Τρίτη, 18 Ιουλίου 2017
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Editorial: Infections, reproductive health, non - communicable diseases and health systems dominate articles in this June issue of African Health Sciences
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Letter to editor: Emerging epidemic of drug resistant tuberculosis in vulnerable populations of developing countries
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Background: Dysphagia is common in inflammatory myopathies and usually responds to corticosteroids. Severe dysphagia requiring feeding by percutaneous endoscopic gastrostomy is associated with significant morbidity and high mortality.
Clinical case: A 56-year old African Black woman initially presented with systemic sclerosis (SSC) - myositis overlap and interstitial lung disease. She responded to high dose corticosteroids and cyclophosphamide followed by azathioprine, with improvement in her lung function and regression of the skin changes. Six years later she had a myositis flare with severe dysphagia. Her myositis improved after high doses of corticosteroids, azathioprine and two doses of intravenous immunoglobulin (IVIG). As her dysphagia persisted, she was fed via a percutaneous endoscopic gastrostomy (PEG) tube and given a course of rituximab. Her dysphagia gradually resolved and the PEG tube was removed within two months. She received another dose of rituximab six months later and continued low dose prednisone and azathioprine. Her muscle power improved, weight returned to normal and she remained well 20 months after hospital discharge.
Conclusion: Our patient with SSC-myositis overlap and severe dysphagia requiring PEG feeding, improved with high dose corticosteroids, azathioprine, two courses of IVIG and rituximab, and remained in remission 20 months after hospital discharge.
Keywords: Severe dysphagia, systemic sclerosis, myositis overlap
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Introduction: Research integrity is the foundation of credible research and a pre-requisite for a successful academic research environment. Lately, a lot of revelations of fraud and other unacceptable behaviour in research have been highly publicized in scientific journals and mass media. Whereas institutions in developed countries have developed guidelines and regulations to ensure responsible conduct of research and appropriately deal with cases of research misconduct, low- and middle-income countries seem to be lagging behind. In Uganda, there seems to be lack of coordinated efforts to address the problem of research misconduct both at the national and institutional level.
Objective: To propose a framework for fostering scientific integrity and deterring misconduct in research in Ugandan research and academic institutions.
Methods: A review of literature on scientific integrity, scientific misconduct, responsible conduct of research, and international ethical guidelines was done.
Results: Basing on the 2012 Inter-Academy Council policy report, initiatives to promote responsible conduct of research in Ugandan research and academic institutions are proposed.
Conclusion: With the proposed framework, an honest and trustworthy research enterprise in Uganda based on principles of scientific integrity is envisioned.
Keywords: Research misconduct, scientific integrity, responsible conduct of research
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Background: Globally, national health systems are challenged to build successful aging models to prepare for biomedical, psychological and social changes. The integral component of psychosocial health in overall quality of life and well-being, however, is underscored and requires greater focus. Changing demographics in Nigeria, in addition to cultural considerations and absence of a social security system, present unique challenges to elderly.
Objective: We aimed to review the literature that describes the current situation and challenges in psychosocial health status in the elderly in Nigeria and provide recommendations that promote health and well-being during the aging process.
Results: Four primary factors affect psychosocial health status of elderly Nigerians, namely: changes in family dynamics, increased demand for healthcare services, increased economic stress, and decreased functional independence.
Conclusion: Like other developing countries, the Nigerian national system faces similar challenges in preparing a national framework that can maximize coverage to citizens in the midst of demographic changes in aging. By focusing on five target areas such as the educational system, health services, community-based initiatives, local or regional policies and national strategies, current framework in Nigeria can be modified to prepare for changing demographics in aging.
Keywords: Aging, family support, Nigeria, psychosocial
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Characterization and antitumor activity of camptothecin from endophytic fungus Fusarium solani isolated from Camptotheca acuminate
Background: Camptothecin (CPT) is a potent drug against cancers, originally from plants. The endophytic fungi could produce the secondary metabolite same as the host and is used as medicine.
Objectives: The aim of this paper was to investigate an endophytic fungal CPT with anti-neoplastic activity.
Methods: Endophytic fungi were isolated from Camptotheca acuminata in China. CPT from strain S-019 was characterized by TLC, HPLC and EI-MS analysis. Anti-tumor activity of fungal CPT was detected by MTT and fluorescent dye methods using Vero and PC-3 cells.
Results: A total of 94 endophytic fungi strains were isolated from tissues of C. acuminata and 16 fungi strains displayed cytotoxic activity on Vero or PC3 cells. Of which, the fungal strain S-019, classified as Fusarium solani, displayed impressive cytotoxic activity on cancer cells and was found to produce CPT by analysis of TLC, HPLC and EI-MS methods. Bioassay studies confirmed that the fungi CPT had potent cytotoxicity on Vero cells and induced apoptosis of Vero cells.
Conclusion: The endophytic fungi from camptotheca trees are a reliable source for natural anticancer compounds. The endophytic fungi could produce CPT same as plant. The fungal CPT exhibited effective activity at inhibiting cell growth and inducing apoptosis on Vero cells.
Keywords: Endophytic fungi, camptothecin, anti-tumor, Camptotheca acuminate
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Objectives: The study focused on the plasma levels of vitamin B6 and homocysteine in different genotypes of MTHFR (C677T, A1298C) and GABRG2 (C588T, C315T) genes in carbamazepine resistant epilepsy in the population of Khyber Pakhtunkhwa.
Methodology: Patients who were possible candidates for carbamazepine therapy were followed for six months for their seizure control. Plasma levels of vitamin B6 and homocysteine were determined using immunoassay based techniques at baseline and after six months. MTHFR (C677T, A1298C) and GABRG2 (C588T, C315T) genes were genotyped using restriction fragment length polymorphisms. Seizure control during therapy was recorded on a standardized proforma.
Results: Low vitamin B6 levels and hyperhomocysteinemia were found in 61.7% of resistant patients (n=34). Resistant patients had the following frequencies of variant genotypes (677CT=38.1% and 677TT=24.4%; 1298AC=42.2% and 1298CC=26.1%; 588CT= 47.6% and 315TT= 33.3%) of MTHFR (C677T and A1298C) and GABRG2 (C588T and C315T) genes. A significant decline in vitamin B6 (P<0.0001) and hyperhomocysteinemia were found in variant genotypes of MTHFR (C677T, A1298C) and GABRG2 (C588T, C315T) genes.
Conclusion: Following six months of carbamazepine of therapy in heterozygous variant genotypes of MTHFR (677CT and 1298AC) and GABRG2 (588CT and 315CT) genes, we observed a significant fall in vitamin B6 levels and hyperhomocysteinemia.
Keywords: Carbamazepine, epileptics, homocysteine, seizure control, RFLP, vitamin B6
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Near vision spectacle coverage and barriers to near vision correction among adults in the Cape Coast Metropolis of Ghana
Purpose: To determine the near vision spectacle coverage and barriers to obtaining near vision correction among adults aged 35 years and older in the Cape Coast Metropolis of Ghana.
Methods: A population-based cross-sectional study design was adopted and 500 out of 576 participants aged 35 years and older were examined from 12 randomly selected clusters in Cape Coast, Ghana. All participants underwent a comprehensive eye examination which included: distance and near visual acuities measurements and external and internal ocular health assessments. Distance and near refractions were performed using subjective refraction technique. Information on participants' demographics, near vision correction status, near visual needs and barriers to acquiring near vision correction were obtained through a questionnaire administered as part of the study.
Results: The mean age of participants was 52.3±10.3 years of whom 280 (56%) were females and 220 (44%) were males. The near vision spectacle coverage was 25%, 33% "met need" for near vision correction in the presbyopic population, and 64% unmet need in the entire study population. After controlling for other variables, age (5th and 6th decades) and educational level were associated with "met need" for near vision correction (OR=2.7 (1.55-4.68), p =0.00, and OR=2.36 (1.18-4.72), p=0.02 respectively). Among those who needed but did not have near vision correction, 64 (26%) did not feel the need for correction, 55 (22%) stated that they were unaware of available interventions, and 53 (21%) found the cost of near vision correction prohibitive.
Conclusion: There was a low near vision spectacle coverage in this population which suggests the need for strategies on health education and promotion to address the lack of awareness of spectacle need and cost of services.
Keywords: Presbyopia, near vision, spectacle coverage, unmet needs, Ghana
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Background: Nigeria still showcases unacceptably high under-five mortality despite all efforts to reduce the menace. Investigating the significant predictors of this occurrence is paramount.
Objective: To examine the interplay between family setting, domestic violence and under-five death in Nigeria.
Methods: Cross-sectional secondary data, the 2013 Nigeria Demographic and Health Survey, (NDHS) women dataset was utilized. Subset of 26,997 ever married and ever had childbirth experience respondents were extracted from the nationally representative women dataset. Dependent and Independent variables were recoded to suit the statistical analysis for the study.
Results: The study revealed that 33.7% of the respondents were in polygyny family setting; one-quarter of the ever married women reported ever experiencing one form of domestic violence or the other. The results of the logistic regressions indicate that family type and domestic violence were significant predictors of under-five children mortality in Nigeria.
Conclusion: The study concludes that women who belong to polygyny family setting and who ever experienced sexual domestic violence are highly susceptible to experience under-five children mortality than their counterparts. The study recommends that strategies and policies aimed at improving child survival should strengthen women empowerment initiatives, discourage multiple wives and campaign against domestic violence in Nigeria.
Keywords: Polygyny, monogamous, domestic violence, Nigerians
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Background: To analyze the epidemiological characteristics and secular trends of the leading causes of death in China.
Methods: Data on the leading causes of death was collected from the Statistical Yearbook of China. Data for 11 years, from 2003 to 2013, was analyzed by regression analysis and chi-square test.
Results: The top 3 causes of death from 2009 to 2013 were cancer, cerebrovascular disease, and cardiopathy, with the role of cardiopathy increasing over time (P<0.01). The proportion of deaths related to cardio-cerebrovascular diseases in urban and rural areas increased to 41.9% and 44.8%, respectively, in 2013, and was significantly higher than that for cancer, 25.5% and 22.4% (both P<0.01). Injury and poisoning in urban or rural areas represented the fifth leading cause of death. In 2006, endocrine, nutritional, and metabolic diseases were the sixth main cause of death, with 3.3% in urban areas. The role of genito-urinary,
respiratory, and digestive system diseases in urban areas and genito-urinary system diseases in rural areas decreased during this period (all P<0.05).
Conclusion: Cancer, cerebrovascular disease, and cardiopathy accounted for more than 67% of all deaths from 2007 to 2013 in China, and significantly increased in proportion from 2003 to 2013.
Keywords: Causes of death; China; cancer; cardiovascular disease
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Aim: To analyze risk factors leading to osteopenia and osteoporosis among young female students.
Methods: Quantitative Ultrasonography measurements were performed in the calcaneal region of 101 young Saudi females. Dietary habits, exercising and sun exposure were assessed using questionnaires. The association between the different studied factors was assessed by Pearson test and multiple linear regression model.
Results: Participants diagnosed with either osteopenia or osteoporosis (>33%.) showed significant higher soft drinks consumption, reduced exercise, limited intake of milk and dairy products, calcium and vitamin D supplementation compared to the healthy group. Multiple regression analysis showed that T-score and Z-score were negatively associated with soft drink intake and positively associated with exercising, milk and dairy products consumption, and calcium and vitamin D supplementation use (p <0.05)
Conclusion: High soft drink intake, lack of exercising and limited calcium and vitamin D supplementation are the combined lifestyle factors leading to osteopenia and osteoporosis among young Saudi females. These findings might serve as a basis of nutrition education intervention to promote healthy bones among this population.
Keywords: Lifestyle factors, osteoporosis, osteopenia, young women, Saudi Arabi
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Disordered eating attitudes: demographic and clinico-anthropometric correlates among a sample of Nigerian students
Objectives: We set out in this study to determine the demographic and clinico-anthropometric correlates of disordered eating attitudes among undergraduate students of two higher institutions in Lagos, Nigeria.
Methods: This cross-sectional descriptive study was conducted among 1,054 participants after written informed consent. A socio-demographic questionnaire, the Eating Attitude Test (EAT-26) and 12-item General Health Questionnaire (GHQ-12) were administered to the participants. In addition, their blood pressure, height and weight were measured, and body mass index (BMI) was calculated.
Results: The study participants comprised of 561(55.6%) males with median age of 21.4 years. The mean (±SD) score on EAT-26 was 11.52(±8.54), and 16% of all the respondents were categorized as having disordered eating attitude. A significant relationship was found between disordered eating attitude and age (p= 0.027), gender (p= <0.001), institution of study (p= 0.005), systolic blood pressure (p=0.019), BMI (p= 0.027) and psychological distress (p=0.005).
Conclusion: Our study observed disordered eating attitude to be prevalent among young adults, and demographic along with clinico-anthropometric factors constituted associated factors. Our findings strengthen the basis to incorporate health awareness programs aimed at improving nutrition and eating behavior among the young adult population. Future research is needed.
Keywords: Anthropometric, correlates, disordered eating attitudes, Nigeria, students
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Background: Amputation is the removal of whole or part of a limb, often as a life saving measure. It is a mutilating surgical procedure altering the body image and producing severe functional deficit. It is a common orthopedic surgical procedure performed worldwide.
Aims and objectives: The aim of this study was to determine the pattern and indications for amputation in Federal Medical Centre, Birnin Kebbi, Kebbi State, Nigeria; between January 2008 and December 2014, in a bid to proffer preventive measures.
Patients and methods: This was a retrospective study of consecutive patients who had major limb amputations at the Federal Medical Centre, Birnin Kebbi, Kebbi State, Nigeria; between January 2008 and December 2014. Case notes of patients were retrieved with relevant information extracted and analyzed.
Results: A total of 112 amputations were studied. The age range of patients was between 3-89 years. Amputation in 23.5% of patients was due to trauma, followed by diabetic foot gangrene in 21% of cases. About 42.9% of the amputations were above knee, followed by below knee amputations in 37% of cases. The lower limbs were involved in 84.8% of cases and upper limbs in 15.2% of cases.
Conclusion: Trauma was the most predominant indication for amputation in this study. This was followed by diabetic foot gangrene. This is usually due to the high rate of road traffic accidents and consequent mismanagement by traditional bone setters.
Keywords: Limb amputations, tertiary hospital, North Western Nigeria
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Effect of low-dose ketamine on post-operative serum IL-6 production among elective surgical patients: a randomized clinical trial
Background: Surgery and Anesthesia cause an excessive pro-inflammatory response. Mulago Hospital is faced with staff shortage making post-operative pain management difficult.Interleukin-6 (IL-6) drives inflammatory pain, endothelial cell dysfunction and fibrogenesis. Ketamine is cheap and, readily available. We hypothesized that its attenuation of serum IL-6 was a surrogate for clinical benefit.
Materials and methods: Institutional Review Board's approval was sought and RCT was registered at clinical trials.gov (identifier number: NCT01339065). Consenting patients were randomized to receive pre-incision intravenous ketamine - 0.5mg/kg or 0.9% saline placebo in weighted dosing. Blood samples were collected and laboratory analyzed at baseline, post-operatively in PACU, 24 and 48 hours respectively.
Results: We recruited 39 patients of whom 18 were randomized to the ketamine arm and 21 in the placebo arm with follow up at 24 and 48 hours. Serum IL-6 and IL-1β levels were analyzed using ELIZA assay of pre-coated micro wells. Ketamine suppressed serum IL-6 at PACU with reduced increase at 24 hours. There was no reaction in 98% of IL-1β assayed.
Conclusion: Low-dose ketamine attenuated early serum IL-6 levels due to surgical response with reduced 24 hour increase, but the difference was not statistically significant and we recommend more studies.
Keywords: Ketamine, post-operative inflammation, interleukin 6, interleukin 1- β
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Objectives: We aimed to prospectively study distraction-related road traffic collision injuries, their contributory factors, severity, and outcome.
Methods: Data were prospectively collected on all hospitalized road traffic collision trauma patients in Al-Ain City who were drivers at the collision time over one and half years. Driver's inattentive behaviors preceding the collision were collected by interviewing the admitted drivers.
Results: There were 444 drivers, 330 of them were fully oriented patients, out of them only 44 (13%) were distracted. Nineteen (5.8%) drivers were distracted by using mobile phones, 12 (3.6%) were pre-occupied with deep thinking, six (1.8%) were talking with other passengers, four (1.2%) were picking things in the vehicle, and three (0.9%) were using entertainment systems. The maximum distraction occurred during the time of 6 am - 12 noon when the traffic was crowded. There were no significant differences between distracted and non-distracted drivers in demographical and physiological factors, injured regions, and outcomes.
Conclusion: Distraction of alert drivers causes 13% of road traffic collisions in Al-Ain city. About 40 percent of the distracted drivers involved in road traffic collisions (RTC) were using mobile phones. Our study supports the ban of use of cell phones while driving.
Keywords: Distraction, prevention, road traffic collision, mobile phone
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Objective: This study aimed to explore the role of miR-126 in coronary artery disease (CAD) patients and the potential gene targets of miR-126 in atherosclerosis.
Methodology: A total of 60 CAD patients and 25 healthy control subjects were recruited in this study. Among the 60 CAD patients, 18 cases were diagnosed of stable angina pectoris (SAP), 20 were diagnosed of unstable angina pectoris (UAP) and 22 were diagnosed of acute myocardial infarction (AMI). Plasma miR-126 levels from both groups of participants were analyzed by real-time quantitative PCR. ELISA was used to measure plasma level of placenta growth factor (PLGF).
Results: The results showed that the miR-126 expression was significantly down-regulated in the circulation of CAD patients compared with control subjects (P<0.01). Plasma PLGF level was significantly upregulated in patients with unstable angina pectoris and acute myocardial infarction (AMI) compared with controls (both P<0.01) the miR-126 expression in AMI was significantly associated with PLGF.
Conclusion: miR-126 may serve as a novel biomarker for CAD.
Keywords: miR-126; PLGF; PCR; coronary artery disease; atherosclerosis
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Assessment of hospital-based adult triage at emergency receiving areas in hospitals in Northern Uganda
Background: Limited health service resources must be used in a manner which does "the most for the most". This is partly achieved through the use of a triage system. Whereas efforts have been made to introduce paediatric triage in Uganda such as Emergency Triage Assessment and Treatment Plus (ETAT+), it is not clear if hospitals have local protocols for adult triage being used in each setting.
Objectives: To determine the presence of existing hospital triage systems, the cadre of staff undertaking triage and barriers to development/improvement of formal triage systems.
Methodology: This was a descriptive cross-sectional study. Acholi sub-region was randomly selected for the study among the three sub-regions in Northern Uganda. The study was conducted in 6 of the 7 hospitals in the region. It was a written self-administered questionnaire.
Results: Thirty-three participants from 6 hospitals consented and participated in the study. Only one hospital (16.7%) of the 6 hospitals surveyed had a formal hospital-based adult triage protocol in place. Only 2 (33.3%) hospitals had an allocated emergency department, the rest receive emergency patients/perform triage from OPD and wards. Lack of training, variation of triage protocols from hospital to another, shortage of staff on duty, absence of national guidelines on triage and poor administrative support were the major barriers to improvement /development of formal triage in all these hospitals.
Conclusion: Formal adult hospital-based triage is widely lacking in Northern Uganda and staff do perform subjective "eyeball" judgments to make triage decisions.
Keywords: Triage, "eyeball" triage, emergency receiving areas, and emergency health conditions
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Constipation is the chief complaint at approximately 3% to 5% percent of pediatric outpatient clinic visits (Borowitz, 2016). This diagnosis is challenging at times and is defined by the North American Society of Gastroenterology, Hepatology, and Nutrition as "a delay or difficulty in defecation present for two weeks or more and sufficient to cause significant distress to the patient" (Borowitz, 2016, p.1). Additionally, up to 25% of all visits to pediatric gastroenterologists are for constipation-related complaints (Nurko & Zimmerman, 2014).
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Gene Expression Networks in the Murine Pulmonary Myocardium Provide Insight into the Pathobiology of Atrial Fibrillation
The pulmonary myocardium is a muscular coat surrounding the pulmonary and caval veins. Although its definitive physiological function is unknown, it may have a pathological role as the source of ectopic beats initiating atrial fibrillation. How the pulmonary myocardium gains pacemaker function is not clearly defined, although recent evidence indicates that changed transcriptional gene expression networks are at fault. The gene expression profile of this distinct cell type in situ was examined to investigate underlying molecular events that might contribute to atrial fibrillation. Via systems genetics a whole lung transcriptome dataset from the BXD recombinant inbred mouse resource was analysed, uncovering a pulmonary cardiomyocyte gene network of 24 transcripts, coordinately regulated by chromosome 1 and 2 loci. Promoter enrichment analysis and interrogation of publicly available ChIP-seq data suggested that transcription of this gene network may be regulated by the concerted activity of NKX2-5, serum response factor and myocyte enhancer factor 2, and also, at a post-transcriptional level by RNA binding protein motif 20. Gene ontology terms indicate that this gene network overlaps with molecular markers of the stressed heart. Therefore, we propose that perturbed regulation of this gene network might lead to altered calcium handling, myocyte growth and contractile force contributing to aberrant electrophysiological properties observed in atrial fibrillation. We reveal novel molecular interactions and pathways representing possible therapeutic targets for atrial fibrillation. In addition, we highlight the utility of recombinant inbred mouse resources in detecting and characterizing gene expression networks of relatively small populations of cells that have a pathological significance.
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An epistatic genetic architecture can have a significant impact on prediction accuracies of genomic prediction (GP) methods. Machine learning methods predict traits composed of epistatic genetic architectures more accurately than statistical methods based on additive mixed linear models. The differences between these types of GP methods suggest a diagnostic for revealing genetic architectures underlying traits of interest. In addition to genetic architecture, the performance of GP methods may be influenced by the sample size of the training population, the number of QTL, and the proportion of phenotypic variability due to genotypic variability (heritability). Possible values for these factors and the number of combinations of the factor levels that influence the performance of GP methods can be large. Thus, efficient methods for identifying combinations of factor levels that produce most accurate GPs is needed. Herein, we employ Response Surface Methods (RSMs) to find the experimental conditions that produce the most accurate GPs. We illustrate RSM with an example of simulated doubled haploid (DH) populations and identify the combination of factors that maximize the difference between prediction accuracies of best linear unbiased prediction (BLUP) and support vector machine (SVM) GP methods. The greatest impact on the response is due to the genetic architecture of the population, heritability of the trait, and the sample size. When epistasis is responsible for all of the genotypic variance and heritability is equal to one, and the sample size of the training population is large the advantage of using the SVM method versus the BLUP method is greatest. However, except for values close to the maximum, most of the response surface shows little difference between the methods. We also determined that the conditions resulting in the greatest prediction accuracy for BLUP occurred when genetic architecture consists solely of additive effects, and heritability is equal to one.
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Echocardiography and passive leg raising in the postoperative period: A prospective observational study.
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Test your knowledge on the challenges of assessing and treating children with capnography
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Gait analysis on force treadmill in children: comparison with results from ground-based force platforms.
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Blood Product Utilization Among Trauma and Nontrauma Massive Transfusion Protocols at an Urban Academic Medical Center.
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Organizational Contributors to the Variation in Red Blood Cell Transfusion Practices in Cardiac Surgery: Survey Results From the State of Michigan.
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Inflammatory Mediators and Pain in the First Year After Acute Episode of Low-Back Pain in Elderly Women: Longitudinal Data from Back Complaints in the Elders—Brazil
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Aerobic Exercise Training in Very Severe Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis
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Effectiveness of Extracorporeal Shock Wave Therapy Without Local Anesthesia in Patients With Recalcitrant Plantar Fasciitis: A Meta-Analysis of Randomized Controlled Trials
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Chronic Resistance Training Does Not Ameliorate Unloading-Induced Decrements in Neuromuscular Function
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Evaluation of an Outpatient Rehabilitative Program to Address Mobility Limitations Among Older Adults
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Nonsurgical Treatment Choices by Individuals with Lumbar Intervertebral Disc Herniation in the United States: Associations with Long-term Outcomes
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Physician Burnout in Physical Medicine and Rehabilitation (PM&R): Should We Focus More on Physiatrists' Mission?
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The Effect of Elective Rotations on the Self-assessment Examination Results of Physical Medicine and Rehabilitation Residents: Implications for Minimizing Educational Resource Disparities in Taiwan
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Ultrasound Findings of Young and Traumatic Amputees With Lower Extremity Residual Limb Pain in Turkey
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Hierarchical Linear Modeling for Analysis of Ecological Momentary Assessment Data in Physical Medicine and Rehabilitation Research
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Sockets Manufactured by CAD/CAM Method Have Positive Effects on the Quality of Life of Patients With Transtibial Amputation
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Paraplegia Following Lumbar Epidural Steroid Injection in a Patient With a Spinal Dural Arteriovenous Fistula
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Ultrasonographic and Electrophysiological Evaluation of Ulnar Nerve Instability and Snapping of the Triceps Medial Head in Healthy Subjects
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The Effect of Nebulized Glycopyrrolate on Posterior Drooling in Patients with Brain Injury: Two Cases of Different Brain Lesions
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The Effect of Different Exercise Programs on Size and Function of Deep Cervical Flexor Muscles in Patients With Chronic Nonspecific Neck Pain: A Systematic Review of Randomized Controlled Trials
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Unusual Location of Intramuscular Lipoma Presenting as an Extensor Tendon Tear: A Diagnostic Dilemma
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Requirements: NREMT, Nevada certification or ability to obtain a Nevada certification, ACLS, PALS, CPR, EVOC, PHTLS or ITLS. Rural EMS experience preferred but not required.
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ATM loss leads to synthetic lethality in BRCA1 BRCT mutant mice associated with exacerbated defects in homology-directed repair [Genetics]
BRCA1 is essential for homology-directed repair (HDR) of DNA double-strand breaks in part through antagonism of the nonhomologous end-joining factor 53BP1. The ATM kinase is involved in various aspects of DNA damage signaling and repair, but how ATM participates in HDR and genetically interacts with BRCA1 in this process is...
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MRG15-mediated tethering of PALB2 to unperturbed chromatin protects active genes from genotoxic stress [Genetics]
The partner and localiser of BRCA2 (PALB2) plays important roles in the maintenance of genome integrity and protection against cancer. Although PALB2 is commonly described as a repair factor recruited to sites of DNA breaks, recent studies provide evidence that PALB2 also associates with unperturbed chromatin. Here, we investigated the...
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Genome sequence of a diabetes-prone rodent reveals a mutation hotspot around the ParaHox gene cluster [Genetics]
The sand rat Psammomys obesus is a gerbil species native to deserts of North Africa and the Middle East, and is constrained in its ecology because high carbohydrate diets induce obesity and type II diabetes that, in extreme cases, can lead to pancreatic failure and death. We report the sequencing...
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Disruption of a horizontally transferred phytoene desaturase abolishes carotenoid accumulation and diapause in Tetranychus urticae [Genetics]
Carotenoids underlie many of the vibrant yellow, orange, and red colors in animals, and are involved in processes ranging from vision to protection from stresses. Most animals acquire carotenoids from their diets because de novo synthesis of carotenoids is primarily limited to plants and some bacteria and fungi. Recently, sequencing...
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Identifying predictors for postoperative clinical outcome in lumbar spinal stenosis patients using smart-shoe technology
Approximately 33% of the patients with lumbar spinal stenosis (LSS) who undergo surgery are not satisfied with their postoperative clinical outcomes. Therefore, identifying predictors for postoperative outcome...
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The victim's injuries were so severe that an officer was tasked with driving the ambulance while EMTs kept the 16-year-old in stable condition
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The Android phone was filmed restarting after an attempt to call for an emergency
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Health-Related Quality of Life for Women Ever Experiencing Infertility or Difficulty Staying Pregnant
Information on the health-related quality of life (HRQOL) for women with infertility is limited and does not account for the co-occurrence of chronic conditions or emotional distress.
We used data from state-added questions on reproductive health included in the 2013 Behavioral Risk Factor Surveillance System in seven states. HRQOL indicators included: self-reported health status; number of days in the past 30 days when physical and mental health was not good; number of days in the past 30 days that poor physical or mental health limited activities. We computed rate ratios for HRQOL for women ever experiencing infertility or difficulty staying pregnant compared with women never reporting these conditions; interactions with chronic conditions and depressive disorders were assessed.
Of 7,526 respondents aged 18–50 years, 387 (4.9%) reported infertility only and 339 (4.3%) reported difficulty staying pregnant only. Infertility was associated with an increase in average number of days with poor physical health for women with chronic conditions [rate ratio (RR) 1.85, 95% confidence interval (CI) 1.04–3.29] but was protective for women without chronic conditions (RR 0.47, 95% CI 0.29–0.75). Difficulty staying pregnant was associated with an increase in average number of days of limited activity among both women with chronic conditions (RR 2.14, 95% CI 1.32–3.45) and women with depressive disorders (RR 1.72 95% CI 1.14–2.62).
Many HRQOL measures were poorer for women who had infertility or difficulty staying pregnant compared to their counterparts; the association was modified by presence of chronic conditions and depressive disorders.
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Publication date: October 2017
Source:Journal of Environmental Radioactivity, Volume 177
Author(s): T.V. Rozhko, O.A. Guseynov, V.E. Guseynova, A.A. Bondar, A.N. Devyatlovskaya, N.S. Kudryasheva
Luminous marine bacteria are widely used in bioassays with luminescence intensity being a physiological parameter tested. The purpose of the study was to determine whether bacterial genetic alteration is responsible for bioluminescence kinetics change under low-dose radiation exposure. The alpha-emitting radionuclide 241Am and beta-emitting radionuclide 3H were used as the sources of low-dose ionizing radiation. Changes of bioluminescence kinetics of Photobacterium phosphoreum in solutions of 241Am(NO3)3, 7 kBq/L, and tritiated water, 100 MBq/L, were studied; bioluminescence kinetics stages (absence of effect, activation, and inhibition) were determined. Bacterial suspension was sampled at different stages of the bioluminescent kinetics; the doses accumulated by the samples were close or a little higher than a tentative limit of a low-dose interval: 0.10 and 0.85 Gy for 241Am, or 0.11 and 0.18 Gy for 3H. Sequence analysis of the 16S ribosomal RNA gene did not reveal a mutagenic effect of low-dose alpha and beta radiation in the bacterial samples. Previous results on bacterial DNA exposed to low-dose gamma radiation (0.25 Gy) were analyzed and compared to those for alpha and beta irradiation. It is concluded that bioluminescence activation and/or inhibition under the applied conditions of low-dose alpha, beta and gamma radioactive exposure is not associated with DNA mutations in the gene sequences tested.
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Radionuclide biokinetics in the Russian sturgeon and phylogenetic consistencies with cartilaginous and bony marine fishes
Publication date: October 2017
Source:Journal of Environmental Radioactivity, Volume 177
Author(s): Ross A. Jeffree, Scott J. Markich, Francois Oberhaensli, Jean-Louis Teyssie
The biokinetics of eight radionuclides (241Am, 109Cd, 134Cs, 75Se, 54Mn, 110mAg, 65Zn, 60Co) absorbed from the aquatic medium by juvenile Russian sturgeon (Acipenser gueldenstaedtii) were experimentally determined in fresh (0.42‰) and brackish (9.0‰) waters, of a similar salinity range to the Caspian Sea, and in conjunction with chemical speciation modelling. Uptake and loss rate constants were determined for each radionuclide for a 14 day exposure at each salinity and during 28 days of exposure to radionuclide-free conditions. Whole body (wet): water concentration factors (CF) achieved over 14 days for these eight radionuclides were used in a comparison with the same radionuclide CFs previously determined experimentally for six species of marine teleosts and chondrichthyans, to further test a phylogeny-based model of multi-nuclide bioaccumulation based on marine chordates. Multivariate analyses (multidimensional scaling and hierarchical clustering) identified the relative affinities among these taxa and also those radionuclides which distinguished most between them, in their differing CFs. They consistently showed that sturgeon aggregated as a group, which was also slightly differentiated with salinity. Sturgeon were distinguished from all teleosts and chondrichthyans but were more dissimilar from chondrichthyans than teleosts, in accordance with sturgeon's different periods of divergence from them in evolutionary time. Variable salinity among experiments may also cause changes in radionuclide bioaccumulation due to variations in (i) bioavailability (ii) osmolarity, and (iii) competitive inhibition of a radionuclide's bioaccumulation by its stable analogue or metabolic model. Their potentially confounding effects on these patterns of radionuclide CFs among taxa were critically evaluated for those radionuclides which discriminated most between sturgeon and teleosts or chondrichthyans. Bioavailability, osmolarity and competitive inhibition effects were identified among salinity treatments, however they were not appreciable enough to override the phylogeny-based signal. The results of this study are thus consistent with a phylogeny-based model of radionuclide bioaccumulation by marine chordates being valid for a fish species living in lower salinity regimes.
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A finite element model development for simulation of the impact of slab thickness, joints, and membranes on indoor radon concentration
Publication date: October 2017
Source:Journal of Environmental Radioactivity, Volume 177
Author(s): E. Muñoz, B. Frutos, M. Olaya, J. Sánchez
The focus of this study is broadly to define the physics involved in radon generation and transport through the soil and other materials using different parameter-estimation tools from the literature. The effect of moisture in the soil and radon transport via water in the pore space was accounted for with the application of a porosity correction coefficient. A 2D finite element model is created, which reproduces the diffusion and advection mechanisms resulting from specified boundary conditions. A comparison between the model and several analytical and numerical solutions obtained from the literature and field studies validates the model.Finally, the results demonstrate that the model can predict radon entry through different building boundary conditions, such as concrete slabs with or without joints, variable slab thicknesses and diffusion coefficients, and the use of several radon barrier membranes. Cracks in the concrete or the radon barrier membrane have been studied to understand how indoor concentration is affected by these issues.
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How do pain, fatigue, depressive, and cognitive symptoms relate to well-being and social and physical functioning in the daily lives of individuals with multiple sclerosis?
Publication date: Available online 18 July 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Anna L. Kratz, Tiffany J. Braley, Emily Foxen-Craft, Eric Scott, John Murphy, Susan L. Murphy
ObjectiveTo examine the relative association between daily change in pain, fatigue, depressed mood, and cognitive function, and four outcomes (positive affect and well-being, ability to participate in social roles and activities, upper extremity (UE) functioning, and lower extremity (LE) functioning).DesignRepeated-measures observational study including a baseline lab visit, followed by seven days of home monitoring that included ecological momentary assessment (EMA) of symptoms (pain, fatigue, depressed mood, and cognitive function) and end-of-day diary surveys of outcomes of interest. Multilevel mixed models were used to test study hypotheses.SettingGeneral community.ParticipantsAmbulatory adults (n=102) with MS recruited through [masked] and the surrounding community.InterventionsNot applicable.Main Outcome Measure(s)Customized short-forms of the Neuro-QOL Positive Affect and Well-Being, Upper Extremity Functioning, and Lower Extremity Functioning item banks and the PROMIS Ability to Participate in Social Roles and Activity item banks, adapted for daily use and administered as end-of-day diaries.ResultsAbove and beyond the effects of demographic and clinical covariates, daily pain was associated with three of the four outcomes; days of higher pain were related to lower same-day social participation (B=-1.00, p=0.002), UE functioning (B=-1.04, p=0.01), and LE functioning (B=-0.71, p=0.04). Daily fatigue and depressed mood were independently related to daily positive affect and well-being; days of worse fatigue (B=-0.54, p=0.006) and depressed mood (B=-1.17, p<0.0001) were related to lower same-day well-being.ConclusionsResults demonstrate the role of fluctuations in symptoms in daily functioning and quality of life of individuals with MS. Daily increases in pain intensity are related to social and physical functioning, whereas increases in fatigue and depressed mood is related to daily lower levels of well-being. Findings implicate a person-centered approach to monitoring and treating symptoms.
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