5 research outputs found
Συστηματική ανασκόπηση της υγειονομικής περίθαλψης των αστέγων στις Ηνωμένες Πολιτείες
Οι Ηνωμένες Πολιτείες μαστίζονται από τεράστιο αριθμό αστέγων με κύριο πρόβλημα την έλλειψη στέγης και την παροχή υγειονομικής περίθαλψης. Συνέπειες της κακής υγιεινής των αστέγων αποτελούν σε ένα πρώτο στάδιο η ακραία φτώχεια, το σκληρό περιβάλλον διαβίωσης καθώς και το τραύμα. Η πρώτη εμφάνιση του φαινομένου της αστεγίας και οι γενιές που ακολούθησαν αποτυπώνονται στην συγκεκριμένη εργασία. Επιπλέον προσπαθεί να εξετάσει πως με την πάροδο του χρόνου οι Ηνωμένες Πολιτείες εφάρμοσαν στρατηγικές και προγράμματα για την αντιμετώπιση και βελτίωση του φαινομένου της αστεγίας, αν και κατά πόσο η ιατρική από την πλευρά της πρόσφερε σε αυτό το εγχείρημα μέσω της παροχής βοήθειας εκεί που υπήρχε η ανάγκη, στο δρόμο. Η παροχή φροντίδας και η σύνδεση αυτών των ατόμων με ολοκληρωμένη πρωτοβάθμια φροντίδα μέσω καταφυγίων και ξενώνων αποτελεί κορμό για την μελέτη του φαινομένου που ερευνούμε. Οι άστεγοι είναι κομμάτι της κοινωνίας και όχι οι κάτοικοι μιας αόρατης πόλης που εκεί βρίσκουν καταφύγιο.The United States is plagued by a huge number of homeless people with the main problem being lack of housing and healthcare. Consequences of poor hygiene of homeless people are in a first stage extreme poverty, harsh living environment as well as trauma. The first appearance of the phenomenon of homelessness and the generations that followed are reflected in this paper. Furthermore, it attempts to examine how over time the United States has implemented strategies and programs to address and improve the phenomenon of homelessness, and whether and to what extent medicine on its part has contributed to this endeavor by providing assistance where the need was there, on the street. The provision of care and linking these individuals to integrated primary care through shelters and hostels is the backbone for the study of the phenomenon we are investigating. The homeless are part of society, not the inhabitants of an invisible city where they find shelter
Cabbage and fermented vegetables : From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19
Large differences in COVID-19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS-CoV-2 binds to its receptor, the angiotensin-converting enzyme 2 (ACE2). As a result of SARS-CoV-2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT(1)R) axis associated with oxidative stress. This leads to insulin resistance as well as lung and endothelial damage, two severe outcomes of COVID-19. The nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is the most potent antioxidant in humans and can block in particular the AT(1)R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are: kimchi in Korea, westernized foods, and the slum paradox. It is proposed that fermented cabbage is a proof-of-concept of dietary manipulations that may enhance Nrf2-associated antioxidant effects, helpful in mitigating COVID-19 severity.Peer reviewe
Nrf2-interacting nutrients and COVID-19 : time for research to develop adaptation strategies
There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPAR gamma:Peroxisome proliferator-activated receptor, NF kappa B: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2 alpha:Elongation initiation factor 2 alpha). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT(1)R axis (AT(1)R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity