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
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
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
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
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: 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
In the Democratic Republic of Congo,the Kafubu River has received,for several decades,mining waste from GECAMINE Kipushi and Lubumbashi as well as those from the CHEMAF plant.Given this situation,we wanted to verify t...In the Democratic Republic of Congo,the Kafubu River has received,for several decades,mining waste from GECAMINE Kipushi and Lubumbashi as well as those from the CHEMAF plant.Given this situation,we wanted to verify the degree of contamination of fish in the Kafubu River with TME(Trace Metal Elements).In doing so,fish samples from this river,downstream of mining activities,as well as samples of reference fish from upstream of any mining activity from the sources of the Panda and Kasungwe rivers and that of the Congo River were analyzed with Inductively Couple Plasma Mass Spectrometry(ICP-MS)and Inductively Couple Plasma Optical Emission Spectroscopy(ICP-OES).Statistical analysis,using the Wilcoxon test,of the results obtained as well as the comparison of these with the thresholds of the WHO(World Health Organization),FAO(Food and Agriculture Organization)and the EU(European Union)revealed that the fish of the Kafubu River are contaminated with As,Cd,Co,Cu,Mn,Ni,Pb,Se and Zn.Thus,it was concluded that the fish of the Kafubu River were not fit for human consumption.In addition,because of the very high level of bioaccumulation of these TMEs in the fish of the Kafubu River,the latter have been described as poisonous for the consuming population.The main principle that emerges from this study is that fish from an ecosystem polluted by mining waste are not fit for human consumption.The results of this study will be brought to the attention of Decision-makers in the Haut-Katanga Province so that rigorous measures can be taken to prohibit metallurgical plants from dumping their mining waste into aquatic ecosystems.展开更多
Introduction: Several studies have reported a high prevalence of dental caries among the people with intellectual disabilities. In order to identify the sociodemographic, clinical and behavioral factors associated wit...Introduction: Several studies have reported a high prevalence of dental caries among the people with intellectual disabilities. In order to identify the sociodemographic, clinical and behavioral factors associated with it, we conducted a study in specialized centers welcoming subjects with intellectual disabilities in Ouagadougou (Burkina Faso). Objectives: The objective of this study was to identify the factors associated with it among intellectually disabled in the specialized centers of Ouagadougou. Methods: The study was cross-sectional analytical. The survey took place between November 2020 and January 2021 among people with intellectual disabilities in reception centers receiving a grant from the Ministry of Women, National Solidarity, Family and Humanitarian Action. Data collection was done with a questionnaire adapted from the World Health Organization (WHO) and dental caries was recorded according to WHO criteria in decayed, missing or filled teeth generating a DMF index. Logistic regression was used to identify factors associated with the presence of dental caries. Results: A total of 193 participants were included in the study with an average age of 12.4 years ± 7.9. The overall prevalence of caries measured with the DMF index was 58.6% 95% CI [51.2 - 65.8]. It was significantly associated with female gender (OR = 4.2;95% CI [1.4 - 12.5], p = 0,01), the clinical form of mental illness (epilepsy OR = 3.8 95%;CI [1.2 - 12.7], p = 0,02, trisomy OR = 5.0;95% CI [1.1 - 22.9], p = 0,03, motor autonomy OR = 0.2 95%;CI [0.1 - 0.7], p = 0,01) and at use of toothpaste OR = 9.33;95% CI [1.05 - 82.7], p = 0,04. Conclusion: Dental caries remains a very present pathology in most people living with an intellectual disability. Also, it is necessary to put in place prevention strategies to reduce its prevalence and improve access to oral care for these people.展开更多
Introduction: Near-infrared fluorescence imaging is a technique that will establish itself in the short term at the international level because it is recognized for its potential to improve the performance of surgical...Introduction: Near-infrared fluorescence imaging is a technique that will establish itself in the short term at the international level because it is recognized for its potential to improve the performance of surgical interventions, its moderate investment and operating costs and its portability. Although the technology is now mature, there is currently the problem of the availability of contrast agents to be injected IV. The aim of this methodology article is to propose an alternative solution to the need for contrast agents for clinical research, particularly in oncology. Methodology: They consist of coupling a fluorescent marker in the form of an NHS derivative, such as IR DYE manufactured in compliance with GMP, with therapeutic monoclonal antibodies having marketing authorization for molecular imaging. For a given antibody, the marking procedure must be the subject of a validation file on the final preparation filtered on a sterilizing membrane at 0.22 μm. Once the procedure has been validated, it would be unnecessary to repeat the tests before each clinical research examination. A check of the marking by thin-layer chromatography (TLC) and place it in a sample bank at +4˚C for 1 month of each injected formulation would be sufficient for additional tests if necessary. Conclusion: Molecular near-infrared fluorescence imaging is experiencing development, the process of which could be accelerated by greater availability of clinical contrast agents. Alternative solutions are therefore necessary to promote clinical research in this area. These methods must be shared to make it easier for researchers.展开更多
Plummer-Vinson syndrome(PVS)is a rare condition marked by postcricoid dysphagia,upper esophageal webs,and iron deficiency anemia.It has been associated with increased risk of hypopharyngeal and esophageal malignancies...Plummer-Vinson syndrome(PVS)is a rare condition marked by postcricoid dysphagia,upper esophageal webs,and iron deficiency anemia.It has been associated with increased risk of hypopharyngeal and esophageal malignancies,necessitating early diagnosis.This case series reviews four patients who presented to Adera Medical and Surgical Center in Addis Ababa,Ethiopia,with PVS.All patients exhibited progressive dysphagia,anemia,and fatigue.Endoscopic evaluation revealed esophageal webs in the upper esophagus,and treatment included iron replacement therapy and esophageal dilation as needed.Hemoglobin levels improved in all cases,with three patients experiencing complete resolution of dysphagia,while one required a repeat dilation after 6 months for recurrence.展开更多
Background: Infertility affected 10% to 25% of couples globally, and about half of the infertility cases were reported in sub-Saharan Africa. Infertility poses significant social, cultural, and health challenges, part...Background: Infertility affected 10% to 25% of couples globally, and about half of the infertility cases were reported in sub-Saharan Africa. Infertility poses significant social, cultural, and health challenges, particularly for women who often face stigmatization. However, comprehensive and nationally representative data, including prevalence, temporal trends, and risk factors, are lacking, prompting a study in Burkina Faso to address the need for informed policies and programs in infertility care and management. Objectives: This study aims to better understand the spatiotemporal trend of infertility prevalence in Burkina Faso. Methodology: This is a retrospective population-based study of women infertility from healthcare facilities in Burkina Faso, during January 2011 to December 2020. We calculated the prevalence rates of infertility and two disparity measures, and examined the spatiotemporal trend of infertility. Results: Over the 10-year period (2011 to 2020), 143,421 infertility cases were recorded in Burkina Faso healthcare facilities, resulting of a mean prevalence rate of 3.61‰ among childbearing age women and 17.87‰ among women who consulted healthcare facilities for reproductive issues (except contraception). The findings revealed a significant increase of infertility, with the prevalence rate varied from 2.75‰ in 2011 to 4.62‰ in 2020 among childbearing age women and from 13.38‰ in 2011 to 26.28‰ in 2020 among women who consulted healthcare facilities for reproductive issues, corresponding to an estimate annual percentage change of 8.31% and 9.80% respectively. There were significant temporal and geographic variations in the prevalence of infertility. While relative geographic disparity decreased, absolute geographic disparity showed an increasing trend over time. Conclusion: The study highlights an increasing trend of infertility prevalence and significant geographic variation in Burkina Faso, underscoring the urgent necessity for etiologic research on risk factors, psychosocial implications, and economic consequences to inform effective interventions and mitigate the socioeconomic impact of infertility.展开更多
The markers of oocyte quality have remained a major controversy in the field of embryology due to the subjectivity of the different methods of oocyte assessment. Various scholars use oocyte quality and oocyte competen...The markers of oocyte quality have remained a major controversy in the field of embryology due to the subjectivity of the different methods of oocyte assessment. Various scholars use oocyte quality and oocyte competence interchangeably. Oocyte quality can be defined as the overall health of an oocyte whereas oocyte competence refers to the ability of an oocyte to be fertilized and develop into a healthy embryo. Diminished oocyte quality is believed to be a result of alterations in oocyte growth and maturation processes that stem from several pelvic and systemic factors before and after oocyte retrieval. In this review, we focus on the morphological and nonmorphological markers of oocyte quality. Strict restrictions that limit the number of oocytes fertilized in various countries have triggered researchers around the world to come up with the most appropriate and noninvasive markers that enhance oocyte selection and optimize IVF outcomes. PubMed, Google Scholar, and the Cochrane Library were used to search for peer-reviewed, original articles about oocyte quality markers. The review was written in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Morphological markers are commonly used, but they are subjective, and no single marker can be used exclusively to predict oocyte competence and subsequent embryonic development potential. Furthermore, transcriptomics of differentially expressed genes in cumulus cells and assessment of metabolomics and other contents of follicular fluid have shown greater precision. However, their specificity to the different quality determinants needs further research.展开更多
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.
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.
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: 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.
文摘In the Democratic Republic of Congo,the Kafubu River has received,for several decades,mining waste from GECAMINE Kipushi and Lubumbashi as well as those from the CHEMAF plant.Given this situation,we wanted to verify the degree of contamination of fish in the Kafubu River with TME(Trace Metal Elements).In doing so,fish samples from this river,downstream of mining activities,as well as samples of reference fish from upstream of any mining activity from the sources of the Panda and Kasungwe rivers and that of the Congo River were analyzed with Inductively Couple Plasma Mass Spectrometry(ICP-MS)and Inductively Couple Plasma Optical Emission Spectroscopy(ICP-OES).Statistical analysis,using the Wilcoxon test,of the results obtained as well as the comparison of these with the thresholds of the WHO(World Health Organization),FAO(Food and Agriculture Organization)and the EU(European Union)revealed that the fish of the Kafubu River are contaminated with As,Cd,Co,Cu,Mn,Ni,Pb,Se and Zn.Thus,it was concluded that the fish of the Kafubu River were not fit for human consumption.In addition,because of the very high level of bioaccumulation of these TMEs in the fish of the Kafubu River,the latter have been described as poisonous for the consuming population.The main principle that emerges from this study is that fish from an ecosystem polluted by mining waste are not fit for human consumption.The results of this study will be brought to the attention of Decision-makers in the Haut-Katanga Province so that rigorous measures can be taken to prohibit metallurgical plants from dumping their mining waste into aquatic ecosystems.
文摘Introduction: Several studies have reported a high prevalence of dental caries among the people with intellectual disabilities. In order to identify the sociodemographic, clinical and behavioral factors associated with it, we conducted a study in specialized centers welcoming subjects with intellectual disabilities in Ouagadougou (Burkina Faso). Objectives: The objective of this study was to identify the factors associated with it among intellectually disabled in the specialized centers of Ouagadougou. Methods: The study was cross-sectional analytical. The survey took place between November 2020 and January 2021 among people with intellectual disabilities in reception centers receiving a grant from the Ministry of Women, National Solidarity, Family and Humanitarian Action. Data collection was done with a questionnaire adapted from the World Health Organization (WHO) and dental caries was recorded according to WHO criteria in decayed, missing or filled teeth generating a DMF index. Logistic regression was used to identify factors associated with the presence of dental caries. Results: A total of 193 participants were included in the study with an average age of 12.4 years ± 7.9. The overall prevalence of caries measured with the DMF index was 58.6% 95% CI [51.2 - 65.8]. It was significantly associated with female gender (OR = 4.2;95% CI [1.4 - 12.5], p = 0,01), the clinical form of mental illness (epilepsy OR = 3.8 95%;CI [1.2 - 12.7], p = 0,02, trisomy OR = 5.0;95% CI [1.1 - 22.9], p = 0,03, motor autonomy OR = 0.2 95%;CI [0.1 - 0.7], p = 0,01) and at use of toothpaste OR = 9.33;95% CI [1.05 - 82.7], p = 0,04. Conclusion: Dental caries remains a very present pathology in most people living with an intellectual disability. Also, it is necessary to put in place prevention strategies to reduce its prevalence and improve access to oral care for these people.
文摘Introduction: Near-infrared fluorescence imaging is a technique that will establish itself in the short term at the international level because it is recognized for its potential to improve the performance of surgical interventions, its moderate investment and operating costs and its portability. Although the technology is now mature, there is currently the problem of the availability of contrast agents to be injected IV. The aim of this methodology article is to propose an alternative solution to the need for contrast agents for clinical research, particularly in oncology. Methodology: They consist of coupling a fluorescent marker in the form of an NHS derivative, such as IR DYE manufactured in compliance with GMP, with therapeutic monoclonal antibodies having marketing authorization for molecular imaging. For a given antibody, the marking procedure must be the subject of a validation file on the final preparation filtered on a sterilizing membrane at 0.22 μm. Once the procedure has been validated, it would be unnecessary to repeat the tests before each clinical research examination. A check of the marking by thin-layer chromatography (TLC) and place it in a sample bank at +4˚C for 1 month of each injected formulation would be sufficient for additional tests if necessary. Conclusion: Molecular near-infrared fluorescence imaging is experiencing development, the process of which could be accelerated by greater availability of clinical contrast agents. Alternative solutions are therefore necessary to promote clinical research in this area. These methods must be shared to make it easier for researchers.
文摘Plummer-Vinson syndrome(PVS)is a rare condition marked by postcricoid dysphagia,upper esophageal webs,and iron deficiency anemia.It has been associated with increased risk of hypopharyngeal and esophageal malignancies,necessitating early diagnosis.This case series reviews four patients who presented to Adera Medical and Surgical Center in Addis Ababa,Ethiopia,with PVS.All patients exhibited progressive dysphagia,anemia,and fatigue.Endoscopic evaluation revealed esophageal webs in the upper esophagus,and treatment included iron replacement therapy and esophageal dilation as needed.Hemoglobin levels improved in all cases,with three patients experiencing complete resolution of dysphagia,while one required a repeat dilation after 6 months for recurrence.
文摘Background: Infertility affected 10% to 25% of couples globally, and about half of the infertility cases were reported in sub-Saharan Africa. Infertility poses significant social, cultural, and health challenges, particularly for women who often face stigmatization. However, comprehensive and nationally representative data, including prevalence, temporal trends, and risk factors, are lacking, prompting a study in Burkina Faso to address the need for informed policies and programs in infertility care and management. Objectives: This study aims to better understand the spatiotemporal trend of infertility prevalence in Burkina Faso. Methodology: This is a retrospective population-based study of women infertility from healthcare facilities in Burkina Faso, during January 2011 to December 2020. We calculated the prevalence rates of infertility and two disparity measures, and examined the spatiotemporal trend of infertility. Results: Over the 10-year period (2011 to 2020), 143,421 infertility cases were recorded in Burkina Faso healthcare facilities, resulting of a mean prevalence rate of 3.61‰ among childbearing age women and 17.87‰ among women who consulted healthcare facilities for reproductive issues (except contraception). The findings revealed a significant increase of infertility, with the prevalence rate varied from 2.75‰ in 2011 to 4.62‰ in 2020 among childbearing age women and from 13.38‰ in 2011 to 26.28‰ in 2020 among women who consulted healthcare facilities for reproductive issues, corresponding to an estimate annual percentage change of 8.31% and 9.80% respectively. There were significant temporal and geographic variations in the prevalence of infertility. While relative geographic disparity decreased, absolute geographic disparity showed an increasing trend over time. Conclusion: The study highlights an increasing trend of infertility prevalence and significant geographic variation in Burkina Faso, underscoring the urgent necessity for etiologic research on risk factors, psychosocial implications, and economic consequences to inform effective interventions and mitigate the socioeconomic impact of infertility.
文摘The markers of oocyte quality have remained a major controversy in the field of embryology due to the subjectivity of the different methods of oocyte assessment. Various scholars use oocyte quality and oocyte competence interchangeably. Oocyte quality can be defined as the overall health of an oocyte whereas oocyte competence refers to the ability of an oocyte to be fertilized and develop into a healthy embryo. Diminished oocyte quality is believed to be a result of alterations in oocyte growth and maturation processes that stem from several pelvic and systemic factors before and after oocyte retrieval. In this review, we focus on the morphological and nonmorphological markers of oocyte quality. Strict restrictions that limit the number of oocytes fertilized in various countries have triggered researchers around the world to come up with the most appropriate and noninvasive markers that enhance oocyte selection and optimize IVF outcomes. PubMed, Google Scholar, and the Cochrane Library were used to search for peer-reviewed, original articles about oocyte quality markers. The review was written in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Morphological markers are commonly used, but they are subjective, and no single marker can be used exclusively to predict oocyte competence and subsequent embryonic development potential. Furthermore, transcriptomics of differentially expressed genes in cumulus cells and assessment of metabolomics and other contents of follicular fluid have shown greater precision. However, their specificity to the different quality determinants needs further research.
