scholarly journals Palliative Care in Pediatric Pulmonology

Children ◽  
2021 ◽  
Vol 8 (9) ◽  
pp. 802
Author(s):  
Taylor Baumann ◽  
Shailendra Das ◽  
Jill Ann Jarrell ◽  
Yuriko Nakashima-Paniagua ◽  
Edith Adriana Benitez ◽  
...  
Keyword(s):  
Palliative Care ◽  
Lung Disease ◽  
Low Income ◽  
Clinical Course ◽  
Low Income Countries ◽  
Pediatric Pulmonology ◽  
Specialized Palliative Care ◽  
End Stage ◽  
Developmental Conditions ◽  
Growing Population

Children with End Stage Lung Disease (ESLD) are part of the growing population of individuals with life-limiting conditions of childhood. These patients present with a diverse set of pulmonary, cardiovascular, neuromuscular, and developmental conditions. This paper first examines five cases of children with cystic fibrosis, bronchopulmonary dysplasia, neuromuscular disease, pulmonary hypertension, and lung transplantation from Texas Children’s Hospital. We discuss the expected clinical course of each condition, then review the integration of primary and specialized palliative care into the management of each diagnosis. This paper then reviews the management of two children with end staged lung disease at Hospital Civil de Guadalajara, providing an additional perspective for approaching palliative care in low-income countries.

scholarly journals The burden of serious health-related suffering among cancer decedents: Global projections study to 2060

2020 ◽  
pp. 026921632095756
Author(s):  
Katherine E Sleeman ◽  
Barbara Gomes ◽  
Maja de Brito ◽  
Omar Shamieh ◽  
Richard Harding
Keyword(s):  
Palliative Care ◽  
Low Income ◽  
Population Based ◽  
World Health ◽  
Low Income Countries ◽  
Cancer Type ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Related ◽  
Health Organization

Background: Palliative care improves outcomes for people with cancer, but in many countries access remains poor. Understanding future needs is essential for effective health system planning in response to global policy. Aim: To project the burden of serious health-related suffering associated with death from cancer to 2060 by age, gender, cancer type and World Bank income region. Design: Population-based projections study. Global projections of palliative care need were derived by combining World Health Organization cancer mortality projections (2016–2060) with estimates of serious health-related suffering among cancer decedents. Results: By 2060, serious health-related suffering will be experienced by 16.3 million people dying with cancer each year (compared to 7.8 million in 2016). Serious health-related suffering among cancer decedents will increase more quickly in low income countries (407% increase 2016–2060) compared to lower-middle, upper-middle and high income countries (168%, 96% and 39% increase 2016-2060, respectively). By 2060, 67% of people who die with cancer and experience serious health-related suffering will be over 70 years old, compared to 47% in 2016. In high and upper-middle income countries, lung cancer will be the single greatest contributor to the burden of serious health-related suffering among cancer decedents. In low and lower-middle income countries, breast cancer will be the single greatest contributor. Conclusions: Many people with cancer will die with unnecessary suffering unless there is expansion of palliative care integration into cancer programmes. Failure to do this will be damaging for the individuals affected and the health systems within which they are treated.

scholarly journals Peritoneal Dialysis Utilization Globally and Opportunities in Lower Income Countries

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Fredric Finkelstein ◽  
Qamar Khan
Keyword(s):  
Peritoneal Dialysis ◽  
Low Income ◽  
Low Income Countries ◽  
Dramatic Improvement ◽  
Middle Income ◽  
Low Resource ◽  
Number Of Patients ◽  
The Government ◽  
Global Increase ◽  
End Stage

There has been an expansion of peritoneal dialysis (PD) utilization globally over the past several years. This has occurred for several reasons. First, there has been a global increase in the number of patients receiving end-stage kidney disease (ESKD) treatment in high income, middle income and low income countries. Second, recent studies have emphasized the reduced cost of PD compared to hemodialysis (HD) if PD supplies can be acquired at a reasonable cost.  Thirdly, it is now widely accepted that since PD is much simpler to do than HD (that is, it does not require large amounts of water, complex water treatment systems, electricity, and machinery), the use of PD in low resource countries has certain obvious advantages. Fourthly, it has become clear from experiences in Hong Kong and Thailand that have developed PD First programs (i.e. the government paying for ESKD care only if PD eligible patients start on PD rather than HD) and programs in Mexico (where there has been limited availability of HD centers) that the vast majority of patients with ESKD, even in low resource countries, are able to successfully be cared for with PD.  And, importantly, as programs expand in low resource countries and experience is gained, outcomes of  PD improve.  Lastly, the International Society of Peritoneal Dialysis (ISPD) has developed comprehensive guidelines for the care of PD patients that has resulted in a dramatic improvement in outcomes for PD patients over the last several years.

scholarly journals The burden of chronic respiratory diseases in adults in Nepal: A systematic review

2021 ◽  
Vol 18 ◽  
pp. 147997312199457
Author(s):  
Winifred Ekezie ◽  
Alex Robert Jenkins ◽  
Ian Philip Hall ◽  
Catrin Evans ◽  
Rajendra Koju ◽  
...  
Keyword(s):  
Lung Disease ◽  
Low Income ◽  
Lung Diseases ◽  
Disease Burden ◽  
Airflow Obstruction ◽  
Chronic Respiratory Disease ◽  
Low Income Countries ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Chronic Lung Diseases

While chronic lung disease causes substantial global morbidity and mortality, global estimates have primarily been based on broad assumptions. Specific country data from low-income countries such as Nepal are limited. This review assessed primary evidence on chronic respiratory disease burden among adults in Nepal. A systematic search was performed in June 2019 (updated May 2020) for studies through nine databases. High levels of heterogeneity deemed a narrative synthesis appropriate. Among 27 eligible studies identified, most were low-moderate quality with cross-sectional and retrospective study design. Chronic lung diseases identified were chronic obstructive pulmonary disease (COPD), asthma, bronchiectasis and restrictive lung diseases. Studies were categorised as: (i) community-based, (ii) hospital-based and (iii) comorbidity-related and disease burden. Reported disease prevalence varied widely (COPD, 1.67–14.3%; asthma, 4.2–8.9%). The prevalence of airflow obstruction was higher among rural dwellers (15.8%) and those exposed to household air pollution from domestic biomass burning as opposed to liquid petroleum gas users (Odds Ratio: 2.06). Several comorbidities, including hypertension and diabetes mellitus added to the disease burden. The review shows limited literature on lung disease burden in Nepal. Publications varied in terms of overall quality. Good quality research studies with prospective cohorts related to respiratory conditions are required.

scholarly journals Bridging the gap in respiratory medicine: How a pulmonologist from other continent can help African children who “can’t breathe?” The story of a European professor and his African trainee

2021 ◽  
Vol 0 ◽  
pp. 1-5
Author(s):  
Abate Yeshidinber Weldetsadik ◽  
Frank Riedel
Keyword(s):  
Low Income ◽  
Cost Effective ◽  
Developed Countries ◽  
Low Income Countries ◽  
Financial Benefit ◽  
Governmental Organization ◽  
Low Income Country ◽  
Local Institution ◽  
Training Cost ◽  
Pediatric Pulmonology

An European pediatric pulmonologist successfully organized a 2-year in-house pediatric pulmonology training with simultaneous establishment of the first pediatric pulmonary center in Ethiopia. Collaboration of the local institution with a non-governmental organization (NGO) facilitated the realization of the program. Training cost was significantly low compared to the expected out of country training, with extra financial benefit enabling purchase of equipment for the center. Our experience shows that specialists from developed countries can be instrumental to establishing cost-effective training programs and founding of specialized services in low-income countries by training subspecialists in their own setting. NGOs and leading international professional societies can support such programs to relieve the suffering of the child who “can’t breathe” because s/he is born in a low income country.

scholarly journals Common elements of service delivery models that optimise quality of life and health service use among older people with advanced progressive conditions: a tertiary systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e048417
Author(s):  
Joanne Bayly ◽  
Anna E Bone ◽  
Clare Ellis-Smith ◽  
India Tunnard ◽  
Shuja Yaqub ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Health Service ◽  
Older People ◽  
Low Income ◽  
Service Use ◽  
Functional Decline ◽  
Low Income Countries ◽  
Health Service Use

IntroductionHealth and social care services worldwide need to support ageing populations to live well with advanced progressive conditions while adapting to functional decline and finitude. We aimed to identify and map common elements of effective geriatric and palliative care services and consider their scalability and generalisability to high, middle and low-income countries.MethodsTertiary systematic review (Cochrane Database of Systematic Reviews, CINAHL, Embase, January 2000–October 2019) of studies in geriatric or palliative care that demonstrated improved quality of life and/or health service use outcomes among older people with advanced progressive conditions. Using frameworks for health system analysis, service elements were identified. We used a staged, iterative process to develop a ‘common components’ logic model and consulted experts in geriatric or palliative care from high, middle and low-income countries on its scalability.Results78 studies (59 geriatric and 19 palliative) spanning all WHO regions were included. Data were available from 17 739 participants. Nearly half the studies recruited patients with heart failure (n=36) and one-third recruited patients with mixed diagnoses (n=26). Common service elements (≥80% of studies) included collaborative working, ongoing assessment, active patient participation, patient/family education and patient self-management. Effective services incorporated patient engagement, patient goal-driven care and the centrality of patient needs. Stakeholders (n=20) emphasised that wider implementation of such services would require access to skilled, multidisciplinary teams with sufficient resource to meet patients’ needs. Identified barriers to scalability included the political and societal will to invest in and prioritise palliative and geriatric care for older people, alongside geographical and socioeconomic factors.ConclusionOur logic model combines elements of effective services to achieve optimal quality of life and health service use among older people with advanced progressive conditions. The model transcends current best practice in geriatric and palliative care and applies across the care continuum, from prevention of functional decline to end-of-life care.PROSPERO registration numberCRD42020150252.

scholarly journals A Systematic Review on Immunotherapy for Guillain- Barre Syndrome

2022 ◽  
Vol 40 (1) ◽  
pp. 57-64
Author(s):  
Abu Nayeem ◽  
Quazi Deen Mohammad ◽  
Zobaida Sultana Susan
Keyword(s):  
Low Income ◽  
Clinical Course ◽  
Guillain Barre Syndrome ◽  
Low Income Countries ◽  
Outcome Study ◽  
Access To Treatment ◽  
Geographical Variations ◽  
Disease Modifying Therapies ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Guillain-Barré syndrome (GBS) is an acute immunemediated polyradiculoneuropathy with a highly variable clinical course and outcome. Intravenous immunoglobulin (IVIG) and plasma exchange (PE) are proven effective treatments, but about half of the patients may not respond to these therapies; moreover, these are not established yet to treat patients of every stage of GBS or its variants. Results from the International Guillain-Barré Syndrome Outcome Study suggest that geographical variations exist in Guillain-Barré syndrome, including insufficient access to immunotherapy in low-income countries. There is a need to provide improved access to treatment for all patients with Guillain-Barré syndrome, and to develop effective disease-modifying therapies that can limit the extent of nerve injury. In this review, the current literature about immunotherapeutic options is highlighted in the context of stages of the disease and its variants and additionally, upcoming modalities are discussed briefly. J Bangladesh Coll Phys Surg 2022; 40: 57-64

Sign in / Sign up

Export Citation Format

Share Document