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1.
Int J Stroke ; 17(1): 18-29, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34986727

RESUMEN

Stroke remains the second-leading cause of death and the third-leading cause of death and disability combined (as expressed by disability-adjusted life-years lost - DALYs) in the world. The estimated global cost of stroke is over US$721 billion (0.66% of the global GDP). From 1990 to 2019, the burden (in terms of the absolute number of cases) increased substantially (70.0% increase in incident strokes, 43.0% deaths from stroke, 102.0% prevalent strokes, and 143.0% DALYs), with the bulk of the global stroke burden (86.0% of deaths and 89.0% of DALYs) residing in lower-income and lower-middle-income countries (LMIC). This World Stroke Organisation (WSO) Global Stroke Fact Sheet 2022 provides the most updated information that can be used to inform communication with all internal and external stakeholders; all statistics have been reviewed and approved for use by the WSO Executive Committee as well as leaders from the Global Burden of Disease research group.


Asunto(s)
Años de vida Ajustados por la Incapacidad , Accidente Cerebrovascular , Salud Global , Humanos , Incidencia , Años de Vida Ajustados por Calidad de Vida , Accidente Cerebrovascular/epidemiología
2.
Environ Int ; 158: 106984, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34991246

RESUMEN

BACKGROUND: Compared with other health areas, the mental health impacts of climate change have received less research attention. The literature on climate change and mental health is growing rapidly but is characterised by several limitations and research gaps. In a field where the need for designing evidence-based adaptation strategies is urgent, and research gaps are vast, implementing a broad, all-encompassing research agenda will require some strategic focus. METHODS: We followed a structured approach to prioritise future climate change and mental health research. We consulted with experts working across mental health and climate change, both within and outside of research and working in high, middle, and low-income countries, to garner consensus about the future research priorities for mental health and climate change. Experts were identified based on whether they had published work on climate change and mental health, worked in governmental and non-governmental organisations on climate change and mental health, and from the professional networks of the authors who have been active in the mental health and climate change space. RESULTS: Twenty-two experts participated from across low- and middle-income countries (n = 4) and high-income countries (n = 18). Our process identified ten key priorities for progressing research on mental health and climate change. CONCLUSION: While climate change is considered the biggest threat to global mental health in the coming century, tackling this threat could be the most significant opportunity to shape our mental health for centuries to come because of health co-benefits of transitioning to more sustainable ways of living. Research on the impacts of climate change on mental health and mental health-related systems will assist decision-makers to develop robust evidence-based mitigation and adaptation policies and plans with the potential for broad benefits to society and the environment.


Asunto(s)
Cambio Climático , Salud Mental , Adaptación Fisiológica , Predicción , Salud Global , Humanos
3.
Biomed Eng Online ; 21(1): 4, 2022 Jan 11.
Artículo en Inglés | MEDLINE | ID: mdl-35016695

RESUMEN

BACKGROUND: Chronic lymphocytic leukemia (CLL) is the most prevalent subtype of leukemia in Western countries, causing a substantial health burden on patients and society. Comprehensive evaluation of the epidemiological characteristics of CLL is warranted, especially in the current context of global population aging. The main objective of this study is evaluating the disease burden of CLL at global, regional, and national levels from 1990 to 2019. As secondary objectives, we studied the influence of demographic factors and performed risk factor analysis. We hope this study could provide evidence for the evaluation of the effectiveness of previous prevention strategies and the formulation of future global health policies. RESULTS: Based on data of CLL between 1990 to 2019 from the Global Burden of Disease (GBD) study 2019, we depicted the age, gender, and regional structure of the CLL burden population and described the impact of social development on the disease burden of CLL. The distribution and changing trends of attributable risk factors were also investigated. The global burden of CLL has increased dramatically. A high incidence has been achieved in males and elder people. Countries and territories with high social-demographic index (SDI) tended to have higher global burden than low-SDI region. Of risk factors, high body mass index and smoking were the major contributors for CLL-related mortality and disability adjusted life-years (DALYs). CONCLUSION: In summary, the global CLL burden continues to rise over the past 30 years. The relocation of medical resource should be considered on a global scale.


Asunto(s)
Carga Global de Enfermedades , Leucemia Linfocítica Crónica de Células B , Anciano , Salud Global , Humanos , Leucemia Linfocítica Crónica de Células B/epidemiología , Masculino , Años de Vida Ajustados por Calidad de Vida , Factores de Riesgo
6.
Surg Clin North Am ; 102(1): 105-115, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-34800380

RESUMEN

This article attempts to review the key components of a multimodal analgesic regimen for the treatment of acute pain. Adhering to these key components will help reduce the opioid burden to surgical patients while reducing acute pain. As well, this regimen is intended to reduce further negative contributions to the opioid crisis.


Asunto(s)
Analgesia/métodos , Recuperación Mejorada Después de la Cirugía , Epidemia de Opioides/prevención & control , Trastornos Relacionados con Opioides/prevención & control , Manejo del Dolor/métodos , Dolor Postoperatorio/terapia , Analgésicos Opioides/uso terapéutico , Anestesia/métodos , Terapia Combinada , Salud Global , Humanos , Trastornos Relacionados con Opioides/etiología , Dolor Postoperatorio/tratamiento farmacológico , Educación del Paciente como Asunto
7.
Nurs Sci Q ; 35(1): 25-27, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34939495

RESUMEN

The advancement of a healthcare discipline is reliant on the disciplines' ability to produce rigorous scholarship activities and products. The healthcare disciplines, especially nursing, are facing ever-changing priorities as shortages loom and exhaustion permeates the climate. Empirical public health priorities during the pandemic have dominated professional healthcare literature and global health communications. This article shall offer ethical implications for the discipline of nursing as it seeks the advancement of scholarship. Topics include straight-thinking issues surrounding nursing and medicine national policy statements, the big data movement, and evolutionary return of competency-based nurse education.


Asunto(s)
Becas , Principios Morales , Atención a la Salud , Salud Global , Humanos
10.
Pediatr Clin North Am ; 69(1): 141-152, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34794671

RESUMEN

Antimicrobials are essential in reducing morbidity and mortality from infectious diseases globally. However, due to the lack of effective surveillance measures and widespread overuse, there is an increasing threat to the effectiveness of antimicrobials. Although there is a global increase in antimicrobial resistance, low- and middle-income countries share a much higher burden. Antimicrobial stewardship efforts such as effective surveillance and reduction in overuse can help combat the increase in antimicrobial resistance.


Asunto(s)
Farmacorresistencia Microbiana , Salud Global , Infecciones/tratamiento farmacológico , Infecciones/epidemiología , Adolescente , Adulto , Antibacterianos/economía , Antibacterianos/uso terapéutico , Antiinfecciosos/economía , Antiinfecciosos/uso terapéutico , Programas de Optimización del Uso de los Antimicrobianos , COVID-19/tratamiento farmacológico , Niño , Preescolar , Países en Desarrollo , Farmacorresistencia Bacteriana Múltiple , Femenino , Enfermedades Gastrointestinales/tratamiento farmacológico , Gonorrea/tratamiento farmacológico , Humanos , Lactante , Recién Nacido , Masculino , Sepsis/tratamiento farmacológico , Adulto Joven
11.
Pediatr Clin North Am ; 69(1): 19-45, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34794675

RESUMEN

Childhood tuberculosis (TB) has been underreported and underrepresented in TB statistics across the globe. Contributing factors include health system barriers, diagnostic barriers, and community barriers leading to an underdetected epidemic of childhood tuberculosis. Despite considerable progress in childhood TB management, there is a concerning gap in policy and practice in high-burden countries leading to missed opportunities for active case detection, early diagnosis and treatment of TB exposure, and infection and disease in children regardless of human immunodeficiency virus status. Bridging this gap requires multisectoral coordination and political commitment along with an eye to research and innovation with potential to scale.


Asunto(s)
Tuberculosis/diagnóstico , Tuberculosis/epidemiología , Vacuna BCG/uso terapéutico , Niño , Preescolar , Epidemias , Femenino , Salud Global , Política de Salud , Humanos , Lactante , Recién Nacido , Masculino , Factores de Riesgo , Prueba de Tuberculina/métodos , Tuberculosis/prevención & control , Tuberculosis Pulmonar/epidemiología
12.
Pediatr Clin North Am ; 69(1): 185-202, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34794674

RESUMEN

Prevention of emerging infections in children is a dynamic arena where substantial medical advances have enabled intervention and prevention of infection outbreaks. This article discusses 5 infections causing significant morbidity and mortality across Asia, Latin America, and Africa. Avian influenza and the Middle East respiratory syndrome are highly contagious zoonoses spread through aerosol and droplets, affecting predominantly Asia. Dengue infection and chikungunya are endemic mosquito-borne viruses in tropical regions across Asia, Latin America, and Africa. Ebola is a highly contagious virus spread through human-to-human contact. The latest information in clinical manifestations, infection, prevention control, chemoprophylaxis, vaccination, and public health measures is reviewed.


Asunto(s)
Fiebre Chikungunya/prevención & control , Enfermedades Transmisibles Emergentes/prevención & control , Infecciones por Coronavirus/prevención & control , Dengue/prevención & control , Fiebre Hemorrágica Ebola/prevención & control , Gripe Humana/prevención & control , Adolescente , África , Animales , Asia , Aves , Niño , Preescolar , Brotes de Enfermedades/prevención & control , Salud Global , Humanos , Lactante , Gripe Aviar/prevención & control , América Latina , Vacunación/métodos
13.
Pediatr Clin North Am ; 69(1): 47-64, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34794676

RESUMEN

Malaria is a leading cause of death in children less than 5 years of age globally, and a common cause of fever in the returning North American traveler. New tools in the fight against malaria have been developed over the past decades: potent artemisinin derivatives; rapid diagnostic tests; long-lasting insecticidal bed nets; and a new vaccine, RTS,S/AS01. Thwarting these advances, parasite and Anopheles vector resistance are emerging. In the meantime, clinicians will continue to see malaria among febrile travelers from the tropics. Early recognition, diagnosis, and treatment can be lifesaving, but rely on the vigilance of frontline clinicians.


Asunto(s)
Salud Global , Malaria/tratamiento farmacológico , Malaria/epidemiología , Lesión Renal Aguda/epidemiología , Anemia/epidemiología , Antimaláricos/uso terapéutico , Combinación Arteméter y Lumefantrina/uso terapéutico , Artemisininas/uso terapéutico , Artesunato/uso terapéutico , Niño , Preescolar , Femenino , Humanos , Lactante , Malaria/diagnóstico , Malaria/prevención & control , Masculino , América del Norte , Plasmodium/aislamiento & purificación , Síndrome de Dificultad Respiratoria/epidemiología , Viaje
18.
Int J Cancer ; 150(1): 91-99, 2022 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-34398966

RESUMEN

A number of organizations are producing resource stratified guidelines (RSGs) for cancer. Despite using similar definitions of resource levels, systemic treatment recommendations often differ between organizations. We systematically searched for RSGs focusing on solid tumors. We qualitatively compared the methods used to generate guidelines using the AGREE-II appraisal tool. We extracted systemic treatment recommendations and assessed interguideline concordance using the Gwet AC1 coefficient, stratified by resource level, treatment setting and cancer type. We identified 69 RSGs cancer covering 15 solid tumors produced by four organizations. Despite using common resource-level definitions (Basic, Core/Limited, Enhanced and Maximal), recommendations differed between organizations. Concordance for chemotherapy recommendations was poor in Basic (58.3%, Gwet 0.20), fair in Core (58.3%, Gwet 0.32) and excellent in Enhanced (92.4%, Gwet 0.92) and Maximal settings (95.4%, Gwet 0.95). Concordance rates for endocrine therapy were good in Basic (80% Gwet 0.61), and excellent in Core (90%, Gwet 0.87), Enhanced (90%, Gwet 0.89) and Maximal settings (90%, Gwet 0.89). There was moderate to excellent concordance in targeted therapy recommendations across all resource levels. Differences in recommendations appeared driven by different opinions among the chosen panel of experts regarding what is resource appropriate. Overall, we found that countries looking to base treatment and health-policy on RSGs will find conflicting information depending on which guidelines are used, particularly for chemotherapy in Basic and Core settings. Improved transparency regarding the methods used to determine the value of a therapy for a given resource level is needed.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Atención a la Salud/normas , Recursos en Salud/normas , Neoplasias/tratamiento farmacológico , Guías de Práctica Clínica como Asunto/normas , Salud Global , Humanos , Neoplasias/patología
19.
Int J Cancer ; 150(2): 290-302, 2022 01 15.
Artículo en Inglés | MEDLINE | ID: mdl-34562270

RESUMEN

The shift towards primary human papillomavirus (HPV)-based screening has necessitated the search for a secondary triage test that provides sufficient sensitivity to detect high-grade cervical intraepithelial neoplasia (CIN) and cancer, but also brings an improved specificity to avoid unnecessary clinical work and colposcopy referrals. We evaluated the performance of the previously described DNA-methylation test (S5) in detecting CIN3 and cancers from diverse geographic settings in high-, medium- and low-income countries, using the cut-off of 0.80 and exploratory cut-offs of 2.62 and 3.70. Assays were performed using exfoliated cervical specimens (n = 808) and formalin-fixed biopsies (n = 166) from women diagnosed with cytology-negative results (n = 220), CIN3 (n = 204) and cancer stages I (n = 245), II (n = 249), III (n = 28) and IV (n = 22). Methylation increased proportionally with disease severity (Cuzick test for trend, P < .0001). S5 accurately separated women with negative-histology from CIN3 or cancer (P < .0001). At the 0.80 cut-off, 543/544 cancers were correctly identified as S5 positive (99.81%). At cut-off 3.70, S5 showed a sensitivity of 95.77% with improved specificity. The S5 odds ratios of women negative for cervical disease vs CIN3+ were significantly higher than for HPV16/18 genotyping at all cut-offs (all P < .0001). At S5 cut-off 0.80, 96.15% of consistently high-risk human papillomavirus (hrHPV)-negative cancers (tested with multiple hrHPV-genotyping assay) were positive by S5. These cancers may have been missed in current primary hrHPV-screening programmes. The S5 test can accurately detect CIN3 and malignancy irrespective of geographic context and setting. The test can be used as a screening and triage tool. Adjustment of the S5 cut-off can be performed considering the relative importance given to sensitivity vs specificity.


Asunto(s)
Biomarcadores de Tumor/genética , Neoplasia Intraepitelial Cervical/diagnóstico , Metilación de ADN , Papillomavirus Humano 16/aislamiento & purificación , Papillomavirus Humano 18/aislamiento & purificación , Infecciones por Papillomavirus/complicaciones , Neoplasias del Cuello Uterino/diagnóstico , Adulto , Neoplasia Intraepitelial Cervical/epidemiología , Neoplasia Intraepitelial Cervical/genética , Estudios Transversales , Detección Precoz del Cáncer , Femenino , Estudios de Seguimiento , Salud Global , Humanos , Persona de Mediana Edad , Infecciones por Papillomavirus/virología , Pronóstico , Estudios Retrospectivos , Neoplasias del Cuello Uterino/epidemiología , Neoplasias del Cuello Uterino/genética , Adulto Joven
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