Evaluation of quality of life and physical activity in patients with type 1 diabetes mellitus during the COVID-19 pandemic

Abstract Objective: The aim of the study is to compare the quality of life, physical activity, anxiety, depression, fear of hypoglycemia, loneliness perception in patients with type 1 diabetes mellitus and controls. Subjects and methods: Forty-four patients and 63 controls were included in this cross-sectional study. Quality of life (Short Form 36-SF-36), physical activity level (International Physical Activity Questionnaire-short form), anxiety and depression (Hospital Anxiety and Depression Scale), fear of hypoglycemia (Hypoglycemia Fear Survey), loneliness perception (UCLA Loneliness Scale) were evaluated. Results: Physical role limitations and general health perception subscale scores of SF-36 questionnaire in patients were significantly lower than the controls (p < 0.05). Conclusion: Role limitations due to physical problems and fear of hypoglycemia are increased, and general health perception is impaired in patients with type 1 diabetes mellitus. Physical inactivity is an important symptom in individuals in the pandemic period. In this regard, telerehabilitation approaches will be beneficial for all individuals in increasing physical activity, improving quality of life, and decreasing anxiety, depression and loneliness perception during the pandemic period for all individuals. The importance of a multidisciplinary approach in diabetes management and dealing with problems should be considered in pandemic.

Ascitis secundaria a endometriosis / Ascites secondary to endometriosis

RESUMEN Introducción: La endometriosis es una enfermedad benigna, inflamatoria, dependiente de estrógenos, caracterizada por la existencia de tejido endometrial fuera de la cavidad uterina. Afecta del 10 % al 20 % de las mujeres en edad reproductiva. La ascitis es la acumulación patológica de líquido dentro de la cavidad peritoneal. La ocurrencia de ascitis secundaria a endometriosis se encuentra raramente y aparece más a menudo en mujeres nulíparas de piel negra. Objetivo: Presentar el caso de una paciente a quien se le practicó laparotomía exploradora electiva por ascitis secundaria a endometriosis. Caso clínico: Paciente femenina de 30 años de edad, color de piel negra, con antecedentes de infertilidad primaria. Atendida en consulta de ginecología por aumento de volumen y molestias abdominales de varios meses de evolución; se detectó ascitis y una masa anexial izquierda. Se realizó laparotomía y se constató ascitis hemorrágica, adherencias pélvicas y quiste de ovario izquierdo. Se realizó aspiración del líquido ascítico, anexectomía y biopsia de epiplón y ombligo. El diagnostico histológico informó endometriosis anexial de ombligo y epiplón. Se indicó tratamiento con danazol y evolucionó satisfactoriamente sin más ascitis. Conclusiones: La asociación ascitis-endometriosis es muy rara. Es una entidad infrecuente que afecta mayormente a mujeres nulíparas, en edad fértil y de color de la piel negra. Imita un tumor ginecológico y rara vez se reconoce antes de la exploración quirúrgica del abdomen, por lo que se hace necesario su estudio para lograr un diagnóstico y tratamiento oportuno.

ABSTRACT Introduction: Endometriosis is a benign, inflammatory, estrogen-dependent disease characterized by the existence of endometrial tissue outside the uterine cavity. It affects 10-20 % of women of reproductive age. Ascites is the pathological accumulation of fluid within the peritoneal cavity. The occurrence of ascites secondary to endometriosis is rarely found and appears more often in black nulliparous females. Objective: To present a patient who underwent elective exploratory laparotomy for ascites secondary to endometriosis. Clinical case: 30-year-old female patient, black skin color, with a history of primary infertility. Attended in Gynecology consultation for presenting increase in volume and abdominal discomfort of several months of evolution; detecting ascites and a left adnexal mass. Laparomoty was performed, finding hemorrhagic ascites, pelvic adhesions, and a left ovarian cyst. Ascites fluid aspiration, adnexectomy and biopsy of omentum, and umbilicus were performed. The histological diagnosis reported adnexal endometriosis, umbilicus and omentum. Treatment with danazol was indicated and she had a satisfactory evolution without further ascites. Conclusions: The ascites-endometriosis association is very rare. It is an infrequent entity that mainly affects nulliparous women, of childbearing age and of black skin color. It mimics a gynecologic malignancy and is rarely recognized prior to surgical exploration of the abdomen. Therefore, its study is necessary to achieve a timely diagnosis and treatment.

Surgical treatment of bulbar urethral strictures: tips and tricks

ABSTRACT The surgical treatment of bulbar urethral strictures is still one of the most challenging reconstructive-surgery problems. Bulbar urethral strictures are usually categorized as traumatic and non-traumatic strictures depending on the aetiology. The traumatic strictures are caused by trauma and they determine disruption of the urethra with obliteration of the urethral lumen, ending with fibrotic gaps between the urethral ends. Differently, the non-traumatic urethral strictures are mainly caused by catheterization, instrumentation, and infection, or they can also be idiopathic. They are usually associated with spongiofibrosis of the segment of the urethra that has been involved. Worldwide, two different surgical approaches are currently adopted for bulbar urethral repair: transecting techniques with end-to-end anastomosis and non-transecting techniques followed by grafting. Traumatic obliterated strictures require transection of the urethra allowing complete removal of the fibrotic tissue that involves the urethral ends. Conversely, non-traumatic, non-obliterated urethral strictures require augmentation of the urethral plate using oral mucosa grafts. Nowadays, it is still difficult to choose the correct surgical management for non-obliterated bulbar stricture repair. Indeed, different surgical techniques have been proposed (pedicled flap vs free graft, dorsal vs ventral placement of the graft, non-transecting technique using or non-using free graft, etc.) but none emerged as the best solution since all techniques have showed similar success and complication rates. Consequently, the final choice is still based on surgeon's preferences and patient's characteristics. Within the current manuscript, we like to present some of our tips and tricks that we developed along our prolonged surgical experience on the treatment of bulbar urethral strictures. These might be of interest for surgeons that approach this complex surgery. Moreover, our suggestions want to be useful regardless the type of chosen technique being adaptable for different scenario.

Frequency of anti-Toxocara antibodies in broiler chickens in southern Brazil / Frequência de anticorpos anti-Toxocara em frangos de corte no Sul do Brasil

Abstract The aim of this study was to evaluate the presence of anti-Toxocara antibodies in naturally infected broiler chickens (n = 189) from the state of Paraná, southern Brazil. The chickens were reared in a semi-intensive system by small family farmers (n = 7). An enzyme-linked immunosorbent assay (ELISA) was performed to detect the presence of anti- Toxocara spp. IgY after serum adsorption with Ascaridia galli antigens. An overall seroprevalence of 67.7% (128/189; 95% CI = 61.1-74.4) was observed. The frequency of positive animals by farm ranged from 29.6% to 100%. The optical density and reactivity index values observed in ELISA test indicated the possible chronicity of infection of the evaluated chickens. Associations between the presence of antibodies and the area where the chickens were reared (p = 0.382) or the population density of dogs on the farm (p = 0.785) were not observed. This study shows a high prevalence of Toxocara spp. antibodies in broiler chickens reared in semi-intensive systems and provides evidence that chickens are a good indicator of environmental contamination by larva migrans agents. Further studies are necessary to assess the risk factors associated with poultry infection and the likelihood of toxocariasis transmission to humans via the ingestion of free-range chicken meat.

Resumo A finalidade do presente estudo foi avaliar a presença de anticorpos anti- Toxocara, em frangos de corte naturalmente infectados (n = 189), no Norte do Paraná, Sul do Brasil. Os frangos foram criados em sistema semi-intensivo, em pequenas propriedades rurais (n = 7). Os testes sorológicos foram realizados pela técnica de ELISA, para detecção de anticorpos IgY (IgG), com pré-adsorção do soro com antígenos de Ascaridia galli. Foi observada uma prevalência de 67,7% (128/189; IC 95% = 61,1-74,4). A frequência de animais soropositivos por propriedade variou de 29,6% a 100%. Os valores da Densidade Ótica e do Índice de Reatividade observados no teste de ELISA indicaram uma possível cronicidade de infecção dos frangos avaliados. Não foi observada correlação entre a positividade dos animais, quando comparada a área (p = 0,382) e a densidade populacional de cães por propriedade (p = 0,785). O presente estudo verificou uma alta prevalência de anticorpos anti-Toxocara em frangos de corte criados em sistema semi-intensivo e oferece dados que apontam esses animais como bons indicadores de contaminação ambiental por agentes de larva migrans . Estudos futuros são necessários para avaliar os fatores de risco associados e a possibilidade da transmissão de toxocaríase ao ser humano pela ingestão de carne de frango.

Effects of reverse headgear on pharyngeal airway in patients with different vertical craniofacial features

The aim of this study was to investigate the effects of reverse headgear (RH) on pharyngeal airway morphology in two groups of Class III patients with different vertical craniofacial features in comparison with an untreated Class III group. Seventeen subjects (9 males, 8 females; mean age 11.3 ± 0.98 years) with optimum vertical growth and 17 subjects (10 males, 7 females, mean age 11.5 ± 1.1 years) with a vertical growth pattern treated with a removable intra-oral appliance and a Delaire type facemask were included. An untreated Class III control group of 11 subjects (8 males, 3 females, mean age 9.1 ± 1.1 years) was included to compare the treated groups. The paired t-test for intragroup and one-way ANOVA for intergroup comparisons were performed. The relationships between changes in the craniofacial morphology and airway were assessed by Spearman correlation analysis. The airway dimensions at the adenoid side and soft palate were increased in the treatment groups compared to the control group (p < 0.05). The nasopharyngeal area demonstrated a significant difference in normodivergent and control subjects (p < 0.05). No significant difference was found in the airway morphology due to different vertical features. The effect of RH treatment on the sagittal airway dimensions revealed no significant difference between different vertical craniofacial features in the short term.

effect of intrauterine death [IUD] of a twin on the survivor co-twin: a report of 2 cases from Benghazi, Libya

This is the first report from Jamahiria Maternity Hospital of Benghazi, Libya concerning two babies who were born in 1995, they survived the death of their co-twins, but developed neurological problems later on. A considerable percentage of twin pregnancies end in loss of one of the fetuses and medical problems in the surviving co-twin; therefore it is appropriate to call this phenomenon as vanishing- surviving syndrome as the death "vanishing" of one fetus leads to impairment of growth and development of the surviving co-twin

Breast-feeding and weaning patterns in Benghazi, Libyan Arab Jamahiriya

An interview survey of 200 mothers attending the emergency service of Al-Fateh Paediatric Hospital, Benghazi, showed that prelacteal feed was given to 18.5% of babies and breast-feeding was ever initiated in 90.5%. After three months exclusive breast-feeding was continued in less than 30%, mixed feeding in 44%-71% and supplementary feeding [with and without breast-feeding] in 65%-97%. Locally consumed food like fruit juice, vegetables, cooked rice and cereals and boiled eggs in mashed form were used as supplementary foods. No association was revealed between the type of feeding and childhood episodes of any illness, including diarrhoea or acute respiratory infection. Measures for prolonged breast-feeding, substitute artificial feeding [when indicated] and supplementary feeding are suggested

Maternal characteristics and infant and young child feeding in Benghazi

Two hundred [200] mothers consecutively attending Al-Fateh Paediatric Hospital, Benghazi in 1992 were interviewed. The majority of women were under 30 years of age, had primary or no education, were housewives, had no experience of pregnancy wastage or child loss, used no contraception, had one to three living children, had information about breast-feeding from the mother-in-law, a relative or a neighbour, considered breast-feeding a natural way, nutritionally superior and hygienic, and practised mixed feeding. The reasons for introducing artificial feeding were maternal in 49.7% of cases, filial [related to the baby] in 36.5% and due to social pressure in 13.8%. Measures for successful breast-feeding are emphasized

Is vernix caseosa a protective material to the newborn? A biochemical approach.

Twenty random samples of vernix caseosa were collected from immediately born neonates, in Jamahiriya Hospital, Benghazi. Biochemical studies of these samples revealed presence of lipids (62.5%), proteins (36%) and carbohydrate (1.5%). Also we could observe inhibition of staph. aureus and klebsiella growth on nutrient agar by this vernix. This observation could be explained either by its higher asparagine content or by its elevated lipid component. In addition tripalmitin was found to be the major lipid constituent, responsible for its hydrophobic property. So we recommend leaving this vernix layer on newborn skin until spontaneous drying.

La rétinopathie diabétique: une étude angiofluorographique chez le noir Africain

Les auteurs ont entrepris ce travail prospectif pour rechercher les lesions angiofluorographiques et certains facteurs de risque des lesions de retinopathie chez le diabetique Noir Africain. 100 malades tous porteurs de diabete; chez qui les donnees demographiques; le type de diabete; les valeurs des glycemies; l'anciennete du diabete; les resultats de l'angiofluorographie ont ete colliges. L'age moyen des 100 malades est de 50;33 ans avec 12;08 ans d'ecart-type sans influence sur la presence de la retinopathie; p=0;287; le sex-ratio de 2 hommes pour 1 femme; 28 pour cent avaient une hypertension arterielle associee; 18 pour cent un antecedent familial hta-diabete; aucune influence des antecedents sur le type de diabete; p=0;2264; 77 pour cent avaient un diabete non insulinodependant ; 23 pour cent un diabete insulinodependant; l'anciennete moyenne du diabete etait de 54;77 mois et influencait la presence ou non de retinopathie; p=0;00537; la glycemie moyenne de base de 15;12 mmol/l; la derniere glycemie 9;50 mmol/l. 52 pour cent de retinopathies etaient observees; dont 88;8 pour cent de retinopathie non proliferative contre 11;12 pour cent de retinopathie proliferative. Ce groupe domine par les diabetes non insulinodependants avaient une anciennete moyenne de diabete relativement basse; une glycemie de base et une derniere glycemie elevees; et un taux important de retinopathie

Les chorioretinites toxoplasmiques au CHU de Lome

La toxoplasmose oculaire represente l'effet pathogene de toxoplasma gondii; elle determine chez les sujets immunocompetents une chorioretinite d'allure necrosante volontiers temporel avec des aspects en rosace; une atteinte du segment anterieur parfois. Sa frequence chez un immunodeprime comme dans l'infection par le VIH serait de 30 fois plus elevee que chez le sujet immunocompetent. Ce present travail est consacre aux differents aspects anatomocliniques observes chez 24 malades presentant une toxplasmose oculaire d'age moyen de 32;09 ans avec des extremes a 14 ans et 57 ans; atteignant les deux sexes dans les proportions de 41;66 pour cent de femmes contre 58;33 pour cent d'hommes. Les lesions etaient dans 91;66 pour cent (22 malades) exclusivement des chorioretinites; deux cas de participation du segment anterieur etaient observes; 66;66 pour cent de localisations temporales sont notees (16 malades); 29;16 pour cent d'atteintes nasales (7 malades) et une seule localisation justapaillaire; 14 localisations droites sont notees contre 10 du cote gauche; 8 lesions eatient evolutives (33;33 pour cent) contre 16 lesions cicatricielles (66;66 pour cent); le dye test de Sabin Feldman etait positif chez tous les malades par contre les lgM etaient variables. La toxoplasmose doit etre recherchee devant toute chorioretinite dans nos milieux car le diagnostic ophtalmoscopique est de haute predictivite

Hemoglobinopathies et retinopathies proliferatives

"Le but de ce travail etait de rechercher les differentes lesions de retinopathie qu'on pouvait observer chez les patients presentant une hemoglobinopathie. Les auteurs ont recrute 32 sujets porteurs d'une bibliographie diagnostiquee par electrophorese sur acetate de cellulose pour un bilan oculaire complet comportant surtout une angiofluorographie retinienne. Ces malades ont ete recrutes sur une periode de 12 mois. 32 patients ont ete vus dont 15 femmes et 17 hommes d'age moyen de 31.09 ans; la repartition selon la forme electrophoretique donne 25 SC; 3SS; 2AC; A2F. Les lesions de retinopathies s'observaient chez les SC et AC; tandis que les SS et les A2F n'avaient pas de retinopathies. Chez les SC; les neovascularisations retineuses peripheriques ou ""Sea fan"" etaient presentes dans 11 cas; chez 1AC on a observe une importante hemorragie musculaire. Les lesions de retinopathie sont frequentes et graves dans les formes SC et AC; car evolutives et pouvant grever le pronostic visuel. Il importe des lors d'axer les efforts vers la prevention des lesions majeures d'ou l'interet d'une photocoagulation au laser argon"