Assessment of urinary podocalyxin as a marker of glomerular injury in obesity-related kidney disease in children and adolescents with obesity compared to urinary albumin creatinine ratio.

Obesity increases the risk of chronic kidney disease in children. Our aim was to assess urinary podocalyxin (PCX) in children and adolescents with obesity as a potential marker of obesity-related kidney disease (ORKD). The current case-control study included 128 children with obesity compared to 60 non-obese age and sex matched controls. Study population were subjected to full history taking as well as thorough physical examination. Urine samples for albumin creatinine ratio (uACR) and PCX were collected from the study population as well as blood samples for assessment of serum creatinine and fasting lipid profile. A statistically significant difference was found between cases and controls regarding urinary PCX (P < .001) and uACR (P = .021). A statistically significant positive correlation was found between uACR and weight SD score (SDS), body mass index SDS, waist circumference, estimated glomerular filtration rate, triglycerides (TG) as well as urinary PCX, whilst urinary PCX correlated significantly with obesity duration and uACR. Cases with microalbuminuria had a statistically significant higher waist circumference, waist-hip ratio, fat percentage, TG and urinary PCX compared to those with normal uACR (P = .042, .034, .05, .018 and .036 respectively). Urinary PCX showed 83.3% sensitivity and 74% specificity in detection of albuminuria. Urinary PCX was increased significantly in children with obesity making it a potential sensitive marker of ORKD in children.

Characteristics of diabetes diagnosis and control in toddlers and preschoolers from families with limited resources: A single center experience.

AIM: To describe the characteristics of diabetes diagnosis, insulin therapy regarding type, dose and frequency also the degree of glycemic control achieved in toddlers and preschoolers coming from families with limited resources. METHODS: Over one year, 69 toddlers and preschoolers clinically diagnosed as type 1 diabetes were included. Data related to presentation at diagnosis, insulin therapy and glycemic control was reviewed from patients' care givers and medical records. RESULTS: Diabetic ketoacidosis (DKA) was recorded in 71% of the children at initial diagnosis. The mean time since diabetes diagnosis was 2 ± 1 years. Most of children (65/69, 94%) were on basal-bolus regimen while four (6%) were on basal insulin only. NPH and long acting analogues were used as basal insulin in (74%) and (26%). Regular insulin and rapid acting analogues were used as bolus insulin (27%) and (73%).The mean frequency of daily self monitoring of blood glucose was (2.9 ± 1). The arithmetic mean of HbA1c done over past 6 months to one year before inclusion in the study was 8.2 ± 1.5% (66 ± 12 mmol/mol) with 65% having HbA1c ≥ 7.5% (≥58 mmol/mol). CONCLUSION: Toddlers and preschoolers with diabetes coming from families with limited resources frequently present with DKA at diagnosis and have suboptimal self-monitoring of blood glucose and glycemic control. NPH is more commonly used in this age group, combined with postprandial rapid analogues and less commonly preprandial regular insulin and that yields more favorable HbA1c but with a greater risk of hypoglycemia. The most common cause of hospital readmission was ketoacidosis and uncontrolled hyperglycemia.

Rapid and highly sensitive detection of pyocyanin biomarker in different Pseudomonas aeruginosa infections using gold nanoparticles modified sensor.

Successful antibiotic treatment of infections relies on accurate and rapid identification of the infectious agents. Pseudomonas aeruginosa is implicated in a wide range of human infections that mostly become complicated and life threating, especially in immunocompromised and critically ill patients. Conventional microbiological methods take more than three days to obtain accurate results. Pyocyanin is a distinctive electroactive biomarker for Pseudomonas aeruginosa. Here, we have prepared polyaniline/gold nanoparticles decorated ITO electrode and tested it to establish a rapid, diagnostic and highly sensitive pyocyanin sensor in a culture of Pseudomonas aeruginosa clinical isolates with high selectivity for traces of pyocyanin when measured in the existence of different interferences like vitamin C, uric acid, and glucose. The scanning electron microscopy and cyclic voltammetry techniques were used to characterize the morphology and electrical conductivity of the constructed electrode. The determined linear range for pyocyanin detection was from 238 µM to 1.9 µM with a detection limit of 500 nM. Compared to the screen-printed electrode used before, the constructed electrode showed a 4-fold enhanced performance. Furthermore, PANI/Au NPs/ITO modified electrodes have demonstrated the ability to detect pyocyanin directly in Pseudomonas aeruginosa culture without any potential interference with other species.

A Power Conundrum: Black Women and Their Sexual Partners in the Midwest.

The purpose of this research was to determine the extent to which women of African ancestry manifested power in their relationships regarding sexual activities and to examine the influence that specific variables had on their sexual partnerships. A sample (N = 200) of midlife women aged 40-65, who lived in the Midwest participated in this research. The Sexual Relationship Power Scale was used to examine these relationships. Face-to-face interviews occurred in community settings. Multiple regression equations were used to examine the potential impact of specific variables on sexual functioning. Results of the analysis revealed that variables such as mental quality of life, decision-making, and health promotion were positively associated with sexual relationships. Conversely, depression and life stress scores were negatively linked to sexual relationships. Knowledge gained from this research could be used to explore the phenomena of power as expressed in the daily lives of women of African descent. The research can also be discussed from the perspective of a "Black tax," that has burdened Black women for centuries and is manifested through years of discrimination, bias, and the lack of equity in most domains of American institutions.

Assessment of health-related quality of life in Egyptian adolescents with type 1 diabetes: DEMPU survey.

BACKGROUND: Type 1 diabetes (T1D) is a serious chronic illness that imposes significant morbidity and mortality with a major impact on the quality of life (QoL) that became a core issue in diabetes care. Understanding the effect of diabetes on QoL is important for day-to-day clinical management and also for public health policy initiatives aiming at improving health outcomes for those with diabetes. The objective of the study was to assess the QoL in adolescents with T1D and assess the applicability of the use of the "Quality of Life for Youth" questionnaire at the Diabetes, Endocrine and Metabolism Pediatric Unit (DEMPU) clinic. METHODS: One hundred and fifty adolescents (82 males and 68 females) (10-18 years), with T1D of at least 1 years' duration, completed the questionnaire that evaluated symptoms related to diabetes, treatment, activities, parent issues, worries about diabetes and health perception. Higher scores indicated a more negative impact of diabetes and poorer QoL. RESULTS: Males showed a significantly better mean QoL score than females (p=0.004). Different age groups showed different QoL scores (p=0.047). Urban adolescents had a better QoL than rural counterparts (p=0.02). Adolescents with poor QoL had generally lower educational level (p=0.02). Better metabolic control was associated with a better QoL (p=0.01). However, duration of diabetes and body mass index (BMI) had no statistically significant effect on QoL. CONCLUSIONS: QoL had a variable significant association with certain socio-demographic and clinical characteristics of diabetics (sex, residence, educational level as well as metabolic control).

Barriers and Facilitators to Engaging Communities in Gender-Based Violence Prevention following a Natural Disaster.

Humanitarian workers in disaster settings report a dramatic increase in gender-based violence (GBV). This was true after the 2010 Haiti earthquake when women and girls lost the relative security of their homes and families. Researchers from the United States Virgin Islands and the United States mainland responded by collaborating with Haitian colleagues to develop GBV-focused strategies. To start, the research team performed a situational analysis to insure that the project was culturally, ethically, and logistically appropriate. The aim of this paper is to describe how the situational analysis framework helped the researchers effectively approach this community. Using post-earthquake Haiti as an exemplar, we identify key steps, barriers, and facilitators to undertaking a situational analysis. Barriers included logistics, infrastructure, language and community factors. Facilitators included established experts, organizations and agencies. Researchers in such circumstances need to be respectful of community members as experts and patient with local environmental and cultural conditions.

Muddling Through the Health System: Experiences of Three Groups of Black Women in Three Regions.

Health-care disparities are a well-documented concern among patients and providers who care for minority groups in the United States. In this study, focus groups were created from an original sample of 606 Black women representing three regions in the United States: the South, the Midwest, and the Virgin Islands. Composed of 10 randomly selected members each (n = 30), the focus groups provided insights into the nature of these disparities, with some suggestions for viable solutions. Participants voiced concerns regarding cultural taboos about discussing menopause, financial concerns, and negative experiences with healthcare leading to distrust in medical systems. The primary solution proposed was an increase in Black health-care professionals who would have increased rapport with, empathy for, and understanding of the concerns of Black women.

Association of orthodontic treatment needs and oral health-related quality of life in Saudi children seeking orthodontic treatment.

INTRODUCTION: The objective was to assess the effects of different orthodontic treatment needs on the oral health-related quality of life (OHRQoL) of Saudi children seeking orthodontic treatment as perceived by the children and their parents. METHODS: A cross-sectional evaluation of orthodontic patients and their attending parents was conducted to assess the relationship between orthodontic treatment needs and the OHRQoL. The study sample comprised 120 young orthodontic patients (36 boys, 84 girls; age range, 12-15 years). Each participant was assessed for orthodontic treatment needs and OHRQoL using the Dental Health Component of the Index of Orthodontic Treatment Needs and the Michigan Oral Health-related Quality of Life Scales-Version C (child) and Version PG (parent/guardian), respectively. RESULTS: Orthodontic treatment needs significantly affected mouth aching, chewing and biting, going to school, and playing. Higher income and borderline index of orthodontic treatment needs are significantly related to oral health impact on quality of life perceived by the child, while younger age and high school education are related to oral health impact on quality of life as perceived by the parent/guardians. CONCLUSION: These findings emphasize the impact of malocclusion on OHRQoL in children.

Hospitalization for ambulatory care sensitive conditions at health insurance organization hospitals in Alexandria, Egypt.

This study aimed at estimating the percentage of hospital discharges and days of care accounted for by Ambulatory Care Sensitive Conditions (ACSCs) at Health Insurance Organization (HIO) hospitals in Alexandria, calculating hospitalization rates for ACSCs among HIO population and identifying determinants of hospitalization for those conditions. A sample of 8300 medical records of patients discharged from three hospitals affiliated to HIO at Alexandria was reviewed. The rate of monthly discharges for ACSCs was estimated on the basis of counting number of combined ACSCs detected in the three hospitals and the hospitals' average monthly discharges. ACSCs accounted for about one-fifth of hospitalizations and days of care at HIO hospitals (21.8% and 20.8%, respectively). Annual hospitalization rates for ACSCs were 152.5 per 10,000 insured population. The highest rates were attributed to cellulitis/abscess (47.3 per 10,000 population), followed by diabetes complications and asthma (42.8 and 20.8 per 10,00 population). Logistic regression indicated that age, number of previous admissions, and admission department are significant predictors for hospitalization for an ACSC.