Neurologic complications of HTLV-1: a review

The human T-cell lymphotropic virus type 1 (HTLV-1) is a retrovirus that infects about 20 million people worldwide and causes immune--mediated diseases of the nervous system. The classical neurological presentation of HTLV-1 infection is the so-called HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). However, HAM/TSP is not the only neurological outcome that can result from HTLV-1 infection. In this Review it is made an update on the many aspects of this important neurological condition, the HTLV-1 neurological comple

Meningite recorrente de Mollaret: uma revisão

A meningite recorrente linfocítica benigna ou meningite de Mollaret, inicialmente descrita pelo neurologista francês Pierre Mollaret em 1944, é uma condição relativamente rara, benigna mas incapacitante durante os seus períodos de agudização. Trata-se de quadro inflamatório meníngeo recorrente devido a reativação de infecção pelo herpes simples vírus, particularmente o herpesvirus do tipo 2 (HSV-2). Pode ser reconhecida a partir do seu quadro clínico de meningismoagudo, perfil liquórico linfocítico e identificação do genoma viral por PCR no líquor. Aciclovir e seus derivados podem ser utilizado no seu tratamento ou na sua profilaxia. Sua identificação é importante no sentido de se excluir outras causas de quadros meníngeos recorrentes

Production Leveling (Heijunka) Implementation in a Batch Production System: a Case Study

Abstract: This paper presents a case study of an implementation of a new method for Production Leveling designed for batch production. It includes prioritizing criteria of products and level production plan. Moreover, it was applied on a subsidiary of a multinational enterprise located on Brazil, which manufacturing processes comprise batch production in a make-to-stock policy. Regarding a qualitative assessment, evidences show that the company had deficient practices related to Operations Planning. Thus, based on a case study approach, proposed method was applied as well empirical data were analyzed. Results were measured before and after this implementation by performance indicators of Costs (inventory), Speed (lead time), Mix flexibility (monthly set up operations) and Reliability (service level). Evidences confirm improvements in operational efficiency as expected. Researchers and practitioners can evaluate general applicability of this method by applying it in different companies that share similarities related to batch processing operations

Leptin and its Association with Obesity among Mexican Adolescents

Purpose: To investigate the association between leptin concentrations and nutritional status among a Mexican adolescent population. Methods: Cross-sectional study with 448 adolescents attending five schools in Durango, Mexico. Serum leptin concentrations were measured by ELISA. Other measurements included height, weight, and waist and hip circumference. Body fat of participants was assessed with bio-electrical impedance using a body composition analyzer InBody-720. Sociodemographic information was also collected. Results: Based on IOTF BMI cut-off points, 34.1% of adolescents were overweight and obese and prevalence rates were higher among females (37.1%) than males (29.5%). In agreement with waist circumference, 22.5% of participants were overweight and had abdominal obesity; and based on waist-to-hip ratio 35.5% had truncal obesity. Leptin concentration levels among females (19.33 ng/dL) were two times higher than among males (40.07 ng/dL) with a statistical significant difference (p=0.000). Leptin levels among obese females (69.92 ng/dL) were three times higher than among underweight females (17.70 ng/dL). Conversely, leptin levels among males (43.52 ng/dL) were four times higher than among their underweight counterparts (10.08 ng/dL). Mean leptin levels among women with body fat greater than 28% (46.44 ng/dL) were statistically different and 1.7 times higher than those with lower body fat (25.96 ng/dL) (p=0.000). Mean leptin levels among males with body fat greater than 20% (30.17 ng/dL) were statistically different (p=0.000) and 2.4 times higher than among males with lower body fat (12.35 ng/dL). Among both females and males, leptin concentration levels were positively and significantly associated with visceral body fat (R2=0.344 females; R2=0.373 males; p=0.000). Conclusions: Significant correlations between leptin and BMI, body fat percentage, and visceral adipose tissue area indicate that this hormone can be used as a biomarker for obesity among adolescents

Relationship Between Dyslipidemia and Obesity in Children

Purpose: Dyslipidemia is a general term that refers to abnormal levels of lipids. The purpose of this research was to determine the relationship among the nutritional state and the percentage of body fat with the levels of lipids in 10 to 13 year old children living in the city of Durango, Mexico. Method: The study was carried out with 823 elementary school children. The selection was done at random. The biochemical studies were done in a subpopulation of 425 children. Each child underwent the following studies: sociodemographic, anthropometric and corporal composition. After fasting overnight, a venous blood sample was obtained. lipid profile including cholesterol, LDL-C, HDL-C and triglycerides were determined in serum. In order to classify lipid levels we used the reference values suggested by the National Cholesterol Education Program (NCEP). The desirable values were: TC \u3c170 mg\u3e/dl, HDL -C \u3e45 mg/dl, LDL -C \u3c110 mg\u3e/dl and TG \u3c100 mg\u3e/dl. The nutritional state was calculated according the age and sex specific BMI values developed by the CDC. Fat mass content was determined using a bioelectrical impedance analyzer (Tanita TBF-215). Statistical analyses were performed using SPSS14. Results: This study included 428 (52%) boys and 395 (48%) girls. Mean age was 11.5 years. The prevalence of overweight and obesity was 36.7. In the population studied we found abnormal levels of lipids in: cholesterol (41.8%), HDL-C (55.8%), LDL-C (32.3%) and TG (38.5%). The girls showed lower levels of HDL-C than the boys (p \u3c 0.05), the other lipoproteins were not statistical different ( p \u3e 0.05). The lipids levels (TC, LDL-C and TG) were higher in those with a BMI greater than 85 th percentile of BMI, and DHL-C was lower. In those with a body fat greater than 20%, all the lipids levels resulted abnormal. Conclusions: A high risk of dislypidemia was associated with gender, BMI and body fat

Relationship Between Leptin and Obesity in Mexican Chidren

Purpose: The expression and secretion of the leptin are thoroughly related with the regulation of food intake, energy balance and body fat. Obesity is defined as excess of body fat. The purpose of this research was to determine the relationship among the nutritional state and the percentage of body fat with the levels of leptin in 10 to 13 year old children living in the city of Durango, Mexico. Method: The study was carried out with 823 elementary school children. The selection was done at random. The biochemical studies were done in a subpopulation of 425 children. Each child underwent the following studies: sociodemographic, anthropometric and corporal composition. After fasting overnight, a venous blood sample was obtained. Leptin, glucose, lipid profile, insulin, Insulin growth factor, growth hormone, cortisol, TNF-alpha and C-reactive protein were determined in serum. The nutritional state was calculated according the age and sex specific BMI values developed by the CDC. Fat mass content was determined using a bioelectrical impedance analyzer (Tanita TBF-215). Statistical analyses were performed using SPSS14. Results: The studied population included 428 (52%) boys and 395 (48%) girls. Mean age was 11.50 years. The prevalence of overweight including obesity (≥85th percentile of the IMC) was 36.7%. The mean of the percentage of corporal fat in the women was 27.04 and in the males 22.05 (p \u3c0.05). The mean of the concentration of leptin in the women was 27.84 ng/mL and in the males 17.62 (p \u3c0.05). In the female group the leptin level increased with the age. The mean of leptin concentration in the group with ≥95th percentile of the IMC was higher (47.07 ng/mL) than those with 5-84.99th percentile of the IMC (14.01 ng/mL) (p \u3c0.05). The mean of leptin concentration in the group with \u3c20% body fat was lower (8.92 ng/mL) than the group with ≥40% body fat (59.94 ng/mL) (p \u3c0.05). Conclusions: The leptin level was associated with gender, body mass index (IMC) and body fat

Insulin Resistance and Obesity in Mexican Youth

Purpose: Although research shows that prevalence rates of insulin resistance (IR) is increasing in children, little is known about the impact of obesity in IR in Mexican youth. This study investigated the association between overweight, obesity, and insulin resistance in Mexican adolescents. Methods: Data were collected from 448 adolescents aged 12 to 18 years from a random sample of a high school student population in Durango, Mexico. After fasting overnight, blood samples were obtained from participants. Glucose, insulin, lipid profile, leptin, insulin growth factor, growth hormone, cortisol, TNF-alpha, and C-reactive protein were determined in serum. Body Mass Index (BMI) was calculated using CDC parameters. Fat mass was determined using a bioelectrical impedance analyzer. THE HOMA index was used to calculate IR and a Keskin diagnosis value of 3.1 was considered. Statistical analyses were conducted. Results: The mean age of the sample was 15.44 years and a majority was female (61.4%). Prevalence of overweight and obesity was 31.9%. The BMI mean was slightly higher in females (65.5) than in males (61.1) (p \u3e0.05). Females had a greater mean of body fat percentage (31.9) than males (20.2) (p\u3c 0.05). Prevalence of resistance to insulin by HOMA-IR was 14.4% with no statistically significant gender differences. The IR mean was higher in adolescents with greater BMI (≥85th percentile) than those with low and normal BMI (\u3c85th percentile) (p \u3c0.05). Adolescents with high IR levels (≥3.1) had higher mean values of corporal fat (37.69%) and BMI (89.76) than those with lower IR levels (\u3c3.1) and lower corporal fat and BMI values (26.4%3 and 61.67, respectively). Conclusions: The significant association found between obesity and insulin resistance in Mexican adolescents suggests a greater risk for the development of degenerative disease in this young population during adulthood. Public health programs among Mexican adolescents are essential to prevent obesity and IR related consequences

Influence of the propagules lignification degree of the garden and minigarden clonal on the cuttings and mini cuttings rooting of Prosopis alba Griseb

Prosopis alba posee potencial para la producción forestal y forrajera, destacándose su utilización en zonas áridas y semi-áridas. La especie, considerada de difícil enraizamiento, se propaga comercialmente mediante semillas. Su clonación permitiría cultivar materiales de interés silvícola altamente productivos y en un menor tiempo. El objetivo de este trabajo fue analizar el grado de lignificación de estacas y miniestacas de P. alba y su relación con su capacidad de enraizamiento. Los brotes obtenidos del jardín y minijardín clonal fueron inducidos al enraizamiento con diferentes concentraciones de IBA. Se realizaron cortes anatómicos de los brotes, previo a la inducción del enraizamiento y 40 días posteriores al mismo para observar la lignificación de estos materiales y relacionarlos con estacas y miniestacas enraizadas. Las miniestacas con mayor grado de juvenilidad y de etiolación presentaron menor grado de lignificación y lograron mayores porcentajes de enraizamiento(99,6%) con respecto a las estacas (7,6%). Se observó que la utilización de la técnica deminiestacas asociada a la de etiolación son promisoras para la propagación vegetativa de P. alba y posiblemente de otras especies nativas de difícil enraizamiento.Prosopis alba has high potential as forest material and important forage features for arid and semi-arid areas. Prosopis alba is commercially propagated by seeds, because of its rooting difficulties. Its cloning would allow to cultivate highly productive silvicultural materials in less time. The aim of this work was to analyze the lignification degree of P. alba cuttings and mini-cuttings and its relation with the rooting capacity. The sprouts obtained from the garden and clonal mini-garden were rooted with different concentrations of IBA. Serial transversal sections of the sprouts were carried out before rooting induction and 40 days after this process to observe the lignification of these material and its relationships with rooted cuttings and mini-cuttings. Results show that mini-cuttings with greater juvenility and etiolation degree presented lower lignification degree and reached higher rooting percentages (99.6%) with respect to cuttings (7.6%). Mini-cutting and etiolation techniques are promising for the vegetative propagation of P. alba and other native species with difficult rooting.Fil: Araujo Vieira de Souza, Jonicelia Cristina. Universidad Nacional del Litoral. Facultad de Ciencias Agrarias; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Bender, Adrian Gabriel. Universidad Nacional del Litoral. Facultad de Ciencias Agrarias; ArgentinaFil: Reutemann Arnolfo, Andrea Guadalupe. Universidad Nacional del Litoral. Facultad de Ciencias Agrarias; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Botánica Darwinion. Academia Nacional de Ciencias Exactas, Físicas y Naturales. Instituto de Botánica Darwinion; ArgentinaFil: Perreta, Mariel Gladis. Universidad Nacional del Litoral. Facultad de Ciencias Agrarias; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Córdoba, M. S.. Universidad Nacional del Litoral. Facultad de Ciencias Agrarias; ArgentinaFil: Tivano, Juan Carlos. Universidad Nacional del Litoral. Facultad de Ciencias Agrarias; ArgentinaFil: Guerra Barroso, Deborah. Universidade Estadual Do Norte Fluminense Darcy Ribeiro. Laboratorio de Fitotecnia; BrasilFil: Gariglio, Norberto Francisco. Universidad Nacional del Litoral. Facultad de Ciencias Agrarias; ArgentinaFil: Mroginski, Luis Amado. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional del Nordeste. Facultad de Ciencias Agrarias; ArgentinaFil: Vegetti, Abelardo Carlos. Universidad Nacional del Litoral. Facultad de Ciencias Agrarias; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations : a systematic analysis from the Global Burden of Disease Study 2016

Background A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0-100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0-100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita. Findings In 2016, HAQ Index performance spanned from a high of 97.1 (95% UI 95.8-98.1) in Iceland, followed by 96.6 (94.9-97.9) in Norway and 96.1 (94.5-97.3) in the Netherlands, to values as low as 18.6 (13.1-24.4) in the Central African Republic, 19.0 (14.3-23.7) in Somalia, and 23.4 (20.2-26.8) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91.5 (89.1-936) in Beijing to 48.0 (43.4-53.2) in Tibet (a 43.5-point difference), while India saw a 30.8-point disparity, from 64.8 (59.6-68.8) in Goa to 34.0 (30.3-38.1) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4.8-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20.9-point to 17.0-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17.2-point to 20.4-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher scores and faster gains for non-communicable diseases. Nonetheless, countries across the development spectrum saw substantial gains in some key health service areas from 2000 to 2016, most notably vaccine-preventable diseases. Overall, national performance on the HAQ Index was positively associated with higher levels of total health spending per capita, as well as health systems inputs, but these relationships were quite heterogeneous, particularly among low-to-middle SDI countries. Interpretation GBD 2016 provides a more detailed understanding of past success and current challenges in improving personal health-care access and quality worldwide. Despite substantial gains since 2000, many low-SDI and middle-SDI countries face considerable challenges unless heightened policy action and investments focus on advancing access to and quality of health care across key health services, especially non-communicable diseases. Stagnating or minimal improvements experienced by several low-middle to high-middle SDI countries could reflect the complexities of re-orienting both primary and secondary health-care services beyond the more limited foci of the Millennium Development Goals. Alongside initiatives to strengthen public health programmes, the pursuit of universal health coverage upon improving both access and quality worldwide, and thus requires adopting a more comprehensive view and subsequent provision of quality health care for all populations. Copyright (C) 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: A systematic analysis from the Global Burden of Disease Study 2016

Copyright © 2018 The Author(s). Published by Elsevier Ltd. Background A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0-100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0-100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita. Findings In 2016, HAQ Index performance spanned from a high of 97·1 (95% UI 95·8-98·1) in Iceland, followed by 96·6 (94·9-97·9) in Norway and 96·1 (94·5-97·3) in the Netherlands, to values as low as 18·6 (13·1-24·4) in the Central African Republic, 19·0 (14·3-23·7) in Somalia, and 23·4 (20·2-26·8) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91·5 (89·1-93·6) in Beijing to 48·0 (43·4-53·2) in Tibet (a 43·5-point difference), while India saw a 30·8-point disparity, from 64·8 (59·6-68·8) in Goa to 34·0 (30·3-38·1) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4·8-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20·9-point to 17·0-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17·2-point to 20·4-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher scores and faster gains for non-communicable diseases. Nonetheless, countries across the development spectrum saw substantial gains in some key health service areas from 2000 to 2016, most notably vaccine-preventable diseases. Overall, national performance on the HAQ Index was positively associated with higher levels of total health spending per capita, as well as health systems inputs, but these relationships were quite heterogeneous, particularly among low-to-middle SDI countries. Interpretation GBD 2016 provides a more detailed understanding of past success and current challenges in improving personal health-care access and quality worldwide. Despite substantial gains since 2000, many low-SDI and middle- SDI countries face considerable challenges unless heightened policy action and investments focus on advancing access to and quality of health care across key health services, especially non-communicable diseases. Stagnating or minimal improvements experienced by several low-middle to high-middle SDI countries could reflect the complexities of re-orienting both primary and secondary health-care services beyond the more limited foci of the Millennium Development Goals. Alongside initiatives to strengthen public health programmes, the pursuit of universal health coverage hinges upon improving both access and quality worldwide, and thus requires adopting a more comprehensive view - and subsequent provision - of quality health care for all populations