Unusual presentations of cutaneous larva migrans in British military personnel

alkiviadis.1961 shared this article with you from Inoreader Unusual presentations of cutaneous larva migrans in British military personnel Via Journal of the Royal Army Medical Corps Online First Cutaneous larva migrans (CLM) is one of numerous skin diseases that occur in British military personnel on deployments to the tropics and sub-tropics. It is typically managed by military primary healthcare services, but diagnostic uncertainty or unavailability of anti-helminthic medication may prompt referral to UK Role 4 healthcare services. Cases of CLM seen at the UK Role 4 Military Infectious Diseases & Tropical Medicine Service from 2005 to 2020 were identified and their case notes were reviewed to identify learning and discussion points. There were 12 cases identified, of which five came from Brunei and three were from Belize. Causes for referral were due to diagnostic uncertainty (58%) and the unavailability of anti-helminthic medication (42%). Several cases had CLM in an unusual distribution due to specific military activities performed in endemic areas. Telemedicine was very useful in making some of the diagnoses in theatre and avoiding the need for medical evacuation. Military personnel may have unusual presentations of CLM due their unique military activities. In areas that are endemic for CLM, clinicians should maintain high clinical suspicion for CLM, carry appropriate anti-helminthic medications and consider screening cases of CLM and their colleagues for other infections with similar aetiology (eg, human hookworm infection and strongyloidiasis). View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sex-Related Differences in Anxious-Depressive and Defensive Behavior in Wistar Rats

alkiviadis.1961 shared this article with you from Inoreader Sex-Related Differences in Anxious-Depressive and Defensive Behavior in Wistar Rats Via Latest Results for Neuroscience and Behavioral Physiology Sex-related differences in the behavior of animals in aversive situations were identified by comparing male and female Wistar rats in tests for anxiety, depression-like behavior, assessments of the dynamics of the acquisition and extinction of a classical defensive reflex and a passive avoidance reflex, and also acquisition of an active avoidance reflex. In tests for anxiety, females differed from males in having lower levels of anxiety and greater movement and exploratory activity. In the Porsolt test, females showed less extensive signs of depression-like behavior. After stress, the blood corticosterone content in females was greater than that in males. Females showed higher pain sensitivity. Conditioned reflex fear in the passive avoidance reflex was greater in males than females; ther e was no difference in animals of different sexes in the classical defensive reflex. Extinction of conditioned reflex fear in these two types of reflex occurred more quickly in females than males. Acquisition of the active avoidance reflex was easier in females than males. It is suggested that females are more inclined to the active defensive strategy and to overestimate danger, while males, conversely, prefer passive defensive responses. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Microelectrophysiological Studies of the Ratio of Excitatory to Inhibitory Synaptic Processes in the Corticonigral Projection in a Model of Parkinson’s

alkiviadis.1961 shared this article with you from Inoreader Microelectrophysiological Studies of the Ratio of Excitatory to Inhibitory Synaptic Processes in the Corticonigral Projection in a Model of Parkinson's Via Latest Results for Neuroscience and Behavioral Physiology Experiments on 23 white male rats (250 g) analyzed the spike activity of individual neurons in the substantia nigra pars compacta (SNc, 242 neurons, n = 11) and substantia nigra pars reticulata (SNr, 289 neurons, n = 12) during high-frequency stimulation of the primary motor cortex (M1)in normal animals and in animals with a rotenone model of Parkinson's disease (BP). SNc neurons in the model of PD showed a complete absence of depressor effects induced by stimulation, though tetanic potentiation was accompanied by posttetanic potentiation and depression at levels 1.65 and 2.02 times greater than in normal animals. In SNr neurons in normal animals, tetanic potentiation, accompanied by post-tetanic potentiation and depression, was 2.37 times greater than tetanic depressi on, while in the model of PD the levels of both depressor and excitatory activity induced by stimulation were below normal. Spike activity frequency in SNc and SNr neurons preceding and accompanying stimulation was significantly greater than normal in the model of PD. This is evidence for excitotoxicity accompanying neurodegenerative damage, which is completed by neuron apoptosis and death. In SNr neurons, both depressor and excitatory reactions accompanying stimulation were markedly dominant over those in SNc neurons, which is evidence for more extensive cortical projections to the SNr. Furthermore, SNc neurons demonstrated greater susceptibility to pathological changes due to poststimulus depressor effects than SNr neurons, with formation of more marked excitatory effects, which is evidence of a greater involvement of the SNc in PD. In the model of PD, lacking stimulation-induced depressor effects and more marked excitatory effects in SNc neurons, SNr neurons retained their depres sor reactions and relatively decreased excitatory reactions, which is evidence of a lower level of susceptibility of SNr neurons to excitotoxicity, extreme increases in the excitability of surviving neurons compensating for the lack of excitation of dead cells. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Acoustic and Perceptual Features of the Emotional Speech of Adolescents Aged 14–16 Years

alkiviadis.1961 shared this article with you from Inoreader Acoustic and Perceptual Features of the Emotional Speech of Adolescents Aged 14–16 Years Via Latest Results for Neuroscience and Behavioral Physiology The goal of the study was to describe perceptual and acoustic characteristics of emotional spontaneous speech of adolescents aged 14–16 years. 18 adolescents aged 14–16 years (9 boys and 9 girls, three people in each age) were participants. Perceptual analysis of speech of children by adults (70 Russian speakers and 70 speakers of other languages) was conducted to define the emotional state via voice and speech characteristics. Instrumental and linguistic analysis was used to determine acoustic features and linguistic information on which listeners rely while recognizing the adolescents' state. It was shown that listeners had difficulty in recognizing the emotional state of adolescents, but Russian-speaking listeners recognized the emotional state better (26% of phrases recognized w ith probability 0.75–1.0) than speakers of other languages. Adults recognized comfort better than discomfort, Russian listeners better than foreigners. Russian listeners are likely to rely on acoustic and linguistic information, speakers of other languages – on acoustic features of adolescents' speech. Phrases uttered in comfort are characterized by a wider pitch range vs. phrases uttered in the neutral state. It was revealed that the phrases of girls uttered in comfort have significantly higher average pitch values vs. discomfort. There were no significant differences between boys and girls in acoustic characteristics of emotional speech. Phrase duration and pitch range values can be included in automatic recognition systems of the speaker's emotional state via speech as additional informative features. The paper discusses the specificity of emotion manifestation in adolescents and the possibility of further use of the results. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Combined Influences of Genetic Factors and Attention Deficit Hyperactivity Disorder on the Development of Dependence on Synthetic Cannabinoids

alkiviadis.1961 shared this article with you from Inoreader Combined Influences of Genetic Factors and Attention Deficit Hyperactivity Disorder on the Development of Dependence on Synthetic Cannabinoids Via Latest Results for Neuroscience and Behavioral Physiology Objectives. To create a complex model of the individual risk of developing dependence on synthetic cannabinoids taking account of the combined influences of genetic predisposition and attention deficit hypera-ctivity disorder (ADHD). Materials and methods. A total of 146 male adolescents consuming synthetic cannabinoids and 136 healthy subjects (controls) were observed. Genetic studies assessed cases with the combination of these dependencies with ADHD. DNA was collected and six polymorphic loci of genes of the dopaminergic and serotoninergic systems were determined; results were analyzed using a series of special statistical methods. Results and conclusions. These data demonstrate the important role of the dopaminergic and serotoninergic systems in the pathogenesis of dependence on psychoactive substances and the significance of changes in the nucleotide sequences of the DRD2, SLC6A3, and HTR2A genes in the development of dependence on synthetic cannabinoids in males with ADHD. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effect of Intraoperative Goal-Directed Fluid Management on Tissue Oxygen Tension in Obese Patients: a Randomized Controlled Trial

alkiviadis.1961 shared this article with you from Inoreader Effect of Intraoperative Goal-Directed Fluid Management on Tissue Oxygen Tension in Obese Patients: a Randomized Controlled Trial Via Latest Results for Obesity Surgery Abstract Background Perioperative subcutaneous tissue oxygen tension (PsqO2) is substantially reduced in obese surgical patients. Goal-directed fluid therapy optimizes cardiac performance and thus tissue perfusion and oxygen delivery. We therefore tested the hypothesis that intra- and postoperative PsqO2 is significantly reduced in obese patients undergoing standard fluid management compared to goal-directed fluid administration. Methods We randomly assigned 60 obese patients (BMI ≥ 30 kg/m2) undergoing laparoscopic bariatric surgery to receive either esophageal Doppler-guided goal-directed fluid management or conventional fluid treatment. Our primary outcome parameter was intra- and postoperative PsqO2 measured with a polarographic electrode in the subcutaneous tissue of the upper arm. A random effects linear regression model was used to analyze the effect of intervention. Results Overall, mean (± SD) PsqO2 was significantly higher in obese patients receiving goal-directed therapy compared to conventional fluid therapy (65.8 ± 28.0 mmHg vs. 53.7 ± 21.7, respectively; repeated measures design adjusted difference: 13.0 mmHg [95% CI 2.3 to 23.7; p = 0.017]). No effect was seen intraoperatively (69.6 ± 27.9 mmHg vs. 61.4 ± 28.8, difference: 9.7 mmHg [95% CI -3.8 to 23.2; p = 0.160]); however, goal-directed fluid management improved PsqO2 in the early postoperative phase (63.1 ± 27.9 mmHg vs. 48.4 ± 12.5, difference: 14.5 mmHg [95% CI 4.1 to 24.9; p = 0.006]). Intraoperative fluid requirements did not differ between the two groups. Conclusions Goal-directed fluid therapy improved subcutaneous tissue oxygenation in obese patients. This effect was more pronounced in the early postoperative period. Clinical Trial Number and Registry The study was registered at ClinicalTrials.gov (NCT 01052519). View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Post-Stent Ballooning during TransCarotid Artery Revascularization

alkiviadis.1961 shared this article with you from Inoreader Post-Stent Ballooning during TransCarotid Artery Revascularization Via Journal of Vascular Surgery Post-stent ballooning/angioplasty (post-SB) have been shown to increase the risk of stroke risk after Transfemoral CAS. With the advancement of TransCarotid Artery Revascularization (TCAR) with dynamic cerebral blood flow reversal, we aimed to study the impact of post-SB during TCAR. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pathways to Enable Primary Healthcare Nurses in Providing Comprehensive Primary Healthcare to Rural, Tribal Communities in Rajasthan, India

alkiviadis.1961 shared this article with you from Inoreader Pathways to Enable Primary Healthcare Nurses in Providing Comprehensive Primary Healthcare to Rural, Tribal Communities in Rajasthan, India Via Frontiers in Public Health | New and Recent Articles Background: Emerging health needs and uneven distribution of human resources of health have led to poor access to quality healthcare in rural areas. Rural pathways provide an approach to plan and evaluate strategies for ensuring availability, retention, motivation, and performance of human resources for health in rural areas. While effectiveness of primary healthcare (PHC) nurses to deliver primary health care is established, there is not enough evidence on ways to ensure their availability, retention, motiva tion, and performance. The paper draws on the program experience and evidence from a primary healthcare network (AMRIT Clinics), in which nurses play a central role in delivering primary healthcare in rural tribal areas of Rajasthan, India, to bridge this gap. Methods: Rural, tribal areas of Rajasthan have limited access to functional healthcare facilities, despite having a high burden of diseases. We used the rural pathway approach to describe factors that contributed to the performance of the nurses in AMRIT Clinics. We analyzed information from the human resource information system and health management information system; and supplemented it with semi-structured interviews with nurses, conducted by an independent organization. Results: Most nurses were sourced from rural and tribal communities that the clinics serve; nurses from these communities were likely to have a higher retention than those from urban areas. Sourcing from rural and tribal communities, on-going t raining in clinical and social skills, a non-hierarchical work environment, and individualized mentoring appear to be responsible for high motivation of the primary healthcare nurses in AMRIT Clinics. Task redistribution with due credentialing, intensive and on-going training, and access to tele-consultation helped in sustaining high performance. However, family expectations to perform gendered roles and pull of government jobs affect their retention. Conclusion: Rural and remote areas with healthcare needs and scarcity of health provisions need to optimize the health workforce by adopting a multi-pronged pathway in its design and implementation. At the same time, there is a need to focus on structural factors that affect retention of workforce within the pathway. Our experience highlights a pathway of up-skilling PHC nurses in providing comprehensive primary healthcare in rural and remote communities in Low and Middle-Income Countries (LMICs). View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Associations Between Maternal Community Deprivation and Infant DNA Methylation of the SLC6A4 Gene

alkiviadis.1961 shared this article with you from Inoreader Associations Between Maternal Community Deprivation and Infant DNA Methylation of the SLC6A4 Gene Via Frontiers in Public Health | New and Recent Articles Introduction: Poverty is negatively associated with health and developmental outcomes. DNA methylation (DNAm) has been proposed as a mechanism that underlies the association between adversity experienced by mothers in poverty and health and developmental outcomes in their offspring. Previous studies have identified associations between individual-level measures of stress and adversity experienced by a mother during pregnancy and infant DNAm. We hypothesized that independent of individual stresses, a mother's community-level deprivation while she is pregnant may also be associated with DNAm among the genes of her offspring that are related to stress response and/or development. Methods: Pregnant mothers (N = 53) completed assessments that measured stress, adversity, and mental health. To evaluate community-level deprivation, mothers' addresses were linked to census-level socioeconomic measures including a composite index of deprivation that combines multiple community-level indicators such as income and highest level of education received. Infant buccal cells were collected at about age 4 weeks to measure DNAm of candidate genes including NR3C1, SCG5, and SLC6A4, which are associated with the stress response and or social and emotional development. Multivariable models were employed to evaluate the association between maternal community deprivation and infant DNAm of candidate genes. Results: No significant associations were identified between maternal community-level depriv ation and the methylation of NR3C1 or SCG5, however, maternal community-level deprivation was significantly associated with higher mean methylation across 8 CpG sites in SLC6A4. Conclusion: This study identified an association between community-level measures of deprivation experienced by a mother during pregnancy and DNAm in their offspring. These findings may have implications for understanding how the community context can impact early biology and potential function in the next generation. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Code-Sharing in Cost-of-Illness Calculations: An Application to Antibiotic-Resistant Bloodstream Infections

alkiviadis.1961 shared this article with you from Inoreader Code-Sharing in Cost-of-Illness Calculations: An Application to Antibiotic-Resistant Bloodstream Infections Via Frontiers in Public Health | New and Recent Articles Background: More data-driven evidence is needed on the cost of antibiotic resistance. Both Japan and England have large surveillance and administrative datasets. Code sharing of costing models enables reduced duplication of effort in research. Objective: To estimate the burden of antibiotic-resistant Staphylococcus aureus bloodstream infections (BSIs) in Japan, utilizing code that was written to estimate the hospital burden of antibiotic-resistant Escherichia coli BSIs in England. Additionally, the pro cess in which the code-sharing and application was performed is detailed, to aid future such use of code-sharing in health economics. Methods: National administrative data sources were linked with voluntary surveillance data within the Japan case study. R software code, which created multistate models to estimate the excess length of stay associated with different exposures of interest, was adapted from previous use and run on this dataset. Unit costs were applied to estimate healthcare system burden in 2017 international dollars (I$). Results: Clear supporting documentation alongside open-access code, licensing, and formal communication channels, helped the re-application of costing code from the English setting within the Japanese setting. From the Japanese healthcare system perspective, it was estimated that there was an excess cost of I$6,392 per S. aureus BSI, whilst oxacillin resistance was associated with an additional I$8,155. Conclusions:S. aureus resistan ce profiles other than methicillin may substantially impact hospital costs. The sharing of costing models within the field of antibiotic resistance is a feasible way to increase burden evidence efficiently, allowing for decision makers (with appropriate data available) to gain rapid cost-of-illness estimates. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Epidemiology and public health response in early phase of COVID-19 pandemic, Veneto Region, Italy, 21 February to 2 April 2020

alkiviadis.1961 shared this article with you from Inoreader Epidemiology and public health response in early phase of COVID-19 pandemic, Veneto Region, Italy, 21 February to 2 April 2020 Via Eurosurveillance latest updates Background Veneto was one of the Italian regions hit hardest by the early phase of the coronavirus disease (COVID-19) pandemic. Aim This paper describes the public health response and epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in the Veneto Region from 21 February to 2 April 2020. Methods Information on the public health response was collected from regional health authorities' official sources. Epidemiological data were extracted from a web-based regional surveillance system. The epidemic curve was represented by date of testing. Characteristics of hospitalised COVID-19 cases were described and compared to those never admitted to hospital. Age- and sex-stratified case-fatality ratios (CFRs) were calculated. Results Key elements of the regional public health response were thorough case-finding and contact tracing, home care for non-severe cases, creation of dedicated COVID-19 healthcare facilities and activation of sub-intensive care units for non-invasive ventilation. As at 2 April 2020, 91,345 individuals were tested for SARS-CoV-2 and 10,457 (11.4%) were positive. Testing and attack rates were 18.6 per 1,000 and 213.2 per 100,000 population, respectively. The epidemic peaked around 20 to 24 March, with case numbers declining thereafter. Hospitalised cases (n = 3,623; 34.6%) were older and more frequently male compared with never-hospitalised cases. The CFR was 5.6% overall, and was higher among males and people > 60 years of age. Conclusion In the Veneto Region, the strict social distancing measures imposed by the Italian government were supported by thorough case finding and contact tracing, as well as well-defined roles for different levels of care. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.