Extant studies have labelled persons-with-addiction and the homeless as ‘invaders’ of public parks, aggressive/violent with psychiatric and medical disorders, a burden to the society, and transmitters of most deadly airborne or chronic diseases. Literature subtly discuses that such people must be chased out of the public. Yet, such studies have not concurrently analyzed from the viewpoint of urban parks users, the persons-with-addiction and the homeless people what needs to be done to improve the situation. Therefore, the study aims to explore whether problematic communities and subcultural factors make the disadvantaged resort to negative copping strategies when their legal means are blocked: how the other park users respond to the homeless drug addicts’ hardship: and the possible suggestions from all the park users. This is done with reference to social disorganization and Sub-culture theory, and through ethnographic research approach (8 months field observation) and in-depth-interviews with 27 participants. Our study found that persons-with-addiction and the homeless are not always aggressive/violent/harmful as they have been labelled. But only disadvantaged individuals who desire to emulate the ideals and ambitions of the middle class but lack resources to achieve such success. Being overwhelmed with such frustrations from their dilemmas, they consider themselves ‘double-failures’ and retreat into drug addiction and find abode in the public spaces. We therefore conclude that persons with addiction and the homeless people are not always violent and criminal persons who are to be chased out of public parks. But only disadvantaged individuals who need help for choosing a negative coping strategy.
For a long time there was no explanation of a study which had revealed that people with schizoaffective disorders and in particular suicidal attempts rarely get cancer. But now, we can assume that there are diseases that are “mirrored” because they occur with reverse/feedback pathophysiological mechanisms so that they are, in fact, antagonists.
Background: End-Stage Kidney Disease and its maintenance hemodialysis treatment force patients to make several lifestyle changes to cope with this debilitating illness. These changes often trigger the onset of notable psychological distress and depressive symptoms. Furthermore, these negative psychological experiences can undermine the effectiveness of the treatment and consequently worsening the health and quality of life of patients. Objective: The study assessed the psychological well-being among hemodialysis patients in Kumasi Metropolis. Further, it explored the relationship between these psychosocial factors and demographic characteristics.Materials and Methods: 30 hemodialysis patients were recruited from two dialysis units in Kumasi, Ghana. Participants were aged 18 and above and had been on hemodialysis treatment for more than three months. The Hospital Anxiety and Depression scale (HADS) was used to assess depression and anxiety whiles the Multidimensional Scale of Perceived Social Support was used to assess perceived social support of participants. Results: The majority of respondents were males (60%), relative to females. The study revealed that 80% were severely depressed, 20% met the criteria for severe anxiety. Some participants reported moderate social support 53.3%; perceived social support being inversely correlated with both depression (r = 0.41; n = 30; p < 0.05) and anxiety (r = -0.59; n = 30; p < 0.05). Income levels were inversely correlated with depression (r = -0.41, n = 30; p < 0.05). Conclusion: Findings of the study suggest that the psychological wellbeing of hemodialysis patients is compromised. Social support appears to alleviate depression and anxiety. Implications for patient treatment are discussed.
Background: The rapid increase in the popularity of internet use and video games is associated with multiple consequences and comorbidities; therefore, investigating this issue is important, especially now that the number of people playing video games has reached approximately 2.2 billion people worldwide.Method: This paper reviews the existing literature on Google Scholar and PubMed to examine the association between internet gaming disorder (IGD) and attention deficit hyperactivity disorder (ADHD) between 2013 and 2020.Result: The reviewed studies reveal a statistically significant association between ADHD and IGD. The reviewed studies demonstrate that ADHD is a predictive factor for the development and persistence of IGD and affects the severity of IGD symptoms.Conclusion: Especially among those with ADHD, IGD causes life distress and social life impairment. This review indicates a statistically significant association between ADHD and IGD; however, longitudinal studies are needed to assist the direction of this association and make relevant and appropriate recommendations to prevent its consequences and comorbidities.
Background: Asthma, a chronic inflammatory respiratory ailment, is characterized by variable airflow obstruction and heightened bronchial reactivity. Despite therapeutic advancements, a comprehensive comprehension of its underlying metabolic mechanisms remains elusive. Metabolomics has emerged as a powerful approach to investigating the complex connections between serum metabolites and disease pathogenesis. However, exploring the causal relationship between serum metabolites and asthma susceptibility demands meticulous examination to unveil potential therapeutic targets.Methods: Mendelian randomization (MR) approach was explored to investigate the potential causal associations between serum metabolites and asthma risk. The main analysis employed the inverse variance weighted method, supported by supplementary approaches such as MR-Egger, weighted median, weighted mode, and sample mode. To enhance the strength and credibility of our results, we conducted sensitivity analyses encompassing heterogeneity testing, assessment of horizontal pleiotropy, and leave-one-out analysis. Additionally, pathway enrichment analysis was performed to further elucidate the results.Results: We identified 18 known and 12 unknown metabolites with potential associations with asthma risk. Among known metabolites, seven exhibited protective effects (e.g., 4-acetamidobutanoate, allantoin, kynurenine, oxidized bilirubin*), while eleven were considered risk factors (e.g., ornithine, N-acetylornithine, alanine). Through the integration of four additional MR models and sensitivity analyses, we revealed a connection between 4-acetamidobutanoate and approximately 6% lower asthma risk (OR = 0.94, 95% CI: 0.90–0.98).Conclusions: Our MR analysis uncovered protective and risk-associated metabolites, alongside 12 unknown metabolites linked to asthma. Notably, 4-acetamidobutanoate demonstrated a nominal 6% reduction in asthma risk, highlighting its potential significance.
Background: Children with congenital heart diseases (CHD) often require palliative or definitive surgical heart interventions to restore cardiopulmonary function. Lack of early cardiac intervention contributes to large numbers of potentially preventable deaths and sufferings among children with such conditions.
Objectives: The aim of this study was to highlight our experience and the importance of international and regional collaboration for open heart surgery in children with CHD and capacity building of local cardiac teams in Bayelsa and Enugu States.
Methodology: In November 2016, a memorandum of understanding (MOU) was signed by the managements of FMC, Yenagoa, Bayelsa State, UNTH, Enugu and an Italian-based NGO- Pobic Open Heart International for collaboration in the area of free open heart surgery for children with CHDs and training of local cardiac teams from both institutions either in Nigeria or in Italy. Patients for the program were recruited from Bayelsa and Enugu States with referrals from all over the country with combined screening and selection done in UNTH. Selected patients were operated on and funded free of charge by the Italian NGO. Hands on training of the local cardiac teams and cardiac intervention was done twice yearly in Nigeria.
Result: From inception of the program in November, 2016 to May, 2019 a total of 47 children (21 Males, 26 Females; age range 6 months to 14 years) with various types of congenital heart defects had free open heart surgery from the program with 41 surgeries done in UNTH & 6 in Italy (complex pathologies). Also, home cardiac teams from UNTH and FMC, Yenagoa gained from on-site capacity training & retraining from the Italian cardiac team both in Nigeria and in Italy. The Success rate was 95.7% (44) and Case Fatality rate was 4.3% (2).
Conclusion: There is a great efficacy in early cardiac intervention. This is with respect to a high success rate and minimal Case Fatality seen in this study. This was achieved through Regional and international collaboration.
As I considered the exciting life of Little Snow-White, I started to think that the Grimm Brothers placed in that novel many hints that grouped the current knowledge of some features related to symptoms shown by allergic people.
Objectives: We describe the clinical course and management of two patients with post-capillary pulmonary hypertension due to diffuse pulmonary venous baffle calcification decades post-Mustard procedure.Background: From the late 1950s to the early 1990s, the definitive surgical repair for children with D-transposition of the great vessels (D-TGA) was an atrial switch procedure (either Senning or Mustard operation) which utilizes atrial-level baffles to shunt pulmonary venous blood to the morphologic right (systemic) ventricle and caval blood to the morphologic left (sub-pulmonary) ventricle. From a hemodynamic standpoint, baffle leaks and stenoses as well as precapillary pulmonary hypertension have all been described as both early and late complications [1]. Recently, delayed post-capillary pulmonary hypertension (in the absence of discrete baffle obstruction) decades post-atrial switch has also been described [2]. The underlying pathophysiology for this postcapillary pulmonary hypertension is unclear but is theorized to involve impaired diastology referable to the pulmonary venous baffle. Methods/Results: Using hemodynamic and imaging data, we describe two patients with extensive pulmonary venous baffle calcification and resultant pulmonary hypertension from the so-called “stiff left atrial (LA) syndrome.” This problem can be difficult to treat medically and is not amenable to catheter-based interventions. We hypothesize that this is an underlying mechanism for pulmonary hypertension in at least some post-Mustard and Senning patients. Conclusion: We describe the treatments and clinical course for each of these patients, and in particular describe how the surgical revision of the pulmonary venous baffle in one case led to the complete resolution of symptoms.
Pseudofungus structures in lymph node tissues have been reported on multiple occasions. Despite a variety of investigative tests including histochemical special stains and energy dispersive spectral analysis, the underlying nature and origin of these pseudofungus structures has never been clearly defined. The most common hypothesis suggests that they represent collagen fibers that become coated with iron and calcium. Herein, evidence is given that the pseudofungus structures identified in the lymph node tissues represent fragments of polyurethane catheters. The evidence includes both a comparison of these pseudofungus structures to fragments of polyurethane well documented in the literature and a comparison of polyurethane catheter scrapings to the pseudofungus structures identified in the literature. In both of these comparisons, the morphology of the polyurethane fragments are identical to the pseudofungus structures. This is the first definitive report identifying polyurethane catheter fragments as representing the true nature and etiology of pseudofungus structures in lymph node tissues.
Background: Chronic rhinosinusitis (CRS) is a heterogeneous and multifactorial inflammatory disease of the nasal and paranasal mucosa. To date, no internationally standardized uniform classification has been developed for this disease.
Usually, a phenotype classification according to CRS with (CRSwNP) and without (CRSsNP) polyposis is performed. However, through a variety of studies, it has been shown that even within these phenotypes, different endotypes of CRS exist, each with a different underlying inflammatory pathophysiology. In this mini-review, we aim to outline the essential immunological processes in CRSwNP and to highlight the modern therapeutic options with biologics derived from this disease.
Methods: Current knowledge on the immunological and molecular processes of CRS, especially CRSwNP, was compiled by means of a structured literature review. Medline, PubMed, national/international trial and guideline registries as well as the Cochrane Library were all searched.
Results: Based on the current literature, the different immunological processes involved in CRS and nasal polyps were elaborated. Current studies on the therapy of eosinophilic diseases such as asthma and polyposis are presented and their results discussed.
Conclusion: Understanding the immunological basis of CRSwNP may help to develop new personalized therapeutic approaches using biologics. Currently, 2 biologics (dupilumab, omalizumab) have been approved for the therapy of CRSwNP (polyposis nasi) in Europe.
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