Progress in Medical Sciences最新文献

{"title":"Telephone Consultations by Medical Scheme Patients for Covid-19 Related Diagnosis-2020, South Africa","authors":"Michael M. Willie","doi":"10.47363/pms/2021(5)143","DOIUrl":"https://doi.org/10.47363/pms/2021(5)143","url":null,"abstract":"Background: The COVID-19 epidemic has adversely affected health systems globally. The utilisation of technology and other innovative channels link up with patients has evolved drastically in the COVID-19 climate. Lockdown measures and COVID-19 regulations and the fear of contracting the virus at a health care facility has also changed health seeing behaviour among patients. The COVID-19 climate has seen a significant increase in the utilisation of virtual platforms to consult with providers. Objectives: The primary objective of this study was to conduct the descriptive analysis of telephonic consultations by members of medical schemes. Methods: The study entailed a descriptive comparative analysis of medical schemes’ claims data. This was mainly outpatient claims information with the service date between March – December 2020. The inclusion criteria were all NAPPI codes associated with a telephonic consultation. The study included only COVID-19 related ICD-10 code primary diagnosis. Results: The analysis covered claims data from a total of 12 medical schemes. The schemes analysed accounted for 1,6 million lives, on 2019 beneficiaries. The total number of COVID-19 confirmed diagnosisrelated telephonic consultations was 8 939 and those related to suspected diagnosis accounted for 12 608, (41% vs. 59%, p<0.001). The median claims amount for a COVID-19 confirmed diagnosis and that of a suspected diagnosis was IQR: R293 (R283-R400) and R288 (R283-R390), respectively. Conclusion: The study found evidence of patients utilising digital platforms to consult the respective practitioners during the COVID-19 pandemic. Greater utilisation patterns were seen in disciplines such as general medical practice, specialists’ family medicine, independent practice specialist medicine and group practices. The main finding of the study was disparities between the scheme tariff amount and the claimed amount. The findings of this study depicted multidisciplinary management of COVID‐19, particularly at a primary health care level, where patients could consult with a practitioner virtually. However, we warn of ethical considerations and risk-related issues such as fraudulent activities that could arise when consulting medical practitioners virtually.","PeriodicalId":121507,"journal":{"name":"Progress in Medical Sciences","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130210183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pool of Free Blood Plasma Amino Acids in Cardiovascular Insufficiency and Substantiation of Methods for Its Metabolic Correction (Mini-Review)","authors":"L. Nefyodov","doi":"10.47363/pms/2021(5)131","DOIUrl":"https://doi.org/10.47363/pms/2021(5)131","url":null,"abstract":"A mini-review of data on the mechanisms of formation of the pool of free amino acids in cardiovascular insufficiency and methods for correcting of metabolic imbalance.","PeriodicalId":121507,"journal":{"name":"Progress in Medical Sciences","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131588403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Atypical Presentation of Legionnaire’s Disease","authors":"Zohra R Malik","doi":"10.47363/pms/2021(5)154","DOIUrl":"https://doi.org/10.47363/pms/2021(5)154","url":null,"abstract":"The multisystem involvement in Legionnaires' disease commonly includes the pulmonary, gastrointestinal tract, renal and neurological manifestations, but the mechanism of disease has not been defined except for the pulmonary system. Circulating toxins are the most likely culprit. We describe a nonfatal case of Legionnaires' disease that had seizures at presentation. The patient was a chronic alcoholic and a very remote history of seizures, the last seizure being 20 years ago. So at the time of presentation, we had to determine whether the seizure was due to withdrawal from substance abuse, was a regular tonic-clonic seizure that the patient was diagnosed with many years ago, or was it a manifestation of infection. An immunologic mechanism is mostly responsible for the extrapulmonary manifestations of Legionnaires' disease.","PeriodicalId":121507,"journal":{"name":"Progress in Medical Sciences","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125974126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological, Clinical and Therapeutic Aspects of Malaria in Children Under 5 Years Old in the Bagira General Referral Hospital","authors":"Aymar Akilimali","doi":"10.47363/pms/2021(5)150","DOIUrl":"https://doi.org/10.47363/pms/2021(5)150","url":null,"abstract":"","PeriodicalId":121507,"journal":{"name":"Progress in Medical Sciences","volume":"86 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124797781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New Variant of SARS-CoV-2 in South Africa","authors":"A. Dawood","doi":"10.47363/pms/2021(5)129","DOIUrl":"https://doi.org/10.47363/pms/2021(5)129","url":null,"abstract":"Viruses often mutate and take different shapes. There are thousands of known strains of the coronavirus. However, some variants are strongly transmissible, including variants first observed in the UK, Brazil and South Africa, and are concerned about their decreased effectiveness in the V aggregation of vaccines.","PeriodicalId":121507,"journal":{"name":"Progress in Medical Sciences","volume":"82 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124110712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between Platelet Count, TSH and Thyroxine in a Patient Presenting with Myxedema","authors":"Zohra R Malik","doi":"10.47363/pms/2021(5)133","DOIUrl":"https://doi.org/10.47363/pms/2021(5)133","url":null,"abstract":"Myxedema is a very rare and life threatening endocrine emergency which results from severe hypothyroidism and effects almost every organ system. We-hereby-present a 64-year-old-woman with PMH of hypothyroidism, liver cirrhosis, DM, HLD who presented to our ED because of altered mental status and dizziness. Patient reported feeling ill for the last two days, appeared lethargic, and responded slowly to questions. She denied headache, fever, changes in vision/smell, neck pain, chest pain, cough/ wheezing, abdominal pain, bowel or urinary symptoms. On arrival to the ED, patient was hypothermic with temperature of 93.2 F, hypotensive with blood pressure of 99/49 mm Hg, heart rate of 53 beats per minute and respiratory rate of 15 breaths per minute. On examination, the patient was lethargic, confused at times, heart sounds regular, no murmurs, soft, non-tender ab-domen, no significant findings on neck exam. Laboratory work-up was significant for white cell count of 2.6 L x 103 /uL, Hb 11.6 g/dL, HCT 33.8%, platelet count 53 x 103 /uL, TSH at presentation 73.30 mIU/L, free T4 was 0.12 ng/dL. Patient was treated with 200 mcg of IV levothyroxine, 10 mcg of leothyronine, 100 mg of hydrocortisone. In the ED, patient was given broad spectrum anti-biotics for the possibility of an infection triggering her myxedema. Over the course of days, it was observed that as the TSH trended down, the thyroid hormone level increased and the platelets trended up.","PeriodicalId":121507,"journal":{"name":"Progress in Medical Sciences","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132425501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Invasive Ductal Carcinoma of the Breast Presenting as Hypercalcemic Encephalopathy","authors":"Zohra R Malik","doi":"10.47363/pms/2021(5)140","DOIUrl":"https://doi.org/10.47363/pms/2021(5)140","url":null,"abstract":"We hereby present the case of a 68-year-old woman who presented to our emergency department with acute onset altered mental status. On evaluation, it was discovered that her serum calcium levels were elevated. The rest of the labs were normal. Through further testing and imaging studies, we found out that she had invasive ductal carcinoma leading to hypercalcemia which was causing her altered sensorium. The diagnosis of hypercalcemic encephalopathy was made with the primary culprit the ductal carcinoma of the breast. Herein, we would like to highlight hypercalcemia as an important cause of encephalopathy. With our report, we are trying to prove encephalopathy can be the first presentation of ductal carcinoma of the breast.","PeriodicalId":121507,"journal":{"name":"Progress in Medical Sciences","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121485070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe Triple Vessel Disease Presenting As a Negative Electrocardiogram Stress Test: Temptations and Pitfalls in the Management of HIV-Associated Cardiometabolic Disease","authors":"J. Kirupakaran","doi":"10.47363/pms/2021(5)147","DOIUrl":"https://doi.org/10.47363/pms/2021(5)147","url":null,"abstract":"A 61-year-old male with human immunodeficiency virus was admitted for non-ST elevation myocardial infarction. He reported a three-year history of stable angina and was previously evaluated one year prior with an electrocardiogram exercise stress test, during which he was able to reach greater than 10 metabolic equivalents. Coronary angiography one year after this benign stress test revealed severe triple vessel disease. Here we describe unique considerations for the diagnosis of ischemic heart disease in patients with HIV-associated cardiometabolic disease.","PeriodicalId":121507,"journal":{"name":"Progress in Medical Sciences","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115529060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender Differences and Dynamic of Health Care Behaviors in Population Aged 25-64 Years from 1988 To 2017","authors":"V. Gafarov","doi":"10.47363/pms/2021(5)132","DOIUrl":"https://doi.org/10.47363/pms/2021(5)132","url":null,"abstract":"Aim: To determine gender differences and dynamic of health care behaviors in an open population of 25-64 years over a long-term period - 29 years in Russia / Siberia (Novosibirsk). Methods: Within the framework of the screening in 1988-89 under the WHO MONICApsychosocial (MOPSY) program (n=1676, 49.5% males, mean age 44.1±0.4 years), in 2003- 2005 under the international project HAPIEE (n=1650, 34,9% males, mean age 54,25±0,2 years), in 2013-2016 (n=975, 43,8% males, mean age 34,5±0,4 years) and 2016-2017 гг.( n=663, 41,3% years 51,95±0,32 years) within the framework of the budgetary theme No. AAAA-A17-117112850280-2, random representative samples of men and women in one of districts in Novosibirsk were examined. The utilization of health care services and careseeking behavior were assessed using the questionnaire \"Knowledge and attitude towards own’ s health\". Results: In terms of diagnostic methods, in 1988, about 40% of men and women relied more on their own well-being. By 2017, confidence in medical opinions had grown among men, but women were more likely to disagree with the doctor's opinion before conducting a thorough examination. The proportion of people who never experienced pleasant emotions associated with medical care was approximately equal for men and women in 1988 - about 40%. This proportion remained unchanged for men by 2017, while for women it dropped to 26.5%. More than half of the male population and 2/3 of the female population aged 25-64 continued to work if they feel unwell at the workplace in 1988. The proportion of such persons decreased in subsequent periods of observation. And women in spite of poor health continued to work more often than men as in 1988. In the case of flu or fever, men were more likely than women to report continuing to work as usual. The proportion of such persons decreased from 1988 to 2017. Women, on average, 3-5% more often than men took measures to return to work as soon as possible. Conclusions: From 1988 to 2017, there was an increase in the level of trust in the opinion of a doctor among men and a higher frequency of using additional diagnostic methods among women. In dynamics, satisfaction with health care services increased only among women. People of both sexes have become more careful about their health in case of feeling unwell at the workplace over 29 years of observations.","PeriodicalId":121507,"journal":{"name":"Progress in Medical Sciences","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121220395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Status Epilepticus Associated with Lidocaine Anesthesia Applied Locally During Circumcision: A Brief Case Report","authors":"Muhammet Mesut Nezir Engin","doi":"10.47363/pms/2021(5)127","DOIUrl":"https://doi.org/10.47363/pms/2021(5)127","url":null,"abstract":"Local anesthetics are generally preferred to provide anesthesia during circumcision. In this article, a case with no history of epilepsy, progressing to intubation after local lidocaine application during circumcision, and developing unconsciousness and status epilepticus will be presented.","PeriodicalId":121507,"journal":{"name":"Progress in Medical Sciences","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116652198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}