Fibre optic confocal imaging (FOCI) of keratinocytes, blood vessels and nerves in hairless mouse skin in vivo

Fibre optic confocal imaging (FOCI) enabled subsurface fluorescence microscopy of the skin of hairless mice in vivo. Application of acridine orange enabled imaging of the layers of the epidermis. The corneocytes of the stratum corneum, the keratinocytes in the basal layers and redundant hair follicles were visualised at depths greater than 100 μm. Cellular and nuclear membranes of keratinocytes of the skin were visualised by the use of acridine orange and DIOC5(3). Imaging of the skin after injection of FITC-dextran revealed an extensive network of blood vessels with a size range up to 20 μm. Blood cells could be seen moving through dermal vessels and the blood circulation through the dermal vascular bed was video-taped. The fluorescent dye 4-di-2-ASP showed the presence of nerves fibres around the hair follicles and subsurface blood vessels. Comparison was made between images obtained in vivo using FOCI and in vitro scanning electron microscopy and conventional histology. FOCI offers the potential to study dynamic events in vivo, such as blood flow, skin growth, nerve regeneration and many pathological processes, in ways which have not previously been possible.     

Evaluation of the ultrasound influence in the cutaneous penetration of d-panthenol: test in vitro

Background d‐panthenol is a popular additive in cosmetic and pharmaceutical preparations. However, in order for this vitamin to provide skin benefits, it must penetrate the stratum corneum. Objective To verify the penetrability of d‐panthenol in the skin and evaluate the effect of ultrasound on the cutaneous penetration of this vitamin. Methods The diffusion cell technique with pig skin as the membrane, distilled water as the receptor solution, and a hydrophilic d‐panthenol gel were used for the research. The experimental groups were gel + d‐panthenol (10%) and gel + d‐panthenol (10%) + ultrasound. The receptor solution was collected at predetermined times and the amount of d‐panthenol was determined by using a spectrophotometer at 406 nm. Results Ultrasound resulted in a statistically significant increase (P < 0.05) in the penetration of d‐panthenol at 2, 60, and 240 min. Conclusion d‐panthenol penetration through the pig's skin is enhanced through the use of ultrasound.     

High-carbohydrate diets: effects on lipid metabolism, body adiposity and its association with physical activity and cardiovascular disease risk

For many years the reduction in the dietary fat has been recommended to the population, in order to prevent cardiovascular diseases, obesity, type 2 diabetes mellitus, among other chronic diseases. The consequence has been the replacement of carbohydrates by fat, resulting in the adoption of high carbohydrate diets. However, it has been still discussed if very rich carbohydrate diets should be recommended to the general population. Researches point out controversies about the association between these dietary habits and harmful effects on health and metabolic aspects, such as raise in de novo lipogenesis and triglyceride concentration, reduction in HDL concentration and effects on adiposity. This review evaluates the effects of diet modification, particularly the high-carbohydrate diet, in cardiovascular risk factors such as dyslipidemia and obesity. It also reviews its interaction with physical activity since it is still unknown with which extension it can minimize possible harmful effects of high carbohydrate diets in the long term.     

Loss to follow-up among youth accessing outpatient HIV care and treatment services in Kisumu,Kenya

Youth are particularly vulnerable to acquiring HIV, yet reaching them with HIV prevention interventions and engaging and retaining those infected in care and treatment remains a challenge. We sought to determine the incidence rate of loss to follow-up (LTFU) and explore socio-demographic and clinical characteristics associated with LTFU among HIV-positive youth aged 15–21 years accessing outpatient care and treatment clinics in Kisumu, Kenya. Between July 2007 and September 2010, youth were enrolled into two different HIV care and treatment clinics, one youth specific and the other family oriented. An individual was defined as LTFU when absent from the HIV treatment clinic for ≥?4 months regardless of their antiretroviral treatment status. The incidence rate of LTFU was calculated and Cox regression analysis used to identify factors associated with LTFU. A total of 924 youth (79% female) were enrolled, with a median age of 20 years (IQR 18–21). Over half, (529 (57%)), were documented as LTFU, of whom 139 (26%) were LTFU immediately after enrolment. The overall incidence rate of LTFU was 52.9 per 100 person-years (p-y). Factors associated with LTFU were pregnancy during the study period (crude HR 0.68, 95% CI 0.53–0.89); CD4 cell count >350 (adjusted hazard ratios (AHR) 0.59, 95% CI 0.39–0.90); not being on antiretroviral therapy (AHR 4.0, 95% CI 2.70–5.88); and non-disclosure of HIV infection status (AHR 1.43, 95% CI 1.10–1.89). The clinic of enrolment, age, marital status, employment status, WHO clinical disease stage and education level were not associated with LTFU. Interventions to identify and enrol youth into care earlier, support disclosure, and initiate ART earlier may improve retention of youth and need further investigation. Further research is also needed to explore the reasons for LTFU from care among HIV-infected youth and the true outcomes of these patients.     

针灸推拿治疗椎-基底动脉供血不足的临床研究进展

综述了近几年来针灸推拿治疗椎-基底动脉供血不足的现状,从针刺、针灸结合、电针、推拿、针刺结合推拿、综合治疗等疗法进行了总结和归纳,阐述了针灸推拿治疗本病的优势与不足,为临床更好的应用针灸推拿治疗该病提供参考.     

Management of gallstones and its related complications

The majority of gallstone patients remain asymptomatic; however, interest toward the gallstone disease is continuing because of the high worldwide prevalence and management costs and the development of gallstone symptoms and complications. For cholesterol gallstone disease, moreover, a strong link exists between this disease and highly prevalent metabolic disorders such as obesity, dyslipidemia, type 2 diabetes, hyperinsulinemia, hypertriglyceridemia and the metabolic syndrome. Information on the natural history as well as the diagnostic, surgical (mainly laparoscopic cholecystectomy) and medical tools available to facilitate adequate management of cholelithiasis and its complications are, therefore, crucial to prevent the negative outcomes of gallstone disease. Moreover, some risk factors for gallstone disease are modifiable and some preventive strategies have become necessary to reduce the onset and the severity of complications.     

Hoarseness and vocal tract discomfort and associated risk factors in air traffic controllers

IntroductionAn air traffic controller is a professional who performs air traffic control functions in air traffic control units and is responsible for controlling the various stages of a flight.ObjectiveTo compare hoarseness and vocal tract discomfort and their risk factors among air traffic controllers in the approach control of São Paulo.MethodsIn a cross-sectional survey, a voice self-evaluation adapted from to self-evaluation prepared by the Brazilian Ministry of Labor for teachers was administered to 76 air traffic controllers at approach control of São Paulo, Brazil.ResultsThe percentage of hoarseness and vocal tract discomfort was 19.7% and 38.2%, respectively. In relation to air pollution, the percentages of hoarseness and vocal tract discomfort were higher among those who consider their working environment to be intolerable than among those in a comfortable or disturbing environment. The percentage of hoarseness was higher among those who seek medical advice due to vocal complaints and among those who experience difficulty using their voice at work than among those who experience mild or no difficulty. The percentage of vocal tract discomfort was higher among those in a very tense and stressful environment than among those who consider their work environment to be mild or moderately tense and stressful. The percentage of vocal tract discomfort was higher among those who describe themselves as very tense and stressed or tense and stressed than among those who describe themselves as calm. Additionally, the percentage of vocal tract discomfort was higher among those who care about their health.ConclusionAmong air traffic controllers, the percentage of vocal tract discomfort was almost twice that of hoarseness. Both symptoms are prevalent among air traffic controllers who considered their workplace intolerable in terms of air pollution. Vocal tract discomfort was related to a tense and stressful environment, and hoarseness was related to difficulty using the voice at work.