37 research outputs found

    Buccal alterations in diabetes mellitus

    Get PDF
    Long standing hyperglycaemia besides damaging the kidneys, eyes, nerves, blood vessels, heart, can also impair the function of the salivary glands leading to a reduction in the salivary flow. When salivary flow decreases, as a consequence of an acute hyperglycaemia, many buccal or oral alterations can occur such as: a) increased concentration of mucin and glucose; b) impaired production and/or action of many antimicrobial factors; c) absence of a metalloprotein called gustin, that contains zinc and is responsible for the constant maturation of taste papillae; d) bad taste; e) oral candidiasis f) increased cells exfoliation after contact, because of poor lubrication; g) increased proliferation of pathogenic microorganisms; h) coated tongue; i) halitosis; and many others may occur as a consequence of chronic hyperglycaemia: a) tongue alterations, generally a burning mouth; b) periodontal disease; c) white spots due to demineralization in the teeth; d) caries; e) delayed healing of wounds; f) greater tendency to infections; g) lichen planus; h) mucosa ulcerations. Buccal alterations found in diabetic patients, although not specific of this disease, have its incidence and progression increased when an inadequate glycaemic control is present

    What "best practice" could be in Palliative Care: an analysis of statements on practice and ethics expressed by the main Health Organizations

    Get PDF
    <p>Abstract</p> <p>Background</p> <p>In palliative care it would be necessary to refer to a model. Nevertheless it seems that there are no official statements which state and describe that model. We carried out an analysis of the statements on practice and ethics of palliative care expressed by the main health organizations to show which dimensions of end-of-life care are taken into consideration.</p> <p>Methods</p> <p>The official documents by the most representative health organisations committed to the definition of policies and guidelines for palliative and end-of-life care had been considered. The documents were analysed through a framework of the components of end-of-life care derived from literature, which was composed of 4 main "areas" and of 12 "sub-areas".</p> <p>Results</p> <p>Overall, 34 organizations were identified, 7 international organisations, and 27 organisations operating on the national level in four different countries (Australia, Canada, UK and United States). Up to 56 documents were selected and analysed. Most of them (38) are position statements. Relevant quotations from the documents were presented by "areas" and "sub-areas". In general, the "sub-areas" of symptoms control as well as those referring to relational and social issues are more widely covered by the documents than the "sub-areas" related to "preparation" and to "existential condition". Indeed, the consistency of end-of-life choices with the patient's wishes, as well as completion and meaningfulness at the end of life is given only a minor relevance.</p> <p>Conclusions</p> <p>An integrated model of the best palliative care practice is generally lacking in the documents. It might be argued that the lack of a fixed and coherent model is due to the relevance of unavoidable context issues in palliative care, such as specific cultural settings, patient-centred variables, and family specificity. The implication is that palliative care staff have continuously to adapt their model of caring to the specific needs and values of each patient, more than applying a fixed, although maybe comprehensive, care model.</p

    Engaging community pharmacists in the primary prevention of cardiovascular disease: protocol for the Pharmacist Assessment of Adherence, Risk and Treatment in Cardiovascular Disease (PAART CVD) pilot study

    Get PDF
    Background: Cardiovascular disease (CVD) is the leading cause of death globally. Community pharmacist intervention studies have demonstrated clinical effectiveness for improving several leading individual CVD risk factors. Primary prevention strategies increasingly emphasise the need for consideration of overall cardiovascular risk and concurrent management of multiple risk factors. It is therefore important to demonstrate the feasibility of multiple risk factor management by community pharmacists to ensure continued currency of their role.Methods/Design: This study will be a longitudinal pre- and post-test pilot study with a single cohort of up to 100 patients in ten pharmacies. Patients aged 50-74 years with no history of heart disease or diabetes, and taking antihypertensive or lipid-lowering medicines, will be approached for participation. Assessment of cardiovascular risk, medicines use and health behaviours will be undertaken by a research assistant at baseline and following the intervention (6 months). Validated interview scales will be used where available. Baseline data will be used by accredited medicines management pharmacists to generate a report for the treating community pharmacist. This report will highlight individual patients&rsquo; overall CVD risk and individual risk factors, as well as identifying modifiablehealth behaviours for risk improvement and suggesting treatment and behavioural goals. The treating community pharmacist will use this information to finalise and implement a treatment plan in conjunction with the patient and their doctor. Community pharmacists will facilitate patient improvements in lifestyle, medicines adherence, and medicines management over the course of five counselling sessions with monthly intervals. The primary outcome will be the change to average overall cardiovascular risk, assessed using the Framingham risk equation.Discussion: This study will assess the feasibility of implementing holistic primary CVD prevention programs into community pharmacy, one of the most accessible health services in most developed countries.<br /

    Grand challenges in entomology: Priorities for action in the coming decades

    Get PDF
    Entomology is key to understanding terrestrial and freshwater ecosystems at a time of unprecedented anthropogenic environmental change and offers substantial untapped potential to benefit humanity in a variety of ways, from improving agricultural practices to managing vector-borne diseases and inspiring technological advances. We identified high priority challenges for entomology using an inclusive, open, and democratic four-stage prioritisation approach, conducted among the membership and affiliates (hereafter ‘members’) of the UK-based Royal Entomological Society (RES). A list of 710 challenges was gathered from 189 RES members. Thematic analysis was used to group suggestions, followed by an online vote to determine initial priorities, which were subsequently ranked during an online workshop involving 37 participants. The outcome was a set of 61 priority challenges within four groupings of related themes: (i) ‘Fundamental Research’ (themes: Taxonomy, ‘Blue Skies’ [defined as research ideas without immediate practical application], Methods and Techniques); (ii) ‘Anthropogenic Impacts and Conservation’ (themes: Anthropogenic Impacts, Conservation Options); (iii) ‘Uses, Ecosystem Services and Disservices’ (themes: Ecosystem Benefits, Technology and Resources [use of insects as a resource, or as inspiration], Pests); (iv) ‘Collaboration, Engagement and Training’ (themes: Knowledge Access, Training and Collaboration, Societal Engagement). Priority challenges encompass research questions, funding objectives, new technologies, and priorities for outreach and engagement. Examples include training taxonomists, establishing a global network of insect monitoring sites, understanding the extent of insect declines, exploring roles of cultivated insects in food supply chains, and connecting professional with amateur entomologists. Responses to different challenges could be led by amateur and professional entomologists, at all career stages. Overall, the challenges provide a diverse array of options to inspire and initiate entomological activities and reveal the potential of entomology to contribute to addressing global challenges related to human health and well-being, and environmental change

    Grand challenges in entomology: priorities for action in the coming decades

    Get PDF
    1. Entomology is key to understanding terrestrial and freshwater ecosystems at a time of unprecedented anthropogenic environmental change and offers substantial untapped potential to benefit humanity in a variety of ways, from improving agricultural practices to managing vector-borne diseases and inspiring technological advances. 2. We identified high priority challenges for entomology using an inclusive, open, and democratic four-stage prioritisation approach, conducted among the membership and affiliates (hereafter ‘members’) of the UK-based Royal Entomological Society (RES). 3. A list of 710 challenges was gathered from 189 RES members. Thematic analysis was used to group suggestions, followed by an online vote to determine initial priorities, which were subsequently ranked during an online workshop involving 37 participants. 4. The outcome was a set of 61 priority challenges within four groupings of related themes: (i) ‘Fundamental Research’ (themes: Taxonomy, ‘Blue Skies’ [defined as research ideas without immediate practical application], Methods and Techniques); (ii) ‘Anthropogenic Impacts and Conservation’ (themes: Anthropogenic Impacts, Conservation Options); (iii) ‘Uses, Ecosystem Services and Disservices’ (themes: Ecosystem Benefits, Technology and Resources [use of insects as a resource, or as inspiration], Pests); (iv) ‘Collaboration, Engagement and Training’ (themes: Knowledge Access, Training and Collaboration, Societal Engagement). 5. Priority challenges encompass research questions, funding objectives, new technologies, and priorities for outreach and engagement. Examples include training taxonomists, establishing a global network of insect monitoring sites, understanding the extent of insect declines, exploring roles of cultivated insects in food supply chains, and connecting professional with amateur entomologists. Responses to different challenges could be led by amateur and professional entomologists, at all career stages. 6. Overall, the challenges provide a diverse array of options to inspire and initiate entomological activities and reveal the potential of entomology to contribute to addressing global challenges related to human health and well-being, and environmental change

    Management of reproduction: indications of gonadotropin use and possible side effects of repeated administration : a review

    Full text link
    Gonadotropins of pituitary origin (follitropin -FSH-, lutropin -LH-, human menopausal gonadotropin -hMG) or trophoblastic origin (human chorionic gonadotropin - hCG- also called pregnant urine gonadotropin -pU-, equine chorionic gonadotropin -eCG- also called pregnant mare serum gonadotropin -PMSG-) are largely used to treat infertility or to better control sexuality in various species of mammals: bovine, canine, caprine, equine, feline, human,ovine, porcine, rabbit, ... This manuscript reports the discovery of these molecules, describes their biochemical characteristics and gives the main indications (e.g. oestrus induction and synchronization, ovulation, superovulation, fertility improvement, anoestrus treatment, receptivity induction) in animals and human. Litterature data reporting on effects and possible side effects of their repeated use are presented. Due to slight differences in amino acids sequences, carbohydrates contents and tridimentionnal structures, repeated use of exogeneous gonadotropins may induce immunological reactions leading to non specific reactions and lower biological response. A reflection concludes this revue, pointing out the positive influence of the philogenetic distance existing between the species origin of the gonadotropin (human or equine) and the treated one, on the intensity of the immune reaction.Les gonadotropines pituitaires (follitropine -FSH-; lutropine -LH-; human Menopausal Gonadotropin -hMG-) et placentaires (human Chorionic Gonadotropin -hCG- encore appelée pregnant Urine gonadotropin -pU-; taquine Chorionic Gonadotropin -eCG- encore appelée Pregnant Mare Serum Gonadotropin -PMSG-) sont couramment utilisées dans le traitement de l'infertilité ou dans la maîtrise de la sexualité chez les mammifères des espèces bovine, canine, caprine, cunicole, équine, féline, ovine, porcine et humaine... Cet article décrit leurs utilisations principales (induction et synchronisation de l'oestrus, induction de l'ovulation, superovulation, augmentation de la fertilité, traitement de certaines formes d'anoestrus, induction de la réceptivité), éclairées d'une relation historique de leur découverte (gonadotropines chorioniques équine et humaine) et de la description de leurs principales propriétés biochimiques. La description de la production d'anticorps anti-gonadotropines chez les dif¬férentes espèces soumises à des expositions répétées à ces molécules exogènes est éclairée par une approche biochimique de leurs structures respectives, mettant en évidence le haut pourcentage d'homologie des séquences d'acides-aminés les composant (conservation de séquences types au cours de l'évolution). Ainsi, les séquences en acides-aminés des différentes gonadotropines (dans un même espèce et entre espèces) sont suffisamment conservées que pour que l'hormone induise une réponse chez un animal traité, mais sont en même temps suffisamment différentes que pour provoquer une réaction immune chez l'animal d'une espèce plus éloignée qui y serait répetitivement exposé. Un bref rappel de notions d'immunologie de base permet au lecteur de recentrer ses connaissances sur les principaux mécanismes physiologiques impliqués dans la pathogénie d'une réaction anaphylactique ou d'immunorésistance. Enfin, une réflexion soulignant l'influence de la distance phylogénétique entre l'espèce source (humaine ou équine) et l'espèce traitée sur l'intensité de la réaction immunitaire termine la revue; elle pourra orienter les praticiens vers une utilisation plus raisonnée des gonadotropine
    corecore