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Introduction: Hypertension is a silent pathology in a way that affects all four spheres to be considered as such; magnitude, transcendence vulnerability, and feasibility. The World Health Organization estimates that 45% of deaths from heart disease and 51% of deaths from stroke globally are caused by hypertension. Material and method: A longitudinal, descriptive and quantitative observational study was carried out on the personnel of high-risk public service providers. Results: The total population sampled was 550 people where it was possible to determine the sex where the disease predominates, since 92% of the hypertensive population belong to the male sex, while 8% of the female population. 57% of the total population were classified as normotensive, while 21% were classified as High Normal, Grade I Hypertension, and Grade II Hypertension. Discussion: AHT is the result of a series of interactions between endogenous and exogenous factors in an organism that tries to adapt to the increase of the cardiac output and the peripheral resistance of the blood vessels, which is manifested by the increase in blood pressure figures. Physical activity has been shown to have a lower risk of hypertension compared to sedentary individuals. The daily stress these workers face predisposes them to suffer their manifestations as headache, muscle pain, fatigue, digestive disorders and constant elevations of blood pressure.

Chronic infection with the hepatitis C virus (HCV) is estimated to affect 58 million people worldwide and around 700,000 individuals in Brazil. Various non-invasive markers of hepatic fibrosis have been proposed, such as transient hepatic elastography (THE) using FibroScan®. However, the reliability of the performance, by operators in the training phase is undetermined, which hinders its applicability in clinical practice. Objectives: The present study aimed to evaluate the impact of training an inexperienced operator to perform the examinations using FibroScan® in patients with chronic hepatitis C. Specifically, the frequency of unreliable results throughout the training was assessed. Methods: This is a cross-sectional study with retrospective data collection including compensated chronic hepatitis C patients who underwent the examinations using FibroScan® between March 2014 and December 2016, performed by two researchers. Included patients were divided into two groups based on the operator's experience in the examination: the Experienced Examiner (EE) group and the Examiner in Training (ET) group, with the latter divided into two phases: phase 1, consisting of the first 100 examinations, and phase 2, comprising subsequent examinations. For the reliability analysis, parameters such as success rate (SR), interquartile range (IQR) to median (Md) ratio (IQR/Md), and reliability criteria of Castéra, et al. and Boursier, et al. were used. Results: Between March 2014 and December 2016, 771 adult HCV-infected individuals were evaluated and divided into EE group (n = 161), ET phase 1 (n = 100), and ET phase 2 (n = 158), showing similar demographic, clinical, and laboratory characteristics. SR and IQR/Md ratios were similar among EE, ET phase 1, and ET phase 2 groups. The proportion of reliable results was comparable in all three groups, using Castéra, et al. reliability criteria (92.5%, 92.0%, and 97.5%, respectively) and Boursier, et al. criteria (96.9%, 95.0%, and 98.1%, respectively). Conclusion: A short training period (up to 100 examinations) seems to be sufficient for them to have good clinical applicability in the hands of an operator with initial experience in the method

Hepatitis C Virus (HCV) infection is usually treated with direct acting antivirals (DAAs) for 12 weeks. In treatment naive patients with genotype (GT) 1 infection without cirrhosis and baseline viral load < 6 million, 8 weeks of Ledipasvir/Sofosbuvir (LDV/SOF) is an option. Eight weeks with Glecaprevir/Pibrentasvir (GLE/PIB) is an option for patients with GT 1 through 6 without cirrhosis. Our objective was to evaluate achievement of Sustained Virologic Response (SVR) after 8 weeks of LDV/SOF or GLE/PIB in our HCV-infected veterans. Patients with HCV infection that received GLE/PIB or LDV/SOF for a planned 8 weeks of therapy in the past four years were reviewed (January 2015-September 2018). Treatment outcomes were evaluated through medical record review. Two hundred sixty-five veterans were initiated on 8 weeks of therapy with either GLE/PIB or LDV/SOF. Of these, 231 (87%) were initiated on 8 weeks of LDV/SOF and 34 (13%) were initiated on 8 weeks of GLE/PIB. The majority of patients had GT 1 (93%) infection. One hundred and ninety-five veterans who completed 8 weeks of LDV/SOF and 30 veterans on GLE/PIB had follow-up viral loads. The overall SVR was 95%. Treatment with GLE/PIB resulted in a higher SVR rate (100%) compared to LDV/SOF (95%). Elderly patients had similar SVR rates. Treatment with 8 weeks of DAA is effective in our veteran population and showed an SVR rate similar to literature reports. The SVR for patients treated with 8 weeks LDV/SOF was slightly lower than the SVR for GLE/PIB; however, the GLE/PIB population was smaller

Introduction: Fluid management is the cornerstone of treatment for acute pancreatitis (AP), but the proper rate and volume is still controversial. We aim to evaluate the role of aggressive hydration in AP patients. Methods: We retrospectively reviewed and analyzed 279 hospitalized patients of AP. Severity was determined by the Revised Atlanta classification; validated clinical scores were also calculated based on clinical information upon presentation. We extracted amount of fluid received by at 6, 12, 24 and 48 hours after presentation. Aggressive hydration was defined as amount higher than 10 ml/kg bolus followed by infusion at 1.5 ml/kg/h. After direct comparison between aggressive versus non-aggressive hydration groups, propensity-score match was performed to control severity, APACHE II and BISAP score. Post-match comparison as well as a subgroup comparison were conducted. Results: At 24 hours, 125 (44.8%) patients received aggressive hydration averaged at 5.1 L (2-18 L), while 154 (55.2%) patients received non-aggressive hydration averaged at 2.5 L. Post-match comparison showed that aggressive hydration group had longer hospital stay (MAP: 5.3 vs 4.5, p = 0.145, MSAP/SAP: 8.3 vs 4.8 d, p = 0.007), and higher rate of intensive care unit admission (mild: 12.9% vs 4.4%, p = 0.042, moderately severe or severe: 36.8% vs 3.1%, p = 0.001), while showed no difference in rate of mortality or re-admission by 1 year. In patients who presented without organ failure, aggressive hydration did not change the rate of development of organ failure (14.1% vs 12.5%, p = 0.731), but the aggressive hydration group had a trend towards longer hospital stay (5.5 vs 4.6 d, p = 0.083) and higher rate of MICU admission (12.1% vs 4.8%, p = 0.051)

A rare case of Diabetic Foot in male of middle age has been shown.

Acute kidney injury is a common condition associated with high morbidity and short-term mortality. Its pathophysiology varies according to the numerous conditions associated with its genesis. Biomarkers allow detecting changes at the level of kidney function; therefore, they play an important role in the prevention, early diagnosis, therapeutic response and prognosis of acute kidney injury. The search for biomarkers for acute kidney injury began over 15 years ago; initially, only serum creatinine was available for diagnosis. However, throughout history, great advances have been made in research, which have allowed the finding of new biomarkers in order to improve the health and quality of life of patients. A narrative review of the literature is carried out on the basis of available scientific evidence to clarify the role and importance of biomarkers in the context of acute renal injury.

Stevia is a natural sweetener that has gained attention as a potential sugar substitute for glycemic control and weight management. Extensive research has shown that high sugar consumption is linked to obesity, dental caries, and other health issues. Stevia, derived from the Stevia rebaudiana plant, offers sweetness without calories and has a favorable glycemic profile. Studies have demonstrated its effectiveness in regulating blood glucose levels and reducing overall sugar and caloric intake. Consumer attitudes suggest a positive reception of Stevia as a sugar substitute among health-conscious individuals. However, further research is needed to understand its long-term effects and consumer sentiments. Future investigations should prioritize human clinical trials, targeted studies in diabetic populations, and exploration of Stevia’s interaction with gut microbiota, among other aspects. Stevia shows promise as a health-conscious alternative in glycemic control and weight management.

Sclerotinia sclerotiorum (Lib.) de Bary caused white mold disease with a wide distribution worldwide. For the control of the disease, it is fundamental to understand the identification, morphology, and genetic diversity of the fungus. The objective of this study was to collect and characterize S. sclerotiorum isolates from different regions of the country. The characteristics evaluated for the mycelium characterization were: the time required for the fungus to occupy the plate; density of the formed mycelium; coloration of the colonies and mycelia growth rate. Sclerotia assessments were based on the time for the formation of the first sclerotia total number formed per plate, the format of distribution in the plate, and the shape of the sclerotia formed by the isolates. Variability was observed for colony colour, type of growth, the diameter of mycelia growth, sclerotia initiation, and number and pattern of sclerotia formation among the isolates. The evaluated populations presented wide variability for the cultural and morphological characteristics, being predominant in the whitish colonies with fast-growing habitats. The majority of isolates produced a higher number of sclerotia near the margin of the plates and with diverse formats. Phylogenetic analysis revealed that the isolates belonged to a similar group of publicly available S. sclerotiorum and were dissimilar from the group of S. minor, and S. trifolium and distinctly differ from S. nivalis group. The present study is the first evidence for morphological and genetic diversity study of S. sclerotiorum in Bangladesh. Therefore, this report contributes to more information about the morphological and genetic diversity of S. sclerotiorum and can be useful in implementing effective management strategies for the pathogen which caused white mold disease.

The widespread availability of non-traditional dietary supplements and pharmacologically active substances via the Internet continues to introduce mechanisms for inadvertent toxidromes not commonly seen. Consumers are virtually unrestricted in their ability to acquire products purporting augmentation of normal physiology for the purposes of enhancement, recreation, and/or potential abuse. The safety profiles at standard or toxic doses remain largely unknown for many agents that can be purchased electronically. We report a case of mixed toxicity related to phenibut and fosaracetam, both of which are readily available for consumer purchase from online retailers. Written and verbal consent was obtained for this case presentation.

Social insects have eradicated the instincts inherited from their solitary ancestors that were harmful to communities. The elimination of these instincts was accomplished by natural selection, the units of which were communities. Man has not yet eradicated the instincts inherited from their solitary animal ancestors that were harmful to communities. But their eradication is underway. And it is also being accomplished by natural selection, the units of which are societies. Completion of evolution in this direction will probably lead to the disappearance of human instincts harmful to society, as they have disappeared in social insects. This will happen after a period of time measured not by historical standards, but by geological.