Corticosteroids in the Management of Severe Coccidioidomycosis

Background

There is limited data suggesting that recovery from severe pulmonary infection with Coccidioides may be hastened by the addition of systemic corticosteroids.

Factors affecting hospital stay in psychiatric patients: the role of active comorbidity

ABSTRACT: BACKGROUND: Research on length of stay (LOS) of psychiatric inpatients is an under-investigated issue. In this naturalistic study we investigated factors which affect LOS in two groups of patients focusing particularly on the impact on LOS of medical comorbidity severe enough to require referral. METHODS: Active medical comorbidity was quantified using referral as the criterion. The study sample comprised of with 200 inpatients with the diagnosis of schizophrenia and 228 inpatients suffering from bipolar disorder (type I or II). Jonckheere and Mann-Whitney tests were used to estimate the influence of referrals on LOS, and regression analyses isolated variables associated with LOS separately for each group. RESULTS: Half of the patients needed one or more referrals for a non-psychiatric problem. The most common medical condition of patients with bipolar disorder was arterial hypertension. Inpatients with schizophrenia suffered mostly from an endocrine/metabolic disease - 12% of referrals were for Hashimoto's thyroiditis. A positive linear trend was found between LOS and number of referrals in both groups, the effect was greater for schizophrenia patients. The effect of referrals on LOS was verified by regression in both groups. Overall, referred patients showed greater improvement in GAF compared to controls. CONCLUSIONS: To our knowledge this is the first study to investigate physical comorbidity in psychiatric inpatients using the criteria of referral to medical subspecialties. Comorbidity severe enough to warrant referral is a significant determinant of hospital stay. This insight may prove useful in health care planning. The results show lack of effective community care in the case of schizophrenia and negative symptoms may be the cause of this. Our findings call for more attention to be paid to the general medical needs of inpatients with severe mental health and concurrent severe medical comorbidity.     

Stem cell therapy in treatment of different diseases

Stem cells are undifferentiated cells with the ability of proliferation, regeneration, conversion to differentiated cells and producing various tissues. Stem cells are divided into two categories of embryonic and adult. In another categorization stem cells are divided to Totipotent, Multipotent and Unipotent cells.So far usage of stem cells in treatment of various blood diseases has been studied (such as lymphoblastic leukemia, myeloid leukemia, thalassemia, multiple myeloma and cycle cell anemia). In this paper the goal is evaluation of cell therapy in treatment of Parkinson's disease, Amyotrophic lateral sclerosis, Alzheimer, Stroke, Spinal Cord Injury, Multiple Sclerosis, Radiation Induced Intestinal Injury, Inflammatory Bowel Disease, Liver Disease, Duchenne Muscular Dystrophy, Diabetes, Heart Disease, Bone Disease, Renal Disease, Chronic Wounds, Graft-Versus-Host Disease, Sepsis and Respiratory diseases. It should be mentioned that some disease that are the target of cell therapy are discussed in this article.     

Acceptability and uptake of HPV vaccine in Argentina before its inclusion in the immunization program: a population-based survey

In Argentina, human papillomavirus (HPV) vaccination was approved in 2006, but not included in the National Immunization Program. In 2008 a mass media campaign was carried out by a cancer Non-Governmental Organization (NGO), but it was stopped due to criticisms about the publicity. In October 2011 the Ministry of Health (MoH) has introduced HPV vaccination in the National Immunization Program. In this context, to assure high HPV vaccine coverage, evidence is needed on factors both associated to vaccine acceptability and uptake. In 2009-2010 we carried out a population-based survey among a representative sample of 1200 women aged 18-49 years from the Metropolitan Area of Buenos Aires. The objective was twofold: first to analyze socio-demographic determinants of women's knowledge on HPV vaccine and secondly, determinants of actual HPV vaccine uptake and acceptability in Argentina after the above-mentioned vaccine advertising shown in mass media in the year 2008. We analyzed vaccine uptake/acceptability separately for women and for their daughters aged 9-15, and willingness to vaccinate one's daughter younger than 9 to receive future HPV vaccination. Results of the 1200 women interviewed, 438 women (36.5%) knew the HPV vaccine and 303 (25%) remembered the mass media advertisement about HPV vaccination. When asked whether she would get vaccinated after having seen/heard the advertisement, around 75% (n=226) of women answered surely/probably yes. No significant differences in socio-demographic characteristics were found among women who would or not get vaccinated. When surveyed, 6 women had been vaccinated. Main reasons for non-vaccination were: "Doctor did not mention/recommend it" (34.1%) and "Vaccine is too expensive" (15.7%). No woman had had their 9-15 year-old daughter vaccinated. Among women who only had at least one daughter under 9 (n=278), 74% answered that they would get their daughter vaccinated if they were pre-adolescents. The conclusion is that, in Argentina, the potential acceptability of the vaccine is high, given that there is acceptance among the professional community, physicians recommend it, and vaccine is affordable.     

Computer-Assisted Clinimetric Tool for the Study of Facial Expression

Clinimetrics is the measurement of clinical phenomena; more specifically, it is mensuration, the act of acquiring and labeling basic raw data that is used to describe or measure symptoms, signs, and other distinctly clinical phenomena. ^1. Over the last 5 years, a new computer method for measuring facial expression has been developed. Refinement and validation of this technique are necessary before clinical applications are appropriate. Four hundred fifty data points from two human observers and the computed method were compared with one another by using indices of location, dispersion, and association within the framework of the logical construct of validity. These results suggest that the computed method is valid. This new method may be nearly ready for clinical applications as a primary or adjunctive clinimetric tool.