A Human-Centered Approach to CV Care: Infrastructure Development in Uganda
Publication date: Available online 21 April 2018Source: Global HeartAuthor(s): Christopher T. Longenecker, Ankur Kalra, Emmy Okello, Peter Lwabi, John O. Omagino, Cissy Kityo, Moses R. Kamya, Allison R. Webel, Daniel I. Simon, Robert A. Salata, Marco A. CostaAbstractIn this case study, we describe an ongoing approach to develop sustainable acute and chronic cardiovascular care infrastructure in Uganda that involves patient and provider participation. Leveraging strong infrastructure for HIV/AIDS care delivery, University Hospitals Harrington Heart and Vascular Institute and Case Western Reserve University have partnered with U.S. and Ugandan collaborators to improve cardiovascular capabilities. The collaboration has solicited innovative solutions from patients and providers focusing on education and advanced training, penicillin supply, diagnostic strategy (e.g., hand-held ultrasound), maternal health, and community awareness. Key outcomes of this approach have been the completion of formal training of the first interventional cardiologists and heart failure specialists in the country, establishment of 4 integrated regional centers of excellence in rheumatic heart disease care with a national rheumatic heart disease registry, a penicillin distribution and adherence support program focused on retention in care, access to imaging technology, and in-country capabilities to treat advanced rheumatic heart valve disease.
ConclusionsAn inexpensive reusable non-commercial LP simulator can be an effective method for teaching invasive procedures like LPs, especially if it can be used both for palpation and US-guided procedures. The method outlined here can be easily reproduced in a relatively short amount of time. We recognize one limitation in the widespread dissemination of this technique being access to a 3D printer and digital designs for printing. Future studies will be necessary to determine the efficacy of the homemade LP simulator in teaching neurointensivist in training.
CONCLUSIONS: The findings of this review suggest that in settings with limited resources, current guideline recommendations to provide enhanced adherence counselling can result in resuppression of a substantial number of these patients, avoiding unnecessary drug regimen changes. Appropriate action on viral load results is limited across a range of settings, highlighting the importance of viral load cascade analyses to identify gaps and focus quality improvement to ensure that action is taken on the results of viral load testing. PMID: 31746541 [PubMed - in process]
The practice of preparing for sex with an enema, or a'rectal douche,'is common for gay and bisexual men, but they need to understand how to protect themselves during anal sex.Medscape Medical News
ConclusionsWe suggest this score as a very strong predictor for CBD stones, and to reduce the strength of total bilirubin and transaminases as predictors.
Publication date: Available online 20 November 2019Source: Arab Journal of GastroenterologyAuthor(s): Shogo Nakano, Kosuke Minaga, Yukitaka Yamashita
Authors: Sanches E, Timmermans M, Topal B, Celik A, Sundbom M, Ribeiro R, Parmar C, Ugale S, Proczko M, Stepaniak PS, Pujol Rafols J, Mahawar K, Buise MP, Neimark A, Severin R, Pouwels S Abstract Introduction: Obesity is associated with various diseases such as type 2 diabetes, hypertension, obstructive sleep apnea syndrome (OSAS), metabolic syndrome, and cardiovascular diseases. It affects several organ systems, including the pulmonary and cardiac systems. Furthermore, it induces pulmonary and cardiac changes that can result in right and/or left heart failure.Areas covered: In this review, authors provide an overv...
In conclusion, EMPA can trigger AMPK signaling pathways and modulate myocardial contractility and reduce myocardial infarct size caused by ischemia and reperfusion independent of hypoglycemic effect. The results for the first time demonstrate that the activation of AMPK by EMPA could one reason about EMPA's beneficial effects on heart disease.Graphical abstract
MRI-guided focused ultrasound provides durable relief in patients with medication-refractory essential tremor and should be considered a safe and effective therapeutic option, researchers say.Medscape Medical News
ConclusionHerbalists widely prescribe medicinal plant species for boosting or restoring the immunity in PLHIV in Uganda.
Publication date: Available online 21 April 2018 Source:Global Heart Author(s): Christopher T. Longenecker, Ankur Kalra, Emmy Okello, Peter Lwabi, John O. Omagino, Cissy Kityo, Moses R. Kamya, Allison R. Webel, Daniel I. Simon, Robert A. Salata, Marco A. Costa In this case study, we describe an ongoing approach to develop sustainable acute and chronic cardiovascular care infrastructure in Uganda that involves patient and provider participation. Leveraging strong infrastructure for HIV/AIDS care delivery, University Hospitals Harrington Heart and Vascular Institute and Case Western Reserve University have partnered with U....