Organ Disorders Research Articles

Self-efficacy and social support enable women to protect their pelvic floor health: A nonrandomized controlled trial in rural Nepal.

Carrying heavy loads increases the risk of pelvic organ disorders, particularly in low-income countries. Low self-efficacy hampers adoption of pelvic-floor-protective behaviors. The enabling hypothesis suggests that social support may strengthen women's behavioral self-efficacy. A three-arm parallel non-randomized controlled trial with 300 women and their social partners experimentally examined whether self-efficacy and social support can enable women's pelvic-floor-protective behaviors in rural Nepal. Three villages received (1) self-efficacy (2) self-efficacy and social support promotion, or (3) information only control. The co-primary outcomes were reduced weight carried and using protective lifting techniques at 2-month follow-up. Self-efficacy promotion increased the use of protective lifting techniques 9% more than information only (d = 0.28). Weight was reduced by 3 kg more when additionally promoting social support compared to self-efficacy alone (d = 0.39). Self-efficacy and social support promotion enable women to better protect their pelvic floor health and may complement educational approaches to health behavior change in low-resource populations.

Frequency of detection of dyssynergic defecation in patients with overlap syndrome of functional disorders of the digestive organs associated with constipation

Introduction. The presence of dyssynergic defecation in a cohort of patients with overlap syndrome of functional disorders is poorly studied.Aim. To assess the motor function and sensitivity parameters of the anorectal zone, to identify dyssynergic defecation and to analyze the frequency of correlation in patients with overlap syndrome of functional gastrointestinal disorders associated with constipation.Materials and methods. A one-stage examination was conducted in four parallel groups. The study included 100 patients aged 30 to 40 years with the following diagnoses: constipation-p redominance irritable bowel syndrome (IBS-C) (group 1), IBS-C combined with functional dyspepsia (group 2), IBS-C combined with functional biliary disorder (group 3) and healthy volunteers (group 0). All patients underwent a balloon expulsion test and high-resolution anorectal manometry to determine the presence of dyssynergic defecation.Results. Based on the analysis of parameters according to anorectal manometry data, dyssynergic defecation was not detected in group 0, in group 1 dyssynergic defecation was detected in 8 people – 32.0% (95% CI 12.3–51.6), in group 2 – in 14 people – 56.0% (95% CI 35.0–76.9), in group 3 – in 16 people – 64.0% (95% CI 43.7–84.2). A negative evacuation test was detected in 8 (32%) patients in group 1, in 14 (56%) patients in group 2, and in 17 (68%) patients in group 3, which confirmed the presence of dyssynergic defecation.Conclusions. This study demonstrated the presence of dyssynergic defecation in three groups of subjects, more often with a combination of irritable bowel syndrome with predominant constipation with functional dyspepsia, and most often with a functional disorder of the gallbladder.

Systemic Implications of Bullous Pemphigoid: Bridging Dermatology and Internal Medicine.

Background: Bullous pemphigoid is an autoimmune bullous disease that frequently affects a large skin surface area, but it can also present in localized areas. It has been hypothesized that bullous pemphigoid affects the systemic functioning of different organs because inflammatory cells and cytokines circulate throughout numerous organs. Results: Recent clinical and experimental studies have revealed an association between bullous pemphigoid and systemic organ disorders. To avoid the emergence of systemic organ diseases, the significance of systemic treatment in cases of severe bullous pemphigoid should be emphasized. Conclusions: Here, we discuss the specific molecular processes underlying typical systemic organ inflammatory diseases associated with bullous pemphigoids.

Body fat percentage, mid-upper arm circumference, and menstrual cycle in female students at x high school

<p><strong>Background</strong>: Irregular menstrual cycle in adolescent girls is an indicator of reproductive organ disorders. One of the risk factor for menstrual cycle disorders is nutritional status problem. Nutritional status can be measured using several anthropometric indicators such as body fat percentage and mid-upper arm circumference (MUAC).</p><p><strong>Objectives</strong>: This study aimed to analyze the correlation between body fat percentage and MUAC with the menstrual cycle in girls of X High School Sidoarjo.</p><p><strong>Methods</strong>: The type of this research was cross-sectional. The sample used 66 students with stratified random sampling technique. Body fat percentage was obtained by using the Mi Body Composition Scale 2, mid-upper arm circumference (MUAC) was measured by using midline, and the menstrual cycle was obtained by using a menstrual cycle questionnaire for the last 3 months. Data were analyzed with Rank Spearman test.</p><p><strong>Results:</strong> The results showed that average of body fat percentage was 26.8%, MUAC was 23.8 cm, and menstrual cycle was 35 days. Based on the test of the relationship between body fat percentage and the menstrual cycle, p-value 0.000 (r-value -0.875) were obtained, while MUAC and the menstrual cycle showed p-value 0.000 (r-value -0.916). The higher the body fat percentage, the shorter the menstrual cycle. The smaller the MUAC, the longer the menstrual cycle.</p><p><strong>Conclusions</strong>: There was a significant relationship between body fat percentage and MUAC with the menstrual cycle within girls in X High School Sidoarjo. Adolescent girls are expected to maintain normal nutritional status in order to maintain the regularity of their menstrual cycle, so as to minimize the risk of infertility in the future.</p>

Obesity in a patient with acromegaly: a case report

Acromegaly is a severe neuroendocrine disease characterized by excessive production of the growth hormone (GH). The slow development of symptoms increases the diagnostic search up to 15 years. Permanent effect of the growth hormone on the human body can cause structural and functional disorders of organs. The main complications of acromegaly include cardiovascular, respiratory, and musculoskeletal system dysfunction, as well as impaired carbohydrate metabolism and an increased risk of developing neoplasms.Often, nonspecific symptoms of acromegaly can be masked by other pathologies or their complications, such as obesity. An increase in subcutaneous fat, increased blood pressure, joint pain, edema, and impaired carbohydrate and lipid metabolism are observed both in acromegaly and in obesity. An additional factor in the development of obesity as a complication of acromegaly is the development of sleep apnea, which triggers a series of pathological processes that ultimately lead to Pickwickian syndrome.We present a clinical case of a patient with acromegaly and obesity, discussing the effects of excess body weight on the course of the underlying disease, the presence of complications, and an individual approach to treatment.

Histological analysis of the spleen of rats immunized with SARS-CoV-2 S protein

SARS-CoV-2 infection can lead to pathological disorders in various organs due to the ubiquitous of angiotensin-converting enzyme 2 (ACE2), which serves as a receptor for SARS-CoV-2. However, tissue damage may not only be the result of viral infection. SARS-CoV-2 has been shown to induce the production of autoantibodies to ACE2, and their presence is associated with disease severity. The spleen is one of the targets for COVID-19. The presence of ACE2 in the red pulp sinus endothelium cells of the spleen and in tissue-resident CD169+ macrophages positioned in the splenic marginal zone makes these cells a potential target of autoimmune reactions to ACE2 triggered by SARS-CoV-2. In addition, antibodies to the SARS-CoV-2 S protein cross-react with a wide range of human tissue proteins and can cause tissue damage. The most common splenic pathologies in deceased COVID-19 patients are lymphocyte depletion and subsequent hemaphagocytosis. Since the spleen plays a fundamental role in the immune response regulation, splenic damage could be one of the causes of immune perturbations associated with severe COVID-19. To test the hypothesis of the autoimmune nature of COVID-19, we developed a non-infectious experimental model of autoimmune multiorgan damage caused by immunization with SARS-CoV-2 S protein. The purpose of this work was to study the spleen in rats with induced multiorgan damage caused by immunization with SARS-CoV-2 S protein, as well as the influence of pre-existing autoimmune disease on the severity of splenic damage caused by an immune response against S protein. Intact Wistar rats and Wistar rats with completed experimental autoimmune encephalomyelitis were immunized with S protein in incomplete Freund’s adjuvant (IFA). Control rats received an injection of IFA. No changes were detected in the secondary follicles number in the spleen of rats immunized with the SARS-CoV-2 S protein. However, in the spleen of rats with previously induced autoimmune encephalomyelitis, immunization with SARS-CoV-2 S protein caused a significant decrease in the number of secondary follicles relative to the control group. Hemosiderin deposits and macrophage hyperplasia of the marginal zones of the white pulp were detected in both groups immunized with S protein. Thus, immunization with the S protein of SARS-CoV-2 causes changes in the spleen of rats similar to those detected in patients who died from COVID-19. Damage to the spleen is more varied and pronounced in rats with previous experimental encephalomyelitis.

Biochemical blood parameters in platinum fox females and males in ontogenesis

Currently, veterinarians pay much attention to the diagnostic examination of animals, including animals kept on fur farms. Blood is the main material used for such examinations. Changes in its composition allows veterinary practitioners to identify disorders in various systems and organs of animals, as well as to assess metabolism in animals. Results of biochemical tests of serum samples from platinum fox males and females of different age groups and comparative assessment thereof are presented. The levels of aspartate aminotransferase (U/L), alanine aminotransferase (U/L), alkaline phosphatase (U/L), total protein (g/L), albumin (g/L), urea (mmol/L), creatinine (μmol/L), α-amylase (U/L), cholesterol (μmol/L) were determined. Aspartate aminotransferase levels in females at the age of 6 months were lower by 69% than that ones in males. Increase in aspartate aminotransferase by the age of 6 months helps animals to accumulate body weight before winter. Sexual differences in the alkaline phosphatase levels were detected in 1.5-month-old kits: alkaline phosphatase levels were higher by 21.05% in males than in females. By the age of 6 months, the alkaline phosphatase levels decreased in both males and females. The decline in alkaline phosphatase level with the age is associated with participation of this enzyme in the development of animal skeleton during ontogenesis. From the age of 4 months, the growth and development of the skeleton slows down, and by the age of 6 months the animals gain the size and body weight of adult animals. Urea and creatinine levels in foxes of both sexes increased during their growth, but remained within the reference limits. Changes in urea levels in blood can be caused by feeding excessively high-protein or excessively low-protein diets. The total protein content in sera from 4 month-old males and females decreased by 32.51 and 43.24%, respectively, compared with that one in sera from animals at the age of 1.5 months, and increased at the age of 6 months up to the level observed at the age of 4 months. According to the literature, rather rapid stabilization of protein metabolism is a biological feature of many mammals born in spring, their growth rate is accelerated and, in general, the maturity phase is shortened.

260. LOW BLOOD LEVEL OF TUMOR SUPPRESSOR MIR-3619 AS A TARGET OF NUCLEIC ACID THERAPY TO PIM-1 IN ESOPHAGEAL CANCER

Abstract Background Numerous studies have attempted to understand the molecular mechanisms of tumorigenesis and identify clinical biomarkers and molecular targets for esophageal squamous cell carcinoma (ESCC). However, there are still only a few biomarkers and targets. We focused on tumor suppressor micro-RNA (miR)s in the plasma of ESCC patients, and we investigated the usefulness of these tumor suppressor miRs as biomarkers and therapeutic agents for ESCC. Methods: Plasma samples of 94 ESCC patients and 86 healthy volunteers were analyzed in this study. Among the group of 2600 miRs candidates registered in miRbase, we selected 25 miRs candidates which are low expressed in ESCC tissues, have tumor suppressive functions, and unreported as a body fluid biomarker. We selected 5 miRs (miR-564/ 637/ 1182/ 3178/ 3619), whose signals were detectable in the blood of healthy volunteers by microarray analysis. By test-scale analysis using TaqMan assay and validation analysis, we identified miR-3619, which showed the most significant difference in ESCC patients compared to healthy volunteers (p < 0.001). Results: 1) Prognostic analysis revealed that a low miR-3619 plasma level was significantly associated with advanced stage and recurrence rate, and was an independent factor predicting poor prognosis in ESCC patients (p = 0.028, HR = 2.09). 2) Overexpression of miR-3619 mimic inhibited the proliferation of ESCC cells, induced the accumulation of apoptosis or G1/S phase cells, and reduced the cell migration and invasion abilities compared with negative control mimic. 3) We tested PIM-1xas candidate putative target genes for miR-3619 using microRNA database. PIM-1 protein expression levels were decreased in miR-3619-5p transfectants compared with NC. 4) In vivo, subcutaneous injection of miR-3619 could significantly inhibit tumor growth in mice. Administration of miR-3619 did not cause any clinical adverse events or side effects in blood-based parameters reflecting organ disorders. Conclusion: These results suggest that depleted tumor-suppressor miR-3619 in plasma could be one of blood-based biomarkers for predicting malignant potential of ESCC.

Radionuclide characterization and handling strategy of irradiated Fission Product Material (FPM) capsule waste from molybdenum-99 production

Abstract Irradiated FPM Capsule waste is one of the types of radioactive waste generated from Molybdenum-99 (99Mo) production. This 99Mo is a 99mTc parent radionuclide that is used for the diagnosis of human organ disorders. In its production, the capsule is used for the emplacement of uranium target for irradiation in the GA Siwabessy Reactor. Since the beginning of production until now, the irradiated FPM capsules waste are still being stored in the hot cells because no data on their characteristics and handling systems that are necessary for their treatment. However, long-term storage of the FPM capsules waste in the hot cells shall be avoided because it can disrupt the production process of 99Mo and pose radiation risk to workers. The objectives of this research are to characterize radionuclides composition in the FPM capsule waste and identify its appropriate handling system. The radionuclides characterization was carried out using ORIGEN 2.1 software whereas the selection of the handling system was based on the suitability or modification of the available facilities at Radioactive Waste Management Installation (RWMI)-BRIN. The characterization results show that up to a decay time of 50 years, an FPM capsule waste contains activation product radionuclides such as 55Fe, 59Ni, and 63Ni with a total specific activity of 7.11x106 Bq/g. Three FPM capsule waste handling systems were identified that can be implemented at the RWMI facility, namely by using a 350 -liter concrete shell and then storing in an interim storage for low and intermediate-level waste, using a 60-liter stainless-steel canister which is then stored in the interim storage pit for high-level waste, or by modifying the interim storage pit for high-level waste. Radionuclide characterization and appropriate handling systems are required for the safe management of irradiated FPM capsule waste. This FPM capsule waste management is important for human and environmental protection.

Euphorbia milii and propolis combination tea reduced hepatic steatosis and hepatocyte apoptosis in high-fat diet rat model

Background: Dyslipidemia can cause various organ disorders, such as fatty liver disease. Over time, fatty liver disease has become more commonplace worldwide and may cause mortality if the progression worsens. Natural components from Euphorbia milii (E. milii) and propolis (EMP) have been demonstrated as immunomodulators that reduce total cholesterol levels.Objective: To prove the effect of EMP tea on inhibiting fatty liver and hepatocyte apoptosis in high-fat diet (HFD)-induced rats.Methods: This study applied a post-test-only control group design using 18 Wistar rats, which were divided into three groups: K0 (received standard feed), KN (received HFD of 2 g/200 g Body weight (BW) in a day), and P (received HFD of 2 g/200 g BW in a day and EMP of tea 40 mg/100 g BW in a day). The interventions were conducted for 30 days, followed by termination on day 31 for liver tissue collection and analysis. We calculated the hepatic steatosis with the help of hematoxylin-eosin (HE) staining. Hepatocyte apoptosis was also determined with terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining.Results: The K0 group had a lower hepatic steatosis percentage (17.87 ± 1.81) than KN (63.75 ± 15.88). We also found no hepatocyte apoptosis in the K0 but a high hepatocyte apoptosis index in the KN (3.98 ± 0.29). The combination of EMP tea in HFD-induced rats significantly reduced hepatic steatosis and apoptosis percentage (25.33 ± 1.17 and 0.91 ± 0.61, respectively). Conclusion: We demonstrated that combining EMP tea reduced hepatic steatosis and hepatocyte apoptotic index in HFD-induced rats, suggesting its potential as a treatment for these conditions.

A Critical Review on Glycosaminoglycan Derived Polymers as a Novel Drug Delivery System in Tissue Engineering: Recent Advancement and Clinical Application

Glycosaminoglycans (GAGs), natural components of the extracellular matrix, exert significant influence over cellular function and regulate the microenvironment surrounding cells. This characteristic makes them promising targets for therapeutic intervention across a spectrum of diseases. In the realm of medical research, there has been a longstanding quest for precise and targeted drug delivery methods to mitigate adverse effects and enhance the efficacy of treatments for conditions, such as wounds, cancer, and organ disorders. However, implementing a systemic delivery approach, particularly for protein-based therapeutics, poses challenges. Addressing this challenge requires the development of biocompatible materials capable of efficiently encapsulating and releasing therapeutic proteins. GAGs emerge as promising candidates possessing these desirable attributes, given their bioderived nature and ability to modulate biological responses. Within the realm of GAGs, various linear polysaccharides exhibit diverse functionalities and payloads. Notably, hyaluronic acid (HA) and chondroitin sulfate (CS) have been utilized as polysaccharide-based biomaterials for drug delivery, particularly in the treatment of rheumatoid arthritis. Modified HA and CS can self-assemble into micelles or micellar nanoparticles (NPs), enabling precise and controlled drug delivery. This paper explores a range of NP formulations derived from HA and CS, including drug conjugates, polymers, small molecules, polyelectrolyte nanocomplexes (PECs), metals, and nanogels. The versatility of these NP formulations extends to various therapeutic applications, including cancer chemotherapy, gene therapy, photothermal therapy (PTT), photodynamic therapy (PDT), sonodynamic therapy (SDT), and immunotherapy. By harnessing the unique properties of HA and CS, these NP-based systems offer promising avenues for advancing therapeutic interventions in diverse clinical settings.

DELAYED EFFECTS OF RADIATION: A LITERATURE REVIEW

Relevance: The effect of radiation on the immune system of the offspring of persons affected by exposure to low doses of various radiation types is still an urgent issue. In the literature, several issues related to delayed consequences, namely, morphofunctional disorders in the organs of the descendants of irradiated individuals, have not received adequate resolution. The purpose was to analyze literature on the long-term effects of radiation, manifested by morphofunctional disorders of the immunocompetent organs in the descendants of persons exposed to radiation, to confirm the importance of further study of this issue. Methods: The review included publications indexed in PubMed, Medline, E-library, and CyberLeninka databases. The search was made using the Google Scholar search engine. The applied search filters included conducted experimental studies over the past eight years (2015-2023). Results: The search revealed insufficient publications devoted to studying metabolic processes and histomorphological changes in the immunocompetent organs of the body of the descendants of exposed individuals. An insufficient number of publications on long-term biochemical and pathohistological changes in immune system organs due to irradiation necessitate a profound study of the topic. Conclusion: The study of morphofunctional disorders in the descendants of the first generation of irradiated individuals remains a task for radiobiologists and oncologists, with the development of criteria for morphological diagnosis.

The therapy of functional disorders of the masticatory organ using computer technology: a case report

The therapy of functional disorders of the masticatory organ using computer technology: a case report

Розлади функції органів малого таза в жінок із діастазом прямих м’язів живота

Diastasis rectus abdominis (DRM), pelvic organ dysfunction are common pathological conditions after pregnancy. Abdominal muscles are weakened with DRM, which leads to inefficient participation of the anterior abdominal wall in the processes of functioning of the main pelvic organs: bladder and rectum. Аim - to evaluate the main determinants of the development of DRM and to establish the relationship between the presence of diastasis and disorders of the pelvic organs in women who have given birth. Materials and methods. We analyzed pelvic organ disorders in 151 patients with diastasis recti abdominis. which were divided into types according to the Nahas classification. Type A diastasis recti abdominis in 21 (13.9%) patients, type B in 81 (53.6%), and types C/D in 49 (32.5%). The endpoint of the study was DRM: significance between its severity and potential pelvic organ disorders was assessed using Fisher's exact test or chi-square test for categorical variables. Results. The frequency of postpartum disorders depended on the severity of diastasis recti abdominis. In patients with type A, the frequency of pain/discomfort, urinary incontinence, and gas/liquid stool incontinence was 52.4%, 61.9%, and 66.7%, respectively. In patients with severe diastasis recti abdominis, the rates were 81.6%, 75.5%, and 79.6%, respectively. Excess weight and episiotomy during delivery were much stronger determinants than the severity of diastasis recti abdominis. The higher risk of the pelvic organ dysfunction was noted in older patients, active smokers, and those who developed gestational diabetes. Conclusions. The severity of DRM depends on age, body mass index, number of pregnancies, episiotomy during delivery, smoking, gestational diabetes. There is no strong dependency on delivery by cesarean section or the use of vacuum/forceps, nor on the presence of hypothyroidism in patients. The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of the women was obtained for the research. The authors declare no conflict of interest.

Comparison of the K Nearest Neighbor Algorithm with Apriori Algorithm to Analyze Lifestyle Patterns in Hypertensive Patients

Hypertension is one of the most influential cardiovascular diseases that can result in organ disorders such as heart dysfunction or stroke, and hypertension is often found by chance. Hypertension is a condition in which blood pressure increases drastically to above-normal limits and forces the heart to work harder in pumping blood to meet the body's oxygen needs. This disease can interfere with the work of other organs if left untreated, especially the heart and kidneys. Not paying attention to diet, exercise, stress, smoking, and drinking alcohol can all be responsible for an increased risk of hypertension. An a priori algorithm was used in the Sei Semayang Health Center case study to predict hypertensive patients and compare their behavioural patterns and lifestyles. So, the results of rapid-miner using a priori algorithm to analyse the Comparison of the K-Nearest Neighbor Algorithm with the Apriori Algorithm to Analyze Lifestyle Patterns in Hypertensive Patients the results obtained U1, which means that there are hypertensive patients aged 25-38 years who have more hypertension. The result is H2, which means that the community has but does not control the doctor with a pattern style such as consuming alcohol, smoking, lack of exercise, consumption of sugar, consumption of saturated fats and foods that contain much salt and rarely consuming vegetables or fruits and foods that contain mucin, so more. More people have hypertension by way of an unhealthy lifestyle.

Musculoskeletal Disorders Related to Upper Limb Disability after One-Year Lung Cancer Resection.

Lung resection represents the main curative treatment in lung cancer; however, this surgical process leads to several disorders in tissues and organs. Previous studies have reported cardiovascular, pulmonary, and muscular disturbances that affect the functional capacity of these patients in the short, mid, and long term. However, upper limb impairment has been scarcely explored in the long term, despite the relevance in the independence of the patients. The aim of this study was to characterize the upper limb impairment in survivors of lung cancer one year after pulmonary resection. In this observational trial, patients who underwent lung cancer surgery were compared to control, healthy subjects matched by age and gender. Upper limb musculoskeletal disorders (shoulder range of motion, pain pressure threshold, nerve-related symptoms) and functional capacity (upper limb exercise capacity) were evaluated one-year post-surgery. A total of 76 survivors of lung cancer and 74 healthy subjects were included in the study. Significant differences between groups were found for active shoulder mobility (p < 0.05), widespread hypersensitivity to mechanical pain (p < 0.001), mechanosensitivity of the neural tissue (p < 0.001), and upper limb exercise capacity (p < 0.001). Patients who undergo lung cancer surgery show upper limb musculoskeletal disorders and upper limb functional impairment after a one-year lung resection. This clinical condition could limit the functionality and quality of life of patients with lung cancer.

ВЛИЯНИЕ ТКАНЕВЫХ АНГИОТЕНЗИНОВ НА ЭЛЕМЕНТЫ КАРДИОВАСКУЛЯРНОЙ СИСТЕМЫ (ЛЕКЦИЯ)

Relevance. The renin-angiotensin system is now one of the oldest and most studied peptide cascades. Understanding the operation of this system is an urgent task for study in medical higher education institutions. The renin-angiotensin system is an important regulatory system that supports the metabolism and functioning of many organs, including blood vessels and the myocardium. Since cardiovascular diseases are the main cause of mortality, the study of positive and negative mechanisms of regulation of the cardiovascular system is an urgent task at the present stage. The aim of the work. To consider modern ideas about the renin-angiotensin system and its role in the regulation of homeostasis. Results. The lecture discusses the classical and tissue renin-angiotensin system, the main angiotensin metabolites, the pathways of their formation and the enzymes that catalyze these transformations. The effects realized by angiotensins through various receptors are shown. The modern point of view on the levels of organization of the renin-angiotensin system in the body and the relationship between various angiotensin antagonists is considered. Conclusion. The renin-angiotensin system is one of the most complex systems of hormonal regulation, including several organs that interact to regulate many body functions. The effects of angiotensins are complex and often oppo-site. An imbalance in the regulation of angiotensin homeostasis leads to metabolic disorders of organs and tissues and manifests itself in pathologies based on inflammatory, hypertrophic and fibrotic phenomena, and is also associated with the development of chronic diseases affecting various organs and tissues.

Disturbance in the potential cardiovascular-bone-skeletal muscle axis and morbidity and mortality in patients undergoing haemodialysis: the Q-Cohort Study.

Disturbances in the cardiovascular system, bone and skeletal muscle are independent risk factors for death among patients receiving haemodialysis (HD). However, the combined impact of disorders of these three organs on morbidity and mortality is unclear in the HD population. A total of 3031 Japanese patients on maintenance HD were prospectively followed. The outcomes were all-cause mortality, major adverse cardiovascular events (MACE) and bone fracture. Patients were divided into four groups (G1-G4) according to the baseline number of diseased organs represented as histories of cardiovascular disease and bone fractures and the presence of low skeletal muscle mass as follows: G1, no organ; G2, one organ; G3, two organs; G4, three organs. Multivariable-adjusted survival models were used to analyse associations between the number of diseased organs and outcomes. During a 4-year follow-up, 499 deaths, 540 MACE and 140 bone fractures occurred. In the Cox proportional hazards model, the risk for all-cause mortality was significantly higher in G2, G3 and G4 than in G1 as the reference {hazard ratio: G2, 2.16 [95% confidence interval (CI) 1.65-2.84], G3, 3.10 [95% CI 2.27-4.23] and G4, 3.11 [95% CI 1.89-5.14]}. Similarly, the risks for developing MACE and bone fractures were significantly elevated as the number of organ disorders increased. Multiple disorders of the cardiovascular-bone-skeletal muscle axis are strong predictors of morbidity and mortality in patients undergoing HD.

Speakezio Application as an Alternative and Augmentative Communication Media for Cerebral Palsy Students

The obstacle experienced by most children with cerebral palsy is limited communication skills. This is due to disorders of the speech organs or limitations in receptive and expressive language abilities experienced by children with cerebral palsy. So, when communicating, you need alternative augmentative media or communication systems (AAC) that can help you communicate. This research aims to develop the Speakezio application as AAC media. The method used is the RD (Research and Development) research method with a qualitative approach. This research involves one subject (single subject) which is used as a model in developing applications. This research obtained results in the form of the Speakezio application which was developed based on the results of assessments on target subjects and trials of the application as a media for the AAC system. The trial results show that this application can improve children's receptive and expressive language skills. Apart from that, this application can help communication between children and parents so that parents can more easily understand the messages conveyed by children.

Knowledge and personal hygiene behavior during menstruation among adolescent girls in various regions: A literature review

Personal hygiene is still a public health issue in Indonesia. Menstrual hygiene is the management of hygiene and health when women experience menstruation as part of a personal hygiene care routine with the concept of clean. Personal hygiene during menstruation plays an important role in a person's health status in avoiding functional disorders of the reproductive organs. Knowledge in Indonesia states that poor personal hygiene behavior during menstruation of adolescent girls is a major concern because it has a health impact. The method used was literature review by searching articles through Google Scholar and Pubmed databases. Selection stages were carried out to obtain articles that met the inclusion and exclusion criteria, and 6 articles were obtained that could be analyzed. The results showed that knowledge has a significant role in determining menstrual hygiene behavior in adolescent girls, there are also differences in knowledge and behavior when performing personal hygiene behavior during menstruation in urban and rural areas. To improve knowledge and behavior of personal hygiene during menstruation, especially in various regions, it can be done with various strategies such as promotion, education, collaboration, improving service quality, and increasing accessibility.