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McCarthy Covington posted an update 5 days, 5 hours ago
Epidemiological aspects of explosion-related deaths in a civilian setting may bring comprehensive knowledge that is important for prevention efforts. This Swedish national study aimed to describe the extent of such deaths, circumstances and fatal injuries. Data, including all explosion-related deaths in Sweden from 2000 through 2018, were retrieved from the register of the National Board of Forensic Medicine. Among all 87 cases found, accidental deaths accounted for 62%, suicides for 21%, homicides for 7% and undetermined manner of death for the remaining 10% of cases. Most victims died on site. Adult males dominated in the study material, but explosions also killed four children. Explosives were most commonly involved in occupational blast deaths, suicides and homicides, followed by flammable gases and fluids. The incidence showed a significant decrease since the 1980s, based on the incidence rate from this study and a previous Swedish study (1979-1984). As already rare occurrences, blast-related deaths are challenging to prevent. mTOR inhibitor Prevention efforts are needed to restrict the availability of explosives and focus on lowering the occupational risk for injury. In addition, child deaths must not be neglected. A vision of no fatalities is an appropriate goal for acting against explosion-related deaths in a civilian setting.The coronavirus disease 2019 pandemic has mandated a response from administrative agencies and the health sector globally, however, the number of cases and deaths continue to rise. While management of the living is paramount, the management of the dead is also important. Guidelines for managing the dead have been issued and implemented by various local administrations, in accordance with national and international guidelines. This questionnaire-based research aims to develop an understanding of the knowledge, perceptions and practices of forensic practitioners from India as regards the management of the dead during the coronavirus disease 2019 pandemic. This Pan-India study included 278 forensic medicine experts (249 males and 29 females) working in various hospitals and medical institutions across the country. The questionnaire included various issues involving the management of dead bodies in cases involving coronavirus disease 2019, such as infection control practices, body screening, handling and autopsy, disposal practices, local administrative policies, and available infrastructure and resources. We found that guidelines are mostly being followed across India, barring disparity in issues relating to testing in the dead bodies, the role of local administration in the body disposal, and the use of personal protective equipment while handling bodies and during autopsies. Mortuaries now need to be upgraded, and general infrastructure requires improvement. Periodic training of all stakeholders and assessment of facilities are recommended.Thalassemia is a genetic disorder, occurring because of an imbalance in the globin chain production. Oxidative stress in erythroid cells of thalassemia is mainly generated from excess globin chains, by Fenton reaction, leading to hemolysis and ineffective erythropoiesis. Previously, data has shown that microRNAs (miRNAs) are involved in oxidative stress regulation in red blood cells (RBCs). microR-214 has been reported to respond with an external oxidative stress in erythroid cells by modulating activating transcription factor 4 (ATF4). In this study, we illustrated the expressions of miR-214 and ATF4 in Hb H (β4) disease, and Hb E (HBB c.79G>A)/β-thalassemia (β-thal) reticulocyte samples. Our results showed miR-214 expression was increased in Hb H disease, but not significantly different in Hb E/β-thal reticulocytes. The ATF4 target was decreased in both thalassemic groups. Moreover, miR-214 expression level positively correlated with the reactive oxygen species (ROS) level, while it was negatively correlated with mean corpuscular volume (MCV), mean corpuscular hemoglobin (Hb) (MCH) and mean corpuscular Hb concentration (MCHC). We suggested that the upregulation of miR-214 correlated with the oxidative stress as well as anemia severity of Hb H disease patients, by suppression of ATF4. Understanding the oxidative pathways in erythrocyte could be useful to manage and relieve the clinical manifestation, such as anemia, in thalassemic patients.A content analysis was conducted to explore sexual indicators of aggression, objectification, exploitation, and agency in 50 “hijab” pornographic videos. Our findings suggest that women were the target of aggressive acts in all videos, with gagging (42%) and spanking (38%) being the most common. Also, in comparison with men, women were more likely to be objectified and exploited, and less likely to possess agency. Limitations of the current study and directions for future research are detailed.Behavioral parent training (BPT) programs are the first-line interventions for childhood disruptive behaviors. In light of the COVID-19 pandemic, adapting these programs to telehealth modalities is necessary to ensure continued services to children and families. This study evaluates the use of telehealth versus in-person modality to deliver the Helping Our Toddlers, Developing Our Children’s Skills (HOT DOCS) BPT. The study design was quasi-experimental with two nonequivalent groups in-person HOT DOCS (n = 152) and internet-HOT DOCS (n = 46). Participants were caregivers of children ages 2-5 exhibiting disruptive behaviors. Pre- and post-intervention outcome measures were collected for child disruptive behavior and parenting stress and post-test only for consumer satisfaction. Multiple linear and Poisson regression models were performed to assess the effect of class modality on the outcomes. Child disruptive behavior and parenting stress post-test scores for in-person and telehealth groups were not significantly different, even after adjusting for baseline characteristics. Consumer satisfaction scores were significantly more positive for the in-person group. The results of this study provide preliminary evidence for the i-HOT DOCS modality as being as effective as the in-person program. Study findings may be beneficial to practitioners utilizing telehealth interventions during the COVID-19 pandemic and onward.Due to a huge crisis extensive to health services many Venezuelan people living with HIV (PLWH) had migrated abroad, including Peru where favorable laws were in place until June 2019. We describe the health status and epidemiological trends of PLWH from Venezuela at an HIV program in Lima. We analyzed baseline and follow-up data of all Venezuelan PLWH enrolled in our HIV program from January 2017 to December 2019. A cross-sectional study in a subsample served to describe ARV adherence and context of migration. Between 2017-2019 our HIV Program registered 398 Venezuelan PLWH, representing 20% of the 2018 annual enrollments; numbers decreased since mid-2019. The median age was 30 years (IQR 26;37) and 90.5% were men. Between 2017 and 2019, the proportion with diagnosis in Peru increased from 14.3% to 60.9%; of AIDS stage at entry, from 8.8% to 27.2%. By December 2019, 182/250 (72.8%) were still in care, and 43 (10.8%) had not started ART. Viral suppression evaluated in 195, was achieved in 71.8%. From 2017 to 2019, migrant PLWH arrived in worsened clinical conditions, with increasing diagnosis in Peru; the flow of migrant PLWH entering care diminished with less favorable laws. Viral suppression rates were suboptimal.
The prospective, randomized AHL2011 trial demonstrated that the use of the doxorubicin, bleomycin, vinblastine, and dacarbazine regimen (ABVD) after two cycles of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP
) in early responders on the basis of a positron emission tomography (PET)-driven strategy was safe and minimized toxicity compared with standard 6 BEACOPP
cycles. This substudy investigated the benefit of this strategy in gonadal function and fertility in patients under 45 years old.
Ovarian function was assessed by serum measurement of follicle-stimulating hormone (FSH), estradiol, and anti-müllerian hormone in women, and semen analysis, FSH, and testosterone levels were used to evaluate testicular function in men at baseline, end of treatment, and during 5 years of follow-up.
A total of 145 women and 424 men, enrolled between May 19, 2011, and April 29, 2014, were included. The risk of premature ovarian insufficiency (FSH > 24 IU/L)onadal dysfunction and infertility in advanced Hodgkin lymphoma.Marla Sokolowski’s work and humanity has influenced the careers of hundreds, perhaps thousands, of younger scientists. Her fundamental research on the neurogenetic underpinnings of behavior in Drosophila melanogaster is remarkable not only for its scientific brilliance, but for the humility, care, and humor with which it was conducted.
Suprascapular neuropathy has been observed in the setting of rotator cuff tears (RCTs), but its association with these tears and their treatment are unclear.
Arthroscopic suprascapular nerve release during rotator cuff repair will not alter the outcomes of neuropathy.
Randomized controlled trial; Level of evidence, 1.
A total of 42 patients with large/massive reparable RCTs and suprascapular neuropathy were recruited and followed up at 6 and 12 months. Electrophysiological results as well as Disabilities of the Arm, Shoulder and Hand (DASH), American Shoulder and Elbow Surgeons (ASES), and Constant scores were evaluated at selected time periods. Patients were randomly assigned to 2 groups. Patients in the control group underwent arthroscopic repair of the rotator cuff without combined arthroscopic release of the superior transverse scapular ligament; in the second group, the superior transverse ligament was released. The primary outcome was to examine full suprascapular nerve recovery through electropAlso, no significant difference was found between the 2 groups regarding other secondary and tertiary outcomes.
Combined arthroscopic release of the superior transverse scapular ligament and rotator cuff repair in patients with large/massive RCTs and suprascapular neuropathy did not produce statistically significant improved outcomes compared with repair of the rotator cuff alone.
NCT02318381 (ClinicalTrials.gov identifier).
NCT02318381 (ClinicalTrials.gov identifier).Introduction Esophagus dysmotility is a crucial risk factor of gastroesophageal reflux disease (GERD), which is one of the most common diseases in digestive medicine globally. This review emphasizes the mechanisms of esophagus dysmotility in diabetes and summarizes more targeted treatments for these patients to avoid the overuse of proton pump inhibitors (PPIs).Areas covered Diabetes mellitus (DM) is a clear factor that must not be neglected in the development of GERD. Previous studies have preliminarily researched the esophagus deterioration in diabetes. However, the multi-faceted mechanisms of esophagus dysmotility in diabetes need more studies. Besides, targeted treatments for these patients rather than conventional PPIs are urgently needed.Expert opinion The treatments for GERD patients with diabetes should be further explored. Pharmacological approaches such as prokinetic agents, psychotherapy can be adopted. Meanwhile, it’s feasible to explore non-drug treatments. For example, Electroacupuncture (EA) at Zusanli (ST-36) may be effective to protect the networks of intestinal cells of Cajal (ICCs) in diabetes.