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Opioid Antagonists: Will they Solve all of the Problems Associated with Opioid Agonists?
No full textPhysicians employed in operating and emergency rooms have utilized opioid antagonist for almost half a century for the treatment of opioid overdose. The prototype antagonist remainsnaloxone hydrochloride, which actually received FDA approval back in 1971. Why after so many years on the market is this medication now being formulated in the form of an easy to use “auto-injector” that was designed for non-medical professionals to be able to utilize at a moment’s notice? Could this wonder product, being hailed as the best possible safety tool available for life threatening opioid emergencies actual make hero’s out of lay people? [1]. </p
An Unusual Case of Recurrent Pyocolpos Following Midtrimester Miscarriage Revealed as Obstructed Hemivagina with Ipsilateral Renal Agenesis (OHVIRA) Syndrome
No full textObstructed hemivagina with ipsilateral renal agenesis (OHVIRA Syndrome) is a rare congenital anomaly. It mostly presents with severe dysmenorrhea and a palpable mass due to unilateral hematocolpos. Sometime it presents in unusual way with prolonged vaginal bleeding and profuse vaginal discharge. We report a case of an 18-year-old married female with OHVIRA syndrome presenting late with symptoms of recurrent pyocolpos following dilatation and evacuation for midtrimester miscarriage that was diagnosed on the basis of MRI and managed by vaginal septotomy.</p
The Interaction between Metabolic Disease and Ageing
No full textTwo of the greatest crises that civilisation faces in the 21st century are the predicted rapid increases in the ageing population and levels of metabolic disorders such as obesity and type 2 diabetes. A growing amount of evidence now supports the notion that energy balance is a key determinant not only in metabolism but also in the process of cellular ageing. Much of genetic evidence for a metabolic activity-driven ageing process has come from model organisms such as worms and flies where inactivation of the insulin receptor signalling cascade prolongs lifespan. At its most simplistic, this poses a conundrum for ageing in humans – can reduced insulin receptor signalling really promote lifespan and does this relate to insulin resistance seen in ageing? In higher animals, caloric restriction studies have confirmed a longer lifespan when daily calorie intake is reduced to 60% of normal energy requirement. This suggests that for humans, it is energy excess which is a likely driver of metabolic ageing. Interventions that interfere with the metabolic fate of nutrients offer a potentially important target for delaying biological ageing. </p
Shaping Immune Responses by Dysregulated Adipokines in Obesity
No full textObesity is a major epidemic worldwide. According to the Centers for Disease Control and Prevention (CDC), about 34.9% of adults and 17% of children and adolescents are obese in the United States. The increasing prevalence of obesity poses a major threat to public health. Clinical and epidemiological data have established that obesity not only links to the development of diabetes, atherosclerosis and cardiovascular diseases, but also increases the risk of many types of cancer [1]. Although tremendous effort has been taken to investigate the pathogenesis of obesity and its associated diseases, the molecular mechanisms by which obesity negatively impacts on metabolic and immunologic homeostasisand increases the morbidity and mortality of many maladies remain largely unknown.</p
Oral Health Status and Anthropometric Conditions among HIV Infected Adolescents on Antiretroviral Therapy in Mozambique
No full textBackground: Malnutrition and weight loss are important characteristics in HIV/AIDS patients.The association between this type of pathology and oral health in HIV/AIDS patients maintains unclear in the literature.Objective: The aim of this study was to assess the oral health status and anthropometric conditions in adolescentstreated and non-treated with HIV infection in Maputo-MZ.Design: Cross-sectional analytical study conducted in the Maputo city, Mozambique in 2012.Methods: The random sample was composed of 143 adolescents from 15-19 years of age,attended to at the Medical Center Hospital and Pediatric Unit of Maputo Hospital. The adolescents were divided into two groups: HIV Group (HIVG)-adolescents with AIDS; Control Group (CG)-adolescents without HIV infection. The oral health conditions were collected by means of the DMFT index, the community periodontal index (CPI) and soft tissue, according to the criteria proposed by the World Health Organization (WHO), by a calibrated researcher. Student’s t-Test and Spearman correlation were used for statistical analysis (p<0.05).Results: The HIV group presented a higher degree ofdental caries (OR= 5.902; 95%CI=2.859-12.188; p=0.000), a trend to lessperiodontal diseases(OR=1.318; 95%CI=0.662-2.624; p=0.540),higheralterations in the soft tissue (OR=0.216; 95%CI=0.057-0.811; p=0.030) and higher normal BMI (OR=0.498; 95%CI=0.252-0.987; p=0.066) than the CG group.Conclusion: HIV/AIDS patients are at major risk for dental caries or alterations of soft tissue and minor risk for periodontal diseases, even when on antiretroviral therapy.</p
Climate Change Challenges on Fisheries and Aquaculture
No full textClimate change poses new challenges to the sustainability of fisheries and aquaculture systems, with serious implications for the 520 million people who depend on them for their livelihoods and then early 3 billion people for whom fish is an important source of animal protein [1]. Two-thirds of all reefs are in developing countries, and 500 million people in the tropics depend heavily on reefs for food, livelihoods, protection from natural disasters and other basic needs. For many coastal communities in reef areas, fishing activities are the sole source of income. Climate changes may affect fisheries and aquaculture directly by influencing fish stocks and the global supply of fish for consumption, or indirectly by influencing fish prices or the cost of goods and services required by fishers and fish farmers. Potential loss of species or shift in composition for capture fisheries and impacts on seed availability for aquaculture, changes in precipitation and water availability are major impacts of climate change. Climate change lowers water quality causing more disease and increased competition with other water users which altered and reduced freshwater supplies with greater risk of drought. Fishing communities that depend on inland fisheries resources are likely to be particularly vulnerable to climate change. Higher inland water temperatures may reduce the availability of wild fish stocks by harming water quality, worsening dry season mortality, bringing new predators and pathogens, and changing the abundance of food available to fishery species.</p
Gigant Laryngocele Airway Management
No full textEmergent airway obstruction is a dreaded emergency among anesthesiologists. Classically has been managed with awake options, particularly fibreoptic intubation. Laryngoceles, if size and accessibility allows for it, can be evacuated by needle aspiration, postponing definitive management.</p
Acute Effect of Aliskiren on Smoking-Induced Endothelial Dysfunction in Smoker
No full textBackground: We aimed to examine the acute effect of aliskiren on smoking-induced endothelial dysfunction in smoker.Methods: Nineteen male smokers were enrolled. After all participants smoked a cigarette, their endothelial function was assessed with brachial artery flow mediated dilation (FMD). An hour after the administration of aliskiren, they smoked again, their FMD was assessed again. A month later, all measurements were performed again without the administration of aliskiren as a control. Blood pressure, plasma renin activity, and serum interleukin-6 concentration were also examined at the same time of FMD measurement.Results: A cigarette smoking led to an acute endothelial dysfunction (6.5 ± 1.7% to 3.4 ± 1.0 %, P = 0.02). Aliskiren administration significantly suppressed blood pressure and plasma renin activity, furthermore, improved FMD (6.7 ± 0.5% to 8.1 ± 0.8 %, P = 0.03). Aliskiren significantly reduced serum interleukin-6 concentration, but not in control.Conclusion: Aliskiren has a beneficial effect on smoking-induced acute endothelial dysfunction.</p
Development of an objective tool for the Measurement of Spatial Neglect: A Proof of Concept Study
No full textObjective: To determine the concurrent validity, specificity and sensitivity of a newly developed tool; New Neglect Test (NNT) with line bisection test (LBT) and semistructured scale for the functional evaluation of hemi-inattention (SSS) in stroke patients, in assessing spatial neglect.Methods: A total of 28 patients participated in the study. Peripersonal neglect was assessed using LBT and NNT; whereas personal and extrapersonal neglects were assessed using SSS and NNT.Results: The results of the study indicated that the new neglect test has a weak to strong correlation with SSS and LBT at assessing personal, peripersonal and extrapersonal neglect, Phi (Ø) correlation coefficient ranging from r=0.05 to r=-0.66. However, NNT has very low sensitivity and specificity in relation to SSS and LBT when the latter tools are considered as goal standards. Additionally, the result showed that only stage of stroke predicts the NNT’s ability to detect spatial neglect in stroke patients, but not age, sex, side affected and MMSE scores.Conclusion: NNT is valid at detecting spatial neglect especially in patients within the acute stage of stroke.</p