Strontium ranelate reduces the risk of vertebral fracture in young postmenopausal women with severe osteoporosis

Early osteoporotic fractures have a great impact on disease progression, the first fracture being a major risk factor for further fractures. Strontium ranelate efficacy against vertebral fractures is presently assessed in a subset of women aged 50-65 years

Das CPCJ aos tribunais da relação : caracterização dos processos de promoção e proteção

O progressivo reconhecimento do lugar que as crianças e jovens ocupam na sociedade enquanto sujeitos de direitos e a importância de incentivar, desenvolver e assegurar o exercício efetivo dos mesmos, tem convocado os interventores políticos e sociais para a observância de boas práticas em matéria de infância e juventude. Mas nem sempre foi desta forma, e existirá ainda um longo caminho a percorrer no que respeita a esta temática. Neste trabalho foi feito o enquadramento da evolução dos direitos da criança até se chegar à intervenção no âmbito da Lei 147/99. Esta intervenção foi depois seguida, desde o seu início até à chegada a sede judicial, através da análise de 92 acórdãos que implicam a matéria de facto. Obtiveram-se resultados que apontam para a maior frequência da aplicabilidade das medidas de “confiança a instituição com vista a futura adoção” e “acolhimento residencial” pelos Tribunais de Família e Menores e da Relação. Também foi possível apurar que a maioria dos recursos são indeferidos pelos Tribunais de Relação. Este estudo aponta para a necessidade de intervenção precoce em matéria de promoção e protecção, para que se possam evitar muitas vezes situações remediativas que acontecem, assim como para a importância do trabalho de acompanhamento das famíliasThe progressive recognition of the place that children and young people have in society as subjects of rights and the importance of encourage, develop and secure its effective exercise, has summoned the political and social intervenors to observe good practices within childhood and youth. It hasn’t always been like this and there’s still a long way to run regarding this issue. In this report we’ve approached the children’s rights evolution until reaching the intervention under the law 147/99. This intervention has been followed since its beginning until reaching the judicial seat, through the analysis of judgements which imply this matter.Results were obtained which aim to a greater frequency of the applicability of measures related with “the trust on an institution regarding a future adoption” and “child residential reception”. Among other results, it was also possible to gather that most of the appeals are denied by Supreme Court. This study aims to the need of early intervention, which can avoid many of the fixing situations happening, as well as the importance of working with the families and families monitoring

Response to IJTLD article, "Having diabetes and being underweight in Asia: a potent risk factor for tuberculosis"

Contains fulltext : 220544pub.pdf (Publisher’s version ) (Closed access

Variational Foundations and Generalized Unified Theory of RVE-Based Multiscale Models

A unified variational theory is proposed for a general class of multiscale models based on the concept of Representative Volume Element. The entire theory lies on three fundamental principles: (1) kinematical admissibility, whereby the macro- and micro-scale kinematics are defined and linked in a physically meaningful way; (2) duality, through which the natures of the force- and stress-like quantities are uniquely identified as the duals (power-conjugates) of the adopted kinematical variables; and (3) the Principle of Multiscale Virtual Power, a generalization of the well-known Hill-Mandel Principle of Macrohomogeneity, from which equilibrium equations and homogenization relations for the force- and stress-like quantities are unequivocally obtained by straightforward variational arguments. The proposed theory provides a clear, logically-structured framework within which existing formulations can be rationally justified and new, more general multiscale models can be rigorously derived in well-defined steps. Its generality allows the treatment of problems involving phenomena as diverse as dynamics, higher order strain effects, material failure with kinematical discontinuities, fluid mechanics and coupled multi-physics. This is illustrated in a number of examples where a range of models is systematically derived by following the same steps. Due to the variational basis of the theory, the format in which derived models are presented is naturally well suited for discretization by finite element-based or related methods of numerical approximation. Numerical examples illustrate the use of resulting models, including a non-conventional failure-oriented model with discontinuous kinematics, in practical computations

Family planning among people living with HIV in post-conflict Northern Uganda: A mixed methods study

<p>Abstract</p> <p>Background</p> <p>Northern Uganda experienced severe civil conflict for over 20 years and is also a region of high HIV prevalence. This study examined knowledge of, access to, and factors associated with use of family planning services among people living with HIV (PLHIV) in this region.</p> <p>Methods</p> <p>Between February and May 2009, a total of 476 HIV clinic attendees from three health facilities in Gulu, Northern Uganda, were interviewed using a structured questionnaire. Semi-structured interviews were conducted with another 26 participants. Factors associated with use of family planning methods were examined using logistic regression methods, while qualitative data was analyzed within a social-ecological framework using thematic analysis.</p> <p>Results</p> <p>There was a high level of knowledge about family planning methods among the PLHIV surveyed (96%). However, there were a significantly higher proportion of males (52%) than females (25%) who reported using contraception. Factors significantly associated with the use of contraception were having ever gone to school [adjusted odds ratio (AOR) = 4.32, 95% confidence interval (CI): 1.33-14.07; p = .015], discussion of family planning with a health worker (AOR = 2.08, 95% CI: 1.01-4.27; p = .046), or with one's spouse (AOR = 5.13, 95% CI: 2.35-11.16; p = .000), not attending the Catholic-run clinic (AOR = 3.67, 95% CI: 1.79-7.54; p = .000), and spouses' non-desire for children (AOR = 2.19, 95% CI: 1.10-4.36; p = .025). Qualitative data revealed six major factors influencing contraception use among PLHIV in Gulu including personal and structural barriers to contraceptive use, perceptions of family planning, decision making, covert use of family planning methods and targeting of women for family planning services.</p> <p>Conclusions</p> <p>Multilevel, context-specific health interventions including an integration of family planning services into HIV clinics could help overcome some of the individual and structural barriers to accessing family planning services among PLHIV in Gulu. The integration also has the potential to reduce HIV incidence in this post-conflict region.</p

Impact of supragingival therapy on subgingival microbial profile in smokers versus non-smokers with severe chronic periodontitis

The aim of this study was to assess subgingival microbiological changes in smokers versus non-smokers presenting severe chronic periodontitis after supragingival periodontal therapy (ST).Non-smokers (n=10) and smokers (n=10) presenting at least nine teeth with probing pocket depth (PPD) (&#x2265;5 mm), bleeding on probing (BoP), and no history of periodontal treatment in the last 6 months were selected. Clinical parameters assessed were plaque index (PI), BoP, PPD, relative gingival margin position (rGMP) and relative clinical attachment level (rCAL). Subgingival biofilm was collected before and 21 days after ST. DNA was extracted and the 16S rRNA gene was amplified with the universal primer pair, 27F and 1492R. Amplified genes were cloned, sequenced, and identified by comparison with known 16S rRNA sequences. Statistical analysis was performed by Student&#x0027;s t and Chi-Square tests (&#x03B1;=5%).Clinically, ST promoted a significant reduction in PI and PPD, and gain of rCAL for both groups, with no significant intergroup difference. Microbiologically, at baseline, data analysis demonstrated that smokers harbored a higher proportion of Porphyromonas endodontalis, Bacteroidetes sp., Fusobacterium sp. and Tannerella forsythia and a lower number of cultivated phylotypes (p&#60;0.05). Furthermore, non-smokers featured significant reductions in key phylotypes associated with periodontitis, whereas smokers presented more modest changes.Within the limits of the present study, ST promoted comparable clinical improvements in smokers and non-smokers with severe chronic periodontitis. However, in smokers, ST only slightly affected the subgingival biofilm biodiversity, as compared with non-smokers

A comprehensive fracture prevention strategy in older adults: The European union geriatric medicine society (EUGMS) statement

Prevention of fragility fractures in older people has become a public health priority, although the most appropriate and cost-effective strategy remains unclear. In the present statement, the Interest group on falls and fracture prevention of the European union geriatric medicine society (EUGMS), in collaboration with the International association of gerontology and geriatrics for the European region (IAGG-ER), the European union of medical specialists (EUMS), the Fragility fracture network (FFN), the International osteoporosis foundation (IOF) – European society for clinical and economic aspects of osteoporosis and osteoarthritis (ECCEO), outlines its views on the main points in the current debate in relation to the primary and secondary prevention of falls, the diagnosis and treatment of bone fragility, and the place of combined falls and fracture liaison services for fracture prevention in older people