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Dermatology
Published in Rachel U Sidwell, Mike A Thomson, Concise Paediatrics, 2020
Rachel U Sidwell, Mike A Thomson
Benign condition occurring in first few days of Life in half of term infants. Eruptions of red papules ± pustules (containing eosinophils) with surrounding erythematous flare. Affects whole body except palms and soles. Self-Limiting condition (2–4 days).
Perspective of a lay adviser in occupational health
Published in Jim Ford, Gordon Parker, Fiona Ford, Diana Kloss, Simon Pickvance, Philip Sawney, Dame Carol Black, Rehabilitation for Work Matters, 2018
Jim Ford, Gordon Parker, Fiona Ford, Diana Kloss, Simon Pickvance, Philip Sawney, Dame Carol Black
What happens next has been the focus of attention both in the scientific literature and in intervention studies. Most sickness absence is short term in nature. Illnesses follow their set patterns, and self-limiting conditions resolve. However, in a proportion of episodes of illness this does not happen. Longer spells of sickness absence are marked by changes in psychological attitudes on the part of the employee, and in organisational behaviour at work. The number of patients moving into long-term sickness absence may be small at any given time, but it is cumulatively large and requires disproportionate amounts of clinical and rehabilitation support.
Health Care in Prisons *
Published in Andrew Stevens, James Raftery, Jonathan Mant, Sue Simpson, Health Care Needs Assessment, 2018
Tom Marshall, Sue Simpson, Andrew Stevens
Prisoners are heavy users of primary care. Although direct data on the reasons for primary care consultations among prisoners is lacking, it is likely that the commonest reasons for consultation are similar to those among young adults in the community. This suggests that minor illnesses and other problems dealt with at the level of primary care are the commonest reasons for prisoners using health care. In the terminology of needs assessment, minor illnesses and other primary care problems are the largest demands on the health care services. However, most minor illnesses are (by definition) self-limiting. In some cases, medical treatment is as likely to do harm as to improve the outcome. In those cases where there is effective treatment, this is often available without a doctor’s prescription. In needs assessment terminology, there is little need for health care for minor illnesses and in those cases where there is need it may be most cost-effective for patients to access it themselves.
Cost-effectiveness of the adjuvanted quadrivalent influenza vaccine in the elderly Belgian population
Published in Expert Review of Vaccines, 2023
Sophie Marbaix, Nicolas Dauby, Joaquin Mould-Quevedo
The cost-effectiveness model estimated the probability of influenza infection for each vaccination alternative based on the influenza attack rate and the respective vaccine effectiveness against influenza strains A and B. The infected patients were symptomatic or asymptomatic. Asymptomatic patients (who are usually not registered in the epidemiological data) were assumed to have no further impact on this analysis. Symptomatic patients were self-limiting or sought medical assistance, which is mainly the case in the elderly population. Adults aged 65 years and older are also more at risk of developing complications consequent to influenza infection. The influenza-related complications considered in the present analysis overlap the complications included in other cost-effectiveness analyses of influenza vaccine [16,20–22] and included bronchitis, pneumonia or any unspecified upper respiratory tract infection (URTI), myocarditis, myocardial infarction (MI), renal or central nervous system (CNS) complications, stroke, and exacerbations of chronic obstructive pulmonary disease (COPD). Cardiac decompensation, defined as a worsening of patients with heart failure, has been reported but must be clearly differentiated from myocarditis. This complication was considered in the scenario analysis.
Efficacy of infliximab in treatment-naïve patients with stricturing small bowel Crohn’s disease
Published in Scandinavian Journal of Gastroenterology, 2021
Bing-xia Chen, Ze-min Han, Qian Zhou, Hong-bin Liu, Pei-chun Xu, Fa-chao Zhi
The diagnostic time interval was the duration from the first symptom onset to the diagnosis of CD. Referring to the previous studies [14,15], the long diagnostic delay was defined according to the time interval in which the 76th to 100th percentile of patients were diagnosed. Clinical disease activity was measured by Harvey Bradshaw Index (HBI) [16]. For patients with obstructive symptoms (nausea, vomiting, cramping and abdominal distension), the severity of obstructive symptoms was classified as mild (spontaneously self-limiting), moderate (outpatient department visit required) and severe (hospitalization required due to obstructive symptoms). Endoscopic disease activity was measured by Simple Endoscopic Score for CD (SES-CD) [17]. Primary non-response to infliximab was defined as failure to achieve a ≥ 2 point decrease in HBI at 14 weeks after infliximab induction therapy [18]. The definition of secondary loss of response to infliximab was that patients who responded to infliximab induction therapy, but subsequently lost response during maintenance therapy [18]. Based on the results of TDM, if primary or secondary non-responders had therapeutic (3–7 μg/mL) or supra-therapeutic (>7 μg/mL) infliximab trough levels or high titers (70 ng/mL) of anti-infliximab antibodies, infliximab was discontinued. For those with sub-therapeutic infliximab trough levels (<3 μg/mL) and no or low detectable anti-infliximab antibodies, dose escalation (7 mg/kg every 8 weeks) or interval shortening (5 mg/kg every 6 weeks) of infliximab was carried out.
Lack of antibiotic knowledge and misuse of antibiotics by medical students in Mali: a cross-sectional study
Published in Expert Review of Anti-infective Therapy, 2021
Jie Chen, Aissata Mahamadou Sidibi, Xiaohui Shen, Kalo Dao, Alain Maiga, Ying Xie, Therese Hesketh
The level of knowledge measured in our study shows no significant relationship with antibiotic misuse. A former study reported that the relationship between knowledge and behavior is not straightforward [39]. If knowledge does not influence behavior it is important to understand what influences antibiotic misuse and what drives the 80% use of antibiotic for self-limiting illness. First, a relatively high incidence of bacterial infection means that antibiotics are more likely to be indicated and may be life-saving. However, by self-limiting we are referring to conditions like the common cold and uncomplicated diarrhea, which medical students should recognize as not requiring antibiotics. Second, antibiotics are very available in retail pharmacies, even in markets, easily purchased, and stored at home, as was common among our respondents. Widespread use is a cultural norm, leading to antibiotics being referred to as ‘peanuts’ [40].