Several factors contribute to the high mortality attributed to severe infections in resource-limited settings. While improvements in survival and processes of care have been made in high-income settings among patients with severe conditions, such as sepsis, guidelines necessary for achieving these improvements may lack applicability or have not been tested in resource-limited settings. The World Health Organization's recent publication of the Integrated Management of Adolescent and Adult Illness District Clinician Manual provides details on how to optimize management of severely ill, hospitalized patients in such settings, including specific guidance on the management of patients with septic shock and respiratory failure without shock. This manuscript provides the context, process and underpinnings of these sepsis guidelines. In light of the current deficits in care and the limitations associated with these guidelines, the authors propose implementing these standardized best practice guidelines while using them as a foundation for sepsis research undertaken in, and directly relevant to, resource-limited settings.
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http://dx.doi.org/10.1186/1741-7015-11-107 | DOI Listing |
Curr Opin Clin Nutr Metab Care
January 2025
Department of Anaesthesiology and Critical Care Medicine, Kepler University Hospital and Johannes Kepler University Linz, Linz, Austria.
Purpose Of Review: To share current concepts and provide an overview of the contextual issues and nutrition practices in critically ill patients in resource-limited settings (RLSs)/low- and middle-income countries (LMICs). Most of the world's population reside in these settings which also carries the greatest burden of critical illness.
Recent Findings: There is a paucity of evidence on nutrition practice in critically ill patients in RLSs and international guidelines are largely based on evidence derived from high-income countries (HICs).
Cureus
December 2024
Emergency, Hospital de Braga, Braga, PRT.
Pericardial effusion refers to the accumulation of fluid within the pericardial sac, the double-layered membrane surrounding the heart. It can be caused by various medical conditions and may lead to serious complications if not diagnosed and managed promptly. Point-of-care ultrasound (POCUS) has emerged as a valuable tool in the clinical evaluation of pericardial effusions, offering real-time visualization and aiding in the assessment of its size, characteristics, and potential hemodynamic impact.
View Article and Find Full Text PDFMediterr J Rheumatol
December 2024
Department of Internal Medicine, B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
Late-onset rheumatoid arthritis (LORA) presents a unique diagnostic challenge among older patients, particularly in poorly resourced healthcare settings. As global life expectancy increases, so does the prevalence of LORA, a condition that differs significantly from young-onset rheumatoid arthritis (YORA). This review explores the distinct clinical presentation, differential diagnosis, laboratory findings, and treatment challenges of LORA, emphasising its impact on low- and middle-income countries.
View Article and Find Full Text PDFPan Afr Med J
January 2025
Kilimanjaro Christian Medical University College, Faculty of Medicine, P.O Box 2240, Moshi, Tanzania.
Neonatal adrenal hemorrhage is a rare condition with various risk factors in the pediatric population. Adrenal hemorrhage commonly affects the right side in about 70% of the cases and bilateral in about 10%. It is usually asymptomatic but can cause adrenal insufficiency and sudden death.
View Article and Find Full Text PDFPan Afr Med J
January 2025
Korea Foundation for International Healthcare, Tanzania Office, Dar es Salaam, Tanzania.
While the significance of strengthening the biomedical workforce in resource-limited settings has been widely acknowledged, there remains a paucity of information specific to the local context. In this regard, we underscore the importance of formulating a biomedical engineering policy based on empirical evidence. To provide such evidence, we conducted an analysis of the government-led biomedical training program in Tanzania, titled 'Capacity Enhancement of Medical Equipment Technical Services (CEOMETS)'.
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