Publications by authors named "Downs P"

Introduction: The heterogeneity in health and functional ability among older patients makes the management of cancer a unique challenge. The Geriatric Oncology Program at the University of Maryland Baltimore Washington Medical Center (BWMC) was created to optimize cancer management for older patients. This study aimed to assess the benefits of the implementation of such a program at a community-based academic cancer center.

View Article and Find Full Text PDF

BACKGROUND An arteriovenous malformation (AVM) is an abnormal connection between an artery and a vein, bypassing the capillary network. An AVM of the superficial temporal artery (STA) can occur after trauma, iatrogenic injury, infection, or spontaneously. Spontaneous, or iatrogenic, presentations of STA AVM are thought to be rare, with very few reported cases.

View Article and Find Full Text PDF

Purpose: Population-based prevalence surveys are essential for decision-making on interventions to achieve trachoma elimination as a public health problem. This paper outlines the methodologies of Tropical Data, which supports work to undertake those surveys.

Methods: Tropical Data is a consortium of partners that supports health ministries worldwide to conduct globally standardised prevalence surveys that conform to World Health Organization recommendations.

View Article and Find Full Text PDF

Baseline trachoma surveys in Côte d'Ivoire (2019) identified seven evaluation units (EUs) with a trachomatous inflammation-follicular (TF) prevalence ≥10%, but a trachomatous trichiasis (TT) prevalence in individuals ≥15 y of age below the elimination threshold (0.2%). Two of these EUs, Bondoukou 1 and Bangolo 2, were selected for a follow-up survey to understand the epidemiology of trachoma using additional indicators of Chlamydia trachomatis infection (DNA from conjunctival swabs) and exposure (anti-Pgp3 and Ct694 antibodies from dried blood spots [DBSs]).

View Article and Find Full Text PDF
Article Synopsis
  • - Trachoma is the leading infectious cause of blindness globally, linked to poor sanitation and hygiene, and controlled through the SAFE strategy, which includes distributing azithromycin to affected regions.
  • - Ivermectin, a drug on the WHO's essential medicines list, is evaluated for its potential to control the Musca sorbens fly, which breeds in human feces, and may enhance trachoma management when used alongside azithromycin in mass drug administration campaigns in Ethiopia.
  • - Preliminary findings suggest that areas receiving both Ivermectin and azithromycin show better trachoma control compared to those receiving only azithromycin, indicating a need for further research to confirm Ivermectin's effectiveness in controlling fly populations. *
View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to evaluate different face shield configurations to ensure they neither hinder grading accuracy nor surgical performance during trachoma surveys and trichiasis surgeries amid the COVID-19 pandemic.
  • Three phases were conducted, including configuration assessment, comfort and clarity trials, and evaluation during routine surgical procedures, with both face shield designs being tested by 124 trachoma graders and 28 surgeons.
  • Results showed that a face shield design with a cut-out for magnifying loupes maintained high grading accuracy and comfort levels among users without negatively affecting trichiasis surgical skills.
View Article and Find Full Text PDF

Introduction: Appendicitis is a very common diagnosis that surgeons manage daily. Some surgeons are still giving antibiotics to patients suffering from uncomplicated appendicitis in the postoperative setting, despite an abundance of evidence to support a single preoperative dose of antibiotics. In this paper, we will describe the management of post-operative antibiotics at our institutions following uncomplicated appendicitis with regard to the use of antibiotics in the post-operative setting.

View Article and Find Full Text PDF

Background: Access to affordable, quality healthcare is the key element of universal health coverage (UHC). This study examines the effectiveness of the neglected tropical disease (NTD) mass drug administration (MDA) campaign approach as a means to deliver UHC, using the example of the Liberia national programme.

Methods: We first mapped the location of 3195 communities from the 2019 national MDA treatment data reporting record of Liberia.

View Article and Find Full Text PDF

Partnerships have been key to significant progress in combating neglected tropical diseases (NTDs). Collaboration between a range of partners, each bringing different skills and resources, helps reach more people in need with greater efficiency. Some partners have contributed in-kind donations, including drugs and volunteer time.

View Article and Find Full Text PDF

Trachoma is the leading infectious cause of blindness in the world and has been known to be a major public health problem in The Gambia for over 60 years. Nationwide blindness surveys, including trachoma, in 1986 and 1996 provided the foundation for a comprehensive plan to implement a trachoma elimination strategy. Impact and pre-validation surveillance surveys in 2011-13 demonstrated that active trachoma was below WHO threshold for elimination but trichiasis remained a public health problem.

View Article and Find Full Text PDF

Background: Onchocerciasis is targeted for elimination of transmission by 2030 in at least 21 countries. To achieve this, recent and accurate data on the extent and intensity of onchocerciasis transmission are required. This will include mapping areas previously unassessed, or remapping of areas that were last visited as part surveys aiming to prevent blindness, not assess transmission in totality.

View Article and Find Full Text PDF

Since its early spread in early 2020, the disease caused by the novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Coronavirus Disease 2019 (COVID-19) has caused mass disruptions to health services. These have included interruptions to programs that aimed to prevent, control, and eliminate neglected tropical diseases (NTDs). In March 2020, the World Health Organization (WHO) released interim guidelines recommending the temporary cessation of mass drug administration (MDA), community-based surveys, and case detection, while encouraging continuation of morbidity management and vector control where possible.

View Article and Find Full Text PDF

Primary benign tumors of the sternum are an exceedingly rare entity. Surgical techniques regarding intervention for these lesions are not clearly defined in the literature given their scarcity. Operative techniques include en-bloc resection of the tumor, and this has proven to be successful in preventing local recurrence despite benign nature of the lesion.

View Article and Find Full Text PDF
Article Synopsis
  • - The COVID-19 pandemic disrupted mass drug administration (MDA) of ivermectin for onchocerciasis, prompting researchers to use mathematical models to analyze the potential effects of these delays on disease control through 2030.
  • - Two transmission models, EPIONCHO-IBM and ONCHOSIM, were employed to simulate the impact of various treatment histories and interruptions, revealing that shorter MDA histories and high-prevalence settings were most negatively affected.
  • - Results suggest that biannual MDA is more effective than simply increasing coverage after interruption and that prioritizing programs with shorter treatment histories for biannual MDA is essential to avoid increased microfilarial load and its associated health risks.
View Article and Find Full Text PDF

Introduction: A number of neglected tropical diseases are targeted for elimination or eradication. An effective surveillance system is critical to determine if these goals have been achieved and maintained. Trachoma has two related but morphologically different presentations that are monitored for elimination, the active infectious form of trachoma and trachomatous trichiasis (TT), the progression of the disease.

View Article and Find Full Text PDF

With the coronavirus disease 2019 (COVID-19) pandemic showing no signs of abating, resuming neglected tropical disease (NTD) activities, particularly mass drug administration (MDA), is vital. Failure to resume activities will not only enhance the risk of NTD transmission, but will fail to leverage behaviour change messaging on the importance of hand and face washing and improved sanitation-a common strategy for several NTDs that also reduces the risk of COVID-19 spread. This so-called "hybrid approach" will demonstrate best practices for mitigating the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by incorporating physical distancing, use of masks, and frequent hand-washing in the delivery of medicines to endemic communities and support action against the transmission of the virus through water, sanitation and hygiene interventions promoted by NTD programmes.

View Article and Find Full Text PDF

Quality control tests of molecular imaging systems are hampered by the complexity of phantom preparation. It is proposed that radioisotopes can be directly incorporated into photo-polymer resins. Use of the radio-polymer in a 3D printer allows phantoms with more complex and reliable activity distributions to be produced whilst simplifying source preparation.

View Article and Find Full Text PDF

People with disabilities and the neglected tropical diseases (NTDs) are separately receiving increased focus. In light of this positive development, and the similarities and intersections between the negative impacts experienced by both people with disabilities and people with NTDs, we believe now is the right time to focus attention on the overlap between the two. Both people with NTDs and people with disabilities experience a myriad of overlapping negative health, financial and socio-cultural consequences.

View Article and Find Full Text PDF

Nursing professional development practitioners led the evaluation of the graphic representation of a health system's professional practice model (PPM) based on evolving expectations and key constructs of a PPM. The aim was to capture direct care nurse perceptions to guide adoption of a revised graphical depiction of the PPM. The specific benefit for nursing professional development practitioners is the ongoing relatability of the PPM to nursing for sustainability of clinical excellence.

View Article and Find Full Text PDF

Foramen of Winslow hernias are one of the most uncommon types of internal hernias that a surgeon will encounter. They are often initially indolent with vague symptoms that present over an extended period of time. Unfortunately, these hernias are not often diagnosed prior to requiring emergent operative intervention.

View Article and Find Full Text PDF

In collaboration with the health ministries that we serve and other partners, we set out to complete the multiple-country Global Trachoma Mapping Project. To maximize the accuracy and reliability of its outputs, we needed in-built, practical mechanisms for quality assurance and quality control. This article describes how those mechanisms were created and deployed.

View Article and Find Full Text PDF

Endemic areas that involve national or local borders present an important challenge to the success of elimination of onchocerciasis; such cross-border endemic foci require special attention to ensure that programme activities are unified. It is vital that national programmes and the committees responsible for the oversight of progress towards elimination are aware and address such issues in their current planning and programmatic activities. Although international borders that intersect endemic zones present the biggest challenge, intracountry borders (such as between administrative districts or loiasis endemic and non-loiasis areas) can also pose problems.

View Article and Find Full Text PDF