Extreme Age Research Articles

P11.32: Brain Death in Uruguay: 19 Years of Experience

Objetive: Describe the Epidemiology of Brain Death (BD) in 19 years. Material and methods: We studied potential donors reported to the National Registry of Donors diagnosed with BD between 2002 and 2020. We analyzed: total number of communications, age distribution, causes of death, BD diagnostic method, medical contraindications, family refusals, real donors and conversion of BD to real donor. Results: They communicated 2770 BD from all over the country, the age distribution was mainly between 18 and 60 years old, representing 70%. In extreme ages we had the lowest percentage of diagnoses with 2.2% between 1 and 5 years and 2% in those older than 75 years. Taking globally those over 65 years of age, these were 10.1% of BD. There were no differences regarding the months of the year or the days of the week in which the BD were reported. The time of greatest communication was between 1:00 and 6:00 p.m., 36% and from 7:00 to 11:00 p.m. 23%. Causes of death: CVA 51.1% followed by TEC with 23.4%. The diagnosis of BD was clinical and Doppler was used in 20%. Doppler was used as an auxiliary method in 6.8% in 2019 and 9.2% in 2020. The medical contraindications were: sepsis 16%, poor hemodynamics 10.8%, tumor 12%, hypertension/diabetes 16%. The family refusal prior to the implementation of the presumed consent law was 54.4% and of the total communications of BD that had prior expression of donation in the National Registry of Donors, 46.7% were negative. The real donors in this period were 1125. Conversion from BD to Real Donor of 40%. Analyzing the conversion in the years following the implementation of presumed consent, the average conversion was 51.6% 860BD/444 DR. DR over 65 years old were 5.4%, 66 to 70 years old 4.1%, 71 to 75 years old 1.1% and over 75 years old 0.08%. Conclusion: Uruguay has a rich experience in donation and transplants. This analysis of 19 years of BD communications leaves some important conclusions: a decrease in BD in children under 5 years of age, low use of people over 65 years of age as real donors, and a clear benefit of the presumed consent law over the refusal to The donation.

God’s Future for Animals: From Creation to New Creation

God’s Future for Animals: From Creation to New Creation

In vivo multiphoton multiparametric 3D quantification of human skin aging on forearm and face

Quantifying skin aging changes and characterizing its 3D structure and function in a non-invasive way is still a challenging area of research, constantly evolving with the development of imaging methods and image analysis tools. In vivo multiphoton imaging offers means to assess skin constituents in 3D, however prior skin aging studies mostly focused on 2D analyses of dermal fibers through their signals’ intensities or densities. In this work, we designed and implemented multiphoton multiparametric 3D quantification tools for in vivo human skin pigmentation and aging characterization. We first demonstrated that despite the limited field of view of the technic, investigation of 2 regions of interest (ROIs) per zone per volunteer is a good compromise in assessing 3D skin constituents in both epidermis and superficial dermis. We then characterized skin aging on different UV exposed areas—ventral and dorsal forearms, face. The three major facts of aging that are epidermal atrophy, the dermal–epidermal junction (DEJ) flattening and dermal elastosis can be non-invasively quantified and compared. Epidermal morphological changes occur late and were only objectified between extreme age groups. Melanin accumulation in suprabasal layers with age and chronic exposure on ventral and dorsal forearms is less known and appears earlier. Superficial dermal aging changes are mainly elastin density increase, with no obvious change in collagen density, reflected by SHGto2PEF ratio and SAAID index decrease and ImbrN index increase on all skin areas. Analysis of the z-dermal distribution of these parameters highlighted the 2nd 20 µm thickness normalized dermal sub-layer, that follows the DEJ shape, as exhibiting the highest aging differences. Moreover, the 3D ImbrN index allows refining the share of photoaging in global aging on face and the 3D SAAID index on forearm, which elastin or fibrillar collagens densities alone do not allow. Photoaging of the temple area evolves as a function of chronic exposure with a more pronounced increase in elastin density, also structurally modified from thin and straight elastic fibers in young volunteers to dense and compact pattern in older ones. More generally, multiphoton multiparametric 3D skin quantification offers rich spatial information of interest in assessing normal human skin condition and its pathological, external environment or product induced changes.

Clinical, Radiological and Pathological Appraisal of Acute Appendicitis in Al Qassim, Saudi Arabia: A Single-Center Retrospective Analysis.

BackgroundAcute appendicitis can occur at any age but is rare among people of extreme age; it is more common in teenagers and young adults. Traditionally diagnosis is made on clinical grounds. In recent times imaging techniques have been deployed to improve diagnosis and reduce negative appendicectomy rates. The aim of the study was to describe the common clinical features of acute appendicitis among our patients, highlight the role of medical imaging, and compare all these with the histological report of the excised appendix.MethodsA 24-months retrospective review of all patients who underwent appendicectomy (July 1, 2019-June 30, 2021) for suspected acute appendicitis was performed. Medical records numbers of patients who had appendicectomies were retrieved from the operating room register. These numbers were used to access the hospital's electronic medical records database for the patients' records. These records were reviewed for biodata, clinical features, laboratory, medical imaging findings, and histological reports.ResultIn this hospital, 354 appendicectomies were performed. Only 336 had complete data set suitable for further review. There were more males (N=257; 76.5%) than females (N=79, 23.5%), yielding a male to female ratio of 4:1. There were also more Saudi citizens (n=266, 79.2%), with the predominant age group being 11-30 years. Abdominal pain was the predominant symptom (100%) and was localized to the right iliac region in 331 (98.7%) of patients. Other symptoms recorded were anorexia (n=247, 73.5%), vomiting (n=190, 56.5%), and nausea (n=93, 27.7%). Atypical symptoms included diarrhoea (n=27, 8%) and constipation (n=12, 3.6%). Acute appendicitis, complicated appendicitis, and no appendicitis were the reported histological disposition in 174 (51.8%), 124 (36.9%), and 38 (11.3%) cases respectively. Abdominal CT scan had a higher sensitivity (98.6% vs 70.5%), higher diagnostic odd ratio (2.5 vs 1.4) and a lower miss (false negative) rate (1.4% vs 29.5%) compared to ultrasonography. However, the CT scan, from this study, has a rather low specificity (3.4%) and high false positive rates (96.5%). Open (n=205; 61%) and laparoscopic (n=131;39%) approaches were used for the appendicectomies. In our study, 44 patients were diagnosed with the decision to operate based on clinical grounds; and of this, 42 (95.4%; n=44) had confirmatory histology reports of appendicitis. Also, 38 patients had negative appendicectomy; giving a negative appendicectomy rate of 11.3%. This high rate may be due to the lower specificity and high false positive rate observed in this study. The post-operative complication rate was 21.4%, and this was solely due to surgical site infection, and this was more common with the open approach (p=0.001).ConclusionSuspected acute appendicitis was the sole indication for our appendicectomies. A computerized tomography scan was a more reliable diagnostic tool than ultrasonography. Despite the fact that acute appendicitis is majorly a clinical diagnosis, and good clinical acumen is an excellent skill in the management of patients, we observed an overreliance on medical imaging for diagnosis. Open appendicectomies were more common, and surgical site infection was the sole complication of surgery. There was a relatively high negative appendicectomy rate for an image-assisted diagnosis.

Risk Factors for Term-Born Periventricular White Matter Injury in Children With Cerebral Palsy: A Case-Control Study.

The aim of this study was to identify possible risk factors associated with term-born children with cerebral palsy (CP) and periventricular white matter injury (PVWMI) on imaging. This is a case-controlled study restricted to term-born children with CP with the cases extracted from the Canadian Cerebral Palsy Registry and controls from Alberta Pregnancy Outcomes and Nutrition (APrON) study. A diagnosis of PVWMI was performed based on expert categorization of MRI reports. Risk factor variables were selected a priori; these included pregnancy complications, antenatal toxin exposure, perinatal infection, sex, small for gestational age, and perinatal adversity (i.e., neonatal encephalopathy presumably on the basis of intrapartum hypoxia-ischemia). We used multivariable analyses to calculate odds ratios (ORs) and their 95% CIs. A total of 160 cases (7.06% of the registry sample) were compared with 1,950 controls. Of the term-born PVWMI participants, 59.4% were male and 13.5% were born to mothers of extreme maternal age. Multivariable analysis of each risk factor controlled for weight showed PVWMI is associated with pregnancy complications (OR = 3.35; 95% CI = 2.23-4.94), antenatal toxin exposure (OR = 2.45; 95% CI = 1.67-3.55), perinatal infection (OR = 3.61; 95% CI = 1.96-6.29), and perinatal adversity (OR = 2.03; 95% CI = 1.42-2.94). Term-born male participants were not more likely to experience PVWMI compared with female participants (OR = 1.37; 95% CI = 0.98-1.93). Multiple regression analyses suggested independent associations between PVWMI and pregnancy complications (OR = 3.75; 95% CI 2.46-5.62), antenatal toxin exposure (OR = 2.80; 95% CI 1.88-4.12), perinatal infection (OR = 4.62; 95% CI 2.46-8.42), and perinatal adversity (OR = 2.49; 95% CI = 1.71-3.69). Risk factors such as pregnancy complications, antenatal toxin exposure, perinatal infection, and perinatal adversity are associated with PVWMI in term-born children, suggesting perhaps variable interactions between antenatal and perinatal factors to yield this under-recognized CP phenotype.

Exploring the Instrumental and Emotional Supports for Sustainability and Social Participation

The prevalence of instrumental and emotional support received was investigated, and several psychosocial characteristics were studied in a Spanish population of all ages (10–85 years) and different social groups, by using an 88-item online questionnaire, with a total of 2013 respondents. Participants reported on the instrumental and emotional supports they receive, and on a set of psychosocial variables (emotion management, motivation, self-efficacy, social and communication skills, and social support), as well as their sociodemographic data; all of which were considered as contributions to a sustainable world. Instrumental and emotional supports for sustainability were significantly less prevalent among older participants, men, people with low educational levels, low autonomy levels, retired individuals, and those with a low-income level. Older and female participants were able to manage their own and other peoples’ emotions significantly more frequently. Participant motivation was less prevalent among the participants with low autonomy levels and low-income levels. Younger participants with low autonomy levels were significantly less able to perform activities related to their self-efficacy. Extreme age groups, those with higher educational levels, singles, and those living alone, reported feeling lonely more often. These results help identify sociocultural characteristics of adults with low social participation, which is critical for developing useful strategies to promote community engagement and related benefits for older adults.

Hospitalizations due to and with chronic obstructive pulmonary disease in Galicia: 20 years of evolution

ObjectiveThis work aims to analyze the evolution of COPD-related hospitalizations in Galicia from 1996 to 2018 both as main cause of admission (DUE TO COPD) or when coded in any diagnostic order (WITH COPD), assessing the influence of age, sex, seasonality, and other main causes of the hospitalization. MethodsAn analysis was conducted of administrative healthcare database (CMBD) data on index COPD-related hospitalizations in Galicia from 1996 to 2018. Crude, specific, and standardized rates were calculated for the entire sample and according to age and sex groups. ResultsIn the period from 1996 to 2018, there were 310,883 index admissions WITH COPD in Galicia, of which 29.6% were DUE TO COPD. Both WITH COPD and DUE TO COPD admission rates increased, mainly in men. There was a clear seasonality that was especially relevant in the DUE TO COPD group. The mean male-to-female ratio was approximately 4:1 in both groups, although it was lower in the extreme age groups, with no change over time. The mean age at admission increased three years in men during this period; there were no changes among women. The main causes of admission in those not hospitalized DUE TO COPD were heart failure and pneumonia. ConclusionThe combined evaluation of records of hospital admissions WITH COPD and DUE TO COPD offers additional information for a better understanding of the trends of this disease and allows for establishing hypotheses that explain the results described, providing information for better healthcare planning.

Investigation of Graphite Electrode Degradation in Lithium-Ion Cells Using 4D-STEM

The development of longer lasting and faster charging lithium-ion batteries (LIBs) remains a critical engineering priority for the U.S. Department of Energy. To enable the next-generation technology, it is essential to understand the nature and extent of materials failure during battery operation. Under fast-charging conditions, it has been shown that graphite particles, which comprise the active material of the LIB anode, suffer irreversible material degradation that limits ultimate battery performance. This damage to the graphite manifests as turbostratic lattice disorder, severe morphological roughening, and anode swelling [1]. While these findings are essential to understand the nature of damage to the anode under fast-charge conditions, it remains to be seen whether such damage occurs at slower rates or is instead accelerated by extreme rate conditions and aging. In this regard, the recent advances in high-resolution electron microscopy (HREM) and four-dimensional scanning transmission electron microscopy (4D-STEM) methods provide the essential tools to enable nanoscopic quantification of battery degradation [2], [3].In this work, we use advanced analytical electron microscopy and diffraction strategies to analyze nanoscopic degradation of graphite anode material under different cycling rate and aging conditions. The results of this work will demonstrate novel strategies for identifying nanoscale structural disorder that arise in battery materials as well as provide key understanding of graphite material failure to aid in the development of high-performance anode materials. We study (in post-mortem) the graphite particle cross-sections harvested from LIBs at different aging conditions for both C/2 (i.e., 2 hours to full charge) and 6C (i.e., 10 minutes to full charge) rate. At the nano- to atomic-scale, we rely primarily on aberration-corrected STEM for imaging and diffraction acquisition for each sample (see Figure 1 for the results). High resolution imaging reveals the extent of lattice disorder and amorphous character localized at graphite pore edges. The 4D-STEM data helps to further quantify the extent and distribution of nanoscale structural disorder (including permanent strain and turbostratic disorder). The experimental methods employed to acquire the datasets and the strategies employed to interpret the data to understand the nature of the resulting damage, including recent progress into Cepstral STEM, will be discussed. Additional supporting evidences of graphite disorder from Raman spectroscopy studies and rate-dependent anode swelling from scanning electron microscopy will also be presented. References : [1] S. Pidaparthy, M.-T. F. Rodrigues, J.-M. Zuo, and D. P. Abraham, “Increased Disorder at Graphite Particle Edges Revealed by Multi-length Scale Characterization of Anodes from Fast-Charged Lithium-Ion Cells,” J. Electrochem. Soc., vol. 168, no. 10, p. 100509, 2021.[2] J.-M. Zuo et al., “Data-Driven Electron Microscopy: Electron Diffraction Imaging of Materials Structural Properties,” arXiv Prepr. arXiv2110.02070, 2021.[3] E. Padgett et al., “The exit-wave power-cepstrum transform for scanning nanobeam electron diffraction: robust strain mapping at subnanometer resolution and subpicometer precision,” Ultramicroscopy, vol. 214, p. 112994, 2020. Acknowledgements: SP acknowledges support from the U. S. Department of Energy Graduate Student Research (SCGSR) program. The SCGSR program is administered by the Oak Ridge Institute for Science and Education for the U. S. Department of Energy under contract number DE‐SC0014664. This work was carried out in part in the Materials Research Laboratory Central Research Facilities, University of Illinois. DA and MTFR acknowledge support from DOE’s Vehicle Technologies Office. This document has been created by UChicago Argonne, LLC, Operator of Argonne National Laboratory (“Argonne”). Argonne, a U.S. Department of Energy Office of Science laboratory, is operated under Contract No. DE-AC02-06CH11357. Figure 1

Lymphocyte subsets and immunoglobulin levels in peripheral blood from cynomolgus monkeys (Macaca fascicularis) of different age groups.

Immunotoxicity assessment is an important part of non-clinical safety evaluation of biotechnology-derived pharmaceuticals. The reference ranges of evaluated parameters, which depend on the sex, age and geographical origin of animals, play a significant role in interpreting the study results. The aim of this study was to determine the reference ranges of parameters commonly used for non-clinical immunotoxicity studies in cynomolgus monkeys (Macaca fascicularis) of different ages. The percentages of CD3+, CD4+, CD8+, CD20+, CD16/56+ lymphocytes, and the serum levels of immunoglobulins A, M, G and E in clinically healthy cynomolgus monkeys of both sexes and different ages (37-104 months) were analysed. The lymphocyte subsets were assessed by flow cytometry and serum immunoglobulin levels were determined by enzyme-linked immunosorbent assay. Statistical analysis showed a weak rank correlation of CD3+, CD20+ lymphocyte levels with the ages of female and male cynomolgus monkeys, and no significant correlation with age for the combined data of both sexes. The serum levels of immunoglobulins A, M, G and E did not have a significant rank correlation with age for the combined data of both sexes, whereas IgA levels in females and IgG levels in males were weakly correlated with age. Overall, these results justify the use of animals aged three to eight years for non-clinical immunotoxicity evaluation of biotechnology-derived pharmaceuticals. It is important to avoid the formation of animal groups with extreme ages (three years or eight years) in one group during randomization.

Omicron Virus Data Analytics Using Extended RNN Technique

The OMICRON case that tainted human beings become first observed in China towards the end of 2021. From that point, OMICRON has spread practically all nations on the planet. To conquer this issue, it requires a fast work to recognize people tainted with OMICRON all the more rapidly. This research article proposes that RNN techniques to be utilized for rapid detection and predicting of OMICRON infections. RNN is finished utilizing the Elman agency and implemented to the OMICRON dataset gathered from Kaggle. The dataset accommodates of 75% preparing information and 25% analyzing information. The learning boundaries utilized were the most extreme age, secret hubs, and late learning. Results are for this exploration results show the level of precision is 88.28. Oddity is one of the elective conclusions for potential OMICRON illness is Recurrent Neural Network (RNN).

Determination of properties of scion and rootstock of cashew for design of bench grafting tool

The information about properties of cashew scion and rootstock is scarce and needs to be known to design the bench grafting tool for grafting of cashew. The properties of scion of Vengurla - 4 variety and rootstock used for softwood grafting were determined. The determination of properties of scion grouped in different diameter classes and cashew rootstock of two extreme ages (3 months and 8 months after sowing), grouped in different diameter classes and moisture content classes for cashew grafting. The mean diameter of scion for size classes D1, D2 and D3 found as 6 mm, 8 mm and 10 mm respectively. The mean diameter of 3 months old rootstock of different size classes R1, R2 and R3 found as 4 mm, 6 mm and 8 mm, and for 8 months old rootstock of different size classes S1, S2 and S3 found 6 mm, 8 mm and 10 mm approximately. The moisture content of scion of diameter 3 -12 mm found as 58.13% to 82.58%. The moisture content of rootstock of diameter 3-10 mm found 67.08 to 90.09%. The hardness of scion found as 16.62 to 51.83 N/mm2. The hardness of rootstock found 2.01 to 33.24 N/mm2. The maximum cutting strength of scion and rootstock found as 7.06 N/mm2.

Hospitalizaciones por y con enfermedad pulmonar obstructiva crónica en Galicia: 20 años de evolución

ObjectiveThis work aims to analyze the evolution of COPD-related hospitalizations in Galicia from 1996 to 2018 both as main cause of admission (DUE TO COPD) or when coded in any diagnostic order (WITH COPD), assessing the influence of age, sex, seasonality, and other main causes of the hospitalization. MethodsAn analysis was conducted of administrative healthcare database (CMBD) data on index COPD-related hospitalizations in Galicia from 1996 to 2018. Crude, specific, and standardized rates were calculated for the entire sample and according to age and sex groups. ResultsIn the period from 1996 to 2018, there were 310,883 index admissions WITH COPD in Galicia, of which 29.6% were DUE TO COPD. Both WITH COPD and DUE TO COPD admission rates increased, mainly in men. There was a clear seasonality that was especially relevant in the DUE TO COPD group. The mean male-to-female ratio was approximately 4:1 in both groups, although it was lower in the extreme age groups, with no change over time. The mean age at admission increased three years in men during this period; there were no changes among women. The main causes of admission in those not hospitalized DUE TO COPD were heart failure and pneumonia. ConclusionThe combined evaluation of records of hospital admissions WITH COPD and DUE TO COPD offers additional information for a better understanding of the trends of this disease and allows for establishing hypotheses that explain the results described, providing information for better healthcare planning.

Polygenic risk scores indicate extreme ages at onset of breast cancer in female BRCA1/2 pathogenic variant carriers

BackgroundClinical management of women carrying a germline pathogenic variant (PV) in the BRCA1/2 genes demands for accurate age-dependent estimators of breast cancer (BC) risks, which were found to be affected by a variety of intrinsic and extrinsic factors. Here we assess the contribution of polygenic risk scores (PRSs) to the occurrence of extreme phenotypes with respect to age at onset, namely, primary BC diagnosis before the age of 35 years (early diagnosis, ED) and cancer-free survival until the age of 60 years (late/no diagnosis, LD) in female BRCA1/2 PV carriers.MethodsOverall, estrogen receptor (ER)-positive, and ER-negative BC PRSs as developed by Kuchenbaecker et al. for BC risk discrimination in female BRCA1/2 PV carriers were employed for PRS computation in a curated sample of 295 women of European descent carrying PVs in the BRCA1 (n=183) or the BRCA2 gene (n=112), and did either fulfill the ED criteria (n=162, mean age at diagnosis: 28.3 years, range: 20 to 34 years) or the LD criteria (n=133). Binomial logistic regression was applied to assess the association of standardized PRSs with either ED or LD under adjustment for patient recruitment criteria for germline testing and localization of BRCA1/2 PVs in the corresponding BC or ovarian cancer (OC) cluster regions.ResultsFor BRCA1 PV carriers, the standardized overall BC PRS displayed the strongest association with ED (odds ratio (OR) = 1.62; 95% confidence interval (CI): 1.16–2.31, p<0.01). Additionally, statistically significant associations of selection for the patient recruitment criteria for germline testing and localization of pathogenic PVs outside the BRCA1 OC cluster region with ED were observed. For BRCA2 PV carriers, the standardized PRS for ER-negative BC displayed the strongest association (OR = 2.27, 95% CI: 1.45–3.78, p<0.001).ConclusionsPRSs contribute to the development of extreme phenotypes of female BRCA1/2 PV carriers with respect to age at primary BC diagnosis. Construction of optimized PRS SNP sets for BC risk stratification in BRCA1/2 PV carriers should be the task of future studies with larger, well-defined study samples. Furthermore, our results provide further evidence, that localization of PVs in BC/OC cluster regions might be considered in BC risk calculations for unaffected BRCA1/2 PV carriers.

Seroprevalence Survey of Anti-SARS-CoV-2 Antibodies in a Population of Emilia-Romagna Region, Northern Italy.

Italy was the first Western European country to be severely hit by the COVID-19 pandemic. Variations in seroprevalence rates were reported according to geographical and temporal differences of previous surveys, as well as depending on demographic and occupational factors. In this cross-sectional study, we evaluated the prevalence of anti-SARS-CoV-2 antibodies in a population of the Emilia-Romagna region in Northern Italy after the first wave in the period from 26 September 2020–26 March 2021. We included 5128 subjects who voluntarily underwent serological tests to determine anti-SARS-CoV-2 antibody positivity, including both self-referred individuals (24.2%) and workers adhering to company screening programs (76.8%). Overall, seroprevalence was 11.3%, higher in self-referred (13.8%) than employed-referred (10.5%) individuals. A slightly higher seroprevalence emerged in women compared to men (12.3% and 10.7%), as well as in the extreme age categories (18.6% for 60–69 years, 18.0% for ≥70 years, and 17.1% for <20 years compared to 7.6% for 20–39 years). Healthcare professionals showed the highest prevalence of seropositivity (22.9%), followed by workers in direct contact with customers, such as the communication, finance, and tourism sectors (15.7%). Overall subgroups seroprevalence increased compared to the first wave data but the trends agreed between the first and subsequent waves, except for an increase in the younger age group and in the sector in direct contact with customers. Among the occupational categories, our study confirms that healthcare workers and workers in the sports sector were at high risk of exposure to SARS-CoV-2.

Addition of Lavender Essential Oil (Lavandula angustifolia) in Manufacture Baby Products Diaper Rash Cream

Essential oils are known by the name of ethereal oil or flying oil (ethereal oil or volatile oil ) which is produced by plants. At high concentrations, essential oils can be used as local anesthetics. Essential oils have strong antibacterial and antifungal properties, one of which is lavender essential oil which has commercial relevance in pharmaceutical applications due to its therapeutic properties, such as anticonvulsive, sedative, antidepressant, antiseptic, antihypertensive, antioxidant, and anti-inflammatory. Not only lavender essential oil, coconut oil or commonly known as VCO is an oil that contains vitamin E that the skin needs and is medically useful for healing cracked skin. Coconut oil or VCO is rich in antibacterial, antiaging, antioxidant, wound healing, and anti-inflammatory properties. Pharmaceutical applications that are very important for humans are antioxidant, anti-inflammatory and antibacterial, especially for babies. Infants are an extreme age group who are at risk of damage to skin integrity in the perianal area. This can be due to factors such as increased humidity causing a rash. The purpose of this study was to determine the benefits of using lavender essential oil using coconut oil VCO in the manufacture of baby diaper rash cream products to prevent skin integrity in infants such as rashes. The method used in this study is a qualitative descriptive analysis test. Where using testing 5 times on 4 samples, it was proven that the 4th sample had a good level of characteristics. The results of this study, the test was proven by organoleptic testing carried out, namely the color produced was white, the aroma was lavender, and it had a creamy texture. Homogeneity test has homogeneous results. The pH test resulted in 7.84. The stickiness test on the 4th sample lasted for 1 minute 10 seconds. The dispersion test with a load of 50 grams is 2 cm, a load of 100 grams is 3.7 cm, a load of 150 grams is 4 cm, a load of 200 grams is 4.2 cm, and a load of 250 grams is 4.5 cm.

SEPSIS WITH ORAL ENTRY GATE IN IMMUNE DEPRESSED PATIENTS - A CHALLENGE TO CURRENT MEDICAL PRACTICE

"Sepsis occurs especially in people with a compromised immune system. Hosts become immunocompromised by chronic conditions, HIV, neoplasms, diabetes, as well as immunosuppressive and cytotoxic treatments. This first research direction aims at conducting an etiopathogenic study on a representative group of patients diagnosed with severe sepsis with oral gateway, following the prevalence and incidence of each clinical entity in the corroborative context of a range of factors influencing the final results, outlining with the real image of a complex pathology on the territory of Moldova is very accurate, aspects with a profound impact in the therapeutic approach both for severe sepsis and for the prophylactic methods of oral pathology. For the clinical study, a representative group of patients was studied: 94 patients hospitalized in the Galați Infectious Diseases Clinic between 2018 and 2019. Patients included in the study group, anchored in the territory of immunosuppression, have a general condition affected by: diabetes mellitus, chronic hepatitis, liver cirrhosis, alcoholism, neoplasms, chronic renal failure, anemia. Age is an important factor in the evolution of sepsis. This study also highlighted a phenomenon described in the literature, namely that there is an increased incidence of sepsis in patients of extreme age."

Introduction: Whose Present? Which History?

There can be little doubt that the history profession is experiencing a turn to the present. The post-2016 “crisis of democracy” has only dramatized it. Long-standing anxieties over presentism have crumbled under the weight of recent events. They have proven little match for Brexit, Trump, the rise of strongmen in the world writ large, racial injustice, and the pandemic. The turn to the present, however, is at times marked by undeniable provincialism—one that consistently offers a narrow perspective for understanding new and emerging global realities. Some historians, for instance, have taken on the role of liberal watchmen ready to strike the tocsin against suspected fascism, but they regularly do so by focusing on Europe's fascist past of the 1930s to explain the contemporary order. Or consider the economic crisis brought on by the coronavirus pandemic. In the search for solutions, scholars proved quick to make historical comparisons to the great war economies of World Wars I and II, but appeared little bothered by the possibility that taking inspiration from Europe's age of extremes might “lead us to look for enemies and scapegoats.” So with the George Floyd protests: certain scholars and pundits likened them to the 1968 student protests in France and the United States, even as other scholars pointed out the historical shortcoming of the comparison.

Multimorbidity as assessed by reporting of multiple causes of death: variations by period, sociodemographic characteristics and place of death among older decedents in England and Wales, 2001–2017

BackgroundMultimorbidity is common at older ages and is associated with disability, frailty and poor quality of life. Research using clinical databases and surveys has shown associations between multimorbidity and indicators...

Interest of individual breast cancer screening by mammography in women aged over 75 years

Retrospective study of a continuous monocentric series of women over 75 having undergone surgery for breast cancer. The following variables were studied: addressing after screening or not, age at diagnosis, UICC stage and therapeutic measures (surgery by lumpectomy or mastectomy, lymph node dissection, adjuvant treatment with chemotherapy, radiotherapy or hormone therapy). 185 women aged 82.8 ± 5.2 years [extreme ages 75 to 95] were included in the study. 136 (73.5%) breast cancers were discovered after palpation and 49 (26.5%) after screening mammography. The distribution by stage was: I - 38.8%, II - 39.5%, III - 15.1% and stage IV - 7%. 164 (87.7%), patients received surgical treatment: 115 lumpectomies (61.2%) and 49 mastectomies (26.5%). 51 (27.6%) patients underwent lymph node dissection. The distribution of adjuvant treatments was: chemotherapy 21.1%, radiotherapy 68.6%, or hormone therapy (79.5%), sometimes combined. Women not screened are older than women screened (84 ± 5.3 versus 79.5 ± 3.6 years; p < 0.0001). Cancers are diagnosed at a more advanced stage in non-screened patients compared to screened patients (p < 0.0001). While there is a higher proportion of stage I among screened patients (75.5%), stage II is the most frequent in women not screened (47%). Stage I and II are the majority in the latter (72%). In multivariate analysis with adjustment for age, screening made it possible to make a diagnosis at a less advanced stage (stage I-II vs II-IV: OR = 5.593; 95% CI [1.575–19.866]; p = 0.0078) and to have conservative surgery more often (lumpectomy vs mastectomy: OR = 2.645; 95% CI [1.079–6.493]; p = 0.0333) without more recourse to surgery (OR = 1.856 95% CI [0.207–16.612]; p = 0.58). After adjusting for age and stage, screening was no longer a determining factor in the choice of type of surgery (OR = 1.934; 95% CI [0.753–4.975]; p = 0.170). At the age when organized breast cancer screening in France stopped, there was a decrease in survival, a diagnosis at a higher stage and an increase in co-morbidities. Our study shows a change in management with heavier treatment, more complications and a greater loss of autonomy without screening. This pleads for a continuation beyond 75 years of the practice of mammography screening for breast cancer in elderly women.

Maternal mortality study in the Eastern Democratic Republic of the Congo

BackgroundThe reduction of maternal mortality in developing countries such as the Democratic Republic of Congo (DRC) still raises many questions. Indeed, this large country in the heart of Africa ranks 4th among the eight countries that alone account for more than 50% of maternal deaths in the world, behind India, Nigeria and Pakistan. However, there is no up-to-date data on maternal mortality in eastern DRC. This study measures the mortality rate rate in health facilities in eastern DRC and identifies the associated risk factors.MethodsThis analytical epidemiological study was based on retrospective data materna deaths recorded in 59 health facilities, in three health zones in the southern part of Maniema province in east DRC. The study was conducted from July 1, 2015 to June 30, 2020. Descriptive, bi and multivariate analyses were used.ResultsThe maternal mortality rate was estimated at 620 deaths per 100,000 live births, of which 46% of maternal deaths were related to a parturients’ delayed decision in seeking healthcare in time (first delay). Maternal deaths were significantly associated with extreme ages (≤ 19 years and ≥ 40 years: p = < 0.001), patient parity (in primigravidas and in large multiparas: p = 0.001), complications such as hemorrhagic, (p = < 0.001), uterine ruptures:(p = < 0.001), infections, (p = < 0.001), and dystocia (p = < 0.001).ConclusionDespite the efforts made by the DRC and its partners in the fight against maternal mortality, women continue to lose their lives when they decide to give birth. The results imply that it is imperative to strengthen both women and health professionals’ knowledge about pregnancy and maternal health and their power to reduce instances of first delay by supporting women in formulating their birth plans.