scholarly journals Exploring the Role of Rheumatic and Musculoskeletal Diseases in Multimorbidity

2020 ◽  
Author(s):  
Daniela Simões ◽  
Raquel Lucas
Keyword(s):  
Musculoskeletal Diseases ◽  
Case Fatality ◽  
Patient Centered ◽  
Behavioral Economic ◽  
Complex Patients ◽  
Equal Importance ◽  
Causal Pathway ◽  
High Prevalence ◽  
High Incidence

Non-communicable diseases (NCDs) frequently aggregate due to shared pathophysiological mechanisms, either as sequential steps in the same causal pathway or as common results of the same exposures, leading to a high prevalence of disease co-occurrence, a phenomenon known as multimorbidity. Multimorbidity is a patient-centered concept where all morbidities are regarded of equal importance irrespective of whether they started before or after any other disease in question. Rheumatic and musculoskeletal diseases (RMDs) are among the most prevalent groups of NCDs, and probably due to their high incidence and low case fatality, they are highly susceptible to multimorbidity. Complex patients, such as some of those with multimorbidity, are nowadays the norm, implying a growing concern that clinical practice guidelines fail to adequately address the care of complex patients. The ramifications of suffering from multimorbidity unfold for each patient, within their social, educational, cultural, behavioral, economic, and environmental contexts, which in turn affect disease management.

The Evolution of Drug Information Services to Asynchronous Delivery of Pharmacist eConsults

2021 ◽  
pp. 875512252110494
Author(s):  
Valerie Clinard ◽  
Marilyn Stebbins ◽  
Shalini Lynch
Keyword(s):  
Drug Information ◽  
Information Services ◽  
Patient Specific ◽  
Drug Information Services ◽  
Specialist Care ◽  
Patient Centered ◽  
Complex Patients ◽  
Academic Medical

Drug information (DI) services provided an avenue to expand the role of pharmacists as the medication experts. The focus of DI has shifted from general questions submitted to DI centers to patient-specific questions that optimize care. One method to increase access to pharmacist expertise is through pharmacy eConsults. Pharmacy eConsults provide specialist care for medically complex patients using a patient-centered, asynchronous approach. The purpose of this article is to describe the evolution of consults from formal drug information services and describe one academic medical center’s implementation of a pharmacy eConsult service to provide patient-specific DI.

High prevalence ofLeucocytozoonspp. in the endangered yellow-eyed penguin (Megadyptes antipodes) in the sub-Antarctic regions of New Zealand

Parasitology ◽  
2013 ◽  
Vol 140 (5) ◽  
pp. 672-682 ◽  
Author(s):  
L. S. ARGILLA ◽  
L. HOWE ◽  
B. D. GARTRELL ◽  
M. R. ALLEY
Keyword(s):  
New Zealand ◽  
Population Declines ◽  
Histological Evidence ◽  
The Past ◽  
Multiple Organs ◽  
High Prevalence ◽  
High Incidence ◽  
Low Prevalence ◽  
Campbell Island

SUMMARYYellow-eyed penguins (YEPs) have suffered major population declines over the past 30 years, with no single cause established.Leucocytozoonwas first identified in yellow-eyed penguins in 2005. During the 2008/09 breeding season, a high mortality was seen in both mainland yellow-eyed penguins as well as those on Enderby Island of the Auckland Islands archipelago. A high overall prevalence ofLeucocytozoonspp. in association with a high incidence of chick mortality was observed during this period on Enderby Island. One chick had histological evidence of leucocytozoonosis with megaloschizonts in multiple organs throughout its body. In addition, a high prevalence (73·7%) ofLeucocytozoonwas observed by PCR in the blood of adult Enderby yellow-eyed penguins taken during the 2006/07 season. These findings were different from the low prevalence detected by PCR on the coast of the South Island (11%) during the 2008/2009 breeding session and earlier on Campbell Island (21%) during the 2006/2007 breeding session. TheLeucocytozoonspp. sequences detected lead us to conclude that theLeucocytozoonparasite is common in yellow-eyed penguins and has a higher prevalence in penguins from Enderby Island than those from Campbell Island and the mainland of New Zealand. The Enderby Island yellow-eyed penguins are infected with aLeucocytozoonspp. that is genetically distinct from that found in other yellow-eyed penguin populations. The role ofLeucocytozoonin the high levels of chick mortality in the yellow-eyed penguins remains unclear.

scholarly journals The role of Helicobacter pylori in metabolic and cardiovascular diseases

2021 ◽  
pp. 86-95
Author(s):  
T. E. Kugler ◽  
G. G. Taradin ◽  
R. Pellicano
Keyword(s):  
Helicobacter Pylori ◽  
Cardiovascular Diseases ◽  
Diagnostic Methods ◽  
Alcoholic Fatty Liver ◽  
High Prevalence ◽  
High Incidence ◽  
H Pylori ◽  
Alcoholic Fatty Liver Disease

Helicobacter pylori (H. pylori) infection is one of the most common in the world. More than 50% of the world’s population is infected and infection rates are especially high in countries with poor socio-economic conditions. H. pylori causes gastroduodenal and extra-gastroduodenal diseases including such metabolic disorders as obesity, diabetes mellitus and non-alcoholic fatty liver disease. Recent epidemiological and clinical studies showed that the long-term persistence of H. pylori infection is associated with the development and progression of atherosclerosis and consequently cardiovascular diseases. However, the correlation between these conditions is ambiguous and there is not enough evidence to confirm it. The lack of consensus might be related to differences in diagnostic methods used for H. pylori and the variety of its genotypes. Considering high prevalence of H. pylori infection as well as high incidence of metabolic and cardiovascular diseases, a verified correlation between these can be of great epidemiological, prophylactic and clinical significance.

Otologic Care in a School for the Deaf

1981 ◽  
Vol 89 (4) ◽  
pp. 651-657 ◽  
Author(s):  
Sylvan E. Stool ◽  
F. Owen Black ◽  
Helen Craig ◽  
Margaret Laird
Keyword(s):  
Deaf Child ◽  
Maintenance Program ◽  
High Prevalence ◽  
High Incidence ◽  
Inner Ear Disease ◽  
Supervision And Training ◽  
School For The Deaf ◽  
And Training

Recent studies at the Western Pennsylvania School for the Deaf revealed both a high prevalence and a high incidence of external, middle, and inner ear disease among the students enrolled. This paper illustrates the role of the otolaryngologist in the otologic evaluation, diagnosis, treatment, and follow-up in this special population and in the supervision and training of relevant health care personnel. Included in this discussion are (1) the implementation and results of an otologic surveillance and maintenance program at the school for the deaf, (2) the methods and results of vestibular evaluation in this population, and (3) an example of the procedures possible to prepare for and facilitate the hospitalization of a deaf child.

scholarly journals Disseminated Kaposi sarcoma following COVID-19 in a 61-year-old Albanian immunocompetent man: a case report and review of the literature

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Giulia Gardini ◽  
Silvia Odolini ◽  
Giovanni Moioli ◽  
Dorothea Angela Papalia ◽  
Vittorio Ferrari ◽  
...  
Keyword(s):  
Viral Infections ◽  
Kaposi Sarcoma ◽  
Clinical Syndrome ◽  
Free Access ◽  
Literature Research ◽  
Susceptibility Factors ◽  
High Prevalence ◽  
High Incidence ◽  
The University

Abstract Background COVID-19 and its related anti-inflammatory treatment (steroids, immunomodulators) may induce the reactivation of latent bacterial, parasitic, and viral infections. According to our knowledge, no case of disseminated HHV-8-related Kaposi sarcoma (KS) after COVID-19 and its treatment has been described so far. Only one case of cutaneous KS concurrently with COVID-19 has been previously reported. Case presentation We describe a case of disseminated KS in a 61-year-old immunocompetent Albanian man after hospitalization for COVID-19. Methods for literature research We used PubMed as biomedical database for the literature research. We selected keyword combinations including “Kaposi sarcoma,” “HHV-8,” “immunocompetent,” “COVID-19,” “SARS-CoV-2,” and “steroids.” No time or language limitation was set. Titles and abstracts of selected articles were systematically screened. Articles were included in the examination if they were published under free access through the digital library of the University of Brescia (Italy), and provided full text. Articles were excluded if the topic was beyond the aim of our study. Finally, we selected 15 articles. Results We describe a case of KS in COVID-19 patient and postulate that Interleukin-6 (IL-6) activity and steroid-induced immunodeficiency may play a major role in KS emergence. No published case of disseminated KS following COVID-19 in otherwise healthy individuals was found through the systematic literature review, despite the high incidence of COVID-19 in areas with medium–high prevalence of HHV-8 infection. This observation might be explained by the role of individual genetic susceptibility factors. Conclusions SARS-CoV-2 infection and its treatment may lead to reactivation of several latent infections, including HHV-8 and its related clinical syndrome, Kaposi sarcoma.

The Role of Shared Decision-Making in Audiologic Rehabilitation

2014 ◽  
Vol 21 (1) ◽  
pp. 15-23 ◽  
Author(s):  
Helen Pryce ◽  
Amanda Hall
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Behavior Changes ◽  
Shared Decision ◽  
Patient Centered ◽  
Treatment Information ◽  
Centered Care ◽  
Potential Risks ◽  
Audiologic Rehabilitation

Shared decision-making (SDM), a component of patient-centered care, is the process in which the clinician and patient both participate in decision-making about treatment; information is shared between the parties and both agree with the decision. Shared decision-making is appropriate for health care conditions in which there is more than one evidence-based treatment or management option that have different benefits and risks. The patient's involvement ensures that the decisions regarding treatment are sensitive to the patient's values and preferences. Audiologic rehabilitation requires substantial behavior changes on the part of patients and includes benefits to their communication as well as compromises and potential risks. This article identifies the importance of shared decision-making in audiologic rehabilitation and the changes required to implement it effectively.

Board of Director Characteristics, Institutional Ownership, and Fraud: Evidence from Australia

2004 ◽  
Vol 23 (2) ◽  
pp. 105-117 ◽  
Author(s):  
Vineeta D. Sharma
Keyword(s):  
Research Evidence ◽  
Institutional Ownership ◽  
Board Of Director ◽  
Composition And Structure ◽  
High Incidence ◽  
The Board Of Directors ◽  
Director Characteristics ◽  
The Relationship ◽  
The U.S

Due to the high incidence of fraud in Australia, regulatory reports suggest strengthening the monitoring role of the board of directors (BOD). These reports recommend greater independence and no duality (chairperson of the BOD should not be the CEO) on the BOD. While there is no Australian evidence, research evidence in the U.S. supports these suggested reforms. It is not clear whether the research evidence observed in the U.S. will generalize to the Australian setting because of contextual differences. This study extends the U.S. findings to the Australian context and investigates the relationship between two attributes of the BOD, independence and duality, and fraud. In addition, I examine whether institutional ownership plays a role in the context of fraud. The more highly concentrated institutional ownership in Australia suggests the presence of some relationship. Using a matched sample of fraud and no-fraud firms from 1988–2000, I find that as the percentage of independent directors and the percentage of independent institutional ownership increases, the likelihood of fraud decreases. As expected, the results show a positive relationship between duality and the likelihood of fraud. These results support the call for strengthening the composition and structure of the BOD in Australia.

scholarly journals The Impact of Ultraviolet Radiation on the Aetiology and Development of Uveal Melanoma

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1700
Author(s):  
Melissa Chalada ◽  
Charmaine A. Ramlogan-Steel ◽  
Bijay P. Dhungel ◽  
Christopher J. Layton ◽  
Jason C. Steel
Keyword(s):  
Risk Factors ◽  
Ultraviolet Radiation ◽  
Uveal Melanoma ◽  
World Health Organisation ◽  
World Health ◽  
Genetic Mutations ◽  
High Incidence ◽  
The World ◽  
The Impact

Uveal melanoma (UM) is currently classified by the World Health Organisation as a melanoma caused by risk factors other than cumulative solar damage. However, factors relating to ultraviolet radiation (UVR) susceptibility such as light-coloured skin and eyes, propensity to burn, and proximity to the equator, frequently correlate with higher risk of UM. These risk factors echo those of the far more common cutaneous melanoma (CM), which is widely accepted to be caused by excessive UVR exposure, suggesting a role of UVR in the development and progression of a proportion of UM. Indeed, this could mean that countries, such as Australia, with high UVR exposure and the highest incidences of CM would represent a similarly high incidence of UM if UVR exposure is truly involved. Most cases of UM lack the typical genetic mutations that are related to UVR damage, although recent evidence in a small minority of cases has shown otherwise. This review therefore reassesses statistical, environmental, anatomical, and physiological evidence for and against the role of UVR in the aetiology of UM.

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