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Poor Patient (poor + patient)

Distribution by Scientific Domains
Medical Sciences75%

Terms modified by Poor Patient

  • poor patient outcome
    		•
  • poor patient survival
    		•

    Selected Abstracts

    Lower genital tract lesions requiring surgical intervention in girls: Perspective from a developing country

    JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 10 2009
    Sebastian O Ekenze
    Aim: To determine the spectrum, outcome of treatment and the challenges of managing surgical lesions of lower genital tract in girls in a low-resource setting. Method: Retrospective study of 87 girls aged 13-years and younger, with lower genital tract lesions managed between February 2002 and January 2007 at the University of Nigeria Teaching Hospital, Enugu, southeastern Nigeria. Clinical charts were reviewed to determine the types, management, outcome of treatment and management difficulties. Results: The median age at presentation was 1 year (range 2 days,13 years). Congenital lesions comprised 67.8% and acquired lesions 32.2%. The lesions included: masculinised external genitalia (24), vestibular fistula from anorectal malformation (23), post-circumcision labial fusion (12), post-circumcision vulval cyst (6), low vaginal malformations (6), labial adhesion (5), cloacal malformation (3), bifid clitoris (3) urethral prolapse (3), and acquired rectovaginal fistula (2). Seventy-eight (89.7%) had operative treatment. Procedure related complications occurred in 19 cases (24.4%) and consisted of surgical wound infection (13 cases), labial adhesion (4 cases) and urinary retention (2 cases). There was no mortality. Overall, 14 (16.1%) abandoned treatment at one stage or another. Challenges encountered in management were inadequate diagnostic facilities, poor multidisciplinary collaboration and poor patient follow up. Conclusion: There is a wide spectrum of lower genital lesion among girls in our setting. Treatment of these lesions may be challenging, but the outcome in most cases is good. High incidence of post-circumcision complications and poor treatment compliance may require more efforts at public enlightenment. [source]

    MELD and prediction of post,liver transplantation survival

    LIVER TRANSPLANTATION, Issue 3 2006
    Shahid Habib
    The model for end-stage liver disease (MELD) was developed to predict short-term mortality in patients with cirrhosis. It has since become the standard tool to prioritize patients for liver transplantation. We assessed the value of pretransplant MELD in the prediction of posttransplant survival. We identified adult patients who underwent liver transplantation at our institution during 1991,2002. Among 2,009 recipients, 1,472 met the inclusion criteria. Based on pretransplant MELD scores, recipients were stratified as low risk (,15), medium risk (16,25), and high risk (>25). The primary endpoints were patient and graft survival. Mean posttransplant follow-up was 5.5 years. One-, 5- and 10-year patient survival was 83%, 72%, and 58%, respectively, and graft survival was 76%, 65%, and 53%, respectively. In univariable analysis, patient and donor age, patient sex, MELD score, disease etiology, and retransplantation were associated with posttransplantation patient and graft survival. In multivariable analysis adjusted for year of transplantation, patient age >65 years, donor age >50 years, male sex, and retransplantation and pretransplant MELD scores >25 were associated with poor patient and graft survival. The impact of MELD score >25 was maximal during the first year posttransplant. In conclusion, older patient and donor age, male sex of recipient, retransplantation, and high pretransplant MELD score are associated with poor posttransplant outcome. Pretransplant MELD scores correlate inversely with posttransplant survival. However, better prognostic models are needed that would provide an overall assessment of transplant benefit relative to the severity of hepatic dysfunction. Liver Transpl 12:440,447, 2006. © 2006 AASLD. [source]

    Attitude of health-care providers toward childhood leukemia patients with different socio-economic status,

    PEDIATRIC BLOOD & CANCER, Issue 5 2008
    Saskia Mostert MD
    Abstract Background Treatment results differ significantly between poor and prosperous children with leukemia in Indonesia. The objective of this study was to determine whether parental socio-economic status influences beliefs, attitude, and behavior of health-care providers (hcp) treating childhood leukemia in Indonesia. Procedure A self-administered semi-structured questionnaire was filled in by 102 hcp (69 doctors, 28 nurses, 2 psychologists, 2 hematology technicians, 1 administrator). Results Most hcp (98%) asked parents about their financial situation. The decision to start treatment was influenced by parental socio-economic status (86%), motivation of parents (80%), and motivation of doctors (76%). Health-care providers stated that prosperous patients comply better with treatment (64%), doctors comply better with treatment for the prosperous (53%), most patients cannot afford to complete treatment (58%), less extensive explanations are given toward poor families (60%), and communication is impeded by differences in status (67%). When dealing with prosperous families a minority of hcp stated that they pay more attention (27%), work with greater accuracy (24%), take more interest (23%), and devote more time per visit (22%). Most hcp denied differences in the quality of medical care (93%) and the chances of cure (58%) between poor and prosperous patients. Conclusions Beliefs, attitude, and behavior of hcp toward poor versus prosperous patients appeared to differ. These differences may contribute to the immense drop-out rate and slight chances of survival among poor patients with leukemia in developing countries. Pediatr Blood Cancer 2008;50:1001,1005. © 2007 Wiley-Liss, Inc. [source]

    Unfettered Consumer Access to Affordable Therapies in the Post-TRIPS Era: A Dead-End Journey for Patients?

    THE JOURNAL OF WORLD INTELLECTUAL PROPERTY, Issue 3 2010
    India Case Studies, Kenya
    Increasing access to essential medicines has become an international priority, given the rapid spread of intractable diseases such as HIV/AIDS, tuberculosis and malaria. It follows that the quests to improve the global quality of healthcare and achieve health equity present a challenge for many countries, especially those that have been hard hit by deadly pandemics and whose populations are also still without essential drugs. Consequently, many countries have stepped up efforts to remove the obstacles to the availability and affordability of essential medicines. The Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) contains flexibilities that can be used as tools for enhancing access to cheap medicines and for controlling drug pricing. However, these flexibilities are not necessarily a panacea and cannot singly solve the problem of limited access to essential medicines. Put differently, cheaper medicines cannot reach the poor without the infrastructure to deliver them. For this to become a reality, commitment on the part of the member countries to adopt comprehensive and cooperative measures to tackle the burdensome barriers that limit access to critical medicines is needed. It is only then that the flexibilities in TRIPS can be optimized and a real difference made in the lives of poor patients across the developing world. [source]