Notes

Nutritional cardoon dinner modulates rumen biohydrogenation along with bacterial group throughout lambs.
Few prospective studies in cutaneous and systemic lupus erythematosus (CLE/SLE) assessed thalidomide-induced peripheral neuropathy (TiPN) incidence/reversibility, and most have not excluded confounding causes neither monitored thalidomide plasma levels.

To evaluate TiPN incidence/reversibility, coasting effect and its association with thalidomide plasma levels in CLE/SLE.

One-year prospective study of thalidomide in 20 CLE/SLE patients without pregnancy potential, with normal nerve conduction study (NCS), and excluded other PN causes. Thalidomide levels were determined by high-performance liquid chromatography/tandem mass spectrometry.

Twelve patients (60%) developed TiPN 33.3% were symptomatic and 66.6% asymptomatic. Half of this latter group developed coasting effect (TiPN symptoms 1-3 months after drug withdrawal). The main predictive factors for TiPN were treatment duration ≥6 months (p = 0.025) and cumulative dose (p = 0.023). No difference in plasma thalidomide levels between patients with/without TiPN was observed (p = 0.464). After drug withdrawal, 75% symptomatic TiPN patients improved their symptoms. Seven TiPN patients underwent an additional NCS after drug withdrawal 42.8% worsened NCS, 14.2% was stable, and 42.8% had improved NCS.

Our data provides novel evidence of coasting effect in half of asymptomatic patients with TiPN. The irreversible nature of this lesion in 25% of TiPN patients reinforces the relevance of early NCS monitoring, and suggests thalidomide use solely as a bridge for other effective therapy for refractory cutaneous lupus patients.
Our data provides novel evidence of coasting effect in half of asymptomatic patients with TiPN. The irreversible nature of this lesion in 25% of TiPN patients reinforces the relevance of early NCS monitoring, and suggests thalidomide use solely as a bridge for other effective therapy for refractory cutaneous lupus patients.
For selection of high-risk systemic lupus erythematosus (SLE) patients it is necessary to obtain indicators of disease severity that predict disease damage. As in systemic sclerosis, nailfold capillary abnormalities could be such a biomarker in SLE. The primary objective of this cross-sectional study is to describe capillary abnormalities in childhood-onset SLE (cSLE) cohort (onset < 18 years) and compare them with matched healthy controls. The secondary objective is to correlate the observed capillary abnormalities with demographical variables in both cohorts and with disease-specific variables in cSLE patients.

Healthy controls were matched for ethnic background, age and gender. Videocapillaroscopy was performed in eight fingers with 2-4 images per finger. Quantitative and qualitative assessments of nailfold capillaroscopy images were performed according to the definitions of the EULAR study group on microcirculation in Rheumatic Diseases.

Both groups (n = 41 cSLE-patients and n = 41 healthy controe in these pediatric patients.The Syrian civil war, which broke out in 2011, caused the displacement of more than one million refugees to Jordan. Most of them settled in the Northern Govenorates of Jordan. Due to this, the local services and infrastructures of the hosting communities, in particular the solid waste management (SWM), were put under great pressure. The aim of this study is to evaluate how the off-camp refugees impacted the SWM in the Greater Irbid Municipality (GIM; in the Irbid Governorate), both quantitatively and qualitatively. Data and results obtained from the studies carried out before the Syrian crisis are compared with data collected by the authors in 2016 using similar or comparable methodologies. Moreover, local citizen perceptions of and satisfaction with the solid waste (SW) service level were assessed. A deterioration of the SWM in GIM between 2011 and 2016 was observed in terms of service performance indicators (e.g., an increase of SW collection and transportation costs by 2.5 times and of fines for improper SW disposal by 2.2 times) and of citizens' views (a decline in SWM quality was felt by 59% of the respondents). An attempt to cope with this situation has been made in recent years with international donors mobilizing efforts and resources to enable municipalities to meet the growing demand in basic SW services. There is however, still much to be done.Dr Božidar Kostić (1892-1960) - physician of noble heart - was born in Niš (Kingdom of Serbia) in a distinguished family of academically educated parents. As there were no medical faculties in Kingdom of Serbia, after high school, which he had finished with great success, in 1911 he enrolled at the Graz University of Medicine, a prestigious medical university. Soon he transferred to the Faculty of Medicine at Charles University in Prague, where he continued his studying for another ten semesters. In Prague, The Golden City, after the First World War, he finished his studies with an average grade of 10. After the Second World War, he worked as a doctor with a private medical practice in Belgrade, but soon he moved to Vranje, where he established the Town Polyclinic and contributed to the final flourishing of the most important forms of health care activities in liberated Vranje, donating his rich knowledge and skills, which led the health service to move to forms of independent work and development of new activities. click here For his contribution to the community, by decree of His Majesty King of Yugoslavia Alexander I Karađorđević, he received the Order of Saint Sava. Dr Božidar Kostić and his wife Pravda devoted their lives to the health and educational upbringing of the people in the south parts of Serbia (then Social Federative Republic of Yugoslavia). Until his last days he lived and worked as a true folk doctor.In the Islamic Golden Age, medicine flourished by the practice of Persian, Arab and Greek physicians (9th to 13th century AD). Ibn rushd (1126-1198 AD) was renowned physician in that period, influenced the progress of medicine by his writings. He was the stalwart of medical sciences and owner of many writings in various fields of science. One of his writings in medicine was "Al- Kulliyat fi Al-Tibb" (Colliget or "Generalities on Medicine"). Many of his writings were studied in every part of globe. Now a day it is need of hour to generalize his knowledge for further researches. In this paper it is trying to compile his historical aspect of life as well as writings.
Extracorporeal membrane oxygenation (ECMO) is a rescue procedure used for cardiac and pulmonary dysfunction. Patients on ECMO often require blood transfusions to maintain oxygen delivery and recover from bleeding complications. Goals of the current study were to determine transfusion requirements while on ECMO, and incidence and transfusion requirements for bleeding complications.

Packed red blood cell (PRBC) transfusions and bleeding complications were identified by retrospective chart review of patients on ECMO from 2010 to 2018 at our institution. Patients were categorized into those who did not bleed (group A) and those who bled (group B). Incidence, sites of bleed, and transfusion requirement for each bleeding were analyzed.

Among 217 patients including veno-arterial (VA) (
 = 148) and veno-venous (VV) (
 = 69) ECMO, we identified 62 patients without bleeding complications (group A) and 155 patients with bleeding complications (group B). In group A, transfusion requirement was 0.6 PRBC/day for VAday mortality rate.High-quality correspondence between healthcare providers is critical for effective patient care. link2 We developed an assessment tool to measure the quality of specialist correspondence to primary care providers (PCPs) via electronic consultation (eConsult), where specialists provide advice without specialist-patient interactions. We incorporated fourteen previously described features of high-quality eConsult correspondence into an assessment tool named the eConsult Specialist Quality of Response (eSQUARE). Six PCPs and two specialists applied the 10-item eSQUARE tool to 30 eConsults of varying quality as informed by PCP survey data. Content, response process, and internal structure validity evidence was gathered. Psychometric properties were calculated using descriptive statistics and generalizability analyses. Mean total score for low-quality eConsults (M = 24 ± 5.6) was significantly lower than moderate-quality eConsults (M = 38 ± 4.7; p less then 0.001) which was significantly lower than high-quality eConsults (M = 46 ± 3.0; p = 0.002). Reliability measures were high, including generalizability coefficient (0.96), inter-item (≥0.55) and item-total correlations (≥0.68). A decision study demonstrated that a single rater was adequate to achieve a reliability measure of ≥0.70. This study demonstrates initial validity evidence including multiple reliability measures for the eSQUARE. A single rater is adequate to achieve reliability measures for formative feedback. Future studies can apply the eSQUARE when planning educational initiatives aiming to improve specialist-to-PCP correspondence via eConsult.In order to understand if a physician prescribed medical information changes, the number of hospital readmission, and death among the heart failure patients. A 12-month randomized controlled trial was conducted (December 2013-2014). Totally, 120 patients were randomly allocated into two groups of intervention (n = 60) and control (n = 60). Accordingly, the control group was given the routine oral information by the nurse or physician, and the intervention group received the Information Prescription (IP) prescribed by the physician as well as the routine oral information. link3 The data was collected via telephone interviews with the follow-up intervals of 6 and 12 months, and also for 1 year after the discharge. The patients with the median age of (IQR) 69.5 years old (19.8) death upon adjusting a Cox survival model, [RR = 0.67, 95%CI 0.46-0.97]. Few patients died during 1 year in the intervention group compared to the controls (7 vs 15) [RR = 0.47, 95%CI 0.20-1.06]. During a period of 6-month follow-up there was not statistically significant on death and readmission between two groups. Physician prescribed information was clinically and statistically effective on the reduction of death and hospital readmission rates among the HF patients in long term follow-up.
Mobile technologies represent a scalable platform for delivering knowledge and interventions targeting adolescents living with HIV (ALWH) in low and middle income countries. Data from mobile interventions can be used to assess the contextual understanding and experiences of ALWH.

We examined HIV-related knowledge, attitudes, beliefs, behaviors, and experiences of Kenyan ALWH revealed in the contextual data from enrollment in a WhatsApp® group chat intervention.

Thirty ALWH (17 female, mean age 15.4) on ART, engaged in HIV care and aware of their status, were enrolled. Qualitative analysis of WhatsApp® chat discussions identified a gap in HIV knowledge, high medication-taking literacy, need for mental health support and significant barriers to adherence. Participants discussed challenges with HIV stigma and medication-taking in the school setting.

These discussions demonstrate a need for education on HIV topics, mental health support for ALWH, and interventions for stigma mitigation in the school setting.
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