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Archives of Pathology & Laboratory... Feb 2017
Topics: Chemistry, Clinical; Humans; Pathology, Clinical
PubMed: 28029803
DOI: 10.5858/arpa.2016-0176-ED -
Journal of Diabetes Science and... Jul 2011Today, lancing fingertips or alternative sites for obtaining a blood sample for self-monitoring of blood glucose (SMBG) is a standard procedure for most patients with... (Review)
Review
Today, lancing fingertips or alternative sites for obtaining a blood sample for self-monitoring of blood glucose (SMBG) is a standard procedure for most patients with diabetes. The need for frequent lancing and associated discomfort and pain can be seen as a key hurdle for patients to comply with SMBG regimens. This article provides an overview of the status quo and future of lancing, focusing on key areas for future developments driven by customer and market needs. We also review technical issues and provide a background for possible improvements. The act of puncturing the skin with a lancet to obtain a blood sample seems to remain the standard procedure for the foreseeable future, because alternate ways of providing a blood sample have not demonstrated overall superiority (e.g., with laser technology). Other methods, which avoid lancing entirely, have also not gained broad market acceptance (e.g., minimally invasive continuous glucose monitoring) or not shown technical viability (e.g., noninvasive glucose monitoring). In relation to blood glucose (BG) meters and test strips, lancing has been a "stepchild" with regards to commercial attention and development efforts. Nevertheless, significant technological improvements have been made in this field to address key customer needs, including better performance (regarding pain, wound healing, and long-term sensitivity), reduced cost, and higher integration with other components of BG monitoring (e.g., integration of the lancing device with the glucose monitor). From a technical perspective, it is apparent that highly comfortable lancing can be accomplished; however, this still requires fairly advanced and complex devices. New developments are necessary to achieve this level of sophistication and performance with less intricate and costly system designs. Manufacturers' motivation to pursue these developments is compromised by the fact that they might not recoup their development cost on commercial advanced lancing systems through direct profits, but only through its positive influence on adherence and increased more profitable sensor utilization. We believe that two main driving forces will continue to push the evolution of lancing and sampling technology: (1) the need for maximum lancing comfort and (2) the advent of fully integrated systems, realizing a device in which all steps for SMBG are incorporated, thus providing a "one-step" experience. Rendering lancing a "nonissue" will eliminate a key barrier to adherence with appropriate SMBG regimens. Providing sophisticated lancing devices that allow the highest level of comfort and/or seamless blood sampling is key to improving user acceptance. This may have a greater impact on metabolic control than many of the new and expensive antidiabetic drugs.
Topics: Blood Glucose; Blood Glucose Self-Monitoring; Blood Specimen Collection; Diabetes Mellitus; Health Services Needs and Demand; Humans; Models, Biological; Patient Satisfaction
PubMed: 21880240
DOI: 10.1177/193229681100500420 -
International Journal of Surgery... Oct 2020Health is a basic human right, yet surgery remains a neglected stepchild of global health. Worldwide, five billion people lack access to safe, timely, and affordable... (Review)
Review
BACKGROUND
Health is a basic human right, yet surgery remains a neglected stepchild of global health. Worldwide, five billion people lack access to safe, timely, and affordable surgical and anesthesia care when needed. This disparity results in over 18 million preventable deaths each year and is responsible for one-third of the global burden of disease. Here, we evaluate the role of surgical care in protecting human rights and attempt to make a human rights argument for universal access to safe surgical care.
MATERIAL AND METHODS
A scoping review was done using the PubMed/MEDLINE, Embase, and Scopus databases to identify articles evaluating human rights and disparities in accessing surgical care globally. A conceptual framework is proposed to implement global surgical interventions with a human rights-based approach.
RESULTS
Disparities in accessing surgical care remain prevalent around the world, including but not limited to gender inequality, socioeconomic differentiation, sexual stigmatization, racial and religious disparities, and cultural beliefs. Lack of access to surgery impedes lives in full health and economic prosperity, and thus violates human rights. Our normative framework proposes human rights principles to make surgical policy interventions more inclusive and effective.
CONCLUSION
Acknowledging human rights in the provision of surgical care around the world is critical to attain and sustain the Sustainable Development Goals and universal health coverage. National Surgical, Obstetric, and Anesthesia Planning and wider health systems strengthening require the integration of human rights principles in developing and implementing policy interventions to ensure equal and universal access to comprehensive health care services.
Topics: Global Health; Health Services Accessibility; Healthcare Disparities; Human Rights; Humans; Surgical Procedures, Operative; Universal Health Insurance
PubMed: 32828980
DOI: 10.1016/j.ijsu.2020.08.004 -
International Journal of Molecular... Jul 2015Multiple sclerosis (MS) is an autoimmune disorder of the central nervous system (CNS) and characterized by the infiltration of immune cells, demyelination and axonal... (Review)
Review
Multiple sclerosis (MS) is an autoimmune disorder of the central nervous system (CNS) and characterized by the infiltration of immune cells, demyelination and axonal loss. Loss of axons and nerve fiber pathology are widely accepted as correlates of neurological disability. Hence, it is surprising that the development of neuroprotective therapies has been neglected for a long time. A reason for this could be the diversity of the underlying mechanisms, complex changes in nerve fiber pathology and the absence of biomarkers and tools to quantify neuroregenerative processes. Present therapeutic strategies are aimed at modulating or suppressing the immune response, but do not primarily attenuate axonal pathology. Yet, target-oriented neuroprotective strategies are essential for the treatment of MS, especially as severe damage of nerve fibers mostly occurs in the course of disease progression and cannot be impeded by immune modulatory drugs. This review shall depict the need for neuroprotective strategies and elucidate difficulties and opportunities.
Topics: Animals; Humans; Multiple Sclerosis; Neuroprotective Agents
PubMed: 26140377
DOI: 10.3390/ijms160714850 -
Life (Basel, Switzerland) Aug 2023MRE has become a standard imaging test for evaluating patients with small bowel pathology, but the indications, interpretation of imaging findings, methodology, and... (Review)
Review
MRE has become a standard imaging test for evaluating patients with small bowel pathology, but the indications, interpretation of imaging findings, methodology, and appropriate use must be standardized and widely known. Several signs of small bowel damage in inflammatory and non-inflammatory small bowel pathology include strictures, abscess, inflammatory activity, sinus tract, wall edema, fistula, mucosal lesions, and mesentery fat hypertrophy, all of which are widely and accurately explained by MRE. MRE is a non-invasive modality that accurately assesses the intra-luminal, parietal, and extra-luminal small bowel. The differential MRE appearance allows us to distinguish between different small bowel pathologies, such as neoplastic and non-neoplastic small bowel diseases. The purpose of this paper is to present the MRE technique, as well as the interpretation of imaging findings, through the approach of a rigorous stepwise methodology.
PubMed: 37629548
DOI: 10.3390/life13081691 -
JACC. Heart Failure Aug 2019
Topics: Cardiac Rehabilitation; Exercise Therapy; Heart Failure; Humans
PubMed: 31302048
DOI: 10.1016/j.jchf.2019.05.006 -
Injury Epidemiology Dec 2018After the publication in 1985 of Injury in America and the establishment of an injury center at the Centers for Disease Control, there was a concerted attempt to create...
BACKGROUND
After the publication in 1985 of Injury in America and the establishment of an injury center at the Centers for Disease Control, there was a concerted attempt to create an "injury field."
MAIN BODY
Thirty-six (36) pioneers in the injury prevention field responded to questions about the major accomplishments and failures of their profession since the publication of the seminal Institute of Medicine report Injury in America in 1985. Much has been accomplished. Indeed, it is difficult to believe that before the 1990s there was no federal agency focused on preventing fall injuries, drownings, sport concussions or bullying in schools. There was no readily available surveillance data on fatal injuries, no national associations of injury researchers or practitioners, no American Public Health Association (APHA) injury and emergency health services (ICEHS) section and few injury journals. Hardly anyone wore seatbelts and virtually no cigarettes were fire-safe. Sadly, there has been little success at limiting firearm and overdose deaths as injury prevention remains a step-child in the health field with funding not nearly commensurate to the size of the problem. Training in effective advocacy has been proposed both to help attract funding and reduce injuries.
CONCLUSION
Injury prevention pioneers have much to teach current public health students, researchers and practitioners about the history and future of the field.
PubMed: 30574666
DOI: 10.1186/s40621-018-0177-4 -
Frontiers in Psychology 2022Darwin's theory of sexual selection provides a useful framework for understanding the behavior of stepparents. A non-human animal whose new mate has dependent young may... (Review)
Review
Darwin's theory of sexual selection provides a useful framework for understanding the behavior of stepparents. A non-human animal whose new mate has dependent young may kill, ignore, or adopt the predecessor's progeny. The third option has been interpreted as courtship ("mating effort"), and whether selection favors such investment over killing or ignoring the young apparently depends on aspects of the species-typical ecology and demography. The tripartite categorization of responses is a simplification, however, There is variability both within and between species along a continuum from rejection to "full adoption." The average stepparent invests less than the average birth parent, but more than nothing. Human stepparents have often been found to kill young children at higher rates than birth parents, but stepparental infanticide cannot plausibly be interpreted as a human adaptation, both because it is extremely rare and because it is almost certainly more likely to reduce the killer's fitness than to raise it. How sexual selection theory remains relevant to human stepparenting is by suggesting testable hypotheses about predictors of the variability in stepparental investment.
PubMed: 35769745
DOI: 10.3389/fpsyg.2022.924238 -
JACC. Heart Failure Mar 2017
Topics: Cardiac Resynchronization Therapy; Echocardiography; Heart Failure; Heart Ventricles; Humans; Ventricular Remodeling
PubMed: 28254123
DOI: 10.1016/j.jchf.2017.01.005