### 8.1 General Proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the procedure of choice for most patients with ulcerative colitis (UC) requiring colectomy.1 Pouchitis is a non-specific inflammation of the ileal reservoir and the most common complication of IPAA in patients with UC.2–7 Its frequency is related to the duration of follow up, occurring in up to 50% of patients 10 years after IPAA in large series from major referral centres.1–9 The cumulative incidence of pouchitis in patients with an IPAA for familial adenomatous polyposis is much lower, ranging from 0 to 10%.10–12 Reasons for the higher frequency of pouchitis in UC remain unknown. Whether pouchitis more commonly develops within the first years after IPAA or whether the risk continues to increase with longer follow up remains undefined. ### Statement 8A The diagnosis of pouchitis requires the presence of symptoms, together with characteristic endoscopic and histological abnormalities [EL3a, RG B]. Extensive UC, extraintestinal manifestations (i.e. PSC), being a non-smoker, p-ANCA positive serology and NSAID use are possible risk factors for pouchitis [EL3b, RG D] #### 8.1.1 Symptoms After proctocolectomy with IPAA, median stool frequency is 4 to 8 bowel movements,1–4,13,14 with about 700 mL of semiformed/liquid stool per day,2,13,14 compared to a volume of 200 mL/day in healthy people. Symptoms related to pouchitis include increased stool frequency and liquidity, abdominal cramping, urgency, tenesmus and pelvic discomfort.2,15 Rectal bleeding, fever, or extraintestinal manifestations may occur. Rectal bleeding is more often related to inflammation of the rectal cuff (“cuffitis,” Section 1.4),16 than to pouchitis. Faecal incontinence may occur in the absence of pouchitis after IPAA, but is more common in patients with pouchitis. Symptoms of pouch dysfunction in patients with IPAA may be caused by conditions other than pouchitis, including Crohn's disease of the pouch,17–19 cuffitis16 and an irritable pouch …
Abstract Transcranial Magnetic Stimulation (TMS) is a non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain. It is primarily used to treat depression and other mental health conditions. When it comes to the safety of TMS during pregnancy, the current evidence is limited but generally suggests that it may be a safer alternative to medications that could potentially harm the fetus. Several small studies and case reports have indicated that TMS does not appear to pose significant risks to the pregnant woman or the fetus. However, the data is not extensive, and more research is needed to fully understand the implications. The procedure is typically avoided in the first trimester unless absolutely necessary, as this is a critical period for fetal development. In summary, while TMS is considered relatively safe during pregnancy, especially compared to some pharmacological treatments, it should only be used when the potential benefits outweigh the risks, and under the close supervision of a healthcare provider. Pregnant women considering TMS should discuss their specific situation with their doctor to make an informed decision.Disclosure of InterestNone Declared
Steel-concrete is a composite material that combines the high strength of steel with the ductility of concrete. This synergy results in improved performance characteristics, particularly for structures subjected to significant static or dynamic loads under fire conditions.In modern construction, steel-concrete composite structures have considerable potential,especially in the design of high-rise buildings, bridges, industrial facilities, as well as in post-conflict reconstruction of damaged infrastructure. The combination of steel frame elements and concrete infill not only reduces the size of structural components but also increases their durability, load-bearing capacity, and fire resistance.The aim of this article is to investigate the behavior of steel-concrete columns under standard fire temperature regimes. The study focuses on analyzing the changes in thermal properties of steel and concrete at elevated temperatures, which significantly affect the load-bearing capacity of the structure. A numerical method based on the finite element approach was used to assess the fire resistance of concrete-filled steel tube (CFST) columns, accounting for the nonlinear behavior of materials over time and space. The research examines the influence of column geometry, cross-sectional shape, and thermal properties of the steel casing on the ultimate performance of the structural element. It was determined that the analyzed CFST column satisfies fire resistance class R 90.The research findings can be applied in the design of fire-resistant load-bearing elements for critical infrastructure facilities.Keywords:steel-concrete, fire resistance, testing, column, composite, temperature.
Abstract Objective This study aimed to investigate the relationship between preoperative disability and postoperative outcomes in elderly patients undergoing major abdominal surgery. Methods This retrospective study included elderly patients aged 65 years and older who underwent elective major abdominal surgery in our hospital from September 2023 to November 2024, aiming to explore the predictive value of preoperative disability levels for the main postoperative outcomes in this population. Patients were divided into a non-disability group and a disability group according to WHODAS 2.0 scores under an ethics-approved waiver of consent. Results A total of 436 elderly patients were included, with 87 cases (19.9%) in the non-disability group and 349 cases (80.1%) in the disability group. Baseline characteristics showed significant differences between the two groups in Clavien-Dindo Grade (complications: 2.3% vs. 10.9%, P = 0.013) and age (68.0 vs. 71.0, P = 0.004). Univariable analysis showed that disability (OR = 5.19, 95% CI = 1.23–21.96, P = 0.025), history of radiotherapy (OR = 4.51, 95% CI = 1.12–18.16, P = 0.034), coronary heart disease (OR = 2.21, 95% CI = 1.02–4.78, P = 0.045), preoperative anemia (OR = 3.32, 95% CI = 1.57–6.76, P = 0.002), ASA III + IV grade (OR = 2.14, 95% CI = 1.02–4.50, P = 0.044), and prolonged surgery time (per 30 min: OR = 1.15, 95% CI = 1.04–1.27, P = 0.005) were factors associated with adverse outcomes. Multivariable analysis through three models with stepwise variable adjustment (Model 1: gender, age, BMI, history of radiotherapy, coronary heart disease, preoperative anemia; Model 2: additionally adjusted for surgery time; Model 3: adjusted for ASA classification) consistently showed that preoperative disability was an independent risk factor for adverse outcomes, with adjusted ORs of 4.65 (95% CI = 1.09–19.98, P = 0.038), 4.57 (95% CI = 1.02–19.62, P = 0.041), and 4.54 (95% CI = 1.06–19.52, P = 0.042), respectively. Conclusion Preoperative disability is independently associated with an increased risk of postoperative complications in elderly patients undergoing major abdominal surgery, emphasizing the need to develop personalized perioperative management plans for disabled elderly patients.
Anna Krysińska, Antonina Drzewiecka, Artur Drzewiecki
et al.
Introduction: Pregnancy is a transformative stage in a woman’s life, often accompanied by questions and concerns about the safety of both the mother and the developing child. Key aspects of daily life, including physical activity, diet, and work, are frequently scrutinized, with many misconceptions persisting about what constitutes a healthy pregnancy. However, scientific evidence consistently demonstrates that an active and healthy pregnancy benefits both maternal and neonatal outcomes.
Aim of the study: This study aims to synthesize current knowledge on the role of physical activity during pregnancy and its impact on labor outcomes. By reviewing recent research, we seek to provide a comprehensive overview of the benefits of physical activity, address barriers to exercise during pregnancy, and highlight evidence-based recommendations. The goal is to raise awareness among healthcare providers and pregnant women about the importance of incorporating physical activity into prenatal care.
Materials and methods: This study incorporated evidence from peer-reviewed articles, meta-analyses, and randomized controlled trials. Over 55 studies, available on PubMed and Google Scholar were analysed and critically reviewed to create a comprehensive overview of the topic.
Conclusion:
Physical activity during pregnancy is a vital component of prenatal care that promotes maternal and neonatal well-being. Regular exercise reduces the likelihood of pregnancy complications and improves delivery outcomes. Additionally, it offers long-term benefits for neonatal development. While current guidelines provide a general framework for exercise during pregnancy, personalized recommendations tailored to individual needs are essential to maximize safety and efficacy. This research emphasizes the importance of raising awareness among healthcare providers and pregnant women about the critical role of physical activity in improving health outcomes during pregnancy and beyond.
Aglaja Busch, Lorena R. R. Gianotti, Frank Mayer
et al.
# Background
Changes in cortical activation patterns after rupture of the anterior cruciate ligament (ACL) have been described. However, evidence of these consequences in the early stages following the incident and through longitudinal monitoring is scarce. Further insights could prove valuable in informing evidence-based rehabilitation practices.
# Purpose
To analyze the angular accuracy, neuromuscular, and cortical activity during a knee joint position sense (JPS) test over the initial six months following ACL reconstruction.
Study design: Cohort Study
# Methods
Twenty participants with ACL reconstruction performed a JPS test with both limbs. The measurement time points were approximately 1.5, 3-4 and 6 months after surgery, while 20 healthy controls were examined on a single occasion. The active JPS test was performed seated with a target angle of 50° for two blocks of continuous angular reproduction (three minutes per block). The reproduced angles were recorded simultaneously by an electrogoniometer. Neuromuscular activity of the quadriceps muscles during extension to the target angle was measured with surface electromyography. Spectral power for theta, alpha-2, beta-1 and beta-2 frequency bands were determined from electroencephalographic recordings. Linear mixed models were performed with group (ACL or controls), the measurement time point, and respective limb as fixed effect and each grouping per subject combination as random effect with random intercept.
# Results
Significantly higher beta-2 power over the frontal region of interest was observed at the first measurement time point in the non-involved limb of the ACL group in comparison to the control group (p = 0.03). Despite individual variation, no other statistically significant differences were identified for JPS error, neuromuscular, or other cortical activity.
# Conclusion
Variation in cortical activity between the ACL and control group were present, which is consistent with published results in later stages of rehabilitation. Both indicate the importance of a neuromuscular and neurocognitive focus in the rehabilitation.
# Level of Evidence
3
Purpose. The purpose of the study is to determine the state, identify the main challenges and risks affecting rural development in Ukraine, and assess their influence on the effectiveness of functioning and financial capacity of rural territorial communities in the conditions of power decentralization and self-government reform. Methodology / approach. The methodological basis of the research was a systematic approach to the study of the investigated phenomena and processes and the dialectical method of cognition, as well as general scientific and special methods. In order to assess the state and trends of rural development in Ukraine, economic and statistical methods were used in analytical studies (comparative analysis to compare the results obtained in certain years, average and relative values, trend analysis, index analysis, etc.). This was done to establish certain relationships, such as identity, similarity, or difference between characteristics and facts. To determine the influence of individual factors on the operational efficiency and financial capacity of territorial communities, multiple correlation and regression analysis was used. A number of abstract-logical techniques made it possible to formulate intermediate and final conclusions and proposals. Results. Current conditions are analyzed and trends of rural development in Ukraine for 1990–2022 are determined. It was found that over the past 32 years, the socio-economic crisis in rural areas continues to worsen, which is manifested in declining employment rates, increasing unemployment, rising poverty, mass migration of peasants, deterioration of infrastructure and access to social services. The main challenges and problems of rural development have been identified and systematized by groups: socio-demographic, economic, environmental and nature protection, institutional, political. To assess the factors influence on the effectiveness of functioning and financial capacity of territorial communities, a multifactorial correlation and regression analysis was conducted. It was found that the level of capital expenditures is most affected by the fiscal return of the community territory per 1 inhabitant. Originality / scientific novelty. The elements of scientific novelty consist in the introduction of a systematic approach to generalizing challenges and problems affecting the development of rural areas and communities, which were systematized by groups: socio-demographic, economic, environmental and nature protection, institutional, political. The scientific and methodological foundations of studying the socio-economic situation in Ukraine’s rural areas in terms of determining the factors and assessing their influence on the effectiveness of functioning and financial capacity of rural territorial communities have been further developed. Practical value / implications. The identification of factors and their influence on the functioning effectiveness and financial capacity of rural territorial communities can be taken into account by state institutions when reviewing previously adopted documents and elaborating strategic plans for the restoration and development of Ukraine’s rural areas, taking into account internal threats and the long-term external aggression of the russian federation against Ukraine.
Emergency situations such as wildfires, water floods, or even terrorist attacks require continuous communication between the coordination centres, the several on-the-field teams, and their respective devices to properly address the adverse circumstances. From a technological point of view, this can be best seen as a live Ubiquitous Sensor Network—composed of human beings (e.g., first responders, victims) and devices (e.g., drones, environmental sensors, radios)—with stringent and special communication requirements in terms of flexibility, mobility, reliability, bandwidth, heterogeneity, and speed of deployment. However, for this specific use case, most of the already deployed and well-known communication technologies (e.g., satellite, 4G/5G) might become unusable and hard to repair due to the associated effects of the disaster itself. The purpose of this paper is (1) to review the emergency communications challenges, (2) to analyse the existing surveys on technologies for emergency situations, (3) to conduct a more updated, extensive, and systematic review of the emergency communications’ technologies, and (4) to propose a heterogeneous communication architecture able to communicate between moving agents in harsh conditions. The proposed approach is conceived to link the relocating agents that constitute a Ubiquitous Sensor Network spanning a large-scale area (i.e., hundreds of square kilometres) by combining Near Vertical Incidence Skywave technologies with Drone-Based Wireless Mesh Networks. The conclusions derived from this research aim to set up the fundamentals of a rapidly deployable Emergency Communications System inspired by the Ubiquitous Sensor Network paradigm.
In the article, based on the data of an empirical sociological study conducted by the authors in February 2023, certain aspects of the social well-being of Russian girls in the conditions of a special military operation are analyzed.The study was conducted in 10 subjects of the Central Federal District of the Russian Federation, as well as on the territory of the Republic of Crimea by online questionnaire. The study sample is quota-based, stratified by gender. The sample size is 960 people, aged 18 to 29 years. The volume of the subsample of young women is 510 people.The article examines the emotional well-being of girls, their stress level, analyzes the impact on them of the geopolitical situation in which Russia is located. The authors draw conclusions about the impact of a special military operation on the professional activities of girls, as well as on their relationships with friends and family. The article substantiates the conclusion about the polarization of young Russians depending on the degree of impact of the military situation on them.
It has been established that at today's stage of development of the democratic Ukrainian society, security issues come to the fore. Mechanisms for responding to crisis situations occupy a special place in the state's national security system. The appropriate level of provision of the state and the population against the threat of crisis situations that threaten national security is a guarantee of sustainable development of society, and this proves the relevance of the chosen research topic. The purpose of the article is the scientific substantiation of the theoretical and methodological foundations of the phenomenon of crisis situations that threaten national security and the provision of practical recommendations for further improvement and development of appropriate response mechanisms of the components of the security and defense sector of Ukraine. It was determined that modern conflicts require a comprehensive solution, as well as the participation of various departments, power structures and organizations in ensuring the safety of citizens, protecting the constitutional system, sovereignty and territorial integrity of the state, in eliminating grave consequences, etc. Under such conditions, the security forces of the security and defense sector of Ukraine play an important role. Today, global globalization processes contribute to the emergence and aggravation of armed conflicts of various levels of intensity. Therefore, the modern theory of international law includes international organizations (UN, NATO, etc.) as possible subjects of international armed conflicts. In addition, recent events in the world clearly show the growth of terrorist attacks, and later military conflicts, based on the processes of globalization. Analyzing the normative legal documents that regulate the defining principles of the functioning of the national security system, it was established that a new term "crisis situations that threaten the national security of Ukraine" was introduced, which characterizes the situation on the eve of the introduction of a special period. These terms are also used in the terminological apparatus used during the response of the components of the security and defense sector to threats to the national security of Ukraine. A key point during the emergence of crisis situations is the introduction of appropriate response mechanisms that require the involvement of additional forces and resources. It was determined that in further scientific research it is necessary to substantiate the proposals for solving the scientific problem regarding the functioning and development of mechanisms for responding to crisis situations that threaten the national security of Ukraine.
Viviana Trigoso, Liliana Vásquez, Soad Fuentes-Alabi
et al.
Objective. To highlight the objectives, achievements, challenges, and next steps for the World Health Organization’s Global Initiative for Childhood Cancer (GICC) framework, a project designed to improve psychosocial care (PSC) in pediatric cancer centers across Latin America and the Caribbean (LAC).
Methods. The project was launched in Peru, the first GICC focal country, in November 2020. The diagnosis phase included a survey and a semistructured interview with health professionals to assess PSC practices in institutions, and a needs assessment survey for caregivers. In the second phase, a strategic plan was developed to address the identified needs, including the adaptation of PSC standards, the establishment of multicenter working groups, the expansion of the proposal, and the development of materials.
Results. The study found that PSC was not being adequately provided in accordance with international standards. Six adapted standards were proposed and validated, and more than 50 regional health professionals participated in online activities to support the project. The implementation process is currently ongoing, with the establishment of five multidisciplinary working groups, one regional committee, and the production of 16 technical outputs.
Conclusion. This project represents a substantial step forward to improve PSC for pediatric patients with cancer and their families in LAC countries. The establishment of working groups and evidence-based interventions strengthen the proposal and its implementation. Development of health policies that include PSC according to standards is needed to achieve sustainable results in the quality of life of children with cancer and their families.
Fernanda Augustini Rigon, M. Ronsoni, A. Vianna
et al.
ABSTRACT The management of diabetes mellitus (DM) requires maintaining glycemic control, and patients must keep their blood glucose levels close to the normal range to reduce the risk of microvascular complications and cardiovascular events. While glycated hemoglobin (A1C) is currently the primary measure for glucose management and a key marker for long-term complications, it does not provide information on acute glycemic excursions and overall glycemic variability. These limitations may even be higher in some special situations, thereby compromising A1C accuracy, especially when wider glycemic variability is expected and/or when the glycemic goal is more stringent. To attain adequate glycemic control, continuous glucose monitoring (CGM) is more useful than self-monitoring of blood glucose (SMBG), as it is more convenient and provides a greater amount of data. Flash Glucose Monitoring (isCGM /FGM) is a widely accepted option of CGM for measuring interstitial glucose levels in individuals with DM. However, its application under special conditions, such as pregnancy, patients on hemodialysis, patients with cirrhosis, during hospitalization in the intensive care unit and during physical exercise has not yet been fully validated. This review addresses some of these specific situations in which hypoglycemia should be avoided, or in pregnancy, where strict glycemic control is essential, and the application of isCGM/FGM could alleviate the shortcomings associated with poor glucose control or high glycemic variability, thereby contributing to high-quality care.
Jessica Chan, Yi-Chien Lu, Melissa Min-Szu Yao
et al.
Abstract Background Previous research has demonstrated a correlation between hand grip strength (HGS) and muscle strength. This study aims to determine the relationship between HGS and muscle mass in older Asian adults. Methods We retrospectively reviewed the dual-energy X-ray absorptiometry (DXA) records of 907 older adults (239 (26.4%) men and 668 (73.6%) women) at one medical institution in Taipei, Taiwan, from January 2019, to December 2020. Average age was 74.80 ± 9.43 and 72.93 ± 9.09 for the males and females respectively. The inclusion criteria were: 1) aged 60 and older, 2) underwent a full-body DXA scan, and 3) performed hand grip measurements. Patients with duplicate results, incomplete records, stroke history, and other neurological diseases were excluded. Regional skeletal muscle mass was measured using DXA. HGS was measured using a Jamar handheld dynamometer. Results Total lean muscle mass (kg) averaged 43.63 ± 5.81 and 33.16 ± 4.32 for the males and females respectively. Average HGS (kg) was 28.81 ± 9.87 and 19.19 ± 6.17 for the males and females respectively. In both sexes, HGS and regional muscle mass consistently declined after 60 years of age. The rates of decline per decade in upper and lower extremity muscle mass and HGS were 7.06, 4.95, and 12.30%, respectively, for the males, and 3.36, 4.44, and 12.48%, respectively, for the females. In men, HGS significantly correlated with upper (r = 0.576, p < 0.001) and lower extremity muscle mass (r = 0.532, p < 0.001). In women, the correlations between HGS and upper extremity muscle mass (r = 0.262, p < 0.001) and lower extremity muscle mass (r = 0.364, p < 0.001) were less strong, though also statistically significant. Conclusion Muscle mass and HGS decline with advancing age in both sexes, though the correlation is stronger in men. HGS measurements are an accurate proxy for muscle mass in older Asian adults, particularly in males.
Over the past decades, Europe has been affected by several low flow periods which had substantial impacts on the hydrology of the rivers themselves as well as on the society and economy. Low flow periods have a direct impact on the environment, on the inland waterway navigation, on the hydropower production as well as on the sediment management, among others. Similar to floods, low flows are naturally occurring phenomena which can significantly hinder different uses and functions of the rivers and impact the aquatic system and the water quality. Moreover, it is projected that, in the future, climate change might lead to drier summers over the European region and therefore to more frequent and severe low flow periods. The results presented here show that the summer 2018 low flow situation, over the Rhine and Elbe Rivers basin, could have been predicted up to two seasons ahead by using previous months' sea surface temperature, sea level pressure, precipitation, mean air temperature and soil moisture. The lagged relationship between the predictand (e.g. seasonal streamflow) and the climate and oceanic predictors varies between 1 month (e.g. precipitation) up to 6 months (e.g. sea surface temperature). Taking into account that all predictors are available in real-time, the forecast scheme can be used to provide early warnings for the upcoming low flow situations, thus offering the possibility for better management of the water resources.
This study aims to clarify oxygen uptake (VO2) and heart rate (HR) kinetics of body mass-based squat exercise (SQBM) with relation to age. Fourteen healthy adults and 19 healthy children performed SQBM 200 times as well as an incremental loaded bicycle test to determine maximal VO2 and HR. The VO2 and HR during SQBM were normalized to maximal VO2 (%VO2peak) and HR (%HRmax), respectively. Electromyograms (EMGs) were recorded from the vastus lateralis, rectus femoris, vastus medialis and biceps femoris muscles from the right leg. In the VO2 and HR during SQBM, the time constant in children was faster than adults, whereas the physiological load (%VO2peak and %HRmax) was almost the same between children and adults. In both groups, %VO2peak was significantly related to %HRmax during SQBM. The slope of the %VO2peak-%HRmax relationship was 0.92 for children, and 0.73 for adults. The current results demonstrate that, compared to adults, the rise in VO2 and HR after initiation of SQBM is faster in children, and the physiological load during SQBM partially depends on individual maximal aerobic capacity.
The paper considers the task of allocating the resources of an automated control system for special purposes in conditions of insufficient information on the development of the operational situation. The object of research is an automated control system for special purposes in the face of uncertainty in the operational environment and limited computing resources. One of the most problematic places in the distribution of resources of an automated control system is the low quality of planning, distribution and use of resources of an automated system in conditions of insufficient information about the operational situation and the inability to predict the actions of the enemy. This reduces the efficiency of both the system itself and its application. The scientific problem is solved with the help of developing a model for the distribution of system resources with the possible appearance of a lot of perturbations at the input, taking into account the features of the current operational situation in the course of the armed conflict and allows forecasting the state of the automated control system. In the course of the study, the authors of the work used the basic principles of queuing theory, automation theory, the theory of complex technical systems, as well as general scientific methods of cognition, namely analysis and synthesis. The novelty of the proposed model lies in the fact that it allows to justify the decomposition of the system. This allows to present a solution to the vector optimization problem in the binary relations of conflict, assistance and indifference. It also takes into account the operational environment and allows predicting the state of the system taking into account external influences, constructing utility functions and guaranteed payoff, as well as a numerical optimization scheme on this set. The proposed model will improve the efficiency of information processing due to its distribution and rational use of available computing resources. It is advisable to use the research results when planning the configuration of the data transmission system and at the stage of operational control of the resources of these systems.
Narisara Paradee, Duangta Kanjanapothi, Tawat Taesotikul
et al.
Objective: To study the effect of perilla fruit oil against carbon tetrachloride (CCl4)-induced liver damage in rats.
Methods: Perilla fruit oil was analyzed in terms of fatty acids, tocopherols and tocotrienols using chromatography. Sub-chronic toxicity of perilla fruit oil was investigated in rats for 90 d followed by a 28 d recovery period. Hematological, biochemical and pathological parameters were determined. To evaluate hepatoprotection, rats were divided into five groups and orally administered with Tween 80 for 10 d; Tween 80, silymarin, perilla fruit oil (0.1 mL/200 g) and perilla fruit oil (1 mL/200 g) for 10 d together with subcutaneous injection of CCl4 (2 mL/200 g) on days 9 and 10. Liver enzymes and pathological parameters were determined.
Results: Perilla fruit oil contained α-linolenic acid (56.55% of total fatty acid), β-tocopherol (49.50 mg/kg) and γ-tocotrienol (43.65 mg/ kg). Rats showed significant changes in the percentage of monocytes and platelet indices following perilla fruit oil consumption for 90 d; in the percentage of neutrophils and lymphocytes, and RBC indices in the recovery period when compared with the deionized water group. Total protein and creatinine levels were increased while alkaline phosphatase and aspartate aminotransferase levels were decreased (P < 0.05). Organ weight index and pathological indicators did not change significantly. The liver of CCl4-induced rats showed remarkable centrilobular fatty changes, which was ameliorated by perilla fruit oil pretreatment. Aspartate aminotransferase, alanine aminotransferase and alkaline phosphatase levels were decreased (P < 0.05) in rats given perilla fruit oil.
Conclusions: Perilla fruit oil is rich in α-linolenic acid, β-tocopherol and γ-tocotrienol and improves blood biomarker levels and protects against CCl4-induced hepatotoxicity. Further studies are required before supporting its use for the treatment of hepatitis.
Vinícius da Silva Oliveira, Roberta Luiza Rodrigues, Vinícius Barros Chaves
et al.
Objetivo. Determinar a existência de aglomerados de municípios (clusters) com alto risco para sífilis congênita (SC) no Brasil e descrever a tendência temporal da doença no país, comparando a população de crianças cujas mães realizaram o pré-natal com aquelas cujas mães não realizaram esse controle.
Métodos. Este estudo ecológico utilizou dados do Sistema de Informação de Agravos de Notificação (SINAN) e do Sistema de Informações sobre Nascidos Vivos (SINASC). Para a análise de aglomerados, a estatística de varredura Kulldorff foi aplicada à população de risco. A significância estatística foi determinada pelo logaritmo da razão de verossimilhança utilizando a distribuição discreta de Poisson. Para a análise das tendências das taxas de detecção do agravo, utilizou-se a regressão de Prais-Winsten. A análise foi realizada com os programas SatScan 9.4 e Stata 14.0.
Resultados. Clusters com taxas de detecção de 41,3, 44,4 e 188,1 casos/10 000 nascidos vivos foram identificados em 2001, 2009 e 2017, respectivamente. Em 2001, as taxas foram 8 vezes maiores nos clusters do que no restante do país; em 2009, foram 3,3 vezes maiores; e, em 2017, 2,5. Detectou-se uma tendência crescente na infecção por SC em todas as regiões e unidades da federação. As taxas foram 8,53 vezes maiores nos neonatos cujas mães não realizaram pré-natal (243,3 casos/1 000 nascidos vivos vs. 28,4 casos/1 000 nascidos vivos em mães com pré-natal).
Conclusões. A identificação de aglomerados de municípios com alto risco para SC e de tendências crescentes de infecção por SC em todo o país, mesmo na presença de pré-natal, indicam a necessidade de melhoria nas ações de saúde pública para o combate dessa doença.