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1.
J Neurol Sci ; 385: 140-143, 2018 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-29406894

RESUMO

INTRODUCTION: Management of critically ill patients in dedicated intensive care units (ICUs) is the standard of care in high income countries (HICs), but remains uncommon in low and middle-income countries (LMICs). We sought to determine the prevalence of neurologic disorders in the ICU of a LMIC and examine if resource appropriate specialized neurocritical care training could benefit these patients. METHODS: From February to March 2017, a trained neurocritical care intensivist recorded encounters in the sole ICU at the University Teaching Hospital (UTH) in Lusaka, Zambia. We stratified each patient by demographics, presence of primary or secondary neurologic deficit, comorbidities, and outcome. RESULTS: Of the 33 patients seen during this period, 26 (78.8%) had a neurologic deficit. An equal number of patients carried a primary neurologic diagnosis (13) versus a secondary neurologic diagnosis (13). Primary neurologic disorders included spinal cord injury/tumor/abscess, intracranial hemorrhage, Guillain-Barre syndrome, and traumatic brain injury. CONCLUSIONS: Over three-quarters of critically ill patients in the observation period carried a neurologic diagnosis. Future research should aim to identify if resource appropriate neurocritical care training of frontline providers may lead to improved clinical outcomes.


Assuntos
Gerenciamento Clínico , Unidades de Terapia Intensiva/estatística & dados numéricos , Doenças do Sistema Nervoso/epidemiologia , Doenças do Sistema Nervoso/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/diagnóstico , Adulto Jovem , Zâmbia/epidemiologia
2.
J Acquir Immune Defic Syndr ; 67(2): 212-5, 2014 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-24977474

RESUMO

Although there is a growing literature on the clinical performance of visual inspection with acetic acid in HIV-infected women, to the best of our knowledge, none have studied visual inspection with acetic acid enhanced by digital cervicography. We estimated clinical performance of cervicography and cytology to detect cervical intraepithelial neoplasia grade 2 or worse. Sensitivity and specificity of cervicography were 84% [95% confidence interval (CI): 72 to 91) and 58% (95% CI: 52 to 64). At the high-grade squamous intraepithelial lesion or worse cutoff for cytology, sensitivity and specificity were 61% (95% CI: 48 to 72) and 58% (95% CI: 52 to 64). In our study, cervicography seems to be as good as cytology in HIV-infected women.


Assuntos
Colposcopia/métodos , Técnicas Citológicas/métodos , Infecções por HIV/complicações , Programas de Rastreamento/métodos , Imagem Óptica/métodos , Displasia do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/diagnóstico , Ácido Acético , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Adulto Jovem , Zâmbia
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