LIVIVO - Search results -

Search results

Result 1 - 10 of total 75

Search options

Article: Persistently elevated intracranial pressure in cryptococcal meningitis- 76 therapeutic lumbar punctures.

Jjunju, Samuel / Nuwagira, Edwin / Meya, David B / Muzoora, Conrad

2023 Volume 40, Page(s) 50–53

Abstract: Cryptococcal meningitis still remains the most common form of adult meningitis in sub-Saharan Africa, due to the burden of HIV/AIDS. Increased intracranial pressure (ICP) is a major complication of cryptococcosis and requires aggressive management with ... ...

Abstract	Cryptococcal meningitis still remains the most common form of adult meningitis in sub-Saharan Africa, due to the burden of HIV/AIDS. Increased intracranial pressure (ICP) is a major complication of cryptococcosis and requires aggressive management with therapeutic lumbar punctures (LPs). In this report, we describe a patient with persistently elevated ICP who underwent 76 LPs over 46 days with good outcome. While unusual, this highlights the importance of serial therapeutic LPs. 2012 Elsevier Ltd. All rights reserved.
Language	English
Publishing date	2023-04-28
Publishing country	Netherlands
Document type	Case Reports
ZDB-ID	2670415-8
ISSN	2211-7539
ISSN	2211-7539
DOI	10.1016/j.mmcr.2023.04.001
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

Article ; Online: Four Learner Categories in Global Health Experiences: A Framework for Successful Resident Engagement.

Guiles, Daniel A / Nuwagira, Edwin / Stone, Geren S

Annals of global health

2022 Volume 88, Issue 1, Page(s) 66

Abstract: An increasing number of residency programs in the United States now offer global health experiences for trainees, yet many participating residents lack the behaviors and skills needed to engage effectively with local partners and colleagues. In the ... ...

Abstract	An increasing number of residency programs in the United States now offer global health experiences for trainees, yet many participating residents lack the behaviors and skills needed to engage effectively with local partners and colleagues. In the experience of the authors, trainees working in global settings fall into 1 of 4 learner categories determined by their degree of cultural humility and their willingness to engage with their hosts. This viewpoint proses the concept of "re-orientation," or ongoing structured mentorship, as a way to provide key opportunities for residents to mature in these two important areas during their global experiences. We propose that residencies should incorporate "re-orientation" as a component of their global health rotations in order to provide their trainees with the skills and behaviors to engage successfully with their local colleagues and partners.
MeSH term(s)	Global Health ; Humans ; Internship and Residency ; United States
Language	English
Publishing date	2022-08-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	2821756-1
ISSN	2214-9996 ; 2214-9996
ISSN (online)	2214-9996
ISSN	2214-9996
DOI	10.5334/aogh.3562
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article: Adverse drug reactions and associated factors in multidrug-resistant tuberculosis: A retrospective review of patient medical records at Mbarara Regional Referral Hospital, Uganda.

Kushemererwa, Oliver / Nuwagira, Edwin / Kiptoo, Joshua / Yadesa, Tadele Mekuriya

SAGE open medicine

2023 Volume 11, Page(s) 20503121231171350

Abstract: Objectives: The World Health Organization pragmatic guidelines recommend shorter duration drug regimens with newer, more efficacious agents for treatment of multidrug-resistant tuberculosis. However, adverse drug reactions associated with the use of ... ...

Abstract	Objectives: The World Health Organization pragmatic guidelines recommend shorter duration drug regimens with newer, more efficacious agents for treatment of multidrug-resistant tuberculosis. However, adverse drug reactions associated with the use of newer, second-line agents may pose a major barrier to adequate management of multidrug-resistant tuberculosis. We therefore sought to investigate the prevalence and factors associated with adverse drug reactions among patients with multidrug-resistant tuberculosis. Methods: We retrospectively reviewed patient medical records at the tuberculosis treatment unit of Mbarara Regional Referral Hospital, between January 2013 and December 2020. Medical records were included in the study, if the patients were aged ⩾18 years, tested sputum positive for multidrug-resistant tuberculosis, with adequate pharmacovigilance data documented. We assessed all documented health-related patient complaints, deranged laboratory values, and clinician suspected adverse drug reactions for scientific/clinical plausibility. Adverse drug reactions were confirmed using published and manufacturer drug references materials. A multidisciplinary clinician team was involved to decide whether to exclude or include a suspected adverse drug reaction. Results: About 6 in 10 (67.4%; 120/178) patients experienced at least one adverse drug reactions during treatment, of which 18.3%, 14.6%, and 11.4% of adverse drug reactions affected the endocrine/metabolic, otic, and musculoskeletal body systems, respectively. Majority of the adverse drug reactions were probable and had a moderate severity. There was an upward trend in adverse drug reaction incidence between 2015 and 2019. Adverse drug reaction occurrence was associated with previous adverse drug reaction history (adjusted odds ratio = 2.85 (1.08, 7.53 at 95% confidence interval)); however, patients who were underweight (adjusted odds ratio = 0.34 (0.16, 0.69 at 95% confidence interval)) and those treated with bedaquiline-based drug regimens (adjusted odds ratio = 0.2 (0.07, 0.59 at 95% confidence interval)) were less likely to experience an adverse drug reaction. Conclusion: Majority of patients with multidrug-resistant tuberculosis experience at least adverse drug reaction during the course of treatment. The newer standard shorter duration drug regimens (9-12 months) may be associated with intolerable adverse drug reactions that hamper effective management of multidrug-resistant tuberculosis. There is need for more studies to assess the clinical adverse drug reaction burden associated with the implementation of shorter duration regimens.
Language	English
Publishing date	2023-05-03
Publishing country	England
Document type	Journal Article
ZDB-ID	2735399-0
ISSN	2050-3121
ISSN	2050-3121
DOI	10.1177/20503121231171350
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article: Is Sub-Saharan Africa prepared for COVID-19?

Nuwagira, Edwin / Muzoora, Conrad

Tropical medicine and health

2020 Volume 48, Page(s) 18

Abstract: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19), is the latest virus to cause global health panic. Due to the rapidly escalating numbers of new infections outside China, COVID-19 was ...

Abstract	Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19), is the latest virus to cause global health panic. Due to the rapidly escalating numbers of new infections outside China, COVID-19 was declared a pandemic by the World Health Organization (WHO) on March 11, 2020, in a message delivered by Dr. Tedros Adhanom Ghebreyesus, the WHO Director-General [1]. As of March 21, about 166 countries globally had recoded cases of the COVID-19 in only 4 months since its outbreak in Wuhan, Hubei Province, China [2, 3]. With the Antarctic continent unaffected, Africa, in particular Sub-Saharan Africa (SSA), has recorded the least number of cases, despite the cited moderate-to-high risk of infection [4]. The biggest challenge is whether Sub-Saharan Africa is ready for this pandemic.
Keywords	covid19
Language	English
Publishing date	2020-04-10
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2209835-5
ISSN	1349-4147 ; 1348-8945
ISSN (online)	1349-4147
ISSN	1348-8945
DOI	10.1186/s41182-020-00206-x
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article ; Online: Persistently elevated intracranial pressure in cryptococcal meningitis– 76 therapeutic lumbar punctures

Samuel Jjunju / Edwin Nuwagira / David B. Meya / Conrad Muzoora

Medical Mycology Case Reports, Vol 40, Iss , Pp 50-

2023 Volume 53

Abstract	Cryptococcal meningitis still remains the most common form of adult meningitis in sub-Saharan Africa, due to the burden of HIV/AIDS. Increased intracranial pressure (ICP) is a major complication of cryptococcosis and requires aggressive management with therapeutic lumbar punctures (LPs). In this report, we describe a patient with persistently elevated ICP who underwent 76 LPs over 46 days with good outcome. While unusual, this highlights the importance of serial therapeutic LPs.2012 Elsevier Ltd. All rights reserved.
Keywords	Cryptococcal meningitis ; Increased intracranial pressure ; Lumbar puncture ; Human Immunodeficiency Virus ; Medicine (General) ; R5-920 ; Biology (General) ; QH301-705.5
Language	English
Publishing date	2023-06-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

Full text online

Full text

Inter-library loan at ZB MED

Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

Article ; Online: Four Learner Categories in Global Health Experiences

Daniel A. Guiles / Edwin Nuwagira / Geren S. Stone

Annals of Global Health, Vol 88, Iss

A Framework for Successful Resident Engagement

2022 Volume 1

Abstract: An increasing number of residency programs in the United States now offer global health experiences. Yet many participating residents lack the worldview needed to succeed in these rotations. Trainees working in international settings fall into four ... ...

Abstract	An increasing number of residency programs in the United States now offer global health experiences. Yet many participating residents lack the worldview needed to succeed in these rotations. Trainees working in international settings fall into four learner categories depending on their degree of cultural humility and their willingness to engage with their hosts. Re-orientation, or ongoing structured mentorship, provides key opportunities for residents to mature in these two important areas. We propose that residencies should incorporate re-orientation into their international experiences in order to shape their trainees’ worldviews and to promote their successful engagement.
Keywords	global health ; medical education ; global health experience ; cultural humility ; Infectious and parasitic diseases ; RC109-216 ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2022-08-01T00:00:00Z
Publisher	Ubiquity Press
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

Full text online

Full text

Inter-library loan at ZB MED

Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

Article ; Online: Adverse drug reactions and associated factors in multidrug-resistant tuberculosis

Oliver Kushemererwa / Edwin Nuwagira / Joshua Kiptoo / Tadele Mekuriya Yadesa

SAGE Open Medicine, Vol

A retrospective review of patient medical records at Mbarara Regional Referral Hospital, Uganda

2023 Volume 11

Abstract	Objectives: The World Health Organization pragmatic guidelines recommend shorter duration drug regimens with newer, more efficacious agents for treatment of multidrug-resistant tuberculosis. However, adverse drug reactions associated with the use of newer, second-line agents may pose a major barrier to adequate management of multidrug-resistant tuberculosis. We therefore sought to investigate the prevalence and factors associated with adverse drug reactions among patients with multidrug-resistant tuberculosis. Methods: We retrospectively reviewed patient medical records at the tuberculosis treatment unit of Mbarara Regional Referral Hospital, between January 2013 and December 2020. Medical records were included in the study, if the patients were aged ⩾18 years, tested sputum positive for multidrug-resistant tuberculosis, with adequate pharmacovigilance data documented. We assessed all documented health-related patient complaints, deranged laboratory values, and clinician suspected adverse drug reactions for scientific/clinical plausibility. Adverse drug reactions were confirmed using published and manufacturer drug references materials. A multidisciplinary clinician team was involved to decide whether to exclude or include a suspected adverse drug reaction. Results: About 6 in 10 (67.4%; 120/178) patients experienced at least one adverse drug reactions during treatment, of which 18.3%, 14.6%, and 11.4% of adverse drug reactions affected the endocrine/metabolic, otic, and musculoskeletal body systems, respectively. Majority of the adverse drug reactions were probable and had a moderate severity. There was an upward trend in adverse drug reaction incidence between 2015 and 2019. Adverse drug reaction occurrence was associated with previous adverse drug reaction history (adjusted odds ratio = 2.85 (1.08, 7.53 at 95% confidence interval)); however, patients who were underweight (adjusted odds ratio = 0.34 (0.16, 0.69 at 95% confidence interval)) and those treated with bedaquiline-based drug regimens (adjusted odds ...
Keywords	Medicine (General) ; R5-920
Subject code	660
Language	English
Publishing date	2023-05-01T00:00:00Z
Publisher	SAGE Publishing
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

Full text online

Full text

Inter-library loan at ZB MED

Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

Article ; Online: Patient-provider experiences with chronic non-communicable disease care during COVID-19 lockdowns in rural Uganda: A qualitative analysis.

Olds, Peter K / Nuwagaba, Gabriel / Obwoya, Paul S / Nuwagira, Edwin / Haberer, Jessica E / Okello, Samson

PloS one

2023 Volume 18, Issue 12, Page(s) e0295596

Abstract: Non-communicable diseases (NCDs) are a growing health burden in Sub-Saharan Africa and especially Uganda, where they account for over one third of all deaths. During the COVID-19 pandemic, public health control measures such as societal "lockdowns" had a ...

Abstract	Non-communicable diseases (NCDs) are a growing health burden in Sub-Saharan Africa and especially Uganda, where they account for over one third of all deaths. During the COVID-19 pandemic, public health control measures such as societal "lockdowns" had a significant impact on longitudinal NCD care though no studies have looked at the lived experience around NCD care during the pandemic. Our objective was to understand the experience of NCD care for both patients and providers in southwestern Uganda during the COVID-19 pandemic. We conducted in-depth, in-person qualitative interviews with 20 patients living with hypertension, diabetes, and/or cardiac disease purposefully selected from the outpatient clinics at Mbarara Regional Referral Hospital and 11 healthcare providers from public health facilities in Mbarara, southwestern Uganda. We analyzed transcripts according to conventional content analysis. We identified four major themes that emerged from the interviews; (1) difficulty accessing medication; (2) food insecurity; (3) barriers to the delivery of NCD clinical care and (4) alternative forms of care. Pre-existing challenges with NCD care were exacerbated during COVID-19 lockdown periods and care was severely disrupted, leading to worsened patient health and even death. The barriers to care were exacerbations of underlying systemic problems with NCD care delivery that require targeted interventions. Future work should leverage digital health interventions, de-centralizing NCD care, improving follow-up, providing social supports to NCD patients, and rectifying supply chain issues.
MeSH term(s)	Humans ; Noncommunicable Diseases/epidemiology ; Noncommunicable Diseases/therapy ; Uganda/epidemiology ; Pandemics ; COVID-19/epidemiology ; Communicable Disease Control
Language	English
Publishing date	2023-12-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0295596
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article ; Online: Coinfection of COVID-19 and Tuberculosis in Uganda.

Nuwagira, Edwin / Mpagama, Stellah G / Katusiime, Asumpta / Natamba, Bobson / Baluku, Joseph Baruch / Lai, Peggy S

The American journal of tropical medicine and hygiene

2023 Volume 108, Issue 6, Page(s) 1240–1243

Abstract: The clinical features and outcomes of tuberculosis (TB) and COVID-19 coinfection are not well established. This short report describes 11 people with TB/COVID-19 coinfection in Uganda. The mean age was 46.9 ± 14.5 years; eight (72.7%) were male and two ( ... ...

Abstract	The clinical features and outcomes of tuberculosis (TB) and COVID-19 coinfection are not well established. This short report describes 11 people with TB/COVID-19 coinfection in Uganda. The mean age was 46.9 ± 14.5 years; eight (72.7%) were male and two (18.2%) were coinfected with HIV. All patients presented with cough whose median duration was 71.1 (interquartile range, 33.1, 109) days. Eight (72.7%) had mild COVID-19 whereas two (18.2%) died, including one with advanced HIV disease. All patients were treated with first-line anti-TB drugs and adjunct therapy for COVID-19 using national treatment guidelines. This report presents the possibility of the coexistence of the two diseases and calls for more vigilance, screening, and collective prevention measures for both COVID-19 and TB.
MeSH term(s)	Humans ; Male ; Adult ; Middle Aged ; Female ; Coinfection/complications ; Uganda/epidemiology ; COVID-19/complications ; Tuberculosis/complications ; Tuberculosis/drug therapy ; Tuberculosis/epidemiology ; Antitubercular Agents/therapeutic use ; HIV Infections/complications ; HIV Infections/drug therapy
Chemical Substances	Antitubercular Agents
Language	English
Publishing date	2023-04-24
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	2942-7
ISSN	1476-1645 ; 0002-9637
ISSN (online)	1476-1645
ISSN	0002-9637
DOI	10.4269/ajtmh.22-0738
Database	MEDical Literature Analysis and Retrieval System OnLINE

In stock of ZB MED Cologne/Königswinter

Ud II Zs.61: Show issues

Location:
Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
ab Jg. 2022: Lesesaal (EG)

Order via subito

Details ▾
- See ZB MED holdings
- Order with fees

Article ; Online: Association between biomarkers of inflammation and dyslipidemia in drug resistant tuberculosis in Uganda.

Baluku, Joseph Baruch / Nalwanga, Robinah / Kazibwe, Andrew / Olum, Ronald / Nuwagira, Edwin / Mugenyi, Nathan / Mulindwa, Frank / Bongomin, Felix

Lipids in health and disease

2024 Volume 23, Issue 1, Page(s) 65

Abstract: Background: Active tuberculosis (TB) significantly increases the risk of cardiovascular disease, but the underlying mechanisms remain unclear. This study aimed to investigate the association between inflammation biomarkers and dyslipidemia in patients ... ...

Abstract	Background: Active tuberculosis (TB) significantly increases the risk of cardiovascular disease, but the underlying mechanisms remain unclear. This study aimed to investigate the association between inflammation biomarkers and dyslipidemia in patients with drug-resistant TB (DR-TB). Methods: This was a secondary analysis of data from a cross-sectional multi-center study in Uganda conducted 2021. Participants underwent anthropometric measurements and laboratory tests included a lipid profile, full haemogram and serology for HIV infection. Dyslipidemia was defined as total cholesterol > 5.0 mmol/l and/or low-density lipoprotein cholesterol > 4.14 mmol/l, and/or triglycerides (TG) ≥ 1.7 mmol/l, and/or high density lipoprotein cholesterol (HDL-c) < 1.03 mmol/l for men and < 1.29 mmol/l for women. Biomarkers of inflammation were leukocyte, neutrophil, lymphocyte, monocyte, and platelet counts, as well as neutrophil/lymphocyte (NLR), platelet/lymphocyte, and lymphocyte/monocyte (LMR) ratios, mean corpuscular volume (MCV), and the systemic immune inflammation index (SII) (neutrophil × platelet/lymphocyte). Modified Poisson Regression analysis was used for determining the association of the biomarkers and dyslipidemia. Results: Of 171 participants, 118 (69.0%) were co-infected with HIV. The prevalence of dyslipidemia was 70.2% (120/171) with low HDL-c (40.4%, 69/171) and hypertriglyceridemia (22.5%, 38/169) being the most common components. Patients with dyslipidemia had significantly higher lymphocyte (P = 0.008), monocyte (P < 0.001), and platelet counts (P = 0.014) in addition to a lower MCV (P < 0.001) than those without dyslipidemia. Further, patients with dyslipidemia had lower leucocyte (P < 0.001) and neutrophil (P = 0.001) counts, NLR (P = 0.008), LMR (P = 0.006), and SII (P = 0.049). The MCV was inversely associated with low HDL-C (adjusted prevalence ratio (aPR) = 0.97, 95% CI 0.94-0.99, P = 0.023) but was positively associated with hypertriglyceridemia (aPR = 1.04, 95% CI 1.00-1.08, P = 0.052). Conclusions: Individuals with dyslipidemia exhibited elevated lymphocyte, monocyte, and platelet counts compared to those without. However, only MCV demonstrated an independent association with specific components of dyslipidemia. There is need for further scientific inquiry into the potential impact of dyslipidemia on red cell morphology and a pro-thrombotic state among patients with TB.
MeSH term(s)	Male ; Humans ; Female ; HIV Infections/complications ; Cross-Sectional Studies ; Uganda/epidemiology ; Inflammation ; Dyslipidemias ; Cholesterol, HDL ; Biomarkers ; Tuberculosis, Multidrug-Resistant ; Hypertriglyceridemia
Chemical Substances	Cholesterol, HDL ; Biomarkers
Language	English
Publishing date	2024-03-01
Publishing country	England
Document type	Multicenter Study ; Journal Article
ZDB-ID	2091381-3
ISSN	1476-511X ; 1476-511X
ISSN (online)	1476-511X
ISSN	1476-511X
DOI	10.1186/s12944-024-02063-7
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

To top

More links

Kategorien

Order via subito

More links

Kategorien

Order via subito

More links

Kategorien

Order via subito

More links

Kategorien

Order via subito

Full text online

More links

Kategorien

Inter-library loan at ZB MED

Full text online

More links

Kategorien

Inter-library loan at ZB MED

Full text online

More links

Kategorien

Inter-library loan at ZB MED

More links

Kategorien

Order via subito

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

More links

Kategorien

Order via subito