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1.
J Investig Med High Impact Case Rep ; 11: 23247096231181060, 2023.
Article in English | MEDLINE | ID: mdl-37334970

ABSTRACT

Disseminated coccidioidomycosis is associated with significant morbidity and mortality. Involvement of the meninges is often fatal if untreated, typically requiring lifelong antifungal therapy and neurosurgical intervention. We present the case of a young male without any known immunocompromising conditions who opted exclusively for medical management of newly diagnosed coccidioidomycosis meningitis with communicating hydrocephalus and discuss the controversy associated with this approach. This case highlights the importance of shared decision-making between patient and clinician, even if the plan diverges from available guidelines. Furthermore, we discuss clinical considerations in approaching the close outpatient monitoring of patients with central nervous system coccidioidomycosis with hydrocephalus.


Subject(s)
Coccidioidomycosis , Hydrocephalus , Meningitis, Fungal , Humans , Male , Coccidioidomycosis/complications , Coccidioidomycosis/diagnosis , Coccidioidomycosis/drug therapy , Hydrocephalus/etiology , Central Nervous System/surgery , Meningitis, Fungal/diagnosis , Meningitis, Fungal/drug therapy , Ventriculoperitoneal Shunt
2.
J Environ Public Health ; 2021: 8714873, 2021.
Article in English | MEDLINE | ID: mdl-34457010

ABSTRACT

Background: Obesity rates in Hispanic women residing in the United States (U.S.) are disproportionately high, increasing the risk of obesity-related disease and mortality. The effectiveness of interventions targeting weight loss in this population remains largely unknown. Purpose: The purpose of this review was to systematically evaluate the evidence related to the effectiveness of weight loss interventions conducted among U.S. Hispanic women and provide guidance for future research. Methods: Bibliographic databases (n = 10, from each database's inception to July 2, 2019) were searched using the PRISMA guidelines for systematic reviews. Randomized controlled trials (RCTs) and quasi-experimental studies with weight change outcomes were included. Results were described in a narrative synthesis. Results: 5,423 articles were assessed for eligibility based on inclusion criteria; 15 studies were included in the final review. Nine trials were RCTs and six were quasi-experimental studies; all but six were pilot studies. Most studies recruited overweight or obese women with no existing medical conditions and did not follow participants beyond the intervention. All trials were delivered in-person. Intervention strategies and content and weight change outcomes were highly variable. Conclusions: RCTs with statistically powered sample sizes are needed to robustly test the effects of weight loss interventions in this population.


Subject(s)
Hispanic or Latino , Obesity , Weight Reduction Programs , Female , Hispanic or Latino/statistics & numerical data , Humans , Obesity/ethnology , Obesity/therapy , Program Evaluation , United States
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