An Analysis of the Applications of Technology to Health Care within the Caribbean and Latin America

This project aims to investigate and document the evolution of health technology applications and uses within the regions of Latin America and the Caribbean. Originally inspired by the Cayman Islands’ thus far successful handling of the Coronavirus pandemic, I was eager to explore how the applications of technology to the field of healthcare have existed within the region currently and over time. With this foundation, I then explored the regions’ trajectory in terms of technological growth and what the future may hold for these countries and communities

Central Lymph Node Dissection In Patients With Papillary Thyroid Cancer: A Population Level Analysis Of 14257 Cases

CENTRAL LYMPH NODE DISSECTION IN PATIENTS WITH PAPILLARY THYROID CANCER: A POPULATION LEVEL ANALYSIS OF 14,257 CASES. Chineme Enyioha, Sanziana Roman and Julie Ann Sosa. Department of Surgery, Yale School of Medicine, New Haven, CT. The role of prophylactic central lymph node dissection (CLND) in patients with differentiated thyroid cancer has been controversial. This study analyzes the impact of patient demographic factors and tumor size on surgery with CLND in patients with papillary thyroid cancer (PTC) in the U.S. All patients \u3e/= 18 with PTC and follicular variant-PTC, who underwent thyroidectomy with or without CLND in SEER, 2004-08, were included. Bivariate and multivariate analyses were performed to determine effects of patient demographic and clinical characteristics on the likelihood of undergoing CLND. Of 14,257 patients in the study, 80.3% were women, 84.3% white, and the average age was 50.1 years. 79.6% had a total thyroidectomy, and 37.1% had a CLND. Bivariate analysis revealed that patients who were older, black, and from the South were less likely to undergo CLND (all p\u3c. 001). Patients with T1 tumors were least likely to undergo CLND (36.6% compared to 57.2% of T4 tumors, p\u3c. 01). 32.1% of patients with 2 cm had CLND, of which 3.6% (microPTC) and 8.8% (tumors 1-2cm) had positive nodes compared to 34.2% of patients with T4 tumors. From 2004 to 2008, there was an 18.3% increase in overall use of CLND. On multivariate analysis, younger age, female gender, white race, and Northeast region were independently associated with an increased likelihood of undergoing CLND. While the use of CLND has increased over time even in patients with T1 tumors, several demographic factors remain associated with lower likelihood of receiving CLND. This variation in practice suggests potential disparity in access and quality of surgical care for PTC in the U.S

Comparative economic evaluation of the options for transporting the Alaska North Slope stranded gas

Thesis (M.S.) University of Alaska Fairbanks, 2006The most effective economic parameter often considered in feasibility analysis is the Return On Investment (ROI). Any Alaskan gas pipeline project is expected to have a high return on investment to be considered economic. A Comparative Economic (CE) model was used in this study to analyze the gas pipeline project options. These options are: The Alaskan Canadian (AlCan) Highway stand alone gas pipeline project, the AlCan Highway gas pipeline with an instate spurline to southern Alaska, the All-Alaskan Liquefied Natural Gas (LNG) Project, the All- Alaskan LNG project with a spur line to southern Alaska, and the Gas-To-Liquid (GTL) project. The CE model makes use of the Crystal Ball and some input parameters like cost, taxes, tariffs and price to determine the economic feasibility of each option based on the ROI, payout period and total revenue accrued from each project. It was shown from the analysis that the AlCan Highway stand-alone pipeline project had the highest return on investment of 33%. This was followed by the AlCan Highway gas pipeline with an instate spurline to southern Alaska with return on investment of 32.6%. The all-Alaskan LNG projects proved feasible but with less return on investment compared to other options

Willingness-To-Try Various Tobacco Cessation Methods Among US Adult Cigarette Smokers

Introduction: Long-term smoking cessation success rates without substantive intervention remain abysmal. Some studies suggest an association between sociodemographic factors andtobacco cessation success. We sought to explore US adult tobacco users’ willingness-to-try diverse tobacco cessation methods by sociodemographics and tobacco use habits.Methods: We electronically surveyed a convenience sample of 562 US adults to explore willingness-to-try various cessation methods among those who reported current tobacco cigarette use. Participants rated their willingness-to-try different cessation methods. Logistic regression models examined associations between willingness-to-try tobacco cessation methods based onsociodemographic and tobacco use characteristics.Results: Non-whites were more likely to report willingness-to-try counseling (RR 1.32, 95% CI 1.14, 1.52) and those with high school education or less were less likely to report willingness-to-try counseling (RR 0.78, 95% CI 0.64, 0.95). Those with lower income were less likely to report willingness-to-try any medication (RR 0.84, 95% CI 0.73, 0.98). High nicotine dependence wasassociated with a high likelihood of reporting willingness-to-try any evidence-based method (RR 1.07, 95% CI 1.04, 1.10) and a history of quit attempts was associated with likelihood to reportwillingness-to-try any evidence-based method (RR 1.31, 95% CI 1.10, 1.56).Conclusion: Sociodemographics and nicotine dependence may affect preferences for tobacco cessation methods and should be considered when counseling patients on tobacco cessationMaster of Public Healt

Huge pyogenic liver abscess in a toddler: Resolution using antibiotics without drainage.

Pyogenic liver abscess is an uncommon disease in children; it is associated with high mortality if treatment is delayed. Percutaneous drainage and systemic antibiotics are the preferred treatment of choice, while surgery is reserved for complicated cases. It is seldom treated with antibiotics alone. The case is A.I, a 3-year old girl that was admittedin our facility with ten days history of fever with progressive and painful right-sided abdominal swelling. She was febrile, and had huge tender hepatomegaly. Her  abdominal ultrasound and Computerized Tomography-scan findings were consistent with pyogenic liver abscess; and the result of her blood culture yielded staphylococcus aureus.She had low corrected serum calcium,  hypoalbuminemia and hypokalemia. She was placed on broad spectrum antibiotics and supportive treatment before parents decided to leave the hospital against medical advice. Review after completing two weeks of oral formulation of 'blood culture-guided antibiotics' showed remarkable resolution of the abscess and restoration of normal clinical state without the need for drainage. Pyogenic liver abscess is not a common disease in children but it could be life-threatening in affected individuals. A guided use of appropriate antibiotics is very important and may aid resolution where percutaneous drainage or surgery seems impossible.Keywords: Pyogenic, Toddler, Hepatic, Abscess, Percutaneous drainage

The Prevalence of Postpartum Depression in Black and Hispanic Women in New Jersey

Postpartum depression (PPD) is defined as symptoms of major depressive disorder (MDD) within one month of giving birth with the prevalence in the United States being 10-15%. There are well documented instances of racial differences and their effects on maternal outcomes including infant, maternal mortality and postpartum mood disorders. In New Jersey, there are monitoring systems that explore the relationships between maternal characteristics such as race, age, education level, insurance status, and racial bias and how they may correlate with higher incidences of Postpartum Depression (PPD) in these communities of women. The purpose of this comparative study is to analyze the prevalence of postpartum depression among Black and Hispanic mothers in the state of New Jersey

Prevalence, histopathological findings and aerobic bacteria flora associated with pneumopathies in goats slaughtered at the Nsukka abattoir

This study was conducted to determine the prevalence, histopathological findings and aerobic bacteria flora associated with pneumopathies in goats slaughtered for human consumption at the Nsukka abattoir. The lungs of 342 goats were examined for gross lesions and samples were collected for histopathological and bacteriological examinations. Microscopic findings of this study showed that a total of 136 (39.8%) of the samples had various types of pneumopathies including bronchopneumonia, interstitial pneumonia, hyperemia, haemorrhages, oedema, etc. Bronchopneumonia was observed in 54 (39.70%) of the 136 lungs with pneumopathies while interstitial pneumonia and non-pneumonic pneumopathies were recorded in 44 (32.35%) and 38 (27.94%) respectively. Seventy-nine (58.11%) out of the examined 136, were recorded during the wet season and 57 (41.9%) in the dry season. Ninety-six (70.6%) of the cases were found in Kano brown goats, 39(28.67%) in West African dwarf goats and 1(0.73%) in Sahel goats. More of the females examined had pneumopathies. Aerobic bacteria isolated from the lungs with pneumopathies were E. coli, Klebsiella pneumoniae, Mannheimia haemolytica, Streptococcus pyogenes, Staphylococcus aureus, Bacillus subtilis, Proteus vulgaris and Pasteurella multocida. E. coli with a prevalence rate of 73.5% was the most predominant isolate. There was no significant association between the lung lesions observed and the associated aerobic bacterial isolates, seasons, sexes and breeds.Keywords: Aerobic bacteria isolates, Bronchopneumonia, Interstitial pneumonia, Pneumopathies, prevalenc

Common Genitourinary Fistulas in Rural Practice: Treatment and Management

Acquired genitourinary fistulas are common in rural practice. They are pathological communications between the urinary and genital tracts, or between either of the tracts and gastrointestinal tract or skin. Vesicovaginal fistula is the commonest and most devastating. They may result from prolonged and obstructed labor, injuries during obstetric, gynecologic, pelvic and urologic procedures, circumcision, fall from heights, road traffic accidents and female genital mutilation. They present as urinary leakage with characteristic odor. Diagnoses are mainly clinical and confirmed by dye tests, contrast radiography and endoscopy. Treatment is individualized according anatomic sites and etiology. Timing of repair is of essence; delayed repair for obstetric and early for focal injuries. Multidisciplinary team approach and cooperation is encouraged in the management of some of these cases. The sustenance of the 2 – way referral system is emphasized in cases beyond the scope of rural practice. Repairs when undertaken by skilled compassionate fistula surgeons with attention to principles of fistula management and surgical treatment, success rate can approach 90%. Interposition of vascularized grafts have improved success rate. The burden of this condition will be reduced through integration of rural practitioners in the preventive strategies of health education of the public and girlchild; improvement of healthcare, education and transportation infrastructures