The extended latissimus dorsi muscle island flap for flexion or extension of the fingers

We describe the technique of transferring the latissmus dorsi muscle as an island flap for the restoration of digital flexion or extension in 28 patients. The latissmus dorsi muscle is raised down to the posterior iliac crest and prolonged with the gluteal superficial facia. We believe that this method is particularly suitable for extensive and prolonged paralysis of the lower elements of brachial plexus. It can be used also for severe Volkmann's contracture or the loss of flexor or extensor muscles of the fingers due to extensive debridement. The technique does not require microsurgery and there is no delay in reinnervation of the muscle.     

Effect of nutritional counseling on low-density lipoprotein cholesterol among Thai HIV-infected adults receiving antiretroviral therapy

HIV-infected patients receiving antiretroviral therapy have increased risk of metabolic syndrome, including dyslipidemia. In this study, we determined whether individual nutritional counseling reduced dyslipidemia, particularly low-density lipoprotein (LDL) cholesterol, among HIV-infected patients with dyslipidemia not currently taking lipid-lowering medication. We conducted a randomized 24-week trial among HIV-infected patients with dyslipidemia who were on antiretroviral therapy and were eligible to initiate therapeutic lifestyle changes according to the Thai National Cholesterol Education Program. Participants were randomly assigned to an intervention group that received individual counseling with a nutritionist for seven sessions (baseline, weeks 2, 4, 8, 12, 18, and 24) and a control group that received standard verbal diet information at baseline and nutritional counseling only at week 24. A 24-h recall technique was used to assess dietary intake for both groups at baseline and week 24. Lipid profile (total cholesterol, LDL, high-density lipoprotein (HDL), and triglyceride) was measured at baseline and after 12 and 24 weeks of therapy. An intention-to-treat and linear mixed model were used. Seventy-two patients were randomly assigned, and 62 (86%) participants completed their lipid profile test. After 12 weeks of follow-up, there were significant reductions in the intervention group for total cholesterol (?14.4?±?4.6?mg/dL, P?=?.002), LDL cholesterol (?13.7?±?4.1?mg/dL, P?=?.001), and triglyceride (?30.4?±?13.8?mg/dL, P?=?.03). A significant reduction in LDL cholesterol was also observed in the control group (?7.7?±?3.8?mg/dL, P?=?.04), but there were no significant differences in change of mean lipid levels between the groups at 12 weeks of follow-up. After 24 weeks, participants assigned to the intervention group demonstrated significantly greater decreases in serum total cholesterol (?19.0?±?4.6?vs. 0.2?±?4.3?mg/dL, P?=?.003) and LDL cholesterol (?21.5?±?4.1?vs. ?6.8?±?3.8?mg/dL, P?=?.009). There were no significant changes in HDL cholesterol or triglyceride levels in either group.     

Prevalence and factors associated with anthropometric failure,vitamin A and iron deficiency among adolescents in a Nigerian urban community

BackgroundUnder nutrition is a problem of severe magnitude in low income countries like Nigeria. Adolescent school children might also be vulnerable. The dearth of data hinders planning of school health and nutrition programmes for school children.ObjectiveTo determine the prevalence of stunting, thinness; vitamin A and iron deficiencies among adolescent students in Nsukka urban, Nigeria and to determine factors that are associated with these nutritional problems.MethodsA total of 400 participants were randomly selected from 717 students aged 12 – 18 years in 3 randomly selected secondary schools. Questionnaires, anthropometric measurements, and blood analyses were the data collection methods employed.ResultsThe prevalence of stunting was 33.3% and thinness 31.0%. Neither overweight nor obesity was observed. While 64.0% were anaemic; 44.0% had vitamin A deficiency (VAD). A total of 48.0% had both anaemia and stunting, 42% had VAD + thinness; while 40% had anaemia + VAD. Household income was a predictor of vitamin A status. Children from medium/high income households had higher odds of having VAD than those from low income households (AOR=0.14; 95% CI=0.031, 0.607; P=0.009). Household income (AOR=0.12; 95% CI=0.021, 0.671; P=0.016), and age (AOR=0.09; 95% CI=0.014, 0.587; P=0.012) were independent determinants of height-for-age status.ConclusionAmong urban adolescent students in Nigeria, stunting, thinness, anaemia and VAD were problems of public health significance. Age and household monthly income played major roles.     

Epidemiologic Evidence on Coffee and Cancer

Coffee consumption is a major and frequent dietary exposure in diverse cultures around the globe whose safety has been questioned. A substantial body of epidemiologic evidence, consisting of over 500 papers relating the consumption of coffee to cancer of various sites, has accumulated to date. Numerous individual, site-specific meta analyses have been undertaken at various times. However, there is no comprehensive, up-to-date overview of the entirety of the knowledge base. To address this need, this review summarized the findings of the meta analyses and recent papers on site-specific human cancers among coffee consumers. For hepatocellular and endometrial cancers, there appears to be a strong and consistent protective association; for colorectal cancer, the direction of association is borderline protective. There appears to be no association with breast, pancreatic, kidney, ovarian, prostate, or gastric cancer. Risk of bladder cancer appears to be associated with heavy coffee consumption in some populations and among men. The associations with childhood leukemia and mother's consumption of coffee were ambiguous—with some suggestion of risk at high levels of daily consumption.     

miRNA-binding site polymorphism in IL-15RA gene in rheumatoid arthritis and systemic lupus erythematosus: correlation with disease risk and clinical characteristics

Clinical Rheumatology - MiRSNPs may interfere with mRNA stability through effects on microRNAs (miRNAs)-mRNA interactions via direct changes in miRNA binding site or effect on the secondary...     

Caring for Dying Patients: Attitude of Nursing Students and Effects of Education

Background:

Education about caring for dying patients could be effective in changing nursing students’ attitude toward caring for dying patients.

Aim:

The aim of the present study was to examine the nursing students’ attitude toward caring for dying patients and effects of education on their attitude.

Materials and Methods:

The present study enjoys a quasi-experimental method with using one-group pre-test/post-test design conducted in Bam in southeast of Iran. The attitude of nursing students was measured using Frommelt Attitude Toward Care of the Dying (FATCOD) scale before and after an educational intervention. Data were analyzed using non-parametric tests in Statistical Package for the Social Sciences (SPSS) 18 software.

Results:

Of 32 students, 30 participated in this study (response rate of 94%). Only 20% of the students reported previous experience of dying patients in their clinical courses. Students showed moderately negative to neutral attitudes toward caring for dying patients. Education has improved students’ attitude significantly (mean score of FATCOD before study were 3.5 ± 0.43 and after intervention were 4.7 ± 0.33) (P < 0.001).

Conclusion:

Educational programs about death and caring for dying patients should be added to undergraduate nursing curricula. Further research recommended examining nursing students’ knowledge about caring for dying patients and the effect of education on their knowledge.