Articles: ninos.
-
Bronchopulmonary dysplasia (BPD) is a chronic lung disease, with its own clinical, radiological, and histopathological characteristics, which mainly affects premature newborns (NBs), resulting from a combination of factors that include immaturity, inflammation, and lung injury, in addition to therapy with mechanical ventilation and exposure to high concentrations of oxygen. However, even with advances in care for critically ill NBs, BPD continues to be a challenge for the care team and family members. This has been identified as one of the most important causes of morbidity and mortality due to prematurity and can have significant impacts on the quality of life of the affected patients. ⋯ Genetic variants in the glutathione S-transferase Mu-1/glutathione S-transferase theta-1-null (GSTM1/GSTT1) genes may be associated with a greater risk of developing BPD in premature NBs, as they affect the function of glutathione S-transferases (GSTs) enzymes and, consequently, the body's ability to eliminate toxic or harmful pro-inflammatory substances. GSTM1/GSTT1-null individuals, due to the absence of gene expression, present loss of enzymatic activity of the respective GST enzymes, triggering failures in the detoxification process and the consequent development of numerous diseases resulting from oxidative damage such as infertility, chronic kidney disease, eryptosis, retinopathy of prematurity, necrotizing enterocolitis, periventricular leukomalacia, intraventricular hemorrhage. The objective of this narrative review was to highlight the role of genetic variants in the GSTM1/GSTT1 genes in the onset of BPD.
-
Regional anesthesia, specifically fascia iliaca compartment blocks (FICB), is highly effective in managing pain, especially in military settings. However, a significant barrier to its implementation is the lack of provider confidence in performing ultrasound-guided procedures. This study evaluates the ability of physician assistant (PA) students, who are often first-line providers in austere locations, to identify the fascia iliaca compartment (FIC) using point-of-care ultrasound (POCUS) after a brief training session and assesses their retention of this skill over a 60- to 90-day period. ⋯ This study demonstrates that PA students can accurately identify the FIC using POCUS after a brief training session. However, there was a significant decline in skill retention over a 60- to 90-day period, underscoring the need for continuous education and practice to sustain proficiency. Further research with larger sample sizes and diverse settings is needed to develop effective training protocols and ensure long-term retention of U.S.-guided procedural skills.
-
Acute anterior cruciate ligament (ACL) injuries can be disabling because of prolonged rehabilitation process following surgical reconstructions. Rates of ACL injuries among military service members are close to 10 times greater than the general civilian population, likely because of the operation tempo and the unique physical requirements. Studies debated functional testing requirements for return to sports, but no study investigated the impact of functional training and re-injury rates following ACL reconstruction and their association with functional testing outcomes and time to return to full duty in United States Naval Academy (USNA) Midshipmen. Therefore, the purpose of this study was to review all ACL reconstructions with and without meniscal injury at USNA, the functional training and testing, timing of return to military training, and associations with postoperative re-injury rates. ⋯ Postoperative injuries and complications following ACLR can delay the ability to return to duty by twice as long, consequently effecting military manpower capability. A functional training and testing program resembling both an athletic and military/operational environment can reduce re-injury and complication rates, resulting in faster return-to-duty rates. Future studies should assess the impact of military rehabilitation participation following ACLR and functional testing protocols to assess physical readiness of Midshipmen to return to full duty. Additionally, methods to assess psychological readiness to return to duty should be further investigated.
-
The 2018 Scottish GP contract established GP Clusters and multidisciplinary team (MDT) expansion. Qualitative studies have suggested sub-optimal progress. ⋯ GPs report few improvements in working life five years after the new contract was introduced, and are responding by planning to reduce their hours or leave direct patient care.