The importance of viral eradication is highlighted, with SVR associated with reduced mortality.
Initial management of septic shock involves following the hour-1 sepsis bundle which includes drawing blood cultures, measuring serum lactate levels, administering appropriate antibiotics within 1 hour of recognition, giving a balanced crystalloid fluid resuscitation, and administering vasopressors if the patient is hypotensive despite fluid resuscitation. A novel early indicator of sepsis called monocyte distribution width (MDW), which can be measured from a routine complete blood count within 30 minutes, may help improve early sepsis detection when used in combination with other clinical factors. Proper recognition and management of sepsis within the first hour can help reduce morbidity and mortality.
1. Chronic HCV infection can lead to increased mortality from both hepatic and extrahepatic diseases such as liver cancer, cardiovascular disease, and kidney disease.
2. HCV infection is associated with a variety of autoimmune manifestations and lymphoproliferative disorders, most notably mixed cryoglobulinemia vasculitis.
3. Treatment of HCV infection with direct-acting antivirals or pegylated interferon/ribavirin can result in remission of extrahepatic manifestations by achieving sustained virological response.
(1) Severe COVID-19 infection can cause a hyperinflammatory response and cytokine release syndrome similar to what is seen with CAR-T therapy. (2) Preliminary evidence from case studies in China and Michigan Medicine's experience show that treating severe COVID-19 patients with IL-6 blockade via drugs like tocilizumab and sarilizumab can improve clinical outcomes by reducing inflammation and oxygen requirements. (3) However, large randomized controlled trials are still needed to determine which patients may benefit most from IL-6 blockade and to fully understand its risks, optimal timing, and effects on viral clearance.
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This document summarizes a study on hospital-acquired bloodstream infections (HABSI) in intensive care units (ICUs) in Hungary between 2005-2013. The study found an overall HABSI incidence rate of 1.0 per 100 patients. The most common pathogens were Staphylococcus aureus, Acinetobacter species, and Klebsiella species. The overall case fatality rate was 24.9%, with coagulase-negative staphylococci and Pseudomonas species most commonly related to death. The conclusion calls for strict application of prevention and control measures to reduce HABSI incidence and mortality.
The document provides new guidelines for the diagnosis and treatment of hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP). It discusses the definitions, epidemiology, risk factors, pathogenesis, diagnosis, and initial antibiotic therapy for HAP and VAP. For diagnosis, it recommends either a clinical approach using criteria like the Clinical Pulmonary Infection Score (CPIS) or a quantitative culture approach using techniques like bronchoscopy. For initial therapy, it stratifies patients into different risk groups and provides treatment recommendations based on the severity of illness and risk of multi-drug resistant pathogens.
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This document provides an annual report on Kuwait's newborn screening program for 2018. It includes statistics on the number of samples received and tested, the screening panel used, positive results, confirmed cases, and performance indicators. A total of 59,655 samples were received in 2018 from various hospitals in Kuwait. Of these, 931 screened positive for various conditions. Further testing confirmed 67 cases across different metabolic disorders and endocrine conditions. Key performance metrics like detection rate, false positive rate, and positive predictive value are provided. The report concludes by thanking the newborn screening team and various doctors for their efforts in the program's success.
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2. STATISTICS FOR TOTAL ADMISSIONS
Total admissions: 227
Total discharge: 141
Total expiries: 69
Referred : 0
LAMA: 15
Under treatment: 0
PERCENT MORTALITY : 30%
DISCHARGE : 62%
3. EXPIRIES STATS 69(30.17%)
EXPIRIES WITHIN 24
HRS OF ADMISSION
20 28% of total expiries
8% of total admissions
EXPIRIES FROM 1 TO 7
DAYS OF ADMISSION
25 36% of total expiries
11% of total admissions
EXPIRIES AFTER 7 DAYS
OF ADMISSION
24 34 % of total expiries
10% of total admissions
5. EXPIRIES STATS AS PER ADMISSIONS
OPD/ER CASES: 28EXPIRIES (125 TOTAL ADMISSIONS)
22.6% OF TOTAL OPD ADMISSIOS
40%% OF TOTAL EXPIRIES
12% OF TOTAL ADMISSIONS
INSIDE ATH REFERRALS: 18 EXPIRIES ( 46 TOTAL ADMISSIONS)
39% % OF ATH ADMISSIONS
26% OF TOTAL EXPIRIES
7.9% OF TOTAL ADMISSIONS
REFFERED CASES: 23EXPIRIES ( 56 TOTAL ADMISSIONS)
41.6 % OF TOTAL REFFERED ADMISSIONS
33% OF TOTAL EXPIRIES
10%% OF TOTAL ADMISSION
8. HIE
Total: 52
discharge: 31
LAMA:7
Expire:14
PERCENT MORTALITY: 26% out of total expiries
of total admissions
6 WITHIN 24 HOURS OF ADMISSION( 42%)
10. Neonatal jaundice
Total admissions: 44
Total discharges: 36
Total expiries: 3
patient presented with kernicterus signs
Lama: 5
Percentage:4.3% of total expiries and 6.8% of total admissions
Exchange transfusions : 3
DOUBLE EXCHANGE: 0
0 cases of G6PD deficiency detected
15 cases of RH incomp.
11. NEONATAL SEPSIS
TOTAL : 42
EXPIRED : 13
LAMA: 1
DISCHARGED: 28
EXPIRED WITH 24 HOURS : 25
PERCENT MORTALITY : 18%of total expiries
5.7% of total admissions
12. EARLY ONSET NEONATAL SEPSIS
TOTAL 24
DISCHARGE 18
EXPIRE 6
LAMA 0
REFERRED 0
PERCENT MORTALITY 8% of total expiries
2.6% of total admissions
13. LATE ONSET NEONATAL SEPSIS
TOTAL 18
EXPIRE 7
DISCHARGE 10
LAMA 1
REFERRED 0
PERCENT
MORTALITY
10% 0f total expiries
3.8%% of total admission
15. TOTAL ADMISSIONS: 62
TOTAL EXPIRIES: 34
8 WITHIN 24 HOUR
TOTAL DISCHARGES: 27
LAMA: 1
MORTALITY:
54%OF TOTAL PRETERM ADMISSIONS
4.3%OF TOTAL EXPIRIES
14%% OF TOTAL ADMISSIONS
16. • IN HOSPITAL PRETERMS: 30
EXPIRED: 18
29% OF IN HOSPITAL PRETERMS
26% OF TOTAL EXPIRIES
• OPD AND REFFERED PRETERMS : 32
EXPIRIED : 16
LAMA: 0
29% OF OPD/REFFERED PRETERM EXPIRED
23% OF TOTAL EXPIRIES
17. Preterm mortality
LESS THAN 28 WEEKS POG
13 out of 15 expired
28+1 to 31+6 WEEKS POG
15 out of 20 expired
32 to 33+6 WEEKS POG
05 out of11 expired
> 34 WEEKS POG
1 out of 6 expired
Gestation age
based mortality
18. IUGR
TOTAL PATIENTS: 02
EXPIRED: 01
DISCHARGED: 1
Lama:0
MORTALITY:
50% OF IUGR babies
1.4%OF TOTAL EXPIRIES
0.4% OF TOTAL ADMISSION
19. Infant mortality rate Pakistan 2022
56/1000
Neonatal mortality rate of Pakistan in 2022 is
42/1000
GLOBAL NMR 17
PAKISTAN
NEONATE
S STATS:
