Efficiency of nickel and chromium removal from child's body through physical activities

© 2020 EDIZIONIMINERVAMEDICA. BACKGROUND: At present, a large number of people live in unfavorable environmental conditions that adversely affect the health of the population, including children. Therefore, it is necessary to look for ways and create methods for removing harmful substances from the body, including physical culture means. METHODS: The following methods were used for the study: Analysis and synthesis of literary sources, atomic absorption analysis, pedagogical experiment, pedagogical observation. RESULTS: The research was conducted in a sanatorium located in a relatively environment-friendly area. More than 1000 preschool children participated in the study. To remove excess nickel and chromium we applied the following techniques in the experimental group: Hiking using cold-protective clothing, swimming in the pool, combined effects of hiking and saunas, saunas and swimming in the pool. The control group followed the standard program of the sanatorium. The results of the research showed that the most effective way for removing nickel from the body of children living in unfavorable environmental areas is physical activity in the pool; for the removal of chromium the most effective way is the combined effect of aquatic physical loads and thermal-air loading. CONCLUSIONS: The children from unfavorable environmental areas have higher content of heavy metals in the solid biological media; to reduce it, these metals must be removed through physical activity; the most effective way for removing nickel from the body of the children living in unfavorable environmental areas is the impact of physical exercises done in the pool; the most effective way for removing chromium from the body of the children living in unfavorable environmental areas is the complex impact of aquatic physical activity in combination with thermal-air loading

The extent of B-cell activation and dysfunction preceding lymphoma development in HIV-positive people

Objectives: B-cell dysfunction and activation are thought to contribute to lymphoma development in HIV-positive people; however, the mechanisms are not well understood. We investigated levels of several markers of B-cell dysfunction [free light chain (FLC)-\u3ba, FLC-\u3bb, immunoglobulin G (IgG), IgA, IgM and IgD] prior to lymphoma diagnosis in HIV-positive people. Methods: A nested matched case\u2013control study was carried out within the EuroSIDA cohort, including 73 HIV-positive people with lymphoma and 143 HIV-positive lymphoma-free controls. Markers of B-cell dysfunction were measured in prospectively stored serial plasma samples collected before the diagnosis of lymphoma (or selection date in controls). Marker levels 64 2 and > 2 years prior to diagnosis were investigated. Results: Two-fold higher levels of FLC-\u3ba [odds ratio (OR) 1.84; 95% confidence interval (CI) 1.19, 2.84], FLC-\u3bb (OR 2.15; 95% CI 1.34, 3.46), IgG (OR 3.05; 95% CI 1.41, 6.59) and IgM (OR 1.46; 95% CI 1.01, 2.11) were associated with increased risk of lymphoma > 2 years prior to diagnosis, but not 64 2 years prior. Despite significant associations > 2 years prior to diagnosis, the predictive accuracy of each marker was poor, with FLC-\u3bb emerging as the strongest candidate with a c-statistic of 0.67 (95% CI 0.58, 0.76). Conclusions: FLC-\u3ba, FLC-\u3bb and IgG levels were higher > 2 years before lymphoma diagnosis, suggesting that B-cell dysfunction occurs many years prior to lymphoma development. However, the predictive value of each marker was low and they are unlikely candidates for risk assessment for targeted intervention

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background: Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods: The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results: A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion: Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)