The environmental profile of a community's health: a cross-sectional study on tobacco marketing in 16 countries.

OBJECTIVE: To examine and compare tobacco marketing in 16 countries while the Framework Convention on Tobacco Control requires parties to implement a comprehensive ban on such marketing. METHODS: Between 2009 and 2012, a kilometre-long walk was completed by trained investigators in 462 communities across 16 countries to collect data on tobacco marketing. We interviewed community members about their exposure to traditional and non-traditional marketing in the previous six months. To examine differences in marketing between urban and rural communities and between high-, middle- and low-income countries, we used multilevel regression models controlling for potential confounders. FINDINGS: Compared with high-income countries, the number of tobacco advertisements observed was 81 times higher in low-income countries (incidence rate ratio, IRR: 80.98; 95% confidence interval, CI: 4.15-1578.42) and the number of tobacco outlets was 2.5 times higher in both low- and lower-middle-income countries (IRR: 2.58; 95% CI: 1.17-5.67 and IRR: 2.52; CI: 1.23-5.17, respectively). Of the 11,842 interviewees, 1184 (10%) reported seeing at least five types of tobacco marketing. Self-reported exposure to at least one type of traditional marketing was 10 times higher in low-income countries than in high-income countries (odds ratio, OR: 9.77; 95% CI: 1.24-76.77). For almost all measures, marketing exposure was significantly lower in the rural communities than in the urban communities. CONCLUSION: Despite global legislation to limit tobacco marketing, it appears ubiquitous. The frequency and type of tobacco marketing varies on the national level by income group and by community type, appearing to be greatest in low-income countries and urban communities

Iohexol-based assessment of intestinal permeability in broilers challenged with Eimeria maxima, Clostridium perfringens or both

Impaired intestinal integrity in broilers reduces performance and health, highlighting the importance of accurately measuring intestinal permeability (IP) to maintain gut health. The objective of this study was to evaluate the efficiency of iohexol as an IP marker in broilers challenged with Eimeria maxima, Clostridium perfringens, or both during both peak challenge (day [d] 21) and recovery (d 28) periods. One-day-old male Ross 708 birds (n = 56) were distributed into 4 treatment groups: NC (no-challenge control); EM (challenged with 5,000 E. maxima sporulated oocysts/bird on d 15); CP (challenged with 1.0 × 108 CFUs/bird of C. perfringens on d 19 and d 20); and EM + CP (challenged by co-infection of E. maxima and C. perfringens as described). On d 21 and d 28, each bird received an iohexol dose of 64.7 mg/kg body weight via oral gavage. One hour later, blood samples were collected from 14 birds (12 in EM) per group on d 21 and from 7 birds (6 in EM) on d 28. For lesion scoring and ileum collection, 7 birds per group (6 birds in EM) were sampled on each d 21 and d 28. Birds in the EM and EM + CP groups had lower body weight gain (BWG) compared to the NC and CP groups on d 19–21 (P ≤ 0.05). These birds also exhibited significantly greater lesion scores and markedly higher serum iohexol levels on d 21 (P ≤ 0.05). However, no significant differences in serum iohexol levels were observed among treatment groups following recovery on d 28. Moreover, significant differentials were observed in the mRNA abundance of key tight junction proteins (CLDN1, CLDN2, and ZO3), pro-inflammatory cytokines (IL-1β, IFNγ, and IL-22), and gut health markers (GLP2, OLFM4, and MUC2) in the EM and EM + CP groups compared to the NC and CP groups on d 21. In conclusion, this study demonstrates that iohexol is an effective marker for assessing IP in broilers under different enteric challenge conditions

The Importance of Fecaliths in the Aetiology of Acute Appendicitis

Aim: Fecaliths, lymphoid hyperplasia, parasites, undigested plant residues and foreign bodies are considered as part of the aetiology of acute appendicitis. In our article we discussed about fecaliths, fecalith formation, and its aetiological value. Methods: Patients which have been operated onfor acute appendicitis between 2009-2010 are analysed retrospectively. Results: The average age was 29,3. The number of cases with fecalith was 261 (36,1%). Out of these, 19 acute appendicites, 95 phlegmons, and 30 perforations were detected. Conclusions: Intraluminal pathologies probably play a major role in the development of acute appendicitis. Intraluminal pathological findings may also be seen in healthy persons without necessarily pointing toacute appendicitis. Disease progresses from intraluminal fecalith with no inflammation to perforation from the beginning. There are many explanations regarding the formation of fecaliths. Diagnosis of the fecalith may be decided with ultrasonography, computed tomography and magnetic resonance imaging techniques. In case of preoperatively demonstrated intraluminal fecalith through ultrasonographic examination with clinical symptoms of acute appendicitis, early appendectomy must be performed in our opinion. Early appendectomy lowers morbidity and mortalityrates

The importance of Fecaliths in the aetiology of acute appendicitis

Aim: Fecaliths, lymphoid hyperplasia, parasites, undigested plant residues and foreign bodies are considered as part of the aetiology of acute appendicitis. In our article we discussed about fecaliths, fecalith formation, and its aetiological value. Methods: Patients which have been operated onfor acute appendicitis between 2009-2010 are analysed retrospectively. Results: The average age was 29,3. The number of cases with fecalith was 261 (36,1%). Out of these, 19 acute appendicites, 95 phlegmons, and 30 perforations were detected. Conclusions: Intraluminal pathologies probably play a major role in the development of acute appendicitis. Intraluminal pathological findings may also be seen in healthy persons without necessarily pointing toacute appendicitis. Disease progresses from intraluminal fecalith with no inflammation to perforation from the beginning. There are many explanations regarding the formation of fecaliths. Diagnosis of the fecalith may be decided with ultrasonography, computed tomography and magnetic resonance imaging techniques. In case of preoperatively demonstrated intraluminal fecalith through ultrasonographic examination with clinical symptoms of acute appendicitis, early appendectomy must be performed in our opinion. Early appendectomy lowers morbidity and mortalityrates. Copyright © Celsius

Effect of supplemental dietary phytogenic blends on growth performance, jejunal histomorphometry, and jejunal immunity of broiler chickens

This study evaluated the effects of two phytogenic blends on broiler performance, intestinal histomorphology, CD4+ (cluster of differentiation) and CD8+ T-cell numbers, and mRNA abundances of several cytokines in broilers. For this purpose, a total of 300 Ross 308 male broiler chicks that were 1 d old were randomly allocated to five experimental groups. The control group was fed a basal diet without any additives, and there were two phytogenic supplement groups (blend A, mainly comprising extracts of Thymus vulgaris and Filipendula ulmaria, and blend B, consisting of Ginkgo biloba and Silybum marianum) with two dosage regimens each (100 and 200 mg kg−1 (denoted A100 and A200) and 100 and 300 mg kg−1 (B100 and B300) of the diet, respectively). Over the total growing period, body weight gain and feed intake were unchanged among the groups, although phytogenic blend B showed a dose-dependent improvement in feed conversion ratio. Both phytogenic blends did not affect carcass characteristics. Jejunal morphology (villus height, crypt depth, and their ratio) was modified depending on both the composition and the dosage levels of the selected phytogenics. Also, both phytogenic blends linearly increased the CD4+ and CD8+ T-cell numbers in the jejunum. Moreover, no major treatment effects were observed on mRNA abundances of cytokines (IL-1β, IL-6, and TNFα). However, across the two phytogenic additives employed, a positive linear dose response in IL-1β abundance was noted on day 21 in broilers fed phytogenic blend B. Overall, dietary phytogenic blend B improved the intestinal health and growth performance of chickens compared to blend A. Further studies are suggested to elucidate the effects of the tested phytogenic blends on gut microbiome and on oxidative stress in broiler chickens.</p

Impact of Antioxidant Therapy on Natural Pregnancy Outcomes and Semen Parameters in Infertile Men: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Purpose: Seminal oxidative stress (OS) is a recognized factor potentially associated with male infertility, but the efficacy of antioxidant (AOX) therapy is controversial and there is no consensus on its utility. Primary outcomes of this study were to investigate the effect of AOX on spontaneous clinical pregnancy, live birth and miscarriage rates in male infertile patients. Secondary outcomes were conventional semen parameters, sperm DNA fragmentation (SDF) and seminal OS. Materials and methods: Literature search was performed using Scopus, PubMed, Ovid, Embase, and Cochrane databases. Only randomized controlled trials (RCTs) were included and the meta-analysis was conducted according to PRISMA guidelines. Results: We assessed for eligibility 1,307 abstracts, and 45 RCTs were finally included, for a total of 4,332 infertile patients. We found a significantly higher pregnancy rate in patients treated with AOX compared to placebo-treated or untreated controls, without significant inter-study heterogeneity. No effects on live-birth or miscarriage rates were observed in four studies. A significantly higher sperm concentration, sperm progressive motility, sperm total motility, and normal sperm morphology was found in patients compared to controls. We found no effect on SDF in analysis of three eligible studies. Seminal levels of total antioxidant capacity were significantly higher, while seminal malondialdehyde acid was significantly lower in patients than controls. These results did not change after exclusion of studies performed following varicocele repair. Conclusions: The present analysis upgrades the level of evidence favoring a recommendation for using AOX in male infertility to improve the spontaneous pregnancy rate and the conventional sperm parameters. The failure to demonstrate an increase in live-birth rate, despite an increase in pregnancy rates, is due to the very few RCTs specifically assessing the impact of AOX on live-birth rate. Therefore, further RCTs assessing the impact of AOX on live-birth rate and miscarriage rate, and SDF will be helpful

Türkiye’de bulunan yoğun bakımlarda sabun, kağıt havlu ve alkol bazlı el dezenfektanı yeterli mi?: Phokai çalışması sonuçları

Introduction: Hand hygiene is one of the most effective infection control measures to prevent the spread of healthcare-associated infections (HCAI). Water, soap, paper towel and hand disinfectant must be available and adequate in terms of effective hand hygiene. The adequacy of hand hygiene products or keeping water-soap and paper towel is still a problem for many developing countries like Turkey. In this multicenter study, we analyzed the adequacy in number and availability of hand hygiene products.Materials and Methods: This study was performed in all intensive care units (ICUs) of 41 hospitals (27 tertiary-care educational, 10 state and four private hospitals) from 22 cities located in seven geographical regions of Turkey. We analyzed water, soap, paper towel and alcohol-based hand disinfectant adequacy on four different days, two of which were in summer during the vacation time (August, 27th and 31st 2016) and two in autumn (October, 12th and 15th 2016).Results: The total number of ICUs and intensive care beds in 41 participating centers were 214 and 2357, respectively. Overall, there was no soap in 3-11% of sinks and no paper towel in 10-18% of sinks while there was no alcohol-based hand disinfectant in 1-4.7% of hand disinfectant units on the observation days. When we compared the number of sinks with soap and/or paper towel on weekdays vs. weekends, there was no significant difference in summer. However, on autumn weekdays, the number of sinks with soap and paper towel was significantly lower on weekend days (p<0.0001, p<0.0001) while the number of hand disinfectant units with alcohol-based disinfectant was significantly higher (p<0.0001).Conclusion: There should be adequate and accessible hand hygiene materials for effective hand hygiene. In this study, we found that soap and paper towels were inadequate on the observation days in 3-11% and 10-18% of units, respectively. Attention should be paid on soap and paper towel supply at weekends as well

The environmental profile of a community’s health: a cross-sectional study on tobacco marketing in 16 countries.

OBJECTIVE: To examine and compare tobacco marketing in 16 countries while the Framework Convention on Tobacco Control requires parties to implement a comprehensive ban on such marketing. METHODS: Between 2009 and 2012, a kilometre-long walk was completed by trained investigators in 462 communities across 16 countries to collect data on tobacco marketing. We interviewed community members about their exposure to traditional and non-traditional marketing in the previous six months. To examine differences in marketing between urban and rural communities and between high-, middle- and low-income countries, we used multilevel regression models controlling for potential confounders. FINDINGS: Compared with high-income countries, the number of tobacco advertisements observed was 81 times higher in low-income countries (incidence rate ratio, IRR: 80.98; 95% confidence interval, CI: 4.15-1578.42) and the number of tobacco outlets was 2.5 times higher in both low- and lower-middle-income countries (IRR: 2.58; 95% CI: 1.17-5.67 and IRR: 2.52; CI: 1.23-5.17, respectively). Of the 11,842 interviewees, 1184 (10%) reported seeing at least five types of tobacco marketing. Self-reported exposure to at least one type of traditional marketing was 10 times higher in low-income countries than in high-income countries (odds ratio, OR: 9.77; 95% CI: 1.24-76.77). For almost all measures, marketing exposure was significantly lower in the rural communities than in the urban communities. CONCLUSION: Despite global legislation to limit tobacco marketing, it appears ubiquitous. The frequency and type of tobacco marketing varies on the national level by income group and by community type, appearing to be greatest in low-income countries and urban communities