Ocular phenotype and genetical analysis in patients with retinopathy of prematurity

Background Retinopathy of prematurity (ROP) is a multifactorial retinal disease, involving both environmental and genetic factors; The purpose of this study is to evaluate the clinical presentations and genetic variants in Chinese patients with ROP. Methods A total of 36 patients diagnosed with ROP were enrolled in this study, their medical and ophthalmic histories were obtained, and comprehensive clinical examinations were performed. Genomic DNA was isolated from peripheral blood of ROP patients, polymerase chain reaction and direct sequencing of the associated pathogenic genes (FZD4, TSPAN12, and NDP) were performed. Results All patients exhibited the clinical manifestations of ROP. No mutations were detected in the TSPAN12 and NDP genes in all patients; Interestingly, three novel missense mutations were identified in the FZD4 gene (p.A2P, p.L79M, and p.Y378C) in four patients, for a detection rate of 11.1% (4/36). Conclusions This study expands the genotypic spectrum of FZD4 gene in ROP patients, and our findings underscore the importance of obtaining molecular analyses and comprehensive health screening for this retinal disease.

Cloning and Characterization of a Novel Alginate Lyase from Paenibacillus sp. LJ-23

As a low molecular weight alginate, alginate oligosaccharides (AOS) exhibit improved water solubility, better bioavailability, and comprehensive health benefits. In addition, their biocompatibility, biodegradability, non-toxicity, non-immunogenicity, and gelling capability make them an excellent biomaterial with a dual curative effect when applied in a drug delivery system. In this paper, a novel alginate lyase, Algpt, was cloned and characterized from a marine bacterium, Paenibacillus sp. LJ-23. The purified enzyme was composed of 387 amino acid residues, and had a molecular weight of 42.8 kDa. The optimal pH of Algpt was 7.0 and the optimal temperature was 45 °C. The analysis of the conserved domain and the prediction of the three-dimensional structure indicated that Algpt was a novel alginate lyase. The dominant degradation products of Algpt on alginate were AOS dimer to octamer, depending on the incubation time, which demonstrated that Algpt degraded alginate in an endolytic manner. In addition, Algpt was a salt-independent and thermo-tolerant alginate lyase. Its high stability and wide adaptability endow Algpt with great application potential for the efficient preparation of AOS with different sizes and AOS-based products.

The appropriateness of health education

The subject of the present dissertation is to emphasize the importance of promoting and using the Health Education Theory and strategies, as an advance that manages to overcome the models that are used within patient care, through traditional methods, which focus on diseases, their prevention and treatments if they are present, giving priority to research to care for diseases, thus only fighting against morbid processes, which have already manifested themselves, from the level prevention or care. The Health Education is a strategy established in Ottawa, Canada in 1986, at the First World Conference on Health Promotion, where it is defined as: the process that provides individuals and communities with the means necessary to exercise greater control over their own health and thus be able to improve it, with its motto "Health for all in the year 2000", which has remained a utopian ideal at this time, still implies a challenge for the new Century and the changes in the comprehensive health approach.

Modelling trends of CD4 counts for patients on antiretroviral therapy (ART): a comprehensive health care clinic in Nairobi, Kenya

Background In resource-limited settings, changes in CD4 counts constitute an important component in patient monitoring and evaluation of treatment response as these patients do not have access to routine viral load testing. In this study, we quantified trends on CD4 counts in patients on highly active antiretroviral therapy (HAART) in a comprehensive health care clinic in Kenya between 2011 and 2017. We evaluated the rate of change in CD4 cell count in response to antiretroviral treatment. We further assessed factors that influenced time to treatment change focusing on baseline characteristics of the patients and different initial drug regimens used. This was a retrospective study involving 432 naïve HIV patients that had at least two CD4 count measurements for the period. The relationship between CD4 cell count and time was modeled using a semi parametric mixed effects model while the Cox proportional hazards model was used to assess factors associated with the first regimen change. Results Majority of the patients were females and the average CD4 count at start of treatment was 362.1 $$cell/mm^3$$ c e l l / m m 3 . The CD4 count measurements increased nonlinearly over time and these trends were similar regardless of the treatment regimen administered to the patients. The change of logarithm CD4 cell count rises fast for in the first 450 days of antiretroviral initiation. The average time to first regimen change was 2142 days. Tenoforvir (TDF) based regimens had a lower drug substitution(aHR 0.2682, 95% CI:0.08263- 0.8706) compared to Zidovudine(AZT). Conclusion The backbone used was found to be associated with regimen changes among the patients with fewer switches being observed, with the use of TDF when compared to AZT. There was however no significant difference between TDF and AZT in terms of the rate of change in logarithm CD4 count over time.

Health, Safety, and Security as a Part of Events Management

The purpose of this chapter is to provide knowledge and propose a methodology for identifying the potential hazards and dealing with health, safety, and security risks in special events. The object of study is special events and the issues caused by their characteristics to concentrate visitors in a certain place for a limited period of time under a planned program. The highlighted issue concerning health, safety, and security in special events is crowd and its management. The author's main thesis is based on the need for a systematic management approach, in which measures are taken for the safety, health, and security of the employees, volunteers, and visitors while planning and conducting an event. This chapter focuses on risk management, which includes identifying potential hazards, risk analysis and risk assessment, measures to prevent or control the risk, as well as developing an action plan. The chapter attempts to provide a comprehensive health, safety, and security risk management framework aimed at special event management and to offer a set of planning and control tools.

The Efficiency of Health Systems in Response to the COVID-19 Pandemic: Evidence from the EU Countries

The COVID-19 pandemic has revealed the insufficient capacities and capabilities of countries around the world to deal with global infectious diseases and stressed the need to improve the international health security frame-work. An efficient and comprehensive health system that is able to cope with public health emergencies is an essential prerequisite for strengthening health security. The paper analyzes the efficiency of health systems in the European Union (EU) countries and their responsiveness to the COVID-19 pandemic. The research covers 27 EU countries and it is based on the secondary data contained in the 2019 Global Health Security Index Re-port. The aim of the paper is to identify key determinants for improving the efficiency of health systems in the EU, as well as to examine the interdependence between health expenditures and the efficiency of health system in this sample of countries. The research is conducted through descriptive statistics and correlation and regression analysis. The conclusions can be useful for the EU policy makers in formulating a strategy to improve the efficiency of Member States’ health systems and preparedness for possible new pandemics.

Fournier Gangrene: Case Report & Litarature Review

Introduction: Necrotizing fasciitis of the perineal and vaginal region is a symptom of Fournier's gangrene, which is caused by a synergistic polymicrobic infection. The clinical presentation varies depending on the original aetiology, ranging from anorectal or vaginal pain with limited evidence of cutaneous necrosis to a rapidly spreading necrosis of the skin and soft tissue, to systemic sepsis without any obvious signs or symptoms. Case history: A 65-year-old male who was admitted in hospital with the chief complaint of Scrotal enlargement, discomfort, hyperemia, pruritus, crepitus, and fever. There may also be a foul-smelling discharge. Symptoms usually appear during a two- to seven-day period. Soft-tissue gas may be present before clinical crepitus is detected. The patient with Fournier gangrene frequently seems poorly on physical examination, with prodromal signs of fever and lethargy lasting 2-7 days. Edema of the overlaying skin is usually present, as is acute pain and tenderness in the genitalia; pruritus may also be present.Skin may show evidence of trauma, surgery, insect or human bites or injection sites, In Respiratory system, B/L Air entry present. In cardiovascular system, S1 and S2 sound heard and Patient get conscious and well oriented to time, place, and person. Then, as quickly as possible, treatment was began; he did not improve after treatment, and treatment would continue till the conclusion of my care. Conclusion: We focus on professional management and superior nursing care in this study so that we may provide the complete treatment that Fournier Gangrene requires while also effectively managing the complex case. After a full recovery, the patient's comprehensive health care team collaborates to help the patient regain his or her previous level of independence and happiness.

Case Report on Chiari Syndrome

Chiari Malformation is a rare condition. A condition known as Chiari malformation occurs when brain tissue spreads into the spinal canal. When a portion of your skull is excessively small or malformed, it presses on your brain and forces it downward. Chiari malformation is a rare occurrence, although the increased use of imaging testing has resulted in more diagnosis. Case Presentation: A 18-year-old boy was admitted to the hospital with the following symptoms: Tingling sensation, numbness over left hand since 2 to 3 months. Neck bend toward right side, pain in left hand since 6 month. Difficulty during eating by hand since 2 to 3 month. On physical examination, indicated a bright attentive person with pale conjunctiva and no symptoms of icterus. He had a tachycardia, bilateral pitting pedal edema and a swollen abdomen with shifting dullness, all of which pointed to as cites. He had a history of intermittent abdominal pain. On admission he complaint of new onset of dyspnea on exertion, fatigue and abdominal swelling. The rest of all physical examination was normal, with no skin changes and an intact arterial pulses in all four extremities. Conclusion: The primary focus of this case study is on professional management and outstanding nursing care, which may provide the holistic care that Chiari Syndrome necessitates while also effectively managing the challenging case. After a full recovery, the patient's comprehensive health care team collaborates to help the patient regain his or her previous level of independence and satisfaction.

Guillain Barre Syndrome: A Case Report and Literature Review

Introduction: The arrival of Guillain-Barre Syndrome is sudden. It’s a type of neuropathy caused by the immune system. Nutrition is very crucial. In impoverished countries, it is a disabling disease. Autoantibodies against diverse antigens can be seen in the outlying site. The occurrence links 0.4 to 1.7 million individuals per year. Case Presentation: A 5-year-old boy was taken to the hospital with chief complaints of Weakness in bilateral upper and lower limbs, trouble in swallowing, inability to hold the neck, mouth-frothing, fever spikes. On physical examination, the patient has experienced weakness in bilateral upper and lower limbs, Bulbar weakness is present, pain experienced in both legs, the gag reflex is absent, In Cardiovascular System, S1 and S2 sound are present, In Respiratory System, Air entry is bilaterally equal, pupils are reflected light, tone, and power of upper and lower limbs are decreased, then treatment was started as soon as possible, he has not improved after receiving treatment, and the patient is on ventilator support, with treatment continuing until the end of my care. Conclusion: In this study, we primarily focus on professional management, and outstanding nursing care may give the holistic care that Guillain Barre Syndrome requires while also effectively managing the challenging case. The comprehensive health care team collaborates to help the patient achieve their prior level of independence and satisfaction after a full recovery.

Child-centred pandemic decisions: how the Precautionary Principle can generate better risk assessment in an era of uncertainty

Key messagesRisk assessment for children has been a polarising issue during the Covid-19 pandemic. Governments around the world are preparing to ‘open up’ before risks to children are fully quantified, with unknown implications for their long-term health.Applying the Precautionary Principle to child health requires decision makers to 1) take preventive action until risks are better understood; 2) ensure that the burden of proof rests with proponents of risk; 3) explore alternatives to the risk; and 4) use participatory approaches to decision-making.Policies relating to children must be centred on the rights and wellbeing of children. We provide a framework for comprehensive Health Impact Assessments to ensure that direct and indirect impacts upon children are taken into account in major policy decisions.Elimination strategies offer an integrated approach to the protection of children’s wellbeing, the wellbeing of the population as a whole, and health equity. Where countries are transitioning away from elimination, a tight suppression approach is preferable to loose suppression or mitigation.