Noeljespersen5612

Background Rheumatic heart disease disproportionately affects women of reproductive age, as it increases the risk of cardiovascular complications and death during pregnancy and childbirth. In sub-Saharan Africa, clinical outcomes and adherence to guideline-based therapies are not well characterized for this population. Methods and Results In a retrospective cohort study of the Uganda rheumatic heart disease registry between June 2009 and May 2018, we used multivariable regression and Cox proportional hazards models to compare comorbidities, mortality, anticoagulation use, and treatment cascade metrics among women versus men aged 15 to 44 with clinical rheumatic heart disease. We included 575 women and 252 men with a median age of 27 years. Twenty percent had New York Heart Association Class III-IV heart failure. Among patients who had an indication for anticoagulation, women were less likely than men to receive a prescription of warfarin (66% versus 81%; adjusted odds ratio, 0.37; 95% CI, 0.14-0.96). Retention in care (defined as a clinic visit within the preceding year) was poor among both sexes in this age group (27% for men, 24% for women), but penicillin adherence rates were high among those retained (89% for men, 92% for women). check details Mortality was higher in men than women (26% versus 19% over a median follow-up of 2.7 years; adjusted hazard ratio, 1.66; 95% CI, 1.18-2.33). Conclusions Compared with men, women of reproductive age with rheumatic heart disease in Uganda have lower rates of appropriate anticoagulant prescription but also lower mortality rates. Retention in care is poor among both men and women in this age range, representing a key target for improvement.Purpose We planned this study to bring attention to the somatosensory impairments in patients with multiple sclerosis (PwMS) and to investigate relationship of somatosensory impairments with dynamic postural stability and upper extremity motor function.Methods Seven males and 23 females, 30 patients with mean EDSS 2.9 (SD = 1.4), aged between 18 and 65 years (mean = 41.43 ± 14.90 years) were included in this clinical study. Light touch sensorial assessment was made with Semmes Weinstein monofilament test and proprioception by distal proprioception test. Hand strength was measured by the Jamar dynamometer, fine motor skill was examined with nine-hole peg test, functional reach test in sitting and standing position was applied. Nottingham Extended Activities of Daily Living Scale (NEADLS) was used to measure everyday activities.Results We found a negative and moderate correlation between FRT in standing and light touch of the middle of the heel (right -0.515), metatarsal bone (right r 0.453, left r -0.426), anded Disability Status Scale; NEADLS Nottingham Extended Activities of Daily Living Scale.Objectives To assess the neurobiology of treatment-resistant depression (TRD), and factors connected with improvement after total sleep deprivation (TSD) with sleep phase advance (SPA), for the augmentation of pharmacotherapy.Methods The study comprised 43 patients with TRD, (15 male, 28 female), aged 48 ± 13 years, with the illness duration 12 ± 9 years, and the depressive episode 8 ± 7 months. TRD was defined as a lack of significant improvement despite at least two antidepressant treatments and the augmentation with mood-stabilizers. Clinical improvement (response) was a reduction of ≥50% of points in the Hamilton Depression Rating Scale (HDRS), and the remission criterion was ≤7 points in HDRS, lasting until the 14th day after TSD + SPA.Results TRD severity was associated with greater activity of the hypothalamic-pituitary-adrenal axis, the pro-inflammatory status of the immune system and lower reactivity of the hypothalamic-pituitary-thyroid axis. The response was achieved by 18 of 42 subjects, and connected with the later onset and shorter duration of the disease. In responders, there was a decrease in cortisol and interferon-gamma. In all subjects, a decrease in thyroid hormones was observed.Conclusions TRD can improve after augmentation of pharmacotherapy by TSD + SPA and some biological changes may be compatible with a decrease in allostatic load.OBJECTIVES To investigate 1) the impact of low back pain (LBP) over 1-year in people recently recovered from an episode of LBP; 2) if the impact differs in people who do and do not experience a recurrence; 3) the impact of LBP based on three definitions of a recurrence of LBP. DESIGN Cohort. METHODS In 250 individuals recently recovered from LBP, the impact of LBP (multi-dimensional measure from 8-50) over the previous three-months was assessed at three-, six-, nine- and 12-months. Recurrence of LBP was assessed monthly and defined as recurrence of an episode of LBP; recurrence of activity-limiting LBP; recurrence of LBP causing care seeking. RESULTS The median impact over one year was 11.5 points (IQR=9.5, 14.8). The impact was 15.2 points (95% CI=13.9, 16.3) for those who reported any recurrence, and 11.1 points (95% CI=10.6, 11.5) for those who did not. When comparing definitions of recurrence, those who had a recurrence that did not cause moderate activity limitation or result in care seeking, had an overall impact of 12.7 points (95%CI=11.6, 13.8). Participants who had recurrences of activity-limiting LBP, but who did not seek care, had an overall impact of 15.5 points (95% CI=13.5, 17.6), and those who had recurrences of LBP for which healthcare was sought had an overall impact of 16.9 points (95% CI=15.3, 18.4). CONCLUSION The average impact due to recurrence of LBP was low and dependent on the definition of recurrence. J Orthop Sports Phys Ther, Epub 16 Apr 2020. doi10.2519/jospt.2020.9345.At present, all parts of the world are hit hard by COVID-19. The first confirmed case of COVID-19 in the territory of Hong Kong was announced on January 23, 2020. Since then, oculoplastic surgeons in Hong Kong have been taking every measure to protect all healthcare workers and patients from contracting the disease. This paper aims to share the experiences of and measures taken by local oculoplastic surgeons in combating COVID-19. Three main aspects are discussed, namely clinical, administrative, and training and educational. We hope our experiences would provide reference to fellow oculoplastic colleagues in other parts of the world in fighting this COVID-19 pandemic.