263 research outputs found

    Control of hypertension among diabetic patients in a referral hospital in Tanzania: a cross-sectional study

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    Background: Hypertension is common among diabetic patients. The co-existence of two conditions carries an excessive risk of severe complications and mortalities. Limited information exists on the determinants of poor hypertension control among these patients. We aimed at determining the prevalence and factors associated with poor hypertension control in these patients. Methods: Data of diabetic patients who were also hypertensive attending an outpatient clinic from 1 August 2015 to 31 December 2015 at Bugando Medical Centre were retrospectively analyzed. Uncontrolled hypertension was defined as a blood pressure of ≥130mmHg and/or ≥80mmHg systolic and diastolic respectively. A designed questionnaire was used to collect data of patients. Continuous variables were summarized by median and interquartile ranges (IQR) and categorical variables were summarized by frequency and percentage. Logistic regression was used to find the predictors of uncontrolled hypertension. Results: The majority of our study population were females, 161/295 (54.6%), and the median age was 57 years (IQR 50-64). The prevalence of hypertension was 206/295 (69.8%). A total of 174/206 (84.5%) patients had uncontrolled hypertension. This poor control was significantly associated with poor adherence to anti-hypertensives (OR 1.73[1.26-2.38] p=0.002), presence of any long-term complication (OR 3.19 [1.65-6.18] p=0.03) and overweight (BMI\u3e24.9 Vs. Conclusion: The prevalence of poor hypertension control among diabetic patients in Tanzania is alarming. Most of the factors associated with this situation can be modified. The clinicians should advocate individualized management, continuous health education and adherence to the available guidelines

    Approaching the adolescent-headed family: A review of teen parenting

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    In the USA, as many as 1 in 6 women nationwide become adolescent mothers, making adolescent pregnancy and childbearing issues a frequently encountered occurrence by pediatricians and adolescent medicine health care providers. Both social and medical programs focus on prevention and management of adolescent pregnancies; however, caring for the adolescent-headed family is less well understood. For many teen parents, various environmental and behavioral risks contributed to early childbearing and parenting. Following delivery of the infant, many of these same psychosocial, environmental, and educational factors continue to play a role in the teen's ability to parent effectively. This review explores these factors in relation to teen parenting as well as describes the limited data available on outcomes of adolescent mothers and their infants. Despite negative social stereotypes regarding adolescent fathers, research suggesting that most fathers desire involvement with their infants and the impact of and factors influencing father involvement is explored. Understanding the dynamics of the coparenting relationship, an expanding field of study, will aid practitioners in strengthening and supporting teen parenting by both mothers and fathers. As most teen parents continue to reside with their families, teen parenting has an important impact on the multi-generational family structure. These relationships can serve both to support and at times to hinder the adolescent parents' development as an individual and as a parent. Successful interventions and programs to support the adolescent-headed family take on various forms but are usually comprehensive and multidisciplinary and consider the developmental status of both the parent and the child. To best care for adolescentheaded families, pediatricians and adolescent medicine providers should understand the psychosocial, developmental, educational, and relationship issues that influence adolescent parenting

    Transition metal complexes with pyrazole-based ligands. Part 29. Reactions of zinc(II) and mercury(II) thiocyanate with 4-acetyl-3-amino-5-methylpyrazole

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    The work is concerned with the crystal and molecular structures of zinc(II) and mercury(II) complexes with 4-acetyl-3-amino-5-methylpyrazole (aamp) of the coordination formulae [Zn(NCS)(2)(aaMP)(2)] and (HaaMP)(2)[Hg(SCN)(4)]. The zinc(II) complex was obtained by the reaction of a warm methanolic solution of aamp with a mixture of zinc(II) nitrate and ammonium thiocyanate, whereas the mercury(II) complex was prepared by the reaction of a warm methanolic solution of aamp and a warm, slightly acidified aqueous solution of [Hg(SCN)(4)](2-). Both complexes have a tetrahedral geometry, which in the case of zinc complex is formed by monodentate coordination of two aamp molecules and two isothiocyanate groups. The Zn(II) and Hg(II) atoms have significantly deformed coordination geometry. In both crystal structures the pyrazole derivative has a planar form, probably stabilized by an intramolecular N-H center dot center dot center dot O hydrogen bond. Apart from the X-ray structural analysis, the isolated complexes were characterized by elemental analysis, IR spectroscopy, conductometric measurements and thermal analysis

    Control of tuberculosis in large cities in developed countries: an organizational problem

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    Tuberculosis (TB) is still a serious public health issue, even in large cities in developed countries. Control of this old disease is based on complicated programs that require completion of long treatments and contact tracing. In an accompanying research article published in BMC Public Health, Bothamley and colleagues found that areas with a ratio lower than one nurse per forty notifications had increased rates with respect to TB notifications, smear-positive cases, loss to follow-up and treatment abandonment across the UK. Furthermore, in these areas there was less opportunity for directly observed therapy, assistance with complex needs, educational outreach and new-entrant screening. In this commentary, we discuss the importance of improving organizational aspects and evaluating TB control programs. According to Bothamley and colleagues, a ratio of one nurse per forty notifications is an effective method of reducing the high TB incidences observed in London and in other cities in developed countries, or to maintain the decline in incidence in cities with lower incidences. It is crucial to evaluate TB programs every year to detect gaps early

    controlling the disease

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    Surveillance and outbreak reports Surveillance of extensively drug-resistant tuberculosis in Europe, 2003-2007 15 by I Devaux, D Manissero, K Fernandez de la Hoz, K Kremer, D van Soolingen, on behalf of the EuroTB network Analysis of tuberculosis treatment outcomes in the European Union and European Economic Area: efforts needed towards optimal case management and control 21 by D Manissero, V Hollo, E Huitric, C Ködmön, A Amato-Gauci Risk of developing tuberculosis from a school contact: retrospective cohort study

    Sensitive and Specific Fluorescent Probes for Functional Analysis of the Three Major Types of Mammalian ABC Transporters

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    An underlying mechanism for multi drug resistance (MDR) is up-regulation of the transmembrane ATP-binding cassette (ABC) transporter proteins. ABC transporters also determine the general fate and effect of pharmaceutical agents in the body. The three major types of ABC transporters are MDR1 (P-gp, P-glycoprotein, ABCB1), MRP1/2 (ABCC1/2) and BCRP/MXR (ABCG2) proteins. Flow cytometry (FCM) allows determination of the functional expression levels of ABC transporters in live cells, but most dyes used as indicators (rhodamine 123, DiOC2(3), calcein-AM) have limited applicability as they do not detect all three major types of ABC transporters. Dyes with broad coverage (such as doxorubicin, daunorubicin and mitoxantrone) lack sensitivity due to overall dimness and thus may yield a significant percentage of false negative results. We describe two novel fluorescent probes that are substrates for all three common types of ABC transporters and can serve as indicators of MDR in flow cytometry assays using live cells. The probes exhibit fast internalization, favorable uptake/efflux kinetics and high sensitivity of MDR detection, as established by multidrug resistance activity factor (MAF) values and Kolmogorov-Smirnov statistical analysis. Used in combination with general or specific inhibitors of ABC transporters, both dyes readily identify functional efflux and are capable of detecting small levels of efflux as well as defining the type of multidrug resistance. The assay can be applied to the screening of putative modulators of ABC transporters, facilitating rapid, reproducible, specific and relatively simple functional detection of ABC transporter activity, and ready implementation on widely available instruments

    Treatment of Open-Angle Glaucoma and Ocular Hypertension with Preservative-Free Tafluprost/Timolol Fixed-Dose Combination Therapy : The VISIONARY Study

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    Funding Information: Funding was provided by Santen SA for the study, medical writing services and Rapid Service Fees. All authors had full access to all of the data in this study and take complete responsibility for the integrity of the data and accuracy of the data analysis. The contribution of IRCCS Fondazione Bietti to this work was supported by the Italian Ministry of Health and by Fondazione Roma. Publisher Copyright: © 2020, The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Introduction: A non-interventional, multicenter, European, prospective evaluation of the effectiveness, tolerability, and safety of a topical preservative-free tafluprost (0.0015%) and timolol (0.5%) fixed-dose combination (PF tafluprost/timolol FC) in adults with open-angle glaucoma (OAG) and ocular hypertension (OHT) demonstrating insufficient response to topical beta-receptor blockers or prostaglandin analogue (PGA) monotherapy. Methods: Mean intraocular pressure (IOP) change from baseline was measured at study visits following a switch to PF tafluprost/timolol FC. Primary endpoint was absolute mean IOP change at month 6. Change from baseline concerning ocular signs and symptoms was also explored. Results: Analyses included 577 patients (59.6% female). Mean age (SD) was 67.8 (11.67) years. Mean (SD) IOP reduction from baseline was significant at all study visits; 5.4 (3.76) mmHg (23.7%) at week 4, 5.9 (3.90) mmHg (25.6%) at week 12, and 5.7 (4.11) mmHg (24.9%) at month 6 (p < 0.0001 for all visits). At month 6, 69.2%, 53.6%, 40.0%, and 25.8% were responders based on ≥ 20%, ≥ 25%, ≥ 30%, and ≥ 35% cutoff values for mean IOP, respectively. Significant reductions were observed concerning corneal fluorescein staining (p < 0.0001), dry eye symptoms, irritation, itching, and foreign body sensation (p < 0.001 for each parameter). Conjunctival hyperemia was significantly reduced at all study visits (p < 0.0001 at each visit). Overall, 69 treatment-related adverse events (AEs) were reported, one of which was serious (status asthmaticus). Most AEs were mild to moderate in severity, and the majority had resolved or were resolving at the end of the study period. Conclusion: In clinical practice, PF tafluprost/timolol FC provided statistically and clinically significant IOP reductions in patients with OAG and OHT insufficiently controlled on or intolerant to PGA or beta-receptor blocker monotherapy. The full IOP reduction appeared at week 4 and was maintained over the 6-month study period. Key symptoms of ocular surface health improved. Trial Registration: European Union electronic Register of Post-Authorisation Studies (EU PAS) register number, EUPAS22204.publishersversionPeer reviewe

    Novel Cell- and Tissue-Based Assays for Detecting Misfolded and Aggregated Protein Accumulation Within Aggresomes and Inclusion Bodies

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    Aggresomes and related inclusion bodies appear to serve as storage depots for misfolded and aggregated proteins within cells, which can potentially be degraded by the autophagy pathway. A homogenous fluorescence-based assay was devised to detect aggregated proteins inside aggresomes and inclusion bodies within an authentic cellular context. The assay employs a novel red fluorescent molecular rotor dye, which is essentially nonfluorescent until it binds to structural features associated with the aggregated protein cargo. Aggresomes and related structures were generated within cultured cells using various potent, cell permeable, proteasome inhibitors: MG-132, lactacystin, epoxomicin and bortezomib, and then selectively detected with the fluorescent probe. Employing the probe in combination with various fluorescein-labeled primary antibodies facilitated co-localization of key components of the autophagy system (ubiquitin, p62, and LC3) with aggregated protein cargo by fluorescence microscopy. Furthermore, cytoplasmic aggregates were highlighted in SK-N-SH human neuroblastoma cells incubated with exogenously supplied amyloid beta peptide 1–42. SMER28, a small molecule modulator of autophagy acting via an mTOR-independent mechanism, prevented the accumulation of amyloid beta peptide within these cells. The described assay allows assessment of the effects of protein aggregation directly in cells, without resorting to the use of non-physiological protein mutations or genetically engineered cell lines. With minor modification, the assay was also adapted to the analysis of frozen or formalin-fixed, paraffin-embedded tissue sections, with demonstration of co-localization of aggregated cargo with β-amyloid and tau proteins in brain tissue sections from Alzheimer’s disease patients
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