BACKGROUND Despite societal guidelines recommending targeted screening for Barrett’s esophagus(BE)and esophageal adenocarcinoma(EAC)in individuals with gastroesophageal reflux symptoms(GERS),screening adherence is su...BACKGROUND Despite societal guidelines recommending targeted screening for Barrett’s esophagus(BE)and esophageal adenocarcinoma(EAC)in individuals with gastroesophageal reflux symptoms(GERS),screening adherence is suboptimal.Current screening approaches fail to identify individuals not seeking medical consultation for GERS or whose GERS are managed with‘over-the-counter’(OTC)acid suppressant therapies.AIM To assess patients’self-management and help-seeking behavior for GERS.METHODS This cross-sectional study collected data from the Dutch general population aged 18-75 years between January and April 2023 using a web-based survey.The survey included questions regarding self-management(e.g.,use of acid suppressant therapy with or without prescription)and help-seeking behavior(e.g.,consulting a primary care provider)for GERS.Simple random sampling was performed to select individuals within the target age group.In total,18156 randomly selected individuals were invited to participate.The study protocol was registered in ClinicalTrials.gov(identifier:NCT05689918).RESULTS Of the 18156 invited individuals,3214 participants(17.7%)completed the survey,of which 1572 participants(48.9%)reported GERS.Of these,904 participants(57.5%)had never consulted a primary care provider for these symptoms,of which 331 participants(36.6%)reported taking OTC acid suppressant therapy in the past six months and 100 participants(11.1%)fulfilled the screening criteria for BE and EAC according to the European Society of Gastrointestinal Endoscopy Guideline.CONCLUSION The population fulfilling the screening criteria for BE and EAC is incompletely identified,suggesting potential underutilization of medical consultation.Raising public awareness of GERS as a risk factor for EAC is needed.展开更多
Objective:To explore health-improving behaviors during COVID-19 pandemic and to reveal the impact of the risk perception of COVID-19 on these behaviors.Methods:We recruited a total of 510 participants for this cross-s...Objective:To explore health-improving behaviors during COVID-19 pandemic and to reveal the impact of the risk perception of COVID-19 on these behaviors.Methods:We recruited a total of 510 participants for this cross-sectional study.The data were collected online using a questionnaire booklet covering a form inquiring about the participants’demographic,physical,and mental characteristics,the Generalized Anxiety Disorder-7 Scale,and the COVID-19 Perceived Risk Scale.Results:The mean age of the participants was(28.7±10.1)years,and 76.1%were females.Of the participants,31.8%were overweight and obese.While 35.1%experienced negative alterations in their dietary patterns,23.9%reported positive changes to their diet during the pandemic.Besides,47.8%reported their sleep to be negatively affected during the pandemic.While the rate of those with extended screen time was 72.5%,it was 44.3%for the participants engaging in regular exercise.More than one-third of the participants(35.9%)had high and severe anxiety.We also found increased risk perception of COVID-19 among females,obese,those with disturbed eating and sleep quality,healthcare workers,and those with severe anxiety.Conclusions:Overall,the pandemic has appeared to have brought both positive and negative impacts on maintaining and improving eating,sleep,physical activity,and mental health.展开更多
As the prevalence of diabetic retinopathy continues to be on the rise, the Chronic Care Model (CCM) offers a transformative, patient-focused approach for efficient diabetic retinopathy care, emphasizing the need for u...As the prevalence of diabetic retinopathy continues to be on the rise, the Chronic Care Model (CCM) offers a transformative, patient-focused approach for efficient diabetic retinopathy care, emphasizing the need for urgent and innovative strategies in the United States. The model integrates community resources, healthcare organizations, self-management support, delivery system design, decision support, and clinical information systems. Addressing challenges and solutions, the model emphasizes proactive and preventive measures, collaborative multidisciplinary care, technological integration, and overcoming resistance to change. This paper proposes the utilization of the Chronic Care Model (CCM) as a possible public health framework for comprehensive management of diabetic retinopathy in the United States. Implementing the CCM offers a comprehensive approach to diabetic retinopathy care, addressing both individual and systemic factors, essential for improving public health outcomes.展开更多
Introduction: Oral health education is an important issue that should be given to children and adolescents, allowing the acquisition of correct oral health behaviors. The objective of this study was to determine the p...Introduction: Oral health education is an important issue that should be given to children and adolescents, allowing the acquisition of correct oral health behaviors. The objective of this study was to determine the prevalence of oral health behaviors among a sample of portuguese adolescents and verify the association with socio-demographic factors, in order to analyze the main needs related with oral health education to improve oral health status among adolescents. Methods: A cross-sectional study was designed with a sample of 447 adolescents aged 12 to 19 years old, attending a public school in Sátão, Portugal. A self-administered questionnaire was applied questioning about socio-demographic factors and oral health behaviors to each adolescent in the classroom. Prevalence was expressed in proportions and crude odds ratio (OR) with 95% confidence intervals (CI) were used to measure the strength of association between oral health behaviors and socio-demographic factors. Results: The prevalence of tooth brushing (twice-a-day or more) was 90.6%. Five point eight percent of adolescents reported daily flossing, more frequent among female gender (female, OR = 2.03, 95% CI = (1.35 to 3.05)) and adolescents older than 15 years (>15 years, OR = 1.90, 95% CI = (1.24 to 2.92)). Sixty-seven percent had at least one dental appointment in the previous twelve months. The prevalence of dental appointments was associated with the father’s professional situation (unemployed, OR = 0.33, 95% CI = (0.17 to 0.65)) and crowding index (>1, OR = 0.4, 95% CI = (0.16 to 0.98)). Thirty-two point nine percent of adolescents referred having at least one episode of dental pain during their lives. Conclusion: Considering the results of the present study that show the need of improvement of some aspects related with oral health among adolescents, oral health community programs and primary preventive strategies, such as improvement of oral health education in schools should be considered in order to reduce the risk level of oral diseases and develop better oral health behaviors.展开更多
Nearly half of the world’s population comprise youths. However, addressing their Sexual and Reproductive Health (SRH) remains a challenge. Globally countries are mandated to continually provide Youth Friendly Sexual ...Nearly half of the world’s population comprise youths. However, addressing their Sexual and Reproductive Health (SRH) remains a challenge. Globally countries are mandated to continually provide Youth Friendly Sexual and Reproductive Health services (YFSRHs) to the youth. The objective of this study was to assess and describe youth’s perspectives on a sustainable model for the provision of YFSRHs in Kenya. Data was collected among 400 youths aged 18 - 24 years in Embu and Kirinyaga counties, Kenya. A structured questionnaire was utilized as the data collection tool. Collected data was analyzed using SAS statistical software version 9.4. Statistical threshold of P ≤ 0.05 was used. Overall the mean age of the study participants was ±standard deviation (SD) 21.2 ± 1.86 years. Majority of the participants’ perspective on the health care system sustainability was that the waiting time at the facility should be less than an hour, accessible geographically (less than a kilometre), affordable (≤20 Ksh.), and convenient working hours (weekday and weekends ratio 1:1). Advocacy was on health care provider’s attributes of politeness, welcoming, confidential and non-judgmental. The most preferred locations for the youth friendly centres by the participants were community and school based locations. Similarly, parental and community support was reported to highly contribute to sustained utilization and provision of the YFSRHs (P < 0.001). Unlike popular belief, 99.8% did not see the need for recreational facilities at the youth centres to ensure sustainability of the model. To ensure a sustainable model for the provision of YFSRHs, there is need for a multi-sectoral and stakeholder involvement that is;youth, health care system structure, health care service providers, parents and community. Further research is needed on parents and health care service provider’s perspectives on how to sustain the provision of YFSRH services.展开更多
Background: The Somali people have some of the worst health indicators in the world, with women and children most affected. Despite modest improvements in maternal and child mortality rates in the last five years, ine...Background: The Somali people have some of the worst health indicators in the world, with women and children most affected. Despite modest improvements in maternal and child mortality rates in the last five years, inequities amongst communities meant that some children and mothers are disproportionately exposed to otherwise avoidable and treatable diseases. The broad aim of this study is to assess utilization of Primary Health Care (PHC) and Its associated factors among Women of Childbearing age living In Mogadishu Somalia. Methodology: Descriptive and Analytical cross-sectional community-based study was conducted among Women of Childbearing age that were living in two districts (Hodan and Abdul-Aziz Districts)-Mogadishu-Somalia-From May 2019 to September 2019. A total of 395 of Women of Childbearing age were targeted during the study period. Descriptive and analytical statistics was used using Statistical package for social science (SPSS) version 20 statistical software. The data were showed tables, figures and graphs for describing the data. Results: The study found that Most of respondents were between 15 to 25 years 41.5% (395 sample sizes), while the age of group of >45 to 55 was only 6% (395 sample size). According to the district 76.5% of respondents were from Hodan, while 23.5% (395 sample size) of respondents were from Abdul-Aziz district. According to awareness to the need of a pregnant mother to be vaccinated at the Mother and child health (MCH) Most respondents 48.2% (395 Sample size) said that pregnant women may or may not need to be vaccinated. According to health-seeking decisions only 3% of ever married respondents were made by themselves whilst 97% of them were made by their husband. Age group was not significantly associated with the level of utilization of Primary Health Care (PHC);this is different from study in Kenya showing that age is an important factor in determining the use of skilled assistance, early antenatal care visits and more than four antenatal visits. Conclusion: The study concluded and recommended that the level of utilization of primary health care is poor and lower than other studies around Somalia as well as World Health Organization (WHO). recommendation And the study recommended that enhancing awareness importance of primary health care (PHC) utilization and empowering women Health care-seeking behavior and their husbands.展开更多
Pressure injuries are frequent secondary complications that occur in patients with Spinal Cord Injury (SCI), and the recurrence rate of ischial pressure injury is highest in SCI patients. Most SCI patients use wheelch...Pressure injuries are frequent secondary complications that occur in patients with Spinal Cord Injury (SCI), and the recurrence rate of ischial pressure injury is highest in SCI patients. Most SCI patients use wheelchairs, and some studies have shown a relationship between buttock pressure and sitting posture. However, the pressure distribution during wheelchair maneuvering is unclear. We measured and compared the shift of the ischial region when maneuvering a standard wheelchair or electric wheelchair in healthy adults. The subjects drove wheelchairs on a flat ground of 10 m and the shift of ischial region was measured with a pressure distribution-measuring device. The ischial region shifted forward or backward while maneuvering both the standard wheelchair and the electric wheelchair, and the shift rate of the ischial region was not significantly different between the standard wheelchair and the electric wheelchair. The ischial region shift occurred when the forward head moved by the video while maneuvering both a standard wheelchair and an electric wheelchair. Therefore, the shift might occurred because the pelvis shifted forward in conjunction with head movement during maneuvering of both the standard wheelchair and the electric wheelchair. This result showed that it is important to reduce head and trunk movements when maneuvering a wheelchair to reduce the shear force on the buttocks and prevent pressure injuries.展开更多
Sexual and reproductive health (SRH) is among the fundamental packages of health care, which all clients seeking health care should receive. However, it is unclear how healthcare providers, in particular, nurses perce...Sexual and reproductive health (SRH) is among the fundamental packages of health care, which all clients seeking health care should receive. However, it is unclear how healthcare providers, in particular, nurses perceive the issue of people with mental problems having sexual health needs. The aim of this study was to explore perceptions of nurses at Ndola Teaching Hospital towards sexual health needs of people with mental health problems. A general descriptive qualitative study design was utilized and data were collected using three focus group discussions (FGDs) that were recorded and later transcribed verbatim. Purposive sampling was used to select 21 nurses who participated in the study. Nine were male, while 12 were female. Each FGD comprised seven participants. Thematic analysis was used to analyze the data, and six major themes: 1) physiological interplay among different body systems, 2) disease process and effects of psychotropic, 3) participant differences in age, gender, educational level, and cultural backgrounds, 4) staff shortages in mental health units, 5) deficient record keeping, and 6) Social stereotypes and labelling theories emerged. Despite acknowledging the existence of sexual activity among people with mental health problems;participants had both positive and negative perceptions. It is, therefore, recommended that interventions aimed at strengthening implementation of SRH guidelines among nurses caring for people with mental health problems should be put in place.展开更多
Background: Physical functional decline is common among elderly individuals with mental disorders, worsening their symptoms. Physiotherapy interventions have shown some evidence in improving physical function and ment...Background: Physical functional decline is common among elderly individuals with mental disorders, worsening their symptoms. Physiotherapy interventions have shown some evidence in improving physical function and mental health outcomes in this population. This study aimed to assess the impact of physiotherapy interventions on the elderly with mental health conditions at Chainama Hills College Hospital in Zambia. Methods: A pre-post single sample design was used to track patient progress over six weeks, with 10 physiotherapy sessions. The study population (N = 30) comprised of all elderly individuals with mental health conditions, encompassing both men and women, who were hospitalized during the research period. The Katz Index of Activities of Daily Living and the six-minute walk test were evaluated before and after the intervention. The IBM SPSS version 26 was used to analyze data and results were presented as mean ± SD with a 95% confidence interval. The variables were described in terms of their mean, SD, and range. A significance level of 0.05 was used for a paired T-test to detect changes and multiple logistic regression was used to identify factors associated with mental health. Results: Following the intervention, the percentage of participants achieving full function and independence increased significantly to 96.7% from the initial 73.3%, supported by a 95% CI = [0.82 - 0.99]. There was also a notable decrease in the proportion of individuals experiencing moderate impairment, dropping from 26.7% to just 3.3%, with a corresponding 95% CI = [0.00 - 0.17]. Conclusion: The findings derived from this study illustrate an enhancement in the aspects of participants’ overall health and functional condition, including blood pressure, heart rate, and respiratory rate. Consequently, physiotherapy exercises can be employed as a tactic to ameliorate the functional status and physical well-being of older individuals afflicted with mental disorders in Zambia.展开更多
Background: Oral cancer presents a heterogeneous geographic incidence. Annually, more than 275,000 new cases are diagnosed worldwide. In spite of the easy accessibility of oral cavity during physical examination, most...Background: Oral cancer presents a heterogeneous geographic incidence. Annually, more than 275,000 new cases are diagnosed worldwide. In spite of the easy accessibility of oral cavity during physical examination, most malignancies are not diagnosed until late stages of disease. Methods: Oral health promotion was our main objective, risk factors were identified and oral cavity self-examination was promoted. The population considered (n = 1117) was divided in two main age groups—a youngest (individuals under 25 years old) mostly targeted for oral cancer awareness and oral cavity self examination promotion, and an older group having accumulated potential risk exposure. Results: The results obtained revealed smoking habits and fruits-vegetables consumption deficit as the highest risks factors found. Considering a Risk Factor Exposure Index analysis, individuals with secondary level of instruction and living in sub-urban areas assumed the highest risk exposure. Alcohol consumption had also contributed as a significant risk exposure. Conclusions: Some of these risk factors work as biological reward of quality of life deficit. A wide comprehension of the problem requires a multidisciplinary approach necessarily involving Health and Social Sciences in order to target the core of oral cancer health promotion. An effective epidemiological strategy must thus support three major aspects: population knowledge, sensitization and visual screening.展开更多
Rationale and Aim: Patient safety is of great interest in health care organisations, worldwide. In Sweden, a national patient safety initiative was launched in 2011. The aim of this study was to examine and compare pa...Rationale and Aim: Patient safety is of great interest in health care organisations, worldwide. In Sweden, a national patient safety initiative was launched in 2011. The aim of this study was to examine and compare patient safety culture change over time from health care staffs’ perspective. A further aim was to examine factors that have had an effect on patient safety culture. Methods: Patient safety culture was assessed in 2009, 2011 and 2013 using the Swedish version of the Hospital Survey of Patient Safety Culture. Respondents in this study were registered nurses (n = 2149), enrolled nurses (n = 959), physicians (n = 355) and managers (n = 159) working in three health care divisions in a Swedish county council. Results: Patient safety culture decreased significantly over time for all but two dimensions. The dimension “Information to Patients/Relatives” was the only dimension to increase significantly over time. Health care staffs’ profession and health care division belonging had significant main effects on 14 and 8 dimensions, respectively. Managers and enrolled nurses scored patient safety culture significantly higher than registered nurses and physicians. Health care staff working in a mixed medical-surgical health care division scored significantly higher than those working in medical or surgical divisions did. Conclusions: Despite efforts for patient safety work in the county council, health care staffs’ perceptions of patient safety culture decreased over time. To improve hospital patient safety culture, managers and staff groups must meet and communicate with each other in order to create a common view of patient safety.展开更多
Objective: 1) To describe the prevalence of undiagnosed obstructive sleep apnea (OSA) and depressive symptoms in hypertensive men and women below 65 years of age, and 2) to describe the association of OSA to subjectiv...Objective: 1) To describe the prevalence of undiagnosed obstructive sleep apnea (OSA) and depressive symptoms in hypertensive men and women below 65 years of age, and 2) to describe the association of OSA to subjective sleep complaints, depressive symptoms and global perceived health. Design: Cross-sectional design focusing on nursing care outcomes of obstructive sleep apnea. Setting: Four primary care health centres in Sweden. PATIENTS: 411 consecutive patients (52% women), mean age 57.9 years (SD 5.9 years), with diagnosed hypertension (BP > 140/90). Main Outcome Measures: Prevalence of OSA and depressive symptoms, and association of OSA to sleep complaints, depressive symptoms and global perceived health. RESULTS: Mild, moderate and severe OSA was seen among 29%, 16% and 14% of patients, respectively. Depressive symptoms were seen in 16% of the total group, with a higher prevalence among men, compared to women, 21% vs. 12%. No differences were found regarding blood pressure, estimated sleep need, sleep sufficiency index, insomnia symptoms, daytime sleepiness or depressive symptoms with respect to different degrees of OSA. Apnea-hypopnea index was significantly associated to perceived health after adjustment for gender and comorbidities, but when depressive symptoms and non-restorative sleep were added to the model, 33% of the variance in global perceived health was explained. Conclusion: OSA is highly prevalent among patients with hypertension in primary care and does together with sleep complaints and depressive symptoms have a negative impact on global perceived health. Hypertensive patients without subjective sleep complaints or depressive symptoms may still have OSA.展开更多
There is a strong evidence supporting the hypothesis of synaptic dysfunction as a major contributor to neural circuit and network disruption underlying emotional and mood dysregulation in psychiatric disorders(Simmons...There is a strong evidence supporting the hypothesis of synaptic dysfunction as a major contributor to neural circuit and network disruption underlying emotional and mood dysregulation in psychiatric disorders(Simmons et al.,2024).Diverse sets of distinct molecular signaling pathways converge on the synapse to regulate synaptogenesis,synaptic function,and synaptic plasticity in brain regions and circuits through complex interactions organized by numerous multivalent protein scaffolds,including the family of proteins known as A-kinase anchoring proteins(AKAPs).展开更多
Objective:To explore the application effect of Problem-Based Learning(PBL)teaching method based on situational simulation videos in undergraduate teaching of internal medicine,and to provide practical basis for optimi...Objective:To explore the application effect of Problem-Based Learning(PBL)teaching method based on situational simulation videos in undergraduate teaching of internal medicine,and to provide practical basis for optimizing the undergraduate teaching mode of internal medicine and improving teaching quality.Methods:A total of 32 undergraduate students majoring in clinical medicine(Grade 2021)from Shanghai University of Medicine&Health Sciences were selected as the research subjects.They were divided into an experimental group and a control group by random number table method,with 16 students in each group.The control group adopted the traditional PBL teaching method,while the experimental group used the PBL teaching method based on situational simulation videos.After the teaching,the mastery of theoretical knowledge of students in the two groups was evaluated by examinations;a questionnaire survey was conducted to assess students’self-perceived improvement in clinical thinking,learning interest,self-directed learning ability and teamwork ability;statistical methods were used to analyze the data.Results:The scores of theoretical knowledge examination of students in the experimental group were significantly higher than those in the control group,and the difference was statistically significant(p<0.05).In terms of self-evaluation,the experimental group showed better performance than the control group in the cultivation of clinical thinking,learning interest and selfdirected learning ability,with statistically significant differences(p<0.05);however,there was no statistically significant difference in the self-evaluation of teamwork ability between the two groups(p>0.05).Conclusion:The PBL teaching method based on situational simulation videos can effectively improve students’level of theoretical knowledge,enhance their clinical thinking,learning interest and self-directed learning ability in undergraduate teaching of internal medicine,and is worthy of further promotion and application in undergraduate teaching of internal medicine.展开更多
BACKGROUND Single-ventricle congenital heart disease often requires the Fontan procedure,which can lead to Fontan-associated liver disease(FALD)and multi-organ failure.Combined heart-liver transplantation(CHLT)is a po...BACKGROUND Single-ventricle congenital heart disease often requires the Fontan procedure,which can lead to Fontan-associated liver disease(FALD)and multi-organ failure.Combined heart-liver transplantation(CHLT)is a potential lifesaving option for these patients.AIMTo investigate the outcomes and complications of CHLT in patients with failing Fontan physiology.METHODSSeven retrospective studies of 121 patients undergoing CHLT were systematically reviewed. Quality was assessedwith the Newcastle-Ottawa Scale. A meta-analysis using random-effects models to calculate odds ratios (ORs) ormean differences (MDs) with 95% confidence intervals.RESULTSThe pooled 30-day, 1-year, 5-year, and 10-year survival rates after CHLT were 92.6%, 86.78%, 81.17%, and 77.8%,respectively. The mean intensive care unit and total hospital lengths of stay were 8.46 and 28.16 days. Meanischemic time was 267.29 minutes, while cardiopulmonary bypass time was 260.27 minutes. Infections (30%), renalreplacement therapy (36.84%), and graft rejection (12.34%) were notable complications. Compared to orthotopicheart transplantation (OHT), CHLT significantly reduced mortality (OR: 0.30, P = 0.009) and ischemic time (MD:–65.93 minutes), with no major differences in perioperative morbidity.CONCLUSIONCHLT offers a survival advantage over OHT for patients with FALD and failing Fontan physiology. Futureprospective studies are warranted to refine eligibility and improve long-term survival.展开更多
TMSG-1 is a newly discovered tumor metastasis suppressor gene,which plays important roles in promoting apoptosis and inhibiting invasion and metastasis of tumor cells.The inhibitory function of TMSG-1 in tumor cells m...TMSG-1 is a newly discovered tumor metastasis suppressor gene,which plays important roles in promoting apoptosis and inhibiting invasion and metastasis of tumor cells.The inhibitory function of TMSG-1 in tumor cells may be related to vacuolar H+-ATPase and ceramide,but the underlying mechanism remains unknown.Studies on TMSG-1 are limited worldwide,and only a research group in Shanghai and our group have recently studied on it.As a new research field,the function of TMSG-1 remains to be explored.This review discusses the discovery of TMSG-1,structure of its encoded protein,its roles and possible mechanism in inhibiting tumor invasion and metastasis.展开更多
Background: The physiological and biochemical demands of intense exercise elicit both muscle-based and systemic responses. The main adaptations to endurance exercise include the correction of electrolyte imbalance, a ...Background: The physiological and biochemical demands of intense exercise elicit both muscle-based and systemic responses. The main adaptations to endurance exercise include the correction of electrolyte imbalance, a decrease in glycogen storage and the increase of oxidative stress, intestinal permeability, muscle damage, and systemic inflammatory response. Adaptations to exercise might be influenced by the gut microbiota, which plays an important role in the production, storage, and expenditure of energy obtained from the diet as well as in inflammation,redox reactions, and hydration status.Methods: A systematic and comprehensive search of electronic databases, including MEDLINE, Scopus, Clinical Trials.gov, Science Direct,Springer Link, and EMBASE was done. The search process was completed using the keywords: "endurance", "exercise", "immune response","microbiota", "nutrition", and "probiotics".Results: Reviewed literature supports the hypothesis that intestinal microbiota might be able to provide a measureable, effective marker of an athlete's immune function and that microbial composition analysis might also be sensitive enough to detect exercise-induced stress and metabolic disorders. The review also supports the hypothesis that modifying the microbiota through the use of probiotics could be an important therapeutic tool to improve athletes' overall general health, performance, and energy availability while controlling inflammation and redox levels.Conclusion: The present review provides a comprehensive overview of how gut microbiota may have a key role in controlling the oxidative stress and inflammatory responses as well as improving metabolism and energy expenditure during intense exercise.展开更多
Prostate cancer （PCa） incidence and mortality have decreased in recent years. Nonetheless, it remains one of the most prevalent cancers in men, being a disquieting cause of men＇s death worldwide. Changes in many ce...Prostate cancer （PCa） incidence and mortality have decreased in recent years. Nonetheless, it remains one of the most prevalent cancers in men, being a disquieting cause of men＇s death worldwide. Changes in many cell signaling pathways have a predominant role in the onset, development, and progression of the disease. These include prominent pathways involved in the growth, apoptosis, and angiogenesis of the normal prostate gland, such as an- drogen and estrogen signaling, and other growth factor signaling pathways. Understanding the foundations of PCa is leading to the discovery of key molecules that could be used to improve patient management. The ideal scenario would be to have a panel of molecules, preferably detectable in body fluids, that are specific and sensitive biomarkers for PCa In the early stages, androgen deprivation is the gold standard therapy. However, as the cancer progresses, it even- tually becomes independent of androgens, and hormonal therapy fails. For this reason, androgen-independent PCa is still a major therapeutic challenge. By disrupting specific protein interactions or manipulating the expression of some key molecules, it might be possible to regulate tumor growth and metastasis formation, avoiding the systemic side effects of current therapies. Clinical trials are already underway to assess the efficacy of molecules specially designed to target key proteins or protein interactions. In this review, we address that recent progress made towards under- standing PCa development and the molecular pathways underlying this pathology. We also discuss relevant molecular markers for the management of PCa and new therapeutic challenges.展开更多
Objective and quantitative intraoperative methods of bowel viability assessment are essential in gastrointestinal surgery. Exact determination of the borderline of the viable bowel with the help of an objective test c...Objective and quantitative intraoperative methods of bowel viability assessment are essential in gastrointestinal surgery. Exact determination of the borderline of the viable bowel with the help of an objective test could result in a decrease of postoperative ischemic complications. An accurate, reproducible and cost effective method is desirable in every operating theater dealing with abdominal operations. Numerous techniques assessing various parameters of intestinal viability are described by the studies. However, there is no consensus about their clinical use. To evaluate the available methods, a systematic search of the English literature was performed. Virtues and drawbacks of the techniques and possibilities of clinical application are reviewed. Valuable parameters related to postoperative intestinal anastomotic or stoma complications are analyzed. Important issues in the measurement and interpretation of bowel viability are discussed. To date, only a few methods are applicable in surgical practice.Further studies are needed to determine the limiting values of intestinal tissue oxygenation and flow indicative of ischemic complications and to standardize the methods.展开更多
Generally, wounds are of two categories, such as chronic and acute. Chronic wounds takes time to heal when compared to the acute wounds. Chronic wounds include vasculitis, non healing ulcer, pyoderma gangrenosum, and ...Generally, wounds are of two categories, such as chronic and acute. Chronic wounds takes time to heal when compared to the acute wounds. Chronic wounds include vasculitis, non healing ulcer, pyoderma gangrenosum, and diseases that cause ischemia. Chronic wounds are rapidly increasing among the elderly population with dysfunctional valves in their lower extremity deep veins, ulcer, neuropathic foot and pressure ulcers. The process of the healing of wounds has several steps with the involvement of immune cells and several other cell types. There are many evidences supporting the hypothesis that apoptosis of immune cells is involved in the wound healing process by ending inflammatory condition. It is also involved in the resolution of various phases of tissue repair. During final steps of wound healing most of the endothelial cells, macrophagesand myofibroblasts undergo apoptosis or exit from the wound, leaving a mass that contains few cells and consists mostly of collagen and other extracellular matrix proteins to provide strength to the healing tissue. This review discusses the various phases of wound healing both in the chronic and acute wounds especially during diabetes mellitus and thus support the hypothesis that the oxidative stress, apoptosis, connexins and other molecules involved in the regulation of chronic wound healing in diabetes mellitus and gives proper understanding of the mechanisms controlling apoptosis and tissue repair during diabetes and may eventually develop therapeutic modalities to fasten the healing process in diabetic patients.展开更多
文摘BACKGROUND Despite societal guidelines recommending targeted screening for Barrett’s esophagus(BE)and esophageal adenocarcinoma(EAC)in individuals with gastroesophageal reflux symptoms(GERS),screening adherence is suboptimal.Current screening approaches fail to identify individuals not seeking medical consultation for GERS or whose GERS are managed with‘over-the-counter’(OTC)acid suppressant therapies.AIM To assess patients’self-management and help-seeking behavior for GERS.METHODS This cross-sectional study collected data from the Dutch general population aged 18-75 years between January and April 2023 using a web-based survey.The survey included questions regarding self-management(e.g.,use of acid suppressant therapy with or without prescription)and help-seeking behavior(e.g.,consulting a primary care provider)for GERS.Simple random sampling was performed to select individuals within the target age group.In total,18156 randomly selected individuals were invited to participate.The study protocol was registered in ClinicalTrials.gov(identifier:NCT05689918).RESULTS Of the 18156 invited individuals,3214 participants(17.7%)completed the survey,of which 1572 participants(48.9%)reported GERS.Of these,904 participants(57.5%)had never consulted a primary care provider for these symptoms,of which 331 participants(36.6%)reported taking OTC acid suppressant therapy in the past six months and 100 participants(11.1%)fulfilled the screening criteria for BE and EAC according to the European Society of Gastrointestinal Endoscopy Guideline.CONCLUSION The population fulfilling the screening criteria for BE and EAC is incompletely identified,suggesting potential underutilization of medical consultation.Raising public awareness of GERS as a risk factor for EAC is needed.
文摘Objective:To explore health-improving behaviors during COVID-19 pandemic and to reveal the impact of the risk perception of COVID-19 on these behaviors.Methods:We recruited a total of 510 participants for this cross-sectional study.The data were collected online using a questionnaire booklet covering a form inquiring about the participants’demographic,physical,and mental characteristics,the Generalized Anxiety Disorder-7 Scale,and the COVID-19 Perceived Risk Scale.Results:The mean age of the participants was(28.7±10.1)years,and 76.1%were females.Of the participants,31.8%were overweight and obese.While 35.1%experienced negative alterations in their dietary patterns,23.9%reported positive changes to their diet during the pandemic.Besides,47.8%reported their sleep to be negatively affected during the pandemic.While the rate of those with extended screen time was 72.5%,it was 44.3%for the participants engaging in regular exercise.More than one-third of the participants(35.9%)had high and severe anxiety.We also found increased risk perception of COVID-19 among females,obese,those with disturbed eating and sleep quality,healthcare workers,and those with severe anxiety.Conclusions:Overall,the pandemic has appeared to have brought both positive and negative impacts on maintaining and improving eating,sleep,physical activity,and mental health.
文摘As the prevalence of diabetic retinopathy continues to be on the rise, the Chronic Care Model (CCM) offers a transformative, patient-focused approach for efficient diabetic retinopathy care, emphasizing the need for urgent and innovative strategies in the United States. The model integrates community resources, healthcare organizations, self-management support, delivery system design, decision support, and clinical information systems. Addressing challenges and solutions, the model emphasizes proactive and preventive measures, collaborative multidisciplinary care, technological integration, and overcoming resistance to change. This paper proposes the utilization of the Chronic Care Model (CCM) as a possible public health framework for comprehensive management of diabetic retinopathy in the United States. Implementing the CCM offers a comprehensive approach to diabetic retinopathy care, addressing both individual and systemic factors, essential for improving public health outcomes.
文摘Introduction: Oral health education is an important issue that should be given to children and adolescents, allowing the acquisition of correct oral health behaviors. The objective of this study was to determine the prevalence of oral health behaviors among a sample of portuguese adolescents and verify the association with socio-demographic factors, in order to analyze the main needs related with oral health education to improve oral health status among adolescents. Methods: A cross-sectional study was designed with a sample of 447 adolescents aged 12 to 19 years old, attending a public school in Sátão, Portugal. A self-administered questionnaire was applied questioning about socio-demographic factors and oral health behaviors to each adolescent in the classroom. Prevalence was expressed in proportions and crude odds ratio (OR) with 95% confidence intervals (CI) were used to measure the strength of association between oral health behaviors and socio-demographic factors. Results: The prevalence of tooth brushing (twice-a-day or more) was 90.6%. Five point eight percent of adolescents reported daily flossing, more frequent among female gender (female, OR = 2.03, 95% CI = (1.35 to 3.05)) and adolescents older than 15 years (>15 years, OR = 1.90, 95% CI = (1.24 to 2.92)). Sixty-seven percent had at least one dental appointment in the previous twelve months. The prevalence of dental appointments was associated with the father’s professional situation (unemployed, OR = 0.33, 95% CI = (0.17 to 0.65)) and crowding index (>1, OR = 0.4, 95% CI = (0.16 to 0.98)). Thirty-two point nine percent of adolescents referred having at least one episode of dental pain during their lives. Conclusion: Considering the results of the present study that show the need of improvement of some aspects related with oral health among adolescents, oral health community programs and primary preventive strategies, such as improvement of oral health education in schools should be considered in order to reduce the risk level of oral diseases and develop better oral health behaviors.
文摘Nearly half of the world’s population comprise youths. However, addressing their Sexual and Reproductive Health (SRH) remains a challenge. Globally countries are mandated to continually provide Youth Friendly Sexual and Reproductive Health services (YFSRHs) to the youth. The objective of this study was to assess and describe youth’s perspectives on a sustainable model for the provision of YFSRHs in Kenya. Data was collected among 400 youths aged 18 - 24 years in Embu and Kirinyaga counties, Kenya. A structured questionnaire was utilized as the data collection tool. Collected data was analyzed using SAS statistical software version 9.4. Statistical threshold of P ≤ 0.05 was used. Overall the mean age of the study participants was ±standard deviation (SD) 21.2 ± 1.86 years. Majority of the participants’ perspective on the health care system sustainability was that the waiting time at the facility should be less than an hour, accessible geographically (less than a kilometre), affordable (≤20 Ksh.), and convenient working hours (weekday and weekends ratio 1:1). Advocacy was on health care provider’s attributes of politeness, welcoming, confidential and non-judgmental. The most preferred locations for the youth friendly centres by the participants were community and school based locations. Similarly, parental and community support was reported to highly contribute to sustained utilization and provision of the YFSRHs (P < 0.001). Unlike popular belief, 99.8% did not see the need for recreational facilities at the youth centres to ensure sustainability of the model. To ensure a sustainable model for the provision of YFSRHs, there is need for a multi-sectoral and stakeholder involvement that is;youth, health care system structure, health care service providers, parents and community. Further research is needed on parents and health care service provider’s perspectives on how to sustain the provision of YFSRH services.
文摘Background: The Somali people have some of the worst health indicators in the world, with women and children most affected. Despite modest improvements in maternal and child mortality rates in the last five years, inequities amongst communities meant that some children and mothers are disproportionately exposed to otherwise avoidable and treatable diseases. The broad aim of this study is to assess utilization of Primary Health Care (PHC) and Its associated factors among Women of Childbearing age living In Mogadishu Somalia. Methodology: Descriptive and Analytical cross-sectional community-based study was conducted among Women of Childbearing age that were living in two districts (Hodan and Abdul-Aziz Districts)-Mogadishu-Somalia-From May 2019 to September 2019. A total of 395 of Women of Childbearing age were targeted during the study period. Descriptive and analytical statistics was used using Statistical package for social science (SPSS) version 20 statistical software. The data were showed tables, figures and graphs for describing the data. Results: The study found that Most of respondents were between 15 to 25 years 41.5% (395 sample sizes), while the age of group of >45 to 55 was only 6% (395 sample size). According to the district 76.5% of respondents were from Hodan, while 23.5% (395 sample size) of respondents were from Abdul-Aziz district. According to awareness to the need of a pregnant mother to be vaccinated at the Mother and child health (MCH) Most respondents 48.2% (395 Sample size) said that pregnant women may or may not need to be vaccinated. According to health-seeking decisions only 3% of ever married respondents were made by themselves whilst 97% of them were made by their husband. Age group was not significantly associated with the level of utilization of Primary Health Care (PHC);this is different from study in Kenya showing that age is an important factor in determining the use of skilled assistance, early antenatal care visits and more than four antenatal visits. Conclusion: The study concluded and recommended that the level of utilization of primary health care is poor and lower than other studies around Somalia as well as World Health Organization (WHO). recommendation And the study recommended that enhancing awareness importance of primary health care (PHC) utilization and empowering women Health care-seeking behavior and their husbands.
文摘Pressure injuries are frequent secondary complications that occur in patients with Spinal Cord Injury (SCI), and the recurrence rate of ischial pressure injury is highest in SCI patients. Most SCI patients use wheelchairs, and some studies have shown a relationship between buttock pressure and sitting posture. However, the pressure distribution during wheelchair maneuvering is unclear. We measured and compared the shift of the ischial region when maneuvering a standard wheelchair or electric wheelchair in healthy adults. The subjects drove wheelchairs on a flat ground of 10 m and the shift of ischial region was measured with a pressure distribution-measuring device. The ischial region shifted forward or backward while maneuvering both the standard wheelchair and the electric wheelchair, and the shift rate of the ischial region was not significantly different between the standard wheelchair and the electric wheelchair. The ischial region shift occurred when the forward head moved by the video while maneuvering both a standard wheelchair and an electric wheelchair. Therefore, the shift might occurred because the pelvis shifted forward in conjunction with head movement during maneuvering of both the standard wheelchair and the electric wheelchair. This result showed that it is important to reduce head and trunk movements when maneuvering a wheelchair to reduce the shear force on the buttocks and prevent pressure injuries.
文摘Sexual and reproductive health (SRH) is among the fundamental packages of health care, which all clients seeking health care should receive. However, it is unclear how healthcare providers, in particular, nurses perceive the issue of people with mental problems having sexual health needs. The aim of this study was to explore perceptions of nurses at Ndola Teaching Hospital towards sexual health needs of people with mental health problems. A general descriptive qualitative study design was utilized and data were collected using three focus group discussions (FGDs) that were recorded and later transcribed verbatim. Purposive sampling was used to select 21 nurses who participated in the study. Nine were male, while 12 were female. Each FGD comprised seven participants. Thematic analysis was used to analyze the data, and six major themes: 1) physiological interplay among different body systems, 2) disease process and effects of psychotropic, 3) participant differences in age, gender, educational level, and cultural backgrounds, 4) staff shortages in mental health units, 5) deficient record keeping, and 6) Social stereotypes and labelling theories emerged. Despite acknowledging the existence of sexual activity among people with mental health problems;participants had both positive and negative perceptions. It is, therefore, recommended that interventions aimed at strengthening implementation of SRH guidelines among nurses caring for people with mental health problems should be put in place.
文摘Background: Physical functional decline is common among elderly individuals with mental disorders, worsening their symptoms. Physiotherapy interventions have shown some evidence in improving physical function and mental health outcomes in this population. This study aimed to assess the impact of physiotherapy interventions on the elderly with mental health conditions at Chainama Hills College Hospital in Zambia. Methods: A pre-post single sample design was used to track patient progress over six weeks, with 10 physiotherapy sessions. The study population (N = 30) comprised of all elderly individuals with mental health conditions, encompassing both men and women, who were hospitalized during the research period. The Katz Index of Activities of Daily Living and the six-minute walk test were evaluated before and after the intervention. The IBM SPSS version 26 was used to analyze data and results were presented as mean ± SD with a 95% confidence interval. The variables were described in terms of their mean, SD, and range. A significance level of 0.05 was used for a paired T-test to detect changes and multiple logistic regression was used to identify factors associated with mental health. Results: Following the intervention, the percentage of participants achieving full function and independence increased significantly to 96.7% from the initial 73.3%, supported by a 95% CI = [0.82 - 0.99]. There was also a notable decrease in the proportion of individuals experiencing moderate impairment, dropping from 26.7% to just 3.3%, with a corresponding 95% CI = [0.00 - 0.17]. Conclusion: The findings derived from this study illustrate an enhancement in the aspects of participants’ overall health and functional condition, including blood pressure, heart rate, and respiratory rate. Consequently, physiotherapy exercises can be employed as a tactic to ameliorate the functional status and physical well-being of older individuals afflicted with mental disorders in Zambia.
文摘Background: Oral cancer presents a heterogeneous geographic incidence. Annually, more than 275,000 new cases are diagnosed worldwide. In spite of the easy accessibility of oral cavity during physical examination, most malignancies are not diagnosed until late stages of disease. Methods: Oral health promotion was our main objective, risk factors were identified and oral cavity self-examination was promoted. The population considered (n = 1117) was divided in two main age groups—a youngest (individuals under 25 years old) mostly targeted for oral cancer awareness and oral cavity self examination promotion, and an older group having accumulated potential risk exposure. Results: The results obtained revealed smoking habits and fruits-vegetables consumption deficit as the highest risks factors found. Considering a Risk Factor Exposure Index analysis, individuals with secondary level of instruction and living in sub-urban areas assumed the highest risk exposure. Alcohol consumption had also contributed as a significant risk exposure. Conclusions: Some of these risk factors work as biological reward of quality of life deficit. A wide comprehension of the problem requires a multidisciplinary approach necessarily involving Health and Social Sciences in order to target the core of oral cancer health promotion. An effective epidemiological strategy must thus support three major aspects: population knowledge, sensitization and visual screening.
文摘Rationale and Aim: Patient safety is of great interest in health care organisations, worldwide. In Sweden, a national patient safety initiative was launched in 2011. The aim of this study was to examine and compare patient safety culture change over time from health care staffs’ perspective. A further aim was to examine factors that have had an effect on patient safety culture. Methods: Patient safety culture was assessed in 2009, 2011 and 2013 using the Swedish version of the Hospital Survey of Patient Safety Culture. Respondents in this study were registered nurses (n = 2149), enrolled nurses (n = 959), physicians (n = 355) and managers (n = 159) working in three health care divisions in a Swedish county council. Results: Patient safety culture decreased significantly over time for all but two dimensions. The dimension “Information to Patients/Relatives” was the only dimension to increase significantly over time. Health care staffs’ profession and health care division belonging had significant main effects on 14 and 8 dimensions, respectively. Managers and enrolled nurses scored patient safety culture significantly higher than registered nurses and physicians. Health care staff working in a mixed medical-surgical health care division scored significantly higher than those working in medical or surgical divisions did. Conclusions: Despite efforts for patient safety work in the county council, health care staffs’ perceptions of patient safety culture decreased over time. To improve hospital patient safety culture, managers and staff groups must meet and communicate with each other in order to create a common view of patient safety.
基金The Swedish Heart Lung Foundation, Grant 20090547
文摘Objective: 1) To describe the prevalence of undiagnosed obstructive sleep apnea (OSA) and depressive symptoms in hypertensive men and women below 65 years of age, and 2) to describe the association of OSA to subjective sleep complaints, depressive symptoms and global perceived health. Design: Cross-sectional design focusing on nursing care outcomes of obstructive sleep apnea. Setting: Four primary care health centres in Sweden. PATIENTS: 411 consecutive patients (52% women), mean age 57.9 years (SD 5.9 years), with diagnosed hypertension (BP > 140/90). Main Outcome Measures: Prevalence of OSA and depressive symptoms, and association of OSA to sleep complaints, depressive symptoms and global perceived health. RESULTS: Mild, moderate and severe OSA was seen among 29%, 16% and 14% of patients, respectively. Depressive symptoms were seen in 16% of the total group, with a higher prevalence among men, compared to women, 21% vs. 12%. No differences were found regarding blood pressure, estimated sleep need, sleep sufficiency index, insomnia symptoms, daytime sleepiness or depressive symptoms with respect to different degrees of OSA. Apnea-hypopnea index was significantly associated to perceived health after adjustment for gender and comorbidities, but when depressive symptoms and non-restorative sleep were added to the model, 33% of the variance in global perceived health was explained. Conclusion: OSA is highly prevalent among patients with hypertension in primary care and does together with sleep complaints and depressive symptoms have a negative impact on global perceived health. Hypertensive patients without subjective sleep complaints or depressive symptoms may still have OSA.
基金supported by the National Institute of Mental Health (NIH/NIMH)the National Institute of Neurological Disorders and Stroke(NIH/NINDS):Grants#R21 MH132136 to FSN and R01 MH123700 and R01 NS040701 to MLD
文摘There is a strong evidence supporting the hypothesis of synaptic dysfunction as a major contributor to neural circuit and network disruption underlying emotional and mood dysregulation in psychiatric disorders(Simmons et al.,2024).Diverse sets of distinct molecular signaling pathways converge on the synapse to regulate synaptogenesis,synaptic function,and synaptic plasticity in brain regions and circuits through complex interactions organized by numerous multivalent protein scaffolds,including the family of proteins known as A-kinase anchoring proteins(AKAPs).
基金Teacher Teaching and Educational Research Project of Shanghai University of Medicine and Health Sciences in 2024(Project No.:CFDY20240035)。
文摘Objective:To explore the application effect of Problem-Based Learning(PBL)teaching method based on situational simulation videos in undergraduate teaching of internal medicine,and to provide practical basis for optimizing the undergraduate teaching mode of internal medicine and improving teaching quality.Methods:A total of 32 undergraduate students majoring in clinical medicine(Grade 2021)from Shanghai University of Medicine&Health Sciences were selected as the research subjects.They were divided into an experimental group and a control group by random number table method,with 16 students in each group.The control group adopted the traditional PBL teaching method,while the experimental group used the PBL teaching method based on situational simulation videos.After the teaching,the mastery of theoretical knowledge of students in the two groups was evaluated by examinations;a questionnaire survey was conducted to assess students’self-perceived improvement in clinical thinking,learning interest,self-directed learning ability and teamwork ability;statistical methods were used to analyze the data.Results:The scores of theoretical knowledge examination of students in the experimental group were significantly higher than those in the control group,and the difference was statistically significant(p<0.05).In terms of self-evaluation,the experimental group showed better performance than the control group in the cultivation of clinical thinking,learning interest and selfdirected learning ability,with statistically significant differences(p<0.05);however,there was no statistically significant difference in the self-evaluation of teamwork ability between the two groups(p>0.05).Conclusion:The PBL teaching method based on situational simulation videos can effectively improve students’level of theoretical knowledge,enhance their clinical thinking,learning interest and self-directed learning ability in undergraduate teaching of internal medicine,and is worthy of further promotion and application in undergraduate teaching of internal medicine.
文摘BACKGROUND Single-ventricle congenital heart disease often requires the Fontan procedure,which can lead to Fontan-associated liver disease(FALD)and multi-organ failure.Combined heart-liver transplantation(CHLT)is a potential lifesaving option for these patients.AIMTo investigate the outcomes and complications of CHLT in patients with failing Fontan physiology.METHODSSeven retrospective studies of 121 patients undergoing CHLT were systematically reviewed. Quality was assessedwith the Newcastle-Ottawa Scale. A meta-analysis using random-effects models to calculate odds ratios (ORs) ormean differences (MDs) with 95% confidence intervals.RESULTSThe pooled 30-day, 1-year, 5-year, and 10-year survival rates after CHLT were 92.6%, 86.78%, 81.17%, and 77.8%,respectively. The mean intensive care unit and total hospital lengths of stay were 8.46 and 28.16 days. Meanischemic time was 267.29 minutes, while cardiopulmonary bypass time was 260.27 minutes. Infections (30%), renalreplacement therapy (36.84%), and graft rejection (12.34%) were notable complications. Compared to orthotopicheart transplantation (OHT), CHLT significantly reduced mortality (OR: 0.30, P = 0.009) and ischemic time (MD:–65.93 minutes), with no major differences in perioperative morbidity.CONCLUSIONCHLT offers a survival advantage over OHT for patients with FALD and failing Fontan physiology. Futureprospective studies are warranted to refine eligibility and improve long-term survival.
基金National Natural Science Foundation of China (No. 30971142)
文摘TMSG-1 is a newly discovered tumor metastasis suppressor gene,which plays important roles in promoting apoptosis and inhibiting invasion and metastasis of tumor cells.The inhibitory function of TMSG-1 in tumor cells may be related to vacuolar H+-ATPase and ceramide,but the underlying mechanism remains unknown.Studies on TMSG-1 are limited worldwide,and only a research group in Shanghai and our group have recently studied on it.As a new research field,the function of TMSG-1 remains to be explored.This review discusses the discovery of TMSG-1,structure of its encoded protein,its roles and possible mechanism in inhibiting tumor invasion and metastasis.
文摘Background: The physiological and biochemical demands of intense exercise elicit both muscle-based and systemic responses. The main adaptations to endurance exercise include the correction of electrolyte imbalance, a decrease in glycogen storage and the increase of oxidative stress, intestinal permeability, muscle damage, and systemic inflammatory response. Adaptations to exercise might be influenced by the gut microbiota, which plays an important role in the production, storage, and expenditure of energy obtained from the diet as well as in inflammation,redox reactions, and hydration status.Methods: A systematic and comprehensive search of electronic databases, including MEDLINE, Scopus, Clinical Trials.gov, Science Direct,Springer Link, and EMBASE was done. The search process was completed using the keywords: "endurance", "exercise", "immune response","microbiota", "nutrition", and "probiotics".Results: Reviewed literature supports the hypothesis that intestinal microbiota might be able to provide a measureable, effective marker of an athlete's immune function and that microbial composition analysis might also be sensitive enough to detect exercise-induced stress and metabolic disorders. The review also supports the hypothesis that modifying the microbiota through the use of probiotics could be an important therapeutic tool to improve athletes' overall general health, performance, and energy availability while controlling inflammation and redox levels.Conclusion: The present review provides a comprehensive overview of how gut microbiota may have a key role in controlling the oxidative stress and inflammatory responses as well as improving metabolism and energy expenditure during intense exercise.
基金Project supported by Fundao para a Ciência e Tecnologia(FCT)(PTDC/QUI-BIQ/118492/2010)Fundo Europeu de Desenvol-vimento Regional(FEDER)(FCOMP-01-0124-FEDER-020895),Portugal
文摘Prostate cancer （PCa） incidence and mortality have decreased in recent years. Nonetheless, it remains one of the most prevalent cancers in men, being a disquieting cause of men＇s death worldwide. Changes in many cell signaling pathways have a predominant role in the onset, development, and progression of the disease. These include prominent pathways involved in the growth, apoptosis, and angiogenesis of the normal prostate gland, such as an- drogen and estrogen signaling, and other growth factor signaling pathways. Understanding the foundations of PCa is leading to the discovery of key molecules that could be used to improve patient management. The ideal scenario would be to have a panel of molecules, preferably detectable in body fluids, that are specific and sensitive biomarkers for PCa In the early stages, androgen deprivation is the gold standard therapy. However, as the cancer progresses, it even- tually becomes independent of androgens, and hormonal therapy fails. For this reason, androgen-independent PCa is still a major therapeutic challenge. By disrupting specific protein interactions or manipulating the expression of some key molecules, it might be possible to regulate tumor growth and metastasis formation, avoiding the systemic side effects of current therapies. Clinical trials are already underway to assess the efficacy of molecules specially designed to target key proteins or protein interactions. In this review, we address that recent progress made towards under- standing PCa development and the molecular pathways underlying this pathology. We also discuss relevant molecular markers for the management of PCa and new therapeutic challenges.
文摘Objective and quantitative intraoperative methods of bowel viability assessment are essential in gastrointestinal surgery. Exact determination of the borderline of the viable bowel with the help of an objective test could result in a decrease of postoperative ischemic complications. An accurate, reproducible and cost effective method is desirable in every operating theater dealing with abdominal operations. Numerous techniques assessing various parameters of intestinal viability are described by the studies. However, there is no consensus about their clinical use. To evaluate the available methods, a systematic search of the English literature was performed. Virtues and drawbacks of the techniques and possibilities of clinical application are reviewed. Valuable parameters related to postoperative intestinal anastomotic or stoma complications are analyzed. Important issues in the measurement and interpretation of bowel viability are discussed. To date, only a few methods are applicable in surgical practice.Further studies are needed to determine the limiting values of intestinal tissue oxygenation and flow indicative of ischemic complications and to standardize the methods.
文摘Generally, wounds are of two categories, such as chronic and acute. Chronic wounds takes time to heal when compared to the acute wounds. Chronic wounds include vasculitis, non healing ulcer, pyoderma gangrenosum, and diseases that cause ischemia. Chronic wounds are rapidly increasing among the elderly population with dysfunctional valves in their lower extremity deep veins, ulcer, neuropathic foot and pressure ulcers. The process of the healing of wounds has several steps with the involvement of immune cells and several other cell types. There are many evidences supporting the hypothesis that apoptosis of immune cells is involved in the wound healing process by ending inflammatory condition. It is also involved in the resolution of various phases of tissue repair. During final steps of wound healing most of the endothelial cells, macrophagesand myofibroblasts undergo apoptosis or exit from the wound, leaving a mass that contains few cells and consists mostly of collagen and other extracellular matrix proteins to provide strength to the healing tissue. This review discusses the various phases of wound healing both in the chronic and acute wounds especially during diabetes mellitus and thus support the hypothesis that the oxidative stress, apoptosis, connexins and other molecules involved in the regulation of chronic wound healing in diabetes mellitus and gives proper understanding of the mechanisms controlling apoptosis and tissue repair during diabetes and may eventually develop therapeutic modalities to fasten the healing process in diabetic patients.
