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Otgontuya D.,National Center for Public Health | Oum S.,University of Health Sciences | Buckley B.S.,University of the Philippines at Manila | Bonita R.,University of Auckland
BMC Public Health | Year: 2013

Abstract. Background: Recent research has used cardiovascular risk scores intended to estimate "total cardiovascular disease (CVD) risk" in individuals to assess the distribution of risk within populations. The research suggested that the adoption of the total risk approach, in comparison to treatment decisions being based on the level of a single risk factor, could lead to reductions in expenditure on preventive cardiovascular drug treatment in low- and middle-income countries. So that the patient benefit associated with savings is highlighted. Methods. This study used data from national STEPS surveys (STEPwise Approach to Surveillance) conducted between 2005 and 2010 in Cambodia, Malaysia and Mongolia of men and women aged 40-64 years. The study compared the differences and implications of various approaches to risk estimation at a population level using the World Health Organization/ International Society of Hypertension (WHO/ISH) risk score charts. To aid interpretation and adjustment of scores and inform treatment in individuals, the charts are accompanied by practice notes about risk factors not included in the risk score calculations. Total risk was calculated amongst the populations using the charts alone and also adjusted according to these notes. Prevalence of traditional single risk factors was also calculated. Results: The prevalence of WHO/ISH "high CVD risk" (≥20% chance of developing a cardiovascular event over 10 years) of 6%, 2.3% and 1.3% in Mongolia, Malaysia and Cambodia, respectively, is in line with recent research when charts alone are used. However, these proportions rise to 33.3%, 20.8% and 10.4%, respectively when individuals with blood pressure > = 160/100 mm/Hg and/or hypertension medication are attributed to "high risk". Of those at "moderate risk" (10- < 20% chance of developing a cardio vascular event over 10 years), 100%, 94.3% and 30.1%, respectively are affected by at least one risk-increasing factor. Of all individuals, 44.6%, 29.0% and 15.0% are affected by hypertension as a single risk factor (systolic ≥ 140 mmHg or diastolic ≥ 90 mmHg or medication). Conclusions: Used on a population level, cardiovascular risk scores may offer useful insights that can assist health service delivery planning. An approach based on overall risk without adjustment of specific risk factors however, may underestimate treatment needs.At the individual level, the total risk approach offers important clinical benefits. However, countries need to develop appropriate clinical guidelines and operational guidance for detection and management of CVD risk using total CVD-risk approach at different levels of health system. Operational research is needed to assess implementation issues. © 2013 Otgontuya et al.; licensee BioMed Central Ltd.


The International Association of HealthCare Professionals is pleased to welcome Kenneth R. Brooks, MD, FAAOS, Orthopedic Surgeon, to their prestigious organization with his upcoming publication in The Leading Physicians of the World. Dr. Brooks is a highly-trained and qualified orthopedic surgeon with a vast expertise in all facets of his work, especially sports medicine, adult reconstructive orthopedic surgery, as well as hip, knee, wrist and hand osteoarthritis. Dr. Brooks has been in practice for more than six years and is currently serving as an Assistant Professor at the University of Texas Medical Branch at Galveston. Furthermore, Dr. Brooks is affiliated with Memorial Hermann Southeast Hospital, John Sealy Hospital, Christus St. John Hospital, and UTMB Specialty Care Center at Victory Lakes. Dr. Brooks’ career in medicine began in 2000 when he graduated with his Medical Degree from The Chicago Medical School, Finch University of Health Sciences. Following his graduation, Dr. Brooks completed his internship and then residency at the University of Medicine and Dentistry of New Jersey. He then went on to undertake his fellowship training at Wayne State University, followed by an additional fellowship at completed at the University of Texas Health Science Center. Dr Brooks is board certified in Orthopedic Surgery, and has earned the coveted title of Fellow of the American Academy of Orthopaedic Surgeons. To keep up to date with the latest advances and developments in his field, Dr. Brooks maintains professional memberships with the American Orthopaedic Society for Sports Medicine, the American Academy of Orthopaedic Surgeons, and the Texas Orthopaedic Association. For his excellence, Dr. Brooks has been recognized with a Patient’s Choice Award in 2013, a Compassionate Doctor Recognition in 2013, and a Rose Award for Outstanding Service Excellence by Oregon Health Sciences University in 2000 and 2001. Dr. Brooks believes effective communication is the foundation for a successful physician-patient partnership. He attributes his great success to his hard work, staying focused, his love for the field and seeing his patients get healthier, and the support from his family. When he is not working, Dr. Brooks enjoys coaching youth soccer, golfing, body surfing, and spending time with his family. Learn more about Dr. Brooks by reading his upcoming publication in The Leading Physicians of the World. FindaTopDoc.com is a hub for all things medicine, featuring detailed descriptions of medical professionals across all areas of expertise, and information on thousands of healthcare topics.  Each month, millions of patients use FindaTopDoc to find a doctor nearby and instantly book an appointment online or create a review.  FindaTopDoc.com features each doctor’s full professional biography highlighting their achievements, experience, patient reviews and areas of expertise.  A leading provider of valuable health information that helps empower patient and doctor alike, FindaTopDoc enables readers to live a happier and healthier life.  For more information about FindaTopDoc, visit:http://www.findatopdoc.com


Couillard S.,University of Québec | Bougault V.,University of Health Sciences | Turmel J.,University of Québec | Boulet L.-P.,University of Québec
Chest | Year: 2014

Objective: Self-reported respiratory symptoms are poor predictors of exercise-induced bronchoconstriction (EIB) in athletes . The objective of this study was to determine whether athletes have an inadequate perception of bronchoconstriction. Methods: One hundred thirty athletes and 32 nonathletes completed a standardized questionnaire and underwent eucapnic voluntary hyperpnea (EVH) and methacholine inhalation test. Perception scores were quoted on a modified Borg scale before each spirometry measurement for cough, breathlessness, chest tightness, and wheezing. Perception slope values were also obtained by plotting the variation of perception scores before and after the challenges against the fall in FEV1 expressed as a percentage of the initial value [(perception scores after - before)/ FEV1 ]. Results: Up to 76% of athletes and 68% of nonathletes had a perception score of ≤ 0.5 at 20% fall in FEV1 following methacholine. Athletes with EIB/airway hyperresponsiveness (AHR) had lower perception slopes to methacholine than nonathletes with asthma for breathlessness only ( P = .02). Among athletes, those with EIB/AHR had a greater perception slope to EVH for breathlessness and wheezing ( P = .02). Female athletes had a higher perception slope for breathlessness after EVH and cough after methacholine compared with men ( P < .05). The age of athletes correlated significantly with the perception slope to EVH for each symptom ( P < .05). Conclusions: Minimal differences in perception of bronchoconstriction-related symptoms between athletes and nonathletes were observed. Among athletes, the presence of EIB/AHR, older age, and female sex were associated with slightly higher perception scores. © 2014 American College of Chest Physicians.


In 1995, 2005 and 2011, cross-sectional studies of 611 parturients at the Centre Hospitalier de Libreville in Gabon assessed the prevalence of maternal malaria and anaemia; two indicators of poor pregnancy outcomes. The prevalence of Plasmodium falciparum infection in maternal peripheral blood decreased from 25% in 2005 to 6% in 2011. Parasite density was significantly lower in 2005 (31 p/μL) than in 1995 (1,240 p/μL) or 2011 (35,055 p/μL). Anaemia prevalence was high (>50%) in 1995 and in 2005, but fell by more than 50% (24%) in 2011. After implementation of new malaria prevention strategies during pregnancy, the prevalence of both maternal peripheral P. falciparum infection and anaemia fell. Studies are necessary to assess the efficacy of these strategies and to seek other causes of anaemia.


Dabboussi F.,University of Health Sciences
Eastern Mediterranean health journal = La revue de santé de la Méditerranée orientale = al-Majallah al-sihhīyah li-sharq al-mutawassit | Year: 2012

Campylobacter species are a major cause of human diarrhoeal disease worldwide. In Lebanon, the true prevalence of Campylobacter infections and the species distribution in childhood diarrhoea are not known. This study in 2010 investigated the prevalence of Campylobacter species and its possible etiologic role in childhood diarrhoea in north Lebanon. A total of 90 stool samples from children (aged 1 month to 10 years) presenting with diarrhoea were collected from 5 hospitals. A polymerase chain reaction technique (PCR) was used for each sample forthe amplification of all Campylobacter species followed by 5 PCR reactions for the amplification of C. jejuni, C. hyointestinalis, C. coli, C. fetus and C. upsaliensis. Of the 90 samples, 10 were positive for Campylobacterspecies (11.1%):1 for C.coli, 1 for C. jejuni, 2 for both C. jejuni and C. coli, and 6 could not be identified to the species level with the available primers. Campylobacter species is frequently associated with childhood diarrhoea in north Lebanon but Campylobacter infection may be significantly underdiagnosed because the search for Campylobacter is not part of the routine stool culture.


Adegbidi H.,University of Health Sciences
Le Mali médical | Year: 2012

The aim of this study was to investigate the epidemiological aspects of drug eruptions in children in hospital area in Cotonou. A retrospective study was carried out in the Department of Dermatology of Cotonou (Benin) from 1998 to 2009. All cases of drug eruption occurred, during the study period, in children under 16 years old were selected for the study. The diagnosis of the drug eruption was based on clinical findings. The Identification of culprit drugs was based on the criteria as defined by the French Group of Pharmaco-vigilance. From 1998 to 2009, 232 cases of drug eruption were diagnosed in the Department of Dermatology. Of this, 35 cases occurred in children under 16 years old. The patient mean age was 6.6 years with a sex ratio of 0.94. 4 patients were HIV positive. The culprit drug was identified in 21 patients (60%): sulfonamides 52.38% (11/21 cases), penicillin 9.52% (2 cases), vaccine 9.52% (2 cases), acetaminophen 9.52% (2 cases), acetyl salicylic acid 4.76% (n = 1), quinine 4.76% (n = 1), phenobarbital 4.76% (n = 1) and ceftriaxone 4.76% (n = 1). The main clinical patterns were: fixed drug eruption 45.71% (16/35), maculopapular rash 17.14% (n = 6), Stevens-Johnson syndrome 17.14% (n=6), and urticaria 8.57% (n = 3), 1 case of toxic epidermal necrolysis was seen and one patient died. Skin reactions caused by drug intake are a rare disorder among children and fixed drug eruption is the main clinical presentation of the disease in Cotonou (Benin).


Theodore Munyuli M.B.,University of Health Sciences
International Journal of Tropical Insect Science | Year: 2013

Little is known about the efficacy of sampling methods for monitoring bee communities in agricultural landscapes in sub-Saharan Africa, in general, and in Uganda, in particular. To provide baseline information on the effectiveness of different sampling methods, 26 sites with varying landscape characteristics were sampled in 2006 in agricultural landscapes in Uganda. Bees were sampled using line transect count, coloured pan trap and hand net methods. In total, 80,883 bee individuals were collected. Totals of 59, 314 and 559 bee species were recorded in transect counts, pan traps and hand nets, respectively. Thus hand nets captured the most species overall. There were few species that overlapped across the three sampling methods. Wild bees were significantly more abundant in yellow pan traps than in blue or white ones. In contrast, bee species richness was significantly higher in blue pan traps than in white or yellow pan traps. Overall, pan-trapping was found to be a complementary method to hand-netting for monitoring bee communities in Uganda. © 2013 icipe.


The rising number of dental implants placed in the treatment of partial or full edentulism confronts the clinician with more implant-related pathology. The presence of a transmucosal component resembles the natural tooth and makes it likewise prone to oral plaque adhesion and plaque-related diseases. However, non-plaque-related diseases can also occur around implants. This clinical case describes the historical background, the diagnosis, treatment and follow-up of a 33-year-old female patient presenting with a peripheral giant cell granuloma surrounding a maxillary implant. Diagnosis was established by histopathologic analysis. The treatment consisted of complete excision and bone curettage, strict plaque-control and intensive aftercare. Eight months later, no recurrence had been observed. Nevertheless, the soft tissues did not return exactly to their original situation. Early diagnosis by means of a biopsy is crucial when an epulis is detected. This results in both a less invasive excision and a more favorable aesthetic outcome.


Recent research results have shown that nursing practice in correctional psychiatric settings is difficult since institutional functionning and correctional culture threaten fundamental socioprofessional standards of care. The aim of this paper is to present the results of a research conducted in a Canadian correctional facility between 2006 and 2009 with nurses providing psychiatric care. This research highlights the challenges faced by the nursing staff who see their professional practice constrained by correctional prerogatives. we believe that the results of our research are paramount if we wish to understand the specificities of this complex field of nursing.


Beaudoin J.-D.,University of Health Sciences | Jodoin R.,University of Health Sciences | Perreault J.-P.,University of Health Sciences
Methods | Year: 2013

Although the majority of the initial G-quadruplex studies were performed on DNA molecules, there currently exists a rapidly growing interest in the investigation of those formed in RNA molecules that possess high potential of acting as gene expression regulatory elements. Indeed, G-quadruplexes found in the 5'-untranslated regions of mRNAs have been reported to be widespread within the human transcriptome and to act as general translational repressors. In addition to translation regulation, several other mRNA maturation steps and events, including mRNA splicing, polyadenylation and localization, have been shown to be influenced by the presence of these RNA G-quadruplexes. Bioinformatic approaches have identified thousands of potential RNA G-quadruplex sequences in the human transcriptome. Clearly there is a need for the development of rapid, simple and informative techniques and methodologies with which the ability of these sequences, and of any potential new regulatory elements, to fold into G-quadruplexes in vitro can be examined. This report describes an integrated methodology for monitoring RNA G-quadruplexes formation that combines bioinformatic algorithms, secondary structure prediction, in-line probing with semi-quantification analysis and structural representation software. The power of this approach is illustrated, step-by-step, with the determination of the structure adopted by a potential G-quadruplex sequence found in the 5'-untranslated region of the cAMP responsive element modulator (CREM) mRNA. The results unambiguously show that the CREM sequence folds into a G-quadruplex structure in the presence of a physiological concentration of potassium ions. This in-line probing-based method is easy to use, robust, reproducible and informative in the study of RNA G-quadruplex formation. © 2013 Elsevier Inc.

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