Hemothorax is a frequent clinical situation often associated with chest injury or with iatrogenic lesions. Spontaneous hemothorax is uncommon and among its cause may include coagulation disorders, pleural, pulmonary or vascular pathology. Diagnostics is based on radiography or ultrasound and thoracentesis which may be also therapeutic solution. The majority of hemothoraxes can be managed non-operatively but hemodynamic instability, the volume of evacuated blood and persisting blood loss or persisting hemothorax require surgery. A surgical approach may vary from open thoracotomy to rapidly developing minimally invasive methods-video-assisted thoracoscopic surgery (VATS) and videothoracoscopy (VTS).
Global healthcare is a political variable that involves both political as well as nongovernmental agencies and refers to health of the whole planet regardless of the geographical and political boundaries. Global healthcare initiatives are programs that address specific global health issues or diseases. The most important objective of a global health initiative is to achieve a major improvements in global populations' health outcomes regardless the geographic location. Global health programs bring and use various resources to improve, prevent and resolve worldwide health issues.
Pregnant or postpartum patients with history of substance use disorder who desire to breastfeed present healthcare providers with numerous issues as drug use increases risk for adverse health outcomes for both the mother and her child. Drug use in the U.S. is common. In 2013, an estimated 24.6 million Americans aged 12 or older were current illicit substance users representing 9.4 % of the population. This statistic unfortunately closely corresponds with substance use in pregnant women. Totally 9% of pregnant women used drugs during their first trimester. Substance use during pregnancy and during breastfeeding presents serious problem for the health of our society. When a mother with a history of illegal/illicit drug use or illegal substance abuse desires to breastfeed, her healthcare providers are faced with several ethical dilemmas. The most obvious is whether she should be allowed to breastfeed her child. Does the benefit of breastfeeding outweigh the risk of possible substance transmission to the infant or is formula feeding safer and more appropriate option for the infant? What is the consequence of formula feeding on the fragile relationship between the newborn and the troubled mother? Lastly, the infant's right to be breastfed needs to be taken into consideration as a part of this complex issue. Healthcare leaders need to be able to understand ethical challenges of this specific population, acknowledge variances between individual substances, and most importantly differentiate between occasional drug use, diagnosable substance use disorder and treated substance use disorder. Healthcare leaders should be able to clearly identify how to best provide the most effective and supportive care. Changes to policies and healthcare practices can advance the overall health of this specific and challenging population as well as can improve the relationship between these patients and their healthcare providers.
Pregnancy related maternal mortality defines the state of maternal health. The increasing incidence of maternal death in the U.S indicates that this complex issue is not unique only to developing countries. It is obvious that improvements are needed to reinsure appropriate healthcare for all pregnant women. Without precise methodical data collection and data evaluation advancement of this important determinant of maternal health can't be achieved. The aim of this paper is to provide contemporary perspective on pregnancy related maternal mortality. In addition, this paper will discuss common ethnical disparities that underline maternal deaths. Furthermore, this paper will address the confusing inconsistencies of maternal death terminology and variations in disease classification. Finally, this paper will propose improvements in defining terminology and data collection that influence the understanding of pregnancy related morbidity. Quick Points 1. Maternal mortality is a determining characteristic of existing maternal health in a given geographical region. 2. While it is impossible to completely eliminate all maternal deaths, preventable pregnancy complications resulting in injury or death need to be reduced across the world. 3. Healthcare leaders need to work on identification of maternal mortality trends and development of strategies to sustainably improve rates of maternal mortality.
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