International Medical Publisher Journals (iMedPub)
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Chronic inflammatory polyneuropathy associated with ulcerative colitis: a reported case in literature
Get PDFAbstractBackground: Peripheral neuropathy is known to be related to inflammatory bowel disease and it is one of the most frequently reported neurologic complications. Various studies have found peripheral nervous system complications, rather than central nervous system involvement, to be predominant. In the literature, there are a few cases of inflammatory polyneuropathy developed in the course of ulcerative colitis : 5 cases of Guillain-Barré syndrome, one case of chronic inflammatory demyelinating polyneuropathy, 10 cases of neuropathy and one case of perineuritis. Case presentation: We describe a case of chronic inflammatory polyneuropathy associated with ulcerative colitis. Conclusion: Peripheral neuropathy is not a common manifestation of IBD, highlighting the need for careful exclusion of other causes of neuropathy when both conditions are encountered in clinical practice. Â
Equity in Health: Conception of Professionals in the Primary Network of the Unifid Health System
No full textBackground: This study refers to the process of investigation about the doctrinal principle of fairness of the Unifid Health System (SUS), through analysis of the theoretical and legal framework and the applicability thereof, specifially in Primary Health Care (APS) level, since it helps in monitoring and referring the population to other levels. The objective of this study was to verify the checked concepts aboutfairness in health on the speech of professionals working in the Family health’s strategy in the city of Juazeiro do Norte-CE, Brazil.Method: An analytical and cross-sectional study was conducted with a qualitative approach to obtain data that demonstrate how equity is perceived by professionals working in the Health Primary Level in Juazeiro do Norte, Ceará, Brazil. The sample included 18 professionals working in the direct assistance of family’s health and who worked for at least six months in family health strategies. Data collection was performed by a previously structured guide with subjective questions, to assist the interview. For data analysis, we usedthe technique of Bardin (2009). The study followed all the provisions of the National Health Council Resolution 466/12 and Ministry of Health.Results: It is possible to see that all employees in different professional categories have diffiulties to defie fairness, even with the majority having higher education, several years of training and expertise in the fild of Public Health. This can result from the lack of interest of these professionals to update their knowledge, lack of initiative in the research area and the lack of continuous and permanent education, which should be required by employers to remain in their positions and to perform their duties at work, not occurring in practice. Through the speeches of participants in this research is perceived that a minority of professionals have an adequate perception of the concept of equity in health, compared to literary concepts, makingcrucial the development of these professionals so that they promote corrections towards providing a more just and resolute assistance.Conclusions: It can be inferred that professionals have some knowledge about what is fair, but this concept is still vague, based on primitive human feelings and social vulnerability of the individual.A favorable position is assumed that health managers should offer to their employees, proper improvement to work in the Single System of Health level, especially in primary care, promoting means of continuous and permanent educatio
Molecular characterization of staphylococcal cassette chromosome mec and virulence encoding genes in methicillin-resistant staphylococci at a medical center in Lebanon
Get PDFBackground: Methicillin-resistant staphylococci (MRS) are major human pathogens accounting for most hospital-acquired (HA) and community acquired (CA) infections worldwide. The recent increase in MRS in a medical center in Lebanon elicited the determination of SCCmec types, genotypes, and prevalence of Panton-Valentine leucociden (PVL) and toxic shock syndrome toxin-1 (TSST-1) among the MRS isolates.   Methods: Thirty-six MRS isolates collected between October 2010 and September 2011 at a medical center, Lebanon were typed using phenotypic and genotypic methods. Antimicrobial susceptibility was determined using the disk diffusion agar method. SCCmec typing was performed by multiplex PCR and sequence analysis. The prevalence of the genes encoding PVL and TSST-1 virulence factors and their transcription levels, were determined respectively by PCR and semi-quantitative real-time PCR. The genomic relatedness of the isolates was assessed by random amplified polymorphic DNA (RAPD) analysis.Results: Antimicrobial susceptibility revealed three distinct antibiotypes. The predominant SCCmec type found among the MRS isolates was type IVa (51%). Twenty-nine percent harbored SCCmec type III and 14% harbored SCCmec type II. One isolate harbored SCCmec type IVc, and another  harbored SCCmec type I. All methicillin-resistant Staphylococcus aureus (MRSA) isolates were negative for the gene encoding for PVL, and two were positive for the gene encoding for TSST-1. RAPD analysis demonstrated high genomic diversity among the MRS isolates.Conclusion: This study demonstrated the SCCmec types and the clonality of the MRS strains, allowing the differentiation between HA and CA-MRS strains. CA-MRS have  increased in the hospital environment and rendered highly resistant to erythromycin and clindamycin
Efficacies of Echinocandins versus Azoles Antifungal agents in Management of Candidaalbicans andCandida dubliniensis
No full textCandidalinfectionis aworld-wide problem with greatly-changed epidemiology.Candida dubliniensis is an emerging non-albicans, shares several phenotypic and genotypic characteristics andclosely related toCandidaalbicans. Fluconazole-resistant Candidabecome asignificant life-threatening problem especially in high risk patients. Echinocandins are promising antifungals with no recorded resistance.This study was done, first to differentiate Candidadubliniensis from Candidaal bicansby different phenotypic and molecular methods and to compare in vitro activities of echinocandins against Candida spp versus azoles. Subjects and Methods:one hundred fifty-seven oral and vaginal swabs collected from Dermatology outpatients of Zagazig University Hospitals. Cultivation was done on Brilliance Candida agar. Growth at elevated temperature;tobacco agar VITECK2-YST and PCRwere evaluated. Antifungal susceptibility testing was done to Candidaalbicans and Candida dubliniensis to fluconazole and caspofungin by microdilution method ResultsA total of 76 Candida isolates were identified. Most of them(61.8%) were Candida albicans, followed by Candida glabrata,Candida dubliniensis and the least was C. krusei (14.5%),(13.2%) and (10.5%) respectively. For further differentiation betweenC.albicans and C.dubliniensis, PCR hadthe highest sensitivity (100%) however, tobacco agar, growth at elevated temperature and VITECK2-YSThad (82.5%), (59.6%) and (84.2%) sensitivities respectively. The Percentage of fluconazole-resistant Candida dubliniensisand Candida albicans were (55.6%) and 23(49%) withMIC ≥64μg/ml. BothCandida albicansand Candida dubliniensis isolates were (100%) sensitive to caspofungin at MIC range of 0.06-1μg/ml. ConclusionBrillance Candida Agar is a reliable-test, for differentiation of Candidaspp,Caspofungin showed activity against fluconazole-resistant C. albicansand C.dubliniensis
Borderline personality disorder in twins: The preponderance of environmental and genetic factors
Get PDFThe borderline personality disorder is a psychiatric disorder that despite being widely researched, still has limitations in addressing certain issues involving the degree of genetic and environmental influence. Although studies indicate the existence of such influences, little had research on different prevalences in twins
Assessment of Soluble Urokinase-Type Plasminogen Activator Receptor (supAR) in Chronic Obstructive Pulmonary Disease
Get PDFBackground: Chronic obstructive pulmonary disease (COPD) is a disease characterized by a progressive airflow limitation. Soluble urokinase-type plasminogen activator receptor (suPAR) is released from the membrane-bound plasminogen activator, and is positively correlated with the activation of immune system.Aims: Release of inflammatory mediators is increased in chronic obstructive pulmonary disease (COPD), particularly during exacerbations. The objective of this study was to compare plasma levels of suPAR and serum levels of C-reactive protein (CRP) during exacerbation and stable periods in patients with COPD.Study Design: Prospective clinical study. Methods: The patients with COPD were divided into 3 groups for evaluations: those with stable COPD [SCOPD] (n= 54), pre-treatment acute exacerbation COPD [AECOPD] (n= 53), and post-treatment AECOPD (n= 52). Plasma suPARand serum CRP levels were assessed for each patient.Results: Whereas the increased serum CRP levels of the participants were 54.82±56.63 mg/l during acute exacerbation period, during the stable period it was 5.02±6.31 mg/l and statistically significant (p= 0.0001). The suPAR level was 1.28±0.52ng/ml during the acute exacerbation period vs.1.21±0.59ng/ml during the stable period, without a difference (p= 0.49). There was a statistically significant decrease in the CRP serum levels; yet, although not statistically significant  a remarkable decrease was seen in the suPAR levels obtained before and after the management of exacerbations (p= 0.001 and p= 0.06 respectively).Conclusion: These results support the idea that suPAR, a novel biomarker, might be an important indicator if verified with further prospective studies in evaluating COPD exacerbations and treatment response like CRP used for decades
Retrograde Endoscopic Treatment of Completely Obstructed Anastomotic Stricture After Anterior Resection
Get PDFMs M is a 38 year female who has a history of severe endometriosis. She underwent resection of pelvic endometriosis, parital cystectomy and an anterior resection and loop ileostomy due to a rectosigmoid stricture. Post operative gastrograffi showed a patent anastomosis. The patient presented electively for closure of the ileostomy three months later. Under general anaesthesia, the patient was examined and it was found that the colorectal anastomosis was completely occluded. This article presents a novel procedure using a colonoscope with a cutting snare, Hegar’s dilators and a Controlled Radial Expansion (CRE) balloon to reopen the lumen
Migration, Integration and Health for Aging LgbtQ2 Populations in the eu:a Strengths-based Approach to Policy
Get PDFhat is often absent in accounts of LGBTQ2 migration experiences are the roles of policies and legislations in the regulation of sexual and gender minoritized populations’ movements across borders. Specifically, many health policies can simultaneously impact on access to and uptake of health services and thereby influence health outcomes among older LGBTQ2 populations. In this paper we offer an analysis of the ways in which current policies and legislation within select European Union (EU) states can impact on freedom of mobility; recognition of same-sex partners and gender-identity in receipt of social benefits; social and labour market integration; language and cultural competency; anti-discrimination policies in health and care; healthy aging initiatives; and the mainstreaming of health policies versus targeted health intervention policies could potentially impact the flow of migration of older LGBTQ2 individuals between select Member States and outside of them. In the following synthesis, we argue the need to approach health policies from ‘strengths-based’ approaches within a life course framework in exploring the development and implementation of policies surrounding the healthy aging of older LGBTQ2 people; and to articulate how policies surrounding these issues could influence the migration of older LGBTQ2 individuals and their families. We argue that there is a need to develop both mainstream and targeted-intervention policies, and direct future research towards the assessment of the specific health needs and initiatives for aging LGBTQ2 populations both in Canada and in EU Member States with comparable health systems
Impacts on perspective of death in relatives of pediatric oncology patients: a systematic review
Get PDFBackground: The impacts of the news of a child/adolescent with cancer are devastating for the patient and his family. This study highlights - through a systematic literature review - the main consequences on the pediatric oncology patient’s family, while facing the cancer situation. Methods and Findings: systematic literature review in BVS (Biblioteca Virtual em Saúde) and SciELO (Scientific Eletronic Library Online) from original studies published from January 1st, 2008 to November 30th, 2012 and that report the trajectories of illness and/or disease course of pediatric oncology patients in the family perspective. The following keywords were chosen as elegibility criteria on the search: "child"[MesH]; "cancer†[Keyword]; “Family" [MeSH] and “death†[MesH]. Of the 569 manuscripts found, 22 met all these eligibility criteria. Studies have shown that the difficulties begin when the cancer is diagnosed. The acceptance of the diagnosis by the family, the overspending expenses, stress, fear and anxiety are examples of emotional overloads which caregivers are exposed. It is noticed that the caregiver job is performed by the mother, while the father is responsible for the "economic mainstay''. On this context, the intimate relation with faith arises or intensifies, in the form of acceptance or denial. Conclusion: The cancer treatment in children should not be focused only on the patient but also on the family – the essential indicator for attenuation on patients suffering
Irinotecan: Electron transfer mechanism in CNS disorders: Electron affinity, ROS, and SAR
Get PDFA recent article deals with promising use of irinotecan in treatment of Angelman Syndrome, a neurological disorder. The present report provides mechanistic evidence for involvement of electron transfer based on preliminary data from computational studies on electron affinity. The drug and the topotecan analog are related to camptothecin, a wellÂknown anticancer drug. The protonated forms are better at electron affinity. Lactone hydrolysis may provide carboxyl for intramolecular protonation. The active phenol metabolits may also play a role. StructureÂactivity relationship (SAR) in addressed. These results buttress the prior hypothesis dealing with irinotecan mechanism in central nervous system toxicit