Background: The increasing prevalence of antibiotic-resistant Helicobacter pylori strains poses a significant threat to children's health. This study investigated antibiotic resistance rates in Helicobacter pylori strains isolated from children in Shanghai and analyzed the presence of virulence genes in these strains. Methods: We obtained 201 Helicobacter pylori strains from pediatric patients with upper gastrointestinal symptoms who underwent gastrointestinal endoscopy between 2019 and 2022. Subsequently, we performed antibiotic susceptibility tests and virulence gene PCR assays on these strains. Results: Helicobacter pylori resistance rates of 45.8%, 15.4%, 1.0%, and 2.5% were detected for metronidazole, clarithromycin, amoxicillin, and levofloxacin, respectively. Among all isolates, 64.7% exhibited resistance to at least one antibiotic. Resistance to metronidazole and clarithromycin increased from 2019 to 2022. The predominant vacA gene subtype was vacA s1a/m2. The prevalence of vacA m2 and dupA exhibited an upward trend, while oipA presented a decreasing trend from 2019 to 2022. The prevalence of dupA was significantly higher in gastritis than peptic ulcer disease, and in non-treatment compared to treatment groups. Conclusions: Helicobacter pylori antibiotic resistance remains high in children and has risen in recent years. Therefore, the increasing use of metronidazole and clarithromycin requires increased monitoring in children. No association was observed between antibiotic resistance and virulence gene phenotypes.
Sekstorsi adalah istilah yang belakangan ini muncul dan berasal dari kata "sex” dan "extortion”. Sekstorsi dapat berupa penyebaran gambar seksual para korban sebagai ancaman untuk mendapatkan uang maupun barang berharga lainnya. Para korban sekstorsi mengalami pengalaman yang buruk sehingga mendatangkan trauma yang memerlukan proses penerimaan diri yang cukup panjang mengenai keadaan yang mereka alami. Tinjauan literatur ini diperoleh dari artikel yang berkaitan dengan permasalahan tersebut dan bertujuan untuk menganalisis proses penerimaan diri para korban sekstorsi pasca kejadian serta menganalisis faktor-faktor yang terlibat dalam proses penerimaan diri para korban. Hasil review dari beberapa literatur menunjukkan bahwa proses penerimaan diri para korban sekstorsi pasca kejadian memiliki beberapa tahapan dimulai dari fase penyangkalan, evaluasi diri, mawas diri dan penerimaan diri. Faktor-faktor yang memengaruhi proses penerimaan diri dibedakan menjadi dua yaitu faktor internal berupa pemahaman diri, kesadaran diri dan kemauan diri untuk mengubah keadaan; serta faktor eksternal, yaitu lingkungan sekitar korban.
Thainá Josiane Cavinatto, Vivian Aline Mininel, Marina Peduzzi
et al.
A educação interprofissional em saúde (EIP) é um modelo de formação, cuja finalidade é preparar estudantes e profissionais da saúde para que desenvolvam habilidades para o trabalho colaborativo em equipe. Este estudo teve o objetivo de avaliar a adequação psicométrica da Readiness for Interprofessional Learning Scale (RIPLS-40), a disponibilidade e as experiências dos estudantes de cursos de graduação em saúde para o aprendizado interprofissional. Tratou-se de uma pesquisa do tipo survey correlacional realizado em uma universidade federal brasileira. A amostra contou com 168 estudantes da graduação de cursos da saúde que responderam à RIPLS-40. Os dados foram submetidos à análise fatorial confirmatória, seguidos de análise estatística comparativa. A RIPLS-40, com três fatores, foi confirmada como uma escala com índices aceitáveis para avaliar a disponibilidade de estudantes para a aprendizagem interprofissional (CFI=0,91, TLI=0,91 e RMSEA=0,058). Atividades de ‘extensão’ (n=22; 13,5%) e ‘atividades extracurriculares diversas’ (n=25;15,7%) foram indicadas pelos estudantes como experiências interprofissionais na graduação. A EIP foi predominante em atividades extracurriculares. Os estudantes mostraram atitudes positivas para o aprendizado interprofissional, o que indica um cenário favorável para a implementação e fortalecimento da EIP nos currículos dos cursos de graduação da saúde. A RIPLS-40 demonstra indicadores psicométricos favoráveis, porém, com menor coeficiente de consistência interna no fator 2 – ‘identidade profissional’.
Miscellaneous systems and treatments, Public aspects of medicine
Stavros Tseremoglou, Christos Michail, Ioannis Valais
et al.
The present study focuses on the determination of the optimal crystal thickness of LaCl<sub>3</sub>:Ce and LaBr<sub>3</sub>:Ce crystal scintillators for Nuclear Medicine Imaging applications. A theoretical model was applied for the estimation of the optical efficiency of the two single-crystal scintillators in terms of Detector Optical Gain (<i>DOG</i>). The theoretical model was validated against the experimental values of the Absolute Efficiency (<i>AE</i>) of the two crystals, obtained in the energy range 110 kVp–140 kVp. By fitting the theoretical model to these experimental data, the propagation probability per elementary thickness k was determined and <i>DOG</i> was theoretically calculated for crystal thicknesses from 0.005 cm to 2 cm, in the energy range of Nuclear Medicine Imaging. k values for LaCl<sub>3</sub>:Ce and LaBr<sub>3</sub>:Ce crystals were significantly higher compared to other single-crystal scintillators. The <i>DOG</i> values of the two crystals may serve as evidence that the LaBr<sub>3</sub>:Ce crystal exhibits significantly better performance compared to the LaCl<sub>3</sub>:Ce crystal. With an increase in energy, the optimum thickness increases for both crystals. Additionally, crystal efficiency generally demonstrates a decrease beyond a certain thickness. The aforementioned insights may provide valuable guidance for the design and optimization of crystal scintillators in Nuclear Medicine Imaging systems.
Background: Despite the push for complementary medicine (CM) practitioners to engage in evidence implementation, and arguments in support of evidence-based practice (EBP), uptake of EBP amongst most CM professions remains low. This review aimed to synthesise the evidence examining the barriers and enablers to evidence implementation in CM. Methods: Any primary study examining enablers and barriers to evidence implementation in CM were eligible for inclusion. Eight databases and search engines were searched for eligible studies. Reference lists of included studies were screened, and authors of included studies were contacted to identify current or unpublished studies that met the inclusion criteria. Results: Thirty-nine published and unpublished studies were included in this review. The seven published qualitative studies and 25 published quantitative studies were rated as moderate to high quality. Fifty-two distinct barriers and 62 discrete enablers were identified. Reported barriers were predominantly structural (e.g. limited availability of time and clinical evidence) and cognitive (e.g. skills deficits), with relatively fewer studies reporting cultural (e.g. lack of industry support) or attitudinal barriers (e.g. lack of interest in, or relevance to CM). Enablers of evidence implementation largely focussed on improving access to bibliographic databases and evidence reviews, supporting skills acquisition, and cultivating leadership and interprofessional/interagency collaboration. Conclusions: The findings of this review highlight the diverse barriers and enablers to evidence implementation in CM that span multiple dimensions. The interplay between these various factors highlights the complexity of evidence implementation, and the need for a targeted multistakeholder, multidimensional solution to optimise evidence-based practice in CM. Study registration: The protocol of this review was registered at PROSPERO (CRD42022308527).
Ann-Christin Björklund, Ann-Christin Björklund, Mats Granlund
et al.
Background: Children treated for brain tumors often experience persistent problems affecting their activity performance and participation in everyday life, especially in school. Linking these problems to the International Classification of Functioning, Disability and Health (ICF) classification system can be described as affecting body function, activity performance, and/or participation. Services involved in the everyday life of the child have different focus and goals when meeting the child in context, which advantage the use of ICF to overcome this impediment to follow-up and provide comprehensive support for children who have completed treatment for a brain tumor.Aim: The aim of the study was to use the ICF classification system to describe how professionals in healthcare, habilitation, and school document problems with everyday life functioning at body, activity, and participation levels for children who completed treatment for a brain tumor.Materials and Methods: A retrospective review of records from healthcare, habilitation, and school concerning nine children completed treatment for brain tumor was implemented. Identified problems in everyday life were linked to ICF codes. Descriptive statistics of ICF-linked code frequency supplemented by network visualization diagrams viewing the co-occurrence between codes within the body, activity participation, and environmental components were performed.Results: Most documented problems were found in healthcare records, whereas the documentation in habilitation and school was sparse. The frequently occurring codes, independent of record source, were linked to the body function component, and ICF-linked problems in habilitation and school were salient in the activity and participation component. To gain a holistic picture of relations between ICF codes and problems, network visualization diagrams were used to illustrate clusters of problems.Conclusion: Code prevalence likely reflects where healthcare professionals and educators focus their attention when meeting the needs of children treated for a brain tumor in context. To maximize the comprehensive view of functioning and participation of children in everyday life, the full range of difficulties regarding body impairments, activity limitations, and participation restrictions must be identified and linked to each other in patterns of co-occurrence, which the ICF facilitate. However, ICF provides no guidance on how to identify networks of problems within the body, activity, and participation. Identifying such networks is important for building comprehensive interventions for children.
Elsa Alves Branco, Raquel Duro, Teresa Brito
et al.
Intra-vesical instillation of bacillus Calmette–Guérin (BCG) is an important treatment modality of superficial bladder cancer. It is usually well tolerated, although some adverse reactions can occur. One possible yet rare complication is granulomatous hepatitis, that is thought to be caused either by BCG infection or a hypersensitivity reaction to the bacillus. We present a case of a 79-year-old apparently immunocompetent patient who developed granulomatous hepatitis a few months after BCG administration for bladder cancer immunotherapy. It is important to notice that acid-fast smears and cultures are often negative, and these should not exclude diagnosis nor delay treatment. Our case highlights the importance of clinical suspicion and prompt initiation of appropriate treatment.
Alexander A. Piña, James Shadiow, A. Tobi Fadeyi
et al.
While the chronic effects of certain styles of yoga on cardiometabolic factors have been investigated, little is known about the acute effects of a single yoga session on these outcomes. Moreover, vinyasa yoga’s potential to modulate cardiometabolic outcomes has not been established. The purpose of this study is to determine the acute effects of a vinyasa yoga session on arterial stiffness, wave reflection, lipid and glucose concentrations, and mood in adults with prior yoga experience. Thirty yoga practitioners with a minimum of 3 months of practice experience were enrolled into the study. Carotid-femoral pulse wave velocity (cf-PWV), augmentation index (AIx), lipid profile, glucose concentrations, and mood (Positive and Negative Affect Scale) were assessed at baseline and immediately following a 1 -h vinyasa yoga session. After the yoga session, participants had significantly lower AIx (p < 0.001), non-HDL cholesterol (p < 0.05), and negative affect (p < 0.01) compared to baseline. These results highlight the efficacy of a single bout of yoga in altering wave reflection while improving mood and lipid concentrations in healthy adults with a history of yoga practice.
Abstract Berberine has significant antibacterial and antipyretic effects and is a commonly used drug for treating infectious diarrhoea. The current research data show that the pharmacological effects of berberine are numerous and complex, and researchers have been enthusiastic about this field. To allow researchers to quickly understand the field and to provide references for the direction of research, using bibliometrics, we analysed 1426 articles, dating from 1985 to 2018, in the field of berberine pharmacology. The research articles we found came from 69 countries/regions, 1381 institutions, 5675 authors, and 325 journals; they contained 3794 key words; they were written in 7 languages; and they were of 2 article types. This study summarizes and discusses the evolution of the historical themes of berberine pharmacology as well as the status quo and the future development directions from a holistic perspective.
Pichamon Poonnotok, Nuchanart Kaewmart, Tanawan Asarath
et al.
Purpose - The purpose of this paper is to describe experiences of caregivers in managing psychotic symptoms of persons with schizophrenia in various circumstances. Design/methodology/approach - The data were obtained via a focus group and in-depth interviews among caregivers who cared for relatives with schizophrenia for more than five years. Thematic analysis was used for data analysis. Findings - “Making it better” emerged as the main theme describing caregivers’ experiences in trying to manage psychotic symptoms. It comprises four sub-themes including cutting off the wind, protecting from harm, preventing relapses and pulling back to normality. The caregivers gradually learned and adjusted their strategies through trial and error. They tried to stop aggressive and violent behaviors soon after they had begun by giving cool water to their relatives to drink or shower, while expressing their own affect with gently talking. They also dealt with a hardship in protecting the patients, other people, their properties and their own selves from harm resulting from violent behavior. When the psychotic symptoms improved, the caregivers tried to prevent relapses by using various strategies to maintain medication adherence and by soothing their relatives’ mental state. They also tried to pull their relatives back to normal as much as they could by promoting their relatives’ memories and abilities to perform daily functions. Originality/value - The findings increase knowledge in nursing regarding psychotic symptoms management. The findings can be applied to the development of a program to help caregivers to manage psychotic symptoms effectively in order to promote good clinical outcomes of patients and alleviate the caregivers’ burden.
Other systems of medicine, Public aspects of medicine
Tadesse Bekele Tafesse, Ariaya Hymete, Yalemtsehay Mekonnen
et al.
Abstract Background Ajuga remota Benth is traditionally used in Ethiopia for the management of diabetes mellitus. Since this claim has not been investigated scientifically, the aim of this study was to evaluate the antidiabetic effect and phytochemical screening of the aqueous and 70% ethanol extracts on alloxan-induced diabetic mice. Methods After acute toxicity test, the Swiss albino mice were induced with alloxan to get experimental diabetes animals. The fasting mean blood glucose level before and after treatment for two weeks in normal, diabetic untreated and diabetic mice treated with aqueous and 70% ethanol extracts were performed. Data were statistically evaluated by using Statistical Package for the Social Sciences software version 20. P-value <0.05 was considered statistically significant. Results The medium lethal doses (LD50) of both extracts were higher than 5000 mg/kg, indicating the extracts are not toxic under the observable condition. Aqueous extracts of A.remota (300 mg/kg and 500 mg/kg body weight) reduced elevated blood glucose levels by 27.83 ± 2.96% and 38.98 ± 0.67% (P < 0.0001), respectively while the 70% ethanol extract caused a reduction of 27.94 ± 1.92% (300 mg/kg) & 28.26 ± 1.82% (500 mg/kg). Treatment with the antidiabetic drug, Glibenclamide (10 mg/kg body weight) lowered blood glucose level by 51.06% (p < 0.05). Phytochemical screening of both extracts indicated the presence of phenolic compounds, flavonoids, saponins, tannins, and steroids, which might contribute to the antidiabetic activity. The extracts, however, did not contain alkaloids and anthraquinones. Conclusion The aqueous extract (500 mg/kg) showed the highest percentage reduction in blood glucose levels and the ability of A. remota extracts in reducing blood glucose levels presumably due to the presence of antioxidant constituents such as flavonoids. The effect of the extract supported the traditional claim of the plant.
Fabiane dos Santos Ribeiro, Maiara Guerra Valente, Fernanda Ferreira Lorenz
et al.
Introdução: A incontinência urinária (IU) afeta uma parte significativa da população feminina e tem impacto direto na qualidade de vida (QV). O avanço científico abriu espaço para novos tratamentos. Objetivo: Verificar o impacto do tratamento com exercícios abdominais hipopressivos (EAH) no aumento da força muscular dos músculos do assoalho pélvico (MAP) e a relação com a QV de mulheres com IU de esforço. Método: Estudo do tipo quase-experimental não controlado, com um grupo de seis mulheres no período pós-menopausa submetidas a um tratamento com EAH por 4 semanas. A força muscular dos MAP foi verificada por meio de equipamento de biofeedback pressórico e da escala de Ortiz, e o impacto sobre a QV por meio do King’s Health Questionnaire (KHQ), no primeiro e último encontro. Resultados: O domínio impacto do KHQ apresentou diminuição significativa na média dos escores após o tratamento (p=0,04), significando melhora na qualidade de vida das pacientes. Houve melhora nos escores dos sintomas polaciúria, noctúria e IU durante a relação sexual. Foi verificado aumento na força dos MAP após o tratamento por ambos os instrumentos (p=7,0 ± 3* no pré e p=43,7 ± 4* no pós). À análise da correlação entre os domínios do questionário e os valores do biofeedback apresentou significação apenas no domínio Limitações sociais (p<0,001) na primeira avaliação. Conclusão: O tratamento com a EAH tem efeito positivo na QV de mulheres com IU de esforço no período pós-menopausa. Uma amostra maior seria relevante para obtenção de dados mais consistentes.
Травматологи-ортопеды, как правило, сталкиваются с проблемой остеопороза, когда пациент обращается уже с осложнением последнего, низкоэнергетическим переломом. У таких пациентов многократно возрастают риски повторных переломов, ухудшается прогноз по качеству и продолжительности жизни, а сам диагноз остеопороз формулируется уже как тяжелый остеопороз. Вследствие этого трудно переоценить роль травматологов-ортопедов в решении обсуждаемой проблемы и чрезвычайно важно знать в какой степени они участвуют в лечении пациентов с остеопорозом. Цель. Оценить степень информированности травматологов-ортопедов по вопросам диагностики и лечения остеопороза, вторичной профилактики остеопоротических переломов костей, а также определение степени их участия в решении указанных проблем. Материал и методы. Нами проведено анкетирование 153 травматолого-ортопедов из всех федеральных округов РФ, принявших участие в научно-практической конференции с международным участием «Вреденовские чтения» в октябре 2015 года. Средний возраст опрошенных составил 37 лет (от 22 до 68 лет), средний стаж работы 13 лет (от 1 до 40 лет), 93% работали в стационаре, 84% выполняли не менее 25 операций ежемесячно. Результаты. 77% врачей не шифруют в медицинской документации диагноз остеопороз согласно кодов МКБ. 75% указали на наличие в их регионе центра профилактики и лечения остеопороза. Наличие денситометра в регионе подтвердил 91% опрошенных, но направляют на него только 71%. При этом средняя доля направленных на денситометрию по отношению ко всем пациентам, которым был поставлен диагноз остеопороз составила лишь 34%. Основным методом диагностики остеопороза врачи считают рентгенографию (78%), а рентгеновскую денситометрию только 61%. Всего 20% используют FRAX. Чаще всего для лечения остеопороза доктора назначают комбинированные препараты кальция и витамина Д3 (70% опрошенных) и препараты кальция (56%). Все остальные варианты медикаментозной терапии набрали по результатам анкетирования менее 50% ответов. Несущественной оказалась разница между парантеральной и пероральной формами назначаемых фисфосфонатов (41% и 39% соответственно). 18% респондентов назначают кальцитонин лосося в виде назального спрея и 21% стронция ранелат, несмотря на существенные ограничения в использовании этих препаратов. 27% опрошенных назначают активные метаболиты витамина Д. На вопросы о сроках назначения медикаментозной терапии 44% ответили, что назначают терапии как можно раньше после перелома, 25% - больше одного года, 22% - сразу после активизации пациента, 13% - на один год. 56% травматологов-ортопедов, из числа назначающих терапию, проводят контроль ее эффективности. 60% с этой целью используют рентгеновскую денситометрию. Только 10% повторно рассчитывают индекс FRAX. Травматологи-ортопеды широко использую немедикаментозные методы лечения остеопороза: лечебную физкультуру 89%, физиотерапию 52%, лечебное питание 42%, пищевые добавки 21% опрошенных. Только 31% респондентов указали на проведение в их учреждении мероприятий по вторичной профилактике переломов костей, среди которых чаще всего были отмечены: 26% - информирование пациентов по вопросам остеопороза, 23% - консультация пациента в специализированном центре или кабинете. Контроль эффективности антиостеопоротического лечения через год и выполнение повторной рентгеновской денситометрии реализуются в 15% и в 16% учреждений соответственно. В тоже время, 95% опрошенных специалистов отметили необходимость таких мероприятий, 73% для всех пациентов с переломами костей и 24% для части из них. Заключение. Впервые в Российской Федерации удалось провести анкетирование столь значительной группы травматологов-ортопедов по вопросам диагностики и лечения остеопороза, представлявших все регионы страны. Полученные данные свидетельствую о недостаточной информированности респондентов в вопросах как диагностики, так и лечения остеопороза, наличии собственных схем и приоритетов в лечении. Однако понимание травматологами и ортопедами важности вопроса вторичной профилактики остеопоротических переломов дает надежду на комплексное решение этой проблемы в ближайшие годы.
José Renato Gatto Júnior, Edmar Jaime de Almeida, Sonia Maria Villela Bueno
Na área da saúde, percebe-se grande influência de modelos biológicos de ensino, em que as questões humanas ficam em segundo plano. Sabendo que os processos de ensino-aprendizagem são influenciados por correntes filosóficas educacionais de várias origens, como é possível tomar o desafio de auxiliar na construção de um Sistema Único de Saúde sem ter ferramentas suficientes para entender, e operacionalizar metodologias de ensino capazes de preparar profissionais crítico-reflexivos, autônomos, conscientes, comprometidos com consolidação do mesmo? Buscou-se conhecer, por meio da revisão sistemática, quais as tendências pedagógicas que permeiam o cotidiano de enfermeiros docentes no processo de ensino-aprendizagem de cursos de graduação em enfermagem. Os resultados apontaram para a existência de grande uso de terminologias educacionais sem profundas discussões para entendimento das mesmas, resultando em uso indiscriminado de termos, para referir-se ao fazer - pedagógico, que muitas vezes não condizem com a realidade. Conclui-se que as tendências pedagógicas acabam sendo uma reprodução de práticas equivocadas, baseadas na experiência vivenciada pelos docentes em suas formações anteriores. Vale destacar que ainda se percebeu discussões que referiam a aprendizagem docente em redes de compartilhamento, o que é bastante promissor na aprendizagem docente permanente e significativa.
Kuete Victor, BetrandTeponno Rémy, Mbaveng Armelle
et al.
<p>Abstract</p> <p>Background</p> <p><it>Dioscorea bulbifera</it> is an African medicinal plant used to treat microbial infections. In the present study, the methanol extract, fractions (DBB1 and DBB2) and six compounds isolated from the bulbils of <it>D</it>. <it>bulbifera</it>, namely bafoudiosbulbins A (<b>1</b>), B (<b>2</b>), C (<b>3</b>), F (<b>4</b>), G (<b>5</b>) and 2,7-dihydroxy-4-methoxyphenanthrene (<b>6</b>), were tested for their antimicrobial activities against Mycobacteria and Gram-negative bacteria involving multidrug resistant (MDR) phenotypes expressing active efflux pumps.</p> <p>Methods</p> <p>The microplate alamar blue assay (MABA) and the broth microdilution methods were used to determine the minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) of the above samples.</p> <p>Results</p> <p>The results of the MIC determinations indicated that when tested alone, the crude extract, fractions DBB1 and DBB2 as well as compounds <b>2</b> to <b>5</b> were able to prevent the growth of all the fifteen studied microorganisms, within the concentration range of 8 to 256 μg/mL. The lowest MIC value for the methanol extract and fractions (16 μg/mL) was obtained with DBB1 and DBB2 on <it>E</it>, <it>coli</it> AG100A and DBB2 on <it>Mycobacterium tuberculosis</it> MTCS2. The lowest value for individual compounds (8 μg/mL) was recorded with compound <b>3</b> on <it>M</it>. <it>smegmatis</it> and <it>M</it>. <it>tuberculosis</it> ATCC and MTCS2 strains respectively. The activity of the samples on many MDR bacteria such as <it>Enterobacter aerogenes</it> EA289, CM64, <it>Klebsiella pneumoniae</it> KP63 and <it>Pseudomonas aeruginosa</it> PA124 was better than that of chloramphenicol. When tested in the presence of the efflux pump inhibitor against MDR Gram-negative bacteria, the activity of most of the samples increased. MBC values not greater than 512 μg/mL were recorded on all studied microorganisms with fraction DBB2 and compounds <b>2</b> to <b>5</b>.</p> <p>Conclusions</p> <p>The overall results of the present investigation provided evidence that the crude extract <it>D</it>. <it>bulbifera</it> as well as some of the compounds and mostly compounds <b>3</b> could be considered as potential antimicrobial drugs to fight against MDR bacteria.</p>
Letícia de Oliveira Borba, Andrea Noeremberg Guimarães, Verônica de Azevedo Mazza
et al.
Esta pesquisa foi realizada com o método da história oral temática e desenvolvida no ano de 2009, em Curitiba, com oito colaboradores pertencentes a três famílias que tinham um integrante com transtorno mental. O objetivo do estudo foi descrever a percepção de familiares e de portadores de transtorno mental sobre a assistência em saúde mental sustentada no modelo psicossocial. Os dados foram obtidos por meio de entrevista semiestruturada, analisados e apresentados de maneira descritiva. Os colaboradores consideraram os serviços extra-hospitalares, como o Centro de Atenção Psicossocial e os ambulatórios de saúde mental, estratégias inovadoras, e mencionaram o atendimento por equipe multiprofissional, a mediação de conflitos familiares e o princípio de territorialidade. Destacaram o acompanhamento do portador de transtorno mental pela Unidade Básica de Saúde e ressaltaram a importância das associações na rede de saúde mental. Atribuíram à inclusão da família no tratamento a melhora na relação familiar e a aceitação da doença.
Rosângela Fernandes Garcia, Marcílio Hubner de Miranda Neto
Este trabalho consta do estudo da constituição e das modificações sofridas pelo segmento inicial da artéria mesentérica superior, com a idade. O material foi obtido de 15 cadáveres, reunidos em 3 grupos etários: A, de 1 dia a 1 ano; B, de 6 a 8 anos e C, de 27 a 40 anos. As peças anatômicas foram submetidas a tratamento histológico. A túnica adventícia da artéria mesentérica apresentava redução de espessura, quando comparavam-se os grupos A, B e C, ao mesmo tempo que seus feixes de fibras colágenas tornavam-se mais espessos e menos ondulados. O contingente de lâminas e feixes de fibras elásticas maduras nos grupos B e C era menor que no grupo A, sendo verificada refução nos feixes de fibras oxitalânicas e elaunínicas, no grupo C. No grupo A, tanto na túnica média quanto na região subendotelial predominavam feixes de fibras musculares, ocorrendo gradativo aumento de fibras colágenas nos grupos B e C. Os feixes de fibras elásticas maduras eram escassos nesta túnica, nos 3 grupos estudados, enquanto os feixes de fibras oxitalânicas e elaunínicas estavam presentes em menor quantidade no grupo A que nos grupos B e C. Na túnica íntima, foram encontrados espessamentos regionalizados nos 3 grupos, sendo estes constituídos por grupamentos celulares e elementos fibrosos. Nestas regiões a lâmina elástica interna delaminava-se, estes espessamentos tornavam-se maiores com o progredir da idade. Discute-se que o aumento de fibras colágenas, oxitalânicas e elaunínicas da túnica média, juntamente com os espessamentos da túnica íntima e o aumento do colágeno subendotelial, reduz a distensibilidade do segmento inicial desse vaso.
Цель исследования. Оценить эффективность препаратов кальция и витамина Д для профилактики снижения МПК у женщин в постменопаузе с остеопенией и субклиническим тиреотоксикозом.
Материалы и методы. 20 женщин в постменопаузе 60 (56-66) лет с остеопенией и субклиническим тиреотоксикозом (70% получали супрессивную терапию после операции по поводу дифференцированного рака щитовидной железы) были рандомизированно разделены на две группы: 1-11 человек получили рекомендации по расширению содержания кальция в рационе питания до 1000 мг; 2-9 человек получали 1000 мг кальция и 800 МЕ витамина Д3 (Кальций-Д3-Никомед форте - 2 жевательные таблетки в сутки). Всем пациентам давались рекомендации по расширению физической активности. Биохимические показатели крови (кальций общ. и иониз., фосфор, креатинин, щелочная фосфатаза, ХС, ТГ, ЛПВП, ЛПНП, ХС/ЛПВП); кальций/креатинин в утренней моче; маркёры костного метаболизма (остеокальцин и СТх), МПК в поясничных отделах позвонков, проксимальном отделе бедра и лучевой кости оценивались в начале и через год лечения.
Результаты. Исходно пациенты 1 и 2 групп не отличались ни по каким показателям за исключением уровней маркёров костного метаболизма, которые были статистически значимо выше во 2 группе ((p=0,03 (ОК) иp=0,0035 (СТх)). Через 12 месяцев наблюдалось статистически не значимое снижение маркёров костного метаболизма преимущественно во 2 группе, при этом 1 и 2 группы перестали статистически значимо отличаться по уровню маркёров костного метаболизма. В обеих группах не наблюдалось изменений в уровнях кальция как в крови, так и в моче и не было выявлено снижения МПК.
Выводы. Назначение препаратов кальция и витамина Д и рекомендации по расширению потребления кальция с продуктами питания одинаково эффективны для предотвращения потери МПК у пациентов с субклиническим тиреотоксикозом. Однако назначение 2 таблеток Кальций Д3 Никомед форте приводит к большему снижению маркёров костного метаболизма и, следовательно, может быть более эффективным для длительной профилактики.
<p>Abstract</p> <p>Background</p> <p>Johrei is an alternative healing practice which involves the channeling of a purported universal healing energy to influence the health of another person. Despite little evidence to support the efficacy of such practices the use of such treatments is on the rise.</p> <p>Methods</p> <p>We assessed cultured human cancer cells for potential responsiveness to Johrei treatment from a short distance. Johrei treatment was delivered by practitioners who participated in teams of two, alternating every half hour for a total of four hours of treatment. The practitioners followed a defined set of mental procedures to minimize variability in mental states between experiments. An environmental chamber maintained optimal growth conditions for cells throughout the experiments. Computerized time-lapse microscopy allowed documentation of cancer cell proliferation and cell death before, during and after Johrei treatments.</p> <p>Results</p> <p>Comparing eight control experiments with eight Johrei intervention experiments, we found no evidence of a reproducible cellular response to Johrei treatment.</p> <p>Conclusion</p> <p>Cell death and proliferation rates of cultured human cancer cells do not appear responsive to Johrei treatment from a short distance.</p>