Resistance to artemether-lumenfantrine in the treatment of malariaAK Sa'ad
Resistance to antimalaria drugs by the causative organisms is a serious concern that needs urgent intervention. This study focuses on suspected resistance to artemether-lumefantrine seen in Abuja Nigeria
The use of patient-centred health information systems in type 2 diabetes mell...Liliana Laranjo
The use of patient-centred health information systems in type 2 diabetes mellitus (poster)
• 17th Wonca Europe conference, September 2011 (Warsaw, Poland)
• International conference on health technology assessment and quality management, February 2012 (Lisbon, Portugal)
Study: Hospice Comes too Late for Many AmericansDylan_Bates
Many Americans delay getting hospice care, if they receive any at all. In fact, Yale University researchers looked into medical records of more than 700 patients and found that only 40 percent took advantage of hospice care during the last year of their lives.
provide recommendations for alternative drug treatments to address.docxsimonlbentley59018
provide recommendations for alternative drug treatments to address the patient’s pathophysiology. Be specific and provide examples
Week 9 Initial Post- Mel Mal,
COLLAPSE
Top of Form
This case study presents a particularly hard case to untangle. The 46-year-old women is exhibiting the night sweats, hot-flushing, and genitourinary symptoms common in menopause. The patient is still getting a regular period, so these symptoms are most likely pre-menopausal, as periods stop in true menopause. In a patient with no familial history increasing the patient’s risk for breast cancer, an estrogen or combination estrogen/progestin therapy would most likely be initiated (Rosenthal et al. 2021). This therapy would likely reduce the uncomfortable symptoms, however in a patient with a family history of breast cancer, the therapy can increase the likelihood of breast cancer occurrence.
Luciano et al., found that both estrogen therapies and combined estrogen/progestin therapies increased the risk for breast cancer (2020). It is important to notice that this study notes that the risks for patients who take the therapy on a short-term basis are at a slightly lower risk, however this patient is young at 46 years old and would possibly need a long-term medication solution.
On the opposite side, Carr summarizes the North American Menopause society’s 2022 updated guidelines on hormonal replacement therapy and explains that a patient with menopausal symptoms can take combined hormone therapy until at least the mean age of menopause (53) without any significant increase in breast cancer (2022). With the newest recommendations, I would recommend that the patient start a combined estrogen and progestin hormone therapy for reduction in symptoms. With this recommendation is the caveat that the patient will need regular visits to re-evaluate the need for the therapy with hopeful cessation of treatment within three to five years to keep any increase in breast cancer risk to a minimum.
The lowest dose medication should be used for the shortest time period in order to reduce comorbidity risk so this patient recommendation will be to start Prempro 0.3mg/1.5mg daily and then reevaluate for effectiveness and need to increase dosage (Rosenthal et al., 2021).
The patient also needs adjustments in her hypertension medication. The patient is currently on Norvasc 10mg daily, and HCTZ 25mg daily. This therapy is within guidelines because she is on Norvasc, a calcium-channel blocker, and Hydrochlorothiazide, a thiazide diuretic, are being used to potentiate each other’s effects. In cases where a thiazide diuretic is ineffective in controlling HTN, a loop diuretic may be added. In this patient, we will recommend adding Furosemide to hopefully control the hypertension. This dosage will start low, at 20mg daily, (taken in the morning to decrease nocturia), with regular home blood pressure checks as well as in office re-evaluation to determine how effective the medication and dosage are (.
Resistance to artemether-lumenfantrine in the treatment of malariaAK Sa'ad
Resistance to antimalaria drugs by the causative organisms is a serious concern that needs urgent intervention. This study focuses on suspected resistance to artemether-lumefantrine seen in Abuja Nigeria
The use of patient-centred health information systems in type 2 diabetes mell...Liliana Laranjo
The use of patient-centred health information systems in type 2 diabetes mellitus (poster)
• 17th Wonca Europe conference, September 2011 (Warsaw, Poland)
• International conference on health technology assessment and quality management, February 2012 (Lisbon, Portugal)
Study: Hospice Comes too Late for Many AmericansDylan_Bates
Many Americans delay getting hospice care, if they receive any at all. In fact, Yale University researchers looked into medical records of more than 700 patients and found that only 40 percent took advantage of hospice care during the last year of their lives.
provide recommendations for alternative drug treatments to address.docxsimonlbentley59018
provide recommendations for alternative drug treatments to address the patient’s pathophysiology. Be specific and provide examples
Week 9 Initial Post- Mel Mal,
COLLAPSE
Top of Form
This case study presents a particularly hard case to untangle. The 46-year-old women is exhibiting the night sweats, hot-flushing, and genitourinary symptoms common in menopause. The patient is still getting a regular period, so these symptoms are most likely pre-menopausal, as periods stop in true menopause. In a patient with no familial history increasing the patient’s risk for breast cancer, an estrogen or combination estrogen/progestin therapy would most likely be initiated (Rosenthal et al. 2021). This therapy would likely reduce the uncomfortable symptoms, however in a patient with a family history of breast cancer, the therapy can increase the likelihood of breast cancer occurrence.
Luciano et al., found that both estrogen therapies and combined estrogen/progestin therapies increased the risk for breast cancer (2020). It is important to notice that this study notes that the risks for patients who take the therapy on a short-term basis are at a slightly lower risk, however this patient is young at 46 years old and would possibly need a long-term medication solution.
On the opposite side, Carr summarizes the North American Menopause society’s 2022 updated guidelines on hormonal replacement therapy and explains that a patient with menopausal symptoms can take combined hormone therapy until at least the mean age of menopause (53) without any significant increase in breast cancer (2022). With the newest recommendations, I would recommend that the patient start a combined estrogen and progestin hormone therapy for reduction in symptoms. With this recommendation is the caveat that the patient will need regular visits to re-evaluate the need for the therapy with hopeful cessation of treatment within three to five years to keep any increase in breast cancer risk to a minimum.
The lowest dose medication should be used for the shortest time period in order to reduce comorbidity risk so this patient recommendation will be to start Prempro 0.3mg/1.5mg daily and then reevaluate for effectiveness and need to increase dosage (Rosenthal et al., 2021).
The patient also needs adjustments in her hypertension medication. The patient is currently on Norvasc 10mg daily, and HCTZ 25mg daily. This therapy is within guidelines because she is on Norvasc, a calcium-channel blocker, and Hydrochlorothiazide, a thiazide diuretic, are being used to potentiate each other’s effects. In cases where a thiazide diuretic is ineffective in controlling HTN, a loop diuretic may be added. In this patient, we will recommend adding Furosemide to hopefully control the hypertension. This dosage will start low, at 20mg daily, (taken in the morning to decrease nocturia), with regular home blood pressure checks as well as in office re-evaluation to determine how effective the medication and dosage are (.
IntroductionThis assignment discusses the anticipatory and alte.docxnormanibarber20063
Introduction:
This assignment discusses the anticipatory and alternative approaches for long-term conditions from different aspects. It consists of five patches explaining the importance of COPD self-management plan, response to COPD deterioration, the role of telehealth in managing those patients as well as philosophy of anticipatory care relating it to nursing models.
Patch one – learning outcome one: self-management strategies.
Approximately three million people are believed to have chronic obstructive pulmonary disease (COPD) in England, with around 30,000 lives lost as a result each year making it the fifth biggest cause of mortality and morbidity in the UK (Stewart et al., 2011; Wilson et al., 2015). Self-management can play a vital part in the management of COPD and can also give the patient a greater sense of autonomy, thereby improving their quality of life (Robbins et al., 2013; Sallnow, Kumar, & Kellehear, 2013). Self-management plan should be comprehensive, individualized and tailored to suit each patient as they have varying symptoms and needs that require individualized plan in order to achieve optimum health outcome. For that reason, there should be a great cooperation, education and person-centered support from specialized health professionals who are COPD knowledgeable and properly trained (Cornforth,2013 ). Based on that, clinician’s goal should be directed towards working with COPD patients collaboratively to discuss and negotiate their tolerated healthy behaviors, the disease nature, its management and encouragement of possible life style modifications, for instance, more exercise, healthy eating, correct inhaler technique and basically smoking cessation( Cornforth,2013).
Patients who have early-stage COPD may not display their symptoms in a way that they recognise (Robbins et al., 2013; Sallnow, Kumar, & Kellehear, 2013); but as COPD worsens there is an increase seen in wheezing, coughing, sputum production, and dyspnoea (Sharp, Moran, & Kuhn, 2013). In some patients these symptoms may become so severe that long-term oxygen therapy is needed (Sharp, Moran, & Kuhn, 2013). It is important that patients are able to recognise their own symptoms and thus any changes in them, which can be done by keeping a daily record (Stewart et al., 2011).
It is important that patients take their medications as prescribed, even during periods of feeling well (Robbins et al., 2013). Continuous use of medication can help prevent exacerbations; but it is important to check for any interactions that may occur with medicines which are available without prescription (Sallnow, Kumar, & Kellehear, 2013). In addition to regular medications, it is also important that patients receive annual vaccinations such as the flu jab and an anti-pneumococcal vaccination which protects against serious infections caused by pneumococcal bacteria (Sallnow, Kumar, & Kellehear, 2013).
Self-monitoring in COPD is a key tool in preventing exacerbations (Sharp, Moran, .
Secondary Malignancy after Treatment of Prostate Cancer. Radical Prostatectom...asclepiuspdfs
Background: This study aims to determine whether the treatment of locally confined prostate cancer (PCa) with external radiotherapy (EBRT) increases the risk to develop secondary malignancies (SM) compared to radical prostatectomy (RPE). Materials and Methods: Data from patients who were treated curatively with RPE or EBRT from 2010 to 2018 and who did not have distant metastases, previous malignancy, or previous treatment with radiotherapy or chemotherapy at the time of diagnosis were reviewed to determine the incidence of SM over a median follow-up period of 47 months (range 12–96 months). Regression models were used to correlate the clinicopathological factors with the incidence of SM.
Adherence to treatment and quality of life during hepatitis C therapy:a prosp...Michel Rotily
Adherence to treatment and quality of life during hepatitis C therapy:a prospective, real-life, observational study by Patrick Marcellin, Michel Chousterman, Thierry Fontanges, Denis Ouzan, Michel Rotily, Marina Varastet,Jean-Philippe Lang, Pascal Melin and Patrice Cacoub, for the CheObs Study Group published in Liver Int 2011
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Antimicrobial stewardship to prevent antimicrobial resistanceGovindRankawat1
India is among the nations with the highest burden of bacterial infections.
India is one of the largest consumers of antibiotics worldwide.
India carries one of the largest burdens of drug‑resistant pathogens worldwide.
Highest burden of multidrug‑resistant tuberculosis,
Alarmingly high resistance among Gram‑negative and Gram‑positive bacteria even to newer antimicrobials such as carbapenems.
NDM‑1 ( New Delhi Metallo Beta lactamase 1, an enzyme which inactivates majority of Beta lactam antibiotics including carbapenems) was reported in 2008
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
2. [ERS] The healthcare burden of non-compliance
to pharmacotherapeutic escalation
recommendations for COPD
Tavares R, Zhang S, Dang-Tan T, Ismaila A,
Stutz M, Coletta N, et al.
Mesa 1
3.
4. To describe the healthcare burden associated with not escalating patients with COPD managed with
LAMA or LABA monotherapy or LAMA/LABA dual therapy to ICS/LAMA/LABA following a moderate
or severe exacerbation.
This observational study utilised medical claims from the Quebec Provincial Health Insurance
administrative database.
Included were patients ≥40 years of age with an incident diagnosis of COPD (during 2002–2011)
receiving a respiratory medicine within 2 weeks of a COPD claim and treated with a LAMA, LABA or
LAMA/LABA without a preceding moderate or severe exacerbation in 2 years preciding.
The study cohort were followed for a median of 3.56 years after the first exacerbation.
Multivariate-adjusted outcomes included incidence density rates for moderate or severe COPD
exacerbations and healthcare utilisation, stratified by escalation to ICS/LAMA/LABA triple therapy
following an exacerbation.
.
6. Overall, 19,198 (49.5%) patients experienced COPD
exacerbations.
Of these, 1,136 (5.9%) were escalated to triple therapy following
an exacerbation.
Compared with patients switched to triple therapy, those not
escalated experienced increased mean incidence density rates
(per 100 person-years) for future exacerbations (any: 0.21 vs
0.18, p<0.001; moderate: 0.10 vs 0.07, p<0.001), ER visits (0.11 vs
0.10, p<0.05), and greater use of antibiotics, oral corticosteroids
and rescue medications (0.94 vs 0.79, 0.76 vs 0.66, 1.08 vs 0.50;
p<0.001).
Hospitalisation rates were similar among patients treated with
triple therapy.
Other outcomes were similar between groups.
.
7. Failure to escalate to ICS/LAMA/LABA triple therapy
following an exacerbation results in increased
exacerbations, ER visits and concomitant medication
use in patients with COPD.
Funded by GSK: HO-13-14097.
8. [ERS] The healthcare burden of non-compliance
to pharmacotherapeutic escalation
recommendations for COPD
Rivera-Ortega P, González J, Restituto P, Varo N, Colina I, et al.
Mesa 1
9. Smoking Definitions
Never Smokers – Adults who have never smoked a
cigarette or who smoked fewer than 100 cigarettes
in their entire lifetime.
Former Smokers – Adults who have smoked at least
100 cigarettes in their lifetime, but say they currently
do not smoke.
Nonsmokers – Adults who currently do not smoke
cigarettes, including both former smokers and never
smokers.
Current Smokers – Adults who have smoked 100
cigarettes in their lifetime and currently smoke
cigarettes every day (daily) or some days (nondaily).