Altitude Acclimatization and Illness Management

2010 ◽  
2013 ◽  
pp. 1-1
Author(s):  
Meenakshi Sachidhanandam ◽  
Salthan Ashok Kumar ◽  
Som Nath Singh ◽  
UdaySankar Ray

2019 ◽  
Vol 15 (2) ◽  
pp. 202-206 ◽  
Author(s):  
Olaitan O. Omitola ◽  
Hammed O. Mogaji ◽  
Andrew W. Taylor-Robinson

Recent research has highlighted the growing public health concern arising from mismanagement of malarial and non-malarial febrile illnesses that present with similar clinical symptoms. A retrospective examination of patient records suggests that a syndrome-based diagnosis results in over-diagnosis of malaria. Consequently, interventions to mitigate the frequency of presumptive treatment of fever in malaria-endemic settings have been sought, especially for resourcelimited areas. Guidelines that promote the use of microbiological tests and modern diagnostic kits have demonstrated laudable progress in the ongoing challenge of febrile illness management. However, this has brought attention to other factors like the complication of mixed infections. These issues, which remain significant limitations to current tools and methods in the accurate diagnosis and subsequent therapy of febrile illnesses, call for innovative diagnostic interventions. Advancements in biomedical research over the last decade have led to the introduction of state-of-the-art molecular techniques of omics origin that provide the possibility of diverse applications in disease diagnostics. Here, we present notable challenges in febrile illness management, describe currently available tools and methods for diagnosis, and discuss the opportunities for future progress, including harnessing cuttingedge transcriptional profiling and proteomics technology to detect host immunological signatures during infection.


CHEST Journal ◽  
1972 ◽  
Vol 61 (2) ◽  
pp. 51S-53S
Author(s):  
J.A. Dempsey ◽  
W.G. Reddan ◽  
M.L. Birnbaum ◽  
H.V. Forester ◽  
J. Thoden ◽  
...  

2017 ◽  
Vol 100 (6) ◽  
pp. 1169-1176 ◽  
Author(s):  
Karen M. Zhang ◽  
Leora C. Swartzman ◽  
Robert J. Petrella ◽  
Dawn P. Gill ◽  
John Paul Minda

1964 ◽  
Vol 19 (1) ◽  
pp. 21-24 ◽  
Author(s):  
James W. Terman ◽  
Jerry L. Newton

In the summer of 1962 at the White Mountain Research Station the early phases of altitude acclimatization were studied in six of the surviving eight members of the 1935 expedition to the Chilean Andes; they were from 58 to 71 years of age. Alveolar and arterial Po2 and Pco2 were determined for each man a few hours after arrival at 3,093 m and at 3,800 and 4,343 m over the next few days. The effects of age were superimposed on the classical responses to high altitude. The arterial and alveolar Pco2 values showed no significant gradient; the alveolar Pco2 was found to be lower for a given altitude than 27 years before. For example, their average alveolar Pco2 at 4,700 m in 1935 was 27.7 mm Hg as opposed to 25.1 mm Hg at 4,343 m in 1962. The case of Hall was exceptional: his alveolar Pco2 ranged from 21 to 24 mm Hg regardless of altitude for his sojourn of 22 days. In 1935 these six men had a mean A-a Po2 gradient of +3.0 mm Hg at 4,700 m, while in 1962 the gradient over the three altitudes was +12.4 mm Hg. These findings would likely be explained partially by age changes in the pulmonary ventilation-perfusion ratio. acclimatization; pulmonary ventilation-perfusion ratio; alveolar-arterial Po2 and Pco2 gradients; alveolar hyperventilation; aging and altitude Submitted on February 19, 1963


Author(s):  
Titus A. A. Beentjes ◽  
Steven Teerenstra ◽  
Hester Vermeulen ◽  
Peter J. J. Goossens ◽  
Maria W. G. Nijhuis-van der Sanden ◽  
...  

Abstract Purpose Complementary interventions for persons with severe mental illness (SMI) focus on both personal recovery and illness self-management. This paper aimed to identify the patient-reported outcome measures (PROMs) associated with the most relevant and meaningful change in persons with SMI who attended the Illness Management and Recovery Programme (IMR). Methods The effect of the IMR was measured with PROMs concerning recovery, illness self-management, burden of symptoms and quality of life (QoL). From the QoL measures, an anchor was chosen based on the most statistically significant correlations with the PROMs. Then, we estimated the minimal important difference (MID) for all PROMs using an anchor-based method supported by distribution-based methods. The PROM with the highest outcome for effect score divided by MID (the effect/MID index) was considered to be a measure of the most relevant and meaningful change. Results All PROMs showed significant pre–post-effects. The QoL measure ‘General Health Perception (Rand-GHP)’ was identified as the anchor. Based on the anchor method, the Mental Health Recovery Measure (MHRM) showed the highest effect/MID index, which was supported by the distribution-based methods. Because of the modifying gender covariate, we stratified the MID calculations. In most MIDs, the MHRM showed the highest effect/MID indexes. Conclusion Taking into account the low sample size and the gender covariate, we conclude that the MHRM was capable of showing the most relevant and meaningful change as a result of the IMR in persons with SMI.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mark van Veen ◽  
Bauke Koekkoek ◽  
Steven Teerenstra ◽  
Eddy Adang ◽  
Cornelis L. Mulder

Abstract Background Long-term community mental health treatment for non-psychotic disorder patients with severe mental illness (SMI) who are perceived as difficult by clinicians, is poorly developed and lacks a structured, goal-centred approach. This study compares (cost-)effectiveness of Interpersonal Community Psychiatric Treatment (ICPT) with Care As Usual (CAU) on quality of life and clinician perceived difficulty in the care for non-psychotic disorder SMI-patients. A multi-centre cluster-randomized clinical tria was conducted in which Community Mental Health Nurses (Clinicians) in three large community mental health services in the Netherlands were randomly allocated to providing either ICPT or CAU to included patients. A total of 56 clinicians were randomized, who treated a total of 93 patients (59 in ICPT-group and 34 in CAU-group). Methods Primary outcome measure is patient-perceived quality of life as measured by the Manchester Short Assessment of Quality of Life (MANSA). Secondary outcome measures include clinician-perceived difficulty, general mental health, treatment outcomes, illness management and recovery, therapeutic relationship, care needs and social network. Patients were assessed at baseline, during treatment (6 months), after treatment (12 months) and at 6 months follow-up (18 months). Linear mixed-effects models for repeated measurements were used to compare mean changes in primary and secondary outcomes between intervention and control group of patients over time on an intention to treat basis. Potential efficiency was investigated from a societal perspective. Economic evaluation was based on general principles of a cost-effectiveness analysis. Outcome measures for health economic evaluation, were costs, and Quality Adjusted Life Years (QALYs). Results Half of the intended number of patients were recruited. There was no statistically significant treatment effect found in the MANSA (0.17, 95%-CI [− 0.058,0.431], p = 0.191). Treatment effects showed significant improvement in the Different Doctor-Patient Relationship Questionnaire-scores and a significant increase in the Illness Management and Recovery–scale Client-version scores). No effects of ICPT on societal and medical costs nor QALYs were found. Conclusions This is the first RCT to investigate the (cost)-effectiveness of ICPT. Compared with CAU, ICPT did not improve quality of life, but significantly reduced clinician-perceived difficulty, and increased subjective illness management and recovery. No effects on costs or QALY’s were found. Trial registration NTR 3988, registered 13 May 2013.


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