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Background: Evidence on treatment practice, discharge outcomes, and associated factors in patients with psychiatric disorders are rarely discussed in Ethiopia. Results from the available studies are also seldom consistent and miss important factors, including treatment-related variables. Therefore, this study intended to describe management practice and discharge outcome among adult psychiatric patients admitted to psychiatry wards of selected specialized settings in Ethiopia. By pointing out associated factors, this study will also provide insight on targets to improve discharge outcomes. Patients and methods: A cross-sectional study was conducted involving 278 adult psychiatry patients admitted to the psychiatry wards of Jimma Medical Center and St. Amanuel Mental Specialized Hospital in the study period from December 2021 to June 2022. The data was analyzed using STATA V.16. Descriptive statistics and logistic regression analysis were performed to present patient characteristics and identify factors associated with discharge outcome, respectively. In all the analysis, p value < 0.05 was used to declare statistical significance. Results: Schizophrenia (125, 44.96%) and bipolar disorders (98, 35.25%) were the top two psychiatric disorders diagnosed at admission. A greater share of patients with schizophrenia were treated with the combination of diazepam, haloperidol, and risperidone than with diazepam and risperidone, 14 (5.04%) each. Patients with bipolar disorder were being treated primarily with the combination of diazepam, risperidone, and sodium valproate, or risperidone and sodium valproate, 14 (5.04%) each. Overall, 232 (83.4%) patients were on psychiatric polypharmacy. In this study, 29 (10.43%) patients were discharged unimproved, and this risk was significantly higher in those patients with a khat chewing habit (AOR = 3.59, 95% CI = 1.21–10.65, P = 0.021) than non-chewers. Conclusion: Psychiatric polypharmacy was found to be a common treatment approach in patients with psychiatric disorders. In the study, a little more than one-tenth of patients with psychiatric disorders were discharged without improvement. Hence, interventions targeting risk factors, especially khat use, should be undertaken to improve discharge outcomes in this population. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the practice patterns of private community speech–language pathologists (SLPs) when treating children with a repaired cleft of the palate with or without a cleft of the lip (CP ± L). Practices were explored in terms of diagnostics and treatment focus, treatment dosage and experienced difficulties when treating children with a CP ± L. Method: Eleven female private community SLPs, who lived in Flanders (i.e. the northern part of Belgium) and were aged between 23 and 62 years participated in this study. Data were collected from semi-structured face-to-face interviews. The qualitative software program NVivo 12 was used for data analysis. The interviews were analysed using an inductive thematic approach. Result: SLPs reported a lack of available information on speech-related cleft care. SLPs expressed the need to receive a referral letter from the hospital in order to make an adequate speech diagnosis. Most therapists reported that they performed an articulatory assessment combined with a language assessment. Most SLPs used a hybrid treatment model including a variety of intervention techniques. These techniques were not always in line with available scientific evidence. SLPs reported the desire to receive practical step-by-step guidelines on how to provide speech intervention to children with a CP ± L. In contrast, there was a strong consensus among the therapists that an individualised treatment plan is necessary. Conclusion: The results of this study have revealed gaps in the dissemination and implementation of scientific evidence relevant to speech services for children with a CP ± L (i.e. a research–practice gap) in Flanders. Research evidence needs to be adequately translated into clinical practice by providing concrete and practical guidelines. [ABSTRACT FROM AUTHOR]

The use of bee products for healing purposes dates back to ancient times. Today, they have taken an honorary place in the medical, cosmetic and dietetic industries. They have found an optimal combination of vitamins and minerals, trace elements and biologically active substances that provide a significant effect in the treatment of a number of diseases. The prophylactic and therapeutic use of all bee products: bee venom, royal jelly, propolis, honey, wax, bee pollen is called apitherapy. The term comes from the words "apis" - bee and "therapy" - treatment. In modern medicine, the need for natural ingredients is increasing every year, and bee products are able to fully satisfy this need. In many countries in the big cities there are offices of apitherapy for the medical institutions, which are very successful among the patients. Today, active research is being done in the field of apitherapy, as well as clinical testing of new products and methods in many clinics, research centers and universities, which confirms the prospects in this direction. The purpose of this study is to trace the development of apitherapy and to provide information on the unique properties of apiculture products and methods of application in therapeutic practice. Material and Methods: Review of scientific literature about researches in the field of apitherapy, Bulgarian and international experience in methods of using bee products. [ABSTRACT FROM AUTHOR]

Coal mine formations are becoming increasingly threatened by water inrush accidents resulting from high-pressure water conditions in limestone formations below mines with increasingly greater mining depths. This paper focuses on the floor of a deeply buried coal seam and the high-pressure fully mechanized mining faces of the Chensilou Coal Mine in China. Based on systematic observations and analysis of the geological and hydrogeological conditions in the study area, this study conducts theoretical analyses, numerical simulations, and underground observations in a comprehensive manner. Accordingly, a systematic and substantive investigation of the deformation and failure of the deep mining floor and the water inrush mechanism (i.e., the high hydraulic pressure within ash-filled fissures) in the Chensilou Coal Mine is carried out. The burial depth is deeper than 761.4 m, and the water pressure in the limestone of the Taiyuan Formation exceeds 4.95 MPa. Furthermore, the mining depth of the working face is 34.25 m. Based on data on water inrush events and subsurface mining failure depth, the water inrush mechanism in the floor of the coal seam in the Taiyuan Formation is analyzed. The end hole depth of the working face is composed of the L8 limestone, and transient electromagnetic detection technology is used to test the grouting effect of the working face floor and ensure the mining safety of the three working faces tested in this study. [ABSTRACT FROM AUTHOR]

Long-acting methylphenidate (MPH) formulations, including OROS-MPH, were found to be effective in alleviating ADHD symptoms throughout the day. However, sustained stimulant activity may lead to prolonged suppression of appetite and insomnia. In this study, we characterized the clinical profile of children and adolescents for whom a once-daily lower dose of OROS-MPH combined with a shorter-acting agent was more tolerable than single higher OROS-MPH dose. In our cohort of 128 children treated with OROS-MPH, 47 (36.7 %) better tolerated a lower dose of OROS-MPH combined with short-acting MPH formulations (Group I). Nevertheless, for the majority (81 patients-63.3 %), a standard single moderate dose of OROS-MPH was sufficient (Group II). The mean daily doses of MPH were: 0.83 ± 0.21 mg/kg for Group I and 1.06 ± 0.29 mg/kg for Group II. There were no significant differences in the prevalence of learning disorders, tic disorders, epilepsy and conduct disorders between these two groups. However, anxiety and marginally depression were more prevalent in Group I (46.8 and 9.7 %) than in Group II (27.2 and 1.2 %). Patients in Group I were also more tending to receive psychotherapy than patients in Group II. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease is a leading cause of death among kidney transplant recipients. Metabolic syndrome increases the risk for cardiovascular events and decreases graft survival. Lately, guidelines for management of the metabolic syndrome, primarily hypertension, diabetes mellitus (DM) and hypercholesterolemia have dramatically changed in an attempt to decrease cardiovascular risks among kidney transplant recipients. In the present study we examined whether these guideline changes had impact on our management of post-transplantation patients and the subsequent treatment outcomes for these diseases. Methods: Data were obtained from kidney transplant clinic files from two follow-up (FU) periods--between 1994-1997 and between 2008-2011. Demographic data, monitoring and screening frequency for cardiovascular risk factors, immunosuppression regimen, treatment for hypertension, diabetes and hyperlipidemia, treatment outcomes and graft function changes were compared between the two follow-up periods. Results: There was a significant increase in the percentage of patients undergoing transplantation due to renal failure secondary to diabetes and/or hypertension. Patient monitoring and screening during the second FU period were less frequent, but more targeted, reflecting changes in clinic routines. Blood pressure was better controlled in the second FU period (p < 0.01), as was hypercholesterolemia (p < 0.001). High fasting glucose levels were more prevalent among patients in the second group (p < 0.005), although more patients received treatment for DM (p < 0.001). Significantly, fewer patients experienced deterioration of kidney functions during the second FU period (p < 0.001). Conclusions: We found that guideline changes had impact on clinical practice, which translated to better control of the metabolic syndrome. DM control is challenging. Overall, stability of kidney function improved. [ABSTRACT FROM AUTHOR]

Long-acting (LA) preparations of methylphenidate allow for once-daily dosing; however, pharmacokinetics may vary and depend on food intake. The objective was to evaluate effectiveness of a two-phase release formulation (Ritalin LA) under daily practice conditions. This was a prospective, multicenter, observational study in Germany. Eligibility and dosing were determined by the physician based on the drug label. Outcomes included changes over 3 months of treatment in assessments of effect duration, clinical global impression (CGI), and quality of life (ILK). In 101 sites, 262 patients (197 boys, 63 girls, and two unknown) with a mean age of 10.9 years were enrolled; 50 were treated for the first time; 212 switched medication to Ritalin LA. After 3 months, CGI improved in 59.4 % of patients, and well-being overall was rated as good by 61.0 % of parents and 63.7 % of children. Based on parents' assessment, the proportion of children suffering from strong disease burden decreased from 40.7 to 15.1 %. In 123 insufficient responders to previous ADHD medications, benefit from Ritalin LA was above average and effect duration was significantly prolonged as compared to pretreatment. Overall, 28 patients (10.7 %) had treatment-related adverse events with one case being serious; 23 patients (8.8 %) discontinued therapy, 7 (2.7 %) due to poor treatment response; and 212 patients (81 %) continued treatment beyond the study. In line with clinical trial data, Ritalin LA provides significant benefit also under routine practice conditions. [ABSTRACT FROM AUTHOR]

The article discusses a study which examined the role of darbepoetin alfa (DA) in improving the quality of life (QoL) of cancer patients with anemia. Topics discussed include treatment of chemotherapy-induced anemia in non-myeloid cancer patients, measurement of QoL using the Linear Analog Scale Assessment (LASA) and Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) questionnaires, and the increase in the hemoglobin levels of patients treated with DA.

Background Nowadays, parasite-based diagnosis by microscopy or malaria rapid diagnostic tests (RDT) is universally promoted before malaria treatment. However, studies on adherence of primary caregivers to malaria test results have provided conflicting results. Methods The antimalarial and antibiotic prescription rates in patients with suspected malaria at Provincial Hospital of Tete, Mozambique, and the features associated with antibiotic prescription in non-severely ill parasite-negative patients were assessed. Results In March and April 2010, Plasmodium falciparum malaria was diagnosed by microscopy or RDT in 728 (27.2%) of 2672 patients tested. Almost all malaria patients were prescribed antimalarials and 20% were also given antibiotics. Of 1944 parasite-negative patients, 126 (6.5%) were prescribed antimalarials and 1213 (62.4%) antibiotics. Among non-severely ill parasite-negative patients with complete information (n = 1607), the antibiotic prescription rate was 68.8% and was more frequent with respiratory symptoms and leukocyte counts >10 000/μL (adjusted OR = 1.62, 95% CI 1.18–2.23 and adjusted OR = 2.12, 95% CI 1.66–2.71, respectively). Conclusions Adherence to malaria test results was good in this reference setting, but antibiotic prescription was relatively frequent in clinically stable non-malaria patients. Optimal management of parasite-negative patients must be further defined along with programmatic deployment of the parasite-based strategy. [ABSTRACT FROM PUBLISHER]

Background: Oral cholinesterase inhibitors at doses efficacious for the treatment of Alzheimer's disease (AD) are often prematurely discontinued due to gastrointestinal side effects. In controlled clinical trials, transdermal rivastigmine demonstrated less such effects at similar efficacy. The current study aimed to verify the validity of this data in daily practice. Methods: This was a prospective, multicenter, observational study on transdermal rivastigmine in Germany. Eligible patients were those with AD who had not yet been treated with rivastigmine. Outcome measures were changes in clock-drawing test, Mini-Mental State Examination (MMSE), Caregiver Burden Scale, Clinical Global Impression (CGI), physicians' assessments of tolerability, and the incidence of adverse events (AEs) over 4 months of treatment. Results: In 257 centers 1113 patients were enrolled; 614 women and 499 men, mean age 76.5 years. In 58% of patients AD was treated for the first time and in 42% therapy was switched to transdermal rivastigmine, mostly due to lack of tolerability (13.6%) or effectiveness (26.9%). After 4 months, 67.4% of patients were on the target dose of 9.5 mg/day and 21.8% were still on 4.6 mg/day. MMSE significantly improved in patients with and without pretreatment (ΔMMSE, 0.9 ± 3.4 and 0.8 ± 3.4, respectively, both P < 0.001); the CGI score improved in 60.9% and 61.3% of patients, respectively. Overall 11.7% of patients had AEs, mainly affecting the skin or the gastrointestinal tract; in 1.1% of cases AEs were serious; 14.7% of patients discontinued therapy, 6.0% due to AEs. With rivastigmine treatment the percentage of patients taking psychotropic comedication decreased, particularly in first-time treated rivastigmine patients (from 27.1% to 22.6%; P < 0.001). Conclusion: Results were in line with data from controlled clinical trials. Switching from any other oral acetylcholinesterase inhibitor to transdermal rivastigmine may improve cognition. [ABSTRACT FROM AUTHOR]

STEINMETZ T., TOTZKE U., SCHWEIGERT M., MITTERMÜLLER J., NAWKA S., TESCH H., GROSCHEK M., SÖLING U., HELLEBRAND E. & TSAMALOUKAS A. (2010) European Journal of Cancer Care The use of erythropoiesis-stimulating agents (ESA) in cancer patients is still under debate. However, little is known about rationales, strategies, objectives, and effectiveness of anaemia treatments in common practice. The Cancer Anaemia Registry prospectively surveyed about 2000 cancer patients with anaemia throughout Germany. The main objectives of anaemia treatment regardless of modality were to improve quality of life (QOL) and to correct haemoglobin (Hb) levels. The Hb threshold for any anaemia treatment (means ± SD: 9.4 ± 1.2 g/dL) but not for blood transfusions (8.7 ± 1.0 g/dL) depended on cancer type and treatment strategy. Physicians preferred ESA as first-line treatment to prevent transfusions in patients with solid tumours, if they thought that chemotherapy caused the anaemia. If they suspected other causes or patients had lymphoproliferative malignancies, physicians preferred transfusions or attempted to correct underlying disorders; both mainly to improve QOL or prognosis. Effectiveness of all strategies was comparable. However, ESA most effectively prevented transfusions; primary transfusions appeared less suitable for correcting Hb or improving QOL. Using supportive treatments for QOL improvement was common whereas diagnostic measures and intravenous iron therapy were underused. Prospective clinical trials using QOL as end point and evaluating diagnostics in cancer-associated anaemia are warranted. [ABSTRACT FROM AUTHOR]

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This article reports the results of a qualitative field study of the ethnotherapeutic treatment practices of curanderos, the practitioners of traditional Mexican medicine, and their effectiveness in the treatment of mental illness. Three healers and their patients from the southwestern state of Oaxaca participated in the study. The patients had a number of psychiatric disorders, including panic and dependency syndrome and schizophrenia. The evaluation of treatment practices was based on a systematic analysis of the psychotherapeutic significance of the healers' central beliefs, such as concepts of mental illness and diagnosis. The psychotherapeutic outcomes of 8 patients were evaluated in a longitudinal case study with a 6‐month follow‐up. 6 of the patients showed complete remission of symptoms, and 2 patients had partial remission. The results were interpreted as evidence for the clinically significant effectiveness of Mexican Curanderismo in the treatment of mental illness. The psychotherapeutic effectiveness could be mainly explained by specific treatment characteristics, such as the extensive use of spirituality, altered states of consciousness, and the bifocality of ritual interventions. [ABSTRACT FROM AUTHOR]

To compare Finnish clinicians’ treatment practices of acute mania and bipolar depression with recommendations of consensus-based guidelines, and contemporary research results. A nation-wide questionnaire survey of 228 Finnish clinicians employed in psychiatric hospitals. Effective response rate was 62%. Clinicians’ practices were fairly adequately in line with contemporary recommendations. The main concerns were over-utilization of conventional antipsychotics in acute mania and underestimating the need for mood stabilizers to prevent induction of mood instability. Continuous educating of clinicians is warranted to narrow the gap between guideline recommendations, research evidence and clinical practices. [ABSTRACT FROM AUTHOR]

Chronic obstructive pulmonary diseases, which have increased due to smoking and ageing of the population, constitute a national health problem, the treatment of which can be expected to arouse considerable discussion in health care organisations currently preoccupied with economic problems. Although extensive medication and easy access to treatment are often regarded as therapeutically desirable, it may be questioned whether they have any impact on objective measures such as mortality. International recommendations for the early treatment of asthma have met with satisfaction and the asthma situation can be said to be under control, even though occurrences tend to be on the increase. It should be noted, however, that the COPD treatment recommendations still remain to be tested and the general attitude towards treatment is still reserved, even pessimistic. By combining data from the Finnish national hospital discharge register and register of deaths with findings regarding the use of medications, differences in the survival of asthmatic and COPD patients can be discerned between areas with different treatment practices. Stressing the fact that effect-differences between different treatment strategies can not be proven on the basis register data and that random clinical trials are needed to gain further knowledge in the field, our results show that extensive medication and easy access to treatment are characteristic of areas where the survival of asthmatics and COPD patients is better. [ABSTRACT FROM PUBLISHER]

Coal mine formations are becoming increasingly threatened by water inrush accidents resulting from high-pressure water conditions in limestone formations below mines with increasingly greater mining depths. This paper focuses on the floor of a deeply buried coal seam and the high-pressure fully mechanized mining faces of the Chensilou Coal Mine in China. Based on systematic observations and analysis of the geological and hydrogeological conditions in the study area, this study conducts theoretical analyses, numerical simulations, and underground observations in a comprehensive manner. Accordingly, a systematic and substantive investigation of the deformation and failure of the deep mining floor and the water inrush mechanism (i.e., the high hydraulic pressure within ash-filled fissures) in the Chensilou Coal Mine is carried out. The burial depth is deeper than 761.4 m, and the water pressure in the limestone of the Taiyuan Formation exceeds 4.95 MPa. Furthermore, the mining depth of the working face is 34.25 m. Based on data on water inrush events and subsurface mining failure depth, the water inrush mechanism in the floor of the coal seam in the Taiyuan Formation is analyzed. The end hole depth of the working face is composed of the L8 limestone, and transient electromagnetic detection technology is used to test the grouting effect of the working face floor and ensure the mining safety of the three working faces tested in this study. [ABSTRACT FROM AUTHOR]