Term Health Effects Research Articles

Iron Treatment in Patients with Iron Deficiency Before and After Metabolic and Bariatric Surgery: A Narrative Review.

Iron is an essential nutrient in living organisms with multiple vital functions. Iron deficiency (ID) can cause long term health consequences beyond iron deficiency anemia (IDA). The high prevalence of ID and its long-term effects in patients with obesity and after metabolic and bariatric surgery (MBS) is recognized. Nevertheless, there is limited knowledge of the optimal route or dose for treatment of patients with obesity and post-MBS, and an evidence-based universal guideline for prevention and treatment of ID in short- and long-term post-MBS (PMBS) is not yet available. ID in the general population is currently treated with oral or parenteral iron, where oral iron treatment is considered the preferred option with parenteral iron as a second-line treatment in case there is intolerance or lack of response to oral iron. In patients with obesity with chronic low-grade inflammation and PMBS patients with altered gut anatomy and function, there are also alterations in the bioavailability and higher risks of side effects of available oral irons. The conclusions of current studies exploring effective treatment of iron deficiency in this population have been inconsistent and further well-planned randomized and prospective studies are needed. This is a narrative review of the literature on the available treatment options and strategies for treatment of ID in PMBS patients to recognize the knowledge gaps and provides topics of future research.

Harm Reduction in Tobaccoism : What Does the Scientific Evidence Say?

Smoking is considered a chronic disease caused by chemical dependence of nicotine. This is highly addicting, it in the brain system it influences our emotions, increases the feeling of pleasure/humor and reduces the anxiety. In a planet with about 8 billion people, around 1,36 billion are smokers. Cigarette smoking is the leading cause of preventable death in the world, around 8 million people die every year. A global public health problem, and those who smoke are vulnerable to 50 tobacco-related diseases, several kinds of cancer, lung diseases, cardiovascular disease, erectile dysfunction, female infertility and pregnancy complications. In 2020, according to data from the World Health Organization, 22,3% of the world population consumed tobacco, 36,7% of men and 7,8%of women. In Brazil, due to policies implemented to smoking control, we had a significant drop in the of period (1989 to 2019) from 34,8% of smokers to 12,6% and in 2021, the total percentage of smokers age 18 or over was 9.1%. All forms of tobacco consumption are harmful to health and there is no safe level. Cigarette smoke 4.720 different toxic substances such as nicotine, irritants, tar and carbon monoxide. In the last 15 years, new heated tobacco devices have arrived on the market with promises of less harm to health. In 78 countries this products are available, including Japan, The United States, Canada, Portugal, Australia, Italy and The United Kingdom. As they do not cause tobacco combustion, they created significantly lower levels of toxic substances, which is the strongest arguments made by defenders of those products. A systematic review of the literature in 2018 on heated tobacco products identified 31 studies randomly and blind over those devices, 11 independent and 20 funded by the products manufacturers, needing further long-term research. Another systematic review (relevant studies from 2015 to February 2021), both “in vitro” as alive has shown that the benefits of heated tobacco are controversial and more research is needed to the short-and-long term health effects. Another large concern is that availability of these smokeless products may encourage cigarette consumption, especially among young people and often with the combined use of traditional cigarettes and heated tobacco products.

Mobile phone specific radiation disturbs cytokinesis and causes cell death but not acute chromosomal damage in buccal cells: Results of a controlled human intervention study

Several human studies indicate that mobile phone specific electromagnetic fields may cause cancer in humans but the underlying molecular mechanisms are currently not known. Studies concerning chromosomal damage (which is causally related to cancer induction) are controversial and those addressing this issue in mobile phone users are based on the use of questionnaires to assess the exposure. We realized the first human intervention trial in which chromosomal damage and acute toxic effects were studied under controlled conditions. The participants were exposed via headsets at one randomly assigned side of the head to low and high doses of a UMTS signal (n = 20, to 0.1 W/kg and n = 21 to 1.6 W/kg Specific Absorption Rate) for 2 h on 5 consecutive days. Before and three weeks after the exposure, buccal cells were collected from both cheeks and micronuclei (MN, which are formed as a consequence of structural and numerical chromosomal aberrations) and other nuclear anomalies reflecting mitotic disturbance and acute cytotoxic effects were scored. We found no evidence for induction of MN and of nuclear buds which are caused by gene amplifications, but a significant increase of binucleated cells which are formed as a consequence of disturbed cell divisions, and of karyolitic cells, which are indicative for cell death. No such effects were seen in cells from the less exposed side. Our findings indicate that mobile phone specific high frequency electromagnetic fields do not cause acute chromosomal damage in oral mucosa cells under the present experimental conditions. However, we found clear evidence for disturbance of the cell cycle and cytotoxicity. These effects may play a causal role in the induction of adverse long term health effects in humans.

The estimated health impact of sustainable diets in the Danish population: a risk-benefit assessment

Abstract Background To mitigate the climate emergency and support a growing world population, sustainable diets have become a popular topic. These plant-forward diets are promising in terms of health effects, but estimated population health impacts linked to changes in nutrition and exposure to food contaminants have yet to be quantified. We used a risk-benefit assessment (RBA) to quantify the net health impact of theoretical dietary changes. Methods We collected dietary consumption data from the Danish National Survey of Diet and Physical Activity, exposure data for selected chemical contaminants (cadmium, methyl mercury, lead, and inorganic arsenic) from Danish food monitoring, and dose-response data for various health outcomes from published epidemiological data. The average Danish diet was compared to multiple dietary scenarios: a Danish-adjusted EAT-Lancet diet and other alternative scenarios that looked at proportional decreases in animal-based foods with plant-based substitutions. Results Shifting to a Danish-adjusted EAT-Lancet diet would require increased consumption of legumes by 6,352%, nuts by 1,036%, bread and cereals by 100%, fruits and berries by 40%, and fish and shellfish by 39%. Red meat and dairy consumption would need decreases of 83% and 25%, respectively. With these changes, we estimated that a net of 22,900 DALYs would be averted in one year in the Danish population. The food groups contributing most to positive health impacts were nuts (-7,721 DALYs), bread and cereals (-6,244), decreased red meat (-5,681), legumes (-2,509), and fruits and berries (-1,396). These results are preliminary; all scenarios will be compared. Conclusions Our results support a beneficial impact on the health of the Danish population due to sustainable dietary transitions. Similar benefits are expected for other populations across Europe. We argue that RBAs are a powerful decision-support tool and can provide quantitative evidence for sustainable diets and future interventions. Key messages • Our comprehensive risk-benefit assessment concluded that transitioning towards a more sustainable diet leads to positive health impacts. • Our conclusions support policy and decision makers in implementing plant-forward dietary recommendations and agendas in the Danish population.

Ergonomic Risk Analysis of Noise and its Effects on the Health of Operators in the Metal-Mechanical Sector.

The risk of developing an occupational pathology due to exposure to noise can cause occupational clinical symptoms with short, medium or long term health effects. The objective of the study is to identify the dysergonomic magnitude of oscillating acoustic comfort, approximately between 80 and 85 decibels, in MSMEs of the metal-mechanic sector and its effects on workers' exposure. The study population consisted of 1300 workers with a sample of 769 workers. The measurement was performed in different workstations with a sound level meter type 1, ISO 28803:2012 standard. Qualitative and quantitative data were obtained to analyze results related to occupational exposure. The sound pressure level was determined in each area of the plant during the different working days. This was done per worker according to their activity and tasks performed. In this way, it was possible to raise discussions about the improvement of the quality of life. The results of the study are satisfactory. Epidemiological surveillance programs (PVE) with an emphasis on audiometry are suggested.

Fluoride Contamination and Water Quality Status

River fluoride contamination is one of public health problems. This study aims to determine the water quality status and fluoride contamination analyses of Cirarab River, Banten-Indonesia. Water sampling was conducted along the Cirarab River from up to downstream at eight (8) stations from February to June 2016. Water fluoride was analyzed using SPADNS method and STORET method for determining water quality status. Results show that the average water fluoride ranges from 2-2.24 mg/L. The maximum fluoride concentration obtained in station 4 (3 mg/L) was recorded in April 2016. Based on the World Health Organization’s (WHO) maximum acceptable fluoride levels of 1.50 mg/l, the overall results show that the water quality status of the Cirarab River was heavily polluted. In some situations, there was a need for continuous monitoring and warning drinking water management resources to minimize the long term health effects on communities consuming, and also the policies that are necessary to achieve sustainable water quality.
 Keywords: fluoride, Cirarab Rivers, water quality

Adolescent health problems and strategies to improve them

Adolescent as any person between ages 10 and 19. It is a transitional stage of physical, physiological and psychological development from puberty to legal adulthood. The data about important adolescent’s health issues in different areas are limited. Hence detailed investigation and reports on adolescent’s health issues is the need of the hour. To achieve wholesome adolescent health, we need to have a multidimensional approach covering all the adolescent health problems with special emphasis on mental health, behavior change communication towards healthy lifestyle and positive social environment to acquire life skills. Availability of good quality care and healthcare workers trained to deal with adolescents is critical for delivering effective health interventions. Providing health care to adolescents presents a dual challenge: the treatment of immediate health problems, and the opportunity through health promotion and disease prevention, to influence health habits, lifestyle choices, and health status in adulthood because health behaviors originating in adolescence may well have long term health consequences.

Quality improvement project in primary care to improve management of women with premature ovarian insufficiency

Background: Premature Ovarian Insufficiency (POI) is defined as the loss of ovarian activity before the age of 40 years. The prevalence in the general population is an estimated 1% in the UK. If untreated, POI can cause serious long term health consequences, including increased risk of cardiovascular disease, osteoporosis, impaired cognition, reduced psychological wellbeing, and quality of life. To lower the risk of these, hormone replacement therapy (HRT) is advised until the natural age of the menopause. Investigations are recommended by ESHRE to look at primary causes as well as a baseline DEXA scan. We present results from a study exploring prevalence, diagnosis, and management of POI in an urban Primary Care Practice in East London.

Diabetes Mellitus and quality of life: lower socio-economic status patients in Indian tertiary healthcare – a cross sectional study

Background: Diabetes mellitus has emerged as one of the most severe diseases in regards to impact on lifestyle. It behaves as a syndrome rather than a single illness owing to its long term complications. Improving the quality of life (QoL) is the main goal to be achieved, thereby making it an essential factor to prognosticate the long term health consequences. Decreased QoL has been observed in patients with long standing diabetes mellitus and worsens when comorbidities add up to it. Routine activities in patients with diabetes is associated with massive physical and psychosocial implications that can lead to lack of self-care, thereby affecting glycaemic control, leading to early development of complications, and finally affecting quality of life. The goal of this study is to understand the relation between the domains of QoL among patients with diabetes mellitus belonging to lower socio-economic status of coastal India. Methods: A cross sectional study focused on individuals seeking services of our tertiary health facility. The study analyzed 100 samples over various domains of QoL. The BG Prasad scale for socio-economic status and the MDQoL-17 questionnaire was used. SPSS version 25.0 was utilized for data analysis. Descriptive statistics namely standard deviation, mean and proportions were used for expressing the outcomes. Results: Data from 100 participants was evaluated of which 63% were males. The mean ages were between 57.2±1.2 years with 31% belonged to ages between 51-60 years. Socio-economic category 4 was highest (52%). Majority of the participants had diabetes since 1-5 years (44%) and >6.5 HbA1c was seen among 95%. A p-value of <0.001 was observed with physical functioning, physical health, emotional wellbeing, emotional health, social functioning and general health that was suggestive of statistical significance. Conclusions: The study was able to correlate various determinants of overall QoL affected, necessitating a targeted approach.

Influences and Willingness to Receive Future COVID-19 Vaccination by Demographic Data and Proposed Interventions

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a rapidly growing problem in the global health community and has affected millions of people worldwide. The resulting COVID-19 disease poses a significant threat as it can lead to both short and long- term health consequences in all demographics. In order to contain this infectious disease and reduce the amount of harm it inflicts; vaccination has been the best recommended course of action in association with mask wearing and appropriately enforced social distancing measures. The increased speed of development for the mRNA COVID-19 vaccines relative to other vaccines and politicization of being immunized against COVID-19 in the United States of America serve as two points of potential divergency for demographics’ willingness to be immunized. The connections between demographic identifiers and immunization attitudes were evaluated using an online survey distributed to adults living in the United States. Representative data on demographics including age, education level, and political affiliation was collected as was the associated willingness to be immunized against COVID-19 and the annual influenza vaccine. The survey collected data on the factors that influence the participants’ attitudes towards immunization for both influenza and COVID-19. Upon analysis of the data, the relationship between political affiliation and willingness to be immunized for COVID-19 reported a chi-squared statistic of 10.8282 which resulted in a p-value of 0.001 < 0.05. The relationship between political affiliation and willingness to be immunized against COVID-19 proved to be statistically significant in the test population. Upon further analysis of the relationship, self-identified Republicans are less likely to receive the COVID-19 vaccine. Also concluded from the study in order of descending importance, people of all demographics decide to be immunized for both COVID-19 and influenza by reviewing primary scientific literature, considering physicians’ opinions, and reflecting on personal health status. However, in the groups with the lowest willingness to be immunized against COVID-19, the timeline of development was cited as the only deviating deciding factor from those listed above. Using this data, an intervention plan was proposed to increase vaccination participation in low-participating demographics in concurrence with the idea that increased vaccination rates offer a higher level of protection against the illness.

Dietary, Cooking, and Eating Pattern Outcomes from the Emory Healthy Kitchen Collaborative.

Context: Teaching kitchens are emerging innovative and engaging models for creating lifestyle behavior change. They are increasingly being utilized in workplace settings. Objective: The Emory Healthy Kitchen Collaborative (EHKC) year-long worksite wellness teaching kitchen program sought to improve self-reported health behaviors, including food choices, cooking skills, and mindful eating habits. Study Design and Analysis: This 12-month program included a 10-week didactic and experiential curriculum followed by continued support and access to health coaching. Participant t-tests were used to compare results at different time points. Setting: Emory worksite wellness program Population Studied: Forty benefits-eligible Emory employees aged 18-65, were recruited to participate in the EHKC. Preference was given to employees with elevated body mass index, co-morbid conditions, and high lifestyle change motivation levels. Intervention/Instrument and Outcome Measures: Self-assessment instruments were obtained at baseline, 3-months, 6-months and 12-months. This included the 8-item Starting the Conversation (STC) food frequency instrument, eight questions from a 17-item cooking frequency and confidence questionnaire, and a 28-item mindful eating questionnaire. Results: Between May 30 - June 30, 2019, 40 benefits-eligible Emory employees were enrolled in the EHKC. Dietary eating patterns improved significantly throughout the duration of the program year, as measured by the STC. The largest improvement in STC occurred from baseline to three months (mean: - 2.18, standard deviation: 2.35, p-value: p=0.002). Although cooking frequency and confidence trended towards improvement, there were no significant changes. The mindfulness eating questionnaire improved significantly at 3-months (0.27, 0.32, p<0.001), 6-months (0.23, 0.33, p<0.001), and 12 months (0.33, 0.28, p<0.001), as compared to baseline. Conclusion: The EHKC worksite wellness program provided valuable knowledge and insight into the use of a teaching kitchen as a unique health care delivery model. The program significantly improved participant dietary patterns and mindful eating habits; though did not significantly improve cooking confidence or frequency. Further research is needed to understand long term health consequences and disease risk reduction of the EHKC program.

Nutrition for diabetic patients (Update 2023)

All patients with diabetes require individual and personalized nutritional consultation with professionals. The patient's needs should be the primary focus of the dietary therapy, taking their lifestyle and the type of diabetes into consideration. With the recommendations to the patient's diet, there need to be specific metabolic goals to reduce the disease's progression and to avoid long term health effects. Therefore, practical guidelines such as portion size and meal planning tips should be the main focus.According to the latest national and international standards, patients suffering from diabetes should have access to nutrition consulting and nutritional training. During consultation they can be supported on- how to manage their health condition and choosing food and beverage to improve their health.These practical recommendations sum up the latest literature on nutritional aspects of diabetes treatment.

814 SLEEP DISORDERS AND DYSBIOSIS: CULPRITS IN CARDIOVASCULAR DISEASES

Abstract Introduction Primary prevention of cardiovascular disease, the leading cause of death worldwide, has become a mainstay in addressing this considerable global challenge. It has become clear that the gut microbiome plays a vital role in human metabolism, immunity, and reactions to diseases, including cardiovascular disease. Growing evidence suggests that sleep quality can be influenced by the Gut Microbiome (GM), since probiotic supplementation has been found to improve subjective sleep healthy. Disruption of sleep and sleep/wake functions has been associated with both short (increased stress responsivity or psychosocial issues) and long term health consequences, including cancer and cardiovascular diseases. Emerging evidence suggests that disturbance of circadian rhythm, which incorporates essential physiological and humoral functions in a 24-hour cycle, could be an understudied risk factor for cardiovascular disease. While impaired sleep quality is a significant contributor to circadian rhythm disturbance, the evidence regarding sleep interventions and their effect on cardiovascular events is lacking. We conduct a literature review to synthesize a body of evidence on the interaction between sleep and GM in order to achieve robust and broad conclusions and implications with the cardiovascular system. Methods We reviewed the literature on the relationship between sleep, gut microbiome and cardiovascular disease, from January 2017 up until August 2022. Results The human GM can influence health through a bidirectional communication channel linking the brain and gut, the Brain-Gut-Microbiome Axis (BGMA). Many authors have described several underlying factors that could be involved in sleep-disorder, such as the immune system, the vagus nerve (VN), the neuroendocrine system, and bacterial metabolites. Furthermore, several interventions targeting the GM have been proved to be beneficial for amelioration of sleep problems: gamma-amino butyric acid (GABA) produced by the intestinal microbiota may influence the central nervous system through the VN and have an influence on sleep, as some studies reported Conclusions Sleep health may constitute a novel cardiovascular risk factor and target for preventive intervention. More research and well-designed studies are needed to better evaluate the role of the microbiome in the multi-directional relationship between sleep, diet and CVD. From our analysis GM provides a wide range of potential therapeutic targets. Challenges ahead include the development of therapeutic interventions that target reversing gut dysbiosis, at an early stage, combined with good sleep behavior, which may open new horizons to prevent cardiovascular disease.

Organ dose calculator for diagnostic nuclear medicine patients based on the ICRP reference voxel phantoms and biokinetic models

The exponential growth in the use of nuclear medicine procedures represents a general radiation safety concern and stresses the need to monitor exposure levels and radiation-related long term health effects in NM patients. In the current study, following our previous work on NCINM version 1 based on the UF/NCI hybrid phantom series, we calculated a comprehensive library of S values using the ICRP reference pediatric and adult voxel phantoms and established a library of biokinetic data from multiple ICRP Publications, which were then implemented into NCINM version 2. We calculated S values in two steps: calculation of specific absorbed fraction (SAF) using a Monte Carlo radiation transport code combined with the twelve ICRP pediatric and adult voxel phantoms for a number of combinations of source and target region pairs; derivation of S values from the SAFs using the ICRP nuclear decay data. We also adjusted the biokinetic data of 105 radiopharmaceuticals from multiple ICRP publications to match the anatomical description of the ICRP voxel phantoms. Finally, we integrated the ICRP phantom-based S values and adjusted biokinetic data into NCINM version 2. The ratios of cross-fire SAFs from NCINM 2 to NCINM 1 for the adult phantoms varied widely from 0.26 to 5.94 (mean = 1.24, IQR = 0.77–1.55) whereas the ratios for the pediatric phantoms ranged from 0.64 to 1.47 (mean = 1.01, IQR = 0.98–1.03). The ratios of absorbed dose coefficients from NCINM 2 over those from ICRP publications widely varied from 0.43 (colon for 99mTc-ECD) to 2.57 (active marrow for 99mTc-MAG3). NCINM 2.0 should be useful for dosimetrists and medical physicists to more accurately estimate organ doses for various nuclear medicine procedures.

Perlindungan Konsumen Atas Peredaran Hand Sanitizer Palsu Yang Tidak Berstandar Kesehatan Di Masa Pendemi Covid-19

Introduction: Selling health products without a permit that does not meet standards is of course our right as consumers.Purposes of the Research: To know and understand the supervision of the PERMENKES on the circulation of fake Hand Sanitizers that do not have health standards during the covid-19 pandemic. To examine the protection of consumers for the circulation of fake Hand Sanitizers that do not have health standards during the covid-19 pandemic Methods of the Research: The method used is a normative juridical research method using a case approach, a statutory approach and a conceptual approach.Results of the Research: The results obtained from the current research are that consumer protection in fulfilling needs should be obtained by every consumer for health products circulating in the market. However, as time goes by, consumers often get worrisome consequences in terms of health as a result of producers taking shortcuts in order to get as much profit as possible but not matched by the quality improvement provided to consumers. The regulation of the minister of health has a role to maintain the stability of public trust in supervising circulating products, but in reality consumers do not get attention to the circulation of fake hand sanitizers that do not have health standards.

Predicting cumulative lead (Pb) exposure using the Super Learner algorithm

Chronic lead (Pb) exposure causes long term health effects. While recent exposure can be assessed by measuring blood lead (half-life 30 days), chronic exposures can be assessed by measuring lead in bone (half-life of many years to decades). Bone lead measurements, in turn, have been measured non-invasively in large population-based studies using x-ray fluorescence techniques, but the method remains limited due to technical availability, expense, and the need for licensing radioactive materials used by the instruments. Thus, we developed prediction models for bone lead concentrations using a flexible machine learning approach--Super Learner, which combines the predictions from a set of machine learning algorithms for better prediction performance. The study population included 695 men in the Normative Aging Study, aged 48 years and older, whose bone (patella and tibia) lead concentrations were directly measured using K-shell-X-ray fluorescence. Ten predictors (blood lead, age, education, job type, weight, height, body mass index, waist circumference, cumulative cigarette smoking (pack-year), and smoking status) were selected for patella lead and 11 (the same 10 predictors plus serum phosphorus) for tibia lead using the Boruta algorithm. We implemented Super Learner to predict bone lead concentrations by calculating a weighted combination of predictions from 8 algorithms. In the nested cross-validation, the correlation coefficients between measured and predicted bone lead concentrations were 0.58 for patella lead and 0.52 for tibia lead, which has improved the correlations obtained in previously-published linear regression-based prediction models. We evaluated the applicability of these prediction models to the National Health and Nutrition Examination Survey for the associations between predicted bone lead concentrations and blood pressure, and positive associations were observed. These bone lead prediction models provide reasonable accuracy and can be used to evaluate health effects of cumulative lead exposure in studies where bone lead is not measured.

Determinants of immediate adverse pregnancy outcomes: A hospital based study

Adverse pregnancy outcomes are a major public health problem which can lead to serious short and long- term health effect to the mother and the newborn. Hence, the objective of this study is to find out the determinants of immediate adverse pregnancy outcomes in tertiary care hospital in South India. The study comprised of antenatal mothers admitted for delivery in selected tertiary care hospital in Belgaum, Karnataka, India from 10th November, 2021 to 20th January 2022. All registered deliveries in the study period have been included, comprises of 101. Bivariate logistic regression was used to determine the factors associated with outcome variables. A significance level of 5% was used to decide the significance of statistical tests. The mean age in years (± SD) of the mother was 24.6 (± 3.9). The average cost invested for a family health check-up in a year was Rupees 18,099. The average birth weight of the newborn was 2.7 kg, while the minimum weight of the newborn was 1.4 kg, and the maximum weight was 3.8 kg. The average week of gestation for the first-time with respect to antenatal care visit of pregnant women was 9.6 weeks. The average weight of the women was 47.6 kg during first antenatal care visit and 61.5 kg during last antenatal care visit. Adverse outcomes reported were post-partum hemorrhage was 7.9%, low birth weight 26.7%, preterm delivery 28.7%, anemia 53.5%, neonatal physiological and jaundice 15.8%. However, use of mode of transportation during antenatal care visit was found to be significant factor for preterm delivery. Every fourth baby was low birth weight, and every fourth women have preterm delivery and every second woman was anemic. Socioeconomic, demographic and chronic illness was associated with immediate adverse pregnancy outcomes.

PSYCHOGENIC NONEPILEPTIC SEIZURES FOLLOWING COVID 19 VACCINE: A REPORT OF TWO CASES IN COLOMBIA

The novel coronavirus SARS-CoV-2 has caused the death of more than 5 million of people worldwide. Vaccination is the best strategy for controlling the pandemic with an estimated of more that 4 million of people completely vaccinated. The reported adverse events secondary to vaccines against SARS-CoV-2 are mainly mild and moderate, however, there are raising concerns about more severe and long-term outcomes, as well as neurological complications due to the vaccine. We present two cases of psychogenic non epileptiform seizures (PNES) in Colombian female patients, following vaccination against Covid-19. There is no evidence of similar adverse reactions reported on the literature and thus, we decided to report these events in order to help clinicians in recognizing early and properly all the possible neurological manifestations related to this novel approach, that aimes to eradicate the viruses which has come along with worldwide devastating consequences in terms of health and social issues.

Evolving spectrum of diabetic wound: Mechanistic insights and therapeutic targets.

Diabetes mellitus is a chronic metabolic disorder resulting in an increased blood glucose level and prolonged hyperglycemia, causes long term health conse-quences. Chronic wound is frequently occurring in diabetes patients due to compromised wound healing capability. Management of wounds in diabetic patients remains a clinical challenge despite many advancements in the field of science and technology. Increasing evidence indicates that alteration of the biochemical milieu resulting from alteration in inflammatory cytokines and matrix metalloproteinase, decrease in fibroblast and keratinocyte functioning, neuropathy, altered leukocyte functioning, infection, etc., plays a significant role in impaired wound healing in diabetic people. Apart from the current pharmacotherapy, different other approaches like the use of conventional drugs, antidiabetic medication, antibiotics, debridement, offloading, platelet-rich plasma, growth factor, oxygen therapy, negative pressure wound therapy, low-level laser, extracorporeal shock wave bioengineered substitute can be considered in the management of diabetic wounds. Drugs/therapeutic strategy that induce angiogenesis and collagen synthesis, inhibition of MMPs, reduction of oxidative stress, controlling hyperglycemia, increase growth factors, regulate inflammatory cytokines, cause NO induction, induce fibroblast and keratinocyte proliferation, control microbial infections are considered important in controlling diabetic wound. Further, medicinal plants and/or phytoconstituents also offer a viable alternative in the treatment of diabetic wound. The focus of the present review is to highlight the molecular and cellular mechanisms, and discuss the drug targets and treatment strategies involved in the diabetic wound.

Childhood obesity and racism: 2022 views and observations

As obesity continues to pose an immense challenge to mitigate effectively, efforts to untangle its determinants continue, especially those that may exacerbate or impact childhood obesity, and its predictable and well-established multiple often irreversible negative health impacts. Studied for many years in various spheres, the role played by socially derived inequalities, and their long term health effects on youth have not been well studied in this regard, however. This mini review discusses what appears to be a possible insidious and contributing factor impacting various forms of service, resource disparities, and situational opportunities that may explain in part the prevailing and unequal childhood obesity rates between minorities and the mainstream child in the United States. Extracted from current literature, it is concluded that this is a topic of high potential and clinical relevance, and one worthy of intense study, more acceptance and recognition, plus dedicated sustainable collaborative policy goals and supportive efforts.