Effectiveness of Tocilizumab in COVID-19 patients with pneumonia: A systematic review

Background and Objective@#COVID-19 contributes significantly to global morbidity and mortality. Age-related comorbidities elevate the risk of severe cases. Studies have recently demonstrated that widely available medications, including tocilizumab (TCZ), can manage severe symptoms. However, its effectiveness is unclear, particularly among the older population. Therefore, this review aimed to evaluate TCZ’s efficacy in managing severe pneumonia in individuals aged 50 and older.@*Methods@#We systematically search several databases and gray literature including Web of Science, CINAHL, Academic Search Complete, PsycINFO, PsycArticles, SocINDEX, CENTRAL/Cochrane Library, PubMed/MEDLINE for original research articles in English across several study designs published in the year 2020-2022. A narrative synthesis was conducted to summarize the evidence. We employed the NIH quality assessment tool for observational cohort studies to evaluate risk of bias. Additionally, we utilized GRADE to appraise the certainty of evidence.@*Results@#Among 539 screened articles, only five studies met the selection criteria. Tocilizumab's impact on severe COVID-19 pneumonia revealed a diverse effect on mortality rate, with 29% in the TCZ group, and 40% in the controls died within 30 days of intubation (OR 0.61; 95% CI, 0.27-1.36). It is also reported that TCZ was not associated with mortality, despite faster decline in pulmonary function and prolonged fever. Hospital mortality in the TCZ group was significantly lower than in the controls, and age over 60 was the only significant risk factor. Moreover, administering TCZ reduced mechanical ventilation needs, with 82% extubated compared to 53% in controls. However, 45% in TCZ group was associated with a higher ventilator-associated pneumonia rate than in the untreated group which was 20% (P < 0.001). Despite this, TCZ-treated patients had shorter hospital stays.@*Conclusions@#The effects of tocilizumab on reducing mortality risk and improving the survival rate of COVID-19 patients with pneumonia remained inconclusive. Yet, the majority of results suggested that giving tocilizumab leads to shorter hospital stays, lowers the requirement for mechanical ventilation, and decreases the likelihood of ICU transfer. Tocilizumab is linked to the incidence of secondary infections; hence, this medication should be closely monitored for side effects.

Research progress on dental materials for preventing root caries / 口腔疾病防治

@#The high incidence and untreated rate of root caries, a common and frequently occurring oral disease with challenging treatment in elderly individuals, is the main cause of tooth loss among elderly people, as rapid development results in pulpitis and periapical periodontitis or residual crown and root, which has been regarded as one of the common chronic oral diseases seriously affecting the quality of life of elderly people. Thus, early intervention and prevention are important. Traditional dental materials for preventing root caries have been widely used in clinical practice; however, they have the disadvantages of tooth coloring, remineralization and low sterilization efficiency. A series of new dental materials for preventing root caries have gradually become a research hotspot recently, which have the advantages of promoting the mineralization of deep dental tissue, prolonging the action time and enhancing adhesion. Future caries prevention materials should be designed according to the characteristics of root surface caries and the application population and should be developed toward simplicity, high efficiency and low toxicity. This review describes current research regarding anti-caries prevention material application, serving as a theoretical underpinning for the research of root caries prevention materials, which is important for both promotion in the effective prevention of root caries and improvement in the status of oral health and the quality of life among old people.

Construção do nome social de pessoas trans e aspectos relacionados em um município de porte médio do Sul do Brasil / The construction behind chosen names of transgender individuals and related aspects in a medium-sized city in the South of Brazil

Resumo O trabalho analisou o processo de construção do nome social e aspectos relacionados em pessoas trans de um município de porte médio do Sul do Brasil. Foram utilizados dados qualitativos de um estudo de método misto descritivo e exploratório. Incluíram-se pessoas autodeclaradas trans com 18 anos ou mais. Foram conduzidos três grupos focais com dez participantes. Estes, com idade variando entre 19 e 52 anos, apresentam nome social documentado, porém metade ainda não fez a alteração nos registros civis. A técnica da análise de conteúdo produziu duas categorias: "construção do nome social como instrumento de validação da identidade trans" e "impactos da construção do nome social na autoaceitação e nas relações familiares e sociais". Os resultados reforçam a importância do respeito ao nome como forma de contribuição para a afirmação de gênero de sujeitos trans. O nome esteve atrelado às suas vivências, individualidades e valores. Seu uso adequado, muito mais do que o cumprimento de uma legislação, significou respeito às possibilidades diversas da existência humana. Espera-se que os resultados apresentados possam ser utilizados como ferramenta de reconhecimento acerca das questões e nuances que permeiam a construção do nome social, bem como contribuam para a validação identitária.

Abstract This study analyzed the construction process of the chosen name and related aspects among transgender individuals from a medium-sized municipality in southern Brazil. Qualitative data from a descriptive and exploratory mixed-method study was used. Self-declared trans people aged 18 or over were included. Three focus groups were conducted with ten participants. These individuals, aged between 19 and 52 years, have a documented chosen name, but half have not yet changed their civil records. The content analysis technique produced two categories: "construction of the chosen name as an instrument for validating the transgender identity" and "impacts of the construction of the chosen name on self-acceptance and on family and social relationships." The results reinforce the importance of respecting the name as a way of contributing to the gender affirmation of transgender individuals. The name was linked to the experiences, individuality and values of these individuals. Its proper use, much more than respect for legislation, meant respect for the different possibilities of human existence. It is expected that the results presented can be used as a tool for recognizing the issues and nuances that permeate the construction of the chosen name and contribute to identity validation.

Comparative analysis of asymptomatic infection prevalence in Beta, Delta, and Omicron surges of COVID-19

Abstract Background The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has had a devastating impact on the global population, with an estimated 650 million people infected and more than 6.6 million lives lost. Asymptomatic individuals have been shown to play a significant role in the transmission of the virus. Therefore, this study aims to investigate and compare the prevalence of asymptomatic individuals across three waves associated with the Beta, Delta, and Omicron variants of the virus. Methods This retrospective study was conducted between December 2020 and March 2022. The study population consisted of passengers on international flights who were referred to the Gerash Clinical and Molecular Diagnosis Laboratory. Real-time PCR was employed for the diagnosis of SARS-CoV-2. Results Out of a total of 8592 foreign travelers referred to our laboratory, 139 (1.16 %) tested positive for SARS-CoV-2 infection and were asymptomatic. During the Beta surge, 35 (1.49 %) out of 2335 passengers tested positive for SARS-CoV-2. In the Delta surge, 31 (0.6 %) out of 5127 passengers tested positive. However, during the Omicron surge, a significantly higher number of passengers, specifically 73 (6.46 %) out of 1130, had a positive result for the SARS-CoV-2 test. Conclusion Considering the significant role of asymptomatic transmission in the spread of COVID-19, it is imperative to reconsider health policies when dealing with future surges of the Omicron subvariants. Additionally, we strongly recommend that the World Health Organization prioritize the development and distribution of second-generation vaccines that target not only disease but also infection prevention.

Fatores de estresse e resiliência no acesso e utilização de serviços de saúde por travestis e mulheres transexuais no nordeste brasileiro / Stress and resilience factors in the access and utilization of health services by travestis and transgender women in northeast Brazil

Resumo O gênero é uma categoria social diretamente ligada à determinação da saúde, mas tem sido frequentemente limitado às categorias de masculino e feminino, invisibilizando demandas importantes de identidades que fogem ao binarismo, como no caso de identidade transgênero (travestis e transexuais). A teoria do estresse de minorias de gênero categoriza fatores de estresse e resiliência relevantes para explicar como as vivências ligadas ao gênero impactam de maneira desproporcional pessoas transgênero, especialmente em desfechos de saúde mental. Nesse contexto, este estudo analisa a relação entre acesso e uso de serviços de saúde e os fatores de estresse e resiliência de travestis e mulheres transexuais no interior do nordeste brasileiro. Foi conduzida uma pesquisa qualitativa em saúde: dados foram coletados por meio de entrevistas semiestruturadas com cinco mulheres trans adultas, residentes da região do Cariri, Ceará. Observou-se homogeneidade no acesso à saúde, mas todas as entrevistadas enfrentaram situações de estresse durante a utilização. Identificaram-se fatores de resiliência que levam essa população a buscar cuidados de saúde fora do sistema de saúde, devido a suas dificuldades de uso. Portanto, evidencia-se a necessidade de discutir a amplitude e o progresso do processo transexualizador e a capacidade de aplicação da Política Nacional de Saúde Integral de Lésbicas, Gays, Bissexuais e Transgêneros no âmbito do Sistema Único de Saúde no interior do nordeste brasileiro.

Abstract Gender is a social category directly linked to health determination, but it has often been constrained to the categories of male and female, obscuring significant demands from identities that go beyond this binary framework, such as transgender identities (travestis and transsexuals). Gender minority stress is a theory that categorizes stress and resilience factors relevant to explaining how gender experiences disproportionately impact transgender individuals, particularly in mental health outcomes. Given this context, this study examines the relations between user access and use of health services and the stress and resilience factors of travestis and transgender women in northeastern Brazil. A qualitative health research was conducted with data collected by means of semi-structured interviews with five adult trans women residing in the Cariri region, Ceará state. Health access was homogeneous, yet all interviewees faced stress-inducing situations during service use. Resilience factors were identified, leading this population to seek healthcare outside the state system due to use challenges. These findings highlight the need to discuss the breadth and progress of gender affirming care and the applicability of the National Policy of Comprehensive Healthcare for LGBT individuals within the Brazilian National Health System in northeastern Brazil.

Enhancing understanding of SARS-CoV-2 infection among individuals with Down syndrome: An integrative review

ABSTRACT BACKGROUND: Down syndrome (DS) is a non-rare genetic condition that affects approximately 1 in every 800 live births worldwide. Further, it is associated with comorbidities, anatomical alterations of the respiratory tract, and immunological dysfunctions that make individuals more susceptible to respiratory infections. OBJECTIVE: To systematize the current scientific knowledge about the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among individuals with DS. DESIGN AND SETTING: This integrative review was conducted at the Universidade Federal de São Carlos, São Paulo, Brazil. METHODS: This review was conducted in the following databases: the Virtual Health Library (Biblioteca Virtual em Saúde, BVS), PubMed, and Web of Science, using MeSH descriptors. The search included English or Portuguese studies published between January 1, 2020, and October 14, 2022. RESULTS: A total of 55 articles from 24 countries were selected, comprising 21 case-control or cohort studies, 23 case reports or series, and 11 narrative reviews or opinion studies. The articles were grouped into five categories: previous comorbidities, coronavirus disease 2019 (COVID-19) clinical features and evolution, cytokine storm and interleukins, living in institutions as a risk factor, and behavioral actions as a protective factor against SARS-CoV-2 infection. CONCLUSION: Individuals with DS are more susceptible to COVID-19 infection due to variables such as previous comorbidities, immunological factors, and their habitable environments. These aspects confer a higher risk of infection and an unfavorable clinical course. The precise pathways involved in the pathophysiology of COVID-19 in individuals with DS are not clear, thus requiring further studies. SYSTEMATIC REVIEW REGISTRATION: The Open Science Framework registered the research protocol (https://osf.io/jyb97/).

Anatomical Variations and Clinical Significance of the Cerebral Arterial Circle in Turkish Cadavers / Variaciones Anatómicas y Significancia Clínica del Círculo Arterial Cerebral en Cadáveres Turcos

SUMMARY: The structure formed by the arteries, which is of great importance in the irrigation of the brain, is called the cerebral arterial circle (Polygon of Willis). Since the cerebral arterial circle provides brain nutrition, vascularabnormalities in this region are highly relevant. Therefore, the aim of our study was to examine the variations of the cerebral arterial circle in cadavers of Turkish individuals. In our study, 32 human cadavers obtained from three different universities were retrospectively examined. Brain tissue obtained from cadavers by craniotomy was kept in 20 % formaldehyde solution for an average of 10 days for fixation. Cerebral arterial circle diagrams were determined in all cadavers by staining and photographs were taken. As a result of the brain examinations, a variation of the cerebral arterial circle was detected in 24/32 brains. Vascular variations have an important place in congenital variations. For this reason, we believe that our brain study will contribute to clinical studies on this topic by investigating variations of the cerebral arterial circle.

La estructura formada por las arterias que tiene una gran importancia en la irrigación del cerebro se denomina círculo arterial cerebral (Polígono de Willis). Dado que el círculo arterial cerebral proporciona la irrigación cerebral, las anomalías vasculares en esta región son muy relevantes. Por lo tanto, el objetivo de nuestro estudio fue examinar las variaciones del círculo arterial cerebral en cadáveres de individuos turcos. En nuestro estudio, se examinaron retrospectivamente 32 cadáveres humanos obtenidos de tres universidades diferentes. El tejido cerebral de los cadáveres fue obtenido por craneotomía y se mantuvo en solución de formaldehído al 20 %, durante 10 días en promedio para su fijación. Se determinaron los diagramas de círculo arterial cerebral en todos los cadáveres mediante coloración y se tomaron fotografías. Como resultado de los exámenes, se detectó una variación del círculo arterial cerebral en 24/32 de los cerebros. Las variaciones vasculares tienen un lugar importante en las variaciones congénitas. Por esta razón, creemos que nuestro estudio contribuirá a estudios clínicos sobre el tema al pesquisar las variaciones del círculo arterial cerebral.

Influência de padrões de multimorbidade nas atividades de vida diária da pessoa idosa: seguimento de nove anos do Estudo Fibra / Influence of multimorbidity patterns on the activities in the day-to-day lives of the elderly: nine-year follow-up of the Fibra Study

Resumo O objetivo foi avaliar a influência da multimorbidade e seus padrões nas atividades básicas de vida diária da pessoa idosa residente na comunidade. Trata-se de estudo de coorte com dados provenientes do Estudo FIBRA, linha de base (2008-2009) e seguimento (2016-2017). As atividades básicas de vida diária (ABVD) foram avaliadas pelo questionário de Katz e as doenças crônicas foram classificadas como (1) multimorbidade e padrões de multimorbidade: (2) cardiopulmonar; (3) vascular-metabólico; e (4) mental-musculoesquelético. Para a análise de dados, utilizou-se o teste qui-quadrado e a regressão de Poisson. Foram analisados 861 indivíduos sem limitação para ABVD na linha de base. As pessoas idosas com multimorbidade (RR = 1,58; IC95%: 1,19-2,10) e classificados nos padrões cardiopulmonar (RR = 2,43; IC95%: 1,77-3,33), vascular-metabólico (RR = 1,50; IC95%: 1,19-1,89) e mental-musculoesquelético (RR = 1,30; IC95%: 1,03-1,65) tiveram maior risco de apresentar declínio funcional nas ABVD no seguimento em comparação aos que não tinham os mesmos padrões de doenças. A multimorbidade e seus padrões aumentaram o risco de incapacidade na pessoa idosa ao longo de nove anos.

Abstract The scope of this article was to evaluate the influence of multimorbidity and associated effects on the activities in the day-to-day lives of community-dwelling elderly individuals. It involved a cohort study with data from the FIBRA Study, the baseline (2008-2009) and follow-up (2016-2017). The basic activities in daily living (ADL) were evaluated using Katz's index, and the chronic diseases were classified as: (1) multimorbidity and multimorbidity patterns; (2) cardiopulmonary; (3) vascular-metabolic; and (4) mental-musculoskeletal. The chi-square test and Poisson regression data were used for analysis. A total of 861 older adults with no functional dependency at baseline were analyzed. Elderly individuals with multimorbidity (RR = 1.58; 95%CI: 1.19-2.10) and classified according to cardiopulmonary (RR = 2.43; 95%CI: 1.77-3.33), vascular-metabolic (RR = 1.50; 95%CI: 1.19-1.89) and mental-musculoskeletal (RR = 1.30; 95%CI: 1.03-1.65) had a higher risk of presenting functional decline in ADL in the follow-up compared to those who didn't have the same disease patterns. Multimorbidity and its patterns increased the risk of functional disability in older adults over the nine-year period.

A novel study on recently discovered fatty acid taste detection threshold among young lean and overweight individuals

Background: It is likely that the sense of taste evolved to alert humans to the nutritive or poisonous nature of possible foods. This study has been undertaken to unravel and highlight a possible relationship between the fat taste threshold and obesity, especially among young population. Aims and Objectives: The aim of the study was to detect the fat taste threshold in young lean and overweight individuals and to compare the threshold in these individuals with age- and sex-matched normal individuals. Materials and Methods: The taste threshold for fat was detected in 50, normal (Body mass index [BMI] (18.5–24.9 kg/m2), lean (BMI <18.5 kg/m2), and overweight individuals (BMI of 25.0–29.9 kg/m2) of both sexes with the age between 18 and 30 years. The statistical analysis was done using Analysis of variance test. Results: Young lean individuals could detect the fatty acid taste at the lower concentration compared to overweight individuals, who detected at higher concentration (P < 0.01). Conclusion: Lean male and female showed a significant taste detection threshold for fat at low concentration compared to overweight male and female as well as with normal individual. Fatty acid taste detection is very important in day-to-day life for the disease-free life.

Identification of Variation in the Extrahepatic Arterial System of Thai Cadavers / Identificación de la Variación en el Sistema Arterial Extrahepático de Cadáveres Tailandeses

SUMMARY: Liver transplantation (LT) is the treatment of choice for decompensated liver cirrhosis. In the LT procedure, an adequate arterial supply is required for anastomosis to prevent postoperative necrosis and maintain hepatic parenchymal functions. The extrahepatic arterial system is primarily responsible for carrying oxygenated blood from the heart, 25 % of total cardiac output. Normally, the celiac trunk gives off the common hepatic artery. The common hepatic artery branches into the hepatic artery proper and supplies blood to the hepatic parenchyma. Recognizing the anatomical variations of the hepatic artery proper is essential for the planning and implementation of LT. The extrahepatic arterial variations are hard to study in live humans because of the limitations of human rights. Studying cadavers can solve this problem. This study investigates the distribution of normal, accessory, and replaced hepatic arteries proper by dissecting Thai cadavers (n = 152; males = 82 and females = 70) in the Gross Anatomy Laboratory at the Department of Anatomy, Faculty of Medicine Siriraj Hospital, Mahidol University. The cadavers were preserved in a 10 % formaldehyde solution. The exclusion criteria for liver specimens were cirrhosis, liver carcinoma, including hepatocellular carcinoma and cholangiocarcinoma, and other liver masses. Accordingly, the extrahepatic arterial system was conventionally dissected and identified at the porta hepatis. The extrahepatic arterial system was identified and documented in terms of features of normal distribution and variations, such as accessory or replaced hepatic arteries. There were 75 % normal type, 18.42 % accessory left hepatic arteries (aLHA), 1.32 % replaced left hepatic arteries (rLHA), 0.66 % accessory right hepatic arteries (aRHA), 1.32 % of replaced right hepatic arteries (rRHA), 1.97 % of aLHA and aRHA, and 1.32 % aortic type. The identification of variations in the hepatic artery system is essential to detection of distribution patterns. This knowledge is crucial for promoting LT.

El trasplante hepático (TH) es el tratamiento de elección para la cirrosis hepática descompensada. En el procedimiento de TH, se requiere un suministro arterial adecuado para la anastomosis para prevenir la necrosis postoperatoria y mantener las funciones del parénquima hepático. El sistema arterial extrahepático es el principal responsable de transportar sangre oxigenada desde el corazón, el 25 % del gasto cardíaco total. Normalmente, el tronco celíaco da origen a la arteria hepática común. La arteria hepática común se ramifica en la arteria hepática propia y suministra sangre al parénquima hepático. Reconocer las variaciones anatómicas de la arteria hepática es fundamental para la planificación e implementación del TH. Las variaciones arteriales extrahepáticas son difíciles de estudiar en humanos vivos debido a las limitaciones de los derechos humanos. El estudio de cadáveres puede resolver este problema. Este estudio investiga la distribución de las arterias hepáticas normales, accesorias y aberrantes mediante la disección de cadáveres tailandeses (n = 152; hombres = 82 y mujeres = 70) en el Laboratorio de Anatomía Macroscópica del Departamento de Anatomía, Facultad de Medicina del Hospital Siriraj, Mahidol. Los cadáveres se conservaron en una solución de formaldehído al 10 %. Los criterios de exclusión para las muestras de hígado fueron cirrosis, carcinoma hepático, incluidos el carcinoma hepatocelular y el colangiocarcinoma, y otras masas hepáticas. En consecuencia, el sistema arterial extrahepático se diseccionó e identificó convencionalmente en el hilio hepático. El sistema arterial extrahepático se identificó y documentó en términos de características de distribución normal y variaciones, como arterias hepáticas accesorias. Hubo 75 % tipo normal, 18,42 % arterias hepáticas izquierdas accesorias (aLHA), 1,32 % arterias hepáticas izquierdas aberrantes (LHAr), 0,66 % arterias hepáticas derechas accesorias (aRHA), 1,32 % arterias hepáticas derechas aberrantes (ARHr), 1,97 % de aLHA y aRHA, y 1,32 % de tipo aórtico. La identificación de variaciones en el sistema de la arteria hepática es esencial para la detección de patrones de distribución. Este conocimiento es crucial para promover LT.

PREVALENCE AND RISK FACTORS OF NON–ALCOHOLIC FATTY LIVER DISEASE IN LEAN INDIVIDUALS: A HOSPITAL BASED STUDY.

Introduction: According to epidemiological studies, NAFLD affects 9% to 53% of India's general population, with a higher frequency among those who are overweight or obese, those who have diabetes, or those who have prediabetes. There is emerging evidence of NAFLD occurring in lean or normal weight individuals. Studies show that between 5 and 34% of lean people have NAFLD. The highest prevalence rates, which were above 30%, were seen in India. Furthermore, Asian men who are slender, healthy, and active have insulin resistance prevalence that is three to four times higher than that of men in the rest of the world. Aim: To access the prevalence and risk factors of NAFLD among lean individuals attending Gauhati Medical College & Hospital with diagnosed Fatty Liver Disease. Materials and methods: A Hospital based Cross sectional study was done. The Gastroenterology department was used to choose the study participants using a purposive sampling method. The sample was made up of all patients with fatty liver disease who visited the gastroenterology outpatient department. The study found that the prevalence of NAFLD in lean individuals is Result: 16.9%. Females are at higher risk (P=0.0313 OR: 0.08316) of developing NAFLD in lean patients. Diabetes (P=0.0260 OR: 3.667) and Hypertension (P=0.0149 OR: 4.189) are significant risk factors. Altered bilirubin levels (P=0.0035 OR: 5.829), lipid profile (P=0.0013 OR: 7.367) and AST/ALT (P=0.0166 OR: 4.321) levels is also associated with NAFLD in lean individuals. NAFLD affects 16.9% of lean Conclusion: people with a BMI under 23. Among the lean population, women have a higher chance of getting NAFLD than men. In the study population, important risk factors for NAFLD include diabetes and hypertension. Patients with NAFLD (BMI <23) are more likely to have abnormal lipid profiles, AST/ALT values and bilirubin levels than non-NAFLD fatty liver patients with BMI <23.

Politización del desecho: Tránsitos políticos de lo abyecto en la racionalidad neoliberal / Politicization of Waste: Political Transits of the Abject in Neoliberal Rationality

Resumen Si queremos reconstruir la política y resistirnos a ser gobernados de esta forma por el neoliberalismo, hemos de reconocer nuestra condición precaria, nuestra finitud e, inevitablemente, la necesidad que tenemos de los otros para poder so brevivir. La salida, en consonancia con lo propuesto por Butler, es una política de alianzas que haga frente a la lógica individualizadora contemporánea que inocula la idea de que existen vidas que importan más que otras y que, por tanto, son más dignas de ser vividas y lloradas.

Abstract If we want to reconstruct politics and resist being governed by neoliberalism, in this way, we must recognize our precarious condition, our finitude and, inevi tably, the need we have for others in order to survive. The way out, in line with Butler's proposal, is a policy of alliances, which confronts the contemporary in dividualizing logic that inoculates the idea that there are lives that matter more than others and that, therefore, they are worthier of being lived and mourned.

Comparison of physical fitness and mental stress in exercising and non-exercising medical students

Background: Both physical fitness and mental fitness are essential to achieve success, especially in medical college students, where the academic pressure is high. Studies have shown that exercise helps to reduce mental stress as well as to maintain the fitness. Aims and Objectives: The present study was aimed to compare the level of physical fitness and level of mental stress in exercising and non-exercising medical students. Materials and Methods: A study was done on 60 medical students of age group of 18–20 years with 30 in the exercise group and 30 in the non-exercise group. Modified Harvard step test was used to assess physical fitness index and perceived stress scale questionnaire to assess mental stress. Descriptive analysis and independent t-test were used for statistical analysis. Results: The study demonstrated higher physical fitness (P < 0.01) and lower mental stress levels (P < 0.01) in the exercising group when compared to the non-exercising group. Conclusion: There was better physical fitness and lower mental stress levels among the exercising group when compared with the non-exercising group.

Individuals living with cancer in Turkey and the COVID-19 pandemic / Las personas que viven con cáncer en Turquía y la pandemia de COVID-19 / As pessoas que vivem com câncer na Turquia e a pandemia da COVID-19

Abstract: The aim of this study is to determine the problems faced by individuals living with cancer (ILCs) in accessing health services during the COVID-19 pandemic in Turkey. This qualitative study's sample consisted of 18 volunteer interviewees from 10 cancer-related patient associations in Turkey. Research data were collected by semi-structured interview method. Data collection and analysis were carried out simultaneously. In the sessions where all researchers participated together, the data were coded with a common view, and main and sub-themes were determined. In the analysis of the data the inductive thematic analysis method was applied. Information was gathered under two main themes: compliance with the measures taken and access to health services. Lack of information about nutrition, physical activity, psychological problems, caused by the lockdown and social distance measures taken within the scope of the pandemic should be accepted as problems within the scope of the right of individuals to access health, and additional programs should be prepared to minimize these. Cancer types should be considered in delaying diagnosis, treatment, and controls related to cancer, so that patients are not harmed at least or at all. It is important to ensure that patients do not hesitate to attend diagnosis, treatment, and controls with the anxiety of being infected with COVID-19, both in transportation to health facilities and in terms of preventing transmission in health facilities.

Resumen: El objetivo de este estudio es determinar los problemas a los que se enfrentan las personas que viven con cáncer (ILC) para acceder a los servicios sanitarios durante la pandemia de COVID-19 en Turquía. La muestra consistió en 18 entrevistados voluntarios de 10 asociaciones de pacientes relacionados con el cáncer en Turquía. Los datos de la investigación se recogieron mediante el método de la entrevista semiestructurada. La recogida y el análisis de los datos se llevaron a cabo simultáneamente. En las sesiones los datos se codificaron con una visión común y se determinaron los temas principales y los subtemas. En el análisis de los datos se aplicó el método de análisis temático inductivo. La información se recogió bajo dos temas principales: el cumplimiento de las medidas adoptadas y el acceso a los servicios sanitarios. La falta de información sobre nutrición, actividad física, problemas psicológicos, causados por el encierro y las medidas de distanciamiento social tomadas en el ámbito de la pandemia, deben ser aceptados como problemas dentro del ámbito del derecho de las personas a acceder a la salud, y se deben preparar programas adicionales para minimizarlos. Los tipos de cáncer deben tenerse en cuenta a la hora de retrasar el diagnóstico, el tratamiento y los controles relacionados, para que los pacientes no se vean perjudicados en lo más mínimo. Es importante asegurar que los pacientes no duden en acudir al diagnóstico, tratamiento y controles con la ansiedad de ser infectados con COVID-19, tanto en el transporte a los centros de salud como en la prevención de la transmisión en estos centros.

Resumo: O objetivo deste estudo é determinar os problemas enfrentados pelas pessoas que vivem com câncer (PLWC) no acesso aos serviços de saúde durante a pandemia da COVID-19 na Turquia. A amostra consistiu de 18 respondentes voluntários de 10 associações de pacientes relacionados ao câncer na Turquia. Os dados da pesquisa foram coletados usando o método de entrevista semi-estruturada. A coleta e análise de dados foram realizadas simultaneamente. Nas sessões, os dados foram codificados com uma visão comum e os principais temas e subtemas foram determinados. O método de análise temática indutiva foi aplicado na análise de dados. As informações foram coletadas sob dois temas principais: conformidade com as medidas tomadas e acesso aos serviços de saúde. A falta de informação sobre nutrição, atividade física, problemas psicológicos causados pelo confinamento e medidas de distanciamento social tomadas no contexto da pandemia deve ser aceita como problemas dentro do escopo do direito de acesso à saúde das pessoas, e programas adicionais devem ser preparados para minimizá-los. Os tipos de câncer devem ser levados em consideração ao atrasar o diagnóstico, tratamento e check-ups relacionados, para que os pacientes não fiquem em desvantagem mínima. É importante assegurar que os pacientes não hesitem em ir para diagnóstico, tratamento e check-ups com a ansiedade de serem infectados pela COVID-19, tanto no transporte para instalações de saúde quanto na prevenção da transmissão nessas instalações.

Effect of age, gender, and body mass index on peak expiratory flow rate and other pulmonary function tests in healthy individuals in the age group 18–60 years

Background: Normal ageing and increasing body mass index (BMI) are related to decline in lung functions in adults in both genders. Females are more likely than age and height-matched males to show smaller lung size and diffusion surface, lower maximal expiratory flow rate, and reduced airway diameter. Lung mechanics and respiratory muscle strength, thoracic compliance, airway resistance, and elastic recoil of the lungs determine the pulmonary function tests (PFTs), and these tests are known to differ with age, sex, socio-economic status, cultural factors, and geographical region of the subject and are related to weight, height and BMI of the individuals. Aim and Objectives: The present study is planned to assess the peak expiratory flow rate (PEFR) and other PFTs and to evaluate the effect of age, gender and BMI on these lung functions. Materials and Methods: This study consists of 200 healthy individuals of age group 18–60 years. A sample was stratified into 5 age groups, and on the basis of BMI, the subjects were categorized as underweight, normal, overweight, and obese. Anthropometric measurements were recorded using standard procedures. PEFR was recorded using Wright’s peak-flow meter and forced vital capacity (FVC), Forced Expiratory Volume in 1 s (FEV1), FEV1/FVC, FEF25–75%, FEF2–1.2, slow vital capacity (SVC), and maximum voluntary ventilation (MVV) were analyzed using Expirograph (Helios 401, RMS, India). Chi-square test was used for analysis of categorical variables. For comparison of two groups, unpaired t-test was used and to assess the relation between the variables, Pearson’s co-relation was used. One way ANOVA was used to compare the difference between the means of more than two groups and Tukey post hoc analysis was done for multiple comparisons. Results: There was highly significant difference in the mean values of PEFR and other PFTs (P < 0.000) among the 5 age groups and a significant difference between younger and older age groups. PEFR, FVC, FEV1, FEV1/FVC, FEF25–75%, FEF0.2–1.2, SVC, and MVV were negatively correlated with age (r = ?0.514, ?0.535, ?0.568, ?0.255, ?0.566, ?0.516, ?0.304, ?0.523, respectively). Females showed reduced mean values of PEFR, FVC, FEV1, FEF25–75%, FEF0.2–1.2, SVC, MVV when compared to males (P < 0.000), and the differences in the mean values were significantly high. Highly significant difference was seen in the mean values of PEFR and other PFTs among the categories of BMI (P < 0.000). The mean values of FVC, FEV1, FEV1/FVC, FEF25–75%, FEF0.2–1.2, MVV were lower among underweight compared to their mean values among individuals with normal BMI. There was negative correlation between PEFR, FVC, FEV1, FEF25–75%, FEF0.2–1.2, SVC, MVV, and BMI (r = ?0.327, ?0.254, ?0.238, ?0.269, ?0.254, ?0.236, ?0.195, respectively). Conclusions: PFTs aid in the prompt and accurate diagnosis of respiratory disorders, such as asthma, chronic obstructive pulmonary disease allowing for efficient management by encompassing a thorough understanding of the disease and exercise respiratory training regimens even in otherwise healthy individuals. The present study showed that PEFR and other PFTs decrease with advancing age and BMI and females showed reduced lung functions compared to males.

Peripheral lymphocyte subset alteration in patients with COVID-19 having differential clinical manifestations

Background & objectives: The COVID-19 disease profile in Indian patients has been found to be different from the Western world. Changes in lymphocyte compartment have been correlated with disease course, illness severity and clinical outcome. This study was aimed to assess the peripheral lymphocyte phenotype and subset distribution in patients with COVID-19 disease from India with differential clinical manifestations. Methods: Percentages of peripheral lymphocyte subsets were measured by flow cytometry in hospitalized asymptomatic (n=53), mild symptomatic (n=36), moderate and severe (n=30) patients with SARS-CoV-2 infection, recovered individuals (n=40) and uninfected controls (n=56) from Pune, Maharashtra, India. Results: Percentages of CD4+Th cells were significantly high in asymptomatic, mild symptomatic, moderate and severe patients and recovered individuals compared to controls. Percentages of Th memory (CD3+CD4+CD45RO+), Tc memory (CD3+CD8+CD45RO+) and B memory (CD19+CD27+) cells were significantly higher in the recovered group compared to both asymptomatic, mild symptomatic patient and uninfected control groups. NK cell (CD56+CD3-) percentages were comparable among moderate +severe patient and uninfected control groups. Interpretation & conclusions: The observed lower CD4+Th cells in moderate+severe group requiring oxygen support compared to asymptomatic+mild symptomatic group not requiring oxygen support could be indicative of poor prognosis. Higher Th memory, Tc memory and B memory cells in the recovered group compared to mild symptomatic patient groups might be markers of recovery from mild infection; however, it remains to be established if the persistence of any of these cells could be considered as a correlate of protection.

Chinese Consensus for Pancreatic Cancer Screening and Surveillance in High ⁃ risk Individuals (2021, Nanjing) / 胃肠病学

Pancreatic cancer is highly malignant with low 5‑year survival rate because it is hard to be diagnosed in early stage. So far, a standardized screening strategy of early pancreatic cancer has not been achieved in China. Based on updated research evidence, a total of 26 recommendations are proposed for screening aims, high ‑ risk individuals, initial screening age, follow ‑ up interval, monitoring methods and timing of operation. Chinese consensus for early pancreatic cancer screening and surveillance is finally formulated.

Additional acute effects of virtual reality head-mounted displays on balance outcomes in non-disabled individuals: a proof-of-concept study

Abstract Aim: This study aims to evaluate the additional acute effect of virtual reality (VR) head-mounted displays (HMD) when associated with balance exercises in balance outcomes in non-disabled individuals. Methods: Thirty individuals were randomized into two groups: balance exercise group (GBE; n = 15); and virtual reality + balance exercise group (GVR + BE; n = 15). The individuals were evaluated by static and dynamic balance using the tandem test (TT), single-leg stance (SLS), and Fukuda stepping test (FST). Both groups performed 30 min of balance exercises. The GVR + BE performed 8 additional minutes of virtual reality prior to balance exercises. A roller coaster application was used for the HMD. The Mann-Whitney test was used for intra-group and differences of inter-group analysis, considering a significance level of p < 0.05. Results: In the GBE group analysis, there was observed an increase of time in TT with closed eyes (p = 0.025) and SLS with closed eyes (p = 0.003). In the same way, the GVR + BE group increase TT with closed eyes (p = 0.003) and SLS with closed eyes (p = 0.002) after the intervention. In the intergroup analysis, the increase in the SLS with closed eyes was superior in the GVR + BE group when compared with GBE (p = 0.006; d = 1.67). Conclusion: The use of HMD in combination with balance exercise has an acute effect on increasing static balance in non-disabled individuals.

Norms Of Prone Plank Testing For Isometric Endurance Assessment In Indian Healthy College Aged Individuals - An Observational Cross Sectional Study

Background:Assessment of Musculoskeletal performance is crucial to analyze for development and improvement of required goals and reducing risk of injuries. Isometric endurance assessment of core, as a part of this analysis is often done with techniques that are valid. Objective: To develop normative percentile separated by genderof hold time of prone plank in Indian college aged individuals, investigate effect of habitual physical activity along with reason for test termination and effect of BMI with hold time of testing. Material And Methods:206 individuals meeting the inclusion criteria performed the prone plank test as long as they can and time was noted. Result:Males produced significantly longer test duration than females and BMI is inversely proportional to hold time. Conclusion:These normative percentiles for abdominal endurance suggest that the abdominal plank test can now be used as an alternative to other abdominal assessments in Indian college students.

Cardiovascular risk factors and major depressive disorder: a cross-sectional study in São Paulo, Brazil

ABSTRACT BACKGROUND: Cardiovascular risk factors can mediate the association between depression and cardiovascular diseases. OBJECTIVE: To evaluate cardiovascular risk factors in adult individuals with and without histories of major depression in the metropolitan region of São Paulo, Brazil. DESIGN AND SETTING: Cross-sectional study in São Paulo (SP), Brazil. METHODS: This study evaluated 423 individuals without any lifetime diagnosis of major depression and 203 individuals with a previous diagnosis of major depression (n = 626). The participants underwent a psychiatric evaluation using a structured clinical interview (SCID-1), an anthropometric evaluation and a clinical evaluation that included blood pressure measurement and assessment of fasting blood glucose, lipid profile and physical activity levels. RESULTS: Individuals with histories of major depression were more likely to be female (P < 0.0001). Individuals with lifetime diagnoses of major depression were more likely to be current smokers (odds ratio, OR 1.61; 95% confidence interval, CI 1.01-2.59) and to have diabetes (OR 1.79; 95% CI 1.01-3.21); and less likely to be obese (OR 0.58; 95% CI 0.35-0.94). CONCLUSION: Individuals with major depression had higher odds of presenting tobacco smoking and diabetes, and lower odds of being obese. Healthcare professionals need to be aware of this, so as to increase the rates of diagnosis and treatment in this population.