...A review of evidence supporting the use of Anti-Biotics in the treatment of Acute Otitis Media in children to prevent Mastoiditis. Word count: 1469 Module Leaders Jeshni Amblum & Stuart Rutland Contents Page 1. Front Sheet 2. Contents Page 3. A review of evidence supporting the use of Antibiotics in the treatment of Acute Otitis Media in children to prevent Mastoiditis. 4. Reference List 5. Appendices: i. SECAMB Clinical Management Plan/Patient Group Directive ii. FIGURE 3 - Thompson et al (2009) A review of evidence supporting the use of Antibiotics in the treatment of Acute Otitis Media in children to prevent Mastoiditis. Student no 18830 Rationale The Paramedic Practitioner (PP) role has recently adopted a number of Clinical Management plans and Patient Group Directives (PGD) increasing the scope of practice. One such PGD (Appendix i) allows for the utilisation of antibiotics, namely Amoxicillin and Clarithromycin, for the treatment of Otitis Media (OM). This essay will look at the evidence supporting the use of these antibiotics, their efficacy and if early use prevents OM from developing in to Mastoiditis. Its primary aim is to enhance a PP’s knowledge and support education working towards clinical autonomy. Description Otitis Media literally means inflammation of the middle ear (Merriam-Webster 2011) and is predominantly caused by an effusion with in the middle ear caused by Eustachian tube dysfunction (Dhillon and East, 1994...
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...“Cystic Fibrosis” Pediatric Case Study March 27, 2013 Kasie Wilson The name cystic fibrosis refers to the characteristic scarring (fibrosis) and cyst formation within the pancreas, first recognized in the 1930s. Cystic fibrosis (CF) is a major cause of serious chronic lung disease in children. It is an inherited recessive trait, in which both parents carry a gene for the disease. Children with cystic fibrosis have a defect in chromosome number seven, which is thought to have developed many years ago as a protective response of the human body against cholera (just a theory). The disease causes thick, sticky mucus to build up in the lungs, digestive tract, and other areas of the body such as the pancreas, liver, and intestine. It also causes a loss of electrolytes in sweat because of an abnormal chloride movement. About one thousand new cases of cystic fibrosis are diagnosed each year and more than seventy percent of these patients are diagnosed by the age of two. Cystic fibrosis is considered a multisystem disease because of the following effects of the thick, viscid secretions. In the respiratory system, small and large airways are obstructed, which then results in difficulty breathing. The accumulation and stasis of the secretions create a medium of growth for organisms that will cause repeated respiratory infections. The thick secretions in the lungs and response of tissues to infections cause hypoxia that can lead to heart...
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...disease when competing bacteria in the gut flora have been wiped out by antibiotics. Clostridia are anaerobic, spore-forming rods. C. difficile is the most serious cause of antibiotic-associated diarrhea (AAD) and can lead to pseudomembranous colitis, a severe inflammation of the colon, often resulting from eradication of the normal gut flora by antibiotics. In a very small percentage of the adult population, C. difficile bacteria naturally reside in the gut. Other people accidentally ingest spores of the bacteria while they are patients in a hospital, nursing home, or similar facility. When the bacteria are in a colon in which the normal gut flora has been destroyed (usually after a broad-spectrum antibiotic such as clindamycin has been used), the gut becomes overrun with C. difficile. This overpopulation is harmful because the bacteria release toxins that can cause bloating and diarrhea, with abdominal pain, which may become severe. C. difficile infections are the most common cause of pseudomembranous colitis, and in rare cases this can progress to toxic megacolon, which can be life-threatening. Latent symptoms of C. difficile infection often mimic some flu-like symptoms and can mimic disease flare in patients with inflammatory bowel disease-associated colitis.[4] Mild cases of C. difficile infection can often be cured by discontinuing the antibiotics responsible.[2] In more serious cases, oral administration of, first, oral metronidazole and - if that fails -...
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...dental pain and removing diseased tissues (Torabinejad). There was an estimated 50 million dental extractions performed in the United States in 1979 (Bullock). With the increased number of people living in the United States for a longer period of time, the occurrence of dental extractions and tooth loss has certainly risen exponentially. Unfortunately, tooth loss, whether it is through dental extractions or other means, has long term clinical sequelae associated with it. Osteonecrosis of the jaw, bacteremia, orbital cellulitis, and other psychological and physiological clinical sequelae that impact the well-being of the patient will be discussed. Osteonecrosis of the jaw (ONJ) is defined as the presence of exposed bone in the mouth that fails to heal after appropriate intervention over a period of 6 to 8 weeks (Reid), and results in chronic osteomyelitis with areas of bone necrosis. Most commonly affecting the mandible (Bagan), patients with ONJ experience symptoms that range from painless exposed bone to severe jaw pain (Sambrook). The majority of cases of ONJ have been found to be initiated and associated with tooth extraction procedures as a result of the introduction of oral flora to the exposed jaw bone that prevents healing and becomes infected (Ruggiero). In addition to tooth extractions being a precipitating event to ONJ, it has been found that ONJ occurs in patients who have previously undergone chemotherapy treatment for cancer and take bisphosphonate medications...
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...treating pain and illness depends on the culture and geographical location of the professional appointed to treat pain. In Western Tradition, physicians are considered to be experts on treating illness and pain by utilizing chiropractic manipulation, acupuncture, physical therapy and synthetic medicines. In Navajo tradition, medicine men are the experts on curing illness and pain with religious ceremonies and the use of natural herbs and remedies. Today, the most advanced practice in the health industry is pain management because of the combination of herbal medicines created by Navajos, and synthetic medicines created by Western Scientists. The study of medicine all began in the 1700s when Christopher Columbus came in contact with Indian people in the 1700s. The Indians and Europeans traded food, weapons, shelter and worked together, in a sense, to discover land and natural resources. Shortly after, Small pox, measles, and tuberculosis broke out and killed many people. This encouraged Western Scientists and Navajo People to try and discover cures for infectious diseases. Western Scientists engineered micro-organisms that would search and destroy harmful bacteria and viruses, later to be named “antibiotics“. Navajo people appointed medicine men who learned to prepare and create medicines from natural vegetation. Both proved to be effective. Navajo Medicine Men discovered many several herbs to treat pain including the Loco Weed, which is a life medicine Raycinda Yazzie describes...
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...Clinicians must take time to explain the chronicity of the disease and cycles of quiescence and flare call for an ongoing maintenance treatment plan with additional medication as required.2 This case presents a typical picture of a person with Acne rosacea (Rosacea) and the common association...
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...In medicine, compliance (also adherence or capacitance) describes the degree to which a patient correctly follows medical advice. Most commonly, it refers to medication or drug compliance, but it can also apply to other situations such as medical device use, self care, self-directed exercises, or therapy sessions. Both the patient and the health-care provider affect compliance, and a positive physician-patient relationship is the most important factor in improving compliance,[1] although the high cost of prescription medication also plays a major role.[2] Compliance is commonly confused with concordance. Concordance is the process by which a patient and clinician make decisions together about treatment.[3] Non-compliance is a major obstacle to the effective delivery of health care. Estimates from the World Health Organization (2003) indicate that only about 50% of patients with chronic diseases living in developed countries follow treatment recommendations.[1] In particular, low rates of adherence to therapies for asthma, diabetes, and hypertension are thought to contribute substantially to the human and economic burden of those conditions.[1] Compliance rates may be overestimated in the medical literature, as compliance is often high in the setting of a formal clinical trial but drops off in a "real-world" setting.[4] Major barriers to compliance are thought to include the complexity of modern medication regimens, poor "health literacy" and lack of comprehension of treatment...
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...Background: Sepsis is a final pathway of infectious disease in critically ill patients. It is highly fatal condition. Though many researches are undertake in pathophysiology, epidemiology and management of sepsis in developed nation ,very limited information is available in low incomes countries where infections are prevalent. Objective: The objective of the study was to determine the prevalence and outcome of sepsis and its prognostic factors in patients admitted to Jimma University Specialized Hospital. Method: Patients with systemic inflammatory response due to infections were studied using prospective cohort study design for four month period in Jimma University hospital. A structured questioner was used to collect data on socio demographic feature of the patient and clinical feature, outcome and prognostic factors . Data was cleaned, edited and entered to SPSS window for analysis. The survival analysis and determination of prognostic factors was done using Cox regression model. The value of p < 0.05 was considered statistically significant. Result: The prevalence of sepsis, severe sepsis, septic and refractory shock in the study population was 14%.7.8%,2.1% and 1.4% with their associated all cause mortality of at the end of 28 days are 35.8%,44.1%,68.8% and 88.9% respectively. The clinical variables that...
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...TESTS | MAIN TREATMENT | Stool gram stain and culture (if bloody stools)Stool for Ova & Parasites (if hx suggestive)CBC – assess for anemia/infectionUrinalysis and urine culture (r/o UTI)Electrolytes | Oral rehydration therapy (ORT) is one of the major worldwide health advances of the last decade:Safer, less painful, and less costly than IV rehydrationOral rehydration solution enhances and promotes reabsorption of H2O and NaReduces vomiting, diarrhea, and duration of illnessORT GuidelinesDiarrhea w/o dehydrationMild dehydrationMod dehydrationSevere dehydrationReplacing ongoing losses | MAJOR TEACHING POINTS | NURSING CONSIDERATIONS | Teach parents at well childcare visits in first yearKeep 24 hour supply of ORT in homeBegin with first sign of diarrheaReplace with ½ cup ORT for each diarrheal stoolSeek medical attention prn signs or dehydrationAfter re-hydration resume breast/formula feeding or normal diet in the older childAdvise them never to try to formulate an OR solution themselves.Teach personal hygiene/ hand washingProper preparation and storage of breast milk or formulaCareful food preparationImmunization for RotavirusAvoid unnecessary antibiotic usage | Acute diarrhea is leading cause of illness in children <5 years (10’s of millions cases in US)65% of hospitalizations and 85% of...
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...begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors’ clinical recommendations. From the Feinberg School of Medicine, Northwestern University, Chicago (A.J.S.); and the University of Manitoba, Winnipeg, Canada (L.E.N.). Address reprint requests to Dr. Schaeffer at the Feinberg School of Medicine, Northwestern University, 303 E. Chicago Ave., Tarry Bldg. 16-703, Chicago, IL 60611, or at jschaeffer@ a northwestern.edu. N Engl J Med 2016;374:562-71. DOI: 10.1056/NEJMcp1503950 Copyright © 2016 Massachusetts Medical Society. An audio version of this article is available at NEJM.org 562 A 79-year-old community-dwelling man presents with urinary frequency, dysuria, and fever. Culture reveals extended-spectrum beta-lactamase Escherichia coli. He had a similar infection several months ago, with the same organism isolated, and he had a response to nitrofurantoin treatment. How would you further evaluate and manage this case? U The Cl inic a l Probl em rinary tract infection in men without indwelling catheters is uncommon among men younger than 60 years of age, but the incidence increases substantially among men 60 years of age or older.1,2 The reported incidence in the community is 0.9 to 2.4 cases per 1000 men among those who are younger than 55 years of age and 7.7 cases per 1000...
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...Similarly, in Alameda County case counts are up from 124 in 2013 to 328 cases as of Nov. 26. The majority (89%) of statewide cases with known ages have occurred in infants and children 18 years of age or younger. One death in an infant 5 weeks old has been reported with disease onset in 2014 (Pertussis, 2015). According to CDC, in developing countries, Pertussis remains a major health problem among children in developing countries, with 195,000 deaths resulting from the disease in 2008 (World Health Organization estimate) (Pertussis, 2014). The incubation period From McKinley Health Center, the duration of the infection is 7-14 days, but may be as long as three weeks and in length of infectious terms is only contagious for 5-7 days if antibiotic therapy is begun (Pertussis,...
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...A number of studies have shown that establishing infection control guidelines based on scientific evidence results in considerable savings. The SENIC study demonstrated that good infection control programs result in real savings and improved health care for the patients. Clinical care protocols and suitable antibiotic use reduce infection, thus reducing the length of stay in hospitals, the single most costly part of medical care. Infection control programs reduce morbidity and mortality. Infection control teams are particularly helpful for preventing outbreaks caused by multidrug-resistant organisms such as methicillin-resistant Staphylococcus aureus (MRSA) or gram-negative bacilli. A significant contribution has been made in high-risk areas, such as intensive care units (ICUs), where infection rates have been reduced by good infection control practice. These patients are usually sicker, require more invasive therapy, medical involvement, and aggressive therapy, and are at higher risk for developing...
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...Cite this article as: Henry G. Grabowski, Joseph A. DiMasi and Genia Long The Roles Of Patents And Research And Development Incentives In Biopharmaceutical Innovation Health Affairs, 34, no.2 (2015):302-310 doi: 10.1377/hlthaff.2014.1047 The online version of this article, along with updated information and services, is available at: http://content.healthaffairs.org/content/34/2/302.full.html For Reprints, Links & Permissions: http://healthaffairs.org/1340_reprints.php E-mail Alerts : http://content.healthaffairs.org/subscriptions/etoc.dtl To Subscribe: http://content.healthaffairs.org/subscriptions/online.shtml Health Affairs is published monthly by Project HOPE at 7500 Old Georgetown Road, Suite 600, Bethesda, MD 20814-6133. Copyright © 2015 by Project HOPE - The People-to-People Health Foundation. As provided by United States copyright law (Title 17, U.S. Code), no part of Health Affairs may be reproduced, displayed, or transmitted in any form or by any means, electronic or mechanical, including photocopying or by information storage or retrieval systems, without prior written permission from the Publisher. All rights reserved. Not for commercial use or unauthorized distribution Downloaded from content.healthaffairs.org by Health Affairs on February 29, 2016 at UNIV OF CALIFORNIA Intellectual Property & Innovation By Henry G. Grabowski, Joseph A. DiMasi, and Genia Long 10.1377/hlthaff.2014.1047 HEALTH AFFAIRS 34, NO. 2 (2015): 302–310 ...
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...PAWAR Roll No. 35 In Partial Fulfilment For The Award Of The Diploma Of PGDM IN PHARMACEUTICAL MANAGEMENT PROJECT GUIDE: INTERNAL GUIDE : MR .KAPIL.MUDLIAR MRS.SUMANA BOSE (PRODUCT MANAGER) (FACULTY) DUPEN LABORITIES PVT. SIESCOMS. S.I.E.S COLLEGE OF MANAGEMENT STUDIES MAY 2010 - JUNE2010 DECLARATION I hereby declare that the project work entitled “MARKET ANALYSIS AND PERCEPTION ON PRE-PROBIOTICS” –PROJECT 1 MARKET ANALYSIS AND PERCEPTION ON LATEST HEMATINIC (FERROUS ASCORBATE+ FOLIC ACID)- PROJECT 2 submitted to SIES COLEGE OF MANAGEMENT STUDIES, NERUL NAVI MUMBAI is a record of an original work done by me under the guidance of Mrs.SUMANA BOSE, Faculty Member,and Dr. Suhas Tambe ,HOD. this project work has not performed the basis for the award of any Degree or diploma/ associate ship/fellowship and similar project if any. GAYATRI PAWAR ABSTRACT The main goal of the report was to investigate about the PRE-PROBIOTICS molecule, its market perception, prescription pattern and the most prescribed and selling brands in Navi Mumbai. This report begins by examining the current prescription rates of Pre-Probiotics...
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...recessive disorder.1,2,22 It is the most common inherited disease in the Caucasian population affecting 1 in 3000 children in Western Europe.3 It is a multiorgan disorder caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) protein, which is located on the long arm of chromosome 7 and encodes for a special chloride ion channel.4,5 The vast majority of mutations involve three or fewer nucleotides and result in primarily amino acid substitutions, frameshifts, splice site, or nonsense mutations.11 Of more than 800 identified CFTR mutations, the 3 base pair deletion of phenylalanine at position 508 is found worldwide in 70% of cystic fibrosis sufferers, therefore making F508 CFTR the most common deadly mutant in the Caucasian populations.6 Since cystic fibrosis has a genetic origin the opportunity to treat by replacing the defective gene with a normal healthy gene (gene therapy) offers a ‘novel therapeutic approach’ for sufferers.7 The estimated survival age of cystic fibrosis sufferers is 33.4 years (Fig 1). In this essay we will discuss the aetiology and symptoms of cystic fibrosis and the current available treatments, with particular emphasis on gene therapy and furanones, which prevent the build up of bacterial biofilms and thus reduce lung infection. Mutations in the CF gene can disrupt CFTR function within epithelial cells in different ways, ranging from complete loss of protein to surface expression with poor chloride conductance...
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