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Purpose: To find out the mean rate of progression (MROP) of visual fields (VF) in patients with primary open?angle glaucoma (POAG) and ocular hypertension (OHT) using FORUM® Glaucoma Workplace. Methods: Two hundred and one eyes of 105 patients were included in this prospective cohort study. Patients with POAG and OHT were recruited, and VF analysis with 24?2 and or 10?2 was done using SITA standard strategy in Zeiss Humphrey Visual Field Analyzer (HFA). All the previous VFs were identified from FORUM software, and the baseline indices were recorded from the first reliable VF analysis. The present VF analysis was compared to the previous one using FORUM software, and the rate of progression (ROP) in VF was obtained by Guided Progression Analysis. Results: MROP of VF in the POAG group was ? 0.085 dB/ year, ranging from ?2.8 to 2.8 dB/year with a standard deviation (SD) of 0.69. In the OHT group, the MROP of VF was ?0.003 dB/year, ranging from ? 0.8 to 0.5 dB/year with an SD of 0.27. The MROP of VF in medically treated eyes with POAG was ?0.14 dB/year with an SD of 0.61 and in surgically treated eyes was ?0.02 dB/year with an SD of 0.78. The overall baseline mean VF index (VFI) was 83.19% and the final mean VFI was 79.80%. There was a statistically significant decrease in the mean VFI value from baseline to the final visit (P?value 0.0005). Conclusion: The mean ROP of VF in the POAG group was ?0.085 dB/year and in the OHT group was ? 0.003 dB/year
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Background: The prevalence of hyperglycemia first detected during pregnancy is showing an escalating increase in recent years contributed by the increasing obesity prevalence, advanced maternal age at delivery, and the universal screening protocol during the first antenatal visit. There exists a very little data on the role of HbA1c in pregnancy and the results remain inconsistent. There is a need to define diagnostic criteria to predict the adverse perinatal outcomes in gestational diabetes mellitus (GDM). Aims and Objectives: This study was aimed to assess the role of HbA1c as a prognostic indicator of third trimester mean blood glucose in GDM pregnancies and in predicting the birth of large for gestational age (LGA) babies. Materials and Methods: 200 pregnant women with GDM and 200 pregnant women without GDM and their neonates participated in this analytical cross-sectional study. Maternal age, height, weight, BMI, and neonatal birth weight were recorded. Third trimester maternal HbA1c level was analyzed by high-performance liquid chromatography. The association between HbA1c and LGA births was analyzed. Results: The mean HbA1c levels and percentage of LGA births were high in GDM group. Multiple logistic regression analysis showed association between high HbA1c values and LGA births in GDM. A Receiver operating characteristic curve was drawn to derive the optimal cut-off value, sensitivity, and specificity of HbA1c in predicting birth of LGA neonates in GDM. Conclusion: This study shows that high third trimester HbA1c levels in GDM increase the risk of LGA births. Further studies are needed to define standard cut-off values of glycated Hb in each trimester of pregnancy.
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Background & objectives: One of the most common problems experienced by breast cancer survivors (BCSs) is fatigue. There has been little research about the status of hormones in breast cancer patients as an aetiology of cancer-related fatigue (CRF). Hence, a pilot study was conducted to assess the levels of hormones such as thyroid, cortisol, dehydroepiandrosterone sulphate (DHEAS), oestrogen and progesterone in BCSs with fatigue. Methods: BCSs with complaints of fatigue were assessed using the Brief Fatigue Inventory (BFI) tool and evaluation of the hormone profiles was done in moderate-to-severe fatigued survivors. Data collected were analyzed to look for any association between fatigue and altered hormonal levels. Results: In this study, 56 per cent (n=62) of survivors experienced moderate-to-severe fatigue out of 110 patients reporting fatigue. Thyroid functions were deranged in 22 patients (35.48%). The thyroid stimulating hormone (TSH) levels were found to have a significant negative association with the severity of fatigue, (P<0.05). Twelve patients (19.35%) had reduced DHEAS levels suggestive of impaired hormone synthesis in the adrenal gland. Twenty two postmenopausal survivors (35.48%) had raised oestradiol levels. Interpretation & conclusions: The findings of this study suggest that the hormonal milieu, especially thyroid hormone and DHEAS may have a role in CRF experienced by BCSs and needs further exploration.
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Aims: To evaluate the effectiveness of low pressure carbon dioxide as a hurdle in raw milk storage. Study Design: Milk samples were stored at under low pressure carbon dioxide at 29°C for 6 hours and the microbial quality of milk was compared with control milk. Place and Duration of Study: Department of Dairy Microbiology, Verghese Kurien Institute of Dairy and Food Technology (VKIDFT), Kerala Veterinary and Animal Sciences University, Mannuthy between January 2020 and December 2020. Methodology: Milk samples were collected from an organized farm. The initial microbial quality of milk was determined and samples were carbonated to a pressure of 20 psi and stored for six hours 29°C, uncarbonated milk sample kept at 29°C acted as the control. The microbial quality of the carbonated milk and uncarbonated milk was determined after storage in terms of total viable count, coliform count and gram negative organism count. Results: Significant growth suppression (P=0.05) of bacteria was observed in the carbonated milk. Total Viable count showed a suppression of 1.05 log cfu/ml while coliforms showed a suppression of 1.3 log cfu/ml. The greatest log reduction was observed in gram negative organisms with a difference of 2.2 log cfu/ml and psychrotrophic organisms with 1.54 log cfu/ml. Conclusion: Carbon dioxide was found to be an effective bacteriostatic agent which could be used for extending the keeping quality of raw milk. The bacteriostatic action could be due to anaerobic conditions developed by carbon dioxide and also due to the increased acidity of the medium.
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Aims: This study evaluated the physical, chemical and rheological properties of exopolysaccharides (EPSs) produced by Lactic Acid Bacteria (LAB) isolated from palm wine. Materials and Methods: EPSs from palm wine LAB strains were produced on 6% sucrose broth, purified and freeze-dried prior to analyses. Molecular weights (MW), rheological and structural composition (functional groups) of the EPSs were determined using standard methods and Fourier transform infrared spectroscopy (FTIR). Results: The average MW of the EPSs ranged from 2.02×106 to 6.53×106 Da while the flow index (n) values ranged from 0.03-3.13 at 0.2%, 0.06-1.51 at 0.4%, 0.38 - 1.85 at 0.6%, 0.14 - 2.26 at 0.8% and 0.55 - 6.42 at 1% concentrations at elevated temperatures for EPS solutions from the ten LAB species. The FTIR spectrum revealed prominent peaks of various groups of OH (3420 cm-1) and CH3 bending (2090 cm-1) in all the EPSs corresponding to both hydroxyl and amine groups, and aliphatic C-H bonds, respectively. EPS synthesized by Leuconostoc lactis, Lactococcus lactis subsp lactis and Lactiplantibacillus plantarum showed weak absorption peaks (1148 – 1145 cm-1) indicating the C-O-C and C-O bonds, while absorption peaks of Lactobacillus lactis, Lactobacillus acidophilus and Lactiplantibacillus plantarum (1267 – 1253 cm-1) indicated O- acetyl ester and other non-sugar components. Conclusions: The FTIR spectra, rheological properties and molecular weight of EPSs synthesized by the ten LAB strains indicated potentials that could be exploited in different industrial applications, and as stabilizers in food industries
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The article is devoted to the study of lipids and fatty acid composition of the above-ground part of the Nepeta olgae Regel (L.) plant of the Laminaceae family. It was found that the content of neutral lipids (NL) is 5.54%, PL - 6.12%, and total lipids (NL, PL) - 11.66%. Of the neutral lipids, the unsaponifiable substances (HB) had a bright yellow color, which is explained by a small amount of carotenoids (88.87 mg%). Glycolipids dominate in PL. Among the unsaponifiable substances were found biologically active components such as hydrocarbons, carotenoids, aliphatic alcohols, sterols and triterpenols. Phytosterols were the main component of unsaponifiable NS. Quantitative and qualitative analysis of fatty acids from the plant Nepeta olgae Regel (L.) was carried out by gas chromatography (GC). 28 acids were identified, of which 11 compounds are saturated, and 7 compounds are unsaturated fatty acids. Of the fatty acids, the main ones are linolenic 18:3 (35.48), palmitic 16:0 (33.38%), as well as ?-3 polyunsaturated fatty acids, including eicosanoic 20:1, cis-11,14-eicosadienoic 20:2, 8,11,14-eicosatriene 20:3 + arachidonic 20:4. Extracts of Nepeta olgae Regel (L.) were distinguished by a high content of polyunsaturated acids, which determines their potential biological activity.
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This article for the first time presents the results of the study of qualitative and quantitative elemental and amino acid composition of the aboveground part of the plant Nepeta olgae Regel (L.) taken in the territory of Chust and Kosonsai districts (from the slopes of Gova and Kosonsai mountains) of Namangan region during the period before and during flowering (May-June, 2021-2022). The use of instrumental analysis of high-throughput energy dispersive X-ray fluorescence spectrometry, allowed to establish 20 mineral elements in the plant Nepeta olgae Regel (L.), among which to vital 9 elements and 3 to conditionally necessary. The amino acid composition of the plant Nepeta olgae Regel (L.) was studied by high performance liquid chromatography (HPLC) and 17 compounds were identified. Of these, 8 were substitutable and 9 essential amino acids.
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Objectives@#Although it is difficult to define the quality of stroke care, acute ischemic stroke (AIS) patients with moderate-to-severe neurological deficits may benefit from thrombectomy-capable hospitals (TCHs) that have a stroke unit, stroke specialists, and a substantial endovascular thrombectomy (EVT) case volume. @*Methods@#From national audit data collected between 2013 and 2016, potential EVT candidates arriving within 24 hours with a baseline National Institutes of Health Stroke Scale score ≥6 were identified. Hospitals were classified as TCHs (≥15 EVT case/y, stroke unit, and stroke specialists), primary stroke hospitals (PSHs) without EVT (PSHs-without-EVT, 0 case/y), and PSHs-with-EVT. Thirty-day and 1-year case-fatality rates (CFRs) were analyzed using random intercept multilevel logistic regression. @*Results@#Out of 35 004 AIS patients, 7954 (22.7%) EVT candidates were included in this study. The average 30-day CFR was 16.3% in PSHs-without-EVT, 14.8% in PSHs-with-EVT, and 11.0% in TCHs. The average 1-year CFR was 37.5% in PSHs-without-EVT, 31.3% in PSHs-with-EVT, and 26.2% in TCHs. In TCHs, a significant reduction was not found in the 30-day CFR (odds ratio [OR], 0.92; 95% confidence interval [CI], 0.76 to 1.12), but was found in the 1-year CFR (OR, 0.84; 95% CI, 0.73 to 0.96). @*Conclusions@#The 1-year CFR was significantly reduced when EVT candidates were treated at TCHs. TCHs are not defined based solely on the number of EVTs, but also based on the presence of a stroke unit and stroke specialists. This supports the need for TCH certification in Korea and suggests that annual EVT case volume could be used to qualify TCHs.
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Among several fruits, mangaba (Hancornia speciosa Gomes), it aroused the interest of producers and consumers due to its attractive sensory characteristics and health beneficial properties (high nutritional value and presence of bioactive substances), thus, this work evaluates the nutritional factors of the flour residue of mangaba processing that is despised by the food industry, and the influence of temperature on its production. The mangaba processing residue was splited in two main groups: in natura sample (control), and other for preparation of flour that was dried at 50 °C and divided into two other groups: treatment A (flour with roasts at 110 °C and 130 °C) and treatment B (flour from drying at 50 °C). The nutritional characteristics of flours were analyzed considering the chemical parameters: pH, titratable total acidity and soluble solids, in addition to the determination of moisture content, total lipids, total dietary fiber and ash, total energy value, antioxidant activity, phytochemical screening, quantification of phenolic compounds and flavonoids, as well as technological functional properties (water absorption index (WAI), water solubility index (WSI), milk absorption index (MAI) and milk solubility index (MSI) and oil absorption index (OAI). The results showed that the bioactive compounds present in the extracts do not have significant properties of acting as free radical kidnappers. The heat treatment, performed in the flour of mangaba processing residues, influenced the nutritional factors and properties of absorption and solubility, which showed statistical differences. These results show that the flour is a viable alternative for the energy enrichment of diets, contributing to the development of new products, the reduction of the disposal of these residues and consequently to the minimization of the environmental impact.
Dentre as diversas frutas a mangaba (Hancornia speciosa Gomes), despertou interesse de produtores e consumidores devido às suas características sensoriais atrativas e propriedades benéficas à saúde (elevado valor nutricional e presença de substâncias bioativas), assim, o trabalho avaliar os fatores nutricionais do resíduo da farinha de processamento de mangaba que é desprezado pela indústria alimentícia e, a influência da temperatura na sua produção. O resíduo de processamento da mangaba foi dividido em dois lotes, sendo um deles utilizado para as análises in natura (amostra controle) e o outro para a confecção da farinha que foi seca a 50 °C, e dividida em dois lotes: tratamento A (farinha com torras a 110 °C e 130 °C) e no tratamento B (farinha oriunda da secagem a 50 °C). Analisou-se as características nutricionais de farinhas considerando os parâmetros químicos: pH, acidez total titulável e sólidos solúveis, além da determinação do teor de umidade, lipídios totais, fibra alimentar total e cinzas, valor energético total, atividade antioxidante, triagem fitoquímica, quantificação de compostos fenólicos e flavonoides, bem como as propriedades funcionais tecnológicas (índice de absorção de água (IAA), índice de solubilidade em água (ISA), índice de absorção de leite (IAL) e índice de solubilidade em leite (ISL) e índice de absorção de óleo (IAO). Na análise foi inferido que os compostos bioativos presentes nos extratos não possuem propriedades significativas de agir como sequestradores de radicais livres. O tratamento térmico, realizado na farinha de resíduos de processamento de mangaba, influenciou nos dados dos fatores nutricionais e das propriedades de absorção e solubilidade, os quais apresentaram diferenças estatísticas. Estes resultados credenciam a farinha como uma alternativa viável para o enriquecimento energético de dietas, contribuindo para o desenvolvimento de [...].
Subject(s)
Apocynaceae/chemistry , Identity and Quality Standard for Products and Services , GarbageABSTRACT
Abstract Among several fruits, mangaba (Hancornia speciosa Gomes), it aroused the interest of producers and consumers due to its attractive sensory characteristics and health beneficial properties (high nutritional value and presence of bioactive substances), thus, this work evaluates the nutritional factors of the flour residue of mangaba processing that is despised by the food industry, and the influence of temperature on its production. The mangaba processing residue was splited in two main groups: in natura sample (control), and other for preparation of flour that was dried at 50 °C and divided into two other groups: treatment A (flour with roasts at 110 °C and 130 °C) and treatment B (flour from drying at 50 °C). The nutritional characteristics of flours were analyzed considering the chemical parameters: pH, titratable total acidity and soluble solids, in addition to the determination of moisture content, total lipids, total dietary fiber and ash, total energy value, antioxidant activity, phytochemical screening, quantification of phenolic compounds and flavonoids, as well as technological functional properties (water absorption index (WAI), water solubility index (WSI), milk absorption index (MAI) and milk solubility index (MSI) and oil absorption index (OAI). The results showed that the bioactive compounds present in the extracts do not have significant properties of acting as free radical kidnappers. The heat treatment, performed in the flour of mangaba processing residues, influenced the nutritional factors and properties of absorption and solubility, which showed statistical differences. These results show that the flour is a viable alternative for the energy enrichment of diets, contributing to the development of new products, the reduction of the disposal of these residues and consequently to the minimization of the environmental impact.
Resumo Dentre as diversas frutas a mangaba (Hancornia speciosa Gomes), despertou interesse de produtores e consumidores devido às suas características sensoriais atrativas e propriedades benéficas à saúde (elevado valor nutricional e presença de substâncias bioativas), assim, o trabalho avaliar os fatores nutricionais do resíduo da farinha de processamento de mangaba que é desprezado pela indústria alimentícia e, a influência da temperatura na sua produção. O resíduo de processamento da mangaba foi dividido em dois lotes, sendo um deles utilizado para as análises in natura (amostra controle) e o outro para a confecção da farinha que foi seca a 50 °C, e dividida em dois lotes: tratamento A (farinha com torras a 110 °C e 130 °C) e no tratamento B (farinha oriunda da secagem a 50 °C). Analisou-se as características nutricionais de farinhas considerando os parâmetros químicos: pH, acidez total titulável e sólidos solúveis, além da determinação do teor de umidade, lipídios totais, fibra alimentar total e cinzas, valor energético total, atividade antioxidante, triagem fitoquímica, quantificação de compostos fenólicos e flavonoides, bem como as propriedades funcionais tecnológicas (índice de absorção de água (IAA), índice de solubilidade em água (ISA), índice de absorção de leite (IAL) e índice de solubilidade em leite (ISL) e índice de absorção de óleo (IAO). Na análise foi inferido que os compostos bioativos presentes nos extratos não possuem propriedades significativas de agir como sequestradores de radicais livres. O tratamento térmico, realizado na farinha de resíduos de processamento de mangaba, influenciou nos dados dos fatores nutricionais e das propriedades de absorção e solubilidade, os quais apresentaram diferenças estatísticas. Estes resultados credenciam a farinha como uma alternativa viável para o enriquecimento energético de dietas, contribuindo para o desenvolvimento de novos produtos, a redução do descarte desses resíduos e consequentemente para a minimização do impacto ambiental.
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Abstract Among several fruits, mangaba (Hancornia speciosa Gomes), it aroused the interest of producers and consumers due to its attractive sensory characteristics and health beneficial properties (high nutritional value and presence of bioactive substances), thus, this work evaluates the nutritional factors of the flour residue of mangaba processing that is despised by the food industry, and the influence of temperature on its production. The mangaba processing residue was splited in two main groups: in natura sample (control), and other for preparation of flour that was dried at 50 °C and divided into two other groups: treatment A (flour with roasts at 110 °C and 130 °C) and treatment B (flour from drying at 50 °C). The nutritional characteristics of flours were analyzed considering the chemical parameters: pH, titratable total acidity and soluble solids, in addition to the determination of moisture content, total lipids, total dietary fiber and ash, total energy value, antioxidant activity, phytochemical screening, quantification of phenolic compounds and flavonoids, as well as technological functional properties (water absorption index (WAI), water solubility index (WSI), milk absorption index (MAI) and milk solubility index (MSI) and oil absorption index (OAI). The results showed that the bioactive compounds present in the extracts do not have significant properties of acting as free radical kidnappers. The heat treatment, performed in the flour of mangaba processing residues, influenced the nutritional factors and properties of absorption and solubility, which showed statistical differences. These results show that the flour is a viable alternative for the energy enrichment of diets, contributing to the development of new products, the reduction of the disposal of these residues and consequently to the minimization of the environmental impact.
Resumo Dentre as diversas frutas a mangaba (Hancornia speciosa Gomes), despertou interesse de produtores e consumidores devido às suas características sensoriais atrativas e propriedades benéficas à saúde (elevado valor nutricional e presença de substâncias bioativas), assim, o trabalho avaliar os fatores nutricionais do resíduo da farinha de processamento de mangaba que é desprezado pela indústria alimentícia e, a influência da temperatura na sua produção. O resíduo de processamento da mangaba foi dividido em dois lotes, sendo um deles utilizado para as análises in natura (amostra controle) e o outro para a confecção da farinha que foi seca a 50 °C, e dividida em dois lotes: tratamento A (farinha com torras a 110 °C e 130 °C) e no tratamento B (farinha oriunda da secagem a 50 °C). Analisou-se as características nutricionais de farinhas considerando os parâmetros químicos: pH, acidez total titulável e sólidos solúveis, além da determinação do teor de umidade, lipídios totais, fibra alimentar total e cinzas, valor energético total, atividade antioxidante, triagem fitoquímica, quantificação de compostos fenólicos e flavonoides, bem como as propriedades funcionais tecnológicas (índice de absorção de água (IAA), índice de solubilidade em água (ISA), índice de absorção de leite (IAL) e índice de solubilidade em leite (ISL) e índice de absorção de óleo (IAO). Na análise foi inferido que os compostos bioativos presentes nos extratos não possuem propriedades significativas de agir como sequestradores de radicais livres. O tratamento térmico, realizado na farinha de resíduos de processamento de mangaba, influenciou nos dados dos fatores nutricionais e das propriedades de absorção e solubilidade, os quais apresentaram diferenças estatísticas. Estes resultados credenciam a farinha como uma alternativa viável para o enriquecimento energético de dietas, contribuindo para o desenvolvimento de novos produtos, a redução do descarte desses resíduos e consequentemente para a minimização do impacto ambiental.
Subject(s)
Dietary Fiber/analysis , Flour/analysis , Fruit/chemistry , Antioxidants/analysis , Nutritive ValueABSTRACT
Plastination is a technique used to preserve biological tissues while retaining most of their original appearance. In the technique, developed by Dr. Gunther von Hagens in 1977, specimens were impregnated with a polymer, such as silicone, epoxy, or polyester. Considered the most suitable material for brain plastination, polyester has a wide application in teaching and research compared with imaging techniques. The materials for plastination are usually imported from Germany and more expensive than domestic products. If domestic polymers were to enter the market it would favor the expansion of plastination in Brazil. Hence, this study evaluated the feasibility of using domestic polyesters to replace the usual Biodur® (P40) in plastination of brain slices. For this evaluation, 2-mm-thick sections of bovine brains were prepared and plastinated with domestic polyester. Slices were compared before impregnation and after curing using standardized photographs taken after dehydration and after curing. Plastination followed the standard protocol: fixation, dehydration, forced impregnation, and curing. Fifteen brain slices were plastinated with each polyester (P40, P18, and C1-3). There was no significant difference in the percent shrinkage between groups after plastination of P18 and P40, but the curing time of Cristalan© polymer was too short for impregnation. Therefore, no initiator was used for C polymers impregnation. Thus, domestic polyester P18 was a viable option for the process.
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ABSTRACT Objectives. To assess the accumulated knowledge of the effects of public health emergencies of international concern on disease control and local health systems, and contribute to a better understanding of their effects on health programs and systems. Methods. This was a systematic review of published and gray literature (in English, Portuguese, or Spanish). Electronic databases (BVS/LILACS, PubMed, and SciELO) and Google Scholar were searched. Search terms were: COVID-19 OR H1N1 OR Ebola OR Zika OR poliomyelitis AND (outbreaks OR epidemics) AND (public health systems OR public health surveillance). Results. A total of 3 508 studies were retrieved, of which 31 met the inclusion criteria. The studies addressed the effects of the emergencies on: communicable diseases notification systems; malaria, HIV/AIDS, tuberculosis, poliomyelitis, and malaria surveillance, control, and treatment; microcephaly; dengue; and vaccinations. The populations affected by the emergencies experienced reduced health services, which included fewer health visits, failures in the diagnostic chain, decrease in vaccination, and increased incidence or underreporting of notifiable diseases. Conclusions. Socioeconomic inequity is a determinant of the effects of public health emergencies of international concern within affected populations. The diversion of resources and attention from health authorities disproportionately affects vulnerable populations and can lead, over time, to a weakening of health systems. The analysis of the effects of public health emergencies is important for the development of new protocols that can better respond to future crises.
RESUMEN Objetivos. Evaluar el conocimiento acumulado acerca de los efectos de las emergencias de salud pública de importancia internacional en el control de enfermedades y en los sistemas de salud locales, y contribuir a una mejor comprensión de estos efectos en los programas y sistemas de salud. Métodos. Se hizo una revisión sistemática de bibliografía gris y publicada (en español, inglés o portugués) para la que se realizaron búsquedas en bases de datos electrónicas (BVS/LILACS, PubMed y SciELO) y en Google Scholar. Los términos de búsqueda fueron: COVID-19 OR H1N1 OR Ebola OR Zika OR poliomyelitis AND (Outbreaks OR epidemics) AND (public health systems OR public health surveillance). Resultados. Se encontraron 3 508 estudios, de los cuales 31 cumplieron los criterios de inclusión. En los estudios se abordaban los efectos de las emergencias en: los sistemas de notificación de enfermedades transmisibles; la vigilancia, el control y el tratamiento de la malaria, el VIH/sida, la tuberculosis y la poliomielitis; la microcefalia; el dengue; y las vacunas. Las poblaciones afectadas por las emergencias experimentaron una reducción de los servicios de salud, incluida una reducción de las consultas de salud, errores en la cadena de diagnóstico, una disminución de la vacunación y el aumento de la incidencia o subnotificación de enfermedades de notificación obligatoria. Conclusiones. La inequidad socioeconómica es un determinante de los efectos de las emergencias de salud pública de importancia internacional en los grupos poblacionales afectados. El desvío de recursos y atención de las autoridades de salud afecta desproporcionadamente a los grupos vulnerables y puede suponer, con el tiempo, un debilitamiento de los sistemas de salud. El análisis de los efectos de las emergencias de salud pública es crucial para la elaboración de nuevos protocolos que puedan mejorar la respuesta ante futuras crisis.
RESUMO Objetivos. Avaliar o conhecimento acumulado sobre os efeitos das emergências de saúde pública de importância internacional no controle de doenças e nos sistemas de saúde locais e contribuir para uma melhor compreensão desses efeitos sobre os programas e sistemas de saúde. Métodos. Trata-se de uma revisão sistemática da literatura branca e cinzenta (em inglês, português ou espanhol) realizada por meio de pesquisas nos bancos de dados eletrônicos BVS/LILACS, PubMed e SciELO e no Google Scholar. Foram utilizados os seguintes termos de busca: COVID-19 OR H1N1 OR Ebola OR Zika OR poliomyelitis AND (outbreaks OR epidemics) AND (public health systems OR public health surveillance). Resultados. Foi identificado um total de 3 508 estudos, dos quais 31 preencheram os critérios de inclusão. Os estudos abordavam os efeitos das emergências sobre: sistemas de notificação de doenças transmissíveis; vigilância, controle e tratamento de HIV/AIDS, tuberculose, poliomielite e malária; microcefalia; dengue; e vacinações. As populações afetadas pelas emergências enfrentaram uma redução nos serviços de saúde, como menos consultas médicas, problemas na cadeia de diagnóstico, diminuição da vacinação e maior incidência ou subnotificação de doenças de notificação compulsória. Conclusões. A desigualdade socioeconômica é um fator determinante dos efeitos das emergências de saúde pública de importância internacional nas populações afetadas. O desvio dos recursos e da atenção das autoridades sanitárias afeta desproporcionalmente as populações vulneráveis e pode levar, com o passar do tempo, a um enfraquecimento dos sistemas de saúde. A análise dos efeitos das emergências de saúde pública é importante para a elaboração de novos protocolos que possam enfrentar melhor futuras crises.
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Chemotherapy is one of the most widely used treatments for breast cancer (BC). However, there is evidence of side effects like cognitive changes related to the chemotherapy treatment. The aim of the study was not only to summarize the existing evidence on the relationship between chemotherapy and cognitive performance in women with BC but also to identify additional consequences and aspects associated with these impairments. We conducted a systematic review with meta-analysis and meta-regression to present updated information on the matter. We retrieved data from the databases PubMed, Web of Science, PsycINFO, CINAHL, and Scopus. Twenty studies comprising over 2,500 women were examined and the results indicated that chemotherapy can compromise cognition in women with BC (-1.10 OR [95%CI: -1.81 to -0.74], P<0.01), with working memory (-0.49 OR [95%CI: -0.85 to -0.13], P=0.03) being the most affected among the domains. Furthermore, additional data indicated that cognitive impairment is most likely amid women with BC having a lower education level (Q=4.85, P=0.02). Our results suggested that chemotherapy affects cognitive functions in women with BC, and certain characteristics can worsen the deterioration. A comprehensive study of women with breast cancer and existing predictors contributes to optimized personal journeys, elevated life prospects, and advanced care that can also aid prognosis and therapeutic approaches.
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The cardioprotective effect of postmenopausal hormone replacement therapy (HRT) has been demonstrated in several studies. Similarly, physical exercise has yielded positive results. However, the effects of their combination remain inconclusive. This review describes the combined effects of physical exercise and hormone therapy on cardiovascular and metabolic health in postmenopausal women. We searched the Scopus, Web of Science, PubMed, and Embase databases and included randomized controlled trials published up to December 2021 on the combined effects of physical exercise and hormone therapy on cardiovascular and metabolic health in postmenopausal women. We identified 148 articles, of which only seven met the inclusion criteria (386 participants; 91 [23%] HRT + exercise; 104 [27%] HRT; 103 [27%] exercise; 88 [23%] placebo). The combined treatment further decreased systolic blood pressure (SBP) compared to the isolated effect of aerobic training (AT) (mean difference [MD]=-1.69; 95% confidence interval [CI]=-2.65 to -0.72, n=73). Nevertheless, it attenuated the decrease in diastolic blood pressure (DBP) (MD=0.78; 95%CI: 0.22-1.35, n=73), and the increase in peak oxygen consumption (VO2 peak) promoted by exercise (AT + HRT=2.8±1.4 vs AT + placebo=5.8±3.4, P=0.02). The combination of AT and oral HRT improved SBP. However, AT alone seemed to have a better effect on physical fitness and DBP in postmenopausal women.
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Background: Secondary trauma is trauma experienced by those in close contact with the victims of trauma. Research shows that some individuals exposed to photographs or video presentations of traumatic events may experience secondary trauma. This includes administrative staff within the South African Police Service (SAPS), who work with trauma dockets. Objectives: We explored the effects of secondary trauma on administrative support staff within the SAPS, their access to psychological support in the SAPS, and their use of the employee health and wellness (EHW) services in the SAPS. Methods: An exploratory qualitative study was conducted among administrative support staff from one of the four Johannesburg clusters of the SAPS. In-depth interviews took place with seven staff members. The data were analysed using Atlas.ti. Results: Administrative support staff are exposed to trauma through incident dockets, victim statements, and gruesome images. The study participants indicated that they experienced trauma daily, and symptoms of trauma such as flashbacks, anxiety, sadness, nightmares, paranoia, avoidance, recurrent thoughts, and fear of death. They were overprotective of their loved ones and paranoid. They were not utilising the EHW services due to lack of access to appropriate services, or the stigma attached to seeking help from mental health professionals. Conclusion: The SAPS needs to develop and implement a strategy to mitigate the impact of secondary trauma on its personnel, which include administrative support staff. Evidence-based interventions, such as resilience training, should be considered as part of the strategy
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Wounds and Injuries , Mental Health , Compassion FatigueABSTRACT
Background@#Elevated pulmonary serum adenosine deaminase (ADA) levels signify lung tissue damage and severe tuberculosis (TB). Serum ADA assays can be used as an additional criterion for assessing TB treatment response and as a prognostic marker in patients with pulmonary TB. The Bandim TB and Karnofsky Performance Scale (KPS) scores were developed based on available clinical data and investigations to allow physicians to evaluate disease treatment and response. This study examined the use of a clinical scoring system (Bandim TB and KPS scores) in the context of serum ADA activity. @*Methods@#Forty adults (aged >18 years) diagnosed with pulmonary TB by Ziehl-Neelsen staining for acid-fast bacilli and/or cartridge-based nucleic acid amplification test were recruited. Standardized questionnaires were used to record Bandim TB and KPS scores. Serum ADA levels were estimated using a commercial kit. @*Results@#The Bandim TB score was positively associated (ρ=0.74, P≤0.001) and the KPS score was negatively associated (ρ=-0.69, P≤0.001) with serum ADA levels. @*Conclusion@#Subjective and objective clinical scores of pulmonary TB were strongly correlated with serum ADA levels. Knowledge of clinical scores corresponding to serum ADA levels could help physicians understand stage and progression of the disease which may aid in early detection and better management, and reduce disease transmission in a TB-endemic country.
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Introduction: Predictive markers enabling Pediatricians to iden?fy which neonates will develop jaundice have mandatory for preven?on of severe hyperbilirubinemia. We aim to determine the cri?cal cord bilirubin and albumin levels and bilirubin/albumin ra?o. Design: This prospec?ve study included131fulltermnewborns. Hyperbilirubinemia can be predicted by Measuring cord bilirubin , albumin and bilirubin/albumin ra?o. Results: Neonatal hyperbilirubinemia (67.8%) had cord albumin level less than or equal to 2.7gm/dl. CordBilirubin/albumin ra?o cutoff value greater than 0.62 had a good predic?ve value with a sensi?vity of 100% and specificity of 88.36%, Conclusion: neonatal hyperbilirubinemia predictors are Cord BILIRUBIN/ALBUMIN ra?o , serum bilirubin and albumin.
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The word Prathishyaya indicates recurrent attack and can participate due to minute etiological factors. Prathishyaya can occur as a separate disease entity or symptoms of many systemic diseases or as a complication of other diseases. Prathishyaya if not treated well in early stage and Ahara-Vihara which are harmful for the disease is continued, it leads to a more complicated stage of Prathishyaya i.e., Dusta Prathishyaya. Virechana Nasya which is recommended in Urdwajatrugata Vikaras is indicated in Prathishyaya. For Virechana Nasya- Madhu, Saindhava, Asava, Pitta, Mutra etc drugs has been mentioned by Acharya Vagbhata. So, Asava is prepared by Shirovirechana Gana Dravya as a Prakshepaka Dravyas which possess Katu, Tiktha, Madhura rasa, Laghu and Teekshna Guna, Ushna Veerya, Katu Vipaka and Vata-Kapha shamaka predominantly, which may help in pacify Dusta Prathishyaya. Materials and Methods: A single group study was undertaken in which, 30 patients of Dusta Prathishyaya were randomly selected and were subjected to Asava Nasya - 4 Bindu (2ml) each nostril for 7 days. The patients were assessed with severity of symptoms subjectively and objectively before and after treatment. Data obtained was statistically analysed. Result and Discussion: In overall effect of treatment in Dusta Prathishyaya, out of 30 patients, 3 patients (10%) got moderate improvement, 23 patients (76.6%) got marked improvement and 4 patients (13.33%) got significant improvement. In overall effect of treatment, statistical analysis showed that the mean score which was 6.86 in before treatment was reduced to 4.81 in after treatment and further reduced to 1.86 in follow up, and there is a statistically significant change (P<0.001). Conclusion: The present study showed highly significant results in which the symptoms like Nasa Srava, Nasa Avarodha, Gandha Agnyana, Shirashoola and Shiro Gaurava got reduced and it indicates that the therapeutic effects is mainly achieved by the efficacy of Shirovirechana Gana Dravya Siddha Asava Nasya in Dusta Prathishyaya w.s.r to Chronic Sinusitis.