Health Sciences

Pharmacist attitudes about the over-the-counter (OTC) sale of HIV rapid tests in pharmacies were explored through interviews conducted among 17 licensed community pharmacists in a Midwestern, moderate HIV incidence state between May and September 2012. Participants recognized that OTC rapid HIV tests would increase the number of people aware of their HIV status. Concerns included linkage to care and results consultation for those who test HIV-positive. Point of sale was identified as an opportunity for consultation about the test and to establish a relationship for future discussion about results and linkage to care. Pharmacists could provide initial test consultation or information, and consultation about the test results in order to provide post diagnosis support and facilitate linkage to care. Las actitudes de los farmacéuticos sobre el over-the-counter (OTC) venta de las pruebas rápidas del VIH en farmacias se exploró a través de entrevistas entre los 17 farmacéuticos comunitarios con licencia en un estado del Midwestern en Estados Unidos, moderado incidencia del VIH entre Mayo y Septiembre de 2012. Los participantes reconocieron que OTC pruebas rápidas de VIH aumentaría el número de personas que conocen su estado serológico. Las preocupaciones incluyen la vinculación con cuidado y consulta los resultados para los que el resultado es VIH-positivo. Point of sale de venta fue identificado como una oportunidad de consulta sobre la prueba y establecer una relación para un discussion futuro sobre los resultados y la vinculación a la atención. Los farmacéuticos podría ofrecer consulta inicial de prueba o información y consulta sobre los resultados de la prueba con el fin de ofrecer apoyo después de diagnóstico y facilitar la vinculación a la atención.

Aims: Overweight and obesity are clinical public-health concerns worldwide. Amongst older adults, the prevalence of overweight and obesity is considered high. the purpose of this study was to provide current data regarding the prevalence and trends of overweight and obesity of adults from 2005 to 2013 in 10 European countries. Methods: the data used in the present study were derived from the first, second, fourth and fifth waves of the survey of Health, Ageing and Retirement in Europe. the present study includes individuals aged ≥50 years from 10 European countries. Body mass index (BMI) was calculated from self-reported height and weight (kg/m 2 ). Results: the general prevalence of overweight (BMI ≥25 kg/ m 2 ) was slightly above 60% and remained stable between 2005 (60.1%, 95% confidence interval (CI): 59.3-60.9%) and 2013 (60.3%, 95% CI: 59.7-60.9%). On the other hand, the prevalence of obesity (BMI ≥30 kg/m 2 ) increased significantly (1.6 points, 95% CI: 0.7-2.6) from 17.5% in 2005 to 19.2% in 2013. Although the prevalence of obesity increased in most countries, the only significant increase was observed in germany (5.8 points, 95% CI: 1.8-9.9). spain was the only country where the prevalence of obesity decreased significantly (-4.7 points, 95% CI: -8.8 to -0.5). sex and age differences are reported. Conclusions: Although the prevalence of overweight was stable, the prevalence of obesity rose. Based on the data currently available for Europe, the prevalence of obesity in European older adults has already reached epidemic proportions, which reinforces the need for the development of effective healthy lifestyle programs.

To examine the risk of mortality associated with interruptions to the continuity of methadone maintenance treatment (MMT), including transfers between services, in opioid-dependent individuals attending specialist addiction services. Design Retrospective cohort study using addiction services and primary care dispensing records, the National Methadone Register and National Drug-Related Death Index (NDRDI). Setting Geographically defined population in Dublin, Ireland. Participants A total of 2899 people prescribed and dispensed methadone in specialist addiction services between January 2010 and December 2015. There were five exposure groups: weeks 1-4 following transfer between treatment providers; weeks 1-4 out of treatment; weeks 5-52 out of treatment; weeks 1-4 of treatment initiation; and weeks 5+ of continuous treatment (reference category). Measurements Primary outcome: drug-related poisoning (DRP) deaths. Secondary outcome: all-cause mortality (ACM). Mortality rates calculated by dividing number of deaths (DRP; ACM) in exposure groups by person-years exposure. Unadjusted and adjusted Poisson regression (covariates age, sex, incarceration, methadone dose and comorbidities) estimated differences in mortality rates. Findings There were 154 ACM deaths, 55 (35.7%) identified as DRP deaths. No deaths were observed in the first month following transfer between treatment providers. The risk of DRP mortality was highest in weeks 1-4 out of treatment [adjusted relative risk (aRR = 4.04, 95% confidence interval (CI) = 1.43-11.43, P = 0.009] and weeks 1-4 of treatment initiation (ARR = 3.4, 95% CI = 1.2-9.64, P = 0.02). Similarly, risk of ACM was highest in weeks 1-4 out of treatment (ARR = 11.78, 95% CI = 7.73-17.94, P < 0.001), weeks 1-4 of treatment initiation (aRR = 5.11, 95% CI = 2.95-8.83, P < 0.001) and weeks 5-52 off treatment (aRR = 2.04, 95% CI = 1.2-3.47, P = 0.009). Conclusions Interruptions to the continuity of methadone maintenance treatment by treatment provider do not appear to be periods of risk for drug-related poisoning or all-cause mortality deaths. Risk of drug related poisoning and all-cause mortality deaths appears to be greatest during the first 4 weeks of treatment initiation/re-initiation and after treatment cessation.

Background: The 'perfect' journey through an Irish Methadone Maintenance Treatment Programme (MMTP) would have a client engage appropriately with all relevant services available to them, inclusive of psychiatry, counselling, out-reach support, nursing and psychology. Concurrently, a client would ideally adhere to their prescribed methadone-dosing regimen, until a client is stabilised allowing them to function optimally. At this point, a client should transfer to the GP community setting. Unfortunately, this fails to occur. To date, very few studies have specifically investigated the reasons why a cohort of clients remain 'trapped' in the high risk, specialist clinical setting. Methods: Qualitative detailed semi-structured interviews were undertaken with 17 clients of one of Ireland's Health Service Executive (HSE) Drug and Alcohol Services, entitled 'HSE Mid-West Limerick Drug and Alcohol Service'. Each client had a severe Opioid Use Disorder (OUD) and clients had spent on average 7.5 years engaging with the MMTP. Results: Participants' life journey prior to an OUD included Adverse Childhood Experiences (ACEs) and early exposure to illicit drug use. Shared life events resulting in their initiating and sustaining an OUD involved continuous hardship into adulthood, mental illness and concurrent benzodiazepine use disorder, often resulting in harrowing accounts of participants' loneliness and lack of life purpose. Their living environments, an erroneous understanding of their illness and poor communication with allied health professionals further perpetuated their OUD. Positive factors influencing periods of abstinence were familial incentives and a belief in the efficacy of methadone. Clients own suggestions for improving their journeys included employing a multi-sectorial approach to managing OUD and educating themselves and others on opioid agonist treatments. If clients were not progressing appropriately, they themselves suggested enforcing a 'time-limit' on clients to engage with the programme or indeed for their treatment to be postponed. Conclusions: To optimise the functioning of the MMTP, three tasks need to be fulfilled: 1) Reduce the incidences of ACEs, 2) Diagnose and treat clients with a dual diagnosis 3) Educate clients, their families, the public and allied health care professionals on all aspects of OUD. A cross-departmental, inter-governmental approach is needed to address opioid misuse as a societal issue as a whole.

Objectives: To determine the prevalence of endometriosis among adolescent school girls with severe dysmenorrhea. Methodology: Data was collected via interviewed questionnaire. Patients with symptoms and signs suggestive of endometriosis were further evaluated by abdominal ultrasonography (AUS), serum cancer antigen 125 (CA125). Laparoscopy was done for confirmation in those who agreed. Those who declined laparoscopy were offered magnetic resonance imaging (MRI). Results: A total number of 654 adolescents were interviewed. Their mean age was 15.2 ±3.53 SD years. The mean duration of cycles and flow days was 29 ± 8.4 SD and 4 ± 2.8 SD respectively. The age of menarche in years was 13 ± 1.2 SD. Cycles were regular in 77.4 % (n=506) while irregular in 22.6 % (n=148). Of all studied girls, 48.9% (n=320) had menstrual pain of varying degree of severity. Severe dysmenorrhea was reported in 68.8 % (n=220/320) of them. Fifty six of these cases (25.5 %) had ultrasound findings suggestive of endometriosis. CA125 was elevated in41.5 % (n= 27/56) of them. Patients accepted laparoscopic confirmations were 34, of them 79.4%, (n=27) had positive histo-pathological evidence of endometriosis. MRI was offered to those declined laparoscopy (n=22). Endometriosis was suggested in 77.3% of them. The study concluded the prevalence of endometriosis in adolescents with severe dysmenorrhea was 12.3 % despite some declined laparoscopy. The unacceptability of laparoscopy and unfeasibility of local examination and trans-vaginal ultrasound add more to the difficulty of diagnosis.

To asses the efficacy of commercially available tests device method for anti HCV detection. Total 2000 blood samples for detection of anti HCV were screened initially by immunochromatographic method. Those found positive on initial screening were re-tested by ELISA method at the Biochemistry Laboratory of the Pakistan Medical Research Council, Fatima Jinnah Medical College, Lahore. Out of a total of 2,000 blood samples, 177 were found to be initially reactive/positive for anti-HCV with immunochromatographic method. When these reactive/positive samples were retested for confirmation with ELISA, 47 blood samples were found to have tested falsely positive for anti-HCV. Overall 2.35% of blood samples were found to be tested false positive for anti-HCV by immunochromatographic device method. Immunochromatographic device method test is rapid and simple, which can be used in setting with limited facility when rapid testing is required. However it should not be used as sole criteria for dia...

BACKGROUND There are many risk factors besides age and immune suppression for herpes zoster. Family history as a risk factor is suggested in some recent studies. The aim of this study was to evaluate the association between herpes zoster and family history. METHODS This case-control study was undertaken in Farshchian Hospital, Hamadan, Iran. &quot;Case group&quot; included patients with confirmed diagnosis of herpes zoster. &quot;Control group&quot; was chosen among other dermatologic patients or their companions without any history of herpes zoster. Immune deficiency was the main excluding criteria. Information about age, gender, dermatome involved (only in patient group), history of chronic dermatologic or systemic diseases and family history of herpes zoster was asked using special questionnaires. RESULTS Case and control groups included 217 and 200 participants respectively. Mean age of cases and controls was 49.08±15.59 and 49.96±15.54 years old respectively (P=0.936). 53.5% of...

Background: Cardiac Autonomic Neuropathy (CAN) is one of Type 1 Diabetes Mellitus complications with a high mortality rate. This condition might occur right after T1DM is diagnosed but is often asymptomatic. Cardiac Autonomic Reflex Tests (CART's) are one of the gold standard, non-invasive diagnostic with high sensitivity used for screening but rarely used in children. Some risk factors are associated with CAN, and one of them is poor glycemic Control. Objective: To delineate risk factors associated with Cardiac Autonomic Neuropathy in children with Type 1 Diabetes Mellitus at Dr. M Jamil Padang Hospital. Methods: A diagnostic test study was performed on children aged under 18 years old who came to the outpatient pediatric endocrinology clinic of M. Djamil Hospital or Pediatric Ward between February till August 2022 whom caregivers agreed to sign in the informed consent and follow instructions to do one of CART's maneuver called Heart Beat to Deep Breathing with ECG and draw a level HbA1C as Glycemic Control. Secondary data was collected from medical records. Data analysis was performed with a 2x2 table using a computer program Result: 34 samples were collected, with mean age T1DM 13,14±2,75 years and mean age at onset 10,4±2,65 years. CAN was diagnosed in 13 (38,2%) T1DM subjects and there was no signification between onset at age (p=1,0), duration of illness (p=0,653), and Glycemic control (p=0,132). Conclusion: No significant correlation was found between risk factors associated with Cardiac Autonomic Neuropathy in Type 1 Diabetes Mellitus.

Introduction: Prediction of complications is an essential part of risk management in surgery. Knowing which patient to operate and those at high risk of developing complications contributes significantly to the quality of surgical care and cost reduction. The postoperative complications of patients who underwent Laparotomy in Mulago Hospital were studied using POSSUM scoring system. The main objective of this study was to determine the postoperative complications of Laparotomy in Mulago Hospital, between September 2003 and February 2004. Methods: Consecutive patients, who underwent Laparotomy in Mulago, were studied using POSSUM system for development of complications. For each patient operated, they were followed up in wards until discharge. When the postoperative complications were reported, they were reexamined by the surgeons, treated and followed up for 30 days postoperatively. Phone contacts were used for the follow up. Surgical reviews were conducted once a week in Mulago Hos...

This is an important volume, containing contributions by an outstanding group of authors on some of the central issues of the Doha agenda negotiations. Distinguishing features of the volume include its comprehensive coverage of the issues, and the way the authors explain them in comprehensible terms, covering both the historical context and the debates currently raging in the WTO. ' -Will Martin,The World Bank, US Agricultural Policy Reform and the WTO provides insights into the effects of the Uruguay Round WTO agreement on agricultural policy and global markets, and considers what is at stake in the Doha Development Agenda Round.

The purpose of this study was to estimate the need for population-level services for alcohol and other drug abuse in support of local planning. Method: Data were drawn from a subsample of 2,942 interviewees from the São Paulo Megacity Study, which evaluated mental health in the general population (18 years and older) of residents in the São Paulo metropolitan area. This population was classified into fi ve hierarchical categories of severity, making it possible to obtain estimates of need for services, combining evaluation criteria regarding drug and alcohol use and general and mental health comorbidities over the last 12 months. For the at-risk groups in this population, estimates from the Potential Demand for the Use of Services survey interviews over the last year were generated. Results: Concerning the need for services, 86.5% of the population (Tier 1) had no problems related to drug and alcohol use, 8.9% (Tier 2) used heavily, 3.5% (Tiers 3, 4, and 5) met criteria for substance abuse disorders, among whom 1.3% (Tiers 4 and 5) require more specialized and intensive treatment and support. The following estimates for the Potential Demand for the Use of Services were found: 25.5% (Tier 3) and 51.1% (Tier 4), indicating that a signifi cant number of individuals met criteria for substance abuse disorders but did not perceive any need for professional help or neglected the help available. Conclusions: In São Paulo there exists a large sector of the population that requires prevention strategies regarding the risks and harm resulting from alcohol and drug use, followed by a group requiring more specialized care. But a large number of substance users requiring specialized support did not use services and did not believe that they needed professional help. (J. Stud. Alcohol Drugs, Supplement 18, 87-95, 2019) RÉSUMÉ. Objectif : Estimer le besoin de la population en termes de services pour l'abus d'alcool et d'autres drogues de façon à soutenir la planification locale. Méthode : Les données proviennent d'un sous-échantillon de 2 942 personnes interrogées dans le cadre de l'Étude sur la mégapole de São Paulo évaluant la santé mentale de la population générale (18 ans et plus) résidant dans la région métropolitaine. Cette population a été classée en cinq catégories hiérarchiques de sévérité, permettant ainsi d'obtenir des estimations de besoins de services, combinant les critères d'évaluation de l'usage d'alcool et de drogues et les comorbidités générales et de santé mentale au cours des 12 derniers mois. Les estimations de l'utilisation de services et des besoins perçus de services, au cours de la dernière année, ont été produites pour les groupes à risque de cette population. Résultats : Concernant le besoin de services, 86,5% de la population (catégorie 1) n'ont aucun problème relié à leur consommation d'alcool et de drogue, 8,9%(catégorie 2) consomment beaucoup, 3,5% (catégorie 3, 4 et 5) présentent les critères diagnostics du trouble de l'utilisation de substances, parmi lesquels 1,3% (catégorie 4 et 5) nécessitent du soutien ainsi qu'un traitement spécialisé et intensif. Les estimations suivantes pour l'utilisation de services/besoins perçus ont été calculées, 25,5 % (catégorie 3) et 51,1% (catégorie 4), indiquant qu'un nombre significatif d'individus présentent les critères diagnostic du trouble d'utilisation de substances mais ne ressentent pas le besoin de recevoir une aide professionnelle ou négligeraient celle qui est disponible. Conclusion : La mise en place de stratégies d'amélioration des options thérapeutiques, de la disponibilité des traitements et du soutien, ainsi qu'un plan de sensibilisation aux dangers de la toxicomanie devraient être des priorités. Estimar la necesidad de servicios a nivel de población para el abuso de alcohol y otras drogas en apoyo de la planificación local. Método: Los datos se obtuvieron de una submuestra de 2,942 entrevistados del Estudio de Megaciudades de São Paulo que evaluó la salud mental en la población general (18 años y más) de residentes en el área metropolitana de São Paulo. Esta población se clasificó en cinco categorías jerárquicas de gravedad, lo que permite obtener estimaciones de la necesidad de servicios, combinando los criterios de evaluación con respecto al uso de drogas y alcohol y las comorbilidades generales y de salud mental en los últimos 12 meses. Para los grupos en riesgo de esta población, se generaron estimaciones para el uso de servicios / necesidad de uso percibida durante el último año. Resultados: Con respecto a la necesidad de servicios, 86,5% de la población (categoría 1) no tuvo problemas relacionados con la droga y el uso de alcohol, 8,9% (categoría 2) que se utilizan en gran medida, 3,5% (categorías 3, 4 y 5) cumplió los criterios para los trastornos por abuso de sustancias, entre los cuales el 1.3% (categorías 4 y 5) requieren un tratamiento y apoyo más especializado e intensivo. Se encontraron las siguientes estimaciones de Uso de servicios / Necesidad de uso percibida, 25.5% (categoría 3) y 51.1% (categoría 4) que indica que un número signifi cativo de personas cumplieron los criterios para trastornos por abuso de sustancias, pero no perciben ninguna necesidad de ayuda profesional o descuidan la ayuda disponible. Conclusiones: Las estrategias para aumentar los conocimientos sobre los peligros del abuso de sustancias, y mejorar las opciones de cuidado y la disponibilidad de tratamiento y el apoyo deben hacerse prioridades.

Plasma melatonin circadian profiles were in- vestigated in a group of 4 patients with anorexia nervosa and 4 healthy regularly cycling women. There were no differences in the mean age of both groups, whereas the anorexia nervosa patients had lower mean body weight (37.8 \ m=+-\ 2.0 vs 57.0 \ m=+-\ 4.9 kg) and body mass index (13.9 \m=+-\ 1. 1 vs 20.8 \ m=+-\2.0). Samples were collected every 2 h and plasma melatonin was measured by using a RIA with an iodinated tracer. Anorexia nervosa patients exhibited higher diurnal (60.7 \ m=+-\ 1.8 vs 25.4 \ m=+-\ 1.72 pmol/l, P< 0.02) and nocturnal (419.2 \ m=+-\37.4 vs 108.0 \ m=+-\ 33.6 pmol/l), P< 0.001) mean plasma melatonin concentrations. There were no differences in the time peak for nocturnal mela- tonin secretion in both groups, detected at 02.00 h. In an- orexia nervosa, the melatonin circadian profile paral- leled that observed in the control group, indicating that the increased melatonin values for anorexia nervosa were probably due to an enhanced secretory pineal func- tion rather than an impaired melatonin metabolism. These results suggest a participation of the pineal gland in the pathophysiology of anorexia nervosa. Anorexia nervosa is a psychoneuroendocrine dis¬ ease characterized by an isolated hypogonadotropic hypogonadism (Boyar et al. 1974; Halmi &

Objectives: There is no single “correct” definition of poverty. However, there is consensus that any definition of poverty needs to acknowledge particular social, economic and cultural contexts. Different meanings of poverty results in different policy implementations in the context of human poverty. There is also less agreement as to whether objective or subjective definitions and measurements of poverty are more valid. Participatory approaches however point to the need to let people define for themselves what it means to be poor and define the magnitude, causes and consequences of being poor. The major focus of this paper was to clarify, explain and define the

Финансиската криза од 2007 година е најлошата економска појава по „Големата депресија“(1929). Илјадници луѓе ги загубија своите заштеди, работни места, а некои и своите домови и животи. Потребата од анализирање на причинителите за оваа појава е повеќе од евидентна, со цел учење од минатото и избегнување на слични кризи во иднина. За правилно да разбереме што се случи, истражувањето е потребно да го започнеме со проучување на основните фактори кои ја предизвикаа кризата. Станува збор за низа погрешно донесени одлуки како резултат на постоењето на асиметрични информации, пропратени со неправилности во менаџментот на ризик. Асиметричните информации, односно неповолната селекција и пред сѐ, моралниот хазард се наоѓаат во самиот фундамент на финансиската криза. Моралниот хазард ни ја претставува можноста за преземање на ризик во поголема мера од она што е нормално, притоа знаејќи дека евентуалните штети би ги претрпел некој друг. Така, миксот помеѓу дерегулацијата, високата концентрациј...

Many young people are beginning to feel isolated because of their mental and emotional decline. Perceptions of mental health can encapsulate a person’s ability to enjoy life and find a balance between health activities and efforts to achieve mental resilience. Mental health is a symptom of emotions and shows effective adaptation to a host of needs. From this perspective, this study was conducted to find ways and means of maintaining mental health among urban youth. The major objectives to conduct this study were to identify the means through which urban adolescents achieve their good mental health and to identify the impact of adolescent’s mental health on quality of life and school performance. Students of 11, 12 and first year bachelors’ were taken as sample. Descriptive method was conducted to find out the results and SPSS technique was used to analyze data. It was seen that many adolescents show common traits os stress and apply common means and strategies to cope their anxiety.

Current literature lacks systematic data on acute perioperative pain management in neonates and mainly focuses only on procedural pain management. In the current review, the neurophysiological basis of neonatal pain perception and the role of different analgesic drugs and techniques in perioperative pain management in neonates are systematically reviewed. Intravenous opioids such as morphine or fentanyl as either intermittent bolus or continuous infusion remain the most common modality for the treatment of perioperative pain. Paracetamol has a promising role in decreasing opioid requirement. However, routine use of ketorolac or other nonsteroidal anti-inflammatory drugs is not usually recommended. Epidural analgesia is safe in experienced hands and provides several benefits over systemic opioids such as early extubation and early return of bowel function.

Program baru pemerintah pusat lewat kementerian Kesehatan (Kemenkes) memberikan jaminan sosial kesehatan bagi masyarakat melalui Badan Penyelenggara Jaminan Sosial Kesehatan (BPJS. Masalah yang sering di jumpai pada pengguna BPJS adalah keluhan pelayanan keperawatan yang diberikan oleh petugas kesehatan tidak semuanya tanpa biaya. Pelayanan yang diberikan oleh petugas kesehatan cenderung tidak memenuhi kepuasan pasien. Tujuan penelitian ini adalah untuk mengetahui tingkat kepuasan pasien BPJS dalam pelayanan keperawatan di Ruang Rawat Inap Mawar  RSUD Dr. Hardjono Ponorogo.       Desain penelitian ini adalah deskiptif. Responden penelitian ini adalah pasien BPJS di RSUD Dr.Hardjono Ponorogo. Teknik sampling penelitian menggunakan Proposive Sampling. Sampel penelitian ini adalah sebagian pasien yang di rawat di ruang rawat inap  mawar di RSUD Dr.Hardjono Ponorogo dengan jumlah 48 responden. Pengumpulan data menggunakan kuisioner sedangkan teknik analisa data menggunakan prosentase.  ...

The fabrication process used for Nb3Sn accelerator magnets comprises coil reaction at high temperature and then impregnation with epoxy to restore the insulation electrical and mechanical properties. The traditional epoxy has a low radiation strength which limits the lifetime of accelerator magnets operating in severe radiation environments. Fermilab performs studies of Matrimid® 5292 - a bismaleimide based material, as a radiation-resistant alternative to epoxy. This material has appropriate viscosity and pot life, and provides excellent mechanical, electrical and thermal coil properties. Two Nb3Sn coils, a 1 m long quadrupole coil and a 2 m long dipole coil, were fabricated and impregnated with Matrimid. The quadrupole coil was tested in a quadrupole mirror at 4.5 and 1.9 K. Coil test results are presented and compared to similar coils impregnated with epoxy.

Patients coming to their family physician (FP) usually have more than one condition or problem. Multimorbidity as well as dealing with it, is challenging for FPs even as a mere concept. The World Health Organization (WHO) has simply defined multimorbidity as two or more chronic conditions existing in one patient. However, this definition seems inadequate for a holistic approach to patient care within Family Medicine. Using systematic literature review the European General Practitioners Research Network (EGPRN) developed a comprehensive definition of multimorbidity. For practical and wider use, this definition had to be translated into other languages, including Croatian. Here presented is the Croatian translation of this comprehensive definition using a Delphi consensus procedure for forward/backward translation. 23 expert FPs fluent in English were asked to rank the translation from 1 (absolutely disagreeable) to 9 (fully agreeable) and to explain each score under 7. It was previou...

To assess patient-reported outcomes, including frequency of nighttime heartburn symptoms, level of discomfort with nighttime heartburn symptoms, and quality of sleep, in patients with gastroesophageal reflux disease (GERD). Methods: Randomized, double-blind, baseline-controlled, two-period, two-treatment crossover study. Placebo was administered during baseline pH measurements. Patients were then randomly assigned to one of the following sequences: pantoprazole/ranitidine (nϭ12) or ranitidine/pantoprazole (nϭ19). Patients underwent two 8-day, double-blind treatment periods (pantoprazole 40 mg once daily or ranitidine 150 mg twice daily) separated by at least a 10-day (up to 21-day) washout period. Patients recorded frequency of nighttime heartburn symptoms (number of episodes per day), level of discomfort (1ϭnone to 7ϭvery severe) with nighttime heartburn symptoms, and sleep quality (1ϭexcellent to 7ϭextremely poor) using daily diaries. Differences between pantoprazole and ranitidine were compared using two-sample t-test or nonparametric Wilcoxon test as appropriate. A P-value Ͻ 0.05 in a two-tailed test was considered significant. Results: On day 1 and 8 during the nighttime (10 pm-8 am) period, the percentage of time that pH was 4 or higher was significantly greater with pantoprazole versus ranitidine (PՅ0.004 and PՅ0.007, respectively). Regardless of period: the frequency of nighttime heartburn symptoms was 0.17Ϯ0.37 for pantoprazole versus 0.50Ϯ0.55 for ranitidine (PϽ0.01), the level of discomfort with nighttime heartburn symptoms was 1.20Ϯ0.36 for pantoprazole versus 1.62Ϯ0.64 for ranitidine (PϽ0.01), and the quality of sleep was 2.76Ϯ0.66 for pantoprazole versus 2.94Ϯ0.59 for ranitidine (PϽ0.05). Conclusions: Pantoprazole has a significantly positive impact on patientreported outcomes including frequency of nighttime heartburn symptoms, level of discomfort with nighttime heartburn symptoms, and quality of sleep, in patients with GERD.

BackgroundVarying degrees of cortical amyloid deposition are reported in the setting of Parkinsonism with cognitive impairment. We performed a systematic review to estimate the prevalence of Alzheimer disease (AD) range cortical amyloid deposition among patients with Parkinson&#39;s disease with dementia (PDD), Parkinson&#39;s disease with mild cognitive impairment (PD‐MCI) and dementia with Lewy bodies (DLB). We included amyloid positron emission tomography (PET) imaging studies using Pittsburgh Compound B (PiB).MethodsWe searched the databases Ovid MEDLINE, PubMed, Embase, Scopus, and Web of Science for articles pertaining to amyloid imaging in Parkinsonism and impaired cognition. We identified 11 articles using PiB imaging to quantify cortical amyloid. We used the metan module in Stata, version 11.0, to calculate point prevalence estimates of patients with “PiB‐positive” studies, that is, patients showing AD range cortical Aβ‐amyloid deposition. Heterogeneity was assessed. A scat...

Reliable biomarkers for amyotrophic lateral sclerosis (ALS) are needed, given the clinical heterogeneity of the disease. Here, we provide proof-of-concept for using multimodal magnetic resonance imaging (MRI) as a diagnostic biomarker for ALS. Specifically, we evaluated the added diagnostic utility of proton magnetic resonance spectroscopy (MRS) to diffusion tensor imaging (DTI). Twenty-nine patients with ALS and 30 age- and gender-matched healthy controls underwent brain MRI which used proton MRS including spectral editing techniques to measure γ-aminobutyric acid (GABA) and DTI to measure fractional anisotropy of the corticospinal tract. Data were analyzed using logistic regression, t-tests, and generalized linear models with leave-one-out analysis to generate and compare the resulting receiver operating characteristic (ROC) curves. The diagnostic accuracy is significantly improved when the MRS data were combined with the DTI data as compared to the DTI data only (area under the R...

Welcome to our annual report on the state of the Academic Health Center . I'd like to welcome our colleagues on the St. Paul and Duluth campuses as well--we're using a new technology today, Breeze, that allows colleagues across town and across the state to see what's going on here, and send questions. Before I move into my reflection on the year past, and plans for the future, I'd like to ask all of you a couple of questions: 1. Does it feel to you that you're working harder than you can ever remember working? As if the volume and pace are simply magnified? 2. And, is that sense leading to a certain tension for you here at the University and in the workplace? If so, welcome to America in 2004. We're hearing from national experts who monitor our attitudes who tell us this country is in what's called a hinge period, or a period of time between defined eras. Whenever that happens--when we're between eras we understand and can define comfortably--we experience all of the symptoms of change ; the transitions and the extremes that come before a new period of consensus. These effects move well beyond the University and our workplace--they're being felt in our social lives and certainl y in our political lives. Of course, within the health professions, we don't need national pollsters to tel l us that we're within a period of change. We experience the effects or impact of change nearly every day. In fact, most of us now recognize that the core of our professions require change--that what we know as fact today will be challenged by new knowledge--and that new knowledge wi ll transform the status quo. In our research labs, we seek that change--those breakthroughs that will improve our ability to care for our pa tients and improve the health of our communities. Just this week on campus, our Lillehei Heart Institute hosted a remarkable group of cardiovascular pioneers who were committed to changing the status quo of their era. Remember that it was just 50 years ago that an infant born with a hole in the heart was slated to die of that defect. That simply wasn't acceptable to the cardiovascular surgeons of the early 1950s--so they led the quest for change. And this week, we celebrated the 50 th anniversary of open heart surgery by cross circulation--a pr ocedure that made a hole in the heart just something to repair. Today--we are facing holes in the fabric of health care that call for pioneering changes beyond the scope of the most skilled of surgeons. The holes I'm referring to will require engagement from all the health professions that are at the core of this great research University--and will require those professions to work together to pioneer solutions. There is a signi ficant gap in our understanding of the connections between animal and human health. We have continuing gaps in our ability to predict and re spond to the health professional needs of our communities. And those gaps or holes lead to significant consequences in access to health care , the safety and quality of that care, and to efforts to engage patients and health care consumers in owning their own health.

Simons a framework of levers controls revealed that effective use and control of the management system (MCS) can significantly contribute to increased financial performance as well as operational performance. However, the main objective and aim of this research study are to evaluate the financial performance of SME firms in Thailand through the role of the effective use of management control systems. This research paper also examines the direct relationship between MCS and the financial performance of the sector. The research model of this study also investigates the mediating role of product and process innovation in improving the relationship between the financial performance of the sector and MCS. To find the impact of MCS on the firm performance this study collects most of the data from selected employees and managers of different SME firms of Thailand with the help of the survey questionnaire. The results that are calculated with the help of structural equation modeling indicate that MCS significantly influence the financial performance of the firm and also made a significant contribution in enhancing the operational performance of the sector. Furthermore, the findings of this study also demonstrate that product innovation improves the relationship between MCS and financial performance. Accepted hypotheses of this 150 research help many future analysts to understand the importance of MCS.

Simons a framework of levers controls revealed that effective use and control of the management system (MCS) can significantly contribute to increased financial performance as well as operational performance. However, the main objective and aim of this research study are to evaluate the financial performance of SME firms in Thailand through the role of the effective use of management control systems. This research paper also examines the direct relationship between MCS and the financial performance of the sector. The research model of this study also investigates the mediating role of product and process innovation in improving the relationship between the financial performance of the sector and MCS. To find the impact of MCS on the firm performance this study collects most of the data from selected employees and managers of different SME firms of Thailand with the help of the survey questionnaire. The results that are calculated with the help of structural equation modeling indicate that MCS significantly influence the financial performance of the firm and also made a significant contribution in enhancing the operational performance of the sector. Furthermore, the findings of this study also demonstrate that product innovation improves the relationship between MCS and financial performance. Accepted hypotheses of this 150 research help many future analysts to understand the importance of MCS.

BACKGORUND: Nurses and surgeons are among the healthcare categories with the highest risk of developing low back pain (LBP). The aim of this study is to present the research protocol of a survey for assessing the presence of low back pain among healthcare workers of a surgical ward and its associated factors. METHODS: The survey will be conducted in the Orthopaedics ward of the teaching hospital “Policlinico Umberto I” in Rome, during the year 2018. The low-back pain will be measured using the Italian version of the Nordic Questionnaire musculoskeletal disorders. Socio-demografic and clinical data will be collected, such as: aghe, gender, heaight, weight, body mass index (BMI), type of work, years of work, working timetable. LBP intensity will be assessed with the Numerical Rating Scale. This is a one-dimension  numerical scale with possible score from 0 (no pain) to 10 (the worst possible pain). The general health status will be assessed with the SF-12 questionnaire, for calculatin...

The research employs the theoretical lens of human ecology of disease to examine the ecology of malaria in Lagos state, Nigeria. As a first step I examine the spatial and temporal trends in clinical malaria infection using a density-based algorithm to identify two locations (Ikeja and Kosofe LGAs) with one of the highest malaria infection rates and ecologically diverse terrain. They form the focus of this research. I gather data and derive measures on 26 theoretically relevant environment and sociocultural risk variables in a cross-section of 208 households using mixed methods that comprise semi-structured interviews, a questionnaire, environmental observations, GIS and remote sensing data and GPS mapping. Through these efforts, I build a household spatial database. I assess the contributory influences of the risk variables through the development and assessment of ten ecologically relevant candidate models of urban malaria using statistical and GIS analysis. I also engage with the everyday lives of the households and qualify the quantitative relationships. Findings reveal that the most parsimonious candidate model is grounded on the human ecology of disease principle. While many of the variables are not statistically significant, some, such as travel history, animal presence and household size, are of public health importance. One important finding emerges. The risk variable "working at night without mosquito protection", though it does not appear in this model, seems to be important across other models. I examine it further and note that its risk within households is higher than those associated with residential locations. In fact, households inhabit low-risk locations and have low vulnerability risk rates. This suggests that in urban areas, infection likely occurs outside homes and mostly from places of work or social gathering, and coincides with older household members rather than vulnerable children. This research suggests further insights for urban-like occupations and behaviours.

One of the prevailing perceptions regarding the ageing of cells and organisms is the intracellular gradual accumulation of oxidatively damaged macromolecules, leading to the decline of cell and organ function (free radical theory of ageing). This chemically undefined material known as “lipofuscin,” “ceroid,” or “age pigment” is mainly formed through unregulated and nonspecific oxidative modifications of cellular macromolecules that are induced by highly reactive free radicals. A necessary precondition for reactive free radical generation and lipofuscin formation is the intracellular availability of ferrous iron (Fe2+) (“labile iron”), catalyzing the conversion of weak oxidants such as peroxides, to extremely reactive ones like hydroxyl (HO•) or alcoxyl (RO•) radicals. If the oxidized materials remain unrepaired for extended periods of time, they can be further oxidized to generate ultimate over-oxidized products that are unable to be repaired, degraded, or exocytosed by the relevant...

Amavata is a disease of chronic joint and body pain, accompanied by a swelling of some or all of the synovial joints. These symptoms are typically accompanied by stiffness of joints, loss of appetite, indigestion, lack of enthusiasm, feeling of heaviness and fever. Among Shodhna therapy described in Ayurveda, Virechana is mostly used in the disorders originated from vitiated Pitta . Along with this, it is also useful in the disorders in which Pitta is associated with Vata or Kapha dosha . It has direct effect on the Agni Adhishthan and also works on Kapha and Vata Adhishsthan . Thus, it rectify not only Pitta but Vata and Kapha Dosha also. A clinical study of 20 registered cases of Amavata revealed that Virechana karma is a very effective treatment of Amavata. This study proved the significance of Virecana karma on classical symptom of Amavata i.e., Angamarda, Aruchi, Trishna, Jwara, Shoth, etc. It reflects that Virechana karma is a potent Shroto-vishodhna, a good anti-inflammatory ...

The concepts involved in sustainable textile fashion, demanding good knowledge about raw materials, processes, end use properties and circuits amongst others, are able to determine the way the textile product is designed and the behavior of the consumer, regarding life style and buying decisions. The textile product`s life integrates raw materials, their processing, distribution, use by the consumer and destination of the product after useful lifetime, this is, his complete life cycle. It is very important to recognize the power of the consumer to influence parameters related to sustainability, namely when he decides how, when and why he buys and afterwards by the attitudes taken during and after use. The conscious act of consumption involves ethical, ecological and technical knowledge in which the concern is overall lifecycle of the fashion product and not exclusively aesthetic and symbolic values strongly related with its ephemeral nature. The present work proposes the classification of textile products by means of an innovative label aiming to establish a rating related to the Life of Fashion Products, by using parameters considered with especial impact in lifecycle, as textile fibers, processing conditions, generated wastes, commercialization circuits, durability and cleaning procedures. This label for sustainable fashion products aims to assist the stakeholders with informed attitudes and correct decisions in order to promote the objectives of sustainable fashion near designers, consumers and industrial experts.

more deeply about the awareness in healthy behavior and covid prevention 19. Coronavirus 2019 (Covid 19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), in Indonesia corona virus transmission still occurs in the community, a total of cases, 49.009 (at time of  writing).  The purpose of this study is the effect of selfmanagement education on changes perceptions and knowledge transmission covid 19 patients in hospital at East Java. Data were obtained from 150 patients coming to clinic clinics in East Java, since December 2019 - May 2020. Sampling through simple random sampling technique. Pretest data collection to identify perceptions and knowledge, then the intervention of selfmanagement education was carried out and finally posttest conducted. Pretest and posttest data collection included closed questionnaire, data analysis was performed with independent T test. Changes of perception after intervention selfmanagement education was to treatment group. Selfmanag...

Objective: To determine the prevalence of hyperuricemia in predialysis CKD patients in a tertiary care hospital and analyze its relationship with various socio-demographic factors. Study Design: Descriptive cross sectional study. Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi, from 1st Jun 2017 30th Nov 2017. Material and Methods: The sample population comprised of 200 predialysis CKD patients, stage 1-5, of a tertiary care hospital in Rawalpindi, Pakistan. Fasting serum uric acid level was obtained from the patients. Relationship of age, gender, education status, marital status, smoking history, dietary history, BMI, eGFR, lipid profile and blood pressure (systolic and diastolic) was assessed with the serum uric acid level. Results: Out of 200 patients, 62.5% had hyperuricemia and 37.5% had normal levels. After applying the logistic regression we found that presence of increased systolic blood pressure, raised cholesterol level, increasing age, lowe GFR and...

The healthcare team is mainly a triad of Physicians, Pharmacist & Nurses. Objective: The purpose of this paper is to help healthcare professionals understand more clearly the role of pharmacists within a health care team, especially interprofessional communication, pharmacists' responsibilities, and availability issues. A total of 200 samples were selected from 4 hospitals which include 100 samples of doctors and 100 of the nurses. Each sample is basically a questionnaire comprising of 23 questions. A total of two hundred questionnaires were distributed and one hundred and seventy-six questionnaires were returned resulting in the response rate of 88%. Pharmacists are being one of the major healthcare professional groups in the world after physicians and nurses are playing a very significant role in health care system. This understanding is a requirement for better communication and collaboration among the professions and for accomplishing the combined goal of better health care system.

OBJECTIVE To determine the re-biopsy rate, positive yield and safety profile of ultrasound guided fine needle aspiration cytology (FNAC) in cervical lymph nodes in terms of its complications and repeat procedures. STUDY DESIGN An analytical study. PLACE AND DURATION OF STUDY Department of Vascular and Interventional Radiology, Dow University Hospital, Dow University of Health Sciences, Karachi, from June to December 2013. METHODOLOGY Eighty neck swellings, which were found to be lymph nodes on ultrasound, underwent ultrasound guided FNAC, from outpatients. Lymph nodes which were included in the study were those that were not easily palpable, located near major blood vessels, where patient refused of direct palpation and wanted image guided FNAC, those directly sent by physician for image guided FNAC and where blind biopsy remained inconclusive. Patients who refused on explanation or did not give consent were excluded. Complications and repeat biopsy were noted. RESULTS This study co...

The healthcare industry has been transitioning from paper-based medical records to electronic health records (EHRs) in most healthcare facilities. However, the current EHR frameworks face challenges in secure data storage, credibility, and management. Interoperability and user control of personal data are also significant concerns in the healthcare sector. Although block chain technology has emerged as a powerful solution that can offer the properties of immutability, security, and user control on stored records, its potential application in EHR frameworks is not yet fully understood. To address this gap in knowledge, this research aims to provide an interoperable blockchain-based EHR framework that can fulfill the requirements defined by various national and international EHR standards such as HIPAA and HL7. The research method employed is a systematic literature review to explore the current state of the art in the field of EHRs, including blockchain-based implementations of EHRs. The study defines the interoperability issues in the existing blockchain-based EHR frameworks, reviews various national and international standards of EHR, and further defines the interoperability requirements based on these standards. The proposed framework can offer safer methods to interchange health information for the healthcare sector and can provide the properties of immutability, security, and user control on stored records without the need for centralized storage. The contributions of this work include enhancing the understanding of the potential application of blockchain technology in EHR frameworks and proposing an interoperable blockchain-based EHR framework that can fulfill the requirements defined by various national and international EHR standards. Overall, this study has significant implications for the healthcare sector, as it can enhance the secure sharing and storage of electronic health data while ensuring the confidentiality, privacy, and integrity of medical records.

Aims: A recently characterized group of undifferentiated small round cell sarcomas harbours fusions of the genes CIC and DUX4. Studies report a distinctive gene expression profile for these sarcomas, including expression of E26 transformation-specific (ETS) family proto-oncogenic transcription factors ETV1, ETV4 and ETV5. To test the utility of an ancillary diagnostic technique for these tumours, we evaluated chromogenic RNA in-situ hybridization assays for ETV1, ETV4 and ETV5 as diagnostic adjuncts for this emerging group of highly malignant sarcomas. Methods and results: We tested six confirmed CIC-DUX4 sarcomas and 105 lesions in the differential, including 48 Ewing sarcomas for expression of ETV1, ETV4 and ETV5, scoring expression utilizing a previously validated scale. ETV1 and ETV4 were positive in five of six cases, while ETV5 was positive in six of six. No Ewing sarcoma or other sarcoma tested showed coexpression of these transcripts, while one ETV1/ETV4/ETV5 triple positive previously unclassified round cell sarcoma was identified as harbouring a CIC rearrangement by breakapart fluorescence in-situ hybridization (FISH). We identified overexpression of ETV1, ETV4 and ETV5 transcripts in situ in CIC-DUX4 sarcomas using a robust assay in routine archival sections. One previously unclassified round cell sarcoma showed ETV1/4/5 positivity, and was proved to harbour a CIC rearrangement by break-apart FISH. The sensitivity and specificity observed with our in-situ hybridization assay implies potential utility as an ancillary diagnostic technique, particularly when faced with limited biopsy samples.

BACKGROUND. Craniofacial osteosarcoma differs from long bone osteosarcoma in that patients are older, tumors are often low grade, and prognosis is more favorable. Although most are sporadic, some tumors occur in association with prior radiation therapy. The purpose of the current study was to compare clinicopathologic and prognostic features of primary and radiation-associated osteosarcoma. The study group consisted of 15 primary and 6 radiation-associated osteosarcomas. Clinical and follow-up data were obtained in every case. Tissue microarrays were immunohistochemically stained for p53, pRB, Ki-67 (MIB-1), and ezrin. DNA was sequenced for TP53 mutations. All radiation-associated osteosarcomas were high grade and half were fibroblastic. In contrast, 47% of primary craniofacial osteosarcomas were high grade and only 1 was fibroblastic. All radiation-associated osteosarcomas recurred, half the patients died of disease, 2 were alive with unresectable tumors, whereas only 1 was alive without disease. In contrast, 80% of patients with primary tumors were alive without disease, 33% had local recurrences, and 13% died of disease. Radiation-associated tumors overexpressed p53 more often (33% vs. 13%), more often had TP53 mutations (33% vs. 8%), had higher proliferative activity (67% vs. 0% showing >50% MIB-1 staining), and expressed ezrin more frequently (83% vs. 40%) than primary tumors. Compared with a control group of 24 high-and 7 low-grade primary extremity osteosarcomas, radiation-associated tumors marked as the high-grade tumors. Craniofacial radiation-associated osteosarcomas are high-grade tumors that behave more aggressively than most primary craniofacial osteosarcomas. In addition, they demonstrate higher expression rates of adverse prognostic indicators, further highlighting the distinction.

Introduction: Risk management is crucial in medical laboratory practice to ensure patient safety, maintain quality standards, and mitigate potential errors. This comprehensive review explores various risk management strategies implemented in medical laboratories to enhance understanding and effectiveness in practice. Methods: To identify and analyze risk management strategies employed in medical laboratory settings, a thorough examination of existing literature, guidelines, and best practices was conducted. Key themes and approaches were synthesized to overview current practices and emerging trends comprehensively. Results: The review highlights various risk management strategies utilized in medical laboratories, including quality control measures, staff training and competency assessment, standardized protocols, and procedures, utilization of technology and automation, error reporting systems, and participation in external quality assessment schemes. These strategies aim to identify, assess, and mitigate risks across all stages of the laboratory testing process, from pre-analytical to post-analytical phases. Conclusion: Effective risk management is essential for maintaining the integrity and reliability of laboratory testing, ultimately contributing to improved patient care outcomes. By implementing comprehensive risk management strategies, medical laboratories can enhance operational efficiency, minimize errors, and ensure compliance with regulatory requirements. Continued vigilance, ongoing education, and integration of new technologies are essential for adapting to evolving risks and challenges in laboratory practice.

The purpose of this epidemiological study was to estimate the degree of change in periodontal attachment level in a sample of adults examined in 1959 and 1987 in Tecumseh, Michigan. Out of 526 individuals between the ages of five and 60 years in 1959, a sample of 325 resided within an 80-km-radius area in 1987. Of those, 167 were re-examined. Loss of periodontal attachment (LPA) was determined with a Michigan #0 probe on four tooth sites (disto-buccal, mid-buccal, mesio-buccal, mid-lingual) for all teeth present. Of the individuals contacted, 28 had lost all their teeth during the 28 years. Of the 167 adults examined, two refused periodontal probing. Out of the 165 adults with LPA measurements in 1987, only 22 (13.3%) had an average increased loss of 2 mm or more per person between 1959 and 1987; five adults (3.0%) had an average LPA increase of 3 mm or more, and only two adults (1.2%) had an average LPA increase of 4 mm or more. The attachment level in 59.3% of all the tooth sites ...

The present study was undertaken to study the comparative effect of SAQ and circuit training program on selected physical fitness variables of school level basketball players. Thirty (30) school level basketball players aged between 14-17 years will randomly be selected from Simpkins School Agra U.P. The subjects were randomly divided in three groups as group A (SAQ training group), group B (circuit training group) and group C (control group). After the pre-test with Physical fitness test Experiment Group-A underwent a training SAQ programme of selected exercise. Experiment Group-B received a Circuit training program of selected exercises, whereas the Control group did not participate in any training program. Group A has gone under SAQ training program and Group has gone under circuit training for 60 minutes three times a week except Sunday for duration of 12 weeks. Post data was collected after 12 weeks of experimental period. Analysis of Variance (ANOCOVA) was applied at 0.05 leve...

Chanting is a pervasive practice in almost every tradition all over the world. It has been found to improve attention and reduce depressive symptoms, stress and anxiety. The current study aimed to determine whether chanting “Om” for 10 minutes would improve attention, positive mood and increase feelings of social cohesion. The effects of vocal and silent chanting as a meditation practice were compared, as well as the effects of chanting for experienced and inexperienced chanters. It was hypothesized that vocal chanting would have a greater effect than silent chanting and experienced chanters would report stronger effects. Experienced and inexperienced chanters were randomly allocated to one of two conditions: vocal chanting or silent chanting. Prior to and following chanting, participants completed the Digit-letter Substitution task, the Positive Affect Negative affect Schedule, the Multidimensional Measure of Empathy and the Adapted Self-Report Altruism Scale. Following chanting pa...

Área de conhecimento: Área das Ciências Biológicas e da Saúde A análise de diversos fatores antropométricos vem sendo utilizado para que seja mais fácil e eficaz a compreensão de indicadores relacionados à aptidão física relacionada à saúde ou ao desempenho. As medidas de composição corporal podem ser usadas para monitorar mudanças durante o crescimento e desenvolvimento, e para analisar a ocorrência dos níveis de gordura em crianças. Este trabalho teve como objetivo investigar a correlação entre composição corporal e potência muscular de membros inferiores em crianças e adolescentes do Município de Joaçaba, SC. A amostra deste estudo foi composta por 1.398 escolares, sendo 704 do sexo feminino e 694 do sexo masculino, com idades de 10 a 17 anos. Para a avaliação da composição corporal, foi utilizado o Índice de Massa Corporal (IMC), e para a avaliação da potência, foi utilizado o teste de velocidade de deslocamento (20 metros), e o peso (Kg); nesse caso, o valor referente à potência foi calculado por meio da fórmula Potência={[peso (kg) x distância (m)]/tempo total(segundos, centésimo)}. A correlação entre o IMC e a Potência muscular de membros inferiores foi estudada utilizando o teste não-paramétrico Spearman. O tratamento estatístico dos dados foi realizado por meio do software Statistical Package for the Social Science (SPSS) versão 20. Após as análises, observou-se que para o sexo masculino, na idade de 17 anos, houve fraca correlação, nas idades de 10, 14 e 16 anos, houve moderada correlação e nas idades de 11, 12, 13 e 15 anos, houve forte correlação. Para o sexo feminino, observou-se uma moderada correlação aos 12, 14 e 15 anos e para as demais idades, foi encontrada uma forte correlação entre o IMC e a potência dos indivíduos. Após a realização do estudo, observou-se que existe correlação entre IMC e Potência muscular de membros inferiores em ambos os sexos e nas três fases de desenvolvimento. Palavras-chave: Antropometria. Composição corporal. Potência.

UM4D4 is a recently defined antigen that is expressed on -25% of peripheral blood T cells, but on the majority of T cells in inflammatory synovial fluid. Anti-UM4D4 activates peripheral blood T cells in the presence of accessory cells and/or phorbol ester. UM4D4 has been assigned to a new antigen cluster termed CDw60. The present study examined the ability of anti-UM4D4 to activate T cell clones derived from the synovial fluid of patients with rheumatoid arthritis. UM4D4 was expressed at varying levels on both lectin-generated and antigen-specific clones, including clones of CD4+, CD8+, and CD4-CD8-phenotypes. Anti-UM4D4 used in soluble form as a single stimulus was typically mitogenic for the CD4+ and some of the CD8+ clones, but not for the CD4-CD8-clones. Phorbol ester boosted the response to anti-UM4D4 in some clones, had no effect in others, and diminished the responses in some cases. In contrast to anti-UM4D4, anti-CD3 was generally not mitogenic in soluble form, although it was mitogenic when conjugated to beads. The data show that T cell clones derived from an inflammatory T cell infiltrate can be readily activated through the UM4D4/CDw60 antigen. o 1990 Academic PWSS, IX.

Arthrogryposis multiplex congenita (A characterized by multiple fixed joint deformities dysfunction. A small fraction of these infants problems resulting from c dysharmony of the head reviewed to de presented disc e neuromuscular this interesting clinical problem. Since first described by tto in 1841, the syndrome own as arthrogryposis multiplex congenita ( C) has been discussed in the orthopedic, neurologic, and pediatric literature. In 1976, Cohen and Hsaacs [5] reviewed their experience with the otolaryngologic signs and symptoms associated with A , since then no further contributions have been made in our literature. This paper serves a dual purpose. First, we wish to clea.r:y define AMC, briefly discussing the many diverse etiologies and the associated neuromuscular pathology. Second, the incidence and clinical significance of head and neck involvement are explored. A case report, retrospCctive chart review and review of the literature are presented.