Schistosomal appendicitis: Case series and systematic literature review

Background Globally, schistosomiasis affects at least 240 million people each year with a high proportion of cases in sub-Saharan Africa. The infection presents a wide range of symptoms mainly at the gastrointestinal and urogenital level. Cases of schistosomiasis-related appendicitis are seldom reported. The aim of the present study is to identify the prevalence of schistosomiasis-related appendicitis in Beira, Mozambique and compare to global prevalence. Methods We retrospectively reviewed all cases of appendicitis recorded from January 2017 to March 2020 at a single pathology department located in Beira in order to assess the prevalence of schistosomiasis. Moreover, we performed a systematic review on the prevalence of schistosomiasis-related appendicitis in all countries. Findings A total of 145 appendicitis cases in Beira showed a 13.1% prevalence of schistosomal-related appendicitis. The mean age of patients was 29.1 years, and 14 (73.7%) were male. The systematic review identified 20 studies with 34,790 inpatientsAUwith: schistosomiasis-related appendicitis with a global prevalence of 1.31% (95% confidence interval (CI): 0.72 to PerPLOSstyle; sufferingfrom2.06); a high heterogeneity (I2 = 96.0%) was observed. Studies carried out in Africa reported a significantly higher prevalence of schistosomiasis-related appendicitis (2.75%; 95% CI: 1.28 to 4.68) than those in Middle East (0.49%; 95% CI: 0.18 to 0.95) (p for interaction < 0.0001). Conclusions Schistosomiasis infection should be considered as possible cause of appendicitis not only in endemic areas but also in developed countries. Considering that prevention is the best way to control the infection, more efforts should be put in place in order to increase the prevention coverage and avoid the cascading implications for health. This is even more so important in this Coronavirus Disease 2019AU(COVID-19): PleasenotethatCOVIDera where the majority19hasbeendefinedasCoof attention and funds are used to fight the pandemic

Prevalence of diabetes mellitus in newly diagnosed pulmonary tuberculosis in Beira, Mozambique

Introduction: Data regarding the association between diabetes mellitus (DM) and tuberculosis (TB) in Africa are scarce. DM screening among TB patients in Mozambique was carried out. Methods: The study was implemented from January to August 2016 in three Urban Health Centers in Beira, Mozambique and recruited adult (>18 years) patients newly diagnosed with pulmonary TB. Results: Three hundred and one patients were enrolled (67.4%, males mean age 31.7(SD 11 years). Diabetes was diagnosed in only 3 patients (1%) and impaired glucose tolerance (IGT) in an additional 6 subjects (2%). Conclusion: A lower than expected prevalence of DM was observed, which could be explained by the lack of traditional risk factors for DM (overweight, age over 45 years, hypertension and smoking) in Mozambique

Neuroprotective effects of ammonium tetrathiomolybdate, a slow-release sulfide donor, in a rodent model of regional stroke

BACKGROUND: Several therapeutic strategies to rescue the brain from ischemic injury have improved outcomes after stroke; however, there is no treatment as yet for reperfusion injury, the secondary damage caused by necessary revascularization. Recently we characterized ammonium tetrathiomolybdate (ATTM), a drug used as a copper chelator over many decades in humans, as a new class of sulfide donor that shows efficacy in preclinical injury models. We hypothesized that ATTM could confer neuroprotection in a relevant rodent model of regional stroke. METHODS AND RESULTS: Brain ischemia was induced by transient (90-min) middle cerebral artery occlusion (tMCAO) in anesthetized Wistar rats. To mimic a clinical scenario, ATTM (or saline) was administered intravenously just prior to reperfusion. At 24 h or 7 days post-reperfusion, rats were assessed using functional (rotarod test, spontaneous locomotor activity), histological (infarct size), and molecular (anti-oxidant enzyme capacity, oxidative damage, and inflammation) outcome measurements. ATTM-treated animals showed improved functional activity at both 24 h and 7-days post-reperfusion, in parallel with a significant reduction in infarct size. These effects were additionally associated with increased brain antioxidant enzyme capacity, decreased oxidative damage, and a late (7-day) effect on pro-inflammatory cytokine levels and nitric oxide products. CONCLUSION: ATTM confers significant neuroprotection that, along with its known safety profile in humans, provides encouragement for its development as a novel adjunct therapy for revascularization following stroke

EDUCAÇÃO E CONSCIENTIZAÇÃO NO TRÂNSITO: CURSO DE PSICOLOGIA DA UNOESC VIDEIRA

As notícias nas redes de comunicação sempre envolvem tragédias no trânsito, que poderiam ser evitadas com o uso dos equipamentos de segurança. Todo acidente decorre de pelo menos três fatores, que envolvem imprudência, imperícia e negligência. Imprudência é o desrespeito às leis de trânsito como a ultrapassagem em local proibido ou transposição do sinal vermelho. Imperícia é a falta de habilidade e conhecimento para operar um veículo, como quem dirige sem habilitação. Negligência é o descaso ou falta de manutenção de um veículo. Os três fatores revelam que acidentes de trânsito são totalmente previsíveis. Com a preocupação de alertar a comunidade, o curso de Psicologia da Unoesc Videira promoveu uma campanha de educação e conscientização. No semáforo da rua Saul Brandalise, acadêmicos e professores apresentaram faixas com frases de impacto, usaram colete de cor preta simbolizando as tragédias com a inscrição #ATENÇÃO, na frente, e nas costas RESPEITO. Foram utilizadas cadeiras de rodas, muletas e andadores para mostrar as formas de cuidados, e entregue folder explicativo com orientações sobre leis do trânsito, auxílio a idoso e portador com necessidades especiais.Palavras-chave: Educação. Conscientização. Trânsito

CONSCIENTIZAÇÃO E PREVENÇÃO AO SUICÍDIO: CURSO DE PSICOLOGIA UNOESC VIDEIRA (SC)

O suicídio não tem explicações objetivas. Agride, silencia, é um tabu, motivo de vergonha, de condenação, sinônimo de loucura, assunto proibido entre filhos, pais, amigos e até mesmo com o psicoterapeuta. As estatísticas revelam que o suicídio precisa sim, ser discutido, pois envolve uma expressão inequívoca de sofrimento individual e um sério problema de saúde pública. Casos de suicídio, muitas vezes, são deliberadamente mascarados nas estatísticas oficiais, como o suicídio de crianças, que são tidos como morte acidental e acidentes de automóvel causados por jovens que dirigem alcoolizados e em alta velocidade. Mas para os especialistas, esses são sim, atos suicidas. Com a preocupação de alertar a comunidade sobre essa temática, o curso de Psicologia da Unoesc Videira promoveu uma campanha para conscientização e prevenção ao suicídio. No dia 16 de setembro, no semáforo da rua Brasil em Videira, os acadêmicos e professores apresentaram faixas com frases de impacto para alertar a comunidade, utilizando um colete de cor amarela simbolizando a cor do mês de setembro com a palavra VIDA. Foi distribuído folder explicativo sobre os mitos e verdades sobre o suicídio junto com um laço amarelo para os motoristas e pedestres.Palavras-chave: Conscientização. Prevenção. Suicídio

CICLO DE DEBATES: EMPODERAMENTO FEMININO

O Ciclo de Debates é um evento tradicional no curso de Psicologia da Unoesc Videira. O tema debatido recentemente foi o empoderamento feminino, relevante para a compreensão e a articulação entre as representações sociais e as relações cotidianas. A psicóloga da DEPECAM de Campos Novos, Bárbara Redante, abordou sobre práticas de seu trabalho na Polícia Civil e a aproximação com o empoderamento feminino. Localizou o fenômeno historicamente, a partir da implantação da Delegacia da Mulher, em Florianópolis, no ano de 1985. Salientou a violência contra a mulher e a naturalização desse fenômeno, em que a dependência financeira faz com que o ciclo de violência se mantenha. Concluiu que a punição, exclusivamente, não é suficiente e que o empoderamento social é uma necessidade e precisa ser viabilizada. A socióloga Michele Leão, docente no IFC câmpus de Videira, questionou o significado de ser mulher. Ressaltou a representação de “mulher padrão” que, quando não alcançada gera frustração na própria mulher. Trata-se de um padrão de corpo, beleza, profissão e maternidade, que aparenta ser um ideal inalcançável e que, concomitantemente, ofusca a manifestação da identidade singular de cada mulher. O empoderamento, então, é visto como a possibilidade de caminhar contra as regras sociais. A acadêmica de Psicologia, Gabriela Fantin, contextualizou sócio-historicamente a desqualificação feminina. Da Grécia Antiga, citou Aristóteles: “A fêmea, por si só, carece de qualidades”. Da China, trouxe o Estatuto de Direitos e Deveres, que servem como uma concepção e um guia para o comportamento da mulher. Do hinduísmo, uma filosofia-religião iniciada na Índia, emprestou o conceito de mulher como propriedade do homem. Logo, se o homem morre, a mulher não tem mais valor. Também citou estatísticas, como os 3.526 casos de estupro coletivos ocorridos no Brasil, em 2016; e o feminicídio, homicídio doloso praticado contra a mulher por contextos marcados pela desigualdade de gênero. Antônia Farias, pedagoga, fez de seu depoimento um relato caso sobre a luta travada historicamente pela mulher para conquistar espaços e valor. Lembrou as lutas que a sua mãe, nos meados do século passado, empreendeu: “Ela abriu mão do primeiro casamento, por não ser livre. E o processo educacional das filhas foi na direção da liberdade”. Mesmo sem saber ler, sua mãe olhava seus trabalhos escolares e era convincente quanto a seus relatos sobre eles. Enquanto descarregava lenha e nó de pinho dos vagões de trem, com vistas a construir a casa própria, a mãe dissera a Antônia: “Você vai ser a diretora do Josefina Caldeira de Andrade!” Inicialmente, Antônia resistiu, mas acabou aceitando e realizando-se assim, contribuindo para a história da educação do município. O filósofo Cláudio Bertotto, docente na Unoesc e no IFC Videira, abordou a capacidade da mulher dar o suporte para que os homens conseguissem vencer a Guerra do Contestado. Resgatou a assertiva do filósofo inglês John Locke, segundo o qual “As mulheres vão mandar no mundo”. Quem organizou o mundo foi quem delimitou o conhecimento; logo, se atualmente, 60% dos estudantes da Unoesc são mulheres, isso vem ao encontro da concepção de empoderamento feminino como uma realidade próxima na região do Contestado, no passado e no presente. Por outro lado, reconheceu aspectos que precisam ser transpostos: as falas bíblicas que desqualificam a mulher, que a colocam como submissa; o fato de que toda mulher, quando não tem dinheiro, tem o sexo, evidência da presença marcante de um machismo institucionalizado. Palavras-chave: Ciclo de Debates. Empoderamento Feminino. Curso de Psicologia. Papel da Mulher

Predictors of therapy failure in newly diagnosed pulmonary tuberculosis cases in Beira, Mozambique.

OBJECTIVE: Tuberculosis (TB) remains a major global health issue, ranking in the top ten causes of death worldwide. A deep understanding of factors influencing poor treatment outcomes may allow the development of additional treatment strategies, focused on the most vulnerable groups. Aims of the study were: (i) to evaluate the treatment outcome among TB subjects followed in an outpatient setting and (ii) to analyze factors associated with treatment failure in newly diagnosed patients with pulmonary TB in Beira, the second largest city of Mozambique. RESULTS: A total of 301 TB adult patients (32.6% females) were enrolled. Among them, 62 (20.6%) experienced a treatment failure over a 6 months follow-up. On multivariate model, being males (O.R. = 1.73; 95% CI 1.28-2.15), absence of education (O.R. = 1.85; 95% CI 1.02-2.95), monthly income under 50 dollars (O.R. = 1.74; 95% CI 1.24-2.21) and being employed (O.R. = 1.57; 95% CI 1.21-1.70), low body mass index values (O.R. = 1.42; 95% CI 1.18-1.72) and HIV status (O.R. = 1.42; 95% CI 1.10-1.78) increased the likelihood of therapy failure over 6 months of follow-up. In this study, patients who need more medical attention were young males, malnourished, with low income and low educational degree and HIV positive. These subjects were more likely to fail therapy

Empagliflozin Use and Fournier’s Gangrene: Case Report and Systematic Literature Review

Background: Fournier’s gangrene (FG) is a rare necrotising soft tissue infection localised in the genital areas with possible dramatic outcomes. Recently, sodium glucose co-transporter-2 (SGLT2) inhibitors were identified as a risk factor. Methods: We present a case report of a 57-year-old female patient with type 2 diabetes mellitus (T2DM) in treatment with empagliflozin which led to the development of FG. Moreover, we performed a systematic review assessing the association between empagliflozin use and FG. Results: The female patient with 15-years treated diabetes presented a massive FG after 6 months from starting empagliflozin. Over the period of two months, she was successfully treated in a low-income setting. The systematic review included two studies with a total of 9915 participants. Although no participant had FG, there was an increased rate of urinary and genital infection in patients treated with empagliflozin compared to those treated with other antidiabetics or placebo. Conclusions: FG should be considered as a possible complication in patients using SGLT2. Patients should be educated to report early signs of genital infection and healthy behaviours as well as a balanced diet should be promoted to aid in the prevention of FG

The association of pain with suicidal ideation and suicide attempts with depressive symptoms among adults aged ≥50 years from low- and middle-income countries

Objectives: We aimed to examine the relationship of pain with suicidal ideation and suicide attempts with depressive symptoms among adults aged ≥50 years from six low- and middle-income countries (LMICs) (China, Ghana, India, Mexico, Russia, and South Africa). Methods: Cross-sectional, community-based, nationally representative data from the WHO Study on global AGEing and adult health were analyzed. Self-reported information on past 12-month suicidal ideation and suicide attempts among people with depressive symptoms was collected. Pain was assessed with the question “Overall in the last 30 days, how much of bodily aches or pain did you have?” With answer options: “none”, “mild”, “moderate”, “severe/extreme”. Multivariable logistic regression was done to assess associations. Results: Data on 34,129 adults aged ≥50 years (mean [SD] age 62.4 [16.0] years; males 47.9%) were analyzed. Compared to no pain, mild, moderate, and severe/extreme pain were associated with 2.83 (95% CI = 1.51–5.28), 4.01 (95% CI = 2.38–6.76), and 12.26 (95% CI = 6.44–23.36) times higher odds for suicidal ideation. For suicide attempt, only severe/extreme pain was associated with significantly increased odds (OR = 4.68; 95% CI = 1.67–13.08). Conclusions: In this large sample of older adults from multiple LMICs, pain was strongly associated with suicidal thoughts and suicide attempts with depressive symptoms. Future studies should assess whether addressing pain among older people in LMICs may lead to reduction in suicidal thoughts and behaviors

Sex differences in the association between dynapenic abdominal obesity and onset of disability in activities of daily living among adults aged ≥50 years: A prospective analysis of the Irish Longitudinal Study on Ageing

Background: Sex differences in the longitudinal relationship between dynapenic abdominal obesity, i.e., impairment in muscle strength and high waist circumference, and disability in activities of daily living have not been investigated to date. Therefore, we aimed to examine sex differences in the longitudinal association between dynapenic abdominal obesity at baseline and the onset of disability in activities of daily living during a four-year follow-up period among Irish adults aged ≥50 years. Methods: Data from Wave 1 (2009–2011) and Wave 3 (2014–2015) of the Irish Longitudinal Study on Ageing survey were analyzed. Dynapenia was defined as handgrip strength of <26 kg for men and <16 kg for women. Abdominal obesity was defined as waist circumference of >88 cm for women and >102 cm for men. Dynapenic abdominal obesity was defined as having both dynapenia and abdominal obesity. Disability was defined as having difficulty with at least one of six activities of daily living (dressing, walking, bathing, eating, getting in or out of bed, using the toilet). Multivariable logistic regression was conducted to assess associations. Results: Data on 4471 individuals aged ≥50 years and free of disability at baseline were analyzed [mean (SD) age 62.3 (8.6) years; 48.3 % males]. In the overall sample, compared to no dynapenia and no abdominal obesity, dynapenic abdominal obesity was associated with 2.15 (95%CI = 1.17–3.93) times higher odds for incident disability at 4-year follow-up. This association was significant among men (OR = 3.78; 95%CI = 1.70–8.38) but not among women (OR = 1.34; 95%CI = 0.60–2.98). Conclusions: Interventions to prevent or address dynapenic abdominal obesity may aid in the prevention of disability, especially among men