scholarly journals Dehydration and renal failure in older persons during heatwaves-predictable, hard to identify but preventable?

2019 ◽  
Vol 48 (5) ◽  
pp. 615-618 ◽  
Author(s):  
Michelle Brennan ◽  
Shaun T O’Keeffe ◽  
Eamon C Mulkerrin
Keyword(s):  
Renal Failure ◽  
Older Persons ◽  
Excess Mortality ◽  
Heat Waves ◽  
Physiological Responses ◽  
Heat Stroke ◽  
Clinical Signs ◽  
Cost Effective ◽  
Diagnostic Tools ◽  
Excess Heat

Abstract Extremes of temperature are likely to increase in frequency associated with climate change. Older patients are particularly vulnerable to the effects of heat with excess mortality well documented in this population. Age-associated neurohormonal changes particularly affecting the renin angiotensin aldosterone system (RAAS), alterations in thermoregulatory mechanisms, changes in renal function and body composition render older persons vulnerable to dehydration, renal failure, heat stroke and increased mortality. Barriers to diagnosis and recognition of dehydration and renal failure include the absence of reliable clinical signs and cost-effective diagnostic tools. Regularly used medications also impact on physiological responses to excess heat as well as interfering with the recognition and management of dehydration during heat waves. In view of the above, anticipatory measures should be instituted ideally prior to the onset of heat waves to minimise morbidity and mortality for older people during periods of excess heat.

scholarly journals Does Ethnic Diversity Impact on Risk Perceptions, Preparedness, and Management of Heat Waves?

2021 ◽  
Vol 9 ◽  
Author(s):  
Maya Siman-Tov ◽  
Kirsten Vanderplanken ◽  
Debarati Guha-Sapir ◽  
Joris A. F. van Loenhout ◽  
Bruria Adini
Keyword(s):  
Ethnic Diversity ◽  
Risk Perceptions ◽  
Excess Mortality ◽  
Heat Waves ◽  
Heat Stroke ◽  
Protective Behavior ◽  
Protective Measures ◽  
Crucial Component ◽  
Majority Groups ◽  
Individual Ability

Detrimental health impacts of heatwaves, including excess mortality, are increasing worldwide. To assess risk perceptions, protective knowledge and behaviors concerning heatwaves in Israel, a study was initiated, comparing attitudes of majority (Jewish) and minority (Arab) populations. A quantitative survey was disseminated through an internet panel, to a representative sample of 556 individuals (79% Jews; 21% Arabs). Overall, 74% consider heatwaves a problem, 93% believe that heatwaves' frequencies will increase, 27% are very concerned about the effects of heatwaves. Higher levels of awareness to heatwaves were found among Jewish compared to Arab respondents; 90 vs. 77% (respectively) could name heatwaves' symptoms (p < 0.001); 81 vs. 56% (respectively) reported knowing how to protect themselves (p < 0.001); 74 vs. 47% (respectively) reported knowing what to do when someone suffers from heat stroke (p < 0.001). Arab compared to Jewish respondents presented higher levels of concern about heatwaves' effects (3.22 vs. 3.09 respectively; t −2.25, p = 0.03), while knowledge of protective measures was higher among Jews compared to Arabs (3.67 vs. 3.56 t = 2.13 p = 0.04). A crucial component of enhancing preparedness to heatwaves is empowerment of minority as well as majority groups, to strengthen their capacity to implement protective behavior and elevate their self-belief in their individual ability and fortitude.

Sonographically guided, transcatheter foam sclerotherapy of the great saphenous vein

Phlebologie ◽  
2007 ◽  
Vol 36 (06) ◽  
pp. 309-312 ◽  
Author(s):  
T. Schulz ◽  
M. Jünger ◽  
M. Hahn
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Clinical Stage ◽  
Clinical Signs ◽  
Cost Effective ◽  
Duplex Sonography ◽  
Foam Sclerotherapy ◽  
Average Loss ◽  
One Year ◽  
The Cost

Summary Objective: The goal of the study was to assess the effectiveness and patient tolerability of single-session, sonographically guided, transcatheter foam sclerotherapy and to evaluate its economic impact. Patients, methods: We treated 20 patients with a total of 22 varicoses of the great saphenous vein (GSV) in Hach stage III-IV, clinical stage C2-C5 and a mean GSV diameter of 9 mm (range: 7 to 13 mm). We used 10 ml 3% Aethoxysklerol®. Additional varicoses of the auxiliary veins of the GSV were sclerosed immediately afterwards. Results: The occlusion rate in the treated GSVs was 100% one week after therapy as demonstrated with duplex sonography. The cost of the procedure was 207.91 E including follow-up visit, with an average loss of working time of 0.6 days. After one year one patient showed clinical signs of recurrent varicosis in the GSV; duplex sonography showed reflux in the region of the saphenofemoral junction in a total of seven patients (32% of the treated GSVs). Conclusion: Transcatheter foam sclerotherapy of the GSV is a cost-effective, safe method of treating varicoses of GSV and broadens the spectrum of therapeutic options. Relapses can be re-treated inexpensively with sclerotherapy.

RE-AUTHORING THE LOSSES AND CHALLENGES OF AGING: OLDER INDIVIDUALS’ EXPERIENCES OF LONGTERM GROUP WORK

2015 ◽  
Vol 27 (1) ◽  
pp. 3-19
Author(s):  
Cecile Frankel ◽  
Brenda Solarsh ◽  
Eleanor Ross
Keyword(s):  
Life Expectancy ◽  
Group Work ◽  
Narrative Therapy ◽  
Older Persons ◽  
Senior Citizens ◽  
Cost Effective ◽  
Life Transitions ◽  
Older Individuals ◽  
Documentary Analysis ◽  
Social Group Work

The increase in life expectancy has highlighted the value of group work interventions as a cost-effective way of helping older persons to deal with life transitions. This article describes a group for senior citizens that continued for 18 years. The aim of the study was to undertake a documentary analysis of the facilitator’s process notes and participans’ reflections to ascertain possible reasons for the group’s longevity. These were attributed to the skill of the facilitator and her creative use of programme material and narrative therapy. Recurring themes included loneliness, the fear of dying, and dilemmas about relinquishing control and independence. Findings have implications for the practice of social group work with older persons.

scholarly journals A heat-health watch and warning system with extended season and evolving thresholds

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mahamat Abdelkerim Issa ◽  
Fateh Chebana ◽  
Pierre Masselot ◽  
Céline Campagna ◽  
Éric Lavigne ◽  
...  
Keyword(s):  
Excess Mortality ◽  
Heat Waves ◽  
Meteorological Data ◽  
Warm Season ◽  
Warning System ◽  
Early Warning Systems ◽  
Climate Projections ◽  
Warning Systems ◽  
Extreme Heat Events ◽  
Watch And Warning System

Abstract Background Many countries have developed heat-health watch and warning systems (HHWWS) or early-warning systems to mitigate the health consequences of extreme heat events. HHWWS usually focuses on the four hottest months of the year and imposes the same threshold over these months. However, according to climate projections, the warm season is expected to extend and/or shift. Some studies demonstrated that health impacts of heat waves are more severe when the human body is not acclimatized to the heat. In order to adapt those systems to potential heat waves occurring outside the hottest months of the season, this study proposes specific health-based monthly heat indicators and thresholds over an extended season from April to October in the northern hemisphere. Methods The proposed approach, an adoption and extension of the HHWWS methodology currently implemented in Quebec (Canada). The latter is developed and applied to the Greater Montreal area (current population 4.3 million) based on historical health and meteorological data over the years. This approach consists of determining excess mortality episodes and then choosing monthly indicators and thresholds that may involve excess mortality. Results We obtain thresholds for the maximum and minimum temperature couple (in °C) that range from (respectively, 23 and 12) in April, to (32 and 21) in July and back to (25 and 13) in October. The resulting HHWWS is flexible, with health-related thresholds taking into account the seasonality and the monthly variability of temperatures over an extended summer season. Conclusions This adaptive and more realistic system has the potential to prevent, by data-driven health alerts, heat-related mortality outside the typical July–August months of heat waves. The proposed methodology is general and can be applied to other regions and situations based on their characteristics.

scholarly journals Cost-Effectiveness of Investigations for Invasive Bladder Cancer

1987 ◽  
Vol 80 (3) ◽  
pp. 143-144 ◽  
Author(s):  
M T Hunt ◽  
C R J Woodhouse
Keyword(s):  
Transitional Cell ◽  
Clinical Signs ◽  
Cost Effective ◽  
Intravenous Urography ◽  
Liver Scan ◽  
Chest X Ray ◽  
Carcinoma Of The Bladder ◽  
Disseminated Disease ◽  
Positive Results ◽  
Diagnostic Investigations

The results of diagnostic and staging investigations in consecutive cases of invasive transitional cell carcinoma of the bladder are reviewed. Urine culture, urine cytology and intravenous urography had positive results in a high percentage of cases. As diagnostic investigations they are cost-effective but certainly do not remove the obligation to perform cystoscopy and examination under anaesthetic. Isotopic bone scan and liver scan showed metastases in 4 and one cases respectively and only when there were clinical signs of disseminated disease. Chest X-ray showed metastases in one case. These investigations are not cost-effective. Lymphangiography was positive in 12 of the 94 cases and, although expensive (£70), is still a staging investigation of value in planning treatment.

Exertional Heat Stroke and Acute Renal Failure in a Young Woman

1988 ◽  
Vol 11 (2) ◽  
pp. 184-187 ◽  
Author(s):  
M.E. Pattison ◽  
J.L. Logan ◽  
S.M. Lee ◽  
D.A. Ogden
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Young Woman ◽  
Heat Stroke ◽  
Exertional Heat Stroke

122 Bioactive Peptides for Enhancing Intestine Health

2021 ◽  
Vol 99 (Supplement_3) ◽  
pp. 65-65
Author(s):  
Julang Li ◽  
Nadeem Akhtar ◽  
Celina Osakowicz ◽  
Lauren Fletcher ◽  
Karmin O ◽  
...  
Keyword(s):  
Animal Health ◽  
Clinical Signs ◽  
Body Weight Loss ◽  
Cost Effective ◽  
Significant Rise ◽  
Feed Ratio ◽  
Resistant Bacteria ◽  
Intestinal Development ◽  
Antibiotic Resistant ◽  
Animal Trials

Abstract Intestinal disorders and colitis affect both animals and humans. The pathogenesis behind the inflammation is complex and not entirely understood. Furthermore, the significant rise in antibiotic-resistant bacteria has emphasized an urgent need for alternative anti-infective therapies. Antimicrobial peptides (AMPs) is one of the appealing alternative to antibiotics due to their antimicrobial activity, mode of actions, and potential role in tissue repair. Epidermal growth factor (EGF) plays an important role in intestinal proliferation and differentiation and thus promotes intestinal development. Using food grade microorganisms such as Lactococcus lactis and yeast as hosts, our laboratory has produced recombinant porcine protegrin-1 (PG-1), a pig originated antimicrobial peptide and EGF via fermentation. Oral administration of PG-1 reduced Citrobacter rodentium induced intestinal infection in mice. This was evidenced by reduced histopathological changes in the colon, prevention of body weight loss, milder clinical signs of disease, and ultimately more effective clearance of bacterial infection. On the other hand, animal trials using the recombinant EGF demonstrated that it enhances intestinal development and growth of early weaned pig fed with antibiotic-free diet. Moreover, piglets challenged with enterotoxigenic Escherchia coli (E. coli) K88 showed similar beneficial responses to EGF as those fed diets with antibiotic in terms of improving gain to feed ratio and lowering oxidative stress. Taken together, our findings suggest the potential for cost-effective production and application of recombinant bioactive proteins as alternatives to antibiotics in animal health and production.

Horner’s syndrome in dogs and cats – a review

2019 ◽  
Vol XXIV (138) ◽  
pp. 34-40
Author(s):  
Laís Limeira Rodrigues ◽  
Leonardo Pereira Mesquita ◽  
Denis Alberto Zanatto ◽  
Paulo César Maiorka
Keyword(s):  
Sympathetic Innervation ◽  
Clinical Signs ◽  
Physiological Characteristics ◽  
Diagnostic Tools ◽  
Horner’S Syndrome ◽  
Horner's Syndrome ◽  
The Third

In dogs and cats, Horner's syndrome is characterized by a group of clinical signs arising from an ipsilateral dysfunction of sympathetic innervation of the eye and its appendages. These signs include ptosis, miosis, anisocoria, prolapse of the third eyelid, and enophtalmos. Lesions that may affect directly or indirectly the sympathetic innervation of the eye, such as trauma, neoplasms, iatrogenic lesions, otitis, encephalitis, among others, can induce HS. The aim of the present study was to review the anatomical and physiological characteristics of sympathetic innervation for the ocular globe, with emphasis on the description of the peculiarities of HS, including its etiology, clinical signs, diagnostic tools, as well as its possible treatments and prognosis.

Renal Medullary Cystic Disease

1988 ◽  
Vol 29 (5) ◽  
pp. 527-529 ◽  
Author(s):  
A. Olsen ◽  
J. Hansen Højhus ◽  
G. Steffensen
Keyword(s):  
Renal Failure ◽  
Renal Disease ◽  
Diagnostic Tools ◽  
Adult Onset ◽  
Cystic Disease ◽  
Terminal Renal Failure ◽  
Medullary Cystic Disease ◽  
Corticomedullary Junction ◽  
Autosomal Inheritance ◽  
Renal Medullary Cystic Disease

Medullary cystic disease (MCD) is an uncommon renal disease with adult onset and autosomal inheritance, eventually progressing to terminal renal failure. It may be difficult to identify because of insufficient diagnostic tools. At urography, the same ring- shaped accumulation of contrast medium at the corticomedullary junction was observed in two patients (mother and son) suffering from MCD. To our knowledge this observation has not been reported before.

scholarly journals Extracellular Glycosaminoglycans in Management of Primary Hepatocellular Carcinoma Rather than Alpha Fetoprotein

2016 ◽  
Vol 3 (1) ◽  
Author(s):  
Abdel-Hamid NM ◽  
◽  
Abdel-Fattah SM ◽  
Nazmy MH ◽  
Mahmoud AS ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Hepatocellular Carcinoma ◽  
Extracellular Matrix ◽  
Cancer Progression ◽  
Cost Effective ◽  
Diagnostic Value ◽  
Primary Hepatocellular Carcinoma ◽  
Diagnostic Tools ◽  
Total Sialic Acid ◽  
Design And Methods

Objectives: Extracellular matrix (ECM) is an essential player at various stages of carcinogenesis. Current study aims to evaluate diagnostic value of components of ECM, released to the serum, i.e. total glycosaminoglycans (TGAGs), total sialic acid (TSA) and free glucosamine (FGA) in primary HCC patients solely or confounded by other conditions (i.e. diabetes mellitus (DM), hepatitis C virus (HCV) or bilharziasis (B). Design and Methods: Our study was conducted upon 40 HCC patients: 32 (80%) males, 8 (20%) females, among these samples, patients with ascites, single/or multiple HCC lesions, as shown in demographic Table. Results: Liver and renal indices were significantly disturbed in HCC patients. Significant elevations of AFP, TGAGS and FGA, non-significant increases in TSA in HCC patients compared to normal control. These parameters except AFP showed significant persistent higher levels during cancer progression. AFP showed irrelevant changes to the stages of HCC lesion. HCC patients with HCV, DM or B showed significantly higher levels of AFP than with HCC solely. Both TGAGs and FGA showed the highest diagnostic accuracy over AFP, but TSA showed the lowest value. Conclusion: TGAGs and FGA may be regarded as cost-effective and more accurate diagnostic tools during primary HCC progression, whether solely, or commixed by other diseases.

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