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Introduction The prevalence of otitis media (OM) is substantial all over the world. Epidemiological data related to the economic burden of OM globally is minimal. The present systematic review was undertaken to estimate the economic burden of this disease in various parts of the world. Objectives An extensive literature search was done using PRISMA guidelines to identify relevant studies that estimated the economic burden of OM in monetary terms. The databases searched were PubMed Central, Ovid, and Embase. The cost estimation was done for one specific year and then compared considering the inflation rate. Data Synthesis The literature search led to the inclusion of 10 studies. The studies evaluated direct and indirect costs in monetary terms. Direct costs (health system and patient perspective) ranged from USD (United States Dollar) 122.64 (Netherlands) to USD 633.6 (USA) per episode of OM. Looking at only the patient perspective, the costs ranged from USD 19.32 (Oman) to USD 80.5 (Saudi Arabia). The total costs (direct and indirect) ranged from USD 232.7 to USD 977 (UK) per episode of OM. The economic burden per year was highest in the USA (USD 5 billion). The incidence of OM episodes was found more in children < 5 years old. Introduction of pneumococcal conjugate vaccines decreased the incidence in children and now the prevalence in adults is of concern. Conclusion The economic burden of OM is relatively high globally and addressing this public health burden is important. Approaches for the prevention, diagnosis, and treatment should be undertaken by the health system to alleviate this disease burden.
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This Systematic Review assesses the economic impact of Respiratory Syncytial Virus (RSV) in Latin America and the Caribbean (LAC) in relation to healthcare resource utilization and associated costs. We searched online databases from January 2012 to November 2022 to identify eligible publications. We identified 12 publications that reported direct costs, indirect costs, and resources associated with RSV and its complications. The primary direct medical resources reported were medical services, diagnostics tests and procedures, and length of stay (LOS). Direct total costs per patient ranged widely from $563 to $19,076. Direct costs are, on average, 98% higher than indirect costs. Brazil reported a higher total cost per patient than Colombia, El Salvador, México, Panamá, and Puerto Rico, while for indirect costs per patient, El Salvador and Panamá had higher costs than Brazil, Colombia, and Mexico. The mean LOS in the general ward due to RSV was 6.9 days (range 4 to 20 days) and the mean Intensive Care Unit LOS was 9.1 days (range 4 to 16 days). In many countries of the LAC region, RSV represents a considerable economic burden on health systems, but significant evidence gaps were identified in the region. More rigorous health economic studies are essential to better understand this burden and to promote effective healthcare through an informed decision-making process. Vaccination against RSV plays a critical role in mitigating this burden and should be a priority in public health strategies.
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Efeitos Psicossociais da Doença , Custos de Cuidados de Saúde , Infecções por Vírus Respiratório Sincicial , Humanos , Infecções por Vírus Respiratório Sincicial/economia , Infecções por Vírus Respiratório Sincicial/epidemiologia , América Latina/epidemiologia , Custos de Cuidados de Saúde/estatística & dados numéricos , Tempo de Internação/economia , Tempo de Internação/estatística & dados numéricos , Região do Caribe/epidemiologia , Vírus Sincicial Respiratório HumanoRESUMO
INTRODUCTION: 2,6-Disubstituted piperidin-3-ols are an important group of piperidine alkaloids found in species such as Senna spectabilis, whose main constituents include cassine and spectaline, compounds with relevant pharmacological activity. The analysis of these compounds is challenging due to the complexity of plant extracts and the absence of chromophores capable of absorbing ultraviolet (UV) radiation. OBJECTIVE: This paper presents a new analytical method to separate and quantify the non-UV-absorbing alkaloids present in ethanol extracts from S. spectabilis flowers using capillary zone electrophoresis (CZE) with indirect UV detection. METHODOLOGY: The optimized CZE method employs a background electrolyte containing 60 mM histidine (His), 15 mM α-cyclodextrin, 20% acetonitrile (ACN), and pH-adjusted to 4.7 with acetic acid (AcOH). RESULTS: The limit of detection (LOD) values was 10.2 and 13.9 mg L-1 for cassine and spectaline, respectively. For both analytes, the precision data were better than 2% of relative standard deviation (RSD) for migration times and peak areas. To evaluate the applicability of the developed method, ethanolic extracts from S. spectabilis flowers were prepared and analyzed. CONCLUSIONS: Thereby, the method proved to be efficient and complementary to conventional techniques, offering a cost-effective alternative in the quantification of the non-UV-absorbing piperidine alkaloids present in plant extracts.
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BACKGROUND: Moyamoya disease, a progressive occlusive arteriopathy mainly affecting the supraclinoid internal carotid artery, leads to abnormal "Moyamoya vessels" and ischemic events in children due to decreased cerebral blood flow. Surgery, especially indirect revascularization, is suggested for pediatric Moyamoya cases. METHOD: We present the Encephalo-Duro-Mio-Synangiosis (EDMS) technique, illustrated with figures and videos, based on 14 years' experience performing 71 surgeries by the senior author (SGJ) and the Moyamoya Interdisciplinary Workteam at "Prof. Dr. J. P. Garrahan" Pediatric Hospital. CONCLUSION: EDMS is a simple and effective treatment for Moyamoya disease, enhancing procedure precision and safety, reducing associated risks, complications, and improving clinical outcomes.
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Revascularização Cerebral , Doença de Moyamoya , Humanos , Doença de Moyamoya/cirurgia , Doença de Moyamoya/diagnóstico por imagem , Revascularização Cerebral/métodos , Criança , Resultado do Tratamento , Angiografia Cerebral/métodos , Masculino , Feminino , Adolescente , Artéria Carótida Interna/cirurgia , Artéria Carótida Interna/diagnóstico por imagemRESUMO
This study investigated the effects of biset, drop-set and traditional resistance training (RT) techniques on metabolic responses in resistance-trained males. Fifteen trained males (age 29.7 ± 6.1 years; body mass 83.4 ± 7.6 kg; RT experience 11.4 ± 6.7 years; one-repetition maximum (1RM) barbell bench press: body mass ratio 1.4 ± 0.1 a.u.) were assigned to three experimental conditions, in a randomized crossover design. The experimental conditions were bi-set (3×10 repetitions at 70%1RM in barbell bench press followed by 10 repetitions at 60%1RM in incline bench press), drop-set (3×10 repetitions at 70%1RM followed by 10 repetitions at 50%1RM in barbell bench press) and traditional RT (3×20 at 60%1RM in barbell bench press). A portable gas analyzer was used to assess energy expenditure and maximal oxygen uptake during the experimental protocols. Blood lactate levels were assessed at baseline and 1, 3, and 5 minutes after the training session. There were no differences for total training volume (p = 0.999). Post hoc comparisons revealed that bi-set elicited higher aerobic energy expenditure (p = 0.003 vs. drop-set; p < 0.001 vs. traditional RT) and aerobic oxygen consumption (p = 0.034 vs. drop-set; p < 0.001 vs. traditional RT) than other RT schemes. There were no differences regarding anaerobic EE between-conditions (p > 0.05). There was a main effect of time and condition for blood lactate levels (p < 0.001). Post hoc comparisons revealed that drop-set training elicited higher blood lactate levels than traditional RT (p = 0.009). The results suggest that RT techniques may have a potential role in optimizing metabolic responses in resistance-trained males.
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Few studies have examined victim participation in parole processes, particularly in countries that have specific procedures for hearing victims' statements in post-conviction proceedings. This study, through in-depth interviews, explores the experiences of seven indirect victims of child sexual homicide, identifying their needs and expectations in a justice system lacking formal mechanisms for their involvement. Results emphasize the necessity for official information for families and the consequent frustration from the absence of formal participation. Parole application becomes a new challenge to the ongoing grieving process, leading to distress responses that may require specialized care. Recommendations about formal mechanisms for victim notification, participation and support during the parole process are noted to acknowledge their experience and emotional impact.
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Leptospirosis is a globally distributed infectious disease caused by pathogenic spirochetes of the Leptospira genus, often overlooked. It is estimated that the disease affects approximately one million people annually, resulting in more than 58,900 deaths. The gold standard for serodiagnosis of leptospirosis is the Microscopic Agglutination Test (MAT). However, the limitations of this technique necessitate the exploration of alternative diagnostic methods. In this study, we evaluated the ErpY-like recombinant protein (rErpY-like) in the development of a serologic diagnostic assay for human leptospirosis. Eighty-six human sera samples, characterized by MAT, underwent evaluation through indirect IgM-ELISA and IgG-ELISA. The sensitivity and specificity values obtained from IgM-ELISA were 60% and 76%, respectively, while those from IgG-ELISA were 96.4% and 100%, respectively. The use of the rErpY-like protein in both IgM-ELISA and IgG-ELISA proves to be a sensitive and specific method for antibody detection. This could potentially serve as a valuable alternative tool in the diagnosis of human leptospirosis.
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Anticorpos Antibacterianos , Ensaio de Imunoadsorção Enzimática , Imunoglobulina G , Imunoglobulina M , Leptospira , Leptospirose , Sensibilidade e Especificidade , Testes Sorológicos , Leptospirose/diagnóstico , Leptospirose/imunologia , Leptospirose/microbiologia , Leptospirose/sangue , Humanos , Anticorpos Antibacterianos/sangue , Imunoglobulina M/sangue , Ensaio de Imunoadsorção Enzimática/métodos , Imunoglobulina G/sangue , Leptospira/imunologia , Testes Sorológicos/métodos , Proteínas Recombinantes/imunologia , Proteínas Recombinantes/genética , Proteínas de Bactérias/imunologia , Proteínas de Bactérias/genética , Antígenos de Bactérias/imunologiaRESUMO
This data article presents information on the measurement of Indirect Tensile Stiffness Modulus of laboratory and field asphalt mixtures. The asphalt mixes are composed of three distinct binders that were categorised by their penetration grade (40/55-TLA, 60/75-TLA, and 60/70-MB) and aggregates (limestone, sharp sand, and filler). The asphalt mixtures are called dense-graded hot mix asphalt (HMA) and gap-graded stone matrix asphalt (SMA). The variables in the dataset were selected in accordance with the specifications of the dynamic modulus models that are currently in use as well as the needs for the quality control and assurance (QC & QA) assessment of asphalt concrete mixes. The data parameters included are temperature, asphalt content, and binder viscosity, air void content, cumulative percent retained on 19, 12.5, and 4.75 mm sieves, maximum theoretical specific gravity, aggregate passing #200 sieve, effective asphalt content, density, flow, marshal stability, coarse-to-fine particle ratio and the Indirect Tensile Stiffness Modulus (ITSM). Utilising soft computing techniques, models were developed utilising the data thus eliminating the requirement for complex and time-consuming laboratory testing.
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Orthobunyavirus oropouche ense virus (OROV), the causative agent of Oropouche fever, is widely dispersed in Brazil and South America, causing sporadic outbreaks. Due to the similarity of initial clinical symptoms caused by OROV with other arboviruses found in overlapping geographical areas, differential diagnosis is challenging. As for most neglected tropical diseases, there is a shortage of reagents for diagnosing and studying OROV pathogenesis. We therefore developed and characterized mouse monoclonal antibodies and, one of them recognizes the OROV nucleocapsid in indirect immunofluorescent (IFA) and immunohistochemistry (IHC) assays. Considering that it is the first monoclonal antibody produced for detecting OROV infections, we believe that it will be useful not only for diagnostic purposes but also for performing serological surveys and epidemiological surveillance on the dispersion and prevalence of OROV in Brazil and South America.
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Infecções por Bunyaviridae , Orthobunyavirus , Animais , Camundongos , Anticorpos Monoclonais , Infecções por Bunyaviridae/diagnóstico , Brasil/epidemiologiaRESUMO
The growth of Nelore cattle was analysed considering the following performance parameters; the effect of the calving order of cows on the phenotypic expression of birth weight (BW), average daily gain from birth to weaning (BWG), and weaning weight (WW), the estimated genetic parameters for the traits, including the covariance components between direct and maternal genetic effects. Genetic trends and correlated responses were also obtained for the studied traits. The calving order of cows, as well as other fixed effects used to obtain the adjusted phenotypic means, were statistically significant (p < 0.001) for studied traits. Direct heritability was estimated at 0.24 ± 0.01 (BW), 0.15 ± 0.01 (BWG), and 0.18 ± 0.01 (WW), while maternal heritability was 0.06 ± 0.01 (BW), 0.12 ± 0.01 (BWG), and 0.11 ± 0.01 (WW). The correlations between direct and maternal effects within the same trait were negligible. Moderate to higher direct genetic correlations (ranging from 0.54 ± 0.04 to 0.98 ± 0.01) and maternal genetic correlations (ranging from 0.34 ± 0.09 to 0.99 ± 0.002) were estimated between the studied traits. Unlike direct genetic effects, there was no significant change in maternal genetic effects over time (p > 0.05). These results indicated the need for revising selection indexes for enhancing maternal ability. Correlated responses were generally lower compared to direct responses, except for BWG. The selection for BWG, considering the maternal genetic effect, would be more efficient to improve maternal ability of the cows for pre-weaning growth in relation to selection for WW. Our results found that direct genetic merit improves pre-weaning weight and this trait can be incorporated into the breeding goal as reflected in the WW.