Costs Associated with Low Birth Weight in a Rural Area of Southern Mozambique

BACKGROUND: Low Birth Weight (LBW) is prevalent in low-income countries. Even though the economic evaluation of interventions to reduce this burden is essential to guide health policies, data on costs associated with LBW are scarce. This study aims to estimate the costs to the health system and to the household and the Disability Adjusted Life Years (DALYs) arising from infant deaths associated with LBW in Southern Mozambique. METHODS AND FINDINGS: Costs incurred by the households were collected through exit surveys. Health system costs were gathered from data obtained onsite and from published information. DALYs due to death of LBW babies were based on local estimates of prevalence of LBW (12%), very low birth weight (VLBW) (1%) and of case fatality rates compared to non-LBW weight babies [for LBW (12%) and VLBW (80%)]. Costs associated with LBW excess morbidity were calculated on the incremental number of hospital admissions in LBW babies compared to non-LBW weight babies. Direct and indirect household costs for routine health care were 24.12 US$(CI 95$ (CI 95% 6.33; 10.72). Of the 3,322 live births that occurred in one year in the study area, health system costs associated to LBW (routine health care and excess morbidity) and DALYs were 169,957.61 US$ (CI 95% 144,900.00; 195,500.00) and 2,746.06, respectively. CONCLUSIONS: This first cost evaluation of LBW in a low-income country shows that reducing the prevalence of LBW would translate into important cost savings to the health system and the household. These results are of relevance for similar settings and should serve to promote interventions aimed at improving maternal care

Bacterial community development in experimental gingivitis.

Current knowledge of the microbial composition of dental plaque in early gingivitis is based largely on microscopy and cultural methods, which do not provide a comprehensive description of oral microbial communities. This study used 454-pyrosequencing of the V1-V3 region of 16S rRNA genes (approximately 500 bp), and bacterial culture, to characterize the composition of plaque during the transition from periodontal health to gingivitis. A total of 20 healthy volunteers abstained from oral hygiene for two weeks, allowing plaque to accumulate and gingivitis to develop. Plaque samples were analyzed at baseline, and after one and two weeks. In addition, plaque samples from 20 chronic periodontitis patients were analyzed for cross-sectional comparison to the experimental gingivitis cohort. All of the healthy volunteers developed gingivitis after two weeks. Pyrosequencing yielded a final total of 344,267 sequences after filtering, with a mean length of 354 bases, that were clustered into an average of 299 species-level Operational Taxonomic Units (OTUs) per sample. Principal coordinates analysis (PCoA) plots revealed significant shifts in the bacterial community structure of plaque as gingivitis was induced, and community diversity increased significantly after two weeks. Changes in the relative abundance of OTUs during the transition from health to gingivitis were correlated to bleeding on probing (BoP) scores and resulted in the identification of new health- and gingivitis-associated taxa. Comparison of the healthy volunteers to the periodontitis patients also confirmed the association of a number of putative periodontal pathogens with chronic periodontitis. Taxa associated with gingivitis included Fusobacterium nucleatum subsp. polymorphum, Lachnospiraceae [G-2] sp. HOT100, Lautropia sp. HOTA94, and Prevotella oulorum, whilst Rothia dentocariosa was associated with periodontal health. Further study of these taxa is warranted and may lead to new therapeutic approaches to prevent periodontal disease.BBSRC Industrial Case Studentship ref no. BB/G01714X/1 in collaboration with GlaxoSmithKline

Ecological phytochemistry of Cerrado (Brazilian savanna) plants

The Cerrado (the Brazilian savanna) is one of the vegetation formations of great biodiversity in Brazil and it has experienced strong deforestation and fragmentation. The Cerrado must contain at least 12,000 higher plant species.We discuss the ecological relevance of phytochemical studies carried out on plants from the Cerrado, including examples of phytotoxicity, antifungal, insecticidal and antibacterial activities. The results have been classified according to activity and plant family. The most active compounds have been highlighted and other activities are discussed. A large number of complex biochemical interactions occur in this system. However, only a small fraction of the species has been studied from the phytochemical viewpoint to identify the metabolites responsible for these interactions

International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

Cadinane sesquiterpenoids of Phomopsis cassiae, an endophytic fungus associated with Cassia spectabilis (Leguminosae)

Five cadinane sesquiterpenes derivatives were isolated by bioassay-guided fractionation from Phomopis cassiae, an endophytic fungus isolated from Cassia spectabilis. The structures of the two diastereoisomeric 3,9,12-trihydroxycalamenenes (1, 2); 3,12-dihydroxycalamenene (3); 3,12-dihydroxycadalene (4) and 3,11,12-trihydroxycadalene (5) were established on the basis of analyses of ID and 2D NMR and HRTOFMS experiments. Antifungal activity of the isolates was evaluated against Cladosporium sphaerospermum and Cladosporium cladosporioides, revealing 5 as the most active compound. (c) 2006 Elsevier Ltd. All rights reserved.67171964196

Perfil audiométrico de trabalhadores do distrito industrial de Maracanaú - CE Audiometric profile of Maracanaú's industrial district workers

OBJETIVO: Estabelecer o perfil audiométrico de trabalhadores expostos ao ruído, acima do nível de ação (85 dB), em empresas do Distrito Industrial de Maracanaú, Ceará. MÉTODOS: Foi realizado um estudo descritivo de prevalência a partir da avaliação de dados de exames audiométricos, coletados de arquivos das empresas pesquisadas realizados no período de abril a outubro de 2006. Foram avaliados 5372 trabalhadores das 47 (52,80%) empresas que autorizaram a pesquisa e as variáveis analisadas foram: faixa etária, tempo total de exposição ao ruído, estado da acuidade auditiva, tipo de perda auditiva, lateralidade da perda auditiva e configuração audiométrica sugestiva de perda auditiva induzida por ruído nos trabalhadores e setor da atividade econômica e porte da empresa. RESULTADOS: Constatou-se que 19,00% da população estudada apresentaram alteração, predominando a perda auditiva sensório neural em 90,67% dos casos. Em 12,71% da população estudada observou-se quadro sugestivo de perda auditiva induzida por ruído (PAIR) e, em 71,77% da população portadora de perda auditiva sensório neural, há indícios de PAIR. Em relação à lateralidade da perda, 39,09% é unilateral, sendo 24,03% unilateral esquerda. CONCLUSÕES: Apesar dos resultados não representarem a prevalência total de perdas auditivas do Distrito, eles apontam para a necessidade não apenas de realização de audiometrias ocupacionais pontuais, mas também de monitoramento da audição dos trabalhadores de forma longitudinal, como parte de um programa de conservação auditiva.<br>PURPOSE: To establish the audiometric profile of workers exposed to noise above the action level (85 dB) in Maracanaú's Industrial District, Ceará (Brazil). METHODS: A descriptive study of prevalence was carried out through the evaluation of audiometric data gathered from the files of the researched companies between April and October of 2006. There were 5372 workers evaluated, from the 47 (52,80%) companies that authorized the study. The studied variables were: age range, total period of exposition to noise, auditory acuity status, type of hearing loss, hearing loss laterality and audiometric configuration suggestive of noise-induced hearing loss (NIHL) in workers, economic activity trade and size of the company. RESULTS: It was observed that 19% of the studied population presented alterations, with predominance of sensory neural hearing loss (SNHL) in 90.67% of the cases. In 12.71% of the population suggestive signs of noise-induced hearing loss (NIHL) were observed, and in 71.77% of the population with SNHL there were signs of NIHL. Regarding laterality of the hearing loss, 39.09% was unilateral, from which 24.03% was on the left ear. CONCLUSION: Although the results do not represent the total prevalence of hearing loss in the District, they point out to the necessity not only to perform occupational audiometry, but also to longitudinally monitor the hearing of these workers as part of a hearing conservation program