Impact of COVID-19 public health responses on income, food security and health services among key and vulnerable women in South Africa

Globally, COVID-19 has impacted lives and livelihoods. Women living with HIV and/or at high risk of acquiring HIV are socially and economically vulnerable. Less is known of the impact of COVID-19 public health responses on women from key and vulnerable populations. The purpose of this cross-sectional survey conducted in four South African provinces with a high burden of HIV and COVID-19 from September to November 2021 was to advance understanding of the socio-economic and health care access impact of COVID-19 on women living with HIV or at high risk of acquiring HIV. A total of 2 812 women >15 years old completed the survey. Approximately 31% reported a decrease in income since the start of the pandemic, and 43% an increase in food insecurity. Among those accessing health services, 37% and 36% reported that COVID-19 had impacted their access to HIV and family planning services respectively. Economic and service disruptions were enhanced by living in informal housing, urbanisation and being in the Western Cape. Food insecurity was increased by being a migrant, having fewer people contributing to the household, having children and experience of gender-based violence. Family planning service disruptions were greater for sex workers and having fewer people contributing to the household. These differentiated impacts on income, food security, access to HIV and family planning services were mediated by age, housing, social cohesion, employment and household income, highlighting the need for improved structural and systemic interventions to reduce the vulnerability of women living with HIV or at high risk of acquiring HIV.

Influence of Circadian Rhythm Disruptions on Exercise Endurance, Blood Pressure and Heart Rate after Exercise in Rats / 中国康复理论与实践

Objective To observe the influence of circadian rhythm disruptions on exercise capability in rats. Methods A total of 30 spontaneously hypertensive rats (SHR) and age and weight matched homologous normal blood pressure WKY rats were randomly divided into normal circadian rhythm group (control group), twelve hours cir-cadian rhythm disruption group (observation group 1), six hours circadian rhythm disruption group (observation group 2). Each group included ten SHR rats and WKY rats, changing the light/dark time to construct circadian rhythm disruption model. Exercise endurance, blood pressure and heart rate after exhaustion were measured be-fore and one, two and three months after modeling. Results The interaction of time and circadian rhythm was significant on the exhaustion time of SHR rats (F=2.409, P=0.047). After three months of modeling, the exhaustion time of the control group was more than that of the obser-vation groups 1 and 2 (F=4.290, P=0.032). The interaction of time and circadian rhythm was not significant on the exhaustion time of WKY rats (F=0.717, P=0.638), there was no significant difference in the exhaustion time among groups (P>0.05). For SHR rats, after three months of modeling, the systolic pressure, diastolic pressure and mean arterial pressure after exhaustion of the observation group 1 were higher than those of the control group and the observation group 2 (P<0.05), the heart rate of the observation groups 1 and 2 was higher than that of the control group (P<0.05). But there was no significant difference in the systolic pressure, diastolic pressure, average arterial pressure and heart rate of WKY rats among groups (P>0.05). Conclusion Circadian rhythm disruptions can reduce the exercise endurance of SHR rats, which may be related to the cardiovascular function impairment.

Anomalías congénitas / Congenital anomalies

Las anomalías congénitas en conjunto con la restricción del crecimiento intrauterino dan cuenta del 50 a 60 por ciento de la mortalidad fetal. En este artículo se describen las malformaciones congénitas más importantes divididas por sistemas, la mayoría son diagnosticables a través del ultrasonido; sin embargo, hay un grupo de ellas que no son posibles de diagnosticar, otras que se desarrollan tardíamente en el embarazo y finalmente existen casos en que el examen ultrasonográfico puede sugerir una anormalidad inexistente. También se profundiza en la incidencia, etiología y factores de riesgo de las malformaciones congénitas, se describe la importancia y características del diagnóstico prenatal y de la prevención por medio de la suplementación de ácido fólico en la dieta.

Congenital anomalies in conjunction with intrauterine growth restriction account for 50-60 percent of fetal mortality. This article describes major birth defects by systems; most can be diagnosed by ultrasound while others cannot. Some anomalies develop later in pregnancy and in some cases sonographic examination may suggest the presence of a nonexistent abnormality. Incidence, etiology and risk factors of congenital malformations are described, as well as the importance and characteristics of prenatal diagnosis and prevention through folic acid supplementation in the diet.

El efecto de los agroquímicos en la espermatogénesis / The effect of the agrochemicals in the spermatogenesis

Se relacionó la exposición ocupacional a agroquímicos con parámetros seminales vinculados con la espermatogénesis. En 104 muestras seminales de pacientes con infertilidad idiopática y 20 a 45 años de edad del Servicio de Reproducción Hospital Centenario (Rosario, Argentina), se efectuó espermograma y estudios funcionales según normas OMS (1999). Se agruparon en G1 (n=42) trabajadores expuestos a agroquímicos y G2 (n=62) hombres sin riesgo espermatogénico. La concentración espermática se determinó en cámara de Neubauer, con Papanicolaou se evaluó la concentración de células germinales y la morfología espermática. Se observó en concentración espermática (espermatozoides.10(6)/ml) G1: 21,1±7,1; G2: 41,6±9,2; morfología ( por ciento espermatozoides normales) G1: 5,2±1,3; G2: 8,2±3,6 y células germinales.10(6)/ml en G1: 0,91±0,51; G2: 0,32±0,21. La concentración espermática fue menor en G1, las alteraciones morfológicas y células germinales mayores en G1. Estos resultados indican que la exposición a agroquímicos altera la espermatogénesis y es un factor a considerar cuando se estudia infertilidad masculina.

The occupational exposition to agrochemicals was related with sperm parameters linked with spermatogenesis. In 104 semen samples of patients with idiopatic infertility of the Reproduction Service of Centenario Hospital (Rosario, Argentina), sperm study and functional tests according to WHO (1999) have been carried out. Two groups were formed: G1 (n=42) workers exposed to agrochemicals; G2 (n=62) men with no spermatogenic risk. The sperm concentration was determined in Neubauer camera, the concentration of germinal cells and the sperm morphology were evaluated with Papanicolaou. The results were: sperm concentration (spermatozoids 10(6)/ml) G1: 21.1 ± 7.1; G2: 41.6 ± 9.2; morphology ( percent normal spermatozoids) G1: 5.2 ± 1.3; G2: 8.2 ± 3.6; and germinal cells 10(6)/ml in G1: 0.91 ± 0.51; G2: 0.32 ± 0.21. The sperm concentration was lower in G1, major morphological changes and germinal cells in G1. This results show that the exposition to agrochemicals alters the spermatogenesis, it is a factor to consider in the male infertility.

The treatment of the fissuration of pancreatojejunal stoma by the bridge-crossing internal drainage / 中华内分泌外科杂志

Objective The purpose of this study was to discuss the therapies for hemorrage caused by the fissuration of pancreatojejunal stoma and pancreatic leakage after pancreatoduodenectomy.Methods After three cases of pancreatoduodenectomy,the disruptions of pancreatojejunal stoma resulted in serious pancreatic leakage and the hemorrage in abdominal cavity.During all the second operations,the drainage-tube insertions into the main pancreatic ducts were used to lead the pancreatic juice into the neighboring loop of jejunum.Results Afer the operations,the supportive treatment,continuous irrigation of peritoneal cavity and pancreatic enzyme inhabition were given to the patients of these cases and all of the patients were successfully cured.Conclusions The bridge-crossing internal drainage which inserts drainage-tube into the main pancreatic duct was a convenient and effective therapy and method to rescue the hemorrage caused by the fissuration of pancreatojejunal stoma and pancreatic leakage after pancreatoduodenectomy.While the patients' lives were saved,their functions of pancreas were preserved and the qualities of life were improved after the operations.