Optimal Patient Care Research Articles

Comparative evaluation of adverse drug reactions for tenofovir alafenamide and tenofovir disoproxil fumarate using the FAERS Database: a disproportionality analysis.

Tenofovir alafenamide (TAF) and tenofovir disoproxil fumarate (TDF) are widely used nucleoside reverse transcriptase inhibitors (NRTIs), necessitating a thorough understanding of their safety profiles to ensure optimal patient care and treatment adherence. We employed statistical methods including the reporting odds ratio (ROR), proportional reporting ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Multi-Item Gamma Poisson Shrinker (MGPS) to compare and evaluate the safety profiles of these NRTIs. TAF was significantly associated with weight increase (ROR: 6.43; 95% CI: 5.93-6.96) and specific psychiatric disorders. TDF showed a notable signal for renal disorders and product-related issues, including product dose omission (ROR: 3.53; 95% CI: 3.22-3.87). Additionally, the study highlighted differences in safety signals related to pregnancy outcomes, with TAF having a higher ROR for maternal exposure (ROR: 7.83; 95% CI: 7.06-8.69) and TDF for fetal exposure (ROR: 4.51; 95% CI: 3.93-5.18), underscoring the need for cautious use in pregnant women. The comparative analysis also identified signals for osteonecrosis (ROR: 108.81; 95% CI: 106.25-111.43) and bone loss (ROR: 714; 95% CI: 685.49-743.68) for TAF and TDF, respectively, highlighting the importance of bone health considerations in treatment plans. These findings underscore the importance of personalized antiviral therapy and patient safety.

Medical school origins of award-winning anaesthetists; analysis of a complete national dataset

BackgroundThe ultimate aim of medical education is to produce successful practitioners, which is a goal that educators, students and stakeholders support. These groups consider success to comprise optimum patient care with consequently positive career progression. Accordingly, identification of the common educational features of such high-achieving doctors will facilitate the generation of clinical excellence amongst future medical trainees. In our study we source data from British clinical merit award schemes and subsequently identify the medical school origins of anaesthetists who have achieved at least national distinction.MethodsBritain operates Distinction Award/Clinical Excellence Award schemes which honour National Health Service doctors in Scotland, Wales and England who are identified as high achievers. This quantitative observational study used these awards as an outcome measure in an analysis of the 2019–20 dataset of all 901 national award-winning doctors. Where appropriate, Pearson's Chi-Square test was applied.ResultsThe top five medical schools (London university medical schools, Edinburgh, Dundee, Aberdeen and Glasgow) were responsible for 56.4% of the anaesthetist award-winners, despite the dataset representing 85 medical schools. 93.6% of the anaesthetist merit award-winners were from European medical schools. 8.06% of the anaesthetist award-winners were international medical graduates compared with 11.5% non-anaesthetist award-winners being international medical graduates.ConclusionsThe majority of anaesthetists who were national merit award-winners originated from only five, apparently overrepresented, UK university medical schools. In contrast, there was a greater diversity of medical school origins among the lower grade national award-winners; tier 3 award-winners represented 20 different medical schools from three continents. As well as ranking educationally successful university medical schools, this study assists UK and international students, by providing a roadmap for rational decision making when selecting anaesthetist and non-anaesthetist medical education pathways that are more likely to fulfil their career ambitions.

Clinicians' viewpoints on current paradigms of care and research in Parkinson's disease.

Aim of this review is to discuss the value of current ongoing research initiatives in Parkinson's disease from the clinicians' point of view. The repeat, recent failures on progress slowing reflect the drifting apart between initially promising experimental and then disappointing clinical outcomes in the translational trials with well selected Parkinson's disease patients. A similar development concerns the emerging gap between novel developed drugs with improved pharmacokinetic behaviour and their limited use in the clinical practice following approval. Restricted regional different worldwide availability and direct, respectively indirect budget limitations for neurologists in private practice are essential hurdles. They prevent the widespread prescription of these compounds. As a result return of investment for the pharmaceutical industry becomes more and more uncertain. The interest for research on novel treatment approaches for the amelioration of motor and non motor symptoms declines. Clinicians crucially scrutinize the claim for an optimum patient care by payers and regulators.

Treatment for chronic idiopathic constipation: Use and satisfaction from a nationwide survey of US participants.

Chronic idiopathic constipation (CIC) is a disorder of gut-brain interaction characterized by a variety of bowel movement-related and abdominal symptoms. A greater understanding of medication use and satisfaction with symptom control may provide insights to optimize patient care. Therefore, we explored these aspects of the disorder in adults with CIC. This study assessed data collected from a large nationwide survey of adult participants in the United States, querying demographics, clinical characteristics, and comorbid conditions, as well as medication use, care-seeking behaviors, and satisfaction with symptom control. Participants were grouped into the CIC cohort if they met Rome IV criteria, with controls matched 1:1 according to age, sex, race, region, and Charlson Comorbidity Index score. All data were self-reported. Two thousand five hundred and thirty-three participants with CIC were matched 1:1 to controls. In the CIC cohort, abdominal pain was the most reported symptom leading to medication use: 15.9% of respondents were receiving a prescription medication in addition to an over-the-counter medication, while 26.3% were taking neither. In addition, only one-third were satisfied with the control of their symptoms; however, satisfaction was significantly higher in respondents taking a prescription medication (p < 0.001). The proportion of reported comorbidities was significantly higher in the CIC cohort versus the control cohort, with chronic pain, anxiety, and depression among the highest (p < 0.001 for all). This study emphasizes the need for better communication regarding prescription medications and their benefits, with the goal of further improving CIC patients' overall symptoms.

Revamping Non-Small Cell Lung Cancer Treatments in Stages II and III: Preparing Healthcare for Cutting-Edge Immuno-Oncology Regimens.

Non-small cell lung cancer (NSCLC) poses a significant challenge in clinical oncology, necessitating continual refinement of treatment approaches in stages II and III. Recent advancements have highlighted the potential of neoadjuvant therapy in optimising patient outcomes. Biomarker testing guides neoadjuvant therapy decisions, including epidermal growth factor receptor (EGFR) mutation and programmed death-ligand 1 (PD-L1) expression testing. Neoadjuvant therapy aims to improve oncological outcomes by treating micrometastatic disease and assessing tumour response before surgery. Disease-free survival is a surrogate endpoint for overall survival in both neoadjuvant and adjuvant settings. Multidisciplinary collaboration is crucial for individualised treatment planning and optimising patient care. The management of NSCLC requires a comprehensive approach, integrating expertise across disciplines and tailoring treatment strategies to individual patient needs. Neoadjuvant therapy shows promise in improving long-term outcomes, with biomarker testing guiding treatment decisions. Challenges such as defining borderline resectability and differentiating pseudoprogression highlight the need for ongoing research and collaboration.

Combined Supine-Prone Myocardial Perfusion Imaging: Enhancing Diagnostic Accuracy.

The combined supine-prone imaging protocol for SPECT myocardial perfusion imaging offers significant advantages over supine imaging alone. By comparing supine and prone images, one can distinguish attenuation artifacts in the inferior and anterior walls from true perfusion defects, thus improving specificity and diagnostic accuracy. The recommended protocol is to perform prone imaging after supine stress imaging when perfusion defects are noted. The additional prone imaging time is 20%-40% less than the standard supine imaging time. Implementing prone imaging can optimize patient care and provide substantial benefits for nuclear cardiology labs, especially those without attenuation correction.

Knowledge, skills, and confidence gaps impacting treatment decision making in relapsed/refractory chronic lymphocytic leukemia and mantle cell lymphoma: a quantitative survey study in France, Germany, and the United States

BackgroundWith recent advancements in the treatment of chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL), healthcare specialists may face challenges making treatment and management decisions based on latest evidence for the optimal care of patients with these conditions. This study aimed to identify specific knowledge, skills, and confidence gaps impacting the treatment of CLL and MCL, to inform future educational activities.MethodsHematologists and hemato-oncologists (HCPs, n = 224) from France (academic settings), Germany, and the United States (academic and community settings) responded to a 15-minute quantitative needs assessment survey that measured perceived knowledge, skills, and confidence levels regarding different aspects of treatment and management of CLL and MCL patients, as well as clinical case questions. Descriptive statistics (cross tabulations) and Chi-square tests were conducted.ResultsFour areas of educational need were identified: (1) sub-optimal knowledge of treatment guidelines; (2) sub-optimal knowledge of molecular testing to inform CLL/MCL treatment decisions; (3) sub-optimal skills when making treatment decisions according to patient profile (co-morbidities, molecular testing results); and (4) challenges balancing the risk of toxicities with benefits of treatment. Over one-third of the respondents reported skill gaps when selecting suitable treatment options and prescribing therapies and reported a lack in confidence to initiate and manage treatment. Larger gaps in knowledge of guidelines and skills in patient assessment were identified in MCL, compared to CLL.ConclusionsThis study suggests the need for continuing medical education specifically to improve knowledge of treatment guidelines, and to assist clinicians in developing skills and confidence when faced with clinical decision-making scenarios of patients with specific comorbidities and/or molecular test results, for example, through case-based learning activities.

Effectiveness of Drug Allergy Management: A Meta-Analysis

Background: Drug allergies pose a significant challenge in clinical practice, impacting patient safety and treatment options. This meta-analysis aims to evaluate the effectiveness of various drug allergy management strategies, including desensitization, graded challenges, and alternative medications. Methods: A systematic search of electronic databases (PubMed, Embase, Cochrane Library) was conducted from 2018 to 2024. Randomized controlled trials (RCTs) and observational studies assessing drug allergy management interventions were included. The primary outcome was the successful administration of the culprit drug without allergic reactions. Secondary outcomes included adverse events and quality of life. Data were extracted and pooled using random-effects models. Results: A total of 32 studies (15 RCTs, 17 observational studies) encompassing 4,215 patients were included. Desensitization protocols demonstrated a high success rate (89%) in enabling the administration of culprit drugs. Graded challenges also showed promising results (75% success rate). The use of alternative medications was associated with a lower risk of allergic reactions but may compromise treatment efficacy in some cases. Conclusion: This meta-analysis highlights the effectiveness of drug allergy management strategies, particularly desensitization and graded challenges. These interventions offer promising avenues to overcome drug allergies and optimize patient care. Further research is needed to explore long-term outcomes and refine management protocols.

Assessing perceptions of nursing knowledge, attitudes, and practices in diabetes management within Chinese healthcare settings.

Effective management of diabetes mellitus (DM) involves comprehensive knowledge, attitudes, and practices (KAP) by nurses, which is essential for optimal patient care and aiding patients in their self-management of the condition. This survey evaluates nurses' self-assessed knowledge, attitudes, and practices (KAP) related to diabetes management, focusing on their perceptions of personnel expertise and care approaches. Using a stratified sampling method, the survey was disseminated across various online platforms from January 2023 to February 2024 within China, including WeChat and Sina Weibo. We employed binary logistic regression and Chi-square tests to explore the statistical correlates of KAP related to DM. A total of 4,011 nurses participated, revealing significant perceived knowledge deficiencies in specialized DM management areas, with only 34% (n = 1,360) proficient in current pharmacological treatments. Attitudinal assessments showed that 54% (n = 2,155) recognized the importance of cultural competence in dietary counseling. Practices were strong in routine glucose monitoring (96%, n = 3,851) but weaker in psychological support (68%, n = 2,736). Regression analysis indicated significant effects of experience on KAP, where nurses with 1-5 years of experience were more likely to show better knowledge (OR = 1.09; p = 0.08), and those with advanced degrees demonstrated higher competence (OR = 1.52; p = 0.028). Marital status influenced attitudes, with single nurses more likely to exhibit positive attitudes (OR = 0.49; p < 0.001), and work environment impacted knowledge, with hospital-based nurses more knowledgeable (OR = 1.15; p = 0.14). Additionally, gender differences emerged, with male nurses showing greater knowledge (OR = 1.65; p = 0.03) and better practices in diabetes care (OR = 1.47; p = 0.04). The study underscores the critical need for targeted educational programs and policy interventions to enhance nursing competencies in DM management. While the study provides valuable insights into nurses' perceptions of their competencies, future research should incorporate objective knowledge assessments to ensure a comprehensive understanding of their actual capabilities. Interestingly, the data also suggests a substantial opportunity to leverage technology and inter-professional collaboration to further enhance DM management efficacy among nurses, fostering an integrated care approach.

A Comprehensive Review of the Role of Magnesium in Critical Care Pediatrics: Mechanisms, Clinical Impact, and Therapeutic Strategies.

Magnesium is an essential mineral with pivotal roles in various physiological processes, including enzyme function, neuromuscular regulation, and cardiovascular health. Magnesium's importance in critically ill pediatric patients is magnified due to its involvement in maintaining cellular homeostasis and potential therapeutic benefits. This review comprehensively analyzes magnesium's role in critical care pediatrics, focusing on its physiological mechanisms, clinical impact, and therapeutic strategies. Magnesium's functions in energy production, protein synthesis, and electrolyte balance underscore its significance in critical illness, where imbalances can lead to severe complications such as arrhythmias, neuromuscular disturbances, and respiratory issues. The review examines the clinical consequences of magnesium deficiency, including its impact on various body systems and the potential exacerbation of critical conditions. It also explores therapeutic strategies to optimize patient care, including supplementation practices, dosing considerations, and monitoring protocols. By summarizing recent research and clinical guidelines, this review aims to enhance understanding of magnesium's role in critical care and provide evidence-based recommendations for its management. The insights provided are intended to guide clinicians in integrating magnesium therapy into critical care practices, ultimately improving patient outcomes and advancing the management of critically ill pediatric patients.

Design and architecture of the CARA infrastructure for visualising and benchmarking patient data from general practice

ObjectiveCollaborate, Analyse, Research and Audit (CARA) project set out to provide an infrastructure to enable Irish general practitioners (GPs) to use their routinely collected patient management software (PMS) data to...

2238 How can effective teaching about dementia be integrated into the undergraduate medical curriculum? A realist review

Abstract Introduction The prevalence of dementia is increasing and yet healthcare professionals (HCP) do not always have sufficient education and training to deliver optimal care for patients with dementia (PWD). There is an evidence base as to how to deliver effective undergraduate education about dementia but this is infrequently integrated into the medical curriculum. Methods We undertook a realist synthesis to review the barriers to integrating effective interventions on dementia into the medical curriculum. A realist synthesis differs from a traditional systematic review in terms of explaining how interventions might succeed (or not) in a particular context, involving iterative cycles of literature review and synthesis to develop and refine a ‘programme theory’ (PT). Results We analysed and synthesised twenty relevant studies of undergraduate educational interventions on dementia to identify common themes. We constructed an ‘initial programme theory’ (IPT) to illustrate the contexts where teaching on dementia occurs and outline four main categories of barriers to curriculum integration: culture, concern for patient welfare, student attitudes, and logistics. Conclusion We have identified key barriers to implementation of undergraduate education about dementia, and potential mechanisms to overcome them. The next stage of our realist synthesis is to gather stakeholder feedback on the validity of the IPT before returning to the next cycle of literature review to refine and finalise our PT. This model will serve as a guide for those aiming to successfully integrate effective education about dementia into the medical curriculum.

Clinical and Radiological Predictors of Positive Microbiological Yield in Vertebral Osteomyelitis: A Retrospective Cohort Study

Objective: To evaluate demographic, laboratory, biopsy, and imaging variables as potential predictors of microbial identification in patients with suspected vertebral osteomyelitis, aiming to enhance diagnostic accuracy and optimize patient care. Methods: This retrospective cohort study analyzed 83 patients who underwent image-guided percutaneous disc-space sampling between June 2020 and December 2023. Inclusion criteria were adults aged ≥18 years with imaging-based evidence of vertebral osteomyelitis and clinical suspicion of infection. Exclusion criteria were presence of known malignancy and non-infective causes. Demographics, clinical history, imaging, biopsy, and microbiology data were collected. Logistic regression analysis was used to identify predictors of positive microbiological yield. Results: Microorganisms were identified in 32 of 83 cases (38.6%), with Mycobacterium tuberculosis being the most common pathogen identified (21.9%). Elevated C-reactive protein (CRP) levels, erythrocyte sedimentation rate (ESR), and paravertebral signal changes on MRI were associated with a positive culture yield. Multivariate analysis identified CRP as an independent predictor of positive microbiological results. CT-guided percutaneous biopsy was found to be safe, with no major complications reported. Conclusion: CT-guided percutaneous biopsy is a reliable and safe diagnostic tool for identifying the causative pathogens in vertebral osteomyelitis. Elevated CRP levels were independently associated with positive microbiological yield, highlighting its role as a crucial predictor in clinical practice. These findings underscore the importance of incorporating CRP levels into the diagnostic process, potentially guiding the selection of patients for biopsy to improve the detection of infection.

MEASURING THE PREVALENCE, SEVERITY, AND SOURCES OF DISABILITY: A NEW APPROACH

BackgroundDisability is an important multifaceted construct. Identifying sources of disability could help optimise patient care. The aim of this study was to test an approach that not only estimates severity of disability, but also identifies the source(s) of this disability.MethodsAn online survey was used to collect data from a convenience sample, recruited via email and social media invitations. Two generic measures of disability, the 8-item Universal Disability Index (UDI8) and Groningen Activity Restriction Scale (GARS) were used to estimate the prevalence and severity of disability in this sample. Non-zero UDI8 item responses generated conditional sub-questions, in which participants could attribute their activity limitations to one or more sources (pain, fatigue, worry, mood, and other). This allowed for a decomposition of UDI8 scores into source components.Results403 participants enrolled; 334 completed all UDI8 and GARS items. Of these, 85.3% (285/334) reported at least one restricted activity via the UDI8, while 43.4% (145/334) reported some reduced independence via the GARS. Disability severity increased with age until approximately 40 years, after which it decreased gradually. Pain component scores were high in all individuals with higher and lower disability severity, whereas fatigue component scores were highest in individuals reporting higher disability severity. Worry, mood, and other component scores were not high at any level of disability severity.ConclusionsThis approach should be used to identify the prevalence, severity and sources of disability in the general population and in specific patient groups.Conflicts of interestNo conflicts of interestSources of fundingNo funding obtained

The genomic landscape of 2,023 colorectal cancers

Colorectal carcinoma (CRC) is a common cause of mortality1, but a comprehensive description of its genomic landscape is lacking2–9. Here we perform whole-genome sequencing of 2,023 CRC samples from participants in the UK 100,000 Genomes Project, thereby providing a highly detailed somatic mutational landscape of this cancer. Integrated analyses identify more than 250 putative CRC driver genes, many not previously implicated in CRC or other cancers, including several recurrent changes outside the coding genome. We extend the molecular pathways involved in CRC development, define four new common subgroups of microsatellite-stable CRC based on genomic features and show that these groups have independent prognostic associations. We also characterize several rare molecular CRC subgroups, some with potential clinical relevance, including cancers with both microsatellite and chromosomal instability. We demonstrate a spectrum of mutational profiles across the colorectum, which reflect aetiological differences. These include the role of Escherichiacolipks+ colibactin in rectal cancers10 and the importance of the SBS93 signature11–13, which suggests that diet or smoking is a risk factor. Immune-escape driver mutations14 are near-ubiquitous in hypermutant tumours and occur in about half of microsatellite-stable CRCs, often in the form of HLA copy number changes. Many driver mutations are actionable, including those associated with rare subgroups (for example, BRCA1 and IDH1), highlighting the role of whole-genome sequencing in optimizing patient care.

Comparison of Infiltration and Inferior Alveolar Nerve Block Injection Techniques in Periodontal Flap Surgery in the Mandible

Abstract Introduction: The efficacy of infiltration versus inferior alveolar nerve block (IANB) injection techniques during periodontal flap surgery in the mandible is crucial for optimising patient care. This comparative study aims to evaluate the pain management, ease of administration and clinical outcomes associated with both anaesthetic methods. Infiltration anaesthesia involves localised administration, targeting specific sites, whereas IANB provides a broader anaesthetic effect by numbing the entire mandibular nerve. Understanding the advantages and limitations of each technique will enhance procedural efficiency and patient comfort. This research contributes valuable insights into best practices for periodontal surgeries. Materials and Methods: Twenty-five subjects who required periodontal flap surgery were included in the study to treat chronic periodontitis in the mandibular jaw. The surgery was performed under local infiltration of an anaesthetic agent on one side of the jaw and by an IANB on the other side. Pain perception was evaluated using the Visual Analogue Scale (VAS) score at various intervals during periodontal flap surgery. The effect of anaesthesia between the two techniques was compared and evaluated by analysis of variance using IBM Corp. IBM Statistical Package for Social Sciences (SPSS) Statistics for Windows [Version 25]. Armonk, New York, USA. IBM Corp; 2017. Results: Analysis determined the onset, duration and termination of anaesthesia induced by infiltration and the IANB technique. The onset and duration of anaesthesia by both techniques were comparable. The pain perception evaluated using the VAS score while using both anaesthesia techniques was also comparable. Conclusion: Infiltration anaesthesia can be used as an alternative to overcome the disadvantages and complications of IANB for periodontal surgery in the mandibular jaw.

Lactate Monitoring in Intensive Care: A Comprehensive Review of Its Utility and Interpretation.

Lactate monitoring is critical in managing critically ill patients in intensive care settings. Elevated lactate levels often signify underlying metabolic disturbances such as tissue hypoxia, anaerobic metabolism, or impaired lactate clearance, which are prevalent in conditions like sepsis, shock, and trauma. Understanding the physiological basis of lactate production and its significance in clinical practice is essential for interpreting its diagnostic and prognostic value. This comprehensive review aims to explore the utility of lactate monitoring across various critical care scenarios. It provides an overview of lactate's metabolic pathways, methods of measurement, and the clinical implications of interpreting lactate levels in different contexts. Additionally, the review discusses current evidence on lactate-guided therapeutic interventions and highlights challenges and limitations to their application. By synthesizing the existing literature and clinical insights, this review aims to enhance the understanding of the role of lactate monitoring in assessing disease severity, guiding treatment strategies, and predicting outcomes in critically ill patients. Ultimately, this review underscores the importance of integrating lactate monitoring into routine clinical practice to optimize patient care and improve clinical outcomes in intensive care settings.

Evaluation of Survival and Durability of Fixed Prosthodontic Restorations in a Tertiary Dental Centre of Eastern Nepal

Background: Fixed prosthodontic restorations play a pivotal role in dental rehabilitation, providing essential functions such as mastication, aesthetics, and oral health preservation. This study aims to assess the survival of fixed prosthodontic restorations within the context of a tertiary dental centre in Eastern Nepal. Materials and Methods: A retrospective cohort study was conducted among 228 patients, involving a comprehensive analysis of patient records from the tertiary dental centre. Data were collected on patient demographics, types of fixed prosthodontic restorations (e.g., crowns, bridges), materials used, adhesive systems, follow-up durations, and any recorded instances of restoration failure. Patient satisfaction scores, including aesthetic outcomes, comfort, and functionality, were also assessed. Results: The mean age of patients undergoing fixed prosthodontic restorations was 43.1 years, predominantly male (66.7%), with good systematic health (68.4%) and varying levels of oral hygiene. Oral hygiene status, parafunctional habits, restoration type, and subjective experiences such as comfort, functionality, and aesthetic satisfaction were all significantly associated with survival rates (p &lt; 0.001). Conclusion: The results may have implications for clinical decision-making, informing practitioners about the most effective materials and techniques for enhancing the durability of fixed prostheses in this region. Further research and continuous evaluation are crucial for refining prosthodontic practices and ensuring optimal patient care in the unique healthcare landscape of Eastern Nepal.

The Role of Cone Beam Computed Tomography (CBCT) in the Diagnosis and Clinical Management of Medication-Related Osteonecrosis of the Jaw (MRONJ).

Medication-related osteonecrosis of the jaw (MRONJ) is a debilitating condition associated with antiresorptive and antiangiogenic medications that are frequently used in treating osteoporosis and cancers. With the ability to produce high-resolution images with a lower radiation dose, cone beam computed tomography (CBCT) is an emerging technology in maxillofacial imaging that offers several advantages in evaluating MRONJ. This review aims to summarise the radiological features of MRONJ as observed via CBCT and highlight its advantages over two-dimensional plain films in assessing MRONJ. CBCT has the capability to detect early MRONJ lesions, characterise the extent and nature of lesions, distinguish MRONJ from other osseous pathologies, and assist in treatment planning. By leveraging the advantages of CBCT, clinicians can enhance their understanding of MRONJ, improve decision making, and ultimately optimize patient care.

High-Level Isolation: A Landscape Analysis of Global Capabilities and Opportunities to Advance the Field.

High-level isolation units (HLIUs) have been established by countries to provide safe and optimal medical care for patients with high-consequence infectious diseases. We aimed to identify global high-level isolation capabilities and determine gaps and priorities of global HLIUs, using a multiple method approach that included a systematic review of published and gray literature and a review of Joint External Evaluations and Global Health Security Index reports from 112 countries. A follow-up electronic survey was distributed to identified HLIUs. The landscape analysis found 44 previously designated/self-described HLIUs in 19 countries. An additional 33 countries had potential HLIUs; however, there were not enough details on capabilities to determine if they fit the HLIU definition. An electronic survey was distributed to 36 HLIUs to validate landscape analysis findings and to understand challenges, best practices, and priorities for increased networking with a global HLIU cohort; 31 (86%) HLIUs responded. Responses revealed an additional 30 confirmed HLIUs that were not identified in the landscape analysis. To our knowledge, this was the first mapping and the largest ever survey of global HLIUs. Survey findings identified major gaps in visibility of HLIUs: while our landscape analysis initially identified 44 units, the survey unveiled an additional 30 HLIUs that had not been previously identified or confirmed. The lack of formalized regional or global coordinating organizations exacerbates these visibility gaps. The unique characteristics and capabilities of these facilities, coupled with the likelihood these units serve as core components of national health security plans, provides an opportunity for increased connection and networking to advance the field of high-level isolation and address identified gaps in coordination, build an evidence base for HLIU approaches, and inform HLIU definitions and key components.