EFEITO DO PROGRAMA DE JOGGING SOBRE A GORDURA VISCERAL DO ALMAJIRAI EM TSANGAYA NA METRÓPOLE DE GUSAU, NIGÉRIA

This study therefore assessed the effect of jogging programme on visceral fat of Almajirai in Tsangaya in Gusau Metropolis, Nigeria. For the purpose of this study, a 1x2 x3 factorial research design was used. The population are Almajirai who are gardi in Gusau Metropolis within the ages of 13-15 years, stratified sampling and simple random sampling technique were used to select 48 Gardi Almajirai in Gusau metropolis who volunteered to participate in the study. Hand-held Bioelectrical Impedance Analysis device was used to assess visceral fat. All of these Girdi Almajirai were found to have met the inclusion criteria and were all assigned to the jogging programme and the baseline values were used as the control. All exercise sessions were preceded by 10 minutes warm-up; the programme lasted between 30 and 45 minutes, which ended with a cool down session. All exercise sessions were conducted between 5.30p.m - 6.00p.m on alternate days every Monday, Wednesday and Friday of the consecutive weeks. Training intensity was maintained between 50-65% of estimated HR max  for 4 weeks and which was increased progressively from 60-70% from the 5 to 8 weeks of training. The data collected were statistically analyzed using repeated measured ANOVA and scheffe post hoc test was used to locate where significant effect lies at level of 0.05. The result of the study revealed that jogging had significant effect on visceral fat p=0.001. It was recommended that Adolescent almajirai should participate every day in 45 minutes or more of moderate to vigorous physical activity that is enjoyable and developmentally appropriate.Este estudo avaliou, portanto, o efeito do programa de jogging na gordura visceral de Almajirai em Tsangaya, na Metrópole de Gusau, Nigéria. Para o propósito deste estudo, foi utilizado um projeto de pesquisa fatorial de 1x2 x3. A população é de Almajirai que é gardi na metrópole de Gusau dentro dos 13-15 anos de idade, amostragem estratificada e técnica simples de amostragem aleatória foram usadas para selecionar 48 Gardi Almajirai na metrópole de Gusau que se voluntariaram para participar do estudo. O dispositivo de Análise de Impedância Bioelétrica manual foi usado para avaliar a gordura visceral. Verificou-se que todas estas Girdi Almajirai cumpriram os critérios de inclusão e foram todas designadas para o programa de jogging e os valores de base foram usados como controle. Todas as sessões de exercício foram precedidas de 10 minutos de aquecimento; o programa durou entre 30 e 45 minutos, o que terminou com uma sessão de resfriamento. Todas as sessões de exercícios foram realizadas entre 17h30min e 18h00min em dias alternados, todas as segundas, quartas e sextas-feiras das semanas consecutivas. A intensidade de treinamento foi mantida entre 50-65% do RH máximo estimado por 4 semanas e que foi aumentado progressivamente de 60-70% das 5 a 8 semanas de treinamento. Os dados coletados foram analisados estatisticamente usando ANOVA medida repetidamente e o teste post-hoc de esquema foi usado para localizar onde o efeito significativo está no nível de 0,05. O resultado do estudo revelou que o jogging teve efeito significativo sobre a gordura visceral p=0,001. Foi recomendado que o adolescente almajirai participasse todos os dias em 45 minutos ou mais de atividade física moderada a vigorosa que seja agradável e apropriada para o desenvolvimento

Medial Open Reduction via Anteromedial Approach in Developmental Hip Dysplasia: Long-term Clinical and Radiological Outcomes

Aim:The anteromedial approach in medial open reduction techniques is rarely used to treat developmental dysplasia of the hip (DDH). The objective of this study was to present the clinical and radiological outcomes of DDH patients treated with the anteromedial approach.Methods:Fifty-nine hips of 52 patients aged between 6 and 18 months who underwent medial open reduction between 2009 and 2017 through an anteromedial approach and who had at least 5 years of follow-up were retrospectively evaluated. Results were reviewed in terms of avascular necrosis (AVN) rates and the need for further surgery.Results:At the last follow-up, the rate of clinically significant AVN was 11.9%. Additional corrective surgery was performed on 20.3% of the patients. According to the modified McKay classification, 91.5% of the patients had excellent results. Radiologically, 93.2% of the patients were classified as Severin type 1. The mean age at operation time and initial Tönnis type of patients were significantly higher in patients who required advanced corrective surgery than in those who did not (p=0.042 and p=0.018, respectively).Conclusion:The anteromedial approach is safe and practical for improving radiological outcomes and reducing the need for further surgery. Long-term studies focusing on the period after bone formation are required

Microstructure and Mechanical Properties of Borided Inconel 625 Superalloy

The Ni- based superalloy Inconel 625 is extensively used owing to its high strength, excellent fabricability,good weldability and outstanding resistance to high temperature corrosion against aggressive environments.However, despite its unique properties and extensive use, its wear resistance is in some cases unsatisfactory.In this study, Inconel 625 was subjected to boriding treatments at different temperature and differentdurations. Microstructural characterization was made by conventional methods (scanning electronmicroscopy, optic microscopy, X-ray diffraction analysis) and mechanical characterization was made bymicrohardness and micro-abrasion wear test. Micro-abrasion wear tests were conducted against a AISI 52100steel under 5, 7.5 and 10 N load in a 25 wt.% SiC slurry at room temperature. Microstructural resultsrevealed that multi-phase boride layer (nickel boride, chrome boride and iron boride) and silicide layer wereformed. The hardness and thickness of the boride layers were found to be 1175--2432 HV0.1 and, 6.61 -- 92.03μm, respectively. Depending on the boriding temperature and time. In spite of silicide layer formation thewear resistance of borided Inconel 625 alloy increased up to 8 times thanks to the increase in the surfacehardness which was caused by boriding process. The boriding treatment caused a transition in the wearmechanism. While grooving was observed in the untreated Inconel 625 samples, mixed (grooving androlling) and rolling type wear was predominant in the borided samples

Determination of Barreling of Aluminum Solid Cylinders During Cold Upsetting Using Genetic Algorithm

This study presents Genetic Programming models for the formulation of barreling of aluminum solid cylindersduring cold upsetting based on experimental results. The maximum and minimum radii of the barreledcylinders having different aspect ratio (d/h= 0.5, 1.0 and 2.0) were measured for various frictional conditions(m=0.1-0.4). The change in radii with respect to height reduction showed different trends before and afterfolding, therefore, the corresponding reduction ratios of folding were also determined by using incrementalupsetting. Genetic programming models were prepared using the experimental results with the input variablesof the aspect ratio, the friction coefficient, and the reduction in height. The minimum and maximum barrelingradii were formulated as output taking the folding into consideration. The performance of proposed GP modelsare quite satisfactory (R2 = 0.908-0.998).Keywords: Upset, forging, barreling, bulging, axisymmetric compression

Comprehensive Analysis of Prognostic Factors Affecting Postoperative Mortality in Adult Patients Undergoing Lower Extremity Amputation due to Diabetic Foot Ulcer

Aim:Mortality is significantly increased in patients undergoing amputation for diabetic foot ulcers (DFUs). The new biomarkers prognostic nutritional index (PNI), C-reactive protein (CRP)/albumin ratio, and comorbidities may help predict prognosis. This study aimed to determine the factors affecting mortality in DFU patients undergoing amputation.Methods:This study is a retrospective case series of patients who underwent lower extremity amputation due to DFU between 2016 and 2018. Data on demographics, clinical information, laboratory test results, comorbidities, hospital stays, re-amputations, and complications were recorded. PNI was calculated using serum albumin concentration and lymphocyte count.Results:A total of 97 patients (21 females and 76 males) were analyzed in the study, with 18 patients having bilateral lower extremity amputations (foot amputation, below-knee amputation, and above-knee amputation). The mean age was 64.48 years, and the mean follow-up period was 34.27 months. The mean length of hospital stay was 19.09 days, with a mean of 1.34 days spent in the intensive care unit. Preoperative laboratory test results showed a mean creatinine level of 1.4 mg/dL, a urea level of 55.22 mg/dL, an albumin level of 2.8 g/L, and a fasting blood glucose level of 168.8 mg/dL. The mean preoperative PNI was 39.31, and the mean CRP/albumin ratio was 42.51. Intensive care unit admission, CRP/albumin ratio, and CRP levels significantly affect 1-year postoperative mortality. The cut-off value for CRP as determined by receiver operating characteristic analysis was 89.9 mg/L. No significant association was found between comorbidities and mortality.Conclusion:We demonstrated that comorbidities and the new biomarker PNI did not affect mortality. CRP levels, intensive care unit admission, and the new predictor CRP/albumin ratio significantly affected 1-year mortality

Investigation of Adhesion and Tribological Behavior of Borided AISI 310 Stainless Steel

In the present study, the effects of the boriding process on adhesion and tribological properties of AISI 310 steel were investigated. Boriding was performed in a solid medium consisting of Ekabor-II powders at 1123 and 1323K for 2 and 6 h. The boride layer was characterized by optical microscopy, the X-ray diffraction technique and the micro-Vickers hardness tester. The X-ray diffraction analysis of the boride layers on the surface of the steels revealed the existence of FexBy, CrxBy and NixBy compounds. Depending on the chemical composition of substrates, the boride layer thickness on the surface of the AISI 310 steel was found to be 56.74 μm. The hardness of the boride compounds formed on the surface of the AISI 310 steel ranged from 1658 to 2284 HV0,1, whereas the Vickers hardness value of the untreated steel AISI 310 was 276 HV0,1. The wear tests were carried out in a ball-disc arrangement under a dry friction condition at room temperature with an applied load of 10N and with a sliding speed of 0.3 m/s, at a sliding distance of 1000m. The wear surfaces of the steel were analyzed using an SEM microscopy and X-ray energy dispersive spectroscopy EDS. It was observed that the wear rate of unborided and borided AISI 310 steel ranged from 4.57 to 71.42 mm3/Nm

Budesonide/formoterol as effective as prednisolone plus formoterol in acute exacerbations of COPD A double-blind, randomised, non-inferiority, parallel-group, multicentre study

<p>Abstract</p> <p>Background</p> <p>Oral corticosteroids and inhaled bronchodilators with or without antibiotics represent standard treatment of COPD exacerbations of moderate severity. Frequent courses of oral steroids may be a safety issue. We wanted to evaluate in an out-patient setting whether a 2-week course of inhaled budesonide/formoterol would be equally effective for treatment of acute COPD exacerbations as standard therapy in patients judged by the investigator not to require hospitalisation.</p> <p>Methods</p> <p>This was a double-blind, randomised, non-inferiority, parallel-group, multicentre study comparing two treatment strategies; two weeks' treatment with inhaled budesonide/formoterol (320/9 μg, qid) was compared with prednisolone (30 mg once daily) plus inhaled formoterol (9 μg bid) in patients with acute exacerbations of COPD attending a primary health care centre. Inclusion criteria were progressive dyspnoea for less than one week, FEV₁30–60% of predicted normal after acute treatment with a single dose of oral corticosteroid plus nebulised salbutamol/ipratropium bromide and no requirement for subsequent immediate hospitalisation, i.e the clinical status after the acute treatment allowed for sending the patient home.</p> <p>A total of 109 patients (mean age 67 years, 33 pack-years, mean FEV₁45% of predicted) were randomized to two weeks' double-blind treatment with budesonide/formoterol or prednisolone plus formoterol and subsequent open-label budesonide/formoterol (320/9 μg bid) for another 12 weeks. Change in FEV₁was the primary efficacy variable. Non-inferiority was predefined.</p> <p>Results</p> <p>Non-inferiority of budesonide/formoterol was proven because the lower limit of FEV₁-change (97.5% CI) was above 90% of the efficacy of the alternative treatment. Symptoms, quality of life, treatment failures, need for reliever medication (and exacerbations during follow-up) did not differ between the groups. No safety concerns were identified.</p> <p>Conclusion</p> <p>High dose budesonide/formoterol was as effective as prednisolone plus formoterol for the ambulatory treatment of acute exacerbations in non-hospitalized COPD patients. An early increase in budesonide/formoterol dose may therefore be tried before oral corticosteroids are used.</p> <p>Clinical trial registration</p> <p>NCT00259779</p

COPD exacerbations in general practice: variability in oral prednisolone courses

<p>Abstract</p> <p>Background</p> <p>The use of oral corticosteroids as treatment of COPD exacerbations in primary care is well established and evidence-based. However, the most appropriate dosage regimen has not been determined and remains controversial. Corticosteroid therapy is associated with a number of undesirable side effects, including hyperglycaemias, so differences in prescribing might be relevant. This study examines the differences between GPs in dosage and duration of prednisolone treatment in patients with a COPD exacerbation. It also investigates the number of general practitioners (GPs) who adjust their treatment according to the presence of diabetic co-morbidity.</p> <p>Methods</p> <p>Cross-sectional study among 219 GPs and 25 GPs in training, located in the Northern part of the Netherlands.</p> <p>Results</p> <p>The response rate was 69%. Nearly every GP prescribed a continuous dose of prednisolone 30 mg per day. Among GPs there were substantial differences in treatment duration. GPs prescribed courses of five, seven, ten, or fourteen days. A course of seven days was most common. The duration of treatment depended on exacerbation and disease severity. A course of five days was especially prescribed in case of a less severe exacerbation. In a more severe exacerbation duration of seven to fourteen days was more common. Hardly any GP adjusted treatment to the presence of diabetic co-morbidity.</p> <p>Conclusion</p> <p>Under normal conditions GPs prescribe prednisolone quite uniformly, within the range of the current Dutch guidelines. There is insufficient guidance regarding how to adjust corticosteroid treatment to exacerbation severity, disease severity and the presence of diabetic co-morbidity. Under these circumstances, there is a substantial variation in treatment duration.</p

The impact of care pathways for exacerbation of Chronic Obstructive Pulmonary Disease: rationale and design of a cluster randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Hospital treatment of chronic obstructive pulmonary disease (COPD) frequently does not follow published evidences. This lack of adherence can contribute to the high morbidity, mortality and readmissions rates. The European Quality of Care Pathway (EQCP) study on acute exacerbations of COPD (NTC00962468) is undertaken to determine how care pathways (CP) as complex intervention for hospital treatment of COPD affects care variability, adherence to evidence based key interventions and clinical outcomes.</p> <p>Methods</p> <p>An international cluster Randomized Controlled Trial (cRCT) will be performed in Belgium, Italy, Ireland and Portugal. Based on the power analysis, a sample of 40 hospital teams and 398 patients will be included in the study. In the control arm of the study, usual care will be provided. The experimental teams will implement a CP as complex intervention which will include three active components: a formative evaluation of the quality and organization of care, a set of evidence based key interventions, and support on the development and implementation of the CP. The main outcome will be six-month readmission rate. As a secondary endpoint a set of clinical outcome and performance indicators (including care process evaluation and team functioning indicators) will be measured in both groups.</p> <p>Discussion</p> <p>The EQCP study is the first international cRCT on care pathways. The design of the EQCP project is both a research study and a quality improvement project and will include a realistic evaluation framework including process analysis to further understand why and when CP can really work.</p> <p>Trial Registration number</p> <p><b>NCT00962468</b></p