Proposed treatment program for acute renal failure (ARF) in the United Republic of Tanzania as a model for sub-Saharan Africa

To date, no sustainable treatment program exists for kidney failure in countries in sub-Saharan Africa. No data are available on the incidence, prevalence or cause of chronic kidney disease (CKD). The world's focus has been on treating 'priority diseases' as defined by the United Nations Millennium Project and the World Health Organization because of their high mortality rates. This is understandable because HIV/AIDS, tuberculosis, diarrheal diseases and malaria claim majority of the lives; however, in many cases, the mortality is due to acute renal failure (ARF) as a consequence of the progression of these diseases. Moreover, to date, no data are available on mortality rates due to ARF as a consequence of these 'priority diseases.' Sustainable Kidney Care Foundation (SKCF), working with industry, institutions, universities and funding organizations, is in the process of establishing a pilot program for the treatment of acute renal failure (ARF) using peritoneal dialysis (PD) as the modality of choice with a special focus on treating children and women of childbearing age in the United Republic of Tanzania.     

海西工业经济又好又快发展初探

"十一五"规划实施两年以来,我州在建设富裕文明和谐社会方面取得了初步成就."十一五"规划实施的后三年,是我州经济社会发展的关键时期.如何把握并充分利用好重要战略机遇,特别是实现柴达木循环经济试验区的目标、搞好资源利用率、加快产业结构优化升级、大力发展下游产业、努力延伸产业链、注重环境保护等是摆在我们面前的首要任务.为此,本文从以下几个方面进行初步探讨.     

Comparative effectiveness of standard endotracheal tubes vs. endotracheal tubes with continuous subglottic suctioning on ventilator-associated pneumonia rates

Ventilator-associated pneumonia (VAP) accounts for the majority of nosocomial pneumonias, which may increase intensive care and prolonged hospital stays. Endotracheal tubes allowing continuous subglottic suctioning may reduce VAP; however, they are more expensive than standard endotracheal tubes not allowing continuous suctioning. he objective of this study was to measure the comparative costs associated with continuous subglottic suctioning endotracheal tubes (CSS-ETT) versus standard endotracheal tubes (S-ETT) among intubated patients and whether cost differential is offset by the occurrence of VAP in patients receiving either type of intubation. A retrospective chart review was conducted for 154 intubated adult patients (77 = S-ETT; 77 = CSS-ETT). The S-ETT group had one case of VAP; the CSS-ETT group had none. The mean total hospital charges were higher for the S-ETT group ($103,600; CSS-ETT= $88,500) (p = 0.3). Although the average number of intubation days and ICU days were greater for the CSS-ETT group, there were no cases of VAP compared to the S-ETT group. ased upon the one S-ETT VAP case and the VAP attributable costs, it is cost effective to use the CSS-ETT.