RESUMO
The COVID-19 pandemic has caused increased anxiety among medical students due to the uncertainty of the long-term effects on the future of medical education. There are currently insufficient studies aimed at investigating the changes in the mental health and studying habits of medical students during public health emergencies such as this pandemic, as well as methods that can be incorporated to appropriately manage anxiety effectively. To investigate the psychological impact and associated factors on medical students during the pandemic. This retrospective, cross-sectional study consisted of 291 medical students of the faculty of medical sciences at the university of the West Indies, St. Augustine campus, Trinidad and Tobago. The mental health and study habits of said students were assessed with the use of questionnaires via an online survey platform. Data of our study showed that 56% of the students were experiencing increased stress and anxiety. Students of 82.8% experienced irregular sleeping habits and 76.3% of participants experienced a change in eating habits brought on by the pandemic. Participants of 67.4% studied less than 4 hrs. a day, 61.5% were less productive, 62.2% showed an inability to focus and avoid distractions in their study environment during the COVID-19 pandemic. There is a need for proper supportive strategies to assist students in effectively managing anxiety and depression during public health emergencies such as COVID-19. It is suggested that all universities, colleges and education bodies alike implement a pandemic preparedness course as well as an accessible online support forum.
Assuntos
COVID-19 , Estudantes de Medicina , Humanos , COVID-19/epidemiologia , Saúde Mental , Pandemias , Estudos Transversais , Emergências , Estudos Retrospectivos , Índias Ocidentais/epidemiologia , HábitosRESUMO
OBJECTIVES: To determine the prevalence and factors associated with depression, anxiety and stress among healthcare workers (HCWs) during COVID-19 pandemic. DESIGN: Cross-sectional online survey. SETTING: HCWs from four major hospitals within the Regional Health Authorities of Trinidad and Tobago. PARTICIPANTS: 395 HCWs aged ≥18 years. MAIN OUTCOME MEASURES: Depression, anxiety and stress scores. RESULTS: Among the 395 HCWs, 42.28%, 56.2% and 17.97% were found to have depression, anxiety and stress, respectively. In the final stepwise regression model, contact with patients with confirmed COVID-19, p<0.001 (95% CI 3.072 to 6.781) was reported as significant predictors of depression. Further, gender, p<0.001 (95% CI 2.152 to 5.427) and marital status, p<0.001 (95% CI 1.322 to 4.270) of the HCWs were considered to be correlated with anxiety. HCWs who had contact with patients with suspected COVID-19 had lower depression, p<0.001 (95% CI -5.233 to -1.692) and stress, p<0.001 (95% CI -5.364 to -1.591). CONCLUSIONS: This study has depicted the prevalence and evidence of depression, anxiety and stress among HCWs during the COVID-19 pandemic. The findings of the study will serve as supportive evidence for the timely implementation of further planning of preventative mental health services by the Ministry of Health, for frontline workers within the public and private health sectors.
Assuntos
Ansiedade/epidemiologia , COVID-19/psicologia , Depressão/epidemiologia , Pessoal de Saúde/psicologia , Estresse Ocupacional/epidemiologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Prevalência , Inquéritos e Questionários , Trinidad e Tobago/epidemiologiaRESUMO
BACKGROUND: Persistent bouts of extended exercise and heavy training are associated with depressed immune cell function. It has recently been demonstrated that interleukin-6 (IL-6) is produced locally in contracting skeletal muscles and acts on a wide range of tissues. Larger amounts of IL-6 are produced in response to exercise than any other cytokines. Though the majority of existing data obtained following prolonged exercise, it remains to be explained the effect of martial arts training on IL-6 and other immunological parameters and associated changes to the duration of this type of exercise. IL-1α is produced mainly by activated macrophages, as well as neutrophils, epithelial cells, and endothelial cells. It possesses metabolic, physiological, hematopoietic activities, and plays one of the central roles in the regulation of the immune responses. This study aimed to evaluate the effect of martial arts training on IL-6 and other immunological parameters among Trinidadian subjects. METHODS: Sixteen healthy, non-smoker individuals who have been martial arts practitioners for the last 5-15 years, aged 25.94±7.6.20 years. Blood samples were collected to determine IL-6 and other immunological parameters at pre-exercise, immediately post exercise (0 hours), 1 hour, 2 hour and 52 hours of post exercise). IL-6 and IL-1 was measured using Human IL-6 and IL-1 ß ELISA kit, blood cell count was done using automated blood cell counter and CD4, and CD3 count was performed using the automated immunofluorescence analysis by flow cytometer. RESULTS: The mean basal IL-6 level was 71.47±4.3 and reduced to 70.1±21.6 immediately after exercise and then increased to 75.70±8.2 after one hour of exercise bout, returning to basal level after two hours and remained so after 52 hours. The CD4 count was decreased as low as 102.2, (much lower than immune-compromised subjects) after the bout of training but returned to normal range within 2 hours of exercise and increased even more after 52 hours. Similar trends have been observed for hematological parameters such as white blood cells, granulocytes and lymphocytes. The white blood cell count, granulocyte count and lymphocyte count increased immediately after exercise and returned to basal level only after 52 hours of exercise. CONCLUSIONS: This study highlights that the martial arts exercise increases key cytokines and other hematological parameters. The magnitude of the martial arts exercise-induced IL-6 response is dependent on intensity and especially duration of the exercise.
Assuntos
Exercício Físico/fisiologia , Interleucina-6/sangue , Artes Marciais/fisiologia , Adulto , Ensaio de Imunoadsorção Enzimática , Humanos , Interleucina-1/sangue , Interleucina-1/imunologia , Interleucina-6/imunologia , Contagem de Linfócitos , Masculino , Músculo Esquelético/imunologia , Músculo Esquelético/metabolismo , Trinidad e Tobago , Adulto JovemRESUMO
OBJECTIVES: To determine the awareness of HbA1c values and correlate this with educational levels, dietary intake and physical activity in type II diabetic population of Trinidad. METHODS: Total of 222 type II diabetic subjects were assessed via questionnaire evaluating their demographics, type and duration of diabetes, type and frequency of glucose testing, dietary intake and physical activity. HbA1c data was coded as patients who were aware versus patients who were not aware. RESULTS: Of the respondents, 41.9% were aware of the term HbA1c while 58.1% were unaware. Statistically, there were positive correlations (p < .05) between HbA1c awareness and level of education received by type II diabetic patients as well as between HbA1c awareness and intensity of exercise performed (p< .05). However, the relationship between dietary breakfast choices and HbA1c awareness was not significant. CONCLUSIONS: A significant correlation was established between HbA1c awareness, intensity of exercise and the level of education obtained.
Assuntos
Diabetes Mellitus Tipo 2/terapia , Exercício Físico , Hemoglobinas Glicadas/análise , Conhecimentos, Atitudes e Prática em Saúde , Hiperglicemia/prevenção & controle , Cooperação do Paciente , Autogestão , Automonitorização da Glicemia , Terapia Combinada , Complicações do Diabetes/etnologia , Complicações do Diabetes/prevenção & controle , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/etnologia , Dieta para Diabéticos/etnologia , Dieta Saudável/etnologia , Escolaridade , Feminino , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Estilo de Vida Saudável , Humanos , Masculino , Cooperação do Paciente/etnologia , Esforço Físico , Autorrelato , Trinidad e TobagoRESUMO
AIMS: To assess the impact of risk factors such as age, gender, ethnicity, family history, body mass index (BMI), waist circumference and hypertension, on the development of type 2 diabetes mellitus in the Trinidadian population. MATERIALS AND METHODS: A cross-sectional case control study comprised 146 non-diabetics and 147 type 2 diabetics ≥18 years of age, from North Central, South West and Eastern regions of Trinidad. RESULTS: Cross-tabulations revealed a significant difference between type 2-diabetes and age at p<0.01, and between type 2 diabetes and family history, ethnicity, waist circumference and hypertension at p<0.05. Logistic regression showed age to be the most influential risk factor. The systolic blood pressure specifically showed a significant difference at p<0.05, with the mean values for non-diabetics and type 2 diabetics being, 130.62 (±2.124) and 141.35 (±2.312), respectively. No significant difference was observed between type 2 diabetes and gender and BMI. CONCLUSIONS: Age was the most significant risk factor of type 2 diabetes. Therefore it can be concluded that family history, ethnicity, waist circumference and hypertension are more significant risk factors of this disease than BMI and gender in the Trinidadian population.
Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Hipertensão/epidemiologia , Obesidade/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Pressão Sanguínea , Índice de Massa Corporal , Estudos de Casos e Controles , Estudos Transversais , Diabetes Mellitus Tipo 2/etnologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores Sexuais , Trinidad e Tobago , Circunferência da CinturaRESUMO
AIMS: Objective of the study is to identify the predictors of plasma triglycerides. MATERIALS AND METHODS: A stratified random sample of university staff categories underwent measurements of anthropometry, blood pressure, and fasting blood glucose, insulin, lipids, CRP and homocysteine. Dietary intakes were assessed using duplicate 24h recalls. HOMA-IR was calculated. Stepwise, multivariate regression analysis was performed with TAG as the dependent variable. RESULTS: The sample (n=251) was 55% females with a mean age of 44.9±9.7 years. African ancestry comprised 43%, followed South Asian 30% and mixed ethnicity 27%. Prevalence of obesity was 19.4%, insulin resistance 22.7% and metabolic syndrome 21.6%. Males had significantly higher (p<0.01) triglycerides and VLDL and lower HDL than females. Africans had significantly lower triglycerides and cholesterol than South Asians and Mix. Triglycerides were significantly (p<0.01) correlated with glucose, cholesterol, insulin, CRP, systolic, diastolic blood pressure, WC, BMI, age and components of MS. Glucose, cholesterol, insulin and total energy intake predicted TAG, to varying extents, in all participants (R(2)=45.1%), males (R(2)=40.3%), females (R(2)=56.0%), Africans (R(2)=35.0%), TSA (R(2)=31.5%) and mix (R(2)=51.0%). CONCLUSIONS: Africans have lower triglycerides and cholesterol than South Asians and mix. Major predictors of triglycerides were fasting glucose and cholesterol independent of gender and ethnicity.
Assuntos
Povo Asiático/estatística & dados numéricos , População Negra/estatística & dados numéricos , Dieta , Obesidade/sangue , Obesidade/etnologia , Triglicerídeos/sangue , Adulto , Glicemia/metabolismo , Índice de Massa Corporal , Proteína C-Reativa/metabolismo , Região do Caribe/epidemiologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Homocisteína/sangue , Humanos , Insulina/sangue , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Análise de Regressão , Fatores de Risco , Estudos de AmostragemRESUMO
OBJECTIVES: To study the relationship of dyslipidemia and serum uric acid with the risk of myocardial infarction among the hypertensive type 2 diabetic and non-diabetic patients of Trinidad. METHODS: Data were obtained from the hospital records of 672 adults who were treated for hypertension in public health clinics in Trinidad. RESULTS: The prevalence of myocardial infarction was 25.45% in the sample. Males accounted for 52.63% while females accounted for 47.37%. Hypertensive type 2 diabetics with dyslipidemia had greater occurrence of MI (23.93%) than non-diabetic hypertensive patients (7.67%) (p=0.008). Useful predictors of MI included: diabetes mellitus, altered lipid profile, family history of any cardiac conditions. On further analysis, hypertension class (p=0.003) and serum uric acid quartile (p=0.029) were also significant predictors of MI. CONCLUSIONS: The results suggest that there is a greater prevalence of MI in hypertensive type 2 diabetic patients with dyslipidemia than in non-diabetic hypertensive patients in Trinidad.
Assuntos
Diabetes Mellitus Tipo 2/sangue , Dislipidemias/sangue , Hipertensão/sangue , Infarto do Miocárdio/sangue , Ácido Úrico/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/fisiopatologia , Dislipidemias/complicações , Dislipidemias/epidemiologia , Dislipidemias/fisiopatologia , Feminino , Humanos , Hipertensão/complicações , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , Lipoproteínas HDL/sangue , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/epidemiologia , Infarto do Miocárdio/etiologia , Infarto do Miocárdio/fisiopatologia , Prevalência , Fatores de Risco , Trinidad e Tobago/epidemiologiaRESUMO
OBJECTIVE: To study the association of low serum creatinine, abnormal lipid profile and demographic variables with type 2 diabetic Trinidadian subjects. METHODS: Data were obtained from a cohort of 1122 diabetic and non-diabetic patients from clinics in Trinidad. Variables measured included demographics, HbA1(c), serum creatinine, lipid profile values and diabetic status. RESULTS: The sample consisted of 476 males (61.6% diabetic) and 646 females (50.3% diabetic). Most patients (59.2%) were Indo-Trinidadian, 23.4% were Afro-Trinidadian and 13.5% were of 'mixed' and 'other' categories. The majority (55.1%) of the patients were diabetic and diabetics were older than non-diabetics (p=0.000). Abnormal lipid profile OR=0.728, CI (0.532, 0.994), serum creatinine categories OR=1.520, CI (1.317, 1.754), gender OR=0.690, CI (0.533, 0.892) and age groups OR=1.305, CI (1.185, 1.437) were useful predictors of type 2 diabetes. Ethnicity was not a useful predictor: OR=1.007, CI (0.869, 1.168). Serum creatinine (mean) was found to be lower in diabetics aged 21-50 than in their non-diabetic counterparts. However, above 50 years old, the reverse was true. Serum creatinine means were higher in males than in females (p=0.000). CONCLUSION: Abnormal lipid profile, gender, age and serum creatinine are associated with type 2 diabetes. While age and gender are non-modifiable risk factors, steps should be taken to monitor and control the serum creatinine and lipid profile values of diabetics and non-diabetics.
Assuntos
Creatinina/sangue , Diabetes Mellitus Tipo 2/epidemiologia , Lipídeos/sangue , Adulto , Fatores Etários , Etnicidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores Sexuais , Trinidad e Tobago/epidemiologia , Adulto JovemRESUMO
The leaves of Carapa guianensis have been used to treat ulcers, skin parasites, and skin problems. The ethanolic extract of C. guianensis leaf was evaluated for its antibacterial and wound healing activity using excision, incision and dead space wound models in rats. The animals were randomly divided into two groups (n = 6) in all the models. In the excision wound model test group animals were treated topically with the leaf extract (250 mg kg(-1) body weight) whereas, control animals were treated with petroleum jelly. In the incision and dead space wound models, the test group animals were treated with extract (250 mg kg(-1) day(-1)) orally by mixing in drinking water and the control group animals were maintained with plain drinking water. Healing was assessed by the rate of wound contraction, period of epithelialization, skin breaking strength, granulation tissue weight and hydoxyproline content. On Day 15 extract-treated animals exhibited 100% reduction in the wound area when compared to controls (95%) with significant decrease in the epithelialization period. The extract failed to demonstrate antibacterial activity. Skin breaking strength (P < .001), wet (P < .002) and dry (P < .02) granulation tissue and hydroxyproline content (P < .03) were significantly higher in extract treated animals. The increased rate of wound contraction, skin breaking strength and hydroxyproline content supports potential application of C. guianensis in wound healing.
RESUMO
Morinda citrifolia is a medicinal plant used to treat diabetes and liver diseases. The fermented fruit juice of the M. Citrifolia (optical density = 1.25) was used to study the hypoglycemic and hepatoprotective properties in diabetes-induced rats. The rats were randomly distributed into 4 groups (control, diabetic experimental, diabetic standard, and diabetic untreated) of 6 each. Diabetes was induced by administering Streptozotocin (50 mg/kg body weight). Fasting blood glucose, body mass, liver tissue glycogen content, and the extent of liver degeneration were assessed. Diabetic experimental animals were treated with M. citrifolia juice (2 ml/kg, twice a day) and diabetic standard with reference hypoglycemic drug, glibenclamide orally for 20 days. Both the groups exhibited a significant reduction in blood glucose level of 150 mg/dl ±15.88 and 125 mg/dl ±3.89, respectively, as compared to diabetic untreated with FBS = 360.0 mg/dl ±15.81, (P < .003). On 10th day of experiment, diabetic experimental animals exhibited a decrease in body mass (10.2 g, 5.11%) which increased significantly by the 20th day (6 g, 3.0%, P < .022). Histological study of liver tissue obtained from untreated diabetic animals revealed significant fatty degeneration as compared to other three groups. The data of this study proved the hypoglycemic and hepatoprotective activity of M. citrifolia.
RESUMO
Morinda citrifolia is a medicinal plant used to treat diabetes and liver diseases. The fermented fruit juice of the M. Citrifolia (optical density = 1.25) was used to study the hypoglycemic and hepatoprotective properties in diabetes-induced rats. The rats were randomly distributed into 4 groups (control, diabetic experimental, diabetic standard, and diabetic untreated) of 6 each. Diabetes was induced by administering Streptozotocin (50 mg/kg body weight). Fasting blood glucose, body mass, liver tissue glycogen content, and the extent of liver degeneration were assessed. Diabetic experimental animals were treated with M. citrifolia juice (2 ml/kg, twice a day) and diabetic standard with reference hypoglycemic drug, glibenclamide orally for 20 days. Both the groups exhibited a significant reduction in blood glucose level of 150 mg/dl ñ15.88 and 125 mg/dl ñ3.89, respectively, as compared to diabetic untreated with FBS = 360.0 mg/dl ñ15.81, (P < .003). On 10th day of experiment, diabetic experimental animals exhibited a decrease in body mass (10.2 g, 5.11%) which increased significantly by the 20th day (6 g, 3.0%, P < .022). Histological study of liver tissue obtained from untreated diabetic animals revealed significant fatty degeneration as compared to other three groups. The data of this study proved the hypoglycemic and hepatoprotective activity of M. citrifolia.
Assuntos
Ratos , Diabetes Mellitus , Hipoglicemiantes , Morinda , Trinidad e TobagoRESUMO
The objective of our study is to investigate the wound healing activity of the bark extract of Carapa guianensis in rats using three different wound models. The animals were randomly divided into two groups of six each in all the models. Test group animals were treated topically with the bark extract (200 mg/kg of body weight), and the controls were treated with petroleum jelly in the excision wound model. In the incision and dead space wound models the test group animals were treated with the extract of C. guianensis (200 mg/kg/day) orally by mixing in drinking water, and the control group animals were maintained with plain drinking water. Healing was assessed by the rate of wound contraction, period of epithelialization, skin breaking strength, granulation tissue weight, and hydoxyproline content. Antimicrobial activities of the extract against the microorganisms were also assessed. On day 15 extract-treated animals exhibited 99% reduction in the wound area compared to controls (93%). The extract-treated wounds were found to epithelialize faster than controls (P < .02). The skin breaking strength was significantly higher in extract-treated animals compared to controls (P < .001). The weight and hydroxyproline content of granulation tissue were significantly increased compared to controls. These observations support the use of C. guianensis is in the management of wound healing.
Assuntos
Ratos , Animais , Ratos , Cicatrização , Meliaceae , Hidroxiprolina , Trinidad e TobagoRESUMO
The objective of our study is to investigate the wound healing activity of the bark extract of Carapa guianensis in rats using three different wound models. The animals were randomly divided into two groups of six each in all the models. Test group animals were treated topically with the bark extract (200 mg/kg of body weight), and the controls were treated with petroleum jelly in the excision wound model. In the incision and dead space wound models the test group animals were treated with the extract of C. guianensis (200 mg/kg/day) orally by mixing in drinking water, and the control group animals were maintained with plain drinking water. Healing was assessed by the rate of wound contraction, period of epithelialization, skin breaking strength, granulation tissue weight, and hydoxyproline content. Antimicrobial activities of the extract against the microorganisms were also assessed. On day 15 extract-treated animals exhibited 99% reduction in the wound area compared to controls (93%). The extract-treated wounds were found to epithelialize faster than controls (P < .02). The skin breaking strength was significantly higher in extract-treated animals compared to controls (P < .001). The weight and hydroxyproline content of granulation tissue were significantly increased compared to controls. These observations support the use of C. guianensis is in the management of wound healing.
Assuntos
Meliaceae/química , Fitoterapia , Casca de Planta/química , Extratos Vegetais/uso terapêutico , Cicatrização , Administração Oral , Administração Tópica , Animais , Tecido de Granulação/química , Tecido de Granulação/patologia , Hidroxiprolina/análise , Masculino , Extratos Vegetais/administração & dosagem , Extratos Vegetais/química , Ratos , Ratos Sprague-Dawley , Cicatrização/fisiologia , Ferimentos e Lesões/tratamento farmacológico , Ferimentos e Lesões/patologia , Ferimentos e Lesões/fisiopatologiaRESUMO
AIMS: To determine the relationship between plasma adiponectin levels and obesity, inflammation, blood lipids and insulin resistance in type 2 diabetics (T2DM) and non-diabetics in a patient population in Trinidad. METHODS: A cohort study of a total of 126 type 2 diabetic (42 males and 84 females) and 140 (43 males and 97 females) non-diabetic public clinic attendees were assessed between December 2008 and July 2009. Along with clinical history and anthropometry, adiponectin, TNF-α, IL-6, CRP, lipid profile, glucose, and insulin were measured in fasting blood samples and insulin resistance (HOMA-IR) was calculated. RESULTS: Diabetics had higher (p<0.05) glucose, insulin, HOMA-IR, triglycerides (TG), VLDL and systolic blood pressure than non-diabetics, but lower (p<0.05) HDL and adiponectin levels. Adiponectin levels were lower (p<0.05) in obese than in non-obese individuals regardless of diabetic status. There were significant gender differences in HDL, LDL and TG. Among non-obese persons, adiponectin correlated negatively with triglycerides (r=-0.280; adiponectin), IL-6 (r=-0.216; p<0.005), HOMA-IR (r=-0.373; p=000) and positively correlated with HDL (r=0.355; p=0.000). Diabetic status (p=0.025), TNF-α (p=0.048) and BMI (p=0.027) were identified as useful predictors of adiponectin by multiple linear regression methods. In addition binary logistic regression analysis found glucose (p=0.001) and adiponectin (p=0.047) to be useful indicators of type 2 diabetes. CONCLUSIONS: Adiponectin decreases with increasing adiposity and insulin resistance. Adiponectin and TNF-α appear to be related to differences in the insulin mediated glucose turnover.
Assuntos
Diabetes Mellitus Tipo 2/sangue , Inflamação/sangue , Insulina/sangue , Lipídeos/sangue , Obesidade/sangue , Adiponectina/sangue , Adiposidade/etnologia , Adulto , Biomarcadores/sangue , Pressão Sanguínea , Proteína C-Reativa/análise , Estudos de Casos e Controles , Diabetes Mellitus Tipo 2/etnologia , Diabetes Mellitus Tipo 2/imunologia , Diabetes Mellitus Tipo 2/fisiopatologia , Feminino , Humanos , Inflamação/etnologia , Inflamação/imunologia , Inflamação/fisiopatologia , Mediadores da Inflamação/sangue , Resistência à Insulina/etnologia , Interleucina-6 , Modelos Lineares , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Obesidade/etnologia , Obesidade/imunologia , Obesidade/fisiopatologia , Medição de Risco , Fatores de Risco , Trinidad e Tobago , Fator de Necrose Tumoral alfa/sangueRESUMO
Our aim was to determine whether the use of serum inflammatory markers such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and procalcitonin (PCT), either individually or in combination, is significantly associated with community-acquired pneumonia and to determine the role in assessment of the severity and outcome. This study was a prospective cohort study, included forty Trinidadian patients diagnosed with community acquired pneumonia. Blood samples were collected to measure inflammatory markers. Patients were classified according to the pneumonia severity index (PSI) scoring where after serum marker levels were compared among respective groups. Proportions test for positive predictive value of the serum marker indicated that CRP (P=0.001) and ESR (P=0.001) had higher sensitivities to community acquired pneumonia than PCT (P=0.05). There was no association between each of the serum markers and PSI. Eighty three percent low risks had a length of stay of two weeks, while only 18% of high risk stayed for the same duration. The combination of highly sensitive markers like CRP and ESR and a specific marker such as PCT emphasize their importance in better risk assessment in community acquired pneumonia patients.
Assuntos
Humanos , Infecções Comunitárias Adquiridas , Pneumonia , Trinidad e TobagoRESUMO
The common Grape L. (Vitaceae) is regarded as an important medicinal plant. European healers have suggested the use of grapevine sap, juice, and whole grape in the treatment of pain, allergic reactions, inflammation, and to promote wound healing. We evaluated grape-skin powder for its wound-healing activity using an excision wound model in rats. Animals were randomly divided into three groups of six (n = 6) each. The test group animals were treated topically with the grape-skin powder (100 mg/kg/day). The controls and standard group animals were treated with petroleum jelly and mupirocin ointment respectively. Healing was assessed by the rate of wound contraction, period of epithelialization, and hydroxyproline content. On day 13, treatment of the wounds with grape-skin powder enhanced significantly the rate of wound contraction (100 %). Treated animals showed significant decrease in the epithelialization period (p < 0.000) and increase in the hydroxyproline content (p < 0.05) when compared to control and the standard. Histological analysis was also consistent with the proposal that grape-skin powder exhibits significant wound-healing potential. Increased rate of wound contraction, hydroxyproline content, and decrease in epithelialization time in the treated animals support the use of grape-skin powder in the management of wound healing.
Assuntos
Fitoterapia , Vitis/química , Cicatrização/efeitos dos fármacos , Animais , Tecido de Granulação/efeitos dos fármacos , Hidroxiprolina/análise , Masculino , Pós/farmacologia , Ratos , Ratos Sprague-DawleyRESUMO
AIM: The rheological properties of erythrocytes are impaired in diabetes mellitus, especially because of changes in their membrane lipid composition.The aim of this study was to determine and examine the relationship between red blood cell (RBC) membrane and serum lipid composition in type II diabetes subjects with and without nephropathy. METHODS: Trinidadian subjects aged 18-65 years were recruited for the study regardless of gender and ethnicity. Fasting blood samples were collected from 60 subjects of whom 20 were healthy individuals, 20 had type II diabetes without complications, and 20 were type II diabetics with nephropathy. Weight, height, waist/hip ratio, and blood pressure were recorded. All the blood samples were analysed to determine the serum lipid concentration, membrane lipid composition and plasma glucose concentration. RESULTS: The body mass index and the systolic blood pressure of the diabetics (28.17 +/- 4.98 kg/m2, 153.21 +/- 22.10 mmHg) and those with nephropathy (25.87 +/- 4.68, 158.60 +/- 22.49 mmHg) were higher when compared with controls (24.67 +/- 5.18, 119.15 +/- 13.03 mmHg). The diabetic (175.89 +/- 102.73 microg/mgprotein) and diabetic nephropathy (358.80 +/- 262.66) subjects showed significantly higher levels of RBC membrane cholesterol compared with controls (132.27 +/- 66.47). The membrane phospholipids, protein and Na+/K+ATPase concentrations were altered in diabetics and diabetic nephropathy patients when compared with controls. The trends of increased serum cholesterol and decreased high-density lipoprotein in diabetics and diabetic nephropathy patients were noted as compared with controls but they are not significant as expected. The low-density lipoprotein cholesterol was significantly higher in diabetics when compared with diabetic nephropathy and control subjects. CONCLUSIONS: Our data suggest that there is a relationship between RBC membrane and serum lipid composition in subjects with type II diabetes with and without nephropathy. This relationship shows that diet and lifestyle plays a significant role in the alterations of the lipids both in serum and RBC membrane. The membrane and serum lipid composition may be used as possible indicators for type II diabetic patients with and without nephropathy to control their diet in the beginning stages to prevent them from further complications.