PlosOne January 20, 2021
https://doi.org/10.1371/journal.pone.0241899
Antibiotic fixed dose combinations (FDCs) can have clinical advantages such as improving effectiveness and adherence to therapy. However, high use of potentially inappropriate FDCs has been reported, with implications for antim...icrobial resistance (AMR) and toxicity.
more
Bioethics - Medical, Ethical and Legal Perspectives
There’s evidence that implementing the four medical ethics principles may be challenging especially in low income country contexts with extreme resource scarcity and limited capacity to facilitate deliberations on the different ethical dilemmas.... These challenges can partly be explained by the social, economic, and political contexts in which the decisions are made, as well as the limited time, training and guidance to facilitate ethical decision making. Based on current literature, and using the example of bedside rationing; this chapter synthesizes the challenges clinicians face when operationalizing the four principle; identifying the opportunities to address them. We suggest that clinicians’ ability to implement the four principles are constrained by meso‐ and macro‐level decision making as well as their lack of training, explicit guidelines, and peer support. To ameliorate this situation, current efforts to strengthen the clinicians’ capacity to make ethical decisions should be complimented with developing of context relevant guidelines for ethical clinical decision making. The renewed global commitment to the sustainable development goals and universal healthcare coverage should be recognized as an opportunity to leverage resources and champion the integration of equity and justice as a core value in resource allocation at the bedside, meso-, macro- and global levels.
more
The Committee discussed the implications for preparedness for smallpox-like events reflected by the ongoing COVID-19 pandemic. The Committee noted how quickly diagnostics and vaccines could be developed and deployed when resources and political will were abundant. This rapidity was also due to the f...act that the genetic sequence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had been shared worldwide. It was noted that in one country SARS-CoV-2 had been reconstructed in a laboratory from the viral genome sequence before the first case of COVID-19 had been reported, highlighting the benefits of synthetic biology technologies for accelerated development of diagnostics as well as the oft-described potential risks. Lessons learned about clinical care during the COVID-19 pandemic were also discussed.
more
Updated 10 August 2020
This document presents an essential medicines list (EML) to manage patients in intensive care units (ICUs) with suspected or confirmed COVID-19 diagnosis, which includes active ingredients with dosage form and concentration, and are preferably in the WHO Model Lists of Essent...ial Medicines 2019; based on clinical presentations and symptoms identified and prioritized in World Health Organization (WHO) and Surviving Sepsis Campaign (SSC) guidelines and the evidence presented in these guidelines.
more
The objective of this paper is to summarise and critically review the available data about onchocerciasis in Mozambique, in order to report epidemiological and clinical aspects related to the disease and identify gaps in knowledge. The paper is intended to raise awareness of the existence and import...ance of this disease and to define research priorities
more
The evolving epidemic of type 2 diabetes mellitus has challenged health-care professionals. It stands among the leading causes of mortality in the present world. It warrants new and versatile approaches to improve mortality and the associated huge quality-adjusted life years lost to it once diagnose...d. A possible venue to lower the incidence is to assess the safety and efficacy of various diabetes prevention strategies. Diet and exercise have a well-developed role in the prevention of weight gain and, ultimately, diabetes mellitus type II in high-risk individuals. However, high-risk individuals can also benefit from adjunct pharmacotherapy. In light of this information, we decided to conduct a systematic review of randomized controlled trials. This article summarizes the evidence in the literature on the pharmacological prevention of diabetes in high-risk individuals.
more
The cardiovascular disease continuum begins with risk factors such as diabetes mellitus (DM), progresses to vasculopathy and myocardial dysfunction, and finally ends with cardiovascular death. Diabetes is associated with a 2- to 4-fold increased risk for heart failure (HF). Moreover, HF patients wit...h DM have a worse prognosis than those without DM. Diabetes can cause myocardial ischemia via micro- and macrovasculopathy and can directly exert deleterious effects on the myocardium. Hyperglycemia, hyperinsulinemia, and insulin resistance can cause alterations in vascular homeostasis. Then, reduced nitric oxide and increased reactive oxygen species levels favor inflammation leading to atherothrombotic progression and myocardial dysfunction. The classification, diagnosis, and treatment of HF for a patient with and without DM remain the same. Until now, drugs targeting neurohumoral and metabolic pathways improved mortality and morbidity in HF with reduced ejection fraction (HFrEF). Therefore, all HFrEF patients should receive guideline-directed medical therapy. By contrast, drugs modulating neurohumoral activity did not improve survival in HF with preserved ejection fraction (HFpEF) patients. Trials investigating whether sodium-glucose cotransporter-2 inhibitors are effective in HFpEF are on-going. This review will summarize the epidemiology, pathophysiology, and treatment of HF in diabetes.
more
Accessed: 02.05.2020
These consolidated guidelines provide recommendations for comprehensive prevention and case management strategies in Kenya
Scope of the Guidelines: Infection prevention and control Patient triage Emergency Medical Services Case management Laboratory testing algorithm
Target... Audience: Health care workers taking care of patients suspected or confirmed to have COVID-19
These guidelines combine both preventive and clinical management of the disease in Kenyan context. The protocol borrows various international recommendations including the World Health Organization, from experience of other countries such as China that has struggled with the outbreak for a longer time and from principles of virology and infectious disease management.
more
Heart failure (HF) is a global public health concern with disproportionate socioeconomic, morbidity and mortality burden on low- and middle-income countries (LMICs). This review summarises contemporary data on the demographic and clinical characteristics, aetiologies, treatment, economic burden and ...outcomes of HF in LMICs. Patients with HF in LMICs are younger than those from high-income countries (HICs) and present at advanced stages of the disease. Hypertension, ischaemic heart disease (IHD), cardiomyopathy (CMO), and rheumatic heart disease (RHD) are the leading causes of HF in LMICs. The contribution of infectious diseases to HF remains prominent in many LMICs. Most health facilities in LMICs lack adequate diagnostic tools for HF, and the use of evidence-based medical and device therapies is suboptimal. Further, HF in LMICs is associated with prolonged hospital stay and high in-hospital and one-year mortality. Finally, HF has profound economic impact on individual patients who, mostly, have no health insurance, and on societies where patients are young, comprising those who have the greatest potential to contribute to economic productivity.
more
Prepared as an outcome of ICMR Subcommittee on Soft Tissue Sarcoma and Osteosarcoma | This consensus document on Management of Soft Tissue Sarcoma and Osteosarcoma summarizes the modalities of treatment including the site-specific anti-cancer therapies, supportive and palliative care and molecular ...markers and research questions. It also interweaves clinical, biochemical and epidemiological studies.
more
Seizures constitute the most common neurological problem in children and the majority of epilepsy has its onset in childhood. Appropriate diagnosis and management of childhood epilepsy is essential to improve quality of life in these children. Evidence-based clinical practice guidelines, modified to... the Indian setting by a panel of experts, are not available.
more
This Manual covers all important aspects of echinococcosis, including parasite biology and life-cycles, geographic distribution and prevalence, epidemiology, clinical presentation in humans and animals, diagnosis and treatment, as well as control and prevention using newly developed tools and method...s. It also provides descriptions of important techniques and a large number of bibliographical references.
more
The Adult Standard Treatment Guidelines and Essential Medicines List for Hospital Level provide a platform for transparency to enable equitable access to safe, effective, and affordable treatment options at hospital level taking into consideration the changing clinical needs of our population and th...e pragmatic implications of the introducing a new health technology.
more
Cochrane Database of Systematic Reviews 2015, Issue 2. Art. No.: CD011386. DOI: 10.1002/14651858.CD011386.pub2
Free access from the website http://onlinelibrary.wiley.com/enhanced/doi/10.1002/14651858.CD011386.pub2
Watch a short film which accompanies this Cochrane Review and talks about applying ...the findings in relevant clinical settings at http://www.cochrane.org/news/new-evidence-helps-health-workers-fight-against-ebola
more
2nd edition .
This Framework applies to the sharing of H5N1 and other influenza viruses with human pandemic potential and the sharing of benefits. This Framework does not apply to seasonal influenza viruses or other non-influenza pathogens or biological substances that may be contained in clinical ...specimens shared under this Framework
This second edition of the Pandemic Influenza Preparedness (PIP) Framework reflects an amendment to Annex 2, Standard Material Transfer Agreement 2, Footnote 1, that was adopted by the Seventy-second World Health Assembly in May 2019.The amendment clarifies that, under certain circumstances, the indirect use of PIP Biological Materials will require the conclusion of an SMTA2. The amendment is in effect from the closure of the Seventy-second World Health Assembly (28 May 2019).
more
Prepared as an outcome of ICMR Subcommittee on Buccal Mucosa Cancer | This consensus document on management of Buccal Mucosa cancers summarizes the modalities of treatment including the site-specific anti-cancer therapies, supportive and palliative care and molecular markers and research questions. ...It also interweaves clinical, biochemical and epidemiological studies.
more
El presente documento técnico tiene la finalidad de guiar el manejode cuidados intensivosde los pacientes conCOVID-19 con undoble objetivo: lograr el mejor tratamiento del paciente que contribuya a subuena evolución clínica; ygarantizar los niveles adecuados de prevención y control de la... infección para la protección de los trabajadores sanitarios y de la población en su conjunto.
more
The guidelines are to be used to guide the management of adults with lower respiratory tract infection (LRTI). As will be seen in the following text, this diagnosis, and the other clinical syndromes within this grouping, can be difficult to make accurately. In the absence of agreed definitions of th...ese syndromes these guidelines are to be used when, in the opinion of a clinician, an LRTI syndrome is present. The following are put forward as def-initions to guide the clinician, but it will be seen in the ensuingtext that some of these labels will always be inaccurate. These definitions are pragmatic and based on a synthesis of available studies. They are primarily meant to be simple to apply in clinical practice, and this might be at the expense of scientific accuracy. These definitions are not mutually exclusive, with lower respiratory tract infection being an umbrella term that includes all others, which can also be used for cases that cannot be classified into one of the other groups. No new evidence has been identified that would lead to a change in the clinical definitions,which are therefore unchanged from the 2005 publication.
Clin Microbiol Infect 2011;17(Suppl. 6): 1–24 The full version of these guidelines can be found on Wiley Online Library.
more
Reduced healthy life expectancy due to the high burden of both mental ill health and noncommunicable diseases (NCDs) is a major public health concern in the European Region. The links between mental disorders and major NCDs are well established.
In clinical practice, however, mental disorders in pa...tients with NCDs as well as NCDs in patients with mental disorders are often overlooked. Premature mortality and disability could be reduced if there were a greater focus on comorbidity.
This report addresses the needs of adults of working age with mental health problems – those with common mental disorders such as depression and anxiety and those with more severe conditions such as schizophrenia and bi-polar affective disorder. It also addresses the needs of those with NCDs, specifically cardiovascular diseases, cancers, chronic respiratory diseases and diabetes mellitus.
more
This treatment guideline is intended to assist clinicians in the Behavioral Health department in treatment planning and service delivery for patients with Post Traumatic Stress Disorder (PTSD). It may also assist clinicians treating patients who have some of the signs and symptoms of PTSD but who do... not meet the full criteria of PTSD. The treatment guideline is not intended to cover every aspect of clinical practice, but to focus specifically on the treatment models and modalities that clinicians in our outpatient treatment setting could provide. These guidelines were developed through a process of literature review and discussion amongst clinicians in the Behavioral Health department and represent a consensus recommendation for service provision for this disorder. The guideline is intended to inform both clinical and administrative practices with the explicit goals of outlining treatment that is: effective, efficient, culturally relevant and acceptable to clinicians, program managers, and patients.
more