A follow-up angiography study must be performed during the early stage (within approximately 3 weeks after onset of symptoms) to confirm the formation or enlargement of an aneurysm, because such conditions may be amenable to surgical treatment. Unruptured VA dissection could otherwise be treated and followed conservatively. Although the majority of dissected lesions seem likely to stabilize within a few months, as evidenced on angiography, in some cases a longer observation period is required.
Sierra Leone experienced intense transmission of Ebola virus disease (EVD) from May 2014 to November 2015 during which a total of 8,704 confirmed cases and over 3,589 confirmed deaths were reported. Our field observation showed many issues in the EVD data management system, which may have contributed to the magnitude and long duration of the outbreak. In this perspective article, we explain the key issues with EVD data management in the field, and the resulting obstacles in analyzing key epidemiological indicators during the outbreak response work. Our observation showed that, during the latter part of the EVD outbreak, surveillance and data management improved at all levels in the country as compared to the earlier stage. We identified incomplete filling and late arrival of the case investigation forms at data management centers, difficulties in detecting double entries and merging identified double entries in the database, and lack of clear process of how death of confirmed cases in holding, treatment, and community care centers are reported to the data centers as some of challenges to effective data management. Furthermore, there was no consolidated database that captured and linked all data sources in a structured way. We propose development of a new application tool easily adaptable to new occurrences, regular data harmonization meetings between national and district data management teams, and establishment of a data quality audit system to assure good quality data as ways to improve EVD data management during future outbreaks.
Previous quantitative cross sectional studies of ethnic Vietnamese drug users in Melbourne have been overwhelmingly drawn from samples of men. In this qualitative investigation, 24 women aged between 18 and 33 years were interviewed. This exploratory study sought: to identify issues surrounding heroin initiation and drug use career; to examine relationships with family and primary sex partners; and to reveal participants' attitudes to drug treatment. Data reveal that for the women in this study the initiation and continued use of heroin was heavily influenced by men, especially their primary sex partners. The women interviewed reported strategies to minimise their risk taking including enrolling in pharmacotherapy treatment programmes, but they remained particularly vulnerable - especially to blood borne viruses - through both injecting and sexual risk behaviour. The data suggest that interventions which focus on the gendered nature of injecting practices within personal relationships may go some way to both reducing harm and increasing control for the women involved.
Summary In order to verify whether vitamin E improves the cognitive impairment induced through aging, aged rats fed a vitamin E-supplemented diet had their learning and memory functions assessed in comparison with the aged rats fed a normal diet using a Morris water maze test. Although normal aged rats showed very poor learning ability concerning the place of a platform in the water maze apparatus, the aged rats fed the vitamin Esupplemented diet learned the place with a marked speed in only 5 trials. After old animals showed the maximum learning ability, they were kept in a normal atmosphere for 48 h without a trial followed by an assessment of their memory function using the same apparatus. The vitamin E-supplementation to aged rats resulted in marked retention of their maximum memory function, although normal aged rats showed a significant memory loss of about 60%. Pyrroloquinoline quinone (PQQ), which increases in the production of nerve growth factor, and protects neurons, had a similar effect on cognitive function to that of vitamin E in the aged rats. These results suggest that vitamin E may improve cognitive deficit caused through aging by not only its neuro-protecting effect but an antioxidant efficacy. Key Words vitamin E, cognitive deficit, learning, memory, aged rat Although it has been recognized that normal aging is accompanied by declines in cognitive performance, the precise mechanisms leading to this deficit during aging are not well understood. It is evident that these declines arise from neurodegeneration through several factors during aging such as stroke, cerebral infarction and oxidative stress. There is substantial notion that oxidative stress is relevant to the aging process. Oxidative stress occurs at the time of an imbalance between reactive oxygen species (ROS) generation and its detoxification by antioxidants in living tissues, so that aging is considered to be accumulation of oxidative damage of living tissues through oxidative stress experienced over a long period of time ( 1 , 2 ).Among organs in living tissues, neurons in the brain are considered to be more vulnerable to oxidative stress than other organs, leading to neuronal oxidative damage, and neurodegenerative disorders such as Alzheimer's disease (AD), Parkinsonism and senile dementia ( 3 ). It is well-characterized that there are increased regional levels of oxidative stress in the AD brain, and hence recent studies have demonstrated a decrease in polyunsaturated fatty acids, increased levels of lipid peroxidation markers, protein oxidation, and DNA and RNA oxidation in AD ( 4 ). Based on the oxidative stress theory of brain aging, our previous study revealed that the levels of thiobarbituric acid reactive substances (TBARS), lipid hydroperoxides, F 2 -isoprostane and conjugated dienes increase significantly with oxidative stress in the rat brain, and the activity of antioxidative enzymes and vitamin E content in the brain decrease markedly ( 5-7 ). Furthermore, in accordance with these phenomena, young rats subjected to ox...
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