Impact of footwear and foot deformities in patients with Parkinson?s disease: A case-series study

Background: Parkinson's disease (PD) is a common and complex neurological problem. Gait abnormalities are frequent in PD patients, and this increases the risk of falls. However, little is known about foot deformities and footwear in this vulnerable population. Here we investigate whether patients with PD use an appropriate shoe size and know if they have foot deformities or alterations. Methodology: A study of a series of observational descriptive cases in a convenience sample (n = 53 patients) diagnosed with Parkinson's disease. One trained investigator evaluated foot and ankle health. The footwear and foot measurements were obtained using a Brannock device. Results: The podiatric examination and footwear examination detected a high presence of podiatric pathologies and inappropriate footwear. This has a negative impact on the quality of life of these patients. Conclusions: This research detected an elevated number of people with foot deformities or alterations. Moreover, a high proportion of participants with PD wear inadequate footwear (in length, width, or both)

Species abundance distributions: moving beyond single prediction theories to integration within an ecological framework

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75247/1/j.1461-0248.2007.01094.x.pd

Effectiveness of: Vigna unguiculata seed extracts in preventing colorectal cancer

Colorectal cancer (CRC) is one of the most common types of cancer, especially in Western countries, and its incidence rate is increasing every year. In this study, for the first time Vigna unguiculata L. Walp. (cowpea) water boiled seed extracts were found to reduce the viability of different colorectal cancer (CRC) cell lines, such as E705, DiFi and SW480 and the proliferation of Caco-2 line too, without affecting CCD841 healthy cell line. Furthermore, the extracts showed the ability to reduce the level of Epidermal Growth Factor Receptor (EGFR) phosphorylation in E705, DiFi and SW480 cell lines and to lower the EC50 of a CRC common drug, cetuximab, on E705 and DiFi lines from 161.7 ng mL-1 to 0.06 ng mL-1 and from 49.5 ng mL-1 to 0.2 ng mL-1 respectively. The extract was characterized in its protein and metabolite profiles by tandem mass spectrometry and 1H-NMR analyses. A Bowman-Birk protease inhibitor was identified within the protein fraction and was supposed to be the main active component. These findings confirm the importance of a legume-based diet to prevent the outbreak of many CRC and to reduce the amount of drug administered during a therapeutic cycle

Valorizing coffee pulp by-products as anti-inflammatory ingredient of food supplements acting on IL-8 release

Coffee is the second traded food commodity in the world. Beyond roasted seeds, the most part of the original fruit -and in particular pulp- is discarded as waste, with severe environmental and economic consequences in many developing countries. Our research focused on developing an eco-friendly extraction protocol of phytocomplexes from coffee pulp and evaluating their bioactivity and beneficial effects to human health as food supplements. Antioxidant activity assays (Folin-Ciocalteu and DPPH assays) were adopted to select the most effective extraction technique and results show antioxidant activity of coffee pulp extracts. After analysis of cytotoxicity on human epithelial gastric cells, measurements of IL-8 release of treated or pre-treated cells were performed. Results showed that the use of soft technical equipment and sustainable solvents (i.e. maceration process, aqueous extraction) can extract phytocomplexes with antioxidant properties. Moreover, IL-8 measurements showed impairment of this chemokine release at concentrations that may be reached in vivo in the gastrointestinal tract, following consumption of reasonable amount of extract. Pre-treatments analysis demonstrated the ability of coffee pulp extracts to prevent IL-8 release by gastric epithelial cells. Chemical evaluation performed by liquid chromatography mass spectrometry showed that quinic acid derivatives are abundant in coffee pulp extract together with procyanidins derivatives: those compounds might be responsible for the high biological activity. This evidence supports future applications of coffee pulp extracts as food supplement with high added value, starting from a waste that can be valorized through simple yet efficient extraction methods

Evaluación del acceso a antivirales para el tratamiento de la hepatitis C en un país con recursos limitados

Resumen: Objetivos: Estimar la proporción de pacientes que acceden al tratamiento de la hepatitis C con antivirales de acción directa (AAD) en Argentina, y evaluar factores asociados a la falta de acceso. Métodos: Estudio de cohorte transversal que incluyó la totalidad de prescripciones consecutivas de AAD realizadas entre enero de 2016 y febrero de 2017 por centros de salud que participan en el proyecto de telemedicina ECHOTM dirigido por el Hospital Italiano de Buenos Aires. Resultados: Se incluyeron 143 prescripciones de tratamiento. El acceso global fue del 70% (IC 95%: 62-77%). Pertenecer al sistema de salud público fue el único factor independiente asociado con la falta de acceso al tratamiento [OR 4.98 (IC95% 2.05-12.09)]. Conclusión: Los pacientes con hepatitis C pertenecientes al sistema de salud público tienen 4 veces más chances de no acceder a tratamiento con AAD que los pacientes con dependencia de otros sistemas de salud (medicina privada u obras sociales). Abstract: Aims: To estimate the number of patients that have access to treatment of hepatitis C with direct-acting antivirals in Argentina and evaluate the factors associated with the lack of access. Materials and methods: A cross-sectional cohort study was conducted that included all the consecutive prescriptions of direct-acting antivirals issued at health centers that participated in the ECHOTM telemedicine project directed by the Hospital Italiano de Buenos Aires, within the time frame of January 2016 and February 2017. Results: A total of 143 treatment prescriptions were included and overall access was 70% (95% CI 62-77%). The only independent factor associated with a lack of treatment access was coverage by a public healthcare system (OR 4.98 [95% CI 2.05- 12.09]). Conclusion: Patients with hepatitis C that were covered by a public healthcare system had a 4 times higher chance of not having access to treatment with direct-acting antivirals than patients covered by other healthcare systems (private insurance or the social welfare system). Palabras clave: Antivirales de acción directa, Acceso, Hepatitis C, Sistemas de salud, Barreras, Keywords: Direct-acting antiviral agents, Access, Hepatitis C, Healthcare systems, Barrier

Access to direct-acting antivirals for the treatment of hepatitis C in a country with limited resources

Aims: To estimate the number of patients that have access to treatment of hepatitis C with direct-acting antivirals in Argentina and evaluate the factors associated with the lack of access. Materials and methods: A cross-sectional cohort study was conducted that included all the consecutive prescriptions of direct-acting antivirals issued at health centers that participated in the ECHOTM telemedicine project directed by the Hospital Italiano de Buenos Aires, within the time frame of January 2016 and February 2017. Results: A total of 143 treatment prescriptions were included and overall access was 70% (95% CI 62-77%). The only independent factor associated with a lack of treatment access was coverage by a public healthcare system (OR 4.98 [95% CI 2.05- 12.09]). Conclusions: Patients with hepatitis C that were covered by a public healthcare system had a 4 times higher chance of not having access to treatment with direct-acting antivirals than patients covered by other healthcare systems (private insurance or the social welfare system). Resumen: Objetivos: Estimar la proporción de pacientes que acceden al tratamiento de la hepatitis C con antivirales de acción directa (AAD) en Argentina, y evaluar factores asociados a la falta de acceso. Métodos: Estudio de cohorte transversal que incluyó la totalidad de prescripciones consecutivas de AAD realizadas entre enero de 2016 y febrero de 2017 por centros de salud que participan en el proyecto de telemedicina ECHOTM dirigido por el Hospital Italiano de Buenos Aires. Resultados: Se incluyeron 143 prescripciones de tratamiento. El acceso global fue del 70% (IC95%: 62-77%). Pertenecer al sistema de salud público fue el único factor independiente asociado con la falta de acceso al tratamiento [OR 4.98 (IC95% 2.05-12.09)]. Conclusión: Los pacientes con hepatitis C pertenecientes al sistema de salud público tienen 4 veces más chances de no acceder a tratamiento con AAD que los pacientes con dependencia de otros sistemas de salud (medicina privada u obras sociales). Keywords: Direct-acting antivirals, Access, Hepatitis C, Healthcare systems, Barriers, Palabras clave: Antivirales de acción directa, Acceso, Hepatitis C, Sistemas de salud, Barrera

Agentes Comunitários de Saúde: experiências e modelos do Brasil Community health agents: Brazilian experiences and models

O presente artigo é parte da tese de doutorado Perfil dos Agentes Comunitários de Saúde da Região de Juiz de Fora-MG e apresenta o perfil dos Agentes Comunitários de Saúde (ACS) sob a ótica das equipes de saúde da família, dos usuários e deles próprios. Discute os modelos e experiências sobre os ACS praticadas no Brasil antes da iniciativa do Ceará, na década de 80. Contextualiza os movimentos ocorridos para o sucesso da reforma dos ACS, que caracterizam um recurso humano central e estratégico para a implementação de ações de promoção da saúde, viabilizando o desenvolvimento de ações básicas voltadas para a comunidade. Demonstra que o agente comunitário de saúde constitui fator chave para viabilizar o apoio, a implementação e o desenvolvimento de ações básicas voltadas para a comunidade, de forma a expandi-las e a fortalecê-las em nível nacional, porém a promoção da saúde não concerne exclusivamente ao próprio setor e nem a um único profissional de saúde. Ela é resultado de ações intersetoriais, agindo nos determinantes gerais e da qualidade de vida.<br>This paper is part of the doctoral thesis Profile of Community Health Workers in the region of Juiz de Fora, MG, and presents a profile of Community Health Agents (CHA) from the perspective of family health teams, of users and themselves. It discusses the models and experiences on the CHA practiced in Brazil before the initiative of Ceará State, in the 1980's. It contextualizes the movements for the successful reform of the CHA, which characterize a central human resource and strategic for the implementation of health promotion actions, enabling the development of basic community-related actions. It shows that community health agents are a key factor to enable the support, implementation and development of basic community-related actions, to expand them and strengthen them nationwide, but health promotion concerns not only the sector itself nor a single health professional. It is the result of inter-sectoral actions acting in general and quality of life determinants

Participação política e cotidiano da gestão em saúde: um ensaio sobre a potencialidade formativa das relações institucionais Political participation and routine of health care management: an essay on the formative potentiality in institutional relations

Este ensaio pretende contribuir para o debate sobre a participação política na experiência do SUS no Brasil. Nele é problematizado o espaço que tem sido reservado para seu exercício efetivo, procurando refletir sobre a atuação dos diferentes sujeitos envolvidos com a produção de políticas de saúde. Parte-se da hipótese de que as instituições de saúde permanecem assentadas na objetivação da dimensão política inerente à vida humana, o que traz limites significativos para a concretização de um sistema de saúde fundado em valores democráticos e universais. O ensaio trabalha teoricamente as relações entre política, cotidiano e linguagem, a partir de conceitos de Hannah Arendt, Antonio Negri e do círculo de Bakhtin. Em seguida, é discutido o problema da cultura política que perpassa as instituições de saúde, considerando que o recurso a capacitações ou estratégias de representação de interesses não tem sido eficaz em solucioná-lo. Nesta perspectiva, são abordadas as potencialidades formativas das relações institucionais, utilizando como referência a Política de Educação Permanente. Como conclusão, o ensaio procura evidenciar que a articulação de novas configurações para a participação política nas instituições de saúde requer a discussão sobre o que seja e o que se deseja da ação de participar, sem o que dificilmente os espaços institucionalizados de participação deixarão de reproduzir as relações de força que os sujeitos historicamente vivenciam no cotidiano do sistema de saúde.<br>This essay aims to contribute to the debate on political participation in the experience of the Brazilian Unified Health System. It discusses the space reserved for its effective exercise, trying to reflect on the actions of different actors involved in the production of health policies. The analysis supports the hypothesis that health institutions remain attached in the objectification of the political dimension inherent to the human life, what derives in significant limits to the achievement of a health system based on democratic and universal values. The text theoretically articulates the relationship between politics, everyday life and language, using concepts of Hannah Arendt, Antonio Negri and Bakhtin's Circle. Then it discusses the problem of political culture present in health institutions, considering that the training focused on skills and the strategies of interest representation has not been effective in solving it. In this perspective, it analyzes the potential formation of institutional relationships, using as reference the Permanent Education Policy. In conclusion, the essay seeks to highlight that a new policy for participation in health system must discuss what is and what is expected from participation. Without this reflection, it will be very difficult for institutionalized spaces to reproduce the power relations which are historically experienced in daily health care system