RESUMEN
Immigrant clinicians are vital to population healthcare delivery and therefore population health. One in four physicians in the USA is foreign-born and notably represented in family and pediatric medicine-specialties charged with administering childhood/adolescent vaccines, such as human papillomavirus vaccine (HPVV). Our examination suggests there may be unique cultural and socialization factors that influence clinician HPVV recommendation practice; however, immigrant clinicians have not been adequately engaged within the national HPVV agenda. Given the volume and significance of immigrant clinicians, engagement of these clinicians, in both community and nation-wide efforts to increase HPVV, is a necessary step for improving and achieving the national health goal of optimizing HPVV for cancer prevention.
Asunto(s)
Emigrantes e Inmigrantes , Infecciones por Papillomavirus , Vacunas contra Papillomavirus , Médicos , Adolescente , Niño , Conocimientos, Actitudes y Práctica en Salud , Humanos , Infecciones por Papillomavirus/epidemiología , Infecciones por Papillomavirus/prevención & control , VacunaciónRESUMEN
BACKGROUND: Ankle-foot orthoses (AFO) are prescribed to manage difficulty walking due to foot drop, bony foot deformities and poor balance. Traditional AFOs are handmade using thermoplastic vacuum forming which provides limited design options, is labour-intensive and associated with long wait times. 3D printing has the potential to transform AFO production and health service delivery. The aim of this systematic review was to determine the feasibility of designing, manufacturing and delivering customised 3D printed AFOs by evaluating the biomechanical outcomes, mechanical properties and fit of 3D printed compared to traditionally manufactured AFOs. METHOD: Electronic databases were searched from January 1985 to June 2018 according to terms related to 3D printing and AFOs. Studies of any design from healthy or pathological populations of any age were eligible for inclusion. Studies must have investigated the effect of customised 3D printed AFOs using any 3D printing technique on outcomes related to walking ability, biomechanical function, mechanical properties, patient comfort, pain and disability. Any other orthotic type or AFOs without a 3D printed calf and foot section were excluded. The quality of evidence was assessed using the GRADE process. RESULTS: Eleven studies met the eligibility criteria evaluating 3D printed AFOs in healthy adults, and adults and children with unilateral foot drop from a variety of conditions. 3D printing was used to replicate traditional AFOs and develop novel designs to optimise the stiffness properties or reduce the weight and improve the ease of use of the AFO. 3D printed custom AFOs were found to be comparable to traditional custom AFOs and prefabricated AFOs in terms of temporal-spatial parameters. The mechanical stiffness and energy dissipation of 3D printed AFOs were found to be similar to prefabricated carbon-fibre AFOs. However, the sample sizes were small (n = 1 to 8) and study quality was generally low. CONCLUSION: The biomechanical effects and mechanical properties of 3D printed AFOs were comparable to traditionally manufactured AFOs. Developing novel AFO designs using 3D printing has many potential benefits including stiffness and weight optimisation to improve biomechanical function and comfort.
Asunto(s)
Ortesis del Pié , Impresión Tridimensional , Articulación del Tobillo/fisiopatología , Fenómenos Biomecánicos , Diseño de Equipo , Estudios de Factibilidad , Marcha/fisiología , Humanos , Modelación Específica para el PacienteRESUMEN
This is a short summary of a meeting of the "African-Caribbean Cancer Consortium", jointly organized by the University of Pittsburgh, Department of Epidemiology and the University of Pittsburgh Cancer Institute, held in Montego Bay, Jamaica as a satellite meeting at the Caribbean Health Research Council, 52nd Annual Council and Scientific meeting on May 4, 2007.
RESUMEN
A case of cervical intraepithelial neoplasia (CIN) of the cervical stump is presented. Human papillomavirus DNA testing before elective supracervical hysterectomy may identify patients with increased risk for future development of CIN and aid in preoperative counseling for the type of surgical procedure performed.
Asunto(s)
Procedimientos Quirúrgicos Electivos , Histerectomía , Papillomaviridae , Infecciones por Papillomavirus/virología , Displasia del Cuello del Útero/virología , Neoplasias del Cuello Uterino/virología , Biopsia , Colposcopía , ADN Viral , Femenino , Humanos , Histerectomía/métodos , Persona de Mediana Edad , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/patología , Infecciones por Papillomavirus/cirugía , Reoperación , Infecciones Tumorales por Virus/cirugía , Infecciones Tumorales por Virus/virología , Neoplasias del Cuello Uterino/patología , Neoplasias del Cuello Uterino/cirugía , Displasia del Cuello del Útero/patología , Displasia del Cuello del Útero/cirugíaRESUMEN
Two clusters of necrotizing fasciitis (NF) due to group A streptococcus (GAS) were identified on the Hawaiian islands of Kauai and Maui during 1997 and 2002, respectively. The emm gene sequence types and the pulsed-field gel electrophoresis patterns were determined for 6 isolates recovered from patients with NF and for 116 isolates recovered from patients with temporally associated community-acquired GAS infection. No predominant emm type was identified, and the emm types of 64 (52.5%) of the isolates were considered to be uncommon in the continental United States. These findings suggest that unusual emm types might be responsible for invasive GAS infections in patients from Hawaii.
Asunto(s)
Fascitis Necrotizante/epidemiología , Fascitis Necrotizante/microbiología , Epidemiología Molecular , Streptococcus pyogenes/genética , Adulto , Anciano , Bacteriemia/epidemiología , Bacteriemia/microbiología , Proteínas Bacterianas/genética , Celulitis (Flemón)/epidemiología , Celulitis (Flemón)/microbiología , Femenino , Hawaii/epidemiología , Humanos , Masculino , Factores de RiesgoRESUMEN
We examined erythromycin and clindamycin susceptibilities with Etest methodology among 546 group A streptococcal isolates collected in Hawaii between February 2000 and November 2004. Erythromycin resistance was low (3.1%). No isolate was clindamycin resistant. The prevalence of erythromycin resistance in group A streptococci remains low in Hawaii.