scholarly journals Diagnosing undernutrition children and adults: new French criteria. Why, for what and for whom? A joint statement of the French National Authority for Health and French Federation of Nutrition

2021 ◽  
pp. 1-38
Author(s):  
Jacques Delarue ◽  
Jean-Claude Desport ◽  
Béatrice Dubern ◽  
Francisca Joly ◽  
Emmanuel Mas ◽  
...  
Keyword(s):  
Weight Loss ◽  
Muscle Mass ◽  
Task Force ◽  
Mass Function ◽  
World Health ◽  
Reading Group ◽  
Randomized Control ◽  
Health Organization ◽  
Meta Analyses ◽  
First Time

Abstract The objective was to establish new diagnostic criteria for undernutrition for the French population, concordant for children aged < 18 years and adults aged < 70 years, easy to use by health professionals, and applicable whatever the situation (in - and outpatients). A multi-disciplinary working and a reading group were involved. The procedure was divided into 4 phases: 1) systematic review and synthesis of the literature; 2) writing of the initial version of the guidelines; 3) reading; 4) finalization. The literature search included international guidelines, meta-analyses, systematic reviews, and randomized control trials from January 2007 to July 31, 2018. A two-step approach was selected: diagnosing undernutrition, and then grading its severity. For diagnosis at least one phenotypic criterion associated with at least one etiologic criterion were required for both children and adults. Phenotypic criteria for children were: weight loss, body mass index (BMI) < International Obesity Task Force curve 18.5, weight stagnation, reduction of muscle mass/function; for adults: weight loss, BMI < 18.5, reduction of muscle mass/function. Etiological criteria for children and adults were: reduction in dietary intake, reduced absorption, and hypercatabolism. Phenotypic metrics were used in both children and adults for grading severity (moderate or severe). These new French recommendations integrate the proposals of recent international recommendations combining etiologic with phenotypic criteria, but for the first time, they are concordant for children and adults. The World Health Organization threshold of 18.5 for BMI was kept as phenotypic criteria because epidemiologic data show an increased mortality for that threshold.

scholarly journals Programme for Harmonization to the International Scale in Latin America for BCR-ABL1 quantification in CML patients: findings and recommendations

2020 ◽  
Vol 58 (12) ◽  
pp. 2025-2035
Author(s):  
María Sol Ruiz ◽  
María Belén Sánchez ◽  
Yuly Masiel Vera Contreras ◽  
Evangelina Agrielo ◽  
Marta Alonso ◽  
...  
Keyword(s):  
Latin America ◽  
Myeloid Leukemia ◽  
World Health ◽  
Molecular Response ◽  
Limit Of Quantification ◽  
International Scale ◽  
Deep Molecular Response ◽  
Health Organization ◽  
First Time

AbstractObjectivesThe quantitation of BCR-ABL1 mRNA is mandatory for chronic myeloid leukemia (CML) patients, and RT-qPCR is the most extensively used method in testing laboratories worldwide. Nevertheless, substantial variation in RT-qPCR results makes inter-laboratory comparability hard. To facilitate inter-laboratory comparative assessment, an international scale (IS) for BCR-ABL1 was proposed.MethodsThe laboratory-specific conversion factor (CF) to the IS can be derived from the World Health Organization (WHO) genetic reference panel; however, this material is limited to the manufacturers to produce and calibrate secondary reference reagents. Therefore, we developed secondary reference calibrators, as lyophilized cellular material, aligned to the IS. Our purpose was both to re-evaluate the CF in 18 previously harmonized laboratories and to propagate the IS to new laboratories.ResultsOur field trial including 30 laboratories across Latin America showed that, after correction of raw BCR-ABL1/ABL1 ratios using CF, the relative mean bias was significantly reduced. We also performed a follow-up of participating laboratories by annually revalidating the process; our results support the need for continuous revalidation of CFs. All participating laboratories also received a calibrator to determine the limit of quantification (LOQ); 90% of them could reproducibly detect BCR-ABL1, indicating that these laboratories can report a consistent deep molecular response. In addition, aiming to investigate the variability of BCR-ABL1 measurements across different RNA inputs, we calculated PCR efficiency for each individual assay by using different amounts of RNA.ConclusionsIn conclusion, for the first time in Latin America, we have successfully organized a harmonization platform for BCR-ABL1 measurement that could be of immediate clinical benefit for monitoring the molecular response of patients in low-resource regions.

Indeterminate Chagas’ disease: Trypanosoma cruzi strain and re-infection are factors involved in the progression of cardiopathy

2003 ◽  
Vol 104 (4) ◽  
pp. 415-420 ◽  
Author(s):  
Juan M. BUSTAMANTE ◽  
Héctor W. RIVAROLA ◽  
Alicia R. FERNÁNDEZ ◽  
Julio E. ENDERS ◽  
Ricardo FRETES ◽  
...  
Keyword(s):  
Survival Rate ◽  
Trypanosoma Cruzi ◽  
Chagas Disease ◽  
Infected Group ◽  
World Health ◽  
Cardiac Lesions ◽  
Health Organization ◽  
Host Parasite ◽  
Β Adrenergic Receptors ◽  
First Time

Chagas' disease is caused by Trypanosoma cruzi, which is transmitted by reduviid bugs. The World Health Organization has estimated that about 16–18 million people in the Americas are infected, and that more than 100 million are at risk. In the present study we have used a murine model to analyse if particular T. cruzi strains (Tulahuen strain and SGO-Z12 isolate from a chronic patient) and/or re-infection may determine, during the indeterminate phase of experimental Chagas' disease, changes that could explain the different evolution of cardiac lesions. Re-infected mice reached higher parasitaemias than those infected for the first time. The survival in the indeterminate phase of mice infected with Tulahuen strain was 50.0%, while the SGO-Z12-infected group presented a significantly higher survival rate (77.1%; P<0.01). The SGO-Z12-re-infected group showed a survival rate (70.9%) significantly higher than that of the Tulahuen-re-infected group (37.0%; P<0.01). Electrocardiographic abnormalities were found in 66% of Tulahuen-infected mice, while in SGO-Z12-infected group such abnormalities were found in only 36% of animals (P<0.01). The two groups exhibited similar percentages of electrocardiographic dysfunction on re-infection, although intraventricular blocks were more frequent in Tulahuen-re-infected mice (P<0.01). Hearts from infected or re-infected mice with either parasite showed mononuclear infiltrates. The SGO-Z12-re-infected and Tulahuen-re-infected groups exhibited a significantly diminished affinity (P<0.05) and a significantly increased density (P<0.05) of cardiac β-adrenergic receptors compared with the infected and non-infected groups. The indeterminate phase of Chagas' disease is defined as a prolonged period that is clinically silent, but the present findings show that different T. cruzi strains and re-infection are able to alter the host–parasite equilibrium, and these factors may be responsible for inducing progressive cardiopathy.

scholarly journals Overweight and obesity of children in a brazilian elementary school: a comparison of three references

2016 ◽  
Vol 26 (3) ◽  
pp. 341
Author(s):  
Marcella Evangelista Melo ◽  
Giovanna Lima Miguéis ◽  
Mikaela Silva Almeida ◽  
Tatiane Dalamaria ◽  
Wagner De Jesus Pinto ◽  
...  
Keyword(s):  
Elementary School ◽  
Task Force ◽  
Cross Sectional Study ◽  
Overweight And Obesity ◽  
World Health ◽  
Sectional Study ◽  
Kappa Index ◽  
International Obesity Task Force ◽  
Cross Sectional ◽  
Health Organization

Introduction: In the diagnosis of overweight and obesity based on body mass index in children and adolescents, several national and international anthropometric references are recommended. However, there is a divergence in the estimated prevalence of overweight and obesity among the references. Objective: To identify the prevalence of overweight and obesity and to analyse the magnitude of agreement among the three references. Methods: A cross-sectional study with 975 students from the early grades of elementary school. The prevalence of overweight and obesity were estimated according to the criteria of the World Health Organization (WHO), the International Obesity Task Force (IOTF) and Conde and Monteiro. The Kappa weighted index was calculated to assess the agreement magnitude among the three references. Results: The highest prevalence of overweight and obesity was estimated by the Conde and Monteiro and WHO references, respectively. Overall, the IOTF revealed lower a magnitude of prevalence than the two other references. The agreement among the references identified by the Kappa index had a range of 0.66 to 0.94. Conclusion: Despite the satisfactory agreement among the three references, this research highlighted the differing magnitudes of the prevalence of overweight and obesity. This fact limits the ability to make comparisons among populations and impairs the development of overweight and obesity prevention actions.

scholarly journals Therapeutic Effectiveness and Safety of Repurposing Drugs for the Treatment of COVID-19: Position Standing in 2021

2021 ◽  
Vol 12 ◽  
Author(s):  
Safaet Alam ◽  
Taslima Binte Kamal ◽  
Md. Moklesur Rahman Sarker ◽  
Jin-Rong Zhou ◽  
S. M. Abdur Rahman ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Case Series ◽  
Basic Knowledge ◽  
World Health ◽  
Current Status ◽  
Drug Candidates ◽  
Health Organization ◽  
Meta Analyses

COVID-19, transmitted by SARS-CoV-2, is one of the most serious pandemic situations in the history of mankind, and has already infected a huge population across the globe. This horrendously contagious viral outbreak was first identified in China and within a very short time it affected the world's health, transport, economic, and academic sectors. Despite the recent approval of a few anti-COVID-19 vaccines, their unavailability and insufficiency along with the lack of other potential therapeutic options are continuing to worsen the situation, with valuable lives continuing to be lost. In this situation, researchers across the globe are focusing on repurposing prospective drugs and prophylaxis such as favipiravir, remdesivir, chloroquine, hydroxychloroquine, ivermectin, lopinavir-ritonavir, azithromycin, doxycycline, ACEIs/ARBs, rivaroxaban, and protease inhibitors, which were preliminarily based on in vitro and in vivo pharmacological and toxicological study reports followed by clinical applications. Based on available preliminary data derived from limited clinical trials, the US National Institute of Health (NIH) and USFDA also recommended a few drugs to be repurposed i.e., hydroxychloroquine, remdesivir, and favipiravir. However, World Health Organization later recommended against the use of chloroquine, hydroxychloroquine, remdesivir, and lopinavir/ritonavir in the treatment of COVID-19 infections. Combining basic knowledge of viral pathogenesis and pharmacodynamics of drug molecules as well as in silico approaches, many drug candidates have been investigated in clinical trials, some of which have been proven to be partially effective against COVID-19, and many of the other drugs are currently under extensive screening. The repurposing of prospective drug candidates from different stages of evaluation can be a handy wellspring in COVID-19 management and treatment along with approved anti-COVID-19 vaccines. This review article combined the information from completed clinical trials, case series, cohort studies, meta-analyses, and retrospective studies to focus on the current status of repurposing drugs in 2021.

scholarly journals Efektivitas Klinis Ofloksasin Topikal Dibanding Ciprofloksasin Oral Pada Terapi Otitis Media Supuratif Kronik Aktif

2017 ◽  
Vol 4 (2) ◽  
Author(s):  
Deasy Mediawaty ◽  
Pujo Widodo ◽  
Dian Ayu Ruspita
Keyword(s):  
World Health Organization ◽  
Otitis Media ◽  
Randomized Control Trial ◽  
World Health ◽  
Control Group ◽  
Control Group Design ◽  
Group Design ◽  
Randomized Control ◽  
Health Organization ◽  
Per Oral

Latar belakang : Otitis media kronik atau sering disebut Otitis Media Supuratif Kronik (OMSK) adalah otitis media yang berlangsung > 12 minggu. Prevalensi OMSK di seluruh dunia sebanyak 65-330 juta dan 60% di antaranya menderita kurang pendengaran yang signifikan. Angka kejadian OMSK aktif mencapai 3,8% dari pasien THT-KL. Gejala OMSK aktif berupa banyaknya discaj, kurang pendengaran, nyeri, pusing berputar, telinga tidak nyaman. Tanda OMSK aktif berupa discaj di liang telinga, perforasi membran timpani, dan gangguan pendengaran. World Health Organization (WHO) mencanangkan strategi untuk mengatasi OMSK secara serius berkaitan dengan komplikasi yang dapat disebabkan. Pilihan terapi medikamentosa yang tepat diperlukan untuk mengatasi OMSK aktif. Ofloksasin topikal dan ciprofloksasin oral adalah antibiotik golongan fluorokuinolon yang banyak digunakan. Efektivitas diantaranya dibuktikan dengan perbaikan gejala dan tanda klinis. Tujuan : Membuktikan efektifitas ofloksasin topikal, ciprofloksasin oral dan efektifitas ofloksasin topikal dibanding ciprofloksasin oral terhadap perbaikan gejala dan tanda klinis. Metode :  Penelitian intervensi dengan rancangan pretest and posttest control group design, randomized control trial Klinik THT-KL BKIM Semarang pada bulan Juni-Agustus 2016. Penderita OMSK aktif dilakukan anamnesis lalu dilakukan pemeriksaan fisik dan pemeriksaan pendengaran dilanjutkan randomisasi. Penderita diberi ofloksasin topikal 10 tetes/12 jam atau ciprofloksasin tablet 500 mg/12 jam per oral. Hari ke 4, 10 dan 14 setelah terapi penderita kontrol. Analisis uji komparatif menggunakan uji parametrik dan non parametrik. Hasil : Jumlah subyek penelitian 108 orang ; ofloksasin topikal 54 orang (50%) dan ciprofloksasin oral 54 orang  (50 %). Gejala dan tanda klinis setelah terapi lebih rendah dibanding sebelum terapi pada kelompok ofloksasin topikal dan ciprofloksasin oral dengan nilai kemaknaan p < 0,05. Gejala klinis kelompok ofloksasin lebih baik dibanding ciproloksasin secara bermakna (p<0,05). Tanda klinis kedua kelompok terdapat perbedaan yang tidak bermakna (p>0,05). Simpulan : Ofloksasin topikal dan ciprofloksasin oral terbukti efektif memperbaiki gejala dan tanda klinis penderita OMSK aktif. Ofloksasin topikal efektif memperbaiki gejala klinis dibandingkan ciprofloksasin oral. Kata kunci : Otitis media supuratif kronik, ofloksasin, ciprofloksasin, gejala dan tanda klinis

scholarly journals Radon Gas in the City of Alicante. High Risk of Low Indoor Air Quality in Poorly Ventilated Buildings

2020 ◽  
Vol 17 (23) ◽  
pp. 8762
Author(s):  
Carlos Rizo-Maestre ◽  
Víctor Echarri-Iribarren
Keyword(s):  
World Health ◽  
Santa Barbara ◽  
Buried Structures ◽  
Gaseous State ◽  
Major Health ◽  
Radon Gas ◽  
Health Organization ◽  
Measurement Location ◽  
First Time ◽  
The City

In December 2019, Spain considered for the first time the presence of radon to the Technical Building Code (Basic Document HS 6: Radon Exposure Protection), although it only mentions minimum presences and the need for ventilation. This research shows that in buried structures or in places with little ventilation, even in soils with a low probability of granite, a high content of radon gas can be found. The city of Alicante has been used as a measurement location for different architectural sites; here, the level of 100 Bq/m3 is the first threshold where the gas must be monitored, and the level of 300 Bq/m3 is the maximum threshold above which corrective ventilation measures must be taken. The research conducted during the years 2015 and 2016 shows that it is necessary to account for also the areas considered to be “low presence of radon gas” to achieve healthy constructions. The renewal of air in the different places will be tested for the presence of radon, i.e., the greater the accumulation is, the less ventilation and the greater the risk of accumulation of radon gas. This study is located in the city of Alicante, where the seven civil constructions are located: two Civil War shelters, the Santa Barbara Castle, the Ereta Powder Keg, the Luceros-Marq and Serra Grossa railway tunnels and the Británica underground deposits. Radon gas is currently a concern for major health and medical agencies because it is considered to be a chemical element that is very harmful to people. The World Health Organization is one of the organisations that has the objective of studying and researching this element, to develop solutions. Radon gas is normally found in a gaseous state and is highly radioactive. It is present in many terrains and it is mostly found in those with granite; although the presence of this element is very low, there is always a minimum presence. In the past, in nongranite soils, the dose of radon was considered to be so low that it was insignificant. Therefore, in this research, the aim is to consider the high presence of radon gas in nongranite soils as long as the conditions for its accumulation are present.

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