Background The positive influence of most types of exercise has been reported repeatedly,but what the most effective exercise approaches are for improving health-related quality of life(HRQoL)in people with cancer rem...Background The positive influence of most types of exercise has been reported repeatedly,but what the most effective exercise approaches are for improving health-related quality of life(HRQoL)in people with cancer remains unknown.The aim of this systematic review and network meta-analysis was to synthesize the evidence from intervention studies to assess the effects of different types of exercise on HRQoL during and after cancer treatment.Methods MEDLINE,SPORTDiscus,the Cochrane Library,Web of Science,and Scopus were searched for randomized controlled trials aimed at testing the effects of exercise interventions meant to improve HRQoL in people with cancer.Separate analyses were conducted for HRQoL as measured by general and cancer-specific questionnaires.We also evaluated whether the effects of exercise were different during and after cancer treatment in both the physical and mental HRQoL domains.Results In total,93 studies involving 7435 people with cancer were included.Network effect size estimates comparing exercise intervention vs.usual care were significant for combined exercise(0.35,95%confidence interval(95%CI):0.14–0.56)for HRQoL as measured by general questionnaires,and for combined(0.31,95%CI:0.13–0.48),mind–body exercise(0.54,95%CI:0.18–0.89),and walking(0.39,95%CI:0.04–0.74)for HRQoL as measured by cancer-specific questionnaires.Conclusion Exercise programs combining aerobic and resistance training can be recommended to improve HRQoL during and after cancer treatment.The scarcity and heterogeneity of these studies prevents us from making recommendations about other exercise modalities due to insufficient evidence.展开更多
Under-five mortality remains a major concern in the world and in Senegal. It is mainly due to preventable and treatable diseases with priority life-saving medicines for under-five children. This study evaluated the av...Under-five mortality remains a major concern in the world and in Senegal. It is mainly due to preventable and treatable diseases with priority life-saving medicines for under-five children. This study evaluated the availability, management and use of these drugs in two health districts in Senegal. A descriptive cross-sectional study was conducted in the health districts of Guediawaye and Pete from 01 November 2018 to 31 January 2019. The health district of Guediawaye is in the region hosting the Senegalese capital while that of Pete is located in the region of Saint Louis, northern Senegal. Nine drugs that can prevent and treat malaria, diarrhea, pneumonia and malnutrition were selected. An inventory form and a self-administered questionnaire were used to collect data that was analyzed with SPSS and expressed as a percentage and average. Drug availability was 50.4% and 54.3% in Guediawaye and in Pete, respectively. Average stock-out duration in the past three months was estimated at 22.6 and 26 days, respectively. The drug management was marked, on the one hand, by a good availability of stock cards in the two districts with proportions equal to 100% and 94.1%, respectively, and on the other hand, by the presence of expired stocks in Pete (12.2%). About 79% and 88% of prescribers reported prescribing the basket drug, respectively. These results show that access to priority life-saving medicines for children remains a challenge. Measures to be taken should include improving the distribution channels and training of health professionals. Further studies should be conducted in other health districts to better understand the barriers to access to child health services.展开更多
Unipolar depressive disorder(UDD)affects more than 264 million people worldwide and was projected well before the severe acute respiratory syndrome coronavirus 2 pandemic to be the leading cause of disability-adjusted...Unipolar depressive disorder(UDD)affects more than 264 million people worldwide and was projected well before the severe acute respiratory syndrome coronavirus 2 pandemic to be the leading cause of disability-adjusted life years lost in 2030.It is imperative for leading economies to implement preventive strategies targeted towards UDD,given consistent policies are currently lacking.Recently established similarities between the aetiological hypotheses of depression and cardiometabolic diseases are shifting paradigms within this field.It is believed that dietary practices could potentially reduce the incidence of depression;similar to their effects on metabolism.Thus,the aim of this review was to compile current evidence on healthy dietary patterns as suitable contributors towards primary prevention strategies against UDD.Most of the well-known biological mechanisms behind depression have been positively associated with healthful diets and dietary patterns to varying degrees.Interestingly,a common factor of UDD is the production and overall effects of inflammatory cytokines,such as interleukin-6,tumor necrosis factor-α,and Creactive protein.These compounds have been associated with depressive symptoms,disturbances in neuroendocrine function,leaky gut,monoamine activity and brain function,while also being key factors in the development of cardiometabolic diseases.The Mediterranean diet(MD)in particular,is well supported by first-level evidence regarding its preventive qualities against metabolic and cardiovascular diseases and thus considered a model for healthy eating by various organizations.In one of the few clinical trials investigating these associations,the PREDIMED trial,individuals with diabetes assigned to a MD supplemented with mixed tree nuts experienced a 41%relative risk reduction for developing depression.Lastly,there is a need to include health related quality of life as an indicator of physical and mental well-being,considering its putative associations with depression and suicide risk.Going forward,focusing on clinical trials,using precise nutritional assessments,and identifying nutritional biomarkers which may be related to depression are needed to fully support the implementation of dietary recommendations in the field of psychiatry.展开更多
Background: Cardiovascular diseases (CVD) are major causes of death in Japan, and controlling the risk factors for CVD is an important public health task. Lifestyle factors, for example, diet and stress, have impacts ...Background: Cardiovascular diseases (CVD) are major causes of death in Japan, and controlling the risk factors for CVD is an important public health task. Lifestyle factors, for example, diet and stress, have impacts on risk factors such as hypertension and hyperlipidemia. Deterioration of mental health is related to CVD pathogenesis. Aim: We investigated the relationships between levels of mental health, 4-year changes in lifestyle, and CVD risk factors among Japanese workers, using the SF-36 (Japanese version), which is a comprehensive scale measuring health-related quality of life. We hypothesized that workers’ mental health levels would influence 4-year changes in their lifestyles and CVD risk factors. Methods: Data from the High-Risk and Population Strategy for Occupational Health Promotion (HIPOP-OHP) study, which were collected by examination and administration of the SF-36, were used. The relationships between mental health levels at baseline, lifestyle chan- ges, and cardiovascular risk factors were longitudinally analyzed. Subjects with total SF-36 scores ≥65 were classified as the “Good Mental Health Group,” and those with total scores <65 were classified as the “Poor Mental Health Group.” Results: Multiple logistic regression analyses showed that, as compared to people who had poor mental health, those who had good mental health at baseline had a significantly higher probability of good maintenance of improvements in body mass index, (OR = 1.20, 95% CI: 1.03 - 1.39), blood pressure (OR = 1.20, 95% CI: 1.01 - 1.43), total cholesterol (OR = 1.07, 95% CI: 0.86 - 1.33) and HDL cholesterol (OR = 1.26, 95% CI: 1.07 - 1.47). Conclusion: Japanese workers with good mental health tend to improve or maintain good lifestyle conditions and minimize CVD risk factors, while those with poor mental health generally have difficulty improving their lifestyles and lowering their CVD risk.展开更多
Hypertension is a major determinant of health and is likely to have an effect on medical economics.The economic burden due to hypertension may be attributable not only to antihypertensive medication but also to the ve...Hypertension is a major determinant of health and is likely to have an effect on medical economics.The economic burden due to hypertension may be attributable not only to antihypertensive medication but also to the very expensive procedures required for cases of cardiovascular disease that occur more frequently in hypertensive compared with normotensive individuals.The objective of this article was to review articles published on prospective cohort studies that measured medical expenditure attributable to hypertension in community-dwelling populations in Japan.Many medical services in these populations are provided under the medical insurance system that requires the enrolment of all Japanese residents.Personal medical expenditure attributable to hypertension increases with worsening severity of the condition.Medical expenditure was increased further in cases of hypertensive patients who have another concomitant cardiovascular risk factor.In particular,hypertension,especially moderate-to-severe untreated hypertension,increases the risk of long-term hospitalization resulting in considerably higher medical expenditure,compared with non-hospitalized cases.Therefore,assuming that the use of antihypertensive medication is essential for hypertensive patients to prevent serious vascular diseases,a cost-effective highrisk strategy needs to be considered to reduce both ill-health and the economic burden due to hypertension.However,from a population perspective,medical expenditure attributable to hypertension comes mainly from pre-to-mild hypertension.Therefore,there is also a need to consider a population strategy that aims to shift the entire population to lower levels of blood pressure.展开更多
Introduction: The diagnosis of cardiothyreosis is based on the presence of the association of thyrotoxicosis and various cardiovascular disorders such as heart failure, coronary artery disease, rhythm or conduction di...Introduction: The diagnosis of cardiothyreosis is based on the presence of the association of thyrotoxicosis and various cardiovascular disorders such as heart failure, coronary artery disease, rhythm or conduction disorders. Data are limited on this entity in Africa which a frequency of 10% to 33% among hyperthyroidism. We aimed to evaluate these risk factors and describe its diagnostic features in Abass Ndao Hospital Center of Dakar. Patients and Methods: It was a descriptive and analytical cross sectional study conducted from 1 January 2010 to 31 December 2014, including all cases of hyperthyroidism with cardiothyreosis. Epidemiological data, cardiovascular risk factors and characteristics of cardiothyreosis were evaluated. Results: 150 cases of cardiothyreosis were collected with a prevalence of 9.8% among 1517 hyperthyroidism. Mean age was 42.6 ± 9 years and sex ratio 0.33. It was a Graves’ disease in 82.2% of cases. Time limit of cardiothyreosis appearance was 27 ± 41 months and cardiothyreosis was inaugural in 46.6%. Electrocardiogram showed an arrhythmia (38.7%), coronary insufficiency (8%). On echocardiography assessment, impairment of left ventricular ejection fraction (LVEF) was found in 18.5%. Of these, it was 34.7% of arrhythmia, 8.6% of coronary insufficiency and 65.2% of heart failure. Among patients with pulmonary artery hypertension (PAH) (57.3%), there were a rhythm disorder (38%), coronary insufficiency (5.6%) and heart failure (78.8%). Female gender was the only one at risk of arrhythmia (p = 0.01) and impaired of left ventricular ejection fraction (p = 0.007). Existence of a free T4 > 50 pmol/L (p = 0.05) were only at risk of developing pulmonary artery hypertension. Conclusion: Cardiothyreosis is a significant complication. These discovery methods call for more early diagnosis and appropriate treatment. Female gender and severity of thyrotoxicosis seem to precipitate the clinical picture. Echocardiography remains an indispensable tool for assessing cardiac consequences.展开更多
The prevalence of enterotoxigenic Staphylococcus aureus was investigated among 200 participants working in three different food processing plants in Egypt. Using skin swabs, 75 (38%) of the 200 tested persons were pos...The prevalence of enterotoxigenic Staphylococcus aureus was investigated among 200 participants working in three different food processing plants in Egypt. Using skin swabs, 75 (38%) of the 200 tested persons were positive for the presence of S. aureus. Of the S. aureus positive persons, 28 (14%) harboured S. aureus produced staphylococcal enterotoxins. The serotypes of these enterotoxins were enterotoxin A (68%), enterotoxin B (36%), enterotoxin C (46%) and enterotoxin D (18%). Some of these isolates produced more than one type of enterotoxins namely AB, AC, BC, BD, ABC and ACD. Analysis of risk factors implicated in skin carriage of S. aureus as age, gender, marital status, education, duration in employment, frequency and method of hand wash and incidence of chronic skin infection revealed insignificant association with staphylococcal skin carriage. The obtained results put forth the risk of food contracting contamination with enterotoxigenic strains of S. aureus owing to skin colonization of S. aureus among food handlers.展开更多
Introduction: Despite being under-reported, domestic violence remains a significant challenge in Senegal. The aim of this study is to provide a descriptive analysis of the epidemiological and clinical factors characte...Introduction: Despite being under-reported, domestic violence remains a significant challenge in Senegal. The aim of this study is to provide a descriptive analysis of the epidemiological and clinical factors characterizing domestic violence in Senegal. Methodology: A descriptive and retrospectively observational study was conducted. The data was collected from the court records of female victims of physical and/or sexual violence registered from 2006 to 2015. Female victims of physical and/or sexual violence at the hands of their husbands who had a court record at one of Senegal’s high courts during this period were also included. All records that met the inclusion criteria were selected for the study, and the data was analyzed using Epi Info 3.3.2. Results: According to the court records of 148 female victims of domestic violence, the average age of the victims was 30.6 ± 10.1 years. More than 3/4 (76.4%) of the victims were housekeepers, 82.4% of whom were uneducated. The average age of the perpetrators was 40.4 ± 11.4 years, and they were self-employed in the informal sector in 47.3% of the cases. Additionally, more than 3/4 (78.4%) of the perpetrators were uneducated. Eleven women (8% of the victims), were abused while pregnant. Physical violence was predominant (95.3%), while those associated with sexual assault accounted for 4.7% of cases. Of the 7 recorded cases of sexual violence, 3 were cases of unwanted sexual touching, and all cases of physical violence were cases of assault and battery. The violence took place at the home of the perpetrators in 81.8% of cases. In 84.7% of the cases, victims received treatment and care within 24 hours or less. Among the victims, 73% showed clinical lesions. Contusions, hematomas and penetrating wounds were most frequent, representing 23.1%;19.4% and 13.9% of cases respectively. Conclusion: Despite the low number of cases registered in the judicial system in the past ten years, much more violence is occurring without being denounced by the victims. Therefore, it seems appropriate to increase awareness within the community and break sociocultural barriers that hinder the recognition of women’s rights in the couple.展开更多
Objective: Few studies have related nutritional factors with quality of life in healthy populations. Our aim was to analyze the relationship between commercial bakery, fast food or soft drinks consumption and mental a...Objective: Few studies have related nutritional factors with quality of life in healthy populations. Our aim was to analyze the relationship between commercial bakery, fast food or soft drinks consumption and mental and physical quality of life. Study Design: This analysis included 8335 participants from the 'Seguimiento Universidad de Navarra' (SUN) Project (a multipurpose, dynamic cohort). Methods: The consumption of commercial bakery, fast food and soft drinks was assessed through a validated food-frequency questionnaire at baseline. Quality of life was measured after 4 years of follow-up with the Short-Form 36 (SF-36) Health Survey. Generalized Linear Models were fit to assess the regression coefficients (b) and their 95% confidence intervals (95% CI) for the association between commercial bakery, fast food and soft drinks consumption and each domain and the two standardized measures of the SF-36. Results: As compared to the participants in the lowest quintile of consumption, those participants in the highest quintile of consumption of commercial bakery, fast food and soft drinks showed a score significantly lower (>2 points) for vitality (b = -2.14, 95% CI = -3.31 to -0.96), role emotional (b = -2.23, 95% CI = -4.33 to -0.13), and role physical (b = -2.31, 95% IC = -4.26 to -0.36) domains with statistically significant dose-response relationships (p for trend < 0.05). When the food groups were analysed separately, significant inverse associations were found only for commercial bakery and fast-food consumption. Conclusions: The results suggest that high consumption of commercial bakery, fast-food and soft drinks at baseline was associated with worse scores on self-perceived quality of life. This association was stronger for the mental domains of the SF-36.展开更多
BACKGROUND: Diet and exercise are recommended first line treatment for overweight, obese, and diabetic patients with the goal of decreasing weight and improving glycemic control. The goal of this study was to determin...BACKGROUND: Diet and exercise are recommended first line treatment for overweight, obese, and diabetic patients with the goal of decreasing weight and improving glycemic control. The goal of this study was to determine the effect that a low calorie diet and behavioral modification program, as implemented by a medically supervised weight loss program, would have on the fasting blood sugar and hemoglobin A1c in overweight or obese diabetic and over-weight or obese non-diabetic participants. METHODS: Charts from 2009 to 2010 were reviewed for 310 diabetic and non-diabetic patients enrolled in the Via Christi Weight Management (VCWM) program in Wichita, Kansas. Data were collected before and after patients underwent a program of meal replacements and weekly physical activity lasting 12 weeks. Variables included pre and post treatment fasting blood sugars, hemoglobin A1c, body mass index, percent body weight lost, and diabetes status. RESULTS: Diabetic participants lost an average of 11.7% of their initial body weight (IBW), and non-diabetic patients lost 12.5% of their IBW over the treatment course. Post-treatment average fasting blood glucose (FBG) decreased in both diabetics and non-diabetics by 15.53 mg/dL and 8.46 mg/dL, respectively (p = 0.08). Diabetic patients experienced a significant decrease of 0.83% from pre to post-treatment in hemoglobin A1c. For diabetic and non-diabetic groups, the changes in FBG were correlated with the change in weight. CONCLUSIONS: Diet and exercise, as prescribed by the VCWM program, is effective in reducing hemoglobin A1c in diabetics and reducing fasting blood sugars in both diabetic and non-diabetic patients.展开更多
Introduction: In Senegal, adolescents aged 10 to 19 years represent 22.9% of the total population. The unmet need for contraception in this part of the population remains high despite the health interventions implemen...Introduction: In Senegal, adolescents aged 10 to 19 years represent 22.9% of the total population. The unmet need for contraception in this part of the population remains high despite the health interventions implemented to promote their sexual health. The aim of this study is to analyze the practice of modern contraception in schools in Dakar high schools in Senegal during the year 2018. Methods: A cross-sectional study was conducted in high schools and colleges in Dakar from March 1 to April 30, 2018. This study involved 452 students. This was a self-administration of the questionnaires. After univaried and bivaried analyses, a multivariate logistic analysis identified the factors associated with students’ use of modern contraception. Results: The prevalence of modern contraceptive use among students is 8.84%. Factors associated with the use of modern contraceptive methods among students were age over 18 years (AR: 4.7, 95% CI [1.02 - 22.5]), male sex (AR: 27.8, 95% CI [6.8 - 100.0]), secondary school level (AR: 10.6, 95% CI [2.1 - 53.0]), access to a youth socio-educational home (AR: 3.9, 95% CI [1.1 - 14.9]) and having a child (AR: 25.6, 95% CI [2.2 - 100.0]). Conclusion: Our results concluded that modern contraceptive needs were better met among older male students, those who had an unfortunate experience of unwanted pregnancy and those attending school’s youth socio-educational homes. This suggests shortcomings in the promotion of sexual health among younger students, particularly those in the secondary grades.展开更多
Motor impairment of cerebral origin is a syndrome that induces a reduction in activity, the origin of which is brain injury or a non-progressive and definitive abnormality occurring in a developing immature brain. Mot...Motor impairment of cerebral origin is a syndrome that induces a reduction in activity, the origin of which is brain injury or a non-progressive and definitive abnormality occurring in a developing immature brain. Motor disability, spastic, dyskinetic or ataxic, is often associated with sensory, cognitive, sensory and behavioral disorders with or without epileptic disease. View of accidental discoveries of corpus callosum abnormalities, most often asymptomatic or associated with psychomotor retardation, epilepsy, neurological disorders or cardiomyopathy, a high technical platform must be available for its diagnosis. We report in this article the case of a 7-year-old boy followed at the neuropsychiatric center Joseph Guislain of the Brothers of Charity of Lubumbashi in Congo (DRC) since 2016 for generalized tonic-clonic seizures, in whom the diagnosis of cerebral palsy on cyst of corpus callosum and in the right parietal lobe, as well as cardiopathy was posed during its consultation in September 2017. This case was published with parental consent.展开更多
BACKGROUND Music has been used to reduce stress and improve task performance during medical therapy.AIM To assess the effects of music on colonoscopy performance outcomes.METHODS We retrospectively reviewed patients w...BACKGROUND Music has been used to reduce stress and improve task performance during medical therapy.AIM To assess the effects of music on colonoscopy performance outcomes.METHODS We retrospectively reviewed patients who underwent colonoscopy performed by four endoscopists with popular music.Colonoscopy performance outcomes,such as insertion time,adenoma detection rate(ADR),and polyp detection rate(PDR),were compared between the music and non-music groups.To reduce selection bias,propensity score matching was used.RESULTS After one-to-one propensity score matching,169 colonoscopies were selected from each group.No significant differences in insertion time(4.97 vs 5.17 min,P=0.795)and ADR(39.1%vs 46.2%,P=0.226)were found between the two groups.Subgroup analysis showed that the insertion time(3.6 vs 3.8 min,P=0.852)and ADR(51.1%vs 44.7%,P=0.488)did not significantly differ between the two groups in experts.However,in trainees,PDR(46.9%vs 66.7%,P=0.016)and ADR(25.9%vs 47.6%,P=0.006)were significantly lower in the music than in the nonmusic group.CONCLUSION The current study found that listening to music during colonoscopy did not affect procedure performance.Moreover,it suggested that music may distract trainees from appropriately detecting adenomas and polyps.展开更多
BACKGROUND Despite improvements in surgical procedures and peri-operative patients management,the postoperative complications in esophagogastric junction(EGJ)cancer remain high because of technical aspects.Several stu...BACKGROUND Despite improvements in surgical procedures and peri-operative patients management,the postoperative complications in esophagogastric junction(EGJ)cancer remain high because of technical aspects.Several studies have indicated the negative influence of postoperative infectious complications on long-term survival after gastrointestinal surgery.However,no study has shown the association between postoperative complications and long-term survival of patients with EGJ cancer.AIM To elucidate influence of postoperative complications on the long-term outcomes of patients with EGJ cancer.METHODS A total of 122 patients who underwent surgery for EGJ cancer at the Keio University were included in this study.We examined the association between complications and long-term oncologic outcomes.RESULTS In all patients,the 3-year overall survival(OS)rate was 71.9%,and the recurrencefree survival(RFS)rate was 67.5%.Compared with patients without anastomotic leakage,those with anastomotic leakage had poor median OS(8 mo vs not reached,P=0.028)and median RFS(5 mo vs not reached,P=0.055).Among patients with cervical anastomosis,there were not significant differences between patients with and without anastomotic leakage.However,among patients who underwent intrathoracic anastomosis,patients with anastomotic leakage had significantly worse OS(P=0.002)and RFS(P=0.005).CONCLUSION Anastomotic leakage was significantly associated with long-term oncologic outcomes of patients with EGJ cancer,especially those who underwent intrathoracic anastomosis.Cervical anastomosis with subtotal esophagectomy may be an option for the patients who are at high risk for anastomotic leakage.展开更多
Introduction: Metabolic and vascular emergencies constitute a risk of lethality in diabetic subjects admitted to hospital. The objective was to evaluate the factors associated with death in subjects admitted for a dia...Introduction: Metabolic and vascular emergencies constitute a risk of lethality in diabetic subjects admitted to hospital. The objective was to evaluate the factors associated with death in subjects admitted for a diabetological emergency to improve management. Materials and Methods: It was a 12-month retrospective, descriptive and analytical study at Dakar’s Marc Sankale Diabetes Center. The study concerned any type of diabetics subjects admitted for a diabetological emergency. We evaluated the profile of diabetes, the pathologies found and factors associated with death. Results: We identified 697 cases of diabetic emergencies with a prevalence of 13.8%. The sex ratio (M/F) was 0.82, the mean age was 49.6 years, and the mean duration of diabetes was 7.1 years. The metabolic profile was hypoglycemia (11.3%), ketoacidosis (34.6%), and hyperosmolar hyperglycemia syndrome (5%). The associated pathologies were vascular (51.1%), infectious (65.3%), kidney function impairment (7.6%), anaemia (13.8%). During the follow-up, 94 patients died, as an annual frequency of 13.5% among diabetological emergencies. In univariate analysis, the factors significantly associated with death were age > 60 years [OR = 4.09 (2.6 - 6.41)], hyperglycemia [OR = 2.58 (1.50 - 4.4)], hyperosmolar hyperglycemia syndrome [OR = 10.5 (5.19 - 21.5)], septic diabetic foot [OR = 3.57 (2.24 - 5.66)]. Vascular pathologies that significantly associated with death were stroke [OR = 4.06 (2.10 - 7.81)], lower limb arteriopathy [OR = 3.25 (1.84 - 5.73)], cardiovascular collapse [OR = 6.85 (2.34 - 20)]. In addition to diabetes, the deceased patients had one (18%), two (34%) and at least three (45.7%) known factors of poor prognosis. Conclusion: Emergencies in diabetology remain frequent in our practice. The comorbidity (vascular and infectious) constitutes a risk of abnormally high death rate. A particular attention must concern on old diabetics subjects with several pathologies.展开更多
Introduction: Anemia in women of reproductive age is a common health problem in Senegal. The objective of this research was to study the contribution of dietary diversity in the fight against anemia in women of reprod...Introduction: Anemia in women of reproductive age is a common health problem in Senegal. The objective of this research was to study the contribution of dietary diversity in the fight against anemia in women of reproductive age in two regions of Senegal using the propensity score method. Methodology: An observational, cross-sectional and analytical study of women of reproductive age and their households was conducted in the Kolda and Kedougou regions in 2015. This was a three-stage random sample survey. The data was collected during an individual interview. Conditional logistic regression was used to identify the risk factor for this anemia. Results: In this study, 1926 women of reproductive age were surveyed. The average age of women of reproductive age surveyed was 27.2 years with a standard deviation of 7.6 years. The median age was 26 years old. Married women were in the majority. Pregnant and lactating women were 43.8%. The percentage of women with adequate diets was 31.5%. The proportion of women with anemia was 51.8%, or 998 women of reproductive age. Adequate dietary diversity is the main factor associated with anemia in these women (OR = 0.75 (0.59 - 0.96)). Conclusion: The prevalence of anemia in women of reproductive age is still high in the southern regions of Senegal. To combat this phenomenon, it is therefore necessary to intensify interventions on the balance of diet, iron and folic acid supplementation in pregnant and lactating women and to strengthen the empowerment of women.展开更多
Introduction: Lack of dietary diversity is a nutritional problem among poor people in developing countries whose daily diet is usually based on a starch source with one or two additional components. Senegal has food i...Introduction: Lack of dietary diversity is a nutritional problem among poor people in developing countries whose daily diet is usually based on a starch source with one or two additional components. Senegal has food insecure regions such as Kolda and Kedougou despite improved agricultural production. This study aims to investigate the determinants of dietary diversity in the Kolda and Kedougou regions. Methodology: It was a cross-sectional, descriptive and analytic household-level study in two southern regions of Senegal (Kolda and Kedougou) between October and December 2015. This was a three-stage random sample survey. Dietary diversity in women of reproductive age was measured using the Women’s Dietary Diversity Score (WDDS) recommended by Food and Agriculture Organization of the United Nations (FAO). The WDDS is a global qualitative indicator of nutrition, which counts the number of food groups consumed by a person in the 24 hours preceding the survey. The data was collected during an individual interview. Linear regression was used to identify the associated factors of dietary diversity. The free and informed consent of the individuals surveyed and the protection of anonymity were respected. Results: A total of 1926 women were surveyed. The mean of WDDS was 2.9 with a standard deviation of 1.4. The Kedougou department has a better WDDS with 3.3 (±1.2) followed by the Kolda department with a score of 3.2 (±1.3). The higher the household’s welfare score, the better the WDDS with a ßcoefficient of 0.11 [0.09 - 0.13]. Households that are in urban areas have a better score than households in rural areas (0.27 [0.13 - 0.41]). The improvement of knowledge in food diversification, in good culinary practice improves the dietary diversity score in women. Conclusion: The WDDS is low in the southern regions of Senegal. To improve dietary diversification in this area, the practice of good cooking practices, the accessibility of micronutrient-rich foods, and the decision-making power of women in the household should be promoted.展开更多
The plasma homocysteine concentration is a good indicator of various diseases such as cardiovascular disease, stroke, and dementia. This study examined the relationship between plasma homocysteine concentrations and d...The plasma homocysteine concentration is a good indicator of various diseases such as cardiovascular disease, stroke, and dementia. This study examined the relationship between plasma homocysteine concentrations and dietary habits in a population of elderly Japanese people from the Amami Islands. Data from 1131 participants collected during a baseline survey for the Japan Multi-institutional Collaborative Cohort study, which is a prospective cohort study, were used. Information on dietary habits was collected using a food frequency questionnaire. The plasma homocysteine concentration was associated with age in women only. Smoking in men and menopause were significantly associated with homocysteine concentrations. Analysis of blood biochemical data showed that estimate of glomerular filtration rate negatively correlated with plasma homocysteine in women (R = ?0.91, p < 0.001) and men (R = ?0.49, p < 0.001). There was no common food associated with homocysteine concentrations among the groups, but in each group, some food types were associated with homocysteine concentrations. In men, Chinese tea was a common factor showing a negative correlation with homocysteine concentrations. Natto showed a negative correlation with homocysteine concentrations in non-smoking men (β = ?0.11, p < 0.05) and premenopausal women (β = ?0.20, p < 0.01). Eggs (β = ?0.21, p < 0.01) and food processed from fish eggs (β = ?0.21, p < 0.01) negatively correlated with homocysteine concentrations in smoking men. Miso soup (β = ?0.13, p < 0.01) and yoghurt (β = ?0.10, p < 0.05) negatively correlated with homocysteine concentrations in postmenopausal women. Consumption of folate-rich food did not necessarily correlate with a low plasma Hcy concentration.展开更多
Introduction: Anemia in women of reproductive age is a common health problem in the region of Kolda (Senegal). The objective of this research was to study the risk factors of anemia among women in reproductive age in ...Introduction: Anemia in women of reproductive age is a common health problem in the region of Kolda (Senegal). The objective of this research was to study the risk factors of anemia among women in reproductive age in Kolda (Senegal). Methodology: A cross-sectional, descriptive and analytical study of women in reproductive age and their households was conducted in the Kolda region between October and December 2015. This was a three-stage random sample survey. The data was collected during an individual interview. Logistic regression was used to identify the factors of this anemia. Results: In this study, 968 women of reproductive age were surveyed. The average age of women was 27 years with a standard deviation of 7.4 years. There were 10% of pregnant women, 36.3% of lactating women and 53.7% of women neither pregnant nor lactating. The average size of the households surveyed was 14 people and the 36.3% had an average economic level. The majority of households were equipped with traditional latrines (76.9%). Women were neither pregnant nor lactating in 53.7%, were uneducated in 70.7% and 81% used micronutrient-rich foods. The prevalence of anemic women was 55.2%. The factors associated with anemia in women in Kolda were the use of traditional latrines (ORa = 1.48 [1.0 - 2.1]), the woman’s pregnancy status (ORa = 5 [2.7 - 9.8]), non-education of the woman (ORa = 1.52 [1.1 - 2.0]), the existence of income-generating activity for the woman (ORa = 0.69 [0.5 - 0.9]), the processing of local products in the household (ORa = 0.5 [0.3 - 0.9]) and the use of at least one micronutrient rich food in the household (ORa = 0.73 [0.49 - 1.0]). Conclusion: The prevalence of anemia among women in reproductive age is still high in the Kolda region. To combat this phenomenon, awareness campaigns on iron and folic acid supplementation should be stepped up, the use of modern latrines should be promoted and the empowerment of women should be strengthened.展开更多
基金supported by the European Regional Development Fund.Supported by Consejería de Educacion,Culturay Deportes-JCCMFondo Europeo de Desarrollo Regional funds (grant no.SBPLY/17/180501/000533)+1 种基金supported by a grant from the University of Castilla-La Mancha (2020-PREDUCLM-15596)supported by a grant from the Universidad de Castilla-La Mancha co-financed by the European Social Fund (2020-PREDUCLM-16746).
文摘Background The positive influence of most types of exercise has been reported repeatedly,but what the most effective exercise approaches are for improving health-related quality of life(HRQoL)in people with cancer remains unknown.The aim of this systematic review and network meta-analysis was to synthesize the evidence from intervention studies to assess the effects of different types of exercise on HRQoL during and after cancer treatment.Methods MEDLINE,SPORTDiscus,the Cochrane Library,Web of Science,and Scopus were searched for randomized controlled trials aimed at testing the effects of exercise interventions meant to improve HRQoL in people with cancer.Separate analyses were conducted for HRQoL as measured by general and cancer-specific questionnaires.We also evaluated whether the effects of exercise were different during and after cancer treatment in both the physical and mental HRQoL domains.Results In total,93 studies involving 7435 people with cancer were included.Network effect size estimates comparing exercise intervention vs.usual care were significant for combined exercise(0.35,95%confidence interval(95%CI):0.14–0.56)for HRQoL as measured by general questionnaires,and for combined(0.31,95%CI:0.13–0.48),mind–body exercise(0.54,95%CI:0.18–0.89),and walking(0.39,95%CI:0.04–0.74)for HRQoL as measured by cancer-specific questionnaires.Conclusion Exercise programs combining aerobic and resistance training can be recommended to improve HRQoL during and after cancer treatment.The scarcity and heterogeneity of these studies prevents us from making recommendations about other exercise modalities due to insufficient evidence.
文摘Under-five mortality remains a major concern in the world and in Senegal. It is mainly due to preventable and treatable diseases with priority life-saving medicines for under-five children. This study evaluated the availability, management and use of these drugs in two health districts in Senegal. A descriptive cross-sectional study was conducted in the health districts of Guediawaye and Pete from 01 November 2018 to 31 January 2019. The health district of Guediawaye is in the region hosting the Senegalese capital while that of Pete is located in the region of Saint Louis, northern Senegal. Nine drugs that can prevent and treat malaria, diarrhea, pneumonia and malnutrition were selected. An inventory form and a self-administered questionnaire were used to collect data that was analyzed with SPSS and expressed as a percentage and average. Drug availability was 50.4% and 54.3% in Guediawaye and in Pete, respectively. Average stock-out duration in the past three months was estimated at 22.6 and 26 days, respectively. The drug management was marked, on the one hand, by a good availability of stock cards in the two districts with proportions equal to 100% and 94.1%, respectively, and on the other hand, by the presence of expired stocks in Pete (12.2%). About 79% and 88% of prescribers reported prescribing the basket drug, respectively. These results show that access to priority life-saving medicines for children remains a challenge. Measures to be taken should include improving the distribution channels and training of health professionals. Further studies should be conducted in other health districts to better understand the barriers to access to child health services.
文摘Unipolar depressive disorder(UDD)affects more than 264 million people worldwide and was projected well before the severe acute respiratory syndrome coronavirus 2 pandemic to be the leading cause of disability-adjusted life years lost in 2030.It is imperative for leading economies to implement preventive strategies targeted towards UDD,given consistent policies are currently lacking.Recently established similarities between the aetiological hypotheses of depression and cardiometabolic diseases are shifting paradigms within this field.It is believed that dietary practices could potentially reduce the incidence of depression;similar to their effects on metabolism.Thus,the aim of this review was to compile current evidence on healthy dietary patterns as suitable contributors towards primary prevention strategies against UDD.Most of the well-known biological mechanisms behind depression have been positively associated with healthful diets and dietary patterns to varying degrees.Interestingly,a common factor of UDD is the production and overall effects of inflammatory cytokines,such as interleukin-6,tumor necrosis factor-α,and Creactive protein.These compounds have been associated with depressive symptoms,disturbances in neuroendocrine function,leaky gut,monoamine activity and brain function,while also being key factors in the development of cardiometabolic diseases.The Mediterranean diet(MD)in particular,is well supported by first-level evidence regarding its preventive qualities against metabolic and cardiovascular diseases and thus considered a model for healthy eating by various organizations.In one of the few clinical trials investigating these associations,the PREDIMED trial,individuals with diabetes assigned to a MD supplemented with mixed tree nuts experienced a 41%relative risk reduction for developing depression.Lastly,there is a need to include health related quality of life as an indicator of physical and mental well-being,considering its putative associations with depression and suicide risk.Going forward,focusing on clinical trials,using precise nutritional assessments,and identifying nutritional biomarkers which may be related to depression are needed to fully support the implementation of dietary recommendations in the field of psychiatry.
文摘Background: Cardiovascular diseases (CVD) are major causes of death in Japan, and controlling the risk factors for CVD is an important public health task. Lifestyle factors, for example, diet and stress, have impacts on risk factors such as hypertension and hyperlipidemia. Deterioration of mental health is related to CVD pathogenesis. Aim: We investigated the relationships between levels of mental health, 4-year changes in lifestyle, and CVD risk factors among Japanese workers, using the SF-36 (Japanese version), which is a comprehensive scale measuring health-related quality of life. We hypothesized that workers’ mental health levels would influence 4-year changes in their lifestyles and CVD risk factors. Methods: Data from the High-Risk and Population Strategy for Occupational Health Promotion (HIPOP-OHP) study, which were collected by examination and administration of the SF-36, were used. The relationships between mental health levels at baseline, lifestyle chan- ges, and cardiovascular risk factors were longitudinally analyzed. Subjects with total SF-36 scores ≥65 were classified as the “Good Mental Health Group,” and those with total scores <65 were classified as the “Poor Mental Health Group.” Results: Multiple logistic regression analyses showed that, as compared to people who had poor mental health, those who had good mental health at baseline had a significantly higher probability of good maintenance of improvements in body mass index, (OR = 1.20, 95% CI: 1.03 - 1.39), blood pressure (OR = 1.20, 95% CI: 1.01 - 1.43), total cholesterol (OR = 1.07, 95% CI: 0.86 - 1.33) and HDL cholesterol (OR = 1.26, 95% CI: 1.07 - 1.47). Conclusion: Japanese workers with good mental health tend to improve or maintain good lifestyle conditions and minimize CVD risk factors, while those with poor mental health generally have difficulty improving their lifestyles and lowering their CVD risk.
文摘Hypertension is a major determinant of health and is likely to have an effect on medical economics.The economic burden due to hypertension may be attributable not only to antihypertensive medication but also to the very expensive procedures required for cases of cardiovascular disease that occur more frequently in hypertensive compared with normotensive individuals.The objective of this article was to review articles published on prospective cohort studies that measured medical expenditure attributable to hypertension in community-dwelling populations in Japan.Many medical services in these populations are provided under the medical insurance system that requires the enrolment of all Japanese residents.Personal medical expenditure attributable to hypertension increases with worsening severity of the condition.Medical expenditure was increased further in cases of hypertensive patients who have another concomitant cardiovascular risk factor.In particular,hypertension,especially moderate-to-severe untreated hypertension,increases the risk of long-term hospitalization resulting in considerably higher medical expenditure,compared with non-hospitalized cases.Therefore,assuming that the use of antihypertensive medication is essential for hypertensive patients to prevent serious vascular diseases,a cost-effective highrisk strategy needs to be considered to reduce both ill-health and the economic burden due to hypertension.However,from a population perspective,medical expenditure attributable to hypertension comes mainly from pre-to-mild hypertension.Therefore,there is also a need to consider a population strategy that aims to shift the entire population to lower levels of blood pressure.
文摘Introduction: The diagnosis of cardiothyreosis is based on the presence of the association of thyrotoxicosis and various cardiovascular disorders such as heart failure, coronary artery disease, rhythm or conduction disorders. Data are limited on this entity in Africa which a frequency of 10% to 33% among hyperthyroidism. We aimed to evaluate these risk factors and describe its diagnostic features in Abass Ndao Hospital Center of Dakar. Patients and Methods: It was a descriptive and analytical cross sectional study conducted from 1 January 2010 to 31 December 2014, including all cases of hyperthyroidism with cardiothyreosis. Epidemiological data, cardiovascular risk factors and characteristics of cardiothyreosis were evaluated. Results: 150 cases of cardiothyreosis were collected with a prevalence of 9.8% among 1517 hyperthyroidism. Mean age was 42.6 ± 9 years and sex ratio 0.33. It was a Graves’ disease in 82.2% of cases. Time limit of cardiothyreosis appearance was 27 ± 41 months and cardiothyreosis was inaugural in 46.6%. Electrocardiogram showed an arrhythmia (38.7%), coronary insufficiency (8%). On echocardiography assessment, impairment of left ventricular ejection fraction (LVEF) was found in 18.5%. Of these, it was 34.7% of arrhythmia, 8.6% of coronary insufficiency and 65.2% of heart failure. Among patients with pulmonary artery hypertension (PAH) (57.3%), there were a rhythm disorder (38%), coronary insufficiency (5.6%) and heart failure (78.8%). Female gender was the only one at risk of arrhythmia (p = 0.01) and impaired of left ventricular ejection fraction (p = 0.007). Existence of a free T4 > 50 pmol/L (p = 0.05) were only at risk of developing pulmonary artery hypertension. Conclusion: Cardiothyreosis is a significant complication. These discovery methods call for more early diagnosis and appropriate treatment. Female gender and severity of thyrotoxicosis seem to precipitate the clinical picture. Echocardiography remains an indispensable tool for assessing cardiac consequences.
基金Financial support for this research was provided by the Agencia Espanola de Cooperaci’on Internacional para el Desarrollo(A/019106/08,A/025113/09 and A1/035779/11).
文摘The prevalence of enterotoxigenic Staphylococcus aureus was investigated among 200 participants working in three different food processing plants in Egypt. Using skin swabs, 75 (38%) of the 200 tested persons were positive for the presence of S. aureus. Of the S. aureus positive persons, 28 (14%) harboured S. aureus produced staphylococcal enterotoxins. The serotypes of these enterotoxins were enterotoxin A (68%), enterotoxin B (36%), enterotoxin C (46%) and enterotoxin D (18%). Some of these isolates produced more than one type of enterotoxins namely AB, AC, BC, BD, ABC and ACD. Analysis of risk factors implicated in skin carriage of S. aureus as age, gender, marital status, education, duration in employment, frequency and method of hand wash and incidence of chronic skin infection revealed insignificant association with staphylococcal skin carriage. The obtained results put forth the risk of food contracting contamination with enterotoxigenic strains of S. aureus owing to skin colonization of S. aureus among food handlers.
文摘Introduction: Despite being under-reported, domestic violence remains a significant challenge in Senegal. The aim of this study is to provide a descriptive analysis of the epidemiological and clinical factors characterizing domestic violence in Senegal. Methodology: A descriptive and retrospectively observational study was conducted. The data was collected from the court records of female victims of physical and/or sexual violence registered from 2006 to 2015. Female victims of physical and/or sexual violence at the hands of their husbands who had a court record at one of Senegal’s high courts during this period were also included. All records that met the inclusion criteria were selected for the study, and the data was analyzed using Epi Info 3.3.2. Results: According to the court records of 148 female victims of domestic violence, the average age of the victims was 30.6 ± 10.1 years. More than 3/4 (76.4%) of the victims were housekeepers, 82.4% of whom were uneducated. The average age of the perpetrators was 40.4 ± 11.4 years, and they were self-employed in the informal sector in 47.3% of the cases. Additionally, more than 3/4 (78.4%) of the perpetrators were uneducated. Eleven women (8% of the victims), were abused while pregnant. Physical violence was predominant (95.3%), while those associated with sexual assault accounted for 4.7% of cases. Of the 7 recorded cases of sexual violence, 3 were cases of unwanted sexual touching, and all cases of physical violence were cases of assault and battery. The violence took place at the home of the perpetrators in 81.8% of cases. In 84.7% of the cases, victims received treatment and care within 24 hours or less. Among the victims, 73% showed clinical lesions. Contusions, hematomas and penetrating wounds were most frequent, representing 23.1%;19.4% and 13.9% of cases respectively. Conclusion: Despite the low number of cases registered in the judicial system in the past ten years, much more violence is occurring without being denounced by the victims. Therefore, it seems appropriate to increase awareness within the community and break sociocultural barriers that hinder the recognition of women’s rights in the couple.
文摘Objective: Few studies have related nutritional factors with quality of life in healthy populations. Our aim was to analyze the relationship between commercial bakery, fast food or soft drinks consumption and mental and physical quality of life. Study Design: This analysis included 8335 participants from the 'Seguimiento Universidad de Navarra' (SUN) Project (a multipurpose, dynamic cohort). Methods: The consumption of commercial bakery, fast food and soft drinks was assessed through a validated food-frequency questionnaire at baseline. Quality of life was measured after 4 years of follow-up with the Short-Form 36 (SF-36) Health Survey. Generalized Linear Models were fit to assess the regression coefficients (b) and their 95% confidence intervals (95% CI) for the association between commercial bakery, fast food and soft drinks consumption and each domain and the two standardized measures of the SF-36. Results: As compared to the participants in the lowest quintile of consumption, those participants in the highest quintile of consumption of commercial bakery, fast food and soft drinks showed a score significantly lower (>2 points) for vitality (b = -2.14, 95% CI = -3.31 to -0.96), role emotional (b = -2.23, 95% CI = -4.33 to -0.13), and role physical (b = -2.31, 95% IC = -4.26 to -0.36) domains with statistically significant dose-response relationships (p for trend < 0.05). When the food groups were analysed separately, significant inverse associations were found only for commercial bakery and fast-food consumption. Conclusions: The results suggest that high consumption of commercial bakery, fast-food and soft drinks at baseline was associated with worse scores on self-perceived quality of life. This association was stronger for the mental domains of the SF-36.
文摘BACKGROUND: Diet and exercise are recommended first line treatment for overweight, obese, and diabetic patients with the goal of decreasing weight and improving glycemic control. The goal of this study was to determine the effect that a low calorie diet and behavioral modification program, as implemented by a medically supervised weight loss program, would have on the fasting blood sugar and hemoglobin A1c in overweight or obese diabetic and over-weight or obese non-diabetic participants. METHODS: Charts from 2009 to 2010 were reviewed for 310 diabetic and non-diabetic patients enrolled in the Via Christi Weight Management (VCWM) program in Wichita, Kansas. Data were collected before and after patients underwent a program of meal replacements and weekly physical activity lasting 12 weeks. Variables included pre and post treatment fasting blood sugars, hemoglobin A1c, body mass index, percent body weight lost, and diabetes status. RESULTS: Diabetic participants lost an average of 11.7% of their initial body weight (IBW), and non-diabetic patients lost 12.5% of their IBW over the treatment course. Post-treatment average fasting blood glucose (FBG) decreased in both diabetics and non-diabetics by 15.53 mg/dL and 8.46 mg/dL, respectively (p = 0.08). Diabetic patients experienced a significant decrease of 0.83% from pre to post-treatment in hemoglobin A1c. For diabetic and non-diabetic groups, the changes in FBG were correlated with the change in weight. CONCLUSIONS: Diet and exercise, as prescribed by the VCWM program, is effective in reducing hemoglobin A1c in diabetics and reducing fasting blood sugars in both diabetic and non-diabetic patients.
文摘Introduction: In Senegal, adolescents aged 10 to 19 years represent 22.9% of the total population. The unmet need for contraception in this part of the population remains high despite the health interventions implemented to promote their sexual health. The aim of this study is to analyze the practice of modern contraception in schools in Dakar high schools in Senegal during the year 2018. Methods: A cross-sectional study was conducted in high schools and colleges in Dakar from March 1 to April 30, 2018. This study involved 452 students. This was a self-administration of the questionnaires. After univaried and bivaried analyses, a multivariate logistic analysis identified the factors associated with students’ use of modern contraception. Results: The prevalence of modern contraceptive use among students is 8.84%. Factors associated with the use of modern contraceptive methods among students were age over 18 years (AR: 4.7, 95% CI [1.02 - 22.5]), male sex (AR: 27.8, 95% CI [6.8 - 100.0]), secondary school level (AR: 10.6, 95% CI [2.1 - 53.0]), access to a youth socio-educational home (AR: 3.9, 95% CI [1.1 - 14.9]) and having a child (AR: 25.6, 95% CI [2.2 - 100.0]). Conclusion: Our results concluded that modern contraceptive needs were better met among older male students, those who had an unfortunate experience of unwanted pregnancy and those attending school’s youth socio-educational homes. This suggests shortcomings in the promotion of sexual health among younger students, particularly those in the secondary grades.
文摘Motor impairment of cerebral origin is a syndrome that induces a reduction in activity, the origin of which is brain injury or a non-progressive and definitive abnormality occurring in a developing immature brain. Motor disability, spastic, dyskinetic or ataxic, is often associated with sensory, cognitive, sensory and behavioral disorders with or without epileptic disease. View of accidental discoveries of corpus callosum abnormalities, most often asymptomatic or associated with psychomotor retardation, epilepsy, neurological disorders or cardiomyopathy, a high technical platform must be available for its diagnosis. We report in this article the case of a 7-year-old boy followed at the neuropsychiatric center Joseph Guislain of the Brothers of Charity of Lubumbashi in Congo (DRC) since 2016 for generalized tonic-clonic seizures, in whom the diagnosis of cerebral palsy on cyst of corpus callosum and in the right parietal lobe, as well as cardiopathy was posed during its consultation in September 2017. This case was published with parental consent.
文摘BACKGROUND Music has been used to reduce stress and improve task performance during medical therapy.AIM To assess the effects of music on colonoscopy performance outcomes.METHODS We retrospectively reviewed patients who underwent colonoscopy performed by four endoscopists with popular music.Colonoscopy performance outcomes,such as insertion time,adenoma detection rate(ADR),and polyp detection rate(PDR),were compared between the music and non-music groups.To reduce selection bias,propensity score matching was used.RESULTS After one-to-one propensity score matching,169 colonoscopies were selected from each group.No significant differences in insertion time(4.97 vs 5.17 min,P=0.795)and ADR(39.1%vs 46.2%,P=0.226)were found between the two groups.Subgroup analysis showed that the insertion time(3.6 vs 3.8 min,P=0.852)and ADR(51.1%vs 44.7%,P=0.488)did not significantly differ between the two groups in experts.However,in trainees,PDR(46.9%vs 66.7%,P=0.016)and ADR(25.9%vs 47.6%,P=0.006)were significantly lower in the music than in the nonmusic group.CONCLUSION The current study found that listening to music during colonoscopy did not affect procedure performance.Moreover,it suggested that music may distract trainees from appropriately detecting adenomas and polyps.
文摘BACKGROUND Despite improvements in surgical procedures and peri-operative patients management,the postoperative complications in esophagogastric junction(EGJ)cancer remain high because of technical aspects.Several studies have indicated the negative influence of postoperative infectious complications on long-term survival after gastrointestinal surgery.However,no study has shown the association between postoperative complications and long-term survival of patients with EGJ cancer.AIM To elucidate influence of postoperative complications on the long-term outcomes of patients with EGJ cancer.METHODS A total of 122 patients who underwent surgery for EGJ cancer at the Keio University were included in this study.We examined the association between complications and long-term oncologic outcomes.RESULTS In all patients,the 3-year overall survival(OS)rate was 71.9%,and the recurrencefree survival(RFS)rate was 67.5%.Compared with patients without anastomotic leakage,those with anastomotic leakage had poor median OS(8 mo vs not reached,P=0.028)and median RFS(5 mo vs not reached,P=0.055).Among patients with cervical anastomosis,there were not significant differences between patients with and without anastomotic leakage.However,among patients who underwent intrathoracic anastomosis,patients with anastomotic leakage had significantly worse OS(P=0.002)and RFS(P=0.005).CONCLUSION Anastomotic leakage was significantly associated with long-term oncologic outcomes of patients with EGJ cancer,especially those who underwent intrathoracic anastomosis.Cervical anastomosis with subtotal esophagectomy may be an option for the patients who are at high risk for anastomotic leakage.
文摘Introduction: Metabolic and vascular emergencies constitute a risk of lethality in diabetic subjects admitted to hospital. The objective was to evaluate the factors associated with death in subjects admitted for a diabetological emergency to improve management. Materials and Methods: It was a 12-month retrospective, descriptive and analytical study at Dakar’s Marc Sankale Diabetes Center. The study concerned any type of diabetics subjects admitted for a diabetological emergency. We evaluated the profile of diabetes, the pathologies found and factors associated with death. Results: We identified 697 cases of diabetic emergencies with a prevalence of 13.8%. The sex ratio (M/F) was 0.82, the mean age was 49.6 years, and the mean duration of diabetes was 7.1 years. The metabolic profile was hypoglycemia (11.3%), ketoacidosis (34.6%), and hyperosmolar hyperglycemia syndrome (5%). The associated pathologies were vascular (51.1%), infectious (65.3%), kidney function impairment (7.6%), anaemia (13.8%). During the follow-up, 94 patients died, as an annual frequency of 13.5% among diabetological emergencies. In univariate analysis, the factors significantly associated with death were age > 60 years [OR = 4.09 (2.6 - 6.41)], hyperglycemia [OR = 2.58 (1.50 - 4.4)], hyperosmolar hyperglycemia syndrome [OR = 10.5 (5.19 - 21.5)], septic diabetic foot [OR = 3.57 (2.24 - 5.66)]. Vascular pathologies that significantly associated with death were stroke [OR = 4.06 (2.10 - 7.81)], lower limb arteriopathy [OR = 3.25 (1.84 - 5.73)], cardiovascular collapse [OR = 6.85 (2.34 - 20)]. In addition to diabetes, the deceased patients had one (18%), two (34%) and at least three (45.7%) known factors of poor prognosis. Conclusion: Emergencies in diabetology remain frequent in our practice. The comorbidity (vascular and infectious) constitutes a risk of abnormally high death rate. A particular attention must concern on old diabetics subjects with several pathologies.
文摘Introduction: Anemia in women of reproductive age is a common health problem in Senegal. The objective of this research was to study the contribution of dietary diversity in the fight against anemia in women of reproductive age in two regions of Senegal using the propensity score method. Methodology: An observational, cross-sectional and analytical study of women of reproductive age and their households was conducted in the Kolda and Kedougou regions in 2015. This was a three-stage random sample survey. The data was collected during an individual interview. Conditional logistic regression was used to identify the risk factor for this anemia. Results: In this study, 1926 women of reproductive age were surveyed. The average age of women of reproductive age surveyed was 27.2 years with a standard deviation of 7.6 years. The median age was 26 years old. Married women were in the majority. Pregnant and lactating women were 43.8%. The percentage of women with adequate diets was 31.5%. The proportion of women with anemia was 51.8%, or 998 women of reproductive age. Adequate dietary diversity is the main factor associated with anemia in these women (OR = 0.75 (0.59 - 0.96)). Conclusion: The prevalence of anemia in women of reproductive age is still high in the southern regions of Senegal. To combat this phenomenon, it is therefore necessary to intensify interventions on the balance of diet, iron and folic acid supplementation in pregnant and lactating women and to strengthen the empowerment of women.
文摘Introduction: Lack of dietary diversity is a nutritional problem among poor people in developing countries whose daily diet is usually based on a starch source with one or two additional components. Senegal has food insecure regions such as Kolda and Kedougou despite improved agricultural production. This study aims to investigate the determinants of dietary diversity in the Kolda and Kedougou regions. Methodology: It was a cross-sectional, descriptive and analytic household-level study in two southern regions of Senegal (Kolda and Kedougou) between October and December 2015. This was a three-stage random sample survey. Dietary diversity in women of reproductive age was measured using the Women’s Dietary Diversity Score (WDDS) recommended by Food and Agriculture Organization of the United Nations (FAO). The WDDS is a global qualitative indicator of nutrition, which counts the number of food groups consumed by a person in the 24 hours preceding the survey. The data was collected during an individual interview. Linear regression was used to identify the associated factors of dietary diversity. The free and informed consent of the individuals surveyed and the protection of anonymity were respected. Results: A total of 1926 women were surveyed. The mean of WDDS was 2.9 with a standard deviation of 1.4. The Kedougou department has a better WDDS with 3.3 (±1.2) followed by the Kolda department with a score of 3.2 (±1.3). The higher the household’s welfare score, the better the WDDS with a ßcoefficient of 0.11 [0.09 - 0.13]. Households that are in urban areas have a better score than households in rural areas (0.27 [0.13 - 0.41]). The improvement of knowledge in food diversification, in good culinary practice improves the dietary diversity score in women. Conclusion: The WDDS is low in the southern regions of Senegal. To improve dietary diversification in this area, the practice of good cooking practices, the accessibility of micronutrient-rich foods, and the decision-making power of women in the household should be promoted.
文摘The plasma homocysteine concentration is a good indicator of various diseases such as cardiovascular disease, stroke, and dementia. This study examined the relationship between plasma homocysteine concentrations and dietary habits in a population of elderly Japanese people from the Amami Islands. Data from 1131 participants collected during a baseline survey for the Japan Multi-institutional Collaborative Cohort study, which is a prospective cohort study, were used. Information on dietary habits was collected using a food frequency questionnaire. The plasma homocysteine concentration was associated with age in women only. Smoking in men and menopause were significantly associated with homocysteine concentrations. Analysis of blood biochemical data showed that estimate of glomerular filtration rate negatively correlated with plasma homocysteine in women (R = ?0.91, p < 0.001) and men (R = ?0.49, p < 0.001). There was no common food associated with homocysteine concentrations among the groups, but in each group, some food types were associated with homocysteine concentrations. In men, Chinese tea was a common factor showing a negative correlation with homocysteine concentrations. Natto showed a negative correlation with homocysteine concentrations in non-smoking men (β = ?0.11, p < 0.05) and premenopausal women (β = ?0.20, p < 0.01). Eggs (β = ?0.21, p < 0.01) and food processed from fish eggs (β = ?0.21, p < 0.01) negatively correlated with homocysteine concentrations in smoking men. Miso soup (β = ?0.13, p < 0.01) and yoghurt (β = ?0.10, p < 0.05) negatively correlated with homocysteine concentrations in postmenopausal women. Consumption of folate-rich food did not necessarily correlate with a low plasma Hcy concentration.
文摘Introduction: Anemia in women of reproductive age is a common health problem in the region of Kolda (Senegal). The objective of this research was to study the risk factors of anemia among women in reproductive age in Kolda (Senegal). Methodology: A cross-sectional, descriptive and analytical study of women in reproductive age and their households was conducted in the Kolda region between October and December 2015. This was a three-stage random sample survey. The data was collected during an individual interview. Logistic regression was used to identify the factors of this anemia. Results: In this study, 968 women of reproductive age were surveyed. The average age of women was 27 years with a standard deviation of 7.4 years. There were 10% of pregnant women, 36.3% of lactating women and 53.7% of women neither pregnant nor lactating. The average size of the households surveyed was 14 people and the 36.3% had an average economic level. The majority of households were equipped with traditional latrines (76.9%). Women were neither pregnant nor lactating in 53.7%, were uneducated in 70.7% and 81% used micronutrient-rich foods. The prevalence of anemic women was 55.2%. The factors associated with anemia in women in Kolda were the use of traditional latrines (ORa = 1.48 [1.0 - 2.1]), the woman’s pregnancy status (ORa = 5 [2.7 - 9.8]), non-education of the woman (ORa = 1.52 [1.1 - 2.0]), the existence of income-generating activity for the woman (ORa = 0.69 [0.5 - 0.9]), the processing of local products in the household (ORa = 0.5 [0.3 - 0.9]) and the use of at least one micronutrient rich food in the household (ORa = 0.73 [0.49 - 1.0]). Conclusion: The prevalence of anemia among women in reproductive age is still high in the Kolda region. To combat this phenomenon, awareness campaigns on iron and folic acid supplementation should be stepped up, the use of modern latrines should be promoted and the empowerment of women should be strengthened.
