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Shewhart Charts and Two-Monthly Screening Interval to Monitor Hepatitis C and Hepatitis B Virus Infections in Two-Year Prospective Cohort Study of Hemodialysis Patients in Vietnam
No full textBackground: Early detection of an increase in the rate of hepatitis C (HCV) and hepatitis B (HBV) acquired during healthcare in hemodialysis setting allows rapid assessment and intervention to prevent subsequent sero-conversions. We retrospectively examined the application of the Shewhart chart to our two-year cohort study to early detect temporal change in HCV and HBV sero-conversions among hemodialysis patients in low-resourced setting provided that there was a known investigated outbreak of HCV occurring in this study period. We also reported our findings of the incidence density, prevalence, genotype and subtype of HCV and HBV infections and their associated risk factors.Methods: All 201 patients treated at the District-6 Hospital in Ho Chi Minh City, Vietnam participated in a prospective cohort study between 2012 and 2014. Patients consented to be tested for HBV surface antigen (HBsAg) and HCV core antigen (HCV-coreAg) and provided information on demographics, lifestyle risk factors and treatment related risk factors two-monthly through an administered questionnaire. Positive patients were tested for viral genotypes. Sero-conversions were plotted retrospectively on a P-control chart.Results: HCV and HBV prevalence rates were 12% (95%CI 8% – 18%) and 8% (95%CI 5% – 12%) respectively. HCV and HBV incidence density rates were 5 (95%CI 3-9) and 2 (95% CI 1-4) new cases per 1,000 person-months. These incidence and prevalence rates of HCV and HBV were not statistically different (P>0.05) except in follow-up months 13 and 14 when HCV outbreak occurred (P = 0.0008). An alarming increase in both HBV (months 11 and 12) and HCV (months 13 and 14) infection was demonstrated by Shewhart chart. Infection control lapses were identified as the cause of these increases. Among typable patients, 5 had HCV genotype 1b, 3 (genotype 1a) and 2 (genotype 6a). Two patients tested HBV genotype B.Conclusion: The applicable Shewhart control chart and two-monthly screening interval should be routinely utilized to detect potential HCV and HBV outbreak in low-resourced hemodialysis settings so that improvement interventions can be in place timely to prevent the spread of diseases. Strict adherence to infection control measures and routine infection control improvement strategies are vital in preventing these healthcare associated infections
Report of Radical Prostatectomy at the Urology Department of the Hopital General de Grand Yoff (HOGGY)
No full textGoal: To show the importance of radical prostatectomy and to evaluate the carcinogenic and functional results of radical prostatectomy (RP) at the Department of Urology of the Hôpital General de Grand Yoff.Patients and Methods: This is a retrospective descriptive study involving 52 patients that had prostate cancer and had gone through RP. The study was held at the Department of Urology of the Hôpital General de Grand Yoff in Dakar over a period of 9 years starting from 1st January 2005 to 31st December 2014. The parameters covered in this study included: Age, existence or non-existence of history of prostate cancer in siblings, circumstances of diagnosis, clinical examination, diagnostic data with histology, therapeutic aspects and prognosis. All data was analyzed using CSPro and EXCEL software with the level of significance at (p < 0.005).Results: The average age of our patients was 61.2 years, ranging between the ages of 50 years and 69 years. In total, 51 patients had a preoperative Gleason score. Amongst them, 26 patients had well differentiated tumors (3+3 =6) and 7 patients had poorly differentiated tumors (4+4 =8) whilst 18 patients showed intermediate tumor differentiation between the two preceding groups (3+4 =7).Histological examination of the specimen among the patients with a preoperative Gleason score of 7 (3 + 4), only 4 of the predicted patients had a definite score of 7 (4 + 3) while 1 patient had a Gleason score of 8. Postoperative Gleason score was evaluated only in 23 of the patients. Post-operative complications included 30 cases of urinary incontinence (56%), one case of ED in 20 cases (37%) and ureteral-bladder stenosis in 4 cases (7%). Biochemical recurrence (BR) was found in 11 patients. We noted clinical recurrence (CR) in 4 of the patients. Among patients with an RB, the resection margins were positive in 2 patients and lymph node invasion in 2 patients. It was equally noted that there was a seminal vesicle invasion in 5 patients in the biochemical recurrence.In the 31 patients being followed up, quality of life was evaluated. Among patients with erectile dysfunction, 15 patients (48.4%) had good erectile functioning while 16 patients (51.6%) were evaluated as satisfactory. Continence was good in 11 patients (38.7%), average in 16 patients (51.6%) and poor in 3 patients (9.7%).Conclusion: Radical prostatectomy gives patients a better chance for cure. The proposition for a PSA of the patients over 50 years of age would increase early diagnosis and would improve the prognosis of the cancer
The Effects of Music Presence on Auditory Verbal Working Memory
No full textBackground and Aim: Music exists in all cultures; many scientists are seeking to understand how music affects cognitive development such as comprehension, memory, and reading skills. More recently, a considerable number of neuroscience studies on music have been developed. This study aimed to investigate the effects of null and positive background music in comparison with silence on auditory-verbal memory performance.Methods: Forty young adults (male and female) with normal hearing, aged between 18 and 26, participated in this comparative-analysis study. An auditory and speech evaluation was conducted in order to investigate the effects of background music on working memory. Subsequently, the Rey auditory-verbal learning test was performed in three different conditions: silence, positive, and null music.Results: The mean score of the Rey auditory-verbal learning test in silence condition was higher than the positive music condition (p=0. 003) and the null music condition (p=0. 01). The tests results did not reveal any between genders differences.Conclusion: It seems that the presence of competitive music (positive and null music) and the orientation of auditory attention have negative effects on the performance of verbal working memory. It is possibly due to the intervention of music with verbal information processing in the brain
Chaos Theory and Behavioral Patterns: A theoretical Approach to Psychosis, Bipolar Disorder and Depression
No full textIntroduction: In this research, we investigate whether chaotic phenomena (Chaos Theory) regulate human brain physiological and pathological behavioral patterns (BP).Methods: Modeling the six basic neurotransmitters of Central Nervous System (CNS), that is to say Dopamine (DA), Serotonin (SE), Noradrenalin (NE), γ-aminobutiric acid (GABA), Glutamate (Glu) and Acetylcholine(Ach), a set of six first order differential equations have been developed and studied in phase-space.Results: The elementary equilibrium points in three (3-DS) and six dimensional (6-DS) phase portrait analysis, include attractors, saddles and repellors. Furthermore, it has been studied the 3-D phase-space of DA, SE and NE.Conclusions: Attractors indicate a stable equilibrium point which corresponds to the most stable behavioral pattern, while the saddles represent a occasional unstable behavioral pattern and finally the repellors correspond to an unstable dynamic system of a totally disorganized BP.. Among other mechanisms, chaotic phenomena seem to regulate in a particular way the CNS basic neurotransmitters resulting in a huge number of different theoretical BP. The implementation in 3-D phase space provides a different view of Psychosis, Bipolar Disorder and Depression. Further research is needed so as to establish the predictive and therapeutic value of this theoretical approach of Human Behavior
A Systematic Review of Metformin Therapy and Renal Outcomes in Type 2 Diabetes Mellitus
No full textBackground: Nephropathy is an important sequelae of diabetes. Current clinical study of the potential nephroprotective effects of metformin in diabetes is small and outcomes of individual studies insufficient to arrive at a firm conclusion. The objective of this systematic review is to evaluate the relationship between metformin treatment and specific renal outcomes in patients with Type 2 Diabetes Mellitus (T2DM).Methods: Two authors independently performed comprehensive searches in relevant health care databases using pre-determined search terms. Included articles described metformin treatment compared to control group(s) whereby baseline and follow-up parameters of relevant renal outcome were adequately described. Study characteristics, outcomes, and methodological quality were extracted according to standard protocols.Results: Initial search yielded 1,147 articles of which 7(6 prospective and 1 retrospective) studies meeting inclusion criteria were included in the overall analysis totaling 62,993subjects exposed to metformin. Comparators included thiazolidinediones (TZDs), sulfonylureas (SUs) and insulin in studies spanning 12 weeks to 4 years. When change from baseline values is compared, metformin demonstrated a more pronounced increase in albumin to creatinine ratio (ACR) than SUs (mean difference [MD] 14.8 mg/g [-4.2 to 25]), while TZDs were consistently associated with improvements. No significant difference in glomerular filtration rate (eGFR) was observed between metformin and TZD (MD 0.22 mL/min [-0.24 to 0.68]), while data between metformin and SU was conflicting.Conclusions: The potential nephroprotective effects of metformin in diabetes patients with or without evidence of pre-existing proteinuria are not supported by our findings. Further long-term prospective study among larger populations is needed
The Function of Saffron and its Constituent in Gastroenterological Tissues
No full textJapan has been moving towards a super aging society, resulting in a rapidly increasing prevalence of lifestyle diseases, including colon cancer. Japanese patients survey by the Ministry of Health, Labour and Welfare reported 235,000 colon cancer patients in 2015, and this number is quickly increasing due to the change of dietary life style from the typical Japanese food to the westernized style food. Although the cancer chemotherapy has been widely developing recently, some natural product support, having wide spectra of bioactivity, however mild, are required. Saffron finds use as folk medicines as well as a flavoring and a coloring agent. Saffron consists of three main chemical components; red color, crocetin glycosides; a bitter taste, picrocrocin; and spicy aroma, safranal. In this chapter, we evaluate the activities of saffron extracts and a major crocetin glycoside, crocin. against colorectal cancer in in vitro and in vivo trials. Saffron crude extracts, which contain approximately 40% of crocin, significantly inhibited the growth of colorectal cancer cell lines HCT-116, HT-29 and SW-480, although crocin did not affect for non-cancer cells. Crocin significantly inhibited the development of colonic adenocarcinomas induced by azoxymethane and dextran sodium sulfate in mice during 18 weeks feeding. The crocin feeding experiment for 4 weeks evidently inhibits the dextran sodium sulfate induced colitis and, then, the clear suppression for the mRNA expression of tumor necrosis factor α, interleukin- (IL-) 1β,IL-6, interferon γ, NF-κB, cyclooxygenase-2, and inducible nitric oxide synthase, and the increase of Nrf2 mRNA expression in the colorectal mucosa occurred. From these results we suggest that crocin can suppress chemically induced colitis and colitis-related colon carcinogenesis in mice mainly through the inhibition of inflammation related cytokines, indicating that saffron and crocin are suitable candidates for the prevention of colitis and inflammation-associated colon carcinogenesis. We further review the supporting phenomena like strong anti-oxidant and anti-inflammation activities of crocin using our previous publications
Osteoma of the Internal Auditory Canal
No full textOsteomas of the internal auditory canal are extremely rare bening lesions which are usually diagnosed incidentally. The etiology of sporadic cases in unknown. Herein, we report on a case of internal auditory canal osteoma in a 39-year-old woman suffering from vertigo, hearing loss and tinnitus on her right ear. The patient underwent decompression of the right internal auditory canal and osteoma ablation via retrosigmoid approach. Postoperatively, the patient improved, both vertigo and facial weakness disappeared. Moderate cephalgia is still present. The patient has been under the regular follow up over the period of two years
Case Report: Carotid Sinus Hypersensitivity During Internal Jugular Venous Cannulation
No full textCarotid sinus hypersensitivity is common in elderly patients. Baroreceptor function generally decreases with age but some people experience hypersensitive carotid baroreflexes. In such individuals, even mild stimulation to the neck results in profound bradycardia and hypotension. In this case, CSH was elicited during internal jugular venous cannulation which is a common procedure in cardiac surgery. Knowledge about CSH can help us to take appropriate precautions in perioperative period and manage cardiac instability arising from this reflex
Interleukin-1β Regulates PCSK9 and LDL Receptor Expression together with de novo Cholesterol Synthesis in HepG2 Cells
No full textBackground and Aim: Chronic inflammation is associated with changes in lipid and cholesterol metabolism in the liver. A predominant finding is changes in surface LDL receptor (LDLR) expression at various stages of disease which may be associated with serum increases in LDL and therefore increased risk of developing atherosclerosis. At the same time, increased cholesterol accumulation has also been observed and linked to development of fatty liver.Methods: Here, we use the hepatoma cell line HepG2 as a model of highly active chronic inflammation and report on cytokine mediated changes in expression of proprotein convertase subtilisin/kexin type 9 (PCSK9), LDLR and low density lipoprotein receptor-related protein 1 (LRP-1) as well as expression of rate limiting enzymes in the cholesterol synthesis.Results: Overall, we observed a predominant role of Interleukin-1b (IL-1b) in reduction of PCSK9 accompanied by increased LDLR expression, whereas LRP-1 expression was not influenced. Key enzymes in cholesterol biosynthesis were all downregulated by IL-1b.Conclusion: In conclusion, we identify IL-1b as a key regulator of cholesterol metabolism
Biliary Atresia Etiopathogenesis: On the Way to Solve the Mystery
No full textBiliary Atresia (BA) is the most common cause of chronic cholestasis in infants and the most frequent cause for surgery in cholestatic jaundice in this age group. It is a destructive inflammatory obliterative cholangiopathy that affects varying lengths of both intrahepatic and extrahepatic biliary tree. The extensive research in BA aims at three main aspects; a) understanding the etiopathogenesis, b) achieving early diagnosis, and c) improving the outcome of surgical interventions. The improvements in the latter two are largely based on the advances in further understanding and revealing the etiopathogenesis. Till the moment, the exact etiology remains a mystery. Biliatresone, a recently identified toxin that causes BA phenotype in zibrafish may open a new horizon for future studies in humans in an attempt to solve the mystery