Histoplasmosis: An Overview Treatment of Histoplasmosis

In 2000, the Infectious Diseases Society of America (IDSA) published a clinical practice guideline on managing patients with histoplasmosis and, in 2020, the first global guideline for diagnosing and managing disseminated histoplasmosis in people living with HIV (PLHIV). The classification of pulmonary histoplasmosis is done after clinical presentation and imaging. The optimal treatment depends on the patient’s clinical syndrome: acute mild/moderate, acute moderately/severe, chronic cavitary pulmonary, mediastinal lesions, or broncholithiasis. Asymptomatic patients or patients with mild cases of histoplasmosis with symptoms lasting less than four weeks do not usually require antifungal treatment. When necessary, itraconazole is the treatment of choice in mild to moderate acute forms of the disease, often for six weeks. For severe histoplasmosis, amphotericin B is recommended as initial therapy, followed by itraconazole as consolidation therapy. Long-term treatment for at least 12 months is recommended in patients with chronic cavitary histoplasmosis

Determination of Major-to-Trace Minerals and Polyphenols in Different Apple Cultivars

The aim of this study was to investigate the concentration level of some major-to-trace elements and toxic minerals and polyphenols (catechin, epicatechin and quercetin) in fruits belonging to different apple cultivars (‘Auriu de Cluj’, ‘Florina’, ‘Generos’, ‘Golden Delicious’, ‘Prima’, ‘Productiv de Cluj’ and ‘Starkrimson’), under specific climate conditions to northwestern Romania. The apple minerals were determined by the inductively coupled plasma mass spectrometry (ICP-MS) and inductively coupled plasma optical emission spectrometry (ICP-OES) after a preliminary, microwave-assisted, acid digestion. The polyphenols were determined by high performance liquid chromatography (HPLC) with MS/MS detection. According to the obtained results, the edible part of the apple contains many minerals with high relative nutritional value (RNV). The major minerals (Na, K, Ca, Mg and P), minor elements (Cu, Fe, Mn, Sr and Zn) and toxic trace elements (Cd, Cr and Pb) were comparatively identified and quantified. It was found that K (31976 mg/kg) was predominant among the major elements, while Fe (3.68 mg/kg) and Cu (3.57 mg/kg) were comparable. The toxic trace metals (Cd, Cr and Pb) were below the limits of detection (0.01, 0.10 and 0.01 mg/kg, respectively) and did not determine any health risk to consumers. The main polyphenols composition (catechin, epicathechin, quercetin) differs slightly among different cultivars. In ‘Idared’ and ‘Jonathan’ cultivars, the investigated polyphenols are in higher quantities comparing to the others. In all investigated apple cultivars, quercetin was proved to be the major polyphenol, followed by epicathechin and catechin. These results suggest that, regarding only the investigated polyphenols, ‘Idared’ and ‘Jonathan’ cultivars have the highest antioxidant character in all investigated genotypes

Rehabilitation therapies in stable chronic obstructive pulmonary disease

Introduction. Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable and treatable disease. The pulmonary rehabilitation (PR) is a mutidisciplinary and comprehensive intervention in symptomatic patients with COPD. Objective. This review aims to synthesize evidence from available studies on the relative efficacies of different methods of rehabilitation therapies in patients with stable COPD. Material and Methods. A search was performed on the databases Pubmed, Embase, ResearchGate. Of the 410 articles retrieved from databases, only 20 met the inclusion criteria. Two reviewers independently reviewed selected eligible studies. Results. Rehabilitation is a multidisciplinary intervention in symptomatic patients with COPD, including speleotherapy, halotherapy, muscular training, soft tissue manual therapy and neuromuscular electrostimulation. All of the case-control studies using speleotherapy reported improved respiratory function to varying degrees and there were improvements in lung functional tests including forced vital capacity (FVC), forced expiratory volume in 1 second (FEV 1), oxygen saturation, partial pressure of oxygen in arterial blood, and partial pressure of carbon dioxide in arterial blood. In addition, halotherapy has been associated with relief of respiratory conditions such as COPD, asthma and cystic fibrosis by its bactericidal effect, improvement of immunity and rheological properties of secretions. Respiratory muscle training is a part of rehabilitation for COPD subjects. In patients who can not perform physical activity, neuromuscular electrostimulation (NMES) increased 6 minute walking distance and time to symptom limitation exercising at a submaximal intensity and reduced the severity of leg fatigue on completion of exercise testing. Conclusion. The management of COPD should include a multidisciplinary therapy, including rehabilitation therapies as an adjuvant to the medical treatment, especially because due to the high prevalence, mortality, and morbidity, COPD will be one of the biggest public health challenges in the next century

The Effect of Climate Change and Air Pollution on Allergenic Potential of Pollens

Climate change is associated with atmospheric warming due to continuous increase in anthropogenic greenhouse gas concentration following the industrial revolution. The urban areas are more responsible for these changes. Europe for example has experienced a progressive warming +0.9°C for 1901-2005. Climate change is unequivocal and represents a possible threat for patients affected by allergic conditions because it is related with an increased distribution and concentration of pollen. Higher temperature, wet condition (especially thunderstorms), wind speed, transition of cold fronts, environmental changes (allergenic pollens arrived in new areas), are mechanisms which involve changes of production, dispersion and allergen content of pollen. Prolonged and more severe pollen seasons are leading to worsened asthma and allergies. The interaction of pollen with urban air pollutants could also lead to an increased effect of aero allergens on allergic patients, with a greater likelihood of the development of an allergic respiratory disease in sensitized subjects and exacerbation of symptomatic patients. Air pollution could induce damage to airways mucosa, thus promoting sensitization of the airways; also it could increase the expression of allergenic proteins (allergen contents of pollen produce by plants is increased by higher temperature and CO2 enriched atmosphere). By increasing pollen concentration or making the airways susceptible to allergens, the climate change and air pollution have a negative impact on human health

The Effect of Climate Change and Air Pollution on Allergenic Potential of Pollens

Climate change is associated with atmospheric warming due to continuous increase in anthropogenic greenhouse gas concentration following the industrial revolution. The urban areas are more responsible for these changes. Europe for example has experienced a progressive warming +0.9°C for 1901-2005. Climate change is unequivocal and represents a possible threat for patients affected by allergic conditions because it is related with an increased distribution and concentration of pollen. Higher temperature, wet condition (especially thunderstorms), wind speed, transition of cold fronts, environmental changes (allergenic pollens arrived in new areas), are mechanisms which involve changes of production, dispersion and allergen content of pollen. Prolonged and more severe pollen seasons are leading to worsened asthma and allergies. The interaction of pollen with urban air pollutants could also lead to an increased effect of aero allergens on allergic patients, with a greater likelihood of the development of an allergic respiratory disease in sensitized subjects and exacerbation of symptomatic patients. Air pollution could induce damage to airways mucosa, thus promoting sensitization of the airways; also it could increase the expression of allergenic proteins (allergen contents of pollen produce by plants is increased by higher temperature and CO2 enriched atmosphere). By increasing pollen concentration or making the airways susceptible to allergens, the climate change and air pollution have a negative impact on human health

Noncoding RNAs and Liquid Biopsy in Lung Cancer: A Literature Review

Lung cancer represents a genetically heterogeneous disease with low survival rates. Recent data have evidenced key roles of noncoding RNAs in lung cancer initiation and progression. These functional RNA molecules that can act as both oncogenes and tumor suppressors may become future biomarkers and more efficient therapeutic targets. In the precision medicine era, circulating nucleic acids have the potential to reshape the management and prognosis of cancer patients. Detecting genomic alterations and level variations of circulating nucleic acids in liquid biopsy samples represents a noninvasive method for portraying tumor burden. Research is currently trying to validate the potential role of liquid biopsy in lung cancer screening, prognosis, monitoring of disease progression, and treatment response. However, this method requires complex detection assays, and implementation of plasma genotyping in clinical practice continues to be hindered by discrepancies that arise when compared to tissue genotyping. Understanding the genomic landscape of lung cancer is essential in order to provide useful and innovative research in the age of patient-tailored therapy. In this landscape, the noncoding RNAs play a crucial role due to their target genes that dramatically influence the tumor microenvironment and the response to therapy. This article addresses present and future possible roles of liquid biopsy in lung cancer. It also discusses how the complex role of noncoding RNAs in lung tumorigenesis could influence the management of this pathology

Smoking in Teenagers from the Social Protection System—What Do We Know about It?

Background and Objectives: The impact of smoking on the young population is an extremely important issue for the public health system. As the prevalence of smoking is considerably increasing amongst the pubescent and adolescent population, the prevention of smoking at this age should be considered of high priority. The primary aim of this observational study was to assess tobacco use in teenagers included in the social protection system. Materials and Methods: 275 foster care teenagers (155 from the Professional Maternal Assistance System (AMP) and 120 from the residential system) from two different counties were enrolled. After a brief interactive session focused on the main consequences of smoking, a self-administered questionnaire was anonymously completed. Results: The mean age of the study group was 14 years, with a significant difference between the residential system and AMP (p = 0.001). Smoking status was significantly higher in participants from family-type houses (36.7%) than in those from the AMP (11.7%) (p < 0.001). The presence of smokers in the family (78.3%) and passive smoking (64.7%) were significantly higher in children from the residential system than in those from the AMP (32.9% and 31.8%, respectively) (p < 0.001). The number of cigarettes consumed daily was associated with the age of the participants (p = 0.01, rho 0.42). In total, 82.3% were cigarette users and 19.4% were e-cigarette users. Smokers bought the majority of their cigarettes from the store (63.2%) or asked a friend (19.3%) or an adult to buy them on their behalf (12.3%). Conclusions: The null hypothesis, according to which children who are abandoned but raised and cared for by professional nursing assistants are predisposed to earlier tobacco activity compared to children raised in a normal familiar environment, is supported. Future education and prevention campaigns conveying the benefits of a healthy long-term lifestyle to this population category are needed

Determination of Major-to-Trace Minerals and Polyphenols in Different Apple Cultivars

The aim of this study was to investigate the concentration level of some major-to-trace elements and toxic minerals and polyphenols (catechin, epicatechin and quercetin) in fruits belonging to different apple cultivars (‘Auriu de Cluj’, ‘Florina’, ‘Generos’, ‘Golden Delicious’, ‘Prima’, ‘Productiv de Cluj’ and ‘Starkrimson’), under specific climate conditions to northwestern Romania. The apple minerals were determined by the inductively coupled plasma mass spectrometry (ICP-MS) and inductively coupled plasma optical emission spectrometry (ICP-OES) after a preliminary, microwave-assisted, acid digestion. The polyphenols were determined by high performance liquid chromatography (HPLC) with MS/MS detection. According to the obtained results, the edible part of the apple contains many minerals with high relative nutritional value (RNV). The major minerals (Na, K, Ca, Mg and P), minor elements (Cu, Fe, Mn, Sr and Zn) and toxic trace elements (Cd, Cr and Pb) were comparatively identified and quantified. It was found that K (31976 mg/kg) was predominant among the major elements, while Fe (3.68 mg/kg) and Cu (3.57 mg/kg) were comparable. The toxic trace metals (Cd, Cr and Pb) were below the limits of detection (0.01, 0.10 and 0.01 mg/kg, respectively) and did not determine any health risk to consumers. The main polyphenols composition (catechin, epicathechin, quercetin) differs slightly among different cultivars. In ‘Idared’ and ‘Jonathan’ cultivars, the investigated polyphenols are in higher quantities comparing to the others. In all investigated apple cultivars, quercetin was proved to be the major polyphenol, followed by epicathechin and catechin. These results suggest that, regarding only the investigated polyphenols, ‘Idared’ and ‘Jonathan’ cultivars have the highest antioxidant character in all investigated genotypes.</p

Am J Community Psychol

Empowerment-based strategies have become widely used method to address health inequities and promote social change. Few researchers, however, have tested theoretical models of empowerment, including multidimensional, higher-order models. We test empirically a multidimensional, higher-order model of psychological empowerment (PE), guided by Zimmerman's conceptual framework including three components of PE: intrapersonal, interactional, and behavioral. We also investigate if PE is associated with positive and negative outcomes among youth. The sample included 367 middle school youth aged 11-16 (M\ua0=\ua012.71; SD\ua0=\ua00.91); 60% female, 32% (n\ua0=\ua0117) white youth, 46% (n\ua0=\ua0170) African-American youth, and 22% (n\ua0=\ua080) identifying as mixed race, Asian-American, Latino, Native American, or other ethnic/racial group; schools reported 61-75% free/reduced lunch students. Our results indicated that each of the latent factors for the three PE components demonstrate a good fit with the data. Our results also indicated that these components loaded on to a higher-order PE factor (X| =\ua032.68; df: 22; p\ua0=\ua0.07;\ua0RMSEA: 0.04; 95% CI: .00, .06; CFI: 0.99). We found that the second-order PE factor was negatively associated with aggressive behavior and positively associated with prosocial engagement. Our results suggest that empowerment-focused programs would benefit from incorporating components addressing how youth think about themselves in relation to their social contexts (intrapersonal), understanding social and material resources needed to achieve specific goals (interactional), and actions taken to influence outcomes (behavioral). Our results also suggest that integrating the three components and promoting PE may help increase likelihood of positive behaviors (e.g., prosocial involvement); we did not find an association between PE and aggressive behavior. Implications and future directions for empowerment research are discussed.R01 HD062565/HD/NICHD NIH HHS/United StatesU01 CE002698/CE/NCIPC CDC HHS/United States2017-12-01T00:00:00Z27709632PMC5161682vault:2779

Increased Vascular Endothelial Growth Factor Serum Level and the Role of +936C/T Gene Polymorphism in Chronic Obstructive Pulmonary Disease

Background and Objectives: Chronic obstructive pulmonary disease (COPD) represents a debilitating disease, with rising morbidity and mortality. Vascular endothelial growth factor (VEGF) plays a major role in angiogenesis, vascular permeability, and airway remodeling. The purpose of this study was to investigate the relationship between VEGF serum levels and VEGF +936 C/T gene polymorphism (rs3025039) with COPD, for the first time in a Romanian population. Materials and Methods: In total, 120 participants from Transylvania were included in this case-control study. Serum levels of VEGF were determined using an enzyme-linked immune-sorbent assay and rs3025039 was investigated by high molecular weight genomic deoxyribonucleic acid (DNA). Spirometric values, arterial blood gas analysis, and the Six Minute Walk Test (6MWT) outcome were also determined. Results: The serum level of VEGF was higher in the COPD group versus controls (p &lt; 0.001), with a positive correlation with the 6MWT outcome. No significant difference was observed in the VEGF serum levels between VEGF +936C/T genotypes. There was no difference in the VEGF +936C/T genotype between COPD patients and healthy subjects (chi2 test p = 0.92, OR = 1.04, 95%CI = 0.41&ndash;2.62), but the presence of the T allele was significantly linked to the presence of COPD (chi2 test p = 0.02, OR = 2.36, 95%CI = 1.12&ndash;4.97). Conclusions: Higher VEGF serum levels were found in moderate and severe COPD and were positively correlated with the distance in the 6MWT. No significant difference was found between CC, CT, and TT genotypes of rs3025039 and the presence of COPD. The presence of the T allele was found to be linked to COPD and also to the degree of airway obstruction