Efeitos da reabilitação precoce no desfecho da reabilitação pós-acidente vascular encefálico (AVE) em mulheres com mais de 65 anos e sua correlação com a gravidade do deficit neurológico inicial

Este trabalho visa examinar os efeitos da reabilitação precoce, a curto e longo prazo, no desfecho do acidente vascular encefálico (AVE) em mulheres com mais de 65 anos; estabelecer a correlação entre o impacto da gravidade do déficit neurológico na predição dos re-sultados do tratamento de Reabilitação e, ainda, investigar a possibilidade do acompanhamento de parâmetros individuais da Medição de Independência Funcional (MIF) na predição do desfecho da reabilitação do AVE. Atualmente, o AVE é a terceira maior causa de mortalidade na população mundial, bem como a maior causa de invalidez permanente. No cenário atual, as doenças cardiovasculares e cerebrovasculares - que antes eram tidas como exclusivas da população masculina – têm afetado também as mulheres. Por outro lado, observamos uma correlação linear entre o envelhecimento e a ocorrência destas doenças. Concluímos que a implantação do método de reabilitação precoce conduz a uma aceleração significativa do processo de tratamento e recuperação após o AVE em mulheres com mais de 65 anos. Concluímos também que certos parâmetros da MIF, por apresentarem o mesmo padrão de evolução, podem ser utilizados na predição da recuperação global do paciente.This study aims at verifying the effects of short- and long-term rehabilitation on the outcome of encephalic vascular accident (EVA) in women older than 65 years; establishing the correlation between the impact of the neurological deficit severity on the prediction of the rehabilitation treatment outcome as well as investigating the possibility of the follow-up of individual parameters at the Functional Independence Measure (FIM) when predicting the EVA rehabilitation outcome. The EVA is currently the third major cause of death in the world’s population, as well as the main cause of permanent disability. In the present scenario, cardiovascular and cerebrovascular diseases, which used to be observed almost exclusively in the male population, now affect the female population as well. On the other hand, we observe a linear correlation between aging and the occurrence of these diseases. We conclude that the implementation of early rehabilitation leads to a significant acceleration in the treatment and recovery process post-EVA in women older than 65 years. We also conclude that certain FIM parameters can be used to predict the patient’s overall recovery, as they present the same evolution pattern

Komercijalna stočarska obiteljska gospodarstva Republike Srbije - trenutno stanje i izazovi

Privatne farme čine najveći broj farmi u Republici Srbiji i posjeduju najveći dio obradivog zemljišta. Zbog svoje veličine, većina ovih farmi nema ekonomsku budućnost. Međutim, treba naglasiti da se u ovoj skupini izdvajaju komercijalne farme koje se bave intenzivnom ratarskom i/ili stočarskom proizvodnjom. Ove farme imaju perspektivu opstanka i razvoja. Cilj istraživanja bio je istražiti u grupi komercijalnih farmi položaj najvećih. Istraživanje je obavljeno na uzorku od 52 farme koje su činile 5 fokus grupa. Rezultati pokazuju da se uspješne farme bave proizvodnjom mlijeka i tovom junadi, ali imaju i prihode izvan poljoprivrede. Smatraju da poslovno okruženje nije uređeno na najbolji način, kao i da se položaj farmi u marketinškom lancu pogoršava. Komunikaciju sa znanstvenim institucijama, savjetodavnom službom i dolaženje do informacija smatraju vrlo značajnim. Farmeri procjenjuju da će oko trećine farmi opstati u budućnosti. Doći će do strukturnih promjena i obrazovanje će biti sve značajnije......Private farms make up the largest number of farms in the Republic of Serbia and own the most of arable land. Because of their size, many of these farms have no economic future. However, it should be noted that in this group there are commercial farms that are intensively involved in agricultural farming and/or livestock production. These farms have the prospect of sustaining and developing. The aim of the research was to investigate the position of largest cattle farms in the family group of commercial farms. The survey was conducted on a sample of 52 farms which made 5 focus groups. The results show that successful farms are dealing with milk production and fattening cattle, but they also have income outside agriculture. They consider that the environment for business is not regulated in the best manner and the position of farms in the marketing chain is deteriorating. Communication with research institutions, extension services seems to be very important. Farmers estimate that about one third of farms will survive in the future. Structural changes in agriculture will take place and education will be more important

Autoimmune Hemolytic Anemia in Inflammatory Bowel Disease—Report of a Case and Review of the Literature

A wide spectrum of extraintestinal manifestations (EIMs) can burden patients with inflammatory bowel disease (IBD). EIMs contribute fairly to morbidity and mortality rates in IBD patients. Moreover, EIMs in IBD patients are so frequent that some suggest that IBD should be approached as a systemic disorder. Anemia is very common in IBD patients. The two most common types of anemia in IBD, iron deficiency anemia and anemia of chronic disease, are extraintestinal complications. Autoimmune hemolytic anemia (AIHA) is a rare extraintestinal manifestation of IBD, more frequent in ulcerative colitis (UC) than in Crohn’s disease (CD). In this case-based review of the literature, we present a 36-year-old female patient diagnosed with Crohn’s disease (CD) and Coombs positive AIHA, complicated by pulmonary thromboembolism and successfully treated with anti-tumor necrosis factor (anti-TNF) therapy. The underlying pathophysiological mechanism of AIHA in IBD is unclear. Treatment options for AIHA in IBD patients before biologic therapy included corticosteroids alone or in combination with azathioprine (AZA), methotrexate, and surgical treatment (colectomy and/or splenectomy). Currently, biologic therapy is a promising therapeutic option, especially in corticosteroid refractory or corticosteroid-dependent IBD patients with AIHA

Supramolecular Perspective of Coordination Effects on Fluorine Interactions

Coordination effects have been considered through the most common interactions in the crystal structures of fluoro compounds (C-H/F and F/F interactions). The supramolecular profile of these effects is based on quantum-chemical calculations for the assessment of the interaction strength and electrostatic potential maps, which provide a qualitative insight into the examined effect. Coordination of aliphatic fluorides leads to an increase of the negative potential of the F atoms, and, hence, an increase in the hydrogen-bonding acceptor ability (strengthening of C-H/F interactions) and a weakening of the F/F interactions, due to an increase in repulsive interactions between the F atoms. There is no significant change in the potential of the F atoms due to coordination of C-6-aromatic fluorides, as in the case of aliphatic ones. This results in slight changes in the strengths of the C-H/F and F/F interactions (coupled with parallel interaction at large offsets, PILO), in a noticeable enhancement of stacking interactions, as well as in a significant enhancement of interactions involving the pi-system (F/pi - and C-H/pi interactions). It has also been shown that a decrease in the charge of the metal ions leads to a decrease in the negative potential of the F atom and also that the nature of the metal ion has a significant influence on the value of the potential of the F atoms

Textural and sensory properties of spreads with sucrose and maltitol

Spreads are confectionery products based on sugar, vegetable fat, cocoa powder, milk powder and other ingredients. Basic properties of these products are good spreadability in wide temperature range (from ambience to fridge temperature), rich creamy chocolate taste, and homogenous smooth structure without oil phase migration. The undesirable attribute of these products is their relatively high energy value (2300 kJ/100 g). In recent years, cocoa cream products with reduced energy values have become very popular among consumers and today they are present in the assortment of many confectionery manufacturers. One way to produce spreads with reduced energy value is the replacement of sugar (sucrose) with adequate sweetener. Maltitol is a low-energy polyol capable to qualitatively and quantitatively replace sucrose. Cocoa spreads with maltitol and with the combination of maltitol and sucrose (produced at different temperatures and mixer rotation speeds) have similar texture and rheological properties compared to the spreads with sucrose. The spreads with maltitol have about 15% lower energy value in comparison to the same product with sucrose

Older Hypertensive Patients’ Adherence to Healthy Lifestyle Behaviors

Non-pharmacological treatment including diet, body weight reduction, smoking cessation and physical activity, is very important part of hypertension treatment. The objective of this study was to investigate the adherence to healthy lifestyle behavior in the representative sample of the older hypertensive patients, and to investigate factors associated with adherence in the studied older population. The study was conducted on random sample of 362 long term hypertensive (> five years) patients older than 65 years of age, at Health Care Center of Kragujevac. Adherence was assessed using the structured questionnaire for the analysis of the implementation of both hypertension and diabetes guidelines in the primary care. Both bivariate and multivariate analyses were conducted. Nearly 35% of examined patients were highly adherent; they exercised regularly, avoided smoking for at least five years and consumed special healthy diet prescribed for hypertension. Another 35.6% of the cases reported exercising regularly, 39.5% followed the recommended diet for the hypertension, while 23.4% of the patients have still consumed cigarettes. Multivariate logistic regression demonstrated that received counseling on healthy lifestyle behaviors by physicians and lack of education predicted high adherence to healthy lifestyle behavior. In order to improve adherence of elderly hypertensive patients to healthy lifestyle, strengthening patient-physician relationships through efforts to enhance communication may be a promising strategy to enhance patients’ engagement in healthy lifestyle behaviors for hypertension. Such an improvement could be achieved through the education of both the physicians and patients

Clinical trials in advanced stage lung cancer: a survey of patients' opinion about their treatment

<p>Abstract</p> <p>Background</p> <p>The major aim of this study was to investigate what patients with advanced stage lung cancer, enrolled in a clinical trial, thought about their treatment. We also wanted to investigate if there exist any characteristics that could influence patients' opinion about the clinical trial.</p> <p>Patients and methods</p> <p>Over the period from June 2008 to June 2009, 59 eligible patients were enrolled in this study. The major inclusion criteria were: participation in a clinical trial, previously treated advanced stage lung cancer, and good performance status (ECOG 0-2). All patients were asked to answer a questionnaire designed to investigate their impressions about participation in a clinical trial. The questionnaire was deposited in a sealed box which was opened at the end of the study.We investigated a possible influence of age, gender, education, lung cancer stage, chemotherapy line and tumor type on the patients' opinion about some aspects of the clinical trial.</p> <p>Results</p> <p>The majority of the patients were aware they were participating in the clinical trial and a significant number of them were very satisfied with the treatment. Of the investigated factors, only the level of education had a statistically significant influence on some of the questions raised in the questionnaire.</p> <p>Conclusions</p> <p>Patients participating in clinical trials are satisfied with their treatment, ready to proceed with it and would recommend it to other patients. It depends mainly on health professionals to maintain this level of confidence and justify their trust.</p

Population pharmacokinetics of 25-hydroxy Vitamin D in non-elderly postmenopausal women

© 2019 Polish Pharmaceutical Society. All Rights Reserved. Vitamin D is one of the keys to bone health, and the serum levels of this vitamin are a major concern for postmenopausal women. The aims of this study were to develop a population pharmacokinetic (PPK) model for the clearance of 25-hydroxy vitamin D in non-elderly postmenopausal women and to identify the factors which have a significant influence on its clearance. The study population consisted of postmenopausal women who had been referred for evaluation of bone mineral density (BMD) by DEXA (dual-energy x-ray absorptiometry) scanner. The population pharmacokinetics modeling was conducted using the ADVAN 1 subroutine from a non-linear mixed effects (NONMEM) program, and thirty-two covariates were assessed. A total of 75 serum concentrations were obtained from the same number of postmenopausal women and used for PPK analysis. The mean value of the participantsí age was 57.92 ± 3.93 years and their body weight was 69.76 ± 11.49 kg. A wide range of 25-hydroxy vitamin D concentrations was observed (from 3.41 to 61.92 ng/mL) with a mean value of 26.19 ± 10.95 ng/mL. A total of 32 covariates were examined and preliminary results suggested the influence of six covariates on 25-hydroxy vitamin D clearance. In the final PPK model, however, only one covariate was shown to have a significant impact on the clearance value ñ the mean daily dietary intake dose of vitamin D (DD). These findings offer a preliminary basis on which to determine the level of vitamin D supplementation required by individual postmenopausal women. It could prove particularly important in achieving optimal serum levels of vitamin D in this vulnerable population