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  • Gissel Coble posted an update 7 hours, 53 minutes ago

    Potential avenues for future research to improve the sexual function in people with CKD may include evaluating the safety and efficacy of established therapies in people with CKD using a variety of observational and interventional study designs, engaging people with CKD and multidisciplinary team members in research, and using implementation science methods to translate what is known about sexual function into clinical practice. Concerted efforts are required to break down barriers and improve sexual function in people with CKD. Patients have identified this as an important research priority, and national networks need to direct efforts to reduce symptom burden.

    This narrative review was limited by a paucity of high-quality studies examining sexual dysfunction specifically in people with kidney disease.

    This narrative review was limited by a paucity of high-quality studies examining sexual dysfunction specifically in people with kidney disease.

    Recent years have witnessed an encouraging expansion of knowledge and management tools in the care of patients with autosomal dominant polycystic kidney disease (ADPKD), including measurement of total kidney volume as a biomarker of disease progression, stringent blood pressure targets to slow cyst growth, and targeted treatments such as tolvaptan.

    We sought to evaluate clinicians’ familiarity with, and usage of, novel evidence-based management tools for ADPKD.

    On-line survey.

    British Columbia, Canada.

    Nephrologists in academic and community practice (excluding clinicians who practice exclusively in transplantation).

    Participants answered multiple-choice questions in 6 domains sources of information, self-identified needs for optimal care delivery, prognostication, imaging tests, blood pressure targets, and use of tolvaptan.

    An online survey was developed and disseminated via email to 65 nephrologists engaged in current clinical practice in British Columbia.

    A total of 29 nephrologists (45%) csms for tolvaptan can vary; therefore, clinicians’ experience with the drug may not be generalizable. Although the response rate was acceptable, the survey is nonetheless subject to responder bias.

    This survey indicates that there is substantial variability in the usage of, and familiarity with, evidence-based ADPKD management tools among contemporary nephrologists, contributing to incomplete translation of evidence into clinical practice. Providing greater access to tolvaptan or imaging tests is unlikely to improve patient care without enhancing knowledge translation and education.

    Not applicable as this was a survey.

    Not applicable as this was a survey.Mycoplasma pneumoniae, Legionella pneumophila and Chlamydia pneumoniae are the most common bacterial agents, which account for 15-40%, 2-15% and 5-10% of atypical community-acquired pneumonia (CAP) respectively. These agents are mostly associated with infection in the outpatient setting. The aim of this study was to evaluate the frequency of these pathogens among patients with CAP attending outpatient clinics in Tehran. A cross-sectional study was carried out of 150 patients attending to educational hospitals in Tehran with CAP. M. pneumoniae, L. pneumophila and Chlamydia spp. were detected by PCR assay, targeting the P1 adhesion gene, macrophage infectivity potentiator (mip) gene and 16S rRNA gene respectively from throat swabs obtained from each patient. A total of 86 (57.3%) of 150 patients were women; median age was 50 years (interquartile range, 35-65 years). M. pneumoniae, L. pneumophila and Chlamydia spp. were detected in 37 (24.7%), 25 (16.7%) and 11 (7.3%) patients respectively; of these, 66 patients (44%) were infected at least by one of these three pathogens. The frequency of L. pneumophila was significantly higher among patients over 60 years old (p 0.03). Coinfection was detected in seven patients (4.7%); six were infected by M. pneumoniae and L. pneumophila, and only one was infected by L. pneumophila and Chlamydia spp. M. BI-4020 ic50 pneumoniae was the most prevalent agent of atypical CAP, and L. pneumophila was more likely to infect elderly rather than younger people. Further studies on the prevalence of CAP and its aetiologic agents are needed to improve the diagnosis and treatment of CAP patients.Coronavirus disease 2019 (COVID-19) is an infectious disease caused by a newly discovered coronavirus. Epidemiological and clinical features of patients with COVID-19 have been examined but socio-economic aspects have been less studied. This study aimed to identify the role of the human development index (HDI) in the incidence and mortality rates of COVID-19 worldwide. Information on the incidence and mortality rates of COVID-19 was obtained from the Worldometer and data about the HDI 2019 were obtained from the World Bank database. Correlations between incidence, mortality rates and HDI parameters were assessed using linear regression. We calculated the concentration index to measure socio-economic inequality in COVID-19-related mortality and incidence. A linear regression analysis showed a direct significant correlation between the incidence and mortality rate of COVID-19 and HDI at the global level. The concentration index was positive for incidence rate (0.62) and mortality rate (0.69) of COVID-19, indicating the higher concentration of the rates among groups with high HDI. The high incidence and mortality rates of COVID-19 in countries with high and very high HDI are remarkable and should be the top priority for interventions by global health policy-makers. Health programmes should be provided to reduce the burden of this disease in regions with high incidence and mortality rates of COVID-19.At the end of 2019, the novel coronavirus disease 2019 (COVID-19) emerged in Wuhan, China, then spread rapidly across the country and throughout the world. The causative agent is severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); according to the International Committee on Taxonomy of Viruses, this virus has a nucleic acid sequence that is different from other known coronaviruses but has some similarity to the beta coronavirus identified in bats. Coronaviruses are a large virus group of enveloped positive-sense single-stranded RNA. They are divided into four genera-alpha, beta, delta and gamma-and alpha and beta coronaviruses are known to infect humans. Rapid and early diagnosis of COVID-19 is a challenging issue for physicians and other healthcare personnel. The sensitivity and specificity of the clinical, radiologic and laboratory tests used to diagnose COVID-19 are variable and largely differ in efficacy depending on the disease’s stage of presentation.

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