Dynapenia, abdominal obesity or both: which accelerates the gait speed decline most?

OBJECTIVE: to investigate whether the combination of dynapenia and abdominal obesity is worse than these two conditions separately regarding gait speed decline over time. METHODS: a longitudinal study was conducted involving 2,294 individuals aged 60 years or older free of mobility limitation at baseline (gait speed >0.8 m/s) who participated in the English Longitudinal Study of Ageing. Dynapenia was determined as a grip strength 102 cm for men and >88 cm for women. The participants were divided into four groups: non-dynapenic/non-abdominal obese (ND/NAO); only abdominal obese (AO); only dynapenic (D) and dynapenic/abdominal obese (D/AO). Generalised linear mixed models were used to analyse gait speed decline (m/s) as a function of dynapenia and abdominal obesity status over an 8-year follow-up period. RESULTS: over time, only the D/AO individuals had a greater gait speed decline (-0.013 m/s per year, 95% CI: -0.024 to -0.002; P < 0.05) compared to ND/NAO individuals. Neither dynapenia nor abdominal obesity only was associated with gait speed decline. CONCLUSION: dynapenic abdominal obesity is associated with accelerated gait speed decline and is, therefore, an important modifiable condition that should be addressed in clinical practice through aerobic and strength training for the prevention of physical disability in older adults

Challenge for planning by using cluster methodology: the case study of the Algarve Region

This study analyses the most appropriate methodology to make similarity classifications among the cities of the Algarve (Portugal) according to 105 sustainability indicators monitored with the Observatory of Sustainability of the Algarve Region for Tourism (OBSERVE). The methodology used to establish the similarities was the cluster analysis with 4 different approaches which reduced the dimensions of the data set: total approach, pillar approach, subject area approach, and indicator approach. By combining the approaches, a total of 620 different cluster analyses were performed. There sults reflected that the data analysis approaches with less dimensions were those that performed the best groups among cities. In this sense, the approaches with a high number of indicators (e.g., the totalor the pillar approach) were characterised by misclassifying cities in more than 30% of the indicators.Thus, the most acceptable cluster analysis approach was that with a low number of indicators.Through this approach, it was possible to make correct groups of the sustainability level of the cities of the Algarve. These results provided an appropriate methodology for the decision-making regarding the sustainability of a region and could be extrapolated to other regions to assess sustainability or environmental indicator

Clinico-demographic characterization of Cutaneous leishmaniasis in patients reporting to two hospitals in Matara and Hambantota districts, Sri Lanka

Background: Cutaneous leishmaniasis (CL) is an established disease in Sri Lanka.Objectives: This study aimed to characterize clinico-demographic pattern of CL, in patients reported to District General Hospital (DGH) Matara and Base Hospital (BH) Tangalle, which report about 100 new cases monthly.Methods: Clinico-demographic findings of 47 CL confirmed patients (>18 years; Slit skin smears (SSS) and/or PCR positive) from preliminary data of a cross sectional study carried out at DGH Matara and BH Tangalle from August/2018 to January /2019 were analysed. Interviewer administered questionnaire was used to gather the demographic data.Results: Median age was 43 years. Out of the 13 cases from DGH Matara, four reported from Urugamuwa and one each from other areas of the district. Of the 34 cases from BHTangalle, 12 were from Beliaththa. Eight SSS negatives became PCR positive and one PCR negative was SSS positive. Majority of the lesions were single (n=40, 85.1%), non-tender (n=38, 80.8%), non-itchy (n=34, 72.3%) and small (< 2cm, n=36, 76.6%) ulcerated nodules (n=14, 29.8%) in upper limbs (n=25, 53.1%) with parasitic grading of 1+ (n=20, 42.5%). Nine patients reported persistent itching without any evidence of secondary pathology. Clinical evidence of secondary bacterial infection presented in four patients and out of them, two had painful lesions. Thirty two lesions were <4 months duration. In addition to ulcerated nodules and plaques, three out of nine papules were ulcerated within 4 months’ by history. Two patients had a family member with CL.Conclusions: Ulceration of papules is a novel observation. Urugamuwa is a possible emerging focus of CL in Matara where Dickwella is the known hot spot. Beliathta could be a main disease focus in Hambantota. This preliminary study based on a smaller sample size needs to be validated with a bigger sample size

Usefulness of information and communication technologies : portuguese nurses' look

Objective: to identify nurses’ perception on the usefulness of information and communication technologies in their professional practice, as well as in communication among the multidisciplinary team. Method: this is a quantitative, descriptive study, of exploratory character, carried through with 3.451 nurses from 36 hospital institutions of Portugal. A questionnaire was used as a data collection instrument. In data analysis, using SPSS® resorted to descriptive statistics. Results: of the nine technologies under study, we found that regarding their usefulness in professional practice, nurses qualified as useful or very useful: Intranet (84.3%), email (79.5%), SClínico® (74.8%), Nursing Practice Support System (70.9%), Physician Support System (63.2%), newsletter (62.9), ALERT® (59.4%), Health Data Platform (42.8%) and SONHO® (31.8). Regarding its usefulness in communication among the multidisciplinary team, nurses qualified as useful or very useful: email (75.2%), Intranet (74.2%), SClínico (72.5%), Nursing Practice Support System (67.1%), Physician Support System (63.6%), ALERT® (58.9%), newsletter (57.2), Health Data Platform (40.1%) and SONHO® (29.4%). Conclusion: despite the usefulness of technologies presenting relevant percentages, it is pertinent to analyze why nurses’ perceived usefulness is superior to Intranet and email when compared with specific technologies of care data used in the hospital context.Objetivo: identificar a percepção dos enfermeiros sobre a utilidade das tecnologias de informação e comunicação na sua prática profissional, bem como na comunicação entre a equipe multidisciplinar. Método: estudo quantitativo, descritivo, de caráter exploratório, realizado com 3.451 enfermeiros, de 36 instituições hospitalares de Portugal Continental. Como instrumento de coleta de dados foi utilizado um questionário. Na análise dos dados, utilizando o SPSS®, recorreu-se à estatística descritiva. Resultados: das nove tecnologias em estudo constata-se que relativamente à sua utilidade na prática profissional, os enfermeiros qualificaram como útil ou muito útil a Intranet (84,3%), o Correio Eletrônico (79,5%), o SClínico® (74,8), o Sistema de Apoio à Prática de Enfermagem (70,9%), o Sistema de Apoio ao Médico (63,2%), o Boletim informativo (62,9), o ALERT® (59,4%), a Plataforma de Dados da Saúde (42,8%) e o SONHO® (31,8). No que se refere à sua utilidade no âmbito da comunicação entre a equipe multidisciplinar, os enfermeiros qualificaram como útil ou muito útil o Correio Eletrônico (75,2%), a Intranet (74,2%), o SClínico (72,5%), o Sistema de Apoio à Prática de Enfermagem (67,1%), o Sistema de Apoio ao Médico (63,6%), o ALERT® (58,9%), o Boletim informativo (57,2), a Plataforma de Dados da Saúde (40,1%) e o SONHO® (29,4%). Conclusão: apesar da utilidade das tecnologias apresentar percentuais relevantes, torna-se pertinente analisar o motivo pelo qual a percepção de utilidade dos enfermeiros é superior para a Intranet e para o Correio Eletrônico quando comparados com as tecnologias específicas de dados assistenciais utilizadas no contexto hospitalar.Objetivo: identificar la percepción de los enfermeros sobre la utilidad de las tecnologías de la información y la comunicación en su práctica profesional, así como en la comunicación entre el equipo multidisciplinario. Método: estudio cuantitativo, descriptivo, exploratorio, realizado con 3.451 enfermeros, de 36 instituciones hospitalarias de Portugal. Como instrumento de recolección de datos se utilizó un cuestionario. En el análisis de datos, usando el SPSS®, fue utilizado estadística descriptiva. Resultados: de las nueve tecnologías estudiadas, encontramos que en relación a su utilidad en la práctica profesional, los enfermeros describieron la Intranet (84,3%), el correo electrónico (79,5%), el SClínico® (74,8%), el Sistema de Apoyo a la Práctica de Enfermería (70,9%), el Sistema de Apoyo al Médico (63,2%), el boletín informativo (62,9), el ALERT® (59,4%), el Plataforma de Datos de Salud (42,8%) y el SONHO® (31,8). En cuanto a su utilidad en el contexto de comunicación entre el equipo multidisciplinar, los enfermeros calificaron el correo electrónico (75,2%), la Intranet (74,2%), el SClínico® (72,5%), el Sistema de Apoyo a la Práctica de Enfermería (67,1%), el Sistema de Apoyo al Médico (63,6%), el ALERT® (58,9%), el boletín informativo (57,2%), la Plataforma de Datos de Salud (40,1%) y el SONHO® (29,4%). Conclusión: a pesar de la utilidad de las tecnologías para presentar porcentajes relevantes, es pertinente analizar la razón por la cual la percepción de utilidad de las enfermeras es superior para la Intranet y para el Correo Electrónico cuando se compara con las tecnologías específicas de datos asistenciales utilizadas en el contexto hospitalario.info:eu-repo/semantics/publishedVersio

The Effects of Dasatinib in Experimental Acute Respiratory Distress Syndrome Depend on Dose and Etiology

Background/Aims: Evidence suggests that tyrosine-kinase inhibitors may attenuate lung inflammation and fibrosis in experimental acute respiratory distress syndrome (ARDS). We hypothesized that dasatinib, a tyrosine-kinase inhibitor, might act differently depending on the ARDS etiology and the dose. Methods: C57/BL6 mice were divided to be pre-treated with dasatinib (1mg/kg or 10mg/kg) or vehicle (1% dimethyl-sulfoxide) by oral gavage. Thirty-minutes after pre-treatment, mice were subdivided into control (C) or ARDS groups. ARDS animals received Escherichia coli lipopolysaccharide intratracheally (ARDSp) or intraperitoneally (ARDSexp). A new dose of dasatinib or vehicle was administered at 6 and 24h. Results: Forty-eight hours after ARDS induction, dasatinib 1mg/kg yielded: improved lung morphofunction and reduced cells expressing toll-like receptor (TLR)-4 in lung, independent of ARDS etiology; reduced neutrophil and levels of interleukin (IL)-6, IL-10 and transforming growth factor (TGF)-β in ARDSp. The higher dose of dasatinib caused no changes in lung mechanics, diffuse alveolar damage, neutrophil, or cells expressing TLR4, but increased IL-6, vascular endothelial growth factor (VEGF), and cells expressing Fas receptor in lung in ARDSp. In ARDSexp, it improved lung morphofunction, increased VEGF, and reduced cells expressing TLR4. Conclusion: Dasatinib may have therapeutic potential in ARDS independent of etiology, but careful dose monitoring is required. © 2015 S. Karger AG, Basel

Protocol for a scoping review of skin self-care of people with spinal cord injury

In recent years, increasing methodological references have been used in scientific research; these are points of support in the search for evidence, formulation and elaboration of instruments, scales, guideline and protocols. However, significant variability currently exists in scoping review conduct and reporting, thus limiting the potential of the methodology to advance research and practice about skin self-care of people with spinal cord injury (SCI). Our objective was to perform a scoping review protocol within the health rehabilitation context of people with SCI, focusing on skin self-care.info:eu-repo/semantics/publishedVersio

Superpulsed low-level laser therapy protects skeletal muscle of mdx mice against damage, inflammation and morphological changes delaying dystrophy progression.

Aim: To evaluate the effects of preventive treatment with low-level laser therapy (LLLT) on progression of dystrophy in mdx mice. Methods: Ten animals were randomly divided into 2 experimental groups treated with superpulsed LLLT (904 nm, 15 mW, 700 Hz, 1 J) or placebo-LLLT at one point overlying the tibialis anterior muscle (bilaterally) 5 times per week for 14 weeks (from 6th to 20th week of age). Morphological changes, creatine kinase (CK) activity and mRNA gene expression were assessed in animals at 20th week of age. Results: Animals treated with LLLT showed very few morphological changes in skeletal muscle, with less atrophy and fibrosis than animals treated with placebo-LLLT. CK was significantly lower (p = 0.0203) in animals treated with LLLT (864.70 U.l−1, SEM 226.10) than placebo (1708.00 U.l−1, SEM 184.60). mRNA gene expression of inflammatory markers was significantly decreased by treatment with LLLT (p<0.05): TNF-α (placebo-control = 0.51 µg/µl [SEM 0.12], - LLLT = 0.048 µg/µl [SEM 0.01]), IL-1β (placebo-control = 2.292 µg/µl [SEM 0.74], - LLLT = 0.12 µg/µl [SEM 0.03]), IL-6 (placebo-control = 3.946 µg/µl [SEM 0.98], - LLLT = 0.854 µg/µl [SEM 0.33]), IL-10 (placebo-control = 1.116 µg/µl [SEM 0.22], - LLLT = 0.352 µg/µl [SEM 0.15]), and COX-2 (placebo-control = 4.984 µg/µl [SEM 1.18], LLLT = 1.470 µg/µl [SEM 0.73]). Conclusion: Irradiation of superpulsed LLLT on successive days five times per week for 14 weeks decreased morphological changes, skeletal muscle damage and inflammation in mdx mice. This indicates that LLLT has potential to decrease progression of Duchenne muscular dystrophy