Annals of medicine
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The East Africa Consortium was formed to study the epidemiology of human papillomavirus (HPV) infections and cervical cancer and the influence of human immunodeficiency virus (HIV) infection on HPV and cervical cancer, and to encourage collaborations between researchers in North America and East African countries. To date, studies have led to a better understanding of the influence of HIV infection on the detection and persistence of oncogenic HPV, the effects of dietary aflatoxin on the persistence of HPV, the benefits of antiretroviral therapy on HPV persistence, and the differences in HPV detections among HIV-infected and HIV-uninfected women undergoing treatment for cervical dysplasia by either cryotherapy or LEEP. It will now be determined how HPV testing fits into cervical cancer screening programs in Kenya and Uganda, how aflatoxin influences immunological control of HIV, how HPV alters certain genes involved in the growth of tumours in HIV-infected women. ⋯ KEY MESSAGESThe East Africa Consortium was formed to study the epidemiology of human papillomavirus (HPV) infections and cervical cancer and the influence of human immunodeficiency virus (HIV) infection on HPV and cervical cancer. Collaborations have been established between researchers in North America and East African countries for these studies. Studies have led to a better understanding of the influence of HIV infection on the detection and persistence of oncogenic HPV, the effects of dietary aflatoxin on HPV detection, the benefits of antiretroviral therapy on HPV persistence, and the differences in HPV detections among HIV-infected and HIV-uninfected women undergoing treatment for cervical dysplasia by either cryotherapy or LEEP.
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For individuals receiving maintenance dialysis, estimating accurate resting energy expenditure (REE) is essential for achieving energy balance, and preventing protein-energy wasting. Dialysis-specific, predictive energy equations (PEEs) offer a practical way to calculate REE. Three PEEs have been formulated via similar methods in different demographic samples; the Maintenance Haemodialysis Equation (MHDE REE), Vilar et al. Equation (Vilar REE) and the Fernandes et al. Equation (Cuppari REE). We compared them in a US cohort and assessed precision relative to measured REE (mREE) from indirect calorimetry. Because of expected imprecision at the extremes of the weight distribution, we also assessed the PEEs stratified by body mass index (BMI) subgroups. ⋯ Dialysis-specific energy equations showed variable accuracy. When categorized by BMI, the equations performed poorly at the extremes, where individuals are most vulnerable. Innovation is needed to understand these variances and correct the imprecision in PEEs for clinical practice.KEY MESSAGESPotentially impacting over millions of patients worldwide, our long-term goal is to understand energy expenditure (EE) across the spectrum of CKD (stages 1-5) in adults and children being treated with dialysis or transplantation, with the intent of providing tools for the health professional that will improve the delivery of quality care.Our research has identified and focussed on disease-specific factors which account for 60% of the variance in predicting EE in patients on MHD, but significant gaps remain.Thus, our central hypotheses are that (1) there are unique disease-specific determinants of EE and (2) prediction of EE for individuals diagnosed with CKD can be vastly improved with a model that combines these factors with more sophisticated approaches.
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Review
Ultrasound assessment of SARS-CoV-2 pneumonia: a literature review for the primary care physician.
The SARS-CoV-2 pandemic is considered one of the most critical global health emergencies in the last century. The diagnostic approach to the novel coronavirus disease (COVID-19) and its possible complications through a point-of-care-ultrasound (POCUS) evaluation could represent a good solution in the primary care setting. POCUS is a non-invasive technique that can be used outside hospitals to screen COVID-19 patients and their complications safely. ⋯ Key MessagesPOCUS is an important tool for the diagnostic approach in the primary care setting already before the start of the SARS-CoV-2 pandemic. Portable devices are useful in monitoring the clinical evolution of patients with infection from SARS-CoV-2 at home. The ultrasonographic features can help the general practice physicians to evaluate the presence of lung involvement and to diagnose complications from the SARS-CoV-2 infection involving districts such as the cardiovascular system.
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Introduction: Phytochemicals have garnered much attention because they are useful in managing several human diseases. Yohimbine is one such phytochemical with significant pharmacological potential and could be exploited for research by medicinal chemists. It is an indole alkaloid obtained from various natural/synthetic sources. ⋯ Key MessagesYohimbine is a natural indole alkaloid with significant pharmacological potential. Humans have used it as a stimulant and aphrodisiac from a relatively early time. It blocks the pre- and postsynaptic α2-adrenergic receptors that could be exploited for managing erectile dysfunction, myocardial dysfunction, inflammatory disorders, and cancer.
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Pancreatitis is the leading gastrointestinal cause of hospitalizations. There are multiple short- and long-term complications associated with pancreatitis. Post-pancreatitis diabetes mellitus (PPDM) is one of the less explored complications of pancreatitis. ⋯ KEY MESSAGESPost-pancreatitis diabetes mellitus (PPDM) is now the second most common cause of new-onset diabetes mellitus (DM) in adults after type II DM surpassing type 1 DM. New-onset diabetes in patients with pancreatitis could also be an early marker of occult pancreatic malignancy. Management of PPDM is complex and requires a team-based approach including gastroenterologists, endocrinologists, primary care physicians, nutritionists, and behavioural health specialists.