Better cerebral autoregulation evaluated with cerebrovascular PRx is significantly correlated with augmented renal clearance in TBI patients and associates with better outcome.
About one third of the population worldwide have M. tuberculosis infections, although 90% of infected individuals never develop clinical disease 1,2 . The association between alcohol consumption and TB is well known 3,4 . Individuals who consume alcohol are considered immune-compromised because they have a greater incidence and severity of infectious diseases than abstainers, and are also more susceptible to lung infections such as TB and pneumonia 4 . In fact alcohol users are a group at high risk for TB who should be addressed accordingly with targeted preventative interventions 5,6 . In the present paper, we tried to determine the threshold of alcohol consumption that increased the risk for active TB in men and women.Cases and controls were recruited from primary health care units in the same geographical region. Pregnant or lactating women, and individuals infected with HIV or other immunosuppressive conditions were excluded. Cases were patients with active pulmonary TB (with or without pleural involvement), more than 18 years-old, and diagnosed with TB at outpatient centers in northern Portugal between August 2013 and September 2015. Controls were healthy individuals older than 18 years-old with no suspicion of active TB or history of TB in the participant's household within the previous 5 years.Registered data included daily alcohol consumption over the previous year (including types of beverages and the quantity consumed), age, sex, area of residence, nationality, and current occupation/employment status. The clinical data included co-morbidities (diabetes, chronic kidney disease, rheumatologic diseases, solid and hematologic cancers, lung disease, silicosis, heart and liver conditions, and history of TB) and other risk factors for TB infection (drug abuse, imprisonment, homelessness, or residence in a community shelter). This project was approved by Portugal's Northern Region Health Administration Ethics Committee, and all participants provided written informed consent. We performed separate analyses of men and women in the present study given the fact that the impact of ethanol is different in the two genders 7 . The crude effect of each evaluated variable on TB infection was investigated by simple logistic regression, except for variables associated with very low numbers of TB infections. Variables that were statistically significant were then included in a multiple binary logistic regression model. The selection of the best model was based on the likelihood-ratio test whenever possible, and otherwise on the Akaike Information Criterion (AIC). The model discriminability was as the AUROC curve. All statistical analyses were performed with R software (version 2.12.1). The level of significance was set at 0.05.We enrolled 289 subjects in this study, 50.5% of whom were male. The mean age (± SD, range) was 51.6 years-old (± 16.9, range: 19 to 87) for men and 50.9 years-old (± 17.2, range: 19 to 85) for women.
Tobacco smoking has been suspected to be a risk factor for tuberculosis (TB) for more than a century, but only recently has consistent epidemiological evidence between tobacco and TB been established [1, 2]. Smokers are more likely to be infected with TB, progress to active disease and die from TB [3][4][5]. However, there are few worldwide studies regarding a dose-response relationship between the number of smoked cigarettes per day (CPD) and TB risk.The aims of the present study were to evaluate the impact of smoking in TB risk and determine a threshold for tobacco consumption that increases the risk for active TB.This cross-sectional study involved subjects recruited from primary healthcare outpatient units in northern Portugal, between August 2013 and September 2015. Cases corresponded to patients aged ⩾18 years and diagnosed with active pulmonary TB. Controls were individuals aged ⩾18 years with no suspicion or diagnosis of active TB including no history of TB in the participant's household within the previous 5 years. Pregnant and/or lactating women and individuals infected with HIV or other acquired immunosuppressive conditions were excluded from the study.Clinical and socio-demographic data were collected. The clinical data included comorbidities such as diabetes, arterial hypertension, chronic kidney/liver/lung diseases, rheumatological diseases, solid/ haematological malignancies, as well as other risk factors for TB infection, such as drug abuse, imprisonment, homelessness or residence in a community shelter. Other registered data included age, sex, area/type of residence, nationality, current occupation/employment, daily alcohol consumption, and smoking habits. Smoking status of the subjects was assessed according to their self-report, and the number of CPD was registered. This project was approved by Portugal's Northern Region Health Administration Ethics Committee. All participants provided written informed consent, and their anonymity was preserved during data analysis.
Chronic stage-1 hypertensive women with normal pregnancy outcomes exhibited a progressively increasing postpartum UtA impedance. This trend also occurred in normotensive women, albeit at a significantly lower magnitude.
In the Huambo province, age, distance to healthcare facility and the first healthcare service consulted were associated with diagnosis delay of TB.
canine leishmaniasis is a major veterinary issue and also a public health challenge due to its zoonotic potential. In this context, serological evaluation is essential for Canine leishmaniasis management. Several serological alternatives, such as rapid diagnostic tests, enzyme-linked immunosorbent assay (ELISA) and immunofluorescence antibody test (IFAT), are well established. In fact, the capacity of distinct tests and antigens, evaluated by their sensitivity and specificity, to detect disease is normally considered sufficient for diagnosing Canine leishmaniasis. In this context, we evaluated the seropositivity using 8 different serological tests (ELISA with Leishmania recombinant proteins (rK39, LicTXNPx); soluble promastigote Leishmania antigens (SPLA); commercial ELISA test) in 82 clinically suspect animals from Northern Portugal. The obtained serological data originated 50% of inconclusive serological information with a mixture of seropositive and seronegative results for individual animals. Cutoff independent risk groups were then generated from the serological data to evaluate the clustering of the samples. This analysis originated risk groups that correlated with the most seropositive samples, suggesting that this method might be used, in a cutoff independent manner, to improve conventional serological evaluation. Ultimately, given that no test prioritization exists, the use of any single serological test increases the potential for misdiagnosis, along with all associated risks for the dog as well as public health. The use of a cutoff independent analysis has the potential to improve the predictive values of these tests, enabling a more accurate evaluation of the dog's condition.
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