Fahmida Hossain
The COVID-19 disease pandemic has shaken the world through its first wave, and we have yet to experience the second wave. Even resourceful countries have failed to adequately prevent epidemics in their country, and for countries like Bangladesh, which already has strained an ineffective healthcare system, the challenges to contain the SARS-CoV-2 virus are that much more severe. Due to the scarcity of resources and systematic failures the Bangladeshi people deeply mistrust the healthcare system. The mistrust is further magnified as healthcare providers are hesitant to treat the patients because of the lack of proper protective gear...
September 18, 2020: Developing World Bioethics
Terrence J Ravine
BACKGROUND: Thermoplastic immobilization masks used during radiation therapy treatment have been shown to harbor several different types of bacteria. Recovered bacteria included Staphylococcus aureus, Enterococcus species, Gram-negative rods, coagulase-negative staphylococci, and several different Bacillus species. Two of the recovered Bacillus bacteria were examined for their ability to attach to and survive over time on patient head-only masks from four different manufacturers. B. halosaccharovorans was recovered from a treatment facility's water bath while B...
September 15, 2020: Journal of Medical Imaging and Radiation Sciences
Vera Sílvia Meireles Martins, Cristina Maria Nogueira Costa Santos, Patrícia Unger Raphael Bataglia, Ivone Maria Resende Figueiredo Duarte
In a time marked by the development of innovative treatments in healthcare and the need for health professionals to deal with resulting ethical dilemmas in clinical practice, this study was developed to determine the influence of the bioethics teaching on the moral competence of medical and nursing students. The authors conduct a longitudinal study using the Moral Competence Test extended version before and after attending the ethics curricular unit, in three nursing schools and three medical schools of Portugal...
September 17, 2020: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
Shahid A Mohammed, Christina Heyboer, Meggen Walsh, Talawnda Bragg
Diffuse alveolar hemorrhage (DAH) is a usual presentation of pulmonary vasculitis. However, several rare conditions have a similar presentation. We present a 73-year-old man with DAH whose diagnosis only became conclusive near the end of his life. The objective is to discuss the important differential diagnoses in a patient presenting with diffuse alveolar hemorrhage. There are very few case reports on pulmonary angiosarcoma and all of them discussed the rarity of the diagnosis, presentation, and treatment...
2020: Respiratory Medicine Case Reports
Abdulmohsen Al-Zalabani, Oussama A AlThobyane, Ayoub H Alshehri, Abdulaziz O Alrehaili, Mohammad O Namankani, Owais H Aljafri
Antibiotic resistance is a rising dilemma of significant implications on global public health. Few data exist for the prevalence and trends of Klebsiella pneumonia antibiotic resistance in Saudi Arabia. Therefore, we have set out to identify the prevalence and trends of Klebsiella pneumonia antibiotic resistance in King Fahad Hospital in Medina over the period between February 27, 2014, and December 31, 2018. The research was carried out as a retrospective cross-sectional study. A total of 15708 isolates taken from 1149 patients were included in the study...
August 13, 2020: Curēus
Kelli M Robertson, Christopher L Harvey, John M Cunningham
BACKGROUND: Varicella zoster virus central nervous system infections can present as aseptic meningitis, encephalitis, myelitis, and vasculopathy. Diagnosis is based on identification of varicella zoster virus deoxyribonucleic acid (DNA) in the cerebrospinal fluid by polymerase chain reaction. Therapy for these infections is acyclovir or valacyclovir. However, acyclovir can have neurotoxic effects that can mimic the presentation of varicella zoster virus central nervous system disease...
September 18, 2020: Journal of Medical Case Reports
Ross Tanis, Julie A Croley, Josh Hammel, Richard F Wagner
Cutaneous head and neck reconstruction following Mohs micrographic surgery frequently presents the surgical dilemma of dog-ear formation during wound closure. Z-plasty corrects a dog-ear deformity without skin excision by recruiting tissue from the axis of the standing cone and redistributing it along another. We describe dog-ear correction using the Z-plasty technique.
August 2020: Cutis; Cutaneous Medicine for the Practitioner
Guangxiao Ma, Shuai Li, Chenglizhao Chen, Aimin Hao, Hong Qin
The 2D image based salient object detection (SOD) has been extensively explored, while the 360° omnidirectional image based SOD has received less research attention and there exist three major bottlenecks that are limiting its performance. Firstly, the currently available training data is insufficient for the training of 360° SOD deep model. Secondly, the visual distortions in 360° omnidirectional images usually result in large feature gap between 360° images and 2D images; consequently, the widely used stage-wise training - a widely-used solution to alleviate the training data shortage problem, becomes infeasible when conducing SOD in 360° omnidirectional images...
September 17, 2020: IEEE Transactions on Visualization and Computer Graphics
Amir Ata Rhanemai-Azar, Maharshi Rajdev, Mayada Ismail, Eric Dean McLoney, Sidhartha Tavri, Mohammed S Al-Natour
In the setting of portal hypertension, intractable bleeding from anorectal varices is a rare occurrence. In this review, clinical presentation and management of this dilemma are presented in a case-based fashion. Bleeding may occur in the absence of prior history of cirrhosis or gastroesophageal varices and measurement of hepatic venous pressure gradient and liver biopsy could help to establish the diagnosis. Successful treatment outcome necessitates tailoring treatment to the patient's anatomy and imaging findings...
September 17, 2020: Abdominal Radiology
Mara Simopoulou, Konstantinos Sfakianoudis, Polina Giannelou, Anna Rapani, Charalampos Siristatidis, Panagiotis Bakas, Nikolaos Vlahos, Konstantinos Pantos
The COVID-19 pandemic has fueled numerous debates in the field of assisted reproductive technology (ART) as the effect of SARS-CoV-2 on pregnancy and infancy is still considered uncharted territory. Various theses and recommendations on what optimal practice is have emerged, as evidenced by surveys, webinars, and recent publications. ART specialists are faced with dilemmas in light of the lack of concrete scientific evidence required to pave the way towards future safe practice. Meanwhile, infertile couples were similarly left in limbo unable to exercise their reproductive autonomy unlike fertile couples-where achieving a pregnancy via natural conception is a matter of decision...
September 16, 2020: Journal of Assisted Reproduction and Genetics
Lysanne Rivard, Pascale Lehoux, Hassane Alami
BACKGROUND: Open do-it-yourself (DIY) health innovations raise new dilemmas for patient-oriented and service-oriented scholars and healthcare providers. Our study aimed to generate practical insights into quality and safety issues to patient care raised by two volunteer-run, open DIY solutions: Nightscout Project (patient-driven, open-source software for type 1 diabetes management) and e-NABLE (volunteers who design and three-dimensionally print upper-limb assistive devices). To this end, we examined the views of health innovators who are knowledgeable about medical devices standards and regulations...
September 16, 2020: BMJ Quality & Safety
Kenneth Reinicke
Several studies report that men, just like women, go through a complex emotional upheaval when they are about to become parents and that men need support to be able to tackle parenthood in the best way possible. This qualitative study addresses the extent to which parenting courses attended by both the mother and the father constitute an appealing institutional service for first-time fathers and whether they find them useful in tackling the challenges they face during the pregnancy and after the birth. The article explores difficulties with recruiting fathers to such courses and ensuring their continued attendance since men's masculinity dilemmas can affect the extent to which they are willing to seek help and to complete such courses...
September 2020: American Journal of Men's Health
Xiaogang Zhu, Quanzhong Zhou, Shan Tong, Yujie Zhou
Coronary artery aneurysms are infrequent but not rare. Due to the lack of supportive data and a substantial knowledge gap in this field,the clinicians are in a dilemma how to manage the patients with coronary artery aneurysms. Most often, coronary artery aneurysms are discovered incidentally, while symptomatic patients present with diverse complications of unstable angina, myocardial infarction, arrhythmias or sudden cardiac death. Therapeutical approaches consist of surgical procedure, percutaneous coronary intervention, and medical management...
September 13, 2020: Hellenic Journal of Cardiology: HJC
Sylvia Gerritsen, Guy Widdershoven, Lia van der Ham, Laura van Melle, Martijn Kemper, Yolande Voskes
High and Intensive Care is a relatively new care model in Dutch mental health care for clinical admissions. One of the goals is to keep the admission short. For some patients, this goal is not realized, which results in a long-term admission. Often, this is experienced as a disruption. Disruptions in care processes are frequently defined in terms of patient characteristics. Yet, it may be that other factors play a role. The aim of this study is to gain better insight into the perceptions of care professionals of what is characteristic for disruptions at High and Intensive Care wards and how professionals can deal with these...
September 16, 2020: International Journal of Mental Health Nursing
Caspar Chorus, Erlend Dancke Sandorf, Niek Mouter
We report and interpret preferences of a sample of the Dutch adult population for different strategies to end the so-called 'intelligent lockdown' which their government had put in place in response to the COVID-19 pandemic. Using a discrete choice experiment, we invited participants to make a series of choices between policy scenarios aimed at relaxing the lockdown, which were specified not in terms of their nature (e.g. whether or not to allow schools to re-open) but in terms of their effects along seven dimensions...
2020: PloS One
Wojciech Pepke, Moritz M Innmann, Michael Akbar
Pathologies of the hip, spine and the lower extremity are often concomitant due to their three-dimensional anatomic and physiological interrelation. The real challenge lies in defining which of the pathologies is most relevant for the patient in terms of clinical symptoms and which organ should be treated first. The purpose of this review article is two-fold: Firstly, to explain the treatment dilemma of hip-spine syndrome to the treating physician. Secondly, to highlight the significance of spinal pathology in this context...
September 16, 2020: Der Orthopäde
Jerome Okudo, Valerie F Civelli, Vishal K Narang, Royce H Johnson, Nadir Khan, Brittany Andruszko, Arash Heidari
Cryptococcus gattii is a species that has received more recognition in the recent past as distinct from Cryptococcus neoformans. C gattii is known to cause meningeal disease in both immunocompetent and immunosuppressed hosts. Patients may be clinically asymptomatic until immunosuppressive conditions occur such as corticosteroid treatment or an HIV infection. HIV-associated cryptococcal infections are most often due to C neoformans. C gattii is found in a minority. Speciation and subtyping of Cryptococcus are not always accomplished...
January 2020: Journal of Investigative Medicine High Impact Case Reports
Petra Borilova Linhartova, Daniela Gachova, Bretislav Lipovy
Toxic epidermal necrolysis (TEN) represents a rare drug-induced autoimmune reaction with delayed-type hypersensitivity that initiates the process of developing massive keratinocyte apoptosis, dominantly in the dermoepidermal junction. Although the etiopathophysiology has not yet been fully elucidated, the binding of Fas ligand (FasL, CD95L) to the Fas receptor (CD95) was shown to play a key role in the induction of apoptosis in this syndrome. The knowledge of the role of immunoglobulin G (IgG) in inhibition of Fas-mediated apoptosis contributed to the introduction of i...
September 15, 2020: Journal of Dermatology
Hong-Long J Ji, Zhenlei Su, Runzhen Zhao, Andrey A Komissarov, Guohua Yi, Shan-Lu Liu, Steven Idell, Michael A Matthay
Background How aberrant fibrinolysis influences the clinical progression of COVID-19 presents a clinicopathological dilemma challenging intensivists. To investigate whether abnormal fibrinolysis is a culprit or protector or both, we associated elevated plasma D-dimer with clinical variables to identify a panoramic view of the derangements of fibrinolysis that contribute to the pathogenesis of COVID-19 based on studies available in the literature. Methods We performed this systematic review based on both meta-analysis and meta-regression to compute the correlation of D-dimer at admission with clinical features of COVID-19 patients in retrospective studies or case series...
September 11, 2020: medRxiv: the preprint server for health sciences
Kenneth Blum, Lisa Lott, David Baron, David E Smith, Rajendra D Badgaiyan, Mark S Gold
A recent analysis from Stanford University suggested that without any changes in currently available treatment, prevention, and public health approaches, we should expect to have 510,000 deaths from prescription opioids and street heroin from 2016 to 2025 in the US. In a recent review, Mayo Clinic Proceedings (October 2019), Gold and colleagues at Mayo Clinic reviewed the available medications used in opioid use disorders and concluded that in private and community practice adherence is more important as a limiting factor to retention, relapse, and repeat overdose...
May 30, 2020: Journal of Systems and Integrative Neuroscience
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