3-Dimensional Versus 2-Dimensional Comparison of Knee Valgus Collapse during Vertical Jump: Clinical Implications for ACL Risk of Injury Assessment
Published on: 21st March, 2017
OCLC Number/Unique Identifier: 7286358320
Time-efficient screening of lower extremity biomechanics to identify potential injurious movement patterns is crucial within athletic medicine settings. When considering biomechanical risk factors for anterior cruciate ligament injuries, several screening tests have been used to assess dynamic knee valgus. Current methods involving 3-dimensional motion capture systems are considered gold standard for such assessment; however, these methods are time consuming and require expensive materials. This study investigated the use of 2-dimentional kinematic evaluation during a standardized vertical jump athletic assessment to screen for potential lower extremity risk of injury. 50 collegiate athletes, 25 male and 25 female, from various sports participated in the study. The vertical jump was chosen because it is a common performance evaluation test that is regularly performed several times a year, providing consistent opportunities for screening while not creating additional obligations for the student athletes. Results showed that the 2-dimentional evaluation method had strong correlations (P<0.0001) with the gold standard 3-dimensional evaluation, suggesting that an accelerated 2-dimentional screening process can be used as a first step to screen for potential injurious lower extremity movement patterns.
Mechanism-related Teratogenic, Hormone Modulant and other Toxicological effects of Veterinary and agricultural surfactants
Published on: 18th September, 2017
OCLC Number/Unique Identifier: 7325078577
Veterinary and agricultural surfactants are supposed to be inert additives, yet these substances commonly exert biological side-effects, in given cases synergistic with those of the active ingredients of these preparations. This is explicitly seen in altered toxicity of veterinary or pesticide formulations compared to their active ingredients alone. Neither the individual effects of these excipients, nor such combination effects are well-studied in toxicology, and therefore, possible toxicity consequences are occasionally not being considered at sufficient significance in the authorization, use and control of these substances. Risk assessment of these substances should cover all hazards they may represent, and corresponding levels of exposure. Surfactants used in veterinary and pesticide formulation enter the environment either by direct dispersion or by indirect release through excrement, leaching, sewage waters or sludge, and in turn, create potential exposure to a number of non-target organisms. Biochemical and (eco)toxicological hazards recently identified regarding certain agricultural surfactants include cytotoxicity (on cell lines of epithelial, neural and other tissues, as well as stem cells and tumor cells), endocrine disrupting effects, as well as aquatic ecotoxicity. This Mini Review summarizes toxicological effects identified in our studies in aquatic toxicity tests, in cell viability and cytotoxicity tests, in estrogenic activity assays, correlated with biochemical analysis of the surfactants and their decomposition. The conclusions are hoped to facilitate environmentally precautious revision of surfactants widely used in agriculture.
Atherogenic risk assessment of naive HIV-infected patients attending Infectious Diseases Service of Kinshasa University Teaching Hospital, Democratic Republic of the Congo (DRC)
Published on: 13th October, 2020
OCLC Number/Unique Identifier: 8689021635
Background and aim: Metabolic abnormalities are common in HIV/AIDS. Increasingly, lipid ratios are used as screening tools for dyslipidaemia in these medical conditions. The aim of this study was to assess the ability of 4 lipid ratios to predict cardiovascular risks.
Methods: This is a cross-sectional and analytical study included 105 HIV+ patients followed in Kinshasa University Teaching Hospital (KUTH). Four indices [Atherogenic Index of Plasma (AIP), Castelli Risk Index (CRI) I and II, Atherogenic coefficient (AC)] were compared. Statistical analyzis consisted of measuring frequencies and means, Student’s t-tests, ANOVA and Ficher’s exact test, and the calculation of the Kappa value.
Results: Lipid ratios predicted respectively the risk in 62% (AIP), 28.6% (CRI-I) and 23.8% (CRI-II). CRI-I and II were elevated, especially in women. The AIP appeared to be a better predictor than CRI-I and II to assess dyslipidaemia in general and the high-risk frequency. The cholesterol detected risk in 66.7% (Low HDL-C), 50% (High LDL-C), 38.9% (High TC and/or TG).
The atherogenic risk was higher with age, advanced WHO stage, HIV-TB, HBV-HCV co-infections, smoking and alcohol intake. Haemoglobin (Hb) and CD4 counts were low when the risk was high. Age ≥ 50 years, stage 4 (WHO), CD4s+ ≤ 200 cells/µL were independent factors associated with atherogenic risk.
Conclusion: Lipid ratios can be used as reliable tools for assessing cardiovascular risk of naïve HIV-infected patients who received HAART.
Damu-Safen pesticide exposure risk assessment, EC (fomesafen, 250 g/l)
Published on: 11th January, 2019
OCLC Number/Unique Identifier: 7991657387
Annually the list of pesticides is replenished by new ones. One of the main criteria for their registration is toxicological and hygienic assessment and its impact on the environment.
In order to register the new soy herbicide Damu - Safen, EC (fomesafen, 250 g/l) it was necessary to assess its toxicological and hygienic impact on the environment and humans. Therefore, for the first time we conducted studies of the environmental objects under the influence of Damu-Safen, EC (fomesafen, 250 g/l) and the risk assessment of the active substance fomesafen and pesticide Damu - Safen, EC on the workers. According to the results of the assessment of working conditions for the workers of the tanker and the tractor operator, an acceptable risk was obtained that meets regulatory and hygienic requirements. Residual amounts of fomesafen not exceeding the normative levels were found during conducted studies on environmental objects.
Consequently, the results of the risk assessment in the application of pesticide Damu-Safen, EC (fomesafen, 250 g/l) and its impact on the working people and environmental objects indicate the possibility of its application in compliance with optimal environmental conditions and compliance with regulations for appliances and personal protective equipment.
Risk evaluation and modeling of soils contaminated with Polycyclic Aromatic Hydrocarbons (PAHs) in parts of Bonny Island, Niger Delta, Nigeria
Published on: 27th May, 2020
OCLC Number/Unique Identifier: 8609740211
Environmental impact of a recent oil spill incident in Bonny terminal using soil media was studied using a risk-based modeling approach. The establishment of the presence of contaminants of concern (CoC), evaluation/assessment, modeling spilled volume and ascertaining potential health risk associated with the spill incident was carried out. The Contaminant of Concern (CoC) included Total Petroleum Hydrocarbons (TPH) and Polycyclic Aromatic Hydrocarbons (PAHs). Soils and groundwater were sampled in the vicinity of the spill incident and further away into the surrounding communities. Soils were sampled into the depths (0.1 m, 0.5 m,1.0 m, 1.5 m), and the results of sieve analysis revealed that the area is predominantly silty sand in composition. This study also revealed that TPH concentration at all locations and depths exceeded DPR target value of 50 mg/kg. The TPH model revealed that a total volume of 222,500m3 of the spill area exceeded DPR intervention value of 5000 mg/kg. The results of PAH showed that only BS-1, BS-6, BS-8, BS-9 and BS-10 exceeded DPR target value of 1.0 mg/kg at some depths. All other sample depths and locations were within the target limit. The 3-D grid generated for PAH showed that 563,000m3 of the study area exceeded the DPR target value. The 3-D block models generated for TPH and PAH, along with the cross-sections and extracted time slices all showed that the concentration of the Contaminant of Concern (CoC) generally decreased with depth, and the centre of the spill located at the south-eastern part of the survey area. Based on these models, three spill zones were identified; Zone 1-highly contaminated areas (BS-8, BS-9, BS-10); Zone 2 - moderately contaminated areas (BS-1, BS-2, BS-6, BS-7); and low contaminated areas (BS-3, BS-4, BS-5). The entire soil in the area were contaminated with TPH and 47% of the area contaminated with PAH. This study has shown the effectiveness of the use of a model-based approach in quantifying hydrocarbon contamination volumes in the area. There is therefore the need for continuous monitoring of hydrocarbon spills in the area.
Cost-analysis comparison of clinical risk assessment with and without ROMA for the management of women with pelvic masses
Published on: 17th August, 2022
Objective: Pelvic masses can be classified as low risk (likely benign) and high risk (likely malignant) based on an initial clinical risk assessment, which involves a detailed history, physical exam, basic laboratory tests, and imaging. In recent years, the Risk of Ovarian Malignancy Algorithm (ROMA), which combines CA125, HE4 and menopausal status, has emerged as a powerful tool in the classification of pelvic masses and triage of patients to either a generalist gynecologist or a gynecologic oncologist for management. The objective of this study was to evaluate whether the use of ROMA, alone or in combination with Initial Clinical Risk Assessment (ICRA), provides cost savings compared to triage based on ICRA alone.Methods: A health-economic decision model was developed to assess clinical and cost differences associated with three different clinical pathways of risk assessment for a pelvic mass: ICRA alone, ROMA alone, or ICRA + ROMA in combination. Using previously reported accuracy rates and patient characteristics from a prospective, multicenter, blinded clinical trial, total healthcare costs were modeled for each clinical pathway using the Medicare 2020 reimbursement rates.Results: A total of 461 patients with pelvic masses were included with 10.4% ultimately diagnosed with epithelial ovarian cancer. Total healthcare costs for patients with benign disease, EOC, or low malignant potential tumors (LMP) (n = 441) triaged using ROMA alone were 3.3% lower than when triaged using ICRA alone. While lab costs increased 55% using ROMA, the use of ROMA alone resulted in a 4% decrease in laparoscopy costs and a 3.1% decrease in laparotomy costs compared with ICRA alone. Similarly, total costs associated with a combination of ICRA + ROMA were 3.9% lower than total costs associated with ICRA alone. The model also predicted a 63% reduction in repeat surgeries resulting from false negative ICRA when using ROMA to triage patients.Conclusion: Triage of women with pelvic masses using the more sensitive ROMA score lowers overall healthcare costs compared to ICRA alone. With fewer false negative results than ICRA alone, the ROMA score improves initial detection of malignancy and reduces second surgical treatments in women with pelvic masses.
Evaluation of Preoperative Cardiology Consultations: Incidence, Characteristics and Implications for Perioperative Management
Published on: 14th August, 2023
Background: This retrospective study examines the importance of preoperative cardiology consultations in optimizing patient care and anesthesia surgical perioperative management.Methods: The study includes 7,756 patients from the Department of Anesthesiology at Mohammed V Military Teaching Hospital. Out of these, 122 patients were referred to cardiology consultations. Demographics, surgical specialties, reasons for referral, diagnostic tests, and interventions were analyzed.Results: Referred patients (average age 61.45 years) were mainly over 65 years old, with 59.01% being male. Common surgical specialties seeking consultations were abdominal surgery (30.327%), orthopedic surgery (26.230%), and urological surgery (19.672%). Hypertension, dyslipidemia, and diabetes were prevalent risk factors. Most patients were classified as ASA II (50%) or ASA III (27.04%), with NYHA I (61.5%) or NYHA II (31.2%) classifications. Referrals were due to ECG abnormalities (41.0%), routine evaluation (19.7%), and history of myocardial infarction or previous coronary angiography (39.3%).Discussion: Preoperative cardiology consultations accounted for 1.57% of all pre-anesthesia clinic patients. They were vital in assessing and managing cardiovascular risks, consistent with previous studies. The impact of these consultations was evident in optimizing patient management through treatment plan adjustments and interventions.Conclusion: Preoperative cardiology consultations play a crucial role in identifying and managing cardiovascular risks, contributing significantly to patient care and improving perioperative management. Further research should evaluate long-term outcomes and cost-effectiveness across different patient populations.
Environmental Modeling for Radiation Safety
Published on: 28th August, 2023
The newly launched IAEA project MEREIA (MEthods for Radiological and Environmental Impact Assessment; 2021- 2025), MEREIA continues some activities of previous IAEA exercises in the field of radioecological modelling and focuses on areas where the probabilistic approach determines the predictive capability of environmental models. The program offered the opportunity to set up well-designed and verified scenarios to collect and compare exposures predicted by particular models based on this scenario and then perform a validation study of contributing models. It consists of the comparison of model prediction with observed data or in the case where there is a lack of measurement data to perform a comparison within model prognoses. The previous international works have brought significant improvement in environmental modeling in terms of better understanding and mathematical description of complex physical and chemical phenomena that occur in various environmental media and also have promoted new areas for experimental investigations. The new experimental results yielded updated handbooks of a large number of environmental parameters for less-known elements. Moreover, the principal objective of the activities in environmental modelling was an integrated risk assessment of the reference group of population and biota associated with radionuclides releases from various kinds of nuclear facilities as from different types and power nuclear reactors, radioactive waste disposal and more complex nuclear research facility. This reflects recent international recommendations to extend protection against radiation hazards of humans to wildlife flora and fauna. However, the statistics supported knowledge on some essential environmental parameters still remain small. Therefore, one could be aware of some limitations of the probabilistic approach that required advanced methods of probabilistic prognosis Monte Carlo.
Aspirin for Primary Prevention of Cardiovascular Disease: What We Now Know
Published on: 9th January, 2024
Cardiovascular disease (CVD), including coronary artery disease and stroke, is the leading cause of death worldwide. Advances in primary and secondary prevention of CVD have improved patient prognoses and outcomes, however, it is imperative that the clinician and patient engage in early risk factor screening and preventive management of modifiable risk factors for CVD. In addition to blood lipid and blood pressure lowering medications, aspirin has been a long-standing therapy targeted to the prevention of CVD based on its antiplatelet and anti-inflammatory activity. However, recent articles and reports on updates to clinical guidelines for the primary prevention of CVD have resulted in confusion about aspirin recommendations. This review aims to assess the latest guidance on aspirin in CVD prevention and how to identify appropriately at-risk patients who may benefit from low-dose aspirin therapy as part of their CVD preventive healthcare choices. Additionally, this review will provide practical application guidance about clinician-patient conversations to clearly explain the benefits and risks of aspirin use and ensure a patient-centric decision to initiate aspirin therapy.
Myeloid Neoplasms: Better Understanding of their Molecular Pathogenesis with Improvised Genomic Testing: A Ray of Hope for Better Clinical Outcomes
Published on: 31st January, 2024
With the increase in incidence and prevalence of myeloid neoplasms in India, it has become a necessity to understand its molecular mechanisms, acquisition of genomic alterations, and understand its primary and secondary resistance pathways which ultimately impact the decision of therapeutics. The objective of this review is to investigate the molecular aspects of this disease type and identify the biomarkers that help with diagnosis, risk assessment, prognosis, and selecting the best line of treatment for a specific myeloid neoplasm. Advancements and innovations in molecular technologies from simplest Real-Time PCR to high throughput next-generation sequencing have played a vital role in screening the most common mutations and fusions to the novel and rare. Molecular technologies have helped to enumerate the genomic landscape of myeloid malignancies. The understanding of both- the mechanisms and the technology is a strong combination as it has helped revolutionize precision oncology and helped in giving better therapeutic choices with better clinical outcomes. The importance of cellular morphology, clinical symptoms, and molecular pathology in assessing the risk of myeloid malignancies is emphasized and summarized in the review. The review concludes that understanding molecular pathogenesis can be improved by using clinical-pathological-molecular strategies for diagnosis and therapy decision-making.
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