BackgroundDue to Lesotho's high adult HIV prevalence (23%), considerable resources have been allocated to the HIV/AIDS response, while resources for non-communicable diseases have lagged. Since November 2011, the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) has supported Lesotho Ministry of Health to roll out Family Health Days (FHDs), an innovative strategy to increase community access to integrated health services, with a focus on hard-to-reach areas where immunization coverage, HIV service uptake, and screening and treatment for chronic diseases are low.MethodsServices were provided at mobile service delivery points from 17th October to 25th November 2011. Delivery points located in rural setting were staffed by multi-disciplinary teams of doctors, nurses, community workers, nutritionists, AIDS officers, and pharmacists (30-40 health professionals present).ResultsDuring this campaign, 8,396 adults were tested for HIV (67.3% female; 32.6% male). In all, 588 (7%) tested HIV-positive (6.7% female; 7.1% male). Among those testing HIV-positive, 68.5% (403) received CD4 testing and 36.6% were enrolled into HIV care at their nearest clinics. A total of 324 ART defaulters were identified and linked back to care. Follow-up with referral facilities showed 100% of patients (defaulters and newly enrolled) linked to care were enrolled at a facility. Standard immunizations were administered to 990 children. 4,454 adults (24.7% male; 75.3% female) were screened for hypertension, and of those screened, 24.2% had elevated blood pressure and were linked to care centers. Addtitionally, 3,045 adults had blood sugar tests (27.0% males; 73.0% females); 3.1% had elevated blood sugar and were linked to care facilities.ConclusionOffering integrated services within hard-to-reach communities can increase access to a variety of critical health services, including those for non-communicable diseases, and can link ART clients lost to follow-up back to facilities. This approach will be scaled up throughout Lesotho as a strategy to reach all populations in the country.
Aim. To compare the effectiveness of telmisartan and perindopril in the treatment of elderly patients with arterial hypertension (AH) and metabolic syndrome (MS) who have suffered ischemic stroke (IS).Material and methods. 92 elderly patients with AH and MS who underwent IS (mean 68±4 years) were examined. Patients were randomly divided into pharmacotherapy groups: 47 patients took telmisartan (80 mg/day) and 45 — perindopril (10 mg/day). Fasting plasma glucose levels, insulin, leptin, total cholesterol, triglycerides, highand lowdensity lipoprotein cholesterol were determined, the HOMA-IR index was calculated, and daily monitoring was performed. Statistical processing was carried out using STATISTICA 10,0. The indicators are presented in the form of the median, interquartile ranges of Me (Q25%; Q75%), and mean ±SD. The comparison was carried out using the Wilcoxon rank criterion. The differences are significant at p<0,05.Results. After 12 months of observation in the telmisartan group, there was a significant decrease in the average daily systolic blood pressure (ВРs) from 152 (146; 156) to 129 (125; 134) mm Hg (p<0,01) and diastolic blood pressure from 89 (83; 96) to 76 (72; 84) mm Hg (p<0,05); reduction of НOMА-IR from 4,1 (3,3; 5,0) to 3,2 (2,7; 3,6) units (p<0,01), leptin from 14,3 (10,2; 17,7) to 11,7 (10,8; 13,6) ng/ml (p<0,01), triglycerides from 2,25 (1,90; 2,53) up to 2,05 (1,84; 2,05) mmol/l (p<0,05). In the perindopril group, ВРs decreased from 149 (144; 154) to 137 (131; 142) mm Hg (p<0,05), НOMА-IR (p=0,059), leptin from 14,4 (10,3; 18,0) to 13,0 (12,3; 13,8) ng/ml (p<0,05), triglycerides (p=0,056).Conclusion. Elderly patients with hypertension on the background of MS and a history of IS had significantly decreased ВРs and ВРd (according to the results of daily monitoring) after 12 months of telmisartan pharmacotherapy, decreased insulin resistance and the level of leptin and triglycerides in the blood serum.
Given the progressive aging of the population, the problem of extending healthy longevity while maintaining high vitality is very important. The "blue zones" – the regions with the highest life expectancy – are of particular scientific interest. The views of scientists from all over the world are riveted to the lifestyle of the inhabitants of these territories. The available studies demonstrate the important role of nutrition in longevity, but there is not enough information about a single resistance diet based on foods consumed by long-livers of the "blue zones". The aim of the study: The purpose of this review is to determine whether the nutrition of long-livers of the "blue zones" has the characteristics of a resilience diet. Materials and methods: Literature data were studied based on the following search words: aging, longevity, gerontology, nutrition of centenarians, blue zones, viability, age viability, resilience diet for 2006-2021 in computer databases: NCBI, Google Scholar, Science Direct, PubMed, Scopus, ISI Web of Science, Cyberleninka, Elsevier and SciELO. Results: Analysis of the literature data showed that the eating habits of centenarians of the "blue zones" of the USA, Greece and Italy, Japan, Costa Rica, Brazil have similar features. Their diet is dominated by plant foods: cereals, beans, pasta from hard varieties, nuts, fruits, vegetables, fresh herbs, olive oil. People in these countries eat meat, especially red meat, milk and dairy products, eggs very rarely, giving preference to fish and seafood. This diet helps prevent cardiovascular disease, diabetes, colorectal cancer, breast and lung cancer, overweight and obesity, early sarcopenia and dementia, and depression. Due to this, the long-livers of the "blue zones" are characterized by high age viability. Conclusion: Based on the analysis of the nutrition of long-livers in the "blue zones", it is possible to form a resistance diet. The dominant foods in the diet should include unrefined cereals, durum wheat pasta, fresh vegetables and fruits, herbs, algae, fermented foods (tofu, miso, sauerkraut). It is also necessary to consume nuts and legumes, olive oil, fish and seafood daily. White meat, dairy products, eggs should be consumed no more than 1-2 times a week. We should limit or exclude red meat, potatoes, white bread, sweets as much as possible. These dietary interventions may be useful for the formation of a healthy pattern of aging with high age viability.
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