The nutritional status of continuous ambulatory peritoneal dialysis patients at a Johannesburg hospital

Objectives: To assess the nutritional status of continuous ambulatory peritoneal dialysis (CAPD) patients in our hospital using different assessment tools, and to assess the correlation between nutritional status and other parameters such as solute clearance. Method: A cross-sectional study was performed on end-stage renal disease patients treated with CAPD at Charlotte Maxeke Academic Hospital, Johannesburg, South Africa. The nutritional status of each patient was assessed using subjective global assessment (SGA), anthropometric parameters including body mass index (BMI), mid-upper arm circumference (MUAC), triceps skin fold (TSF), arm muscle area (AMA) and arm fat area (AFA), and biochemical parameters including serum albumin and total cholesterol levels. Dialysis adequacy was assessed by solute clearance measurement. Results: The mean age of the patients was 37.9 ± 13.4 years, 54% were males and 74 % were black. The mean BMI was 24.8 ± 3.5 kg/m2, mean MUAC was 28.5 ± 3.9 cm, mean TSF 85.6 ± 41.5 cm, mean serum albumin was 37.1 ± 7.6 mg/dl, while mean serum cholesterol was 5.32 ± 1.7 mmol/l. Based on SGA scores, 42% were well nourished, 50% moderately undernourished, while 8% were severely malnourished. We noted significant correlation between the SGA score and anthropometric parameters (BMI, MUAC) and there was no significant correlation between the nutritional parameters and the solute clearance. Conclusion: Malnutrition is common among CAPD patients in our centre, without a significant correlation between the nutritional status and the solute clearance. There is thus a need for ongoing nutritional assessment and support among these patients.Keywords: nutritional status, peritoneal dialysis patients, Johannesburg, Afric

Neonatal Acute Compartment Syndrome as First Manifestation of Hematologic Disease: Case Report

Hemophilia A, characterized by deficiency of functional plasma clotting factor VIII, is an X-linked disorder. Signs and symptoms depend on factor VIII levels. Severe hemophilia A (factor levels less than 1%) is usually diagnosed in the first two years of life. Pediatric compartment syndrome is most associated with trauma, but infectious and vascular causes must also be considered. We report a case of a newborn who presented with a severe hand hematoma after venous puncture, complicated by compartment syndrome. An isolated prolonged partial thromboplastin time was found, and hemophilia was suspected. Factor VIII levels less than 1% were consistent with severe hemophilia A. The patient received recombinant factor VIII perioperatively. Fasciotomy was performed and the patient was kept on antibiotics until closure.info:eu-repo/semantics/publishedVersio

Persistence of Left Superior Vena Cava Associated to Esophageal Atresia: Presentation of 5 Cases

Objectivos: A atresia do esófago está associada a uma variedade de malformações congénitas de outros órgãos. A persistência da veia cava superior esquerda e uma das malformações venosas torácicas mais comuns, ocorrendo em 0,3% da população. O objectivo deste estudo é caracterizar a persistência da veia cava superior esquerda nos doentes com atresia do esófago tratados no Hospital Dona Estefânia. Métodos: Estudo retrospectivo dos doentes admitidos por atresia do esófago desde Janeiro 2002 a Dezembro 2013. As seguintes variáveis foram estudadas, considerando, idade gestacional, o peso à nascença, o sexo, tipo de atresia do esófago, ecocardiograma no pré-operatório, malformações associadas, abordagem cirúrgica, eventual ecocardiograma no pós-operatório e angioressonância. Resultados: De um total de 107 doentes, em cinco casos foi diagnosticada persistência da veia cava superior esquerda. Destes, apenas um tinha diagnostico pré-natal. A restante investigação revelou um doente com atresia duodenal e outro com malformação do aparelho urinário, coloboma e malformação bilateral dos pavilhões auriculares. Todos os cinco doentes foram submetidos a toracotomia, esofagoesofagostomia primária após laqueação da fístula traqueo-esofágica e angio-ressonância para caracterizar a malformação vascular. Não houve registo de complicações, quer intra-operatórias quer pós-operatórias. Conclusão: Apesar do estudo pré-operatório, apenas se diagnosticou persistência da veia cava superior esquerda num dos doentes. O diagnóstico é geralmente feito de forma incidental durante a colocação rotineira de catéteres venosos centrais à esquerda. É importante identificar estes doentes e caracterizar o seu padrão de retorno venoso cardíaco, pelo risco de complicações embó1icas paradoxais para o sistema arterial

Combining Cognitive Screening Tests for the Evaluation of Mild Cognitive Impairment in the Elderly

OBJECTIVE: To determine the accuracy of the Mini-Mental State Examination combined with the Verbal Fluency Test and Clock Drawing Test for the identification of patients with mild cognitive impairment and Alzheimer's disease (AD). METHOD: These tests were used to evaluate cognitive function in 247 older adults. Subjects were divided into three groups according to their cognitive state: mild cognitive impairment (n=83), AD (n=81), cognitively unimpaired controls (n=83), based on clinical and neuropsychological data. The diagnostic accuracy of each test for discriminating between these diagnostic groups (mild cognitive impairment or AD vs. controls) was examined with the aid of Receiver Operating Characteristic (ROC) curves. Additionally, we evaluated the benefit of the combination of tests on diagnostic accuracy. RESULTS: Although they were accurate enough for the identification of Alzheimer's disease, neither test alone proved adequate for the correct separation of patients with mild cognitive impairment from healthy subjects. Combining these tests did not improve diagnostic accuracy, as compared to the Mini-Mental State Examination alone, in the identification of patients with mild cognitive impairment or Alzheimer's disease. CONCLUSIONS: The present data do not warrant the combined use of the Mini-Mental State Examination, the Verbal Fluency Test and the Clock Drawing Test as a sufficient diagnostic schedule in screening for mild cognitive impairment. The present data do not support the notion that the combination of test scores is better that the use of Mini-Mental State Examination scores alone in the screening for Alzheimer's disease

APPLICATION OF BIOMECHANICAL CONCEPTS IN PROFESSIONAL LIFE OF PHYSICAL EDUCATION TEACHER

The aim of this study was to determine which biomechanical concepts the physical education teachers apply in their professional life and whether there are differences between those who work in training field or at school. For this purpose a questionnaire was answered by 32 teachers. It was found that in the two areas more than half of the subjects said that apply the concepts, respectively 81% and 69%. The used concepts in training was levers (n=9) and motion analysis (n=8) and at school analysis of movement (n=8). The Physical Education professionals do not recognize the substance content of biomechanics, because movement analysis is an elementary part of biomechanics qualitatively and quantitatively. We conclude that Biomechanics’ teachers in the University should readjust the content of the discipline to fit the needs of the professional

Grass and Olea Airborne Pollen Allergens in Outdoor Air Samples and its Correlation with Pollen Counts

RATIONALE: In Portugal, grass and Olea europaea pollen are certainly one of the main sources of athmospheric aeroallergens and as such, one of the main causes of respiratory allergy. For these reasons, it is useful the development of new strategies for prevention and treatment of these pathologies. The aim of this study was to evaluate the putative correlation between the concentration of some of the major allergens of and with their pollen counts. METHODS: On a meteorological platform at the town center of Evora (south Portugal), ambient air was sampled at 800L/min with a Chemvol high-volume cascade impactor equipped with stages PM>10μm, 10 μm>PM>2.5μm. The polyurethane impacting substrate was extracted with 0.1M NH4HCO3, pH8.1, supplemented with 0.1% BSA. The major pollen allergens from grass Phleum p 5 and olive Ole e 1 were determined with allergen specific ELISA's. Airborne pollen of and Olea europaea simultaneously monitored with a Burkard Seven Day Recording Volumetric Spore TrapÒ, between the 30th of April and the 8th of July of 2009. Both samplers were placed side-by-side with air input at the same level. RESULTS: During the pollen season of 2009, high values of grass pollen were recorded between May 2th and June 1 th. It was also observed that the air content of Phl p5 or Ole e1 aeroallergens were directly correlated with airborne pollen counts of Poaceae and Oleaceae, respectively. CONCLUSIONS: Results suggest that the directly quantification of aeroallergens may contribute, together with pollen counts of air samples, to define the allergic risk with higher precision

Retail crowding: meta-analysis of contextual and cultural moderators

De Oliveira Santini, F., Ladeira, W. J., Pinto, D. C., Herter, M. M., Mattila, A. S., & Perin, M. G. (2022). Retail crowding: meta-analysis of contextual and cultural moderators. Marketing Intelligence and Planning, 40(1), 57-71. https://doi.org/10.1108/MIP-03-2021-0076Purpose – Although academics and retail managers share a common belief that crowded stores generate more sales, there is a growing concern about the negative impact of retail crowding on customer relationship management (CRM). This research aims to understand the underlying processes driving the effect, and it explores potential moderators that may mitigate the negative effects on consumer satisfaction. Design/methodology/approach – This research employs a meta-analysis on retail crowding effects and potential moderators. Findings – The integrative model of retail crowding reveals that social needs, crowd similarity, crowd expectation and uncertainty avoidance mitigate the negative retail crowding effects on satisfaction. Research limitations/implications – The authors advance the retailing literature by synthesizing recent studies on retail crowding. The findings also provide a clearer understanding of the mediating role of negative emotions in the relationship between retail crowding and satisfaction. Practical implications – This research offers guidance for retail managers on how to mitigate the harmful effects of crowding on customer satisfaction. Originality/value – This research contributes to the retailing literature and offers guidance for retailers on how to mitigate the harmful effects of crowding on customer satisfaction. Our moderation analyses provide insights into how and when crowding drives consumer satisfaction.authorsversionpublishe

Sugarcane bagasse delignification with potassium hydroxide for enhanced enzymatic hydrolysis

The optimization of an alkaline pretreatment process for the delignification of sugarcane bagasse (SCB) to enhance the subsequent enzymatic hydrolysis was performed according to the Doehlert uniform shell design. In this experimental design, the effect of two factors—potassium hydroxide (KOH) concentration and autoclaving time at 121 C (1 atm)—on cellulose, hemicellulose, or the total polysaccharide and lignin content in SCB was evaluated. This response surface methodology revealed that KOH concentration is the factor that most influences the chemical characteristics of treated SCB (SCBt), with optimal conditions for the highest delignification being KOH in the range 5–10% (w/v) and an autoclaving time of 35 min, which provides an average of 97% total polysaccharides without inhibitor accumulation (furfural, 5-hydroxymethyl furfural) and #5% lignin. SCBt samples from two pretreatment conditions (KOH 3.25% – 13 min; KOH 10% – 35 min) were selected, based on the greatest delignification (70–74%) and polysaccharide availability (95–97%) after pretreatment, and further hydrolysed for fermentable sugar production. High sugar yields were obtained from both the pretreated samples (866 to 880 mg sugar per g biomass, respectively) in contrast with the 129 mg sugar per g raw biomass obtained from untreated SCB. These results demonstrate the effectiveness of KOH alkali pretreatments, which improves the overall digestibility of raw SCB polysaccharides from about 18% up to 91%. However, harsh alkali treatment (KOH 10%) is the most effective if the highest glucose/xylose ratio in the final sugar-rich hydrolysate is the aim. Hence, the use of sugar-rich hydrolysates obtained from SCBt as the carbon source for industrial purposes may provide a sustainable and economic solution for the production of bio-based added-value products, such as second generation (2G) bioethanol