RESUMEN
AIM: To explore the experiences of African-Caribbean patients with advanced glaucoma. METHODS: Semi-structured qualitative interviews were used to elicit patients' subjective experiences of becoming a glaucoma patient, receiving treatment, undergoing surgery, and its aftermath. Interview transcripts underwent narrative analysis. RESULTS: The surgeon-patient relationship was central to developing effective coping strategies. Participants described their experiences in terms of what they considered were their responsibilities as patients to the surgeon-patient relationship. They also defined the surgeon's responsibilities and obligations. CONCLUSIONS: The use of patient narratives provides a valuable resource for enhancing communication skills and relationship-centred care in the hospital eye service.
Asunto(s)
Población Negra/etnología , Glaucoma/cirugía , Trabeculectomía/psicología , Actitud Frente a la Salud , Enfermedad Crónica , Comunicación , Glaucoma/etnología , Glaucoma/psicología , Humanos , Narración , Relaciones Médico-Paciente , Responsabilidad Social , Indias Occidentales/etnologíaRESUMEN
Since the height of HIV incidence in the mid-1980s, advances in treatment have delayed progression of HIV infection. As a result, surveillance of AIDS cases alone is no longer sufficient to monitor the current status of the HIV epidemic. At the national level, new HIV diagnoses and progression of these cases to AIDS are used to describe the epidemic. The capacity to monitor the national HIV epidemic has consistently improved over the last several years. An increasing number of states report diagnosed HIV cases to the national surveillance system, allowing data from this system to better represent the national picture. Monitoring the national HIV epidemic depends on a nationwide system using standardized methods of data collection, and establishing such a comprehensive system remains one of the highest priorities for national HIV case surveillance.
Asunto(s)
Notificación de Enfermedades , Infecciones por VIH/epidemiología , Vigilancia de la Población , Administración en Salud Pública , Infecciones por VIH/mortalidad , Humanos , Puerto Rico/epidemiología , Vigilancia de Guardia , Estados Unidos/epidemiologíaRESUMEN
High seroprevalence rates for Helicobacter pylori are reported in developing countries, yet few seroincidence studies exist that determine age of initial acquisition and risk factors for H. pylori seroconversion. Two H. pylori serosurveys were conducted in August 1996 and November 1997. Of 188 children aged 21 months to 6 years who were seronegative in the first survey, 44 (23%) had seroconverted at follow-up, yielding an 18% annual seroincidence. The largest increase in seroincidence occurred between children aged 2 years (10%) and children aged 3 years (32%). Use of a lidded, narrow-mouthed water vessel was protective against seroconversion (odds ratio [OR], 0.3; 95% confidence interval [CI], 0.1-0.8), and the presence of another H. pylori-seropositive sibling in the household was a risk factor for seroconversion (OR, 3.1; 95% CI, 1.3-8.7). Although not a randomized intervention trial, this study suggests that the use of a narrow-mouthed water vessel may prevent the transmission of H. pylori in households in developing countries.
Asunto(s)
Infecciones por Helicobacter/epidemiología , Helicobacter pylori/inmunología , Bolivia/epidemiología , Niño , Preescolar , Estudios de Cohortes , Infecciones por Helicobacter/inmunología , Humanos , Lactante , Factores de Riesgo , Estudios SeroepidemiológicosRESUMEN
Eikenella corrodens, a fastidious, slow-growing, gram-negative, facultative anaerobic bacillus may be encountered in wounds exposed to human saliva, especially human bites and head and neck infections. An unusual case of a mixed flora E corrodens and Streptococcus septic arthritis with adjacent osteomyelitis secondary to saliva contamination from licking an intravenous (i.v.) needle is presented. A literature search showed 53 previous cases of E corrodens infections in i.v. drug users. However, none of these infections affected bones or joints. The microbiology and unusual antibiotic sensitivity are presented. Recommendations for treatment include penicillin or ampicillin. Tetracycline is recommended in the penicillin-allergic patient. This is the first case that draws attention to the connection between E corrodens, i.v. drug use, and septic arthritis and osteomyelitis.