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Objective:The determine the prevalence of stillbirth and identify associated factors among parturients in a faith-based secondary health centre.Method:This was a retrospective audit of two hundred and twenty-five stillbirth deliveries at the Our Lady of Apostle Catholic Hospital at Oluyoro, OkeOffainIbadan, Nigeria,betweenstst1January2010, and 31December, 2015. Data was extractedfromhospitalrecordsforsociodemographiccharacteristics, obstetricfactors,complications, and outcomes of pregnancy. Data analysis was done using SPSS version 20 and the level of statistical significance was set at p < 0.05. Results:The stillbirth rate was 27.75 per 1000 births. More than half (129; 57.4%) were macerated. The ratio of still birth rate among the booked and unbooked parturients was 1:21. The commoncausesofstillbirthswerehypertensivedisordersinpregnancy (24.9%), anaemia in pregnancy (20.4%); while the least were congenital anomalies (1.0%) and gestational diabetes mellitus (1.0%Conclusion: This study confirmed that most of the stillbirths were due to unsupervised or poorly supervised pregnancies. There is need to ensure quality antenatal care services for the early detection and management of risk factors in order to reduce the burden of stillbirths.
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Humans , Delivery of Health Care , Clinical Audit , Child Mortality , StillbirthABSTRACT
Communities and countries and ultimately the world are only as strong as the health of their women." - Michelle Obama, 2016 On 24 June 2022, the Supreme Court of the United States (SCOTUS) decided on Dobbs v Jackson Women's Health Center, overturning the historic Roe v. Wade decision that has, since 1973, confirmed and enshrined the constitutional right of a woman to seek an abortion1 . Restrictions to legal, safe abortions are known to have serious repercussions for maternal and infant health. Evidence shows that restricting access to abortion does not reduce the number of abortions; it only makes abortion less safe and more likely to lead to preventable complications, including maternal death. Conversely, expanding access to safe, legal abortiona common medical procedure that carries very little risk when performed by a trained provider in an appropriate environmentis associated with improved maternal health outcomes. Further, illegal abortion results in negative societal outcomes, including chronic morbidity for the individual woman; economic burdens to women and their communities when they cannot work or finish school; and added stress to families, communities, and already over-stretched public health systems.
Subject(s)
Cold Temperature , Abortion , Women , Reproductive Health , Infant Health , Public Health SystemsABSTRACT
OBJECTIVES@#Renal cancer is a common malignancy of the urinary system, and the partial nephrectomy is a common surgical modality for early renal cancer. 3D printing technology can create a visual three-dimensional model by using 3D digital models of the patient's imaging data. With this model, surgeons can perform preoperative assessment to clarify the location, depth, and blood supply of the tumor, which helps to develop preoperative plans and achieve better surgical outcomes. In this study, the R.E.N.A.L scoring system was used to stratify patients with renal tumors and to explore the clinical application value of 3D printing technology in laparoscopic partial nephrectomy.@*METHODS@#A total of 114 renal cancer patients who received laparoscopic partial nephrectomy in Xiangya Hospital from June 2019 to December 2020 were enrolled. The patients were assigned into an experimental group (n=52) and a control group (n=62) according to whether 3D printing technology was performed, and the differences in perioperative parameters between the 2 groups were compared. Thirty-nine patients were assigned into a low-complexity group (4-6 points), 32 into a moderate-complexity group (7-9 points), and 43 into a high-complexity group (10-12 points) according to R.E.N.A.L score, and the differences in perioperative parameters between the experimental group and the control group in each score group were compared.@*RESULTS@#The experimental group had shorter operative time, renal ischemia time, and postoperative hospital stay (all P<0.05), less intraoperative blood loss (P=0.047), and smaller postoperative blood creatinine change (P=0.032) compared with the control group. In the low-complexity group, there were no statistically significant differences between the experimental group and the control group in operation time, renal ischemia time, intraoperative blood loss, postoperative blood creatinine changes, and postoperative hospital stay (all P>0.05). In the moderate- and high- complexity groups, the experimental group had shorter operative time, renal ischemia time, and postoperative hospital stay (P<0.05 or P<0.001), less intraoperative blood loss (P=0.022 and P<0.001, respectively), and smaller postoperative blood creatinine changes (P<0.05 and P<0.001, respectively) compared with the control group.@*CONCLUSIONS@#Compared with renal tumor patients with R.E.N.A.L score<7, renal cancer patients with R.E.N.A.L score≥7 may benefit more from 3D printing assessment before undergoing partial nephrectomy.
Subject(s)
Female , Humans , Male , Blood Loss, Surgical , Creatinine , Ischemia , Kidney Neoplasms/surgery , Laparoscopy/methods , Nephrectomy/methods , Printing, Three-Dimensional , Retrospective Studies , Treatment OutcomeABSTRACT
Fundamento: actualmente se aprecia un incremento del consumo de bebidas alcohólicas en adolescentes, lo cual puede convertirse en un importante problema de salud.Objetivo: describir el consumo de bebidas alcohólicas en adolescentes.Métodos: estudio descriptivo realizado de enero 2014 a enero del 2015, en el área IV de salud del Municipio Cienfuegos, que incluyó 315 adolescentes seleccionados mediante muestreo aleatorio simple. Se analizaron las siguientes variables: edad, sexo, consumo de alcohol, edad de inicio al consumo de alcohol, primera bebida alcohólica que consumió, frecuencia del consumo, lugar donde consume, si ha sufrido de estado de embriaguez y sensación experimentada, consumo de alcohol por los familiares con los que convive y por amigos o compañeros de colegio, información sobre de los efectos indeseables del alcohol y quién le proporcionó la información. Resultados: todos los adolescentes refirieron que consumen bebidas alcohólicas; el 58, 4 % lo inició con la ingestión de cerveza; el 22 % consume una vez por semana; el 88, 9 % lo hace en bares, discotecas y lugares públicos; 50, 5 % de los consumidores son fumadores y el 73, 6 % refirió a la familia como fuente para obtener información sobre consumo de alcohol. La edad de inicio del consumo en general es entre los 14 y 16 años, con un inicio más temprano en el sexo femenino. Casi la totalidad refirió consumo de alcohol por familiares, se presentó una relación casi similar por amigos o compañeros de la escuela y la totalidad conocen los efectos indeseables del alcohol. Conclusiones: el consumo de bebidas alcohólicas en adolescentes constituye un problema de salud en el territorio.
Foundation: There is currently an increase in the consumption of alcoholic beverages in adolescents, which can become an important health problem. Objective: To describe alcoholic beverages consumption in adolescents. Method: A descriptive study conducted from January 2014 to January 2015, in Area of health IVof the Cienfuegos Municipality, which included 315 adolescents selected through simple random sampling. The following variables were analyzed: age, sex, alcohol consumption, age of onset of alcohol consumption, first alcoholic beverage consumed, frequency of consumption, place of consumption, if experienced drunkenness and experienced sensation, alcohol consumption by relatives with whom he lives and by friends or schoolmates, information on the undesirable effects of alcohol and who provided the information. Results: All adolescents reported consuming alcoholic beverages; 58, 4% started it with the ingestion of beer; 22% consume once a week; 88, 9% do it in bars, discos and public places; 50, 5% of consumers are smokers and 73, 6% referred to the family as a source for information on alcohol consumption. The age of onset of consumption in general is between 14 and 16 years, with an earlier onset in the female sex. Almost all referred alcohol consumption by relatives, showed a near similar relationship by friends or school friends and the whole know the undesirable effects of alcohol. Conclusion: Alcoholic beverage consumption is a health problem in the Territory.
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La modalidad de educación a distancia por medio de plataformas gestoras, al ser un entorno pedagógico con sus particularidades, requiere de la incorporación de los supuestos teóricos del aprendizaje desarrollador. El objetivo del presente trabajo es analizar la inclusión educativa en el contexto de la educación a distancia, con énfasis en el uso de determinados mediadores como vía pedagógica de solución a esta problemática. Sobre las bases teóricas del aprendizaje desarrollador y las concepciones epistemológicas de los mediadores en el proceso de enseñanza aprendizaje, se desarrollan esquemas sobre la didáctica de los mediadores, elementos fundamentales para garantizar una educación inclusiva en la modalidad de educación a distancia.
The mode of distance education through management platforms, being a pedagogical environment with its particularities, requires the incorporation of the theoretical assumptions of developing learning. The objective of the present work is to analyze educational inclusion in the context of distance education, with emphasis on the use of certain mediators as a pedagogical way of solving this problem. On the theoretical bases of the developing learning and the mediators´ epistemological conceptions in the process of teaching learning, schemes are developed on mediators´ didactics, fundamental elements to guarantee an inclusive education in the modality of distance education.
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La influencia e impacto de los programas educativos en los estilos de vida y particularmente en la salud está reconocido por la literatura, sin embargo, son pocos los estudios que lo sistematizan. Con el objetivo de evaluar la efectividad de las intervenciones educativas se realizó esta revisión sistemática siguiendo las directrices PRISMA. Los artículos para ser incluidos se identificaron a través de las bases de datos MEDLINE, LILACS y EMBASE durante los meses de enero a mayo de 2016. Se seleccionaron 24 artículos. El total de sujetos participantes en los estudios evaluados fue de 3 426 y el 58 % fueron no mayores de 17 años. Se constata que este tipo de programa constituye un recurso adecuado para lograr cambios en los estilos de vida, particularmente en las edades tempranas, de igual manera se destaca que aquellas intervenciones que cuentan con el vínculo familiar son altamente efectivas.
The influence and impact of life style educational programs and in particular in health has been recognized by literature, however, studies which systematize it are limited. With the objective of assessing the effectiveness of educational interventions a systematic review was done following Prisma Guidelines. Articles to be included were identified by MEDLINE, LILACS and EMBASE Database between January and May 2016. Twenty four articles were selected. The total subjects participating in the assessed studies was 3 426 and 58% were younger than 17 years. It was corroborated that this kind of program is a suitable resource to produce lifestyle changes, particularly in early ages, so as it is emphasized that interventions involving the family are highly effective.
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Objective T o observe and analyze the confirm ed cases of paternity testing, and to explore the m utation rules of ST R loci. Methods T he m utant ST R loci w ere screened from 20723 confirm ed cases of paternity testing by G oldeneye 20A system .T he m utation rates, and the sources, fragm ent length, steps and increased or decreased repeat sequences of m utant alleles w ere counted for the analysis of the characteristics of m utation-related factors. Results A total of 548 m utations w ere found on 19 ST R loci, and 557 m utation events w ere observed. T he loci m utation rate w as 0.07‰-2.23‰. T he ratio of pater-nal to m aternal m utant events w as 3.06:1. O ne step m utation w as the m ain m utation, and the num ber of the increased repeat sequences w as alm ost the sam e as the decreased repeat sequences. T he repeat se-quences w ere m ore likely to decrease in tw o steps m utation and above. M utation m ainly occurred in the m edium allele, and the num ber of the increased repeat sequences w as alm ost the sam e as the decreased repeat sequences. In long allele m utations, the decreased repeat sequences w ere significantly m ore than the increased repeat sequences. T he num ber of the increased repeat sequences w as alm ost the sam e as the decreased repeat sequences in paternal m utation, w hile the decreased repeat sequences w ere m ore than the increased in m aternal m utation. Conclusion T here are significant differences in the m utation rate of each locus. W hen one or tw o loci do not conform to the genetic law , other detection system should be added, and PI value should be calculated com bined w ith the inform ation of the m utate ST R loci in order to further clarify the identification opinions.
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T A R D N A-binding dom ain protein 43 (T D P-43) is a highly conserved and w idely expressed nuclear protein. N ow adays, the expression of T D P-43 can be found in m ost neurodegenerative diseases such as A lzheim er's disease, w hich m akes it becom e a neurodegenerative disease associated m arker pro-tein. From the current research status at hom eland and abroad, and around the relationship betw een the expression of T D P-43 and brain injury, this article em phatically probes into the specific expression and function of T D P-43 in acute and chronic brain injury based on the know ledge of its biological charac-teristics, w hich aim s to explore the feasibility for determ ining the cause of death and the injury and dis-ability situations by T D P-43 in forensic pathology.
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A s an im portant part of epigenetic m arker, D N A m ethylation involves in the gene regulation and attracts a w ide spread attention in biological auxology, geratology and oncology fields. In forensic science, because of the relative stable, heritable, abundant, and age-related characteristics, D N A m ethyla-tion is considered to be a useful com plem ent to the classic genetic m arkers for age-prediction, tissue-identification, and m onozygotic tw ins' discrim ination. V arious m ethods for D N A m ethylation detection have been validated based on m ethylation sensitive restriction endonuclease, bisulfite m odification and m ethylation-C pG binding protein. In recent years, it is reported that the third generation sequencing m ethod can be used to detect D N A m ethylation. T his paper aim s to m ake a review on the detection m ethod of D N A m ethylation and its applications in forensic science.
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U nder hypoxia condition, m icroR N A (m iR N A ) can interact w ith transcription factors for regu-lating the cell m etabolism , angiogenesis, erythropoiesis, cellular proliferation, differentiation and apoptosis. T he biological processes above m ay play an im portant role in m echanical asphyxia death. T his article re-view s the regulating function of m iR N A under hypoxia condition and the influence of hypoxia to biosynthesis of m iR N A , w hich m ay provide som e new ideas to the research of m iR N A on determ ining the cause of m echanical asphyxia death in the field of forensic m edicine.
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Background: Aspiration of enlarged lymph node is commonly done. Although open biopsy with histopathological examination of tissue still remains the gold standard yet F.N.A.C. is an integral part of initial diagnosis. Objective: To highlight the role of F.N.A.C. in the diagnosis of etiological profile of lymphadenopathy and to find out the accuracy of F.N.A.C. in comparison to histopathological diagnosis. Methods: The prospective study was done for two years. The results of lymph node F.N.A.C. were compared and evaluated taking histopathology as gold standard. Results: Cervical lymph node were most commonly involved. Most common cause of lymphadenopathy in children was reactive hyperplasia and tuberculosis in adults.Conclusion: The sensitivity and diagnostic accuracy of F.N.A.C. results were high when compared with histopathological findings.
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RNA has received m ore attention in the field of forensic m edicine and the developm ent of the new biological m arkers based on RNA show s great significance in the analysis of com plex cases. circular RNA (circRNA ) is a kind of non-coding RNA w hich is w idely reported recently. A lthough the regulatory m echanism s of generation and expression are not fully clear, the existing research indicates that circRNA has im portant biological functions. C ircRNA has a cell-type-specific expression w ith great stability and a high expression level, w hich m akes it m eaningful in forensic applications potentially. In this paper, the research progress, the generation and regulation of circRNA as w ell as its biological characteristics and functions are sum m arized, w hich w ill provide references for related studies and foren-sic applications.
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Objective To com pare the concentration of teeth DNA extracted by three different pretreatm ent m ethods and to explore a sim ple, econom ical and practical pretreatm ent m ethod w ith high concentration of extracted DNA from teeth. Methods A total num ber of 21 m olars w ere collected from 7 corpses. The pretreatm ent of 3 m olars from each individual w as random ly perform ed by tooth crum b m ethod, ball-m illing m ethod and liquid nitrogen m illing m ethod and 50 m g tooth crum b w as w eight and DNA w as extracted by A utoM ate ExpressTM forensic DNA extraction system . Subsequently, the concentration of DNA and corresponding STR genotyping of three m ethods w ere com pared. Results The DNA concentration extracted by tooth crum b m ethod, ball-m illing m ethod and liquid nitrogen m illing m ethod w as 0.055 6-1.989 1 ng/μL , 0.036 6-1.175 6 ng/μL and 0.037 8-1.249 0 ng/μL , respectively. The DNA concentration ob-tained by tooth crum b m ethod w as higher (P<0.05) and the success rate of STR genotyping w as high. Conclusion C om bined w ith A utoM ate ExpressTM forensic DNA extraction system , tooth crum b m ethod is an efficient and feasible m ethod to extract DNA from teeth, w hich can be applied in forensic practice.
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Objective To com pare and explore the application value of diatom nitric acid digestion method and plankton 16S rDNA PCR method for drow ning identification. Methods Forty drow ning cases from 2010 to 2011 were collected from Department of Forensic Medicine of Wenzhou Medical University. Sam ples including lung, kidney, liver and field water fromeach case were tested with diatom nitric acid digestion method and plankton 16S rDNAPCR method, respectively. The Diatom nitric acid digestion method and plankton 16S rDNAPCR method required 20 gand 2g of each organ,and 15 mL and 1.5 mL of field water, respectively. The inspection time and detection rate were com pared between the two methods. Results Diatom nitric acid digestion method m ainly detected two species of diatom s, Centriae and Pennatae, while plankton 16S rDNA PCR method am plified a length of 162 bp band. The average inspection time of each case of the Diatom nitric acid digestion method was (95.30±2.78) min less than (325.33±14.18)min of plankton 16S rDNA PCR method (P<0.05).The detection rates of two methods for field water and lung were both 100% . For liver and kidney, the detection rate of plankton 16S rDNA PCR method was both 80% , higher than 40% and 30% of diatom nitric acid digestion method (P<0.05), respectively. Conclusion The laboratory testing method needs to be appropriately selected according to the specific circum stances in the forensic appraisal of drow ning. Com pared with diatom nitric acid digestion method, plankton 16S rDNA PCR method has practice values with such advantages as less quantity of sam ples, huge inform ation and high specificity.
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Este artigo aborda os estudos de uma pesquisa e intervenção realizada em uma sala de aula com alunos da 7ª série de uma escola pública de São Paulo. Estes jovens, amantes do ritmo e da poesia, são descendentes de famílias afro-brasileiras e indígenas Pankararu, oriundas do sertão de Pernambuco, que se alojaram em São Paulo, a partir da década de 50, período desenvolvimentista, servindo como mão-de-obra da construção civil paulistana. Apesar de conhecida, a história desta comunidade não se revelou integrada à cultura escolar - cuja tendência parecia ser a de negar a herança afro-indígena nordestina do corpo discente. Neste sentido, o objetivo do estudo foi investigar e propiciar, pela via poético-musical dos jovens, formas de interlocução com este passado recente.
This article is based in a research and intervention with seventh grade students in a classroom at a public school in Sao Paulo. These rhythm and poetry young lovers descend from Afro-Brazilian and Pankararu indian families who came from the countryside of Pernambuco and settled down in Sao Paulo after the 1950s (developmental phase) to work as civil construction workers. We observed that this history wasn't proven integrated to the school culture - the tendency of which seemed to deny the students are Northeastern Afro-Indian descendent. Therefore, the objective of this study was not only to investigate but also to provide the students with ways to dialogue with their recent past by means of their poetic-musical manners.
Este artículo aborda el estudio y la investigación de intervenciones realizadas en un aula con alumnos de séptimo grado en una escuela pública de São Paulo. Estos jóvenes amantes del ritmo y la poesía, son descendientes de familias afro-brasileñas y Pankararu indígenas, procedentes del interior de Pernambuco, que se quedó en São Paulo, a partir de los años 50, período de desarrollo, sirviendo como mano de obra São Paulo de obra civil de la construcción. Se observó que la historia no estaba integrados en la cultura escolar - la tendencia parecía ser a negar la herencia de los estudiantes del noreste de África y la India. En este sentido, el objetivo del estudio fue investigar y proporcionar, a través de político-musical para los jõvenes, las formas de diálogo con el pasado reciente.
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Humans , Male , Female , Child , Anthropology, Cultural , Ethnicity , Schools , Poetry as TopicABSTRACT
ObjectiveTo study the risk factors of renal artery pseudoaneurysm (RAP) following partial nephrectomy.MethodsOpen partial nephrectomy was performed on a total of 464 cases of renal cell cancer from July 2003 to May 2010. Five patients ( 1.1％ ) had postoperative hemorrhage from RAP.The surgery technique of the open partial nephrectomy, the clinical presentation, imaging findings and treatment of RAP were reviewed. The anatomical characteristics of these five renal tumors on enhanced CT were quantified using the R.E.N.A.L. Nephrometry Score System.ResultsAll five cases were male, two had tumors on the left side and three on the right side. Median tumor size was 3.6 cm ( range from 2.5 to 5 cm; Radius score 1 - 2). Four tumors were exophytic of these, three had a major endophytic component (≥50％) deep in the parenchyma (Exophytic/endophytic score 2 ), one was entirely endophytic (score 3 ). The distance of all the tumors to the collecting system was ≤4 mm ( Nearness score 3 ). Four of the five tumors were across the polar line and/or renal axial midline ( Location score 3 ). The other tumor was located under the lower pole ( Location score 1 ) but close to the renal hilar. All patients presented with delayed gross haematuria and decreasing hemoglobin occurred on mean postoperative day 12 (3 -23 day). Four patients complained of flank pain, two of which had signs of hypovolemia requiring blood transfusion. The diagnosis was confirmed by the contrast medium-enhanced CT and selective angiography, and RAP was found most commonly arising from the segmental branch of renal artery. Superselective microcoil angioembolization was successfully performed in four cases, once in three cases and twice in the remaining case. The procedure failed in one patient and a nephrectomy was done. At a mean follow-up of 21 months (12 -30) , all patients had normal renal function without evidence of recurrence.ConclusionsRAP should be considered in all patients who had delayed hematuria after partial nephrectomy. A central, deep tumor and its relationship to the segmental branch of renal artery could be an important risk factor for this complication. Choosing the case properly for partial nephrectomy and suturing the transected vessels and the defect of parenchymal correctly could reduce occurrence of this serious complication. Early use of selective angioembolization could be a primary choice of treatment.