Pub Date : 2023-01-01DOI: 10.18103/mra.v11i7.1.4112
Fernanda Zottmann, Jiviane Silva, S. Khatib, Gabriela Guimarães, Julia Coneglian, Bibiana Vinholes, L. Gebrin, C. Borges
In SC hemoglobinopathy, a rare type of sickle cell disease, patients may experience vaso-occlusive phenomena, but in a milder condition than in the SS form, considered classic and the most common among them. This current study aims to present a case of a patient with this rare form of hemoglobinopathy, who received a late diagnosis, and its clinical evolution, including symptoms, treatment and life expectancy based on the literature, but mainly on how the patient is clinically found after seven years of follow-up. It is important to have epidemiological studies about hemoglobinopathies, specially the rare forms, to obtain more information regarding the incidence/prevalence of the disease and clinical manifestations.
{"title":"SC Hemoglobinopathy: a rare case report","authors":"Fernanda Zottmann, Jiviane Silva, S. Khatib, Gabriela Guimarães, Julia Coneglian, Bibiana Vinholes, L. Gebrin, C. Borges","doi":"10.18103/mra.v11i7.1.4112","DOIUrl":"https://doi.org/10.18103/mra.v11i7.1.4112","url":null,"abstract":"In SC hemoglobinopathy, a rare type of sickle cell disease, patients may experience vaso-occlusive phenomena, but in a milder condition than in the SS form, considered classic and the most common among them. This current study aims to present a case of a patient with this rare form of hemoglobinopathy, who received a late diagnosis, and its clinical evolution, including symptoms, treatment and life expectancy based on the literature, but mainly on how the patient is clinically found after seven years of follow-up. It is important to have epidemiological studies about hemoglobinopathies, specially the rare forms, to obtain more information regarding the incidence/prevalence of the disease and clinical manifestations.","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82551335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Timing is essential to morphogenesis of the embryonic and fetal nervous system and intricately associated with onset of expression of developmental genes. Mitotic cell cycles are timed. Teratogenic toxins and other adverse influences are teratogenic in the context of timing by interfering with developmental processes. Each of the 3 axes of the neural tube is associated with two opposing genetic gradients. Many neural malformations can be analyzed pathologically as interference with genetic gradients of one or more of the axes, even if the specific genetic mutation is not yet identified. Examples of cerebral malformations closely associated with defective timing are agenesis of forebrain commissures (anterior and hippocampal commissures form 3 weeks before corpus callosum), neuronogenesis and gliogenesis in disorders of the mTOR signaling pathway (time of expression of postmitotic somatic mutation in relation to the 33 mitotic cycles of neuroepithelium determines extent of lesion of focal cortical dysplasia II or hemimegalencephaly), prosencephalic cleavage and eversion (holoprosencephaly; telencephalic flexure for Sylvian fissure), neuromeric disorders of segmentation of the neural tube (deletion of neuromeres; Chiari I), maturation of individual neurons, synaptogenesis (precocious synaptic circuitry in holoprosencephaly; delayed synapse formation in many genetic/metabolic encephalopathies), myelination (delay in many congenital encephalopathies) and neural crest migrations including craniofacial development (facial dysmorphisms in many genetic syndromes and hypertelorism in some cases of callosal agenesis). Timing of relation of genes in cascade or inhibitory genes acting on others is a key element of normal and abnormal morphogenesis.
{"title":"Timing in Morphogenesis of the Developing Nervous System: Relation to Genetic Programming and Exogenous Teratogenesis","authors":"H. Sarnat","doi":"10.18103/mra.v11i6.3940","DOIUrl":"https://doi.org/10.18103/mra.v11i6.3940","url":null,"abstract":"Timing is essential to morphogenesis of the embryonic and fetal nervous system and intricately associated with onset of expression of developmental genes. Mitotic cell cycles are timed. Teratogenic toxins and other adverse influences are teratogenic in the context of timing by interfering with developmental processes. Each of the 3 axes of the neural tube is associated with two opposing genetic gradients. Many neural malformations can be analyzed pathologically as interference with genetic gradients of one or more of the axes, even if the specific genetic mutation is not yet identified. Examples of cerebral malformations closely associated with defective timing are agenesis of forebrain commissures (anterior and hippocampal commissures form 3 weeks before corpus callosum), neuronogenesis and gliogenesis in disorders of the mTOR signaling pathway (time of expression of postmitotic somatic mutation in relation to the 33 mitotic cycles of neuroepithelium determines extent of lesion of focal cortical dysplasia II or hemimegalencephaly), prosencephalic cleavage and eversion (holoprosencephaly; telencephalic flexure for Sylvian fissure), neuromeric disorders of segmentation of the neural tube (deletion of neuromeres; Chiari I), maturation of individual neurons, synaptogenesis (precocious synaptic circuitry in holoprosencephaly; delayed synapse formation in many genetic/metabolic encephalopathies), myelination (delay in many congenital encephalopathies) and neural crest migrations including craniofacial development (facial dysmorphisms in many genetic syndromes and hypertelorism in some cases of callosal agenesis). Timing of relation of genes in cascade or inhibitory genes acting on others is a key element of normal and abnormal morphogenesis.","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81373126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The present case, reports the cause of death of a 45-year-old male victim of fire incident. Autopsy findings reveal gross laryngeal oedema with narrowing of the air passage. The burn injuries involved about 8 % of the total body surface area. The person suffered from inhalation injuries along with burn injuries. Inhalational injuries are not easy to diagnose and a clear suspicion of their presence plays a significant role in determining the survival of burn patient. A thorough literature review brought forth the fact that laryngeal oedema and inhalational injuries can be a delayed complication of burn injury and timely intubation could save patient’s life. Incidence of laryngeal oedema, clinical features of inhalational injuries and priorities in inhalational injuries research are discussed in the paper with review of literature.
{"title":"Fatal Laryngeal Oedema in Cases of Burns: An Evaluation of Inhalational Injuries","authors":"R. Kaushik, K. Kumar, Priti Singh, Prafulla Kumar","doi":"10.18103/mra.v11i5.3827","DOIUrl":"https://doi.org/10.18103/mra.v11i5.3827","url":null,"abstract":"The present case, reports the cause of death of a 45-year-old male victim of fire incident. Autopsy findings reveal gross laryngeal oedema with narrowing of the air passage. The burn injuries involved about 8 % of the total body surface area. The person suffered from inhalation injuries along with burn injuries. Inhalational injuries are not easy to diagnose and a clear suspicion of their presence plays a significant role in determining the survival of burn patient. A thorough literature review brought forth the fact that laryngeal oedema and inhalational injuries can be a delayed complication of burn injury and timely intubation could save patient’s life. Incidence of laryngeal oedema, clinical features of inhalational injuries and priorities in inhalational injuries research are discussed in the paper with review of literature.","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78644122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Lansdale, Geoffrey Gratwick, Samar Gupta, S. Shoor, Cindy Flower, Matthew Liang
Mentor has roots in Greek mythology. Its current practitioners have lent their own interpretation and meaning by their actions. We offer the case studies and lived experience of a select group who have never met all the others. Each asked the same questions, they tell the story of how each found their mentor(s), try to be mentors themselves, and what they try to impart to their mentees through the vicissitudes of their professional responsibilities and personal lives over a career.
{"title":"Finding and Being a Mentor through a Lifetime","authors":"T. Lansdale, Geoffrey Gratwick, Samar Gupta, S. Shoor, Cindy Flower, Matthew Liang","doi":"10.18103/mra.v11i4.3753","DOIUrl":"https://doi.org/10.18103/mra.v11i4.3753","url":null,"abstract":"Mentor has roots in Greek mythology. Its current practitioners have lent their own interpretation and meaning by their actions. We offer the case studies and lived experience of a select group who have never met all the others. Each asked the same questions, they tell the story of how each found their mentor(s), try to be mentors themselves, and what they try to impart to their mentees through the vicissitudes of their professional responsibilities and personal lives over a career.","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78901763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.18103/mra.v11i7.2.3962
J. E. Fortune
The earliest stages of ovarian follicular development, follicle formation and development of the capacity to activate, are critical to the size of the ovarian reserve. In primates and most domestic animals, these stages occur during fetal life and thus, are difficult to study. Our laboratory has used cattle, an excellent model for human ovarian development, to elucidate the regulation of these early stages in fetal bovine ovarian tissue in vitro. The experiments described here were designed to determine if fetal bovine ovaries have activin A and its receptors and if activin A affects follicular formation and/or activation to begin growth. During the second trimester, when follicles first form, activin increased the total number follicles and the number of primary (activated) follicles in cultured ovarian cortical pieces, compared to control medium; its effects were similar to the positive control, insulin. During the second trimester, activin decreased primordial follicle numbers and increased primary and secondary follicles, again mimicking the positive control. Our previous experiments showed that fetal ovaries produce ovarian steroids, particularly during the second trimester, and that estradiol and progesterone inhibit follicle formation and activation. In control and gonadotropin-treated ovarian pieces, activin A increased progesterone, but decreased androstenedione and estradiol accumulation in the medium. Messenger RNA for activin and its type II receptors was detected in fetal bovine ovaries, with ACVR2A receptor mRNA more abundant than ACVR2B. Immunohistochemistry localized mRNA for activin A and ACVR2A to germ cells of all stages, granulosa cells, and theca cells of early secondary follicles. Staining for ACVR2B was weaker and mostly confined to germ calls. Taken together, these results strongly suggest that activin A of fetal ovarian origin 3 plays a role in ovarian development by promoting follicle formation and activation and modulating ovarian steroidogenesis.
{"title":"Activin Stimulates Follicle Formation and Activation and Modulates Steroidogenesis in Fetal Bovine Ovarian Tissue in Vitro 1","authors":"J. E. Fortune","doi":"10.18103/mra.v11i7.2.3962","DOIUrl":"https://doi.org/10.18103/mra.v11i7.2.3962","url":null,"abstract":"The earliest stages of ovarian follicular development, follicle formation and development of the capacity to activate, are critical to the size of the ovarian reserve. In primates and most domestic animals, these stages occur during fetal life and thus, are difficult to study. Our laboratory has used cattle, an excellent model for human ovarian development, to elucidate the regulation of these early stages in fetal bovine ovarian tissue in vitro. The experiments described here were designed to determine if fetal bovine ovaries have activin A and its receptors and if activin A affects follicular formation and/or activation to begin growth. During the second trimester, when follicles first form, activin increased the total number follicles and the number of primary (activated) follicles in cultured ovarian cortical pieces, compared to control medium; its effects were similar to the positive control, insulin. During the second trimester, activin decreased primordial follicle numbers and increased primary and secondary follicles, again mimicking the positive control. Our previous experiments showed that fetal ovaries produce ovarian steroids, particularly during the second trimester, and that estradiol and progesterone inhibit follicle formation and activation. In control and gonadotropin-treated ovarian pieces, activin A increased progesterone, but decreased androstenedione and estradiol accumulation in the medium. Messenger RNA for activin and its type II receptors was detected in fetal bovine ovaries, with ACVR2A receptor mRNA more abundant than ACVR2B. Immunohistochemistry localized mRNA for activin A and ACVR2A to germ cells of all stages, granulosa cells, and theca cells of early secondary follicles. Staining for ACVR2B was weaker and mostly confined to germ calls. Taken together, these results strongly suggest that activin A of fetal ovarian origin 3 plays a role in ovarian development by promoting follicle formation and activation and modulating ovarian steroidogenesis.","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"343 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76401540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Y. Lodi, Adam Bowen, Aria Soltani, Irfan Khan, H. Polavarapu, A. Hourani
Background: Despite the advancement in acute ischemic stroke with large vessel occlusion (LVO), golden time is lost in assessment lengthy neurological examination and redundantly in the Emergency department, often after emergency medical service prehospital stroke scale evaluation indicating possible LVO. A simple acute ischemic stroke scale (AISS) of the cortical representations of the anterior circulation can rapidly predict LVO, saving precious time to initiate early intravenous tissue plasminogen activator and endovascular mechanical thrombectomy. We proposed an ASIS in the emergency department called Gaze Weakness Neglect Speech (GWNS) to evaluate its feasibility and predictability for the detection of LVO in anterior circulation in the emergency department. Additionally, to evaluate if time can be gained that has been lost in obtaining National Institute of Health stroke Scale (NIHSS) and computed tomographic angiography (CTA), avoiding unnecessary radiation. Methods: This is a prospective observational study. An institutional review board permission was obtained, and patient enrollment started in January 2020 and ended in January 2021. Consecutive patients from January 2020 to September 2021 were selected from the database. The GWNS stroke scale was used by stroke and vascular neurologist during the emergency triage. The GWNS stroke scale scores range from 0 to 4 (1 for positive 0 for negative). The GWNS stroke scale assesses gaze deviation or gaze preference (G), presence of any weakness (W), neglect/disregard (N), and any speech impairment (S). Demographic data, CTA/cerebral angiographic data, and scores from NIHSS were also collected. The collected data was analyzed by a biostatistician to determine the association between the GWNS scale score and LVO. Results: In our study,109 qualifying patients were selected. Fifty-eight patients had GWNS stroke scale score of 3 or 4, with 57 having confirmed LVO and 1 presenting after a seizure. The GWNS stroke score ≥3 (0.86) correlated with LVO better than NIHSS (0.67), regardless of hemisphere side involvement. The GWNS stroke scale score of ≥3 also was effective in detection of proximal and distal blood vessels occlusion in the anterior circulation (Internal carotid artery, middle cerebral artery and its branches). A GWNS stroke scale score of ≥3 with presence of gaze was the most predictive for LVO (0.9) followed by neglect/disregards (0.8). The time to obtain GWNS stroke scale was 1.5 minutes (range 1-3) and time to obtain/interpretation CTA was 41.3 +/- 7.4 minutes after emergency department arrival (range: 29-51 minutes). Conclusions: Our Gaze Weakness Neglect Speech stroke scale can be performed rapidly in the emergency department and is highly predictive of LVO in the internal carotid artery, middle cerebral artery and middle cerebral branches. A GWNS stroke scale score of ≥3 is highly predictive of LVO, especially when gaze or neglect is present. Patients can potentially bypass CTA or ad
{"title":"Gaze Weakness Neglect and Speech: An Acute Stroke Scale for Large Vessel Occlusion in the Emergency Department for Faster Treatment ","authors":"Y. Lodi, Adam Bowen, Aria Soltani, Irfan Khan, H. Polavarapu, A. Hourani","doi":"10.18103/mra.v11i5.3865","DOIUrl":"https://doi.org/10.18103/mra.v11i5.3865","url":null,"abstract":"Background: Despite the advancement in acute ischemic stroke with large vessel occlusion (LVO), golden time is lost in assessment lengthy neurological examination and redundantly in the Emergency department, often after emergency medical service prehospital stroke scale evaluation indicating possible LVO. A simple acute ischemic stroke scale (AISS) of the cortical representations of the anterior circulation can rapidly predict LVO, saving precious time to initiate early intravenous tissue plasminogen activator and endovascular mechanical thrombectomy. We proposed an ASIS in the emergency department called Gaze Weakness Neglect Speech (GWNS) to evaluate its feasibility and predictability for the detection of LVO in anterior circulation in the emergency department. Additionally, to evaluate if time can be gained that has been lost in obtaining National Institute of Health stroke Scale (NIHSS) and computed tomographic angiography (CTA), avoiding unnecessary radiation. Methods: This is a prospective observational study. An institutional review board permission was obtained, and patient enrollment started in January 2020 and ended in January 2021. Consecutive patients from January 2020 to September 2021 were selected from the database. The GWNS stroke scale was used by stroke and vascular neurologist during the emergency triage. The GWNS stroke scale scores range from 0 to 4 (1 for positive 0 for negative). The GWNS stroke scale assesses gaze deviation or gaze preference (G), presence of any weakness (W), neglect/disregard (N), and any speech impairment (S). Demographic data, CTA/cerebral angiographic data, and scores from NIHSS were also collected. The collected data was analyzed by a biostatistician to determine the association between the GWNS scale score and LVO. Results: In our study,109 qualifying patients were selected. Fifty-eight patients had GWNS stroke scale score of 3 or 4, with 57 having confirmed LVO and 1 presenting after a seizure. The GWNS stroke score ≥3 (0.86) correlated with LVO better than NIHSS (0.67), regardless of hemisphere side involvement. The GWNS stroke scale score of ≥3 also was effective in detection of proximal and distal blood vessels occlusion in the anterior circulation (Internal carotid artery, middle cerebral artery and its branches). A GWNS stroke scale score of ≥3 with presence of gaze was the most predictive for LVO (0.9) followed by neglect/disregards (0.8). The time to obtain GWNS stroke scale was 1.5 minutes (range 1-3) and time to obtain/interpretation CTA was 41.3 +/- 7.4 minutes after emergency department arrival (range: 29-51 minutes). Conclusions: Our Gaze Weakness Neglect Speech stroke scale can be performed rapidly in the emergency department and is highly predictive of LVO in the internal carotid artery, middle cerebral artery and middle cerebral branches. A GWNS stroke scale score of ≥3 is highly predictive of LVO, especially when gaze or neglect is present. Patients can potentially bypass CTA or ad","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87605533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Lallemand, R. Ferrando-Miguel, F. Pauli, Florian Deisenhamer, M. Tovey
Highly sensitive reporter-gene assays have been developed that allow the precise quantification of both the direct vascular endothelial growth factor-A neutralizing activity of bevacizumab and the ability of bevacizumab to activate antibody dependent cellular cytotoxicity. The use of these assays to analyzes samples from patients with ovarian cancer following four cycle of bevacizumab treatment revealed a close correlation between bevacizumab neutralizing activity and antibody dependent cellular cytotoxicity activity, and a reasonably good correlation between both activities and circulating drug levels determined using an enzyme-linked immunosorbent assay. Analysis of longitudinal samples from a small cohort of patients with glioblastoma treated with bevacizumab revealed a lower correlation between these parameters. We report herein that reanalysis of the grouped samples from the two studies using the nonparametric Spearman rank correlation coefficient revealed a surprisingly good correlation between the two facets of bevacizumab activity, and between both activities and circulating drug levels despite the different indications and treatment regimens, revealing new insights into the action of bevacizumab in neoplastic disease.
{"title":"Analysis of Bevacizumab Activity Following Treatment of Patients with Ovarian Cancer or Glioblastoma","authors":"C. Lallemand, R. Ferrando-Miguel, F. Pauli, Florian Deisenhamer, M. Tovey","doi":"10.18103/mra.v11i3.3652","DOIUrl":"https://doi.org/10.18103/mra.v11i3.3652","url":null,"abstract":"Highly sensitive reporter-gene assays have been developed that allow the precise quantification of both the direct vascular endothelial growth factor-A neutralizing activity of bevacizumab and the ability of bevacizumab to activate antibody dependent cellular cytotoxicity. The use of these assays to analyzes samples from patients with ovarian cancer following four cycle of bevacizumab treatment revealed a close correlation between bevacizumab neutralizing activity and antibody dependent cellular cytotoxicity activity, and a reasonably good correlation between both activities and circulating drug levels determined using an enzyme-linked immunosorbent assay. Analysis of longitudinal samples from a small cohort of patients with glioblastoma treated with bevacizumab revealed a lower correlation between these parameters. We report herein that reanalysis of the grouped samples from the two studies using the nonparametric Spearman rank correlation coefficient revealed a surprisingly good correlation between the two facets of bevacizumab activity, and between both activities and circulating drug levels despite the different indications and treatment regimens, revealing new insights into the action of bevacizumab in neoplastic disease.","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87167631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. Asaolu, Gbadegesin O. Alawode, S. Ajike, Ololade O. Ogunsanmi, Mustapha Bello, John O. Ibitoye, Adebusola Oyeyemi, Adeniyi A. Adeniran, Chisom Emeka, O. Obembe, Olubunmi Ojelade, Olutayo Asaolu, A. Ugwu, Christopher Obanubi, Abdulmalik Abubakar, Adekemi Asaolu, Olubayode Asaolu, Nannim Nalda, Adebayo O. Amao, Oladimeji Folorunso-Ako, Ishaq K. Salako, C. Agbede
Medication adherence and antiretroviral therapy retention are required for successful durable, virologic suppression and treatment outcomes among youths. The use of peer-led health education in increasing medication adherence and antiretroviral therapy retention has been advocated. Therefore, this study investigated the effect of peer education on medication adherence and antiretroviral-therapy retention practices among Youth Living with HIV in Niger state, Nigeria. The study was a quasi-experimental design in two selected hospitals. One hospital was assigned to a one-hour peer-led health education session for six weeks, and the 2nd served as the control group. Data were collected at baseline, immediate post-intervention, and at the sixth-week follow-up. Data were analyzed using descriptive and inferential statistics at a 0.05 level of significance. Majority of respondents practice Islam and are within the ages of 20-24 years (control: 100%, 89%; intervention: 83%, 73%), from the Hausa Ethnic group (control: 62%; intervention: 56%). Majority of respondents in the control group have Islamic education (50%) and Secondary education (50%), while the majority of those in the intervention group have primary education (35%), secondary (29%), tertiary (19%) and Islamic (17%) respectively. Medication adherence and ART retention was higher in the intervention group (27%, 16%) compared with the control (17%, 9%). A significant association between knowledge and perception due to peer education on medication adherence was found (24%, 80%) in the intervention group and (11%, 36%) in the control group. Subsequently, the 6th week follow-up sustained findings from the intervention period on medication adherence and ART retention (27%, 16%) in the intervention group compared with control group (17%, 9%). Similarly, knowledge and perception follow-up post intervention was sustained (24%, 80%) in the intervention group and (11%, 36%) in the control group. Interventions leveraging peer-led health education enhanced HIV medication adherence and antiretroviral therapy retention practices among youths. Thus, we recommend scale-up of the structured peer-led curriculum and integration into the health systems to improve health outcomes among HIV positive youths, achieve epidemic control and accelerate progress for the UNAIDS 95:95:95 goals.
{"title":"The The Influence of Peer-Led Health Education Intervention on Medication Adherence Practices Among Youths Living with HIV In Nigeria","authors":"O. Asaolu, Gbadegesin O. Alawode, S. Ajike, Ololade O. Ogunsanmi, Mustapha Bello, John O. Ibitoye, Adebusola Oyeyemi, Adeniyi A. Adeniran, Chisom Emeka, O. Obembe, Olubunmi Ojelade, Olutayo Asaolu, A. Ugwu, Christopher Obanubi, Abdulmalik Abubakar, Adekemi Asaolu, Olubayode Asaolu, Nannim Nalda, Adebayo O. Amao, Oladimeji Folorunso-Ako, Ishaq K. Salako, C. Agbede","doi":"10.18103/mra.v11i8.4285","DOIUrl":"https://doi.org/10.18103/mra.v11i8.4285","url":null,"abstract":"Medication adherence and antiretroviral therapy retention are required for successful durable, virologic suppression and treatment outcomes among youths. The use of peer-led health education in increasing medication adherence and antiretroviral therapy retention has been advocated. Therefore, this study investigated the effect of peer education on medication adherence and antiretroviral-therapy retention practices among Youth Living with HIV in Niger state, Nigeria. The study was a quasi-experimental design in two selected hospitals. One hospital was assigned to a one-hour peer-led health education session for six weeks, and the 2nd served as the control group. Data were collected at baseline, immediate post-intervention, and at the sixth-week follow-up. Data were analyzed using descriptive and inferential statistics at a 0.05 level of significance. Majority of respondents practice Islam and are within the ages of 20-24 years (control: 100%, 89%; intervention: 83%, 73%), from the Hausa Ethnic group (control: 62%; intervention: 56%). Majority of respondents in the control group have Islamic education (50%) and Secondary education (50%), while the majority of those in the intervention group have primary education (35%), secondary (29%), tertiary (19%) and Islamic (17%) respectively. Medication adherence and ART retention was higher in the intervention group (27%, 16%) compared with the control (17%, 9%). A significant association between knowledge and perception due to peer education on medication adherence was found (24%, 80%) in the intervention group and (11%, 36%) in the control group. Subsequently, the 6th week follow-up sustained findings from the intervention period on medication adherence and ART retention (27%, 16%) in the intervention group compared with control group (17%, 9%). Similarly, knowledge and perception follow-up post intervention was sustained (24%, 80%) in the intervention group and (11%, 36%) in the control group. Interventions leveraging peer-led health education enhanced HIV medication adherence and antiretroviral therapy retention practices among youths. Thus, we recommend scale-up of the structured peer-led curriculum and integration into the health systems to improve health outcomes among HIV positive youths, achieve epidemic control and accelerate progress for the UNAIDS 95:95:95 goals.","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"142 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86235547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.18103/mra.v11i7.1.4125
V. Pak
Alpha-fetoprotein is an oncofetal protein the embryo produces during fetal development. The protein serves two critical functions simultaneously: it delivers nutrients to growing embryo cells and immature myeloid-derived suppressor cells, so the mother’s immune system doesn’t attack the embryo. The protein is present in minuscule amounts in adults and elevated alpha-fetoprotein levels serve as pregnancy or tumor markers. Exogenous alpha-fetoprotein has a new application as an immunotherapy drug. It can deliver drugs in a natural shuttle manner to myeloid-derived suppressor cells and stimulate them to calm the hyperactive immune response during many physiological and pathological conditions. On the other hand, alpha-fetoprotein loaded with toxins kills myeloid-derived suppressor cells and unleashes natural killer cells and cytotoxic lymphocytes to erase cancer. Most cancers have cells that specifically bind alpha-fetoprotein, and this protein targets chemotherapy to them also. So, alpha-fetoprotein with toxins combines both potent cancer immunotherapy and targeted chemotherapy activities. Alpha-fetoprotein can be chemically conjugated with or bind toxins non-covalently. Both preparations have demonstrated superior efficacy and safety compared to chemotherapy alone. Alpha-fetoprotein-toxin immuno/chemotherapy is not personalized. There is no need to preselect patients for cancer treatments as they have elevated myeloid-derived suppressor cell levels. The anti-cancer efficacy of porcine alpha-fetoprotein non-covalent complexes with selected toxins administered orally is a remarkable discovery that needs research. Cancer treatment and prevention are different issues, and they could need different approaches. Alpha-fetoprotein administration with drugs or toxins could be as effective in early cancer and metastasis prevention as mifepristone pills in pregnancy prevention.
{"title":"Alpha-Fetoprotein: A Revolutionary Anti-Cancer Drug","authors":"V. Pak","doi":"10.18103/mra.v11i7.1.4125","DOIUrl":"https://doi.org/10.18103/mra.v11i7.1.4125","url":null,"abstract":"Alpha-fetoprotein is an oncofetal protein the embryo produces during fetal development. The protein serves two critical functions simultaneously: it delivers nutrients to growing embryo cells and immature myeloid-derived suppressor cells, so the mother’s immune system doesn’t attack the embryo. The protein is present in minuscule amounts in adults and elevated alpha-fetoprotein levels serve as pregnancy or tumor markers. Exogenous alpha-fetoprotein has a new application as an immunotherapy drug. It can deliver drugs in a natural shuttle manner to myeloid-derived suppressor cells and stimulate them to calm the hyperactive immune response during many physiological and pathological conditions. On the other hand, alpha-fetoprotein loaded with toxins kills myeloid-derived suppressor cells and unleashes natural killer cells and cytotoxic lymphocytes to erase cancer. Most cancers have cells that specifically bind alpha-fetoprotein, and this protein targets chemotherapy to them also. So, alpha-fetoprotein with toxins combines both potent cancer immunotherapy and targeted chemotherapy activities. Alpha-fetoprotein can be chemically conjugated with or bind toxins non-covalently. Both preparations have demonstrated superior efficacy and safety compared to chemotherapy alone. Alpha-fetoprotein-toxin immuno/chemotherapy is not personalized. There is no need to preselect patients for cancer treatments as they have elevated myeloid-derived suppressor cell levels. The anti-cancer efficacy of porcine alpha-fetoprotein non-covalent complexes with selected toxins administered orally is a remarkable discovery that needs research. Cancer treatment and prevention are different issues, and they could need different approaches. Alpha-fetoprotein administration with drugs or toxins could be as effective in early cancer and metastasis prevention as mifepristone pills in pregnancy prevention.","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82924711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.18103/mra.v11i7.2.4204
U. Guevara-López, M. Luna, E. Ramírez
Background: The teaching-learning process is a fundamental competence in high-risk environments such as the operating room. Although conventional approaches are based on learning from negative performance, it is convenient to visualize the virtuous behavior of actors in specialties where security events are latent. Objective: to explore through a survey the perception of crisis in the teaching of anesthesia in Mexico, and to identify the possible causes and precipitating factors. Methods: A prospective observational design was used, prior approval from the research ethics committee. It was studied by means of a survey with 40 items to people who carry out their professional practice in the Mexican Republic. The positive and/or negative characteristics of specialists, student teachers, the educational program and work environment were explored. Results: 1,125 participants responded. The highest percentage believed that there is a severe deficit in the teaching of the specialty, indicating in descending order the students, the work environment, and in similar proportions, the structure of the program and the characteristics of the teachers as the causes. Significant statistical differences were found in the attitude and values of the residents, in lack of adherence to educational programs, in the lack of stimuli, motivation and lack of recognition and encouragement to teachers, p < 0.000. Conclusions: Our findings indicate that anesthesiologists are doing many things "right", but the existing educational deficit can be corrected to avoid an eventual crisis, suggesting a clinical practice based on evidence and values in a better environment.
{"title":"Education in Anesthesiology: Crisis, Values and Perspectives","authors":"U. Guevara-López, M. Luna, E. Ramírez","doi":"10.18103/mra.v11i7.2.4204","DOIUrl":"https://doi.org/10.18103/mra.v11i7.2.4204","url":null,"abstract":"Background: The teaching-learning process is a fundamental competence in high-risk environments such as the operating room. Although conventional approaches are based on learning from negative performance, it is convenient to visualize the virtuous behavior of actors in specialties where security events are latent. Objective: to explore through a survey the perception of crisis in the teaching of anesthesia in Mexico, and to identify the possible causes and precipitating factors. Methods: A prospective observational design was used, prior approval from the research ethics committee. It was studied by means of a survey with 40 items to people who carry out their professional practice in the Mexican Republic. The positive and/or negative characteristics of specialists, student teachers, the educational program and work environment were explored. Results: 1,125 participants responded. The highest percentage believed that there is a severe deficit in the teaching of the specialty, indicating in descending order the students, the work environment, and in similar proportions, the structure of the program and the characteristics of the teachers as the causes. Significant statistical differences were found in the attitude and values of the residents, in lack of adherence to educational programs, in the lack of stimuli, motivation and lack of recognition and encouragement to teachers, p < 0.000. Conclusions: Our findings indicate that anesthesiologists are doing many things \"right\", but the existing educational deficit can be corrected to avoid an eventual crisis, suggesting a clinical practice based on evidence and values in a better environment.","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88951717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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