A scoping review of interventions to mitigate common non-communicable diseases among people with TB.

BACKGROUND: Recommendations have been made to integrate screening for common non-communicable diseases (NCDs) within TB programs. However, we must ensure screening is tied to evidence-based interventions before scale-up. We aimed to map the existing evidence regarding interventions that address NCDs that most commonly affect people with TB.METHODS: We systematically searched PubMed, Medline, and Embase for studies that evaluated interventions to mitigate respiratory disease, cardiovascular disease, alcohol and substance use disorder, and mental health disorders among people with TB. We excluded studies that only screened for comorbidity but resulted in no further intervention. We also excluded studies focusing on smoking cessation interventions for which evidence-based guidelines are well established.RESULTS: The search identified 20 studies that met our inclusion criteria. The most commonly evaluated intervention was referral for diabetes care (6 studies). Other interventions included pulmonary rehabilitation (5 studies), care programs for alcohol use disorder (4 studies), and psychosocial support or individual counselling (5 studies).CONCLUSION: There is limited robust evidence to support identified interventions in changing individual outcomes, and a significant knowledge gap remains on the long-term durability of the interventions´ clinical benefit, reach, and effectiveness. Implementation research demonstrating feasibility and effectiveness is needed before scaling up.

Effects of focal cooling of medulla oblongata structures on quiet breathing in cats.

Experiments were carried out on 16 anaesthetized, non-paralysed cats to determine the effects of unilateral, successive focal cooling of the nuclei of the dorsal and ventral respiratory groups (DRG, VRG) of the medulla oblongata on quiet breathing parameters. The results of cold block tests of the respiratory nuclei showed that: 1. Compared with the control state, cooling of the ventrolateral part of the nucleus solitarii (vl. NTS) and the rostral part of the nucleus retroambigualis (r. NRA) to 20 degrees C or 15 degrees C decreased the respiration rate (p less than 0.001), prolonged the inspiration time (p less than 0.01 and p less than 0.001 respectively) and the development of apneustic breathing. A decrease in the inspiratory pleural pressure values (p less than 0.01) was found after cooling the r. NRA region to 15 degrees C. In 45% of the cases of cooling of the vl. NTS and 66.7% of cooling of the r. NRA to 15 degrees C, an incidence of short inspiratory efforts was observed. 2. Focal cooling of the nucleus retrofacialis (nucl. RF) region to 20 degrees C always arrested rhythmic respiration. 3. The effects of unilateral focal cooling of the respiratory nuclei were always bilaterally symmetrical and, after discontinuing cooling, reversible. 4. The findings indicate that the inspiratory neurones of the r. NRA participate more in regulation of the intensity of inspiration than those of the vl. NTS, while the nucl. RF region may be a part of central regulatory mechanisms essential for the maintenance of rhythmic breathing in cats.