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Keywords: long COVID, Ivermectin, long haulers.
easy, partly because adolescents tend to shy away from medical institutions. Some medical institutions
specialize in adolescent care, but many children are in need of medical intervention. In this study, 584 children
between the ages of 11 and 18 who visited 14 local clinics were asked to fill out a simple questionnaire, which
was then used to talk to the children regardless of the reason for their visit. 93.3% of the respondents found the
questionnaire useful, and 88.0% found it useful in five minutes or less. In 93.3% of the cases, the questionnaire
was useful, and 88.0% of the respondents reported that they were able to conduct the interview in a short time,
less than five minutes. Most of the clinics were positive about this approach.
Keywords: Adolescent, interview, pediatric clinic, bio-psycho-social model
aim of this work is to propose a computational method to carry out segmentation on diabetic foot ulcer images
of patients treated with the Heberprot-P. This drug accelerates the wound healing process and reduces the risk of
amputation. The used material is a bank of 1176 images provided by the Center for Genetic Engineering and
Biotechnology at Havana, and as a method, we propose the use of the model of Mask R-CNN and the concept of
learning transfer to automatically locate the region that delimits the ulcer. The proposed model obtained very
satisfactory results, and we validated its performance together with specialist physicians, on a set of 1010
images.
Keywords: Learning transfer, Heberprot-P, Mask R-CNN.
implications worldwide. Epidemiologic data indicate that SARS-CoV2 is spread by respiratory droplets and contact.
The lack of acquired human immunity to the virus and the absence of a vaccine, has meant that current management
strategies aimed at virus containment through mask wearing, social distancing and enforced lockdowns. Although
the World Health Organization recommends 1,5 meters distancing to minimize transmission, recent studies have
demonstrated high stability in aerosols and transmission distances up to 10 meters from emission sources .
Health care workers are at particular risk from SARS-CoV-2. At present, no reliable prophylactic therapy exists to
minimize their risk of acquiring SARS-CoV-2, and so they rely solely upon hand hygiene and the wearing of
appropriate personal protective equipment (PPE), which is often in limited supply. Several studies have shown that
the salivary gland and tongue express the ACE2 receptor, suggesting that the oral cavity is a perfect host for the
invasion of COVID. Theoretically, agents that can inhibit viral adhesion and replication within the primary sites of
viral entry (the nasal and oral cavity), may have a role in preventing SARS-CoV-2 transmission. Use of these agents
prophylactically, would be especially beneficial in health care workers, particularly given the delay in results from
viral RNA detection diagnostic test and the fact that many infected patients may have mild or no symptoms of the
virus in the early stages. Two possible substances have been identified as candidate prophylactic agents in the fight
against SARS-CoV-2. Carrageenans are naturally occurring extracts from the Rhodophyceas seaweed. Recently, the
viricidal capacity of carrageenan has been reported, through inhibition of viral- host cell adhesion and early
replication. Iota-carrageenan demonstrates potent antiviral activity in vitro, reducing rhinovirus, herpes simplex
virus and the Japanese encephalitis virus reproduction and their cytopathic effects. Similarly, ivermectin has also
been shown to posess antiviral activity against a whole host of RNA viruses (Zika, dengue, yellow fever, human
immunodeficiency virus type 1). Thus, the combination of both products can provide an extra protection for those at
risk of contagion.
Keywords: COVID-19, Ivermectin, SARS-CoV-2.
and thus contribute to a better understanding of organs target organs of this disease
Objective: To assess the retina of COVID-19 patients for possible microvascular damage.
Design: Uncontrolled observational cohort study.
Setting: Referral university hospital in Sao Paulo, Brazil.
Participants: 24 consecutive patients with laboratory diagnosis of COVID-19.
Exposure: Infection with SARS-CoV-2 and successive assessment of retina.
Main Outcome Measure: Qualitative interpretation of OCT retina and optical disc images.
Results: Most patients had no evident changes in the retina, nor the optical disc. Six eyes had nonspecific
changes with no clinical manifestation most possibly unrelated to SARS-CoV-2 infection.
Conclusion and Relevance: The patients with previous infection by SARS-CoV-2 evaluated in this study
did not present any images on OCT that can be associated to the virus.
Keywords: OCT retina, Covid-19, SARS-CoV-2.
contributes to the pathology of age-related macular degeneration (AMD). If confirmed, these data also
suggest that agents that prevent or reduce cell senescence may be useful in the treatment of AMD.
Metformin has been shown to inhibit the development of senescence in a number of cell types, although its
effects of RPE cells have not yet been reported. A recent study showed that metformin also reduces the risk
of AMD in patients taking this drug for the treatment of diabetes. In the present study we examine the
effects of metformin on RPE cell senescence induced by oxidative stress. We report that metformin reduces
two hallmarks of senescence in these cells: increased senescence-associated beta-galactosidase activity, and
increased levels of p21. These results suggest that metformin may be useful in the treatment of AMD by
inhibiting RPE cell senescence.
Keywords: Age-related macular degeneration, cell senescence, p21, retinal pigment epithelial cells,
senescence-associated beta-galactosidase
mortality risk. Respondents are those aged over 50 from the Health and Retirement Study (N=10,366) who provided
blood pressure measures in 2006/2008. Systolic and diastolic blood pressures were measured three times; and we
averaged the three readings. Pulse pressure was calculated as systolic minus diastolic blood pressure. Seven
combinations of systolic and diastolic blood pressure (low/normal/high of each) and three levels of pulse pressure
(low/normal/high) were used to categorize blood pressure. Over 1 to 10 years of follow-up (average follow-up time
of 7.8 years), 2,820 respondents died after blood pressure measurement in 2006/2008. Potential covariates including
age, gender, education, BMI, total cholesterol, HbA1c, antihypertensive medication intake and lifetime-smoking
pack years were adjusted in Cox proportional hazard models and survival curves. The blood pressure subgroup with
low systolic blood pressure (<90 mmHg) and low diastolic blood pressure (< 60 mmHg) had the highest relative risk
of mortality (HR=2.34, 95% CI: 1.45-3.80), followed by those with normal systolic blood pressure but low diastolic
blood pressure (HR=1.45, 95% CI: 1.17-1.81) among those with cardiovascular conditions at baseline. For those
without cardiovascular conditions at baseline, low blood pressure, either systolic or diastolic, was not related to
mortality. Those with high levels of both systolic and diastolic blood pressure had a higher risk of mortality than
those with both blood pressures normal but no other subgroups with low blood pressure differed from
normal/normal in predicting mortality. Pulse pressure did not predict mortality. How high and low blood pressures
are related to mortality needs to be examined by jointly looking at systolic and diastolic blood pressure.
Keywords: Systolic blood pressure, diastolic blood pressure, pulse pressure, mortality, Health and Retirement
Study.
population movements that have an impact on public health policies such as vaccination. The objective of this
work was to evaluate the impact of these prevention measures on routine vaccination in hospitals since the
advent of the pandemic in Senegal.
Methodology: This is a retrospective cross-sectional study carried out in August 2020 in the vaccination unit of
the Abass NDAO hospital centre. We compared data from the vaccination unit during the period from March to
August of the last three years (2018, 2019 and 2020). The parameter studied was the number of vaccine doses
administered for the different periods according to the expanded programme of immunization.
Results: For the vaccines administered in the sixth week in April, the number of doses was 36 in 2018, 29 in
2019 and 15 in 2020, i.e. a 50% drop compared to March. In July the number of doses administered was 40 in
2018, 35 in 2019 and 15 in 2020, a reduction of 42% compared to 2019.
Conclusion: Measures to fight this pandemic should not make us forget routine vaccination, especially in our
resource-constrained countries. It is essential to continue vaccination for children and to identify children who
have missed vaccine doses for catch-up.
Keywords: COVID19, Vaccination, Impact, Children, Senegal
Keywords:Gastrointestinal Bleeding,Iron deficiency anemia
Myocardial Infarction (NSTEMI) and underlying severe Aortic Valve stenosis (AS). The patient was initially
treated with Bilevel Positive Airway Pressure (BIPAP) and diuretics, followed by intubation because of
respiratory deterioration and Continuous Venovenous Hemofiltration (CVVH) because of metabolic disorders
and ongoing pulmonary oedema. Eventually, the patient’s overall condition declined with transfer to the cathlab.
First, an urgent Percutaneous Transluminal Aortic Valvuloplasty (PTAV) was performed, followed by coronary
angiography and Percutaneous Coronary Intervention (PCI) of a dominant Circumflex. Finally, as a ventricular
support device, an Impella was implanted to unload the left ventricle. Despite all the effort, multi organ failure
(MOF) occurred and the patient passed away17 days after admission to the hospital.
Arginine is a conditionally essential amino acid that is involved in protein synthesis, the detoxification of ammonia, and its conversion to glucose as well as being catabolized to produce energy; in addition to these physiological functions, arginine has shown to have ergogenic potential. Arginine-based supplement may be used on an acute basis for delaying the onset of neuromuscular fatigue (i.e., PWCFT) and improving the ventilatory threshold. The present research was conducted according to an experimental double-blind controlled design (vs. placebo), with the aim to evaluate the clinical efficacy and safety of the Bioarginina® (1.66g/20ml vials of L-arginine) in oral administration.
The changes in the parameters relevant to physical and/or mental fatigue, monitored for the evaluation of the efficacy of the experimental treatment, showed a clear difference in patients treated with Bioarginina® compared to those treated with placebo, with a statistically better trend in the Bioarginina® group than in the placebo group.
The general conditions, especially at the end of the observation period, improved significantly in the Bioarginina® group compared to the placebo group. Overall, asthenia symptoms had a marked improvement in patients in the Bioarginina® group, with a reduction of almost 25% of their intensity after 30 days of therapy and over 70% at the end of the treatment; by contrast, in the placebo group, the symptomatology underwent to an impairment, assessable in the order of 14% after one month and 25% at the end of the therapy. Overall the results of the present study strongly support the effectiveness of oral Bioarginina® for the treatment of symptoms associated to asthenia and highlight the possibility of a clinical application of Bioarginina® in the treatment of asthenia.
Keywords: Bioarginina®, Asthenia, Fatigue, L-arginine.
Results: Higher food prices resulted in low, - middle - and high-income groups increasing the expenditures on food (p <0.01). Reductions in the proportion of households’ significantly lowering the post-devaluation intake of high-quality foods, such as fruits, vegetables, lean meat and fatty fish were observed (p<0.01). Furthermore, changes in the intake of low-quality foods were witnessed as well, with proportions of households significantly reducing the intake of discretionary foods and terminating eating out-of-home (p <0.01).
Conclusion: The fall of the Surinamese currency, in combination with country’s dependency on imported foods, increased local food prices and with salaries remaining the same, resulted in both lower- and higher-income households increasing their food expenditures. Post-devaluation changes in regular dietary pattern and food intake enrolled, with a significant reduction in the consumption of high-quality foods being noticed, especially within lower-economic households. On the one hand, significant proportions of Surinamese households possess a decreased probability of consuming healthy diets. On the other hand, households with also a significant reduction in the intake of low-quality foods might encounter a beneficial health impact if already coping with overweight and related non-communicable diseases.
Keywords: Devaluation, Food price rises, nutrition, Food consumption, Low and Middle-income countries.
Methods: Although there are several post-mortem techniques to show iron accumulation in the brain we only present the results of studies with 7.0-tesla magnetic resonance imaging, using the GRE T2* weighted sequence, and those with particle-induced X-ray emission.
Results: Hemorrhagic as well as non-hemorrhagic cerebral infarcts have a high iron content in the acute as well as in the residual stages. In lobar hematomas the iron increase moves from the core of the bleeding in the acute phase to the boundaries afterwards. Iron accumulation in the subpial space allows the demonstration of superficial cortical siderosis. Lacunar infarcts and ischemic white matter changes do not contain increased iron content. Cortical micro-bleeds can be seen as small iron deposits in contrast to cortical micro-infarcts, where they are absent.
Discussion: In cerebrovascular diseases the Fe accumulation is a secondary phenomenon, linked to the development of infarcts and/or hemorrhages and due to the disturbances of the blood-brain barrier.
Keywords: Post-mortem magnetic resonance imaging, particle induced X-ray emission, brain iron accumulation, cerebral infarct, lobar hematoma, cortical superficial siderosis, lacunar infarct, ischemic white matter changes, cortical micro-infarct, cortical micro-bleed.
Patient-centered care also r quires that the health care provider become a patient advocate and strive to provide care that not only is effective but also safe. Researches has shown that promoting patient centered care activities will improve patients‟ adherence, promote patients‟ responsibilities for health status and lead to improved health outcomes.
This article provides more clarity to the concept of patient centered care, its dimensions, and benefits in relation to both patients and health care organizations. It also considers the contribution of nurses to PCC and in the enhancement of service delivery.
Keywords: Patient Centered Care, Nursing, Patients.
Methods: We conducted an overview on the breast-conserving therapy for early-stage breast cancer with low risk of recurrences searching articles in the Pubmed literature with care on the role of intraoperative radiotherapy.
Conclusions: nowadays it become important to establish a correct therapeutic timing, adapting it to the characteristics of the individual patient and to the biology of the tumor. Radiotherapy and chemotherapy programs should be able to embrace according to modulable times and take into account the differences of each individual case. The reduction of post actinic toxicity represents an objective to be pursued, also for the possible overlap with the toxicity of the chemotherapeutic treatment and in this a fundamental role could be played by IORT. Moreover, considering the increase in patient survival that will inevitably lead to an increase in local recurrences, the possibility of a re-irradiation will be more and more frequent. Recent studies on the modulation of inflammation factors induced by the use of drugs during surgery could lead to new considerations on chemotherapy treatment. In conclusion, It could be useful to limit the field of action of complementary treatments for selected patients, like in the past it was proposed for surgical treatment, to allow any future therapy or reinterventions in case of recurrences, even with reconstructive intent.
Keywords: Intraoperative radiotherapy (IORT), breast conservative surgery (BCS), accelerated partial breast irradiation (APBI).
Case report: A 35-year old male with a history of bilateral refractive surgery presented with sudden onset of bilateral central vision loss. His symptoms were unable to be corrected with refraction. On initial history, he denied the use of any medications or recreational drugs. He was referred for spectral domain optical coherence tomography (SD-OCT), which showed disruption of the foveal photoreceptor outer segments in both eyes. Upon further questioning, he admitted to the use of alkyl nitrites – colloquially known as “poppers” – 12 hours prior to the onset of visual symptoms. The patient was counselled on the guarded prognosis of this condition and was agreeable to ongoing follow-up with interval SD-OCT to monitor for potential resolution of the outer retinal changes.
Conclusion: A case of “poppers maculopathy” on a recent background of refractive surgery is presented, highlighting the importance of taking a detailed clinical and social history in patients with unexplained vision loss that cannot be improved with refraction.
Keywords: Post-refractive, Poppers maculopathy, Alkyl nitrite toxicity
Statins have thus become a major first line therapy for treating patients with known hyperlipidemia and coronary artery disease; however, statin medications are often discontinued in a clinical setting with nearly 75% of patients discontinuing therapy within 2 years of initiation [5,7]. The 2009 SEARCH trial first identified an association between the pharmacogenetic test for solute carrier organic anion transporter family member 1B1 (SLCO1B1) and statin-associated symptoms, and has been replicated among numerous other studies, particularly with simvastatin [9-12]. There is some evidence that suggests the implication of SLCO1B1 results can change the prescribing pattern for providers [15]. With the use of this testing technology, clinicians are able to identify and predict possible statin-induced myopathy side effects in patients, increase compliance, and provide a more personalized treatment regimen.
Keywords: Statin, Cardiovascular disease, Vitamin D, SLCO1B1, Statin associated myopathy, coronary artery disease, management, prevention, hyperlipidemia.
Keywords: long COVID, Ivermectin, long haulers.
easy, partly because adolescents tend to shy away from medical institutions. Some medical institutions
specialize in adolescent care, but many children are in need of medical intervention. In this study, 584 children
between the ages of 11 and 18 who visited 14 local clinics were asked to fill out a simple questionnaire, which
was then used to talk to the children regardless of the reason for their visit. 93.3% of the respondents found the
questionnaire useful, and 88.0% found it useful in five minutes or less. In 93.3% of the cases, the questionnaire
was useful, and 88.0% of the respondents reported that they were able to conduct the interview in a short time,
less than five minutes. Most of the clinics were positive about this approach.
Keywords: Adolescent, interview, pediatric clinic, bio-psycho-social model
aim of this work is to propose a computational method to carry out segmentation on diabetic foot ulcer images
of patients treated with the Heberprot-P. This drug accelerates the wound healing process and reduces the risk of
amputation. The used material is a bank of 1176 images provided by the Center for Genetic Engineering and
Biotechnology at Havana, and as a method, we propose the use of the model of Mask R-CNN and the concept of
learning transfer to automatically locate the region that delimits the ulcer. The proposed model obtained very
satisfactory results, and we validated its performance together with specialist physicians, on a set of 1010
images.
Keywords: Learning transfer, Heberprot-P, Mask R-CNN.
implications worldwide. Epidemiologic data indicate that SARS-CoV2 is spread by respiratory droplets and contact.
The lack of acquired human immunity to the virus and the absence of a vaccine, has meant that current management
strategies aimed at virus containment through mask wearing, social distancing and enforced lockdowns. Although
the World Health Organization recommends 1,5 meters distancing to minimize transmission, recent studies have
demonstrated high stability in aerosols and transmission distances up to 10 meters from emission sources .
Health care workers are at particular risk from SARS-CoV-2. At present, no reliable prophylactic therapy exists to
minimize their risk of acquiring SARS-CoV-2, and so they rely solely upon hand hygiene and the wearing of
appropriate personal protective equipment (PPE), which is often in limited supply. Several studies have shown that
the salivary gland and tongue express the ACE2 receptor, suggesting that the oral cavity is a perfect host for the
invasion of COVID. Theoretically, agents that can inhibit viral adhesion and replication within the primary sites of
viral entry (the nasal and oral cavity), may have a role in preventing SARS-CoV-2 transmission. Use of these agents
prophylactically, would be especially beneficial in health care workers, particularly given the delay in results from
viral RNA detection diagnostic test and the fact that many infected patients may have mild or no symptoms of the
virus in the early stages. Two possible substances have been identified as candidate prophylactic agents in the fight
against SARS-CoV-2. Carrageenans are naturally occurring extracts from the Rhodophyceas seaweed. Recently, the
viricidal capacity of carrageenan has been reported, through inhibition of viral- host cell adhesion and early
replication. Iota-carrageenan demonstrates potent antiviral activity in vitro, reducing rhinovirus, herpes simplex
virus and the Japanese encephalitis virus reproduction and their cytopathic effects. Similarly, ivermectin has also
been shown to posess antiviral activity against a whole host of RNA viruses (Zika, dengue, yellow fever, human
immunodeficiency virus type 1). Thus, the combination of both products can provide an extra protection for those at
risk of contagion.
Keywords: COVID-19, Ivermectin, SARS-CoV-2.
and thus contribute to a better understanding of organs target organs of this disease
Objective: To assess the retina of COVID-19 patients for possible microvascular damage.
Design: Uncontrolled observational cohort study.
Setting: Referral university hospital in Sao Paulo, Brazil.
Participants: 24 consecutive patients with laboratory diagnosis of COVID-19.
Exposure: Infection with SARS-CoV-2 and successive assessment of retina.
Main Outcome Measure: Qualitative interpretation of OCT retina and optical disc images.
Results: Most patients had no evident changes in the retina, nor the optical disc. Six eyes had nonspecific
changes with no clinical manifestation most possibly unrelated to SARS-CoV-2 infection.
Conclusion and Relevance: The patients with previous infection by SARS-CoV-2 evaluated in this study
did not present any images on OCT that can be associated to the virus.
Keywords: OCT retina, Covid-19, SARS-CoV-2.
contributes to the pathology of age-related macular degeneration (AMD). If confirmed, these data also
suggest that agents that prevent or reduce cell senescence may be useful in the treatment of AMD.
Metformin has been shown to inhibit the development of senescence in a number of cell types, although its
effects of RPE cells have not yet been reported. A recent study showed that metformin also reduces the risk
of AMD in patients taking this drug for the treatment of diabetes. In the present study we examine the
effects of metformin on RPE cell senescence induced by oxidative stress. We report that metformin reduces
two hallmarks of senescence in these cells: increased senescence-associated beta-galactosidase activity, and
increased levels of p21. These results suggest that metformin may be useful in the treatment of AMD by
inhibiting RPE cell senescence.
Keywords: Age-related macular degeneration, cell senescence, p21, retinal pigment epithelial cells,
senescence-associated beta-galactosidase
mortality risk. Respondents are those aged over 50 from the Health and Retirement Study (N=10,366) who provided
blood pressure measures in 2006/2008. Systolic and diastolic blood pressures were measured three times; and we
averaged the three readings. Pulse pressure was calculated as systolic minus diastolic blood pressure. Seven
combinations of systolic and diastolic blood pressure (low/normal/high of each) and three levels of pulse pressure
(low/normal/high) were used to categorize blood pressure. Over 1 to 10 years of follow-up (average follow-up time
of 7.8 years), 2,820 respondents died after blood pressure measurement in 2006/2008. Potential covariates including
age, gender, education, BMI, total cholesterol, HbA1c, antihypertensive medication intake and lifetime-smoking
pack years were adjusted in Cox proportional hazard models and survival curves. The blood pressure subgroup with
low systolic blood pressure (<90 mmHg) and low diastolic blood pressure (< 60 mmHg) had the highest relative risk
of mortality (HR=2.34, 95% CI: 1.45-3.80), followed by those with normal systolic blood pressure but low diastolic
blood pressure (HR=1.45, 95% CI: 1.17-1.81) among those with cardiovascular conditions at baseline. For those
without cardiovascular conditions at baseline, low blood pressure, either systolic or diastolic, was not related to
mortality. Those with high levels of both systolic and diastolic blood pressure had a higher risk of mortality than
those with both blood pressures normal but no other subgroups with low blood pressure differed from
normal/normal in predicting mortality. Pulse pressure did not predict mortality. How high and low blood pressures
are related to mortality needs to be examined by jointly looking at systolic and diastolic blood pressure.
Keywords: Systolic blood pressure, diastolic blood pressure, pulse pressure, mortality, Health and Retirement
Study.
population movements that have an impact on public health policies such as vaccination. The objective of this
work was to evaluate the impact of these prevention measures on routine vaccination in hospitals since the
advent of the pandemic in Senegal.
Methodology: This is a retrospective cross-sectional study carried out in August 2020 in the vaccination unit of
the Abass NDAO hospital centre. We compared data from the vaccination unit during the period from March to
August of the last three years (2018, 2019 and 2020). The parameter studied was the number of vaccine doses
administered for the different periods according to the expanded programme of immunization.
Results: For the vaccines administered in the sixth week in April, the number of doses was 36 in 2018, 29 in
2019 and 15 in 2020, i.e. a 50% drop compared to March. In July the number of doses administered was 40 in
2018, 35 in 2019 and 15 in 2020, a reduction of 42% compared to 2019.
Conclusion: Measures to fight this pandemic should not make us forget routine vaccination, especially in our
resource-constrained countries. It is essential to continue vaccination for children and to identify children who
have missed vaccine doses for catch-up.
Keywords: COVID19, Vaccination, Impact, Children, Senegal
Keywords:Gastrointestinal Bleeding,Iron deficiency anemia
Myocardial Infarction (NSTEMI) and underlying severe Aortic Valve stenosis (AS). The patient was initially
treated with Bilevel Positive Airway Pressure (BIPAP) and diuretics, followed by intubation because of
respiratory deterioration and Continuous Venovenous Hemofiltration (CVVH) because of metabolic disorders
and ongoing pulmonary oedema. Eventually, the patient’s overall condition declined with transfer to the cathlab.
First, an urgent Percutaneous Transluminal Aortic Valvuloplasty (PTAV) was performed, followed by coronary
angiography and Percutaneous Coronary Intervention (PCI) of a dominant Circumflex. Finally, as a ventricular
support device, an Impella was implanted to unload the left ventricle. Despite all the effort, multi organ failure
(MOF) occurred and the patient passed away17 days after admission to the hospital.
Arginine is a conditionally essential amino acid that is involved in protein synthesis, the detoxification of ammonia, and its conversion to glucose as well as being catabolized to produce energy; in addition to these physiological functions, arginine has shown to have ergogenic potential. Arginine-based supplement may be used on an acute basis for delaying the onset of neuromuscular fatigue (i.e., PWCFT) and improving the ventilatory threshold. The present research was conducted according to an experimental double-blind controlled design (vs. placebo), with the aim to evaluate the clinical efficacy and safety of the Bioarginina® (1.66g/20ml vials of L-arginine) in oral administration.
The changes in the parameters relevant to physical and/or mental fatigue, monitored for the evaluation of the efficacy of the experimental treatment, showed a clear difference in patients treated with Bioarginina® compared to those treated with placebo, with a statistically better trend in the Bioarginina® group than in the placebo group.
The general conditions, especially at the end of the observation period, improved significantly in the Bioarginina® group compared to the placebo group. Overall, asthenia symptoms had a marked improvement in patients in the Bioarginina® group, with a reduction of almost 25% of their intensity after 30 days of therapy and over 70% at the end of the treatment; by contrast, in the placebo group, the symptomatology underwent to an impairment, assessable in the order of 14% after one month and 25% at the end of the therapy. Overall the results of the present study strongly support the effectiveness of oral Bioarginina® for the treatment of symptoms associated to asthenia and highlight the possibility of a clinical application of Bioarginina® in the treatment of asthenia.
Keywords: Bioarginina®, Asthenia, Fatigue, L-arginine.
Results: Higher food prices resulted in low, - middle - and high-income groups increasing the expenditures on food (p <0.01). Reductions in the proportion of households’ significantly lowering the post-devaluation intake of high-quality foods, such as fruits, vegetables, lean meat and fatty fish were observed (p<0.01). Furthermore, changes in the intake of low-quality foods were witnessed as well, with proportions of households significantly reducing the intake of discretionary foods and terminating eating out-of-home (p <0.01).
Conclusion: The fall of the Surinamese currency, in combination with country’s dependency on imported foods, increased local food prices and with salaries remaining the same, resulted in both lower- and higher-income households increasing their food expenditures. Post-devaluation changes in regular dietary pattern and food intake enrolled, with a significant reduction in the consumption of high-quality foods being noticed, especially within lower-economic households. On the one hand, significant proportions of Surinamese households possess a decreased probability of consuming healthy diets. On the other hand, households with also a significant reduction in the intake of low-quality foods might encounter a beneficial health impact if already coping with overweight and related non-communicable diseases.
Keywords: Devaluation, Food price rises, nutrition, Food consumption, Low and Middle-income countries.
Methods: Although there are several post-mortem techniques to show iron accumulation in the brain we only present the results of studies with 7.0-tesla magnetic resonance imaging, using the GRE T2* weighted sequence, and those with particle-induced X-ray emission.
Results: Hemorrhagic as well as non-hemorrhagic cerebral infarcts have a high iron content in the acute as well as in the residual stages. In lobar hematomas the iron increase moves from the core of the bleeding in the acute phase to the boundaries afterwards. Iron accumulation in the subpial space allows the demonstration of superficial cortical siderosis. Lacunar infarcts and ischemic white matter changes do not contain increased iron content. Cortical micro-bleeds can be seen as small iron deposits in contrast to cortical micro-infarcts, where they are absent.
Discussion: In cerebrovascular diseases the Fe accumulation is a secondary phenomenon, linked to the development of infarcts and/or hemorrhages and due to the disturbances of the blood-brain barrier.
Keywords: Post-mortem magnetic resonance imaging, particle induced X-ray emission, brain iron accumulation, cerebral infarct, lobar hematoma, cortical superficial siderosis, lacunar infarct, ischemic white matter changes, cortical micro-infarct, cortical micro-bleed.
Patient-centered care also r quires that the health care provider become a patient advocate and strive to provide care that not only is effective but also safe. Researches has shown that promoting patient centered care activities will improve patients‟ adherence, promote patients‟ responsibilities for health status and lead to improved health outcomes.
This article provides more clarity to the concept of patient centered care, its dimensions, and benefits in relation to both patients and health care organizations. It also considers the contribution of nurses to PCC and in the enhancement of service delivery.
Keywords: Patient Centered Care, Nursing, Patients.
Methods: We conducted an overview on the breast-conserving therapy for early-stage breast cancer with low risk of recurrences searching articles in the Pubmed literature with care on the role of intraoperative radiotherapy.
Conclusions: nowadays it become important to establish a correct therapeutic timing, adapting it to the characteristics of the individual patient and to the biology of the tumor. Radiotherapy and chemotherapy programs should be able to embrace according to modulable times and take into account the differences of each individual case. The reduction of post actinic toxicity represents an objective to be pursued, also for the possible overlap with the toxicity of the chemotherapeutic treatment and in this a fundamental role could be played by IORT. Moreover, considering the increase in patient survival that will inevitably lead to an increase in local recurrences, the possibility of a re-irradiation will be more and more frequent. Recent studies on the modulation of inflammation factors induced by the use of drugs during surgery could lead to new considerations on chemotherapy treatment. In conclusion, It could be useful to limit the field of action of complementary treatments for selected patients, like in the past it was proposed for surgical treatment, to allow any future therapy or reinterventions in case of recurrences, even with reconstructive intent.
Keywords: Intraoperative radiotherapy (IORT), breast conservative surgery (BCS), accelerated partial breast irradiation (APBI).
Case report: A 35-year old male with a history of bilateral refractive surgery presented with sudden onset of bilateral central vision loss. His symptoms were unable to be corrected with refraction. On initial history, he denied the use of any medications or recreational drugs. He was referred for spectral domain optical coherence tomography (SD-OCT), which showed disruption of the foveal photoreceptor outer segments in both eyes. Upon further questioning, he admitted to the use of alkyl nitrites – colloquially known as “poppers” – 12 hours prior to the onset of visual symptoms. The patient was counselled on the guarded prognosis of this condition and was agreeable to ongoing follow-up with interval SD-OCT to monitor for potential resolution of the outer retinal changes.
Conclusion: A case of “poppers maculopathy” on a recent background of refractive surgery is presented, highlighting the importance of taking a detailed clinical and social history in patients with unexplained vision loss that cannot be improved with refraction.
Keywords: Post-refractive, Poppers maculopathy, Alkyl nitrite toxicity
Statins have thus become a major first line therapy for treating patients with known hyperlipidemia and coronary artery disease; however, statin medications are often discontinued in a clinical setting with nearly 75% of patients discontinuing therapy within 2 years of initiation [5,7]. The 2009 SEARCH trial first identified an association between the pharmacogenetic test for solute carrier organic anion transporter family member 1B1 (SLCO1B1) and statin-associated symptoms, and has been replicated among numerous other studies, particularly with simvastatin [9-12]. There is some evidence that suggests the implication of SLCO1B1 results can change the prescribing pattern for providers [15]. With the use of this testing technology, clinicians are able to identify and predict possible statin-induced myopathy side effects in patients, increase compliance, and provide a more personalized treatment regimen.
Keywords: Statin, Cardiovascular disease, Vitamin D, SLCO1B1, Statin associated myopathy, coronary artery disease, management, prevention, hyperlipidemia.