Анализ отдаленных результатов санаторно-курортного лечения детей с реактивными артритами

На підставі вивчення віддалених результатів санаторно-курортного лікування з використанням клініко-лабораторних і функціональних параметрів 50 дітей з реактивними артритами встановлений сприятливий ефект в перебігу захворювання, що виявлялося відсутністю загострень, поліпшенням клінічної картини захворювання, зменшенням проявів суглобового синдрому, підвищенням функціональної активності нервово-м'язового апарату, поліпшенням показників якості життя.On the basis of study of remote results of resort medical treatment with the use of clinics,-laboratory and functional at 50 children with reactive arthritics a favorable effect in the flow of disease is set, that showed up absence of intensifications, improvement of clinical picture of disease, reduction of displays of joint syndrome, rise of functional activity of muscle vehicle, by the improvement of indexes of quality of life

Thyroid hormone metabolism and environmental chemical exposure

<p>Abstract</p> <p>Background</p> <p>Polychlorinated dioxins and –furans (PCDD/Fs) and polychlorinated-biphenyls (PCBs) are environmental toxicants that have been proven to influence thyroid metabolism both in animal studies and in human beings. In recent years polybrominated diphenyl ethers (PBDEs) also have been found to have a negative influence on thyroid hormone metabolism. The lower brominated flame retardants are now banned in the EU, however higher brominated decabromo-diphenyl ether (DBDE) and the brominated flame retardant hexabromocyclododecane (HBCD) are not yet banned. They too can negatively influence thyroid hormone metabolism. An additional brominated flame retardant that is still in use is tetrabromobisphenol-A (TBBPA), which has also been shown to influence thyroid hormone metabolism.</p> <p>Influences of brominated flame retardants, PCDD/F’s and dioxin like-PCBs (dl-PCB’s) on thyroid hormone metabolism in adolescence in the Netherlands will be presented in this study and determined if there are reasons for concern to human health for these toxins. In the period 1987-1991, a cohort of mother-baby pairs was formed in order to detect abnormalities in relation to dioxin levels in the perinatal period. The study demonstrated that PCDD/Fs were found around the time of birth, suggesting a modulation of the setpoint of thyroid hormone metabolism with a higher 3,3’, 5,5’tetrathyroxine (T4) levels and an increased thyroid stimulating hormone (TSH). While the same serum thyroid hormone tests (- TSH and T4) were again normal by 2 years of age and were still normal at 8-12 years, adolescence is a period with extra stress on thyroid hormone metabolism. Therefore we measured serum levels of TSH, T4, 3,3’,5- triiodothyronine (T3), free T4 (FT4), antibodies and thyroxine-binding globulin (TBG) in our adolescent cohort.</p> <p>Methods</p> <p>Vena puncture was performed to obtain samples for the measurement of thyroid hormone metabolism related parameters and the current serum dioxin (PCDD/Fs), PCB and PBDE levels.</p> <p>Results</p> <p>The current levels of T3 were positively correlated to BDE-99. A positive trend with FT4 and BDE-99 was also seen, while a positive correlation with T3 and dl-PCB was also seen. No correlation with TBG was seen for any of the contaminants. Neither the prenatal nor the current PCDD/F levels showed a relationship with the thyroid parameters in this relatively small group.</p> <p>Conclusion</p> <p>Once again the thyroid hormone metabolism (an increase in T3) seems to have been influenced by current background levels of common environmental contaminants: dl-PCBs and BDE-99. T3 is a product of target organs and abnormalities might indicate effects on hormone transporters and could cause pathology. While the influence on T3 levels may have been compensated, because the adolescents functioned normal at the time of the study period, it is questionable if this compensation is enough for all organs depending on thyroid hormones.</p

Accelerating the transformation of public health services to tackle NCDs

Noncommunicable Diseases (NCDs) are a major public health issue globally. This article identifies two priorities to support public health services in tackling NCDs. The first priority is to invest in strengthened health promotion and disease prevention systems through financing, improved professional education and clearer governance. The second priority is to promote proportionate universalism across public services, especially within universal health coverage. The implications of proportionate universalism for NCDs are significant, providing leapfrogging opportunities for Member States to accelerate population health and avoid a potential widening in inequity

The use of expert elicitation in environmental health impact assessment: a seven step procedure

<p>Abstract</p> <p>Background</p> <p>Environmental health impact assessments often have to deal with substantial uncertainties. Typically, the knowledge-base is limited with incomplete, or inconsistent evidence and missing or ambiguous data. Consulting experts can help to identify and address uncertainties.</p> <p>Methods</p> <p>Formal expert elicitation is a structured approach to systematically consult experts on uncertain issues. It is most often used to quantify ranges for poorly known parameters, but may also be useful to further develop qualitative issues such as definitions, assumptions or conceptual (causal) models. A thorough preparation and systematic design and execution of an expert elicitation process may increase the validity of its outcomes and transparency and trustworthiness of its conclusions. Various expert elicitation protocols and methods exist. However, these are often not universally applicable, and need customization to suite the needs of a specific study. In this paper, we set out to develop a widely applicable method for the use of expert elicitation in environmental health impact assessment.</p> <p>Results</p> <p>We present a practical yet flexible seven step procedure towards organising expert elicitation in the context of environmental health impact assessment, based on existing protocols. We describe how customization for specific applications is always necessary. In particular, three issues affect the choice of methods for a particular application: the types of uncertainties considered, the intended use of the elicited information, and the available resources. We outline how these three considerations guide choices regarding the design and execution of expert elicitation. We present signposts to sources where the issues are discussed in more depth to give the newcomer the insights needed to make the protocol work. The seven step procedure is illustrated using examples from earlier published elicitations in the field of environmental health research.</p> <p>Conclusions</p> <p>We conclude that, despite some known criticism on its validity, formal expert elicitation can support environmental health research in various ways. Its main purpose is to provide a temporary summary of the limited available knowledge, which can serve as a provisional basis for policy until further research has been carried out.</p